Purpose: Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder often accompanied by orofacial dysfunctions and parafunctions, such as mouth breathing or sleep bruxism. Myofunctional therapy is increasingly used as an adjunctive treatment method; however, in clinical practice, there is a lack of a tool enabling the simultaneous assessment of OSA symptoms and orofacial dysfunctions potentially modifiable by this therapy. The aim of this study was to develop the OSA-OFS-12 questionnaire as a self-assessment tool for the integrated evaluation of these symptoms. Materials and methods: The questionnaire was developed based on a review of the literature regarding OSA symptoms, orofacial dysfunctions, and the effects of myofunctional therapy. Initially, 24 potential items were generated and then selected according to three criteria: a documented association with the pathophysiology of OSA, potential susceptibility to change through myofunctional therapy, and the possibility of reliable self-assessment by the patient. The final version of the questionnaire comprises 12 items rated on a nume-rical scale (0–10), divided into two domains: symptoms of orofacial dysfunction and symptoms characteristic of OSA. Results: As a result of the instrument development process, a 12-item OSA-OFS-12 questionnaire was developed, enabling the simultaneous assessment of OSA symptoms and orofacial dysfunction. Individual items were selected based on their clinical and pathophysiological significance, and the rationale for their inclusion is presented in tabular form. Conclusions: The OSA-OFS-12 is a proposed brief self-assessment tool that enables an integrated assessment of OSA symptoms and orofacial dysfunctions that may be modified by myofunctional therapy. The tool may be used in clinical practice as a diagnostic and therapeutic aid. Further research is necessary to assess the psychometric properties and validate the questionnaire.
Introduction: A hiatal hernia (HH) occurs when abdominal structures, most commonly a portion of the proximal stomach, herniate through the oesophageal hiatus into the mediastinum due to increased intra-abdominal pressure. The principal concern is the risk of acute complications that may require emergency surgery. Case report: The study reports an 81-year-old man who was urgently admitted to the surgical department with an HH showing signs of incarceration and gastrointestinal perforation. Notably, on admission, the patient was haemodynamically stable. He reported three days of upper abdominal quadrant pain with vomiting, including haematemesis since the previous day. The last bowel movement had occurred one day earlier. Abdominal examination revealed tenderness without peritoneal signs. Of the inflammatory parameters, only PCT was significantly elevated. A non-contrast CT scan confirmed the initial suspicion. Urgent laparoscopic surgery was performed, which also revealed purulent fluid in the abdominal cavity. Procedures included hiatal repair, gastric suturing, gastropexy, and subsequent peritoneal lavage with drainage. Postoperatively, inflammatory parameters and procalcitonin levels gradually decreased. The patient was discharged on day 7 in good general condition. Conclusion: Incarceration of a HH does not always present the typical features of an acute abdomen and may therefore be deceptive. Maintaining clinical vigilance is essential, particularly in elderly patients.
Introduction: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age and is increasingly associated with an elevated risk of cardiometabolic complications. PCOS is linked to vascular changes, including endothelial dysfunction and subclinical atherosclerosis. These alterations may occur even in young women and before the development of overt cardio-vascular disease. Therefore, a comprehensive review of current evidence is needed to better understand the mechanisms of vascular remodeling in PCOS, identify clinically relevant vascular markers, and summarize potential therapeutic approaches aimed at reducing cardiovascular risk in this population. Purpose: To review current evidence on the pathophysiological mechanisms underlying vascular remodeling and endothelial dysfunction in women with PCOS, with particular emphasis on the role of hyperandrogenism. Additionally, the study aimed to summarize clinically relevant non-invasive vascular markers and evaluate available therapeutic approaches that may reduce cardiovascular risk in this population. Material and methods: This narrative review was based on a structured literature search conducted in PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar. The search covered publications available from database inception to 31 March 2026 and focused on vascular remodeling, endothelial dysfunction, clinical vascular markers, and therapeutic approaches in PCOS. Eligible publications included original studies, reviews, meta-analyses, guidelines, and relevant mechanistic or preclinical studies. Conclusions: Hyperandrogenism-driven vascular remodeling significantly increases cardiovascular risk in specific PCOS phenotypes. Non-invasive vascular assessment and targeted therapies may support the clinical management of cardiovascular risk in these patients. Further research should focus on large-scale prospective studies, evaluate phenotype-specific cardiovascular trajectories, and validate emerging therapeutic targets to improve long-term outcomes.
