Nathan K Evanson, Pratyusha Veldhi, Caitlyn Scherpenberg, John M Riccobono, Haitham Eid, Jennifer L McGuire
{"title":"Extracranial Effects of Traumatic Brain Injury: A Narrative Review.","authors":"Nathan K Evanson, Pratyusha Veldhi, Caitlyn Scherpenberg, John M Riccobono, Haitham Eid, Jennifer L McGuire","doi":"10.3390/clinpract15030047","DOIUrl":"10.3390/clinpract15030047","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) is often associated with other injuries and comorbidities. However, even isolated TBI directly leads to dysfunction in multiple body systems outside the central nervous system. These extracranial effects of TBI target systems including the autonomic nervous, cardiovascular, renal, pulmonary, immune, gastrointestinal, and hemostasis systems, as well as causing significant alteration to systemic metabolism.</p><p><strong>Aim: </strong>This review is intended to outline the effects of TBI on other body systems, and place these in context with treatment considerations for these patients.</p><p><strong>Significance: </strong>Systemic effects of TBI have implications for acute and critical care management of patients with TBI, including pharmacologic treatment. They also affect treatment decisions in chronic TBI care, as well as TBI-unrelated routine medical care for patients with chronic TBI. In addition, extracranial effects of TBI should be considered in research settings.</p><p><strong>Conclusions: </strong>It is important for clinicians and researchers to be aware of these extracranial effects, and consider their effects on pathology, treatment decisions, and interpretation of research findings.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vasileios Daglas, Nikolaos Kostopoulos, Michalis Mitrotasios, Antigoni Sarantaki, Maria Iliadou, Athanasios Moustogiannis, Maria Dagla, Evangelia Antoniou
{"title":"Self-Reported Physical Activity Behavior and Practice of Healthcare Professionals During the Second and Third Trimester of Pregnancy in Greece.","authors":"Vasileios Daglas, Nikolaos Kostopoulos, Michalis Mitrotasios, Antigoni Sarantaki, Maria Iliadou, Athanasios Moustogiannis, Maria Dagla, Evangelia Antoniou","doi":"10.3390/clinpract15030045","DOIUrl":"10.3390/clinpract15030045","url":null,"abstract":"<p><p><b>Background/Objectives:</b> The primary aim of the study was to investigate the self-reported behavior and practice of healthcare professionals (midwives and obstetricians) regarding physical activity during the second and third trimesters of pregnancy. The secondary goal of the study was to highlight sociodemographic and professional characteristics affecting the aforementioned behavior. <b>Methods</b>: The study was of cross-sectional design and was conducted between January 2022 and March 2023 with the participation of 235 midwives and obstetricians working in public and private facilities in the region of Attica, Greece. The participants completed a demographic characteristics form as well as a questionnaire structured to serve the aim of the study. Eight independent models of multivariate analyses of variance were performed. <b>Results</b>: Among the participants, over 97% recommended exercising during the second and third trimesters of pregnancy. Cardio exercises were the most commonly suggested type (93.1% in the second trimester and 88.5% in the third trimester), followed by relaxation exercises (87.7% and 89.8%, respectively). The majority recommended exercising 2-3 times per week, with session durations ranging from 15 to 30 min in the second trimester and 30 to 45 min in the third trimester. The intention for recommending physical activity during the second trimester was associated with the profession (<i>p</i> < 0.001), the personal attitude toward the necessity of exercising (<i>p</i> = 0.006), the participants' belief regarding the importance of being informed about relevant recommendations (<i>p</i> = 0.003), and the degree of knowledge regarding the relevant international guidelines (<i>p</i> = 0.031). With respect to the third trimester, the associated factors included gender (<i>p</i> = 0.011), the participant's profession (<i>p</i> = 0.006), the degree of knowledge regarding the relevant international guidelines (<i>p</i> = 0.008), their positive attitude toward physical activity during pregnancy (<i>p</i> = 0.011), and the degree of knowledge regarding the relevant international guidelines (<i>p</i> = 0.008). <b>Conclusions</b>: The aforementioned factors should be taken into consideration when designing interventions for the promotion of physical activity during pregnancy. The structure of relevant instruments would facilitate the evaluation of health professionals' behavior toward physical activity.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Osama A Alsulaiman, Maha I Alghannam, Dalal M Almazroua, Abdulaziz S Alamri, Suliman Y Shahin, Essam A Nassar, Naif N Almasoud, Abdulrahman T Alsulaiman, Ahmed A Alsulaiman
