Romanian Journal of Internal Medicine最新文献

{"title":"Utilization of Probiotics in Relieving Post-Colonoscopy Gastrointestinal Symptoms: A Systematic Review and Meta-Analysis.","authors":"Virly Nanda Muzellina, Steven Alvianto, Nicolas Daniel Widjanarko","doi":"10.2478/rjim-2024-0023","DOIUrl":"10.2478/rjim-2024-0023","url":null,"abstract":"<p><strong>Introduction: </strong>Colonoscopy is regarded as a safe diagnostic and therapeutic procedure, nevertheless, some patients may still encounter post-colonoscopy gastrointestinal symptoms. This study aimed to evaluate the utilization of probiotics before and after colonoscopy to relieve those symptoms.</p><p><strong>Methodology: </strong>This study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines. Included studies were all interventional studies examining the effects of probiotics use before and after colonoscopy. Articles were retrieved from MEDLINE, EBSCO-Host, Cochrane, ProQuest, and Google Scholar electronic databases, utilized specific keywords <i>(</i> <i>\"</i> <i>Probiotic</i> <i>\" OR \"</i> <i>Probiotics</i> <i>\"</i>) <i>AND</i> (<i>\"</i> <i>Colonoscopy</i> <i>\" OR \"</i> <i>Colonoscopies</i> <i>\"</i>). The Cochrane Risk of Bias (RoB) 2 and Joanna Briggs Institute (JBI) Critical Appraisal tools were used for study quality assessment, as well as Review Manager (RevMan) 5.4 to perform the meta-analysis.</p><p><strong>Results: </strong>A total of ten studies were included in this systematic review. Six studies assessed the effect of probiotics consumption after colonoscopy, three examined the impact before colonoscopy, and one study assessed both. The most common type of probiotics used were <i>Lactobacillus</i> and <i>Bifidobacterium</i>. Quantitative synthesis of probiotics before colonoscopy showed no significant differences among bloating, abdominal pain, nausea, and vomiting symptoms (p=0.49, p=0.14, p=0.30, and p=0.42, respectively). Similarly, quantitative synthesis of probiotics after colonoscopy showed no significant differences in bloating and abdominal pain (p=0.16 and p=0.63, respectively).</p><p><strong>Conclusions: </strong>Probiotic administration pre- and post-colonoscopy exhibited preliminary evidence for reducing gastrointestinal symptoms, but a quantitative synthesis revealed non-significant findings, necessitating further investigations.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":"387-403"},"PeriodicalIF":1.6,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141420628","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":"HIV and kidney transplantation in Romania: The index case.","authors":"Bogdan Marian Sorohan, Gener Ismail, Cristiana Oprea, Dorina Tacu, Ileana Constantinescu, Liliana Domnișor, Ionuț Manea, Ioanel Sinescu, Cătălin Baston","doi":"10.2478/rjim-2024-0020","DOIUrl":"10.2478/rjim-2024-0020","url":null,"abstract":"<p><strong>Introduction: </strong>Human immunodeficiency virus (HIV) is no longer considered a contraindication for kidney transplantation (KT). KT management in HIV patients is a complex process with challenges, such as drug interactions between immunosuppression and antiretroviral (ARV) therapy. In our country, no KT has been performed thus far in this category of patients.</p><p><strong>Case presentation: </strong>We present the case of a 29-year-old female patient with HIV and end-stage renal disease (ESRD) who performed a KT from a related living donor in March 2022. KT immediate evolution was favorable. No transplant-related complications were reported. HIV viral load remained undetectable and CD4+ T cells were constantly > 500 cell/ μL, during the 18 months of follow-up. The main challenge in our case was the drug interaction between the protease inhibitor-based regimen and tacrolimus. This led to tacrolimus overdose, and, subsequently, change in ARV therapy. ARV switching was performed on a regimen based on integrase inhibitor and nucleoside reverse transcriptase inhibitors. After the ARV change, the therapeutic level of tacrolimus was easily reached and maintained. Kidney graft function remained normal during follow-up, despite tacrolimus overexposure, and no rejection or anti-HLA antibodies were observed. Another challenge was related to the donor's hepatitis C virus status (positive antibodies, negative nucleic acid test). The recipient did not develop seroconversion or detectable viremia at 3-, 6-, 12- and 18-months post-KT.</p><p><strong>Conclusion: </strong>We reported the first case of a successful KT in an ESRD patient with HIV in Romania, in whom the post-transplant evolution was favorable.