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200 papers
Echocardiographic Assessment of Right Ventricular Systolic Function in Patients with Myocardial Infarction: Methods and Clinical Implications.
Bratu V, Copciag R, Vinereanu D
Maedica (Bucur) · 2025 Dec · PMID 41537083 · Full text
Myocardial infarction (MI) remains one of the leading causes of death worldwide. Currently, echocardiographic assessment focuses mainly on the function of the left ventricle, whereas the right ventricle is frequently ove...
Myocardial infarction (MI) remains one of the leading causes of death worldwide. Currently, echocardiographic assessment focuses mainly on the function of the left ventricle, whereas the right ventricle is frequently overseen. This review aims to provide an overview of the current knowledge regarding right ventricular involvement in MI, as this is frequent, and carries prognostic significance. We also describe the currently available echocardiographic methods for RV systolic function assessment, including newer speckle tracking and 3D echocardiographic parameters, as well as their use in clinical practice, related to patient risk stratification and acute management.
The Role of Laparoscopic Surgery in Gynecological Congenital Anomalies.
Tlais M, Khalil LM, Haddad K … +9 more , Obeid N, El Fawal K, Hawi J, Nasreddine AS, El Hachem C, Seifeddine G, Bou Rizk R, Fassih I, Fakih G
Maedica (Bucur) · 2025 Dec · PMID 41537082 · Full text
BACKGROUND: Müllerian duct anomalies (MDAs) comprise a heterogeneous group of congenital malformations of the uterus, cervix and vagina that can impair menstruation, sexual function and fertility. Over the past three dec...
BACKGROUND: Müllerian duct anomalies (MDAs) comprise a heterogeneous group of congenital malformations of the uterus, cervix and vagina that can impair menstruation, sexual function and fertility. Over the past three decades, minimally invasive techniques have largely replaced laparotomy for their surgical management; yet, data remain fragmented across small series and diverse anomaly types. OBJECTIVE: To synthesize contemporary evidence on laparoscopic and robotic management of MDAs, highlighting indications, key surgical techniques and reproductive and functional outcomes, while addressing psychosocial and ethical considerations. METHODS: A comprehensive narrative review was conducted in PubMed, Scopus and Google Scholar (January 1995-June 2024) using predefined Boolean combinations for specific anomalies and minimally invasive procedures. We included English-language, peer-reviewed clinical studies and sizable case series (n ≥ 3) reporting laparoscopic, laparoscopic-assisted, or robotic management of congenital uterine, cervical, or vaginal anomalies. The review was designed and reported in accordance with SANRA guidelines for narrative reviews. RESULTS: Laparoscopy has become central to the management of fusion and obstructive anomalies. Laparoscopic Strassman metroplasty in selected bicornuate uteri and laparoscopic excision of rudimentary horns in unicornuate uteri achieve high rates of symptom relief, reduction in miscarriage risk, and subsequent term pregnancies, with fewer adhesions than open surgery. In uterus didelphys and obstructed hemivagina and ipsilateral renal anomaly (OHVIRA), combined vaginal and laparoscopic approaches effectively relieve obstruction while preserving the functional uterus. For vaginal agenesis in Mayer-Rokitansky-Küster-Hauser syndrome, laparoscopic Vecchietti, Davydov and sigmoid vaginoplasties consistently provide anatomically adequate neovaginas and satisfactory sexual function. Robotic assistance facilitates complex suturing in selected reconstructions, but clear superiority over conventional laparoscopy has not been demonstrated. CONCLUSIONS: Minimally invasive surgery has transformed the management of MDAs by enabling effective correction of complex malformations with reduced morbidity and favorable reproductive and functional outcomes in appropriately selected patients. However, the evidence base is dominated by observational studies from specialized centers, with limited standardized reporting of fertility and psychosexual endpoints. Future multicenter, prospective research integrating uniform classification, core outcome sets and long-term psychosocial follow-up is needed to refine patient selection and optimize care pathways.
Systolic, Diastolic. Is Anyone Worse?
Cinteza M
Maedica (Bucur) · 2025 Dec · PMID 41537081 · Full text
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Pancreaticojejunostomy Versus Pancreaticogastrostomy for the Prevention of Postoperative Pancreatic Fistula Following Pancreaticoduodenectomy: a Comprehensive Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Coco D, Leanza S
Maedica (Bucur) · 2025 Dec · PMID 41537080 · Full text
BACKGROUND: Pancreaticoduodenectomy (PD) is the primary curative procedure for malignancies of the pancreatic head and periampullary region. The critical step of reconstructing the pancreatic stump is most commonly perfo...