{"title":"Mental Health and Malocclusion: A Comprehensive Review.","authors":"Osama A Alsulaiman, Maha I Alghannam, Dalal M Almazroua, Abdulaziz S Alamri, Suliman Y Shahin, Essam A Nassar, Naif N Almasoud, Abdulrahman T Alsulaiman, Ahmed A Alsulaiman","doi":"10.3390/clinpract15030044","DOIUrl":"10.3390/clinpract15030044","url":null,"abstract":"<p><p>The purpose of this study is to comprehensively review the relationship between malocclusion and anxiety and depression. While the physical implications of malocclusion are well documented, recent scholarship has shifted focus to examining the direct relationship between malocclusion and both anxiety and depression. It has been hypothesized that individuals with skeletal or dental malocclusion experience a range of psychological sequelae, including diminished quality of life (QoL), reduced oral-health-related quality of life (OHRQoL), increased vulnerability and appearance-related bullying, and impaired body image. Furthermore, these factors are postulated to collectively contribute to overall mental health, with malocclusion potentially serving as a contributing etiological factor in the development of elevated levels of anxiety and depression. Contemporary scholarship has established a complex relationship between dentofacial deviations and the psychological well-being of affected individuals. Evidence shows that malocclusion may contribute to increased depression and anxiety levels in some individuals, influencing their social functioning and treatment-seeking behavior. Dentofacial disharmony has also been associated with altered self-perception, potentially impacting an individual's OHQOL and overall quality of life. While the findings exhibit some inconsistency, a modest body of evidence indicates a possible correlation between pronounced skeletal or dental malocclusion and anxiety and depression. These adverse psychosocial impacts, in turn, contribute to an elevated risk of anxiety and depression, underscoring the far-reaching consequences of malocclusion beyond oral health. Therefore, clinicians need to consider these issues in their treatment plans, incorporating interdisciplinary approaches that address both orthodontic and psychological aspects of patient care.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Factors Associated with Mental Health Problems Among Tuberculosis Patients Attending Tertiary Care Hospitals in the Bangkok Metropolitan Region, Thailand: A Hospital-Based Survey.","authors":"Kanjana Konsaku, Titaporn Luangwilai, Parichat Ong-Artborirak","doi":"10.3390/clinpract15030043","DOIUrl":"10.3390/clinpract15030043","url":null,"abstract":"<p><p><b>Background:</b> Little is known about mental health among tuberculosis (TB) patients in Thailand. This study aimed to identify factors associated with mental health problems in TB patients in urban Thailand. <b>Methods:</b> This cross-sectional study collected data from 210 TB patients receiving treatment at two tertiary care hospitals in the Bangkok Metropolitan Region of Thailand using consecutive sampling. The General Health Questionnaire (GHQ-12) and the Patient Health Questionnaire (PHQ-9) were used to assess mental health problems and probable depression, respectively. <b>Results:</b> Among TB patients, 34.3% had mental health problems (95% CI: 27.8-40.8), and 23.8% had depression (95% CI: 18.0-29.6). The final model from logistic regression with forward selection identified factors significantly associated with mental health problems, including high family support (OR = 0.45; 95% CI: 0.24-0.83) and perceived stigma: low (OR = 2.77; 95% CI: 1.16-6.60), moderate (OR = 3.56; 95% CI: 1.66-7.65), and high (OR = 3.56; 95% CI: 1.31-9.67) versus no stigma. Depression was associated with income ≥10,000 baht (OR = 0.43; 95% CI: 0.21-0.87), alcohol consumption (OR = 2.90; 95% CI: 1.27-6.64), and high social support from healthcare providers (OR = 0.44; 95% CI: 0.22-0.87). <b>Conclusion:</b> This study highlights the need to integrate mental health services into the TB care program to address the TB challenge in Thailand. Policies such as routine mental health screening and psychological counseling alongside treatment, as well as expanded social support and stigma reduction interventions, should be implemented to reduce the risk of mental health issues, particularly depression, and improve treatment outcomes among Thai TB patients.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11940974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Victor Niculescu, Delia Carmen Nistor-Cseppento, Sebastian Tirla, Brigitte Osser, Cristina Aur, Diana Mocuta, Gheorghe Ion Popescu, Radu Dan Necula
