Items · Current Health Sciences Journal

Evaluation of the Incidence of Different Types of Malocclusions in Patients with Early Loss of Temporary Teeth

R. Uleanu-BICIUSCA; D. Agop-FORNA; D. CIOLOCA; A. ADUMITROAIE; V. TOMA

2025/03/31

10.12865/CHSJ.51.01.13

Medicine

The aim of the study is to identify the dental somato-facial anomalies in young patients with early loss of temporary teeth, with the identification of crowding and other present clinical entities. The study was carried out on a working batch of 635 subjects who referred to the Pediatric Dentistry Clinic in Iasi and the private dental practice for various dental treatments, without any obvious dysfunctional subjective symptomatology. Out of 635 subjects,254were female (40%) and 381 male patients (60%), distributed in the rural area (n=157; 24.7%) and urban area (n=478; 75.3%). By applying the selection criteria, the aim was to avoid issues of differential diagnosis with other disorders of the orofacial system. The mean age of the girls in the group was 8.26±1.840 years and the mean age of the boys was 8.77±1.856 years; the mean age of the rural children was 8.88±1.962 years, with an average of 8.46±1.823 years for the urban children. Dental malocclusions represent complex clinical entity, capable of producing functional, aesthetic and psychological disharmonies. Malocclusions can be caused by a combination of factors, in which the early loss of temporary teeth, the frequency of vicious habits, without excluding genetic determinism, are particularly important. The disorders that occur in the case of malocclusion may be aesthetic, masticatory, speech impairments, temporomandibular joint dysfunctions and social integration disorders.

Full text,

Correlations of Peri-Implant Parameters with Plaque and Inflammation Indices in Posterior Fixed Implant-Prosthetic Rehabilitation: A Cross-Sectional Study

A. DAVIDESCU; N. FORNA; D. Agop-FORNA; C. DASCALU; M. M. SCUTARIU

2025/03/31

10.12865/CHSJ.51.01.12

Medicine

Purpose. The aim of the study was to analyze the peri-implant clinical and radiological parameters and their correlations with the plaque index (mPI) and the inflammation index (GI) in fixed implant-prosthetic therapy. Materials and method. This research was a retrospective study including 48 patients with posterior partial edentulism (age: mean 63.04±10.723 years) treated by implant-supported metal-ceramic bridges, with a mean 6.19 years follow-up. A total of 166 implants were evaluated by clinical (peri-implant pocket depth-PPD) and radiological (peri-implant marginal bone loss-MBL) examen. Plaque index (mPI) and inflammation index (GI) were recorded for each implant site. Mean values of PPD, MBL (mesial), MBL (distal) were assessed. A comparative analysis was conducted regarding relation between PPD and MBL values (distal and mesial) in relation to the mPI and GI indices using the non-parametric Mann-Whitney and Kruskal-Wallis tests. Correlations between the variables PPD, MBL (mesial), and MBL (distal) for the entire study group were calculated by Pearson linear correlation coefficient. Results. There were very high positive correlations between pocket depth and mesial marginal bone loss (r=0.951, p <0.001; 95% CI: 0.934-0.964); pocket depth and distal marginal bone loss (r=0.961, p <0.001; 95% CI: 0.947-0.971), and mesial and distal bone loss values (r=0.935, p <0.001; 95% CI: 0.913-0.952). Conclusion. The findings indicate that peri-implant bone loss and pocket depth are strongly correlated and significantly influenced by plaque accumulation and inflammation, highlighting the critical role of the patients' oral hygiene in maintaining peri-implant tissue health.

Full text,

Histopathological Assessment of Non-Small Cell Lung Carcinomas

D. F. GRECU; M. V. ZORILA; L. STANCA; A. F. GRECU; O. I. CREU; A. M. BADIU; B. C. ANDREIANA; M. M. FLORESCU; A. E. STEPAN

2025/03/31

10.12865/CHSJ.51.01.11

Medicine

Non-small cell lung carcinomas (NSCLC) are common lung tumors with numerous growth patterns associated with lesion types, which are frequently diagnosed late and are associated with a reserved prognosis. In this study, we analyzed histopathologically and statistically 52 cases of NSCLC, for which the growth types/patterns were described and compared with tumor grade, the presence of vessels invasion and stage of tumor. We observed the predominance of adenocarcinomas (ADK) and acinar, cribriform, solid and papillary growth patterns, frequent mixed transitional areas, while for squamous cell carcinomas (SCC) the non-keratinized aspect was dominant. Vascular invasion was identified in 38.5% of cases, most NSCLC being in advanced stages, respectively 57.7%. ADK with cribriform, solid, and micropapillary patterns, as well as nonkeratinized SCC (NKSCC) and large cell carcinoma (LCC) were significantly associated with high grade, vessels invasion, and advanced stage of tumors. Transitional areas of ADK and focal keratinizations in SCC suggest the presence of specific lung tumor histological lesions, which in evolution acquire aggressive patterns.

