Search Results (92)

Background: Cancer survivors may continue to experience health issues that affect their quality of life and raise the risk of other chronic diseases. Methods: This study aimed to assess adherence to general health check-ups, cancer-specific screenings, and chronic disease management among five-year cancer survivors using nationally representative data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted between 2013 and 2021. A total of 2597 cancer survivors and 2458 matched non-cancer controls were selected via 1:1 propensity score matching based on demographic and lifestyle characteristics. We analyzed health behaviors (smoking and alcohol use), participation in general and cancer-specific screenings, and medication adherence for hypertension, diabetes, and dyslipidemia. Results: Compared to controls, cancer survivors, especially those diagnosed more than five years ago, were significantly less likely to participate in recommended cancer screenings (adjusted OR: 0.82, p = 0.014) and had lower adherence to treatment for hypertension (adjusted OR: 1.84, p = 0.004) and dyslipidemia (adjusted OR: 1.42, p = 0.026). However, cancer survivors were less likely to smoke or consume alcohol. Conclusions: These findings underscore the need for comprehensive survivorship care policies that integrate both cancer surveillance and chronic disease management. Full article

Objectives: Scarce data are available regarding preventive medicine in forcibly displaced populations especially regarding non-communicable diseases like neoplasia, while even more limited data are available on Ukrainian refugees in Romania. To address this research gap, the present analysis was performed to investigate Ukrainian refugee women’s beliefs, attitudes, and opinions towards the Romanian and Ukrainian healthcare system in a comparison model while focusing on the HPV immunization rates and factors influencing the uptake for themselves and their children. Methods: Participants were recruited using the snowball sampling method through their General Practitioner (GP) and a health mediator. Results: In total, 105 women completed the online or physical survey. The mean age was 50 years. In total, 40% of women had not been to a gynecological check-up in 3 or more years, and more than 56% had never been screened. Only four were vaccinated against HPV, and none remembered which type of vaccine was dispensed or how many doses were utilized. The primary hindrances to accessing health services or immunization programs were language barriers, financial burdens, and a lack of information. Respondents’ general distrust of health systems and healthcare workforces were recurrent themes. Relationship status, living arrangements, and previous engagement in screening practices influenced immunization rates. Perceiving the healthcare officials as proactive concerning optional vaccination programs such as HPV immunization and actively receiving recommendations drove respondents to pursue vaccination. Conclusions: This analysis offers a foundational insight into the specific needs of refugee women. It can guide the development of effective public health interventions to improve health outcomes and vaccination rates among Ukrainian refugees in Romania. Tailored preventive campaigns with adequate native language information and prompts from medical experts in designated centers should be deployed to ensure inclusive tactics for vulnerable populations. Full article

Background and Objectives: Physical activity represents a cornerstone in the management of diabetes mellitus; however, the majority of persons with diabetes remain insufficiently active. Current guidelines emphasise the need to educate individuals with diabetes on physical activity at each clinical visit. The aim of the study was to develop an adequate instrument and test diabetologists’ knowledge on physical activity and related guidelines in diabetes, as well as investigate their prescribing habits. Materials and Methods: The instrument was developed with four diabetologists using Delphi and RAND appropriateness methods, then distributed to diabetologist societies in 12 Southeast European countries for anonymous completion by their members. Data were analysed using Mann–Whitney U test and Pearson ${ x}^2$ test. Results: Out of 302 analysed respondents, 123 (41%) worked at university hospitals, at average four days a week in outpatient departments, mean number of patients was 16 a day; 95 (32%) had a PhD, and 105 (35%) university teaching positions. Median overall knowledge was 15 (Q1–Q3, 13–17) out of 22 maximum points. 26% diabetologists knew recommended level of physical activity for people with diabetes. Physical activity goals were discussed during check-ups in 53.0% of cases; re-education and goal adjustments were provided in 33.4% when health status changed; and clear instructions were documented in 25.5% of medical records. Conclusions: Diabetologists’ overall knowledge of physical activity was found to be at least satisfactory in 90% of participants. Knowledge of the guidelines is insufficient in 75% of participants. The prescribing habits are inadequate in half of the participants. Full article

