Practica Medicala最新文献

{"title":"Diagnostic accuracy of digital mammography and breast ultrasonography in prediction of response to neoadjuvant systemic treatment in breast cancer patients","authors":"A. Oprea, B. Gulluoglu, R. Georgescu, Tiberiu-Bogdan Szekely, Alexandra Sava, Andra-Diana Popa, C. Mǎrginean","doi":"10.37897/rjmp.2023.2.3","DOIUrl":"https://doi.org/10.37897/rjmp.2023.2.3","url":null,"abstract":"Aim: The aim of our study was to assess the accuracy of a combination of digital mammography and breast ultrasonography in the prediction of response to neoadjuvant systemic treatment in breast cancer patients with different tumor subtypes. Methods: The study was designed as a retrospective diagnostic accuracy study. Stage I-III female breast cancer patients who received any type of neoadjuvant systemic treatment with radiological response assessment by both mammography and breast ultrasound and followed by surgical treatment in the breast and axilla were included in the study. The primary outcome was the diagnostic accuracy of combined modalities of mammography and breast ultrasonography for predicting the pathological complete response. On mammography and breast ultrasonography, the radiological response was categorized into complete response and non-complete response. Pathological complete response on surgical specimens was described based on current guidelines. True and false positive cases as well as true and false negative cases were counted and compared among patients with 4 different molecular subtypes. The diagnostic accuracy of combined imaging modalities was analyzed for positive and negative predictive values, sensitivity, and specificity rates. All rates were calculated according to the previously described formulas. Results: Eighty-one breast cancer cases were included in the study. Positive predictive values of imaging were 100%, 75%, 100%, and 83%, whereas negative predictive values were 67%, 75%, 100%, and 100% in patients with HR+/HER2-, HR+/HER2+, HR-/HER2+ and HR-/HER2- tumors, respectively. Sensitivity rates were found to be 98%, 90%, 100%, and 100%, whereas specificity rates were 100%, 50%, 100%, and 67% in patients with HR+/HER2-, HR+/HER2+, HR-/HER2+ and HR-/HER2- tumors, respectively. Conclusion: Digital mammography and breast ultrasonography as a combined modality seem to show the pathological complete response after neoadjuvant systemic treatment in HR+/HER2- breast cancer patients with a very high specificity rate. Therefore, these conventional tools may help surgeons to select patients who might benefit from loco-regional treatment de-escalation with higher accuracy.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44758819","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 pattern of the frailty syndrome in chronic heart failure","authors":"Snejana B. Ventrila, Livi T. Grib, A. Ivanes","doi":"10.37897/rjmp.2023.2.2","DOIUrl":"https://doi.org/10.37897/rjmp.2023.2.2","url":null,"abstract":"Introduction. The coexistence of cardiovascular diseases and frailty has been demonstrated, with the prevalence of frailty ranging from 19% to 76%. The presence of frailty significantly influences decision-making regarding the type and timing of diagnostic strategies. Objectives. To assess the features of frailty syndrome in patients with heart failure. Material and methods. A comprehensive search was conducted in PubMed, Google Search, and ResearchGate databases using the keywords “frailty”, “heart failure”, following the STROBE criteria and PRISMA recommendations. Outcomes. The first publication on frailty syndrome in patients with heart failure dates back to 2007, with research in this area peaking in 2021. The prevalence of frailty in heart failure varies due to differences in age groups, assessment methods, and study designs. Frailty affects approximately 70% of heart failure patients over 80 years of age, challenging the stereotype that frailty is solely associated with elderly individuals. Recently issued data by the World Health Organization (WHO) stated that although frailty and heart failure are common in older adults, the prevalence of frailty in this category of patients is independent of age. It is worth noting that frailty is more common in women, yet women tend to have a better prognosis. Diagnosing frailty in heart failure patients is challenging due to the overlap of clinical symptoms. The interaction between heart failure and frailty increases the risk of decompensation, dependency, and negative outcomes. Conclusions. Previous studies have primarily focused on frailty in elderly patients with heart failure. However, chronological age cannot represent an independent parameter in the assessment of frailty, and patients with heart failure should be assessed for the presence of frailty sovereignly of age for prudent risk stratification. Recognizing and early identification of frailty across all age groups will improve prognosis by reducing hospitalizations and enhancing quality of life.