Current Health Sciences Journal
vol. 42 no. 1, 2016
1. Toxocariasis, Intestinal Parasitoses and Eosinophilia in Schoolchildren from Argentina
MARIA LAURA CIARMELA(1), BETINA CECILIA PEZZANI(1), MARTA CECILIA MINVIELLE(1)
View online - Abstract - Download PDF Toxocariasis, Intestinal Parasitoses and Eosinophilia in Schoolchildren from Argentina PDF
The purpose was to analyze the relationship between toxocariasis, intestinal parasitosis, eosinophilia, pet ownership and signs and symptoms present in 370 schoolchildren (3-12 years old) of Argentina. The positive serology for toxocariasis was 19.5%, associated with eosinophilia and possession of cats as pets. The stool testing revealed 70.0% of parasitized children. Its frequency was 44.9% helminthes and 53.5% protozoan resulting single significant presence of protozoa in children aged 10-12 years. The species were: Blastocystis hominis (45.7%), Enterobius vermicularis (43.2%), Giardia intestinalis (16.2%), Hymenolepis nana (2.4%), Ascaris lumbridoides (1.6%) and Trichuris trichiura (0.3%). The survey showed 13.0% of children with sporadic abdominal pain and 13.5% with pruritus ani. The results indicate relationship between positive serology and eosinophilia compatible with a clinical aspect of covert toxocariasis self-limiting, associated with cats ownership; in school children from our region who also have high frequency of intestinal parasitoses.
2. Determination of Rational Drug Use Behaviors of Adult Individuals - A Cross-Sectional Study from Turkey
DILEK (KARA) YILMAZ(1), NILGUN ALTUN(1), MINES KILIC(1)
View online - Abstract - Download PDF Determination of Rational Drug Use Behaviors of Adult Individuals - A Cross-Sectional Study from Turkey PDF
Purpose: The aim of this study was to determine rational drug usage behaviour of adults. Material/Methods: The study was descriptive and cross-sectional. The study was conducted between January-March 2014 in Mustafa Kemal Pasa Cevizli Family Health Center in the province of Bursa, Turkey. The sample of study was composed 129 individuals who 18 years and over, had not the communication problem with place, and time orientation and accepted a voluntary basis in the study. In the collection of study data, individual identification questionnaire and questionnaire for rational drug use which by researchers in the direction of literature was used. Results: It was found that 30.2% (n: 39) of the individuals enrolled in the study were in the 18-30 age range, 57.4% (n: 74) were male, 42.6% (n: 55) were graduated from primary school, 34.9% (n: 45) were housewife, and 32.6% (n: 42) have chronic disease. 52.7% (n: 68) of the individuals, found that they used irregular their drugs, 70.6% (n: 48) did not comply the hours of taking drug, 23.3% (n: 30) used drug before consulting a doctor, 69% (n: 89) read the prospectus of drugs, 73,5% (n: 95) was prescribed the most analgesic drugs, and 65.9% (n: 85) didn’t stop before the end of the antibiotic group drugs. It was found that there did have a significant difference between the presence of chronic disease of the individuals who participated in the study and their habits of regular drug using and their situation of drug prospectus reading (p<0.05). Conclusions: As a result, it was found that individuals do not comply for rational drug use. In this respect; it is recommended to organize training programs the individuals to increase awareness about rational drug use and to perform the study on the most the sample.
