Items

  • The Role of Uterine Artery Doppler in the Second and Third Trimesters for Prediction of Preeclampsia and Fetal Growth Restriction Developed as a Consequence of Placental-Mediated Diseases

    A. TUDOR; L. NOVAC; I. V. CAMEN; M. M. MANOLEA; M. S. SANDULESCU; S. C. VRABIE; M. S. SERBANESCU; M. V. BOLDEANU; A. M. ISTRATE-OFITERU; A. L. DIJMARESCU
    2023/06/30
    10.12865/CHSJ.49.02.15
    Medicine
    Placenta-mediated pregnancy disorders represent a disease that includes preeclampsia (PE) and the birth of small for gestational age (SGA) children, these conditions increase the risk of mortality and morbidity both maternal and fetal/neonatal, in the short and long-term. Methods: The prospective study included 106 patients in whom ultrasound Doppler scans of uterine artery (UtA) were performed in the 2nd trimester between 20.0-23.6 weeks of gestation and the 3rd trimester between 28.0-32.6 weeks of gestation. Results: In the second trimester, the average of the UtA-PI percentiles was statistically significant (p<0.05) in correlation with PE and SGA, as in the third trimester. Statistically significant (p<0.05) was also the correlation of UtA-PI >95 percentile with the development of PE and SGA. On the other hand, the present notch, in the two trimesters studied, analyzed as a single index, did not present a statistically significant association (p>0.05). Conclusions: The results of our study showed that UtA-PI Doppler is the best predictor of preeclampsia considering the association of intrauterine growth restriction, as most studies have found.
    Full text,
    Read More

  • Correlation between Coronary Artery Disease and Non-Alcoholic Fatty Liver Disease Using Computed Tomography Coronary Calcium Scans

    D. C. CUCORANU; M. POP; R. NICULESCU; I. B. KOSOVSKI; R. O. TOGANEL; R. A. LICU; A. BACAREA
    2023/06/30
    10.12865/CHSJ.49.02.14
    Medicine
    Introduction: Concerns about how non-alcoholic fatty liver disease (NAFLD) might contribute to the development of cardiovascular disease (CVD) have grown as the importance of NAFLD and its relationship to the metabolic syndrome has grown. The purpose of this cross-sectional retrospective is to investigate potential correlations between hepatic steatosis in liver segments seen when measuring calcium score and the presence of atherosclerotic CAD (coronary artery disease). Methods: Two hundred patients (mean age, 57 years±10) who underwent coronary cardiac computed tomography (CT) scans were included. CT scans were analysed to assess the attenuation of liver parenchyma and the coronary artery calcification (CAC). Results: Age, gender, body mass index (BMI) and CAC score were significantly associated with hepatic steatosis. Among all patients, CAC score (r=-0.31, p<0.0001), and BMI (r=-0.40, p<0.0001) had a moderate negative correlation with the values of liver attenuation. BMI (OR: 1.109, p=0.001), CAC score (OR: 1.629, p<0.001), and age (OR: 1.050, p<0.001) were found to be independent predictors of hepatic steatosis through logistic regression. Conclusions: A statistically significant correlation between CAC score and the presence of NAFLD as evaluated by non-contrast-enhanced CT was demonstrated. BMI, CAC score, and age were identified as independent predictors of hepatic steatosis.
    Full text,
    Read More

  • Statical Association between Clinical and Histopathological Parameters for Keratinocyte Carcinomas

    A. C. BADIU; C. E. SIMIONESCU; A. E. STEPAN; C. MARGARITESCU; M. M. FLORESCU; B. C. ANDREIANA; A. M. BADIU; O. I. CREU; A. MURARU; C. GEORMANEANU; R. N. CIUREA
    2023/06/30
    10.12865/CHSJ.49.02.13
    Medicine
    The most common tumor of the western world is comprised of forms of non-melanoma skin cancers, previously known as keratinocyte carcinomas (KCs) The purpose of this study was to determine de incidence of non-melanoma skin tumors and the relationship between histopathological risk factors in patients with skin cancers. The study was composed from 332 cases of skin malignancies for which clinical and histopathological aggressivity factors were statistically analyzed through comparison tests and also stored digitally. For basal cell carcinoma (BCC) statistical analysis indicated significant relationships between pT category and gender, tumor size, ulceration, depth of invasion and positive resection limits. For squamous cell carcinoma (SCC) statistical analysis indicated significant relationships between pT category and tumor size, depth of invasion and positive resection limits. Clinical and histological analysis of certain characteristics of the above-mentioned skin cancers is an essential step in documenting and improving both prognosis and therapy standards.
    Full text,
    Read More

