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Open access

Ayca Tuzcu, Rabia Aydogan Baykara, Ahmet Omma, Gunseli Karaca Acet, Erdal Dogan, Medine Cumhur Cure, Sevinc Can Sandikci, Erkan Cure, Salim Neşelioğlu and Ozcan Erel

Abstract

Background. Oxidative stress may play an important role in rheumatoid arthritis (RA) etiopathogenesis. The thiol group is a very strong antioxidant. In this study, we aimed to investigate the presence of oxidative stress in patients with RA by evaluating thiol/disulfide homeostasis.

Material and methods. A total of 50 female RA patients and 50 healthy female controls were included in this study. Thiol and disulfide values were calculated utilizing novel methods.

Results. Native thiol (p < 0.001) and total thiol (p < 0.001) levels of RA patients were significantly lower compared to values in the control group. However, the disulfide (p < 0.001) levels of RA patients were strongly higher than in healthy individuals. A negative correlation was found between thiol and disease activity score-28 among the patients, whereas a positive correlation was found between disulfide and disease activity score-28 among the patients.

Conclusion. We found that the thiol–disulfide rate deteriorated in RA patients, with the proportion of disulfide increasing. There is a strong correlation between the decrease in thiol levels, increase in disulfide levels and the disease activity scores.

Open access

Anca Chiriac, Adrian Năznean, Cristian Podoleanu, Claudiu Molnar and Simona Stolnicu

Abstract

Background: Daclizumab is a humanized monoclonal antibody against the D-subunit (CD25) of the high-affinity interleukin (IL)–2 receptor, used for the treatment of relapsing-remitting multiple sclerosis with a large spectrum of cutaneous adverse reactions. Case presentation: We present the case of a middle-aged man treated with daclizumab for multiple sclerosis, who developed skin reactions difficult to evaluate. A 4 mm punch-biopsy was taken from the plantar area. Histological examination of the biopsy revealed hyperkeratosis and acanthosis but no parakeratosis, while a discrete inflammatory infiltrate was noticed around vessels in the dermis. Treatment with fluconazole 50 mg/day for 10 days, moisturizers, and grade I topical steroids was followed by slight improvement of the clinical picture. Treatment with daclizumab was not discontinued. Conclusion: The clinical efficacy and side effects of daclizumab have to be reported and confirmed in clinical practice in the following years. Any clinical report can contribute to validate the efficacy and risk of the drug’s administration. Any type of adverse skin reaction must be reported for clarifying the diagnosis.

Open access

Mojtaba Hedayat Yaghoobi, Abbas Taher, Mohamad Ali Seifrabie, Mohammadmahdi Sabahi and Farshid Rahimi-Bashar

Abstract

Background and Objective. Vitamin D deficiency is considered one of the most common nutritional deficiencies associated with weakened immune system and increased likelihood of sepsis. The current study was conducted to investigate the association between serum vitamin D level and the severity and prognosis of ventilator associated pneumonia (VAP) in inpatients in intensive care unit (ICU).

Methods. Eighty-four consecutive patients with VAP were enrolled in this observational, prospective study conducted in the ICU of Besat Hospital, Hamadan. The patients were examined for serum 25-hydroxyvitamin D (vitD3) level and VAP severity and prognosis. Clinical pulmonary infection score was used for the diagnosis, and Sequential Organ Failure Assessment (SOFA) Score was used to determine the severity of VAP.

Results. Low level serum vitD3 (under 30 ng/mL) was found in 66 (78.6%) patients. In this series of VAP patients, there were no significant differences in blood culture results, 14 and 28-day sepsis-associated mortality, mechanical ventilation duration, or SOFA Score on days 3, 7, and 14 between the low level and normal level vitD3 patients (p > 0.05).

Conclusion. Serum vitD3 level was not associated with mortality from VAP or complications due to sepsis in the inpatients in the ICU.

Open access

Anca Chiriac, Cristian Podoleanu, Adrian Năznean and Simona Stolnicu

Abstract

Hyperkeratotic lesions result from continuous mechanical action on the skin forming a callus or a corn. The accumulation of horny layers will increase pressure, creating a vicious cycle. We present a new approach based on relieving pressure or friction, strictly based on the results of pedography (pedobarography).

Open access

Alina Dima, Ciprian Jurcut and Mariana Jinga

Open access

Pooneh Pashapour, Samad Ghaffarii and Ahmad Separham

Abstract

Introduction. One of the inflammatory factors affecting the prognosis of myocardial infarction is the high level of neutrophil count in the blood. In this study, we investigated the relationship of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in peripheral blood with ST-segment resolution and clinical outcomes of patients with ST-elevation myocardial infarction (STEMI) receiving thrombolytic therapy.

Methods. This cross-sectional study was conducted on the patients referring to the emergency department in Tabriz, Iran who were diagnosed with STEMI and began receiving treatment with reteplase. The patients were asked questions to gather information about their demographic characteristics as well as their risk factors, level of response to thrombolytic therapy, etc. For all of the patients, electrocardiogram (ECG) was recorded and different blood tests were performed upon their admission to the emergency department and the obtained data were fed into SPSS Version 19 to explore the possible relationships among different variables.

