Materia socio-medica最新文献

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.

Background: Arterial tortuosity syndrome (ATS) is a rare congenital connective tissue disorder characterized by elongation and generalized tortuosity of the major and distal arteries, including the aorta. Clinically syndrome is associated with hyperextensible skin and hypermobility of joints.

Objective: Here we present a three-year-old boy who was referred to our center for investigation of incidental murmur; but subsequently he was found to have ATS.

Results: A 3-year-old boy with lax joints and hyper flexibility of the skin was found to have severe tortuosity of the great vessels along with critical aortic coarctation. Diagnosis and management aspects have been discussed. 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: Acute mesenteric ishemia(AMI) is a rare but very serious disease with high rate of mortality and morbidity. About 1-2% of all gastrointestinal disease is AMI. Mortality is about 60-80% and depends of time between starting of symptoms and establishing of diagnosis, type AMI, comorbidities. AMI is often in older population with coronary syndrom and atrial fibrilation. AMI may be occlusive(embolisatio arteriae mesentericae superior(AMS), or thrombosis of AMS, mesenterial vein thrombosis) and nonoclusive form(NOMI). NOMI is rising in critical ill patients in shock or sepsis. Pathophysiology of AMI is very complex and significant role in this proces has ischemia and also reperfusion. Reperfusion injury including oxidative stres, inflamation, infection. The best diagnostic approach is CT angiography but after high clinical suspicion on AMI. Patients have sudden, catastrophic abdominal pain, vomitus, bloody diarrhoea. Therapy is multidisciplinary-basic treatment(resuscitation with cristaloids, antibiotic, anticoagulans...), surgical treatment-resection necrotic segments of intestinum without anastomosis or endovascular treatment. In early phases conservative treatment is possible( vasodilatation, thrombolysis). In some countries there are Intestinal Stroke Centers (ISC) in which patients with AMI have better prognosis. Because of progressive nature of AMI( rapide worsening) rare are clinical study,but there are many experimental study on animal models. Most of experimental study investigate protective effects of some supstances on damage on intestinum and remote organs during ishemia and reperfusion.

Objective: To present literature data of clinical and experimental study, describe experiments on animal models and mention supstances whit promising results in protective strategies during AMI.

Methods: We analysed Pubmed by using mesh terms such as acute mesenteric ischemia, intestinal injury, reperfusion, experimental study, clinical and therapeutic approach. Results: Sudden abdominal pain resists on opioids analgetics, high rate of CRP, hyperlactatemia, increase of D dimer is enough for suspicion of AMI. Often is delayed in establishing of diagnosis of AMI. CT angiography has sensitivity of 94%. Pneumatosis is sign of necrosis of intestinal wall. Classical surgical approach is dominant, more than 70%,. Endovascular treatment became often last few years. Experimental studies investigate occlusion of AMS with atraumatic clamp, with schemia and reperfusion in different intervals Most animals models are on wistar male rats.

Conclusion: AMI has still high rate of mortality. Better diagnostic and therapeutic principles (shorter interval between appearance of symptoms and starting of therapy, multidisciplinary approach, higher percent of endovascular procedures), could decrease mortality. Experimental studies on animal models may be succesfull in development of

Background: Sexual education of adolescents with autism spectrum disorder (ASD) is a complex challenge, as the lack of specialized programs limits effective learning. Adolescents with ASD have difficulty understanding abstract concepts such as consent, personal boundaries and safety, which increases the risk of exploitation.

Objective: This study seeks to examine the experiences and challenges parents face in providing sexuality education to their children with ASD, highlighting the need for programs that respond to the particular needs of these adolescents.

Methods: The research was based on a qualitative methodology, using semi-structured interviews with 10 parents of adolescents with autism, aged 12-18 years. Thematic analysis of the data revealed important categories related to sexuality, consent, personal boundaries, and safety.

Results: Parents face serious difficulties in communicating these issues with their children. The lack of specialized tools and limited support from the education system make it difficult to provide sex education. The need for practical examples and repeated teaching was emphasized.

Conclusion: The research highlights the imperative to develop tailored sex education programs that will help adolescents with ASD understand critical concepts. Collaboration between parents, educators and health professionals is vital to strengthen sexuality education and protect adolescents from potential risks of exploitation.

Background: Iraq has yet to establish and initiate any vaccination initiatives to address the ongoing COVID-19 outbreak and mitigate its spread and mortality.

Objective: This study aimed to evaluate the existing knowledge, attitudes, and behaviors surrounding COVID-19 vaccination amid the third wave of the outbreak.

Methods: This cross-sectional study utilized an anonymous online questionnaire, modeled after a study conducted in Bosnia and Herzegovina, to investigate COVID-19 vaccination attitudes and practices during the third wave of the outbreak in the country.

Results: In total, 2744 subjects from 27 camp for Internally Displaced People (IDP camps) in the Kurdistan region of Iraq, mostly male 1642 (61.4%), either with no previous education 701 (26.2%) or with a primary school degree 973 (36.4%), married 1610 (60.2%) and since 2014 1540 (57.6%) stationaed in the IDP Camps were included in the study. Mean age of our sample was 35.2±12.9 ranging 18- 94 years. The mean knowledge test score for our sample was 6.9±3.7 with correct answer rates ranging 27.7-78.2%. Only 31 (1.2%) of subjects scored maximum points on the knowledge test score. In total 1170 (42.7%) subjects agreed that COVID-19 vaccination programs will prevail in a battle versus COVID-19, while 1592 (58.0%) agreed that everyone should be vaccinated against COVID-19. Regarding the vaccination rates, only 421 (15.3%) have already been vaccinated against COVID-19, while 1658 (62.7%) expressed interest to get vaccinated in the future.

