Conectar
Sleep, a fundamental element of health, accounts for about one-third of our lives, and is as crucial as nutrition and exercise. Among university students, medical students are one subset that seems particularly susceptible to sleep problems, perhaps due to the length and complexity of their studies and being under a high level of stress. Yoga Nidra has been studied as a therapeutic intervention for various medical conditions. The aim of the study is to evaluate the efficacy of short-duration Yoga Nidra for improving sleep quality in students at a tertiary healthcare centre in Rishikesh, Uttarakhand.
A two-group parallel randomised controlled trial will be conducted among undergraduate medical students with a Pittsburgh Sleep Quality Index (PSQI) score >5. Efficacy of short-duration Yoga Nidra in comparison to sleep education will be evaluated for PSQI scores, heart rate variability, respiratory rate, pulse rate, body mass index, blood pressure, random blood sugar, lipid profile, interleukin 6, salivary cortisol, generalised anxiety disorder and depressive disorder. The intervention will be pre-recorded with the duration of 12 min. The intervention group participants will receive three sessions per week for 4 weeks. The sample size is 160 students. All analyses will follow the intention-to-treat approach using SPSS V.26. Descriptive statistics, test of associations, parametric and/or non-parametric methods (as appropriate) will be used to assess within and between group changes.
The Institutional Ethics Committee (All India Institute of Medical Sciences (AIIMS), Rishikesh) has approved the study (#AIIMS/ie,C/22/231) and the trial has been prospectively registered in Clinical Trials Registry-India: CTRI/2022/07/044426. The results will be published in a peer-reviewed journal.
CTRI/2022/07/044426.
by Htay-Wah Saw, Arie Kapteyn
An extensive literature studies the relation between demographic and socio-economic characteristics and attrition in longitudinal studies. In this study, we analyze the independent effects of non-demographic variables—respondent personality traits, panel tenure, and survey topics, using unique datasets from two recently completed high-frequency online longitudinal studies conducted in the U.S. We used latent class analysis to group respondents into various classes based on similarities in their nonresponse patterns across all survey waves, which revealed substantial variations in patterns of nonresponse. Our results indicate that respondent personality traits were strong predictors of nonresponse patterns. Specifically, conscientiousness is positively associated with a lower likelihood of wave nonresponses. In contrast, more open, extroverted, neurotic, and agreeable respondents are more likely to exhibit higher wave nonresponses, but with effect sizes smaller than that of conscientiousness. We found no significant demographic effects on wave nonresponse in one of the studies focused on aging and well-being. However, in the study primarily focused on COVID-19-related topics conducted during the pandemic, we found a few significant demographic effects. Collectively, our findings suggest that personality traits may play a more significant role than conventional demographic and household variables in predicting nonresponse patterns in high frequency (at least one survey per month) online surveys.
Electrical burns are among the most severe burn injuries, often leading to deep tissue damage, systemic complications, and prolonged hospitalisation. In Lebanon, limited national data on electrical burn injuries limits the understanding of their epidemiology and management. This study aims to assess the prevalence and characteristics of electrical burns in patients admitted to the specialised burn care unit in Geitaoui Hospital in Lebanon. A retrospective observational study was conducted by reviewing the medical records of patients admitted from 1st January 2011 to 31st December 2024. Data on demographics, burn characteristics, hospitalisation outcomes, infections, surgical interventions, and laboratory findings were extracted and analysed using SPSS version 26. Thirty patients were included, with a male predominance (96.7%) and the mean age was 29.6 years. Third-degree burns were observed in 70.0% of cases, and 66.7% of patients had burns affecting 10%–30% of their total body surface area. High-voltage injuries accounted for 50.0% of cases. Upper extremities were the most commonly affected site (93.3%). The mean hospital stay was 25.69 days, and the mortality rate was 10.0%. Infection was documented in 43.3% of cases. The most frequently isolated pathogens were Acinetobacter (20.0%) and Pseudomonas aeruginosa (16.7%). Surgical intervention was required in 63.3% of patients, most frequently skin grafting (36.7%). This study contributes national data on electrical burns and emphasises the importance of preventive and multidisciplinary care strategies.
