Romanian Journal of Internal Medicine最新文献_第10页

Hyper-inflammation after COVID-19 mARN vaccination: at the crossroads of multisystem inflammatory disease and adult-onset Still's disease. Does terminology matter? COVID-19 - mARN疫苗接种后的高度炎症:处于多系统炎症性疾病和成人发病斯蒂尔氏病的十字路口术语重要吗?

IF 1.9

Romanian Journal of Internal Medicine Pub Date : 2022-03-17 Print Date: 2022-03-01 DOI: 10.2478/rjim-2021-0035

Cristian Baicus, Caterina Delcea, Larisa Pinte, Gheorghe Andrei Dan

{"title":"Hyper-inflammation after COVID-19 mARN vaccination: at the crossroads of multisystem inflammatory disease and adult-onset Still's disease. Does terminology matter?","authors":"Cristian Baicus, Caterina Delcea, Larisa Pinte, Gheorghe Andrei Dan","doi":"10.2478/rjim-2021-0035","DOIUrl":"https://doi.org/10.2478/rjim-2021-0035","url":null,"abstract":"As the pandemic evolves, different facets of the SARS-CoV-2 infection, as well as immunization, with varying complexity and prognostic implications are discovered. One of them is the multisystem inflammatory syndrome (MIS)[1]. Characterized by elevated ferritin levels and hyper-inflammation with vital implications, MIS was proposed as the fifth clinical entity to constitute the “hyperferritinaemic syndromes”, alongside the macrophage activation syndrome (MAS), adult-onset Still’s disease (AOSD), catastrophic anti-phospholipid syndrome and septic shock [2]. Although most reports were related to SARS-COV-2 infection, MIS was recently described in relation to COVID-19 vaccination as well [3]. We hereby report the case of a previously healthy 22-year-old male, who received the first dose of BNT162b2 vaccine on May 1 2021. Thirteen days after vaccination, he developed a hyperinflammatory state, fulfilling the criteria for adult multisystem inflammatory syndrome (MIS-A) [2] (fever, sore throat, myalgias, myocarditis, hepatic injury, maculo-papular rash, diarrhoea, hypotension, and highly elevated inflammatory markers including a procalcitonin level of 33 ng/ml). He was initially admitted in another hospital’s Cardiology department with a diagnosis of acute coronary syndrome. At that moment the patient presented with chest pain, ST elevation on ECG, high troponin level, segmental left ventricular hypokinesia, and mid-range ejection fraction. The coronary angiography was normal,","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":"60 1","pages":"3-5"},"PeriodicalIF":1.9,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39406490","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}

引用次数: 19

The frailty phenotype in hemodialysis patients and its association with biochemical markers of mineral bone disorder, inflammation and nutrition. 血液透析患者的脆弱表型及其与骨矿物质紊乱、炎症和营养生化指标的关系。

IF 1.9

Romanian Journal of Internal Medicine Pub Date : 2022-03-17 Print Date: 2022-03-01 DOI: 10.2478/rjim-2021-0030

Alma Mutevelić-Turković, Halima Resić, Badema Čengić Roljić, Amela Dervišević, Amela Bećiragić

