Materia socio-medica最新文献

Background: Asthma and chronic obstructive pulmonary diseases are chronic diseases and have high mortality rates in Vietnam and other countries. Chronic pulmonary disease Management Unit is a management model connecting inpatient and outpatient treatment for asthma and COPD patients. Patients receive long-term management and full consultation to share experiences and be provided with necessary information about the disease.

Objective: The main purpose was to evaluate the effectiveness of the unit for patients with COPD and asthma in Vietnam.

Methods: A Combined cross-sectional study and retrospective longitudinal study was conducted in 310 COPD and asthma patients at Hai Duong, Bac Giang, Thai Nguyen. The questionnaires included 30 questions with two sections including sociodemographic data and using management and treatment services.

Results: After 24 months of management and treatment, knowledge of the disease, medicine use, symptoms, range of activities, eating, sleeping status, and disease control of patients were improved better. For ACT score, the points increased by 2.1 points, 3.4 points, and 4 points, respectively. For the CAT score, the point reduced by 3.7 points, 6.4 points, and 9.1 points, respectively. Improved severe breathlessness efficiency index from 0.6% at 6 months to 9.5% after 24 months.

Conclusion: Our findings suggest that the government need to invest in facilities, equipment, and human resources to maintain and replicate the CMU to help patients receive timely management and treatment, contributing to reducing treatment costs and improving quality of life for asthma and COPD patients.

Background: Out-of-hospital cardiac arrest (OHCA) refers to the cessation of mechanical cardiac activity outside healthcare facilities which requires prompt intervention and intensive resuscitative efforts. The COVID-19 pandemic has caused significant disruptions to OHCA systems-of-care, adversely affecting every component of the chain of survival.

Objective: The objective of this study was to examine the potential impacts of the COVID-19 pandemic on OHCA events, to draw comparisons between the period before and during the COVID-19 pandemic.

Methods: This cross-sectional study encompassed data pertaining to all OHCA incidents attended to by the Emergency Medical Service of Canton Sarajevo, covering the period from January 2017 to December 2022, before and during the COVID-19 pandemic.

Results: During observed period, a total of 1418 [796 (56.1%) before and 622 (43.9%) during COVID-19 pandemic] OHCA events have occurred in Canton Sarajevo of which 297 (20.9 %) [180 (12.7%) before and 117 (8.2%) during COVID-19 pandemic] obtained ROSC. After a 30-day period following the ROSC) it was observed that the predominant outcome, accounting for 181 (12.7%) [106 (7.4%) before and 75 (5.2%) during COVID-19 pandemic] of cases, was a complete recovery. An examination before and during COVID-19 pandemic revealed a decline in OHCA during the year 2021 and 2022 when COVID-19 pandemic was at its highest in the country Being younger, quicker EMT response time and individuals with the initial rhythm of VF or VT were significantly associated with obtaining ROSC (p<0.05). Only 48 (3.3%) of 1418 OHCA events were assisted by bystanders There was no report of AED usage.

Conclusion: In conclusion, our investigation highlights the impact of the COVID-19 pandemic on OHCA events in Canton Sarajevo, revealing a decrease in OHCA incidence and a reduction in cases achieving ROSC. Notably, EMT response time was shorter during the pandemic.

Background: Hypertension, a significant public health concern, is frequently linked to emotional disorders like depression. Research shows a reciprocal link between depression and hypertension, potentially influencing patients' adherence to self-care routines.

Objective: This systematic review aimed to examine the association between depressive symptoms and aspects of self-care, with a focus on medication adherence in individuals diagnosed with hypertension.

Methods: Following PRISMA guidelines, a systematic review was conducted by searching PubMed, PsycINFO and Scopus until March 17, 2023. The included studies involved quantitative primary research conducted in English, focusing on adults (≥18 years) diagnosed with hypertension and experiencing depressive symptoms. Observational studies were assessed using the Newcastle-Ottawa Scale, and randomized controlled trials were evaluated using the revised Cochrane Risk of Bias Tool (RoB 2.0). Due to the great diversity of these studies, a narrative synthesis of the results was undertaken. Results: A total of 18 studies involving 6,131 people with hypertension, that met our eligibility criteria were ultimately included. The reported rates of depressive symptoms ranged from 4% to 43%. Of these studies, nine reported a statistically significant association, showcasing an adverse impact of depressive symptoms on medication adherence. The remaining nine did not confirm the above.

Conclusion: This systematic review highlights the diverse body of research exploring depressive symptoms and medication adherence among individuals with hypertension. The review suggests a need for increased attention to self-care practices, particularly in relation to adherence to antihypertensive medication. However, it recommends the conduction of more robust longitudinal studies to comprehensively explore this relationship.

