46 research outputs found
Analisi e progettazione di un sistema di contenimento e movimentazione di un bersaglio per la raccolta di isotopi radioattivi di interesse medico
Una delle applicazioni del progetto SPES è l'utilizzo dei fasci di ioni radioattivi nel ambito della medicina nucleare (il progetto ISOLPHARM). Tale lavoro di tesi presenta un dispositivo che si interfaccia alla linea del fascio ed è in grado di raccogliere all'interno di una capsula "Camera Target Secondario" una quantità di radionuclidi necessari ai laboratori farmaceutici. La Camera Target secondaria è sostenuta da un sistema semiautomatico di movimentazione con 2 gdl.ope
The new approaches in the treatment of systemic lupus erythematosus
Introduction. In recent years, the incidence of SLE has increased. The variety of clinical manifestations have an undulating course with alternating remissions and exacerbations, which make this disease one of the most difficult to diagnose, treat and evaluate the effectiveness of therapy. Despite the fact that half of patients starts with low SLE activity, the disease progresses in the future is affecting many organs and systems.
The purpose This article presents the new approaches and recommendations in the treatment of Lupus the peculiarities of the evolution and activity of the disease.
Material and methods: When carrying out this study, we analyzed a group of patients diagnosed with systemic lupus erythematosus, which includes the years 2020-2022, patients admitted to the rheumatology and arthralgia department, within the Republican Hospital of the Republic of Moldova.
Results. Considering that the treatment must be guided according to the activity and severity of the disease, with a moderate activity index were detected 17,4 %patients, with high activity 82,6% patients. We have established that the first-line therapy in patients with non-life-threatening SLE are glucocorticosteroids, hydroxychloroquine, NSAID.
In case of vitally dangerous organic damage with high activity of the disease in treatment se use immunosuppressants (CYC, Azathioprine, MMF, Methotrexate and/or drugs biological (Belimumab, Rituximab).
Conclusions. in the care of systemic lupus erythematosus:
the manifestation of the disease evolves depending on the activity of the disease, the developed lesions, which will define the treatment strategies for the sick
COMORBID PATHOLOGY IN PATIENTS WITH PSORIASIC ARTHRITIS
Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Artrita psoriazică (APs) afectează aproximativ 20-30% dintre pacienții cu psoriazis. Pacienții cu APs au o prevalență mai mare a comorbidităților comparativ cu populația generală. Scopul studiului a fost evaluarea relației patologiei comorbide cu caracteristicile clinice ale APs. Material și metode. A fost selectat un lot de 92 pacienți, cu APs, stabilită în conformitate cu criteriile de diagnostic CASPAR (2006). Rezultate. Conform datelor primite entezita clinică a fost observată la 47 (51,1%) pacienți, numărul articulațiilor dureroase a fost de 11,3% (145/1288), a celor tumefiate - 4,5% (58/1288), care a fost de 40% (58/145) în rândul tuturor articulațiilor dureroase. Cea mai frecventă patologie a fost hipertensiunea arterială cu o frecvență de 38% (35 din 92), angină pectorală de efort - la 5,4% (5 din 92), cardioscleroză postinfarct (CSPI) la 2,2% (2 din 92) dintre pacienți, insuficiență cardiacă cronică (ICC) la 6,5% (6 din 92) dintre pacienți. Patologia cardiovasculară combinată a fost observată la 16,3% (15 din 92) dintre pacienți. Tulburări cerebrovasculare au fost depistate în 3.3% (3 din 92). Concluzii. La pacienții cu APs, s-a observat o frecvență ridicată a patologiei comorbide: la 60,9% dintre pacienți, s-a observat mai mult de o patologie comorbidă, cu cea mai mare frecvență s-au înregistrat boli ale sistemului musculo-scheletal (42,4%), cardiovascular (41,3%) și boli ale sistemului digestiv (41,3%). Datorită frecvenței înalte a patologiei comorbide în APs (60,9%), managementul pacienților trebuie efectuat de un reumatolog și internist împreună cu medici de specialități conexe pentru diagnosticarea și tratamentul la timp util al bolilor comorbide.Introduction. Psoriatic arthritis (APs) affects about 2030% of patients with psoriasis. Patients with APs have a higher prevalence of comorbidities compared to the general population. Objective of the study was to evaluate the relationship of comorbid pathology with the clinical features of APs. Material and methods. A batch of 92 patients with APs, selected according to the CASPAR (2006) diagnostic criteria, was selected. Result. According to the data received, clinical