Medical Science Monitor最新文献

BACKGROUND In the context of healthcare, nurses' professional values and job satisfaction and the ethical climate in the hospital are key elements affecting the quality of patient care. The purpose of this study was to assess these elements among Polish nurses and explore their interrelationships to improve nurses' professional well-being and patient outcomes. MATERIAL AND METHODS A descriptive, correlational, cross-sectional survey was conducted among 388 Polish nurses between March 2021 and February 2023. RESULTS The following scores were obtained on the scales: Nurses Professional Values Scale-3 (NPVS-3): 84.47; Minnesota Satisfaction Questionnaire, Short Form (MSQ-SF): 60.37; and Hospital Ethical Climate Survey (HECS): 77.66. A positive correlation was observed between MSQ-SF and HECS scores (rho=0.169; P<0.001). CONCLUSIONS Our study revealed numerous strong correlations between nurses' professional values, their job satisfaction, and the ethical climate in hospitals, which may provide important information for managerial personnel working on strategies to increase nurses' job satisfaction. Effective management of the professional values and ethical climate of hospitals has become a key pillar in building a healthy work environment and influencing job satisfaction, which in turn is capable of improving the well-being of nurses and the quality of patient care. Moreover, the ethical climate of the hospital has an impact on patient satisfaction through the professional values of nurses.

Medical orthotic insoles are commonly used to support the ankle and foot while standing and walking to enhance gait mechanics and reduce foot discomfort. Medical orthotic insoles are especially effective in addressing congenital or acquired orthopedic issues and degenerative diseases. Among the various therapeutic options, three-dimensional (3D)-printed insoles have emerged as a promising alternative due to their potential for customization and improved performance compared to traditional insoles. This review investigated the effectiveness of 3D-printed insoles in managing 3 common foot conditions: flexible flatfoot, diabetic foot ulcers, and plantar fasciitis. A literature search was conducted using the MEDLINE, Embase, Scopus, and the Cochrane Library databases. Studies comparing traditional insoles or barefoot conditions with 3D-printed insoles were included; 4 studies met the eligibility criteria. The findings revealed that patients with flexible flatfoot, diabetic foot ulcers, and plantar fasciitis reported greater comfort with 3D-printed insoles compared to traditional insoles. Additionally, 3D-printed insoles provided more effective pressure relief in affected foot areas. These results highlight the therapeutic potential of 3D-printed insoles in improving foot health and gait efficiency. 3D printing technology has the potential to revolutionize the manufacturing of medical orthotic insoles by enabling personalized, efficient, and data-driven treatments. However, practical challenges, including high costs, material limitations, and the need for specialized expertise and regulatory frameworks, must be addressed to facilitate its widespread adoption. This review aimed to analyze the role of 3D printing in manufacturing medical orthotic insoles, focusing on its therapeutic potential and the need for further research to validate its efficacy.

BACKGROUND Thyroid nodules, common in adults, especially females and older individuals, are mostly asymptomatic. While the nodules are largely benign, distinguishing malignant lesions is crucial. Overdiagnosis and overtreatment pose risks. Knowledge, attitude, and practice (KAP) surveys can identify knowledge gaps and inform targeted education; however, no studies have explored this in Chinese patients with thyroid nodules. This study aimed to investigate the KAP toward thyroid nodules among patients with thyroid nodules. MATERIAL AND METHODS This web-based cross-sectional study was conducted among patients with thyroid nodules, using a self-administered questionnaire. RESULTS A total of 456 valid questionnaires were included. The mean knowledge, attitude, and practice scores were 7.07±3.19, 26.39±3.98, and 29.16±4.65, respectively. Knowledge (OR=1.111, P=0.002), junior college (OR=1.933, P=0.035), and bachelor's degree or above (OR=2.193, P=0.015) were associated with proactive practice. Structural equation modeling showed knowledge directly influenced attitude (ß=0.244, P<0.001) and practice (ß=0.404, P<0.001). Attitude directly influenced practice (ß=-0.129, P=0.020). Occupation (ß=-0.279, P=0.038), marital status (ß=-0.752, P=0.002), thyroid nodule TIRADS classification (ß=-0.699, P=0.004), and education (ß=0.501, P<0.001) directly influenced knowledge. Average per capita income (ß=0.942, P<0.001) and education (ß=0.380, P=0.309) directly influenced attitude. Education (ß=0.457, P=0.028) directly influenced practice. CONCLUSIONS Patients with thyroid nodules have poor knowledge and unfavorable attitudes but proactive practice toward thyroid nodules. Anxiety-reducing techniques should be incorporated during education sessions, and workplace wellness programs should be explored, to promote healthy practices and early detection.

