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  • 1
    Online Resource
    Online Resource
    What Is the Comparative Efficacy of Surgical, Endoscopic, Transanal Resection, and Radiotherapy Modalities in the Treatment of Rectal Cancer?
    MDPI AG ; 2023
    In:  Healthcare Vol. 11, No. 16 ( 2023-08-20), p. 2347-
    Details
    In: Healthcare, MDPI AG, Vol. 11, No. 16 ( 2023-08-20), p. 2347-
    Abstract: Background: Rectal cancer is a significant healthcare burden, and effective treatment is crucial. This research aims to compare the effectiveness of surgical and endoscopic resection, transanal resection, and radiotherapy. Methods: A literature analysis was conducted in order to identify relevant studies, by comparing the different surgical approaches and variables affecting treatment decisions. The findings were analyzed and synthesized to provide a comprehensive overview. Results: Surgical treatment, particularly TME (total mesorectal excision), proved consistent efficacy in achieving complete tumor resection and improving long-term survival. Endoscopic treatment and transanal resection techniques were promising for early-stage tumors but were associated with higher local recurrence rates. Radiotherapy, especially in combination with chemotherapy, played a crucial role in locally advanced cases, improving local control and reducing recurrence risk. Patient data, tumor characteristics, and healthcare system factors were identified as important factors in treatment modality selection. Conclusion: Surgical treatment, specifically TME, remains the recommended standard approach for rectal cancer, providing excellent oncological outcomes. Endoscopic treatment and transanal resection techniques can be considered for selected early-stage cases, while radiotherapy is beneficial for locally advanced tumors. Treatment decisions should be personalized based on patient and tumor characteristics, considering the available resources and expertise within the healthcare system.
    Type of Medium: Online Resource
    ISSN: 2227-9032
    URL: Article
    DOI: 10.3390/healthcare11162347
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2721009-1
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  • 2
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    Thyroid Pathology in End-Stage Renal Disease Patients on Hemodialysis
    MDPI AG ; 2020
    In:  Diagnostics Vol. 10, No. 4 ( 2020-04-23), p. 245-
    Details
    In: Diagnostics, MDPI AG, Vol. 10, No. 4 ( 2020-04-23), p. 245-
    Abstract: Objectives: Chronic kidney disease is a rising cause of morbidity and mortality in developed countries, including end-stage renal disease (ESRD). The prevalence of thyroid comorbidities in persons with chronic kidney disease is documented higher than in normal population. The study aims to investigate the prevalence of morphological and functional thyroid disorders in patients with chronic kidney disease, with renal replacement therapy (hemodialysis). Methods: A cross-sectional study was performed on 123 consecutive patients with chronic kidney disease stage 5, on hemodialysis during a period of one month (May 2019–June 2020). All patients were enrolled for maintenance hemodialysis in B Braun Hemodialysis Center Timisoara and were examined on conventional 2B ultrasound. Thyroid blood tests were done, including serum free thyroxin (FT4), free triiodothyronine (FT3) and thyroid-stimulating hormone (TSH) at the time of starting hemodialysis. Results: We evaluated 123 patients (male to female ratio 70/53) mean age 62.2 ± 11.01, mostly above 65 years old, enrolled in the end-stage renal disease program, on renal replacement therapy. From the cohort, 76/123 presented thyroid disease, including autoimmune hypothyroidism, nodular goiter or thyroid cancer. Among them, 63 patients presented nodular goiter, including 3 thyroid cancers, confirmed by surgery and histopathological result, 22 patients had thyroid autoimmune disease. The serum thyroid-stimulating hormone levels found in the cohort was 3.36 ± 2.313 mUI/mL, which was in the normal laboratory reference range. The thyroid volume was 13 ± 7.18 mL. A single patient in the cohort presented Graves Basedow disease, under treatment and three patients present subclinical hyperthyroidism. We have found that thyroid disease risk is increased by 3.4-fold for the female gender and also the increase of body mass index (BMI) with one unit raises the risk of developing thyroid disease with 1.083 times (p = 0.018). Conclusion: To conclude, this study aimed to quantify the prevalence of thyroid disease in end-stage kidney disease population, especially nodular goiter, important for differential diagnosis in cases with secondary hyperparathyroidism. Thyroid autoimmune disease can be prevalent among these patients, as symptoms can overlap those of chronic disease and decrease the quality of life. We have found that thyroid disease has a high prevalence among patients with end-stage renal disease on hemodialysis. Thyroid goiter and nodules in ESRD patients were more prevalent than in the general population. Clinical surveillance and routine screening for thyroid disorders can improve the quality of life in these patients.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics10040245
