Background: Severe trauma is a major cause of death and disability and requires rapid, coordinated management. Traditional emergency care is often fragmented across departments, which may delay critical interventions. This study evaluated the effectiveness of the Trauma Center emergency model, an integrated multidisciplinary system with standardized protocols, compared with conventional care in patients with severe trauma. Methods: This non-randomized time-series study included 100 patients with severe trauma admitted to Zigong Fourth People's Hospital from January to December 2025. Severe trauma was defined as a Shock Index >0.8. Patients were assigned chronologically to a control group receiving traditional emergency care and a study group managed under the Trauma Center model, with 50 patients in each group. Outcomes included time to intravenous access, emergency department processing time, complication rate, and rescue success rate. Results: Compared with the control group, the Trauma Center group had significantly shorter time to intravenous access (12.17 +/- 3.43 vs. 19.79 +/- 5.88 min; mean difference 7.62 min, 95% CI 5.71-9.53; p-value < 0.001) and shorter emergency department processing time (78.32 +/- 25.42 vs. 103.54 +/- 39.27 min; mean difference 25.22 min, 95% CI 11.89-38.55; P < 0.001). The complication rate was lower (14.0% vs. 40.0%; p-value = 0.004), while rescue success was higher (92.0% vs. 80.0%; p-value = 0.003). Conclusion: Implementation of the Trauma Center emergency model in severe trauma care significantly reduces critical time intervals, lowers complication rates, and improves rescue success.
Background: Chronic Obstructive Pulmonary Disease (COPD) seriously threatens the quality of life in middleaged and elderly populations. Respiratory function exercise is a core non-pharmacological treatment, yet patient adherence is often suboptimal. This study aimed to analyze the factors influencing adherence to respiratory function exercise among middle-aged and elderly COPD patients in primary care settings, providing a reference for clinical intervention. Methods: A cross sectional study that employs a total of 100 middle-aged and elderly COPD patients admitted to The People's Hospital of Gaoxian from February 2025 to January 2026 was selected. All participants were hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). General demographic data were collected, and assessments were conducted using anxiety, depression, and social support scales. Adherence to respiratory function exercise was also evaluated. SPSSAU software was used for statistical analysis. Univariate analysis employed the chi(2) test, and multivariate analysis employed logistic regression. Results: Among the 100 patients, 64 (64%) exhibited poor adherence, while 36 (36%) exhibited good adherence. Multivariate logistic regression analysis revealed that age <= 70 years (OR=0.145), educational level of junior high school or below, disease duration <5 years, drug dependence, and anxiety were all risk factors for poor adherence to respiratory function exercise. Conclusion: Adherence to respiratory function exercise in middle-aged and elderly COPD patients is associated with age, educational level, disease duration, drug dependence, and anxiety. Clinical practice should address these factors with targeted measures to improve adherence and prognosis.
The management of complex renal stones presents a persistent and significant challenge in urology. While percutaneous nephrolithotomy (PCNL) remains a standard, retrograde intrarenal surgery (RIRS) has gained prominence as a major minimally invasive alternative, valued for its rapid recovery and favorable safety profile. This narrative review explores how recent technological innovations are expanding the role and efficacy of RIRS for these difficult cases. Key developments include the integration of negative-pressure suction systems, which effectively mitigate stone migration and reduce residual fragment rates. Furthermore, the emergence of artificial intelligence (AI) leverages big data to facilitate personalized surgical planning and intraoperative guidance, enhancing both precision and safety. Concurrently, advancements in high-power, short-pulse laser technology have substantially improved the efficiency and safety of stone dusting. The introduction of novel digital flexible nephroscopes offers superior flexibility and high-definition imaging, proving particularly valuable for stones in challenging locations and for large stone burdens. Finally, combined strategies, such as RIRS with micro-percutaneous nephrolithotomy (MPCNL), represent an effective trend, achieving high stone-free rates while further minimizing overall surgical trauma. In conclusion, the ongoing evolution of RIRS, through its synergy with suction, AI, advanced lasers, and new instrumentation, is profoundly transforming the therapeutic landscape for complex renal stones. These integrated approaches position RIRS as a cornerstone of safer, more efficient, and highly personalized minimally invasive treatment.
