Acta Informatica Medica最新文献

Background: The relationship between the thyroid hormones and reproductive function is complex. Increased thyroid function can directly affect ovarian function and can lead to infertility. After treatment to achieve a euthyroid state, symptoms such as menstrual disorders, shakiness, or rapid heartbeat are resolved, but the question is whether fertility problems can persist even when thyroid function is improved or restored to normal.

Objective: Our study aimed to initially evaluate the impact of women's hyperthyroid status on the outcome of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) when the patients have been treated to achieve a euthyroid state.

Methods: This retrospective study included 48 infertile couples with hyperthyroidism-treated females (HT group) and 48 infertile couples due to blocked fallopian tubes as a control group from January 2022 to April 2024 at IVF and Tissue Engineering Center, Hanoi Medical University Hospital. The outcomes were the characteristics of IVF cycles and pregnancy rates in the first embryo transfers compared between the two groups.

Results: There were no significant differences in baseline characteristics, including age, type of infertility, or quality of semen, between the two groups. The BMI of the HT group was significantly lower than that of the control group. The number and rate of mature oocytes in the HT group tended to be lower than in the group without this disorder (7.2 ± 4.4 vs. 9.2 ± 5.6 mature oocytes per cycle, p = 0.055, and 63.0 ± 24.3% vs. 70.3 ± 15.6%, p = 0.079). However, no difference in pregnancy rates was observed between the HT group and the control group.

Conclusion: In our study, it seems that hyperthyroidism could affect the oocyte maturation in the ovarian stimulation cycle even after treatment to achieve a euthyroid state, but there was no difference in pregnancy rates between the HT group and the control group.

Background: Carbonic Anhydrase II (CA-II) plays a pivotal role in various physiological processes, including maintaining acid-base balance. Its implications in testicular health, especially cryptorchidism, make it an essential focus for researchers. ELISA is widely used to measure biomarker concentrations, with OD serving as a key indicator. Understanding the precision of OD measurements for CA-II can enhance its diagnostic and research applications.

Objective: This study aims to evaluate the relationship between OD and CA-II concentration using linear regression analysis, thereby establishing a quantitative framework for accurate and reproducible CA-II measurements. By validating the OD-to-concentration relationship, this research will aid in developing standardized protocols that can improve diagnostic reliability, enhance monitoring of disease progression, and support therapeutic interventions targeting CA-II.

Methods: Standardized ELISA was employed to determine CA-II concentrations across sample groups, recording OD at specific wavelengths. Data were analyzed for linearity, group differences using ANOVA, and pairwise comparisons via Tukey's HSD test. Correlation analysis was performed to evaluate the relationship between CA-II concentration and OD.

Results: A linear regression model (y=0.3758x+0.1604) demonstrated a nearly perfect R2 value of 0.9957. Statistical tests revealed a strong correlation (0.998) between CA-II concentration and OD values. ANOVA did not indicate significant differences among concentration quartiles; however, the data strongly supported OD's use as a reliable proxy for CA-II measurement.

Conclusion: The established linear relationship between CA-II concentration and OD confirms the accuracy of ELISA in CA-II measurement. This methodology supports future investigations into CA-II's involvement in testicular health, potentially aiding in diagnostics and understanding of conditions such as cryptorchidism.

Background: Spigelian hernia, also known as spontaneous lateral ventral hernia, is defined as a protrusion of abdominal contents through an abdominal wall defect within the transversus aponeurosis. The entity was first reported in 1742 and named after Adrian van der Spieghel. It is recognized as a rare condition, accounting for 1 to 2% of all abdominal wall hernias. Cirrhotic patients, in particular, are more predisposed to hernias of all types. When Spigelian hernia is accompanied by hepatic cirrhosis, the decision to repair gets into a controversial aspect. Herein, we present the emergency management of an incarcerated spigelian hernia in a cirrhotic patient, highlighting the challenges in managing similar cases.

