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Clinical and Morphological Study of Cervical Squamous Intraepithelial Lesions
L. IOVAN; I. M. LILIAC; A. M. ISTRATE-OFITERU; C. G. ROSU; L. MOGOANTA2023/06/3010.12865/CHSJ.49.02.11MedicineSquamous 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. -
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. CALINA2023/06/3010.12865/CHSJ.49.02.10MedicineStroke 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. -
Comparative Statistical Analysis of Key Performance Indicators in the Health System
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. -
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. RADULESCU2023/06/3010.12865/CHSJ.49.02.08MedicineWe 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. -
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. CIUREA2023/06/3010.12865/CHSJ.49.02.07MedicineComplex 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. -
Assessment of Stroke Patients Admitted to a Tertiary Emergency County Hospital of Mehedin?i - Romania
O. PAUN; M. S. SERBANESCU; O. BADEA; L. MOGOANTA2023/06/3010.12865/CHSJ.49.02.06MedicineCerebrovascular 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. -
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. VERE2023/06/3010.12865/CHSJ.49.02.05MedicineThe 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. -
Clinical Evaluation of Periodontal Status and IL-6 Gingival Fluid Level in Patients with Sjogren’s Syndrome
D. N. GHEORGHE; D. M. POPESCU; S. C. DINESCU; M. V. BOLDEANU; P. SURLIN; F. VREJU; P. L. CIUREA2023/06/3010.12865/CHSJ.49.02.04MedicineThe objective of the cross-sectional study was to assess periodontal and implant health condition among individuals diagnosed with Sjogren's Syndrome (SS), taking into account the clinical circumstances associated with this patient population. The clinical parameters employed to evaluate the periodontal status of both natural teeth and implants included: periodontal probing depth (PPD) measured at six sites per tooth/implant, clinical attachment level (CAL), bleeding on probing index (BOP), plaque index (PLQ). Gingival crevicular fluid samples were collected for interleukin-16 level evaluation. After clinical and immunological assessment of the study and control groups, the data was centralized, compiled and submitted for statistical analysis. In all four types of assessed periodontal parameters, there were statistically significant differences between the SS patients with no dental implants and the other test (SSi) and control groups (Cni and Ci). Nevertheless, in SS patients with dental implants, plaque levels were similar to that of controls. In addition, other periodontal parameters (PPD, BOP and CAL) were similar in SS patients with dental implants and controls, with no statistically significant difference. The highest GCF IL-6 levels were found in SS patients with no dental implants, the differences to the other study and control groups being statistically significant. In patients with SS and dental implants, there were no statistically significant differences to the other groups. Individuals diagnosed with Sjogren's Syndrome (SS) exhibit a less favorable periodontal condition compared to controls without SS. Notably, SS patients who undergo dental implant procedures demonstrate an improvement in their periodontal status. This highlights the importance of proactive and ongoing dental and periodontal surveillance for SS patients, aiming to decrease the risk of developing periodontal diseases. -
Optimization Techniques of Single-Detergent Based Protocols for Heart Tissue Decellularization
M. MESINA; I. MINDRILA; M. I. MESINA-BOTORAN; L. A. MINDRILA; A. FARHANGEE; I. PIRICI2023/06/3010.12865/CHSJ.49.02.03MedicineThe extracellular matrix (ECM) scaffolds are considered a gold standard for the engineering of appropriate grafts used in regenerative medicine for tissue repair, and decellularization of myocardial tissue is one of the most studied processes for obtaining natural ECM to date. Decellularization methods, agents used, or treatment durations can be varied to optimize cardiac tissue decellularization parameters. In this work we performed a morphological and morphometric analysis of cardiac tissue subjected to decellularization protocols based on Sodium Deoxycholate (SD) or Sodium Lauryl Sulfate (SLS) to identify factors that allow optimization of single-detergent based protocols for cardiac ECM manufacturing. For this, Wistar rat hearts (n=10) were subjected to 5 different decellularization protocols (n=2) and then histologically processed to achieve H&E or Azan trichrome stained sections for the morphological and morphometric analysis of the obtained ECM. The results of this study showed that SLS alters the spatial distribution of cardiac ECM collagen fibers, and SD can be successfully used in tailoring single-based detergent decellularization protocols by appropriately adjusting the application times of hypo/hyperosmotic shocks, which increases the lytic action of the detergent, and the washing times for the efficient elimination of cellular residues. -
