Nina Čamdžić, V. Muzika, S. Čustović, M. Babić, Mirsad Dorić, Edina Lazović Salčin, Suada Kuskunović-Vlahovljak
Abstract Objective of this study was to identify the histopathological patterns and their frequency in testicular biopsy specimens from azoospermic patients and to categorize it according to Modified Johnsen scoring system. Methods: Testicular biopsies from male patients with clinical diagnosis of azoospermia were included in this study. All tissue samples were fixed in buffered 10% formalin, routinely processed and stained with Hematoxylin and Eosin. All cases were examined microscopically and categorized according to the histopathological patterns and Modified Johnsen scoring system. Results: Total 219 cases of testicular biopsies from 125 azoospermic male patients were evaluated, with 94 cases of bilateral testicular biopsy. The most prevalent age group was of 30-39 years (66.2%). The most common histological pattern was of Sertoli cell only syndrome (58.4%) while the least represented pattern was germ cell maturation arrest, seen in 4.6% cases. The most common Modified Johnsen score was 2 (66.7%). There was discordance in histologic pattern in both testes in 12.76% of patients who had bilateral testicular biopsy. Conclusion: Our study gives an insight on the most common histopathological patterns of azoospermic patients and emphasizes the need for a better national statistics and epidemiological studies of this entity. It also points out the significance of the bilateral testicular biopsy, as both, diagnostic and therapeutic procedure.
{"title":"Histological patterns of testicular biopsy in patients with azoospermia: single-institution experience","authors":"Nina Čamdžić, V. Muzika, S. Čustović, M. Babić, Mirsad Dorić, Edina Lazović Salčin, Suada Kuskunović-Vlahovljak","doi":"10.2478/amma-2023-0038","DOIUrl":"https://doi.org/10.2478/amma-2023-0038","url":null,"abstract":"Abstract Objective of this study was to identify the histopathological patterns and their frequency in testicular biopsy specimens from azoospermic patients and to categorize it according to Modified Johnsen scoring system. Methods: Testicular biopsies from male patients with clinical diagnosis of azoospermia were included in this study. All tissue samples were fixed in buffered 10% formalin, routinely processed and stained with Hematoxylin and Eosin. All cases were examined microscopically and categorized according to the histopathological patterns and Modified Johnsen scoring system. Results: Total 219 cases of testicular biopsies from 125 azoospermic male patients were evaluated, with 94 cases of bilateral testicular biopsy. The most prevalent age group was of 30-39 years (66.2%). The most common histological pattern was of Sertoli cell only syndrome (58.4%) while the least represented pattern was germ cell maturation arrest, seen in 4.6% cases. The most common Modified Johnsen score was 2 (66.7%). There was discordance in histologic pattern in both testes in 12.76% of patients who had bilateral testicular biopsy. Conclusion: Our study gives an insight on the most common histopathological patterns of azoospermic patients and emphasizes the need for a better national statistics and epidemiological studies of this entity. It also points out the significance of the bilateral testicular biopsy, as both, diagnostic and therapeutic procedure.","PeriodicalId":36282,"journal":{"name":"Acta Marisiensis - Seria Medica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139191200","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}
Abstract Marcus Gunn jaw wink phenomenon or Trigeminal oculomotor synkinesis, is a congenital disorder in which the upper lid moves synkinetically in response to jaw movement during chewing. The term synkinesis describes the simultaneous movement or a coordinated sequence of movements of muscles, which are supplied by different nerves or by separate peripheral branches of the same nerve. Although it rarely manifests bilaterally, it is typically unilateral. In 1883, Dr Robert Marcus Gunn, a Scottish Ophthalmologist described a 15-year-old girl with a peculiar type of congenital ptosis that included an associated winking motion of the affected eyelid on the movement of the jaw. It is known to affect both men and women equally. This phenomenon has been reported to be a similar phenomenon affecting 2-13% of all cases of congenital ptosis. It can be congenital or acquired, for example through trauma. The Congenital Marcus Gunn jaw wink phenomenon is thought to arise from the connection between the branch of the trigeminal nerve (responsible for chewing) supplying the middle or lateral pterygoid muscle and the branch of the oculomotor nerve supplying the upper superior levator ocular defect. Here we present a case report of Marcus Gunn’s Jaw-Winking Synkinesis in congenital ptosis.