Introduction: Prediabetes and T2DM can lead to structural changes in both white and gray matter of the brain, including lacunar infarction, white matter hyperintensity, and brain atrophy. These alterations are strongly associated with cognitive decline and may be linked to the effects of diabetes on brain structures. Therefore, this study aimed to explore the onset of abnormal glucose metabolism on brain gray and white matter microstructure and to examine how clinical features correlate with changes in generalized fractional anisotropy (GFA), fractional anisotropy (FA), and mean diffusivity (MD). Methods: The study included 23 patients with type 2 diabetes mellitus (T2DM), 20 individuals with prediabetes, and 22 with normal glucose metabolism (NGM). Microstructural indices (GFA, FA, MD) were obtained for gray and white matter. Pearson and Spearman correlation analyses assessed relationships between these indices and clinical features. Results: Patients with prediabetes and T2DM showed abnormal GFA, FA, and MD values across multiple gray matter regions, while no significant white matter differences were found (P > 0.05). Cognitive scores did not differ between prediabetes and NGM groups but were lower in the T2DM group. After adjusting for sex, correlation analyses indicated that different clinical features variably affected brain microstructure across glucose-metabolism stages. Conclusion: Abnormal gray matter microstructure may be a potential factor underlying diabetes-related cognitive impairment, particularly in T2DM. Early recognition and intervention of structural brain changes in prediabetes and T2DM are essential to help prevent cognitive decline.
Background Otorhinolaryngological diseases are highly prevalent and significantly impacts patients' quality of life. While adequate health literacy is crucial for effective self-management and optimal clinical outcomes, research focusing specifically on otorhinolaryngology outpatients remains scarce. This population faces unique barriers, as impairments in auditory and speech functions can directly hinder their ability to access and comprehend health information. Therefore, this study aims to investigate the health literacy status of patients with otorhinolaryngological diseases, analyze its influencing factors, and provide a basis for developing targeted intervention strategies. Methods: This cross-sectional study utilized a random sampling method and included 100 outpatients from the Otorhinolaryngology Department of Zigong Fourth People's Hospital, selected between October 1, 2025, and February 5, 2026. Data collection involved a general information questionnaire, the Brief Health Literacy Screen (BHLS), the Family Assessment Device, the Self-Rating Anxiety Scale (SAS), and the Pittsburgh Sleep Quality Index (PSQI). To identify factors linked to health literacy, univariate analysis and multiple linear regression analysis were conducted. Results: The average BHLS score for the 100 patients was (7.3 +/- 2.6), suggesting a general need for improvement in health literacy. Univariate analysis showed significant differences (P < 0.05) in health literacy levels based on gender, age, education level, employment status, medical payment method, and family function. Further, multiple linear regression identified age >= 60 years as an independent negative predictor of health literacy (P<.001). Conversely, having a high school education or above (P < 0.001) and good family function (P < 0.001) were positive predictors. Conclusion: The health literacy level of patients with otorhinolaryngological diseases is jointly fluenced by age, education level, and family function. In clinical practice, focused attention should be given to elderly patients and those with lower educational attainment. Comprehensive intervention measures, including strengthening family support systems, should be implemented to improve their health literacy effectively
Background: Maintenance hemodialysis (MHD) patients often face chronic oxidative stress and a low quality of life. Sidhakarya meditation, a mind-body intervention based on Balinese culture, is believed to modulate the psychoneuro-immunological system. This study aimed to assess the effect of Sidhakarya meditation on malondialdehyde (MDA) levels and quality of life in MHD patients. Methods: A randomized controlled trial with a pre-posttest control group design was conducted on 40 MHD patients at Ari Canti Hospital, Ubud. Three patients declined to participate. Participants were randomly assigned to an intervention group that underwent the Sidhakarya meditation program daily for seven days, and a control group that received standard care. Measured parameters included MDA levels (mg/dL) and a quality of life score based on the WHOQOL-BREF instrument. Results: The results showed that the intervention group experienced significant improvements, with a decrease in MDA levels (median 4.07 mg/dL to 2.80 mg/dL; p<0.001) compared to controls (median 2.8 mg/dLto 2.89 mg/dL; p=0.107) and an increase in quality of life scores in the domains of physical health (18 to 27; p<0.001) compared to controls (27 to 22; p=0.710), psychological (20 to 22.5; p=0.001) compared to controls (22 to 21; p=0.308), social relationships (9 to 11.5; p<0.001) compared to controls (10 to 10; p=0.729), and environmental support (26 to 29.5; p=0.001) compared to controls (28 to 28; p=0.589). Conclusion: Sidhakarya meditation has the potential to reduce oxidative stress and improve the quality of life of MHD patients.
