Journal of Interdisciplinary Medicine最新文献

{"title":"The Napkin-Ring Sign – the Story Behind Invasive Coronary Angiography","authors":"Z. Parajkó, I. Kovács, M. Chițu, I. Benedek","doi":"10.2478/jim-2021-0006","DOIUrl":"https://doi.org/10.2478/jim-2021-0006","url":null,"abstract":"Abstract Coronary artery disease (CAD) represents one of the leading causes of morbidity and mortality across Europe. Most of the patients do not experience any warning sign before the coronary event develops, therefore screening this group of patients is essential to prevent major cardiac events. Coronary computed tomography angiography (CCTA) offers a noninvasive approach of the coronary arteries, providing information not only on the presence and severity of the coronary stenosis, but is also able to characterize the structure of the coronary wall. CCTA allows complex evaluation of the extension of CAD, and by assessing the structure of the atherosclerotic plaque, it can identify its degree of vulnerability. The napkin-ring sign (NRS) represents a ring-like attenuation of the non-calcified portion of the coronary lesion and has a high specificity (96–100%) for the identification of thin cap fibroatheroma (TCFA) or culprit lesion in acute coronary syndromes (ACS). It is also an independent predictor for ACS events and the strongest predictor for future ACS. Modern CCTA can provide submillimeter isotropic spatial resolution. Thus, CT attenuation-based tissue interpretation enables the assessment of total coronary plaque burden and individual plaque components, with a similar accuracy as intravascular ultrasoud-based investigations. This review aims to present the important role of CCTA as a potent screening tool for patients with CAD, and the current evidences in the detection and quantification of vulnerable plaques.","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128142337","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":"Cardiovascular Risk Factors from Another Point of View","authors":"Péter Balázs Oltean, I. Kovács, R. Hodaș, T. Benedek","doi":"10.2478/jim-2021-0003","DOIUrl":"https://doi.org/10.2478/jim-2021-0003","url":null,"abstract":"Abstract Cardiovascular diseases remain the main cause of death in western societies. This contributes to the appearance of new diagnostic and treatment methods addressed to reduce the burden of cardiovascular diseases. In the last decades new imaging methods have emerged; furthermore, routine biomarkers were found to be useful in cardiovascular risk stratification. Data reviewed in this article emphasize the multifactorial etiology of cardiovascular disease. The authors describe the role of inflammation in the precipitation and progression of atherosclerosis and atrial fibrillation. Affordable and well-known inflammatory markers can be used alone or in combination with new imaging methods for a better cardiovascular risk stratification. Coronary computed tomographic angiography findings and inflammatory markers are capable to identify patients with high risk of major adverse cardiovascular events or atrial fibrillation. Furthermore, they also have an important role in the choice of treatment strategy and follow-up.","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122396444","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":"Acute Coronary Syndrome and Arrhytmia Induced by SARS-CoV-2 Infection in a Patient with Non-Significant LAD Lesion. A Case Report","authors":"Péter Balázs Oltean, I. Kovács, R. Hodaș, N. Raț, T. Benedek","doi":"10.2478/jim-2021-0010","DOIUrl":"https://doi.org/10.2478/jim-2021-0010","url":null,"abstract":"Abstract Background: Coronavirus disease 2019 (COVID-19) has emerged as a pandemic and public health crisis of an unprecedent effect. Clinical studies reported an association between COVID-19 and cardiovascular disease, whereas COVID-19 itself can induce myocardial injury, arrhythmia, acute coronary syndrome, and venous thromboembolism. Case summary: A patient diagnosed via screening coronary computed tomography angiography with non-obstructive coronary artery disease was hospitalized with non-ST elevation myocardial infarction and atrial flutter during a severe respiratory infection episode with SARS-CoV-2. After recovery from the infectious episode, fractional flow reserve-guided elective percutaneous coronary intervention with drug-eluting stent was performed. Conclusions: COVID-19 intercurrence in a cardiovascular patient with nonobstructive coronary artery disease triggered coronary plaque vulnerabilization with subsequent development of an acute coronary syndrome. SARS-CoV-2 proved to be involved via direct viral tissue involvement and concomitant mechanisms derived from systemic illness in the development of a severe supraventricular arrhythmic event.","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127467937","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":"Imaging Vulnerable Plaque in a Modern School of Cardiology – the PlaqueImage Project","authors":"T. Benedek","doi":"10.2478/jim-2021-0011","DOIUrl":"https://doi.org/10.2478/jim-2021-0011","url":null,"abstract":"","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116214705","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":"Coronary Computed Tomography Angiography for Assesment of Stable Coronary Artery Disease – a Cost-effectiveness Perspective","authors":"R. Hodaș, Ș. Polexa, Manuca Rareș, T. Benedek","doi":"10.2478/jim-2021-0004","DOIUrl":"https://doi.org/10.2478/jim-2021-0004","url":null,"abstract":"Abstract Patients with chest pain presenting to the emergency room are currently investigated using either invasive coronary angiography (ICA) or noninvasive coronary computed tomography angiography (CCTA). ICA remains an expensive diagnostic tool and exposes patients to a high risk of periprocedural