Medicine最新文献

{"title":"Unusual extension of a left-sided retroperitoneal lipoma into the thigh: A case report.","authors":"Abdul Muqeet, Emad Uddin Sajid, Mohammad Faisal Ibrahim, Anfal Atif, Absar Hyder, Muhammad Imran Siraj, Nour Fakih","doi":"10.1097/MD.0000000000043528","DOIUrl":"10.1097/MD.0000000000043528","url":null,"abstract":"<p><strong>Rationale: </strong>Retroperitoneal liposarcomas are rare mesenchymal tumors often diagnosed late due to asymptomatic growth. While they typically extend into adjacent retroperitoneal structures, invasion into the thigh is exceedingly rare, posing unique diagnostic and therapeutic challenges.</p><p><strong>Patient concerns: </strong>A 45-year-old South Asian female presented with a progressively enlarging swelling in the left upper thigh, extending into the left inguinal and flank regions, accompanied by intermittent pain.</p><p><strong>Diagnoses: </strong>Imaging revealed a large, lobulated, fat-attenuating mass measuring 11 × 9 cm in the axial plane with a craniocaudal extent of 30.7 cm, spanning from the retroperitoneum to the thigh. Histopathology confirmed a well-differentiated liposarcoma.</p><p><strong>Interventions: </strong>The patient underwent surgical resection via a combined laparotomy and thigh incision, achieving complete excision with negative margins.</p><p><strong>Outcomes: </strong>Postoperative recovery was uneventful. At 6-month follow-up, there was no tumor recurrence or functional limitation reported.</p><p><strong>Lessons: </strong>This case highlights the importance of comprehensive imaging and meticulous surgical planning in managing atypical tumor extensions such as retroperitoneal liposarcomas invasion into the thigh. Given the rarity of this presentation, it contributes valuable insights into clinical and surgical management strategies for similar cases.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43528"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of systemic inflammatory response index with serum uric acid levels, hyperuricemia, and gout in adults aged 20 years and older in the United States: A cross-sectional study.","authors":"Yifan Lu, Chengyin Lu, Pei Chen, Zhiqiang Luo, Wangyang Li, Hui Xiong, Yuxing Guo","doi":"10.1097/MD.0000000000043566","DOIUrl":"10.1097/MD.0000000000043566","url":null,"abstract":"<p><p>This study aimed to explore the association between the systemic inflammatory response index (SIRI) and the prevalence of gout, hyperuricemia, and serum uric acid (SUA) levels with the help of the National health and nutrition examination survey database. This study analyzed the association of SIRI with SUA levels, hyperuricemia, and gout using National health and nutrition examination survey data for the period 2007 to 2018. We applied smoothed curve fitting to confirm the nonlinear correlation between SIRI and the above indicators and further verified this relationship through threshold effect analysis. In addition, we applied receiver operating characteristic curve analysis to evaluate the validity of SIRI in the diagnosis of hyperuricemia and gout. Including 29,929 adults aged 20 and older, the study found significant positive correlations between SIRI and SUA levels, hyperuricemia, and gout after adjusting for potential confounders. These correlations were consistent in gender-stratified subgroup analyses. Threshold effect analysis revealed an inflection point for SIRI at 1.508 (1000 cells/µL) for gout and 0.529 (1000 cells/µL) for hyperuricemia, with significant positive associations observed up to these points. Receiver operating characteristic analysis confirmed SIRI's diagnostic value for hyperuricemia (area under the curve = 0.5534) and gout (area under the curve = 0.6041). Association between SIRI and SUA levels, prevalence of gout and hyperuricemia. Our study reveals SIRI as an emerging, validated, and convenient composite inflammatory index that may serve as a new indicator for assessing gout and hyperuricemia disease activity in U.S. adults aged 20 years and older.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43566"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of massive hemorrhage on outcome in patients with orthotopic liver transplant: A retrospective unicenter study.","authors":"Iulian Buzincu, Mihaela Blaj, Adi-Ionut Ciumanghel, Irina Gîrleanu, Eliza Isabela Bărbuță, Irina Ciumanghel, Ana-Maria Trofin, Cristian Dumitru Lupașcu","doi":"10.1097/MD.0000000000043575","DOIUrl":"10.1097/MD.0000000000043575","url":null,"abstract":"<p><p>Despite advancements in surgical and anesthetic techniques, significant bleeding remains a common challenge during orthotopic liver transplantation (OLT). The extensive nature of the surgical procedure, combined with the patient's fragile coagulation