Search Results (12,503)

Background: The growing number of older adults undergoing surgical procedures requires care models that minimise hospital exposure, optimise safety, and support rapid recovery. Day surgery has become an increasingly attractive option for selected older patients, provided their medical, functional and psychosocial needs are carefully assessed. Recent developments in prehabilitation, geriatric-focused perioperative pathways and enhanced post-discharge follow-up have further expanded its potential. This narrative review aims not only to synthesise current evidence, but also to provide a clinically oriented framework for patient selection, perioperative optimisation, and safe implementation of day surgery pathways in older adults. Main findings: Evidence from the past decade indicates that day surgery can be safe and effective for adults aged ≥65 when supported by structured preoperative assessment, targeted optimisation, and clear discharge criteria. Older patients benefit particularly from reduced risks of hospital-acquired complications, including infection, delirium, immobility and functional decline. Prehabilitation programmes focusing on nutrition, strength, balance and medication review are associated with improved postoperative stability and faster return to baseline function. Multidisciplinary teamwork, integrating surgeons, anaesthetists, geriatricians, nurses, physiotherapists, dietitians and caregivers, play a key role in identifying modifiable risks and ensuring continuity of care. Studies also highlight the value of post-discharge telephone follow-up, caregiver engagement and close collaboration with primary care in preventing readmissions. Conclusions: Day surgery is a viable and patient-centred option for many older adults when careful selection and preparation are combined with age-sensitive perioperative care. Most adverse outcomes can be mitigated through systematic prehabilitation, thoughtful anaesthetic planning, early mobilisation and structured follow-up. The evidence suggests that older patients may benefit from reduced hospital stay, less exposure to harm, and faster functional recovery. Implications for practice: The findings support broader integration of geriatric day surgery into routine care pathways, especially within health systems facing capacity constraints. Clinicians should consider implementing standardised geriatric assessment, multidisciplinary optimisation strategies, and robust discharge and follow-up protocols to enhance safety and effectiveness. With appropriate preparation and coordinated teamwork, day surgery can contribute meaningfully to safer, more efficient and more patient-centred surgical care for older adults. Full article

Background: Hip fracture represents a major public health challenge in aging populations and is associated with high morbidity, functional decline, and increased healthcare utilization. Early mobilization within the first 24 h after surgery is considered a key quality indicator in hip fracture care and has been associated with improved functional recovery and reduced postoperative complications. The aim of this study was to evaluate compliance with early mobilization and identify clinical and organizational factors associated with its implementation. Methods: A retrospective observational study was conducted in the surgical hospitalization unit of a tertiary hospital in Madrid, Spain. All adult patients who underwent hip fracture surgery between January and December 2023 were included. Sociodemographic, clinical, and functional variables were collected from electronic medical records. Early mobilization within the first 24 h after surgery was defined as the primary outcome and analyzed in relation to clinical and organizational variables. Results: A total of 139 patients were included, with a mean age of 82.4 ± 11.3 years, and 79.1% were women. Early mobilization was achieved in 66.2% of patients. Significant associations were observed between early mobilization and blood transfusion requirements (p = 0.002), postoperative radiography performed within the first 24 h (p = 0.004), and the presence of an explicit medical order for mobilization (p < 0.001). No significant associations were identified with age, sex, functional dependency, cognitive impairment, baseline mobility, or ASA classification. Conclusions: Early mobilization after hip fracture surgery was associated with several modifiable clinical and organizational factors in this cohort. However, these findings should be interpreted with caution because fracture-specific and surgery-specific variables were not available. Implementing standardized protocols, automatic mobilization orders, and optimized perioperative management strategies may improve compliance with this key quality indicator and enhance postoperative recovery. Full article

