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200 papers
Anti-Inflammatory Therapy to Treat Atherothrombosis.
PhD MCM
Maedica (Bucur) · 2025 Jun · PMID 40880707 · Full text
Abstract loading — click title to view on PubMed.
Unraveling a Diagnostic Enigma: Navigating an Intricate Case of Spontaneous Cerebrospinal Fluid Rhinorrhea.
Psoma O, Psoma AN, Christopoulou F … +4 more , Arkoumani E, Chaidou A, Georgoulas P, Tzimas T
Maedica (Bucur) · 2025 Jun · PMID 40880706 · Full text
Cerebrospinal fluid (CSF) rhinorrhea is a relatively rare medical condition characterized by the drainage of CSF through the nasal cavity. Cerebrospinal fluid leakage can be attributed to a plethora of different causes,...
Cerebrospinal fluid (CSF) rhinorrhea is a relatively rare medical condition characterized by the drainage of CSF through the nasal cavity. Cerebrospinal fluid leakage can be attributed to a plethora of different causes, mostly traumatic or iatrogenic, but it can also be spontaneous. Due to its rare entity, CSF rhinorrhea is often a diagnostic trap and can be misdiagnosed and mistreated as rhinosinusitis or allergic rhinitis. This can result in severe complications, such as meningitis, which could potentially have life-threatening consequences if not accurately identified and managed. In this case report, a 53-year-old Caucasian woman presented at the emergency department with symptoms of headache, fever, transparent nasal discharge from her left nostril when leaning forward and mild neck stiffness. Based on the patient's clinical presentation and physical examination findings, there was a high suspicion of central nervous system infection and cerebrospinal fluid leakage. A lumbar puncture confirmed the diagnosis of meningitis, while imaging exams, including computed tomography (CT) and magnetic resonance imaging (MRI) scans, revealed a fistula between the posterior wall of sphenoid sinus and the subarachnoid space. Additional findings included an empty sella turcica, suggesting a potential underlying cause for this condition and an incidental meningioma near the area of leakage. The patient received empiric intravenous antibiotic therapy and was discharged after ten days. She was referred to the neurosurgical department for surgical repair of the CSF leak and removal of the meningioma, in line with appropriate treatment guidelines. This study highlights the importance of promptly identifying and thoroughly investigating potential causes of CSF leakage to provide appropriate medical management.
Impact of the COVID-19 Pandemic on Brain Metastases in Breast Cancer Patients.
Vatavu R, Misailoaie A, Gavril RF … +2 more , Lucasievici CG, Sava A
Maedica (Bucur) · 2025 Jun · PMID 40880705 · Full text
OBJECTIVES: To evaluate the impact of the COVID-19 pandemic on the diagnosis and treatment delays of brain metastases secondary to breast cancer, and to compare patient demographics, disease characteristics and outcomes...
OBJECTIVES: To evaluate the impact of the COVID-19 pandemic on the diagnosis and treatment delays of brain metastases secondary to breast cancer, and to compare patient demographics, disease characteristics and outcomes before and during the pandemic. MATERIALS AND METHODS: A retrospective study was conducted on 100 patients who were surgically treated for brain metastases in the Neurosurgery Clinic of "Prof. Dr. Nicolae Oblu" Clinical Emergency Hospital, Iasi, Romania. Patients were divided into two groups: pre-pandemic (2018-2020, n=57) and pandemic (2020-2022, n=43). Clinicopathological data, including demographics, metastasis localization, number and duration, were collected and analyzed. RESULTS: The pandemic period saw a shift towards younger patients, with 51% younger than 55 years compared to an average age of 57.9 years before the pandemic. Metastases were mostly located in the parietal lobe (61%). Despite a balanced rural-urban patient distribution, diagnostic delays were observed, with an average metastasis duration of 17 months. Patients from rural areas and older subjects showed tendencies towards later diagnosis. The number of metastases varied, with nearly half presenting a single lesion. CONCLUSIONS: COVID-19 pandemic-related disruptions in healthcare services led to delayed diagnosis and treatment of brain metastases, particularly impacting older and rural patients. These findings underscore the need for improved healthcare resilience and equitable access to oncological care to minimize delays and optimize outcomes during public health emergencies.
Innovative Therapeutic Approaches in Systemic Mastocytosis: an Updated Review.
Soare D, Leru P, Bumbea H
Maedica (Bucur) · 2025 Jun · PMID 40880701 · Full text
INTRODUCTION: Systemic mastocytosis (SM) is a heterogeneous clonal disorder characterized by the accumulation of abnormal mast cells in various tissues, predominantly the bone marrow. Given the rarity of the disease, the...
