Materia socio-medica最新文献

Background: Primary central nervous system lymphoma(PCNSL) is an aggressive, rare form of Non-Hodgkin lymphoma, characterized by the absence of systemic disease. There are limited data and no strictly defined guidelines for management of PCNSL.

Objective: The aim of this study was to report a 10 year experience of PCNSL treatment, to evaluate treatment outcomes and asses Progression Free and Overall Survival of these patients.

Methods: Study was conducted on the Haematology Clinic, Clinical center University of Sarajevo, BH, in the period from January 2012.-December 2022. Total sample of 24 patients were enrolled. All have undergone diagnostic surgery. Patients were treated with regimens based on High dose Methotrexate, with/without whole brain radiotherapy as consolidation. Treatment response was captured by imaging techniques. Patients who have relapsed were evaluated with imaging techniques and treated according to Methotrexate-based treatment protocols.

Results: We have captured equal gender distribution. The median age of patients was 59.5 years (range 20-79). Pathohistological analysis confirmed DLBCL diagnosis in 22 patients, T cell lymphoma and anaplastic large cell lymphoma, each in 1 patient. Chemotherapy, chemotherapy combined with WBRT and radiotherapy were given to 5, 18 and 1 patients, respectively. The overall complete response rate (CR) was 87,15%. Those receiving combined modality-treatment had higher CR than those receiving chemotherapy (94,4% versus 60%). Out of 24 patients, 11 of them relapsed. The median time to relapse was 29 months (from 1 to 105). After second line of the treatment, CR was 54,5%, while 45,45% of patients died during the treatment. 4 patients relapsed for the second time with median time to relapse of 9 months (from 2 to 77). 2 year OS rate was 67%, and the median OS rate was 45,9 months. 2 year PFS rate was 31%.

Conclusion: The OS and PFS rates indicate the usage of new drugs and consolidation with autologous stem cell transplantation in patients with PCNSL in order to achieve better treatment outcomes.

Background: Job satisfaction refers to an individual's overall attitude towards their job. It is influenced by various factors such as work environment, job role, work-life balance, compensation, anxiety, opportunities for growth and development. However, low levels of job satisfaction can have a significant impact on an individual's mental health and overall well-being.

Objective: We contacted this study in order to assess the effect of PICU nurses' and pediatricians' job satisfaction on their psychosocial functioning and to examine the role of anxiety as a mediating factor in this relationship.

Methods: A sample of 155 nurses and pediatricians at 7 University Hospitals in Greece has consented to participate in the study. Socio-demographic data, Hamilton Rating Scale for Anxiety, Minnesota Satisfaction Questionnaire -short form and a Brief Inventory of Psychosocial Functioning were used to evaluate anxiety, job satisfaction and psychosocial functions.

Results: According to our results, participants with moderate or severe levels of anxiety showed moderate or low job satisfaction, while moderate or severe anxiety was also associated with low levels of participants' psychosocial functioning. Job satisfaction is a dynamic situation that is affected by the levels of anxiety of each worker in PICU.

Conclusion: The presence of anxiety may be related to comorbid mental health disorders since it affects the psychosocial functions of the worker. We propose a longer rest period, a change of department in case an employee wishes it or shows symptoms of increased stress or another mental health disorder, regular assessments by mental health experts for all PICU's staff and support after a diagnosis of a mental health problem.

Background: In Vietnam, lung cancer ranks second among common types of cancer. Although there have been many advances in the diagnosis and treatment of lung cancer, it is still one of the deadliest types of cancer.

Objective: We investigated the prognostic value of pretreatment white blood cell (WBC) and platelet counts of patients with lung cancer.

Methods: This was a prospective, descriptive study with longitudinal follow-up. Data from 203 patients with stage IIIA-IV lung cancer presenting at Can Tho City Oncology Hospital between June 2020 and June 2022 were analyzed. Complete blood cell counts were obtained using standard methods. Lung cancer diagnoses and histological classifications were obtained from cancer registries. The optimal overall survival cutoff point for pretreatment WBC and platelet counts was determined using maximally selected rank statistics.

