Acute lower respiratory infections (ALRI) in children under 5 years old represent a significant cause of morbidity and mortality worldwide, particularly in low- to middle-income countries. ALRI may be caused by numerous microorganisms, with viruses being the most frequent culprits. Preventive measures have been taken to decrease the incidence and mortality of the most prevalent causative agents, namely respiratory syncytial virus (RSV), influenza A and B, and some adenoviral subtype. Nonetheless, only the vaccines for type A and B influenza are currently available and recommended for use in children. Among these viruses, RSV stands out as the leading cause of ALRI and is also responsible for a significant proportion of hospitalizations related to bronchiolitis and pneumonia. Another distinctive aspect of RSV is its seasonal pattern, typically peaking during colder months in temperate regions, and during the rainy season in tropical areas. Given its predictive epidemiological behavior, other measures have been developed to decrease its incidence and morbimortality during this specific time- span. Available evidence of high and moderate certainty has shown that monoclonal antibodies (mAbs) significantly reduce the rates of RSV infection as well as the need for hospitalization, need for ICU admission, and RSV-associated mortality. Motavizumab, nirsevimab, palivizumab, and suptavumab are some of the available alternatives to decrease the global impact of RSV and ALRI. The aim of this review is to analyze the mechanism of action of mAbs to decrease the burden of RSV in children's health, analyzing primary outcomes such as mortality, hospital admissions, and ICU admissions; moreover, financial aspects will also be discussed.
Mental health is an entity closely related to the perception of personal image; therefore, it is logical to believe that modifications of the body image by surgical methods may impact mental health in positive or negative ways. Most findings suggest that a large part of the subjects that decide to undergo cosmetic procedures frequently have some type of mental disorder, predominantly depression, anxiety, and body dysmorphic disorder. Furthermore, it has also been found that these individuals after surgery tend to have better self-esteem and quality of life in comparison to previous to it. Nevertheless, some studies suggest certain procedures may increase the risk of suicide. Although there are many risk factors for suicide and it cannot be attributed solely to an aesthetic procedure, the idea of establishing protocols for the screening for mental disorders in esthetic surgery clinics should be considered in order to assure the complete well-being of the patients.
Introduction: Heart disease can have debilitating physical and mental consequences that can affect the care behavior of the elderly. The aim of study was the effect of a support program based on the psychosocial needs of the family on the family care burden of ischemic heart patients. Methods: Science Direct, Pub Med, Google Scholar, SID, MagIran databases were reviewed and electronic data were used to identify the psychosocial needs of the family on the burden of family care of heart patients. In the initial search, 824 articles were obtained, of which 379 duplicate articles were removed. Considering the inclusion and exclusion criteria, the number of articles was reduced to 445 articles. Finally, 10 articles were included in study. Results: Atotal of 824 articles were screened, which led to the selection of 11 studies that met the inclusion criteria and were included in study. Some studies defined caregivers as family caregivers. Five studies focused on life partners and caregivers of patients. Some studies generally defined caregivers as someone identified by the patient as a caregiver. Conclusion: Providing a training program about the different dimensions of support that family caregivers need reduces the perceived stress of family caregivers of cardiac patients.
steoarthritis (OA) is a frequent comor- bidity in obese patients, which signifi- cantly impacts their quality of life and represents a common cause of disability. The pathogen- esis of OA is often related to overuse and mechanical overload, which are markedly present in obese patients. However, this approximation oversimplifies the complex metabolic and inflammatory pathways connecting obesi- and OA. Indeed, other frequent obesity comorbidities like diabetes, hypertension, and metabolic syndrome are closely related to OA. Moreover, low-grade chronic inflammation, an obesity hallmark, is associated with articular cartilage damage through several pathways. Furthermore, mechanical overload is a mechanism that depends on several molecular pathways. From the role of mechanosensitive receptors to the induction of proin- flammatory cytokines, the degeneration of articular car- tilage in OA is highly dependent on inflammatory path- ways. Understanding the pathophysiology of OA allows for the inclusion of new therapeutic targets. Neverthe- less, more research is needed to properly comprehend the pathophysiology of OA and to implement new strate- gies accordingly. This review aims to analyze the mo- lecular mechanisms associated with mechanical over- load and their participation in the origin of OA; likewise, other mechanisms associated with obesity will also be reviewed.
