Ulcerative colitis is one of the idiopathic inflammatory diseases of the large intestine with an unknown cause, which occurs in recurrent attacks of inflammation in the lining of the mucosa and below the intestinal mucosa. Impaired mucosal immune responses, the involvement of inflammatory cytokines such as IL-1, TNF-α, and IL-6, and other inflammatory mediators such as arachidonic acid metabolites play an important role in the immunopathogenesis of ulcerative colitis. Based on medical findings on the pathogenesis of the disease, new therapies have focused on the responses of the intestinal immune system and the inflammatory process. However, the widespread use of treatments such as aminosalicylates and corticosteroids continues. Most of these drugs have severe side effects. Some patients do not respond well to these treatments and sometimes have to undergo surgery and colectomy. Therefore, extensive studies are being conducted to control and prevent disease to use natural treatment methods such as the use of antioxidants with the approach of removing free radicals that prevent the destruction of cells and tissues in the body. Today, various studies have pointed to the effects of herbal medicines as a complementary treatment in inflammatory diseases. Their low cost and high effectiveness have attracted the attention of researchers in this field. The aim of the present study is a comprehensive review of modern and traditional treatments based on herbal medicines in the field of ulcerative colitis.
Mercury is a chemical element that has been known since prehistoric times and has been used over time as a component of paints, in the treatment of various diseases, and later in various industrial compounds. Mercury enters the body transcutaneously, by inhaling or by ingesting food contaminated with mercury. The most common cause of mercury poisoning is eating seafood, but people can get mercury poisoning from industrial processing, thermometers, dental work, and old paints. The most vulnerable are people at occupational risk due to chronic exposure, as well as fetuses in the intrauterine period. Mercury poisoning produces extremely serious effects on the nervous, renal, and gastrointestinal systems. The nature and extent of mercury poisoning depend on factors such as the route of exposure, the rate of exposure, the distribution and biotransformation of mercury in the body, the chemical form of mercury or the mercury compound. Both mercury in the blood and the urine should not exceed 10 μg/L. The critical values of mercury in the blood are >150 μg/L and the lethal ones exceed 800 μg/L. New diagnostic methods allow the rapid and accurate identification of the concentration of mercury in biological products. Treatment is based on the use of chelating agents. However, the prognosis of mercury poisoning is extremely variable, due to the potentially irreversible nature of the lesions.
Family Medicine has always been regarded as an interdisciplinary specialty, but lately, in most Eastern-European countries, such as Romania, it has been supported by many laws and regulations. The outcome of this prolific background has brought both advantages and disadvantages. Some advantages relate to a sustainable structure, and, at the same time, Family Medicine has been recognized as being the gate-keeper in almost any health care system. Further, due to the privatization of most family practice offices, in Romania, appeared a modern organizational approach, in the shape of a consortium of family physician practices. Some family physicians consider providing their services in a private office as a benefit, but for others the freedom and autonomy to become responsible of their own practice is considered to be a drawback because, apart from the clinical activity, many family physicians have to deal with managerial and marketing issues. In Romania, a consortium of family practice offices has to overcome a very competitive environment and some Marketing specific trends. The aim of this paper is to investigate the usefulness of marketing strategies in the Romanian family physician practice.
Background: The number of studies with the application of scales, such as Attitudes Toward Obese Persons Scale (ATOP), on morbid obese patients are limited. Therefore, we wanted to examine the attitudes toward obese people through the eyes of morbid obese patients. Methods: Between October 2019 - April 2020, 70 female and 20 male, morbid obese patients, who were admitted to the general surgery department to be evaluated for bariatric surgery were included in this study. These 90 morbid obese patients were asked to fill out ATOP, which included 20 statements. Results: The mean ATOP score of all morbid obese patients was 63.44±18.58 (range:19-116). The mean ATOP score of female patients was 63.47±20.34 (range:19-116), whereas the mean ATOP score of male patients was 63.35±10.69 (range:43-80) (p=0.98). The frequency of the responses given by the male and female patients to the third statement, which was “Most obese people are more self-conscious than other people” pointed out a statistically significant difference (p=0.02). Conclusions: Based on ATOP scores gained from morbid obese patients, 60% of morbid obese patients did not feel as happy as non-obese people, whereas 74.4% of the morbid obese patients thought that obese people were not as healthy as non- obese people. Moreover, ATOP scores which were slightly higher than 60 points in both female and male morbid obese patients indicated that morbid obese patients had neither negative nor highly positive attitudes toward obese people.
Background: The most frequently encountered complication of anastomotic surgery is fistula. In addition to the medical history of the patient, local conditions, the operative moment and surgical technique that were chosen, a series of some other factors can interfere, leading to suture disunity. Aim: The aim of the study was to analyze the existence of a relationship between the use of cecostomy (as a mechanism of temporary diversion) and the frequency of anastomotic fistulas. Materials and methods: We conducted a retrospective study, over a period of 7 years, between 2011-2018 taking into consideration 194 patients who benefited from resections completed with anastomoses in the transverse colon, descending colon, sigmoid and rectum. They were divided into two categories: patients who benefited from cecostomy and patients for whom we did not use this technique. The frequency of fistulas was analyzed for the two main groups and in association with each type of surgery. Results: It was observed the existence of a relationship between the appearance of fistulas and the use of a decompression mechanism such as cecostomy in the sense of a lower number of fistulas for the first situation (2.66%) compared to 11.76% for cases without cecostomy (p=0.034). The duration of hospitalization in the group with cecostomy was shorter than in those without this derivative stoma and the postoperative recovery was good. Conclusions: Cecostomy is a useful protection for the anastomosis line, with the advantage that, when the tube is suppressed, the stoma will spontaneously close.