  • Remote Monitoring in Cardiac Resynchronization Therapy-First Experience in Romania with a CRT Virtual Ward

    E. V. GOANTA; A. UNGUREANU; G. TARTEA; A. MURARETU; D. MANCIU; C. VACARESCU; L. PETRESCU; D. COZMA
    2023/06/30
    10.12865/CHSJ.49.02.12
    Medicine
    Background: Remote monitoring (RM) is becoming a standard of care for patients with cardiac resynchronization therapy (CRT). This technology combines the use of pacemakers or implantable cardioverter-defibrillators (ICD) and wireless communication to provide physicians with continuous, real-time information on the patient's cardiac activity. The purpose of the study was to evaluate if the remote monitoring technology in the follow-up CRT patients is feasible and safe. Methods: A total of nine patients were enrolled in the study, implanted with a CRT system with wireless transmission capabilities. Immediately after the procedure received the RM, were enrolled in the virtual clinic and instructed by the doctor how to use the device at home. Regular virtual transmissions were made automatically every 3 weeks, respecting optimal transmission conditions. The accumulation of fluid in the lungs, atrial or ventricular tachyarrhythmia together with system integrity automatically activate alerts. Results: One hundred and one transmissions were collected and analyzed from the virtual ward. Average follow-up was 7.7±4.8 months, longest follow-up was 18 months. None of the patients experienced complications during the study period, with three of them being follow-up solely through telemetric means by implanting physician. Treatment optimization was successfully conducted via phone consultations, when necessary, without any adverse events. Conclusions: The results of our study suggest that RM could be integrated into routine CRT management protocols, enhancing patients care and resource utilization.
    Full text,
    Read More

  • Clinical and Morphological Study of Cervical Squamous Intraepithelial Lesions

    L. IOVAN; I. M. LILIAC; A. M. ISTRATE-OFITERU; C. G. ROSU; L. MOGOANTA
    2023/06/30
    10.12865/CHSJ.49.02.11
    Medicine
    Squamous intraepithelial lesions (SILs) are cancer precursors targeted by secondary prevention of cervical cancer programs that are sometimes difficult to grade accurately. Mena is an actin regulatory protein involved in membrane protrusion, cell motility, in tumor invasion and metastasis. We studied retrospectively 68 cases of patients diagnosed with squamous intraepithelial lesions that received expedited treatment (treatment without colposcopic biopsy). We analyzed demographic, behavioral data, obstetrical and medical history, from the patients’ medical charts and we studied the cervical fragments or cones harvested after the excisional procedure. Our study failed to identify a correlation between SILs and risk factors such as low socioeconomic status, combined oral contraceptive use, intrauterine device use, parity, gravity, except for the tobacco smoking habit that proved to be related to the cervical lesions’ development. Mena was expressed in most of the analyzed SILs and its expression was correlated with lesions’ grade in terms of both area and intensity, suggesting that Mena stains especially abnormal cells and that its expression intensity correlates with the risk of malignant transformation. Further studies are needed to validate Mena as an early stage of cervical carcinogenesis marker.
    Full text,
    Read More

  • Investigating the Neuroprotective and Neuroregenerative Effect of Trazodone Regarding Behavioral Recovery in a BL6C57 Mice Stroke Model

    I. K. S BOBOC; A. C. CHIREA; V. GHEORMAN; A. GRESITA; T. A. BALSEANU; B. CATALIN; D. CALINA
    2023/06/30
    10.12865/CHSJ.49.02.10
    Medicine
    Stroke is a major cause of death and disability worldwide. Between 1990 and 2010, its global burden increased notably with reference to the absolute number of incident events, number of deaths, and disability-adjusted life-years lost. Trazodone is a triazolopyridine derivative that was approved for more than 40 years as monotherapy or in combination with other antidepressant drugs for the treatment of major depressive disorder in adult patients. The aim was investigated if trazodone can improve behavioural outcome after stroke in a mice model of middle cerebral artery occlusion (MCAo) due to the potential neuroprotective and neurodegenerative effects by using three behavioural tests: adhesive tape test, beam test and hole board test. Trazodone administration show modest improvements regarding the motor-sensorial function after stroke especially in the acute post-stroke phase in aged and young animals. The antidepressant effect of the drug was observed in the post-stroke period in aged animals and to a lesser extent in young animals. Future research is needed to evaluate the effects of trazodone at the cellular level to be sure that it has no benefit in stroke patients who do not suffer from depression.
    Full text,
    Read More

