Pub Date : 2021-12-01DOI: 10.2478/orvtudert-2021-0015
Fülöp Zsolt Zoltán, Fülöp Réka Linda, Scurtu Georgiana Alexandra, Simu Patricia, Molnár Andrea Henrietta, Bara Tivadar, J. János, ifj. Bara Tivadar
Abstract Background: The incidence of rectum cancer is rising worldwide. New prognostic factors need to be applied to improve patients’ prognosis. The incidence of sarcopenia has been observed in various malignancies. The quantity of skeletal muscle mass is reflected in the psoas muscle index (PMI), suggesting the presence of sarcopenia. Our aim is to investigate the association of postoperative prognosis of patients with rectum cancer with the occurrence of preoperative sarcopenia with quantitative and qualitative reduction of skeletal muscle mass. Material and method: We performed a multidisciplinary research and we examined patients diagnosed with rectal cancer. The PMI was determined at the lower edge of the L3 vertebral body, using CT scan. We present our research partial results within three cases. Results: The PMI of three male patients with rectum cancer who received neoadjuvant chemoradiotherapy was: Case 1 has a PMI of 7.378 cm2/m2, the mean psoas muscle density was 50.14 UH. Case 2 has a PMI of 6,942 cm2/m2 and a mean psoas density of 43.81 UH. Case 3 has a PMI of 8.4885 cm2/m2 and an average density of 43.85 UH in the right and left psoas. Conclusions: The PMI value can be calculated with simple radiologic measurements, thus determining the diagnosis of sarcopenia. Calculations are performed using standard preoperative CT-scans. A PMI value above the threshold limit is promising in the short term, but in the long term it is not responsible for the deterioration of patients’ general condition and tumor recurrence.
{"title":"Preoperative psoas muscle index a modern prognostic factor in the follow-up of patients with rectal cancer who underwent surgery","authors":"Fülöp Zsolt Zoltán, Fülöp Réka Linda, Scurtu Georgiana Alexandra, Simu Patricia, Molnár Andrea Henrietta, Bara Tivadar, J. János, ifj. Bara Tivadar","doi":"10.2478/orvtudert-2021-0015","DOIUrl":"https://doi.org/10.2478/orvtudert-2021-0015","url":null,"abstract":"Abstract Background: The incidence of rectum cancer is rising worldwide. New prognostic factors need to be applied to improve patients’ prognosis. The incidence of sarcopenia has been observed in various malignancies. The quantity of skeletal muscle mass is reflected in the psoas muscle index (PMI), suggesting the presence of sarcopenia. Our aim is to investigate the association of postoperative prognosis of patients with rectum cancer with the occurrence of preoperative sarcopenia with quantitative and qualitative reduction of skeletal muscle mass. Material and method: We performed a multidisciplinary research and we examined patients diagnosed with rectal cancer. The PMI was determined at the lower edge of the L3 vertebral body, using CT scan. We present our research partial results within three cases. Results: The PMI of three male patients with rectum cancer who received neoadjuvant chemoradiotherapy was: Case 1 has a PMI of 7.378 cm2/m2, the mean psoas muscle density was 50.14 UH. Case 2 has a PMI of 6,942 cm2/m2 and a mean psoas density of 43.81 UH. Case 3 has a PMI of 8.4885 cm2/m2 and an average density of 43.85 UH in the right and left psoas. Conclusions: The PMI value can be calculated with simple radiologic measurements, thus determining the diagnosis of sarcopenia. Calculations are performed using standard preoperative CT-scans. A PMI value above the threshold limit is promising in the short term, but in the long term it is not responsible for the deterioration of patients’ general condition and tumor recurrence.