Items

  • Intestinal Stomas in Abdominal Surgery: Etiological Circumstances, Indications, High Gravity Factors and Complications

    E. L. ALBULESCU; S. RAMBOIU; M. V. SURLIN; V. T. GRIGOREAN; I. C. BARSAN; R. N. NEMES; L. C. CHIUTU
    2023/09/30
    10.12865/CHSJ.49.03.09
    Medicine
    This is a retrospective study of 264 intestinal stomas performed in the surgical unit of the Emergency Clinical Hospital “Bagdasar Arseni”, Bucharest, within a 7-year period (2015-2021) aiming to evaluate their evolutive complications, risk factors, management and prevention strategies. Material and method. Colostomies: 218 (82.57%) cases, ileostomies 46 (17.43%) cases. Temporary stomas (103 cases or 39.02%) were isolated stomas of discharge in 45 cases and associated with other colorectal procedures in 58 cases. Postoperative complications included general systemic complications in 60 (22.72%) cases and local complications specific to stomas in 84 (31.81%) cases and common to abdominal surgery in 94 (35.60%) cases, which were solved by reoperation in 51 cases, with a reintervention rate of 19.31%. Stoma closures were performed in 34 (33.0%) of the 103 patients with temporary stomas. Of these, 26 (25.24%) patients died in the early postoperative period (< 30 days), the remaining 60 patients refused reintervention or were lost to follow-up. Conclusions. Faecal diversion still represents a therapeutic option for a wide range of benign or malignant digestive or extra-digestive abdominal diseases performed in emergency or scheduled surgeries, mostly for colorectal cancer and its complications.
    Full text,
    Read More

  • Etiological Profile of Epistaxis: Pre-Pandemic Versus Pandemic

    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.49.03.08
    Medicine
    Nosebleed or epistaxis is one of the most common forms of presenting an emergency in the ENT field. Since March 11, 2020, the World Health Organisation has proclaimed COVID-19 a global pandemic, and the world has been closed down. The main objective of the study is to analyse and compare the dynamics of epistaxis aetiology among the cases that required hospitalisation in the pre-pandemic period and the period of the COVID 19 pandemic. The study is multicenter retrospective from October 2018 to May 2022, including 380 cases of hospitalised epistaxis, with the mention that March 2020 is considered the beginning of the pandemic period. 60.8% of the patients enrolled in the study in the pre-pandemic period (60.8%) and 39.2% in the pandemic period. Differences between groups were not statistically significant between study entries (pre-pandemic vs. pandemic) and age (p=0.331), gender (p=0.916) or existence of local causes for epistaxis (p=0.895). Patients with general causes for epistaxis were more frequently enrolled in the pandemic period, while patients without general causes for epistaxis were more frequently enrolled in the pre-pandemic period. Patients with a hospitalisation period of more than 5 days were more frequently enrolled in the pre-pandemic period while patients with a hospitalisation period of 3 to 5 days were more frequently enrolled in the pandemic period. Also, patients with idiopathic epistaxis were more frequently enrolled in the pre-pandemic period. Based on the results presented in our study, the period of the Covid 19 pandemic directly influenced both the number of patients and the period of hospitalisation.
    Full text,
    Read More

  • Partial Decellularization as a Method to Improve the Biocompatibility of Heart Tissue Implants

    M. MESINA; I. MINDRILA; M. I. M. BOTORAN; L. A. MINDRILA; I. PIRICI
    2023/09/30
    10.12865/CHSJ.49.03.07
    Medicine
    Increasing the biocompatibility of some biological implants through tissue engineering is important for regenerative medicine, which recently has a rapid development dynamic. In this study we used tree different washing protocols, respectively with Sodium Lauryl Sulfate (SLS), with Sodium Deoxycholate (SD), and with saline (Sa) to achieve partial decellularization of 2-3mm thick cross-sections through Wistar rat hearts. Pieces of the heart tissue were either histologically analyzed to evaluate the decellularization processes or implanted for 5 days on 9-day-old chick embryo chorioallantoic membrane (CAM) and then histologically analyzed to evaluate CAM-implant interactions. Histological analysis of SLS or SD washed tissues showed different microscopic features of the decellularization processes, SLS-washing leading to the formation of a completely decellularized ECM layer at the periphery of the heart tissue. Both detergents induced changes in the spatial arrangement of collagen fibers of the heart tissue. Histological analysis of the CAM implants shoved that the peripheral zone with complete decellularization induced by SLS increased the biocompatibility of heart tissue implants by favoring neovascularization and cell migration. These results suggested that the biocompatibility of the heart tissue implant can be modulated by the appropriate use of a SLS-based decellularization protocol.
    Full text,
    Read More

