Comprehensive Medical Care Research Articles

The effect of integrated medical care on the daily life of patients with coronary heart disease.

This study aims to explore the impact of comprehensive medical care on the daily life of patients with coronary heart disease (CHD) and to evaluate its effectiveness in improving quality of life, alleviating symptoms, and reducing the risk of cardiac events. A new comprehensive medical care scheme combining Traditional Chinese Medicine nursing differentiation, collaborative nursing interventions, and specialized community care was proposed. Patients with CHD were recruited as study subjects. Data were collected via questionnaires and interviews to assess the real-world impact of comprehensive medical care on the daily lives of patients. Significant improvements were observed in the observation group across multiple metrics. Baseline characteristics between the 2 groups showed no significant differences initially. Post-intervention, the observation group demonstrated significant improvements in left ventricular ejection fraction and self-assessment of stress (SAS), with left ventricular ejection fraction values increasing to 53.8% compared to 47.2% in the control group, and SAS scores decreasing markedly (P < .05). Additionally, the Disease Severity Index (DSI) indicated a significant reduction in disease severity in the observation group compared to a nonsignificant change in the control group (P > .05). Quality of life, assessed via MacNew and activities of daily living scores, also improved significantly post-intervention in the observation group compared to the control group (P < .05). Furthermore, the observation group exhibited a lower incidence of myocardial ischemia, myocardial infarction, and thrombosis over a 3-year period, with patient satisfaction significantly higher in the observation group (90% reported perfect contentment) compared to the control group (70% reported perfect contentment; P < .001). These findings suggest that the comprehensive nursing care approach significantly enhances cardiac function, quality of life, and patient satisfaction in CHD patients.

Neuropsychiatric Disorders and Burn Trauma: Insights From a Tertiary Care Hospital.

Burn injuries pose a significant risk for individuals with neurological disorders, particularly during altered states of consciousness. This study investigated the relationship between various neurological disorders and burn injuries in a tertiary care hospital setting. This prospective observational study was conducted over 24 months at a university-affiliated tertiary care hospital. Medical records of patients with burn injuries attributed to neuropsychiatric causes were analyzed. Data collected included demographic details, neurological cause, burn severity, anatomical distribution, and management. The study revealed a higher prevalence of burn injuries among females (47, 54.76%) compared to males (37, 45.23%). While there was no statistically significant difference in the duration of neuropsychiatric disorders between males (8.5 ± 2.8 years) and females (10.43 ± 3.94 years) (p = 0.321), epilepsy was the most common neurological disorder (56, 66.52%), followed by mental disability (15, 17.85%), dementia (6, 7.15%), cerebrovascular disorders (5, 5.95%), and Parkinson's disease (3, 3.57%). Females experienced a higher percentage of scald burns (26.19%) compared to males (29.76%) (p = 0.012) and a higher proportion of third-degree burns (24.4% vs. 11.9% in males) (p = 0.010). Anatomically, burns were most prevalent on the head and neck (26, 30.95% females vs. 14, 31.1% males) (p = 0.003), upper extremities (16, 19.04% females vs. 17, 20.23% males), and anterior trunk (18, 21.40% females vs. 11, 24.4% males). Common interventions included debridement and dressings (17, 31.1% females vs. 14, 20.23% males), tangential excision with split-thickness skin grafting (18, 21.40% females vs. 16, 19.04% males), and conservative dressings (9, 10.71% females vs. 5, 5.90% males). Females had a longer mean duration of hospital stay (13.65 days ± 4.68) compared to males (10.54 days ± 3.27). Neuropsychiatric disorders, particularly epilepsy, mental disability, and dementia, significantly contribute to burn injuries among affected individuals. This underscores the importance of targeted interventions in seizure management, home safety, and comprehensive medical care. Multidisciplinary collaboration and culturally informed strategies are essential for addressing this public health challenge effectively and improving patient outcomes.

