Discoveries (Craiova, Romania)最新文献

{"title":"The Impact of Dementia on Patients with Hip Fracture.","authors":"Andrei Vlad Bradeanu, Iulian Bounegru, Loredana Sabina Pascu, Anamaria Ciubara","doi":"10.15190/d.2024.7","DOIUrl":"https://doi.org/10.15190/d.2024.7","url":null,"abstract":"<p><p>Hip fractures are a serious global health concern with a substantial impact on senior patients' mobility, quality of life, and morbidity. Patients with psychiatric pathology may experience heightened levels of distress, making pain management more challenging. The presence of multiple comorbidities may complicate the therapeutic management of hip fractures. Treatment plans must be carefully tailored to accommodate each individual's unique medical history and current health status. We looked for improving pain evaluation and management in patients with dementia and choosing the best treatment according to age and comorbidities. This study highlights the mortality rate in surgically and non-surgically treated patients and possible correlations with other factors. We conducted a prospective study on 184 patients over 60 years old, with dementia and hip fractures, between 2018 and 2020 in Romania, within the Galati County Clinical Hospital. We applied the Charlson Comorbidity Index, ACE III test, EQ5D5L, and Harris test scores to assess the comorbidities, respectively, pain levels, mobilization in daily life activities, self-care and severity of dementia to exert the optimal treatment for patients with dementia and hip fracture. Our study pointed out that pain was frequently excruciating in non-operated patients compared to those who were operated. Most non-operated patients were immobilized in bed, they required careful and permanent care, while most of the operated patients experienced lower pain levels. While some risk factors of morbidity and mortality, such as comorbidities, severity of dementia, high age, and previous living situations are not preventable, delayed surgery, and general anesthesia risks may be prevented. Despite the treatment, mortality was high both at 6 months and 2 years, with increased survival rate in surgical treated patients. Our study addresses issues such as the importance of mental state evaluation in elderly patients in therapeutic decisions, the surgical intervention and the particularities in pre- and postoperative pain control in patients with dementia, topics that are insufficiently established in the current practical guidelines.</p>","PeriodicalId":72829,"journal":{"name":"Discoveries (Craiova, Romania)","volume":"12 2","pages":"e188"},"PeriodicalIF":0.0,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11421493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding suicide.","authors":"Lavinia Horoșan, Diana-Elena Nistor, Adriana Ion, Mihai Corban, Ana Giurgiuca","doi":"10.15190/d.2024.2","DOIUrl":"https://doi.org/10.15190/d.2024.2","url":null,"abstract":"<p><p>Suicide remains a significant public health challenge globally, requiring comprehensive approaches for prevention and treatment. Almost 90% of individuals who commit suicide suffer from mental health disorders at the time of death, emphasizing the central role of psychiatry in understanding and preventing suicide. Suicidal thoughts, planning, attempts, and completed suicides exist on a continuum, with the highest suicide rates occurring within six months after an attempt and more severe attempts increasing the risk of future suicide. History plays a significant role in shaping the perception of suicide, from considering it a sin to recognizing it as a mental illness. Emile Durkheim's ground-breaking work on suicide as a social phenomenon furthered our understanding. Knowledge regarding the complexities surrounding suicide is paramount to developing effective strategies. Early detection through clinical interviews and screening tools and creating safe spaces for discussion are critical prevention measures. Pharmacological and non-pharmacological interventions are essential for addressing underlying psychiatric disorders and reducing suicidal thoughts and behaviors. While significant progress has been made in understanding suicide risk factors and implementing prevention strategies, continued research and community engagement are imperative. Destigmatizing mental health discourse and fostering supportive environments are essential steps toward reducing the incidence of suicide and supporting individuals in distress. By embracing a holistic approach that integrates pharmacological and non- pharmacological interventions, along with societal engagement, we can strive towards a future where suicide is increasingly rare, and individuals feel valued, supported, and connected.