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1.
Maedica (Bucur) ; 16(2): 302-306, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34621356

RESUMO

Introduction: Smooth muscle tumor of uncertain malignant potential (STUMP) still represents a medical and surgical challenge, being rare and hard to diagnose. Normally STUMP consists in a multitude of uterine tumors that do not meet the current histologic criteria for a specific malignant or benign tumor. Clinical, imagistic and laboratory investigations seem to only raise the presumptive diagnosis in these cases, the diagnosis being confirmed during histological examination of the post hysterectomy/myomectomy specimen. Case report: We present the case of a 50-year-old female patient who was examined for the first time for pelvic pain and sensation of increased pressure in the lower abdomen in June 2020. A gynecology consultation was performed, during which a large uterine mass was felt on vaginal digital examination combined with pelvic palpation. Further pelvic ultrasound examination revealed a voluminous tumor of the left ovary. Then, a magnetic resonance imaging was performed, which showed a large pelvi-abdominal tumor of probable ovarian origin with a mixt tissue type and cystic structure, the presence of pathological abdominal and pelvic lymph nodes, ascites with a suspicion of peritoneal carcinomatosis. The patient was referred to a tertiary center and the multidisciplinary team recommended surgical treatment. A total hysterectomy with bilateral oophorectomy and stadial lymphadenectomy was performed. After surgery, the patient had a favorable evolution and was discharged five days after the intervention in a good health condition. Macroscopic and histological examinations of the biopsy pieces showed morphological aspects of uterine smooth muscles tumors with uncertain malignancy potential/STUMP and multiple uterine leiomyomas. Discussion:Due to the rarity of these tumors, the scientific literature needs to be constantly updated in order to help physicians to correctly identify and treat this pathology. It is highly recommended to identify tumors with a high malignancy potential, so that the follow up will be sufficient to discover and treat recurrences before they become life-threatening. Conclusion:Smooth muscle tumor of uncertain malignant potential remains a difficult diagnosis due to uncertainty between malignancy and benign features. Treatment approaches are difficult in these cases and must always be in accordance with the patients' desire to maintain their reproductive functions and fertility. Recurrence of STUMP has been reported, therefore a close follow up of these patients must always be performed.

2.
Antioxidants (Basel) ; 10(6)2021 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-34205576

RESUMO

Knee osteoarthritis (KOA) is a chronic multifactorial pathology and a current and essential challenge for public health, with a negative impact on the geriatric patient's quality of life. The pathophysiology is not fully known; therefore, no specific treatment has been found to date. The increase in the number of newly diagnosed cases of KOA is worrying, and it is essential to reduce the risk factors and detect those with a protective role in this context. The destructive effects of free radicals consist of the acceleration of chondrosenescence and apoptosis. Among other risk factors, the influence of redox imbalance on the homeostasis of the osteoarticular system is highlighted. The evolution of KOA can be correlated with oxidative stress markers or antioxidant status. These factors reveal the importance of maintaining a redox balance for the joints and the whole body's health, emphasizing the importance of an individualized therapeutic approach based on antioxidant effects. This paper aims to present an updated picture of the implications of reactive oxygen species (ROS) in KOA from pathophysiological and biochemical perspectives, focusing on antioxidant systems that could establish the premises for appropriate treatment to restore the redox balance and improve the condition of patients with KOA.

3.
Aggress Behav ; 47(3): 354-363, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33611803

RESUMO

Despite the efforts of recent decades to reduce gender inequality, sexism is still prevalent among adolescents. The objective of this study was to identify the main socioeconomic characteristics, personal experiences, resources, and competencies associated with sexism in a sample of adolescents from different European countries. Baseline data from the Lights4Violence project included 1555 students ages 12-17 from secondary schools in six European countries (Spain, Italy, Romania, United Kingdom, Portugal, and Poland). Linear regression models were carried out, stratified by sex for benevolent (BS) and hostile (HS) dimensions of the Ambivalent Sexism Inventory. The average age of the sample was 14.3 years (SD = 1.5), 59.3% were girls. Boys scored higher on the measure of sexism (mean BS = 29.7; HS = 29.1) than girls (BS = 27.5, HS = 23.0; p < .001). Girls whose mothers had a university degree reported lower BS (ß = -0.113; p = .023) (reference: lower education). Girls who had experienced dating violence reported higher HS (ß = .080; p = .010) than those who had never been in an intimate relationship. For both sexes, high aggressiveness was associated with high levels of HS, and high aggressiveness was related to high levels of BS in boys. High assertiveness was associated with high levels of BS in both sexes and with high levels of HS in boys. A high level of problem-solving ability was associated with lower HS in both sexes. The study reinforces the need to invest in school programs aimed at preventing dating violence and promoting positive youth development.