Background: Worldwide, gastric cancer remains the fifth most prevalent type of cancer and is the third leading cause of cancer-related deaths. Gastric cancer is responsible for around 7% of global cancer occurrence and approximately 9% of annual cancer-related mortalities.

Objective: The aim of the study was to analyze gastric cancer dataset posted on Kaggle (https://www.kaggle.com/datasets/datasetengineer/gastric-cancer-gc-dataset).

Methods: This dataset comprises 212354 participants, of whom 10% had gastric cancer. This dataset was analyzed to extract the information regarding gastric cancer. The analysis of data was performed SPSS version 25. Descriptive analysis was used to describe data including frequency and percentages to describe categorical variables such as age, and the mean and standard deviation to describe non-categorical variables such as age. The relationships between variables and gastric cancer were calculated based on Chi-Square and One Way ANOVA tests, significance was considered if p value ≤0,05.

Results: The mean age was 53.2580±18.98 years. Seventy percent of participants were males. About 30% of participants had a family history of gastric cancer. About 40% of participants were smokers. About 50% of participants were alcoholic. About 75% of participants had Helicobacter pylori. 80% of participants were at high salt intake. About 50% of participants had chronic gastritis. Abnormal endoscopic image reports were reported in approximately 30% of participants. Biopsy results were negative in 90% of participants. The reports of CT scans were negative in approximately 80%. Genetic mutations were detected in Tp53 (50.1%), KRAS (20%), and CDH1 (29,9%). No significant relationships were found between gastric cancer and study variables.

Conclusion: Most of the people had risk factors such as Helicobacter pylori infection, salt intake, and mutations in TP53, KRAS, and CDH1. However, statistical analyses did not find significant correlations between those and gastric cancer.

Background: Nursing management is essential in the care of patients with internal diseases, supporting disease management, health promotion, and patient education.

Objective: This study examines the impact of effective nursing management on patient outcomes in Albania.

Methods: Data was collected from 175 patients diagnosed with various internal diseases across healthcare facilities. Participants were divided into two groups based on the nursing management approach received. Group A received standard nursing care, while Group B received enhanced nursing interventions, including structured patient education, medication management, and coordinated care. The effectiveness of these interventions was evaluated through a pre- and post-intervention design, assessing patient compliance, health outcomes, and satisfaction levels. Descriptive statistics were applied using SPSS software, with chi-square tests to compare groups and multiple regression analysis to explore relationships between nursing management practices and patient outcomes.

Results: Results showed that patients in Group B who received enhanced nursing management had significantly improved treatment adherence compared to Group A. The mean compliance rate increase was 30% higher in Group B.

Conclusion: This study highlights the critical role of nursing management in managing internal diseases in Albania and supports the need for enhanced training and resources for nursing professionals to adopt comprehensive management strategies. Prioritizing effective nursing management can lead to better patient outcomes, improved health, and quality of life for individuals with chronic and acute internal conditions.

Background: The Out-of-hospital cardiac arrest (OHCA) remains a major public health challenge worldwide, with survival outcomes heavily influenced by early intervention. The presence of an initial shockable rhythm significantly increases the likelihood of survival when combined with timely cardiopulmonary resuscitation (CPR) and defibrillation.

Objective: To analyze patient outcomes and the incidence of bystander and dispatch-guided CPR in cases of OHCA with an initial shockable rhythm treated by physician-led emergency medical teams in Bosnia and Herzegovina.

Methods: Data for this study were collected over a 5-year period, from January 2019 to September 2023, using the Utstein protocol. Hospital records were analyzed to determine patient outcomes, with a focus on the 30-day survival rate and favorable neurological outcomes. Instances of dispatch-guided and bystander CPR were recorded for each case based on available patient records.

Results: In this study, 1,020 patients were included, with 151 cases (14.8%) having an initial shockable rhythm, of which 14.3% of males and 4.4% of females achieved return of spontaneous circulation (ROSC). ROSC rates varied by year, with the highest in 2019 (20.4%) and 2022 (17.9%). Thirty-day survival with a good neurological outcome was observed in a small percentage of cases. The initial shockable rhythm was found to be statistically significant (p<0.001) for achieving a good neurological outcome after 30 days. Dispatch-guided CPR was attempted in 12.9% of cases, with success in 1.9%. Bystander CPR was performed in 1.4% of cases, and only one case involved the use of an automated external defibrillator (AED). The median response time for successful resuscitations was 2 minutes, while for unsuccessful resuscitations, it was 6 minutes. The findings emphasize the role of age, initial rhythm, and response time in determining outcomes for OHCA patients.

Conclusion: The promising survival rate of OHCA patients, despite limited bystander CPR, highlights the impact of short response times and skilled physician-led teams, underscoring the need for public education and a unified registry to address gaps and better understand OHCA epidemiology in Bosnia and Herzegovina.