Objective: The goal was to investigate the relationship between methodological adherence and clinical outcomes in Progressive Resistance Training (PRT) for Parkinson’s Disease (PD), specifically identifying why findings of “superiority” over active controls remain inconsistent. Methods: This umbrella review utilized a multi-stage process to identify a sample of the primary literature for methodological analysis. An initial search identified 38 systematic reviews published within the specified timeframe. From the reference lists of these reviews, a subset of 34 primary clinical studies was purposefully selected. Inclusion was prioritized for studies providing comprehensive methodological data on PRT protocols and standardized clinical outcomes. Interventions were evaluated using a three-tiered framework: (1) training protocol with specifications of Frequency, Intensity, Time, Type, Volume, and Progression (FITT-VP) (General Exercise), (2) FITT-VP integrated with the American College of Sports Medicine (ACSM) Supplementary Guidelines (Integrated Guidelines), and (3) principles of progression (mechanistic growth). Studies were categorized by control type (active (e.g., aerobic or balance), n = 26; passive (e.g., standard care or no exercise), n = 8). Results: In trials that compared PRT with an active control group, PRT achieved clinical superiority in 57% (n = 15) of trials and 46% (n = 12) when focusing on trials with an effect on specific functional or balance outcomes. Among these successful interventions, 75% maintained high adherence (≥70%) to the Integrated Guidelines, and 58% maintained high adherence to the principles of progression. In the 53% (n = 14) of studies where PRT was found non-superior (equivalent or inferior in functional or balance outcomes) to an active control, 0% met the high adherence threshold for progression. While general FITT-VP compliance remained high (78%), the failure to implement systematic load, specificity, and variation served as a definitive barrier to competitive superiority. In the 100% of studies where PRT outperformed passive controls, high progression was present in 57% of cases. This may suggest that while a baseline resistance stimulus outperforms inactivity, it is fundamentally insufficient to outperform other active clinical therapies. Conclusions: This umbrella review indicates that adherence to the principles of progression may be an important factor influencing the clinical outcomes of PRT in individuals with PD. The variability observed in the current literature suggests that inconsistent application of established exercise frameworks—rather than the failure of the modality itself—could be a contributing element to the reported “inconclusiveness.” To potentially enhance functional outcomes and the comparative effectiveness of PRT, future research should consider prioritizing structured adherence to FITT-VP, Integrated Guidelines, and progression-based frameworks. Establishing a 70% adherence threshold is proposed as a potential benchmark to improve protocol consistency and support rehabilitation efficacy in this population. Full article

Background and Objectives: Halitosis is a common condition with substantial psychosocial impact, frequently driven by intra-oral biofilm, tongue coating, and reduced salivary clearance. This study compared the short-term effectiveness of standardized counseling alone, probiotic lozenges containing Streptococcus salivarius K12, and a zinc-containing mouthrinse in adults with persistent intra-oral halitosis. Materials and Methods: In this 4-week, parallel-group, randomized pragmatic trial, 117 adults with bothersome halitosis for at least 3 months and baseline organoleptic score ≥ 2 were allocated 1:1:1 to standard care, probiotic lozenges, or zinc mouthrinse. All participants received standardized counseling and tongue cleaning instructions. The primary endpoint was change in volatile sulfur compounds (VSCs) measured by portable sulfide monitoring. Secondary outcomes included organoleptic score, Halitosis Associated Life-Quality Test (HALT), Oral Health Impact Profile-14 (OHIP-14), tongue coating, plaque, and salivary Solobacterium moorei quantified by qPCR. Results: Baseline demographic, clinical, and biochemical characteristics were comparable across groups. All interventions improved outcomes over 4 weeks, but improvements followed a consistent gradient favoring zinc mouthrinse, followed by probiotic lozenges, then standard care. Mean VSC reduction was −12.7 ± 33.9 ppb with standard care, −47.3 ± 42.2 ppb with probiotics, and −78.5 ± 36.3 ppb with zinc mouthrinse (p < 0.001). Organoleptic scores improved by −0.2 ± 0.7, −0.8 ± 0.8, and −1.2 ± 0.8, respectively (p < 0.001). HALT and OHIP-14 scores showed parallel reductions, and moderate/severe halitosis at week 4 remained most frequent in the standard care group (58.9%) and least frequent in the zinc group (20.5%; p = 0.004). Conclusions: Both active adjunctive strategies improved intra-oral halitosis beyond standardized counseling alone, but the zinc-containing mouthrinse produced the greatest short-term benefits across objective, clinician-rated, and patient-reported outcomes. These findings support zinc-based rinses as a practical short-term adjunct for managing persistent intra-oral halitosis in outpatient dental care. Durability after discontinuation and potential relapse beyond 4 weeks were not assessed in this trial. Full article

