Background: The prevalence of smoking among students is a growing concern, particularly among medical students. Being associated with stress, competitiveness, and various social influences, smoking can have detrimental effects on self-esteem and self-efficacy and may create a vicious cycle that may contribute to student’s well-being and academic performance outcomes. We aimed to investigate the relationship between self-esteem, self-efficacy, and smoking habits among medical students and their sociodemographic correlates. Methods: A cross-sectional study on 456 medical students was conducted via an online survey using structured questionnaires on socio-demographic characteristics, smoking habits, nicotine dependence, self-esteem, and self-efficacy. Results: The prevalence of smoking was 31.1% The scores of self-esteem and self-efficacy were positively correlated with smoking habits (W1=0.957, W2=0.975, P<0.05). Students presented rather low smoking addiction with male students having slightly higher scores than female students on self-esteem and self-efficacy, military students had higher self-esteem scores than civilians with physical activity having a positive correlation with non-smoking behavior. Conclusion: According to our results, self- esteem and self-efficacy were slightly positively correlated with smoking habits. Furthermore, there was no statistically significant association between other social factors and smoking. Our results may develop a theoretical basis for medical students’ psychological variables studying for further implementation of university educational programs and preventive interventions empowering students towards an overall better quality of life, addressing, among others, smoking behaviors.
Clostridium difficile infection (CDI) is one of the most common healthcare-associated infections and an important cause of morbidity and mortality worldwide. The objective of the study was to identify the predictive factors for unfavorable evolution and deaths among patients with CDI. Materials and methods: We conducted a retrospective, observational, non-randomized study on 202 patients diagnosed with CDI in the Clinical Emergency Hospital of Bucharest, Romania, for a period of two years. For the statistical analysis, the R program was used, with p-values <0.05 being considered statistically significant. Results: The average age of the patients included in the study was 70.8 years, the average duration of hospitalization was 18.4 days, and the mortality rate was 25.7%. During the follow-up period, only 5% of the patients presented a recurrence of CDI. Multiple binomial logistic regression defined as independent risk factors for death among CDI patients: advanced age, comorbidities such as chronic obstructive pulmonary disease (p=0.008), chronic kidney disease (p=0.007), or COVID-19 (p=0.036), leukocytes ≥ 16,755/mm3 (p=0.009) and serum albumin < 2.83 g/dL (p<0.001). Conclusions: The identification of certain negative prognostic factors in patients with CDI requires a careful follow-up of the patients, for an early identification of complications and adaptation of therapeutic management.
Background: The effect of stress on sympathetic modulation measured by HRV has been studied in various population groups exposed to different stressors. HRV measurement tools are based on the electrocardiogram (ECG), portable tools such as POLAR V800, and recently photoplethysmography (PPG). The aim of this study was to analyze the validity of a PPG mobile app to measure HRV with a validated V800 system in a tactical athlete population. Methods HRV of 53 professional militaries were analyzed by POLAR V800 and an HRV Camera app with a smartphone during 5 min and 30 s protocol respectively. Results: The HRV values obtained by the PPG presented a significant negative significant correlation in the HRVI index, LF, HF, LF (n.u.), HF (n.u.), and a positive significant correlation in TINN index by the Polar V800 system with the application of a regression equation over the data obtained. Conclusions: HRV Camera PPG App 30s record analysis protocol could be applied using a regression formula depending on the HRV variables after the comparison with a standard 5-minute test conducted with a validated Polar V800. In future research, it is suggested to validate PPG protocols with longer durations.
A multipurpose hall designed for CBRN (Chemical, Biological, Radiological, and Nuclear) purposes plays a vital role in enhancing preparedness, response, and recovery capabilities in the face of CBRN incidents. A multipurpose hall for CBRN purposes provides a dedicated and specialized environment to support CBRN preparedness, response, and recovery efforts. It enhances coordination, facilitates training and exercises, ensures proper equipment storage, and fosters collaboration, ultimately strengthening the ability to protect personnel, mitigate risks, and minimize the impact of CBRN incidents. This study is qualitative research based on the content analysis method. To design and build multipurpose halls for CBRN events, this study can be used as a checklist. The purpose of this study is to collect important factors and sub-factors in the design, construction, and equipping of buildings and multi-purpose CBRN structures.
Background: As total hip replacement cases increase year after year, registry-wide data becomes increasingly important in order to assess pathology distribution, reimbursement efficiency as well as physician performance. In order to assess all these factors patient evolution needs to be documented after surgery as well, but the main impediment to doing this is losing patients to follow-up. For this reason, the present study aims to perform a descriptive analysis of the hospital’s internal registry data as well as to determine what percentage of patients can be expected to return to follow-up after total hip replacement. Methods: A query of the hospital’s internal registry data in the last years was performed. Patient demographics, county distribution as well as ICD-10 code usage were documented. Data standardization was performed to determine the probability and cumulative distribution of the patient’s age. The chi2 test of independence was used to assess whether there is a correlation between the patient’s gender and ICD-10 codes. Pot hoc power analysis was performed to assess the accuracy of correlation analysis. Results: Only 29.6% of the patients undergoing total hip replacement are from the county within which the hospital is located. 25% of the patients were under 60 years old. Conclusions: Current registry data reveals that most patients undergoing total hip replacement are around 67.5 ± 11 years old, suffer from unilateral or bilateral primary or secondary hip osteoarthritis and only 29.6% of them are likely to return to follow-up.
