Romanian Journal of Military Medicine最新文献

{"title":"Progress and Challenges of Diabetic Foot Diagnostic and Treatment","authors":"C. Constantin, M. Georgescu, I. Staicu","doi":"10.55453/rjmm.2023.126.3.7","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.3.7","url":null,"abstract":"\"Diabetic foot is one of the main long-term complications of diabetes, having a significant impact on a patient’s quality of life. However, prevention by daily checking of the limbs and observance of the rules of care remains particularly important to avoid total or partial amputation. This paper aims to highlight the main challenges and progress in the treatment of the diabetic foot. To achieve this, we analyzed a database consisting of more than 100 articles published in recent years, approaching the treatment of the diabetic foot. The main problems that occur with the diabetic foot are peripheral vascular disease and diabetic neuropathy. These can lead to blisters and skin lesions that can eventually lead to ulcers in the lower limbs and even amputation. In conclusion, prevention is the main method of treatment for diabetic foot, followed by the treatment of each complication depending on when it is identified and its severity. \"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47136886","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}

{"title":"Image of a Junior Officer in Military Personnel Participating in Combat Operations with Symptoms of Post-traumatic Stress Disorder","authors":"Yanina Matsegora, O. Kolesnichenko, I. Prykhodko, Vira Kramchenkova, A. Bolshakova, O. Zaitseva, K. Marushchenko, Y. Rumiantsev, I. Tovma","doi":"10.55453/rjmm.2023.126.3.8","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.3.8","url":null,"abstract":"\"According to the results of the conducted study there were distinguished the peculiarities of perception of the image of a junior officer by servicemen who participated in hostilities and had various PTSD symptoms. The study included 233 male servicemen with combat experience. The age of the participants varied from 20 to 55 years. It was determined that the image perception of the direct commander by the servicemen who did not have any PTSD symptoms had been influenced by both the key features of the modern way of fighting and the way a protective mechanism of consciousness acted, which gave the possibility to maintain mental health under combat conditions. These servicemen considered the awareness, kindness, and physical strength of their commander to be not important. The first stage was occupied by his/her ability to adequately fulfill his/her leadership function and the power of his/her spirit – the courage and love of the Motherland, which formed his/her reliability. Servicemen who had PTSD symptoms were less satisfied with the role of a junior officer and considered him/her to be less capable of meeting their expectations. They were less interested in commanders who could involve them in situations that required quick, brave action and complete responsibility for the entrusted part of common affairs. The most important factors in the structure of the direct commander image in both studied groups were the power of personality (the ability of self-regulation); however, the servicemen with PTSD symptoms had a specific orientation of these factors – to help their subordinates. They were quite selfishly aimed at using their direct commanders as a way of getting help. \"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44643436","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}

{"title":"Aesthetic Principles in Nasal Reconstruction after Squamous Cell Carcinoma Resection","authors":"A. Grigore, A. Oproiu, I. Florescu","doi":"10.55453/rjmm.2023.126.3.11","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.3.11","url":null,"abstract":"\"A successful nose reconstruction is represented by a normal look and nasal breathing preservation. The choice of method is based on the site, size, depth of the defect, donor availability, and surgeon experience. There are multiple methods of restoring nasal cover, from primary repair to healing by secondary intention, from primary suture, skin graft to locoregional flaps, but all of them should be integrated into a personalized approach, keeping the nasal functions, a good aesthetic outcome and without any tumor infiltration. This paper consisting of a retrospective study of 9 patients diagnosticated with squamous cell carcinoma revealed the importance of skin properties and skin changes during aging. Despite all aesthetic principles, skin is the most important resource in facial reconstruction. \"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48184088","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}