3. Fetal Kidneys Ultrasound Appearance in the First Trimester - Clinical Significance and Limits of Counseling
STEFANIA TUDORACHE(1), MONICA-LAURA CARA(2), D.G. ILIESCU(1), A. STOICA(3), CRISTIANA SIMIONESCU(4), LILIANA NOVAC(5), DANIELA CERNEA(6)
View online - Abstract - Download PDF Fetal Kidneys Ultrasound Appearance in the First Trimester - Clinical Significance and Limits of Counseling PDF
Objective. The objective of this study was to determine the visualizing rate of fetal kidneys at various gestational ages in late first trimester (FT) and to establish the clinical significance of their two-dimensional ultrasound (2DUS) appearance in the FT. Methods. In a prospective cross-sectional study, 1456 women from an unselected population underwent a detailed assessment of fetal anatomy at 11+0 -13+4 weeks of gestation with the use of transabdominal sonography. Information on the ultrasound findings, antenatal course and perinatal outcome was obtained in 1331 cases. Results. 44 cases in which a congenital kidney disease was detected by ultrasound in the prenatal period were identified. The renal pathology was suspected in the FT in 8 cases, and confirmed by a standard test (postmortem autopsy or second-trimester scan) in 4 cases. The standard detailed second-trimester scan at 18-22 weeks diagnosed another 23 cases but refuted suspicion in 4 FT positive cases. The third trimester added another 17, all confirmed by the postpartum scan. For FT presence or absence of congenital renal anomalies, sensitivity, specificity, +LRs and -LRs of 2DUS were 9.09%, 99.69%, 29.25, and 0.91. Conclusion. FT prenatal kidneys’ visualization is critically dependent on the gestational age. FT diagnosis holds uncertainty. An early diagnosis carries a risk of providing a false-positive or a false-negative result, because the differentiation of the renal system is delayed or the diagnosis is not amenable yet to prenatal ultrasound. No FT findings can exclude the mid-trimester follow-up ultrasound scan. Second and third trimester scan are relevant for congenital kidney diseases.
4. Blood Glutathione Peroxidase Activity in Patients with Osteoarthritis Treated with Oxicams
DENISA-CONSTANTINA AMZOIU(1), CATALINA GABRIELA PISOSCHI(2), ANCA-MIHAELA (BULEARCA) STOIAN(3), GABRIELA RAU(3)
View online - Abstract - Download PDF Blood Glutathione Peroxidase Activity in Patients with Osteoarthritis Treated with Oxicams PDF
Purpose. The main objective of this study was the comparison of the influence for three non-steroidal anti-inflammatory drugs (NSAIDs) belonging to the oxicam class, namely piroxicam and tenoxicam, as non-selective inhibitors of cyclooxygenase (COX), and meloxicam, a selective COX-2 inhibitor, on glutathione peroxidase (GPx) activity in patients with osteoarthritis of the knee. Material/Methods. Thirty adult subjects clinically and radiographically diagnosed with knee osteoarthritis, who were not previously subjected to any treatment, were enrolled. They were divided in three groups, each with ten subjects. The serum levels of GPx were assessed at baseline and after twenty days of treatment. The first group received piroxicam at a dose of 20 mg orally daily, the second group was treated with tenoxicam at a dose of 20 mg orally daily, and in the third group meloxicam was administrated in a dose of 15 mg orally daily. Results. After the treatment, it was observed an increase of the GPx activity in all groups. The group treated with meloxicam presented the highest rise in the GPx level (p = 0.052). Conclusions. The 20 days study concerning the effects of treatment with NSAIDs belonging to the oxicam class in subjects with knee osteoarthritis revealed that piroxicam, tenoxicam and meloxicam determined a slightly increase in the GPx activity, although this rise had no statistical significance.
