Veterinary medicine - Repository of PHD, master's thesis
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The role of the inflammatory response and the severity of the disease as a clinical predictor of the development of anxiety, depression and post traumatic stress disorder in patients treated in hospital for COVID 19
No full textNamjera nam je bila istražiti simptome depresije, anksioznosti, stresa i PTSP-a i njihov odnos s težinom bolesti kod akutno bolesnih pacijenata koji su hospitalizirani u KB Dubrava s koronavirusom (COVID-19). Provedena je jednocentrična presječna opservacijska studija u dvjema vremenskim točkama koja je probirala psihijatrijske simptome korištenjem dvije sasmoocjenske psihijatrijske ljestvice. Uključeno je ukupno 169 bolesnika. Svi bolesnici bili su odrasli i bijele rase te su tijekom hospitalizacije razvili respiratornu insuficijenciju. Demografski, klinički i laboratorijski podatci procijenjeni su kao prediktori psihijatrijskih simptoma. Pronašli smo da su intenzitet simptoma bolesti COVID-19 i veća potreba za kisikom bili povezani s pojavom depresije, anksioznosti, stresa i simptoma PTSP-a. Svi psihijatrijski simptomi bili su izraženiji u bolesnica, simptomi depresije i anksioznosti povezani su s prethodnom kroničnom opstruktivnom bolešću pluća. SII i CRP nisu bili statistički značajno povezani s prisutnim simptomima anksioznosti, stresa i depresivnosti, te PTSP-a, naša hipoteza u kojoj smo očekivali povezanost, nije potvrđena. Akutno bolesni hospitalizirani pacijenti pokazali su visoku prevalenciju akutnih psihijatrijskih posljedica, osobito žene, a teži COVID-19 uglavnom je utjecao na težinu simptoma depresije. U postakutnoj fazi nakon 3 mjeseca pokazuje se pad anksioznosti, depresivnosti,stresa isimptoma PTSP-a.We aimed to investigate symptoms of depression, anxiety, stress, and PTSPand their relationship with disease severity in acutely ill patients hospitalized in KB Dubrava with COVID-19. A single-center cross-sectional observational study was conducted at two time points that screened psychiatric symptoms using two self-rated psychiatric scales. A total of 169 patients were included. All patients were adults and of white race and developed respiratory insufficiency during hospitalization. Demographic, clinical and laboratory data were evaluated as predictors of psychiatric symptoms. We found that the intensity of the symptoms of the disease of COVID-19 and a higher need for oxygen were associated with the occurrence of depression, anxiety, stress and PTSD symptoms. All psychiatric symptoms were more pronounced in female patients, symptoms of depression and anxiety were associated with previous chronic obstructive pulmonary disease. SII and CRP were not statistically significantly related to the presence of symptoms of anxiety, stress and depression, and ptsp, our hypothesis in which we expected a connection was not confirmed.Acutely ill hospitalized patients showed a high prevalence of acute psychiatric consequences, especially women, and more severe COVID -19 mainly affected the severity of depressive symptoms.
In the post-acute phase after 3 months, there is a decrease in anxiety, depression and stress and a slight increase in PTSD symptoms (by about 10%)
The role of trace elements in the development of cardiomiopathy
No full textElementi u tragovima zastupljeni su u ljudskom organizmu u vrlo malim količinama. Odlikuju se kompleksnim interakcijama u staničnom okruženju jer vrlo lako stupaju u razne oksidacijske i redukcijske reakcije. Za elemente teških metala poznato je da uzrokuju nastanak slobodnih radikala koji uzrokuju razna oštećenja strukture i funkcije stanice. Takav mehanizam leži u podlozi raznih bolesti i stanja poput neurodegenerativnih bolesti, otrovanja, karcinogenze i starenja. Budući da su objavljena istraživanja kojima je utvrđeno nakupljanje određenih elemenata ove skupine kod oboljelih od kardiomiopatije isti mehanizam može biti odgovoran za razvoj tih bolesti ili može značajno doprinijeti njihovom razvoju. Osim oksidativnog potencijala razni metali imaju afinitet vezanja na stanične metaloproteine čime potencijalno oštećuju stanicu i