Items · Current Health Sciences Journal

Acute Epstein-Barr Virus and SARS-CoV-2 Coinfection: A Case Report

M. E. Tesch Ferreira ALVES; L.De Figueiredo MELLO; F.R.Ferreira ALVES

2024/09/30

10.12865/CHSJ.50.03.14

Medicine

Introduction. The present case describes one of the few reported occurrences of coinfection by EBV and SARS-CoV-2, initially treated as streptococcal pharyngitis. Case Description. An 18-year-old female was admitted with whitish plaques in the throat associated with pain, cough, hoarseness, asthenia, tonsillar exudate, hypertrophy, hyperemia, and adenomegaly on the cervical region. Based on suspicion of bacterial tonsillitis, the patient was already taking amoxicillin with clavulanate. A rapid test was negative for group A streptococci. Laboratory exams revealed elevated counts of Anti-VCA IgM and Anti-VCA IgG for EBV. The cytomegalovirus (IgM and IgG) result was negative, and the blood count was within normal limits. However, a COVID-19 infection was confirmed by qPCR. The management was supportive treatment for symptom relief and isolation for 14 days. The patient remained afebrile and clinically stable during this period, with saturation ranging from 98% to 100%. However, the patient evolved with anosmia and ageusia. Then, olfaction training therapy was initiated, as well as continuing asthenia. Five days later, she presented petechiae on the chest and upper limbs, associated with mild pruritus. Conclusion. Epstein-Barr mononucleosis and COVID-19 are similar in some aspects, and their viruses may be associated with a coinfection, which could make the diagnoses difficult and aggravate the clinical condition. In addition, it is essential to emphasize the importance of laboratory tests to avoid erroneous treatments that may worsen the patient's condition and change his prognosis.

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Anterior Pituitary Hormones are Important in Growth, but does their Deficiency Cause Skeletal Deformity? A Case Report

Y. YUMUSAKHUYLU; A. ICAGASIOGLU; A. GUVEN

2024/09/30

10.12865/CHSJ.50.03.13

Medicine

Hypopituitarism is a clinical syndrome that occurs when the anterior pituitary gland fails to secrete one or more hormones. Developmental delay is frequently seen in these patients. However, skeletal deformities and postural instability are unexceptional. We present a 17-year-old male patient with panhypopituitarism (PHP) with back and leg pain, postural malalignment, and skeletal deformities referred by the pediatric endocrinology clinic. According to the physical examination, laboratory tests, and radiographic assessments, the patient was considered as sequela spondyloarthropathy (SpA). Autoimmune and rheumatic diseases are frequently encountered in patients with hypogonadism. However, the association of PHP and ankylosing spondylitis (AS) has not yet been demonstrated. This case was presented to draw attention to the alignment of PHP and SpA and also to emphasize that skeletal deformities were not encountered in the absence of anterior hypophysis hormones.

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Cutaneous Metastases of Signet-Ring Cell Gastric Carcinoma: A Case Report

G. I. KURMUS; F. CANPOLAT; M. GONUL; A. GOKCE; S. P. KARTAL

2024/09/30

10.12865/CHSJ.50.03.12

Medicine

The cutaneous metastases from carcinoma of the stomach are rare and either an index of a silent visceral neoplasm or a recurrence of an already diagnosed malignancy. They usually present as asymptomatic nodules or plaques; thus, they can be mistaken for other skin conditions, which leads to a potential misdiagnosis. The definition of signet-ring cell (SRC) gastric carcinoma is that it can easily cause a diffusion enbloc through lymphatic and hematogenous pathways, inducing skin manifestations such as indurated plaques, nodules, and erysipelas-like lesions. The infrequency of skin metastasis from gastric carcinoma underlines once more the need for increased awareness on the part of clinicians. Diagnosis, histopathological examination, and immunohistochemistry are essential. The confirmation of SRC tumors is done by staining for mucin, such as periodic acid-Schiff (PAS) and mucicarmine, and by using immunohistochemical markers like CK7. Almost always, cutaneous metastasis from SRC gastric carcinoma has a poor prognosis since these tumors are highly aggressive and chemotherapy-resistant. We present a case of cutaneous metastasis from SRC gastric carcinoma, a subtype of gastric cancer with a well-documented tendency both for distant and cutaneous spread. Generally, skin metastases from SRC gastric carcinoma are associated with poor prognosis, rapid progression of the disease, and a high mortality rate. This case underlines the need for early detection and a multidisciplinary approach by dermatologists, oncologists, and surgeons to improve outcomes in such patients.

