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Primary and secondary antibody deficiencies (PAD and SAD) are amongst the most prevalent immunodeficiency syndromes, often necessitating long-term immune globulin replacement therapy (IRT). Both intravenous immunoglobulin (IVIG) and subcutaneous immunoglobulin (SCIG) have demonstrated efficacy in antibody deficiency. Comparative analyses of these two routes of administration are limited to nurse-administered IVIG and home therapy with self-administered SCIG. A third programmatic approach, SCIG administered by nurses in hospital-based outpatient infusion clinics, combines certain advantages of IVIG and home SCIG such as the provision of nursing support and the reduced risk of systemic reactions associated with the subcutaneous route. This cross-sectional study aimed to compare the viability and resource utilization of nurse-administered SCIG with IVIG in patients with antibody deficiency. We hypothesized that nurse-administered SCIG would require a similar amount of infusion clinic time per month as IVIG, despite more frequent dosing, due to shorter individual appointments, while maintaining high patient satisfaction. Information on infusion duration, time in the infusion chair, direct nursing time, and treatment satisfaction using the Life Quality Index was collected. Time measures for each patient were expressed as minutes/4 weeks to account for the more frequent dosing of nurse-administered SCIG compared to IVIG. We determined that the total time, infusion time, and nursing time needed to provide nurse-administered SCIG was comparable to IVIG. The more frequent dosing of SCIG was offset by the shorter times required per infusion. Patients reported favorable treatment satisfaction with both nurse-administered SCIG and IVIG. We conclude that nurse-administered SCIG may be a useful treatment modality for well-selected individuals. [ABSTRACT FROM AUTHOR]

Purpose: Understanding patient experience is crucial for advancing patient-centered care and improving hospital service quality. This study aimed to design and validate a Persian version of a patient experience assessment questionnaire to evaluate hospital services. Methods: This descriptive-analytical study on tool development was conducted cross-sectionally during 2021–2022 in Iran. The study consisted of two stages: (1) In the first stage, a deductive approach and comprehensive literature review were employed to develop the initial questionnaire items, based on the framework from prior research titled "Developing a Model for Evaluating Patient Experience in Teaching Hospitals in Iran." (2) In the second stage, validation was carried out by assessing face validity, content validity (using expert panels to evaluate the Content Validity Index (CVI) and Content Validity Ratio (CVR)), and construct validity through confirmatory factor analysis. Sampling for the face validity stage included 30 randomly selected patients, while construct validity was assessed with a sample of 340 participants, of which 300 provided complete and valid data. Reliability was determined using internal consistency (Cronbach's alpha) and stability (intra-cluster correlation coefficient) measures. Results: The initial questionnaire comprised 44 items. Following expert reviews and validation processes, 10 items were removed, resulting in a final version with 33 items. The confirmatory factor analysis confirmed the five-dimensional structure, with a Cronbach's alpha of 0.97 and an intra-cluster correlation coefficient of 0.89, indicating strong internal consistency and reliability. Conclusion: This study successfully developed and validated a 33-item questionnaire for assessing patient experience in Iranian hospitals, ensuring cultural relevance and robust psychometric properties. [ABSTRACT FROM AUTHOR]

Background: Thyroid nodules are common, and fine needle aspiration biopsy (FNAB) is essential for diagnosis and treatment. Patients' service needs are rarely addressed and discussed. This study was to analyze the nursing service needs of patients undergoing outpatient thyroid FNAB. Methods: Using the Delphi method, indicators of nursing service needs were established. A survey based on the Kano model was conducted from February to May 2024 to analyze service needs among patients undergoing thyroid FNAB. A quadrant analysis chart was used to visualize the impact of service characteristics on patient satisfaction. Results: Among the 32 service needs, 12 items were in the improved category, 10 items were in the advantage category, 9 items were in the reserved category, and 1 item was in the observation category. Conclusions: The Kano model effectively categorizes the service needs of outpatients undergoing thyroid FNAB, guiding healthcare providers to enhance patient satisfaction through optimized services. Trial registration: The registration number is ChiCTR2400080522, and the registration date is January 30, 2024. [ABSTRACT FROM AUTHOR]

Introduction: Spinal muscular atrophy is a rare genetic disease. Nusinersen and Risdiplam, recognized as disease-modifying therapies, were included in the National Reimbursement Drug List in 2022 and 2023, respectively, in China. Policies have been implemented to enhance a multi-level medical security system, particularly for rare diseases. This study explores the self-perceived burden and offers policy suggestions to improve China's social security for rare diseases. Methods: In our mixed study, we conducted 37 semi-structured online interviews and a quantitative survey with 3 adult SMA patients and 34 family members (primary caregivers) in collaboration with the Meier Advocacy and Support Center. The interviews explored self-perceived burdens in psychology, domestic relations, medical care, rehabilitation, and economy, analyzing mainly through thematic analysis and multiple linear regression. Results: Respondents reported significant psychological burdens mainly stemming from limited treatment access. The instability within these families was linked to inconsistent therapeutic schedules, the lack of development opportunities, and misunderstandings. Choices between institutional and home rehabilitation were influenced by economic conditions and symptom severity. After the inclusion of medications, six patients (16.2%) still had not received pharmacological treatment, and many of those who underwent treatment were dissatisfied with the outcomes. The high costs of rehabilitation, family labor loss, and an incomplete medical security system resulted in significant economic burdens. Respondents called for more effective medications and better patient support. Conclusion: Although the inclusion of medications in National Reimbursement Drug List has improved availability and affordability, families still experienced significant burdens across multiple domains. A broader focus on social security is needed to enhance the comprehensive development of patients with rare diseases. [ABSTRACT FROM AUTHOR]

Introduction: Office hysteroscopy (OH) offers a "see and treat" strategy, enabling most gynecological conditions to be addressed outside the operating room without anesthesia. Despite its convenience, the associated pain and stress remain significant barriers to its widespread success among women. Both pharmacological and non-pharmacological interventions have been explored to mitigate these challenges, albeit with mixed outcomes. Methods: This study aimed to evaluate the effectiveness of virtual reality (VR) in reducing pain and stress associated with OH using objective measurements. Results: Our findings indicate that VR significantly reduced pain during OH compared to the control group (−1.08, 95%CI; −1.93–0.23, on the Visual Analogue Scale (VAS), p = 0.013) and 10 min post-procedure (−1.24, 95%CI; −1.99–0.48, p = 0.001), without significant effects on stress-related variables. Stratified analyses further revealed that the efficacy of VR in pain reduction is influenced by individual patient characteristics, with greater effectiveness observed in women with lower baseline stress, premenopausal status and a history of childbirth, regardless of vaginal delivery. Conclusions: VR represents a promising strategy for managing OH-associated pain, with its effectiveness largely depending on patient-specific variables. [ABSTRACT FROM AUTHOR]

Aim: The objective of this research was to compare two methods of conscious sedation (midazolam vs. sevoflurane) used for performing oral surgical procedures in the older adult population by analyzing dental treatment-related anxiety levels, the quality of sedation, and potential hemodynamic changes during the interventions, as well as post-recovery symptoms and patient satisfaction levels. Methods: A total of 104 patients underwent oral surgery with intravenous (age: 84.00 ± 8.410; 17 men and 36 women) and inhalation conscious sedation (age: 82.73 ± 8.809; 18 men and 33 women). Anxiety levels were recorded using the Modified Corah Dental Anxiety Scale (MDAS) and the Hamilton Anxiety Rating Scale (HARS). During the intervention, the heart rate, systolic/diastolic blood pressure, oxygen saturation, episodes of hypoxia (<90%SpO2), sedation duration, and Sedation–Agitation Scale (SAS) values were monitored. Upon completion of their treatment, all patients completed three questionnaires which evaluated their recall of the intervention, postoperative symptoms, and recommendation of the sedation method used. Results: Anxiety levels were slightly higher in the midazolam group (MDAS score: 9.60 ± 5.849; HARS score: 27.19 ± 6.802) compared to the sevoflurane group (MDAS score: 8.37 ± 5.063; HARS score: 24.92 ± 5.199), with no statistical significance (MDAS, p = 0.453/HARS, p = 0.065). No significant differences in the analyzed hemodynamic parameters were observed between the two groups. However, SAS values were significantly higher in the sevoflurane group (p = 0.006), while the sedation duration was longer in the midazolam group (p = 0.000). Postoperative symptoms, particularly gastrointestinal disturbances and dry mouth, were significantly more prevalent in the midazolam group, while there were no differences in neurological symptoms between the two groups. The majority of patients expressed a preference for either of these sedation methods. Conclusions: Sedation with agents such as midazolam and sevoflurane appears to be quite safe, given the absence of relevant hemodynamic changes. Midazolam has been shown to be effective for a longer duration, as well as to have a lower risk of developing greater digestive problems during the postoperative period. On the contrary, sevoflurane produced a greater sensation of dry mouth. Both sedative agents are perceived by the older adult population as satisfactory, recommending their use. [ABSTRACT FROM AUTHOR]

Aims: Intra-articular (IA) injection therapy, particularly IA hyaluronic acid (HA), is a common treatment for knee osteoarthritis, but it does have limitations. The injection of IA polynucleotide (PN) has emerged as an alternative, potentially offering superior clinical outcomes. This study investigates current practice patterns and the perceived effectiveness of PN among clinicians for treating knee osteoarthritis in the Republic of Korea. Methods: Based on a survey conducted among clinicians who use PN in clinical practice, we explored the current practices and assessed the perceived effectiveness of IA PN in treating knee osteoarthritis. Results: A total of 265 clinicians who used IA PN for knee osteoarthritis participated in the survey. Most clinicians (73.3%) used PN therapy for the treatment of chronic pain, with varying administration frequencies. In addition, 25.8% of clinicians used PN for the treatment of acute flare-ups. In cases of knee effusion, 55.5% of clinicians removed the effusion prior to administering PN. Clinicians rated PN as more effective than HA for both chronic pain and acute flare-ups, with higher scores for cushioning, anti-inflammatory effects, and delaying joint degeneration. The clinicians stated that patients expressed a higher satisfaction with IA PN compared with IA HA, noting improvement in joint smoothness, noise reduction, pain relief, and a reduction in heat sensation and swelling. Conclusions: The results of the present study highlight the extensive use and perceived benefits among clinicians of IA PN for knee osteoarthritis in the Republic of Korea. Further research is warranted to explore the effectiveness of PN in acute flare-ups and to validate these findings in broader populations. [ABSTRACT FROM AUTHOR]