Introduction: Dental photography is an important component of contemporary dental practice. In addition to its diagnostic and documentary value, it may support patient education, shared decision-making and clinical communication. Purpose: To analyse the current state of knowledge on the role of dental photography in patient education and to assess its significance in improving dentist-patient communication. Materials and methods: A narrative review of scientific literature published between 2016 and 2026 was conducted using the PubMed and ScienceDirect databases. The search used combinations of the following terms: "dental photography", "intraoral photography", "clinical photography", "patient education", "oral health education" and "patient communication". After screening 114 unique records against predefined eligibility criteria, 11 publications on the application of dental photography in patient education and clinical communication were included in the analysis. Results: The reviewed studies indicate that dental photography improves patients' understanding of their oral health status, facilitates the presentation of diagnoses and treatment plans, and may increase engagement with therapeutic recommendations. Visualisation of the patient's oral condition was associated with improved motivation for oral hygiene and favourable changes in selected periodontal parameters. Relevance was also identified in paediatric dentistry, where visual materials may support communication with children and parents. Conclusions: Dental photography is an effective adjunct to patient-centred dental care. Its clinical use may enhance communication, improve patient motivation and support documentation and follow-up. Wider implementation requires attention to staff training, workflow organisation, equipment costs, data protection and informed consent.
Aim: To determine the effect of perceived spousal support on breastfeeding motivation in primiparous and multiparous mothers.Methods: This descriptive and correlational study was conducted with 200 women who had given birth in the obstetrics ward of a university hospital between July and September 2024. Data were collected using a descriptive information form, breastfeeding motivation scale and spouse support scale. Data were analyzed using the Statistical Package for Social Science (SPSS) 25.0 program. Descriptive statistics (number, percentage, mean, standard deviation, maximum and minimum) were used to analyze the socio-demographic chara-cteristics of the participants and Spearman correlation analysis was used to examine the correlation between the scales. Statistical significance p<0.05 was accepted.Results: The mean score of the spousal support scale of primiparous women was 72.633.97. It was found that there was a weak negative correlation between the mean scores of the spouse support scale and the external regulation-instrumental needs sub-dimension of the breastfeeding motivation scale in primiparous women (r=-.236; p=.044). The mean score of the spouse support scale of multiparous women was found to be 69.447.07. It was determined that there was no significant correlation between the spouse support scale and the sub-dimensions of the breastfeeding motivation scale in multiparous women (p>.05).Conclusions: Spousal support scores of primiparous and multiparous women were high. It was seen that in primiparous women, spousal support influences breastfeeding. Further studies with larger samples and at different time intervals after delivery are recommended.
Aim: This study was conducted to examine the perceptions of diabetic patients about the current method used in blood glucose measurement and non-invasive technologies in glucose measurement.Material and methods: The study was conducted with 257 diabetes patients who applied to a training and research hospital in western Turkey. The patients included in the study were given a brochure introducing new non-invasive technological products in glucose measurement, and the patients were asked to review this brochure. After reviewing the brochure, the patients were asked to complete the individual introduction form and the Diabetes Self-Management Scale. Scale scores were compared across sociodemographic characteristics using One-Way ANOVA and Independent Samples t-test.Results: It was determined that 51.4% (n=132) of the participants stated that they would prefer the Glucowise device, one of the innovative technologies, and all participants would like to use innovative technologies even if they were in our country. It was determined that the total mean score of the participants from the Diabetes Self-Management Scale was 4.691.66. The mean score of glucose management from the sub-dimensions was 5.53, the mean score of diabetes control was 4.63, the mean score of physical activity was 4.31, and the mean score of the sub-dimension of control of health services was 3.87.Conclusions: It was determined that the diabetes self-management of the patients was low. It has been determined that all patients will prefer noninvasive blood glucose meters in the future and expect new technologies not to cause pain. It was determined that most patients would prefer the Glucowise blood glucose meter. Our results will guide noninvasive blood glucose devices to be produced in the future.
