The recent increase in life expectancy is the main argument for a better understanding of the pathophysiological mechanisms underlying aging. These, once known, can provide possible links to therapies to prevent aging or slow down the process. Normal aging is associated with a progressive decrease in the glomerular filtration rate. Accurate estimation of GFR in the elderly is under the suspicion of multiple errors mainly due to sarcopenia and decreased protein intake. Differentiation between chronic kidney disease and the physiological decline of GFR might be a challenge in clinical practice and this has consequences on the evolution and treatment of the numerous comorbidities of the elderly. The current trend to use non-invasive diagnostic techniques explains the need to identify a serological marker to help differentiate between decreased GFR secondary to kidney aging or the development of chronic kidney disease.
Trust in health care professionals is considered as a basis for patients’ care. This study aimed to compare the level of patients' trust in physicians and nurses in both general and COVID-19 wards in a reference hospital in Tehran during the pandemic. This was a cross-sectional descriptive study. The study population comprised patients from Baqiyatallah Hospital in 2022. The data collection tool was the scale of patients’ trust in nurses and the Wake-Forest physician trust scale. Data analysis was performed using SPSS-26 software. The level of patients’ trust in physicians in COVID-19 wards was significantly lower than in Non-COVID-19 wards (P<0.001), but there was no difference between the two groups in the trust of nurses. The lowest level of trust was in the receiving of required information from nurses, which had a lower score compared to other questions in the questionnaire, and the average amount of receiving required information for patients in general wards was significantly lower than that of patients in COVID-19 (P=0.006). Trust in nurses and physicians in both COVID-19 and general wards was optimum. During the COVID-19 pandemic, the medical staff worked tirelessly and despite the difficulties and complications of the pandemic, patients have high trust in physicians and nurses.
Improving the mental health of nurses and investigating the factors affecting it leads to the improvement of job performance and the quality of nursing care. Aim: The present study aimed to determine the relationship between mental health, life satisfaction, and job satisfaction of nurses in Ilam city in 2022. The present correlational study was carried out on 160 nurses working in educational hospitals of Ilam city and was selected by stratified random sampling in 2022. A four-part questionnaire was used: the first part included a question on demographic information. Minnesota Satisfaction Questionnaire (MSQ) (1977), Diener et al.'s Satisfaction with Life Scale (SWLS) (1985), and Derogatis et al.'s Symptom Checklist-90 (SCL-9) (1973) were included in the second, third and the fourth parts, respectively. Results showed no significant relationship between the total score of mental health and the total score of job satisfaction. There was a significant relationship between the total job satisfaction score and life satisfaction score (r=0.267, p=0.001). There was also an inverse and significant relationship between the total mental health score and the life satisfaction score (r=0.294, p=0.001). The collected data was analyzed using descriptive tests (frequency, mean percentage, and standard deviation) and non-parametric Spearman and Kruskal-Walli’s correlation tests in SPSS ver. 22. P- value<0.05 was considered as the significance level in all tests. Job satisfaction is effective in creating motivation, efficiency, responsibility, and social accountability in the personnel of any organization. Job dissatisfaction can lead to complications such as job burnout, illness, absenteeism, the job left, leaving many nursing jobs, and the reluctance of the young workforce to attend the wards. Therefore, it is necessary to make further efforts in this field by healthcare policymakers.
Hippo signaling has been recognized as a newly identified tumor suppressor signaling pathway that can regulate cellular processes including regeneration, cell death, differentiation, and development. Its dysregulation through overexpression of YAP (Yes-associated protein) and TAZ (PDZ-binding motif) as two main oncogenic factors of the Hippo pathway has a crucial role in several cancers. Because of the limited prognosis and therapeutic targets, further understanding of molecular pathways involved in tumorigenesis is one of the interesting issues in studies. Here, we demonstrated that some viruses, through dysregulation of the Hippo signaling pathway can be implicated in transformation, metastasis, and chemotherapeutic drug resistance in virus-related cancer and also help processes involved in the pathogenesis of viral infection such as persistence.
We wanted to evaluate the efficacy of intravenous immunoglobulin (IVIG) treatment in Covid-19 patients in the intensive care unit (ICU). Sixteen (66.7%) male and 8 (33.3%) female adult severe Covid-19 patients who were treated with IVIG in the tertiary ICU between April 2020 and October 2021 at Ankara City Hospital were retrospectively reviewed. The median age of the patients was 63 (interquartile range (IQR):19). The patients were evaluated in terms of laboratory values and clinical results before and after IVIG treatment. There was no statistically significant difference between survived and deceased Covid-19 patients treated with IVIG in terms of age, gender, the onset of symptoms, presence of concomitant diseases, APACHE-II scores, duration of mechanical ventilator support, and length of stay in the ICU. When the laboratory values before and after IVIG treatment were compared, a significant decrease was identified only in alanine transaminase levels (p=0.01). However, there was a statistically significant difference in mortality in 5 patients with Guillain-Barré syndrome who all survived (p=0.001). IVIG treatment was effective in Covid-19 patients with Guillain-Barré syndrome. However, IVIG treatment did not have a statistically significant effect on pre and post-treatment laboratory values, morbidity, and mortality of severe Covid-19 patients in the ICU.