{"title":"The frailty phenotype in hemodialysis patients and its association with biochemical markers of mineral bone disorder, inflammation and nutrition.","authors":"Alma Mutevelić-Turković, Halima Resić, Badema Čengić Roljić, Amela Dervišević, Amela Bećiragić","doi":"10.2478/rjim-2021-0030","DOIUrl":"https://doi.org/10.2478/rjim-2021-0030","url":null,"abstract":"Introduction: Frailty is a state of increased vulnerability to physical stressors. It is common in patients with end-stage renal disease (ESRD) who are on hemodialysis (HD).The aim of this study was to analyze the presence of frailty phenotype among HD patients and to evaluate their interrelationship with different biochemical markers.Methods: For the frailty assessment the Frailty Phenotype by Fried et al. was used, where frailty was reported if three of the following criteria were met: unintentional weight loss, self-reported exhaustion, weakness, slow walking speed and low physical activity. From 281 HD patients, 126 patients were frail, 58 were pre-frail (two criteria were met) and the rest of the study population were robust (97 patients). BMI was calculated for all patients and venous blood samples were taken to determine laboratory parameters for bone alkaline phosphatase (BAP), phosphate (P), potassium (K), C-reactive protein (CRP) and albumin.Results: Patients who were on HD longer than 60 months have more characters of frailty. (p=0.019). A statistically significant positive correlations between frailty score and BAP (rho = 0.189; p = 0.001), and CRP (rho = 0.233; p < 0.001) were observed, and significant negative correlations between frailty score and albumin (rho = - 0.218; p < 0.001) and K (rho = - 0.198; p = 0.001).Conclusions: The associations of frailty with markers of mineral bone disorder, inflammation and nutrition indicate the importance of these parameters in the indirect assessment of the frailty phenotype in HD patients.","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":"60 1","pages":"42-48"},"PeriodicalIF":1.9,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39264374","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}

引用次数: 3

A practical review of diabetes mellitus type 2 treatment in primary care. 初级保健中2型糖尿病治疗的实践综述。

IF 1.9

Romanian Journal of Internal Medicine Pub Date : 2022-03-17 Print Date: 2022-03-01 DOI: 10.2478/rjim-2021-0031

Justin T Call, Pedro Cortés, Dana M Harris

引用次数: 2

Imaging characteristics of nontuberculous mycobacterial pulmonary nodules. 非结核性分枝杆菌肺结节的影像学特征。

IF 1.9

Romanian Journal of Internal Medicine Pub Date : 2021-11-20 Print Date: 2021-12-01 DOI: 10.2478/rjim-2021-0016

Kengo Nishino, Kesato Iguchi, Osamu Ishibashi, Yuika Sasatani, Gen Ohara, Katsunori Kagohashi, Hiroaki Satoh

{"title":"Imaging characteristics of nontuberculous mycobacterial pulmonary nodules.","authors":"Kengo Nishino, Kesato Iguchi, Osamu Ishibashi, Yuika Sasatani, Gen Ohara, Katsunori Kagohashi, Hiroaki Satoh","doi":"10.2478/rjim-2021-0016","DOIUrl":"https://doi.org/10.2478/rjim-2021-0016","url":null,"abstract":"Abstract Introduction. Nontuberculous mycobacteriosis (NTM) of the lungs can develop nodules. In order to clarify some of the characteristics of lung NTM nodules, we examined volume doubling time (VDT) and maximum standardized uptake value (SUVmax) in positron emission tomography (PET) of pathologically diagnosed NTM nodules. Methods. From November 2012 to August 2018, clinical and radiological information were retrospectively investigated in eight patients who were surgically resected and diagnosed as NTM. These eight patients were followed up until November 2020 and were confirmed to have no appearance of lung cancer or reappearance of lung NTM nodules. The VDT was calculated using the Schwartz formula. Results. The median maximum diameter of the nodule at the time of the first CT scan was 16.0 (range: 9.9–20.0) mm. The median maximum diameter of the nodule on CT performed before the surgical biopsy was 18.8 (range: 10.4–32.8) mm. The median doubling time calculated from these results was 203 (range: 20–568) days. Caseous granulomas and acid-fast bacilli were histologically confirmed in all eight patients. Culture of excised nodules revealed Mycobacterium intracellulare in five patients and Mycobacterium avium in three patients. Six patients received PET, and median SUVmax was: 7.0 (range: 3.3–21.0). Median VDT was around 200 days. Some patients had irregular-shaped nodules. Conclusions. CT/PET-CT characteristics of lung nodules are not reliable in differentiating lung NTM nodules from malignant ones. To avoid unnecessary resection, it may be better to collect various information on imaging findings in the nodule itself and in opacities other than the nodule.","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":"59 4","pages":"369-374"},"PeriodicalIF":1.9,"publicationDate":"2021-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38867544","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}