olorectal diseases represent a significant burden in modern medicine, with a severe impact on patients' quality of life. This has driven the need for effective treatments and the refinement of currently available methods. Surgical intervention remains the gold standard for most colorectal conditions. However, because of the complexity of such surgeries, the steep learning curves for surgeons, operator-associated complications, and many other factors, the availability of highly specialized colorectal surgeons does not meet the growing demand. To optimize patient care, several strategies have been analyzed to address these obstacles, most of which focus on shifting from conventional surgical methods to more novel approaches. Robotic surgery (RS) has been a prominent topic since its introduction and has provided outstand ing results in various clinical scenarios. Compared with traditional methods, robotic techniques offer distinct advantages. The enhanced dexterity and range of motion provided by robotic tools are invaluable in the surgical field. Moreover, the magnified view provides more clarity, enabling more precise maneuvers. As surgical practices continue to evolve, minimally invasive methods and robotic techniques are gaining relevance worldwide. In this review, we assess the suitability of robotic methods in colorectal surgeries by comparing their outcomes, associated costs, operator learning curves, intraoperative and postoperative complications, and conversion rates to open surgery in contrast to traditional methods.
n this paper, the authors aim to study different methods, analyses of proliferative activity and morphometric indices of fibroblasts as a key link in in vitro experiments for the possibility of enhancement reparative regeneration processes to improve the quality of prevention and treatment in cardiovascular and pulmonary diseases. In the process of research the authors conduct an analysis of publications in peer-reviewed journals, performed using electronic databases PUBMED.com, RINC (Russian Science Citation Index), as well as scientific electronic library eLIBRARY.RU analysed publications and studies on the topic of scientific work. Based on the study of published literature data on the study of proliferative activity of fibroblasts morphometric indices changes, the authors come to conclusions about their significance, identifying the most evidence-based techniques for use in in vitro experiments to improve the regenerative processes in various organs and systems of the human body (including pathologies of the pulmonary, cardiovascular systems). Purpose: studying different techniques used to analyse proliferative activity and changes in morphometric indices of fibroblasts as a key link in in vitro experiments enhancement of reparative regeneration processes to improve the quality of prevention and treatment in cardiovascular and pulmonary diseases.
This literature review summarizes the results of the assessment of the survey of microbial associations of upper respiratory tract systems in residents of the Tyumen Oblast and the Far North of different age groups. The features of upper respiratory tract biotopes: nasal and oral cavities are characterized. And also the retrospective analysis of diagnostics of treatment and rehabilitation of healthy residents of the above-mentioned regions and patients with various cardiovascular diseases, respiratory diseases and musculoskeletal system was carried out. The oral micro biota represents an exceptional large ecosystem and is considered the most accessible for scientific research. Modern sources speak about the essential role of opportunistic microorganisms: Staphylococcus aureus and Pseudomonas aeruginosa, in the occurrence of various infectious diseases and complications. The study of human oral cavity, description of its species composition allows one to trace the interaction of micro- and macro-organism to understand the mechanisms of impact of microorganisms, as well as their metabolites on the formation of unhealthy conditions and the human body as a whole. This review article provides a description of the human upper respiratory tract micro biome. Including a great attention is paid to complications associated with cardiovascular pathology, pathology of the respiratory system, urinary system, which may arise due to disturbance of the balance of the micro biome in the human body. The results of the study prove the significance of studying the relationship between the micro biota of the oral and nasal cavities and the risk of upper respiratory tract infections and cardiovascular complications, which makes it possible to correct treatment and increase rehabilitation potential.
Benign gallbladder disease (BGD), namely cholelithiasis and chronic cholecystitis, pose a significant public healthcare problem given their impact on morbimortality and healthcare costs. Furthermore, cholelithiasis and chronic cholecystitis are the most frequent risk factors for developing gallbladder cancer (GBC), a condition that is often incurable at diagnosis due to delayed symptomatology; thus further contributing to the burden of morbidity and mortality. In light of this panorama, some healthcare systems began to adopt prophylactic cholecystectomy (PCH) as a preventive measure in patients diagnosed with BGD, aiming to reduce the potential development of GBC, as well as the need for recurrent consultation to the emergency room due to complications. Indeed, implementing a preventive surgical strategy, particularly in regions with higher incidence of GBC, has become a topic for active discussion and continuous exploration. Evidence regarding PCH and its related benefits is emerging globally, with varied results and perspectives depending on local epidemiology and healthcare resources. As expected, studies across different populations reveal disparities in GBC rates as well as disparities regarding PCH outcomes and benefits. The great heterogeneity within the available data sets the ground for debate on the efficacy and advisability of this preventive approach. This review aims to analyze the impact of PCH on cancer incidence and mortality, adjusting for different populations and making a contrast between the pros and cons of this measure.