Full text,

Tertiary Dentin Barrier Formation: A Comparison Between the Effects of Two Calcium Silicate Based Materials

A. M. COVACI; M. ANDREI; I. DINCA; L. T. CIOCAN; M. N. MATEI; A. C. DIDILESCU

2025/03/31

10.12865/CHSJ.51.01.10

Medicine

Pulp capping is a vital pulp therapy that aims to prolong the life of a tooth by protecting it after pulp exposure occurred. Pulp capping biomaterials are intended to induce odontoblasts to deposit a natural tertiary dentin barrier to protect the pulp-dentin complex. Two pulp capping agents with calcium silicates in their composition, but with different mechanisms of the setting reaction were tested in vivo with the main objective of comparing their effect on the pulp-dentin complex. The specific aim was to evaluate the preservation of pulp vitality following in vivo direct and indirect pulp capping on eight human third molars. TheraCal LC, a light-cured calcium silicate-based material, was tested both by direct and indirect pulp capping, while the mineral trioxide aggregate (MTA) cement was tested by direct pulp capping. The molars were assessed by micro-computed tomography (micro-CT) and by light microscopy and stereo-microscopy following histological processing of the teeth. Dental pulp vitality testing was performed before tooth extraction. Inflammatory pulp status was performed on light microscopy images and it was investigated the presence of inflammatory infiltrate, edema, vascular congestion and pulp necrosis. Following pulp capping, the MTA cement showed more favorable results, generating the formation of complete or incomplete dentin bridges in all treated teeth, while TheraCal LC induced the formation of dentin bridges in only two teeth. Tooth vitality was preserved in all tested teeth. In conclusion, both materials stimulated neodentinogenesis, with the MTA cement being more effective and presenting a much more favorable biological pulpal response.

Full text,

Using Convoluted Neural Networks in Diagnosing Lung Cancer on Computed Tomography Scans

O. CIMPEANU; I. M. LILIAC; M. MAMULEANU; S. V. VOINEA; M. OLTEANU; C. T. STREBA

2025/03/31

10.12865/CHSJ.51.01.09

Medicine

Introduction: Lung cancer represents a major health issue of the modern world, accounting for both most new cases and highest mortality rates worldwide. Early diagnosis and treatment remain essential in managing the disease; therefore, developing novel computer-assisted tools for processing large quantities of imaging data can prove indispensable. Our aim was to develop a novel convoluted neural network (CNN) to classify lung computed tomography (CT) images of suspect nodules. Materials and Methods: After obtaining ethical clearance, we included consenting patients with a lung mass found on a chest radiography, visible lung tumor on computer tomography and positive pathology or follow-up. After data augmentation, we trained a deep learning model to classify input images into two classes, malignant or benign. We evaluated the model by calculating accuracy, recall and precision. Results: We successfully enrolled 176 patients from a total of 192 cases. Most were male (135 cases, accounting for 76.7%) and came from urban areas (111 cases, 63%). Most tumors were found on the right lung (103 cases). The model performed well on an imbalanced dataset, with recall values at 79.31%, while precision reached 62.16%, a training accuracy of 76.34% and a validation accuracy of 77.01%. Conclusions: We proved that a CNN model can easily be implemented on regular hardware to successfully classify malignant and benign lung lesions on CT images. Future CNN implementations can greatly improve the imaging diagnosis of lung lesions; however, the physicians should always decide the medical management.

Full text,

Complications of Thyroid Surgery-Can We Further Minimize the Risk?

A. L. MANDA; S. A. DRACEA; A. L. DIMA; D. V. DAVITOIU; D. VASILE; D. I. VOICULESCU

2025/03/31

10.12865/CHSJ.51.01.08

Medicine

Thyroid surgery is nowadays a mostly safe and standardized procedure, with low complication and mortality rates. The specific complications of thyroid surgery are lesion of the recurrent laryngeal nerve (RLN), hypoparathyroidism, either transient or permanent, and hemorrhage that can be in some cases life-threatening; even if not, the impact on the quality of life can be negative. The identification of risk factors for complications of thyroid surgery and development of strategies for reducing morbidity are important for the thyroid surgeon. We conducted a retrospective study on a database of 60 patients operated for a thyroid disease in a period of two years in the setting of a non-specialized general emergency hospital in both general surgery department and thoracic surgery department. The main complication was transient hypoparathyroidism (defined by lower than 8mg/dl serum calcium postoperatively)-18.33% of the group, followed by cervical minor hematoma-5.00% of cases and RLN injury in one case-1.67%. Regression analysis showed type of thyroid surgery (p-value 0.0471), histopathology type of disease (p-value 0.0566) and difficulty of surgery defined by operative time (p-value 0.0494) as the risk factors for postoperative complications, of which only the last one can be modifiable by some extent. Identifying and minimizing the risk factors of difficult surgery might improve also complication rates.