Background and Objectives: Chronic Kidney Disease (CKD) affects 6,7% of the adult population in Romania and is associated with high morbidity. About one out of three adults with diabetes has kidney disease. According to current literature data, the prevalence of diabetes is very high, up to 11,6%, of whom 2,4% had undiagnosed diabetes, and is the leading cause of kidney damage and the need for renal replacement therapy (RRT). COVID-19 has brought with it a lot of unanswered questions, regarding the risk factors, the disease evolution, and the treatment possibilities. It became clear that diabetic kidney disease (DKD) is among the independent risk factors that predict unfavorable outcomes upon SARS-CoV-2 infection, so we aimed to evaluate the characteristics of diabetic and non-diabetic dialyzed patients, COVID-19 positive. Materials and Methods: It is an observational, single-center study that analyzed type 2 diabetes mellitus and non–diabetic patients in maintenance hemodialysis hospitalized for SARS CoV-2 infection. Results: A total of 101 adult dialyzed patients were admitted with a SARS-CoV-2 RT-PCR positive test, out of which 42 had a long history of diabetes mellitus type 2 and 59 of them have been known with other etiologies of CKD. Hypertension and heart disease were the most commonly associated comorbidities. Inflammatory markers and anemia were significantly increased in diabetic patients compared to non-diabetic. Conclusions: We found that anemia was more severe in patients COVID-19-positive MHD T2DM patients.
Chronic inflammation and immunosuppressive treatment may play a role in the etiopathogenesis of cancer in psoriasis patients. We wanted to evaluate the Papanicolaou smear (Pap smear) results of female patients with psoriasis which were performed for cervical cancer screening before the initiation of biological agent treatment. Between April 2019 and November 2021, Pap smear results of female patients with psoriasis were reviewed retrospectively. This study included 70 female psoriasis patients with a mean age of 48.41±11.62 years. 49 (70%) patients were biologically naive, whereas 21 (30%) patients previously received biological agents. Obscuring inflammation was reported in 33 (47.1%) patients. Atrophy, intermediate cell predominance, reactive cellular changes due to inflammation, and both atrophy and reactive cellular changes were detected in 15 (21.4%), 7 (10%), 3 (4.3%) patients, and 1 (1.4%) patient, respectively. No malignancy or intraepithelial lesion was observed in 69 (98.6%) patients, whereas atypical squamous cells of undetermined significance were reported in 1 (1.4%) patient. Infections such as bacterial vaginosis, candidiasis, and actinomycosis were detected in 13 (18.6%) patients. Pap smear tests should be performed in female psoriasis patients to detect premalignant lesions of the cervix before the initiation of biological agent treatment. Moreover, psoriasis treatment guidelines should be updated accordingly.
Background: Pheochromocytomas (Pheo) are rare neuroendocrine tumors with a suggestive clinical picture, characterized by hypersecretion of catecholamines and other neuroendocrine biomarkers. Methods: The purpose of the study was to analyze the diagnostic features of Pheo and investigate the role played by different neuroendocrine and hormonal markers in diagnosing Pheo.The retrospective study involved a group of 69 patients diagnosed and treated with Pheo, who had both urinary and plasma catecholamines and neuroendocrine markers measured pre- and postoperatively. Results: After comparing pre- and postoperative hormonal parameters and neuroendocrine biomarker changes, numerous statistically significant findings were found. The analysis of the relationships between chromogranin A (CgA) levels, plasma and urine metanephrines, and normetanephrine and Pheo tumor size was included in the study. Additionally, we evaluated Cg A's diagnostic efficacy in comparison to plasma metanephrines, normetanephrine, and neuron-specific enolase (NSE) for Pheo. Conclusions: We obtained statistically significant data on pre- and postoperative differences for plasma and urinary catecholamines, CgA and NSE. Pheo tumor size is interdependent with serum levels of Cg A, plasma and urinary metanephrines, and normetanephrine. The best diagnostic power for Pheo was plasma normetanephrine, followed by plasma metanephrines and CgA.
The term "panniculitis" refers to a heterogeneous group of conditions that involve inflammation of the subcutaneous cellular tissue. Although there is no universally accepted classification of panniculitis, to facilitate the diagnosis, they were divided into two large classes, based on the histopathological criteria: predominantly lobular and predominantly septal panniculitis. Depending on the presence or absence of vascular damage, each of the two classes mentioned above is divided in turn into panniculitis without vasculitis and panniculitis with vasculitis. The diagnosis of various types of panniculitis can sometimes be very difficult, due to the histopathological changes that occur in the various evolutionary stages of the lesions. Thus, the positive diagnosis relies on the corroboration of clinical data, histopathological examination, and ancillary laboratory tests. We provide an overview of the clinical and histopathological features of panniculitis, classified according to the histopathological criteria.
Objective: The study subject approaches a topic of cerebral pathology, namely the development of a pathological diagnosis that is as accurate as possible for the cerebral tumors and the metastases, using a new method that complements the optical microscopic examination and immunohistochemistry to correctly diagnose cerebral malignancies. Methods: Two-photon excitation (TPE) microscopy techniques are non-linear optical imaging methods that are gaining momentum in the investigation of fixed tissue sections, fresh tissue, or even for in vivo experiments. This method can be used for offering complementary information on the tissue architecture. We argue that using non-linear optical microscopy (which includes TPE microscopy) images collected on this category of brain tissue samples, can facilitate the interpretation of brain tumors and metastases, thus it is a solution worthy to explore. Scanning large areas of the lesions is important to avoid false-negative diagnoses because lesions are often non-uniform. Finding potential invasion sites is also restricted when using a narrow field-of-view imaging method. Results: Our study demonstrated that TPE microscopy can detect specific cellular features of cerebral tumors and metastases in good correlation with histopathological results. This approach can improve the accuracy of the cerebral tumors diagnosis and possibly other neoplasms. Conclusion: TPE microscopy is very important for future research because it could prevent the false or inadequate diagnosis of specific lesions and differentiate a primary tumor from a metastasis. The significance of the findings is attributable to cross-disciplinary cooperation and the constant use of a working standard across all of the experiments in this study.
