Abstract Morphologic changes in organs vary from nonspecific to specific ones, depending on causes of sudden death, e.i whether it is an acute, subacute or chronic event. The aim of this pilot study was to observe the appearance and occurrence of morphological characteristics on organs that were exposed to long-term effects of hyperthermia. A sample of 7 rats was exposed to a water temperature of 41 °C, which is defined in the literature as “heat stroke temperature”, both sexes, weighing 250 to 300 g were used. Tissue samples, obtained by dissection of rats, were fixed in 10% buffered neutral formalin, at room temperature, then incorporated into paraffin blocks, cut at 4-5 microns, mounted and stained with standard hematoxylin-eosin (HE) method. In order to prove/exclude lipid and glycogen accumulation in hepatocytes we did additional histochemical staining, using Sudan black and Periodic Acid Shiff (PAS) method, respectively. We obtained samples from kidney, liver, pancreas, spleen, lung and brain. Analyzing tissue samples of different organs obtained from seven Wistar rats, we gained insight into morphological changes caused by induced hyperthermia. All sampled organs showed congestion and some degree of oedema. The most prominent changes were observed in liver and lung samples. Tissue samples of the lung of all seven rats showed signs of acute bronchitis and bronchiolitis, together with signs of initial bronchopneumonia. We also noticed signs of focal acute emphysema as well as focal accumulations of foamy macrophages. Our study suggests that changes in the vascular bed occur soon after hyperthermia and while some organs are more tolerant to heat stroke than others, most organs show similar changes consisting of capillary dilation, congestion and interstitial extravasation, observed after 30 minutes at a temperature of 40.5 °C, with the most significant changes observed in liver and lung samples.
{"title":"Multiorgan morphological changes caused by hyperthermia: Case study on experimental model","authors":"Emina Dervišević, Nina Čamdžić, Suada Kuskunović-Vlahovljak, Muamer Dervišević","doi":"10.2478/amma-2023-0026","DOIUrl":"https://doi.org/10.2478/amma-2023-0026","url":null,"abstract":"Abstract Morphologic changes in organs vary from nonspecific to specific ones, depending on causes of sudden death, e.i whether it is an acute, subacute or chronic event. The aim of this pilot study was to observe the appearance and occurrence of morphological characteristics on organs that were exposed to long-term effects of hyperthermia. A sample of 7 rats was exposed to a water temperature of 41 °C, which is defined in the literature as “heat stroke temperature”, both sexes, weighing 250 to 300 g were used. Tissue samples, obtained by dissection of rats, were fixed in 10% buffered neutral formalin, at room temperature, then incorporated into paraffin blocks, cut at 4-5 microns, mounted and stained with standard hematoxylin-eosin (HE) method. In order to prove/exclude lipid and glycogen accumulation in hepatocytes we did additional histochemical staining, using Sudan black and Periodic Acid Shiff (PAS) method, respectively. We obtained samples from kidney, liver, pancreas, spleen, lung and brain. Analyzing tissue samples of different organs obtained from seven Wistar rats, we gained insight into morphological changes caused by induced hyperthermia. All sampled organs showed congestion and some degree of oedema. The most prominent changes were observed in liver and lung samples. Tissue samples of the lung of all seven rats showed signs of acute bronchitis and bronchiolitis, together with signs of initial bronchopneumonia. We also noticed signs of focal acute emphysema as well as focal accumulations of foamy macrophages. Our study suggests that changes in the vascular bed occur soon after hyperthermia and while some organs are more tolerant to heat stroke than others, most organs show similar changes consisting of capillary dilation, congestion and interstitial extravasation, observed after 30 minutes at a temperature of 40.5 °C, with the most significant changes observed in liver and lung samples.","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":"135639277","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}
Florina Ruta, Elena Mardale, Andrada Pintea, Calin Avram
Abstract The diet is an important factor that can influence the structures and function of the population of germs that compose the intestinal microbiota. This review presents current data on the response of the intestinal microbiota depending on the diet. While many studies have shown that the intestinal microbiota is influenced by macronutrient and micronutrient compounds of the diet, the studies on healthy human subjects were fewer and showed only to a small extent the influence of cooked food on the intestinal microbiota. Additional research is still needed regarding the effect of the way food is cooked can have on the intestinal microbiota, before beneficial dietary recommendations can be made.
