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200 papers
Disruptions in Renal Stone Management during the COVID-19 Pandemic: a Retrospective Single-Center Study.
Militaru A, Bulai CA, Multescu RD … +7 more , Ene CV, Ene MA, Mares C, Balacescu S, Georgescu DA, Geavlete PA, Geavlete BF
Maedica (Bucur) · 2025 Jun · PMID 40880703 · Full text
OBJECTIVES: This study evaluated changes in renal stone management during the COVID-19 pandemic in a single center, focusing on treatment methods, patient outcomes and healthcare delivery models. MATERIALS AND METHODS: W...
OBJECTIVES: This study evaluated changes in renal stone management during the COVID-19 pandemic in a single center, focusing on treatment methods, patient outcomes and healthcare delivery models. MATERIALS AND METHODS: We conducted a retrospective analysis comparing patients treated for kidney stones between July-September 2019 (pre-pandemic period) and July-September 2020 (pandemic period). We assessed the number of treated patients, treatment modalities and postoperative outcomes. RESULTS: A total of 77 inpatients were analyzed, of whom 50 had been admitted to hospital during the pre-pandemic period and 27 during the pandemic, which represented a 46% decrease in hospitalizations. There were no significant differences in body mass index, average age, stone laterality, size, or location. Serum creatinine levels and positive urine cultures were also comparable between the groups. A trend toward more minimally invasive procedures was observed during the pandemic, with an increased use of flexible ureteroscopy (62% vs . 70.4%) and a decrease in percutaneous nephrolithotomy (12% vs . 7.4%). Operative times and hospital stays were similar across groups. However, the stone-free rate significantly decreased during the pandemic (91.1% vs . 84.07%). CONCLUSIONS: The COVID-19 pandemic significantly disrupted renal stone management, leading to a preference for minimally invasive surgery but a lower stone-free rate.
Robotic Rehabilitation for Gait Imbalance in Patients with Multiple Sclerosis (MS): a Systematic Review and Meta-Analysis.
Ghorbanpour S, Astkar M, Rohani S … +1 more , Ghajarzadeh M
Maedica (Bucur) · 2025 Jun · PMID 40880702 · Full text
UNLABELLED: Objective: To estimate the pooled effect of robotic rehabilitation on gait in subjects with multiple sclerosis (MS). METHODS: We conducted a systematic search in PubMed, Scopus, EMBASE, IEEE and Web of Scienc...
UNLABELLED: Objective: To estimate the pooled effect of robotic rehabilitation on gait in subjects with multiple sclerosis (MS). METHODS: We conducted a systematic search in PubMed, Scopus, EMBASE, IEEE and Web of Science databases on October 1 st 2022, without any time or language limitation. Also, we investigated the grey literature, including conference abstract and references of references, to identify potentially relevant articles. The primary outcomes were the six-minute walking test (6MWT) and Timed Up and Go (TUG). The risk of bias in the included studies was evaluated using the Cochrane's risk of bias tool for non-randomized studies (ROBINS-I) and the Cochrane risk-of-bias tool for randomized trials (RoB2). Meta-analyses were performed using a fixed-effects model as the heterogeneity between study results (I2) was less than 50%. The standardized mean difference (SMD) was calculated as the effect size for study outcomes. RESULTS: Our systematic search retrieved 6878 studies and, after deleting duplicate results, 5019 articles remained. Two researchers screened the titles and abstracts, with 4942 studies remaining for further screening. After full-text assessment, 12 studies were included for meta-analysis, most of which were conducted in the USA and Italy and were published between 2007 and 2022. The mean age of participants in the selected studies ranged between 46-55 years and the mean expanded disability status scale (EDSS) between 5 and 6.5. The SMD of 6MWT (AFTER-BEFORE) was 0.22 (95% CI -0.01-0.45) (I 2 =0%, P=0.90). The SMD of TUG (AFTER-BEFORE) was -0.29 (95% CI -0.56, -0.02) (I 2 =0%, P=0.70). CONCLUSION: This systematic review and meta-analysis concluded that robotic rehabilitation was effective for gait rehabilitation in patients with MS.
Comparison of Cognitive Functions among Bilinguals and Multilinguals.
Kalpana M, Katta R, Parag PU … +7 more , Tikka S, Madhusudhan U, Gaur A, Ganji V, Taranikanti M, John NA, Kasturi V
Maedica (Bucur) · 2025 Jun · PMID 40880699 · Full text
BACKGROUND: Language is one of the most fundamental aspects of any society. It is how individuals communicate with one another, form relationships and foster a feeling of community. Language processing is one of the most...