  • Comparative Statistical Analysis of Key Performance Indicators in the Health System

    L. MIRESCU; A. M. C. POPESCU; I. M. DRAGOMIR
    2023/06/30
    10.12865/CHSJ.49.02.09
    Medicine
    In this paper, a comparative statistical analysis of some performance indicators from the health system at SCJU Craiova and SJU Slatina is made in the period 2010-2021. Also, the correlations between the average duration of hospitalization, the bed utilization rate, the number of cases and the case complexity index for each hospital are studied. It is found that there are similarities, but also statistically significant differences between the two analyzed hospitals. Thus, it turns out that there are no significant differences between the bed utilization rate and the complexity index between the two hospitals, but there are statistically significant differences at a significance threshold of 5% between the average duration of hospitalization and the number of cases registered at the two hospitals analyzed. Moreover, the case complexity index is strongly negatively correlated with the bed utilization rate and with the number of cases in both hospitals, but positively correlated with the average duration of hospitalization at SCJU Craiova and weakly negatively correlated at SJU Slatina.
    Full text,
    Read More

  • Pleural Effusion as a Negative Prognostic Factor in Patients with Acute Pancreatitis and COVID-19

    P. M. RADULESCU; A. F. NEMES; C. CALARASU; I. GEORGESCU; D. RADULESCU
    2023/06/30
    10.12865/CHSJ.49.02.08
    Medicine
    We conducted a retrospective multicentre study to investigate the association between acute pancreatitis, COVID-19, and pleural effusion. The study involved a total of 433 patients. Among them, 405 patients did not have COVID-19 infection, while 28 patients had both acute pancreatitis and COVID-19. Out of the 28 patients with both conditions, 12 also had pleural effusion. Among the 405 patients with acute pancreatitis without COVID-19, 48 had pleural effusion. The results showed that the relative risk of death associated with pleural effusion was approximately 4 times higher in patients with COVID-19 and pleural effusion compared to those with pleural effusion without COVID-19.
    Full text,
    Read More

  • Preliminary Study on the Antioxidant Effect of Natural Based Products with Potential Application in Complex Regional Pain Syndrome

    C. E. BITA; S. C. DINESCU; F. A. VREJU; A. E. MUETESCU; A. BITA; C. CRIVEANU; A. L. BARBULESCU; A. FLORESCU; P. L. CIUREA
    2023/06/30
    10.12865/CHSJ.49.02.07
    Medicine
    Complex regional pain syndrome (CRPS) is a complex condition characterized by chronic pain and various sensory, motor, and autonomic symptoms. It involves a complex interplay of mechanisms in the nervous system, including neuroinflammation, sensitization of pain pathways, and dysfunction of the sympathetic nervous system. Antioxidants may play a role in CRPS by helping to counteract oxidative stress, which is an imbalance between the production of reactive oxygen species (ROS) and the body’s antioxidant defences. CRPS involves inflammation and tissue damage, which can lead to increased ROS production and oxidative stress. Our paper represents a preliminary study on various commercially available natural-based products regarding their antioxidant effect. Several natural products with antioxidant properties, such as vitamins C and E, polyphenols, flavonoids, and botanical extracts, have shown promise in preclinical studies for their potential to alleviate pain and reduce inflammation associated with CRPS. The potential use of natural-based products with antioxidant effects for mitigating CRPS symptoms is still an area of ongoing research and investigation, but nonetheless it holds promise.
    Full text,
    Read More

  • Assessment of Stroke Patients Admitted to a Tertiary Emergency County Hospital of Mehedin?i - Romania