Introduction: Laparoscopic radical nephrectomy (LRN) is an established treatment for localized renal tumors. However, its application in large renal tumors (>7 cm) remains controversial, especially in low-and middle-income settings where surgical expertise and healthcare infrastructure may be inconsistent. This study aimed to compare perioperative outcomes and exploratory overall survival between laparoscopic and open radical nephrectomy in patients with renal tumors > 7 cm in an Indonesian tertiary referral center. Methods: Retrospective cohort analysis was performed at a single tertiary referral center, including patients who had undergone radical nephrectomy for renal tumors > 7 cm between 2017 and 2022. Perioperative outcomes assessed were postoperative pain at 24 hours (VAS), estimated intraoperative blood loss, transfusion needs, operative time, ICU admission, and duration of hospitalization. Overall survival was examined as an exploratory outcome using Kaplan-Meier analysis (with log-rank test) and Cox proportional hazards regression for risk adjustment. Results: Thirty-seven patients were included (LRN n=9; ORN n=28). The LRN group experienced lower postoperative pain scores (mean VAS 2.91 +/- 0.94 vs 4.67 +/- 1.16; p < 0.001), reduced blood loss (median 500 mL vs 2000 mL; p = 0.005), fewer transfusions (45.5% vs 89.3%; p = 0.008), and lower ICU admission rates (9.1% vs 42.9%; p = 0.044). Positive surgical margins were observed only in the ORN group (5.4%). Local recurrence rates were similar between groups (21.4% vs 22.0%; p = 0.643). Although unadjusted survival favored the LRN group, this finding should be interpreted with caution due to potential selection bias and the retrospective study design. Conclusion: In this tertiary center cohort, LRN for tumors > 7 cm was associated with improved perioperative recovery compared with ORN. Survival outcomes were exploratory, indicating the need for larger studies with comprehensive oncologic endpoints.