引用次数: 0

Evaluation of severity scoring systems in patients with severe community acquired pneumonia. 重度社区获得性肺炎患者严重程度评分系统的评价。

IF 1.9

Romanian Journal of Internal Medicine Pub Date : 2021-11-20 Print Date: 2021-12-01 DOI: 10.2478/rjim-2021-0025

Katerina Spasovska, Krsto Grozdanovski, Zvonko Milenkovic, Mile Bosilkovski, Marija Cvetanovska, Nikola Kuzmanovski, Kosta Kapsarov, Emilija Atanasovska

{"title":"Evaluation of severity scoring systems in patients with severe community acquired pneumonia.","authors":"Katerina Spasovska, Krsto Grozdanovski, Zvonko Milenkovic, Mile Bosilkovski, Marija Cvetanovska, Nikola Kuzmanovski, Kosta Kapsarov, Emilija Atanasovska","doi":"10.2478/rjim-2021-0025","DOIUrl":"https://doi.org/10.2478/rjim-2021-0025","url":null,"abstract":"Background. The aim of this study was to evaluate the ability of severity scoring systems to predict 30-day mortality in patients with severe community-acquired pneumonia. Methods. The study included 98 patients aged ≥18 years with community acquired pneumonia hospitalized at the Intensive Care Unit of the University Clinic for Infectious Diseases in Skopje, Republic of North Macedonia, during a 3-year period. We recorded demographic, clinical and common biochemical parameters. Five severity scores were calculated at admission: CURB 65 (Confusion, Urea, Respiratory Rate, Blood pressure, Age ≥65 years), SCAP (Severe Community Acquired Pneumonia score), SAPS II (Simplified Acute Physiology Score), SOFA (Sequential Organ Failure Assessment Score) and MPM (Mortality Prediction Model). Primary outcome variable was 30-day in-hospital mortality. Results. The mean age of the patients was 59.08 ± 15.76 years, predominantly males (68%). The overall 30-day mortality was 52%. Charlson Comorbidity index was increased in non-survivors (3.72 ± 2.33) and was associated with the outcome. All severity indexes had higher values in patients who died, that showed statistical significance between the analysed groups. The areas under curve (AUC) values of the five scores for 30-day mortality were 0.670, 0.732, 0,726, 0.785 and 0.777, respectively. Conclusion. Widely used severity scores accurately detected patients with pneumonia that had increased risk for poor outcome, but none of them individually demonstrated any advantage over the others.","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":"59 4","pages":"394-402"},"PeriodicalIF":1.9,"publicationDate":"2021-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39035764","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}

引用次数: 1

Healthcare-associated Clostridioides difficile infection during the COVID-19 pandemic in a tertiary care hospital in Romania. 罗马尼亚一家三级保健医院COVID-19大流行期间与医疗保健相关的艰难梭菌感染

IF 1.9

Romanian Journal of Internal Medicine Pub Date : 2021-11-20 Print Date: 2021-12-01 DOI: 10.2478/rjim-2021-0020

Eliza Manea, Raluca Jipa, Alexandru Milea, Antonia Roman, Georgiana Neagu, Adriana Hristea

