Background: Prescription errors (PE) in psychiatric hospitals can compromise treatment and patient safety. While well studied in general healthcare, evidence from psychiatric settings, particularly in Germany, remains scarce. Aim: This pre-liminary study investigates the prevalence, types, and severity of PE in a German psychiatric hospital over 12 months. Methodology: A prospective observational study was conducted at St. Josef AMEOS Psychiatric Hospital, Oberhausen, Germany (2023–2024). All 6,020 paper-based therapeutic plans were screened. From these, 150 cases of PE were identified for interim analysis. Errors were categorized using adapted EQUIP methodology and classified by severity (minor, major, serious, potentially fatal) and by drug group according to the British National Formulary (BNF). Results: Of the 150 cases, 93.3% were minor, 5.0% were major, and 1.7% were serious; no potentially fatal errors were observed. Writing errors were most common (38%). Errors most frequently involved musculoskeletal medications (BNF 10; 36.7%), followed by gastrointestinal (BNF 1; 18.7%) and CNS/psychotropics (BNF 4; 14.7%). Most errors occurred in inpatient settings and were primarily attributed to residents and consultants. Significant asso¬ciations were found between error type and drug class, and between error type and severity (p<0.05). Conclusion: These interim results suggest that PE in psychiatric hospitals are mostly minor, with somatic medications more often affected than psychotropics. Given the small interim sample (150 of 6,020 plans), findings should be interpreted cau¬tiously and considered hypothesis-generating. Larger, multi-center studies and evaluation of electronic prescribing systems are needed to confirm these patterns and guide interventions.

Background: Job satisfaction is a fundamental factor affecting nurse well-being, retention, and healthcare system performance. Aim: This study explores the determinants of job satisfaction among nurses, with particular emphasis on the differences between temporary agency nurses and those in permanent positions in North Rhine-Westphalia, Germany. Methodology: A cross-sectional study was conducted to assess job satisfaction among nurses working under both temporary agency and permanent employment contracts. Data were collected from a sample of 195 nurses using the Job Satisfaction Survey (JSS), a standardized instrument designed to measure multiple domains of job satisfaction. The survey included items related to supervision, salary, promotion opportunities, work relationships, and benefits. Statistical analyses were performed to identify and compare job satisfaction levels between the two employ¬ment groups. Results: Temporary nurses reported consistently higher satisfaction than permanent nurses across most domains of the Job Satisfaction Survey. Supervision was the most positively rated factor (97.9% of temporary vs. 72.2% of permanent nurses), while pay (73.0% vs. 11.1%) and benefits (51.8% vs. 9.3%) also showed large dispari¬ties. Promotion opportunities were rated lowest by both groups (7.1% vs. 3.7%), and satisfaction with co-worker rela¬tionships remained stable across groups (63.1% vs. 63.0%). The most pronounced contrast was observed in overall job satisfaction: 61.7% of temporary nurses reported being satisfied compared with only 5.6% of permanent nurses. Regression analysis confirmed that permanent employment was negatively associated with satisfaction, whereas higher educational attainment predicted higher satisfaction with pay and overall job satisfaction. Conclusion: The findings reveal significant and counterintuitive differences in job satisfaction between temporary and permanent nurses. Contrary to expectations, temporary nurses consistently reported higher satisfaction across most domains of work life. Addressing issues related to compensation, career progression, and job stability is essential to enhance satisfaction and reduce turnover. Healthcare organizations should implement targeted strategies that acknowledge the distinct needs of both employment groups and foster a supportive working environment.