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Two-Year Outcomes in Preterm Infants Suffering from Moderate to Severe Bronchopulmonary Dysplasia with or without Associated Pulmonary Hypertension

I. BRANESCU; D. O. ALEXANDRU; S. VLADAREANU;; A. KULKARNI

2024/09/30

10.12865/CHSJ.50.03.11

Medicine

Objectives: to assess the impact of pulmonary hypertension (PH) on short and long-term respiratory and neurodevelopmental outcomes in extremely preterm infants, diagnosed with moderate to severe bronchopulmonary dysplasia (MSBPD). Study design: cohort study, with retrospective analysis of the medical records of infants born at ?32 weeks gestation admitted to a single neonatal tertiary centre from 2010 to 2020. Primary outcome was consistent with hospital re-admissions by 2 years post menstrual age. Neurodevelopment was assessed using Bayley’s Scales of Infant and Toddler Development 3rd edition (Bayley-III) as a secondary outcome. Results: 201 infants with no PH and 23 infants with PH were analysed. The PH group showed higher risk for respiratory and paediatric intensive care unit re-admission (65%) during the first 2 years of life (OR: 3.15; 95% CI: 1.28 to 7.78; p<0.5). In contrast to current published literature, our study showed that pulmonary hypertension complicating moderate to severe bronchopulmonary dysplasia had no negative impact on neurodevelopmental outcomes (OR: 1.87; 95% CI: 0.72 to 4.88; p value=0.19). However, in our population, ethnicity, chorioamnionitis and need for persistent ductus arteriosus treatment were all independently associated with poor neurodevelopmental outcomes (p values <0.5). Conclusion: infants with MSBPD associated pulmonary hypertension (MSBPD-PH) are more likely to need intensive care and respiratory hospital re-admissions. Ethnicity, chorioamnionitis and need for ductus arteriosus treatment are independently associated with poor neurodevelopmental outcomes regardless of the pulmonary hypertension status.

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The Relationship between Sleep Bruxism Index and Quality of Life

E. C. SIN; G. RAFTU; S. G. BUSTUIC; A. CARAIANE; R. BRICEAG

2024/09/30

10.12865/CHSJ.50.03.10

Medicine

Aim of the study: The aim of this study was represented by the identification of the type of relation between the bruxism sleep index and the global quality of life. Materials and Methods: The study group was composed of a number of 40 patients, both women and men, who did not report health problems and who were identified with a positive self-report regarding the existence of sleep bruxism. For the identification of the bruxism index, the Bruxoff device, Bioelettronica, Turin, Italy, was used. Quality of life inventory (QOLI) was used to determine quality of life scores (T-score). Results: The gender distribution of the batch is as follows: 52.5%-male, 47.5%-female. The maximum value of the bruxism index was 10.5, and the minimum was 2.10, with a mean of 6.30 and a standard deviation of 2.22. Quality of life T-score recorded maximum value equal to 62, minimum value equal to 40, mean equal to 51.87. The Pearson correlation coefficient calculated to test the correlation between the bruxism indicator and the QOLI T Score presented a negative value (-0.643), which signifies a negative but very strong relation between the two variables. 77.5% of the participants were included in a mean level of quality of life. Conclusions: A statistically strong negative relation was found between global quality-of-life (T-scores) and the bruxism indicator in patients with bruxism activity during sleep.

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Assessment of Neutrophil-Lymphocyte Ratio and Systemic Immune-Inflammation Index in Systemic Scleroderma Patients with Focus on Cardiopulmonary Manifestations

C. PALICI; S. C. DINESCU; C. E. BITA; A. FLORESCU; A. E. MUSETESCU; F. VREJU; P. L. CIUREA

2024/09/30

10.12865/CHSJ.50.03.09

Medicine

To quantify levels of two inflammation-related indexes, namely neutrophil-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) in systemic scleroderma patients and determine the association with clinical manifestations and features of heart ultrasound. Methods: The study group consisted of 34 patients with diagnosis of systemic scleroderma which were admitted to the hospital during 2015-2019. Patient data included the presence and type of clinical manifestations of systemic scleroderma, chest imaging to screen for lung disease, heart ultrasound reports and the laboratory investigations needed to quantify inflammatory indexes. We analysed the levels of inflammatory indexes and compared results based on the prevalence of systemic manifestations. Results: Higher serum levels of NLR and SII are associated with the presence of joint, lung and pericardial involvement. Statistical significance was observed only for NLR levels with regard to the presence of articular involvement and ILD. Low ejection fraction was also associated with higher levels of both inflammatory indexes, without statistical significance. Conclusion: Inflammatory indexes are cost-effective markers that reflect active disease manifestations of systemic scleroderma and can thus be a useful tool to include in the regular follow-up of patients in order to better inform organ-specific assessments.