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":"362-368"},"PeriodicalIF":1.6,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288527","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":"In memoriam: Professor Radu Voiosu.","authors":"","doi":"10.2478/rjim-2024-0014","DOIUrl":"https://doi.org/10.2478/rjim-2024-0014","url":null,"abstract":"","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864209","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":"Is there an association between lymph node size and hyperprogression in immunotherapy-treated patients?","authors":"Mohammad S Alkader, Rashed Z Altaha, Eslam H Jabali, Ola A Attieh, Ala' W Matalqa","doi":"10.2478/rjim-2023-0025","DOIUrl":"10.2478/rjim-2023-0025","url":null,"abstract":"<p><strong>Background: </strong>Hyperprogressive disease (HPD) can be described as an accelerated increase in the growth rate of tumors combined with rapid clinical deterioration observed in a subset of cancer patients undergoing immunotherapy, specifically with immune checkpoint inhibitors (ICIs). The reported incidence of HPD ranges from 5.9% to 43.1% in patients receiving ICIs. In this context, identifying reliable predictive risk factors for HPD is crucial as it may allow for earlier intervention and ultimately improve patient outcomes.</p><p><strong>Methods: </strong>This study retrospectively analyzed ten metastatic renal cell carcinoma (mRCC) patients. The identification of HPD was based on the diagnostic criteria proposed by Ferrara R <i>et al.</i> This study aimed to investigate whether there is an association between LN size and HPD using a cutoff value of 3 cm for LN size. Given the limited sample size, Fisher's exact test was used to test this association. We conducted a Kaplan-Meier (KM) analysis to estimate the median overall survival (OS) of patients with HPD and compared it to those without HPD.</p><p><strong>Results: </strong>Three patients (30%) developed HPD, while seven (70%) did not. Fisher's exact test revealed a statistically significant association between the HPD and LN size ≥ 3 cm (p=0.008). In the HPD group, the median OS was significantly shorter, with a median OS of 3 months, whereas in the non-HPD group, the median OS was not reached (P =0.001).</p><p><strong>Conclusion: </strong>The present study found a significant association between LN size ≥ 3 cm in the pretreatment period and HPD development.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":"33-43"},"PeriodicalIF":1.9,"publicationDate":"2024-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50162773","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 crucial role of gadolinium-enhanced MRI in a case of amaurosis fugax - a case report and literature review.","authors":"Maria Mirabela Manea, Dorin Dragoş, Ana-Maria Dobri, Maria Iuliana Ghenu, Iulia-Cosmina Stoican, Iulia-Ioana Enache, Sorin Tuta","doi":"10.2478/rjim-2023-0026","DOIUrl":"10.2478/rjim-2023-0026","url":null,"abstract":"<p><p>Optic perineuritis is the inflammation of the optic nerve sheath. This affliction can lead to visual field impairment and other signs and symptoms related to the orbital space, such as pain, disc edema, ophthalmoplegia, proptosis. However, not all patients present with such suggestive symptoms, requiring a thorough assessment. We report the case of a young male admitted to our hospital for recurrent episodes of monocular blindness. Amaurosis fugax is a well-known presentation of transient ischemic attacks (TIA) and it was ruled out. Gadolinium-enhanced MRI revealed a typical aspect of optic perineuritis. It was mandatory to consider all possible causes of secondary optic perineuritis as they all represent serious clinical conditions, even if the idiopathic form is more frequent. The clinical and paraclinical evaluation of the patient excluded an underlying disease and primary optic perineuritis was diagnosed. Corticosteroid therapy is usually curative and a course of methylprednisolone was initiated for our patient with good outcome. However, response to treatment is not diagnostic as both primary and secondary optic perineuritis are normally responsive, hence thorough differential diagnosis is necessary.