We present a case of a critically ill patient with severe Legionella pneumonia complicated by morbid obesity (BMI ≥ 40 kg/m²) who was successfully treated with early initiation of veno-venous ECMO (V-V-ECMO) without any sequelae. The patient, a 48-year-old male, initially presented with symptoms of a sore throat, fever, significant fatigue, and decreased appetite. Upon diagnosis of severe pneumonia complicated by morbid obesity, he was transferred to our hospital for further management. Upon admission, he was promptly intubated and placed on mechanical ventilation. Due to a positive urinary Legionella antigen test indicating a risk of deterioration, V-V ECMO was initiated immediately after intubation. During ECMO support, the patient received Levofloxacin Hydrate at 500 mg/day and Prednisolone Sodium Succinate at 100 mg/day. He was successfully weaned off ECMO after 12 days and transferred back to the referring hospital on day 20. While ECMO therapy for morbidly obese patients was traditionally considered relatively contraindicated, this case suggest that obesity alone is not a contraindication to initiating ECMO.

Introduction: Health-related quality of life in patients undergoing dialysis decreases over time, not only due to the treatment of the disease but also due to the reduction of physiological, psychological and social well-being. Aim: The aim of this research is to study social support and nursing care that patients with dialysis receive, their levels of fatigue and their quality of life. In addition, the effect of social support and nursing care on the patients'' levels of quality of life is examined. Methodology: A quantitative cross-sectional study was conducted using the questionnaires “Multidimensional Scale of Perceived Social Support”, Fatigue Assessment Scale (FAS), Missoula-VITAS Quality of Life Index and nursing care. The study involved 69 patients on dialysis. Results: Interpersonal relationships were associated with social support (p <0.01). Quality of life was associated with social support (p <0.05). Conclusions: It seems that there is a strong association between social support and quality of life in patients on dialysis.

Objective: The effects of muscle fatigue appear to elicit a transient means of postural instability; however, the recovery of postural stability after fatiguing exercise has not been extensively studied. This study aimed to determine the immediate effect of local vibration applied to fatigued plantar flexor muscles on postural stability in healthy young adults. Design: True Experimental (pre-test - post test design with a control group). Setting: A tertiary care centre. Participations: 42 healthy young adults. Intervention: Fatigue of plantar flexors muscles was induced by repeated dynamic contractions performed to maximum exhaustion. Experimental group (n= 21) received local vibration to fatigued muscles with a handheld vibrator whereas the control group (n = 21) received no intervention (rest). Postural stability was assessed using one leg stance test (OLST) under three different conditions viz. pre-fatigue, post-fatigue and post rest/vibration. Results: Comparative analysis of postural stability within the group was done pre-fatigue, post-fatigue and post rest/vibration condition using Kruskal-Wallis test. A significant decrease from pre-fatigue to post-fatigue condition (p-value < 0.001); and a significant increase from post-fatigue to post rest/vibration condition (p-value < 0.001) was observed in OLST in both - control group and experimental group. However, further comparison of OLST between the groups (using unpaired t test) showed a significant difference in post-fatigue condition versus post rest/vibration condition in favour of the experimental group. Conclusion: Plantar flexors fatigue significantly affects one leg stance time in healthy young adults. Results of this study show that there is an immediate effect of vibration to fatigued muscles on recovery of postural stability in healthy young adults. Recovery of postural stability achieved quickly with such a simple tool may help increase the degree of participation in sports and other similar activities which can cause muscles to fatigue. However, more studies are required to determine this effect using other clinical measures.

Background: Propranolol is a non-cardio-selective beta-blocker, commonly used in patients with hyperthyroidism to treat the hyperadrenergic symptoms but also for its additional effect of blocking the peripheral conversion of inactive T4 to active T3. However, propranolol has many side effects, one of them being secondary Raynaud phenomenon. Case presentation: S.K., 55 years old was hospitalized in the Endocrinology Department as an untreated hyperfunctioning goiter with typical clinical manifestations such as fatigue, anxiety, palpitations, heat intolerance, difficulties in swallowing and breathing. Unimazole 5 mg (2-2-2 tb) and Propranolol 40 mg (¼ -0- ¼ tb) were prescribed. Thirty minutes after taking Propranolol (the dose 40 mg), she had difficulties breathing, was agitated, sweating and had nausea. Her face was hyperemic and edematous and her extremities were getting blue and cold. Her vitals remained stable and her airways were opened, as evaluated from laryngoscopy and CT-scan of the neck. 8 hours later, her clinical manifestations got worse: her facial edema spread in her lips and submandibular region. On both cases, she clinically improved after prednisolone administration. 12 hours after taking propranolol, she showed no more signs of cyanosis or edema. Propranolol was replaced by Nebivolol, with no side effects. Conclusion: Secondary Raynaud phenomenon is a common side effect of beta-blockers and should be taken in consideration in very patient presenting with cold and cyanotic peripherals. In these cases, propranolol should be stopped and replaced. Further studies on beta-blockers side effects in patients with hyperthyroidism should be made.

