Comparison of Robotic Versus Conventional Open Thyroidectomy for Recurrent Laryngeal Nerve Safety: A Systematic Review and Meta-Analysis.

This review aims to investigate the safety of recurrent laryngeal nerve (RLN) by comparing robotic thyroidectomy (RT) versus open thyroidectomy (OT) in Western and Asian populations. Two main outcomes of this review were (1) the safety of RLN comparing the robotic and OT assessing transient and permanent laryngeal nerve (PLN) palsy as a postoperative complication in each surgical procedure and (2) the safety of RLN comparing the robotic and OT assessing transient and permanent laryngeal nerve (PLN) palsy as a postoperative complication between studies conducted in USA/Europe and Asia. We searched relevant literature in electronic databases such as PubMed, MEDLINE, Cochrane CENTRAL, ScienceDirect, and Cumulative Index to Nursing & Allied Health (CINAHL) up to September 2022. Further research was performed during January 2024 in the Scopus database. Two primary outcomes were set: transient RLN palsy and permanent RLN palsy, comparing RT and OT. In this review, 18 non-randomized studies were included. A statistically significant difference between robotic and conventional OT was not observed either in transient RLN or in permanent RLN palsy. The odds ratio (OR) for the overall comparison of transient RLN palsy was 1.18, and the 95% confidence interval (95% CI) was 0.80-1.74. The subgroup analysis for transient RLN palsy between USA/Europe studies was OR 1.28, and the 95% CI was 0.64-2.58. The subgroup analysis for transient RLN palsy between Asian studies was OR 1.14, and the 95% CI was 0.72-1.82. The OR for the overall comparison of permanent RLN palsy was OR 0.90, and the 95% CI was 0.38-2.15. The subgroup analysis for permanent RLN palsy between USA/Europe studies was OR 0.45, and the 95% CI was 0.07-2.97. The subgroup analysis for permanent RLN palsy between Asian studies was OR 1.13, and the 95% CI was 0.42-3.05. Heterogeneity I2 was 0% in all outcomes. The Mantel-Haenszel method fixed effect was used. First, RT and open conventional thyroidectomy have comparable safety for RLN, although the analysis showed no statistically significant results. Second, no statistically significant results were found for RLN safety in either USA/Europe or Asian studies. Considering that there is not a statistically significant difference between the two approaches for RLN safety, and due to the limited number of studies from Western countries, the results should be considered with caution. Important factors such as the patient's body characteristics, the existing thyroid pathology, and the surgical approach should be kept in mind. More comparable studies are needed on the Western population.

Satisfaction of Patients with HIV/AIDS Infection from the Care Provided in the Special Infection Unit of University General Hospital of Alexandroupoli.

Background: C HIV/AIDS infection is characterized by a very low number of T lymphocytes (CD4), which makes sufferers vulnerable to various infections, and so they seek continuous care in Special Infections Units. Objective: The purpose of the survey is to investigate the factors that contribute to the satisfaction derived from the health services provided to people living with the human immunodeficiency virus; and they are monitored at the Special Infections Unit of the University General Hospital of Alexandroupoli. Methods: All patients who came to the Special Infections Unit of the University General Hospital of Alexandroupoli during the period June - July 2021 were asked to complete an anonymous questionnaire on satisfaction derived from the health services provided (E - PQ - SPCSS) and satisfaction derived from their work and quality of life (Occupational Stress Questionnaire, JCQ). The statistical package SPSS 19.0 was used for the statistical analysis of the data. With the help of the ANOVA statistical test, the differences between the variables were checked. P-Value in all audits was set at 0.05. Values showing equal to or less than 0.05 were considered statistically significant. Results: They were 85 patients who participated. Amongst them, they were mainly men (75.3%), the mean age was 35-50 years (50.6%), residents of Thrace (62.3%). 37.7% of the participants said they had some difficulty accessing SIU. Quality of life was positively correlated with education (p<0.001) where the higher reported level of education was, the higher satisfaction rates were. A positive correlation (p<0.001) was also observed amongst income rates where the higher incomes reported, the higher the satisfaction rates were. Lower incomes were significantly associated (p = 0.029) with mental disorders (anxiety, depression). Quality of life was positively associated with both satisfaction with medical as well as nursing care (p <0.008). The adequacy and clarity of the information the patients receive from SIU physicians during their visit shows a significant positive correlation (p<0.001). In addition, there is a significant correlation regarding the problems patients may have experienced in the last 6 months in terms of access to treatment (p<0.021). Conclusion: Participants showed high satisfaction rates from the medical and nursing care provided at the SIU of the PGNA. The opportunity of expression given to users - patients through satisfaction studies promotes and creates a climate of trust between them and the decision-making teams of health units.

