The visual art as a learning tool in medical education

The literature has identified promising findings regarding the application of methodology using visual art to develop the cognitive skill of observation and description to enhance critical thinking among medical students. This longitudinal controlled quasi-experimental study aims to demonstrate that Visual Thinking Strategies method and other art activities are effective in improving and maintaining the ability to observe, describe and critically interpret artistic or medical images in undergraduate medical students. The course of art and medicine was given at the 3rd, 4th, and 5th year at the same cohort of students within the curriculum of Medicine and Surgery of Sapienza University of Rome and a baseline pre-post assessment was performed using a validated rubric to score a written test on observation and interpretation of paintings and clinical images. All the students increased their score from pre to post-test in the 3rd year, but only the students attending the electives during the 4th and 5th year maintained their ability to observe, describe and critically interpret. Our findings suggest that The Visual Thinking Strategies, as arts-based learning activities, are an effective methodology to increase the professional abilities of medical students but if our findings are coherent with what is already known about the effectiveness of the observation of fine arts to increase clinical visual skills but it needs persistence of these activities. Therefore they should be added to medical curricula as a mandatory component

Robotic Complex Abdominal Wall Reconstruction: The Evolution of Component Separation

From the first description of the component separation technique in the literature at the end of the twentieth century to the current state of complex abdominal wall reconstruction, this rapidly evolving field of General Surgery has advanced at an accelerated pace. With the advancement of technological breakthroughs that stem from the original open technique, endoscopic, laparoscopic, and more recently robotic approaches have been developed to facilitate complex abdominal wall reconstruction to restore the body’s anatomy and physiology to functional levels. This chapter will give an overview of the historic progression of these advanced techniques and will illustrate the key steps for their safe and effective performance including the endoscopic external oblique anterior release as well as posterior release techniques such as the robotic transversus abdominis release (TAR). Finally, other useful variations of complex repair such as the robotic extended totally extraperitoneal (eTEP) approach will be described

Bariatric surgery on social media: A cross-sectional study

Introduction Bariatric Surgery (BS) represents a viable option for the treatment of obesity and its risks. Nevertheless, it is still being underused by the eligible patient population because of the general lack of information, false beliefs, and the stigmatization of obesity. Social media seems to be a solution for overcoming this problem. Materials and methods The search terms “Bariatric surgery”, “Metabolic surgery”, “Obesity surgery” and “Weight loss surgery” were employed to analyze the Twitter accounts and Facebook pages dedicated to Bariatric Surgery. The most relevant metadata from each account was collected and analyzed with descriptive statistics. Results 293 Facebook pages and 122 Twitter accounts were analyzed, being most of them created in the US (42%). No significant differences were found between the mean of followers of both platforms. Medical centers were the biggest creator category with 69.24% of the total number of followers. Although the promotion of medical services accounted for 68.65% of the total number of followers, the promotion of medical products had a significant higher mean of followers. (p = 0.002). Conclusion Doctors and businesses acknowledge the importance of social media for informing patients about BS and promoting their services. Accounts with commercial purposes presented the highest number of followers. The high number of supporters this commercial content has, along with the relative lack of followers in educational and support groups, could lead to undeliberate decisions in detriment of the patients and their well-being

Exploring the Multifaceted Landscape of MASLD: A Comprehensive Synthesis of Recent Studies, from Pathophysiology to Organoids and Beyond

Non-alcoholic fatty liver disease (NAFLD) is a widespread contributor to chronic liver disease globally. A recent consensus on renaming liver disease was established, and metabolic dysfunction-associated steatotic liver disease, MASLD, was chosen as the replacement for NAFLD. The disease’s range extends from the less severe MASLD, previously known as non-alcoholic fatty liver (NAFL), to the more intense metabolic dysfunction-associated steatohepatitis (MASH), previously known as non-alcoholic steatohepatitis (NASH), characterized by inflammation and apoptosis. This research project endeavors to comprehensively synthesize the most recent studies on MASLD, encompassing a wide spectrum of topics such as pathophysiology, risk factors, dietary influences, lifestyle management, genetics, epigenetics, therapeutic approaches, and the prospective trajectory of MASLD, particularly exploring its connection with organoids

Rebranding of Predatory Journals and Conferences:Understanding Its Implication and Prevention Strategy

Academic conference participation and publications serve as a litmus test to evaluate researchers irrespective of their scientific discipline. Predatory or fake conferences and journals exploit this issue and rebrand themselves through multiple methods. This paper serves to introduce rebranding as one of the features adopted by predatory journals and conferences and formulate some important measures that could be taken by academic libraries, researchers, and publishers to address this issue. We found that rebranding serves as an efficient measure to evade legal implications. However, empirical longitudinal studies addressing the issue are absent. We have explained rebranding, multiple ways of rebranding, issues surrounding predatory publishing, and the role of academic libraries and provided a five-point prevention strategy to protect researchers from academic malpractices. Dedicated tools, scientific prowess, and vigilance of academic libraries and researchers can safeguard the scientific community. Creating awareness, increasing transparency of available databases, and the support of academic libraries and publishing houses along with global support will serve as effective measures to tackle predatory malpractices

The Role of mTOR Inhibitors after Liver Transplantation for Hepatocellular Carcinoma

