Search Results (30)

Background/Objectives: One of the metabolic complications of obesity is known as Metabolic Syndrome (MetS). This narrative review aims to synthesize current research on MetS in young populations, identify knowledge gaps, and guide future studies and funding priorities. It provides evidence-based insights into screening, diagnosis, and treatment, offering practical guidance for healthcare professionals. Methods: A comprehensive search of the literature was conducted to identify relevant studies on obesity in MetS in PubMed and Google Academic electronic database. The search was performed using a combination of “obesity”, “complications”, “metabolic syndrome”, “children”, and “adolescents” keywords. Studies were selected based on predefined inclusion and exclusion criteria to ensure relevance and methodological rigor. Results: The lack of universally accepted diagnostic criteria for MetS in children has led to inconsistencies in its definition across medical literature. Irrespective of the chosen diagnostic approach, the prevalence of MetS in children and adolescents has exhibited a concurrent rise with the increasing rates of obesity in this age group. The pathophysiology of MetS remains incompletely understood, with ongoing discussions on the interplay of genetic, epigenetic, environmental, dietary, and lifestyle factors. Screening for MetS is recommended for overweight and obese children. Conclusions: Establishing global, consensus-driven criteria that account for ethnicity, gender, and age would enhance diagnostic accuracy and treatment approaches. The prevention of excessive weight among children and adolescents stands as a paramount objective within modern society’s healthcare system. Considering the complexity of the disease and the treatment, the team must be multidisciplinary. Full article

The present scoping review underlines the molecular interplay between allergic rhinitis (AR), chronic rhinosinusitis with nasal polyps (CRSwNP), and interleukin-8 (IL-8). A query of PubMed database resulted in the inclusion of 34 articles in the final analysis of this scoping review. IL-8 is one interconnecting immune mediator in the physiopathology of AR and CRS. An influx of cytokines, such as interleukin (IL)-4 and IL-13, occurs from mast cells, four to six hours after the initial response signifying the development of the late-phase response allowing the entrance of eosinophils, basophils, and T-lymphocytes at the level of nasal mucosa. Chronic rhinosinusitis (CRS) is a chronic inflammatory disease that occurs in the mucosa of the nasal cavity and sinuses with two external phenotypes, but with molecular mechanisms that overlap with allergic rhinitis. Interleukin 8 induces neutrophil chemokinetic movement providing a chemotactic or directional cue. Clinical and fundamental studies established an implication of IL-8 in the disease mechanism of allergic rhinitis and CRSwNP. Moreover, there is still missing a randomized, large-cohort study with three patients groups (normal control, AR, CRSwNP) that analyzes the impact of IL-8 simultaneously. Future possible developments could focus on IL-8 as possible target for biologic treatments. Full article

Background/Objectives: Otitis media (OM) is a common pediatric condition that significantly impacts hearing, language development, and quality of life. Emerging evidence suggests that vitamin D plays a crucial role in immune regulation and that deficiency may predispose children to recurrent OM. This study aimed to evaluate whether low serum vitamin D levels are associated with increased incidence and severity of OM in children aged 2–7 years. Methods: A cross-sectional study was conducted at a pediatric otolaryngology clinic in northwest Romania between November 2023 and April 2024. A total of 118 children were enrolled, including 87 children with documented episodes of OM within the preceding six months and 31 quasi-controls without recent OM episodes. Participants were stratified into three age groups (2–3, 4–5, and 6–7 years) and classified into clinical subtypes of OM (Acute Suppurative Otitis Media, Serous Otitis Media, and Acute Congestive Otitis Media). Serum 25-hydroxyvitamin D levels were measured using a chemiluminescence immunoassay and categorized as deficient (≤20 ng/mL), insufficient (21–29 ng/mL), or sufficient (≥30 ng/mL). Statistical analyses included one-way ANOVA with post-hoc tests, chi-square tests, linear regression, logistic regression, and Poisson regression. Results: Children with OM exhibited significantly lower vitamin D levels compared to controls, with the most pronounced deficiency observed in the Acute Suppurative OM group. One-way ANOVA revealed significant differences among the groups (F(3,114) = 82.30, p < 0.001), and linear regression demonstrated a strong inverse correlation between vitamin D levels and the frequency of OM episodes (r = −0.793, adjusted R² = 0.63, p < 0.001). Logistic regression indicated that vitamin D insufficiency significantly increased the odds of OM (OR ≈ 120.74, p < 0.001), while Poisson regression showed incidence rate ratios of 13.62 for deficient and 10.47 for insufficient vitamin D status (p < 0.001). Conclusions: The findings indicate that low serum vitamin D levels are significantly associated with an increased risk and frequency of otitis media in preschool-aged children. These results support the role of vitamin D deficiency as an independent, modifiable risk factor for recurrent OM, suggesting that vitamin D screening and supplementation could be beneficial in reducing the clinical and economic burden of this condition. Full article

