Medicina Moderna - Modern Medicine最新文献

{"title":"Therapeutic Management of Breast Cancer Related Upper Limb Lymphedema","authors":"Andreea GROSU-BULARDA, Flavia-Francesca Lita, A. Serban, F. Hodea, A. Stoian, I. Lascar, R. Teodoreanu","doi":"10.31689/rmm.2021.28.4.367","DOIUrl":"https://doi.org/10.31689/rmm.2021.28.4.367","url":null,"abstract":"Lymphedema represents a chronic condition with impaired lymphatic transport, having primary and secondary etiologies. The most common type of secondary lymphedema in western countries is represented by breast cancer related upper limb lymphedema. This condition, once installed, determines limb structure changes, progressive functional impairment, specific complications, consequently impacting the quality of patient’s life. An accurate diagnosis is mandatory, using both clinical and imagistic methods with clear definition disease extent as per standardized staging systems, in order to further provide an adequate therapeutic strategy. The main therapeutic goal in patients with lymphedema is represented by limb volume reduction with subsequent symptoms relief, improving quality of life and avoiding complications such as recurrent infections. Through this paper, we aim to present a comprehensive overview of current therapeutic options of breast cancer upper limb related lymphedema. Therapeutic approach comprises of non-surgical (conservative) therapy, which is mandatory as initial therapy and surgical procedures for selected cases. Most patients with lymphedema benefit from conservative treatment alone. In non-responsive cases, in patients with progressive disease, in late stage complicated lymphedema, and also recently added as prophylactic strategy, surgical treatment, trough recent developed techniques, offer very good results in long-term control of disease. Surgical options are classified firstly in physiologic procedures that aim to create new lymphatic channels, promote physiologic drainage of the lymph and should be considered early in the course of the disease, and secondly ablative procedures that reduce through liposuction or various excision techniques the volume of the affected limb. Both types of techniques can be combined to ensure the best functional outcome of the patient.","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":"127769524","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":"Statistical Study Regarding the Presence of Gram Bacteria in Patients with Cardiovascular Disease and Periodontal Disease","authors":"I. Voinescu, D. Ferechide","doi":"10.31689/rmm.2021.28.4.413","DOIUrl":"https://doi.org/10.31689/rmm.2021.28.4.413","url":null,"abstract":"Pathogenic bacteria, originating in the inflamed periodontium, can make their way into the body through the vascular system, either by entering the bloodstream or lymph directly or as internalized particles of immune cells. This research aims to investigate the existence of a potential connection between two pathologies – periodontitis and ischemic heart disease – by utilizing a DNA-DNA hybridization technique to highlight the presence of seven periodontal pathogens: A. actinomycetemcomitans, P. gingivalis, P. endodontalis, P. intermedia, T. forsythia, C. rectus and F. Nucleatum. The study was conducted over a period of 3 years on a sample consisting of 119 patients with cardiovascular disease and periodontal disease, divided into 3 groups by pathologies, as follows: the first group consisted of 31 patients with ischemic cardiomyopathy, the second group consisted of 43 patients with periodontal disease and ischemic cardiomyopathy, and the third group consisted of 45 patients with periodontal disease. The results show the possibility of a correlation between the composition of the bacterial flora in the group of patients with cardiac disease and those with associated pathologies. In conclusion, we may state that periodontitis may be seen as a risk factor in heart disease, which may certify the possibility of an etiological connection between the two pathologies.","PeriodicalId":380281,"journal":{"name":"Medicina Moderna - Modern Medicine","volume":"21 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":"131299071","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":"Comparative Analysis of Vertical Transmission of SARS-CoV-2 Antibodies in Vaccinated and Non-Vaccinated Pregnant Women","authors":"Mădălina Iordache, D. Secară, C. Mehedințu, M. Antonovici, N. Turcan, M. Cirstoiu","doi":"10.31689/rmm.2021.28.4.419","DOIUrl":"https://doi.org/10.31689/rmm.2021.28.4.419","url":null,"abstract":"Pregnancy