Conectar
by Ece Zengin, Aybuke Ucgun, Mehmet Emir Çevik, Sehnaz Evrimler, Ihsaniye Suer Dogan
BackgroundEpicardial adipose tissue (EAT) is associated with cardiometabolic disorders such as diabetes mellitus (DM), hyperlipidemia, and nonalcoholic fatty liver disease. However, its potential relationship with pancreatic steatosis and pancreatitis remains unclear, and existing studies offer inconsistent findings. Therefore, a clearer understanding of whether EAT reflects broader systemic ectopic fat burden or inflammatory processes is needed.This study evaluated the relationships between EAT thickness and DM, hyperlipidemia, hepatosteatosis, pancreatic steatosis, and pancreatitis.
MethodsThis retrospective, single-center study included 200 patients who underwent abdominal CT between 2022 and 2024. EAT thickness was measured at the mid-RCA and LAD levels, and subcutaneous fat was measured at the umbilical level. Liver and pancreatic steatosis were assessed with CT or MRI. Demographic and clinical data (age, gender, LDL cholesterol, diabetes, and history of pancreatitis) were collected. Mann-Whitney U, Spearman correlation, and logistic regression were used in analyses; p Results
Of the 200 patients, 31.4% had diabetes, 42% had hepatosteatosis, and 73.5% had a history of pancreatitis. EAT and subcutaneous fat were significantly higher in women at all levels (p Conclusions
EAT thickness is significantly associated with DM, LDL cholesterol, pancreatitis history, and age, supporting its role as a potential imaging biomarker of cardiometabolic risk. These findings suggest that EAT may serve as an imaging marker of broader metabolic and inflammatory burden, supporting its relevance for cardiometabolic risk assessment.
Thromboangiitis obliterans (TAO) is a rare, tobacco-associated vasculitis that primarily affects the distal extremities of young males. In advanced stages, it often leads to chronic limb ischemia with ischemic ulceration, culminating in amputation. Data on risk factors for reamputation in this population remain limited. This study aimed to identify clinical, radiological and microbiological predictors of reamputation in patients with TAO-related foot ulcers undergoing amputation. A retrospective cohort study was conducted on 25 patients (31 limbs) with Fontaine stage IV TAO ulcers who underwent lower extremity amputation between January 2021 and December 2024. Patients were stratified into two groups based on whether they underwent repeat amputation (Group 1) or a single procedure (Group 2). Preoperative magnetic resonance imaging, intraoperative tissue cultures and laboratory data were evaluated. Smoking status, hospitalisation metrics and adjunctive therapies were recorded. Statistical analysis included Mann–Whitney U, Fisher's exact test, ROC curve analysis and multivariate logistic regression. Seventeen limbs required reamputation. Persistent smoking was observed in 100% of Group 1 compared with 58.4% of Group 2 (p = 0.015). Positive intraoperative cultures were significantly more frequent in Group 1 (64.7% vs. 21.4%; p = 0.029), with all multidrug-resistant organisms confined to this group. Length of hospital stay was significantly longer in Group 1 (25.2 ± 6.4 vs. 15.8 ± 5.3 days; p = 0.001). ROC analysis identified > 19 days of hospitalisation as a threshold for reamputation risk (AUC = 0.781; p = 0.018). Multivariate analysis identified three independent predictors of reamputation: persistent smoking (OR: 5.2, 95% CI: 1.2–22.8; p = 0.015), positive intraoperative culture (OR: 4.7, 95% CI: 1.1–20.1; p = 0.041), and hospitalisation longer than 19 days (OR: 6.5, 95% CI: 1.4–29.4; p = 0.018). Reamputation in advanced-stage TAO is strongly associated with modifiable factors, particularly ongoing tobacco use, Gram-negative infection and prolonged hospital stay. Early identification and targeted intervention addressing these variables may improve limb preservation outcomes in this high-risk population.
