Interaction between healthcare professionals and patients is a complex process influenced by communication, environmental, individual, and organizational factors. To synthesize qualitative and quantitative evidence and identify key characteristics of effective interaction between patients and nurse anesthetists during the perioperative period. A systematic literature search was conducted in PubMed, MEDLINE, CINAHL, Embase, and the Cochrane Library to identify qualitative and quantitative studies examining factors influencing interaction between patients and nurse anesthetists in the perioperative setting. Both facilitators and barriers to effective interaction were identified. Facilitators included respectful, patient-centered care, a supportive work environment, and clear, timely communication. Barriers included negative staff attitudes, procedural stress, interpersonal conflicts, exposure to violence, and communication challenges such as low speech volume, unclear articulation, and limited language proficiency. Effective communication was associated with improved patient safety, enhanced team cohesion, and more efficient information exchange. However, increased reliance on advanced technology may reduce patient engagement and interpersonal communication within the healthcare team. Nurse anesthetists play a critical role in supporting patients during potentially stressful perioperative experiences. Organizational factors, time constraints, and communication strategies may influence the quality of patient–provider interaction. Further research is needed to determine how these factors can be optimized to improve perioperative care and patient outcomes.

AIM To evaluate factors associated with perioperative anxiety in patients undergoing major abdominal surgery under general anaesthesia (GA) using the Hamilton Anxiety Rating Scale (HAM-A). METHODS This prospective observational study included 107 adult patients scheduled for major abdominal surgery under GA. Anxiety was assessed preoperatively and postoperatively using the HAM-A. Demographic characteristics, medical history, lifestyle habits, and perioperative variables were analysed. Multivariable analysis was conducted to identify factors independently associated with pre- and postoperative anxiety. RESULTS Preoperative anxiety was observed in 54 patients (50.5%), while postoperative anxiety occurred in 34 patients (31.8%). Multivariable analysis identified alcohol consumption (β = 8.10, 95%CI: 0.46-14.07; p = 0.037), hyperlipoproteinemia (β = 1.81, 95%CI: 1.42-2.19; p < 0.001), preoperative fasting duration (β = 0.03, 95%CI: 0.02-0.04; p = 0.005), surgery duration (β = -0.45, 95%CI: -0.74- -0.13; p = 0.006), and anaesthesia duration (β = 0.43, 95%CI: 0.07-0.70; p = 0.015) as factors independently associated with preoperative anxiety. The type of intravenous anaesthetic showed a trend toward significance (β = -5.45, 95%CI: -10.20-0.08; p = 0.054). Factors independently associated with postoperative anxiety included age (β ='0.08, 95%CI: 0.01-0.17; p = 0.018), previous hospitalisations (β = 6.43, 95%CI: 3.69-11.86; p < 0.001), previous surgeries (β = 8.13, 95%CI: 6.25-14.44; p < 0.001), and preoperative fasting duration (β = 2.87, 95%CI: 1.90-4.79; p < 0.001). CONCLUSION Routine assessment using the HAM-A scale may help identify high-risk patients and guide targeted perioperative strategies, including preoperative counselling and optimization of fasting protocols.

INTRODUCTION Environmental factors may influence postoperative outcomes and quality of life following total hip replacement (THR). This study investigated the impact of the geographical location of the surgical site, as well as the patient’s place of birth and residence, on treatment outcomes in individuals with artificial hips. METHODS A prospective study was conducted involving 280 patients (both genderes; mean age 62 ± 8.8 years) who underwent THR due to primary or secondary hip osteoarthritis. Patients were divided into two groups: Group A (n = 64) included individuals who were not operated on in their place of birth and residence, while Group B (n = 216) consisted of those who were born, resided, and underwent surgery in the same geographical location. Outcomes were assessed using the EQ-5D questionnaire (covering mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), the Visual Analogue Scale (VAS) for pain, and a VAS-based treatment satisfaction scale, administered preoperatively and one year postoperatively. Statistical analysis was performed using Fisher’s exact test (p < 0.05). RESULTS Only 22.9% of all patients underwent surgery in their place of birth and residence, mostly for primary hip osteoarthritis. Preoperatively, Group A reported significantly greater limitations in self-care (p < 0.05). One year postoperatively, Group B showed significantly higher VAS scores for treatment satisfaction (p < 0.05). CONCLUSION Patients who underwent total hip replacement in their place of birth and residence demonstrated better postoperative outcomes compared to those who had relocated.

