Search Results (12,106)

Background: Endometriosis is a chronic condition affecting a substantial proportion of women of reproductive age and leading to impaired quality of life. Despite its potential occupational implications, evidence on how occupational physicians (OPs) manage workers affected by endometriosis remains scarce. This study aimed to assess the knowledge, attitudes, and practices (KAP) regarding endometriosis among Italian OPs. Methods: A cross-sectional web-based survey was conducted between 1 and 18 April 2026 by recruiting a convenience sample of 155 occupational physicians. The questionnaire was specifically designed and investigated knowledge status, risk perception, perceived barriers to workplace management, and previous experience of participating professionals. Results: Most respondents considered themselves adequately informed about endometriosis (78.1%) and reported previous professional experience with affected workers (81.3%). Knowledge gaps were identified, particularly regarding disease prevalence (26.5% correct responses), familial predisposition (34.8%), and diagnostic pathways (31.6%). Overall, 65.8% of participants reported having previously issued conditioned fitness-for-work appraisals, most frequently recommending increased work breaks, avoidance of night shifts, or limitations on shift work. In multivariable analysis, male gender (adjusted odds ratio [aOR] 5.69, 95% confidence interval [95% CI] 1.84–17.58), participation in continuing medical education activities (aOR 85.72, 95% CI 6.60–1114.21), information obtained from colleagues (aOR 4.67, 95% CI 1.23–17.77), and employment in healthcare settings (aOR 5.91, 95% CI 1.92–18.16) were independently associated with having previously issued restricted fitness-for-work judgments, whereas relying exclusively on undergraduate medical education was negatively associated with this outcome (aOR 0.07, 95% CI 0.01–0.39). Conclusions: Among the sampled Italian OPs, endometriosis was recognized as a clinically relevant condition frequently encountered in daily practice. Continuous professional education, interdisciplinary exchange, and practical experience were more strongly associated with occupational decision-making than undergraduate training alone. These findings support the development of targeted educational interventions and shared occupational recommendations aimed at improving workplace management and promoting the inclusion and retention of women affected by endometriosis in the workforce. Full article

Background and Objectives: Advanced practice nurses (APNs) play an increasingly important role in improving healthcare quality and outcomes. This systematic review synthesized evidence on APN roles and healthcare outcomes in Thailand. Methods: The review protocol was prospectively registered in PROSPERO (CRD420261331793). Four databases (PubMed, CINAHL, Scopus, and Thai Journals Online) were searched from inception to January 2026. Two independent reviewers performed study selection, data extraction, and methodological quality assessment using the Mixed Methods Appraisal Tool (MMAT, 2018) for mixed-methods studies and the Joanna Briggs Institute (JBI) critical appraisal checklists for quasi-experimental, analytical cross-sectional, and qualitative studies. A narrative synthesis was undertaken because of methodological heterogeneity. Results: Twenty studies were included, comprising eight quasi-experimental studies, six cross-sectional studies, four mixed-methods studies, one retrospective study, and one qualitative descriptive study. APNs performed diverse roles, including direct clinical care, care coordination, consultation, patient education, mentoring, and implementation of evidence-based practice. APN-led models of care were associated with favorable clinical outcomes, enhanced self-care and quality of life, increased patient and caregiver satisfaction, and reduced hospital length of stay and healthcare costs. Conclusions: The available evidence suggests that APN-led models of care may be associated with favorable patient, family, and health system outcomes in Thailand. However, these findings should be interpreted cautiously because the evidence was derived predominantly from non-randomized and observational studies, and the independent effects of APN practice could not always be isolated. Full article

