Medical Science Monitor最新文献

Pregnancy-related stress affects not only the woman but also her partner. The issue of postpartum depression in women is increasingly discussed, apart from its occurrence in men, which can develop up to 12 months after giving birth. Risk factors for depression in young fathers are numerous and include hormonal fluctuations, socioeconomic conditions, and co-occurrence of other diseases. Emerging depressive symptoms are nonspecific and can be missed even by experienced medical personnel. Currently, screening tests use questionnaires that do not consider male risk factors. Perhaps the development of more personalized diagnostic methods would enable early identification of men at risk and include preventive measures. The proposed treatment methods of postpartum depression, such as sertraline or cognitive-behavioral therapy, enable patients to recover and provide appropriate support. The disease can cause long-term consequences that negatively affect the development and functioning of the child's psyche. Behavioral disorders and emotional problems are observed in children whose fathers had postpartum depression. Moreover, partner relationships deteriorate and the father-child bond is impaired. Further research should focus on identifying risk factors in men from different social classes, considering environmental, personal, and ethnic characteristics, and on the effectiveness of postpartum depression treatment in men. This article aims to review the incidence, causes, diagnosis, and management of male postpartum depression.

BACKGROUND The purpose of the study was to compare the effects of core stabilization exercise (CSE) and proprioceptive neuromuscular facilitation (PNF) exercise on core muscle activation, core muscle endurance, proprioception, and balance in 80 obese children. MATERIAL AND METHODS In this single-blind, randomized controlled study, 80 obese children aged 10-13 years were randomly divided into 3 groups. The first group received CSE (n=27) and the second group received PNF exercises (n=27) 3 days a week for 8 weeks. The third group, which was the control group (n=26), received no treatment. Participants were evaluated before treatment (BT) and after treatment (AT) and at follow-up (3 months after treatment). Core muscle activation level was evaluated by Sahrmann Core Stability test (SCST), lumbar core muscle endurance was evaluated by McGill core endurance tests, and lumbar joint position sense (JPS) was evaluated by laser cursor. The single-leg standing balance test (SLSBT) and Y balance test (YBT) were used for static and dynamic balance, respectively. RESULTS AT and at follow-up, core activation, core endurance, JPS, and static balance were significantly different between the groups (P<0.05). There was no significant difference between the groups in YBT dominant and non-dominant side mixed reach distances (P>0.05). Clinical effect sizes were higher in the CSE group for all outcome measures. CONCLUSIONS CSE and PNF exercises improve the level of core muscle activation, lumbar core muscle endurance, lumbar JPS, and balance in obese children. However, the results of this study show that CSE are more clinically effective in obese children. The effects decline in the medium term.

BACKGROUND The aim of this study was to evaluate the time-dependent release of calcium (Ca⁺⁺) and hydroxyl (OH⁻) ions from 3 different pulp dressing materials used to cap root canal orifices in pulpotomized premolars. MATERIAL AND METHODS Freshly extracted (n=40) premolars were subjected to standardized pulpotomy procedure and finally restored in 5 groups using resin-modified glass ionmmer liner (RMGI) and bonded resin composite directly against the pulp chamber's floor (Control, G2) and over 3 different orifices' capping materials - Dycal (G3), Endo Sequence root repair material (ESRRM, G4), and mineral trioxide aggregate (MTA) Angelus (G5). Another 10 sound premolars served as the Reference group (G1). The restored teeth were incubated at 37±1°C in sealed containers filled with deionized water to assess Ca⁺⁺ and OH⁻ ions release after 24 h and at 1, 4, and 8 weeks. Two-way ANOVA and Tukey's comparisons at alpha=0.05 were used to statistically analyze the collected data. RESULTS Two-way ANOVA revealed significant differences in Ca⁺⁺ ions between test groups at different testing time intervals (P<0.05). Despite the constant (Tukey's, P<0.05) pH levels (OH⁻ release), Group 5 specimens exhibited higher Ca⁺⁺ ion release in comparison to Groups 4 and 3 at different testing timepoints (Tukey's, P<0.05). CONCLUSIONS Although all the assessed pulp dressing materials had equivalent and stable pH levels, ESRRM and MTA-Angelus had the highest Ca⁺⁺ ion release at the assessment intervals.

BACKGROUND Chronic heart failure (CHF) is a complex clinical syndrome associated with frequent, recurrent, and long-term hospitalizations. This study from a single center in Lithuania aimed to evaluate outcomes in 87 elderly patients hospitalized with CHF. The methods used included comparing transthoracic impedance cardiography (ICG), amino-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, the six-minute walk test (6MWT), and dilatation of the right pulmonary artery on chest X-ray (dRPAcXR). MATERIAL AND METHODS The study sample consisted of 87 patients (49 men and 38 women). All subjects underwent 6MWT and ICG in addition to the standard CHF tests. The median duration of the follow-up was 23 months. Data about patient outcomes were gathered from the National Medical Record Database. RESULTS By multivariate Cox proportional analysis, thoracic fluid content (TFC) ≥41.1 1/kΩ (hazard ratio [HR] 32.354, 95% confidence interval [CI] 2.758-379.488), NT-proBNP ≥332.0 pmol/L (HR 4.739, 95% CI 1.656-13.559), 6-minute walk distance (6MWD) ≤203.5 m (HR 3.975, 95% CI 1.002-15.770), and dRPAcXR (HR 5.555, 95% CI 1.714-18.005) were associated with a poor prognosis in CHF patients (all P<0.05). The correlations between ICG and 6MWD and other non-invasive diagnostic tests examined in this study were weak to moderate. CONCLUSIONS TFC ≥41.1 1/kΩ, NT-proBNP ≥332.0 pmol/L, 6MWD ≤203.5 m, and dRPAcXR had a combined prognostic value in predicting cardiovascular death in patients with CHF. Therefore, these parameters may be of value in the assessment of the diagnosis and prognosis in this patient cohort.

