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

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

Effectiveness of Ultrasound Cardiovascular Images in Teaching Anatomy: A Pilot Study of an Eight-Hour Training Exposure

The present study aimed to evaluate the students&rsquo; progress in evaluating ultrasound (US) and cadaveric cardiac images and long-time retention of information. First-year medical students were invited to participate in four two-hour online lectures during one week voluntarily. The students were trained to recognize cardiovascular anatomical structures on US and cadaveric images during the intervention. The participants&rsquo; abilities to identify specific anatomical structures were tested before, immediately after and six months after the training. A group of second-year students without US training participated as a control group and filled the same test once. Ninety-one first-year students agreed to participate, and forty-nine completed all three tests. The performances in the correct identification of cardiovascular structures on the US images significantly improved after the training but significantly decreased after six months. In the intervention group, the accurate identification of cardiovascular structures was significantly higher on cadaveric images (80% vs. 53%, p-value &lt; 0.0001, n = 91 at post-training; 70% vs. 33%, p-value &lt; 0.0001, n = 49 at 6 months after training). The correct answers percentage score in the control group varied from 6.7% to 66.7% for US cardiovascular anatomical without a significant difference than the intervention group (p-value = 0.7651). First-year students&rsquo; knowledge of heart US anatomy proved less effective than cadaveric images, significantly improved after training and decreased over time, indicating the need for repetition reinforcement

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

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

Medical Informatics and Statistics in an Undergraduate Nursing Curriculum: Survey of Students’ Perception

Aim: A survey was conducted in undergraduate medical students enrolled in 3 or 4-year degree programs in Nursing, Midwifery, Radiology and Medical Imaging (technician), Physiotherapy and Kinetotherapy (technician) and Clinical laboratory (technician) in order to identify their perception of the medical informatics and statistics curriculum. Material and Method: A qualitative study was carried out in 1st year undergraduate students at the “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania during the 2008-2009 academic year. A questionnaire containing 10 categories of items for assessing lectures and 19 for assessing practical activities was developed as an online tool with a database connection using Google Docs. Results: Students’ attendance to lectures proved not to be statistically related with their final mark. The mean final mark obtained by students (6.02±1.57) proved to be statistically lower compared to the expected mean (6.58±1.23; t = -2.76, DF = 54, p = 0.0078). The teacher, the problems solved during lectures, the lecture summaries as well as the course web page proved to statistically influence the learning process. The results revealed that all students were satisfied with the materials used within lectures and practical activities as well as with the objectiveness of the final evaluation. Most students classified the difficulty of the practical activities as reasonable (p < 0.05) and their pace as just about right (p< 0.05). The overall quality of the practical activities was classified as easy by 13% of respondents, pretty easy by 30%, reasonable by 29%, and difficult by 25%. Conclusions: Overall, undergraduate students were satisfied with the materials used within lectures and practical activities as well as with the teacher’s attitude and support in the learning process

Social Media as Source of Medical Information for Healthcare Students

Introduction: The scope of the research was a more detailed understanding of the influence of social media and the importance of student’s usage of social media context in relation to medical information. The research aimed to increase the understanding of social media and the impact on medical information use, informing policy and practice while highlighting gaps in the literature and areas for further research. Methods: The search of PubMed database was performed in October 2015, using terms to identify peer-reviewed research in which social media technologies were an important feature for health occupations, premedical, pharmacy, nursing or medical students. A systematic approach was used to retrieve papers and extract relevant data. Results: There were initially identified 435 studies involving social media, healthcare information and medical students subject headings (MeSH) terminology. After filtering for free full text articles, and exclusion of not students or social media specific ones, 33 articles were reviewed. The majority of the studies were interventional studies that either assessed the outcomes of online discussion groups or teaching methods through social media. The majority of studies focused on the use of social media as a teaching tool, how students use it and the implications upon their education. The largest number of original papers was published in 2013. Facebook, Podcasts, Multiplayer virtual worlds, Blogs, and Twitter were identified as being used by medical students. Conclusion: Social media is used as a tool of information for students mainly as the means for engaging and communicating with students