Medicina
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The management of foreign body airway obstruction has evolved over time from back blows and chest thrusts to abdominal thrusts. However, current guidelines worldwide are based on outdated data, with unclear evidence regarding the effectiveness and safety of these rescue manoeuvres. Concerns persist about the potential of these techniques to cause injury, especially in children; therefore, a critical revision to ensure optimal child safety is necessary. ⋯ First aid guidelines and recommendations for paediatric choking are divergent and generally grounded in low-quality evidence derived primarily from case studies. Studies since 2015 have shown highly diverse methodologies and often lack details on the execution of individual techniques, body positioning or the specific characteristics of study groups, which are crucial when comparing the effectiveness and safety of rescue manoeuvres. Updating evidence-based scientific knowledge for future recommendations is crucial.
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Observational Study
Impact of Paired Remote Ischemic Preconditioning on Postreperfusion Syndrome in Living-Donor Liver Transplantation: A Propensity-Score Matching Analysis.
Background and Objectives: Postreperfusion syndrome (PRS) is a significant challenge in liver transplantation (LT), leading to severe circulatory and metabolic complications. Ischemic preconditioning (IPC), including remote IPC (RIPC), can mitigate ischemia-reperfusion injury, although its efficacy in LT remains unclear. This study evaluated the impact of paired RIPC, involving the application of RIPC to both the recipient and the living donor, on the incidence of PRS and the need for rescue epinephrine during living-donor LT (LDLT). ⋯ Conclusions: Paired RIPC, involving both the recipient and the living donor, effectively reduces the occurrence of PRS and the need for rescue epinephrine during LDLT. These findings suggest that paired RIPC protects against ischemia-reperfusion injury in LDLT. Future randomized controlled trials are needed to verify our results and to explore the underlying mechanisms of the protective effects of RIPC.
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Background and Objectives: This study aimed to investigate the relationship between lower urinary tract symptoms (LUTS) and tooth loss due to chronic periodontitis. Materials and Methods: A total of 232 patients aged 40 years or older with LUTS were evaluated. The number of remaining teeth and the severity of LUTS were assessed using the overactive bladder symptom score, international prostate symptom score, and urodynamic tests. ⋯ Conclusions: Tooth loss due to chronic periodontitis is strongly associated with the severity of LUTS, including storage and voiding symptoms. Maintaining good oral health may help reduce the risk of OAB and related urinary symptoms. This study underscores the importance of dental care in managing and preventing LUTS, suggesting that improving oral health could play a key role in mitigating these conditions.
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Background and Objectives: Poststroke depression (PSD) is a psychiatric complication occurring after a stroke, and is known to negatively impact quality of life. In the present study, the possible relationship between serum vascular endothelial growth factor (VEGF-A) levels and early-onset PSD, as well as the predictive value of serum VEGF-A levels for early-onset PSD, were investigated. Materials and Methods: The study included 88 individuals diagnosed with acute ischemic stroke (AIS). ⋯ Moreover, VEGF-A levels and lesion localization were similar between mild, moderate, and severe PSD groups (p = 0.130). The MoCA score was negatively (r = -0.498, p < 0.001) correlated and the NIHSS score was positively correlated (r = 0.497, p < 0.001) with the HAMD-17 score. Conclusions: Our findings suggest that longitudinal studies in large cohorts including healthy control groups are needed to examine the possibility of using serum VEGF-A level as a marker for predicting early-onset PSD.
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Background and Objectives: Non-union is a severe complication of traumatic fracture that often leads to disability and decreased quality of life, with treatment remaining complex due to a lack of standardized protocols. This study examines the effectiveness of autologous conditioned serum (ACS) for non-union in patients who have a failed open reduction internal fixation (ORIF). Materials and Methods: Eleven patients with confirmed non-union at least 9 months post-ORIF or total hip replacement were enrolled. ⋯ Ten patients achieved union at the last follow-up visit, indicating the effectiveness of ACS in non-union cases unresponsive to ORIF. ACS demonstrated promising results in facilitating bone union in these challenging cases. Conclusions: ACS has the potential as an alternative or adjective treatment for non-union and is worthy of being investigated further for the benefits of patients.