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":"75-81"},"PeriodicalIF":1.9,"publicationDate":"2024-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71426532","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 hidden and complex relationship between dietary phosphorus and malnutrition in hemodialysis patients with chronic kidney disease.","authors":"Clonia Milla, Widodo, Teddy Heri Wardhana","doi":"10.2478/rjim-2023-0029","DOIUrl":"10.2478/rjim-2023-0029","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease (CKD) has always been a complicated global challenge, ranking as the 12th leading cause of death worldwide. Hemodialysis, being one of the most opted renal replacement therapies (RRTs) for patients with end-stage renal disease (ESRD), still possesses some limitations in preventing complications, such as malnutrition and mineral bone disease (CKD-MBD). While efforts have focused on controlling CKD-MBD parameters like calcium and phosphate, less attention has been given to dietary interventions. Moreover, the adoption of low-phosphorus diets for hemodialysis patients is very complex due to potential conflicts with the guideline-recommended high-protein dietary approach. This study sought to investigate the relationship between dietary phosphorus intake and nutritional status in CKD patients undergoing regular hemodialysis.</p><p><strong>Method: </strong>This non-randomized cross-sectional study comprising 88 patients was conducted at the Hemodialysis Unit, RSUD Dr. Soetomo, Surabaya, East Java, using a three-day dietary record in March 2022. Relationships between variables were analyzed using Spearman and ANOVA tests.</p><p><strong>Result: </strong>No significant positive association was found between dietary calcium with corrected calcium levels (p = 0.988; r_s = -0.002) and between dietary phosphorus with plasma phosphate levels (p = 0.082; r_s = 0.187). However, Spearman's analysis revealed a weak but positive correlation between dietary phosphorus and nutritional status (p = 0.022; r_s = 0.215*).</p><p><strong>Conclusion: </strong>Our study highlights a positive relationship between dietary phosphorus and nutritional status among hemodialysis patients, offering insights into potential strategies for optimizing patient care and outcomes.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":"52-60"},"PeriodicalIF":1.9,"publicationDate":"2024-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138291735","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 dysfunction in patients with end stage kidney disease; Immunosenescence - Review.","authors":"Viorica Ileana Bumbea, Horia Bumbea, Ana Maria Vladareanu","doi":"10.2478/rjim-2023-0030","DOIUrl":"10.2478/rjim-2023-0030","url":null,"abstract":"<p><p>The body's defense against environmental factors is realized by physical barriers and cells of both the innate and adaptive immune systems. Patients with end stage kidney disease (ESKD), especially those treated by hemodialysis, have changes in both the function and the number or percent of different leukocyte subsets. Changes were described at the level of monocytes and lymphocyte subsets, which are associated with immunodeficiencies and pro-inflammatory status correlated with degenerative changes and increased cardiovascular risk. These abnormalities have been compared over the past years with alterations appearing as a result ageing. Also, similitudes regarding immunosenescence observed in ESKD patients, in combination with chronic inflammation, are described as the so-called \"inflammaging syndrome\".</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":"12-19"},"PeriodicalIF":1.9,"publicationDate":"2024-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138291734","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":"Central retinal vein occlusion : an uncommon complication in sarcoidosis.","authors":"Imen Chabchoub, Chifa Damak, Marwa Bouhamed, Mouna Rekik, Cyrine Abid, Faten Frikha, Sonda Kammoun, Yoldez Ben Jemaa, Sameh Marzouk, Zouhir Bahloul","doi":"10.2478/rjim-2023-0024","DOIUrl":"10.2478/rjim-2023-0024","url":null,"abstract":"<p><p>Sarcoidosis is a multi-system granulomatosis of unknown etiology, defined by the presence of epithelioid and gigantocellular granulomas, without caseous necrosis. Ocular sarcoidosis manifests mainly as bilateral granulomatous anterior uveitis. Occlusion of the central retinal vein in sarcoidosis is a rare manifestation, which is the particularity of our observation. We report the case of a patient presenting with unilateral central retinal vein occlusion associated with granulomatous anterior uveitis on the same side. Systemic manifestations and further investigations led to the diagnosis of sarcoidosis.