Maedica最新文献

{"title":"Mechanical Preparation of the Colon before Colorectal Surgery - Is It Still Actual?","authors":"Maria-Alexandra Dragomir, Alexandru Constantinescu, Octavian Andronic","doi":"10.26574/maedica.2024.19.4.769","DOIUrl":"10.26574/maedica.2024.19.4.769","url":null,"abstract":"<p><p>Mechanical bowel preparation (MBP) has long been a subject of debate in colorectal surgery. While it was historically regarded as a standard preoperative practice, recent evidence has questioned its necessity and effectiveness, especially when used in isolation. This review explores the evolving role of MBP, its combination with oral antibiotics (OA), and its impact on postoperative outcomes, such as surgical site infections (SSI) and anastomotic leakage (AL). Studies suggest that MBP combined with OA offers superior benefits compared to MBP alone, particularly in left-sided colorectal and rectal surgeries. However, the role of MBP remains contentious in right-sided resections, with conflicting evidence regarding its effectiveness. Furthermore, concerns about patient discomfort, dehydration, and electrolyte imbalances have raised doubts about its routine use. Our comprehensive analysis, based on 11 years of published research, highlights that the decision to employ MBP should be individualized, taking into account the type of surgical intervention, patient comorbidities and overall health status. While MBP+OA shows promise in reducing SSI rates, further research is needed to evaluate its broader clinical implications and to explore alternatives, including newer antibiotics, to minimize reliance on MBP.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"769-774"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461231","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":"Micro-Epigenetic Markers in Viral Genome: SARS-CoV-2 Infection Impact on Host Cell MicroRNA Landscape.","authors":"Aristeidis Chrysovergis, Vasileios Papanikolaou, Dimitrios Roukas, Despoina Spyropoulou, Sofianiki Mastronikoli, Sotirios Papouliakos, Evangelos Tsiambas, Pavlos Pantos, Panagiotis Fotiades, Dimitrios Peschos, Vasileios Ragos, Nicholas Mastronikolis, Efthymios Kyrodimos, Athanasios Niotis","doi":"10.26574/maedica.2024.19.4.842","DOIUrl":"10.26574/maedica.2024.19.4.842","url":null,"abstract":"<p><strong>Introduction: </strong>MicroRNAs (miRs) are crucial micro-genetic markers that significantly manipulate gene expression in neoplastic/malignant and non-neoplastic diseases, as viral infections. Different expression patterns of miRs seem to partially influence the response rates to specific chemo-targeted therapeutic regimens and prognosis in cancer patients. Concerning their nature, miRs are short non-coding RNAs including 20-25 nucleotides hosted in intra- or intergenic regions. Their most important function is the positive regulation of post-transcriptional gene silencing levels. Based on this activity, they enhance normal cell functions, including proliferation, apoptosis and tissue differentiation. Their deregulation in cancerous cells due to epigenetic and transcriptional imbalances is correlated with an excessive production of target mRNA.</p><p><strong>Objective: </strong>In the current paper, our aim was to generally describe the role of MiRs in cancer genome and we mainly focused on specific host target-cell miRs that are affected by SARS-CoV-2 in the COVID-19 pandemic.</p><p><strong>Material and method: </strong>A systematic review of the literature was carried out based on the international database PubMed focused on miR nature, origin, structure and function in cancer genome and more recently on the influence of SARS-CoV-2 on affected cells. The following keywords were used: microRNA, SARS-CoV-2, COVID-19, infection, cancer, virus. A pool of 52 important articles were selected for the present review at the basis of exploring the SARS-CoV-2 efficacy in miRs.</p><p><strong>Results: </strong>A broad set of miRs, including miR-122, miR-16-2-3p, miR-3605-3p, miR-15b-5p, miR-486-3p, miR-486-5p, miR-447b, miR-3672, miR-325, miR-447b and miR-222, has been identified to be deregulated by SARS-CoV-2 infection.</p><p><strong>Conclusions: </strong>miRs represent significant micro-epigenetic markers frequently deregulated in SARS-CoV-2 mediated infection (COVID-19). Interactions between miRs and SARS-CoV-2 RNA genome are under investigation. miR overexpression/expression loss in SARS-CoV-2 affected epithelia is correlated with specific genetic and by epigenetic signatures in the corresponding patients.