Introduction: The coexistence of type 2 diabetes mellitus (T2DM) with coronavirus disease 2019 (COVID-19) poses a major global healthcare concern. Even though both have become significant worldwide health issues, little is still known about how they interact in this region of the world. The purpose of this study is to examine the laboratory markers and clinical features of COVID-19-infected individuals with T2DM. Methods: The medical records of hospitalized T2DM patients with proven COVID-19 infection at the Prince Mohammed Bin Abdulaziz Hospital (PMAH) in Riyadh, Saudi Arabia, between March 15, 2020, and July 15, 2020, were examined in this single-center retrospective analysis. Laboratory, clinical, and demographic data were collected and examined. The relationships between different demographic traits and T2DM with COVID-19 infection were evaluated using the Fisher Exact test, binary logistic regression, and odds ratio (OR). The quantitative factors between individuals with type 2 diabetes and those without the disease were compared using the Mann-Whitney U test. A P value of less than 0.05 was deemed significant. Results: About 142 (59.4%) of the 239 patients had type 2 diabetes, and they were substantially older (56 +/- 13.1; P < 0.001) than those without the disease. Among T2DM patients, cough (P = 0.02), tachypnea (P = 0.001), and dyspnea (P = 0.001) were significant symptoms. Among T2DM patients, hypertension (P = 0.001) and hyperlipidemia (P = 0.001) were common comorbidities. Patients with type 2 diabetes had substantially higher levels of creatinine (P = 0.001), blood urea nitrogen (P = 0.004), LDH (P = 0.033), CRP (P = 0.001), and fibrinogen (P = 0.001). Tachypnea (aOR = 3.46 (1.65-7.24) P = 0.001) and dyspnea (aOR = 3.25 (1.49-7.05) P = 0.001) demonstrated statistical significance on binary logistic regression analysis. In both bivariate analysis and logistic regression, hypertension (aOR = 2.07 (1.03-4.14); P = 0.040) and dyslipidemia (aOR = 12.27 (2.63-57.20); P = 0.001) maintained statistical significance. Conclusion: Significantly higher laboratory and inflammatory values are seen in T2DM with COVID-19, underscoring the significance of targeted treatment approaches and resource allocation.
Introduction: Primary headache and epilepsy are common neurological conditions that often coexist, sharing pathophysiological factors such as hereditary vulnerability and cortical spreading depression. The purpose of this study is to examine the quality-of-life, neuropsychological, demographic, and seizure-related characteristics of epilepsy patients with and without concurrent primary headache. Methods: This was a single-center, retrospective study. Between January 2024 and December 2025, clinical information was gathered from 140 epileptic patients receiving care at Zigong Fourth People's Hospital. The two groups were compared in terms of general demographics, seizures, cognitive state, and quality of life. Chi-square tests were used for categorical variables and independent samples t-tests for continuous variables. Results: Significantly more females (41/56 vs. 41/84, P=0.009), longer epilepsy duration (mean difference: 4.91 months, P<0.001), more frequent seizures (mean difference: 1.15 times/month, P<0.001), higher rates of anxiety (31/56 vs. 13/84, P<0.001) and depression (35/56 vs. 24/84, P<0.001), more severe cognitive impairment (mean QOLIE-31 score: 45.16 vs. 60.58, P<0.001). Education level (P=0.068), monthly household income (P=0.073), age (P=0.199), kind of seizure (P=0.915), and number of antiseizure drugs (P=0.240) did not differ statistically significantly between the two groups. Conclusion: The associations between primary headache comorbidity and lower education or income were not statistically significant in this sample and require further investigation in larger, prospective, multicenter studies.
Background: Clinical internship is a critical phase in nursing education, particularly in respiratory medicine, where patient conditions are complex and dynamic. Traditional teaching methods often fail to meet diverse learning needs. Blended leaming, combining face-to-face and online approaches, has been shown to enhance critical thinking, self-directed learning, and academic performance. This study aims to evaluate the effectiveness of an internet-based blended teaching model in improving knowledge, clinical skills, and learning satisfaction among nursing interns. This study aims to evaluate the effectiveness of an Internet-based blended teaching model in respiratory medicine clinical education for nursing interns. Methods: In this prospective randomized controlled study, 60 nursing interns undergoing respiratory medicine rotation between February 2024 and February 2026 were randomly assigned to a control group or an intervention group (n=30 each). The control group received conventional teaching, while the intervention group was trained using the internet with a blended learning model integrating digital platforms (learning management system, WeChat, and online assessments) with bedside teaching. Outcomes included theoretical and practical examination scores, comprehensive competence, self-directed learning ability, and satisfaction. Results: The intervention group achieved significantly higher scores in theoretical knowledge (91.35 +/- 4.20 vs. 85.49 +/- 4.23, P < 0.001 ) and practical skills (91.92+3.97 vs. 85.07 +/- 3.79, P < 0.001 ) Total comprehensive competence scores were also significantly greater (271,88 +/- 13.75 vs. 252.71 +/- 14.45, P < 0.001 ) Self-directed learning ability was significantly improved across all domains, including self-management, information literacy, and collaborative learning (all P <= 0.002 ) . Additionally, satisfaction rates were higher in the intervention group (93.33% vs. 70.00%, P = 0.0191 Conclusion: The internet with a blended teaching model significantly enhances academic performance, dinical competence, and self-directed learning among nursing interns, while also improving satisfaction. These findings support its integration into clinical education, although further multicenter studies are warranted to confirm generalizability.
