Clinical presentations of colorectal cancer

Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of MoldovaIntroduction. Colorectal cancer is the third leading cause of cancer death for men and women combined. Its incidence and mortality are higher in individuals older than 50 years. Early detection is lifesaving

IMPACT OF COVID-19 ON PATIENTS WITH PRE-EXISTING NEUROLOGICAL DISEASES

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Pacienții care suferă de afecțiuni neurologice sunt mai vulnerabili la complicațiile posibile ale infecției COVID-19. Scopul lucrării: analiza impactul infecției COVID-19 asupra pacienților cu patologie neurologică preexistentă din cohorta Republicii Moldova în registrul ENERGY. Materiale și metode. Din cohorta de 169 de pacienți din registru ENERGY au fost selectate 64 de pacienți cu patologia neurologica preexistentă: AVC (32p), dementa (5p), boala Parkinson, precum (2p), scleroza multipla (2p), neuropatie (3p), patologia neuromusculară (2p) și altele (21p). Rezultate: Lotul de studiu compus din 54.7% bărbați și 45.3% femei, vârsta medie 64.53±14.5 ani, 12.5 % fumători, 18.8% vaccinați. Au prezentat comorbidități somatice: HTA- 79.7%, DZ – 28.1%, cancer – 18.8% și patologie renală- 17.2%. Au suferit complicații 68.8%, dintre care: pneumonie (64.1%), dispnee (45.3%), tulburări de coagulare (7.8%), complicații cardiovasculare (6.3%) și au necesitat ventilație mecanica (18.8%). Rata de mortalitate - 40.6%. Manifestările neurologice au fost: AVC (53.1%), cefalee (48.4%), vertij (34.4%), sindrom disexecutiv (26.6%), coma (18.8%), ataxie (18.7%), semne vegetative (14.1%), delir hiperactiv (12.9%) și hipoactiv (12.5%), mialgii (11%), status epileptic (7.9%). Scala Rankin modificată înainte de infectare a fost 1.81p, la externare – 3.53p și peste 6 luni – 3.21p. Concluzii. Pacienții cu patologie neurologică preexistentă au prezentat complicații severe în timpul infectării cu COVID 19, preponderent pneumonie, au suferit accidente vasculare cerebrale, cefalee și comă cu rata de mortalitate crescută (40.6%).Introduction. Patients with neurological disorders are more vulnerable to possible complications of COVID-19. Objective of the study. Analysis of COVID-19 impact on patients with pre-existing neurological disease from the cohort of the ENERGY registry in the Republic of Moldova. Materials and methods. 64 patients with pre-existing neurological disease were selected from the cohort of 169 patients in the ENERGY registry: stroke (32p), dementia (5p), Parkinson’s disease (2p), multiple sclerosis (2p), neuropathy (3p), neuromuscular pathology (2p) and other (21p). Results. The study group consisted of 54.7% men and 45.3% women, mean age was 64.53 ± 14.5 years, 12.5% smokers, 18.8% vaccinated. They had somatic comorbidities: hypertension - 79.7%, DM - 28.1%, cancer - 18.8% and renal pathology - 17.2%. Suffered complications 68.8% of patients of which: pneumonia (64.1%), dyspnea (45.3%), coagulation disorders (7.8%), cardiovascular complications (6.3%), and required mechanical ventilation (18.8%). Mortality rate - 40.6%. The neurological manifestations were stroke (53.1%), headache (48.4%), vertigo (34.4%), dysexecutive syndrome (26.6%), coma (18.8%), ataxia (18.7%), and vegetative signs (14.1%), hyperactive (12.9%) and hypoactive delirium (12.5%), myalgia (11%), and status epilepticus (7.9%). The modified Rankin scale was 1.81p before infection, 3.53p at discharge and 3.21p over 6 months. Conclusions. Patients with pre-existing neurological pathology experienced severe complications during COVID 19 infection, mainly pneumonia, suffered strokes, headaches, and coma with an increased mortality rate (40.6%)