Role of psychooncology in cancer treatment – a literature review

Introduction and objective. Receiving a cancer diagnosis can lead to significant mental distress, highlighting the necessity for comprehensive medical care that includes psychological support. Effective psycho-oncological therapy can help patients find fulfillment regardless of their prognosis, while also improving overall outcomes and treatment adherence. This article aims to review the medical literature on the mental health challenges faced by cancer patients and to explore potential treatment modalities. Review methods. Implementing Google Scholar and PubMed, a literature analysis was conducted, with particular attention paid to terms like "psychooncology," "anxiety," "depression," "cancer," "grief," and "PTSD." The period of consideration for articles was from 2017 to 2024. Brief description of the state of knowledge. Grief, anxiety, PTSD, despair, and other mental health problems can arise after receiving a cancer diagnosis. In order to improve treatment adherence and survival rates, psychological well-being must be addressed. Empirical evidence indicates that psychological disorders can hinder adherence to therapy and elevate the risk of death from cancer. Furthermore, as families often endure significant stress throughout the disease, psychological care is beneficial to both patients and their relatives. It is possible to enhance adherence and reduce symptoms by using an integrated strategy that takes into consideration both physical and mental health. Conclusions. An essential part of holistic cancer care is psycho-oncology, which enhances patients' general health and quality of life. Psycho-oncological therapy must be incorporated into standard cancer care in order to improve treatment outcomes and assist patients in overcoming their condition.

Impact of medical-nursing combined policy pilot on hospitalization frequency of middle-aged and older patients with chronic diseases: a quasi-experimental study based on China Health and Retirement Longitudinal Study.

To address the growing burden of older adult care, the Chinese government has introduced a policy that integrates medical care with elder care, launching two batches of national pilot projects. A majority of the older adult population suffers from one or more chronic diseases, with many experiencing multiple chronic conditions, necessitating support from both elder care and medical services. Using panel data from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2011 to 2020, this study employs the difference-in-difference (DID) model to analyze the impact of the integrated medical-nursing policy on the physical health of older patients with chronic diseases. The study found that the average annual number of hospitalizations for older individuals with one or more chronic diseases was 0.276. The integrated medical-nursing policy reduced hospitalizations by 0.0405. Additionally, the average annual hospitalization rate for older individuals with two or more chronic diseases was 0.339, higher than the former group. The integrated medical-nursing policy reduced hospitalizations by 0.0738 in this group. The pilot study demonstrates that the implementation of the integrated medical-nursing policy has significantly improved the physical health of older patients with chronic diseases. The government should promote these policies on a larger scale, explore various forms of integrated medical care, and provide more comprehensive medical and elder care services for older patients with chronic diseases.

ENHANCING SOLDIER RESILIENCE: ACUPUNCTURE TECHNIQUES FOR PAIN AND STRESS MANAGEMENT ON THE FRONTLINES

This article examines the growing interest in acupuncture as a potential treatment on the battlefield, particularly for pain relief and aiding the recovery of soldiers. This trend is part of a broader movement toward the integration of complementary and alternative medicine (CAM) into military healthcare systems. The article highlights how acupuncture’s holistic approach, which differs significantly from traditional Western medicine, makes it particularly effective in managing pain by considering the physical, psychological, and other patient characteristics that contribute to imbalances. Modern research and evidence further support the integration of acupuncture into pain management strategies, especially in military contexts. The article also explores the development and application of Battlefield Acupuncture, a protocol designed for rapid pain relief in combat settings. Additionally, the introduction of innovative approaches, such as finger acupuncture for self-help on the battlefield, offers a practical and low-risk alternative for soldiers in field conditions where access to comprehensive medical care may be limited. The effectiveness, simplicity, and potential for self-treatment make acupuncture a valuable tool in military medicine, particularly in resourceconstrained environments.

Об отдельных актуальных проблемах правового статуса врача и необходимости их законодательного решения.

Federal Law No. 323-FZ dated 11/21/2011 «On the Basics of Public Health protection in the Russian Federation» identifies two close, interrelated, but at the same time independent rights of a citizen: in article 21, the right to choose a doctor, taking into account the consent of a doctor, i. e. the right to choose any doctor at all and not only the attending physician, and in article 70 the patient’s right to choose the attending physician. At the same time, with the exception of the district service, the Basics do not disclose the mechanism for a citizen to choose a doctor, including a doctor, when providing him with primary specialized medical care and specialized medical care. This mechanism has not been disclosed in the procedures for providing medical care. In this regard, the authors proposed to supplement article 21 of the Fundamentals with instructions that the procedures for providing medical care, including the procedure for choosing a doctor by the patient. In addition, the publication noted that the absence of detailed and comprehensive medical care in the relevant procedures.

