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200 papers
Balancing Precision and Practicality: SOFA qSOFA in the Diagnosis and Management of Sepsis.
Diaconu L, Musat F, Ion D … +6 more , Paduraru DN, Bolocan A, Bajenaru OL, Nuta CR, Constantinescu A, Andronic O
Maedica (Bucur) · 2024 Dec · PMID 39974437 · Full text
Sepsis is a complex and multifaceted condition that remains a leading cause of morbidity and mortality worldwide. The sequential organ failure assessment (SOFA) and quick sequential organ failure assessment (qSOFA) score...
Sepsis is a complex and multifaceted condition that remains a leading cause of morbidity and mortality worldwide. The sequential organ failure assessment (SOFA) and quick sequential organ failure assessment (qSOFA) scores are widely used to predict sepsis outcomes, but their utility varies depending on the clinical setting. This narrative review compares the predictive validity, sensitivity and specificity of SOFA and qSOFA, as well as other markers such as serum lactate and SIRS, across different healthcare environments. We conducted a comprehensive literature search of articles published over the last 10 years, focusing on studies that provided full-text access. Our analysis highlights the superior predictive performance of SOFA within intensive care units and the practical advantages of qSOFA in emergency departments. Additionally, this study examines the limitations of these scores and discusses the impact of the 2016 Sepsis-3 definition changes. By synthesizing data from diverse studies, we aimed to provide a thorough understanding of the current landscape of sepsis diagnosis and management, offering insights into how these tools can be optimized to improve patient outcomes.
Fibromas and Infertility. What is the Role of Myomectomy in the Improvement of Fertility?
Nikolettos K, Kotanidou S, Tsikouras P … +6 more , Damaskos C, Garmpis N, Kontomanolis E, Gerede A, Nikolettos N, Daniilidis A
Maedica (Bucur) · 2024 Dec · PMID 39974436 · Full text
INTRODUCTION: Uterine fibroids, also known as myomas, are benign tumors that develop from the smooth muscle cells of the uterus. Fibroids are estimated to occur predominantly in 20% to 40% of women of reproductive age, i...
INTRODUCTION: Uterine fibroids, also known as myomas, are benign tumors that develop from the smooth muscle cells of the uterus. Fibroids are estimated to occur predominantly in 20% to 40% of women of reproductive age, in whom they can cause symptoms like pressure, discomfort and excessive hemorrhage. EVIDENCE ACQUISITION: Precise assessment of fibroid size, number and location is crucial for selecting the appropriate treatment for the patient. Treatment options include medical management, interventional radiology and surgery, depending on the patient's symptoms and fertility desires. EVIDENCE SYNTHESIS: Gynecologists must create personalized plans based on fibroid characteristics and their potential impact on fertility. Hysteroscopic myomectomy has been shown to improve pregnancy rates in certain cases. However, myomectomy is not always recommended for asymptomatic women with fibroids that do not distort the uterine cavity. It may be considered when pelvic anatomy is significantly affected, because it hinders procedures like oocyte retrieval. The relationship between specific number, size and position of myomas (excluding submucosal myomas or intramural myomas that distort the endometrial cavity) with the outcomes of pregnancy has not been verified. CONCLUSION: Considering the lack of current randomized controlled trials (RCTs) investigating the effects of myomectomy, it is advisable to conduct future multicenter prospective studies.
Association of HPV with Oral and Oropharyngeal Cancer: Current Evidence.
Kokkinis E, Bastas NS, Mega I … +2 more , Tsironis C, Lianou AD
Maedica (Bucur) · 2024 Dec · PMID 39974435 · Full text
Oral cancer is a significant worldwide health issue which has an annual incidence of over 377,000 new cases. It was historically associated with tobacco and alcohol use, but recent research has also emphasized the role o...
Oral cancer is a significant worldwide health issue which has an annual incidence of over 377,000 new cases. It was historically associated with tobacco and alcohol use, but recent research has also emphasized the role of human papilloma virus (HPV), specifically types 16 and 18, to the development of oropharyngeal malignancies. Human papilloma virus, a common sexually transmitted infection, impacts approximately 9-13% of the worldwide population. Currently, there have been 202 recognized virus types associated with HPV. HPV-positive oral cancers have different clinical and molecular features compared to HPV-negative ones. The HPV-positive tumors tend to better respond to radiation and chemotherapy treatments. This review compiles findings from an extensive literature search in PubMed and Google Scholar. It highlights the growing occurrence of HPV-positive oropharyngeal malignancies, especially among younger age groups, in different regions of the world. There has been a noticeable increase in the occurrence of these tumors, particularly in Europe and the Middle East. The rates of HPV infection are influenced by factors such as inadequate oral hygiene, sexual habits and gender differences. The research emphasizes the necessity for enhanced diagnostic methods, such as PCR-based assays, and shows the potential advantages of HPV vaccination and public health education in reducing the increasing cancer burden. Conducting additional research is crucial in order to create efficient methods for preventing and treating these conditions.