profile, places individuals undergoing OLT at a high risk for massive hemorrhage (MH). Blood transfusions and hemostatic products are frequently required and can be life-saving. However, these resources are often limited, and their use may be associated with numerous complications. This study aimed to evaluate the impact of MH on the day of surgery on the outcomes of patients undergoing OLT from brain-dead donors at our institution. We conducted a retrospective single-center study including all adult patients who underwent OLT from brain-dead donors at the Emergency County Clinical Hospital \"Saint Spiridon\" in Iași. Preoperative circulating blood volume was calculated for each patient and compared with the estimated blood loss on the day of surgery. Patients who lost >1 circulating blood volume were classified as having experienced MH. The study population was divided into 2 groups: those with MH and those without. Outcomes were assessed based on 30-day and 1-year mortality, as well as medical and surgical complications. The study included 53 patients, with a median blood loss of 5500 mL (4650 mL). MH occurred in 26 patients (49.1%). Patients with a lower body mass index (24.3 vs 26.6, P = .028) and thrombocytopenia (55.5 vs 75 × 10³/µL, P = .04) were more likely to experience MH. Those with MH had higher rates of cardiovascular complications (38.5% vs 7.4%, P = .007), infectious complications (69.2% vs 37%, P = .009), and surgical reintervention (34.6% vs 11.1%, P = .04). Mortality rates at 30 days and 1 year did not significantly differ between patients with and without MH. MH adversely affects the outcomes of OLT patients, as evidenced by increased rates of cardiovascular and infectious complications and a higher likelihood of requiring surgical reintervention.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43575"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential impacts of internal and external corporate social responsibility on emotional labor among clinicians in Chinese public hospitals: A cross-sectional study.","authors":"Guoyu Luo, Mohd Anuar Arshad, Xianhang Xu, Mengjiao Zhao","doi":"10.1097/MD.0000000000043276","DOIUrl":"10.1097/MD.0000000000043276","url":null,"abstract":"<p><p>Chinese clinicians face significant emotional labor challenges due to an imbalance in the doctor-patient ratio, long working hours, high regional work stress, and cultural expectations. While research on the relationship between corporate social responsibility (CSR) and emotional labor has grown, the specific impact of internal versus external CSR remains unclear. This study aims to explore the differential effects of internal and external CSR on emotional labor, organizational identification (OI), and perceived social support (PSS) among Chinese clinicians, providing insights into how these factors interact to affect clinicians' emotional well-being. We surveyed clinicians in grade 3A public hospitals across China. Using PLS-SEM with Smart-PLS4, we analyzed 350 valid responses to examine the relationships between internal and external CSR, emotional labor, OI, and PSS. Our findings confirmed that internal CSR negatively affects surface acting and positively affects deep acting (DA), indicating that organizational support fosters authentic emotional engagement rather than superficial emotional responses. The mediating role of OI was also validated, with internal CSR enhancing clinicians' identification with the organization, reducing emotional dissonance. However, external CSR did not significantly affect either surface or DA, suggesting that social responsibility outside the organization may not directly alleviate emotional labor. The moderating role of PSS was only partially supported, with social support buffering some of the negative effects of emotional labor but not all. This study is significant for policymakers and healthcare managers, as it highlights the critical role of internal CSR in reducing emotional labor among clinicians. The findings suggest that organizations should focus on internal social responsibility practices (such as fostering a supportive work environment and enhancing OI ) to reduce surface acting and promote DA. By doing so, hospitals can create a more sustainable work environment for clinicians, improving their well-being and reducing burnout.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43276"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of Gegen Qinlian decoction combined with mesalazine for the treatment of UC: A meta-analysis and systematic review.","authors":"Yanjie Chen, Ruoqi Li, Yuping Yuan, Haomin He, Wei Yang, Cheng Yuan, Jinyin Xiao, Yile Qin, Min Lian, Zhouyu Yang","doi":"10.1097/MD.0000000000042266","DOIUrl":"10.1097/MD.0000000000042266","url":null,"abstract":"<p><strong>Background: </strong>To systematically evaluate the clinical efficacy and safety of a Gegen Qinlian decoction combined with mesalazine for the treatment of ulcerative colitis (UC).