Open bite is a challenging malocclusion that can affect both function and aesthetics, often requiring complex orthodontic and surgical interventions. The use of microimplants, or temporary anchorage devices (TADs), has emerged as an effective, minimally invasive treatment alternative for managing open bite cases. This article explores the biomechanics of open bite correction using microimplants, highlighting their role in molar intrusion and skeletal anchorage. Clinical case studies and recent research findings are reviewed to demonstrate the advantages of TAD-assisted open bite treatment, including reduced reliance on patient compliance, enhanced vertical control, and avoidance of orthognathic surgery in certain cases. While microimplants offer promising outcomes, considerations such as implant placement, stability, and patient-specific factors must be carefully evaluated to ensure treatment success. This article aims to provide clinicians with insights into the indications, limitations, protocols, and expected outcomes of microimplant-based open bite correction, reinforcing their role in modern orthodontic practice.
Introduction: Speech disorders, regardless of cause, significantly affect an individual's social function-ning, including communication, education, career, and relationships. Quality of life in this population depends on access to specialized care, support, and social acceptance. This narrative review aims to present the issue of quality of life among people with speech disorders from an international perspective.Materials and methods: A review of current literature was conducted using the PubMed (MEDLINE) and Google Scholar search engines. Inclusion criteria covered studies published since 2015 in Polish or English.Results: Research shows that children with speech disorders have a lower quality of life than their peers, particularly in health, emotional well-being, and school participation. Factors such as social support and therapeutic engagement are crucial in improving outcomes. Positive attitudes toward therapy and early intervention contribute significantly to well-being.Conclusions: The review highlights disparities in access to care and levels of social acceptance across countries. In regions with developed healthcare and inclusive education systems, individuals with speech disorders experience a better quality of life. In contrast, limited access to services often leads to exclusion and reduced social participation. Cultural norms and systemic factors strongly influence public perception and support structures. Recognizing these global differences is key to developing more effective, equitable strategies to enhance the quality of life for this population.
Introduction: Regular physical activity supports immune balance. Moderate exercise improves immune function and reduces inflammation, while intense exertion may lead to temporary immune dysregulation. Humoral and autoimmune markers such as IgG, IgA, and anti-thyroid peroxidase (anti-TPO) antibodies are emerging indicators of immune adaptation under physical stress.Objective: This review evaluates the influence of intense physical exercise on IgG, IgA, and anti-TPO antibody levels in healthy adults. It explores both acute and chronic training effects to assess immunological risks and adaptive responses.Materials and methods: A narrative literature review covering peer-reviewed studies from the past two decades was conducted, focusing on healthy adults engaged in high-intensity physical activity. Studies were grouped by immune marker and compared for trends and inconsistencies.Results: Acute intense exercise leads to a temporary drop in mucosal IgA, increasing upper respiratory tract infection (URTI) risk. IgG changes vary with intensity and duration, showing both transient rises and long-term anti-inflammatory glycosylation shifts. Data on anti-TPO are limited but suggest no acute changes and possible long-term reductions.Conclusion: Intense exercise induces complex, marker-specific immune responses. IgA decreases transiently; IgG adapts based on training history; anti-TPO appears stable but may decrease with regular activity. Longitudinal studies are essential to evaluate implications for autoimmune risk.