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Epidemiological and Histopathological Features of Oral Squamous Cell Carcinoma-A Retrospective Study

I. ILIE; O. C. MARGARITESCU; A. E. STEPAN; R. N. CIUREA; M. M. FLORESCU; C. MUNTEANU; M. S. SERBANESCU; C. MARGARITESCU

2024/09/30

10.12865/CHSJ.50.03.08

Medicine

Oral Squamous Cell Carcinoma (OSCC) it was reported to be the 6th on the list of human malignant neoplasms responsible for high morbidity and mortality worldwide. We conducted a retrospective study between 2009-2019, investigating 50 such cancers hospitalized and diagnosed during this period in our institution. The purpose of the study was to establish a clinical-morphological profile of this type of cancer developed in the geographical area served by our institution. The epidemiological study highlighted the predominance of cases in men over 50 years old, mainly affecting the tongue, followed by the lips and oral floor. The histopathological study showed the prevalence of conventional cases of OSCC (70%) and the rest of the cases belonging to rarer forms (acantholytic-18%, verrucous-6%, basaloid-4% and sarcomatoid-2%). In terms of the degree of differentiation, the moderately differentiated cases prevailed (64%) and according to the TNM clinical stage, most cases were diagnosed in stage II (36%) and IV (26%). 70% of investigated cases presented muscle invasion and 38% perineural invasion. Our investigation highlighted the existence of particular morpho-clinical profiles depending on the tumor topography. Thus, tumors developed at the tongue level reached the maximum frequency in the 6th decade of life, being absent in the 8th decade and most often associated muscle invasion and perineural invasion, being diagnosed in advanced pTNM stages.

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Is Serum Matrix Metalloproteinase 9 and/or D-Dimer Levels a Marker for Identifying Abdominal Aortic Aneurysms in Patients with Significant Coronary Atherosclerosis?

D. A. BRIE; A. M. JIANU; R. POPESCU; D. M. BRIE; M. BORUGA

2024/09/30

10.12865/CHSJ.50.03.07

Medicine

Our research aims to find a connection between the levels of MMP-9 and D-dimers in the blood and the prevalence of AAAs in subjects with atherosclerotic coronary disease. We selected fifty patients from each group and measured their MMP-9 and D-dimer levels in the blood. We discovered that in subjects with significant coronary disease and angina pectoris, the level of MMP-9 is higher compared to the subjects with angina pectoris but without significant coronary disease. When comparing this group with those with significant coronary disease and AAA, the level of MMP-9 is lower. Additionally, the D-dimer level was significantly higher in subjects with both AAA and significant coronary atherosclerosis compared to patients with significant coronary disease alone or those without significant coronary disease or AAAs. Subjects with significant coronary disease and AAA have elevated levels of MMP-9 and D-dimer compared to patients with significant coronary disease alone or without coronary artery disease or AAAs. These two factors could be used as indicators for diagnosing AAA in patients with angina pectoris.

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Testing a Psychological Intervention in Elite Athletes to Alleviate the Psychomotor Consequences of Doping: The Moderating Role of Personality

E. COLITA; L. ZAGREAN; M. GRIGORE; A.POPA-WAGNER

2024/09/30

10.12865/CHSJ.50.03.06

Medicine

This study aimed to evaluate a psychological intervention intended to reduce the psychomotor effects of doping. The research also examined how conscientiousness and emotional stability moderated the intervention's effectiveness. The intervention was developed based on the literature and included two components: biofeedback and mental imagery/rehearsal. Athletes reported higher scores post-intervention in coordination, sports skills, overall physical condition, strength, flexibility, endurance, and general self-esteem. Similar results have been observed in previous studies related to biofeedback and mental imagery. According to the results, athletes with higher conscientiousness benefited more from the intervention in terms of coordination, flexibility, and endurance. The data support the idea that emotionally stable athletes benefit more from the intervention in terms of overall physical condition and general self-esteem. Theoretically, the studies highlight the importance of psychological interventions in enhancing athletes' psychomotor performance and the interaction between these interventions and individual differences among participants. The findings are relevant for sports psychology practitioners, as they provide additional evidence for the use of biofeedback and mental imagery with athletes.

