Search

What is the state of knowledge on the use of phytotherapy in the following urological benign diseases: prostatic hyperplasia, erectile dysfunction, male infertility, urolithiasis and low-urinary tract symptoms? Supplements derived from natural products are used in medicine alone or in combination with drugs. In urology, there are many products used for symptom management in benign conditions. The aim of this review was to investigate the use of herbal medicines to treat benign urological diseases. A systematic review was conducted using the PubMed, CINAHL, Cochrane Library, Embase and Scopus (2010–2021) databases. The inclusion criteria were studies describing the use of phytotherapeutic strategies to treat adult patients with urological diseases. Quality assessments were performed using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Nineteen studies were included in this systematic review: 13 randomized controlled trials, 3 pilot studies, 1 quasi-experimental study, 1 retrospective observational study and 1 post hoc analysis. Phytotherapeutic agents used to treat benign prostatic hyperplasia included royal jelly, Viola odorata, Echium amoenum, Physalis alkekengi, soy isoflavones, Serenoa repens, Trigonella foenum-graecum, lycopene and selenium. Tribulus terrestris is widely used to treat erectile dysfunction and male infertility. Lycopene, Korean ginseng berries, Indian ginseng and Curcuma improve sperm characteristics and motility. Lupeol therapy reduces kidney stone size, improving urolithiasis symptoms and accelerating the expulsion of small stones. No standard of care has been established for the use of phytotherapeutic agents to manage patients with symptomatic urological disorders. Although randomized controlled trials were the most common study type in our review, the sample sizes were limited, and the study duration and follow-up periods were often very short.

BACKGROUND The recent discovery that a combination of noradrenergic and antimuscarinic drugs improved upper airway muscle function during sleep and reduced OSA severity has revitalized interest in pharmacologic therapies for OSA. RESEARCH QUESTION Would 1 week of reboxetine plus oxybutynin (Reb-Oxy) be effective on OSA severity? STUDY DESIGN AND METHODS A randomized, placebo-controlled, double-blind, crossover trial was performed comparing 4-mg reboxetine plus 5-mg oxybutynin (Reb-Oxy) vs placebo in patients with OSA. After a baseline in-laboratory polysomnogram (PSG), patients underwent PSGs after 7 nights of Reb-Oxy and 7 nights of placebo to compare apnea-hypopnea index (AHI), which was the primary outcome. Response rate was based on the percentage of subjects with a ≥ 50% reduction in AHI from baseline. Secondary outcomes included Epworth Sleepiness Scale (ESS) score and psychomotor vigilance test (PVT) values. Home oximetry evaluated overnight oxygen desaturation index (ODI) throughout treatment. RESULTS Sixteen subjects aged 57 [51-61] years (median [interquartile range]) with a BMI of 30 [26-36] kg/m2 completed the study. Reb-Oxy lowered AHI from 49 [35-57] events per hour at baseline to 18 [13-21] events per hour (59% median reduction) compared with 39 [29-48] events per hour (6% median reduction) with placebo (P < .001). Response rate for Reb-Oxy was 81% vs 13% for placebo (P < .001). Although ESS scores were not significantly lowered, PVT median reaction time decreased from 250 [239-312] ms at baseline to 223 [172-244] ms on Reb-Oxy vs 264 [217-284] ms on placebo (P < .001). Home oximetry illustrated acute and sustained improvement in the oxygen desaturation index on Reb-Oxy vs placebo. INTERPRETATION The administration of Reb-Oxy greatly decreased OSA severity and increased vigilance. These results highlight potential possibilities for pharmacologic treatment of OSA. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov; No.: NCT04449133; URL: www.clinicaltrials.gov.