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. It progresses rapidly and can often develop into septic shock. This pathological process is characterized by vasodilation, signifi-cantly increased capillary permeability, and a sharp decrease in effective circulating blood volume, which easily leads to inadequate tissue perfusion and multiple organ failure, resulting in high mortality. In this context, early and precise volume management is crucial for stabilizing circulation, improving tissue perfusion, and ultimately reducing patient mortality. Current volume management has shifted from reliance on traditional static parameters to strategies centered on dynamic indicators and functional hemodynamic monitoring. The application of novel biomarkers and point-of-care ultrasound techniques provides new perspectives for the accurate assessment of vol-ume status. However, achieving individualized management at different stages of resuscitation and balancing the benefits of resuscitation against the risks of fluid overload remain major challenges in current clinical practice. In conclusion, volume management in sepsis is a complex and dynamic process. Future research should focus on inte-grating multimodal monitoring data to establish phased, individualized precision management protocols, thereby further improving patient outcomes.
Background: Pharmaceutical care is a patient-centered approach in which pharmacists assume responsibility for patients' medication needs to achieve positive therapeutic outcomes. Globally, community pharmacists contribute to medication adherence, counseling, and chronic disease management. In Saudi Arabia, community pharmacies serve as primary access points to healthcare; however, pharmaceutical care remains underdeveloped due to regulatory, structural, and educational barriers. Therefore, this study aims to provide a nationwide assessment of pharmaceutical care in Saudi community pharmacies Methods: A nationwide cross-sectional survey was conducted among licensed community pharmacists across the five administrative regions of Saudi Arabia. A structured bilingual questionnaire assessed demographics, pharmaceutical care practices, barriers, and research involvement. Stratified sampling targeted 450 pharmacists. Data were collected electronically and analyzed using descriptive and inferential statistics, including chi-square tests and ANOVA. Results: A total of 420 pharmacists participated. Most were aged 25-34 years (46.9%) and female (57.1%), with over half having less than one year of practice experience. Counseling was routinely provided by 81.0% of respondents, while 44.8% always assessed drug-drug interactions. Adequate training was reported by 70.2%. Awareness of pharmaceutical care research was limited (42.1%), with 29.3% having participated in research; 84.3% expressed interest in future involvement. Counseling was the most common service (75.5%), while barriers included time constraints (59.5%), lack of patient interest (19.3%), and insufficient training (15.5%). Gender and years of experience were significantly associated with counseling frequency and training adequacy (p < 0.05). Conclusion: Pharmaceutical care in Saudi community pharmacies remains limited, with counseling as the predominant service. Barriers include time constraints, insufficient training, and a lack of systemic support. Despite these challenges, pharmacists' interest in research and professional development indicates strong potential for capacity building. Policy reforms, structured training, and collaborative research networks are needed to align practice with international standards and Saudi Vision 2030