by Grant L. Austin, Feng Wang, Steven Q. Le, Alexander Sorensen, Shan Li, Lai C. Foong, Srikanth Singamsetty, Jill Wood, Tsui-Fen Chou, Patricia I. Dickson
Mucopolysaccharidosis type IIID (MPS IIID; Sanfilippo D) is caused by biallelic pathogenic variants in N-acetylglucosamine-6-sulfatase (GNS), which participates in catabolism of heparan sulfate (HS) glycosaminoglycans. Characterization of MPS IIID disease at a cellular level has not been robustly achieved. We used unbiased quantitative proteomics to establish a cellular phenotype for MPS IIID mice. Recombinant human GNS (rhGNS), a variant of which previously demonstrated single dose efficacy in MPS IIID human fibroblasts and in MPS IIID neonatal mice, was used to establish a repeat dosing schedule to treat MPS IIID mice. Adult Gns KO mice or heterozygous carriers were treated via intracerebroventricular (ICV) injections and received 3, 30, or 200 μg rhGNS in 4 doses over 2 weeks or vehicle. Twenty-four hours after the final dose, HS in brain and CSF showed dose-dependent reductions, reaching carrier levels in the higher dose groups. Furthermore, the proteomic perturbations that we described were corrected by rhGNS treatment. Next, Gns KO or carrier adult mice were treated via ICV and received 3, 30 or 200 μg rhGNS or vehicle once every two weeks (Day 1, 15, 29, 43, 57, 71, 85) and were euthanized on day 91. Following treatment, total HS and MPS IIID-specific HS (GlcNAc6S) showed dose-dependent reductions in brain and CSF and markers of neuroinflammation were substantially reduced. ICV enzyme replacement therapy with rhGNS restores CNS pathology of adult MPS IIID mice even with treatment at 14-day intervals, demonstrating preclinical efficacy for MPS IIID.
by Chayanee Noosak, Pavarish Jantorn, Suvimol Surassmo, Sittichat Chukaew, Jirut Meesane, Dennapa Saeloh Sotthibandhu
Chronic osteomyelitis, often accompanied by bone loss, requires an adequate angiogenic response for bone regeneration. Loading growth factors into a drug vehicle to promote angiogenesis can address this challenge. In a previous study, we demonstrated the potential of sericin/polyvinyl alcohol (PVA) hydrogel as a functional biomaterial carrier for osteomyelitis treatment. In this study, we optimized sericin/PVA hydrogel for enhanced angiogenesis by supplementing sericin nanoparticles as vascular endothelial growth factor (VEGF) nanocarriers. Sericin nanoparticles, 284.20 ± 13.20 nm in size, exhibited a spherical morphology with 86% VEGF encapsulation efficiency. After integrating VEGF-loaded sericin nanoparticles, the hydrogel was coated with 0.1% and 1% gelatin, and its physical and mechanical properties were assessed. Coating the hydrogel with gelatin enhanced its swelling properties, providing an appropriate degradation rate to support bone regeneration and angiogenesis, and improve mechanical properties. The uncoated hydrogel and hydrogels coated with 0.1% and 1% gelatin exhibited burst release rates of 70%, 60%, and 45% with cumulative release rates on day 14 measured at 76%, 67%, and 57%, respectively. The hydrogels were biocompatible with MC3T3-E1 osteoblastic cell lines and human umbilical vein endothelial cells (HUVEC). The gelatin-coated hydrogels also promoted cell attachment of HUVEC cells. Gelatin-coated hydrogels containing VEGF-loaded sericin nanoparticles were evaluated for their bioactivity on HUVEC cell proliferation. After a 14-day treatment, cell proliferation in 0.1% gelatin-coated hydrogel was significantly higher than in 1% gelatin-coated hydrogel, with over a 160% increase. The expression levels of genes related to angiogenesis were quantitatively examined and results suggested that the hydrogels affected the eNOS pathway to promote angiogenesis. Despite optimization efforts, the sericin/PVA hydrogel maintained effective antibacterial activity against Gram-positive and Gram-negative bacteria. The enhanced sericin/PVA hydrogel showed promise as a novel implant biomaterial for treating chronic osteomyelitis, particularly by promoting angiogenesis.