INTRODUCTION: Systemic mastocytosis (SM) is a heterogeneous clonal disorder characterized by the accumulation of abnormal mast cells in various tissues, predominantly the bone marrow. Given the rarity of the disease, the available data in Romania are extremely limited. It is estimated that the total number of diagnosed patients is approximately 170. In recent years, significant advances have been made in understanding the molecular pathogenesis of SM, leading to the development of targeted therapies that have transformed the management of this condition. The approval of tyrosine kinase inhibitors (TKIs), particularly midostaurin and avapritinib, has provided new therapeutic options for patients with advanced SM, demonstrating significant improvements in overall survival (OS) and symptom control. OBJECTIVE: To conduct a systematic review of clinical trials, observational studies and international or national guidelines published since 2000 to evaluate the efficacy, safety and mechanistic rationale of innovative therapeutic approaches for SM - including KIT inhibitors, monoclonal antibody-based therapies, stem cell transplant - and to compare the impact of these interventions with conventional cytoreductive and symptomatic treatments on overall response rate, survival, mediator-related symptom burden, quality of life and treatment-related adverse events. MATERIALS AND METHODS: A comprehensive search was performed in MEDLINE ( via PubMed), Embase, the Cochrane Central Register of Controlled Trials and Web of Science from 1 January 2000 to 1 May 2025. ClinicalTrials.gov, WHO ICTRP. Search strings combined controlled vocabulary ( e.g. , "Mastocytosis") and free-text terms for the disease (systemic mastocytosis, advanced SM, indolent SM) with key innovative interventions (KIT inhibitors, avapritinib, midostaurin, monoclonal antibodies, stem cell transplant). No language limits were set at the search stage; non-English full texts were excluded only if an accurate translation could not be obtained. As the review relied exclusively on published or publicly available data, ethical approval and informed consent were not required. CONCLUSION: The present review provides an updated overview of the evolving therapeutic landscape of SM, emphasizing recent clinical trial data, novel targeted therapies and emerging treatment paradigms. We discuss the implications of this progress on patient outcomes and future directions for personalized medicine in SM.
Turicella otitidis Extra-otic Infections in Humans - a Narrative Review.
Maraki S, Mavromanolaki VE, Kasimati A
Maedica (Bucur) · 2025 Jun · PMID 40880700 · Full text
Turicella otitidis is a Gram-positive bacillus, commensal inhabitant of the external auditory canal. It is the causative agent of external otitis and otitis media. Extra-otic infections are rarely been identified especia...
Turicella otitidis is a Gram-positive bacillus, commensal inhabitant of the external auditory canal. It is the causative agent of external otitis and otitis media. Extra-otic infections are rarely been identified especially in patients with comorbidities. A narrative review was performed based on a search of PubMed/Medline and Scopus databases to collect information on the epidemiologic, clinical and microbiologic data of extra-otic infections by T. otitidis . Studies published until December 2024 were screened and analyzed to extract data on pathogen characteristics, antibiotic resistance profiles, treatment and outcomes. A total of 13 studies reporting infections by T. otitidis other than otitis including an equal number of patients were eligible. The mean age of patients was 34.08 years (range, 3-75 years). A male predominance was observed (1.6:1). Four patients were immunocompromised and four underwent recent surgical procedures. The most common infection type was bacteremia (38.4%), followed by abscesses, mastoiditis, ocular infections and skin and soft tissues infections. In the majority of cases (63.6%) a single method of identification was applied, such as matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS), polymerase chain reaction (PCR), Vitek 2 automated system and analytical profile index (API) Coryne. Antimicrobial resistance to erythromycin was 80%, while all isolates were susceptible to vancomycin. Vancomycin (45.5%) and cephalosporins (45.5%) were the most commonly used antimicrobials. In all cases with available data, the outcome was favorable. T. otitidis is an emerging pathogen causing extra-otic infections in humans, especially in the presence of predisposing conditions. Future studies are warranted to elucidate the microorganism's pathogenicity and the factors and mechanisms underlying its virulence.
Chorion Membrane and Concentrated Growth Factor Membrane in Treating Bilateral Miller's Class I and II Gingival Recessions in Maxillary Premolars - a Clinical Study.
Nallathambi K, Elangovan R, Maganti DC … +3 more , Maganti A, Soman D, Diwekar N
Maedica (Bucur) · 2025 Jun · PMID 40880694 · Full text
Periodontitis causes many clinical presentations, one of which is gingival recession, which leads to root exposure, hypersensitivity and esthetic issues. One of the most accepted surgical procedures of root coverage is t...