Case presentation: A 65-year-old lady, presented to our emergency department complaining of a left lower quadrant (LLQ) abdominal pain associated with a painful swelling for 9 hours duration. Upon assessment, the patient was jaundiced and haemodynamically stable. Abdominal examination revealed a soft and lax but distended abdomen, with irreducible tender swelling over the LLQ, measuring around 3x2 cm. Laboratory investigations showed anemia, hypoalbuminemia, hyperbilirubinemia, lactic acidosis and prolonged coagulation profile. A contrast-enhanced computed tomography (CT) scan of the abdomen showed evidence of incarcerated left spigelian hernia. Moreover, advanced cirrhosis of the liver was detected with hypertrophy of the caudate lobe, extensive ascites and splenomegaly. After establishing the diagnosis of incarcerated spigelian hernia, with a picture of advanced liver cirrhosis, Child-Pugh-Turcotte (CPT) score of C and a Model for End-Stage Liver Disease (MELD) score of 19 and Mayo score for post-operative mortality of 16% in 7 days and 53% in 30 days. Given the patient's condition which necessitates urgent operative intervention beside the risk of decompensation of pre-existing liver disease and high mortality. Decision was made to proceed with laparoscopic hernia repair. Intraoperatively, ischemic small bowel segment was resected with creation of end ileostomy. Conventional anatomical repair of the hernia defect was performed. Postoperatively, the patient was managed and resuscitated in critical care unit and then discharged home in a satisfactory condition on post-operative day 15. She passed away prior to liver transplantation, thirty-two days post-operatively in a different institution.

Conclusion: The surgical management of complicated hernias in an emergency setting comprise a notable number of cases encountered by surgeons. It always needs special attention. Moreover, cirrhotic patients with their predicted high morbidity and mortality require even further vigilance. Therefore, a patient-tailored approach is always recommended when managing similar cases to provide optimal outcomes.

Background: Malnutrition is a prevalent and critical complication in chronic kidney disease (CKD) patients, adversely affecting clinical outcomes.

Objective: This study aimed to assess the prevalence, associated factors, and implications of malnutrition in CKD patients, focusing on the role of nutritional interventions and family support.

Methods: A cross-sectional study was conducted among CKD patients, utilizing the Subjective Global Assessment (SGA) method to evaluate nutritional status. Additional parameters included body mass index (BMI), serum albumin levels, and self-reported information on nutritional counseling and family support. Logistic regression analysis identified risk factors for malnutrition.

Results: Malnutrition was identified in 76.1% of patients, with a higher prevalence among those aged ≥60 years and those with a disease duration ≥2 years. Elderly patients exhibited a 3.29-fold higher risk of malnutrition, while prolonged disease duration was associated with a 3.68-fold increased risk (both p < 0.05). BMI indicated chronic energy deficiency in 34.0% of patients, highlighting the utility of multi-parameter nutritional assessments. Only 23.2% of patients received nutrition-related information from healthcare professionals, and 81.2% relied on family support, which played a complex yet significant role in dietary adherence.

Conclusion: Malnutrition remains a pervasive issue among CKD patients, driven by aging, prolonged disease duration, and limited access to structured nutritional counseling. Comprehensive strategies incorporating early assessment, individualized nutritional interventions, and family engagement are essential to mitigate malnutrition and improve outcomes. Future research should focus on longitudinal, multi-center studies to refine and scale effective nutritional care models for CKD populations.

Background: The author of the first Croatian medical book, also the first in Southeast Europe, was Dr.John the Baptist Lalangue. He is the one who is most responsible for the fact that in the second half of the 18th century.

Objective: The aim of thiis article was to describe important facts abot the first original medical professional printed books in the Croatian language.

Methods: The authors searched imprtant information abot the book of the author Lalangue's titled "Medicina ruralis iliti Vrachtva ladanyszka, za potrebochu musev, y sziromakov. Horvatczkoga orszaga y okolu nyega, blisnesseh meszt" deposited in libraries in Zagreb and Varazdin, and also published articles deposited in scientific databases PubMed, PubMed Central, EBSCO., etc.