摘要 马库斯-冈下颌眨眼现象或三叉神经眼球运动同步症是一种先天性疾病，患者在咀嚼时上眼皮会随着下颌运动而同步运动。所谓同步运动，是指由不同神经或同一神经的不同外周分支所供应的肌肉同时运动或一连串协调的运动。虽然很少表现为双侧，但通常是单侧。1883 年，苏格兰眼科医生罗伯特-马库斯-贡（Robert Marcus Gunn）博士描述了一名 15 岁女孩的先天性上睑下垂病例，该女孩患有一种特殊类型的先天性上睑下垂，在下颌运动时，患侧眼睑会伴有眨眼动作。据了解，这种现象对男性和女性都同样有影响。据报道，这种现象在所有先天性上睑下垂病例中占 2%-13%。它可以是先天性的，也可以是后天性的，例如通过外伤造成的。先天性马库斯-冈下颌眨眼现象被认为是由于三叉神经分支（负责咀嚼）供应翼状肌中部或外侧与眼球运动神经分支（供应眼球上提肌缺损）之间的连接引起的。我们在此报告一例先天性上睑下垂患者马库斯-冈恩 "颌眨眼综合征 "的病例。
{"title":"Marcus Gunn jaw-winking syndrome: A case report","authors":"Sivan Sathish, Manonmani Subramani, Pranay Patel, Nidhi Hirani, Priyadharshini Arjunan","doi":"10.2478/amma-2023-0040","DOIUrl":"https://doi.org/10.2478/amma-2023-0040","url":null,"abstract":"Abstract Marcus Gunn jaw wink phenomenon or Trigeminal oculomotor synkinesis, is a congenital disorder in which the upper lid moves synkinetically in response to jaw movement during chewing. The term synkinesis describes the simultaneous movement or a coordinated sequence of movements of muscles, which are supplied by different nerves or by separate peripheral branches of the same nerve. Although it rarely manifests bilaterally, it is typically unilateral. In 1883, Dr Robert Marcus Gunn, a Scottish Ophthalmologist described a 15-year-old girl with a peculiar type of congenital ptosis that included an associated winking motion of the affected eyelid on the movement of the jaw. It is known to affect both men and women equally. This phenomenon has been reported to be a similar phenomenon affecting 2-13% of all cases of congenital ptosis. It can be congenital or acquired, for example through trauma. The Congenital Marcus Gunn jaw wink phenomenon is thought to arise from the connection between the branch of the trigeminal nerve (responsible for chewing) supplying the middle or lateral pterygoid muscle and the branch of the oculomotor nerve supplying the upper superior levator ocular defect. Here we present a case report of Marcus Gunn’s Jaw-Winking Synkinesis in congenital ptosis.","PeriodicalId":36282,"journal":{"name":"Acta Marisiensis - Seria Medica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139194026","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}
Abstract Background/aim : Diabetes mellitus is a metabolic disorder of multiple etiologies characterized by a lack of insulin, with a consequent disordered metabolism of glucose, fats, and proteins. A number of complications, such as diabetic nephropathy and retinopathy, may develop as a result of long-term diabetes. The aim of this study aimed to determine the correlation between diabetic nephropathy and diabetic retinopathy as long-term complications of diabetes mellitus. Materials and methods : Retrospective, descriptive, and analytical research was conducted at the department of Endocrinology, Clinical Center, University of Sarajevo. The study included 158 patients hospitalized in time between 1st of January and 31st of December 2012. Results : New-onset diabetes was found in 38%, and diabetes type 2 patients 132 (83.5%), female 105 (66.5%) while older than 60 years were 100 (63.3%). Upon discharge from hospital 83,7% of patients were discharged with glycemia <10 mmol / l. We found that 47,5% of patients had HbA1c> 10%. Reduced kidney function, different degrees of failure was at 66.5%. More than half (62.7%) patients had proteinuria as a sign of diabetic nephropathy. Diabetic retinopathy was diagnosed with different types in 54.4%. Conclusion : Diabetes leads to an increase in nitrogen compounds, and the development of diabetic nephropathy manifests as various degrees of renal insufficiency. The duration of diabetes and occurrence of diabetic retinopathy were significantly interrelated. The correlation between the degree of renal failure and changes in the ocular fundus has not been proven, but more severe renal insufficiency is associated with a higher incidence of diabetic retinopathy compared to patients with less impaired renal function.
{"title":"Correlation between diabetic nephropathy and diabetic retinopathy as a long term complications of diabetes mellitus","authors":"Muamer Dervišević, Damir Rebić, Emina Dervišević","doi":"10.2478/amma-2023-0024","DOIUrl":"https://doi.org/10.2478/amma-2023-0024","url":null,"abstract":"Abstract Background/aim : Diabetes mellitus is a metabolic disorder of multiple etiologies characterized by a lack of insulin, with a consequent disordered metabolism of glucose, fats, and proteins. A number of complications, such as diabetic nephropathy and retinopathy, may develop as a result of long-term diabetes. The aim of this study aimed to determine the correlation between diabetic nephropathy and diabetic retinopathy as long-term complications of diabetes mellitus. Materials and methods : Retrospective, descriptive, and analytical research was conducted at the department of Endocrinology, Clinical Center, University of Sarajevo. The study included 158 patients hospitalized in time between 1st of January and 31st of December 2012. Results : New-onset diabetes was found in 38%, and diabetes type 2 patients 132 (83.5%), female 105 (66.5%) while older than 60 years were 100 (63.3%). Upon discharge from hospital 83,7% of patients were discharged with glycemia <10 mmol / l. We found that 47,5% of patients had HbA1c> 10%. Reduced kidney function, different degrees of failure was at 66.5%. More than half (62.7%) patients had proteinuria as a sign of diabetic nephropathy. Diabetic retinopathy was diagnosed with different types in 54.4%. Conclusion : Diabetes leads to an increase in nitrogen compounds, and the development of diabetic nephropathy manifests as various degrees of renal insufficiency. The duration of diabetes and occurrence of diabetic retinopathy were significantly interrelated. The correlation between the degree of renal failure and changes in the ocular fundus has not been proven, but more severe renal insufficiency is associated with a higher incidence of diabetic retinopathy compared to patients with less impaired renal function.","PeriodicalId":36282,"journal":{"name":"Acta Marisiensis - Seria Medica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135639514","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}
Abstract As the most common intraocular malignancy in children, retinoblastoma poses a vision, globe, and life-threatening risk and hence requires thorough evaluation and surveillance. While the disease is one of the most curable malignancies in established countries, children of lower-middle-income countries are not so fortunate, especially those with familial history of retinoblastoma. The delay of diagnosis proposes a grave prognosis, thus screening is a must. This study aimed to review the literature on various screening programs and applications described for the early detection of retinoblastoma, especially in a setting where genetic examination performance is limited. A literature search across PubMed®, ProQuest, and EbscoHost (MEDLINE Full text) with the topic of current methods and programs of retinoblastoma screening in neonates, infants, and children were carried out denoting various guideline and recommendations but the implementation is not uniform. Examination under anesthesia and red-reflex tests are among the most frequently conducted but the practices vastly vary especially in a place with low resources. Recent updates in mobile phone freeware should be rigorously upgraded due to its current inadequate sensitivity and specificity in detecting retinoblastoma but pose a promising future for retinoblastoma screening and diagnosis, especially in lower-middle-income countries.
{"title":"Current screening and diagnostic approaches of retinoblastoma in limited setting","authors":"Nunki Puspita Utomo, Devie Kristiani, Sri Mulatsih, Pande Komang Wahyu Pradana","doi":"10.2478/amma-2023-0032","DOIUrl":"https://doi.org/10.2478/amma-2023-0032","url":null,"abstract":"Abstract As the most common intraocular malignancy in children, retinoblastoma poses a vision, globe, and life-threatening risk and hence requires thorough evaluation and surveillance. While the disease is one of the most curable malignancies in established countries, children of lower-middle-income countries are not so fortunate, especially those with familial history of retinoblastoma. The delay of diagnosis proposes a grave prognosis, thus screening is a must. This study aimed to review the literature on various screening programs and applications described for the early detection of retinoblastoma, especially in a setting where genetic examination performance is limited. A literature search across PubMed®, ProQuest, and EbscoHost (MEDLINE Full text) with the topic of current methods and programs of retinoblastoma screening in neonates, infants, and children were carried out denoting various guideline and recommendations but the implementation is not uniform. Examination under anesthesia and red-reflex tests are among the most frequently conducted but the practices vastly vary especially in a place with low resources. Recent updates in mobile phone freeware should be rigorously upgraded due to its current inadequate sensitivity and specificity in detecting retinoblastoma but pose a promising future for retinoblastoma screening and diagnosis, especially in lower-middle-income countries.","PeriodicalId":36282,"journal":{"name":"Acta Marisiensis - Seria Medica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135639557","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}
Marius Călin Cherecheș, Alin Dospinescu, Hajnal Finta
Abstract Objective Food for Special Medical Purposes (FSMP) is a niche area in the food and healthcare industries that produces foods to meet the dietary requirements of people with specific medical conditions. These products provide specific nutrient amounts and ratios, which can be used as a supplement to a conventional diet, part of an entire medical treatment plan, or as a sole source of Nutrition. The market is expected to generate revenues of $19.67 billion in 2028. Most FSMPs products are purchased individually by patients or caregivers. Although these products are not advertised directly to the public might be bought online from pharmacies and other online shops. This research aims to evaluate the online presence of the most important brands within the FSMPs category and how the patients get to the online shops without direct-to-consumer advertisement. Methods: This exploratory qualitative research study examines the online presence of FSMP products and key brands using SEO as the main digital technique. Data sources included Romanian websites, Google SERPs, Brandmentions.com, Semrush, and Ubersuggest. Results : The findings showed that these websites received only a small amount of direct traffic, with only a few hundred monthly visits. To increase organic visibility, businesses must follow regulatory requirements, collaborate with medical experts, engage with potential clients, and exhibit their products at medical events and fairs. Content marketing is crucial for FSMP brands to engage with their target audience and deliver valuable information. Conclusions : FSMP brands cannot advertise directly to consumers. Instead, they should focus on SEO, reputable online pharmacies, e-commerce shops, and content marketing. This research applies to FSMP brands, digital marketers, and online pharmacies to effectively connect with target demographics, promote products, navigate regulatory constraints, and enhance online presence, improving accessibility and awareness.
{"title":"The digital presence of the leading brands in the category of Food for Special Medical Purposes","authors":"Marius Călin Cherecheș, Alin Dospinescu, Hajnal Finta","doi":"10.2478/amma-2023-0029","DOIUrl":"https://doi.org/10.2478/amma-2023-0029","url":null,"abstract":"Abstract Objective Food for Special Medical Purposes (FSMP) is a niche area in the food and healthcare industries that produces foods to meet the dietary requirements of people with specific medical conditions. These products provide specific nutrient amounts and ratios, which can be used as a supplement to a conventional diet, part of an entire medical treatment plan, or as a sole source of Nutrition. The market is expected to generate revenues of $19.67 billion in 2028. Most FSMPs products are purchased individually by patients or caregivers. Although these products are not advertised directly to the public might be bought online from pharmacies and other online shops. This research aims to evaluate the online presence of the most important brands within the FSMPs category and how the patients get to the online shops without direct-to-consumer advertisement. Methods: This exploratory qualitative research study examines the online presence of FSMP products and key brands using SEO as the main digital technique. Data sources included Romanian websites, Google SERPs, Brandmentions.com, Semrush, and Ubersuggest. Results : The findings showed that these websites received only a small amount of direct traffic, with only a few hundred monthly visits. To increase organic visibility, businesses must follow regulatory requirements, collaborate with medical experts, engage with potential clients, and exhibit their products at medical events and fairs. Content marketing is crucial for FSMP brands to engage with their target audience and deliver valuable information. Conclusions : FSMP brands cannot advertise directly to consumers. Instead, they should focus on SEO, reputable online pharmacies, e-commerce shops, and content marketing. This research applies to FSMP brands, digital marketers, and online pharmacies to effectively connect with target demographics, promote products, navigate regulatory constraints, and enhance online presence, improving accessibility and awareness.","PeriodicalId":36282,"journal":{"name":"Acta Marisiensis - Seria Medica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135639165","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}
Ingrid Nădășan, Loránd Ferencz, Geanina Moldovan, Zoltán Ábrám, Valentin Nădășan
Abstract Background and objective : Providing brief advice to stop smoking (BASS) can significantly increase motivation to quit, long-term smoking cessation rates, and substantially impact public health. The study aimed to evaluate knowledge, attitudes, and willingness of community pharmacy staff in Mures County, Romania, to provide BASS to smokers. Methods : The observational, cross-sectional study included a sample of 96 professionals working in community pharmacies in Mures County, Romania. Data were collected using an online questionnaire. Descriptive statistics were calculated. Results : Generally, more than 90% of the respondents acknowledged that smoking is addictive, represents a health hazard, and increases the risk of lung and laryngeal cancer, chronic obstructive pulmonary disease, heart attack, and stroke. Up to 70% of the respondents recognized the most common scientifically proven quit medications, such as nicotine replacement therapy, bupropion, and varenicline. Most pharmacists agreed that they should regularly ask the patients about their smoking status and encourage smokers to quit. They also declared they should receive continual education regarding quit services, medications, and techniques. BASS was credited with very high efficacy by 17.1%, high efficacy by 26.8%, and moderate efficacy by 46.3% of the respondents. The most common perceived barriers to providing BASS in community pharmacies were lack of demand from smokers (78.0%), lack of time (73.2%), and lack of educational materials (39.0%). About 70% of the pharmacists received no formal training regarding quit services, but more than 75% were interested in earning such a qualification. About 65% of the respondents estimated they could dedicate 10-15 minutes of their daily working time to provide BASS to interested customers. Conclusions : Overall, the study found an acceptable level of knowledge and willingness of the participants in offering BASS, suggesting that a program to provide BASS in Mures County community pharmacies may be feasible and useful.
{"title":"Knowledge, attitudes, and willingness of community pharmacy staff in Mures County, Romania, to provide the brief advice to stop smoking: A cross-sectional study","authors":"Ingrid Nădășan, Loránd Ferencz, Geanina Moldovan, Zoltán Ábrám, Valentin Nădășan","doi":"10.2478/amma-2023-0030","DOIUrl":"https://doi.org/10.2478/amma-2023-0030","url":null,"abstract":"Abstract Background and objective : Providing brief advice to stop smoking (BASS) can significantly increase motivation to quit, long-term smoking cessation rates, and substantially impact public health. The study aimed to evaluate knowledge, attitudes, and willingness of community pharmacy staff in Mures County, Romania, to provide BASS to smokers. Methods : The observational, cross-sectional study included a sample of 96 professionals working in community pharmacies in Mures County, Romania. Data were collected using an online questionnaire. Descriptive statistics were calculated. Results : Generally, more than 90% of the respondents acknowledged that smoking is addictive, represents a health hazard, and increases the risk of lung and laryngeal cancer, chronic obstructive pulmonary disease, heart attack, and stroke. Up to 70% of the respondents recognized the most common scientifically proven quit medications, such as nicotine replacement therapy, bupropion, and varenicline. Most pharmacists agreed that they should regularly ask the patients about their smoking status and encourage smokers to quit. They also declared they should receive continual education regarding quit services, medications, and techniques. BASS was credited with very high efficacy by 17.1%, high efficacy by 26.8%, and moderate efficacy by 46.3% of the respondents. The most common perceived barriers to providing BASS in community pharmacies were lack of demand from smokers (78.0%), lack of time (73.2%), and lack of educational materials (39.0%). About 70% of the pharmacists received no formal training regarding quit services, but more than 75% were interested in earning such a qualification. About 65% of the respondents estimated they could dedicate 10-15 minutes of their daily working time to provide BASS to interested customers. Conclusions : Overall, the study found an acceptable level of knowledge and willingness of the participants in offering BASS, suggesting that a program to provide BASS in Mures County community pharmacies may be feasible and useful.","PeriodicalId":36282,"journal":{"name":"Acta Marisiensis - Seria Medica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135639173","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}
Abstract Introduction : Peripheral sensorimotor polyneuropathy is present in nearly half of the patients diagnosed with diabetes mellitus. Over the past 10 years, animal and human studies have suggested that vitamin D3 treatment may have a role in preventing or reducing neuropathic complaints and symptoms. Material and method : Our clinical, prospective, interventional, placebo-controlled study investigated the therapeutic effect of 2.000 IU oral cholecalciferol administered for three months on diabetic polyneuropathy. Patients treated with vitamin D and B, thioctic acid, and other analgesics were excluded. Using the single-blind technique, they were randomly assigned into vitamin D-treated and placebo-treated groups. In addition to recording anamnestic data, the study included - a Toronto Clinical Neuropathy Scoring System and Michigan Neuropathy Screening Instrument based - questionnaire to assess subjective symptoms and a physical examination including sensory tests (fine touch-, temperature awareness, pain-, vibration perception). Vitamin D levels were measured. After three months of therapy, the examination was repeated. Results : Most of the patients were found to have vitamin D deficiency (36% of the total population) or insufficiency (43%). In the cholecalciferol-treated group, but not in the control group, subjective symptoms decreased in intensity and/or frequency, and a significant improvement in the overall complaint scale was observed (p = 0.006), but no change regarding the sensory tests (p > 0.05). Conclusions : Our results show that oral administration of cholecalciferol for three months significantly reduced subjective symptoms and neuropathic pain as assessed by our questionnaire, however, there was no significant change in the results of the sensory tests. Vitamin D deficiency/insufficiency was common in diabetic patients (79% in our population), therefore screening is recommended.
{"title":"Effects of vitamin D3 (cholecalciferol) supplementation on diabetic polyneuropathy in patients diagnosed with diabetes mellitus","authors":"László Marton, Monica IM Szabó","doi":"10.2478/amma-2023-0023","DOIUrl":"https://doi.org/10.2478/amma-2023-0023","url":null,"abstract":"Abstract Introduction : Peripheral sensorimotor polyneuropathy is present in nearly half of the patients diagnosed with diabetes mellitus. Over the past 10 years, animal and human studies have suggested that vitamin D3 treatment may have a role in preventing or reducing neuropathic complaints and symptoms. Material and method : Our clinical, prospective, interventional, placebo-controlled study investigated the therapeutic effect of 2.000 IU oral cholecalciferol administered for three months on diabetic polyneuropathy. Patients treated with vitamin D and B, thioctic acid, and other analgesics were excluded. Using the single-blind technique, they were randomly assigned into vitamin D-treated and placebo-treated groups. In addition to recording anamnestic data, the study included - a Toronto Clinical Neuropathy Scoring System and Michigan Neuropathy Screening Instrument based - questionnaire to assess subjective symptoms and a physical examination including sensory tests (fine touch-, temperature awareness, pain-, vibration perception). Vitamin D levels were measured. After three months of therapy, the examination was repeated. Results : Most of the patients were found to have vitamin D deficiency (36% of the total population) or insufficiency (43%). In the cholecalciferol-treated group, but not in the control group, subjective symptoms decreased in intensity and/or frequency, and a significant improvement in the overall complaint scale was observed (p = 0.006), but no change regarding the sensory tests (p > 0.05). Conclusions : Our results show that oral administration of cholecalciferol for three months significantly reduced subjective symptoms and neuropathic pain as assessed by our questionnaire, however, there was no significant change in the results of the sensory tests. Vitamin D deficiency/insufficiency was common in diabetic patients (79% in our population), therefore screening is recommended.","PeriodicalId":36282,"journal":{"name":"Acta Marisiensis - Seria Medica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135639286","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}
Valentin Moroșanu, Iulian Roman-Filip, Sanda Petruțiu, Rodica Bălașa
Abstract Epilepsy affects approximately 50 million of people worldwide and 30% of them are resistant to drugs. Neuromodulation is becoming a key option in patients with drug-resistant epilepsy who are not feasible for resective surgery. Vagus nerve stimulation (VNS) is the most commonly used adjunctive neuromodulatory method in every patient aged 4 years and older who is unsuitable for resective surgery. It is a minimally invasive, non-teratogenic, extracranial pacemaker-like device which delivers electrical stimuli to the vagus nerve and desynchronize aberrant cerebral rhythms involved in epileptogenesis. In this review we approached the information and clinical data of VNS development history, clinical applications and possible mechanism of action. We will also review optimal stimulation parameters and information about closed and open loop devices. Vagus nerve stimulation is safe, efficient with no significant side effects and substantial cost-saving benefit, that also shows an important improvement in mood, behavior, cognition and quality of life. The overall responder rate was observed in more than 50% of patients. On the other hand, it is not clear which patients will respond to this method of treatment and why the response is not immediate, there are no available biomarkers or other features like age, sex, seizure type/epileptic syndrome to predict response to vagus nerve stimulation therapy. The VNS Therapy System continues to be an important prospect in the treatment of pharmacoresistant epilepsy, that requires further studies in order to ensure the most advantageous therapeutic response.
