ARS Medica Tomitana Feed

Managerial and Emotional Challenges for Parents of Children with Bronchiolitis

Tue, 14 Oct 2025 00:00:00 GMT

One of the most common respiratory conditions in infants and young children is bronchiolitis, which, in addition to the medical problems it causes, can have a serious emotional impact on parents. To highlight the psychosocial demands associated with this medical experience, this research examines the emotional and administrative difficulties faced by parents of children with bronchiolitis. The study was conducted on a sample of approximately 2,650 pediatric cases, of which 350 were diagnosed with bronchiolitis. The parents of these children completed a standardized questionnaire on emotional experiences, difficulties in understanding medical information, stress levels, perceived social support, and ability to manage critical situations. To further explore the quantitative data, a subgroup of 50 parents participated in semi-structured interviews, which provided a detailed perspective on the difficulties experienced on a personal and family level. The results showed high levels of stress (82%), anxiety (78%), and feelings of helplessness (65%) among parents. Challenges related to communication with medical staff, lack of social support, and financial difficulties were also identified. Qualitative analysis highlighted recurring themes such as fear of the child’s condition worsening, lack of clarity in medical information, and the emotional impact on family balance. The study emphasizes the importance of a family-centered approach in the care of children with bronchiolitis and highlights the need to integrate psychological support into pediatric medical practice.

A Data-Centric Perspective on Nosocomial Infections Following Surgical Procedures

Tue, 14 Oct 2025 00:00:00 GMT

Background: Postoperative nosocomial infections (NIs) increase morbidity, hospitalisation, and mortality. The emergence of multidrug-resistant organisms (MDROs) complicate care and require strict infection control and antibiotic therapy. This study examined postoperative NIs’ clinical, microbiological, treatment profiles and identified risk factors. Methods: This retrospective observational study included 56 adult surgical patients from two tertiary centers in Constanta, Romania. We analysed demographics, comorbidities, operation type, microbiology, inflammatory indicators, ICU admission, mortality, and antibiotic resistance/sensitivity. Results: Patients had a mean age of 53.21 ± 22.61 years, with a slightly male predominance. The ICU had 26.4% admission and 9.4% death. The most common comorbidities were dementia, obesity, diabetes, and atrial fibrillation. Pseudomonas aeruginosa, Acinetobacter baumannii, and Staphylococcus epidermidis dominated the pathogens spectrum. In particular, 40% of cultures were resistant to tetracycline, ceftriaxone, and erythromycin, while vancomycin and linezolid were effective. Klebsiella pneumoniae, Serratia marcescens, and Bacteroides fragilis polymicrobial infections increased ICU utilisation and hospitalisation. Conclusion: Host, procedural, and microbiological variables affect postoperative NIs. Antimicrobial medicines must be tailored to multidrug resistance patterns, and surveillance and stewardship programs are essential. Early detection of high-risk infections may enhance results with focused therapy.

Socio-Behavioral Dynamics: Pretty Privilege’s Effect on Social Relationships in Contemporary Society

Tue, 14 Oct 2025 00:00:00 GMT

Pretty privilege” refers to the social and professional advantages enjoyed by physically attractive individuals, regardless of their actual competence. This study examined the phenomenon through an international online survey completed by over 100 participants from diverse cultural and social contexts. The main objectives were to identify which social relationships are most influenced by attractiveness bias and to explore the dynamics that increase this vulnerability. Findings indicated that professional relationships, especially employer–employee interactions, were perceived as most affected, followed by friendships and client–server relationships. Demographic analyses revealed variations by nationality, gender, work experience, and relationship status, showing that perceptions of attractiveness are culturally and contextually shaped. Furthermore, 71.4% of respondents admitted using attractiveness as a basis for assumptions, linked to the halo effect and self-fulfilling prophecy. Social comparison emerged as an ambivalent factor: it facilitates relationship initiation for attractive individuals but also generates intimidation and jealousy, undermining authenticity. The conclusions highlight two directions: targeted awareness campaigns in different social domains and early educational interventions to equalize expectations toward children regardless of appearance. Addressing pretty privilege therefore requires both immediate measures and long-term strategies to promote equity and ensure that merit, rather than appearance, drives social progress.