The objective of this research was to investigate work-family conflict among management staff of hotels in the Accra Metropolis of Ghana. The study employs the pragmatism approach and Convergent parallel mixed methods research technique. The population of the study is all-star-rated management staff of star-rated hotels in the Accra metropolis. Stratified, random and convenient sampling techniques were used to select 182 out of 356 respondents. One hundred (100) were sampled using a formula and a table determination of sample size based on the confidence level needed from a given population as provided by Krejcie and Morgan in 1970 for the study. Ten managers were conveniently interviewed on the issues of work-family conflict. The main instruments for data collection were a questionnaire and a semi-structured interview guide. This study adopted factor analysis and a structural equation model to examine factors that influence work-family conflict. This statistical technique was used in the research to investigate the factorability of the variables of work-related and family-related factors separately and a structural equation model was used to combine both factors to better understand the relationship. Linear regression was used to determine the relationship between work-family conflict. Pearson product-moment Correlation and structural equation model were used to determine the consequences of work-family conflict. It can be concluded that both work-related such as work overload, job type and involvement as well as family-related factors such as life cycle stage, and childcare arrangement predict work-family conflict among managers of hotels in the Accra metropolis. It is also deducted WFC affect managers’ performance on the job, exhaust them emotionally and also influences their intentions to leave the job for another. Managers usually feel fatigued to prepare for work and physically drained after work. They also feel depressed and emotionally drained sometimes. It is recommended that top management of hotels should allocate a budget to build an organisational culture that encourages work-family balance. Frontline managers should be trained to be aware of the benefit of providing support in the work environment that will help staff balance work and family. It is also recommended that hotel jobs be redesigned by the human resource unit to reduce workload and make it more interesting for managers so they may not feel overworked. Overworking of managers will enhance their intentions to quit the job and this will be costly for hotels.

Oncology nurses are more likely to get compassion fatigue (CF) than nurses in other fields because of the emotional stress and poor outlook of cancer patients. Because of this, the care might not be very good, the job might not be very satisfying, and there is a good chance that the patient's pain won't be noticed. Aim. To synthesize empirical evidence on compassion fatigue in order to extract the common, central, and fundamental elements that may improve nursing care. Design. An integrative review Results. Fifteen (15) studies met the eligibility criteria wherein five themes emerged. These are the level of compassion fatigue among oncology nurses, the oncology nurses' perspectives on compassion fatigue, precipitating factors leading to CF with 2 subthemes (work environment and a feeling of lack of support), the influence of compassion fatigue on the personal lives and general well-being of cancer nurses, and the consequences on the quality of oncology nurses' professional lives at work. Conclusion. CF is a significant problem for nurses who work in specialized areas such as cancer units, demonstrated as a basic incapacity to nurture others. The integration of studies provides evidence of clinical practice application which can provide better outcomes and improve nursing care. Implications for Practice. The findings provide understanding into healthcare practice on how to avoid compassion fatigue. Clinical management approaches that can mitigate compassion fatigue and its negative repercussions are presented, as well as the formation of peer support groups that have the ability to ameliorate CF.

Exercise is an important factor of rehabilitation in heart failure patients, improving several indicators of disease prognosis and functional capacity. The aim of the present study was to examine the effect of a cardiorespiratory rehabilitation program on the physical and mental fatigue, general health and anxiety in patients suffering from heart failure. Thirty-one patients with heart failure [(M±SD) age: 67.59±7.60 years] participated in a cardiorespiratory rehabilitation program. The program included aerobic exercise on cycle ergometers and muscle strengthening for 3 months (12 weeks), 3 times/week. Before and after the program, patients' fatigue, general and mental health were assessed using the following self-reported questionnaires: a) Fatigue Assessment Scale (FAS), b) Goldberg's General Health Questionnaire (GHQ-28) and c) Spielberger's Anxiety Questionnaire. Data analysis showed a statistically significant tendency of reduction in social dysfunction (from 1.99±0.42 to 1.75±0.45, p=0.05), while anxiety (from 27.10±7.61 to 26.40±4.35) showed no change (p>0.05).Also, evaluating the changes in the health level after attending the program, there was a trend of improvement in physical activity and functioning with the appearance of fewer physical symptoms (from 1.38±0.43 to 1.24±0.31, p=0,13). These results show that exercise can contribute to increasing the general well-being of these patients and reducing feelings of helplessness, making them able to cope with their daily activities and tasks.

