Pub Date : 2023-01-01DOI: 10.55453/rjmm.2023.126.2.12
M. S. Isfeedvajani, Esmat Davoudi-Monfared, Mahboubeh Rouhollahei
"How people behave in an emergency depends on many social, cultural, and contextual factors. This study aimed to determine the COVID-19 risk perception in Iranian people. This study was descriptive. The study population was the assistant of patients who had come to Baqiyatallah Hospital in 2021. The number of participants was 500. The study tool was the COVID-19 risk assessment questionnaire. Data were analyzed using SPSS-22 software. The mean risk perception score was 2.78(±0.6) on a 7-point scale. The lowest and highest mean of the predictors of risk perception in COVID-19 was trust in government and personal efficacy, respectively. There was a significant difference between men and women in the mean of collective efficacy (P= 0.032). Social knowledge (p=0.007), trust in science (p=0.001), and trust in medical professionals (p=0.050) in positive direct experience people were significantly more than in people with negative direct experience of COVID-19. The most important predictors of risk perception in the COVID-19 epidemic were gender, education, social knowledge, and trust in science (P<0.05). People's perception of the risk of COVID-19 depends on several various factors, the most important factors were gender, level of education, social knowledge, and people's trust in science. "
{"title":"Covid-19 Risk Perception in a Sample of Iranian Population","authors":"M. S. Isfeedvajani, Esmat Davoudi-Monfared, Mahboubeh Rouhollahei","doi":"10.55453/rjmm.2023.126.2.12","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.2.12","url":null,"abstract":"\"How people behave in an emergency depends on many social, cultural, and contextual factors. This study aimed to determine the COVID-19 risk perception in Iranian people. This study was descriptive. The study population was the assistant of patients who had come to Baqiyatallah Hospital in 2021. The number of participants was 500. The study tool was the COVID-19 risk assessment questionnaire. Data were analyzed using SPSS-22 software. The mean risk perception score was 2.78(±0.6) on a 7-point scale. The lowest and highest mean of the predictors of risk perception in COVID-19 was trust in government and personal efficacy, respectively. There was a significant difference between men and women in the mean of collective efficacy (P= 0.032). Social knowledge (p=0.007), trust in science (p=0.001), and trust in medical professionals (p=0.050) in positive direct experience people were significantly more than in people with negative direct experience of COVID-19. The most important predictors of risk perception in the COVID-19 epidemic were gender, education, social knowledge, and trust in science (P<0.05). People's perception of the risk of COVID-19 depends on several various factors, the most important factors were gender, level of education, social knowledge, and people's trust in science. \"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70959199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.55453/rjmm.2023.126.2.8
Emad Behboudi, M. Hashemzadeh, A. Ramezani, Ali Jari, Negar Ebrahimi, Somayeh Ghasemi, M. Makvandi, Tahereh Gholamzadeh, E. Faghihloo
"Hippo signaling has been recognized as a newly identified tumor suppressor signaling pathway that can regulate cellular processes including regeneration, cell death, differentiation, and development. Its dysregulation through overexpression of YAP (Yes-associated protein) and TAZ (PDZ-binding motif) as two main oncogenic factors of the Hippo pathway has a crucial role in several cancers. Because of the limited prognosis and therapeutic targets, further understanding of molecular pathways involved in tumorigenesis is one of the interesting issues in studies. Here, we demonstrated that some viruses, through dysregulation of the Hippo signaling pathway can be implicated in transformation, metastasis, and chemotherapeutic drug resistance in virus-related cancer and also help processes involved in the pathogenesis of viral infection such as persistence "