Full text,

Comparison of Running Versus Interrupted Sutures for Fascial Closure in Ileostomy Takedown

T. TALPAI; B. MARUNELU; V. SURLIN; S. D. PREDA; C. A. PIRVU; S. PANTEA; A. DOBRINESCU

2025/03/31

10.12865/CHSJ.51.01.07

Medicine

Temporary loop ileostomies are common after colorectal cancer surgery to reduce anastomotic leak severity. However, ileostomy takedown carries risks like surgical site infections (SSIs) and incisional hernias. The optimal fascial closure technique during takedown remains debated. This study compared these techniques regarding postoperative complications. This retrospective study analyzed data from 69 patients undergoing scheduled loop ileostomy closure between 2016-2020 at two Romanian surgical departments. Data collected included demographics, clinical variables (ASA score, comorbidities), surgical details (suture type, closure time, skin closure type), and follow-up data including CT assessments for hernia detection. The cohort included 69 patients (mean age 63, 64% male). Fascial closure was used in 17 (24.7%) and interrupted in 52 (75.4%) patients. Running sutures were significantly faster (mean 19 vs. 22 min, p=0.028). Overall SSI rate was 21.7%. Ileostomy site incisional hernias occurred in 13 patients (18.6%) after a mean follow-up of 30.7 months. No statistically significant difference in hernia rates was found between running (3/17) and interrupted (10/52) suture groups (p=1). Significant risk factors for hernia development included longer follow-up (OR=0.87, p=.025), BMI?30 (OR=176, p=.009), and Clavien-Dindo grade 3 postoperative complications (OR=112, p=.033). While running sutures offer faster fascial closure, this study found no significant difference in ileostomy site incisional hernia rates between running and interrupted techniques. Patient factors like BMI ?30 and severe postoperative complications are significant predictors of hernia formation. Careful technique is crucial, but primary closure without mesh remains standard.

Full text,

Chromosome Abnormality Detection Rates of QF-PCR in Early Pregnancy Loss

G. POPESCU-HOBEANU; M. G. CUCU; A. L. RIZA; I. STREATA; R. M. PLESEA; S. DOROBANTU; A. BARBU; L. G. ZORILA; M. DINU; A. L. DIJMARESCU; S. TUDORACHE; D. ILIESCU; F. BURADA

2025/03/31

10.12865/CHSJ.51.01.06

Medicine

Early pregnancy loss (EPL) is the most common form of miscarriage and establishing its exact etiology is vital for the proper prognosis and management of possible future pregnancies. The aim of our study was to assess the incidence and types of chromosome abnormalities in product-of-conception (POC) samples analyzed by Quantitative Fluorescent Polymerase Chain Reaction (QF-PCR). Two hundred fifty-seven POC samples meeting EPL criteria were referred to the Human Genomics Laboratory of the University of Medicine and Pharmacy of Craiova, Romania. DNA was extracted from both POC tissue and maternal blood samples, while PCR products were migrated on the ABI3730xl platform. A total of 124 samples were successfully analyzed, 46 cases (37.1%) showing various types of abnormalities, while no aneuploidies were found in the remaining 78 samples (62.9%). The most common abnormalities were monosomy X, followed by triploidy, trisomy 18, 16 and 15. The basic QF-PCR kit had an overall detection rate of 25.8%, but the detection rate rose to 37.1% when employing the extended kit. Our study proves that QF-PCR can be used as a first approach in the genetic analysis of POC, followed by conventional karyotyping (KT) or Chromosomal Microarray Analysis (CMA) as follow-up. QF-PCR is able to identify maternal cell contamination, as well as provide timely results.

Full text,

Blood Donation Attitudes and Knowledge of Medical School Students at the University of Crete, Greece: An Intra-Institutional Exploration

M. T. ATHANASAKI; P. VOLKOS; M. LINARDAKIS; E. K. SYMVOULAKIS

2025/03/31

10.12865/CHSJ.51.01.05

Medicine

In the last decade, demand for blood has been increased internationally, while there is a consistent shortage of regular blood donors. Medical students are a potential pool of regular blood donors. The present study investigated the attitudes and knowledge of undergraduate medical students, regarding blood donation. During the May of 2023 data from 320 medical students of the University of Crete, Greece who were studying from the first to the sixth year were analyzed. It was a cross-sectional observational study and data collection was performed by completing an anonymous questionnaire with socio-demographic items and the Blood Donation Attitudes and Knowledge Scale. Three hundred twenty undergraduate students participated in this study. Sophomores accounted for 20.3% (n=65). Only 25.9% of the participants donated blood repeatedly. Most students (99.4%; p<0.001) believed that donating blood was a good act and 87.5% reported that religious beliefs should not influence blood donation (both p<0.001). The frequency of students in the 4th-6th year who achieved a high score in Attitudes and Knowledge scale was higher compared to the 1st-3rd year students (23.6% vs. 10.6%, p=0.002). Higher score on Attitudes and Knowledge about Donation was significantly associated with increased year of study (r=0.196, p<0.001). Moderate levels of Attitudes and Knowledge Scale about Blood Donation were reported with a significant tendency to increase along the years of study. Perhaps, medical students may mature their perception towards blood donation alongside with their training advancement in Medicine.