{"title":"The role of diet in modulating the intestinal microbiota in healthy adults: Is the evidence enough?","authors":"Florina Ruta, Elena Mardale, Andrada Pintea, Calin Avram","doi":"10.2478/amma-2023-0025","DOIUrl":"https://doi.org/10.2478/amma-2023-0025","url":null,"abstract":"Abstract The diet is an important factor that can influence the structures and function of the population of germs that compose the intestinal microbiota. This review presents current data on the response of the intestinal microbiota depending on the diet. While many studies have shown that the intestinal microbiota is influenced by macronutrient and micronutrient compounds of the diet, the studies on healthy human subjects were fewer and showed only to a small extent the influence of cooked food on the intestinal microbiota. Additional research is still needed regarding the effect of the way food is cooked can have on the intestinal microbiota, before beneficial dietary recommendations can be made.","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":"135639545","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}
Sabrina Nicoleta Munteanu, Andreea Raluca Cozac-Szőke, Simona Mocan, Tania Mihaela Zait, Răzvan Iacob Rus, Răzvan Emil Petri, Anca Negovan
Abstract Objective : The objective of the present study is to clarify the value of clinic, endoscopic, and histologic variables that may predict anemia in patients performing esophagogastroduodenoscopy for gastrointestinal complaints in the absence of bleeding signs or lower digestive disease. Methods : This study included 654 patients referred for endoscopy that were divided based on biological parameters performed in the same day in the study group (306 patients diagnosed with anemia) and the control group (348 patients without anemia). Results : Anemia is frequent in elderly patients, especially in the presence of premalignant gastric lesions, and it is associated with multiple comorbidities. In two multivariate regression models antivitamin K oral anticoagulants were found to be independently associated with anemia (p = 0.01), but not with antiplatelet therapy, or with non-antivitamin K anticoagulants. Multiple regression models support that epigastric pain and heartburn are inversely associated with anemia, while weight loss remained an independent predictor for simultaneous anemia and premalignant lesions. Non-infectious chronic gastritis (p<0.001) is an independent predictor for anemia and premalignant gastric lesions, increasing the odds of anemia by 2.2 times, while reactive gastropathy is inversely associated. Gastric erosions and ulcer remained independent predictors for concomitant anemia and premalignant lesions. Conclusions : Chronic inactive gastritis and premalignant gastric histologic lesions are predictors for anemia in endoscopic population, while active H. pylori infection is not. Dyspeptic symptoms, epigastric pain (p<0.001,OR 0.2-0.5) and heartburn (p<0.001,OR 0.07-0.3) are inversely associated with anemia alone or associated with premalignant gastric lesions.
{"title":"Predictors of anemia without active bleeding signs in patients referred for endoscopy","authors":"Sabrina Nicoleta Munteanu, Andreea Raluca Cozac-Szőke, Simona Mocan, Tania Mihaela Zait, Răzvan Iacob Rus, Răzvan Emil Petri, Anca Negovan","doi":"10.2478/amma-2023-0036","DOIUrl":"https://doi.org/10.2478/amma-2023-0036","url":null,"abstract":"Abstract Objective : The objective of the present study is to clarify the value of clinic, endoscopic, and histologic variables that may predict anemia in patients performing esophagogastroduodenoscopy for gastrointestinal complaints in the absence of bleeding signs or lower digestive disease. Methods : This study included 654 patients referred for endoscopy that were divided based on biological parameters performed in the same day in the study group (306 patients diagnosed with anemia) and the control group (348 patients without anemia). Results : Anemia is frequent in elderly patients, especially in the presence of premalignant gastric lesions, and it is associated with multiple comorbidities. In two multivariate regression models antivitamin K oral anticoagulants were found to be independently associated with anemia (p = 0.01), but not with antiplatelet therapy, or with non-antivitamin K anticoagulants. Multiple regression models support that epigastric pain and heartburn are inversely associated with anemia, while weight loss remained an independent predictor for simultaneous anemia and premalignant lesions. Non-infectious chronic gastritis (p<0.001) is an independent predictor for anemia and premalignant gastric lesions, increasing the odds of anemia by 2.2 times, while reactive gastropathy is inversely associated. Gastric erosions and ulcer remained independent predictors for concomitant anemia and premalignant lesions. Conclusions : Chronic inactive gastritis and premalignant gastric histologic lesions are predictors for anemia in endoscopic population, while active H. pylori infection is not. Dyspeptic symptoms, epigastric pain (p<0.001,OR 0.2-0.5) and heartburn (p<0.001,OR 0.07-0.3) are inversely associated with anemia alone or associated with premalignant gastric lesions.","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":"135639554","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}