The Association of Family Function with Anxiety and Depression among Patients Undergoing Hemodialysis: a Cross-Sectional Study in Iran.
Mohammadi R, Varjoshani NJ, Bousari MP … +1 more , Ghahremani Z
Maedica (Bucur) · 2024 Dec · PMID 39974434 · Full text
BACKGROUND: Background: Anxiety and depression are highly prevalent in hemodialysis patients. Social support can help in reducing these disorders. OBJECTIVES: This study is aimed to examine the relationship of family fun...
BACKGROUND: Background: Anxiety and depression are highly prevalent in hemodialysis patients. Social support can help in reducing these disorders. OBJECTIVES: This study is aimed to examine the relationship of family functioning with anxiety and depression in hemodialysis patients. METHODS: The present cross-sectional study was conducted on 199 patients referred to the hemodialysis centers of Zanjan province, Iran, in 2019. Stratified sampling was used. A demographic questionnaire, hospital anxiety and depression questionnaire (HADS) and McMaster family assessment device (FAD) were employed as data collection tools. Data was analyzed using descriptive statistics and Pearson's correlation coefficient test. RESULTS: Of all study participants, 52.3% were males, 76.4% were married and 52.7% were over 60 years old. Patients' family functioning in all dimensions was within the normal range. Among the dimensions of family functioning, problem solving (mean 1.88) was the best dimension and roles (mean 2.36) the weakest one. Patients had a mean anxiety score of 9, which indicated a mild level of the condition, and 60.8% of subjects had different stages of anxiety. The mean score of depression was 9.46, which also revealed a mild level, and 68.8% of subjects had different stages of depression. With the improvement of family functioning, patients' anxiety and depression decreased. CONCLUSIONS: A better family functioning was associated with a lower level of anxiety and depression in the investigated subjects. Therefore, it is recommended to provide educational and counseling services, effective and comprehensive social support from various support systems in the society for improving patients' family function.
How Effective is Ozone Therapy in Treatment of Lumbar Disc Disease: a Systematic Review of Prospective Studies.
Kumar V, Ifthekar S, Raj V … +5 more , Varikasuvu SR, Jain A, Vatkar A, Kandwal P, Barik S
Maedica (Bucur) · 2024 Dec · PMID 39974433 · Full text
OBJECTIVE: With numerous studies reporting on the clinical efficacy of ozone therapy, there has been a growing interest in its use for disc herniation in lumbar disc disease. The aim of this meta-analysis is to explore t...
OBJECTIVE: With numerous studies reporting on the clinical efficacy of ozone therapy, there has been a growing interest in its use for disc herniation in lumbar disc disease. The aim of this meta-analysis is to explore the results of the prospective studies using ozone for the treatment of lumbar disc disease. METHODS: Online electronic databases of PubMed, Embase and Scopus were searched using relevant keywords. This review included prospective studies on the treatment of lumbar disc herniation using ozone therapy. RESULTS: A mean improvement of 4.25 (95% CI 2.93-5.58) in visual analogue scale (VAS) scores was noted. A mean improvement of 20.57 (95% CI 18.47-22.68) in Oswestry disability index (ODI) was noted across the studies on meta-analysis. Meta-regression of the pre-operative and post-operative VAS score did not show any significant association with age at procedure, gender or the level of lumbar disc disease. None of the selected studies reported any minor or major complication. CONCLUSION: Ozone treatment in low back pain associated with herniated disc is an effective therapy and can be considered as a standard treatment in cases which failed for conservative treatment. Ozone therapy is a simple method and can be effectively delivered with minimal adverse effects. However, additional meta-analysis with high quality randomised controls can be done to further strengthen the evidence for this mode of treatment.
The Role of Self-Esteem in the Adherence of Patients with Obstructive Sleep Apnea Syndrome to Continuous Positive Airway Pressure Therapy.