Results and discussion: The original medical first printed in the area of Southeast Europe by John the Baptist Lalangue is a book that deserves admiration. It is also the first printed original medical book in the Croatian language. The book "Medicina ruralis iliti Vrachtva ladanyszka, za potrebochu musev, y sziromakov. Horvatczkoga orszaga y okolu nyega, blisnesseh meszt" was published by Lalangue in Varaždin in 1776 at the Trattner printing house. After that, doctor Lalangue published a series of capital works of Croatian medicine, as well as medicine of Southeast Europe.

Conclusion: Doctor Lalangue is the author of a Croatian midwifery textbook and a balneological first, which are also firsts in the area of Southeast Europe. In this way, we remember the greats of medical thought and express the desire to respect him in accordance with his magnificent achievements.

Background: In recent years, correlation between personality and professional success has become increasingly evident. In modern times, it is well accepted that a persons' personality combined with their abilities are a prerequisite for the successful practice of any profession.

Objective: The aim of this study was to explore factors associated with ICU nurses' personality types.

Methods: The sample of the study included 102 nurses working pediatric ICUs. Data collection was performed by the method of the interview using the questionnaire "Greek Version of the TIPI (Ten-Item Personality Inventory)"which includes the following traits: a) Openness to Experience, b) Conscientiousness, c) Extraversion, d) Agreeableness and e) Emotional Stability.

Results: A fairly high "agreement" (above average) was observed with all five personality types of the "TIPI" scale (median val ≥5 in all subscales). After multiple linear regression, it was found that nurses who wished to move from the ICU have 0.42 units lower "Extraversion" compared to those who do not wish to (β=-0.42, 95%CI: -0.88 - -0.04). An increase in the age of the nurses by one year increases the score of "Agreeableness" by 0.02 units (β=0.02, 95%CI: 0.01 - 0.04) and the score of "Conscientiousness" by 0.03 points (β=0.03, 95%CI: 0.01 - 0.06). Male pediatric ICU nurses have a 3.95-point higher score of "Openness to experience" than women (β=3.95, 95%CI: 2.96-5.64). No factor was found to be significantly associated with "emotional stability".

Conclusion: Conclusion: Nurses characteristics are associated personality traits. For the health sciences, this is important to recognizes the vital characteristics that make a health professional a competent, safe and ethical worker.

Background: Gastric cancer is one of the most common cancers. We can use AI for predictive models and help us in early detection and diagnosis.

Objective: This study examines the use of a neural network model to classify gastric cancer based on clinical, demographic and genetic data.

Methods: The data from the participants were divided into two subsets. 70% training data and 30% testing data. The neural network model has 12 input variables. Factors influencing a disease can be age, sex, family history, smoking, alcohol, Helicobacter pylori infection, food habits, diseases, endoscopic images, biopsy, CT scan, gene variants (TP53, KRAS, CDH1). The hyperbolic tangent activation function has four units in the hidden layer of a model. The output layer used a Softmax activation function and cross-entropy error function which predicted the presence of gastric cancer. The assessment was done on the predictors.

Results: The training and testing datasets showed 100% accuracy predicting gastric cancer in the model outputs. Age, gender, family history, infection with Helicobacter pylori, smoking, and drinking alcohol are the biggest predictors. Information from clinical diagnosis like endoscopic images, biopsy and CT scans helped the predictive model.

Conclusion: The neural network was able to perform well for gastric cancer predictions using multiple clinical and demographic factors, showing great utility. The outcomes for AI-based diagnostic tools look promising in cancer, however generalization needs to be confirmed using external datasets. The study shows how artificial intelligence can better precision medicine and cancer diagnosis.

Background: Anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDARE) can occur after herpes simplex encephalitis (HSE) and Japanese encephalitis (JE). We describe the clinical features of children with anti-NMDARE after viral encephalitis.

Objective: This study aims to describe the clinical characteristics, laboratory findings, and treatment outcomes of these patients.

Methods: We describe the clinical characteristics of 14 children of anti-NMDARE following viral encephalitis treated at National Children's Hospital from January 2021 to December 2022. Patients with evidence of viral reactivation or other antibodies were excluded.