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Assessment of Surgical and Non-surgical Outcomes in Patients with Dementia and Hip Fractures

A. V. BRADEANU; I .BOUNEGRU; L. S. PASCU; A. CIUBARA; T. A. BALSEANU

2024/09/30

10.12865/CHSJ.50.03.05

Medicine

Introduction: The aging population is associated with increased osteoporosis and risk of hip fractures. Cognitive decline has recorded exponential increases in the last decades, with the rise in life expectancy. Material and methods: We conducted a prospective study on 65 patients over 65 years old associated with dementia and hip fractures. We used pre-and post-treatment variables such as age, type of fracture, type of treatment, Charlson Comorbidity Index (CCI), EQ-5D-5L score, and the Harris hip score (HHS) to assess pain, mobility, and mortality. We performed follow-ups at 6 months, 1 year, 2 years, and 3 years. Results: Patients with dementia typically arrive at the hospital without any previous analgesic treatment and receive lower doses due to poor pain recognition. The 6-month mortality rate was 48.22% and increased to 78.46% at 3 years. The best survival rates were in patients with bipolar prosthesis and Gamma nails, with a 3-year survival rate of 40% and 50%, respectively. Conclusions: Patients with dementia have a higher mortality rate compared to cognitively intact patients and the treatment decisions require a multidisciplinary team and individualized recommendations for each patient, due to high surgical risk in the elderly.

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Assessment and Rehabilitation in Sarcopenic Patients

B. M. VLADUTU; M. SERBANESCU; M. R. TRAISTARU

2024/09/30

10.12865/CHSJ.50.03.04

Medicine

Sarcopenia is a degenerative disorder that particularly affects older people and is defined by a pathological decrease in muscle strength. This disease represents one of the topics of great interest in the medical world of the last two decades. In our study, we tried to underline the importance of an adapted recovery program based on physical exercise for regaining clinical and functional status in patients with age-related sarcopenia. No nutritional intervention was applied. We performed our rehabilitation program in accordance with present international recommendations for sarcopenia. After complete assessment, our patients were randomised into two groups: G1 (Lot 1=25 patients) and G2 (Lot 2=15 patients). G1 patients were compliant with kinetic training, and performed all rehabilitation measures, and G2 patients accepted rehabilitation program without kinetic exercises. Patients assessment (lab tests, gait analysis, VAS and the Clinical Frailty Scale) was made on two levels-first (T1-inpatient assessment), and after 6 months (T2-outpatient assessment). The rehabilitation program based on the kinetic program brought positive improvements in physical performance and locomotion (gait speed and walking cadence) in sarcopenic patients.

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Limb Salvage Surgery in Pediatric Patients with Osteosarcoma

S. A. NICULESCU; A. F. GRECU C. GHEONEA; D. C. GRECU

2024/09/30

10.12865/CHSJ.50.03.03

Medicine

Osteosarcoma, although rare, is acknowledged as the most common primary bone tumor in children and adolescents. Osteosarcoma is a highly malignant osteogenic tumor that can develop in any bone, but commonly develops at the metaphysis of long bones. The positive diagnosis of osteosarcoma is based on the pathology exam, since there are no other specific diagnostic tools, and the patients with osteosarcoma are typically treated by a multidisciplinary team of specialists. The mainstream for the surgical treatment of limb osteosarcoma is the limb salvage surgery, whenever this approach does not compromise the oncological outcomes. A large spectrum of reconstructive surgical procedures is used in various centers, and to date there is no large consensus on recommending one over another. It is often that the practitioner has to decide whether the final impact on the quality of life of the child undergoing endoprosthetic replacement or osteoarticular allograft is better with the subsequent inequality of the length of the limb or the radical approach by amputation is better. Special consideration has to be given on the aspects of psychosocial wellbeing of the patients following the initial surgical intervention.

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Comparison of Blood Pressure Measurement Results from Two Different Regions (Upper Arm and Ankle)

A. COBANOGLU

2024/09/30

10.12865/CHSJ.50.03.02

Medicine

Background: This study was conducted to determine the clinical concordance of non-invasive blood pressure (NIBP) measurements from the upper arm and ankle and to determine whether there is a difference between them. Methods: A prospective and cross-sectional research design was used in this study. The study population included 106 patients hospitalized in the surgical clinics of a training and research hospital. Non-invasive blood pressure measurements were performed from both upper arms and ankles in the supine position. In the data analysis, ANOVA and the Bland-Altman plot were employed. Results: Based on the results of NIBP measurements from the arm and ankle, the differences between diastolic blood pressure (DBP) and mean blood pressure (MBP) were acceptable and within the limits of concordance. The difference between the mean systolic blood pressure (SBP) was found to be significantly different and outside the limits of concordance. The difference between the mean SBP measured from the ankle and the upper arm was determined to be 18 mmHg. Conclusion: It was determined that the results of SBP measured from the ankle were significantly higher and outside the limits of concordance compared to the upper arm, while the results of DBP and MBP measurements were within acceptable limits.