Background: Tranexamic acid (TXA) is an antifibrinolytic agent that helps prevent and manage bleeding events. In patients with trauma, TXA reduced bleeding-related deaths by one-third. Moreover, TXA showed a lower risk of mortality from bleeding in postpartum patients. Few studies have examined the appropriateness of TXA use for the management of bleeding in critically ill patients. This study aimed to describe the clinical outcomes and the safety of TXA use in critically ill patients with bleeding. Methods: This single-center, single-arm descriptive study was conducted at King Faisal Specialist Hospital & Research Center, Jeddah, between January 2018 and March 2023. The study included adult patients 18 years or older who were admitted to the medical intensive care unit (ICU) for ≥48 h and had documented bleeding that was treated with TXA for at least one dose. The primary outcome was the frequency of thrombotic events. Secondary outcomes included time from bleeding onset to bleeding resolution, rebleeding event at 30 days, time from bleeding onset to rebleeding event, ICU and hospital length of stay, and 30-day all-cause mortality. Results: A total of 129 patients were included in the study, 55% of whom were male. The median age was 60.9 years. The median APACHE II score was 22 (15–29). At baseline, 24.8% of patients had a history of bleeding. Major bleeding occurred in 86.1% of the patients. The frequency of thrombotic events was 2.3%. The median bleeding duration was 3.9 days (1.9–7.0). Rebleeding events at 30 days occurred in 24.8% of patients, with a median time of 11.7 days (8–14.8) from bleeding onset to rebleeding. The average ICU length was 12 days (6–24), and the average hospital length of stay was 25 days (15–50). The 30-day all-cause mortality rate was 55.8%. Multivariable analysis assessing factors contributing to mortality revealed that higher APACHE II score was strongly associated with increased mortality (adjusted OR 1.14 per point increase, 95% CI 1.07–1.21, p < 0.001), while higher platelet counts were independently protective, with each 10 × 10⁹/L increase associated with a 4% reduction in mortality odds (adjusted OR 0.96, 95% CI 0.93–0.99, p = 0.034). Conclusions: In this descriptive study, TXA use in critically ill patients was accompanied by low absolute rates of thrombotic and rebleeding events. Further studies with larger sample sizes and comparable groups are needed to examine the appropriateness of TXA use in managing bleeding events in the ICU. Full article

Background: Understanding how demographic and clinical factors influence SARS-CoV-2 infection patterns, vaccination uptake and disease outcomes in community settings is essential for effective primary care-based public health planning. Objectives: This study aimed to investigate the distribution of SARS-CoV-2 infections among adults attending Primary Healthcare (PHC) facilities in Giannitsa, Greece, from 2020 to 2024, and to examine associations between demographic and clinical characteristics, vaccination category and disease outcomes. Methods: A retrospective analysis was conducted using data from the National Registry of Patients with COVID-19. The study included 1144 adults diagnosed with SARS-CoV-2 at PHC facilities from 19 November 2020 to 3 October 2024; all cases included in the present analysis had been confirmed by rapid antigen testing. Variables included age, gender, residence, registry-recorded underlying medical conditions, vaccination category, seasonality and clinical outcome. Results: Significant shifts in case distribution were observed across time, with younger adults predominating in 2020–2022 and older adults (61–90 years) in 2023–2024 (p < 0.001). Winter months showed higher case incidence overall (p < 0.001). Vaccination coverage increased annually, reaching 84.8% in 2024 (p < 0.001). Hospitalization/death occurred in 1.7% of patients and was strongly associated with age ≥61 years (6.0% vs. 0.3%), the presence of at least one registry-recorded underlying medical condition (9.2% vs. 0.9%) and vaccination category; specifically, hospitalization/death occurred in 10.4% of individuals diagnosed during the pre-vaccine period, 2.3% of unvaccinated individuals during the vaccination era and 0.9% of vaccinated individuals (all p < 0.001). Conclusions: Older age, underlying medical conditions and a lack of vaccination were key predictors of worse outcomes. The findings underscore the importance of strengthening vaccination outreach and targeted PHC interventions, particularly for high-risk and rural populations. Full article

