Outcomes and Prognostic Factors of Intravitreal Bevacizumab Monotherapy in Zone I Stage 3+ and Aggressive Posterior Retinopathy of Prematurity

Purpose. This study aims to evaluate the regression of retinopathy of prematurity (ROP) after one intravitreal injection of bevacizumab and the factors that influenced it. Methods. This retrospective case series was carried out at the “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania. It includes all the consecutive infants treated for ROP with one intravitreal bevacizumab injection, from January 1, 2009, throughout July 31, 2013. The follow-up continued for 60 weeks after injection. We recorded ROP classification, regression, gender, gestational age, birth weight, postnatal age and postmenstrual age at treatment, and pregnancy type. Regression was analyzed according to each of the abovementioned factors, with the program IBM SPSS 20 (Chicago, Illinois, USA). Results. This study includes 74 eyes of 37 infants of which 52 had aggressive posterior ROP (70.27%) and 22 had zone I stage 3+ ROP (29.72%). One week after the bevacizumab injection, ROP regressed in 63 eyes (85.13%), with a statistically significant higher rate in zone I stage 3+ ROP (100%), as compared with aggressive posterior ROP (78.84%) (P=0.03). We recorded no complications subsequent to the intravitreal injections of bevacizumab. We identified no late retinal detachment. Conclusion. ROP regression rate after one intravitreal bevacizumab injection was 85.13%. This trial is registered with trial registration number IRCT2014101618966N2

Matrix Gla Protein – a new marker for colorectal cancer detection? A systematic review

Background. Colorectal cancer is a real public health issue, with high morbidity and severe impact on quality of life. Although mortality from this type of cancer is decreasing due to modern diagnostic and treatment methods, the understanding of its genetic and molecular mechanisms is important to develop a broader range of diagnostic and therapeutic approaches. Genetic therapy is an important strategy in cancer treatment, and the matrix Gla protein (MGP) gene expression has been described in numerous studies as increased in tumour pathology. In this article, we have summarized the currently available evidence on the connection between MGP and colorectal cancer. Materials and Methods. Following the PRISMA guidelines, we have searched the PubMed, ProQuest and ScienceDirect databases for relevant published works that studied the connection between colorectal cancer and MGP gene expression. Results. Three relevant works were included in this systematic review. Two of these studies have observed MGP gene overexpression in tumour cells, a result that contradicts the third study, where the MGP gene was underexpressed. Conclusions. The data provided by these articles is contradictory, and therefore more studies are needed on larger sets of subjects, to fully understand the connection between MGP and colorectal cancer. Materials and methods: Following the PRISMA guidelines, we have searched the PubMed, ProQuest and ScienceDirect databases for relevant published works that studied the connection between colorectal cancer and MGP gene expression. Results: Three relevant works were included in this systematic review. Two of these studies have observed MGP gene overexpression in tumour cells, a result that contradicts the third study, where the MGP gene was underexpressed. Conclusions: The data provided by these articles is contradictory, and therefore more studies are needed on larger sets of subjects, to fully understand the connection between MGP and colorectal cancer

THE RELATIONSHIP BETWEEN BACTERIAL BIOFILMS AND INFLAMMATORY TISSUE CHANGES IN PATIENTS WITH CHRONIC RHINOSINUSITIS

Objectives. The involvement of bacterial biofilms in the pathophysiology of chronic rhinosinusitis (CRS) is intensively debated, despite the acknowledgement of their negative impact on postoperative evolution of the disease. This study aimed to evaluate the relationship between bacterial biofilms and inflammatory infiltrate of sinus mucosa, and the influence of comorbidities on biofilm development. Materials and methods. The study comprised 50 CRS patients, treated by endoscopic surgery. For biofilm identification and inflammatory infiltrate evaluation, sinus mucosa samples were taken during surgical intervention and studied by haematoxylin-eosin and toluidine blue staining. Results. Biofilms were present in 34 patients (68%). Among them, 22 patients displayed an abundant inflammatory infiltrate of the sinus mucosa, this association being statistically significant (p < 0.001). Biofilm development was also significantly associated with the following comorbidities: bronchial asthma (p = 0.006) and atopic background (p < 0.001). Conclusions. Bacterial biofilms were significantly associated with an abundant inflammatory infiltrate of the sinus mucosa, demonstrating an intensive local inflammatory response. Among the comorbidities frequently associated with CRS, bronchial asthma and atopic background proved a significant increase in the odds of biofilm development