Chronic pain—defined as pain persisting or recurring for over three months and affecting roughly 20% of adults in Europe and the United States—often involves both nociceptive and neuropathic mechanisms. This review examines the role of adjuvant analgesics in chronic pain management, with particular emphasis on neuropathic and cancer-related pain. A systematic search of MEDLINE/PubMed (April–June 2025) identified studies on tricyclic antidepressants (TCAs), serotonin–norepinephrine reuptake inhibitors (SNRIs), gabapentinoids, carbamazepine, capsaicin, α₂-agonists, ketamine, lidocaine, and cannabinoids. TCAs (e.g., amitriptyline) alleviate pain via serotonergic/noradrenergic modulation and NMDA receptor antagonism, but evidence is mixed; SNRIs -especially duloxetine -offer robust efficacy and a favorable safety profile. Gabapentinoids demonstrate consistent benefit in diabetic neuropathy and postherpetic neuralgia but carry adverse effects. Carbamazepine remains first-line for trigeminal neuralgia, while high-concentration capsaicin patches rival gabapentinoids for focal neuropathic pain. α₂-Agonists (e.g., clonidine) and lidocaine provide adjunctive relief when first-line agents fail. Ketamine shows potential as an opioid-sparing NMDA antagonist, though data are inconclusive. Cannabinoids yield modest neuro-pathic pain relief, with limited cancer-pain evidence. Overall, TCAs, SNRIs, and gabapentinoids are first-line for neuropathic pain; topical agents are suited for localized symptoms; adjuvant agents can enhance cancer-pain management and reduce opioid requirements.
Introduction: Investment in human capital is a strategic imperative in a highly competitive work environment, such as that of a hospital. Job satisfaction and retention in the profession largely depend on staff motivation.Purpose: This review study focuses on Herzberg's motivation-hygiene theory and its application in the nursing profession to improve job satisfaction and performance.Materials and methods: A literature review was conducted using articles and research studies from the last decade, retrieved from the electronic databases PubMed and Google Scholar.Results. Nursing is one of the most demanding and psychologically draining professional fields. Hospital management is required to find ways to enhance the working culture of nurses. In this context, Herzberg's motivation-hygiene theory can be applied to the nursing profession to improve job satisfaction and performance.Conclusions: Nurse motivation is linked to moral satisfaction, recognition, and career development. Herzberg's theory can serve as a foundation for designing policies that promote a respectful environment with growth opportunities.
The epidemiological triangle is designed to examine interrelationships between host-agent-environmental factors in causation of infectious diseases. The application of this model for chronic diseases is limited; however, can provide valuable insight. Here we use the epidemiology triangle for heart disease one of the most common chronic disease. Host factors include age, sex, race/ethnicity, genetics, behavior, and the physiological state of the individual. Agent factors comprise nutritional attributes, physical characteristics, and genetic makeup. Environmental factors encompass social, economic, biological, and political conditions. Unlike infectious disease models, the host, agent and, environmental factors overlap, providing an interesting interrelationships between heart disease determinants.
Periodontitis, a chronic inflammatory disease affecting the supporting structures of the teeth, is a leading cause of tooth loss worldwide. The pathogenesis of periodontitis involves complex interactions between periodontal pathogens, the host immune response, and tissue remodeling. One key player in the disease process is urokinase-plasminogen activator (uPA), a serine protease involved in the regulation of fibrinolysis (the breakdown of fibrin clots) by conversion plasminogen to enzymatically active plasmin, an anticoagulant. [1,2] Though initially recognized for its role in clot dissolution, uPA has been found to have a much broader range of physiological functions, including tissue remodeling [3], wound healing [3], cell migration, and even cancer metastasis. Emerging research suggests that uPA is integral to the progression of periodontitis and may offer new insights into potential therapeutic strategies. In this article, we explore the role of uPA in periodontitis, its mechanisms of action, and the potential for targeting this enzyme in the treatment of periodontal disease.