Background/Objectives: Virtual autopsy (virtopsy) is a new domain of research for interdisciplinary teams of radiologists and forensic specialists. This scoping review aims to underline the current state-of-the-art research using combined imaging modalities. Methods: We searched the PubMed database using the term virtopsy for articles that are available in free full text, indexed in the Medline Database, and published in English. The query returned 49 articles on this subject that have been published since 2002. Results: The main imaging modalities used for postmortem imaging were computed tomography (PMCT), angiography (PMCTA), magnetic resonance imaging (PMMRI), and ultrasonography (PMUS). PMCT is highly effective for detecting complex osseous injuries, tracing bullet trajectories, or identifying characteristic findings in drowning cases. PMCTA is valuable for evaluating vascular lesions, particularly in natural death cases. PMMRI is superior in analyzing soft tissues, including brain and spinal structures, cerebrospinal fluid, microbleeds, and laryngohyoid lesions, and identifying cardiomyopathies in young individuals. PMUS serves as an alternative, and its portability also allows for use in forensic settings. One specific situation observed was the increased number of studies published about virtopsy during the COVID-19 pandemic. Another aspect is the increased focus on this alternative to conventional autopsy in the regions where maneuvering of the deceased is limited according to cultural and social customs. Conclusions: We underline the advantages and limitations of each imaging modality used for virtopsy. Further studies need to be developed in order to gather supplementary data regarding the use of these imaging modalities in the new era of artificial intelligence in medicine. Full article

Background/Objectives: The gut–liver axis is bidirectional and influences the body’s homeostasis. Pathologies such as metabolic dysfunction-associated steatotic liver (MASL) can have detrimental effects on the human microbiome, with multiple systemic effects. Furthermore, the geographical particularities of the intestinal microbiome may influence liver disease. The study’s outcome was to identify dysbiosis in a group of patients with MASL from the western region of Romania. Methods: The NGS shotgun genomic sequencing (WGS metagenomics) method was used to identify bacteria in fecal samples. The data were analyzed using IBM SPSS Statistics software [version 29.0.2.0 (20)]. Results: Out of the 122 MASL patients included in the study, 43 (35.24%) exhibited low alpha diversity. In the subgroup with a normal biodiversity index, approximately half were identified with a Firmicutes/Bacteroidetes ratio below the lower reference value, while the remaining patients presented dysbiosis based on decreased concentrations of Proteobacteria and Prevotella, considered among the most relevant species supporting dysbiosis. A higher prevalence of Prevotella species (15.99 ± 13.65%) was identified in the study cohort. Conclusions: The present study demonstrates that patients with MASL from the western region of Romania exhibit criteria for intestinal dysbiosis, namely reduced bacterial diversity, along with significant alterations in populations of Firmicutes, Bacteroidetes, Proteobacteria, and Prevotella. Together, these findings suggest a possible influence of geo-cultural factors on the intestinal microbiome, highlighting the need for regionally adapted therapeutic interventions to support liver health. Full article

