Depression is highly prevalent among postmenopausal women with osteoporosis,driven by the combined effects of hormonal changes,reduced bone density,and psychosocial stress.A recent study by Cui and Su reported that 73...Depression is highly prevalent among postmenopausal women with osteoporosis,driven by the combined effects of hormonal changes,reduced bone density,and psychosocial stress.A recent study by Cui and Su reported that 73.3%of affected women exhibited depressive symptoms,with low bone mineral density,chronic comorbidities,and reduced serotonin(5-hydroxytryptamine)levels as key risk factors.Notably,nurse-led psychological interventions improved both mood and quality of life.This editorial underscore the need to integrate mental health support into standard osteoporosis care.Simple,scalable strategies such as routine screening and nurse-delivered emotional support may help bridge the gap between physical and psychological health.These approaches are especially relevant for aging populations across diverse healthcare settings.A dual focus on bone and emotional well-being is essential to improving outcomes in this vulnerable group.展开更多
Objective:This study aimed to explore the strategies used by acute care hospitals in implementing a national standard for comprehensive care.Methods:A qualitative descriptive study was conducted with 28 care professio...Objective:This study aimed to explore the strategies used by acute care hospitals in implementing a national standard for comprehensive care.Methods:A qualitative descriptive study was conducted with 28 care professionals(20 nurses,two doctors,and six allied health professionals)recruited from a broad range of Australian acute care hospitals.Data were collected using semi-structured interviews from March to August 2023.The interviews were audio-recorded,transcribed,and thematically analyzed.Results:Strategies for implementing the Comprehensive Care Standard(CCS)vary,even within a health service organization.We identifiedstrategies hospitals used regarding the implementation team and plan,communication,education and training,documentation system,patient care plan,networking,incentives and pressure,feedback,and reflectingand evaluating.Conclusions:This interview study sheds light on the various strategies adopted by hospitals in implementing the CCS,providing a practical foundation to inform implementation efforts both within Australia and internationally.展开更多
Introduction: Lymphaticovenous malformations (LVM) are benign congenital anomalies of the venous and lymphatic systems, frequently presenting as complex masses in the head and neck region of children. While the clinic...Introduction: Lymphaticovenous malformations (LVM) are benign congenital anomalies of the venous and lymphatic systems, frequently presenting as complex masses in the head and neck region of children. While the clinical features of LVM are well-documented, there is a lack of comprehensive studies addressing their holistic impact on affected children and their families. Objectives: This qualitative study explores the physical, psychological, and social challenges faced by children with head and neck LVM and the emotional and financial burdens experienced by their parents. It also evaluates the effectiveness of a multidisciplinary approach in managing these challenges. Methods: Over seven months, data were collected through monthly multidisciplinary team (MDT) clinics, bi-monthly tele-clinics, and continuous email communication. The MDT included interventional radiologists, surgeons, psychologists, physiotherapists, nurse specialists, and administrative staff. Additional specialists were consulted as needed. The study focused on children’s physical symptoms (appearance concerns, pain, infections, bleeding, heaviness, tongue involvement), psychological and social issues (bullying, self-esteem, social isolation, school absenteeism), and parental concerns. Management strategies and their outcomes were also documented. Results: Children with LVM experienced significant distress due to visible deformities, chronic pain, and recurrent infections, leading to social isolation, bullying, and low self-esteem. Parents reported constant stress over their child’s well-being, concerns about social interactions, and financial strain from taking time off work for care and medical appointments. Interventions—including surgical procedures and interventional radiology treatments like sclerotherapy, counseling, laser treatments, and camouflage techniques—resulted in reported improvements across physical, psychological, and social domains. Conclusions: LVM significantly impacts the biopsychosocial well-being of both children and their parents. A multidisciplinary approach is essential for effective management, addressing not only the medical but also the psychological and social needs of affected families. Future studies with larger, multi-center cohorts are recommended to further validate these findings and explore new therapeutic strategies.展开更多