  • Gastric Cancer in Gorj County - a Clinical-Statistical Study

    A. GIUBELAN; M. I. STANCU; S. S. MOGOANTA; R. I. RADU; G. D. MALAESCU
    2023/09/30
    10.12865/CHSJ.49.03.06
    Medicine
    Gastric cancer (GC) is the fourth most common cause of cancer death worldwide, with about 769,000 deaths/year worldwide. Recent studies showed a continuous decrease in the incidence and mortality of gastric cancer mainly in developed countries, while the incidence remains increased in some countries in Eastern Asia and Eastern Europe. For the assessment of some parameters of gastric cancer in Gorj county, all the medical records of patients diagnosed with gastric cancer, found in the Archive of the County Emergency Hospital of Tg Jiu, were analyzed, namely the admission records within the Surgery and Oncology departments, the observation sheets of every individual patient, the biological test reports, the histopathological records of the patients with gastric cancer undergoing surgery, the histopathological records of gastric biopsies, the medical imaging records (ultrasound, x-ray, computer tomography and magnetic resonance). The analysis of the medical records showed that the disease mainly affects men, the ratio of men/women being 2/1-3/1. Most cases undergoing surgery within the County Hospital of Tg. Jiu were diagnosed in stages III or IV. The most numerous cases (over 85% of the total group of patients) were identified in people over 61 years old. The most common histopathological form of cancer was adenocarcinoma (95% of all gastric tumors).
    Full text,
    Read More

  • Anastomotic Leakage after Colorectal Surgery: Risk Factors, Diagnosis and Therapeutic Options

    M. M. DENICU; D. CARTU; S. RAMBOIU; M. CIORBAGIU; V. SURLIN; R. NEMES; L. C. CHIUTU
    2023/09/30
    10.12865/CHSJ.49.03.05
    Medicine
    Anastomotic leakage (AL) is the most severe and devastating complication of colorectal surgery. The objectives of this study were to identify the risk factors involved in the development of AL, evaluate diagnostic methods and explore therapeutic options in case of colorectal cancer surgery. Material and Methods: we conducted a retrospective study on 28 AL recorded after 315 elective colorectal cancer surgeries performed in 1st Surgery Clinic of Craiova over an 8-year period (2014-2022). Results: The overall incidence of AL was 8.88%. The identified risk factors were rectal cancer (22.38%), low anterior rectal resection (50%), open approach, advanced age (82.15% over 60 years old), male sex (3:1), and the presence of two or more co-morbidities. Medical conservative treatment was the primary line of treatment in all cases. Leakage closure was achieved in 22 cases (78.56%), with exclusive conservative treatment in 15 cases (46.42%) and combined conservative and surgical treatment in 7 cases (25.0%). Overall morbidity was recorded at 64.28%, with 8 cases of general evolving complications and 10 cases of local complications. General mortality was reported at 6 (21.42%), with 3 (16.66%) occurring after conservative treatment and 3 after re-interventions (30%). Conclusions: our study identified advanced age, the presence of two or more co-morbidities, male sex, rectal surgery, and neoadjuvant chemoradiation as the most important risk factors for AL. Medical conservative treatment was the primary treatment modality, while reoperation was necessary in cases of uncontrollable sepsis and MODS. Mortality after re-intervention was nearly double compared to conservative treatment.
    Full text,
    Read More

  • Evaluation of Transient Ischemic Stroke Cases Admitted to a Tertiary Hospital in Mehedin?i County, South-West of Romania

    O. PAUN; L. MOGOANTA
    2023/09/30
    10.12865/CHSJ.49.03.04
    Medicine
    The transient ischemic attack (TIA) is a common cerebrovascular ischemic disease whose symptoms resolve within a maximum of 24 hours. The study carried out by us is a retrospective descriptive one, in which we sought to highlight the main characteristics of TIA in patients admitted to the Emergency Hospital in Turnu-Severin municipality in Mehedin?i county, in the period 2016-2020, including a group of 53 patients, mainly from Mehedin?i county. The analysis of the study group and the risk factors showed that TIA mainly affects the elderly, over 50 years old, with the highest incidence being recorded in the 60-80-year age groups, with an extremely low incidence under 40 years. Significant differences were found between the sexes and between the social environments, with women and people from the urban environment being more prone to suffer a TIA. Among the most important modifiable risk factors encountered in TIA patients included in the study, the following were highlighted: HTN, obesity and atherosclerosis. Knowing the modifiable factors and combating them can improve the prognosis of AIT.
    Full text,
    Read More

  • Sildenafil in Pulmonary Hypertension Associated with Bronchopulmonary Dysplasia: Friend or Foe?