Background: Prescription errors in substitution therapy for addiction treatment, including opioid substitution therapy (OST) with methadone and buprenorphine and pharmacotherapy for alcohol use disorder (AUD) with naltrexone, acamprosate, and disulfiram, pose a critical patient safety issue. These errors are a major contributing factor to adverse drug events (ADEs), poor treatment adherence, discontinuation, and severe outcomes such as fatal overdoses. Additional factors such as miscommunication, inadequate training, and complex medication regimens exacerbate the risk. Aim: This systematic review aims to evaluate the prevalence, causes, and consequences of prescription errors in substitution therapy for addiction treatment. It explores the roles of healthcare professionals, system-level factors and their impact on patient safety, focusing on adherence, treatment outcomes, and ADEs. Methodology: A systematic search was conducted in PubMed, Scopus, and Google Scholar for studies published between January 2000 and July 2025. Studies addressing prescription errors in OST or AUD pharmacotherapy, including generic or therapeutic substitution, were included. Data on error types, prevalence, contributing factors, consequences, and interventions were extracted. Qualitative data underwent thematic analysis, while quantitative data were synthesized descriptively. Results: Prescription error rates in OST varied widely, from 1.7% in older adults to 30.3% in overdose reports, with methadone and buprenorphine implicated most frequently. Common errors included incorrect dosing, dispensing errors, and inadequate monitoring, leading to respiratory depression, overdose, and treatment failure. Key contributing factors were miscommunication, insufficient training, frequent formulary changes, and patient-related factors such as cognitive impairment. Pharmacist-led interventions, digital prescribing systems, and standardized protocols significantly reduced errors. Data on AUD pharmacotherapy errors were sparse, highlighting a critical research gap. Conclusion: Prescription errors in substitution therapy pose significant risks to patient safety, primarily due to systemic and human factors. Enhanced training, standardized protocols, and digital tools are effective mitigation strategies. Further research is needed to quantify errors in AUD pharmacotherapy and develop targeted interventions.

Background: Breast carcinoma is among the three most common types of cancer worldwide, including lung cancer and colon cancer, regardless of gender. The Bcl-2 oncogene is involved in a number of malignant neoplasms, includ¬ing leukaemia and lymphoma, through the regulation of the cell apoptosis process. Aim: The main purpose of the present study is to investigate the association of Bcl-2 with other molecular parameters of significant prognostic and predictive value for disease and more specifically the ER and PR receptors, along with HER-2 and Ki-67 (MIB-1). Methodology: Immunohistochemical assessment of Bcl-2, ER and PR receptors, HER-2 and Ki-67 was conducted in a case series of 100 surgically resected primary breast carcinomas and the association of Bcl-2 with the other bi¬omarkers was statistically investigated. Results: High (3+) Bcl-2 expression was observed in 65% of cases, moderate (2+) in 12%, low (1+) in 4% and negative expression in 19%. Association of Bcl-2 with ER-PR receptors and HER2 and Ki67 was conducted with Fisher’s exact and Chi square (x2) test of Cramer's V statistics tests were performed where appropriate. Bcl-2 oncogene was positively and highly associated with estrogen ER receptors (Phi=0.760, p=<0.0001); the findings of the association of Bcl-2 oncogene with PR progesterone receptors were similar: a positive association was found between the two specific biomarkers (Phi=0.626, p=<0.0001). Finally, negative association of Bcl-2 with HER2 (Phi=-0.350, p=<0.0001). Conclusion: Considering the association of Bcl-2 expression with the ex¬pression of genes that are related to therapy prediction (ER and PR) it remains to be ascertained whether Bcl-2 could be used as a potential predictive marker. Moreover, the negative association of Bcl-2 with Ki67 and HER2 should be furthermore investigated for its association with disease outcome and response to targeted therapy. Overall, this study suggests that Bcl-2 should be further tested for its incorporation into a multivariate prediction model for breast cancer therapy. In addition, more investigations are required into targeted anti-Bcl-2 therapy may be used to modify re¬sponses to current breast cancer therapy, in order to reduce resistance.