complication. Besides the currently available expansive economic evidence, there is still an important lingering issue: to establish, from the healthcare provider’s point of view, which is the most cost-effective investigation tool for the detection of significant coronary artery disease. The aim of this article is to present the latest developments in the field of imaging tools for the detection of coronary atherosclerosis in patients with chest pain, from the perspective of a cost-effectiveness analysis.","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123632585","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 Physical Therapy the Early Solution for Post-Acute Myocardial Infarction Patients? A Meta-Analysis","authors":"M. Copotoiu, Mihaela-Maria Șușcă, H. Popoviciu, D. Popescu, T. Benedek","doi":"10.2478/jim-2020-0026","DOIUrl":"https://doi.org/10.2478/jim-2020-0026","url":null,"abstract":"Abstract Background: Physical rehabilitation is essential to improve the quality of life of patients with acute myocardial infarction (AMI). Study aim: The study intended to demonstrate the benefits of early rehabilitation in patients with AMI. Material and method: We performed a meta-analysis to document the benefits of physical treatment in patients who suffered an AMI. Studies were searched in the following databases: PubMed, PlosOne, Mendeley, and clinicaltrials.gov. The terms used in our research were “rehabilitation”, “physical exercise”, “physical training” “quality of life”, “early”, and “post MI”. The inclusion criteria consisted in the assessment of the following parameters: heart rate, maximal/submaximal capacity, and characteristics of the left ventricle – end-diastolic volume, ejection fraction, and left ventricle hypertrophy included in the study design. Results: The database search identified 710 studies, of which only 10 passed the inclusion criteria. Out of 1,515 patients who underwent early physical therapy, 960 reported improvement in the quality of their life (p <0.001). A number of 2,703 patients out of a total of 3,595 underwent a complete physical treatment and medication program. From the ten studies included in the meta-analysis, six had a positive feedback to the multimodal treatment within 1 month post-AMI. Patients who performed physical exercises within a month after the cardiac arrest (1,103 post-AMI patients from a total of 1,278) demonstrated a high heterogeneity represented by the coefficient I2 = 84% but with a significant statistical value of p <0.00001. Conclusion: Early physical therapy initiation significantly improves the quality of life of patients with AMI.","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124112240","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 Profiles of Thyroid Dermopathy: A Dermato-Endocrinological Perspective","authors":"T. Azeez, Ayobami Chioma Egbu","doi":"10.2478/jim-2020-0031","DOIUrl":"https://doi.org/10.2478/jim-2020-0031","url":null,"abstract":"Abstract Thyroid disorders sometimes have extra-thyroidal manifestations. Hyperthyroidism is a clinical syndrome resulting from excessive secretion of thyroid hormones. The most common cause is Graves’ disease. About 0.5–4.3% of patients with Graves’ disease have an infiltrative dermopathy called thyroid dermopathy, which is due to excessive deposition of glycosaminoglycans from activated fibroblasts. Skin fibroblasts are activated by thyroid stimulating hormone receptor antibodies the whole process being initiated by T lymphocytes. Rarely, thyroid dermopathy is also found in other thyroid disorders such as Hashimoto thyroiditis. The diffuse non-pitting edema variant is the most common clinical presentation. Other variants include the nodular, plaque, mixed, and elephantiasis types. Usually, the main concerns of the patients are cosmetic, discomfort, and difficulty in wearing shoes. Thyroid dermopathy usually presents after the diagnosis of Graves’ disease, but it may also present together or sometime after this condition. Rarely, thyroid dermopathy presents before the diagnosis of Graves’ disease is made. Apart from the shin and feet, other sites that can be affected include the arms, forearms, back, thighs, pinna, and nose. The management is multidisciplinary, involving dermatologists and endocrinologists. Usually, controlling the thyroid dysfunction does not translate into regression of the skin lesions. However, many patients have their thyroid dermopathy regress spontaneously, while others usually require local therapy. Other therapeutic options include systemic therapy such as pentoxifylline, compressive physiotherapy, and surgery.","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"212 0 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132685977","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":"Examination of Air Pollution’s Relationship with COVID-19, Physical and Mental Health","authors":"Hina Islam, Irfan Sharif Shakoori, F. Aslam, Gohar Ashraf, H. Akram","doi":"10.2478/jim-2020-0027","DOIUrl":"https://doi.org/10.2478/jim-2020-0027","url":null,"abstract":"Abstract Air pollution is a result of natural phenomena or human activities that can cause the release of harmful substances in the environment, leading to adverse health outcomes among living beings. Pollution is associated with adverse health impacts on multiple organ systems among humans. While the respiratory and cardiovascular systems are mainly affected, there are other health issues related to the eyes, skin, brain, blood, immunity, behavioral/mental well-being, and reproduction among exposed individuals. Air pollutants can especially have higher health impacts on people at the extremes of their ages (children and elderly) and on those suffering from underlying respiratory and heart issues. Pollutants such as ozone, sulfur dioxide, particulate