</p>","PeriodicalId":72829,"journal":{"name":"Discoveries (Craiova, Romania)","volume":"12 1","pages":"e183"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Study of Aberrant Aortic Origin of the Right Coronary Artery.","authors":"Jenab Hojefa Badodiyawala, Arpita Meher, Raju Shah, Bipin Chandra Aditya Dasari","doi":"10.15190/d.2024.3","DOIUrl":"10.15190/d.2024.3","url":null,"abstract":"<p><p>This case report examines a rare cardiovascular abnormality, the Aberrant Aortic Origin of the Right Coronary Artery (AAORCA), in a 75-year-old patient with a history of myocardial infarction, acute renal injury, and cardiogenic shock. Rapid medical intervention, including coronary angioplasty, demonstrated the significance of prompt care. Chronic issues, including tobacco use and left ventricular dysfunction, complicated matters, emphasizing the importance of comprehensive long- term therapy. This study underscores the critical clinical significance of AAORCA (Anomalous aortic origin of the right coronary artery) following the SCARE 2023 reporting criteria. This abstract emphasizes the delicate relationship between congenital defects, chronic hazards, and proactive healthcare in complex cardiovascular situations.</p>","PeriodicalId":72829,"journal":{"name":"Discoveries (Craiova, Romania)","volume":"12 1","pages":"e184"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11682872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrial Bigeminy, a Potential Diagnostic Clue for Glioblastoma.","authors":"Cristina Mihaela Stirbu, Daniel Teleanu, Mircea Furtos, Teodora Ghica, Ruxandra Dragoi Galrinho","doi":"10.15190/d.2024.4","DOIUrl":"https://doi.org/10.15190/d.2024.4","url":null,"abstract":"<p><p>Glioblastoma represents the most common and aggressive primary malignant central nervous system tumor, often manifesting with unusual signs. This case report highlights a patient diagnosed with glioblastoma following an unusual cardiac presentation, with syncopes, sinus bradycardia, and atrial bigeminy. A 51-year-old female, brought to the emergency room after experiencing repeated syncope episodes, displayed neurological deficits upon examination. Noteworthy, she presented abnormal ECG showing sinus bradycardia and atrial bigeminy. Following the diagnostic procedure, a tumor was identified with indication to surgical removal. A subtotal tumor resection was obtained and the morphopathology examination led to a glioblastoma diagnosis. Interestingly, post-operatively, the ECG was completely normalized. However, the patient experienced complications, consisting of a massive thromboembolism. While sporadic cases describe unusual glioblastoma manifestations, this report is unique in showcasing atrial bigeminy, among other ECG manifestation. The remission of atrial bigeminy post-operatively suggests its association with the glioblastoma. Tumor localization in the basal ganglia is crucial in understanding such manifestations. Idiopathic cardiac manifestations should not be disregarded, holding potential relevance in central nervous system etiology considerations.</p>","PeriodicalId":72829,"journal":{"name":"Discoveries (Craiova, Romania)","volume":"12 1","pages":"e185"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11550789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering healthcare professionals with no-code artificial intelligence platforms for model development, a practical demonstration for pathology.","authors":"Sayed Shahabuddin Hoseini, Rajan Dewar","doi":"10.15190/d.2024.1","DOIUrl":"10.15190/d.2024.1","url":null,"abstract":"<p><p>Artificial intelligence (AI) and machine learning based applications are thought to impact the practice of healthcare by transforming diagnostic patient management approaches. However, domain knowledge, clinical and coding expertise are likely the biggest challenge and a substantial barrier in developing practical AI models. Most informatics and AI experts are not familiar with the nuances in medicine, and most doctors are not efficient coders. To address this barrier, a few \"no-code\" AI platforms are emerging. They enable medical professionals to create AI models without coding skills. This study examines Teachable Machine™, a no-code AI platform, to classify white blood cells into the five common WBC types. Training data from publicly available datasets were used, and model accuracy was improved by fine-tuning hyperparameters. Sensitivity, precision, and F1 score calculations evaluated model performance, and independent datasets were employed for testing. Several factors that influence the performance of the model were tested. The model achieved 97% accuracy in classifying white blood cells, with high sensitivity and precision. Independent validation supported its potential for further development. This is the first study that demonstrates the value of a free no-code algorithm based AI platforms use in hematopathology using authentic datasets for training. It opens an opportunity for the healthcare professionals to get hands-on experience with AI and to create practical AI models without coding expertise.