Background: Growing exposure to both medical and environmental sources of radiation has raised important public health concerns, yet many individuals still have a limited understanding of the associated risks and their potential link to cancer. Exploring how the public perceives these risks and how such perceptions shape preventive actions is essential for guiding educational and awareness efforts. Objectives: This study aimed to examine public knowledge, attitudes, and practices regarding radiation safety and cancer prevention, while also identifying demographic factors that contribute to stronger preventive behaviors. Methods: A cross-sectional online survey was administered to adults in Saudi Arabia. The survey captured four domains: knowledge of radiation risks, attitudes toward safety and cancer prevention, preventive practices, and perceived barriers. Descriptive analysis, Pearson correlation, and multiple linear regression were used to explore relationships between these domains and to determine predictors of preventive behavior. Results: A total of 523 adults participated in the study. Higher knowledge was associated with more positive attitudes (r = 0.56, p <0.001) and improved practices (r = 0.49, p<0.001). Attitudes showed the strongest connection with preventive behavior (r = 0.63, p <0.001). Barriers were inversely related to knowledge, attitudes, and practices. Regression findings showed that stronger attitudes (beta= 0.41, p <0.001), greater knowledge (beta= 0.23, p < 0.001), fewer barriers (beta = -0.22, p < 0.001), female gender (beta = 0.09, p = 0.009), and higher education (beta = 0.07, p = 0.03) were significant predictors of better preventive practices. Conclusion: Although the public shows moderate awareness of radiation risks, notable gaps remain in preventive action and safety behaviors. Enhancing knowledge, fostering positive attitudes, and reducing perceived barriers are essential components for strengthening radiation safety practices and supporting cancer prevention initiatives.
Background: Partial tears of the supraspinatus tendon are a common cause of shoulder pain and functional impairment. Non-operative treatment is often preferred, particularly in regions where access to surgical care is limited. Corticosteroid injections are widely used for pain control, while platelet-rich plasma (PRP) injections have been proposed as a biological treatment that may enhance tendon healing. However, comparative evidence regarding their clinical effectiveness remains inconsistent. The purpose of this study was to evaluate the effects of traditional corticosteroid injection vs ultrasound-guided platelet-rich plasma injection on pain alleviation and functional improvement in patients with partial supraspinatus tendon rupture. Methods: A prospective cohort study was conducted at a tertiary orthopaedic center in Mongolia. Patients with partial supraspinatus injuries verified by MRI were randomized to receive either a subacromial corticosteroid injection or a single ultrasound-guided leukocyte-poor PRP injection. The Oxford Shoulder Score (OSS) was used to measure shoulder function, and the Visual Analog Scale (VAS) was used to measure pain severity. Outcomes were measured at baseline, 1 month, and 6 months following the intervention. Results: 31 patients divided into 15 patients in the intervention group (PRP) and 16 patientss in the control group (corticosteroid). Both groups showed improvement in OSS and VAS score after agent administration at several observation (p<0.001). 6 months, the PRP group showed significantly greater improvement in pain reduction and functional scores compared with the corticosteroid group (p < 0.05). No fatal complications were reported. Conclusion: PRP injection demonstrated superior mid-term clinical outcomes, suggesting a potential advantage for sustained recovery. PRP may be considered a valuable non-operative treatment option, particularly in Asian populations where long-term functional preservation is essential.