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"842-847"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461232","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":"Giant Cell Tumor of the Tendon Sheath in the Anatomical Snuffbox - Report of an Unusual Location.","authors":"Dimitrios Giotis, Christos Konstantinidis, Sotiris Plakoutsis, Christos Kotsias, Charilaos Galanis, Alkisti Konstantinou, Evangelos Anagnostou, Dimitrios Tsiampas, Dimitrios Vardakas, Vasileios Panagiotopoulos","doi":"10.26574/maedica.2024.19.4.856","DOIUrl":"10.26574/maedica.2024.19.4.856","url":null,"abstract":"<p><p>The aim of this study is to present a case of giant cell tumor of the tendon sheath in the anatomical snuffbox, an extremely unusual location of such neoplasms. A 54-year-old male came to our hospital with a mass in his left hand that had appeared over the past two years, demonstrating a recent rapid increase in size. The physical examination revealed that the mass did not cause any pain or restriction in the range of motion. The neurovascular function remained intact. The magnetic resonance imaging (MRI) detected a 2.5 x 1.5 cm mass in the anatomical snuffbox but without a clear diagnosis. A meticulous marginal surgical excision was performed and biopsy sample was sent for histopathologic examination. Intraoperatively, it was observed that the tumor extended in-between the tendons of the first and third dorsal compartments, reaching the radial artery at the depth of the anatomical snuffbox. Macroscopically, the tumor resembled a giant cell tumor, which was confirmed by histological examination. The patient was discharged from the hospital on the same day. He fully resumed his daily activities three weeks after surgery. Three years later, he remained free of symptoms without any recurrence of the tumor. Giant cell tumor of the tendon sheath is a benign neoplasm that demonstrates local aggressiveness. In several cases, nerves and blood vessels might be entrapped within the tumor. This complication along with its high recurrence rate renders surgical excision of the tumor a particularly demanding procedure.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"856-860"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461038","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":"Fingolimod-Associated Central Serous Retinopathy Presenting Eight Years after Treatment Initiation: a Case Report.","authors":"Panos Gartaganis, Panagiotis Stavrakas, Evita Evangelia Christou, Marina Vasalaki, Efthymios Karmiris","doi":"10.26574/maedica.2024.19.4.869","DOIUrl":"10.26574/maedica.2024.19.4.869","url":null,"abstract":"<p><p>Fingolimod is an efficacious treatment option in the management of multiple sclerosis, while variable ocular adverse effects have been associated with its use. Herein, we present a case with development of central serous retinopathy (CSR) in the long-term after commencement of fingolimod treatment. A 53-year-old female with relapsing-remitting multiple sclerosis presented with central vision metamorphopsia in the left eye. Medical history revealed that the patient had been on treatment with fingolimod for eight years. Ophthalmological examination revealed retinal findings suggestive of CSR changes. Given the necessity to continue fingolimod treatment, the patient commenced topical nonsteroidal anti-inflammatory (nepafenac) medication for the retinal condition. There was a prompt and successful resolution of fluid following treatment; however, a subsequent presumed ocular surface disease urged the discontinuation of anti-inflammatory drops. Four weeks later, the patient presented with recurrence of fluid in the subRPE level. Thereafter, fingolimod treatment was switched to dimethyl fumarate. The patient's condition remained clinically stable without recurrence of fluid during a three-month follow-up period. Our case provides insight into the fingolimod associated retinal findings manifesting as CSR changes, indicating that ocular complications may occur even in the long-term, while discontinuation of treatment may lead to reversal of structural findings and maintain functional outcomes.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"869-873"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461082","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":"Comparative Evaluation of Intralesional Injection of Botulinum Toxin Type A <i>versus</i> Triamcinolone Acetonide in Treating Post-Burn Pruritus.","authors":"Seyed Saheb Hoseininejad, Roozbeh Rahbar, Mahtab Farhadi, Shahram Godarzi","doi":"10.26574/maedica.2024.19.4.763","DOIUrl":"10.26574/maedica.2024.19.4.763","url":null,"abstract":"<p><strong>Background and objectives: </strong>Pathological scars resulting from burns can impair both aesthetic and physical functions, often causing chronic pruritus. Thus, this study aimed to compare the effectiveness of intralesional botulinum toxin type A (BTX-A) and triamcinolone acetonide (TAC) in reducing pruritus and scar thickness caused by burns.</p><p><strong>Methods: </strong>This single-blind clinical trial was conducted on 60 patients experiencing post-burn pruritus. Patients selected a scar area with the highest degree of pruritus, which was divided into two equal parts. BTX-A was injected into one half and TAC into the other. Pruritus severity was assessed using the visual analog scale (VAS), the pain was assessed using the numeric rating scale (NRS), and scar thickness and the Vancouver scar scale (VSS) scores were at four time points.