Trend in incidence (2005–2022) and medical and social problems in 15–17 years adolescents

Introduction. The analysis of the incidence in adolescents (15–17 years old inclusive) showed its significant increase during the first two decades of the XXI century. The prevalence of borderline mental disorders among adolescents and cases with deviant behaviour, unhealthy lifestyle, conflict and difficult life situations are increasing. Adolescents and young people need comprehensive medical care, managed with taking into account age-related psychological and social characteristics. The purpose of the study is to analyze the trend in health indicators of older adolescents, social problems affecting the development of their health and education, and scientific substantiation of the main directions and principles of managing medical care and social assistance to adolescents and youth. Materials and methods. According to official statistics, a comparative analysis of the incidence in 0–14 years children and 15–17 years adolescents for the period 2005–2022 was carried out by the main classes of somatic pathology and mental disorders. According to scientific literature, basic information about the medical and social problems in adolescents and 15–25 years youth has been systematized. Results. Analysis of the incidence in adolescents showed its growth and revealed classes of diseases for which the rates of adolescents are higher than in children. This allows determining the main directions of treatment and preventive work. The main medical and social problems of adolescents include: health risks caused by educational factors; unhealthy lifestyle; destructive forms of behaviour; early sexual activity; early employment; professional choice that does not correspond to individual health characteristics. Limitations. The considered medical and social problems are characteristic of older adolescents (15–17 years old inclusive) and young people. Conclusion. Due to the high incidence and unfavourable course of pathologies, psychological characteristics, and the significant prevalence of medical-social problems in adolescence and young people, it is advisable to create medical-social centers for adolescents and youth on the basis of medical institutions in the country.

Innovative Wearable Sweat Sensor Array for Real-Time Volatile Organic Compound Detection in Noninvasive Diabetes Monitoring.

Wearable sweat sensors are reshaping healthcare monitoring, providing real-time data on hydration and electrolyte levels with user-friendly, noninvasive devices. This paper introduces a highly portable two-channel microfluidic device for simultaneous sweat sampling and the real-time detection of volatile organic compound (VOC) biomarkers. This innovative wearable microfluidic system is tailored for monitoring diabetes through the continuous and noninvasive tracking of acetone and ammonia VOCs, and it seamlessly integrates with smartphones for easy data management. The core of this system lies in the utilization of carbon polymer dots (CPDs) and carbon dots (CDs) derived from monomers such as catechol, resorcinol, o-phenylenediamine, urea, and citric acid. These dots are seamlessly integrated into hydrogels made from gelatin and poly(vinyl alcohol), resulting in an advanced solid-state fluorometric sensor coating on a cellulose paper substrate. These sensors exhibit exceptional performance, offering linear detection ranges of 0.05-0.15 ppm for acetone and 0.25-0.37 ppm for ammonia, with notably low detection limits of 0.01 and 0.08 ppm, respectively. Rigorous optimization of operational parameters, encompassing the temperature, sample volume, and assay time, has been undertaken to maximize device performance. Furthermore, these sensors demonstrate impressive selectivity, effectively discerning between biologically similar substances and other potential compounds commonly present in sweat. As this field matures, the prospect of cost-effective, continuous, personalized health monitoring through wearable VOC sensors holds significant potential for overcoming barriers to comprehensive medical care in underserved regions. This highlights the transformative capacity of wearable VOC sweat sensing in ensuring equitable access to advanced healthcare diagnostics, particularly in remote or geographically isolated areas.

HIV Incidence and Transactional Sex Among Men Who Have Sex With Men in Ningbo, China: Prospective Cohort Study Using a WeChat-Based Platform.

