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Aims: Ultrasound (US) examination is an important tool in the diagnosis of arteriovenous (AVF) stenoses; different US measures are available for assessing the severity of stenoses. The aim of our study was to analyse risk factors and consequences of AVF stenosis and its severity and to compare the usefulness of different US measures of stenoses' severity.Material and Methods: Ninety-seven prevalent patients from a single dialysis centre with patent AVF were included. We recorded history of disease, clinical and laboratory data. US was used to diagnosis the stenosis and to measure blood flow in the brachial artery, resistivity index (RI), and the diameter of the vessels (arteries, anastomosis, venous outflow).Results: Stenosis was present in 54.64% of the patients (59.6% juxtaanastomotic). Stenosis patients had higher age, lower diameter of the brachial artery, lower anastomosis diameter, and lower diastolic blood pressure (DBP). Atherosclerosis, delayed maturation of AVF, and statin treatment were more prominent in the stenosis group. Logistic regression disclosed delayed maturation, cholesterol, atherosclerosis, and DBP as significant predictors of stenosis. When severe stenosis was measured by the diameter reduction, stenosis patients had higher age, lower HDL cholesterol, and poorer dialysis efficacy. Flow in the brachial artery and RI were less useful for identifying risk factors or differences in outcome.Conclusions: Prevalence of stenosis was high in our cohort, more than half of the patients having some degree of stenosis. Risk factors for stenosis were related to atherosclerosis, low DBP, and delayed maturation of AVF. Diameter of stenosis is the most useful marker of severity. [ABSTRACT FROM AUTHOR]

The objective of the study was to examine the prognostic factors involved in the survival of patients with acquired aplastic anemia. Methods. We included in the study 80 patients diagnosed with aplastic anemia. We analyzed the prognostic factors related to the patient and disease. Results. Survival at 2 months, 5 years and 10 years was of 86.1%, 67.5% and 31.3%. By multivariate analysis, we obtained: severity of the disease, duration until the start of treatment, major bleeding and CsA were risk factors for death in 10 years. [ABSTRACT FROM AUTHOR]

Aims: The aim of the study was to assess the evolution of time-intensity curves parameters of contrast-enhanced ultrasonography (CEUS) after 6 months of conventional treatment in early arthritis patients with wrist involvement. Material and methods: Patients diagnosed with early rheumatoid arthritis or undifferentiated arthritis on the basis of 2010 ACR/EULAR classification criteria, with bilateral wrist arthritis and both radiocarpal (RC) and intercarpal (IC) synovial hypertrophy identified by grey-scale ultrasonography, were enrolled. Synovial hypertrophy was semi-quantitatively scored (grade 0-3) by grey-scale and by Power Doppler at wrist level. CEUS was performed using Sonovue. The region of interest was selected as the area corresponding to the synovial hypertrophy of the RC and IC joints. Time-intensity curves parameters were calculated with Contrast Dynamic Software. The minimum and the maximum values of Peak, area under the curve (AUC), and slope were selected for each patient at baseline and after 6 months of conventional treatment. The difference between the visits was noted as "Λ ". Results: Eleven patients fulfilled the inclusion criteria. Maximum time-intensity curves parameters' difference significantly decreased at 6 months: Peak (30.00±5.90% vs 23.22±5.22%, p=0.008), AUC (1206.08±216.91%s vs 949.13±280.12%s, p=0.04) and slope (1.6 (1.4;2.3) %/s vs 1(0.7;1.2) %/s, p=0.03). Moderate correlations were found between maximum Λ Peak, maximum Λ AUC and maximum Λ Power Doppler grade (r=0.44, p=0.17; r=0.46, p=0.16, respectively). Conclusions: Peak and AUC for joints that had high baseline values significantly decreased following treatment with conventional synthetic drugs in EA patients with wrist arthritis. This decrease in Peak and AUC was moderately correlated with a decrease in US parameters. The joint with the highest values of these parameters may be used for evaluation of EA patients at follow-up. [ABSTRACT FROM AUTHOR]

Background. Medical students' physical activity preferences are important to explore, as this population subgroup represents future models in society. Aims. To explore the infrastructure and community programs accessed by medical students when being physically active. Methods. Online questionnaire administered to medical school students in Cluj-Napoca and Iasi. Results. 65% of the options expressed accessed free-of-charge infrastructure (outdoor, university and home or around home). Students in the 1st and 2nd years of study accessed the University infrastructure significantly more than their 3rd to 6th year peers. Only 16% of the respondents accessed community programs for practicing physical activity in the last 12 months. Conclusions. Medical school students prefer free-of-charge (outdoor) sport infrastructure and have a very low participation rate in community physical activity programs. Efforts should be directed into research and policy for ensuring proper physical activity services to medical school students. [ABSTRACT FROM AUTHOR]

Aim: The aim of our study was to investigate the understanding of statistical terms commonly used in lectures presented at summer schools for residents and young specialists. Material and Method: A survey was distributed to all the participants at the "Diabetic neuropathy from theory to practice" Summer School, 2014. The program was addressed to residents or young specialists in diabetes, neurology, surgery, and orthopedic from Romania. The survey consists of 6 multiple-choice questions and the first four questions evaluate the understanding of statistical terms. Results: There were 51 (42.5%) participants who completed the questionnaires. From 204 total questions 81 (39.7%) had correct answers. At the question 1, where relative risk was evaluated, only 3 (5.9%) respondents answered correctly while at the question 2 (number need to treat) about 78.4% (40) of answers were correct. At the question 3 (sensitivity), 22 (43.1%) respondents answer correct while at the question 4 (Receiver Operating Characteristic curves) only 16 (31.4%) respondents provided a correct answer. Tire overall mean score of correct answers was 1.56±0.91. Conclusion: Our study showed that young specialists who participated to the survey were not familiarized with simple statistical terms commonly used in presentations. [ABSTRACT FROM AUTHOR]

Diabetic kidney disease is an important complication of type 2 diabetes mellitus (T2DM) and has an economic impact in growth due to the increasing prevalence of T2DM. Identification of diabetic kidney disease risk factors is a priority for both the patient and the healthcare system. The aim of our study was to rank the risk factors using VIKOR method applied on a database with patients with T2DM. Data from 53 T2DM patients were analyzed with VIKOR method. 18 possible risk factors were taken in consideration as alternatives and four separate criteria of renal function: two for albumin excretion - quantified as urinary albumin/creatinine ratio (UACR) and two for GFR (glomerular filtration rate). In the top of the VIKOR method hierarchy was serum adiponectin followed by triglycerides, systolic blood pressure, duration of diabetes and age. Malondialdehyde and HDL-cholesterol influenced chronic kidney disease as protective factors (18th, respective 17th position in the hierarchy). VIKOR method brought new information about the similarity between the positions of some factors in the hierarchy. [ABSTRACT FROM AUTHOR]