Assuntos
Sexismo , Adolescente , Criança , Europa (Continente) , Feminino , Humanos , Itália/epidemiologia , Masculino , Portugal/epidemiologia , Espanha , Reino Unido
4.
Artigo em Inglês | MEDLINE | ID: mdl-33546373

RESUMO

Dating violence (DV) among adolescents is a public health issue because of its negative health consequences. In this study, we aimed to analyse the prevalence and the psychosocial and socioeconomic risk and protective factors associated DV among male and female adolescents in Europe. It was performed a cross-sectional study based on a non-probabilistic sample of 1555 students aged 13-16 years (2018-2019). The global prevalence of DV victimization was significantly greater among girls than boys (girls: 34.1%, boys: 26.7%; p = 0.012). The prevalence of DV in both girls and boys was greater for those over age 15 (girls: 48.5% p < 0.001; boys: 35.9%; p = 0.019). There was an increased likelihood of DV victimization among girls whose fathers did not have paid employment (p = 0.024), who suffered abuse in childhood, and reported higher Benevolent Sexism [PR (CI 95%): 1.01 (1.00-1.03)] and machismo [1.02 (1.00-1.05)]. In the case of boys, the likelihood of DV increased with abuse in childhood (p = 0.018), lower parental support [0.97 (0.96-0.99)], high hostile sexism scores (p = 0.019), lower acceptance of violence (p = 0.009) and high machismo (p < 0.001). Abuse in childhood was shown to be the main factor associated with being a victim of DV in both population groups, as well as sexism and machismo attitudes. These results may contribute to future DV prevention school programs for both, teenagers and children of elementary school ages.


Assuntos
Comportamento do Adolescente , Bullying , Vítimas de Crime , Violência por Parceiro Íntimo , Adolescente , Criança , Estudos Transversais , Europa (Continente) , Feminino , Humanos , Masculino
5.
Artigo em Inglês | MEDLINE | ID: mdl-33271817

RESUMO

The aim of the article is to show the role of school social support and school social climate in dating violence victimization prevention among adolescents in Europe. Study participants were students from secondary schools (age 13-16) in Spain, Italy, Romania, Portugal, Poland and UK. The analysis in this text concern student with dating experience (n = 993) (57.2% of girls and 66.5% of boys). School social support was measured by School Social Climate, Factor 1 Scale (CECSCE) and by Student Social Support Scale (CASSS), subscales teachers and classmates. The association between school social support and different types of dating victimization (physical and/or sexual dating violence, control dating violence and fear) was measured by calculating the prevalence ratios and their 95% confidence intervals, estimated by Poisson regression models with robust variance. All the models were adjusted by country and by sociodemographic variables. The results show that the average values of all types of social support are significantly lower in young people who have suffered any type of dating violence or were scared of their partner. The likelihood of suffering physical and/or sexual dating violence decreased when school social support increased [PR (CI 95%): 0.96 (0.92; 0.99)]. In the same way, the likelihood of fear decreased when school social climate increased [PR (CI 95%): 0.98 (0.96; 0.99)].There is an association between school social support and school social climate and experiences of being victim of dating violence among adolescents in Europe. Our results suggest that in the prevention of dating violence building a supportive climate at schools and building/using the support of peers and teachers is important.