{"title":"Deregulation of the Hippo Signaling Pathway in Virus-Associated Cancer","authors":"Emad Behboudi, M. Hashemzadeh, A. Ramezani, Ali Jari, Negar Ebrahimi, Somayeh Ghasemi, M. Makvandi, Tahereh Gholamzadeh, E. Faghihloo","doi":"10.55453/rjmm.2023.126.2.8","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.2.8","url":null,"abstract":"\"Hippo signaling has been recognized as a newly identified tumor suppressor signaling pathway that can regulate cellular processes including regeneration, cell death, differentiation, and development. Its dysregulation through overexpression of YAP (Yes-associated protein) and TAZ (PDZ-binding motif) as two main oncogenic factors of the Hippo pathway has a crucial role in several cancers. Because of the limited prognosis and therapeutic targets, further understanding of molecular pathways involved in tumorigenesis is one of the interesting issues in studies. Here, we demonstrated that some viruses, through dysregulation of the Hippo signaling pathway can be implicated in transformation, metastasis, and chemotherapeutic drug resistance in virus-related cancer and also help processes involved in the pathogenesis of viral infection such as persistence \"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70959909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.55453/rjmm.2023.126.2.3
C. Sîrbu, A. Mihai, F. Pleșa, T. M. Vasile, Ionuț Caloianu, A. M. Manole, S. Tuță
"This article aims to highlight the burnout burden among neurologists and provide information on some of its causes and consequences. We report an original article that reviews our current understanding of burnout matter in the neurology field. The main search engine through which we performed extensive literature research was PubMed, Scopus, and Google Scholar. The following information was collected: triggers of burnout and factors that perpetuate it, major complaints, values, and goals that dictate how coaching with it. Physician burnout is an umbrella term characterized by symptoms determined by exposure to chronic workplace stressors. Simply put, it encompasses many dimensions: emotional exhaustion, feelings of cynism, detachment (depersonalization), and a sense of ineffectiveness at work (low personal accomplishment). Burnout is common among all medical specialties, but neurology ranks at the top of the list. Several identified factors continue to fuel this problem. Properly addressing them, rethinking practice, and implementing wise, modern strategies can make significant contributions to reducing it. Aside from the chronic harm to the physician, burnout puts at risk the healthcare community at many levels including patients, other professionals, finances, etc. This paper wants to emphasize that burnout in neurology should be regarded as a global crisis. Thus, some strategies are proposed "
{"title":"Is Still Neurology Desirable as a Specialty for Aspiring Physicians?","authors":"C. Sîrbu, A. Mihai, F. Pleșa, T. M. Vasile, Ionuț Caloianu, A. M. Manole, S. Tuță","doi":"10.55453/rjmm.2023.126.2.3","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.2.3","url":null,"abstract":"\"This article aims to highlight the burnout burden among neurologists and provide information on some of its causes and consequences. We report an original article that reviews our current understanding of burnout matter in the neurology field. The main search engine through which we performed extensive literature research was PubMed, Scopus, and Google Scholar. The following information was collected: triggers of burnout and factors that perpetuate it, major complaints, values, and goals that dictate how coaching with it. Physician burnout is an umbrella term characterized by symptoms determined by exposure to chronic workplace stressors. Simply put, it encompasses many dimensions: emotional exhaustion, feelings of cynism, detachment (depersonalization), and a sense of ineffectiveness at work (low personal accomplishment). Burnout is common among all medical specialties, but neurology ranks at the top of the list. Several identified factors continue to fuel this problem. Properly addressing them, rethinking practice, and implementing wise, modern strategies can make significant contributions to reducing it. Aside from the chronic harm to the physician, burnout puts at risk the healthcare community at many levels including patients, other professionals, finances, etc. This paper wants to emphasize that burnout in neurology should be regarded as a global crisis. Thus, some strategies are proposed \"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70959298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.55453/rjmm.2023.126.2.11
M. S. Isfeedvajani, Esmat Davoudi-Monfared, Mahboubeh Rouhollahei, Mohammadhasan Delavari