Introduction. Experimental and clinical studies suggest an inverse relationship between adiponectin and oxidative stress. In this study we evaluated the relationship between serum adiponectin and oxidative stress in patients with type 2 diabetes mellitus with diabetic neuropathy. Material and methods. We included in this study 26 patients with type 2 diabetes mellitus and diabetic neuropathy, from the outpatient settings of the Clinic of Nephrology Mihai Manasia Cluj and 48 patients with type 2 diabetes without diabetic neuropathy. Exclusion criteria were: chronic renal disease other than diabetic nephropathy, diabetic nephropathy stage 4-5 KDOQI, the presence of acute inflammatory/infectious, uncontrolled hypertension. Results. In patients with neuropathy plasma adiponectin was significantly correlated with lipid peroxides-malondialdehyde r=-0.42, p=0.03, with catalase r=0.56, p=0.009, with high-density lipoprotein cholesterol r=0.53, p=0.005 and glycated hemoglobin r=-0.54, p=0.005. Lipid peroxides - malondialdehyde was significantly correlated with age r=-0.46, p=0.02, glycated hemoglobin r=-0.54, p=0.005; abdominal circumference r=-0.39, p=0.05. Superoxide dismutase was significantly correlated with blood glucose r=-0.84, p<0.001. In multivariate linear regression adiponectine was dependent of lipid peroxides - malondialdehyde (p=0.04), body mass index (p=0.002), high-density lipoprotein cholesterol (p=0.002) and glycated hemoglobin (p<0,001). In patients without neuropathy, multivariate linear regression found that adiponectine was dependent of urinary albumin/urinary creatinin report (p<0.001), high-density lipoprotein cholesterol (p<0.001), body mass index (p=0.009) and C-reactive protein (p=0.001). There were no significant differences in levels of adiponectin and oxidative stress parameters between diabetic neuropathy and without neuropathy group. Conclusion. In patients with diabetes mellitus type 2 and diabetic neuropathy, low level of oxidative stress was correlated with high level of adiponectin. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Both kidney expression and soluble serum Klotho are influenced by chronic kidney disease (CKD) and diabetes. Serum Klotho is a yet poorly explored biomarker. We describe, for the first time to our knowledge, serum Klotho in diabetic patients with CKD and its relationship to vascular endothelial growth factor A (VEGF-A). Design and methods: We included 43 controls and 146 diabetic patients with different stages of CKD. Laboratory evaluation, urinary albumin/creatinine ratio (UACR), Klotho (ELISA), VEGF-A (ELISA) were performed. Results: Klotho was 0.40(0.10–1.30)ng/mL in diabetic patients without CKD and 0.80(0.30–1.30)ng/mL in controls, p=0.20; VEGF-A was higher in diabetic patients 73.85(57.32–119.00)pg/mL than in controls 43.20(30.1–65.9)pg/mL, p<0.0001. Klotho increased with CKD stage: 0.2(0.10–0.40)ng/mL in CKD 1/2, 0.60(0.20–1.1)ng/mL in CKD 3/4 and 1.45(0.425–2.90)ng/mL in dialysis patients, p<0.0001; it also increased with decreasing glomerular filtration rate (GFR). Klotho was lower in albuminuric (UACR>30mg/g) patients 0.20(0.10–0.70)ng/mL than in normoalbuminuric (UACR<30mg/g) ones 0.50(0.20–1.30)ng/mL, p=0.03; lowest Klotho was found in microalbuminuric (UACR 30–300mg/g) patients, p=0.07. VEGF was lower in microalbuminuric patients but was not influenced by GFR. In diabetic patients but not in controls, Klotho correlated to VEGF-A (r=0.29, p=0.0003); in multiple regression VEGF-A was the only significant predictor of Klotho: b=0.27, 95%CI (0.01–0.04), p=0.001. Conclusions: In diabetic patients, Klotho is decreased in early CKD and increases thereafter, paralleling reduced GFR. VEGF-A is higher in diabetic patients than in controls. Both Klotho and VEGF-A are decreased in the presence of microalbuminuria. In diabetes, Klotho strongly correlates to VEGF-A. [Copyright &y& Elsevier]

Background. Adiponectin, an anti-inflammatory and insulin-sensitizing cytokine, has been shown to reduce proteinuria and glomerulosclerosis in experimental models. We assessed the relationship of plasma adiponectin to the progression of kidney disease in type 2 diabetes (T2D) patients. Methods. T2D nonnephrotic patients with glomerular filtration rate (GFR) >30 ml/min and without acute cardiovascular/inflammatory conditions were included. Laboratory standard evaluation, urinary albumin/creatinine ratio (UACR), total plasma adiponectin, and CRP (C-reactive protein) were determined at inclusion and the end of study. Results. Eighty-six patients (62.79% male) were followed up for 20.53±5.46 months. Baseline GFR was 72.85±26.29 ml/min and UACR was 20.53 (interquartile range 6.82-86.39) mg/g. At baseline adiponectin was significantly correlated to UACR (r =0.40, p =0.0001), HDL cholesterol (r =0.30, p =0.005), GFR (r =− 0.23, P =0.04), body mass index (BMI) (r =− 0.26, P =0.02) and waist circumference (r =−0.27, p =0.01). In multiple regression UACR ( p =0.0003) and BMI ( p =0.03) were significantly related to baseline adiponectin. The progression of kidney disease was estimated as the difference (D) between end and baseline UACR/month and between end and baseline GFR/month. None of the baseline parameters correlated to ΔGFR, but adiponectin inversely (r =− 0.26, p =0.02) correlated to ΔUACR. In multiple regression only adiponectin ( p <0.0001) predicted ΔUACR. A computed progression index (PI) resulting from a linear combination of GFR and UACR was also used to assess progression. Baseline adiponectin was significantly correlated to ΔPI between end of study and baseline (r =− 0.43, p <0.0001), and predicted Δ PI in multiple regression ( p =0.009). Conclusion. Low plasma adiponectin predicts progression of kidney disease in T2D patients. [ABSTRACT FROM AUTHOR]

The purpose of multicriteria decision models is to help decision maker to evaluate each alternative and to rank them in descending order of performance. A problem can appear when the criteria are not independent. This study explores the effect of multicollinearity between criteria in decision making with the technique for order preference by similarity to ideal solution (TOPSIS) and proposes an algorithm to resolve this problem. The algorithm was based on the application of the TOPSIS method several times until all the components are uncorrelated. The algorithm was applied on two examples from medical field to demonstrate its effectiveness. After we applied the purposed algorithm on two examples the index result from TOPSIS was equal correlated with all the criteria. [ABSTRACT FROM AUTHOR]

Aim: The physico-chemical properties of an experimental composite resin used for indirect dental restorations were investigated. The goal was to evaluate the variation of water sorption and solubility of the composite specimens during a 7 day period of immersion and to assess the effect of an additional post-curing treatment on these properties. Material and Methods: The specimens were prepared and investigated according to the ISO standard 4049:2000. Two group of specimens were studied i.e. light-cured and post-cured (group A) samples and light-cured (group B) samples. Results: Significant statistical differences were observed regarding water sorption in both groups (p<0.05), the mean values being higher in the first days of immersion. Regarding the water solubility, negative values were obtained, that varied throughout the entire period of immersion; the solubility is masked by the higher values of water sorption. Conclusion: All the specimens present relative high water sorption values especially during the first three days of immersion. The additional post-curing treatment decreases the water sorption and solubility values. [ABSTRACT FROM AUTHOR]