Periodontitis causes many clinical presentations, one of which is gingival recession, which leads to root exposure, hypersensitivity and esthetic issues. One of the most accepted surgical procedures of root coverage is the coronally advanced flap (CAF) technique. Newer regenerative modalities such as placental-derived chorion membranes and autologous concentrated growth factor (CGF) membranes have a higher capacity to heal because of the bioactive nature of these membranes. A randomized controlled clinical trial study was carried out on 10 patients with bilateral gingival recession in maxillary premolars. They happened to receive CAF with chorion membrane on one side (Group A) and CGF membrane on the other side (Group B). Such clinical parameters as probing depth (PD), clinical attachment level (CAL), recession height (RH), recession width (RW) and width of keratinized tissue (WKT) were measured at baseline and after three months of follow-up. Paired and unpaired t-tests were undertaken through IBM SPSS 23.0. In both groups, all clinical parameters improved statistically significant after the surgery (p < 0.05). Group A root coverage mean was 89 percent and Group B 82 percent. The postoperative values of PD, CAL, RH, RW and WKT did not differ statistically between the two groups (p < 0.05), but Group A had slightly superior results. Human chorion membrane and concentrated growth factor membrane being used with CAF lead to effective root coverage and clinical improvement, which is considered significant in Miller Class I and II gingival recessions. Both membranes are effective, but the chorion membrane might provide slightly better clinical results. Longitudinal research involving bigger samples should be done.
Refining the Management of Prostate Imaging Reporting Category 3 Lesions through SelectMDx Urinary Biomarker Evaluation.
Calinoiu PC, Badescu D, Nechita OC … +7 more , Toma CV, Neculai D, Rascu S, Petca RC, Aurelian J, Sima CS, Jinga V
Maedica (Bucur) · 2025 Jun · PMID 40880692 · Full text
OBJECTIVES: This study aimed to evaluate the clinical utility of the SelectMDx urinary biomarker test in men with PI-RADS 3 lesions identified through multiparametric magnetic resonance imaging (mpMRI), a subgroup in whi...
OBJECTIVES: This study aimed to evaluate the clinical utility of the SelectMDx urinary biomarker test in men with PI-RADS 3 lesions identified through multiparametric magnetic resonance imaging (mpMRI), a subgroup in which prostate cancer diagnosis remains uncertain. The primary objective was to assess whether SelectMDx can improve risk stratification for clinically significant prostate cancer and thereby reduce unnecessary prostate biopsies. MATERIALS AND METHODS: A prospective cohort of 40 patients with serum prostate-specific antigen (PSA) levels ≥3 ng/mL and PI-RADS ≥ 3 lesions on mpMRI was analyzed. All participants underwent mpMRI, followed by targeted magnetic resonance imaging/transrectal ultrasound (MRI/TRUS) fusion-guided biopsy and standard TRUS-guided biopsy. Prior to biopsy, urine samples were collected post-digital rectal examination for SelectMDx analysis. The test evaluates messenger ribonucleic acid (mRNA) expression of distal-less homeobox 1 (DLX1) and homeobox C6 protein (HOXC6), integrating molecular data with clinical parameters to generate individualized risk scores. Diagnostic performance was assessed through sensitivity, specificity, predictive values and logistic regression analyses. RESULTS: Among patients with PI-RADS 3 lesions (n=40), a significant correlation between SelectMDx results and biopsy-confirmed clinically significant prostate cancer was observed. Clinically significant cancer was detected in 57.1% of patients with a positive SelectMDx result, compared to 18.2% in those with a negative result (p=0.031). The test demonstrated a sensitivity of 57.14%, a specificity of 81.82%, a positive predictive value of 40% and a negative predictive value of 90%, with an overall diagnostic accuracy of 77.5%. While age emerged as the only independent predictor in multivariate analysis, SelectMDx showed a strong potential to exclude malignancy and support more selective biopsy strategies.
Exocrine Pancreatic Insufficiency: Postoperative Complication Emerging Decades after Surgery?
Pereira JPSL, Veigas E, Oliveira E … +1 more , Nascimento E
Maedica (Bucur) · 2025 Jun · PMID 40880691 · Full text
Exocrine pancreatic insufficiency (EPI) arises from a deficiency in pancreatic enzymes, leading to malabsorption and varied symptoms such as gastrointestinal discomfort, weight loss and steatorrhea. Though EPI commonly f...
Exocrine pancreatic insufficiency (EPI) arises from a deficiency in pancreatic enzymes, leading to malabsorption and varied symptoms such as gastrointestinal discomfort, weight loss and steatorrhea. Though EPI commonly follows chronic pancreatitis or pancreatic surgery, its delayed onset is rarely discussed. We report a unique case of EPI manifesting 29 years after pancreaticoduodenectomy. A 71-year-old female, who underwent pancreaticoduodenectomy for carcinoma in 1992, presented with fatigue, weight loss, edema, diarrhea and paresthesias. Physical examination revealed mucocutaneous pallor, ascites, lower limb edema and brittle hair. Laboratory results indicated anemia, hypoproteinemia, vitamin deficiencies and severe fecal elastase reduction. After excluding other possible etiologies such as malignancy, autoimmune and infectious, the diagnosis of EPI was established. Treatment included enzyme replacement, vitamin supplementation and diuretics, leading to symptom resolution and normalization of laboratory parameters over a 12-month period. This case underscores the prolonged latency of post-surgical EPI, presenting diagnostic challenges. Exocrine pancreatic insufficiency can severely impair nutrient absorption, causing significant morbidity. In our patient, timely enzyme supplementation and nutritional management reversed the symptoms and deficiencies. The 29-year delay in symptom onset is among the longest documented, emphasizing the need for long-term vigilance in post-pancreatic surgery patients.