Full text,

The Role of miRNAs and Epigenetic Factors in Non-Alcoholic Fatty Liver Disease - a Systematic Review

V. C. STOICA; M. M. DICULESCU; M. MANUC; I. CONSTANTINESCU; I. P. GARDAN; A. D. GARDAN

2025/03/31

10.12865/CHSJ.51.01.04

Medicine

Non-alcoholic liver disease is affecting approximately a quarter of the global population, with a significant morbidity and mortality rate. The present paper takes into discussion a systematic review of the literature concerning the role that microRNAs (miRNAs) and epigenetic factors can have in relation with NAFLD. Using PRISMA methodology guidelines, the systematic review offers a comprehensive image of the relevant scientific literature that explains the complex role of miRNAs in relation with NAFLD. Throughout the process of reviewing there has been highlighted seven different subtopics that can synthetize the nature and the content of the different studies: the role of miRNAs in fibrosis and liver disease progression; use of microRNAs as biomarkers for diagnosing steatotic liver disease; microRNAs and targeted therapies for NAFLD (Nonalcoholic fatty liver disease) /NASH (Non-alcoholic Steatohepatitis); metabolic regulation and obesity via microRNAs; interaction of miRNAs with other factors at the molecular level in disease pathogenesis; the role of miRNAs in systemic inflammation and effects on various other organs and the role of miRNAs as regulators and highly specialized epigenetic factors affecting NAFLD pathogenesis and evolution. Overall, this review presents diverse approaches on microRNAs and gives a background for future applied research that can explain and test their potential as biomarkers for diagnosing and understanding disease mechanisms, particularly in populations exposed to historical nutritional imbalances.

Full text,

Deep Learning and The Retina: A New Frontier in Multiple Sclerosis Diagnosis

S. E. Abdul-SALAM; R. M. FLORESCU; V. SFREDEL; D. O. NALEXANDRU; M. S. SERBANESCU; A. D. ROTARU-ZAVALEANU

2025/03/31

10.12865/CHSJ.51.01.03

Medicine

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system that leads to neurodegeneration and functional disability. Because recent advances in retinal imaging have revealed that the retina is a non-invasive window into the brain, offering valuable biomarkers for MS diagnosis and progression tracking, we explored the integration of artificial intelligence (AI), particularly deep learning (DL), in the analysis of fundus-based imaging techniques such as Optical Coherence Tomography (OCT), fundus photography, and Scanning Laser Ophthalmoscopy (SLO). These investigations allow for the detection of subtle retinal changes, such as thinning of the retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL), which are closely associated with MS pathology with the help of AI-driven models, including convolutional neural networks (CNNs), generative adversarial networks (GANs), and explainable AI approaches and they have demonstrated high accuracy in classifying MS patients, even at early stages, and predicting disease severity. The review also discusses the challenges and future directions of applying AI in ophthalmic diagnostics, including data standardization, model interpretability, and clinical integration. Overall, AI-enhanced retinal imaging is emerging as a powerful, non-invasive tool that can complement traditional neurological assessments and support earlier, more personalized MS care.

Full text,

Recent Advances in the Etiology and Neural Pathways Underlying Attention-Deficit and Hyperactivity Disorder

M. Grigore; M. V. Ionica; L. Patru; V. Gheorman; A. Popa-Wagner

2025/03/31

10.12865/CHSJ.51.01.02

Medicine

The prevalence of mental disorders is increasing across the European Union, with at least one in four individuals expected to experience a psychiatric condition at some point in their lifetime. Notably, men and women often present with distinct symptomatology. Among neuropsychiatric disorders, attention-deficit/hyperactivity disorder (ADHD) is the most common and functionally impairing condition in childhood, affecting approximately 5% of minors. Its persistence into adulthood is substantial, with prevalence estimates reaching up to 3% in adult populations. ADHD is characterized by dysregulated dopaminergic signaling, which disrupts reward processing and motivation. Additionally, disturbances in circadian rhythms contribute to sleep dysregulation and metabolic dysfunction, further exacerbating symptom severity. While both mechanisms have been well-documented, their interaction remains insufficiently explored, particularly regarding its implications for diagnosis and treatment optimization. Future research should systematically examine the interplay between dopaminergic and noradrenergic dysfunction and circadian disruptions in ADHD, particularly in relation to symptom expression and comorbid conditions. Experimental paradigms assessing reward processing may provide valuable insights into dopamine and norepinephrine system alterations, while chronotherapeutic interventions-such as light therapy, sleep regulation, and behavioral adjustments-hold promise as potential therapeutic strategies. By integrating perspectives from neurobiology, chronobiology, and psychopharmacology, a more refined and individualized approach to ADHD management can be developed. Advancing this understanding may not only enhance ADHD treatment strategies but also yield novel therapeutic avenues for addressing its frequently co-occurring conditions.