5. High Frequency Ultrasonography of the Hand in Rheumatoid Arthritis, Psoriatic Arthritis, Gout and Osteoarthritis Patients
F.A. VREJU(1), BEATRICE ANDREEA CHISALAU(2), CRISTINA DORINA PARVANESCU(2), ANDREEA BARBULESCU(2), OTILIA ROGOVEANU(3), SINETA FIRULESCU(2), ANCA ROSU(1), PAULINA CIUREA(1)
View online - Abstract - Download PDF High Frequency Ultrasonography of the Hand in Rheumatoid Arthritis, Psoriatic Arthritis, Gout and Osteoarthritis Patients PDF
Over the past decades, management of rheumatic diseases improved both due to development of new drugs and to new imaging techniques. Objective: The aim of this study was to evaluate the type and frequency of different structures involvement in the hand of patients with rheumatoid arthritis, psoriatic arthritis and gout compared to patients with osteoarthritis of the hand Methods: We designed an observational, transverse study, which included 110 consecutive patients evaluated in the Rheumatology Department, Emergency County Hospital Craiova, during one year 2014-2015, from which 50 were diagnosed with rheumatoid arthritis, 20 with psoriatic arthritis, 20 with gout and 20 with osteoarthritis. All patients uderwent clinical, biological and US examination. Results: The global prevalence showed any US abnormalities at the hand level in 47 (94%) RA patients with respect to 17 (85%) patients in PsA group, 15 (75%) patients with gout and 12 (60%) patients in OA group (p=0.01) (Table 1). In all groups, except PsA patients, the tendon involvement (Figure 3a,b) was present in less than 30% of the patients, the high global prevalence being explained by the joint involvement (Figure 3c,d). In most of the patients with tendon involvement, we found joint involvement too. Conclusions: In conclusion, although further studies are needed, with more patients and more homogenous population, the study reveals some US involvement pattern depending on the patient`s disease.
6. Minimally Invasive Video-Assisted Total Thyroidectomy (mi V.A.T.T.) - Case Series of 48 Patients
KONSTANTINOS SAPALIDIS(1), K.S. MYLONAS(1), E. KOTIDIS(2), N. MICHALOPOULOS(1), I. ANASTASIADIS(1), I.D. KANELLOS(1)
View online - Abstract - Download PDF Minimally Invasive Video-Assisted Total Thyroidectomy (mi V.A.T.T.) - Case Series of 48 Patients PDF
Purpose: The first report of miVATT was published in 1998 by Miccoli, leading to a revolution in the field of thyroid surgery. This prospective study aims to evaluate the technique with regard to our department’s experience over a four-year period. Material-Methods: Between September 2009 and October 2013, 48 adult patients (37 females, 11 males) with a mean age of 41.3 (± 11.6) years underwent scheduled miVATT for benign thyroid lesions. Selection criteria included thyroid volume <15 ml and nodules not exceeding 3.5 cm of diameter. Thyroiditis, previous neck surgery and previous irradiation, mediastinal goiter and involvement in another clinical study constituted the exclusion criteria. The procedure we performed was miVATT as described by Miccoli with the only additions being the use of the Harmonic Scalpel and the fixation of the endoscope on a holding device. Also, no drains were applied. Results: No conversions to open surgery were needed. Operation time for total thyroidectomy was 71.23 min (± 23.81) with a mean hospitalization of 1.14 days (± 0.4). Five patients (10.4%) exhibited transient hypocalcemia, whereas there were no recurrent laryngeal nerve palsies. Post-operative pain was mild and the final aesthetic result was considered excellent by the patients. Conclusion: miVATT is a safe and feasible alternative to the conventional thyroidectomy when performed in carefully selected patients by experienced surgeons.
7. Blood Pressure Variability and Left Ventricular Mass in Hypertensive Patients
EDME ROXANA MUSTAFA(1), O. ISTRATOAIE(1), RODICA MUSETESCU(1)
View online - Abstract - Download PDF Blood Pressure Variability and Left Ventricular Mass in Hypertensive Patients PDF
Objectives The purpose of the study is to evaluate 24h blood pressure values by automatic ambulatory monitoring (ABPM) in a group of hypertensive patients already on therapy and to find correlations between different blood pressure parameters and the presence of left ventricular hypertrophy (LVH). Design and method: 39 patients diagnosed with essential hypertension grades 1-3 were enrolled in the study; echocardiography was done and left ventricular mass and mass index were calculated. Based on 24 h ABPM we calculated BP variability estimated as standard deviation (SD) and average real variability (ARV), pulse pressure, dipper profile and morning BP surge. We compared these parameters in pts with and without LVH and calculated correlations with LV mass. Results: Nocturnal diastolic BP variability estimated as SD had significantly higher values in pts with LVH (13,2 vs 9,9 mmHg, p=0,015), ARV/24 hour and ARV during nighttime had higher values in pts with LVH vs those with normal LV mass (12,25 vs 9,7 mmHg and 12,35 vs 9,36 mmHg, p=0,03). Nocturnal diastolic BP variability correlated with LV mass index (r=0,325 for ARV and r =0,327 for SD). Other variables did not correlate with LV mass. Conclusions Nocturnal diastolic BP variability correlates with LVH independently of mean BP value. ABPM offers a valueable analysis of BP and enables the calculation of different parameters- as variability- which predict target organ damage.