Sexual transmission among men who have sex with men (MSM) has become the major HIV transmission route. However, limited research has been conducted to investigate the association between transactional sex (TS) and HIV incidence in China. This study aims to investigate HIV incidence and distinguish sociodemographic and sexual behavioral risk factors associated with HIV incidence among MSM who engage in TS (MSM-TS) in China. We conducted a prospective cohort study using a WeChat-based platform to evaluate HIV incidence among Chinese MSM, including MSM-TS in Ningbo, recruited from July 2019 until June 2022. At each visit, participants completed a questionnaire and scheduled an appointment for HIV counseling and testing on the WeChat-based platform before undergoing offline HIV tests. HIV incidence density was calculated as the number of HIV seroconversions divided by person-years (PYs) of follow-up, and univariate and multivariate Cox proportional hazards regression was conducted to identify factors associated with HIV incidence. A total of 932 participants contributed 630.9 PYs of follow-up, and 25 HIV seroconversions were observed during the study period, resulting in an estimated HIV incidence of 4.0 (95% CI 2.7-5.8) per 100 PYs. The HIV incidence among MSM-TS was 18.4 (95% CI 8.7-34.7) per 100 PYs, which was significantly higher than the incidence of 3.2 (95% CI 2.1-5.0) per 100 PYs among MSM who do not engage in TS. After adjusting for sociodemographic characteristics, factors associated with HIV acquisition were MSM-TS (adjusted hazard ratio [aHR] 3.93, 95% CI 1.29-11.93), having unprotected sex with men (aHR 10.35, 95% CI 2.25-47.69), and having multiple male sex partners (aHR 3.43, 95% CI 1.22-9.64) in the past 6 months. This study found a high incidence of HIV among MSM-TS in Ningbo, China. The risk factors associated with HIV incidence include TS, having unprotected sex with men, and having multiple male sex partners. These findings emphasize the need for developing targeted interventions and providing comprehensive medical care, HIV testing, and preexposure prophylaxis for MSM, particularly those who engage in TS.

Health Supervision for Children and Adolescents With Sickle Cell Disease: Clinical Report.

Sickle cell disease (SCD) is a group of complex genetic disorders of hemoglobin with multisystem manifestations. The scope of this clinical report is such that in-depth recommendations for management of all complications is not possible. Rather, the authors present an overview focused on the practical management of children and adolescents with SCD and the complications that are of particular relevance to pediatric primary care providers. References with detailed commentary provide further information. Timely and appropriate treatment of acute illness is critical, because life-threatening complications may develop rapidly. Specialized comprehensive medical care decreases morbidity and mortality during childhood. The provision of comprehensive care is a time-intensive endeavor that includes ongoing patient and family education, periodic comprehensive evaluations and other disease-specific health maintenance services, nursing support, psychosocial care, and genetic counseling. Ideally, this care includes comanagement by the pediatrician or other pediatric primary care provider and a team of specialist SCD experts: Hematologist, other pediatric specialists, advanced practice providers, nurse specialists, social workers, patient navigators, and educational liaisons.

Radiofrequency echographic multi-spectrometry-based measurement of bone mineral density in patients with severe motor and intellectual disability: An opportunity for patients with severe scoliosis and hip dislocation

PurposeRadiofrequency echographic multi-spectrometry (REMS) is an ultrasound technology currently used for the densitometric evaluation of osteoporosis and has been validated against dual-energy X-ray absorptiometry. However, the use of REMS for bone densitometry in patients with severe motor and intellectual disabilities (SMID) remains to be reported. This study aimed to investigate whether REMS technology can be used for densitometric evaluation of osteoporosis in patients with SMID with hip dislocation and severe scoliosis. MethodsSixty-five patients with SMID, who resided in a long-term care facility and received comprehensive medical and rehabilitation care, underwent REMS scans of the femoral neck and/or lumbar spine. Data regarding anthropometric parameters (height and weight), bone mineral density (BMD), clinical diagnostic classification, physical ability, presence of scoliosis and hip dislocation, and frontal radiographs of both hip joints were obtained. ResultsWe included 29 men and 34 women (mean age: 52.6 years). All patients underwent successful scanning at either the femoral neck (82.5 %) or lumbar spine (95.2 %). BMD measurements obtained using REMS revealed low values, with a mean BMD, T-score, and Z-score of 0.67 g/cm2, −2.39 standard deviation (SD), and − 1.38 SD, respectively, at the femoral neck and 0.66 g/cm2, −2.70 SD, and − 1.87 SD, respectively, at the lumbar spine. The average Cobb angle of the lumbar spine was 34.0°; furthermore, dislocation rates did not significantly differ between those with and without successful BMD measurements (p = 0.073). Lumbar BMD T-scores were significantly correlated with femoral neck BMD T-scores (p < 0.001, r = 0.530). ConclusionAll patients with SMID were able to undergo measurements of either spinal or femoral neck BMD; furthermore, 77.7 % of the patients underwent measurements at both the lumbar spine and femur. Our data suggest that REMS is useful for measuring BMD in patients with SMID who are residing in institutions.