Full text,

Burn Debridment - Approach and Review

E. A. MARINESCU; A. A. NEGRILA; R. A. MARINESCU; O. NICA; A. TALABAN; A. M. CIUREA

2025/03/31

10.12865/CHSJ.51.01.01

Medicine

Between January 2020 and December 2024, a significant number of burn patients were admitted to the Plastic Surgery Clinic of the Craiova Emergency Clinical Hospital. Due to the high incidence of burns requiring hospitalization and the limited number of beds available for such patients, it became essential to identify optimal treatment methods that could reduce hospital stay while ensuring favorable functional and aesthetic outcomes. Early debridement is considered a vital first step in the treatment of burn patients, ideally performed within the first few days post-injury. Burn treatment involves both surgical and systemic approaches. Surgical management includes debridement, skin grafting, and reconstruction. Tangential surgical debridement remains the gold standard for deep burns, allowing precise removal of necrotic tissue while preserving viable skin. However, it may be associated with disadvantages such as intraoperative blood loss and incomplete excision. Alternative methods have evolved, such as hydrodissection, which uses a high-pressure saline jet for selective debridement, particularly useful in partial thickness burns. Larval therapy (using sterile Lucilia sericata maggots) is another option, especially effective in infected or necrotic wounds, offering antimicrobial benefits as well. Enzymatic debridement, particularly with bromelain-based products, is a modern, selective, and less invasive method that promotes healing with minimal bleeding and often reduces the need for grafting. A clinical case from Craiova highlights the success of enzymatic debridement: a 75-year-old patient with extensive burns showed significant improvement and near-complete epithelialization after 24 days, without requiring grafts. These outcomes support the growing use of enzymatic agents as a valuable tool in modern burn management, offering rapid, effective treatment and better patient recovery.

Full text,

Non-Alpine Thyroid Angiosarcoma Presenting with Unique Spinal Metastasis: A Rare Case Report from Pakistan

S. FAISAL; H. WALI; T. MUHAMMAD; T. E. KAMRAN; R. SALEEM

2024/09/30

10.12865/CHSJ.50.03.15

Medicine

Thyroid angiosarcoma is an extraordinarily sparse malignancy, often populating alpine regions. Clinically, thyroid angiosarcomas tend to be nonspecific in presentation, starkly dependent on site, size, extension, and metastases. Tumors are locally aggressive and can present with sudden onset pain due to intra-nodular hemorrhage and compressive symptoms from sudden expansion. Due to the disease being a scarcely reported entity, there is little scholarship regarding its management. We report an interesting case of a 63-year-old man presenting with a swelling in the neck, incidentally found to be a thyroid angiosarcoma with a first-time reported associated spinal metastasis. The patient has a uniquely presenting thyroid angiosarcoma and is the first patient to present as such within a non-alpine South Asian region.

Full text,

Acute Epstein-Barr Virus and SARS-CoV-2 Coinfection: A Case Report

M. E. Tesch Ferreira ALVES; L.De Figueiredo MELLO; F.R.Ferreira ALVES

2024/09/30

10.12865/CHSJ.50.03.14

Medicine

Introduction. The present case describes one of the few reported occurrences of coinfection by EBV and SARS-CoV-2, initially treated as streptococcal pharyngitis. Case Description. An 18-year-old female was admitted with whitish plaques in the throat associated with pain, cough, hoarseness, asthenia, tonsillar exudate, hypertrophy, hyperemia, and adenomegaly on the cervical region. Based on suspicion of bacterial tonsillitis, the patient was already taking amoxicillin with clavulanate. A rapid test was negative for group A streptococci. Laboratory exams revealed elevated counts of Anti-VCA IgM and Anti-VCA IgG for EBV. The cytomegalovirus (IgM and IgG) result was negative, and the blood count was within normal limits. However, a COVID-19 infection was confirmed by qPCR. The management was supportive treatment for symptom relief and isolation for 14 days. The patient remained afebrile and clinically stable during this period, with saturation ranging from 98% to 100%. However, the patient evolved with anosmia and ageusia. Then, olfaction training therapy was initiated, as well as continuing asthenia. Five days later, she presented petechiae on the chest and upper limbs, associated with mild pruritus. Conclusion. Epstein-Barr mononucleosis and COVID-19 are similar in some aspects, and their viruses may be associated with a coinfection, which could make the diagnoses difficult and aggravate the clinical condition. In addition, it is essential to emphasize the importance of laboratory tests to avoid erroneous treatments that may worsen the patient's condition and change his prognosis.