Prevalence of anxiety and depression of health care workers during COVID-19 - a systematic review and meta-analysis.

Introduction: During the COVID-19 pandemic, the workload of healthcare workers managing the disease, increased significantly. The objective of this review is to determine the anxiety and depression prevalence among healthcare workers during the pandemic period. Methods: We searched systematically the literature in five electronic databases such as PubMed, CINAHL, ScienceDirect, MEDLINE, and Cochrane COVID-19 study register. The last online research was performed in May 2022. We included only cross-sectional studies and performed a meta-analysis of pooled prevalence. Publication bias was assessed with a funnel plot and Egger's and Begg's tests. A random effect was applied and heterogenicity I2 was calculated. Quality assessment of included studies was performed using the Joanna Briggs Institute tool. Results: In this review, we included 14 cross-sectional studies comprising 7780 healthcare workers. Participants were from the whole spectrum of healthcare workers. The pooled prevalence of depression was 33.8% (95% CI: 24.6 - 43.6), heterogenicity I2: 98.69%. The pooled prevalence of anxiety was 41.3% (95% CI: 30.2 - 52.9), heterogenicity I2: 99.01%. Conclusion: One-third of healthcare workers suffered from depression, and more than one-third suffered from anxiety during the COVID-19 pandemic. Increased measures of surveillance of mental health should have been taken, as well as the support of healthcare workers running a high risk of psychological distress during the COVID-19 pandemic.

House Dust Mite and Grass Pollen Allergen Extracts for Seasonal Allergic Rhinitis Treatment: A Systematic Review.

BACKGROUND: The treatment of allergic rhinitis is important due to the burden that the disease causes globally. The objective of this review is to explore the efficiency of house dust mite and grass pollen extracts in allergic rhinitis treatment. METHODS: We performed research in electronic databases and searched relevant articles on PubMed, CINAHL, OVID, ScienceDirect, Cochrane CENTRAL, and MEDLINE. We used keywords such as 'allergic rhinitis', 'sublingual immunotherapy', 'randomized controlled trials', 'grass pollen', 'allergen immunotherapy', and 'house dust mite'. We included nine randomized controlled trials (RCTs). Quality assessment of included studies was performed independently by two authors. RESULTS: We included nine eligible RCTs in this review. Five RCTs were about grass pollen extracts and four RCTs were about house dust mite extracts. Most of the studies reported positive results and suggested further evaluation of sublingual immunotherapy (SLIT) treatment. Grass pollen extracts mostly used were Dactylis glomerata, Poa pratensis, Lolium perenne, Anthoxanthum odoratum, Phleum pratense, and Parietaria. House dust mite extracts used were from Dermatophagoides pteronyssinus and Dermatophagoides farina. According to the quality assessment, no bias was observed in the included studies. CONCLUSIONS: Although sublingual allergen immunotherapy shows a benefit compared to placebo in the treatment of allergic rhinitis and rhino-conjunctivitis in adults, the results are interpreted with caution due to the high heterogenicity among studies in treatment protocols and dosing. More standardization among studies is needed.