Frailty fractures of the pelvis,particularly isolated pubic ramus fractures,are often perceived as benign,especially in elderly patients.However,this perception can obscure the risk of delayed hemorrhage from occult v...Frailty fractures of the pelvis,particularly isolated pubic ramus fractures,are often perceived as benign,especially in elderly patients.However,this perception can obscure the risk of delayed hemorrhage from occult vascular injuries.Clinical deterioration is frequently subtle,with signs like fatigue or confusion mis-attributed to baseline status.In frail patients,these injuries may rapidly evolve into life-threatening scenarios.Conservative management,while standard,may be insufficient when vascular frailty or anticoagulation are present.Early clinical suspicion,serial hemoglobin checks,and multidisciplinary involvement are crucial.A dynamic assessment model that incorporates frailty,comorbidities,and physiological reserve alongside radiographic findings can better guide inter-vention and monitoring.Clinicians must lower the threshold for advanced imaging,such as computed tomography angiography,and consider early vascular consultation even in seemingly stable cases.Adopting a holistic,risk-based approach can mitigate complications and improve outcomes for this vulnerable population.展开更多
BACKGROUND Functional neurological disorder(FND)in children is a complex and multifaceted condition characterized by neurological symptoms that cannot be explained by organic pathology.Despite its prevalence,FND in pe...BACKGROUND Functional neurological disorder(FND)in children is a complex and multifaceted condition characterized by neurological symptoms that cannot be explained by organic pathology.Despite its prevalence,FND in pediatric populations remains under-researched,with challenges in diagnosis and management AIM To synthesize the current literature on FND in children,focusing on clinical presentation,diagnostic approaches,treatment strategies,and outcomes.METHODS A comprehensive literature search was conducted across multiple databases,including PubMed,Scopus,and Web of Science,for articles published up to August 2024.Studies were included if they addressed FND in pediatric populations,specifically focusing on review articles,research articles,systematic reviews,meta-analyses,case reports,guidelines,expert opinions,and editorials.Data extraction and quality assessment were performed according to PRISMA guidelines.A total of 308 articles were included in the final analysis.RESULTS The analysis included 189 review articles,57 research articles,3 systematic reviews and meta-analyses,5 case reports,2 guidelines,5 expert opinions,and 2 editorials.Key findings revealed a broad spectrum of symptoms,including motor and sensory disturbances and psychological factors contributing to the onset and persistence of FND.Diagnostic challenges were frequently highlighted,emphasizing the need for interdisciplinary approaches.Treatment strategies varied,with cognitive-behavioral therapy(CBT)and multidisciplinary care emerging as the most effective approaches.The outcomes varied,with early intervention being critical for a better prognosis.CONCLUSION Early diagnosis and multidisciplinary care,including CBT,are critical for improving outcomes in pediatric FND.Standardized diagnostic criteria and treatment protocols are needed to enhance clinical management.展开更多
Metabolic-associated steatotic liver disease(MASLD)is a global health burden intricately linked to cardiovascular disease(CVD)through shared pathways-insulin resistance,dyslipidemia,and chronic inflammation.CVD has be...Metabolic-associated steatotic liver disease(MASLD)is a global health burden intricately linked to cardiovascular disease(CVD)through shared pathways-insulin resistance,dyslipidemia,and chronic inflammation.CVD has become the leading cause of mortality in MASLD,necessitating integrated management strategies.This review synthesizes evidence on bidirectional MASLD-CVD interactions and evaluates therapeutic approaches:Lifestyle modifications,pharmacotherapy(e.g.,GLP-1 receptor agonists,SGLT2 inhibitors,statins),and metabolic interventions.Despite progress,critical gaps persist in risk stratification tools,personalized treatment algorithms,and long-term outcomes of novel agents like resmetirom.A multidisciplinary care model,bridging hepatology and cardiology,is essential to address these challenges and improve patient outcomes.展开更多
Wang et al explored the metabolic improvement effects of jejunoileal side-to-side anastomosis in patients with type 2 diabetes mellitus(T2DM),focusing on its multitarget metabolic regulatory potential through enhanced...Wang et al explored the metabolic improvement effects of jejunoileal side-to-side anastomosis in patients with type 2 diabetes mellitus(T2DM),focusing on its multitarget metabolic regulatory potential through enhanced secretion of glucagon-like peptide-1.This surgical procedure alters the direction of nutrient flow,activates distal ileal L cells,and increases endogenous glucagon-like peptide-1 levels,supporting glucose homeostasis,enhancing insulin sensitivity,regulating body weight,and improving cardiovascular health.This structural adjustment transforms the gastrointestinal