{"title":"Healthcare-associated Clostridioides difficile infection during the COVID-19 pandemic in a tertiary care hospital in Romania.","authors":"Eliza Manea, Raluca Jipa, Alexandru Milea, Antonia Roman, Georgiana Neagu, Adriana Hristea","doi":"10.2478/rjim-2021-0020","DOIUrl":"https://doi.org/10.2478/rjim-2021-0020","url":null,"abstract":"Introduction. Information on healthcare-associated C.difficile infection (HA-CDI) in COVID-19 patients is limited. We aimed to assess the characteristics of HA-CDI acquired during and before the COVID-19 pandemic. Methods. We conducted a retrospective study in a tertiary care hospital, in which since March 2020 exclusively COVID-19 patients are hospitalized. We compared HA-CDI adult patients hospitalized in March 2020-February 2021 with those hospitalized during the same period in 2017-2018. Results. We found 51 cases during 2020-2021 (COVID-19 group), incidence 5.6/1000 adult discharge and 99 cases during 2017-2018 (pre-COVID-19 group), incidence 6.1/1000 adult discharge (p=0.6). The patients in COVID-19 group compared to pre-COVID-19 group were older (median age 66 vs 62 years), with similar rate of comorbidities, but with higher rate of cardiovascular diseases (62.7% vs 42.4%) and less immunosuppression (21.6% vs 55.6%), they had a higher proton pump inhibitors use (94.1% vs 32.3%), and a longer hospitalization (median 19 vs 14 days). Eighty-five (85.9%) patients in pre-COVID-19 group versus 44 (86.3%) patients in COVID-19 group received antimicrobial treatment - mainly cephalosporins (34,1%), quinolones (22,3%) and glycopeptides (21,1%) in pre-COVID-19 group and mainly cephalosporins and macrolides (63,6% each) in COVID-19 group. We found four HA-CDI-related deaths in pre-COVID-19 group and none in the COVID-19 group. Conclusions. The HA-CDI incidence in COVID-19 group did not change versus the same period of time during 2017-2018. The antibiotic use was the most important factor associated with HA-CDI. We identified a high use of broad-spectrum antibiotics despite the lack of empirical antimicrobial recommendations in COVID-19.","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":"59 4","pages":"409-415"},"PeriodicalIF":1.9,"publicationDate":"2021-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39032499","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}

引用次数: 9

The relationship of vitamin D deficiency with severity and outcome of acute stroke. 维生素D缺乏与急性脑卒中严重程度及转归的关系。

IF 1.9

Romanian Journal of Internal Medicine Pub Date : 2021-11-20 Print Date: 2021-12-01 DOI: 10.2478/rjim-2021-0013

Reza Ebrahimi Rad, Mohammadreza Zarbakhsh, Samira Sarabi

{"title":"The relationship of vitamin D deficiency with severity and outcome of acute stroke.","authors":"Reza Ebrahimi Rad, Mohammadreza Zarbakhsh, Samira Sarabi","doi":"10.2478/rjim-2021-0013","DOIUrl":"https://doi.org/10.2478/rjim-2021-0013","url":null,"abstract":"Background. There are currently conflicting results regarding the link between vitamin D deficiency and the increased risk for stroke and its poor prognosis. The present study aimed to assess the relationship between vitamin D deficiency and prognosis of acute stroke. Methods. This bi-center cross-sectional study was performed on 140 consecutive patients who referred to two general hospitals in Iran with the diagnosis of acute stroke. The levels of 25-hydroxy vitamin D were evaluated by Electrochemiluminescence (ECL) technique. Clinical severity of stroke on admission as well as on discharge time were evaluated using the National Institutes of Health Stroke Scale (NIHSS) or Modified Rankin (mRS) tools. Results. Mean serum level of vitamin D was 25.51 ± 18.87 ng/mL, ranging from 3.0 to 98.6 ng/ml. There was a significant difference between the two groups (with and without vitamin D deficiency) in terms of stroke severity and disability, as reflected by mRS (P=0.003) and NIHSS evaluation (14.24 ± 9.23 versus 9.73 ± 7.36, P=0.003). Also, regarding patients' clinical condition, the mean NIHSS score in those with deficient and normal levels of vitamin D was 14.24 ± 9.23 and 9.73 ± 7.36, respectively with NIHSS score > 5 in 76.1% and 61.5%, respectively (P = 0.003). Conclusion. According to the results of study, vitamin D status can be related to the severity of stroke. However, considering the cross-sectional design of our study, it could not point out the causality between vitamin D deficiency and acute stroke and further studies are warranted. It is not possible to draw any conclusions in terms of causality. Further studies are required in order to assess the relationship between the serum vitamin D levels and stroke severity.","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":"59 4","pages":"351-358"},"PeriodicalIF":1.9,"publicationDate":"2021-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38880686","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}

引用次数: 6

Could ferritin, vitamin B₁₂, and vitamin D play a role in the etiopathogenesis of fibromyalgia syndrome? 铁蛋白、维生素B12和维生素D在纤维肌痛综合征的发病机制中起作用吗?