BACKGROUND: Pancreaticoduodenectomy (PD) is the primary curative procedure for malignancies of the pancreatic head and periampullary region. The critical step of reconstructing the pancreatic stump is most commonly performed via pancreaticojejunostomy (PJ) or pancreaticogastrostomy (PG). Postoperative pancreatic fistula (POPF) remains the most formidable complication, which drives significant morbidity and mortality. The ongoing debate regarding the optimal reconstruction technique lacks a definitive evidence-based consensus. OBJECTIVE: To conduct a rigorous systematic review and meta-analysis comparing the efficacy and safety of PG versus PJ in preventing POPF and other critical postoperative outcomes in patients undergoing PD. METHODS: We systematically searched major electronic databases (CENTRAL, MEDLINE, Embase, CINAHL) and clinical trial registries up to September 2016 for all relevant randomized controlled trials (RCTs). Our primary outcomes were the incidence of POPF (any grade, A-C), clinically significant POPF (grades B & C) and 90-day postoperative mortality. Secondary outcomes encompassed length of hospital stay, re-intervention rates, overall surgical complications, postoperative bleeding, intra-abdominal abscess, quality of life and cost-analysis. Methodological quality was appraised using the Cochrane Risk of Bias tool and the certainty of evidence was graded using the GRADE framework. RESULTS: Our analysis incorporated 10 RCTs with a pooled cohort of 1,629 participants. The meta-analysis demonstrated no statistically significant difference in the overall incidence of POPF between PJ and PG (24.3% vs. 21.4%; RR 1.19, 95% CI 0.88 to 1.62; low-quality evidence). The evidence for clinically significant POPF was highly uncertain (19.3% vs. 12.8%; RR 1.51, 95% CI 0.92 to 2.47; very low-quality evidence). A comparable postoperative mortality between groups was found (3.9% vs. 4.8%; RR 0.84, 95% CI 0.53 to 1.34; moderate-quality evidence). A notable trade-off was observed: PJ was associated with a significantly lower risk of postoperative bleeding (9.3% vs. 13.8%; RR 0.69, 95% CI 0.51 to 0.93) but a significantly higher risk of intra-abdominal abscess (14.7% vs. 8.0%; RR 1.77, 95% CI 1.11 to 2.81). No significant differences for other secondary outcomes were detected. CONCLUSION: The current body of evidence does not establish the superiority of either PJ or PG for pancreatic reconstruction following PD. The choice of technique should be individualized, relying on surgeon expertise and specific patient- and pancreas-related factors, while weighing the distinct risk profiles of each procedure (bleeding vs. abscess).
Diagnostic Accuracy of Breast Ultrasonography Parameters in Idiopathic Granulomatous Mastitis Patients: a Cross-Sectional Study.
Yazdipour N, Motamedfar A, Gharibvand MM … +2 more , Fazelinezhad Z, Farhadi E
Maedica (Bucur) · 2025 Dec · PMID 41537079 · Full text
BACKGROUND: Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast condition. Accurate diagnosis is crucial for effective management. The present study aimed to evaluate the diagnostic accuracy of breast u...
BACKGROUND: Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast condition. Accurate diagnosis is crucial for effective management. The present study aimed to evaluate the diagnostic accuracy of breast ultrasonography (US) parameters in IGM patients. METHODS: This cross-sectional study enrolled patients with IGM. Patients were first assessed by their pathology as a reference test, immediately followed by the breast US as an index test. The binary data of breast US parameters (parenchymal heterogeneity, irregular lesion border, axillary lymphadenopathy, fistula, hyperkeratosis and well-defined heterogeneous lesion) was assessed and reported with diagnostic parameters. RESULTS: Finally, 140 patients were enrolled in this study. Key US parameters for diagnostic accuracy were identified: irregular lesion border (sensitivity: 81.8%, specificity: 62.5%), fistula (predicitive positive value: 100%) and hyperkeratosis (predicitive positive value: 100%). Axillary lymphadenopathy and parenchymal Heterogeneity showed lower diagnostic value. The optimal ultrasound score cut-point was 1.5, with a Youden index of 0.81, sensitivity of 0.81, and specificity of 1.00. The area under the ROC curve was 0.95. CONCLUSION: This study highlights the importance of specific US parameters in diagnosing IGM, providing valuable insights for clinicians and radiologists.
Validity and Reliability of the Persian Version of Fatigue Scale for Motor and Cognitive Functions (FSMC) in Patients with Multiple Sclerosis (MS).
Naser Moghadasi A, Hamtaei Ghashti S, Nourbakhsh B … +1 more , Ghajarzadeh M
Maedica (Bucur) · 2025 Dec · PMID 41537078 · Full text
BACKGROUND: Fatigue is one of the most common symptoms in patients with multiple sclerosis (MS), and the cognitive aspect of fatigue is not fully evaluated in these patients. After reviewing existing questionnaires and n...