tract into an active endocrine regulatory organ,providing a pathway for metabolic improvement in patients with T2DM and other complex metabolic disorders.Although this procedure demonstrates significant metabolic improvements within 3-6 months after surgery,integrating hormone level measurements,metabolic marker analysis,and long-term follow-up has become crucial for exploring the complex mechanisms of T2DM in the field of metabolic surgery and T2DM management.Multidisciplinary collaboration involving support from endocrinology,nutrition,and rehabilitation teams before and after surgery is becoming increasingly vital in the long-term management of patients with T2DM.This collaboration optimizes surgical outcomes and enhances metabolic management.Side-to-side anastomosis shows potential in the multitarget metabolic management of T2DM,providing an additional intervention option for patients with T2DM and metabolic disorders.展开更多
Liver cancer presents unique challenges due to its systemic impact and complex treatment modalities.Patients often experience a range of complications,including cardiovascular,renal,hematological,and metabolic abnorma...Liver cancer presents unique challenges due to its systemic impact and complex treatment modalities.Patients often experience a range of complications,including cardiovascular,renal,hematological,and metabolic abnormalities,which can significantly affect treatment outcomes and quality of life.This article emphasizes the integration of multidisciplinary strategies and artificial intelligence-driven diagnostics,which have the potential to improve patient outcomes by optimizing early detection and targeted management of these complications.A recent study on 60 liver cancer patients undergoing interventional therapy highlighted the importance of recognizing and managing these complications.This article offers an overview of systemic complications in liver cancer,focusing on pathophysiological mechanisms,risk factors,and strategies to improve care.By addressing gaps in the existing literature and proposing future research directions,it underscores the importance of comprehensive,patient-centered approaches to refine therapeutic strategies.展开更多
<strong>Introduction:</strong> The glycemic control of type 2 diabetes is a very important challenge that requires a multidisciplinary group of specialists, an adequate psychosocial environment and family ...<strong>Introduction:</strong> The glycemic control of type 2 diabetes is a very important challenge that requires a multidisciplinary group of specialists, an adequate psychosocial environment and family support and searching for better measures for the control and prevention of complications, which encourages the patient to improve his lifestyle. <strong>Method: </strong>The analysis was made with two primary care medical units, the Mutual Aid Group (GAM) from the Los Pinos Medical center, and the Chronic disease Specialized Medical Unit (UNEME EC), which provided integral care in the municipality of San Cristóbal de Las Casas, Chiapas. A sample of 138 patients was obtained through a random sampling with 95% confidence and a margin of error of ±5. The recollection of data was made with the application of the questionnaire “Lifestyle and adherence to pharmacological treatment in patients with type 2 diabetes, which consists of four sections that evaluate 1) socio-demographic data;2) anthropometric and clinical;Pharmacological adherence with Morisky’s 8-item questionnaire (MMSA-8);3) Lifestyle: with the instrument to Measure Lifestyle in Diabetics (IMEVID). <strong>Results:</strong> 37.6% had an HbA1c lesser than 7%, A prevalence of 50.7% was obtained in patients adhering to the pharmacological treatment, and 39.8% patients with a favorable lifestyle. The association of the patients’ results with an adequate glycemic control demonstrated by an HbA1C lesser than 7% was obtained through Student’s T test in which these patients are related with a better score on questionnaires by IMEVID and MMAS-8. <strong>Conclusions:</strong> The units with integral care and multidisciplinary treatment are fundamental in the care of patients with type 2 diabetes;the use of questionnaires such as IMEVID or MMAS-8 is useful in the daily clinical practice.展开更多
Intensive care units(ICU)for various reasons,including the increasing age of admitted patients,comorbidities,and increasingly complex surgical procedures(e.g.,transplants),have become"the epicenter"of nosoco...Intensive care units(ICU)for various reasons,including the increasing age of admitted patients,comorbidities,and increasingly complex surgical procedures(e.g.,transplants),have become"the epicenter"of nosocomial infections,these are characterized by the presence of multidrug-resistant organisms(MDROs)as the cause of infection.Therefore,the perfect match of fragile patients and MDROs,as the cause of infection,makes ICU mortality very high.Furthermore,carbapenems were considered for years as last-resort antibiotics for the treatment of infections caused by MDROs;unfortunately,nowadays carbapenem resistance,mainly among Gram-negative pathogens,is a matter of the highest concern for worldwide public health.This comprehensive review aims to outline the problem from the intensivist's perspective,focusing on the new definition and epidemiology of the most common carbapenem-resistant MDROs(Acinetobacter baumannii,Pseudomonas aeruginosa and Enterobacterales)to emphasize the importance of the problem that must be permeating clinicians dealing with these diseases.展开更多
