171 results on '"Pharmacy, Bucharest, Romania"'
Search Results
2. Benefits and challenges of the integration of haptics-enhanced virtual reality training within dental curricula.
- Author
-
Felszeghy S, Mutluay M, Liukkonen M, Flacco N, Bakr MM, Rampf S, Schick SG, Mushtaq F, Sittoni-Pino MF, Ackerman K, Arias-Herrera S, Audsley B, Bágyi K, Bell S, Bistey T, Byrne S, Carpegna G, Carramolino-Cuéllar E, da Costa JB, Durham MR, Galán-Gil S, Gerber G, González-Carrasco D, Gourley K, Hermann P, Huhtela O, Hytönen H, Kämppi A, Lampe M, López-Roig C, Marincsák R, Morton D, Nagasawa M, Nagy K, Nagy L, Øilo M, Orsini C, Palotie U, Pantea M, Pasqualini D, Pétercsák A, Pino-Valenzuela D, Quenta-Silva E, Ranauta A, Rederiene G, Riutord-Sbert P, Rodakowska EJ, Rodríguez-Hopp MP, Saenz-Laguna-Saavedra M, Suominen AL, Tricio J, Voog-Oras Ü, Wolcott MD, Usta SN, Lingström P, Shazib MA, Manzanares-Céspedes MC, Greany TJ, Maggio M, Stolberg R, Gülsün G, Bencharit S, and Quinn B
- Abstract
Background: Haptics-enhanced virtual reality (VR-haptic) simulation in dental education has evolved considerably during the past decade, representing a promising resource of simulation-based training opportunities to support conventional practice. We aim to summarize current literature on the applications of VR-haptics in learning, practicing, and teaching dental education., Methods: A literature search was performed using PubMed, focusing on research articles published between January 2010 and January 2024. Out of the 667 articles that matched the search terms (dentistry, education, haptic, teaching, training, virtual reality), 105 were screened, and 42 were eligible for full-text reading and utilization. Findings from an ongoing educator survey on the use of VR-haptics in dental education have also been provided., Results: VR-haptic simulation has been shown to have a supportive role in dental simulation practice. Despite training within a digital world, hand skill transfer to the real world has been demonstrated, which affords educators more flexibility in how to train their students before and during traditional preclinical and clinical practical education. The individualized VR-haptic training and feedback help students in mastering essential working techniques, while also increasing engagement and motivation., Conclusions: VR-haptics-supported dental education can help students effectively address challenges during their preclinical and clinical training, as well as in their subsequent careers, and it may help mitigate some weaknesses of the current educational system. Validation is a key factor for the acceptance of VR-haptic simulators; thus, further research and verification are needed before VR-haptics could be considered a primary hand skill development method of learning in dental education. VR-haptic simulation may in the future be used as an assessment tool for the students' and clinicians' credentialing process., (© 2024 The Author(s). Journal of Dental Education published by Wiley Periodicals LLC on behalf of American Dental Education Association.)
- Published
- 2024
- Full Text
- View/download PDF
3. Genetic landscape of Romanian PPGLs.
- Author
-
Lider-Burciulescu SM, Gheorghiu M, Braha E, Stanescu LS, Patocs A, and Badiu C
- Subjects
- Humans, Female, Male, Romania epidemiology, Middle Aged, Adult, Retrospective Studies, Proto-Oncogene Proteins c-ret genetics, Genetic Predisposition to Disease, Aged, Mutation genetics, Pheochromocytoma genetics, Pheochromocytoma pathology, Paraganglioma genetics, Paraganglioma pathology, Adrenal Gland Neoplasms genetics, Adrenal Gland Neoplasms pathology, Germ-Line Mutation genetics
- Abstract
Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumours that originate from chromaffin cells and occur in the adrenal medulla and in the sympathetic or parasympathetic ganglia. Nearly 70% of PPGLs result from germline or somatic mutations in a single driver gene. The aim of this study was to characterize the genetic background and clinical characteristics related to genetic profile of patients with PPGLs from Romania. We retrospectively retrieved data of 125 patients consecutively registered, diagnosed with PPGLs in a tertiary referral center of endocrinology from Romania, between 1976 and 2022. We identified 88 (70.4%) women, and 37 (29.6%) men, with a mean age at diagnosis of 48.5 ± 15 years. From these 125 patients, 80 (64%) were submitted to the genomic study; 35% (n = 28) had a germline mutation (20 RET, 3 VHL, 1 SDHB, 1 NF1, 1 SDHD, 1 FANCA, 1 CASR) while 65% (n = 52) presented sporadic disease. Patients with hereditary disease had significantly lower age at diagnosis comparing to sporadic cases (37 ± 15 vs. 49.9 ± 12.2 years, p = 0.001). Bilateral tumors developed in twelve patients from the hereditary group. Metastatic disease was described in 4 out of 80 patients (2 of them with hereditary disease). Patients from sporadic group tended to have a right lateralisation of the tumour compared to hereditary cases, where the tumour was more often left sided. RET pathogenic variant (p.Cys634Trp) associated with MEN2A syndrome was the most prevalent in Romanian population with PPGLs and could be considered as a founder effect. Patients with hereditary disease are diagnosed at a younger age and develop bilateral tumors more frequently compared to sporadic cases., (© 2024 The Author(s). Journal of Cellular and Molecular Medicine published by Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd.)
- Published
- 2024
- Full Text
- View/download PDF
4. Quality of life measurement in urticaria: Position statement of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient-Oriented Outcomes and Urticaria and Angioedema.
- Author
-
Chernyshov PV, Finlay AY, Tomas-Aragones L, Zuberbier T, Kocatürk E, Manolache L, Pustisek N, Svensson A, Marron SE, Sampogna F, Bewley A, Salavastru C, Koumaki D, Augustin M, Linder D, Abeni D, Salek SS, Szepietowski J, and Jemec GB
- Subjects
- Humans, Europe, Surveys and Questionnaires, Adult, Advisory Committees, Child, Dermatology, Quality of Life, Angioedema, Urticaria psychology
- Abstract
The European Academy of Dermatology and Venereology (EADV) Task Forces on quality of life (QoL) and patient-oriented outcomes and on urticaria and angioedema recommendations for the assessment of Health-related (HR) QoL in all patients with urticaria in research and practice are as follows: to use the DLQI for adults and the CDLQI for children as dermatology-specific and the CU-Q2oL as a disease-specific HRQoL instruments in urticaria; to use generic instruments to provide comparison of data on urticaria with non-dermatologic diseases, or to compare with healthy volunteers or the general population; to select validated HRQoL instruments with appropriate age limits; to present exact numeric data for HRQoL results; correct title of any HRQoL instrument should be used, along with its correct abbreviation and the reference to its original publication, where possible. The EADV TFs discourage the use of non-validated HRQoL instruments and modified HRQoL instruments that have not undergone standard validation., (© 2024 European Academy of Dermatology and Venereology.)
- Published
- 2024
- Full Text
- View/download PDF
5. Scabies treatment with benzyl benzoate in patients younger than 2 years: A single-centre experience.
- Author
-
Salavastru CM, Cretu S, Dascalu M, Sendrea AM, Suru A, and Tiplica GS
- Published
- 2024
- Full Text
- View/download PDF
6. Acute generalized exanthematous pustulosis: European expert consensus for diagnosis and management.
- Author
-
Tetart F, Walsh S, Milpied B, Gaspar K, Vorobyev A, Tiplica GS, Didona B, Welfringer-Morin A, Kucinskiene V, Bensaid B, Marvanova E, Salavastru C, Brezinova E, Chua SL, Lovgren ML, Hammers CM, Barbaud A, Mortz CG, Horvath B, Meyersburg D, Lebrun-Vignes B, Bodemer C, Brüggen MC, French LE, and Ingen-Housz-Oro S
- Subjects
- Humans, Europe, Review Literature as Topic, Acute Generalized Exanthematous Pustulosis diagnosis, Acute Generalized Exanthematous Pustulosis etiology, Acute Generalized Exanthematous Pustulosis therapy, Consensus
- Abstract
Acute generalized exanthematous pustulosis (AGEP) is a rare, usually drug-induced, acute pustular rash. Despite the lack of strong data supporting the effectiveness of topical or systemic corticosteroids in this drug reaction, they are widely used. More generally, there is no consensus on the diagnostic modalities and the management of patients with AGEP. We aimed to provide European expert recommendations for the diagnosis and management or patients with AGEP. Members of the ToxiTEN group of the European Reference Network (ERN)-skin, all dermatologists and/or allergologists with expertise in drug reactions, elaborated these recommendations based on their own experience and on a review of the literature. Recommendations were separated into the following categories: professionals involved, assessment of the diagnosis of AGEP, management of the patient and allergological work-up after the acute phase. Consensus was obtained among experts for the list of professionals involved for the diagnosis and management of AGEP, including the minimum diagnostic work-up, the setting of management, the treatments, the modalities and the timing of allergological work-up and follow-up. European experts in drug allergies propose herein consensus on the diagnosis and management of patients with AGEP. A multidisciplinary approach is warranted, including dermatologists, allergologists and pharmacovigilance services., (© 2024 The Author(s). Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.)
- Published
- 2024
- Full Text
- View/download PDF
7. Sentinel lymph node biopsy may no longer be a critical component of melanoma management.
- Author
-
Kyrgidis A, Dixon AJ, Sladden M, Steinman HK, Zouboulis CC, Lallas A, Schneider S, Smith H, Nirenberg A, Longo C, Argenziano G, Popescu C, Tzellos T, Anderson S, and Thomas JM
- Published
- 2024
- Full Text
- View/download PDF
8. BAUSSS biomarker improves melanoma survival risk assessment.
- Author
-
Dixon AJ, Steinman HK, Nirenberg A, Zouboulis CC, Sladden M, Popescu C, Anderson S, Longo C, and Thomas JM
- Abstract
Background: The American Joint Committee on Cancer (AJCC) method of staging melanoma is dated and inaccurate. It ignores important prognostic melanoma features, especially the patient's age. BAUSSS is more accurate in determining survival risk for primary cutaneous melanoma patients who have no clinical or imaging evidence of nodal or distant metastases. BAUSSS is an algorithm incorporating analysis of Breslow thickness, Age, Ulceration, Subtype of melanoma, Sex and Site. These are the six features from the patient history along with the details from the melanoma pathology report that are most predictive of mortality outcome., Objective: To develop a single-page document that allows the clinician to determine BAUSSS biomarker-predicted prognosis in consultation with the patient., Method: From various data sources, we developed an algorithm to predict melanoma mortality using the BAUSSS biomarker system. The single-page algorithm was made available to download at https://globalmelanoma.net/bausss-survival-chart, thus being readily available without charge to all clinicians and their patients., Results: BAUSSS method of determining melanoma prognosis is more accurate and less costly than the AJCC staging system. The only surgery the patient requires is wide local excision of the primary tumour. This method of ascertaining melanoma risk does not require added surgery, costs, hospitalization, tests and anaesthesia, such as would be required if sentinel lymph node biopsy was undertaken. BAUSSS can be a useful tool in determining which primary melanoma patients are at sufficiently high risk to be considered for adjuvant drug therapy., Conclusion: We encourage clinicians to download and print in colour this single-page BAUSSS mortality prediction tool, laminate it, and use it face to face with the patient in consultations. Not only will the patient be able to recognize his/her long-term prognosis but will also be able to see how their tumour severity compares with others., (© 2024 European Academy of Dermatology and Venereology.)
- Published
- 2024
- Full Text
- View/download PDF
9. Increased mRNA expression for serotonin receptor 1B (HTR1B) is associated with thrombosis in BCR::ABL1-negative myeloproliferative neoplasms.
