Current health sciences journal最新文献

Background: This study was conducted to determine the clinical concordance of non-invasive blood pressure (NIBP) measurements from the upper arm and ankle and to determine whether there is a difference between them.

Methods: A prospective and cross-sectional research design was used in this study. The study population included 106 patients hospitalized in the surgical clinics of a training and research hospital. Non-invasive blood pressure measurements were performed from both upper arms and ankles in the supine position. In the data analysis, ANOVA and the Bland-Altman plot were employed.

Results: Based on the results of NIBP measurements from the arm and ankle, the differences between diastolic blood pressure (DBP) and mean blood pressure (MBP) were acceptable and within the limits of concordance. The difference between the mean systolic blood pressure (SBP) was found to be significantly different and outside the limits of concordance. The difference between the mean SBP measured from the ankle and the upper arm was determined to be 18 mmHg.

Conclusion: It was determined that the results of SBP measured from the ankle were significantly higher and outside the limits of concordance compared to the upper arm, while the results of DBP and MBP measurements were within acceptable limits.

Introduction: The present case describes one of the few reported occurrences of coinfection by EBV and SARS-CoV-2, initially treated as streptococcal pharyngitis.

Case description: An 18-year-old female was admitted with whitish plaques in the throat associated with pain, cough, hoarseness, asthenia, tonsillar exudate, hypertrophy, hyperemia, and adenomegaly on the cervical region. Based on suspicion of bacterial tonsillitis, the patient was already taking amoxicillin with clavulanate. A rapid test was negative for group A streptococci. Laboratory exams revealed elevated counts of Anti-VCA IgM and Anti-VCA IgG for EBV. The cytomegalovirus (IgM and IgG) result was negative, and the blood count was within normal limits. However, a COVID-19 infection was confirmed by qPCR. The management was supportive treatment for symptom relief and isolation for 14 days. The patient remained afebrile and clinically stable during this period, with saturation ranging from 98% to 100%. However, the patient evolved with anosmia and ageusia. Then, olfaction training therapy was initiated, as well as continuing asthenia. Five days later, she presented petechiae on the chest and upper limbs, associated with mild pruritus.

Conclusion: Epstein-Barr mononucleosis and COVID-19 are similar in some aspects, and their viruses may be associated with a coinfection, which could make the diagnoses difficult and aggravate the clinical condition. In addition, it is essential to emphasize the importance of laboratory tests to avoid erroneous treatments that may worsen the patient's condition and change his prognosis.

Objectives: The study has as main objective the evaluation of the potential roles of vitamin D, the neutrophil to lymphocyte ratio (NLR), and the systemic inflammation index (SII) as future biomarkers regarding the classification of flares in systemic lupus erythematosus (SLE).

Material and methods: Individuals diagnosed with SLE were encompassed in this observational study. The current applicable criteria, namely The European Alliance of Associations for Rheumatology (EULAR)/American College of Rheumatology (ACR) 2019 criteria had to be fulfilled. The participants underwent specific musculoskeletal examination, paraclinical investigations including complete blood count (CBC), determination of serum creatinine levels, as well as liver enzymes, and also the markers of inflammation. The fractions of the serum complement (C3 and C4) were also evaluated, together with serum vitamin D concentrations. Safety of Estrogens in Lupus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) was required in order to analyze the research group's disease activity.

Results: NLR and SII demonstrated validity, having statistically significant correlations with SELENA-SLEDAI (p value less than 0.001). The ROC analysis proved a strong discriminative power for NLR (AUC=0.96) and SII (AUC=0.963) in predicting severe disease flares. Optimal cut-off values were 3.45 for NLR and 877,002.19 for SII. Serum vitamin D concentrations had a weak association with the SLEDAI score (p=0.048, r=0.213).

Conclusions: NLR and SII can be considered reliable biomarkers for discriminating between the levels of disease activity in SLE individuals. Low serum levels of vitamin D may also influence disease severity, but require further validation.

Objectives: To quantify levels of two inflammation-related indexes, namely neutrophil-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) in systemic scleroderma patients and determine the association with clinical manifestations and features of heart ultrasound.

Methods: The study group consisted of 34 patients with diagnosis of systemic scleroderma which were admitted to the hospital during 2015-2019. Patient data included the presence and type of clinical manifestations of systemic scleroderma, chest imaging to screen for lung disease, heart ultrasound reports and the laboratory investigations needed to quantify inflammatory indexes. We analysed the levels of inflammatory indexes and compared results based on the prevalence of systemic manifestations.

Results: Higher serum levels of NLR and SII are associated with the presence of joint, lung and pericardial involvement. Statistical significance was observed only for NLR levels with regard to the presence of articular involvement and ILD. Low ejection fraction was also associated with higher levels of both inflammatory indexes, without statistical significance.

Conclusion: Inflammatory indexes are cost-effective markers that reflect active disease manifestations of systemic scleroderma and can thus be a useful tool to include in the regular follow-up of patients in order to better inform organ-specific assessments.

Objectives: to assess the impact of pulmonary hypertension (PH) on short and long-term respiratory and neurodevelopmental outcomes in extremely preterm infants, diagnosed with moderate to severe bronchopulmonary dysplasia (MSBPD).

Study design: cohort study, with retrospective analysis of the medical records of infants born at ≤32 weeks gestation admitted to a single neonatal tertiary centre from 2010 to 2020. Primary outcome was consistent with hospital re-admissions by 2 years post menstrual age. Neurodevelopment was assessed using Bayley's Scales of Infant and Toddler Development 3rd edition (Bayley-III) as a secondary outcome.

