bluuebunny/crossref_metadata_2025 huggingface dataset:
Physical treatment of posttraumatic elbow contractures in children – our experience
Authors: Gocevska Marija , Nikolikj Dimitrova Erieta , Koevska Valentina , Mitrevska Biljana , Gjerakaroska Savevska Cvetanka , Kalchovska Biljana , Manoleva Maja , Todorovic Lazar
Published: May 2023

The most common complications of elbow trauma are contractures and neurovascular injuries. The complications can be a result of the initial injury, but they can also be a result of a surgical treatment. In addition to orthopedic treatment of elbow fractures, physical therapy and rehabilitation play a significant role in treatment of posttraumatic contractures. To determine the effects of physical therapy and rehabilitation of posttraumatic elbow contractures in children. This was a retrospective cross-sectional study conducted in the University Clinic for Physical Medicine and Rehabilitation, Skopje in the period 01.01.2021 – 01.07.2022. A total of 52 children were included, at the age between 2 and 13 years who had a posttraumatic elbow contracture, limited range of motion, pain and/or limitations in accomplishing daily activities. Depending on the clinical finding, children underwent a relevant physical therapy (kinesitherapy, functional therapy, electrotherapy, thermotherapy, hydrotherapy and magnetotherapy) in duration of three weeks. For assessing the effects of the rehabilitation therapy, the range of motion of the elbow and forearm was examined along with the Flynn’s scale in all children, prior to and after completion of the physical treatment. Applied physical treatment resulted in a significant improvement in all analyzed movements such as: elbow flexion (p=0.00001), elbow extension (p=0.00001), forearm pronation (p=0.00001), forearm supination (p=0.0000) and Flynn’s scale (p=0.0000). After completion of the rehabilitation treatment, excellent results were registered in 41 (85%) children, moderate in 10 (19.23%) and favorable in 1 (1.92%). Timely and adequate application of physical therapy and rehabilitation can significantly improve the final outcome in treatment of posttraumatic elbow contractures in children. A combination of different physical procedures adequately applied and personalized can significantly improve the range of motion of the elbow.
The Impact of Posyandu Cadre Training on the IYCF-Related Knowledge, Attitudes, and Communication Skills
Authors: Ekayanthi Ni Wayan Dian , Susilawati Enung Harni , Pramanik Novita Dewi
Published: May 2023

BACKGROUND: Undernutrition, malnutrition, and stunting all have a detrimental effect on the developing newborn. Nutzritional problems are prevented when the mother and family provide proper nutrition, which involves assistance from the community. Support from the community must be established through the empowerment of posyandu cadres who educate and motivate mothers and families about proper infant and young child feeding (IYCF).
AIM: The study’s objective was to assess the impact of complementary feeding training on infant feeding patterns.
METHODS: The study employed an incomparable control group. The sample consists of 50 currently active posyandu cadres (25 persons in the intervention group and 25 persons in the control group). Analysis was performed using the t test, independent t test, Wilcoxon, and Mann–Whitney test.
RESULTS: Significant changes in knowledge, attitudes, and communication abilities were discovered between cadres who received training (intervention group) and those who did not (control group) before to and during the intervention. Cadres who have been taught have a significant impact on baby feeding practices.
CONCLUSION: It was recommended that health cadres be included into health promotion activities, particularly IYCF for women and families.
Perceptions of COVID-19 Vaccines Side Effects
Authors: Shabani Zamira , Guli Arketa , Kraja Julian , Ramaj Arlinda , Podgorica Nertila
Published: May 2023

BACKGROUND: Vaccines are one of the best interventions developed for eradicating COVID-19. In Albania, COVID-19 vaccination uses different types of vaccines: Pfizer, AstraZeneca, CoronaVac, and Sputnik V. Like any other vaccine, these have side effects too.
AIM: This study was carried out to identify the perception of the side effects of vaccines.
METHODS: A quantitative study using a cross-sectional survey was conducted between April and September 2021 to collect data on the effects of the COVID-19 vaccine among individuals in Shkodra region. Data were collected online through a self-administered survey created on Google Forms which had been randomly delivered to individuals (aged ≥18 years) using social media sites (Email and WhatsApp). All data collected were analyzed with Microsoft Office Excel 2010, using the exact Fisher’s test and ꭓ² test.
RESULTS: This study included 292 citizens, out of which 200 were female and 92 were male; 62% were from urban areas and 38% from rural areas of Shkodra region. The random sample of the citizens who took part in this study is 44.5% (18−30 years old). A massive percentage of the participants, 66.4%, had received the second dose of the vaccine. Our study shows that 55.8% of these citizens have had side effects after the first vaccination dose, and only 43.8% have had side effects after the second dose. About 80.6% of the participants were well informed about the type of vaccine they got.
CONCLUSIONS: Side effects from vaccines were reported. Injection site pain and fatigue were the most common first dose side effects (55.8%). The same side effects were reported for the second dose. The side effects were presented during the first 12 h after the vaccination in most cases. Side effects were more prevalent in people >50 years old. Older people have a higher probability to have more side effects from the COVID vaccine. There is no statistically significant relationship between gender and the presence of the side effect from the COVID vaccine. People living in urban areas have a higher probability to have side effect from COVID vaccine comparing with people living in rural areas. People being vaccinated with Pfizer vaccine have a higher probability to admit the presence of side effects.
The Risk Factors of Obesity in Children during COVID-19 Pandemic Era in Gorontalo City
Authors: Irwan Irwan , Mokodompis Yasir , Ayini S lalu Nur , Mallongi Anwar
Published: May 2023