"Trust in health care professionals is considered as a basis for patients’ care. This study aimed to compare the level of patients' trust in physicians and nurses in both general and COVID-19 wards in a reference hospital in Tehran during the pandemic. This was a cross-sectional descriptive study. The study population comprised patients from Baqiyatallah Hospital in 2022. The data collection tool was the scale of patients’ trust in nurses and the Wake-Forest physician trust scale. Data analysis was performed using SPSS-26 software. The level of patients’ trust in physicians in COVID-19 wards was significantly lower than in Non-COVID-19 wards (P<0.001), but there was no difference between the two groups in the trust of nurses. The lowest level of trust was in the receiving of required information from nurses, which had a lower score compared to other questions in the questionnaire, and the average amount of receiving required information for patients in general wards was significantly lower than that of patients in COVID-19 (P=0.006). Trust in nurses and physicians in both COVID-19 and general wards was optimum. During the COVID-19 pandemic, the medical staff worked tirelessly and despite the difficulties and complications of the pandemic, patients have high trust in physicians and nurses. "
{"title":"A Comparative Study of Patients’ Trust in Physicians and Nurses in COVID-19 and Non-COVID 19 Wards in a Reference Hospital in Tehran, Ira","authors":"M. S. Isfeedvajani, Esmat Davoudi-Monfared, Mahboubeh Rouhollahei, Mohammadhasan Delavari","doi":"10.55453/rjmm.2023.126.2.11","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.2.11","url":null,"abstract":"\"Trust in health care professionals is considered as a basis for patients’ care. This study aimed to compare the level of patients' trust in physicians and nurses in both general and COVID-19 wards in a reference hospital in Tehran during the pandemic. This was a cross-sectional descriptive study. The study population comprised patients from Baqiyatallah Hospital in 2022. The data collection tool was the scale of patients’ trust in nurses and the Wake-Forest physician trust scale. Data analysis was performed using SPSS-26 software. The level of patients’ trust in physicians in COVID-19 wards was significantly lower than in Non-COVID-19 wards (P<0.001), but there was no difference between the two groups in the trust of nurses. The lowest level of trust was in the receiving of required information from nurses, which had a lower score compared to other questions in the questionnaire, and the average amount of receiving required information for patients in general wards was significantly lower than that of patients in COVID-19 (P=0.006). Trust in nurses and physicians in both COVID-19 and general wards was optimum. During the COVID-19 pandemic, the medical staff worked tirelessly and despite the difficulties and complications of the pandemic, patients have high trust in physicians and nurses. \"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70959429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.55453/rjmm.2023.126.2.14
A. Dumitrașcu, A. Cucu, D. Terzea, E. Petrova, M. Carsote
"Collision tumors, rare neoplasms underlying two distinct histological types of carcinomas (with different origins) separated by normal tissue, are described in many organs including the thyroid gland, but to a lesser extent. We aim to overview the current published data concerning collision tumors of the thyroid (CTT). This is a narrative review considering papers published on PubMed through a search starting from the terms “collision” and “thyroid”. Inclusion criteria are full-length articles, the English language, the timeline from inception to December 2022, and original studies with different levels of statistical evidence. We followed the main types of thyroid carcinomas: differentiated thyroid carcinoma of papillary and follicular type, anaplastic/ undifferentiated/poorly differentiated carcinoma, respectively medullary thyroid carcinoma. We identified 92 papers based on the mentioned key words criteria. We excluded 54 papers (reviews or non-thyroid CTT or other topics outside our purpose). We included in the final analysis 38 papers: 34 case reports (1 patient per paper), 2 case series (2 individuals per each article), one case series of 3 subjects, and a single study of retrospective type (including 21 subjects) – a total of 62 patients on published cases which represents the largest study on published cases to our knowledge (according to our methodology) "