Anxiety disorders are among the most prevalent mental health conditions globally, causing significant personal and societal burdens. Traditional therapies, while effective, often face barriers such as limited accessibility, high costs, and the stigma associated with seeking mental health care. The emergence of artificial intelligence (AI) chatbots offers a novel solution by providing accessible, cost-effective, and immediate support for individuals experiencing anxiety. This comprehensive review examines the evolution, efficacy, advantages, limitations, challenges, and future perspectives of AI chatbots in the treatment of anxiety disorders. A methodologically rigorous literature search was conducted across multiple databases, focusing on publications from 2010 to 2024 that evaluated AI chatbot interventions targeting anxiety symptoms. Empirical studies demonstrate that AI chatbots can effectively reduce anxiety symptoms by delivering therapeutic interventions like cognitive-behavioral therapy through interactive and personalized dialogues. The advantages include increased accessibility without geographical or temporal limitations, reduced costs, and an anonymity that encourages openness and reduces stigma. However, limitations persist, such as the lack of human empathy, ethical and privacy concerns related to data security, and technical challenges in understanding complex human emotions. The key challenges identified involve enhancing the emotional intelligence of chatbots, integrating them with traditional therapy, and establishing robust ethical frameworks to ensure user safety and data protection. Future research should focus on improving AI capabilities, personalization, cultural adaptation, and user engagement. In conclusion, AI chatbots represent a promising adjunct in treating anxiety disorders, offering scalable interventions that can complement traditional mental health services. Balancing technological innovation with ethical responsibility is crucial to maximize their potential benefits. Full article

Background/Objectives: Upper respiratory tract infections (URTIs) are a significant global health burden, and understanding the immune response is crucial for developing effective diagnostic tools and treatment strategies. Methods: This study investigated the levels of specific biomarkers in 188 patients with URTIs and their association with demographic factors, comorbidities, and clinical outcomes. Immunoglobulin A (IgA), immunoglobulin E (IgE), neutrophils, serum iron, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were measured. Results: The median age of the patients was 5 years, with 46% being female and 63% from urban areas. Adenoiditis (37%), otitis (25%), and rhinitis (20%) were the most common diagnoses. While most biomarkers did not vary significantly by gender, neutrophil levels were significantly higher in females (p = 0.020). IgE levels were significantly elevated in rural patients compared to urban counterparts (p = 0.034). Conclusions: ESR was significantly associated with rhinitis diagnosis, and IgE and ESR were predictive of otitis in multivariate models. However, many biomarkers did not significantly correlate with other diagnoses, contradicting previous research focusing on individual biomarkers. This study highlights the complexity of immune responses in URTIs and the need for more effective diagnostic tools. The findings can inform the development of tailored treatment strategies based on gender, area of origin, and infection type. Full article

Anxiety disorders represent one of the most widespread mental health challenges globally, yet access to traditional therapeutic interventions remains constrained, particularly in resource-limited settings. This study evaluated the effectiveness of an AI-powered chatbot, developed using ChatGPT, in managing anxiety symptoms through evidence-based cognitive-behavioral therapy (CBT) techniques. Fifty participants with mild to moderate anxiety symptoms engaged with the chatbot over two observational phases, each lasting seven days. The chatbot delivered personalized interventions, including mindfulness exercises, cognitive restructuring, and breathing techniques, and was accessible 24/7 to provide real-time support during emotional distress. The findings revealed a significant reduction in anxiety symptoms in both phases, with an average improvement of 21.15% in Phase 1 and 20.42% in Phase 2. Enhanced engagement in Phase 2 suggested the potential for sustained usability and familiarity with the chatbot’s functions. While participants reported high satisfaction with the accessibility and personalization of the chatbot, its inability to replicate human empathy underscored the importance of integrating AI tools with human oversight for optimal outcomes. This study highlights the potential of AI-driven interventions as valuable complements to traditional therapy, providing scalable and accessible mental health support, particularly in regions with limited access to professional services. Full article

Background/Objectives: Liver function tests (LFT) are essential for diagnosing and monitoring liver status in patients with chronic hepatitis. In addition, tracking the systemic implications reflected in the changes in metabolic parameters is essential for correctly managing the cases. This study addresses the critical gap in the literature by evaluating the effects of glecaprevir/pibrentasvir on key liver function markers (AST, ALT, GGT, TB) and metabolic parameters (TC, TG, HbA1c) in patients with chronic hepatitis C (CHC). Moreover, this study will evaluate the impact of glecaprevir/pibrentasvir on A2MG, which provides insights into its effects on liver fibrosis. Awareness of these effects is critical for the optimal management of patients during and following antiviral therapy to ensure that therapeutic success does not come at the expense of overall liver and metabolic health. These parameters should be monitored as they supply clinicians with essential data, informing treatment more accurately and ensuring a holistic approach in CH patients. Methods: This study consists of 104 patients with chronic hepatitis C treated with glecaprevir/pibrentasvir and monitored from January to June 2024. Assessments comprised standard liver markers, lipid profiles, glycated hemoglobin, and alpha-2-macroglobulin, as well as specific non-invasive tests of liver injury. Results: 95.2% of the patients experienced a sustained virologic response. Biochemical markers and total cholesterol values were significantly decreased with glecaprevir/pibrentasvir therapy. Non-significant elevations in total bilirubin and glycated hemoglobin support the drug’s favorable tolerability profile. Conclusions: In the treatment of chronic hepatitis C patients, glecaprevir/pibrentasvir therapy leads to normalization in biochemical markers (AST, ALT, and GGT), as well as in total cholesterol. Full article