BACKGROUND This in vitro study aimed to compare the color stability and the effect of polishing on single-shade and conventional resin-based composite after immersion in commonly consumed beverages over certain time intervals. MATERIAL AND METHODS We prepared 120-disc specimens using 2 universal single-shade and 2 conventional composite resins (n=30) and then each group was divided into 3 groups of solutions (n=10/solution): distilled water, coffee, and cola. To mimick the clinical situation, polishing with the Soflex system was performed. Color stability measurement was recorded for every specimen after 1 week (T1), 1 month (T2), and after polishing (T3) after immersion in staining solutions. Color stability was assessed by using the clinical spectrophotometer (Color-Eye 7000A, Greta Macbeth, USA). Data were analyzed using SPSS Version 25, and comparisons between groups were made with the value of significance kept under 0.05 (P>0.05). RESULTS Color changes after 1 week, after 1 month, and after polishing showed a high significant difference in all parameters (L, a and b) as P value 0.05). CONCLUSIONS Within the limitation of this in vitro study, it can be concluded that the different solutions used affected the color stability of all the different composites used, with the coffee solution showing greater color change than cola and distilled water. Additionally, polishing may affect the composite surface's quality, which suggests that polishing can change the color of composite resins.

BACKGROUND Globally, esophageal cancer ranks as the sixth leading cause of cancer-related mortality. This retrospective study from a single center in Turkey aimed to evaluate hematological inflammatory biomarkers in complete blood count (CBC) data and outcomes in 113 patients with advanced esophageal carcinomas. MATERIAL AND METHODS We conducted a retrospective analysis of 113 patients with metastatic esophageal cancer composed of squamous (92), adenocarcinoma (18), and small cell (3) histology. We investigated neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), neutrophil-to-platelet lymphocyte ratio (NLPR), neutrophile-to-monocyte ratio (NMR), systemic inflammation index (SII), systemic inflammatory response index (SIRI), and aggregate index of systemic inflammation (AISI) in terms of prognosis. RESULTS The initial treatment for 25.7% of patients consisted of a carboplatin-paclitaxel combination. In response to the initial round of chemotherapy, 52.2% of patients showed improvement (15% complete, 37.2% partial), while 18.6% experienced disease progression. Neutropenia was observed as the most prevalent severe (grades 3-4) adverse reaction, affecting 19.8% of patients. Higher NLR, PLR, SII, NLPR, SIRI, and AISI values were associated with worse survival (P=0.016, P=0.008, P=0.011, P=0.028, P=0.014, P=0.001, respectively), whereas higher LMR was correlated with better survival (P=0.001). The NMR analysis showed no significant association (P=0.46). Multivariate analysis identified independent prognostic factors except histology, PLR, and NLPR. CONCLUSIONS Research indicates that inflammatory indicators obtained from complete blood count analyses possess prognostic significance for individuals with metastatic esophageal cancer. These biomarkers demonstrate diverse capacities in forecasting the course of the disease. These simple and inexpensive markers need further confirmation to guide individualized treatment planning.

BACKGROUND Postherpetic neuralgia (PHN) is closely related to the host immune response. This study explored the cellular and humoral immune functions of acute immunocompetent herpes zoster (HZ) patients and their relationship with PHN. MATERIAL AND METHODS We selected 188 patients with acute HZ admitted to our hospital and 79 individuals who underwent physical examinations during the same period. We measured and compared the levels of peripheral blood lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+, CD19+, CD56+), serum immunoglobulins (IgA, IgG, IgM), and complement (C3, C4) between the 2 groups. Based on whether they had neuralgia during follow-up, we divided the patients into an HZ-PHN group and an HZ-control group, and compared their differences in immune functions and their relationship with PHN. RESULTS Compared with the control group, the levels of CD3+ and CD4+ and CD4+/CD8+ ratios of HZ patients were significantly lower (P<0.05). Among 188 HZ patients, 91 (48.4%) developed PHN. The patients in the HZ-PHN group were significantly older (P<0.01) and the levels of CD3+, CD4+, and CD8+ and CD4+/CD8+ ratios were significantly lower than those in the HZ-control group (P<0.05, P<0.01). Binary logistic regression analysis showed that age and CD4+/CD8+ ratios are independent risk factors for determining whether HZ patients develop PHN. CONCLUSIONS Acute immunocompetent HZ patients, especially those who are older and more prone to developing PHN, exhibit significant cellular immune dysregulation. Age and CD4+/CD8+ ratios may be useful predictors of PHN in acute HZ patients.

BACKGROUND This study examined how osteopathic techniques, including compression of the fourth ventricle (CV4) and rib raising (RR), influence autonomic nervous system (ANS) activity using heart rate variability (HRV) as a measurement tool. This study aimed to evaluate the effects of the fourth ventricle compression technique and the rib raising osteopathic technique on the activity of the autonomic nervous system measured by heart rate variability in 100 healthy adults. MATERIAL AND METHODS A total of 100 healthy participants were divided into 3 groups: CV4+RR (33 subjects), CV4 only (34 subjects), and a control group (33 subjects) undergoing a simulated procedure. Three 30-minute sessions were performed. HRV was recorded during a 5-minute seated session to assess ANS activity. RESULTS While no significant differences in the overall HRV parameter were observed between groups, significant changes were found in specific frequency domain parameters. The low-frequency (LF) parameter differed significantly between groups (p=0.005). A significant interaction effect was observed for the high-frequency (HF) parameter (F2=(4,194)=3.262; p=0.013), indicating group-dependent variations. Additionally, the LF/HF ratio showed a significant interaction effect between group membership and measurement time points (F2=(4,194)=5.39; p<0.001), highlighting differences across groups and time points. CONCLUSIONS The findings demonstrate that osteopathic techniques, particularly the combined CV4+RR approach, significantly affect certain HRV parameters, such as LF%, HF%, and the LF/HF ratio. The CV4+RR group exhibited notable changes compared to the control group, which showed no significant changes. These results suggest the potential effectiveness of the applied interventions in modulating ANS activity.