{"title":"A Retrospective Study on the Incidence of Periprosthetic Fractures Related to Total Hip Arthroplasty and Postoperative Complications During Hospitalization.","authors":"Victor Niculescu, Delia Carmen Nistor-Cseppento, Sebastian Tirla, Brigitte Osser, Cristina Aur, Diana Mocuta, Gheorghe Ion Popescu, Radu Dan Necula","doi":"10.3390/clinpract15030042","DOIUrl":"10.3390/clinpract15030042","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Periprosthetic fractures (PFs) are serious complications that can occur after total hip arthroplasty (THA), particularly in elderly patients who often have multiple comorbidities and low bone density. The surgical treatment of PFs typically involves internal fixation or revision arthroplasty, depending on the fracture type categorized by the Vancouver classification. This study examines the annual incidence of PFs and the complications that arise during hospitalization, as well as the predictive role of age in the occurrence of these fractures and their associated complications. <b>Methods</b>: Based on a retrospective observational study conducted over three years (2021-2023) at the Bihor County Emergency Hospital in Oradea, we analyzed 783 patients who underwent various hip surgeries. <b>Results:</b> The retrospective analysis identified 38 cases of PF out of 768 hip surgeries, resulting in an incidence of PF of 4.5%. Most PFs were classified as Vancouver B, with surgeries mainly involving internal fixation. Complications occurred in 23.68% of cases, including a mortality rate of 7.90%. A correlation analysis examining the relationship between age and post-surgical complications demonstrates a weak and statistically insignificant association (r = 0.120, <i>p</i> = 0.478). To highlight whether age is a predictive factor for PFs, we used the linear regression model; this suggests that older age explains 2.7% of the total variability in the incidence of PFs, being statistically significant ([F(1, 766) = 20.923], <i>p</i> < 0.001). <b>Conclusions</b>: The rising incidence of periprosthetic fractures is closely linked to the increasing number of total hip arthroplasties and the aging population. Fractures of this type are more common in elderly women, with no statistically significant differences have been found between the sexes.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pedro Céspedes, Francisco M Martínez-Arnau, María Dolores Torregrosa, Omar Cauli, Cristina Buigues
{"title":"Effects of a Multimodal Program on Frailty Syndrome and Psychological Alterations in Breast Cancer Women Treated with Aromatase Inhibitors.","authors":"Pedro Céspedes, Francisco M Martínez-Arnau, María Dolores Torregrosa, Omar Cauli, Cristina Buigues","doi":"10.3390/clinpract15030041","DOIUrl":"10.3390/clinpract15030041","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Treatment with aromatase inhibitors can worsen frailty syndrome and psychological symptoms in women diagnosed with breast cancer (BC) receiving these drugs to prevent cancer recurrence. We analyze whether postmenopausal women with localized BC receiving aromatase inhibitors (AIs) treatment can achieve improvements in their mental health and their level of frailty through a multimodal program that includes supervised physical exercise and health education workshops. <b>Methods:</b> A total of 52 postmenopausal women with a prior diagnosis of BC and receiving hormonal treatment with AIs were included in the multimodal physical exercise and health education program and evaluated before and after it. The assessment included the following five frailty syndrome (FS) criteria: involuntary weight loss, weakness, low physical activity, slow gait speed, and low muscle strength. Mental health was assessed using the Goldberg scale, with its subscales for anxiety and depressive symptoms. The Athens scale was used to assess subjective sleep quality. <b>Results:</b> There was a significant difference in the number of robust, pre-frail and frail women after the program compared to the baseline. Six women did not fulfill any criteria for (robust) FS before the program (11.5%), and thirty-three women (63.5%) after the program did not fulfill any criteria for FS. A total of 33 (63.5%) women met one or two FS criteria (pre-frail) before the program, and 18 (34.6%) met one or two FS criteria after the program; thirteen (25%) women met three or more FS criteria (frail) before the program and one (1.9%) after it (<i>p</i> < 0.001). A statistically significant improvement on the Goldberg scale was observed (on both the subscales for anxiety and depressive symptoms) (<i>p</i> < 0.001). A statistically significant improvement was also noted on the Athens insomnia scale (<i>p</i> < 0.001). A multivariate regression model analysis identified marital status (being married) (<i>p</i> = 0.047, beta coefficient= -0.249, 95% CI -1.4844--0.14) and the percentage of attendance at training sessions (<i>p</i> = 0.041, beta coefficient = -0.290, 95% CI 0.104-0.002) as associated variables, with a lower score on the Goldberg depression subscale. <b>Conclusions:</b> Mental health and frailty, common in postmenopausal women diagnosed with BC on hormonal treatment with AI, can be improved with multimodal programs of supervised physical exercise and health education.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jetsi Marlen González-Fuentes, Miguel Angel Noyola-Frías, Oscar Arturo Benítez-Cárdenas, Elhi Manuel Torres-Hernández, Jessika Arlina González-Macías, Andreu Comas-García, Ricardo Martínez-Rider, Marlen Vitales-Noyola