</p><p><strong>Results: </strong>The study involved 60 patients with a mean age of 35.72 years (range: 21-64 years). The results indicated that BTX-A was more effective than TAC in reducing scar thickness and pruritus. Changes in scar thickness from V1 to V4 demonstrated that BTX-A achieved more significant scar reduction than TAC (P=0.0287), and pruritus severity decreased significantly in the BTX-A group (P=0.0482).</p><p><strong>Conclusion: </strong>Based on the results, BTX-A treatment is more effective than TAC in reducing pruritus and scar thickness in patients with chronic post-burn pruritus. Further studies with larger sample sizes and extended follow-up periods are required to confirm these findings.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"763-768"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461085","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":"Ig Nobel Prize.","authors":"Mircea Cinteza Md PhD","doi":"10.26574/maedica.2024.19.4.675","DOIUrl":"10.26574/maedica.2024.19.4.675","url":null,"abstract":"","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"675-677"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461118","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":"How Effective is Ozone Therapy in Treatment of Lumbar Disc Disease: a Systematic Review of Prospective Studies.","authors":"Vishal Kumar, Syed Ifthekar, Vikash Raj, Seshadri Reddy Varikasuvu, Aakash Jain, Arvind Vatkar, Pankaj Kandwal, Sitanshu Barik","doi":"10.26574/maedica.2024.19.4.816","DOIUrl":"10.26574/maedica.2024.19.4.816","url":null,"abstract":"<p><strong>Objective: </strong>With numerous studies reporting on the clinical efficacy of ozone therapy, there has been a growing interest in its use for disc herniation in lumbar disc disease. The aim of this meta-analysis is to explore the results of the prospective studies using ozone for the treatment of lumbar disc disease.</p><p><strong>Methods: </strong>Online electronic databases of PubMed, Embase and Scopus were searched using relevant keywords. This review included prospective studies on the treatment of lumbar disc herniation using ozone therapy.</p><p><strong>Results: </strong>A mean improvement of 4.25 (95% CI 2.93-5.58) in visual analogue scale (VAS) scores was noted. A mean improvement of 20.57 (95% CI 18.47-22.68) in Oswestry disability index (ODI) was noted across the studies on meta-analysis. Meta-regression of the pre-operative and post-operative VAS score did not show any significant association with age at procedure, gender or the level of lumbar disc disease. None of the selected studies reported any minor or major complication.</p><p><strong>Conclusion: </strong>Ozone treatment in low back pain associated with herniated disc is an effective therapy and can be considered as a standard treatment in cases which failed for conservative treatment. Ozone therapy is a simple method and can be effectively delivered with minimal adverse effects. However, additional meta-analysis with high quality randomised controls can be done to further strengthen the evidence for this mode of treatment.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"816-822"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461173","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":"Balancing Precision and Practicality: SOFA <i>vs.</i> qSOFA in the Diagnosis and Management of Sepsis.","authors":"Laura Diaconu, Florentina Musat, Daniel Ion, Dan Nicolae Paduraru, Alexandra Bolocan, Ovidiu Lucian Bajenaru, Catalina Raluca Nuta, Alexandru Constantinescu, Octavian Andronic","doi":"10.26574/maedica.2024.19.4.789","DOIUrl":"10.26574/maedica.2024.19.4.789","url":null,"abstract":"<p><p>Sepsis is a complex and multifaceted condition that remains a leading cause of morbidity and mortality worldwide. The sequential organ failure assessment (SOFA) and quick sequential organ failure assessment (qSOFA) scores are widely used to predict sepsis outcomes, but their utility varies depending on the clinical setting. This narrative review compares the predictive validity, sensitivity and specificity of SOFA and qSOFA, as well as other markers such as serum lactate and SIRS, across different healthcare environments. We conducted a comprehensive literature search of articles published over the last 10 years, focusing on studies that provided full-text access. Our analysis highlights the superior predictive performance of SOFA within intensive care units and the practical advantages of qSOFA in emergency departments. Additionally, this study examines the limitations of these scores and discusses the impact of the 2016 Sepsis-3 definition changes. By synthesizing data from diverse studies, we aimed to provide a thorough understanding of the current landscape of sepsis diagnosis and management, offering insights into how these tools can be optimized to improve patient outcomes.