This study investigates the knowledge, attitudes, and practices of the Lebanese population regarding thermal burns to inform targeted interventions. Using a cross-sectional design, data was collected from 1090 participants though a structured questionnaire. Key findings revealed a mean knowledge score of 14.89/20, indicating moderate understanding, with gaps in identifying third-degree burns and optimal cooling durations. Attitudes scores averaged 36.97/50, reflecting a strong support for burn prevention but low confidence in first aid. Practices scored 12.37/20, with many participants adhering to safety measures but relying on unverified remedies and lacking emergency preparedness. Significant correlations were found between the three domains, particularly between knowledge and practices (r = 0.328, p < 0.001), emphasising the role of education and attitudes in shaping behaviours. Multivariate analysis identified formal first aid training, education, and urban residency as strong predictors across all three domains, while older age negatively influenced knowledge. These results underscore the need for culturally tailored education and enhanced training to address gaps in burn prevention and management among the Lebanese population.
Trauma and orthopaedic surgery (TOS) can result in surgical site infections (SSIs), and the repercussions include prolonged and increased cost of treatment. This study investigated the incidence and risk factors of SSI following TOS. A prospective cohort study was conducted at the Tamale Teaching Hospital from September 2023 to May 2024. Data on demographics, comorbidities, preoperative, intra-operative and postoperative parameters were collected from patients, medical records and the operation report. SSI was defined following the Centers for Disease Control and Prevention criteria. The incidence of SSI during the study period was determined, and univariate and multivariate logistic regression analyses were used to identify the independent risk factors of SSI. A total of 210 patients were enrolled of which 6.7% (14) developed SSIs, including 1.0% (2) deep and 5.7% (12) superficial SSIs. The incidence of open fractures and closed fractures in this study was 3.3% (7) and 2.9% (6), respectively. According to multivariate regression analysis, blood transfusion before surgery (p = 0.034; OR = 3.53; 1.10–11.33) was identified as an independent risk factor of SSI following TOS. However, there was a significant association between the type of dressing used on the surgical site after surgery (p = 0.035; OR = 4.08; 1.10–15.08) and SSI. The study reported the overall incidence rate of SSI after TOS to be 6.7% (67 per 1000 surgical operations). Blood transfusion before surgery was an independent risk factor of SSI following TOS. Local and global measures that limit the rates of SSI after TOS should be adopted especially in managing high-risk patients such as those who require pre-operative blood transfusion.
by Khomsan Ruangrit, Kittiya Phinyo, Sahassawat Chailungka, Kritsana Duangjan, Apitchaya Naree, Jearanai Thasana, Wassana Kamopas, Senoch Seanpong, Jeeraporn Pekkoh, Nuttapol Noirungsee
This study investigates the effectiveness of biochar immobilized with algicidal Bacillus sp. AK3 and denitrifying Alcaligenes sp. M3 in mitigating harmful algal blooms (HABs) and reducing nitrate pollution in aquatic environments. Over a six-day period, we analyzed changes in algal bloom-forming Microcystis density, chlorophyll-a levels (indicative of algal biomass), nitrate concentration, and microbial community composition in water treated with biochar and Bacillus sp. AK3 and Alcaligenes sp. M3-immobilized biochar. In water treatment using the AK3 and M3-immobilized biochar, Microcystis density decreased from 600,000 cells/mL to 80,000 cells/mL, and chlorophyll-a concentrations also substantially reduced, from 85.7 µg/L initially to 42.8 µg/L. Nitrate concentrations in the AK3 and M3-immobilized biochar treatment significantly decreased from approximately 23 mg/L to around 14 mg/L by Day 6, demonstrating the enhanced denitrification capabilities of the immobilized Alcaligenes sp. M3 and associated bacterial communities. The results also showed significant shifts in bacterial communities, with a decrease in Microcystis, highlighting the specific algicidal activity of Bacillus sp. AK3. The study underscores the potential of biochar-based treatments as a sustainable and effective approach for improving water quality and mitigating the environmental impacts of nutrient pollution and HABs.
by Fatemeh Shahbazi, Marzieh Fattahi-Darghlou, Samad Moslehi, Minoo Dabiri-Golchin, Marjan Shahbazi
BackgroundPrevious studies have documented the effectiveness of music therapy in improving adverse neonatal outcomes in premature infants. However, this review aims to address the question of how long listening to music can enhance these neonatal outcomes.
