A two-study validation of a single-item measure of relationship satisfaction: RAS-1

Research addressing relationship satisfaction is a constantly growing area in the social sciences. The aim of the present investigation was to examine the similarities and differences between the seven-item Relationship Assessment Scale (RAS) and the single-item measure of relationship satisfaction (RAS-1), using proximal and distal constructs as correlates. Two studies using two independent samples were conducted, assessing more proximal constructs, such as love and sex mindset in Study 1 (N = 380; female = 195) and more distant ones, such as loneliness and problematic pornography use in Study 2 (N = 703; female = 360). Structural equation modeling revealed that love (beta(RAS-1) = .55; p < .01; beta(RAS) = .71; p < .01), sex mindset beliefs (beta(RAS-1) = .18; p < .01; beta(RAS) = .13; p < .01) and loneliness (beta(RAS-1) = -.35; p < .01; beta(RAS) = -.37; p < .01) had significant positive and negative associations with RAS and RAS-1, respectively; while problematic pornography use did not. These results suggest that RAS-1 may be an equally adequate instrument for measuring relationship satisfaction as the RAS with respect to proximal and distal correlates. Thus, RAS-1 is recommended to be used in large-scale studies when the number of items is limited

Postoperative median incisional hernias occurrence and their surgical treatment with retromuscular prolene mesh and hernial sac

University of Medicine and Pharmacy of Targu Mures, Romania, The 6th International Medical Congress for Students and Young Doctors, May 12-14, 2016Introduction: Median incisional hernias are the most frequent postoperative complications in the surgical practice. They can occur in different forms and at different ages. Because of its high incidence rate, many surgical techniques are being used, but neither one is superior over the others. However some creative combined techniques show promising results. Aim: Analyzing occurrence rates and types of postoperative median incisional hernias at different ages and genders. Evaluation of the efficiency of different surgery techniques. Materials and Methods: We conducted a retrospective study at the 2nd Department of Surgery, Emergency County Hospital in Tirgu Mures, during January 2010 and January 2016. Results: From 763 patients 517(67.76%) were females and 246(32.24%) were males. The highest incidence rate was noticed between the age of 60 and 70, at both genders (35.13%). We found in 18(2.36%) cases giant incisional hernias and in 98(12.84%) cases multilocular hernias. There were 48(6.29%) life threatening cases, caused by incarcerated incisional hernias. Recurrences appeared in 51(6.68%) cases. In most of the cases (485=63.57%) abdominal wall reconstructions were made with prolene mesh in retromuscular position, followed by primary suture repairs (211=27.65%) and finally (67=8.78%) prolene mesh in retromuscular position and hernial sac were used together in the surgical treatment. The two most common early complications were: rectus sheath hematomas and subcutaneous seromas. Conclusion: Postoperative median incisional hernias have a high incidence and recurrence rate, especially between the age 60 and 70. Prolene mesh in retromuscular position or primary suture repairs are not always enough. Using prolene mesh in retromuscular position together with the hernial sac is a more secure and low cost proceeding, especially in cases of giant incisional hernias

Colorectal cancer: an update upon the diagnostic and therapeutic transdiciplinary approach

