The digit ratio (2D:4D) has been associated with prenatal hormonal influences and various traits and pathologies. This article explores the relationship between 2D:4D and a series of common polymorphisms and Torque Teno Viruses. In this study, 120 healthy participants were included. The IGF2 Apa I, ACE I/D, INS -23 Hph I, VDR Fok I, VDR Apa I, VDR Taq I, AT1R A1166C polymorphism were genotyped by PCR-RFLP technique, and the IL-6 -174 G/C polymorphism by tetra-primer ARMS-PCR. The presence of TTV was identified by a hemi-nested PCR technique. Haplotype analyses were performed using the SHEsis software. The average 2D:4D values were similar for men and women. Overweight men presented higher 2D4D ratios than normal-weight women (p<0.05). Lower 2D:4D values were recorded in women with pregnancy loss or one child or none (p<0.001). Men with lower 2D4D ratios reported a higher number of children (p<0.001). The IGF2 GG and ACE DD were associated with a higher digit ratio in all subjects and in the women’s subset. A significant association was found in men between 2D:4D and the INS-23 Hph I – IGF2 Apa I T-G haplotype (p<0.01). The data obtained in this study indicate a sexual dimorphism for the digit ratio. The associations between 2D:4D and the genetic polymorphisms studied could be influenced by gender.
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.
There is a potential lateralization of vegetative influences at the cerebral level. We sought to understand the impact of these influences in the setting of ischemic stroke. We conducted a prospective study on 110 who presented with acute ischemic stroke (symptom onset maximum 24 hours before admission). We investigated correlations between stroke subtype, insular location or lateralization, stroke severity, hospital mortality, and the dynamic of enzymes (Tn, TnT, CK, CK-MB). We demonstrated that a higher cardiac enzyme value is associated either with stroke severity or with a higher risk of death in the short term, this growth being a marker for a more severe prognosis of a large stroke rather than an independent cause of mortality. Cardiac monitoring in the acute phase of ischemic stroke can prevent cardiac morbidity and mortality, which is why it is important to identify patients at high risk of heart complications after stroke.
Objective: This study aimed to examine the relationship between mental adjustment mechanisms and somatic symptoms in cancer survivors, a topic with limited research in Psycho-oncology. Methods: In this exploratory cross-sectional study, 88 cancer patients were surveyed using the Somatic Symptoms Scale (SSS-8), the Somatic Symptom Disorder Scale (SSD-12), and the MiniMental Adjustment to Cancer Scale (MINI-MAC). Additional questions were asked regarding cancer stage, treatment, and illness relapses. Data collection occurred over one month at a local oncology unit. Results: Several significant correlations were observed between the scales and subscales of the instruments applied during this study. The most important results showed that maladaptive adjustment mechanisms were significantly associated with somatic symptoms, while adaptive mechanisms were not. However, "fighting spirit," an adaptive mechanism, acted as a moderator between somatic symptoms and their psychological impact (effect size t = 0.157, p < 0.05). Lower "fighting spirit" scores correlated with higher SSS-8 and SSD-12 scores, indicating its potential protective role. Conclusion: A more specific assessment of somatic symptoms and their link to mental adaptation to cancer is needed. Psycho-oncological interventions should address both adaptive and maladaptive adjustment mechanisms due to their significant influence on patient outcomes.
Background: Patients with Lyme disease often suffer from neuro-motor sequelae following Borrelia infection, leading to impairments in balance, posture, and spinal musculoskeletal functionality. This study aims to evaluate the effectiveness of physical therapy in addressing these impairments. Methods: Initial assessments were conducted using the GPS Posture-test System to evaluate static bipodal balance and posture, and BACKFIX Technology for unipedal balance and spinal functionality. Disturbances in balance, postural asymmetries, and a forward-shifted center of gravity were observed. The patient then underwent two 10 sessions (each during two weeks) of computer-assisted physical therapy focused on neuro-muscular movement and balance control. Results: Post-therapy evaluations showed significant improvements in both bipodal and unipedal static balance, segmental and overall body posture, and spinal musculoskeletal functionality. The therapy effectively addressed the postural asymmetries and shifted the center of gravity closer to the optimal vertical posture point. Conclusion: Computer-assisted physical therapy with visual feedback significantly improved posture, balance, and spinal functionality in patients with Lyme disease-related neuro-motor sequelae. This approach facilitated the restoration of muscle coordination and enhanced motor control, aligning with findings from the existing literature.