Background: Septic arthritis (SA) is a serious and rapidly progressive condition that can result in significant morbidity and mortality. Current clinical guidelines endorse a combination of surgical debridement and targeted antibiotic therapy as the gold standard treatment for adults with knee SA. Despite the effectiveness of this approach, patients often experience prolonged inflammation, leading to long-term complications such as cartilage degeneration and chronic pain. Since inflammatory cytokines contribute to cartilage destruction, it is considered to be possible that mitigating their levels through the use of steroids could potentially prevent cartilage damage. Methods: This study is designed as a multicenter, open-label, randomized controlled trial aimed at evaluating the efficacy of intravenous dexamethasone as an adjunctive therapy for adults diagnosed with knee joint SA. Participants aged 18 years and older will be randomized to receive either standard treatment (surgical debridement and antibiotics) or the same regimen with the addition of dexamethasone. The primary objective is to assess pain reduction at four days post-surgery using the EQ-VAS scale and knee joint effusion, while secondary objectives will include the evaluation of additional surgical interventions, pain control over time, joint function, normalization of inflammatory markers, and overall healthcare resource utilization. Discussion: While corticosteroids have demonstrated efficacy in pediatric populations with septic arthritis, the evidence for their use in adults remains limited. This trial aims to ascertain whether the anti-inflammatory effects of corticosteroids can mitigate complications and enhance clinical outcomes in adult patients with SA. The findings from this study could provide critical insights into optimizing treatment strategies for this complex condition, ultimately improving patient quality of life. Full article

Background/Objectives: Self-injurious behavior (SIB) is one of the most disabling manifestations of Lesch–Nyhan disease (LND), frequently involving the oral cavity and severely affecting patients’ quality of life and caregiver burden. Evidence regarding the impact of dental interventions on patient- and caregiver-reported outcomes remains limited. This study investigated the characteristics of SIB in patients with LND and explored the perceived effectiveness, tolerability, and psychosocial impact of intraoral devices and dental extractions. Methods: A questionnaire-based observational study was conducted among patients with LND. A purpose-built 32-item questionnaire, developed by dentists with expertise in Special Care Dentistry at Mauriziano Umberto I Hospital (Turin, Italy), was administered to patients attending the Pediatric Dentistry and Orthodontics Unit at IRCCS Istituto Giannina Gaslini (Genoa, Italy). The questionnaire assessed demographic and clinical characteristics, SIB features, dental management strategies, treatment-related complications, and patient- and caregiver-reported outcomes. Results: Twenty-four questionnaires were analyzed. SIB was reported in 21 patients (87.5%). Fingers (80%) and lips (70%) were the most frequently affected sites, with multiple anatomical sites involved in 80% of patients. Intraoral devices were used in 14 patients (66.7%), whereas dental extractions were performed in 4 (19%). Among patients treated with intraoral devices, 78.6% reported increased reassurance and protection. Device-related complications occurred in three patients and were mainly periodontal. All patients and caregivers reported relief following dental extraction, although SIB persisted in 50% of cases. Conclusions: SIB is highly prevalent among individuals with LND and commonly affects multiple anatomical sites. Intraoral devices are the most frequently adopted treatment strategy and are generally well tolerated, whereas dental extractions were associated with substantial perceived relief but do not necessarily eliminate SIB. Patient- and caregiver-reported outcomes should be considered when evaluating treatment effectiveness. Full article

Background/Objectives: Functional bowel disorders (FBDs) are chronic gastrointestinal conditions that substantially impair quality of life. This randomized, double-blind, placebo-controlled trial investigated the effects of Heyndrickxia coagulans IDCC 1201 (COA 1201) in adults with FBD. Methods: Participants received COA 1201 or a placebo for 8 weeks, with outcomes assessed using the irritable bowel syndrome (IBS) Symptom Severity Score (IBS-SSS), IBS Quality of Life (IBS-QOL), and bowel activity measures. And Fecal microbiome and metabolomics were measured by 16S rRNA gene sequencing gas chromatography-mass spectrometry, respectively. Results: Both groups showed improvement from baseline, but COA 1201 produced greater symptom relief, particularly in abdominal bloating, post-defecation discomfort, and the body image domain of IBS-QOL. Fecal microbiome profiling revealed modest changes in global diversity, yet taxa linked to saccharolytic activity and short-chain fatty acid production—including Ruminococcus bromii, Agathobacter rectalis, and Bifidobacterium—were enriched in participants receiving COA 1201, whereas Clostridium leptum increased in those receiving a placebo. Untargeted metabolomics demonstrated distinct metabolic signatures between groups, confirmed by supervised partial least squares discriminant analysis. Exploratory metabolites were identified using variable importance in projection scores (>1.5), statistical significance (p < 0.05), and absolute log₂ fold change (>1). Alanine and proline emerged as time-dependent metabolites, while tryptophan, lactic acid, and phytosphingosine were specifically associated with COA 1201 treatment. Conclusions: Collectively, these findings suggest that COA 1201 alleviates FBD symptoms by modulating the gut microbiome and metabolome. Full article