Scop: Prezentarea unor date actualizate referitoare la rolul ONCOTEAM în diagnosticul și terapia pacientului cu cancerului colorectal (CRC). Material și metode: În perioada 2018-2023, 147 de pacienți cu CRC au beneficiat de un abord individualizat. Evaluarea imagistică preoperatorie cu CT-scan/MRI cu difuzie a fost urmată de o descriere de tip ”hartă” a informațiilor pe baza cărora s-a efectuat intervenția chirurgicală și procesarea histopatologică conform metodologiei descrise anterior de echipa noastră în jurnalelel Diagnostics (DOI: 10.3390/diagnostics11020314) și Journal of the Belgian Society of Radiology (DOI: 10.5334/jbsr.3186). Examinările genetice au fost efectuate la indicațiile oncologului iar terapia post-operatorie a luat în considerare profilul molecular al celulelor tumorale. Rezultate: Utilizând acest protocol adaptat, am obținut un număr mediu de 15±2.23 limfonoduli prelevați per caz. Numărul depozitelor tumorale a fost, de asemenea, crescut și a dus la o supra-stadializare a 15% din cazuri. Utilizând o valoare a ”lymph node ratio” de 0.15, am obținut valori superioare celor obținute la abordarea clasică a 120 cazuri examinate anterior (p=0.002). Determinările genetice efectuate în timp au dus la o începere rapidă a terapiei oncologice individualizate și, deși profilul genei BRAF V600E este dificil a fi evaluat în țesuturi incluse în parafină, extracția ADN și determinările PCR au fost adecvate în toate cazurile examinate. Concluzii: Abordarea transdiciplinară a CRC poate fi efectuată doar dacă fiecare membru al echipei este implicat conștiincios în fiecare pas al diagnosticului sau terapiei. Costurile determinărilor au fost parțial acoperite în cadrul proiectelor PCCF 20/2018 și 10127/13/2021.Aim: To present an update regarding the role of the ONCOTEAM in the diagnosis and therapy of colorectal cancer (CRC). Materials and methods: During 2018-2023, 147 patients with CRC have benefited by an individualized approach. Preoperatively evaluation was done with CT-scan/diffusion-weighted MRI and a lymph node station map was typed. The next step consisted on surgical removal, based on the indications included in the map. Histopathological examination was based on the methods described by our team previously (DOI: 10.3390/diagnostics11020314; DOI: 10.5334/jbsr.3186). Genetic examinations were done based on the indications of the oncologist and the post-operative therapy was performed according to the molecular profile. Results: Based on the in-house adapted protocol, the median number of harvested lymph nodes per case was 15±2.23. The number of identified deposits was also significant and up-staged the tumors in 15% of the cases. The lymph node ratio value, using a cut-off of 0.15, was also superior to the classic approach of other 120 cases (p=0.002). The genetic examinations proved to be useful for an earlier start of post-operative therapy, without any cost for the patients. As regarding pre-analytical factors, although BRAF V600E gene profile is hard to be detected from paraffin-embedded tissues, the DNA extraction and PCR examinations were succesful in all of the cases. Conclusions: A proper transdiciplinary approach can be done only if any member of the team is attentively involved in each step of the diagnosis and therapy. The costs were partially supported by the projects PCCF 20/2018, and 10127/13/2021

Brain abscess caused by trauma of the rhinobasis: an endoscopic challenge

Brain abscess is a rare but life-threatening infection of the brain. It often occurs as a complication of infection, trauma, or surgery. This case presents a brain abscess in a 22-month-old boy that developed after a transnasal injury with a foreign body. A minimal-invasive, transnasal, endoscopic-controlled technique was used, during which the foreign object was removed and the abscess drained. Bacteriological samples were obtained and the abscess cavity irrigated. Postoperative care included antibiotics and daily irrigation of the abscess cavity. Follow-up MRI scans showed reduction in abscess size. A spinal drain was inserted temporarily to address rhino-liquorrhoea. The patient remained asymptomatic during one-year of follow-up. This case report highlights the occurrence of a brain abscess in childhood following a transnasal injury and demonstrates a minimal-invasive, transnasal, endoscopic-controlled surgical technique. The findings underscore the importance of considering brain abscess as a potential complication in cases of head trauma, particularly in atypical presentations

Levosimendan: a cardiovascular drug to prevent liver ischemia-reperfusion injury?

INTRODUCTION: Temporary occlusion of the hepatoduodenal ligament leads to an ischemic-reperfusion (IR) injury in the liver. Levosimendan is a new positive inotropic drug, which induces preconditioning-like adaptive mechanisms due to opening of mitochondrial KATP channels. The aim of this study was to examine possible protective effects of levosimendan in a rat model of hepatic IR injury. MATERIAL AND METHODS: Levosimendan was administered to male Wistar rats 1 hour (early pretreatment) or 24 hours (late pretreatment) before induction of 60-minute segmental liver ischemia. Microcirculation of the liver was monitored by laser Doppler flowmeter. After 24 hours of reperfusion, liver and blood samples were taken for histology, immuno- and enzyme-histochemistry (TUNEL; PARP; NADH-TR) as well as for laboratory tests. Furthermore, liver antioxidant status was assessed and HSP72 expression was measured. RESULTS: In both groups pretreated with levosimendan, significantly better hepatic microcirculation was observed compared to respective IR control groups. Similarly, histological damage was also reduced after levosimendan administration. This observation was supported by significantly lower activities of serum ALT (pearly = 0.02; plate = 0.005), AST (pearly = 0.02; plate = 0.004) and less DNA damage by TUNEL test (pearly = 0.05; plate = 0.034) and PAR positivity (pearly = 0.02; plate = 0.04). Levosimendan pretreatment resulted in significant improvement of liver redox homeostasis. Further, significantly better mitochondrial function was detected in animals receiving late pretreatment. Finally, HSP72 expression was increased by IR injury, but it was not affected by levosimendan pretreatment. CONCLUSION: Levosimendan pretreatment can be hepatoprotective and it could be useful before extensive liver resection