Background: Post-COVID-19 syndrome affects 10–60% of SARS-CoV-2 survivors. While conventional treatments show limited efficacy, emerging evidence suggests the potential benefits of balneotherapy in managing persistent symptoms. We aimed to systematically evaluate the efficacy and safety of balneotherapy and thermal treatment interventions in treating post-COVID-19 syndrome. Methods: We conducted a systematic review following PRISMA guidelines, searching major databases through 31 January 2024. Eligible studies included randomized controlled trials, observational studies, and pilot studies investigating thermal spa treatments for adult post-COVID-19 patients. Results: Analysis of six eligible studies (n = 617) demonstrated significant therapeutic benefits. The largest cohort (n = 159) showed 47% reduction in fatigue and 48% reduction in muscle pain (p < 0.01). Comprehensive spa therapy achieved complete symptom resolution in one-third of the participants. Combined spa-ubiquinol therapy improved metabolic function (p < 0.05). All interventions demonstrated favorable safety profiles. Conclusions: Preliminary evidence suggests balneotherapy effectively ameliorates multiple post-COVID-19 symptoms, particularly fatigue, muscle pain, and exercise intolerance. While safety profiles appear favorable, larger randomized controlled trials with standardized protocols are needed to establish definitive therapeutic recommendations. [ABSTRACT FROM AUTHOR]

Featured Application: Phygital solutions for automation of healthcare processes. Emergency department (ED) overcrowding and limited staff availability pose ongoing challenges to healthcare efficiency. Recent advancements in automated health technologies, such as the health pod, aim to alleviate these pressures by automating vital sign measurements for low-risk patients. Over three months, the CAPSULA Health Pod was implemented and used in a paired setting with normal triage procedures in an urban hospital ED; it demonstrated improvements in triage efficiency and patient satisfaction, aligning with evidence that supports automation as a solution in high-demand healthcare settings. With 1342 assessments across 404 patients, despite some challenges with elderly patient engagement, CAPSULA achieved excellent measurement accuracy and relevant efficiency for the first assessment of patients in crowded situations and for reassessment. The findings indicate CAPSULA's potential to reduce patient wait times, improve workflow efficiency, and support resource-limited EDs. Although the main limitation remains IT integration, the system demonstrates scalability and potential for broader adoption. [ABSTRACT FROM AUTHOR]

Background: Small conjunctival incision size is desirable in strabismus surgery under topical anesthesia. Objective: To study the feasibility and tolerability of a small bulbar conjunctival incision (SB). Design: Non-randomized feasibility pilot study. Methods: After applying a 5-0 PGA (polyglycolic acid) traction suture, we did a 3–4 mm single conjunctival incision posterior and parallel to the rectus muscle insertion. A hang-back recession was done (6-0 PGA suture), and the conjunctiva closed (8-0 PGA suture). The outcome measures were feasibility, tolerability, and motor result. Results: Twenty-five patients were included. The median pain scale score was 3/10, and the satisfaction Net Promoter Score was 72. Mean duration of a recession was 12 min (range: 9–14 min). Mean duration of inflammatory signs and hemorrhage were 2.2 days (95% CI, 1.4–2.9), and 8.5 days (95% CI, 7.1–9.9), respectively. Distance deviation at 2 months was 3.1 Prism Diopters (95% CI, 1.5–4.5). Conclusion: SB is feasible and well tolerated for extraocular rectus muscle surgery. [ABSTRACT FROM AUTHOR]

Interventional radiology (IR) has evolved rapidly, but the clinical integration of interventional radiologists has not kept pace with technical advancements. This trial will address a gap in the literature by providing a robust investigation into specific measures for enhancing the clinical role of interventional radiologists, with potential implications for improving patient experiences and outcomes. The single-center randomized controlled trial will include 428 patients undergoing IR procedures. The control group will receive information about the procedure from the ordering physician, while the experimental group will have an additional consultation with an interventional radiologist and be shown procedure-specific explanatory videos. The primary outcomes are patients' knowledge, satisfaction with the information and communication, and anxiety. Data collection will involve specific questionnaires and scales. This trial is designed to investigate the importance of proactive clinical roles in patient care within IR. The study explores the potential of consultations and audiovisual tools, highlighting their role in educating patients about procedures. The results may help foster a more widespread acceptance of clinical responsibilities in IR and underscore the pivotal role of audiovisual aids in patient education and satisfaction. Trial registration: NCT05461482 at clinicaltrials.gov. Relevance statement: This randomized controlled trial will assess the impact of clinical consultations and explanatory audiovisual tools on patient understanding, satisfaction, and anxiety in interventional radiology. The findings could help establish a more proactive clinical role for interventional radiologists and improve the overall quality of patient-centered care. Key Points: We describe the protocol of an interventional radiology randomized clinical trial. The control group will receive procedure information from the referring physician and the experimental group receives additional consultation with interventionalists and views a video. Knowledge, satisfaction with information, and patient anxiety will be evaluated. This study will provide insights about the benefits of consultations and videos in interventional radiology. [ABSTRACT FROM AUTHOR]

Background: Tele-robotic ultrasound (US) is a novel technique that might help overcome the current shortage of radiologists and poor access to radiologists and/or sonographers in remote or rural areas. Despite the promising results of this technology in the past two decades, there is still insufficient data about its advantages and limits, as well as the implementation in routine clinical practice and the learning curve for the user. The purpose of this prospective cohort-based study is to evaluate the performance of a 5G-based tele-robotic US system for abdominal and thyroid gland assessment in a cohort of healthy volunteers and outpatients, as well as assessing the learning curve and patient satisfaction. Results: 64 participants (23 male, 41 female) were consecutively included during the recruitment period, for a total of 51 abdominal and 37 thyroid gland US studies. The mean age was 45.23 ± 18.90 years old, and the body mass index of the abdominal cohort was 22.97 ± 2.95 kg/m2. The learning curve estimated a minimum of 20 patients for abdominal tele-robotic US training, being almost non-existent in the thyroid gland cohort. All the variables showed no-statistical differences between standard US and tele-robotic US in the abdominal post-trained cohort except the visualization of the left kidney short axis and its interpolar length. Thyroid gland variables showed no statistical differences. The mean time of exploration for the tele-robotic US for abdomen and thyroid gland examinations were 18.33 ± 6.26 min and 4.64 ± 0.97 min respectively. Most participants (> 70%) felt comfortable and safe while being examined by the tele-robotic US. Conclusion: Tele-robotic US achieves equal performance in comparison with the standard US when evaluating abdominal structures in this cohort of patients, as well as a relatively fast learning curve and good patient satisfaction. The performance when assessing the thyroid gland is almost identical to the standard US, which makes it a strong first candidate for a future clinical implementation. [ABSTRACT FROM AUTHOR]

Background: Total laparoscopic hysterectomy (TLH) is nowadays the standard to treat benign and malignant disease occurring in the uterus, but the number of robotic-assisted surgeries is increasing worldwide. To facilitate the handling of sutures in a bi- and tri-dimensional plane, a new type of suture material has been developed, named barbed sutures, which are in use in different indications. In comparison to conventional suture materials, the barbs anchor the suture in the tissue, provide tissue approximation and prevent slippage without the need for knot tying. Several meta-analyses and systematic reviews have shown that they are safe and efficient. The current study investigates the clinical outcome of a novel unidirectional mid-term absorbable barbed suture which differs in its configuration from other barbed sutures. The collected data will be prospectively compared to the results of a competitor's unidirectional mid-term absorbable barbed suture and retrospectively to the findings reported for conventional sutures after hysterectomy in the literature. Methods: An international, randomised, multicentric, single-blinded design was chosen. A total of 132 patients will be included receiving randomly either the novel unidirectional barbed suture versus the competitor unidirectional barbed suture in a 3:1 ratio. Both suture materials will be applied to close the vaginal cuff after laparoscopic hysterectomy and the time for suturing is the primary endpoint. As secondary objectives, the following parameters will be collected and compared in both suture groups: intraoperative handling of the suture material, quality of life using the Female Sexual Function Index (FSFI), patient satisfaction, pain, and complications occurring in the short-term and long-term follow-up. For each patient, the study lasts 6 months after surgery. Discussion: This study will assess the clinical performance of a novel unidirectional mid-term absorbable barbed suture material for the first time in gynaecology surgery and, to our knowledge, it will be the second largest RCT performed so far in total laparoscopic hysterectomy using unidirectional mid-term absorbable barbed suture materials. Trial registration: The study was prospectively registered before the enrolment of the first patient. Registration was performed under www.clinicaltrials.gov, NCT 06024109. Registered on 15 August, 2023. [ABSTRACT FROM AUTHOR]

Background: To investigate the impact of central corneal astigmatism on postoperative visual outcomes in patients with trifocal intraocular lens (IOL) implantation. Methods: This retrospective study included 278 eyes of 278 patients who underwent uneventful cataract surgery with implantation of the trifocal IOL (AT LISA tri 839MP). Patients were divided into two groups according to the total corneal refractive power (TCRP) in 3 mm zone centered on the corneal apex: low astigmatism group, TCRP ≤ 0.75 diopter (D); high astigmatism group, TCRP > 0.75D. Postoperative evaluations were conducted at 3 months after surgery, including visual acuity, defocus curves, contrast sensitivity (CS), and objective and subjective visual quality. Results: The low astigmatism group exhibited significantly better uncorrected near and intermediate visual acuity than the high astigmatism group (both P < 0.05). Significantly higher percentages of eyes in the low astigmatism group achieved uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) of 0.00 logMAR or better compared to the high astigmatism group (UDVA: 67% vs. 54%, CDVA: 76% vs. 64%, both P < 0.05). Defocus curves revealed that the low astigmatism group showed better visual acuity at defocus levels of + 0.5D, 0D, -0.5D, -3.0D, and − 3.5D than the high astigmatism group (all P < 0.05). Moreover, the high astigmatism group showed significantly poorer CS, greater higher-order aberrations, and more symptoms of blurred vision and diplopia. Percentages of spectacle independence and patient satisfaction did not differ between groups. Conclusions: In eyes with central corneal astigmatism above 0.75D, suboptimal postoperative visual outcomes may be obtained after trifocal IOL implantation. [ABSTRACT FROM AUTHOR]

Significance: Cataract surgery is one of the most performed surgical procedures worldwide. As a potential complication following cataract surgery, dry eye has the potential to impact visual outcomes, lower patient satisfaction, and be detrimental to quality of life. Purpose: To evaluate the effect of cataract surgery on dry eye outcomes postoperatively. Methods: We searched Ovid MEDLINE and Embase from 01/01/2010 to 16/08/2021 and included observational studies of participants ≥ 18 years old undergoing any cataract surgical procedure. We compared postoperative dry eye outcomes with baseline including Ocular Surface Disease Index (OSDI), tear break up time (TBUT), Schirmer's I test (ST1), and corneal fluorescein staining (CFS) at short-term (< 1 week) and medium-term (≥ 1 week to 3 months) follow-up. Results: Our search yielded 11,133 records. After title and abstract, and then full text screening, we included 20 studies with 1,694 eyes. There was some evidence indicating a decrease in the TBUT during the short-term (within 1 week) and medium-term (1 week up to 3 months) periods following cataract surgery. There was a considerable degree of heterogeneity between studies across other outcomes. At medium-term follow-up most studies that reported ST1 and CFS showed deterioration of these outcomes but there was conflicting evidence of the effect of cataract surgery on OSDI. The review is limited by variability in follow-up timeframes which were unable capture potential clinical course like peak occurrence and duration. Conclusion: Dry eye may persist up to three months postoperatively following cataract surgery. Further studies are required to determine if dry eye outcomes return to baseline at longer term follow-up. [ABSTRACT FROM AUTHOR]

Background: The incidence of osteoporosis in children has increased dramatically during the last decade. This has been attributed to better survival rates of children living with chronic disorders, the increased use of medications known to have a negative impact on the children's bones, and the increased preference for indoor activities and sedentary life in healthy children. Recent advances in pediatric osteoporosis definition, along with a lack of management recommendations or national consensus on its diagnosis and treatment, have led to a wide range of approaches being implemented to manage this illness. The aim of this work was to develop an optimal evidence-based consensus, target-oriented, on-steered therapeutic approach for children with osteoporosis. Based on 15 key clinical questions, a qualitative literature evaluation was conducted to provide evidence-based recommendations for the treatment of pediatric osteoporosis. An expert panel of 14 pediatric osteoporosis specialists conducted a Delphi survey. The level of evidence for each element was assessed using the Oxford Centre for Evidence-based Medicine (CEBM) System, when available, and/or based on the expert panel's personal experience. All recommendations with an agreement rate of 75% or higher were included. Results: Thirty-six recommendations, categorized into 13 domains, had evidence 4 or 5 and consequently were included in the Delphi survey. This was assessed online and a response rate of 82.4% was achieved. Delphi 2 round revealed that all the recommendations achieved 75% or more level of agreement and therefore have been accepted and included in this management recommendations. Based on that an algorithm showing an approach to pediatric osteoporosis management and maintenance of therapy has been developed. Conclusion: For the management of children with osteoporosis, consulting a pediatric bone specialist is strongly advised, either by referral or by advice. This is extremely relevant because children are uniquely capable of recovering spontaneously or with the assistance of medication. This includes also vertebral fractures reshaping. Consequently, there is a huge opportunity to improve bone mass accretion and thus musculoskeletal health in children with osteoporosis. [ABSTRACT FROM AUTHOR]

Burn scars present psychological and social challenges for patients, classified into atrophic and hypertrophic types. Treatments like corticosteroid injections, laser therapy, and platelet-rich plasma (PRP) injections are commonly recommended for hypertrophic scars, while regenerative medicine and fractional CO2 lasers are linked to some degree of improvement for atrophic scars. Hypopigmented and depigmented burn scars pose ongoing challenges for healthcare providers and patients, with therapies such as intense pulsed light and fractional CO2 laser showing variable effects in treating these conditions. This study evaluates the effectiveness of latanoprost, a prostaglandin analog, in combination with fractional CO2 laser for repigmentation of hypopigmented burn scar lesions. During the study, patients were treated with 0.005% latanoprost eye drop or normal saline twice a day for 6 months and underwent six monthly fractional CO2 laser sessions. Treatment instructions were provided by the physician, and patients were instructed to report any complications and avoid using other medications in the treatment area. Assessments included photography at the start of the study and in three follow-up sessions at three-month intervals. Improvement was assessed using the Subject Global Aesthetic Improvement Scale (SGAIS) by both the physician and patients. Patient satisfaction was evaluated using a Grade scale, and side effects were monitored in all follow-up sessions. In the third follow-up session, physicians assessing the Subject Global Aesthetic Improvement Scale (SGAIS) observed that a higher proportion (85.7%) of cases in the fractional CO2 laser with latanoprost group achieved a grade of 4 (50–74% improvement). In the placebo group, 0% of patients achieved grade 4, and 71.4% were classified as grade 2 (0–24% improvement), indicating a significant difference (P-value: 0.0001). Patient satisfaction, measured by the "Grade scale to evaluate patient satisfaction" index, revealed a notable contrast between the two groups, with average satisfaction scores of 8.50 ± 0.65 and 4.64 ± 1.00 for the fractional CO2 laser with latanoprost and placebo groups, respectively, indicating a statistically significant difference (P = 0.0001). Furthermore, throughout the study, no severe side effects were reported by any of the patients. Prostaglandin analogs, particularly latanoprost, have proven to be effective in promoting repigmentation of hypopigmented and depigmented burn scar lesions. When this topical medication is combined with fractional CO2 laser treatment, it enhances the laser's efficacy and overall effectiveness in treating the lesions. This combination is crucial for improving hypopigmented scar treatment by enhancing both the laser's effectiveness in scar improvement and the delivery of latanoprost through the laser. What is already known about this topic?: Hypopigmented burn scars are one of the manifestations of burns that are resistant to treatment. These scars not only cause discomfort for patients but also present a treatment challenge for physicians. In previous studies, latanoprost and bimatoprost, analogs of prostaglandin PGF2a, showed effectiveness in repigmenting vitiligo lesions. However, no study has examined the role of these topical drugs in treating hypopigmented and depigmented burn scars. What does this study add?: The fractional CO2 laser caused significant repigmentation in hypopigmented lesions of burn scars. 64.3% of the patients who received this intervention showed grade 2 improvement (0-24% improvement), 7.1% showed grade 3 improvement (25-49% improvement), and 28.6% showed no improvement (grade 1) in the third follow-up session based on the SGAIS criteria as evaluated by the patients. The combination of CO2 fractional laser and latanoprost caused significant repigmentation in hypopigmented burn scar lesions. 85.7% of patients showed grade 4 improvement (50-74% improvement), and 14.3% showed grade 3 improvement (25-49% improvement) and 0% showed no improvement (grade 1) in the third follow-up session based on the SGAIS criteria as evaluated by the patients. The combination of CO2 fractional laser and latanoprost was significantly more effective than CO2 fractional laser alone based on the SGAIS criteria, as evaluated by physicians and patients in all three follow-up sessions. Additionally, the satisfaction of the patients in the combined treatment group was significantly higher than that of the CO2 fractional laser treatment group. [ABSTRACT FROM AUTHOR]

Androgenic alopecia (AGA) is the most common form of non-scarring hair loss, characterized by marked hair follicle miniaturization. AGA is a challenging skin condition with limited treatment results. Laser light can promote hair growth at specific wavelengths. The efficacy of fractional CO2 laser in scalp AGA treatment was reported in a few studies. We aimed to compare the efficacy of fractional CO2 laser alone versus the combination of fractional CO2 laser with topical dutasteride in the treatment of male AGA. 30 male patients with AGA were enrolled in the study; they were divided into two groups. All patients received three sessions of ablative fractional CO2 laser one month apart on the scalp, where group (I) patients were subjected to laser sessions only, and group (II) patients were subjected to topical dutasteride, first immediately after each session and secondly fifteen days after each session. The evaluation was done according to dermoscopy (DermLite® DL4) and photographic assessment. Patient satisfaction and side effects were reported. According to the global photo assessment, the combination of fractional CO2 laser with topical dutasteride showed a statistically significant improvement compared to the fractional CO2 laser alone group. The combination of fractional CO2 laser with topical dutasteride is more efficient in improving male androgenic alopecia than fractional CO2 laser alone according to the investigator's global assessment. There was a significant improvement in all dermoscopic parameters in both groups. [ABSTRACT FROM AUTHOR]

