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Background: Hepatitis B Virus (HBV) remains a major global health challenge, with significant morbidity and mortality associated with chronic infections. Methods: This study examines the epidemiology, screening, and risk factors associated with HBV in Romania, focusing on a comprehensive national screening program, LIVE(RO)2, involving 320,000 individuals (majority of them considered vulnerable population). A questionnaire was used to collect information on the potential risk factors for HBV transmission. Results: The overall prevalence rate of HBV chronic infection among all the participants tested was 1.67% (confidence interval: 1.63–1.72%), with significant differences (p = 0.0001) between participants from the main geographical regions of residence (North-East 1.89%, South 1.38%, South-East 2.06%, and South-West 1.54%). Male persons aged 30–49 or 60–69 years old, from the rural and Eastern parts of Romania and non-Romanian ethnia, with a low level of education, unvaccinated, not married, unemployed, with family members with hepatitis, with personal histories of blood or blood product transfusion, surgical interventions, tattooing, hospitalizations, imprisonment, haemodialysis, unsafe sexual contacts, or with sexual transmitted infectious diseases were risk factors associated with HBsAg seropositivity. Conclusions: Our findings highlight significant demographic and epidemiological patterns of reduced HBV prevalence even in vulnerable persons, as well as modified risk factors and the impact of socio-economic factors. [ABSTRACT FROM AUTHOR]

(1) Background: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a tool designed to measure disability in accordance with the International Classification of Functioning, Disability and Health. Measuring disability is becoming increasingly important due to its high prevalence, which continues to rise. Rehabilitation interventions can reduce disability and enhance functioning. (2) Objective: The present study aims to assess the impact of rehabilitation interventions on reducing disability, as measured by the WHODAS 2.0 questionnaire. It also seeks to identify which specific rehabilitation interventions are more effective and to explore other disability assessment questionnaires. (3) Methods: Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) methodology, we conducted a systematic review, with the protocol registered with the identifier CRD42023495309, focused on "WHODAS" and "rehabilitation" using PubMed and Web of Science electronic databases. (4) Results: We identified 18 articles from various regions encompassing patients with various health conditions, related to stroke, the cardiovascular system (cardiovascular disease, chronic heart failure), the pulmonary system (chronic obstructive pulmonary disease), the neurologic system (Parkinson's disease, cerebral palsy, neurodegenerative disease), the musculoskeletal system (orthopaedic surgery), cancer, and chronic pain, and among frail elderly. These patients have received a wide range of rehabilitation interventions: from conventional therapy to virtual reality, robot-assisted arm training, exergaming, and telerehabilitation. (5) Discussion and Conclusions: A wide range of rehabilitation techniques can effectively improve disability with various comorbidities, offering numerous benefits. The WHODAS 2.0 questionnaire proves to be an efficient and reliable tool for measuring disability, and scores have a tendency to decrease after rehabilitation. [ABSTRACT FROM AUTHOR]

The negative consequences of microgravity for the human body are central aspects of space travel that raise health problems. Altered functions of the same systems and treatment options are common points of spaceflight physiology, age-related diseases, and oral medicine. This work emphasizes the convergence of knowledge between pathophysiological changes brought on by aging, physiological reactions to microgravity exposure, and non-pharmacological and non-invasive treatment methods that can be used in spaceflight. Sarcopenia, peripheral nerves alterations, neuromotor plaque in the masticatory muscles, lingual, labial, and buccal weakness, nociplastic pain in oral mucosal diseases, and microgravity, as well as soft tissue changes and pathologies related to chewing and swallowing, corticomotor neuroplasticity of tongue, and swallowing biomechanics, are of particular interest to us. Neurologic disease and other pathologies such as recovery from post-stroke dysphagia, nociplastic pain in glossodynia, sleep bruxism, and obstructive sleep apnea have been studied and, in some cases, successfully treated with non-invasive direct and transcranial magnetic stimulation (TMS) methods in recent decades. An interdisciplinary team from medical specialties, engineering, and biophysics propose an exploratory study based on the parallelism of ageing and space physiology, along with experiment scenarios considering TMS and non-invasive direct methods. [ABSTRACT FROM AUTHOR]

