Romanian Journal of Internal Medicine最新文献

{"title":"Polypharmacy and Potentially Inappropriate Medications: Cognitive Consequences in Older Heart Failure Outpatients.","authors":"Dina Aprillia Ariestine, Salomo Malkysua Sinamo","doi":"10.2478/rjim-2026-0021","DOIUrl":"https://doi.org/10.2478/rjim-2026-0021","url":null,"abstract":"<p><strong>Introduction: </strong>Cognitive impairment is prevalent among older heart failure (HF) outpatients. Polypharmacy and potentially inappropriate medications (PIMs) may contribute to cognitive vulnerability, yet evidence using the Beers Criteria 2023 with locally validated cognitive screening in Indonesia remains limited.</p><p><strong>Methods: </strong>A cross-sectional analytic study enrolled 107 consecutive HF outpatients aged 60 years or older at a tertiary teaching hospital in Medan, North Sumatra, Indonesia (August to October 2025). Polypharmacy was categorized as non-polypharmacy, polypharmacy, or hyperpolypharmacy. PIM exposure was classified by Beers Criteria 2023. Cognitive function was assessed by MoCA-INA v7.1. Proportional-odds ordinal logistic regression was used with collinearity assessed by variance inflation factors.</p><p><strong>Results: </strong>Mean age was 67.6±6.2 years; 59 (55%) were female. Polypharmacy (72%) and hyperpolypharmacy (23%) were prevalent; severe PIM exposure occurred in 39%. Mean MoCA-INA was 22.0±3.3; 78% had mild cognitive impairment and 10% had mild to moderate dementia. Cognitive category correlated with polypharmacy (ρ=0.276; p=0.004) and PIM level (ρ=0.264; p=0.006). All VIFs were below 1.5. In the fully adjusted model, education was independently protective (aOR 0.82 per year; 95% CI 0.68 to 0.99; p=0.04) and HFrEF was associated with worse cognition (aOR 6.10; 95% CI 1.25 to 29.87; p=0.03). Polypharmacy (aOR 2.88; p=0.10) and PIM burden (aOR 1.70; p=0.10) showed directionally consistent but inconclusive adjusted associations (Nagelkerke R²=0.368).</p><p><strong>Conclusion: </strong>Higher medication burden and Beers-2023 PIM exposure were associated with worse cognitive status in unadjusted analyses; adjusted models showed directionally consistent but statistically inconclusive associations (polypharmacy aOR=2.88, p=0.099; PIM burden aOR=1.70, p=0.098). HFrEF was the most robust independent predictor of worse cognitive status (aOR 6.10; 95% CI 1.25 to 29.87; p=0.03), consistent across all three adjusted models. Education was independently protective. Routine cognitive screening integrated with structured medication review is warranted in HF outpatient care, with particular attention to patients with HFrEF phenotype.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114464","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":"Real-World Effectiveness of Biologic Therapy in Patients with Psoriasis: Metabolic Comorbidities and Treatment Outcomes.","authors":"Adelina F Ghilencea, Daniel O Costache, Constantin Căruntu, Cristian Scheau, Ilinca Savulescu-Fiedler, Ioana Dicu-Andreescu, Damian Cojocaru, Raluca S Costache","doi":"10.2478/rjim-2026-0020","DOIUrl":"https://doi.org/10.2478/rjim-2026-0020","url":null,"abstract":"<p><strong>Introduction: </strong>Psoriasis is a chronic systemic inflammatory disease, frequently associated with metabolic comorbidities that may influence therapeutic outcomes. Real-world evidence on the effectiveness of biologic therapy in this complex clinical context remains limited.</p><p><strong>Objectives: </strong>To assess the prevalence of comorbidities in patients with psoriasis receiving biologic therapy and to identify factors associated with treatment response.</p><p><strong>Methods: </strong>A retrospective observational study including 121 patients with chronic plaque psoriasis. Demographic data, comorbidities, biologic treatment class, and PASI/DLQI evolution at baseline and at standardized 6 and 12 months assessments was analyzed, together with the latest available clinical assessment recorded in 2025 after variable treatment durations.