Impactul COVID-19 asupra pacienților cu patologie neurologică preexistentă

Introduction. Patients with neurological disorders are more vulnerable to possible complications of COVID-19. Objective of the study. Analysis of COVID-19 impact on patients with pre-existing neurological disease from the cohort of the ENERGY registry in the Republic of Moldova. Materials and methods. 64 patients with pre-existing neurological disease were selected from the cohort of 169 patients in the ENERGY registry: stroke (32p), dementia (5p), Parkinson’s disease (2p), multiple sclerosis (2p), neuropathy (3p), neuromuscular pathology (2p) and other (21p). Results. The study group consisted of 54.7% men and 45.3% women, mean age was 64.53 ± 14.5 years, 12.5% smokers, 18.8% vaccinated. They had somatic comorbidities: hypertension - 79.7%, DM - 28.1%, cancer - 18.8% and renal pathology - 17.2%. Suffered complications 68.8% of patients of which: pneumonia (64.1%), dyspnea (45.3%), coagulation disorders (7.8%), cardiovascular complications (6.3%), and required mechanical ventilation (18.8%). Mortality rate - 40.6%. The neurological manifestations were stroke (53.1%), headache (48.4%), vertigo (34.4%), dysexecutive syndrome (26.6%), coma (18.8%), ataxia (18.7%), and vegetative signs (14.1%), hyperactive (12.9%) and hypoactive delirium (12.5%), myalgia (11%), and status epilepticus (7.9%). The modified Rankin scale was 1.81p before infection, 3.53p at discharge and 3.21p over 6 months. Conclusions. Patients with pre-existing neurological pathology experienced severe complications during COVID 19 infection, mainly pneumonia, suffered strokes, headaches, and coma with an increased mortality rate (40.6%).Introducere. Pacienții care suferă de afecțiuni neurologice sunt mai vulnerabili la complicațiile posibile ale infecției COVID-19. Scopul lucrării: analiza impactul infecției COVID-19 asupra pacienților cu patologie neurologică preexistentă din cohorta Republicii Moldova în registrul ENERGY. Materiale și metode. Din cohorta de 169 de pacienți din registru ENERGY au fost selectate 64 de pacienți cu patologia neurologica preexistentă: AVC (32p), dementa (5p), boala Parkinson, precum (2p), scleroza multipla (2p), neuropatie (3p), patologia neuromusculară (2p) și altele (21p). Rezultate: Lotul de studiu compus din 54.7% bărbați și 45.3% femei, vârsta medie 64.53±14.5 ani, 12.5 % fumători, 18.8% vaccinați. Au prezentat comorbidități somatice: HTA- 79.7%, DZ – 28.1%, cancer – 18.8% și patologie renală- 17.2%. Au suferit complicații 68.8%, dintre care: pneumonie (64.1%), dispnee (45.3%), tulburări de coagulare (7.8%), complicații cardiovasculare (6.3%) și au necesitat ventilație mecanica (18.8%). Rata de mortalitate - 40.6%. Manifestările neurologice au fost: AVC (53.1%), cefalee (48.4%), vertij (34.4%), sindrom disexecutiv (26.6%), coma (18.8%), ataxie (18.7%), semne vegetative (14.1%), delir hiperactiv (12.9%) și hipoactiv (12.5%), mialgii (11%), status epileptic (7.9%). Scala Rankin modificată înainte de infectare a fost 1.81p, la externare – 3.53p și peste 6 luni – 3.21p. Concluzii. Pacienții cu patologie neurologică preexistentă au prezentat complicații severe în timpul infectării cu COVID 19, preponderent pneumonie, au suferit accidente vasculare cerebrale, cefalee și comă cu rata de mortalitate crescută (40.6%)

Complicațiile neurologice la pacienții cu infecția COVID-19: rezultatele ENERGY în Republica Moldova