Diabetic autonomic neuropathy is probably the most undiagnosed but serious complication of diabetes. The main objectives were to assess the prevalence of peripheral and autonomic neuropathy in a population of diabetic patients, analyze it in a real-life outpatient unit scenario and determine the feasibility of performing SUDOSCAN tests together with widely used tests for neuropathy. A total of 33 patients were included in the study. Different scoring systems (the Toronto Clinical Neuropathy Score—TCNS; the Neuropathy Disability Score—NDS; and the Neuropathy Symptom Score—NSS) were applied to record diabetic neuropathy (DN), while the SUDOSCAN medical device was used to assess sudomotor function, detect diabetic autonomic neuropathy and screen for cardiac autonomic neuropathy (CAN). Fifteen (45.5%) patients had sudomotor dysfunction. The SUDOSCAN CAN risk score was positively correlated with the hands' electrochemical sweat conductance (ESC), diastolic blood pressure (DBP), the level of the glycated hemoglobin, as well as with the TCNS, NDS and NSS. Performing SUDOSCAN tests together with other tests for DN proved to be a feasible approach that could be used in daily clinical practice in order to screen for DN, as well as for the early screening of CAN, before more complex and time-consuming tests. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) causes specific hormonal disturbances, such as variations in leptin and testosterone levels and function. These disturbances can promote errors in signaling interaction and cellular information processing and can be implicated in the pathogenesis of atherosclerosis. This study investigates the factors that affect leptin in CKD patients and examines how leptin is related to markers of vascular disease. We conducted a cross-sectional study of 162 patients with CKD in pre-dialysis and dialysis stages. We recorded clinical and laboratory data, including leptin, testosterone, and subclinical atherosclerosis markers like brachial–ankle pulse wave velocity (ba PWV) in pre-dialysis CKD patients and flow-mediated vasodilation (FMD) and nitroglycerin-mediated vasodilation (NMD) in hemodialysis (HD) patients. Leptin was significantly correlated with testosterone in CKD pre-dialysis stages (p < 0.001) and also in HD (p = 0.026), with adipose tissue mass in pre-dialysis stages (p < 0.001), and also in HD (p < 0.001). In women HD patients, leptin correlated with NMD (p = 0.039; r = −0.379); in all HD patients, leptin correlated with C reactive protein (p = 0.007; r = 0.28) and parathormone (p = 0.039; r = −0.220). Our research emphasizes the connection between leptin, adipose tissue, and testosterone in all stages of CKD. Leptin was associated with NMD in HD women and correlated with inflammatory syndrome and parathyroid hormone in all HD patients. [ABSTRACT FROM AUTHOR]

Pro-B amino-terminal natriuretic peptide (NT-proBNP) is a diagnostic marker for heart failure (HF), a severe complication of chronic kidney disease (CKD). However, its significance in CKD is not clear, as other factors, such as renal function, may also have an impact. Recent studies have shown that ghrelin treatment is effective in HF in the general population, but the impact of ghrelin on cardiac function in CKD patients is still unknown. Our study aimed to investigate the factors associated with NT-proBNP in pre-dialysis CKD patients and to evaluate the correlation between NT-proBNP and ghrelin and acyl-ghrelin, molecules determined using ELISA methods. In a cross-sectional observational study, we included 80 patients with pre-dialysis CKD, with a mean age of 68 years and 50% men. The median values for NT-proBNP were 351.8 pg/mL, for acyl ghrelin 16.39 pg/mL, and for ghrelin 543.32 pg/mL. NT-proBNP was correlated with ghrelin (p = 0.034, r = 0.24), acyl-ghrelin (p = 0.033, r = −0.24), estimated glomerular filtration rate (p = 0.027, r = −0.25), serum urea (p = 0.006, r = 0.31), and ferritin (p = 0.041, r = 0.28). In multivariate analysis, ghrelin (p = 0.040) and blood urea (p = 0.040) remained significant predictors for NT-proBNP levels. NT-proBNP was a significant predictor for acyl-ghrelin (p = 0.036). In conclusion, in pre-dialysis CKD patients, a high value of NT-proBNP was associated with a high value of total ghrelin and a low value of acyl-ghrelin. [ABSTRACT FROM AUTHOR]

Diabetic foot ulcer non-reimbursed treatment depends on multiple factors, including the patient's buying behaviors. Factors affecting buying behaviors for the removable off-loading devices are not completely understood. The aim of this study was to investigate the patients' buying behaviors of the removable off-loading devices and their influence on the DFU treatment outcomes remotely monitored during the COVID-19 pandemic. In this prospective observational study, 45 patients affected by diabetic peripheral neuropathy, with/without peripheral arterial disease, with foot ulcers treated with removable devices were remotely monitored. Prefabricated removable cast walkers, insoles, and therapeutic footwear were the proposed off-loading methods. Patients affected by high blood pressure (p = 0.018), peripheral arterial disease (p = 0.029), past amputations (p = 0.018), and ulcer on the left foot (p = 0.007) bought removable cast walkers. Rural provenience (p = 0.011) and male (p = 0.034) did not buy a removable walker. The healing rate was 69.4%, while the median healing time was 20 weeks. High blood pressure negatively influenced healing time (p = 0.020). Patients who bought the most efficient treatment method for DFUs were females from urban provenience, with amputation in the past, with peripheral arterial disease, and with high blood pressure. [ABSTRACT FROM AUTHOR]

End-stage renal disease (ESRD) is the final stage of chronic kidney disease. This study explored the association between human leukocyte antigen (HLA) and ESRD. The interaction between genetic and environmental factors may also play a role in the development of ESRD. The study included 2392 ESRD patients who were awaiting renal transplantation. Blood samples were genotyped by SSOP and SSP-PCR methods. Multivariate logistic regression analysis showed that HLA-A*11 (p = 0.027), HLA-A*34 (p = 0.017), HLA-A*69 (p = 0.012), HLA-B*41 (p < 0.001), HLA-B*50 (p = 0.004), HLA-DRB1*10 (p = 0.027), and HLA-DRB1*14 (p = 0.004) were positively associated with ESRD (OR > 1); HLA-DRB1*07 (p < 0.001), HLA-DRB1*08 (p = 0.005), and HLA-DRB1*13 (p < 0.001) were protective against ESRD (OR < 1); and the three-locus haplotype HLA-A*02–B*41–DRB1*03, containing one susceptible allele, was strongly associated with ESRD (p < 0.001, OR = 3.15). In conclusion, this retrospective analysis of HLA typing in patients with ESRD of various etiologies suggests that molecular data on the HLA polymorphism should be collected in order to identify high-risk ESRD patients and to improve graft survival after kidney transplantation. [ABSTRACT FROM AUTHOR]

Foot orthotics prescription is based on the foot functioning paradigms with tissue stress theory being in avant-garde. The main goal of orthotic therapy is to reduce the internal tissue's pathological stresses in the foot structures. Traditionally, ultrasound scanning technique depicts anatomic related data of both common and uncommon pathology encountered in the clinical practice, helping in diagnosing, treating and evaluating, which are equally important for the practitioners. Its accessibility, compared to biomechanical modelling, makes this technique a valuable tool in the field of foot and ankle disorders. Despite its user-dependent limitation, the ongoing technical progress improves the ability of ultrasonography as a highly advanced procedure in musculoskeletal imaging, being also a valuable searching tool for musculotendinous mechanics or morphological changes as a result of a conservative intervention. The aim of the present work was to perform a review of the state of the art concerning the usefulness of ultrasonography in the study of foot orthotic therapy and to analyze its effectiveness. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases (CVD) are the first cause of chronic kidney disease (CKD) mortality. For personalized improved medicine, detecting correctable markers of CVD can be considered a priority. The aim of this study was the evaluation of the impact of nutritional, hormonal and inflammatory markers on brachial-ankle Pulse Wave Velocity (PWV) in pre-dialysis CKD patients. A cross-sectional observational study was conducted on 68 pre-dialysis CKD patients (median age of 69 years, 41.2% with diabetes mellitus, 52.9% male). Laboratory data were collected, including levels of prolactin, triiodothyronine, TGF α, IL-6, and IL-1β. The high values of brachial-ankle PWV were associated with reduced muscle mass (p = 0.001, r = −0.44), low levels of total cholesterol (p = 0.04, r = −0.26), triglycerides (p = 0.03, r = −0.31), triiodothyronine (p = 0.04, r = −0.24), and prolactin (p = 0.02, r = −0.27). High PWV was associated with advanced age (p < 0.001, r = 0.19). In the multivariate analysis, reduced muscle mass (p = 0.018), low levels of triiodothyronine (p = 0.002), and triglycerides (p = 0.049) were significant predictors of PWV, but age (p < 0.001) remained an important factor. In conclusion, reduced triiodothyronine together with markers of malnutrition and age were associated with PWV in pre-dialysis CKD patients. [ABSTRACT FROM AUTHOR]

