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Iliescu MG, Stanciu LE, Uzun AB, Cristea AE, Motoască I, Irsay L, Iliescu DM, Vari T, Ciubean AD, Caraban BM, Ciufu N, Azis O, Ciortea VM. Assessment of Integrative Therapeutic Methods for Improving the Quality of Life and Functioning in Cancer Patients-A Systematic Review. J Clin Med 2024; 13:1190. [PMID: 38592012 PMCID: PMC10931598 DOI: 10.3390/jcm13051190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Cancer rehabilitation represents a series of measures adopted for the recovery of psychological, emotional, social, and financial functioning in the case of cancer patients. The purpose of this study is to identify the main elements of therapeutic management in the field of medical rehabilitation, as well as integrative, complementary medicine and holistic approaches that can be performed on the oncological patient. Methods: This systematic literature review follows the methodology outlined in the "Preferred Reporting Items for Systematic Reviews and Meta-Analysis" ("PRISMA") statement, which is an internationally recognized and widely accepted standard. Results: Active rehabilitative therapies offer therapeutic options for improving the functioning and quality of life of oncological patients; these therapies comprehensively address both the physical and psychological aspects of the disease. This review also includes the latest novelties and nanotechnologies applied in oncological rehabilitation, for example, drugs (or supplements) inspired by nature. Conclusions: Physical and rehabilitation medicine, mostly using stimulating therapeutic methods, was recently added to the list of contraindications in the management of oncological patients, both as an approach to the pathological concept itself and as an approach to the main clinical consequences and functional aspects of oncological therapies. Integrative, complementary medicine presents an important therapeutic resource in the case of oncological patients. Advanced studies are needed in the future to further ascertain the role of these therapies.
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Affiliation(s)
- Mădălina Gabriela Iliescu
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
- Medical Doctoral School, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Liliana-Elena Stanciu
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Andreea-Bianca Uzun
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
- Medical Doctoral School, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Adelina-Elena Cristea
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
- Medical Doctoral School, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Irina Motoască
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Laszlo Irsay
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Dan Marcel Iliescu
- Department of Anatomy, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Titus Vari
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Alina Deniza Ciubean
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Bogdan Marian Caraban
- Department of Plastic Surgery, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Nicolae Ciufu
- Department of General Surgery, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Olgun Azis
- Department of Urology, Faculty of Medicine, Ovidius University of Constanta, 1 University Alley, Campus-Corp B, 900470 Constanta, Romania
| | - Viorela Mihaela Ciortea
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy "Iuliu Hatieganu", 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
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Obada B, Iliescu DM, Popescu IA, Petcu LC, Iliescu MG, Georgeanu VA. Clinical outcomes of modified direct lateral approach of Hardinge for total hip arthroplasty. Acta Orthop Belg 2023; 89:625-633. [PMID: 38205752 DOI: 10.52628/89.4.10942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
The aim of the study was to evaluate a modified direct lateral approach for total hip arthroplasty in terms of clinical and functional outcomes, rate of complications and hospitalization. We retrospectively reviewed the data of 526 patients with THA operated in our department between January 2017 and December 2021. Clinical examination, functional outcome and radiographic evaluation were performed during follow-up. Patients were evaluated at the following time points: preoperatively and postoperatively at 3 days, 6 weeks, 12 weeks and 1 year and we registered surgery related data, complications, Visual Analogue Scale pain score, Harris Hip Score, the Western Ontario McMaster Osteoarthritis Index. Low intraoperative blood loss, short operation time, short hospitalization, early mobilization of the patient and good range of motion imposed the modified direct lateral approach as a valuable procedure for the patients with THA. VAS score evaluated at 3 days and 6 weeks indicated a very good overall postoperative experience. The HHS and Womac scores were evaluated at 6 weeks, 12 weeks and 1 year and showed excellent results. Trendelenburg gait and abductor weakness, traditionally related with direct lateral approach, were not significant statistically and complete reversible. We registered a very low complication rates with good functional outcome. The modified direct lateral approach can lead to superior outcomes, improved quality of life, with reduced intra and postoperative complications rate.