Background/Objectives: Preterm infants are particularly vulnerable to nutritional deficiencies and electrolyte imbalances during the early stages of extrauterine life. To ensure optimal metabolic support, they often require the early initiation of “aggressive” parenteral nutrition (PN), which is a known risk factor for Refeeding Syndrome (RS), a potentially serious metabolic condition characterized by fluid and electrolyte disturbances, the most significant of which is hypophosphatemia. Hypophosphatemia can impair the metabolism, survival, and function of red blood cells, leading to a reduction in key intracellular metabolites and the development of a metabolic block that alters their quality and decreases their stability. It is therefore hypothesized that RS may contribute to the development of anemia of prematurity (AOP). At the same time, early enteral nutrition (EN) may promote metabolic adaptation and reduce exposure to the complications of prolonged parenteral support, potentially protecting against AOP. The primary aim of this study was to determine whether preterm infants who develop RS are at increased risk of AOP. A secondary aim was to evaluate whether early EN may act as a protective factor against the development of AOP. Methods: This retrospective observational study was conducted on infants with a gestational age ≤ 34 weeks and/or birth weight ≤ 1500 g, admitted to the Neonatal Intensive Care Unit of Policlinico Umberto I—Sapienza University of Rome, between January 2015 and November 2022. Infants diagnosed with AOP were classified as cases, while those without AOP served as the control group. Results: A total of 412 preterm infants were enrolled (110 cases, 302 controls). Refeeding Syndrome was significantly more frequent in infants with AOP (30.9% vs. 11.6%, p < 0.001). In the logistic regression model adjusted for gestational age, RS was independently associated with AOP (OR = 2.81; 95% CI: 1.55–5.10; p < 0.001), along with gestational age ≤ 34 weeks (OR = 7.10; 95% CI: 2.13–24.0; p = 0.001). Early enteral nutrition during the first week of life was associated with a significantly lower risk of AOP (OR = 0.12; 95% CI: 0.029–0.52; p = 0.005). The association between RS and AOP was confirmed in the model adjusted for birth weight (OR = 2.06; 95% CI: 1.16–3.79; p = 0.021). Infants with AOP showed significantly higher parenteral nutrition intake, delayed initiation of enteral feeding, and later achievement of full enteral nutrition compared with controls (all p < 0.001). Conclusions: RS is significantly associated with AOP in preterm infants, likely through pathophysiological mechanisms related to hypophosphatemia. Importantly, early EN may be a protective factor against AOP, suggesting that timely initiation and advancement in enteral feeding may counteract the metabolic derangements associated with intensive parenteral support. These findings support a nutritional approach that prioritizes early and progressive enteral nutrition as a strategy to reduce the risk of both RS and AOP. Further prospective studies are needed to confirm these associations and to define optimal EN protocols for this population. Full article