Results: 201 infants with no PH and 23 infants with PH were analysed. The PH group showed higher risk for respiratory and paediatric intensive care unit re-admission (65%) during the first 2 years of life (OR: 3.15; 95% CI: 1.28 to 7.78; p<0.5). In contrast to current published literature, our study showed that pulmonary hypertension complicating moderate to severe bronchopulmonary dysplasia had no negative impact on neurodevelopmental outcomes (OR: 1.87; 95% CI: 0.72 to 4.88; p value=0.19). However, in our population, ethnicity, chorioamnionitis and need for persistent ductus arteriosus treatment were all independently associated with poor neurodevelopmental outcomes (p values <0.5).

Conclusion: infants with MSBPD associated pulmonary hypertension (MSBPD-PH) are more likely to need intensive care and respiratory hospital re-admissions. Ethnicity, chorioamnionitis and need for ductus arteriosus treatment are independently associated with poor neurodevelopmental outcomes regardless of the pulmonary hypertension status.

Hypopituitarism is a clinical syndrome that occurs when the anterior pituitary gland fails to secrete one or more hormones. Developmental delay is frequently seen in these patients. However, skeletal deformities and postural instability are unexceptional. We present a 17-year-old male patient with panhypopituitarism (PHP) with back and leg pain, postural malalignment, and skeletal deformities referred by the pediatric endocrinology clinic. According to the physical examination, laboratory tests, and radiographic assessments, the patient was considered as sequela spondyloarthropathy (SpA). Autoimmune and rheumatic diseases are frequently encountered in patients with hypogonadism. However, the association of PHP and ankylosing spondylitis (AS) has not yet been demonstrated. This case was presented to draw attention to the alignment of PHP and SpA and also to emphasize that skeletal deformities were not encountered in the absence of anterior hypophysis hormones.

Thyroid angiosarcoma is an extraordinarily sparse malignancy, often populating alpine regions. Clinically, thyroid angiosarcomas tend to be nonspecific in presentation, starkly dependent on site, size, extension, and metastases. Tumors are locally aggressive and can present with sudden onset pain due to intra-nodular hemorrhage and compressive symptoms from sudden expansion. Due to the disease being a scarcely reported entity, there is little scholarship regarding its management. We report an interesting case of a 63-year-old man presenting with a swelling in the neck, incidentally found to be a thyroid angiosarcoma with a first-time reported associated spinal metastasis. The patient has a uniquely presenting thyroid angiosarcoma and is the first patient to present as such within a non-alpine South Asian region.

Aim of the study: The aim of this study was represented by the identification of the type of relation between the bruxism sleep index and the global quality of life.

Materials and methods: The study group was composed of a number of 40 patients, both women and men, who did not report health problems and who were identified with a positive self-report regarding the existence of sleep bruxism. For the identification of the bruxism index, the Bruxoff device, Bioelettronica, Turin, Italy, was used. Quality of life inventory (QOLI) was used to determine quality of life scores (T-score).

Results: The gender distribution of the batch is as follows: 52.5%-male, 47.5%-female. The maximum value of the bruxism index was 10.5, and the minimum was 2.10, with a mean of 6.30 and a standard deviation of 2.22. Quality of life T-score recorded maximum value equal to 62, minimum value equal to 40, mean equal to 51.87. The Pearson correlation coefficient calculated to test the correlation between the bruxism indicator and the QOLI T Score presented a negative value (-0.643), which signifies a negative but very strong relation between the two variables. 77.5% of the participants were included in a mean level of quality of life.

Conclusions: A statistically strong negative relation was found between global quality-of-life (T-scores) and the bruxism indicator in patients with bruxism activity during sleep.

Our research aims to find a connection between the levels of MMP-9 and D-dimers in the blood and the prevalence of AAAs in subjects with atherosclerotic coronary disease. We selected fifty patients from each group and measured their MMP-9 and D-dimer levels in the blood. We discovered that in subjects with significant coronary disease and angina pectoris, the level of MMP-9 is higher compared to the subjects with angina pectoris but without significant coronary disease. When comparing this group with those with significant coronary disease and AAA, the level of MMP-9 is lower. Additionally, the D-dimer level was significantly higher in subjects with both AAA and significant coronary atherosclerosis compared to patients with significant coronary disease alone or those without significant coronary disease or AAAs. Subjects with significant coronary disease and AAA have elevated levels of MMP-9 and D-dimer compared to patients with significant coronary disease alone or without coronary artery disease or AAAs. These two factors could be used as indicators for diagnosing AAA in patients with angina pectoris.

Introduction: The aging population is associated with increased osteoporosis and risk of hip fractures. Cognitive decline has recorded exponential increases in the last decades, with the rise in life expectancy.

Material and methods: We conducted a prospective study on 65 patients over 65 years old associated with dementia and hip fractures. We used pre-and post-treatment variables such as age, type of fracture, type of treatment, Charlson Comorbidity Index (CCI), EQ-5D-5L score, and the Harris hip score (HHS) to assess pain, mobility, and mortality. We performed follow-ups at 6 months, 1 year, 2 years, and 3 years.

Results: Patients with dementia typically arrive at the hospital without any previous analgesic treatment and receive lower doses due to poor pain recognition. The 6-month mortality rate was 48.22% and increased to 78.46% at 3 years. The best survival rates were in patients with bipolar prosthesis and Gamma nails, with a 3-year survival rate of 40% and 50%, respectively.

Conclusions: Patients with dementia have a higher mortality rate compared to cognitively intact patients and the treatment decisions require a multidisciplinary team and individualized recommendations for each patient, due to high surgical risk in the elderly.