Background: Frailty is a major challenge for the aging population, increasing the risk of falls, disability, hospitalization, and death. It's common with age, and often linked to reduced physical activity and poor diet, especially in those prone to sarcopenia. Gait speed tests are frequently used to assess mobility in older adults. Materials and methods: This six-month study at "Sfântul Luca" Chronic Disease Hospital involved 143 patients over 65 (mean age 72.85 ± 10.07), 113 of whom were women. The Tensiomed Arteriograph measured heart rate, pulse wave velocity, and central aortic blood pressure to assess acute vascular stiffness. Results: As patients aged, their physical circumstances changed: in the age group 75-84 years (“Very elderly”) only 39% of the subjects achieved medium- and good-physical performance, while 56% of them were characterized by low-physical activity (Chi-square test, p <0.001). The mean Mini-Mental State Examination (MMSE) values of individuals with inadequate physical activity were significantly lower (21.02 ± 4.68 points) than those with adequate physical activity (Student t-test, p <0.001). Conclusion: Regular physical activity has been shown to improve hemodynamic factors and potentially slow down arterial aging, thus promoting healthy aging. It is imperative for healthcare professionals to promptly evaluate whether older, frail patients can benefit from rehabilitation, enabling swift recovery through multidisciplinary care.
The study aims to assess the frequency of ESKAPE pathogens and their antimicrobial resistance profile during the COVID- 19 pandemic in a multidisciplinary hospital. Based on microbiological reports, the present study retrospectively evaluated the frequency and antimicrobial resistance (AMR) profile of ESKAPE microorganisms during 2020-2022 in a multidisciplinary hospital in Romania. There were reported 1117 bacterial isolates during the study and ESKAPE pathogens account for 33.5% of the strains. The specific AMR of ESKAPE pathogens cumulates 30.9%, while antimicrobial multidrug resistance characterizes 21% of all ESKAPE strains. The AMR profile of K. Pneumoniae, followed by S. aureus, and P. aeruginosa are alarming on ESKAPE surveillance. The most frequent bacterial isolates and antibiotic resistance reports were identified in the urology department. Based on the local AMR data we suggest the first-line antibiotic recommendations when ESKAPE pathogens are suspected. The directions of the near future antibiotic stewardship program focus on revising the clinical protocols of diagnosis and treatment in each department, increasing the bacteriological samples collection, improving the microbiological diagnostic techniques for AMR identification, and intensifying the epidemiological actions of surveillance, control, and education.
Paneth cells (PCs) are specialized epithelial cells located at the base of the crypts of Lieberkühn in the small intestine and colon, that have been occasionally identified in colorectal adenomas and adenocarcinomas. Their presence in these lesions has raised questions regarding their role in colorectal neoplasia and their potential association with adenoma burden. To understand their potential role in carcinogenesis, we conducted an extensive review of the available literature on PubMed, focusing on the occurrence, molecular mechanisms, and implications of Paneth cells in neoplastic lesions of the colorectum. This review synthesizes current findings and discusses the potential of Paneth cells as diagnostic biomarkers and therapeutic targets in colorectal cancer.
The phenomenon of substance use disorders (SUDs) presents extremely complex etiopathogenesis with intermingled psychological, social, economic, and biological factors. Therefore, the prophylactic and therapeutic approach is multidimensional and should involve targeting all the aforementioned variables. However, it is frequently difficult to separate these factors and construct specific strategies to mitigate their direct negative effects, so caution is needed when formulating recommendations for this population, starting from guidelines for case management and finishing with optimization of healthcare policies. Based on the lack of good practices approved at the national level in Romania for the prevention and treatment of SUDs, this article suggests a draft for such an instrument that could help both clinicians and decisional factors with attribution in healthcare and drug abuse prevention. The methods used in this article are (1) a literature review of studies, guidelines, and other reviews focused on specific aspects of drug abuse/dependence and (2) expert opinions derived from clinical and administrative experience. The results are formulated as recommendations, scored according to the GRADE system, and grouped into three categories: (1) preventative measures for SUDs, (2) secondary prophylaxis, (3) therapeutic and other SUD-targeted interventions. In conclusion, the need for guidelines and policies focused on the prevention and treatment of SUDs, especially in vulnerable populations, is an unmet need in our country. The suggested algorithm in this paper tried to bridge the gap between the available literature dedicated to SUDs, practical experience, and future policies in the healthcare of patients with SUDs.
Patients' trust in their physicians is reflected in their steadfast confidence, which encourages greater patient cooperation in treatment, thereby enhancing the prognosis of the disease. We aimed to evaluate the validity and reliability of the Trust in Physician Scale questionnaire (TIPS) by translating it into Persian. After obtaining the main author's permission, the forward- backward translation technique was employed to develop the Persian version. We conducted a cross-sectional study utilizing the TIPS questionnaire among adult patients who presented to the hospital emergency room. This survey involved 310 patients, of which 157 (50.6%) were male and 153 (49.4%) were female. During the study, the mean and standard deviation of patients' age were 56.6 and ± 20.6 years, respectively. The Cronbach's alpha coefficient for this scale was 0.875, demonstrating good internal consistency of the questionnaire. Using factor analysis, the scale items filled one subgroup. To evaluate the reliability of this test, the intra-class correlation coefficient (ICC) was determined to be 0.75, confirming its reliability. This study demonstrated acceptable validity and reliability of the TIPS questionnaire for evaluating patients' trust in their physicians in a Persian-speaking society.