by Mehmet Yildirim, Timothy Carter, Holly Blake
Poor mental well-being is common among healthcare workers, affecting individual health, patient safety, and organisational performance. Mobile app-based self-care interventions are promising due to their accessibility, low cost, and ease of use. This study aimed to assess the feasibility of a self-monitoring mobile app called MYARKEO, to improve mental well-being among healthcare workers and healthcare trainees in the United Kingdom (UK). The study evaluated recruitment and retention rates, variability of key outcomes to inform a future randomised controlled trial (RCT), intervention engagement, barriers and facilitators to engagement, and potential refinements to the mobile app. A mixed-method feasibility RCT was conducted with two groups: an intervention group using MYARKEO to monitor mental well-being over 6 weeks, and a non-intervention control group. Data were collected at baseline and post-intervention and included the Warwick-Edinburgh Mental Well-being Scale (WEMWBS), the Depression Anxiety and Stress Scale (DASS-21), and the mHealth App Usability Questionnaire (MAUQ). Qualitative data were collected through semi-structured interviews (n = 13) and analysed using thematic analysis. Forty-nine participants (32 workers, 17 trainees; aged 18–60+) were included in the trial, with a 20.5% dropout rate. Daily app usage averaged 64.5%. Participants frequently monitored mood, sleep, food, and exercise. Interviews identified themes of “Usefulness,” “Enablers of engagement,” “Barriers to engagement,” and “Suggested intervention improvements.” This study demonstrates the feasibility of using a mobile app to monitor and promote mental well-being among healthcare workers and trainees. While app engagement was promising, challenges were identified, highlighting the need for refinements to the app’s content, interface, and design for future trials.by Arif Özsarı, Halil Uysal, Gültekin Lekesiz, Mehmet Çağrı Çetin, Murat Tilki, Erkan Gülgösteren, Tolga Tek, Mehmet Altın
Physical inactivity is a prevalent issue worldwide with concerning implications for public health. Regular participation in sporting activities is associated with numerous physical, psychological, and social benefits. This research aimed to examine the the impact of sport engagement on sportive life satisfaction, mental well-being, and psychological well-being among 473 Turkish athletes, comprising 246 females and 227 males, from various sports disciplines: football, rugby, wrestling, kickboxing, archery, table tennis, taekwondo, volleyball, swimming, cycling, handball, and karate. Research data were collected through validated scales measuring sport engagement, sportive life satisfaction, mental well-being, and psychological well-being. In addition to descriptive statistics, hypotheses formulated within the research model were tested via correlation and multiple regression analyses within the relational model framework. Correlation analysis demonstrated a positive association between sport engagement and all three well-being dimensions. Multiple regression analyses further confirmed that sport engagement significantly and positively predicted sportive life satisfaction, mental and psychological well-being. Sports participation should be encouraged to enhance life satisfaction, mental and psychological well-being.To evaluate whether implementing the Comprehensive Assessment and Risk Evaluation (CARE) record, developed to operationalise Standard 5: Comprehensive Care of the Australian National Safety and Quality Health Service Standards was associated with improvements in patient safety and quality of care. A secondary objective was to explore staff and patient experiences of implementation.
Mixed-methods pre–post evaluation combining quantitative analysis of routinely collected hospital data with staff surveys and patient interviews.
A metropolitan hospital network in Melbourne, Victoria, Australia
Quantitative analysis included 88 041 admissions pre-implementation and 23 765 post implementation. Staff surveys were completed by 117 staff (84% nurses, 60% with >5 years at the service). Structured interviews were conducted with 39 patients (mean age 65.6 years, 64% male).
The CARE record was a structured record embedding validated risk assessments (STRATIFY, Braden Scale, Malnutrition Screening Tool, Confusion Assessment Method/4 ‘A’s Test, Broset Violence Checklist, Columbia-Suicide Severity Rating Scale) and care planning into routine workflows, to meet requirements of Standard 5.
Primary outcomes were the incidence of falls and pressure injuries. Secondary outcomes were completion of the CARE record, staff and patient experiences, and documentation of other hospital-acquired complications (HACs) (delirium, malnutrition, violence and aggression, suicide and self-harm). Data were compared for two time periods: 1 January 2016 to 28 February 2019 (before CARE record implementation) and 1 March 2019 to 30 March 2020 (after CARE record implementation but before COVID-19).
Post implementation, overall falls decreased (OR 0.85; 95% CI 0.78 to 0.93), though severe falls increased (OR 1.89; 95% CI 1.17 to 3.07). Pressure injuries decreased in coded data (OR 0.41; 95% CI 0.23 to 0.73) and incident reports (OR 0.79; 95% CI 0.68 to 0.92). Documentation of delirium (OR 2.02), malnutrition (OR 2.03), aggression/violence (OR 2.09) and suicide/self-harm (OR 1.92) increased. Half of the staff (50.4%) felt they knew more about patients, but 61.2% reported more time to admit patients. Communication between nursing and allied health improved (65.8%). Patients were generally satisfied, though 50% repeated information frequently and 20% felt unprepared for discharge.
CARE record implementation, mandated by the Australian Commission on Safety and Quality in Health Care’s Standard 5, was associated with fewer pressure injuries and overall falls (though there was an increase in falls resulting in serious injury), and greater documentation of other complications. Staff and patient experiences highlighted some benefits but also documentation time challenges. Findings provide lessons for the national implementation of Standard 5 and the need to balance structured processes with clinical judgement.
FreshRSS 