Pediatric oncology nursing is among the highest-intensity care specialties, exposing nurses to repeated child death and sustained emotional investment in family relationships. This occupational burden is a recognized psychosocial risk factor and a driver of compassion fatigue, burnout, and reported intention to leave, yet the organizational and educational determinants of this risk remain poorly captured by existing assessment approaches. This study investigated the lived experiences of nurses caring for terminally ill children in a pediatric onco-hematology unit and hospice ward in central Italy (N = 15), using a qualitative descriptive design, informed by a phenomenological sensibility to lived experience, supported by computer-assisted textual analysis. Structured face-to-face interviews were analyzed through thematic content analysis with stepwise replication, while quantitative textual analysis was performed using T-Lab software to map co-occurrence patterns among key lemmas, providing a frequency-based, semantically grounded picture of nurses’ representations of occupational risk. Seven themes emerged, including quality of nursing care, parental relationships, coping with a child’s death, and impact on personal and professional life. Findings showed that reported intention to leave was associated, in participants’ accounts, with absent psychological debriefing, cumulative emotional burden, inadequate end-of-life training, and a near-total absence of organizational vocabulary for peer-level support—a gap directly visible in the co-occurrence structure of nurses’ language. As a secondary aim, by combining qualitative depth with complementary lexical analysis of thematic patterns, this study also offers a methodological example of how psychosocial risk in high-intensity care settings can be assessed and translated into actionable indicators for organizational climate and workforce well-being. The findings inform concrete prevention strategies and policy recommendations for nursing education and occupational health, consistent with this Special Issue’s focus on methodological innovation for psychosocial risk assessment and public health policy design. Full article

