Late-life major depression is a high-incidence and difficult-to-treat affective disorder. Diagnosis of major depression in old age could also could be a challenge, due to aspects like (1) there is a higher vulnerability to the stigma of depression in this population, (2) hypochondriac ideation and somatic symptoms are the main symptoms, while depressive disposition or anhedonia are under-reported by such patients, (3) differential diagnosis includes various organic diseases, but also several psychiatric disorders, like neurocognitive disorders, organic affective disorders, drug induced affective disorders etc. Reduction of social relationships caused by retirement and loss of spouse and friends, as well as a decrease of personal income could precipitate or maintain depressive disorders during late-life. Quality of life in patients diagnosed with depressive major disorders is a rarely monitored parameter, although its importance for case management could not be overemphasized. A reduction of life quality correlates with a poorer functional prognosis, persistence of neglected residual symptoms, low adherence to treatment plan etc.
Osteoporosis is a systemic skeletal condition, characterized by a microarchitectural degradation of bone density and quality, giving low resistance and an increased risk of fracture. Osteoporosis is an important public health problem, with considerable medical, social and economic impact. Data accumulated in recent years demonstrate a significant incidence of osteoporosis in the group of patients with major collagen diseases; of these, Systemic Lupus Erythematosus (SLE) is the prototype of autoimmune disease in which osteoporosis and associated complications have a significant clinical impact. Although additional studies are needed to deepen the relationship between SLE - osteoporosis - associated fractures, we believe that these patients should be managed from the early stages of the disease.
Background: Acute cholecystitis is the most frequent complication of cholelithiasis and counts for one third of surgical emergencies. Aim: The study evaluates the outcomes and limits of laparoscopic cholecystectomy in acute cholecystitis. Materials and methods: A retrospective study was performed for 2 years, between 01.01.2016-31.12.2017 in the 2nd Surgery Department of the Sibiu County Emergency Clinical Hospital, on hospitalized patients with acute cholecystitis, who underwent surgery. The severity of acute cholecystitis was analyzed using the Tokyo Guidelines (TG13 / TG18) severity risk scale. The preoperatory evaluation of the anesthetic-surgical risk was based on American Society of Anesthesiologists Physical Status Classification (ASA PS) and Charlson Comorbidity Index (CCI) (9). Statistical analysis was performed to analyze the outcomes and limits of laparoscopic cholecystectomy and the risk factors for conversion and open surgery. Results: Out of the 262 patients in the study group, most of the patients (61%) were diagnosed with moderate acute cholecystitis, while 67 patients (26%) were diagnosed with mild form and 34 (13%) with severe acute cholecystitis. Laparoscopic cholecystectomy was performed in 96.1% of cases with no conversion to open surgery. The postoperative complications were ligature slippage (1.9%), main bile duct injury (1.9%), postoperative hemorrhage (3.9%) and surgical site infections (2.4%), most of them being managed conservatory. Conclusions: Laparoscopic cholecystectomy can be performed nowadays with minimal morbidity in acute cholecystitis. Knowledge of various factors predicting possible conversion helps in adequate pre-operative selection and counseling for open procedure with further reduction in the overall morbidity of laparoscopic cholecystectomy.
Colorectal cancer is an important health problem, being the third most frequent cancer pathology both in men and women. Programmes have been developed to decrease CRC incidence and mortality, including primary prevention strategies focusing on population education regarding diet and physical activity and secondary prevention programmes such as screening. Modifiable risk factors are known to be diet, obesity, smoking, alcohol and read meat consumption. Non-modifiable risk factors are age, inflammatory bowel disease, genetic syndromes and family history of colorectal cancer.