BACKGROUND: Obesity is a condition that is often associated with an increased risk of infection for coronavirus disease 2019 or COVID-19, which can be fatal or even cause death.
AIM: The study aimed to analyze the risk factors of obesity incidents in children during COVID-19 pandemic era in Gorontalo City.
MATERIALS AND METHODS: The risk factors for obesity include physical activity, history of obesity, fast food consumption, sleep duration at night, and breakfast. It applied analytical observational research with a case–control study design, matching the gender and age. The case was students when measured with a body mass index (BMI) equal to or above 25 kg/m2, while the control was student when measured with a BMI of 18.5–22.9 kg/m2. At the same time, the numbers of samples were 150 children in which the sampling was carried out non-random by applying purposive sampling technique.
RESULTS: Finding denoted that all the variables examined significantly correlated with obesity incidents during COVID-19 pandemic, with odds ratio (OR) value was <1. Specifically, the physical activity variable had the highest OR value compared to other variables, namely, OR 2.939, and this meant that adolescents who do not exercise or exercise <3 times a week during the COVID-19 period were at 2.939 times risk compared to adolescents who exercise 3 times a week.
CONCLUSION: The finding of this study concluded that in the COVID-19 pandemic era, physical activity or exercise is the most influential risk factor for the incidence of obesity compared to other variables.
Firmicutes/Bacteroidetes Ratio of Gut Microbiota and Its Relationships with Clinical Parameters of Type 2 Diabetes Mellitus: A Systematic Review
Authors: Kusnadi Yulianto , Saleh Mgs Irsan , Ali Zulkhair , Hermansyah Hermansyah , Murti Krisna , Hafy Zen , Yuristo Eddy
Published: May 2023

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a global health problem with multifactorial etiopathogenesis. Recent studies show gut microbiota dysbiosis that plays a crucial role in pathogenesis and complications of T2DM. Firmicutes and Bacteroidetes phylum ratio (F/B ratio) is one of the markers for gut microbiota dysbiosis which remains to be investigated in recent decades.
AIM: The present study summarized the correlation between B/F ratio with some clinical parameters of T2DM.
METHODS: A systematic review of the literature for clinical studies was performed on PubMed, ProQuest, and Google Scholar. Studies were assessed for risk of bias using Newcastle–Ottawa scale. All observational cross-sectional, case–control, and cohort studies that studied F/B or B/F ratio in T2DM were included. Key evidence was analyzed and qualitatively synthesized.
RESULT: Seven relevant studies were included. Five studies were high-quality and two studies were medium-quality. The F/B ratio of the gut microbiota varies in different types of T2DM and is associated with different clinical parameters. The F/B ratio decreased inT2DM and had significant negative correlation with OGTT blood glucose but had unsignificant correlation with fasting fasting blood glucose, postprandial blood glucose, and HbA1C. The F/B ratio might increase in T2DM and was positively correlated with lean tissue index and associated with the wider left atrial size.
CONCLUSION: Current systematic review demonstrated that intestinal microbiota dysbiosis played a key role in the pathogenesis of T2DM. The gut microbiota F/B ratio was varied and was associated with various clinical parameters in T2DM.
Comparison of Serum Vitamin D Levels in Patients with Severe Preeclampsia and Normal Pregnancy at Dr. Zainoel Abidin Regional General Hospital Banda Aceh
Authors: Yeni Cut Meurah , Ayu Dara Meutia , Dewi Tgk Puspa , Hasanuddin Hasanuddin , Nora Hilwah
Published: May 2023

AIM: This study aims to assess differences in the mean maternal Vitamin D levels between severe preeclampsia (SPE) and normal pregnant women at the Dr. Zainoel Abidin Hospital Banda Aceh, Indonesia.
METHODS: This research was a case–control study conducted at the Dr. Zainoel Abidin Regional General Hospital Banda Aceh. Pregnant women with confirmed SPE and normal pregnancies were involved in the study. The level of 25(OH)D3 was assessed by taking serum samples and examined by the enzyme immunoassay method. The Mann–Whitney U test analysis was conducted for bivariate analysis with a 95% confidence level.
RESULTS: A total of 82 participants were involved in this study, with 41 subjects in the case group and 41 patients in the control group. A total of 30 SPE patients (70.3%) showed moderate Vitamin D deficiency. The mean levels of 25(OH)D3 in the SPE and normal pregnancy groups, respectively, were 14.43 ng/mL and 27.94 ng/mL (p < 0.001). Based on the 20 ng/mL cutoff point, the difference in 25(OH)D3 levels between the two groups showed an odd ratio (OR) of 15.05.
CONCLUSION: Serum Vitamin D levels in SPE patients were two times lower than in the normal group. Evaluation of serum Vitamin D levels needs to be carried out periodically during pregnancy as a screening and diagnostic effort to prevent the potential development of SPE.
Advantages of Total Bilirubin for Predicting Malignant Obstructive Jaundice, A Combination of the Pandemic Era and Limited Resources Settings
Authors: Suchitra Avit , Rivai M. Iqbal , Mitra Juni , Rachman Irwan Abdul , Suswita Rini , Tansa Rizqy
Published: May 2023