Results: The median follow-up was 6 (interquartile range 4-8) months and the median age was 61.3 years. The number of male patients was higher than the number of female patients. Most (71.4%) patients had adenocarcinoma; 62.1% of the patients had a WBC count of > 10 × 109/L and 38.4% had a platelet count of > 400 × 109/L. The median overall survival (OS) of all patients was 8 months. The 3-month, 6-month, and 1-year OS was 88.7%, 62.4%, and 28.3%, respectively. Patients with a WBC count of <9.18 × 109/L had a higher OS than those with a count of ≥ 9.18 × 109/L (17 months versus 8 months; p < 0.001) Patients with a platelet count of < 453 × 109/L had a higher OS than those with a count of ≥ 453 × 109/L (8 months versus 7 months; p < 0.001).

Conclusion: White blood cell and platelet count tests are routine investigations that are valuable, in combination with other factors, for predicting OS of lung cancer patients. They can help clinicians to monitor treatment response and survival.

Background: Knee osteoarthritis is the most common rheumatic disease characterized by pain, structural changes and impairment of quality of life. This disease has a multifactorial etiopathogenesis, and the main role is attributed to mechanical factors. There is a primary and secondary form of osteoarthritis. Osteoarthritis diagnosis is carried out on the basis of history, clinical picture and radiological examinations. Osteoarthritis is a major cause of absenteeism for middle-aged people. In the treatment of osteoarthritis, the triad is important: education, rehabilitation and supportive therapy with chondroprotective drugs. As part of the study, 60 patients with clinical and radiographic signs of knee osteoarthritis were given Cartinorm (1500mg glucosamine sulfate, 800mg chondroitin sulfate, 5000mg forti gel, 250mg vitamin C). After 3 months of treatment, there was an improvement in movement, a reduction in pain and an improvement in activities of daily living as measured by the Oswestry score. Objective: The aim of this study was to evaluate the reduction of pain, improvement of the clinical picture and improvement of the quality of life, after three months of supportive therapy with chondroprotective drugs (Cartinorm -1500mg glucosamine sulfate, 800mg chondroitin sulfate, 5000mg forti gel, 250 mg vitamin C).

Methods: In a study that is prospective, analytical and descriptive, 60 subjects of both sexes with clinical and radiological signs of knee osteoarthritis were included. The study was conducted in six cities (Sarajevo, Tuzla, Banja Luka, Mostar, Zenica and Bijeljina) and lasted three months. During the study for pain relief, patients could only use Paracetamol and all patients took Cartinorm 1x a day. Pain Scale and Ostwestry index tests were performed for each patient to assess the quality of life at the beginning of the study, at the end of the first, second and third month. Results and.

Results: Total number of 60 subjects with clinical and radiological signs of knee osteoarthritis were included in the study. The analysis of the gender structure showed the dominance of the female gender (43 respondents), compared to the male population (17 respondents). The largest number of respondents had bilateral knee osteoarthritis. Assessment of pain through the VAS pain scale on the first day and at the end of the 3-month study showed a statistically significant reduction in pain. Analysis of the quality of life at the beginning of the study showed that 22 subjects performed activities with many difficulties, and at the end of the study only 5 subjects performed activities with many difficulties, which shows an improvement in the quality of life after 3 months of taking Cartinorm. Conclusion: Proper education of subjects with knee osteoarthritis and application of chondroprotective drugs (Cartinorm) for a period of 3 months showed an improvement in terms of pain reduction measured

Background: Nursing home care refers to the provision of long-term care services to individuals who are unable to live independently and require assistance with activities of daily living such as bathing, dressing, eating, and medication management.

Objective: To explore the experience of nursing home care in Shkoder during COVID - 19 and to explore the key challenges and concerns associated with nursing home care during the quarantine period.