Full text,

Anterior Pituitary Hormones are Important in Growth, but does their Deficiency Cause Skeletal Deformity? A Case Report

Y. YUMUSAKHUYLU; A. ICAGASIOGLU; A. GUVEN

2024/09/30

10.12865/CHSJ.50.03.13

Medicine

Hypopituitarism is a clinical syndrome that occurs when the anterior pituitary gland fails to secrete one or more hormones. Developmental delay is frequently seen in these patients. However, skeletal deformities and postural instability are unexceptional. We present a 17-year-old male patient with panhypopituitarism (PHP) with back and leg pain, postural malalignment, and skeletal deformities referred by the pediatric endocrinology clinic. According to the physical examination, laboratory tests, and radiographic assessments, the patient was considered as sequela spondyloarthropathy (SpA). Autoimmune and rheumatic diseases are frequently encountered in patients with hypogonadism. However, the association of PHP and ankylosing spondylitis (AS) has not yet been demonstrated. This case was presented to draw attention to the alignment of PHP and SpA and also to emphasize that skeletal deformities were not encountered in the absence of anterior hypophysis hormones.

Full text,

Cutaneous Metastases of Signet-Ring Cell Gastric Carcinoma: A Case Report

G. I. KURMUS; F. CANPOLAT; M. GONUL; A. GOKCE; S. P. KARTAL

2024/09/30

10.12865/CHSJ.50.03.12

Medicine

The cutaneous metastases from carcinoma of the stomach are rare and either an index of a silent visceral neoplasm or a recurrence of an already diagnosed malignancy. They usually present as asymptomatic nodules or plaques; thus, they can be mistaken for other skin conditions, which leads to a potential misdiagnosis. The definition of signet-ring cell (SRC) gastric carcinoma is that it can easily cause a diffusion enbloc through lymphatic and hematogenous pathways, inducing skin manifestations such as indurated plaques, nodules, and erysipelas-like lesions. The infrequency of skin metastasis from gastric carcinoma underlines once more the need for increased awareness on the part of clinicians. Diagnosis, histopathological examination, and immunohistochemistry are essential. The confirmation of SRC tumors is done by staining for mucin, such as periodic acid-Schiff (PAS) and mucicarmine, and by using immunohistochemical markers like CK7. Almost always, cutaneous metastasis from SRC gastric carcinoma has a poor prognosis since these tumors are highly aggressive and chemotherapy-resistant. We present a case of cutaneous metastasis from SRC gastric carcinoma, a subtype of gastric cancer with a well-documented tendency both for distant and cutaneous spread. Generally, skin metastases from SRC gastric carcinoma are associated with poor prognosis, rapid progression of the disease, and a high mortality rate. This case underlines the need for early detection and a multidisciplinary approach by dermatologists, oncologists, and surgeons to improve outcomes in such patients.

Full text,

Two-Year Outcomes in Preterm Infants Suffering from Moderate to Severe Bronchopulmonary Dysplasia with or without Associated Pulmonary Hypertension

I. BRANESCU; D. O. ALEXANDRU; S. VLADAREANU;; A. KULKARNI

2024/09/30

10.12865/CHSJ.50.03.11

Medicine

Objectives: to assess the impact of pulmonary hypertension (PH) on short and long-term respiratory and neurodevelopmental outcomes in extremely preterm infants, diagnosed with moderate to severe bronchopulmonary dysplasia (MSBPD). Study design: cohort study, with retrospective analysis of the medical records of infants born at ?32 weeks gestation admitted to a single neonatal tertiary centre from 2010 to 2020. Primary outcome was consistent with hospital re-admissions by 2 years post menstrual age. Neurodevelopment was assessed using Bayley’s Scales of Infant and Toddler Development 3rd edition (Bayley-III) as a secondary outcome. Results: 201 infants with no PH and 23 infants with PH were analysed. The PH group showed higher risk for respiratory and paediatric intensive care unit re-admission (65%) during the first 2 years of life (OR: 3.15; 95% CI: 1.28 to 7.78; p<0.5). In contrast to current published literature, our study showed that pulmonary hypertension complicating moderate to severe bronchopulmonary dysplasia had no negative impact on neurodevelopmental outcomes (OR: 1.87; 95% CI: 0.72 to 4.88; p value=0.19). However, in our population, ethnicity, chorioamnionitis and need for persistent ductus arteriosus treatment were all independently associated with poor neurodevelopmental outcomes (p values <0.5). Conclusion: infants with MSBPD associated pulmonary hypertension (MSBPD-PH) are more likely to need intensive care and respiratory hospital re-admissions. Ethnicity, chorioamnionitis and need for ductus arteriosus treatment are independently associated with poor neurodevelopmental outcomes regardless of the pulmonary hypertension status.

