Materia socio-medica最新文献

Background: Atrial fibrillation is the most common type of arrhythmia. The symptoms of atrial fibrillation not only significantly impacted quality of life but also associated with thrombotic events and heart failure, thereby increased risk of mortality. According to current guidelines, the initial treatment strategy for patients with atrial fibrillation is antiarrhythmic medication.

Objective: This study aimed to evaluate the safety, efficacy, and procedural adaptations required for cryoablation in Vietnamese patients with paroxysmal atrial fibrillation (AF).

Methods: Fifteen patients with paroxysmal AF underwent cryoablation using a standardized protocol. Patient characteristics, procedural parameters, and outcomes were recorded. Safety was assessed by monitoring acute complications, and procedural success was defined as complete pulmonary vein isolation (PVI) confirmed by bidirectional block.

Results: Complete PVI was achieved in 100% of patients, with an average procedural duration of 125 ± 32 minutes and fluoroscopy time of 14 ± 8 minutes. No acute complications related to cryoablation.

Conclusion: Cryoablation demonstrated safety and efficacy in achieving PVI for paroxysmal AF in a resource-limited setting. Larger studies with extended follow-up are required to further validate these outcomes and explore the long-term efficacy and sustainability of cryoablation techniques.

Background: Herbal medicinal products, a subgroup of complementary and alternative therapy (CAM), are widely used for pediatric respiratory symptoms in Saudi Arabia. However, regional variations and safety concerns remain understudied.

Objective: This study examines the prevalence and patterns of herbal remedy use for cough and respiratory illness among Saudi children.

Methods: A multi-center cross-sectional questionnaire-based study was conducted across five Saudi regions (N=475). Data were collected via a validated questionnaire (Cronbach's α = 0.85) and analyzed using SPSS v25.

Results: The mean age was 3.97 ± 3.60 years. Herbal remedy use was highest in the Western province (37.8%, p <0.001). Sesame oil (19.8%) and olive oil (18.2%) were most common. Family/friends provided 82.8% of advice. Self-rated improvement was "excellent/good" in 59.9%, with 96.6% reporting no adverse effects. Fathers with postgraduate degrees used fewer herbal remedies (p=0.003).

Conclusion: Herbal remedy use is prevalent, emphasizing the need for healthcare providers to document usage and educate families. Further research is required to evaluate efficacy and safety.

Background: The biomedical sciences associated with the behavior of humans dissipate diseases and its development is called behavioral medicine. Drawing together insights from medicine, neuroscience, psychoneuroimmunology, psychology, sociology epidemiology, anthropology, and health education, it looks at health in the biological, psychological social environmental and spiritual.

Objective: The objectives of this study were: a) to specify the scope and domains of modern behavioral medicine, b) to clarify prevention, diagnosis, treatment, and outcomes, c) to specify the patient-physician relationship and technology use, and d) to describe how behavioral medicine links delivery, utilization, education, and reform of health and social systems.

Methods: The methodology involves looking at differing complex comprehensive models as well as the models that control functioning in illness and disease.

Results: Today's behavioral medicine has multiple applications (e.g. clinical care, prevention, health promotion, systems innovation)." It promotes a patient-physician relationship that is socially adept and facilitated by technology. It also addresses health problems of the individual and social problems at the community level. Furthermore, it integrates life and social sciences in order to influence etiology, diagnosis, treatment and health outcome through the cognitive, emotional, psychosocial and environmental pathways. The discipline seeks to unite the health system family, focusing on wellness rather than illness.

Conclusion: Behavioral medicine acts as an integrative platform for disciplines and health systems that further prevention, diagnosis, treatment, and population health. This allows for comprehensive, scalable approaches to enhance health outcomes and inform health system reform by focusing on the patient-physician relationship, utilizing appropriate technology and acting at the level of individuals and communities.

Background: Combined hormonal contraception (CHC) is a widely accepted contraceptive method for women of reproductive age. It is considered a safe and user-friendly option for women without risk factors for cardiovascular diseases; however, it is contraindicated in women with established cardiovascular disease or overt risk factors. CHC increases the incidence of cardiovascular events through higher risk for thromboembolic events and potential increases of blood pressure.

Objective: The aim of this article was to explain when and how arterial hypertension should be addressed as absolute and relative contraindication for CHC use as well as a possible consequence of CHC therapy.

Methods: This is descriptive method which should be crucial to identify women who are not suitable candidates for CHC by thoroughly assessing their medical history, including current and previous conditions, evaluating potential risk factors, calculating body mass index (BMI), and regularly monitoring blood pressure and weight.

