39 research outputs found

    Lifestyle Changes and Weight Loss: Effects in PCOS

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    Even though controversies surrounding the polycystic ovary syndrome are not yet close to be solved, its clinical manifestations are well known—insulin resistance and obesity, hirsutism, irregular and anovulatory menstrual cycles. The treatment of polycystic ovarian syndrome (PCOS) is mainly symptomatic as its etiology is not yet clear. Lifestyle changes are the primary therapy in overweight and obese women with PCOS. According to majority of the studies, lifestyle changes are the most effective form of treatment not only for weight loss but also for the improvement of insulin sensitivity, decreasing incidence of metabolic syndrome and type 2 diabetes. Studies also show that weight loss has fertility benefits by restoring ovulatory cycles. Although initial studies researching pharmacologic treatment were showing excellent results concerning the weight loss, maintenance of weight loss and reduction of cardiovascular risks, some of these drugs were in the end, has proven to actually increase the risk for cardiovascular events and were removed from the market. Bariatric surgery has been demonstrated to improve or even cure type 2 diabetes, hypertension, hyperlipidemia, and obstructive sleep apnea. More so, there are studies that reported complete resolution of all features of PCOS, even hirsutism, hyperandrogenism, anovulation, and menstrual irregularity

    Stress and anxiety among physicians and nurses in Romania during the COVID-19 pandemic

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    Objective. This study aimed at identifying the stress and anxiety levels among physicians and nurses working in Romanian hospitals during the COVID-19 pandemic. Methods and Results. We conducted an online survey with a questionnaire completed by 169 healthcare providers aged between 25 and 69 years from COVID and non-COVID hospitals. There were 87.6% physicians and 12.4% nurses, with 61.5% women and 38.5% men. Clinicians experienced high levels of stress in 2.7% of the cases, medium stress in 68.9% of the cases, and low stress in 28.4% of the cases. Women experienced more stress (2.9% high level, 66.3% medium level) than men (1.5% high level, 64.6% medium level), while men are more anxious (73.8% high level, 26.2% medium level) than women (63.6% high level, 33.7% medium level). In both COVID and non-COVID healthcare providers, the stress score directly correlates with the anxiety score. Overall, during this period, the responders felt stressed and anxious (p=0.001). Conclusions. The COVID-19 pandemic is a strong reason for increased stress and anxiety among physicians and nurses. Men are more anxious and women more stressed. The stress and anxiety scores are different according to the hospital type

    Does sentinel lymph node detection play a role in patients with vaginal cancer?

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    The role of sentinel lymph node detection was clearly demonstrated in patients diagnosed with gynecologic malignancies such as breast, endometrial, cervical or vulvar cancer. Therefore, the method provides an adequate staging of the disease with minimal postoperative complications when compared to classical extended lymphadenectomy. Recently, the method has been successfully reported in vaginal cancer patients. This is a literature review of the current papers published so far on the issue of sentinel lymph node detection in vaginal cancer patients. Although only few cases have been reported so far, it seems that sentinel lymph node biopsy in vaginal cancer patients represents a safe, effective and feasible method to diminish the rates of unnecessary extended lymph node dissection in vaginal cancer patients. However, due to the rarity of the disease in association with the low number of cases reported so far, the method is not part of the therapeutic standard protocol for this disease, larger studies still being needed

    Psycho-Emotional Impact of Anomaly Ultrasound Scan in Romanian Pregnant Women

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    Objective: Second-trimester anomaly scan was introduced as a regulated practice in Romania in 2019, causing misperceptions and unrealistic expectations about this examination among pregnant women. This study aimed to assess whether second trimester anomaly scan is a reason “per se” for maternal anxiety. Design: A prospective type 1 cohort study was conducted in a tertiary prenatal diagnosis center with three locations in Bucharest, Romania, among pregnant women who underwent a second trimester anomaly scan between 1 December 2019 and 29 February 2020. Main outcome measure: Anxiety at the time of prenatal anomaly scan. Results: Out of the 138 participants, 32.6% believed that the anomaly scan could detect all fetus defects, 13.8% considered that the baby is bothered by the probe “light”, 8.7% believed that the scan could harm the fetus, 96.4% reported that it was a pleasant experience, and 95% felt that it strengthened their bond with the fetus. The State-Trait Anxiety Inventory (STAI) score revealed that women with high state anxiety were more anxious at pre-scan (p = 0.001). Conclusion: Ultrasound scan in the second trimester is correlated with a significant anxiety for women who are prone to this psychological trait. It is also a good opportunity to screen for highly anxious women who could benefit from prenatal psychological counseling to facilitate timely recognition and prevention of postpartum psychiatric disorders such as depression