Resilience-the dynamic capacity to maintain or restore mental and physical health in the face of adversity-has been linked to improved treatment adherence,reduced psychological distress,and enhanced long-term recovery...Resilience-the dynamic capacity to maintain or restore mental and physical health in the face of adversity-has been linked to improved treatment adherence,reduced psychological distress,and enhanced long-term recovery in patients confronting serious illnesses such as cancer.Psychosocial resources(e.g.,social support,peer-led groups)and neurobiological mechanisms(e.g.,Hypothalamic-Pituitary-Adrenal axis modulation,neural plasticity)interact to buffer the physiological and emotional impact of diagnosis and therapy.Interventions including cognitive-behavioural therapy,mindfulness-based stress reduction,and digitally delivered programs demonstrate moderate-to-large effect sizes(Hedges'g 0.33-1.45)in strengthening resilience and improving quality of life.However,inconsistent terminology,the absence of standardized,multidimensional assessment tools,and logistical challenges in implementation limit widespread adoption.We advocate for a unified resilience framework that integrates psychometric scales,biomarker assays,and real-time digital monitoring;the embedding of resilience-promoting strategies within multidisciplinary care pathways;and the alignment of policy support and reimbursement models to sustain these efforts.Longitudinal,multicenter trials and culturally sensitive adaptation will be essential to validate scalable models,ensuring that resilience becomes a fundamental pillar of compassionate,patient-centered care.展开更多
Gastric cancer remains one of the leading causes of cancer-related mortality worldwide.Advances in surgical techniques,especially laparoscopic surgery,have revolutionized the management of gastric cancer by reducing p...Gastric cancer remains one of the leading causes of cancer-related mortality worldwide.Advances in surgical techniques,especially laparoscopic surgery,have revolutionized the management of gastric cancer by reducing perioperative morbidity and enabling faster recovery.However,medium-to long-term survival remains understudied,and identifying factors that influence outcomes is essential for improving care.Gan et al’s study analyzes the 3-year survival outcomes and prognosis in patients with primary gastric cancer undergoing laparoscopic surgery.The study identifies the important variables associated with survival,including age,tumor node metastasis stage,tumor characteristics,surgical factors,and postoperative complications.While the study provides important data for clinical practice,further research is warranted to refine risk stratification and explore the role of emerging therapies.展开更多
Pediatric inflammatory bowel disease(IBD),encompassing Crohn’s disease,ulcerative colitis,and IBD-unclassified,has become increasingly prevalent worldwide,including in previously low-incidence regions.Children often ...Pediatric inflammatory bowel disease(IBD),encompassing Crohn’s disease,ulcerative colitis,and IBD-unclassified,has become increasingly prevalent worldwide,including in previously low-incidence regions.Children often present with more extensive and aggressive disease,creating unique diagnostic and management challenges that differ significantly from adult-onset IBD.This review aims to synthesize current knowledge on pediatric IBD,highlighting historical challenges while exploring emerging frontiers in diagnosis,treatment,and long-term care strategies.A narrative synthesis of global and regional epidemiological data,clinical classifications,diagnostic advancements,management approaches,and psychosocial considerations was conducted,with a particular emphasis on innovations in precision medicine,microbiome-targeted therapy,and multidisciplinary care models.Pediatric IBD continues to rise globally,driven by environmental and genetic interactions,especially in rapidly industrializing regions.Novel diagnostic tools,age-specific treatment protocols,biologics,nutritional strategies,and psychosocial support are reshaping care.Emphasis on very early-onset IBD,transition care,and regional policy adaptations underscores the evolving complexity of managing pediatric IBD.The landscape of pediatric IBD care is rapidly evolving.Addressing the distinct pathophysiology,developmental impact,and healthcare challenges of pediatric patients requires an integrated,child-centered approach.Ongoing research into genetics,immune pathways,and the microbiome will be essential in tailoring precision therapies and improving outcomes globally.展开更多
基金Supported by the National Natural Science Foundation of China,No.82260873.
