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The presence of risk factors in the home environment that influences the fall of people of the third age
Get PDFIntroduction: Aging is a natural, irreversible physiological process that depends on genetic, environmental, and lifestyle factors. Many physiological, biological, psychological, and other factors play a major role. According to the World Health Organization, falls are the second leading cause of unintentional injury death in the world and represent a major global public health problem. Falls are most commonly caused by intrinsic and extrinsic risk factors. A comprehensive assessment of fall risk is critical to the development of effective fall prevention programs. The screening protocol is brief, easy to use, and multifactorial and allows the identification of risk factors for falls. The aim of this study is to investigate the importance of the presence of risk factors in the home environment and the impact on increasing the risk of falls in people in the third age.
Methods: The study was conducted in the municipality of Podgorica. 109 elderly people from urban and rural areas were included in the study using the snowball method. The instruments used in our study are a standardized checklist for assessing risk factors in the home environment, inside and outside the home (HASSAT), and a self-assessment scale of one’s own concern about a possible falls efficacy scale international. The survey was conducted from the end of October to the end of November 2023.
Results: There is a statistically significant difference in social and physical activities of daily living in the area of concern about falling. When analyzing the overall result of the fear of falling scale in relation to gender, a significant statistical difference is found. The analysis of the individual rooms in relation to the age of the respondents shows that there is a significant statistical difference.
Conclusion: The results obtained show that the high risk of falling is present in all rooms of the home environment for people in their 3rd year of life and that fear of falling increases with age
Perceptions of women on sexuality, intimacy, andhealth-related quality of life during the COVID-19 epidemic
Get PDFIntroduction: The COVID-19 epidemic and its restrictions have affected all aspects of people’s lives, including health-related quality of life and, considering sexuality as an integral part of individual needs, also intimacy and sexuality. Therefore, the aim of this article was to investigate women’s sexual functioning and health-related quality of life assessment in Slovenian women in the reproductive period.
Methods: An online survey with valid questionnaires (short form 36 [SF-36] and Female sexual function index [FSFI-19]) was conducted in January 2022. All research ethical measures were taken to ensure the integrity of the participants.
Results: The FSFI scale score was 25.37 ± 8.29, 1.18 points above the cutoff point, indicating a higher risk of sexual dysfunction (26.55). The estimated prevalence of sexual dysfunction was 36.8%, with sexual desire being the most problematic area. The mean score on the SF-36 scale in our sample reached 73.52 ± 13.84 on a 100-point scale, with 0 representing the worst and 100 the best quality of life; fatigue (x̅ = 48.50) was the most problematic category. The results partly reflect the results of foreign studies, but we must be aware of cultural differences in the understanding of sexuality and keep in mind that some countries faced difficult circumstances during the COVID-19 pandemic and that social constraints were different in 2020 than in 2022.
Conclusion: The epidemic affected the sexual function of women of reproductive age and their perception of (health-related) quality of life
Laboratory inflammatory parameters depending on the COVID-19 test result
Get PDFIntroduction: The diagnosis of coronavirus disease 2019 (COVID-19) disease is necessary for the further treatment of patients with the present symptoms, and molecular diagnostics is considered the gold standard. However, it is already known that patients with symptoms of the disease can have a negative test due to various factors. The purpose of this study is to evaluate the laboratory parameters in patients with symptoms of COVID-19 infection who have both positive and negative test results.
Methods: The study included 101 samples from patients who tested positive for COVID-19 and 101 samples from patients who tested negative, both groups presenting symptoms of COVID-19. Data on the complete blood count, the absolute values of the differential blood count, and the D-dimer values were collected from the samples that were taken. Using blood count data, neutrophil-to-lymphocyte ratios, platelet-to-lymphocyte ratios, and systemic immune-inflammatory index (SII) were calculated.
Results: Based on the examination and research, a significant increase and change in the values of inflammatory indices and D-dimer were determined. In addition to the increase of these values above the reference value, a positive correlation was confirmed between the inflammation index value and the D-dimer value.
Conclusion: COVID-19-negative patients with characteristic symptoms of COVID-19 had higher values of lymphocytes and the determination of platelets and SII in these patients can be added to the diagnostic algorithm
The relationship of limited mobility of the cervical spinewith postural and mental reactions of students
Get PDFIntroduction: Previous studies have found that, in addition to the general factors for the occurrence of pain and reduced mobility of the cervical spine, the use of electronic devices promotes these, the excessive use of which can also lead to the occurrence of depressive symptoms in students. The aim of this study was to determine the mobility limitation of the cervical spine in students with reported neck pain, to determine the degree of disability and depression due to neck pain, to determine the correlation of mobility limitation of the cervical spine with the degree of disability and depression of students, and to determine the correlation of the degree of disability with the degree of depression.
Methods: The research was conducted as a cross-sectional study from May to July 2021 at the University of Zenica in four faculties. The study used the General Questionnaire and two standardized questionnaires to assess disability due to neck pain (Index of Disability due to Neck Pain) and the degree of depression (patient health questionnaire).