    O. PAUN; M. S. SERBANESCU; O. BADEA; L. MOGOANTA
    2023/06/30
    10.12865/CHSJ.49.02.06
    Medicine
    Cerebrovascular accidents (CVA)-strokes represent a major public health problem worldwide, due to the large number of people affected. Also, there is a large number of people who die from stroke, especially in developing countries. Our study included a group of 119 patients, diagnosed with stroke and admitted to the Emergency Hospital of Drobeta Turnul-Severin, Mehedin?i county, between 2016-2020. The analysis of risk factors and associated comorbidities showed that stroke can affect both the elderly and young people, under 20 years old. However, approximately 4/5 of CVA patients (79.83%) were aged over 50 years old. If non-ischemic strokes predominated in patients under the age of 50, after this age there is a tendency to balance the incidence between the eight main forms of stroke. No significant differences were observed regarding the social environment of the patients, which shows that the risk factors are almost identical in both social environments. Among the modifiable risk factors, we highlighted: high blood pressure in 55.46% of cases, obesity in 19.33% of cases, atherosclerosis in 10.92% of cases, diabetes mellitus in 10.92%, kidney failure in 6.72% of cases. The data we obtained show that there are possibilities to reduce the incidence of stroke by controlling and reducing the modifiable risk factors.
    Full text,
    Read More

  • The Assessment of Heart Rate Variability in Patients with Pancreatic Cancer

    M. PETRESCU; I. UDRISTOIU; F. MILITARU; A. R. PETRESCU; G. TARTEA; V. RAICEA; A. M. CIUREA; A. M. PETRESCU; C. C. VERE
    2023/06/30
    10.12865/CHSJ.49.02.05
    Medicine
    The aim of our study is to provide an assessment of heart rate variability (HRV) as a predictor for the survival of patients with pancreatic cancer (PCa). We conducted a retrospective, descriptive study. 53 consecutive patients who were newly diagnosed with pancreatic cancer (PCa), were included. In the end, 41 patients were included in the analysis, out of which 14 patients survived at least until the 24-month follow-up, while 27 patients died within 24 months from the diagnosis. These patients were monitored with 24-hour Holter electrocardiogram (ECG) prior to the initiation of any therapy for determining heart rate variability. To establish the cut-off values of HRV, 24-hour Holter ECG recordings of 20 healthy subjects were analyzed. In addition to heart rate analysis, HRV indices were also analyzed: SDNN, rMSSD, ULF and VLF. Median survival in patients with low value of SDNN was 9 months, compared to patients with hight SDNN where median survival was 15 months (Hazard ratio 2.301, 95% CI of ratio 0.9080 to 5.833, p= 0.034). Although low values of the HRV indices in the frequency domain were associated with reduced survival, no statistically significant differences were recorded. The reduction of heart rate variability indices is a negative prognostic factor in patients newly diagnosed with pancreatic cancer.
    Full text,
    Read More

  • Clinical Evaluation of Periodontal Status and IL-6 Gingival Fluid Level in Patients with Sjogren’s Syndrome

    D. N. GHEORGHE; D. M. POPESCU; S. C. DINESCU; M. V. BOLDEANU; P. SURLIN; F. VREJU; P. L. CIUREA
    2023/06/30
    10.12865/CHSJ.49.02.04
    Medicine
    The objective of the cross-sectional study was to assess periodontal and implant health condition among individuals diagnosed with Sjogren's Syndrome (SS), taking into account the clinical circumstances associated with this patient population. The clinical parameters employed to evaluate the periodontal status of both natural teeth and implants included: periodontal probing depth (PPD) measured at six sites per tooth/implant, clinical attachment level (CAL), bleeding on probing index (BOP), plaque index (PLQ). Gingival crevicular fluid samples were collected for interleukin-16 level evaluation. After clinical and immunological assessment of the study and control groups, the data was centralized, compiled and submitted for statistical analysis. In all four types of assessed periodontal parameters, there were statistically significant differences between the SS patients with no dental implants and the other test (SSi) and control groups (Cni and Ci). Nevertheless, in SS patients with dental implants, plaque levels were similar to that of controls. In addition, other periodontal parameters (PPD, BOP and CAL) were similar in SS patients with dental implants and controls, with no statistically significant difference. The highest GCF IL-6 levels were found in SS patients with no dental implants, the differences to the other study and control groups being statistically significant. In patients with SS and dental implants, there were no statistically significant differences to the other groups. Individuals diagnosed with Sjogren's Syndrome (SS) exhibit a less favorable periodontal condition compared to controls without SS. Notably, SS patients who undergo dental implant procedures demonstrate an improvement in their periodontal status. This highlights the importance of proactive and ongoing dental and periodontal surveillance for SS patients, aiming to decrease the risk of developing periodontal diseases.
    Full text,
    Read More

  • Optimization Techniques of Single-Detergent Based Protocols for Heart Tissue Decellularization

