Medicina Moderna - Modern Medicine最新文献

{"title":"Incidence of Viral Hepatitis in Military Personnel Performing External Missions","authors":"Izabela Oana STOICA VADUVA, Magdalena Irina Dumitru","doi":"10.31689/rmm.2021.29.1.49","DOIUrl":"https://doi.org/10.31689/rmm.2021.29.1.49","url":null,"abstract":"Soldiers on missions are at risk of contracting major infectious diseases. Some of the most common food or water-borne diseases include diarrhea (bacterial and protozoan), hepatitis A, and typhoid fever, all of which pose serious threats to communities. The studied group consists of 102 people who performed missions in the theater of operations in Mali between December 2020 and September 2021. The tests were performed in the medical analysis laboratory of the Military Emergency Hospital. The group consists of male with an average age of 35-45 years. Analyzes were performed in the fields of microbiology, virology and biochemistry. negative on departure and return only one person was positive, Ac anti HCV remained the same (97 negative people and 5 positive), Ac anti HAV were present in all military personnel returned from the mission, only one soldier returned with Ag Hbe positive (those in which Ag Bhs was also positive), Ac anti Hbs positive in all military. Following the analyzes performed, we came to the conclusion that the protection measures taken in the theaters of operations are effective, as there is no contamination on the studied group with endemic germs of the area.","PeriodicalId":380281,"journal":{"name":"Medicina Moderna - Modern Medicine","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125166647","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":"Differentiated Thyroid Cancer Genetic Mechanisms - Focus on Vitamin D Receptor and Methylenetetrahydrofolate Reductase Gene Polymorphisms","authors":"A. Cocolos, C. Poiană","doi":"10.31689/rmm.2021.29.1.7","DOIUrl":"https://doi.org/10.31689/rmm.2021.29.1.7","url":null,"abstract":"Thyroid cancer is the most frequent endocrine cancer representing 1-1.5% of all cancers. Approximately 90% of these are differentiated thyroid carcinomas (DTC) with a favorable prognosis and cure rate. DTC has recently witnessed an increase in incidence with a relatively stable mortality rate, mostly due to intensive screening. Despite being considered indolent and the 10-year survival rate being above 90%, local or distant recurrence can be observed in up to 20% of cases. Mutations in BRAF, RET, RAS, NTRK1, PAX8-PPARG are commonly found in DTC but studies show that genetic alterations with apparently no correlation to DTC might improve or aggravate prognosis. Vitamin D deficiency and vitamin D receptor (VDR) gene polymorphisms is consider to be one of these factors, due to the fact that it exerts immunological and antineoplastic functions throught its antiproliferative and prodifferentiating actions. FokI gene polymorphism has been associated with later stage and negative prognosis in different studies. Also, polymorphisms of genes involved in folate metabolism (MTHFR, MTR, RFC1) may be incriminated in carcinogenesis, folate being an extremely important factor in DNA synthesis. Studies suggest that through correction and avoidance of incriminated neoplastic agents, thyroid cancer incidence, evolution and prognosis might improve significantly. For this to be possible we need to be aware of the molecular pathways these environmental factors use to exert their carcinogenic effects.","PeriodicalId":380281,"journal":{"name":"Medicina Moderna - Modern Medicine","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116634057","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 Relation between Parathyroid Hormone with Some Bone Biochemical Markers in Type II Diabetes Mellitus","authors":"Sanhareeb Wajdi Sabih AL- ROBAIEE, S. Z. Hussein","doi":"10.31689/rmm.2021.29.1.59","DOIUrl":"https://doi.org/10.31689/rmm.2021.29.1.59","url":null,"abstract":"Background: Diabetes mellitus of type II (T2DM) has a link to bone resorption, as seen by the great level of most osteoclastic activity indicators. As a result, the mineral density of bones is not reduced in individuals with non-insulin-managed T2DM, and this type does not seem to contribute to osteoporosis. This study aims to evaluate the bone metabolism biochemical markers in T2DM patients. Materials and Methods: A total of 120 blood samples were divided into (70) patients (with quite equal numbers of both females and males), and (50) normal cases as controls (also with quite equal numbers of both females and males), the ages were between 30 and 65 years old. During the period between February and August 2020, patients were admitted to Ballad and Salah Aldeen General Hospitals. The samples that were undertaken were (blood sugar, albumin, total calcium, corrected calcium, parathyroid hormone and phosphorus). Results: In male DM patients, there were high significant differences (P≤0.01) in (blood sugar, parathyroid hormone, total