BACKGROUND: Fatigue is one of the most common symptoms in patients with multiple sclerosis (MS), and the cognitive aspect of fatigue is not fully evaluated in these patients. After reviewing existing questionnaires and noting that the fatigue scale for motor and cognitive functions (FSMC) questionnaire has not been validated in Persian, we designed this study to assess the validity and reliability of the Persian version of the FSMC questionnaire in patients with MS. METHODS: One hundred and forty patients and 63 healthy participants who met the inclusion criteria for healthy controls (age-matched with cases, no history of neurological or psychiatric disorders and not taking anti-depressant medications in the past three months) were enrolled in the present study. Both groups completed the FSMC questionnaire, while the patient group was asked to fill out the valid and reliable Persian version of the modified fatigue impact scale (MFIS), fatigue severity scale (FSS) and Beck depression inventory (BDI). Internal consistencies, content, convergent and discriminant validities were evaluated. We considered the MFIS score as the comparator with a cut-off value of 33 to dichotomize fatigued and non-fatigued individuals, then we plotted the ROC curves of total FSMC, cognitive and motor sub-scales to estimate the best cut-off value of FSMC. RESULTS: The Cronbach's alpha for the total FSMC was calculated as 0.95, for the FSMC cognitive subscale as 0.92, and the motor subscale as 0.94. The ICC for the motor subscale was 0.962, and for the cognitive subscale was 0.963. Content validity index (CVI) and content validity ratio (CVR) for all questions of FSMC questionnaire were 100% (content validity). There were significant positive correlations between FSMC and its subscales with MFIS, FSS, BDI and expanded disability status scale (EDSS) (convergent validity). The FSMC score and its subscales were significantly different between patients and healthy individuals (discriminant validity). CONCLUSION: The Persian version of FSMC provides a valid and reliable tool for evaluating motor and cognitive aspects of MS fatigue, which could be applied in clinical practice and research purposes.
Breastfeeding Practices and Psychological Experiences of Romanian Mothers with SARS-CoV-2 Infection.
Cigaran RG, Peltecu G, Botezatu R … +1 more , Gica N
Maedica (Bucur) · 2025 Dec · PMID 41537077 · Full text
BACKGROUND: SARS-CoV-2 infection posed multiple challenges for breastfeeding women. We intended to examine the impact of maternal coronavirus disease (COVID-19) on breastfeeding experiences and continuation. The aim was...
BACKGROUND: SARS-CoV-2 infection posed multiple challenges for breastfeeding women. We intended to examine the impact of maternal coronavirus disease (COVID-19) on breastfeeding experiences and continuation. The aim was to generate insights that could inform strategies to support mothers in managing stress during illness and to promote positive breastfeeding outcomes. METHODS: Our survey recruited 120 Romanian breastfeeding women who contracted SARS-CoV-2 infection using a 46-item questionnaire. It was disseminated through Facebook, Instagram, obstetrics-related online communities and medical networks. We included questions which addressed demographic characteristics, breastfeeding practices, SARS-CoV-2 infection during lactation, related concerns and perceptions of the pandemic and disease period. Study participants were split into groups based on their symptomatology - mild or moderate COVID-19. RESULTS: Women with moderate SARS-CoV-2 infection reported greater physical impairment and more negative emotional symptoms compared with those with mild disease. Despite these challenges, breastfeeding practices were largely preserved: most mothers continued to nurse their infants, many maintained exclusive breastfeeding for over one year and nearly all refrained from isolating from their children. The adoption of additional hygiene measures reflected maternal awareness of transmission risks and a desire to mitigate them while sustaining close contact. The lack of significant differences in breastfeeding experience between women with mild and moderate infection indicated that, within this group, disease severity exerted only a limited influence on maternal decisions regarding infant care. CONCLUSION: Maternal SARS-CoV-2 infection did not substantially disrupt breastfeeding practices or the mother-infant relationship despite the challenges of the disease. These findings highlight the importance of providing adequate healthcare support to infected mothers, both to reduce stress associated with breastfeeding under restrictive conditions and to promote practices that safeguard maternal and infant health.
Evaluation of Inflammatory Biomarkers in Post-COVID-19 Arthritis: a Cross-Sectional Study from Telangana, South India.
Singhal A, Sahoo D, Patle A … +11 more , Patil S, Lakkireddy M, Raja S, Pyati A, Arora A, Dhole S, Sakthivadivel, Patil P, Taranikanti M, John NA, Ravi N
Maedica (Bucur) · 2025 Dec · PMID 41537076 · Full text
BACKGROUND: Long COVID, a post-COVID-19 syndrome, has been linked to various musculoskeletal manifestations, particularly arthritic symptoms. This study aimed to evaluate the inflammatory markers associated with long COV...
BACKGROUND: Long COVID, a post-COVID-19 syndrome, has been linked to various musculoskeletal manifestations, particularly arthritic symptoms. This study aimed to evaluate the inflammatory markers associated with long COVID in patients diagnosed with COVID arthritis. METHODS: A cross-sectional prospective study was conducted in a tertiary care centre in Telangana, India, involving 139 PCR-confirmed COVID-19 patients diagnosed with arthritis. Eligible participants were COVID-free for one month to six months. Clinical histories, including severity of arthritis symptoms, levels of inflammatory markers (LDH, uric acid, serum ferritin, rheumatoid factor [RF] and CRP) and radiological investigations (radiographs and ultrasound) were recorded and analyzed. Follow-up assessments occurred at six months, with repeated measurements of inflammatory markers for statistical significance. RESULTS: The predominant clinical presentations included joint aches, restricted movement, swelling, myalgia and fatigue, with 95% of subjects relying on over-the-counter analgesics. Notably, all measured inflammatory markers decreased over the six-month follow-up, with statistically significant reductions being observed in LDH, RF and CRP levels. CONCLUSION: COVID arthritis is a complication of long COVID that affects both men and women, with persistent elevation of inflammatory biomarkers. While levels decreased during the follow-up period, extended monitoring is necessary to determine the duration required for normalization. Further research is warranted to understand the long-term implications of these findings.
