Items · Current Health Sciences Journal

Immunoexpression of Claudin-4 In Non-Small Cell Lung Carcinomas

D. F. GRECU; M. V. ZORILA; L. STANCA; A. F. GRECU; O. I. CRETU; A. E. STEPAN

2024/12/31

10.12865/CHSJ.50.04.05

Medicine

Non-small cell lung carcinomas (NSCLC) are the most common histological forms of lung cancer, lesions that by their incidence and associated mortality constitute a health problem worldwide. Alteration of the expression of claudins with a role in the stability of cell adhesion constitutes one of the complex biomolecular mechanisms involved in tumor initiation and progression. In this study, Claudin-4 immunoexpression was investigated in 52 cases of NSCLC in relation to epidemiological and histopathological prognostic parameters of the lesions. Although the staining scores were higher in patients in younger age groups, in women, in smokers and in squamous cell carcinomas (SCC) and large cell carcinoma (LLC) compared to adenocarcinomas (ADK), the aspects were not statistically significant. We found significantly higher differences in micropapillary, cribriform and solid ADK compared to other histological subtypes, in well and poorly differentiated lesions (G1/G3), with vascular invasion and in advanced tumor stages. Reaction analysis indicated translocation of Claudin-4 signals from the membrane level to the cytoplasm and nucleus in aggressive histological subtypes. The study indicated differences in Claudin-4 expression, which can be used to identify aggressive NSCLC and to stratify patients for specific therapy.

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Clinical Features of SARS-CoV-2 Infected Patients in a Large Population Cohort from the South-West Region of Romania

F. I. BUIBAS; A. R. CERCEL; M. S. SERBANESCU; A. TURCU; F. DUMITRESCU; I. PIRICI; L. MOGOANTA

2024/12/31

10.12865/CHSJ.50.04.04

Medicine

SARS-CoV-2 infection was first detected in Wuhan City, Hubei Province, China, in the last months of 2019 as an atypical pneumonia, from where it rapidly spread worldwide causing the most severe pandemic of the 21st century. The disease had a complex symptomatology, with clinical signs of pulmonary impairment, frequently accompanied by digestive, renal, cardiovascular or nervous signs. In the present study, we aimed at analyzing a group of 5649 patients, aged between 3 and 104 years old, diagnosed with Covid-19 and hospitalized within the Clinical Hospital of Infectious Diseases in Craiova between 2020-2022. In Romania, the first cases of COVID-19 started in the first quarter of 2020. Our study revealed that, in the first year of the pandemic, 1404 (24.85%) patients were hospitalized; in 2021, 3670 (64.97%) patients were hospitalized, and in 2022, as a result of prophylaxis measures and the introduction of the anti-COVID-19 vaccination, the number of hospitalized patients decreased to 575 (10.18%). SARS-CoV-2 infection affected all age groups, from children younger than 5 years of age to people over 100 years of age, but most patients (3060 patients, representing 54.17% of the whole investigated group) were aged between 55 and 75 years old. Regarding sex, we found that the disease affected both sexes equally. The most common clinical signs were: cough and temperature change, each present in 62% of the total group of patients and dyspnea present in 29% of patients. The most common comorbidities were cardiovascular disease (39%), diabetes mellitus (9%) and chronic lung disease (10.21%).

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The Comparative Effects of Cryotherapy and Music Therapy on Pain and Anxiety in Vascular Access Procedures: A Randomized Clinical Trial

H. JAFARIMANESH; S. SAMIEI; M. ZAKERIMOGHADAM; M. ZAREIE; A. N. SUUK

2024/12/31

10.12865/CHSJ.50.04.03

Medicine

Purpose: The fear of vascular access procedures reduces patient cooperation, often resulting in unsuccessful venipuncture attempts and prolonging the overall treatment process. Because people getting venipunctures in medical and surgical settings usually feel pain and anxiety, the goal of this study was to look at and compare how cryotherapy (CT) and music therapy (MT) affected the levels of pain and anxiety (P&A) these people felt. Method: This research utilized a randomized controlled trial methodology. The target population consisted of patients hospitalized in the medical-surgical wards of Valiasr Hospital, Arak, Iran. One hundred twenty patients were purposively selected and then randomly assigned (using block randomization) to one of four groups: MT, CT, combination therapy (COBT), or control. P&A levels were assessed using the Visual Analogue Scale (VAS) and the Visual Anxiety Intensity Scale (VAIS). Data were analyzed utilizing version 21 of the Statistical Package for the Social Sciences (SPSS) software. Descriptive statistics, including mean, standard deviation, frequency, and percentage, along with inferential statistics, such as the analysis of variance test, paired t-test, and Chi-square, were employed for analysis. Findings: The findings revealed a statistically significant disparity in pain levels among the four groups (P<0.001). The mean pain score in the COBT group (1.66±1.66) was lower than that of the MT group (2.03±1.84) and the CT group (2.43±2.16). However, the three intervention groups (MT, CT, and COBT) showed no notable difference from a statistical perspective (P>0.05). Additionally, a statistically substantial distinction in anxiety levels was observed among the four groups after the study (P<0.05). Both the COBT and MT therapies markedly diminished anxiety severity in comparison to the control group. Conclusion: The study results demonstrated that MT, CT, and COBT are effective in alleviating P&A in patients having venipuncture procedures. These interventions may serve as valuable complementary or alternative approaches in clinical practice.