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48989224","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":"Patient satisfaction with nursing care and the role of nurses in the management of arterial hypertension","authors":"Besarta Pelaj, Hateme Nimani, Shpresa Ademi","doi":"10.37897/rjmp.2023.2.8","DOIUrl":"https://doi.org/10.37897/rjmp.2023.2.8","url":null,"abstract":"HTA is estimated to be the cause of about 7.1 million deaths per year worldwide, as well as the cause of about 64.3 million disabled for life-years. Purpose. Identification of best practices for improving the quality of nursing care in patients with high blood pressure. Comparison and analysis of patient satisfaction with nursing services. The use of a standard questionnaire among SR nurses in Peja, focused on the Department of Internal Medicine, and in the coronary unit in the role of nurses in the management of patients with hypertension; as well as their ability to educate these patients. For the realization of this paper, the partial research method was also used, which is carried out through questionnaires prepared and divided into descriptive and retrospective phases from the statistics obtained from the protocols of the Regional Hospital of Peja. Excel and SPSS programs. Results. Total of 50 nurses from the regional hospital of Peja participated in the research Specialist ambulances and 200 patients. From the analysis of the hypotheses, we came to the conclusion that the management of nursing care and the perception of nurses regarding the information and education of patients have a positive influence on the management of nursing care of patients with HTA, this is proven through the correlation (rho=0.625**, value and p=0.000). The results hypothesis show that good nursing care practices as guidance through brochures, determination of appropriate therapy and hospital support have positive impact on patient satisfaction and Hypertension disease management arterial with correlation (rho=0.767**, p value=0.000). Discussion. Well as in our country and in other countries, there is a lack of studies on the specific preparation of nurses and regulatory protection of NCD. Conclusion. Education programs improve care, reduce re-hospitalization and increase quality of life and functional status of patients, as well as decrease mortality from HTA.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136365121","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":"Treatment with intravenous immunoglobulin in a subclinical neonatal myocarditis – Review of the literature and a case report","authors":"Maria-Andreea Racean, L. Suciu, Laura Beligan, C. Mărginean","doi":"10.37897/rjmp.2023.2.1","DOIUrl":"https://doi.org/10.37897/rjmp.2023.2.1","url":null,"abstract":"Myocarditis is an inflammatory disease of the myocardium that is associated with significant morbidity and mortality. We present the case of a male infant born at 38 weeks gestational age detected with subclinical myocarditis. The diagnosis was suggested by the raised cardiac enzymes, small voltages on electrocardiogram and biventricular hypertrophy on echocardiography. The newborn was managed with supportive, immunomodulatory therapy, diuretics and anti-platelet agents (Aspirin). Early intravenous immunoglobulin administration may have helped to reduce morbidity and mortality, even if administration of intravenous immunoglobulin is not yet clearly established in the neonatal population.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43270563","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":"Technological aspects regarding the process of obtaining of ceramic veneers – Part I","authors":"R. Costea, S. Drafta, Firas Sbeiti, M. Burlibașa, V. Perieanu, Ileana Ionescu, Simion Gheorghe Dumitru, M. Perieanu, L. Burlibașa, Florentina Caministeanu, Cristina Maria Serbanescu, C. Ionescu","doi":"10.37897/rjmp.2023.1.8","DOIUrl":"https://doi.org/10.37897/rjmp.2023.1.8","url":null,"abstract":"Dental veneers made of ceramic masses are considered on conservative solution for patients that require an enhancement of shape, shade, dimension and/or position of anterior teeth. Ceramic veneers are successfully used on large scale to hide tooth discoloration, to correct the position and minor defects of teeth, without removing significant quantities of hard tissues.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48376221","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 delirium as a form of presentation of a thalamic hemorrhagic stroke","authors":"Alberto Ibáñez Navarro, Paula Castillo Aguirre, Laura Mercedes Sarrasqueta Saenz, María Jesús Martínez Valles","doi":"10.37897/rjmp.2023.1.6","DOIUrl":"https://doi.org/10.37897/rjmp.2023.1.6","url":null,"abstract":"Delirium is a frequent cause of decompensation in the elderly, especially with higher prevalence in highly dependent patients, in advanced ages and senile dementia. It is important to always look for the principal cause before treating only the symptom. This case describes a 79-year-old woman with an episode of agitation and disorientation lasting several days, underestimated by its mild nature, but which ends up being a thalamic hemorrhagic stroke. Hemorrhagic stroke is a less common pathology than ischemic stroke but with higher morbidity and mortality. Specifically focused on the thalamus produces behavioral and sensory alterations that can be confused with multiple pathologies. Early identification and approach influence recovery and the sequelae that are being worked with different physiotherapeutic therapies.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43916427","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":"Neutrophil to lymphocyte ratio in ovarian cancer – a new prognostic marker?","authors":"I. Bălescu, N. Bacalbaşa, I. Brezean, C. Stoica, C. Tomescu, Cristina Martac, Andrei Voichitoiu, B. Gaspar","doi":"10.37897/rjmp.2023.1.1","DOIUrl":"https://doi.org/10.37897/rjmp.2023.1.1","url":null,"abstract":"Neutrophil to lymphocyte ratio represents a novel prognostic marker which is usually associated with the presence of proinflammatory conditions such as obesity, metabolic syndrome or certain benign and even malignant diseases. Moreover, in cases in which a malignant condition is present, the value of the neutrophil to lymphocyte ratio also seems to be positively corelated with the biological aggressivity of the tumor. The aim of the current paper is to discuss about the most relevant studies which discuss about the role of this parameter as a new biological marker in ovarian cancer patients.