Burcea R, Mihaltan FD
Maedica (Bucur) · 2024 Dec · PMID 39974432 · Full text
INTRODUCTION: Continuous positive airway pressure therapy (CPAP) is the gold standard for the treatment of obstructive sleep apnea syndrome (OSAS). This therapy eliminates daytime sleepiness and prevents cardiovascular c...
INTRODUCTION: Continuous positive airway pressure therapy (CPAP) is the gold standard for the treatment of obstructive sleep apnea syndrome (OSAS). This therapy eliminates daytime sleepiness and prevents cardiovascular complications of OSAS. Given that CPAP is a chronic therapy and that in most cases it must be used for life, good adherence to treatment is essential for the patient to feel its benefits. Psychological factors play an important role in the compliance of OSAS patients with CPAP therapy. Self-esteem (SE) can be defined as a person's positive or negative attitude toward the self in totality. MATERIALS AND METHODS: We conducted a prospective, observational, non-randomized study on an essay of 380 observations with 95 patients. After the evaluation period, based on the average time of CPAP used, the patients were divided into two groups: a first group consisting of 50 patients who were considered adherent to the instituted therapy and a second group comprising 45 patients who were considered non-adherent to the instituted therapy. The aim of this article is to assess the role of self-esteem in the adherence of patients with OSAS to CPAP therapy. Determinants of self-esteem at the beginning of treatment (To) were evaluated. The secondary objectives of the study consisted of investigating the existence of other predictors for the evolution of OSA such as self-esteem and clinical/demographic/paraclinical parameters. RESULTS: In the present study, the adherence of patients with OSAS to CPAP therapy was 52.63%. The self-esteem score was higher in adherent patients than non-adherent ones. The main factors associated with increased self-esteem levels included good adherence to therapy, education, patient income, absence of alcohol and tobacco consumption, absence of nocturnal symptoms, use of Auto-CPAP, use of nasal mask, absence of other pulmonary pathology, absence of psychological type D. CONCLUSIONS: Psychological factors play an important role in the compliance of OSAS patients with CPAP therapy. Along with other factors, self-esteem may be one of the predictive factors for patients' adherence to CPAP therapy.
Advantage of Amnion Dressing (Biological Dressing) + Silver Sulfadiazine Cream Standard Silver Sulfadiazine Cream Dressings in Acute Deep Second-Degree and Third-Degree Burn Wounds: a Single Center Experience.
Khodadad N, Hoseininejad SS, Nazeri A
Maedica (Bucur) · 2024 Dec · PMID 39974431 · Full text
INTRODUCTION: This study compared the benefits of amnion dressing (biological dressing) + silver sulfadiazine cream with standard silver sulfadiazine cream dressings in treating deep second- and third-degree acute burn w...
INTRODUCTION: This study compared the benefits of amnion dressing (biological dressing) + silver sulfadiazine cream with standard silver sulfadiazine cream dressings in treating deep second- and third-degree acute burn wounds. METHODS: This prospective clinical trial was conducted on 50 patients with deep second- and third-degree burns who were admitted to Taleghani Hospital in Ahvaz, Iran. Participants were divided into two groups: the first one comprised subjects who received silver-amnion biological dressing (silver sulfadiazine 1%) and the second group consisted of patients treated with standard silver sulfadiazine cream dressings. RESULTS: In the amnion-silver group, the average time required for graft readiness was eight days, compared to 11 days in the standard dressing group, which indicated a 27% reduction in recovery time. The treatment costs in the amnion-silver group were 20.8 Euro compared to 26.3 Euro for the standard dressing group, reflecting a 21% cost reduction. Narcotic consumption in the amnion-silver group was zero, but the average narcotic use in the standard dressing group was 50 mg of pethidine, revealing a 100% reduction. Based on the visual analog scale (VAS), the mean pain intensity was 4 in the amnion-silver group and 5.5 in the standard dressing group. Patient satisfaction was 85% in the amnion-silver group versus 60% in the standard dressing group. No infections were reported in the amnion-silver group, while three cases were observed in the standard dressing group. CONCLUSION: The results of the present study indicate that amnion-silver dressing can be an effective and economical treatment option for wound healing. In the amnion-silver group versus standard group, a considerable reduction in recovery time was observed, which was also reflecting a cost reduction. Furthermore, the mean pain intensity was lower in the amnion-silver group than the standard dressing group. Patient satisfaction was higher in the amnion-silver group.
Anxiety and Depression in Non-Small Cell Lung Cancer Patients Receiving Chemotherapy Compared to Those Receiving Immunotherapy.