Background: Persistent scarring, which significantly affects quality of life, is highly prevalent among acne patients, with some estimates reaching as high as 95%. The fractional ablative laser is a well-established technology for scar management, with numerous recent studies focusing on improving outcomes and reducing adverse effects. Latin Americans' skin types represent a challenge due to the risk of postinflammatory hyperpigmentation (PIH). This retrospective data collection presents findings from acne scarstreated with melanogenesis inhibitors before and after treatment, the post-treatment satisfaction level, and the complication rate in the Argentinian skin population treated with a fractional carbon dioxide (CO2) laser device. Methods: Data from adolescents and adults with facial acne scars treated with a fractional CO2 laser with two different handpieces, higher parameters, and several passes between April 2010 and April 2024 were retrospectively analyzed. Tranexamic acid 5% with glycolic acid 10% cream was indicated 1 month before and 3 to 6 months after treatment for patients with Fitzpatrick III to V. The primary endpoint was the baseline change in qualitative Goodman and Baron (GB) acne scores. The secondary endpoints included the general aesthetic improvement scale (GAIS) score and patient satisfaction score, both of which are measured on a 5-point scale (1 [low] to 5 [high]). Additionally, several factors were evaluated as potential predictors. The occurrence and frequency of adverse events (AEs) were monitored for safety assessment. Results: Forty-one patients, 25 males and 19 females, with an average age of 30 y.o. (16 youngest y.o., 56 oldest y.o.) were treated and included in this study. Following treatment, 81% of patients (33 patients) presented a reduction in GB score which was significantly different from baseline value (Wilcoxon signed-ranke test,, p < 0.001). The mean patient satisfaction score was 4.09, and the mean GAIS score was 3.95. No statistically significant relationships were found between any potential predictive factors and outcomes. Nearly 70% of patients (28) did not experience any AEs. The remaining patients experienced temporary and anticipated postinflammatory hyperpigmentation (PIH) and erythema. No scars or permanent side effects resulting from laser treatment were observed. Conclusions: This study demonstrated the high level of satisfaction, safety, and efficacy of fractional CO2 laser with relative high parameters and several passes associated with two different handpieces for treating acne scars over Argentinien skin types with only one or two sessions, including those with relatively high Fitzpatrick skin types, and the importance of using pre- and posttreatment melanogenesis inhibitors to prevent and treat PIH. Level of evidence: Level IV, Risk / Prognostic Study. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic radical gastrectomy has been reported to be associated with substantial trauma and pain. This study compared the impact of ultrasound-(US)-guided, bilateral, double-injection intertransverse process block (ITPB) on postoperative analgesia with subcostal transversus abdominis plane block (TAPB) in patients who were undergoing laparoscopic radical gastrectomy. Methods: Sixty-two patients who were undergoing laparoscopic radical gastrectomy surgery under general anesthesia were included. These patients were randomized to either the ITPB group or the TAPB group. Patients in the ITPB group received a double-shot US-guided bilateral ITPB at the thoracic level T6/7 and T9/10 level using ropivacaine (0.3%, 15 mL). Patients in the TAPB group received bilateral subcostal TAPB one injection per side using ropivacaine (0.3%, 30 mL). All patients used a BIS-guided combined intravenous and inhalation anesthesia. The primary outcome was defined as postoperative morphine-equivalent consumption during the first 24 h. Results: The study recruited 62 patients (31 in each group) for the analysis. A comparatively less postoperative opioid consumption was observed in the ITPB group compared with the subcostal TAPB group within the first 24 h postoperatively (mean [standard deviation-(SD)] morphine-equivalent dose): 27.8 (5.7) mg vs 31.2 (4.4) mg, P < 0.001. The ITPB group showed lower intraoperative opioid use, and statistical significantly lower scores at rest and coughing at 6, 24 h postoperatively. The time to first requiring rescue analgesia was longer in the ITPB group than the subcostal TAPB group (median [IQR]): 8.0 [8.0] vs 6.0 [6.0] h, P = 0.009. The patients in the ITPB group exhibited earlier independent movement, lower incidence of postoperative complications and higher levels of satisfaction (P = 0.021). Conclusion: This study showed that the double-shot bilateral ITPB could reduce opioids consumption and achieve longer and better pain relief. Additionally, it promoted early postoperative activity and improved patient satisfaction. Trial registration: ChiCTR2300072986. Registered 29 June 2023. [ABSTRACT FROM AUTHOR]

Background: Various analgesic techniques have been applied, the pain after video assisted thoracic surgery (VATS) is still challenging for anesthesiologists. Paracetamol provide analgesic efficacy in many surgeries. However, clinical evidence in the lung surgery with regional block remain limited. This monocentric double-blind randomized controlled trial investigates the efficacy of paracetamol after VATS with regional block. Methods: A total of 90 patients were randomized to receive paracetamol (1 g) or normal saline. Erector Spinae Plane Block and Intercostal Nerve block were applied during the surgery. The Visual Analogue Scales (VAS) pain score was measured in the PACU as well as 6, 12, 24, and 48 h postoperatively. And the total dose of rescue analgesics administered to patients in morphine milligram equivalents (MME), satisfaction score, length of hospital stays, and incidence of nausea and vomiting were also recorded. Results: The VAS pain score at each time point, the primary endpoint, did not differ between the groups (3.09 ± 2.14 vs. 2.53 ± 1.67, p = 0.174 at PACU; 4.56 ± 2.80 vs. 4.06 ± 2.46, p = 0.368 at 6 h; 3.07 ± 1.98 vs. 3.44 ± 2.48, p = 0.427 at 12 h; 2.10 ± 2.00 vs. 2.49 ± 2.07, p = 0.368 at 24 h; and 1.93 ± 1.76 vs. 2.39 ± 1.97, p = 0.251 at 48 h postoperatively). Satisfaction scores (4.37 ± 0.76 vs. 4.14 ± 0.88, p = 0.201), nausea (35.6% vs. 37.8%, p = 0.827), hypotension (2.2% vs. 0.0%, p = 0.317), and bradycardia (6.7% vs. 2.2%, p = 0.309) were also reported at similar rates. Conclusions: The analgesic efficacy of one gram of paracetamol with ESPB and ICNB after VATS was not proven. Thus, caution should be exercised when prescribing paracetamol for pain control during VATS. Trial registration: this trial was registered on Clinical Research Information Service (CRIS), Republic of Korea (KCT0008710). Registration date: 17/08/2023. [ABSTRACT FROM AUTHOR]

Background: Extemporaneous compounding for dermatological use is an important therapeutic alternative for patients whose clinical needs are not met by approved drug products circulated in the market. Evaluating patients' perceptions and levels of satisfaction towards such services is an important factor for the adherence of patients and maintaining the quality of healthcare services. The current study aimed to assess patients' perception and level of satisfaction with the compounding service and extemporaneous preparations rendered at ALERT hospital. Methods: An institution-based cross-sectional study was conducted among patients receiving compounding pharmacy services at ALERT hospital, Addis Ababa, Ethiopia from 10th April to 10th May 2023. A consecutive sampling technique was used to recruit the study participants. Data were collected using an interviewer-administered structured questionnaire, entered into the EPI info, exported and analyzed using SPSS. Multivariate linear regression analysis was performed to determine possible predictors of patient satisfaction and p-value < 0.05 considered as statistically significant. Results: A total of 422 patients recruited and most were predominantly females (64.4%) and aged between 26 and 35 years (38.4%). Nearly 2/3rd had a previous history of compounded medicine use. Majority of the respondents strongly agreed with their satisfaction with price (51.4%), the adequacy of information provided (67.8%), the ease and smoothness of communication with staff (72.0%), and the politeness and supportiveness of staff (73.2%). However, 39.1% of participants disagreed towards the fairness of compounding service waiting time. The overall positive perception and satisfaction level of patients at ALERT hospital receiving the compounding service for their dermatological preparations were 84.41% and 78.57%, respectively. Conclusions: The patients' perception and satisfaction towards the compounding service at ALERT hospital indicated that the dermatological preparations and the services are optimal. Hence, health professionals and the hospital management should take further steps to improve service quality and enhance patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: Nipple reconstruction (NR) offers increased satisfaction among breast reconstruction patients. However, there is great variability in the way that post-NR outcomes and satisfaction are reported in literature, despite the advent of the standardized BREAST-Q. This poses significant difficulty in synthesizing findings across studies. Methods: A systematic review of literature assessing NR outcomes and satisfaction was conducted using PubMed, Web of Science, and Cochrane Library from 2010 to 2023 via PRISMA guidelines. Data was collected on methods of evaluating and reporting patient satisfaction and postoperative outcomes. Results: Among the 16 articles included, all discussed postoperative aesthetic outcomes of the nipple. Postoperative complications were discussed in 75%, though only 6.3% defined parameters for surgical complications. Patient-reported satisfaction was included in 87.5% of studies. When comparing the five NR satisfaction items included in BREAST-Q to the studies included, nipple height was addressed in all, overall look in 75%, shape in 43.8%, color in 25%, and natural appearance in 12.5%. However, 81.3% of studies also utilized measures of satisfaction that differed from those of BREAST-Q. Additionally, patient race was not reported in 93.8% of studies. Conclusions: A standardized method of reporting patient outcomes and satisfaction in NR is warranted via wider implementation of the NR component of BREAST-Q. Incorporating additional measures of NR satisfaction to BREAST-Q, like nipple position or size, would also improve surgeons' understanding of patient outcomes and satisfaction. Better characterization of demographics and race can also modify best practices to improve NR outcomes among specific populations. Level of evidence: Not gradable. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this web-based study is to analyze the attributes of bariatric surgery cases ensuing health implications. Additionally, the study seeks to delve into the factors influencing post-bariatric psychological evaluations and the impact of various bariatric surgeries on weight loss and psycho-social assessment scores for patients who had undergone bariatric surgeries within a specific bariatric surgery center in Egypt between January 2017 and January 2024. Methods: An analytical cross-sectional study recruited 411 adults who had undergone different bariatric procedures by the same surgical team. We collected the data using a validated self-administered questionnaire that included the Body Image Scale (BIS), the Rosenberg Self-Esteem Scale (RSES), the quality-of-life score (QOLS), and the modified General Patient Satisfaction Score after Bariatric Surgeries (GSABS). Results: The most commonly performed bariatric surgery was sleeve gastrectomy (SG), accounting for 82.7% of the procedures. The majority of the patients (78%) were female, with a mean age of 35.8. Among the participants, 32.4% reported experiencing complications, and 21.2% of those individuals were still experiencing complications at the time of assessment. The BIS had a mean score of 16.54 ± 6.27, indicating an average body image perception. The RSES yielded a mean score of 20.11 ± 4.63, indicating average self-esteem, while the GSABS had a mean score of 8.08 ± 2.39, indicating an overall average level of patient satisfaction. No statistically significant differences were found between the various types of bariatric surgeries in terms of total body weight loss percentage, excess body weight loss percentage, or the timing of the intervention. However, increased time intervals from surgeries noted a significant reduction in the BIS. Conclusion: The majority of patients who underwent SG and Roux-en-Y gastric bypass (RYGB) surgeries exhibited high GSABS scores. SG patients also had high BIS scores. However, all other interventions showed normal GSABS and BIS scores. All types of surgeries resulted in normal RSES and QOLS. Furthermore, the BIS score increases with the intervention's recentness, but it significantly decreases after the second-year post-surgery. Conversely, the older the timing of the intervention, the higher the RSES score after surgery. [ABSTRACT FROM AUTHOR]

