Iranian Red Crescent Medical Journal
Volume:25 Issue: 3, May 2023

Patients with obstructive sleep apnea (OSA), related to cardiovascular and metabolic consequences of the disease, are physically and mentally vulnerable during the outbreak.

To investigate the association between pandemic-related changes and positive airway pressure (PAP) adherence and sleep quality in OSA patients.

This was a multi-center cross-sectional study, and the necessary data were collected prospectively. A total of 221 patients were included in the study, who were invited from four different centers from June 1 - December 1, 2020. Pittsburgh Sleep Quality Index (PSQI) was administered to evaluate sleep quality. Information on demographics positive airway pressure (PAP) device use and Coronavirus disease (COVID-19 were collected by a questionnaire. Patients >18 years with a diagnosis of OSA and prescribed PAP treatment before the pandemic period were included in the study. Lack of cooperation with the questionnaires and incompliant with PAP treatment for longer than one year were the exclusion criteria.

Of the 221 participants, 79.2% were men. The mean apnea-hypopnea index was obtained at 40.8±24.3. A positive COVID-19 test was reported in nine cases, and three patients had hospitalization. During the pandemic, 102 (46.2%) subjects were retired, 26 (11.8%) lost their jobs, and 34 (15.3%) reported home office work or on-call or on leave. Poor sleep quality was found in 54 (24.4%) individuals. It was also reported that poor sleep quality was more common in those who reported mask use difficulty (38.7% vs. 18.9%; P=0.004) and increased or decreased PAP use (increased, decreased, no change in PAP use: 45.5%, 36.0%, 19.4%, respectively; P=0.01). The good sleep quality group had higher PAP use than the poor sleep quality group (6.2±1.5 vs. 5.3±2.4 night/week; P=0.002; 6.2±1.5 vs. 5.5±2.2 hour/night; P=0.01).

Pandemic period had several negative effects on sleep apnea patients regarding sleep quality and social lives which also influenced PAP adherence in OSA patients. Most patients did not change their regular PAP use attitudes during this period. Similar to the pre-COVID-19 disease period, PAP adherence and compliance positively influenced sleep quality; people who were "good sleepers" were the ones who were the "good PAP device users".

Hyperthermic intraperitoneal administration of chemotherapy (HIPEC) targets microscopic residues remaining after complete cytoreduction.

We systematically presented the development process of the HIPEC treatment regimen, the most remarkable publications on this topic, the most productive countries, and the future of treatment in the coming years.

The source of our study was the Web of Science (WoS) database which included the Korean Journal Database, core collection index, Russian Science Citation Index, and Sci ELO citation index.

We reached a total of 3,343 publications by analyzing the WoS database using the keyword of "Hyperthermic intraperitoneal chemotherapy". When the citations of the documents written about HIPEC were evaluated, we found that the highest citation was made in 2019. Co-citation analysis showed that there were 27,724 authors investigating the issue of HIPEC. The most active university was determined as Wake Forest University, USA. Collaboration and citation collaboration was observed between Wake Forest University, the University of Pittsburgh, and the University of Texas. The intersection point of all researcher countries was the USA. While reviewing the articles on HIPEC, we also identified new trends and topics in this regard. Ovarian cancers, gastric cancers, and colorectal cancers were found to be the types of cancer that had the strongest relationship with HIPEC.

HIPEC therapies should be considered an area of research that has been studied, published, and cited by surgeons, oncologists, and pharmacologists interested in the treatment of tumors with peritoneal spread.

Dyspnea and atelectasis after Coronary Artery Bypass Graft (CABG) are common and need nursing attention. Inhalation and exhalation incentive spirometry is recommended for preventing alveolar collapse and atelectasis.

This study aimed to compare different methods of incentive spirometry on dyspnea severity and atelectasis of the patients undergoing CABG.