Assuntos
Comportamento do Adolescente , Vítimas de Crime , Violência por Parceiro Íntimo , Apoio Social , Adolescente , Europa (Continente) , Feminino , Humanos , Itália , Masculino , Polônia , Portugal , Romênia , Instituições Acadêmicas , Espanha
6.
Case Rep Med ; 2020: 8283565, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32089704

RESUMO

Costal osteocartilaginous exostoses, also known as osteochondromas, are the most common neoplasms of the long bones but are rare tumors of the ribs. Osteochondroma is often asymptomatic and incidentally observed. Tumors typically begin to grow before puberty and continue until bone maturation is reached. Our paper presents the case of a 16-year-old young male who was admitted to the hospital with nonspecific symptoms and having a family history of exostosis. Chest X-ray and computed tomography imaging revealed multiple costosternal exostoses, manifested as mediastinal masses, with protrusion into the thoracic cavity, exerting compressive effects on the ascending aorta and pulmonary parenchyma. Surgery is required in childhood if lesions are painful. But if tumor formation occurs in adulthood, such pathological bony outgrowths should always be resected for avoiding further complications. In this patient, surgical intervention removed the tumoral masses and improved the symptoms. Subsequently, histological exam confirmed the diagnosis of osteocartilaginous exostoses and showed the lack of dysplastic changes.

7.
Medicina (Kaunas) ; 55(10)2019 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-31569502

RESUMO

Due to the anatomical and functional complexity of the region, craniofacial tumor removal requires some of the most challenging surgical approaches, often complemented with advanced chemo-radiotherapy techniques. However, these modern therapies often lead to sequelae that can drastically reduce the quality of life for the surviving patients. Recent advances in the field of regenerative medicine opened new avenues for craniofacial reconstruction following head and neck cancer treatment. One of the most promising recent strategies relies on the use of autologous fat transplant. In this mini review, we briefly present some of the fat's biological properties that make it an ideal tissue for craniofacial reconstruction following cancer treatment. We then outline the recent advances that led to a better understanding of the detailed anatomy of the craniofacial fat depots. Furthermore, we provide a succinct review of the methods used for fat harvesting, processing and engrafting in the craniofacial area after head and neck tumor removal, discussing their main applications, advantages and limitations.


Assuntos
Tecido Adiposo/transplante , Neoplasias de Cabeça e Pescoço/cirurgia , Transplante Autólogo/métodos , Tecido Adiposo/anatomia & histologia , Tecido Adiposo/fisiologia , Face/cirurgia , Humanos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Coleta de Tecidos e Órgãos/métodos
8.
Exp Ther Med ; 18(4): 3046-3052, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31572544

RESUMO

The present study aimed to analyze the histological characteristics of surgical thoracic aortic aneurysm (TAA) and abdominal aortic aneurysm (AAA) specimens on the basis of the most recent consensus documents on non-inflammatory and inflammatory lesions. The current study also aimed to establish an association with various risk factors. Aortic wall specimens were collected from 52 patients (38 men and 14 women; age, 19-80 years) undergoing surgery for aortic dilatation at The Cardiovascular Disease Institute (Iasi, Romania). For histological evaluation, the aortic specimens (39 TAAs and 13 AAAs) were stained with hematoxylin-eosin, Van Giessen, alcian blue and Movat pentachrome. The specimens were evaluated and graded according to the severity of histopathological conditions: Fragmentation of elastic fibers, medial mucoid accumulation, smooth muscle cell loss and medial fibrosis. The severity of atherosclerotic lesions in surgically resected segments of the aorta were graded as follows: i) mild=1; ii) moderate=2; and iii) severe=3. The risk factors associated with TAA were the male sex (80%), smoking (56%), hypertension (33%) and bicuspid aortic valve (13%). Advanced age (70 years), male sex (69%) and smoking (54%) were determined to be the risk factors of AAA. The histopathological abnormalities included medial degeneration (MD) (82%), atherosclerosis (ATS) (42%) and aortitis (10%). MD was the leading histopathological diagnosis in TAA and the severity of lesions were graded as follows: Mild (8% of cases), moderate (44% of cases) and severe (31% of cases). Severe atherosclerotic lesions were identified in AAA (100% of cases). In the present study, medial degenerative aortic lesions (1, mild; 2, moderate; and 3, severe) significantly correlated with advanced age (>65 years; r=-0.39; P<0.01) and male sex (r=0.27; P<0.05). Significant correlations were also identified between atherosclerotic aortic lesions (1, mild; 2, moderate; and 3, severe) and advanced age (>65 years) (r=-0.40, P<0.01) or smoking (r=-0.29; P<0.05). Advanced age, male sex and smoking were determined to be the main risk factors for the development of degenerative aortic aneurysms.