In modern knee arthroplasty, surgeons increasingly aim for individualised implant selection based on data-driven decisions to improve patient satisfaction rates. The identification of an implant design that optimally fits to a patient's native kinematic patterns and functional requirements could provide a basis towards subject-specific phenotyping. The goal of this study was to achieve a first step towards identifying easily accessible and intuitive features that allow for discrimination between implant designs based on kinematic data. A squat-cycle was simulated on eight fresh frozen specimens mounted in a weight-bearing knee rig, each initially tested under native conditions, and then after implantation with four different implant types (CR/CS, MS, LS, and PS). The kinematic signals of these five configurations were compared to determine whether key differences between implants could be detected leveraging two methodological approaches: (1) statistical parametric mapping to directly compare waveforms and (2) simple paired t-tests to compare the three-dimensional coordinates of the functional centres of rotation determined using a previously published REference FRame Alignment Method (REFRAME). While statistical parametric mapping of the kinematic data revealed only small differences in certain comparisons (e.g. LS vs. PS, and MS vs. LS) under lenient statistical testing conditions, the application of REFRAME showed clear differences between implants (for all implant combinations except for CR/CS vs. LS), even under conservative statistical testing. Since for most implant combinations, significant differences in the centres of rotation were found using REFRAME, this approach could present a suitable tool for discriminating between the kinematics of different implant types. Preoperative assessment of joint kinematics, combined with this REFRAME application, could therefore provide a key approach for improved clinical selection of implant type. [ABSTRACT FROM AUTHOR]

ABSTRACT Background/Aim Materials and Methods Results Conclusion Studies on large cross‐arch bridges in patients with severe periodontitis show that such bridges can stabilize the periodontal condition. However, it is not known if these bridges will reduce long‐term tooth loss and what factors are important for their long‐term survival. The aim of the study was to study all patients with Stages III/IV periodontitis who received cross‐arch bridges for up 35 years in a private practice.All patients referred for periodontal treatment from 1986 who received cross‐arch bridges with observation period of minimum 7 years were assessed. All dropouts were accounted for.Ninety‐eight patients (1.7% of the patient population) with 111 bridges were observed (57 females and 37 males). Age at bridge construction was 55.4 years (SD = 7.1, range 39–79). Failure rate was 14.4% at 16.1 years (SD = 4.0 range 10–22). Reasons for failure were poor oral hygiene (p = 0.0093) and complications such as caries, endontics, porcelain fractures and gingival retractions during maintenance therapy (p = 0.0059). Fewer abutment teeth were lost from the bridges than teeth from the same and opposing arches (8.8% vs. 34.4% and 25.4%) (p < 0.0001).Cross‐arch bridges constructed for patients with Stages III and IV periodontitis were successful in terms of longevity, low failure rates, tooth preservation and patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: Indigenous peoples with substance use disorders (SUD) and intergenerational trauma (IGT) face complex healthcare needs. Therefore understanding Indigenous patient experiences is crucial for enhancing care delivery, fostering engagement, and achieving optimal outcomes, yet few studies explore the motivations for seeking, staying in, and utilizing treatment from an Indigenous perspective. The goal of this study was to understand the patient experience with an abstinence-based treatment model in a residential treatment setting. Methods: A qualitative thematic study was conducted between April 2018 and February 2020 at Benbowpka treatment centre in Blind River, Ontario, Canada. We evaluated the results of the abstinence-based model intervention from the patient's perspective. The Client Quality Assurance Survey tool was employed to gather this data. The data underwent thematic analysis to derive meaningful insights. Results: A total of 157 patients were interviewed. The results were categorized into three parts: (1) Critical events that encouraged participants to seeking treatment; (2) Benefits experienced by participants while they were in the program; (3) Participants take-aways and priorities after completing the program. Core themes emerged in each category and each theme is sub-categorized into quadrants of the Medicine Wheel. Firstly, there was a critical juncture that significantly impacted participants' lives that motivated them to seek treatment at the Benbowpka Treatment Centre. Second, during the study, participants admission to the Benbowopka Treatment Centre, the participants benefitted from a holistic program that addresses spiritual, physical, mental and emotional aspects of healing. Third, participants identified tangible ways in which they implement the skills they gained during the program in their daily lives. Overall, study demonstrates that clients benefitted from both the program activities and the traditional healing practices. Conclusion: This research identified that SUD Indigenous residential treatment programs need to include culture, healing practices, activities and relationships that are part of the treatment process. This study found that the cultural elements and healing practices of the program were highly valued by clients. [ABSTRACT FROM AUTHOR]

Background: Cryotherapy is a non-pharmacological option that complements drug therapy to achieve the most comprehensive multimodal analgesia. Various techniques are currently available, including the conventional gel cold pack, the cryo-cuff, and a novel mobile cold compression device (MCCD). This study aimed to evaluate and compare three cryotherapy techniques in terms of efficacy and patient satisfaction in patients undergoing total knee arthroplasty (TKA). Methods: This prospective randomized study included 108 patients who were scheduled for primary unilateral TKA. The patients were allocated to 3 groups for postoperative cryotherapy techniques: gel cold pack, cryo-cuff, and MCCD. Scores on the visual analog scale (VAS) for pain intensity, morphine consumption, knee range of motion (ROM), knee swelling, length of hospital stay, and patient satisfaction were collected. Results: Postoperative VAS scores showed a significant difference among the groups at 8 and 72 h after surgery (P = 0.002 and 0.026, respectively). At the earliest postoperative time point, post hoc analysis demonstrated that patients in the MCCD group had lower pain scores than those in the gel cold pack (P < 0.001) and the cryo-cuff group (P = 0.030). However, cryo-cuff reduced knee swelling significantly compared to gel cold pack (P = 0.028) and MCCD (P = 0.011) at postoperative 72 h. The total satisfaction score was 86.8, 82.8, and 89.1 with gel cold pack, cryo-cuff, and MCCD, respectively. Conclusions: Cryotherapy is an adjunct to post-TKA pain control at the surgical site. MCCD has shown superior efficacy in pain reduction during the earliest postoperative period, and achieved high patient satisfaction. Trial registration: This study was registered in the Thai Clinical Trials Registry database (no. TCTR20200517002). [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare different treatment modalities to correct ill-fitted maxillary complete denture either by the conventional relining method or by scanning the relining impression and digitally construct a new denture regarding patient satisfaction, denture retention, and adaptation. Materials and methods: Twelve edentulous patients suffering from loose maxillary complete dentures were selected, dentures' borders and fitting surfaces were prepared, and relining impressions were taken, the impressions were scanned and the STL files were used for CAD/CAM milling (computer aided designing/ computer aided manufacturing) of new maxillary dentures (Group A), then the relining impression went through the conventional laboratory steps to fabricate (Group B) maxillary dentures. Both groups were evaluated regarding patient satisfaction by a specially designed questionnaire, retention values were measured by a digital force gauge at denture insertion appointment and two weeks later, geomagic software was used to evaluate dentures adaptation to oral tissues. Results: Both groups (A and B) were completely satisfied with their dentures except regarding esthetics, all group A and 50% of group B were satisfied. Both groups showed a statistically significant increase in retention values at the two-week follow-up period compared to those at denture insertion time, with higher values were for group B. Finally, the relined dentures showed better oral tissue adaptation than digitally constructed dentures. Conclusion: Relined maxillary dentures showed better retention, esthetics, and denture adaptation with lower cost than digitally constructed maxillary dentures which showed acceptable retention and adaptation, with better time and data saving. Trial registration: Clinical trials number: NCT06366321. With registration date on ClinicalTrials.gov public website: 13/ 4/ 2024. [ABSTRACT FROM AUTHOR]