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Potential Biomarkers for Disease Activity in Systemic Lupus Erythematosus

O. R. PREDESCU; A. F. VREJU; S. C. DINESCU; A. FLORESCU; C. E. BITA; A. E. MUSETESCU; A. L. BARBULESCU; P. L. CIUREA

2024/09/30

10.12865/CHSJ.50.03.01

Medicine

Objectives: The study has as main objective the evaluation of the potential roles of vitamin D, the neutrophil to lymphocyte ratio (NLR), and the systemic inflammation index (SII) as future biomarkers regarding the classification of flares in systemic lupus erythematosus (SLE). Material and Methods: Individuals diagnosed with SLE were encompassed in this observational study. The current applicable criteria, namely The European Alliance of Associations for Rheumatology (EULAR)/American College of Rheumatology (ACR) 2019 criteria had to be fulfilled. The participants underwent specific musculoskeletal examination, paraclinical investigations including complete blood count (CBC), determination of serum creatinine levels, as well as liver enzymes, and also the markers of inflammation. The fractions of the serum complement (C3 and C4) were also evaluated, together with serum vitamin D concentrations. Safety of Estrogens in Lupus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) was required in order to analyze the research group’s disease activity. Results: NLR and SII demonstrated validity, having statistically significant correlations with SELENA-SLEDAI (p value less than 0.001). The ROC analysis proved a strong discriminative power for NLR (AUC=0.96) and SII (AUC=0.963) in predicting severe disease flares. Optimal cut-off values were 3.45 for NLR and 877,002.19 for SII. Serum vitamin D concentrations had a weak association with the SLEDAI score (p=0.048, r=0.213). Conclusions: NLR and SII can be considered reliable biomarkers for discriminating between the levels of disease activity in SLE individuals. Low serum levels of vitamin D may also influence disease severity, but require further validation.

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Case Presentation of a Minor Patient, Survivor of a Burn with ABSI Score - 12 Points (Probability of Survival Below 20%)

D. M. CANUT; R. TATAR; D. M. ENESCU; A. E. MARINESCU; A. I. TALABAN; V. PARVANESCU; M. E. CIUREA; I. NACEA

2024/06/30

10.12865/CHSJ.50.02.22

Medicine

According to the World Health Organization, burns represent a major global public health issue, causing approximately 180,000 deaths annually. The article presents the case of a 17-year-old patient with burns after electric shock (27,000 volts), with a burned area of approximately 72%, 3rd degree, segment IIB, with ABSI score=12, who was treated in a centre dedicated to paediatric burn patients. The use of treatment of paediatric burns not only enhances the quality of healthcare but also has the potential to reduce suffering and improve the chances of recovery for children who go through such traumatic experiences.

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A Rare Variant of Hashimoto’s Thyroiditis

A. L. MANDA; A. L. DIMA; V. D. BALEANU; D. VASILE; D. I. VOICULESCU

2024/06/30

10.12865/CHSJ.50.02.21

Medicine

Hashimoto's thyroiditis (HT) is the most frequently diagnosed thyroid disorder worldwide, characterized by hypothyroidy and thyroid autoimmunity. The fibrous variant accounts for a small number of cases. A 48 years old woman, with 20-years history of Hashimoto thyroiditis presented for a large recent goiter with compressive symptoms, in hypothyroidic state and with very high thyroid antibodies antithyroglobulin and antithyroperoxidase. Ultrasound and fine needle aspiration biopsy showed an enlargement of the thyroid gland with nonhomogeneous structure and trachea shifting posteriorly, Bethesda III. CT scan showed similar aspect of the thyroid gland with compression on the trachea and the left common jugular vein. Surgery was performed due to suspicion of malignancy and compression symptoms. Thyroidectomy was uneventful, but the patient developed hypoparathyroid symptoms postoperatively that resolved with high dose calcium, magnesium and vitamin D supplementation. The pathology report was consistent of Hashimoto’s thyroiditis fibrous variant. This case report presents a rare case of the fibrous variant of Hashimoto’s thyroiditis that is rarely taken under consideration in the preoperative setting as diagnosis is hard to establish with the usual algorithm of imaging and FNA biopsy. The multidisciplinary management in pre-and postoperative approach and evaluation are of utmost importance for successful management of such case.