Results: A total of 147 students with reported neck pain participated in the study. A limitation of mobility was found in 30.6% of the students in flexion, 25.2% in rotation, 23.8% in lateral flexion, and 20.4% on extension. Mild disability due to neck pain was found in 58.5% of students, moderate in 23.8%, and severe in 2.7%. 45.6% of the students had mild depression, 18.4% had moderate depression, and 5.4% had severe depression.Conclusion: Restricted flexion and rotation are more common than restricted lateral flexion and extension of the cervical spine. About half of the students who reported neck pain had a mild degree of disability and mild depression. A strong positive correlation was found between the degree of disability and depression in students with neck pain
Effectiveness of physiotherapy lymphedema management in limb circumference and shoulder mobility among women with breast cancer-related lymphedema
Get PDFIntroduction: This study aimed to evaluate the effectiveness of physiotherapy lymphedema management (LM) in upper limb circumference (LC) and shoulder mobility and determine whether baseline muscle strength (MS) was associated with LC and shoulder mobility in women with breast cancer-related lymphedema.
Methods: This study analyzed 79 patients (mean age = 58.89 ± 10.22 years) who were categorized by age group (<60 and ≥60 years) and lymphedema stage (stages 1-2 and 3-4) and completed 8 sessions of LM. Key outcomes evaluated included shoulder flexor strength, LC, and shoulder flexion range of motion (ROM). Data were analyzed using a paired t-test and Pearson’s correlation based on age group and stage of lymphedema.
Results: There was a significant reduction in LC by 12.56%, 16.41%, 9.60%, 22.84%, and 7.76% for all patients, those aged <60 years (n = 38), ≥60 years (n = 41), stage 1-2 (n = 41), and stage 3-4 (n = 38), respectively (all p < 0.05). Shoulder flexion ROM improved by 3.99% (p < 0.05), 3.06% (p > 0.05), 5.06% (p < 0.05), 2.95% (p > 0.05), and 5.5% (p < 0.05) for all patients, those <60 years, ≥60 years, stage 1-2, and stage 3-4, respectively. Baseline MS was significantly correlated with LC at pre- and post-treatment for all groups (r = −0.53-−0.92) (p < 0.05), except for the LC of those with stages 1-2 of lymphedema at post-treatment while baseline MS was significantly correlated with shoulder flexion ROM at pre- and post-treatment in all groups (r = 0.86-0.98), except for stages 1-2.
Conclusion: An 8 sessions of LM may effectively reduce lymphedema and improve shoulder mobility. MS may be associated with LC and ROM; thus, the LM protocol should include regular assessment of MS and incorporate progressive strengthening exercises at an early stage
Measurement of palliative care competencies using PALCOM instrument
Get PDFIntroduction: An essential component of any profession is competent and confident staff. In palliative care, a wellrounded approach and versatile knowledge of staff and students are of great importance. Measuring these competencies is very important for the development of palliative care and health care.
Methods: Measurement of competencies in palliative care by analyzing existing instruments and questions in palliative care. Process of developing a new instrument for measurement of competencies in palliative care PALCOM, using cross-sectional methodology with nurses from Bosnia and Herzegovina.
Results: The results are presenting findings of research done with nurses from BIH using two main variables: Years of work experience and level of education of the participants. Main difference is between the two competencies: Pain assessment and management, education, and care for the patient’s family regarding the level of education.
Conclusion: The need for measuring competencies is evident in the daily evolution of palliative care, community-based palliative care, hospice care, and subspecialized palliative care. There is no questionnaire that can measure all competencies, but the use of the general competencies in the PALCOM questionnaire can cover this area with the measurement of different domains and the competencies specific to these domains
Optimisation of the bone single photon emission computed tomography in oncology patients
No full textIntroduction: The introduction of hybrid imaging systems such as Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) has completely changed the scanning procedure of conventional diagnostic nuclear medicine protocols. Modern bone scintigraphy protocols include SUV quanitification and Whole Body (WB) SPECT/CT scanning modality. The major limitation of these new technologies is relatively long scanning time. New detector systems with modern reconstruction softwares have been developed for fast scanning SPECT protocolos. These new technologies can produce images of reduced acquisition with same quality as full scanning acquisition. As a result new studies suggest that planar WB scintigraphy should be replaced with WB SPECT/CT.
Methods: One hundred oncology patients performed SPECT/CT as a part as their clinical follow-up. Three different scanning and three reconstruction protocols have been evaluated. Two nuclear medicine physicians evaluated with Likert scale image sharpness, lesion visibility, and lesion background detectability. The overall image quality was determined as the sum of these three parameters.
Results: In terms of scan duration reduction on image quality, Volumetrix Evolution for Bone performed during ultra-fast SPECT acquisition achieved the highest score, which is superior compared to the standard SPECT acquisition protocol. The overall image quality was the best with the Volumetrix MI Evolution for Bone protocol for ultra-fast acquisition
Conclusion: The Evolution for Bone protocol for ultra-fast acquisition showed best results compared to other protocols. The adoption of new acquisition SPECT protocol may offer more comfortable exams, resulting in higher patient satisfaction. The implementation of this new protocol can lead to an improvement in SPECT sensitivity, primarily due to the reduction of SPECT motion artifacts
Public health challenges in households - Food safety
Get PDFIntroduction: Most foodborne illnesses can be prevented by proper food preparation. The estimated prevalence of these diseases is 300-350 times higher than the data available today, which represents only the “tip of the iceberg.” Although restaurants are cited as the most common sites for food poisoning, these cases are three times more likely to occur in households. Therefore, assessing food consumer knowledge and practices provides a basis for formulating and designing programs to promote food safety in households.