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Pop MS, Cheregi DC, Onose G, Munteanu C, Popescu C, Rotariu M, Turnea MA, Dogaru G, Ionescu EV, Oprea D, Iliescu MG, Minea M, Stanciu LE, Silișteanu SC, Oprea C. Exploring the Potential Benefits of Natural Calcium-Rich Mineral Waters for Health and Wellness: A Systematic Review. Nutrients 2023; 15:3126. [PMID: 37513544 PMCID: PMC10384676 DOI: 10.3390/nu15143126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/10/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
This systematic review investigates the potential health and wellness benefits of natural calcium-rich mineral waters. It emphasizes the importance of dietary calcium sourced from natural mineral waters in promoting bone health, maintaining cardiovascular function, aiding in weight management, and enhancing overall well-being. The review process involved the comprehensive analysis of peer-reviewed articles, clinical trials, and experimental studies published within the last decade. Findings reveal that consuming calcium-rich mineral water can contribute significantly to daily calcium intake, particularly for those with lactose intolerance or individuals adhering to plant-based diets. The unique bioavailability of calcium from such waters also appears to enhance absorption, thus potentially offering an advantage over other calcium sources. The potential benefits extend to the cardiovascular system, with some studies indicating a reduction in blood pressure and the prevalence of cardiovascular diseases. Emerging evidence suggests that calcium-rich mineral water might have a role in body weight management, though further research is needed. The review identifies several areas requiring additional research, such as the potential interaction between calcium-rich mineral water and other dietary components, the effects on populations with specific health conditions, and the long-term effects of consumption. In conclusion, natural calcium-rich mineral waters show promise as a readily accessible and bioavailable sources of dietary calcium, potentially beneficial for a broad range of individuals. However, further investigation is required to fully understand its range of health impacts and define optimal intake levels.
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Affiliation(s)
- Manuela Simona Pop
- Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | | | - Gelu Onose
- Teaching Emergency Hospital "Bagdasar-Arseni" (TEHBA), 041915 Bucharest, Romania
- Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila" (UMPCD), 020022 Bucharest, Romania
| | - Constantin Munteanu
- Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila" (UMPCD), 020022 Bucharest, Romania
- Faculty of Medical Bioengineering, University of Medicine and Pharmacy "Grigore T. Popa" Iași, 700454 Iași, Romania
| | - Cristina Popescu
- Teaching Emergency Hospital "Bagdasar-Arseni" (TEHBA), 041915 Bucharest, Romania
- Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila" (UMPCD), 020022 Bucharest, Romania
| | - Mariana Rotariu
- Faculty of Medical Bioengineering, University of Medicine and Pharmacy "Grigore T. Popa" Iași, 700454 Iași, Romania
| | - Marius-Alexandru Turnea
- Faculty of Medical Bioengineering, University of Medicine and Pharmacy "Grigore T. Popa" Iași, 700454 Iași, Romania
| | - Gabriela Dogaru
- Faculty of Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Clinical Rehabilitation Hospital, 400437 Cluj-Napoca, Romania
| | - Elena Valentina Ionescu
- Faculty of Medicine, Ovidius University of Constanta, 900527 Constanta, Romania
- Balneal and Rehabilitation Sanatorium of Techirghiol, 34-40 Dr. Victor Climescu Street, 906100 Techirghiol, Romania
| | - Doinița Oprea
- Faculty of Medicine, Ovidius University of Constanta, 900527 Constanta, Romania
- Balneal and Rehabilitation Sanatorium of Techirghiol, 34-40 Dr. Victor Climescu Street, 906100 Techirghiol, Romania
| | - Mădălina Gabriela Iliescu
- Faculty of Medicine, Ovidius University of Constanta, 900527 Constanta, Romania
- Balneal and Rehabilitation Sanatorium of Techirghiol, 34-40 Dr. Victor Climescu Street, 906100 Techirghiol, Romania