The Quality of Health Services Provided to Patients Undergoing Myocardial Perfusion Imaging by a Nuclear Medicine Department.

Background: Nuclear medicine procedures can be delivered in different healthcare settings, such as outpatient centers, medical clinics, mobile units, and hospitals. The process of providing care to the patient can be modified according to the provision arrangement; however, the basic level of quality of service should be maintained, and continuous improvement should be pursued. Objective: The objective of this research study is to investigate the quality of health services provided to patients undergoing myocardial perfusion imaging by a nuclear medicine department. Methods: The data collected through the questionnaires were saved in an Excel sheet, and then, they were analyzed by using the SPSS 24 statistical software platform. Firstly, the demographic data of the sample are presented by using a frequency table. In terms of the main questions, for those of them that were not answered in the Likert scale, frequency charts were used to present their results. Results: From the analysis, it emerged that 75% (n=75) of the sample was composed of male patients, and 25% (n=25) was composed of female patients. Regarding the age distribution of the patients of the survey, it was observed that 39% (n=39) were between 45 and 64 years old, 35% (n=35) were over 65 years old, and 26% (n=26) were between 18 and 44 years old. Moreover, it was observed that 17% (n=17) of the sample were Secondary School graduates, 17% (n=17) were Technological Education graduates, 16% (n=16) were Primary School graduates, 16% (n=16) were High School graduates, and 14% (n=14) were University graduates. Conclusion: The levels of satisfaction ranged were moderate regarding access to the clinics, and were lower regarding the time required between the date of making the appointment and the date of performing the examination.

Intratympanic Versus Systemic Steroid Therapy for Idiopathic Sudden Hearing Loss: A Systematic Review and Meta-Analysis.

Idiopathic sudden sensorineural hearing loss (ISSHL) is a common condition characterized by hearing threshold reduction, most often of unknown causes. The patient experiences a sudden reduction of the hearing threshold in one or both ears. Steroids are the mainstream of the treatment. This study aims to investigate the effectiveness of intratympanic steroid administration compared with systemic administration and the combination of the two steroid treatments in the hearing recovery of patients with idiopathic sudden sensorineural hearing loss. We searched electronic databases such as PubMed, ScienceDirect, CINAHL, Cochrane (Central), Ovid, and Medline from August 31, 2021, to November 31, 2021, and from February 5 to 10, 2022. We included 12 randomized controlled trials (RCTs) and performed a meta-analysis comparing the efficiency in the hearing recovery of intratympanic versus systemic steroid treatment, systemic versus combined, and intratympanic versus combined steroid treatment. The results of the intratympanic versus systemic steroid therapy comparison showed no actual difference in efficiency and no statistical significance (odds ratio: 1.07 (Mantel-Haenszel (M-H), fixed, 95% confidence interval (CI): 0.76-1.51)). Systemic steroid treatment was inferior to combined steroid treatment and was the only outcome with statistical significance (odds ratio: 0.55 (M-H, fixed, 95% CI: 0.38-0.80)). Intratympanic steroid treatment was inferior to combined steroid treatment, although the results were not statistically significant (odds ratio: 0.65 (M-H, fixed, 95% CI: 0.37-1.16)). In conclusion, systemic steroid therapy was inferior to combined steroid therapy. The comparison of intratympanic with systemic therapy and intratympanic with combined therapy showed no statistical significance. Further research is needed with more RCTs, and side effects should be considered.

An Overview of Play Therapy.