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"37 1","pages":"107 - 117"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79385824","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 Medullary thyroid carcinoma (MTC) is a rare neuroendocrine malignant tumor of parafollicular C-cell origin of the thyroid gland, whose tumor cells typically produce calcitonin. The serum level of calcitonin produced by tumor cells is a sensitive tumor marker. An elevated serum level of this and the simultaneous presence of a thyroid nodule confirmed by ultrasound raise a reasonable suspicion of MTC. Still, the first-line MTC confirmation method in diagnosing MTC is fine-needle aspiration cytology (FNA). Objective: The aim of our study was the clinicopathological and cytomorphological analysis of histologically confirmed MTC cases obtained with FNA, as well as their comparison with the clinicopathological and cytomorphological characteristics of papillary thyroid carcinoma (PTC). Material and method: In our retrospective study, we analyzed the FNA cytology findings of patients with nodular goiter examined between 2013-2019 and the available clinical data. Results: In the 7-year period, 1,808 fine-needle aspiration examinations were performed, of which we identified 12 MTC and 77 PTC cases. The average age of patients diagnosed with MTC was 53±13 years. There were nine women and three men in examined cases. The average diameter of the nodules was 14±5 mm. All of our cases were of the sporadic type. The average age of patients diagnosed with MTC was greater than that of patients diagnosed with PTC (53 vs. 44 years, p=0.02367). A female predominance is observed in both diseases, although this is more pronounced in PTC. The diameter of the MTC nodules does not differ significantly from the mean size of the PTC nodules (14 vs. 17 mm, p=0.3138). The cytomorphological characteristics of the MTC cases we examined correspond to those described in the international literature, with minor differences. Conclusions: MTC is one of the rarer thyroid cancers, which is often difficult to distinguish from other types of thyroid cancer based on clinical features alone. Average age at diagnosis is greater than patients with PTC. Accurate diagnosis is critical as it requires a different approach than other types of thyroid cancer, it may require a different surgical approach, and may benefit from targeted therapy. Therefore, knowledge of the cytomorphology of MTC is essential for accurate diagnosis and optimal patient care.
摘要甲状腺髓样癌(MTC)是一种罕见的起源于甲状腺滤泡旁c细胞的神经内分泌恶性肿瘤，其肿瘤细胞通常产生降钙素。肿瘤细胞产生的血清降钙素水平是一种敏感的肿瘤标志物。血清中此水平升高并同时存在甲状腺结节，超声证实可合理怀疑MTC。尽管如此，诊断MTC的一线确认方法是细针穿刺细胞学(FNA)。目的:对FNA获得的经组织学证实的甲状腺乳头状癌进行临床病理和细胞形态学分析，并与甲状腺乳头状癌(PTC)的临床病理和细胞形态学特征进行比较。材料与方法:在回顾性研究中，我们分析了2013-2019年结节性甲状腺肿患者的FNA细胞学检查结果和现有临床数据。结果:7年间共行细针穿刺检查1808例，其中MTC 12例，PTC 77例。诊断为MTC的患者平均年龄为53±13岁。在接受检查的病例中，有9名女性和3名男性。结节的平均直径为14±5mm。我们所有的病例都是散发性的。MTC患者的平均年龄大于PTC患者的平均年龄(53岁vs. 44岁，p=0.02367)。两种疾病均以女性为主，但在PTC中更为明显。MTC结节的直径与PTC结节的平均大小没有显著差异(14 vs. 17 mm, p=0.3138)。我们检查的MTC病例的细胞形态学特征与国际文献中描述的一致，差异较小。结论:MTC是较为罕见的甲状腺癌之一，仅凭临床特征难以与其他类型的甲状腺癌区分。诊断时的平均年龄大于PTC患者。准确的诊断是至关重要的，因为它需要不同于其他类型甲状腺癌的方法，它可能需要不同的手术方法，并可能受益于靶向治疗。因此，了解MTC的细胞形态学对准确诊断和最佳患者护理至关重要。
{"title":"Cytomorphological analysis of histologically confirmed cases of medullary thyroid carcinoma","authors":"Mezei Tibor, Gyenge Mónika, Gurza Kriszta-Beáta, Orbán Ildikó, Réti Zsuzsanna, Pașcanu Ionela, Kolcsár Melinda","doi":"10.2478/orvtudert-2021-0018","DOIUrl":"https://doi.org/10.2478/orvtudert-2021-0018","url":null,"abstract":"Abstract Medullary thyroid carcinoma (MTC) is a rare neuroendocrine malignant tumor of parafollicular C-cell origin of the thyroid gland, whose tumor cells typically produce calcitonin. The serum level of calcitonin produced by tumor cells is a sensitive tumor marker. An elevated serum level of this and the simultaneous presence of a thyroid nodule confirmed by ultrasound raise a reasonable suspicion of MTC. Still, the first-line MTC confirmation method in diagnosing MTC is fine-needle aspiration cytology (FNA). Objective: The aim of our study was the clinicopathological and cytomorphological analysis of histologically confirmed MTC cases obtained with FNA, as well as their comparison with the clinicopathological and cytomorphological characteristics of papillary thyroid carcinoma (PTC). Material and method: In our retrospective study, we analyzed the FNA cytology findings of patients with nodular goiter examined between 2013-2019 and the available clinical data. Results: In the 7-year period, 1,808 fine-needle aspiration examinations were performed, of which we identified 12 MTC and 77 PTC cases. The average age of patients diagnosed with MTC was 53±13 years. There were nine women and three men in examined cases. The average diameter of the nodules was 14±5 mm. All of our cases were of