In this study, symptoms, functions, and outcomes of patients who underwent surgery with the diagnosis of Elastofibroma dorsi between 2007-2019 in our clinic were discussed retrospectively. A total of 19 patients were operated on with the diagnosis of Elastofibroma dorsi in our clinic. The demographic characteristics of patients such as age and gender, symptoms, clinical findings, diagnostic and radiological features, surgical procedures, results of surgical treatments, and postoperative follow-up results were evaluated based on the records. The mean age of patients who underwent surgery was 55.7 and there were 13 females and 6 males. The most common clinical complaint was swelling (61%). Seven of ED were located on the right side, 3 of them were located on the left side and 7 of ED were located bilaterally. The mass in all cases was over 5 cm in diameter, complete surgical excision was done via muscle-sparing technique. All patients were followed up postoperatively and there was no recurrence. ED should be considered in terms of differential diagnosis when middle-aged patients present with a mass in the scapular region and shoulder pain. Total excision is surgically sufficient in symptomatic patients.
All large armies (EU and/or NATO) have pharmaceutical production facilities to provide the necessary antidotes for the troops and the population: The French Army Medical Directorate produces many military-specific pharmaceutical products in its own laboratory, the Turkish Army owns its own medicines factory, including CBRN antidotes, the US Army, in addition to a sustained drug purchase program in the pharmaceutical industry has launched a new concept: Pharmacy on demand. Providing the armed forces with antidotes is a necessity, the concept for their endowement in this sense can be based on imports (sometimes impossible to achieve) or on the national development of a specialized production structure. The design or construction of a specific production capacity for antidotes can be accomplished on multiple variants, with a complexity proportional to the identified need. The total costs are high, but the objective and implementation of effective antidote supply mechanisms is a security guarantee for the armed forces and the civilian population (through commercialization to allied forces), given the risks of terrorist threats and hybrid warfare.
Peptide Nucleic Acids (PNAs) are nanostructures similar to nucleic acid molecules (synthetic DNA/RNA analogs) wherein the negatively charged backbone (sugar-phosphate) present in DNA/RNA molecules is replaced by a backbone without polyamide or peptide charge. Later, it was found that PNAs containing both purine and pyrimidine bases form highly stable duplexes with DNA and RNA. Although it is not as stable as 2PNA/DNA triplexes containing a homopyrimidine strand, it is still more stable than DNA/DNA and/or DNA/RNA duplexes. The unique characteristics of PNAs add new aspects to these nanostructures relative to conventional analogs to make them appropriate for molecular biology studies. The most important applications include the use of these nanostructures in the detection and treatment of diseases caused by threatening biological agents using the antisense/antigen technology and as genetic regulator drugs.
Mass shootings incidents occur with increasing frequency over time. Studying these cases proved that, despite their diversity, several common features could be taken into account in the early detection and possible prevention of certain future cases. Accepting that such incidents may occur anywhere and anytime, societies need to be prepared for their more effective response. Informing citizens about the best way to react to a mass shooting event is considered crucial and essential. The "Run-Hide-Fight" guideline/directive seems to be the most appropriate guideline given to the public. Proper training, of both the Suppression Forces and the emergency medical care providers, is considered of utmost importance. The role of the Incident Commander, regarding the incident management, as well as the external bleeding control of the injured people, are factors of paramount importance in trying to mitigate the casualties from such an incident. The alertness of both citizens and organizations/structures may lead to early detection of potential perpetrators and thereby averting a mass shooting incident. To achieve increased survival and a reduced number of casualties from a mass shooting event it is vital proper education be present at all levels. The response to a mass shooting event should be imprinted in an Emergency plan. Such a plan should have been decided and made, by the Security and Suppression Forces, the Healthcare Institutions, and the Public Safety Answering Point.
Introduction: Public interest in burnout has grown recently in developed countries, as has media coverage. Burnout has been a topic of scientific research in recent years for psychologists and sociologists alike. They have published numerous articles on the identification and classification of burnout syndrome. The medical staff is quite exposed to burnout because they often experience strong emotions such as the desire to treat or save their patients, fear of failure, occasional failures in the treatment of diseases. Materials and methods: This study aims to highlight the impact of the burnout syndrome in the Emergency Department of the Central Military Emergency Hospital during the COVID-19 pandemic, by conducting a comparative study based on the results of a questionnaire applied to the medical staff before and during the COVID-19 pandemic. Results: The study interviewed 65 participants aged between 20 and 60 years. They had to anonymously answer 16 questions marked with scores from 1 to 4. Comparing the results highlighted by the questionnaire, applied before the COVID-19 period, with those obtained in the questionnaire applied between May and June 2020, we noticed an increase in the level of burnout in all categories interviewed during the pandemic. Conclusions: In conclusion, the high level of contagiousness and the lack of a vaccine or treatment against SARS-CoV2 infection are additional concerns for burnout syndrome among healthcare professionals.