{"title":"Surgical Treatment of Cranial Fasciitis in an Atypical Maxillary Region of a Pediatric Patient: A Case Report.","authors":"Jetsi Marlen González-Fuentes, Miguel Angel Noyola-Frías, Oscar Arturo Benítez-Cárdenas, Elhi Manuel Torres-Hernández, Jessika Arlina González-Macías, Andreu Comas-García, Ricardo Martínez-Rider, Marlen Vitales-Noyola","doi":"10.3390/clinpract15030039","DOIUrl":"10.3390/clinpract15030039","url":null,"abstract":"<p><p><b>Objective:</b> The aim of this case report is to show the surgical treatment of cranial fasciitis in a 2-year-old patient. Cranial fasciitis is an uncommon, nonmalignant, and swiftly proliferating lesion that primarily involves the cranium, predominantly in the temporoparietal area. It mostly comprises smooth muscle tissue, connective tissue, and diverse immune cells. The lesion often manifests as an indurated, asymptomatic mass, averaging approximately 2.5 cm in size, although it may exceed 15 cm. Cranial fasciitis predominantly manifests in children below the age of 6. The diagnosis is validated via histological investigation, which identifies a benign tumor defined by the proliferation of spindle-shaped cells organized in a myxoid matrix, frequently displaying a storiform pattern. <b>Methods:</b> We present a case of cranial fasciitis in a 2-year-old pediatric patient, characterized by an atypical manifestation in the maxillary region. The lesion underwent surgical intervention resulting in total excision. <b>Results:</b> Three years after the surgery, the patient is asymptomatic and shows no signs of recurrence. Regular clinical follow-up and imaging are scheduled biannually, and the patient is anticipated to have a favorable long-term prognosis. <b>Conclusions:</b> Cranial fasciitis is a very rare benign lesion that occurs more commonly in childhood. In this case, surgical resection was effective, and three years later, the patient remains asymptomatic and free of recurrence, with a favorable long-term prognosis.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dirk Rades, Jan-Dirk Küter, Michael von Staden, Ahmed Al-Salool, Christian Ziemann, Stefan Janssen, Julia Koeck, Justus Domschikowski, Charlotte Kristiansen, Christine Vestergård Madsen, Marciana N Duma, Tobias Bartscht, Jon Cacicedo, Florian Cremers
{"title":"Evaluation of Reminder App for Optimization of Bladder Filling Status During Hypo-Fractionated Irradiation for Prostate Cancer: Protocol of REFILL-PAC-HYPO Trial.","authors":"Dirk Rades, Jan-Dirk Küter, Michael von Staden, Ahmed Al-Salool, Christian Ziemann, Stefan Janssen, Julia Koeck, Justus Domschikowski, Charlotte Kristiansen, Christine Vestergård Madsen, Marciana N Duma, Tobias Bartscht, Jon Cacicedo, Florian Cremers","doi":"10.3390/clinpract15030040","DOIUrl":"10.3390/clinpract15030040","url":null,"abstract":"<p><p><b>Background/Objectives:</b> During radiotherapy for prostate cancer, the risk of radiation cystitis is increased if the volume of the bladder is small. According to previous studies, it is important that bladder volumes are ≥200 mL. Drinking protocols may be helpful in this context. Adherence to such protocols can be challenging, and may be improved by an app reminding patients before each session of radiotherapy to drink a certain amount of water. Our prospective phase 2 trial (REFILL-PAC-HYPO, NCT06784115) evaluates the impact of a reminder app on bladder filling in prostate cancer patients treated with hypo-fractionated radiotherapy. <b>Methods:</b> Twenty-seven patients need to be recruited for the REFILL-PAC-HYPO trial. Radiotherapy, preferably with volumetric-modulated arc therapy, uses hypo-fractionation with 20 × 3.0 Gy over four weeks. An app reminds patients to drink water (300 mL) 45 min before each session of hypo-fractionated irradiation. On the last day of their treatment, patients are asked about their satisfaction with the app. In the case of a dissatisfaction rate of >20%, the app requires modifications. If this rate is >40%, the app is considered not useful. Additionally, patients are asked about the impact of their participation in the trial and using the app on their general attitude towards health technology. Furthermore, the phase 2 cohort is compared to a historical control group treated with hypo-fractionated radiotherapy during recent years but not supported by an app. The REFILL-PAC-HYPO trial will contribute to identifying the potential value of a reminder app for bladder filling during hypo-fractionated radiotherapy for prostate cancer.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 3","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11941454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael Metze, Silke Zimmermann, Holger Kirsten, Robert Werdehausen, Rhea Veelken, Florian van Bömmel, Timm Denecke, Hans-Jonas Meyer, Sebastian Ebel, Manuel Florian Struck