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Research Progress of EMR2 Receptor Function in Glioma and its Potential Application as Therapeutic Target

I. M. BUZATU; A. COSTACHI; A. O. DOCEA; E. V. MANEA; O. ZLATIAN

2024/12/31

10.12865/CHSJ.50.04.02

Medicine

The most frequent primary brain malignancy is glioma. Alterations in several adhesion G-protein-coupled receptors (aGPCRs) are present in cancer as they regulate adhesion, migration, and guidance. Epidermal growth factor (EGF) module-containing mucin-like receptor 2 (EMR2) is included in group II GPCRs and functionally in a family of brain angiogenesis inhibitor molecules (BAIs). Recent studies have shown that BAIs regulate phagocytosis and synaptogenesis, and their extracellular domain inhibits angiogenesis and tumor growth. In neoplastic processes, EMR2 appears to play a role in disease aggressiveness, patient survival rates, and tumor grade. This review summarizes the EMR2 involvement in cellular mechanisms and pathologies, particularly in cancer. We searched the Pubmed Central, Google Scholar and Scopus databases for terms “EMR2” and “glioma”. The initial search yielded a total of 92 results. After excluding studies not written in English, based on design, and excluding duplicates and non-relevant studies, we included 38 studies in the review. EMR2 was shown to be expressed in various histologic grades of gliomas and to be linked to the PI3K pathway, as both are upregulated in glioblastoma after bevacizumab therapy. The PI3K-Akt pathway is involved in tumorigenesis, and upregulation of EMR2 may in turn upregulate PI3K, leading to increased tumor invasiveness. Indeed, overexpression of EMR2 was associated with the mesenchymal glioblastoma subtype, tumor invasiveness, and poor survival. EMR2 also regulates neutrophil function by producing reactive oxygen species (ROS) and degranulation. Possible therapeutic approaches have been studied, such as the stimulation of microglia and monocytes to inhibit tumor-initiating cells by down-regulating the EMR2 gene or through an antibody against EMR2. The current review summarizes the knowledge about the EMR2 receptor that can serve as motivation for future studies on its role in the clinical evolution and tumor biology of gliomas in order to find new modulator therapeutic approaches.

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A Brief Review of Drugs and Supplements Testing in Induced Osteoarthritis Murine Models: Methodologies and Findings

G. BICA; O. C. ROGOVEANU; I. A. PALIU; I. MINDRILA

2024/12/31

10.12865/CHSJ.50.04.01

Medicine

Knee osteoarthritis (OA) is a complex, progressive disorder that involves the gradual breakdown of articular cartilage, alteration of the subchondral bone, synovial inflammation, and joint space limitation, ultimately leading to stiffness, pain, and impaired balance and mobility. At this moment there is no cure to stop the evolution of the disease, only symptomatic treatment. This fact is due to the lack of understanding of the underlying mechanisms, thus limiting the possibilities of developing disease-modifying drugs. This challenge arises from an incomplete understanding of the underlying mechanisms of disease, which limits the development of effective disease-modifying drugs due to the fact that human tissue samples are typically obtained in the advanced stages of the disease, usually when the patient is subjected to joint replacement surgery, making the study of early OA stages more difficult. For researchers, the murine animal model provides a useful tool for assessing the full evolution of the pathology and the study of the efficacy and safety of novel experimental drugs and supplements. The aim of our review is to present the diverse currently used murine models ranging from spontaneous to chemically and surgically induced OA and pharmacological results that were obtained on such models and are available for human use or represent a potential innovative therapy in the near future.

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Clinical and Radiological Spectrum in Cleidocranial Dysplasia: A Case Series

F. M. DEBTA; K. AGARWAL; B. BERA; R. PANDA; S. MURMU

2025/06/30

10.12865/CHSJ.51.02.14

Medicine

Cleidocranial dysplasia (CCD) is an autosomal dominant disorder caused by a mutation in Runt-related transcription factor 2 (RUNX2), primarily affecting bones undergoing intramembranous ossification, characterized by generalized dysplasia of bones and teeth. Affected individuals exhibit short stature, partial or complete absence of clavicles, delayed fontanel closure, open skull sutures, multiple wormian bones. Dental issues include retention of deciduous teeth, delayed eruption of permanent teeth, supernumerary teeth, absence of cellular cementum. Diagnosis is based on clinical & radiographic findings. Early diagnosis enhances treatment and quality of life. This case series presents spectrum of clinical radiographic findings of four adult CCD patients with varying dysplasia manifestations.

