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Monica Cirstoiu, Octavian Munteanu, Oana Bodean, Florina Paulet, Bogdan Șerban, Bogdan Cretu and Cătălin Cirstoiu

Abstract

This report represents an analysis of 19 confirmed cases of breast cancer throughout a period of 14 months (January 2018 - February 2019), in which we assessed the incidence and sites of osseous metastases, in correlation with their histopathologic classification. This retrospective analysis is based on medical imaging techniques (X-ray radiography and nuclear medicine functional imaging).

Open access

Ramona Dobre, Dan Niculescu, Gheorghe Popescu, Adrian Barbilian, Cătălin Cîrstoiu and Cătălina Poiană

Abstract

Introduction: Hip fracture is the most severe consequence of osteoporosis and an important cause of excess mortality in the elderly.

Objective: We aimed to evaluate the in-hospital mortality rate after osteoporotic hip fracture in patients treated surgically or functionally in specialized centers in Bucharest.

Materials and methods: We calculated the in-hospital mortality rate in 745 patients (540 women [72.48%], with a mean age of 79.1 ± 11 years), surgically or functionally treated for fragility hip fracture over a 12 months period.

Results: Average length of hospitalization was 18.12 days. In hospital mortality rate was 5.36% (n=40, women 60%). An important risk factor associated with mortality was age, p=0.001. The male sex was also a risk factor with a mortality rate of 7,8% (n=16), compared to 4.44% in women, p<0.005, with OR of 1.57. Out of the 40 patients, 57.5% had a femoral neck fracture, 35% intertrochanteric, and 5.5% atypical fracture in absence of bisphosphonates. 7.5% had previous fragility fractures. 85% of the patients had a history of one or more cardiac pathologies (34.28% with atrial fibrillation), 57.5% underwent surgical intervention (n=23) with an average day of intervention of 8.82 after admission. None of the patients had an osteoporosis treatment before the event and on average 3.73 medications with an increased risk of falling and fracture.

Conclusion: In-hospital mortality rate after hip fracture remains high; probably this being related to the high comorbidity associated with male sex and increased age as risk factors.

Open access

Alexandru Papuc, Ioan Mihai Japie, Traian Ciobanu, Octavian Nutiu, Dragos Radulescu and Radu Radulescu

Abstract

The GCT is an aggressive benign tumor with metastatic potential, most often within the lungs in 2-3% of the patients. It makes about 5% of total bone tumors and about 15% of total benign bone tumors.

The maximum incidence occurs between 30 and 40 years old, most frequently affecting the long bones epiphysis (distal femur, proximal tibia, and distal radius).

We report the case of a 50-year-old female, with no previous medical history, admitted in the emergency department (ED) for significant pain and functional impairment of the left knee. Clinical examination and imaging tests established the diagnosis of distal femoral tumor.

The patient underwent surgical segmental resection of the tumor within oncological limits and subsequent arthroplasty with cemented modular tumoral prosthesis was performed.

Even if the GCT is a benign tumor, it has an aggressive behavior and malignancy potential with an important impact on quality of life. Due to localization, this type of tumor can quickly manifest clinically, which allows an early diagnosis and a less invasive surgical technique.

Open access

Urška Šunta, Miha Žitnik, Noemi Concetta Finocchiaro, Tjaša Griessler Bulc and Karmen Godič Torkar

Abstract

The aim of this study was to identify and quantify faecal indicator bacteria in blackwater collected from a source separation unit and determine the amount of E. coli isolates resistant to antimicrobials and their potential to produce extended spectrum β-lactamases (ESβLs) and metallo-β-lactamases (MβLs), which hydrolyse the most important antibiotics used in clinical practice. Most of the isolates were resistant to amoxicillin with clavulanic acid (36.4 %), followed by ticarcillin with clavulanic acid (22.7 %) and tetracycline (18.2 %). ESβL-producing genes bla CTX-M and bla TEM were found in three (13.6 %) and four (18.2 %) E. coli strains, respectively, while MβL genes were found in two (9.1 %). By separating at source, this pilot study clearly shows that gastrointestinal bacteria of healthy people can be an important source of antibiotic resistance released into the environment through wastewaters. One way to prevent that is to treat wastewater with a combination of TiO2, UV light, or ozone, as successful methods to remove resistant bacteria and prevent their spread in the environment.

Open access

Teodora Serban, Iulia Satulu, Ioana Cretu, Oana Vutcanu, Mihaela Milicescu and Mihai Bojinca

Abstract

Background: Osteoarthritis (OA) and rheumatoid arthritis (RA) can overlap and the presence of OA can interfere with the evaluation of patients with RA.

Objectives: The aim of this study was to evaluate the possible impact of OA on the clinical, laboratory and ultrasound parameters currently evaluated in patients with early RA (ERA).