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2662336-5
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  • 3
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    Online Resource
    Evidence of Pulmonary Hypertension after SARS-CoV-2 Infection in Subjects without Previous Significant Cardiovascular Pathology
    MDPI AG ; 2021
    In:  Journal of Clinical Medicine Vol. 10, No. 2 ( 2021-01-07), p. 199-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 10, No. 2 ( 2021-01-07), p. 199-
    Abstract: Background: Coronavirus (Covid-19) infection represents a serious medical condition, often associated with cardiovascular complications, pulmonary hypertension (PH), and right ventricle dysfunction (RVD). The aim of this study is to show, by means of transthoracic echocardiography (TTE), the presence of an increased estimated systolic pressure in the pulmonary artery (esPAP) and altered right ventricular global longitudinal strain (RV-GLS) in patients without history of PH. Methods: In a group of 91 patients, aged under 55 years, hospitalized for a moderate Covid-19 infection, a thorough cardiologic and TTE examination were performed two months after discharge. Their initial thorax computer-tomography (TCT) images and laboratory data were accessed from the electronic data base of the hospital. Results: We observed an increased prevalence of PH (7.69%) and RVD (10.28%), significantly correlated with the initial levels of the TCT score and inflammatory factors (p ˂ 0.001), but borderline changes were observed in more patients. Multivariate regression analysis showed that these factors and RV-GLS explain 89.5% of elevated esPAP. Conclusions: In COVID-19 infection, PH and RVD are common complications, being encountered after the recovery even in moderate cases. It appears to be a connection between their severity and the extent of the initial pulmonary injury and of the inflammatory response.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    URL: Article
    DOI: 10.3390/jcm10020199
    DOI: 10.37473/dac/10.3390/jcm10020199
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2662592-1
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  • 4
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    Online Resource
    Echocardiographic Parameters as Predictors for the Efficiency of Resynchronization Therapy in Patients with Dilated Cardiomyopathy and HFrEF
    MDPI AG ; 2021
    In:  Diagnostics Vol. 12, No. 1 ( 2021-12-24), p. 35-
    Details
    In: Diagnostics, MDPI AG, Vol. 12, No. 1 ( 2021-12-24), p. 35-
    Abstract: Cardiac resynchronization therapy (CRT) represents an increasingly recommended solution to alleviate symptomatology and improve the quality of life in individuals with dilated cardiomyopathy (DCM) and heart failure (HF) with reduced ejection fraction (HFrEF) who remain symptomatic despite optimal medical therapy (OMT). However, this therapy does have the desired results all cases, in that sometimes low sensing and high voltage stimulation are needed to obtain some degree of resynchronization, even in the case of perfectly placed cardiac pacing leads. Our study aims to identify whether there is a relationship between several transthoracic echocardiographic (TTE) parameters characterizing left ventricular (LV) performance, especially strain results, and sensing and pacing parameters. Between 2020–2021, CRT was performed to treat persistent symptoms in 48 patients with a mean age of 64 (53.25–70) years, who were diagnosed with DCM and HFrEF, and who were still symptomatic despite OMT. We documented statistically significant correlations between global longitudinal strain, posterolateral strain, and ejection fraction and LV sensing (r = 0.65, 0.469, and 0.534, respectively, p 〈 0.001) and LV pacing parameters (r = −0.567, −0.555, and −0.363, respectively, p 〈 0.001). Modern imaging techniques, such as TTE with cardiac strain, are contributing to the evaluation of patients with HFrEF, increasing the chances of CRT success, and allowing physicians to anticipate and plan for case management.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics12010035
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2662336-5
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  • 5
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    Online Resource