Results: There are 12 children with anti-NMDARE after HSE and 2 children after JE. The median age was 2.1 years (range 0.6-12.9), with 8 male patients. All patients (100%) had fever and seizures, while 50% exhibited focal neurological signs. No patients experienced movement disorders, psychiatric symptoms, or sleep disturbances during the viral encephalitis phase. In contrast, the most common symptoms during the anti-NMDARE phase were as follows: movement disorders in 92.9% (13/14), recurrent or prolonged fever in 71.4% (10/14), sleep disturbances in 64.3% (9/14), seizures in 50% (7/14), and psychiatric symptoms in 50% (7/14). The median cerebrospinal fluid (CSF) white blood cell count in the viral encephalitis and anti-NMDARE phases was 57 (4-410) and 13 (2-48), respectively. The mean CSF protein concentration was 0.43 ± 0.16 g/L and 0.85 ± 0.63 g/L, respectively. Brain MRI was performed in both encephalitis phases for 10/14 patients, with 8/10 showing no new lesions.

Conclusion: There were differences in clinical symptoms and CSF findings between the two phases of encephalitis; however, most patients did not develop new lesions on brain MRI.

Background: Carotid atherosclerosis is often mentioned as one of the main causes of stroke. Currently, embolization is considered the most common mechanism that causes ischemic strokes due to atherosclerotic lesions in the carotid artery. Transcranial Doppler (TCD) ultrasound provides relatively inexpensive, noninvasive, real-time measurement of blood flow characteristics and cerebrovascular hemodynamics within brain arteries. The pulsatile index measured by transcranial Doppler is a parameter that indicates the degree of elasticity of the blood vessels of the brain.

Objective: The aim of this study is to determine the relationship between the value of the pulsatile index of the middle cerebral artery and the basilar artery in patients with carotid stenosis using transcranial Doppler and the value of the pulsatile index in relation to the degree of carotid stenosis.

Methods: The study involved a total of 140 patients examined at the Color Doppler and Transcranial Doppler Department of the Neurology Department of the General Hospital "Prim Dr. Abdulah Nakas" Sarajevo The patients were divided into two groups. The research was conducted in the General Hospital "Prim. dr. Abdulah Nakas" in Sarajevo at the Department for Color Doppler and Transcranial Doppler of the Department of Neurology and included patients examined in the period from February 2022 to December 2022. All patients underwent extracranial Doppler of the carotid arteries and transcranial Doppler of the middle cerebral artery and basilar artery.

Results: The mean values of PI in ACM in the total sample were statistically significantly lower in patients with stenosis up to 50% compared to the average in patients with stenosis over 50%. Average values of PI in AB in the total sample were statistically significantly lower in patients with stenosis up to 50% compared to the mean values in patients with stenosis over 50%.

Conclusion: Transcranial Doppler findings showed an increased pulsatile index in patients who had carotid stenosis greater than 50% compared to patients with mild carotid stenosis. The study showed that in clinical work it would be necessary to introduce the pulsatile index as an indispensable neurosonological parameter that would be included in the findings of the transcranial Doppler and thus objectify the potential risk of a cerebrovascular ischemic event.

Background: Perianal manifestations of Crohn's disease (CD) are common, with fistulas being the most prevalent and challenging to manage.

Objective: The aim of this articles was to describe and explain how Perianal fistulizing Crohn's disease significantly impacts patients' quality of life and poses a therapeutic challenge for clinicians.

Methods: The author used published papers deposited in index databases PubMed Central, Scopus, HINARY etc. rergarding Surgical Management of Perianal Crohn's Disease: Current Management requires a multidisciplinary and multimodal approach, integrating both medical and surgical interventions tailored to disease severity and fistula complexity.

Results and discussion: Despite advancements in therapy, the majority of patients require multiple interventions due to high rates of primary non-healing, surgical morbidity, and recurrence..Medical treatment primarily includes biologics, particularly anti-TNF agents such as infliximab and adalimumab, which have demonstrated efficacy in fistula closure and symptom control. Surgical approaches remain critical with various degrees of success.

Conslusion: Despite the availability of multiple therapeutic options, Perianal fistulizing Crohn's disease remains a complex condition with ongoing challenges in achieving sustained remission. Future research should focus on novel treatment strategies and optimizing individualized patient care.