Background/Objectives: The Individualized Neuromuscular Quality-of-Life Questionnaire (INQoL) is a widely used measure of quality of life in patients with various neuromuscular diseases. This study aimed to adapt and test the validity and reliability of this measure in Hungarian patients with neuromuscular disease. Methods: According to the widely accepted method of validation, we first translated the original INQoL version into Hungarian, and then a native English speaker translated it back into English to test its validity. Following a pretest procedure, the INQoL was administered to 80 patients with various muscular diseases and 30 age-matched controls. The internal consistency and test–retest reliability were assessed. Concurrent validity was measured using the 36-item Short Form Survey (SF-36) questionnaire. Results: For all INQoL subscales, Cronbach’s alpha was above 0.7, demonstrating the reliability of the subscales. The highest Cronbach alpha value was for the Weakness subscale (0.983) and the lowest for the Treatment subscale (0.794). The intraclass correlation coefficient test values ranged from 0.810 (Treatment) to 0.988 (Pain), indicating excellent test–retest reliability. There was a strong correlation between the SF-36 Physical Function and multiple INQoL subscales, including Weakness (r = 0.754, p < 0.001), Fatigue (r = 0.704, p < 0.001), Activities (r = 0.744) p < 0.001, Independence (r = 0.791 p < 0.001), Body Image (r = 0.714 p < 0.001), and overall Quality of Life (r = 0.742 p < 0.001). Conclusions: Our findings indicate that the Hungarian-language adaptation of the questionnaire possesses adequate reliability and construct validity for assessing the quality of life in patients with muscular disorders. Full article

The impact of oncological diseases extends far beyond the clinical patient, profoundly affecting the mental health of caregivers, family members, and volunteers who navigate complex emotional landscapes of grief, anxiety, and trauma. While the domain of digital health has seen a proliferation of serious games aimed at pediatric patient education and treatment adherence, the specific perspective of the “second-order patient”, the caregiver or survivor, remains significantly under-explored. The primary objective of this study is to systematically review the current state of interactive narratives in oncology, palliative care, and grief support, identifying research gaps to inform the broader design space of empathy-driven serious games. Following the PRISMA guidelines, 31 articles were selected from an initial query of 116 records. Interventions were categorized into Serious Games, Games, and Gamification. The analysis reveals a critical thematic transition: early interventions relied heavily on biological “battle” metaphors to empower patients, whereas the current literature advocates for “thanatosensitive” designs that foster empathy. However, a distinct research gap persists regarding narratives that explore post-loss meaning reconstruction and the hospital volunteer experience. Synthesizing these findings, this paper establishes an evidence-based theoretical framework demonstrating a significant opportunity for games that prioritize dialogue and emotional processing over traditional winning conditions. As a practical application of these findings, we also briefly outline the conceptualization of a prototype simulating a widower’s experience volunteering in a palliative ward, shifting the ludic focus from defeating a disease to navigating loss. Full article

Background/Objectives: Hyperkalemia is common in patients with chronic kidney disease (CKD). However, its epidemiology may be evolving due to population aging, new therapeutic developments and novel estimated glomerular filtration rate (eGFR) equations. We have re-evaluated the epidemiology of hyperkalemia in a contemporary cohort in which eGFR was assessed using the EKFC equation recommended by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM). Methods: We analyzed 190,579 laboratory tests with serum potassium values corresponding to individual outpatients in Primary or Specialty Care from a single laboratory in 2023, representing 42% of the catchment area population. Results: Hypokalemia (<3.5 mmol/L) was present in 0.3% patients, hyperkalemia (≥5.0 mmol/L) in 10.5% (11.5% of men, 9.7% of women). Hyperkalemia was mostly mild (9.4%) but was severe in 0.1% overall and in 10.5% of CKD G5. One in four patients with hyperkalemia had CKD. Hyperkalemia was more common among patients with CKD G3–G5 defined using the CKD-EPI2009 equation than defined using the EKFC equation (20.5 vs. 18.6%, p < 0.0001). Using EKFC, hyperkalemia prevalence increased with decreasing eGFR from G1 (6.6%) to G2 (10.8%) and, especially in CKD G3–G5 (G3 17.2% to G5 47.5%). In multivariate logistic analysis, worse renal function, worse diabetes control, older age, and surrogates for release of intracellular potassium during sample processing (red blood cell counts or size, platelet counts, elevated calcium levels) were independently associated with hyperkalemia. This multivariate model yielded an area under the curve (AUC) of the Receiver Operating Characteristic (ROC) curve for hyperkalemia of 0.678 (95% CI 0.674–0.682). Random forest also identified GFR as the most important feature associated with hyperkalemia and generally concurred with logistic analysis findings. Conclusions: Hyperkalemia remains common, especially in CKD G5. While hyperkalemia is mainly associated with low eGFR, sample processing should be optimized. Full article