- Author
-
Gurban P, Mambet C, Botezatu A, Necula LG, Matei L, Neagu AI, Pitica IM, Dragu LD, Nastasie Schulman A, Ataman M, Nedeianu S, Chivu-Economescu M, Bleotu C, Anton G, and Diaconu CC
- Subjects
- Humans, Female, Male, Middle Aged, Aged, Adult, Fusion Proteins, bcr-abl genetics, Leukocytes, Mononuclear metabolism, Aged, 80 and over, Receptor, Serotonin, 5-HT1B genetics, Receptor, Serotonin, 5-HT1B metabolism, RNA, Messenger genetics, RNA, Messenger metabolism, Myeloproliferative Disorders genetics, Myeloproliferative Disorders complications, Myeloproliferative Disorders metabolism, Thrombosis genetics
- Abstract
BCR::ABL1-negative myeloproliferative neoplasms (MPNs) are clonal haematopoietic stem cell disorders characterized by specific driver mutations and an increased risk of both macrothrombosis and microthrombosis. Serotonin receptor type 1B (HTR1B) was found to be expressed by various solid tumours, and also primary bone marrow mononuclear cells from myelodysplastic neoplasm and acute myeloid leukaemia patients, representing a potential therapeutic target. In this study we assessed for the first time the expression levels of HTR1B mRNA in the peripheral blood mononuclear cells (PBMC) of 85 newly diagnosed MPN patients, consisting of 28 polycythemia vera, 25 essential thrombocythemia and 32 primary myelofibrosis cases. Levels of HTR1B expression between MPN subtypes and control group were not significantly different. However, at clinical data examination, it was observed that MPN patients with a recent history of major thrombosis and/or signs of impaired microcirculation exhibited significantly higher HTR1B expression levels compared to non-thrombotic MPNs and control group. Moreover, thrombotic MPN patients had significantly higher HTR1B expression than patients with recent thrombosis and absence of MPN diagnostic criteria. These findings suggest that increased levels of HTR1B expression in PBMC might be associated with thrombosis in MPN patients, but larger studies are needed for confirmation, including testing of the receptor protein expression level., (© 2024 The Author(s). Journal of Cellular and Molecular Medicine published by Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd.)
- Published
- 2024
- Full Text
- View/download PDF
10. Real-life effectiveness of iGlarLixi (insulin glargine 100 U/mL and lixisenatide) in people with type 2 diabetes according to prior insulin use.
- Author
-
Seufert J, Freemantle N, Guja C, Haluzík M, Tournay M, Vera C, Bonnemaire M, and Kis JT
- Subjects
- Humans, Female, Male, Middle Aged, Aged, Glycated Hemoglobin analysis, Glycated Hemoglobin drug effects, Glycated Hemoglobin metabolism, Treatment Outcome, Blood Glucose drug effects, Blood Glucose metabolism, Drug Combinations, Glucagon-Like Peptide-2 Receptor, Diabetes Mellitus, Type 2 drug therapy, Insulin Glargine therapeutic use, Insulin Glargine administration & dosage, Hypoglycemic Agents therapeutic use, Peptides therapeutic use, Peptides administration & dosage
- Published
- 2024
- Full Text
- View/download PDF
11. European consensus-based interdisciplinary guideline for diagnosis, treatment and prevention of actinic keratoses, epithelial UV-induced dysplasia and field cancerization on behalf of European Association of Dermato-Oncology, European Dermatology Forum, European Academy of Dermatology and Venereology and Union of Medical Specialists (Union Européenne des Médecins Spécialistes).
- Author
-
Kandolf L, Peris K, Malvehy J, Mosterd K, Heppt MV, Fargnoli MC, Berking C, Arenberger P, Bylaite-Bučinskiene M, Del Marmol V, Dirschka T, Dreno B, Forsea AM, Harwood CA, Hauschild A, Heerfordt IM, Kauffman R, Kelleners-Smeets N, Lallas A, Lebbe C, Leiter U, Longo C, Mijušković Ž, Pellacani G, Puig S, Saiag P, Šitum M, Stockfleth E, Salavastru C, Stratigos A, Zalaudek I, and Garbe C
- Subjects
- Humans, Carcinoma, Squamous Cell prevention & control, Carcinoma, Squamous Cell diagnosis, Carcinoma, Squamous Cell therapy, Carcinoma, Squamous Cell etiology, Ultraviolet Rays adverse effects, Europe, Consensus, Dermatology standards, Dermatology methods, Keratosis, Actinic diagnosis, Keratosis, Actinic therapy, Keratosis, Actinic prevention & control, Skin Neoplasms prevention & control, Skin Neoplasms diagnosis, Skin Neoplasms therapy, Skin Neoplasms etiology
- Abstract
A collaboration of multidisciplinary experts from the European Association of Dermato-Oncology, the European Dermatology Forum, the European Academy of Dermatology and Venereology, and the European Union of Medical Specialists was formed to develop European recommendations on AK diagnosis and treatment, based on current literature and expert consensus. This guideline addresses the epidemiology, diagnostics, risk stratification and treatments in immunocompetent as well as immunosuppressed patients. Actinic keratoses (AK) are potential precursors of cutaneous squamous cell carcinoma (cSCC) and display typical histopathologic and immunohistochemical features of this malignancy in an early stage. They can develop into cSSC in situ and become invasive in a low percentage of cases. AK is the most frequent neoplasia in white populations, frequently occurring within a cancerous field induced by ultraviolet radiation. Since it cannot be predicted, which lesion will progress to cSCC and when treatment is usually recommended. The diagnosis of AK and field cancerization is made by clinical examination. Dermatoscopy, confocal microscopy, optical coherence tomography or line-field confocal-OCT can help in the differential diagnosis of AK and other skin neoplasms. A biopsy is indicated in clinically and/or dermatoscopically suspicious and/or treatment-refractory lesions. The choice of treatment depends on patients' and lesion characteristics. For single non-hyperkeratotic lesions, the treatment can be started upon patient's request with destructive treatments or topical treatments. For multiple lesions, field cancerization treatment is advised with topical treatments and photodynamic therapy. Preventive measures such as sun protection, self-examination and repeated field cancerization treatments of previously affected skin areas in high-risk patients are advised., (© 2024 European Academy of Dermatology and Venereology.)
- Published
- 2024
- Full Text
- View/download PDF
12. Sentinel lymph node biopsy is unreliable in predicting melanoma mortality for both younger and older patients.
- Author
-
Dixon AJ, Kyrgidis A, Steinman HK, Dixon JB, Sladden M, Garbe C, Lallas A, Zachary CB, Leiter-Stöppke U, Smith H, Nirenberg A, Zouboulis CC, Longo C, Argenziano G, Apalla Z, Popescu C, Tzellos T, Anderson S, Nanz L, Cleaver L, and Thomas JM
- Subjects
- Humans, Middle Aged, Aged, Young Adult, Adult, Aged, 80 and over, Sentinel Lymph Node Biopsy, Neoplasm Staging, Prognosis, Retrospective Studies, Melanoma pathology, Skin Neoplasms pathology, Sentinel Lymph Node pathology
- Abstract
Background: Melanoma disease patterns vary with patient age., Aim: To evaluate sentinel lymph node biopsy (SLNB) in managing melanoma at differing patient ages., Methods: Online prediction tools were applied to compare SLNB positivity (SLNB
+ ) and survival risk at patient ages 20-80. Tübingen melanoma data were used to determine variations in the hazard ratio of SLNB+ for mortality at different patient ages., Results: Regardless of tumour thickness, predicted SLNB+ rates were markedly higher than mortality rates for 20-year-old patients. For 80-year-old patients, it is the opposite., Discussion: If 1000 20-year-olds with a 0.4 mm thickness non-ulcerated melanoma underwent SLNB, 100 would likely be positive. If all 100 were to be offered adjuvant drug therapy (ADT), fewer than three more melanoma deaths in those 1000 patients would be avoided. In total, 97 patients would have received medication they may never have needed. If 1000 80-year-olds with a 3 mm thickness non-ulcerated melanoma underwent SLNB, only 40 would likely be positive. In total, 274 patients would be predicted to die of melanoma, 245 being SLNB negative and 29 SLNB+ . ADT linked to SLNB+ could deny treatment to 89% of these high-risk patients., Limitations: The authors relied on published risk data., Conclusion: SLNB has poor specificity at predicting mortality in young melanoma patients and poor sensitivity in older patients. SLNB is not indicated in managing cutaneous melanoma for patients under 40 or over 60 years of age. Many such patients could be managed with wide local excision alone in their clinician's office-based practice. For all cutaneous melanoma patients at all ages, linking ADT to BAUSSS biomarker, (an algorithm of Breslow thickness, age, ulceration, subtype, sex and Site) rather than SLNB+ is likely more appropriate. BAUSSS provides a more accurate melanoma-specific mortality risk assessment for patients without burdening them with added surgery, hospitalization, costs or morbidity risk., (© 2024 European Academy of Dermatology and Venereology.)- Published
- 2024
- Full Text
- View/download PDF
13. Telemedicine with special focus on allergic diseases and asthma-Status 2022: An EAACI position paper.
- Author
-
Smolinska S, Popescu FD, Izquierdo E, Antolín-Amérigo D, Price OJ, Alvarez-Perea A, Eguíluz Gracia I, Papadopoulos NG, Pfaar O, Fassio F, Hoffmann-Sommergruber K, Dramburg S, Agache I, Jutel M, Brough HA, Fonseca JA, Angier E, Boccabella C, Bonini M, Dunn Galvin A, Gibson PG, Gawlik R, Hannachi F, Kalayci Ö, Klimek L, Knibb R, Matricardi P, and Chivato T
- Subjects
- Humans, Pandemics, Confidentiality, Telemedicine methods, Hypersensitivity diagnosis, Hypersensitivity epidemiology, Hypersensitivity therapy, Asthma diagnosis, Asthma epidemiology, Asthma therapy
- Abstract
Efficacious, effective and efficient communication between healthcare professionals (HCP) and patients is essential to achieve a successful therapeutic alliance. Telemedicine (TM) has been used for decades but during the COVID-19 pandemic its use has become widespread. This position paper aims to describe the terminology and most important forms of TM among HCP and patients and review the existing studies on the uses of TM for asthma and allergy. Besides, the advantages and risks of TM are discussed, concluding that TM application reduces costs and time for both, HCP and patients, but cannot completely replace face-to-face visits for physical examinations and certain tests that are critical in asthma and allergy. From an ethical point of view, it is important to identify those involved in the TM process, ensure confidentiality and use communication channels that fully guarantee the security of the information. Unmet needs and directions for the future regarding implementation, data protection, privacy regulations, methodology and efficacy are described., (© 2023 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)
- Published
- 2024
- Full Text
- View/download PDF
14. LncRNAs expression profile in a family household cluster of COVID-19 patients.
- Author
-
Iancu IV, Diaconu CC, Plesa A, Fudulu A, Albulescu A, Neagu AI, Pitica IM, Dragu LD, Bleotu C, Chivu-Economescu M, Matei L, Mambet C, Nedeianu S, Popescu CP, Sultana C, Ruta SM, and Botezatu A
- Subjects
- Humans, SARS-CoV-2 genetics, SARS-CoV-2 metabolism, Biomarkers metabolism, Disease Progression, COVID-19 epidemiology, COVID-19 genetics, RNA, Long Noncoding genetics, RNA, Long Noncoding metabolism
- Abstract
More than 3 years after the start of SARS-CoV-2 pandemic, the molecular mechanisms behind the viral pathogenesis are still not completely understood. Long non-coding RNAs (lncRNAs), well-known players in viral infections, can represent prime candidates for patients' risk stratification. The purpose of the current study was to investigate the lncRNA profile in a family cluster of COVID-19 cases with different disease progression, during the initial wave of the pandemic and to evaluate their potential as biomarkers for COVID-19 evolution. LncRNA expression was investigated in nasopharyngeal swabs routinely collected for diagnosis. Distinct expression patterns of five lncRNAs (HOTAIR, HOTAIRM1, TMEVPG1, NDM29 and snaR) were identified in all the investigated cases, and they were associated with disease severity. Additionally, a significant increase in the expression of GAS5-family and ZFAS1 lncRNAs, which target factors involved in the inflammatory response, was observed in the sample collected from the patient with the most severe disease progression. An lncRNA prognostic signature was defined, opening up novel research avenues in understanding the interactions between lncRNAs and SARS-CoV-2., (© 2024 The Authors. Journal of Cellular and Molecular Medicine published by Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd.)