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Spectrum of Post Tuberculosis Chronic Lung Disease in Patients with Previous Bacteriologically Confirmed Pulmonary Tuberculosis

I. A. ARGHIR; A. O. CRISTINA; I. T. ANDRONACHE; I. ION

2025/06/30

10.12865/CHSJ.51.02.13

Medicine

The discovery of anti- tuberculosis (TB) drugs, in the middle of last century, did not resolve the goal of a better healing, and the most important cause is represented by delayed diagnosis of TB disease. We conducted a single-center case control study, from January, 1st, 2017 to December, 31st, 2024, including 400 adult symptomatic inpatients diagnosed with post TB lung disease (PTLD), after a previous episode of treated TB disease. There were excluded 168 patients without pulmonary function testing (PFT), those with significant occupational exposure, and/or diseases autoimmune, COVID-19 or HIV infection, which might interfere lung function assessment. All demographics, behavioral and baseline PTB characteristics (relapses, clinical, imagistic, endoscopic, microbiologic, PFT, evolution) were assessed in order to inventorying sequelae and lung damage, types of lung function impairment. Eligible patients (n=232), mean aged 60.94+/-11.895 years, males (55.17%), were divided into 129 cases with previous bacteriologically confirmed PTB (mean age 58.37+/-11.86 years; 55.81% males) and 103 controls with previous clinically diagnosed PTB (mean age 60.04+/-11.222; 54.37% males). Delayed diagnosis and relapses of PTB had greater impact on PTLD development in cases (p=0.000), as well as previous cavitary PTB (p=0.000). The risk of death, during hospitalization, was greater in cases (p=0.000). Spectrum of PTLD, in cases, was dominated by bronchiectasis (p=0.000), suppurative episodes (p=0.004), open healing cavitation (p=0.000), intracavitary aspergilloma (p=0.002), fibrothorax (p=0.000), lung function impairment (p=0.030). In conclusion, PTLD severity is related to delayed diagnosis of previous contagious PTB, permanent lung damage, impairment of lung function, having a higher risk of death.

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High School Teachers’ Awareness of Internet Addiction and Related Factors Among Greek Adolescent Students

N. VLACHOPOYLOS; A. E. MANTADAKI; E. MOYRELLOY; P. VOLKOS; E. SMYRNAKIS; I. RAMOUTSAKI; G. PITSOULIS; A. PAPADAKIS; E. KOUTENTAKI; A.KAMEKIS; M.LINARDAKIS; N.RIKOS; E. K. SYMVOULAKIS

2025/06/30

10.12865/CHSJ.51.02.12

Medicine

In recent years, concerns about internet addiction (IA) have grown. The study aimed to assess to what extent teachers are informed about IA and are familiar with the internet, and to investigate their personal views and their perceptions of students’ daily habits. A cross-sectional survey was conducted from Nov 2023-to-Apr 2024 across public high schools (Day Lyceums) in Crete, Greece, with high school teachers from 42 randomly selected schools completing an original structured questionnaire on internet use. Habits and IA were assessed through regression analysis. Of the 349 high school teachers with a mean age of 47.1 years (±9.1), 65.9% were female. The teachers primarily used the internet for educational purposes (70.5%) or for social media/communication (50.7%). In fourteen questions regarding IA, feeling curiosity when using the internet was the most prevalent response (74.2%), while the mean total IA score (scale 0-100) was low (36.3±14.2). Discussions with students about rational internet use were more common among female teachers in relation to male (83.9% vs. 73.9%, respectively, p=0.026), those with longer work experience (14.3 years vs. 11.4 years, p=0.014), and those who had a lower mean IA score (34.6 vs. 41.3, p<0.001). In general, teachers who discussed rational internet usage with students had a lower IA score (unstandardized ?=-6.62, p<0.001). High school teachers' perceptions highlight the complex relationship between teachers and internet use. Our findings underscore the crucial role that teachers play in promoting healthy lifestyles and the need for better training in digital literacy and internet safety practices.

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Preoperative Oral Health Screening in Patients Undergoing Hip and Knee Arthroplasty: A Cross-Sectional Study

