Comprehensive Care Research Articles

Narrative Review of Internet-Based Self-Help Tools for Body-Focused Repetitive Behaviors: Recommendations for Clinical Practice.

Body-focused repetitive behaviors (BFRBs), such as skin-picking, hair-pulling, and nail-biting, impair quality of life (QOL). While habit reversal training (HRT) is effective, access is often limited. Internet-based self-help interventions offer an alternative, improving accessibility for patients unable to attend in-person therapy. We reviewed randomized controlled trials analyzing self-help or internet-based interventions for BFRBs in adults. PubMed searches yielded 1033 studies, 12 of which met the inclusion criteria, focusing on self-guided interventions for various BFRBs. The review found that the "Free from BFRB" website was the most studied resource and consistently had high patient satisfaction. Self-guided HRT, decoupling, and decoupling in-sensu consistently reduced symptoms and improved QOL. Decoupling techniques were especially effective for trichotillomania and nail-biting. Internet-based self-help interventions, especially self-help HRT, decoupling, and decoupling in-sensu, offer effective and accessible treatment options for managing BFRBs, particularly for those facing barriers to traditional therapy such as stigma, cost, or location. Engagement and frequency of use are important for the efficacy of self-help options, and therapist-guided treatments may offer more personalized, comprehensive care.

Diagnostic and Surgical Outcomes for Congenital Diaphragmatic Hernia in Neonates : A Literature Review

Introduction: The literature surrounding congenital diaphragmatic hernia (CDH) in neonates has evolved significantly over the past decade, reflecting advances in both diagnostic and surgical approaches. Literature Review : Chaudhary et al. (2019) further contribute to understanding prognostic factors associated with CDH, identifying critical indicators that correlate with survival outcomes. Their retrospective audit highlights the variability in survival rates among healthcare centers, underscoring the need for standardized protocols in managing CDH. Similarly, Raitio et al. (2021) systematically review the impact of hernia sac presence on survival outcomes, revealing that the presence of a hernia sac may confer physiological advantages, thereby improving prognosis. Long-term outcomes for CDH survivors remain a critical concern, as highlighted by Yamoto et al. (2022), who report that while survival rates have improved, these patients are at risk for various long-term complications. Cimbak and Buchmiller (2024) reinforce this by advocating for long-term follow-up clinics to manage the complex health issues that arise in CDH survivors. Their work emphasizes the necessity of a structured approach to longitudinal care that adapts to the evolving needs of this patient population. Conclusion: In conclusion, the literature reflects a multifaceted understanding of the diagnostic and surgical outcomes for congenital diaphragmatic hernia in neonates. Continued research, collaboration among healthcare professionals, and comprehensive care strategies are essential for optimizing outcomes and addressing the long-term challenges faced by CDH survivors.

Use of Screening Tools to Measure Supportive Care Needs in Former Cancer Patients of Adolescent and Young Adult Age: A Systematic Review of the Literature.

With the increasing number cancer survivors treated during pediatric, adolescent and young adult (AYA) ages, it has become essential to develop comprehensive long-term follow-up care tailored to each patient. The combination of being a cancer survivor and reaching AYA age at the time of long-term follow-up can make adherence to the proposed follow-up care challenging. To overcome the difficulties associated with the lack of follow-up, it is important to identify supportive care needs (SCN) for this population using effective tools. The main objective of this systematic review was to explore the screening tools for SCN used in long-term follow-up of survivors who have reached AYA age. We conducted a literature search on PubMed, Cochrane, and Science Direct for studies published since 2004. Articles were screened independently by two reviewers. Data were extracted and descriptive analyses were performed. Of the 3968 articles found, 14 met the inclusion criteria. Seven studies used tools specifically designed for the study that were not previously validated. The three tools used in the other seven studies encompassed an average of only 2.8 SCN per study. The tools currently used in clinical practice are insufficient to provide a comprehensive assessment of the SCN of AYA-aged survivors during long-term follow-up.