A scoping review of hospital to home transitional care programmes for stroke survivors.

The study was aimed at exploring the current scope of hospital to home transitional care programmes for stroke survivors. Stroke survivors face the dilemma of solving many complex problems that leave survivors at high risk for readmission as they discharge from hospital. The transitional care model has proved to be effective in reducing readmissions and mortality, thereby improving health outcomes and enhancing patient satisfaction for survivors with stroke. A scoping review. Conducted in accordance with the Joanna Briggs Institute (JBI) Methodology for Scoping Reviews. A comprehensive search was conducted in nine databases, including PubMed, Web of Science, Cochrane Library, EMBASE, CINAHL, Medline, China Knowledge Net-work, Wanfang Database and China Biomedical Literature Database (SinoMed) from January 2014 to June 2023. Title and abstract screening was performed on 10,171 articles resulting in 287 articles for full-text screening. Full-text screening yielded 49 articles that met inclusion criteria. This study identified transitional care programmes for stroke survivors, as well as areas for future consideration to be explored in more depth to help improve transitional care for stroke survivors as they transition from hospital to home. This study demonstrates that multidisciplinary collaboration becomes an integral part of the transitional care model for stroke survivors, which provides comprehensive and precise medical care to them. PRISMA checklist for scoping reviews. No patient or public contribution was part of this study.

Quality of Life Outcomes Following Aortofemoral and Iliofemoral Bypass Surgery in Patients With Peripheral Arterial Disease: A Two-Year Follow-Up Study.

Peripheral arterial disease is a circulatory disorder characterized by reduced blood flow to the extremities, predominantly affecting the lower limbs. This study aims to evaluate the impact of aortofemoral and iliofemoral bypass surgeries on patients' quality of life two years post operation and identify predictors of quality-of-life improvements. This cross-sectional study included adult patients with aortoiliac disease who underwent bypass surgery (aortofemoral or iliofemoral) at East Jeddah General Hospital from January 2020 to December 2022. Quality of life was assessed using the Arabic version of the Short Form Health Survey 12 (SF-12) preoperatively and two years postoperatively. Data on sociodemographic factors (age, sex, education, income) and medical factors (smoking, BMI, comorbidities) were collected. Statistical analyses included descriptive statistics, t-tests, one-way ANOVA, and regression analyses using IBM SPSS version 25.0 (IBM Corp., Armonk, NY). The study included 275 patients. Significant improvements in both physical and mental SF-12 scores were observed postoperatively across all patient groups (P < 0.001). Older age, unemployment, and lower income were associated with lower SF-12 scores. Males had higher postoperative mental scores (P = 0.036). Higher BMI and smoking pack-years negatively correlated with SF-12 scores. Patients with comorbidities had significantly lower preoperative and postoperative SF-12 scores (P < 0.05)but showed significant improvements postoperatively (P < 0.001). Aortofemoral and iliofemoral bypass surgeries significantly improve the quality of life in peripheral arterial disease patients two years post operation. Key predictors of lower quality of life include older age, unemployment, lower income, high BMI, smoking, and comorbidities. Targeted interventions, such as smoking cessation programs, weight management, and comprehensive medical care, are essential for optimizing postoperative outcomes and enhancing patients' physical and mental well-being.

Exploring Reproductive Experiences With Women Enrolled in the International Vasculitis Pregnancy Registry.