Background: Medication-related osteonecrosis of the jaw (MRONJ) is drug-induced bone destruction that is exposed for a minimum of 6 to 8 weeks in patients who have not received head and neck radiotherapy and who have not been diagnosed with facial bone metastases. MRONJ treatment outcomes are unpredictable. Therefore, alternative treatment methods are being explored, such as blood-derived platelet-rich preparations enriched with growth factors, including advanced platelet-rich fibrin (A-PRF). The presence of growth factors may enhance healing and reduce post-procedure complications. There are no studies examining the effect of A-PRF on the healing of patients with MRONJ. The aim of this study was to retrospectively evaluate treatment outcomes of patients with MRONJ surgically treated without and with the use of A-PRF. Materials and methods: This retrospective study included 28 patients who suffered from osteomyelitis due to MRONJ and underwent surgical treatment between 2019 and 2024. The patients were divided into two groups: the first group received surgical treatment without A-PRF, and the second group received surgical treatment with the application of A-PRF. This study analyzed demographic and clinical data, as well as treatment outcomes. Results: The patients were aged from 43 to 82 years. The most common cause of MRONJ was the administration of zoledronic acid for oncological reasons (22 patients, 78.6%), given intravenously. In 20 patients (71.4%), the antiresorptive treatment lasted longer than three years. The obtained healing distribution was binomial (presence or absence of healing). Estimation of the probability of healing using the maximum likelihood method provided a result of approximately 64%. The probability of ten or more healed patients in the A-PRF group was 41%. A-PRF helps with a probability of 59%, and without A-PRF, it was lower. Concomitantly, the differences between the group with A-PRF and without A-PRF were not statistically significant. Conclusions: The patients with MRONJ should have regular check-ups with radiological examinations at least every six months to detect possible recurrence. Treatment for MRONJ is long and difficult. Treatment of non-advanced lesions, without additional risk factors (such as treatment with zoledronate intravenously for oncological purposes for 3 years), showed a better prognosis. Sometimes, in addition to surgery, it is necessary to consider alternative methods. A-PRF may enhance MRONJ healing. However, there is no evidence of a significant effect of A-PRF on the healing of MRONJ. Full article

Background: During the coronavirus disease 2019 (COVID-19) pandemic, people in Japan were urged to stay at home as much as possible, and this resulted in significant changes in lifestyle behavior. The new lifestyle included factors affecting both energy intake and energy consumption, and it is now thought that weight gain during the lockdown was the result of complex effects. The aim of this study was to determine the relationships among lifestyle habits, laboratory data, and body weight gain during the lockdown using medical check-up data. Methods: A total of 3789 individuals who had undergone consecutive medical check-ups during the period from 2018 to 2020 were included in this study. Participants whose body weight had increased by 5% or more were divided into two groups: a before-lockdown group (participants who had gained weight between 2018 and 2019) and an after-lockdown group (participants who had gained weight between 2019 and 2020). Physical measurements, laboratory data, and answers to six questions about lifestyle habits, for which information was obtained from the records from medical check-ups, were compared in the two groups. Results: There was no significant difference between the distribution of weight changes in 2018–2019 before the lockdown and the distribution of weight changes in 2019–2020 after the lockdown. The before-lockdown and after-lockdown groups both included about 7% of the total participants (279 and 273 participants, respectively). Diastolic blood pressure and levels of AST, ALT, and LDL-C were significantly higher in the after-lockdown group than in the before-lockdown group. The percentages of participants with alcohol consumption and exercise habits were significantly higher in the after-lockdown group than in the before-lockdown group, and an analysis by gender showed that the differences were significant for women but not for men. Conclusions: The distributions of weight changes before and during the COVID-19 pandemic were similar. Exercise habits and alcohol consumption might have been unique factors causing weight gain during the COVID-19 pandemic, particularly in women. Our findings suggest that the impact of behavioral restrictions and lifestyle changes during a pandemic may be different in men and women. Full article