Background: Mindfulness, originating from ancient meditation practices, has garnered substantial scientific interest in recent decades due to its potential to enhance various aspects of well-being. The rise of scientific interest in mindfulness has led to the development of Mindfulness-Based Stress Reduction (MBSR) and other mindfulness-based interventions (MBIs), which have demonstrated positive effects on stress reduction, emotional regulation, and cognitive flexibility.

Objective: This study aimed to explore the characteristics and applications of mindfulness, investigate its impact on mental health, and assess the potential benefits of combining mindfulness with nature-based interventions in promoting the well-being of children and adolescents.

Methods: This review draws from existing literature, scholarly articles, and empirical studies related to mindfulness, nature exposure, and their effects on mental health.

Results: The results highlight the manifold benefits of mindfulness in different populations, including health professionals, patients, children, adolescents, and the general public. Mindfulness practice has been associated with notable reductions in stress, anxiety, and depression, and has shown positive effects on brain plasticity and cognitive functioning. Furthermore, the integration of mindfulness with exposure to natural environments holds potential for enhanced stress reduction and cognitive restoration.

Conclusion: The findings underscore the potential of mindfulness as a cost-effective and accessible intervention to promote mental health across diverse age groups and settings. Further research should explore the specific mechanisms and long-term effects of this integrated approach to optimize its benefits.

Background: Lyme borreliosis is a multisystemic infection caused by the spirochete Borrelia burgdorferi. Erythema migras is the main clinical marker of the disease.

Objective: This study aimed was to investigate the frequency and clinical manifestations of European borreliosis on the skin, and to determine the significance of these findings for diagnosis and therapy.

Methods: A retrospective-prospective clinical study of outpatients treated and monitored in a private clinic of an infectologist was conducted over nine years from to 2013-2021. The study was clinical, descriptive and analytical in nature.

Results: In the investigated period, 509 (30.8%) patients with borreliosis symptoms were treated. EM in our patients occurred under the following conditions: a) ringed redness, b) redness of target cels and d) continuous round or oval redness of different sizes of individual redness, or multiple occurrences with primary dissemination. Skin changes with multiorgan chronic symptoms of borreliosis occurred in 67.7% of cases the including: walking redness of different shapes and sizes, pink borreliosis stretch marks, white borreliosis stretch marks, borreliosis palms and soles, psoriatic changes, Acrodermatitis chronica atrophicans, Scleroderma circumscripta-morphae, Erythema nodosum, Granuloma anulare and Lichen striatus et atrophicans. Of the 509 patients treated for borreliosis, 32.3% with multi-organ symptomatology had no skin changes.

Conclusion: The skin manifestations of European borreliosis are multi-layered and Erythema migrans are basic, but not the only markers of the disease. 'Pink borreliose stretch marks, "white borreliosis striae", "borreliosis palms or soles", and intermittent redness accompanied by itching are unique markers for the diagnosis of chronic borreliosis, if they are manifested.

Background: Low back pain (LBP) is a leading cause of morbidity in the healthcare profession. It is a complex problem of the biopsychosocial factors (BPS) effect, where processing mechanisms affect the experience of pain, function, participation in society and personal prosperity. Psychological factors are important predictors of poor outcomes because they can significantly influence pain management and coping.

Objective: To determine the prevalence of psychological factors, the difference in general health and the tendency toward psychological dysfunction of healthcare professionals with low back pain at different levels of healthcare system.

Methods: A cross-sectional study was conducted in five primary, secondary and tertiary level healthcare institutions in Boka Kotorska, Montenegro (December 2021 - July 2022). The study involved 192 subjects with LBP who voluntary entered the study and met the inclusion criteria. The study instrument was the General Health Questionnaire (GHQ-12), which provides information on mental health by identifying symptoms of distress. The data were analyzed using the χ2 test with a statistical significance limit of p<0.05.

Results: The study included n=67 (34.9%) respondents working at secondary level, n=63 (32.8%) at the primary level and n=62 (32.3%) working at tertiary level, predominantly female. Analysis of the psychological factors representation indicate significant differences in overcoming difficulties (p=0.05), enjoyment in daily activities (p=0.042) and feelings of happiness and progress (p=0.004). There were statistically significant differences in general health and in the tendency to psychological dysfunction (p=0.005). Tendency to somatic symptoms is most prevalent at primary (55.6%) and tertiary (51.6%) healthcare level. Respondents working at Secondary level showed a tendency towards social dysfunction, anxiety and depression (50.7%, 17.9% and 3%).

Conclusion: Psychological factors are represented differently in the healthcare profession. A statistically significant difference was found among healthcare professionals of the examined levels, especially in the feeling of inability to overcome difficulties, enjoyment in usual daily activities, and feeling of happiness and progress. There is also a significant difference in the representation of psychological dysfunction at the primary, secondary and tertiary levels of healthcare, while general health is most impaired among healthcare professionals working at the secondary level.