BACKGROUND: Hepatopancreatobiliary (HPB) cancer incidence and mortality are increasing worldwide. An initial diagnostic predictor is needed for recommending further diagnostic modalities, referral, and curative or palliative decisions. There were no studies conducted in area with limited accessibility setting of the COVID-19 pandemic, coupled with limited human resources and facilities.
AIM: We aimed to investigate the advantages of total bilirubin for predicting malignant obstructive jaundice, a combination of the pandemic era and limited resources settings.
METHODS: Data from all cholestasis jaundice patients at M. Djamil Hospital in Pandemic COVID-19 period from July 2020 to May 2022 were retrospectively collected. The data included demographics, bilirubin fraction results, and final diagnosis. Bivariate analysis for obtain demographic risk factor, and Receiver Operating Characteristics (ROC) analysis for getting bilirubin value.
RESULTS: Of a total 132 patients included, 35.6% were malignant obstructive jaundice, and Pancreatic adeno ca was the most malignant etiology (34.4%). Bivariate analysis showed a significant correlation between age and malignant etiology (p = 0,024). Direct and total Bilirubin reach the same level of Area Under Curve (AUC). Total bilirubin at the cutoff point level of 10.7 mg/dl had the most optimal results on all elements of ROC output, AUC 0.88, sensitivity 76.6%, specificity 90.1%, +LR 8.14, and -LR 0.26.
CONCLUSION: The bilirubin fraction is a good initial indicator for differentiating benign and malignant etiology (AUC 0.8–0.9) in pandemic era and resource-limited areas to improve diagnostic effectiveness and reduce referral duration.
Cisplatin-induced Nephrotoxicty and its Predisposing Factors for Unrecovered Kidney Injury: A Report from Indonesia National Cancer Center
Authors: Sutandyo Noorwati , Wahyuni Puteri , Kurniawati Sri Agustini , Tadjoedin Hilman , Adella Devina
Published: May 2023

BACKGROUND: Cisplatin-induced nephrotoxicity is the most common and devastating side effects which affects long-term outcome. It may be reversible in some patients but may also cause permanent kidney injury.
AIM: This research aims to evaluate risk factors of cisplatin nephrotoxicity and unrecovered kidney function at national cancer hospital in Indonesia.
METHODS: This is a retrospective and cohort study conducted at Dharmais National Cancer Hospital, Jakarta, Indonesia. All cancer patients aged 18 years old and above, who received cisplatin-based regimen as the first-line chemotherapy and completing all cycles with at least four cycles, were included in the study. Demographic data were collected and kidney function was evaluated using estimated glomerular filtration rate (eGFR) before, 3 times during chemotherapy, 1 and 3 months after the last dose.
RESULTS: A total of 177 patients were included in the analysis, with mean age of 45.80 ± 11.75 years old, majority diagnosed with nasopharynx cancer (58.8%), and have baseline eGFR of 102.76 ± 20.68 mL/min 1.73m2. Nephrotoxicity is occurred in 80 (45.2%) patients with 27 (15.3%) toxicity occurred after the first cycle. Age above 50, hypertension and non-steroidal anti-inflammatory drugs (NSAID) use associated with increased risk of cisplatin-induced nephrotoxicity. Nephrotoxicity risk factors include age above 50 (OR 4.18, 95% CI 2.11–8.28; p < 0.0001), hypertension (OR 2.03, 95% CI 1.03–4.01; p = 0.040), and NSAID use (OR 2.34, 95% CI 1.22–4.93; p = 0.025). Risk factors of patients who unrecovered above 75% eGFR baseline were hypertension (OR 0.47, 95% CI 0.17–0.56; p = 0.001) and gender (OR 0.018, 95% CI 0.03–0.95; p = 0.043).
CONCLUSION: Nephrotoxicity occurs in 45.2% patients throughout cisplatin-based chemotherapy cycles. Risk factors of nephrotoxicity includes age above 50, hypertension, and NSAID while hypertension and female gender are risk factor for not recover above 75% eGFR baseline after cisplatin cycles.
Serum Level of Granulocyte-macrophage Colony-stimulating Factor in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis
Authors: Huyen Tran Thi , Lan Pham Thi
Published: May 2023

BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse drug reactions. Activated T-cells secrete high amounts of cytokines that increase the expression and activity of keratinocytes, including granulocyte-macrophage colony-stimulating factor (GM-CSF).
AIMS: The aims of this study were to evaluate the serum level of GM-CSF in SJS and TEN as well as the relationship between it and the progress of SJS and TEN.
METHODS: This was a sectional descriptive study conducted at the National Hospital of Dermatology and Venereology, in Hanoi, Vietnam, from October 2017 to September 2019. Forty-eight SJS/TEN patients, 43 erythema multiforme (EM) patients, and 20 healthy controls (HCs) participated. GM-CSF levels were measured using the fluorescence covalent microbead immunosorbent assay (ProcartaPlex Immunoassay Panels kit, Thermo Fisher Scientific, USA). The Mann–Whitney U-test was used to compare serum SJS/TEN levels of the two groups. The Wilcoxon tests were used to compare quantitative variables before and after the treatment. Differences were considered to be statistically significant at p < 0.05.
RESULTS: There were 19 SJS patients (39.5%) and 29 TEN patients (60.5%). The mean age was 49.3 years, range of 19–77 years. The male patients were 47.9%. The most common causative drugs were traditional medicine (29.1%), followed by carbamazepine (12.5%), and allopurinol (12.5%). On the day of hospitalization, the mean serum level of GM-CSF in the SJS/TEN group was 10.6 pg/mL, which was significantly higher than that of the EM group (p < 0.05) but not higher than that of the HCs group and was higher than that on the day of re-epithelialization (3.6 pg/mL) and the difference was statistically significant with p < 0.05.
CONCLUSION: Serum GM-CSF level can be a good biomarker to evaluate the progress of SJS/TEN.
The Survival Probability of Covid-19 Patients with Type 2 Diabetes Mellitus during Pandemic at Al Ihsan Hospital, West Java Province, Indonesia
Authors: Septiriani Oka , Sudaryo Mondastri Korib , Syarif Syahrizal , Citra Citra
Published: May 2023

