Current health sciences journal最新文献

The advent of highly active antiretroviral therapy (HAART) in 1996 has markedly enhanced the life expectancy of people living with HIV (PLWH), largely due to the effectiveness of reverse transcriptase inhibitors (RTIs). These drugs target the reverse transcriptase enzyme, crucial for the HIV virus to convert its RNA into DNA within host cells, effectively disrupting the viral replication process. This action reduces the patient's viral load, helping preserve immune function and prevent progression to AIDS. Consequently, the predominant causes of mortality among individuals living with HIV have transitioned from opportunistic infections and AIDS-related cancers to liver disease and cardiovascular complications. Liver damage in PLWH could arise from multiple sources including co-infections, chronic substance use, and notably, antiretroviral therapy itself, which can be hepatotoxic. This review highlights the risks of hepatic damage associated with nucleoside and non-nucleoside RTIs and underscores the variability in hepatotoxicity risks among different drugs. It emphasizes the necessity for regular monitoring of liver health in PLWH and adjusting antiretroviral regimens to minimize liver fibrosis risk. This risk is particularly pronounced in patients who associate the infection with hepatitis B or C virus, where the potential for hepatotoxicity significantly increases.

Hashimoto's thyroiditis (HT) is the most frequently diagnosed thyroid disorder worldwide, characterized by hypothyroidy and thyroid autoimmunity. The fibrous variant accounts for a small number of cases. A 48 years old woman, with 20-years history of Hashimoto thyroiditis presented for a large recent goiter with compressive symptoms, in hypothyroidic state and with very high thyroid antibodies antithyroglobulin and antithyroperoxidase. Ultrasound and fine needle aspiration biopsy showed an enlargement of the thyroid gland with nonhomogeneous structure and trachea shifting posteriorly, Bethesda III. CT scan showed similar aspect of the thyroid gland with compression on the trachea and the left common jugular vein. Surgery was performed due to suspicion of malignancy and compression symptoms. Thyroidectomy was uneventful, but the patient developed hypoparathyroid symptoms postoperatively that resolved with high dose calcium, magnesium and vitamin D supplementation. The pathology report was consistent of Hashimoto's thyroiditis fibrous variant. This case report presents a rare case of the fibrous variant of Hashimoto's thyroiditis that is rarely taken under consideration in the preoperative setting as diagnosis is hard to establish with the usual algorithm of imaging and FNA biopsy. The multidisciplinary management in pre-and postoperative approach and evaluation are of utmost importance for successful management of such case.

Aging is the primary risk factor for cognitive decline, impacting multiple cognitive domains and significantly elevating the risk of conditions such as mild cognitive impairment and dementia. In addition to aging, several diseases contribute to cognitive decline. Alzheimer's disease, a progressive neurodegenerative disorder, leads to the loss of neurons and synapses in the brain, resulting in a profound decline in cognitive abilities and functional capacity. Several studies provide compelling evidence that modifiable lifestyle factors play a crucial role in influencing cognitive health. Adopting healthier behaviors has been shown to significantly reduce the risk of cognitive decline. Genetic factors also play a crucial role in cognitive decline, with several genes being identified that influence the risk of developing conditions like Alzheimer's disease and other dementias. Long-term use of opioids and cocaine is also associated with cognitive decline, affecting functions such as memory and executive processes. Understanding the factors contributing to cognitive decline in aging and disease is essential for developing strategies to mitigate its impact. The drugs available to treat patients with cognitive decline due to advanced aging and drug abuse are also summarize.

Osteoarthritis (OA) of the hip, also known as coxarthrosis, is a degenerative disease marked by gradual biomechanics alterations cause by articular cartilage damage in the coxofemural joint. The goal of this study was determining the incidence of patients with hip osteoarthritis who undergo surgery (hip arthroplasty) within the Department of Orthopedics and Traumatology of the Emergency County Hospital of Drobeta-Turnu Severin, hospitalized between January 2014 and December 2019. Furthermore, we proposed gathering details about incidence, distribution according to age group, gender, living conditions, and type of arthroplasty used in studied patient group. The study included 485 patients with hip OA mainly diagnosed in elderly patients, 87.83% being over 60 years old. In terms of gender, the disease primarily impacted women, with a female/male ratio of 2/1.

