Materia socio-medica最新文献

Background: Assessing patient experiences is essential for evaluating hospital quality.

Objective: This study aimed to describe the experiences of hemodialysis patients at Hanoi Nephrology Hospital in 2023 and identify several factors related to patient experience.

Methods: A cross-sectional study was conducted in 2023 among 401 patients at the Hemodialysis department of the Hanoi Nephrology Hospital. The study utilized a structured questionnaire titled "In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH CAHPS)" to conduct face-to-face interviews with the selected patients. Logistic regression analysis was applied to identify several factors associated with patient experiences.

Results: Overall, patients reported positive experiences, particularly in their interactions with nephrologists. The highest satisfaction (78%) was for updates on treatment information from other doctors. Positive experiences were more likely to be reported by patients aged 55-64 years (versus. ≥75 years), having health insurance or other insurance (versus. No insurance), and having middle education (versus. Lower education). Living 15-30 km from a dialysis center and being a business traders increased satisfaction.

Conclusion: This study emphasized the necessity of improving communication and patient education in hemodialysis care, specifically concerning treatment options. It recommended targeted interventions and additional research to enhance the patient experience and the quality of care in Vietnam's hemodialysis centers.

Background: Chronic obstructive pulmonary disease (COPD) is a common global condition, yet real-world data on exacerbations in Vietnamese patients remains limited. This highlights the need for further exploration of clinical complexities in this population.

Objective: The aim of this study was to characterize the clinical and paraclinical features of COPD and identify predictors of exacerbation.

Methods: A cross-sectional, prospective study was conducted on 180 inpatients at Vietnam National Lung Hospital from January 2016 to June 2021. Clinical and paraclinical data were collected.

Results: The mean patient age was 69.38 ± 9.40 years, with 92.8% male. Common symptoms included dyspnea (97.8%), cough (85.6%), and expectoration (80.0%). GOLD stage distribution was: GOLD III (53.7%), GOLD IV (29.3%), and GOLD II (17.0%). Significant predictors of exacerbation included smoking (OR=2.79), comorbidities (OR=3.95), increased dyspnea (OR=14.83), increased sputum (OR=3.13), decreased alveolar murmur (OR=4.11), wheezing (OR=2.70), white blood cell count ≥10 G/L (OR=4.79), GOLD group D (OR=9.75), and FEV1 <30% (GOLD IV) (OR=7.51) (p < 0.05).

Conclusion: Clinical and paraclinical predictors can aid in forecasting and mitigating COPD exacerbations.

Background: Chronic inflammation and oxidative stress are central to the pathophysiology of Type 2 Diabetes Mellitus (T2DM), contributing to the progression of metabolic dysfunction and related complications.

Objective: The aim of this study was to explore the therapeutic potential of combining hypoxia-preconditioned mesenchymal stem cell SH-MSC with alkaline water in a T2DM rat model.

Methods: T2DM was induced in Wistar rats through a high-fat diet (HFD) followed by streptozotocin (STZ) administration. A total of 30 healthy male Wistar rats were randomly assigned to five groups: healthy control, T2DM, T2DM + Metformin, T2DM + SH-MSC, and T2DM + SH-MSC + alkaline water.

Results: The combination of SH-MSC and alkaline water significantly reduced malondialdehyde (MDA) levels, a key indicator of lipid peroxidation, and suppressed the expression of p65 mRNA, a crucial component of the NF-κB signaling pathway. Notably, the most pronounced reduction in p65 mRNA expression was observed in the group receiving both SH-MSC and alkaline water, suggesting a synergistic effect in mitigating oxidative stress and inflammation.

Conclusion: These findings highlight the potential of SH-MSC and alkaline water as a novel therapeutic strategy for alleviating T2DM.

Background: Tuberculosis (TB), primarily recognized as a pulmonary disease, can manifest in various extrapulmonary forms, with abdominal tuberculosis (ATB) being one of the most common. Abdominal tuberculosis is one of the diseases known as "the great imitator" - it can mimic the clinical presentation of various diseases that are more common, such as appendicitis, acute cholecystitis, colitis, and some malignant diseases such as colon or stomach neoplasms. Diagnosis of ATB is often delayed, especially if a clinician in a nonendemic country does not include ATB in the differential diagnosis. Given the rising migration of people from the endemic to the nonendemic countries, we believe it is mandatory to raise consciousness about this clinical entity, as well as to lower a threshold to include ATB in the differential diagnosis.

Objective: We present a case of a 31-year-old patient from Nepal, who was admitted through the emergency department of General Hospital Zabok, Croatia, with signs of acute abdomen, later successfully diagnosed and treated for ATB.

Case presentation: We also deliver a brief literature review, summarizing the epidemiology, clinical presentation, diagnostic and therapeutic algorithms for ATB. Migrations are inevitably changing the vaccination status and epidemiological risks of any host country.

Conclusion: Medical personnel should keep upgrading and revising their knowledge of the "usual suspects" whilst differentially diagnosing both immigrants and non-immigrants, in order to make timely and good quality diagnosis and treatment.

Background: Early recognition of developmental milestones is vital for timely detection of delays. While studies in Saudi Arabia have assessed parental awareness, little is known about the general adult population's knowledge.