This randomized clinical trial study was conducted on 66 patients undergoing CABG admitted to the Intensive Care Unit (ICU) of Cardiac Surgery Department in Hamadan, Iran, in 2020. The patients were selected through convenient sampling and were divided into two groups through block permutation: inhalation incentive spirometry and intermittent inhalation-exhalation spirometry. Both groups performed incentive spirometry according to the instructions they had received for four days. Then, they were examined for dyspnea and atelectasis using the Borg scale and chest x-ray, respectively.

During the intervention, dyspnea significantly decreased in the intermittent inhalation-exhalation group relative to the inhalation group (P<0.05). Most patients in both inhalation (63.6%) and intermittent inhalation-exhalation (65.6%) groups had atelectasis; however, no significant differences were observed between the two groups (P=0.867).

Incentive spirometry via intermittent inhalation-exhalation method was more effective on dyspnea compared to the inhalation method. Therefore, this method is recommended to patients and nurses to reduce pulmonary complications after CABG.

There is no standard method for the treatment of pilonidal sinus disease (PSD). Today, many different treatment methods are attempted. Some of the leading methods are surgical procedures with different flap techniques and less invasive methods, such as crystallized phenol, laser pilonidoplasty, radiofrequency excision, and monopolar electrocautery excision.

This study aimed to compare the monopolar and bipolar electrocautery excision techniques that we performed in our clinic for PSD.

Patients who received pilonidal sinus treatment in our clinic between January 2018 and January 2021 were analyzed retrospectively. The exclusion criteria were diabetes mellitus, renal failure, immunosuppression, and children (<16 years of age). The study included a total of 36 patients who met the criteria. Data were retrospectively obtained from hospital archive records (operative notes, discharge summary, and outpatient dressing records). The patients were then divided into two groups, namely monopolar electrocautery excision (group 1) and bipolar electrocautery excision (group 2).

The mean age of 36 patients included in the study was 22.9 years. There was no difference between the two groups in terms of predisposing factors (gender, obesity, hirsutism, and smoking). There was also no statistical difference in terms of mean healing time and recurrence rate. Monopolar and bipolar electrocautery excisions lasted 32.2±8.9 and 38.8±7.8 minutes, respectively (P<0.05). Accordingly, the operative time was significantly different between the groups, and it was shorter in the monopolar electrocautery excision group. Furthermore, the bipolar electrocautery group showed shorter wound infection duration, compared to the monopolar electrocautery excision group (P<0.05).

Both excision techniques were similar in terms of wound healing, hospital stay, and recurrence rates. The operative times were longer in bipolar cautery; however, the wound infection was less.

Post-treatment nursing care is essential for patients with venous malformations (VMs) after they have undergone treatment. Effective post-treatment nursing care requires adequate resources, effective communication, patient compliance, and addressing psychological distress. However, the clinical care plan for VMs in the pharyngeal isthmus is not clear.

The present study aims to explore the clinical nursing strategy after the treatment of VMs in the pharynx area.

In this study, the patients with VM in the pharynx region who received anhydrous ethanol sclerosis injection and/or surgical treatment in our Hospital from January 2013 to November 2018 were recruited. A total of 143 patients who had completed medical records were included in this prospective cohort study. The patients' post-operative vital signs were closely observed, the respiratory tract was maintained, the oral cavity was cleaned, and the nursing care of indwelling endotracheal intubation or tracheotomy was performed. After the clinical follow-ups of one to five years, long-term efficacy was also observed. We summarized their nursing care treatments.

The results showed that there were 0 patients rated as grade I, 3 patients rated as grade II, 17 patients rated as grade III, and 123 patients rated as grade IV after long-term efficacy.

Appropriate anhydrous ethanol sclerotherapy can be selected for patients with pharyngeal venous malformation, and this method combined with the clinical nursing strategy after treatment concluded in this study can effectively reduce the volume of VM, with fewer side effects, and can effectively improve breathing, swallowing, and vocal function.