{"title":"Vagus Nerve Stimulation (VNS) Therapy System in pharmacoresistant epilepsy: A literature review","authors":"Valentin Moroșanu, Iulian Roman-Filip, Sanda Petruțiu, Rodica Bălașa","doi":"10.2478/amma-2023-0027","DOIUrl":"https://doi.org/10.2478/amma-2023-0027","url":null,"abstract":"Abstract Epilepsy affects approximately 50 million of people worldwide and 30% of them are resistant to drugs. Neuromodulation is becoming a key option in patients with drug-resistant epilepsy who are not feasible for resective surgery. Vagus nerve stimulation (VNS) is the most commonly used adjunctive neuromodulatory method in every patient aged 4 years and older who is unsuitable for resective surgery. It is a minimally invasive, non-teratogenic, extracranial pacemaker-like device which delivers electrical stimuli to the vagus nerve and desynchronize aberrant cerebral rhythms involved in epileptogenesis. In this review we approached the information and clinical data of VNS development history, clinical applications and possible mechanism of action. We will also review optimal stimulation parameters and information about closed and open loop devices. Vagus nerve stimulation is safe, efficient with no significant side effects and substantial cost-saving benefit, that also shows an important improvement in mood, behavior, cognition and quality of life. The overall responder rate was observed in more than 50% of patients. On the other hand, it is not clear which patients will respond to this method of treatment and why the response is not immediate, there are no available biomarkers or other features like age, sex, seizure type/epileptic syndrome to predict response to vagus nerve stimulation therapy. The VNS Therapy System continues to be an important prospect in the treatment of pharmacoresistant epilepsy, that requires further studies in order to ensure the most advantageous therapeutic response.","PeriodicalId":36282,"journal":{"name":"Acta Marisiensis - Seria Medica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135639629","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}
Boglárka Varga, László Marton, Anita Balázs, Anita Lőrincz, Tímea Kovács, Orsolya Sorbán, Monica IM Szabó
Abstract Background : Literacy and education levels were demonstrated to be low in the Roma population. The outcomes after the implementation of different educational policies, in different countries, were not properly assessed for Roma subgroups until now. Aims: We aimed to study literacy, education level, and healthcare attendance in two well-defined Roma subgroups, compared to the majority population, in a specific Transylvanian rural region. Material and methods : A non-interventional, cross-sectional comparative survey was conducted in 2016-2017 between two Roma subgroups and the general population, from a rural region in Transylvania regarding their literacy, education level and healthcare attendance. Results : Illiteracy was 33.3%, 66.6%, and 4.2% in the Gabor, Lovari Roma, and general population (p < 0.001). 29.5% of the Gabors and 45.6% of the Lovari Roma did not attend any school, compared to 2.7% of the general population. Almost none of the Roma population attended school after finishing 8 classes. Healthcare service attendance was significantly lower for the Roma subgroups, and directly related to their education level. 32.7% of the Gabors, 28.3% of the Lovari Roma, comparing to 7.3% of the general population never attended the general practitioner (p < 0.001). Conclusions : Gabor Roma population had a significantly lower proportion of illiteracy and a higher school attendance than Lovari Roma group, but still illiterate by a high percentage. The Roma’s healthcare attendance was far lower than the general population’s, having been even worse in the Gabor group. Healthcare counseling was directly correlated with education level.