After almost 50 years of data analysis, screening for colorectal cancer has proven to be an effective tool in reducing colorectal cancer mortality. However, implementing the optimal strategy represents a challenge for many healthcare facilities around the world. There is much discussion regarding how screening should be done, the optimal tools that should be used, and the proper timing for screening procedures. Another essential step is to maintain the adherence of patients to screening programs. Also, the recommendation for lowering the age to initiate screening is in progress, as there is an increase in colorectal incidence in people born after 1970. [ABSTRACT FROM AUTHOR]

Copyright of Farmacia is the property of Societatea de Stiinte Farmaceutice Romania and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Inflammatory bowel disease (IBD) is a chronic affliction that requires careful regular monitoring and focused treatment, defined by remissions and flares, with frequent hospital admissions, surgical procedures in complicated cases and progression towards dysplasia in longstanding disease. The patient's quality of life is considerably affected by the disease per se but also by the frequent follow-ups and invasive procedures used for disease activity monitoring. The diagnosis of inflammatory bowel disease rests on symptoms, clinical signs, laboratory and imaging tests and is confirmed by bioptic endoscopy with subsequent pathology examination. Endoscopy is an important tool not just for disease diagnosis but also for disease progression monitoring, early dysplastic lesions diagnosis and therapeutic intervention. Endoscopy offers a fast and straightforward evaluation of the colonic mucosa, enabling the description of the extent and severity of the intestinal lesions leading to the prediction of the disease's aggressive nature and the introduction of appropriate treatment. The ultimate goal when dealing with IBDs is to reach mucosal healing, thus ensuring a significant improvement of the quality of life and prognosis and a drop in hospitalization expenses and in the need for surgical measures. This paper aims to review the latest Gastrointestinal Endoscopy Society standards of practice guidelines so as to offer a useful algorithm for the use of endoscopy in patient care. [ABSTRACT FROM AUTHOR]

Copyright of Farmacia is the property of Societatea de Stiinte Farmaceutice Romania and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of our paper is to highlight the main therapeutic principles and the management options in the case of a diabetic patient who has had a sudden hearing loss. Mainly, the aim is to underline the sudden hearing loss treatment adjustment of the diabetic patient compared to the non-diabetic patient. By understanding the mechanism of sudden hearing loss in a diabetic patient, namely the impact of glycemic variations and their implication on the microvascular structures of the inner ear, we try to underline the treatment principles and management options of the previously mentioned combined pathologies. Thus, it is necessary to adapt the classes of drugs used in the case of sudden sensorineural hearing loss of the diabetic patient in comparison with the non-diabetic patient, in order not to aggravate or complicate the patient's functional status. Therefore, the treatment will need to be adapted both by classes of medication and by the type of administration used. Adequate control of the progression, treatment and complications of diabetes mellitus ensures optimal treatment management in case of a sudden hearing loss and therefore interferes with the favorable functional hearing outcomes. The role of this paper is not only to state the therapeutic principles in the case of sudden hearing loss in a diabetic patient, but also to analyze the impact on the management of potential local and systemic risk factors. [ABSTRACT FROM AUTHOR]

Primary gastric lymphoma (PGL) represents a rare pathology, which can be easily misdiagnosed because of unspecific symptoms of the digestive tract. Histologically, PGL can vary from indolent marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) to aggressive diffuse large B-cell lymphoma (DLBCL). During the years, clinical trials revealed the important role of Helicobacter pylori (H. pylori) in the pathogenesis of gastric MALT lymphoma. Infection with Helicobacter pylori is an influential promoter of gastric lymphomagenesis initiation. Long-term studies revealed that eradication therapy could regress gastric lymphomas. [ABSTRACT FROM AUTHOR]