D. N. MIHAI; P. D. SIRBU; L. SAVIN; N. FORNA; C. DASCALU; N. FORNA

2025/06/30

10.12865/CHSJ.51.02.11

Medicine

Aim of study was to assess the prevalence and distribution of oral infections potentially leading to bacteriemia in patients scheduled for hip and knee arthroplasty. Materials and Methods: This prospective research was performed on a study group of 51 patients (mean age 67.51+/-5.78 years; 21-males, 30-females) diagnosed with hip osteoarthritis and knee osteoarthritis, scheduled for hip or knee arthroplasty in Clinical Rehabilitation Hospital (Iasi, Romania). A dental specialist performed a standardized clinical and paraclinical intraoral examination on all patients. The following conditions were assessed as oral sources of infection: chronic periapical lesions, endo-periodontal lesions, deep periodontal pockets, residual roots, fixed prosthetic restorations with inadequate marginal adaptation. Results: All patients were diagnosed with periodontal disease. Chronic periapical lesions (23.5%) and endo-periodontal lesions (41.2%) were frequently in maxillary molars. Residual roots were detected in 84.3% of patients (mostly in mandibular molars) while ill-fitting fixed prosthetic restorations in 64.7% of patients. Periodontal treatment of deep periodontal pockets was the most commonly treatment need, followed by replacement of ill-fitted fixed prosthetic restorations, and tooth extraction. Conclusions: Oral infectious foci-associated pathologies were frequent among patients scheduled for hip or knee arthroplasty, with deep periodontal pockets being the most frequent source of oral infection, followed by residual roots and ill-fitted fixed prosthetic restorations. Our results emphasize the necessity of the preoperative oral health evaluations for patients scheduled for hip and knee arthroplasty, a therapeutic approach required especially in the case of those with comorbidities or with risk of systemic bacteriemia of dental origin.

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Statin Use in Cervical Artery Dissection and Subsequent Ischemic Stroke

O. U. H. LODHI; S. YAGHI; L. SHU; N. CHUNG; C. R. LEON GUERRERO; J. E. KAUFMAN; S. ENGELTER; C. Traenka; W. KAM; A. S. ZUBAIR; M. ALMAJALI; J. P. MARTO; M. AFFAN

2025/06/30

10.12865/CHSJ.51.02.10

Medicine

Background and purpose: The role of statins in preventing recurrent ischemic strokes in the setting of non-traumatic cervical artery dissection remains unclear. This study, a secondary analysis of Antithrombotic Treatment for Stroke Prevention in Cervical Artery Dissection (STOP-CAD) study, investigates the impact of statin therapy on subsequent ischemic stroke. Methods: STOP-CAD, a multicenter retrospective observational study, included 4023 patients with non-major trauma-related CAD. For this sub study, we included 2610 patients with ischemic stroke, excluding those with non-ischemic presentations and missing statin information. Patients were stratified based on statin use at hospital discharge and a sensitivity analysis was conducted based on intensity: high-intensity, moderate-intensity, low-intensity, or no statin. Primary outcome was the incidence of subsequent ischemic stroke after hospital discharge. Secondary outcomes included major hemorrhage, mortality and 90-day functional outcomes. Statistical analyses included univariate analyses, Cox regression models to evaluate odds and hazard ratios. Results: There was no significant difference in subsequent ischemic strokes after hospital discharge between the statin group (3.1%) and no statin group (3.3%) (aHR 0.73 95% CI, 0.43-1.24, p=0.25). Similarly, the incidence of major hemorrhage, mortality and 90-day functional outcomes showed no significant differences between the groups. Conclusion: Statin therapy did not significantly reduce the risk of subsequent ischemic stroke, major hemorrhage, functional outcome, or mortality. While statins are beneficial in reducing vascular events and improving outcomes in ischemic stroke, its benefits in CAD-related ischemic strokes are less clear. These findings highlight the need for individualized treatment strategies and further research to optimize secondary prevention in CAD-related stroke.

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Biosafety and Selective Cytotoxicity of Kojic and Ellagic Acids in Salivary Gland Carcinoma: A Preclinical Perspective

F. IACOB; D. H. ALI; D. CHIORAN; L. C. RUSU; S. DINU; I. MUNTEAN; C. V. TIGMEANU

2025/06/30

10.12865/CHSJ.51.02.09

Medicine

Salivary gland carcinomas (SGCs) are rare, aggressive tumors with high histopathological diversity and resistance to conventional therapies. The need for novel therapeutic approaches has drawn attention to natural compounds with antitumor potential. Objective: This study aims to investigate the in vitro and in ovo cytotoxic and safety profiles of two natural agents, kojic acid (KA) and ellagic acid (EA), on human submandibular salivary gland carcinoma (A253) cells and human immortalized keratinocytes (HaCaT), as well as to assess their irritant potential via the HET-CAM assay. The cytotoxicity and morphological changes of A253 and HaCaT cells were evaluated using the MTT assay and brightfield microscopy. The HET-CAM assay was applied to evaluate the irritant effects of the compounds in ovo. Both KA and EA reduced A253 cell viability in a dose-dependent manner, with the highest cytotoxicity observed at 100 µM. In contrast, HaCaT cells maintained high viability and exhibited no notable morphological alterations post-treatment, supporting the selectivity of the compounds. HET-CAM scores for both KA and EA fell within the non-irritant range (IS=0.07), further confirming their biosafety. KA and EA exhibit promising antitumor activity against A253 salivary gland carcinoma cells, with minimal toxicity toward normal epithelial cells and no significant irritation potential. These findings justify further investigation of these compounds for their potential use as adjuvant agents in the treatment of salivary gland carcinoma (SGC).