</p><p><strong>Results: </strong>Comorbidities were present in 84.3% of patients, most frequently hepatic steatosis (73.6%), obesity (45.5%), hypertension (41.3%), and diabetes (19%). A significant improvement in PASI and DLQI scores was observed at all follow-up points (p < 0.001). Complete skin clearance (PASI 100) was achieved by 18.1% of the patients at 6 months and by 44.6% at 12 months. In multivariable logistic regression analysis, lower PASI scores at six months were independently associated with a higher likelihood of achieving PASI 100 at one year.</p><p><strong>Conclusions: </strong>Biologic therapy was associated with marked clinical and quality-of-life improvement. Although metabolic comorbidities were highly prevalent, no significant association between metabolic comorbidities and PASI 100 response at one year was identified in the analyses performed.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025874","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":"A Novel Metabolic Liver Fibrosis Risk Score for the Identification of Elevated Liver Stiffness in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Pilot Study.","authors":"Szymon Suwała, Paweł Rajewski, Roman Junik","doi":"10.2478/rjim-2026-0019","DOIUrl":"https://doi.org/10.2478/rjim-2026-0019","url":null,"abstract":"","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148970986","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":"Forced Vital Capacity and Six-Minute Walk Test as Indicators of Interstitial Lung Disease Extent on High-Resolution Computed Tomography in Systemic Sclerosis.","authors":"Sahat Halim, Cleopas Martin Rumende, Rm Suryo Anggoro Kusumo Wibowo, Aulia Rizka, Gurmeet Singh, Mohamad Syahrir Azizi, Kaka Renaldi, Saut Horas Hatoguan Nababan, Kuntjoro Harimurti","doi":"10.2478/rjim-2026-0018","DOIUrl":"https://doi.org/10.2478/rjim-2026-0018","url":null,"abstract":"<p><strong>Introduction: </strong>Interstitial lung disease (ILD) is a leading cause of morbidity and mortality in systemic sclerosis (SSc). High-resolution computed tomography (HRCT) is the gold standard for assessing ILD extent but is limited by cost, availability, and radiation exposure. Practical functional tools are thus needed to identify extensive ILD in routine practice.</p><p><strong>Methods: </strong>This cross-sectional study enrolled adult patients with SSc-associated ILD at a tertiary referral hospital in Jakarta, Indonesia. All participants underwent spirometry and the six-minute walk test (6MWT). Forced vital capacity (FVC), 6MWT distance, and exertional oxygen desaturation were evaluated. ILD extent on HRCT was classified as non-extensive (<20%) or extensive (≥20%). Associations were analyzed using bivariate analysis, receiver operating characteristic (ROC) curves, and multivariable Poisson regression with robust standard errors.</p><p><strong>Results: </strong>A total of 83 patients were included; 21 (25%) had extensive ILD. Six-minute walk test distance did not differ significantly between groups (p = 0.492; AUC 0.550). Exertional oxygen desaturation ≥4% and FVC <70% predicted were each significantly associated with extensive ILD. FVC alone achieved an AUC of 0.795, whereas adding 6MWT distance resulted in only a marginal improvement in discrimination (AUC 0.799; ΔAUC 0.005), with adequate calibration and stable internal validation.</p><p><strong>Conclusion: </strong>FVC alone may serve as a practical functional indicator of ILD extent, particularly where HRCT access is limited. Routine addition of 6MWT distance is not justified solely for estimating ILD extent, although the 6MWT remains valuable for assessing functional capacity and exertional desaturation.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907001","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":"Primary Angiitis of the Central Nervous System: A Medical Mystery.","authors":"Seby Robert, Reddy Deepica, Ketty Arpitha, Claire Wilson","doi":"10.2478/rjim-2026-0017","DOIUrl":"https://doi.org/10.2478/rjim-2026-0017","url":null,"abstract":"<p><p>Primary angiitis of the central nervous system is an extremely rare diagnosis, with an incidence of 2.4 cases per 1,000,000 person-years. The exact cause of PACNS remains unknown, and typically cases present with a long prodrome. It is a diagnosis of exclusion, and various infectious, autoimmune, and malignant processes must be excluded prior to final diagnosis. Given the rarity of this condition, there is often a delay in diagnosis that can range from 6 to 23 months. It is imperative that all clinical providers be aware of this diagnosis when managing patients who present with insidious and non-specific neurological symptoms. We present a case of PACNS that responded well to a therapeutic regimen of high-dose steroids and cyclophosphamide.