Short- and Long-Term Impact of Metabolic Surgery on Obesity Outcomes in Iranian Non-Diabetic Obese Patients.
Moradi L, Farhangiyan Z, Tangestani M … +1 more , Ashrafi A
Maedica (Bucur) · 2025 Jun · PMID 40880689 · Full text
INTRODUCTION: Metabolic surgery (MS) has been demonstrated to achieve sustained weight loss with significant improvement of metabolic parameters, including reduced cardiovascular diseases and diabetes. This study aimed t...
INTRODUCTION: Metabolic surgery (MS) has been demonstrated to achieve sustained weight loss with significant improvement of metabolic parameters, including reduced cardiovascular diseases and diabetes. This study aimed to evaluate the effect of MS on obesity outcomes and cardiovascular risk factors in Iranian non-diabetic obese patients. METHODS: This retrospective follow-up study included non-diabetic obese patients with a body mass index (BMI) of 30 kg/m 2 or higher who underwent MS (LSG or GB) in a single institution in Ahvaz, Iran, from April 2019 to March 2023. Of the 162 reviewed patients, 139 subjects (85.80%) who completed one-year follow-up visits were included in this study. Medical history, anthropometric, biochemical parameters, comorbidities and Framingham risk score (FRS) were evaluated at baseline and annual visits after MS. RESULTS: The mean weight and BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), FRS, lipid profile, liver enzymes and fasting blood glucose (FBS) were significantly improved 12 months postoperatively. The percentage of total weight loss (%TWL) and BMI loss (%BMI) was 30.32±8.14 and 30.32±8.14, respectively, at the one-year follow-up after surgery. At one-year follow-up, a significant resolution of hypertension and dyslipidemia was observed in 44.4% and 73.9% of patients, respectively, and this improvement was stable throughout the follow-up period, with no significant difference between procedures. The type of MS had no effect on changes in weight and BMI at one-year and long-term follow-up after surgery (P>0.05), except the mean weight loss was greater with RYGB than LSG at one-year follow-up.
Evaluating the Complications and Risk of Urosepsis after Flexible Ureteroscopy in a Sodium-Glucose Co-transporter-2 Inhibitor Population with Heart Failure with Reduced Ejection Fraction.
Munteanu MA, Nicolae C, Dragomiristeanu G … +6 more , Lungu A, Andrei I, Ionita D, Cacoveanu MC, Munteanu AE, Nanea TI
Maedica (Bucur) · 2025 Jun · PMID 40880687 · Full text
INTRODUCTION: Recent guidelines highlight the significant role of sodium-glucose co-transporter-2 inhibitors (SGLT2is) in enhancing the overall condition of patients with heart failure with reduced ejection fraction (HFr...
INTRODUCTION: Recent guidelines highlight the significant role of sodium-glucose co-transporter-2 inhibitors (SGLT2is) in enhancing the overall condition of patients with heart failure with reduced ejection fraction (HFrEF), leading to their widespread use, but recent studies revealed an increased prevalence of urinary tract infections (UTIs) associated with this medication. The aim of the present study is to evaluate the risk of urosepsis after flexible ureteroscopy with flexible navigable vacuum assisted access sheath in patients diagnosed with renal stone disease who are using SGLT2i for HFrEF. MATERIALS AND METHODS: This prospective comparative study included patients who were taking a SGLT2i (dapagliflozin 10 mg per day or empagliflozin 10 mg per day) for HFrEF and underwent flexible ureteroscopy in "Prof. Dr. Theodor Burghele" Clinical Hospital, Bucharest, Romania, between 01.01.2021 and 31.12.2024 for renal stone disease. All patients were completely assessed via imaging exam, complete blood count and urine analysis. The inclusion criteria were as follows: patients over 18 years old, established documented diagnosis of symptomatic HFrEF (Heart Failure New York Heart Association functional class II-IV), which has been present for at least two months and was optimally treated with pharmacological and/or device therapy, administration of SGLT2i, single-use flexible ureteroscopy, flexible and navigable vacuum-assisted ureteral access sheath (UAS) and the largest stone diameter less than 2 cm. The surgical technique met the same standard according to the recent recommendations of the International Alliance of Urolithiasis guideline on retrograde intrarenal surgery. RESULTS: Seventy-three patients who met the inclusion criteria were divided into two groups, according to previous SGLT2i administration, as follows: Group 1 (patients with SGLT2i) and Group 2 ( non-SGLT2i patients ). After analysing the demographic data, a slightly increased prevalence in female subjects was observed. There were no statistically different results regarding important pre-surgical data, such as mean stone dimension or density (HU), but there were preoperative differences regarding the prevalence of UTIs. After analyzing perioperative parameters such as mean previous JJ stented patients, mean surgical time and mean fluoroscopy time, the findings revealed no statistically significant differences. Regarding the main objective of the study, the present results revealed no differences in overall postoperative complications. There was a small number of postoperative urinary sepsis cases: three patients in Group 1 and two patients in Group 2. CONCLUSION: Although SGLT2i administration may even increase the risk of developing UTIs, this does not influence the postoperative complications outcome after flexible ureteroscopy for renal stone disease. High-standard equipment such as single-use devices and suction ureteral access sheaths has a safe profile regarding sepsis occurrence even in UTIs, facilitating drug administration.