MethodsTo conduct this dose-response meta-analysis, we searched the PubMed, Scopus, Web of Science, and Cochrane Library databases. The inclusion criteria comprised randomized clinical trials that investigated the effects of music therapy on improving adverse neonatal outcomes. Preterm infants were defined as those born between 27 and 37 weeks of gestation, as fetuses are known to respond to auditory stimuli starting at the 27th week of pregnancy. The initial search was performed on January 28, 2024, and there were no restrictions on the time frame for the search. Ultimately, we employed a two-stage random effects model using the “drmeta” package in Stata software to perform this dose-response meta-analysis.
ResultsIn total, 30 articles (1855 participants) were identified for inclusion in our meta-analysis. According to pooled analysis with each minute increase in music therapy, the means of respiratory rate, pain score, SBP, DBP, behavioral score, and body temperature decrease by 35.3 beats per minutes, 15.3 VAS, 30.7 mmHg, 8.9 mmHg, 2.7, and 0.27°C. On the other hand, with each minute increase in listening to the music, the mean of O2 saturation, heart rate and sleep duration increase 1.7%, 89.2 beats per minutes and 5.081 minutes per day, respectively.
ConclusionMusic therapy improves the neonatal outcomes of O2 saturation, heart rate, respiratory rate, sleep duration, body temperature and systolic and diastolic blood pressures. Therefore, the existence of a dose-response relationship can indicate a causal relationship between music therapy and the improvement of neonatal outcomes.
by Alex Thabane, Sarah Saleh, Sushmitha Pallapothu, Tyler McKechnie, Phillip Staibano, Jason W. Busse, Goran Calic, Ranil Sonnadara, Sameer Parpia, Mohit Bhandari
BackgroundCreativity fuels societal progress and innovation, particularly in the field of medicine. The scientific study of creativity in medicine is critical to understanding how creativity contributes to medical practice, processes, and outcomes. An appraisal of the current scientific literature on the topic, and its gaps, will expand our understanding of how creativity and medicine interact, and guide future research.
ObjectivesWe aimed to assess the quantity, trends, distribution, and methodological features of the peer-reviewed on creativity in medicine.
MethodsWe searched the MEDLINE, EMBASE, and PsycINFO databases for peer-reviewed primary research publications on creativity in medicine. Screening, full-text review, and data extraction were performed independently and in duplicate by pairs of reviewers, with discrepancies resolved by a third reviewer. We performed descriptive analyses, graphically displaying the data using charts and maps where appropriate.
ResultsEighty-one studies were eligible for review, enrolling a total of 18,221 physicians, nurses and midwifes across all studies. Most research on creativity in medicine was published in the last decade, predominately in the field of nursing (75%). Researchers from Taiwan (22%) and the United States (21%) produced the most eligible publications, and the majority research was cross-sectional in nature (54%). There was substantial variability in the definitions of creativity adopted, and most studies failed to specify a definition of creativity. Forty-five different measurement tools were used to assess creativity, the most popular being divergent thinking tests such as the Torrance Test of Creative Thinking (24%) and Guilford Creativity Tests (16%).
