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Clin Ter. 2025 May_Jun;176(3):363-370. doi: 10.7417/CT.2025.5235.
ABSTRACT
INTRODUCTION: Workplace safety is continually improving in many developed countries, but, despite this, work-related injuries, including fatal ones, are on the rise. Furthermore, in all cases of serious non-fatal accidents, a high morbidity rate for workers has been documented, burdened by an equally large expense that the State will have to sustain as damage compensation. Often, in case of fatal accidents, it is necessary to reconstruct the dynamics that caused the death, which makes it necessary to analyze all the lesions detectable on corpses. In this perspective, postmortem computed tomography (PMCT) has become essential to increase the speed and diagnostic accuracy, especially in case of lesions affecting the bone structures.
METHODS: A retrospective analysis aimed at evaluating the data collected from judicial autopsies performed between January 2019 and the recent month of March 2023 was carried out, focusing on those related to fatal accidents occurred at work.
RESULTS: According to the inclusion criteria, 18 out of the 204 autopsies carried out during the pre-established time frame were included, as certainly classifiable as “occupational deaths”. Among the 18 enrolled corpses, 16 were male and 2 female subjects. The traumatic events responsible of the death were analysed: 40% were related to falls from heights greater than 2 meters, 28% to explosion, 22% to accidental crush, 5% to electrocution and 5% to semi-truncation.
DISCUSSION AND CONCLUSIONS: Among fatal accidents, those related to falls from great heights and crushing are described as the most common, while among the least common are deaths due to electrocution. With reference to the location of injuries, those involving the head are considered the most fatal, while rib fractures are considered as the most common. In this context, postmortem computed tomography can be very helpful, not only for the two- and three-dimensional reconstruction of fractures, but also for understanding the dynamics with which fatal accidents develop in the workplace. This can both ensure a better assessment of the responsibilities of workers and/or the employer, and lead to the evaluation of the suitability of protective devices, also allowing to make them safer.
PMID:40525370 | DOI:10.7417/CT.2025.5235
Clin Ter. 2025 May_Jun;176(3):336-343. doi: 10.7417/CT.2025.5231.
ABSTRACT
OBJECTIVE: The pervasiveness of social media has led to a growing cause for concern regarding potential adverse effects that may stem from excessive social media usage, particularly in relation to its psychological effects. The authors in this study investigated problematic social media use and it’s predictors among emerging adults in the Indian context.
METHODS: We employed stratified cluster sampling technique in this cross-sectional study to select a sample of 204 students from government and private institutions. The inclusion criteria was specific to emerging adults aged 18 to 22 years. Tools included a proforma on socio-demographic data, the Social Media Disorder Scale and Rosenberg’s Self-Esteem Scale. We examined the prevalence and predictors of problematic social media use from self-reports of emerging adults.
RESULTS: Prevalence of problematic social media use was measured at 7.8%. There was a negative correlation observed (r = -0.270, p<0.0001) between problematic social media use and self-esteem of the participants. Living in low-income households and signing up on a single social media platform were protective while lower age at initially signing up and and having a felt need for followers on social media networks increased the odds of problematic social media use.
CONCLUSION: Problematic social media use is inversely correlated with self-esteem of emerging adults. Characteristics of social media usage such as the age at signing up, the number of platforms signed up on and the need for followers significantly predicted problematic social media usage among emerging adults.
PMID:40525366 | DOI:10.7417/CT.2025.5231
Clin Ter. 2025 May_Jun;173(3):310-316. doi: 10.7417/CT.2025.5227.
ABSTRACT
OBJECTIVES: This study aimed to determine the efficacy of the De Ritis ratio, which is cheaper and easily accessible compared to celiac antibodies, in the diagnosis of celiac disease and in predicting dietary compliance in follow-up.
MATERIAL AND METHODS.: 152 patients over 18 years of age who were diagnosed with celiac disease during a 4-year period in the gastroenterology department of a tertiary care regional hospital and 237 patients without celiac disease as control group were included. Endoscopy and pathology results, laboratory values and pre-diagnostic De Ritis ratios of both groups were compared. Patients with celiac disease were divided into 2 groups as diet-compliant and diet-incompliant. Laboratory values and De Ritis ratios of these 2 groups at diagnosis and at the end of the first year were compared.
RESULTS: There were 152 patients in the celiac group and 237 patients in the control group. AST (p<0.001) and AST/ALT mean value (p<0.001) were higher in the celiac patient group compared to the control group. AST/ALT ratio at the time of diagnosis was similar to the AST/ALT ratio at the end of first year in the diet non-compliant group, but the difference between them was not statistically significant (p=0.945). However, AST/ALT ratio at the end of the first year in diet-compliant celiac patient group was lower than at the time of diagnosis (1.17; 1.02, p<0.001).
CONCLUSION: De Ritis ratio may be a promising inexpensive, simple and easily accessible candidate to help clinicians differentiate Celiac disease and assess disease activity and dietary adherence.
PMID:40525362 | DOI:10.7417/CT.2025.5227
Clin Ter. 2025 May_Jun;176(3):301-309. doi: 10.7417/CT.2025.5226.
