Current health sciences journal最新文献

We conducted a retrospective study based on 55 patients diagnosed with gastroenteropancreatic neuroendocrine tumors (GEP-NETs)-gastric (G-NET), small bowel (SB-NET) and colonic (C-NET), hospitalized and evaluated within the Surgical, Gastroenterology and Internal Medicine Clinics, in The Clinical Emergency County Hospital Craiova, between May 2016 and April 2024. We aimed in this study to analyze the epidemiological aspects and clinical characteristics of patients with GEP-NETs. In our study group, the patients' ages were between 39-82 years, with a mean of 66.40 (±12.46) years. The incidence of GEP-NETs cases in young patients was insignificant low-1 case. 45.46% of all patients lived in urban areas. 16.36% were G-NET, 14,54 were SB-NET and 69.09% were C-NET. The GEP-NETs diagnosis was established by immunohistochemistry features. Also, we observed that the most frequency localization was on the ascending colon, while the rarest on the colon it is located on the transverse colon and the rarest is on the small bowel, in spite of the generally literature data. From the C-NET group, 49.09% have been presented arterial hypertension probable explained by serotonin and dopamine secretion an inflammatory through phenotype expression and just one patient has been presented an erythematous psoriasis, which could be also explained by the same neurotransmitter's involvement as a possible purposed mechanism. The results obtained in our study demonstrate that could be a common profile of GEP-NETs patients through epidemiological general information and clinical characteristics. Also, we demonstrate that, in the last years, the incidence increased for the GEP-NETs.

From the category of biliary disease, gallstones registered an increase during the last years, approximately 6% of men and 9% of women being affected by the pathology in the United States only. In western countries between 10-20% of the adult population is suffering from cholelithiasis. Although increasing age is a major risk factor for their formation, late studies correlate gallstones appearance with an age decrease for the onset of symptoms. We therefore face a younger population manifesting pain and sometimes functional disability. In accordance with statistical analysis, the economic impact of gallstones in highly industrialized countries such as United States produces costs of up to 6.5 billion dollars annually. In this context, the appropriate timing for intervention becomes a factor of major interest. The present review uses 28 articles and specialized literature. Article selection was based on keywords and followed the effectiveness of imaging investigation such as ultrasound, CT and MRI for patients diagnosed with cholelithiasis. Since a direct comparison between the imaging investigation techniques is not concluding we have tried to establish the sensitivity and specificity offered by each imaging assessment. The comparative analysis revealed a p Kruskal-Wallis <0.001 for sensitivity and p Kruskal-Wallis=0.474 for specificity.

Background: Obstructive ventilatory dysfunctions have an increased incidence, and through functional assessment determined by the International Classification of Functioning, Disability and Health (ICF), appropriate treatment can be established.

Aims: The objectives of our research are represented by the application of respiratory rehabilitation sessions according to the ICF in patients with obstructive ventilatory dysfunctions-with COPD or asthma, using a unique, international language and the evaluation of the results obtained before and after completion pulmonary rehabilitation.

Methods: We conducted a randomized prospective study between November 2022-April 2023, which included 84 patients diagnosed with obstructive ventilatory dysfunctions and who performed respiratory rehabilitation. They were divided into two categories: category 1-C1 which included 43 patients with Chronic Obstructive Pulmonary Disease-COPD and category 2-C2 which included 41 patients diagnosed with asthma. The rehabilitation program lasted 8 weeks, with exercises performed from Monday to Friday, with a weekend break. Respiratory rehabilitation consisted of physical therapy, inspiratory and expiratory muscle training (IEMT), proper nutrition, and psychotherapy.

Results: At the end of the program, most of the patients showed improvements in the ICF qualifiers, a fact that supported us that respiratory recovery is one of the basic therapies of patients with obstructive ventilatory dysfunctions.

Conclusions: The ICF allows the application of a personalized respiratory rehabilitation program. The ICF qualifiers are used for the functional assessment of patients and allow they to be included in individualized medical rehabilitation programs.