</p><p><strong>Methods: </strong>Chinese (CNKI, CSPD, CCD, and CBM) and foreign databases (PubMed, Web of Science, Cochrane Library, and Embase) were searched for randomized controlled trials related to the treatment regimen used in this study. The risk of bias of the included studies was evaluated using the Cochrane assessment tool. Revman5.0 and Stata17.0 were used for the meta-analysis and sensitivity analysis. Trial sequential analysis was used for sequential analysis. Gradepro3.6 was used to evaluate the level of evidence quality of outcome indicators.</p><p><strong>Results: </strong>Fifteen studies involving 1428 patients were included. The results of meta-analysis showed that the intervention group in the treatment of UC improved the total clinical effective rate (P < .001, relative risk = 1.22, 95% confidence interval (CI) [1.16-1.28]), the main clinical symptoms (P < .001, standard mean difference [SMD] = 1.58, 95% CI [1.86, 1.30]), intestinal mucosal barrier function (P < .001, SMD = 1.02, 95% CI [1.20, 0.84]), reduce the incidence of adverse reactions (P = .05, relative risk = 0.59, 95% CI [0.35, 1.00]), modified Mayo score (P < .001, SMD = 1.53, 95% CI [2.17, 0.89]), Baron endoscopic score (P < .001, SMD = 0.93, 95 CI [1.18, 0.68]), regulate immune function (P < .001, SMD = 0.69, 95% CI [0.47, 0.90]), inflammatory factor levels (P < .001, SMD = 0.69, 95% CI [0.47, 0.90]), intestinal flora (P = .004, SMD = 1.42, 95% CI [0.44, 2.39]), the intervention group were better than the comparison group. But there was no significant difference in oxidative stress index (P = .54, SMD = -0.44, 95% CI [-1.82, 0.95]).</p><p><strong>Conclusion: </strong>Gegen Qinlian decoction combined with mesalazine has definite clinical efficacy and safety for the treatment of UC. Owing to the limited methodological quality of the included studies, high-quality randomized controlled trials are still needed for verification in the future.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e42266"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between dietary diversity and oral frailty in elderly gynecologic tumor patients.","authors":"Tao Liu, Lu Huang","doi":"10.1097/MD.0000000000043298","DOIUrl":"10.1097/MD.0000000000043298","url":null,"abstract":"<p><p>This study explores the relationship between dietary diversity and oral frailty in elderly gynecologic tumor patients. A total of 180 gynecologic tumor patients treated in our hospital from January 2021 to December 2024 were selected. Patients were divided into an oral frailty group (n = 71) and a non-oral frailty group (n = 109) based on the occurrence of oral frailty ( ≥ 4). Influencing factors were analyzed using univariate and binary logistic regression analysis. The correlation between variables was assessed with Pearson correlation analysis. The predictive value of Dietary Diversity Score (DDS) for the occurrence of oral frailty in elderly gynecologic tumor patients was evaluated using the receiver operating characteristic curve, and the dietary intake of patients with different oral frailty statuses was observed. The average DDS score among the 180 patients was 3.96 ± 1.39. There was no statistically significant difference in DDS among patients with different general characteristics (P > .05). Similarly, there was no statistically significant difference in general characteristics between the oral frailty group and the non-oral frailty group (P > .05). However, a statistically significant difference was observed between DDS and smoking status (P < .05). Binary logistic regression analysis indicated that DDS was a significant factor influencing the occurrence of oral frailty in elderly gynecologic tumor patients (P < .05). Receiver operating characteristic analysis showed that the area under the DDS predictive curve was 0.883, with a standard error of 0.025 (95% confidence interval: 0.834-0.932, P < .001); the Youden index was 0.60, with a sensitivity of 70.42% and specificity of 89.91%. The optimal cutoff value was 4.5. There was no statistically significant difference in the intake of eggs, fish, milk, and dairy products (P > .05), while there were statistically significant differences in the intake of meat, legumes, yogurt, vegetables, and fruits (P < .05). Pearson linear correlation analysis showed that Oral Frailty Index-8 was negatively correlated with vegetable intake, fruit intake, and DDS (r = -0.300, -0.233, -0.338, respectively; P < .05). Increased severity of oral frailty in elderly gynecologic tumor patients is associated with reduced dietary diversity.