Background: The 12-lead electrocardiogram (ECG) is an extremely useful tool for analyzing cardiac arrhythmias and numerous ECG algorithms have been developed to predict the origin of right ventricular outflow tract (RVOT) arrhythmias. Aim: To determine if using complex, time-consuming analysis, and difficult-to-memorize ECG algorithms is feasible and preferable before the ablation procedure when compared with the use of multipolar mapping catheter use during the ablation procedure. Methods: 47 consecutive patients admitted for radiofrequency catheter ablation of idiopathic PVC were included prospectively in this study. Of the algorithms selected for comparison, three have a memorable design and easy applicability (Dixit, Joshi, Pytkowski) and the fourth has a complex, detailed design and is more difficult to memorize (Zhang). Results: The greatest accuracy was observed for the algorithms proposed by Dixit and Pytkowski – 92. 3%. However, when the algorithms were compared for their accuracy, specificity, and sensitivity, no significant differences were found (p=0. 96). Conclusions: 3-D guided mapping using a conventional ablation catheter in a narrower, precise area of interest in the RVOT, based on ECG algorithms is not inferior compared to the multielectrode catheter mapping in the whole RVOT, in terms of mapping time, total procedural time, and radiofrequency application time.
The triglyceride-glucose index is a newly discovered parameter that indicates insulin resistance. This study aims to investigate the relationship between the triglyceride-glucose index and triglyceride/high-density lipoprotein ratio with glycemic control in patients with type 2 diabetes mellitus. This study was performed retrospectively in 296 patients with type 2 diabetes mellitus. Patients were divided into two equal groups according to their HbA1c levels as having good glycemic control (HbA1c 7 and below) and poor glycemic control (HbA1c above 7). Age, gender, body mass index, fasting blood glucose, HbA1c, total cholesterol, serum triglyceride level, serum HDL level, serum LDL level, triglyceride-glucose index, and triglyceride/HDL ratio were compared between the groups. Fasting blood glucose, HbA1c, triglyceride, HDL, triglyceride-glucose index, and triglyceride/HDL ratio was significantly different between patient groups with good and poor blood glucose regulation (p0.05). Triglyceride-glucose index and triglyceride/HDL ratio may be indicators of poor glycemic control in diabetic individuals. These indices are cheaper, universal, and easy-to-measure parameters compared to HbA1c and can be used to predict glycemic regulation.
The cytogenetic aberrations induced by doxorubicin (DOX) may be influenced by diet. Investigation regarding effects of low doses of DOX on chromosomal aberrations frequency in mice bone marrow. The study explored a possible relationship between diet, follow-up period, and cytostatic doses. Four mice groups received normal or high-fat (pork) diet. At the beginning of the 8th day mice from each group received a single intraperitoneal injection with DOX (dose range: 1.7-7.7 mg/kg b.w.) or isotonic saline solution (0.02 mL/g control mice). In the 10th (groups I, II) and 14th (groups III, IV) days from the beginning of the experiment, the mice were euthanized and chromosome aberrations were tested in bone marrow cells. The body weight of all mice who received DOX decreases, especially at higher doses. In the first three days post-injection, weight loss percentage was significantly influenced by DOX doses and/or type of diet (p0.05). DOX doses were able to increase the frequency of chromosomal aberrations. DOX acts as a potent inductor of cytogenetic aberrations in bone marrow cells, regardless of the type of diet.
Background: A germline mutation of the MisMatch Repairgene that causes a malfunctioning DNA system is the defining feature of the hereditary illness known as Lynch syndrome. This review will discuss the endocrine aspects of LS and highlight current advancements in the area. Methods: We searched the available literature of the last 10 years for terms such as endocrine tumors and LS. Our goal is to provide a summary of the most recent information available on the endocrine perspective in Lynch syndrome. Results: The hormonal chemoprevention methods cited are the use of combined oral contraceptives, the use of progestogen-releasing intrauterine devices, and the use of progesterone-only drugs. In addition, after surgical exclusion of the uterus and ovaries, a method frequently adopted for LS patients, it is necessary to start hormonal menopausal therapy, taking into account certain age-specific features. In addition, numerous LS-associated endocrine tumor types have been described. Conclusions: Many hormonal variants are available that are useful in the chemoprevention involved in the treatment of LS. Menopausal hormone therapy is imperative for LS patients who need it. Clinicians need to be aware of the possible association of certain types of aggressive endocrine cancers associated with LS.
Lynch syndrome (LS) is one of the most common inherited cancer predisposition syndromes and the most important cause of hereditary colorectal and endometrial cancers. It is inherited in an autosomal dominant pattern, caused by a pathogenic germline variant in one of the mismatch repair (MMR) genes (MLH1, MSH2, MSH6, or PMS2), which encode proteins responsible for maintaining genome stability. A defective MMR system confers an elevated risk of developing certain types of cancer, at a younger age than in the general population and at a high rate of multiple primary neoplasia. Lynch syndrome is not just one disease, but a collection of different subtypes of underlying molecular aspects with specific clinical implications. A better understanding of these subgroup profiles could offer better care for each patient, leading to more personalized risk-reduction and surveillance strategies. Lynch syndrome is a frequent but yet underdiagnosed condition that needs multidisciplinary increased awareness for correct diagnosis and management. The aim of this review is to provide a summary of available literature data on the genetic aspects of Lynch syndrome together with geno-type-phenotype correlations and its clinical implications in the detection, genetic counseling, genetic testing, risk stratification, and management of this condition.
