Gynecologic cancers are among the most common cancers in women and are a significant cause of mortality in women worldwide. FDG-PET images play a critical role in several areas of oncology and are an essential tool for the diagnosis and staging of gynecologic cancer, providing information about tumor metabolism. Aim: The aim of this study was to investigate the relationship between tumor differentiation, type of malignancy, and glucose metabolism in patients with confirmed gynecologic cancer. Materials and Methods We performed a retrospective review of 60 consecutive patients (ages 31-76) with histopathologically confirmed gynecologic cancer who underwent PET-CT in our department between January 2021 and March 2022. Quantitative data on glucose metabolism were collected using the maximum standardized uptake value normalized by lean body mass (SULmax). We reviewed a total of 60 patients with a mean age of 60±9 years, and a median of 62. Results: 14 patients were diagnosed with cervical cancer, 20 with endometrial cancer, and 26 with ovarian cancer; 13 patients had well- differentiated cancer, 11 had moderately differentiated cancer, and 36 had poorly differentiated cancer. A positive correlation was observed between the measured SULmax and the degree of tumor differentiation, indicating higher glucose uptake in poorly differentiated cancer. When examining the relationship between the type of cancer and SULmax, we found that endometrial cancer exhibited the highest mean SULmax (8.36±6.75), followed by ovarian cancer and cervical cancer. Additionally, we noted that glucose uptake was higher in patients aged over 62 years. Regardless of the tumor differentiation, the findings in endometrial cancer showed the highest mean SUVmax values in all grades of tumor differentiation. Conclusion: Our study showed that glucose consumption correlates not only with the degree of differentiation but also with age and type of tumor, with the highest values in patients older than 62 years with endometrial cancer. Given the correlation between glucose consumption and tumor aggressiveness, this finding may be important for prognostic evaluation of patients with gynecologic malignancies.
Boosted by the COVID-19 pandemic, the adoption of technology has shifted people’s lifestyles, impacting social interactions and leading to an increase in the use of telemedicine, including teledermatology (TD). Social media platforms facilitate communication between patients and physicians, between primary care physicians and specialists, and between dermatologists. The study aimed to assess the attitudes, views, and usage of dermatologists regarding TD consultations. A cross- sectional study was performed with the use of an anonymous, web-based questionnaire intended to be completed by dermatologists. A total number of 73 physicians, both resident and board-certified dermatologists completed the survey. Almost everyone (98.6%) used some form of teledermatology, the most frequently used platforms being WhatsApp, followed by classical telephone calls/messages, email, and other forms of TD. TD is considered to be especially useful in communicating with peer colleagues (94.4%), with physicians of other specialties (90.0%), with family doctors (72.9%) and with patients (69.9%). Since TD can facilitate the treatment-related follow-up of adverse effects, while also being useful in the triage of patients, its use will likely increase in the future. The main concerns were related to the accuracy of the diagnosis through TD, a less developed doctor- patient relationship, a less informative consultation, an increased workload as well and a diminished financial reimbursement. Dermatologists currently use TD in addition to the classical consultations of patients, as well as to communicate with family physicians and peer colleagues to better manage complex cases. Furthermore, TD proves to be an important tool in the education of young dermatologists.
Mental disorders clearly are among the major challenges of global health causing many concerns for health systems, health experts, and health policy makers. The present study was conducted to evaluate the mental health program in comprehensive health centers and health houses under the coverage of Ilam University of Medical Sciences in the West of Iran. The present study was conducted based on the reports obtained from the mental health program in 2019. The data were recorded into registration and evaluation forms of mental disorders with the codes 102-19-03 and 102-19-01 and then entered into the Excel software. The prevalence per 100 and 100,000 people, as well as their 95% confidence intervals were calculated using Formula 1 ROUND (Number of cases*100000/population) and Formula 2 ROUND (Prevalence ±1.96*SQRT (Prevalence *(1- Prevalence)/population). The results showed that the prevalence of depression was 19,100 [95% CI: 18999-19201] 19100), and the prevalence of anxiety was 304,66 [95% CI: 20348-30584] per 100,000 population. The highest prevalence among mental disorders was related to depression and anxiety. Considering the high average score of mental health status in people over 65 years old, it is necessary to implement measures and interventions to improve these individuals’ mental condition and upgrade their mental health.
Nutritional interventions in the field of psychiatry have been explored more intensively in the last two decades, but definitive conclusions based on the retrieved data in the literature about the efficacy of this therapeutic approach are difficult to formulate. This observation has multiple explanations, e.g., these therapeutic interventions are very heterogenous, cohort studies usually enroll different psychiatric populations or healthy subjects with minor psychiatric symptoms, nutritional supplements or special diets are commonly recommended as add-ons to the pharmacological interventions (thus making it difficult to differentiate the impact of each therapy on the outcomes), placebo-controlled randomized studies are still very few, etc. Therefore, a narrative review focused on the main challenges reported during the research in the field of nutritional psychiatry (NP) may be useful for clinicians interested in strategies to augment the efficacy of pharmacological treatments or to find new solutions with low risk of adverse events in patients with organic comorbidities or multiple concomitant medications. Data about the efficacy and tolerability of nutritional interventions explored for psychiatric disorders were searched in four electronic databases (PubMed, Cochrane, Clarivate/Web of Science, and EMBASE). Omega-3 polyunsaturated fatty acids supplementation, healthy diet interventions, folate and vitamin B12, S-adenosyl-L-methionine, N-acetyl cysteine, vitamin B1 and B6, vitamin D, minerals, psychobiotics, inositol, and herbal products were the main interventions identified, and their demonstrated efficacy was quite heterogenous, while their tolerability and safety were good. Therefore, NP is a domain of research that may benefit from more good-quality and longer-duration trials, in order to verify the effectiveness of such augmentation strategies to the already validated treatments.