Background: Cervical radiculopathy is a common and disabling condition with both nociceptive and neuropathic pain components. Epidural steroid injections (ESIs) are widely used as an interventional treatment modality; however, the optimal cervicothoracic interlaminar access level and injectate volume remain subjects of ongoing debate. Because injection level and injectate volume have historically been varied together in routine practice rather than independently, prospectively designed comparative data are lacking. Methods: In this retrospective, multicenter cohort study, 166 patients with MRI-confirmed cervical radiculopathy treated between January 2022 and December 2025 at three participating institutions received fluoroscopy-guided cervicothoracic interlaminar epidural steroid injections with dexamethasone and bupivacaine at either C7/T1 (6 mL; n = 87) or T1/T2 (8 mL; n = 79), with protocol determined by the treating institution rather than randomization. The prespecified primary outcome was the baseline-adjusted between-group difference in arm-pain Numeric Rating Scale (NRS) score at 3 months, analyzed by analysis of covariance (ANCOVA) adjusted for a directed acyclic graph-informed covariate set (age, symptom duration, baseline pain severity, number of stenotic levels, DN4 score, and treatment center); the same covariates were used in a generalized estimating equation (GEE) model with a group-by-time interaction and in a multivariable logistic regression for treatment response. Secondary outcomes—neck-pain NRS and VAS, neuropathic pain (DN4), functional disability (NDI), quality of life (SF-36, EQ-5D), Patient Global Impression of Change (PGIC), analgesic consumption, and cardiovascular/metabolic safety outcomes—were assessed at baseline, 3 months, and 6 months. Results: Both groups showed significant within-group reductions in arm-pain NRS (C7/T1: 8.7 ± 0.4 to 3.5 ± 0.4 at 3 months and 4.1 ± 0.6 at 6 months; T1/T2: 9.2 ± 0.7 to 3.9 ± 0.5 at 3 months and 4.9 ± 0.7 at 6 months; both p < 0.001). Baseline pain scores and symptom duration were not balanced between groups (baseline-adjusted analysis was therefore used). After adjustment for baseline severity, age, symptom duration, and center, the T1/T2–8 mL protocol was associated with higher (worse) adjusted arm-pain NRS than the C7/T1–6 mL protocol at 3 months (adjusted difference 0.41 points, 95% CI 0.21–0.61) and 6 months (0.66 points, 95% CI 0.35–0.97); a multivariable-adjusted logistic regression model likewise showed lower odds of achieving a ≥50% arm-pain reduction at 3 months with the T1/T2–8 mL protocol (adjusted OR 0.18, 95% CI 0.04–0.82). NDI decreased from a mean of 48.1 points at baseline to 28.1 points at 3 months (pooled cohort, score capped at the 0–50 scale maximum; the majority of baseline NDI source records could not be individually verified and this is reported as a limitation), and analgesic consumption decreased over follow-up. Among hypertensive patients (45/166, 27.1%), 78% experienced transient blood pressure elevation and 40% required temporary antihypertensive adjustment; among diabetic patients (13/166, 7.8%), 92% developed transient hyperglycemia. Because injection level, injectate volume, and treatment center were confounded by design, these findings should be interpreted as a comparison of two center-specific treatment protocols rather than an isolated effect of anatomical level or volume. Conclusions: Both center-specific cervicothoracic interlaminar epidural steroid injection protocols were associated with improvements in pain and function over six months, with no catastrophic procedural complications documented; however, near-complete confounding of injection level with injectate volume and treatment center, together with imbalanced baseline pain severity, precludes conclusions about the comparative effectiveness of C7/T1 versus T1/T2 access. Transient cardiovascular and metabolic effects were common and support consideration of post-procedural monitoring in patients with pre-existing hypertension or diabetes. Full article

Digital technologies are reshaping economies, labor markets, social security systems, and societal well-being across the European Union, increasing the need for decision-support methods capable of systematically analyzing complex survey evidence. This study proposes B-MIDIA, a parametric extension of the belief-structure TOPSIS framework that integrates the MIDIA (Multi-Criteria Method Integrating Distances to Ideal and Anti-Ideal Points) aggregation mechanism with belief-structure-based multi-criteria decision analysis. The framework preserves the ordinal structure of survey responses and follows the standard belief-structure representation adopted in B-TOPSIS, in which uncertain (“Don’t know”) responses are incorporated into the evaluation through the normalization procedure. Using published country-level response distributions from Special Eurobarometer 554, the study evaluates public perceptions of recent digital technologies, including artificial intelligence (AI), across EU Member States in five domains: the economy, society, quality of life, current job, and social security benefits. Sensitivity analyses performed for alternative values of the aggregation parameter α, together with comparisons with the benchmark B-TOPSIS rankings, demonstrate the robustness of the proposed aggregation mechanism within the adopted belief-structure framework. Across most dimensions, Lithuania and Malta achieved the highest evaluations, whereas France, Italy, and Romania generally ranked among the lowest. Economic and employment-related evaluations formed the central perception structure and were strongly associated with quality-of-life assessments. The proposed framework extends the analytical capabilities of belief-structure TOPSIS by enabling systematic sensitivity analysis of aggregation assumptions while preserving methodological compatibility with the original framework. Full article