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Congenital Bilateral Anophthalmia: A Case Report

F. ALHUBAISHI; A. ALMEDFAA; M. ANDACHEH

2024/06/30

10.12865/CHSJ.50.02.20

Medicine

Introduction. Anophthalmia and microphthalmia are orbito-facial developmental disorders characterized by deficient growth and impaired visual capability [1]. These rare disorders may be unilateral or bilateral. Congenital anophthalmia is the complete absence of the eye [2,3]. The prevalence of both conditions is estimated at 0.2-3 per 10,000 births [4]. We report a case of congenital bilateral anophthalmia that was undetected during follow-up but diagnosed after birth. Case Description. 24-year-old Bahraini female, who is not a known case of any medical illnesses, primigravida at 39+6 weeks of gestation gave birth to a live male baby via vacuum extraction delivery due to recurrent variable decelerations and poor maternal effort. On physical examination, bilateral anophthalmia was immediately observed. No other anomalies were detected. The investigations ordered were MRI brain and orbit, which showed: Absence of bilateral eye globes-features of bilateral anophthalmia. We advised the parents the baby will need socket expansion/ conformer placement to maintain facial symmetry and cosmetic outcome with neurocognitive and development assessment every 2 months as well as speech and language evaluation. Conclusion. Although many probable factors leading to anophthalmia are suggested, many cases arise idiopathically. Due to the nature of the defect, oftentimes prenatal diagnosis with routine scans is challenging. Therefore, more research into probable causes will prompt the healthcare professional to use more sensitive studies to detect the anomaly prenatally to potentially reduce the psychological and financial impact on the parents

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Case Series Analysis of Late-Onset Atopic Dermatitis: Unraveling Clinical Variants

G. G. MITROI; M. R. MITROI; G. F. MITROI; L. S. IANOSI

2024/06/30

10.12865/CHSJ.50.02.19

Medicine

Atopic Dermatitis (AD), recognized as one of the most prevalent chronic inflammatory skin disorders among children, is characterized by skin barrier dysfunction and immune system abnormalities. Historically viewed as a childhood condition, recent findings underscore a notable prevalence of AD in adults, prompting a critical examination of this demographic. Diagnosis hinges largely on subjective clinical assessments due to the absence of universally accepted biomarkers. Consequently, efforts are underway to identify dependable biomarkers to enhance diagnostic precision. This paper underscores the scarcity of AD diagnoses in adults despite its pediatric prominence, emphasizing the need for heightened awareness and tailored diagnostic approaches in adult populations. Severity scores such as SCORing Atopic Dermatitis (SCORAD) and dermatological life quality index (DLQI) play pivotal roles in evaluating disease severity and its impact on quality of life, guiding the development of personalized treatment strategies for adult AD patients. In this study, we aim to present four compelling cases of adult-onset atopic dermatitis, each offering unique insights into this increasingly recognized phenomenon. What makes these cases particularly noteworthy is the absence of any prior atopic history in two out of four patients, challenging the conventional understanding of AD as a condition predominantly linked to childhood. Moreover, the clinical presentation in all four cases was markedly atypical, underscoring the elusive nature of adult-onset AD diagnosis. In our investigation, interleukin 4 (IL-4), interleukin 13 (IL-13), and Immunoglobulin E (IgE) were utilized as diagnostic biomarkers for our patient cohort. Given the established pivotal roles of IL-4 and IL-13 in AD pathogenesis, elevated serum levels of these biomarkers, although not universally endorsed, hold potential for diagnostic utility. Furthermore, heightened levels of IgE, indicative of allergic responses and inflammation inherent to the condition, emphasize its significance as a key biomarker and therapeutic target in AD management.

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Patent Foramen Ovale Secondary to a Paradoxical Embolism Leading to Acute Limb Ischemia: A Case Report and Brief Review of Literature

K. ENGLISH

2024/06/30

10.12865/CHSJ.50.02.18

Medicine

Acute limb ischemia, or ALI, is a rapid decrease in limb perfusion due to an occlusion of an artery or a bypass graft. Most cases result from in situ thrombosis or embolism in patients with antecedent peripheral arterial disease. Potential sources of arterial embolism as a cause of this condition include cardiogenic, aortic, peripheral aneurysms with an associated mural thrombus or, less commonly, a paradoxical embolism through a septal defect. We present a rare case of ALI due to an underlying patent foramen ovale that was successfully treated following revascularization. This article emphasizes one of the more unusual mechanisms of ALI. Despite the rarity, physicians should maintain a high index of clinical suspicion for a paradoxical embolism across a patent foramen ovale in unexplained arterial occlusion. Correct mechanism identification ensures adequate referral and prompt treatment that may reduce complications

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Population Profile of Children in Romania Affected by Burns