Stylianou C, Konstantinidis T, Kalemikerakis I … +5 more , Papageorgiou DK, Kafazi A, Prapa P, Alevizopoulos N, Govina O
Maedica (Bucur) · 2024 Sep · PMID 39553374 · Full text
BACKGROUND: Non-small cell lung cancer (NSCLC) presents with a range of symptoms and is associated with a poor prognosis. Although both immunotherapy and chemotherapy improve survival, they are still associated with psyc...
BACKGROUND: Non-small cell lung cancer (NSCLC) presents with a range of symptoms and is associated with a poor prognosis. Although both immunotherapy and chemotherapy improve survival, they are still associated with psychological disorders due to the reduced quality of life. This study aimed to investigate the levels of anxiety and depression in Greek patients with NSCLC receiving second-line chemotherapy compared to second-line immunotherapy. MATERIALS AND METHODS: This is a comparative, prospective, non-randomized follow-up study in which measurement scales have been used to compare data from NSCLC patients in two hospitals in Athens, Greece. All patients completed a demographic data form in the first therapy cycle, while the hospital anxiety and depression scale (HADS) (value range 0-21) was completed from treatment cycle 1 to treatment cycle 6. RESULTS: Of the 111 selected patients, the majority (75.7%) were men, with a mean age of 66.5±9.2 years. Second-line chemotherapy was received by 61 patients and second-line immunotherapy by 50 patients. According to HADS, from treatment cycle 1 to treatment cycle 6, the mean anxiety score decreased from 4.83±5.1 to 3.2±3.8 (p=0.287), while the mean depression score decreased from 5.64±5.53 to 4.61±4.75 (p=0.113). Depressive symptoms were statistically significantly higher in patients who received chemotherapy from the fourth cycle onwards (p<0.05), but in any of the study groups, the value did not exceed the critical threshold of seven points. In the anxiety subscale, after cycle 3 there was a significant decrease (p=0.014) of a similar degree (p=0.608) in both groups. CONCLUSIONS: The present study was the first attempt to investigate differences in psychological symptoms between treatment groups in Greek NSCLC patients. Anxiety and depression levels did not appear to be serious problems in the chemotherapy and immunotherapy group of patients.
An Evaluation of Cognitive Abilities in Vestibular Disorders.
Madhusudhan U, Hage N, Kalpana M … +7 more , Vidya G, Gaur A, Singaravelu V, Pyati A, Nitin AJ, Taranikanti M, Patil P
Maedica (Bucur) · 2024 Sep · PMID 39553373 · Full text
BACKGROUND: Research evidence suggests the role of the vestibular system in cognitive functions like visuospatial memory, objective memory, spatial navigation, etc. Vestibular cortices send projection to the hippocampus...
BACKGROUND: Research evidence suggests the role of the vestibular system in cognitive functions like visuospatial memory, objective memory, spatial navigation, etc. Vestibular cortices send projection to the hippocampus and to the medial entorhinal cortex (MEC); the latter houses place cells, grid cells, and head direction cells, which play a major role in the formation of a cognitive map based on inputs from the vestibular apparatus. So, the present study aimed to assess cognitive functions in vestibular disorder patients. MATERIALS AND METHODS: All patients with vestibular disorders were included after bedside tests like the Dix Hallpike test, head impulse test, Romberg test on foam with eyes closed/the clinical test of sensory interaction and balance (CTSIB) and timed up and go test. After that, a dizziness handicap inventory (DHI) was used to assess the severity of the vestibular dysfunction. Patients with diagnosed neurological disorders were excluded from the study. Cognitive function assessment was done using the trail making test (TMT) and the digit symbol substitution test (DSST). The assessment results were correlated with the severity of the vestibular dysfunction using Pearson correlation. RESULTS AND DISCUSSIONS: Out of a total of 40 patients, 26 (62.5%) were males and 14 (37.5%) females. The results of TMT part A and part B were 86.14±11.00 and 247.07±39.0, respectively, in mild handicap score patients, and 102.7±10.69 and 290.0±10.35 in moderate handicap score patients, which was significantly (p<0.05) higher when compared to mild handicap patients. Even DSST scores in moderately handicapped subjects were significantly (p<0.05) lower than those with a mild handicap. CONCLUSION: Patients with vestibular dysfunction have significant cognitive decline, and cognition is decreasing with the severity of the vestibular dysfunction.
Ten Years After.
PhD MCM
Maedica (Bucur) · 2024 Sep · PMID 39553372 · Full text
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The Incidence of Myocardial Infarction after Vaccination against COVID-19: a Meta-Analysis and Systematic Review.
