Search

Classic polyarteritis nodosa (PAN) is a vasculitis with systemic manifestations that is characterized by inflammatory and necrotizing lesions affecting medium and small muscular arteries, most frequently at the bifurcation of the vessels. These lesions lead to the formation of microaneurysms, hemorrhaging ruptured aneurysms, thrombosis, and, consequently, ischemia or organ infarction. Background and Objectives : We present a complex clinical case of a patient with a late diagnosis of polyarteritis nodosa with multiorgan involvement. Materials and Methods : The 44-year-old patient, in an urban environment, presented on her own in the emergency room for acute ischemia phenomena and forearm and right-hand compartment syndrome, requiring surgical decompression in the Plastic Surgery Clinic. Results : Significant inflammatory syndrome is noted, alongside severe normocytic hypochromic iron deficiency anemia, nitrogen retention syndrome, hyperkalemia, hepatic syndrome, and immunological disturbances: absence of cANCA, pANCA, anti Scl 70 Ac, antinuclear Ac, and anti dDNA Ac, as well as a low C3 fraction of the plasmatic complement system. The morphological aspect described in the right-hand skin biopsy correlated with the clinical data supports the diagnosis of PAN. Conclusions : The viral form of PAN seems to be individualized as a distinct entity, requiring early, aggressive medication.

Background In Romania, as in other parts of the world, the family doctor is the first to make contact with a healthy patient and is also the first to notice even the smallest pathological changes. In the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the patient's communication with the family doctor became even closer and some behavioral changes could be easily noticed. Objective To assess the symptoms of anxiety and depression in the Romanian population using social media platforms in the context of the COVID-19 pandemic. Methods We conducted an anonymous, web-based cross-sectional survey consisting of 31 questions related to general characteristics (age, gender, education, inhabitancy, residence, smoking status, and alcohol consumption) and adapted GAD-7 (7-item General Anxiety Disorders questionnaire) and PHQ-9 (9-item Patient Health Questionnaire). This questionnaire was sent to volunteers in an electronic format through a social network (Facebook, Twitter). The data collected were statistically processed using IBM SPSS v25.0 (IBM Corp., Armonk, NY). The inclusion criteria were age over 18 years and no history of chronic disease. The exclusion criteria consisted of the absence of a mental illness diagnosis. Results From the 1254 respondents, 1232 cases were selected for statistical analysis after applying the exclusion criteria. The mean age was 35.94 (SD = 11.4, 95%CI=10.9-11.9) with a minimum of 18 years and a maximum of 97 years. Eighty-four point nine percent (84.9%; N=1046) of all study participants are female and 79.13% (N= 975) live in the urban area. A total of 188 (15.25%) were diagnosed with COVID-19 of which 31 (16.66%) were male and 157 (15%) were female. N=170 (13.8%) reported moderate symptoms of anxiety during the last two weeks before the survey while N=96 (7.8%) had severe anxiety. Twenty-two point two percent (22.2%; N=274) of the participants reported moderate symptoms of depression while 10.1% (N=125) had moderately severe symptoms and 6.6% (N=81) could be diagnosed with severe depression. A greater likelihood of screening for depression diagnosis was associated with ages between 25 and 34 years (OR=0.90, 95%CI=0.86-0.94, P<. 001), 35 and 44 years (OR=0.88, 95%CI=0.84-0.93, P<. 001), and 45 and 54 years (OR=0.87, 95%CI=0.82-0.92, P<. 001). Also, a tendency was observed for women to be more prone to high levels of anxiety (OR=1.21, 95%CI=1.08-1.35, P< . 001) and depression (OR=2.16, 95%CI=1.51-308, P< . 005). Conclusions Regarding the high prevalence of depression and anxiety, especially in women, appropriate measures for the risk categories should be applied. In the new social context created by the COVID-19 pandemic, screening for psychiatric and psychological disorders should be performed by telemedicine., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Popa et al.)

The purpose of the study was to determine the prevalence and to describe the clinical presentations of Attention Deficit Hyperkinetic Syndrome in the pediatric patients of the Outpatient Specialty Clinic of the "Sf. Spiridon" University Hospital of Iaşi (a pediatric neuro-psychiatry practice and a general pediatric practice). The studied group consisted of 51 children and adolescents ages 2 years 6 month-18 years of age (urban environment 34 children--66%, rural environment 17 children--34% ; male gender 36 children--70%, female gender 15 children--30%). The pediatric patients represented a prevalence of 1.9% of the Attention Deficit Hyperkinetic Syndrome having the main features: motor and psychological instability, lack of attention, negativism, impulsivity, and social and school integration difficulties. The existence in 40% of cases of family problems (couple pathology, parents with psychiatric disorders, alcoholism, etc) proves the importance of the family patterns description in the apparition and evolution of Attention Deficit Hyperkinetic Syndrome. The study performed underlines the existence of the Attention Deficit Hyperkinetic Syndrome, the necessity of multi-disciplinary intervention with the purpose of precise and on-time diagnosis of this syndrome, to ensure a better integration of these children and teenagers in the social and school environment.