Purpose: Dysphagia may occur in all critically ill patients, and large-scale clinical data show that post-extubation dysphagia (PED) is commonly observed in intensive care unit (ICU) patients. The study aimed to determine how dysphagia is diagnosed after extubation, and what factors influence the incidence of dysphagia after invasive airway support in selected ICUs. Methods: A prospective observational study was conducted for five months (07/2023 to 11/ 2023), in the acute ICU and long-term ICU of the Teaching hospital in the Czech Republic. Results: Of the 101 extubated patients in the study, only 27.7% (n = 28) were examined by a physician, and PED was confirmed in 26.7% (n = 27), representing 99% of all extubated patients. Age, gender, and ICU type were not significantly related to PED occurrence. However, the type of airway management (p < 0.001), duration of mechanical ventilation (p = 0.017), and main diagnosis (p < 0.001) were significantly associated with PED occurrence. Conclusion: The study confirmed the underdiagnosis of PED in ICU patients post-extubation. Higher PED incidence was linked to tracheostomy + endotracheal cannula use, mechanical ventilation longer than 9 days, and neurological diagnoses. Training health professionals to identify PED symptoms is essential to establish uniform procedures for diagnosing and preventing PED-related complications.
- MeSH
- extubace * metody škodlivé účinky MeSH
- intratracheální intubace metody škodlivé účinky MeSH
- lidé MeSH
- mechanické ventilátory klasifikace škodlivé účinky MeSH
- péče o pacienty v kritickém stavu metody MeSH
- poruchy polykání * diagnóza etiologie MeSH
- prospektivní studie MeSH
- tracheostomie metody škodlivé účinky MeSH
- umělé dýchání metody přístrojové vybavení škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Česká republika MeSH
Aim: The study aimed to assess the prevalence of birth trauma in postpartum women and to identify factors that may influence the development of birth trauma. Methods: The sample consisted of 238 women at 6-12 weeks postpartum. Data were collected using the City Birth Trauma Scale (CityBiTS), a standardized tool that identifies a woman's potentially traumatic experiences during or after her last childbirth. The questionnaire was supplemented with sociodemographic data. Results: Nearly 11% of participants experienced some form of post-traumatic stress disorder (PTSD) after childbirth. The most intense symptoms were those belonging to the hyperarousal subscale, especially feelings of nervousness, tension, irritability, and aggression. Statistically significant differences in the prevalence of birth trauma were found with regard to the presence of a birth support person (p = 0.044) and week of gestation at the time of delivery (p = 0.001). Differences related to participants' age, education, and type of delivery were not statistically significant. Conclusion: Our findings suggest that participants only experienced birth trauma symptoms to a small extent. The CityBiTS is a useful tool for measuring postpartum trauma. Women identified as having some form of PTSD should be referred for further psychological testing and psychological care.
- MeSH
- hodnocení rizik metody MeSH
- lidé MeSH
- poporodní období psychologie MeSH
- porod * psychologie MeSH
- posttraumatická stresová porucha * diagnóza epidemiologie etiologie MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: Myelodysplastic Syndrome (MDS) is a devastating hematologic malignancy associated with advanced age. Diabetes Mellitus (DM) is one of the most common morbidities worldwide, with metformin serving as the first line therapy for several decades. However, the potential association between previous metformin use and the risk of developing MDS remains uncertain. METHODS: This cross-sectional study addressed the possible association between prior metformin use in DM patients and the subsequent development of MDS. RESULTS: Data from 54,869 DM patients was retrieved from their medical records from a tertiary medical center. Of these, 20,318 patients had been exposed at some point in time to metformin, with 133 (0.7%) subsequently developing MDS. In contrast, among 34,551 DM patients with no prior exposure to metformin, only 154 (0.4%) developed MDS later in life. The Odds Ratio (OR) for MDS development amongst metformin users compared to the entire study population was 1.48 (95% CI 1.17-1.86; p = 0.001). A multivariate analysis adjusting for gender, age, congestive heart failure and chronic kidney disease, past exposure to metformin remained an independent risk factor for MDS development (OR = 1.6, 95% CI 1.26-2.03; p < 0.001). CONCLUSION: Previous exposure to metformin amongst DM patients is associated with an increased risk for MDS development later in life. This is a preliminary, cross-sectional study that show that larger studies in variable MDS patient populations are warranted.