Background: Falls are a significant cause of injury, disability, and loss of independence among older adults worldwide. Physiotherapy-based interventions play a central role in fall prevention; however, the global research structure, thematic evolution, and collaborative patterns in this field have not been systematically mapped. This study aims to conduct a large-scale bibliometric analysis of international research explicitly related to physiotherapy for fall prevention among older adults from 2000 to 2025. Methods: A bibliometric analysis was conducted using the OpenAlex database to identify peer-reviewed journal articles published between 2000 and 2025. Eligible studies focused on physiotherapy or rehabilitation interventions for fall prevention in adults aged >= 65 years. Only English-language human studies were included. Bibliometric analyses were performed using the bibliometrix package in R and visualised using VOSviewer. Publication trends, citation patterns, co-authorship networks, keyword co-occurrence, and co-citation clusters were analysed. ARIMA models were applied to forecast publication and citation trends. Results: A total of 963 articles were included. Annual publications increased steadily, with a marked rise after 2018 and a peak in 2025. The most productive countries were the United States, the United Kingdom, Canada, and Australia, supported by strong international collaboration networks. Keyword and co-citation analyses identified 14 thematic clusters, with dominant themes including balance and strength training, gait rehabilitation, frailty management, Otago-based programmes, and emerging digital and tele-rehabilitation approaches. Forecasting indicated sustained publication output through 2030, although annual citation growth is expected to stabilise. Conclusion: Physiotherapy-focused fall-prevention research has expanded substantially over the past 25 years, with increasing thematic diversity and global collaboration. Core research remains centred on exercise-based interventions, while newer studies emphasise technology-supported and community-based models of care. These findings provide a comprehensive overview of the field and inform future research, policy, and clinical practice.
Link of Video Abstract: https://youtu.be/fvoK2OTh-F8 Objective: Schizophrenia, a severe mental disorder with unclear etiology, involves disturbances in perception, thinking, emotions, and behavior, causing significant patient and family burdens. Enhancing understanding and psychological support is crucial. In China, schizophrenia prevention and treatment efforts are growing alongside clinical research advancements. Subjects and Methods: This study explores the benefits of novel antipsychotic combination therapy in schizophrenia treatment, focusing on reducing adverse reactions and improving quality of life. A systematic literature review was conducted using databases like Pubmed, Ovid,WOS， Medline, Embase, and Scopus, analyzing interactions among schizophrenia, innovative drug therapy, and adverse reactions to assess prognostic outcomes. Results: Compared to monotherapy, novel antipsychotic combination therapy significantly benefits patients and families, reducing adverse effects, improving efficacy, alleviating reactions, and lowering relapse risk. This study provides critical evidence for clinicians. Conclusions: Novel antipsychotics are being developed to better address schizophrenia and bipolar disorder symptoms. This paper reviews recent clinical advances, mechanisms, and evidence on efficacy, safety, and tolerability, demonstrating combination therapy’s superiority over monotherapy in reducing side effects and enhancing outcomes. Keywords: Schizophrenia treatment, novel antipsychotic drugs, research exploration, latest developments, monotherapy, combination therapy.
Video Abstract: https://youtu.be/Vw8nboaiUa4 Abstract: Objective: This study provides a comprehensive overview of Urology Oncology Nursing, exploring its scope, roles, significance, and challenges, while highlighting opportunities for professional growth and future trends in the field. Through literature review and expert insights, it examines the evolving role of Urology Oncology Nurses in cancer care and innovative approaches to patient needs. Subjects and Methods: A systematic analysis of scholarly literature, including studies, guidelines, and expert opinions, was conducted. Key focus areas included patient care models, assessment and diagnosis, monitoring and management strategies, patient education, support systems, and interdisciplinary collaboration. Results: Urology Oncology Nursing is pivotal in holistic urologic cancer care, emphasizing patient-centered approaches amid challenges and opportunities. The study identifies emerging trends, interdisciplinary collaboration, and the growing recognition of nurses' roles in optimizing outcomes. It underscores the need for adaptive strategies to address evolving healthcare demands. Conclusions: Urology Oncology Nursing is essential for improving patient outcomes, requiring sustained investment, professional development, and interdisciplinary partnerships. Integrating evidence-based practices and innovative technologies is critical to advancing care quality and meeting patient needs. The study advocates for continued focus on this specialty to drive transformative change in cancer care.