9.
Lipids Health Dis ; 18(1): 141, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31189474

RESUMO

BACKGROUND: The adipocyte expansion is a critical process with implications in the pathogenesis of obesity associated metabolic syndrome. Impaired adipogenesis leads to dysfunctional, hypertrophic adipocytes, local inflammation and peripheric insulin resistance. METHODS: We assessed the relationship between the adipogenic differentiation capacity of the subcutaneous adipose derived stem cells (ASCs), evaluated by total lipid accumulation, and the metabolic and hormonal profile in a group of obese female patients proposed for bariatric surgery (N = 20) versus normal weight female controls (N = 7). RESULTS: The lipid accumulation (measured as optical density at 492 nm) of ASCs during their differentiation to adipocytes was significantly lower in ASCs isolated from obese patients as compared to ASCs isolated from normal weight patients (0.49 ± 0.1 vs. 0.71 ± 0.1, p < 0.001). Significant negative correlations between lipid accumulation in adipogenic differentiated ASCs and plasma concentrations of triglycerides (p < 0.01), insulin (p < 0.001), HOMA-IR (p < 0.01), adiponectin (p < 0.05) and leptin/adiponectin ratio (p < 0.05) were found in obese group. CONCLUSIONS: In severely obese female patients, the abnormal adipogenesis is related to insulin resistance and leptin/adiponectin ratio. The abnormal lipid accumulation in the mature adipocyte derived from obese ASCs could possible predict the further development of type 2 diabetes mellitus in severely obese patients and influence the selection of patients for bariatric surgery.


Assuntos
Adiponectina/sangue , Cirurgia Bariátrica , Obesidade/sangue , Obesidade/metabolismo , Gordura Subcutânea/metabolismo , Adiponectina/metabolismo , Adulto , Diferenciação Celular/fisiologia , Células Cultivadas , Feminino , Imunofluorescência , Humanos , Resistência à Insulina/fisiologia , Leptina/sangue , Leptina/metabolismo , Síndrome Metabólica/sangue , Síndrome Metabólica/metabolismo , Pessoa de Meia-Idade , Obesidade/cirurgia
10.
Int Urol Nephrol ; 51(1): 155-162, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30515732

RESUMO

OBJECTIVE: The study aims to objectively and precisely describe, in elderly dialysis patients from a single center, the prevalence of malnutrition and severe cognitive/functional impairment and to establish the prognostic role of malnutrition assessment for patient's severe cognitive/functional status. DESIGN: Cross-sectional study. SETTING: A single dialysis center from north-eastern Romania. SUBJECTS: Eighty-one elderly ambulatory hemodialysis patients. INTERVENTION: The aim of the study was to establish in hemodialysis elderly patients a correlation between two malnutrition scores [Mini Nutritional Assessment (MNA) and Subjective Global Assessment (SGA)] and geriatric tests (Geriatric Depression Scale-GDS), daily activities (Activities of Daily Living-ADL, Instrumental Activities of Daily Living-IADL), and cognitive impairment scores (Mini Mental State Examination-MMSE). A correlation between objective malnutrition parameters (bioimpedance lean tissue index (LTI) and fat tissue index (FTI) by bioimpedance) was also assessed. MAIN OUTCOME MEASURE: Using area under the curve analysis, two malnutrition scores and bioimpedance assessed nutritional status were explored as possible predictors for the most severe category of functional and cognitive status. RESULTS: All patients had mild/moderate malnutrition by SGA, while the MNA test reported malnutrition in 14.5%, and 58% of cases. There was no correlation between subjective scores and objective biomarkers of malnutrition (albumin levels, bioimpedance-derived LTI, FTI). ROC curve analysis showed that MNA and SGA predict the most severe category of depression and functional impairment with relatively good accuracy (specificity, sensibility). CONCLUSION: The study confirms the important correlation between malnutrition and cognitive/functional impairment and confirms that malnutrition scores could be useful in predicting depression and physical dependance in elderly dialysis patients.