BACKGROUND: Language is one of the most fundamental aspects of any society. It is how individuals communicate with one another, form relationships and foster a feeling of community. Language processing is one of the most common, yet complex, tasks we perform regularly. Being multilingual facilitates effective communication and such people are better problem solvers. The benefits of multilingualism extend beyond the capacity to communicate in another language and provide individuals with a broader perspective of the world. This study aims to assess the cognitive functions of bilinguals and multilinguals and to compare the cognitive functions among bilingual and multilingual individuals. MATERIALS AND METHODS: Nearly 115 members were screened for anemia, thyroid abnormalities, diabetes mellitus and other electrolyte imbalances to select the study participants in the age group of 30-50 years. Strub black mental status test was used for reading and writing, and controlled word association test for fluency. Depending on these observations, participants were divided into monolinguals, bilinguals, trilinguals and multilinguals. Stroop test was used to assess the cognitive function. RESULTS: Mean scores and reaction time for color-to-word tests among monolingual and multilingual were 7.7±1.99, 21.65±3.68 and 9.9±0.29, 16.44±1.81, respectively. Mean scores and reaction time for word-to-color tests among monolinguals and multilinguals were and 7.65±1.12, 23.61±3.69 and 9.7±0.696, 13.80±3.14, respectively. CONCLUSION: Inculcating multiple languages at a younger age might enhance cognitive skills and overall effectiveness.
Multidisciplinary Insights into Perioperative Cardiac Events in Non-Cardiac Surgery: an ECG Holter Monitoring Study.
Palcau AC, Paduraru LF, Dinulescu A … +4 more , Musat F, Ion D, Paduraru DN, Iliesiu AM
Maedica (Bucur) · 2025 Jun · PMID 40880698 · Full text
BACKGROUND: Cardiovascular complications after non-cardiac surgery have a major impact on perioperative morbidity and mortality. Despite several scales and scores for assessing the preoperative cardiovascular status, an...
BACKGROUND: Cardiovascular complications after non-cardiac surgery have a major impact on perioperative morbidity and mortality. Despite several scales and scores for assessing the preoperative cardiovascular status, an individualized assessment focused on each patient is mandatory. AIM: To identify the new cardiac events that occur after non-cardiac surgery. METHODS: In 100 patients hospitalized in the general surgery department with acute and chronic surgical pathologies, the perioperative cardiac events were assessed using Holter monitoring along with clinical and biochemical markers, including C reactive protein (CRP) and high-sensitive troponin (hscTnI). RESULTS: Out of the 100 participants with a mean age of 54.5 (43-77.9) years, 54% were men. Ten patients developed paroxysmal postoperative atrial fibrillation (AF), which was related with longer surgery time 165 (150-180) vs 120 (90-150) minutes (p=0.002) and postoperative anaemia [haemoglobin (Hg) 10.4 (9.37-12.6) vs 12.1 (11-13.2) g/dL, (p=0.041)]. Higher CRP levels were also correlated with paroxysmal AF. The AF group correlated with higher values of presurgical CRP: 81 (46.5-186.75) vs 27 (6-102.5) mg/dL, (p=0.041). Higher postsurgical CRP values were also found in the AF group: 76 (47.75-110.75) vs 40.5 (12-82.5) mg/dL (p=0.045). Sinus pauses were present in nine patients and there was a strong association between sinus pauses and age (p = 0.011), history of high blood pressure (HBP) (p = 0.031), intraoperative HBP (p = 0.026) and the preexisting AF (p = 0.028). Postsurgical ST changes were present in 30 patients and ST depression was correlated with age (p < 0.001), prolonged surgery time [150 (120-180) vs 120 (90-150) minutes (p < 0.001)], history of HBP [(33.3% vs 12.2%) (p=0.017)] and intraoperative maximum values of BP (p = 0.007). CONCLUSIONS: There is an increased risk of cardiovascular events during the postoperative period of non-cardiac surgery in patients with advanced age, pre-existing diseases (hypertension, preexisting atrial fibrillation, diabetes mellitus), the level of inflammation and longer intraoperative stress. Holter monitoring revealed rhythm and conduction disorders as well as ST segment changes that were associated with the inflammatory status and slightly elevated cardiac enzyme levels. Future studies are needed to see the impact of cardiac complications in the long term.
A Rare Anatomical Venous Variant in the Lower Extremity.
Toumanidou M, Karakatsanis S, Kotteas E … +6 more , Kollias A, Liasis N, Mariolis-Sapsakos T, Filippou D, Troupis T, Dimakakos E
Maedica (Bucur) · 2025 Jun · PMID 40880697 · Full text
We describe a rare venous anatomical variant identified in a 68-year-old male with lung cancer and deep vein thrombosis (DVT). Color duplex ultrasonography revealed direct drainage of the popliteal vein into the common f...