BACKGROUND: The high prevalence of diabetes mellitus (DM) in the population causes DM to become one of the most common comorbidities of coronavirus disease 2019 (COVID-19). Patients with diabetes have a higher risk of experiencing serious complications from COVID-19 and even death.
AIM: This study was aimed to determine the difference in survival probability of COVID-19 patients, based on their DM status and to determine the association between type 2 DM and COVID-19 mortality at Al Ihsan Hospital, West Java Province, Indonesia.
METHODS: The population of this retrospective cohort study were COVID-19 patients, aged ≥18 years and were treated at Al Ihsan Hospital, from March 2020 to December 31, 2021. Differences in survival probability were obtained from survival analysis with Kaplan–Meier. Cox Proportional Hazard regression was used to determine the association between type 2 DM and COVID-19 mortality.
RESULTS: Totally, 308 confirmed positive COVID-19 patients were recruited in this study. During the 21 days of observation, survival probability of COVID-19 patients with type 2 DM was significantly lower than those without type 2 DM (71.24% vs. 84.13% respectively, with p = 0.0056). There was a statistically significant association between type 2 DM and COVID-19 mortality after controlling for age, cough symptoms, acute respiratory distress syndrome, vaccination, chronic kidney disease, ventilator use, antiviral therapy, and the percentage of bed occupation rate COVID-19 isolation at admission. The adjusted hazard ratio showing association between type 2 DM and COVID-19 mortality in the final model of multivariate analysis was 2.68 (95% CI 1.24–5.73).
CONCLUSIONS: The survival probability of COVID-19 patients with type 2 DM was significantly lower than those without type 2 DM. COVID-19 patients with DM in Al Ihsan Hospital were almost 3 times more likely to be fatal as compared COVID-19 patients without DM.
Knowledge about COVID-19 and its Precautionary Measures among Healthcare Workers at the National Cancer Institute, Cairo University
Authors: Atef Nora , Bendary Mohamed , Khater Amira
Published: May 2023

BACKGROUND: The core of the healthcare system is healthcare workers (HCWs). A skilled and healthy workforce is essential during a health emergency like the coronavirus disease 2019 (COVID-19) epidemic.
AIM: This study evaluated knowledge of COVID-19, its preventive measures, and factors affecting it among HCWs at the National Cancer Institute (NCI), Cairo University to determine their desire to obtain the available COVID-19 vaccines in addition to the factors that may affect it.
METHODS: This descriptive cross-sectional study included 151 HCWs in Egypt using a self-administered questionnaire created by the researchers after examining the information supplied by the Egyptian Ministry of Health and Population, World Health Organization, and the relevant research regarding knowledge assessment. Initially, demographic data were collected. Participants were asked their source of knowledge about COVID-19 and their intent to receive the available vaccines. Knowledge about COVID-19 and preventive measures was compared between different HCWs in NCI. In addition, knowledge score was compared according to different factors to determine factors affecting knowledge.
RESULTS: Physicians represented about 40% of the total number of participants. HCWs’ knowledge of COVID-19 was higher among physicians, with a higher percentage of correct answers than the other two groups (nurses and pharmacists and employees and technicians). Younger age groups had a significantly higher median knowledge score than the older groups. Physicians had significantly higher median scores than employee and technician groups.
CONCLUSION: The overall knowledge about COVID-19 and its preventive measures among HCWs was generally good, especially among physicians more than allied health professionals. However, some of the virus-related knowledge was less advanced than expected for the HCWs position.
Nuclear Factor Erythroid 2-Related Factor 2 Versus Reactive Oxygen Species: Potential Therapeutic Approach on Fighting Liver Fibrosis
Authors: Setiawati Lenny , Liem Isabella Kurnia , Husna Firda Asma'ul
Published: May 2023

Chronic liver disease (CLD) is a progressive deterioration of the liver due to exposure to viruses, drugs, fat accumulation, and toxicity which lead to an imbalance between extracellular matrix accumulation and degradation. Accumulation of the extracellular matrix is a normal liver response at the beginning of the injury. However, increasing extracellular matrix accumulation leads to fibrosis, cirrhosis, and organ failure. Until today, liver transplant is the gold standard therapy for end-stage CLD. Unfortunately, the liver transplant itself faces difficulties such as finding a compatible donor and dealing with complications after treatment. This review provides further information about nuclear factor erythroid 2-related factor 2 (Nrf2) as an alternative approach to fight liver fibrosis. Transformation of hepatic stellate cell (HSC) to myofibroblast has been known as the main mechanism that occurs in fibrosis while epithelial-mesenchymal transition (EMT) and mitochondrial dysfunction become the mechanism followed. In these conditions, oxidative stress is the great promoter which builds a vicious cycle leading to CLD progressivity. Hence, Nrf2 as antioxidant regulator becomes the potential target to break the cycle. While reactive oxygen species (ROS) in oxidative stress induce HSC activation, EMT, and mitochondrial dysfunction through activation of many signaling pathways, Nrf2 acts to diminish ROS directly by regulating secreted antioxidants and its scavenging action. Nrf2 also inactivates fibrosis signaling pathways and plays a role in maintaining mitochondrial health. Therefore, Nrf2 can be a potential target for liver fibrosis therapy.
Prevalence of Obstructive Sleep Apnea in Patients with Difficult Intubation: Looking for Evidence?
Authors: Eldin Mohamed Shams , Yehia Ayman , Abdallah Randa , Sobhy Gehan , Abdelaziz Marwa
Published: May 2023