Department of Neurology no. 1, Nicolae Testemitanu SUMPhBackground. ENERGY registry developed by the European Academy of Neurology study neurological manifestations in patients with COVID-19 infection. Diomid Gherman Institute of Neurology and Neurosurgery join these efforts in December 2020. Objective of the study. The aim of the study was to present the Moldovan cohort of patients with COVID 19 infection and neurological manifestation registered in the ENERGY. Material and Methods. The registry record demographic data, comorbidities, complications, new neurological finds in confirmed COVID-19 patients during the consultation or hospital stay, and status at discharge appreciated with Rankin score. The patients were evaluated at 6 and 12 months by phone. Results. Moldovan cohort of patients with COVID 19 and neurologic manifestation by May 2021 consist of 168 patients (50,6% men and 49,4% women). New neurological findings in patients with COVID-19 infection were: Stroke (62,5%); Headache (48,2%); Cognitive impairment (35,7%); Vertigo(32,2%); Disexecutive sindrom (27,3%); Stupor/coma (22,1%); Hipoactive delirium/ acute encefalopathy (17,9%); Myalgia (11,3%); Hiperactive delirium (9,5%); Dysautonomia (9,5%); Ataxia (9,4%); Spinal cord disorder (7,2%); Peripheral neuropathy(5,4%); Sleep disturbances (4,8%). Mortality rate in the cohort was 22.61%. Conclusion. The most frequently neurological manifestation was stroke, cognitive impairment and headache. They have many comorbidities, history of neurological disease, complication during hospital stay and high mortality rate.Introducere. Registrul ENERGY dezvoltat de Academia Europeană de Neurologie studiază manifestările neurologice la pacienții cu infecție COVID-19. Institutul de Neurologie și Neurochirurgie „Diomid Gherman” aderă la acest proiect din decembrie 2020. Scopul lucrării. Prezentarea unui lot de pacienți din Republica Moldova cu infecție COVID-19 și cu manifestări neurologice, înregistrați în Registrul ENERGY. Material și Metode. Registrul include date demografice, istoricul pacientului (deprinderi nocive, comorbidități), simptome și semne neurologice raportate la consultații și pe parcursul spitalizării, evoluția maladiei, inclusiv complicațiile sesizate și aprecierea stării la externare după scala Rankin. Pacienții au fost contactați și evaluați la 6 și 12 luni prin telefon. Rezultate. Lotul de pacienți cu COVID-19 și manifestări neurologice până în mai 2021 consta din 168 de pacienți (50,6% bărbați și 49,4% femei). Manifestările neurologice au fost: accidente cerebro-vasculare (62,5%); cefalee (48,2%); tulburări cognitive (35,7%); vertigo (32,2%); disexecutiv sindrom (27,3%); stupor/coma (22,1%); delir hipoactiv/encefalopatie acută (17,9%); mialgie (11,3%); delir hiperactiv (9,5%); disautonomia (9,5%); ataxie (9,4%); mielopatie (7,2%); polineuropatie (5,4%); tuburări de somn (4,8%). Rata de mortalitate reprezintă 22,61%. Concluzii. Cele mai frecvente manifestări neurologice sunt accidentele cerebro-vasculare, cefalee și tulburări cognitive. Acești pacienți au multe comorbidități, istoric pe patologii neurologice, dezvoltă complicații pe parcursul spitalizării și prezintă o rată înaltă de mortalitate

Mortalitatea la pacienții cu COVID-19 și afectare neurologică. Rezultatele registrului ENERGY în Republica Moldova

