Items

  • Should PI-RADS 3 be Subclassified According to ADC Values in the Transition Zone?

    R. V. TEICA; C. M. CIOFIAC; L. M. FLORESCU; I. A. GHEONEA
    2023/12/31
    10.12865/CHSJ.49.04.12
    Medicine
    The premise of this paper starts from the fact that a more precise definition related to the intensity of the lesions on the ADC sequence can lead to a new subclassification of PI-RADS 3 lesions in the transitional zone and to an improvement of the specificity of the PI-RADS classification. The study was retrospective and included only patients who, based on prostate MRI examinations, contained exclusively PI-RADS 3 lesions, without other PI-RADS 4 or 5 lesions. The number of cases that meet all these conditions was reduced to 18, where a series of characteristics were noted for each one: PI-RADS 3 lesion area on the ADC sequence, the minimum and average ADC value of the lesion, the average ADC value of the transitional zone outside the lesion, PSA, prostatic volume, PSA density and biopsy result. The average ADC value of the negative lesions was 865(±165) µm2/sec, and of the positive ones was 869(±118) µm2/sec, which denies the hypothesis that there could be a value limit ADC to delimit PI-RADS 3 from PI-RADS 2 or 4 in this sample of patients. Furthermore, we reported the average ADC value of each such lesion to the adjacent unchanged transitional zone and obtained a greater difference of 432(±163) µm2/sec between the negative lesions and their adjacent transitional zone, compared to the difference of 399(±127) µm2/sec between the positive lesions and their adjacent ones.
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  • Immunoexpression of Mismatch Repair Proteins in a Cohort of Colorectal Cancer Patients

    A. E. CIOBANU; C. M. MARGINEAN; C. MESINA; T. A. BALSEANU; D. CIOBANU; M. M. FLORESCU
    2023/12/31
    10.12865/CHSJ.49.04.11
    Medicine
    One of the molecular routes of colorectal carcinogenesis is the lack of mismatch repair (MMR) proteins, which may have substantial clinical consequences in predicting therapy success. This study aimed to analyze the expression of the MutL homolog 1 (MLH1), MutS homolog 2 (MSH2), and MutS homolog 6 (MSH6) in a cohort of 91 colorectal cancer (CRC) patients, and to evaluate the relationship between patient clinicopathological characteristics and immunoexpression of these biomarkers. In this study, we obtained the highest scores of the MLH1 immunoexpression in non-mucinous tumors, moderately differentiated lesions, and in stage IV. The highest values of the MSH2 and MSH6 scores were observed in mucinous tumors, and poorly differentiated lesions, in stages II-III, and stages III-IV, respectively. To improve the stratification criteria for targeted oncological therapy and to predict patient outcomes, markers used may help evaluate the aggressiveness of lesions.
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  • The Role of Neutrophil to Lymphocyte Ratio in the Assessment and Rehabilitation of Knee Osteoarthritis Patients

    O. F. FUGARU; M.S. SERBANESCU; M.R. TRAISTARU
    2023/12/31
    10.12865/CHSJ.49.04.10
    Medicine
    Osteoarthritis (OA) is considered to be a real problem for many people. The last decade is characterized through an increased interest in using a non-specific, simply and readily available marker of inflammation-neutrophil to lymphocyte ratio (NLR)-to predict various chronic diseases (gastrointestinal and colorectal cancers, lung cancer, cardiovascular events, sarcoidosis, arthritis). The aim of our study is to establish the correlation between NLR and other parameters of clinical and functional status in KOA patients and to compare the NLR values before and after rehabilitation program. 90 patients, aged 40 to 82 years, diagnosed with mild (8 patients), moderate (70 patients) and severe (12 patients) KOA, in accordance with Kellgren and Lawrence score. Statistical assessment showed different values for the erythrocyte sedimentation (ESR) rate at 1-hour, Visual Analogue Scale (VAS), and Lequesne index in the studied group. NLR regression was significant for ESR at 1 and 2 hours. As an independent diagnostic marker, NLR has limited value, however it can be considered an inexpensive additional biomarker for the diagnosis of KOA and for monitoring the rehabilitation program.
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  • Predictive Value of Pulmonary Involvement in Stroke Patients Co-Infected with COVID-19