Background: Comprehensive "senior-friendly hospital" (SFH)-programs have been developed to counteract negative health outcomes in hospitalized older adults. The aim of this narrative review was to provide an overview of published SFH-programs and their elements and to summarize evidence of their effect on quality of care and patient satisfaction. Summary: A search of the databases Pubmed/Medline from inception to July 2023 and of governmental, regional, and hospital websites was performed. Programs were earmarked as SFH-programs if they primarily focused on the hospital setting, and comprised a hospital wide, multilevel approach and consisted of multiple elements. Articles and reports were included if participants were hospitalized and aged 60 years and older, and described the effect on quality of care or patient satisfaction. Articles focusing on specific patient groups or wards or on a health system or network were excluded. Ten SFH-programs were identified, with mutual elements like "organizational support," "social climate and services," "processes of care," and "physical environment." Only for the "Acute Care for Elders" program (USA), evidence was found showing positive effects on functional abilities, falls, delirium, length of stay, and patient satisfaction; effectiveness of other SFH-programs could not be found. Key Message: Elements of SFH-programs may improve care for hospitalized older adults, but the evidence of their effectiveness is scarce. Background: Comprehensive "senior-friendly hospital" (SFH)-programs have been developed to counteract negative health outcomes in hospitalized older adults. The aim of this narrative review was to provide an overview of published SFH-programs and their elements and to summarize evidence of their effect on quality of care and patient satisfaction. Summary: A search of the databases Pubmed/Medline from inception to July 2023 and of governmental, regional, and hospital websites was performed. Programs were earmarked as SFH-programs if they primarily focused on the hospital setting, and comprised a hospital wide, multilevel approach and consisted of multiple elements. Articles and reports were included if participants were hospitalized and aged 60 years and older, and described the effect on quality of care or patient satisfaction. Articles focusing on specific patient groups or wards or on a health system or network were excluded. Ten SFH-programs were identified, with mutual elements like "organizational support," "social climate and services," "processes of care," and "physical environment." Only for the "Acute Care for Elders" program (USA), evidence was found showing positive effects on functional abilities, falls, delirium, length of stay, and patient satisfaction; effectiveness of other SFH-programs could not be found. Key Message: Elements of SFH-programs may improve care for hospitalized older adults, but the evidence of their effectiveness is scarce. [ABSTRACT FROM AUTHOR]

This narrative review examines the evolving role of opioids in managing procedural and surgical pain in pediatric oncology patients. The review evaluates studies on opioid use across various oncological surgeries including thoracic, abdominal, orthopedic, and neurosurgical procedures, as well as for common painful procedures such as bone marrow aspirations and lumbar punctures. While opioids remain important for acute procedural and postoperative pain management in pediatric oncology patients, there is an increasing emphasis on multimodal, opioid-sparing approaches. The evidence presented within this review highlights the growing focus on judicious postoperative opioid prescribing to mitigate risks of adverse effects and persistent use or potential misuse. The review synthesizes findings from studies investigating various analgesic regimens, including the use of regional anesthesia techniques like epidural analgesia and peripheral nerve blocks, which have shown promise in reducing opioid requirements. For procedural pain, the review explores the efficacy of combining opioids with sedatives like midazolam or propofol, as well as the potential of ketamine as an opioid-sparing alternative. Key findings indicate that opioid-sparing techniques can effectively reduce overall opioid consumption without compromising pain control or patient satisfaction. Several studies demonstrated that regional anesthesia techniques and non-opioid adjuncts can significantly lower postoperative opioid requirements across various surgical procedures. For procedural pain, ketamine-based regimens often showed comparable or superior pain control to opioid-based approaches, with some studies reporting better patient satisfaction. This review also addresses the importance of tailored postoperative opioid prescribing, with some studies presenting algorithms to predict outpatient opioid needs more accurately. These approaches aim to ensure adequate pain control while minimizing excess opioid dispensing. [ABSTRACT FROM AUTHOR]

Procedural sedation and analgesia (PSAA) is integral to facilitating painful and anxiety-inducing medical procedures in the emergency department (ED). Optimal PSAA enhances procedural success and improves both patient and provider satisfaction. The selection of appropriate sedative and analgesic agents, routes, and dosages, which depend on various patient- and procedure-specific factors is a complex process. Alternative routes of administration, such as intranasal, intramuscular, and oral, are all options, each with their own inherent benefits and limitations. It is important for providers to take into account patient-specific considerations, including age, medical history, body weight composition, and pregnancy, which can significantly impact PSAA effectiveness and safety. Implementation strategies targeted to minimize medication errors and optimize workflow are also important considerations in PSAA. By adopting a comprehensive and evidence-based approach, health care providers can navigate the intricacies of PSAA and ensure the best possible care for patients in the ED. [ABSTRACT FROM AUTHOR]

Background: Arthroscopic rotator cuff repair (RCR) is a common procedure, yet long-term patient-centered outcome studies remain limited. This study aims to evaluate the outcomes of arthroscopic RCR using a single-row metallic anchor technique over a 12-year follow-up, focusing on patient-reported outcomes and potential risk factors. Methods: A monocentric cohort study was conducted on patients who underwent complete arthroscopic RCR with a single-row metallic anchor technique from January 2007 to July 2011. A total of 628 patients completed three standardized questionnaires: Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), and the Simple Shoulder Test (SST). They were also asked for their overall satisfaction on the procedure with a single direct question. Outcomes were analyzed by gender, age at surgery, lesion pattern, and follow-up duration. Results: The mean follow-up period was 12.9 ± 1.3 years. Overall satisfaction was 96.5%. The mean scores for QuickDASH, ASES, and SST were 7.2 ± 15.7, 83.8 ± 23.9, and 89.9 ± 22.3, respectively. Female patients reported significantly lower QuickDASH (p < 0.001), ASES (p < 0.001), and SST (p = 0.004) than male patients, but overall satisfaction did not differ by gender. Age, number of tendons repaired, anterior tear, and follow-up length were not significantly associated with differences in outcome measures. Conclusions: Single-row arthroscopic RCR provides excellent long-term patient-reported outcomes and high patient satisfaction. Female gender may be associated with slightly lower functional scores, yet satisfaction remains unaffected. This study supports the single-row technique as a reliable, efficient, and cost-effective option for long-term success in RCR, challenging the need for more complex multi-anchor approaches. [ABSTRACT FROM AUTHOR]

Background: Facial feminization surgery (FFS) is critical to gender-affirming surgery, consisting of craniomaxillofacial procedures to align facial features with a patient's gender identity. Central to FFS is genioplasty, which reshapes or repositions the chin; however, limited research exists on genioplasty in FFS. This review and cohort analysis aim to evaluate current practices and outcomes for individuals undergoing FFS with genioplasty. Methods: A systematic review included transfeminine individuals undergoing FFS with genioplasty. A retrospective study reviewed FFS cases with genioplasty between 2017 and 2024. Data collected included demographics, imaging, virtual surgical planning (VSP), complications, and patient-reported outcomes (PROs). Results: The review included 12 studies with 1417 patients, with 34.2% undergoing genioplasty. The mean age was 37.3 years, and 60.1% were White. Preoperative imaging and VSP were used in 66.7% of studies, 3D-printed cutting guides in 37.5%, and 3D reconstruction in 75.0%. Reduction genioplasty was the most common technique. All PROs indicated high satisfaction, with a 2.67% revision rate. Complications were low (0.55%), with infections being most frequent (0.48%). In the institutional cohort, 351 patients underwent FFS, with 64.4% undergoing genioplasty, significantly higher than in the review (p < 0.001). Sliding genioplasty was preferred without preoperative imaging or VSP. Postoperative dissatisfaction was 3.54%, with 0.88% requiring revision (p = 0.063). Complication rates (1.77%) were similar to those of the review (p = 0.065). Conclusions: Genioplasty is important in FFS, with low complication and revision rates and high patient satisfaction. However, gaps remain in validated PROs and technique-specific outcomes. While preoperative imaging and VSP show benefits, comparable outcomes are achievable without them. [ABSTRACT FROM AUTHOR]

Background: Involutional lower eyelid ectropion is a common disorder of the elderly population. Several surgical approaches have been described in the literature to address the multifactorial nature of this condition, each targeting different factors contributing to its development. Nevertheless, no single procedure has proven to be superior to the others. This study aims to assess the safety and effectiveness of a new 3-step combined technique in treating involutional ectropion. Methods: The surgical technique consists of a combination of lateral lid-shortening with removal of a base-up triangle (modified Bick procedure), lower eyelid skin release, and transposition of a laterally based myocutaneous flap from the upper eyelid. A retrospective chart review was conducted for all patients treated with this procedure at our institution between 2012 and 2023 was performed. Self-reported patient satisfaction with functional and esthetic outcomes was evaluated three months after surgery. Results: A total of thirty-six patients (forty-five eyelids) were included in the study, with a mean follow-up period of 22 months (range 3–144). Minor surgical revision was performed in one case for early wound dehiscence following premature stitches removal. The overall success rate was 93.2%, with one case of undercorrection and two cases of recurrence recorded at three years postoperatively. No additional complications or recurrences were observed during the follow-up period. Conclusions: The 3-step combined procedure demonstrated high efficacy and safety, offering excellent functional and esthetic outcomes. This approach provides a reliable solution for treating involutional ectropion, making it a valuable addition to the surgical options for this condition. [ABSTRACT FROM AUTHOR]

Introduction: Oral semaglutide is a glucagon-like peptide 1 receptor agonist (GLP-1RA) approved for improving glycemic control in adults with type 2 diabetes (T2D). The PIONEER REAL program evaluates clinical and patient-reported outcomes of oral semaglutide treatment as part of routine clinical practice across 13 countries. Here, data from Canada, Denmark, Italy, the Netherlands, Sweden, Switzerland, and the UK are pooled and analyzed to address treatment satisfaction as well as glycated hemoglobin (HbA1C) and body weight changes in relevant subgroup analyses. Methods: This pooled analysis encompasses seven country-specific, non-interventional, multicenter, phase 4, prospective, single-arm clinical studies assessing the use of oral semaglutide in adults with T2D. Primary endpoint was the change in HbA1C from baseline to end of study (EOS), and secondary endpoints included changes in body weight and treatment satisfaction. For the analyses, results were stratified by age, T2D duration, and oral semaglutide dose at EOS as well as baseline HbA1C, body weight, and body mass index. Results: Oral semaglutide treatment was initiated by 1615 participants. At EOS, 1222 (76%) participants out of the 1483 (92%) who completed the study were on treatment. Estimated changes in HbA1C and body weight from baseline to week 38 were − 1.0%-point (95% CI − 1.08 to − 0.97; P < 0.0001) and − 5.0% (CI − 5.37 to − 4.72; P < 0.0001). Treatment satisfaction increased significantly during the study. Shorter T2D duration interacted with higher HbA1C reduction and body weight loss. Interaction was also observed between higher baseline HbA1C and more pronounced decrease in HbA1C. No significant interactions were detected between clinical outcomes and age or physician setting. Conclusion: The PIONEER REAL pooled analysis shows that people initiating oral semaglutide treatment experience improved glycemic control and body weight loss across age groups and T2D duration. This occurs regardless of specialist or primary care practice setting and is accompanied by an increased treatment satisfaction. Clinical Trial Registrations: NCT04559815 (Canada), NCT04537637 (Denmark), NCT05230615 (Italy), NCT04601740 (the Netherlands), NCT04601753 (Sweden), NCT04537624 (Switzerland), NCT04862923 (UK). [ABSTRACT FROM AUTHOR]