Isolation and quarantine during the Covid-19 pandemic affected the lifestyle and daily functioning of the population around the world, leading to social, psychological, and economic changes which further multiplied the stress related to the threat of coronavirus contagion by adding financial, relational, academic, professional and mental health vulnerabilities. To assess the impact of isolation and quarantine over the quality of life in the Romanian population, we conducted a Web-based survey focused on the evaluation of stress level, perception of lifestyle changes, communication patterns, mental health, major concerns, perception of one’s future, but also on the preferred coping strategies that people have used to deal with the isolation stress. The answers were collected during one month and the results for the first 2 weeks of quarantine/isolation were compared with the results after one month of such regimen. Several recommendations based on the survey results analysis were formulated regarding possible strategies for decreasing the impact of stress factors over the general population and specific, vulnerable groups.
Medical personnel is constantly exposed to a variety of stressful events, starting from work overloading, to threats to one's own health or personal integrity, disruptions in personal relationships due to high stress in the professional environment, continuous need to keep in touch with the advances of medical science and therapeutic guidelines etc. Structured evaluation of work-related stress disorders (WRSD) is important both for screening purposes in a vulnerable population like the medical personnel, and for the monitoring of the overall status evolution during individual or organizational interventions. Beside burnout syndrome, major depressive episodes, anxiety disorders, acute stress reactions, posttraumatic stress reactions, substance use disorders, adjustment disorders are also included in the category of WRSD. A specific instrument has been designed for the purpose of screening for WRSD in this specific population, i.e. the Work-related Stress Inventory for Medical Personnel, structured as a 20 items, self-administered instrument (WRSIMP-20). This inventory evaluates three main dimensions- (1) mood symptoms and somatic equivalents, (2) work and professional environment- related discomfort, and (3) interpersonal relationship-associated distress. The results of online administration of WRSIMP- 20 in 81 health care workers and 52 individuals not related in any way to health care professions (control group) were consistent with the premises, as this inventory has been proven valid for the targeted population. Larger trials and test-retest evaluation are needed in order to complete the psychometric properties of WRSIMP-20, but this instrument seems promising in the detection of individuals vulnerable to WRSD.
Chronic pelvic pain syndrome (CPPS) presents a diagnostic challenge due to its multifactorial nature, often involving urological, gynecological, and psychological components. This study focuses on the effectiveness of prophylactic phytotherapy in preventing CPPS recurrence, aiming to mitigate symptoms and psychosocial impact. The study includes 74 patients following a six-month treatment regimen with Graminex, Seronoa Repens, Curcuma Longa, and Acediboswellic ke-to-acetyl-11. Symptom assessment employs the IPSS and NIH-CPSI questionnaires, conducted at 3, 6, 8, 9, and 12 months. Patients exhibit significant improvements in IPSS scores, with maintenance of treatment impact observed at 3, 6, and 9 months. Interruption of therapy leads to symptom recurrence, but upon resumption, responses are more effective. The third group, under observation for three months, reports positive outcomes. Both IPSS and NIH-CPSI scores show a consistent impact on urinary symptoms and pelvic pain, indicating the therapy's effectiveness. The study demonstrates a concordance in the positive effects of phytotherapy across different age groups, emphasizing its efficacy in alleviating urinary symptoms and pelvic pain in CPPS patients. Symptom remission or improvement in quality of life is reported, with a notable tropism for symptom reduction in the cold season. Patient adherence to treatment is high, and even after treatment interruption, resumed therapy yields significant improvements. The observed benefits include the absence of pelvic pain, dysuria, and enhanced sexual competence, contributing to an overall improvement in the quality of life for patients with CPPS.
With recent advances in the understanding of psoriatic disease, it is increasingly considered a systemic inflammatory condition rather than limited to the skin and joints. A variety of biologics are available today for the treatment of psoriasis, but with them, characteristics such as rapidity of onset, long-term efficacy, safety profile, and effects on comorbidities differ. We designed an observational, non-interventional, retrospective study of patients with severe psoriasis receiving biologic treatment with IL-17 inhibitors and aimed to investigate the correlations between etiopathogenic factors and the efficacy and persistence of these therapies in a group of psoriasis patients from Romania. Study results show that patients treated with ixekizumab had better persistence and high adherence compared to those treated with secukinumab. In this study, ixekizumab demonstrated lower risks of non-persistence, discontinuation, and switching and a higher likelihood of high adherence compared with secukinumab. This study contributes to the understanding of the persistence of anti-IL17 biologic therapies in psoriasis and the factors that may influence it.
This review explores the trajectory of photoplethysmography (PPG) technology from its inception in 1934 to its integration into smart devices in 2013. While PPG has proven effective in estimating left ventricular ejection time (LVET) and distinguishing between hypertensive and normotensive patients, challenges persist. The need for a robust mathematical model to explain physiological behaviors, address calibration protocols, and handle waveform variability is emphasized. Despite limitations, PPG is on the cusp of achieving clinical-grade confidence, particularly in estimating blood pressure and tracking vasomotor states. Integration into wearable devices is a prominent trend, with major companies exploring applications for improved health monitoring. Open-source databases and the availability of physiological data aim to enhance understanding, paving the way for universally accepted protocols. As PPG advances, it holds promise for personalized healthcare, revolutionizing treatment evaluations and preventive measures. However, potential disagreements over protocols may impede progress. Nevertheless, the technology's potential to remotely monitor cardiovascular markers could reduce physicians' workload for routine tasks. PPG stands as a beacon for the future of noninvasive cardiovascular assessment.