Objetivo: compreender o imaginário coletivo sobre pacientes com diagnóstico de esquizofrenia por parte de enfermeiros inseridos na Atenção Primária, com foco em suas possíveis reverberações no tocante à atenção em saúde mental. Método: pesquisa qualitativa, orientada pelo método investigativo psicanalítico, desenvolvida junto a 15 enfermeiros. O instrumento utilizado foi o Procedimento de Desenho-Estória com Tema, e os dados coletados foram interpretados psicanaliticamente visando à captação dos campos de sentido. Resultados: no imaginário coletivo da maioria dos participantes, ocupa lugar central a crença de que o acompanhamento de pacientes com diagnóstico de esquizofrenia é responsabilidade exclusiva de profissionais e/ou serviços de saúde “especializados”, o que aparentemente atravessa, de modo marcante, os (des)encontros que se estabelecem entre os enfermeiros e os referidos pacientes. Conclusão: essa crença é incompatível com os preceitos da Reforma Psiquiátrica Brasileira e com o papel a ser desempenhado, na Atenção Primária, pelos enfermeiros.

Could shift nurses develop overactive bladder (OAB) as a result of metabolic syndrome (MetS)? Shift work and consequent sleep disorders are risk factors of developing MetS. The aim of this literature review was to describe the correlation between MetS OAB and shift work. Search terms (free terms, MeSH): ‘metabolic syndrome’, ‘urologic diseases’; papers published in the last 10 years (2009–2019) were searched in major medical databases (PubMed, CINAHL, Scopus, Embase and Cochrane Database of Systematic Review). We included all randomized controlled trials, observational studies, reviews and we included papers studying MetS and OAB. Quality assessment of the papers was conducted according to the Dixon-Woods checklist. Seven articles were analysed. The literature review pointed out that insulin resistance, hypertension, obesity, high-density lipoproteins (HDL), cholesterol and triglycerides have a relationship with MetS. The prevalence of obesity and insulin resistance increases the risk of urolithiasis especially in women. Nurses are an occupational category at risk for MetS, due mainly to shift work. All this could therefore put nurses in a position to develop OAB, but studies are needed that analyse the urinary habits of this professional category to prevent bad habits and reduce absenteeism.

Can the use of mobile applications (apps) improve quality of life and disease management in adult patients with urologic disease? Technology has created new opportunities to promote behavioural change in the daily lives of patients. One third of adults in the United States who own smartphones or tablets use health apps to improve their health. The aim of this review was to analyse whether use of mobile apps improves the quality of life and symptom management of urological patients. Databases: PubMed, CINAHL, Scopus. Search terms (free terms, MeSH): mobile apps, urologic diseases. Papers searched included all randomized controlled trials, quasi-experimental studies, analytical cross-sectional studies, cohort studies, and case–control studies. Nine articles were analysed. The review showed that mobile apps purpose-built for urological patients can improve quality of life, signs and symptoms. It is necessary that nurses and physicians be familiar with these apps in order to identify and benefit those patients who deal with disabling diseases that prevent them performing their daily activities to the desired degree. Mhealth makes inroads into the medical profession, both doctors and nurses should maintain awareness not only of drug and other therapies but also of the efficacy of the mobile health apps available. Digital health treatment has arrived and can no longer be considered merely peripheral.

Nursing students must face quality- and safety-related content early in the classroom and in clinical environments. This study investigated nursing students’ self-perceived quality and safety skill...

Background The literature emphasizes the importance of the intensive care unit (ICU) diary to fill the gaps and recover the delusional memories of patients admitted to ICU in order to build the history of their illness. The ICU diary is a measure originally intended to support the severely ill patient, but it would also seem to be useful for family members and carers. According to our analysis of the literature, this study is the first description of the contents of ICU diaries in the Italian context. Aim The aim of the study was to describe the contents of ICU patients' diaries filled in by their caregivers, in order to explore the experience and significance attributed to the diaries. Design A qualitative longitudinal narrative investigation was conducted at an ICU during the period from April 2016 to April 2017 with a sample composed of 32 families. Methods The participants were caregivers selected through purposive sampling. An ICU nurse explained the study to caregivers and offered the opportunity to participate. Results The sample included 32 diaries. Through the analysis we identified seven themes: future plans and memories; the people who care for the patient and the context; the love surrounding the patient; the clinical progression of the patient and the passage of time; what happens outside the patient's life; references to the usefulness/non-usefulness of the diary; communication/reflection on the likely death of the patient. Conclusions Some themes emerged that have never explored in the literature, and it would be necessary to understand whether the themes that emerged depend on cultural issues. Relevance to clinical practice The diaries could be adapted to the Italian context and this could make the diary a common practice in Italy as well.