The scientific and medical world is making permanent efforts to study, understand, and cure the complicated pathology of Systemic Lupus Erythematosus (SLE) – the disease with 100 faces, due to the diversity and complexity of the symptoms. SLE has a devastating impact on the patient’s life, causing multiple metabolic imbalances produced by both the disease itself and the necessary medication. This case report addresses the therapeutic aspects of SLE and diabetes mellitus, on a 47-year-old male with a sensitive multi-pathology and aggressive evolution, medication, and approaching psychomotor rehabilitation therapy, up to now, when SLE treatment has ended. Also, this case study report highlights the importance of flexibility in the psychomotor rehabilitation strategy, in the context of a large range of factors that influence its definition.
Currently, the educational process must integrate new tools, to keep pace with technological progress. Our paper aims to investigate the extent to which the preferences of medical students for the autonomous use of multimedia resources in the learning process are correlated with their opinions towards the Internet and the intensity of using it in their daily activities. Methods: We investigated 395 medical students from 4 medical universities in Romania, 75.9% females, and 88.8% in the 1st and 2nd years of study. Students were asked to express on Likert-scales their agreement with a list of statements about Internet services, as well as whether they like learning using multimedia tools and how intensively they use Internet services. Results: The students agree to a medium to large extent with the favorable statements about Internet services but are also aware of the negative influences that indiscriminate use of such technology can have. The intensity of Internet usage is high, although not exaggerated. With small exceptions, the students who enjoy using multimedia resources during the learning process have also favorable opinions about Internet services, and use them constantly, mainly for information and instant messaging on social networks.
The article shows the development of the method of psychological evaluation called “Evaluation of Negative Mental Reactions and States of Combatants”. In the study participated 1300 male servicemen (29.84% from junior lieutenant to colonel and servicemen under contract and demobilized, and 70.16% from private to senior warrant officer). The age of participants varied from 20 to 55 years. The system of evaluation developed consisted of 16 instruments that could help to determine the presence of negative psychological symptoms of servicemen related to their participation in hostilities. The results indicated that the evaluation method developed is a tool that allows determining the presence of negative psychological symptoms related to participation in combat. Likewise, it is a useful and fast method to assess the effectiveness of short-term psychological recovery programs. Unlike existing methods of diagnosing negative mental reactions and states of an individual, which arose after their participation in hostilities, the developed psychodiagnostic toolkit could consider the physical and mental fatigue of the respondents, their deterioration, and other cognitive dysfunctions.
We aimed to evaluate the efficacy of adsorption therapy as an extracorporeal blood purification technique in critically ill patients with Coronavirus disease 2019 (COVID-19). A retrospective analysis was performed on 17 adult patients with severe COVID-19, who underwent adsorption therapy using an HA330 cartridge, at Ankara City Hospital. Each adsorption therapy was administered for three consecutive days, and each therapy session lasted three hours. Several parameters, including cytokine levels, blood count, biochemistry panel, clinical status, and mortality rate were assessed before and after each therapy session. The results obtained from this study revealed that adsorption therapy reduced IL-6 levels and improved oxygenation in the short term. However, heart rate, mean arterial pressure and SOFA score did not demonstrate significant changes. Notably, the dose of norepinephrine increased after the third session. Regrettably, only 4 out of 17 patients (23.5%) survived. Consequently, adsorption therapy appears to be effective in reducing IL-6 levels in severe COVID-19 patients. Nonetheless, further investigation is warranted to evaluate its impact on clinical outcomes.
The conundrum of post-psychotic depression (PPD) is still present in the psychiatric literature, for more than a century since it was first described by Mayer-Gross. After a short existence in the DSM-IV and ICD-10, this nosological construct was excluded from newer versions of the mental disorders classifications. Therefore, an exploratory analysis of the PPD concept was considered useful both from clinical and theoretical perspectives. There is a high prevalence of depressive symptoms in patients with schizophrenia spectrum disorders (SSD) and, although not all of them represent cases of PPD, they are considered risk factors for suicide. The arguments and contra-arguments for/against PPD were reviewed, and the potential pharmacological interventions for this disorder were analyzed. The explored evidence indicates that PPD is worth further investigation, and in order to differentiate it from schizoaffective disorder, negative symptoms of SSD, or depressive manifestations within the acute psychotic episodes, clearly defined criteria should be found. The use of validated scales, like the Calgary Depression Scale for Schizophrenia and the InterSePT Scale for Suicidal Thinking, is recommended for the initial assessment of depression and suicidal risk in patients with SSD, but also for their monitoring during the acute and maintenance phases. Besides the administration of combined, antidepressant and antipsychotic treatment, the use of clozapine, and the recommendation to initiate treatment for SSD with atypical antipsychotics whenever possible, there is a dearth of studies exploring specific interventions for PPD. Future studies are expected to address the validity of the nosological construct of PPD and the most adequate therapeutic and prophylactic interventions in patients with SSD.