Methods: A qualitative phenomenal approach study was conducted. Data were collected through one in one semi-constructed interviews. In this study were included 30 nurses who offered their service at home of patients during pandemic. Only the nurses who have a bachelor's degree in nursing and have at least 1 year of experience in providing home care were included in the interview. Those who refused and people who did not offer this service at home were excluded. Out of 37 nurses, 30 agreed to be part of this study. All these people have been invited for an interview via WhatsApp. Then we went to their place of work where the interviews were conducted in a separate room at their place of work. All audio recorded interviews were transcribed into type written text and qualitatively analyzed using an inductive thematic analysis approach. Inductive thematic analysis is a method for identifying, analyzing and reporting patterns or themes independently from existing theoretical frameworks or categories. The period time of this study was January - February 2023.

Results: The nurses in Shkodra encountered various challenges while providing home care services during the Covid-19 pandemic.

Conclusion: Shkodra's nurses have exemplified resilience and dedication as they navigate the complexities of providing home care services during the ongoing Covid-19 pandemic.

Background: Transplantation of cells, tissues, and organs enables many patients to regain impaired organ function, promoting healing or prolonging life and improving overall quality of life.

Objective: The aim of this study was to assess the knowledge and attitudes of students in Federation of Bosnia and Herzegovina regarding organ donation and transplantation of organs.

Methods: A cross-sectional study was carried out with 255 students from four different faculties in Federation of Bosnia and Herzegovina, with the majority enrolled in either the Faculty of Medicine or the Faculty of Health Sciences. The students collected data using a self-administrative questionnaire, providing sociodemographic characteristics, knowledge and attitudes about organ donation and transplantation. Statistical analysis was performed using Microsoft Excel version 3645 and R studio v2024.04.2, based on R 4.4.1.

Results: Out of all students, 49 of them (19.3%) demonstrated poor knowledge, while 131 students (51.6%) exhibited average knowledge. Analyzing the data by Faculty type revealed significantly higher levels of knowledge among students in Medical and Health faculties compared to those in the Educational Science Faculty (χ²=10.196, p=0.006). Regarding attitudes, 56 students (22%) had a negative attitude, while 117 students (45.9%) had a highly positive attitude. Only 13 students (5.1%) owned a donor card.

Conclusion: Students from Faculty of Medicine and Faculty of Health Sciences generally possess higher basic knowledge about organ donation, yet despite this knowledge, their attitudes toward organ donation often remain negative. It is essential to implement effective strategies aimed at raising awareness and fostering a positive attitude toward organ donation.

Background: Effective radiology diagnostic services are crucial for the timely and precise diagnosis and treatment of stroke, a medical emergency, in multidisciplinary hospitals. However, the efficiency of these services might be impeded by various logistical and operational challenges present in a multidisciplinary hospital setup.

Objective: This review endeavours to explore the ways for optimizing stroke management in multi-disciplinary hospitals, delving into its benefits, current challenges, and future prospects.

Methods: Electronic databases, namely PubMed, Scopus, and Web of Science, were utilized for this review. Studies that focus on the organizational and functional aspects of radiology diagnostic services in multidisciplinary hospitals for stroke patients were analysed.

Results: This review delves into a variety of strategies that could be harnessed to enhance radiology diagnostic services, thereby better-serving stroke patients in multidisciplinary hospital settings. It sheds light on the current hurdles in the optimization of stroke management, discussing them in detail. This article also explores the application and significance of Process Mapping in streamlining workflow for stroke management in hospitals, providing insights into its benefits, challenges, and future implications. Furthermore, the potential of Artificial Intelligence (AI) and Machine Learning (ML) in refining stroke management processes is also analysed and discussed.

Conclusion: The quest for optimizing the organization of radiology diagnostic services in multidisciplinary hospitals unveils a multi-pronged pathway. It beckons a harmonious blend of technological innovation, operational finesse, and multidisciplinary camaraderie. stepwise implementation of the identified optimization strategies, coupled with a continual assessment of their impact on patient care and operational efficiency, is recommended.

Background: Flexible flatfoot is a normal finding in infants and the arch is shaped spontaneously in most children before the age of 10 years. Flexible flatfoot is a common deformity in both adolescent and adult populations.

Objective: This prospective study aims to assess the functional and radiological outcomes of subtalar arthroereisis in adolescent patients with symptomatic flexible flatfoot.