Determinants in the quality of life of breast cancer survivors

Determinants in the quality of life of breast cancer survivors

Comparative inpatient care of cancer vs. non-cancer patients in Switzerland during the national COVID-19 lockdown: a nationwide interrupted time series analysis

BackgroundThe COVID-19 pandemic exerted unprecedented pressure on healthcare systems worldwide, leading governments and hospitals to postpone elective procedures to prioritize care for COVID-19 patients. Cancer patients, who often require frequent interactions with hospital services, may have been disproportionately affected by these disuptions in healthcare delivery. This study aimed to analyze and compare hospital care provided to cancer and non-cancer inpatients during the lockdown and post-lockdown periods in Switzerland.MethodsThis study analyzed comprehensive adult acute care inpatient records from national administrative hospital data spanning 2017 to 2021. Using monthly patient-level data, comparative interrupted time series and difference-in-differences analysis were conducted to assess changes in hospital care between patients with and without an ICD-10 cancer diagnosis. Changes in admission volumes, hospital outcomes (length of stay, mortality), and cancer-specific treatments (chemotherapy, radiation therapy, and palliative care) during the lockdown and post-lockdown phases of the pandemic were analyzed.ResultsHospital admissions decreased substantially during the lockdown period. From March to May 2020, non-cancer patients experienced a reduction of 17′368 admissions (-18%) (95% CI [-24′333, -10′402]), compared with a reduction of 966 admissions (-9%) (95% CI [-1′636, -296]) for cancer patients. However, despite reduction in admissions, cancer inpatients received critical treatments at rates that were no lower for chemotherapy, and 6% (95% CI [1, 12]) and 15.2% (95% CI [10; 20]) higher for radiation therapy and palliative care, respectively, during the lockdown period compared to pre-pandemic levels. The mortality rate for both groups increased during the lockdown, but the rise was 22% (95% CI [8, 32]) smaller for cancer patients compared to non-cancer patients. The length of stay increased for both groups during the lockdown. However, the difference in length of stay between cancer and non-cancer patients vanished during the lockdown, with a higher length of stay of only 0.06 days (95% CI [-0.05, 0.18]) for cancer patients, compared to 0.40 days (95% CI [0.37, 0.43]) before the lockdown.ConclusionSwiss hospitals were able to maintain access to cancer services during the pandemic, mitigating the impact of the COVID-19 crisis for cancer population. These findings contribute to highlight the resilience of healthcare systems and understand decision-making processes during public health emergencies. However, long-term consequences of reduced care for cancer patients warrants further investigation.

Effect of travel distance on utilization of ancillary services among patients with pancreatic ductal adenocarcinoma: A single institution study.

Fragmentation of care among patients with pancreatic cancer between specialized tertiary centers and community centers may be associated with increased patient burden and poorer outcomes. However, the impact of distance from a tertiary center on utilization of key ancillary services such as dietician consultation, and palliative or pain medicine consultation is unclear. We sought to examine how this travel distance influences the utilization of key ancillary services. This retrospective cohort study included 200 consecutive patients who were seen for a diagnosis of pancreatic ductal adenocarcinoma (PDAC) in 2021. Patients were grouped by travel distance: < 12.5, 12.5-49, and > 50 miles. Demographics, disease staging, and use of key ancillary services such as, dietician consultation, palliative, and pain medicine consultation were compared. Multiple logistic regression assessed associations between travel distance and ancillary service utilization. Of the 200 patients, 14.5% traveled < 12.5 miles, 39.5% traveled 12.5-49 miles, and 46% traveled over 50 miles to our institution. Patients living over 50 miles away were significantly more likely to receive chemotherapy and radiation locally (81.8% vs 44.4%, p < 0.001). Importantly, they were less likely to utilize key ancillary services, including registered dietician consultation (Odds Ratio (OR) 0.34, p = 0.03), pancreatic enzyme prescriptions (OR 0.35, p = 0.03), pain medicine consultation (OR 0.20, p < 0.01), and palliative care consultation (OR 0.24, p < 0.01) compared to those living closer. Patients living over 50 miles from our institution were significantly less likely to receive key supportive services. Despite similar clinical characteristics, these disparities show how initiatives are necessary to guarantee equitable access to comprehensive cancer care, regardless of geographic location.

Characteristics and outcomes of medication-assisted treatment care models for pregnant women with opioid use disorder: A scoping review.

Pregnant women and their unborn children are often overlooked in the opioid crisis, despite increased rates of both maternal complications and neonatal opioid withdrawal syndrome. Although medications for opioid use disorder (MOUD) are considered the gold standard for pregnant women, many either do not have access to or are not offered MOUD as an option. To describe the characteristics of MOUD care models and assess the effectiveness of MOUD Care Models on initiation, adherence, and engagement in treatment for pregnant women with OUD. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol directed the process of this scoping review. A search for English, peer-reviewed, quantitative studies, published between 2012 and 2023 was conducted in eight scholarly databases. The Joanna Briggs Critical Appraisal tools were used to assess study quality. The integrated care models included medication management, psychotherapy support, behavioral health care, and medical care management, with added focus on prenatal and postpartum care. Synthesis revealed that treatment engagement, medication adherence, breastfeeding rates, and postdelivery MOUD referrals were higher in integrated care models compared with nonintegrated care models. Pregnant women with OUD in integrated care models have better outcomes compared with those in nonintegrated care models. Improvements in care models are necessary to tackle provider shortages, stigma, and financial, geographic, and technological barriers. Addressing these issues will enhance nurse practitioners' ability to provide comprehensive and accessible care to this vulnerable population.

Epidemiological, clinical and microbiological aspects of infective endocarditis in Türkiye.

Infective endocarditis (IE) is a evolving disease with a shifting epidemiology and disease burden over time. This study aimed to compare the epidemiological and clinical aspects of IE over three time periods across eleven years. This was a retrospective cohort, multicenter study conducted in Türkiye, comparing three periods: 2013-2016, 2017-2020, and 2021-2023. Epidemiological and microbiological characteristics, as well as patient outcomes, were analyzed and compared across these periods. A total of 1,044 patients diagnosed with IE were included. The median (Q1-Q3) age was 57 (44-68) years, with an increasing pattern (p < 0.001). Throughout the study period, the prevalence of intracardiac devices increased, whereas the prevalence of degenerative and congenital heart diseases declined. Among all patients, the most frequently identified pathogens were staphylococci (36.4%), followed by streptococci (14.0%) and enterococci (11.9%). Throughout the three periods, there was a significant increase in staphylococci, with S. aureus emerging as the predominant pathogen in all type IE. The in-hospital mortality rate among all patients was 22.5%. Independent risk factors for in-hospital mortality included ≥ 65 age(OR = 1.9), chronic kidney disease (OR = 1.9), nosocomial acquisition (OR = 2.1), Candida spp. infection (OR = 2.9), prosthetic valve IE (OR = 1.9), vegetation size > 15mm (OR = 1.6), and central nervous system emboli (OR = 2). The epidemiology of IE is undergoing significant changes, leading to shifts in microbiological profiles and clinical presentations. Effective management of IE should be guided by established clinical guidelines while integrating up-to-date epidemiological data to ensure comprehensive and evidence-based patient care.

The impact of refractive error correction on health-related quality of life in nursing home residents in Armenia

Purpose This study assessed the impact of refractive error (RE) correction on health-related quality of life (HRQoL) among nursing home residents. Materials/methods This quasi-experimental study with comparison group enrolled 249 participants for baseline and follow-up assessments in August 2021 and January 2022, respectively. Ophthalmic examination was conducted and visual acuity was assessed at baseline. Spectacles were distributed at three months before the follow-up. The interviewer-administered questionnaire assessed participants’ socio-demographics and HRQoL using a 36-item Short-Form Health Survey (SF-36). Patient compliance with wearing spectacles was measured. Results The mean age of participants was 72.6. About 42.0% had mild to severe visual impairment (VI), while 5.0% were blind. At the follow-up, the normal vision improved from 52.8% to 64.9%, while mild to severe VI decreased from 42.3% to 30.3%. In the RE correction group, 83.3% of visually impaired people improved their vision to normal after receiving spectacles and 70.8% had corrected presbyopia. At the follow-up, those who had corrected their vision reported significantly better physical (PHC) and mental health component (MHC) scores of SF-36, particularly in physical functioning, emotional well-being, and pain. Those who had not corrected their vision reported no significant improvement in both PHC and MHC. There were no significant differences in baseline to follow-up mean change scores for PHC and MHC between those who corrected their vision and those who had not. Conclusion Access to comprehensive eye care services including regular eye screenings, provision of spectacles, and interventions facilitating spectacle-wearing compliance might improve ophthalmic health and HRQoL in this population.

The Impact of Comprehensive Postoperative Nursing Care on Pain Levels and Quality of Life in Patients Undergoing Traumatic Fracture Surgery.

This study aims to evaluate the impact of comprehensive postoperative nursing care on pain levels and quality of life in patients undergoing traumatic fracture surgery. A total of 200 patients who underwent traumatic fracture surgery were enrolled in this study and divided into 2 groups: the observation group, which received comprehensive postoperative nursing care, and the control group, which received standard postoperative nursing care. Pain levels were measured using the Visual Analogue Scale (VAS) at 6, 12, 24, and 48 hours postoperatively. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) on postoperative days 1 and 2. Quality of life was evaluated using the SF-36 questionnaire at 1 and 3 months postoperatively. Changes in pain levels, sleep quality, and quality of life were compared between the 2 groups before and after nursing care. The observation group exhibited significantly lower pain levels at all postoperative time intervals compared with the control group (P<0.001). In addition, the observation group showed better sleep quality and higher quality of life scores at 1 and 3 months postoperatively (P<0.001). Comprehensive postoperative nursing care significantly reduces pain levels, improves sleep quality, and enhances the quality of life in patients with traumatic fractures.