Background and Aim: Abdominal compartment syndrome is a life-threatening complication that can occur in trauma patients and greatly increase their mortality. Although there is a better scientific understanding of the general phenomena involved in the pathogenesis of this complication, the particular risk factors and their implications in the trauma patient population are yet to be deciphered. Methods: The authors conducted research through 3 electronic databases (PubMed, Scopus, and ScienceDirect) using the following search formula: “(ACS OR abdominal compartment syndrome) AND (*trauma*) AND (risk factor)”. Subsequently, additional search formulas were used, including the risk factors taken into consideration (i.e. “shock”, “hypotension”, “acidosis”, “base deficit”, ”coagulopathy”, “retroperitoneal hematoma”, “HOB elevation”, “fluid resuscitation”, “damage control laparotomy”). Results: Throughout the 41 articles analyzed in this paper, 7 risk factors transcended and were further discussed: head of bed elevation/patient positioning, fluid resuscitation, the “lethal triad” of acidosis hypothermia and coagulopathy, Damage Control Laparotomy, shock/hypotension, retroperitoneal hematoma and demographics (age, gender, and race). Conclusions: To summarize, many potential risk factors were evaluated for the envisagement of the present paper, but the ones that prevailed the most were excessive fluid resuscitation, shock/hypotension, retroperitoneal hematomas, and the lethal triad. Consistent with other studies, no connection was found between age, gender, or race and the development of ACS. Further studies should focus more on the likely involvement of damage control laparotomy and patient positioning, as well as hypocalcemia, in the unfolding of ACS in trauma patients.
Background: The highlighting of possible risk factors for urinary colonization in patients with obstructive urolithiasis that needed double J catheters implanted to preserve renal function. Methods: We performed a descriptive, retrospective study, carried out in the Urology Department of the Bucharest Central Military Hospital, between January 2020 and January 2022 and included 168 patients with urolithiasis who required the insertion of double J catheters. We studied the bacteriological profile, using both urine and JJ catheter samples. Results: We obtained a double J catheter colonization rate of 32% (54 patients) and 29% of urinary colonization (49 patients). The rate of urinary colonization is higher in patients with colonized ureteral catheters regardless of sex, age, and associated comorbidities. At the same time, we noticed an increased rate of urinary colonization in patients associated with diabetes, hypertension, and chronic kidney disease. Conclusions: The prevalence of urinary colonization in patients with double J catheters was 29%. The colonization of the JJ catheters, as well as the association with chronic diseases, such as diabetes, hypertension, and CKD (Chronic Kidney Disease), show an increased risk of urinary colonization.
Malignant melanoma and urological cancers originate from different tissues and organs, yet several studies highlight connections between these malignancies, including common risk factors, genetic predispositions, and immunological pathways. Evidence from recent studies suggests that a prior diagnosis of melanoma may increase the likelihood of subsequently developing renal cell carcinoma (RCC), and, conversely, patients with RCC appear to face a heightened risk of being diagnosed with melanoma. Shared factors such as a personal or family history of cancer, UV radiation exposure, smoking, and obesity have all been linked to an increased incidence of various cancer types. A major link between malignant melanoma and urological cancers is the presence of shared genetic mutations and familial cancer syndromes. Key mutations, including germline mutations in BRCA1, MITF, CDKN2A, TP53, and alterations in the PI3K/AKT pathway, significantly contribute to the risk of both types of malignancies. Personalized medicine, which tailors prevention and treatment strategies to an individual’s genetic, environmental, and lifestyle factors, has significantly improved cancer care. The primary aim is to select the most effective treatment for each patient, maximizing therapeutic outcomes, reducing side effects, and minimizing the risk of drug resistance. Advances in genomics and immunology are driving the development of personalized therapies that target specific molecular pathways and immune responses common to both melanoma and urological cancers. Angiogenesis inhibitors and checkpoint inhibitors have demonstrated notable success in treating these cancers, with tumor mutational burden serving as a valuable biomarker for predicting the efficacy of immune checkpoint inhibitors.
AB0 blood group type has been linked with different types of cancer. For rectal cancer, there isn’t enough data to assess whether such risk exists. We conducted a retrospective study to evaluate the association between ABO blood type and risk of susceptibility to development, progression, or protection against rectal cancer. We analyzed the medical records of 690 patients with rectal cancer from “Prof. Dr. Alexandru Trestioreanu” Oncological Institute of Bucharest during 8 years of follow-up. Data were scraped using Python. For analysis, we used the Chi-square test. The blood group count was A (287, 41.6.%) followed by 0 (250, 36.2%), B (32, 4.6%), and AB (121, 17.5%). There are no differences in the female and male subgroups regarding blood type and the lack of evidence for the null hypothesis rejection was shown using the χ2 test statistic (χ2 = 2.1, d.f. 3, p = 0.55 for males and χ2 = 2.9, d.f. 3, p = 0.4 for females). These findings are consistent with the notion that even if AB0 blood type is a risk factor for many types of cancer, there is no specific association between rectal cancer and blood group type.