matter, and nitrogen dioxide have respiratory effects among children and adults and are associated with increased respiratory diseases, asthma exacerbations, and related hospitalizations. Carbon monoxide interferes with transporting oxygen by forming carboxyhemoglobin leading to cardiovascular, neurological, and respiratory problems. Particulate matter is a heterogeneous mixture of tiny particles of varying compositions found in the atmosphere and has a wide variety of severe health effects. Particulate matter emits from combustion, diesel engines, power generation, and wood-burning, and certain industrial activities. Lead is considered neurotoxic and has more severe consequences among children. Here we summarize characteristics of six criteria air pollutants and associated air quality risk assessment parameters known as the Pollutant Standard Index (PSI). The present manuscript also examines the impact of air pollution on human behavior, mental well-being, and neurological health consequences, as air pollution has been associated with cognitive decline, hyperactivity, dementia, anxiety, depression, aggression, and Alzheimer’s disease-related changes. Lastly, we also attempt to look into any relationship between air pollutants and Coronavirus disease (COVID-19) and examine its possible association with a higher COVID-19 incidence, complications, and mortality.","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130828336","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 Medical Effects and Economic Impact of Anastomotic Leakage in Patients with Colorectal Cancer. A Middle-Income Country Perspective","authors":"E. Élthes, Á. Török, M. Dénes, R. Neagoe, D. Sala, János Székely","doi":"10.2478/jim-2020-0025","DOIUrl":"https://doi.org/10.2478/jim-2020-0025","url":null,"abstract":"Abstract Introduction: Anastomotic leakage is one of the most serious surgical complications that can increase the potential postoperative morbidity, mortality, and overall costs of patient care. Aim of study: To assess the economic burden of anastomotic leakage and to estimate its major clinical effects on patient evaluation. Materials and methods: We retrospectively reviewed single-surgeon data about patients who underwent surgical intervention for colorectal cancer at the 2nd Surgery Department of the Mureș County Emergency Clinical Hospital between January 2019 and July 2020. We assessed general characteristics, surgical data, postoperative information, oncologic results, and financial aspects for each patient. Depending on the presence of anastomotic leakage, patients were divided into two groups: a study group (SG) – patients with postoperative anastomotic failure, and a control Group (CG) – patients without postoperative anastomotic failure. Results: Patients with anastomotic leakage presented increased use of antibiotics, greater number of surgical reinterventions, longer period of intensive care treatment, prolonged hospitalization, increased overall costs, and significantly greater financial loss for the hospital. Conclusion: Anastomotic leakage leads to important negative effects, including longer hospitalization, prolonged intensive care unit stay, greater incidence of surgical reintervention, increased hospitalization costs, and significant financial loss.","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117304594","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 Influence of Oxidative Stress-Related Factors on Pregnancy and Neonatal Outcomes","authors":"Zsuzsánna Simon-Szabó, E. Nemes-Nagy, L. Dénes, B. Szabó","doi":"10.2478/jim-2020-0033","DOIUrl":"https://doi.org/10.2478/jim-2020-0033","url":null,"abstract":"Abstract Background: Pregnancy is a physiological process associated with an excessive oxidative stress for both the mother and the neonate. Oxidative stress was extensively studied and is still in focus as a factor of maternal pathologies during pregnancy, with consequences on the outcome of the neonate. Aim: The aim of our study was to determine whether oxidative stress-related factors can influence the outcome of pregnancy, delivery, and the neonate’s wellbeing. Material and methods: The study was conducted using a questionnaire among pregnant women with voluntary enrollment. Exclusion criteria were preeclampsia or other cardiovascular diseases, gestational diabetes, and hypothyroidism at admission. Patients were enrolled in a control group of 60 pregnant women without preexisting pathology and pregnancy with physiological course, a premature group of 21 pregnant women with premature delivery, and a cardiac group of 8 pregnant women with fetal heart disease known before birth. The study population was separated into subgroups based on dietary supplement use within the three main groups, and other subgroups for smoking/non-smoking mothers in the control group and one for smoking/non-smoking mothers in the premature and cardiac groups together. Results: The mean Apgar score at 1 minute was significantly higher in the control group compared to the cardiac group (p = 0.0023). The 1-minute Apgar score was significantly lower in infants that were born premature, from smoking mothers, compared to babies that were delivered at term (p = 0.0191). Although we did not obtain significant differences in birth weight corrected by gestational age between the control (mature) group and premature group, there was a good correlation in gestational age and birth weight of the preterm born infants (r = 0.8517, p <0.0001). Conclusions: Smoking can aggravate oxidative stress in pregnancy, which will contribute to a difficult postnatal adaptation of newborns from smoking mothers and will increase the risk of premature delivery.","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127916109","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}