This article explores access intimacy as feeling, interactional practice, and political vision through an inclusive research project in Hong Kong, where 12 visually impaired adults and 35 university students collaboratively developed accessible board games. Drawing on Mingus’s interdependence framework and Valentine’s justice-based access, we position visually impaired participants as primary knowledge producers while critically examining vulnerability, power dynamics, and research ethics. Analysis of field observations and in-depth interviews reveals three key dimensions: (1) collaborative game design enabled visually impaired participants to experience emotional access by fostering friendship, recognition, and belonging beyond logistical accessibility; (2) negotiation around “independence” and “fairness” generated transformative empowerment for both visually impaired and sighted participants, reframing interdependence as strength; and (3) reciprocal vulnerability in sighted guiding practices disrupted ableist assumptions about autonomy, care, and risk, revealing care as mutual rather than unidirectional. We argue that access intimacy functions as a learnable relational skill, and that attending to it in research design, community planning, and accessibility policy fosters justice-based paradigms that move beyond accommodation toward genuine interdependence and solidarity. Full article

Background/Objectives: Pediatric HIV case-finding and monitoring remain constrained by delayed early infant diagnosis (EID), loss to follow-up, and limited viral load (VL) testing—challenges particularly consequential in the operationally diverse Asia–Pacific region. We systematically reviewed innovations in point-of-care (POC) and near-patient HIV diagnostics and digital monitoring relevant to children and adolescents. Methods: Following a registered protocol (INPLASY2025110058) and PRISMA 2020 guidance, we searched PubMed, EMBASE, Cochrane Library, and WHO Global Index Medicus for studies on POC/near-patient EID and VL testing, dried blood spot (DBS) workflows, and digital monitoring tools. Risk of bias was assessed using RoB 2, QUADAS-2, and MMAT. Results: Fifty-three primary studies were included (39 sub-Saharan Africa, 12 Asia–Pacific, 1 multi-country/global, 1 Americas/Caribbean). Patient selection and flow/timing were common limitations in diagnostic accuracy studies; sample representativeness and nonresponse bias were frequent concerns in implementation studies. The most consistent benefits of POC EID and near-patient VL testing were shorter turnaround times and improved cascade completion when paired with quality assurance and connectivity. Conclusions: POC diagnostics and digital monitoring can help close pediatric HIV cascade gaps, though evidence derives predominantly from sub-Saharan Africa. Impact depends on implementation design. Asia–Pacific programs should prioritize generating context-specific evidence alongside the adaptation of established lessons. Full article

Objectives: Despite the widespread availability of digital clinical information, timely access to relevant biomedical evidence during routine consultations remains limited in practice. Primary care clinicians, in particular, face significant time constraints that make it difficult to integrate comprehensive literature searches into everyday workflows. This study evaluates whether an ontology-based recommender system can support routine clinical workflows by reducing information retrieval time while preserving the clinically acceptable usefulness of retrieved evidence. We assessed the performance of the HOPE (Health Operation for Personalised Evidence) system compared with realistic manual PubMed searches conducted by physicians. Materials and Methods: We conducted an observational evaluation involving 50 primary care physicians, who independently assessed 30 anonymised, rewritten clinical cases representative of common primary care scenarios. HOPE automatically extracted biomedical concepts from case descriptions using natural language processing and mapped them to Unified Medical Language System (UMLS) ontologies to generate ranked PubMed recommendations. A subset of 10 physicians also conducted manual PubMed searches in line with their usual clinical practice. Article relevance was assessed using a predefined binary criterion, and a reference relevance set was established by consensus among three senior physicians using a pooled document set. Retrieval performance was evaluated using Precision@k, relative Recall@k, and Normalised Discounted Cumulative Gain (NDCG@k). Manual search time was measured using a standardised stopwatch protocol, whereas HOPE response time was logged automatically by the system. Results: Inter-physician agreement in relevance assessment was substantial (Fleiss’ κ = 0.66; 95% CI: 0.61–0.70). HOPE achieved moderate-to-high precision within the top-ranked results (Precision@3 = 0.72), with relative recall increasing as additional documents were considered. Ranking metrics indicated that relevant articles were generally positioned early in the result lists. The mean total retrieval time for manual PubMed searches was 13.3 ± 1.7 min per case, compared with 17.4 ± 2.1 s for HOPE-assisted retrieval (p < 0.001). Conclusions: In a controlled, workflow-oriented evaluation using synthetic clinical cases, HOPE substantially reduced information retrieval time while maintaining clinically acceptable relevance in the retrieved literature. These findings support the use of ontology-based, AI-assisted systems as workflow-support tools to facilitate timely access to biomedical evidence, without replacing clinical judgment. Full article