The Prevalent Cases of Endometrial Carcinoma in Different Life Periods of Women-Clinical and Histopathological Diagnosis
Abnormal uterine bleeding is a term used to describe any irregular bleeding from the uterus that is not part of a woman's normal menstrual cycle and can happen during different life periods. Abnormal uterine bleeding can have structural etiologies (polyp, adenomyosis, leiomyoma, malignancy) or nonstructural etiologies (coagulopathy, ovulatory dysfunction, and not-classified). The post- and pre-menopausal period requires a detailed investigation to establish the etiology of the bleeding because the chances that the woman has a malignancy are plentiful in this period. The treatment plan is determined based on the underlying cause of the bleeding. The main objective of this paper was to determine the prevalence of endometrial carcinoma in different periods, focusing on the postmenopausal period. This research was a cross-sectional study and included 79 cases of abnormal uterine bleeding in different periods of women's lives. Our study found that abnormal uterine bleeding occurs more frequently during the premenopausal period (59%) and that the causes of irregular bleeding during this period were mainly benign. Our study focused on the postmenopausal period, where we found that 32.9% of irregular uterine bleeding occurs during this period, and the leading causes were malignant pathologies (83.3%), mainly endometrial adenocarcinomas. The average age was 66.7 years. During the study, it was observed that 50% of women with abnormal uterine bleeding due to malignancy were classified as overweight, 25% were obese, and 25% had normal weight. It was confirmed that obesity is a co-factor of malignancy in the postmenopausal period, and the pathophysiological mechanism is well understood now. Our study also found a high number of co-morbidities among women with abnormal uterine bleeding due to malignancy. We came to the conclusion that any abnormal uterine bleeding should be initially investigated in a multidisciplinary manner, an accurate diagnosis should be determined, and then a treatment plan should be established. The treatment strategy should be determined depending on the cause of abnormal bleeding. -
A Review of Psychological Outcomes in Patients with Complex Hand Trauma: A Multidisciplinary Approach
A. F. GHITAN; V. GHEORMAN; D. PIRVU; V. GHEORMAN; I. UDRISTOIU; M. E. CIUREA2023/06/3010.12865/CHSJ.49.02.01MedicineThis systematic review aimed to assess the psychological outcomes in patients with complex hand trauma and explore the importance of a multidisciplinary approach in addressing both physical and mental health needs. The study employed a rigorous methodology, including a comprehensive search of relevant databases, strict inclusion and exclusion criteria, and data synthesis from the included studies. The results demonstrated the significant negative psychological impact of complex hand trauma on patients' overall health and quality of life. This trauma affected patients emotionally, psychologically, and physically, highlighting the essential role of hand function in performing daily activities. The findings emphasize the need for continued research aimed at identifying effective psychological interventions to support the rehabilitation of patients with complex hand trauma. Providing these patients with multidisciplinary care, addressing both the physical and mental health components of recovery, can result in a more favorable long-term outcome. -
Surfactant Deficiency Causing Severe Pneumonia in a Child
I. GJETA; D. SALA; I. BAKALLI; E. CELAJ; E. KOLA2023/03/3110.12865/CHSJ.49.01.17MedicineSurfactant deficiency is a rare genetic disease. Clinical presentation is manifested with a large specter that varies from severe form to lethal in neonatal age and to progressive, chronic form of the interstitial lung disease in older child. In this manuscript we want to present the case of a two years and 7-month-old child, which was diagnosed with Pediatric Acute Respiratory Distress Syndrome (PARDS) as consequence of bilateral interstitial pneumonia. The child was treated in a supportive way, placed in mechanical ventilation, antibiotic therapy and corticosteroid. After the complete examination, the child resulted with surfactant metabolism dysfunction of type ABCA3. In this case we want to emphasize the attention for rare genetic disease like surfactant deficiency as a cause of recurrent pneumonia cases with unclear focus. -
An L2/3 Disc Herniation-Related L5 Radiculopathy