is a risk factor for developing a severe, complicated form of COVID-19. Medical reports have revealed that pregnancy increases three times the risk of ICU admission and 1.7 times the risk of death in patients with COVID-19. The crossing of the placenta by the antibodies generated through vaccination offer a level of protection that should not be ignored. We aimed to comparatively analyze the levels of SARS-CoV-2 IgG and IgM antibodies in pregnant women who have had this infection during pregnancy or have undergone a complete vaccination cycle during pregnancy, as well as antibody levels in newborns. The inclusion criterion was history of SARS-CoV-2 infection during pregnancy or COVID-19 complete vaccination. For each case the peri-partum values of IgG and IgM SARSCoV- 2 antibodies were analyzed in the same laboratory along with those of their newborns. The vaccination rate in our study group was about 6%. All cases had a significant value of protective IgG SARS-CoV-2 antibodies and the level of protective antibodies of the newborns closely followed maternal values. From the cases with SARS-CoV-2 infection during pregnancy, only 16.6% had a protective level of antibodies and 75% of the newborns from these cases had protective levels of IgG SARS-CoV-2 antibodies. Our results clearly plead in favor of vaccination in pregnancy which provides significant benefits for both mothers and infants.","PeriodicalId":380281,"journal":{"name":"Medicina Moderna - Modern Medicine","volume":"17 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":"116342224","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 Case of Multiple System Atrophy (MSA) – First Presentation in a Psychiatry Service","authors":"Elena Alina Rosca, Andra Livia Bronescu, O. Tudor","doi":"10.31689/rmm.2021.28.4.461","DOIUrl":"https://doi.org/10.31689/rmm.2021.28.4.461","url":null,"abstract":"A 67 years old female developed cognitive defficits, depression and anxiety as first symptoms of multiple system atrophy (MSA). In the course of an year autonomic failure, parkinsonism and cerebellar ataxia also developed. The case is particular because of the somatic symptoms that were initially categorised as psychogenic, the presence of confusional and vertigo episodes that were recurring but not permanent.","PeriodicalId":380281,"journal":{"name":"Medicina Moderna - Modern Medicine","volume":"373 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":"116540292","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 Value of Morphologic Study (MRI) of the Median Nerve in Stadialization and Treatment of the Carpal Tunnel Syndrome","authors":"F. G. Panculescu, R. Ştefănescu, I. Bordeianu, I. Bratu","doi":"10.31689/rmm.2021.28.4.407","DOIUrl":"https://doi.org/10.31689/rmm.2021.28.4.407","url":null,"abstract":"Carpal tunnel syndrome is a sensitive neuropathy of the upper limb caused by chronic compression of the median nerve. The presented study focused on highlighting the value of morphological changes of the median nerve - shown by MRI in the management of carpal tunnel syndrome. The study group included 23 patients, adults, treated in the Plastic Surgery Clinic of the County Emergency Clinical Hospital in Constanta - prospective study. Magnetic resonance imaging allowed accurate measurement of the median nerve diameter and showed significant decreases in most cases, which suggested an advanced stage of the disease - morphological changes being corroborated with clinical ones. This imagistic investigation opens a new way in establishing the surgical indication, which is required in case of reduction of the nerve diameter by at least 1.5mm at the site of compression. The criterion of diameter decrease can be a benchmark in order to establish a therapeutic algorithm in carpal tunnel syndrome.","PeriodicalId":380281,"journal":{"name":"Medicina Moderna - Modern Medicine","volume":"50 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":"123684753","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":"Versatility of Vein Grafts in Hand Neurovascular Reconstruction – Clinical Cases and Literature Review","authors":"A. Stoian, F. Hodea, Roxana Maria TOMEK ENESCU, Andreea GROSU-BULARDA, M. Andrei, Flavia-Francesca Lita, M. Popescu, I. Lascar, R. Teodoreanu","doi":"10.31689/rmm.2021.28.4.453","DOIUrl":"https://doi.org/10.31689/rmm.2021.28.4.453","url":null,"abstract":"Injuries to the upper limb may determine unexpected simple or complex soft tissue defects, due to different types of underlying