Artificial Intelligence-Assisted Diagnosis of Retinal and Neuro-Ophthalmic Diseases: a Comparative Evaluation of ChatGPT, Google Gemini and An Ophthalmologist.
Shrinkhal, Shukla A, Shukla M … +3 more , Garg P, Shukla R, Singh SP
Maedica (Bucur) · 2025 Dec · PMID 41537075 · Full text
OBJECTIVES: This study evaluated the diagnostic performance of two large language models (LLMs), ChatGPT and Google Gemini, to identify common retinal and optic nerve diseases benchmarked against an experienced ophthalmo...
OBJECTIVES: This study evaluated the diagnostic performance of two large language models (LLMs), ChatGPT and Google Gemini, to identify common retinal and optic nerve diseases benchmarked against an experienced ophthalmologist. METHODS: Thirty standardized case vignettes, each comprising a brief clinical history and a high-resolution fundus image, were independently evaluated by ChatGPT, Google Gemini and an ophthalmologist. Ten retinal and optic nerve diseases were included. Diagnostic accuracy was calculated against a gold standard defined by consensus of two retina specialists. Inter-rater agreement was assessed using Cohen's kappa (κ). Secondary outcomes included interpretation time and clarity of explanation. RESULTS: The ophthalmologist achieved the highest diagnostic accuracy (96.7%), followed by ChatGPT (90.0%) and Google Gemini (86.7%). Agreement between ChatGPT and Gemini was moderate (κ = 0.51, p = 0.004). ChatGPT showed moderate agreement with the ophthalmologist (κ = 0.47, p = 0.002), while Gemini demonstrated fair agreement with the ophthalmologist (κ = 0.36, p = 0.01). ChatGPT was the fastest (mean 21.7 seconds), followed by Gemini (25.7 seconds) and the ophthalmologist (149.8 seconds). Clarity of interpretation was highest for the ophthalmologist (mean 4.53/5), followed by ChatGPT (3.60/5) and Gemini (2.96/5), with significant differences between groups. CONCLUSION: Ophthalmologists remain superior in diagnostic accuracy and clarity. However, ChatGPT and Google Gemini demonstrated strong performance in several retinal conditions. Their rapid evaluation times indicate potential utility as adjunct tools in triage, screening and education.
Short-Term Outcomes of Burn Patients: a Tertiary Hospital's Four-Year Experience.
Ungureanu A, Marinescu SA, Giuglea C … +5 more , Trandafir AN, Marinescu MC, Gavrila IM, Rugina AI, Gheorghiu-Branaru MC
Maedica (Bucur) · 2025 Dec · PMID 41537074 · Full text
Burns are the fourth cause of trauma worldwide, with a yearly death toll of 180,000. Multiple studies have investigated prognostic factors for the short-term and long-term evolution of burns, commonly citing age, percent...
Burns are the fourth cause of trauma worldwide, with a yearly death toll of 180,000. Multiple studies have investigated prognostic factors for the short-term and long-term evolution of burns, commonly citing age, percentage of total body surface area affected (BSA), percentage of third-degree burn, inhalation injury, surgery and overall depth of burn. The aim of our study is to review all cases managed in a tertiary emergency center and find factors associated with duration of hospital stay. The official reporting of burns from 2020-2023 "Bagdasar-Arseni" Emergency Clinical Hospital was reviewed, and clinical data regarding age, gender, burn severity and duration of hospitalisation, of Burns ICU time and mechanical ventilation was gathered and analysed using SPSS, version 26. A total of 337 cases were gathered, with a death rate of 14.54% (36.51% of inhalatory lesions are associated). 59.05% of patients were men, the majority (21.36%) were between 51 and 60 years old, most patients suffered burns on less than 10% of the total body area (50.45%). Most patients had third degree burns (60.2%), followed by second degree (39.2%). On average, patients were hospitalised for 16.5 days, of which approximately 8.5 were spent in the Burns ICU, and 3.3 days of mechanical ventilation were needed. The durations of hospitalisation, Burns ICU stay and mechanical ventilation were significantly higher in older patients, those with 31-40% BSA burns, subjects with third degree burns and those who died during the hospital stay. Of all managed cases, most patients were males, middle-aged, over half of them were suffering from small area burns and most of the burns were third degree. Regarding the duration of the required medical services, patients with severe burns (third degree) and those who did not survive required a longer duration of hospitalisation, more time in the Burns ICU and more time on mechanical ventilation.
A Cross-Sectional Study on the Prevalence of Metabolic Syndrome among Smokers Versus Non-Smokers.
Nishath, Channaiah SG, Patel S
Maedica (Bucur) · 2025 Dec · PMID 41537073 · Full text
BACKGROUND: Metabolic syndrome represented a clustering of abdominal obesity, dysglycaemia, dyslipidaemia and elevated blood pressure that together conferred an increased risk of type 2 diabetes and cardiovascular diseas...
BACKGROUND: Metabolic syndrome represented a clustering of abdominal obesity, dysglycaemia, dyslipidaemia and elevated blood pressure that together conferred an increased risk of type 2 diabetes and cardiovascular disease. The present study consequently examined the prevalence of metabolic syndrome among smokers versus non-smokers and characterised any differences in its constituent components and related risk profiles. METHODS: This was a hospital-based comparative cross-sectional study attending general medicine and preventive clinics. Smoking status was assessed by structured interview, while metabolic syndrome was defined based on standard criteria requiring at least three out of five components, consisting of central obesity, raised triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure and elevated fasting plasma glucose. RESULTS: Smokers and non-smokers were similar in age, socio-economic status and overall adiposity, but smokers more frequently consumed alcohol and were predominantly male. Compared with non-smokers, smokers had higher mean levels of triglycerides and lower mean high-density lipoprotein cholesterol, while the differences in blood pressure and fasting glucose were smaller and did not reach statistical significance. The prevalence of metabolic syndrome was significantly higher in smokers than non-smokers; smokers more often had three or more clustered components, with higher frequency of raised triglycerides and reduced high-density lipoprotein cholesterol. CONCLUSION: Current smoking was associated with a higher prevalence and greater clustering of metabolic syndrome components compared with non-smoking in this adult outpatient population, driven largely by a more adverse lipid profile and more frequent accumulation of three or more metabolic risk factors.
Analysis of Fatty Liver Prevalence in Non-Obese Women Diagnosed with Polycystic Ovary Syndrome.
Amiri F, Rashidi H, Moradi L … +2 more , Ghderian S, Taghavi R
Maedica (Bucur) · 2025 Dec · PMID 41537072 · Full text
BACKGROUND: Polycystic ovary syndrome (PCOS) has various causes that are largely unknown. The present study was aimed to evaluate metabolic and biochemical markers as well as body mass index (BMI) related to PCOS among t...
BACKGROUND: Polycystic ovary syndrome (PCOS) has various causes that are largely unknown. The present study was aimed to evaluate metabolic and biochemical markers as well as body mass index (BMI) related to PCOS among two groups including patients and healthy controls. METHODS: A case-control study included women younger than 45 years who did not suffer from obesity. Women with male-factor infertility served as the control group, while patients detected with PCOS via the Rotterdam criteria made up the case group. There were 86 randomly selected participants in each group. Fasting blood sugar (FBS), lipid profiles, alanine aminotransferase (ALT) and other biochemical tests were gathered with demographic data, medical records, physical exams and anthropometric measurements. Ultrasound, liver enzyme levels and medical history were utilized to diagnose non-alcoholic fatty liver disease (NAFLD). RESULTS: About 172 women were selected for the research; 86 had PCOS, while the remaining 86 were healthy controls. A younger mean age and a higher BMI were found in women with PCOS. The findings showed that mild to moderate fatty liver was more prevalent in the PCOS group than the control one (P = 0.04). Although metabolic indices, liver enzymes, hematologic parameters and hormone levels did not alter significantly, the PCOS group had lower fasting blood sugar levels (P = 0.029). The correlation between total cholesterol and PCOS was still poor after adjusting for age in logistic regression analysis. Still, it became statistically insignificant after adjusting for BMI index. CONCLUSION: Non-obese women with PCOS had a higher prevalence of fatty liver, with minor differences in metabolic parameters, and BMI partly mediated these associations.
Anterior Segment Optical Coherence Tomography in the Diagnosis of Corneal Stromal Dystrophies in Romania.
Gheorghe AG, Arghirescu AM, Voinea LM … +2 more , Ciuluvica R, Burcel MG
Maedica (Bucur) · 2025 Dec · PMID 41537071 · Full text
PURPOSE: To evaluate the diagnostic and surgical relevance of anterior segment optical coherence tomography (AS-OCT) in granular, lattice and macular corneal dystrophies in Romania, and to illustrate key imaging features...
PURPOSE: To evaluate the diagnostic and surgical relevance of anterior segment optical coherence tomography (AS-OCT) in granular, lattice and macular corneal dystrophies in Romania, and to illustrate key imaging features using cases from our centre. METHODS: We searched the PubMed/MEDLINE database for articles published between January 2010 and January 2025 using combinations of the following terms "granular corneal dystrophy", "lattice corneal dystrophy", "macular corneal dystrophy" with "anterior segment optical coherence tomography". We excluded studies that contained no anterior segment optical coherence tomography data. We prioritised peer-reviewed original articles and systematic reviews. Given the rare nature of these dystrophies, case reports were included if they contained relevant AS-OCT data. Representative slit-lamp and AS-OCT images from our clinic were included to contextualize findings. RESULTS: Stromal dystrophies are rare in Romania and their overlapping clinical features make diagnosis difficult. Anterior segment optical coherence tomography helps by offering depth-resolved visualization of epithelial, Bowman's layer and stromal changes. It allows more reliable differentiation between entities: granular dystrophy shows sharply defined hyperreflective deposits; lattice dystrophy shows linear, branching stromal amyloid; and macular dystrophy shows diffuse stromal hyperreflectivity with associated thinning. These layer-specific patterns improved phenotypic differentiation and, in surgical candidates, helped estimate lesion depth and residual clear stroma, thereby informing the choice of keratoplasty technique and postoperative monitoring. CONCLUSIONS: Anterior segment optical coherence tomography refines diagnosis, enhances early detection and guides surgical decision-making in stromal corneal dystrophies. Its objective imaging markers facilitate monitoring of disease progression and postoperative recurrence. Continued advances in multimodal imaging and automated analysis are expected to further strengthen its role in personalised management.
