Archive issue

Current Health Sciences Journal

vol. 48 no. 4, 2022

1. Relationship between Adipocytokines, Nontraditional Anthropometric Indices and Coronary Heart Disease Risk in Diabetic Patients

A. Fajkic, O. Lepara, A. Dervisevic, A. Kurtovic, A. Dzubur, M. Ejubovic, A. Djozic, A. Mujakovic, R. Jahic

Introduction: Diabetes mellitus type 2 (T2DM) significantly increase the risk of cardiovascular (CV) disease morbidity and mortality. This study aimed to evaluate the potential of some novel anthropometric indices and adipocytokines to evaluate CV risk among T2DM patients. Methods: A total of 112 patients (men, 57; women, 55) with T2DM visiting Family Medicine and Endocrine counseling in the area of Health centers of Sarajevo Canton were included in this study. The sera samples were analyzed for fasting blood glucose (FBG), HbA1c, lipid profile parameters, adiponectin, and resistin levels. The Adiponectin/Resistin Index (A/R Index) was estimated using the formula. The novel anthropometric measurements, including the Conicity index (CI), Lipid Accumulation Product (LAP), visceral adiposity index (VAI), abdominal volume index (AVI), and Body adiposity index (BAI) were estimated. The 10-year risk for coronary heart disease (CHD) and fatal coronary heart disease (fCHD) is calculated by using UKPDS Risk software. Results: The adiponectin was shown as a statistically significant negative association with CHD in female subjects, and the A/R index as a statistically significant association with CHD and fCHD in male subjects. The AVI is superior to the CI, LAP, VAI, and BAI in assessing cardiometabolic risk in T2DM patients. Conclusions: Our study indicated that measuring adiponectin and A/R index, together with measuring AVI as a measure of general volume, can be used as surrogates in the evaluation of high cardiovascular risk among T2DM patients.

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2. Immunoexpression of Claudin 4 in Gastric Adenocarcinomas

O.I. Cretu, M.D. Stepan, M.M. Florescu, A.E. Stepan

Disturbance of the intercellular adhesion system represents a basic biomolecular mechanism in gastric carcinogenesis. Claudin 4 is member of a protein family involved in maintaining homeostasis and epithelial integrity. In this study, we analyzed the immunoexpression of Claudin 4 in 58 cases of gastric adenocarcinomas, in relation to the main histopathological parameters of aggressiveness, the reactions obtained being evaluated through the intensity of the reactions and the number of positive cells. Positive membranous reactions of Claudin 4 were observed in all cases, in tumor cells and some stromal elements, but in some high grade gastric adenocarcinomas also cytoplasmic immunostaining was present. Claudin 4 high scores were associated with tubular, tubulopapillary and hepatoid adenocarcinomas, of low grade and in early stages, aspects that suggest the usefulness of the marker in evaluating the aggressiveness of gastric epithelial tumors.

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3. Investigation of Anxiety Levels of Nursing Students Related to Intravenous Interventions and Factors Affecting the Anxiety

D. Tekin, E. Ergin, S.C. Yucel

This descriptive type study was conducted in order to determine the anxiety levels experienced by nursing students during IV intervention and the factors causing anxiety. The study was completed with a total of 260 students, 86 of whom were year-2, 72 were year-3, and 102 were year-4 students, who voluntarily participated in the study. Data were collected online with a Google survey using the Personal Information Form and the Trait Anxiety Inventory. As per the study results, a total of 80.4% of the students were found to experience anxiety during IV interventions, and their trait anxiety (45.10±8.8) levels were moderate. A statistically significant difference was found between the achievement status of the students and their mean trait anxiety score (p<0.05). As a conclusion of the study, the students were found to experience moderate levels of anxiety during IV interventions and their level of anxiety decreased as their achievement levels increased. This was the first study on the subject in our country and new studies are needed.