BACKGROUND: The link between obstructive sleep apnea and difficult intubation needs to be fully investigated and made clear. If a compromised airway can be anticipated and managed; it can lessen the likelihood of adverse consequences.
AIM: The aim of this study was to investigate the incidence, severity, and possible association of obstructive sleep apnea in individuals with unexpected difficult endotracheal intubation and their associated clinical and polysomnographic findings.
METHODS: Thirty patients referred for examination after difficult endotracheal intubation were enrolled in the study group, while 30 cases from the sleep laboratory unit database with a history of surgical intervention without difficult intubation were randomly selected for the control group. Documentation was obtained for the office clinical examination and fiber-optic nasopharyngolaryngoscopy assessment by Muller maneuver. The inspected upper airway was graded clinically using the Modified Mallampati technique. A comprehensive polysomnographic assessment was done overnight. The available data from the anesthetic record, as well as those derived from clinical and polysomnographic examination, such as age, sex, Body mass index, M Mallampati score, clinical positive findings, Cormack and Lehane grade, Apnea-Hypopnea Index (AHI), desaturation index, and average O2%, were statistically analyzed.
RESULTS: The mean ± SD of the AHI of the study group was (29.7 ± 16.1) while in the control group, it was (13.1 ± 9.9), and the difference was of statistical significance (p < 0.001). The grading of the severity of obstructive sleep apnea (OSA) was significantly different between both groups, with 53.3% of the studied cases having severe OSA and the rest having moderate (26.7%) or mild OSA (13.3%). The desaturation index was significantly higher in the study group (28.9 ± 17.4) than the control group (10.2 ± 7.4), while the average O2% saturation was significantly lower among cases (91.8 ± 6.2). The mean modified Mallampati score was significantly higher among cases with grade III-CL, and the significance was also noticed in class IV.
CONCLUSION: OSA is a major risk factor for difficult airway management and OSA patients are more likely to have difficult intubations. Patients who underwent a difficult intubation had a higher incidence and severity of OSA compared to the control group. OSA severity and higher modified Mallampati scores were independently related.
Determinants Analysis Factors Affecting the Capability of Family Healthcare of Chronic Kidney Disease with Hemodialysis
Authors: Faridah Virgianty Nur , Nursalam Nursalam , Kurniawati Ninuk Dian , Maghfiroh Isni Lailatul
Published: May 2023

BACKGROUND: Family members have an important role in the healthcare of other family members, especially for hemodialysis patients.
AIM: The purpose of this study is to analyze the determinants of factors that affect the ability of families to care for patients of chronic kidney disease (CKD) with hemodialysis.
METHODS: This research was used descriptive-analytical with a cross-sectional approach. The utilized population was families of CKD patients with hemodialysis in three hospitals in East Java, Indonesia. Through multistage random sampling, 155 families were obtained. The research data were taken with family questionnaire, patient questionnaire, social support questionnaire, and health-care services questionnaire. After tabulating the data, the hypothesis was tested with Structural Equation Modeling-Partial Least Squares with a significance level of ≤ 0.05 or the value of t-statistic ≥t-table (1.96).
RESULTS: The results showed that the family factors (t = 2.527) with six indicators (Age, education, family structure and function, motivation, experience and skill, and knowledge) had a strong effect on family health-care ability, with p = 0.012. The patient factors (t = 2.355) with four indicators (physical, psychological condition, lenght of care, and disease severity) had a strong effect on family health-care ability, with p = 0.019. The social support factor (t = 8.051) with three indicators (family, peer, and health-care support) had a strongest effect on family health-care ability, with p = 0.000. The health service factor (t = 2.820) had a strong effect on family health-care ability, with p = 0.005.
CONCLUSION: Based on those results, it becomes necessary to increase the knowledge of family members. Besides that, improve the physical and psychological condition of patients by involving support from peer groups and health workers can be done. The quality of health services must also improved so the family’s health-care ability of CKD patients with hemodialysis can increase.
Influence of Space Organisation on Kitchen Design From 2012 - 2022 in North Macedonia
Authors: Zafirovska Dijana
Published: May 2023

In the period from 2012 to 2022, the kitchen space is understood as the most economically frequent room, and in terms of specific requirements, the most complex for planning action. In the process of anthropological deposition and creation of these complex requirements, the kitchen project relies heavily on modern materials, and thus on new technologies. The paper will cover 20 (twenty) kitchen projects, concepts of existing projects from the Macedonian low-rise and high-rise housing structure with all their positive and negative aspects. The project is where everything begins and ends. The paper includes and makes typologies of projects that are most often encountered and projects for which the user experience shows through analyzes that they are accepted as functionally useful. By reviewing a series of changes in the architecture of kitchen spaces over the past 10 years, with a focus on the types of kitchens that were used and how they evolved over time according to the dimensions of the space and the needs of the user, the research focuses on the types of kitchens according to available kitchen dimensions.
Traditional Blacksmith Workshops (Majdani) In Ocevlje Near Vares
Authors: Hadrovic Ahmet
Published: May 2023