| | - Mihaela Minea
- Balneal and Rehabilitation Sanatorium of Techirghiol, 34-40 Dr. Victor Climescu Street, 906100 Techirghiol, Romania
| | - Liliana Elena Stanciu
- Faculty of Medicine, Ovidius University of Constanta, 900527 Constanta, Romania
- Balneal and Rehabilitation Sanatorium of Techirghiol, 34-40 Dr. Victor Climescu Street, 906100 Techirghiol, Romania
| | - Sînziana Călina Silișteanu
- Faculty of Medicine and Biological Sciences, "Stefan cel Mare" University of Suceava, 720229 Suceava, Romania
| | - Carmen Oprea
- Faculty of Medicine, Ovidius University of Constanta, 900527 Constanta, Romania
- Balneal and Rehabilitation Sanatorium of Techirghiol, 34-40 Dr. Victor Climescu Street, 906100 Techirghiol, Romania
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Irsay L, Ungur RA, Borda IM, Tica I, Iliescu MG, Ciubean AD, Popa T, Cinteza D, Popa FL, Bondor CI, Ciortea VM. Safety of Electrotherapy Treatment in Patients with Knee Osteoarthritis and Cardiac Diseases. Life (Basel) 2022; 12:life12111690. [PMID: 36362845 PMCID: PMC9699242 DOI: 10.3390/life12111690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 10/16/2022] [Accepted: 10/21/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE: To assess the safety of electrotherapy applied in the knee area in patients with known atrial arrhythmias or ischemic heart disease, as it is not known whether this treatment induces or aggravates arrhythmias during or immediately after therapy. MATERIAL AND METHODS: The analytical and transversal study involved 46 patients with degenerative knee osteoarthritis (OA), with or without cardiac diseases, from the Clinical Rehabilitation Hospital inpatient center, Cluj-Napoca, Romania. All patients underwent a 10-day physical therapy program for knee OA (electrotherapy, massage and kinesiotherapy). Heart rate and the total number of ventricular and supraventricular extrasystoles were evaluated before and after treatment, by 24 h Holter ECG monitoring. RESULTS: There was no significant increase in heart rate or in the number of ventricular or supraventricular extrasystoles before or after electrotherapy treatment, regardless of the positive or negative history of arrhythmia or ischemic heart disease (all p > 0.05). Mean values during day 1 were: 35.15 (95% CI [9.60−60.75]) for ventricular ones extrasystoles and 91.7 (95% CI [51.69−131.7]) for supraventricular ones, which during day 2 were 38.09 (95% CI [3.68−72.50]), 110.48 (95% CI [48.59−172.36]), respectively. CONCLUSION: One of the most important things to consider when dealing with an OA patient is that they are most likely older than 65 years, which increases the chance of having a cardiac disease. This raises the need for viable interventions regarding the management of this disease in patients that probably have multiple comorbidities, and where pharmacological and surgical management are not possible, limited or have multiple side effects. Electrotherapy used for treating knee OA did not cause a significant increase in heart rate or number of ventricular and supraventricular extrasystoles in this category of patients.
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Affiliation(s)
- Laszlo Irsay
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy, “Iuliu Hatieganu”, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Rodica Ana Ungur
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy, “Iuliu Hatieganu”, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Ileana Monica Borda
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy, “Iuliu Hatieganu”, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
| | - Irina Tica
- Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, Campus—Corp B, 900470 Constanta, Romania
| | - Mădălina Gabriela Iliescu
- Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, Campus—Corp B, 900470 Constanta, Romania
- Correspondence: (M.G.I.); (A.D.C.)
| | - Alina Deniza Ciubean
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy, “Iuliu Hatieganu”, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
- Correspondence: (M.G.I.); (A.D.C.)