Recent Advances in Forensic Medicine at the Horizon of Omics Sciences and New Biomarkers for Postmortem Interval Estimation.
Turlea IR, Curca GC
Maedica (Bucur) · 2025 Dec · PMID 41537070 · Full text
OBJECTIVES: To present recent advances in forensic sciences with omics sciences and new biomarkers for postmortem interval (PMI) estimation. MATERIALS AND METHODS: We conducted a narrative review screening PubMed and Sco...
OBJECTIVES: To present recent advances in forensic sciences with omics sciences and new biomarkers for postmortem interval (PMI) estimation. MATERIALS AND METHODS: We conducted a narrative review screening PubMed and Scopus databases in the last 10 years (2015-2025) with the following keywords in the title and abstract: "postmortem interval" OR "post-mortem interval" AND "proteomics" OR "proteomic" OR "metabolomics" OR "metabolomic" OR "transcriptomic" OR transcriptomics" OR microRNA" OR "microRNAs" OR "lipidomic". RESULTS: Conventional methods of postmortem interval estimation are presented. Some of the most important studies and molecular techniques in genomics, transcriptomics, proteomics, metabolomics, lipidomics, old and new biomarkers for postmortem interval estimation are summarized. Single-omics or multi-omics, critical issues like data reproducibility and interpretation, judicial validity according to Daubert standard and ethical issues of PMI research are discussed. CONCLUSIONS: Postmortem interval estimation continues to be one of the most disputed issues of forensic medicine. Conventional methods for PMI estimation still offer a solid bench for practical means. As single-omics and multi-omics research continues to progress, we will likely discover new biomarkers and innovative techniques. Efforts will focus on identifying biomarkers that can deliver reliable and predictable outcomes, thereby facilitating their general acceptance and admissibility in legal proceedings.
Artificial Intelligence-Based McNamara Analysis of Different Types of Cleft and Non-Cleft Individuals.
Alam MK, Alfawzan AA
Maedica (Bucur) · 2025 Dec · PMID 41537069 · Full text
This research utilizes artificial intelligence-based McNamara cephalometric analysis to evaluate skeletal discrepancies in individuals with and without cleft lip and palate (CLP). The study examines gender differences an...
This research utilizes artificial intelligence-based McNamara cephalometric analysis to evaluate skeletal discrepancies in individuals with and without cleft lip and palate (CLP). The study examines gender differences and compares McNamara parameters across cleft types using a comprehensive dataset. Demographic data and McNamara measurements, including maxillary length (Co-A), mandibular length (Co-Gn) and maxillomandibular differential (MMD), were extracted from 123 individuals. Statistical analyses included independent samples tests, ANOVA, robust testing, and Tukey HSD post-hoc comparisons. The sample comprised 56.9% males and 43.1% females. Cleft distribution: non-cleft (NC) (24.4%), bilateral cleft lip and palate (BCLP) (43.9%), unilateral cleft lip and palate (UCLP) (13.8%), unilateral cleft lip (UCL) (10.6%), unilateral cleft lip and alveolus (UCLA) (7.3%). No significant gender differences were observed in McNamara parameters. Significant differences existed between NC and CLP groups in all parameters (p < 0.001). ANOVA revealed significant differences across cleft types for Co-A (p = 0.002), Co-Gn (p = 0.003) and MMD (p < 0.001). Post-hoc tests identified specific group differences. While gender does not significantly impact McNamara parameters, significant differences exist between NC and CLP individuals and among cleft subtypes. These findings highlight the importance of cleft-specific considerations in orthodontic and craniofacial treatment planning.
Atypical Polypoid Adenomyoma in a Patient with Hyperprolactinemia: a Novel Case and Systematic Review of the Systematic Reviews.
Peitsidis P, Vlachadis N, Zervoudis S … +3 more , Iavazzo C, Tsikouras P, Iatrakis G
Maedica (Bucur) · 2025 Dec · PMID 41537068 · Full text
BACKGROUND: A 34-year-old nulligravid lady was referred to the outpatient gynecology department with the symptoms of abnormal menstrual bleeding and mild anemia. A transvaginal ultrasound (TVS) revealed the presence of a...