An Improved Score for the Evaluation of Mucosal Healing in Inflammatory Bowel Disease—A Pilot Study

Inflammatory bowel diseases are chronic conditions characterized by periods of remission, alternating with episodes of exacerbation, in which the primary therapeutic target is mucosal healing. Although colonoscopy is currently considered the gold standard for assessing disease activity, it presents a significant number of disadvantages. Over time, various inflammatory biomarkers have been proposed to detect disease activation, but current biomarkers have many limitations. Our study aimed to analyze the most commonly used biomarkers for patient monitoring and follow-up both independently and taken together as a group, in order to propose an improved activity score that more accurately reflects the changes occurring at the intestinal level, in order to limit the number of colonoscopic interventions. By applying logistic regression as a method of statistical analysis to the retrospectively collected data, we obtained an easy-to-calculate improved score that quantifies the chance that a given patient may be in remission or in a period of endoscopic activity. To achieve a widely accessible score that is easily accessible in clinical practice, we have included only the most commonly used clinical and biological parameters

Inflammation and Oxidative Stress in Young and Aged Rats after Acute Homocysteine Administration

Introduction: Hyperhomocysteinemia plays an etiologic role in homocystinuria, neurodegenerative and cardiovascular diseases. Potential mechanisms involved in the degenerative diseases of aging include: oxidative stress, endothelial dysfunction and inflammation. Aim: In the present study we evaluated the effect of acute administration of homocysteine (Hcy), at a level similar to that found in homocystinuria, on biochemical markers of inflammation (such as IL-6) and of oxidative stress (such as gluthathione peroxidase - GPx). Material and Method: The study was performed on 40 young and older Wistar rats. IL-6 serum level was quantified by a high-sensitivity enzyme-linked immunoabsorbent assay (ELISA) method and the activity of whole blood GPx was measured using a commercially available Randox kit. Results: Our results showed that Hcy administration increased the pro-inflammatory cytokine IL-6 in young rats (p<0.3) and decreased IL-6 level in older rats (p<0.008), when compared to the control group. GPx activity was found to increase with age (587.07 U/gHb versus 847.5 U/gHb, p<0.001). Two hours after Hcy administration, GPx activity was found to decrease, but not in a statistically significant manner. The difference between GPx activities in Hcy treated groups remains statistically significant (p<0.01) in the younger group, compared to older group (556.62 U/gHb versus 748.38 U/gHb). Conclusion: Our results indicate the existence of a correlation between hyperhomocysteinemia, proinflammatory state and oxidative stress, illustrated by the direct dependence of whole blood GPx activities on the increasing age

Laboratory diagnosis and follow-up of Romanian Gaucher disease patients

Background: Gaucher disease (GD) is caused by a recessively inherited deficiency of glucocerebrosidase which is encoded by the GBA gene in which nearly 450 mutations have been described. However, only a few genotype- phenotype correlations have been clearly established. The aim of this study was to investigate molecular features of GD in Romanian patients and to evaluate their impact on treatment response. Material and methods: 69 patients, diagnosed between 1997 and 2014 at our national referral laboratory, were included in this study. Frequent point mutations (N370S, L444P, 84GG, R463C) were detected by amplification and restriction enzyme digestion. Recombinant alleles (recTL, recNciI, recA456P) were screened by DNA sequencing. Plasma chitotriosidase served as a biomarker of disease severity throughout the follow-up period. Results: 66 patients had the non-neuronopathic (type 1) form of GD and 3 had the chronic neuronopathic (type 3) phenotype. We identified 79% of the mutant alleles, among which the most frequent mutations were N370S (54%) and L444P (18%). We found a statistically significant (p<0.001) and moderate to good correlation between the total therapeutic dose and the residual chitotriosidase activity (R = 0.621). After two years of treatment, we noticed statistically significant variations in chitotriosidase activity corresponding to the most frequent genotypes (N370S/ unknown allele, N370S/L444P, N370S/N370S and N370S/R463Q). Conclusions: Allele distribution displayed specific features in Romanian GD patients, such as the high prevalence of the N370S allele. Chitotriosidase activity measurement allowed the investigation of genotype influence on treatment outcome

Macular OCT’s Proficiency in Identifying Retrochiasmal Visual Pathway Lesions in Multiple Sclerosis—A Pilot Study