This article discusses the influence of various lifestyle factors on blood pressure, such as diet, physical activity and stress. Arterial hypertension is one of the leading risk factors for cardiovascular disease, and adjusting daily habits can significantly improve a person's health status. The role of a balanced diet, including limiting salt and saturated fat, eating foods rich in potassium and magnesium, in lowering blood pressure is discussed. An active lifestyle and regular physical activity help to improve cardiovascular health, reduce stress levels and lower overall blood pressure levels. Stress, in turn, is a key factor that can both directly increase blood pressure and indirectly through negative effects on habits such as diet and activity. The article analyses current research data and offers recommendations for the prevention and control of arterial hypertension through lifestyle changes.
This article discusses the relationship between arterial hypertension (AH) and dental procedures, as well as well as the impact of this disease on treatment and prevention of complications. Arterial hypertension, being one of the most common chronic pathologies of the cardiovascular system, can have a significant impact on the process of dental treatment. The paper analyses the risk factors associated with the increase of blood pressure in patients during dental interventions, the features of pharmacotherapy, as well as well as the role of dentists in the early detection of hypertension. Particular attention is paid to the necessity of correct choice of anesthesia and anesthetic techniques, as well as well as the importance of blood pressure control before, during and after procedures to reduce the risk of complications such as hypertensive crises and bleeding. The article emphasizes the importance of a multidisciplinary approach to the management of patients with arterial hypertension, including coordination between dentists and general practitioners to improve the safety and effectiveness of medical interventions.
Blood pressure (BP) is a key indicator of cardiovascular health, and its control is particularly important in the dental intervention setting where different types of anesthesia are used. This article examines the relationship between blood pressure and the use of anesthesia in dentistry, and reviews safety and recommendations for patients with hypertension and other cardiovascular diseases. The main objective of the study is to evaluate the effect of local and general anesthesia on blood pressure levels in patients and to develop recommendations to ensure the safety of dental procedures. The study analyzed BP changes during and after dental procedures using different types of anesthesia, identified risk groups among patients with hypertension and other cardiovascular diseases, and studied protocols to minimize the risks of complications associated with BP changes. It has been determined that local anesthesia with adrenaline can cause a transient increase in BP, especially in patients with uncompensated hypertension. According to studies, the use of anesthetics without adrenaline has shown less effect on BP. General anesthesia has a more significant effect on BP, including both increases and decreases, which requires careful monitoring. Patients with cardiovascular disease require special monitoring and possibly adjustment of anesthetic doses. Preliminary examination and stabilization of BP before dental procedures are recommended. The administration of anesthesia should be carried out under blood pressure control with the possibility of immediate medical attention if necessary. Accordingly, the use of anesthesia in dentistry requires careful management of patients with high BP and cardiovascular disease. Adequate blood pressure management when using anesthesia in dentistry is a critical aspect to ensure patient safety. Implementation of appropriate guidelines and protocols will minimize risks and improve the quality of dental care for patients with different BP values.
his article examines therapeutic approaches to the care and management of patients who have undergone abdominal surgery. The study focuses not only on postoperative recovery, but also on an integrated approach to ensuring the physical and psychological well-being of patients. The issues of effective control over the process of wound healing, pain management and rehabilitation, including physical rehabilitation and restoration of the functionality of organs that have undergone surgery, are considered. Special attention is paid to the psychological support of patients, since abdominal operations can have a significant impact on their emotional state. The results of the study provide a basis for developing more effective strategies to improve the quality of care and treatment outcomes in this category of patients. The authors also discuss issues related to possible complications after abdomi nal surgery and ways to prevent them. In the context of therapeutic approaches, various methods of infection control, diet optimization and rational use of pharmacotherapy to improve the general condition of patients are considered. An important aspect of the discussion is also the individualization of therapy depending on the nature of the operation performed and the characteristics of the patient's disease. This includes developing personalized rehabilitation and care plans that take into account factors such as age, general health, and the presence of comorbidities. In general, the importance of modern therapeutic strategies aimed at optimizing the results of treatment and the quality of life of patients who have undergone abdominal surgery is emphasized.
