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

Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences https://webbut.unitbv.ro/index.php/Series_VI <h2>Aim</h2> This is a medical multidisciplinary journal publishing original research papers, and case presentations. The yearly journal presents the latest results in medical research, focusing on integrated, interdisciplinary approaches. Also, it is committed to publishing work on different fields of the health profession and the history of medicine. The aim of the journal is to promote excellence and is open to research groups all over the world and mostly welcomes scientific papers from groups involving young researchers. The Journal is indexed in EBSCO Publishing DataBase (<a href="http://webbut.unitbv.ro/public/site/documents/admin/a9h-subject.xls">http://www.ebscohost.com/titleLists/a9h-subject.xls</a>), from 2010, ProQuest Central (<a href="https://search.proquest.com/central/" target="_blank" rel="noopener">https://search.proquest.com/central/</a>), from 2008, and in Crossref (<a href="https://search.crossref.org" target="_blank" rel="noopener">https://search.crossref.org</a>), from January 2019. <a href="http://webbut.unitbv.ro/index.php/Series_VI/about" target="_blank" rel="noopener">Read more</a> Old Site Use this <a title="Series_VI" href="http://webbut2.unitbv.ro/Bulletin/Series%20VI/Series%20VI.html" target="_blank" rel="noopener">LINK </a>to access the content of the old Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences journal site! Transilvania University Press en-US Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences 2065-2216 A Retrospective Observational Study: Clinical and Paraclinical Aspects of Infectious Endocarditis https://webbut.unitbv.ro/index.php/Series_VI/article/view/6874 A multitude of data on infectious endocarditis has already been published so far. Nevertheless, the medical care of patients with infective endocarditis remains a significant challenge, and debates on this topic will continue. The diagnosis of this pathology can be difficult, and the treatment is prolonged and presents many challenges, as patients with infective endocarditis are susceptible to numerous both local and systemic complications. We correlated data from the medical records of patients hospitalized with infective endocarditis to analyze their predisposing conditions, clinical and biological parameters, and treatment outcomes. We concluded that infective endocarditis most commonly affects patients over 60 years who already have structural valve changes, most often involving the aortic valve, with the course of patients being mostly burdened by perivalvular abscesses. G.L. Stefanescu L.A. Tudose N. Cojocaru V. Benza H. Rus E. Bobescu A. Covaciu Copyright (c) 2023 Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences 2024-01-19 2024-01-19 1 10 10.31926/but.ms.2023.65.16.2.1 Assessment of the Etiological Spectrum of Urinary Infections in Diabetic Patients and of the Resistance Patterns of the Uropathogenic Germs Involved https://webbut.unitbv.ro/index.php/Series_VI/article/view/6875 The aim of the retrospective-descriptive study consisted of the analysis of the spectrum of urinary infections and antimicrobial resistance of the uropathogenic bacteria involved in diabetic patients. The etiological spectrum was wide, being dominated by Escherichia coli (67,68%), Klebsiella sp. (14,14%), Proteus sp. (7,07%), and Enterococcus sp. (6,31%). Enterobacteriaceae had higher percentages of resistance to trimethoprim-sulphamethoxazole, quinolones, and cephalosporines, antibiotics frequently used in the therapy of urinary infections but also of other infections in diabetics. Over 50% of Enterococcus strains were resistant to fluoroquinolones. The detection of the carbapenem-resistant strains (imipenem – 8% and meropenem – 10,2%) is worrying. Colistin, carbapenems, and amikacin were most effective in vitro against Gram-negative bacilli and linezolid, vancomycin, and teicoplanin, in the case of Gram-positive cocci. The study results reveal the importance of monitoring the etiological spectrum and the resistance to antibiotics of the germs involved in urinary infections in diabetic patients, for the initiation of an effective therapy and the optimal management of the cases. Mihaela Elena Idomir Copyright (c) 2023 Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences 2023-01-19 2023-01-19 11 18 10.31926/but.ms.2023.65.16.2.2 What is the Ideal Surgical Approach for Perforated Gastro-Duodenal Ulcer? https://webbut.unitbv.ro/index.php/Series_VI/article/view/6876 This is a single-center, non-randomized retrospective study that compares various clinical and evolutionary aspects of patients with perforated gastro-duodenal ulcers in order to determine the best surgical approach. The study included 35 patients who underwent surgical treatment for a perforated gastro-duodenal ulcer at Brașov County Emergency Clinical Hospital (SCJU BV) between January 2021 and January 2023. They were then divided into two groups based on whether the surgery was laparoscopic or traditional. A variety of