{"title":"Collision Tumors of the Thyroid","authors":"A. Dumitrașcu, A. Cucu, D. Terzea, E. Petrova, M. Carsote","doi":"10.55453/rjmm.2023.126.2.14","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.2.14","url":null,"abstract":"\"Collision tumors, rare neoplasms underlying two distinct histological types of carcinomas (with different origins) separated by normal tissue, are described in many organs including the thyroid gland, but to a lesser extent. We aim to overview the current published data concerning collision tumors of the thyroid (CTT). This is a narrative review considering papers published on PubMed through a search starting from the terms “collision” and “thyroid”. Inclusion criteria are full-length articles, the English language, the timeline from inception to December 2022, and original studies with different levels of statistical evidence. We followed the main types of thyroid carcinomas: differentiated thyroid carcinoma of papillary and follicular type, anaplastic/ undifferentiated/poorly differentiated carcinoma, respectively medullary thyroid carcinoma. We identified 92 papers based on the mentioned key words criteria. We excluded 54 papers (reviews or non-thyroid CTT or other topics outside our purpose). We included in the final analysis 38 papers: 34 case reports (1 patient per paper), 2 case series (2 individuals per each article), one case series of 3 subjects, and a single study of retrospective type (including 21 subjects) – a total of 62 patients on published cases which represents the largest study on published cases to our knowledge (according to our methodology) \"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70959602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.55453/rjmm.2023.126.2.7
Ş. Bektaş, Ç. M. Ayaz, Mehmet Eren Yuksel, S. Izdes
"We wanted to evaluate the efficacy of intravenous immunoglobulin (IVIG) treatment in Covid-19 patients in the intensive care unit (ICU). Sixteen (66.7%) male and 8 (33.3%) female adult severe Covid-19 patients who were treated with IVIG in the tertiary ICU between April 2020 and October 2021 at Ankara City Hospital were retrospectively reviewed. The median age of the patients was 63 (interquartile range (IQR):19). The patients were evaluated in terms of laboratory values and clinical results before and after IVIG treatment. There was no statistically significant difference between survived and deceased Covid-19 patients treated with IVIG in terms of age, gender, the onset of symptoms, presence of concomitant diseases, APACHE-II scores, duration of mechanical ventilator support, and length of stay in the ICU. When the laboratory values before and after IVIG treatment were compared, a significant decrease was identified only in alanine transaminase levels (p=0.01). However, there was a statistically significant difference in mortality in 5 patients with Guillain-Barré syndrome who all survived (p=0.001). IVIG treatment was effective in Covid-19 patients with Guillain-Barré syndrome. However, IVIG treatment did not have a statistically significant effect on pre and post-treatment laboratory values, morbidity, and mortality of severe Covid-19 patients in the ICU "
{"title":"Does Intravenous Immunoglobulin Therapy Have a Role in the Treatment of Severe Coronavirus-19 Patients?","authors":"Ş. Bektaş, Ç. M. Ayaz, Mehmet Eren Yuksel, S. Izdes","doi":"10.55453/rjmm.2023.126.2.7","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.2.7","url":null,"abstract":"\"We wanted to evaluate the efficacy of intravenous immunoglobulin (IVIG) treatment in Covid-19 patients in the intensive care unit (ICU). Sixteen (66.7%) male and 8 (33.3%) female adult severe Covid-19 patients who were treated with IVIG in the tertiary ICU between April 2020 and October 2021 at Ankara City Hospital were retrospectively reviewed. The median age of the patients was 63 (interquartile range (IQR):19). The patients were evaluated in terms of laboratory values and clinical results before and after IVIG treatment. There was no statistically significant difference between survived and deceased Covid-19 patients treated with IVIG in terms of age, gender, the onset of symptoms, presence of concomitant diseases, APACHE-II scores, duration of mechanical ventilator support, and length of stay in the ICU. When the laboratory values before and after IVIG treatment were compared, a significant decrease was identified only in alanine transaminase levels (p=0.01). However, there was a statistically significant difference in mortality in 5 patients with Guillain-Barré syndrome who all survived (p=0.001). IVIG treatment was effective in Covid-19 patients with Guillain-Barré syndrome. However, IVIG treatment did not have a statistically significant effect on pre and post-treatment laboratory values, morbidity, and mortality of severe Covid-19 patients in the ICU \"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70959900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.55453/rjmm.2023.126.2.5