Background. The European Academy of Neurology registry (ENERGY) is an international instrument that studies neurological complications in patients with COVID 19. From December 2020, the Institute of Neurology and Neurosurgery adheres to this register. Objective of the study. Analysis of deceased patients with COVID 19 infection and neurological manifestations in the Republic of Moldova, registered in the ENERGY. Methods and materials. The registry includes general variables, demographics data (source of infection, place of visit, and duration of infection), comorbidities, neurological manifestations, and COVID-19 complications reported during hospitalization, diagnostic tests, disease progression. Results. The study included 58 deaths, 21 men (36.2%) and 37 women (63.8%), mean age - 70.6 ± 12.1 years; most examined at the hospital (98.3%); source of infection - unknown (84.5%). Reinfected with COVID-19 - 2 people, 8 patients were vaccinated. The neurological manifestations were: Stroke (62.1%), headache (41.4%), cognitive impairment (44.8%), vertigo (24.1%), myalgia (6.9%), hypersomnolence (12.1%), coma (3.4%), sleep disturbances (1.7%), disexecutive syndrome (35.5%). Complications were present in 87.9% of patients: dyspnea (63.8%), pneumonia (84.5%), cardiovascular (17.2%), ventilation (43.1%). 53 patients (91.4%) had multiple comorbidities. 79.3% patients were admitted to intensive care. Conclusions. Mortality rate is very high (34.3%) due to the presence of many comorbidities, risk factors, old age, the association of severe neurological manifestations with the development of complications during hospitalization. Women were the most prone.Introducere. Registrul Academiei Europene de Neurologie (ENERGY) reprezintă un instrument internațional care studiază complicațiile neurologice la pacienții cu infecția COVID-19. Din decembrie 2020 Institutul de Neurologie și Neurochirurgie aderă la acest registru. Scopul lucrării. Analiza pacienților decedați cu infecție COVID-19 și cu manifestări neurologice din Republica Moldova, care au fost înregistrați în registrul ENERGY. Material și metode. Registrul include variabile generale, date demografice (sursa de contagiune, locul vizitei, durata infecției), comorbidități, manifestări neurologice și complicațiile COVID-19 raportate pe parcursul spitalizării, testele diagnostice, evoluția maladiei. Rezultate. Studiu a inclus 58 decese, 21 bărbați (36.2%) și 37 femei (63.8%) cu vârsta medie 70.6 ± 12.1 ani; majoritatea examinați la spital (98.3%); sursa de infectare – necunoscută (84.5%). S-au reinfectat cu COVID-19 – 2 persoane, s-au vaccinat - 8 pacienți. Manifestările neurologice au fost: AVC (62.1%),cefalee (41.4%),tulburări cognitive (44.8%), vertigo (24.1%), mialgie (6.9%), hipersomnolența (12.1%), coma (3.4%), tulburări de somn (1.7%), disexecutiv sindrom (35.5 %). Complicațiile au fost prezente la 87.9% pacienți: dispnee (63.8%), pneumonie (84.5%), cardiovasculare (17.2%), ventilație (43.1%). 53 pacienți (91.4%) au avut comorbidități multiple. Au fost admiși în terapie intensivă 79.3% pacienți. Concluzii. Rata de mortalitate este foarte înaltă (34.3%) din cauza prezenței multor comorbidități, factori de risc, a vârstei înaintate, asocierea manifestărilor neurologice severe cu dezvoltarea complicațiilor pe parcursul spitalizării. Femeile au fost cele mai predispuse