{"title":"Differences in literacy, education level, and healthcare attendance in two different Roma subgroups from Transylvania, Romania","authors":"Boglárka Varga, László Marton, Anita Balázs, Anita Lőrincz, Tímea Kovács, Orsolya Sorbán, Monica IM Szabó","doi":"10.2478/amma-2023-0028","DOIUrl":"https://doi.org/10.2478/amma-2023-0028","url":null,"abstract":"Abstract Background : Literacy and education levels were demonstrated to be low in the Roma population. The outcomes after the implementation of different educational policies, in different countries, were not properly assessed for Roma subgroups until now. Aims: We aimed to study literacy, education level, and healthcare attendance in two well-defined Roma subgroups, compared to the majority population, in a specific Transylvanian rural region. Material and methods : A non-interventional, cross-sectional comparative survey was conducted in 2016-2017 between two Roma subgroups and the general population, from a rural region in Transylvania regarding their literacy, education level and healthcare attendance. Results : Illiteracy was 33.3%, 66.6%, and 4.2% in the Gabor, Lovari Roma, and general population (p < 0.001). 29.5% of the Gabors and 45.6% of the Lovari Roma did not attend any school, compared to 2.7% of the general population. Almost none of the Roma population attended school after finishing 8 classes. Healthcare service attendance was significantly lower for the Roma subgroups, and directly related to their education level. 32.7% of the Gabors, 28.3% of the Lovari Roma, comparing to 7.3% of the general population never attended the general practitioner (p < 0.001). Conclusions : Gabor Roma population had a significantly lower proportion of illiteracy and a higher school attendance than Lovari Roma group, but still illiterate by a high percentage. The Roma’s healthcare attendance was far lower than the general population’s, having been even worse in the Gabor group. Healthcare counseling was directly correlated with education level.","PeriodicalId":36282,"journal":{"name":"Acta Marisiensis - Seria Medica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135639783","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}
Abstract Objective : The primary objective of this study was to investigate the association between biomarkers of iron metabolism and metabolic dysfunction-associated fatty liver disease in individuals with type 2 diabetes and non-diabetic individuals compared to a control group. We also examined the possible association between estimated liver fibrosis and serum ferritin levels in all three groups. Methods : We conducted a descriptive, cross-sectional, comparative study involving subjects diagnosed with diabetes and/or metabolic dysfunction-associated fatty liver disease from an outpatient diabetology clinic and two general practices in Târgu Mureș. The patient population was divided into 3 groups: first group including diabetic patients suffering from fatty liver disease, second group including patients without fatty liver disease and third group with non-diabetic patients suffering from fatty liver disease. We compared the three groups based on specific laboratory tests. Results : Patients with fatty liver disease had significantly higher ferritin and transferrin saturation levels than non-fatty liver disease sufferers (p<0.05). Transferrin saturation of the first group was significantly (p<0.05) higher compared to the non-diabetic fatty liver disease group. Ferritin correlated well with Fibrosis-4 index level (τ= 0.193, p<0.01) considering the whole sample and especially in the first group. Conclusions : In our study, there was a clear association between higher ferritin levels and the presence of metabolic dysfunction-associated fatty liver disease. The higher transferrin saturation observed in diabetic patients suffering from metabolic dysfunction-associated fatty liver disease may indicate the possible etiological significance of iron overload. Higher ferritin levels in diabetes increase the risk of liver fibrosis.
{"title":"Iron metabolism and metabolic dysfunction-associated fatty liver disease","authors":"Zoltán-Zsombor Élthes, Monica Iudita Maria Szabó","doi":"10.2478/amma-2023-0031","DOIUrl":"https://doi.org/10.2478/amma-2023-0031","url":null,"abstract":"Abstract Objective : The primary objective of this study was to investigate the association between biomarkers of iron metabolism and metabolic dysfunction-associated fatty liver disease in individuals with type 2 diabetes and non-diabetic individuals compared to a control group. We also examined the possible association between estimated liver fibrosis and serum ferritin levels in all three groups. Methods : We conducted a descriptive, cross-sectional, comparative study involving subjects diagnosed with diabetes and/or metabolic dysfunction-associated fatty liver disease from an outpatient diabetology clinic and two general practices in Târgu Mureș. The patient population was divided into 3 groups: first group including diabetic patients suffering from fatty liver disease, second group including patients without fatty liver disease and third group with non-diabetic patients suffering from fatty liver disease. We compared the three groups based on specific laboratory tests. Results : Patients with fatty liver disease had significantly higher ferritin and transferrin saturation levels than non-fatty liver disease sufferers (p<0.05). Transferrin saturation of the first group was significantly (p<0.05) higher compared to the non-diabetic fatty liver disease group. Ferritin correlated well with Fibrosis-4 index level (τ= 0.193, p<0.01) considering the whole sample and especially in the first group. Conclusions : In our study, there was a clear association between higher ferritin levels and the presence of metabolic dysfunction-associated fatty liver disease. The higher transferrin saturation observed in diabetic patients suffering from metabolic dysfunction-associated fatty liver disease may indicate the possible etiological significance of iron overload. Higher ferritin levels in diabetes increase the risk of liver fibrosis.","PeriodicalId":36282,"journal":{"name":"Acta Marisiensis - Seria Medica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135639814","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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