Patient-reported outcomes in head and neck cancer: a cross-sectional analysis of quality of life domains across early and advanced UICC stages

BackgroundHead and neck cancer (HNC) patients experience a variety of post-treatment symptoms that affect their quality of life (QoL). This study aims to assess the most prevalent symptoms and their relationship to cancer stage (UICC I–IV) while identifying areas for targeted intervention.MethodsA cross-sectional study was conducted involving 340 HNC patients at the University Hospital Erlangen from January to December 2019. QoL and its domains were assessed using the German version of the University of Washington Quality of Life Questionnaire Version 4 (UW-QoL v.4), with comparisons made between early-stage (UICC I & II, n = 180) and advanced-stage (UICC III & IV, n = 160) patients. Statistical analysis examined differences in QoL and its individual domains.ResultsAdvanced-stage patients reported significantly greater impairments in several QoL domains, including swallowing (p = 0.003, η2 = 0.038), saliva production (p < 0.001, η2 = 0.104), and taste (p = 0.009, η2 = 0.030), compared to early-stage patients. Psychological symptoms, such as anxiety and mood disturbances, were prevalent across all stages, but no significant differences were found between early- and advanced-stage patients for pain, speech, mood, or anxiety (p > 0.05). Patient demographics, including age, gender, and comorbidities, were similar between groups. The greater impairments in QoL domains observed in advanced-stage patients are likely due to more intensive treatments, such as multimodal therapy and radiochemotherapy.ConclusionAdvanced-stage HNC patients experience a significantly higher burden of physical symptoms, particularly issues with swallowing, saliva, and taste, necessitating early and targeted interventions. Psychological issues are also prevalent and should be addressed in both early- and advanced-stage patients. Despite non-significant differences in some symptoms, their clinical relevance may still be important, particularly in individual cases. Comprehensive care, including physical and emotional support, is essential to improving long-term QoL for HNC patients. Further research should focus on longitudinal assessments and clinically meaningful thresholds for symptom management.

Representations of skin tone and sex in dermatology by generative artificial intelligence: a comparative study.

With generative artificial intelligence demonstrating potential in dermatologic education, assessment of skin tone diversity is imperative to ensure comprehensive patient care. Evaluating DALL-E3, Midjourney, and DreamStudio Beta, we generated five images for eight common dermatologic conditions designated by the American Academy of Dermatology. The Massey-Martin Skin Color Scale was used to evaluate the images, and interrater reliability was further assessed by a non-rater. Sex determination was based on identifying features. 120 images were generated: 88 (73.3%) had concordant skin tone ratings and 109 (90.8%) displayed an identifiable sex. Of the 88 images, 85 (96.6%) rated light-toned, 3 (3.4%) rated medium-toned, and 0 rated dark-toned. Of the 109 images, 74 (68%) were male, and 35 (32%) were female. Highlighting substantial biases currently present in common AI platforms, this study underscores the need for AI algorithms to address both skin tone and sex biases as they continue to skyrocket in popularity.

Sleep and dreams: how the American Academy of Sleep Medicine and its members have shaped the future of the sleep field for 50 years.

Over the past century, sleep has transitioned from the domain of artists, poets, and philosophers to the realm of scientists and clinicians. In the 20th century, pioneering sleep researchers and clinicians advanced their respective fields by forming organizations such as the American Academy of Sleep Medicine (AASM). For 50 years, the AASM has played a leading role in creating and shaping the field of sleep medicine, leveraging the multi-disciplinary expertise of its members to forge a new medical specialty. The organization emerged from a meeting in 1975, where academics whose research focused on sleep gathered to evaluate the necessity of establishing a new professional society to represent the nascent sleep disorders centers that were beginning to open across the country. The formation of the AASM was led by Dr. William Dement and other pioneers who played crucial roles in establishing the field through the clinical application of sleep research. Through the AASM, they created the building blocks of a medical specialty by developing accreditation and certification programs, diagnostic classifications, clinical practice guidelines, clinical training programs, peer-reviewed scientific journals, and a clinical and scientific meeting. Their persistent efforts eventually secured for the sleep medicine specialty both national recognition and broad acceptance within the medical community. Today, the field of sleep medicine remains strong as sleep physicians and other members of the clinical sleep team provide high-quality, comprehensive care for patients who have sleep and circadian disorders. Built on this solid foundation, the AASM and its members will continue to shape the future of sleep medicine.