Esophageal Surgery in Greece during the 19th Century.
Laios K, Samolis A, Lytsikas-Sarlis P … +7 more , Tsapralis D, Sakarellos P, Zografos CG, Noskova I, Zisiadis D, Tsoucalas G, Schizas D
Maedica (Bucur) · 2025 Jun · PMID 40880686 · Full text
BACKGROUND: The purpose of this manuscript is to highlight the endeavors of the Greek surgeons during the 19 th century to perform various types of operation on esophagus. METHODS: Research has been conducted in the arch...
BACKGROUND: The purpose of this manuscript is to highlight the endeavors of the Greek surgeons during the 19 th century to perform various types of operation on esophagus. METHODS: Research has been conducted in the archives of National Greek Library and the medical archives of the major Greek hospitals during the 19 th century. RESULTS: The research found that the surgery of esophagus during the 19 th century in Greece was limited to esophagostomy, removal of foreign objects, dilation and suturing. CONCLUSION: Greek surgeons of the 19 th century faced similar problems as their colleagues in Europe in the surgical approach of the esophagus.
Prognostic Significance of Mast Cell Count and Angiogenesis in Central Giant Cell Granulomas of the Jaws.
Parto M, Halimi M, Shahrabi-Farahani S … +2 more , Saatloo MV, Kouhsoltani M
Maedica (Bucur) · 2025 Jun · PMID 40880722 · Full text
OBJECTIVES: Mast cells (MCs) secrete different angiogenic factors stimulating angiogenesis. The purpose of this study was to assess MC count and microvessel density (MVD) in aggressive and non-aggressive central giant ce...
OBJECTIVES: Mast cells (MCs) secrete different angiogenic factors stimulating angiogenesis. The purpose of this study was to assess MC count and microvessel density (MVD) in aggressive and non-aggressive central giant cell granulomas (CGCGs) of the jaws. MATERIALS AND METHODS: Sixteen aggressive and 14 non-aggressive paraffin-embedded samples of CGCGs were prepared for immunohistochemical analysis using anti-MC tryptase and anti-CD31 antibodies. RESULTS: Mean values±SEM (standard error of mean) for MC count and MVD in aggressive and non-aggressive CGCGs were: 7.48±0.84, 3.85±0.51, 5.55±0.89, 3.19±0.61, respectively. All CGCG cases demonstrated MCs. Differences for both MC count and MVD were statistically significant between aggressive and non-aggressive CGCGs (p=0.002 and p=0.045, respectively), i.e. , MC count and MVD were significantly higher in aggressive lesions. Moreover, there was a significant positive correlation between MC count and MVD in CGCG (r=0.570, p=0.001). CONCLUSION: Mast cell count and MVD might be used as prognostic markers of aggressive behavior of CGCGs at the time of initial biopsy. Our findings might postulate that therapeutic strategies against MC mediators and angiogenesis may benefit in aggressive CGCG as a non-surgical modality of treatment. With further studies, their prognostic significance and therapeutic application can be evaluated in patients suffering from aggressive CGCG.
Mechanical Versus Injection Endoscopic Therapy for Dieulafoy's Lesion: a Systematic Review and Meta-Analysis.
Nahle T, Farhat H, Harb R … +4 more , Hoteit L, Fasih I, Yaghi C, Slim R
Maedica (Bucur) · 2025 Jun · PMID 40880720 · Full text
BACKGROUND: Dieulafoy's lesion is a rare but potentially life-threatening gastrointestinal condition that often requires endoscopic management. However, there is a lack of consensus on the optimal endoscopic intervention...