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"789-795"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461063","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":"Measurement Accuracy of CBCT <i>Versus</i> MDCT for the Linear Distance between the Stapes and Round Window, and the Incudostapedial Joint Thickness for Cochlear Implantation Treatment Planning.","authors":"Sanaz Sharifishoshtari, Nader Saki, Zohreh Roozbahani, Mohammad Ghasem Hanafi, Maryam Farasat, Zahra Saadi","doi":"10.26574/maedica.2024.19.4.697","DOIUrl":"10.26574/maedica.2024.19.4.697","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to compare the measurement accuracy of cone-beam computed tomography (CBCT) and multi-detector computed tomography (MDCT) for the linear distance between the stapes and round window, and the incudostapedial joint thickness for cochlear implantation treatment planning.</p><p><strong>Materials and methods: </strong>In this in vitro study, 12 temporal bones along with their covering soft tissue underwent high-resolution (HR) and low-resolution (LR) CBCT and MDCT. The linear distance between the stapes and round window as well as the incudostapedial joint thickness were measured on images by an oral radiologist and a general radiologist. Data were analyzed by paired t-test, Wilcoxon test and Pearson's correlation test (alpha=0.05).</p><p><strong>Results: </strong>Significant correlations and excellent agreement were noted between HR-CBCT and MDCT, HR-CBCT and LR-CBCT, and LR-CBCT and MDCT in both measurements (P<0.05). The mean distance between the stapes and round window on HR-CBCT was significantly higher than that on MDCT and LR-CBCT, and there were significant differences in the measurement accuracy of HR-CBCT with MDCT (P=0.014) and LR-CBCT (P=0.027). The difference between LR-CBCT and MDCT was not significant (P=0.102). The mean joint thickness on HR-CBCT was significantly higher than that on MDCT and the measurement accuracy of CBCT and MDCT was significantly different in this respect (P=0.014). The differences between LR-CBCT and MDCT, and HR-CBCT and LR-CBCT were not significant (P<0.05).</p><p><strong>Conclusions: </strong>The results of the present study showed an acceptable accuracy of CBCT comparable to that of MDCT for measurement of the linear distance between the stapes and round window, and the incudostapedial joint thickness for cochlear implantation treatment planning.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"697-703"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461205","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":"Narrative Review on the Use of Indocyanine Green Fluorescence in Surgical Oncology.","authors":"Danilo Coco, Silvana Leanza","doi":"10.26574/maedica.2024.19.4.807","DOIUrl":"10.26574/maedica.2024.19.4.807","url":null,"abstract":"<p><p>Indocyanine green (ICG) has emerged as a transformative tool for intraoperative imaging in the field of oncology, significantly improving the identification and localization of tumors, lymphatic structures and metastatic lesions. This narrative review aims to synthesize findings from a comprehensive range of studies that evaluate the efficacy, applications and limitations of ICG fluorescence-guided surgery across various surgical specialties, including colorectal, gynecologic and hepatobiliary oncology. We meticulously analyzed studies published from 2010 to the present, highlighting the technical aspects of ICG administration and imaging techniques as well as the quantitative metrics of success, such as detection rates and negative surgical margins. The review identifies a trend toward increasing use of ICG due to its ability to provide real-time feedback during surgery, thus facilitating more precise and minimally invasive procedures. Moreover, this review explores recent advancements in ICG applications, including multimodal imaging techniques that combine fluorescence with other imaging modalities, such as near-infrared imaging and preoperative imaging studies. These innovations hold promise for further enhancing surgical precision, improving patient outcomes and optimizing intraoperative decision-making. Limitations associated with ICG use, such as variability in fluorescence intensity among different tumor types and the challenge of quantifying the optimal dosage, are also discussed. In conclusion, this narrative review underscores the critical role of ICG fluorescence in modern surgical oncology and provides insights into future research directions aimed at refining its use and expanding its applicability. Potential avenues for investigation include standardized protocols for ICG administration, investigation of patient selection criteria and comprehensive evaluations of long-term outcomes associated with ICG-guided surgical procedures.</p>","PeriodicalId":74094,"journal":{"name":"Maedica","volume":"19 4","pages":"807-815"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459926","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}