Methods: Representatives of 384 households in six urban and rural municipalities in Sarajevo Canton participated in the survey. A previously designed and validated household food safety questionnaire was used to explore the knowledge and practices of the population regarding household food safety. Respondents’ knowledge and practices were assessed by the score they achieved, with one point awarded for each correct answer. The range of scores for knowledge and practices was divided into quartiles. The Chi-square test was used to examine whether there was a difference between expected and observed scores in one or more categories in contingency tables.
Results: In the assessment of food safety knowledge, 62% of the respondents had good knowledge, 33.1% had average knowledge, and 4.9% had poor knowledge. The results showed that 59.4% of the respondents had average practices and 22.4% had poor practices regarding food safety in their households. It was confirmed that various socioeconomic factors had a significant influence on consumers’ knowledge and practice regarding food safety in their households (p < 0.05).
Conclusions: Nowadays, the topic of food safety is rarely discussed in households, and the public is not aware of the risks they face. Urgent action should be taken to raise collective awareness of the importance of household food safety to public health
The importance of removing interference caused by Darzalex® (daratumumab) in pre-transfusion testing
Get PDFIntroduction: Multiple myeloma (MM) is a hematologic malignacy characterized by the uncontrolled proliferation of abnormal plasma cells in the bone marrow. Darzalex® (daratumumab) has emerged as a highly effective therapeutic agent for MM, offering an additional treatment option for patients who have developed resistance to other therapies. However, the use of Darzalex® poses challenges in pre-transfusion testing due to its strong binding affinity of the monoclonal anti-CD38 antibody to CD38 protein, resulting in panreactivity with test erythrocytes and complicating the detection of erythrocyte alloantibodies. The objective of this case report is to outline the procedures, significance, and methodologies for mitigating this interference using the DaraEx® reagent.
Case Report: We present the cases of three patients diagnosed with MM and treated with Darzalex® at our institution in 2023. Following the administration of Darzalex®, all three patients exhibited positive results on indirect antiglobulin tests (IAT). Cross-matching tests conducted with red blood cell concentrates also yielded positive results, with strengths ranging from 2+ to 3+. To eliminate interference, we used a specific DaraEx® reagent that utilizes Fab fragments of anti-CD38 to mitigate interference by masking CD38 on the cell surface. Subsequent application of this reagent resulted in negative IAT results for all three patients. However, one patient still displayed a weakly positive cross-matching test (<1+), suggesting that complete elimination of interference may not always be achievable with the DaraEx® method.
Conclusion: Despite the availability of reliable methods such as dithiothreitol and the DaraEx® reagent for mitigating interference, complete success in eliminating interference remains elusive. This underscores the importance of implementing proactive measures to prevent interference. Patients undergoing Darzalex® therapy should undergo comprehensive immunohematological testing before medication administration. Given the increased need for blood transfusions in MM patients, ensuring the compatibility of blood products is essential for safe transfusion practices
Evaluation of indirect indices in the insulin resistance assessment in patients with different body mass index
Get PDFIntroduction: Insulin resistance (IR) is a complex pathophysiological condition with multifactorial etiology characterized by a reduced responsiveness of target tissues to insulin (INS). Indirect indices based on mathematical models and derived from laboratory parameters have become increasingly popular in the past two decades. In this study, we evaluated their ability to predict IR in a population with different body mass index (BMI).
Methods: The matched case–control study was conducted in 2021 and 2022. Secondary data from 129 subjects were obtained from medical records, including demographic characteristics, anthropometric measurements, and biochemical laboratory test results. The studied group consisted of 91 subjects with a suspected diagnosis of IR who were further categorized according to BMI, while control group consisted from 38 age- and gender-matched subjects. Six widely used indirect indices were calculated: Homeostatic Model Assessment for IR (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), McAuley index (MCAi), metabolic score for IR (METS-IR), triglyceride to glucose index (TyG), and TyG to BMI (TyG-BMI).
Results: Significant differences between the subgroups were found in the mean values for HOMA-IR, TyG, TyG-BMI, and METS- IR, while the control group had the highest mean values for the indirect indices QUICKI and MCAi (p < 0.001). HOMA-IR, TyG, and TyG-BMI showed statistical significance in predicting IR regardless of BMI (p < 0.05). In the obese group, TyG-BMI had good predictive power for discriminating IR (area under the curve [AUC] = 0.820), with a sensitivity and specificity of 84.1% and 87.7%, respectively. HOMA-IR showed moderate predictive power to discriminate IR in the obese group (AUC = 0.720), with a sensitivity and specificity of 70.4% and 89.1%, respectively.
Conclusion: As IR is a multifactorial disease, indirect indices combining laboratory and anthropometric data can significantly help in predicting and mitigating complications