D. Balan, F. Calangiu, G. Tănase, R. Tulin, Sebastian Isac, D. Georgescu, D. Dragoș, C. Cobilinschi, L. V. Chiperi, D. Ionescu, Andra-Elena Balcangiu-Stroescu, A. Călinoiu, Adina Rusu, I. A. Vacaroiu
"Introduction: As general population tends to have increasing life expectancy, the risk associated with developing chronic kidney disease (CKD) with multiple incapacitating concequences, also increases. Method: For the present study, we registered the data from the observation files of 37 patients diagnosed with CKD undergoing treatment by chronic hemodialysis and noted the CKD associated diagnoses included in the notion of comorbidities. We monitored their statistical incidence both in the whole group and separately, in women and men using TTEST and CORREL. Results: The median age of the subjects was 55.86 (± 12.00) years. The study population mean weight was 74.90 (± 14.44) kg, with a mean weight of 69.33 kg for female subjects, and 77.92 kg for males, respectively. Diabetes was identified in 35.13% of patients, whilst heart failure was present in 16.21% of patients. Conclusions: Following the analysis of the information about the patients with CKD in the dialysis program, which we included in the study group, we observed the existence of variations that occur with age, significant correlations between age and weight and between albuminemia and weight. The most common comorbidity is high blood pressure followed by anemia. "
{"title":"Etiology of Chronic Kidney Disease and Comorbidities in Chronic Hemodialysis Patients","authors":"D. Balan, F. Calangiu, G. Tănase, R. Tulin, Sebastian Isac, D. Georgescu, D. Dragoș, C. Cobilinschi, L. V. Chiperi, D. Ionescu, Andra-Elena Balcangiu-Stroescu, A. Călinoiu, Adina Rusu, I. A. Vacaroiu","doi":"10.55453/rjmm.2023.126.2.5","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.2.5","url":null,"abstract":"\"Introduction: As general population tends to have increasing life expectancy, the risk associated with developing chronic kidney disease (CKD) with multiple incapacitating concequences, also increases. Method: For the present study, we registered the data from the observation files of 37 patients diagnosed with CKD undergoing treatment by chronic hemodialysis and noted the CKD associated diagnoses included in the notion of comorbidities. We monitored their statistical incidence both in the whole group and separately, in women and men using TTEST and CORREL. Results: The median age of the subjects was 55.86 (± 12.00) years. The study population mean weight was 74.90 (± 14.44) kg, with a mean weight of 69.33 kg for female subjects, and 77.92 kg for males, respectively. Diabetes was identified in 35.13% of patients, whilst heart failure was present in 16.21% of patients. Conclusions: Following the analysis of the information about the patients with CKD in the dialysis program, which we included in the study group, we observed the existence of variations that occur with age, significant correlations between age and weight and between albuminemia and weight. The most common comorbidity is high blood pressure followed by anemia. \"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70959823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.55453/rjmm.2023.126.2.6
A. S. Capisizu, D. Cuzino, S. Stanciu