injury mechanism, clean cut/stabs, crushing, torsion, avulsion or mixed types, which pose a challenge for the reconstructive surgeon. Ideally, all arterial, venous and nervous lesions, in the distal upper limb should be repaired in an end-to-end technique, outside of injury zones, with healthy ends, in a tension free manner. However, situations arise where, either a tension-free repair is not possible, or a considerable defect is met, often representing a challenge to the surgeon. Therefore, a timely decision is imposed in order to find the most favorable approach to restore limb or segment perfusion, ensuring efficient venous return, as well as providing a sensate repair. Usage of vein grafts represents an essential tool comprised in the reconstructive surgeon’s armamentarium, with high versatility in nerve, arterial and venous reconstruction. Not only does it provide an ideal solution, with high adaptability to each case, but it also may enhance short- and long-term outcome, offering an optimal reconstructive option in any upper limb trauma situation, regardless of etiology. We aim to describe our therapeutic strategies in a series of challenging trauma cases involving digital structures from the upper limb. Interposed vein grafts were used to re-stablish sensate function in a patient with a collateral digital nerve defect, but also to bridge vital digit arterial defect in a torsion-avulsion thumb amputation, as well as re-establishing venous flow in patients with Urbaniak II finger degloving injury.","PeriodicalId":380281,"journal":{"name":"Medicina Moderna - Modern Medicine","volume":"14 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":"114992277","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":"How Can We Predict Success in Poor Responders?","authors":"A. Bordea, E. Brătilă, D. Mihai, M. Antonovici, C. Mehedințu, A. Carp-Velișcu","doi":"10.31689/rmm.2021.28.4.361","DOIUrl":"https://doi.org/10.31689/rmm.2021.28.4.361","url":null,"abstract":"Objectives: The aim of this study was to evaluate how can we predict success in poor responder patients in terms of pregnancy rate and live birth rate. Material and method: This study is a review of the newest papers that have in the center the poor responders undergoing treatment involving assisted reproductive techniques (ART). Outcomes: The results show that the most reliable factors when counseling a poor responder patient are age and Anti-Müllerian hormone (AMH) level. Conclusions: The most important factors that influence pregnancy rate are age and ovarian reserve, but other factors such as male pathology and laboratory techniques must be studied deeper.","PeriodicalId":380281,"journal":{"name":"Medicina Moderna - Modern Medicine","volume":"24 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":"125929704","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":"Lipid Profile of the Patient with Acute Coronary Syndromes Undergoing Coronary Angiography (CAG) in Rural Costal Region of Maharashtra","authors":"Deshpande Janhavi Jaywant, Amit Bhalerao, Vikas Ratnaparkhi, Suryakant Nisale, P. Shamraj, U. Kulkarni, S. Kotkunde, N. Kesarkar, S. Nanaware, Vikas Deokar, Chaitanya Madkar, R. Sing","doi":"10.31689/rmm.2021.28.4.397","DOIUrl":"https://doi.org/10.31689/rmm.2021.28.4.397","url":null,"abstract":"Background: Coronary Heart Disease (CHD) is widely prevalent across the globe and significantly high level of Cholesterol in circulation is a single major risk factor associated with coronary heart disease. It is well established that cardiovascular disease is associated with hypertension and elevated blood levels of low-density lipoprotein (LDL), total cholesterol, and triglycerides. In disparity, a low level of high-density lipoprotein (HDL) is a risk factor for mortality from cardiovascular disease. Aim: The present study was conducted with the aim to assess the lipid profile in patients of Acute Coronary Syndrome (ACS) undergoing coronary angiography (CAG) in rural coastal population. Patients and Methods: The present study was done on 62 patients with Acute Coronary Syndrome (ACS) undergoing coronary angiography (CAG) Serum levels of total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides were examined in biochemical laboratory of the hospital. Coronary angiography was performed for the presence of lesions. Results: 43.5% of the patients (n=27) were elderly (age>60 years). Approximately 82% of the patients (n=51) aged more than 50 years. Males outnumbered females with a ratio of 2.4:1. 