Hemodynamic instability, including hypotension and bradycardia, can occur due to spinal anesthesia by bupivacaine. However, it is possible to reduce the chance of hemodynamic changes by the reduction of the dose of bupivacaine and/or the addition of adjunctive agents.

This study aimed to compare the effects of the addition of intrathecal dexmedetomidine and sufentanil to spinal anesthesia with bupivacaine in elective cesarean section (CS).

This prospective single-blinded randomized clinical trial with parallel groups was performed on 60 pregnant women who were candidates for elective CS in Imam Reza Hospital in Kermanshah, Iran. In addition to receiving 10 mg of hyperbaric bupivacaine 0.5%, they were randomly divided into two groups to receive intrathecal sufentanil 5 μg (30 cases) or dexmedetomidine 5 μg (30 cases). Changes in blood pressure, heart rate, and occurrence of side effects (e.g., nausea, vomiting, headache, and shivering) were recorded within 1 h after the injections. Moreover, the postoperative analgesia rate and durati on (using a visual analog scale [VAS]) were recorded within the first 24 h after the completion o f the CS. Headache severity (using a VAS) was also measured during the first week after CS.

Patients declared their satisfaction with analgesia after surgery. No significant difference was found between the two groups in terms of heart rate and systolic and diastolic blood pressure changes during the first 60 min. Similarly, no significant difference was observed between the two groups in terms of the severity of incision pain in the first 24 h after CS surgery. On days 3, 4, and 5, none of the patients in the sufentanil and bupivacaine group had headaches (VAS=0), but patients in the dexmedetomidine and bupivacaine group had some degree of headache (P=0.040).

Based on the results, intrathecal administration of bupivacaine with either sufentanil or dexmedetomidine in CS did not have significantly different effects, except for slightly more severe headaches in the dexmedetomidine group. Therefore, no superiority of one drug over the other was observed for intrathecal administration with bupivacaine in CS.

Recent studies have demonstrated that Hiwi has a crucial role in stem cell self-renewal in various organisms, and it is associated with some cancers.

In the present study, Hiwi expression was examined in different grades of primary human colorectal cancer (CRC), colorectal cancer stem cells (CRCSCs), and HT-29 CRC cell line.

The CRC tissue samples were collected from 20 patients with CRC. Furthermore, the HT-29 cell line, CRCSC, and 13 normal colorectal tissue samples were prepared. The expression of Hiwi at mRNA and protein levels was determined by real-time polymerase chain reaction (Real-time PCR), flow cytometry, Western blot, and immunohistochemistry.

The overexpression of Hiwi was detected in 40% (3.351±2.94, P<0.05) of clinical CRC tissue specimens. We also observed a significant increase in the expression of Hiwi in CRCSCs (5.94±0.05, P<0.005). Hiwi expression was significantly higher in CRCSC compared to that in the colorectal cancer tissue and HT-29 cells (P<0.01). Hiwi mRNA level was significantly correlated to tumor grade (P< 0.01) and stage (P< 0.01).

As evidenced by the obtained results, Hiwi can be considered an oncogene in progressive cancer and, therefore, can be a valuable biomarker and target in therapeutic procedures.

The effect of emergency epidemic prevention and control and the quality of emergency pre-testing and triage under the normalization of COVID-19 epidemics was evaluated by quality evaluation system based on the SERVQUAL model.

This study aimed to develop a quality evaluation system for emergency pre-test and triage under a normal COVID-19 epidemic, based on the SERVQUAL model.

Based on the SERVQUAL model, a quality evaluation system of emergency pre-examination and triage under the normalization of the COVID-19 epidemic was developed. Two rounds of expert consultation were conducted by the Delphi method, involving 15 experts.

