Intentional Ingestion of Foreign Object(s) (IIFO) is a distinct, increasingly recognised form of self-harm that poses complex management challenges. The effect of motivation on outcomes following IIFO has not been studied. To synthesise evidence on outcomes following IIFO and determine whether patient motivation, object characteristics, or demographics influence the need for intervention, complications, or mortality. A systematic literature search identified studies reporting intentional ingestion of non-nutritive foreign bodies in humans. Eligible studies included any design and age group reporting endoscopic, surgical, or conservative outcomes. Exclusions were accidental or substance ingestion, non-English full texts, animal studies, and reports lacking motivation, object, or outcome data. Screening was performed by a single reviewer with 10 χ ^2 testing and univariate meta-regression. Seventy-one case reports ( n=71 ) and three case series ( n=90 ) were included. Pooled outcome rates were: endoscopy 50 <1 ≈ 80 ≈ 90 p=0.003 ). Intent-to-harm increased surgical risk six-fold (OR = 5.68, 95 p=0.020 ). Adults aged 40–64 had lower surgical rates but higher mortality, often with psychiatric comorbidity. Motivation significantly influences IIFO outcomes. Protest ingestion may be managed conservatively, whereas intent-to-harm and psychiatric comorbidity indicate higher surgical risk. Improved prospective reporting is needed.
The SaCoVLM™ video laryngeal mask (VLM) enables ventilation and visually guided intubation. This study compared the hemodynamic responses, intubation performance, and airway-related complications of SaCoVLM™ and direct laryngoscopy (DL) in elective surgery. This prospective observational study included 204 adults undergoing general anesthesia between March and June 2024 (VLM, n = 103; DL, n = 101). Airway characteristics, first-attempt intubation success, procedure time, hemodynamic responses, and complications were evaluated. First-attempt intubation success was 89.3
β-thalassemia major (β-TM) is a lifelong transfusion-dependent chronic condition associated with significant physical and psychosocial burden. Although self-management plays a central role in chronic disease care, qualitative evidence remains limited regarding how individuals with β-TM enact and sustain self-management in everyday life and how this process informs patient education and counseling practices. To explore how individuals with β-TM enact and sustain self-management in everyday life, with attention to implications for patient education and counseling. Guided by Max van Manen’s hermeneutic phenomenology, we conducted semi-structured, in-depth interviews with 16 purposively sampled adults receiving care at a thalassemia unit (2024). Data were thematically interpreted. The entire reporting process adhered to the COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines to ensure transparency and trustworthiness in qualitative research. Five interrelated themes described the multidimensional work of self-management: (1) struggle and adaptation with the body; (2) time shaped by self-management; (3) everyday spaces as sites of self-management; (4) dynamics that strengthen or undermine self-management; and (5) self and future orientation through the search for self-management. Self-management in β-TM extends beyond medical regimens to include emotional meaning-making, family dynamics, and institutional contexts. Holistic, individualized education and counseling—embedded across routine care—are central to sustaining self-management. Clinical teams should pair medical follow-up with culturally sensitive education, family-inclusive counseling, and support for patients’ emotional and existential needs, adapting plans to the social and institutional contexts in which self-management occurs.
Dexmedetomidine is a highly selective α2-adrenergic receptor agonist with sedative, analgesic, and sympatholytic effects. The use of dexmedetomidine during nephrectomy has been investigated in several randomized controlled trials, although the findings remain inconsistent. This systematic review and meta-analysis evaluate the efficacy and safety of perioperative dexmedetomidine administration in patients undergoing nephrectomy. We searched PubMed, Scopus, Web of Science, and Cochrane Library from inception to November 2025. Randomized controlled trials and observational studies comparing dexmedetomidine versus control in patients undergoing nephrectomy were included. Primary outcomes included acute kidney injury (AKI) incidence, renal replacement therapy, Cystatin C, and serum creatinine. Meta-analysis was performed using RevMan software with random-effects models. Eight studies (n = 1140) were included. Systemic intravenous dexmedetomidine did not significantly reduce AKI incidence (RR 1.08, 95
Fever of unknown origin (FUO) represents a significant diagnostic challenge in infectious diseases practice, and granulomatosis with polyangiitis (GPA), a rare non-infectious cause of FUO, may lead to diagnostic delay when presenting with prostatic involvement. This study aims to present an atypical case of prostatic GPA and to increase clinical awareness through a focused review of reported cases published after the 2017 International ANCA Consensus. We retrospectively reviewed a 2023 case initially diagnosed as urinary tract infection and subsequently identified as GPA after further evaluation. In addition, a targeted literature search was conducted using PubMed, Google Scholar, Scopus, Web of Science, and Embase to identify adult cases with biopsy-confirmed prostatic involvement for descriptive analysis. Our patient presented with refractory prostatitis and FUO and was diagnosed with GPA based on PR3-ANCA positivity and multiorgan biopsies. Overall, 19 cases were analyzed, with a mean age of 52.4 ± 16.7 years. FUO with concomitant lower urinary tract symptoms was present in 27.8