Sadatnaseri A, Ghoshouni H, Razavi SZE … +6 more , Mirmosayyeb O, Azadvari M, Hosseini M, Guitynavard F, Ghajarzadeh M, Pourshams M
Maedica (Bucur) · 2024 Sep · PMID 39553371 · Full text
BACKGROUND: Vaccines were developed to stop the pandemic stage of COVID-19. A wide range of adverse effects, including vascular complications, has been reported after vaccination. Up to now, various studies have reported...
BACKGROUND: Vaccines were developed to stop the pandemic stage of COVID-19. A wide range of adverse effects, including vascular complications, has been reported after vaccination. Up to now, various studies have reported different rates of myocardial infarction (MI) after COVID-19 vaccination. So, this meta-analysis and systematic review study was designed to estimate the pooled incidence of MI after COVID-19. METHODS: Two experienced researchers conducted searches in various databases and sources such as EMBASE, Scopus, Web of Science, Google Scholar, PubMed and gray literature, including references from studies published before March 2023. They collected information on participant count, the number of individuals who experienced MI after vaccination, average age, vaccine type, primary author, publication year and country of origin. RESULTS: A total of 385 articles were revealed by a literature search, and for further evaluation, 248 studies remained after removing duplicates. Seven articles remained for meta-analysis. Three studies provided the number of controls and the incidence of MI in both vaccinated and non-vaccinated groups. The incidence of MI after COVID-19 vaccines was ignorable (0%, I=99%, P<0.001). After COVID-19 vaccines, the odds of MI were 0.99 (95% CI 0.84-1.18) (I=0, p=0.9). CONCLUSION: As shown by the results of the present meta-analysis and systematic review, the incidence of MI after COVID-19 vaccination can be ignorable and the risk was not increased by vaccination.
Chronic Cough: a Symptom between Pulmonary and Psychogenic Disease. A Case of Misdiagnosed Endobronchial Hamartoma.
Patsouras A, Patsouras M, Garmpis N … +7 more , Garmpi A, Diamantis E, Farmaki P, Kyriakos G, Savvanis S, Gravvanis N, Damaskos C
Maedica (Bucur) · 2024 Sep · PMID 39553370 · Full text
Endobronchial hamartoma is a benign mesenchymal tumor. It contains fat, cartilage and even bone tissue. It can be asymptomatic or cause respiratory symptoms such as cough and pneumonias. We report a case of a 68-year-old...
Endobronchial hamartoma is a benign mesenchymal tumor. It contains fat, cartilage and even bone tissue. It can be asymptomatic or cause respiratory symptoms such as cough and pneumonias. We report a case of a 68-year-old male who suffered from cough for the last four years. During this period of time, he was treated with different therapeutic approaches, including antibiotics, inhaled corticosteroids, pregabaline and bronchodilators, without clinical improvement. Allergic and gastrointestinal diseases were excluded. Pulmonary function tests were all normal. His symptoms had been attributed to anxiety disorder as psychogenic cough. However, a chest computed tomography (CT) was never conducted. Chest CT and bronchoscopy revealed an endobronchial hamartoma. Its endoscopical removal led to impressive remission of symptoms.
Is There a Place for Robotic Inguinal Hernia Repair in the Realm of Laparoscopic and Open Inguinal Hernia Repair? A Narrative Review.
Ungureanu CO, Stanculea F, Ginghina O … +2 more , Ene C, Iordache N
Maedica (Bucur) · 2024 Sep · PMID 39553369 · Full text
Robotic hernia repair is gaining popularity among general surgeons and has potential benefits; however, there are also several issues, of which the one related to increased cost compared to other procedures is the most i...
Robotic hernia repair is gaining popularity among general surgeons and has potential benefits; however, there are also several issues, of which the one related to increased cost compared to other procedures is the most important one. Integrating a robotic platform in the hernia territory is a difficult task, and this review attempts to analyze the various implications of using robotic assistance in inguinal hernias. From a hernia surgeon's perspective, each new addition to hernia procedures is important; therefore, we encompass the advantages and drawbacks of this technology. The final point is obviously improving hernia surgery and quality of life in our patients.
Papillary Thyroid Carcinoma within a Second Branchial Cleft Cyst. A Diagnostic and Treatment Challenge.