Diagnosis of Esophagogastric Junction Cancer - Retrospective Study

Tue, 14 Oct 2025 00:00:00 GMT

Esophagogastric junction cancer is a distinct anatomical and oncological entity with specific clinical and therapeutic characteristics. It is a pathology located at the interface between the esophagus and the stomach. It is classified according to the system proposed by Siewert into three types (I, II, III), depending on the location of the tumor center relative to the esophagogastric junction. From an anatomopathological point of view, esophagogastric junction cancer is an adenocarcinoma. The incidence of this type of neoplasm has been increasing in recent decades, especially in developed countries, and is associated with risk factors such as chronic gastroesophageal reflux, obesity, and Helicobacter pylori infection. The clinical diagnosis is based on the appearance of swallowing disorders, which at onset are represented by a feeling of retrosternal discomfort or a foreign body sensation, and in advanced stages by obstructive phenomena, manifested by dysphagia, which also associates general signs: asthenia, fatigue, weight loss. Occult or obvious bleeding may also occur, with secondary anemia. Paraclinically, upper digestive endoscopy assesses the tumor level and degree of obstruction, and biopsy sampling allows for histopathological typing, grading, and immunohistochemical and genetic testing. Computed tomography is still the most widely used investigation for diagnosis, pre-treatment TNM staging, assessment of neoadjuvant treatment efficacy, and detection of recurrence. In conclusion, the diagnosis of esophagogastric junction cancer involves a multimodal approach, which is essential for accurate staging and choice of therapeutic strategy.

Intestinal Gel Infusion Therapy in Advanced Parkinson’s Disease: Practical Insights and Real-World Experience

Tue, 14 Oct 2025 00:00:00 GMT

As Parkinson’s disease (PD) progresses to advanced stages, treatment optimization becomes imperative for managing refractory motor fluctuations and non-motor symptoms. Conventional oral and transdermal therapies demonstrate limited efficacy in >70% of patients after 5-7 years of treatment. Device-aided therapies (DATs) providing continuous dopaminergic stimulation represent an established approach, reducing OFF-time by 4-6 hours/day in clinical trials. The novel levodopa-entacapone-carbidopa intestinal gel (LECIG) formulation, approved in 202X, uniquely combines continuous duodenal levodopa delivery with peripheral COMT inhibition, enhancing bioavailability while reducing dose requirements. This article has two primary aims: firstly to review LECIG’s pharmacokinetic profile and synthesize clinical evidence from real-world experience, including patient-reported outcomes from early adopters (e.g., Swedish cohorts); and secondly to offer practical guidance for clinicians initiating LECIG, covering transitions from oral therapies or other DATs (e.g., LCIG), stepwise dosing titration, and adverse event management. Notably, LECIG demonstrates motor improvements comparable to standard levodopa–carbidopa intestinal gel (LCIG) but achieves therapeutic plasma concentrations at lower doses due to entacapone’s enhancement of levodopa bioavailability. These features position LECIG as a valuable option for personalized advanced PD care.

Acquired Cystic Disease Associated Renal Cell Carcinoma Clinically Manifested as a Retroperitoneal Hematoma – Brief Presentation and Review of the Literature

Tue, 14 Oct 2025 00:00:00 GMT

Acquired cystic disease associated renal cell carcinoma is an entity first described in 2006 and recognized in the WHO (World Health Organization) guidelines of 2016, also present in the current edition, which develops in the context of chronic kidney disease. We present the case of a 61 years old patient with significant comorbidities, on hemodialysis for 15 years, who was admitted to the hospital’s Emergency Department for a retroperitoneal hematoma. The histopathological examination of the left nephrectomy specimen revealed polycystic kidney disease, chronic pyelonephritis, and a malignant neoplastic proliferation. Immunohistochemical tests established the diagnosis of acquired cystic disease associated renal cell carcinoma. The particularity of this case consisted in its clinical presentation, the incidental finding of the malignant renal tumor in the context of polycystic kidney disease, and the variable immunoexpression of the CK7 marker within the tumor tissue.