    M. MESINA; I. MINDRILA; M. I. MESINA-BOTORAN; L. A. MINDRILA; A. FARHANGEE; I. PIRICI
    2023/06/30
    10.12865/CHSJ.49.02.03
    Medicine
    The extracellular matrix (ECM) scaffolds are considered a gold standard for the engineering of appropriate grafts used in regenerative medicine for tissue repair, and decellularization of myocardial tissue is one of the most studied processes for obtaining natural ECM to date. Decellularization methods, agents used, or treatment durations can be varied to optimize cardiac tissue decellularization parameters. In this work we performed a morphological and morphometric analysis of cardiac tissue subjected to decellularization protocols based on Sodium Deoxycholate (SD) or Sodium Lauryl Sulfate (SLS) to identify factors that allow optimization of single-detergent based protocols for cardiac ECM manufacturing. For this, Wistar rat hearts (n=10) were subjected to 5 different decellularization protocols (n=2) and then histologically processed to achieve H&E or Azan trichrome stained sections for the morphological and morphometric analysis of the obtained ECM. The results of this study showed that SLS alters the spatial distribution of cardiac ECM collagen fibers, and SD can be successfully used in tailoring single-based detergent decellularization protocols by appropriately adjusting the application times of hypo/hyperosmotic shocks, which increases the lytic action of the detergent, and the washing times for the efficient elimination of cellular residues.
    Full text,
    Read More

  • The Prevalent Cases of Endometrial Carcinoma in Different Life Periods of Women-Clinical and Histopathological Diagnosis

    H. LATIFI; A. M. GASHI; D. LATIFI
    2023/06/30
    10.12865/CHSJ.49.02.02
    Medicine
    Abnormal uterine bleeding is a term used to describe any irregular bleeding from the uterus that is not part of a woman's normal menstrual cycle and can happen during different life periods. Abnormal uterine bleeding can have structural etiologies (polyp, adenomyosis, leiomyoma, malignancy) or nonstructural etiologies (coagulopathy, ovulatory dysfunction, and not-classified). The post- and pre-menopausal period requires a detailed investigation to establish the etiology of the bleeding because the chances that the woman has a malignancy are plentiful in this period. The treatment plan is determined based on the underlying cause of the bleeding. The main objective of this paper was to determine the prevalence of endometrial carcinoma in different periods, focusing on the postmenopausal period. This research was a cross-sectional study and included 79 cases of abnormal uterine bleeding in different periods of women's lives. Our study found that abnormal uterine bleeding occurs more frequently during the premenopausal period (59%) and that the causes of irregular bleeding during this period were mainly benign. Our study focused on the postmenopausal period, where we found that 32.9% of irregular uterine bleeding occurs during this period, and the leading causes were malignant pathologies (83.3%), mainly endometrial adenocarcinomas. The average age was 66.7 years. During the study, it was observed that 50% of women with abnormal uterine bleeding due to malignancy were classified as overweight, 25% were obese, and 25% had normal weight. It was confirmed that obesity is a co-factor of malignancy in the postmenopausal period, and the pathophysiological mechanism is well understood now. Our study also found a high number of co-morbidities among women with abnormal uterine bleeding due to malignancy. We came to the conclusion that any abnormal uterine bleeding should be initially investigated in a multidisciplinary manner, an accurate diagnosis should be determined, and then a treatment plan should be established. The treatment strategy should be determined depending on the cause of abnormal bleeding.
    Full text,
    Read More

  • A Review of Psychological Outcomes in Patients with Complex Hand Trauma: A Multidisciplinary Approach

    A. F. GHITAN; V. GHEORMAN; D. PIRVU; V. GHEORMAN; I. UDRISTOIU; M. E. CIUREA
    2023/06/30
    10.12865/CHSJ.49.02.01
    Medicine
    This systematic review aimed to assess the psychological outcomes in patients with complex hand trauma and explore the importance of a multidisciplinary approach in addressing both physical and mental health needs. The study employed a rigorous methodology, including a comprehensive search of relevant databases, strict inclusion and exclusion criteria, and data synthesis from the included studies. The results demonstrated the significant negative psychological impact of complex hand trauma on patients' overall health and quality of life. This trauma affected patients emotionally, psychologically, and physically, highlighting the essential role of hand function in performing daily activities. The findings emphasize the need for continued research aimed at identifying effective psychological interventions to support the rehabilitation of patients with complex hand trauma. Providing these patients with multidisciplinary care, addressing both the physical and mental health components of recovery, can result in a more favorable long-term outcome.
    Full text,
    Read More