ObjectiveTo summarise the available clinical evidence on the efficacy and safety of osteopathic manipulative treatment (OMT) for different conditions.DesignOverview of systematic reviews (SRs) and meta-analyses (MAs). PROSPERO CRD42020170983.Data sourcesAn electronic search was performed using seven databases: PubMed, EMBASE, CINAHL, Scopus, JBI, Prospero and Cochrane Library, from their inception until November 2021.Eligibility criteria for selecting studiesSRs and MAs of randomised controlled trials evaluating the efficacy and safety of OMT for any condition were included.Data extraction and synthesisThe data were independently extracted by two authors. The AMSTAR-2 tool was used to assess the methodological quality of the SRs and MAs. The overview was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.ResultsThe literature search revealed nine SRs or MAs conducted between 2013 and 2020 with 55 primary trials involving 3740 participants. The SRs reported a wide range of conditions including acute and chronic non-specific low back pain (NSLBP, four SRs), chronic non-specific neck pain (CNSNP, one SR), chronic non-cancer pain (CNCP, one SR), paediatric (one SR), neurological (primary headache, one SR) and irritable bowel syndrome (IBS, one SR). Although with a different effect size and quality of evidence, MAs reported that OMT is more effective than comparators in reducing pain and improving functional status in acute/chronic NSLBP, CNSNP and CNCP. Due to small sample size, presence of conflicting results and high heterogeneity, questionable evidence existed on OMT efficacy for paediatric conditions, primary headache and IBS.No adverse events were reported in most SRs. According to AMSTAR-2, the methodological quality of the included SRs was rated low or critically low.ConclusionBased on the currently available SRs and MAs, promising evidence suggests the possible effectiveness of OMT for musculoskeletal disorders. Limited and inconclusive evidence occurs for paediatric conditions, primary headache and IBS. Further well-conducted SRs and MAs are needed to confirm and extend the efficacy and safety of OMT.

The aim was to understand the knowledge, attitudes, and behaviors of Health Care workers regarding the Novel Coronavirus 2019 cases at the start of the diffusion of the disease in Italy.Cross-sectional survey of nurses working in Italian hospitals.Most of the sample showed good knowledge and behaviors about the new virus and good attitudes. Logistic regression analysis demonstrated that predictive variables of knowledge, attitude, and behavior were: educational background, work experience years and age of nurses.This study is the first one in a time of a full health emergency. It would be appropriate to develop further studies to better analyze the skills implemented to tackle Novel Coronavirus 2019 disease. Novel Coronavirus 2019 pandemic has put on health personnel a considerable workload. Despite this, the Italian nursing staff has been showing excellent knowledge, attitude, and good behavior in the management of this pandemic. (www.actabiomedica.it).