E. CHUN-PU CHU; K. HOI-YING YAU; D. L. BELLIN2023.03.3110.12865/CHSJ.49.01.16MedicineThe key factors contributing to radiculopathy caused by lumbar disc herniation include mechanical compression. It was commonly believed that the disc herniation causes the compression on the nerve root exiting under the pedicle of the vertebral body at the adjacent inferior level. However, a disc herniation might occasionally result in non-adjacent, isolated radicular symptoms. We report the case of a 74-year-old female who presented with a 2-years history of progressive low back pain associated with L5 radiculopathy and reduced quality of life. The patient had undergone a magnetic resonance image showing a large L2/3 disc herniation. Symptoms had progressively worsened and failed to respond to conservative treatments including pain medication, exercise rehabilitation, and acupuncture at the lower lumbar region. The patient was diagnosed with L5 radiculopathy caused by L2/3 disc herniation. Consequently, her symptoms improved with chiropractic rehabilitation which involved spinal manipulative therapy and intermittent motorized traction at the L2/3 level to reduce herniated disc. Therefore, an L2/3 Disc herniation-related L5 radiculopathy should be considered in the differential diagnosis of cases of inconsistency of level of disc herniation and nerve root pattern. -
Hepatectomy During the Pandemic, a Curative Treatment in High-Grade and/or Hemodynamically Unstable Blunt Liver Trauma
G-J. BOLDEA; E. F. GEORGESCU; I. GEORGESCU; D. RADULESCU; M. PIRCOVEANU2023/03/3110.12865/CHSJ.49.01.15MedicineThe liver is among the most affected organs in the case of abdominal trauma. In the last decades there have been significant changes in therapeutic protocols, non-operative management is now the first intention in most cases due to good results offered previously. In high-grade or hemodynamically unstable injuries, hepatectomy is the best approach, even though this was viewed with skepticism in the past, technical advances in medicine have proven otherwise. This article presents a case report of a 29-year-old man with blunt abdominal trauma, who initially underwent conservative atypical right hepatectomy without a favourable outcome, later he was transferred to a liver transplant center where he underwent a controlled right hepatectomy, all this in a new epidemiological context, the COVID-19 Pandemic. We want to present the hypothesis that in making a therapeutic decision, the hemodynamic status of the patient must be considered equally along with the injury degree. This case represents an opportunity to review the role of liver resection in the management of complex liver injuries. -
Normal Coronary Arteries
M. B. PINTOS-BELOTTO; O. A. CENTURION; C. CACERES; C. ROJAS-DURE; E. J. GALEANO2023/03/3110.12865/CHSJ.49.01.14MedicineDespite the beneficial effects of anti-COVID-19 vaccination, monitoring its safety has identified potential cardiac adverse events, mainly myocarditis and pericarditis. The case of a healthy 32-year-old male patient who developed acute myocardial infarction (AMI) 48 hours after the second dose of anti-COVID-19 mRNA vaccine (BNT162b2) is reported. This is the first reported case in the literature of an AMI associated to post-COVID-19 vaccination with mRNA vaccine (BNT162b2) in a healthy young adult without coronary risk factors and normal coronary arteries. Despite this adverse event, the continuation of the anti-COVID-19 vaccination campaign is encouraged due to the benefits it brings. -
Vertebral Artery Dissection: A Case Report and Review of the Literature
O-A DOGARIU; I. DOGARIU; M. BERCEANU; R. SANDU; I. A. GHEONEA2023/03/3110.12865/CHSJ.49.01.13MedicineArterial dissection is the result of blood entering along the intima-media plane through a breach produced either spontaneously or traumatically. Cervical arterial dissections are an important cause of acute ischemic stroke in children, young adults, and patients with cranio-cervical traumatic injuries. Arterial dissections occur either spontaneously, in genetic diseases, the most important association being with fibromuscular dysplasia. In most of the cases dissection involve the extracranial portions of the internal carotid and vertebral arteries. Magnetic resonance with T1 fat-saturation (T1 FS) sequence of the cervical region or computed tomography (CT) with computed tomography angiography (CTA) shows a very high sensitivity and specificity in the diagnosis of cervical artery dissections. Therapeutic options are still debatable in patients with acute ischemic stroke and vertebral or carotid artery dissection. -
Melanoma Originating from the Dura-Mater: A Case Report and Review of the Literature
P. M. MESQUITA FILHO; L. MARTINI; R. SALTIEL; D. SCHWINGEL; J. PASTORELLO2023/03/3110.12865/CHSJ.49.01.12MedicineMelanomas originating from the dura-mater are extremely rare tumors. The diagnosis is complex, and usually only made after excluding other entities. The prognosis is poor, with average free-disease survival of 20 months, after treatment with complete surgical excision and adjuvant therapy. We report the case of a 41-year-old asymptomatic patient, presenting with a subcutaneous mass in the left parieto-occipital region, later diagnosed as a primary dura mater melanoma. Treatment included complete microsurgical excision, radiotherapy and adjuvant immunotherapy. Therefore, due to the rare nature of the disease and its high lethality, correct diagnosis and treatment are medical challenges. -