    I. BRANESCU; S. VLADAREANU; S. SHETTY; D. O. ALEXANDRU; A. KULKARNI
    2023/09/30
    10.12865/CHSJ.49.03.03
    Medicine
    Introduction: Sildenafil is a phosphodiesterase-5 inhibitor used to treat pulmonary hypertension, although its efficiency remains disputed in the neonatal population. We aimed to assess the clinical use of this drug in extremely premature infants diagnosed with pulmonary hypertension associated to bronchopulmonary dysplasia. Study design: This is a retrospective study of 18 patients born at ? 32 weeks gestational age with pulmonary hypertension complicating moderate to severe bronchopulmonary dysplasia, which was diagnosed on echocardiography at 36 weeks corrected gestational age. Median corrected gestational age at starting sildenafil was 48 weeks (range 32-60). In 4 cases there was a period of > 2 weeks between the evidence of moderate-severe pulmonary hypertension and starting sildenafil. In all other cases it was started as soon as the diagnosis was suspected or confirmed. Results: All infants tolerated the use of sildenafil. However, 5 babies (26.31%) died despite ongoing intensive care, and 5 babies (26.31%) died after having care redirected due to severe chronic lung disease (1 due to co-existing neurological abnormality), with on overall mortality of this study of 52.62%. Eight babies (42.1%) survived: 5 continued on sildenafil until hospital discharge, 1 continued on transfer to the paediatric intensive care unit and 2 stopped while inpatients. Upon follow up to 2 years of age, out of the 5 patients who continued upon hospital discharge, 4 stopped at 6, 7, 12 and 18 months respectively, with 1 child being lost to follow up. Two patients (10.52%) restarted sildenafil use later in childhood. Echocardiographic evidence of improvement was noted in 58% (11 cases), with no improvement in 6 cases (32%) and incorrect original diagnosis in 1 case (5%). One infant died less than a week from the initiation of treatment. Conclusion: sildenafil use showed no clinical improvement of pulmonary hypertension complicating moderate to severe bronchopulmonary dysplasia in extremely premature infants.
    Full text,
    Read More

  • Association between Direct-Acting Agents Adherence and Health-Related Quality of Life of Patients with Hepatitis C

    I. P. DOICA; A. T. STIOLICA; B. S. UNGUREANU; D. N. FLORESCU; I. ROGOVEANU; D. I. GHEONEA
    2023/09/30
    10.12865/CHSJ.49.03.02
    Medicine
    This observational study included all patients undergoing HCV treatment with direct-acting antiviral (DAA)-based therapy between May 2020 and September 2023 at the Dolj County Hospital, Romania. The aim was to investigate adherence to DAAs among HCV patients and the effect of this treatment on their health-related quality of life (HRQoL). Chronic HCV-infected patients were prospectively evaluated at baseline (T0), before the beginning of treatment, and 12 weeks after completing DAAs treatment (T1). The HCV-AD10 questionnaire was used to measure DAAs adherence, and HRQoL was assessed with the 15D instrument. The 15D questionnaire was administered at two time points: T0 and T1, during which the Sustained Virologic Response (SVR) was also measured. The primary outcome was DAAs adherence, with secondary outcomes including quality of life (QoL), and sustained virologic response (SVR). DAAs based therapy was initiated for 368 patients, all of whom were health insured. HRQoL and psychological state of HCV patients clinically improved. The DAAs adherence was very good (mean±SD, 91.51±8.34), being influenced by age (younger patients were much adherent, rho=-0.112, p-value=0.031) and the severity of the disease (patients with more severe hepatitis were less adherent, rho=-0.167, p-value=0.001). DAAs had a significant effect on improving HRQoL of HCV patients, but did not influence medication adherence.
    Full text,
    Read More

  • Mechanisms of Altered Immune Response in Skin Melanoma

    R. F. FRUNTEALATA; M. MATEI; I. K. S. BOBOC; S. I. MITRAN; M. E. CIUREA; G. A. STOICA
    2023/09/30
    10.12865/CHSJ.49.03.01
    Medicine
    Melanoma, a deadly form of skin cancer, poses significant challenges to the host immune system, allowing tumor cells to evade immune surveillance and persist. This complex interplay between melanoma and the immune system involves a multitude of mechanisms that impair immune recognition and promote tumor progression. This review summarizes the intricate strategies employed by melanoma cells to evade the immune response, including defective immune recognition, immune checkpoint activation, and the role of regulatory T-cells, myeloid-derived suppressor cells, and exosomes in suppressing anti-tumor immunity. Additionally, we discuss potential therapeutic targets aimed at reversing immune evasion in melanoma, highlighting the importance of understanding these mechanisms for developing more effective immunotherapies. Improved insights into the interactions between melanoma and the immune system will aid in the development of novel treatment strategies to enhance anti-tumor immune responses and improve patient outcomes.
    Full text,
    Read More

