Current Health Sciences Journal最新文献

Non-melanoma skin cancer (NMSC) represent an important health problem in medical practice. This is the most frequent type of cancer and its incidence is constantly increasing. Basal cell carcinoma and squamous cell carcinoma constitute the majority of NMSC, respectively 70% and 25% of total cases. The present retrospective study was conducted over a one-year period and included 439 cases of NMSC, of which 336 BCC and 103 SCC. We analyzed a series of clinical parameters: gender, age, tumor size and tumor topography. The statistical analysis of the investigated parameters indicated gender-age associations for BCC, and topography-gender, as well as topography-age for SCC.

Introduction: Chronic obstructive pulmonary disease (COPD) has become a global issue. The Global Burden of Disease Study reports a prevalence of 251 million cases of COPD in 2016, while it is estimated that 3.17 million deaths were caused by the disease during that period. In this paper we conduct an ecological study, to analyze the effects of socio-economic factors and air pollution on the COPD prevalence at the population level in Albania.

Methods: Group-level data from 61 municipalities in Albania was used to assess the relationship between environmental exposures, living conditions, and socioeconomic factors with the prevalence of chronic obstructive pulmonary disease.

Results: The regression analysis shows that for every percent increase in the concentration of PM2.5 in Albanian cities, a 32% increase in the prevalence of COPD was observed. Similarly, there was an increase in COPD prevalence associated with the increase of the urban population and the number of vehicles registered per city. It is worth mentioning that no statistically significant relationship was observed between the prevalence of COPD, smoking levels, and the Poverty Index.

Conclusions: Within the limitations of an ecological analysis, these findings support an association between the prevalence of chronic obstructive pulmonary disease and environmental exposures, socioeconomic factors, and living conditions. However, there is a call to more individual-level analysis and more in-depth research to further investigate the extent of this association in Albania.

The depressive disorder represents nowadays an important global health problem, with severe effects for the affected person and for the society as a whole. The psycho-social factors are a major risk element in the onset of depression, overlapping both on the individual vulnerabilities of the affected person, and on the coping mechanisms, especially the disadaptive one. Our study aims were the comparative evaluation of the cognitive coping mechanisms in the evolution of depression and in determining the quality of the therapeutic response in two samples of depressive patients benefiting from pharmacologic treatment, respectively pharmacologic therapy and cognitive-behavioral psychotherapy. The most frequently used cognitive coping strategies in the depressive patients from the two samples in the study were predominantly maladaptive, more precisely ruminating, catastrophizing, self-culpability, respectively putting into perspective. It was evident though that the adaptative coping mechanisms, such as accepting the current situation, positive refocus and positive re-evaluation, are protective factors contributing to reaching psycho-social rehabilitation and granting support to the combined therapeutic intervention. Consequently, the identification of coping mechanisms dominant in each individual with major depression is required in order to increase the efficiency of cognitive behavior therapy as enhancer for pharmaco-therapy.

Non-cutaneous melanoma is a very rare clinical entity. Gastric melanoma can be primary or secondary, but determining their nature is in most cases very challenging. To date, very few cases of primary gastric melanoma have been described in the literature. We report the first case of primary gastric melanoma documented in a Romanian patient, confirmed through clinical, imagistic, and pathological diagnosis. A 68-year-old female patient presented to our hospital with complaints of dyspepsia, abdominal pain, and weight loss. Esophagogastroduodenoscopy revealed two large sessile masses in the gastric fundus, which was histologically compatible with melanoma; immunohistochemistry staining was positive for vimentin, S100 protein, HMB45 antibody and Melan A/MART1, and negative for pan-CKAE1/AE3, leukocyte common antigen and DOG1. Extensive dermatological and ophthalmological examinations did not identify a primary lesion. The patient was therefore diagnosed with primary melanoma of the stomach. At the time of the diagnosis, multiple bone and pulmonary metastases were detected and considering the poor general status of the patient, surgery was not recommended. She died three months following diagnosis. A review of the literature identified only 32 other reported cases of primary gastric melanoma, all in individuals ≥50 years of age and most of them in male patients. Partial or total gastrectomy was the usual treatment of choice, but prognosis was overall poor. Awareness of this rare condition must be increased among healthcare providers, as early detection can improve survival chances.

Purpose: The research included the analysis and processing of questionnaires applied in county hospitals in Craiova. The purpose of this article is to highlight the qualities, skills and competencies of a leader, necessary in the development of leadership and professional development skills.

Material and method: We performed a descriptive and cross-sectional study involving 166 medical staff from hospitals in Craiova. Between January 2020 and January 2021, we used a questionnaire as an investigative tool containing 26 questions on complex leadership issues. The results were stored in Microsoft Excel files (Microsoft Corp., Redmond, WA, USA) and were statistically analyzed using the Microsoft Excel XLST AT (Addinsoft) software suite. SARL, Paris,). Secondary data processing: calculation of fundamental statistical parameters, mean and standard deviation of their ratio, coefficient of variation, graphical representation and calculation of regression coefficients was performed with Excel, Pivot Tables using controls, Functions, Statistics, Diagram and Data Analysis module. In conclusion, a better organization of the management of the hospital units is required, taking into account the leadership in nursing.