drugim mehanizmima.Trace elements are present in the human body in very small quantities. They are characterized by complex interactions in the cellular environment because they very easily enter into various oxidation and reduction reactions. Heavy metals are known to generate free radicals that cause various damage to cell structure and function. Such a mechanism is present in pathogenesis of various diseases and conditions such as neurodegenerative diseases, poisoning, carcinogenesis and aging. It has been shown that these elements are elevated in some patients with cardiomyopathy, suggesting that trace elements may contribute to development of this disease. In addition to the oxidative potential, various metals have an affinity for binding to cellular metalloproteins, potentially damaging the cell by other mechanisms as well
Early predictors of neurodevelopmental outcome in children with congenital cytomegalovirus infection
No full textKonatalna citomegalovirusna infekcija je najčešća vertikalno prenošena zarazna bolest. U zaražene djece je često asimptomatska, ali može biti uzrokom teških neurorazvojnih odstupanja kao što su poremećaji sluha i vida, motoričko odstupanje do razvoja cerebralne paralize, intelektualno oštećenje, epilepsija ili poremećaj iz spektra autizma. Budući da se probir novorođenčadi na konatalnu citomegalovirusnu infekciju ne provodi sustavno, sumnja na infekciju u većini slučajeva se postavlja temeljem kliničke slike. Studijom je obuhvaćeno 103 djece s dokazanom infekcijom čiji je razvoj praćen 4-17,9 godina. Prosječna dob postavljanja sumnje na infekciju je u skupini djece sa simptomatskom infekcijom bila 3,3 mjeseca, a u skupini djece s asimptomatskom infekcijom 5,1 mjesec. Simptomi temeljem kojih je postavljena sumnja na infekciju, a povezani su s lošim neurorazvojnim ishodom, su bili mikrocefalija i oštećenje sluha. Utvrđeno je da djeca sa simptomatskom infekcijom imaju značajno lošiji ukupni neurorazvojni ishod od djece s asimptomatskom infekcijom, iako je loš ishod moguć i u asimptomatskoj skupini. Mikrocefalija je kao početni simptom, ali i kao jedan od ishoda infekcije, značajno povezana s lošim neurorazvojnim ishodom i s teškim oštećenjem mozga. Zbog moguće progresije bolesti, osobito oštećenja sluha, konatalno inficirana djeca zahtijevaju dugotrajno praćenje. S obzirom na nemogućnost pravodobnog otkrivanja djece s KCMVI predlaže se provođenje sveobuhvatnog ili ciljanog novorođenačkog probira.Congenital cytomegalovirus infection is the most common vertically transmitted infectious disease. Infected children are often asymptomatic, but infection can also cause severe neurodevelopmental disorders such as hearing and visual impairments, cerebral palsy, intellectual impairment, epilepsy or autism. Since no universal screening for congenital cytomegalovirus infection is performed, diagnosis is usually set by clinical appearance of early clinical simptoms of infection. Study described 103 children with proven congenital cytomegalovirus infection folowed for 4-17,9 years. The average age at which infection was suspected was 3.3 months in the group of children with symptomatic infection, and 5.1 months in the group of children with asymptomatic infection. Symptoms which raised the clinical suspicion and were associated with a poor neurodevelopmental outcome, were microcephaly and hearing impairment. Children with symptomatic infection had significantly worse neurodevelopmental outcome than children with asymptomatic infection, although a poor outcome was also possible in the asymptomatic group. Microcephaly, as an initial symptom, but also as one of the outcomes of the infection, was significantly associated with poor neurodevelopmental outcome and severe brain damage. Due to the possible progression of the disease, especially hearing impairment, congenitaly infected children require long-term follow-up. Due to failure of timely detection of children with congenital cytomegalovirus infection, comprehensive or targeted newborn screening is suggested
Equivalent: Glucagon-like peptide-1 receptor agonists decrease total and LDL-cholesterol in obese type 2 diabetic patients.