Introduction: This research aims to describe a progressive pattern of ultrasound placental remodeling in patients with a history of SARS-CoV-2 infection during pregnancy. Materials and Methods: This was a longitudinal, cohort study which enrolled 23 pregnant women with a history of former mild SARS-CoV-2 infection during the current pregnancy. Four obstetricians analyzed placental ultrasound images from different gestational ages following COVID infection and identified the presence and degree of remodeling. We assessed the inter-rater agreement and the interclass correlation coefficients. Pathology workup included placental biometry, macroscopic and microscopic examination. Results: Serial ultrasound evaluation of the placental morphology revealed a progressive pattern of placental remodeling starting from 30–32 weeks of gestation towards term, occurring approximately 8–10 weeks after the SARS-CoV-2 infection. Placental changes—the "starry sky" appearance and the "white line" along the basal plate—were identified in all cases. Most placentas presented normal subchorionic perivillous fibrin depositions and focal stem villi perivillous fibrin deposits. Focal calcifications were described in only 13% of the cases. Conclusions: We identified two ultrasound signs of placental remodeling as potential markers of placental viral shedding following mild SARS-CoV-2. The most likely pathology correspondence for the imaging aspect is perivillous and, respectively, massive subchorionic fibrin deposits identified in most cases. [ABSTRACT FROM AUTHOR]

Background and aim. Cigarette smoking has negative effects on general health, including oral health. The aim of our study was to assess the correlations between nicotine dependence, exhaled carbon monoxide levels and oral hygiene status. Methods. Smoker and non-smoker participants were enrolled in this observational study. The Fagerström test was used to classify nicotine dependences: low (score: 0-3), medium (score: 4-6) or high (score: 7-10). The oral hygiene status was classified according to the oral hygiene indices of plaque, calculus and gingival inflammation. Lastly, the exhaled carbon monoxide levels were measured with a MicroSmokelyzer (Bedfont Scientific Ltd., Kent, United Kingdom). Results. Sixty five participants (50 smokers in the study group and 15 nonsmokers in the control group) were enrolled between 11th and 29th of January 2016. No statistical differences were observed between the study group and the control group in terms of age (mean age±SD 23.5±1.9 and 24.0±1.5, respectively) or gender (50% and 26.6%, respectively). A statistically significant difference was observed between the 2 groups in terms of plaque, (p=0.036), calculus (p=0.001) and gingival indices (p<0.001). A positive correlation was found between the exhaled levels of carbon monoxide and the general Fagerström score (r=0.97, p<0.001) or the Fagerström score in smokers (r=0.93, p<0.001); a negative correlation was observed between the exhaled carbon monoxide levels and the number of tooth brushings daily (r=-0.41, p=0.001). The plaque index was statistically significantly associated with the exhaled carbon monoxide levels (p=0.008), general Fagerström score (p=0.016) and number of tooth brushings daily (p<0.001). The calculus and gingival indices were statistically significantly associated with the exhaled carbon monoxide levels (p<0.001), general Fagerström score (p<0.001) and score in smoker participants (p=0.029 and p=0.001, respectively) as well as the number of tooth brushings daily (p<0.001). Conclusion. Our study found a significant association between the plaque, calculus and gingival indices and smoking. Moreover, nicotine dependence was significantly associated with the number of daily tooth brushings and the gingival index. [ABSTRACT FROM AUTHOR]

The present analysis suggests a need for further research, in order to potentially reassess the current cardiac contraindications for ET treatment and to bring more evidence regarding the safety of ET application in patients with different cardiac diseases. Even though ET is widely used, research is scarce regarding its effects in patients with associated arrhythmias or ischemic heart disease, and it is not known whether ET itself induces or aggravates certain arrhythmias during or immediately after therapy. Keywords: electrotherapy; contraindications; cardiac arrhythmia; ischemic heart disease; knee osteoarthritis EN electrotherapy contraindications cardiac arrhythmia ischemic heart disease knee osteoarthritis 1690 8 11/17/22 20221101 NES 221101 1. Each patient was clinically evaluated and was furthermore prescribed a PT program (ET, massage and exercise therapy) by their doctors, based on their clinical judgment and with respect to the patient's contraindications. [Extracted from the article]

As the Neonatal Hearing Screening Programme is still being implemented in Romania, it is important to study parent satisfaction because the success of the hearing screening depends on the parent's cooperation. We aimed at validating the Romanian version of The Parent Satisfaction Questionnaire with A Neonatal Hearing Screening Programme. This study included 137 participants and a sample of 30 participants who filled out a second copy of the questionnaire a month later. We recorded high levels of overall satisfaction, but smaller levels of satisfaction for each of the four dimensions of the questionnaire: the satisfaction with the information, the medical staff responsible for hearing testing and the appointment schedule. The Romanian version of the questionnaire showed a good internal consistency, strong test-retest reliability and positive significant correlations between overall satisfaction with all dimensions of the questionnaire. The Parent Satisfaction Questionnaire with the Neonatal Hearing Screening Programmeme proved to be valid and reliable for assessing parent satisfaction with the hearing screening. [ABSTRACT FROM AUTHOR]

Aim: To assess endothelial cell selective adhesion molecule (ESAM) as predictor of cardiovascular mortality in diabetic dialysis patients (DDPs). Methods: ESAM, clinical and laboratory parameters were assessed in 73 DDP. Cardiovascular mortality was recorded in a 2 years’ prospective observational study. Results: Baseline ESAM was 17.1 (10.05–24.8) ng/ml and was correlated to phosphate (r = −0.42,p = 0.008), parathormone (r = −0.36,p = 0.048), albumin (r = −0.24,p = 0.048). ESAM significantly predicted cardiovascular death in univariate [HR = 1.03, 95% CI (1.006–1.054),p = 0.01] and multivariate [HR = 1.034, 95% CI (1.003–1.066),p = 0.03] Cox analysis. Time to cardiovascular death was shorter for patients with ESAM >12.44 ng/ml,p = 0.0045. Conclusion: ESAM is an independent predictor of cardiovascular mortality in DDP. [ABSTRACT FROM PUBLISHER]

Background: Arteriovenous fistula (AVF) failure due to thrombosis is a major cause of morbidity in patients undergoing regular hemodialysis (HD). Advanced glycation end products (AGEs) and their receptor (RAGE) might contribute to inflammation, neointimal hyperplasia, and thrombosis. RAGE has a C-truncated secretory receptor form, called soluble RAGE (sRAGE). In this study, we aimed to evaluate the association of serum sRAGE with AVF failure due to thrombosis in HD patients. Methods: Eighty-eight prevalent HD patients with functional AVF were included in the study. The presence of stenosis, clinical and laboratory data, and serum sRAGE was evaluated at inclusion. sRAGE concentration was measured by a competitive enzyme-linked immunosorbent assay, and stenosis was detected by ultrasound. Patients were prospectively followed up for 36 months. During this period, AVF failure (defined as the absence of blast or palpable thrill and impossible cannulation with 2 needles because of complete thrombosis) was noted and thrombosis was certified by ultrasound examination. Results: During follow-up, 16 (18.18%) patients lost their vascular access due to thrombosis. In multivariate Cox regression analysis, sRAGE was a significant predictor of vascular access thrombosis (hazard ratio = 1.15, 95% confidence interval: 1.03–1.25, p = 0.012). Kaplan-Meier analysis showed a significantly lower AVF patency time in patients with sRAGE >16.78 ng/mL than those with sRAGE <16.78 ng/mL (p = 0.02). In the subgroup of patients with stenosis at baseline, sRAGE, serum albumin, obesity, and ischemic heart disease were associated with thrombosis. Conclusion: In our study, baseline, systemic sRAGE is associated with the occurrence of thrombosis of AVF, and this marker has a significant impact on AVF survival. [ABSTRACT FROM AUTHOR]