BACKGROUND: Play is an essential parameter of children's growth and expression and this is the reason of why the use of play therapy is considered as fundamental means of preventing and dealing with problems and difficulties presented to children. OBJECTIVE: The aim of this paper is to review the parameters related to this issue, emphasizing the efficacy of this therapeutic approach to various problems of children. METHODS: A review of the recent literature on the issue, searching through Greek and international databases (Medline, Heal-link), in English and Greek language. RESULTS: The review shows that play therapy as a form of prevention and treatment is suitable mainly for preschool and school age children. It is addressed to children who are in a transition period of their lives (after a divorce, a loss), with difficulties in managing feelings, in socializing or children who have behavioral problems. It is also addressed to children who have been witnesses of domestic violence, who have suffered some form of abuse, children who are to undergo a major surgery or those who have speech disorders. Furthermore, it is suitable for children who have some kind of developmental disorder (autism or attention deficit / hyperactivity disorder). Its efficiency is demonstrated by numerous research papers reporting a significant decrease of negative emotions and behaviors by its use. CONCLUSION: Play therapy is an alternative proposal of intervention on important issues related to children. Its implementation and value is widely known and is constantly expanding. The only condition for its implementation is the correct theoretical training of the professionals and the proper diagnosis.

Care of Patients with Alzheimer's Disease.

INTRODUCTION: Alzheimer's disease is one of the irreversible dementias and leads to death. About 10% of people over 60 years and 20% of people over 80 will have Alzheimer's sometime in their lives. In the case of Alzheimer's disease, care can turn into an extremely large and unevenly distributed burden. The burden that caregivers are called upon to lift is particularly high at the physical, psychological, and social levels. PURPOSE: The purpose of this study was to describe the characteristics and needs of caregivers and even informal ones, that is, patients in the patient's family or friendly environment who voluntarily or unintentionally offer unpaid care to patients with Alzheimer's disease. MATERIAL AND METHODS: The present study was conducted using the Carer Well-Being and Support Questionnaire (CWSv2) at Thessaloniki Psychiatric Hospital between October and December 2019. For the statistical analysis, the SPSS package 23 was used. RESULTS: Alzheimer-type dementia is a condition with gradual, inevitable, and uncontrollable deterioration. So, it was expected that those involved in the care of these patients would be afraid of what their patient future care would be. Consequently, there is a high correlation coefficient between the two relevant variables (Fisher's Exact Test: 31,426; Sig: 0.007). Caregivers need to be alert at all times in order to fulfill their role and care for their loved one. There is a strong correlation index between the two variables (Fisher's Exact Test: 32,761; Sig: 0.003). The situation of a lack or distorted form of communication between patients and caregivers may also create or exacerbate caregivers' anxiety, causing them feelings of depression and deadlock that is also reflected in the relevant correlation index (Fisher's Exact Test: 30,053; Sig: 0.001). Women were more in need for additional help, with the two variables being marginally statistically significant (Fisher's Exact Test: 5.373; Sig: 0.05). CONCLUSIONS: Taking into account the results, as reflected through the elaboration of the closed and open questions of this tool, new structures and services should be created in order to facilitate caregivers' job.

Nurses' Attitudes Toward Lifelong Learning via New Technologies.

Introduction: Lifelong professional education is considered as a qualitative indicator in the health discipline, as it can improve health professionals' knowledge and skills, as well as nursing care. Purpose: The purpose of this original research is to examine and record the attitudes and behavior of nurses working in state-run hospitals in the Municipality of Thessaloniki regarding lifelong education through new technologies. Identification of nurses' motivations for lifelong distance education, recording of nurses' perception of the need for continuing nursing education, and determining how nurses pursue lifelong learning are the objectives of this study. Methodology: The study was conducted between January and March 2019. The sample of the study consisted of 124 nurses (n = 124) from three state hospitals of the Municipality of Thessaloniki. A questionnaire consisting of 5 parts was used as a research tool. SPSS 23 statistical software platform was used for statistical analysis. Results: The sample consisted of 124 participants, 12 were men and 112 were women. The mean age of the participants was 42.37 years and the mean experience in the field was 16.78 years. Two main reasons for continuing education were attributed to the upgrade of the nursing profession and the need to improve the quality of care provided. Conclusions: Nurses believe that continuing education is essential and their professional knowledge must periodically be enriched and renewed.