  • Epidural Extramedullary Plasmacytoma Successfully Treated with Surgical Excision and Bortezomib, Cyclophosphamide and Dexamethasone

    A. E. MARTIO; G. J. MIOTTO; P. M. MESQUITA FILHO; W. S. CHAVES; O. R. KARAM
    2023/06/30
    10.12865/CHSJ.49.02.20
    Medicine
    Plasma cell neoplasms are common, accounting for more than 1% of all malignancies. Its most common form is multiple myeloma, but others, such as extramedullary plasmacytoma (EMP), exist. Spinal cord compression secondary to these pathologies is not uncommon, however, adjacent bone involvement is usually present. Spinal cord compression caused by isolated epidural EMP is extremely rare, with only one case reported to date. We describe the case of a 75-year-old female patient that presented with paraparesis, due to an isolated epidural EMP associated with light chain amyloidosis. She was treated with surgical decompression and neoadjuvant chemotherapy, and is currently with a 15-month disease-free period.
    Full text,
    Read More

  • Periodontitis Burden in Diffuse Versus Limited Systemic Sclerosis Subtypes: A Pilot Study

    A. STANOMIR; I. C. MICU; A. PICOS; A. ROMAN; A. SOANCA; D. ONET; T. N. ONEA; S. REDNIC A. CIUREA; C. PAMFIL
    2023/06/30
    10.12865/CHSJ.49.02.19
    Medicine
    Introduction. This study aimed to evaluate the periodontal status of a group of Romanian systemic sclerosis (SSc) patients and to investigate the relationships between periodontitis and SSc subtypes. Materials and methods. This observational study included patients diagnosed with limited SSc (lcSSc) and diffuse SSc (dcSSc). Demographic data were collected from medical records. Each participant underwent a full-mouth periodontal examination including Bleeding on Probing (BOP) index, Oral Hygiene (OH) index, Probing Depth (PD), Gingival Recession (GR), and Clinical Attachment Loss (CAL). The periodontal status was defined according to presently recognised case definition system. Results. The study included 30 patients with lcSSc and 30 patients with dcSSc with a mean age of 52.45±11.75 years. The overall periodontitis frequence in our SSc group was 95%. The frequency of stage III/IV periodontitis was higher in the dcSSc group (90%) than in the lcSSc group (60%). The frequency of stage III/IV periodontitis was 90% in the dcSSc group and 60% in the lcSSc group. Within the group of SSc patients, significant positive correlations were observed between age, BoP index, OH index, the number of missing teeth, mean PD, mean CAL on one side and periodontitis diagnosis on the other side (r=0.588, p=0.001; r=0.399, p=0.002; r=0.388, p=0.002; r=0.574, p=0.001; r=0.444, p=0.001; r=0.571, p=0.001). A significant positive correlation existed between the diagnostic of periodontitis and SSc subtypes (r=0.327, p <0.001). Conclusions. Periodontitis was highly prevalent in both lcSSc and dcSSc groups. More stage III/IV periodontitis cases were detected dcSSc group of patients.
    Full text,
    Read More

  • Considerations on Patients' Quality of Life Following Hand and Forearm Trauma in the Oltenia Region

    A. F. GHITAN; V. GHEORMAN; I. UDRISTOIU; M. E. CIUREA
    2023/06/30
    10.12865/CHSJ.49.02.18
    Medicine
    Hand and forearm trauma is a significant public health concern that has notable physical, psychological, and socioeconomic implications. Understanding the variations in occurrence and characteristics of injuries across different regions is crucial for effective implementation of preventive measures, management strategies, and resource allocation. The study involved 86 cases, with a range of ages from 18 to 70 years old. The participant group consisted of 11 females and 75 males. A series of clinical parameters were analyzed, including gender, age, environment, and cause of trauma. The study requested that participants provide information regarding if they reintegrated into their professional lives and complete the WHOQOL-BREF assessment, which is a tool used to evaluate quality of life. The current investigation has determined that the primary etiologies for hand and forearm injuries are crush and sharp cuts. The results of the investigation indicate a noteworthy association among Age and Cause, Gender and Age, Age and Professional reintegration, as well as between WHOQOL-BREF scores and different parameters. The procurement of epidemiological data plays a crucial role in broadening our comprehension of acute hand and forearm injuries in the Oltenia region.
    Full text,
    Read More