Dual Therapeutic Pathways in TMJ Disorders: Insights from Hyaluronic Acid and PRP Interventions

Tue, 14 Oct 2025 00:00:00 GMT

Background: Temporomandibular joint (TMJ) disorders are multifactorial conditions characterized by pain, dysfunction, and reduced quality of life. Minimally invasive biologic therapies such as hyaluronic acid (HA) and platelet-rich plasma (PRP) infiltrations have emerged as promising alternatives to conventional management. Methods: Fifty patients treated with HA and fifty patients treated with PRP were analyzed retrospectively. Baseline demographics, etiology, imaging profiles, and adjunctive therapies were recorded. Clinical outcomes were assessed using maximal mouth opening, visual analog scale (VAS) for pain, and patient-reported results. Results: HA patients were older (mean 47.3 years) with predominantly degenerative imaging findings, while PRP patients were younger (mean 38.6 years) with parafunctional or inflammatory etiologies. HA infiltrations improved oral opening by more than 10 mm on average, whereas PRP achieved comparable functional recovery but significantly greater pain reduction (VAS decrease from 5.6 to 1.4). Patient-reported remission was more frequent in the PRP group, while HA provided consistent moderate improvement. Conclusion: Both HA and PRP represent effective therapeutic pathways in TMJ management, with complementary benefits. HA is best suited for degenerative cases requiring improved mobility, while PRP provides superior pain relief in inflammatory and parafunctional disorders.

The Burden of Postoperative Nosocomial Infections: Mortality, ICU Admissions, and Prolonged Hospitalization

Tue, 14 Oct 2025 00:00:00 GMT

Background: Postoperative nosocomial infections are a major cause of morbidity and mortality in surgical patients, increasing ICU admissions, prolonging hospitalization, and driving healthcare costs. The emergence of multidrug-resistant organisms further complicates management. Materials and Methods: We conducted a retrospective observational single-center study at Municipal Hospital Mangalia (January 2019–December 2024). Data collected comprised demographics, comorbidities, surgical site, laboratory values, bacterial cultures, and antibiotic resistance patterns. Outcomes analyzed included ICU admission, in-hospital mortality, and prolonged hospitalization. Results: 56 patients met the inclusion criteria. Gram-negative bacteria predominated, with Pseudomonas aeruginosa (25.0%) most common. Antibiotic resistance was present in 60.7% of isolates, most frequently to tetracycline (19.6%) and erythromycin (16.1%). ICU admission occurred in 14 patients (25.0%), and in-hospital mortality was 10.7%. Median hospital stay was 23.5 days (IQR 15.0–33.25), significantly longer than in non-infected patients (p < 0.05). Multivariate analysis identified SOFA score as an independent predictor of ICU admission (OR 8.29, 95% CI 1.13–60.90, p = 0.038) and qSOFA score as a predictor of mortality (OR 8.67, 95% CI 1.41–53.29, p = 0.020). Conclusions: Postoperative nosocomial infections in this cohort were associated with high ICU admission rates, increased mortality, and prolonged hospitalization. Severity scores were strong prognostic markers, underscoring their utility for early risk stratification in surgical patients.

Comparative Outcomes of Hyaluronic Acid Versus Platelet-Rich Plasma Infiltrations in Temporomandibular Joint Disorders