Ana-Maria-Catalina Hadad, Florina Vultur, Marius-Alexandru Beleaua, Karin Horvath
Abstract Introduction : Mycoplasma pneumoniae is known as a common cause of respiratory tract infections, especially in children. Regarding extrapulmonary manifestations, many dysfunctions have been linked to circulating IgM antibodies, including eye diseases and disorders. In this report, we aim to highlight the importance of considering Mycoplasma pneumoniae a potential etiological agent that can cause significant eye structures inflammation. Case presentation : We present a case of a 22-year-old male patient who arrived at the Emergency Department complaining of visual acuity decrement. Fundoscopic examination outlined a pale optic nerve, covered by pre-papillary infiltrates and peripheric inflammatory infiltrates, accompanied by signs of vasculitis. Investigations were performed and a multidisciplinary assessment was conducted. General antibiotic and antimycotic treatment and topical non-steroidal anti-inflammatory drops were administrated but his symptoms were aggravating, although it was continuously upgraded. Antibodies for Mycoplasma pneumoniae were determined with positive IgM and macrolide antibiotherapy was administrated, with favorable evolution. Conclusions : Mycoplasma pneumoniae should not be excluded as a possible cause of severe ocular inflammations, even in asymptomatic patients. The patient’s management should include multidisciplinary assessment for an easier diagnosis in cases of uncertainty.
{"title":"Diagnostic difficulties in a very rare case of mycoplasma pneumoniae uveitis","authors":"Ana-Maria-Catalina Hadad, Florina Vultur, Marius-Alexandru Beleaua, Karin Horvath","doi":"10.2478/amma-2023-0035","DOIUrl":"https://doi.org/10.2478/amma-2023-0035","url":null,"abstract":"Abstract Introduction : Mycoplasma pneumoniae is known as a common cause of respiratory tract infections, especially in children. Regarding extrapulmonary manifestations, many dysfunctions have been linked to circulating IgM antibodies, including eye diseases and disorders. In this report, we aim to highlight the importance of considering Mycoplasma pneumoniae a potential etiological agent that can cause significant eye structures inflammation. Case presentation : We present a case of a 22-year-old male patient who arrived at the Emergency Department complaining of visual acuity decrement. Fundoscopic examination outlined a pale optic nerve, covered by pre-papillary infiltrates and peripheric inflammatory infiltrates, accompanied by signs of vasculitis. Investigations were performed and a multidisciplinary assessment was conducted. General antibiotic and antimycotic treatment and topical non-steroidal anti-inflammatory drops were administrated but his symptoms were aggravating, although it was continuously upgraded. Antibodies for Mycoplasma pneumoniae were determined with positive IgM and macrolide antibiotherapy was administrated, with favorable evolution. Conclusions : Mycoplasma pneumoniae should not be excluded as a possible cause of severe ocular inflammations, even in asymptomatic patients. The patient’s management should include multidisciplinary assessment for an easier diagnosis in cases of uncertainty.","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":"135639654","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 Ewing sarcoma with renal localization is one of the rarest members of the Ewing sarcoma family with less than 200 cases reported in the Medline database. Considering the fact that the majority of data published on the Ewing sarcoma with neuroectodermal differentiation is obtained through a few case reports and case series, it becomes understandable why we currently have no universally accepted treatment regimens. Case summary : A 33-year-old patient presented to the Emergency Department with right lumbar pain following a mild trauma and an episode of macroscopic hematuria. Physical examination confirmed hematuria and flank pain and a palpable flank mass was identified. MRI showed a cystic lesion of the upper pole of the right kidney of 127/110/123 mm. After prior agreement of the multidisciplinary team, a 3D laparoscopic right radical nephrectomy was done. The histopathological diagnosis revealed an Ewing sarcoma with extensive neuroectodermal differentiation staged as pT3N1M0L1V2R0. Despite swift implementation of the chemotherapy protocol, the progression of the disease was quickly noted. Currently, one year after diagnosis, the disease is still progressing despite the chemotherapy treatment, the patient being a third line chemotherapy candidate. As renal localization of Ewing sarcoma with extensive neuroectodermal differentiation is extremely rare, multimodal treatment strategies must be established by a multidisciplinary team. Despite its aggressive biological behavior, a proper therapeutic management might increase patient life expectancy.