BACKGROUND: A 34-year-old nulligravid lady was referred to the outpatient gynecology department with the symptoms of abnormal menstrual bleeding and mild anemia. A transvaginal ultrasound (TVS) revealed the presence of a hyperechoic lesion measuring 9.5x4.5 mm in the uterine cavity at the level isthmus (lower uterine segment), suggestive of an endometrial polyp. Consequently, a diagnostic hysteroscopy was performed. Transcervical hysteroscopic resection (TCR) and diagnostic curettage (D&C) were accomplished. A macroscopic analysis of the specimen exhibited a white, pale polypoid formation measuring 1x1 cm with a hard consistency. Histology analysis confirmed the diagnosis of an atypical polypoid adenomyoma (APA). All these findings were explained to the patient and the risk of potential progression to endometrial carcinoma was discussed in detail. A multidisciplinary meeting (MDT) was held and conservative management with levonorgestrel coil insertion or Methoxy progesterone administration per os, along with frequent hysteroscopies every three months, was offered. The patient decided to undergo a hysterectomy with preservation of the ovaries, despite the lack of childbearing. A laparoscopic-assisted vaginal hysterectomy with preservation of adnexa was performed. The pathology analysis confirmed the diagnosis of APA with coexistence of well-differentiated (low-grade) endometrioid carcinoma of the endometrium, stage Ia. METHODS: We performed a systematic review of systematic reviews with APA and quality assessment of the included studies. Furthermore, a flow-chart guideline for the management of APA in premenopausal and postmenopausal women is offered. CONCLUSIONS: Atypical polypoid adenomyoma is a rare clinical entity. It occurs mainly during the reproductive period of a woman. It is associated with abnormal vaginal bleeding, infertility, nulliparity, obesity, metabolic syndrome, hyperprolactinemia and hyperestrogenism. It is a risk factor for the development of endometrial hyperplasia and subsequent endometrial cancer. Preoperative diagnosis is extremely difficult; there are no specific imaging landmarks in ultrasound and magnetic resonance imaging (MRI) assessment. In patients with a desire for fertility, the management is complicated and should be based on a four-step hysteroscopic transcervical resection of the lesion. Hysterectomy is the right option for post-menopausal women and for women not wishing to conceive.
Efficacy and Safety of Retatrutide in the Treatment of Diabetes and/or Obesity Comorbid with Chronic Kidney disease: a Systematic Review and Meta-Analysis.
Pallavi K, Chandra A, Kumar K … +4 more , Martand K, Sahu SS, Mohan L, Verma A
Maedica (Bucur) · 2025 Dec · PMID 41537067 · Full text
There are still substantial clinical challenges in treating patients who come with type 2 diabetes and/or obesity in addition to chronic kidney disease (CKD). Retatrutide, an innovative agent, represents a potential adva...
There are still substantial clinical challenges in treating patients who come with type 2 diabetes and/or obesity in addition to chronic kidney disease (CKD). Retatrutide, an innovative agent, represents a potential advancement in therapy; however, its performance and safety profile specifically in a CKD population are not fully determined yet. This meta-analysis and systematic review sought to consolidate existing research on the use of retatrutide in this comorbid patient group. A comprehensive literature search identified relevant randomized controlled trials for inclusion. Reductions in glycated hemoglobin (HbA1c) and body weight were the primary goals for evaluating effectiveness, whereas adverse events were used to evaluate safety. Eight studies were included in the present research work. A significant mean reduction in HbA1c of -1.04% (95% CI -1.42 to -0.67) and a noticeable loss in weight, reaching up to -24.2%, were both linked with retatrutide treatment. A subgroup analysis indicated that the glycemic benefits were dose-dependent, with lower doses (≤8 mg) demonstrating a greater HbA1c reduction (-1.39%) than higher doses (≥12 mg, -0.65%). Furthermore, secondary analyses pointed toward possible renoprotective effects, evidenced by a reduction in albuminuria. The safety profile is primarily characterized by gastrointestinal adverse events, which is anticipated for this drug class. In conclusion, retatrutide exhibits strong efficacy for improving glucose levels and promoting weight loss in patients with diabetes, obesity and CKD, displaying a distinctive dose-response pattern where lower doses may be more effective for glycemic control. Its potential for kidney protection is promising, though clinicians should be mindful of managing gastrointestinal tolerability.
Age-Related Hearing Loss and Correlation with Cognitive Decline: a Narrative Review.
Lianou AD, Kokkinis E, Bastas NS … +2 more , Basios A, Mega I
Maedica (Bucur) · 2025 Dec · PMID 41537066 · Full text
Age-related hearing loss (ARHL), also known as presbycusis, is one of the most prevalent long-term sensory difficulties in older people. It affects more than two-thirds of people over 70. In addition to communication cha...