Objective: To investigate the association between coffee consumption and visceral obesity (VO). Methods: We conducted a retrospective, cross-sectional, observational study using data from 45,630 participants who underwent a general health check-up program at a medical center in Japan between 2015 and 2018. After excluding participants with missing data or duplicated visits, 19,253 subjects were included in the final analysis. Visceral fat area (VFA) was measured using computed tomography (CT), and data on metabolic disorders, history of lifestyle-related diseases, coffee consumption, and other lifestyle factors were collected via a self-administered questionnaire. Results: The mean ± SD VFA was 74.0 ± 49.7 cm², and the mean ± SD age was 53.3 ± 9.8 years. The prevalence of VO (VFA ≥ 100 cm²) was 25.5%. The mean coffee consumption was 1.7 ± 1.3 cups per day. In multivariate logistic regression analysis, coffee consumption was significantly inversely associated with VO. Compared to non-coffee drinkers, the odds ratios (ORs) for VO were as follows: 1 or 2 cups/day (OR: 0.75, 95% confidence interval [CI]: 0.68–0.83), 3 or 4 cups/day (OR: 0.67, 95% CI: 0.59–0.75), and ≥5 cups/day (OR: 0.65, 95% CI: 0.53–0.80). In multiple linear regression analysis, coffee consumption was significantly associated with lower VFA (Model 3: β = −1.86, SE = 0.230, p < 0.05). Conclusions: Coffee consumption was significantly associated with lower VO. Full article

Background/Objectives: The prevalence of chronic kidney disease (CKD) is increasing worldwide, and this tendency is also visible in pediatric patients. The major clinical challenge is to achieve a diagnosis as early as possible, despite an overt clinical course, especially in the early stages of the disease. Unfavorable external conditions may disturb the proper treatment of chronically ill patients and delay the time of diagnosis. The recent COVID-19 pandemia might have altered the usual diagnostic pathways of different comorbidities, and CKD was probably one of them. However, there are no data on newly diagnosed CKD in children during the time of the pandemia, so our aim was to approach this problem. Methods: We analyzed medical records of 154 children with CKD who were hospitalized in the Department of Pediatric Nephrology in prepandemic (years 2015–2019) vs. pandemic and postpandemic (2020–2024) conditions, analyzing the eGFR value and stage of CKD at diagnosis, the underlying diseases leading to CKD, and sex-related differences. Results: The number of patients who were diagnosed with CKD in both time periods was comparable. Children hospitalized in the years 2020–2024 presented more often with advanced stages of CKD. The trend towards an increasing share of glomerulopathies, acute kidney injury, and unknown causes of CKD was noticeable under pandemic conditions. Conclusions: The COVID-19 pandemic could, probably owing to reduced access to primary healthcare and disrupted routine check-ups, delay the process of diagnosing CKD in children. Full article

Background: Hypothyroidism is the most common thyroid dysfunction in childhood, resulting from the decreased biological activity of thyroid hormones in tissues. Pediatric patients with hypothyroidism, when left untreated or when thyroid hormone levels fail to normalize despite treatment, may exhibit various complications such as growth retardation, obesity, and hypercholesterolemia. Aim: We conducted a monocentric retrospective study to evaluate potential differences in obesity rates and auxological parameters between healthy patients and children with hypothyroidism undergoing levothyroxine replacement therapy. Additionally, we examined possible differences in lipid and glucose metabolism between the two groups. Materials and Methods: We collected and analyzed data from the electronic medical records of 108 patients who were regularly followed up for thyroid dysfunction at the Pediatric Endocrinology Unit of the Fondazione Policlinico Universitario A. Gemelli IRCCS from January 2016 to June 2024. We also included 104 healthy controls who underwent thyroid function testing during the same period, followed up in the same department for regular auxological check-ups. Results: Our findings revealed that patients with acquired hypothyroidism had a lower height z-score compared to healthy controls (t(210) = −2.6; p = 0.01). Additionally, they exhibited higher blood glucose and triglyceride levels, although these values remained within the normal range. Conclusions: We highlight the critical importance of the early diagnosis of hypothyroidism to initiate levothyroxine replacement therapy promptly and mitigate the long-term effects of hypothyroidism on children’s growth. Full article