{"title":"Renal Ewing sarcoma with extensive neuroectodermal differentiation: Case report and literature review","authors":"Alexandra Daniela Sava, Tiberiu Bogdan Szekely, Cornelia Togănel, Adela Vacar, Catalina Bungardean, Simona Gurzu","doi":"10.2478/amma-2023-0034","DOIUrl":"https://doi.org/10.2478/amma-2023-0034","url":null,"abstract":"Abstract Ewing sarcoma with renal localization is one of the rarest members of the Ewing sarcoma family with less than 200 cases reported in the Medline database. Considering the fact that the majority of data published on the Ewing sarcoma with neuroectodermal differentiation is obtained through a few case reports and case series, it becomes understandable why we currently have no universally accepted treatment regimens. Case summary : A 33-year-old patient presented to the Emergency Department with right lumbar pain following a mild trauma and an episode of macroscopic hematuria. Physical examination confirmed hematuria and flank pain and a palpable flank mass was identified. MRI showed a cystic lesion of the upper pole of the right kidney of 127/110/123 mm. After prior agreement of the multidisciplinary team, a 3D laparoscopic right radical nephrectomy was done. The histopathological diagnosis revealed an Ewing sarcoma with extensive neuroectodermal differentiation staged as pT3N1M0L1V2R0. Despite swift implementation of the chemotherapy protocol, the progression of the disease was quickly noted. Currently, one year after diagnosis, the disease is still progressing despite the chemotherapy treatment, the patient being a third line chemotherapy candidate. As renal localization of Ewing sarcoma with extensive neuroectodermal differentiation is extremely rare, multimodal treatment strategies must be established by a multidisciplinary team. Despite its aggressive biological behavior, a proper therapeutic management might increase patient life expectancy.","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":"135639519","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 aim of this study was to assess glial fibrillary acidic protein (GFAP) as a marker of short-term neurodevelopmental delay in pediatric patients with congenital defects (CHD) after cardiovascular surgical intervention. Methods: Included patients were screened by Denver Developmental Screening Test II scale a few days before and then at 4 to 6 months after the surgical intervention. Blood samples were collected preoperatory and at 24 hours after surgery; GFAP levels were assessed by enzyme-linked immunosorbent assay using commercial kit form BioVendor. Results: Forty children were enrolled and dichotomized into two groups based on peripheric oxygen saturation: cyanotic (<95%) and non-cyanotic (>=95%) group. 63% from our population had an abnormal neurodevelopmental outcome. Significant differences between groups were found in language domain scores preoperatory (p=0.03) and in fine motor domain postoperatory (p=0.03). In the postoperatory period, GFAP had significantly higher values (p=0.0248) in the cyanotic CHD group. Association between GFAP and NIRS were analyzed and significant differences were found in both groups with a good predicting model in the non-cyanotic CHD group (aria under curve of 0.7 for receiver operative characteristic). Higher GFAP levels from the postoperatory period correlated with neurodevelopmental impairment (mean value of: 0.66 ± 0.02ng/ml in those with good neurodevelopmental score, 0.69 ± 0.02ng/ml in those with low neurodevelopmental score, p=0.01). Conclusions: GFAP could be a reliable neuromarker in identifying early acute brain injury documented by NIRS monitorization during perioperatory period and it also could identify short term neurodevelopmental impairment documented by lower neurodevelopmental scores.