No full textGlucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly utilized in the management of type 2 diabetes mellitus
(T2DM). GLP-1 RAs have been associated with improvements in serum lipid profiles in clinical trials. Their long-term cardiovascular safety and benefit have also been confirmed in the recently published LEADER trial. In the current study, we assessed the effects of GLP-1 RAs (exenatide and liraglutide) on serum lipid profiles (total, LDL, HDL-cholesterol and triglycerides) of obese patients with T2DM. A total of 85 patients were included in the study (43 on exenatide and 42 on liraglutide) and followed up for 22 and 13 months, respectively. Treatment with exenatide was associated with a significant decrease in total cholesterol from 5.1±1.3 to 4.9±1.2 mmol/L (p=0.02) and LDL-cholesterol from 3.0±1.1 to 2.6±0.8 mmol/L (p=0.01). Treatment with liraglutide was also associated with a significant decrease in total cholesterol from 4.8±1.2 to 4.2±0.8 mmol/L (p=0.001) and LDL-cholesterol from 2.5±0.8 to 2.1±0.5 mmol/L (p=0.006). Treatment with liraglutide and exenatide did not significantly affect HDL-cholesterol and triglyceride levels. The results of our study suggest that treatment with exenatide and liraglutide may significantly reduce total and LDL-cholesterol in obese patients with T2DM
Intrathecal morphine for analgesia after total hip arthroplasty
No full textMorfij, opioidni analgetik, intratekalnim načinom primjene u širu upotrebu ušao je 1979. godine. Operativni zahvat ugradnje totalne endoproteze kuka je najizvođeniji elektivni kirurški zahvat u razvijenom svijetu. Međutim, često je praćen sa značajnim postoperativnim bolovima koji mogu negativno utjecati na oporavak bolesnika te postoperativnu rehabilitaciju. PROSPECT smjernice za postoperativnu analgeziju kod THA preporučuju upotrebu intratekalnog morfija kao dodatka spinalnoj anesteziji radi postoperativne analgezije. Iako se operativni zahvat ugradnje potpune endoproteze kuka sve više izvodi u sklopu jednodnevne kirurgije ili sa kratkim boravkom u bolnici, anesteziolozi su još uvijek suzdržani oko primjene intratekalnog morfija unatoč njegovom dobrom analgetskom učinku, ponajviše zbog straha od nuspojava u vidu postoperativne mučnine i povraćanja respiratorne depresije. Ove komplikacije mogu rezultirati produljenim bolničkim liječenjem, povećati postoperativni morbiditet i smanjiti zadovoljstvo pacijenta liječenjem, čime učinkovitost i dobrobiti ovog analgetskog modaliteta usmjerenog na pacijenta padaju u drugi plan. Intratekalni morfij pokazao se kao značajna analgetska metoda za liječenje postoperativne boli nakon operacija ugradnje totalne endoproteze kuka. Prema tome, pažljiva primjena uz poslijeoperacijski nadzor bolesnika, te imajući na umu nuspojave koje su uglavnom ovisne o dozi, osigurava intratekalnom morfiju mjesto jednog od važnijih analgetskih modaliteta za kirurške zahvate na donjim ekstremitetima. Međutim, daljnje randomizirane studije vezane za optimalno doziranje IT morfija svakako trebaju biti provedene.Morphine, an opioid analgesic, was widely used by the intrathecal method in 1979. The operative procedure of total hip arthroplasty is the most performed elective surgical procedure in the developed world. However, it is often accompanied by significant postoperative pain that can negatively affect the patient's recovery and postoperative rehabilitation. The PROSPECT guidelines for postoperative analgesia for THA, the use of intrathecal morphine as an adjunct to spinal anesthesia for postoperative analgesia is recommended. Although the total hip arthroplasty is increasingly performed as part of a one-day surgery or with a short hospital stay, anesthesiologists are still reluctant to use intrathecal morphine despite its good analgesic effect, mostly due to the fear of side effects in the form of postoperative nausea and vomiting and respiratory depression. These complications can result in prolonged hospital stay, increase postoperative morbidity, and decrease patient satisfaction, thus compromising the effectiveness and benefit of this patient-centered analgesic modality. Intrathecal morphine has been shown to be a significant analgesic method for the treatment of postoperative pain in total hip arthroplasty. Therefore, careful application with postoperative patient monitoring, and keeping in mind its side effects that are mostly dose-dependent, ensures that intrathecal morphine is one of the most important analgesic modalities for surgical interventions on the lower extremities. But given the many open questions, further randomised studies should be conducted particularly considering the optimal dosing regimen
Difference in reproduction, discrimination and production of perceived and presented time intervals
No full textTajming, tj. percepcija i procesiranje vremenskih intervala, označava subjektivno iskustvo prolaženja fizičkog vremena te interpretaciju trajanja događaja, a od ključnog je značaja za kognitivno, perceptivno i motoričko funkcioniranje čovjeka.