Skalias A, Garefis K, Tsetsos N … +1 more , Goudakos J
Maedica (Bucur) · 2024 Sep · PMID 39553368 · Full text
INTRODUCTION: Lateral cervical cystic masses are a relatively common occurrence in the otolaryngology practice, which are often attributed to second branchial cleft cysts. However, there should always be a high suspicion...
INTRODUCTION: Lateral cervical cystic masses are a relatively common occurrence in the otolaryngology practice, which are often attributed to second branchial cleft cysts. However, there should always be a high suspicion for malignancy until proven otherwise. CASE PRESENTATION: We present a clinical report of a lateral cervical cyst surgical excision where histopathological examination has revealed features of a branchial cleft cyst harboring a papillary thyroid carcinoma. This led to the clinically latent thyroid primary which was treated through thyroidectomy with selective neck dissection and radioactive iodine therapy. DISCUSSION: Across current literature regarding thyroid carcinomas arising within branchial cysts, primary thyroid carcinoma was identified in almost half the cases where thyroidectomy was performed. There is no established consensus on the decision of whether to perform a thyroidectomy in such cases, due to the paucity of data for similar cases. CONCLUSION: Although branchial cyst is a benign condition, it can harbor malignancy. When thyroid carcinoma occurs within such a cyst, without solid evidence of a thyroid primary, treating physicians are presented with a diagnostic and treatment dilemma. As more cases are discovered and reported, navigating this challenging dilemma will become clearer for the treating physicians.
Mixed Germ Cell Tumor (GCT) of Ovary with Atypical Presentation.
Jhirwal M, Trivedi S, Shekhar S … +1 more , Sharma C
Maedica (Bucur) · 2024 Sep · PMID 39553367 · Full text
OBJECTIVE: Ovarian carcinomas are considered one of the deadliest malignancies, accounting for a significant number of cancer-related deaths than any other gynecological malignancy. Advanced stage at diagnosis can be att...
OBJECTIVE: Ovarian carcinomas are considered one of the deadliest malignancies, accounting for a significant number of cancer-related deaths than any other gynecological malignancy. Advanced stage at diagnosis can be attributed to vague presenting symptoms, rarely bizarre, which usually point towards any disease but ovarian tumour. Here, we discuss a similar case, with presentations that compel us to think in favor of disseminated Koch's, but turns out to be germ cell tumor (GCT) of the ovary; thereby pointing at the wide spectrum of bizarre signs and symptoms which should have ovarian malignancies as a differential during workup. CASE REPORT: A 21-year-old unmarried female came to our gynecology outpatient department with complaints of pain lower abdomen, high-grade fever, shortness of breath, and progressively increasing abdominal distension. After routine hematological and imaging workup, she was diagnosed with an ovarian tumour with ascites and bilateral pleural effusion. Fertility-sparing surgery was done after the patient was hemodynamically stable. The histopathology report was suggestive of mixed GCT. The patient was thereby referred to the department of medical oncology for adjuvant chemotherapy. CONCLUSION: Mixed GCTs are among the rare and inordinately malignant tumours of the ovary. Though they have their usual presentations, we ought to be heedful of their atypical presentations as well because these form grounds for early diagnosis and management. In our patients, the unusual feature was the high-grade fever with associated shortness of breath (due to pleural effusion), but the effusion was non-malignant and non-infectious in origin. In the literature, there are not many cases of atypical clinical presentation; hence, this could be an area of further research. Besides, such case reports with bizarre manifestations widen our spectrum of diagnostic probabilities, thereby avoiding any gaps in management. Our workup should be comprehensive enough to diagnose the patient as early as possible because these tumors, though aggressive, have a very good prognosis due to excellent chemosensitivity.
The Importance of Elastography in the Early Diagnosis of Highly Differentiated Parotid Tumors: a Case-Report.
Lianou AD, Basiari L, Malisovas T … +2 more , Koutsikou C, Psychogios G
Maedica (Bucur) · 2024 Sep · PMID 39553366 · Full text
It is indisputable that high-resolution ultrasound (US) is the diagnostic gold standard for the evaluation of superficial parotid gland diseases. It is a dynamic, quick, simple, easily available, cost-effective, noninvas...