    E. A. PINOSANU; E. BURADA D. PIRSCOVEANU; M. ALDEA; C. V. ALBU; R. SURUGIU; R. E. SANDU
    2023/12/31
    10.12865/CHSJ.49.04.09
    Medicine
    In response to the intricate clinical challenges posed by the intersection of COVID-19 and acute ischemic stroke, the Neuropsychiatry Hospital of Craiova, Romania, initiated a comprehensive study. This research aims to unravel the impacts of pulmonary complications on ischemic stroke outcomes, comparing patients with concurrent SARS-CoV-2 infection to those without. The study integrates pulmonary assessments, acknowledging the significant role respiratory involvement plays in the progression and prognosis of stroke patients during the pandemic. By systematically examining individuals with both acute ischemic stroke and COVID-19, the study seeks to shed light on the complex interplay between cerebral and pulmonary health. The findings are expected to enhance patient care by informing clinical decisions and leading to more effective management approaches for stroke patients in the COVID-19 era.
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  • Is the Ellipsoid Formula Reliable in Prostate MRI?

    R. V. TEICA; C. M. CIOFIAC; L. M. FLORESCU; I. A. GHEONEA
    2023/12/31
    10.12865/CHSJ.49.04.08
    Medicine
    Our study seeks to study the accuracy of the ellipsoidal formula in prostate MRI of different sizes and to establish the limits of its use. The study included 31 patients with a well-visualized, intact prostatic capsule, excluding malignantly transformed prostates, as well as treated prostates, in which the contrast between the prostatic capsule and parenchyma is reduced. Each patient's prostatic volume was recalculated according to the ellipsoidal formula, and then it was compared with the prostatic volume calculated by the segmentation method. The two calculated volumes were similar, in some cases almost identical, with a slight tendency to underestimate prostate volume below 100cm3, in total in 18 cases, on average by 7.6% (+/-6%), overestimation of those with a volume over 100cm3, a total of 13 cases, on average by 3.2% (+/-2.5%), and of all, in 4 cases the difference between the two formulas was below 1%.There was no statistical difference between the two variables, Student's t-test p-value=0.039. With a precision of 92% (+/-6%), the ellipsoidal formula can be considered accurate when it is correctly performed, but if we take into account the importance that PSA density is starting to have in diagnosis, treatment and follow-up, the calculation of a secondary value through the segmentation method or high-precision software can be motivated when the ellipsoidal formula returns a value close to a threshold.
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  • Postoperative Pain after Inguinal Hernia Repair Using the Tension-Free Lichtenstein Procedure: A Retrospective Study

    M. RACAREANU; S. D. PREDA; A. PREDOI; S. KONSTANTINOS; T. BRATILOVEANU; G. F. R. MOGO; A. DOBRINESCU; S. RAMBOIU; D. MARGARITESCU; D. CARTU V. SURLIN
    2023/12/.31
    10.12865/CHSJ.49.04.07
    Medicine
    Inguinal hernia surgery is a constantly evolving field, with ongoing research efforts aimed at enhancing surgical techniques and outcomes for patients. This retrospective study conducted between 2015 and 2020 in the First Surgical Clinic of Craiova Emergency Clinical Hospital focused on the occurrence and characteristics of postoperative pain following inguinal hernia repair using the tension-free Lichtenstein procedure. A total of 178 patients were included in the study, with 16.85% reporting postoperative pain. The average pain intensity was 6.4 on a scale of 1 to 10. Patients described the pain as numbness, burning sensation, stinging, pressure, and tingling sensations. Notably, 50% of patients reported pain related to weather changes. While the study explored potential relationships between patient demographics, hernia type, and postoperative pain, no statistically significant associations were found. Approximately 20% of patients with postoperative pain reported adverse effects on their work, and 10% used analgesics for pain management. This study highlights the multifaceted nature of postoperative pain following inguinal hernia repair, emphasizing the need for further research to identify individual risk factors and adherence to international guidelines for hernia management. The findings also underscore the importance of effective pain management strategies to improve patient comfort and quality of life post-surgery.
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  • Understanding Attitudes Toward Influenza Vaccination: Insights from a Romanian Family Medicine Patient Population