ABSTRACT
OBJECTIVE: Pediatric low-grade gliomas (pLGGs) and pediatric high-grade gliomas (pHGGs) reportedly exhibit variations in outcomes and treatment. This study aimed to investigate whether histogram analysis (HA) of diffusion-weighted imaging (DWI) imaging using a manually segmented three-dimensional (3D) volume of interest (VOI), excluding cystic or necrotic portions, could demonstrate a higher correlation with the tumor characteristics than an entire tumor VOI, therefore could improve the preoperative evaluation of supratentorial pediatric gliomas.
MATERIALS AND METHODS: In a current prospective study, 31 pediatric patients with pathologically-confirmed gliomas who underwent baseline DWI were enrolled. The patients were classified by histopathology according to tumoral grade: 15 had pLGGs and 16 had pHGGs. Tumoral VOIs were calculated and transferred to apparent diffusion coefficient (ADC) maps. Histogram analysis (HA) was performed to determine mean, maximum (max), minimum (min), kurtosis, skewness, entropy, standard deviation (SD), mean of positive pixels (MPP), and uniformity of positive pixel (UPP) values for ADC. Comparisons of the values of each ADC parameter within the entire tumoral VOIs (VOI 1) and the tumoral VOIs excluding cystic or necrotic portions (VOI 2) were performed.
RESULTS: In VOI 1 placement, ADCmin and rADCmin were significantly lower in pHGG compared with pLGG with p = 0.004 and 0.002, respectively. In VOI 2 placement, ADCmean, ADCmedian, ADCmin, ADC MPP, rADCmean, rADCmedian, rADCmin and rADC MPP were significantly lower in pHGG compared with pLGG with p < 0.001. The HA parameters and the ratio of HA parameters of peritumoral edema were not statistically significant difference between LGG and HGG groups with p < 0.05. In VOI 1 placement, the ratio of ADCmin had higher diagnostic ability (AUC = 0.838) compared with ADCmin (AUC = 0.800). In VOI 2 placement, ADCmin had highest diagnostic ability with AUC = 0.904. The optimal cut-off for ADCmin was 587×10-6 mm2/s with Se of 93.3%, Sp of 81.2% and Youden index of 0.746. Other parameters such as ADCmean, ADCmedian, ADC MPP, rADCmin, rADC mean, rADCmedian and rADC MPP also showed higher AUC values compared with AUC values in VOI 1 placement.
CONCLUSION: The HA parameters showed value in grading pediatric gliomas. Excluding cystic and necrotic portions from the entire tumor in measuring HA parameters had higher diagnostic value than the entire tumor VOI method. By using this segmentation, ADCmin had the highest performance in the prediction of histological glioma grading, followed by ADCmean, ADCmedian, ADC MPP, rADCmin, rADC mean, rADCmedian and rADC MPP.
PMID:40525361 | DOI:10.7417/CT.2025.5226
J Prim Care Community Health. 2025 Jan-Dec;16:21501319251346417. doi: 10.1177/21501319251346417. Epub 2025 Jun 17.
ABSTRACT
INTRODUCTION/OBJECTIVE: Surgery-induced losses in physical fitness may have detrimental consequences for patients with low reserve capacity at start. Our objective was to evaluate the effect of preoperative exercise on physical fitness in older patients with low physical fitness scheduled for colorectal cancer surgery.
METHODS: In this randomized, controlled trial, patients ≥65 years of age, who were scheduled for colorectal cancer surgery were included if they had a low maximal walking speed. Exercise for 2 to 3 weeks before surgery was home-based, high-intensity, and partly supervised by a primary care physiotherapist. The intervention consisted of inspiratory muscle training, aerobic, and strength exercises. A control group underwent usual preoperative care. Physical fitness was assessed with the 6-min walk test (primary outcome), the 30-s chair stand test and maximal inspiratory pressure which estimates inspiratory muscle strength (secondary outcomes). The effect of preoperative exercise on these outcomes before and after surgery was analyzed with linear mixed-models for the 6-min walk test and maximal inspiratory pressure and with a non-parametric Friedman rank sum test for the 30-s chair stand test. To evaluate adherence, physical activity was measured and compared for both groups.
RESULTS: A total of 52 participants were included. Analyses showed a statistically significant effect of preoperative exercise on postoperative inspiratory muscle strength. We did not find an effect of preoperative exercise on 6-min walk test or 30-s chair stand test performance. Regarding preoperative physical activity, the intervention group engaged more in high-intensity physical activity in relation to their total stepping time compared to the control group.
CONCLUSIONS: Short-term exercise before colorectal cancer surgery can provide benefits in terms of increased postoperative inspiratory muscle strength in older patients with low physical fitness. While we could not demonstrate an effect of preoperative exercise on any other outcomes, these results should be interpreted with caution due to a small sample size.
TRIAL REGISTRATION: Clinicaltrials.gov, identification number: NCT04878185, URL: Study Details | Optimizing Physical Function Before Cancer Surgery in Older People at Risk | ClinicalTrials.gov.
PMID:40525350 | DOI:10.1177/21501319251346417