8. Kinetic Program and Functional Status in Patients with Parkinson`s Disease
RODICA TRAISTARU(1), DIANA KAMAL(2), DANIELA MATEI(1), OTILIA ROGOVEANU(1), DIANA TRASCA(1)
View online - Abstract - Download PDF Kinetic Program and Functional Status in Patients with Parkinson`s Disease PDF
The main purpose of kinetic program integrated in complex medical assistance of PD patients is the improvement of life quality, through amelioration of self-care activities, and possibility of making various activities in stability, balance and coordination conditions. We choose the kinetics techniques according to the clinical form and the gravity of the functional deficit. Taking into consideration the locomotors dysfunctional status, almost patients were included in the second and third evolutional stages. For quantize the results and monitories the patients with assessment of the kinetic program benefits we have use different scales and questionnaires. The age of the patients was over 45 years and more patients were male then women; this aspect confirm the increase frequency of disease in the male subjects. The individual and global clinical motor aspects were been influenced by the kinetic program. The global functional impact upon the individual general state was appreciated with scale FIM scale (Functional Independence Measure). Each patient and the entire studied group had presented an increase of the final motor score; this evolution mode proved the important of the kinetic program in the management of the Parkinsonism patient global state. “The PD patients have not be help” in the quotidian activities performance – is one of the kinetic rules that has be respected by all the family patient members.
9. Assessing Endothelial Dysfunction in Patients with Ankylosing Spondylitis
DIANA RODICA TUDORASCU(1), PAULINA LUCIA CIUREA(2), A.F. VREJU(2), ANDREEA BARBULESCU(3), R.P. TUDORASCU(4), D.C. PIRVU(1), RALUCA NICULINA CIUREA(5)
View online - Abstract - Download PDF Assessing Endothelial Dysfunction in Patients with Ankylosing Spondylitis PDF
The objectives proposed were the evaluation of the endothelial dysfunction by ultrasonographic with examination in patients with (AS), the evaluation of the lipid profile of these patients and the identification of some correlations with certain clinical and biological parameters. Material and method: The study has a prospective nature, type case-control, and took place in the Rheumatology Clinic of Emergency County Hospital Craiova and was performed on 140 patients, who were divided in two groups, patients from the population of patients suffering from ankylosing spondylitis and non-inflammatory rheumatic affections assisted in the same period of the research. Study design involved: patients with AS registration, duration of the disease, type of joint damage (axial or peripheral), progression of the disease, activity indices (BASDAI), mobility (BASFI) and severity, therapeutic protocol, complete physical examination, ESR, hs-CRP, level of the glucose in the blood, creatinine, uric acid, complete lipid profile, bonejoint radiological examination, ultrasound examination (2D+Doppler) of the carotid arteries. Results and discussions: endothelial dysfunction was more important in patients with AS and was significantly associated with the inflammatory status-especially with hs-CRP, age, duration and severity of the disease. Results of the study show that patients suffering from AS are included in a high risk class due to the chronic inflammatory status and to the pro-atherogenic lipid profile, mutually reinforcing variables. Conclusions: Patients with AS have a pro-atherogenic status and early atherosclerotic lesions.