Objective: The aim of this study was to evaluate the awareness and knowledge of developmental milestones among adults in Saudi Arabia.

Methods: A cross-sectional study was conducted from July to November 2024 using an online questionnaire in Arabic and English. The survey assessed knowledge across five devel-opmental domains. A total of 924 adults aged 18-65 years participated. Knowledge scores were categorized into high, moderate, and low levels. Data were analyzed with SPSS version 29, and associations with sociodemographic variables were tested.

Results: Overall, 31% of participants demonstrated high knowledge, 44.8% moderate, and 24.2% low. Awareness was stronger for gross motor skills in older children but weaker for infant and early speech/language milestones. Only 43.3% recognized the expected vocabulary at 24 months, and many expressed uncertainty about early infancy mile-stones. Knowledge was significantly associated with gender, age, marital status, educa-tion, occupation, and income (p < 0.05). Informal sources, particularly family and friends, were the most common source of information, while healthcare professionals and formal resources were less utilized.

Conclusion: Substantial gaps in developmental milestone knowledge exist among Saudi adults, especially regarding infant and speech/language development. Targeted public health education and greater involve-ment of healthcare providers are needed to strengthen awareness and support early in-tervention.

Background: An initial presentation of ovarian carcinoma with brain metastasis has been reported in the literature in a limited number of cases, as ovarian cancer rarely metastasizes to the brain.

Objective: This study aims to a) Systematically review the literature to identify studies on ovarian carcinoma presenting initially as cerebral metastasis and b) to investigate cases of ovarian carcinoma that were initially presented with cerebral metastasis.

Methods: A PRISMA-guided systematic review was conducted, coupled with a retrospective study at the King Abdullah University Hospital from 2005 to 2020. Two hundred sixty-three ovarian carcinoma cases were analyzed for the presence of brain metastasis, out of which 25 were positive for brain metastasis, and seven of them presented initially with neurological symptoms. Demographics, clinical features, histopathology, and treatments were identified.

Results: Eight out of 215 studies conducted between 1999 and 2024 satisfied the criteria for ovarian cancer initially manifesting with neurological symptoms. In the retrospective analysis, 85% and 71% of patients, with a mean age of 41, exhibited headache and impaired vision. Serous cancer manifested in 58%, with solitary brain lesions observed in 71%; surgical intervention yielded improved outcomes. Multimodal treatments involving craniotomy, radiation, and chemotherapy resulted in a median survival of 18.7 months. Fertility drugs utilization was recorded in 57%, indicating a possible association with aggressive illness.

Conclusion: This study illustrates that ovarian cancer presenting as brain metastases at its initial presentation is rare and should be considered in younger women with fertility drugs usage. Long-term risks of fertility drugs should be assessed as use increases. Multimodal therapy improves survival and results.

Background: Indonesia reported the second-highest global burden of tuberculosis after India, with a 2.6% increase in cases from the previous year.

Objective: This study aimed to evaluate case-finding of latent tuberculosis infection (LTBI) and differences in tuberculin induration diameters among household contacts of index patients, stratified by contact follow-up interval (1-180 months). Methods: A total of 240 index patients were recruited from four primary health cares in Simalungun District and assigned to four time interval groups in duration of 0-180 months. Tuberculin skin tests were administered to 912 contacts. Latent tuberculosis infection incidence was analyzed using proportion tests, and differences in induration diameter across time interval were tested using ANOVA (α = 0.05).

Results: The overall latent tuberculosis infection incidence was 22.4% (95% CI: 19.2-26.1) across time intervals of 1-180 months, with rates of 10.7% for 1-6 months, 21.4% for 7-24 months, 30.2% for 25-60 months, and 28.0% for 61-180 months. Significant differences in induration diameter were observed between 1-6 months and 7-24 months (p < 0.01), 1-6 months and 25-60 months (p < 0.01), and 1-6 months and 61-180 months (p < 0.01).

Conclusion: Increasing incidence of latent tuberculosis infection across time intervals of 0-180 months, indicating a rising potential for future active tuberculosis cases. This pattern reflects a progressive tuberculin conversion among household contacts, particularly between 0-6 and 7-24 months.

Background: Falls impose a heavy financial burden on society, and the incidence is age-related. The correction of refractive errors has been mooted as a valuable procedure to prevent falls. However, depth perception, estimated by stereo acuity tests, is reduced in the older population and has been cited as contributing to the higher incidence of falls in the elderly.

Objective: To explore the clinical relationship between age, interocular differences in the corrected distance and near logMAR visual acuities, refractive errors, axial (eyeball) lengths, pupil sizes, and higher-order ocular aberrations (HOAs) on clinical measures of stereoacuity and aniseikonia in asymptomatic presbyopic habitual spectacle wearers.

Methods: Total amount of 91 subjects underwent clinical assessment of i) subjective refractive error, ii) stereoacuity at 6m and 40cm (Randot Stereotests), iii) aniseikonia at 6m (Awaya test along vertical and horizontal meridian) iv) higher order aberrations (Hartman-Shack aberrometer) v) eyeball length and pupil size (IOL master 700). The Pythagorean theorem was applied to each pair of aniseikonia values to calculate the resultant aniseikonia (AR).