- Published
- 2024
- Full Text
- View/download PDF
15. Towards an electroencephalographic measure of awareness based on the reactivity of oscillatory macrostates to hearing a subject's own name.
- Author
-
Șerban CA, Barborică A, Roceanu AM, Mîndruță IR, Ciurea J, Stancu M, Pâslaru AC, Zăgrean AM, Zăgrean L, and Moldovan M
- Subjects
- Humans, Electroencephalography, Acoustic Stimulation, Hearing, Brain Ischemia, Stroke
- Abstract
We proposed that the brain's electrical activity is composed of a sequence of alternating states with repeating topographic spectral distributions on scalp electroencephalogram (EEG), referred to as oscillatory macrostates. The macrostate showing the largest decrease in the probability of occurrence, measured as a percentage (reactivity), during sensory stimulation was labelled as the default EEG macrostate (DEM). This study aimed to assess the influence of awareness on DEM reactivity (DER). We included 11 middle cerebral artery ischaemic stroke patients with impaired awareness having a median Glasgow Coma Scale (GCS) of 6/15 and a group of 11 matched healthy controls. EEG recordings were carried out during auditory 1 min stimulation epochs repeating either the subject's own name (SON) or the SON in reverse (rSON). The DEM was identified across three SON epochs alternating with three rSON epochs. Compared with the patients, the DEM of controls contained more posterior theta activity reflecting source dipoles that could be mapped in the posterior cingulate cortex. The DER was measured from the 1 min quiet baseline preceding each stimulation epoch. The difference in mean DER between the SON and rSON epochs was measured by the salient EEG reactivity (SER) theoretically ranging from -100% to 100%. The SER was 12.4 ± 2.7% (Mean ± standard error of the mean) in controls and only 1.3 ± 1.9% in the patient group (P < 0.01). The patient SER decreased with the Glasgow Coma Scale. Our data suggest that awareness increases DER to SON as measured by SER., (© 2023 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.)
- Published
- 2024
- Full Text
- View/download PDF
16. One third of cases of new-onset diabetic ketosis in adults are associated with ketosis-prone type 2 diabetes-A systematic review and meta-analysis.
- Author
-
Kovacs A, Bunduc S, Veres DS, Palinkas D, Gagyi EB, Hegyi PJ, Eross B, Mihaly E, Hegyi P, and Hosszufalusi N
- Subjects
- Adult, Humans, Autoantibodies, Diabetic Ketoacidosis epidemiology, Diabetic Ketoacidosis etiology, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2 epidemiology, Ketosis
- Abstract
Aims: Ketosis-prone type 2 diabetes was defined by the World Health Organization in 2019. According to the literature, the diagnosis is based on the presence of ketosis, islet autoantibody negativity and preserved insulin secretion. Our meta-analysis assessed the prevalence and clinical characteristics of ketosis-prone type 2 diabetes among patients hospitalised with diabetic ketoacidosis (DKA) or ketosis., Methods: The systematic search was performed in five main databases as of 15 October 2021 without restrictions. We calculated the pooled prevalence of ketosis-prone type 2 diabetes (exposed group) within the diabetic population under examination, patients with ketoacidosis or ketosis, to identify the clinical characteristics, and we compared it to type 1 diabetes (the comparator group). The random effects model provided pooled estimates as prevalence, odds ratio and mean difference (MD) with 95% confidence intervals., Results: Eleven articles were eligible for meta-analysis, thus incorporating 2010 patients of various ethnic backgrounds. Among patients presenting with DKA or ketosis at the onset of diabetes, 35% (95% CI: 24%-49%) had ketosis-prone type 2 diabetes. These patients were older (MD = 11.55 years; 95% CI: 5.5-17.6) and had a significantly higher body mass index (BMI) (MD = 5.48 kg/m
2 ; 95% CI: 3.25-7.72) than those with type 1 diabetes., Conclusions: Ketosis-prone type 2 diabetes accounts for one third of DKA or ketosis at the onset of diabetes in adults. These patients are characterised by islet autoantibody negativity and preserved insulin secretion. They are older and have a higher BMI compared with type 1 diabetes. C-peptide and diabetes-related autoantibody measurement is essential to identify this subgroup among patients with ketosis at the onset of diabetes., (© 2023 The Authors. Diabetes/Metabolism Research and Reviews published by John Wiley & Sons Ltd.)- Published
- 2024
- Full Text
- View/download PDF
17. Quality of life measurement in teledermatology. Position statement of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Teledermatology.
- Author
-
Chernyshov PV, Finlay AY, Tomas-Aragones L, Tognetti L, Moscarella E, Pasquali P, Manolache L, Pustisek N, Svensson A, Marron SE, Bewley A, Salavastru C, Suru A, Koumaki D, Linder D, Abeni D, Augustin M, Blome C, Salek SS, Evers AWM, Poot F, Sampogna F, and Szepietowski JС
- Subjects
- Child, Humans, Quality of Life, Pandemics, Venereology, Dermatology methods, Skin Diseases diagnosis, Skin Diseases therapy
- Abstract
Many events, including the COVID-19 pandemic, have accelerated the implementation of teledermatology pathways within dermatology departments and across healthcare organizations. Quality of Life (QoL) assessment in dermatology is also a rapidly developing field with a gradual shift from theory to practice. The purpose of this paper organized jointly by the European Academy of Dermatology and Venereology (EADV) Task Force (TF) on QoL and patient-oriented outcomes and the EADV TF on teledermatology is to present current knowledge about QoL assessment during the use of teledermatology approaches, including data on health-related (HR) QoL instruments used in teledermatology, comparison of influence of different treatment methods on HRQoL after face-to-face and teledermatology consultations and to make practical recommendations concerning the assessment of QoL in teledermatology. The EADV TFs made the following position statements: HRQoL assessment may be an important part in most of teledermatology activities; HRQoL assessment may be easily and effectively performed during teledermatology consultations. It is especially important to monitor HRQoL of patients with chronic skin diseases during lockdowns or in areas where it is difficult to reach a hospital for face-to-face consultation; regular assessment of HRQoL of patients with skin diseases during teledermatology consultations may help to monitor therapy efficacy and visualize individual patient's needs; we recommend the use of the DLQI in teledermatology, including the use of the DLQI app which is available in seven languages; it is important to develop apps for dermatology-specific HRQoL instruments for use in children (for example the CDLQI and InToDermQoL) and for disease-specific instruments., (© 2023 European Academy of Dermatology and Venereology.)
- Published
- 2024
- Full Text
- View/download PDF
18. A new technique to transfer the upper maxillary arch position using a facebow, a transfer table, and a reference block with a CAD application.
- Author
-
Petre A, Drafta S, and Oancea L
- Subjects
- Maxilla, Workflow, Computer-Aided Design, Dental Articulators, Mandible
- Abstract
This paper presents a method for the digital transfer of the upper maxillary arch position using a facebow, a transfer table, and a reference block with a CAD application without requiring physical casts mounted with articulating gypsum. This technique facilitates the prosthetic digital workflow when the impression is made via intraoral scanning, to obtain the placement of the maxillary arch in the anatomical reference planes and in relation to the axes of rotation of the mandibular movements., (© 2023 by the American College of Prosthodontists.)
- Published
- 2024
- Full Text
- View/download PDF
19. Hidradenitis suppurativa: Detangling phenotypes and identifying common denominators.
- Author
-
Vișan MA, Căruntu C, Costache RS, Tiplica G, and Costache DO
- Subjects
- Humans, Quality of Life, Skin, Mutation, Phenotype, Hidradenitis Suppurativa diagnosis, Hidradenitis Suppurativa genetics, Hidradenitis Suppurativa complications
- Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with a severe impact on patients' quality of life through its recurrent and painful nature, as well as its comorbidity burden. The shift in the pathogenic paradigm from a condition of the apocrine glands to an autoinflammatory disease associated with follicular destruction has rendered its understanding difficult, as there are still large gaps in pinpointing the underlying mechanisms, which cannot currently explain the existing clinical variation and as a result, translate into suboptimal therapy. Multifactorial involvement is hypothesized, with an implication of genetic mutations, microbiome dysbiosis, cytokine upregulation and environmental factors. Clinical observation is fundamental for diagnosis, however, the marked heterogeneity in presentation leads to delays in detection and challenges in treatment selection, showcasing clear limits in defining the link between genetic aspects of HS, the role of epigenetic factors and its pathogenic pathways. There have been attempts to formulate phenotypes that could aid in prognostication and management, however, current classification schemata show significant overlap and no validation through longitudinal studies. In this context, nomenclature poses a great challenge due to the lack of global agreement in the definition of lesions, which should be addressed by future research to enable simplified recognition and allow for more precise severity scoring. This could be complemented by the addition of extra dermatologic findings or paraclinical assessment in constructing phenotypes. The development of valid, predictive and reliable classifications of HS may lead to an improvement in comprehending its pathophysiology, favouring a more personalized approach in management. This could be achieved through consensus in the characterization of clinical features and data gathering, as well as validation attempts for described phenotypes. Ultimately, the genotype-endotype-phenotype correlation in HS requires targeted, systematic inquiries and should be addressed more largely to broaden the perspective on this debilitating entity., (© 2023 European Academy of Dermatology and Venereology.)
- Published
- 2024
- Full Text
- View/download PDF
20. The evolving landscape of COVID-19 and post-COVID condition in patients with chronic lymphocytic leukemia: A study by ERIC, the European research initiative on CLL.
- Author
-
Visentin A, Chatzikonstantinou T, Scarfò L, Kapetanakis A, Demosthenous C, Karakatsoulis G, Minga E, Chamou D, Allsup D, Cabrero AA, Andres M, Antic D, Baile M, Baliakas P, Besikli-Dimou S, Bron D, Chatzileontiadou S, Cordoba R, Correa JG, Cuéllar-García C, De Paoli L, De Paolis MR, Delgado J, Dimou M, Donaldson D, Catherwood M, Doubek M, Efstathopoulou M, Eichhorst B, Elashwah S, Enrico A, Espinet B, Farina L, Ferrari A, Foglietta M, Frederiksen H, Fürstenau M, García-Marco JA, García-Serra R, Collado R, Gentile M, Gimeno E, Glenthøj A, da Silva MG, Hakobyan YK, Herishanu Y, Hernández-Rivas JÁ, Herold T, Innocenti I, Itchaki G, Jaksic O, Janssens A, Kalashnikova ОB, Kalicińska E, Kater AP, Kersting S, Labrador J, Lad D, Laurenti L, Levin MD, Lista E, Lopez-Garcia A, Malerba L, Marasca R, Marchetti M, Marquet J, Mattsson M, Mauro FR, Morawska M, Motta M, Munir T, Murru R, Niemann CU, Rodrigues RN, Olivieri J, Orsucci L, Papaioannou M, Pavlovsky MA, Piskunova I, Popov VM, Quaglia FM, Quaresmini G, Qvist K, Rigolin GM, Ruchlemer R, Šimkovič M, Špaček M, Sportoletti P, Stanca O, Tadmor T, Capasso A, Del Poeta G, Gutwein O, Karlsson LK, Milosevic I, Mirás F, Reda G, Saghumyan G, Shrestha A, Te Raa D, Tonino SH, Van Der Spek E, van Gelder M, van Kampen R, Wasik-Szczepanek E, Wróbel T, Segundo LYS, Yassin M, Pocali B, Vandenberghe E, Iyengar S, Varettoni M, Vitale C, Coscia M, Rambaldi A, Montserrat E, Cuneo A, Stavroyianni N, Trentin L, Stamatopoulos K, and Ghia P
- Subjects
- Humans, SARS-CoV-2, Post-Acute COVID-19 Syndrome, Retrospective Studies, COVID-19, Leukemia, Lymphocytic, Chronic, B-Cell drug therapy
- Abstract
In this retrospective international multicenter study, we describe the clinical characteristics and outcomes of patients with chronic lymphocytic leukemia (CLL) and related disorders (small lymphocytic lymphoma and high-count monoclonal B lymphocytosis) infected by SARS-CoV-2, including the development of post-COVID condition. Data from 1540 patients with CLL infected by SARS-CoV-2 from January 2020 to May 2022 were included in the analysis and assigned to four phases based on cases disposition and SARS-CoV-2 variants emergence. Post-COVID condition was defined according to the WHO criteria. Patients infected during the most recent phases of the pandemic, though carrying a higher comorbidity burden, were less often hospitalized, rarely needed intensive care unit admission, or died compared to patients infected during the initial phases. The 4-month overall survival (OS) improved through the phases, from 68% to 83%, p = .0015. Age, comorbidity, CLL-directed treatment, but not vaccination status, emerged as risk factors for mortality. Among survivors, 6.65% patients had a reinfection, usually milder than the initial one, and 16.5% developed post-COVID condition. The latter was characterized by fatigue, dyspnea, lasting cough, and impaired concentration. Infection severity was the only risk factor for developing post-COVID. The median time to resolution of the post-COVID condition was 4.7 months. OS in patients with CLL improved during the different phases of the pandemic, likely due to the improvement of prophylactic and therapeutic measures against SARS-CoV-2 as well as the emergence of milder variants. However, mortality remained relevant and a significant number of patients developed post-COVID conditions, warranting further investigations., (© 2023 The Authors. American Journal of Hematology published by Wiley Periodicals LLC.)