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Purine Derivatives in the Management of Antiresorptive Drug-Related Osteonecrosis of the Jaw

N. FARAJOLLAH; O. M. DINCA; M. B. BUCUR; V. G. VLADAN; A. BUCUR

2025/06/30

10.12865/CHSJ.51.02.08

Medicine

Purinic derivatives has recently attracted attention as a potential therapeutic agent, with preliminary evidence suggesting its utility in the management of osteonecrosis of the jaw. work aims at providing an update of the current literature, shedding light on the purinic derivatives treatment for patients who received intravenous antiresorptive drugs and developed osteonecrosis of the jaw. A retrospective study was conducted at the Oral and Maxillofacial Surgery Department of ”Prof. Dr. Dan Theodorescu” Clinical Hospital in Bucharest, Romania, involving 160 consecutive patients diagnosed with refractory, established antiresorptive drug-related osteonecrosis of the jaw between 2022 and 2024. A study group of 23 consecutive patients was selected to receive adjunctive therapy with pentoxifylline (800 mg/day) and vitamin E (1000 IU/day) for six months, while the remaining 137 patients who were not eligible for pentoxifylline tretament formed the control group. Bone healing outcomes were assessed based on the extent of exposed necrotic bone. The study results indicate the fact that 100% of patients in the study group experienced symptomatic improvement, despite a higher prevalence of stage III medication-related osteonecrosis of the jaw, provides strong evidence supporting the therapeutic efficacy observed in this sample population. Post-hoc power analysis showed that the study was strongly powered to detect the observed differences, supporting the reliability of the results. Treatment with purine derivatives demonstrates significant therapeutic potential in the management of antiresorptive drug-related osteonecrosis of the jaw and should be considered as complementary to the standard therapy, particularly in advanced stages of the disease.

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Correlation between Early Life Exposure to Regulatory Relevant Doses of Herbicide Mixtures Based on Glyphosate and Development of Liver Dysfunction

V. DINCA; A. M. HBOUS; A. O. DOCEA; L. CERCELARU; R. MESNAGE; C. MARGINEAN; O. ZLATIAN; V. RAKITSKII; R. MITRUT; M. ANTONIOU; A. TSATSAKIS; D. CALINA

2025/06/30

10.12865/CHSJ.51.02.07

Medicine

Human exposure to low-level mixtures of herbicides is widespread, yet regulatory assessments still rely on single-compound, high-dose studies. This study aimed to determine whether prenatal-to-adolescent exposure to regulatory doses of glyphosate (GLY) alone or combined with 2,4-D and dicamba (COMB) alters liver function in rats. Pregnant Wistar dams (n=5/group) received drinking-water containing (i) no herbicide (BLANK), (ii) GLY at the EU acceptable daily intake (ADI, 0.5mg/kg bw/day; GLY 1), (iii) GLY at the EU NOAEL (50mg/kg bw/day; GLY 2) or (iv) the COMB mixture (each herbicide at its EU ADI). Offspring (?10/sex/group) continued the same exposure until 90 days post-weaning. Serum lipids and liver enzymes were quantified; livers were weighed and examined histologically. In COMB-exposed males, ALAT, ASAT and ALP increased significantly; females showed elevated ALAT, ASAT, cholesterol and triglycerides. GLY 2 reproduced this pattern in males, while GLY 1 heightened ALAT and ALP in males and triglycerides in females. Liver weight was unchanged, but histology revealed dose-related centrilobular vein dilation, granular degeneration, micro-vacuolar change and focal necrosis, most severe in the COMB group. Continuous exposure from gestation to young adulthood to herbicide doses at or below current “safe” limits produced clear biochemical and structural liver injury, amplified by the glyphosate plus 2,4-D and dicamba mixture and with sex-specific sensitivity. These findings challenge the adequacy of single-chemical risk assessments and underscore the need to re-evaluate mixture toxicity, particularly for vulnerable populations.

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Basic and Descriptive Spectrum of Tuberculosis in a Large Cohort of Hospitalized Patients

I. A. ARGHIR; I. T. ANDRONACHE; I. ION

2025/06/30

10.12865/CHSJ.51.02.06

Medicine

After 143 years from the discovery of Koch bacillus, the natural history of tuberculosis (TB) is characterized by heterogeneity and gaps of staging defining. The aim of the study consists in assessing the prevalence and characteristics of TB stages, from infection to disease, from acute to chronic disease, among inpatients of Constanta Clinical Pneumophthisiology Hospital. A cross sectional 8-year study, performed, from January 2017 to March 2025, among 630 inpatients, mean aged 58.23 years+/-13.812 std dev, mostly men (n=436; 69.2%) and smokers (n=414; 65.71%), enrolled with a positive diagnosis of TB infection (75 cases, based on positive QuantiFERON TB Gold Plus, 4% progressive forms), or disease (424 infectious, 410 new cases and 178 relapses, 35 multi drug resistant, 17 with mono or poly drug resistance). Subclinical TB was significantly more infectiousness than clinical forms (p=0.000). Active TB disease is characterized by delayed diagnosis (58.57%) and advanced extensive cavitary lesions (73.17%). Post treated lung TB disease (PTLD) occurred in 74.91% of cases, after a mean interval of almost 17 years (205.68 months+/-214.00 std dev), calculating from the first episode of treated TB disease. TB mortality rate was 16.66%o. In conclusion, landscaping tuberculosis? new stages is very complex and challenging. TB infection and subclinical TB are intricated through progressive forms of infection. PTLD must be considered a part of the basic triangle of TB spectrum, standing near infection and active disease, states in a continuous dynamic relation, overlapping through reinfections and relapses, causing PTLD and death.

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Esophageal Stenting Using Laparogastroscopy Compared With Esophageal Endoscopic Stenting: Retrospective Analysis

N. HASSAN; S. DAN; V. DAN; N. CRISTINA

2025/06/30

10.12865/CHSJ.51.02.05

Medicine

Esophageal stenosis is a debilitating condition that impairs swallowing and markedly reduces quality of life. Its etiology is multifactorial, including gastroesophageal reflux, radiation, caustic and surgical injuries, benign and malignant tumors. Endoscopic stenting represents a modern, minimally invasive treatment, yet some cases remain refractory to such approaches. Surgical options in benign strictures are limited, often leading to feeding enterostomies that compromise patient outcomes. Laparo-gastroscopic esophageal endoprosthesis, introduced in 1997, bridges endoscopy and surgery, reducing morbidity. This hybrid technique offers a reliable alternative for patients unfit for conventional surgical repair. Our study evaluates its role compared to standard endoscopic stenting, focusing on patient selection, outcomes, and dysphagia improvement.

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Underutilization of Respiratory Assessment and Management in Chronic Neck Pain: Exploring Physiotherapists' Practice Patterns

V. DANI; N. PANDYA; G. VASWANI

2025/06/30

10.12865/CHSJ.51.02.04

Medicine

Background: A significant link has been reflected between the respiratory dysfunction and chronic neck pain. Patients with chronic neck pain (CNP) experience various symptoms related to respiratory dysfunction due to its close relationship between muscular attachments and thoracic cage movements. Therefore, it is essential to include respiratory assessment and management while treating patients with CNP. Hence, the present study aims to determine whether physiotherapists incorporate respiratory assessment and management in their practice while treating patients with CNP. Methodology: It was a cross sectional, observation study, carried out using a Google form, which included a self-structured questionnaire inquiring about the current practice pattern of physiotherapists for managing patients with CNP. Total of 141 Physiotherapists managing patients with CNP were recruited through personal contacts and snowball sampling. Frequency and proportions of responses were analyzed. Results: Of 141 responses collected, only 3 physiotherapists (2.13%) included respiratory assessment and management in their practice for CNP patients, while majority focus on neuro-musculoskeletal system to be addressed while assessing and managing patients with CNP. Conclusion: A notable awareness and knowledge gap is revealed by the low number (2.13%) of physiotherapists who treat respiratory dysfunction in CNP patients. This highlights the necessity of better instruction and training in order to understand the importance of respiratory assessment and care for patients with CNP.

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Genistein: A Preliminary In Vitro Evaluation on IMR-32 Neuroblastoma Cells

A. HEGHES; A. SEMENESCU; G. MOISE; I. PREDESCU; C. TRANDAFIRESCU; D. S. ANTAL; D. C. VLAD; S. ARDELEAN

2025/06/30

10.12865/CHSJ.51.02.03

Medicine

Neuroblastoma (NB) is a frequent pathology among children with a serious prognosis. Although there is currently a chemotherapeutic treatment, over the years resistance to existing therapy has developed, necessitating new therapeutic approaches. The current study aimed to evaluate in vitro genistein (GEN) on human neuroblastoma cells-IMR-32, a possible candidate for treating NB. The results indicated that GEN does not affect healthy cells (HaCaT), but has a cytotoxic effect on tumor cells, at concentrations of 50 and 75µM, significantly reducing viability. Moreover, depending on the dose, GEN degraded the cell membrane by releasing LDH and caused changes in the cell shape as well as at the nuclear level similar to apoptosis. The data provide an important perspective on the therapeutic effect of GEN at the NB level, opening the way to new directions in treating this pathology with natural compounds.