文摘Depression is highly prevalent among postmenopausal women with osteoporosis,driven by the combined effects of hormonal changes,reduced bone density,and psychosocial stress.A recent study by Cui and Su reported that 73.3%of affected women exhibited depressive symptoms,with low bone mineral density,chronic comorbidities,and reduced serotonin(5-hydroxytryptamine)levels as key risk factors.Notably,nurse-led psychological interventions improved both mood and quality of life.This editorial underscore the need to integrate mental health support into standard osteoporosis care.Simple,scalable strategies such as routine screening and nurse-delivered emotional support may help bridge the gap between physical and psychological health.These approaches are especially relevant for aging populations across diverse healthcare settings.A dual focus on bone and emotional well-being is essential to improving outcomes in this vulnerable group.
基金supported by an Australian Government Research Training Program Scholarshippart of the project“Improving quality of care for people with dementia in the acute care setting(eQC)”which is funded by the National Health and Medical Research Council of the Australian Government(No.APP1140459)。
文摘Objective:This study aimed to explore the strategies used by acute care hospitals in implementing a national standard for comprehensive care.Methods:A qualitative descriptive study was conducted with 28 care professionals(20 nurses,two doctors,and six allied health professionals)recruited from a broad range of Australian acute care hospitals.Data were collected using semi-structured interviews from March to August 2023.The interviews were audio-recorded,transcribed,and thematically analyzed.Results:Strategies for implementing the Comprehensive Care Standard(CCS)vary,even within a health service organization.We identifiedstrategies hospitals used regarding the implementation team and plan,communication,education and training,documentation system,patient care plan,networking,incentives and pressure,feedback,and reflectingand evaluating.Conclusions:This interview study sheds light on the various strategies adopted by hospitals in implementing the CCS,providing a practical foundation to inform implementation efforts both within Australia and internationally.
文摘Introduction: Lymphaticovenous malformations (LVM) are benign congenital anomalies of the venous and lymphatic systems, frequently presenting as complex masses in the head and neck region of children. While the clinical features of LVM are well-documented, there is a lack of comprehensive studies addressing their holistic impact on affected children and their families. Objectives: This qualitative study explores the physical, psychological, and social challenges faced by children with head and neck LVM and the emotional and financial burdens experienced by their parents. It also evaluates the effectiveness of a multidisciplinary approach in managing these challenges. Methods: Over seven months, data were collected through monthly multidisciplinary team (MDT) clinics, bi-monthly tele-clinics, and continuous email communication. The MDT included interventional radiologists, surgeons, psychologists, physiotherapists, nurse specialists, and administrative staff. Additional specialists were consulted as needed. The study focused on children’s physical symptoms (appearance concerns, pain, infections, bleeding, heaviness, tongue involvement), psychological and social issues (bullying, self-esteem, social isolation, school absenteeism), and parental concerns. Management strategies and their outcomes were also documented. Results: Children with LVM experienced significant distress due to visible deformities, chronic pain, and recurrent infections, leading to social isolation, bullying, and low self-esteem. Parents reported constant stress over their child’s well-being, concerns about social interactions, and financial strain from taking time off work for care and medical appointments. Interventions—including surgical procedures and interventional radiology treatments like sclerotherapy, counseling, laser treatments, and camouflage techniques—resulted in reported improvements across physical, psychological, and social domains. Conclusions: LVM significantly impacts the biopsychosocial well-being of both children and their parents. A multidisciplinary approach is essential for effective management, addressing not only the medical but also the psychological and social needs of affected families. Future studies with larger, multi-center cohorts are recommended to further validate these findings and explore new therapeutic strategies.