Results and discussion: Several explanations have been proposed to explain blood pressure elevations. The estrogenic component in CHC stimulates renin-angiotensin-Aldosterone system (RAAS) through increased hepatic production of angiotensinogen. The regulation of anti-diuretic hormone (ADH) through osmoreceptors may also be altered. Before prescribing CHC, gynecologists should conduct a thorough cardiovascular risk assessment. This should include a targeted questionnaire addressing cardiovascular disease history and risk factors, such as smoking and elevated lipid levels. Additionally, BMI calculation and blood pressure measurement should be performed. It is advisable to assess thyroid function by measuring THS levels at the initiation of CHC and every five years thereafter, as thyroid dysfunction is associated with increased cardiovascular risk, particularly arterial hypertension Laboratory testing should include lipid profiles, glucose levels and thyroid function assessment performed prior to initiating CHC and at regular intervals during its use. This article focuses on arterial hypertension addressing its role as both an absolute and relative contraindication for CHC use as well as a possible consequence of CHC therapy.

Conclusion: Women with well-controlled arterial hypertension may, in certain circumstances, safely use CHC. The combination of estetrol and drospirenone holds promise as an ideal choice for women with arterial hypertension seeking CHC.

Background: Interprofessional collaboration involves coordinated efforts by professionals from various disciplines, such as physicians and nurses, aimed at improving patient care outcomes. This teamwork enhances cooperation among healthcare professionals with diverse expertise, contributing significantly to patient safety, satisfaction, expedited recovery, cost-effectiveness, and reduced mortality rates.

Objective: This paper explores the available evidence regarding the attitudes of physicians and nurses towards interprofessional collaboration and identifies factors that influence their willingness to engage in collaborative practice.

Methods: A systematic review was conducted spanning from 2016 to 2023, adhering to predefined criteria and the PRISMA guidelines and checklist. Searches were performed in PubMed, Scopus, CINAHL Plus, Cochrane, and Google Scholar. The inclusion criteria comprised studies (regardless of design) addressing interprofessional collaboration, published within the last ten years, and involving both physicians and nurses. Only articles with full text access and written in English or Greek were included.

Results: The review identified 13 relevant studies. The analysis revealed that nurses generally exhibit more favourable attitudes towards interprofessional collaboration compared to physicians. Moreover, thematic analysis highlighted key factors influencing the attitudes of both nurses and physicians, including education level, age and years of experience.

Conclusion: This review highlights critical aspects and gaps in current literature, emphasizing the need for future research to further explore these areas. Findings also underscore the importance of incorporate these insights into hospital policies to effectively enhance interprofessional collaboration.

Background: Severity of illness assessment tools are utilized to triage critically-ill patients and provide a valuable inputs to the healthcare provider to decide the type and intensity of treatment or interventions.

Objective: The aim of this study was to evaluate the discriminatory capabilities of Acute Physiology And Chronic Health Evaluation II (APACHE II) score in the prediction of Intensive care units (ICUs) mortality among patients with sepsis admitted to the ICU.

Methods: Records of patients with sepsis admitted to ICUs were retrospectively reviewed. Discriminatory performance of APACHE II score was assessed by using the receiver operating characteristic's (ROC's) area under the curve (AUC).

Results: The mean±SD of APACHE II score was 27.1±8.4. APACHE II score demonstrated a very good discriminatory performance with an accuracy rate of 75% and an AUC-ROC 0.80 (95%CI: 0.74 - 0.85) at an optimal cutoff of 26. APACHE II score was found to be correlated with ICU mortality with a correlation coefficient of (0.52). ICU mortality was significantly higher in patients with APACHE II score ≥26.

Conclusion: This study revealed that the discriminatory performance of APACHE II score in predicting ICU mortality in patient with sepsis was very good. These findings can have potential clinical implications in the identification and management of patients with sepsis admitted to the ICU.

Background: The presence of blood in breast milk gives it a rusty or brownish color, which is referred to as "Rusty Pipe Syndrome (RPS)".

Objective: This study presents case reports to raise awareness about RPS and examine differences from existing literature.

Methods: Data from six cases with confirmed RPS were collected from Rea Maternity Hospital in Athens, Greece and Alexandroupolis General University Hospital in Alexandroupolis, Greece, from March 2020 until July 2024.

Results: Six women aged 25 to 36, experienced RPS during breastfeeding. The majority of them had no previous birth history (83%), were primigravida (83%) and had bilateral presence of blood in the milk (67%), with symptoms appeared on the second postpartum day (50%).

Conclusion: Based on extensive studies and literature reviews, RPS is generally considered a benign condition, typically presenting bilaterally. However, unilateral cases, such as those observed in our study, are rare.

Background: SARS-CoV-2, though primarily a respiratory pathogen, exhibits multi-organ tropism, with the liver among the commonly affected organs. Elevations in liver enzymes are frequent in hospitalized COVID-19 patients, yet acute and pronounced hepatocellular injury in young, clinically stable individuals is uncommon. The underlying mechanisms may include direct viral cytopathic effects mediated by ACE2 receptors, immune-mediated injury, systemic inflammation, and metabolic stress. Notably, hepatic involvement can develop independently of respiratory compromise.