How scientific evidence can contribute to improve the diagnosis and comprehensive care of patients with TEMPI syndrome: A scoping review protocol

How scientific evidence can contribute to improve the diagnosis and comprehensive care of patients with TEMPI syndrome: A scoping review protocol

Comprehensive substance use services within primary care settings: The Safer Opioid Supply program at London InterCommunity Health Centre.

This paper describes the Safer Opioid Supply (SOS) program, a public health intervention in London, Ontario, in response to the toxic unregulated drug supply which is driving the overdose crisis in Canada. The London InterCommunity Health Centre (LIHC) SOS program provides comprehensive harm reduction and primary health care services to individuals at risk of overdose from the toxic drug supply. Clients are prescribed high-dose pharmaceutical opioids as replacement for unregulated toxic substances within a low-barrier primary care clinic, with wraparound interdisciplinary social services, embedded in the Ontario Community Health Centre model of care. The program serves people dependent on street-acquired fentanyl who are experiencing medical issues due to their substance use, and who are experiencing challenges accessing other forms of healthcare. A qualitative analysis of interviews and focus groups conducted in 2022-2023 with staff (n=5) and clients (n=20) was used to explore impacts of the SOS program. Four outcomes are discussed: safer supply as crucial to engage clients in primary care; safer supply as one component of comprehensive care; the use of a harm reduction approach; and challenges with limited medication options and program capacity. Positive health and social outcomes demonstrate the utility of embedding comprehensive substance use services within a primary health care model to address health and social complexity among people who use drugs amid the continuing toxic drug crisis. Responding to an increasingly volatile unregulated supply of drugs, having limited medication options, and providing comprehensive care without long-term funding remain ongoing challenges.

Being an Insider Nurse Researcher: Navigating the Challenges and Benefits to Ensure Rigour.

To provide insights into the challenges and benefits of being an insider nurse researcher in case study research. To describe strategies used to maintain rigour and trustworthiness when conducting insider research. Case study with insider research methodology was used to evaluate a nurse-led supportive care model for patients with Chronic Obstructive Pulmonary Disease and their caregivers. This paper reports a reflection on using insider research within a clinical context, utilising reflexive techniques such as journaling and discussions with academic supervisors to mitigate subjectivity. Informed consent and confidentiality were maintained to ensure ethical integrity. The study found that insider research offers both challenges and benefits. The established therapeutic relationship with patients and caregivers provided a deep understanding but also posed risks of assumptions, role conflict, and bias toward positive responses. Insider research was effective in evaluating a nurse-led model of care, providing unique insights from patients and caregivers. This discussion demonstrates the importance of reflexive practices and maintaining ethical rigour to balance roles and manage potential biases. The paper highlights both the challenges and benefits of insider research that may be helpful for other researchers. This study highlights the value of insider research in a nursing context, demonstrating how nurses can leverage therapeutic relationships to enhance patient and caregiver voices to inform evidence-based practice. It also provides practical guidance for researchers on reflexive practices to manage the potential for bias and role conflicts, and the maintenance of ethical standards to ensure the integrity and trustworthiness of the research process. The study addressed the challenges and benefits of being an insider nurse researcher in the context of evaluating a nurse-led supportive care model for patients with COPD and their caregivers. While insider research can provide unique insights, it also poses risks of assumptions, role conflict, and bias. This paper describes how these can be mitigated through reflexive techniques and integration of outsider perspectives. Established nurse-patient therapeutic relationships facilitated deeper understanding in a research setting; however, they require careful management to avoid bias. Ethical integrity was maintained through informed consent, confidentiality, and reflexive journaling. The research will impact patients and caregivers by improving their access to timely and comprehensive supportive and palliative care and offers valuable strategies for other nurse researchers to enhance the quality and trustworthiness of insider research. The development of the model of care in this study is informed by ongoing evaluation from patients with COPD and their caregivers.