Video Abstract: https://youtu.be/qU2IS7W1tIw Background: Stevens-Johnson syndrome (SJS) is a severe, acute mucocutaneous disorder primarily triggered by medications, marked by significant morbidity and mortality. Despite improved supportive care, therapeutic management of SJS remains controversial due to inconsistent evidence regarding the optimal immunomodulatory approach. Systemic corticosteroids and intravenous immunoglobulin (IVIG) are commonly employed treatments, either individually or in combination, yet consensus on their comparative efficacy and safety is lacking. This systematic review aims to clarify the clinical effectiveness and safety of combining IVIG with systemic corticosteroids compared to corticosteroid monotherapy in patients with SJS. Methods: A systematic literature search was conducted in accordance with PRISMA guidelines, utilizing electronic databases. The databases searched included PubMed, Scopus, Google Scholar, and the Cochrane Library. Included studies are clinical trials on SJS, SJS-TEN, and TENS. All studies were evaluated using the Newcastle-Ottawa scale. Result: Of the 385 studies in the initial search, only eight cohort studies were eligible for this review, representing the analysis of 481 patients worldwide. Disease severity was primarily assessed using the SCORTEN (Severity of Illness Score for Toxic Epidermal Necrolysis) system in most studies, with mean and median SCORTEN scores ranging from 1.63 to 3. Combination therapy was associated with trends toward lower mortality, significantly faster disease resolution, and shorter hospitalisation time across multiple studies. Combination therapy arrests disease progression earlier, potentially reducing the total dose of corticosteroid needed. All studies reported adverse events and complications, including infections and IVIG-related adverse events (such as fever and chills). Conclusion: The combination of IVIg and corticosteroids may offer superior advantages in terms of increased survival benefits compared to corticosteroid monotherapy.
Background: Fluid overload (FO) is commonly associated with cardiovascular complications, but its role in promoting systemic inflammation, particularly in dialysis patients, has received increasing attention. Inflammation is believed to contribute to the worsening outcomes in fluid-overloaded individuals. This systematic review aims to evaluate the role of fluid overload and inflammation levels in CKD patients. Methods: A systematic review was conducted by searching PubMed, Embase, and Scopus databases to identify studies examining the relationship between fluid overload and pro-inflammatory mediators (TNF-α, CRP, IL-6) in dialysis patients. Studies were screened for relevance, duplicates and reviews were excluded, and data were extracted for analysis. The risk of bias was assessed for each included study. Results: Out of 826 initially identified studies, six studies met the inclusion criteria, comprising a total of 6,085 dialysis patients. All included studies reported on the association between the degree of fluid overload and inflammatory marker levels. Patients with fluid overload consistently showed significantly higher levels of CRP, IL-6, and TNF-α compared to normovolemic controls (p < 0.001). Conclusion: Fluid overload is strongly associated with elevated levels of systemic inflammatory markers in dialysis patients, suggesting a bidirectional relationship between fluid status and inflammation. These findings highlight the need for long-term, randomized studies with larger sample sizes to elucidate this relationship and its clinical implications further.
Introduction: Recurrent strokes can occur immediately, months, or years after the first attack. One of the most common risk factors for this occurrence is hypertension. This study aims to determine the relationship between hypertension and the occurrence of recurrent strokes. Methods: This observational analytical study uses a case-control study approach with a sample size of 70 patients, divided into 35 patients in the case group and 35 patients in the control group which were selected using a total sampling technique. Data were collected through the patient medical records at Sultan Agung Islamic Hospital Semarang and then analyzed using the Chi-Square test and Odds Ratio (OR) to determine the relationship between the risk of hypertension and the occurrence of recurrent stroke. Result: The research results show that in the case group, 30 patients (85.7%) experienced recurrent strokes with hypertension, and 5 patients (14.3%) experienced recurrent strokes without hypertension. The hypothesis test results in this study obtained a p-value of 0.029 (p<0.05) and OR = 3.545 (CI 95% = 1.102 – 11.411). Conclusion: Hypertension has a significant relationship with the occurrence of recurrent stroke, with a risk of 3.545 times higher for experiencing recurrent stroke compared to stroke patients without hypertension. Therefore, patients with hypertension require hypertension management to prevent recurrent stroke events.