Cilj rada bio je istražiti razlike u procesiranju vremenskih intervala u rasponu milisekundi i sekundi na temelju eksperimentalnih paradigmi reprodukcije, diskriminacije i produkcije vremenskih intervala, kako bi se dobili dokazi u prilog teoriji o jednom namjenskom (zajedničkom) mehanizmu ili intrinzičnim mehanizmima (više lokalnih mehanizama) mjerenja vremena u mozgu. U istraživanju je sudjelovalo 115 sudionika u dobi od 19-24 godine. Pokazatelje izvedbi tajminga predstavljale su vrijednosti varijabilnosti (SD i CV) i preciznosti (AI), a u daljnjim inferencijalnim analizama te su vrijednosti predstavljale zavisne varijable.
Rezultati pokazuju kako se varijabilnost izvedbi navedenih paradigmi tajminga statistički značajno razlikuje (F(1.43, 143.01) = 264.10, p < .001, ηp 2 = .73) u korist motoričkoga tajminga, koji se pokazao kao najstabilniji, dok se perceptivni tajming pokazao kao najvarijabilniji. U produkciji intervala pronađena je veća varijabilnost intervala kraćih od sekunde (F(1, 104) = 164.11, p < .001, ηp 2 = .61) i značajna povezanost unutar pojedinih skupova pokazatelja izvedbi, no ne i između jednog i drugog skupa. Pokazalo se kako radno pamćenje nije povezano s pokazateljima izvedbi u paradigmama reprodukcije i produkcije intervala, a konkurentni zadatak uzrokuje povećanje varijabilnosti motoričkog (automatskog) tajminga (F(1,90) = 122.47, p < .001, ηp 2 = .58). O rezultatima se raspravlja u bihevioralnom kontekstu eksperimenta, ali i uz korištenje argumenata iz neurobioloških teorija i istraživanja. Općenito gledano, rezultati govore u prilog teorijama prema kojima je procesiranje vremenskih intervala pod kontrolom specijaliziranih i distribuiranih mreža, a ne centralnog sata.Timing, or the perception and processing of time intervals, refers to the subjective experience of physical time and the interpretation of event durations. It plays a crucial role in an individual's cognitive, perceptual, and motor functions. Current research aimed to explore differences in the processing of time intervals, ranging from milliseconds to seconds, using experimental paradigms involving reproduction, discrimination, and production of time intervals. The goal was to gather evidence supporting either a single dedicated mechanism (common timing) or multiple intrinsic mechanisms (local timing) for time measurement in the brain. A total of 115 participants, aged 19-24, took part in the study. Timing performance was assessed using indicators of variability (SD and CV) and precision (AI), which served as dependent variables in further inferential analyses. The findings revealed statistically significant differences in performance variability across the timing paradigms (F(1.43, 143.01) = 264.10, p < .001, ηp 2 = .73), with motor timing emerging as the most stable and perceptual timing as the most variable. Greater variability was observed in the production of intervals shorter than one second (F(1,
104) = 164.11, p < .001, ηp 2 = .61), alongside significant relationships within individual sets of performance measures, though not between the two sets. Additionally, working memory was found to be unrelated to performance in the interval
reproduction and production paradigms. However, introducing a competitive task increased the variability of motor (automatic) timing (F(1,90) = 122.47, p < .001, ηp 2 = .58). The results are discussed concerning the behavioral context of the experiment and supported by neurobiological theories. Overall, the findings suggest that the timing is governed by specialized, distributed networks in the brain, rather than by a central clock
Pulmonary rehabilitation outcome in relation to the nutritional status of patients with chronic obstructive pulmonary disease
No full textUvod: Kronična opstruktivna plućna bolest (KOPB) jedan je od vodećih uzroka smrti u svijetu i predstavlja velik javnozdravstveni problem. Liječenje je kompleksno te uz farmakološke, ključnu ulogu imaju i nefarmakološke mjere, prije svega plućna rehabilitacija. U dosadašnjim brojnim istraživanjima bolesnika s KOPB-om praćene su promjene u nutritivnom statusu bolesnika koje utječu na mortalitet, funkcionalni status bolesnika i kvalitetu života te pozitivan učinak plućne rehabilitacije.
Ispitanici i metode: U istraživanje je bio uključen 121 ispitanik s dijagnozom KOPB-a upućen na plućnu rehabilitaciju u Kliniku za plućne bolesti Jordanovac. Ispitanici su podijeljeni u tri skupine (A, B ili C) ovisno o nutritivnom statusu prema upitniku subjektivne općenite procjene (engl. Subjective Global Assessment - SGA). Svim ispitanicima je učinjena bioimpedancijska analiza i mjerene su vrijednosti albumina i prealbumina u krvi. Mjereni su ishodi plućne rehabilitacije, procjenom funkcijskog kapaciteta vježbanja, težine bolesti i kvalitete života, te su mjerene vrijednosti markera sistemske upale i lipidnog profila ispitanika.