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Association of Visual Impairment and Falls in Elderly Individuals-A Cross-Sectional Study

J. GEETHA; S. GOVINDHAN; M. R. H. M. KALIFA; A. GAUR; S. VARATHARAJAN

2025/06/30

10.12865/CHSJ.51.02.02

Medicine

Background: Falls are considered to be the most frequent and significant cause of unintentional harm and mortality among the elderly. Impaired vision is a significant risk factor for falls. Aim: To analyse the relationship between visual impairment and falls in the elderly. Methodology: This hospital-based cross-sectional study included 270 participants after obtaining informed consent. Details of demographic profile, lifestyle, gait and balance deficits, ophthalmic and systemic condition were collected. The identification of independent risk variables for falls in the elderly was performed by logistic regression analysis. Results: Among 270 participants, 115 participants had falls. The mean age of fallers was 72.97 years. Females had significant falls. 87.8% of participants had visual impairment. Visual risk factors like cataract (80.9%), uncorrected refractive error (59.1%), glaucoma (24.3%), age-related macular degeneration (20.2%), and corneal opacity (13%) were very strongly associated with fall (P<0.001). On multivariate logistic regression analysis visual risk variables like Cataract, uncorrected refractive error and glaucoma had a significant association with falls (P<0.05) with an adjusted odds ratio (aOR) of less than 1. Diabetic retinopathy had strong association of fall (P<0.001) with aOR of 41.8 (95% CI 4.27-409.2). Conclusion: Falls and visual impairment are public health concerns that require attention. Since many causes of visual impairment in the elderly are reversible, lowering the risk of falls in this population may be a controllable goal.

Family Doctors’ Perception of Patient Safety Issues in Rural Versus Urban Primary Healthcare Facilities

C. TEREANU; E. URPIS; G. BUTA

2025/06/30

10.12865/CHSJ.51.02.01

Medicine

Background: The Republic of Moldova is an Eastern European country with the capital in Chisinau and 2,5 million inhabitants (57% rural areas). Aim: To identify differences between rural, urban and Chisinau family doctors’ perception of patient safety culture and to benchmark the results. Methods: This cross-sectional study is based on 776 responses gathered with the AHRQ MOSOPSC in 2020. Percent of positive responses (PPRs) by item and administrative area were analyzed and benchmarked against other countries. Results: PPRs based on responses from Chisinau (45%), rural (33%) and urban (22%) primary healthcare facilities (PHFs) were ? 75% for 80% items and ?50% for tree items: rush when taking care of patients, high ratio patient/personnel, inadequate capacity to handle everything effectively. Five items in urban areas had PPRs significantly lower than in the other areas: exchanging accurate, complete and timely information with hospitals (70%); level of disorganization in the office (64%); workflow problems in the office (60%), difficulty to voice disagreement (56%), insufficient staff to handle the patient load (36%). Conclusion: Significant differences were only found in urban PHFs. High shortage of resources in rural areas and free choice of family doctors by rural residents increase affluence to urban or Chisinau PHFs. Urban PHFs have less resources to cope with patient number and workflow than Chisinau and this is likely to lead to significant differences in the family doctors’ perception of patient safety culture.

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Pineal cyst asociated with apoplexy and hydrocephalus: a case report

D. M. KIELING; A. Hedel KOERICH; R. A. DOS SANTOS JUNIOR; P. M. Mesquita FILHO

2025/03/31

10.12865/CHSJ.51.01.19

Medicine

Pineal cysts (PCs) are common findings on (Magnetic resonance Imaging) MRI, often incidental in females and asymptomatic throughout life. Rare complications, like pineal apoplexy with acute hydrocephalus, require differential diagnosis and urgent intervention. We report a 19-year-old male with a progressive headache and visual decline. MRI showed a 2.3 cm pineal cyst with hemorrhagic features (apoplexy) causing hydrocephalus. He underwent endoscopic third ventriculostomy and microsurgical resection, both successful. Postoperatively, symptoms resolved completely. Though often benign, complicated PCs can be life-threatening. This case highlights their management, aiding understanding of etiologies, differential diagnoses, and treatments, enhancing medical knowledge.

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Polymethyl-Methacrylate Hypersensitivity with Associated Folliculitis Decalvans After Cranioplasty: A Case Report

A. E. MARTIO; O. R. KARAM; L. Zambonato COSTAMILAN; V. BALEN-RONSONI; R. M. FERREIRA-SALTIEL; P. M. MESQUITA-FILHO

2025/03/31

10.12865/CHSJ.51.01.18

Medicine

Polymethyl methacrylate (PMMA) has been routinely used as bone cement, being well tolerated by most patients. The authors report the case of a 42-year-old patient that underwent cranioplasty with PMMA prosthesis, that reported progressive and persistent skin symptoms starting 45 days after surgery. Dermatologic evaluation revealed an extensive reddish scar plaque, associated with polytrichia and alopecia, located only in the left parieto-occipital region, above the PMMA cranioplasty. Scalp biopsy and bone cement specific patch test revealed both folliculitis decalvans (FD) and weak PMMA hypersensitivity. The patient was managed with dapsone for FD, and graft removal was not necessary. This is the second case of post-cranioplasty PMMA hypersensitivity, and the first report of potential contact dermatitis induced FD.