71% of the patients were males. Mean cholesterol levels were 177.86 mg/dl. Approx 3/4th of the patients (n=41) had cholesterol level <200 mg/Dl. Mean triglycerides levels in the patients were 158.29 mg/dl. Only 11 patients out of 62 CAD patients had abnormal triglycerides. Mean LDL level was 119.5 mg and Mean HDL level was 34.5 mg %. The high plasma concentration of low-density lipoprotein (LDL-C) in 30% and the low plasma concentration of high-density lipoprotein (HDL-C) n 33% of patients were important abnormal findings in our patients. Conclusion: Dyslipidemia as in form of very low levels of HDL cholesterol with comparatively high levels of LDL-c with near normal total Cholesterol and triglyceride levels associated with ACS in our rural costal region of Maharashtra.","PeriodicalId":380281,"journal":{"name":"Medicina Moderna - Modern Medicine","volume":"144 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":"131651010","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 Bucharest College of Physicians’ Study on Burnout Amongst Healthcare Professionals in Romania’s Capital City during COVID-19 Pandemic","authors":"Fabian Klein, B. Popescu, L. Negreanu, H. Bumbea, A. Mihalaş, C. Poiană","doi":"10.31689/rmm.2021.28.4.383","DOIUrl":"https://doi.org/10.31689/rmm.2021.28.4.383","url":null,"abstract":"The importance of burnout amongst medical staff was highlighted by various papers, showing that this issue implies job demands and job resources. The current challenge of SARS-CoV-2 pandemic also raised many concerns about its impact on healthcare sector. A new survey after 4 years from the previous study of the Bucharest College of Physicians is coming with new data, containing the effect of COVID-19 on the psychological wellbeing of its members. The increasing of burnout was found in all categories, and the most frequently solutions claimed by the respondents were related to decreasing of workload and bureaucracy, and an important number of physicians identify the need for specialized psychological assistance. The COVID-19 pandemic period exacerbated the system related factors that contribute to the phenomenon of burnout.","PeriodicalId":380281,"journal":{"name":"Medicina Moderna - Modern Medicine","volume":"129 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":"132863589","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":"Mucormycosis Infections during the Second Wave of COVID-19: Experience from a Tertiary Care Centre in India","authors":"S. Bhandari, Shivankan Kakkar, A. Dube, M. Grover, S. Bhargava, A. Tak, Bhoopendra Patel, Minal Kachhawa","doi":"10.31689/rmm.2021.28.4.425","DOIUrl":"https://doi.org/10.31689/rmm.2021.28.4.425","url":null,"abstract":"Background: Mucormycosis is an uncommon fungal infection with high morbidity and mortality. There had been a sudden surge in the cases of mucormycosis during the second wave of Coronavirus Disease 2019 (COVID-19) in India. Objective: The etiology, pathophysiology, and correlations of mucormycosis at tertiary hospital in India is explored in the present study. Methods: In this retrospective observational study, all coronavirus disease associated mucormycosis (CAM) cases admitted at this center between April 2021 to June 2021 were included. The cases were evaluated in terms of their background, most common presentations, chief underlying etiologies, severity of disease, comorbidities, investigation profiles, prognosis, and treatment provided. Results: Among the total 231 cases reported with mucormycosis, age group of 40 - 50 years (28%) was the most afflicted and the 20 30 year was the least. Men (68%) were more afflicted than Women. 66% patients had a history of vaccination against COVID-19. 63% patients presented with a High-Resolution Computerized Tomography (HRCT) score of 9-16. 60% required oxygen support and 71% required steroids. Diabetes mellitus was the most prevalent comorbidity. Conclusion: The salience of the second inferno wave of COVID-19 was witness to COVID-19 patients who had pre existing diabetes mellitus. Individuals with diabetes in general foster more extreme COVID-19 infections and end up using corticosteroids. In any case, the corticosteroids – alongside diabetes – increment the danger of getting mucormycosis. The specific pathophysiology of COVID-19 may represent co-morbidity with Invasive Fungal diseases (IFI).","PeriodicalId":380281,"journal":{"name":"Medicina Moderna - Modern Medicine","volume":"2 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":"134618950","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}