Portable, custom-made electronic dynamometry for the foot and ankle is a promising assessment method that enables foot and ankle muscle function to be established in healthy participants and those affected by chronic conditions. Diabetic peripheral neuropathy (DPN) can alter foot and ankle muscle function. This study assessed ankle toque in participants with diabetic peripheral neuropathy and healthy participants, with the aim of developing an algorithm for optimizing the precision of data processing and interpretation of the results and to define a reference frame for ankle torque measurement in both healthy participants and those affected by DPN. This paper discloses the software chain and the signal processing methods used for voltage—torque conversion, filtering, offset detection and the muscle effort type identification, which further allowed for a primary statistical report. The full description of the signal processing methods will make our research reproducible. The applied algorithm for signal processing is proposed as a reference frame for ankle torque assessment when using a custom-made electronic dynamometer. While evaluating multiple measurements, our algorithm permits for a more detailed parametrization of the ankle torque results in healthy participants and those affected by DPN. [ABSTRACT FROM AUTHOR]

Inactivity negatively influences general health, and sedentary behaviour is known to impact the musculoskeletal system. The aim of the study was to assess the impact of time spent in active and sedentary behaviour on foot muscle strength. In this observational study, we compared the acute effects of one day of prolonged sitting and one day of low-to-moderate level of activity on ankle torque in one group of eight healthy participants. Peak ankle torque was measured using a portable custom-made electronic dynamometer. Three consecutive maximal voluntary isometric contractions for bilateral plantar flexor and dorsiflexor muscles were captured at different moments in time. The average peak torque significant statistically decreased at 6 h (p = 0.019) in both static and active behaviours, with a higher average peak torque in the active behaviour (p < 0.001). Age, gender, body mass index and average steps did not have any significant influence on the average value of maximal voluntary isometric contraction. The more time participants maintained either static or active behaviour, the less force was observed during ankle torque testation. The static behaviour represented by the sitting position was associated with a higher reduction in the average peak ankle torque during a maximal voluntary isometric contraction when compared to the active behaviour. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to detect the types of the cervix lesions and to establish the correlations between age, environment of origin, diagnosis and gravity of the lesions. Methods: In the period 2009-2012, all cervical secretions from female subjects presented at Integrated Outpatient Unit, of the Clinical Hospital for Infectious Diseases, Cluj-Napoca, Romania were tested by Babeş-Papanicolaou examination. Babeş-Papanicolaou cytological smear was performed according to the 2001 Bethesda System criteria. Results: From 3153 cervical secretions (2736 female subjects from urban areas and 417 female subjects from rural areas) with age 10 - 87 years, 2899 (91.9%) smears (372 women from rural area and 2527 women from urban area) had normal appearance. Premalignant or malignant lesions (positive cases) were detected in 254 (8.1%) smears (45 (12.1%) cases from rural area, 209 (8.3%) cases from urban area). In the urban area, most positive cases were recorded in the age range of 45-54 years, while in the rural areas in the age range of 35-44 years. The multivariate logistic regression analysis showed that environment and age significantly influenced the occurrence of positive cases (OR=1.44 95% CI 1.02-2.02, p=0.04 for rural area, OR=0.71 95% CI 0.60-0.85, p<0.001 for age). The correlation between age and the degree of severity diagnosis (r=-0.09, p=0.14) was not significant. Conclusions: Cervical lesions detected through Babeş-Papanicolaou test in adult women are more common in the rural area. [ABSTRACT FROM AUTHOR]

Objectives: In this prospective, randomized trial in patients with acute myocardial infarction (AMI) admitted for primary percutaneous coronary intervention (PPCI), loaded with 600 mg clopidogrel, we hypothesized that eptifibatide administered downstream of the coronary occlusion leads to a lower degree of microvascular cbstruction compared with no additional eptifibatide. Methods: Fifty patients with AMI, loaded with 600 mg of clopidDgrel at the first hospital contact, with occlusion of the left anterior descending artery (LAD), were randomized to an eptifibatide group (EG) or a control group (CG). In both groups, stenting was performed after thrombus aspiration. Microvascular reperfusion was assessed by angiography, electrocardiography, and transthoracic Doppler ultrasonography of the LAD. Results: TIMI myocardial perfusion grade 2-3 was not different between the EG (72%) and the CG (E;4%) (p = 0.31). ST segment resolution >70% was similarly detected in both groups (32 vs. 40%; p = 0.56). The mean diastolic deceleration time did not differ significantly between the CG (856.36 ± 397.88 ms) and the EG (935.72 ± 252.22ms) (p = 0.41). Multivariate logistic regression revealed no significant influence of the treatment with eptifibatide on ST segment resolution (OR 0.47; 95% Cl 0.11-2.10, p = 0.32), TIMI myocardial perfusion (OR 0.52; 95% Cl 0.1 0-2.59, p = 0.42), and diastolic deceleration time (OR 0.21; 95% Cl 0.03-1.51, p = 0.12). Conclusions: In AMI patients loaded with 600 mg of clopidogrel undergoing PPCI, intracoronary administration of eptifibatide does not clearly improve microvascular obstruction. [ABSTRACT FROM AUTHOR]

Abstract: Aims: Our study addressed the influence of early inflammatory stages of diabetic kidney disease: leukocyte adhesion and monocyte activation (as assessed by intercellular leukocyte adhesion molecule-ICAM-1 and monocyte chemoatractant protein-MCP-1) on the degree of albuminuria. Plasma levels of adiponectin, a possible anti-inflammatory counteracting mechanism, were also studied in correlation to the above-mentioned cytokines. Methods: 79 consecutive type 2 diabetic outpatients and 46 controls were included. Routine laboratory analysis, urinary albumin to creatinine ratio (uACR), plasma adiponectin, plasma ICAM-1 and urinary MPC-1 were assessed. Results: In multiple regression ICAM-1 (p =0.004) and adiponectin (p =0.04) were the main determinants of uACR. Plasma adiponectin positively correlated to ICAM-1 (p =0.03, r =0.24). In albuminuric patients (uACR ≥30mg/g) plasma adiponectin was significantly higher compared to normoalbuminuric ones (uACR <30mg/g). In albuminuric patients the main determinants of uACR were plasma ICAM-1 and adiponectin. In multiple regression ICAM-1 is the only one that retains statistical significance (p =0.02). Urinary MCP-1 did not correlate to uACR. Conclusions: In our type 2 diabetic patients, plasma levels of ICAM-1 and adiponectin are predictive for albuminuria. Urinary MCP-1 does not correlated to uACR. Plasma adiponectin positively correlates to adhesion molecule ICAM-1 in our cohort. [Copyright &y& Elsevier]

Background. Coenzyme Q10 (CoQ10) is a vitamin-like compound with a direct and indirect antioxidant role, energetic role and with an increase of the immune system. The modifications of oxidant/antioxidant (O/AO) balance in exercise with the oxidative stress (SO) production, determined us to study the effects of CoQ10 supplementation on the leucocytes phagocytic capacity, which through the phagocytic function on the reactive species of oxigen (SRO) production have a favourable role in the antimicrobian defence in the body. Aims. The following were studied: 1. influence of CoQ10 supplementation on the aerobic exercise capacity; 2. influence of exercise and CoQ10 supplement on the leukocytes and phagocytic capacity. Methods. The investigation was carried out in 3 groups of 10 male albino Wistar rats: group I: animals trained to exercise; group II: animals trained to exercise with CoQ10 supplementation; group III: sedentary animals with CoQ10 supplementation. Venous blood samples were taken from the retroorbitar vein on the 1st day, 14th day and 28th day. Leukocytes count and the leukograme (polymorphonuclear neutrophil leucocytes: PMNN; monocytes: MO), phagocytic capacity (phagocytic index: FI; phagocytic activity: FA; peroxidase activity: Px) were detected. Results. The training determined significant increases of the aerobic exercise capacity, with or without CoQ10 supplementation. The exercise influence the phagocytic capacity, with the significant decreases of FI on the 14th day and on the 28th day as compared with the 1st day, the significant increases of FA on the 14th day and restoration to the initial values on the 28th day, and without significantly influence on the Px. The exercise and CoQ10 supplementation did not determine significant changes of the counts of leucocytes and PMNN, but produced significant MO increases, with maximum values on the 14th day, as compared with the 1st day; influencing favourably the phagocytic capacity, while supplementation in the sedentary animals determined a significant decrease of FI after 14 days and 28 days, and significant increases of FI and FA after 28 days; Px decreased significantly, as compared with the 1st day. The CoQ10 supplementation in sedentary animals determined the significant decrease of FI after 14 days and 28 days, and increases of FA which are significant after 28 days; Px increased significantly during the exercise, as compared with the 1st day. [ABSTRACT FROM AUTHOR]