Traditional blacksmith workshops (Majdani) are one of the examples of businesses in Bosnia and Herzegovina that have existed in their authenticity for more than five centuries (Geographical coordinates: 44º10'09.01''N, 18º27'52.79''E, elevation: 797). It is a specific way of producing a wide range of wrought iron products using resources from the immediate environment. Iron production has been a strategic issue since the beginning of human civilizations, both for the individual and for all levels of the social communities to which he belonged.
The exploitation of iron ore, as well as its processing, was always strictly supervised and controlled by the very top of a social community (emperor, king, political and military top of the state).
Acute Myocarditis after Pfizer-BioNTech COVID-19 m-RNA Vaccination
Authors: Grueva-Nastevska Elena , Andova Valentina , Zafirovska Planinka , Kandic Ema , Chelikikj Ana , Vrajnko Elif , Jovchevska Simona , Busljetikj Oliver , Zimbakov Zhan , Spiroski Igor M. , Jovanova Silvana
Published: May 2023

BACKGROUND: Prosthetic mechanical valve endocarditis (PVE) can be manifested as early PVE (acquired perioperatively) and late PVE (resulting from infections unrelated to the valve operation). Causes of both are similar but are late PVE are more prone to less virulent microbes. PVE resulting with paravalvular abscess is confirmed through echocardiography (transthoracic or transesophageal), it results with a high mortality rate especially if it is not early recognized.
CASE PRESENTATION: We are presenting a patient with heart failure symptoms caused by PVE after Pfizer-BioNTech coronavirus disease-2019 (COVID-19) m-RNA vaccination.
CONCLUSION: The exact mechanism of myocarditis in young men who received the second dose of mRNA COVID-19 vaccine is not yet known. However, this is a rare complication and most people generally recover quickly requiring only supportive treatment. In contrast, the risk of developing myocarditis from the viral infection is much higher.
Safety and Feasibility of Retrograde Recanalization of Radial Artery Occlusion in Patients with Need for Repeated Wrist Procedures
Authors: Spiroski Igor M. , Zafirovska Biljana , Kedev Sasko , Zimbakov Zhan , Pejkov Hristo , Kitanoski Darko , Vasilev Ivan , Jovkovski Aleksandar , Taravari Hajber , Bosev Marijan
Published: May 2023

AIM: The purpose of the study was to present a new technique of retrograde recanalization of radial artery (RA) occlusion (RAO) in patients with need for repeated wrist access percutaneous angiographic procedures.
MATERIALS AND METHODS: During a 10-year period from March 2011–May 2021, 53 000 patients were referred for percutaneous coronary intervention (PCI) in a high-volume transradial center. RAO on angiography was documented in 1165 patients. Retrograde recanalization of RAO was attempted in 70 patients. The selected patients were with multiple previous bilateral wrist interventions (n = 3–9). Ipsilateral ulnar artery was usually rudimented or occluded and contralateral wrist approach could not be used. We examined clinical and procedure characteristics, access site bleeding and ischemic complications and procedural success of retrograde recanalization of RAO. Visual analog scale (VAS) score forearm pain assessment was performed after procedure. Technique: All patients had palpable pulse distal of previous puncture site due to collaterals from ipsilateral ulnar and interosseous artery. The RA was punctured with an inner metallic needle with a plastic cannula. Using retrograde radial angiography performed by injecting contrast through the plastic cannula, the occluded segment was visualized and crossed with different types of hydrophilic chronic total occlusion guide wires. After sheath insertion, balloon dilatation of the occluded RA segment, successful catheterization, and/or percutaneous coronary intervention was performed. Final RA angiography was performed on all patients.
RESULTS: Successful retrograde opening of RAO was achieved in 65 out of 70 patients (92%). PCI was performed in 56% of patients through the opened RAO and 5 patients underwent CAS. Procedural success through opened RA was achieved in all 65 patients. Forearm pain during procedure was present in all cases (VAS score 3 ± 2.1). Access site bleeding EASY score 3 and 4 occurred in 6 patients (8.5%). One patient had discharge of embolic material up the arm without clinical consequences. In one patient, we observed dissection of the interosseous artery. Clinical and duplex long-term follow-up with a median of 4.1 years showed patent RA in only 20 patients. There were no registered cases of hand ischemia. About 61% of patients underwent subsequent PCIs, through other alternative access sites.
CONCLUSION: Retrograde recanalization of RAO is successful and safe in patients with need of repeated coronary angiography procedures and inability to use other wrist access sites. Puncturing the collateral and performing retrograde radial angiography through the cannula is a key factor in successful opening of the RAO.
Gender Differences in High-risk CAS through Radial Access
Authors: Petkoska Danica , Zafirovska Biljana , Paljoskovska-Jordanova Savetka , Vasilev Ivan , Bosevski Marijan , Kedev Sasko
Published: May 2023