BACKGROUND The objective of this study was to develop and validate machine learning (ML) algorithms to predict the 30-day and 6-month risk of deteriorating functional status following surgical treatment for thoracic spinal stenosis (TSS). We aimed to provide surgeons with tools to identify patients with TSS who have a higher risk of postoperative functional decline. MATERIAL AND METHODS The records of 327 patients with TSS who completed both follow-up visits were analyzed. Our primary endpoint was the dichotomized change in the perioperative Japanese Orthopedic Association (JOA) score, categorized based on whether it deteriorated or not. The models were developed using Naïve Bays, LightGBM, XGBoost, logistic regression, and random forest classification models. The model performance was assessed by accuracy and the c-statistic. ML algorithms were trained, optimized, and tested. RESULTS The best-performing algorithms for predicting functional decline at 30 days and 6 months after TSS surgery were XGBoost (accuracy=88.17%, c-statistic=0.83) and Naïve Bays (accuracy=86.03%, c-statistic=0.80). Both algorithms presented good calibration and discrimination in our testing data. We identified several significant predictors, including poor quality of intraoperative SSEP/MEP baseline, poor quality of preoperative SSEP, duration of symptoms, operated level, and motor dysfunction of the lower extremity. CONCLUSIONS The best-performing algorithms for predicting functional decline at 30 days and 6 months after TSS surgery were XGBoost (accuracy=88.17%, c-statistic=0.83) and Naïve Bays (accuracy=86.03%, c-statistic=0.80). Both algorithms presented good calibration and discrimination in our testing data. We identified several significant predictors, including poor quality of intraoperative SSEP/MEP baseline, poor quality of preoperative SSEP, duration of symptoms, operated level, and motor dysfunction of the lower extremity.

BACKGROUND Technetium (99mTc)-labelled Methoxy-2-Isobutylisonitrile (MIBI) is a diagnostic lipophilic cationic radiotracer used to evaluate the cardiac, breast, thyroid, and parathyroid pathology. This study aimed to evaluate the role of MIBI combined with Tc-99m pertechnetate thyroid scintigraphy, thyroid ultrasonography, and measurement of thyrotropin, thyroid hormones, and autoantibodies to subtype amiodarone-induced thyrotoxicosis (AIT) and the contribution of semi-quantitative analysis of MIBI uptake. MATERIAL AND METHODS This cross-sectional study included 36 patients with AIT who underwent thyrotropin, thyroid hormone, and autoantibody analysis using chemiluminescent method, ultrasonography, pertechnetate, and MIBI thyroid scintigraphy with semi-quantitative uptake, including calculation of the target-to-background ratio (TBR) with 2 different background regions. The MIBI washout rate (WR) was analyzed in all groups. Statistical analysis was performed using descriptive statistics, correlations, and the receiver operating characteristic curve - area under the curve (ROC-AUC). The results were compared with the control group. RESULTS Based on visual and semi-quantitative analyses, patients were successfully categorized into AIT groups (AIT-1, AIT-2 and AIT-3) but the latter method enabled better differentiation of MIBI uptake between all groups. Additionally, ROC-AUC analysis determined cutoff values which enabled discerning between AIT-1 and AIT-2 groups, and AIT-1 and AIT-3 groups. WR showed no significant difference between all AIT groups and controls (P>0.05). CONCLUSIONS Visual MIBI analysis enabled differentiation between AIT-1 and 2 groups, but the method was substantially improved with semi-quantitative analysis, especially in defining AIT-3 group. However, multicenter collaboration with larger studies is needed to standardize the method and obtain more accurate and consistent results.

BACKGROUND Fibromyalgia (FM) is a multifactorial syndrome characterized by chronic widespread pain, fatigue, sleep and cognitive impairment and functional symptoms. The aim of this study was to assess disability and its associated factors. The study was conducted among 691 patients with fibromyalgia in Poland using an online survey. MATERIAL AND METHODS This was a cross-sectional study of the disability of patients with fibromyalgia aged 18 years and over in Poland. The study was conducted by means of an online questionnaire distributed to patients affiliated with the National Association of Patients with Fibromyalgia. A total of 691 records were analyzed. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) 36-item version was used to assess disability. The Beck Depression Inventory was used to assess the participants' emotional state. Sociodemographic and selected health data were collected. RESULTS The study group had a significant general level of disability as measured by the WHODAS 2.0 (mean=49.69). The greatest limitations were found in the following areas: life activity (mean=73.43), social participation (mean=64.59), and mobility (mean=62.07). The categorical sociodemographic variables that statistically significantly differentiated the participants in terms of general level of disability were occupational status (P<0.005), pain level (P<0.001), number of medications taken (P=0.005), and level of depression (P<0.001). CONCLUSIONS Disability is present in fibromyalgia and is a major concern. Understanding the determinants of disability in fibromyalgia can contribute to the development of effective therapies and symptom relief.