Background: No systematic review in the literature has analyzed the intensity and frequency of moral distress among ICU nurses. No study seems to have mapped the leading personal and professional characteristics associated with high levels of moral distress. This systematic review aimed to describe the intensity and frequency of moral distress experienced by nurses in ICUs, as assessed by Corley’s instruments on moral distress (the Moral Distress Scale and the Moral Distress Scale–Revised). Additionally, this systematic review aimed to summarize the correlates of moral distress. Methods: A systematic search and review were performed using the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), the National Library of Medicine (MEDLINE/PubMed), and Psychological Abstracts Information Services (PsycINFO). The review methodology followed PRISMA guidelines. The quality assessment of the included studies was conducted using the Newcastle–Ottawa Scale. Results: Findings showed a moderate level of moral distress among nurses working in ICUs. The findings of this systematic review confirm that there are a lot of triggers of moral distress related to patient-level factors, unit/team-level factors, or system-level causes. Beyond the triggers of moral distress, this systematic review showed some correlates of moral distress: those nurses working in ICUs with less work experience and those who are younger, female, and intend to leave their jobs have higher levels of moral distress. This systematic review’s findings show a positive correlation between professional autonomy, empowerment, and moral distress scores. Additionally, nurses who feel supported by head nurses report lower moral distress scores. Conclusions: This review could help better identify which professionals are at a higher risk of experiencing moral distress, allowing the early detection of those at risk of moral distress, and giving the organization some tools to implement preventive strategies.

Collaboration between colleagues is an essential element of clinical nursing care because it helps to ensure patient safety. This study aimed to evaluate the psychometric properties of the XXX version of the Nurse-Nurse Collaboration Scale (NNCS). The secondary goal of this study was to assess the degree of collaboration between nurses in Italy.First, the cultural adaptation of the NNCS tool was performed. The face and content validity of the tool were assessed through the involvement of nursing experts. To test construct validity, a descriptive cross-sectional study was conducted on a sample of 362 nurses.The Italian version of the NNCS was composed of 23 items distributed across five domains. The five-dimensional model showed an adequate model goodness of fit (RMSEA=0.075, CFI=0.883, SRMR=0.072). The NNCS dimension with the highest average score was Professionalism (M=3.10 ± 0.45), while Conflict Management (M=2.14 ± 0.47) exhibited the lowest score.The Italian version of the NNCS is a valid and reliable tool. More effort should be made to ensure the proper management of conflicts in healthcare environments.

Background: Moral distress has frequently been investigated in single healthcare settings and concerning a single type of professional. This study aimed to describe the experience of moral distress in all the types of professionals providing daily care to elderly patients and residents. Methods: The Grounded Theory approach, developed by Corbin and Strauss, was used. This study included participants from hospital and nursing homes of northern Italy. Purposive and theoretical sampling was used. Between December 2020 and April 2021, semi-structured interviews were conducted. Results: Thirteen participants were included in the study. Four categories were derived from the data: talking and listening, care provider wellbeing, decision making, protective factors, and potential solutions. The core category identified was “sharing daily”. Interviewees confirm how hard it may be to communicate to the elderly, but at the same time, how adequate communication with the leader is a protective factor of moral distress. They also confirm how communication is key to managing or downsizing misunderstandings at all levels. Findings highlight the scarcity of operators as a fundamental trigger of moral distress. Conclusions: Many determinants of this phenomenon lie behind the direct control of professionals, but education can help them learn how to prevent, manage, or downsize the consequences.

A crise psiquiátrica constitui um importante desafio ao cuidado psicossocial, mas tem sido tematizada em poucas pesquisas empíricas nacionais. O presente estudo teve como objetivo compreender o imaginário coletivo de um grupo de profissionais de um CAPS acerca do paciente com transtorno mental em crise psiquiátrica. Trata-se de um estudo qualitativo, do qual participaram 10 profissionais lotados em um CAPS. A coleta de dados foi realizada individualmente mediante o emprego do Procedimento de Desenho-Estória com Tema. O corpus foi constituído pela transcrição das verbalizações dos participantes e, secundariamente, por seus desenhos. A análise de dados visou à formulação de interpretações voltadas à demarcação de campos de sentido.