calcium, and corrected calcium), but non-significant differences (P≥0.05) in phosphorus. On contrary, in female DM patients, there was high noticeable difference (P≤0.01) in blood sugar, and a considerable difference (P≤0.05) only in albumin, but non-significant differences (P≥0.05) in parathyroid hormone, total calcium, and corrected calcium. Conclusion: The current findings concluded that hyperglycemia combined with an insulin deficiency can result in a hypoparathyriod status with PTH downregulation.","PeriodicalId":380281,"journal":{"name":"Medicina Moderna - Modern Medicine","volume":"5 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132506833","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 between Young and Elderly Onsetof Rheumatoid Arthritis in a Romanian Cohort","authors":"A. Bobircă, Madalina Mihalceanu, Cristina Alexandru, A. Florescu, F. Bobircă, A. Ioan, M. Bojincă","doi":"10.31689/rmm.2021.29.1.67","DOIUrl":"https://doi.org/10.31689/rmm.2021.29.1.67","url":null,"abstract":"Rheumatoid arthritis (RA) is a chronic inflammatory disease that predominantly affects middle-aged adults in the third to fifth decades of life, but can also occur at any age. Significant differences were observed between patients with the diagnose of the disease under the age of 65 years – young- onset of RA (YORA) and those with the onset over the age of 65 years -elderly-onset of RA (EORA). The literature has shown that patients in the EORA group, in comparison to the young, have more severe onset, shorter duration of morning stiffness, lower frequency of sero- positivity and a more important biological inflammatory syndrome. Objective: Describe and compare the clinical characteristics, laboratory features, functional status, therapeutic approach and disease progression in elderly-onset and young-onset rheumatoid arthritis (RA) patients. Materials and methods: This retrospective, transversal study included 102 patients diagnosed with rheumatoid arthritis according to the ACR / EULAR criteria and who had at least 3 visits to our clinic, the last one during 2019-2020. Depending on the age at disease onset, we divided them into 2 groups- EORA and YORA and analyzed them comparing the clinical, laboratory and treatment data obtained at diagnosis. Subsequently we studied the evolution of the disease activity and the therapy efficiency at 6 months of follow-up and at the last hospitalization for each group. Results: The percentage of women is similar and predominant in both groups, YORA and EORA (68.3% and 71.8%). YORA was associated with a longer disease length and a prolonged symptom duration prior to the diagnosis in comparison to EORA (p<0.001 and P=0.002). Extra-articular manifestations were more frequent in elderly onset RA patients at diagnosis, especially the presence of rheumatoid nodules (46.2% vs 22.2%. p=0.011) and weight loss (82.1% vs 34.9%, p<0.001). Anemia was statistically associated with the EORA group (p=0.037). Analyzing the radiological findings, there was a greater number of patients who showed erosions (48.7%) and geodes (28.2%) in EORA, than in YORA group (33.3% and 19.0%). The prevalence of specific auto-antibodies positivity as anti-CCP was higher in YORA (76.2% vs 53.8%, p=0.019), as well as the positivity of Rheumatoid factor (RF) (84.1% vs 61.5%, p=0.010). The majority of patients began treatment with synthetic DMARD monotherapy, 54.0% of YORA and 64.1% of EORA. Methotrexate was the main drug administrated in both groups (61.5% in EORA and 54.0% in YORA, p-value= 0.602). Other medications, such as Sulfasalazine and Leflunomide, were less preferred in the two groups. Biologic therapy was preferred in younger patients than in those with RA at 65 years of age or over (69.8% vs 35.9%, p=0.001). Disease activity measured with DAS28(CRP) score was similar between the two groups at baseline, but significantly lower for YORA patients measured at the last hospitalization (p=0.020), treat to target (low disease activity and remissi","PeriodicalId":380281,"journal":{"name":"Medicina Moderna - Modern Medicine","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129742597","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":"Neurological Paraneoplastic Syndromes: the Early Diagnosis of Lung Cancer","authors":"A. Paroșanu, A. Popa, Cristian Iaciu, M. Olaru, Cristina Orlov-Slavu, H. Cotan, Miruna Stanciu, R. Vrabie, C. Nitipir","doi":"10.31689/rmm.2021.29.1.93","DOIUrl":"https://doi.org/10.31689/rmm.2021.29.1.93","url":null,"abstract":"Paraneoplastic syndromes of the nervous system are rare disorders, strongly linked with lung cancer. This report aims to explore the challenges in the diagnosis and treatment of a patient with early-stage small cell lung cancer and neurological manifestations as initial clinical symptoms.","PeriodicalId":380281,"journal":{"name":"Medicina Moderna - Modern Medicine","volume":"48 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113969868","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":"Levels