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43298"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research on the mechanism of action of the Li Qi Dao Tan Decoction in the treatment of schizophrenia based on network pharmacology and molecular docking.","authors":"Shuo Wang, Fei Guo, Chen Zhao, Gezi Shi, Jing Liu, Shichang Yang","doi":"10.1097/MD.0000000000043462","DOIUrl":"10.1097/MD.0000000000043462","url":null,"abstract":"<p><p>This study explores the potential targets and signaling pathways of the Li Qi Dao Tan Decoction (LQDTD) in the treatment of schizophrenia using network pharmacology and molecular docking technology. The traditional Chinese medicine systems pharmacology database and analysis platform database was searched to obtain the active ingredients and targets of the LQDTD. Databases such as GeneCards, DrugBank, and OMIM were searched for schizophrenia-related disease targets. By drawing a Venn diagram, the intersection targets of LQDTD and schizophrenia were obtained. The STRING database was used to construct the protein-protein interaction. The online tool of the DAVID database was used to analyze the gene ontology and Kyoto Encyclopedia of Genes and Genomes pathways of the intersection targets of LQDTD and schizophrenia. The Cytoscape software was employed to construct the network of traditional Chinese medicine ingredients, targets, and pathways. AutoDock, Chem3D, and PyMOL software facilitated molecular docking and the calculation of binding energy for the identified key active ingredients and targets, from which the 7 pairs with the lowest binding energy were selected. PyMOL was utilized for analysis and visualization. We identified 5 active ingredients of LQDTD: luteolin, nobiletin, baicalin, quercetin and licochalcone A. Key proteins, including signal transducer and activator of transcription 3, TP53, and EGFR, were identified through the protein-protein interaction map. Kyoto Encyclopedia of Genes and Genomes analysis indicated that the pathways involved primarily included lipid and atherosclerosis pathways, hepatitis B virus-related pathways, AGE-RAGE signaling pathways, Chemical carcinogenesis receptor activation, and prostate cancer signaling pathways. The treatment of schizophrenia may influence key proteins such as signal transducer and activator of transcription 3, TP53, and EGFR, intervening in lipid and atherosclerotic pathways, hepatitis B virus-related pathways, AGE-RAGE signaling pathways, chemical carcinogenesis receptor activation, and prostate cancer signaling pathways. However, the exact mechanisms of action require further experimental verification.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43462"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary alveolar proteinosis complicated by pulmonary and intracranial cryptococcal infection: A case report.","authors":"Chun-Xing Ye, Huan-Qing Lin, Zi-Ran Wang, Guo-Qing Qiu, Si-da Chen, Jing-Shen Wu, Xiang-Qin Xu, Yan Shen","doi":"10.1097/MD.0000000000043536","DOIUrl":"10.1097/MD.0000000000043536","url":null,"abstract":"<p><strong>Rationale: </strong>Pulmonary alveolar proteinosis (PAP) is a rare interstitial lung disease. Superimposed opportunistic Cryptococcus gattii infection can significantly complicate clinical management.</p><p><strong>Patient concerns: </strong>A 34-year-old male patient presented to the respiratory department with a paroxysmal cough for 2 months.</p><p><strong>Diagnoses: </strong>Typical computed tomography manifestation and lung biopsy were consistent with PAP. Culture of lung lavage fluid, cerebrospinal fluid, and targeted next-generation sequencing of lung tissue revealed Cryptococcus infection.</p><p><strong>Interventions: </strong>Amphotericin B, fluconazole, and flucytosine were used for induction therapy. Right lower lobectomy combined with postoperative voriconazole was continued.</p><p><strong>Outcomes: </strong>The CSF cryptococcal antigen titer has declined, and brain MRI shows a reduction in lesions. The clinical course is now stable and improving.</p><p><strong>Lessons: </strong>Patients with PAP may have relatively rare opportunistic infections. Multifaceted examinations are very necessary for the diagnosis of C. gattii. During the treatment of C. gattii, great attention should be paid to possible adverse reactions such as liver and kidney damage and thrombosis.