the sporadic type. The average age of patients diagnosed with MTC was greater than that of patients diagnosed with PTC (53 vs. 44 years, p=0.02367). A female predominance is observed in both diseases, although this is more pronounced in PTC. The diameter of the MTC nodules does not differ significantly from the mean size of the PTC nodules (14 vs. 17 mm, p=0.3138). The cytomorphological characteristics of the MTC cases we examined correspond to those described in the international literature, with minor differences. Conclusions: MTC is one of the rarer thyroid cancers, which is often difficult to distinguish from other types of thyroid cancer based on clinical features alone. Average age at diagnosis is greater than patients with PTC. Accurate diagnosis is critical as it requires a different approach than other types of thyroid cancer, it may require a different surgical approach, and may benefit from targeted therapy. Therefore, knowledge of the cytomorphology of MTC is essential for accurate diagnosis and optimal patient care.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"39 1","pages":"137 - 148"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78596578","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 : 2021-12-01DOI: 10.2478/orvtudert-2021-0014
Abram Zoltán
Abstract Between 2012–2018 the University of Medicine and Pharmacy from Tirgu Mureș in partnership with American, Hungarian and Romanian scientists from dozen institutions have launched a research entitled Building Capacity for Tobacco Research in Romania composed of seven complementary research studies. In our paper there are highlighted some timely and specific issues inside the research such as the possibility of computer-based online school prevention, smoking habits of residents and employees of social children’s institutions, the adaptation of a proper legislation and tobacco control, right to clean and smoking-free air. It remains very important the support for tobacco smoke-free, the maintenance of anti-smoking campaigns, the extension of prevention to the juvenile population in order to reduce smoking and the use of alternative tobacco products.
{"title":"Tobacco Control: Research, Prevention, Legislation, Human Rights","authors":"Abram Zoltán","doi":"10.2478/orvtudert-2021-0014","DOIUrl":"https://doi.org/10.2478/orvtudert-2021-0014","url":null,"abstract":"Abstract Between 2012–2018 the University of Medicine and Pharmacy from Tirgu Mureș in partnership with American, Hungarian and Romanian scientists from dozen institutions have launched a research entitled Building Capacity for Tobacco Research in Romania composed of seven complementary research studies. In our paper there are highlighted some timely and specific issues inside the research such as the possibility of computer-based online school prevention, smoking habits of residents and employees of social children’s institutions, the adaptation of a proper legislation and tobacco control, right to clean and smoking-free air. It remains very important the support for tobacco smoke-free, the maintenance of anti-smoking campaigns, the extension of prevention to the juvenile population in order to reduce smoking and the use of alternative tobacco products.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"2002 1","pages":"70 - 73"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82747655","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 : 2021-07-01DOI: 10.2478/orvtudert-2021-0004
G. Árpád, K. Mihály, Gyéresi Mária
Abstract Before 150 years the first Hungarian pharmacopoeia was compiled in 1871 as a result of nearly one century of national efforts. The first four editions were published in two languages, Hungarian and Latin. The second edition (1888) became better than the first one showing significant progress mainly in terms of speciality language. Based on the first edition Prof. Kálmán Balogh, medical doctor, published an encyclopaedic commentary, which is an unparalleled source-work of the contemporary Hungarian pharmacological literature. Geyza Karlovszky and Lajos Winkler issued a pocket edition (“Pocket Commentary”) based on the chemistry articles of the second edition of the pharmacopoeia, which became an important practical handbook of pharmacist education.