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4. Factors Affecting Prevention Behaviors Against Covid-19 Infection Among Iranian Pregnant Women: Application of Protection Motivation Theory

F. Khorsand, M. Barati, S. Bashirian, E. Jenabi, S. Khazaei

Considering the epidemic of corona disease in the world and the importance of paying attention to pregnant women as one of the most important vulnerable groups, it is felt necessary to conduct studies and properly teach them preventive behaviors. Therefore, the present study was conducted with the aim of investigating the factors influencing the prevention of covid-19, based on the Protection Motivation Theory (PMT), among pregnant women. This cross-sectional study was conducted during 2020 with the participation of 231 pregnant women who referred to the comprehensive health service centers of Langrod city, who were selected by simple random sampling. The tool of data collection was a questionnaire consisting of two sections of demographic information and PMT constructs. According to the results, 10.32% reported a history of Covid-19 infection. Carrying out protective behaviors, such as using a mask (94.4 percent), washing hands frequently with soap and water (88.8 percent), maintaining a distance of at least one and a half meters from other people (84.5 percent) in a favorable position and avoiding. The participation in the periods (71.4 percent) was relatively favorable. The result of linear regression analysis showed that perceived self-efficacy (β=0.450) and perceived response effectiveness (β=0.305) were predictors of protective motivation or intention to perform protective behaviors against Covid-19. Also, 66.7% of women were on the path of perceived risk. The PMT can be used as a framework in designing educational programs in order to perform preventive behaviors against infectious diseases such as Covid-19.

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5. Snail Immunoexpression in Endometrioid Endometrial Carcinomas

M.M. Florescu, O.I. Cretu, A. Muraru, D.N. Florescu, C.E. Simionescu

Endometrial carcinoma is one of the most prevalent cancers affecting women with epidemiological placing it as the sixth most common cancer in women. One of the factors implicated in EMT (epithelial-mesenchymal transition), Snail is regarded as having a pivotal role. We selected a number of 30 endometrial carcinomas, in a 2-year period (2020-2022). Snail immunoexpression was identified in the tumor cells for 70% of the endometroid carcinoma cases studied. Tumor cells showed both nuclear and cytoplasmic expression but only nuclear signals were quantified. The average percent of marked tumor cells was 38.6±24.9, corresponding to well differentiated carcinomas. Our analysis also showed a significant association between higher tumor grade and snail expression (p=0.000). Alteration of the epithelial-mesenchymal phenotype in endometrial carcinomas by Snail overexpression in high-grade and advanced-stage lesions constitutes mechanisms involved in the process of tumor progression.

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6. Determining Required Teaching Methods in Distance Undergraduate Medical Education Based on the Non-University Learning Methods Medical Students Used During Covid-19: An Exploratory Factor Analysis

L. Ashour, K. Funjan

In order to improve the distance learning experience for undergraduate medical education, this study aims to evaluate the teaching methods used by universities in Jordan during the distance learning period and identify the best methods in this situation based on non-university educational avenues utilized by medical students during COVID-19. We conducted a survey of 195 medical students from universities across the country using a questionnaire that measures how dependent students are on educational resources provided by universities before and during the distance learning condition and looks into medical students’ most used non-university learning methods in face-to-face and distance learning conditions, and the extent to which medical students used them. We found that the main methods used by medical students for non-university learning were non-university educational videos like YouTube videos (92.8%) and non-university textual explanations (i.e., explanations on websites and summaries of materials made by other students) (67.7%). Before the remote learning situation, there was a large reliance on non-university learning materials, which rose significantly during the distance learning situation (p < 0.001, r=0.54). We conducted a polychoric correlations-based Exploratory Factor Analysis (EFA) on 10 items, 7 of which were retained in the final model that revealed 2 factors, to analyze the relationship between the universities' educational methods used in distance learning and the non-university methods medical students used. The first factor reflected the change in “students’ use of non- university visualization learning methods in distance learning” (external videos, general dependence on non-university methods, and simulation apps had the highest significant loadings (> 0.3)). The second factor reflected the change in “universities' use of visualization and interactive learning methods in distance learning” (deductive discussions, educational videos, and practical methods had significant loadings). A moderately negative correlation was detected between the two factors after applying a Promax rotation (r= -0.41), indicating that the decrease in universities' use of visualization and interactive learning aids in connection with insufficient visualization in the distance educational sessions increased students' use of the aforementioned visualized learning methods in distance learning. This study identifies the optimal visual teaching aids to improve distance undergraduate medical education.