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43536"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary hypertension associated with rheumatoid arthritis: A case report and causal association verification through Mendelian randomization.","authors":"Jingwei Liu, Chunyan Rong, Yin Wang, Baoguo Wang, Xuhan Liu, Weihua Zhang","doi":"10.1097/MD.0000000000043116","DOIUrl":"10.1097/MD.0000000000043116","url":null,"abstract":"<p><strong>Rationale: </strong>Rheumatoid arthritis (RA) is a chronic systemic autoimmune connective tissue disease characterized by joint swelling and pain, affecting multiple organs. Pulmonary hypertension (PH) is a known but relatively rare pulmonary vascular complication in RA patients. The pathophysiological mechanisms linking RA and PH are diverse, and Mendelian randomization analysis can be used to explore their correlation.</p><p><strong>Patient concerns: </strong>A 43-year-old woman presented with swelling and pain in multiple joints of both hands and dyspnea on exertion lasting over 6 months.</p><p><strong>Diagnoses: </strong>Laboratory tests showed elevated rheumatoid factor, erythrocyte sedimentation rate, C-reactive protein, and anticyclic citrullinated peptide antibody. Echocardiogram revealed PH and mild tricuspid regurgitation. Pulmonary computed tomography scan showed no signs of interstitial lung disease. Pulmonary function tests indicated severe reduction in diffusion capacity and alveolar volume. Right heart catheterization confirmed postcapillary PH with elevated mean pulmonary artery pressure and pulmonary vascular resistance.</p><p><strong>Interventions: </strong>The patient received antirheumatic drugs combined with PH-targeted therapies for 4 months.</p><p><strong>Outcomes: </strong>At follow-up, the patient's pulmonary artery pressure returned to normal levels.</p><p><strong>Lessons: </strong>The pathophysiology of RA-associated PH involves multiple inflammatory components. Accurate diagnosis requires right heart catheterization, pulmonary computed tomography, and pulmonary function testing. Combined antirheumatic and PH-targeted treatments can effectively reduce autoantibody levels and alleviate PH.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43116"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Second-victim experience in anesthesia and intensive care settings: Organizational gaps, support preferences, and recommendations for action - a cross-sectional study.","authors":"Pinar Ayvat, Ali Galip Ayvat, Gunal Bilek, Ozlem Oner, Gulsah Sehitoglu Alpagut, Omer Faruk Sonmez","doi":"10.1097/MD.0000000000043375","DOIUrl":"10.1097/MD.0000000000043375","url":null,"abstract":"<p><p>Healthcare professionals involved in the management of adverse events often experience psychological and physical distress, known as the \"second victim experience.\" Anesthesia and intensive care settings are particularly vulnerable to such occurrences due to the high-stakes, and highly stressful work being performed by healthcare professionals. This study aimed to assess the prevalence and dimensions of second-victim experiences among anesthesia and intensive care professionals in Türkiye, while also identifying support preferences and organizational deficiencies. A cross-sectional study was conducted with 175 healthcare professionals working in anesthesia and intensive care units in Türkiye. The Turkish adaptation of the second-victim experience and support tool (T-SVEST) was used to assess psychological distress, physical distress, professional self-efficacy, perceived support mechanisms, and outcome variables such as turnover intentions and absenteeism. Psychometric analyses, confirmatory factor analysis, and correlation/regression tests were performed to evaluate the scale's validity and to explore correlations among key variables. The T-SVEST demonstrated strong internal consistency (Cronbach α = 0.86) and an improved factor structure following the removal of low-performing items. High levels of psychological and physical distress significantly associated with professional self-efficacy, absenteeism, and turnover intentions were reported. Supervisor and institutional support were perceived as insufficient, particularly among less experienced staff. Age and work experience were positively correlated with colleague support, while married participants reported significantly lower physical distress. Peer support and professional counseling emerged as the most desired support mechanisms. Second-victim experiences are common and consequential among anesthesia and intensive care professionals in Türkiye. The findings have highlighted substantial gaps in organizational support structures and a strong demand for evidence-based peer support systems. Institutional efforts must focus on building a culture of safety and compassion through structured interventions, supervisor training, and proactive debriefing practices to mitigate the impact of adverse events on healthcare providers.</p>","PeriodicalId":18549,"journal":{"name":"Medicine","volume":"104 30","pages":"e43375"},"PeriodicalIF":1.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}