Introduction: Anophthalmia and microphthalmia are orbito-facial developmental disorders characterized by deficient growth and impaired visual capability [1]. These rare disorders may be unilateral or bilateral. Congenital anophthalmia is the complete absence of the eye [2, 3]. The prevalence of both conditions is estimated at 0.2-3 per 10,000 births [4]. We report a case of congenital bilateral anophthalmia that was undetected during follow-up but diagnosed after birth.

Case description: 24-year-old Bahraini female, who is not a known case of any medical illnesses, primigravida at 39+6 weeks of gestation gave birth to a live male baby via vacuum extraction delivery due to recurrent variable decelerations and poor maternal effort. On physical examination, bilateral anophthalmia was immediately observed. No other anomalies were detected. The investigations ordered were MRI brain and orbit, which showed: Absence of bilateral eye globes-features of bilateral anophthalmia. We advised the parents the baby will need socket expansion/ conformer placement to maintain facial symmetry and cosmetic outcome with neurocognitive and development assessment every 2 months as well as speech and language evaluation.

Conclusion: Although many probable factors leading to anophthalmia are suggested, many cases arise idiopathically. Due to the nature of the defect, oftentimes prenatal diagnosis with routine scans is challenging. Therefore, more research into probable causes will prompt the healthcare professional to use more sensitive studies to detect the anomaly prenatally to potentially reduce the psychological and financial impact on the parents.

Background: The external carotid artery (ECA) is typically regarded as coursing between the styloid muscles to continue into the parotid space. The anatomical possibility of an ECA with an ascending parapharyngeal trajectory continuing posteriorly to an elongated styloid process (ESP), thus retrostyloid, to the parotid space is overlooked. It was, therefore, aimed to document the prevalence of this retrostyloid variant of the ECA's course.

Methods: We investigated a retrospective random cohort of 160 archived CT angiograms of 97 males and 63 females aged between 47 and 76. The presence of an ESP and the retrostyloid course of the ECA were bilaterally documented.

Results: An ESP was identified in 99/320 sides (30.94%), regardless of the ECA course. In the overall group, we obtained 35% null cases for the two variables on the right and 34.06% for the left. ESPs were identified in 8.75% on the right side and 10.31% on the left. The ECAs had retrostyloid courses in 6.25% on the right side and 5.63% on the left. Thus, of the 320 ECAs documented on both sides, 221 (69.06%) had no retrostyloid courses, and we did not identify any ESP in those cases. ESPs were detected in 19.06% of the sides but without retrostyloid ECAs, and retrostyloid courses of the ECAs were detected in 11.88%.

Conclusions: The possibility of a retrostyloid course of the ECA should not be ignored. An ESP may misinform the surgeon about the main carotid artery located immediately deep to it.

Our observational study included on 54 patients with PsO, evaluated into the Dermatology Department of the Emergency County Hospital Craiova, Romania, between August 2023 and January 2024, and 40 controls. Our research proposed determining the prevalence of MetS in a cohort of PsO patients, and its relationship to subclinical atherosclerosis, evaluated by carotid ultrasound. Metabolic syndrome (MetS) was established according to National Cholesterol Education Program (NCP) Adult Treatment Panel (ATP) III criteria for MetS for 35 of the patients (64.81%) vs. 11 of the control group (27.5%), p=0.0003. An overview of each component of MetS depending on the diagnostic criteria for MetS showed that waist and total cholesterol exerted significant differences. Carotid ultrasound evaluation revealed an increased ITM, of over 0.9mm, for 19 (35.18%) or PsO patients, significantly increased compared to controls, as well as the presence of carotid plaques in significantly different percentages (37.03% PsO vs. 17.5% controls, p=0.001). We also noted that for patients with MetS, US examination displayed increased results for IMT compared to those without MetS. The prevalence of carotid atheroma plaque was augmented in patients with MetS and PsO. In our PsO group IMT exerted a positive inter-relation with: age, MetS, blood glucose, disease duration, and PASI. Important to note is that after multiple linear regression analysis, age and MetS were independent indicators of IMT (p=0.02 for age and p=0.001 for MetS). Our findings sustain a firm relationship between MetS and psoriasis and the major consequence of this observation is the inherent risk of cardiovascular events.

Background: Various methods are used to treat patients with coronavirus, including drug therapy and alternative and non-invasive therapies Research has been done on the effects of body position on cardiac function in patients with COVID-19 diagnosis.