  • Ventral Hernia Repair and Diabetes Mellitus - A Prospective, Observational and Comparative Study of Outcomes

    A. M. STAN SOARE; S.D. PREDA; S. RAMBOIU; D. CARTU; S. PATRASCU; S. CAZACU; V. BICIUSCA; A. TURCU-STIOLICA; O. ANDRONIC; D. N. PADURARU; I. DANIEL; V. BINTINTAN; V. OPREA; D. MARINESCU; V. SURLIN
    2023/06/30
    10.12865/CHSJ.49.02.17
    Medicine
    Diabetes mellitus (DM) and obesity are known to influence postoperative outcomes in surgical patients. This study aimed to analyze the divergence in outcomes between patients with and without DM who underwent ventral hernia repair, while also assessing the additional impact of obesity on postoperative complications, hospitalization, and costs. A prospective, non-interventional, observational study was conducted over five years (2018-2022) at the First Surgical Clinic of Craiova Emergency Clinical Hospital. The study included 216 patients, with 42 (19.44%) having DM, half of whom were also obese. There were no significant differences in age between patients with or without DM. However, diabetes and obesity were more prevalent in female patients. The mean duration of hospitalization was 10.7±8.6 days, with no significant differences observed between patients with or without DM or obesity. Statistical analysis revealed that patients with DM had a higher incidence of seroma formation, wound infection, and hematoma formation compared to patients without DM. However, there were no significant differences in mesh infection, hospitalization days, or costs between the two groups. Similarly, no significant differences were found between obese and non-obese patients in terms of complications, hospitalization days, or costs. In conclusion, this study highlights that DM is associated with an increased risk of specific complications in ventral hernia repair, including seroma formation, wound infection, and hematoma formation. However, the impact of obesity on these outcomes appears to be limited. Individualized preoperative optimization and targeted interventions are necessary to mitigate the risk of complications in patients with DM or obesity.
    Full text,
    Read More

  • Bruxism in Children and Adolescents and its Association with Some Possible Aetiological Factors

    A. E. CRACIUN; D. CERGHIZAN; S. POPSOR; C. BICA
    2023/06/30
    10.12865/CHSJ.49.02.16
    Medicine
    Bruxism is a nocturnal parafunctional activity represented by grinding and clenching of the teeth. Bruxism is considered to be the most harmful of the parafunctional activities of the stomatognathic system, being responsible for tooth wear, periodontal lesions and joint and/or muscle lesions. This study consists of a group of 189 children (111 male and 78 female) that responded correctly and completely to a questionnaire that contained nine items assessing sleep bruxism. According to our research, there was a statistically significant association between bruxism and headache (p<0.0001), tooth/gingival sensitivity (p<0.0001), muscle stiffness, presence of stress (p<0.0001), and vicious habits. Within the limits of this study, parafunctional phenomena such as nocturnal bruxism interest an important percentage, over 60%, involving children of both genders in relatively equal proportions.
    Full text,
    Read More

  • The Role of Uterine Artery Doppler in the Second and Third Trimesters for Prediction of Preeclampsia and Fetal Growth Restriction Developed as a Consequence of Placental-Mediated Diseases

    A. TUDOR; L. NOVAC; I. V. CAMEN; M. M. MANOLEA; M. S. SANDULESCU; S. C. VRABIE; M. S. SERBANESCU; M. V. BOLDEANU; A. M. ISTRATE-OFITERU; A. L. DIJMARESCU
    2023/06/30
    10.12865/CHSJ.49.02.15
    Medicine
    Placenta-mediated pregnancy disorders represent a disease that includes preeclampsia (PE) and the birth of small for gestational age (SGA) children, these conditions increase the risk of mortality and morbidity both maternal and fetal/neonatal, in the short and long-term. Methods: The prospective study included 106 patients in whom ultrasound Doppler scans of uterine artery (UtA) were performed in the 2nd trimester between 20.0-23.6 weeks of gestation and the 3rd trimester between 28.0-32.6 weeks of gestation. Results: In the second trimester, the average of the UtA-PI percentiles was statistically significant (p<0.05) in correlation with PE and SGA, as in the third trimester. Statistically significant (p<0.05) was also the correlation of UtA-PI >95 percentile with the development of PE and SGA. On the other hand, the present notch, in the two trimesters studied, analyzed as a single index, did not present a statistically significant association (p>0.05). Conclusions: The results of our study showed that UtA-PI Doppler is the best predictor of preeclampsia considering the association of intrauterine growth restriction, as most studies have found.
    Full text,
    Read More