Full text,

The Relationship between Sleep Bruxism Index and Quality of Life

E. C. SIN; G. RAFTU; S. G. BUSTUIC; A. CARAIANE; R. BRICEAG

2024/09/30

10.12865/CHSJ.50.03.10

Medicine

Aim of the study: The aim of this study was represented by the identification of the type of relation between the bruxism sleep index and the global quality of life. Materials and Methods: The study group was composed of a number of 40 patients, both women and men, who did not report health problems and who were identified with a positive self-report regarding the existence of sleep bruxism. For the identification of the bruxism index, the Bruxoff device, Bioelettronica, Turin, Italy, was used. Quality of life inventory (QOLI) was used to determine quality of life scores (T-score). Results: The gender distribution of the batch is as follows: 52.5%-male, 47.5%-female. The maximum value of the bruxism index was 10.5, and the minimum was 2.10, with a mean of 6.30 and a standard deviation of 2.22. Quality of life T-score recorded maximum value equal to 62, minimum value equal to 40, mean equal to 51.87. The Pearson correlation coefficient calculated to test the correlation between the bruxism indicator and the QOLI T Score presented a negative value (-0.643), which signifies a negative but very strong relation between the two variables. 77.5% of the participants were included in a mean level of quality of life. Conclusions: A statistically strong negative relation was found between global quality-of-life (T-scores) and the bruxism indicator in patients with bruxism activity during sleep.

Full text,

Assessment of Neutrophil-Lymphocyte Ratio and Systemic Immune-Inflammation Index in Systemic Scleroderma Patients with Focus on Cardiopulmonary Manifestations

C. PALICI; S. C. DINESCU; C. E. BITA; A. FLORESCU; A. E. MUSETESCU; F. VREJU; P. L. CIUREA

2024/09/30

10.12865/CHSJ.50.03.09

Medicine

To quantify levels of two inflammation-related indexes, namely neutrophil-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) in systemic scleroderma patients and determine the association with clinical manifestations and features of heart ultrasound. Methods: The study group consisted of 34 patients with diagnosis of systemic scleroderma which were admitted to the hospital during 2015-2019. Patient data included the presence and type of clinical manifestations of systemic scleroderma, chest imaging to screen for lung disease, heart ultrasound reports and the laboratory investigations needed to quantify inflammatory indexes. We analysed the levels of inflammatory indexes and compared results based on the prevalence of systemic manifestations. Results: Higher serum levels of NLR and SII are associated with the presence of joint, lung and pericardial involvement. Statistical significance was observed only for NLR levels with regard to the presence of articular involvement and ILD. Low ejection fraction was also associated with higher levels of both inflammatory indexes, without statistical significance. Conclusion: Inflammatory indexes are cost-effective markers that reflect active disease manifestations of systemic scleroderma and can thus be a useful tool to include in the regular follow-up of patients in order to better inform organ-specific assessments.

Full text,

Epidemiological and Histopathological Features of Oral Squamous Cell Carcinoma-A Retrospective Study

I. ILIE; O. C. MARGARITESCU; A. E. STEPAN; R. N. CIUREA; M. M. FLORESCU; C. MUNTEANU; M. S. SERBANESCU; C. MARGARITESCU

2024/09/30

10.12865/CHSJ.50.03.08

Medicine

Oral Squamous Cell Carcinoma (OSCC) it was reported to be the 6th on the list of human malignant neoplasms responsible for high morbidity and mortality worldwide. We conducted a retrospective study between 2009-2019, investigating 50 such cancers hospitalized and diagnosed during this period in our institution. The purpose of the study was to establish a clinical-morphological profile of this type of cancer developed in the geographical area served by our institution. The epidemiological study highlighted the predominance of cases in men over 50 years old, mainly affecting the tongue, followed by the lips and oral floor. The histopathological study showed the prevalence of conventional cases of OSCC (70%) and the rest of the cases belonging to rarer forms (acantholytic-18%, verrucous-6%, basaloid-4% and sarcomatoid-2%). In terms of the degree of differentiation, the moderately differentiated cases prevailed (64%) and according to the TNM clinical stage, most cases were diagnosed in stage II (36%) and IV (26%). 70% of investigated cases presented muscle invasion and 38% perineural invasion. Our investigation highlighted the existence of particular morpho-clinical profiles depending on the tumor topography. Thus, tumors developed at the tongue level reached the maximum frequency in the 6th decade of life, being absent in the 8th decade and most often associated muscle invasion and perineural invasion, being diagnosed in advanced pTNM stages.

Full text,

Is Serum Matrix Metalloproteinase 9 and/or D-Dimer Levels a Marker for Identifying Abdominal Aortic Aneurysms in Patients with Significant Coronary Atherosclerosis?