The introduction of artificial intelligence (AI) in health sciences has brought tremendous innovation worldwide. In particular, in the field of surgery, AI plays a significant role by providing increased capabilities through algorithms, patterns, and other applications associated with better outcomes for the quality of patient care. The aim of this review is to explore the role of artificial AI in cardiothoracic surgery. In particular, algorithms based on machine learning, augmented reality, and others enable cardiac surgeons to perform procedures with high precision, reducing the risk of complications for the patient. This type of technology provides cardiac surgery with tools with high-resolution capabilities for large volumes of patient data that will be useful in preoperative planning, intraoperatively and postoperatively, creating an individualized patient care plan. Finally, despite the advantages offered by AI in the health sector, there are many issues to be resolved, such as ethical issues and issues related to data privacy, for it to be adopted in daily clinical practice.
The use of implant-supported overdentures has gained widespread popularity as a reliable and cost-effective solution for edentulous patients. Specifically, four-implant-supported overdentures offer enhanced stability, improved function, and patient satisfaction compared to conventional dentures. This approach involves the strategic placement of four dental implants in the mandibular or maxillary arch, providing support and retention for the overdenture. The biomechanical advantages include improved load distribution and preservation of alveolar bone. Clinical outcomes demonstrate high success rates, minimal complications, and significant improvements in masticatory efficiency and quality of life. This paper reviews the indications, placement protocols, prosthetic considerations associated with four-implant-supported overdentures, emphasizing their role as a predictable treatment modality in restorative dentistry.
Calcium pyrophosphate deposition (CPPD) disease was first described in the 1960s and primarily affects the elderly population today. Its prevalence is estimated at 4% to 14% among individuals aged 60 years and older. Men and women are equally affected. Advancing age and osteoarthritis are significant risk factors for the development of CPPD. Chondrocalcinosis is characterized by CPPD crystal deposition in cartilage, triggering the inflammatory arthritis known as pseudogout or CPPD deposition disease. It highlights persistent inconsistencies in diagnosing and managing the disease, largely due to differing interpretations of symptoms and imaging findings. The absence of standardized diagnostic criteria and variations in treatment methodologies result in less effective care and poorer patient outcomes. CPPD has many features of osteoarthritis, with an unusual distribution. For example, it tends to be symmetrically distributed and involves the intercarpal and metacarpophalangeal joints, particularly in the hands. To confirm the diagnosis, it was necessary to identify crystals by demonstrating both characteristic calcifications on X-rays and the presence of CPP crystals in synovial fluid using polarized light microscopy. Non-steroidal anti-inflammatory drugs, corticosteroids, and colchicine are effective in managing acute CPP arthritis. Currently, there is no specific treatment to eliminate CPP crystals.
In this article, we discuss the use of ruqyah, a traditional and complementary medicine (T&CM), in neuropsychiatric disorders to highlight its importance in conventional clinical care. T&CM is a health practice with strong historical and cultural roots, which has global acceptability and applicability. T&CM use is on the rise. Systematic reviews of the effectiveness of T&CM find several approaches to be promising for the treatment of mental illness. T&CM is used in conventional psychiatric care in many countries, such as the United States, Sweden, Malaysia, and the Kingdom of Saudi Arabia. Ruqyah, one of the T&CM, refers to the healing method based on the Quran and hadith. Ruqyah practices aim to restore human nature (fitrah) to a state of inner peace and happiness. The studies showed that ruqyah has favorable effects on many neuropsychiatric disorders, such as post-traumatic stress disorder, anxiety, and depression. Today, ruqyah is also widely used in many countries. Furthermore, Malaysia has institutionalized T&CM, including Islamic medical practice (ruqyah), through specialized laws. Therefore, we strongly believe that ruqyah should be integrated into conventional psychiatric care as in the Malaysian model.
