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.
During COVID-19 era, a special attention was considered for autoimmune disorders (AD), including at thyroid, which are regarded at higher risk knowing that stress and infections might aggravate the pattern of anti-thyroid antibodies as well as thyroid dysfunction. In this study, we aim to analyse how COVID-19 infection influenced the evolution of HT parameters versus patients with HT who did not go through infection. Study design: an observational, bi-centric study in Romania during first 14 months of pandemic. By the end of April 2022, Romania registered 1,047,520 total cases of COVID- 19 infection (a morbidity rate calculated for entire Romanian population of 5.23%) with 27,267 total deaths (a lethality rate of 2.6%) and around 2000 new patients a day. From our database of 2210 HT patients, a number of 386 HT subjects were assessed (14 months). Among them, 33/386 patients had a different form of COVID-19 infection. The prevalence of COVID- 19 infection among HT patients was 9.35% which is statistically significant higher when compare with official ratio for entire Romanian population (a morbidity rate of 5.23%, z = 3.162, p = 0.00033). A feminine prevalence was identified (89.37%, N=31/33), while age was not different between subgroups (average age over 50 y). At the moment of diagnostic, thyroid levels at the diagnostic time was 650 UI/mL in group 1 versus 840 UI/mL in group 2 (both groups had very high ATPO values, normal cut-offs below 34 UI/mL) with not statistical significance difference - of ATPO evolution was undulatory in 74.07% of patients, decreasing - 3.7%, increasing - 11.11%, unmodified (stationary) - 11.11%, similarly with group 2, meaning that ATPOs had the same profile, regardless the fact that some subjects went through COVID-19 infection. The rate of associated AD was 28.24% (N=2210), COVID-group of 42.42%, non-COVID group of 38.53% (z = 0.44, p = 0.66). In our COVID cohort of 33 patients with HT, we registered the following clinical stages of coronavirus infection: 4/33 patients who were asymptomatic; all women, average age: 65.65 years; 2/33 patients with lack of smell and taste; women, over 65 years old; 14/33 patients with mild form; from 31 years old to 70.5 years old (only one man); 10 patients with a moderate form; all women, from 34 to 71 years old; one 87-year-old male with a severe form; one 50-year old female with a very severe form in addition to a hematologic disease and a history of severe allergic reactions; and a single patient (a 68-year-old, obese female with a severe allergic background) died of COVID-19 infection (thus generating a lethality rate of 3.03%). Conclusion. Our study showed a higher prevalence of COVID-19 infection among HT patients. These individuals do not associate increased levels of ATPO or a elevated prevalence of AD when compare with non- COVID – HT group, and have similar age and sex ratio. Whether HT exposes the subjects to coronavirus infection is an open issue.
Blockchain is the technology that allows people to make transactions without intermediaries. Bitcoin was the first cryptocurrency launched. Cryptocurrencies are digital tokens that can be used for transactions. They use cryptography to establish their authenticity and are not linked to a central authority. Blockchain has many advantages for the healthcare industry and can be used in various fields such as: implementation and improvement of electronic patient records, in clinical trials, neuroscience, pharmaceutical industry and research. Its security can help to improve the confidentiality of patient data and can also help secure the supply chain of medicines. The security and transparency of the blockchain will play a crucial role in the medical industry. This will allow companies to register their products and conduct secure transactions. QR codes can also be placed on the back of medicine containers to help customers identify the authenticity of the products they purchase. The exchange of health information through the blockchain will also have various challenges, such as maintaining the confidentiality of patient data. At the same time, due to the different regulations in different countries, it can be difficult to establish an efficient and secure exchange. Unlike other cryptocurrencies, blockchains are usually immutable, which means that the data added in the chain will always remain. This eliminates the risk of data loss.
Left ventricle systolic function is an essential parameter in different clinical scenarios and the usual methods available for its assessment are sometime suboptimal, depending on the filling conditions of the heart. Therefore, the development and implementation in clinical practice of a new parameter for assessing left ventricle contractile function is desirable. Mechanical work defined as energy transferred to or from an object via the application of force along a displacement seems to be a promising method for myocardial performance estimation. Although initially this parameter was calculated on the left ventricle volume-pressure curve estimated by cardiac catheterization, an easier method considering non-invasive left ventricle pressure and global longitudinal strain assessed by speckle tracking echocardiography was developed recently. Myocardial work offers information regarding the segmental and global function of the left ventricle, and it is considered a more sensitive marker for assessing left ventricle performance compared to ejection fraction and global longitudinal strain. Its applicability in various cardiac pathologies was demonstrated recently in several studies and its use in every day practice may bring important additional information for clinical decision making.