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7. The Effect of Β-Arrestin2 Overexpression Regarding Viability and Temozolomide Treatment in High-Grade Glioma Cells

A. Oprita, G.A. Staicu, C. Baloi, A. Dricu, S.A. Artene

The β-arrestins (β-arr) family are proteins that regulate the signaling and trafficking of various G protein-coupled receptors. Out of the four members, β-arr 1 and 2 have been proven as essential actors behind different processes that lead to the progression of cancer as cell proliferation, migration, invasion and metastasis. In addition to this, these proteins are also capable of transmitting anti-apoptotic signals, influence tumor growth rate and drug resistance. Several studies have demonstrated that β-arr 2 overexpression corelates with an impaired overall survival and also showed that it may mediate multidrug resistance in certain types of cancer. In the current study we analyzed the effect of β-arr 2 overexpression on proliferation and how it affects Temozolomide (TMZ) response on the CL2:6 High Grade Glioma (HGG) cell line. We observed contradictory results after transfection, with β-arr 2 overexpressing cells having a superior proliferation rate after 24 and 48h, when compared to untransfected cells, while the opposite was noted after 72h. In terms of response to TMZ, we observed a similar contradictory pattern with modest differences between doses being observed at 24h, while the smallest and largest doses in our experiment produced opposite effects after 48h and 72h. This further underscores the scarcity of information regarding the exact roles and the importance of β-arrs in the intrinsic mechanisms which govern cancer cells.

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8. Ezrin Immunoexpression in Prostate Adenocarcinomas

T.C.T. Popescu, A.E. Stepan, M.M. Florescu, C.E. Simionescu

Ezrin is a component of cell surface structures, the most important member of the Ezrin/radixin/moesin family. In this study, we aimed to evaluate the expression of ezrin in 50 cases of prostate carcinoma (PA) in relation to the ISUP (International Society of Urological Pathology) groups. Ezrin expression analysis was identified in 78% of the PA cases investigated, with predominantly cytoplasmic staining pattern and variable intensity. Overall, we observed an increase in the intensity of the immunostaining progressively with the decrease in cell differentiation. Statistical analysis indicated the predominance of high FSS in the ISUP 4-5 groups and low FSS in the ISUP 1-2 groups, aspects that were statistically significant. Ezrin was expressed in the majority of PAs analyzed and its expression was associated with ISUP grades, an aspect that suggests involvement in PA progression.

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9. Evaluation of the Relationship of Employment and Economic Status with the Feeling of Mental Well-Being in the Elderly Living in Northern Iran

S.S. Fard, A. Kavosi, A. Sanagoo, L. Jouybari

Background and purpose: The feeling of mental well-being plays a role in mental and physical health, increased life expectancy, and sense of comfort and well-being in human beings. Moreover, quality of life along with economic and social indicators is the greatest desire and most important goal of human life. The aim of this study was to investigate the relationship of employment and economic status with the feeling of mental well-being in the elderly. Materials and Methods: In this descriptive-analytical study, 200 elderly people living in Northern Iran, in 2018 were recruited to the study through available sampling method. The data collected using the Subjective Well-Being Questionnaire were analyzed using descriptive (mean, standard deviation, and frequency) and inferential statistical tests (Pearson correlation coefficient and linear regression). The significance level was considered at P<0.050. Results: The mean and standard deviation of the age of the research units was 69.00±8.22 years. The results showed that the mean of psychological well-being was higher than that of other dimensions (80.00±11.80), and emotional well-being had the lowest mean (37.00±6.36). The Pearson correlation coefficient test did not show a significant relationship between employment and feeling of mental well-being (P=0.550), but a positive and significant correlation was observed between economic status and feeling of mental well-being (P<0.001). Conclusion: Due to the correlation between economic status and the feeling of mental well-being of elderly people, it is essential to consider the necessary solutions in this regard.

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10. Positive Effects of Pulmonary Rehabilitation Among Patients with Obstructive Ventilatory Dysfunction Post COVID-19

G.M. Brindus, E.A. Marcu, M. Olteanu, M.R. Traistaru

Background.SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) infection appeared for the first time in Wuhan, China in December 2019, and in March 2020 it was declared a pandemic by the World Health Organization (WHO). Thus, a new disease was registered-COVID-19 (Coronavirus Disease 2019). Our study followed the patients who had the diagnosis of obstructive ventilatory dysfunction in their personal pathological antecedents, who tested positive for SARS-CoV-2 infection. The patients were in the hospital records with chronic obstructive pulmonary disease (COPD) or asthma. After discharge, patients had a number of outstanding symptoms: fatigue, cough, dyspnea, mental and cognitive disorders, palpitations, headaches, dysfunctions of taste and smell. All patients underwent pulmonary rehabilitation after hospitalization. Aims. In this study, we looked at the benefits of respiratory rehabilitation over a period of six months after SARS-CoV-2 infection. The medical rehabilitation program included physical training, muscle training, nutritional support, psychological support and patient education. Methods. A retrospective study was defined between April 2021-December 2021, including 72 patients who had SARS-CoV-2 infection and who presented various symptoms on discharge. The study was carried out at the Clinical Hospital of Infectious Disease and Pneumoftiziology “Victor Babeș” from Craiova-Pulmonology Department. These patients had a history of obstructive ventilatory dysfunction: asthma or COPD. Patients were monitored during the respiratory rehabilitation program at 3 and 6 months after discharge. Results. An improvement in clinical and functional parameters was obtained as a result of the pulmonary rehabilitation. Conclusions. Patients with COPD are increase risk to develop severe forms of COVID-19. Smoking is an important risk factor for SARS-CoV-2 infection and obstructive ventilatory dysfunction. Vaccination against SARS-CoV-2 infection is effective, being associated with mild forms of COVID-19. Pulmonary rehabilitation is a key point in the management of patients with COVID-19, improving exercise capacity, reducing dyspnea, improving health, increasing oxygen saturation and quality of life.