of Leptin, Adiponectin, and Insulin in COVID-19 Patients","authors":"S. Z. Hussein, M. Abdalla","doi":"10.31689/rmm.2021.29.1.89","DOIUrl":"https://doi.org/10.31689/rmm.2021.29.1.89","url":null,"abstract":"In SARS-CoV-2 infected patients, obesity is a risk factor for the development of respiratory failure. Many pro-inflammatory adipokines and mediators are produced from adipose tissue. Blood samples were collected from 60 COVID-19 patients after three to five days from symptoms and signs were appeared like headache, fatigue, fever, and cough. All patients were diagnosed as positive COVID-19 infection with a pharyngeal swab which is positive by RT-PCR who attended to Isolated Hospital in Tikrit City in Iraq from December 2020 to March 2021 and 30 samples from healthy individuals. Levels of leptin, adiponectin, and insulin were increased in COVID-19 patients with highly significant (P≤0.01) when compared with healthy individuals. Increased levels of leptin, adiponectin, and insulin in COVID-19 patients may occur because all patients were obese with severe respiratory inflammation.","PeriodicalId":380281,"journal":{"name":"Medicina Moderna - Modern Medicine","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130666637","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 Predictive Factors of Response to Biologics in IBD","authors":"R. Sadagurschi, A. Dobromirescu, R. Babiuc, L. Negreanu","doi":"10.31689/rmm.2021.29.1.15","DOIUrl":"https://doi.org/10.31689/rmm.2021.29.1.15","url":null,"abstract":"Background: Growing insights into complex molecular pathways involved in the pathogenesis of inflammatory bowel diseases (IBD) have led to advent of new treatment options. Currently, there are three classes of biological agents approved for the treatment of IBD: anti-tumor necrosis factor agents (anti-TNFs), vedolizumab (VDZ) and ustekinumab. Each of these molecules have different targets in the inflammatory process, inhibiting specific mediators. Since the therapeutic options tend to increase and become more and more variate, it would be important to establish predictive markers of response to choose the best therapeutic option for the most suitable patient. Nowadays, the concept of „personalized medicine” which means selecting the right drug for the right person at the right time based on the characterization of an individual’s phenotype and genotype seems to be more reasonable and tends to replace the strategy “one drug suits all” that we used for many years. Aim: To present the currently available data regarding the clinical predictors of response not only to anti-TNFs, but also to VDZ and ustekinumab. Methods: A literature search was performed in PubMed to identify publications reporting on predictive factors of response to biologic therapy in patients with IBD, using pre-defined keywords. We selected RCTs, observational studies, reviews and meta-analyses. Results: For anti-TNF agents most of the evaluated factors have not proved to be accurate enough as to enter daily clinical practice as a decisive tool to enable an individualized therapeutic approach. Factors identified as potential predictors include disease behavior/ phenotype, disease severity, CRP, prior anti-TNF exposure, but the results were variable and sometimes conflicting. For VDZ, even more discouraging results were obtained, with only few factors (disease severity and prior anti-TNF exposure) showing limited value. Regarding ustekinumab, no predicting factor has been reported yet to be helpful in clinical practice. Conclusion: Current scientific results cannot establish a single biomarker that fulfills all criteria for being an appropriate prognostic indicator for response to any biological treatment in IBD. Further research is needed to identify new and more reliable predictors or to better evaluate the existing ones.","PeriodicalId":380281,"journal":{"name":"Medicina Moderna - Modern Medicine","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133304631","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":"Association of rs 10038177 and rs 1971050 Polymorphism of WDR 36 Gene with Clinical Profile in POAG Patients","authors":"Mehvish Malik, T. Khan, L. Singh, T. Raza, Syed Shahaan","doi":"10.31689/rmm.2021.28.4.433","DOIUrl":"https://doi.org/10.31689/rmm.2021.28.4.433","url":null,"abstract":"Aim: To study WDR36 gene polymorphism (rs10038177 , rs1971050) and its association with clinical parameters in patients of primary open angle glaucoma. Methods: A cross sectional study conducted on 105 cases of POAG to study its association with WDR36 gene polymorphisms (rs 10038177, rs 1971050). The study subjects underwent complete ophthalmic examination, slit lamp examination, IOP measurement by Goldmann’s Applanation Tonometer, gonioscopy, fundus evaluation by 90D lens. RNFL thickness was measured using cirrus 500 OCT by Carl Zeiss. Peripheral blood samples were collected in EDTA-anticoagulant tubes, then DNA was extracted