Medicina
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Background and Objective: The complexity of antiretroviral therapy (ART) regimens in people living with HIV (PLHIV) poses significant challenges for medication management, impacting adherence and overall health outcomes. The Medication Regimen Complexity Index (MRCI) is a tool that quantifies regimen complexity, yet its correlation with hospitalization rates and adverse drug reactions (ADRs) in PLHIV remains underexplored. Materials and Methods: This prospective study, which was conducted at a government-funded antiretroviral treatment center, investigated the relationships among MRCI scores, hospitalization due to ADRs, and the ADR rates in 285 PLHIV participants over 18 months. ⋯ There was no significant association between average MRCI scores and overall ADR rates or non-ADR-related hospitalizations. Conclusions: These findings emphasize the importance of monitoring medication regimen complexity in PLHIV, particularly in the context of preventing hospitalizations related to ADRs. Further research is needed to understand the multifactorial influences on ADR occurrence and to optimize ART regimens for better patient outcomes.
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Background/Objectives: Arteriovenous (AV) graft is a procedure for hemodialysis performed in the arm. Optimizing AV graft design is vital to enhance haemodialytic efficiency in patients with kidney disease. Despite being a standard procedure, making it work optimally is still difficult due to various graft diameters and anastomosis configurations, which have limited studies. ⋯ Results: As a result, the design with a diameter of 14.5 mm and a 40° angle was overall the most ideal in terms of minimal wall shear stress and turbulence. Conclusions: Thus the brachiocephalic area or the forearm is calculated to be the most optimal implantation site. Additionally, varying angles do affect dialysate flow, as smaller values cause less stress.
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Background and Objectives: Certain lifestyle behaviors can act as either buffering or aggravating factors influencing the mental well-being of university students. The current investigation assessed the association between academic performance and the risk of anxiety, depression, and stress among university students and how physical activity might buffer the levels of these conditions. Materials and Methods: A cross-sectional design was utilized to reach a sample of university students from Saudi Arabia. ⋯ Exercising regularly was associated with a protective effect against depression and stress (p < 0.05). However, the buffering effect of exercise was more apparent among students with a GPA of "very good" or above compared to students with lower academic achievement. Conclusions: The lack of a statistically significant association between physical activity regularity and mental well-being among students classified as low academic achievers may indicate the need for additional psychological support in addition to the promotion of a physically active lifestyle.
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Review Case Reports
Early-Stage and Locally Advanced Cervical Cancer during Pregnancy: Clinical Presentation, Diagnosis and Treatment.
In this comprehensive review supported by clinical examples, the authors explore the topic of cervical cancer in pregnancy, with emphasis on potential pre-cancer progression, the possibility of coexisting preinvasive and invasive disease, and neoadjuvant chemotherapy. This manuscript addresses the challenges of managing cervical cancer in pregnant women with a pregnancy-preserving approach, including the importance of screening, the timing of surgery, and the impact of pregnancy on the course of the disease. The first case study illustrates the potential for a benign cervical lesion to transform into a malignant one during pregnancy and the possible coexistence of preinvasive lesions together with early-stage cervical cancer. ⋯ The second presented clinical example shows the histologically confirmed response to neoadjuvant chemotherapy, resulting in a radiologically diagnosed FIGO stage IIA1 being downgraded to adenocarcinoma in situ in the histology report after surgery performed six weeks postpartum. The treatment of cervical cancer, which is becoming increasingly prevalent among pregnant women, and the necessity for an individualized diagnostic and therapeutic approach represent significant challenges for contemporary medicine. Discrepancies in therapeutic options proposed among centers within the same region lead to the conclusion that there is a need for centralization and unification of evidence-based management in referral centers with both high-level oncological and perinatal care.
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Randomized Controlled Trial
Post-Lunch Napping as a Strategy to Enhance Physiological Performance and Cognitive Function in Elite Volleyball Players.
Background and Objectives: Volleyball demands high levels of anaerobic strength, flexibility, agility, and mental focus. Adequate sleep has been shown to enhance athletic performance and cognitive function. This study investigates the impact of post-lunch naps of varying durations (25 and 45 min) on the physiological performance and cognitive focus of elite volleyball players. ⋯ Conclusions: Post-lunch naps, especially of 25 or 45 min, enhance both physiological and cognitive performance in elite volleyball players. These findings suggest that integrating short naps into athletes' training regimens can improve performance and focus, with potential gender-specific benefits. Further research is needed to explore long-term effects and variations across other sports.