Current health sciences journal最新文献

Introduction: Sudden death, defined as death occurring suddenly or within 24 hours of the onset of terminal symptoms without known trauma, poisoning, or violent asphyxia, remains a significant concern. This study aims to review autopsy findings in sudden death cases, identify common causes, and explore emerging trends.

Methods: This one-year cross-sectional, randomized, prospective study included cases of sudden, unexpected deaths of individuals over 18 years old who were brought for medico-legal autopsies. Exclusion criteria were cases involving trauma, intoxication, poisoning, and violent deaths.

Results: Out of 464 autopsies performed, 146 cases (31%) were sudden death cases. The majority were older adults (46.6%), with a significant male predominance (83.6%). Cardiovascular diseases were the leading causes of death, with coronary artery disease (45.8%) and acute myocardial infarction (35.6%) being the most common. Pulmonary edema and pneumonia were significant respiratory causes of death, each accounting for 25.4% and 18.4% respectively. Obesity analysis revealed that 18.4% of the cases were obese, with ischemic heart disease being the predominant cause of death among obese individuals. Other causes included septicemia, pulmonary embolism, intracranial hemorrhage, typhoid, and malignancies.

Conclusion: The study provides valuable insights into the causes of sudden, unexpected deaths, highlighting the significant impact of cardiovascular diseases, demographic factors, and obesity. The findings call for targeted public health interventions, enhanced awareness, early diagnosis, and timely management of chronic conditions to reduce the incidence of sudden deaths.

Background parenchymal enhancement (BPE) on breast magnetic resonance imaging (MRI) is a functional marker influenced by hormonal and vascular factors. It has been linked to breast cancer in prior studies, but shows wide variability across patient and clinical characteristics. Understanding its patterns is essential, yet data from Eastern European populations remain scarce. We retrospectively analyzed 353 women who underwent breast MRI at our center between January 2019 and January 2025. BPE and fibroglandular tissue (FGT) were classified according to Breast Imaging Reporting and Data System (BI-RADS). Patient age, menopausal status, body mass index (BMI), and tamoxifen use were recorded. Associations between BPE and clinical variables were evaluated with chi-square and Kruskal-Wallis tests. BPE decreased with age and was substantially lower in postmenopausal women (p<0.001). Women with heterogeneous (C) or extreme (D) FGT showed higher levels of BPE, reflecting the predominance of dense parenchyma among younger patients. BMI showed a modest but significant association (p=0.042), with overweight and obese women relatively more represented among moderate or marked enhancement. All patients on tamoxifen (n=25) displayed minimal BPE (p<0.001). In conclusion, BPE was strongly associated with age, menopausal status, FGT, and tamoxifen therapy in this cohort. These findings confirm its role as a hormonally driven imaging feature and underline the need to interpret BPE together with patient characteristics in daily practice.

This study focused on exploring the experiences of people with dementia (PD) with advance care planning (ACP) during the pandemic. We analyzed the barriers and facilitators to implementing ACP and made recommendations for research, practice and policy. Regarding the design, the review followed Joanna Briggs Institute (JBI) guidelines. The protocol was registered on PROSPERO. Three databases (CINAHL, PUBMED, Embase) were searched, and records from 2019-2023 were screened against eligibility criteria. The experiences of PD in various international settings, including care homes, community hospitals, tertiary health settings and research facilities were explored. More precisely, we followed PD and their carers who engaged with ACP tools during the pandemic, while applying qualitative and quantitative measurements. The results were based on nine studies that were included. Themes related to timing of ACP, methods used to conduct ACP during the pandemic and the topics discussed. The pandemic prompted discussions about goals of care and PD found digital interventions to be a viable alternative to in-person ACP. Barriers to this included accessibility issues, difficulty with using technology, and lack of electronic means. In conclusion, digital ACP interventions are a viable method of delivering ACP, but they should be adapted and used alongside in-person consultations.

The work analyzes the neurocognitive mechanisms underlying athletic performance, with emphasis on the impact of doping-particularly anabolic-androgenic steroids (AAS)-on cognitive abilities and emotional regulation in elite athletes. It clarifies the conceptual distinction between abilities and skills, referencing Fleishman's classification and highlighting cognitive domains such as spatial orientation, attention, and memory. Key perceptual-cognitive abilities essential to high-level sports are discussed in relation to anticipation, reaction speed, and decision-making efficiency. Evidence from behavioral and neuroimaging studies indicates that prolonged AAS use leads to impairments in visuospatial memory, executive functioning, and attentional control, likely resulting from neurobiological alterations in prefrontal-limbic networks. Emotional regulation emerges as another crucial determinant of performance, with cognitive appraisal and reappraisal playing central roles in modulating affective responses under competitive pressure. By integrating cognitive, neurobiological, and emotional dimensions, the article contributes to a more comprehensive understanding of how performance-enhancing substances disrupt the neural and psychological mechanisms that support optimal athletic function and self-regulation.