- MeSH
- diabetes mellitus epidemiologie chemicky indukované MeSH
- dospělí MeSH
- hypoglykemika * terapeutické užití škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- metformin * terapeutické užití škodlivé účinky MeSH
- myelodysplastické syndromy * epidemiologie chemicky indukované MeSH
- průřezové studie MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: A comparison of body composition assessments using military circumferences to bioelectrical impedance analysis (BIA) and the reference standard dual-energy X-ray absorptiometry (DEXA) can gauge effectiveness of assessments. High-frequency (500 KHz) direct segmental multifrequency bioelectrical impedance analysis (DSM-BIA) accurately calculates total water mass and body fat% (BF%), but it is unknown whether higher frequencies (1,000 KHz) increase measurement accuracy. The purpose was to compare DSM-BIA 500, DSM-BIA 1000, the DoD Circumference Method (CM), and the reference-standard DEXA. MATERIALS AND METHODS: Design: Cross sectional, observational study. Participants/Setting: A total of 62 participants from the military healthcare system (n = 25 males, 38.8 ± 11.4 years, n = 37 females 43.7 ± 15.95 years) were measured in an outpatient clinic setting. Statistical Analysis: BF% was estimated via DEXA, DSM-BIA 500, DSM-BIA 1000, and CM to identify the relationship between methods using Pearson correlation, intraclass correlation coefficients (ICCs), and Bland-Altman plots. The study was approved by the IRB from Walter Reed National Military Medical Center at Bethesda and Concordia University Chicago. RESULTS: Circumference Method BF% was moderately correlated with DSM-BIA 500 (males r = 0.63, ICC = 0.76; females r = 0.77, ICC = 0.85), DSM-BIA 1000 (males r = 0.59, ICC = 0.74; females r = 0.77, ICC = 0.85), and DEXA (males r = 0.62, ICC = 0.62; females r = 0.73, ICC = 0.82). DSM-BIA 500 BF% was strongly correlated with DSM-BIA 1000 (males r = 0.99, ICC = 0.99; females r = 0.99, ICC = 0.99) and DEXA (males r = 0.93, ICC = 0.94; females r = 0.89, ICC = 0.89). Lastly, DSM-BIA 1000 BF% was also strongly correlated with DEXA (males r = 0.93, ICC = 0.94; females r = 0.84, ICC = 0.90) (P for each reported r < 0.01). Bland-Altman analysis confirmed an overall mean bias of -1.72% CM vs. DEXA in females, indicating the tendency of CM to underestimate BF% compared to DEXA limits of agreement from -14.24 to 10.8. There was an upward slope of the linear relationship between the bias and mean of the measures (Beta = 0.34, P = 0.01). In the full cohort, there was an overall mean bias of 1.14% of CM vs. DSM BIA 1000, with CM tending to overestimate BF% compared to DSM BIA 1000 with limits of agreement -11.13 to 13.41%. There is an upward slope line of the linear relationship between the bias and the mean of the measures (Beta = 0.17, P = .03). CONCLUSION: This study found that CM BF% was moderately correlated with DSM-BIA 500 kHz, DSM-BIA 1,000 kHz BIA, and DEXA. Both DSM-BIA 500 and DSM-BIA 1,000 kHz strongly correlated well with DEXA implying that there was no further increase in correlation with increased frequency. Additionally, there was proportional bias in BF% in the female group between CM and DEXA and in the total group between CM and DSM BIA 1000.
- MeSH
- absorpční fotometrie * metody statistika a číselné údaje MeSH
- dospělí MeSH
- elektrická impedance * MeSH
- index tělesné hmotnosti MeSH
- lidé středního věku MeSH
- lidé MeSH
- průřezové studie MeSH
- složení těla * fyziologie MeSH
- tuková tkáň diagnostické zobrazování fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- srovnávací studie MeSH
Background: Ethical decision making is a complex process in health and nursing care. Whenever nurses make ethical decisions, they also have to consider what benefits the patient. Some studies have shown that nurses' ethical perceptions and sensitivities directly affect quality of health care. Aim: This study aimed to assess the impact of internal medicine nurses' ethical perceptions and sensitivities on the quality of care. Methods: The sample of this analytical cross-sectional study consisted of two hundred nurses (n = 200) from internal medicine clinics of a university hospital (in Turkey). Data collection tools used to collect the data were a Nurse Information Form, the Caring Behaviors Inventory-24 (CBI-24), the Moral Sensitivity Questionnaire (MSQ), and the Hospital Ethical Climate Survey (HECS). Data were analyzed with percentages, the Mann-Whitney U test, and correlation analysis. Results: A significant negative correlation was found between the total score of the CBI-24 (r = -0.152, p < 0.005) and the total score of the MSQ. A significant positive correlation (p < 0.05) was found between all subscale and total scores of the BDI-24 and all subscale and total scores of the HECS. There was no statistically significant correlation between HECS and MSQ (p > 0.05).