BACKGROUND: Dieulafoy's lesion is a rare but potentially life-threatening gastrointestinal condition that often requires endoscopic management. However, there is a lack of consensus on the optimal endoscopic intervention for this condition. This meta-analysis aimed to compare the efficacy and safety of endoscopic mechanical interventions versus endoscopic injection interventions in the treatment of Dieulafoy's lesion. METHODS: A systematic literature search was conducted using PubMed, Google Scholar pages 0-20 and Cochrane Library databases to identify relevant studies published up to March 2023. Studies comparing the outcomes of endoscopic mechanical and injection interventions for Dieulafoy's lesion were included. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random or fixed effects model depending on the heterogeneity I 2 value. A total of seven comparative studies were included in the meta-analysis consisting of three clinical trials and four retrospective studies. The clinical outcomes consisted of the initial hemostasis, as well as adverse events: recurrent bleeding, death and the need for an operation. RESULTS: It was shown that endoscopic injection therapy was associated with a lower risk of recurrent bleeding in the treatment of Dieulafoy's lesion compared to mechanical therapy (95% CI, OR=0.33 [0.16, 0.69] , p-value=0.003). However, there were no significant differences between mechanical and injection techniques in terms of initial hemostasis, death, or need for an operation. CONCLUSION: Our findings suggest that injection methods may be preferred over mechanical techniques in the management of Dieulafoy's lesion due to its potential to reduce recurrent bleeding. Although it is a simple and a non-expensive technique, further studies are needed to confirm these findings and evaluate the long-term outcomes of both interventions.
Crafting Kinship Beyond Biology: Maternal Experiences in Non-Genetic Family Formation - a Systematic Review.
Vidali M, Sousamli A, Dourou P … +3 more , Deltsidou A, Vivilaki V, Sarantaki A
Maedica (Bucur) · 2025 Jun · PMID 40880717 · Full text
Parenthood without a genetic link, such as in adoption or through assisted reproductive technologies (ART) like oocyte and embryo donation, presents unique challenges for mothers. These challenges include psychological,...
Parenthood without a genetic link, such as in adoption or through assisted reproductive technologies (ART) like oocyte and embryo donation, presents unique challenges for mothers. These challenges include psychological, emotional and social pressures related to maternal identity, bonding and disclosure practices. This systematic review synthesizes existing research on the emotional and psychological experiences of mothers in non-genetic family formations, particularly focusing on how these experiences shape maternal identity and family dynamics. A comprehensive literature search was conducted using PubMed, Scopus, Google Scholar and Web of Science, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies on maternal experiences in adoption, oocyte donation and embryo donation were included.ualitative, quantitative and mixed-method studies were analyzed using a narrative synthesis approach. Eighteen studies covering maternal experiences across various cultural contexts were included. Key themes identified include maternal identity conflicts, anxiety surrounding disclosure of the child's origins and societal stigma. Despite these challenges, most mothers developed strong emotional bonds with their children. Differences in cultural norms influenced disclosure practices, affecting family cohesion and maternal well-being. The findings highlight the need for psychological support and clear guidance on disclosure for non-genetic mothers. Future research should focus on developing long-term support systems and culturally tailored interventions to improve the psychological well-being of non-genetic mothers.
Haemolysis Generated with the Use of Glass Bottles Instead of PVC, DEHP-Free Blood Collection Bags in the Oxygen-Ozone Therapy.
Franzini M, Chirumbolo S, Valdenassi L
Maedica (Bucur) · 2025 Jun · PMID 40880716 · Full text
This study investigates the safety implications of using glass bottles versus PVC, DEHP-free plastic bags for autologous blood collection in major autohaemotherapy with oxygen-ozone (O 2 -O 3 -MAHT). Concerns have arisen...
This study investigates the safety implications of using glass bottles versus PVC, DEHP-free plastic bags for autologous blood collection in major autohaemotherapy with oxygen-ozone (O 2 -O 3 -MAHT). Concerns have arisen regarding increased haemolysis when blood is collected in glass containers, particularly due to high shear stress, surface irregularities and turbulence associated with vacuum-based collection. Historical data from transfusion medicine already established that glass induces higher red blood cell (RBC) rupture rates, a finding confirmed through mathematical modelling and simulations in this study. The release of haemoglobin and formation of meta-haemoglobin, both pro-inflammatory mediators, pose potential risks to patient safety. The authors applied ordinary differential equations (ODEs) to model haemolysis, biochemical stability and inflammatory responses, revealing that plastic bags offer superior preservation of RBC integrity and reduce inflammation risks. Comparative data on foam formation, albumin adsorption and oxygenation efficacy further reinforce the advantage of plastic containers. Forecast modelling suggests that treatment failure and safety risks increase significantly with glass use, particularly at higher ozone doses. The study concludes that DEHP-free plastic bags provide a more reliable, safe and biocompatible method for O 2 -O 3 -MAHT and recommends phasing out glass bottles to minimize haemolysis and ensure the therapeutic efficacy of medical ozone procedures.
Ankle-Foot Musculoskeletal Pathologies and Age-Related Arthro-Kinematic Changes: a Case-Control Study.
Charmode SH, Mishra AK, Mehra S
Maedica (Bucur) · 2025 Jun · PMID 40880714 · Full text
BACKGROUND: The aging process profoundly influences the health of foot and ankle joints, impairing stride and range of motion and resulting in several musculoskeletal disorders. Despite extensive research on ankle arthro...