| | - Theodor Popa
- Department of Rehabilitation Medicine, Clinical Rehabilitation Hospital, 46-50 Viilor Street, 400337 Cluj-Napoca, Romania
| | - Delia Cinteza
- 9th Department—Physical Medicine and Rehabilitation, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Florina Ligia Popa
- Physical Medicine and Rehabilitation Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, Victoriei Blvd., 550024 Sibiu, Romania
- Academic Emergency Hospital of Sibiu, Coposu Blvd., 550245 Sibiu, Romania
| | - Cosmina Ioana Bondor
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy, “Iuliu Hatieganu”, 6 Pasteur Street, 400349 Cluj-Napoca, Romania
| | - Viorela Mihaela Ciortea
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy, “Iuliu Hatieganu”, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania
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Popa FL, Diaconu C, Canciu A, Ciortea VM, Iliescu MG, Stanciu M. Medical management and rehabilitation in posttraumatic common peroneal nerve palsy. Balneo and PRM Research Journal 2022. [DOI: 10.12680/balneo.2022.496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction. The common peroneal nerve and the tibial nerve are the two major components into which the sciatic nerve divides. The severity of common peroneal nerve damage depends on the aetiopathogenic mechanism and the place of injury. The peroneal ram of the sciatic nerve injury is the most common cause of mononeuropathy of the lower limb which can cause a signi-ficant disability if is not properly diagnosed and treated. Material and method. We present the case of a 40-year-old patient who suffered a polytrauma by road accident resulting in left tro-chanteric-diaphyseal femoral comminuted open fracture, lacerated wound on the posterolateral middle third of the left thigh, left sacral wing fracture without displacement, left L1, L2, L3 tran-sverse apophyseal fractures and splenic laceration, treated surgically and orthopedically. The pa-tient was admitted to the Medical Reabilitation Department of Sibiu for left leg motor deficit, mechanical pain and functional deficit of the left hip and ankle, gait disorders. Complex rehabi-litation treatment was initiated 3 months after the accident. Results and discussion. Common pe-roneal nerve palsy was confirmed following neurological consultation the day after admission to Orthopaedics-Traumatology Department of Sibiu where continuous extension-traction was performed in order to relax the fracture and subsequent osteosynthesis surgery of the femur fracture. The presence of a deep and lacerating wound on the posterolateral left thigh caused the nerve injury. The coagulase-negative Staphylococcus aureus overinfection of the wound required secondary suturing and subsequently led to fibrous scar formation, adversely affecting the post-injury repair of the common fibular nerve. Conclusions. In patients with posttraumatic common peroneal nerve palsy, early diagnosis and appropriate treatment, including medical rehabilitation, are essential. Medical rehabilitation should be continued on a sustained basis be-cause nerve regeneration occurs slowly. The prognosis mainly depends on the severity of the initial nerve injury.
Keywords: common fibular nerve injury, polytrauma, medical rehabilitation
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Affiliation(s)
- Florina Ligia Popa
- Physical Medicine and Rehabilitation Department, ”Lucian Blaga” University of Sibiu, Faculty of Medicine, Academic Emergency Hospital of Sibiu, Sibiu, Romania
| | - Cosmina Diaconu
- Nursing Department, ”Lucian Blaga” University of Sibiu, Faculty of Medicine, Academic Emer-gency Hospital of Sibiu, Sibiu, Romania
| | | | - Viorela Mihaela Ciortea
- ”Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Department of Rehabili-tation, Clinical Rehabilitation Hospital Cluj-Napoca, Romania
| | - Mădălina Gabriela Iliescu
- Faculty of Medicine, ‘Ovidius’ University of Constanta, Constanta, Romania, Balneal and Reha-bilitation Sanatorium Techirghiol, Techirghiol, Romania
| | - Mihaela Stanciu
- Department of Endocrinology,”Lucian Blaga” University of Sibiu, Academic Emergency Hospi-tal of Sibiu, Sibiu, Romania
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Ciortea VM, Borda MI, Motoașcă I, Șușman S, Ciubean AD, Pintea AL, Ungur RA, Iliescu MG, Irsay L. Influence of melatonin on systemic inflammatory status and bone histopathological modifications in female rats with surgically induced menopause. Balneo and PRM Research Journal 2022. [DOI: 10.12680/balneo.2022.493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background. Melatonin, N-acetyl-5-methoxy-tryptamine is the major secretion product of the pineal gland with important anti-inflammatory and antioxidant properties, also being an im-portant marker of bone remodelling associated with menopause. Objectives. The aim of our study was to evaluate the effect of the co-administration of melatonin and estrogen on systemic inflammatory status and bone histopathological modifications in surgically induced menopau-sal female rats. Materials and methods. The study was performed on a number of 40 female rats, Wistar breed, which underwent bilateral surgical ovariectomy. Within 14 days postoperative, hormone replacement therapy with estrogen or estrogen with melatonin was initiated, in differ-ent doses. The treatment was administered for 12 consecutive weeks. At the end of the treatment we measured the serum levels of IL-6 and TNF-α. The femoral bones were harvested after sacri-ficing the animals and the thickness of the cortical bones was measured and histologically ana-lysed.