Delirium is associated with lower quality of life, increased healthcare costs, longer hospitalizations, and worse prognosis when detected in patients who are already confronted with a severe and invalidating disease, like the major neurocognitive disorder (MND). In order to identify the most evidence-based interventions that could be included in case management for patients with both delirium and MND, this narrative review explored three electronic databases (Pubmed, Cochrane, and Web of Science/Clarivate) for primary and secondary sources dedicated to this topic. All papers published in English between the inception of each database and September 2024 were screened for relevant data on pharmacological and non-pharmacological therapies targeting delirium. The results supported the use of a multicomponent approach as the first line of treatment, mitigating the precipitating factors, and only as a second line, the use of pharmacological instruments. There is a lack of validated therapies targeting specifically the delirium superimposed on MND, most of the recommendations being extrapolated from studies with delirium in the general population or in elderly patients with different organic diseases. Further studies are required to investigate the specifics of delirium in patients with MND and potential strategies focused on neurobiological mechanisms instead of just clinical manifestations.
Radiotherapy plays an indispensable role in cancer treatment, with its ability to target malignant cells and improve patient survival. However, its impact on healthy tissues poses significant challenges for reconstructive surgery. The altered tissue environment resulting from radiation, including fibrosis, vascular damage, and compromised wound healing, complicates reconstructive efforts and increases the risk of surgical complications. As cancer therapies advance, the approaches for managing radiation-induced complications must also adapt accordingly. This article explores the complex interaction between radiotherapy and reconstructive surgery, particularly in the treatment of head and neck cancers, breast reconstruction following mastectomy, and sarcoma management. Special attention is given to the customization of surgical approaches based on cancer type, with the goal of optimizing both functional and aesthetic outcomes. A multidisciplinary approach, integrating advanced imaging techniques, modern radiation delivery methods, and innovative surgical techniques is essential for improving patient outcomes.
A multinodular and vacuolating neuronal tumor (MVNT) is a rare non-malign central nervous system tumor. The cerebral cortex of young to middle-aged adults is affected and seizures and focal neurological deficits could reveal it. Despite being considered a low-grade tumor, MVNT can be challenging to diagnose and manage due to its histopathological similarities to other neuronal tumors. The limited number of reported cases makes it difficult to establish definitive guidelines for treatment and follow-up. Given the relatively recent discovery of MVNT, there is a need for further research to better understand its pathogenesis, optimal treatment and long-term strategies. Furthermore, studying MVNT can contribute to the broader understanding of brain tumor biology and the intricacies of tumor heterogeneity. This paper explores the challenges and perspectives surrounding MVNT to improve clinical decision-making and patient outcomes. Based on the present narrative review, advancements in diagnostic technologies have shown promise in addressing the challenges associated with diagnosing MVNTs. Liquid biopsy is an innovative and non-invasive diagnostic tool that analyzes biomarkers to provide information about tumors, and radiomics is a method that extracts quantitative data from medical images to provide detailed insights into tumor characteristics. Such innovative diagnostic technologies are important because they have the potential to significantly improve the current diagnostic landscape for MVNTs, allowing for earlier detection, accurate classification, and personalized treatment strategies.
NAFLD (Non-alcoholic fatty liver disease) is a condition of high importance due to its increased prevalence, estimated at 24% of the global population, and its potential progression to advanced liver disease, cirrhosis, and hepatocellular carcinoma. Onequarter of NAFLD patients have NASH (non-alcoholic steatohepatitis), which is histologically described as liver steatosis, inflammation, fibrosis, hepatocyte injury, and death. Metabolic disruptions, such as obesity, diabetes, and dyslipidemia, are considered to have a great impact on the development of NASH. Patients may have NAFLD for a long time before progressing into NASH, which highlights the necessity of periodic imaging and biochemical evaluation of the liver, and also presents an optimal window of therapeutic intervention. The challenge in developing treatment for NASH stems from the slow progression of the disease and the reliance on sequential biopsies as the diagnostic and staging tools. Several non-invasive tests have been developed as potential future alternatives to the current invasive gold standard. This review aims to assess the current available methods of diagnosis and treatment targeting inflammation.