{"title":"Effects of Protamine Reversal on Coagulation Parameters After High-Dose Heparin Administration in Percutaneous Hepatic Chemosaturation Intervention.","authors":"Michael Metze, Silke Zimmermann, Holger Kirsten, Robert Werdehausen, Rhea Veelken, Florian van Bömmel, Timm Denecke, Hans-Jonas Meyer, Sebastian Ebel, Manuel Florian Struck","doi":"10.3390/clinpract15020038","DOIUrl":"10.3390/clinpract15020038","url":null,"abstract":"<p><strong>Background: </strong>Intravenous protamine administration for heparin reversal after percutaneous hepatic chemosaturation intervention is generally recommended, but its effectiveness on coagulation parameters remains unclear.</p><p><strong>Methods: </strong>In a single-center retrospective observational study, the effects of different postinterventional protamine doses on the activated partial thromboplastin time (aPTT), international normalized ratio (INR), prothrombin time (PT), fibrinogen, platelet count (PLT), and hemoglobin (Hb) were analyzed in consecutive patients who underwent high-dose heparin administration (>300 U/kg body weight) and extracorporeal circulation for chemosaturation treatment. Due to the multiple treatments of individual patients, linear mixed-effects models were applied.</p><p><strong>Results: </strong>Thirty-one patients underwent 90 chemosaturation interventions, 68 (75.6%) of which involved heparin reversal with protamine. All investigated variables showed significant postinterventional alterations, while protamine use was associated with significantly lower aPTT, lower INR, higher PT, and higher fibrinogen levels, whereas PLT and Hb levels were comparable to those in procedures without protamine use. After adjustment for aPTT, significant independent effects of protamine remained for the INR and PT. Dose-dependent effects of protamine were observed for reductions in aPTT and an increase in fibrinogen levels, which were confirmed after adjustment for the heparin dose. A 10% higher protamine dose resulted in a 3% decrease in aPTT and a 4% increase in fibrinogen. An increase of 0.1 in the protamine-to-heparin ratio was associated with an increase of 9% in fibrinogen.</p><p><strong>Conclusions: </strong>The present results suggest that protamine contributes to the normalization of the aPTT, INR, PT, and fibrinogen levels. Further prospective studies should be conducted to determine optimal dosing ratios.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11854874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Development and Psychometric Validation of the Fainareti Screening Tool for Perinatal Mental Health in Greek Pregnant Women.","authors":"Maria Dagla, Irina Mrvoljak-Theodoropoulou, Vassilis Daglas, Evangelia Antoniou, Eleni Rigoutsou, Alexandros Papatrechas, Calliope Dagla, Eleni Tsolaridou, Despoina Karagianni","doi":"10.3390/clinpract15020037","DOIUrl":"10.3390/clinpract15020037","url":null,"abstract":"<p><p><b>Background/Objectives</b>: It would be helpful for primary healthcare professionals to have access to a brief, general screening tool allowing them to detect patients suffering from major mental illness. This also holds for organizations and institutions at which pregnant women ask for support during the perinatal period. An evaluation of the psychometric properties, validity, and reliability of the Fainareti mental health screening tool was carried out in Greek women in this study. <b>Methods</b>: The study participants consisted of 518 women retrospectively followed from pregnancy to their first year postpartum as part of a health intervention at the Day Center for Women's Mental Health Care (Perinatal Mental Health Disorders), operated by the non-profit organization Fainareti. Alongside the newly developed screening tool, this study utilized the Perinatal Anxiety Screening Scale (PASS), the Patient Health Questionnaire (PHQ-9), and the Edinburgh Postnatal Depression Scale (EPDS). <b>Results</b>: The assessment of the tool's internal reliability included computing two separate internal consistency indices, with both indicating its significant level of reliability. The correlation analysis between the tool and the scales included in this study demonstrated the tool's strong convergent validity, while factor analyses confirmed its satisfactory construct validity. <b>Conclusions</b>: Overall, these findings suggest that the one-factor Fainareti mental health screening tool is suitable for initial assessments of the mental health of Greek women.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 2","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11854083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}