Age-related hearing loss (ARHL), also known as presbycusis, is one of the most prevalent long-term sensory difficulties in older people. It affects more than two-thirds of people over 70. In addition to communication challenges, ARHL has recently been revealed as a possible modifiable risk factor for cognitive decline and dementia. Comprehending this link is crucial for creating preventative interventions and maintaining healthy cognitive aging. This narrative review intended to analyze the evidence comprehensively relating age-related hearing loss (ARHL) with cognitive decline, define the possible pathophysiological mechanisms that may explain this association and assess the plausibility of hearing rehabilitation as a preventative therapy. A full literature search was done in PubMed, MEDLINE, Google Scholar and Frontiers databases employing the phrases "hearing loss" AND ("cognitive decline" OR "aging"). We only looked at articles that were published in English between 2014 and 2024 and were either systematic reviews, meta-analyses, or original research. We did not include any papers that were not peer-reviewed, not about people or not written in English. A total of 37 publications satisfied the inclusion criteria and underwent extensive review. There is strong evidence that ARHL is associated with rapid cognitive decline and an increased risk of dementia. Epidemiological studies suggest that hearing loss contributes to roughly 8-9% of worldwide dementia cases, which represents one of the primary modifiable risk factors. Some of the suggested ways that ARHL and cognitive decline are connected include through increased cognitive load, neuroplastic rearrangement, vascular dysfunction, oxidative stress and social isolation. Neuroimaging studies have revealed a reduction in gray matter and cortical atrophy in the auditory and associative areas of the brain in individuals with hearing loss. Hearing rehabilitation with hearing aids and cochlear implants has been connected to increased communication, higher social engagement and decreased cognitive decline; nevertheless, findings are rather inconsistent due to methodological errors and limited follow-up periods. Age-related hearing loss is a moderately widespread risk factor for cognitive decline and dementia that can be reduced. Early examination and effective auditory therapy can slow down cognitive decline and make life better for older people. Future longitudinal, multicenter and interventional studies are important to explain causal pathways, enhance intervention timing and assess cost-effective public health techniques for sustaining cognitive health in aging populations.
Comparison of Morphological Patterns and Location of Maxillary Sinus Septa in Dentate and Edentulous Patients Using Cone-Beam Computed Tomography.
Razavi M, Shirafkan S, Chitsaz A … +1 more , Hesari A
Maedica (Bucur) · 2025 Dec · PMID 41537065 · Full text
BACKGROUND AND OBJECTIVE: Evaluation of anatomical structures, such as the maxillary sinus septa, is critical for the success of sinus surgeries. This study compared the morphological patterns and locations of maxillary...
BACKGROUND AND OBJECTIVE: Evaluation of anatomical structures, such as the maxillary sinus septa, is critical for the success of sinus surgeries. This study compared the morphological patterns and locations of maxillary sinus septa in dentate and edentulous patients using cone-beam computed tomography (CBCT). METHODS: This retrospective descriptive-analytical study included 164 patients (327 maxillary sinuses) who were referred to a private radiology clinic in Ahvaz during 1399-1400. Cone-beam computed tomography images were obtained using a NewTom VGi unit and evaluated with NNT Viewer software. Data were analyzed using SPSS software version 26 and the chi-square test and analysis of variance. RESULTS: Of the 327 sinuses examined by us, 135 septa (41.2%) were identified. The prevalence of septa in the complete dentition (32.8%), complete edentulism (27.8%) and partial dentition (34.1%) groups did not differ significantly. Septa were most frequently located on the lateral wall (48.1%) and the distribution of septal location among the different groups was statistically significant (P = 0.042). The vertical morphological pattern was the most commonly found one (53.3%) and the molar region showed the highest frequency of septa (58.8%). The mean septal length was 8.23 mm. CONCLUSION: The findings indicated that maxillary sinus septa are common structures, predominantly with a vertical pattern and located on the lateral wall and in the molar region.
Can We Predict Posterior Cruciate Ligament Degeneration with Functional Tests?
Aydin ME, Atik A, Turan G
Maedica (Bucur) · 2025 Dec · PMID 41537064 · Full text
OBJECTIVES: The PCL (posterior cruciate ligament) is the primary stabilizer to prevent posterior translation of the knee. It provides femoral roll-back, stability and proprioception. Pathology of the PCL are limited in t...
OBJECTIVES: The PCL (posterior cruciate ligament) is the primary stabilizer to prevent posterior translation of the knee. It provides femoral roll-back, stability and proprioception. Pathology of the PCL are limited in the literature. The aim of this study was to histopathologically examine the PCL of patients undergoing total knee arthroplasty for gonarthrosis and to investigate the correlation of PCL histopathology with preoperative functional scores. MATERIALS AND METHODS: Seventy-three patients (19 males, 54 females) aged 50-75 years, with primary osteoarthritis, where bilateral knee arthroplasty was performed in three patients, resulting in 76 tibial plateaus, were included in the present study. Patients with a history of previous intra-articular knee surgery and rheumatic disease were excluded. Posterior cruciate ligament materials were graded between stages 0 and 4 according to the extent of histopathological changes recorded under light microscopy. Correlation of PCL histopathology with preoperative functional scores. SF-36 limitations of activities and physical health problems, Pain Quality Assessment Scale (PQAS), Lysholm and WOMAC scoring systems were assessed preoperatively. RESULTS: There were significant correlations between light microscopic histopathologic staging of PCL and preoperative SF-36 limitations of activities (p<0.01), physical health problems (p<0.05); PQAS intense (p<0.05), radiating (p<0.01), throbbing (p<0.05), aching (p<0.05), heavy (p<0.05); Lysholm total (p<0.001); and WOMAC total scores (p<0.01). The correlation between histopathologic staging of PCL and using a cane or crutches of Lysholm and radiating of PQAS was found to be moderately significant (p<0.001, p<0.01). CONCLUSION: Despite significant correlations, the commonly used functional scores may not be sufficiently precise for granular preoperative assessment of PCL microscopic degeneration, highlighting the need for PCL-specific scoring systems.
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