The treatment of patients complaining of chronic constipation is still far from ideal, and there is a discrete percentage of them that are labeled as refractory to the usual therapeutic approaches. In these patients there is often the need to use alternative approaches. Among these, transanal irrigation seems promising. Our aim was to evaluate the effect of transanal irrigation on symptoms and quality of life in patients with severe refractory constipation. To this end, we retrospectively analyzed the charts of 31 such patients undergoing transanal irrigation, and evaluated them basally and one and three months after the treatment. Data were collected by means of the Wexner score and the SF12 questionnaire for quality of life. Overall, there was a significant decrease of the constipation scores and an improvement of quality of life score after treatment, after both one and three months. No important side effects were documented. In conclusion, treatment with transanal irrigation may be useful, alone or as combination therapy, in patients with constipation refractory to the conventional therapeutic approaches, but studies in more numerous cohorts of subjects are needed to firmly validate this approach.
This study was conducted to reveal the effects of a Chronic Care Model (CCM)-based intervention offered to elderly patients with diabetes on their medication adherence, self-management, and activities of daily living. This randomized controlled study was conducted on diabetic patients; older adults received inpatient treatment in an internal medicine clinic of a state hospital; the patients in the trial group were provided with training using the CCM. The comparisons following the trial revealed that the differences between the group mean values were statistically significant in all variables except the Katz ADL (p < 0.05). The mean MARS score and mean total DSMS score of the trial group were found to be statistically significantly higher than those of the control group (p < 0.001). The study confirmed that CCM-based interventions offered to elderly patients with diabetes were effective on medication adherence and self-management.
Lung clearance index (LCI) measures ventilation heterogeneity, but its relationship with pulmonary involvement in Langerhans cell histiocytosis (LCH) remains insufficiently characterized. We examined the cross-sectional association of LCI with radiological pulmonary involvement and compared its discrimination with conventional pulmonary function measures, including diffusing capacity for carbon monoxide (DLCO).79 patients with LCH were retrospectively recruited: 54 with and 25 without pulmonary involvement at HRCT). Baseline nitrogen multiple-breath washout, pulmonary function testing, and high-resolution computed tomography were obtained within one week. Analyses included receiver operating characteristic curves, paired DeLong comparisons, and Firth penalized logistic regression. All analyses were exploratory.Mean LCI value in PLCH was significantly higher compared to LCH (mean difference 4.35, 95
Chronic alcohol consumption is associated with sarcopenia, a metabolic disorder characterized by progressive loss of muscle mass and function. The red blood cell distribution width-to-albumin ratio (RAR) has emerged as a composite biomarker reflecting inflammation, oxidative stress, and nutritional status. This study aimed to evaluate the prognostic value of RAR in patients with alcohol use disorder and sarcopenia. We conducted a prospective observational study including 231 patients with chronic alcohol consumption (mean intake 200 g/day) recruited at a tertiary hospital between 2008 and 2025. Clinical, analytical, and body composition variables were assessed using densitometry and handgrip strength. Probable sarcopenia was defined according to EWGSOP2 criteria based on low muscle strength. Cox and logistic regression models and ROC curve analysis were performed. RAR was positively associated with liver dysfunction and inflammatory markers, and inversely correlated with appendicular lean mass and handgrip strength. In patients with probable sarcopenia, RAR was independently associated with 12-month mortality (hazard ratio 1.67; 95