{"title":"Glial fibrillary acidic protein as a serum neuromarker of brain injury in pediatric patients with congenital heart defects undergoing cardiac surgery","authors":"Lacramioara-Eliza Chiperi, Adina Huţanu","doi":"10.2478/amma-2023-0037","DOIUrl":"https://doi.org/10.2478/amma-2023-0037","url":null,"abstract":"Abstract Objective: The aim of this study was to assess glial fibrillary acidic protein (GFAP) as a marker of short-term neurodevelopmental delay in pediatric patients with congenital defects (CHD) after cardiovascular surgical intervention. Methods: Included patients were screened by Denver Developmental Screening Test II scale a few days before and then at 4 to 6 months after the surgical intervention. Blood samples were collected preoperatory and at 24 hours after surgery; GFAP levels were assessed by enzyme-linked immunosorbent assay using commercial kit form BioVendor. Results: Forty children were enrolled and dichotomized into two groups based on peripheric oxygen saturation: cyanotic (<95%) and non-cyanotic (>=95%) group. 63% from our population had an abnormal neurodevelopmental outcome. Significant differences between groups were found in language domain scores preoperatory (p=0.03) and in fine motor domain postoperatory (p=0.03). In the postoperatory period, GFAP had significantly higher values (p=0.0248) in the cyanotic CHD group. Association between GFAP and NIRS were analyzed and significant differences were found in both groups with a good predicting model in the non-cyanotic CHD group (aria under curve of 0.7 for receiver operative characteristic). Higher GFAP levels from the postoperatory period correlated with neurodevelopmental impairment (mean value of: 0.66 ± 0.02ng/ml in those with good neurodevelopmental score, 0.69 ± 0.02ng/ml in those with low neurodevelopmental score, p=0.01). Conclusions: GFAP could be a reliable neuromarker in identifying early acute brain injury documented by NIRS monitorization during perioperatory period and it also could identify short term neurodevelopmental impairment documented by lower neurodevelopmental scores.","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":"135639652","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}
Sonia Daga, Janipalli Lakshmi Prasad, Naveen P. Kumar
Abstract Introduction : Hospital administration will have to constantly work around predicting demand of the critical care beds and evaluating the options of expanding the existing capacity. These expansions will be constantly requested by clinicians in private hospitals in India. It becomes imperative to infuse capital into such expansions predicting the utilisation pattern of the new beds. This study concentrates on factors considered for estimating the infrastructure enhancement in step down beds in progression of patient care. Methodology : Retrospective measurement of past bed occupancy rates of existing critical care beds, number of patients denied admissions through emergency department due to lack of intensive care beds was counted during previous 1 year. Cost estimates of building, equipment, manpower was collected. The prices that can be charged per rack basis was estimated, for revenue calculation. Return on investment tool using annual revenues divided by annual investment was used to measure the outputs. Results : For setting up a 34 bed HDU (High Dependency Unit), 4760 square feet of space was utilised, with USD 594,555 as investment, at a revenue of USD 527,425, which is 75% return in first year, provided occupancy is at 100%. At occupancy of 60%, which was seen within 6 months of commissioning new HDU, the breakeven can be achieved at 450 days. At 100% occupancy breakeven can be achieved in 290 days. Conclusion : Demand estimation and Utilisation analysis is valuable tools for administration to make decisions on major capital investments.
{"title":"Evaluating demand of High Dependency Unit beds in a hospital with insights on return on capital investment","authors":"Sonia Daga, Janipalli Lakshmi Prasad, Naveen P. Kumar","doi":"10.2478/amma-2023-0033","DOIUrl":"https://doi.org/10.2478/amma-2023-0033","url":null,"abstract":"Abstract Introduction : Hospital administration will have to constantly work around predicting demand of the critical care beds and evaluating the options of expanding the existing capacity. These expansions will be constantly requested by clinicians in private hospitals in India. It becomes imperative to infuse capital into such expansions predicting the utilisation pattern of the new beds. This study concentrates on factors considered for estimating the infrastructure enhancement in step down beds in progression of patient care. Methodology : Retrospective measurement of past bed occupancy rates of existing critical care beds, number of patients denied admissions through emergency department due to lack of intensive care beds was counted during previous 1 year. Cost estimates of building, equipment, manpower was collected. The prices that can be charged per rack basis was estimated, for revenue calculation. Return on investment tool using annual revenues divided by annual investment was used to measure the outputs. Results : For setting up a 34 bed HDU (High Dependency Unit), 4760 square feet of space was utilised, with USD 594,555 as investment, at a revenue of USD 527,425, which is 75% return in first year, provided occupancy is at 100%. At occupancy of 60%, which was seen within 6 months of commissioning new HDU, the breakeven can be achieved at 450 days. At 100% occupancy breakeven can be achieved in 290 days. Conclusion : Demand estimation and Utilisation analysis is valuable tools for administration to make decisions on major capital investments.","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":"135639806","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}
I. Bernatchi, S. Voidăzan, M. Petrut, Gabriella Gábos, Mădălina Bălășescu, C. Nicolau
Abstract Objective: Endoscopy is an essential and invaluable diagnostic tool in the arsenal of every gastroenterologist. ESGE presented additional guidelines for standardized image documentation in upper and lower gastrointestinal endoscopy. Clinical disagreement is a common challenge in most, if not all, fields of medicine. Settling disagreements is important so as to find ways to minimize it. Clinical disagreement in gastroscopy may be demonstrated by studying the observer variability. Methods: We retrospectively recruited 120 random patients that underwent conventional upper gastrointestinal endoscopy between 2021-2022 in our Department of Gastroenterology, all of them performed by one endoscopist. As part of the study, all video-endoscopic recordings were stored using one internal server. In order to study interobserver variability, four physicians (endoscopists and gastroenterologist specialists) were invited to complete the questionnaire. Results: The interob-server variability in our study ranged from moderate to very good in the assessment of the esophagus, with the highest degree of agreement in response to questions concerning characteristic findings such as normal mucosa, esophagitis Class A Los Angeles, hiatal hernia for the esophagus endoscopic evaluation, benign ulcer niche in gastric antrum, normal gastric corpus mucosa, intestinal metaplasia and angiodysplasia in gastric corpus. The question on atrophic mucosa in the first and second part of the duodenum was the most difficult to agree upon. Conclusion: The present study found that the variability between observers in the assessment of images obtained from patients that underwent conventional upper gastrointestinal endoscopy in our center was acceptably good.