Results. Serum values of inflammatory markers were negatively correlated with melatonin ad-ministration, the differences being more important at higher doses of melatonin (for both IL-6 and TNF-α the difference between group E_2M with estrogen substitution and melatonin in double dose and control group W, without hormone replacement, was highly statistically signif-icant with p <0.0001). Bone diameters improved in the case of female rats that received hormone replacement with estrogen and higher dose of melatonin (p = 0.0004 between group E_2M, with hormone replacement and group W, control group). Conclusions. Melatonin improved inflam-matory status and bone histopathological changes in ovariectomized female rats.
Keywords: melatonin, estrogen replacement therapy, inflammation, low bone density
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Affiliation(s)
- Viorela Mihaela Ciortea
- 1 Department of Rehabilitation, ”Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania 2 Clinical Rehabilitation Hospital Cluj-Napoca, Romania
| | - Monica Ileana Borda
- 1 Department of Rehabilitation, ”Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania 2 Clinical Rehabilitation Hospital Cluj-Napoca, Romania
| | | | - Sergiu Șușman
- Department of Histology, ”Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
| | - Alina Deniza Ciubean
- Department of Rehabilitation, ”Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
| | - Alina Liliana Pintea
- Dental Medicine and Nursing Department, ”Lucian Blaga” University of Sibiu, Faculty of Medi-cine, Academic Emergency Hospital of Sibiu, Romania
| | - Rodica Ana Ungur
- 1 Department of Rehabilitation, ”Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania 2 Clinical Rehabilitation Hospital Cluj-Napoca, Romania
| | | | - Laszlo Irsay
- 1 Department of Rehabilitation, ”Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania 2 Clinical Rehabilitation Hospital Cluj-Napoca, Romania
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Tica I, Niculescu C, Mocanu L, Iliescu MG, Tica VI, Niculescu Z. Nodular subcutaneous lesion - an alarming sign for an upcoming pancreatic disorder. Rom J Morphol Embryol 2019; 60:1343-1347. [PMID: 32239115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Pancreatic panniculitis represents a rare dermatological manifestation mainly due to a pancreatic disorder, but other etiologies are possible. Even rarer, it can occur prior to the clinical signs of the underlying disease, and its presence must orientate the investigations especially towards pancreas, liver and neuroendocrine system. We report a rare case of a 47-year-old male patient who presented to the Emergency Unit complaining about a two weeks-long-persistent pain in the upper abdomen and biliary vomiting. The medical history included alcohol abuse. Several days prior to the onset of these symptoms, the patient has noticed the occurrence of a nodular inflammatory lesion of 5∕3 cm on the right calf (this makes the case even rarer). Based on clinical aspect and high levels of pancreatic enzymes, acute pancreatitis was diagnosed. Contrast-enhanced abdominal computed tomography (CT) revealed a cystic pancreatic mass and dilated intrahepatic biliary ducts. Abdominal magnetic resonance imaging (MRI) revealed a cystic tumor of the pancreatic head and thrombosis of the portal vein, which increased the suspicion of pancreatic adenocarcinoma. Biopsy was performed from the calf nodular lesion, with the diagnosis of panniculitis. This case, besides its rarity, supports the clinical important value of a pancreatic workup in case of histologically proved panniculitis, even without pancreatic related symptoms.