Simple Summary: Individuals with cancer, including multiple myeloma, often have significant nursing needs. The specific nature of their condition and the functional difficulties from treatment impact their overall quality of life. Therefore, it is crucial to provide the highest quality care, addressing needs such as pain relief, health status monitoring post-therapy, and proper nursing activities. Considering patients' perspectives and tailoring care to their needs is also important. In our study, we checked the opinions of multiple myeloma patients from Poland about the quality of nursing care. The results obtained give a picture of the situation and may be helpful in formulating areas requiring improvement. Background/Objectives: Patient satisfaction is one of the indicators of the quality of nursing care. The purpose of this study is to find out the level of satisfaction of patients with multiple myeloma with the quality of nursing care in oncology units. Methods: Data were obtained by a diagnostic survey method, using the Newcastle Nursing Satisfaction Scale. The survey was conducted among patients from four oncology departments in Poland on the day the patient was discharged or transferred to another unit. Participation in the study was voluntary and required patient consent. Patients were assured of the anonymity of their responses. Results: The study included 65 men and 75 women treated with chemotherapy and autologous hematopoietic stem cell transplant. Experiences and satisfaction with nursing care presented a level of 71.80 points and 74.46 points, respectively. The analysis showed no statistically significant differences between the groups in terms of treatment and gender. A statistically significant negative association was shown between age and nursing care experience score (r = −0.19; p = 0.024). Positive associations were shown between length of stay on the unit and rating of experience of nursing care (r = 0.23; p = 0.006) and satisfaction with nursing care (r = 0.26; p = 0.002). Conclusions: The experience and satisfaction with nursing care among patients treated for multiple myeloma in Polish oncology units is moderate. Efforts should be made to improve the quality of nursing care, especially taking into account the needs of the elderly. [ABSTRACT FROM AUTHOR]

Breast cancer is one of the most prevalent cancers worldwide, and following its treatment, many women turn to plastic surgery for reconstruction. A diagnosis of cancer is a heavy burden on patients. Yet, the effect of psychological/psychiatric comorbidities on patient satisfaction following their reconstruction remains unexplored. Thus, this paper aims to investigate how pre-existing psychological and psychiatric conditions impact patient-reported outcomes postreconstruction, compared to women without such conditions. A systematic review of PubMed, Web of Science, and Cochrane was completed. A qualitative synthesis of all included studies was then performed, and a subgroup analysis was then performed using a random effect model. A total of 24 papers were included, encompassing a total population of 220,565 patients undergoing breast reconstruction between the ages of 18 and 84. The follow-up time ranged between 1.5 mo and 61 mo. In our study of breast reconstruction outcomes, the cohort with psychological/psychiatric comorbidities exhibited significant decreases in postoperative BREAST-Q scores compared to the control group: a 24-point [95% confidence interval (CI; −40, −8)] difference in satisfaction, a 20-point [95% CI (−57, −17)] difference in psychosocial well-being, an 18-point [95% CI (−28, 9)] difference in physical well-being, and a 33-point [95% CI (−51, −15)] difference in sexual well-being. Ultimately, our analysis suggests that presurgical psychology status is a critical determinant of postsurgical patient-reported outcomes. These results encourage the development and inclusion of well-being screening and optimization prior to surgery as a mean to improve surgical outcomes. [ABSTRACT FROM AUTHOR]

Surgical creation of arteriovenous fistulas has been the gold standard for vascular access in hemodialysis patients. However, recent advancements in endovascular technology, the need for alternative hemodialysis access options in nonsurgical candidates, and patient preference for nonsurgical approaches have led to the development of percutaneous arteriovenous fistula creation. Currently, there are two Food and Drug Administration (FDA) approved systems, namely WavelinQ and Ellipsys. The aim of this article is to review the available literature on the outcomes of percutaneous arteriovenous fistula creation. Studies have reported high technical success rates for both the WavelinQ and Ellipsys systems. However, re-interventions were necessary for maturation, maintenance of patency, and treatment of complications. Reported re-intervention rates have varied across studies, device used, and patient populations, ranging from 0.46 to 2.7 per patient-year. While percutaneous arteriovenous fistula creation shows promise in terms of technical success rates, patency, and patient satisfaction, the rate of re-interventions adds to the overall procedural burden and may impact cost-effectiveness. [ABSTRACT FROM AUTHOR]

Elderly Health Care Voucher Scheme represents a form of demand-side subsidy given to the elders to choose a spectrum of medical services in the private medical sector. The current paper aims at (a) conducting a needs assessment of the scheme with an analytical framework of the Four A 's approach (i.e., availability, awareness, accessibility, and acceptance regarding a social program) and (b) evaluating whether the outcome measures of the scheme (i.e., the use of private healthcare services, the use of primary care and the empowerment of the elders in the choice of services) were achieved. The needs assessment concludes that the utilization rate of the elders, awareness and satisfaction rate are high. The positive sides concluded from the needs assessment, however, failed to turn into the fulfillment of outcome measures due to the structural barriers. Recommendations at short-term, medium-term and long-term are made. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate visual outcomes and patient satisfaction after bilateral implantation of a new hydrophobic acrylic intraocular lens called Clareon (Alcon) using the mini-monovision technique. Methods: A single-center, prospective, nonrandomized study was conducted in Tandil (Buenos Aires, Argentina), including patients scheduled for cataract surgery. To achieve mini-monovision, the spherical equivalent was calculated between −0.25 and +0.25 D for the dominant eye, and between −0.75 and −1.00 D for the non-dominant eye. The main outcomes were uncorrected distance visual acuity (UDVA) and uncorrected intermediate visual acuity (UIVA) evaluated at 66 cm. A secondary outcome, patient satisfaction, was assessed using the CatQuest-9SF questionnaire. Results: The mean binocular UDVA was 0.01 ± 0.05 logMAR three months after surgery, while the mean binocular UIVA was 0.20 ± 0.06 logMAR. The postoperative mean spherical equivalent in the dominant eye was −0.27 ± 0.12, and in the non-dominant eye was −0.87 ± 0.25. Before surgery, the CatQuest-9SF questionnaire revealed that 83.33% of patients were dissatisfied with their vision during daily activities. Over 50% reported significant difficulties with reading newspapers, sewing, and reading TV subtitles. Additionally, 66.6% struggled with recognizing faces, 50% with seeing product prices, and 50% with walking on uneven ground. Post-surgery, most patients experienced improved vision for daily tasks, with no reports of high dissatisfaction or significant difficulties. Patients were quite satisfied with their vision for hobbies and TV subtitles, and very satisfied (90%) with seeing supermarket prices. Conclusions: patients implanted with a new enhanced monofocal IOL using the mini-monovision technique showed improved distance and intermediate visual acuity, reduced need for glasses, and expressed a high degree of satisfaction. [ABSTRACT FROM AUTHOR]

Multimorbidity poses significant challenges for patients and healthcare systems, often exacerbated by fragmented care and insufficient collaboration across providers. Blended Collaborative Care (BCC) is a promising strategy to address care complexity by partnering care managers (CMs) with primary care providers (PCPs) and specialists. This study aimed to adapt and pilot a BCC intervention for patients aged 65+ with heart failure and physical–mental multimorbidity. Our objectives were to assess the feasibility of the study procedures, patient recruitment, participant satisfaction and acceptability, and to identify necessary adjustments for improving intervention delivery. We evaluated goal attainment and intervention fidelity through standardised electronic documentation by CMs, and patient acceptance and satisfaction through semi-structured interviews. A monocentric, one-arm pilot study involved nine patients with a mean of 6.7 contacts with their CM over three months. Patients' health goals primarily focused on lifestyle changes and psychosocial support. The intervention was generally well-accepted, with no reported negative consequences. Difficulties in establishing working alliances with PCPs were a barrier to effective implementation. The analysis indicated the need for minor procedural adjustments. Next steps include launching the ESCAPE trial, a large randomised-controlled trial across different European healthcare systems and developing strategies to facilitate PCP involvement. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effectiveness of a patient-centered standardized prophylaxis process in improving patient satisfaction and intentions to return to dental clinics. Conducted in a first-tier city in China from 9 June to 26 July 2023, the cross-sectional survey included 826 patients from 38 dental clinics. Among the respondents, 438 received standardized prophylaxis services, while 388 were in the non-standardized group, with a mean age of 38.2 ± 12.1 years and 50.24% male participation. The results revealed that patients in the standardized prophylaxis group reported significantly higher satisfaction scores (average 4.74 vs. 3.34, p < 0.0001) and greater intentions to return (average 4.77 vs. 4.10, p < 0.0001) compared to those receiving non-standardized care. The ordinal logistic regression analysis identified patient satisfaction as a strong predictor of return intention, with an odds ratio of 24.487, while the standardized service group had an odds ratio of 16.063, indicating a substantial positive effect on satisfaction. Age was also found to significantly affect return intention, reflected in an odds ratio of 0.969. Furthermore, the model showed strong predictive accuracy, which was supported by a Somers' D value of 0.806. Additionally, an impressive 89.9% of the observations were correctly ordered, which strengthens the reliability of the findings. These outcomes highlight the significant contribution of patient-centered, standardized practices to the satisfaction of the patients as well as the development of their desire to return for follow-up care. However, the findings should be interpreted with caution due to the study's cross-sectional nature, which limits causal inferences, and the specific demographic characteristics that may affect the general applicability of the results. Further research is needed to explore these dynamics across diverse populations and settings. [ABSTRACT FROM AUTHOR]