AIMS: Transradial (TR) carotid artery stenting (CAS) has been established as an acceptable alternative to carotid endarterectomy, especially in patients with a high risk for surgery. The purpose of this study was to evaluate the gender differences of radial access CAS in high-risk patients.
MATERIALS AND METHODS: This was a prospective analysis which included 54 consecutive patients in the period from December 2020 to January 2022. According to the Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy study for high-risk CAS, patients with at least one anatomic or comorbid factor associated with increased surgical risk were included in the study. Subjects were divided into two groups according to sex. Follow-up assessments included neurological exams, 12-lead electrocardiogram, and duplex ultrasound (DUS). The primary endpoint was 30-day composite rate of stroke, death, and myocardial infarction. Secondary endpoints included procedure success, access site complications according to Early Discharge after TR Stenting of Coronary Arteries (EASY) score classification, target lesion revascularization, and in-stent restenosis evaluated with DUS.
RESULTS: The study population was predominantly male 37 (61.1%) and females were 17 (38.9%). Mean age in the women group was 64.4 ± 7.43 years, and in men, it was 69.1 ± 8.01 years (p = 0.0223). From risk factors for coronary artery disease, hypertension and smoking were more frequent in the male group and hyperlipidemia and diabetes in the female group. Most of the male patients were symptomatic compared to the female group (p = 0.0151). Procedural success was obtained in all cases. Transient vasospasm induced by the distal protection device was present in one male patient. No 30-day major adverse events were recorded between the two groups. Minor access site bleeding complications according to EASY score (Easy type 1) were recorded in 4 patients (3 males vs. 1 female). There were no cases of hand ischemia after procedure or follow-up. None of the patients had in-stent restenosis >70% on DUS during 1-year follow-up.
CONCLUSION: Results from this study demonstrate no gender-related differences in radial access CAS for high-risk patients.
Greater Saphenous Vein Aneurysm: Case Report
Authors: Sterjo Edi , Otljanski Aleksandar , Murtezan Nezafet
Published: May 2023

BACKGROUND: Venous aneurysms are rare vascular pathology. They were first described by Sir Wiliam Osler in 1915 and thereafter Harris in 1928. Aneurysm on greater saphenous vein is mostly asymptomatic or they are responsible for no more than local discomfort, pain, and tenderness and it is detected when patients were referred for the treatment or evaluation of a femoral or inguinal hernia or soft-tissue masses.
CASE PRESENTATION: We presented a case of a 64-year-old man admitted to the hospital for elective surgical treatment of greater saphenous vein aneurysm. Computed tomography angiography showed an aneurysmatic change on the saphenous vein on the right lower leg with dimension of aneurismae 41 × 40 × 39 mm. After the diagnostic examination was finish, there was an indication for surgical treatment. The patient was successfully operated with non-postoperative complications.
CONCLUSION: The indications for surgical treatment in superficial venous aneurysms are the presence of symptoms, the risk of thrombosis, compression of nearby structures, and more commonly esthetic problems. Surgical treatment is the treatment of choice for reducing the symptoms, risk of thrombosis, and esthetic problems and it has excellent results if there are not any other vascular pathologies.
Systemic Circulating Leptin – Aiding New Dimension of Immune-Related Skin Carcinogenesis and Lipid Metabolism
Authors: Neagu Monica , Surcel Mihaela , Constantin Carolina
Published: May 2023

AIM: The link between the development of melanoma skin cancer and obesity is gaining recently an increased attention. A plethora of immune-related factors sustain a chronic inflammatory state modulated by the metabolic imbalance, the main examples being tumor necrosis factor alpha, interleukin 6, monocyte chemoattractant protein (MCP1), and several adipokines. Among the adipokines leptin (LEP) is steadily increasing interests as it involved in modulating different signaling pathways (e.g., JAK2/STAT3 and MAPK cascade/FOS) and immune cells fate by promoting the switch of memory cells to T helper-1 cell response, increases CD4+CD25- T-cell proliferation, and reduces autophagy during T-cell receptor stimulation. Our work investigates in a pilot study, using protein microarray technology, the LEP circulatory levels in melanoma patients in comparison to other cytokines and chemokines already reported as significantly involved in melanoma initiation and progression.
METHODS: Serum from melanoma cases and pool of serum from healthy volunteers were analyzed by an antibody array platform for a 42-cytokine profile.
RESULTS: The investigation of cytokines, chemokines, and growth factors has shown that all the proinflammatory circulating molecules are elevated in the melanoma patient’s serum. Inflammatory cytokines were found elevated and were correlated to the more advanced stage of the investigated patient (M2). The highest circulatory level was registered for LEP in both melanoma cases; moreover, in M1 patient, although the LEP level was completely comparable with the one found in M2, its IL-1 serum level was normal. In addition, there are ten analytes that show clear abnormal values and in patient M2 high LEP concentration is correlated with high IL-1, MCP-2, MCP-3, MCSF, and TARC serum concentrations.
CONCLUSION: Leptin is pleiotropic adipocytokine involved in various diseases, including skin cancer and melanoma. As it is involved in favoring inflammation and further tumorigenesis, the development of effective leptin-based therapeutic approaches opens new possibilities of adjuvant therapy in skin cancers.
Functional Connectivity and Structural Signatures of the Visual Cortical System in Fibromyalgia: A Magnetic Resonance Imaging Study
Authors: Nhu Nguyen Thanh , Chen David Yen-Ting , Kang Jiunn-Horng
Published: May 2023

Objective

Abnormal functional connectivity (FC) and structure in the brain are found in patients with fibromyalgia (FM). This study investigated FC and structural alterations of the visual cortical system, the emerging contributor to pain processing, in patients with FM.