    Psychometric properties of the Romanian version of the female sexual function index (FSFI-RO)
    Springer Science and Business Media LLC ; 2023
    In:  BMC Women's Health Vol. 23, No. 1 ( 2023-10-06)
    Details
    In: BMC Women's Health, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2023-10-06)
    Abstract: Female sexual dysfunction (FSD) is a highly prevalent health disorder and no self-report questionnaire on female sexual function is available in Romanian. Therefore we considered the Female Sexual Function Index (FSFI) to be the most appropriate due to its excellent psychometric properties. The FSFI is a measuring scale with 19 items that assess the six domains of female sexual function: desire, arousal, lubrication, orgasm, satisfaction and pain. The paper aims to analyze the psychometric reliability and validity of the FSFI-RO (Romanian Version of the Female Sexual Function Index). Methods 385 women (aged 18 to 51) enrolled in the present study. To assess the presence of FSD we used the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria for sexual dysfunction. Then we categorized the participants into two groups: the FSD group (41%) and the healthy control group (59%). Women were then asked to fill out a form that included sociodemographic information and the FSFI-RO questionnaire. A sample of 50 women agreed to re-answer FSFI-RO in a 4-week interval in order to evaluate the test-retest validity of the questionnaire. The data were summarized using descriptive statistics: the test-retest reliability was measured by the intraclass correlation coefficient (ICC); Cronbach’s alpha was employed to evaluate the internal consistency of the Romanian version of the FSFI, and validity was assessed by the content and construct validity. Results The results showed high test-retest reliability, with ICC from 0.942 to 0.991 in the domains and 0.987 in the total score. Regarding the internal consistency of the FSFI-RO, Cronbach’s α coefficients were found to be high (α = 0.944). Convergent construct validity proved to be moderate to high in desire, arousal, lubrication, orgasm and, satisfaction domains, and weak correlation in the pain domain. Regarding the discriminant construct validity, the scores for each domain and the total score showed statistically significant differences between the FSD group and the control group. Conclusions The FSFI-RO showed similar psychometric properties to those of the original version, therefore being a reliable and valid instrument that can be used in Romanian-speaking women.
    Type of Medium: Online Resource
    ISSN: 1472-6874
    URL: Article
    DOI: 10.1186/s12905-023-02676-7
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2050444-5
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  • 6
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    Bridging the Gap: A Literature Review of Advancements in Obesity and Diabetes Mellitus Management
    MDPI AG ; 2024
    In:  Applied Sciences Vol. 14, No. 15 ( 2024-07-27), p. 6565-
    Details
    In: Applied Sciences, MDPI AG, Vol. 14, No. 15 ( 2024-07-27), p. 6565-
    Abstract: This literature review explores advancements in obesity and diabetes mellitus diagnosis and treatment, highlighting recent innovations that promise more personalized and effective healthcare interventions. For obesity diagnosis, traditional methods like body mass index (BMI) calculations are now complemented by bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA) scans, with emerging biomarkers from “omics” technologies. Diabetes diagnosis has advanced with standard hemoglobin A1c (HbA1c) testing supplemented by novel measures such as advanced glycation end products (AGEs) and autoantibodies, alongside the use of artificial intelligence to enhance diagnostic accuracy. Treatment options for obesity are expanding beyond traditional methods. Minimally invasive bariatric surgeries, endoscopic procedures, fecal microbiota transplants (FMTs), and pharmaceuticals like GLP-1 receptor agonists (semaglutide, tirzepatide) show promising results. Cognitive behavioral therapy (CBT) and prescription digital therapeutics (PDTs) are also valuable tools for weight management. Diabetes treatment is also undergoing a transformation. Ultra-long-acting insulins and innovative oral insulin delivery methods are on the horizon. SGLT2 inhibitors and GLP-1 receptor agonists are proving to be effective medications for blood sugar control. Continuous glucose monitoring (CGM) systems and closed-loop insulin delivery are revolutionizing diabetes management, while stem cell therapy holds promise for the future. By integrating advanced diagnostic tools with personalized treatment plans, obesity and diabetes care are entering a new era. This personalized approach empowers patients and paves the way for improved health outcomes and a better quality of life.