Copyright of Farmacia is the property of Societatea de Stiinte Farmaceutice Romania and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Farmacia is the property of Societatea de Stiinte Farmaceutice Romania and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Objectives: Despite being largely preventable, cervical cancer mortality still remains an important public health problem globally, in Europe, and in Romania. The European Union member states are urged to implement systematic, population-based screenings for cervical cancer, but the programs developed by the countries remain very heterogeneous. This study aimed to investigate the differences in cervix cancer mortality between Romania and EU and within Romania over the last two decades and to reveal the major sources of inequalities and the policy implications. Materials and Methods: We analyzed the number of deaths and the mortality rates by cervical cancer, standardized using the direct method, over two decades (2001–2016 for the EU, and 2001–2019 for the national and sub-national analyses). Trends, mortality reduction over the years, and mortality differences at the beginning and end of the time interval have been calculated for the EU and Romania, at national and sub-national levels (rural–urban and regions). Results: Our results revealed differences in cervical cancer mortality between Romania and EU and within Romania (among regions and rural–urban areas). These differences used to be very high in the past and are still persisting. Conclusions: The country should revisit its national cervical cancer screening program, which has been implemented for many years, but with a very limited participation rate. Due to the similar problems existing in Central-Eastern Europe, targeted support from the EU for the members from this geographical area could contribute to the minimization of differences in cervical cancer mortality among the EU members. [ABSTRACT FROM AUTHOR]

Background. The treatment of stage II colon cancer has been a subject of debate for a long time. In the last years, a few risk factors have been proposed in order to guide any treatment decision more accurately. One of these risk factors is the number of resected lymph nodes, and according to the latest guidelines, it is recommended that at least 12 lymph nodes should be resected for optimal staging. The aim of this study is to evaluate the role of lymph node resection, in stage II colon cancer and the implication of suboptimal lymph node resection on disease free survival and overall survival. Patients and methods. This was a prospective study that included 130 patients with stage II colon cancer who were monitored between October 2014 and October 2016. The relation between patients' tumour characteristics that include number of lymph node resection and the use of adjuvant chemotherapy using Chi test and multiple logistic regression was analyzed. The disease-free survival and overall survival were estimated with the Kaplan-Meier method and compared with the log-rank test. Results. 130 patients with stage II colon cancer were recruited. 56 patients were treated with surgery alone and 74 patients received fluorouracil- based chemotherapy after surgery. Patients' age varied from 37 years to 81 years. According to the number of resected lymph nodes, patients were divided into two groups - with less than 12 lymph nodes resected and at least 12 lymph nodes resected. The number of resected lymph nodes varied from 2 to 32 lymph nodes. Median follow up was 36 months. Suboptimal resections of lymph nodes confirmed to be a negative prognostic factor for survival without disease recurrence. Conclusion. Data results confirmed the importance of lymph node resection as a prognostic factor for stage II colon cancer and the role of chemotherapy for patients with suboptimal lymph node resection. [ABSTRACT FROM AUTHOR]

Background and aims. For the 8-week OPrD regimen, real world data are insufficient. This study aims to compare the efficacy of the two types of regimens (12-week versus 8-week) in a real world cohort of patients with genotype 1b. Material and methods. We analysed a multicentric retrospective cohort enrolling 1436 patients who started HCV therapy in 2018-2019. Liver fibrosis was staged in all subjects by Fibromax. Efficacy was assessed by the percentage of patients achieving SVR 12 weeks post-treatment (SVR12). Results. Out of the 1436 analysed patients, 112 received 8 weeks therapy and 1324 received 12 weeks. In this cohort the proportion of male patients was 25.2%, the median age 61 years, 28.2% were interferon pre-treated, and the rate of co-morbidities was 47%. 42% of the subjects had F2 fibrosis, 29% F1 fibrosis, 16% F3 and 12% F4. The SVR rate was comparable in both groups of patients (97% in those treated with OPrD 12 weeks vs 96.4% in those that received OPrD 8 weeks) (by intention-to-treat). In the 12 weeks arm, the drop-out rate was 0.8% and the rate of severe adverse events was 1%, while in the arm of 8 weeks therapy there were no severe adverse events reported and no drop-out (p = 0.25). The only predictive factor for non-response in both treatment arms was the male sex. Conclusions. OPrD 8 weeks proved to be highly efficient in our patients with a 96.4% SVR. No serious adverse events and no drop out were reported. [ABSTRACT FROM AUTHOR]