文摘Frailty fractures of the pelvis,particularly isolated pubic ramus fractures,are often perceived as benign,especially in elderly patients.However,this perception can obscure the risk of delayed hemorrhage from occult vascular injuries.Clinical deterioration is frequently subtle,with signs like fatigue or confusion mis-attributed to baseline status.In frail patients,these injuries may rapidly evolve into life-threatening scenarios.Conservative management,while standard,may be insufficient when vascular frailty or anticoagulation are present.Early clinical suspicion,serial hemoglobin checks,and multidisciplinary involvement are crucial.A dynamic assessment model that incorporates frailty,comorbidities,and physiological reserve alongside radiographic findings can better guide inter-vention and monitoring.Clinicians must lower the threshold for advanced imaging,such as computed tomography angiography,and consider early vascular consultation even in seemingly stable cases.Adopting a holistic,risk-based approach can mitigate complications and improve outcomes for this vulnerable population.
文摘BACKGROUND Functional neurological disorder(FND)in children is a complex and multifaceted condition characterized by neurological symptoms that cannot be explained by organic pathology.Despite its prevalence,FND in pediatric populations remains under-researched,with challenges in diagnosis and management AIM To synthesize the current literature on FND in children,focusing on clinical presentation,diagnostic approaches,treatment strategies,and outcomes.METHODS A comprehensive literature search was conducted across multiple databases,including PubMed,Scopus,and Web of Science,for articles published up to August 2024.Studies were included if they addressed FND in pediatric populations,specifically focusing on review articles,research articles,systematic reviews,meta-analyses,case reports,guidelines,expert opinions,and editorials.Data extraction and quality assessment were performed according to PRISMA guidelines.A total of 308 articles were included in the final analysis.RESULTS The analysis included 189 review articles,57 research articles,3 systematic reviews and meta-analyses,5 case reports,2 guidelines,5 expert opinions,and 2 editorials.Key findings revealed a broad spectrum of symptoms,including motor and sensory disturbances and psychological factors contributing to the onset and persistence of FND.Diagnostic challenges were frequently highlighted,emphasizing the need for interdisciplinary approaches.Treatment strategies varied,with cognitive-behavioral therapy(CBT)and multidisciplinary care emerging as the most effective approaches.The outcomes varied,with early intervention being critical for a better prognosis.CONCLUSION Early diagnosis and multidisciplinary care,including CBT,are critical for improving outcomes in pediatric FND.Standardized diagnostic criteria and treatment protocols are needed to enhance clinical management.
文摘Metabolic-associated steatotic liver disease(MASLD)is a global health burden intricately linked to cardiovascular disease(CVD)through shared pathways-insulin resistance,dyslipidemia,and chronic inflammation.CVD has become the leading cause of mortality in MASLD,necessitating integrated management strategies.This review synthesizes evidence on bidirectional MASLD-CVD interactions and evaluates therapeutic approaches:Lifestyle modifications,pharmacotherapy(e.g.,GLP-1 receptor agonists,SGLT2 inhibitors,statins),and metabolic interventions.Despite progress,critical gaps persist in risk stratification tools,personalized treatment algorithms,and long-term outcomes of novel agents like resmetirom.A multidisciplinary care model,bridging hepatology and cardiology,is essential to address these challenges and improve patient outcomes.