It is indisputable that high-resolution ultrasound (US) is the diagnostic gold standard for the evaluation of superficial parotid gland diseases. It is a dynamic, quick, simple, easily available, cost-effective, noninvasive procedure, with absence of ionizing radiation examination that can be performed safely and in special categories of patients such as pregnant women and children. It is widely accepted that on US, benign tumors have clear, smooth and well-defined borders, homogeneous hypoechoic parenchyma and a defined distribution of vessels. On the other hand, malignant lesions usually have unclear borders; also, they are inhomogeneous and sometimes can have areas of necrosis, increased hypoechogenicity and diffuse vascularization. However, many times these findings are not decisive due to the overlap that often occurs in parotid tumors. Shear wave elastography (SWE) represents a new imaging technique that provides additional information about tissue elasticity and stiffness in a selected region of interest. Since malignant tissues show greater stiffness than benign ones, sonoelastography is used to assist differential diagnosis between malignant and benign lesions. In many other organs, such as breast, thyroid, prostate and liver, it has been already successfully used for the differential diagnosis between malignant and benign lesions. The present article highlights the role of elastography in the diagnosis of a small malignant tumor in the left parotid gland of a 73-year-old female patient.
Impact of Peripheral Arterial Disease on Outcomes of Acute Coronary Syndrome.
Gherasie FA, Popescu MR, Bartos D
Maedica (Bucur) · 2024 Sep · PMID 39553365 · Full text
BACKGROUND: Peripheral artery disease (PAD) refers to the extracardiac localization of atherosclerotic disease, generally in arteries that vascularize the lower limbs. More than 50% of patients with PAD also have coronar...
BACKGROUND: Peripheral artery disease (PAD) refers to the extracardiac localization of atherosclerotic disease, generally in arteries that vascularize the lower limbs. More than 50% of patients with PAD also have coronary artery disease (CAD). There are concerns about possible differences in mortality rates among hospitalized patients and the need for immediate revascularization during hospital stay across different types of acute coronary syndrome (ACS) when PAD is present. METHODS: This was a retrospective study that included 100 patients admitted with ACS between October 2019 and May 2022. Participants were divided into two groups: those with ACS and PAD (n=32) and those without PAD (n=68). We used the SYNTAX score to evaluate the severity of coronary artery disease, the amount of contrast and dose area product (DAP) dosage per patient during the procedure and how these factors vary. RESULTS: There was a 6.8 higher average SYNTAX score among patients with ACS and PAD (p=0.034), which could negatively affect their prognosis. In addition, there was a 12.7-point increase in the SYNTAX score for patients with non-ST-segment elevation acute coronary syndrome (NSTEACS) and PAD (p=0.008). Patients with ACS and concomitant PAD were more likely to require complete revascularization of the left main disease. CONCLUSION: Patients with PAD and concomitant ACS have more severe CAD, with more frequent involvement of the left main artery than those without PAD.
Psychoemotional and Financial Impact on Infertile Women in a Romanian Population.
Popescu CD, Sima RM, Balalau DO … +3 more , Amza M, Bogheanu D, Ples L
Maedica (Bucur) · 2024 Sep · PMID 39553364 · Full text
OBJECTIVES: The diagnosis of infertility affects between 8-12% of couples of childbearing age worldwide. It is difficult to manage infertility, which often generates anxiety and depression. MATERIAL AND METHODS: We condu...
OBJECTIVES: The diagnosis of infertility affects between 8-12% of couples of childbearing age worldwide. It is difficult to manage infertility, which often generates anxiety and depression. MATERIAL AND METHODS: We conducted a study that included women of childbearing age who were unsuccessful in getting pregnant. Our research was based on a questionnaire distributed online via social media and it was carried out over a period of two months. The questionnaire comprised 35 questions and intended to highlight the psychological impact of infertility diagnosis on the female participants in the present study. RESULTS: A total of 486 women with a diagnosis of infertility responded to the online questionnaire. Subjects had an average age between 31 and 40 years (58.4%) and most of them (80.2%) came from urban areas. It was found that 38.1% of patients experienced a very high level of stress generated by their infertility diagnosis and 54.7% stated that their greatest fear was that they would never get pregnant; 41.4% of these patients claimed that their quality of life was affected and 31.7% indicated a negative impact even on their couple life. Of all participants to the questionnaire, 96.6% stated that the costs of treatments or even assisted reproduction procedures were an additional stress and 73.7% believed that religion played an important moral role. CONCLUSIONS: The women who were enrolled in the current study recognized the negative impact of their infertility diagnosis on both themselves and their couple's lives. At the same time, they believed in Divine help and looked optimistically to the future in terms of achieving pregnancy.
NF-kB p65 and NF-kB p50 of the Rel Family. A Comparison between Irritable Bowel Syndrome and Inflammatory Bowel Disease Patients.