- Published
- 2023
- Full Text
- View/download PDF
21. The role of in vivo reflectance confocal microscopy for the management of acne: A systematic review.
- Author
-
Cretu S, Papachatzopoulou E, Dascalu M, and Salavastru CM
- Subjects
- Humans, Adolescent, Young Adult, Adult, Middle Aged, Skin pathology, Intravital Microscopy, Microscopy, Confocal methods, Acne Vulgaris diagnostic imaging, Acne Vulgaris pathology, Skin Diseases pathology, Skin Neoplasms pathology
- Abstract
Acne diagnosis, severity assessment and treatment follow-up rely primarily on clinical examination. In vivo reflectance confocal microscopy (RCM) provides non-invasively, real-time images of skin lesions with a level of detail close to histopathology. This systematic literature review aims to provide an overview of RCM utility in acne and a summary of specific features with clinical application that may increase objectivity in evaluating this condition. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting our results. We systematically searched three databases: PubMed, Clarivate and Google Scholar (January 2022). All included studies used RCM to investigate acne in human patients and reported the investigated skin area and type (acne lesions or clinically uninvolved skin), the substance used in the case of treatment. Our search identified 2184 records in the three databases investigated. After duplicate removal, 1608 records were screened, 35 were selected for full-text assessment, and 14 were included in this review. We used the QUADAS-2 tool to evaluate the risk of bias and applicability concerns. RCM was selected as the index test and clinical examination as the reference standard. The total number of patients from all studies was 291, with 216 acne patients and 60 healthy participants aged between 13 and 45 years. The 14 considered studies analysed 456 follicles from healthy participants, 1445 follicles from uninvolved skin in acne patients and 1472 acne lesions. Consistent RCM findings concerning follicles of acne patients reported across studies were increased follicular infundibulum size, thick, bright border, intrafollicular content and inflammation. Our analysis indicates that RCM is a promising tool for acne evaluation. Nevertheless, standardization, a unified terminology, consistent research methods and unitary reporting of RCM findings are necessary. PROSPERO registration number CRD42021266547., (© 2023 European Academy of Dermatology and Venereology.)
- Published
- 2023
- Full Text
- View/download PDF
22. Design and preclinical testing of an anti-CD41 CAR T cell for the treatment of acute megakaryoblastic leukaemia.
- Author
-
Tigu AB, Constantinescu CS, Teodorescu P, Kegyes D, Munteanu R, Feder R, Peters M, Pralea I, Iuga C, Cenariu D, Marcu A, Tanase A, Colita A, Drula R, Bergthorsson JT, Greiff V, Dima D, Selicean C, Rus I, Zdrenghea M, Gulei D, Ghiaur G, and Tomuleasa C
- Abstract
Acute megakaryoblastic leukaemia (AMkL) is a rare subtype of acute myeloid leukaemia (AML) representing 5% of all reported cases, and frequently diagnosed in children with Down syndrome. Patients diagnosed with AMkL have low overall survival and have poor outcome to treatment, thus novel therapies such as CAR T cell therapy could represent an alternative in treating AMkL. We investigated the effect of a new CAR T cell which targets CD41, a specific surface antigen for M7-AMkL, against an in vitro model for AMkL, DAMI Luc2 cell line. The performed flow cytometry evaluation highlighted a percentage of 93.8% CAR T cells eGFP-positive and a limited acute effect on lowering the target cell population. However, the interaction between effector and target (E:T) cells, at a low ratio, lowered the cell membrane integrity, and reduced the M7-AMkL cell population after 24 h of co-culture, while the cytotoxic effect was not significant in groups with higher E:T ratio. Our findings suggest that the anti-CD41 CAR T cells are efficient for a limited time spawn and the cytotoxic effect is visible in all experimental groups with low E:T ratio., (© 2023 The Authors. Journal of Cellular and Molecular Medicine published by Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd.)
- Published
- 2023
- Full Text
- View/download PDF
23. Online prediction tools for melanoma survival: A comparison.
- Author
-
Dixon A, Steinman HK, Kyrgidis A, Smith H, Sladden M, Zouboulis C, Argenziano G, Apalla Z, Lallas A, Longo C, Nirenberg A, Popescu C, Tzellos T, Cleaver L, Zachary C, Anderson S, and Thomas JM
- Subjects
- Humans, Aged, Aged, 80 and over, Prognosis, Sentinel Lymph Node Biopsy, Disease-Free Survival, Melanoma pathology, Skin Neoplasms pathology
- Abstract
Background: Breslow thickness, patient age and ulceration are the three most valuable clinical and pathological predictors of melanoma survival. A readily available reliable online tool that accurately considers these and other predictors could be valuable for clinicians managing melanoma patients., Objective: To compare online melanoma survival prediction tools that request user input on clinical and pathological features., Methods: Search engines were used to identify available predictive nomograms. For each, clinical and pathological predictors were compared., Results: Three tools were identified. The American Joint Committee on Cancer tool inappropriately rated thin tumours as higher risk than intermediate tumours. The University of Louisville tool was found to have six shortcomings: a requirement for sentinel node biopsy, unavailable input of thin melanoma or patients over 70 years of age and less reliable hazard ratio calculations for age, ulceration and tumour thickness. The LifeMath.net tool was found to appropriately consider tumour thickness, ulceration, age, sex, site and tumour subtype in predicting survival., Limitations: The authors did not have access to the base data used to compile various prediction tools., Conclusion: The LifeMath.net prediction tool is the most reliable for clinicians in counselling patients with newly diagnosed primary cutaneous melanoma regarding their survival prospects., (© 2023 European Academy of Dermatology and Venereology.)
- Published
- 2023
- Full Text
- View/download PDF
24. Relationship Between Azithromycin and Cardiovascular Outcomes in Unvaccinated Patients With COVID-19 and Preexisting Cardiovascular Disease.
- Author
-
Bergami M, Manfrini O, Nava S, Caramori G, Yoon J, Badimon L, Cenko E, David A, Demiri I, Dorobantu M, Fabin N, Gheorghe-Fronea O, Jankovic R, Kedev S, Ladjevic N, Lasica R, Loncar G, Mancuso G, Mendieta G, Miličić D, Mjehović P, Pašalić M, Petrović M, Poposka L, Scarpone M, Stefanovic M, van der Schaar M, Vasiljevic Z, Vavlukis M, Vega Pittao ML, Vukomanovic V, Zdravkovic M, and Bugiardini R
- Subjects
- Humans, Azithromycin adverse effects, COVID-19 Drug Treatment, SARS-CoV-2, Cardiovascular Diseases epidemiology, Cardiovascular Diseases chemically induced, COVID-19 complications
- Abstract
Background Empiric antimicrobial therapy with azithromycin is highly used in patients admitted to the hospital with COVID-19, despite prior research suggesting that azithromycin may be associated with increased risk of cardiovascular events. Methods and Results This study was conducted using data from the ISACS-COVID-19 (International Survey of Acute Coronavirus Syndromes-COVID-19) registry. Patients with a confirmed diagnosis of SARS-CoV-2 infection were eligible for inclusion. The study included 793 patients exposed to azithromycin within 24 hours from hospital admission and 2141 patients who received only standard care. The primary exposure was cardiovascular disease (CVD). Main outcome measures were 30-day mortality and acute heart failure (AHF). Among 2934 patients, 1066 (36.4%) had preexisting CVD. A total of 617 (21.0%) died, and 253 (8.6%) had AHF. Azithromycin therapy was consistently associated with an increased risk of AHF in patients with preexisting CVD (risk ratio [RR], 1.48 [95% CI, 1.06-2.06]). Receiving azithromycin versus standard care was not significantly associated with death (RR, 0.94 [95% CI, 0.69-1.28]). By contrast, we found significantly reduced odds of death (RR, 0.57 [95% CI, 0.42-0.79]) and no significant increase in AHF (RR, 1.23 [95% CI, 0.75-2.04]) in patients without prior CVD. The relative risks of death from the 2 subgroups were significantly different from each other ( P
interaction =0.01). Statistically significant association was observed between AHF and death (odds ratio, 2.28 [95% CI, 1.34-3.90]). Conclusions These findings suggest that azithromycin use in patients with COVID-19 and prior history of CVD is significantly associated with an increased risk of AHF and all-cause 30-day mortality. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT05188612.- Published
- 2023
- Full Text
- View/download PDF
25. Improved methodology in determining melanoma mortality and selecting patients for immunotherapy.
- Author
-
Dixon AJ, Steinman HK, Kyrgidis A, Smith H, Sladden M, Zouboulis C, Argenziano G, Apalla Z, Lallas A, Longo C, Nirenberg A, Popescu C, Dixon JB, Tzellos T, Zachary C, Cleaver L, Anderson S, Zagarella S, and Thomas JM
- Subjects
- Humans, Patient Selection, Immunotherapy methods, Melanoma, Skin Neoplasms
- Published
- 2023
- Full Text
- View/download PDF
26. iGlarLixi (insulin glargine 100 U/ml plus lixisenatide) is effective and well tolerated in people with uncontrolled type 2 diabetes regardless of age: A REALI pooled analysis of prospective real-world data.
- Author
-
Guja C, Kis JT, Haluzík M, Bonnemaire M, Bigot G, Tournay M, Freemantle N, and Seufert J
- Subjects
- Adult, Humans, Aged, Insulin Glargine adverse effects, Glycated Hemoglobin, Prospective Studies, Blood Glucose, Drug Combinations, Hypoglycemic Agents adverse effects, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 drug therapy
- Abstract
Aim: To evaluate the effectiveness and safety in routine clinical practice of insulin glargine/lixisenatide (iGlarLixi) in people with type 2 diabetes (T2D) according to age., Methods: Patient-level data were pooled from 1316 adults with T2D inadequately controlled on oral antidiabetic drugs with or without basal insulin who initiated iGlarLixi for 24 weeks. Participants were classified into age subgroups of younger than 65 years (N = 806) and 65 years or older (N = 510)., Results: Compared with participants aged younger than 65 years, those aged 65 years or older had a numerically lower mean body mass index (31.6 vs. 32.6 kg/m
2 ), a longer median diabetes duration (11.0 vs. 8.0 years), were more likely to receive prior basal insulin (48.4% vs. 43.5%) and had a lower mean HbA1c (8.93% [74.10 mmol/mol] vs. 9.22% [77.28 mmol/mol]). Similar and clinically relevant reductions in HbA1c and fasting plasma glucose from baseline to week 24 of iGlarLixi therapy were observed regardless of age. At 24 weeks, least-squares adjusted mean (95% confidence interval [CI]) change in HbA1c from baseline was -1.55% (-1.65% to -1.44%) in those aged 65 years or older and -1.42% (-1.50% to -1.33%) in those aged younger than 65 years (95% CI: -0.26% to 0.00%; P = .058 between subgroups). Low incidences of gastrointestinal adverse events and hypoglycaemic episodes were reported in both age subgroups. iGlarLixi decreased mean body weight from baseline to week 24 in both subgroups (-1.6 kg in those aged ≥ 65 years and -2.0 kg in those aged < 65 years)., Conclusions: iGlarLixi is effective and well tolerated in both younger and older people with uncontrolled T2D., (© 2023 Sanofi. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.)- Published
- 2023
- Full Text
- View/download PDF
27. Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesis.