Bacterial resistance to antibiotics is considered the most important health problem in developed and developing countries. Studies on new pharmaceutical strategies, such as probiotics and their derivatives, have increased. The purpose of this study is to isolate and purify bacteriocin and biosurfactant from Lactobacillus rhamnosus and investigate its antibacterial and anti-biofilm activity. Bacteriocin and biosurfactant produced by Lactobacillus rhamnosus standard strain were isolated and purified. Biosurfactant screening tests, including oil expansion test and drop spreading test, were conducted. Bacteriocin was separated using two different methods, including separation with the help of 2-propanol and separation with the help of ammonium sulfate. The purification of bacteriocin was realized by dialysis, and the effect of biosurfactant and bacteriocin on Staphylococcus aureus and Escherichia coli was realized using the disc diffusion method. The antibacterial properties of these substances were determined by diffusion method from its anti-biofilm disk with the help of the ELISA reader. Statistical Program for Social Sciences (SPSS) software was utilized for data analysis. The diameter of the non-growth halo of E.coli in contact with the disc impregnated with bacteriocin in concentrations of 250, 500, and 1000mg/ml was 21 ± 1, 21.33 ± 2.3 and 34.66 ± 7.02 mm, respectively, and in Staphylococcus aureus was evaluated as 18.33 ± 3.78, 24.33 ± 4.72 and 43.66 ± 4.72 mm, respectively. The order was evaluated as 18.33 ± 2.88, 25 ± 5, 43.33 ± 5.77 mm. The biofilm inhibition percentage was measured for Escherichia coli 0.36, 2.15, and 71.75%, respectively, and for Staphylococcus aureus 1.07%, 5.96%, and 53.3%, respectively, at the mentioned concentrations. The results showed that bacteriocin and biosurfactant isolated from Lactobacillus rhamnosus have high antibacterial and anti-biofilm properties
AB0 blood group type has been linked with different types of cancer. For rectal cancer, there isn’t enough data to assess whether such risk exists. We conducted a retrospective study to evaluate the association between ABO blood type and risk of susceptibility to development, progression, or protection against rectal cancer. We analyzed the medical records of 690 patients with rectal cancer from “Prof. Dr. Alexandru Trestioreanu” Oncological Institute of Bucharest during 8 years of follow-up. Data were scraped using Python. For analysis, we used the Chi-square test. The blood group count was A (287, 41.6.%) followed by 0 (250, 36.2%), B (32, 4.6%), and AB (121, 17.5%). There are no differences in the female and male subgroups regarding blood type and the lack of evidence for the null hypothesis rejection was shown using the χ2 test statistic (χ2 = 2.1, d.f. 3, p = 0.55 for males and χ2 = 2.9, d.f. 3, p = 0.4 for females). These findings are consistent with the notion that even if AB0 blood type is a risk factor for many types of cancer, there is no specific association between rectal cancer and blood group type.
Ultrasonography (US) is one of the most widely utilized imaging methods in contemporary medical practice. Unlike other imaging techniques primarily within the radiology domain, ultrasonography has been adopted by various medical and surgical specialties and tailored to the specific needs of each. This adaptability has contributed to ultrasonography's rapid diversification and remarkable evolution over recent decades. Ultrasonography was first employed in dermatology in 1979 when Alexander et al. used it to measure skin thickness. However, due to the limitations of conventional ultrasound devices at the time, which had resolutions and frequencies below 15 MHz, detailed elements of the skin could not be analyzed, tempering enthusiasm for the technique [2]. Modern dermatologic ultrasonography began with the development of fixed-frequency devices operating above 20 MHz, enabling detailed visualization of skin structures. Numerous studies on skin physiology and pathophysiology were conducted using this approach. Modern ultrasonography enables us to visualize skin structures, at times surpassing the detail provided by traditional anatomical dissections in educational settings. Given that patient safety and quality medical care remain fundamental priorities, ultrasonography, with its safety profile and versatility, represents the next step in modern dermatology. Ultrasonography represents a rapidly evolving diagnostic tool that holds the promise of significantly improving diagnostic accuracy and the quality of medical dermatology practice.
Psoriasis is a chronic, inflammatory, immune-mediated skin disease affecting 1-3% of the adult population. It mainly involves the skin, nails, and joints. However, psoriasis can be associated with several comorbidities, including ocular complications. The most frequently reported pathologies are dry eyes syndrome, blepharitis, and uveitis. Being a systemic inflammatory disease, psoriasis also has the potential to directly affect the retina. It has been reported that ocular manifestations tend to appear much later than skin and joint involvement. Eye complications begin insidiously, and progress asymptomatically. This can lead to a decrease in the quality of life and even permanently compromised visual function if not treated properly. Thus, the present review aimed to present current pathological explanations between psoriasis and ocular manifestation, and to evaluate the prevalence of ocular changes in patients with psoriasis, in order to be diagnosed and managed appropriately.
Pancreaticoduodenectomy (PD) is a complex procedure with a high complication rate. Postoperative pancreatic fistula (POPF) is a major complication. Therefore, preoperative determination of POPF risk is clinically important. The C-reactive protein- albumin ratio (CAR) is a parameter used for prognosis in some types of cancer. We hypothesized that CAR could serve as a predictive parameter of POPF. In this study, we investigated whether CAR can predict the risk of POPF after PD in patients with pancreatic cancer. Methods: A total of 83 patients were included in this study between March 2017 and December 2023. This retrospective evaluation included demographic characteristics, preoperative laboratory findings, preoperative clinic and hospital records, and the surgical and treatment conditions of patients undergoing PD for pancreatic cancer in our department. Results: POPF was observed in 41 patients. CAR value was significantly elevated in the POPF group (P< 0.001). According to the Receiver Operating Characteristic (ROC) analysis results, the optimal cut-off point determined for CAR was 0.445. Univariate and Multivariate Binary Logistic Regression analyses showed that CAR was reliable for predicting POPF (odds 57.2). Conclusion: Preoperative CAR is a reliable predictive marker for POPF following PD.