This study explored the reproductive journeys of women with vasculitis, including their conversations with healthcare providers, disease activity, medication changes, and delivery experiences. Interviews were conducted with women registered in the Vasculitis Pregnancy Registry (VPREG), an online patient-reported registry of pregnant women with vasculitis. A team of physicians, patients, and qualitative researchers developed a qualitative interview guide. Participant responses were evaluated using thematic analysis. Eighteen patients with vasculitis who had experienced pregnancy were interviewed (10 antineutrophil cytoplasmic antibody-associated vasculitis, 4 Takayasu arteritis, 2 Behçet disease, 1 IgA vasculitis, 1 relapsing polychondritis). Thematic analysis revealed common experiences in the decision-making process during pregnancy planning, including accessing information from multiple sources, communicating with medical professionals, and changing treatment for vasculitis. Women sought information about vasculitis and pregnancy from various sources, including social media; however, opinions from their physicians and family members were most influential. Patients were more likely than providers to initiate conversations regarding family planning. Balancing differing opinions from subspecialists was challenging as many patients recalled acting as a liaison between multiple physicians during pregnancy. The need for self-advocacy was a common experience among patients. Most women had pregnancies that resulted in live births with delivery at term. When making decisions about pregnancy, women of reproductive age with vasculitis used multiple resources. Patients consistently valued their medical provider's opinion over alternative sources of information. To ensure comprehensive medical care, half of women relied on self-advocacy to coordinate communication among subspecialists. Most women had pregnancies that resulted in live births with delivery at term.

A Questionnaire Study to Compare The Role of Nursing and Medical Laboratory Staff in Promoting Awareness About Thalassemia

Introduction: One of the most common genetically transmitted blood disorders is thalassemia. Hematology is a matter of great concern, warranting global awareness and understanding among healthcare professionals. We aim to highlight the roles of nursing and medical laboratory employees in the task of spreading information about thalassemia through this research, which has taken a self-reporting survey. Methods: More of the nursing staff and also the medical laboratory staff were interviewed to evaluate their knowledge about thalassemia, their perception of their role in thalassemia care, and their level of involvement with education activities on the issue. Data analysis, for example, correlation and hypothesis testing, has been done in this study to look for group differences. Results: The results demonstrated that thalassemia knowledge levels and the roles of nursing and lab staff were very varied among themselves. Medical laboratory staff had greater knowledge of thalassemia, and there were staff nurses who considered their job in caring for thalassemia more positively. Conclusions: Increased education and increased educational seminars on thalassemia would help to increase thalassemia awareness and provide better patient care services. The results of this study can be used to increase the training of medical care personnel to provide comprehensive medical care for thalassemia patients.

Managing Undernutrition in Pediatric Oncology: A Consensus Statement Developed Using the Delphi Method by the Polish Society for Clinical Nutrition of Children and the Polish Society of Pediatric Oncology and Hematology.

"Managing Undernutrition in Pediatric Oncology" is a collaborative consensus statement of the Polish Society for Clinical Nutrition of Children and the Polish Society of Pediatric Oncology and Hematology. The early identification and accurate management of malnutrition in children receiving anticancer treatment are crucial components to integrate into comprehensive medical care. Given the scarcity of high-quality literature on this topic, a consensus statement process was chosen over other approaches, such as guidelines, to provide comprehensive recommendations. Nevertheless, an extensive literature review using the PubMed database was conducted. The following terms, namely pediatric, childhood, cancer, pediatric oncology, malnutrition, undernutrition, refeeding syndrome, nutritional support, and nutrition, were used. The consensus was reached through the Delphi method. Comprehensive recommendations aim to identify malnutrition early in children with cancer and optimize nutritional interventions in this group. The statement underscores the importance of baseline and ongoing assessments of nutritional status and the identification of the risk factors for malnutrition development, and it presents tools that can be used to achieve these goals. This consensus statement establishes a standardized approach to nutritional support, aiming to optimize outcomes in pediatric cancer patients.

Melanoma and basal cell skin cancer in a patient with HIV infection. Clinical observation