Asthmatic children who tested positive for COVID-19 experienced changes in lung function and persistent symptoms following SARS-CoV-2 infection, even for several months after diagnosis, and with the same features as in an acute phase. This study aimed to analyze a pediatric age group (between 0 and 17 years old) diagnosed with asthma, and SARS-CoV-2 infection attending regular monitoring visits in a Pediatric Department of a Regional Tertiary Hospital (Filantropia Clinical Municipal Hospital Craiova, Romania) during the COVID-19 pandemic and post-pandemic time interval (i.e., March 2020–July 2024), and identify how the infection influenced their long-term symptoms and treatment. Materials and Methods. The following variables were recorded: demographic data (gender, age group, residence), data related to allergies (allergic rhinitis, atopic dermatitis, and food allergies), the presence of exacerbations, the fraction of exhaled nitric oxide, the ventilatory function, the asthma phenotype (allergic or non-allergic), as well as the GINA assessment of asthma control at clinical visits were analyzed. SARS-CoV-2 infections were evaluated in terms of year of infection, symptoms, cough presence and persistence, and modifications of the asthma treatment during and after COVID-19 disease. The data were statistically analyzed with SPSS, using the Mann–Whitney U, Kruskal–Wallis H, and Chi-Square tests. Results. A lower incidence of COVID-19 cases was recorded in the first pandemic of asthmatic patients (2020 and 2021), but an increase in the rate of cases was observed at the beginning of the second pandemic, in 2022. The nitric oxide values in asthmatic children who were infected with SARS-CoV-2 were statistically significantly increased (p < 0.0005), especially for children with persistent cough for more than 4 weeks. A significant increase in the number of exacerbations was also observed in patients who tested positive for SARS-CoV-2 infection (p < 0.0005). Ventilatory function values were statistically significantly different in asthmatic children with and without SARS-CoV-2 infection (p < 0.05). Conclusions. The persistence of cough after the acute phase of SARS-CoV-2 infection as well as the changes in ventilatory tests emphasize the need of periodic medical check-ups, as well as the implementation of a therapeutic regimen appropriate for each pediatric patient. Full article

Background and Objectives: Osteoporosis is a common disease of the skeletal system that increases the risk of fracture. The prevalence of osteoporosis has been increasing as the aging population increases, affecting more than 200 million people worldwide. This study aimed to shed light on the clinical impact of osteoporosis on women’s health and quality of life by evaluating the prevalence and risk factors for this disease among postmenopausal women, using a 10-year dataset from a tertiary center. Materials and Methods: This retrospective cohort study was conducted at Dokuz Eylül University, Department of Obstetrics and Gynecology, between 2010 and 2022. A total of 3289 postmenopausal women aged 50–60 years who were undergoing routine gynecological checkups were included in the study. Patients with a prior diagnosis, a history of medical conditions, or who were taking medications affecting bone mineral density (BMD) were excluded. Data on demographics, smoking status, diabetes status, body mass index (BMI), parity, and fracture history were collected. BMD scores were classified as normal, osteopenia, or osteoporosis. Results: The prevalence of osteoporosis was 10.4%. The median age of the patients was 56.0 years. Smoking, diabetes, and a history of bone fractures were found to significantly increase the risk of osteoporosis. BMI was found to have a protective effect against osteoporosis. According to multivariate analysis, the risk of osteoporosis increased by 2.46 times in patients who smoke, 3.78 times in patients with diabetes, and 6.23 times in patients with a history of fractures. Conclusions: Awareness of modifiable risk factors such as smoking is crucial for preventing osteoporosis-related complications. Diabetes, even when it is not complicated, increases the risk of osteoporosis. Physical exercise, calcium, and vitamin D intake are important, especially during young adulthood, as they are the primary contributors to peak bone mass. Because neck fractures are more common in patients with osteopenia, early diagnosis and routine screening can mitigate future complications. Full article