基金Supported by the National Natural Science Foundation of China,No.82471616,No.82170418 and No.82271618Natural Science Foundation of Hubei Province,No.2022CFA015+2 种基金Central Guiding Local Science and Technology Development Project,No.2022BGE237Key Research and Development Program of Hubei Province,No.2022BCE001 and No.2023BCB139Hubei Provincial Health Commission Project,No.WJ2023M151。
文摘Wang et al explored the metabolic improvement effects of jejunoileal side-to-side anastomosis in patients with type 2 diabetes mellitus(T2DM),focusing on its multitarget metabolic regulatory potential through enhanced secretion of glucagon-like peptide-1.This surgical procedure alters the direction of nutrient flow,activates distal ileal L cells,and increases endogenous glucagon-like peptide-1 levels,supporting glucose homeostasis,enhancing insulin sensitivity,regulating body weight,and improving cardiovascular health.This structural adjustment transforms the gastrointestinal tract into an active endocrine regulatory organ,providing a pathway for metabolic improvement in patients with T2DM and other complex metabolic disorders.Although this procedure demonstrates significant metabolic improvements within 3-6 months after surgery,integrating hormone level measurements,metabolic marker analysis,and long-term follow-up has become crucial for exploring the complex mechanisms of T2DM in the field of metabolic surgery and T2DM management.Multidisciplinary collaboration involving support from endocrinology,nutrition,and rehabilitation teams before and after surgery is becoming increasingly vital in the long-term management of patients with T2DM.This collaboration optimizes surgical outcomes and enhances metabolic management.Side-to-side anastomosis shows potential in the multitarget metabolic management of T2DM,providing an additional intervention option for patients with T2DM and metabolic disorders.
文摘Liver cancer presents unique challenges due to its systemic impact and complex treatment modalities.Patients often experience a range of complications,including cardiovascular,renal,hematological,and metabolic abnormalities,which can significantly affect treatment outcomes and quality of life.This article emphasizes the integration of multidisciplinary strategies and artificial intelligence-driven diagnostics,which have the potential to improve patient outcomes by optimizing early detection and targeted management of these complications.A recent study on 60 liver cancer patients undergoing interventional therapy highlighted the importance of recognizing and managing these complications.This article offers an overview of systemic complications in liver cancer,focusing on pathophysiological mechanisms,risk factors,and strategies to improve care.By addressing gaps in the existing literature and proposing future research directions,it underscores the importance of comprehensive,patient-centered approaches to refine therapeutic strategies.
文摘<strong>Introduction:</strong> The glycemic control of type 2 diabetes is a very important challenge that requires a multidisciplinary group of specialists, an adequate psychosocial environment and family support and searching for better measures for the control and prevention of complications, which encourages the patient to improve his lifestyle. <strong>Method: </strong>The analysis was made with two primary care medical units, the Mutual Aid Group (GAM) from the Los Pinos Medical center, and the Chronic disease Specialized Medical Unit (UNEME EC), which provided integral care in the municipality of San Cristóbal de Las Casas, Chiapas. A sample of 138 patients was obtained through a random sampling with 95% confidence and a margin of error of ±5. The recollection of data was made with the application of the questionnaire “Lifestyle and adherence to pharmacological treatment in patients with type 2 diabetes, which consists of four sections that evaluate 1) socio-demographic data;2) anthropometric and clinical;Pharmacological adherence with Morisky’s 8-item questionnaire (MMSA-8);3) Lifestyle: with the instrument to Measure Lifestyle in Diabetics (IMEVID). <strong>Results:</strong> 37.6% had an HbA1c lesser than 7%, A prevalence of 50.7% was obtained in patients adhering to the pharmacological treatment, and 39.8% patients with a favorable lifestyle. The association of the patients’ results with an adequate glycemic control demonstrated by an HbA1C lesser than 7% was obtained through Student’s T test in which these patients are related with a better score on questionnaires by IMEVID and MMAS-8. <strong>Conclusions:</strong> The units with integral care and multidisciplinary treatment are fundamental in the care of patients with type 2 diabetes;the use of questionnaires such as IMEVID or MMAS-8 is useful in the daily clinical practice.