    C. M. DANILESCU; V. M. RADULESCU; A. R. DELUREANU; M. C. PIRLOG
    2023/12/31
    10.12865/CHSJ.49.04.06
    Medicine
    Introduction: Influenza represents a global respiratory virus infection with significant individual and societal implications, leading to considerable economic burdens and substantial mortality rates. Vaccine hesitancy, characterized by delays or refusals despite vaccine availability, presents a growing challenge in achieving adequate vaccination rates globally. Aim: This study aimed to assess the attitudes of Romanian general practitioners' patients toward influenza vaccination during the recommended immunization period. Materials and Methods: A prospective multi-centered study involving 319 patients across five Family Medicine Offices in Romania was conducted. Participants completed a 12-item Vaccination Attitudes Examination (VAX) scale, assessing factors influencing vaccine acceptance. Statistical analyses were performed to evaluate the impact of demographic variables and attitudes toward vaccination. Results: The study revealed significant variations in attitudes influencing influenza vaccine acceptance. Trust in vaccine benefits and confidence in natural immunity emerged as primary motivators for vaccine acceptance/denial, whereas concerns about commercial profiteering held lesser importance. Gender and residential environment impacted specific attitudes toward vaccination, while factors such as education and employment status did not significantly influence vaccine acceptance. Discussion: The study underscores the critical role of trust in vaccine benefits as a primary driver for vaccine acceptance, diverging from prevalent conspiracy theories. While gender and residential environment influenced attitudes toward vaccination, education and employment status did not exhibit significant correlations with vaccine acceptance. Conclusions: Understanding public attitudes toward vaccination is crucial in designing effective public health strategies. This study emphasizes the importance of trust in vaccine benefits in driving vaccine acceptance, offering insights to enhance vaccination initiatives regionally.
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  • Bone Injuries in the Hand and Forearm: Prevalence and Psychological Ramifications

    A. F. GHITAN; V. GHEORMAN; V. GHEORMAN; F. MILITARU; I. UDRISTOIU; M. E. CIUREA
    2023/12/31
    10.12865/CHSJ.49.04.05
    Medicine
    Complex bone injuries in the hand and forearm pose considerable physical and psychological challenges to patients. However, there is limited research on the psychological effects of these injuries. This study seeks to clarify the psychological impact and frequency of injuries in various hand bones. This cross-sectional study included 166 patients with complex hand and forearm injuries. Injuries were classified based on amputations and fractures involving phalanges, fingers, and other bones. Psychological assessments utilised standardised tools to gauge post-traumatic stress disorder (PTSD) levels. Our findings suggest that injury rates differ among the phalanges and individual fingers. The intermediate phalanx (P2) of the thumb had the most injuries, while no injuries were found in the proximal phalanx (P1) of the small finger. Amputations and fractures were found to be positively associated with increased symptoms of PTSD. This study emphasises the importance of recognising the psychological effects of hand and forearm bone injuries. The data indicate the need for a multi-disciplinary treatment approach that includes psychological interventions for optimal patient care. The study emphasises the necessity for additional research to further investigate these matters.
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  • Aflibercept Versus Bevacizumab as First-Line Therapy in Age-Related Macular Degeneration

    M. C. P. SALAVAT; E. P. SECLAMAN; A. A. MUAT; M. BORUGA; C. PATONI; M. N. POPESCU; O. E. TEODORESCU; O. MUAT; S. I. P. PATONI
    2023/12/31
    10.12865/CHSJ.49.04.04
    Medicine
    Background: AMD (age-related macular degeneration) is the main cause of central vision loss in the population over 60 years old. AMD does not affect peripheral vision and complete blindness does not occur, instead, central vision is affected both for distance and for near. The purpose of this study is to evaluate the neovascular form of AMD treatment and compare ocular and systemic effects after intravitreal injection of aflibercept, respectively after bevacizumab when administered in comparable dosages and regimens. We conducted a retrospective, single-center study from June 2021 to December 2022 and enrolled 20 patients with neovascular AMD who had not received any prior treatment for this condition. We randomly assigned them to two groups of 10: group one received aflibercept and group two received bevacizumab as intravitreal injections under aseptic conditions. We excluded 2 patients who did not meet the criteria and ended up with two groups of 9 patients who received monocular treatment. We gave the patients 3 monthly injections of anti-VEGF agent and followed them up at 1 month, 3 months, and 9 months after the treatment. We assessed their visual acuity, intraocular pressure and OCT appearance at each follow-up visit. The primary outcome was visual acuity. All 18 patients included in the study reported an improvement in visual acuity after the intervention. When comparing the two anti-VEGF agents, data revealed the effect of aflibercept was prompter and more long-lasting. Areas of retinal ischemia appeared in both cases. However, they were observed faster in the case of patients treated with aflibercept. Thus, neovascular AMD is a disease that occurs with age, it can be early detected by OCT and slowed the progression to central blindness with intravitreal treatment.
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  • ELTD1 Review: New Regulator of Angiogenesis in Glioma