Breast cancer is the most commonly diagnosed form of cancer in women. Several studies have shown the benefits of physical activity (PA) before and after treatment on the physical and psychological components of patients. Almost all of the studies mentioned are carried out on non-African patients over the age of 40. And no experimental studies have been carried out in young patients undergoing treatment for breast cancer. This is how we asked ourselves the question of whether a physical exercise program carried out on young Beninese women under the age of 30 undergoing treatment for breast cancer at the Saint Nicolas clinic in Porto-Novo could it have the same effects on their physical and psychological components? Our objective through this research is to study the potential effect of a physical activity program on the physical and psychological state in women under 30 years old (27±5.8 years) undergoing treatment for a breast cancer at the Saint Nicolas clinic in Porto-Novo. An experimental study was then carried out with 13 patients (very low rate of women in this section suffering from breast cancer) undergoing treatment throughout 2022 at the Saint Nicolas clinic in Porto-Novo. The experimental group followed a physical activity program consisting of aerobic and muscular exercises; over a period of 8 weeks. According to the data collected and the feedback from the patients, the physical activity program seems to have been beneficial for most of them. There is an improvement in the quality of life and the physical condition of the patients. In addition, the management of physical fatigue and psychological fatigue also seem to improve. There was also a marked improvement in the ability to concentrate and self-esteem. The physical activity program has improved the physical and psychological state of Beninese women with breast cancer

The SARS-COV-2 rapid spread caused an international public health emergency with unprecedented rates of morbidity and mortality. Post COVID-19 condition occurs as a spectrum of symptoms that present four or more weeks after acute infection with SARS-CoV-2. Most published data to date state 50-70% of hospitalized patients experienced at least one post-acute COVID-19 symptom up to 3 months after discharge. Commonly reported symptoms include; neurocognitive post COVID-19 (fatigue, dizziness, inattention, and brain fog), respiratory post-COVID (dyspnea, chest pain, and cough), and mental health related symptoms (insomnia, depression, and post-traumatic stress disorder). Additionally, gastro-intestinal post COVID-19 (diarrhea, vomiting, and abdominal pain) along with decline in quality of life and decreased ability to perform activities of daily living were reported. The response to post COVID-19 symptoms is still in its infancy despite being an emerging crisis as scientific evidence and robust data are nonetheless required for clear definition, identification of time frame, classification and management of the condition. New studies are needed to identify total and individual incidence/prevalence rates of different clinical presentations of post COVID-19 symptoms. These future studies will help us to o improve early recognition of long term symptoms after acute infection of COVID-19.

Health professionals are the base of the healthcare systems in all societies. Their daily contact with the patient in a context of demanding and difficult working conditions affect their general health. This research was carried out to describe the levels of general health among health professionals and their perceived levels of fatigue and social support. Additionally, the purpose of this study was to examine the above three variables in relation to demographic (education, gender) and employment factors (working hours, department). The research was conducted in 165 health professionals working in hospitals in the region of Eastern Macedonia-Thrace and in the urban centers of Athens and Thessaloniki. The General Health Questionnaire (GHQ-28), the Fatigue Assessment Scale (FAS) as well as the Multidimensional Scale of Perceived Social Support (MSPSS) were used to measure the research variables. The processing and statistical analysis of the data was done using IBM SPSS. The majority of health professionals presented a high score in GHQ-28 subscales indicating low general health (avg 8.59≥5). One hundred thirty nine out of 165 health professionals (84%) were tired and 15 out of 165 (9%) were too tired. The perceived social support was at high levels (avg 5.57). Health professionals exhibit high fatigue and low levels of general health and quality of life. Instead, they receive high social support. Existence of circular hours and work in heavy part worsens the levels of fatigue and quality of life. Measures are needed to increase the number of health professionals and organizational and structural measures to improve their working conditions and strengthen their social work.

Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide and it has been a widespread concern. Japan had some problems in psychiatric wards such as long hospital stay. The purpose of this study investigated recognition of nurses in psychiatric wards for future care. We conducted questionnaire research for psychiatric nurses and they described recognition of nursing in free description. Qualitative analysis was performed on description. Results showed that six categories were chosen like “Increase of stress and fatigue caused of infection control,” “Negative effects to body and mind of patients,” “Effects to nursing care in psychiatric nursing,” “Differences of attitude toward infection control in the hospital,” “Cognition for social movement related to Coronavirus,” and “New awareness by Coronavirus infection and future.” These results suggest the following, 1) some kind of supports will be needed for nurses’ stress for infection control, 2) supports or interventions for palliate of patients stress like limitation of prolonged quarantine, limit of visiting or home stay overnight, 3) integrated leaderships to cognition and behavior for infection control in a hospital.