Conclusion: Our study sheds light on vaccination attitudes among IDP camps in the Kurdistan region of Iraq. Despite lower knowledge scores, willingness to vaccinate against COVID-19 is relatively high, likely due to limited access to vaccines, perceived risk of the disease, and trust in healthcare providers.

Background: Evaluated values of body mass index (BMI), waist circumeference (WC) and waist-to-hip ratio (WHR) increase the risk of stroke, but the extent to which this is mediated by hypertension, diabetes, lipid status, smoking and alcohol consumption is not fully understood.

Objective: The aim of this research is to examine the influence of modifying and non-modifying factors as well as obesity defined through BMI, WC and WHR on the occurrence of stroke.

Methods: A total of 440 subjects were included in the cohort divided in to two groups. The first group were patients with stroke and another without stroke. We investigate modifable factor for stroke (hypertension (HTA), lipid status, diabetes mellitus (DM), smoking, alcohol consumption, educational status) as well as WHR, BMI and WC as determinants for obesitiy.

Results: The majority of respondents in both groups had a secondary level of education. Smoking and alcohol consumption were slightly more prevalent in the group without stroke, while HTA and DM were slightly more prevalent in the group with stroke, but without a statistically significant difference. The largest number of respodents without stroke had HDL cholesterol values in the range of optimal >1.5, 70.9%, while 35.5% of respodents with stroke had values in the risk range, as well as 32.3% in the high risk range. LDL cholesterol values were on average statistically significantly higher in the group of respodents with stroke - 3.77±1.29 compared to the values in respodents without stroke - 3.20±1.20. The largest WC had patients with a hemorrhagic stroke 96.4 ± 15.5 cm. The average BMI was slightly higher in the group of patients with embolic stroke (28.5 ± 2.8) compared to patients with hemorrhagic stroke (28.4 ± 5.9) and thrombotic stroke (28.1 ± 4, 2). WHR was almost identical in all three types of stroke.

Conclusion: There is correlation between modifable risk factor and obesity in stroke occurence.

Background: In developing and developed countries, the prevalence of overweight and obesity has grown. The college phase is a critical period during which healthy behaviors are learned through lifestyle and social environment. College students are prone to increased stress, negatively affecting their daily activities and academic performance.

Objective: The general study objective was to investigate the prevalence of obesity among Jazan University students.

Methods: This observational cross-sectional study used a pre-tested self-administered anonymous electronic questionnaire to evaluate the prevalence of obesity among 474 Jazan University students and its association with academic performance, physical activity, and social support. Data were analyzed using the Statistical Package for the Social Sciences, and associations between variables were assessed using the chi-square test.

Results: Approximately 21% and 9.2% of the male and female students were obese, respectively, and the prevalence of obesity significantly differed between them. The use of one or more tobacco products was significantly associated with the prevalence of obesity (P < 0.001); the prevalence of obesity was substantially higher among the tobacco product users than among the non-users (35.3% vs. 14.4%). The presence of a morbidity was also significantly associated with the prevalence of obesity (P = 0.007); the prevalence of obesity was significantly higher among the students with at least one comorbidity than among the medically free students (28.8% vs. 14.9%). Conversely, obesity was not associated with academic performance and depression. Specifically, the grade point average was not affected across the academic years (P = 0.085 and P = 0.308, respectively).

Conclusion: Obesity is significantly associated with male sex and the use of one or more tobacco products. This finding warrants the need for strategic and multidisciplinary plans at all levels to encourage healthy behaviors among college students, including an active, healthy lifestyle.

Background: Non-surgical periodontal therapy, including mechanical debridement and root planning, is the gold standard in the treatment of periodontal diseases. The most commonly used instruments for non-surgical therapy are sonic/ultrasonic devices and manual instruments such as curettes.

Objective: This study evaluates the clinical effectiveness and patient experience of non-surgical periodontal therapy using the Vector® Paro Pro ultrasonic device, emphasizing its impact on periodontal indices and patient comfort.

Methods: Fifty patients with gingivitis, periodontitis, or peri-implantitis participated. Baseline data, including Plaque Index (PI), Gingival Index (GI), Papillary Bleeding Index (PBI), Probing Depth (PD), and Clinical Attachment Loss (CAL), were recorded. Patients underwent treatment using the Vector® Paro Pro system. Evaluations were conducted at baseline, two weeks, and one month post-therapy. Statistical analyses utilized repeated measures ANOVA and paired t-tests, with a significance threshold of p<0.05. Patient experience was assessed via a questionnaire.

Results: All periodontal indices showed significant improvement post-therapy. The mean PI decreased from 1.18±0.12 to 0.52±0.08 after two weeks and 0.44±0.09 after one month (p<0.001). Significant reductions were observed in PBI (from 1.68±0.10 to 0.46±0.09) and PD (>4 mm pockets: from 5.55±0.19 to 3.65±0.45; p<0.001). CAL improved significantly (from 0.80±0.18 to 0.70±0.16 after one month; p<0.001). Patient-reported outcomes revealed that 98% experienced no pain during therapy.

Conclusion: The Vector® Paro Pro ultrasonic device demonstrated significant clinical improvements in periodontal health, particularly in bleeding reduction and deep pocket management. Its hydroxyapatite-enhanced fluid effectively polished root surfaces and reduced post-therapeutic sensitivity. Patients reported minimal discomfort, underscoring the device's potential as a comfortable, efficient alternative for non-surgical periodontal therapy. Further studies with longer follow-up periods are recommended to confirm these findings.