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Affiliation(s)
- Irina Tica
- Department of Surgery, Faculty of Medicine, "Ovidius" University of Constanţa; Ist Department of Obstetrics and Gynecology, Emergency County Hospital, Constanţa, Romania;
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Oprea D, Ionescu EV, Stanciu LE, Oprea C, Badiu R, Iliescu MG. The severity of the articular deformities of the hands depending on the seropositivity in rheumatoid arthritis. ARS Medica Tomitana 2017. [DOI: 10.1515/arsm-2017-0035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background. Rheumatoid arthritis (RA), met in the literature also as chronic evolving polyarthritis, is a chronic inflammatory disease, which typically involves the small and medium joints, with a symmetric distribution. Clinical studies shown that a proportion of patients with RA, without measurable rheumatoid factors are a distinct entity from those patients with seropositive RA. Around one third of patients with RA are seronegative for those two serological markers, the rheumatoid factors (RF) and anti-citrullinated peptide antibodies (Anti-CCP). Hands are the most frequently affected in both seropositive and seronegative RA and the first joints involved in the inflammatory process are the metacarpo-phalangeal joints, IFP joints and the radiocarpian joint. The big joints become later symptomatic, after the small joints are affected. Materials and methods: 66 patients files and the personal records of the patients consecutively admitted in the Rheumatology Department of the Clinical Emergency County Hospital Constanta. Patients from county Constanta were included in the study, with diagnosis of rheumatoid arthritis (diagnosis confirmed at least 2 years ago), including both forms (seropositive and seronegative) of the disease. The complete clinical exam was done for the patients included in the study, following the identification of the active joint disease. The mechanical status of the joint was observed by a single evaluator for each of those 66 patients with RA, with special focus on the presence of the deformities / ankyloses of the hands joints. Therefore, there were evaluated: the mobility (the number of the joints with limited movements), deformities, ankyloses (the number of the joints without mobility). The joint mobility was assessed by counting the hand joints with limited movements and the worsening of the prehension function. The presence of the following hand deformities was followed: fingers in “swan neck”, “fusiform fingers”, the thumb “in Z”, and the aspect of “hand in the shape of a camel back”. For evaluating the painful or swollen joints we used: the 28 joint index, the overall evaluation of the disease activity - by the patient (Patient Global Assessment-PGA) and by the doctor (Medical Doctor Global Assessment- MDGA), the score of disease activity DAS 28 (DAS28 - Disease Activity Score 28), the index of the clinical activity of the disease (Clinical Disease Activity Index- CDAI), as well as the simplified index of activity of the disease (Simplified Disease Activity Index-SDAI). It was determined for each patient the plasma RF and anticitrullinated peptide antibodies. Results and discussion. As expected, there is a bigger frequency of female patients in both forms of the disease (seropositive and seronegative) and regarding males the recurrence is approximate equal between those two groups. By comparing the frequency of the joint deformities at hand level between the 2 groups of patients included in the study (seropositive PR and seronegative PR), we saw a superiority of these (with all their forms) in the patients with seropositive polyarthritis. Conclusions. The clinical study done in this work is completing the data offered by the studies of some dedicated authors, who analysed the characteristic elements of rheumatoid arthritis depending on seropositivity. Our results confirm the idea that seronegative rheumatoid arthritis has a more gentle clinical evolution and is a less destructive form of disease.
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Affiliation(s)
- Doiniţa Oprea
- Faculty of Medicine, University „Ovidius” of Constanţa , Romania
- Balnear and Rehabilitation Sanatorium Techirghiol, Constanţa , Romania
| | - Elena Valentina Ionescu
- Faculty of Medicine, University „Ovidius” of Constanţa , Romania
- Balnear and Rehabilitation Sanatorium Techirghiol, Constanţa , Romania
| | | | - Carmen Oprea
- Faculty of Medicine, University „Ovidius” of Constanţa , Romania
- Balnear and Rehabilitation Sanatorium Techirghiol, Constanţa , Romania
| | - Ruxandra Badiu
- Balnear and Rehabilitation Sanatorium Techirghiol, Constanţa , Romania
| | - Mădălina Gabriela Iliescu
- Faculty of Medicine, University „Ovidius” of Constanţa , Romania
- Clinical Rehabilitation Hospital, Eforie Nord , Romania
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Tucmeanu AI, Popescu DM, Ionescu EV, Oprea C, Mociu A, Iliescu MG. Increasing the quality of health management in Romania through specific consultancy services. ARS Medica Tomitana 2017. [DOI: 10.1515/arsm-2017-0019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Health management consultancy has become an important source of innovation in management, a bridge between the academic environment, companies and opinion-makers in the field. The objective of this work is to identify the success factors of a consultancy mission within the health system, with the proposal of direct investigation of the hypothesis regarding the positive association between the success of consultancy missions and the consultant’s professional integrity. The survey was carried out during January and February 2017, in Bucharest health units, by applying questionnaires to 68 managers both in the public and private system. The analyzed parameters were: the consultant’s professional integrity, the consultant's competency, the relations with the consultant, the correct definition of the mission, available financial resources, term observance, and related costs. The information obtained was statistically processed using the SPSS system. The answer options to the items in the questionnaire allowed statistical correlations, verifying the survey hypothesis regarding the association between success and professional integrity. Any consultancy mission entails negotiation skills from the consultant, as well as an open attitude, listening and communications skills. The environment created by the manager can even further influence the change acceptance.