Increased levels of cholesterol and triglycerides can be caused by a lack of physical activity, resulting in plaque buildup in blood vessels and metabolic disorders. This study aims to explain the effect of total cholesterol and triglyceride levels before and after a 30-minute aerobic run carried out 4 times a week for 6 weeks on trained football players and an untrained group. This research method uses a quasi-experimental non-control group design that has been determined for the criteria as a research sample. The research sample used a purposive sampling method by taking 15 trained football players and 15 untrained people. Total cholesterol and triglyceride levels were measured before the 30-minute program and after the 30-minute program. The ShapiroWilk test showed a normal distribution. Data were analyzed using paired t-tests. The mean total cholesterol level before 188.06 +/- 43.46 and after 158.86 +/- 31.12. The results of the data analysis showed that there was a significant effect on total cholesterol levels (p=0.000). For the level of triglycerides, the Shapiro-Wilk test showed a normal distribution. The result of the data analysis with Paired t -test showed there was no significant difference between the total triglyceride values of the two groups (p=0.32).
Oxidative stress induced by mercury can cause an inflammatory state in cells that results in cell damage. Free radical formation and decreased antioxidant defences create an imbalance that contributes to the incidence of diabetes mellitus. Mercury as a free radical agent targets its action on pancreatic beta cells and causes defects in these cells resulting in abnormalities in insulin secretion as the pathophysiological basis of diabetes is closely related to apoptosis and necrosis through oxidative stress pathways. One of the components of pancreatic beta cells that mercury targets to cause defects is the endoplasmic reticulum. The role of endoplasmic reticulum in pancreatic beta cells as an intracellular calcium store not only regulates cytosolic calcium signalling but also the conformation of protein folds, so if there is a defect in endoplasmic reticulum homeostasis, known as endoplasmic reticulum stress, it is an early event in the pathophysiology of diabetes mellitus
rethroplasty (UP) is currently considered the gold standard of surgical management for urethral stricture (URS). Although UP has a high success rate and is more costeffective than other alternatives, recurrence of URS remains a significant problem after UP in this context. According to available evidence, the recurrence of URS after UP is determined by several factors, which may be categorized into technique -inherent, strictureinherent, and patient -inherent factors. The different UP techniques have proven to be very efficient overall, but some are more suitable for specific types of stricture; thus, the physician must make informed choices to improve clinical outcomes. Likewise, longer and bulbopenile strictures require unique management because of the significantly greater risk of recurrence. Furthermore, assessing patients' comorbidities like DM and obesity, prior history of endourological procedures, etiology of the strictures, and many other factors is vital to establish preventive measures accordingly. Overall, risk management, proper diagnosis, and optimal surgical choice significantly improve clinical outcomes and reduces URS recurrence rates after UP. Gathering positive predictive factors for URS recurrence allows for realistic yet optimal assessment for the patient and the physician. Likewise, some variables are easily modifiable, which allows for preoperative preventive measures that can significantly increase the success rate of this surgical procedure. This review aims to analyze the risk factors and positive predictive factors for URS recurrence after UP, including the different techniques and surgical approaches.
Cardiovascular events represent an important proportion of the worldwide morbidity and mortality, and thus, an important burden regarding economics and public health. One of the main objectives in medicine is to prevent cardiovascular events, which demands the identification of the population at risk. This has represented a genuine challenge for decades. Although several tables and scales exist to estimate cardiovascular risk, they fail to accurately predict with efficacy all cases of cardiovascular events, in particular in select ethnic populations. In this regard, high sensitivity troponin I (hs-TnI) and high sensitivity troponin T (hs-TnT) have emerged to serve as possible solutions for this scenario. Both are able to predict with fair precision cardiovascular events, so their standardization and use are not far from reality. However, further research is required to define specific cutoff points for various populations in order to avoid the same pitfalls of current more traditional risk factors. The objective of this review is to assess the viability of the evaluation of high sensitivity troponins as cardiovascular risk factors, and their supporting evidence.