    I. BUZATU; D. E. TACHE; E. V. MANEA CARNELUTI; O. ZLATIAN
    2023/12/31
    10.12865/CHSJ.49.04.03
    Medicine
    Glioblastoma (GBM) is a severe brain cancer in which angiogenesis is controlled by G protein-coupled receptors (GPCRs), such as Epidermal Growth Factor Latrophilin and seven transmembrane domain-containing protein 1 (ELTD1), which are crucial for tumor progression. ELTD1 is an understudied GPCR with a broad expression profile in various tissues, including the human brain, especially in the cerebral cortex. It plays a significant role in angiogenesis and tumorigenesis and is regulated by interconnected VEGF and DLL4/Notch pathways. ELTD1 also modulates the JAK/STAT3/HIF-1? signaling axis, affecting the response of cells to low-oxygen conditions and promoting cell proliferation. However, their specific ligands and functional mechanisms remain unclear. ELTD1 expression is associated with different outcomes in various cancers. For example, in GBM, higher ELTD1 levels are linked to more mature and less leaky blood vessels, potentially enhancing drug delivery and therapeutic success. It also has divergent prognostic implications in renal, ovarian, and colorectal cancer. Additionally, ELTD1 overexpression in central nervous system endothelial cells suggests that it is a potential biomarker for multiple sclerosis. Therapeutically, blocking ELTD1 inhibits vessel formation, possibly slowing tumor growth. Initial therapies used polyclonal antibodies, but the shift has been towards more targeted monoclonal antibodies, particularly in preclinical glioma models. This review aimed to translate these insights into effective clinical treatments. However, several gaps remain in our knowledge regarding ELTD1 ligands and their potential involvement in other physiological or pathological processes that future research can address to elucidate the role of ELTD1 in cancer, through angiogenesis and other intracellular pathways.
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  • Stem Cell Treatments in Preclinical Relevant Stroke Models

    L. R. PINOSANU; N. WOLFF; D. G. OLARU; A. P. WAGNER
    2023/12/31
    10.12865/CHSJ.49.04.02
    Medicine
    Since stroke has limited treatment options, an active search for new therapeutic approaches is required. Initial excitement of using cell-based therapies to stimulate recovery processes in the ischemic brain turned into a more measured perspective, acknowledging obstacles related to the unfavorable environments associated in part with aging. Given the predominance of stroke in older populations, evaluating the effectiveness of cell therapies in aged brain environments is essential and clinically relevant. Despite a common perception of the aged brain being resistant to regeneration, recent research with neural precursor cells and bone marrow-derived mesenchymal stem cells indicates that cell-based therapy can promote plasticity and remodeling in the aged rat brain. However, significant differences in the aged brain compared to the young brain, such as expedited progression of ischemic injury to brain infarction, decreased rate of endogenous neurogenesis, and delayed onset of neurological recovery, must be noted. The effectiveness of cell-based therapies may further be connected to age-related comorbidities such as diabetes or hyperlipidemia, potentially leading to maladaptive or impaired brain remodeling. These age-related factors need careful consideration in the clinical application of restorative therapies for stroke.
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  • Update in LV Only Fusion CRT Pacing: Annals and Future Perspectives