Background and purpose: The role of statins in preventing recurrent ischemic strokes in the setting of non-traumatic cervical artery dissection remains unclear. This study, a secondary analysis of Antithrombotic Treatment for Stroke Prevention in Cervical Artery Dissection (STOP-CAD) study, investigates the impact of statin therapy on subsequent ischemic stroke.

Methods: STOP-CAD, a multicenter retrospective observational study, included 4023 patients with non-major trauma-related CAD. For this sub study, we included 2610 patients with ischemic stroke, excluding those with non-ischemic presentations and missing statin information. Patients were stratified based on statin use at hospital discharge and a sensitivity analysis was conducted based on intensity: high-intensity, moderate-intensity, low-intensity, or no statin. Primary outcome was the incidence of subsequent ischemic stroke after hospital discharge. Secondary outcomes included major hemorrhage, mortality and 90-day functional outcomes. Statistical analyses included univariate analyses, Cox regression models to evaluate odds and hazard ratios.

Results: There was no significant difference in subsequent ischemic strokes after hospital discharge between the statin group (3.1%) and no statin group (3.3%) (aHR 0.73 95% CI, 0.43-1.24, p=0.25). Similarly, the incidence of major hemorrhage, mortality and 90-day functional outcomes showed no significant differences between the groups.

Conclusion: Statin therapy did not significantly reduce the risk of subsequent ischemic stroke, major hemorrhage, functional outcome, or mortality. While statins are beneficial in reducing vascular events and improving outcomes in ischemic stroke, its benefits in CAD-related ischemic strokes are less clear. These findings highlight the need for individualized treatment strategies and further research to optimize secondary prevention in CAD-related stroke.

Human exposure to low-level mixtures of herbicides is widespread, yet regulatory assessments still rely on single-compound, high-dose studies. This study aimed to determine whether prenatal-to-adolescent exposure to regulatory doses of glyphosate (GLY) alone or combined with 2,4-D and dicamba (COMB) alters liver function in rats. Pregnant Wistar dams (n=5/group) received drinking-water containing (i) no herbicide (BLANK), (ii) GLY at the EU acceptable daily intake (ADI, 0.5mg/kg bw/day; GLY 1), (iii) GLY at the EU NOAEL (50mg/kg bw/day; GLY 2) or (iv) the COMB mixture (each herbicide at its EU ADI). Offspring (≈10/sex/group) continued the same exposure until 90 days post-weaning. Serum lipids and liver enzymes were quantified; livers were weighed and examined histologically. In COMB-exposed males, ALAT, ASAT and ALP increased significantly; females showed elevated ALAT, ASAT, cholesterol and triglycerides. GLY 2 reproduced this pattern in males, while GLY 1 heightened ALAT and ALP in males and triglycerides in females. Liver weight was unchanged, but histology revealed dose-related centrilobular vein dilation, granular degeneration, micro-vacuolar change and focal necrosis, most severe in the COMB group. Continuous exposure from gestation to young adulthood to herbicide doses at or below current "safe" limits produced clear biochemical and structural liver injury, amplified by the glyphosate plus 2,4-D and dicamba mixture and with sex-specific sensitivity. These findings challenge the adequacy of single-chemical risk assessments and underscore the need to re-evaluate mixture toxicity, particularly for vulnerable populations.

In recent years, concerns about internet addiction (IA) have grown. The study aimed to assess to what extent teachers are informed about IA and are familiar with the internet, and to investigate their personal views and their perceptions of students' daily habits. A cross-sectional survey was conducted from Nov 2023-to-Apr 2024 across public high schools (Day Lyceums) in Crete, Greece, with high school teachers from 42 randomly selected schools completing an original structured questionnaire on internet use. Habits and IA were assessed through regression analysis. Of the 349 high school teachers with a mean age of 47.1 years (±9.1), 65.9% were female. The teachers primarily used the internet for educational purposes (70.5%) or for social media/communication (50.7%). In fourteen questions regarding IA, feeling curiosity when using the internet was the most prevalent response (74.2%), while the mean total IA score (scale 0-100) was low (36.3±14.2). Discussions with students about rational internet use were more common among female teachers in relation to male (83.9% vs. 73.9%, respectively, p=0.026), those with longer work experience (14.3 years vs. 11.4 years, p=0.014), and those who had a lower mean IA score (34.6 vs. 41.3, p<0.001). In general, teachers who discussed rational internet usage with students had a lower IA score (unstandardized β=-6.62, p<0.001). High school teachers' perceptions highlight the complex relationship between teachers and internet use. Our findings underscore the crucial role that teachers play in promoting healthy lifestyles and the need for better training in digital literacy and internet safety practices.