MORTALITY IN PATIENTS WITH COVID-19 AND NEUROLOGICAL IMPAIRMENT. RESULTS OF ENERGY STUDY IN THE REPUBLIC OF MOLDOVA

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Registrul Academiei Europene de Neurologie (ENERGY) reprezintă un instrument internațional care studiază complicațiile neurologice la pacienții cu infecția COVID-19. Din decembrie 2020 Institutul de Neurologie și Neurochirurgie aderă la acest registru. Scopul lucrării. Analiza pacienților decedați cu infecție COVID-19 și cu manifestări neurologice din Republica Moldova, care au fost înregistrați în registrul ENERGY. Material și metode. Registrul include variabile generale, date demografice (sursa de contagiune, locul vizitei, durata infecției), comorbidități, manifestări neurologice și complicațiile COVID-19 raportate pe parcursul spitalizării, testele diagnostice, evoluția maladiei. Rezultate. Studiu a inclus 58 decese, 21 bărbați (36.2%) și 37 femei (63.8%) cu vârsta medie 70.6 ± 12.1 ani; majoritatea examinați la spital (98.3%); sursa de infectare – necunoscută (84.5%). S-au reinfectat cu COVID-19 – 2 persoane, s-au vaccinat - 8 pacienți. Manifestările neurologice au fost: AVC (62.1%),cefalee (41.4%),tulburări cognitive (44.8%), vertigo (24.1%), mialgie (6.9%), hipersomnolența (12.1%), coma (3.4%), tulburări de somn (1.7%), disexecutiv sindrom (35.5 %). Complicațiile au fost prezente la 87.9% pacienți: dispnee (63.8%), pneumonie (84.5%), cardiovasculare (17.2%), ventilație (43.1%). 53 pacienți (91.4%) au avut comorbidități multiple. Au fost admiși în terapie intensivă 79.3% pacienți. Concluzii. Rata de mortalitate este foarte înaltă (34.3%) din cauza prezenței multor comorbidități, factori de risc, a vârstei înaintate, asocierea manifestărilor neurologice severe cu dezvoltarea complicațiilor pe parcursul spitalizării. Femeile au fost cele mai predispuse.Background. The European Academy of Neurology registry (ENERGY) is an international instrument that studies neurological complications in patients with COVID 19. From December 2020, the Institute of Neurology and Neurosurgery adheres to this register. Objective of the study. Analysis of deceased patients with COVID 19 infection and neurological manifestations in the Republic of Moldova, registered in the ENERGY. Methods and materials. The registry includes general variables, demographics data (source of infection, place of visit, and duration of infection), comorbidities, neurological manifestations, and COVID-19 complications reported during hospitalization, diagnostic tests, disease progression. Results. The study included 58 deaths, 21 men (36.2%) and 37 women (63.8%), mean age - 70.6 ± 12.1 years; most examined at the hospital (98.3%); source of infection - unknown (84.5%). Reinfected with COVID-19 - 2 people, 8 patients were vaccinated. The neurological manifestations were: Stroke (62.1%), headache (41.4%), cognitive impairment (44.8%), vertigo (24.1%), myalgia (6.9%), hypersomnolence (12.1%), coma (3.4%), sleep disturbances (1.7%), disexecutive syndrome (35.5%). Complications were present in 87.9% of patients: dyspnea (63.8%), pneumonia (84.5%), cardiovascular (17.2%), ventilation (43.1%). 53 patients (91.4%) had multiple comorbidities. 79.3% patients were admitted to intensive care. Conclusions. Mortality rate is very high (34.3%) due to the presence of many comorbidities, risk factors, old age, the association of severe neurological manifestations with the development of complications during hospitalization. Women were the most prone

Reliability and Reproducibility of a Novel Grading System for Lesions of the Ligamentous-Fossa-Foveolar Complex in Young Patients Undergoing Open Hip Preservation Surgery.

Background Several classification systems based on arthroscopy have been used to describe lesions of the ligamentum teres (LT) in young active patients undergoing hip-preserving surgery. Inspection of the LT and associated lesions of the adjuvant fovea capitis and acetabular fossa is limited when done arthroscopically but is much more thorough during open surgical hip dislocation. Therefore, we propose a novel grading system based on our findings during surgical dislocation comprising the full spectrum of ligamentous-fossa-foveolar complex (LFFC) lesions. Purpose To determine (1) intraobserver reliability and (2) interobserver reproducibility of our new grading system. Study Design Cohort study (diagnosis); Level of evidence, 3. Methods We performed this validation study on 211 hips (633 images in total) with surgical hip dislocation (2013-2021). We randomly selected 5 images per grade for each LFFC item to achieve an equal representation of all grades (resulting in 75 images). The ligament, fossa, and fovea were subcategorized into normal, inflammation, degeneration, partial, and complete defects. All surgeries were performed in a standardized way by a single surgeon. The femur was disarticulated using a bone hook, the LT was inspected, documented and resected, then the fossa and fovea were documented with the femoral head in full dislocation using a 70° arthroscope. Six observers with different levels of expertise in hip-preserving surgery independently conducted the measurements twice, and intraclass correlation coefficients (ICC) were calculated to determine (1) intraobserver reliability and (2) interobserver reproducibility of the novel grading system. Results For intraobserver reliability, excellent ICCs were found in both the junior and the experienced raters for grading the ligament, fossa, fovea, and total LFFC (ICCs ranged from 0.91 to 0.99 for the LFFC score). We found excellent interobserver reproducibility between raters for all items of the LFFC (all interobserver ICCs ≥ 0.76). Conclusion Our new grading system for lesions of the LFFC is highly reliable and reproducible. It covers the full spectrum of damage more precisely than arthroscopic classifications do and offers a scientific basis for standardized intraoperative evaluation