D. A. BRIE; A. M. JIANU; R. POPESCU; D. M. BRIE; M. BORUGA

2024/09/30

10.12865/CHSJ.50.03.07

Medicine

Our research aims to find a connection between the levels of MMP-9 and D-dimers in the blood and the prevalence of AAAs in subjects with atherosclerotic coronary disease. We selected fifty patients from each group and measured their MMP-9 and D-dimer levels in the blood. We discovered that in subjects with significant coronary disease and angina pectoris, the level of MMP-9 is higher compared to the subjects with angina pectoris but without significant coronary disease. When comparing this group with those with significant coronary disease and AAA, the level of MMP-9 is lower. Additionally, the D-dimer level was significantly higher in subjects with both AAA and significant coronary atherosclerosis compared to patients with significant coronary disease alone or those without significant coronary disease or AAAs. Subjects with significant coronary disease and AAA have elevated levels of MMP-9 and D-dimer compared to patients with significant coronary disease alone or without coronary artery disease or AAAs. These two factors could be used as indicators for diagnosing AAA in patients with angina pectoris.

Full text,

Testing a Psychological Intervention in Elite Athletes to Alleviate the Psychomotor Consequences of Doping: The Moderating Role of Personality

E. COLITA; L. ZAGREAN; M. GRIGORE; A.POPA-WAGNER

2024/09/30

10.12865/CHSJ.50.03.06

Medicine

This study aimed to evaluate a psychological intervention intended to reduce the psychomotor effects of doping. The research also examined how conscientiousness and emotional stability moderated the intervention's effectiveness. The intervention was developed based on the literature and included two components: biofeedback and mental imagery/rehearsal. Athletes reported higher scores post-intervention in coordination, sports skills, overall physical condition, strength, flexibility, endurance, and general self-esteem. Similar results have been observed in previous studies related to biofeedback and mental imagery. According to the results, athletes with higher conscientiousness benefited more from the intervention in terms of coordination, flexibility, and endurance. The data support the idea that emotionally stable athletes benefit more from the intervention in terms of overall physical condition and general self-esteem. Theoretically, the studies highlight the importance of psychological interventions in enhancing athletes' psychomotor performance and the interaction between these interventions and individual differences among participants. The findings are relevant for sports psychology practitioners, as they provide additional evidence for the use of biofeedback and mental imagery with athletes.

Full text,

Assessment of Surgical and Non-surgical Outcomes in Patients with Dementia and Hip Fractures

A. V. BRADEANU; I .BOUNEGRU; L. S. PASCU; A. CIUBARA; T. A. BALSEANU

2024/09/30

10.12865/CHSJ.50.03.05

Medicine

Introduction: The aging population is associated with increased osteoporosis and risk of hip fractures. Cognitive decline has recorded exponential increases in the last decades, with the rise in life expectancy. Material and methods: We conducted a prospective study on 65 patients over 65 years old associated with dementia and hip fractures. We used pre-and post-treatment variables such as age, type of fracture, type of treatment, Charlson Comorbidity Index (CCI), EQ-5D-5L score, and the Harris hip score (HHS) to assess pain, mobility, and mortality. We performed follow-ups at 6 months, 1 year, 2 years, and 3 years. Results: Patients with dementia typically arrive at the hospital without any previous analgesic treatment and receive lower doses due to poor pain recognition. The 6-month mortality rate was 48.22% and increased to 78.46% at 3 years. The best survival rates were in patients with bipolar prosthesis and Gamma nails, with a 3-year survival rate of 40% and 50%, respectively. Conclusions: Patients with dementia have a higher mortality rate compared to cognitively intact patients and the treatment decisions require a multidisciplinary team and individualized recommendations for each patient, due to high surgical risk in the elderly.

Full text,

Assessment and Rehabilitation in Sarcopenic Patients

B. M. VLADUTU; M. SERBANESCU; M. R. TRAISTARU

2024/09/30

10.12865/CHSJ.50.03.04

Medicine

Sarcopenia is a degenerative disorder that particularly affects older people and is defined by a pathological decrease in muscle strength. This disease represents one of the topics of great interest in the medical world of the last two decades. In our study, we tried to underline the importance of an adapted recovery program based on physical exercise for regaining clinical and functional status in patients with age-related sarcopenia. No nutritional intervention was applied. We performed our rehabilitation program in accordance with present international recommendations for sarcopenia. After complete assessment, our patients were randomised into two groups: G1 (Lot 1=25 patients) and G2 (Lot 2=15 patients). G1 patients were compliant with kinetic training, and performed all rehabilitation measures, and G2 patients accepted rehabilitation program without kinetic exercises. Patients assessment (lab tests, gait analysis, VAS and the Clinical Frailty Scale) was made on two levels-first (T1-inpatient assessment), and after 6 months (T2-outpatient assessment). The rehabilitation program based on the kinetic program brought positive improvements in physical performance and locomotion (gait speed and walking cadence) in sarcopenic patients.

Full text,