The individual values of combatants determine life goals, how to achieve them, and perform an important adaptive and protective function under conditions of combat stress. Understanding them enables mental health professionals to create an effective system of Combat and Operational Stress Control for military personnel. The purpose of this research was to determine the personal value sphere typology of individual values of combatants of the War in Eastern Ukraine, and, on its basis, to predict the vector of PTSD development. The value sphere (Rokeach Value Scale) and peculiarities of mental status (“Traumatic Stress Questionnaire”) of nine hundred forty three Ukrainian combatants were investigated. Cluster analysis made it possible to create a typology of combatants' values, consisting of five types: “Passionary”, “The one who does not leave the comfort zone”, “Romantic”, “Formal military man”, “Routine”. The most resistant to combat stress are combatants who are aimed at interiorizing values, expanding the boundaries of existing norms, and public recognition (“Passionary” (2.19%), “Romantic” (3.82%)), and the most vulnerable are those who are “Routine” (15.30%) and “Formal military man” (4.37%). The majority of Ukrainian combatants have a defined type of “The one who does not leave the comfort zone” type (74.32%). For them, safety and well-to-do life are the main priorities.
The field of nursing has a lot of responsibilities and workload and is considered as a hard job. If a person does not have the spirit of being responsible for work or interest in service, he cannot survive in the difficult conditions that exist in the field of nursing, such as fatigue, work shifts, stress. Occupational concerns such as insufficient staff, high workload, long working hours and work pressure make nurses unable to play their role in front of their families. On the other hand, nurses are usually unable to perform their duties in the workplace due to family problems. In this study, related articles from the years 2000-2020 were reviewed. The results of studies showed that due to the importance of work-life balance in nurses, it is recommended that managers create the conditions for creating effective methods and techniques for job flexibility for nurses and help nurses to better perform these approaches with the necessary training. Taking care of nurses living conditions, question and answer sessions and interviews with nurses, establishing kindergartens with long working hours can also be effective in creating balance.
Introduction – Pain is known the most common complaint in emergency departments. Several studies are administered many different protocols to control pain in trauma patients. The aim of the study was to review the major relevant articles in case of application of intravenous paracetamol and intravenous morphine sulfate for management of patients with trauma injuries. Methods – We searched the online databases such as PubMed, MEDLINE, EMBASE, ISI Web of Knowledge. We applied keywords included pain, acute, chronic, morphine sulfate, paracetamol, trauma, limb, wounds, and injuries, damage and etc. Results – We included four eligible randomized clinical trials in this study. Three studies reported superior effects in intravenous paracetamol compared to intravenous morphine sulfate in controlling pain in trauma patients (limb trauma and trauma headache). However, a study reported no significant differences between the two groups in knee arthroscopy in trauma patients. All studies used from VAS methods for measurement of pain score. Conclusion – The results indicated that IV paracetamol presents a superior analgesia than IV morphine sulfate particularly after acute limb trauma and trauma headache. However, further studies should be done that clinician could be have better decision for control pain in trauma patients.
Background: Coronavirus disease 2019 (COVID-19) was recognized by the World Health Organization (WHO) as a global pandemic on March 11, 2020. Since then, researchers worldwide have focused their attention on identifying effective treatments and developing vaccines to combat this disease. Aim: To report the effectiveness of the drugs employed in the COVID-19 treatment protocols based on data from clinical trial studies conducted from the beginning of the pandemic until December 10, 2020. Methods: Following the PRISMA guidelines, we conducted an advanced search in several electronic databases. A total of 13553 studies was screened by two people simultaneously and separately based on the article title, abstract and full-text. The quality of the studies was evaluated using the Cochrane criteria. Results: Of the 13553 studies identified, 50 clinical trials were included in this systematic review. Of these, three studies explored the use of remdesivir, nine studies the use of hydroxychloroquine, five studies the use of lopinavir/ritonavir, six studies the use of favipiravir, one study the use of tocilizumab, two studies the use of interferon beta-1a and two studies the use of umifenovir.
Surgical site infections (SSI) greatly concern clinicians, as they are associated with significant morbidity and mortality, prolonged hospitalization, and costs. Antibiotic prophylaxis plays a pivotal role among the procedures that are usually employed for the prevention of surgical-related infections. This narrative review aims to cover some of the particular situations when the clinician might consider individualizing antibiotic prophylaxis for a patient. With the rising incidence of multi-drug resistant bacteria carriage among not only hospitalized or institutionalized patients but also patients from the community, there might be a tendency to use extended-spectrum antibiotics for longer periods for surgical infection prevention. However, the inappropriate use of antibiotics increases the selection pressure, thus favoring the spreading of resistant bacteria. Moreover, specific patient characteristics or pathologies might need to be considered to customize the type, dose, or length of administration of an antibiotic as surgical prophylaxis. Using prosthetic material or prolonged surgeries with large fluid shifts are other situations when individualized antibiotic prophylaxis might be thought of. Keeping in mind that it is of utmost importance that everyone adheres to the current guidelines for surgical antibiotic prophylaxis, customization of local protocols according to well-thought-out strategies might prove beneficial in SSI prevention.
