One of the most controversial topics in total knee arthroplasty is rotation of the femoral component. The current gold-standard in total knee arthroplasty consists in positioning the femoral component in 3 degrees of external rotation to the epicondylar axis, having as reference the tangent to the posterior condyles. Achieving the correct rotation of the femoral components is one of the main goals during total knee arthroplasty. Multiple complications can result from internal femoral rotation, such as lateral patellar tilt, patellar subluxation or dislocation, mobilization with movement on pain, and low survival rates of the femoral components. Postoperative rotational assessment of protective components can only be performed correctly using computed tomography. The known evaluation methods are related to anteversion of the femoral neck, femoral trans-epicondylar line, insertion of the posterior cruciate ligament from the tibia and tibial tuberosity. The purpose of this study was to evaluate the rotation of the prosthetic components in the group of patients with the methods validated by studies and to find alternatives to evaluate the rotation of the femoral component. Thirty-four patients diagnosted with gonarthrosis, proposed for total knee arthroplasty, were included in the study. This is a prospective cohort study in which applied statistics consisted of analyzing data using frequency and percentage for qualitative and mean variables and standard deviation for quantitative variables.
Background and Aim: The prevalence of high-risk behaviors is one of the most serious issues threatening the health of young people. The first step in preventing youth risk-taking is to recognize the problem and its dimensions. The purpose of this study was to investigate high- Methods: This cross-sectional descriptive-analytical study was conducted from March to August 2019. The sample set was 4,000 students. Data was collected by multi-stage sampling at eight universities in Tehran. Demographic information and standard youth-risk questionnaires were used. SPSS 19 software was used to perform an independent t-test, Pearson ANOVA, and linear regression at a significance level of 0.05 on the questionnaire data collected. Results: The mean of the total tendency to high-risk behavior was 130.34±40.37. Significant risks identified were driving (27.3±8.33), violence (18.86±6.4), smoking (18.86±7.68), drugs (22.47±8.83), alcohol (24.10±8.57), and high-risk sexual behavior (18.47±7.49). High-risk behaviors were more common in men, single people, and people living in dormitories (P<0.05). Age and gender were the best-correlated predictors of students' high-risk behaviors. Conclusions: Results show that the tendency to high-risk behaviors in students is a worrying situation. as, at younger ages, the tendency to engage in high-risk behaviors is greater. Among young men and in dormitory life, students are more prone to high-risk behaviors. So, more monitoring in dormitories, especially male dormitories, and better planning and education to reduce high-risk behaviors among students, is necessary.
Infection complication has a major impact on outcomes of patients with combat related penetrating head injuries. There is still a discussion around which factor influence outcomes and infection complication. In the beginning of war, in 2014, the evacuation system was not ready for a sudden start of hostilities because of limited medical resources, the lack of neuro visualization in the frontline, the lack of trained personnel provided first aid to the wounded. Aim: The aim of this study is to determine the factors that influenced the development of infectious complications in penetrating combat head injuries with limited medical capabilities on theatre Materials and methods: This is retrospective study of 79 military cases with penetrating head injuries, which was received during the fighting in eastern Ukraine in the period from March 2014 to the end of December 2017. Information was collected on demographics, evacuation assistance, type of injury and infectious complications. R commander was used for statistical analysis. Statistical significance was defined as p<0.05. Results: Infection complication of CNS were detected in 31 cases (39,24%). Factors that influence rate of infection are low GCS on first evaluation (p<0.001), CSF leak (p=0.002), ventricular injury (p<0.005), installation of tidal drainage (p=0.005), superficial wound infection (p=0.013) and wound dehiscence (p<0.001). Conclusions: There are many controversies in managing penetrating gunshot wounds to the head. Still exist lack of information that neurosurgeon can trust. Data even about small samples still very informative.
Million people worldwide are affected by the hepatitis C virus (HCV). The highest incidence of illness was between 1945 and 1975. It was also estimated that 70% of those people were not tested for the disease. Most recent treatment concepts are safe, highly effective and have a vital public health influence by achieving a viral constant response in a significant proportion of treated patients. It helps reduce liver fibrosis, liver cancer risk and dissemination. With its increased population incidence, HCV becomes a serious public health problem. This review discusses the current literature in this field in terms of the importance of screening of HCV, follow-up, treatment and includes considerations in specific populations such as patients with cirrhosis, with HIV/HCV co-infection, patients with HBV/HCV co-infection and with renal damage.
The appropriate clinical decision-making of the nurses can improve the patient outcome and reduce costs, otherwise delaying the recovery and preferably the death of the patient especially in acute care setting. The aim of this study was to describe the clinical decision making in care of patients with acute care in critical nurses. This study was a qualitative study conducted in 2020. Purposive sampling was used and continued until saturation. The study involved sixteen semi-structured interviews were conducted with critical nurses who had experience providing care for acute patients in critical care units. Interviews transcript and analyzed by qualitative content analysis. Two major themes were generated from the data included instantaneous decision-making and life-saving of the patient. This process was depended on the nurse’s ability to summarize in the moment, to consider everything, to focus on the patient, to combine experience and knowledge, to concern the patient's life, to prevent the deterioration of the patient's conditions and responsibility to their patients.
The present study aimed to examine the mediating role of ego-strength in the relationship between religious health behaviors and mental health symptoms during the COVID-19 pandemic in Iran. A total of 346 university students (301 women, 45 men) completed the Ego-Strength Scale, Religious Health Promoting Behaviors Inventory, and Mental Health Inventory from May 2021 to August 2021. The structural equation modeling and the Pearson correlation method were used. The results revealed that religious health behaviors have a positive and significant relationship with, psychological well- being, and ego-strength, as well as a negative significant relationship with psychological distress. The results also showed ego-strength has a negative relationship with psychological distress. Ego-strength mediated the relationship between religious health behaviors and symptoms of mental health. Ego-strength can be considered as a very important variable in religious health psychology; reinforcing ego-strength may have some implications for mental health during the Covid-19 pandemic.