Background/Objectives: Oral mucosal melanoma (OMM) is a malignancy in which durable local control must be balanced against preservation of speech, swallowing, mastication, and oral structure. Although cryotherapy is a repeatable and function-preserving local modality, its role within contemporary multidisciplinary care has not been clearly defined. This study describes a stage-adapted cryotherapy-based management framework for primary OMM and evaluates survival, local recurrence, and prognostic factors in a contemporary single-center cohort. Methods: We retrospectively reviewed 43 patients with primary OMM treated between 2016 and 2026. Treatment allocation was non-randomized and made through multidisciplinary assessment: stage II–III patients received cryotherapy alone, whereas stage IV patients received cryotherapy combined with wide local excision; postoperative adjuvant therapy was considered individually. Overall survival (OS) was estimated using Kaplan–Meier methods, and prognostic factors were explored using univariable Cox regression. Results: Median follow-up was 35 months. Estimated 2-year and 5-year OS for the whole cohort were 93.0% and 69.8%, respectively. Local recurrence occurred in 2/11 stage II–III patients and 18/32 stage IV patients. Among stage IV patients, postoperative adjuvant therapy was associated with OS in an unadjusted exploratory comparison (p = 0.03); this association may be affected by confounding by indication and selection bias and should not be interpreted as a treatment effect. Nodal metastasis was associated with worse OS in univariable analysis (HR, 3.342; p = 0.036). Conclusions: This small, single-center, non-randomized cohort describes an institutional stage-adapted cryotherapy-based management framework for OMM. The findings do not establish comparative efficacy or objectively demonstrate functional preservation. Prospective multicenter studies with standardized treatment selection, complete treatment reporting, validated functional outcomes, and quality-of-life measures are required. Full article

The low-FODMAP diet (LFD) reduces gastrointestinal symptoms, restricting poorly absorbed short-chain carbohydrates to reduce colonic fermentation. It has been proposed as a dietary strategy for irritable bowel syndrome (IBS) and ulcerative colitis (UC) patients. However, this diet could affect patients’ nutritional status and alter their gut microbiota. We aimed to evaluate the effects of a 10-week LFD on nutritional status, quality of life, and gut microbiota in patients with IBS, UC, and a control group without gastrointestinal symptoms. A randomized, single-blind clinical trial was conducted, including adults with IBS and UC, as well as a control group. Participants were randomly assigned to receive either an LFD or a standard diet (STD). Nutritional status, stool consistency, bowel habits, and quality of life were assessed, and stool samples were collected. Stool microbiota was profiled by 16S rRNA gene sequencing (V3) and analyzed for alpha diversity, beta diversity and differential abundance. Body composition was assessed by bioelectrical impedance. The follow-up period lasted 10 weeks (W0 to W10). Analyses were conducted in the per-protocol population. In total, 86 patients were included (IBS n = 40, UC n = 34, Control n = 12) with an average age of 40 ± 11 years. After adjustment for baseline values, no statistically significant differences in anthropometric or body-composition outcomes were observed between the LFD and STD groups. Similarly, there was a notable reduction in diarrhea frequency (53.3% vs. 20%, p = 0.058). Additionally, patients with IBS and UC exhibited similar microbiota profiles at W0. Among UC patients following the LFD, there was increased presence of BX12, CAG-1427, Holdemania, Evtepia, and Granulicatella, while Angelakisella and CAG-177 were less abundant. LFD was associated with changes in stool consistency, bowel habits, quality of life, and gut microbiota in patients with UC and IBS. Full article