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Acute Pancreatitis after Major Spine Surgery: A case study

K. ZYGOGIANNIS; P. C. CHRISTAKAKIS; I. CHATZIKOMNINOS; D. KOULALIS; A. KALAMPOKIS

2025/03/31

10.12865/CHSJ.51.01.17

Medicine

Postoperative acute pancreatitis can be a relatively common complication regarding abdominal surgery, especially for general surgeons who have a high suspicion and expertise in the specific field. After spine surgery, on the other hand, it is considered rare, and when it settles, it is non-negligible as it may progress to a life-threatening condition. Although there is a plethora of reports regarding postoperative acute pancreatitis after spine surgery, especially scoliosis correction surgery or extended fusion surgery, many spine surgeons do not acknowledge this rare complication. Factors that may favor the apparition of acute pancreatitis include intraoperative hypoperfusion, hemodynamic instability, correction techniques in spinal deformity conditions, and mechanical abdominal pressure due to the patient's position. We report a case of acute pancreatitis after posterior lumbar fixation and decompression for spinal canal stenosis.

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The Case of the “Double Pylorus”

A. SUTARIA; S. EJAZ; I. M. CAZACU; A. SAFTOIU; M. S. BHUTANI

2025/03/31

10.12865/CHSJ.51.01.16

Medicine

A 68-year-old female with a history of small cell carcinoma of the lung and peptic ulcer disease presented for evaluation of dysphagia after undergoing radiation and chemotherapy. Esophagogastroduodenoscopy (EGD) revealed a radiation-induced esophageal stricture and incidentally a “double pylorus (DP)” with an adjacent similar opening cephalad to the pylorus. There was no evidence of perforation or traumatic injury leading to this finding and upon intubation, both openings led to the duodenal bulb that appeared to be normal. No endoscopic and surgical intervention was offered as patient was asymptomatic.

Functional Outcome of Intra-Articular Fracture of Distal End Radius Treated with External Fixator; A Prospective Study

P. SIWACH; S. V. SINGH; G. PURI; J. SINGH

2025/03/31

10.12865/CHSJ.51.01.15

Medicine

Fracture distal end radius is one of the most common fracture treated in orthopedic emergencies. Nearly 1/6th (16%) of all fractures in orthopedic emergencies involve the distal end of the Radius. This is a prospective-interventional study conducted in the department of Orthopedic Surgery, Sanjay Gandhi Memorial Hospital, Mangolpuri, New Delhi with a sample size of the study is thirty patients treated with an external fixator from January 2021 to June 2022. Out of 30 patients, the number of female patients was 16 (53.33%) and the number of male patients was 14 (46.67%). The mean age of the patient was 50.5 years. 27 (90%) out of 30 patients were right-handed people which was a common behavioral finding and thus we expect more right side distal radius fracture in our study. Functional outcome was evaluated with the Gartland & Werley scoring system. 14 patients (46.67%) showed excellent results, 11 patients (36.67%) showed good, 3 patients (10%) showed fair, whereas 2 (6.67%) patients showed poor results. Stiffness was the most common complication seen in 6 patients (20%). From this study, it is concluded that an external fixator is a simple, safe, and cost-effective method for the treatment of distal end radius fracture with a lesser duration of hospital stay. It reduces the fracture by means of ligamentotaxis and maintains the reduction as well as restores the radial length without interfering with the fracture healing process.

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Analysis of Imaging, Pathology and Demographic Data of Lung Cancer Patients Diagnosed in a Tertiary Medical Center in the South-West Region of Romania

O. CIMPEANU; I. M. LILIAC; D. N. PIRICI; M. OLTEANU; C. T. STREBA

2025/03/31

10.12865/CHSJ.51.01.14

Medicine

Introduction: Lung cancer is the most common type of primary tumor in both males and females, accounting for significant mortality worldwide. Clear evidence regarding comorbidities and aggravating factors exist, with multiple pathways being cited in recent literature. Patients and methods: Our aim was to review relevant sources and demonstrate through an original statistical study that tumor type, location, comorbidities, as well as demographic factors, may play a limited role in the evolution of lung adenocarcinoma. After obtaining ethical clearance, we enrolled consenting lung cancer patients in an observational cross-sectional study, collecting relevant demographic and medical information. Patients were recruited from a single tertiary medical center in Craiova, Romania, between January 2021 and January 2025. We used the Anova and the chi-square tests, considering p values below 0.05 as statistically significant. Results: We enrolled 189 patients (143 males, 75.6% of the entire lot), from urban and rural settings (49.7% from urban areas). The mean age was 64.94±10.47 years, with minimal variance when accounting for gender or provenance (Anova test, p>0.05). Most tumors were located in the upper portions of the lungs, with 111 cases, 53.44%. We found that 55.24% of males had tumors of the right lung, while only 39.13% of females had this location. Men had higher COPD rates (79 cases, 55.24%) and only two females (4.34%), p<0.05. However, we found statistically significant more women smokers than men (82.6% women vs. 41.25% of men). Conclusion: We hereby demonstrated that lung cancer remains a significant medical burden for the medical system, with prevalence in both sexes, irrespective of provenance. Most cases were diagnosed between 40 and 65 years, smoking and toxic exposure being predominant.

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