</p>","PeriodicalId":72829,"journal":{"name":"Discoveries (Craiova, Romania)","volume":"12 1","pages":"e182"},"PeriodicalIF":0.0,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11682784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Roles of molecular neuroimaging techniques in Parkinsonism.","authors":"Emad Singer, Kinal Bhatt, Adarsh Thomas Anthony, Mohamad Badi Dabjan, Sara Muhammad, Jeffrey Tsai, George Michel","doi":"10.15190/d.2023.16","DOIUrl":"https://doi.org/10.15190/d.2023.16","url":null,"abstract":"<p><p>Parkinson's disease affects millions worldwide and is characterized by alpha-synuclein accumulation and loss of dopaminergic neurons in the brain. Until now, there is no cure for Parkinson's disease, and the existing treatments aim to alleviate symptoms. Parkinson's disease diagnosis is primarily based on clinical observation of bradykinesia, mood, and cognition symptoms. Nonetheless, clinical diagnosis has its drawbacks since symptoms of parkinson's disease only manifest in later stages and can be similar to those of other conditions, such as essential tremors or atypical Parkinsonian syndromes. Molecular imaging techniques, including magnetic resonance imaging (MRI), single-photon emission computed tomography (SPECT), and positron emission tomography (PET), can objectively detect changes in the brain's neurochemical processes and help diagnose and study neurodegenerative diseases. The paper discusses functional imaging objectives, the tracers employed for imaging, and the condition of each target in Parkinson's disease. Functional imaging can bestow invaluable revelations concerning the intricate mechanisms underlying both motor and nonmotor impairments in Parkinson's disease while concurrently illuminating the involvement of striatal dopamine in behavioral phenomena extending beyond mere motor regulation. Furthermore, this cutting-edge technology exhibits great potential in investigating the preclinical stage of the ailment, thereby enhancing our comprehension of the merits and limitations associated with surgical interventions and the efficacy of neuroprotective approaches.</p>","PeriodicalId":72829,"journal":{"name":"Discoveries (Craiova, Romania)","volume":"11 4","pages":"e177"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of C-reactive protein in disease progression, diagnosis and management.","authors":"Sarah Ali, Aiza Zehra, Muhammad Umair Khalid, Momina Hassan, Syed Imran Ali Shah","doi":"10.15190/d.2023.18","DOIUrl":"10.15190/d.2023.18","url":null,"abstract":"<p><p>C-reactive protein (CRP) is a ring-shaped pentameric protein synthesized in the liver via CRP gene transcription. It is an inflammatory marker, whose serum levels can be measured using traditional and high-sensitivity tests. In healthy adults, the normal CRP serum concentrations vary between 0.8 mg/L and 3.0 mg/L. These can be grouped into low-, moderate-, and high-risk categories according to CRP levels of less than 1, 1-3, and greater than 3 mg/L, respectively. Elevated levels have been observed in infections, autoimmune diseases, neurodegenerative disorders, and malignancies. However, it is not specific to any disease. Serum CRP levels have also been shown to indicate the risk of cardiovascular disease, owing to their role as inflammatory markers in atherosclerosis, coronary artery disease, and peripheral arterial disease. Furthermore, its role in autoimmune diseases, such as Systemic Lupus Erythematosus and rheumatoid arthritis, and its involvement in the development of cancers, including breast, colorectal, ovarian, prostate, and lung cancers, have also been studied. The involvement of CRP in determining the course of infection and differentiating between bacterial and viral infections has also been investigated. This review summarizes the published literature on C-reactive protein and its role in disease management and progression.