    A. GURGU; L. PETRESCU; C. T. LUCA; C. VACARESCU; G. TARTEA; E. V. GOANA; L. CIRIN; D. COZMA
    2023/12/31
    10.12865/CHSJ.49.04.01
    Medicine
    Triple-chamber cardiac devices are utilized for cardiac resynchronization therapy (CRT) and is the standard-of-care therapy for heart failure (HF) patients in the current guidelines. In the setting of biventricular (BIV) pacing it involves a mandatory implantation of right ventricular (RV) lead that allows simultaneous BIV pacing with 0 ms VV (ventricular to ventricular) interval. Nevertheless, it seems that response to CRT is not related to RV lead position. RV pacing is known for deleterious effects on RV/Left Ventricle (LV) function and should not be used in persons with normal atrioventricular conduction (AV) and sinus rhythm. As it compensates for the additional asynchrony induced by unnecessary stimulation of RV pacing, only pacing the left ventricle (LV) may result in improved cardiac resynchronization therapy (CRT) outcomes and a decrease in the number of individuals who do not respond to the procedure. Furthermore, leadless LV fusion CRT pacing without RV lead could be a potential CRT therapy alternative to BIV pacing in nonischemic heart failure patients with preserved AV conduction. The aim of our study is to made an update in cardiac resynchronization therapy with LV only fusion pacing.
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  • Genomic Profiling - A Need for Clinical Decision? - Case Reports

    A. M. CIUREA; M. SCHENKER; C. M. CIOFIAC; L. STREBA; R. SCHENKER; C. T. STREBA
    2023/09/30
    10.12865/CHSJ.49.03.22
    Medicine
    Cancer is still an important health issue worldwide due to increased incidence and mortality. Personalized medicine is the future of cancer treatment. Development in technology improved technical skills in DNA/RNA sequencing. NGS technology in solid-tumor samples can describe DNA or RNA analysis by including the entire genome to detect clinical relevant mutations. Genetic results may be considered having a dynamic impact because of heterogenous molecular alterations depending of time and treatment influence. We conducted a retrospective study of all NGS tests made in the last five years for the patients from ‘Sf. Nectarie’ Oncology Center, Craiova, Romania. We selected three relevant clinical cases where NGS analysis was performed and the results changed the perspective of the clinical decision. Our aim is to evaluate the importance of NGS results in clinical approach. Although medicine known an important development during the last decades, only a few patients can benefit of advanced personalized treatments. It is still hard to identify the alterations or gene mutations because of genetic tests are not easily available and only a small proportion of patients carries genetic alterations.
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  • Imaging Aspects of Enchondromas in Pediatric Patients

    I. BAILESCU; M. POPESCU; D. DUMITRESCU; I. MINDRILA; O. VISAN; M. C. MORARU; R.M. BALAN; D.M. ALBULESCU
    2023/09/30
    10.12865/CHSJ.49.03.21
    Medicine
    Enchondromas are benign tumors located primarily in long bones, some of which can be accidentally discovered during imaging exams conducted for other pathologies. These benign cartilaginous tumors are hard to differentiate from low grade chondrosarcomas, which require periodic follow ups. The purpose of this study was to identify the incidence of enchondromas in pediatric patients, to determine medical imaging criteria (Computed Tomography-CT and Magnetic Resonance Imaging-MRI) in order to differentiate enchondromas from other atypical cartilaginous tumors, and to identify a potential correlation between imaging aspects and clinical signs. The aim of this study was to review imaging findings of enchondromas in children.
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  • Open Spina Bifida: The Role of Ultrasound Markers in the First Trimester and Morphopathology Correlation

    D. R. UNGUREANU; M. C. COMANESCU; A. M. ISTRATE-OFITERU; G. L. ZORILA; R. C. DRAGUSIN; D. G. ILIESCU
    2023/09/30
    10.12865/CHSJ.49.03.20
    Medicine
    Objectives-To evaluate ultrasound markers during a first-trimester (FT) routine ultrasound examination for an early detection of open spina bifida (OSB) and to correlate the sonographic findings with the morpho-histological ones. Materials and Methods: This retrospective research was performed using data from foetuses that underwent FT anatomy scans (FTAS) with a gestational age between 11 weeks and 13 weeks and 6 days in the Prenatal Diagnostic Unit of the Clinical Emergency County Hospital Craiova from October 2022 until September 2023. Results: The study included 648 FT singleton pregnancies and 5 OSB cases were detected. In the OSB group, we found abnormal aspects of the fourth ventricle, also named intracranial translucency (IT) in 4 out of 5 cases of OSB (80%), a brain stem anteroposterior diameter, and brain stem to occipital bone ratio abnormal in all 5 cases (greater than 1) (100%), the crash sign was present in 80% (4 out of 5 cases) and the spinal defect was visualized in 4 out of 5 patients (80%). Medical termination of pregnancy (MTOP) was the preferred option in all cases of OSB. This allowed us to include an extended histological study to confirm the ultrasound diagnosis. Conclusions: A combined detailed FTAS that includes both cranial ultrasound markers of the posterior fossa and also a good visualization of the foetal spine offers an early optimal detection rate of spine abnormalities.
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  • Hydrocephalus Resolution with Third Ventriculostomy with Floor Stenting: Technical Note and Literature Review