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679866","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":"Cotton wool spots as the only fundoscopic manifestation of giant cell arteritis: A scoping review.","authors":"Ioana Teodora Vladareanu, Raluca Claudia Iancu, Ruxandra Coroleuca, Dan George Deleanu, Alexandra Vrapciu, Radu Zorel Filipescu, Andrada Elena Mirescu-Deleanu, Alina Popa-Cherecheanu","doi":"10.2478/rjim-2026-0016","DOIUrl":"https://doi.org/10.2478/rjim-2026-0016","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to review and describe isolated cotton wool spots (CWS) on retinal examination in patients with systemic or occult presentation of giant cell arteritis (GCA).</p><p><strong>Material and methods: </strong>In this scoping review, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Extension for Scoping Reviews, PubMed, Scopus, and Web of Science were searched for peer-reviewed articles reporting an association between GCA and CWS from 1960 to 13^th of June 2026. Case reports and case series of confirmed GCA with CWS as the sole fundoscopic finding were included. Data were charted independently by two reviewers using a standardized Excel extraction form.</p><p><strong>Results: </strong>Sixteen articles, including fifteen case reports and one case series, were included in the study. 76.19% of patients had concurrent systemic symptoms, while the remaining 23.81% had an occult presentation. Patients with occult GCA tended to be younger at presentation compared with those with systemic disease. No difference in inflammatory markers was observed between the occult and the systemic presentation of the disease.</p><p><strong>Conclusion: </strong>This review summarizes the current evidence and characteristics of CWS as an isolated retinal manifestation of GCA. The included evidence suggests that this atypical presentation may occur even in the absence of systemic symptoms, highlighting the importance of early clinical recognition, as delayed diagnosis may lead to irreversible visual loss.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797801","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":"Withdrawal <i>versus</i> continuation of guideline-directed medical therapy in heart failure with improved ejection fraction: a systematic review and meta-analysis.","authors":"Juan Camilo Hernández Jaramillo, Juan Esteban Suárez Muñoz, María Cristina Oviedo Arroyo, María José Díaz Gutiérrez, Gloria Ibis Tirado Romero","doi":"10.2478/rjim-2026-0015","DOIUrl":"10.2478/rjim-2026-0015","url":null,"abstract":"<p><strong>Background: </strong>Heart failure with improved ejection fraction (HFimpEF) is characterized by recovery of left ventricular systolic function after treatment for heart failure with reduced ejection fraction. The safety of withdrawing guideline-directed medical therapy (GDMT) after recovery remains uncertain.</p><p><strong>Objective: </strong>To evaluate the effects of GDMT withdrawal versus continuation in patients with recovered or improved left ventricular systolic function.</p><p><strong>Methods: </strong>A systematic review was conducted according to PRISMA 2020 guidelines. MEDLINE, Embase, LILACS, and the Cochrane Central Register of Controlled Trials were searched through March 2025. Comparative studies evaluating GDMT withdrawal versus continuation in HFimpEF were included. The primary outcome was relapse of left ventricular systolic dysfunction. Secondary outcomes were heart failure hospitalization, mortality, and quality of life.