"Coronary CT angiography is a non-invasive method of analyzing the coronary lumen through which the atheromatous bur-den can be evaluated, with the analysis of the type of plaque (soft, calcified, mixed) and the impact on the arterial lumen (stenosis, occlusion). The anatomical evaluation by coronary CT is indicated in symptomatic patients with low and medium risk factors for coronary atherosclerotic disease, in those with inconclusive laboratory and EKG results, patients with un-certain stress test results, in the evaluation of coronary grafts and intrastent stenoses. Depending on the result of the angiography, the severity of the stenosis and the management of the patient are established. In the case of mild and medium stenoses, risk factors management and drug treatment are recommended. For severe stenoses, patients are referred for interventional coronary angiography or functional evaluation. Coronary CT angiography increases the certainty of coronary atherosclerotic disease diagnosis. It has a superior discriminative capacity of plaques with low attenuation, the main predictor of myocardial infarction, with almost five-fold higher risk. Coronary CT angiography increases the adaptation of medication, and the inclusion of statin therapy decreases the risk of fatal and nonfatal myocardial infarction at 5 years and increases the quality of life "
{"title":"The Role of Coronary CT Angiography in the Management of Patients with Coronary Atherosclerotic Diseas","authors":"A. S. Capisizu, D. Cuzino, S. Stanciu","doi":"10.55453/rjmm.2023.126.2.6","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.2.6","url":null,"abstract":"\"Coronary CT angiography is a non-invasive method of analyzing the coronary lumen through which the atheromatous bur-den can be evaluated, with the analysis of the type of plaque (soft, calcified, mixed) and the impact on the arterial lumen (stenosis, occlusion). The anatomical evaluation by coronary CT is indicated in symptomatic patients with low and medium risk factors for coronary atherosclerotic disease, in those with inconclusive laboratory and EKG results, patients with un-certain stress test results, in the evaluation of coronary grafts and intrastent stenoses. Depending on the result of the angiography, the severity of the stenosis and the management of the patient are established. In the case of mild and medium stenoses, risk factors management and drug treatment are recommended. For severe stenoses, patients are referred for interventional coronary angiography or functional evaluation. Coronary CT angiography increases the certainty of coronary atherosclerotic disease diagnosis. It has a superior discriminative capacity of plaques with low attenuation, the main predictor of myocardial infarction, with almost five-fold higher risk. Coronary CT angiography increases the adaptation of medication, and the inclusion of statin therapy decreases the risk of fatal and nonfatal myocardial infarction at 5 years and increases the quality of life \"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70959865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.55453/rjmm.2023.126.2.2
Andreea M. Dușa, E. Bălășescu, Ș. Busnatu, O. Andronic
"Background: Cardiovascular disease can be triggered and accelerated by hypertension and the underlying changes in the structure and function of arteries. The purpose of this review is to explore some vascular changes that occur in hypertension as a consequence of the imbalance between cell proliferation and cell death, processes that play an important role in stabilizing the thickness of the arterial wall during vascular remodeling. Methods: The authors conducted research through PubMed and Google Scholar databases using the following search formula: (hypertensive*) AND ((vascular modifications)) OR (vascular changes)) AND (cell death). Results: From 40 articles, only 17 publications were included in this study, taking into account four processes that can be preceded or followed by inflammation and depend on the interaction between local growth factors, vasoactive substances, and hemodynamic stimuli: Cell proliferation and growth; Cell migration; Cell death; Degradation or reorganization of extracellular matrix. Conclusions: To summarize, maladaptive vascular changes in hypertension can represent a major argument for prompt and maximal therapeutic intervention in patients with high cardiovascular risk. Moreover, they can represent an important step in discovering new markers of cardiovascular risk and in the development of new targeted therapies for different pathways of cellular signaling through which the reversibility of abnormal vascular changes could be obtained. "
背景:高血压和动脉结构和功能的潜在变化可触发和加速心血管疾病。这篇综述的目的是探讨高血压患者由于细胞增殖和细胞死亡之间的不平衡而发生的一些血管变化，这些变化在血管重塑过程中对稳定动脉壁厚度起重要作用。方法:作者通过PubMed和谷歌Scholar数据库进行研究，检索公式为:(hypertension *) and (vascular modification) OR (vascular changes) and (cell death)。结果:从40篇文章中，只有17篇出版物被纳入本研究，考虑了炎症发生之前或之后的四个过程，并取决于局部生长因子、血管活性物质和血流动力学刺激之间的相互作用:细胞增殖和生长;细胞迁移;细胞死亡;细胞外基质的降解或重组。结论:总之，高血压患者血管的不适应变化是对高危心血管患者进行及时和最大限度治疗干预的主要理由。此外，它们在发现心血管风险的新标记和开发针对不同细胞信号传导途径的新靶向治疗方面迈出了重要的一步，通过这些途径可以获得异常血管变化的可逆性。”