文摘Intensive care units(ICU)for various reasons,including the increasing age of admitted patients,comorbidities,and increasingly complex surgical procedures(e.g.,transplants),have become"the epicenter"of nosocomial infections,these are characterized by the presence of multidrug-resistant organisms(MDROs)as the cause of infection.Therefore,the perfect match of fragile patients and MDROs,as the cause of infection,makes ICU mortality very high.Furthermore,carbapenems were considered for years as last-resort antibiotics for the treatment of infections caused by MDROs;unfortunately,nowadays carbapenem resistance,mainly among Gram-negative pathogens,is a matter of the highest concern for worldwide public health.This comprehensive review aims to outline the problem from the intensivist's perspective,focusing on the new definition and epidemiology of the most common carbapenem-resistant MDROs(Acinetobacter baumannii,Pseudomonas aeruginosa and Enterobacterales)to emphasize the importance of the problem that must be permeating clinicians dealing with these diseases.
文摘Resilience-the dynamic capacity to maintain or restore mental and physical health in the face of adversity-has been linked to improved treatment adherence,reduced psychological distress,and enhanced long-term recovery in patients confronting serious illnesses such as cancer.Psychosocial resources(e.g.,social support,peer-led groups)and neurobiological mechanisms(e.g.,Hypothalamic-Pituitary-Adrenal axis modulation,neural plasticity)interact to buffer the physiological and emotional impact of diagnosis and therapy.Interventions including cognitive-behavioural therapy,mindfulness-based stress reduction,and digitally delivered programs demonstrate moderate-to-large effect sizes(Hedges'g 0.33-1.45)in strengthening resilience and improving quality of life.However,inconsistent terminology,the absence of standardized,multidimensional assessment tools,and logistical challenges in implementation limit widespread adoption.We advocate for a unified resilience framework that integrates psychometric scales,biomarker assays,and real-time digital monitoring;the embedding of resilience-promoting strategies within multidisciplinary care pathways;and the alignment of policy support and reimbursement models to sustain these efforts.Longitudinal,multicenter trials and culturally sensitive adaptation will be essential to validate scalable models,ensuring that resilience becomes a fundamental pillar of compassionate,patient-centered care.
文摘Gastric cancer remains one of the leading causes of cancer-related mortality worldwide.Advances in surgical techniques,especially laparoscopic surgery,have revolutionized the management of gastric cancer by reducing perioperative morbidity and enabling faster recovery.However,medium-to long-term survival remains understudied,and identifying factors that influence outcomes is essential for improving care.Gan et al’s study analyzes the 3-year survival outcomes and prognosis in patients with primary gastric cancer undergoing laparoscopic surgery.The study identifies the important variables associated with survival,including age,tumor node metastasis stage,tumor characteristics,surgical factors,and postoperative complications.While the study provides important data for clinical practice,further research is warranted to refine risk stratification and explore the role of emerging therapies.
文摘Pediatric inflammatory bowel disease(IBD),encompassing Crohn’s disease,ulcerative colitis,and IBD-unclassified,has become increasingly prevalent worldwide,including in previously low-incidence regions.Children often present with more extensive and aggressive disease,creating unique diagnostic and management challenges that differ significantly from adult-onset IBD.This review aims to synthesize current knowledge on pediatric IBD,highlighting historical challenges while exploring emerging frontiers in diagnosis,treatment,and long-term care strategies.A narrative synthesis of global and regional epidemiological data,clinical classifications,diagnostic advancements,management approaches,and psychosocial considerations was conducted,with a particular emphasis on innovations in precision medicine,microbiome-targeted therapy,and multidisciplinary care models.Pediatric IBD continues to rise globally,driven by environmental and genetic interactions,especially in rapidly industrializing regions.Novel diagnostic tools,age-specific treatment protocols,biologics,nutritional strategies,and psychosocial support are reshaping care.Emphasis on very early-onset IBD,transition care,and regional policy adaptations underscores the evolving complexity of managing pediatric IBD.The landscape of pediatric IBD care is rapidly evolving.Addressing the distinct pathophysiology,developmental impact,and healthcare challenges of pediatric patients requires an integrated,child-centered approach.Ongoing research into genetics,immune pathways,and the microbiome will be essential in tailoring precision therapies and improving outcomes globally.