Assuntos
Disfunção Cognitiva , Falência Renal Crônica , Desnutrição , Avaliação Nutricional , Diálise Renal , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Cognição , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/fisiopatologia , Estudos Transversais , Depressão/diagnóstico , Depressão/fisiopatologia , Feminino , Avaliação Geriátrica/métodos , Humanos , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/psicologia , Falência Renal Crônica/terapia , Masculino , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Desnutrição/fisiopatologia , Desnutrição/psicologia , Estado Nutricional , Valor Preditivo dos Testes , Prevalência , Diálise Renal/efeitos adversos , Diálise Renal/métodos , Romênia/epidemiologia
11.
Rev Med Chir Soc Med Nat Iasi ; 120(2): 223-7, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27483696

RESUMO

Obesity is a medical and social problem with a dramatically increasing prevalence. It is important to take action since childhood to prevent and treat obesity and metabolic syndrome. Infantile obesity affects all body systems starting in childhood and continuing to adulthood. Understanding the impact of stressors on weight status may be especially important for preventing obesity. The relationship between stress, eating behavior and obesity is not fully understood. However, there is evidence that stress causes disorders in hypothalamic-pituitary-adrenal (HPA) axis, system that regulates both stress and feeding responses. Also, the response is different depending on the type of stressors. Chronic stress, especially when people live in a palatable food environment, induces HPA stimulation, excess glucocorticoids, insulin resistance, which lead to inhibition of lipid mobilization, accumulation of triglyceride and retention of abdominal fat.


Assuntos
Comportamento Alimentar , Sistema Hipotálamo-Hipofisário , Síndrome Metabólica/psicologia , Obesidade/psicologia , Sistema Hipófise-Suprarrenal , Estresse Psicológico/complicações , Estresse Psicológico/fisiopatologia , Adulto , Índice de Massa Corporal , Criança , Humanos , Sistema Hipotálamo-Hipofisário/fisiopatologia , Síndrome Metabólica/fisiopatologia , Obesidade/fisiopatologia , Obesidade Pediátrica/psicologia , Sistema Hipófise-Suprarrenal/fisiopatologia , Prevalência , Recompensa , Romênia/epidemiologia
12.
Rev Med Chir Soc Med Nat Iasi ; 120(2): 239-43, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27483699

RESUMO

Childhood obesity is a global epidemic with long term implications. The main cause of obesity is an increase in calorie intake and a decrease in physical activity, but also there is clear evidence suggesting a link between the duration and quality of sleep and obesity risk. Good sleep habits are involved in increased ability to concentrate at school, improvement of general state, immune system development, increased quality of life. On the other hand, there are several mechanisms by which chronic sleep deprivation induces weight gain: disturbance of hormones that control hunger center, increased time for meals, reduced physical activity, metabolic changes. Recently, nighttime sleep duration has declined, in contrast with the increasing prevalence of obesity. Childhood sleep habits have a long term effect on weight, with repercussions even into adulthood. This is the reason why there is increasing interest to include sleep quality on the list for childhood obesity prevention. Sleep represents an important and independent risk factor of obesity in children and adolescents and it should be taken into consideration in the management of obesity.


Assuntos
Obesidade Pediátrica/etiologia , Obesidade Pediátrica/prevenção & controle , Qualidade de Vida , Privação do Sono , Adolescente , Índice de Massa Corporal , Peso Corporal , Criança , Hábitos , Humanos , Fatores de Risco
13.
Rev Med Chir Soc Med Nat Iasi ; 120(2): 404-8, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27483726

