This narrative review aims to summarize non-pharmacological interventions for pain management in hemodialysis patients, assessing their potential benefits and limitations in enhancing patient well-being and quality of life. We reviewed the current literature on five primary non-pharmacological interventions: acupuncture, cognitive behavioral therapy, relaxation techniques, virtual reality, and alternative methods such as transcutaneous electrical nerve stimulation, music therapy, and aromatherapy. We analyzed the evidence regarding their effectiveness, feasibility, and optimal implementation strategies. The existing evidence supports the potential benefits of these interventions in managing pain and improving the well-being of hemodialysis patients. However, further high-quality research is needed to confirm their effectiveness, establish implementation best practices, and assess their long-term impact on patient outcomes. Non-pharmacological interventions hold promise for pain management in hemodialysis patients. Additional research is required to optimize these interventions and validate their effectiveness, contributing to comprehensive pain management strategies for this vulnerable patient population.

Background: Preeclampsia (PE) remains a significant cause of maternal and fetal morbidity and mortality, with diagnostic criteria still evolving. Serum albumin, a potential marker of endothelial dysfunction and protein loss, has been proposed as a severity indicator in PE. This study evaluates the clinical utility of serum albumin levels, particularly values below 2 g/dL, in assessing PE severity and predicting maternal–fetal complications. Methods: We conducted a prospective and descriptive study including 59 pregnant women diagnosed with PE. The participants were divided into mild (n = 23) and severe (n = 36) PE groups based on national guidelines. Serum albumin, 24 h proteinuria, renal and hepatic function markers, and fetal outcomes were analyzed. ROC curve analysis was employed to determine albumin’s diagnostic performance. Results: Serum albumin levels were significantly lower in the severe PE group compared to the mild PE group (1.82 ± 0.50 vs. 2.44 ± 0.36 g/dL, p < 0.001). ROC analysis identified a threshold of 2.3 g/dL (sensitivity: 88.9%, specificity: 73.9%) for distinguishing PE severity. A strong association was observed between albumin < 2 g/dL and severe proteinuria (>3 g/24 h), but no significant association emerged with renal or hepatic dysfunction, fetal complications, or birth outcomes. Conclusions: Although serum albumin < 2 g/dL is associated with severe proteinuria, it does not independently correlate with other maternal or fetal complications in PE. These findings suggest that albumin may serve as a complementary, but not a standalone, marker in assessing PE severity.

Objectives: Depressive syndrome is commonly observed in patients with autoimmune thyroid diseases, often coexisting with specific endocrine symptoms. This study highlights a higher prevalence of depression in patients from urban environments, potentially influenced by occupational, educational, and psychosocial factors, as well as environmental endocrine disruptors. Depression may develop at any age, with increased frequency among older individuals due to chronic health conditions. Early identification using tools such as the Beck Depression Inventory can support timely intervention and appropriate treatment strategies. Methods: This paper presents a clinical observational study involving 80 patients with autoimmune thyroid disease from the Dobrogea region, Romania. Participants were divided into two groups: Group 1 with chronic autoimmune thyroiditis (CAT, n=62) and Group 2 with Graves’ disease (GD, n=18), reflecting the lower prevalence of GD. Inclusion criteria required confirmed autoimmune thyroid disease and residence in Constanța County. Patients underwent clinical and paraclinical evaluations, including hormonal and antibody testing, as well as vitamin D level assessment. Depression was screened using the Beck Depression Inventory II (BDI-II), a 21-item tool used to assess the presence and severity of depressive symptoms, particularly in relation to vitamin D deficiency. Results: The study found that depression was more prevalent among GD patients (66.7%) compared to those with CAT (53.2%), with higher incidence in urban areas and among older individuals. Increased depression severity was associated with lower vitamin D levels, higher ATPO and TRAb levels, and suboptimal thyroid function. Mild depression was most common and linked to vitamin D deficiency in both groups. The Beck Depression Inventory-II effectively captured varying depression degrees across clinical and biochemical parameters. Conclusions: Depression is a common comorbidity in autoimmune thyroid disorders and should be systematically assessed, with a multidisciplinary approach and attention to vitamin D status using cost-effective screening methods.