clinical and paraclinical data were collected and compared. There were no variations in gender distribution, age, or site of the ulcer perforation across the groups. Patients who underwent a laparoscopic procedure had a smaller ulcer perforation, a faster resumption of intestinal transit, and a shorter hospital stay than those who underwent a standard procedure. At 3 days postoperatively, the Neutrophil-to-Lymphocyte Ratio (NLR) and the Systemic Inflammation Response Index (SIRI) were significantly lower in the laparoscopic group. Patients who underwent traditional surgery had a higher Boey score, needed more complex interventions, and had a higher rate of postoperative complications and mortality. In perforated gastro-duodenal ulcer cases, the laparoscopic approach is a viable option with numerous advantages, particularly in patients with a low Boey score. Meanwhile, the traditional approach may be reserved for cases with a high Boey score and complex surgical interventions. C. Fugaretu A. Sefciuc C. Misarca Copyright (c) 2023 Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences 2024-01-19 2024-01-19 19 28 10.31926/but.ms.2023.65.16.2.3 Immune Thrombocytopenia in Children https://webbut.unitbv.ro/index.php/Series_VI/article/view/6877 Immune thrombocytopenia is a hematological disorder defined by an isolated decrease in platelet numbers. We present a retrospective-descriptive study that enrolls twenty-five children (aged 0-18 years old) admitted to Brasov Children’s Hospital from the 1st of January 2020 until the 1st of September 2023 with the diagnosis of idiopathic thrombocytopenic purpura (ITP). We could find proof of recent viral infection in seven patients out of twenty-five; three of them also had immunological findings- positive antinuclear, positive direct Coombs test, or antiplatelet antibodies. The medical literature mentions glucocorticoids and IVIG therapy as the first line of treatment for immune thrombocytopenic purpura, while new pharmaceutical agents are still under review. D.M. Voda I. Luca Copyright (c) 2023 Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences 2024-01-19 2024-01-19 29 34 10.31926/but.ms.2023.65.16.2.4 Cystic Fibrosis Transmembrane Regulator Modulator Therapy Perspective: Findings in Clinical Outcomes in a Series of Pediatric Patients https://webbut.unitbv.ro/index.php/Series_VI/article/view/6878 Cystic Fibrosis (CF) is the most frequent autosomal recessive disorder in Caucasians and has reduced life expectancy. It is caused by mutations in the CF transmembrane conductance regulator (CFTR) gene which results in impairment of production, expression, and trafficking of the CFTR protein. CF has a multifaceted clinical representation with respiratory involvement as a main cause of morbidity and mortality. The multidisciplinary approach, care in specialized centers, early diagnosis through neonatal screening, and development of symptomatic treatments improved survival in the last decades. CFTR modulators were developed based on the discovery of the CF gene in 1989 and the improvement of genetic testing and have changed the perspective of a debilitating disease. These therapies, acting more upstream in the pathogenic cascade, overcome the underlying dysfunctions caused by CFTR mutations, having the ability to enhance or restore the resulting functional effects. CFTR modulator therapies are highly effective treatments for cystic fibrosis patients as shown in many clinical trials and real-life analyses so far. Improvement of quality of life, lung function, and pulmonary exacerbation rates are indisputable targets when evaluating the efficacy and efficiency of medical interventions in such a disease as CF, and they have been substantially changed in the era of modulators. We analyzed a small group of patients who were initiated on Kaftrio as per the indicated protocol. All significant clinical and functional aspects were improved, demonstrating the disease-changing potential of this therapy. We did not observe threatening side effects, no patients were stopped from the medication. CFTR modulators are the beginning of a new era in CF, a perspective for the improvement and effectiveness of precision medicine in CF patients. O.C. Patran L.L. Dracea Copyright (c) 2023 Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences 2024-01-19 2024-01-19 35 40 10.31926/but.ms.2023.65.16.2.5 Imaging Findings and Management of Kidney Cysts – A Pictorial Essay https://webbut.unitbv.ro/index.php/Series_VI/article/view/6879 Renal cysts have become more commonly recognized in asymptomatic patients due to the improvement and frequency of the use of advanced imaging modalities, such as CT and MRI. The purpose of the following review is to illustrate the main and most important aspects of renal cysts, including a checklist of top differential diagnoses and also, their further management and treatment options. Some renal cysts can have significant clinical implications; this is why increased awareness of these renal lesions is of the utmost importance to avoid diagnostic pitfalls or further complications. R.E. Coroiu R.M. Popa E.M. Popa A.C. Hogea R.M. Manea I. Scarneciu Copyright (c) 2023 Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences 2024-01-19 2024-01-19 41 48 10.31926/but.ms.2023.65.16.2.6 Challenges of the Treatment with Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia – Case Presentation https://webbut.unitbv.ro/index.php/Series_VI/article/view/6880 We present the case of a 33-year-old male patient diagnosed with chronic phase chronic myeloid leukemia in June 2008. According to treatment protocols enforced at that time, the patient started oral treatment with imatinib 400 mg/day, reaching a major molecular response (MMR) in 18- month time. The molecular response improved over time, with an undetectable BCR-ABL1 transcript level after 36 -48 months of treatment. However, the profound molecular response did not last, requiring a switch to the second line of therapy after 75 months of imatinib. Taking nilotinib 400 mg x2/day, the patient achieved a major molecular response in 12 months, and after 18 months of treatment, the level of BCR-ABL1 became undetectable. However, two vasooclusive events occurred in 2018 – a transient left parietal ischemic stroke and a left femoral artery occlusion – and by ESMO 2017 recommendations, nilotinib treatment was interrupted. The treatment-free remission decision was made with monthly monitoring of the BCR-ABL1 transcript level, but since the 4th month of monitoring, the deep molecular response disappeared. Administration of dasatinib, the third tyrosine kinase inhibitor, resulted in a deep molecular response which currently lasted until now, during the 58 months of treatment. The presented case represents the evolution of the concept of treatment in this haemato-oncological disease during the last decade. A.P. Benea A.M. Ilea C.M. Gavris Copyright (c) 2023 Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences 2023-01-19 2023-01-19 49 58 10.31926/but.ms.2023.65.16.2.7 The Impact of SARS-CoV-2 on the Coagulation Profile of Pregnant Women https://webbut.unitbv.ro/index.php/Series_VI/article/view/6882 A prospective study was conducted in the Clinic Hospital of Obstetrics and Gynecology "Dr. I.A. Sbârcea" Brașov, which included hospitalized pregnant women diagnosed with COVID-19 from January 1, 2020, to March 8, 2022. The study aimed to evaluate the influence of SARS-CoV-2 on the coagulation status, the blood levels of coagulation parameters, and the presence of disseminated intravascular coagulation in pregnant women with COVID-19. To analyze the coagulation status of the pregnant women we used the following parameters: Fibrinogen level, INR, D-dimer test, and the presence of disseminated intravascular coagulation. Following the study, we concluded that the occurrence of coagulation disorders in pregnant women is related to the severity of the SARS-CoV 2. LMWH administration generally improved the prognosis of pregnancy-associated COVID-19 and mostly prevented the occurrence of severe thromboembolic complications such as disseminated intravascular coagulation or deep venous thrombosis. S. Casap N. Ciobanu M.A. Moga C. Martinescu A. Huda D. Festila Copyright (c) 2023 Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences 2024-01-19 2024-01-19 59 68 10.31926/but.ms.2023.65.16.2.8 Aromatherapy – A Non-Pharmacological Approach in Pain Control https://webbut.unitbv.ro/index.php/Series_VI/article/view/6883 Pain represents an unpleasant sensory and emotional experience and is one of the most frequent symptoms in clinical practice. Pain control is crucial not only for the physical but also for the emotional and psychological support of the patient. Pain treatment includes pharmacological and non-pharmacological methods. Integrating the non-pharmacological methods in pain management provides o holistic approach to the patient, addressing both the physical symptoms, and the psycho-emotional aspects of the patient’s suffering. Aromatherapy is an important non-pharmacological method that involves the use of essential oils extracted from plants to promote relaxation and reduce stress, contributing to pain relief. Certain scents were demonstrated to have analgesic and calming effects. This article presents the most important components of essential oils and the mechanisms explaining their effects on pain, mood, and behavior modulation, in promoting relaxation and stress management, improving well-being and life quality in individuals dealing with pain, as demonstrated by evidence-based studies meeting the criteria of aromachology, the science analyzing the olfactory effects on mood, physiology, and behavior. A lot of published data show positive outcomes about the therapeutical effects of essential oils in pain control, but there is still a large individual variability in responsivity to aromatherapy so the effectiveness of aromatherapy in pain management cannot be yet conclusive to establish standard protocols for the use of aromatherapy in pain modulation. L. Mihailov V. Poroch A.M. Pascu Copyright (c) 2023 Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences 2024-01-19 2024-01-19 69 84 10.31926/but.ms.2023.65.16.2.9