  • Surfactant Deficiency Causing Severe Pneumonia in a Child

    I. GJETA; D. SALA; I. BAKALLI; E. CELAJ; E. KOLA
    2023/03/31
    10.12865/CHSJ.49.01.17
    Medicine
    Surfactant deficiency is a rare genetic disease. Clinical presentation is manifested with a large specter that varies from severe form to lethal in neonatal age and to progressive, chronic form of the interstitial lung disease in older child. In this manuscript we want to present the case of a two years and 7-month-old child, which was diagnosed with Pediatric Acute Respiratory Distress Syndrome (PARDS) as consequence of bilateral interstitial pneumonia. The child was treated in a supportive way, placed in mechanical ventilation, antibiotic therapy and corticosteroid. After the complete examination, the child resulted with surfactant metabolism dysfunction of type ABCA3. In this case we want to emphasize the attention for rare genetic disease like surfactant deficiency as a cause of recurrent pneumonia cases with unclear focus.
    Full text,
    Read More

  • An L2/3 Disc Herniation-Related L5 Radiculopathy

    E. CHUN-PU CHU; K. HOI-YING YAU; D. L. BELLIN
    2023.03.31
    10.12865/CHSJ.49.01.16
    Medicine
    The key factors contributing to radiculopathy caused by lumbar disc herniation include mechanical compression. It was commonly believed that the disc herniation causes the compression on the nerve root exiting under the pedicle of the vertebral body at the adjacent inferior level. However, a disc herniation might occasionally result in non-adjacent, isolated radicular symptoms. We report the case of a 74-year-old female who presented with a 2-years history of progressive low back pain associated with L5 radiculopathy and reduced quality of life. The patient had undergone a magnetic resonance image showing a large L2/3 disc herniation. Symptoms had progressively worsened and failed to respond to conservative treatments including pain medication, exercise rehabilitation, and acupuncture at the lower lumbar region. The patient was diagnosed with L5 radiculopathy caused by L2/3 disc herniation. Consequently, her symptoms improved with chiropractic rehabilitation which involved spinal manipulative therapy and intermittent motorized traction at the L2/3 level to reduce herniated disc. Therefore, an L2/3 Disc herniation-related L5 radiculopathy should be considered in the differential diagnosis of cases of inconsistency of level of disc herniation and nerve root pattern.
    Full text,
    Read More

  • Hepatectomy During the Pandemic, a Curative Treatment in High-Grade and/or Hemodynamically Unstable Blunt Liver Trauma

    G-J. BOLDEA; E. F. GEORGESCU; I. GEORGESCU; D. RADULESCU; M. PIRCOVEANU
    2023/03/31
    10.12865/CHSJ.49.01.15
    Medicine
    The liver is among the most affected organs in the case of abdominal trauma. In the last decades there have been significant changes in therapeutic protocols, non-operative management is now the first intention in most cases due to good results offered previously. In high-grade or hemodynamically unstable injuries, hepatectomy is the best approach, even though this was viewed with skepticism in the past, technical advances in medicine have proven otherwise. This article presents a case report of a 29-year-old man with blunt abdominal trauma, who initially underwent conservative atypical right hepatectomy without a favourable outcome, later he was transferred to a liver transplant center where he underwent a controlled right hepatectomy, all this in a new epidemiological context, the COVID-19 Pandemic. We want to present the hypothesis that in making a therapeutic decision, the hemodynamic status of the patient must be considered equally along with the injury degree. This case represents an opportunity to review the role of liver resection in the management of complex liver injuries.
    Full text,
    Read More

  • Normal Coronary Arteries

    M. B. PINTOS-BELOTTO; O. A. CENTURION; C. CACERES; C. ROJAS-DURE; E. J. GALEANO
    2023/03/31
    10.12865/CHSJ.49.01.14
    Medicine
    Despite the beneficial effects of anti-COVID-19 vaccination, monitoring its safety has identified potential cardiac adverse events, mainly myocarditis and pericarditis. The case of a healthy 32-year-old male patient who developed acute myocardial infarction (AMI) 48 hours after the second dose of anti-COVID-19 mRNA vaccine (BNT162b2) is reported. This is the first reported case in the literature of an AMI associated to post-COVID-19 vaccination with mRNA vaccine (BNT162b2) in a healthy young adult without coronary risk factors and normal coronary arteries. Despite this adverse event, the continuation of the anti-COVID-19 vaccination campaign is encouraged due to the benefits it brings.
    Full text,
    Read More