Purpose: Peripheral neuropathy is prevalent in hyperglycemic patients, significantly affecting neuromuscular function. However, a gap exists in understanding whether motor neuron discharge patterns change earlier within normoglycemic blood sugar range, during resting and active conditions, and to identify thresholds for such early deterioration.Aim of the study: To investigate the relationship between normoglycemic blood sugar levels and motor neuron discharge patterns of the gastrocnemius muscle in sedentary men, specifically exploring whether elevated glucose impacts neuromuscular function and contributes to bilateral asymmetry.Material and methods: The study included forty randomly selected sedentary males (aged 45–65 years) divided into two groups based on random blood sugar levels: Group 1 (<100 mg/dL) and Group 2 (≥100 mg/dL). Surface electromyography (sEMG) was used to measure the electrical activity of the gastrocnemius muscles of both legs during resting and standardized peripheral lower limb exercises. Statistical analysis included the Shapiro-Wilk normality test, descriptive statistics, and two-tailed t-tests for group comparisons. Statistical significance was set at p<0.05.Results: Significant differences were observed in electromyographic variables, that is, maximum myoelectric activity (EMGmax) and root mean square (RMS) of both legs, during resting and working conditions. The right leg showed alterations in both resting and exercise states, whereas the left leg exhibited significant differences, specifically during exercise conditions.Conclusion: This study demonstrated that even within normoglycemic ranges, blood sugar levels >100 mg/dL may influence motor neuron function, particularly during physical activity. The bilateral asymmetry in neuromuscular responses suggests that early alterations in motor unit discharge patterns occur before the clinical manifestation of hyperglycemia. These findings emphasize the importance of early monitoring of neuromuscular function in sedentary elderly male with blood sugar levels approaching the pre-hyperglycemic range, suggesting the need for early intervention strategies to prevent neuromuscular complications.
Introduction: Cone-beam computed tomography(CBCT) has become a vital imaging modality indental and maxillofacial diagnostics due to its high-resolution imaging and lower radiation exposurecompared to conventional CT. However, optimizingCBCT parameters—particularly field of view(FOV), resolution, and radiation dose—is crucial tobalance diagnostic quality with patient safety.Materials and Methods: A comprehensiveliterature review was conducted using PubMed,Scopus, and Google Scholar, focusing on studiesfrom 2013 to 2024. The search targeted peer-reviewed articles discussing the interplay betweenFOV, resolution, and radiation dose in CBCT, witha special emphasis on ultra-low dose (ULD)protocols. Inclusion criteria encompassed studiesinvolving human subjects or phantoms thataddressed dose-reduction strategies and diagnosticefficacy.Results: The review demonstrated that reducingFOV size significantly lowers radiation exposure—by up to 100-fold in focused diagnostic tasks—whilepreserving image quality. ULD protocols reduced radiation dose by 60–77% compared to standardprotocols and maintained diagnostic adequacy inover 95% of cases across applications such asorthodontics, implant planning, and pediatricimaging. Resolution adjustments affected dose, butthe use of optimized ULD settings allowed for highdiagnostic accuracy even with small voxel sizes(e.g., 0.075 mm). Tables summarizing effective dosevariations by FOV, voxel size, and protocol typereinforced the effectiveness of ULD imaging indiverse clinical contexts.Conclusions: Optimizing CBCT parameters—especially by narrowing FOV and implementingULD protocols—can significantly reduce radiationdose without compromising diagnostic quality.These findings support the use of patient-specific,indication-based imaging strategies and highlightthe need for standardized dose reference levels.Continued advancements in imaging technology andprotocol refinement are essential to ensure CBCTremains both safe and clinically effective.
Introduction: Synchronous multiple primarymalignancies (SMPMs) are two or more primarymalignancies occurring together in one patient. Asthe number of cases increases, the diagnosis andtreatment of patients with MPMs still presents manychallenges.Case presentation: A 66-year-old woman with ahistory of smoking and symptoms of mild,infrequent abdominal pain was diagnosedsimultaneously with lung adenocarcinoma anduterine serous carcinoma. The use of diagnostictechniques, such as CT-guided biopsy and 18F-FDGPET imaging, allowed for a fast and accurate diagnosis of both primary lesions and thedevelopment of a treatment strategy addressing bothmalignancies.Conclusion: Diagnosis of SMPMs is stillchallenging, especially in mildly symptomatic andasymptomatic patients. The use of advancedimaging techniques can decrease the risk ofmisdiagnosis while accelerating the diagnosticprocess.