{"title":"Comments on the Hungarian pharmacopoeias in the 19th century","authors":"G. Árpád, K. Mihály, Gyéresi Mária","doi":"10.2478/orvtudert-2021-0004","DOIUrl":"https://doi.org/10.2478/orvtudert-2021-0004","url":null,"abstract":"Abstract Before 150 years the first Hungarian pharmacopoeia was compiled in 1871 as a result of nearly one century of national efforts. The first four editions were published in two languages, Hungarian and Latin. The second edition (1888) became better than the first one showing significant progress mainly in terms of speciality language. Based on the first edition Prof. Kálmán Balogh, medical doctor, published an encyclopaedic commentary, which is an unparalleled source-work of the contemporary Hungarian pharmacological literature. Geyza Karlovszky and Lajos Winkler issued a pocket edition (“Pocket Commentary”) based on the chemistry articles of the second edition of the pharmacopoeia, which became an important practical handbook of pharmacist education.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"272 1","pages":"25 - 33"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76570831","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 : 2021-07-01DOI: 10.2478/orvtudert-2021-0006
György Tamás, Kovács Zsolt
Abstract Introduction: The importance of early screening for congenital metabolic diseases is well illustrated by hereditary fructose intolerance (HFI), in which the enzyme aldolase B is not synthesized normally in the organism due to a mutation in the ALDOB (9q31.1) gene, and so the breakdown of fructose- 1-phosphate is inadequate. Early diagnosis is essential in the selection of appropriate treatment, as soon as possible. Otherwise, constant intake of fructose into the body can lead to worsening of symptoms and liver damage, which can finally lead to death. Objective: The aim of our research is to facilitate the screening of hereditary fructose intolerance, thus making possible the selection of the correct treatment as soon as possible. For this purpose, we used bioinformatics and the help of an application we made. Methods: Bioinformatic analysis is designed to facilitate the comparison of the patient’s gene obtained by chromosomal sequencing with the nucleotide sequence of the healthy gene. The program we created can recognize and compare the sequence of the patient’s ALDOB gene with the normal one. In a further step, the program can create the mRNA of the introduced gene, and from this, the structure of the protein encoded by the tested gene. Results: The program written in C# can recognize the ALDOB gene introduced in FASTA format, and in case of any differences, it determines the exact positions these can be found, and the type of nucleotides that differ from the normal ones in the introduced sequence. Conclusion: Bioinformatic processing provides a reliable and quick solution for early screening of HFI, since the necessary genetic sampling can be done even on the first week after birth, thus contributing to the establishment of correct treatment. This could also reduce the frequency of complications of patients with HFI and the number of deaths recorded mainly in infants.
{"title":"The role of bioinformatic analysis in the early diagnosis of hereditary fructose intolerance","authors":"György Tamás, Kovács Zsolt","doi":"10.2478/orvtudert-2021-0006","DOIUrl":"https://doi.org/10.2478/orvtudert-2021-0006","url":null,"abstract":"Abstract Introduction: The importance of early screening for congenital metabolic diseases is well illustrated by hereditary fructose intolerance (HFI), in which the enzyme aldolase B is not synthesized normally in the organism due to a mutation in the ALDOB (9q31.1) gene, and so the breakdown of fructose- 1-phosphate is inadequate. Early diagnosis is essential in the selection of appropriate treatment, as soon as possible. Otherwise, constant intake of fructose into the body can lead to worsening of symptoms and liver damage, which can finally lead to death. Objective: The aim of our research is to facilitate the screening of hereditary fructose intolerance, thus making possible the selection of the correct treatment as soon as possible. For this purpose, we used bioinformatics and the help of an application we made. Methods: Bioinformatic analysis is designed to facilitate the comparison of the patient’s gene obtained by chromosomal sequencing with the nucleotide sequence of the healthy gene. The program we created can recognize and compare the sequence of the patient’s ALDOB gene with the normal one. In a further step, the program can create the mRNA of the introduced gene, and from this, the structure of the protein encoded by the tested gene. Results: The program written in C# can recognize the ALDOB gene introduced in FASTA format, and in case of any differences, it determines the exact positions these can be found, and the type of nucleotides that differ from the normal ones in the introduced sequence. Conclusion: Bioinformatic processing provides a reliable and quick solution for early screening of HFI, since the necessary genetic sampling can be done even on the first week after birth, thus contributing to the establishment of correct treatment. This could also reduce the frequency of complications of patients with HFI and the number of deaths recorded mainly in infants.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"18 1","pages":"45 - 50"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86280692","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 : 2021-07-01DOI: 10.2478/orvtudert-2021-0007