  • Vertebral Artery Dissection: A Case Report and Review of the Literature

    O-A DOGARIU; I. DOGARIU; M. BERCEANU; R. SANDU; I. A. GHEONEA
    2023/03/31
    10.12865/CHSJ.49.01.13
    Medicine
    Arterial dissection is the result of blood entering along the intima-media plane through a breach produced either spontaneously or traumatically. Cervical arterial dissections are an important cause of acute ischemic stroke in children, young adults, and patients with cranio-cervical traumatic injuries. Arterial dissections occur either spontaneously, in genetic diseases, the most important association being with fibromuscular dysplasia. In most of the cases dissection involve the extracranial portions of the internal carotid and vertebral arteries. Magnetic resonance with T1 fat-saturation (T1 FS) sequence of the cervical region or computed tomography (CT) with computed tomography angiography (CTA) shows a very high sensitivity and specificity in the diagnosis of cervical artery dissections. Therapeutic options are still debatable in patients with acute ischemic stroke and vertebral or carotid artery dissection.
    Full text,
    Read More

  • Melanoma Originating from the Dura-Mater: A Case Report and Review of the Literature

    P. M. MESQUITA FILHO; L. MARTINI; R. SALTIEL; D. SCHWINGEL; J. PASTORELLO
    2023/03/31
    10.12865/CHSJ.49.01.12
    Medicine
    Melanomas originating from the dura-mater are extremely rare tumors. The diagnosis is complex, and usually only made after excluding other entities. The prognosis is poor, with average free-disease survival of 20 months, after treatment with complete surgical excision and adjuvant therapy. We report the case of a 41-year-old asymptomatic patient, presenting with a subcutaneous mass in the left parieto-occipital region, later diagnosed as a primary dura mater melanoma. Treatment included complete microsurgical excision, radiotherapy and adjuvant immunotherapy. Therefore, due to the rare nature of the disease and its high lethality, correct diagnosis and treatment are medical challenges.
    Full text,
    Read More

  • Management and Treatment of Coxarthrosis in the Orthopedic Outpatient Clinic

    A. T. PARALIOV; M. M. IACOV-CRAITOIU; M. M. MOGOANTA; O. I. PREDESCU; L. MOGOANTA; S. CRAITOIU
    2023/03/31
    10.12865/CHSJ.49.01.11
    Medicine
    Coxarthrosis, or hip osteoarthritis (OA), is one of the main causes of hip pain, which can affect patients of all ages, being one of the most common reasons for patients presenting to the specialized outpatient clinic. The objective of our research was to determine the number of patients with coxarthrosis who presented to the Department of Orthopaedics and Traumatology within the Emergency County Hospital of Drobeta Turnu Severin, between 2017-2019, the sex, age, social environment of the patients. All patients underwent a thorough clinical examination to determine the risk factors, the favouring factors and their correlation with the paraclinical data obtained through imaging investigation (pelvis X-ray, computer tomography and nuclear magnetic resonance). The study included 462 patients, aged between 23 and 89 years old, who were diagnosed with varying degrees of coxarthrosis within the specialized outpatient clinic. The main risk factors were obesity, osteoporosis, chronic smoking, rural environment, female sex, the existence of a hip injury and intense physical exertion. The main purpose of the research was to analyse a series of data, which would bring information on the incidence, distribution by age groups, sex, living environment and professional activity of the population with coxarthrosis, in order to develop a therapeutic management as effective as possible.
    Full text,
    Read More

  • Intraplacental Villous Artery Doppler can Improve the Ability to Predict Placenta-Mediated Disease