    J. R. VANZIN; A. E. MARTIO; M. N. SANTOS; N.D. AZAMBUJA JR.; O.R. KARAM; L.B. MANZATO
    2023/09/30
    10.12865/CHSJ.49.03.19
    Medicine
    Introduction: The management of refractory obstructive hydrocephalus is a paramount neurosurgical challenge. The endoscopic third ventriculostomy (ETV) has been accepted as the procedure of choice for obstructive hydrocephalus, depending on the presence of certain risk factors, such as intracranial infections, young age, previous shunt failure and distorted anatomy of the ventricular floor, that predispose occlusion or obstruction of the CSF outflow through the stoma. Case Report: A 20-year-old man with obstructive hydrocephalus due to primary aqueductal stenosis performed several neurosurgical procedures, including two previous ETV, without long term resolution. We performed another ETV, with stent placement at the stoma to prevent occlusion. After 25 months of asymptomatic follow-up, the patient presented with an enlarged fourth ventricle, and a new neuroendoscopic procedure showed a patent stoma and a well-placed stent. Discussion: Stent placement on the third ventricular floor was already reported 19 times in the literature. Its success rate is about 94,7%, and complications happened in 2 cases, with functional impaired in only one of them. Conclusion: Third ventriculostomy with floor stenting proved to be an effective procedure in our case of complex hydrocephalus. It is a viable option in cases where there is a greater chance of stoma occlusion.
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  • Retrospective Study of a Patient with Multiple de Novo Skin Tumor Formations

    R.F. FRUNTEALATA; T. A. BALSEANU; O. NICA; A. A.NEGRILA; I. L.PETROVICI; E. A. MARINESCU; G. A. STOICA; M. STOICA; A.M. CIUREA; M.E. CIUREA
    2023/09/30
    10.12865/CHSJ.49.03.18
    Medicine
    In Romania, the incidence of malignant melanocytic tumors is continuously increasing. According to the World Health Organization, the incidence of melanocytic and non-melanocytic skin neoplasms has increased considerably and globally, in the last decade. We present the case of a 49-year-old patient who, over the course of 7 years, came in the Plastic Surgery Clinic of the Emergency County Hospital of Craiova for the excision of a number of 25 skin tumor formations, located on the face, cervical region, trunk and upper limbs. Treatment included complete microsurgical excision and supervision. In the end, the patient's treatment compliance decreased significantly.
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  • Acute Toxicity by Salvia Officinalis: A Rare Cause of Intestinal Sub-Occlusion

    A. RAPINO; G. CECCUZZI; B. PERNA; R. D. GIORGIO; M. GUARINO
    2023/09/30
    10.12865/CHSJ.49.03.17
    Medicine
    Salvia officinalis is a perennial plant commonly used in culinary and medical preparations. Its large intake is usually related to psychiatric disorders (such as pica) and might induce different symptoms (e.g. vomiting, nausea, diarrhoea, salivation, arterial hypertension, tachycardia, vertigo, flushes, cyanosis and convulsions) likely ascribable to pro-cholinergic effects of various constituents. The identification of this toxicity is challenging because of its rarity and possible underlying psychiatric comorbidities. Herein we describe the case of a schizophrenic 56-year-old male admitted to the Emergency Department for abdominal pain and diarrhea resulted in a rare case of acute toxicity by Salvia officinalis.
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  • Probe - Based Confocal Endomicroscopy and Endoscopy in NBI Module - The Role in Clinical Decision - Case Reports