As general population tends to have increasing life expectancy, the risk associated with developing chronic kidney disease (CKD) with multiple incapacitating concequences, also increases. Method: For the present study, we registered the data from the observation files of 37 patients diagnosed with CKD undergoing treatment by chronic hemodialysis and noted the CKD associated diagnoses included in the notion of comorbidities. We monitored their statistical incidence both in the whole group and separately, in women and men using TTEST and CORREL. Results: The median age of the subjects was 55.86 (± 12.00) years. The study population mean weight was 74.90 (± 14.44) kg, with a mean weight of 69.33 kg for female subjects, and 77.92 kg for males, respectively. Diabetes was identified in 35.13% of patients, whilst heart failure was present in 16.21% of patients. Conclusions: Following the analysis of the information about the patients with CKD in the dialysis program, which we included in the study group, we observed the existence of variations that occur with age, significant correlations between age and weight and between albuminemia and weight. The most common comorbidity is high blood pressure followed by anemia.
This article aims to highlight the burnout burden among neurologists and provide information on some of its causes and consequences. We report an original article that reviews our current understanding of burnout matter in the neurology field. The main search engine through which we performed extensive literature research was PubMed, Scopus, and Google Scholar. The following information was collected: triggers of burnout and factors that perpetuate it, major complaints, values, and goals that dictate how coaching with it. Physician burnout is an umbrella term characterized by symptoms determined by exposure to chronic workplace stressors. Simply put, it encompasses many dimensions: emotional exhaustion, feelings of cynism, detachment (depersonalization), and a sense of ineffectiveness at work (low personal accomplishment). Burnout is common among all medical specialties, but neurology ranks at the top of the list. Several identified factors continue to fuel this problem. Properly addressing them, rethinking practice, and implementing wise, modern strategies can make significant contributions to reducing it. Aside from the chronic harm to the physician, burnout puts at risk the healthcare community at many levels including patients, other professionals, finances, etc. This paper wants to emphasize that burnout in neurology should be regarded as a global crisis. Thus, some strategies are proposed.
Collision tumors, rare neoplasms underlying two distinct histological types of carcinomas (with different origins) separated by normal tissue, are described in many organs including the thyroid gland, but to a lesser extent. We aim to overview the current published data concerning collision tumors of the thyroid (CTT). This is a narrative review considering papers published on PubMed through a search starting from the terms “collision” and “thyroid”. Inclusion criteria are full-length articles, the English language, the timeline from inception to December 2022, and original studies with different levels of statistical evidence. We followed the main types of thyroid carcinomas: differentiated thyroid carcinoma of papillary and follicular type, anaplastic/ undifferentiated/poorly differentiated carcinoma, respectively medullary thyroid carcinoma. We identified 92 papers based on the mentioned
We aim to introduce a 2022 update on CHD (carcinoid heart disease) considering a multidisciplinary perspective. This is a narrative mini-review. We searched English, full-length papers (PubMed). Inclusion criteria: original articles regardless of the level of statistical significance. We identified 44 papers and manually selected those with CHD, as follows: 8 original studies, 1 case series (N=9 patients), 16 case reports (N=1 patient/paper), and a total of 1,030 patients on published studies. The most remarkable results are the longest period of enrolment of 3-4 decades; CHD ratio among carcinoid syndrome of 37%; 30-day mortality post-cardiac surgery of 12%; median survival in CHD from 1.3 to 3.9 years (more than 2 years if valve intervention is provided); most useful prognostic markers: 5HIIA, NT-pro-BNP, but, potentially, chromogranin A. The specific protective role of somatostatin analogs against developing CHD is yet to be determined. CHD in the absence of carcinoid syndrome/liver metastasis may be related to ovarian NEN (neuroendocrine neoplasia) with a better outcome if prompt intervention. Remarkably, 3 guidelines are released regarding CHD on behalf of ENETS (European Neuroendocrine Tumor Society), and ESC (European Society of Cardiology). CHD still represents a most challenging entity situated at the crossroads of surgery, cardiology, oncology, endocrinology, and gastroenterology.
Coronary CT angiography is a non-invasive method of analyzing the coronary lumen through which the atheromatous bur-den can be evaluated, with the analysis of the type of plaque (soft, calcified, mixed) and the impact on the arterial lumen (stenosis, occlusion). The anatomical evaluation by coronary CT is indicated in symptomatic patients with low and medium risk factors for coronary atherosclerotic disease, in those with inconclusive laboratory and EKG results, patients with un-certain stress test results, in the evaluation of coronary grafts and intrastent stenoses. Depending on the result of the angiography, the severity of the stenosis and the management of the patient are established. In the case of mild and medium stenoses, risk factors management and drug treatment are recommended. For severe stenoses, patients are referred for interventional coronary angiography or functional evaluation. Coronary CT angiography increases the certainty of coronary atherosclerotic disease diagnosis. It has a superior discriminative capacity of plaques with low attenuation, the main predictor of myocardial infarction, with almost five-fold higher risk. Coronary CT angiography increases the adaptation of medication, and the inclusion of statin therapy decreases the risk of fatal and nonfatal myocardial infarction at 5 years and increases the quality of life.