Peripheral nerve injuries are one of the most important causes for disability generating considerable costs around the world. Appropriate assessment of the extent of peripheral nerve lesions and the choice of the right therapeutic protocol remain some of the biggest challenges. Non-invasive neuroimaging approaches are suitable in managing peripheral nerve repairs, providing in the same time accuracy details in structural neural detection, with minimal discomfort at a low cost. Medical imaging technology development has led to progress in examination of peripheral nervous system, using a series of tools and methods, such as: ultrasonography (US), positron emission tomography (PET), magnetic resonance imaging (MRI) and magnetic diffusion tensor imaging (DTI). In this study, we evaluated the regeneration process in Wistar rats after sciatic nerve defects repair with 4 different techniques (i.e. nerve graft, rat aorta used as a nerve conduit, rat aorta filled with platelet rich plasma (PRP) and rat aorta filled with stem cells) by using MRI investigation alongside the clinical evaluation. Our results showed that among the 4 batches, the PRP batch had the best results in muscle atrophy condition (both on MRI scan and on gastrocnemius index); on the second place the stem cell batch, then the nerve graft batch and finally the aortic conduit batch. MRI proved to be a reliable non-invasive monitoring method and showed good result in correlation with the footprint test (sciatic functional index) and the gastrocnemius index.
Background and aim: After two years of pandemic, planning and budgeting for use of healthcare resources and services is very important. Inpatient COVID-19 hospitalizations costs, regardless of ICD-10 procedure codes, in a Covid-19 support military hospital were analyzed. Methods: The national protocol for the treatment of Covid-19 infection was applied. The costs for laboratory tests, drugs, protection equipment and radiological investigations (imaging techniques such as computed-tomography or radiography), hospitalization days and food were assessed. Results: In our hospital, from August 2020 through June 2021, 241 patients were hospitalized with COVID-19: mean age 59.92±7.8 years, 46% men, 26% military personnel, 11.57±3 days of hospitalization; two third of patients had moderate and severe forms of COVID-19. The main manifestations were: 69% respiratory (18% with severe pneumonia), 3.3% cardiac (2.9% with pulmonary embolism, diagnosed by computed tomography angiography), 28% digestive and 33% psychiatric (most commonly anxiety). The average estimated costs were about 3000€/patient, without significant differences based on disease severity. Equipment costs were 2 times higher than for drugs and 3 times than for laboratory tests. Conclusions: In a Covid-19 support military hospital that cared for patients with predominantly moderate forms of COVID-19, the costs for equipment were much higher than those for treatment. New criteria for hospitalization of these forms of COVID-19 deserve to be analyzed in order to avoid useless costs.
Due to its scarcity, the basosquamous carcinoma represents a challenging pathology both as a result of its aggressiveness and potential of relapse and metastases, and also due to unclear management guides. Encountered under the name of basal cell carcinoma or metatypical carcinoma, the pathophysiology of such tumors is still unclear and it is not known yet if it either derives from a basal cell carcinoma or it could be a variant of transition to a squamous cell carcinoma. Due to low incidence, unclear treatment protocols and not enough research regarding squamous component in the aggressivity of basosquamous carcinoma, the aim of this paper is to analyze histopathological features of 5 cases of basosquamous carcinoma from Plastic Surgery Department of Emergency University Hospital, Bucharest, and correlate them with current literature.
During the COVID-19 pandemic, neuropsychiatric disorders have been diagnosed both in the acute phase, and in the aftermath of this disease. Inpatients, as well as outpatients recently diagnosed with mild, moderate or severe forms of Coronavirus infection have reported neuropsychiatric manifestations with variable duration, symptoms that could be directly or indirectly related to the viral pathogenic agent. Patients who are recovering from the acute phase of COVID-19 also may exhibit various psychopathological manifestations, during the so-called “post-COVID-19 syndrome” or “long COVID-19 syndrome”. Explanations regarding the onset of this type of clinical manifestations and the SARS-CoV-2 infection are extremely diverse, ranging from biological factors (e.g., direct central nervous system viral activity, cerebral hypo- oxygenation, high level of inflammatory response) to psycho-social stressors (e.g., isolation, fear of death, anxiety related to possible somatic complications or sequelae). Objectives: The primary objective of this article was to analyze psychiatric manifestations in patients with acute COVID-19 disease and in patients during post-COVID-19 phase. The secondary objective was to propose a conceptual framework for the evaluation and treatment of these patients. Methods: Patients included in this analysis were screened positive for COVID-19 infection in the last 6 months before their first psychiatric examination. These patients were further evaluated to detect any personal history of psychiatric disorders, somatic comorbidities, or significant concomitant pharmacological treatments. Specific scales for the measurement of symptoms severity and functional impairment were administered in all patients. Results: Five patients were included in this analysis, one during the acute phase of COVID-19 infection, and four patients were evaluated after the complete remission of this disease. Hyperactive delirium, mild neurocognitive disorder, major depressive episode, panic disorder with agoraphobia, or acute psychotic disorder were the main diagnoses in these patients. All patients received adequate treatment and they were monitored using psychological scales until symptoms remission or stabilisation. Conclusions: Psychosocial stressors, neurobiological changes, systemic inflammatory reaction, and individual vulnerability factors may contribute to a diathesis- stress model for psychiatric disorders onset within the acute phase or after the remission of acute manifestations in COVID- 19-diagnosed patients.