Immigrant populations frequently encounter barriers when accessing healthcare services, potentially affecting patient safety, healthcare utilization, and clinical outcomes. Understanding these barriers is essential for improving equitable and patient-centered care. A systematic review of qualitative and quantitative studies was conducted in accordance with PRISMA 2020 guidelines. PubMed/MedLINE, Embase, Cochrane Library, PsycINFO, EconLit, Web of Science (WoS), and CINAHL were searched from January 2005 to August 2023. Inductive thematic analysis was used to synthesize findings across studies. The review was not prospectively registered, included only English-language studies, and relied predominantly on qualitative evidence. Heterogeneity across study designs and healthcare settings may limit generalizability. The authors received no external funding for this study. Three interconnected themes consistently emerged: limited transcultural competence, language barriers, and discrimination in healthcare. Inadequate cultural competence was associated with communication difficulties and reduced care effectiveness. Language barriers contributed to miscommunication, delayed care, and increased healthcare utilization. Experiences of discrimination were linked to reduced trust in healthcare systems and poorer patient engagement. These factors negatively influenced patient safety, satisfaction, and clinical outcomes. Immigrant patients face persistent and interrelated barriers to healthcare access. Strengthening culturally responsive care, improving access to professional interpreter services, and addressing discriminatory practices are essential to improving patient safety, satisfaction, and clinical outcomes. Future research should evaluate targeted interventions aimed at improving communication, cultural competence, and healthcare equity.

Background: Many deaths during heat waves stem not only from body overheating but also from heat stress, which can intensify pre-existing medical conditions, leading to fatal outcomes. Aim: This study aimed to investigate whether the intensity of pathological changes in the heart muscle and lung tissue of albino rats exposed to hyperthermia correlates with different water temperatures (WT) and to determine whether the histological structure of the myocardium and lungs varies. Methods: A sample of 21 albino rats was exposed to water temperatures of 37°C, 41°C, and 44°C. Temperature readings were recorded before immersion, immediately after immersion, at the point of reaching hyperthermia, at 20 minutes, and at the time of death. Tissue samples were collected from the dissected rats, fixed in 10% buffered formalin at room temperature, embedded in paraffin, sectioned into 4–5 μm slices, and stained using the hematoxylin-eosin method. Results: The severity of myocardial histopathological alterations increased with both higher temperatures and longer exposure durations WT. However, the progression of morphological alterations in cardiomyocytes was not markedly significant, likely due to the brief exposure time, which limited the visualization of subcellular alterations in Hematoxylin and Eosin staining-stained tissue. All lung samples from the seven rats exposed to the highest temperatures displayed bronchiolitis and acute bronchitis, along with early bronchopneumonia. Conclusion: While some organs exhibit greater tolerance to heat stroke than other organs, most organs show similar alterations characterized by capillary dilation, vascular pathway disruption, and extravasation. The extent of pathological changes in myocardial and lung tissue intensified with higher temperatures and longer exposure durations to elevated WT. However, the progression of morphological alterations in cardiomyocytes did not demonstrate marked significance, likely because of the brief exposure period. This short duration may limit the detection of subcellular changes when using hematoxylin-eosin staining.

Introduction: Vitamin D (VD) deficiency has become a global epidemic in the past 2 decades. Cardiac troponin is a specific biomarker for detecting myocardial injury, particularly in the context of myocardial infarction (MI), where elevated levels are indicative of myocardial necrosis. This study aimed to investigate the relationship between VD levels and troponin values in patients admitted to the Intensive Care Unit under suspicion of acute coronary syndrome, including comparisons with patients ultimately not diagnosed with ACS. Materials and Methods: This cross-sectional study included a group of 69 patients who were hospitalized in the Intensive Care Unit of the Hospital under suspicion of acute coronary syndrome. The control consisted of patients without ACS. The content of VD-(25[OH]D) in blood plasma was measured by enzyme-linked immunosorbent assay during June–August 2024. Blood samples were taken in tubes with ethylenediaminetetraacetic acid anticoagulant. The tubes without anticoagulant were used for collecting blood for VD, fibrinogen, D-dimer, and lipid parameter measurement. Results: A statistically significant difference in total cholesterol levels was observed between patients with angina pectoris and those with MI (P < 0.05). Pearson correlation analysis also demonstrated a moderate negative correlation between VD levels and troponin values in patients diagnosed with MI (P < 0.05), indicating that lower VD concentrations may be associated with greater myocardial injury. Conclusions: Based on the data obtained, the medical community is inclined to believe that correction of VD deficiency has great prognostic significance. Further clinical and experimental studies are needed to study in more detail the mechanisms of the negative effects of VD deficiency on the cardiovascular system.