COVID-19 has not been adequately investigated in patients with psoriasis. We wanted to evaluate the effect of COVID- 19 and COVID-19 vaccines on disease course in patients with psoriasis. We retrospectively reviewed the medical records of patients who were admitted for the treatment of psoriasis between March 2020 and May 2022. Afterward, patients were contacted by telephone call to collect data on COVID-19. This study included 257 patients, 118 females, and 139 males. 238 (92.6%) patients were vaccinated against COVID-19. The mean age of the vaccinated and unvaccinated patients was 49.23±14.60 and 40.37±11.66 years, respectively (p=0.010). Exacerbation of psoriasis after COVID-19 vaccination was detected in 32 (13.4%) patients. 114 (44.4%) patients had been diagnosed with COVID-19 and 18.4% of them stated exacerbation of psoriasis after COVID-19. No association was detected between COVID-19 and having an accompanying disease and psoriasis treatment (p=0.843, p=0.845, respectively). Hospitalization was required in 12 (10.5%) patients. Unvaccinated patients with psoriasis were significantly younger than those who were vaccinated. Exacerbation of psoriasis was reported in 13.4% of vaccinated patients and in 18.4% of patients after COVID-19. Nevertheless, accompanying disease and conventional or biological agent treatment were associated neither with COVID-19 nor COVID-19-related hospitalization.
Spiritual care is an integrated section of nursing. Proper implementation of it to patients requires that care providers have the necessary competencies in this regard. Therefore, this study was performed to investigate the effect of an empowering program on spiritual care competence (SCC) in nursing students. This study was a randomized controlled trial that was performed on 60 nursing students at Kashan University of Medical Sciences, Iran. Participants were randomly assigned to two groups. The intervention group was under the spiritual empowering plan in seven sessions. The control group was traditionally trained. Data were collected by a spiritual care competence scale and analyzed using Fisher, independent and paired t-test in SPSS 16v. Baseline characteristics were similar in the two groups. The mean score of SCC was significantly increased post-empowerment for the intervention group. The differences between the two groups were statistically significant in the SCC scores (p<0.037). A significant difference was observed between the mean of the SCC score of the intervention group before and after the empowering (p < 0.0001). While, no significant changes were observed in the control group, before and after the study (p= 0.44). Empowering spiritual care skills in nursing students develops the quality of care in patients, which requires more attention in the educational curriculum.
A rare zoonotic disease, monkeypox is brought on by the Monkeypox virus, which is a member of the Orthopoxvirus genus, Chordopoxvirinae subfamily, and Poxviridae family. Smallpox-like symptoms are brought on by the monkeypox disease, which is closely linked to the variola virus (smallpox virus). In the past, it has been demonstrated that smallpox vaccination with the vaccinia virus (another orthopoxvirus) is 85% protective against monkeypox. The two most likely forms of monkeypox transmission are animal-human transmission and human-human transmission. Transmission between people has been connected to respiratory droplets, coming into contact with bodily fluids, contaminated patient things or surroundings, and skin lesions on infected people. Numerous strategies or tactics have been developed by monkeypox to subvert or exacerbate the host's immune reaction to infection. A crucial element of innate immunity, natural killer [NK] cells employ cytokines to kill virus-infected cells and interfere with the operation of other cell types like T cells and dendritic cells. Studies have shown that the smallpox vaccine provides cross-protection against other Orthopoxvirus species, including monkeypox. This study was out to provide a thorough overview of the pathogenesis, prevention, risks, immune response problems, and analysis of possible concerns associated with the monkeypox virus.
Background: Healthcare providers should care for everyone without discrimination based on gender, race, religion, ethnic background, and social and economic status. Therefore, considering the importance of ethical challenges in war, this study was conducted with the aim of investigating the ethical challenges of healthcare providers in war. Method: This integrative review study was conducted in the field of ethical challenges for healthcare providers in war. Using the
Cervical cancer is a major cause of morbidity and mortality among women. It is the fourth most commonly diagnosed cancer in females. Screening strategies such as colposcopy can cause anxiety, discomfort, and pain in patients during this procedure and poor quality of life. The aim of this study was to evaluate the effect of psychoeducation on pain perception and anxiety in women undergoing colposcopy. This randomized clinical trial included 60 women, candidates for colposcopy referred to the surgical clinic of Kashan, Iran. The patients were randomly assigned into two groups: the experimental group, which received 60 minutes of psychoeducation, and the control group. Data were collected with the Spielberger anxiety inventory and visual analog score of pain and were analyzed using independent and dependent t-tests, Chi-square, and co-variance performed with SPSS version 16. The means of anxiety scores were significantly decreased post-psychoeducation in the intervention group, and the differences between the two groups were statistically significant in the anxiety scores (P < 0.0001). A significant difference was observed between the mean anxiety scores of the intervention group prior to and after the psychoeducational program (PEP) intervention (99.50 ± 5.28 vs. 84.89 ± 8.80) (P 0.05). There was no statistically significant difference between the mean pain score between the study and the control group at the end of the study (P= 0.17). Psychoeducation resulted in reduced anxiety in women undergoing colposcopy. Therefore, it is recommended to consider this intervention as a suitable and effective complementary, non-invasive, low-cost method to reduce anxiety in these patients.