ConclusionsPeer-reviewed scientific research on creativity in medicine, mostly conducted in the nursing profession, is sparse and performed on variable methodological grounds. Further scientific research on the topic, as well as the development of medicine-specific definitions and measurement tools, is required to uncover the utility of creativity in the medical domain.
by Oluwadamilare Akingbade, Ka Yi Hong, Oluwabukola Sharon Ayo, Adetutu Sefinat Alade, Moshood Akinwumi Lawal, Ibironke Elizabeth Somoye, Victoria Adediran, Olamide Sado, Ka Ming Chow
BackgroundBreast cancer (BC) remains a significant health burden globally, with high incidence and mortality rates, particularly in Nigeria. Chemotherapy, a common treatment modality for BC, often leads to various physical and psychological side effects, impacting patients’ quality of life. Despite the growing use of mobile health (mHealth) interventions to provide psychoeducational support, there is a paucity of evidence regarding their feasibility and acceptability among Nigerian women with BC.
ObjectiveTo develop and investigate the feasibility and acceptability of a mHealth psychoeducational intervention (mPEI) named the ChEmo Nurse Breast cancer Application (CENBA) programme.
MethodsA multi-centre, assessor-blinded, parallel-group pilot randomised controlled trial (RCT) was conducted at Lagos State University Teaching Hospital (LASUTH) and Lagos University Teaching Hospital (LUTH). Thirty women newly diagnosed with BC and undergoing chemotherapy were randomly assigned to an intervention or a control group. The intervention group received the CENBA programme, which included BC education, coping skills training, a discussion forum, and nurse-led consultations, delivered via a mobile application and phone calls over six weeks. The control group received standard care. Feasibility was assessed through consent, attrition, and completion rates, while acceptability was explored via qualitative interviews.
ResultsThe completion rate was 93.3%. Qualitative data indicated that participants found the intervention beneficial, particularly appreciating the educational content and the emotional support provided through the discussion forum and nurse consultations.
ConclusionThe CENBA programme was perceived as a feasible and acceptable mHealth intervention for providing psychoeducational support to Nigerian women with BC undergoing chemotherapy. These findings suggest that the CENBA programme could be a valuable tool in addressing the psychoeducational needs of this population, warranting further investigation in a full-scale RCT.
Trial registrationThis manuscript reports a feasibility study preceding the full trial, which was registered with the United States Clinical Trials registry (number NCT05489354).
Preventing pressure injuries is a primary objective for care and treatment teams in intensive care units (ICUs). Therefore, the current study aimed to compare the efficacy of Zinc Oxide and Vaseline prophylactic dressings in preventing sacral pressure injuries in patients admitted to the ICU. This clinical trial was conducted in the ICU in 2023. The study population included patients at moderate to high risk for pressure injuries based on the Braden scale criteria. Eligible patients were randomly assigned to one of five groups using random allocation software: (1) the intervention group receiving Zinc Oxide as a prophylactic dressing, (2) the intervention group using Zinc Oxide as a topical application, (3) the intervention group with Vaseline as a prophylactic dressing, (4) the intervention group using Vaseline as a topical application and (5) the control group. Participants were homogenous regarding demographic information in all five groups. The frequency distribution of pressure injuries across the five groups was analysed using the Chi-square test. The results revealed no pressure injuries were observed in the Zinc Oxide and Vaseline with dressing groups. In contrast, the Zinc Oxide without dressing group had five cases, the Vaseline without dressing group had six cases and the Control group had 14 cases of pressure injuries. These differences were statistically significant (p < 0.05). The results of this study showed that Zinc Oxide and Vaseline as preventive dressings in the sacral area of patients admitted to ICUs can be considered an effective and affordable strategy for healthcare providers.
by Arjay Cayetano, Christoph Stransky, Andreas Birk, Thomas Brey
Fish age is an important biological variable required as part of routine stock assessment and analysis of fish population dynamics. Age estimates are traditionally obtained by human experts from the count of ring-like patterns along calcified structures such as otoliths. To automate the process and minimize human bias, modern methods have been designed utilizing the advances in the field of artificial intelligence (AI). While many AI-based methods have been shown to attain satisfactory accuracy, there are concerns regarding the lack of explainability of some early implementations. Consequently, new explainable AI-based approaches based on U-Net and Mask R-CNN have been recently published having direct compatibility with traditional ring counting procedures. Here we further extend this endeavor by creating an interactive website housing these explainable AI methods allowing age readers to be directly involved in the AI training and development. An important aspect of the platform presented in this article is that it allows the additional use of different advanced concepts of Machine Learning (ML) such as transfer learning, ensemble learning and continual learning, which are all shown to be effective in this study.