{"title":"Comparison of Serum Vitamin D Levels with Glucose, Lipid, and the Other Biochemical Parameters: A Cross-Sectional Study","authors":"Y. Sezgin, Y. Hacıoğlu, A. Kaplan","doi":"10.55453/rjmm.2023.126.3.14","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.3.14","url":null,"abstract":"\"Since vitamin D is synthesized from cholesterol, it is claimed to be associated with insulin resistance, suggesting that there may be an association between vitamin D glucose and lipids. For this reason, we aimed to investigate a relationship between vitamin D and biochemical parameters, including glucose and lipids. This cross-sectional study included 198 patients .admitted to the family medicine outpatient clinic between June and December 2016. There was no significant correlation between vitamin D and serum glucose, total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol, calcium, magnesium, sodium, TSH, and body mass index values in both men and women. There was a correlation between vitamin D and total cholesterol and LDL cholesterol levels in the younger subjects below 41 years (p=0.002). Regression analysis with other variables showed no statistical significance between vitamin D levels on LDL-C levels (P=0.309). Despite previous studies, our study did not confirm the effects of vitamin D on serum glucose, lipid, calcium, and other biochemical parameters. However, these results suggest that the standard up-to-date literature showing the relationship between vitamin D and various metabolic and hormonal disorders may need to be confirmed by new large-scale studies. \"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49099429","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}

{"title":"Postirradiation Angiosarcoma – A Late, Severe Complication of Radiotherapy for Mammary Neoplasm","authors":"Raluca Lascu, A. Alexandru, Alexandra Oltenescu, Oana Vlaicu, R. Andrei","doi":"10.55453/rjmm.2023.126.3.3","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.3.3","url":null,"abstract":"\"Angiosarcoma is a malignant tumor derived from the endothelium of the blood and lymphatic vessels. Its aggressive behavior results in a poor prognosis for the patients. Radiation-associated angiosarcoma is a rare recently described particular subtype of angiosarcoma best shown in patients after treatment of breast cancer. The latency period of development is approximately 8 years, thus the 5-year standard follow-up after mammary neoplasm therapy needs to be extended up to 10 years. Radiotherapy is an independent risk factor for angiosarcoma development. Rapid diagnosis is essential for prompt therapeutical intervention to improve the patient’s prognosis. The importance of early diagnosis is emphasized by a case of a 54 years old woman, with a diagnosis of breast cancer treated by sectorectomy and radiotherapy 7 years prior, presenting to our Dermatology Department for the recent occurence of erythemato-violaceous cutaneous patches on the area subjected to radiotherapy. \"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44552561","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}

{"title":"Investigating the Operational Management Challenges of a Reference Military Hospital in the COVID-19 Pandemic","authors":"Mahboubeh Rouhollahei, Esmat Davoudi-Monfared, A. Shahriyari, M. S. Isfeedvajani","doi":"10.55453/rjmm.2023.126.1.5","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.1.5","url":null,"abstract":"\"Introduction: Following the crisis of coronavirus outbreak in numerous regions of the world, this epidemic enhanced promptly in most countries, including Iran, and sent a host of patients in need of medical services to hospitals. This study aimed to investigate the challenges of operational management of a reference military hospital during the pandemic COVID-19. Methods: This research is a qualitative study with the content analysis method with a deductive and guided approach. Data collection was conducted through a semi-structured interview method and utilizing a questionnaire designed based on the management functions of the Hospital Incident Command System (HICS). The targeted sampling method and participants in this study included senior-middle managers working in organizational positions of the reference hospital in 2020 employed during the organizational position in Covid-19 Pandemic. Classifications and coding were performed employing MAXQDA 2018 software. Results: The findings of this study were explored in the form of strengths, weaknesses, and challenges. Weaknesses included taking surprise, early and non-missionary entry into the COVID-19 crisis, lack of appropriate depot, instant management, deficiencies in the training of patients and staff, poor functioning of the crisis management system, deficiencies in monitoring, and poor provision of psychological support. The strengths were the devoted and altruistic presence of the medical staff and managers, the financial support of the headquarters, the effective field research of the management team of the organization, and the proper management of the volunteer forces. The most significant challenge was the poor coordination with the relevant organizations, including the headquarters, the Defense Organization, and the Ministry of Health. Conclusions: The findings of this study demonstrate that in the peak period of the COVID-19 pandemic to promote the operational management of the hospital, sticking to the general policies of the organization, structured coordination with internal and external organizations, organized management of equipment and human resources, generating a robust documentation structure and decision-making based on the evidence, effective and practical use of the crisis management system, systematic training of staff and patients, prioritizing the safety of patients and staff, organized dissemination of information and systematic monitoring as well as evaluation are the most significant points to deal with the epidemic crisis. \"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43993076","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}