Optical coherence tomography (OCT) is a non-invasive imaging technique based on the principle of low-coherence interferometry that captures detailed images of ocular structures. Multiple sclerosis (MS) is a neurodegenerative disease that can lead to damage of the optic nerve and retina, which can be depicted by OCT. The purpose of this pilot study is to determine whether macular OCT can be used as a biomarker in the detection of retrochiasmal lesions of the visual pathway in MS patients. We conducted a prospective study in which we included 52 MS patients and 27 healthy controls. All participants underwent brain MRI, visual field testing, and OCT evaluation of the thicknesses of the peripapillary retinal nerve fiber layer (pRNFL), macular ganglion cell layer (GCL), and macular inner plexiform layer (IPL). OCT measurements were adjusted for optic neuritis (ON). VF demonstrated poor capability to depict a retrochiasmal lesion identified by brain MRI (PPV 0.50). In conclusion, the OCT analysis of the macula appears to excel in identifying retrochiasmal MS lesions compared to VF changes. The alterations in the GCL and IPL demonstrate the most accurate detection of retrochiasmal visual pathway changes in MS patients

Social Media Usage for Patients and Healthcare Consumers: A Literature Review

The evolution of Internet from static Web “publishing” to the highly participative, and data-driven, innovations of Web 2.0 has been influencing how people search for health-related information. This review included studies indexed in the PubMed electronic database that focused on social media analysis, examining relationships between participants (patients and healthcare consumers) through social media usage. The obtained results showed that previous research regarding social media’s impact on patients and healthcare consumers aimed at a combination of platforms, but there is a penury of information about niche topics or its usage for retrieving medical information. Nevertheless, social media proved to be to be a promising tool in research mainly for recruitment purposes. The review has outlined that eHealth literacy is an attribute for populations that are female and relatively young and educated. Blogs share personal experiences, YouTube contains unregulated, high- and low-quality information that can mislead individuals, Facebook contains more marketing than health-related information, while Wikipedia is recommended for providing high-quality information. Despite healthcare practitioners’ and healthcare public institutions’ reluctance about the use of social media, this review demonstrates the usefulness of social media for patients and healthcare consumers in retrieving health-related information based on content availability and usage implications, and highlights gaps in knowledge that further research needs to fill

Identifying Optical Coherence Tomography Markers for Multiple Sclerosis Diagnosis and Management

Background: Multiple sclerosis (MS) is a common neurological disease affecting the optic nerve, directly or indirectly, through transsynaptic axonal degeneration along the visual pathway. New ophthalmological tools, arguably the most important being optical coherence tomography (OCT), could prove paramount in redefining MS diagnoses and shaping their follow-up protocols, even when the optic nerve is not involved. Methods: A prospective clinical study was conducted. In total, 158 eyes from patients previously diagnosed with relapsing remitting MS (RRMS)—with or without optic neuritis (ON), clinically isolated syndrome (CIS) with or without ON, and healthy controls were included. Each patient underwent an ophthalmologic exam and OCT evaluation for both eyes (a posterior pole analysis (PPA) and the optic nerve head radial circle protocol (ONH-RC)). Results: The macular retinal thickness (the 4 × 4, respectively, 2 × 2 grid) and thickness of the peripapillary retinal nerve fiber layer (pRNFL) were investigated. Various layers of the retina were also compared. Our study observed significant pRNFL thinning in the RRMS eyes compared to the control group, the pRNFL atrophy being more severe in the RRMS-ON eyes than the RRMS-NON eyes. In the ON group, the macular analysis showed statistically significant changes in the RRMS-ON eyes when compared only to the CIS-ON eyes, regarding decreases in the inner plexiform layer (IPL) thickness and inner nuclear layer (INL) on the central 2 × 2 macular grid. The neurodegenerative process affected both the inner retina and pRNFL, with clinical damage appearing for the latter in the following order: CIS-NON, CIS-ON, RRMS-NON, and RRMS-ON. In the presence of optic neuritis, SMRR patients presented an increase in their outer retina thickness compared to CIS patients. Conclusions: To differentiate the MS patients from the CIS patients, in the absence of optic neuritis, OCT Posterior Pole Analysis could be a useful tool when using a central 2 × 2 sectors macular grid. Retinal changes in MS seem to start from the fovea and spread to the posterior pole. Finally, MS could lead to alterations in both the inner and outer retina, along with pRNFL