Máté Tihamér, Mihály István, Kelemen Krisztina, Szász József Attila, Szatmári Szabolcs
Abstract During the coronavirus pandemic neurology departments were forced to treat diseases that had hitherto been treated by other specialities. In our case presentation, we describe an unusual association of two diseases that raised interesting questions regarding differential diagnostics and has not yet been presented in the literature. A 34-year-old male patient was admitted to the neurology department with an urgent referral because of impaired speech comprehension and expression upon awakening. He had a history of anticoagulant therapy for thrombosis of the posterior tibial artery, discontinued after two weeks. Physical examination revealed a 1 cm diameter painful lump in the subcutis of his right thigh and a systolic murmur over the mitral and aortic valves. Nonenhanced head CT showed a small hemorrhage near the occipital horn of the left ventricle, which could not explain the mixed aphasia. In addition, the SWAN MRI sequence showed supra- and infratentorial microbleeds, suggesting cavernomatosis, which was confirmed by the detection of another typical popcorn-like bleeding cavernoma on repeated MRI examination. Due to the heart murmurs and positive inflammatory markers, a detailed cardiac examination was warranted, confirming infective endocarditis caused by Streptococcus gordonii. Due to COVID-19-related regulations the patient couldn’t be transferred to the Department of Cardiology or Infectious Diseases, thus his treatment and follow-up was carried out at the Department of Neurology. Following targeted antibiotic treatment the patient’s symptoms resolved and he underwent successful cardiac surgery 7 weeks after his discharge in a symptom-free state. The peculiarity of the case lies in the fact that the clinical picture and course of the disease, consistent with the diagnosis of infective endocarditis suggested cerebral septic emboli with microbleeds, but cerebral cavernomatosis was confirmed by brain imaging.
{"title":"Cerebral microbleeds in a young patient – case presentation with rare disease association and literature review","authors":"Máté Tihamér, Mihály István, Kelemen Krisztina, Szász József Attila, Szatmári Szabolcs","doi":"10.2478/orvtudert-2021-0007","DOIUrl":"https://doi.org/10.2478/orvtudert-2021-0007","url":null,"abstract":"Abstract During the coronavirus pandemic neurology departments were forced to treat diseases that had hitherto been treated by other specialities. In our case presentation, we describe an unusual association of two diseases that raised interesting questions regarding differential diagnostics and has not yet been presented in the literature. A 34-year-old male patient was admitted to the neurology department with an urgent referral because of impaired speech comprehension and expression upon awakening. He had a history of anticoagulant therapy for thrombosis of the posterior tibial artery, discontinued after two weeks. Physical examination revealed a 1 cm diameter painful lump in the subcutis of his right thigh and a systolic murmur over the mitral and aortic valves. Nonenhanced head CT showed a small hemorrhage near the occipital horn of the left ventricle, which could not explain the mixed aphasia. In addition, the SWAN MRI sequence showed supra- and infratentorial microbleeds, suggesting cavernomatosis, which was confirmed by the detection of another typical popcorn-like bleeding cavernoma on repeated MRI examination. Due to the heart murmurs and positive inflammatory markers, a detailed cardiac examination was warranted, confirming infective endocarditis caused by Streptococcus gordonii. Due to COVID-19-related regulations the patient couldn’t be transferred to the Department of Cardiology or Infectious Diseases, thus his treatment and follow-up was carried out at the Department of Neurology. Following targeted antibiotic treatment the patient’s symptoms resolved and he underwent successful cardiac surgery 7 weeks after his discharge in a symptom-free state. The peculiarity of the case lies in the fact that the clinical picture and course of the disease, consistent with the diagnosis of infective endocarditis suggested cerebral septic emboli with microbleeds, but cerebral cavernomatosis was confirmed by brain imaging.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"4 1","pages":"51 - 60"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82458046","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 : 2021-07-01DOI: 10.2478/orvtudert-2021-0001