{"title":"The Relationship Between the Tolerance for Uncertainty and Psychophysiological Qualities of Servicemen","authors":"V. Kalnysh, A. Shvets, O. Maltsev, O. Nagovitsyn","doi":"10.55453/rjmm.2023.126.1.6","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.1.6","url":null,"abstract":"\"The purpose of this study was to establish the relationship between the tolerance for uncertainty level and several psychophysiological and psychological qualities of military specialists for determining additional approaches to occupational selection. The study was conducted on a group of servicemen who performed special tasks and were capable of responding to terrorism – 49 men (main group) and 19 military doctors (control group) – men aged 25-34 years. Tolerance for uncertainty was studied based on the modified S. Badnder’s method. The level of manipulation score (MAC) was assessed by the adapted I.A. Romanova and O.O. Zhdanov questionnaire (estimated by the so-called \"\"MacScale\"\"). Psycho-physiological parameters were determined using a special computer program. Statistical analysis of data was performed by descriptive and nonparametric statistics, as well as a cluster, stepwise discriminant, and correlation analysis. A personality trait “tolerance for uncertainty” was valuable for the occupational activity of servicemen performing special tasks. The such feature had 63.3% of servicemen in the studied group. The specificity of the occupational activity of military doctors was the quality of manipulation of people. Moreover, those who were the most tolerant of uncertainty had an inverse relationship with Machiavellianism, which indicates the existence of compensatory psychological mechanisms balancing and harmonizing service and personal relationships among micro-teams of servicemen. Servicemen with a lower level of tolerance for uncertainty had positive relationships with several psychophysiological functions (strength and mobility of nervous processes, quality of dynamic memorization), which confirms the idea of psychophysiological mechanisms to enhance tolerance for uncertainty by increasing the working capacity of these people. Such personal quality as tolerance for uncertainty is a valuable occupationally important feature that allows performing the selection of servicemen who are more efficient and reliable in the performance of official duties tasks. \"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43152916","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}

{"title":"The Effect of Reciprocal Imitation Training on Increasing Expressive Vocabulary of Children with Autism Spectrum Disorders","authors":"Zahra Malmir, Nasibeh Soltani","doi":"10.55453/rjmm.2023.126.1.7","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.1.7","url":null,"abstract":"\"Objective: One of the areas of impairment in childhood autism spectrum disorders is delayed imitation. Due to the defect in the social function of imitation in these children and its negative consequences on lexical and verbal skills, Researchers in the field of educating autistic children consider increasing imitation skills to be a very important therapeutic goal. Previous studies have shown the effects of improving imitation on increasing the social, linguistic, and verbal skills of these children. In the present study, the effect of reciprocal imitation training on increasing the vocabulary of autistic children was investigated. Materials and Methods: This was an interventional study with a pretest-posttest design. 16 autistic children were trained in crossborder imitation based on expressive vocabulary in 96 sessions. After performing post-test and data collection in data analysis from the McNemar test to determine the changes of each word before and after the intervention and the Wilcoxon Marked Test was used to determine changes in vocabulary categories before and after the intervention and the level of statistical significance was considered (P> 0.05). Results: The results of data analysis show that the average number of responses \"\"expresses\"\" in each of the words after the intervention increased significantly in all vocabulary groups (P> 0.05). It seems that the intervention resulted in significant changes in participants. Conclusion: The results of this study show that teaching the method of reciprocal imitation has a significant effect on increasing the number of expressive words in autistic children. \"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45881357","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}