The recovery rates for the two rounds of expert consultation were 100 %, the expert authority coefficient was 0.954, and the Kendall coordination coefficients were 0.273 and 0.182. The coefficients of variation of the three-level indicators of the two rounds of expert consultation were 0.003-0.275 and 0.052-0.125, respectively. An evaluation system including 5 first-level indicators, 14 second- level indicators, and 42 third-level indicators of 5 dimensions (tangibility, reliability, responsiveness, assurance, and empathy) of the SERVQUAL model was established.

Based on the SERVQUAL model, a quality evaluation system for emergency pre-examination and triage under the normalization of the COVID-19 epidemic situation was completed. It reflected the medical services, triage, and epidemic prevention and control required to provide the requisite quality of emergency pre-examination and triage under the normalization of the COVID-19 epidemic situation. It provided a reference for the quality supervision of emergency pre-examination and triage under the normalization of the COVID-19 epidemic situation.

Posttraumatic coagulopathy is a common problem; however, the risk factors are not fully known.

This study aimed to retrospectively determine the frequency of coagulopathy related to trauma, as well as risk factors and their effects, on prognosis among patients admitted to the intensive care unit (ICU) after trauma.

In total, 184 patients who were admitted to the 20-bed general adult ICU of Ankara Yıldırım Beyazıt University Medical Faculty Hospital between 2011 and 2017 after trauma were retrospectively analyzed. Two groups were selected by examining the laboratory results of the patients (considering the 1st- and 3rd-day platelet count), Prothrombin Time (PT), activated Partial Thromboplastin Time (aPTT), and International Normalized Ratio (INR) values with and without trauma-associated coagulopathy.

The mean age of 184 patients included in the study was obtained at 41.7716.91 years. The majority of the patients (n=149; 81%) were male. Coagulopathy was detected in 78 (42.4%) patients (on the first day [n=60; 32.6%] and on the third day [n=18; 9.8%]). It was found that patients with coagulopathy had more comorbidities (OR=3.080; %95 CI: 1.033-9.176), lower Glasgow Coma Score (GCS) (OR: 0.890; %95 CI: 0.827-0.957), lower Revised Trauma Score (RTS) (OR=0.699; %95 CI: 0.568-0.862), higher Acute Physiology and Chronic Health Evaluation-II (APACHE-II) score (OR=1.092; %95 CI: 1.041-1.145), lower albumin values (OR:0.392; %95 CI: 0.203-0.758), and higher 28-day mortality (P<0.005), compared to patients without coagulopathy.

In this study, co-morbidity, high APACHE-II, low GCS, RTS, and albumin levels were determined as independent risk factors for the development of post-traumatic coagulopathy. Since it is not possible to change the risk factors of critical trauma patients, such as GCS and co-morbidity, it is taught that the prevention of risk factors, such as hypoalbuminemia, with appropriate approaches can reduce the incidence of coagulopathy, as well as the mortality rate.

One of the most important harmful effects related to the coronavirus disease 2019 (COVID-19) is the psychological effects that can affect all population groups.

This study aimed to evaluate the effect of home quarantine caused by COVID-19 on parents' stress, as well as children's anxiety and depression.

This study included 230 parents who had children aged 5-12 years. The data were collected using the Children Symptom Inventory (CSI-4) and the Impact of Event Scale-Revised (IES-R), which were sent to people through the social messenger WhatsApp. (22). Different variables including the impact of the event, avoidance, intrusion, hyperarousal, anxiety, and depression were measured and analyzed using these two questionnaires.

The results of the correlation analysis showed that the impact of the quarantined event caused by the COVID-19 pandemic and the IES-R subscales in parents were directly and significantly related to the anxiety and depression scores in their children. In addition, multivariate regression analysis showed that higher IES-R scores by parents can significantly predict higher anxiety and depression scores in children.

Based on the findings of this study, it can be concluded that the home quarantine caused by the COVID-19 pandemic causes stress in parents and this also increases anxiety and depression in their children. Therefore, it is suggested that in addition to the management, control, and treatment of these types of pandemic diseases, special attention be paid to their psychological effects, especially during home quarantine.