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Irina Ilea, Iulia Lupan, Daniel Corneliu Leucuta, Caius Romulus Duncea and Maria Dronca

-23 6. Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol 1983; 51(3): 606. 7. Eckerson HW, Wyte CM, La Du BN. The human serum paraoxonase/arylesterase polymorphism. Am J Hum Genet 1983; 35(6): 1126-1138. 8. R Development Core Team. (2012). R (Version 2.15). Retrieved from 9. Brophy VH, Jampsa RL, Clendenning JB, McKinstry LA, Jarvik JP, Furlong CE. Effets of 5’ regulatory region polymorphisms on paraoxonase-gene (PON1) expression. Am J Hum

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Zuh S.G, Nagy Ö., Zazgyva Ancuța, Russu O.M., Gergely I. and Pop T.S.

change: the lesson of Cronbach. Journal of clinical epidemiology. 50(8), 869-879. 24. Hoeksma H.L., Van Den Ende C.H., Ronday H.K., Heering A. & Breedveld F.C. (2003). Comparison of the responsiveness of the Harris Hip Score with generic measures for hip function in osteoarthritis of the hip. Annals of the rheumatic diseases. 62(10), 935-938. 25. Guyatt G.H., Townsend M., Berman L.B. & Keller J.L. (1987). A comparison of Likert and visual analogue scales for measuring change in function. Journal of chronic diseases. 40(12), 1129

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Emese Rapolti, Theodora Benedek, István Kovács, Szilamér Korodi, Zsuzsanna Suciu, Sebastian Condrea, Edvin Benedek, András Mester and Imre Benedek


Introduction: Peripheral artery disease, a frequent consequence of atherosclerosis, is usually associated with concomitant ischaemic coronary artery disease and with a high rate of cardiovascular mortality.

Material and methods: The study population consisted of 24 patients, admitted to our clinic with peripheral artery disease, 10 of them with critical limb ischaemia. In all cases, cardiovascular risk factors, left ventricular dysfunction and ejection fraction were analyzed. Peripheral Multislice Angio CT examination was used to determine the TASC class and to assess the peripheral arterial lesions. The Coronary Calcium Score and the Syntax Score were determined with angio CT of the coronary arteries.

Results: Patients were between 39 and 84 years of age, and 54% were in Fontaine class 2B, 21% in Fontaine class 3 and 25% in Fontaine class 4. 12.5% of patients presented TASC class A, 33.3% TASC class B, and 54.2% TASC class C. Coronary Calcium Scores were between 0 and 100 in 16.6% of patients, between 100 and 400 in 41.8%, and >400 in 41.6% of patients. The SYNTAX Score was <22 in 54% of patients, between 22 and 32 in 37.5%, and >32 in 8.5% of patients. A significant correlation was found between the Coronary Calcium Score and the SYNTAX Score (r = 0.82, p = 0.03). The Syntax Score was 22.43 ± 3.2 in TASC A patients, 26.2 ± 5.4 in TASC B patients, 32.1 ± 2.3 in TASC C patients (p = 0.005).

Conclusions: The severity of coronary artery disease characterized by the Syntax Score, by the presence of left main stenosis and segmental left ventricular hypokinesis presents significant correlation with the severity of peripheral artery disease, characterized by the TASC classification.

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Sachidanand Gautam, Anubhav Sharma and S.C. Dulara


Background: Acute subdural hematoma is the most common type of traumatic intra cranial hematoma accounting for 24% cases of severe head injuries and caries highest mortality. The aim of this study is to analyze the prognostic factors and to propose Neuro-clinical and radiological prognostic scoring system on the clinical spectrum and to evaluate the postoperative outcome and validate the same. Methods: This is a prospective Study which included 100 patients admitted in Government Medical College, Kota, Rajasthan from 01st Jan 2016 to 30 June 2017 with head injury and were diagnosed to have Traumatic Subdural Hemorrhage. A detailed clinical history, Physical examination, Computerized Tomography scan was performed in all patients and were divided into 2 groups; that is conservative or surgical interventional as per Neuro-clinical and radiological prognostic scoring system. Results: The maximum patients suffering from Subdural Hematoma were in the age group of 11-60 years with male predominance 72%. The most common mode of injury was RTA with 68 % of incidence. 36 out of 100 cases presented to hospital with GCS <8 while 44 patients showed improvement of GCS after resuscitation. Out of 100 cases, surgical approach was considered in 34 patients while remaining patients were managed conservatively. Pupillary reaction, Hypotension, CT scan findings that is, thickness of hematoma >10mm and midline shift of >5mm, delay in interval between the surgery had greatly affected on outcome of patients. Conclusions: According to the results, use of Neuro-clinical and radiological prognostic scoring system is very useful in determining early intervention and also avoids unnecessary surgical intervention.

Open access

Tanja Kamin, Ana Kolar and Peter M. Steiner

Statist Software 2011; 45: 1-67. 18. Steiner PM, Cook DL. Matching and propensity scores. In: Little TD, editor. The Oxford handbook of quantitative methods. New York: Oxford University Press, 2013. 19. Hansen BB, Klopfer SO. Optimal full matching and related designs via network flows. J Computat Graph Statist 2006; 15: 609-627. 20. Crompton R. Class and stratification: an introduction to current debates. Cambridge: Polity Press, 2004. 21. Kropivnik S, Luthar B. Class, cultural capital, and the mobile phone

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Christian Peiper, Svenja Schinkel, Dortje Brinkmann, Karsten Junge, Uwe Klinge and Volker Schumpelick

Tailored Repair in Inguinal Hernia Surgery Using the Head-Score

The aim of the study. To support a tailored inguinal hernia repair, we developed a score system based on anamnestic risk factors for recurrence.