Tue, 14 Oct 2025 00:00:00 GMT

Background: Temporomandibular disorders (TMD) are prevalent musculoskeletal conditions that impair function and quality of life. Intra-articular therapies such as hyaluronic acid (HA) and platelet-rich plasma (PRP) have emerged as minimally invasive options, yet comparative real-world evidence remains limited. Methods: A total of 100 patients with TMD were analyzed in two parallel cohorts: 50 treated with HA and 50 with PRP. Baseline characteristics, treatment protocols, and outcomes were extracted from clinical databases. Primary outcomes included changes in mouth opening (mm) and pain intensity (VAS, 0–10). Secondary outcomes included imaging findings and patient-reported improvement. Statistical analysis was performed using SPSS version 29.0. Results: Patients in the HA group were older on average (47.3 ± 17.9 years) compared with PRP patients (38.6 ± 10.8 years). HA-treated patients more frequently presented with degenerative or structural etiologies, whereas PRP was preferred in cases of parafunctional habits and post-traumatic etiologies. HA was associated with greater improvement in mouth opening (+10.7 mm), while PRP provided superior pain relief (VAS reduction: –4.3 vs. –3.6). Imaging revealed more frequent disc displacement in HA patients (16%), whereas PRP patients more often presented with effusion and degenerative changes (24% and 76%, respectively). Patient-reported outcomes favored PRP, with major improvement or remission more commonly reported. Conclusion: Both HA and PRP provided clinically meaningful improvements in TMD management but with distinct therapeutic profiles. HA appeared most effective in improving function in degenerative disease, whereas PRP offered superior analgesia and higher patient satisfaction. These findings support a patient-tailored approach, with future trials needed to confirm long-term comparative effectiveness and the potential role of combination therapy.

Surgical Management of Esophagogastric Junction Cancer - Retrospective Study

Tue, 14 Oct 2025 00:00:00 GMT

Esophagogastric junction cancer is a boundary oncological pathology characterized by tumors located at the interface between the esophagus and stomach, with proximal and distal limits established according to the Siewert classification, which describes three types (I, II, and III) depending on the position of the tumor center relative to the esophagogastric junction. The surgical approach is determined both by this classification and by the surgeon’s experience and the level of expertise of the center where the procedure is performed. Radical surgery is based on preoperative TNM staging. The types of surgery performed and agreed upon by most centers are: transthoracic esophagectomy (Ivor Lewis), transhiatal esophagectomy (Orrienger), abdominal esophagogastrectomy (Hill), McKeown esophagectomy (triple approach), and total gastrectomy. Restoring digestive continuity usually involves the use of the stomach and jejunum, but when the situation requires it, the colon can also be used. As for lymph node dissection, it is performed either by dissection or by en bloc excision, both approaches being accepted. For the most accurate postoperative staging, at least 15 lymph nodes must be harvested. Splenectomy has a limited indication and is justified only when imaging or intraoperative findings reveal invasion of lymph nodes located along the splenic artery or at the splenic hilum. Neoadjuvant chemoradiotherapy is indicated for patients with locally advanced esophagogastric junction adenocarcinoma (Siewert type I-III), with the aim of reducing tumor volume and increasing the probability of achieving complete resection (R0). In situations where radical surgery is not possible, treatment options include endoscopic esophageal stenting, feeding gastrostomy (PEG or classic), and palliative chemotherapy. In conclusion, the surgical management of esophagogastric junction cancer is complex, guided by the Siewert classification and preoperative staging according to the TNM system -fundamental landmarks in establishing the therapeutic approach.

Impact of Thyroid Autoimmunity on Pregnancy in Iodine-Sufficient Areas

Mon, 19 May 2025 00:00:00 GMT

Objectives: Pregnancy has a profound impact on maternal thyroid morpho-functionality; thus, thyroid dysfunction can cause multiple perinatal risks and complications. The aim of the study is to determine the incidence of maternal thyroid autoimmunity and dysfunction, their influence on some gestational and perinatal parameters of the newborn, and the impact of iodine status on thyroid autoimmunity in a region with sufficient iodine intake. Material and method: Retrospective study conducted on a number of 74 full-term pregnancies with singletons, pregnant women originating from the perimarine area of Romania. The participants were divided into 2 groups: group 1 - pregnant with chronic autoimmune thyroiditis and subclinical/clinical manifest hypothyroidism; group 2 - pregnant without thyroid pathology considered as a control group. Maternal variables studied: dosage of thyroid hormone and antithyroid autoantibodies, median urinary iodine concentration; and for the newborns: birth weight, APGAR score, gestational age, incidence of perinatal events. The administration of iodine supplements during pregnancy was monitored. Results: The incidence of chronic autoimmune thyroiditis was 36.4%. Maternal thyroid autoimmunity is associated with low birth weight and premature birth compared to the control group. The predominant perinatal pathology among pregnant women with thyroid autoimmunity was represented by spontaneous abortion, presenting a 2.8x higher risk compared to the control group. Median urinary iodine concentration was under 150 mcg/L in both studied groups of pregnant women. Iodine nutritional deficiency, but also excess iodine intake, were positively correlated with maternal thyroid autoimmunity. Consumption of iodine supplements and iodized salt was reduced in the category of pregnant women with thyroid autoimmunity. Conclusions: Thyroid autoimmunity during pregnancy presents significant challenges even in iodine-sufficient geographical areas. Maternal autoimmune thyroiditis represents a risk factor with effects on fetal development and repercussions in the perinatal period. Evaluation of thyroid function parameters before conception or in the first weeks of pregnancy is recommended as a diagnostic and prophylactic measure.