Berecki Bernadett, Iakab Noemi, Szabó Monica Iudita Maria
Abstract Introduction: Marfan syndrome (MFS) is a genetically determined connective tissue disorder caused by a mutation in the FBN1 gene, located on chromosome 1, which regulates the production of the glycoprotein Fibrillin 1. This results in different connective tissue diseases, especially cardiovascular involvement. Objective: The aim of our presentation is the description of a case in which type 1 autoimmune diabetes and thyreoiditis coexists in a previously undiagnosed patient with MFS. Case presentation: A 27-years-old female patient presented to the emergency department with a 6 months long polyuria-polydipsia syndrome, with weight loss of -10kg. The onset of diabetes manifested with severe ketoacidosis (blood glucose=674 mg/dl, pH=7,036, urinary ketone bodies=159 mg/dl). Pathological laboratory findings include C-peptide=212 ng/ml, anti glutamic acid decarboxylase (GAD) = 5,1UI/ml, ATPO=558 UI/ml. Clinical features of MFS could be recognised, like dolicocephalic face with enophthalmus, height: 184 cm, weight: 40 kg with a BMI of 11,81 kg/m2 respectively 50 kg and 14,77 kg/m2 before weight loss; long limbs, arachnodactyly, kyphoscoliosis, mitral systolic murmur. Imaging procedures showed atrial septal defect with a 6 mm bidirectional shunt, the ascending aorta, the trunk and the aortic isthmus were dilated, mitral valve prolapse, tricuspid valve insufficiency and dilatation of the right heart cavities, interatrial septal aneurysm and pulmonary hypertension. The ECG showed a right branch block. Ophthalmologic examination confirms the lens subluxation. Discussion: The etiology of diabetes and thyroiditis has proven to be autoimmune. With the introduction of base-bolus insulin therapy glycemic control was obtained and beta-blocker treatment was started for the cardiac involvement. Summary: This particular case is unique due to the fact that associates two serious lifelong diseases. MFS should be considered on the basis of morphological characteristics, which requires further investigation due to its serious long term complications.
{"title":"Marfan syndrome associated with type 1 diabetes and autoimmune thyroiditis in a 27 years old female patient - Case presentation","authors":"Berecki Bernadett, Iakab Noemi, Szabó Monica Iudita Maria","doi":"10.2478/orvtudert-2021-0001","DOIUrl":"https://doi.org/10.2478/orvtudert-2021-0001","url":null,"abstract":"Abstract Introduction: Marfan syndrome (MFS) is a genetically determined connective tissue disorder caused by a mutation in the FBN1 gene, located on chromosome 1, which regulates the production of the glycoprotein Fibrillin 1. This results in different connective tissue diseases, especially cardiovascular involvement. Objective: The aim of our presentation is the description of a case in which type 1 autoimmune diabetes and thyreoiditis coexists in a previously undiagnosed patient with MFS. Case presentation: A 27-years-old female patient presented to the emergency department with a 6 months long polyuria-polydipsia syndrome, with weight loss of -10kg. The onset of diabetes manifested with severe ketoacidosis (blood glucose=674 mg/dl, pH=7,036, urinary ketone bodies=159 mg/dl). Pathological laboratory findings include C-peptide=212 ng/ml, anti glutamic acid decarboxylase (GAD) = 5,1UI/ml, ATPO=558 UI/ml. Clinical features of MFS could be recognised, like dolicocephalic face with enophthalmus, height: 184 cm, weight: 40 kg with a BMI of 11,81 kg/m2 respectively 50 kg and 14,77 kg/m2 before weight loss; long limbs, arachnodactyly, kyphoscoliosis, mitral systolic murmur. Imaging procedures showed atrial septal defect with a 6 mm bidirectional shunt, the ascending aorta, the trunk and the aortic isthmus were dilated, mitral valve prolapse, tricuspid valve insufficiency and dilatation of the right heart cavities, interatrial septal aneurysm and pulmonary hypertension. The ECG showed a right branch block. Ophthalmologic examination confirms the lens subluxation. Discussion: The etiology of diabetes and thyroiditis has proven to be autoimmune. With the introduction of base-bolus insulin therapy glycemic control was obtained and beta-blocker treatment was started for the cardiac involvement. Summary: This particular case is unique due to the fact that associates two serious lifelong diseases. MFS should be considered on the basis of morphological characteristics, which requires further investigation due to its serious long term complications.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"20 1","pages":"1 - 6"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75446675","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 : 2021-07-01DOI: 10.2478/orvtudert-2021-0003