Objective: To provide a rationale for a collaborative care model involving oncology and primary care pharmacists to improve the coordination of care of medications for cancer patients with multiple chronic conditions. Data Sources: A review of selected literature and the authors' own research was used. Studies illustrating the gaps in care for medications and pharmacists' roles in oncology and primary care settings from PubMed were reviewed. Data Summary: There has been a substantial increase in the development and utilization of oral anticancer agents (OAAs). Although OAAs offer convenience and flexibility, they also introduce challenges related to medication adherence, monitoring, and managing side effects. Up to 17.5% of patients experience moderate to severe symptoms from OAAs and about 30% report less than excellent medication adherence. Further, studies showed that 30% to 53% of adult cancer patients have at least one chronic condition that complicates their treatment plan due to the need for medications, increasing the risk of drug interactions, side effects, and non-adherence. The Primary Care Oncology Model (PCOM) incorporates both primary care and oncology pharmacists with comprehensive medication review and patient-reported outcome measure, respectively, to enhance medication appropriateness and effectiveness, and improve overall patient experience. Conclusion: Implementing PCOM may improve the medication management of patients taking OAAs for active cancer treatment and chronic medications for their multiple chronic conditions. This collaborative approach can transform patient care by leveraging the expertise of both primary care and oncology pharmacists. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to adapt, validate, and evaluate the feasibility of a mindful exercise program (Mindful Standing Yoga combined with Baduanjin) for older patients with primary osteoporosis. Methods: The study was conducted in 3 stages. Stage 1 involved a qualitative focus group discussion with 6 experts to gather perspectives on modifying the exercise program. Stage 2 used a Delphi approach with another 6 experts to validate the program. In Stage 3, a feasibility study was conducted with 20 eligible patients (out of 23 initially enrolled) at a traditional Chinese medicine hospital, using a single-group pre- and posttest design. The strenuousness of the adapted exercise was assessed through heart rate (HR) and rating of perceived exertion (RPE). Its effects were measured using the Global Pain Scale (GPS), the Five Facets Mindfulness Questionnaire—Short Form (FFMQ-SF), the Tampa Kinesiophobia-11 Scale, and the Timed Up and Go test. Patient satisfaction and feedback were also collected. Results: The modified program, consisting of 9 movements and taking 30 min to complete, was validated by experts as suitable, safe, and effective for practice. HR and RPE measurements confirmed it as a low-intensity exercise and not strenuous for the study population. The program significantly improved back pain and mindfulness in the feasibility study, with most participants expressing satisfaction with the protocol. Conclusion: Experts and participants affirmed that the program was appropriate and satisfactory for older patients with primary osteoporosis, particularly those with back pain. Further high-quality randomized controlled trials are needed to validate its effectiveness. [ABSTRACT FROM AUTHOR]

Purpose: To assess the impact of incorporating internet-based resources and popular science workshops on self-care management among hemodialysis patients with arteriovenous fistula. Design: A randomized controlled trial involving 110 hemodialysis patients with arteriovenous fistula, randomly assigned to either the experimental or control group. Methods: The experimental group received self-management training utilizing internet resources and interactive workshops, while the control group received conventional health education methods. After the intervention, the self-management proficiency of both groups was assessed, including comprehension of arteriovenous fistula-related information, satisfaction levels, self-care abilities, engagement in functional exercises, quality of life, and other relevant factors. Findings: Patients in the experimental group exhibited significantly greater proficiency in arteriovenous fistula self-management knowledge, higher levels of patient satisfaction, enhanced self-management abilities, improved functional exercise performance, and better overall quality of life compared to those in the control group (p < 0.05). Conclusions: The combination of internet resources and popular science workshops presents a novel and promising approach for educating and promoting self-care management among hemodialysis patients with arteriovenous fistula. This method holds potential for widespread dissemination and implementation in science education. Clinical Evidence: The study demonstrates the tangible benefits of integrating internet-based resources and popular science workshops into self-management training for arteriovenous fistula among hemodialysis patients, as evidenced by improved knowledge, satisfaction, abilities, exercise performance, and quality of life in the experimental group compared to the control group. [ABSTRACT FROM AUTHOR]

Purpose: Patients and caregivers in Singapore experience issues managing dysphagia care at home following hospital discharge, and they prioritized improving access to postdischarge dysphagia care and support. Hence, a postdischarge dysphagia telehealth service was developed. This study aimed to evaluate the feasibility of this service by examining patient and service outcomes, preliminary costs, and consumer satisfaction. Method: Patients with dysphagia and their caregivers attended one or more telehealth sessions over the initial month post--hospital discharge. Reviews of dietary adherence and preparation, swallowing function, and therapy progress were conducted. If needed, clinical support and intervention were provided. Data related to patient and service outcomes, preliminary costs, and consumer satisfaction were collected and analyzed using descriptive statistics and content analysis. Results: Twenty patients attended 42 telehealth sessions. No support was provided during 10 sessions, minor support was provided during 13 sessions, and major support and intervention were provided to address patient and swallowing safety during 19 sessions. Out of 20 patients, 19 required support and intervention during the first week postdischarge, but they experienced fewer issues with each subsequent session. They were highly satisfied with the service. The average session duration was 29.6 min. No sessions were cancelled. This service can be delivered with minimal additional health service resources and at a low cost to consumers. Conclusions: This service is feasible, cost-effective, and well accepted by consumers. It facilitates early identification and management of swallowing and patient safety during the initial month post--hospital discharge. Wider implementation of this service model should be considered. Supplemental Material: https://doi.org/10.23641/asha.27327345 [ABSTRACT FROM AUTHOR]

Background and Aim: Empathic communication has a great impact on patient satisfaction and health outcomes. With the advent of technology in healthcare human touch in caring for patients is diminishing gradually. This study explores the satisfaction of the patients with the empathic communication of nurses. Methods: A descriptive cross-sectional study design was used to conduct the study. Data were collected by a self-structured 5-point Likert scale to assess the satisfaction of patients with the empathic communication skills of nurses in the month of August 2021. Results: The mean age of the participants was 43.36 ± 15.76. 41% of respondents have an overall moderate satisfaction with the empathic communication skills of nurses, 33.33% had low satisfaction and only 25.7% had high satisfaction with empathic communication skills of nurses. Furthermore, a significant number of patients (87.5%) reported that their opinion was recognized and respected by nurses and more than 80% reported that nurses were good in communication. Conclusion: This study provides significant data about one of the most important factors in the improvement of patient satisfaction. Nurse's empathic communication skills can be improved and sustained by training programmers on regular basis. [ABSTRACT FROM AUTHOR]

BACKGROUND: Periorbital hyperpigmentation (POH) is a therapeutic problem. Platelet-rich plasma (PRP) has been successfully used in some pigmentary disorders including POH. Proper evaluation of treatment in POH can be difficult. OBJECTIVE: To assess the efficacy and safety of PRP injections for POH in skin phototypes III and IV by multiple clinical tools. METHODS: A clinical trial included 30 patients with POH, skin phototypes III and IV. Three sessions of intradermal PRP injections were used in periorbital area every month. Treatment was assessed on different clinical levels 1 month after the last session by POH severity grading, blinded photographic assessment, and patient satisfaction. Adverse effects of PRP were evaluated. RESULTS: A significant improvement in POH was documented by disease severity grading, patient satisfaction, and to a lesser extent by photographic evaluation. Grade II-POH showed the best improvement. More than half of the cases were satisfied and very satisfied. Lower disease grades, constitutional POH, and epidermal pigmentation showed significant improvement. Side effects were mostly tolerated. CONCLUSION: The present results confirmed the beneficial role of PRP in improving POH. Multiple clinical tools are preferred for a more reliable assessment of treatment. Certain clinical types and grades of POH are suggested to respond more to PRP therapy. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. BACKGROUND: Nonablative lasers treat photoaged skin and stimulate new collagen formation while sparing epidermal damage. OBJECTIVE: To evaluate the effectiveness and safety of nonablative fractional diode combination laser skin resurfacing treatment (1440 and 1927 nm) in mild-to-moderate photoaged skin. MATERIALS AND METHODS: The entire face was treated with both 1440-nm and 1927-nm wavelengths per treatment, with a total of 4 treatments spaced 1 month apart. Follow-up occurred at 1 and 3 months post-treatment. Outcomes were improvement in the appearance of ≥1 measure of photodamage (rhytides, skin texture, dyschromia/pigment, skin radiance, pore size, and overall appearance) at the 3-month (primary) and 1-month (secondary) follow-up visits. Safety was monitored throughout the study. RESULTS: Participants (N = 28; 89% female; mean age, 40 years) experienced significant mean improvement from baseline in all measures of photodamage with combination laser treatment at 1 and 3 months post-treatment (all p <.001). No serious adverse events occurred. Post-treatment erythema and edema were minimal, and pain levels remained consistent throughout treatment. Most participants (96.4%) considered their overall appearance as improved and expressed satisfaction with treatment outcomes. CONCLUSION: Nonablative combination laser skin resurfacing treatment was well tolerated and significantly improved measures of photodamage in photoaged skin across diverse skin types. [ABSTRACT FROM AUTHOR]