    A. TUDOR; L. NOVAC; I. V. CAMEN; M. M. MANOLEA; S. C. VRABIE; M. S. SANDULESCU; M. S. SERBANESCU; M. V. BOLDEANU; A. D. NEAMU; A. M. ISTRATE OFIERU; A. L. DIJMARESCU; M. B. NOVAC
    2023/03/31
    10.12865/CHSJ.49.01.10
    Medicine
    Objective. Evaluation of Intraplacental Villous Artery Doppler (IPVA) as a predictive factor compared to umbilical artery (UA) Doppler in placenta-mediated disease (PMD). Methods. This prospective study included a group of 106 pregnant women, of which 76 patients constituted the PMD group: preeclampsia (PE) and small for gestational age (SGA), and 30 pregnant women constituted the control group. IPVA and UA Doppler evaluation was performed in 2 pregnancy periods: 20.0-23.6 weeks, and 28.0-32.6 weeks of gestation. Results. From the study of maternal characteristics and risk factors for the presented pathology, we found that no studied risk factor was statistically involved in the evolution toward PMD during pregnancy. In the control group, we noticed a decrease in IPVA PI and RI, along with an increase in gestational age, while in the PMD group, these indices increased. Both in the 2nd and the 3rd trimester, we had a significant statistical difference between the two groups (p<0.001). Regarding the degree of prediction of the changes that occurred at this level, we found a good statistical correlation. A higher degree of positive predictability is noted, for IPVA-PI, but also for UA-PI, but with better sensitivity (72.27%) for UA PI in the 2nd trimester. Conclusions. We can conclude that both Doppler measurements, IPVA and UA can be used to evaluate and detect pregnancy complications that belong to PMD, preeclampsia, and/or fetal growth restriction.
    Full text,
    Read More

  • Socioeconomic Inequalities in Cancer Incidence: A Comparative Investigation Based on Population of Iranian Provinces

    B. AHADINEZHAD; A. MALEKI; M. AMERZADEH; B. MOHTASHAMZADEH; M. SAFDARI; O. KHOSRAVIZADEH
    2023/03/31
    10.12865/CHSJ.49.01.09
    Medicine
    Cancer is the second important cause of death worldwide. Cancer is one of the top health priorities in Iran. We aimed to study the socio-economic inequality of cancer incidence in Iran provinces. We conducted this cross-sectional study using provincial data. We obtained the required data from the statistical yearbook report, the Statistics Center Report and the National Cancer Registration Program Report of Iran’s Ministry of Health and Medical Education (MoHME) for 2018. Socio-economic inequality of cancer incidence was analyzed by estimating the concentration index and extracting the concentration curve. Statistical analyzes were performed using STATA 14. Our findings revealed that cancer incidence was unequally distributed in terms of the socio-economic status in Iranian provinces. Cancer incidence is slightly concentrated in the provinces with higher than average literacy, per capita income and insurance coverage and household size below average. The concentration of cancer incidence has been to the detriment of the provinces that have a slightly better ranking in terms of the socio-economic index. The employment rate did not significantly affect cancer's distribution burden. We recommend policymakers facilitate early cancer detection by providing insurance coverage for screening services, payment exemptions, and public awareness.
    Full text,
    Read More

  • Research on the Influence of MUVON PLUS Treatment Upon the Biomechanical Behavior of the Human Osteoarthritic Knee

    D. ILIUA; D. TARNIA; A. PETCU; O. ZLATIAN; O. ROGOVEANU; D. N. TARNIA
    2023/03/31
    10.12865/CHSJ.49.01.08
    Medicine
    Background. This study aimed to investigate the effects of MUVON PLUS, a dietary supplement containing hydrolized collagen, chondroitin sulfate, and vitamin C, on the biomechanical behavior of the knee joint in patients with second-degree osteoarthritis (OA). Material and method. The study included 15 participants who underwent biomechanical testing before and after 3 and 6 months of supplement administration. Biometrics and SimiMotion software were used to process and analyze the data. Results showed significant improvements in biomechanical parameters such as joint range of motion, joint torque, and joint stiffness for all patients during the treatment. Improvements were observed across various tests, including horizontal walking, stairs climbing and descending, sitting/standing up from a chair, and knee squats. This improvement in biomechanical performance was also reflected in the patients' reported quality of life. For the stairs climbing test, the maximum flexion-extension angle increased by approximately 7% after 3 months and 12% after 6 months. In the stairs descending test, the maximum flexion-extension angle increased by approximately 8% after 3 months and 19% after 6 months. These results highlight an improvement in mobility for the study participants. Conclusions. Significant improvements of the biomechanical parameters of the knee joint were found in all patients during the treatment with the MUVON PLUS in all tests, which indicates the clear clinical benefit, revealed by improving the quality of life reported by patients. Overall, the study demonstrated the effectiveness of MUVON PLUS in enhancing the biomechanical behavior of the knee joint in patients with OA, providing valuable insights for future research and treatment.
    Full text,
    Read More