Methods: We have evaluated the data obtained from patients with ERA referred to our Early Arthritis Research Center (EARC). Only data from patients who fulfilled EULAR/ ACR 2010 criteria for RA and had symptom duration of less than 12 months were analyzed. All patients underwent clinical examination, laboratory tests and ultrasound (US) examination.

Results: There was a clear predominance of women (62.8%). The mean age was 55.47±13.71 years. At baseline, 21 patients (48.8%) were diagnosed with OA. Hand OA did not influence the values of any of the parameters assessed (p>0.05). For patients with knee OA, significantly higher values were observed only for DAS28 at baseline (p=0.018) as well as after 12 months of observation (p=0.031).

Conclusions: Significantly higher values of DAS28 were observed in patients with ERA who associated knee OA, while the values of SDAI were not influenced, suggesting that SDAI may be superior to DAS28 in evaluating patients with ERA and knee OA. The values of patient’s VAS were not influenced by the presence of hand or knee OA suggesting that these types of OA do not influence the patients’ perception of the disease activity. Moreover, the values of ultrasound scores were not influenced by the presence of OA.

Open access

Adrijana Košćec Bjelajac, Jasminka Bobić, Jelena Kovačić, Veda Marija Varnai, Jelena Macan and Šime Smolić

Abstract

The aim of this study was to examine mental health and cognitive functions in older Croatian workers (50–65 years) taking into account their employment status, self-assessed health, and a set of demographic characteristics. We analysed the data collected on 650 older workers (71 % employed) in the Wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE). Unemployed workers reported symptoms of loneliness more often than the employed, while in rural areas unemployment was additionally associated with more pronounced symptoms of depression. Feeling of loneliness was also higher in those living without a partner in the household and in those with poorer health. In urban residents symptoms of depression were more severe in women, respondents with higher education, those living without a partner, and those who rated their health as poorer. As for cognitive functions, unemployment significantly predicted poorer subtraction in the rural subsample. Women in general showed less efficient numerical abilities. In the urban subsample poorer numerical abilities were also associated with lower education and living without a partner in the household. Better verbal recall was predicted by higher education and better self-rated memory. Higher scores in verbal fluency were predicted by urban residency and better self-rated health. Our results indicate that the protective factors for good mental health and cognitive functioning in older Croatian workers are being employed, having more education, living with a partner in the household, and being healthier. These findings stress the importance of implementing broader social policy strategies covering employment, education, and health.

Open access

Ivana Huljev Šipoš, Slavica Labor, Iva Jurić, Davor Plavec, Kristian Vlahoviček, Siniša Bogović, Justinija Pavkov Vukelić and Marina Labor

Abstract

Exhaled breath temperature (EBT) is a biomarker of inflammation and vascularity of the airways already shown to predict incident COPD. This cross-sectional study was aimed to assess the potential of EBT in identifying “healthy” smokers susceptible to cigarette smoke toxicity of the airways and to the risk of developing COPD by analysing the dynamics of EBT after smoking a cigarette and its associations with their demographics (age, smoking burden) and lung function. The study included 55 current smokers of both sexes, 29–62 years of age, with median smoking exposure of 15 (10–71.8) pack-years. EBT was measured at baseline and 5, 15, 30, 45, and 60 min after smoking a single cigarette. Lung function was measured with spirometry followed by a bronchodilator test. To compare changes in EBT between repeated measurements we used the analysis of variance and the area under the curve (EBTAUC) as a dependent variable. Multivariate regression analysis was used to look for associations with patient characteristics and lung function in particular. The average (±SD) baseline EBT was 33.42±1.50 °C. The highest significant increase to 33.84 (1.25) °C was recorded 5 min after the cigarette was smoked (p=0.003), and it took one hour for it to return to the baseline. EBTAUC showed significant repeatability (ICC=0.85, p<0.001) and was significantly associated with age, body mass index, number of cigarettes smoked a day, baseline EBT, and baseline FEF75 (R2=0.39, p<0.001 for the model). Our results suggest that EBT after smoking a single cigarette could be used as early risk predictor of changes associated with chronic cigarette smoke exposure.

Open access

Marija Srbinoska, Zoran Kavrakovski, Vesna Rafajlovska and Jana Simonovska

Abstract

The use of electronic cigarettes or vaping has been gaining momentum among Macedonian smokers but has also raised great many concerns about the toxicity of liquid refills and its aerosols, especially as the nicotine levels in refill liquids (e-liquids) are not required to be declared accurately or at all by current regulations. The aim of this study was therefore to determine nicotine levels in fifteen samples of e-liquids purchased in specialised shops in Macedonia using gas chromatography. Nicotine concentrations deviated from manufacturer’s declarations in nine of the twelve samples: in five they were higher and in four lower than declared, ranging from −16.7 % to +30.0 %. These significant discrepancies between the actual and declared nicotine concentrations in the analysed e-liquids call for closer attention of the healthcare and the regulating authorities.