Evaluation of the size of the kidney's parameters of patients with vesicoureteral reflux (VUR) can provide relevant knowledge about the prognosis factors of VUR's complications. The study aimed to assess the size of the renal parameters of children with VUR and compare the results with healthy matched cases by the ultrasound method. Methods: In this case-control study, children under 14 years of age with VUR in our pediatric urology practice from May 2019 to May 2020 were included. Eighty children were included in the two groups (case (40 cases) and control group (40 cases)) in the study. The case group included children with VUR, while the control group included healthy children. The data regarding Urinary Tract Infection (UTI), the length and width of the kidney, the size of the pelvis, parenchyma thickness, and volume of the kidney were recorded. Results: The mean age of children was 3.07 ± 3.05 years, and 35.0% of them were male. The mean number of UTIs in the VUR group was 1.90 ± 1.15 and in the control group was 1.10±0.30 (P=0.031). The incidence of UTIs was significantly higher in the VUR group than in the control group (P<0.001). Length, width, the posterior-anterior diameter of kidney, renal parenchyma thickness, and renal volume in the VUR group were significantly lower than the control group (P< 0.001). There was no difference between case and control groups in terms of anterior-posterior diameter of the pelvis (P= 0.653). Conclusions: The results showed that the size of kidneys parameters in children with VUR was less than in the control group. Also, the incidence of UTIs in the VUR group was significantly higher than in the control group. Ultrasound is a safe and non- invasive tool that can use for checking the size of the children's kidneys with VUR for predict of possible complications.
Vitamin D receptor gene polymorphisms have been intensively studied in relation with many diseases, including neurodegenerative disorders. We investigated the relationship between VDR polymorphisms and spinal muscular atrophy type I, a common lower motor neuron disease. Forty clinically and molecular diagnosed patients and 54 healthy subjects were analyzed PCR-RFLP method. We found an association trend (p=0.01) for the BsmI polymorphism taken individually and a significant association for two of four-locus inferred haplotypes (fBAt and fbaT). Also, baT, Bat and bAT were the most frequent estimated haplotypes in our control group, which is in accordance with previous published reports for Caucasian populations. We concluded that future studies performed in order to identify possible modifier genes for spinal muscular atrophy disease should take into consideration the involvement of vitamin D receptor gene polymorphisms.
Atopic dermatitis (AD) is the most common chronic inflammatory skin condition, characterized by multiple recurrent eczematous lesions and intense itchiness. It is a multifactorial skin disorder involving an association between genetic and environmental factors that lead to a defect of the epithelial barrier in conjunction with immunological dysregulation. Over the last decade, there has been an increasing understanding of the role of the human microbiota in preserving skin integrity and that a shift in the homeostasis of these microorganisms may lead to dysbiosis and disease. Diversity in the intestinal microbiome and its role in the etiopathogenesis of AD has been described and has become of great interest. In this report, we have reviewed the importance of the gut microbiome and the possible mechanism in the pathogenesis of AD as well as the therapeutic impact of probiotics and prebiotics.
Nanotechnology is applied in wide-ranging fields including energy, information technology, consumables, medicine, etc. Nanomedicine includes the medical applications of nanomaterials in the fields of diagnosis and treatment. This paper focuses on the application of nanotechnology in medical diagnostics for which the main applications of nanomedicine include the detection and discovery of specific biomarkers and rapid identification of biological agents. The
Auto-immune rheumatic diseases are characterised by high levels of inflammation that accelerate the development of atherosclerosis, increasing the cardiovascular risk. Direct evaluation of arteries such as of intima media thickness measurement is a simple test that asesses the cerebral and cardiovascular risk. In the initial stages, an increase of the intimal media thickness can be observed. Later on, atherosclerosis (plaques), stenosis and occlusion of the arteries can be identified. Indirect evaluation of the cardiovascular risk can be performed using serological markers - fibrinogen, C reactive protein, estimated sedimentation rate, total cholesterol, low density lipoproteins and high density lipoproteins, homocysteine levels etc. The presence of certain lifestyle factors that increase the risk, such as smoking, sedentarism and associated pathologies such as obesity, diabetes, hypertension were assesed in patients with rheumatoid arthritis. The aim of the study is to prove the relationship between anti-tumor necrosis factor alpha therapy effect on the cardiovascular risk in rheumatoid arthritis patients.
Worldwide, adults and childhood obesity are increasing alarmingly, being a major health problem. Obesity is correlated with an increased incidence of various systemic diseases including cancer, heart diseases, and diabetes mellitus type 2. Risk factors for obesity are dysbiosis, genetic, socioeconomic, behavioural and environmental. The gut microbiota has beneficial effects on human health, like host immune system stimulation, being influenced by pH, or nutrient intake. Studies performed on humans and animal models reported differences regarding microbiota at lean and obese individuals. The consumption of probiotics and prebiotics may balance the microbiota with positive effects in obesity. The main aim of this review is to reveal the interaction between dysbiosis and obesity.