- Author
-
Bousquet J, Melén E, Haahtela T, Koppelman GH, Togias A, Valenta R, Akdis CA, Czarlewski W, Rothenberg M, Valiulis A, Wickman M, Akdis M, Aguilar D, Bedbrook A, Bindslev-Jensen C, Bosnic-Anticevich S, Boulet LP, Brightling CE, Brussino L, Burte E, Bustamante M, Canonica GW, Cecchi L, Celedon JC, Chaves Loureiro C, Costa E, Cruz AA, Erhola M, Gemicioglu B, Fokkens WJ, Garcia-Aymerich J, Guerra S, Heinrich J, Ivancevich JC, Keil T, Klimek L, Kuna P, Kupczyk M, Kvedariene V, Larenas-Linnemann DE, Lemonnier N, Lodrup Carlsen KC, Louis R, Makela M, Makris M, Maurer M, Momas I, Morais-Almeida M, Mullol J, Naclerio RN, Nadeau K, Nadif R, Niedoszytko M, Okamoto Y, Ollert M, Papadopoulos NG, Passalacqua G, Patella V, Pawankar R, Pham-Thi N, Pfaar O, Regateiro FS, Ring J, Rouadi PW, Samolinski B, Sastre J, Savouré M, Scichilone N, Shamji MH, Sheikh A, Siroux V, Sousa-Pinto B, Standl M, Sunyer J, Taborda-Barata L, Toppila-Salmi S, Torres MJ, Tsiligianni I, Valovirta E, Vandenplas O, Ventura MT, Weiss S, Yorgancioglu A, Zhang L, Abdul Latiff AH, Aberer W, Agache I, Al-Ahmad M, Alobid I, Ansotegui IJ, Arshad SH, Asayag E, Barbara C, Baharudin A, Battur L, Bennoor KS, Berghea EC, Bergmann KC, Bernstein D, Bewick M, Blain H, Bonini M, Braido F, Buhl R, Bumbacea RS, Bush A, Calderon M, Calvo-Gil M, Camargos P, Caraballo L, Cardona V, Carr W, Carreiro-Martins P, Casale T, Cepeda Sarabia AM, Chandrasekharan R, Charpin D, Chen YZ, Cherrez-Ojeda I, Chivato T, Chkhartishvili E, Christoff G, Chu DK, Cingi C, Correia de Sousa J, Corrigan C, Custovic A, D'Amato G, Del Giacco S, De Blay F, Devillier P, Didier A, do Ceu Teixeira M, Dokic D, Douagui H, Doulaptsi M, Durham S, Dykewicz M, Eiwegger T, El-Sayed ZA, Emuzyte R, Fiocchi A, Fyhrquist N, Gomez RM, Gotua M, Guzman MA, Hagemann J, Hamamah S, Halken S, Halpin DMG, Hofmann M, Hossny E, Hrubiško M, Irani C, Ispayeva Z, Jares E, Jartti T, Jassem E, Julge K, Just J, Jutel M, Kaidashev I, Kalayci O, Kalyoncu AF, Kardas P, Kirenga B, Kraxner H, Kull I, Kulus M, La Grutta S, Lau S, Le Tuyet Thi L, Levin M, Lipworth B, Lourenço O, Mahboub B, Martinez-Infante E, Matricardi P, Miculinic N, Migueres N, Mihaltan F, Mohammad Y, Moniuszko M, Montefort S, Neffen H, Nekam K, Nunes E, Nyembue Tshipukane D, O'Hehir R, Ogulur I, Ohta K, Okubo K, Ouedraogo S, Olze H, Pali-Schöll I, Palomares O, Palosuo K, Panaitescu C, Panzner P, Park HS, Pitsios C, Plavec D, Popov TA, Puggioni F, Quirce S, Recto M, Repka-Ramirez MS, Robalo Cordeiro C, Roche N, Rodriguez-Gonzalez M, Romantowski J, Rosario Filho N, Rottem M, Sagara H, Serpa FS, Sayah Z, Scheire S, Schmid-Grendelmeier P, Sisul JC, Sole D, Soto-Martinez M, Sova M, Sperl A, Spranger O, Stelmach R, Suppli Ulrik C, Thomas M, To T, Todo-Bom A, Tomazic PV, Urrutia-Pereira M, Valentin-Rostan M, Van Ganse E, van Hage M, Vasankari T, Vichyanond P, Viegi G, Wallace D, Wang DY, Williams S, Worm M, Yiallouros P, Yusuf O, Zaitoun F, Zernotti M, Zidarn M, Zuberbier J, Fonseca JA, Zuberbier T, and Anto JM
- Subjects
- Humans, Allergens, Multimorbidity, Rhinitis diagnosis, Rhinitis epidemiology, Rhinitis complications, Asthma diagnosis, Asthma epidemiology, Asthma etiology, Rhinitis, Allergic complications
- Abstract
Asthma, rhinitis, and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of "one-airway-one-disease," coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitization and multimorbidity, (iii) advances in mHealth for novel phenotype definitions, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches, and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper- and lower-airway allergic diseases with skin, gut, and neuropsychiatric multimorbidities, is the "Epithelial Barrier Hypothesis." This review determined that the "one-airway-one-disease" concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme "allergic" (asthma) phenotype combining asthma, rhinitis, and conjunctivitis. Rhinitis alone and rhinitis and asthma multimorbidity represent two distinct diseases with the following differences: (i) genomic and transcriptomic background (Toll-Like Receptors and IL-17 for rhinitis alone as a local disease; IL-33 and IL-5 for allergic and non-allergic multimorbidity as a systemic disease), (ii) allergen sensitization patterns (mono- or pauci-sensitization versus polysensitization), (iii) severity of symptoms, and (iv) treatment response. In conclusion, rhinitis alone (local disease) and rhinitis with asthma multimorbidity (systemic disease) should be considered as two distinct diseases, possibly modulated by the microbiome, and may be a model for understanding the epidemics of chronic and autoimmune diseases., (© 2023 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)
- Published
- 2023
- Full Text
- View/download PDF
28. Quality of life measurement in rosacea. Position statement of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa.
- Author
-
Chernyshov PV, Finlay AY, Tomas-Aragones L, Steinhoff M, Manolache L, Pustisek N, Dessinioti C, Svensson A, Marron SE, Bewley A, Salavastru C, Dréno B, Suru A, Koumaki D, Linder D, Evers AWM, Abeni D, Augustin M, Salek SS, Nassif A, Bettoli V, Szepietowski JС, and Zouboulis CC
- Subjects
- Humans, Quality of Life, Hidradenitis Suppurativa therapy, Venereology, Dermatology, Acne Vulgaris, Rosacea therapy
- Abstract
The European Academy of Dermatology and Venereology (EADV) Task Forces (TFs) on Quality of Life (QoL) and Patient-Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa (ARHS) do not recommend the use of any generic instrument as a single method of Health Related (HR) QoL assessment in rosacea, except when comparing quimp (quality of life impairment) in rosacea patients with that in other non-dermatologic skin diseases and/or healthy controls. The EADV TFs on QoL and Patient-Oriented Outcomes and ARHS recommend the use of the dermatology-specific HRQoL instrument the Dermatology Life Quality Index (DLQI) and the rosacea-specific HRQoL instrument RosaQoL in rosacea patients. The DLQI minimal clinically important difference may be used as a marker of clinical efficacy of the treatment and DLQI score banding of 0 or 1 corresponding to no effect on patients' HRQoL could be an important treatment goal. This information may be added to consensuses and guidelines for rosacea., (© 2023 European Academy of Dermatology and Venereology.)
- Published
- 2023
- Full Text
- View/download PDF
29. Further insights into the wider impact of childhood atopic dermatitis - Comment on "Burden of childhood atopic dermatitis on parents: Fathers' and mothers' respective feelings" by Mahé et al.
- Author
-
Chernyshov PV, Tomas-Aragones L, Linder D, Bewley A, Salavastru CM, Marron SE, Manolache L, Pustisek N, Evers AWM, Koumaki D, Abeni D, Suru A, Salek SS, and Finlay AY
- Subjects
- Female, Humans, Male, Parents, Emotions, Fathers, Mothers, Dermatitis, Atopic
- Published
- 2023
- Full Text
- View/download PDF
30. Securing wider EU commitment to the elimination of hepatitis C virus.
- Author
-
Wedemeyer H, Tergast TL, Lazarus JV, Razavi H, Bakoyannis K, Baptista-Leite R, Bartoli M, Bruggmann P, Buşoi CS, Buti M, Carballo M, Castera L, Colombo M, Coutinho RS, Dadon Y, Esmat G, Esteban R, Farran JC, Gillyon-Powell M, Goldberg D, Hutchinson S, Janssen HLA, Kalamitsis G, Kondili LA, Lambert JS, Marinho RT, Maticic M, Patricello A, Peck-Radosavljevic M, Pol S, Poljak M, Pop C, Sokol T, Sypsa V, Tözün N, Younossi Z, Aghemo A, Papatheodoridis GV, and Hatzakis A
- Subjects
- Humans, Hepacivirus, Antiviral Agents therapeutic use, Pandemics, Hepatitis C, Chronic drug therapy, Hepatitis C, Chronic epidemiology, Hepatitis C, Chronic prevention & control, COVID-19, Hepatitis C diagnosis, Hepatitis C drug therapy, Hepatitis C epidemiology, Liver Neoplasms drug therapy
- Abstract
In 2016, the Hepatitis B and C Public Policy Association (HepBCPPA), gathered all the main stakeholders in the field of hepatitis C virus (HCV) to launch the now landmark HCV Elimination Manifesto, calling for the elimination of HCV in the EU by 2030. Since then, many European countries have made progress towards HCV elimination. Multiple programmes-from the municipality level to the EU level-were launched, resulting in an overall decrease in viremic HCV infections and liver-related mortality. However, as of 2021, most countries are not on track to reach the 2030 HCV elimination targets set by the WHO. Moreover, the COVID-19 pandemic has resulted in a decrease in HCV diagnoses and fewer direct-acting antiviral treatment initiations in 2020. Diagnostic and therapeutic tools to easily diagnose and treat chronic HCV infection are now well established. Treating all patients with chronic HCV infection is more cost-saving than treating and caring for patients with liver-related complications, decompensated cirrhosis or hepatocellular carcinoma. It is more important than ever to reinforce and scale-up action towards HCV elimination. Yet, efforts urgently need the dedicated commitment of policymakers at all governmental and policy levels. Therefore, the third EU Policy Summit, held in March 2021, featured EU parliamentarians and other key decision makers to promote dialogue and take strides towards securing wider EU commitment to advance and achieve HCV elimination by 2030. We have summarized the key action points and reported the 'Call-to-Action' statement supported by all the major relevant European associations in the field., (© 2022 The Authors. Liver International published by John Wiley & Sons Ltd.)
- Published
- 2023
- Full Text
- View/download PDF
31. Quality of life measurement in vitiligo. Position statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes with external experts.