    P. POPA; M. MATEI; L. STREBA; M. M. FLORESCU; C. T. STREBA
    2023/09/30
    10.12865/CHSJ.49.03.16
    Medicine
    Cancer remains a significant global cause of mortality, irrespective of a country's level of development. Among all cancer types, gastrointestinal cancers claim the highest number of lives annually. This disease predominantly affects individuals in their 6th to 8th decades of life. Unfortunately, diagnoses often occur during advanced stages of the illness, rendering chemotherapy less effective and offering a reserved prognosis. Conventional endoscopy, however, struggles to differentiate lesions based on their histological composition. Consequently, the management of patients largely depends on histopathological examinations, which can be time-consuming. Biopsy results are sometimes delayed, with precious weeks passing, particularly critical for patients with malignant lesions. Moreover, biopsies may yield inconclusive results if not precisely targeted, leading to potential mismanagement, unnecessary resections and burdensome pathology services. This series of cases underscores, as previous studies have, the value of modern endoscopic techniques in determining the appropriate therapeutic approach for each patient, an approach that ensures the highest quality of life.
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  • PLGA-The Smart Biocompatible Polimer: Kinetic Degradation Studies and Active Principle Release

    M. V. CIOCILTEU; G. RAU; M. O. AMZOIU; D. C. AMZOIU; C. G. PISOSCHI; B.A.M. POENARIU
    2023/09/30
    10.12865/CHSJ.49.03.15
    Medicine
    The aim of our research was the development of prolonged delivery systems for therapeutic agents with various properties (prevention and treatment of bone diseases, anti-neoplastic, anti-inflammatory, antioxidant) that would ensure sustained therapeutic levels of the active principle, above the minimum inhibitory concentration, without reaching toxic levels over a long period of time as alternatives to conventional routes of administration. PLGA (poly lactic-co-glycolic acid), a biodegradable and biocompatible synthetic polymer, FDA approved, with a 65:35 lactic acid (LA): glycolic acid (GA) copolymer ratio, was chosen as delivery system. Our studies have shown that in PBS it undergoes two simultaneous degradation processes, hydrolysis and autohydrolysis, degrading completely in about 40 days. The release of the active principle is determined by the diffusion from inside the polymer matrix to the outside, which occurs simultaneously with the erosion of the polymer, during 35 days.
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  • Micronutrient Research in Autism Spectrum Disorder. A Clinical Study

    C. M. ANASTASESCU; E. STOICANESCU; O. BADEA; F. POPESCU
    2023/09/30
    10.12865/CHSJ.49.03.14
    Medicine
    Autistic spectrum disorders are part of the category of neurodevelopmental disorders, characterized by: difficulties in communication and social interaction, restrictive and repetitive patterns of behaviours and activities, which are present throughout the developmental period, and can be diagnosed in the first five years of life. Due to the increase in the incidence of this disorder in recent years, it has become a topic of great interest both to specialists in child and adolescent psychiatry and to researchers in the field. Given the polymorphism of Autism Spectrum Disorder and the need to discover factors that better explain the etiology of this disorder, studies related to biomarkers are extremely varied. One of the areas of study that have exercised particular interest is related to the involvement of metals in the pathology of autism spectrum disorder. Apart from the controversies related to heavy metals that according to studies affect the developmental process, there are studies that suggest that some micronutrients such as zinc, copper, selenium, iron, magnesium, may be involved in the etiology of autism spectrum disorder. Starting from these studies, we set out to investigate to what extent these essential metals for the body are involved in the etiology of autism spectrum disorder and how they influence the severity of symptoms.
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  • Multicenter Epidemiological Study of Nosebleeds Requiring Hospitalization

    A. N. VLAESCU; E. IONITA; F. ANGHELINA; C. A. MOGOANTA; S. M. CIOLOFAN; A. RUSESCU; I. G. IONITA; C. VOIOSU; R. HAINAROSIE
    2023/09/30
    10.12865/CHSJ.49.03.13
    Medicine
    Epistaxis is a common presenting symptom either emergency condition or ambulatory in Otorhinolaryngology, affecting people of all ages. A multicentric retrospective descriptive study of 380 patients who were hospitalized with epistaxis over a 3.8 year period was carried out. Data collected was analyzed using IBM SPSS Statistics 25 and illustrated using Microsoft Office/Word 2016. The current study showed that male adults after 60 years old are most affected by nasal bleeding. More than half of hospitalized patients have severe epistaxis at the time of hospitalization. However, further studies are necessary to be done in order to fully elucidate the epidemiology of nosebleeds requiring hospitalization.
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  • In vitro Antimicrobial Activity of Some Extracts of Salvia spp Harvested from the Oltenia Flora Using Different Solvents