using the genomic DNA extraction and genotyped by PCR-RFLP by using (AluI) enzyme.Data analysis by SPSS, version 21.0. Chi-square and Independent sample ‘t’-tests used for comparison. Results: The association of genotypic expression of rs10038177 polymorphism with different clinical variables in POAG patients, and the mean IOP (31.66 + 5.88) and CDR (0.72+ 0.15) for heterozygous genotype TC was significantly higher as compared to homozygous de33eeeee4(p<0.05) while in rs1971050 polymorphism, Diabetic history was significantly higher in genotype TC(60%)(p=0.012) as compared to genotype TT (19.1%). Conclusion: Our study shows that WDR 36 polymorphism (rs10038177) and (rs1971050) have an association with higher IOP and RNFL thinning which could be the underlying factors in pathogenesis and progression of POAG.","PeriodicalId":380281,"journal":{"name":"Medicina Moderna - Modern Medicine","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122079863","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":"Evaluation of Treatment Response in Lupus Nephritis","authors":"A. Bobircă, F. Bobircă, A. Florescu, Carmen Iorgus, Radu Tinca, A. Mușetescu, M. Bojincă, I. Ancuta","doi":"10.31689/rmm.2021.28.4.389","DOIUrl":"https://doi.org/10.31689/rmm.2021.28.4.389","url":null,"abstract":"Objectives: To evaluate the effectiveness of the treatment reflected by the rate of response to therapy at 6 months and 12 months of follow-up respectively. Methods: We retrospectively analyzed clinical, laboratory data, treatment regimens, the type of response and relapse rate of 51 patients diagnosed with LN between January 2017 and February 2020. Results:47.06% of the patients underwent renal biopsy, classes III and IV being the most common lupus nephritis types (totaling 35.3% of biopsied patients). All induction therapy choices analyzed in the study- CYC, Glucocorticoids (GCs) and MMF- proved effective at reducing the proteinuria of the patients (p=0.001, p=0.012 and p=0,019 respectively. The 12 months evaluation demonstrated an ascending trend of the complete response, starting from 27.45% at 6 months and almost doubling at 1 year (56.86%). Almost half of patients (49.02%) did not relapse, while most of them (27.45%) had only 1 relapse. Analyzing the risk of relapse for each induction drug used, CYC had the highest rate of recurrence (62.07%). The use of MMF as a maintenance drug associated the lowest degree of recurrence. Conclusions: Both CYC and MMF as induction therapy are significantly effective in reducing proteinuria. The complete response was more frequently identified as an endpoint at 12 months of follow-up.","PeriodicalId":380281,"journal":{"name":"Medicina Moderna - Modern Medicine","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124088621","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":"Multiple Relapses of Parathyroid Carcinoma with Severe Systemic Complications - Case Report and Literature Review","authors":"Andreea Ilieșiu, A. Ciongariu, B. Socea, M. Ceaușu","doi":"10.31689/rmm.2021.28.4.441","DOIUrl":"https://doi.org/10.31689/rmm.2021.28.4.441","url":null,"abstract":"Parathyroid carcinoma is an exceptionally uncommon endocrine neoplasm, accounting for less than 1% of parathyroid tumours and also a rare cause of primary hyperparathyroidism. Although this malignant lesion is usually slowly progressive, it is frequently associated with local recurrences and also with metastases involving the local lymph nodes or distant sites. We present a 59-year-old male patient who developed a parathyroid carcinoma metastasis involving the anterior mediastinal lymph nodes and thymus remnants, 3 years after the primary tumour was identified and treated by surgical excision followed by chemo and radiotherapy. The patient presented with severe, symptomatic hyperparathyroidism and a gamma scan revealed increased uptake hyperfixation in the paratracheal lymph nodes. A lymphadenectomy was performed and the gross examination of the specimen showed a pinkish – white, firm, poorly circumscribed mass. The microscopic examination revealed an epithelial proliferation with a predominantly nodular/solid growth pattern, composed of cells exhibiting moderate nuclear pleomorphism, prominent nucleoli and high mitotic activity, involving two lymph nodes and thymus remnants. Upon immunohistochemical analysis, the proliferation showed positive staining for GATA 3, as well as a high Ki 67 index, whereas TTF 1 and thyroglobulin were negative in the tumour cells. Thus, the diagnosis of metastatic parathyroid carcinoma was established. The aim of this paper is to gain further knowledge about the histopathological and immunohistochemical features, as well as about the clinical behaviour of parathyroid malignant lesions, especially considering their rarity.","PeriodicalId":380281,"journal":{"name":"Medicina Moderna - Modern Medicine","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124091168","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}