Background and Objectives: On a local and national scale, genitourinary malformations (GUMs) are the second most encountered congenital anomaly in children. GUMs are linked to several risk factors, including maternal co-morbidities and insufficient folic acid. They may also be related to maternal health and care during pregnancy. Expanding our knowledge about these factors is necessary for the development of preventative measures, which could reduce GUM incidence. This study evaluated the local youth’s understanding and perceptions of genitourinary anomalies. Materials and Methods: This cross-sectional, qualitative, anonymous, questionnaire-based study involved members of the local population, aged 18 years or over. Based on a 5% type I error rate (α = 0.05) and an 80% response rate, a sample size of 481 was determined. The questionnaire was completed by 902 people. The data were analyzed using SPSS version 25 (IBM). Results: Over half (57%) of respondents believed that hormonal therapy during pregnancy could increase GUM risk. Moreover, 46% thought that maternal chronic diseases could be another risk factor, while 43% believed that pregnancy-related conditions, such as pre-eclampsia, increased GUM risk. Women had higher odds of high perception scores than men, according to the univariate and multivariate analyses. Most participants (74%) strongly agreed that proper and ongoing prenatal follow-ups are necessary, 69% agreed that premarital medical check-ups are necessary, and 67% believed that optimal nutrition throughout pregnancy is necessary to reduce GUM risk. Conclusions: The results emphasize the necessity of developing healthcare strategies specifically designed to increase knowledge about GUMs and overcome incorrect community perceptions of risk factors that could also help improve attitudes towards prevention and ultimately reduce the incidence of GUMs. Full article

Background and Aims: Dehydration is a prevalent and costly healthcare concern, linked to heightened risks of acute kidney injury and in-hospital mortality. Despite its significance, limited evidence exists regarding its prevalence and correlation with renal function decline in apparently healthy individuals. This retrospective cohort study aimed to investigate the prevalence and association of dehydration with renal function decline and the development or progression of chronic kidney disease (CKD) in the general population. Methods: The medical records of subjects undergoing annual health check-ups from 2016 to 2019 at a single center in Taiwan were analyzed, and those with CKD stage V, insufficient data, or an increased estimated glomerular filtration rate (eGFR) were excluded. Serum osmolality, eGFR, and relevant parameters were measured. Logistic regression and Kaplan–Meier analyses were used to assess associations between osmolality and CKD-related outcomes. Results: Among the 4449 eligible subjects, those in the higher osmolality quartiles had an elevated risk of CKD or CKD progression. Multivariate analyses identified age, systolic blood pressure, serum osmolality, uric acid, proteinuria, and a history of diabetes as independent risk factors, with high-density lipoprotein being protective. Cumulative incidence curves demonstrated a significant increase in the risk of CKD with increasing osmolality levels. Restricted cubic spline analyses confirmed a nonlinear relationship between osmolality and CKD risk. Conclusions: Elevated serum osmolality independently predicted renal function decline and CKD development in apparently healthy individuals, and this effect persisted after adjusting for established risk factors. Our findings underscore the importance of addressing dehydration as a modifiable risk factor for CKD. Full article