Liver transplantation is a treatment option for nonresectable patients with early-stage HCC, with more significant advantages when Milan criteria are fulfilled. An immunosuppressive regimen is required to reduce the risk of graft rejection after transplantation, and CNIs represent the drugs of choice in this setting. However, their inhibitory effect on T-cell activity accounts for a higher risk of tumour regrowth. mTOR inhibitors (mTORi) have been introduced as an alternative immunosuppressive approach to conventional CNI-based regimens to address both immunosuppression and cancer control. The PI3K-AKT-mTOR signalling pathway regulates protein translation, cell growth, and metabolism, and the pathway is frequently deregulated in human tumours. Several studies have suggested the role of mTORi in reducing HCC progression after LT, accounting for a lower recurrence rate. Furthermore, mTOR immunosuppression controls the renal damage associated with CNI exposure. Conversion to mTOR inhibitors is associated with stabilizing and recovering renal dysfunction, suggesting an essential renoprotective effect. Limitations in this therapeutic approach are related to their negative impact on lipid and glucose metabolism as well as on proteinuria development and wound healing. This review aims to summarize the roles of mTORi in managing patients with HCC undergoing LT. Strategies to overcome common adverse effects are also proposed

The Role of Growth Hormone and Insulin Growth Factor 1 in the Development of Non-Alcoholic Steato-Hepatitis: A Systematic Review

Diabetic and obese patients have a high prevalence of non-alcoholic fatty liver disease (NAFLD). This condition groups a spectrum of conditions varying from simple steatosis to non-alcoholic steatohepatitis (NASH), with or without fibrosis. Multiple factors are involved in the development of NAFLD. However, details about its pathogenesis and factors that promote the progression to NASH are still missing. Growth hormone (GH) and insulin-like growth factor 1 (IGF-1) regulate metabolic, immune, and hepatic stellate cell functions. Increasing evidence suggests they may have roles in the progression from NAFLD to NASH. Following the PRISMA reporting guidelines, we conducted a systematic review to evaluate all clinical and experimental studies published in the literature correlating GH and IGF-1 to inflammation and fibrosis in NAFLD and NASH. Our results showed that GH and IGF-1 have a fundamental role in the pathogenesis of NASH, acting in slightly different ways to produce a synergic effect. Indeed, GH may mediate its protective effect in the pathogenesis of NASH by regulating lipogenesis pathways, while IGF-1 has the same effect by regulating cholesterol transport. Therefore, they could be used as therapeutic strategies in preventing NAFLD progression to NASH

The Role of Growth Hormone and Insulin Growth Factor 1 in the Development of Non-Alcoholic Steato-Hepatitis: A Systematic Review

Diabetic and obese patients have a high prevalence of non-alcoholic fatty liver disease (NAFLD). This condition groups a spectrum of conditions varying from simple steatosis to non-alcoholic steatohepatitis (NASH), with or without fibrosis. Multiple factors are involved in the development of NAFLD. However, details about its pathogenesis and factors that promote the progression to NASH are still missing. Growth hormone (GH) and insulin-like growth factor 1 (IGF-1) regulate metabolic, immune, and hepatic stellate cell functions. Increasing evidence suggests they may have roles in the progression from NAFLD to NASH. Following the PRISMA reporting guidelines, we conducted a systematic review to evaluate all clinical and experimental studies published in the literature correlating GH and IGF-1 to inflammation and fibrosis in NAFLD and NASH. Our results showed that GH and IGF-1 have a fundamental role in the pathogenesis of NASH, acting in slightly different ways to produce a synergic effect. Indeed, GH may mediate its protective effect in the pathogenesis of NASH by regulating lipogenesis pathways, while IGF-1 has the same effect by regulating cholesterol transport. Therefore, they could be used as therapeutic strategies in preventing NAFLD progression to NASH

Additional file 1 of Young nursing and medical students’ knowledge and attitudes towards sexuality and contraception in two spanish universities: an inferential study

Supplementary Material

Burden of liver disease progression in hospitalized patients with type 2 diabetes mellitus

BACKGROUND AND AIMS: There are uncertainties on the burden of liver disease in patients with type-2 diabetes (T2D). METHODS: We measured adjusted hazard ratios of liver disease progression to hepatocellular cancer and/or decompensated cirrhosis in a 2010-2020 retrospective, bicentric, longitudinal, cohort of 52,066 hospitalized patients with T2D. RESULTS: Mean age was 64±14 years and 58% were men. Alcohol use disorders accounted for 57% of liver-related complications and were associated with all liver-related risk factors. Non-metabolic liver-related risk factors accounted for 37% of the liver burden. T2D control was not associated with liver disease progression. The incidence (95% confidence interval) of liver-related complications and of competing mortality were 3.9 (3.5-4.3) and 27.8 (26.7-28.9) per 1000 person-years at risk, respectively. The cumulative incidence of liver disease progression exceeded the cumulative incidence of competing mortality only in the presence of a well-identified risk factors of liver disease progression, including alcohol use. The incidence of hepatocellular cancer was 0.3 (95% CI, 0.1-0.5) per 1000 person-year in patients with obesity and it increased with age. The adjusted hazard ratios of liver disease progression were 55.7 (40.5-76.6), 3.5 (2.3-5.2), 8.9 (6.9-11.5), and 1.5 (1.1-2.1), for alcoholic liver disease, alcohol use disorders without alcoholic liver disease, non-metabolic liver-related risk factors, and obesity, respectively. The attributable fractions of alcohol use disorders, non-metabolic liver risk-related risk factors, and obesity to the liver burden were 55%, 14%, and 7%, respectively. CONCLUSIONS: In this analysis of data from two hospital-based cohorts of patients with T2D, alcohol use disorders, rather than obesity, contributed to most of the liver burden. These results suggest that patients with T2D should be advised to drink minimal amounts of alcohol. LAY SUMMARY: • There is uncertainty on the burden of liver-related complications in patients with type-2 diabetes • We studied the risks of liver cancer and complications of liver disease in over 50,000 patients with type-2 diabetes • We found that alcohol was the main factor associated with complications of liver disease • This finding has major implications on the alcohol advice given to patients with type-2 diabetes