BACKGROUND Apical periodontitis is caused by infected dental pulp and may be associated with dental caries or trauma, which can destroy periradicular tissues. This study included periapical tissue of patients with chronic apical periodontitis and aimed to evaluate the presence of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) using polymerase chain reaction (PCR), and to determine the levels of inflammatory cytokines using enzyme-linked immunoassay (ELISA). MATERIAL AND METHODS A total of 79 patients participated in this study. Periapical lesions were taken from the tooth roots indicated for extraction, and were divided into 2 groups: symptomatic and asymptomatic. PCR was used to identify HCMV and EBV. Interleukin 6 (IL-6), interleukin 8 (IL-8), tumor necrosis factor-alpha (TNF-alpha), and transforming growth factor beta-1 (TGFß-1) were determined using ELISA. RESULTS The occurrence of HCMV (P<0.05) and dual HCMV/EBV infection (P<0.05) was significantly more frequent in symptomatic lesions compared to asymptomatic. The concentrations of IL-6, IL-8, and TNF-alpha were significantly higher in virus-positive lesions compared to virus-negative ones (P<0.05); especially high cytokine levels were found in lesions with dual HCMV/EBV infection (P<0.05). The level of TGF-ß1 was higher in virus-positive compared to virus-negative lesions, but the difference was significant only in lesions with dual HCMV/EBV infection (P<0.05). CONCLUSIONS The higher prevalence of herpesviruses in symptomatic lesions compared to asymptomatic ones indicates their important role in pathogenesis of periapical lesions. Expression of TNF-alpha, IL-6, and IL-8 may be of importance in the development and clinical features of herpesvirus-infected lesions, while TGF-ß1 appears to be of no significance.

BACKGROUND Patients undergoing invasive diagnostic and treatment procedures benefit from receiving educational information before the procedure. Amniocentesis can be particularly stressful for the pregnant mother, who may be concerned about the safety of the procedure for herself and the fetus. This study aimed to compare pain and anxiety levels during amniocentesis in 100 women with and without pre-procedural video-based information. MATERIAL AND METHODS The study included 100 pregnant women (50 cases, 50 controls) with a positive screening test for aneuploidy. The State-Trait Anxiety Inventory (STAI) and Visual Analog Scale (VAS) were completed during their initial visit ("Pre-amniocentesis"). The case group watched a 5-minute video about amniocentesis and completed the assessments again ("Post-video"). After the procedure, both groups were reassessed ("Post-amniocentesis"). Results were compared within and between groups. RESULTS Significant differences were found in both STAI-1 and VAS scores between pre- and post-amniocentesis assessments in the case group (P<0.05 for all). However, no significant decrease were observed in the control group. The case group reported less anxiety (38.35 vs 45.25, P: 0.001), pain (16.7 vs 18.5, P: 0.125) and stress (2.18 vs 4.20, P: 0.001) scores after amniocentesis procedure compared to the control group. CONCLUSIONS Video-based education more effectively reduces anxiety and stress levels compared to traditional methods, potentially enhancing patient satisfaction.

BACKGROUND Trimethylamine N-oxide (TMAO), a gut-derived uremic toxin, is linked to hypertension, cardiovascular events, and mortality. Peripheral arterial disease (PAD), defined by a low ankle-brachial index (ABI), increases mortality in kidney transplantation (KT) recipients. This study investigated the association between serum TMAO levels and PAD in KT recipients. MATERIAL AND METHODS This cross-sectional study included 98 KT recipients. Serum TMAO levels were quantified using liquid chromatography-mass spectrometry, and ABI values were assessed with an automated oscillometric device. Patients with ABI <0.9 were categorized as having PAD. Additional clinical and laboratory data were collected from medical records for analysis. RESULTS Among 98 KT recipients, 22 (22.4%) had low ABI values. The low-ABI group had higher serum TMAO levels (P<0.001) and a higher diabetes prevalence (P=0.035). In multivariate analysis, serum TMAO levels were independently associated with PAD (odds ratio: 1.154, 95% CI: 1.062-1.255, P=0.001). Both the left and right ABI values were negatively correlated with TMAO levels (P<0.001). In the Spearman correlation analysis, the estimated glomerular filtration rate (eGFR) was negatively correlated with TMAO levels (P=0.005). The area under the receiver operating characteristic curve for TMAO predicting PAD was 0.868 (95% CI: 0.784-0.928, P<0.001). CONCLUSIONS Elevated serum TMAO levels are independently associated with PAD in KT recipients, as evidenced by their significant negative correlation with ABI values. These findings suggest that TMAO may serve as a potential biomarker for identifying KT recipients at higher risk of PAD.