Management and Treatment of Coxarthrosis in the Orthopedic Outpatient Clinic
A. T. PARALIOV; M. M. IACOV-CRAITOIU; M. M. MOGOANTA; O. I. PREDESCU; L. MOGOANTA; S. CRAITOIU2023/03/3110.12865/CHSJ.49.01.11MedicineCoxarthrosis, or hip osteoarthritis (OA), is one of the main causes of hip pain, which can affect patients of all ages, being one of the most common reasons for patients presenting to the specialized outpatient clinic. The objective of our research was to determine the number of patients with coxarthrosis who presented to the Department of Orthopaedics and Traumatology within the Emergency County Hospital of Drobeta Turnu Severin, between 2017-2019, the sex, age, social environment of the patients. All patients underwent a thorough clinical examination to determine the risk factors, the favouring factors and their correlation with the paraclinical data obtained through imaging investigation (pelvis X-ray, computer tomography and nuclear magnetic resonance). The study included 462 patients, aged between 23 and 89 years old, who were diagnosed with varying degrees of coxarthrosis within the specialized outpatient clinic. The main risk factors were obesity, osteoporosis, chronic smoking, rural environment, female sex, the existence of a hip injury and intense physical exertion. The main purpose of the research was to analyse a series of data, which would bring information on the incidence, distribution by age groups, sex, living environment and professional activity of the population with coxarthrosis, in order to develop a therapeutic management as effective as possible. -
Intraplacental Villous Artery Doppler can Improve the Ability to Predict Placenta-Mediated Disease
A. TUDOR; L. NOVAC; I. V. CAMEN; M. M. MANOLEA; S. C. VRABIE; M. S. SANDULESCU; M. S. SERBANESCU; M. V. BOLDEANU; A. D. NEAMU; A. M. ISTRATE OFIERU; A. L. DIJMARESCU; M. B. NOVAC2023/03/3110.12865/CHSJ.49.01.10MedicineObjective. Evaluation of Intraplacental Villous Artery Doppler (IPVA) as a predictive factor compared to umbilical artery (UA) Doppler in placenta-mediated disease (PMD). Methods. This prospective study included a group of 106 pregnant women, of which 76 patients constituted the PMD group: preeclampsia (PE) and small for gestational age (SGA), and 30 pregnant women constituted the control group. IPVA and UA Doppler evaluation was performed in 2 pregnancy periods: 20.0-23.6 weeks, and 28.0-32.6 weeks of gestation. Results. From the study of maternal characteristics and risk factors for the presented pathology, we found that no studied risk factor was statistically involved in the evolution toward PMD during pregnancy. In the control group, we noticed a decrease in IPVA PI and RI, along with an increase in gestational age, while in the PMD group, these indices increased. Both in the 2nd and the 3rd trimester, we had a significant statistical difference between the two groups (p<0.001). Regarding the degree of prediction of the changes that occurred at this level, we found a good statistical correlation. A higher degree of positive predictability is noted, for IPVA-PI, but also for UA-PI, but with better sensitivity (72.27%) for UA PI in the 2nd trimester. Conclusions. We can conclude that both Doppler measurements, IPVA and UA can be used to evaluate and detect pregnancy complications that belong to PMD, preeclampsia, and/or fetal growth restriction. -
Socioeconomic Inequalities in Cancer Incidence: A Comparative Investigation Based on Population of Iranian Provinces
B. AHADINEZHAD; A. MALEKI; M. AMERZADEH; B. MOHTASHAMZADEH; M. SAFDARI; O. KHOSRAVIZADEH2023/03/3110.12865/CHSJ.49.01.09MedicineCancer is the second important cause of death worldwide. Cancer is one of the top health priorities in Iran. We aimed to study the socio-economic inequality of cancer incidence in Iran provinces. We conducted this cross-sectional study using provincial data. We obtained the required data from the statistical yearbook report, the Statistics Center Report and the National Cancer Registration Program Report of Iran’s Ministry of Health and Medical Education (MoHME) for 2018. Socio-economic inequality of cancer incidence was analyzed by estimating the concentration index and extracting the concentration curve. Statistical analyzes were performed using STATA 14. Our findings revealed that cancer incidence was unequally distributed in terms of the socio-economic status in Iranian provinces. Cancer incidence is slightly concentrated in the provinces with higher than average literacy, per capita income and insurance coverage and household size below average. The concentration of cancer incidence has been to the detriment of the provinces that have a slightly better ranking in terms of the socio-economic index. The employment rate did not significantly affect cancer's distribution burden. We recommend policymakers facilitate early cancer detection by providing insurance coverage for screening services, payment exemptions, and public awareness. -