The aim is to present the results of the anamnesis, diagnosis and treatment of a case of a combination of malignant melanoma of the skin and basal cell carcinoma of the skin in a patient with HIV infection. Material and methods. The clinical observation of the development of multiple skin lesions with malignant neoplasms (melanoma and basal cell carcinoma) against the background of HIV infection in a patient with low adherence to follow-up and antiretroviral therapy (ART) is described. Clinical and anamnestic data, results of examination and therapy are presented. Results and discussion. Malignant neoplasms of the patient’s skin were first identified by a dermatovenerologist. The patient was routed to an oncologist, fully examined and successfully treated with a combined method (surgical removal of tumors, photodynamic therapy and immunotherapy). Further observation and examination revealed the metastasis of melanoma. The above observation indicates the need for timely and comprehensive examination of people living with HIV (PLHIV) for early detection of oncological diseases. The case demonstrates the possibility of obtaining effective treatment of a malignant neoplasm of the skin against the background of immunosuppression in the short term, despite the patient’s low adherence to therapy. Conclusion. It is especially important for outpatient doctors (infectious disease specialists, dermatovenerologists, surgeons, etc.) to be oncological when working with PLHIV. It is necessary to include malignant neoplasms of the skin, including melanoma and basal cell carcinoma, in the range of differential diagnostic search for erosive ulcerative and nodular lesions. The presented case highlights the need for timely provision of comprehensive medical care and proper routing of comorbid patients.

Hereditary Hemorrhagic Telangiectasia - a literature review

Introduction and purpose: Hereditary hemorrhagic telangiectasia (HHT), also known as Osler-Weber-Rendu syndrome, is a rare and complex vascular disorder characterized by abnormal blood vessel formation. It can present significant challenges in diagnosis and management, as it is currently estimated up to 90% of those affected are never diagnosed. Despite its rarity, HHT can carry substantial implications for patients and their families, at times requiring comprehensive medical care and support. This paper aims to provide an in-depth exploration of HHT, encompassing its epidemiology, genetics, clinical manifestations, diagnostic approaches, and current management strategies. Moreover, we hope to point out possible areas in need of future research.&#x0D; Description of the state knowledge: HHT is an autosomal dominant genetic disorder that affects 1 in 5-10,000 people. Its most prominent symptoms include telangiectasia of skin and mucous membranes, recurrent epistaxis, gastrointestinal bleeding and arteriovenous malformations in vital organs. In the vast majority of cases, it is caused by a mutation in one of the following genes: ENG, ACVRL1, SMAD4; however, mutations in other genes have been described to cause a similar or much the same constellation of symptoms. Treatment options are focused on managing symptoms and improving quality of life, but possible new treatment options are being researched that could change the landscape of HHT management.&#x0D; Summary: HHT is a severely underdiagnosed disease that has seen a surge of researchers’ interest in recent years. We firmly believe that, combined with plummeting costs of genetic testing and possible new treatment options, means that HHT will become increasingly important in physicians’ everyday practice.

Analysis of the demand for mental health consultation and liaison programmes: a comprehensive view.

IntroductionThe mental health consultation and liaison programme plays a crucial role in comprehensive medical care by addressing psychiatric co-morbidities in hospitalised patients.ObjectivesThe aim of this study is to analyse demand and assess referral patterns to the mental health consultation and liaison programme in order to identify areas for improvement and optimise the provision of care.Methods A descriptive cross-sectional study was conducted by analysing records of referrals to the mental health consultation and liaison programme over a one-year period. Demographic data, origin of demand, type of request, episodic diagnosis, psychiatric diagnoses, follow-up and discharge referral were collected.ResultsA total of 1180 referrals to the mental health consultation and liaison programme were reviewed. Most of the episodic diagnoses were related to anxious-depressive symptomatology, acute stress reaction and acute confusional syndrome. The majority of patients followed up did not require further referral to mental health facilities.ConclusionsAnalysis of the demand for the mental health consultation and liaison programme helps us to optimise care on psychiatric co-morbidities. These results support the importance of integrated care that addresses both medical and psychiatric aspects of inpatient health. Strategies to improve collaboration between different services should be implemented to ensure optimal care and provide a holistic approach.Disclosure of InterestNone Declared

College health centers: An update on medical issues

College health centers are an important source of health care for large numbers of young adults throughout the country. With 16.9 million students enrolled in 2023 in post-secondary institutions in the United States, the potential impact that health centers at these institutions have is significant. Late adolescence and early adulthood is a particularly vulnerable stage of both cognitive and psychosocial development, and college health centers that provide comprehensive medical and mental-health care play an important role in providing comprehensive care for this age group. As we move into a post-pandemic era, colleges and universities across the country continue to navigate all the changes that have been brought about by the COVID-19 pandemic. It is perhaps now more important than ever to review and assess the clinical care college health centers provide, who they provide this care to, and identify opportunities for improvement and where there may be need for change.