Methods

Thirty pain-free participants and 26 patients with FM were enrolled. Clinical characteristics were evaluated using standardized scales. Structural and resting-state functional magnetic resonance imaging were conducted. Seed-based FC analyses, voxel-based morphometry, and surface-based morphometry were performed. The FC and cortical structure of the visual system were compared between the 2 groups. The correlation between functional and structural changes in the visual cortical system with clinical presentation in the FM group was analyzed.

Results

The patients with FM showed increased FCs within visual networks, of which the FC between the visual medial network and the right lingual gyrus (LG) was positively correlated with the Fibromyalgia Impact Questionnaire (FIQ) score. However, the FM group showed decreased FCs from the visual occipital network (VON) to several regions, of which the FCs from the VON to the bilateral frontal orbital cortices were negatively correlated with the FIQ and Pittsburgh Sleep Quality Index scores. Cortical thickness of the lateral occipital cortex, LG, and pericalcarine in FM tended to increase.

Conclusion

Altered FCs and structure in the visual cortical system might be involved in the pathomechanisms and clinical presentation in FM. These findings could potentially support further studies that seek to find diagnostic methods and mechanism-based therapies in patients with FM.
Translation and Cultural Adaptation of the Preferences for Everyday Living Inventory for Korean Nursing Home Settings
Authors: Shin So Young , Kwon Jenny Hyosun
Published: May 2023

Valid and reliable measures are necessary to provide person-centered care. However, there are no such measures in Korean nursing home (NH) settings. The purpose of the current study was to translate and culturally adapt the Preferences for Everyday Living Inventory (PELI) into Korean following the International Society for Pharmacoeconomics and Outcomes Research guidelines. Face validity was assessed by cognitively capable Korean older adults (
N
= 10) using a 4-point Likert scale (1 =
strongly disagree
to 4 =
strongly agree
). Mean score was 2.7 (
SD
= 0.82) for grammar and wording; 3.7 (
SD
= 0.48) for understandability; and 3.7 (
SD
= 0.67) for cultural relevance. Participants found the Korean version of the PELI (PELI-K) easy to understand and interpret, and culturally relevant. Results suggest that the PELI was successfully translated and culturally adapted to Korean. Implementing the PELI-K in Korean NHs and incorporating individual preferences into care delivery will improve quality of care. [
Journal of Gerontological Nursing, 49
(5), 5–10.]
Individuals Who Developed Delirium While Enrolled in the Hospital Elder Life Program: An Exploratory Study
Authors: Babine Rhonda L. , Hyrkäs Kristiina E. , Scott Christin , Wierman Heidi R.
Published: May 2023

Delirium prevention in hospitalized older adults is important due to delirium's high prevalence and negative impact on outcomes. Today, there are evidence-based programs with well-documented effectiveness aimed at preventing delirium, such as the Hospital Elder Life Program (HELP); however, approximately 4% to 5% of patients develop delirium regardless of implemented prevention interventions. It remains unknown why some patients develop delirium. The current retrospective exploratory chart review analyzed 98 records for clinical risk factors and outcomes of patients who developed delirium while enrolled in the HELP. On admission, immobility (86.7%) was the most common risk factor. Patients developed delirium approximately 70 hours after admission. Average length of stay was 8 days. Approximately one half (44.9%) of patients died within 1 year. Immobility (97.7% vs. 77.8%,
p
= 0.005) and renal disease (52.3% vs. 24.1%,
p
= 0.008) were more often found in patients who died. This study identifies risk factors that seem to require heightened attention during hospitalization to prevent the negative outcomes associated with delirium in older adults. [
Journal of Gerontological Nursing, 49
(5), 19–29.]
Patient Preferences in Short-Interval Staged Bilateral Rotator Cuff Repair
Authors: Fliegel Brian E. , Hall Anya , Patel Akash , Lee Donghoon , Cohen Steven B. , Freedman Kevin , Tjoumakaris Fotios
Published: May 2023

The decision to seek and undergo treatment for bilateral rotator cuff tears is often complex. The purpose of this study was to investigate patient preferences for undergoing short-interval staged bilateral rotator cuff repair; timing of surgeries; and order of surgeries. A retrospective analysis was performed for patients who underwent bilateral arthroscopic rotator cuff repairs within 12 months at a single institution. Postoperative patient-reported outcomes, satisfaction, and decision-making factors were collected via REDCap surveys. Ninety patients were included (63 men and 27 women; mean age, 58.1 years). The mean time between surgeries was 7.33 months. Forty-two percent of patients had left rotator cuff repair first. Patients reported a mean satisfaction score of 91.6 of 100 with the order of the surgeries and 87.3 of 100 with the timing of the surgeries. Mean postoperative American Shoulder and Elbow Surgeons standardized assessment scores were 94.6 and 93.7 (left vs right shoulder first, respectively) for left shoulders and 94.2 and 93.9 (left vs right shoulder first, respectively) for right shoulders. Mean postoperative Single Assessment Numeric Evaluation scores were 86.5 and 83.9 (left vs right shoulder first, respectively) for left shoulders and 87.3 and 86.0 (left vs right shoulder first, respectively) for right shoulders. Decision-making factors noted as highly important included night pain, function, surgeon recommendation, and daily pain. Most patients who undergo short-interval staged bilateral rotator cuff repair are satisfied with the order and timing of their surgery. Decision-making factors such as night pain and functional limitation play a key role in the timing and order of bilateral rotator cuff repairs. [
Orthopedics
. 2023;46(6):e347–e352.]