enthesitis was observed in 47 (51.1%) patients, the number of painful joints was 11.3% (145/1288), of those swollen - 4.5% (58/1288), which was 40% (58/145) among all painful joints. The most common pathology was high blood pressure with a frequency of 38% (35 out of 92), angina pectoris - at 5.4% (5 out of 92), post-infarction cardiosclerosis (CSPI) at 2.2% (2 out of 92) among patients, chronic heart failure (CHF) in 6.5% (6 of 92) of patients. Combined cardiovascular disease was observed in 16.3% (15 of 92) of patients. Cerebrovascular disorders were found in 3.3% (3 of 92). Conclusions. In patients with APs, a high frequency of comorbid pathology was observed: in 60.9% of patients, more than one comorbid pathology was observed, with the highest frequency of diseases of the musculoskeletal system (42.4%), cardiovascular (41.3%) and diseases of the digestive system (41.3%). Due to the high frequency of comorbid pathology in PAs (60.9%), a rheumatologist and internist together with related physicians for the timely diagnosis and treatment of comorbid diseases should perform patient management
Patologia comorbidă printre pacienții cu artrită psoriazică
Introduction. Psoriatic arthritis (APs) affects about 20-
30% of patients with psoriasis. Patients with APs have a higher
prevalence of comorbidities compared to the general
population. Objective of the study was to evaluate the relationship
of comorbid pathology with the clinical features
of APs. Material and methods. A batch of 92 patients with
APs, selected according to the CASPAR (2006) diagnostic criteria,
was selected. Result. According to the data received,
clinical enthesitis was observed in 47 (51.1%) patients, the
number of painful joints was 11.3% (145/1288), of those
swollen - 4.5% (58/1288), which was 40% (58/145) among
all painful joints. The most common pathology was high blood
pressure with a frequency of 38% (35 out of 92), angina
pectoris - at 5.4% (5 out of 92), post-infarction cardiosclerosis
(CSPI) at 2.2% (2 out of 92) among patients, chronic
heart failure (CHF) in 6.5% (6 of 92) of patients. Combined
cardiovascular disease was observed in 16.3% (15 of 92) of
patients. Cerebrovascular disorders were found in 3.3% (3
of 92). Conclusions. In patients with APs, a high frequency
of comorbid pathology was observed: in 60.9% of patients,
more than one comorbid pathology was observed, with the
highest frequency of diseases of the musculoskeletal system
(42.4%), cardiovascular (41.3%) and diseases of the digestive
system (41.3%). Due to the high frequency of comorbid
pathology in PAs (60.9%), a rheumatologist and internist
together with related physicians for the timely diagnosis
and treatment of comorbid diseases should perform patient
management.Introducere. Artrita psoriazică (APs) afectează aproximativ
20-30% dintre pacienții cu psoriazis. Pacienții cu APs
au o prevalență mai mare a comorbidităților comparativ cu
populația generală. Scopul studiului a fost evaluarea relației
patologiei comorbide cu caracteristicile clinice ale APs.
Material și metode. A fost selectat un lot de 92 pacienți,
cu APs, stabilită în conformitate cu criteriile de diagnostic
CASPAR (2006). Rezultate. Conform datelor primite entezita
clinică a fost observată la 47 (51,1%) pacienți, numărul
articulațiilor dureroase a fost de 11,3% (145/1288), a celor
tumefiate - 4,5% (58/1288), care a fost de 40% (58/145)
în rândul tuturor articulațiilor dureroase. Cea mai frecventă
patologie a fost hipertensiunea arterială cu o frecvență
de 38% (35 din 92), angină pectorală de efort - la 5,4% (5
din 92), cardioscleroză postinfarct (CSPI) la 2,2% (2 din 92)
dintre pacienți, insuficiență cardiacă cronică (ICC) la 6,5%
(6 din 92) dintre pacienți. Patologia cardiovasculară combinată
a fost observată la 16,3% (15 din 92) dintre pacienți.
Tulburări cerebrovasculare au fost depistate în 3.3% (3 din
92). Concluzii. La pacienții cu APs, s-a observat o frecvență
ridicată a patologiei comorbide: la 60,9% dintre pacienți,
s-a observat mai mult de o patologie comorbidă, cu cea mai
mare frecvență s-au înregistrat boli ale sistemului musculo-
scheletal (42,4%), cardiovascular (41,3%) și boli ale sistemului
digestiv (41,3%). Datorită frecvenței înalte a patologiei
comorbide în APs (60,9%), managementul pacienților
trebuie efectuat de un reumatolog și internist împreună cu
medici de specialități conexe pentru diagnosticarea și tratamentul
la timp util al bolilor comorbide
Evaluări clinice şi imagistice la etape timpurii ale spondilartritelor seronegative
Sondilartritele seronegative sunt grupul de maladii
infl amatorii care întrunesc manifestări musculoscheletale
comune.