Mortalitatea la pacienții cu COVID și afectare neurologică: rezultatele registrului ENERGY în Republica Moldova

Introducere. Registrul Academiei Europene de Neurologie(ENERGY) reprezintă un instrument internațional care studiază complicațiile neurologice la pacienții cu infecția COVID 19. Din decembrie 2020 Institutul de Neurologie și Neurochirurgie aderă la acest registru. Scopul lucrării. Analiza pacienților decedați cu infecție COVID 19 cu manifestări neurologice din Republica Moldova, care au fost înregistrați în registrul ENERGY. Material şi metode. Registrul include variabile generale, date demografice (sursa de contagiune, locul vizitei, durata infecției), comorbidități, manifestări neurologice și complicațiile COVID 19 raportate pe parcursul spitalizării, testele diagnostice, evoluția maladiei. Rezultate. • 58 decese • vârsta medie 70.6 ± 12.1 ani Concluzii. Rata de mortalitate este foarte înaltă (34.3%) din cauza prezenței multor comorbidități, factori de risc, a vârstei înaintate, asocierea manifestărilor neurologice severe cu dezvoltarea complicațiilor pe parcursul spitalizării. Femeile au fost cele mai predispuse

Preliminary results of the ENERGY study (Ean NEuro-covid ReGistrY) in the Republic of Moldova

Background: ENERGY registry developed by the European Academy of Neurology studies neurological manifestations in patients with COVID-19 infections. Diomid Gherman Institute of Neurology and Neurosurgery joined these efforts in December 2020. The aim of the study was to present the Moldovan cohort of patients with COVID-19 infection and neurological manifestations registered in the ENERGY. Material and methods: The registry recorded demographic data, comorbidities, complications, neurological symptoms in confirmed COVID-19 patients. The patients were evaluated at 6 and 12 months by phone. Results: The Moldovan cohort of patients with COVID-19 and neurological manifestations by May 2021 consists of 168 patients (50.6% men and 49.4% women). Most patients (86.9%) had comorbidities, such as arterial hypertension – 83.3%, diabetes mellitus – 23.2 %, cardiovascular – 27.4 %, obesity – 21.4 %. History of neurological diseases with impact on patient’s health was dementia 3.0%, Parkinson’s disease – 1.2%, stroke – 19.0%, multiple sclerosis – 1.2%, neuromuscular disorder – 1.2%, neuropathy – 1.8%. Complications requiring medical intervention were dyspnea – 44.6%, pneumonia – 61.9%, cardiovascular – 7.1%, renal insufficiency – 1.2%, coagulation disorder – 4.2% and mechanical ventilation – 16.1%. New neurological findings in patients with COVID-19 infection were headache (24.4%), vertigo (14.3%), cognitive impairment (35.7%), stupor/coma (22.1%), stroke (62.5%), ataxia (11.4%), spinal cord disorder (7.2%), peripheral neuropathy (5.4%). Mortality rate in the cohort was 22.61%. Conclusions: The Moldovan cohort of patients with neurological manifestations during COVID-19 infections registered in the ENERGY registry presented most frequently at the emergency department with stroke, cognitive impairment and headache. They have many comorbidities, history of neurological diseases, complications during hospital stay and high mortality rate

Feasibility of recovered toner powder as an integral pigment in concrete

Colour is an important property in many construction materials with pigments, coatings and paints being used primarily for aesthetic, safety and restoration purposes. However, the use of integral pigments in materials like mortar and concrete can significantly increase material costs. Recovered toner powder (RTP) from printer and photocopier cartridges has the potential to be a low cost, sustainable alternative pigment. The aim of this research was to examine the feasibility of using cyan, yellow, magenta and black RTP to create a range of colour options for mortar and concrete, and thereafter assess the colour stability in outdoor, indoor, UV and wet/dry conditions using the colour change parameter (ΔE). The work showed that the RTP as a pigment could be blended to make a range of primary and secondary colours had good colour stability in all environments with minimal impact on selected properties of hardened concrete