Background. Coenzyme Q10 (CoQ10) is a vitamin-like compound with a direct and indirect antioxidant role, energetic role and with an increase of the immune system. The modifications of oxidant/antioxidant (O/AO) balance in exercise with the oxidative stress (SO) production, determined us to study the effects of CoQ10 supplementation on the leucocytes phagocytic capacity, which through the phagocytic function on the reactive species of oxigen (SRO) production have a favourable role in the antimicrobian defence in the body. Aims. The following were studied: 1. influence of CoQ10 supplementation on the aerobic exercise capacity; 2. influence of exercise and CoQ10 supplement on the leukocytes and phagocytic capacity. Methods. The investigation was carried out in 3 groups of 10 male albino Wistar rats: group I: animals trained to exercise; group II: animals trained to exercise with CoQ10 supplementation; group III: sedentary animals with CoQ10 supplementation. Venous blood samples were taken from the retroorbitar vein on the 1st day, 14th day and 28th day. Leukocytes count and the leukograme (polymorphonuclear neutrophil leucocytes: PMNN; monocytes: MO), phagocytic capacity (phagocytic index: FI; phagocytic activity: FA; peroxidase activity: Px) were detected. Results. The training determined significant increases of the aerobic exercise capacity, with or without CoQ10 supplementation. The exercise influence the phagocytic capacity, with the significant decreases of FI on the 14th day and on the 28th day as compared with the 1st day, the significant increases of FA on the 14th day and restoration to the initial values on the 28th day, and without significantly influence on the Px. The exercise and CoQ10 supplementation did not determine significant changes of the counts of leucocytes and PMNN, but produced significant MO increases, with maximum values on the 14th day, as compared with the 1st day; influencing favourably the phagocytic capacity, while supplementation in the sedentary animals determined a significant decrease of FI after 14 days and 28 days, and significant increases of FI and FA after 28 days; Px decreased significantly, as compared with the 1st day. The CoQ10 supplementation in sedentary animals determined the significant decrease of FI after 14 days and 28 days, and increases of FA which are significant after 28 days; Px increased significantly during the exercise, as compared with the 1st day. Conclusions. CoQ10 supplementation determined significant increases of the aerobic exercise capacity, without significant changes of the total leukocytes count; phagocytic capacity increased based on the FI and on the FA, but decreased because of Px. These changes can be attributed to the direct or indirect antioxidant role of the CoQ10 and to its energetic generating effect on the exercise capacity. [ABSTRACT FROM AUTHOR]

Objective: To determine the diagnostic value of virtual autopsy using post mortem-MRI (pm-MRI) at 3Tesla (T) compared to classic autopsy for the confirmation of fetal structural anomalies and secondly to establish which cases of termination of pregnancy would benefit mostly from a virtual autopsy. Methods: In each of 32 fetuses included in the study, 32 anatomical structures were assessed, after termination of pregnancy in the second trimester. All cases were evaluated by prenatal ultrasonography, virtual autopsy and classic autopsy, and then divided into four groups: Cerebral Group, Cardiac Group, Renal Group and Other Group (miscellaneous group). The concordance of virtual autopsy with classic autopsy was calculated overall and for each group and each structural item. Also, the concordance between the two methods was assessed using a diagnostic error score (DgE_score), calculated as the absolute value of the difference between the number of malformations detected by classic autopsy per case (CA score) and the number of malformations detected at virtual autopsy per case (VA score). Results: Overall virtual autopsy demonstrated a diagnostic sensitivity (Se) compared to classic autopsy of 67.33% [95% CI 57.28–76.33], with a specificity (Sp) of 98.37% [95% CI 97.33–99.09], a positive predictive value (PPV) of 81.93% [95% CI 71.95–89.52], a negative predictive value (NPV) of 96.49% [95% CI 95.11–97.57] achieving a diagnostic accuracy of 95.31% [95% CI 93.83–96.52]. Overall, no statistic significant correlation was demonstrated between DgE_score and the gestational age of the fetuses or between DgE_score and the weight of the fetuses, but a significant correlation was revealed between the virtual autopsy and classic autopsy score. The diagnostic utility of virtual autopsy using pm-MRI at 3 T as compared to classic autopsy for each category of termination of pregnancy revealed in the Cerebral Group a Se of 80.00% [95% CI 28.36–99.49], with a 96.30% [95% CI 81.03–99.91], a PPV of 80.00% [95% CI 35.75–96.64] a NPV of 96.30% [95% CI 81.81–99.34], with a diagnostic accuracy of 93.75% [95% CI 79.19% to 99.23] and a Cohen's Kappa coefficient of 0.76 [95% CI 0.4494–1.0765]; in the Renal Group a Se and Sp of 100%, but in the Cardiac Group the Se was only 60.00% [95% CI 26.24–87.84], Sp 75% [95% CI 34.91–96.81], the PPV 75.00% [95% CI 44.92–91.69], NPV 60% [95% CI 38.87–77.96], with a diagnostic accuracy of 66.67% [95% CI 40.99–86.66] and a Cohen's Kappa coefficient of 0.32 [95% CI -0.07–0.76]. Conclusions: The results support virtual autopsy using pm-MRI at 3T as a reliable alternative to classic autopsy for the non-forensic analysis of second trimester fetuses. Analyzing the diagnostic utility of virtual autopsy using pm-MRI at 3 T for the confirmation of prenatal ultrasound findings in second trimester fetuses as compared to classic autopsy, the best results were obtained in the Cerebral and Renal Group. Reserved results were found in the Cardiac Group. Therefore, for the pregnancies with termination of pregnancy for cerebral or renal abnormalities, virtual autopsy by pm-MRI at 3T can be taken into consideration as a first-line investigation to confirm the prenatal findings. [ABSTRACT FROM AUTHOR]

Inflammation has an important role in the progression of various viral pneumonia, including COVID-19. Circulating biomarkers that can evaluate inflammation and immune status are potentially useful in diagnosing and prognosis of COVID-19 patients. Even more so when they are a part of the routine evaluation, chest CT could have even higher diagnostic accuracy than RT-PCT alone in a suggestive clinical context. This study aims to evaluate the correlation between inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR), platelets-to-lymphocytes ratio (PLR), and eosinophils with the severity of CT lesions in patients with COVID-19. The second objective was to seek a statically significant cut-off value for NLR and PLR that could suggest COVID-19. Correlation of both NLR and PLR with already established inflammatory markers such as CRP, ESR, and those specific for COVID-19 (ferritin, D-dimers, and eosinophils) were also evaluated. One hundred forty-nine patients with confirmed COVID-19 disease and 149 age-matched control were evaluated through blood tests, and COVID-19 patients had thorax CT performed. Both NLR and PLR correlated positive chest CT scan severity. Both NLR and PLR correlated positive chest CT scan severity. When NLR value is below 5.04, CT score is lower than 3 with a probability of 94%, while when NLR is higher than 5.04, the probability of severe CT changes is only 50%. For eosinophils, a value of 0.35% corresponds to chest CT severity of 2 (Se = 0.88, Sp = 0.43, AUC = 0.661, 95% CI (0.544; 0.779), p = 0.021. NLR and PLR had significantly higher values in COVID-19 patients. In our study a NLR = 2.90 and PLR = 186 have a good specificity (0.89, p = 0.001, respectively 0.92, p<0.001). Higher levels in NLR, PLR should prompt the clinician to prescribe a thorax CT as it could reveal important lesions that could influence the patient's future management. [ABSTRACT FROM AUTHOR]