Unplanned reintervention (UR) occurs across a broad spectrum of general surgical procedures; and it is considered to be the postoperative complication that confers the highest risk of mortality. As a result, the ability to predict such events can significantly improve the general outcomes of patients. Available evidence concerning risk factors for UR in abdominal surgery is far-reaching but highly segmented. Some risk factors can be applied to many procedures, but others are highly bound to specific procedures. Considering the above, designing a predictive model for all abdominal surgeries is a formidable task. Nevertheless, a general predictive model should be developed to reach as many procedures as possible, and then arranged and segmented to fit specific procedures. This review aims to investigate risk factors associated with UR and available models concerning reoperation decision -making.
The work is devoted to the role of a balanced diet in the prevention of diseases of the gastrointestinal tract. The study is based on the analysis of current scientific data and clinical studies aimed at identifying the effect of nutrients on the health of the digestive system. The authors emphasize the importance of a balanced diet, which includes the necessary number of proteins, fats, carbohydrates, vitamins and minerals. The mechanisms through which various elements of nutrition contribute to maintaining the normal function of the gastrointestinal tract, including stimulation of peristalsis, improvement of digestion and ensuring proper intestinal microflora, are considered. Special attention is paid to the role of diet in the prevention of chronic diseases such as peptic ulcer, chronic gastritis, irritable bowel syndrome, etc. Effective nutrition strategies to reduce the risk of developing these diseases are discussed, including moderate fat intake, increased fiber and vitamin intake, and limiting the consumption of irritating foods. In conclusion, it is emphasized that a conscious and balanced diet plays a key role in maintaining the health of the gastrointestinal tract. Practical recommendations on the formation of a healthy diet that contributes to the prevention of various diseases of the digestive system are proposed. The analysis of these aspects allows us to provide doctors, nutritionists and patients with valuable information for the development of effective nutrition strategies to maintain the health of the gastrointestinal tract.
Background: Pelvic congestion syndrome (PCS) characterized by chronic pelvic pain, frequently linked with perineal or vulvar varices due to reflux or obstruction in the gonadal, gluteal, or periuterine veins. The of study is to evaluating the clinical characteristics and outcomes of patients with pelvic congestion syndrome (PCS) treated with coil embolization. Method: This retrospective descriptive analysis aims to evaluate the clinical characteristics and outcomes of patients with pelvic congestion syndrome (PCS) treated with coil embolization. The study seeks to analyze historical data to provide sights into patient demographics, procedure details, and outcomes. Additionally, it compares these findings with existing literature on the PCS coil embolization procedure. Results: A detailed review of patient records and cathlab database from 2021 to 2023 included 20 female patients with pelvic congestion syndrome treated with embolization. The mean age was 31.35 years, with multiparous women. All experienced chronic pelvic pain for over 6 months, with additional symptoms including dysmenorrhea (40%), dyspareunia (30%), and psychological issues (10%). Trans-abdominal ultrasound was the primary diagnostic tool, with 50% also undergoing CT/MRV. The procedure was successful in all patients, with a mean of 2.3 coils used. Pain levels, measured by VAS, significantly decreased from 8.5 pre-intervention to 2.3 at 18 months' post-intervention. Conclusion: Endovascular coil embolization is a valuable therapeutic option for pelvic congestion syndrome, providing effective symptom relief with a favorable safety profile. While comparative studies show varying outcomes across ferent treatments, embolization remains a cornerstone managing PCS. Continued investigation and refinement of this clinical practice are warranted.
Introduction: Ventilator-associated pneumonia (VAP) is the most common hospital-acquired respiratory infection, making it a significant health problem due to its associated increase in morbidity and mortality, higher medical financial burden, and a substantial impact on public health and the economy. Amongst the benefits of administering nebulized antibiotics for respiratory tract infections, one of the highlights is the ability to deliver effective concentrations of such drugs directly to the site of infection while minimizing systemic adverse effects. Objective: To identify nursing considerations regarding the use of nebulized antibiotics in adults with invasive ventilator-associated pneumonia through a literature review. Methodology: A literature review was conducted using databases such as PubMed, Epistemonikos, and Trip. The search strategy included the MESH terms ventilator-associated pneumonia, nosocomial pneumonia, nebulized antibiotics, and inhaled antibiotics, combined with boolean operators. The PRISMA guidelines were employed for classification and screening. Results: The research showed favorable results from the use of nebulized antibiotics. However, there is a disparity between the large amount of experimental evidence supporting the administration of nebulized antibiotics and the scarcity of clinical studies confirming the efficacy and safety of these drugs and, more importantly, the lack of scientific material published by nursing staff regarding the nursing care to be taken into account.