Understanding the Role of Maternal Mental Health in Pregnancy and Postpartum Depression

Objective: This study aimed to investigate the dynamics of maternal mental health during pregnancy and the postpartum period, examining the prevalence of mental health disorders, changes over time, and the role of social support. Methods: A longitudinal study design was employed, with a sample of 80 pregnant women recruited from obstetrics and gynaecology clinics. Participants completed standardized measures assessing depressive symptoms, anxiety levels, stress, and perceived social support at multiple time points from the second trimester to twelve months postpartum. Qualitative interviews were also conducted to explore participants' subjective experiences. Results: The study found high prevalence of depressive symptoms, anxiety, and stress during pregnancy and the postpartum period. Depressive symptoms decreased over time, while anxiety and stress remained stable. Perceived social support was associated with better mental health outcomes. Qualitative analysis revealed diverse emotional experiences of pregnancy and coping strategies employed by participants. Conclusion: Addressing maternal mental health is crucial for comprehensive perinatal care. Routine screening, early intervention, and fostering social support networks are essential for promoting maternal well-being.

Humanização no Tratamento de Transtornos Mentais no SUS: Uma Abordagem naSaúde Coletiva

This article discusses the humanization in the treatment of individuals with mentaldisorders in the Unified Health System (SUS), aiming to analyze its application withincollective health. The systematic review focuses on the Psychiatric Reform and theNational Humanization Policy, highlighting the importance of these policies in the careof users with mental disorders. The study also explores the National Mental Health Policyand its impact on the organization of care in SUS, considering the recovery of subjectivityand the promotion of comprehensive and humane care. The analysis is based on thePRISMA methodology.

The Burden of Multiple Sclerosis in Mexico.

Multiple sclerosis (MS) is a CNS disease causing significant disability, mainly in young and middle-aged individuals. Despite extensive global research, Mexico lacks comprehensive epidemiologic data on MS, complicating effective health care planning and intervention. This study analyzes the epidemiology of MS in Mexico using data from the Global Burden of Disease (GBD) study. It focuses on prevalence, incidence, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) from 1990 to 2021. In addition, it examines the relationship between the sociodemographic index (SDI) and MS burden across Mexican states. Data were sourced from the GBD 2021 and analyzed using standard GBD methodologies. Key metrics included prevalence, DALYs, YLDs, and YLLs, standardized by age. Pearson correlation and linear regression were used to evaluate the association between SDI and MS prevalence. A locally weighted regression (LOESS) model was applied to compare observed and expected DALY rates based on SDI, identifying regional disparities in MS burden. In 2021, an estimated 18,016 individuals (95% uncertainty interval [UI] 14,993-21,337) lived with MS in Mexico, with an age-standardized prevalence of 13.10 per 100,000 inhabitants (95% UI 10.91-15.50). The incidence rate was 0.65 per 100,000 inhabitants (95% UI 0.55-0.75). Total DALYs for MS in 2021 were 17,947 (95% UI 14,458-20,542), comprising 13.05 age-standardized DALYs per 100,000 inhabitants. YLLs accounted for 9.47 per 100,000 inhabitants (95% UI 8.24-10.85) and YLDs for 3.56 (95% UI 2.45-4.77). The LOESS model revealed significant regional discrepancies, with Northern Mexico exhibiting better-than-expected health outcomes while Central and Southern Mexico displaying higher observed DALYs than expected. The findings highlight substantial regional disparities in the MS burden across Mexico. Northern Mexico showed better-than-expected health outcomes while Central and Southern Mexico exhibited higher disease burdens than anticipated. These discrepancies suggest that socioeconomic factors and health care accessibility significantly affect MS outcomes. The study's limitations include reliance on hospital records and potential underdiagnosis in less developed regions. Enhanced data collection and comprehensive health care strategies are essential to effectively address the growing MS burden in Mexico.

Management of drug-induced gingival overgrowth associated with calcium channel blocker therapy using a diode laser: a clinical case report

Relevance. Drug-induced gingival overgrowth (DIGO) is a recognized adverse effect of various medications, often leading to significant impairments in dental aesthetics, phonetics, mastication, and oral hygiene.Clinical case description. This report describes a clinical case of drug-induced gingival overgrowth (DIGO) associated with calcium channel blocker therapy. Initial non-surgical periodontal therapy, consultation with the patient’s physician, and diode laser-assisted gingival contouring, along with strong patient adherence, led to stable clinical outcomes over a one-year follow-up period with minimal risk of recurrence.Conclusion. This clinical case demonstrates the efficacy of diode laser treatment in managing similar conditions and emphasizes the importance of an interdisciplinary approach in the comprehensive care of patients with drug-induced gingival overgrowth.