by Lianyu Shan, Mojdeh Matloubi, Ifeoma Okwor, Sam Kung, Mohamed Sadek Almiski, Sujata Basu, Andrew Halayko, Latifa Koussih, Abdelilah S. Gounni
Dendritic cells (DCs) are pivotal in regulating allergic asthma. Our research has shown that the absence of Sema3E worsens asthma symptoms in acute and chronic asthma models. However, the specific role of PlexinD1 in these processes, particularly in DCs, remains unclear. This study investigates the role of PlexinD1 in CD11c+ DCs using a house dust mite (HDM) model of asthma. We generated CD11c+ DC-specific PlexinD1 knockout (CD11cPLXND1 KO) mice and subjected them, alongside wild-type controls (PLXND1fl/fl), to an HDM allergen protocol. Airway hyperresponsiveness (AHR) was measured using FlexiVent, and immune cell populations were analyzed via flow cytometry. Cytokine levels and immunoglobulin concentrations were assessed using mesoscale and ELISA, while collagen deposition and mucus production were examined through Sirius-red and periodic acid Schiff (PAS) staining respectively. Our results indicate that CD11cPLXND1 KO mice exhibit significantly exacerbated AHR, characterized by increased airway resistance and tissue elastance. Enhanced mucus production and collagen gene expression were observed in these mice compared to wild-type counterparts. Flow cytometry revealed higher CD11c+ MHCIIhigh CD11b+ cell recruitment into the lungs, and elevated total and HDM-specific serum IgE levels in CD11cPLXND1 KO mice. Mechanistically, co-cultures of B cells with DCs from CD11cPLXND1 KO mice showed significantly increased IgE production compared to wild-type mice.These findings highlight the critical regulatory role of the plexinD1 signaling pathway in CD11c+ DCs in modulating asthma features.
by Olindah Silaule, Nokuthula Gloria Nkosi, Fasloen Adams
Informal caregivers of persons with mental disorders encounter various challenges in their role of caregiving. As such, they require support to enable them to cope with the demands of their caregiving. There is comprehensive evidence on the experiences of burden among informal caregivers in mental health; however, there is a limited number of studies that report on the mental health services aimed specifically at supporting informal caregivers in their role. To address this gap, this study aimed to explore the perspectives of the service providers regarding the challenges encountered by informal caregivers and the mental health services available to support these caregivers. Semi-structured interviews were conducted with mental health coordinators at provincial, district, and sub-district level and mental health professionals from a district hospital. Focus group discussions were conducted with primary healthcare supervisors and community health workers in Bushbuckridge municipality, South Africa at participants’ workplaces and sub-district offices. Semi-structured interviews and focus group guides with semi-structured questions were used to direct data collection in August 2022–January 2023. All interviews were audio recorded and transcribed verbatim. Reflexive thematic inductive analysis was conducted using NVivo 12 software. Three themes were identified, namely perceived caregiving consequences and related factors, current state of mental health services, and factors affecting delivery of informal caregiver mental health services. The service providers acknowledged the negative consequences faced by informal caregivers. This includes the experience of caregiver burden which was attributed to the uncooperative and violent behaviours exhibited by the mental health care users. The current state of formal and informal community mental health services was described and considered inadequate to meet informal caregivers’ needs. Various personal, health system, and contextual factors influencing the provision of caregiver-orientated services were identified. The findings revealed the need for intersectoral collaborations between hospital-based and community-based mental health service providers, and community stakeholders to ensure provision of user-friendly and accessible mental health services for informal caregivers.