  • Correlation between Coronary Artery Disease and Non-Alcoholic Fatty Liver Disease Using Computed Tomography Coronary Calcium Scans

    D. C. CUCORANU; M. POP; R. NICULESCU; I. B. KOSOVSKI; R. O. TOGANEL; R. A. LICU; A. BACAREA
    2023/06/30
    10.12865/CHSJ.49.02.14
    Medicine
    Introduction: Concerns about how non-alcoholic fatty liver disease (NAFLD) might contribute to the development of cardiovascular disease (CVD) have grown as the importance of NAFLD and its relationship to the metabolic syndrome has grown. The purpose of this cross-sectional retrospective is to investigate potential correlations between hepatic steatosis in liver segments seen when measuring calcium score and the presence of atherosclerotic CAD (coronary artery disease). Methods: Two hundred patients (mean age, 57 years±10) who underwent coronary cardiac computed tomography (CT) scans were included. CT scans were analysed to assess the attenuation of liver parenchyma and the coronary artery calcification (CAC). Results: Age, gender, body mass index (BMI) and CAC score were significantly associated with hepatic steatosis. Among all patients, CAC score (r=-0.31, p<0.0001), and BMI (r=-0.40, p<0.0001) had a moderate negative correlation with the values of liver attenuation. BMI (OR: 1.109, p=0.001), CAC score (OR: 1.629, p<0.001), and age (OR: 1.050, p<0.001) were found to be independent predictors of hepatic steatosis through logistic regression. Conclusions: A statistically significant correlation between CAC score and the presence of NAFLD as evaluated by non-contrast-enhanced CT was demonstrated. BMI, CAC score, and age were identified as independent predictors of hepatic steatosis.
    Full text,
    Read More

  • Statical Association between Clinical and Histopathological Parameters for Keratinocyte Carcinomas

    A. C. BADIU; C. E. SIMIONESCU; A. E. STEPAN; C. MARGARITESCU; M. M. FLORESCU; B. C. ANDREIANA; A. M. BADIU; O. I. CREU; A. MURARU; C. GEORMANEANU; R. N. CIUREA
    2023/06/30
    10.12865/CHSJ.49.02.13
    Medicine
    The most common tumor of the western world is comprised of forms of non-melanoma skin cancers, previously known as keratinocyte carcinomas (KCs) The purpose of this study was to determine de incidence of non-melanoma skin tumors and the relationship between histopathological risk factors in patients with skin cancers. The study was composed from 332 cases of skin malignancies for which clinical and histopathological aggressivity factors were statistically analyzed through comparison tests and also stored digitally. For basal cell carcinoma (BCC) statistical analysis indicated significant relationships between pT category and gender, tumor size, ulceration, depth of invasion and positive resection limits. For squamous cell carcinoma (SCC) statistical analysis indicated significant relationships between pT category and tumor size, depth of invasion and positive resection limits. Clinical and histological analysis of certain characteristics of the above-mentioned skin cancers is an essential step in documenting and improving both prognosis and therapy standards.
    Full text,
    Read More

  • Remote Monitoring in Cardiac Resynchronization Therapy-First Experience in Romania with a CRT Virtual Ward

    E. V. GOANTA; A. UNGUREANU; G. TARTEA; A. MURARETU; D. MANCIU; C. VACARESCU; L. PETRESCU; D. COZMA
    2023/06/30
    10.12865/CHSJ.49.02.12
    Medicine
    Background: Remote monitoring (RM) is becoming a standard of care for patients with cardiac resynchronization therapy (CRT). This technology combines the use of pacemakers or implantable cardioverter-defibrillators (ICD) and wireless communication to provide physicians with continuous, real-time information on the patient's cardiac activity. The purpose of the study was to evaluate if the remote monitoring technology in the follow-up CRT patients is feasible and safe. Methods: A total of nine patients were enrolled in the study, implanted with a CRT system with wireless transmission capabilities. Immediately after the procedure received the RM, were enrolled in the virtual clinic and instructed by the doctor how to use the device at home. Regular virtual transmissions were made automatically every 3 weeks, respecting optimal transmission conditions. The accumulation of fluid in the lungs, atrial or ventricular tachyarrhythmia together with system integrity automatically activate alerts. Results: One hundred and one transmissions were collected and analyzed from the virtual ward. Average follow-up was 7.7±4.8 months, longest follow-up was 18 months. None of the patients experienced complications during the study period, with three of them being follow-up solely through telemetric means by implanting physician. Treatment optimization was successfully conducted via phone consultations, when necessary, without any adverse events. Conclusions: The results of our study suggest that RM could be integrated into routine CRT management protocols, enhancing patients care and resource utilization.
    Full text,
    Read More

