The Prospects of Secondary Moderate Mitral Regurgitation after Aortic Valve Replacement —Meta-Analysis

Aortic valve replacement for aortic stenosis represents one of the most frequent surgical procedures on heart valves. These patients often have concomitant mitral regurgitation. To reveal whether the moderate mitral regurgitation will improve after aortic valve replacement alone, we performed a systematic review and meta-analysis. We identified 27 studies with 4452 patients that underwent aortic valve replacement for aortic stenosis and had co-existent mitral regurgitation. Primary end point was the impact of aortic valve replacement on the concomitant mitral regurgitation. Secondary end points were the analysis of the left ventricle reverse remodeling and long-term survival. Our results showed that there was significant improvement in mitral regurgitation postoperatively (RR, 1.65; 95% CI 1.36–2.00; p < 0.00001) with the average decrease of 0.46 (WMD; 95% CI 0.35–0.57; p < 0.00001). The effect is more pronounced in the elderly population. Perioperative mortality was higher (p < 0.0001) and long-term survival significantly worse (p < 0.00001) in patients that had moderate/severe mitral regurgitation preoperatively. We conclude that after aortic valve replacement alone there are fair chances but for only slight improvement in concomitant mitral regurgitation. The secondary moderate mitral regurgitation should be addressed at the time of aortic valve replacement. A more conservative approach should be followed for elderly and high-risk patients

Artificial intelligence approaches to the biochemistry of oxidative stress: Current state of the art

Artificial intelligence (AI) and machine learning models are today frequently used for classification and prediction of various biochemical processes and phenomena. In recent years, numerous research efforts have been focused on developing such models for assessment, categorization, and prediction of oxidative stress. Supervised machine learning can successfully automate the process of evaluation and quantification of oxidative damage in biological samples, as well as extract useful data from the abundance of experimental results. In this concise review, we cover the possible applications of neural networks, decision trees and regression analysis as three common strategies in machine learning. We also review recent works on the various weaknesses and limitations of artificial intelligence in biochemistry and related scientific areas. Finally, we discuss future innovative approaches on the ways how AI can contribute to the automation of oxidative stress measurement and diagnosis of diseases associated with oxidative damage

Effect of regional vs general anesthesia on vital functions after cesarean section: a single center experience

Background The aim was to determine the effect of regional anesthesia (RA) on postoperative vital functions in contrast to general endotracheal anesthesia (GEA) after the cesarean section. Methods Prospective cohort study included consecutive term pregnant women delivered by cesarean section (GEA, n = 284; RA, n = 249). Results Higher levels of blood pressure and heart rate, as well as lower levels of pulse oximetry were found for GEA in contrast to RA (p < 0.001). The application of RA presented less side-effects (p < 0.05). Conclusions RA for cesarean section should be preferred when balancing the risks and benefits for the mother and fetus

Comparison of Post-Cesarean Pain Perception of General Versus Regional Anesthesia, a Single-Center Study

Background and Objectives: Pain during and after the procedure remains the leading concern among women undergoing cesarean section. Numerous studies have concluded that the type of anesthesia used during a cesarean section undoubtedly affects the intensity and experience of pain after the operation. Materials and Methods: This prospective cohort study was conducted at the Clinic for Gynecology and Obstetrics, Clinical Center “Dragisa Misovic—Dedinje”, Belgrade, Serbia. Patients at term pregnancy (37–42 weeks of gestation) with an ASA I score who delivered under general (GEA) or regional anesthesia (RA) by cesarean section were included in the study. Following the procedure, we assessed pain using the Serbian McGill questionnaire (SF–MPQ), Visual Analogue Scale (VAS) and the pain attributes questionnaire at pre-established time intervals of 2, 12, and 24 h after the procedure. Additionally, time to patient’s functional recovery was noted. We also recorded the time to the first independent mobilization, first oral intake, and lactation establishment. Results: GEA was performed for 284 deliveries while RA was performed for 249. GEA had significantly higher postoperative sensory and affective pain levels within intervals of 2, 12, and 24 h after cesarean section. GEA had significantly higher postoperative VAS pain levels. On pain attribute scale intensity, GEA had significantly higher postoperative pain levels within all intervals. Patients who received RA had a shorter time to first oral food intake, first independent mobilization, and faster lactation onset in contrast to GEA. Conclusions: The application of RA presented superior postoperative pain relief, resulting in earlier mobilization, shorter time to first oral food intake, and faster lactation onset in contrast to GEA

Nursery teachers in preschool institutions facing burnout: Are personality traits attributing to its development?

IntroductionThe aim of the study was to assess the prevalence of burnout syndrome among nursery teachers in Belgrade's preschool institutions, and to assess the role of personality traits in its development.Materials and methodsA cross-sectional study was conducted in all Belgrade's preschool institutions. A stratified cluster sampling method was used to obtain a representative sample. Burnout was measured using the Maslach Burnout Inventory- General Survey (MBI-GS). The MBI-GS adaptation was based on an internationally accepted methodology for translation and cultural adaptation. Psychometric properties of the Serbian version of the MBI-GS were analyzed through the examination of factorial structure and internal consistency. A shortened version of Big Five Plus Two questionnaire was used to measure Personality traits.ResultsThree hundred two health care professionals were enrolled. The mean age was 38±9.2 years and all were female. Confirmatory factor analysis validated the three-factor structure of the questionnaire (exhaustion, cynicism and professional efficacy). Overall, 251 (83.1%) respondents were found to have moderate burnout. In multiple regression analysis, positive valence and conscientiousness were significantly associated with professional efficacy. Aggressiveness, neuroticism, openness, and age, were significantly associated with exhaustion. Aggressiveness, neuroticism and additional jobs showed association with cynicism.ConclusionPresent study provided the evidence for the appropriate metric properties of the Serbian version of MBI-GS. Most nurses demonstrated moderate burnout level. Personality traits are characteristics that affect presence of burnout syndrome in healthcare professionals working in preschool institutions