Left Gonadal Vein

Mon, 19 May 2025 00:00:00 GMT

Our study on 51 cases was performed by dissection and injection of plastic mass followed by corrosion with NaOH, on formalinized human cadavers and on organic blocks aorta-inferior vena cava-right and left kidneys. The trajectory of the gonadal veins was in all cases rectilinear, in 47.06% of cases being oriented supero-medially, and in 52.04% of cases being vertical. At the termination the gonadal vein made with the corresponding renal vein an open lateral angle ranging between 37-900. The termination of the gonadal vein in the renal vein was most frequently on its postero-inferior surface, an aspect encountered in 54.90% of cases. The gonadal vein ended in the renal vein closer to the aorta (56.86% of cases). Compared to the termination of the left inferior adrenal vein, the gonadal vein ended laterally from it in 58.82% of cases, in 33.33% of cases ending at the same level as it, and in 4 cases (7.84% of cases) it ended laterally from the inferior adrenal vein. The caliber of the gonadal vein at the termination in the renal vein was found to be between 1.3-3.2 mm, the average being 2.04 mm. The present study examines the morphological features of the left gonadal veins, providing insights into the increased prevalence of varicocele on the left side. Anatomical knowledge of testicular vein variations and their spatial relationships with neighboring vessels is crucial for urologists and vascular surgeons, as it aids in the accurate diagnosis of urogenital conditions and helps prevent complications during retroperitoneal surgeries and imaging procedures.

Pain Assessment in Patients Undergoing Upper Limb Orthopedic Surgery: A Retrospective Study

Mon, 19 May 2025 00:00:00 GMT

In upper limb orthopedic surgeries, two main anesthetic techniques are used: regional anesthesia (RA), more precisely brachial plexus block, and general anesthesia (GA). The objective of this study was to compare the two techniques by assessing postoperative pain using the NRS (Numerical Rating Scale), opioid consumption, and antiemetic consumption, to identify the differences and advantages of each method. This retrospective observational study was conducted in the Orthopedics and Traumatology Clinic of SCJU Constanța. 82 patients with ASA I-III classification were included in the study, of which 43 received general anesthesia (GA) and 39 regional anesthesia (RA) via brachial plexus block, axillary approach. The GA group was treated according to a uniform general anesthesia protocol, while the RA group followed the same postoperative analgesia scheme. All included patients underwent surgical interventions in the distal arm, elbow, forearm, and hand RAea. The NRS pain scores assessed at 2, 4, 6, and 12 hours postoperatively were significantly lower in the RA group compared to the GA group. Regarding opioid use, 66% of patients in the GA group required administration, while only 2.3% of patients in the RA group required them. No patients in the RA group received antiemetics, while 30% of patients in the GA group required this type of medication. Regional anesthesia through brachial plexus block demonstrated superior benefits compared to general anesthesia, both in terms of reducing postoperative pain scores and in reducing the need for opioids and antiemetics.