  • Clinical and Morphological Study of Cervical Squamous Intraepithelial Lesions

    L. IOVAN; I. M. LILIAC; A. M. ISTRATE-OFITERU; C. G. ROSU; L. MOGOANTA
    2023/06/30
    10.12865/CHSJ.49.02.11
    Medicine
    Squamous intraepithelial lesions (SILs) are cancer precursors targeted by secondary prevention of cervical cancer programs that are sometimes difficult to grade accurately. Mena is an actin regulatory protein involved in membrane protrusion, cell motility, in tumor invasion and metastasis. We studied retrospectively 68 cases of patients diagnosed with squamous intraepithelial lesions that received expedited treatment (treatment without colposcopic biopsy). We analyzed demographic, behavioral data, obstetrical and medical history, from the patients’ medical charts and we studied the cervical fragments or cones harvested after the excisional procedure. Our study failed to identify a correlation between SILs and risk factors such as low socioeconomic status, combined oral contraceptive use, intrauterine device use, parity, gravity, except for the tobacco smoking habit that proved to be related to the cervical lesions’ development. Mena was expressed in most of the analyzed SILs and its expression was correlated with lesions’ grade in terms of both area and intensity, suggesting that Mena stains especially abnormal cells and that its expression intensity correlates with the risk of malignant transformation. Further studies are needed to validate Mena as an early stage of cervical carcinogenesis marker.
    Full text,
    Read More

  • Investigating the Neuroprotective and Neuroregenerative Effect of Trazodone Regarding Behavioral Recovery in a BL6C57 Mice Stroke Model

    I. K. S BOBOC; A. C. CHIREA; V. GHEORMAN; A. GRESITA; T. A. BALSEANU; B. CATALIN; D. CALINA
    2023/06/30
    10.12865/CHSJ.49.02.10
    Medicine
    Stroke is a major cause of death and disability worldwide. Between 1990 and 2010, its global burden increased notably with reference to the absolute number of incident events, number of deaths, and disability-adjusted life-years lost. Trazodone is a triazolopyridine derivative that was approved for more than 40 years as monotherapy or in combination with other antidepressant drugs for the treatment of major depressive disorder in adult patients. The aim was investigated if trazodone can improve behavioural outcome after stroke in a mice model of middle cerebral artery occlusion (MCAo) due to the potential neuroprotective and neurodegenerative effects by using three behavioural tests: adhesive tape test, beam test and hole board test. Trazodone administration show modest improvements regarding the motor-sensorial function after stroke especially in the acute post-stroke phase in aged and young animals. The antidepressant effect of the drug was observed in the post-stroke period in aged animals and to a lesser extent in young animals. Future research is needed to evaluate the effects of trazodone at the cellular level to be sure that it has no benefit in stroke patients who do not suffer from depression.
    Full text,
    Read More

  • Comparative Statistical Analysis of Key Performance Indicators in the Health System

    L. MIRESCU; A. M. C. POPESCU; I. M. DRAGOMIR
    2023/06/30
    10.12865/CHSJ.49.02.09
    Medicine
    In this paper, a comparative statistical analysis of some performance indicators from the health system at SCJU Craiova and SJU Slatina is made in the period 2010-2021. Also, the correlations between the average duration of hospitalization, the bed utilization rate, the number of cases and the case complexity index for each hospital are studied. It is found that there are similarities, but also statistically significant differences between the two analyzed hospitals. Thus, it turns out that there are no significant differences between the bed utilization rate and the complexity index between the two hospitals, but there are statistically significant differences at a significance threshold of 5% between the average duration of hospitalization and the number of cases registered at the two hospitals analyzed. Moreover, the case complexity index is strongly negatively correlated with the bed utilization rate and with the number of cases in both hospitals, but positively correlated with the average duration of hospitalization at SCJU Craiova and weakly negatively correlated at SJU Slatina.
    Full text,
    Read More

  • Pleural Effusion as a Negative Prognostic Factor in Patients with Acute Pancreatitis and COVID-19

    P. M. RADULESCU; A. F. NEMES; C. CALARASU; I. GEORGESCU; D. RADULESCU
    2023/06/30
    10.12865/CHSJ.49.02.08
    Medicine
    We conducted a retrospective multicentre study to investigate the association between acute pancreatitis, COVID-19, and pleural effusion. The study involved a total of 433 patients. Among them, 405 patients did not have COVID-19 infection, while 28 patients had both acute pancreatitis and COVID-19. Out of the 28 patients with both conditions, 12 also had pleural effusion. Among the 405 patients with acute pancreatitis without COVID-19, 48 had pleural effusion. The results showed that the relative risk of death associated with pleural effusion was approximately 4 times higher in patients with COVID-19 and pleural effusion compared to those with pleural effusion without COVID-19.
    Full text,
    Read More