Background: Between 10% and 80% of surgical patients experience some form of fear and anxiety before surgery. This is often attributed to inadequate or incorrect preoperative information. Objectives: This study aimed to critically evaluate and compile research that describes the impact of preoperative information on the patient's well-being before surgery. Methods: A systematic search was conducted on PubMed, Medline, CHINAL, Embase, and the Cochrane Library database for qualitative and quantitative literature regarding factors influencing patients' well-being before surgery. An inductive thematic analysis generated categories and subcategories. Nineteen studies were included. Results: Two main categories emerged from the thematic analysis of the included articles. These were the direct impact of information on fear and anxiety and the indirect impact of information on fear and anxiety. Information from healthcare professionals, alternative sources of information, shortage of healthcare professionals, music, and inability to receive information were some of the factors that can influence the well-being of patients before surgery. There are different reasons for the patient's fear and anxiety preoperatively, as well as the importance of direct and indirect information and other methods. For some patients, however, too much information could cause more fear and anxiety. Conclusion: The importance of the patient's discomfort being highlighted by the healthcare professionals emerges clearly and shows negative experiences in those cases where the patient feels his fears and concerns are not being addressed. More qualitative and quantitative research in the same theme, education and using person-centred care, and the right amount of information based on the patient's wishes are needed to improve the patient's well-being.

Introduction Nurse anesthetists (NAs) rely on various tools to perform their daily tasks effectively, with communication being one of the most essential during the perioperative phase. The study aimed to explore NAs' experiences with the perioperative dialogue with patients and how this dialogue has evolved over the past 30 years. Materials and methods The study employed a qualitative design, with data gathered through three group interviews focusing on NAs' experiences. Interpretive content analysis, following the approach of Graneheim and Lundman, was used. Initially, 27 NAs were recruited, and 18 (three men and 15 women) participated in the interviews. Their ages ranged from 33 to 72 years, with work experience spanning 17 to 42 years. Results The text analysis identified three categories: advantages of perioperative dialogue, disadvantages of its absence, and suggestions for improvement. Key challenges included maintaining continuity of care, ensuring a high level of patient and NA safety, reducing care-related complications, minimising patient socialisation, providing incomplete care, and increasing stress for both NAs and patients. The NAs also offered several suggestions for improvement. Conclusion Perioperative meetings should be better structured to improve communication and assess outcomes. Enhancing patient involvement, developing NAs' skills, and providing clearer information in multiple languages could improve satisfaction and safety. Further research is needed to establish the dialogue’s role as a guiding principle for staff and patients.

AIM To investigate immigrant women's experiences of childbirth in Swedish maternity care. METHODS A systematic search was conducted in PubMed, Embase, CINAHL, and Web of Science for qualitative and quantitative literature on immigrant women's experiences with Swedish maternity care. An inductive thematic analysis generated themes and subthemes. RESULTS Sixteen studies were included in this research. The three main themes were access to healthcare, professional treatment, and feeling significant in care. Key findings revealed that immigrant women struggled with trauma, difficult interactions with midwives, communication issues, interpreter problems, lack of detailed information, the role of doulas, and future concerns. CONCLUSION Immigrant women's experiences of Swedish maternity care were marked by information gaps, ignorance, and disrespect, leading to mistrust and delayed help-seeking. Language barriers with midwives caused misunderstandings. A sense of belonging to Swedish society was crucial for a positive experience. More qualitative research, education in transcultural care, and training in interpreter use are needed to improve maternity care for foreign women.

ABSTRACT Background: The triglyceride/high-density lipoprotein (TG/HDL) ratio emerges as a promising marker for cardiovascular risk. However, the relationship between overall serum lipid levels and hemorrhagic stroke (HS) remains uncertain. Therefore, our study aims to explore the association between this novel index and mortality in HS patients. Methods: Utilizing a retrospective-prospective framework from January 2020 to August 2023, we scrutinized data from 104 hospitalized patients diagnosed with HS, with particular attention to their medical backgrounds and lipid profiles. Results: Age (odds ratio [OR], 1.078; 95% confidence interval [CI], 1.032–1.125; P = 0.001), atrial fibrillation (OR, 0.237; 95% CI, 0.074–0.760; P = 0.015), glucose level (OR, 1.121; 95% CI, 1.007–1.247; P = 0.037), and TG/HDL index (OR, 0.368; 95% CI, 0.173–0.863; P = 0.020) emerged as independent predictors for in-hospital mortality, as determined by both univariable and multivariable logistic regression analyses. Conclusion: Our results add weight to the growing evidence backing the utility of the TG/HDL index in assessing cardiovascular risk among HS patients. They emphasize the necessity of adopting a comprehensive risk assessment and management strategy that incorporates both traditional markers and novel indicators.