Morphology of Double Renal Veins

Mon, 19 May 2025 00:00:00 GMT

The study was performed on 116 kidneys, using dissection and injection of plastic mass (followed by dissection or corrosion) as study methods. We found 6 cases of double renal veins (5.17% of cases), 5 cases being straight veins (9.62% of right veins) and 1 single case on the left being left veins (1.56% of left veins). In the formation of the venous trunk, both at the level of the superior veins and at the level of the inferior veins, two branches of origin participated in all cases, which most frequently were of different caliber. The trajectory of the superior renal vein in 4 cases was obliquely supero-medially, and in one case it was obliquely infero-medially, respectively horizontal. The trajectory of the inferior renal vein in 4 cases was obliquely supero-medially, and in 2 cases it was horizontal. The termination of the superior renal vein in the inferior vena cava is was done in 3 cases on the lateral side, respectively on the postero-lateral side. The termination of the inferior renal vein in the inferior vena cava was done in 3 cases on the postero-lateral side, in 2 cases on the antero-lateral side, and in only one case) on the lateral side. The caliber of the superior renal vein at the level of its termination in the vena cava, we found to be between 2.72-8.50 mm, the caliber of the inferior renal vein being between 2.10-3.60 mm. Significant morphological variations, particularly in venous morphometry, were observed compared to existing literature. These differences may be explained by methodological diversity, sample characteristics, and anatomical variability related to geographical area, sex, and age.

Trend of Diabetes Costs in Constanta County

Mon, 19 May 2025 00:00:00 GMT

Diabetes mellitus is a major public health issue, with the number of cases continuously increasing. This results in significant direct and indirect costs, representing a massive economic burden on the healthcare system. In Romania, costs are covered through the National Diabetes Program, so analyzing the cost trends can help better allocate funds, potentially improving program efficiency in the long term. Using a retrospective descriptive study with data on medication and monitoring costs for diabetes patients in Constanța County from 2018-2022, provided by the National Health Insurance House, it was found that the total number of patients reimbursed for antidiabetic medications steadily increased, with costs in 2022 almost doubling compared to the start of the study period. Non-insulin medication generated the most significant costs, being 4-6 times higher than those for insulin. The results highlight the growing economic challenges associated with proper diabetes management, emphasizing the need for more efficient solutions to reduce costs.

Hiv-Related Progressive Multifocal Leukoencephalopathy: A Case Report

Wed, 18 Dec 2024 00:00:00 GMT

The JC virus is widespread within individuals across the globe. It is usually in a latent form, but if immunity is decreased in a person this virus is reactivated leading to progressive multifocal leukoencephalopathy (PML). This is a rare neurological disease that can occur in cases of uncontrolled HIV/ AIDS. This report aims to highlight the importance of patients with HIV following a strict treatment regime and ensuring that this message is expressed to them by physicians in practice. We specifically report a patient case study in which our patient was non-compliant with his HIV medication, leading to neurological deficits. On admission, our patient presented with left limb paraesthesia, walking difficulties, and temporospatial disorientation. Many investigations and bedside tests were carried out before an MRI confirmed the presence of demyelinating gliotic lesions in the brain, leading to the diagnosis of PML. Due to the nature of PML, despite antiviral treatment, his condition progressively worsened. He presented two months later with further neurological pathologies, specifically a visual field disorder. Despite this disease being rare, the aim of this paper is to place emphasis on the lethality of the condition, therefore shifting a focus on preventing the disease in the first place via patient compliance with HIV medication.

Acute Esophageal Necrosis in the Alcoholic Patient: Case Presentation

Wed, 18 Dec 2024 00:00:00 GMT

Acute esophageal necrosis (AEN) is an uncommon but fatal cause of upper gastrointestinal bleeding with an incidence of 0.01%–0.2%. Endoscopically, it is characterized by circumferential or diffuse black pigmentation of the esophageal mucosa, conditioned by mucosal necrosis. Risk factors include gender (male), advanced age, cardiovascular disease, hemodynamic insufficiency, alcohol consumption, diabetic ketoacidosis, malnutrition, kidney disease, and trauma. Diagnosis is based on esophagogastroduodenoscopy (EGD). Treatment of AEN consists of intravenous fluids, proton pump inhibitors (PPIs), sucralfate, parenteral nutrition, and antacids. We report a rare case from our hospital, emphasizing the importance of prompt diagnosis and intervention in case management. A 64-year-old man with a history of heavy drinking was hospitalized for severe bleeding (melena) caused by a condition called acute esophageal necrosis. He underwent an emergency procedure to examine his esophagus (EGD) and found significant damage. This case illustrates a rare etiology of AEN due to active alcohol consumption that may be overlooked. The early recognition of this clinical entity is an essential factor in the therapeutic management of the disease.