{"title":"Inter-observer variability on the value of endoscopic images for the documentation of upper gastrointestinal endoscopy - our center experience","authors":"I. Bernatchi, S. Voidăzan, M. Petrut, Gabriella Gábos, Mădălina Bălășescu, C. Nicolau","doi":"10.2478/amma-2023-0015","DOIUrl":"https://doi.org/10.2478/amma-2023-0015","url":null,"abstract":"Abstract Objective: Endoscopy is an essential and invaluable diagnostic tool in the arsenal of every gastroenterologist. ESGE presented additional guidelines for standardized image documentation in upper and lower gastrointestinal endoscopy. Clinical disagreement is a common challenge in most, if not all, fields of medicine. Settling disagreements is important so as to find ways to minimize it. Clinical disagreement in gastroscopy may be demonstrated by studying the observer variability. Methods: We retrospectively recruited 120 random patients that underwent conventional upper gastrointestinal endoscopy between 2021-2022 in our Department of Gastroenterology, all of them performed by one endoscopist. As part of the study, all video-endoscopic recordings were stored using one internal server. In order to study interobserver variability, four physicians (endoscopists and gastroenterologist specialists) were invited to complete the questionnaire. Results: The interob-server variability in our study ranged from moderate to very good in the assessment of the esophagus, with the highest degree of agreement in response to questions concerning characteristic findings such as normal mucosa, esophagitis Class A Los Angeles, hiatal hernia for the esophagus endoscopic evaluation, benign ulcer niche in gastric antrum, normal gastric corpus mucosa, intestinal metaplasia and angiodysplasia in gastric corpus. The question on atrophic mucosa in the first and second part of the duodenum was the most difficult to agree upon. Conclusion: The present study found that the variability between observers in the assessment of images obtained from patients that underwent conventional upper gastrointestinal endoscopy in our center was acceptably good.","PeriodicalId":36282,"journal":{"name":"Acta Marisiensis - Seria Medica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77460093","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}
Suhina Mitra, D. Kamath, Nishmitha D. Shetty, S. Natarajan
Abstract Aim: The present study aims to evaluate the efficacy of naturally-derived bovine hydroxyapatite (Cerabone) versus demineralized freeze-dried bone allograft both combined with platelet-rich fibrin for treatment of grade II mandibular furcation defects. Method: This clinical study included 20 systemically healthy patients, with grade II mandibular furcation defects, performed over 6 months. Control group comprised of open flap debridement + demineralized freeze-dried bone allograft + platelet-rich fibrin and test group comprised of open flap debridement + Cerabone + platelet-rich fibrin. Clinical parameters included: Plaque index, Modified Sulcular bleeding index, Vertical probing pocket depth, Horizontal probing depth, Probing clinical attachment level, Radiographic furcation depth, and radiographic bone fill percentage. Results: Both groups showed satisfactory bone regeneration and improvement in clinical parameters. The test group exhibited greater reduction in vertical probing pocket depth, horizontal probing depth, and higher radiographic bone fill percentage when compared to control group, although these findings were not statistically significant. Conclusion: Both bone grafts were equally effective in treatment of grade II furcation defects. Further long-term studies are required to explore their maximum regenerative potential.