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11. Relationship between Serum Gamma-Glutamyltransferase and Glutathione Antioxidant System in Patients with Liver Cirrhosis of Various Etiology

M.M. Pomacu, C.E. Stanciulescu, D.M. Trasca, V. Padureanu, L.D. Goga, C.G. Pisoschi, A.M. Buga

Oxidative stress involvement in liver diseases has been extensively studied. A direct assessment of the reactive species incriminated is avoided due to their short lifespan and high cost. For these reasons an inexpensive and easy to perform test for whole body oxidative stress is highly desired. This pilot study was conducted to assess the relationship between γ-glutamyl transferase (GGT) activity and markers of oxidative stress: reduced glutathione (GSH), glutathione peroxidase (GPx) activity and lipid peroxidation in patients with liver cirrhosis due to chronic ethanol consumption and viral hepatitis. Forty-eight patients with alcoholic liver cirrhosis and cirrhosis developed after HBV and HCV infection were included in this study.Blood GSH andGPxand serum GGT and MDAwere assayed and the results were statistically analyzed. The activity of serum GGT was significantly higher in the alcoholic group. The relationship between GGT activity, GSH and MDA levels was different between groups.A strong significant positive correlation between GGT and GSH was noticed for the patients from GGT Q3 and Q4 quartiles in the group of viral liver cirrhosis, while for alcoholics the relationship between GGT and GSH showed the trend for a negative correlation.The values of serum MDA differ significantly between groups (p<0.015); a very significant variation was observed at low levels of GGT activity (p<0.006). Our study demonstrates that the GSH antioxidant defense system is more compromisedin alcoholic cirrhosisand tends to correlate negatively with GGT. Even in its normal range GGT might be an early and sensitive marker of oxidative stress.

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12. Vertical Cephalometric Characteristics in Class III Malocclusions

A.S. Aristide, A.O. Dragomirescu, M.A. Bencze, A. Baluta, E. Ionescu

The phenotypic variety of Angle Class III malocclusion requires in-depth investigation of the skeletal changes from a diagnostic, prognostic and therapeutic perspective alike. The aim of our study was to evaluate the particularities of vertical cephalometric parameters of patients with Class III malocclusions, according to gender and age group. Eight parameters were analyzed on lateral cephalograms of patients with Class III malocclusions and, comparatively, on lateral cephalograms of a group with Class I malocclusions. The results, grouped by gender and age, suggest that values of the gonial angle, values of the angles formed between the mandibular plane and the anterior cranial base, respectively the Frankfurt Horizontal plane were higher for patients with Class III malocclusions, differences being statistically significant especially after the pubertal growth period. Class III patients had lower values for the upper gonial angle and higher ones for the lower gonial angle. Furthermore, for patients with Class III malocclusions the Jaraback ratio decreased, based on the significantly higher values of the anterior facial height. No sexual dimorphism was associated with variation of the investigated parameters.

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13. Simultaneous Rupture of Quadriceps Tendon and Contra-Lateral Patellar Tendon: A Case Report and Review of Literature

G. Caruso, E. Gambuti, E. Spadoni, L. Massari

Simultaneous rupture of quadriceps and contra-lateral patellar tendons represents an extremely rare injury in healthy individuals. Several systemic diseases predispose patients to this type of condition such as chronic renal failure, rheumatologic disease and hyperparathyroidism. However, there are very few cases in the English literature where a healthy individual presents with this condition. The pathophysiology of this disease is not well known despite numerous hypotheses. Sutures with or without anchors of the quadriceps and patellar tendons seems to lead to satisfactory outcome with knee flexion greater than 100°.

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