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49617483","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":"Classic Hodgkin Lymphoma- mixed cellularity – case report and review of literature","authors":"Mihaela Oprea-Lebedenco, N. Berbec, O. Stanca, A. Turbatu, S. Marín, C. Dobrea, M. Andreescu, A. Lupu","doi":"10.37897/rjmp.2023.1.5","DOIUrl":"https://doi.org/10.37897/rjmp.2023.1.5","url":null,"abstract":"Hodgkin's lymphoma, formerly known as Hodgkin's disease, is a type of cancer of the lymphatic system, an important part of the site where immune processes take place. The disease can affect people of any age, but it is much more common in the age range of 20-40 years and in people over 55 years old. In Hodgkin's lymphoma, cells in the lymphatic system multiply uncontrollably and can spread outside of it. Advances in the diagnosis and treatment of Hodgkin's lymphomas present a chance for patients to achieve a complete remission of this type of cancer. The prognosis is constantly improving for people with this diagnosis. This article will present the case of a 27-year-old patient with classic Hodgkin's Lymphoma - histological subtype mixed cellularity - chemo refractory.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41560377","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 place of mini-invasive Transanal-Hemorrhoidal-Dearterialisation and Rectopexy technique in the treatment of hemorrhoidal disease, an evaluation from cost-effectiveness point of view","authors":"R. Mehic, A. Diaconeasa, M. Beuran, A. Chiotoroiu","doi":"10.37897/rjmp.2023.1.4","DOIUrl":"https://doi.org/10.37897/rjmp.2023.1.4","url":null,"abstract":"Background. Choosing the most suitable treatment for Hemorrhoidal Disease (HD) still poses problems for both patients and doctors. THD-RAR although it has proven its superiority regarding postoperative complications, length of hospital stay, return to daily activity compared to Hemorrhoidectomy (HE), it still has a low rate of less than 10% in our hospital, the main causative factor being the increased cost of consumables. Our aim is to analyze the veracity of this factor. Methods. We performed a case-control study in the period 2009-2022 and we evaluated two groups of 50 patients, operated by the THD-RAR method and HE respectively. We had as Main Objective the comparison of average hospitalization costs and as Secondary Objectives the evaluation of postoperative hospitalization, complications, recurrences, the influence on the final cost of social costs. Results. Financially, the elderly had less accessibility to THD-RAR. Internal hemorrhoids predominated in the THD-RAR-group and associated ones in the HE-group (64% and 48%, respectively; p<0.001). Bleeding was the predominant symptom in THD-RAR-group versus prolapse in the HE-group. The mean operation time was longer in THD-RAR compared to HE (48 and 56 min respectively; not significant). The significantly longer postoperative hospital stay in the HE-group compared to the THD-RAR-group (2.52 versus 1.74 days; p<0.001), obviously influenced the hospitalization expenses (834 versus 485 EUR; p<0,001). Thus, although the expenses with the operation were higher for THD-RAR compared to HE, in the end summing up the hospitalization expenses and the social expenses, the difference tilted in detriment of HE (277 EUR). Conclusion. Our study shows that if we subtract from the amortization expenses, the savings made from hospitalization expenses and social expenses, then THD-RAR-HE balance will be in favor of THD. THDRAR must take its place both in the hospitals' own therapeutic protocols and in the national guidelines, being a cost-effective method.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45031714","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":"Phototherapy in allergic rhinitis","authors":"R. Bugari, S. Baschir, Luminiţa Turcin, D. Chita, D. Zdremţan, Ioana Floarea, A. Jompan, Alexandru Chioreanu","doi":"10.37897/rjmp.2023.1.2","DOIUrl":"https://doi.org/10.37897/rjmp.2023.1.2","url":null,"abstract":"Allergic rhinitis, commonly known as hay fever, is a condition characterized by the inflammation of the nasal passages caused by allergens such as pollen, dust mites, animal dander, and mold. It affects approximately 10-30% of the global population, and its symptoms include sneezing, runny nose, nasal congestion, itchy eyes, and throat irritation. One of the treatment options for allergic rhinitis is phototherapy, a non-invasive and drug-free approach that has shown promising results in managing the condition. Objectives. The main objective is to study phototherapy in the treatment of allergic rhinitis compared with placebo therapy. We want to apply an effective therapeutic method, a safe one, without notable side effects, cheaper, which improve the health of our patients, and the quality of their life. Methods. It is randomized study, investigating the effect of placebo controlled rhinophototherapy, for a total of 187 patients who met the criteria for inclusion/exclusion. Rhinophototherapy effect was investigated measuring the nasal flow (rhinomanometry) and individual scores for subjective and objective symptoms. Results. Patients treated with phototherapy = 65, placebo = 32 patients treated. Evolution lot phototherapy: very good - 67% improvement, good improvement - 28%, 5%-unfavorable evolution. Analyzing the placebo treated group: good results-10%, 43% moderate-improvement, evolution-47% unfavorable. Conclusions. Phototherapy is an effective therapeutic method to treat patients with allergic rhinitis, is a well tolerated therapy, with minor side effects, easy to implement and monitor.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45568372","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}