Resumo O estudo teve por objetivo compreender crenças e emoções acerca do usuário com diagnóstico de esquizofrenia vigentes no imaginário coletivo de enfermeiros inseridos na Atenção Primária à Saúde. Trata-se de estudo de abordagem qualitativa pautado pelo método investigativo psicanalítico. Os participantes foram 15 enfermeiros que atuavam no referido nível de atenção em saúde de uma cidade de médio porte. A coleta de dados foi realizada com o emprego do Procedimento de Desenho-Estória com Tema (PDE-T) e a análise de dados buscou captar campos de sentido mediante a execução dos movimentos técnicos preconizados para a operacionalização do método investigativo psicanalítico. Verificou-se que, de modo não-consciente, o usuário com diagnóstico de esquizofrenia é representado negativamente no imaginário coletivo dos participantes, pois é visto como alguém inconveniente, que cria alvoroço e desperta medo, sobretudo devido à sua “agitação” supostamente típica. Assim, deparar-se com tal usuário corresponde, para os participantes, a uma situação a ser “resolvida” com rapidez. Este estudo, portanto, demarca dificuldades no tocante à atenção em saúde mental oferecida ao usuário com diagnóstico de esquizofrenia, as quais estão relacionadas a elementos não-conscientes da subjetividade grupal que, ao mesmo tempo, possuem caráter social e individual. Abstract This study aimed to understand beliefs and emotions about the user diagnosed with schizophrenia current in the collective imaginary of nurses working in Primary Health Care. It is a qualitative study based on the psychoanalytic investigative method. The participants were 15 nurses who worked at the referred level of health care in a medium-sized city. Data collection was performed using the Drawing-Story with Theme Procedure (PDE-T) and data analysis sought to capture fields of meaning through the execution of the technical movements recommended for the operationalization of the psychoanalytic investigative method. It was found that, in a non-conscious way, the user diagnosed with schizophrenia is negatively represented in the collective imaginary of the participants, because he is seen as an inconvenient person, who creates uproar and arouses fear, mainly due to his supposedly typical “agitation”. Thus, facing such a user means, for the participants, a situation to be quickly “solved”. Therefore, this study highlights difficulties concerning mental health care offered to users diagnosed with schizophrenia, which are related to non-conscious elements of group subjectivity that, at the same time, have a social and individual character.

The recent discovery that a combination of noradrenergic and antimuscarinic drugs improved upper airway muscle function during sleep and reduced OSA severity has revitalized interest in pharmacologic therapies for OSA.Would 1 week of reboxetine plus oxybutynin (Reb-Oxy) be effective on OSA severity?A randomized, placebo-controlled, double-blind, crossover trial was performed comparing 4 mg reboxetine plus 5 mg oxybutynin (Reb-Oxy) vs placebo in patients with OSA. After a baseline in-laboratory polysomnogram (PSG), patients underwent PSGs after 7 nights of Reb-Oxy and 7 nights of placebo to compare apnea-hypopnea index (AHI), which was the primary outcome. Response rate was based on the percentage of subjects with a ≥ 50% reduction in AHI from baseline. Secondary outcomes included Epworth Sleepiness Scale (ESS) score and psychomotor vigilance test (PVT) values. Home oximetry evaluated overnight oxygen desaturation index (ODI) throughout treatment.Sixteen subjects aged 57 [51-61] years (median [interquartile range]) with a BMI of 30 [26-36] kg/mThe administration of Reb-Oxy greatly decreased OSA severity and increased vigilance. These results highlight potential possibilities for pharmacologic treatment of OSA.ClinicalTrials.gov; No.: NCT04449133; URL: www.clinicaltrials.gov.