Research on the Influence of MUVON PLUS Treatment Upon the Biomechanical Behavior of the Human Osteoarthritic Knee
D. ILIUA; D. TARNIA; A. PETCU; O. ZLATIAN; O. ROGOVEANU; D. N. TARNIA2023/03/3110.12865/CHSJ.49.01.08MedicineBackground. This study aimed to investigate the effects of MUVON PLUS, a dietary supplement containing hydrolized collagen, chondroitin sulfate, and vitamin C, on the biomechanical behavior of the knee joint in patients with second-degree osteoarthritis (OA). Material and method. The study included 15 participants who underwent biomechanical testing before and after 3 and 6 months of supplement administration. Biometrics and SimiMotion software were used to process and analyze the data. Results showed significant improvements in biomechanical parameters such as joint range of motion, joint torque, and joint stiffness for all patients during the treatment. Improvements were observed across various tests, including horizontal walking, stairs climbing and descending, sitting/standing up from a chair, and knee squats. This improvement in biomechanical performance was also reflected in the patients' reported quality of life. For the stairs climbing test, the maximum flexion-extension angle increased by approximately 7% after 3 months and 12% after 6 months. In the stairs descending test, the maximum flexion-extension angle increased by approximately 8% after 3 months and 19% after 6 months. These results highlight an improvement in mobility for the study participants. Conclusions. Significant improvements of the biomechanical parameters of the knee joint were found in all patients during the treatment with the MUVON PLUS in all tests, which indicates the clear clinical benefit, revealed by improving the quality of life reported by patients. Overall, the study demonstrated the effectiveness of MUVON PLUS in enhancing the biomechanical behavior of the knee joint in patients with OA, providing valuable insights for future research and treatment. -
Evaluation of Early Repolarization Pattern in Children with Mitral Valve Prolapse
M. A. PALANGSARAI; M. MOBINIKHALEDI; E. FARAHANI; F. DORREH; P. YOUSOFICHAIJAN; Y. GHANDI2023/03/3110.12865/CHSJ.49.01.07MedicineBackground: Patients with mitral valve prolapse (MVP) may be prone to ventricular arrhythmias and sudden cardiac death and presence early repolarization pattern (ERP) in electrocardiography may be predict for ventricle arrhythmia. This study aimed to evaluation ERP in Children with MVP. Methods: In a cross-sectional study, we enrolled ERP in 70 MVP children with 70 age-and sex-matched healthy individuals. After echocardiography procedure for confirmation MVP, standard 12-lead electrocardiography recordings with sweeping rate of 25mm/s and an amplitude of 10mV/cm, and two cardiologists assessed who were blinded to the both groups. Result: We detected ERP in 17.14% of MVP patient’s and seen in 8 case (11.43%) in control group, (P=0.23). the ERP occurred in MVP patient’s mild, moderate and severe 4, 6 and 2 cases, (P=0.29). The ERP found in patients with and without chest pain 13 and 7, respectively (P=0.46) and, in patients with and without palpitations 15 and 5 cases, respectively (P=0.24). The ERP occurred 1.6 time more in patient with MVP in comparing with individual without MVP. The ERP occurred more frequently in among patients with moderate MVP in comparing with severe and mild. Chest pain and palpitation occurred more frequently in among patients with severe MVP. Conclusion: The prevalence of ERP in children with MVP has been at a higher-level incidence, especially among patients with complaining from chest pain. We suggested that children with MVP are in need of follow up considering the occurrence of arrhythmias. -
Correlations of Serum Vitamin D Level with Markers of Oxidative Stress and Apoptosis in Liver Cirrhosis
M. M. POMACU; D. M. TRACA; V. PADUREANU; E. C. STANCIULESCU; C. J. BUSUIOC; C. G. PISOSCHI; A. M. BUGA2023/03/3110.12865/CHSJ.49.01.06MedicineIn this study we investigated the relationship between vitamin D and markers of oxidative stress and apoptosis in patients with liver cirrhosis stratified according serum GGT activity. Forty-eight patients with liver cirrhosis of various aetiology were selected, among which 58% cases (n=28) diagnosed with alcoholic liver cirrhosis and 42% (n=20) with cirrhosis after hepatitis virus infection. Each group was divided into three quartiles according GGT activity. 