Atypical Presentation and Management of Giant Tonsillolith: A Case Report and Literature Review

Wed, 18 Dec 2024 00:00:00 GMT

This report details a unique case of a 53-year-old patient presenting with dysphagia, odynophagia, and trismus in ”Sf. Apostol Andrei” County Emergency Clinical Hospital Constanta, Romania. Examination revealed a large mass within the left tonsil, prompting a differential diagnosis encompassing malignancy, abscess, and foreign body. Radiological evaluation proved challenging, as the mass mimicked a tumor on initial studies. Ultimately, CT scan confirmed the presence of a giant tonsillolith measuring an exceptional 51/23/31mm - exceeding the largest previously documented case (4.2 cm). Surgical excision under local anesthesia successfully removed the tonsillolith. This case underscores the importance of considering giant tonsilloliths in the differential diagnosis of oropharyngeal dysphagia, particularly in patients with suboptimal oral hygiene. We further emphasize the potential diagnostic challenges associated with these rare presentations and the crucial role of advanced imaging modalities. A comprehensive review of the literature regarding tonsillolith formation, diagnosis, and management is included.

Evaluation of Thyroid Activity in Patients with Liver Cirrhosis

Wed, 18 Dec 2024 00:00:00 GMT

Background: Liver cirrhosis is increasingly becoming a public health problem. The aim of study is to evaluate the relationship levels thyroid stimulating hormone (TSH), triiodothyronine (T3), free thyroxine (fT4) and and liver cirrhosis(LC) severity, measured by Child-Pugh (CP) and MELD scores. Methods: 419 patients diagnosed with liver cirrhosis were included in the study. Biological tests for TSH, T3, fT4 on admission and discharge were used. All analysis was performed using, One-Sample Wilcoxon test and Kruskal-Wallis test. Results: The mean values for TSH were statistically significant higher compared to normal values only at admission (p<.05), and the mean values for T3 were statistically significant lower both on admission (p<.001) and on discharge (p<.001). No effect was observed for fT4. TSH on the admission and discharge moments were statistically significant differences (p<.001), T3 (p<.001) and fT4 (p<.004). The CP also influenced the hormone's values for TSH at admission (p<.01 and discharge (p<.001), and T3 at admission (p<.001) and discharge (p<.001) but not for fT4. For MELD score, a low power positive associations were observed only with TSH, on admission and discharge and negative associations with F3, in both situations. Conclusions: Elevated TSH levels at admission, coupled with their negative correlation with the CP score and differences between TSH-CP group C and groups A and B, highlighting the necessity for vigilant endocrine monitoring in hepatic patients. Also, admission T3 levels are lower than normal and negatively correlate with cirrhosis severity and MELD scores underscore potential clinical utility of monitoring thyroid function in assessing disease progression and improving patient survival outcomes.

Hermann Brehmer’s Tuberculosis Treatment Methods: Potential Applications for Cachexia in Aids and Cancer

Wed, 18 Dec 2024 00:00:00 GMT

The innovative treatment methodologies for tuberculosis by the German physician Hermann Brehmer (1826-1889), established in the mid-19th century, achieved significant success and may offer valuable insights for the modern treatment of cachexia in AIDS and cancer. Brehmer's approach, which included hydrotherapy, a special diet, and rigorous physical activity, demonstrated impressive patient outcomes and highlighted the potential for integrating historical methods with contemporary therapeutic strategies. This paper provides a comprehensive understanding of Brehmer's methods, their evolution, and their potential applicability to modern chronic infectious diseases and conditions associated with cachexia, ensuring that the audience is well-informed and knowledgeable. By examining the interplay between nutrition, physical activity, and immune function, a holistic approach is proposed that combines Brehmer’s principles with immunotherapy to optimize treatment outcomes for HIV, tuberculosis, and cancer patients.