Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences

The Quality of Online Medical Information Regardind Hypertension

D.C. Mereu — 2024-05-16

The aim of this paper is to evaluate the completeness, accuracy and credibility of the medical information found online about hypertension and to compare the quality of the Romanian and English websites. This observational, cross-sectional study included 25 Romanian and 25 English websites. Pre-established inclusion and exclusion criteria were used for sample selection. Credibility was assessed using 12 criteria based on the eEurope 2002 expert recommendations. Completeness and accuracy of information were evaluated using a quality standard based on information from literature and guidelines. The credibility, completeness and accuracy scores were rated on a scale from 0 to 10. Student t test and Mann-Whitney U were used to compare the two languages subsamples. Spearman and Pearson’s tests were applied to test the correlations. The threshold for statistical significance was set at 0.05. The average credibility score was 4.7 for the Romanian websites and 5.6 for English websites (p=0.0686). The average completeness score was 3.7 for the Romanian websites and 5.3 for English websites (p=0.0007). The average accuracy score was 3.88 for the Romanian websites and 3.62 for English websites (p=0.5215). Significant moderate intensity correlation was found between the Google rank and the accuracy of the Romanian websites (r=-0.5438, p=0.0050). The overall quality scores of the Romanian and English websites presenting information about hypertension were modest. This study found a correlation between the Google rank and the accuracy score of the Romanian websites but since this was the only significant correlation, the findings are not sufficient to infer general recommendations. The study suggests that knowing both Romanian and English doesn't offer a significant advantage in accessing high-quality online information about hypertension. The Google rank cannot be used as a quality indicator since there is no consistent correlation between it and the quality scores.

Irritable Bowel Syndrome Characterization in a Population from Bihor County Romania

C. Hocopan — 2024-06-07

Our aim was to analyse the characteristics of a large cohort of patients with IBS from Bihor County. We retrospectively studied 525 patients with IBS admitted between 2018-2023 in Bihor Emergency Clinical County Hospital. We extracted, interpreted and statistically analysed the following parameters: age, gender, environment, family history, smoking and alcohol status, Bristol scale, results of colonoscopy and treatment. The overall prevalence of IBS was 0.2%. Fifty-six % were women, 61% of patients were from urban environment, average age was 57.74 years, with a significant statistical difference between medium age in women vs men. There was a significant statistical correlation between the medium age, medium height, and weight of our patients and smoking status, alcohol consumption, and positive family history. Colonoscopy was done in 148 patients and conditions found in addition to IBS appeared in 7.6% of the cases. The dominant finding was tumoral (4% of IBS cases), followed by various inflammatory conditions. The mean age for patients with normal results was 55.07 years, 50.84 years for patients with inflammatory lesions and 67.81 years for tumoral lesions, with statistically significant correlations between age and the results of colonoscopy. We did not find statistical correlation between Bristol Scale and the results of colonoscopy. Only 142 patients followed specific treatment, suggesting low compliance. The epidemiological traits of our IBS patients seem to remain constant along the time as our research lines up with other studies. Among these, age, female gender and urban provenance seem to be the most significant factors, whereas habits, body mass index, and family history seem not to be statistically significant. As Rome criteria accurately diagnose IBS, we have to remember that colonoscopy should be recommended to a rather small and well selected cases of patients of older age, as in such cohorts tumoral lesions were most frequent.

Metformin Beyond Diabetes: Exploring Off-Label Applications across Medical Frontiers

L.M. Isop — 2024-07-01

Metformin, widely used for T2D, is increasingly explored for off-label use in both endocrine and non-endocrine conditions, showing promise for improving patient outcomes. In polycystic ovary syndrome, metformin has demonstrated efficacy in lowering anti-Müllerian hormone levels and improving hormonal and metabolic parameters, though its role in managing hirsutism, especially in adolescents, remains uncertain. In gestational diabetes mellitus, metformin effectively reduces maternal weight gain, lowers the risk of preeclampsia, neonatal hypoglycemia, and macrosomia, and improves glycemic control without affecting fetal neurodevelopment. Beyond endocrine disorders, metformin's broader applications are under investigation. Although early observational studies suggested that metformin reduces cancer risk in diabetics, subsequent analyses revealed significant biases, and randomized clinical trials found no anticancer benefit. This highlights the need for caution when interpreting observational data and the importance of robust randomized trials to assess metformin's true impact on cancer outcomes. In cardiovascular diseases, metformin shows promise in reducing mortality and adverse cardiovascular events. Research also suggests metformin's potential to protect against diabetic kidney disease and neurodegenerative conditions such as Alzheimer's and Parkinson's diseases. However, additional studies are needed to better understand and enhance metformin's clinical effectiveness across various patient groups.

Successful Non-Operative Management of a Patient with Grade IV Right Renal Trauma Associated with Hepatic and Right Adrenal Trauma – A Case Report

A.C. Hogea — 2024-07-01

In case of a traumatic event, preservation of the injured renal and kidney function represents the goal of non-operative management (NOM) of renal trauma. The substantial benefits of non-operative management for minor blunt renal injury have already been clearly described in current literature, but its value for major blunt and penetrating renal injuries are still under debate and not clearly highlighted. We hereby fully report a case of a 64 years old male patient with a history of a thoraco-abdominal blunt trauma, victim of aggression caused by a blunt object, which resulted in grade IV injury of the right kidney and associated grade II hepatic injury and right adrenal injury – grading according to the American Association for the Surgery of Trauma (AAST) injury scale guidelines – evaluated through contrast enhanced emergency CT imaging. The patient was hemodynamically stable upon admission to the Emergency Department of Clinical Emergency County Hospital of Brașov, Romania. Non-operative management strategy was chosen, therefore constant and close monitorization and follow-up CT examinations were performed. The patient was subsequently discharged after 8 days, with no further complications reported.