The objective of this study is to determine prevalent behaviors and knowledge of oral hygiene on the late adolescents. Only individuals in the late stage of adolescence, specifically between the ages of 18 and 24, that were students from the "Ovidius" University of Constanta were chosen. The involvement was optional. A printed questionnaire was provided for them to complete. A total of 50 participants took part in this study, consisting of 26% (n=13) males and 74% (n=37) females. When asked about their toothbrush preference, 50% (n=25) individuals indicated using just manual toothbrushes. Out of all individuals who have utilized orthodontic appliances, 70.8% (n=17) reported that the dentist recommended for them to receive professional dental hygiene care while undergoing treatment. 78.0% (n=39) individuals reported participating in oral hygiene meetings and would be interested for additional information regarding the topic. It is essential to provide youngsters with early instruction about the importance of oral hygiene in order to develop long-lasting healthy habits.

The purpose of our study was the phenotypic classification of patients with osteoarthritis of the knee (KOA) and the dynamic assessment of functional status, monitored both numerically and in conformity with the International Classification of Functioning, Disability, and Health (ICF-basic set, shortened form). We conducted a prospective study in the Department of Physical Medicine and Rehabilitation, Filantropia Hospital, Craiova, from June of 2022 to November of 2023. In total, 100 patients with KOA were enlisted. Using data from the literature, physiotherapeutic examination, and results from paraclinical examinations, we classified studied patients into the five phenotypic categories: chronic pain (F1), local pathology with predominance of inflammatory mechanisms (F2), local pathology with predominance of metabolic mechanisms of bone and cartilage structures (F3), metabolic disorders (F4) and comorbidities (F5)-primarily chronic venous insufficiency in the lower limbs. We analyzed the values of generic qualifiers (at two evaluation time points) for the most significant elements of the core ICF set, abbreviated form, used in OAG, across each of the five phenotypes. Phenotypes F4 and F5 showed significant improvements across all evaluated functions, indicating increased efficacy in patients with comorbidities and metabolic diseases. Reduction in pain sensation, improvement in joint and muscle mobility, as well as enhancements in functions related to walking, dressing, and hand use, reflect an overall improvement in the quality of life for these patients.

Burns in children represent a significant challenge in the global health domain. The research aims to analyze the profile of children in Romania affected by burns, focusing on demographic characteristics, severity of burns, applied treatment, and impact on parents. Through this analysis, we aim to better understand the factors involved in these cases and provide relevant information for improving the management and care of children with burns. This study aims to explore various aspects related to the healing of burn injuries in pediatric patients in Romania, analyzing data collected through a questionnaire administered to 107 parents. The profile of children in Romania affected by burns is primarily composed of relatively young children, with an average age of 8.7 years and an even distribution between genders. Most come from rural areas, and the degree of burns ranges from first to fourth degree, reflecting a wide range of severity of injuries. Treatment is diverse, with a tendency towards conservative approaches and a significant proportion of cases without complications. Parental satisfaction is not significantly influenced by the type of treatment, indicating a similar perception regardless of the mode of medical intervention. Improving the management and care of children with burns is achieved through adopting a multidisciplinary and integrative perspective. This involves the use of non-pharmacological therapies such as hypnosis and regional anesthesia for pain and anxiety control. Additionally, the inclusion of adjunctive therapies, such as the use of mesenchymal stromal cells and tilapia skin xenograft, contributes to improving the healing process.

Aim: The aim of the study was to assess the inflammatory status in individuals diagnosed with atrial fibrillation (Afi) and establish an association between this status and the clinicopathological features.