Background: The Bcl-2 protein is a member of the bcl family of proteins, which play a key role in the cell apoptosis process. Its tumorigenic potential has been established long ago in animal experimental models, and was subse¬quently supported by the finding of its overexpression in a variety of human tumours. Bcl-2 has been suggested as a prognostic marker for the neoplastic diseases; new evidence keeps arising providing further support to this finding. Aim: This study investigated the association of Bcl-2 expression with prognostically important clinicopathological fea¬tures in breast carcinoma in the Greek population. Methodology: Immunohistochemical assessment of Bcl-2 was conducted in a case series of 100 surgically resected primary breast carcinomas from November 2022 to July 2023 and the association of Bcl-2 with the grade of histological differentiation and Lymph nodes pN was statistically inves¬tigated. Results: The histological grade profile of the studied samples was: Grade III (24%), Grade II (62%), Grade I (14%). High (score 3+) Bcl-2 expression was found in 65% of cases, moderate (score 2+) expression in 12%, low (score 1+) in 4%, while negative expression was shown in 19% of the samples. A statistically significant inverse association between Bcl-2 expression and the grade of histological differentiation was detected (Phi=-0.850, p=< 0.0001). Bcl-2 expression was also inversely associated with Lymph nodes pN stage (p=0.001). Conclusion: The observed association of immunohistochemical Bcl-2 expression with clinicopathological characteristics which are known prognositc indicators for breast cancer (grade and pN stage) provides confirmatory evidence to the potential important prognostic value of this marker in breast cancer. Future investigations should incorporate Bcl-2 expression in multivariate prediction models to weigh its value in the clinical management of breast cancer.

Background: Spirometric reference equations are essential for accurate interpretation of lung function tests. However, most globally used equations are derived from Western populations and may not reflect the physiological norms of Arab populations. Aim: To systematically evaluate the applicability of internationally adopted spirometric reference equations within Arab populations and to assess the availability of population-specific equations in the Arab world. Methodology: A systematic review was conducted using PubMed, Scopus, Google Scholar, and CORE databases for studies published up to July 2023. Studies were included if they developed, validated, or assessed spirometric reference equations in Arab populations. Out of 57 initially identified studies, 14 met the inclusion criteria. Results: Based on the 14 studies conducted, the majority of studies reported that predicted values for forced expiratory volume in one second (FEV₁) and forced vital capacity (FVC) in Arab populations were significantly lower than those predicted by equations derived from Western populations. This discrepancy suggests potential misclassification of respiratory diseases when non-local reference values are applied. Conclusion: The routine application of spirometric reference equations developed in Western populations may lead to inaccurate interpretation of lung function in Arab individuals. There is a clear need for developing standardized, population-specific reference equations that account for the ethnic and anthropometric characteristics of Arab populations to enhance diagnostic accuracy and clinical decision-making.

This review explores the complex relationship between thyroid function and menopause, focusing on physiological interactions, clinical implications, and diagnostic challenges associated with thyroid dysfunction in postmenopausal women. Drawing on recent studies and current understanding, it examines how menopausal hormonal changes influ¬ence thyroid health, increasing the risk of conditions such as hypothyroidism, hyperthyroidism, and subclinical thyroid disorders. Overlapping symptoms, including mood changes, sleep disturbances, weight fluctuations, and reduced libido, complicate diagnosis, as they can be attributed to both menopause and thyroid dysfunction. Hormonal shifts can also impact bone mineral density, cardiovascular health, and metabolism, while prolonged estrogen exposure and surgical menopause are linked to an elevated risk of thyroid cancer. Diagnostic complexity is heightened by age-related changes, comorbidities, and potential interferences in thyroid function tests. Routine thyroid assessment is recommended for women with surgical menopause or other risk factors. Personalized management, including meno¬pausal hormone therapy (MHT), can address overlapping symptoms and mitigate skeletal and cardiovascular risks. A patient-centred approach is crucial, with treatment tailored to individual health profiles. Further research is needed to clarify the interactions between menopause and thyroid function to improve clinical care.

Cellulite treatments vary in their mechanisms, invasiveness, and durability of outcomes. Non-invasive options, such as topical agents and oral supplements, provide moderate benefits but require prolonged use. Massage and energy-based therapies offer better cosmetic improvements but often require multiple sessions with results that may not be long-lasting. Invasive treatments, like subcision and injectable options, directly address structural issues underlying cellulite. The choice of treatment depends on individual patient needs, cellulite severity, and the desired balance between invasiveness and results. A tailored approach considering the underlying structural and aesthetic concerns often yields the best outcomes.