We describe a rare venous anatomical variant identified in a 68-year-old male with lung cancer and deep vein thrombosis (DVT). Color duplex ultrasonography revealed direct drainage of the popliteal vein into the common femoral vein, with absence of the superficial femoral vein. This previously undescribed variation may have contributed to thrombogenesis in the hypercoagulable setting of malignancy. Recognition of such variants is essential for accurate diagnosis and appropriate management of DVT.
Pulmonary Plasmacytoma - Rare Occurrence in Multiple Myeloma: Case Presentation and Short Review of the Literature.
Diaconescu D, Iordan I, Dumitru I … +4 more , Ilinescu AM, Soare D, Ene G, Bumbea H
Maedica (Bucur) · 2025 Jun · PMID 40880696 · Full text
Multiple myeloma is a hematological malignancy mostly diagnosed in the elderly. It is characterized by a chronic evolution with alternating periods of remission and relapses. Plasmacytoma, a tumor comprised of monoclonal...
Multiple myeloma is a hematological malignancy mostly diagnosed in the elderly. It is characterized by a chronic evolution with alternating periods of remission and relapses. Plasmacytoma, a tumor comprised of monoclonal plasma cells, is a typical finding in multiple myeloma patients, being more frequently observed during relapses. The most involved sites are bones, kidneys, liver, skin, ear, nose and throat. Extramedullary lung plasmacytomas are a rare presentation, with an incidence of well under 5% of all plasmacytomas. The clinical manifestations are heterogeneous and depend on the affected site. Differentiating plasmacytoma from other pathologies can be challenging, with the diagnosis being established via tumor biopsy. The presence of plasmacytoma is associated with poor prognosis and is a marker of rapid disease progression. We report the case of a 63-year-old patient diagnosed with IgA lambda multiple myeloma, stage IIIB Salmon-Durie complicated by lung plasmacytoma identified in the setting of relapse. Despite undergoing treatment, the disease exhibited an aggressive course, rapidly progressive towards death. The case underlines the rarity of pulmonary plasmacytoma and the diagnostic challenges.
Early Experience with Robotic Pancreatic Resections: a Retrospective Cohort Study of 20 Consecutive Cases.
Coco D, Leanza S, Viola MG
Maedica (Bucur) · 2025 Jun · PMID 40880695 · Full text
BACKGROUND: Robotic pancreatic surgery has emerged as a minimally invasive alternative to open procedures, offering potential benefits in precision and recovery. This study evaluates the feasibility, safety and learning...
BACKGROUND: Robotic pancreatic surgery has emerged as a minimally invasive alternative to open procedures, offering potential benefits in precision and recovery. This study evaluates the feasibility, safety and learning curve of robotic duodenopancreatectomy (RDP) and robotic distal splenopancreatectomy (RDSP) during the initial phase of implementation at a single institution. METHODS: A retrospective analysis of 20 consecutive patients, who underwent RDP (n=12) or RDSP (n=8) between January 2020 and December 2022, was performed. Data on operative time, intraoperative blood loss, conversion rates, postoperative complications (classified by Clavien-Dindo and ISGPS criteria) and length of hospital stay (LOS) were collected. Early (first six RDPs and four RDSPs) and late cases were compared to assess progression along the learning curve. Statistical analysis included Mann-Whitney U and Fisher's exact tests. RESULTS: The median operative time for RDP decreased from 480 minutes [interquartile range (IQR) 420-540] in early cases to 390 minutes (IQR 360-420) in later cases (p=0.03). The operative time for RDSP remained stable at 300 minutes (IQR 240-360; p=0.12). Intraoperative blood loss was 200 mL (IQR 100-400) for RDP and 150 mL (IQR 50-300) for RDSP. Two RDP cases (16.7%) required conversion to open surgery due to vascular adhesions. Postoperative complications included pancreatic fistula in 20% of cases, delayed gastric emptying in 15% of cases and major complications (Clavien-Dindo ≥III) in 25% of cases. The median LOS was 10 days (IQR 8-18) for RDP and seven days (IQR 5-10) for RDSP. No 90-day mortality was observed. CONCLUSIONS: Robotic pancreatic resections are feasible and safe during the early learning curve, with morbidity comparable to open surgery. Operative efficiency improved significantly for RDP, highlighting the importance of structured training and case volume. These findings support the adoption of robotic techniques in pancreatic surgery, though further studies are needed to validate long-term outcomes.
Comparing Pencil Push-up and Cat Card Exercises in Patients with Convergence Insufficiency.