Dimény Edina, Brassai Attila
Abstract Suicide is defined by the World Health Organization as an act in which an individual ends his or her own life. Suicidal behavior is a major public health problem worldwide. According to the World Health Organization, the global suicide rate is 10,5/100.000 – 13,5/100.000 in case of men and 7,7/100 000 in case of women and is the 2nd most common cause of violent death. Suicide is a multifactorial phenomenon that can be approached from different perspectives. In Romania, this rate is similar to the global rate: in 2016, the estimated suicide rate was 10.4/100,000, well below the European average. Suicide rates vary by region, age group, gender, ethnicity, and registration of mortality statistics. The aim of the present study is to investigate the psycho-socio-demographic indicators of a cohort of patients with suicidal thoughts emergency referred to a particular psychiatric ward in one year. In our research, we performed a case-control, analytical, randomized, observational study at the Clinical Hospital of Neurology and Psychiatry Brasov among adult psychiatric patients admitted during 2014. The following data on patients were processed: demographic data (age, gender, place of residence), psychosocial data (social background, marital status, education), chronic somatic comorbidities, family history of psychiatric illness, pre-existing psychiatric illnesses, previous suicide attempts and their characteristics. The risk of suicide was assessed by the Modified Scale for Suicide Ideation - Miller et al. Questionnaire and distinguished 3 categories. In our sample of 77 cases we identified 14 patients with low suicide risk, 17 with moderate risk and 46 with high suicide risk. The focus of our study was on suicidal behavior. Suicide attempt, as a complex clinical problem with a waste complexity of ethiology, has high demands on psychiatric care. Being familiar with the different psycho-socio-demographic profiles by gender is proved to be a useful tool in both “screening” and in subsequent case management. These principles can facilitate decision-making, can increase adherence to treatment, and reduce the risk of repetitive attempts.
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Pub Date : 2021-07-01DOI: 10.2478/orvtudert-2021-0005
G. Árpád, K. Mihály, Gyéresi Mária
Abstract Two editions of the epoch-making first Hungarian pharmacopoeia (1871, 1888) were published in the 19th century. In the 20th century, this was followed by five more editions of the National Pharmacopoeia. There were many prominent Transylvanian specialists among the co-workers of these publications (III. - VII., 1909-1986) Lajos Dávid, senior dr. Béla Issekutz, dr.Zsigmond Jakabházy, junior dr. Miklós Jancsó, László Kovács, Dénes Kőszegi, István Novák, Tibor Széki, Lajos Winkler representing almost all fields of pharmacology and pharmacy. Their role in the field of Hungarian medical and pharmacist training, education and organization of scientific research proved to be perpetual. On the 150th anniversary of the publication of the first Hungarian pharmacopoeia, with this study we pay tribute to the memory of these outstanding scientists and their endeavour to create lasting values.
19世纪出版了具有划时代意义的第一部匈牙利药典(1871年、1888年)的两个版本。在20世纪，《国家药典》又出版了五个版本。在这些出版物的合作者中有许多著名的特兰西瓦尼亚专家(III)。——七世。(1909-1986) Lajos Dávid，高级博士b伊塞库兹博士，zsigmond博士Jakabházy，初级博士Miklós Jancsó， László Kovács, d Kőszegi, István Novák, Tibor sz， Lajos Winkler代表几乎所有药理学和药学领域。他们在匈牙利医学和药剂师培训、教育和组织科学研究方面的作用证明是永久的。在第一部匈牙利药典出版150周年之际，我们通过这项研究向这些杰出的科学家和他们创造持久价值的努力致敬。
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Pub Date : 2021-07-01DOI: 10.2478/orvtudert-2021-0008
Abram Zoltán
Abstract On the occasion of her death a hundred years ago, this commemoration presents the bibliography of the first Hungarian woman. Hugonnai Vilma obtained the medical degree in Zurich, which was accredited only after eighteen years. She is an example of giving help and care for those in need.
{"title":"Dr. Hugonnai Vilma, the first Hungarian woman with medical diploma","authors":"Abram Zoltán","doi":"10.2478/orvtudert-2021-0008","DOIUrl":"https://doi.org/10.2478/orvtudert-2021-0008","url":null,"abstract":"Abstract On the occasion of her death a hundred years ago, this commemoration presents the bibliography of the first Hungarian woman. Hugonnai Vilma obtained the medical degree in Zurich, which was accredited only after eighteen years. She is an example of giving help and care for those in need.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"85 1","pages":"61 - 62"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86428224","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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