RESUMO

Vitamin D (VitD), a lipid-soluble hormone, is able to regulate the transcription of many genes through vitamin D receptor (vitD receptor-VDR). It has been shown that VitD deficiency is associated with obesity, characterized by a low degree inflammatory state, which contribute to the pathogeny of metabolic syndrome and type 2 diabetes mellitus. VitD deficiency is a public health problem, at the same time the global prevalence of obesity and cardiovascular diseases is continuously growing. Evidence from recent studies on animal models suggest that VitD or VDR deficiency promotes cardiomyocyte hypertrophy, which can be one of the mechanisms for increasing cardiovascular risk. The heart is one of the target organs of action for VitD, because VDR is expressed in cardiomyocytes. Also, previous in vitro studies have shown that VitD is able to inhibit the production of monocyte chemotactic factors (MCP-1) and other pro-inflammatory mediators in human preadipocytes and mature adipocytes. Inflammation is an important factor in the pathogenesis of atherosclerosis. In obesity there are not known data about correlations between plasma levels of VitD and VDR expression in the subcutaneous fat tissue, epicardial visceral adipose tissue, and in particular in myocardium. Also, there are still no studies to test VDR expression in myocardial cells and to investigate the results of dietary VitD supplementation on the expression of VDR in the epicardial adipose tissue and myocardium.


Assuntos
Doenças Cardiovasculares/metabolismo , Obesidade/metabolismo , Receptores de Calcitriol/metabolismo , Deficiência de Vitamina D/metabolismo , Adipócitos/metabolismo , Índice de Massa Corporal , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/fisiopatologia , Medicina Baseada em Evidências , Humanos , Inflamação/metabolismo , Miócitos Cardíacos/metabolismo , Obesidade/epidemiologia , Obesidade/fisiopatologia , Fatores de Risco , Romênia/epidemiologia , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/fisiopatologia
14.
Exp Ther Med ; 12(2): 804-808, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27446279

RESUMO

Coronary artery bypass graft (CABG) is a surgical procedure able to improve the blood supply to the myocardium. In the present study, the distal segments of grafts taken from the internal thoracic artery (ITA), radial artery (RA) and saphenous vein (SV) for use in aortocoronary bypass surgery were examined. The morphologies of the grafts were investigated in order to draw conclusions concerning their patency and viability. In addition, clinical and laboratory risk factors considered to be significant predictors of lesion severity in graft vessels used in CABGs were investigated. In total, 54 distal graft segments of ITAs, RAs and SVs from 20 men and 6 women aged between 42 and 78 years, were evaluated. Histological analyses were used to visualize graft lesions. Morphometrically, the intimal thickness index (ITI) and luminal narrowing were assessed as an indication of graft patency. The histological changes observed in the graft vessel walls included the presence of distinct atheromatous plaques (fatty streaks in 2 cases) or thickening of the intima (20 cases) and media (17 cases). Morphometric analysis showed that the mean ITI of the vessel conduits was 0.37 in the SVs, 0.95 in the RAs, and 1.66 in the ITAs. No patient had >50% conduit stenosis. By assessing the association between risk factors and graft lesions, it was found that all the patients showed risk factors for atherosclerosis, such as age (61.54%), arterial hypertension (65.38%), hyperlipidemia (65.38%), smoking (34.61%), diabetes mellitus (38.46%) and obesity (15.38%). The presence of pre-existing lesions in bypass grafts may contribute to a reduction in their viability, particularly in the case of venous grafts. Further long-term follow-ups are mandatory to evaluate the consequences of such lesions upon the patency of the grafts.

15.
Obes Facts ; 9(3): 206-20, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27319017

RESUMO

AIM: High-quality national representative data on obesity in Romanian children are needed to shape public health policies. To provide a unified data landscape on national prevalence, trends and other factors associated with underweight, overweight, and obesity in Romanian children aged 6-19 years, across the last decade (2006-2015). METHODS: Using a common protocol, we selected published and unpublished studies that measured Romanian children in schools between 2006 and 2015. Children's BMI was classified using the current WHO, IOTF, and CDC references. RESULTS: 25,060 children from 8 Romanian counties were included in the analysis. The prevalence of underweight children was 5%/4.5%/8.5% (WHO/IOTF/CDC), while the prevalence of overweight (including obese) children was 28.3%/23%/23.2% (WHO/IOTF/CDC). The prevalence of overweight children did not change significantly over the last decade (chi-square test p = 0.6). Male gender (odds ratio (OR) 1.37; 95% CI 1.29-1.45, compared to female); prepubertal age (OR = 3.86; 95% CI 3.41-4.36,compared to postpubertal age), and urban environment (OR 1.12; 95% CI 1.01-1.26, compared to rural environment) had higher risk for overweight. CONCLUSION: While the prevalence of underweight children was low, almost one in four children in Romania was overweight or obese (according to WHO criteria) between 2006 and 2015. This prevalence remained relatively stable over the last decade. Male gender, prepubertal age, and urban environment, were the most relevant risk factors associated with overweight status in Romanian children.