- MeSH
- kvalita zdravotní péče etika MeSH
- lidé MeSH
- ošetřovatelská etika * MeSH
- osoby s mentálním postižením MeSH
- práva pacientů etika MeSH
- průřezové studie MeSH
- rozhodování MeSH
- vnitřní lékařství etika metody MeSH
- zdravotní sestry * psychologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- Geografické názvy
- Turecko MeSH
Introduction: The study of smoking and alcohol consumption habits is one of the most relevant and common elements of health behaviour assessment. According to European Health Interview Survey data, 27% of women aged 18-34 years and 35% of men smoke daily. According to the WHO, alcohol consumption also presents a negative picture and is responsible for 3 million deaths worldwide each year. Objective: Our primary objective was to examine how university students' health values relate to smoking and alcohol consumption habits. Methods: Our data collection method was interviewing, and our questionnaire consisted of nearly 30 questions that could be divided into several main groups. For data collection, we used a validated questionnaire, the IRVS Values Importance and Achievement Scale. For the assessment of smoking habits, we used the questionnaire from the National Population Survey (2003), compiled by the National Center for Epidemiology. A total of 380 university students completed the questionnaire. Data were processed using SPSS 26.0 statistical software. Differences were considered significant at p < 0.05. Results: Using principal component analysis, we obtained the eight-item variable, 'Importance of health value', with the highest loading of the value 'Health importance' (0.711 points). Our results showed a significant negative association between the health value and the number of cigarettes smoked per day, rs = -0.089, p = 0.041 (1-tailed), using Spearman correlation. Conclusion: Promoting a healthier lifestyle among university-aged individuals should be encouraged and prioritized. We believe that it is important to develop a preventive approach and create an inclusive educational environment.
Objective: The aim of this study is to examine the sociodemographic factors and the utilization of preventive healthcare services associated with self-rated health status among adults and the elderly in Turkiye. Methods: We performed statistical tests to evaluate differences in the frequency of preventive health service use, based on perceived health status across various age groups. We utilized multi-level probit regression models to scrutinize the self-rated health status, considering factors associated with sociodemographic variables and the receipt of preventive healthcare among adult groups and the elderly using the Turkiye Health Survey (HS) Micro Dataset (2022). Results: This study highlights a clear and positive association between self-rated health status and preventive health services, particularly in consultations with general practitioners, blood pressure measurements, and blood sugar tests. Notably, regular utilization of these services within the past year positively influences health status. This relationship is more pronounced with age, especially among young and middle-aged adults. Typically, tobacco and alcohol use have a negative impact on health for each age group, while education level has a positive effect. Additionally, affordability constraints on accessing healthcare services and medication have a clear negative impact. Conclusion: Subsidizing primary healthcare, screenings, and expanding healthcare services are essential for effective health policy implementation. Policies should focus on subsidizing primary care and screenings to encourage regular check-ups, considering both age and gender.
- MeSH
- diagnostické sebehodnocení * MeSH
- dospělí MeSH
- lidé MeSH
- senioři MeSH
- služby preventivní péče * metody MeSH
- socioekonomické faktory MeSH
- zdravotní politika MeSH
- zdravotní stav MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- senioři MeSH
- Publikační typ
- klinická studie MeSH
- Geografické názvy
- Turecko MeSH
Objectives: This study evaluates the test-retest reliability and inter-rater reliability of the MyotonPRO for measuring Achilles tendon stiffness at two standardized sites over various time frames and settings. Methods: Eight healthy participants underwent assessments by three raters over six visits. Tendon stiffness was measured at proximal (mid-portion) and distal (insertional) regions of the Achilles tendon at various time frames (10-15 s, 10-15 min, 24 h, and 14 days apart). Measurements included participant repositioning and two activity stimuli (daily living and sport). Reliability was calculated using the intraclass correlation coefficient (ICC), its 95% confidence interval, coefficient of variation, standard error of measurement, and minimal detectable change. Results: Short-term reliability (10-15 min) was excellent, with an ICC of 0.956 (0.929-0.974). Between days reliability (24 h) was good, with an ICC of 0.889 (0.802-0.938). Between weeks reliability (2 weeks) was good with an ICC of 0.886 (0.811-0.931). Short-term reliability with the simulation of activity of daily living was good, with an ICC of 0.917 (0.875-0.945). Short-term reliability with the simulation of sport was good with an ICC of 0.933 (0.891-0.96). Between days reliability with the simulation of sport was good, with an ICC of 0.920 (0.859-0.955). Conclusions: When used in a standardized position, the MyotonPRO demonstrates reliable repeated measurements of Achilles tendon stiffness. This protocol provides a foundation for clinical research and rehabilitation by clarifying expected reliability across minutes, days, and weeks, thus aiding clinicians and researchers in monitoring tendon adaptations and making evidence-based decisions.
- Publikační typ
- časopisecké články MeSH
BACKGROUND: The study aimed to assess the acute effects of overcoming isometric split squats on subsequent single-leg drop jump (DJ) performance and the contralateral effect in volleyball players, considering training status differences. METHODS: Ten male elite (ELI) and ten amateur (AMA) volleyball players took part in two experimental sessions in which they performed conditioning activity (CA) consisted of 3 sets of overcoming isometric 3-second split squats, differing in the limb used: dominant (DL) or non-dominant (ND-L). Single-leg DJ was performed before and at the 4th and 8th minute post-CA for both limbs. The best post-CA attempt in terms of jump height (JH) was analyzed. RESULTS: Results revealed a significant increase in jump height (JH) in the non-dominant limb (ND-L) from 13.7 ± 2.6 cm to 15.5 ± 2.7 cm after CA performed by the ND-L (p = 0.001; Hedge's g = 0.65). Similarly, the reactive strength index (RSI) of the ND-L improved from 0.40 ± 0.06 to 0.45 ± 0.08 (p = 0.008; g = 0.58). Additionally, contact time in the ND-L increased significantly from 342 ± 36 ms to 375 ± 42 ms after CA performed by the dominant limb (p = 0.001; g = 0.66). In the elite (ELI) group, JH significantly increased from 16.4 ± 2.4 cm to 18.3 ± 3.3 cm (p < 0.001; g = 0.79), while RSI in the dominant limb (DL) improved from 0.47 ± 0.06 to 0.53 ± 0.07 (p = 0.011; g = 0.68). CONCLUSIONS: Results suggest that the examined CA effectively induces the post-activation performance enhancement in DJ among elite volleyball players, with a predominantly local impact on the limb executing the CA. TRIAL REGISTRATION: NCT06459050 (Retrospectively registered).
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: Human and animal skin is colonized by a complex microbial population. An imbalance of these microorganisms is often associated with dermatological diseases. METHODS: The aim of this work was to describe the skin bacterial microbiota composition of healthy dogs and dogs with inflammatory skin lesions. Genomic DNA was sequenced using primers that target the V4 region of the bacterial 16S rRNA gene. Superficial skin swabs were collected from eight body areas of six healthy dogs (n = 48) and directly from inflammatory altered canine skin (n = 16). RESULTS: The skin of healthy dogs was predominantly colonized by phylum Bacillota (34.4 ± 27.2%), followed by Actinomycetota (32.2 ± 20.3%), Pseudomonadota (16.4 ± 12.2%), and Bacteroidota (8.7 ± 11.6%). At the level of genera, Streptococcus spp. (19.4 ± 26.1%) was the most abundant genus across all samples collected from healthy skin, followed by Curtobacterium (5.4 ± 12.1%), Bacteroides (5.2 ± 11.1%) and Corynebacterium_1 (4.3 ± 13.2%). More specifically, Streptococcus spp. was the most abundant on the chin (49.0 ± 35.5%), nose (37.9 ± 32.1%), perianal region (21.1 ± 28.2%), abdomen (11.0 ± 12.8%), dorsal back (12.4 ± 10.3%) and interdigital area (5.5 ± 2.2%). Curtobacterium spp. was predominant on inner pinna (17.8 ± 24.8%) and axilla (6.7 ± 10.8%). Alpha diversity analysis (Shannon index) showed maximum on interdigital area but minimum on a chin (p-value: 0.0416). Beta diversity analysis showed clustering across samples from the individual skin sites but also across samples collected from individual dogs. Staphylococcus spp. was the most abundant genus in 12/16 samples collected from inflammatory skin. In addition, a lower bacterial diversity was observed in samples from skin lesions compared to samples from healthy canine skin. DISCUSSION: The results confirm the fact that the microbiome of healthy skin is very diverse. Compared to other studies, streptococci predominated on healthy canine skin. Shannon index showed only minor differences in diversity between different parts of canine skin. Results of beta-diversity showed the fact that the main force driving the skin microbiota composition is the individual, followed by the skin site. On the area of skin lesions, dysbiosis was observed with a significant predominance of staphylococci.
- Publikační typ
- časopisecké články MeSH