10. The Study of Uropathogenicity Factors for Escherichia Coli Strains
ANCA UNGUREANU(1), ALICE ELENA GAMAN(1), ADRIANA TURCULEANU(1), MIHAELA MITROI(2), A.I. DROCAS(3), MARIA DOBRITOIU(4), RALUCA GABRIELA ANDRONIC(4)
View online - Abstract - Download PDF The Study of Uropathogenicity Factors for Escherichia Coli Strains PDF
Urinary tract infection (UTI) is the most common form of extraintestinal Escherichia Coli infection (E.coli), and E. coli is the most common cause of UTI.The aim of this paper is to study the uropathogenicity factors for some strains of E.coli involved in the etiology of UTI and the affiliationof urinary E.coli strains to the serogroups involved in the UTI.We studied 208 strains of E. coli from urine samples sterilely collected from patients with clinical suspicion of urinary tract infection.The study was conducted in Emergency County Hospital Craiova between 2012-2014.Out of the 208 strains of E. coli submitted to the study, 60 strains (28.84%) - MRHA with human red cells, 28 strains (13.50%) - MRHA human red cells and blood red cells MSHA with guinea pigs, and 44 strains (21.12%) - MSHA with guinea pig red blood cells; 76 strains (36.54%) - no hemagglutination. Regarding our study, 42,34% of E.coli strains presented human MRHA putting forward their potential to cause pyelonephritits. The 68 hemolytic strains (37,20%) of urinary E. coli were tested for the production of the cytotoxin, thus obtaining characteristic cytotoxic effect for 26 strains (38.20%) whereas its absence was registered in 42 strains (61.80%). E. coli O6 strains isolated from hospitalized adults are more frequently hemolytic than those isolated from the other groups and MRHA was more common in hemolytic strains of the same group O6). Mannose-resistant hemagglutination is more frequent in strains that develop HLy but do not produce CNF(Cytotoxic Necrotizing Factor), than in strains producing CNF.
11. Feasibility Study of a Novel Navigation System for Biopsy of Peripheral Lesions in the Lungs
L.G. GRUIONU(1), A. SAFTOIU(2), T. POPA(3), C. CIOBARCA(3), C.T. STREBA(4), ANA-MARIA IONCICA(4), G. GRUIONU(5)
View online - Abstract - Download PDF Feasibility Study of a Novel Navigation System for Biopsy of Peripheral Lesions in the Lungs PDF
A novel system for electromagnetic navigation in bronchoscopy (ENB) to improve peripheral lesion targeting and diagnostic is currently under development, and preliminary tests on a complex phantom are presented in this paper. The system named Transbite is proving to be easy to use, accurate and useful for experienced and beginner users, with precision around 5-9 mm in reaching targets in sub-segmental bronchi where a conventional video-bronchoscope cannot extent. Transbite system consists of a planning and orientation software, a navigation and biopsy forceps, an active marker that is placed on patient chest and an electromagnetic tracking system from the market connected to a computer containing the software. Transbite can be used with any bronchoscopy system, has a short set-up procedure and learning curve.
12. Ranking the Meso Level Critical Factors of Electronic Medical Records Adoption Using Fuzzy Topsis Method
HOSSEIN AHMADI(1), MEHRBAKHSH NILASHI(1), OTHMAN IBRAHIM(1), KOMEIL RAISIAN(1)
View online - Abstract - Download PDF Ranking the Meso Level Critical Factors of Electronic Medical Records Adoption Using Fuzzy Topsis Method PDF
As Electronic Medical Records (EMRs) have a great possibility for rising physician’s performance in their daily work which improves quality, safety and efficiency in healthcare, they are implemented throughout the world (Boonstra and Broekhuis, 2010). In physician practices the rate of EMRs adoption has been slow and restricted (around 25%) according to Endsley, Baker, Kershner, and Curtin (2005) in spite of the cost savings through lower administrative costs and medical errors related with EMRs systems. The core objective of this research is to identify, categorize, and analyse meso-level factors introduced by Lau et al, 2012, perceived by physicians to the adoption of EMRs in order to give more knowledge in primary care setting. Finding was extracted through questionnaire which distributed to 350 physicians in primary cares in Malaysia to assess their perception towards EMRs adoption. The findings showed that Physicians had positive perception towards some features related to technology adoption success and emphasized EMRs had helpful impact in their office. The fuzzy TOPSIS physician EMRs adoption model in meso-level developed and its factors and sub-factors discussed in this study which provide making sense of EMRs adoption. The related factors based on meso-level perspective prioritized and ranked by using the fuzzy TOPSIS. The purpose of ranking using these approaches is to inspect which factors are more imperative in EMRs adoption among primary care physicians. The result of performing fuzzy TOPSIS is as a novelty method to identify the critical factors which assist healthcare organizations to inspire their users in accepting of new technology.