Material and methods. We used the HEAD-Score in a county hospital and suggested mesh repair in scores of 15 or greater. Patients were followed in a prospective study for 2 weeks and 12 months.

Results. We used mesh repair in 61.5% of the 281 inguinal hernia repairs. In mesh repair, we observed significantly more seroma formation (48.5% vs 20.4%). We found only two recurrences after Lichtenstein repair. In the Shouldice group, two patients underwent re-operation due to an ilioinguinal entrapment syndrome.

Conclusions. Tailored inguinal hernia repair with the help of the HEAD-Score is possible and leads to acceptable complication rates and a low recurrence rate (0.9%) after one year. The risk of mesh-depended complications can be reduced with this approach.

Open access

Makovický Pavol, Makovický Peter, Nagy Melinda, Rimárová Kvetoslava and Diabelková Jana

References 1. Haenlein GFW: About the evolution of goat and sheep milk production. Small Rumin Res 2007, 68:3-6. 2. Barillet F, Rupp R, Mignon-Grasteau S, Astruc JM, Jacquin M: Genetic analysis for mastitis resistance and milk somatic cell score in French Lacaune dairy sheep. Genet Sel Evol 2001a, 33:397-415. 3. Fernández G, Álvarez P, San Primitivo F, De la Fuente LF: Factors affecting variation of udder traits of dairy ewes. J Dairy Sci 1995, 78:842-849. 4. De la Fuente LF, Fernández G, San

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Nicoleta Valentina Florea, Dorina Antoneta Tănăsescu and Anişoara Duică


We are in the fifth era of marketing development, that of relationship marketing, where the environment is influenced by globalization, informatization, market liberalization, and the overcapacity of production, and the focus will be not on increasing the volume of production, but on obtaining profit using relationship with profitable customers. Customer-centricity, customization, one-to-one relationship and measuring the value of each customer is an advantage in the fearless market. Organizations if they knew what customers wants would offering only those products or services they want, but to help them to know the customers’ needs better, they use models, new methods and calculation of performance indicators. One of the models which help organizations to determine the customer value and centricity is Net Promoter Score (NPS), its formula being developed by Reichheld F. in 2006. Our research is made on 10 organizations and on 150 respondents and is consisting in using NPS in order to observe customers’ perception of the analysed brands, to measure how well the brand is having satisfayed and loyal customers, and the desire for recommendation of the analysed brand. Our article is using simulation, modeling and IT programs to observe possible relationships and future trends.

Open access

Enikő Csifo, Tímea Katona, Juliánna Arseni, E. Nagy, I. Gergely and Ö. Nagy


Objectives: Study of circulating and synovial levels of osteocalcin, osteoprotegerin and tumor necrosis factor-alpha (TNF-α) in patients with different stages of knee osteoarthritis and correlation analysis of these parameters with disease severity.

Methods: We enrolled 20 patients with different stages of knee osteoarthritis. The IKDC score (International Knee Documentation Comittee, 2000) was determined for each patient. Based on these data patients were divided into two groups: group I (advanced osteoarthritis) and group II (early osteoarthritis). Serum and synovial fluid levels of osteocalcin, osteoprotegerin, TNF-α were determined.

Results: For the entire group the level of osteocalcin in the serum showed higher values than in the synovial fluid. We found statistically significant differences in the serum levels of osteocalcin between the two groups (group I: 2.18 ± 0.54 ng/ml, group II: 6.07 ± 1.98 ng/ml, p = 0.019). Serum and synovial osteocalcin in the whole study lot could not be correlated with the disease score, however we observed a tendency towards significant negative correlation between the serum osteocalcin and IKDC score for group I and between synovial osteocalcin and IKDC score in group II. In the entire group, synovial osteoprotegerin concentration was six times higher than the serum osteoprotegerin level (p <0.0001) and TNF-α showed higher circulating levels than local concentrations.

Conclusions: In the advanced osteoarthritis group the serum and synovial osteocalcin show lower values than in the early osteoarthritis group, which means that as the disease progresses, bone anabolism decreases. In the case of osteoprotegerin, no significant difference between the two groups was detected.

Open access

Satoshi Nagano, Yuhei Yahiro, Masahiro Yokouchi, Takao Setoguchi, Yasuhiro Ishidou, Hiromi Sasaki, Hirofumi Shimada, Ichiro Kawamura and Setsuro Komiya


Background. The utility of ultrasound imaging in the screening of soft-part tumours (SPTs) has been reported. We classified SPTs according to their blood flow pattern on Doppler ultrasound and re-evaluated the efficacy of this imaging modality as a screening method. Additionally, we combined Doppler ultrasound with several values to improve the diagnostic efficacy and to establish a new diagnostic tool.

Patients and methods. This study included 189 cases of pathologically confirmed SPTs (122 cases of benign disease including SPTs and tumour-like lesions and 67 cases of malignant SPTs). Ultrasound imaging included evaluation of vascularity by colour Doppler. We established a scoring system to more effectively differentiate malignant from benign SPTs (ultrasound-based sarcoma screening [USS] score).

Results. The mean scores in the benign and malignant groups were 1.47 ± 0.93 and 3.42 ± 1.30, respectively. Patients with malignant masses showed significantly higher USS scores than did those with benign masses (p < 1 × 10-10). The area under the curve was 0.88 by receiver operating characteristic (ROC) analysis. Based on the cut-off value (3 points) calculated by ROC curve analysis, the sensitivity and specificity for a diagnosis of malignant SPT was 85.1% and 86.9%, respectively.

Conclusions. Assessment of vascularity by Doppler ultrasound alone is insufficient for differentiation between benign and malignant SPTs. Preoperative diagnosis of most SPTs is possible by combining our USS score with characteristic clinical and magnetic resonance imaging findings.