Assuntos
Sobrepeso/epidemiologia , Magreza/epidemiologia , Adolescente , Índice de Massa Corporal , Criança , Estudos Transversais , Meio Ambiente , Grupos Étnicos , Feminino , Humanos , Masculino , Obesidade/epidemiologia , Razão de Chances , Política Pública , Fatores de Risco , Romênia/epidemiologia , População Rural , Instituições Acadêmicas , Meio Social , População Urbana
16.
Exp Ther Med ; 11(5): 2028-2032, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27168846

RESUMO

The types of lesion instability responsible for the majority of acute coronary events frequently include plaque disruption and plaque erosion with superimposed thrombosis. The term 'vulnerable plaque is used to describe atherosclerotic (ATS) plaques that are particularly prone to rupture and susceptible to thrombus formation, such as the thin-cap fibroatheroma (TCFA). The aim of the present study was to assess the morphological and histological differences between plaques that are unstable and those that are vulnerable to instability. Carotid artery endarterectomy specimens were obtained from 26 patients with carotid artery stenosis, consisting of 20 men and 6 women (age range, 35-80 years). Histological and morphometric methods were used to visualize and characterize the ATS plaques. Among the 26 carotid ATS plaques, 23% were stable, 23% were unstable and 54% were vulnerable. With regard to morphometric characteristics, the following mean values were obtained for the TCFA and unstable plaques, respectively: Fibrous cap thickness, 21.91 and 11.66 µM; proportion of necrotic core area in the total plaque area, 25.90 and 22.03%; and the proportion of inflammatory area in the total plaque area, 8.41 and 3.04%. No plaque calcification was observed in any of them. Since ATS coronary artery disease is considerably widespread and fatal, it is crucial to further study ATS lesions to obtain an improved understanding of the nature of vulnerable and unstable plaques. The methods used to detect plaque size, necrotic core area and fibrous cap thickness are considered to be particularly useful for identifying vulnerable and unstable plaques.

17.
Rev Med Chir Soc Med Nat Iasi ; 120(1): 114-8, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27125082

RESUMO

UNLABELLED: We present a 77-year-old woman with no histor of trauma, or associated with low-energy trauma, admitted to our clinic after three weeks of a left femoral fracture threated in Orthopedic Clinic. The patient was in treatment with bisphosphonates over 10 years for osteoporosis. DISCUSSION AND CONCLUSIONS: The causal re lationship between prolonged bisphosphonate use and the occurrence of atypical femora fractures (AFF) has not yet been established. For the patient at high risk of fracture, it may be beneficial to continue bisphosphonate treatment beyond five years. The absolute risk of atypical femoral fractures is low (about 100 cases per 100,000 person-years among long term users). For most people with osteoporosis, the proven fragility-fracture risk-reduction. benefits of bisphosphonates outweigh the risks of AFF.


Assuntos
Conservadores da Densidade Óssea/efeitos adversos , Difosfonatos/efeitos adversos , Fraturas do Fêmur/induzido quimicamente , Fraturas Espontâneas/induzido quimicamente , Osteoporose/tratamento farmacológico , Idoso , Relação Dose-Resposta a Droga , Feminino , Humanos , Fatores de Risco , Fatores de Tempo
18.
Rev Med Chir Soc Med Nat Iasi ; 120(3): 491-96, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-30044562

RESUMO

Sarcopenia, the key point of frailty syndrome, leads to decreased physical activity, with important consequences upon the quality of life in elderly. The prevalence of sarcopenia is still uncertain because of the lack of homogeneity of the studied populations, and also because of the variety of techniques. The development of biological markers that can be used in a cost effective manner to guide diagnosis and facilitate monitoring patients with sarcopenia, would mark an important step in managing the care of geriatric patients. Nutrition combined with physical activity is the key component of the management of sarcopenia, with a synergistic effect that helps combat malnutrition and improve the quality of life.