Background/Objectives: Vaccination represents a significant achievement of public health and should be regarded not only as a protective measure against infectious diseases but also an active preventive intervention and a component of health promotion. Methods: This cross-sectional study assessed vaccination coverage among adults aged ≥60 years who attended a Primary Health Care Center during a predefined period of at least two months (November–December 2025) in a rural area of Crete, Greece, and examined determinants of immunization, including demographic, clinical, psychosocial, and health service utilization factors. The sample comprised 366 participants who consented to complete a structured questionnaire, primarily via interview, followed by verification of vaccination status through medical records. Results: High vaccination coverage was observed for influenza (82.5%), moderate coverage for pneumococcal (68.3%) and herpes zoster (56.0%) vaccines, and very low coverage for tetanus–diphtheria–pertussis booster doses (≈13%) and RSV vaccination (5.2%). For SARS-CoV-2, 96.2% received the three doses which were mandatory during the pandemic years. The overall Vaccination Coverage Score (VCS) averaged 43.1/100, while only 10.1% of participants achieved high coverage. Regression analysis showed that higher educational level, multimorbidity, and extensive use of health services were independently associated with better vaccination coverage (p < 0.05). Conclusions: The findings reveal fragmented vaccination patterns and underscore the need for systematic assessment of adult vaccination status within routine Primary Health Care. Targeted counseling, promotion of health literacy, and preventive vaccination strategies are expected to reduce vaccine-preventable morbidity and support healthy aging. Full article

Background/Objectives: The prevalence of allergic diseases has markedly increased in developed countries, with environmental and dietary factors considered important contributors. Folic acid is an essential micronutrient involved in one-carbon metabolism and DNA methylation, playing a key role in epigenetic regulation of immune function. Both high and low folate exposure have been associated with allergic outcomes, but the data on postnatal folate status in paediatric populations remain limited. This study aimed at assessing serum folate status in children with atopic diseases compared with children without chronic allergic disease in Croatia. Methods: This cross-sectional study included 292 paediatric patients from the University Hospital in Split and a paediatric primary care practice between January 2024 and January 2025. Serum folic acid concentrations were measured using electrochemiluminescence immunoassay. Additional laboratory parameters included vitamin B12, total IgE levels, and eosinophil counts. Demographic and clinical data were obtained from medical records. Statistical analyses included Chi-square tests, Mann–Whitney U tests, linear regression modelling, and analysis of covariance with statistical significance set at p < 0.05. Results: Folic acid deficiency was present in 66.4% of all participants. Children with atopic diseases were significantly more likely to have folate deficiency and had lower mean serum folate concentrations compared to children without allergic disease. There were no significant differences in folate levels between children with and without asthma. Lower folate levels were associated with higher IgE levels, higher eosinophil counts, and older age. When controlling for the effects of age on folic acid levels, the differences between participants with and without atopic diseases remained significant. Conclusions: Folic acid deficiency is highly prevalent among children in the Mediterranean region of Croatia and is significantly associated with atopic diseases and markers of allergic inflammation. These findings highlight a potential role of folate status in paediatric allergic disease and support the need for longitudinal studies to clarify causality and potential clinical implications. Full article