{"title":"Comparative clinical evaluation of xenograft (Cerabone) versus allograft combined with platelet-rich fibrin for treatment of grade II mandibular furcation defects","authors":"Suhina Mitra, D. Kamath, Nishmitha D. Shetty, S. Natarajan","doi":"10.2478/amma-2023-0016","DOIUrl":"https://doi.org/10.2478/amma-2023-0016","url":null,"abstract":"Abstract Aim: The present study aims to evaluate the efficacy of naturally-derived bovine hydroxyapatite (Cerabone) versus demineralized freeze-dried bone allograft both combined with platelet-rich fibrin for treatment of grade II mandibular furcation defects. Method: This clinical study included 20 systemically healthy patients, with grade II mandibular furcation defects, performed over 6 months. Control group comprised of open flap debridement + demineralized freeze-dried bone allograft + platelet-rich fibrin and test group comprised of open flap debridement + Cerabone + platelet-rich fibrin. Clinical parameters included: Plaque index, Modified Sulcular bleeding index, Vertical probing pocket depth, Horizontal probing depth, Probing clinical attachment level, Radiographic furcation depth, and radiographic bone fill percentage. Results: Both groups showed satisfactory bone regeneration and improvement in clinical parameters. The test group exhibited greater reduction in vertical probing pocket depth, horizontal probing depth, and higher radiographic bone fill percentage when compared to control group, although these findings were not statistically significant. Conclusion: Both bone grafts were equally effective in treatment of grade II furcation defects. Further long-term studies are required to explore their maximum regenerative potential.","PeriodicalId":36282,"journal":{"name":"Acta Marisiensis - Seria Medica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86488042","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}
Harshita Sharma, C. Thimmaiah, Almas Binnal, M. Golla, B. Suprabha
Abstract A common primary bone malignancy in childhood and adolescence is Ewing’s sarcoma. Here we report multidisciplinary approach in the management of chronic hyperplastic candidiasis and xerostomia secondary to chemotherapy with vincristine, doxorubicin and cyclophosphamide (VDC) in a pediatric male patient with Ewing’s sarcoma of Ethmoid sinus. The initial diagnosed oral lesion was treated with topical clotrimazole 1%w/v for two weeks and Sucralfate 1g/10mL oral rinse for one month. Upon subsequent VDC chemotherapy cycle, the patient developed grade IV oral mucositis, severe neutropenia and associated oesophageal candidiasis. Treatment included combination of topical clotrimazole 1%w/v and Fluconazole 300mg/day (IV for 5 days and Tablet for 14 days). To prevent caries risk, pit and fissure sealants were applied and topical fluoride therapy was given; patient was encouraged to have frequent sips of water and prescribed kids xylitol gum for 15 days to minimize xerostomia. At 5-week follow up, reduction in burning sensation and resolution of white lesion was noted.
{"title":"Vincristine, doxorubicin and cyclophosphamide chemotherapy induced oral chronic hyperplastic candidiasis and xerostomia in a young patient with Ewing’s sarcoma: A case report","authors":"Harshita Sharma, C. Thimmaiah, Almas Binnal, M. Golla, B. Suprabha","doi":"10.2478/amma-2023-0018","DOIUrl":"https://doi.org/10.2478/amma-2023-0018","url":null,"abstract":"Abstract A common primary bone malignancy in childhood and adolescence is Ewing’s sarcoma. Here we report multidisciplinary approach in the management of chronic hyperplastic candidiasis and xerostomia secondary to chemotherapy with vincristine, doxorubicin and cyclophosphamide (VDC) in a pediatric male patient with Ewing’s sarcoma of Ethmoid sinus. The initial diagnosed oral lesion was treated with topical clotrimazole 1%w/v for two weeks and Sucralfate 1g/10mL oral rinse for one month. Upon subsequent VDC chemotherapy cycle, the patient developed grade IV oral mucositis, severe neutropenia and associated oesophageal candidiasis. Treatment included combination of topical clotrimazole 1%w/v and Fluconazole 300mg/day (IV for 5 days and Tablet for 14 days). To prevent caries risk, pit and fissure sealants were applied and topical fluoride therapy was given; patient was encouraged to have frequent sips of water and prescribed kids xylitol gum for 15 days to minimize xerostomia. At 5-week follow up, reduction in burning sensation and resolution of white lesion was noted.","PeriodicalId":36282,"journal":{"name":"Acta Marisiensis - Seria Medica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79125522","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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