Introduction. The knowledge of medical staff on oral health status during pregnancy is particularly important. Issues related to periodontal disease and oral cavity diseases may influence the pregnancy and birth. The objective of the study was to assess the knowledge of qualified personnel (dentists, obstetricians / gynecologists) on the oral health during pregnancy. Material and method. A cross sectional study was conducted on a number of 105 dentists and 105 obstetricians / gynecologists from Cluj Napoca, Romania, in the interval 1.01.2016 - 28.02.2016. With a questionnaire containing 19 questions with multiple answers were gathered information on: personal data (gender, age, specialty and years in practice), opinion regarding dental treatments and medication in pregnancy, knowledge on the link between periodontal disease and pregnancy, (complications and side effects on birth), sources of information about oral health during pregnancy. Data were statistically analyzed descriptive and comparative using SPSS program. Results. Both dentists and obstetricians had demonstrated knowledge about the status of oral health during pregnancy. Even if most of the respondents were aware of the connection between oral health and pregnancy (95.2% dentists and 87.6% obstetricians) only a third of obstetricians and a quarter of dentists mentioned a possible association between oral health and pregnancy pathology: preterm birth (29.5% dentists and 35.2% obstetricians) and low birth weight (20% dentists and 33.3% obstetricians). There were statistically significant differences between the opinions of these two categories of specialists, concerning mainly the administration of pharmaceuticals during pregnancy with minimal risks. Conclusions. The possible association between oral diseases and pregnancy pathology was understood by the majority of dentists and obstetricians; moreover, there was consensus in the most frequent dental treatments and protocols. However, the information regarding the possible correlation between periodontal health and pregnancy was not enough acknowledged by neither dentists nor obstetricians. [ABSTRACT FROM AUTHOR]

Context:Soluble CD40 ligand (sCD40l) can predict cardiovascular events (CVE) and mortality in haemodialysis (HD) patients (short-, medium-term follow-up studies). Objective:To evaluate the relationship between sCD40l and survival, CVE and mortality in HD patients on long-term follow-up. Methods:We registered 46 HD patients’ baseline characteristics, mortality and CVE for 108 months. Results: SCD40l correlated positively with C-reactive protein, was higher in survivors, but had no impact on survival and was not predictive for CVE or CV mortality. Conclusion:The levels of sCD40l have no influence on survival or CVE and mortality in HD patients in a long-term follow-up. [ABSTRACT FROM PUBLISHER]

Aim: To assess the osteoprotegerin (OPG) relationship with cardiovascular complications in hemodialysis (HD) patients. Methods: The study included 87 HD patients. Clinical characteristics, ankle-arm index (AAI), OPG and mineral markers levels were recorded. Arterial intimal calcification (AIC) and arterial medial calcification (AMC) were registered. Results: OPG levels were increased in HD patients. Patients with AIC ( p = 0.006)/ AMC ( p = 0.01) had higher OPG levels. OPG did not have any relation with cardiovascular diseases. OPG correlated positively with age, increased HD vintage and inversely with albumin and AAI. OPG has not been a risk factor for VC or cardiovascular disease. Conclusion: OPG rising could be a reaction in defense to vascular aggression, because OPG was associated with VC, but not with vascular disease. [ABSTRACT FROM AUTHOR]

Background: Previous reports associated ADIPOQ 276G>T polymorphism with plasma adiponectin levels and diabetes. Our objective was to study this polymorphism in type 2 diabetes (T2D) Romanian patients and to assess its influence on plasma adiponectin levels; possible link to prevalence of T2D was also addressed. Design: Case control study Material and Methods: Consecutive T2D patients, age and sex matched controls were genotyped for the 276 ADIPOQ locus. Medical history, laboratory evaluation, plasma adiponectin were assessed. Outcomes: 105 T2D patients and 48 controls were included. Adiponectin was higher in controls (17.04±3.02 µg/ml) than in T2D patients (10.32±1.16 µg/ml), difference failed to reach significance (p=0.06). Genotype distribution wasn't different between T2D patients and controls. 44 (41.90%) of T2D patients had GG genotype, 51 (48.57%) GT and 10 (9.52%) TT genotype. Adiponectin was higher (19.03±3.46 µg/ml) in diabetic TT allele carriers than in GT (9.96±1.76 µg/ml) or GG patients (8.71±1.60 µg/ml) p=0.003. In controls, 28 (58.33 %) subjects were carriers of the GG genotype, 16 (33.33%) had GT genotype and 4 (8.33%) had TT genotype. There weren't significant differences in the studied parameters between different genotypes in the control group. Logistic regression disclosed age p=0.0001 (OR 1.086; CI 1.041/1.133), waist circumference p=0.00049 (OR 1.084; CI 1.036/1.135), adiponectinemia p=0.036 (OR 0.963; CI 0.929/0.998) but not genotype as predictors for the presence of diabetes. Conclusion: Presence of the TT allele at the 276 locus of the ADIPOQ gene is associated with higher plasma adiponectin levels in type 2 diabetes patients. Plasma adiponectin, and not genotype at the 276 locus is predictive for the presence of T2D. [ABSTRACT FROM AUTHOR]

Background: Previous reports associated ADIPOQ 276G>T polymorphism with plasma adiponectin levels and diabetes. Our objective was to study this polymorphism in type 2 diabetes (T2D) Romanian patients and to assess its influence on plasma adiponectin levels; possible link to prevalence of T2D was also addressed. Design: Case control study Material and Methods: Consecutive T2D patients, age and sex matched controls were genotyped for the 276 ADIPOQ locus. Medical history, laboratory evaluation, plasma adiponectin were assessed. Outcomes: 105 T2D patients and 48 controls were included. Adiponectin was higher in controls (17.04±3.02 J4g/ml) than in T2D patients (10.32±1.16 ~~ig/ml), difference failed to reach sign~ficance (p=O.06). Genotype distribution wasn't different between T2D patients and controls. 44 (41.90%) of T2D patients had GG genotype, 51(48.57%) GT and 10 (9.52%) TT genotype. Adiponectin was higher (19.03±3.46 yg/ml) in diabetic TT allele carriers than in GT (9.96±1.76 yg/ml) or GG patients (8.71±1.60 yg/mi) p=O.003. In controls, 28 (58.33 %) subjects were carriers of the GG genotype, 16 (33.33%) had GT genotype and 4 (8.33%) had TT genotype. There weren't significant differences in the studied parameters between different genotypes in the control group. Logistic regression disclosed age p=O.000i (OR 1.086; CI 1.041/1.133), waist circumference p=O.00049 (OR 1.084; CI 1.036/1.135), adiponectinemia p=0.036 (OR 0.963; CI 0.929/0.998) but not genotype as predictors for the presence of diabetes. Conclusion: Presence of the TTallele at the 276 locus of the ADIPOQ gene is associated with higher plasma adiponectin levels in type 2 diabetes patients. Plasma adiponectin, and not genotype at the 276 locus is predictive for the presence of T2D. [ABSTRACT FROM AUTHOR]