BACKGROUND: The aging process profoundly influences the health of foot and ankle joints, impairing stride and range of motion and resulting in several musculoskeletal disorders. Despite extensive research on ankle arthrokinematics in Western and East Asian populations, India has yet to witness any such studies. We conducted a two-phased research study to evaluate the arthrokinematics of the ankle joint-foot complex. The first phase investigated how different types of physical activity were affecting the biomechanics of the ankle joint-foot complex in both healthy people and those with painful conditions, and the results have already been published. AIM: This article shares the results of phase 2 of the project, which looks at how age and gender affect the size and movement of the ankle-foot complex in healthy people and those with pain. METHODS: This observational cross-sectional study comprised 158 patients randomly selected from those presenting at the orthopaedic outpatient department. We obtained ethical clearance and finalized the Clinical Trial Registry of India (CTRI) registration for the study before commencement. The study assessed the impact of age and gender on the anthropometric and biomechanical parameters of the ankle joint-foot complex in patients experiencing foot and ankle joint pain (cases) and in pain-free individuals (controls). RESULTS: The middle age group (25-64 years) was identified as the most susceptible demographic for ankle joint-foot complex diseases, accounting for 146 out of all 158 cases (92.4%). The average dorsiflexion, plantarflexion, inversion and eversion in both unaffected and diseased feet diminished with advancing age. Female patients had a greater prevalence of ankle and foot diseases compared to male subjects. CONCLUSIONS: As people get older, the range of motion of the ankle and foot decreases significantly because of several physical reasons such as weaker muscles, stiffer joints and less flexible connective tissues.
Functional and Radiological Outcomes of Open Versus Arthroscopic Latarjet for Anterior Shoulder Instability.
Koukos C, Kanellopoulou G, Giotis D … +7 more , Yiannakopoulos C, Kapetanakis S, Konstantinidis C, Shanmugasundaram S, Pakos EE, Sahin K, Montoya F
Maedica (Bucur) · 2025 Jun · PMID 40880712 · Full text
OBJECTIVES: The purpose of this study is to compare the clinical, functional and radiographic outcomes among 42 patients with anterior shoulder instability treated with either the open or arthroscopic Latarjet procedure....
OBJECTIVES: The purpose of this study is to compare the clinical, functional and radiographic outcomes among 42 patients with anterior shoulder instability treated with either the open or arthroscopic Latarjet procedure. MATERIALS AND METHODS: Between 2011 and 2018, we treated 42 patients with anterior shoulder instability, 19 underwent the open Latarjet procedure (OLP) and 23 underwent the arthroscopic Latarjet procedure (ALP). In the OLP group, 17 patients were males, with a mean age of 21.3 years (range: 16-37 years ) and a mean follow-up of 6.2 years (range: 5.5-7.2 years). In the ALP group, 20 patients were males, with a mean age of 20.6 years (range: 17-31 years) and a mean follow-up of 2.5 years (range: 2-3.1 years). All procedures were performed by a single surgeon. Functional outcomes were assessed using the University of California-Los Angeles (UCLA) shoulder score and the constant score (CS). Radiographic evaluations included standard radiographs and computed tomography (CT) scans. The two groups were compared to analyze differences in outcomes. RESULTS: All patients returned to their pre-injury level of activity. The arthroscopic Latarjet procedure resulted in better graft integration and inferior screw positioning. No major complications were reported in either group. CONCLUSIONS: Anterior shoulder instability remains a complex issue in orthopedics regarding the optimal management approach. However, this study suggests that the arthroscopic Latarjet procedure offers advantages, including superior visualization and effective restoration of damage.
Analysis of Efficacy and Safety Profile of Vaginal Surgery and Hysteroscopic Electric Resection in the Management of Post-Cesarean Section Isthmocele: a Systematic Review.
Dande M, Lamba N, Patel RB
Maedica (Bucur) · 2025 Jun · PMID 40880711 · Full text
INTRODUCTION: The present study has discussed the increasing prevalence of isthmocele, which is related to growing cesarean sections. It is also due to enhanced diagnostics, which includes transvaginal ultrasound (TVUS)...
INTRODUCTION: The present study has discussed the increasing prevalence of isthmocele, which is related to growing cesarean sections. It is also due to enhanced diagnostics, which includes transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) that significantly affects women's reproductive health and quality of life. Management differs by defect size, from hysteroscopic to laparoscopic repair, which also highlights the necessity for standardized protocols. AIM: s and objective: To evaluate the efficacy and safety profile of vaginal surgery and hysteroscopic electric resection in the management of post-cesarean section isthmocele. METHODS: This systematic review analyzed the efficacy and safety of vaginal surgery and hysteroscopic electrotomy for managing post-cesarean section isthmocele. Relevant studies were identified from PubMed, Embase, Cochrane Library and Web of Science using terms like "cesarean scar", "isthmocele" and "hysteroscopic electrotomy". We conducted the present review using a PRISMA flowchart, which resulted in the inclusion of eight studies after screening and eligibility assessment. RESULTS: The hysteroscopic method consistently shows a lower risk compared to the vaginal method, with a pooled risk ratio of 0.71 (95% CI 0.59-0.85), indicating statistical significance. Heterogeneity analysis reveals no significant variability among studies (I² = 0%), suggesting consistent results. Additionally, the hysteroscopic group outperforms the vaginal group in efficacy for diverticulum recovery, supporting hysteroscopy as the more effective approach across both outcomes. CONCLUSION: The present study has concluded that the hysteroscopic electric resection was safer and more efficient in the management of isthmocele among patients who underwent a cesarean section.