</p><p><strong>Results: </strong>Eight studies were included. Relapse of left ventricular dysfunction occurred in up to 58% of patients after therapy withdrawal in recovered dilated cardiomyopathy, whereas most patients with atrial fibrillation-mediated cardiomyopathy maintained preserved ventricular function during short-term follow-up. In a meta-analysis of three prospective studies (n = 133), GDMT withdrawal was associated with a significantly increased risk of relapse compared with continued therapy (OR 15.37, 95% CI 2.75-85.82; I² = 0%). Observational studies consistently reported higher rates of heart failure hospitalization and adverse cardiovascular outcomes after treatment withdrawal.</p><p><strong>Conclusions: </strong>GDMT withdrawal may increase the risk of recurrent ventricular dysfunction and adverse cardiovascular outcomes in HFimpEF. The available evidence supports continuation of therapy in most patients, although further randomized studies are needed to identify patients who may safely discontinue treatment.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":"173-182"},"PeriodicalIF":1.6,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562888","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":"Severe persistent hypereosinophilia of undetermined significance: diagnostic challenges in clinical practice and two-year follow-up.","authors":"Polliana Mihaela Leru, Vlad Florin Anton, Daniela Georgeta Georgescu","doi":"10.2478/rjim-2026-0014","DOIUrl":"10.2478/rjim-2026-0014","url":null,"abstract":"<p><strong>Background: </strong>Hypereosinophilia of undetermined significance (HE-US) represents a rare subtype of hypereosinophilia (HE) defined by a persistent absolute eosinophil count (AEC) ≥ 1500/uL without an identifiable reactive or clonal cause, and importantly, without evidence of eosinophil-mediated end-organ damage. Long-term structured follow-up is essential due to its unpredictable outcome and the risk of transition into overt hypereosinophilic syndrome (HES) or occult malignancies.</p><p><strong>Case presentation: </strong>We report the case of a 47-year-old woman with severe, persistent blood hypereosinophilia (up to 13600/uL) accompanied by chronic inconstant fixed erythematous-violaceous skin lesions. Extensive diagnostic evaluation for secondary, autoimmune, and clonal etiologies was negative, including fluorescence in situ hybridization (FISH) for FIP1L1-PDGFRA mutation. Bone marrow biopsy showed granulocytic hyperplasia with eosinophils <10% and mild reticulin fibrosis (MF-1). Whole-body computed tomography (CT) revealed small generalized lymphadenopathy (≤ 11 mm) without parenchymal infiltration. The patient declined lymph-node biopsy. Although skin biopsy revealed eosinophilic infiltration, it was characterized as a non-specific reactive pattern without objective evidence of eosinophil-mediated cytotoxicity. The case was provisionally diagnosed as HE-US, acknowledging that lymphoproliferative disease could not be definitively excluded in the absence of the lymph-node biopsy. Intermittent systemic corticosteroids provide rapid hematologic response, but prompted immediate recurrence when tapered.</p><p><strong>Conclusion: </strong>The reported case underscores the diagnostic complexity and difficulties in managing hypereosinophilia of undetermined significance in clinical practice. While current evidence suggests a generally benign course, rare progression to hypereosinophilic syndrome or other malignancies requires structured long-term monitoring and individualized therapeutic decision-making.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":"221-229"},"PeriodicalIF":1.6,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309344","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":"Immune Checkpoint Inhibitor-Associated Myocarditis: A Retrospective Case Series.","authors":"Michael Acevedo Monsanto, Artur Schneider, Razvan M Chirila, Paulamy Ganguly, Camily Morales Lopez, Eric C Zuberi","doi":"10.2478/rjim-2026-0013","DOIUrl":"10.2478/rjim-2026-0013","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) improve outcomes across malignancies but can cause immune-related adverse events (irAEs), notably myocarditis, with case-fatality up to 50%.</p><p><strong>Methods: </strong>We retrospectively reviewed five patients with potential ICI-associated myocarditis treated at Mayo Clinic Florida (2019-2024) and summarize the existing literature. Cases were retrospectively categorized as definite, probable, or possible myocarditis according to cardiac magnetic resonance (CMR) findings and histopathology when available.