Methods: This study was performed on patients admitted with COVID-19 diagnosis. Patients with inclusion criteria were selected based on purpose and entered into the study. They were divided into three groups: Group A patients were placed in a semi-sitting position, group B patients were placed in a tripod position, and group C patients were placed in a prone position. After being placed in the relevant positions at 15 and 60 minutes were measured in terms of heart rate and blood pressure at the mentioned times in the relevant checklist.

Results: The results showed that there was no statistically significant difference in heart rate between the three groups before the intervention (P>0.05). In other words, changes in heart rate over time between the three groups (in several measurements) were statistically significant (P<0.05). Regarding Systolic Blood Pressure (SBP) and Diastolic Blood pressure patterns, the results showed that the three position groups was not statistically different before and 15 and 60 minutes after the intervention (P>0.05).

Conclusion: According to the results, it can be concluded that placing the patient in all three positions of the tripod, prone and semi-sitting can be effective in improving the patient's heart rate pattern and lead to improving the patient's clinical condition.

The study aimed to test the validity and reliability of the Romanian version of short form of Fear of Dental Pain questionnaire (s-FDPQ), modified by adding an item about dental implant insertion.

Material and methods: The design of the study was cross-sectional. Data were collected through an online questionnaire completed by university students, administered from January to March 2024. The survey included information about past dental treatments, the Dental Anxiety Scale (DAS), and items of s-FDPQ.

Results: 186 participants were included in the study. The Romanian version of the modified s-FDPQ had a good reliability Sperman-Brown coefficient is 0.878, and Cronbach alpha is 0.92. The questionnaire had a good convergent validity, with all items being moderately correlated with the DAS score. The one-factor model was tested and has a good fit according to the confirmatory factor analysis. The participants were afraid of pain mostly regarding having a wisdom tooth extracted or a dental implant inserted. A statistically significant higher fear of dental pain was observed in those who did not previously have a root canal treatment (p=0.008) and in those who had dental implants in the past (p=0.046). Those attending regular dental check-ups had lower levels of fear of dental pain.

Conclusion: The Romanian version of s-FDPQ, modified by adding a question about dental implant insertion, has good reliability and validity. Fear of dental pain seemed to be influenced by features of dental procedures and previous dental experience.

Knee osteoarthritis (KOA) represents a progressive and painful disease that in time can lead to loss of function and disability. Early diagnosis and correct treatment are essential in preventing the advancement of the condition to a stage where it can affect the quality of life. The development of new imagistic methods and devices can help detect changes in the structure of the join before the onset of symptoms. At the moment there are no disease- modifying drugs approved, so the current treatment is symptomatic, focusing on pain reduction, improving function and trying to prevent progression towards disability.

Juvenile Idiopathic Arthritis (JIA) includes a range of inflammatory conditions that exhibit chronic arthritis with various clinical presentations. The disease's heterogeneity leads to different impacts on children's health, both short and long-term. Compromised growth, seen as growth retardation and delayed puberty, is a common complication in children with JIA, severely impacting their quality of life. This impairment is linked to disease duration and activity, with severe cases in systemic and polyarticular subtypes. Literature reports growth retardation incidence from 8% to 41%, but data on pubertal impairment is lacking. Growth in children is influenced by systemic and local mechanisms. Chronic inflammation, prolonged glucocorticosteroid (GCS) use, and nutritional issues contribute to growth stunting and pubertal delays. Chronic inflammation in JIA flattens growth curves, while steroid treatment impairs growth and causes weight gain. Disruption of the GH/IGF1 axis is known, but data on systemic hormonal resistance in JIA are insufficient. Optimizing JIA treatment, including biological therapies, is expected to improve growth velocity and reduce long-term impacts by better disease control and reduced GCS doses. Thyroid function also influences growth and puberty, but comprehensive studies on thyroid involvement in JIA are lacking. Given the early onset of chronic inflammatory consequences, preventive auxological screening measures are necessary for children with JIA. Early detection of developmental disorders can enhance therapeutic management. This article summarizes information from a cohort study on growth in children with JIA and proposes a diagnostic algorithm for clinical use.