    Type of Medium: Online Resource
    ISSN: 2076-3417
    URL: Article
    DOI: 10.3390/app14156565
    Language: English
    Publisher: MDPI AG
    Publication Date: 2024
    detail.hit.zdb_id: 2704225-X
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  • 7
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    Online Resource
    Evolution of Echocardiographic Abnormalities Identified in Previously Healthy Individuals Recovering from COVID-19
    MDPI AG ; 2022
    In:  Journal of Personalized Medicine Vol. 12, No. 1 ( 2022-01-04), p. 46-
    Details
    In: Journal of Personalized Medicine, MDPI AG, Vol. 12, No. 1 ( 2022-01-04), p. 46-
    Abstract: (1) Background: Although the infection with the SARS-CoV-2 virus affects primarily the lungs, it is well known that associated cardiovascular (CV) complications are important contributors to the increased morbidity and mortality of COVID-19. Thus, in some situations, their diagnosis is overlooked, and during recovery, some patients continue to have symptoms enclosed now in the post-acute COVID-19 syndrome. (2) Methods: In 102 patients, under 55 years old, and without a history of CV diseases, all diagnosed with post-acute COVID-19 syndrome, we assessed by transthoracic echocardiography (TTE) four patterns of abnormalities frequently overlapping each other. Their evolution was followed at 3 and 6 months. (3) Results: In 35 subjects, we assessed impaired left ventricular function (LVF), in 51 increased systolic pulmonary artery pressure, in 66 diastolic dysfunction (DD) with normal LVF, and in 23 pericardial effusion/thickening. All TTE alterations alleviated during the follow-up, the best evolution being observed in patients with pericarditis, and a considerably worse one in those with DD, thus with a reduction in severity (4) Conclusions: In patients with post-acute COVID-19 syndrome, several cardiac abnormalities may be assessed by TTE, most of them alleviating in time. Some of them, especially DD, may persist, raising the presumption of chronic alterations.
    Type of Medium: Online Resource
    ISSN: 2075-4426
    URL: Article
    DOI: 10.3390/jpm12010046
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662248-8
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  • 8
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    Online Resource
    Cardiovascular Abnormalities and Mental Health Difficulties Result in a Reduced Quality of Life in the Post-Acute COVID-19 Syndrome
    MDPI AG ; 2021
    In:  Brain Sciences Vol. 11, No. 11 ( 2021-11-02), p. 1456-
    Details
    In: Brain Sciences, MDPI AG, Vol. 11, No. 11 ( 2021-11-02), p. 1456-
    Abstract: (1) Background: Post-acute COVID-19 syndrome, characterized by persisting symptoms up to 12 weeks after the acute illness, impairs numerous people’s physical and mental health. (2) Methods: 64 inpatients and 79 outpatients, aged under 55 years, with post-acute COVID-19, were evaluated by a transthoracic echocardiography (TTE), mental health examination, Quality of Life (QoL) questionnaire, post-COVID-19 functional status scale (PCFS) and Hospital Anxiety and Depression Scale (HADS). (3) Results: all inpatients had mild/moderate pulmonary injury during acute COVID-19, in contrast to 37.97% of outpatients. Inpatients who reported an average of 5 persisting symptoms, had, predominantly, level 3 PCFS and a median QoL of 62, compared to outpatients, who reported an average of 3 symptoms, level 1 PCFS and a median QoL score of 70. Increased pulmonary artery pressure was detected in 28.11% of inpatients, compared to 17.72% of outpatients, while diastolic dysfunction was diagnosed in 28.12% of inpatients, in comparison with 20.25% of outpatients (p = 0.02). Abnormal systolic function was assessed in 9.37% of inpatients, and 7.58% of outpatients. According to the HADS depression subscale, 46.87% of inpatients and 27.84% of outpatients had clinical depression. Concomitantly, anxiety was detected in 34.37% of inpatients and 40.5% of outpatients (4) Conclusions: cardiovascular and mental health difficulties were frequently detected in patients with post-acute symptoms of COVID-19, which correlated with the number and intensity of persisting symptoms and reduced QoL scores.