</p><p><strong>Results: </strong>The median age was 74 years, and four of the five patients were male. Myocarditis developed between 5 and 30 days after initiation of anti-PD-1 therapy. Presentations included dyspnea (three patients), chest pain (one patient), and asymptomatic troponin elevation detected on routine monitoring (one patient). Troponin T elevation above the 99th percentile was seen in all five cases (normal <15 ng/L). Electrocardiograms (ECG) demonstrated conduction abnormalities or ventricular ectopy in each patient. Left ventricular ejection fraction was preserved in four patients and severely reduced in one. CMR provided findings supportive of myocarditis in two of the five cases, while one endomyocardial biopsy (EMB) was performed and did not demonstrate active inflammation. Based on predefined criteria, one case was classified as definite myocarditis, one as probable, and three as possible ICI-associated myocarditis. All five patients received corticosteroid therapy. Two required escalation of immunosuppression. One patient developed concurrent myasthenia gravis, consistent with myocarditis-myositis-myasthenia (MMM) overlap, and underwent plasmapheresis for the neuromuscular component. Three patients recovered. Two patients died during follow-up; in both cases, myocarditis was considered a contributing factor, although direct causality could not be definitively established.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":"213-220"},"PeriodicalIF":1.6,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296131","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":"Clinical construct validity and subgroup stability of the Romanian version of the Boston Carpal Tunnel Questionnaire in nerve-conduction-confirmed carpal tunnel syndrome - a cross-sectional study.","authors":"Daniela Nicoleta Popescu, Claudiu Popescu, Oana Morari, Natalia Blidaru, Alice Rakoczy, Magda Ileana Parvu, Cătălin Codreanu, Luminița Enache","doi":"10.2478/rjim-2026-0012","DOIUrl":"10.2478/rjim-2026-0012","url":null,"abstract":"<p><strong>Introduction: </strong>The Romanian Boston Carpal Tunnel Questionnaire (BCTQ) has been linguistically and internally validated, but data on clinical construct validity and subgroup stability in routine practice are limited. This study evaluated its performance in a consecutive outpatient sample of patients with idiopathic, electrophysiology-confirmed carpal tunnel syndrome (CTS) after exclusion of major secondary causes.</p><p><strong>Methods: </strong>In this cross-sectional study, consecutive patients with idiopathic CTS diagnosed according to AAOS guidelines and confirmed by nerve conduction studies (NCS) were included. Clinical examination, grip strength testing, BCTQ, EQ-5D-5L (analyzed as an exploratory unweighted severity index), and electrophysiological assessment were performed within 7 days. Hand-level analyses were conducted using linear mixed-effects models to account for within-patient correlation and to assess associations with demographic and clinical variables.</p><p><strong>Results: </strong>A total of 193 hands met electrodiagnostic criteria for CTS. Overall BCTQ scores did not differ significantly across age, sex, or education groups. SSS and FSS correlated with grip strength (ρ = -0.16/-0.39; p < 0.03), sensory and motor conduction velocities (SCV ρ = -0.33/-0.31; MCV ρ = -0.19/-0.27; p ≤ 0.012), unweighted EQ-5D-5L severity index (ρ = 0.38/0.59; p < 0.001), and the presence of Tinel's and Phalen's signs. Higher BCTQ scores were associated with worse NCS grades. In multivariable models, grip strength, nerve velocities, EQ-5D-5L, and clinical signs remained significant predictors (all p < 0.001).</p><p><strong>Conclusions: </strong>The Romanian BCTQ demonstrates expected associations with clinical, electrophysiological, and patient-reported measures, supporting its use as a complementary PRO in CTS assessment.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":"199-212"},"PeriodicalIF":1.6,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148034584","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}