Rezultati: Od svih ispitanika podjednak broj muškaraca i žena je bio u svakoj skupini (A, B i C). Prosječna dob uključenih ispitanika bila je 66,5 ± 7,5 godina uz najstariju populaciju u skupini SGA A. Temeljem bioimpedancijske analize i vrijednosti prealbumina nađene su statistički signifikantne razlike između skupina A, B i C (p<0,001). Usporedbom razlike u poboljšanju vrijednosti plućnih funkcija, 6-minutnog testa hoda te upitnika kvalitete života i težine bolesti između SGA skupine A, B i C, ishodi plućne rehabilitacije su bez statistički signifikantne razlike među skupinama. U laboratorijskim nalazima nije nađena signifikantna razlika u vrijednostima leukocita, CRP-a, fibrinogena i lipidnog profila između SGA skupina A,B i C.
Zaključak: Plućna rehabilitacija poboljšava kapacitet vježbanja i kvalitetu života bolesnika s KOPB-om, neovisno o njihovom nutritivnom statusu.Introduction: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in the world and represents a major public health problem. The treatment of those patients is complex and, in addition to pharmacological treatment, non-pharmacological measures are very important, especially pulmonary rehabilitation.
Methods: The study included 121 subjects diagnosed with COPD who were referred for pulmonary rehabilitation at the Clinic for Respiratory disease Jordanovac. Subjects were divided into three groups (A, B and C) depending on nutritional status according to the Subjective Global Assessment (SGA) questionnaire. All subjects underwent bioimpedance analysis and measured albumin and prealbumin blood values. Pulmonary rehabilitation outcomes were measured by assessing the exercise capacity, disease severity and the quality of life. Values of the markers of systemic inflammation and the lipid profile were also measured.
Results: An equal number of men and women were in each group (A, B and C). The average age of the included subjects was 66.5 ± 7.5 years, with the oldest population in the SGA group A. Based on bioimpedance analysis and prealbumin values, statistically significant differences were found between groups A, B and C (p<0.001). By comparing the difference in the improvement of pulmonary function values, the 6-minute walk test and the quality of life questionnaire and disease severity between SGA groups A, B and C, the results of pulmonary rehabilitation were without statistically significant differences between the groups. In the laboratory findings, no significant difference was found in the values of leukocytes, CRP, fibrinogen and lipid profile between SGA groups A, B and C.
Conclusion: Pulmonary rehabilitation improves exercise capacity and quality of life in patients with COPD, regardless of their nutritional status
Balancing tradition and innovation: rethinking the dichotomy in anatomy teaching
No full textMedical education has undergone a significant reform in response to evolving health care demands, technological advancements, and emerging research in biomedical and education sciences. The teaching methods in anatomy, a core component of medical education, have notably changed, with traditional cadaveric dissection being increasingly replaced by digital and hybrid alternatives. Despite research indicating no significant difference in short-term knowledge retention between students who engaged in cadaveric dissection and those engaging in alternative methods, dissection uniquely fosters professionalism, empathy, and ethical awareness - traits essential for holistic medical education. This review critically examines the dichotomy between traditional and innovative teaching methods in anatomy education, questioning the assumption that traditional methods hinder progress in modern health care. The findings suggest that changes in medical education are primarily influenced by organizational issues, which frequently results in an incomplete implementation of innovative teaching approaches. The inconsistent application of innovative teaching methods makes it difficult to assess their effectiveness and compare them with traditional methods. Reliable data on their long-term impact can only be generated by randomized controlled trials and longitudinal studies. In the meantime, we need to ensure that current medical students receive high-quality education by incorporating best practices from diverse teaching methods based on valuable insights from experienced educators and current students' learning preferences
The Role of Abbreviated Breast Magnetic Resonance Imaging in Women with the Family History of Breast Cancer Involved in National Breast Cancer Early Detection Program
No full textCilj: Utvrditi korisnost prepoznavanja žena s obiteljskom anamnezom raka dojke, uključenih u Nacionalni program ranog otkrivanja raka dojke, i probira magnetskom rezonancijom dojki kao dodatnom dijagnostičkom metodom.