The main goal of this systematic review on the flavonol class secondary metabolite quercetin is to evaluate and summarize the existing research on quercetin’s potential health benefits, therapeutic properties, and effectiveness in disease prevention and treatment. In addition to evaluating quercetin’s potential for drug development with fewer side effects and lower toxicity, this type of review attempts to collect scientific evidence addressing quercetin’s roles as an antioxidant, anti-inflammatory, antibacterial, and anticancer agent. In the first part, we analyze various flavonoid compounds, focusing on their chemical structure, classification, and natural sources. We highlight their most recent biological activities as reported in the literature. Among these compounds, we pay special attention to quercetin, detailing its chemical structure, physicochemical properties, and process of biosynthesis in plants. We also present natural sources of quercetin and emphasize its health benefits, such as its antioxidant and anti-inflammatory effects. Additionally, we discuss methods to enhance its bioavailability, analyzing the latest and most effective delivery systems based on quercetin. Full article

Background/Objectives: COVID-19 led to a pandemic that has brought misery to millions of people but more so to those with pre-existing conditions. For this infection, several antiviral drugs were employed, including remdesivir (R) and Paxlovid (nirmatrelvir/ritonavir (NR)). Methods: The current study compared the effectiveness of remdesivir and Paxlovid treatment for COVID-19 patients with comorbid conditions. Data from a cohort of 151 adult patients with COVID-19 who also had associated comorbidities were used in this study. These patients were treated with antivirals according to local guidelines. The subjects included 78 case-patients assigned to group R and 73 to group NR. Results: In group NR, a considerable improvement in oxygen saturation was seen in the first 24 h of treatment (p = 0.010), but the levels were significantly higher from the second day of treatment (p < 0.001) in group R of patients. At the end of the 5 days of treatment, the oxygen saturation improved statistically significantly compared to the admission day, but only in the R group (95.11 ± 1.80; 91.76 ± 1.80; p < 0.001). Conclusions: Both drugs can be considered a breakthrough in the current treatment approach to the COVID-19 disease since they provide readily available options that can alleviate the severity of the disease and, hence, the prognosis of patients. That is why their effectiveness relies on the correct administration time and choosing the patient with suitable characteristics regarding the presence of comorbidities and the likelihood of the critical further development of the process. Full article

Background/Objectives: The hepatitis C virus (HCV) is a significant threat to people with persistent infections. In recent years, the treatment of chronic hepatitis C (CHC) has been transformed significantly with the use of Direct-Acting Antivirals (DAAs). Hematological changes are seen in patients suffering from CHC due to both the disease and its therapy. This study aims to address the gaps in knowledge by thoroughly evaluating the hematological parameter alterations in CHC patients treated with Mavyret. Methods: This study reported that it took place over six months in 2024 on 101 patients observed at the gastroenterology department of Pitesti County Hospital in Romania, who had confirmed diagnoses of CHC and who were receiving the DAA Mavyret. Results: The values of leukocytes significantly decreased after treatment (8.69 ± 2.96 vs. 7.93 ± 1.78, p = 0.009). Similarly, neutrophils showed a statistically significant decrease after using Mavyret (5.45 ± 2.06 vs. 4.91 ± 1.29, p = 0.018). In the case of lymphocytes, the values slightly increased from 2.14 ± 0.69 before treatment to 2.20 ± 1.19 after it, but without a statistically significant difference (p = 0.320). The values of monocytes and eosinophils significantly decreased after antiviral therapy (0.81 ± 1.02 vs. 0.59 ± 0.15, p = 0.020; 0.21 ± 0.15 vs. 0.14 ± 0.09, p < 0.001). For basophils, the mean values remained almost unchanged after DAA therapy (0.09 ± 0.08 vs. 0.09 ± 0.15, p = 0.433). Conclusions: Mavyret has proven to be a safe medication for administering to patients with CHC, but its minor adverse effects on red blood cells, white blood cells, and platelets require constant monitoring, mainly when used for an extended period and in patients who are vulnerable in this regard. Full article