  • Preliminary Study on the Antioxidant Effect of Natural Based Products with Potential Application in Complex Regional Pain Syndrome

    C. E. BITA; S. C. DINESCU; F. A. VREJU; A. E. MUETESCU; A. BITA; C. CRIVEANU; A. L. BARBULESCU; A. FLORESCU; P. L. CIUREA
    2023/06/30
    10.12865/CHSJ.49.02.07
    Medicine
    Complex regional pain syndrome (CRPS) is a complex condition characterized by chronic pain and various sensory, motor, and autonomic symptoms. It involves a complex interplay of mechanisms in the nervous system, including neuroinflammation, sensitization of pain pathways, and dysfunction of the sympathetic nervous system. Antioxidants may play a role in CRPS by helping to counteract oxidative stress, which is an imbalance between the production of reactive oxygen species (ROS) and the body’s antioxidant defences. CRPS involves inflammation and tissue damage, which can lead to increased ROS production and oxidative stress. Our paper represents a preliminary study on various commercially available natural-based products regarding their antioxidant effect. Several natural products with antioxidant properties, such as vitamins C and E, polyphenols, flavonoids, and botanical extracts, have shown promise in preclinical studies for their potential to alleviate pain and reduce inflammation associated with CRPS. The potential use of natural-based products with antioxidant effects for mitigating CRPS symptoms is still an area of ongoing research and investigation, but nonetheless it holds promise.
    Full text,
    Read More

  • Assessment of Stroke Patients Admitted to a Tertiary Emergency County Hospital of Mehedin?i - Romania

    O. PAUN; M. S. SERBANESCU; O. BADEA; L. MOGOANTA
    2023/06/30
    10.12865/CHSJ.49.02.06
    Medicine
    Cerebrovascular accidents (CVA)-strokes represent a major public health problem worldwide, due to the large number of people affected. Also, there is a large number of people who die from stroke, especially in developing countries. Our study included a group of 119 patients, diagnosed with stroke and admitted to the Emergency Hospital of Drobeta Turnul-Severin, Mehedin?i county, between 2016-2020. The analysis of risk factors and associated comorbidities showed that stroke can affect both the elderly and young people, under 20 years old. However, approximately 4/5 of CVA patients (79.83%) were aged over 50 years old. If non-ischemic strokes predominated in patients under the age of 50, after this age there is a tendency to balance the incidence between the eight main forms of stroke. No significant differences were observed regarding the social environment of the patients, which shows that the risk factors are almost identical in both social environments. Among the modifiable risk factors, we highlighted: high blood pressure in 55.46% of cases, obesity in 19.33% of cases, atherosclerosis in 10.92% of cases, diabetes mellitus in 10.92%, kidney failure in 6.72% of cases. The data we obtained show that there are possibilities to reduce the incidence of stroke by controlling and reducing the modifiable risk factors.
    Full text,
    Read More

  • The Assessment of Heart Rate Variability in Patients with Pancreatic Cancer

    M. PETRESCU; I. UDRISTOIU; F. MILITARU; A. R. PETRESCU; G. TARTEA; V. RAICEA; A. M. CIUREA; A. M. PETRESCU; C. C. VERE
    2023/06/30
    10.12865/CHSJ.49.02.05
    Medicine
    The aim of our study is to provide an assessment of heart rate variability (HRV) as a predictor for the survival of patients with pancreatic cancer (PCa). We conducted a retrospective, descriptive study. 53 consecutive patients who were newly diagnosed with pancreatic cancer (PCa), were included. In the end, 41 patients were included in the analysis, out of which 14 patients survived at least until the 24-month follow-up, while 27 patients died within 24 months from the diagnosis. These patients were monitored with 24-hour Holter electrocardiogram (ECG) prior to the initiation of any therapy for determining heart rate variability. To establish the cut-off values of HRV, 24-hour Holter ECG recordings of 20 healthy subjects were analyzed. In addition to heart rate analysis, HRV indices were also analyzed: SDNN, rMSSD, ULF and VLF. Median survival in patients with low value of SDNN was 9 months, compared to patients with hight SDNN where median survival was 15 months (Hazard ratio 2.301, 95% CI of ratio 0.9080 to 5.833, p= 0.034). Although low values of the HRV indices in the frequency domain were associated with reduced survival, no statistically significant differences were recorded. The reduction of heart rate variability indices is a negative prognostic factor in patients newly diagnosed with pancreatic cancer.
    Full text,
    Read More