Shrinkhal, Garg P, Shukla R … +3 more , Shukla A, Shukla M, Singh SP
Maedica (Bucur) · 2025 Jun · PMID 40880693 · Full text
UNLABELLED: Purpose: To compare the effectiveness of two widely practiced home-based convergence exercises - cat card exercise (CCE) and pencil push-up exercise (PPE) - in patients with symptomatic convergence insufficie...
UNLABELLED: Purpose: To compare the effectiveness of two widely practiced home-based convergence exercises - cat card exercise (CCE) and pencil push-up exercise (PPE) - in patients with symptomatic convergence insufficiency. METHODS: This retrospective observational study was conducted from June 2023 to June 2024 in the Department of Ophthalmology of a Tertiary Care Centre in North India. In this study, eighty patients aged 10 to 35 years, all exhibiting the best-corrected visual acuity of 20/20 and a receded near point of convergence (NPC) greater or equal to 7.5 cm were included. Participants were arbitrarily allocated to receive either PPE or CCE, each lasting 15 minutes a day, five days a week, for six weeks. Patients were reassessed after the six-week period. Enhancement in NPC was the main outcome. Data were analysed employing suitable statistical tests, with a significance threshold established at P 0.05. RESULTS: Both CCE and PPE groups demonstrated a significant improvement in NPC after six weeks of therapy. However, the gap regarding NPC advancement in the two groups remained statistically significant (P > 0.05). CONCLUSION: Cat card and pencil push-up exercise are both effective home-based treatment options for symptomatic convergence insufficiency, with comparable outcomes.
Clinical Significance of Micrometastases and Isolated Tumor Cells in Breast Cancer.
Ampatzis C, Zervoudis S, Eskitzis P … +3 more , Tsikouras P, Papakonstantinou A, Iatrakis G
Maedica (Bucur) · 2025 Jun · PMID 40880690 · Full text
We decided to do a literature search for information about the clinical significance of micrometastases (pN1mi) and isolated tumor cells (ITCs). A detailed search was conducted in the existing bibliography. We found that...
We decided to do a literature search for information about the clinical significance of micrometastases (pN1mi) and isolated tumor cells (ITCs). A detailed search was conducted in the existing bibliography. We found that pN1mi and ITCs had differences in prognosis and were handled in a different way. However, some researchers do not accept this difference. Many studies have shown no differences in their prognosis and the distinction of these terms is questioned. This fact is attributed to different definitions, diagnostic approaches that have been used and not well organised research. For their diagnosis, single hematoxylin and eosin (H) stain slide section, and not routine immunohistochemical (IHC) stain, is recommended, despite a lot of institutions perform multiple level sections and IHC stains for each block of sentinel lymph nodes (SLNs). Once the limits within pN1mi and ITCs were defined, they have been based in small data, and here is an area where we should focus and build evidence based definitions that have proven differences and importance in clinical management. As for their therapy, in ITCs cases, axillary lymph node dissection (ALND) is omitted, but a large amount of data questions the safety of this omission. In pN1mi cases, ALND is performed.
Factors Leading to Conversion from Laparoscopy to Open Surgery in Partial Nephrectomy: a Case Series and Literature Review.
Iordache A, Mares NA, Iordache N … +3 more , Ungureanu CO, Popescu RI, Ginghina O
Maedica (Bucur) · 2025 Jun · PMID 40880688 · Full text
Minimally invasive surgery offers significant benefits for partial nephrectomy. Intraoperative incidents and postoperative complications lead to conversion to open surgery and increase perioperative morbidity and mortali...
Minimally invasive surgery offers significant benefits for partial nephrectomy. Intraoperative incidents and postoperative complications lead to conversion to open surgery and increase perioperative morbidity and mortality. Understanding the factors that contribute to the occurrence of complications is important for reducing the perioperative risk. Between 2022 and 2024, we prospectively observed intraoperative complications in cases of partial nephrectomy performed laparoscopically in the Urology Department of 'Professor Dr. Theodor Burghele' Clinical Hospital, Bucharest, Romania. We report seven cases in which laparoscopic partial nephrectomy was converted to an open approach, requiring prompt management. The most common complication leading to conversion was the presence of adhesions, which made dissection of the planes difficult, followed by intraoperative bleeding, which hindered optimal visualization. Laparoscopic partial nephrectomy is challenging and its management must be individualized. Conversion during laparoscopic renal procedures is usually rare; however, a significant event is influenced by the complexity of the procedure and patient characteristics.
Usefulness of Non-Invasive Myocardial Work and Systemic Inflammation Assessment in Predicting Left Ventricular Dysfunction in Patients with Acute Coronary Syndrome.