3D-printed geopolymer mortars (3DPGPMs) are emerging as low-carbon construction materials that combine digital fabrication with alkali-activated binder technology. However, their hardened performance remains difficult to assess because it is controlled not only by geopolymer chemistry but also by printing parameters, rheological evolution, curing conditions, interlayer bonding, pore structure, and loading direction. This review critically examines the current literature on extrusion-based 3DPGPMs, with emphasis on mechanical properties, durability, sustainability, standardization, and practical implementation. The reviewed studies show that precursor type, activator system, aggregate/binder ratio, additives, printing conditions, and curing regime strongly influence compressive, tensile, flexural, interlayer bond, and anisotropic mechanical responses. Durability performance is also governed by the coupled effects of matrix chemistry and printing-induced features, including interlayer voids, directional pore networks, weak interfaces, and transport pathways that may affect shrinkage, water absorption, chloride penetration, carbonation, acid and sulphate resistance, freeze–thaw response, and elevated-temperature behavior. From a sustainability perspective, the environmental benefits of 3DPGPMs are conditional and depend on activator production, precursor availability, curing demand, transport distance, life-cycle assessment boundaries, and field-scale implementation conditions. The review identifies that the main knowledge gap is the limited availability of integrated datasets linking fresh-state rheology, interlayer quality, multi-scale porosity, mechanical anisotropy, durability indicators, and structural-scale validation. Future research should therefore prioritize standardized reporting, performance-based acceptance criteria, long-term exposure testing, field-scale validation, and predictive material–process–durability models. Overall, this review provides a hardened-performance-oriented synthesis to support the development of reliable, durable, and sustainable 3DPGPMs for construction applications. Full article

Background and Objectives: Individuals with heroin-related opioid use disorder are at high risk of poor oral health and impaired oral health-related quality of life (OHRQoL). However, data on the determinants of OHRQoL in this population remain limited. This study aimed to assess oral health status and OHRQoL and to identify key predictors of OHRQoL among hospitalized patients with heroin-related opioid use disorder. Materials and Methods: A cross-sectional study was conducted among 97 hospitalized patients with heroin-related opioid use disorder. Data were collected through structured interviews and clinical oral examinations, including the Decayed, Missing, and Filled Teeth (DMFT) index and the Simplified Oral Hygiene Index (OHI-S). OHRQoL was assessed using the Oral Health Impact Profile-14 (OHIP-14). Spearman correlation and multiple linear regression analyses were performed to examine associations and identify predictors of OHRQoL. Results: Participants had poor oral health, with high DMFT (19.1 ± 6.1) and OHI-S (2.0 ± 1.2) scores. OHRQoL was markedly impaired, with a mean OHIP-14 score of 29.6 ± 7.0, particularly in the psychological and social domains. OHIP-14 scores were strongly correlated with DMFT (r = 0.754, p < 0.001) and OHI-S (r = 0.552, p < 0.001). Longer duration of heroin use was associated with higher DMFT scores, poorer oral hygiene, and greater OHRQoL impairment. Multiple linear regression analysis identified unstable housing/homelessness (β = 0.166, p = 0.012), DMFT (β = 0.624, p < 0.001), and OHI-S (β = 0.272, p = 0.007) as significant predictors of poorer OHRQoL. Conclusions: Individuals with heroin-related opioid use disorder experienced substantial oral health burden and impaired OHRQoL, strongly associated with caries experience, poor oral hygiene, and housing instability. These findings highlight the need to integrate prevention-oriented dental care into addiction treatment services and to address the broader social determinants of oral health. Full article

Background: Lumbar radicular pain, commonly referred to as sciatica, is a prevalent musculoskeletal condition that negatively impacts patients’ quality of life. Evidence regarding the use of foot orthoses in patients with sciatica secondary to lumbar disc herniation remains limited. Objectives: To determine the influence of custom-made foot orthoses on health-related quality of life and perceived pain in patients with chronic radicular pain secondary to non-traumatic lumbar or lumbosacral disc herniation. Methods: A randomized, controlled, double-blind clinical trial was conducted. Fifty-two patients (mean age: 46.12 ± 9.37 years; 53.8% men, 46.2% women) were allocated to either a customized functional foot orthoses group or a cushioning flat insole group. Pain, foot-related disability, low back disability, and health-related quality of life were assessed at baseline and after three months using the 11-point Numeric Pain Rating Scale (NPRS), Manchester Foot Pain and Disability Index (MFPDI), Oswestry Disability Index (ODI), and Short Form-12 (SF-12) questionnaire. Results: No statistically significant differences were observed between treatment groups in foot pain ($p=0.821$), lower-limb pain ($p=0.244$), low back pain ($p=0.497$), low back disability ($p=0.684$), or physical quality of life ($p=0.069$) after follow-up. However, participants treated with customized functional foot orthoses showed significant intragroup improvements in foot function (MFPDI-Function: $p=0.046$; MFPDI-Total: $p=0.033$) and in the physical component of health-related quality of life (SF-12 Physical: $p=0.031$), whereas no significant changes were observed in the cushioning insole group ($p>0.05$). Conclusions: Customized functional foot orthoses may improve foot function and physical health-related quality of life in patients with chronic radicular pain secondary to lumbar or lumbosacral disc herniation. Further studies with larger sample sizes and longer follow-up periods are required to confirm these findings. Full article