BACKGROUND Stainless-steel crowns (SSCs) have been the most effective and efficient methods of tooth restoration in pediatric dentistry, and they have shown consistently high success rates. This study aimed to evaluate the knowledge, awareness, and practice of SSCs among dental professionals in Sana'a City, Yemen. MATERIAL AND METHODS A modified questionnaire was prepared from previous similar studies and distributed to 700 participants. It consisted of 3 parts: the first was related to participant characteristics; the second consisted of questions related to knowledge and awareness of SSCs such as indications, advantages, challenges, and parent's rejection to SSCs; and the third part was correlated to questions related to the use and practice of SSCs, number of children treated, and SSCs cemented per week. Statistical significance was determined using a chi-square test, and the P value was set at <0.05 for statistical significance. RESULTS A total of 604 dental professionals answered the questionnaire, 159 (26.3%) had used SSC restoration, and 12 (80.0%) of them had a degree in pediatric dentistry, with significant differences among participants (P<0.000). Respondents with higher academic qualifications recorded higher percentages in using SSCs during their clinics, with significant differences (P<0.005). A significant difference was detected between general practitioners and pedodontists in practice questions (P=0.000). Most of the respondents (78.8%) indicated a desire for more practice and hands-on training in use of SSCs. CONCLUSIONS General dentists in Sana'a City, Yemen, do not frequently use SSCs. Most of the respondents stated that they lacked practical training and expressed a need for further knowledge and continuing education.

BACKGROUND Awake endotracheal intubation (AEI) involves the placement of an endotracheal tube in patients who can maintain spontaneous respirations. This retrospective study aimed to compare sedation with remimazolam during AEI with that of dexmedetomidine in patients who underwent scoliosis correction surgery. MATERIAL AND METHODS This is a retrospective study based on data from 98 patients who had AEI procedures between January and December 2023. The remimazolam group included 55 patients, and the dexmedetomidine group included 43 patients. Remimazolam 0.05 mg/kg was injected 1 min before intubation, while dexmedetomidine 1 ug/kg was pumped 10 min before intubation. Evaluations of AEI, hemodynamics, and respiratory adverse events were then compared between the 2 groups. RESULTS There was no significant difference in demographic data between the groups. After administrating sedation, dexmedetomidine led to a larger reduction of mean arterial pressure (MAP) and heart rate (HR) than did remimazolam (11.30±1.86 vs 8.33±2.28 mmHg, P<0.001; 12.28±2.50 vs 2.85±1.82 beats/min, P<0.001). When conducting intubation, the increase of MAP in the remimazolam group was lower than that in the dexmedetomidine group (7.40±2.81 vs 9.26±5.08 mmHg, P=0.024), while the difference in HR change was not significant (7.53±5.41 vs 8.37±5.31 beats/min, P=0.441). When combined with local anesthesia, the success rate of AEI, time of AEI procedure, attempt times, increase of MAP during intubation, depth of sedation, and respiratory adverse events were comparable between the groups (P>0.05). CONCLUSIONS With local anesthesia, remimazolam and dexmedetomidine sedation can facilitate AEI for patients with scoliosis. However, remimazolam is associated with more stable hemodynamics.

This article provides a comprehensive review of recent developments regarding a new atypical antipsychotic drug - cariprazine - considering the mechanism of action, efficacy, safety, and promising therapeutic option for various psychiatric disorders, including schizophrenia and bipolar disorder, therapy of addictions, and treatment in the pediatric population. Its distinct pharmacological profile, characterized by partial agonism at dopamine D2 and D3 receptors, as well as serotonin receptors - 5HT1A with a preference for the D3 receptor - sets it apart from other antipsychotics. The unique mechanism of action contributes to cariprazine's positive impact on negative symptoms in schizophrenia and an antidepressant effect. Its relatively low risk of adverse effects, such as sedation, metabolic issues, and hypotension, enhances its tolerability. In bipolar affective disorder, cariprazine exhibits effectiveness in managing both depressive and manic episodes. Ongoing research in pediatric populations suggests potential benefits in schizophrenia, bipolar I disorder, and autism spectrum disorder, but further research is necessary to establish safety and efficacy. Moreover, cariprazine shows promise in addiction therapy, particularly with coexisting psychiatric disorders. Continued research and clinical exploration may discover additional insights, broadening its use in diverse patient populations. This article aims to review the role of cariprazine, a dopamine D2/D3 and serotonin 5-HT1A receptor partial agonist, in the management of psychotic illnesses, including schizophrenia, bipolar disorder, addiction therapy, and pediatric treatment.