Copciag R, Bratu V, Rimbas R … +6 more , Magda S, Lungeanu L, Corlan A, Schiopu A, Simionescu M, Vinereanu D
Maedica (Bucur) · 2025 Jun · PMID 40880685 · Full text
BACKGROUND: Left ventricular (LV) remodeling plays a pivotal role in the pathophysiology of heart failure (HF) following acute coronary syndrome (ACS). Left ventricular ejection fraction (LVEF), left ventricular (LV) vol...
BACKGROUND: Left ventricular (LV) remodeling plays a pivotal role in the pathophysiology of heart failure (HF) following acute coronary syndrome (ACS). Left ventricular ejection fraction (LVEF), left ventricular (LV) volumes and, more recently, speckle tracking echocardiography (STE) are used to describe LV performance. Myocardial work (MW) is a new noninvasive imaging method that integrates loading conditions and can be used to detect early myocardial dysfunction before LVEF decreases. AIM: This study aims to characterize the relationship between MW, high-sensitivity troponin (hs-cTn I) and C-reactive protein (CRP) as an inflammation biomarker. Their use as predictors for LV dysfunction in the acute phase of ACS is of particular interest but is still under debate. METHOD: Complete clinical examination and two-dimensional echocardiography (2-DE), with speckle-tracking and myocardial work measurements, were performed in the first 24 hours after admission. Locally available biomarkers were assessed in the same timeframe, with special interest in hs-cTn I and CRP, as a marker for inflammation. A follow-up visit, including the same clinical, biological, and echocardiographic measurements, was performed six to eight weeks after the index event. RESULTS: We evaluated 56 patients (53 ± 10 years, 45 men) with ACS. Baseline hs-cTn I significantly correlated with baseline global longitudinal strain (GLS) (r=0.43, p=0.001) and baseline MW parameters (GWI: r=-0.44, p=0.001; GCW: r=-0.40, p=0.002). A correlation between hs-cTn I and LVEF was not statistically relevant. C-reactive protein, which was used to assess systemic inflammation, also failed to correlate with LVEF. However, CRP significantly correlated with relevant MW parameters (GWE: r=-0.53, p<0.001 and GWW: r=0.48, p<0.001). C-reactive protein levels above 28 mg/L correlated with a decrease in MW performance assessed by GWE, suggesting a possible tendency to adverse remodeling. CONCLUSIONS: C-reactive protein level in the first 24 hours after ACS and its correlation with MW parameters may be a potential indicator of future LV dysfunction and heart failure.
Applying Cone Beam Computed Tomography to Examine Maxillary Sinus Septa and Figuring Out the Occurrence of Morphological Patterns.
Razavi M, Mousavi SE, Bakhshi A
Maedica (Bucur) · 2025 Mar · PMID 40677676 · Full text
A comprehensive examination of anatomical characteristics, particularly the maxillary sinus septa, is crucial for the efficacy of sinus interventions. The current research employed cone beam computed tomography (CBCT) to...
A comprehensive examination of anatomical characteristics, particularly the maxillary sinus septa, is crucial for the efficacy of sinus interventions. The current research employed cone beam computed tomography (CBCT) to figure out the position of the maxillary sinus septa and the prevalence of particular morphological patterns. This descriptive-analytical retrospective study was conducted in 2020. The sample size (n=108 samples) was determined by a census method, where all CBCT images of the maxillary arches of patients visiting the Radiology Department of the Faculty of Dentistry, Ahvaz University of Medical Sciences, Iran, during the years 2018-2019, were included in the present study. All images were obtained and stored using the NewTom VGi (QR, Verona, Italy) system under automatic exposure conditions. Data were collected by the researcher using a checklist and then analyzed using SPSS version 22 at a significance level of 0.05. The results indicated that the prevalence of septa was 21.3%, with the majority (8.3%) on the inferior wall. The distribution of septa was similar between genders and across the molar and premolar regions. The direction of septa was vertical in 60% of cases, with no significant difference between genders (P>0.05). Vascular structures were present in 40% of cases, with no significant gender-related differences (P>0.05). The maxillary sinus septa were 5.51±9.34 mm long and 4.94±1.09 mm apart from the vascular structures. It is hoped that the results of this study may help reduce the risk of complications during sinus lift surgeries, particularly in terms of minimizing the occurrence of severe bleeding.
Effect of Yoga on Pulmonary Function Tests and Arterial Stiffness in Post-COVID-19 Mild Moderate Cases.