- Author
-
Chernyshov PV, Tomas-Aragones L, Manolache L, Pustisek N, Salavastru CM, Marron SE, Bewley A, Svensson A, Poot F, Suru A, Salek SS, Augustin M, Szepietowski JС, Koumaki D, Katoulis AC, Sampogna F, Abeni D, Linder DM, Speeckaert R, van Geel N, Seneschal J, Ezzedine K, and Finlay AY
- Subjects
- Child, Humans, Quality of Life, Surveys and Questionnaires, Dermatology, Venereology, Vitiligo therapy
- Abstract
Members of the European Academy of Dermatology and Venereology (EADV) Task Force on Quality of Life (QoL) and Patient Oriented Outcomes reviewed the instruments available for health-related (HR) QoL assessment in vitiligo and together with external vitiligo experts (including representatives of the EADV Vitiligo Task Force) have made practical recommendations concerning the assessment of QoL in vitiligo patients. The Dermatology Life Quality Index (DLQI) was the most frequently used HRQoL instrument, making comparison of results between different countries possible. Several vitiligo-specific instruments were identified. The vitiligo Impact Scale (VIS) is an extensively validated vitiligo-specific HRQoL instrument with proposed minimal important change and clinical interpretation for VIS-22 scores. VIS-22 was developed for use in India, where there are some specific cultural beliefs concerning vitiligo. The EADV Task Force on QoL and Patient Oriented Outcomes recommends use of the DLQI and the Children's Dermatology Life Quality Index (CDLQI) as dermatology-specific instruments in vitiligo. There is a strong need for a valid (including cross-cultural validation) vitiligo-specific instrument that can be either a new instrument or the improvement of existing instruments. This validation must include the proof of responsiveness., (© 2022 European Academy of Dermatology and Venereology.)
- Published
- 2023
- Full Text
- View/download PDF
32. Molecular profile of the NF-κB signalling pathway in human colorectal cancer.
- Author
-
Dobre M, Trandafir B, Milanesi E, Salvi A, Bucuroiu IA, Vasilescu C, Niculae AM, Herlea V, Hinescu ME, and Constantinescu G
- Subjects
- Humans, NF-kappa B genetics, NF-kappa B metabolism, Gene Expression Regulation, Neoplastic, Signal Transduction genetics, MicroRNAs metabolism, Colorectal Neoplasms pathology
- Abstract
The development and progression of colorectal cancer (CRC) have been associated with inflammation processes that involve the overactivation of the NF-κB signalling pathway. The characterization of the NF-κB expression profile in CRC is an important topic since the suppression of NF-κB represents a potential therapeutic approach. In this study, we assessed the expression levels of 84 NF-κB-related genes in paired tumoral (T) and peritumoral (PT) tissues from 18 CRC patients and 18 normal colonic mucosae, and the expression levels of three miRNAs targeting the most dysregulated genes revealed by the case-control analysis. Comparing the gene expression profile of T and controls, 60 genes were dysregulated. The comparison of T and PT revealed 17 dysregulated genes in the tumoral tissues, with IL1B, CXCL8, IL1A, and CSF2 being the most upregulated. Notably, through a bioinformatics analysis, the differential gene expression of 11 out of the 17 genes was validated on a larger cohort of 308 CRC patients compared with 41 controls. Moreover, a decrease in the levels of RELA, NOD1, CASP8, BCL2L1, ELK1, and IKBKB was identified in poorly differentiated tumours compared to moderately differentiated tumours. The analysis of the three miRNAs targeting IL1B, CXCL8, IL1A, and CSF2 showed that miR-182-5p was upregulated in T compared with PT, whereas miR-10b-5p was downregulated in T compared with PT and control tissues. Our results may contribute to the design of new experimental therapeutic strategies based on endogenous molecules, such as miRNAs, to target the genetic key players of the NF- κB pathway., (© 2022 The Authors. Journal of Cellular and Molecular Medicine published by Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd.)
- Published
- 2022
- Full Text
- View/download PDF
33. Acne care in health care providers during the COVID-19 pandemic: A national survey.
- Author
-
Cretu S, Dascalu M, and Salavastru CM
- Subjects
- Anti-Bacterial Agents, Benzoyl Peroxide, Cross-Sectional Studies, Health Personnel, Humans, Pandemics, Retinoids, Salicylic Acid therapeutic use, Acne Vulgaris chemically induced, Acne Vulgaris epidemiology, Acne Vulgaris therapy, COVID-19 epidemiology, Dermatologic Agents
- Abstract
The medical face mask, widely used by health care providers (HCPs) during the COVID-19 pandemic, is reported to be associated with adverse reactions, among which acne is one of the most common. This study aims to evaluate treatment strategies employed by HCPs affected by acne in association with prolonged medical face mask use, their openness towards accessing telemedicine as a patient, and other lifestyle factors with potential influence on the evolution of their acne. Our online-based cross-sectional survey was distributed between December 17, 2020, and February 17, 2021, and targeted HCPs from different medical centers in Romania. From the n = 134 respondents, 50% reported current acne lesions and 56.7% required treatment. Of the latter, 65.8% self-medicated and 34.2% sought medical advice. The most common treatment associations between anti-acne topical products were: retinoids and salicylic acid (18.18%; n = 8), retinoids and benzoyl peroxide (13.64%; n = 6), salicylic acid and benzoyl peroxide (13.64%; n = 6), and azelaic acid together with salicylic acid (9.09%; n = 4). The health care provider responders were reluctant to use telemedicine, as only 14.2% participants were open to telemedicine. Our results suggest inadequate management of acne in HCPs using medical face masks. As with other occupational hazards and proper usage of personal protective equipment, HCPs should receive adequate screening, training, and treatment for this condition., (© 2022 Wiley Periodicals LLC.)
- Published
- 2022
- Full Text
- View/download PDF
34. Perioperative trajectory of plasma viscosity: A prospective, observational, exploratory study in cardiac surgery.
- Author
-
Valeanu L, Andrei S, Ginghina C, Robu C, Ciurciun A, Balan C, Stefan M, Stoian A, Stanculea I, Cheta A, Dima L, Stiru O, Filipescu D, Bubenek-Turconi SI, and Longrois D
- Subjects
- Adult, Blood Viscosity, Fibrinogen analysis, Hemoglobins, Humans, Microcirculation, Prospective Studies, Viscosity, Cardiac Surgical Procedures
- Abstract
Objective: Plasma viscosity is one of the critical factors that regulate microcirculatory flow but has received scant research attention. The main objective of this study was to evaluate plasma viscosity in cardiac surgery with respect to perioperative trajectory, main determinants, and impact on outcome., Methods: Prospective, single center, observational study, including 50 adult patients undergoing cardiac surgery with cardiopulmonary bypass between February 1, 2020 and May 31, 2021. Clinical perioperative characteristics, short term outcome, standard blood analysis, plasma viscosity, total proteins, and fibrinogen concentrations were recorded at 10 distinct time points during the first perioperative week., Results: The longitudinal analysis showed that plasma viscosity is strongly influenced by proteins and measurement time points. Plasma viscosity showed a coefficient of variation of 11.3 ± 1.08 for EDTA and 12.1 ± 2.1 for citrate, similarly to total proteins and hemoglobin, but significantly lower than fibrinogen (p < .001). Plasma viscosity had lower percentage changes compared to hemoglobin (RANOVA, p < .001), fibrinogen (RANOVA, p < .001), and total proteins (RANOVA, p < .001). The main determinant of plasma viscosity was protein concentrations. No association with outcome was found, but the study may have been underpowered to detect it., Conclusion: Plasma viscosity had a low coefficient of variation and low perioperative changes, suggesting tight regulation. Studies linking plasma viscosity with outcome would require large patient cohorts., (© 2022 John Wiley & Sons Ltd.)
- Published
- 2022
- Full Text
- View/download PDF
35. 2021 European guideline for the management of vulval conditions.
- Author
-
van der Meijden WI, Boffa MJ, Ter Harmsel B, Kirtschig G, Lewis F, Moyal-Barracco M, Tiplica GS, and Sherrard J
- Subjects
- Female, Humans, Vulvar Diseases diagnosis, Vulvar Diseases therapy
- Published
- 2022
- Full Text
- View/download PDF
36. Granulocyte macrophage-colony stimulating factor and keratinocyte growth factor control of early stages of differentiation of oral epithelium.
- Author
-
Das R, Virlan MJR, Xenaki V, Kulasekara KK, Lukandu O, Neppelberg E, Vintermyr OK, Johannessen AC, Calenic B, and Costea DE
- Subjects
- Cell Differentiation, Cells, Cultured, Collagen metabolism, Epithelium, Fibroblasts metabolism, Granulocytes metabolism, Humans, Keratinocytes, Macrophages metabolism, Fibroblast Growth Factor 7 metabolism, Fibroblast Growth Factor 7 pharmacology, Granulocyte-Macrophage Colony-Stimulating Factor metabolism, Granulocyte-Macrophage Colony-Stimulating Factor pharmacology
- Abstract
Oral epithelial differentiation is known to be directed by underlying fibroblasts, but the responsible factor(s) have not been identified. We aimed here to identify fibroblast-derived factors responsible for oral epithelial differentiation. Primary normal human oral keratinocytes and fibroblasts were isolated from healthy volunteers after informed consent (n = 5) and 3D-organotypic (3D-OT) cultures were constructed. Various growth factors were added at a range of 0.1-100 ng/ml. 3D-OTs were harvested after ten days and assessed histologically, by immunohistochemistry and the TUNEL method. Epithelium developed in 3D-OT without fibroblasts showed an undifferentiated phenotype. Addition of granulocyte macrophage-colony stimulating factor (GM-CSF) induced expression of cytokeratin 13 in suprabasal cell layers. Admixture of GM-CSF and keratinocyte growth factor (KGF) induced, in addition, polarization of epidermal growth factor (EGF) receptor and β1-integrin to basal cell layer and collagen IV deposition. Terminal differentiation with polarization of TUNEL-positive cells to superficial layers occurred only in the presence of fibroblasts in collagen gels either in direct contact or at distance from normal oral keratinocytes. Taken together, these results show that major aspects of oral epithelial differentiation are regulated by the synergic combination of GM-CSF and KGF. However, the terminal stage seems to be controlled by other yet unidentified fibroblast-derived diffusible factor(s)., (© 2022 The Authors. European Journal of Oral Sciences published by John Wiley & Sons Ltd on behalf of Scandinavian Division of the International Association for Dental Research.)
- Published
- 2022
- Full Text
- View/download PDF
37. Mid- and long-term outcomes of thoracic endovascular aortic repair in acute and subacute uncomplicated type B aortic dissection.
- Author
-
Jubouri M, Al-Tawil M, Yip HCA, Bashir A, Tan SZCP, Bashir M, Anderson R, Bailey D, Nienaber CA, Coselli JS, and Williams I
- Subjects
- Humans, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Aortic Dissection etiology, Aortic Aneurysm, Thoracic etiology, Blood Vessel Prosthesis Implantation adverse effects, Endovascular Procedures methods
- Abstract
Background: Uncomplicated type B aortic dissection (un-TBAD) has been managed conservatively with medical therapy to control the heart rate and blood pressure to limit disease progression, in addition to radiological follow-up. However, several trials and observational studies have investigated the use of thoracic endovascular aortic repair (TEVAR) in un-TBAD and suggested that TEVAR provides a survival benefit over medical therapy. Outcomes of TEVAR have also been linked with the timing of intervention., Aims: The scope of this review is to collate and summarize all the evidence in the literature on the mid- and long-term outcomes of TEVAR in un-TBAD, confirming its superiority. We also aimed to investigate the relationship between the timing of TEVAR intervention and results., Methods: We carried out a comprehensive literature search on multiple electronic databases including PubMed, Scopus, and EMBASE to collate and summarize all research evidence on the mid- and long-term outcomes of TEVAR in un-TBAD, as well as its relationship with intervention timing., Results: TEVAR has proven to be a safe and effective tool in un-TBAD, offering superior mid- and long-term outcomes including all-cause and aorta-related mortality, aortic-specific adverse events, aortic remodeling, and need for reintervention. Additionally, performing TEVAR during the subacute phase of dissection seems to yield optimal results., Conclusion: The evidence demonstrating a survival advantage in favor TEVAR over medical therapy in un-TBAD means that with further research, particular trials and observational studies, TEVAR could become the gold-standard treatment option for un-TBAD patients., (© 2022 Wiley Periodicals LLC.)
- Published
- 2022
- Full Text
- View/download PDF
38. Possible mechanisms of neuropathies associated with the COVID-19 vaccines.
- Author
-
Maria Mirabela M, Iulia E, and Sorin T
- Subjects
- COVID-19 Vaccines adverse effects, Humans, SARS-CoV-2, COVID-19 prevention & control, Peripheral Nervous System Diseases
- Published
- 2022
- Full Text
- View/download PDF
39. Restrictive versus liberal transfusion in patients with diabetes undergoing cardiac surgery: An open-label, randomized, blinded outcome evaluation trial.