Results. The findings of this study revealed that there is no significant relationship between either NLR or PLR of patients suffering from myocardial infarction and their level of response to thrombolytic therapy. Moreover, no significant relationship was observed between NLR or PLR of these patients and their ejection fraction. However, the results indicated that NLR and PLR associated with an increase in the incidence rate of major adverse cardiac events (MACE) in STEMI patients.

Conclusion. The results of this study indicated that NLR and PLR are directly associated with the rate of in-hospital major adverse effects following STEMI irrespective of the ST resolution.

Open access

Irene Rasanu

Abstract

Parkinson’s disease is defined nowadays as a neurodegenerative disease with prominent motor symptoms accompanied by a wide range of comorbidities, some of them, like type 2 diabetes mellitus, probably implicated in the pathogenesis and progression of the disease. In order to achieve this article, which aimed to realize an up to date synthesis of published dedicated papers, a PubMed search was performed; it revealed increasing evidence that these two morbid conditions share many pathogenic pathways and current studies are trying to finally transform the accumulated knowledge into curative therapy or effective prevention for these frequent and complex diseases.

Open access

Adela-Gabriela Firănescu and Maria Moța

Abstract

Tuberculosis (TB) and diabetes mellitus (DM) are two chronic diseases with major impact on worldwide morbidity and mortality. DM significantly increases the risk of death, therapeutic failure and relapse of TB, requiring a much more careful monitoring of these patients. In this article we present the case of a patient with type 2 DM in the stage of major chronic complications, with numerous risk factors for TB and atypical symptomatology, pulmonary X-ray showing active TB lesions. The patient did not follow the diabetologist's recommendations, discontinuing the antidiabetic treatment on his own initiative. The glycemic imbalance and chronic alcoholism caused the failure of the anti TB therapy.

Open access

Zoi-Despoina Tzima, Nikolaos Economides, Christos Gogos and Ioannis Kolokouris

Summary

Background/Aim: To investigate the incidence of procedural errors with the use of a novel nickel-titanium rotary system (Hyflex CM, Coltene/Whaledent, Altstätten Switzerland), evaluate the technical quality of root canal treatments and assess a questionnaire completed by the participants themselves in an undergraduate dental clinic between 2014 and 2017 (Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki).

Material and Methods: 118 undergraduate students in their first year of clinical practice performed a root canal treatment on a patient’s molar (maxillary/mandibular). None of the participants had previous experience in rotary instrumentation. The periapical radiographs were taken with the use of the paralleling technique for standardization and were collected and evaluated by the investigator. After the root canal treatment was performed the students completed a questionnaire in order to evaluate their training on rotary instrumentation.

Results: The overall incidence of instrument separation, apical perforation, root perforation, straightening and ledges was 0.8%, 4.4%, 2.3%, 5.5% and 29% respectively on root canal level. Ledges were detected more often in mandibular mesiobuccal canals. The frequency of root canals with an ‘acceptable’ filling was 68.4%, while overfilled and underfilled canals were found to be 8.6% and 16.2% respectively. The response rate was high (94.9%), 35% of the participants encountered no difficulty in the use of rotary instrumentation and 98.2% would use it again.

Conclusions: The incidence of procedural errors was considerably low and the technical quality of the filled root canals was superior to that of similar studies. The responses of the questionnaire demonstrated a positive attitude toward rotary instrumentation.

Open access

Fiastuti Witjaksono, Marcellus Simadibrata, Widjaja Lukito, Andi Wijaya and Fariz Nurwidya

Abstract

Introduction. The current study aimed to assess profiles of peptide YY and ghrelin, visual analog scales (VAS) for hunger and satiety, and ad libitum intake in obese and non-obese women.

Methods. This open-label non-randomized interventional study involved obese (BMI ≥ 25–35 kg/m2) and non-obese (BMI 18.5–23.0 kg/m2) women subjects. Levels of peptide YY and ghrelin were determined by radioimmunoassay and enzyme-linked immunosorbent assay (ELISA), respectively, while the degrees of hunger and satiety were measured using visual analog scale (VAS) questionnaires. The results were compared in fasting condition and in 15, 60, 120, and 180 minutes after breakfast with balance composition formulation. This study also compared the ad libitum intake within 4 hours after breakfast.

Results. As compared to the non-obese group, the obese group have significantly lower levels of peptide YY in fasting, and in 15, 60, 120, and 180 minutes post-prandial, and smaller AUC (Area Under the Curve) of fasting peptide YY. Furthermore, the obese group showed significantly higher ad libitum intake. The obese group also have lower levels of ghrelin and lower VAS for hunger and higher in VAS for satiety as compared to the non-obese group.

Conclusions. There were significant differences in peptide YY level, 4 hours after breakfast ad libitum intake, ghrelin level, and VAS for hunger and satiety, between obese group and non-obese one.