Objectives During a pandemic, healthcare workers (HCWs) are essential to the health system response. Based on our knowledge, little information is available regarding the psychosocial impact on HCWs or interventions for supporting them during pandemics. Therefore, the study aimed to assess available literature on perceived stress and psychological responses to influenza pandemics in HCWs and identify implications for healthcare practice and future research. Methods This is a rapid review of the literature. The review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis. Results Across all the studies—both qualitative and quantitative—HCWs working during the epidemic reported frequent concerns regarding their own health and the fear of infecting their families, friends and colleagues. Moreover, social isolation, uncertainty, fears of stigmatization and reluctance to work or considering absenteeism were frequently reported. Moreover, many studies highlighted a high prevalence of high levels of stress, anxiety and depression symptoms, which could have long-term psychological implications in HCWs. Conclusions This rapid review offers an overview of the major concerns regarding HCWs’ psychosocial well-being and possible preventive strategies, which could be useful for the current COVID-19 outbreak and similar future pandemics. Studies suggested to invest on preventive psychological, social, family and physical support and to guaranteeing reasonable work conditions and others in order to protect HCWs from the long-lasting psychological effect of the COVID-19 pandemic.

The shift work increased the metabolic syndrome and urolithiasis in nurses? Problem metabolic syndrome and urolithiasis are two worldwide important health problems. Shift work and consequent sleep disorders are risk factors of developing metabolic syndrome. The aim of this literature review is to describe the effects of shift work on metabolic syndrome and urolithiasis in nurses. Search terms (free terms, MeSH): ‘metabolic syndrome’, ‘urologic diseases’; papers published in the last 10 years (2009-2019) were searched in some databases (PUBMED, CINAHL, Scopus, Embase and Cochrane Database of Systematic Review). We included all randomized controlled trials (RCTs), observational studies, reviews and we included papers studying metabolic syndrome and urolithiasis. Quality assessment of the papers was verified according to Dixon-Woods checklist. Seven articles were analysed. The literature review has shown that insulin resistance, hypertension, obesity, cardio vascular disease have a relationship with metabolic syndrome. People with obesity, insulin resistance or hypertension have a low urinary pH. The prevalence of obesity and insulin resistance has increased the risk of urolithiasis in both men and women. This risk has further increased in shift workers especially in nurses. There seems to be a bilateral association between hypertension and urolithiasis. Nurses are a population at risk of developing metabolic syndrome and consequently urolithiasis. It is important to understand whether nurses may be at risk of urolithiasis, to prevent bad habits and to anticipate days off. Nurses are a population at risk of developing metabolic syndrome and consequently urolithiasis.

Monoubiquitylation of histone H2B (H2Bub1) is catalyzed mainly by the RNF20/RNF40 complex and erased by multiple deubiquitylating enzymes (DUBs). H2Bub1 influences many aspects of chromatin function, including transcription regulation and DNA repair. Cancer cells often display reduced levels of H2Bub1, and this reduction may contribute to cancer progression. The let-7 family of microRNAs comprises multiple members with reported tumor suppressive features, whose expression is frequently downregulated in cancer. We now report that let-7b and let-7c can positively regulate cellular H2Bub1 levels. Overexpression of let-7b and let-7c in a variety of non-transformed and cancer-derived cell lines results in H2Bub1 elevation. The positive effect of let-7b and let-7c on H2Bub1 levels is achieved through targeting of multiple mRNAs, coding for distinct components of the H2B deubiquitylation machinery. Specifically, let-7b and let-7c bind directly and inhibit the mRNAs encoding the DUBs USP42 and USP44, and also the mRNA encoding the adapter protein ATXN7L3, which is part of the DUB module of the SAGA complex. RNF20 knockdown strongly reduces H2Bub1 levels and increases the migration of non-transformed mammary epithelial cells and breast cancer-derived cells. Remarkably, overexpression of let-7b, which partly counteracts the effect of RNF20 knockdown on H2Bub1 levels, also reverses the pro-migratory effect of RNF20 knockdown. Likewise, ATXN7L3 knockdown also increases H2Bub1 levels and reduces cell migration, and this anti-migratory effect is abolished by simultaneous knockdown of RNF20. Together, our findings uncover a novel function of let-7 microRNAs as regulators of H2B ubiquitylation, suggesting an additional mechanism whereby these microRNAs can exert their tumor suppressive effects.