Patients with lung cancer are at increased risk of developing cancer-related cognitive impairment (CRCI), and oxidative stress may contribute to its development. We conducted an assessor-blinded randomized controlled trial to evaluate whether a 12-week antioxidant-focused dietary intervention improved cognitive function, oxidative stress biomarkers, and quality of life (QoL) in lung cancer patients with CRCI. One hundred participants were randomized to standard dietary counseling or an antioxidant-focused dietary intervention. Continuous outcomes were assessed at baseline and week 12 and analyzed using linear mixed-effects models under the intention-to-treat principle. The mean age was 66.10 ± 5.39 years, and 78.0% of participants were male. Ninety-one participants completed the week-12 assessment. Participants receiving the intervention demonstrated greater increases in Montreal Cognitive Assessment scores (β = 2.626; 95% CI: 0.825, 4.427; p = 0.005), dietary oxidative balance score (β = 2.292; 95% CI: 0.656, 3.928; p = 0.006), and physical and mental QoL component scores than those in the control group (p < 0.05). In the complete-case analysis (n = 91), the proportion meeting CRCI criteria was lower in the intervention group (60.0% vs. 93.5%; p < 0.001). Biomarker analyses showed increases in glutathione and superoxide dismutase and a reduction in malondialdehyde in the intervention group (p < 0.05). The intervention demonstrated a large effect on cognitive function (Cohen’s d = 0.84), supporting antioxidant-focused dietary intervention as a promising supportive-care strategy for managing CRCI in lung cancer patients. Full article

Background: Pilonidal sinus disease is an inflammatory condition characterised by formations ranging from minor cysts to extensive sinus tracts in the natal cleft in the sacrococcygeal area. Due to its complex and unique symptoms, the condition may not be adequately captured by the generic quality of life (QoL) instruments. In this study, we evaluated a newly developed pilonidal sinus disease-specific quality of life (SQoL) questionnaire, valuating its validity and applicability for measuring postoperative outcomes of pilonidal sinus disease. Materials and Methods: The study involved developing a SQoL. A total of 116 adult patients with chronic and acute symptomatic disease at the Kaunas Hospital of the Lithuanian University of Health Sciences (LUHS) were asked to complete both the SQoL and the SF-36v2 questionnaire. Key evaluation criteria for the SQoL questionnaire included internal consistency, measurement stability, as well as construct and discriminant validity. Results: 2 months after the procedure, 103 patients (response rate 88.79%) completed both questionnaires. Internal consistency was assessed 1 week after surgery, with the overall questionnaire achieving a Cronbach’s α coefficient of 0.919. The Spearman correlation coefficient for the total questionnaire score in the test–retest validation was 0.55 (CI 0.406–0.679), indicating a moderately significant correlation for all questions. Construct validity was evaluated by comparing the SQoL questionnaire with the results from various SF-36v2 domains 1 week after surgery. The highest inverse correlations were found between the corresponding domains of Physical Functioning and Role Physical Functioning (−0.770 and −0.600), with all correlations being statistically significant. Conclusions: A newly developed SQoL questionnaire has shown promise in assessing the impact of the disease and its treatment, particularly by addressing disease-specific symptoms. Standardising outcome measures can improve the reliability of meta-analyses and systematic reviews, which in turn helps to create more personalised care plans. The trial was registered in ClinicalTrials.gov with the identifier of NCT05982028. Full article