This study is dedicated to the investigation of the interfaces between the dentin biostructure and composite inlays manufactured using the trade-mark Gradia and the experimental Barodent biomaterials. The restorations were luted with a self-adhesive resin cement and with a conventional resin cement associated either with a two-step etch & rinse adhesive or with a three-step etch & rinse adhesive. The scanning electron microscopy examination and the optical microscopy coupled with the microleakage investigations, followed by a statistical analysis of data, allowed the qualitative and quantitative evaluation of the interface between composite biomaterials and tooth biostructure, as influenced by the restoring material and the resin cement. The two investigated composite materials gave similar results regarding the interface quality and the marginal adaptation in dentin. The conventional resin cement associated with the etch& rinse adhesive systems gave the lowest microleakage values and formed the most homogeneous interface between the composite inlay and dental biostructure. [ABSTRACT FROM AUTHOR]

Background: Adiponectin, an insulin-sensitizing, anti-inflammatory and antiatherogenic adipokine, seems to conserve its protective effect against cardiovascular complications in dialysis patients. In diabetic dialysis patients however results are less consistent, higher adiponectin levels being associated with mortality. We intend to study the prognostic value of plasma adiponectin for atherosclerotic complications and all-cause mortality in type 2 diabetic patients on hemodialysis in a multicenter trial; we hereby present our pilot study. Material and methods: All (28) diabetic patients on maintenance hemodialysis in our center were included in the study. History, clinical data, routine laboratory assessment and total plasma adiponectin were obtained. Patients were compared to a control group of 20 nondiabetic hemodialysis patients. During 1 year of follow-up, new occurrence of cardiovascular complications due to atherosclerosis (myocardial infarction and revascularization, amputation or revascularization due to arteriosclerosis obliterans, stroke) and all-cause mortality were recorded. Results: Type 2 diabetic dialysis patients had lower adiponectin levels than dialysis controls (21.08±3.17/ml versus 39.00±10.11μg/ml, p=0.03). In simple regression, adiponectin was correlated to body mass index (r=-0.43, p=0.01) and serum triglycerides (r=-0.62, p=0.0003); in multiple stepwise regression, triglycerides remained the only predictor of plasma adiponectin (p=0.01). Adiponectin levels were higher in women than in men (28.73±5.76 μg/ ml versus 15.33±2.88 μg/ml, p=0.03). There was a statistically significant difference in plasma adiponectin levels between patients with proliferative retinopathy and patients without this condition (27.22±4.87 μg/ ml versus 16.46±3.91 μg/ml, p=0.02). Patients with new onset of cardiovascular events had lower adiponectin levels than controls (12.76±3.52 μg/ml versus 23.34±3.81 μg/ml but the difference did not reach statistical significance, probably due to the small number of patients. Baseline adiponectin was higher in deceased patients than in survivors (29.87±10.32 μg/ml versus 19.61±3.29 μg/ml); again, statistical significance was not reached due to the small cohort. The number of patients to be included in the multicenter trial in order to attain statistical significance for each arm of the above mentioned comparisons was calculated. Conclusions: In diabetic patients treated with hemodialysis, lower adiponectin levels were found in patients with new onset of complications of atherosclerosis, while increased adiponectin might predict all-cause mortality. Further large-scale prospective studies are required to confirm these findings. [ABSTRACT FROM AUTHOR]

The negative effects of SARS-CoV-2 infection on the musculoskeletal system include symptoms of fatigue and sarcopenia. The aim of this study is to assess the impact of COVID-19 on foot muscle strength and evaluate the reproducibility of peak ankle torque measurements in time by using a custom-made electronic dynamometer. In this observational cohort study, we compare two groups of four participants, one exposed to COVID-19 throughout measurements and one unexposed. Peak ankle torque was measured using a portable custom-made electronic dynamometer. Ankle plantar flexor and dorsiflexor muscle strength was captured for both feet at different ankle angles prior and post COVID-19. Average peak torque demonstrated no significant statistical differences between initial and final moment for both groups (p = 0.945). An increase of 4.8%, p = 0.746 was obtained in the group with COVID-19 and a decrease of 1.3%, p = 0.953 was obtained in the group without COVID-19. Multivariate analysis demonstrated no significant differences between the two groups (p = 0.797). There was a very good test–retest reproducibility between the measurements in initial and final moments (ICC = 0.78, p < 0.001). In conclusion, peak torque variability is similar in both COVID-19 and non-COVID-19 groups and the custom-made electronic dynamometer is a reproducible method for repetitive ankle peak torque measurements. [ABSTRACT FROM AUTHOR]

Custom-made dynamometry was shown to objectively analyze human muscle strength around the ankle joint with accuracy, easy portability and low costs. This paper describes the full method of calibration and measurement setup and the measurement procedure when capturing ankle torque for establishing reliability of a portable custom-built electronic dynamometer. After considering the load cell offset voltage, the pivotal position was determined, and calibration with loads followed. Linear regression was used for calculating the proportionality constant between torque and measured voltage. Digital means were used for data collection and processing. Four healthy consenting participants were enrolled in the study. Three consecutive maximum voluntary isometric contractions of five seconds each were registered for both feet during plantar flexion/dorsiflexion, and ankle torque was then calculated for three ankle inclinations. A calibration procedure resulted, comprising determination of the pivotal axis and pedal constant. Using the obtained data, a measurement procedure was proposed. Obtained contraction time graphs led to easier filtering of the results. When calculating the interclass correlation, the portable apparatus demonstrated to be reliable when measuring ankle torque. When a custom-made dynamometer was used for capturing ankle torque, accuracy of the method was assured by a rigorous calibration and measurement protocol elaboration. [ABSTRACT FROM AUTHOR]

The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte (PLR) ratio are two extensively used inflammatory markers that have been proved very useful in evaluating inflammation in several diseases. The present article aimed to investigate if they have any value in distinguishing among various respiratory disorders. One hundred and forty-five patients with coronavirus disease 2019 (COVID-19), 219 patients with different chronic respiratory diseases (interstitial lung disease, obstructive sleep apnea(OSA)-chronic obstructive pulmonary disease (COPD) overlap syndrome, bronchiectasis) and 161 healthy individuals as a control group were included in the study. While neither NLR nor PLR had any power in differentiating between various diseases, PLR was found to be significant but poor as a diagnostic test when the control group was compared with the OSA-COPD group. NLR was found to be significant but poor as a diagnostic test when we compared the control group with all three groups (separately): the OSA-COPD group; interstitial lung disease group, and bronchiectasis group. NLR and PLR had poor power to discriminate between various respiratory diseases and cannot be used in making the differential diagnosis. [ABSTRACT FROM AUTHOR]

Chest high-resolution computed tomography (HRCT) is considered the "gold" standard radiological method in interstitial lung disease (ILD) patients. The objectives of our study were to evaluate the correlation between two transthoracic lung ultrasound (LUS) scores (total number of B-lines score = the total sum of B-lines in 10 predefined scanning sites and total number of positive chest areas score = intercostal spaces with ≥3 B-lines) and the features in HRCT simplified scores, in different interstitial disorders, between LUS scores and symptoms, as well as between LUS scores and pulmonary function impairment. We have evaluated 58 consecutive patients diagnosed with ILD. We demonstrated that there was a good correlation between the total number of B-lines score and the HRCT simplified score (r = 0.784, p < 0.001), and also a good correlation between the total number of positive chest areas score and the HRCT score (r = 0.805, p < 0.005). The results confirmed the value of using LUS as a diagnostic tool for the assessment of ILD compared to HRCT. The use of LUS in ILD patients can be a useful, cheap, accessible and radiation-free investigation and can play a complementary role in the diagnosis and monitoring of these patients. [ABSTRACT FROM AUTHOR]