Assuntos
Sarcopenia/diagnóstico , Idoso , Biomarcadores/análise , Idoso Fragilizado , Avaliação Geriátrica , Humanos , Estado Nutricional , Qualidade de Vida , Sarcopenia/etiologia
19.
Exp Ther Med ; 10(6): 2299-2304, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26668632

RESUMO

Postoperative atrial fibrillation (POAF) is a common complication subsequent to cardiac surgery. Various risk factors have been reported for the development of this complication; however, their precise role in POAF is unknown. In the present study, we attempted to identify clinical factors and histopathological changes in atrial tissue that may predict the development of POAF. Atrial tissue was sampled from 103 patients in sinus rhythm that had undergone open-heart surgery, including elective coronary artery bypass grafting (79.61%) and heart valve surgery (20.38%). Atrial surgical biopsies were obtained from the right atrial appendage at the site of cannulation, prior to cardiopulmonary bypass. Tissues were processed routinely for light microscopy, then stained with hematoxylin and eosin and sirius red. Microscopical exams were used to observe the atrial lesions and morphometry was conducted for quantification. In total, 37 patients (35.92%) developed POAF and atrial lesions were identified in the majority of patients in the normal postoperative sinus rhythm and POAF groups, but were most common in the POAF patients. The most common risk factors involved in developing POAF were found to be: Age of >60 years, male gender, ejection fraction of <50% and increased pulmonary hypertension. Furthermore, interstitial fibrosis and myocytolysis were the most common injuries identified. Abnormalities in atrial surgical biopsies may indicate the susceptibility of a patient to developing POAF. The present results suggest that the pre-existent alterations in the structure of the right atrium may be a major determinant in the development of POAF.

20.
Rev Med Chir Soc Med Nat Iasi ; 119(2): 310-8, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26204630

RESUMO

Vitamin D is important for good health, growth and strong bones. Vitamin D is mostly made in the skin by exposure to sunlight. Most foods contain very little vitamin D naturally, though some are fortified with added vitamin D. Hypovitaminosis D is associated with cardiovascular disease, the metabolic syndrome, type 2 diabetes mellitus, cancer as well as with increased mortality. Further, Vitamin D deficiency is related to depression and impaired cognitive function. Increasing age and elevated body fat mass contribute to an increased risk of Vitamin D deficiency. A mild lack of vitamin D may not cause symptoms but can cause tiredness and general aches and pains. A more severe lack can cause s rious problems such as rickets (in children) and osteomalacia in adults). During menopause, the decline of estrogens results in increased bone turnover, a decrease in bone mineral density and elevated fracture risk. Treatment is with vitamin D supplements. Some people are more at risk of vitamin D deficiency, and so are recommended to take vitamin D supplements routinely. These include all pregnant and breastfeeding women, all infants (babies) and young children aged 6 months to 5 years, people aged 65 and over, and people who are not exposed to much sun. There are precise recommendations regarding a sufficient Vitamin D intake in order to prevent bone loss in peri- and postmenopausal women. It is also recommend routine supplements for certain people with darker skin, and for people with certain gut, liver or kidney diseases.


Assuntos
Doenças Cardiovasculares/complicações , Diabetes Mellitus Tipo 2/complicações , Síndrome Metabólica/complicações , Neoplasias/complicações , Deficiência de Vitamina D/complicações , Índice de Massa Corporal , Conservadores da Densidade Óssea/uso terapêutico , Cognição/efeitos dos fármacos , Depressão/complicações , Humanos , Osteomalacia/etiologia , Raquitismo/etiologia , Fatores de Risco , Vitamina D/uso terapêutico , Deficiência de Vitamina D/tratamento farmacológico
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