- Author
-
Mistry N, Shehata N, Carmona P, Bolliger D, Hu R, Carrier FM, Alphonsus CS, Tseng EE, Royse AG, Royse C, Filipescu D, Mehta C, Saha T, Villar JC, Gregory AJ, Wijeysundera DN, Thorpe KE, Jüni P, Hare GMT, Ko DT, Verma S, and Mazer CD
- Subjects
- Erythrocyte Transfusion adverse effects, Hemoglobins analysis, Humans, Cardiac Surgical Procedures adverse effects, Diabetes Mellitus epidemiology, Myocardial Infarction etiology
- Abstract
Aim: To characterize the association between diabetes and transfusion and clinical outcomes in cardiac surgery, and to evaluate whether restrictive transfusion thresholds are harmful in these patients., Materials and Methods: The multinational, open-label, randomized controlled TRICS-III trial assessed a restrictive transfusion strategy (haemoglobin [Hb] transfusion threshold <75 g/L) compared with a liberal strategy (Hb <95 g/L for operating room or intensive care unit; or <85 g/L for ward) in patients undergoing cardiac surgery on cardiopulmonary bypass with a moderate-to-high risk of death (EuroSCORE ≥6). Diabetes status was collected preoperatively. The primary composite outcome was all-cause death, stroke, myocardial infarction, and new-onset renal failure requiring dialysis at 6 months. Secondary outcomes included components of the composite outcome at 6 months, and transfusion and clinical outcomes at 28 days., Results: Of the 5092 patients analysed, 1396 (27.4%) had diabetes (restrictive, n = 679; liberal, n = 717). Patients with diabetes had more cardiovascular disease than patients without diabetes. Neither the presence of diabetes (OR [95% CI] 1.10 [0.93-1.31]) nor the restrictive strategy increased the risk for the primary composite outcome (diabetes OR [95% CI] 1.04 [0.68-1.59] vs. no diabetes OR 1.02 [0.85-1.22]; P
interaction = .92). In patients with versus without diabetes, a restrictive transfusion strategy was more effective at reducing red blood cell transfusion (diabetes OR [95% CI] 0.28 [0.21-0.36]; no diabetes OR [95% CI] 0.40 [0.35-0.47]; Pinteraction = .04)., Conclusions: The presence of diabetes did not modify the effect of a restrictive transfusion strategy on the primary composite outcome, but improved its efficacy on red cell transfusion. Restrictive transfusion triggers are safe and effective in patients with diabetes undergoing cardiac surgery., (© 2021 John Wiley & Sons Ltd.)- Published
- 2022
- Full Text
- View/download PDF
40. Kinetics and persistence of cellular and humoral immune responses to SARS-CoV-2 vaccine in healthcare workers with or without prior COVID-19.
- Author
-
Chivu-Economescu M, Bleotu C, Grancea C, Chiriac D, Botezatu A, Iancu IV, Pitica I, Necula LG, Neagu A, Matei L, Dragu D, Sultana C, Radu EL, Nastasie A, Voicu O, Ataman M, Nedeianu S, Mambet C, Diaconu CC, and Ruta SM
- Subjects
- Adult, Antibodies, Neutralizing blood, Antibodies, Neutralizing immunology, Antibodies, Viral blood, Antibodies, Viral immunology, Health Personnel, Humans, Immunoglobulin A blood, Immunoglobulin A immunology, Immunoglobulin G blood, Immunoglobulin G immunology, Interferon-gamma blood, Interferon-gamma immunology, Kinetics, Longitudinal Studies, Middle Aged, Spike Glycoprotein, Coronavirus immunology, Time Factors, BNT162 Vaccine immunology, COVID-19 immunology, Immunity, Cellular, Immunity, Humoral
- Abstract
SARS-CoV-2 vaccines are highly efficient against severe forms of the disease, hospitalization and death. Nevertheless, insufficient protection against several circulating viral variants might suggest waning immunity and the need for an additional vaccine dose. We conducted a longitudinal study on the kinetics and persistence of immune responses in healthcare workers vaccinated with two doses of BNT162b2 mRNA vaccine with or without prior SARS-CoV-2 infection. No new infections were diagnosed during follow-up. At 6 months, post-vaccination or post-infection, despite a downward trend in the level of anti-S IgG antibodies, the neutralizing activity does not decrease significantly, remaining higher than 75% (85.14% for subjects with natural infection, 88.82% for vaccinated after prior infection and 78.37% for vaccinated only). In a live-virus neutralization assay, the highest neutralization titres were present at baseline and at 6 months follow-up in persons vaccinated after prior infection. Anti-S IgA levels showed a significant descending trend in vaccinated subjects (p < 0.05) after 14 weeks. Cellular immune responses are present even in vaccinated participants with declining antibody levels (index ratio 1.1-3) or low neutralizing activity (30%-40%) at 6 months, although with lower T-cell stimulation index (p = 0.046) and IFN-γ secretion (p = 0.0007) compared to those with preserved humoral responses., (© 2022 The Authors. Journal of Cellular and Molecular Medicine published by Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd.)
- Published
- 2022
- Full Text
- View/download PDF
41. Multiple cranial nerve palsies following COVID-19 vaccination-Case report.
- Author
-
Manea MM, Dragoș D, Enache I, Sirbu AG, and Tuta S
- Subjects
- Adult, BNT162 Vaccine, COVID-19 Vaccines, Humans, Male, SARS-CoV-2, Vaccination, COVID-19, Cranial Nerve Diseases chemically induced
- Abstract
Background: The novel COVID-19 vaccines have side effects that require efficient and close monitoring., Aims of the Study: To examine whether the Pfizer-BioNTech vaccine is associated with multiple cranial neuropathy., Methods: We report the case of a 29-year-old male patient with no notable history who presented with left oculomotor, abducens, trigeminal and facial palsies 6 days after receiving the first dose of the Pfizer-BioNTech COVID-19 vaccine., Results: Gadolinium-enhanced MRI of the brain revealed enhancement in the left facial, trigeminal and oculomotor nerves, which persisted upon repeated examination. The cerebrospinal fluid analysis showed no sign of inflammation, both initially and after 1 month from the start of the patient's symptoms. Other causes were excluded by laboratory tests. The patient received high doses of corticosteroids, with improvement of symptoms., Conclusions: In our case, the most probable etiology of the patient's multiple cranial neuropathy is the Pfizer-BioNTech vaccine, which highlights the need for prolonged surveillance of COVID-19 vaccine neurological complications., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Published
- 2022
- Full Text
- View/download PDF
42. Three-dimensional right ventriculo-arterial coupling as an independent determinant of severe heart failure symptoms in patients with dilated cardiomyopathy.
- Author
-
Vîjîiac A, Onciul S, Deaconu S, Vătășescu R, Guzu C, Verinceanu V, Scărlătescu A, Zamfir D, Petre I, Scafa-Udriște A, and Dorobanţu M
- Subjects
- Humans, Prognosis, Stroke Volume, Ventricular Function, Left, Ventricular Function, Right, Cardiomyopathy, Dilated complications, Cardiomyopathy, Dilated diagnostic imaging, Heart Failure complications, Heart Failure diagnostic imaging
- Abstract
Background: Right ventricular-pulmonary artery coupling (RVPAC) is a predictor of outcome in pulmonary hypertension. However, the role of this parameter in dilated cardiomyopathy (DCM) remains to be established. The aim of this study was to assess the contribution of RVPAC to the occurrence of severe heart failure (HF) symptoms in patients with DCM using three-dimensional (3D) echocardiography., Methods: We prospectively screened 139 outpatients with DCM, 105 of whom were enrolled and underwent 3D echocardiographic assessment. RVPAC was estimated non-invasively as the 3D right ventricular stroke volume (SV) to end-systolic volume (ESV) ratio. Severe HF symptoms were defined by New York Heart Association (NYHA) class III or IV. We evaluated differences in RVPAC across NYHA classes and the ability of RVPAC to predict severe symptoms., Results: Mean left ventricular (LV) ejection fraction was 28±7%. Mean RVPAC was 0.77±0.30 and it was significantly more impaired with increasing symptom severity (p = 0.001). RVPAC was the only independent determinant of severe HF symptoms, after adjusting for age, diuretic use, LV systolic function, LV diastolic function, and pulmonary artery systolic pressure (OR 0.035 [95% CI, 0.004-0.312], p = 0.003). By receiver-operating characteristic analysis, the RVPAC cut-off value for predicting severely symptomatic status was 0.54 (area under the curve = 0.712, p < 0.001)., Conclusion: 3D echocardiographic SV/ESV ratio is an independent correlate of severe HF symptoms in patients with DCM. 3D RVPAC might prove to be a useful risk stratification tool for these patients, should it be further validated in larger studies., (© 2022 Wiley Periodicals LLC.)
- Published
- 2022
- Full Text
- View/download PDF
43. Personal protective equipment use and face acne in health care providers during the COVID-19 pandemic in Romania: A new occupational acne type?
- Author
-
Cretu S, Dascalu M, Georgescu SR, and Salavastru CM
- Subjects
- Health Personnel, Humans, Pandemics, Personal Protective Equipment, Romania epidemiology, SARS-CoV-2, Acne Vulgaris epidemiology, COVID-19
- Published
- 2022
- Full Text
- View/download PDF
44. The atomic portrait of SARS-CoV-2 as captured by cryo-electron microscopy.
- Author
-
Fertig TE, Chitoiu L, Terinte-Balcan G, Peteu VE, Marta D, and Gherghiceanu M
- Subjects
- Angiotensin-Converting Enzyme 2 immunology, Angiotensin-Converting Enzyme 2 metabolism, Antibodies, Viral biosynthesis, COVID-19 immunology, COVID-19 virology, COVID-19 Vaccines administration & dosage, COVID-19 Vaccines biosynthesis, Cryoelectron Microscopy, Epitopes chemistry, Epitopes immunology, Epitopes metabolism, Humans, Models, Molecular, Protein Binding, Protein Interaction Domains and Motifs, Protein Structure, Secondary, Receptors, Virus immunology, Receptors, Virus metabolism, SARS-CoV-2 drug effects, SARS-CoV-2 pathogenicity, SARS-CoV-2 ultrastructure, Serine Endopeptidases chemistry, Serine Endopeptidases immunology, Serine Endopeptidases metabolism, Spike Glycoprotein, Coronavirus immunology, Spike Glycoprotein, Coronavirus metabolism, Virion drug effects, Virion pathogenicity, Virion ultrastructure, Angiotensin-Converting Enzyme 2 chemistry, Antibodies, Viral chemistry, COVID-19 prevention & control, COVID-19 Vaccines chemistry, Receptors, Virus chemistry, Spike Glycoprotein, Coronavirus chemistry
- Abstract
Transmission electron microscopy has historically been indispensable for virology research, as it offers unique insight into virus function. In the past decade, as cryo-electron microscopy (cryo-EM) has matured and become more accessible, we have been able to peer into the structure of viruses at the atomic level and understand how they interact with the host cell, with drugs or with antibodies. Perhaps, there was no time in recent history where cryo-EM was more needed, as SARS-CoV-2 has spread around the globe, causing millions of deaths and almost unquantifiable economic devastation. In this concise review, we aim to mark the most important contributions of cryo-EM to understanding the structure and function of SARS-CoV-2 proteins, from surface spikes to the virus core and from virus-receptor interactions to antibody binding., (© 2021 The Authors. Journal of Cellular and Molecular Medicine published by Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd.)