With the increase in insured patients and an aging population, managing the length of stay (LOS) for inpatients has become crucial for controlling medical costs. Analyzing the factors influencing LOS is necessary for effective management. Previous studies often used multiple or logistic regression analyses, which have limitations such as unmet assumptions and the inability to handle time-dependent variables. To address these issues, this study applied survival analysis to examine the factors affecting LOS using the National Health Insurance Service (NHIS) sample cohort data from 2016 to 2019, covering over 4 million records. We used Kaplan–Meier survival estimation to assess LOS probabilities based on sociodemographic, patient, health checkup, and institutional characteristics. Additionally, the Cox proportional hazards model controlled for confounding factors, providing more robust validation. Key findings include the influence of age, gender, type of insurance, and hospital type on LOS. For instance, older patients and medical aid recipients had longer LOS, while general hospitals showed shorter stays. This study is the first in Korea to use survival analysis with a large cohort database to identify LOS determinants. The results provide valuable insights for shaping healthcare policies aimed at optimizing inpatient care and managing hospital resources more efficiently. Full article

Background/Objectives: In Korea’s emergency medical system, when an emergency patient arises, patients receive on-site treatment and care during transport at the pre-hospital stage, followed by inpatient treatment upon hospitalization. From the perspective of emergency patient management, it is critical to identify the high death rate of patients with certain conditions in the emergency room. Therefore, it is necessary to compare and analyze the determinants of the death rate of patients admitted via the emergency room and generally hospitalized patients. In fact, previous studies investigating determinants of survival periods or length of stay (LOS) primarily used multiple or logistic regression analyses as their main research methodology. Although medical data often exhibit censored characteristics, which are crucial for analyzing survival periods, the aforementioned methods of analysis fail to accommodate these characteristics, presenting a significant limitation. Methods:Therefore, in this study, survival analyses were performed to investigate factors affecting the dying risk of general inpatients as well as patients admitted through the emergency room. For this purpose, this study collected and analyzed the sample cohort DB for a total of four years from 2016 to 2019 provided by the Korean National Health Insurance Services (NHIS). After data preprocessing, the survival probability was estimated according to sociodemographic, patient, health checkup records, and institutional features through the Kaplan–Meier survival estimation. Then, the Cox proportional hazards models were additionally utilized for further econometric validation. Results: As a result of the analysis, in terms of the ‘city’ feature among the sociodemographic characteristics, the small and medium-sized cities exert the most influence on the death rate of general inpatients, whereas the metropolitan cities exert the most influence on the death rate of inpatients admitted through the emergency room. In terms of institution characteristics, it was found that there is a difference in determinants affecting the death rate of the two groups of study, such as the number of doctors per 100 hospital beds, the number of nurses per 100 hospital beds, the number of hospital beds, the number of surgical beds, and the number of emergency beds. Conclusions: Based on the study results, it is expected that an efficient plan for distributing limited medical resources can be established based on inpatients’ LOS. Full article

Objective: We conducted a study to determine if antenatally collected maternal urine cotinine (a metabolite of nicotine) measurements can be used to assess the neonatal impact of nicotine exposure during pregnancy. This was a prospective longitudinal cohort of mother–infant dyads. Only term singleton pregnancies were included. The primary outcome measure was the correlation between maternal urine cotinine and infant birth weight. Methods: We analysed data from 238 mother–neonate dyads. Smoking habits were recorded during routine prenatal check-ups and urine samples were collected to measure cotinine and creatinine levels. Results: Urine cotinine was detected in 50.4% (120/238) of women from the whole cohort, but only 16% (38/238) self-reported as smokers (chi-square 39.7, p < 0.0001), and these women had significantly smaller babies (p = 0.010). There was a significant negative correlation between maternal urine cotinine and birth weight (Spearman’s coefficient = −0.0226, p = 0.013). Female babies born to women with nicotine in their urine were significantly smaller (p = 0.001). Conclusions: Infant birth weight significantly reduced in mothers with exposure to nicotine during pregnancy. The number of women exposed to nicotine during late pregnancy (measured in urine) was markedly higher than self-reported and national smoking percentages, suggesting an urgent need for an improvement in medical record reporting on smoking habits to better assess neonatal outcomes. Full article