Background. Biological therapy has reduced the number of cases requiring surgical interventions, but at least half of the patients are operated during their lifetime. Choosing the optimal surgical moment is based on a series of factors related to the patient, preoperative medication, long term complications of the disease. Aim. Stratification of risk factors for postoperative morbidity, based on clinical guidelines for surgical therapy in Crohn's disease. Methods. The analysis of our own series of cases, superimposed on the statistical data from the ECCO surgical treatment guide, highlighted a series of risk factors, which were stratified according to the possibilities of preoperative correction. Results. The most frequent postoperative complications were identified as: anastomotic and enterocutaneous fistulas, intraperitoneal abscesses, wound dehiscences, general complications (pneumonia, urinary infections). The following factors were taken into account: Preoperative nutritional status, especially in patients with long periods of disease evolution, preoperative corticosteroid medication, control of sepsis sources (including clostridium difficile infection), cessation or not of immunological therapy. The nutritional status of patients with malabsorption syndrome or long-standing stenoses can be improved preoperatively by parenteral nutrition, minimally invasive treatment of the sources of intraperitoneal sepsis, correction of stenosis (percutaneous drainage of abscesses, balloon dilatations for short stenoses), antibiotic therapy and discontinuation of cortisone medication, can reduce the risk of postoperative complications. Conclusion. The surgical moment is not clearly coded and it is difficult to choose. The decision must be multidisciplinary and take into account the patients' quality of life and the operative risk. Delaying the intervention can lead to nutritional degradation and increased postoperative morbidity as a result of prolonged corticotherapy or the installation of malabsorption syndrome. There are often situations in which surgery represents a new beginning for the gastroenterologist in re-initiating drug therapy, such as situations in which the timing of the intervention until the non-invasive therapeutic resources are exhausted can lead to the failure of a surgical solution that, applied early, would have been beneficial. [ABSTRACT FROM AUTHOR]

Background. Lynch syndrome (LS former known as HNPCC) is a subject of interest for gastroenterologists and other specialties. The design of a multidisciplinary center for Lynch syndrome requires not only equipment but also the existence of a complex team of specialists who are trained to possess expertise in this field. Aim. In order to design the project, we started a colorectal cancer prevalence study among patients who present themselves in a university emergency hospital. The purpose of the study was to characterize epidemiologically and clinically the cases of colorectal cancer diagnosed and treated in our hospital and to highlight among them the potential cases of LS. This study represents only one part of the prevalence study of digestive or gynecological tumors that may present the defining elements of LS. Methods. We performed an observational, retrospective study in a single tertiary center were the complete diagnosis and treatment is recommended by the tumor board team. The board's goal is to determine the best possible cancer treatment and care plan for an individual patient. The complete medical files of the patients discharged with CCR diagnosis confirmed by biopsies were collected and analyzed, on a period of one year before (2019), during (2020-2021) and a year after (2022) pandemic time. From the total number of patients discharged with CCR, we chose those younger than 50 years old, for whom we searched the medical records if they fulfill the Amsterdam criteria. All patients underwent pathological examination and IHC. Those who presented microsatellite instability MSI, were registered to undergo genetic tests to identify the possible presence of LS. Results. from 1850 CCRs discharged patients who performed histological examination and IHC (2019-2022), 165 (8.91%) were under 50 year old at diagnosis and 24 of them (14,4%) had MSI high on IHC. Of these, only 3 patients fulfill the family history for LS. For all 24 patients we recommend genetic testing in order to confirm the specific mutations. From 165 patients, we lost for follow-up 18 (10.9%) Conclusions. The design of a multidisciplinary center for LS is feasible, under the premise that the data collection methodology is homogenous and the patients go through the diagnostic and follow-up protocol under the coordination of a team of specialists in genetic syndromes. The high percentage of patients with MSI on IHC offers the opportunity to diagnose those with genetic LS by complete family history anamnesis and genetic testing. [ABSTRACT FROM AUTHOR]