- Published
- 2022
- Full Text
- View/download PDF
45. Sexually transmitted infections - 30 years later.
- Author
-
Tiplica GS
- Subjects
- Humans, Sexual Behavior, HIV Infections, Sexually Transmitted Diseases epidemiology
- Published
- 2021
- Full Text
- View/download PDF
46. Management of anaphylaxis due to COVID-19 vaccines in the elderly.
- Author
-
Bousquet J, Agache I, Blain H, Jutel M, Ventura MT, Worm M, Del Giacco S, Benetos A, Bilo BM, Czarlewski W, Abdul Latiff AH, Al-Ahmad M, Angier E, Annesi-Maesano I, Atanaskovic-Markovic M, Bachert C, Barbaud A, Bedbrook A, Bennoor KS, Berghea EC, Bindslev-Jensen C, Bonini S, Bosnic-Anticevich S, Brockow K, Brussino L, Camargos P, Canonica GW, Cardona V, Carreiro-Martins P, Carriazo A, Casale T, Caubet JC, Cecchi L, Cherubini A, Christoff G, Chu DK, Cruz AA, Dokic D, El-Gamal Y, Ebisawa M, Eberlein B, Farrell J, Fernandez-Rivas M, Fokkens WJ, Fonseca JA, Gao Y, Gavazzi G, Gawlik R, Gelincik A, Gemicioğlu B, Gotua M, Guérin O, Haahtela T, Hoffmann-Sommergruber K, Hoffmann HJ, Hofmann M, Hrubisko M, Illario M, Irani C, Ispayeva Z, Ivancevich JC, Julge K, Kaidashev I, Khaitov M, Knol E, Kraxner H, Kuna P, Kvedariene V, Lauerma A, Le LTT, Le Moing V, Levin M, Louis R, Lourenco O, Mahler V, Martin FC, Matucci A, Milenkovic B, Miot S, Montella E, Morais-Almeida M, Mortz CG, Mullol J, Namazova-Baranova L, Neffen H, Nekam K, Niedoszytko M, Odemyr M, O'Hehir RE, Okamoto Y, Ollert M, Palomares O, Papadopoulos NG, Panzner P, Passalacqua G, Patella V, Petrovic M, Pfaar O, Pham-Thi N, Plavec D, Popov TA, Recto MT, Regateiro FS, Reynes J, Roller-Winsberger RE, Rolland Y, Romano A, Rondon C, Rottem M, Rouadi PW, Salles N, Samolinski B, Santos AF, S Sarquis F, Sastre J, M G A Schols J, Scichilone N, Sediva A, Shamji MH, Sheikh A, Skypala I, Smolinska S, Sokolowska M, Sousa-Pinto B, Sova M, Stelmach R, Sturm G, Suppli Ulrik C, Todo-Bom AM, Toppila-Salmi S, Tsiligianni I, Torres M, Untersmayr E, Urrutia Pereira M, Valiulis A, Vitte J, Vultaggio A, Wallace D, Walusiak-Skorupa J, Wang DY, Waserman S, Yorgancioglu A, Yusuf OM, Zernotti M, Zidarn M, Chivato T, Akdis CA, Zuberbier T, and Klimek L
- Subjects
- Aged, COVID-19 Vaccines, Epinephrine, Humans, Male, SARS-CoV-2, Anaphylaxis etiology, Anaphylaxis prevention & control, COVID-19
- Abstract
Older adults, especially men and/or those with diabetes, hypertension, and/or obesity, are prone to severe COVID-19. In some countries, older adults, particularly those residing in nursing homes, have been prioritized to receive COVID-19 vaccines due to high risk of death. In very rare instances, the COVID-19 vaccines can induce anaphylaxis, and the management of anaphylaxis in older people should be considered carefully. An ARIA-EAACI-EuGMS (Allergic Rhinitis and its Impact on Asthma, European Academy of Allergy and Clinical Immunology, and European Geriatric Medicine Society) Working Group has proposed some recommendations for older adults receiving the COVID-19 vaccines. Anaphylaxis to COVID-19 vaccines is extremely rare (from 1 per 100,000 to 5 per million injections). Symptoms are similar in younger and older adults but they tend to be more severe in the older patients. Adrenaline is the mainstay treatment and should be readily available. A flowchart is proposed to manage anaphylaxis in the older patients., (© 2021 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.)
- Published
- 2021
- Full Text
- View/download PDF
47. Quality of life measurement in alopecia areata. Position statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes.
- Author
-
Chernyshov PV, Tomas-Aragones L, Finlay AY, Manolache L, Marron SE, Sampogna F, Spillekom-van Koulil S, Pustisek N, Suru A, Evers AWM, Salavastru C, Svensson A, Abeni D, Blome C, Poot F, Jemec GBE, Linder D, Augustin M, Bewley A, Salek SS, and Szepietowski JC
- Subjects
- Hair, Humans, Quality of Life, Alopecia Areata, Dermatology, Venereology
- Abstract
New treatment options may lead to an increased interest in using reliable and sensitive instruments to assess health-related quality of life in people with alopecia areata (AA). The purpose of this paper is to present current knowledge about quality of life assessment in AA. The dermatology-specific Dermatology Life Quality Index (DLQI) was the most widely reported health-related quality of life instrument used in AA. Three AA-specific (Alopecia Areata Symptom Impact Scale, Alopecia Areata Quality of Life Index and Alopecia Areata Patients' Quality of Life) and three hair disease-specific instruments (Hairdex, Scalpdex and 'hair-specific Skindex-29') were identified with a range of content and validation characteristics: there is little evidence yet of the actual use of these measures in AA. Scalpdex is the best-validated hair disease-specific instrument. Further extensive validation is needed for all of the AA-specific instruments. The European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes recommends the use of the dermatology-specific DLQI questionnaire, hair disease-specific Scalpdex and the alopecia areata-specific instruments the Alopecia Areata Symptom Impact Scale or Alopecia Areata Quality of Life Index, despite the limited experience of their use. We hope that new treatment methods will be able to improve both clinical signs and health-related quality of life in patients with AA. In order to assess the outcomes of trials on these new treatment methods, it would be helpful when further development and validation of AA-specific instruments is being encouraged and also conducted., (© 2021 European Academy of Dermatology and Venereology.)
- Published
- 2021
- Full Text
- View/download PDF
48. Right ventricular-arterial coupling - A new perspective for right ventricle evaluation in heart failure patients undergoing cardiac resynchronization therapy.
- Author
-
Deaconu S, Deaconu A, Scarlatescu A, Petre I, Onciul S, Vijiac A, Onut R, Zamfir D, Marascu G, Iorgulescu C, Radu DA, Bogdan S, Vatasescu R, and Dorobantu M
- Subjects
- Aged, Echocardiography, Doppler, Female, Heart Ventricles diagnostic imaging, Humans, Male, Middle Aged, Prospective Studies, Pulmonary Artery diagnostic imaging, Stroke Volume, Ventricular Function, Left, Ventricular Function, Right, Cardiac Resynchronization Therapy, Heart Failure diagnostic imaging, Heart Failure therapy
- Abstract
Background: Right ventricular - arterial (RV-PA) coupling can be estimated by echocardiography using the ratio between (TAPSE) and pulmonary arterial systolic pressure (PASP). TAPSE/PASP ratio proved to be a prognostic parameter in patients with heart failure and reduced ejection fraction (HFrEF)., Objective: To evaluate the significance of RV-PA coupling in patients with HFrEF undergoing cardiac resynchronization therapy (CRT)., Methods: Patients undergoing CRT in our center between January 2017 and November 2019 were eligible. Response to CRT was defined by a reduction of more than 15% of left ventricle systolic volume (LVESV) one year after CRT. Primary endpoint was a composite of HF hospitalizations and death during follow-up., Results: 54 patients (Age 64.0 ± 13.8 years; 58% male; left ventricular ejection fraction (LVEF) 28.4 ± 1.3%) were prospectively included. After a mean follow-up of 31 ± 12.9months, the primary endpoint had occurred in 18 (33.3%) patients. A lower TAPSE/PASP ratio was associated with baseline worse HF symptoms, lower LVEF and long-term less LV reverse remodeling (P < .05). After one year CRT improved RV systolic function (TAPSE, RV global longitudinal strain, P < .05), but not TAPSE/PASP ratio (P = .4). The ratio TAPSE/PASP (AUC=0.834) ≥ 0.58 mm/mm Hg showed good sensitivity (90%) and specificity (81.8%) for predicting response to CRT while a ratio <0.58 mm/mm Hg was associated with a higher risk of death and HF hospitalizations during the follow-up (HR 5.37 95%CI [1.6-18], P < .001)., Conclusion: RV-PA coupling evaluation using TAPSE/PASP ratio predicts CRT response. A lower TAPSE/PASP ratio is associated with a higher risk of adverse cardiovascular events., (© 2021 Wiley Periodicals LLC.)
- Published
- 2021
- Full Text
- View/download PDF
49. Subclinical left ventricular dysfunction in men under androgen deprivation therapy for prostate cancer, revealed by speckle-tracking-derived parameters, repolarization, and myocardial injury markers.
- Author
-
Gheorghe ACD, Ciobanu A, Hodorogea AS, Radavoi GD, Jinga V, Rascu ASC, Nanea IT, and Gheorghe GS
- Subjects
- Aged, Androgen Antagonists adverse effects, Androgens, Electrocardiography, Humans, Male, Middle Aged, Prospective Studies, Prostatic Neoplasms complications, Prostatic Neoplasms drug therapy, Ventricular Dysfunction, Left chemically induced, Ventricular Dysfunction, Left diagnosis
- Abstract
Objective: To analyze global left ventricular longitudinal strain (GLS), mechanical dispersion (MD), electrocardiographic repolarization, and myocardial injury markers changes during androgen deprivation therapy (ADT) and subsequent hypogonadism in men with advanced prostate cancer., Methods: We included 31 patients 69.7 ± 7.3 years old, in sinus rhythm, with stable cardiac conditions and evaluated them by echocardiography, electrocardiography, and blood sampling for high sensitivity cardiac troponin I (hs-cTnI), and N-terminal pro-brain natriuretic peptide (NTproBNP), at ADT initiation (M0) and after 6 months of treatment (M1). Peak longitudinal strain by speckle-tracking echocardiography was assessed in 17 left ventricular segments and averaged to GLS. Standard deviation of time intervals from the start of Q/R on electrocardiogram to peak longitudinal strain in the 17 segments (MD
SD ), and the difference between the longest and shortest time-to-peak strain intervals (MDdelta ) were calculated as indices of MD. Fridericia corrected electrocardiographic repolarization parameters were analyzed as follows: QT interval (QTc), mean and maximum values of Tpeak-Tend interval (Tpe), and Tpe/QT ratio, Tpe dispersion (Tped)., Results: Significant impairments of the following parameters were registered between M0 and M1: GLS (%) (-16.93 ± 3.89; -14.43 ± 3.57, P < .001), MDSD (ms) (77.4 ± 21.4; 89 ± 27, P = .004), MDdelta (ms) (225.3 ± 78.3; 259.9 ± 108.4, P = .02), QTc (ms) (458.8 ± 43.4; 485.6 ± 45.1, P = .01), maxTpe/QT (0.246 ± 0.04; 0.268 ± 0.04, P = .01), maxTpe (ms) (105.4 ± 23.2; 119.5 ± 26.4 P = .01), meanTpe (ms) (83.3 ± 16.8; 90.7 ± 19.3, P = .02), and hs-cTnI (ng/mL) (4.6 ± 5.4; 5.4 ± 6.4, P = .01). Mean serum testosterone level at M1 was 0.1 ± 0.13 ng/mL. The patients' clinical cardiological status remained stable during follow-up., Conclusions: ADT and subsequent hypogonadism induce subclinical alterations in GLS, MD, electrocardiographic repolarization parameters, and hs-cTnI during the first 6 months of treatment., (© 2021 The Authors. Echocardiographypublished by Wiley Periodicals LLC.)- Published
- 2021
- Full Text
- View/download PDF
50. Fibroepithelioma of Pinkus: Dermoscopic and reflectance confocal microscopic patterns.
- Author
-
Lupu M, Clatici VG, Barinova E, and Voiculescu VM
- Subjects
- Dermoscopy, Diagnosis, Differential, Humans, Microscopy, Confocal, Carcinoma, Basal Cell diagnostic imaging, Skin Neoplasms diagnostic imaging
- Published
- 2021
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.