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":"82-87"},"PeriodicalIF":1.9,"publicationDate":"2024-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49681757","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":"Carpal tunnel syndrome and nerve conduction studies in fibromyalgia patients.","authors":"Gülseren Demir Karakiliç, Güven Arslan","doi":"10.2478/rjim-2023-0031","DOIUrl":"10.2478/rjim-2023-0031","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study is to evaluate ENMG results of female patients with Fibromyalgia Syndrome (FMS) with a preliminary diagnosis of carpal tunnel syndrome (CTS) and to examine whether there are differences in ENMG results compared to control group.</p><p><strong>Material and methods: </strong>Ethical approval was obtained for this study on 30.12.2022 with number E. Kurul-2022-20/32 and recorded retrospectively between January 2021 and January 2023. 201 female patients who were diagnosed with FMS in Physical Therapy and Rehabilitation polyclinic and who were requested to have ENMG testing with a preliminary diagnosis of CTS were included in study as patient group. 201 patients were ıncluded as control group.</p><p><strong>Results: </strong>While the number of patients with right CTS was 39 (25.49%) in the FMS group, the number of patients with right CTS was 38 (24.20%) in control group. While the number of patients with left CTS was 34 (25%) in the FMS group, number of patients with left CTS in the control group was 36 (24.65%). When we analyzed a total of 592 ENMG results in our study, we found a high normal ENMG rate of 75%.</p><p><strong>Conclusion: </strong>We found that there was no difference between the FMS and the control group in terms of compatibility between the pre-diagnosis and electroneurophysiological diagnosis in the ENMG results requested with the pre-diagnosis of CTS in our study. The ENMG examination should be requested for right patient in right indication, by first evaluating the patient well.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":"61-66"},"PeriodicalIF":1.9,"publicationDate":"2024-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138291733","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":"Massive primary pulmonary artery rhabomyosarcoma: A case report.","authors":"Farid Rashidi, Eissa Bilehjani, Seyed Ali Mousavi-Aghdas, Rezayat Parvizi","doi":"10.2478/rjim-2023-0032","DOIUrl":"10.2478/rjim-2023-0032","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary artery sarcomas (PAS) are rare tumours causing an insidiously progressive obstruction of the pulmonary circulation. The clinical presentation is often indistinguishable from chronic thromboembolic pulmonary hypertension (CTEPH). However, the atypical appearance of a heterogeneous filling defect in CT pulmonary angiography (CTPA) should prompt further investigation.</p><p><strong>Case presentation: </strong>A previously healthy young man presented with massive haemoptysis, acute respiratory distress, and progressive exertional dyspnea since the year before. Echocardiography demonstrated severe right ventricular dysfunction and highly probable pulmonary hypertension. CTPA revealed an extensive filling defect with an appearance concerning PAS. Due to syncopal episodes at rest, the patient underwent urgent pulmonary artery endarterectomy (PEA). A massive tree-like tumour was excised as a result. Post-operatively, reperfusion injury and refractory pulmonary oedema mandated extracorporeal membrane oxygenation (ECMO). Unfortunately, ECMO was complicated with massive haemolysis and acute kidney injury. The patient succumbed to multi-organ failure. Through tissue analysis established a diagnosis of embryonal rhabdomyosarcoma.</p><p><strong>Discussion: </strong>Unfortunately, the patient had not reached out for his worsening dyspnea. PASs should not be mistaken for a thrombus and anticoagulation should be avoided. The urgent condition precluded biopsy and tissue diagnosis. Similarly, neoadjuvant chemotherapy was not feasible. Post-operatively, reperfusion injury and pulmonary oedema ensued, which mandated ECMO. This complication should be anticipated preoperatively. There is a need for more data on PASs to establish a consensus for management.</p>","PeriodicalId":21463,"journal":{"name":"Romanian Journal of Internal Medicine","volume":" ","pages":"67-74"},"PeriodicalIF":1.9,"publicationDate":"2024-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138478508","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}