Introduction: The human knee is one of the most complex human joints, by the number of components, by the stresses to which it is subjected, by the complicated spatial geometry of the components and by the existence of multiple contacts between different components.

Material and method: A series of modern devices and equipment that were used for the three-dimensional reconstruction of the components of the analyzed systems.

Results: Also, the elements of a knee prosthesis were modeled in a parameterized virtual environment and six orthopedic systems were compared. These systems have been studied using the finite element method using loads specific to normal human gait.

Discussion: The results obtained consisting of maps of displacements, deformations and stresses were stored, analyzed and compared.

Conclusions: Finally, important conclusions were highlighted.

Tissue healing is a complex process of replacing damaged tissue structures, being a dynamic process with spatial and temporal involvement. In practice, there are three types of healing: primary, secondary and tertiary. Since even tertiary healing can cause different problems depending on the individual patient, the medical world has always strived for new, easier, more effective, faster, and low cost-effective methods to cover skin wounds. This experiment aims to find a method that is as efficient and fast as possible, with minimal costs, of native healing of skin wounds and the development of a protocol that is as reliable and safe as possible for the patient. The experiment was carried out within the animal facility of the University of Medicine and Pharmacy of Craiova, with the agreement of our institutional Ethics Committee. The experimental group consisted of 30 individuals (Wistar laboratory rats), clinically healthy, male and female, being divided into 3 sublots of 10 individuals each. Each sublot was sacrificed at different time intervals: 7, 14 and 21 days, respectively. The local evolution of each individual was monitored during the experimental days, as well as their general state of health. Before slaughter, the lesions were examined macroscopically, following their size, whether or not the infection was present and the presence of other self-inflicted lesions later. Macroscopically, a faster wound healing was found where PRP enriched with hyaluronic acid was applied from the 7th day, so we can say that at first glance the "free" healing period in the case of enhanced epithelialization was about 7 days shorten. This fact will be confirmed or refuted following histopathological examinations and immunohistochemistry.

Uterine hemangioma (UH) is a rare benign lesion involving the myometrium and cervix. UH often presents as an endometrial polypoid mass that mimics an endometrial polyp. UH is commonly present in women of reproductive age with menorrhagia or pregnancy-associated complications. However, reported cases in postmenopausal women present with postmenopausal bleeding. The bleeding hemangiomatous polyps are treated with hysteroscopic polypectomy. We report the case of a 65-year-old postmenopausal woman with vaginal bleeding severe enough to seek emergency medical care. Transvaginal ultrasonography showed an endometrial thickness of 10.1mm but was otherwise unremarkable. Hysteroscopic examination revealed two endometrial polyps measuring 2.0cm, and 0.5cm. Surgeons had difficulty removing these polyps using usual methods, ultimately resorting to sharp excision. Microscopic examination showed scant endometrium without hyperplasia and a polypoid lesion with numerous CD31 positive capillaries entirely filling the stroma, supporting the diagnosis of capillary hemangioma. The contributing factor to UH in our case was unclear, which opens the door for future investigation of UH in post-menopausal women.

Starting from December 2020, vaccination against COVID-19 became available in Romania. There are a lot of uncertainties regarding the kinetics of immunity and its persistance over time. This is a small prospective study developed between January-September 2021 in the Infectious Diseases Clinic from Craiova and comprising 61 subjects immunised with BNT162b2 (Comirnaty). We have found that after two doses of vaccine there is a strong humoral response, but the immunity lowers six months later. Subjects with a diagnosis of COVID-19, previously or in between the two doses, have had the most significant immunological response, but, also, the sharpest decline in antibody titer. The immune response seems to be the same, regardless the gender of the subjects. There are a variety of responses at the individual level, but overall vaccine effectiveness is 96.72% two weeks following immunisation and 88.52% after six months; however for those who have been in contact with the virus, they all had an antibody titer well above the laboratory limit.

Background: Inflammatory bowel diseases (IBD) represent a category of chronic diseases of gastrointestinal tract with a long-term evolution which includes flares and periods of remission. The aim of the study is to identify and quantify the relationship between IBD status, perceived stress, coping mechanisms, and patients QOL.

Methods: Cross-sectional study on two samples consisting of 70 IBD patients monitored in the Gastroenterology Department of the Emergency Clinical County Hospital Craiova, Romania, respectively 70 healthy volunteers. Collected data include socio-demographic details, personal and familial medical history, clinical status, presumed risk factors, perceived stress (Perceived Stress Scale-PSS), coping strategies (COPE questionnaire) and Health-Related Quality of Life (HRQOL-SF-36 scale).

Results: Perceived stress was considerably higher on IBD subjects (p<0.0001). The assessment of HRQOL has shown that patients had the best perception over their physical and emotional domains of SF-36 (p<0.0001), while the most often coping mechanisms used are those from the problem-focused category.

Conclusions: There is a significant relationship between increased activity of IBD and higher level of stress, that led to the development of problem-focused coping strategies. We did not find a strong correlation between lower HRQOL levels and the items considered as potential risk factors.