    R. M. BALASOIU; A. BITA; E. C. STANCIULESCU; M. BALASOIU; C. BEJENARU; L. E. BEJENARU; C. G. PISOSCHI
    2023/09/30
    10.12865/CHSJ.49.03.12
    Medicine
    In this study, the antimicrobial activity of three Salvia spp. (S. glutinosa, S. splendens, S. verticillata) extracts prepared with different solvents was assessed using the diffusion method and the quantification of the minimum inhibitory concentration for each extract on S. aureus, E. coli and C. albicans standard strains. The results showed that the extracts of the three Salvia spp. are suppressing the growth of the bacteria tested with variable potency. Among the different solvent extracts, n-butanolic extracts of all the three species of Salvia spp. revealed the most important antibacterial activity against S. aureus and E. coli. S. splendens extracts proved to be the most efficient on C. albicans regardless of the solvent used.
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  • Obesity and Myocardial Infarction-The Place of Obesity Among Cardiovascular Risk Factors-Retrospective Study

    C. E. NEGROIU; I. TUDORASCU; C. G. MOISE; E. VINTURIS; C. M. BEZNA; R. DANOIU; M. E. GAMAN; S. DANOIU
    2023/09/30
    10.12865/CHSJ.49.03.11
    Medicine
    Since the 21st century, the leading cause of death is cardiovascular disease, with myocardial infarction being the most common. The incidence and prevalence of obesity has risen sharply in recent years, and it is commonly recognised as a cardiovascular risk factor among tobacco smoking, dyslipidemia (high LDL-C, high triglycerides, low HDL-C), hypertension, diabetes, age, gender, hereditary predisposition. Materials and methods. This study is a retrospective study conducted at the Craiova Emergency Clinical Hospital between October 2020 and January 2023. Enrolled patients are 60, 36 patients with ST-segment elevation myocardial infarction and 24 patients with non-ST-segment elevation acute myocardial infarction. The data was collected from the hospital's official database and then analyzed using Microsoft Excel and the Toolbar Data Analysis. Results. The mean age of the patients in the study was 62 years with a minimum of 34 years and a maximum of 84 years. 23(38.3%) of patients were smokers, 7(11.6%) were ex-smokers and 30(50%) were non-smokers. 49(81.6%) patients were hypertensive. 44(73%) had cholesterol greater than 200mg/dl. 54(90%) had LDL>100mg/dl, 18(30%) had HDL>45mg/gl, 24(40%) patients had serum TG>150mg/dl, 17(28%) were overweight and 13(22%) were obese, 30(50%) were normal weight. 18(30%) patients had type 2 diabetes. Conclusions. Among the cardiovascular risk factors in the patients studied, hypertension was the most common, followed by dyslipidemia, obesity, smoking, diabetes mellitus, and very rarely the use of drugs and anabolic substances.
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  • Zinc-Boron Complex-Based Dietary Supplements for Longevity and Healthy Life

    A. BITA; I. R. SCOREI; T. A. BALSEANU; G. RAU; M. V. CIOCILTEU; G. D. MOGOSANU
    2023/09/30
    10.12865/CHSJ.49.03.10
    Medicine
    The nutritional role of zinc (Zn) and boron (B) in the plant-animal-human food chain is highly topical worldwide research. Our data indicated that Zn-B complex (ZBC)-based dietary supplements can be used as stable non-toxic formulations, with high intestinal absorption rate, inducing alpha2-macroglobulin (A2M) expression for longevity and healthy life. ZBC is metabolized by hydrolysis, mainly at the absorption site (intestinal level), and most of it is excreted in the urine. Within seven hours from the administration in mice, almost the entire amount of orally absorbed ZBC is eliminated in a metabolized form. The highest amount of A2M protein in mouse liver was determined by immunoabsorbance assay in the chronic experiment (1000mg/kg of ZBC), followed by the subchronic experiment (at the same dose of ZBC), and by the acute experiment (5000mg/kg of ZBC).
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