Material and methods: Our study was conducted retrospectively and initially involved 278 patients. However, after excluding 27 patients, we ultimately ended up with 167 patients who had an inflammatory status and 84 patients who did not have an inflammatory status. These patients were then analyzed.

Results: Patients who had inflammation showed higher values for the CHA2DS2-VASc and HAS-BLED scores (P= 0.0132 for CHA2DS2-VASc and P= 0.0024 for HAS-BLED). Also, it was observed that patients with associated inflammation exhibited an increase in both the volume and the area of the left atrium. Patients with hypertension had a higher prevalence of inflammation, with heart failure and with ischemic heart disease. It is worth noting that patients with atrial fibrillation and increased inflammatory status exhibited higher rates of stroke (22.75% vs 10.71% in patients without inflammation, odds ratio = 2.455, 95% confidence interval 1.161 to 5.425, p = 0.0253).

Conclusions: Our research has demonstrated that patients diagnosed with atrial fibrillation and exhibiting a heightened inflammatory status also present association with other comorbidities, including hypertension, heart failure, ischemic heart disease, and stroke.

Backround: Pancreaticojejunal anastomosis has a high risk of pancreatic leakage, which several surgical techniques have been described. Our main objective is to determine what is the association of postoperative pancreatic leakage in patients undergoing pancreaticoduodenectomy according to the pancreaticojejunal anastomosis technique used (Cattel vs Blumgart)?

Material and methods: Historical cohort, all cancer patients undergoing pancreaticoduodenectomy were included. From April 2020 to May 2021, Cattel technique was used; from June 2021 to June 2022, Blumgart technique was used. All procedures were performed by a single board-certified surgical oncologist at Oncology Hospital.

Results: 24 patients (11 men and 13 women). The first 9 procedures were performed with the Cattel technique, starting from procedure 10, the Blumgart technique was used. No differences were observed regarding the consistency of the pancreas (p=0.28) or the size of the duct (p=0.51) between the two groups. Pancreatic leakage was observed in 100% with the Cattel technique and in 6.7% with the Blumgart technique (p= 0.0001). An amylase value was observed in the left drainage at 6 days > 200 U/L with the Cattel technique and < 200 U/L with Blumgart (p=0.0001). Intraoperative bleeding (Cattel 1200 ml vs. Blumgart 400 ml, p= 0.03) and 90-day mortality (Cattel 33.3% vs. Blumgart 0%, Log-Rank: 0.022) also showed a difference in favor of Blumgart technique. Blumgart technique is a protective factor for the presence of pancreatic leakage (RR 0.06, 95% CI 0.01-0.44, p=0.0001).

Discussion: A lower risk of pancreatic leakage was found using the Blumgart technique, compared to the Cattel technique.

We conducted a retrospective, observational study, based on 91 patients diagnosed with colorectal cancer (CRC), hospitalized and evaluated within the Surgical and the 2nd Internal Medicine Clinic, the Clinical Emergency County Hospital Craiova, between October 2020 and October 2022. We aimed in this study to analyze the epidemiological aspects and clinical characteristics of patients with CRC. In our study group, the patients' ages were between 30-89 years, with mean a of 68.06 (±9.39) years. The incidence of CRC cases in young patients was relatively low. 56.04% of all patients lived in urban areas. In 57.14% of cases, tumors were found on the left colon. The histopathological (HP) examination revealed the net predominance of adenocarcinoma. Depending on the HP grade, the tumor formations were represented predominantly by moderate and poorly differentiated tumors, having G2 and G3 grades. The T3 tumors predominated the total tumors identified. We observed that obstructions have the highest percentages on the left colon, while haemorrhages and perforations have higher percentages on the right side of the colon. The results obtained in our study largely validated the hypothesis proposed at the beginning of the study, according to which, using the clinical, paraclinical, and HP data, we can create a typology of the patient with CRC, from the Craiova Reference Center, to guide us in identifying some measures to decrease the percentage of CRC, as well as to improve the efficiency of the surgical treatment for these cases.