Papadatos SS, Mitselou A, Lampri E … +5 more , Varouktsi A, Grammeniatis V, Klaroudas A, Katsanos K, Galani V
Maedica (Bucur) · 2024 Sep · PMID 39553363 · Full text
BACKGROUND/AIM: This study aims to explore the role of NF-kB p65/p50 expression in patients with inflammatory bowel disease (IBD), those with irritable bowel syndrome (IBS) and normal controls. PATIENTS AND METHODS: Twen...
BACKGROUND/AIM: This study aims to explore the role of NF-kB p65/p50 expression in patients with inflammatory bowel disease (IBD), those with irritable bowel syndrome (IBS) and normal controls. PATIENTS AND METHODS: Twenty patients with IBS, 19 subjects with IBD and 18 normal controls, who underwent colonoscopy, provided us with biopsies from the terminal ileum, cecum and rectum. Patients with IBS were categorized according to bowel habits. Two polyclonal antibodies, alpha-p65 rabbit Ab and alpha-p50 rabbit Ab, were applied for immunohistochemical examination. RESULTS: It was found that in patients with IBD, the expression of intensity and distribution of NF-kB p65/p50 were lower than in IBS patients and normal controls (p>0.05), but the NF-kB p65/p50 ratio was elevated (p>0.05). The NF-kB p65/p50 ratio was lower than in IBD patients and rather similar to normal controls. The distribution of NF-kB p65 as well as the distribution and intensity of NF-kB p50 expression were higher in IBS patients with predominant diarrhea, and the difference was statistically significant in the cecum epithelium. The NF-kB p65/p50 expression ratio was higher in IBS patients with predominant diarrhea, but statistical significance was documented only in cecum epithelium specimens. CONCLUSION: The NF-kB p65/p50 ratio offers more significant information than each subunit. The increased expression of NF-kB p50 in IBS patients compared to IBD subjects or controls seems to be an early event in the process of inflammation. The similar pattern of NF-kB p65/p50 expression in IBS patients with predominant diarrhea and IBD patients may suggest possible common pathogenetic pathways.
Considerations on Image Preprocessing Techniques Required by Deep Learning Models. The Case of the Knee MRIs.
Botnari A, Kadar M, Patrascu JM
Maedica (Bucur) · 2024 Sep · PMID 39553362 · Full text
OBJECTIVES: This study aims to demonstrate the preprocessing steps for knee MRI images to detect meniscal lesions using deep learning models and highlight their practical implications in diagnosing knee conditions, espec...
OBJECTIVES: This study aims to demonstrate the preprocessing steps for knee MRI images to detect meniscal lesions using deep learning models and highlight their practical implications in diagnosing knee conditions, especially meniscal injuries, often caused by degeneration or trauma. Magnetic resonance imaging (MRI) is key in this field, especially when combined with ligament evaluations, and our research underscores the relevance and applicability of these techniques in real-world scenarios. Importantly, our findings suggest a promising future for the diagnosis of knee conditions. MATERIALS AND METHODS: We initially worked with DICOM-format images, the standard for medical imaging, utilizing the Python packages PyDicom and SimpleITK for preprocessing. We also addressed the NIfTI format commonly used in research. Our preprocessing methods, designed with efficiency in mind, encompassed modality-specific adjustments, orientation, spatial resampling, intensity normalization, standardization and conversion to algorithm input format. These steps ensure efficient data handling, accelerate training speeds, and reassure the audience about the effectiveness of our research. RESULTS: Our study processed PD-sagittal images from 188 patients to create a test set for training a deep learning segmentation model. We successfully completed all preprocessing steps, including accessing DICOM header information using hexadecimal encoded identifiers and utilizing SimpleITK for efficient handling of both 2D and 3D DICOM data. Resampling was performed for all 188 sets. Additionally, manual segmentation was conducted on 188 MRI scans, focusing on regions of interest (ROIs), such as normal tissue and meniscus tears in both the medial and lateral menisci. This involved contrast adjustment and precise hand-tracing of the structures within the ROIs, demonstrating the effectiveness and potential of our research in diagnosing knee conditions, and offering hope for the future of knee MRI diagnosis. CONCLUSIONS: Our study introduces innovative preprocessing methods that have the potential to advance the field. By enhancing researchers' understanding of the importance of preprocessing steps, we anticipate that our techniques will streamline the preparation of standardized formats for deep learning model training and significantly benefit radiologists and orthopedic surgeons. These techniques could reduce time and effort in tasks like meniscal tear segmentation or localization, inspiring hope for more efficient and effective achievements in the field.
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