{"title":"The Endocrine Approach of Melanoma: The Puzzle of Estrogen Receptors Expression","authors":"F. Șandru, A. Popa, M. Dumitrașcu, Ruxandra D. Sinescu-Bălțăteanu, Ș. Bucur, M. Carsote","doi":"10.55453/rjmm.2023.126.1.4","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.1.4","url":null,"abstract":"\"Melanoma outcome seems different between females and males, with a potential protective role of estrogen (E) through estrogen receptors (ER) expression into the tumor. In the study of ERs, both alfa (ERα) and beta (ERβ) is a well-known endocrine elements in non-melanoma tumors, like mammary and endometrial cancer. Immunohistochemistry (IHC) assessment of melanoma concerning ERs represents a path to explore the tumor profile to provide useful information concerning the prognostic and potential adjuvant treatment. Currently, this is not a routine practice, nor a mandatory step for deciding the medical therapy. Typically, IHCs are based on usual kits for mammary tumors regarding ERs configuration. Prior/concomitant use of oral contraceptives and hormonal replacement therapy is not correlated with a better prognostic in melanoma; neither have they represented a contraindication for survivors of melanoma; a subset of tumors might present a higher ER expression which is potentially targeted by the hormone-based treatment as SERMs (Selective Estrogen Receptors Modulator), for instance, tamoxifen. Experimental studies on melanoma cell lines confirmed the anti-tumor activity of ERβ which might function as a prognostic marker. G-protein-coupled estrogen receptors in melanocytes and keratinocytes might be involved, too. Additional crosstalk of TGF-β (Transforming Growth Factor β), respective IGF1 (Insulin-like Growth Factor), and ERα expression are involved in tumorigenic pathways. Recent preclinical studies showed the potential benefits of diarylpropionitrile, a selective agonist of ERβ; pyrazole derivates 21-23 can block ERs. Murine melanoma models showed the interference of anti-estrogenic medication (like molecule fulvestrant) to enhance immune checkpoint blockade, a modern approach to solid cancers. The proliferation of melanoma might be partially explained by ERs; whether this is generally applicable or there is a subgroup of tumors particularly related to E status is still debatable. The subject of E status in melanoma is far from clear at this point and further studies are necessary concerning this particular issue to implement it as a practical approach in the daily management of a disease that still has a very severe prognostic nowadays \"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48369279","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}

{"title":"Dichotomisation of Rotator Cuff Tendinopathy in Shoulder MRIs Reveals the Need for Further Diagnostic Improvements: A Cohort Study","authors":"G. Avram, A. Stefan, Miruna Harabagiu, D. Cuzino, Szekely Tamas, Szekely Lazlo, F. Săvulescu, Ș. Mitulescu, E. Cernat","doi":"10.55453/rjmm.2023.126.1.3","DOIUrl":"https://doi.org/10.55453/rjmm.2023.126.1.3","url":null,"abstract":"\"Background: Rotator cuff tendinopathy is most often described as a continuum between the normal cuff and rotator cuff tears with calcific tendinitis having its place along this continuum. Although many studies have focused on the role of magnetic resonance imagining (MRI) in diagnosing the extent of rotator cuff tears and their associated findings with good interobserver reliability, the same cannot be stated about MRI tendinopathy findings. Because of this discrepancy in diagnostic reliability, tendinopathy tends to be overtreated with injections when associated with symptoms, thus potentially increasing the risk of calcific tendinitis and progression toward rotator cuff tears. This study aims to assess whether diagnosing shoulder MRI tendinopathy patterns through dichotomization can accelerate clinical progress toward consensus. Methods: This study is a large retrospective cohort of 184 patients that underwent a 1.5T shoulder MRI for shoulder pain. Inclusion criteria were acromioclavicular arthrosis diagnosed in patients of any age. Exclusion criteria were partial or complete rotator cuff tears. Tendinopathy was considered the dependent variable and registered as a dichotomous variable while acromioclavicular joint arthrosis together with gender was categorical and age was the continuous variable. An attempt was made to generate a clinically significant binary logistic regression to assess the odds ratio of diagnosing tendinopathy based on age, gender, and acromioclavicular joint arthrosis status. Results: An overwhelming proportion of patients was positive for tendinopathy findings (95.11%). 64.12% of patients were within the active age group with patients within the 50-59 group being diagnosed the most with rotator cuff tendinopathy. Conclusions: Due to the high variability of MRI findings that can be considered positive for rotator cuff tendinopathy, an overwhelming skew toward a positive diagnosis was observed, thus dichotomizing tendinopathy diagnosis is not appropriate for clinically relevant conclusion-making \"","PeriodicalId":21298,"journal":{"name":"Romanian Journal of Military Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44812130","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}