The Bee Cosmetic Surgery Scale (BCSS) is a novel clinical tool designed to assess the psychopathological, psychosocial, and decision-making factors involved in accepting cosmetic procedures. This prospective, multicenter study aimed to propose and validate the BCSS, which considers aesthetic aspects, personal pathological history, and psychopathological implications leading to the acceptance of invasive or non-invasive aesthetic interventions. The study included 281 participants aged 18–66 years, divided into three groups: non-invasive cosmetic surgery (NICS), invasive and non-invasive cosmetic surgery (INICS), and individuals who had not undergone cosmetic surgery (NCS). Participants were randomly selected from patients visiting plastic surgery services and various medical services in Oradea, Romania, between October 2022 and March 2024. The BCSS comprises 20 items with Likert-type responses, ranging from one to five. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure perceived social support. The BCSS aims to elucidate the patient’s desire for aesthetic procedures, whether it stems from an impulsive act, warrants a longer decision-making period, or necessitates addressing psychological or psychiatric conditions before scheduling the procedure. The scale enables cosmetic surgeons to assess whether the patient has been adequately informed and understands the risks and complications associated with the cosmetic surgical procedure. Full article

Background/Objectives: The thyroid gland can represent the seat of development for giant tumors exceeding 10 cm in diameter. A retrospective analysis on 21 cases of giant thyroid tumors with comorbidities, operated in the ENT Department of the Bucharest University Emergency Hospital has been conducted. Methods: Giant benign tumors accounted for 28.57% of the cases studied and reached gigantic volumes in an average time interval of 3 years, with an average resection piece weight of 318 g. Malignant tumors accounted for 71.43%, with an average duration of evolution of 7 years, with an average resection piece weight of 581 g. Results: Dysphagia was present in all patients, dyspnea in 47.61% and dysphonia in 38.09% of cases. Total thyroidectomy is the gold standard in giant thyroid tumors, associated with radical neck dissection, extended to groups VI and VII in malignant tumors. In 10 of 11 cases of giant malignant thyroid tumors (90.90%), without anaplastic thyroid carcinoma, the survival at 5 years after multimodal oncologic treatment was favorable. Anticoagulant treatment increased the risk of postoperative reversible recurrent laryngeal nerve lesion. Conclusions: The management of giant thyroid tumors in patients with multiple comorbidities needs a multidisciplinary team including endocrinologist, radiologist, anesthesiologist, pathologist, ENT surgeon, thoracic surgeon, oncologist and radiotherapist. Full article

Glioblastoma (GBM) is one of the most aggressive malignant tumors of the brain. We queried PubMed for articles about molecular predictor markers in GBM. This scoping review aims to analyze the most important outcome predictors in patients with GBM and to compare these factors in terms of absolute months of survival benefit and percentages. Performing a gross total resection for patients with GBM undergoing optimal chemo- and radiotherapy provides a significant benefit in overall survival compared to those patients who received a subtotal or partial resection. However, compared to IDH-Wildtype GBMs, patients with IDH-Mutant 1/2 GBMs have an increased survival. MGMT promoter methylation status is another strong outcome predictor for patients with GBM. In the reviewed literature, patients with methylated MGMT promoter lived approximately 50% to 90% longer than those with an unmethylated MGMT gene promoter. Moreover, KPS is an important predictor of survival and quality of life, demonstrating that we should refrain from aggressive surgery in important brain areas. As new therapies (such as TTFs) emerge, we are optimistic that the overall median survival will increase, even for IDH-Wildtype GBMs. In conclusion, molecular profiles are stronger outcome predictors than the extent of neurosurgical resection for GBM. Full article