Metode: Uključeno je 178 ispitanica s obiteljskom anamnezom raka dojke u dobi od 50 do 69 godina koje su se odazvale na poziv za mamografiju u 7. ciklusu programa probira. Nakon mamografije napravljen je MR dojki prema skraćenom protokolu. Zlatni standard za ocjenu dijagnostičke točnosti mamografije i MR-a dojki, a s obzirom na sumnjive nalaze BI-RADS 4 i BI-RADS 5, bila je patohistološka dijagnoza nakon učinjene biopsije pod nadzorom UZV-a dojki.
Rezultati: Otkriveno je 12 novih slučajeva raka dojki, od čega je njih 7 (58,3%) bilo otkriveno samo MR-om dojki, njih 4 (33,3%) bilo je otkriveno i s mamografijom i s MR-om dojki, a 1 (8,3%) rak dojke bio je otkriven samo mamografijom. Osjetljivost magnetske rezonancije dojki prema skraćenom protokolu za otkrivanje raka dojke bila je 91,7%, specifičnost 94,6%, PPV 55,0% i NPV 99,4%, a kod mamografije te su vrijednosti bile 41,7%, 96,4%, 45,5% i 95,8%.
Zaključci: Ovi podatci potvrđuju da smo uvođenjem MR-a dojki otkrili 7 slučajeva raka dojke koji bi ostali neotkriveni da u program probira uz mamografiju nije dodan pregled MR-om dojki. S obzirom na rezultate provedenog istraživanja može se preporučiti da se ženama s obiteljskom anamnezom raka dojke najprije procijeni imaju li povećani rizik, a nakon toga uz mamografiju omogući i godišnji pregled MR-om dojki s ciljem što ranijeg otkrivanja i početka liječenja bolesti.Objective: To determine the utility of identifying women with a family history of breast cancer, enrolled in the National Breast Cancer Early Detection Program, through breast magnetic resonance imaging (MRI) screening as an additional diagnostic method.
Methods: A total of 178 participants with a family history of breast cancer aged 50 to 69 who responded to the invitation for mammography in the 7th screening cycle were included. Following mammography, a breast MRI was performed according to an abbreviated protocol. The gold standard for assessing the diagnostic accuracy of mammography and breast MRI, considering suspicious BI-RADS 4 and BI-RADS 5 findings, was the histopathological diagnosis after ultrasound-guided breast biopsy.
Results: Twelve new cases of breast cancer were detected, with 7 (58.3%) identified only by breast MRI, 4 (33.3%) detected by both mammography and breast MRI, and 1 (8.3%) diagnosed only by mammography. The sensitivity of breast MRI according to the abbreviated protocol for breast cancer detection was 91.7%, specificity 94.6%, positive predictive value (PPV) 55.0% and negative predictive value (NPV) 99.4%, while for mammography, these values were 41.7%, 96.4%, 45.5%, and 95.8%, respectively.
Conclusions: These data confirm that the introduction of breast MRI led to the discovery of 7 cases of breast cancer that would have remained undetected if breast MRI had not been added to the screening program alongside mammography. Considering the results of the conducted research, it is recommended to assess whether women with a family history of breast cancer have an increased risk, and subsequently, provide annual breast MRI screening in addition to mammography for the early detection and initiation of treatment
Equivalent: Wearing surgical face mask has no significant impact on auscultation assessment
No full textObjective
During the COVID-19 pandemic, universal mask-wearing became one of the main public health interventions. Because of this, most physical examinations, including lung auscultation, were done while patients were wearing surgical face masks. The aim of this study was to investigate whether mask wearing has an impact on pulmonologist assessment during auscultation of the lungs.
Methods
This was a repeated measures crossover design study. Three pulmonologists were instructed to auscultate patients with previously verified prolonged expiration, wheezing, or crackles while patients were wearing or not wearing masks (physician and patients were separated by an opaque barrier). As a measure of pulmonologists’ agreement in the assessment of lung sounds, we used Fleiss kappa (K).
Results
There was no significant difference in agreement on physician assessment of lung sounds in all three categories (normal lung sound, duration of expiration, and adventitious lung sound) whether the patient was wearing a mask or not, but there were significant differences among pulmonologists when it came to agreement of lung sound assessment.
Conclusion
Clinicians and health professionals are safer from respiratory infections when they are wearing masks, and patients should be encouraged to wear masks because our research proved no significant difference in agreement on pulmonologists’ assessment of auscultated lung sounds whether or not patients wore masks