Methods: This is a prospective study and included 26 feet in 19 patients who underwent subtalar arthroereisis for symptomatic flexible flatfeet deformity. Preoperative and postoperative functional assessment based on the American Orthopedic Foot and Ankle Society (AOFAS) hindfoot scale. Radiographic parameters included preoperative and postoperative Kite`s angle, talonavicular coverage angle, Anterior-Posterior talo-1st metatarsal angle, Meary`s angle, talar declination angle, calcaneal inclination angle and lateral talocalcaneal angle.

Results: The mean follow-up period was 22.5±9.4 months and the mean preoperative AOFAS score was 54.6±6.0, while the mean AOFAS score at the last follow-up visit was 86.3±3.9 (P<0.001).The mean preoperative and postoperative radiological measurements were 19.0°±8.2° and 7.4°±3.9° for the AP Talo-1st metatarsal angle (P<0.001); 23.6°±9.1° and 8.0°±4.0° for talonavicular coverage angle (P<0.001); 35.4°±3.7° and 24.1°±3.4° for Kite`s angle (P<0.003); 22.4°±6.1° and 7.5°±3.7° for Meary`s angle (P<0.001); 41.0°±4.4° and 25.2°±7.1° for talar declination angle (P<0.001); 13.5°±3.7° and 21.3°±3.6° for calcaneal inclination angle (P<0.001) and 52.4°±7.2° and 42.9°±4.8° for lateral talocalcaneal angle (P<0.041) respectively.

Conclusion: Subtalar arthroereisis is an effective and minimally invasive procedure that showed clinical and radiological improvement for symptomatic flexible flatfoot in our study group.

Background: Evaluating the Health-Related Quality of Life (HRQoL) in patients with hypertension and diabetes is vital for improving treatment adherence and outcomes.

Objective: This study assessed HRQoL and its influencing factors among patients with both type 2 diabetes mellitus and hypertension at Can Tho Hospital, Vietnam.

Methods: A cross-sectional study was performed on 310 outpatients at the polyclinic, using the Short Form-36 Health Survey (SF-36) between July 2021 and July 2022.

Results: The average HRQoL score among patients was 50.56 ± 21.73. Normal HRQoL was observed in 68.7% of patients, 16.8% had good HRQoL, and 14.5% had poor HRQoL. Lower HRQoL was more common in older patients, females, those with lower education levels, unemployed individuals, insulin users, and those with complications. Significant factors affecting HRQoL included age, occupation, education, and treatment outcomes.

Conclusion: Patients with complications and those on insulin therapy should be closely monitored to maintain their overall health and HRQoL.

Background: Sixteen RECs were randomly selected from various institutions across Kazakhstan, representing both public and private sectors and covering biomedical and socio-behavioral research reviews.

Objective: This research addresses a critical knowledge gap by providing empirical data on REC operations in Kazakhstan, facilitating a better understanding of how these committees align with international ethical standards and best practices. Furthermore, by situating our findings within the broader context of REC performance in LMICs, we aim to highlight specific challenges unique to Kazakhstan and propose evidence-based recommendations.

Methods: Data were collected using a culturally adapted, semi-structured questionnaire based on a validated self-assessment tool. Descriptive statistics were used to analyze the data.

Results: The overall average score for the RECs was 71.9% out of a possible 100%, indicating generally effective functioning but highlighting significant areas needing improvement. Strengths included well-established organizational aspects, diverse membership, and adequate educational training. However, weaknesses were identified in the thoroughness of protocol evaluations and resource allocation, with low scores in "Review of Specific Protocol Items" (33.7%) and "REC Resources" (56.2%). Additionally, 38.5% of RECs were not registered with national authorities, underscoring the need for improved regulatory oversight.

Conclusion: While RECs in Kazakhstan demonstrate strengths in organizational structure and member training, critical gaps exist in protocol review processes and resource support. Targeted interventions - such as enhancing training programs for REC members, increasing funding and resources, and establishing a national accreditation system - are recommended to improve the quality of ethical oversight in research. Strengthening these areas will ensure comprehensive protocol reviews and better protection of research participants.