Mundhe R, Ganji V, Neeraja V … +5 more , Taranikanti M, John NA, Kalpana M, Umesh M, Gaur A
Maedica (Bucur) · 2025 Mar · PMID 40677675 · Full text
COVID-19 caused by the novel coronavirus SARS-CoV-2 has resulted in significant morbidity and mortality worldwide. Long term respiratory complications secondary to COVID-19 have been described, which were not fully explo...
COVID-19 caused by the novel coronavirus SARS-CoV-2 has resulted in significant morbidity and mortality worldwide. Long term respiratory complications secondary to COVID-19 have been described, which were not fully explored. The severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) directly infects endothelial cells, with inducing marked endothelial damage and inflammation contributing to increased arterial stiffness. Yoga is a holistic psychosomatic approach that leads to improvement of pulmonary and cardiovascular functions. Hence, this study aimed to evaluate the effect of yoga on pulmonary functions and arterial stiffness who have suffered from COVID-19. The aim of the present interventional study was to measure and investigate the effect of yoga on the pulmonary function tests and arterial stiffness in post-COVID-19 mild and moderate cases. After taking the approval of the Institutional Ethical Committee (IEC), 30 post-COVID-19 patients were recruited into the study. The baseline arterial stiffness (oscillometric method) and baseline pulmonary functions tests were assessed (using computerized spirometer HELIOS 70). The study participants were then subjected to a yoga intervention for eight weeks. Pulmonary function tests and arterial stiffness was assessed after the yoga intervention and findings were compared with the baseline data. After eight weeks of yoga intervention, there was a statistically significant increase in the mean values of FEV1, FEV3, FVC and percentage of FEV1/FVC ratio (p<0.05), and a highly significant decrease in two arterial stiffness parameters, including brachial-ankle pulse wave velocity (baPWV) (p<0.001) and carotid-femoral pulse wave velocity (cfPWV) (p<0.001). This shows that performing yoga regularly has a significant effect on the body vasculature and arterial stiffness. Pearson correlation test showed a positive correlation between systolic blood pressure (SBP) and baPWV (r=0.45) (p<0.001). There was also a positive correlation observed between cfPWV (r=0.37) and systolic blood pressure (SBP) (p<0.05). The study indicates that pulmonary function tests and arterial stiffness improve in post-COVID-19 mild and moderate cases with eight weeks of regular yoga practice.
Efficacy of Arthroscopic Surgery in the Management of Synovial Giant Cell Tumors: a Case Report.
Konstantinidis C, Konstantinou A, Plakoutsis S … +7 more , Kotsias C, Panagiotopoulos V, Koukos C, Anagnostou E, Pakos EE, Vardakas D, Giotis D
Maedica (Bucur) · 2025 Mar · PMID 40677674 · Full text
Giant cell tumors of the synovial membrane are benign but locally aggressive lesions that primarily affect synovial joints. Histologically, they are characterized by the proliferation of histiocytes, multinucleated giant...
Giant cell tumors of the synovial membrane are benign but locally aggressive lesions that primarily affect synovial joints. Histologically, they are characterized by the proliferation of histiocytes, multinucleated giant cells and prominent hemosiderin deposition. Clinically, patients often experience joint pain, swelling and restricted movement, which can significantly impact their mobility and quality of life. Traditionally, open surgical excision has been the standard approach for managing these tumors. However, advancements in minimally invasive techniques, particularly arthroscopic surgery, have emerged as effective alternatives. Arthroscopy offers several benefits, including reduced postoperative pain, quicker recovery and minimal surgical trauma, while still allowing for complete tumor removal. This article presents a case of a giant cell tumor of the synovial membrane in the knee of a female patient, highlighting the successful use of arthroscopic treatment and the favorable postoperative outcomes. By presenting this case, we aim to emphasize the growing role of arthroscopic intervention in managing these tumors, further supporting its integration into clinical practice.
Vitamin K-Dependent Inhibition Mechanisms in Human Aortic Valve Calcification.
Mavroudeas SE, Apostolos A, Spyropoulou D … +8 more , Matthaiopoulos G, Katsaros O, Kafkas N, Tsiambas E, Aggeli K, Tousoulis D, Tsioufis C, Toutouzas K
Maedica (Bucur) · 2025 Mar · PMID 40677673 · Full text
Stenosis of the aortic valve is a leading cause of severe cardiovascular lesions. Progressive calcification, rheumatic modifications and also congenital events are the main etiopathogenetic factors. Extended fibrotic cha...