</p>","PeriodicalId":72829,"journal":{"name":"Discoveries (Craiova, Romania)","volume":"11 4","pages":"e179"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Flow Diverters in Managing Multiple Aneurysms: A Clinical Case Report.","authors":"Erekle Ekvtimishvili, Rahul Yedpallikar Rajesh, Rowyna Reji Koshy, Binu Thomas Maliyil, Arsha Anil Kumar","doi":"10.15190/d.2023.20","DOIUrl":"10.15190/d.2023.20","url":null,"abstract":"<p><p>Brain aneurysms, also known as cerebral aneurysms, are the growths of the parent artery. Based on their shape, aneurysms can be categorized as saccular or non-saccular. Several factors have been linked to multiple brain aneurysms but the most prevalent is arterial hypertension. In the treatment of cerebral aneurysms, endovascular techniques like coil embolization have essentially taken the place of surgical clipping. Brain aneurysm treatment has undergone a revolutionary change owing to flow diverters. They are now used for complex aneurysms that are unresponsive to standard therapies, in addition to unruptured lesions that were previously treated with standard surgical or coil-based endovascular procedures. Flow diversion has shown to be a more successful treatment for aneurysms than other approaches due to its reduced complication and high recovery rate. We discuss the case of a patient who arrived with headache and was subsequently diagnosed with numerous aneurysms of the left internal carotid artery. Flow diverter stenting was employed to thrombose our patient's existing aneurysms, followed by dual antiplatelet therapy (Ticagrelor and Thrombo ASS) as a post-procedural need. Despite the fact that our patient had both large and minor aneurysms impacting challenging locations, there were no complications after treatment.</p>","PeriodicalId":72829,"journal":{"name":"Discoveries (Craiova, Romania)","volume":"11 4","pages":"e181"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mammary Myofibroblastoma - An Elusive Cause of Breast Lump.","authors":"Nilay Nishith, Sankalp Sancheti, Puneet Kaur Somal, Aishwarya Sharma, Ravikiran N Pawar","doi":"10.15190/d.2023.19","DOIUrl":"https://doi.org/10.15190/d.2023.19","url":null,"abstract":"<p><p>Mammary myofibroblastoma (MM) is an uncommon, benign mesenchymal neoplasm with a favourable prognosis. Its resemblance to various other benign and malignant lesions of the breast makes precise diagnosis challenging when examining biopsy samples. The rarity of mammary myofibroblastoma in India and worldwide underscores the importance of our case report, as we aim to contribute to the existing literature and expand the knowledge base of this neoplasm. Furthermore, we have delved into the diagnostic complexities associated with this lesion and highlighted the ancillary techniques employed to achieve an accurate and reliable diagnosis.</p>","PeriodicalId":72829,"journal":{"name":"Discoveries (Craiova, Romania)","volume":"11 4","pages":"e180"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11550795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic Navigation in Dental Implantology.","authors":"Lata Goyal, Hariram Sankar, Meghna Dewan, Yeshwanth Perambudhuru","doi":"10.15190/d.2023.17","DOIUrl":"https://doi.org/10.15190/d.2023.17","url":null,"abstract":"<p><p>Implant placement for dental rehabilitation has gained more popularity among patients in the recent past. Dental Implants are the workhorse of dentistry. Previously, the implants were placed with the help of the traditional freehand approach. Even though the conventional technique was successful, it has his own shortcomings. Various methods have been introduced, like stent -guided implant placement and navigation guided implant placement, that enhance the precision of implant position. The three different methods for placing the implants are freehand approach, static navigation and dynamic navigation. Among these approaches, the dynamic navigation system is a promising technology in implant dentistry. The dynamic navigation system is being used successfully in various other fields and is well known for its accuracy. It gives an advantage to clinician by providing real-time three-dimensional position of implant and better clinical and patient related treatment outcomes. This review summarizes- the literature and evidence available on dynamic navigation, its potential application, advantages, disadvantages with future directions.</p>","PeriodicalId":72829,"journal":{"name":"Discoveries (Craiova, Romania)","volume":"11 4","pages":"e178"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11709457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}