D. M. CANUT; M. E. CIUREA

2024/06/30

10.12865/CHSJ.50.02.17

Medicine

Burns in children represent a significant challenge in the global health domain. The research aims to analyze the profile of children in Romania affected by burns, focusing on demographic characteristics, severity of burns, applied treatment, and impact on parents. Through this analysis, we aim to better understand the factors involved in these cases and provide relevant information for improving the management and care of children with burns. This study aims to explore various aspects related to the healing of burn injuries in pediatric patients in Romania, analyzing data collected through a questionnaire administered to 107 parents. The profile of children in Romania affected by burns is primarily composed of relatively young children, with an average age of 8.7 years and an even distribution between genders. Most come from rural areas, and the degree of burns ranges from first to fourth degree, reflecting a wide range of severity of injuries. Treatment is diverse, with a tendency towards conservative approaches and a significant proportion of cases without complications. Parental satisfaction is not significantly influenced by the type of treatment, indicating a similar perception regardless of the mode of medical intervention. Improving the management and care of children with burns is achieved through adopting a multidisciplinary and integrative perspective. This involves the use of non-pharmacological therapies such as hypnosis and regional anesthesia for pain and anxiety control. Additionally, the inclusion of adjunctive therapies, such as the use of mesenchymal stromal cells and tilapia skin xenograft, contributes to improving the healing process.

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Phenotypic Classification and Functional Assessment in Knee Osteoarthritis Patients

O. FUGARU; D. RADULESCU; M. SERBANESCU; M. R. TRAISTARU

2024/06/30

10.12865/CHSJ.50.02.16

Medicine

The purpose of our study was the phenotypic classification of patients with osteoarthritis of the knee (KOA) and the dynamic assessment of functional status, monitored both numerically and in conformity with the International Classification of Functioning, Disability, and Health (ICF-basic set, shortened form). We conducted a prospective study in the Department of Physical Medicine and Rehabilitation, Filantropia Hospital, Craiova, from June of 2022 to November of 2023. In total, 100 patients with KOA were enlisted. Using data from the literature, physiotherapeutic examination, and results from paraclinical examinations, we classified studied patients into the five phenotypic categories: chronic pain (F1), local pathology with predominance of inflammatory mechanisms (F2), local pathology with predominance of metabolic mechanisms of bone and cartilage structures (F3), metabolic disorders (F4) and comorbidities (F5)-primarily chronic venous insufficiency in the lower limbs. We analyzed the values of generic qualifiers (at two evaluation time points) for the most significant elements of the core ICF set, abbreviated form, used in OAG, across each of the five phenotypes. Phenotypes F4 and F5 showed significant improvements across all evaluated functions, indicating increased efficacy in patients with comorbidities and metabolic diseases. Reduction in pain sensation, improvement in joint and muscle mobility, as well as enhancements in functions related to walking, dressing, and hand use, reflect an overall improvement in the quality of life for these patients.

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Obstructive Ventilatory Dysfunctions-Functional Assessment and Rehabilitation Program

G. ANDREI; E. MARCU; M. OLTEANU; R. CIOBOATA; M. R. TRAISTARU

2024/06/30

10.12865/CHSJ.50.02.15

Medicine

Background. Obstructive ventilatory dysfunctions have an increased incidence, and through functional assessment determined by the International Classification of Functioning, Disability and Health (ICF), appropriate treatment can be established. Aims. The objectives of our research are represented by the application of respiratory rehabilitation sessions according to the ICF in patients with obstructive ventilatory dysfunctions-with COPD or asthma, using a unique, international language and the evaluation of the results obtained before and after completion pulmonary rehabilitation. Methods. We conducted a randomized prospective study between November 2022-April 2023, which included 84 patients diagnosed with obstructive ventilatory dysfunctions and who performed respiratory rehabilitation. They were divided into two categories: category 1-C1 which included 43 patients with Chronic Obstructive Pulmonary Disease-COPD and category 2-C2 which included 41 patients diagnosed with asthma. The rehabilitation program lasted 8 weeks, with exercises performed from Monday to Friday, with a weekend break. Respiratory rehabilitation consisted of physical therapy, inspiratory and expiratory muscle training (IEMT), proper nutrition, and psychotherapy. Results. At the end of the program, most of the patients showed improvements in the ICF qualifiers, a fact that supported us that respiratory recovery is one of the basic therapies of patients with obstructive ventilatory dysfunctions. Conclusions. The ICF allows the application of a personalized respiratory rehabilitation program. The ICF qualifiers are used for the functional assessment of patients and allow they to be included in individualized medical rehabilitation programs.