Stenosis of the aortic valve is a leading cause of severe cardiovascular lesions. Progressive calcification, rheumatic modifications and also congenital events are the main etiopathogenetic factors. Extended fibrotic changes and aberrant ectopic calcification of the specific aortic valve interstitial cells are the most recognizable histopathological features. In fact, the previously referred cells are transformed from their initial myofibroblast phenotype to an osteoblast-like cell formation mediated by an inflammatory process. Concerning the potentially effective anti-calcification, inhibition strategies, some molecules are under investigation. Among them, vitamins seem to be involved in this process by preventing aortic wall extensive calcification. The purpose of the current review was to explore the involvement of Vitamin K complex in the inhibition mechanisms of the human aortic valve calcification process. A systematic retrospective review of the literature was carried out based on PubMed international medical database. The following keywords were used: vitamin, calcification, cardiovascular, stenosis, aorta. A broad spectrum of seventy (n=70) significant articles - focused on the vitamin K complex structural and functional aspects and its implication in anti-calcification mechanisms - were selected for the current review study. The majority of medical data referred to after 2015 published articles, whereas specific references of great importance and value were also included. Specific vitamin K members play a crucial role by regulating the activity of proteins such as osteocalcin that induces endothelial calcification. Interestingly, vitamin K also modifies the function of the matrix-Gla proteins that are implicated in this process. In fact, vitamin K-related molecular and biochemical mechanisms in the human aortic valve calcification inhibition are crucial and represent an interesting field for research.
Peripheral Opioid Receptors in the Modulation of Inflammatory Pain: a Narrative Review.
Jafal NM, Stoleru S, Orban C … +1 more , Fulga IG
Maedica (Bucur) · 2025 Mar · PMID 40677672 · Full text
Opioid receptors are key modulators of pain, with both central and peripheral subtypes contributing to analgesia. While central opioid receptors have been extensively studied, peripheral opioid receptors, located on sens...
Opioid receptors are key modulators of pain, with both central and peripheral subtypes contributing to analgesia. While central opioid receptors have been extensively studied, peripheral opioid receptors, located on sensory nerve terminals and immune cells, have gained attention for their ability to provide localized analgesia and anti-inflammatory effects without central side effects such as respiratory depression and sedation. This narrative review explores the classification, localization, and activation of peripheral opioid receptors, emphasizing their role in inflammatory pain modulation. These receptors are upregulated in inflamed tissues, enhancing analgesic efficacy. Their activation modulates nociceptive signaling through inhibition of excitatory neurotransmitter release, potassium channel activation, and immune regulation. Peripherally acting opioid receptor agonists offer targeted pain relief, while selective antagonists mitigate opioid-induced constipation without affecting central analgesia. Preclinical studies, including carrageenaninduced inflammation models, have reinforced the potential of peripheral opioid receptor targeting in pain therapy. Future research should focus on optimizing these agents for clinical use, improving drug delivery systems, and integrating them into multimodal pain management strategies.
Robotic-Assisted Right Upper Lobe Pulmonary Metastasectomy in a Patient with Rectal Adenocarcinoma: a Case Report.
Dobrea VC, Berbescu B, Brezean I
Maedica (Bucur) · 2025 Mar · PMID 40677671 · Full text
Pulmonary metastases from colorectal cancer (CRC) present a complex therapeutic challenge. Robotic-assisted thoracic surgery (RATS) is increasingly utilized for its precision and minimally invasive advantages. We report...
Pulmonary metastases from colorectal cancer (CRC) present a complex therapeutic challenge. Robotic-assisted thoracic surgery (RATS) is increasingly utilized for its precision and minimally invasive advantages. We report the case of a 55-year-old male diagnosed with T1N0M0 rectal adenocarcinoma, who underwent abdominoperineal resection without adjuvant chemotherapy. Fourteen months later, positron emission tomography-computed tomography (PET-CT) identified bilateral pulmonary metastases. A robotic-assisted wedge resection of the right upper lobe nodule was performed at the Thoracic Surgery Department of GHRMSA "Emile Muller", Mulhouse, France. Lymphadenectomy was not conducted, which was consistent with current evidence suggesting limited benefit in CRC metastases. The patient's overall survival was 18 months from the initial diagnosis to the first metastasectomy. Robotic-assisted metastasectomy offers a safe, precise and efficient option for managing pulmonary metastases from CRC. This case highlights the role of molecular profiling in prognostication and the evolving surgical approaches in metastatic CRC.
The impact of Low-Anterior Resection Syndrome (LARS) on the Quality of Life in Rectal Cancer Survivors: a Narrative Review.
Stanculea F, Ungureanu CO, Roca D … +4 more , Ginghina O, Mihailov R, Grama F, Iordache N
Maedica (Bucur) · 2025 Mar · PMID 40677670 · Full text
Low anterior rectal cancer is based on oncological radicality and recurrence rates, which translate to survival. Rectal dysfunction occurred in at least one-quarter of patients. This dysfunction is a myriad of symptoms r...