The Dark Side of the Moon - Significant Disagreements between Two-Dimensional and Three-Dimensional Echocardiographic Parameters of the Right Ventricular Function in Patients with Acute Myocardial Infarction.
Bratu V, Copciag R, Lixandru T … +1 more , Vinereanu D
Maedica (Bucur) · 2025 Jun · PMID 40880709 · Full text
OBJECTIVES: The present study aims to assess correlations and agreements between parameters and classification of the right ventricular (RV) function obtained by 2D echocardiography (2DE) - tricuspid annular plane systol...
OBJECTIVES: The present study aims to assess correlations and agreements between parameters and classification of the right ventricular (RV) function obtained by 2D echocardiography (2DE) - tricuspid annular plane systolic excursion (TAPSE), RV systolic wave velocity (S'T), fractional area change (FAC) and RV ejection fraction (3D RVEF) obtained by advanced 3D echocardiography (3DE). MATERIALS AND METHODS: Patients admitted with acute myocardial infarction (AMI) were enrolled in the study after emergency coronary angiography. Standard 2DE and 3DE acquisitions were carried out in the first 48 hours since admission and later analysed offline by an advanced echocardiographer with five years of training in 2DE and three years of training in 3DE. Correlations between continuous echocardiographic variables were assessed using the Pearson correlation test. Patients were classified as having normal RV function or dysfunction based on current practice guidelines cut-off values and association between 2DE and 3DE parameters was assessed using the Pearson Chi-square test. Further, agreement between these categories was analysed using Cohen's k test. RESULTS: Sixty-three patients (52 males, mean age 56.8 ± 10.3 years) enrolled between December 2019 and June 2022 were analysed. The correlation between 3D RVEF and TAPSE, S'T and FAC was no statistically significant (r = 0.217, p = 0.088), weak (r = 0.385, p 0.001) and modest (r = 0.482, p = 0.002), respectively. Classification of RV function by FAC was the only 2DE parameter that exhibited statistically significant agreement [(χ2 (1, n=63) = 7.725, p=0.005)] and association (k = 0.3345, CI [-0.0747,0.5943]) when compared with 3D RVEF based classification. CONCLUSIONS: Our study shows that, in a population of patients with acute myocardial infarction, measurements of RV function obtained by standard 2DE have varying degrees of correlation with 3D RVEF, and the subsequent classification of RV function using current cut-off values for these parameters leads to the misclassification of a significant number of patients.
Comparison of Autonomic Indices in Normal Weight, Overweight and Obese Adults - a Comparative Analysis Using South East Asian Criteria for Obesity Classification.
Seoran JP, Srivastav S, Nayak P
Maedica (Bucur) · 2025 Jun · PMID 40880704 · Full text
OBJECTIVES: Autonomic function assessment, performed using heart rate variability and Ewing's battery, can help unravel autonomic neuropathy in many clinical disorders. This assessment can be affected by obesity. We revi...
OBJECTIVES: Autonomic function assessment, performed using heart rate variability and Ewing's battery, can help unravel autonomic neuropathy in many clinical disorders. This assessment can be affected by obesity. We revisited the relationship between autonomic function parameters and obesity. The body mass index (BMI) based stratification based on standard World Health Organization (WHO) classification and revised South East Asian (SEA) classification was employed. MATERIALS AND METHODS: Apparently, healthy subjects of either sex were included in the present study. Subjects were classified into normal weight (NOR), overweight (OW) and obese (OB) categories using both guidelines. An autonomic function test was performed, documenting heart rate variability (HRV) and Ewing's battery of tests including postural challenge, deep breathing, cold pressor and isometric exercise. Parameters were compared between the three groups. RESULTS: We recruited 105 healthy subjects (89 males, 16 females) with a mean age of 29.83 ± 5.44 years. There were 33, 29 and 43 subjects in the NOR, OW and OB categories, respectively, as per the revised SEA classification. Similarly, 63 subjects were NOR, 42 OW, and six OB, as per the WHO criteria. There was no significant difference between HRV parameters and autonomic reactivity parameters between NOR, OW and OB subjects as per the revised SEA and WHO criteria. CONCLUSIONS: The WHO criteria underestimated obesity in our population sample. In addition, there was no significant difference in autonomic parameters between NW, OW and OB subjects as per the SEA criteria. We propose that the effect of obesity on autonomic parameters may require a revisit in light of revised BMI criteria for the SEA population.
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