IF 1.9

Romanian Journal of Internal Medicine Pub Date : 2021-11-20 Print Date: 2021-12-01 DOI: 10.2478/rjim-2021-0022

Adem Kucuk, Rabia Aydogan Baykara, Ayca Tuzcu, Ahmet Omma, Medine Cumhur Cure, Erkan Cure, Gunseli Karaca Acet, Erdal Dogan

{"title":"Could ferritin, vitamin B12, and vitamin D play a role in the etiopathogenesis of fibromyalgia syndrome?","authors":"Adem Kucuk, Rabia Aydogan Baykara, Ayca Tuzcu, Ahmet Omma, Medine Cumhur Cure, Erkan Cure, Gunseli Karaca Acet, Erdal Dogan","doi":"10.2478/rjim-2021-0022","DOIUrl":"https://doi.org/10.2478/rjim-2021-0022","url":null,"abstract":"Introduction. Fibromyalgia syndrome (FS) comprises general body pain, sleep disturbances, and fatigue. Vitamin B12 (VB), vitamin D (VD), and iron deficiencies lead to similar complaints. First, this study aimed to evaluate the VB, VD, and ferritin levels of patients with FS. Second, it aimed to investigate whether there was a relationship between these parameters and FS severity. Material and methods. The study included 58 female patients with FS and 58 healthy females as a control group. The patients completed the Fibromyalgia Impact Questionnaire (FIQ), Visual Analog Scale (VAS), fatigue questionnaire, Pittsburgh sleep quality scale, and the Short Form-36 (SF-36). This study examined the VD, VB, and ferritin levels of the patient and control groups. Results. The VB (240.0 [110.0-394.0] vs 291.0 [210.0-609.0] pg/ml, p<0.001), VD (12.5 [3.0-45.0] vs 20.0 [5.0-54.0] ng/ml, p=0.013), and ferritin levels (21.2 [4.0-86.0] vs 32.0 [7.1-120.0], ng/ml, p=0.009) of the FS patients were determined to be significantly lower than those of the control group. A negative correlation was determined between the number of tender points and VB, VD, and ferritin levels. In the regression analysis, we found low ferritin levels (odds ratio [OR] 1.036, 95% confidence interval [CI] 1.015-1.058, p<0.001) and VB (OR 1.010, CI 1.002-1.018, p=0.010) to be an independent risk factor for FS. Conclusions. There may be a relationship between VB, VD, and ferritin levels and the number of tender points in patients with FS. Levels of iron and VB may play a vital role in FS etiopathogenesis. However, VD levels may not be a risk factor for FS etiopathogenesis.","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":"59 4","pages":"384-393"},"PeriodicalIF":1.9,"publicationDate":"2021-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39244273","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}

引用次数: 1

Spontaneous bacterial peritonitis: update on diagnosis and treatment. 自发性细菌性腹膜炎:诊断和治疗的最新进展。

IF 1.9

Romanian Journal of Internal Medicine Pub Date : 2021-11-20 Print Date: 2021-12-01 DOI: 10.2478/rjim-2021-0024

Roxana-Emanuela Popoiag, Carmen Fierbințeanu-Braticevici

引用次数: 3

Clinical risk scores for the prediction of incident atrial fibrillation: a modernized review. 预测房颤发生的临床风险评分:一项现代化的综述。

IF 1.9

Romanian Journal of Internal Medicine Pub Date : 2021-11-20 Print Date: 2021-12-01 DOI: 10.2478/rjim-2021-0018

Anna Maria Louka, Christos Tsagkaris, Alexandra Stoica

引用次数: 3