Levosimendan Administration in Limb Ischemia: Multicomponent Signaling Serving Kidney Protection

AIMS AND OBJECTIVES: Acute renal failure is a severe complication of lower extremity major arterial reconstructions, which could even be fatal. Levosimendan is a dual-acting positive inotropic and vasodilatory agent, which is suspected to have protective effects against cardiac ischemia. However, there is no data available on lower limb or remote organ ischemic injuries therefore the aim of the study was to investigate the effect of levosimendan on lower limb ischemia-reperfusion injury and the corollary renal dysfunction. METHODS: Male Wistar rats underwent 180 min bilateral lower limb ischemia followed by 4 or 24 hours of reperfusion. Intravenous Levosimendan was administered continuously (0.2mug/bwkg/min) throughout the whole course of ischemia and the first 3h of reperfusion. Results were compared with sham-operated and ischemia-reperfusion groups. Hemodynamic monitoring was performed by invasive arterial blood pressure measurement. Kidney and lower limb muscle microcirculation was registered by a laser Doppler flowmeter. After 4h and 24h of reperfusion, serum, urine and histological samples were collected. RESULTS: Systemic hemodynamic parameters and microcirculation of kidney and the lower limb significantly improved in the Levosimendan treated group. Muscle viability was significantly preserved 4 and 24 hours after reperfusion. At the same time, renal functional laboratory tests and kidney histology demonstrated significantly less expressive kidney injury in Levosimendan groups. TNF-alpha levels were significantly less elevated in the Levosimendan group 4 hours after reperfusion. CONCLUSION: The results claim a protective role for Levosimendan administration during major vascular surgeries to prevent renal complications

Attenuation of Skeletal Muscle and Renal Injury to the Lower Limb following Ischemia-Reperfusion Using mPTP Inhibitor NIM-811.

INTRODUCTION: Operation on the infrarenal aorta and large arteries of the lower extremities may cause rhabdomyolysis of the skeletal muscle, which in turn may induce remote kidney injury. NIM-811 (N-metyl-4-isoleucine-cyclosporine) is a mitochondria specific drug, which can prevent ischemic-reperfusion (IR) injury, by inhibiting mitochondrial permeability transition pores (mPTP). OBJECTIVES: Our aim was to reduce damages in the skeletal muscle and the kidney after IR of the lower limb with NIM-811. MATERIALS AND METHODS: Wistar rats underwent 180 minutes of bilateral lower limb ischemia and 240 minutes of reperfusion. Four animal groups were formed called Sham (receiving vehicle and sham surgery), NIM-Sham (receiving NIM-811 and sham surgery), IR (receiving vehicle and surgery), and NIM-IR (receiving NIM-811 and surgery). Serum, urine and histological samples were taken at the end of reperfusion. NADH-tetrazolium staining, muscle Wet/Dry (W/D) ratio calculations, laser Doppler-flowmetry (LDF) and mean arterial pressure (MAP) monitoring were performed. Renal peroxynitrite concentration, serum TNF-alpha and IL-6 levels were measured. RESULTS: Less significant histopathological changes were observable in the NIM-IR group as compared with the IR group. Serum K+ and necroenzyme levels were significantly lower in the NIM-IR group than in the IR group (LDH: p<0.001; CK: p<0.001; K+: p = 0.017). Muscle mitochondrial viability proved to be significantly higher (p = 0.001) and renal function parameters were significantly better (creatinine: p = 0.016; FENa: p<0.001) in the NIM-IR group in comparison to the IR group. Serum TNF-alpha and IL-6 levels were significantly lower (TNF-alpha: p = 0.003, IL-6: p = 0.040) as well as W/D ratio and peroxynitrite concentration were significantly lower (p = 0.014; p<0.001) in the NIM-IR group than in the IR group. CONCLUSION: NIM-811 could have the potential of reducing rhabdomyolysis and impairment of the kidney after lower limb IR injury

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation