Medicina

Background and Objectives: Psoriasis (PsO) is a chronic autoimmune inflammatory skin disorder frequently associated with psychiatric and psychological burden. The objective of this study was to determine the incidence of psychiatric comorbidities in patients with PsO from a dermatology clinic of a university hospital in northeastern Romania, thereby providing physicians with evidence to support more holistic and integrated care approaches. Materials and Methods: This is a 10-year retrospective epidemiological study on 2219 patients diagnosed with PsOwho were admitted to a Romanian university hospital between January 2013 and December 2022. Psychiatric and dermatological diagnoses were extracted from medical records using International Classification of Diseases—Tenth Revision (ICD-10) codes. Relative risks (RR) and 95% confidence intervals (CI) were calculated using Cox proportional hazards models, with p < 0.05 considered statistically significant. Results: Among 2219 patients, the most common psychiatric comorbidities were unspecified depressive disorder (120 patients, 5.4%, p < 0.01), mixed anxiety-depressive disorder (34 patients, 1.5%, p < 0.01), and mild depression (24 patients, 1.1%, p < 0.01). Female PsO patients demonstrated a relative risk (RR) [95% confidence interval (CI)] of 1.55 [1.12–2.14] (p = 0.007) for developing psychiatric comorbidities compared to males. Patients aged less than 18 years exhibited an RR [95% CI] of 2.032 [1.297–3.186] (p = 0.002) for psycho-emotional stress, the highest among all age groups. Notably, patients with concurrent psoriatic arthritis (PsA) showed a significantly elevated risk with RR [95% CI] of 1.546 [1.06–2.20] (p = 0.002). Conclusions: Depression and anxiety represent substantial psychiatric comorbidities in PsO patients, particularly affecting female individuals, younger patients, and those with concurrent PsA. These findings underscore the necessity for integrated mental health screening and psychological support within dermatological care protocols.

Background and Objectives: Diabetes mellitus (DM) is a growing global health concern linked to increased hospitalization rates, longer hospital stays, and higher mortality. Older adults with DM are particularly prone to intracranial injuries due to frailty and DM-related complications such as neuropathy and cardiovascular diseases. This study explores the impact of DM on in-hospital outcomes in patients with intracranial injuries. Material and Methods: This retrospective cohort study used data from 45 hospitals in Germany, including 12,720 patients aged ≥40 years hospitalized between January 2019 and December 2023 with a primary diagnosis of intracranial injury. Patients were categorized based on the secondary presence of DM diagnosis (ICD-10 E10-E14). Outcomes included in-hospital mortality, rehospitalization within 1 year and hospital length of stay (LOS). Multivariable logistic regression models were used to analyze associations between DM and the different outcomes, adjusting for age, sex, hospitalization year, and comorbidities. Results: Among 12,720 patients, 2394 had a known DM diagnosis. The median age was higher in DM patients (82 vs. 79 years). In-hospital mortality rates were similar for patients with and without DM (4.7% vs. 4.6%; OR: 0.98; 95% CI: 0.78–1.22). DM was not associated with rehospitalization risk (OR: 1.06; 95% CI: 0.89–1.26) but showed a trend toward longer hospital stays (≥7 days: OR: 1.13; 95% CI: 1.01–1.26). Conclusions: While DM did not significantly influence mortality or rehospitalization after intracranial injuries, it showed a non-significant trend towards extended LOS (≥7 days). These findings underscore the importance of targeted management strategies to optimize outcomes in this population.

Background and Objectives: Catheter-related bloodstream infections (CRBSIs) are one of the most severe complications in children with intestinal failure (IF) who require long-term parenteral nutrition (PN). Taurolidine–citrate solution (TCS), with proven antimicrobial and antibiofilm properties, has been proposed as a promising alternative to heparin locks for preventing infection. The aim is to evaluate the efficacy and safety of the TCS in reducing the rates of CRBSI and pathogen-specific infections in pediatric patients with indwelling central venous catheters (CVCs) who are receiving PN. Materials and Methods: This retrospective study included 48 pediatric IF patients treated at an intestinal rehabilitation and transplantation center in Türkiye. Patients received either TCS or heparinized saline (0.9% saline solution containing 100 IU of heparin) as a catheter lock. Infection data were extracted from medical records and expressed as events per 1000 catheter days. Group comparisons were performed using non-parametric tests, and Poisson regression was applied to calculate rate ratios (RRs) and 95% confidence intervals (CIs). Adjusted rate ratios were obtained from a Poisson regression model that included the following variables: age, sex, diagnosis category, ostomy status, catheter type, and follow-up duration. Log(catheter-days) was incorporated as an offset term. Overdispersion was assessed and not detected. Results: The crude CRBSI rate was lower in the TCS group than in the heparinized saline group (29.4 vs. 42.8 per 1000 catheter days), though this difference was not statistically significant (p = 0.383). However, after adjustment by Poisson regression, TCS use was significantly associated with reduced infection rates (adjusted RR = 0.78, 95% CI = 0.70–0.87, p < 0.001). TCS use was also significantly associated with reduced rates of Gram-positive (RR = 0.78, p = 0.006), Gram-negative (RR = 0.48, p < 0.001) and fungal (RR = 0.63, p < 0.001) infections. No adverse events were observed among the TCS group. Conclusions: Standardized TCS lock therapy effectively and safely reduces CRBSIs in pediatric patients with IF, particularly those caused by Gram-negative and fungal organisms. These results support the use of TCS as a prophylactic option for preventing infection in long-term CVC use.