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Affiliation(s)
- A. I. Tucmeanu
- “Valahia” University of Târgovişte, Târgovişte , Romania
| | | | - Elena Valentina Ionescu
- Techirghiol Balneal and Recovery Sanatorium, Techirghiol , Romania
- Faculty of Medicine, “Ovidius“ University of Constanţa, Constanţa , Romania
| | - Carmen Oprea
- Techirghiol Balneal and Recovery Sanatorium, Techirghiol , Romania
- Faculty of Medicine, “Ovidius“ University of Constanţa, Constanţa , Romania
| | - A. Mociu
- Ovidius Clinical Hospital, Constanța , Romania
| | - Mădălina Gabriela Iliescu
- Faculty of Medicine, “Ovidius“ University of Constanţa, Constanţa , Romania
- Rehabilitation Hospital of Eforie Nord, Constanţa , Romania
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Ionescu EV, Tica I, Oprea C, Iliescu DM, Petcu LC, Iliescu MG. ADIPONECTIN CORRELATION WITH BIOCLINICAL BENEFITS OF USING NATURAL THERAPEUTIC FACTORS IN KNEE OSTEOARTHRITIS. Acta Endocrinol (Buchar) 2017; 13:308-313. [PMID: 31149192 DOI: 10.4183/aeb.2017.308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Context and objective The new insights in the pathogenesis of osteoarthritis (OA) reveal the implications of adipocytokines. This study aims to analyze the correlations between the serum value of adiponectin and the clinical rehabilitation effects in patients diagnosed with knee OA, admitted and treated in the complex balneal resort of Techirghiol lake. Subjects and methods The prospective randomized clinical study included 23 patients in the study group, diagnosed with knee OA according to ACR criteria, and a matching control group of 23 subjects. Serum level of adiponectin (using ELISA technique), uric acid, triglycerides, cholesterol, HDL-cholesterol and clinical response using a visual analog scale (VAS) were evaluated in all patients on their admission day and after 10 days of balneal treatment. Control group benefited from the same procedures except for cold mud therapy and mineral water baths. Results Plasma adiponectin levels (23.73±6.44 ng/dL) were statistically higher (p<0.05) in the study group compared to the control group (18.15±6.49 ng/dL). The mean VAS in both groups was decreased (p<0.005) compared to the initial moment. Conclusions Cold peloidotherapy combined with physical therapy and balneal factors induces serum adiponectin elevation and improves knee pain in OA. Therapeutic properties of Techirghiol mud still need further research.
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Affiliation(s)
- E V Ionescu
- Balneal and Rehabilitation Sanatorium of Techirghiol, "Ovidius" University of Constanta, Romania
| | - I Tica
- Faculty of Medicine - Medical Department, Constanta, Romania
| | - C Oprea
- Balneal and Rehabilitation Sanatorium of Techirghiol, "Ovidius" University of Constanta, Romania
| | - D M Iliescu
- Faculty of Medicine - Medical Department, Constanta, Romania
| | - L C Petcu
- Faculty of Dentar Medicine - Departament of Biophysics, Biostatistics and Medical Informatics, Constanta, Romania
| | - M G Iliescu
- Departament of Rehabilitation Balneophysiokinetotherapy, Constanta, Romania
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