    Type of Medium: Online Resource
    ISSN: 2076-3425
    URL: Article
    DOI: 10.3390/brainsci11111456
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2651993-8
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  • 9
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    Impact of COVID-19 Pandemic on the Implantation of Intra-Cardiac Devices in Diabetic and Non-Diabetic Patients in the Western of Romania
    MDPI AG ; 2021
    In:  Medicina Vol. 57, No. 5 ( 2021-05-03), p. 441-
    Details
    In: Medicina, MDPI AG, Vol. 57, No. 5 ( 2021-05-03), p. 441-
    Abstract: Background and Objectives: COVID-19 pandemic severely impacted public health services worldwide, determining a significant decrease of elective cardiovascular (CV) procedures, especially in patients with associated chronic diseases such as diabetes mellitus (DM). Materials and Methods: This study was first started in 2019 in the western of Romania, to analyze the differences regarding the implantations of intra-cardiac devices such as permanent pacemakers (PPM), cardiac resynchronization therapy (CRT), or implantable cardioverter-defibrillators (ICD) in 351 patients with and without DM and the situation was reanalyzed at the end of 2020. Results: of the first 351 patients with and without DM. 28.20% of these patients had type 2 DM (p = 0.022), exceeding more than twice the prevalence of DM in the general population (11%). Patients with DM were younger (p = 0.022) and required twice as often CRT (p = 0.002) as non-diabetic patients. The state of these procedures was reanalyzed at the end of 2020, a dramatic decrease of all new device implantations being observed, both in non-diabetic and in patients with type 2 DM (79.37%, respectively 81.82%). Conclusions: COVID-19 pandemic determined a drastic decrease, with around 75% reduction of all procedures of new intra-cardiac devices implantation, both in non-diabetics, this activity being reserved mostly for emergencies.
    Type of Medium: Online Resource
    ISSN: 1648-9144
    URL: Article
    DOI: 10.3390/medicina57050441
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2088820-X
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  • 10
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    Online Resource
    Parathyroid Elastography―Elastography Evaluation Algorithm
    MDPI AG ; 2020
    In:  Timisoara Medical Journal Vol. 2020, No. 1 ( 2020-12-03), p. 1-
    Details
    In: Timisoara Medical Journal, MDPI AG, Vol. 2020, No. 1 ( 2020-12-03), p. 1-
    Abstract: (1) Background: Primary hyperparathyroidism is a common disorder of the parathyroid glands and the third most frequent endocrinopathy, especially among elderly women. Secondary hyperparathyroidism is a common complication of chronic kidney disease, associated with high cardiovascular morbidity and mortality. In both primary and secondary hyperparathyroidism, the need to correctly identify the parathyroid glands is mandatory for a better outcome. Elastography can be an effective tool in the diagnosis of parathyroid lesions, by differentiating possible parathyroid lesions from thyroid disease, cervical lymph nodes, and other anatomical structures. There are currently no guidelines or recommendations and no established values on the elasticity of parathyroid lesions. (2) Material and Methods: In our studies, we have evaluated, by Shear Wave elastography (SWE), both primary and secondary hyperparathyroidism, determining that parathyroid glands have a higher elasticity index than both thyroid tissue and muscle tissue. (3) Results: For primary hyperparathyroidism, we have determined, using 2D-SWE, the parathyroid adenoma tissue (mean elasticity index (EI) measured by SWE 4.74 ± 2.74 kPa) with the thyroid tissue (11.718 ± 4.206 kPa) and with the surrounding muscle tissue (16.362 ± 3.829 kPa). For secondary hyperparathyroidism, by SWE elastographic evaluation, we have found that the mean EI in the parathyroid gland was 7.83 kPa, a median value in the thyroid parenchyma of 13.76 kPa, and a mean muscle EI value at 15.78 kPa. (4) Conclusions: Elastography can be a useful tool in localizing parathyroid disease, whether primary or secondary, by correctly identifying the parathyroid tissue. We have determined that an EI below 7 kPa in SWE elastography correctly identifies parathyroid tissue in primary hyperparathyroidism, and that a cut-off value of 9.98 kPa can be used in 2D-SWE to accurately diagnose parathyroid disease in secondary hyperparathyroidism.
    Type of Medium: Online Resource
    ISSN: 1583-526X
    URL: Article
    DOI: 10.35995/tmj20200105
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2167800-5
    SSG: 15,3
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