Results: Mean (±sd,95%CI) age of the subjects was 56.2years (±8.10,54.6-57.9). Root mean square (RMS) interocular differences (±sd,95%CI) in spherical refractive errors, axial lengths and pupil sizes were 0.66D(±0.93,0.47-0.85), 0.24mm (±0.33,0.17-0.31), 0.15mm (±0.11,0.12-0.17). The median (mode, interquartile range) values for AR were 2.8(1.0,1.3-4.0). Significant correlations (p<.01) were revealed between: a) log distance stereoacuity (y1), age (x1) and RMS difference in the corrected distance logMAR visual acuity (x2). b) log near stereoacuity (y2), RMS differences in the corrected distance (x2) and near visual acuities (x3). These key associations are best described by: y1=0.011x1+1.101x2+1.553 (r² =0.169, n=91); y2=1.715x2+1.883x3+1.725 (r² = 0.239, n=91).

Conclusion: Stereoacuity is age-related, influenced by interocular differences in the corrected visual acuities but not related to interocular differences in pupil sizes, HOAs or clinical measures of aniseikonia in older habitual spectacle wearers. Assessment of stereoacuity and aniseikonia, in older persons is useful when advising to prevent accidental mis-location and falls.

Background: Posterior pericardiotomy has been proposed as a preventive strategy against postoperative pericardial effusion and cardiac tamponade in patients undergoing coronary artery bypass grafting (CABG). However, data regarding its clinical outcomes and potential associations with postoperative complications remain limited.

Objective: To evaluate intraoperative and postoperative outcomes in patients undergoing off-pump CABG with concomitant posterior pericardiotomy, and to assess potential associations between perioperative variables and the development of common postoperative complications.

Methods: This retrospective study included 38 patients who underwent off-pump CABG with posterior pericardiotomy. Demographic and clinical characteristics, procedural details, postoperative complications, and outcomes were analyzed. Associations between operative time, comorbidities (sex, diabetes mellitus, smoking), and postoperative complications such as atrial fibrillation, pleural and pericardial effusions, and drainage volume were statistically evaluated using chi-square and correlation analysis.

Results: The study cohort had a mean age of 66.64 ± 7.28 years, with 68.1% male patients. Arterial hypertension was present in all patients, diabetes mellitus in 44.7%, and prior myocardial infarction in 65.7%. The mean left ventricular ejection fraction was 42.86 ± 10.21%, and triple-vessel disease was observed in 63.2% of patients. All patients underwent off-pump CABG. The mean operative time was 254.31 ± 59.04 minutes. Postoperative complications included new-onset atrial fibrillation in 15.7% of patients, pleural effusion in 42.1%, and pericardial effusion in 10.5%. No cases of cardiac tamponade were reported. A significant association was found between smoking and new-onset atrial fibrillation (p = 0.050), while no significant associations were observed between sex or diabetes and postoperative complications. Operative time was not significantly associated with pericardial or pleural effusion, nor with drainage volume. Complete recovery was observed in all 100.0% of patients.

Conclusion: Posterior pericardiotomy performed during off-pump CABG was associated with a low incidence of pericardial effusion and no occurrence of cardiac tamponade. The procedure appears to be safe and may contribute to favorable postoperative outcomes. Smoking may be a risk factor for new-onset atrial fibrillation, warranting further investigation.

Background: Health-related quality of life is a major issue among patients with multiple sclerosis (MS). Chronic rhinosinusitis (CRS) poses a significant occupational health concern, particularly among factory workers exposed to environmental irritants such as cement dust.

Objective: To determine the prevalence of CRS among Vietnamese cement factory workers and to identify associated demographic, occupational, and environmental risk factors.

Methods: A cross-sectional study was conducted from June 2023 to June 2024 at the Hai Phong Cement Factory, involving 1,054 workers directly exposed to cement dust. CRS diagnosis followed Rosenfeld's clinical criteria, including symptom duration, endoscopic findings, and imaging results. Data on demographic, occupational, and environmental characteristics were collected through structured interviews and clinical assessments. Logistic regression analyses identified predictors of CRS.

Results: The prevalence of CRS was 8.92% (n=94). Significant risk factors included co-existing ear, nose, and throat (ENT) diseases (OR: 4.67, 95% CI: 2.59-8.41, p<0.001), regular mask usage (OR: 1.88, 95% CI: 1.14-3.12, p=0.013), and exposure to carbon monoxide (CO) (OR: 2.78, 95% CI: 1.42-5.44, p=0.003). Protective factors included employment in electrical workshops (OR: 0.41, 95% CI: 0.21-0.77, p=0.006), vocational training (OR: 0.53, 95% CI: 0.30-0.92, p=0.026), and advancing age (OR: 0.94, 95% CI: 0.90-0.98, p=0.004).

Conclusion: CRS prevalence among factory workers highlights a critical occupational health challenge. Co-existing ENT diseases and exposure to CO significantly increase CRS risk, whereas protective factors such as vocational training and work in less dusty environments mitigate this risk.