Objective: The aim of this case report was to describe three adult patients with serologically confirmed SARS-CoV-2 infection and mild respiratory symptoms who presented with acute liver injury in the absence of other identifiable causes.

Case report: During a confirmed COVID-19 wave in Bosnia and Herzegovina, a targeted outpatient study was performed in a family medicine setting. Routine liver testing was conducted for all suspected COVID-19 cases. Laboratory evaluation included liver enzymes, hepatitis serology, autoimmune markers, and inflammatory parameters, with imaging (ultrasound or MRI) to exclude structural pathology. Three previously healthy male patients (aged 25-45) developed acute liver injury during mild febrile illness, all with serologically confirmed SARS-CoV-2 infection (positive IgM and IgG). Retrospective assessment revealed unrecognized metabolic dysfunction-associated steatotic liver disease (MASLD) in all cases. Initial symptoms were fatigue and myalgia without respiratory distress. Laboratory findings demonstrated marked elevations of AST and ALT (>1000 U/L), GGT (>900 U/L), and raised ferritin and D-dimer, while bilirubin remained normal. This biochemical profile - disproportionately elevated transaminases and GGT with preserved bilirubin - was consistent across cases, suggesting SARS-CoV-2-related hepatocellular injury. All patients recovered rapidly with supportive outpatient care, without progression to liver failure.

Conclusion: Clinically stable COVID-19 patients may experience acute hepatocellular injury, particularly those with underlying metabolic dysfunction such as MASLD. The recurring biochemical pattern of significantly elevated AST, ALT, GGT, and ferritin with normal bilirubin suggests a distinctive SARS-CoV-2-associated liver injury phenotype. Recognition of this presentation is essential for appropriate evaluation and management. Routine liver function monitoring should be considered in COVID-19 patients, regardless of respiratory symptom severity, especially in those with metabolic risk factors.

Background: The Infertility refers to the inability of couples to conceive after 12 months of regular, unprotected sexual intercourse. The incidence of infertility is increasing and is estimated to be 8-12%, or even up to 20%. Primarily, it involves organic causes, but the psychological aspect is not excluded.

Objective: The aim of this article was to discrabe the observing of various causes of infertility.

Methods: Authors used, as sources, published relevant facts in the articles deposited in important scientific indexed databases Medline, Scopus, PubMed Central, Hinari, etc. to write this review.

Results and discussion: The diagnosis of female infertility involves a detailed medical history, laboratory tests, hormonal evaluation, and imaging studies such as ultrasound and eventually hysteroscopy and laparoscopy. Advances in genetic testing have deepened our understanding of infertility origins in both genders. Sperm analysis is pivotal for diagnosing male infertility. Infertility treatment includes identifying causes and applying various therapies, including conservative surgical, and assisted reproductive technology (ART).

Conclusion: The currently used ART methods include ovulation tracking with planned intercourse, insemination and in vitro fertilization (IVF).

Background: Psoriasis, a common skin disorder, involves immune cells and cytokines in its pathogenesis. Narrow band ultraviolet B (NB-UVB) treatment has demonstrated efficacy and safety in managing this condition.

Objective: This study aimed to assess changes in serum interleukin (IL)-17, IL-23, and tumor necrosis factor-alpha (TNF-α) levels during NB-UVB treatment for psoriasis vulgaris.

Methods: An interventional, pre-post comparative study was conducted on patients with moderate to severe psoriasis vulgaris undergoing NB-UVB treatment. Patients were randomly allocated to Group 1 (n=39) receiving NB-UVB based on minimal erythema dose (MED) and Group 2 (n=32) based on Fitzpatrick skin type classification. Serum IL-17, IL-23, and TNF-α levels were measured before treatment and upon achieving PASI75.

Results: There were no significant differences in serum IL-17, IL-23, and TNF-α levels between Group 1 and Group 2 at either time point. In Group 1, IL-17 levels decreased from median 2.6 pg/ml before treatment to 2.5 pg/ml at PASI75 (P=0.0107). In Group 2, IL-23 levels decreased from median 9.6 pg/ml pre-treatment to 1.3 pg/ml at PASI75 (P<0.0190). Across all patients, pre-treatment IL-17 and IL-23 levels (median 2.6 pg/ml and 7.1 pg/ml, respectively) were significantly higher compared to levels at PASI75 (P=0.0349 and P=0.0023, respectively).

Conclusion: NB-UVB effectively treats moderate to severe psoriasis vulgaris, leading to reduced serum IL-17 and IL-23 levels irrespective of MED-based or skin type-based dosing strategies.