After 143 years from the discovery of Koch bacillus, the natural history of tuberculosis (TB) is characterized by heterogeneity and gaps of staging defining. The aim of the study consists in assessing the prevalence and characteristics of TB stages, from infection to disease, from acute to chronic disease, among inpatients of Constanta Clinical Pneumophthisiology Hospital. A cross sectional 8-year study, performed, from January 2017 to March 2025, among 630 inpatients, mean aged 58.23 years+/-13.812 std dev, mostly men (n=436; 69.2%) and smokers (n=414; 65.71%), enrolled with a positive diagnosis of TB infection (75 cases, based on positive QuantiFERON TB Gold Plus, 4% progressive forms), or disease (424 infectious, 410 new cases and 178 relapses, 35 multi drug resistant, 17 with mono or poly drug resistance). Subclinical TB was significantly more infectiousness than clinical forms (p=0.000). Active TB disease is characterized by delayed diagnosis (58.57%) and advanced extensive cavitary lesions (73.17%). Post treated lung TB disease (PTLD) occurred in 74.91% of cases, after a mean interval of almost 17 years (205.68 months+/-214.00 std dev), calculating from the first episode of treated TB disease. TB mortality rate was 16.66%o. In conclusion, landscaping tuberculosis' new stages is very complex and challenging. TB infection and subclinical TB are intricated through progressive forms of infection. PTLD must be considered a part of the basic triangle of TB spectrum, standing near infection and active disease, states in a continuous dynamic relation, overlapping through reinfections and relapses, causing PTLD and death.

Aim of study was to assess the prevalence and distribution of oral infections potentially leading to bacteriemia in patients scheduled for hip and knee arthroplasty.

Materials and methods: This prospective research was performed on a study group of 51 patients (mean age 67.51+/-5.78 years; 21-males, 30-females) diagnosed with hip osteoarthritis and knee osteoarthritis, scheduled for hip or knee arthroplasty in Clinical Rehabilitation Hospital (Iasi, Romania). A dental specialist performed a standardized clinical and paraclinical intraoral examination on all patients. The following conditions were assessed as oral sources of infection: chronic periapical lesions, endo-periodontal lesions, deep periodontal pockets, residual roots, fixed prosthetic restorations with inadequate marginal adaptation.

Results: All patients were diagnosed with periodontal disease. Chronic periapical lesions (23.5%) and endo-periodontal lesions (41.2%) were frequently in maxillary molars. Residual roots were detected in 84.3% of patients (mostly in mandibular molars) while ill-fitting fixed prosthetic restorations in 64.7% of patients. Periodontal treatment of deep periodontal pockets was the most commonly treatment need, followed by replacement of ill-fitted fixed prosthetic restorations, and tooth extraction.

Conclusions: Oral infectious foci-associated pathologies were frequent among patients scheduled for hip or knee arthroplasty, with deep periodontal pockets being the most frequent source of oral infection, followed by residual roots and ill-fitted fixed prosthetic restorations. Our results emphasize the necessity of the preoperative oral health evaluations for patients scheduled for hip and knee arthroplasty, a therapeutic approach required especially in the case of those with comorbidities or with risk of systemic bacteriemia of dental origin.

Esophageal stenosis is a debilitating condition that impairs swallowing and markedly reduces quality of life. Its etiology is multifactorial, including gastroesophageal reflux, radiation, caustic and surgical injuries, benign and malignant tumors. Endoscopic stenting represents a modern, minimally invasive treatment, yet some cases remain refractory to such approaches. Surgical options in benign strictures are limited, often leading to feeding enterostomies that compromise patient outcomes. Laparo-gastroscopic esophageal endoprosthesis, introduced in 1997, bridges endoscopy and surgery, reducing morbidity. This hybrid technique offers a reliable alternative for patients unfit for conventional surgical repair. Our study evaluates its role compared to standard endoscopic stenting, focusing on patient selection, outcomes, and dysphagia improvement.