Low anterior rectal cancer is based on oncological radicality and recurrence rates, which translate to survival. Rectal dysfunction occurred in at least one-quarter of patients. This dysfunction is a myriad of symptoms referred to as low anterior resection syndrome (LARS). In this review, we analyzed the definitions, risk factors and pathophysiological mechanisms of LARS. A better understanding of this syndrome can lead to improved prevention and treatment of LARS.
Gender Differences in Depressive Disorders in Children and Adolescents: Results from a Clinical Sample.
Andrei LE, Mihailescu I, Buica AM … +3 more , Moise M, Dobrescu I, Rad F
Maedica (Bucur) · 2025 Mar · PMID 40677669 · Full text
Adolescence is a unique period of significant neurodevelopmental changes that can increase vulnerability to mental health problems. We are currently witnessing an increase in depressive symptoms among adolescents, with s...
Adolescence is a unique period of significant neurodevelopmental changes that can increase vulnerability to mental health problems. We are currently witnessing an increase in depressive symptoms among adolescents, with suicide being among the top three causes of death for young people aged 10-25 years. In depressive disorders (DD) there are significant differences between genders in terms of symptomatology, risk factors, evolution and prognosis. Thus, the objective of our study is to investigate gender differences among children and adolescent patients admitted for evaluation of depressive symptomatology to our clinic. The current study is an analytical, non-experimental, retrospective study on children and adolescents admitted to the Pediatric psychiatry clinic at "Prof. Dr. Al. Obregia" Clinical Psychiatry Hospital in Bucharest, Romania, between 1 January 2020 and 30 June 2024, who were diagnosed with DD. Descriptive analysis of the qualitative and quantitative variables was performed. The variables were processed and analyzed using Microsoft Office Excel 2007 and Microsoft Power BI 2024. The present study included 915 patients (77.04% females, 22.96% males) aged 9-17 years, with a mean age of 15.42 ± 1.79. Most patients [43.83% (34.21% females, 9.62% males)] were diagnosed with severe depressive episode without psychotic symptoms. Suicidal ideation or suicidal attempts at admission were identified in 30% of our patients (24% females, 6% males). In the analyzed time period, pediatric patients have been increasingly diagnosed with depressive disorders: from 120 patients diagnosed in 2020 to 265 in 2023 and 120 in the first half of 2024. Our study shows an increase in DD and suicidality in pediatric patients, with important differences among genders in terms of clinical aspects, severity and evolution, thus highlighting the need for early identification and targeted therapeutical interventions.
The Experience of SARS-CoV-2 in Patients with Benign Prostatic Hyperplasia: Is There Any Correlation between Them?
Balacescu S, Geavlete B, Ungureanu C … +7 more , Ene C, Ene CD, Bulai C, Mares C, Punga A, Militaru A, Geavlete P
Maedica (Bucur) · 2025 Mar · PMID 40677668 · Full text
Recent studies suggest that the international prostate symptom score (IPSS), especially in older men, may result from COVID-19, and that LUTS may be high in the early stages of the illness. The primary goal of the presen...
Recent studies suggest that the international prostate symptom score (IPSS), especially in older men, may result from COVID-19, and that LUTS may be high in the early stages of the illness. The primary goal of the present review is to ascertain the true impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the development of patients with benign prostatic hyperplasia (BPH) by analyzing the body of available literature. By May 2023, a comprehensive and categorized search of the literature was conducted utilizing the following global databases: the Cochrane Library, Web of Science, PubMed, Embase and Scopus. To assess their eligibility, all English-language records were included, including peer-reviewed online publications and published works. Additional sources were identified using the retrieved material's citations. There were no limitations on the sample size. SARS-CoV-2 penetrates cells by attaching itself to the angiotensin-converting enzyme 2 (ACE2) receptor of the prostate. This combination may cause direct harm to the prostate and accelerate the development of BPH. The pathophysiology of BPH involves androgen receptors, and the infection caused by SARS-CoV-2 may be androgen-mediated. This may cause the symptoms of BPH to worsen and progress. Pro-inflammatory pathways can be triggered and cytokine release increased by SARS-CoV-2 infection. This inflammation can exacerbate lower urinary tract symptoms (LUTS) and cause the prostate gland to become inflamed. Benign prostatic hyperplasia may occur because of metabolic disturbances brought on by the coronavirus disease caused by SARS-CoV-2 (COVID-19), such as newly diagnosed diabetes and cardiovascular issues. To illustrate the impact of COVID-19 on the onset of these symptoms and quantify the changes in them, it is desirable to identify the factors that contribute to the worsening of BPH-related LUTS after COVID-19 recovery.
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