Diabetic foot ulcer is a debilitating complication of long-standing diabetes mellitus. Patients lose their earning potential, face repeated hospitalizations, and are forced to bear heavy treatment costs. This places an enormous financial burden on the patients and their families. This study seeks to ascertain the out-of-pocket expenditure among these patients and correlate it with their risk factor profile. In this hospital-based cross-sectional study, a total of 154 patients with diabetic foot ulcers or amputations have been studied with an elaborate patient questionnaire and relevant clinical examinations. The costs incurred and the risk factors of the patients were analyzed for statistical association. The median total annual out-of-pocket expenditure for the management of diabetic foot ulcers among the study participants was found to be ₹29 775 (₹9650–₹81 120) ($378.14 [$122.56–$1030.22]). Out of the total expenditure, 58.49% went towards direct medical costs, 5.64% towards direct non-medical costs, and 35.88% for indirect costs. Medications, ulcer dressing and periodic debridement have accounted for 79.26% of direct medical costs. Transportation (61.37%) and patient's loss of income (89.45%) account for the major costs under the direct non-medical and indirect cost categories, respectively. A high ulcer grade and area, long ulcer duration, and past history of ulcers have higher expenditure. Patients seeking treatment from private establishments and those engaged in professional/skilled occupations have higher expenses. Adequate dressing of foot ulcers and proper footwear are associated with lower treatment expenditure. 68.8% of the participants have faced catastrophic expenditure due to treatment costs of diabetic foot ulcers. Adequate glycaemic control and proper foot care are necessary. Patients must seek medical care at the earliest in case of foot ulceration. Clinicians must provide proper wound care, institute effective antibiotics, and manage the complications. Government and insurance schemes are required to alleviate the patients' financial burden.
Burn survivors experience profound physiological changes following injury, which may have lasting implications for cardiovascular health. This study aims to investigate the cardiovascular risk profile among burn survivors treated at a burn center in northern Iran. This observational study was conducted from 2022 to 2023 at the burn centre affiliated with Guilan University of Medical Sciences, Rasht, Iran. This study assessed a cohort study of 210 burn survivors, focusing on individuals with ≥20% TBSA burn injuries who had recovered and returned to their daily lives. This study assessed patients' lipid profiles, Framingham General Cardiovascular Risk Score (FGCRS) and risk factors, including demographics, clinical variables and physical activity. Statistical analysis employed descriptive and inferential statistics. The mean age was 49.23 years, and the mean TBSA burned was 37.06%. The risk of cardiovascular disease in 66% of the study population was less than 10%, and in 13%, it was more than 20%. Significant associations were identified between CVD risk and sex, diabetes, hypertension, BMI, TBSA burned, years after burn, physical activity level and LDL. Of the lipid profile measures, LDL, triglycerides and TC/HDL exceeded the desirable levels. This research highlights the heightened cardiovascular risk in burn survivors, emphasizing the necessity for targeted interventions and regular monitoring. Identifying modifiable risk factors enables healthcare practitioners to develop tailored strategies, enhancing cardiovascular health in this vulnerable population and improving overall outcomes and quality of life.
To review the application of telehealth guidelines developed by Bondini et al for clinicians to determine patient suitability for telehealth in an outpatient Chronic Wound Service, including the proportion of patients suitable for telehealth, type and mode of telehealth encounters. Retrospective, random convenience sample of patients attending the Chronic Wound Service in 2021. Fifty-six patients were included, most with leg/foot wounds (93%), median age 74 [54–84], 64% male. Four patients at admission and 19 patients at review met criteria for telehealth. Six percent of encounters were telehealth; phone-only (82%), unscheduled nursing reviews (77%) in patients with healing wounds. Thirty patients (54%) received at least one telehealth encounter. Telehealth occurred 35.6 days later in the admission than face-to-face encounters (p < 0.05, 95% CI 14.9–56.3). There was a significant relationship between patients receiving telehealth and meeting telehealth suitability criteria on reviews (X 2 (1) = 19.6*, p < 0.001). Eighteen percent of patients required wound-related hospitalisation during their outpatient admission. Telehealth guidelines identified patients suitable for telehealth, although the proportion of patients was small. Telehealth was mostly utilised for nurse-led telephone calls in patients with improving wounds. Future research into use of telephone review for clinical standards of wound care is warranted.
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