Cu scopul de a evidenţia unele aspecte clinice şi paraclinice
în evoluarea acestor maladii la etapele timpurii,
am separat un lot de 58 de pacienţi: 17 aveau artrită psoriazică,
13 – spondilartrită anchilozantă, 20 – artrită reactivă
şi 8 – spondilartrită nediferenţiată. Evaluarea axială
a fost efectuată prin radiografi a articulaţiilor sacroiliace,
RMN şi scintigrafi a osoasă. Au fost determinate manifestări
musculoscheletale concomitente (axiale şi periferice)
la 32 (58.6%) pacienţi, predominant axiale – la 17 (29.3%)
versus periferice – în 13 (22.4%) cazuri. La obiectivizarea
manifestărilor clinice vis-à-vis de scintigrafi a osoasă s-a
determinat o corelaţie puternică cu entezitele. Astfel, manifestările
axiale (sacroiliitele) şi cele periferice (dactilitele,
entezitele şi artritele) au fost mai puţin evidenţiate radiografi
c comparativ cu scanarea scintigrafi că osoasă
The impairment of locomotion system in patients with systemic sclerosis
Clinica Medicală nr.5 (Reumatologia și Nefrologia), USMF “Nicolae Testemiţanu”A lot of 85 patients with systemic sclerosis was analyzed with variants and frequency of
the locomotion system impairment. Significant statistic differences were revealed between
clinical manifestation and clinical form of the disease, the activity of it being assessed by the
EUSTAR score.
Pe un lot de 85 pacienți cu sclerodermie sistemică s-au analizat variantele și frecvența
afectărilor aparatului locomotor. S-au depistat diferențe statistic semnificative dintre frecvența
depistării manifestărilor clinice și forma clinică a bolii, activitatea bolii apreciate prin scorul
EUSTAR
Studiul comparativ al expresiei osteoporozei la pacienţii cu artrită reumatoidă
Subiecţii au fost examinaţi clinico-paraclinic, cu aprecierea ulterioară a densităţii minerale osoase prin DXA. Pacienţii seropozitivi au un număr mai mare de articulaţii afectate. La pacienţii seronegativi s-a determinat o durată semnificativ mai crescută redorii matinale, cât frecvenţa mai crescută a cazurilor cu osteopenie şi osteoporoză. Dezvoltarea masei osoase maximale depinde de maladiile concomitente aşa ca artrita reumatoidă
Difficulty in diagnosis of secondary parasitic reactive arthritis
IP USMF Nicolae TestemițanuWe present a rare case of reactive arthritis secondary to an Echinococcus infection. In regions where the disease is endemic, such as the southern regions of Moldova, the possibility of musculoskeletal involvement due to hydatid cyst should be considered in patients with musculoskeletal symptoms
Impact of vitamin D in chronic kidney disease and its effect on the musculoskeletal system
Abstract
Introduction. Vitamin D plays an important role in
maintaining musculoskeletal health. As the glomerular filtration rate decreases, vitamin D deficiency also occurs. The
aim of this paper is to highlight the level of vitamin D depending on the stage of chronic kidney disease.
Materials and methods. A structured search was performed in the PubMed, Scopus and HINARI databases,
where the relevant articles have been taken into account,
published in the last 20 years. The search terms used (in
English) were: „vitamin D deficiency”, „pathogenesis of vitamin D”, ”the impact of vitamin D in chronic kidney disease”,
„chronic kidney disease”.
Results. Several studies have shown that the change in
vitamin D levels is dependent to the decrease of glomerular
filtration rate. The lowest serum vitamin D concentration
was observed in stage 5 of chronic kidney disease. Vitamin D deficiency occurs due to a decrease in the number of
nephrons and a decrease in the number of proximal tubular
cells that absorb vitamin D (25 (OH) D) to be subsequently
hydroxylated to its active form by 1α-hydroxylase.
Conclusions. Patients with vitamin D-deficient due to
chronic kidney disease have an increased risk of decreased
bone mineral density and multiple fracture
Idiopathic hypertrophic osteoarthropathy misdiagnosed as juvenile idiopathic arthritis. Case study
Background. Pachydermoperiostosis (or primary hypertrophic osteoarthropathy) is a rare genetic disease that usually
begins in childhood or adolescence, is characterized by certain clinical signs (pachydermia, periostosis, drum sticks) that
gradually progress over many years until the disease stabilizes. Currently, there are 2 genes in which mutations are associated with the development of pachydermoperiostosis - HPGD and SLCO2A1. The functions of these genes are not fully
understood, but their influence on the metabolism of prostaglandin E2 is known.
Case presentation. We present a case of a 20-year-old patient mistakenly diagnosed as juvenile idiopathic arthritis. Symptoms on admission to the hospital: pain accompanied by swelling in the hands and feet, arthralgias in the talocrural joints,
knees with slight swelling, paresthesia in the extremities, hyperhidrosis, fatigue. Clinical and paraclinical examinations
confirmed the diagnosis of pachydermoperiostosis.
Conclusions. Pachydermoperiostosis should be considered as a differential diagnosis when a patient presents with hypertrophic osteoarthropathy and acromegalic features