13. Diastematomyelia - Imaging Findings, Case Report
DANA ALBULESCU(1), CARMEN ALBU(2), C. CONSTANTIN(3), ZOIA STOICA(3), IULIANA NICOLESCU(1)
View online - Abstract - Download PDF Diastematomyelia - Imaging Findings, Case Report PDF
Diastematomyelia consists in dividing into two hemi spinal cord cords symmetric and asymmetric in the presence of a bone spur. Malformation is more common in women, and this paper presents the case of a patient with this rare spinal dysmorphism, in terms of imaging, MRI is the only method of exploration that can establish the diagnosis and also can highlight and malformations associated.
14. Psoriasis Vulgaris in Children - Case Presentation
CRISTINA SINGER(1), SIMONA COSOVEANU(1), LOREDANA ELENA STOICA(2), DIANA MONICA GEORGESCU(3), ILEANA PUIU(4), DANIELA NEAGOE(5), F. DRAGOMIR(6)
View online - Abstract - Download PDF Psoriasis Vulgaris in Children - Case Presentation PDF
A seven-year-old girl, with erythematous-squamous rash, was admitted to our clinic to decide upon the diagnosis and treatment, being transferred from a county hospital. Heredo-collateral antecedents – an aunt, related to her mother, with psoriasis. When admitted, the patient presented prominent non-pruriginous erythematous plaques, clearly marked and covered by thick, silvery-white scales, easily exfoliating, all over at the level of: scalp, earlobes, neck, torso, limbs, periungual, axillary and genital areas. The dermatological examination: psoriasis vulgaris in patches and plaques, a diagnosis also confirmed histopathologically. Using a local dermatologic treatment, the evolution was favorable, the patient initially presenting thick squamae, then, gradually, there occurred the psoriasis whitening. We presented this case since psoriasis is rarely met at this early age.
15. Verrucous Carcinoma - Observations on 4 Cases
V. PATRASCU(1), OANA ENACHE(1), RALUCA NICULINA CIUREA(2)
View online - Abstract - Download PDF Verrucous Carcinoma - Observations on 4 Cases PDF
Verrucous carcinoma (VC) is a rare well-differentiated squamous cell carcinoma with the clinical forms: oral florid papillomatosis, epithelioma cuniculatum, papilomatosis cutis and Buschke-Löwenstein tumor. We present four patients and the four clinical forms of CV. The diagnosis we held after clinical examination and histopathological examination of the balance sheet expansion. First described by Ackermanin the oral mucosal, today it has a reported incidence of 1-3 cases per million inhabitants. CV can involve both skin and mucous membranes. Etiopathogenesis is uncertain, but participation HPV is widely accepted. WHO recognizes the CV as a rare form of well-differentiated squamous cell carcinoma with slow and continues evolution, with the invasion of underlying tissues, frequent relapses and very low risk of metastasis. The elective therapy is surgical excision with safety oncological margins. Diagnosis involves corroboration of clinical data with histopathological appearance and evolutive behavior of the tumor. Given the increased risk for recurrence, the patient should be reviewed quarterly to finding healing.
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