    Cold Atmospheric Plasma, Platelet-Rich Plasma, and Nitric Oxide Synthesis Inhibitor: Effects Investigation on an Experimental Model on Rats

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    The evolution of reconstructive methods for defects of the human body cannot yet replace the use of flap surgery. Research is still preoccupied with the ideal techniques for offering the best chances of survival of the flaps. In our study, we investigated the effects of cold atmospheric plasma (CAP), N-nitro-L-arginine methyl ester (L-NAME), and platelet-rich plasma (PRP) injectable solutions on flap survival using an in vivo model. Twenty-four Wistar rats (four groups) had the McFarlane flap raised and CAP, L-NAME, and PRP substances tested through a single dose subcutaneous injection. The control group had only a saline solution injected. To the best of our knowledge, this is the first study that evaluated a CAP activated solution through injection on flaps. The flap survival rate was determined by clinical examination (photography documented), hematology, thermography, and anatomopathological tests. The image digital analysis performed on the flaps showed that the necrosis area (control—49.64%) was significantly lower for the groups with the three investigated solutions: CAP (14.47%), L-NAME (18.2%), and PRP (23.85%). Thermography exploration revealed less ischemia than the control group on the CAP, L-NAME, and PRP groups as well. Anatomopathological data noted the best degree of angiogenesis on the CAP group, with similar findings on the L-NAME and PRP treated flaps. The blood work did not indicate infection or a strong inflammatory process in any of the subjects. Overall, the study shows that the CAP activated solution has a similar (better) impact on the necrosis rate (compared with other solutions with known effects) when injected on the modified dorsal rat skin flap, and on top of that it can be obtained fast, in unlimited quantities, non-invasively, and through a standardized process

    Non-operative management of the sigmoid volvulus – case presentation

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    Sigmoid volvulus happens when the sigmoid wraps around itself and its mesentery. Sigmoid volvulus accounts for 2% to 50% of all colonic obstructions. This pathology generally affects adults, and it is more common in males. The etiology is multifactorial and controversial; the main symptoms are diffuse abdominal pain, distention and constipation, while the pregnant signs are abdominal distention and tenderness. Laboratory findings are not pathognomonic: abdominal X-ray radiographs show a dilated sigmoid colon and multiple intestinal air-fluid levels, abdominal CT and MRI demonstrate a whirled sigmoid mesentery. Flexible endoscopy reveals a spiral sphincter-like twist of the mucosa. The diagnosis of sigmoid volvulus is established by clinical, radiological, endoscopic, and sometimes operative findings. Although flexible endoscopic detorsion is advocated as the primary treatment choice, emergency surgery is required for patients who present with peritonitis, bowel gangrene, or perforation, or for patients whose non-operative treatment is unsuccessful. Although emergency surgery includes various non-definitive or definitive procedures, resection with primary anastomosis is the most commonly recommended procedure. After a successful non-operative detorsion, elective sigmoid resection and anastomosis is recommended. The overall mortality is 10% to 50%, while the overall morbidity is 6% to 24%

    Cholelitiasis in an adult patient with mild hereditary spherocytosis – a case report

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    Hereditary spherocytosis (HS) is an inherited abnormality of the red blood cell, caused by defects in structural membrane proteins. The condition is dominantly inherited in 75% of people. The severity of the disorder is related to the type and amount of membrane disruption, which is genetically determined. A patient who suffers from this disorder is commonly found in a surgical ward when the disease becomes unmanageable by a hematologist. Surgeons encounter complications such as: jaundice, splenomegaly, gallstone sand severe anemia. We present the case of a 66-year-old woman with a history of hereditary spherocytosis who presented at the emergency room for pain in the right upper quadrant, jaundice and anemia and was diagnosed with gallbladder stones and common bile duct obstruction

    MERKEL CELL CARCINOMA – PRO AND CONS ASPECTS FOR SENTINEL LYMPH NODE BIOPSY

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    Merkel cell carcinoma represents an aggressive histopathological subtype of skin cancer with a high propensity to spread via lymphatic route. Once the benefits of the sentinel lymph node detection have been proven in malignant melanoma, the effectiveness of the method was investigated further on in Merkel cell carcinoma, as long as the two tumoral subtypes seem to have a common embryological origin. Surprisingly, the results reported so far in Merkel cell carcinoma are rather confusing, the method not being so far associated as part of the standard therapeutic protocol. However, it seems that the method plays a certain role in identifying the high risk patients and further tailoring the therapeutic strategy. This is a literature review of the most eloquent studies conducted on this theme
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