25-hydroxyvitamin D [25-(HO) vit D], markers of oxidative stress (catalase, superoxide dismutase) and apoptosis (M30) were compared. Higher levels of GGT were correlated with elevated AST, ALT and ALP values in both groups. A statistically significant difference was observed when comparing 25-(OH) vit D levels of patients suffering from ethanol-induced liver cirrhosis versus control group for all the quartiles as well as for those from the first quartile of viral-induced liver cirrhosis. For SOD, statistically significant differences were noticed between all cirrhosis subgroups and the control group. CAT values in all cirrhosis subgroups were lower than in control, but significant differences were only between Q2.2 and Q1.3 quartiles and Q2.2 and control. Correlation of 25-(OH) vit D versus SOD yields statistically significant results in ethanol-induced cirrhosis patients. M30 activity was increased in patients with alcoholic cirrhosis compared to controls and those with virus-induced cirrhosis, being correlated with the degree of GGT activity. Our results emphasized that vitamin D deficiency is associated with enhanced liver dysfunction regardless of the trigger responsible for disease onset. Furthermore, vitamin D deficiency augments liver injury by promoting oxidative stress which influence the survival mechanisms of parenchymal liver cells. -
Stress and Prevalence of Musculoskeletal Disorders Among the Nursing Personnel of a Tertiary Hospital Unit in Greece: A Cross-Sectional Study
C. DIMITRIOU; A. ALEGAKIS; I. KARAGEORGIOU; A. E. MANTADAKI; E. K. SYMVOULAKIS2023/03/3110.12865/CHSJ.49.01.05MedicineBackground: Work-related musculoskeletal injuries and disorders (WMSD) are a significant cause of morbidity in the health care sector. Healthcare professionals are routinely exposed to various physical and psychosocial factors that increase the risk of developing a WMSD. Nurses are more susceptible to the manifestation of such disorders. Methods: A cross-sectional study was conducted during the second semester of 2020. The Nordic Questionnaire (NMQ) was used to investigate the prevalence of musculoskeletal symptoms, the Short Anxiety Screening Test (SAST) for stress detection, and a data collection sheet was developed for the registration of clinical, demographic, and anthropometric characteristics of the nursing personnel of the tertiary hospital unit of Heraklion, Crete, Greece. Results: A percentage of 82% of nurses had developed at least one musculoskeletal symptom in the last 12 months. The most common anatomical areas at which symptoms were present the last 12 months were the neck (53.9%), shoulders (50.8%), and the lower back (49.5%). The same areas were also the reported anatomical regions, most affected by musculoskeletal symptoms when stress levels were high. Absence from work was associated with the onset of musculoskeletal symptoms (p<0.001), while nurses’ financial expenses (out-of-pocket payment) appeared to be associated with the onset of any symptom at 12 months, musculoskeletal symptoms limiting everyday activity at 12 months, and current musculoskeletal symptoms (p=0.001, p=0.002, and p=0.002 respectively). Conclusions: Musculoskeletal disorders were common among the nursing personnel. Higher levels of stress were related with a higher prevalence of musculoskeletal symptoms. -
Progress Toward Reversed Uterine Diastolic Flow in the Third Trimester - An Inauspicious Sign
M. DINU; A. D. HODOROG; A. F. CISMARU-STANCIOI; C. L.PATRU; C. A. COMANESCU; S. O. TICA; B. C. ANDREIANA; T. A. BALEANU; S. TUDORACHE2023.03.3110.12865/CHSJ.49.01.04MedicineBackground. Increased uteroplacental resistance is associated with high uterine artery pulsatility and resistance indices and early diastolic notching. Evolution toward reversed diastolic uterine flow in the third trimester was scarcely reported previously. The feature was related to severe complications for both mother and fetus. Material and methods: Data were collected from 3638 pregnancies undergoing prenatal care in our hospital. In this study, we aimed to identify those pregnancies with development of a reversed diastolic flow at the spectral Doppler interrogation of uterine arteries later than 24 weeks of gestation. A secondary aim was to follow up and actively manage these pregnancies. Results: Previously, reversed uterine diastolic flow was reported during the third trimester in four cases only. In our study three pregnancies only developed reversed uterine arteries diastolic flow, none being associated with preeclampsia. All cases evolved with complications at birth. Conclusions: Progressive deterioration of uterine arteries flow is possible during pregnancy. Reversed diastolic flow is a rare occurrence in the third trimester of pregnancy. Based on current knowledge, it may be considered an ominous sign and should trigger a close follow-up. Future studies using routine investigation of uterine arteries flow late in pregnancy may prove informative.
ISSN 2067-0656 (print)
ISSN 2069-4032 (online)
Nr.1/2026
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