{"title":"Vascular Changes in Hypertension: Is There Cell Death Involved? – A Narrative Review","authors":"Andreea M. Dușa, E. Bălășescu, Ș. Busnatu, O. Andronic","doi":"10.55453/rjmm.2023.126.2.2","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.2.2","url":null,"abstract":"\"Background: Cardiovascular disease can be triggered and accelerated by hypertension and the underlying changes in the structure and function of arteries. The purpose of this review is to explore some vascular changes that occur in hypertension as a consequence of the imbalance between cell proliferation and cell death, processes that play an important role in stabilizing the thickness of the arterial wall during vascular remodeling. Methods: The authors conducted research through PubMed and Google Scholar databases using the following search formula: (hypertensive*) AND ((vascular modifications)) OR (vascular changes)) AND (cell death). Results: From 40 articles, only 17 publications were included in this study, taking into account four processes that can be preceded or followed by inflammation and depend on the interaction between local growth factors, vasoactive substances, and hemodynamic stimuli: Cell proliferation and growth; Cell migration; Cell death; Degradation or reorganization of extracellular matrix. Conclusions: To summarize, maladaptive vascular changes in hypertension can represent a major argument for prompt and maximal therapeutic intervention in patients with high cardiovascular risk. Moreover, they can represent an important step in discovering new markers of cardiovascular risk and in the development of new targeted therapies for different pathways of cellular signaling through which the reversibility of abnormal vascular changes could be obtained. \"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70959206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.55453/rjmm.2023.126.2.15
D. Radulescu, F. Perde, C. David, G. Lupusoru, M. Lupușoru, F. Tulin, D. Ionescu, A. Călinoiu, Sebastian Isac, I. A. Vacaroiu
"The recent increase in life expectancy is the main argument for a better understanding of the pathophysiological mechanisms underlying aging. These, once known, can provide possible links to therapies to prevent aging or slow down the process. Normal aging is associated with a progressive decrease in the glomerular filtration rate. Accurate estimation of GFR in the elderly is under the suspicion of multiple errors mainly due to sarcopenia and decreased protein intake. Differentiation between chronic kidney disease and the physiological decline of GFR might be a challenge in clinical practice and this has consequences on the evolution and treatment of the numerous comorbidities of the elderly. The current trend to use non-invasive diagnostic techniques explains the need to identify a serological marker to help differentiate between decreased GFR secondary to kidney aging or the development of chronic kidney disease."
{"title":"Diagnosis of Chronic Kidney Disease in the Elderly – A Challenge for the Practitioner","authors":"D. Radulescu, F. Perde, C. David, G. Lupusoru, M. Lupușoru, F. Tulin, D. Ionescu, A. Călinoiu, Sebastian Isac, I. A. Vacaroiu","doi":"10.55453/rjmm.2023.126.2.15","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.2.15","url":null,"abstract":"\"The recent increase in life expectancy is the main argument for a better understanding of the pathophysiological mechanisms underlying aging. These, once known, can provide possible links to therapies to prevent aging or slow down the process. Normal aging is associated with a progressive decrease in the glomerular filtration rate. Accurate estimation of GFR in the elderly is under the suspicion of multiple errors mainly due to sarcopenia and decreased protein intake. Differentiation between chronic kidney disease and the physiological decline of GFR might be a challenge in clinical practice and this has consequences on the evolution and treatment of the numerous comorbidities of the elderly. The current trend to use non-invasive diagnostic techniques explains the need to identify a serological marker to help differentiate between decreased GFR secondary to kidney aging or the development of chronic kidney disease.\"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70959512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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