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Validity and Reliability of the Romanian Version of a Modified Short Form of Fear of Dental Pain Questionnaire

A. E. DONE; E. PREOTEASA; C. T. PREOTEASA

2024/06/30

10.12865/CHSJ.50.02.14

Medicine

The study aimed to test the validity and reliability of the Romanian version of short form of Fear of Dental Pain questionnaire (s-FDPQ), modified by adding an item about dental implant insertion. Material and methods: The design of the study was cross-sectional. Data were collected through an online questionnaire completed by university students, administered from January to March 2024. The survey included information about past dental treatments, the Dental Anxiety Scale (DAS), and items of s-FDPQ. Results: 186 participants were included in the study. The Romanian version of the modified s-FDPQ had a good reliability Sperman-Brown coefficient is 0.878, and Cronbach alpha is 0.92. The questionnaire had a good convergent validity, with all items being moderately correlated with the DAS score. The one-factor model was tested and has a good fit according to the confirmatory factor analysis. The participants were afraid of pain mostly regarding having a wisdom tooth extracted or a dental implant inserted. A statistically significant higher fear of dental pain was observed in those who did not previously have a root canal treatment (p=0.008) and in those who had dental implants in the past (p=0.046). Those attending regular dental check-ups had lower levels of fear of dental pain. Conclusion: The Romanian version of s-FDPQ, modified by adding a question about dental implant insertion, has good reliability and validity. Fear of dental pain seemed to be influenced by features of dental procedures and previous dental experience.

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Subclinical Atherosclerosis in a Gout Cohort: Prevalence and Associations

C. D. PARVANESCU; A. L. BARBULESCU; S. C. DINESCU; C. E. BITA; S. C. FIRULESCU; B. A. TRASCA; R. C. DASCALU; R. E. SANDU; F. A. VREJU

2024/06/30

10.12865/CHSJ.50.02.13

Medicine

The current observational, prospective study enrolled 65 patients with gout, diagnosed according to 2015 ACR/EULAR criteria [17], evaluated in Rheumatology Clinic, Emergency County Hospital Craiova, and 40 healthy subjects. This research aimed to determine the presence of subclinical carotid atherosclerosis, revealed by an increased intima media thickness and carotid plaques in gout patients, by US examination. Secondary, we aimed to search for the possible correlations displayed between the presence of subclinical carotid atherosclerosis and several disease variables. CCAIMT over 0.9mm was identified for 19 patients (29.23%), percentage statistically significant different compared to controls (7; 17.5%), p=0,0428. For 23 patients (35.38%) carotid plaques were present at US examination, more prevalent compared to controls (19; 29.23%), p=0.002. Using multivariate logistic regression, we pointed out that SUA (OR 2,103; p=0.0002), age (OR=1,051; p<0.001), disease duration (OR=1.740; p=0.0039) and LDLc (OR=1,003; p=0.0029) were independently associated to an increased IMT in patients with gout, similar results being obtained for carotid plaques. MSKUS was performed for all patients, with important results. The presence of deposits associated with an increased risk of a thick IMT; similar results were obtained for double contour sign, aggregates and tophi. A statistically significant risk was noticed for the presence of deposits (p=0.002). Regarding the presence of carotid atheroma plaques, a higher risk was associated to deposits identification, double contour sign, aggregates, tophi and PD signal. Our results sustain that carotid ultrasound is an easily accessible imagistic method that offers important predictors of atherosclerotic status

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Oral Hygiene Study in Late Adolescence

M. MOCIU; C. BARTOK-NICOLAE; G. RAFTU; R. BRICEAG; A. CARAIANE

2024/06/30

10.12865/CHSJ.50.02.12

Medicine

The objective of this study is to determine prevalent behaviors and knowledge of oral hygiene on the late adolescents. Only individuals in the late stage of adolescence, specifically between the ages of 18 and 24, that were students from the “Ovidius” University of Constanta were chosen. The involvement was optional. A printed questionnaire was provided for them to complete. A total of 50 participants took part in this study, consisting of 26% (n=13) males and 74% (n=37) females. When asked about their toothbrush preference, 50% (n=25) individuals indicated using just manual toothbrushes. Out of all individuals who have utilized orthodontic appliances, 70.8% (n=17) reported that the dentist recommended for them to receive professional dental hygiene care while undergoing treatment. 78.0% (n=39) individuals reported participating in oral hygiene meetings and would be interested for additional information regarding the topic. It is essential to provide youngsters with early instruction about the importance of oral hygiene in order to develop long-lasting healthy habits.

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