Journal Description
Medicina
Medicina
is an international, peer-reviewed, open access journal that covers all problems related to medicine. The journal is owned by the Lithuanian University of Health Sciences (LUHS) and is published monthly online by MDPI. Partner Societies are the Lithuanian Medical Association, Vilnius University, Rīga Stradiņš University, the University of Latvia, and the University of Tartu.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, MEDLINE, PMC, and other databases.
- Journal Rank: CiteScore - Q2 (General Medicine)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 19.6 days after submission; acceptance to publication is undertaken in 2.5 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Impact Factor:
2.6 (2022);
5-Year Impact Factor:
2.9 (2022)
Latest Articles
Diabetic Nephropathy, Retinopathy, and Functional Hypogonadism in a Patient with MODY10: A Case Report
Medicina 2024, 60(5), 830; https://doi.org/10.3390/medicina60050830 (registering DOI) - 18 May 2024
Abstract
(1) Background and objectives: Maturity-onset diabetes of the young (MODY) is a group of diabetes caused by gene defects related to insulin secretion. MODY1, MODY2, and MODY3 are the most common and account for approximately 80% of all cases. Other types are
[...] Read more.
(1) Background and objectives: Maturity-onset diabetes of the young (MODY) is a group of diabetes caused by gene defects related to insulin secretion. MODY1, MODY2, and MODY3 are the most common and account for approximately 80% of all cases. Other types are relatively rare. This study describes the clinical, analytical, and genetic characteristics of a patient with MODY10, and diabetic nephropathy, retinopathy, and functional hypogonadism diagnosis. (2) Materials and methods: A clinical case was analyzed and whole exome generation sequencing (WES) was used to detect mutations related to a monogenic variant. (3) Results: A seventeen-year-old male patient, who was diagnosed with apparent type 1 diabetes at the age of eight was started with insulin therapy. He came to the emergency room with glycemic decompensation, facial, and lower limb edema. During his evaluation, he had near-nephrotic range proteinuria of 2902 mg/24 h, a kidney ultrasound showing mild pyelocalyceal dilation, proliferative diabetic retinopathy, and was also diagnosed with functional hypogonadotropic hypogonadism. These comorbidities improved with adequate glycemic control. WES showed missense variant c.94G>A (p.Gly32Ser) in the INS gene, according to Clinvar corresponding to MODY10. It was a “de novo” variant not reported in his parents. (4) Conclusions: Monogenic diabetes (MD) is rare and MODY10 is among the less frequent types. MODY should be suspected in patients with type 1 phenotype with negative autoimmunity even in the absence of a family history of diabetes. To the best of our knowledge, we present here the first patient with these phenotypic traits of MODY10 reported in Latin America.
Full article
(This article belongs to the Section Endocrinology)
►
Show Figures
Open AccessArticle
Healing of Periodontal Suprabony Defects following Treatment with Open Flap Debridement with or without Hyaluronic Acid (HA) Application
by
Octavia Carolina Vela, Marius Boariu, Darian Rusu, Vincenzo Iorio-Siciliano, Luca Ramaglia, Simina Boia, Viorelia Radulescu, Ioana Ilyes and Stefan-Ioan Stratul
Medicina 2024, 60(5), 829; https://doi.org/10.3390/medicina60050829 - 17 May 2024
Abstract
Background and Objectives: This randomized, double-arm, multicentric clinical trial aims to compare the clinical outcomes following the treatment of suprabony periodontal defects using open flap debridement (OFD) with or without the application of hyaluronic acid (HA). Materials and Methods: Sixty systemically healthy patients
[...] Read more.
Background and Objectives: This randomized, double-arm, multicentric clinical trial aims to compare the clinical outcomes following the treatment of suprabony periodontal defects using open flap debridement (OFD) with or without the application of hyaluronic acid (HA). Materials and Methods: Sixty systemically healthy patients with at least two teeth presenting suprabony periodontal defects were randomly assigned with a 1:1 allocation ratio using computer-generated tables into a test (OFD + HA) or control group (OFD). The main outcome variable was clinical attachment level (CAL). The secondary outcome variables were changes in mean probing pocket depth (PPD), gingival recession (GR), full-mouth plaque score (FMPS), and full-mouth bleeding score (FMBS). All clinical measurements were carried out at baseline and 12 months. Results: Sixty patients, thirty in each group, were available for statistical analysis. The mean CAL gain was statistically significantly different (p < 0.001) in the test group compared with the control group (3.06 ± 1.13 mm vs. 1.44 ± 1.07 mm). PPD reduction of test group measurements (3.28 ± 1.14 mm) versus the control group measurements (2.61 ± 1.22 mm) were statistically significant (p = 0.032). GR changes were statistically significant only in the test group 0.74 ± 1.03 mm (p < 0.001). FMBS and FMPS revealed a statistically significant improvement mostly in the test group. Conclusions: Suprabony periodontal defects could benefit from the additional application of HA in conjunction with OFD in terms of improvement of the clinical parameters compared with OFD alone.
Full article
(This article belongs to the Special Issue Advances in Clinical Periodontology)
►▼
Show Figures
Figure 1
Open AccessArticle
The Relationship between the Ewing Test, Sudoscan Cardiovascular Autonomic Neuropathy Score and Cardiovascular Risk Score Calculated with SCORE2-Diabetes
by
Andra-Elena Nica, Emilia Rusu, Carmen Dobjanschi, Florin Rusu, Claudia Sivu, Oana Andreea Parlițeanu and Gabriela Radulian
Medicina 2024, 60(5), 828; https://doi.org/10.3390/medicina60050828 - 17 May 2024
Abstract
Background and Objectives: Cardiac autonomic neuropathy (CAN) is a severe complication of diabetes mellitus (DM) strongly linked to a nearly five-fold higher risk of cardiovascular mortality. Patients with Type 2 Diabetes Mellitus (T2DM) are a significant cohort in which these assessments have
[...] Read more.
Background and Objectives: Cardiac autonomic neuropathy (CAN) is a severe complication of diabetes mellitus (DM) strongly linked to a nearly five-fold higher risk of cardiovascular mortality. Patients with Type 2 Diabetes Mellitus (T2DM) are a significant cohort in which these assessments have particular relevance to the increased cardiovascular risk inherent in the condition. Materials and Methods: This study aimed to explore the subtle correlation between the Ewing test, Sudoscan-cardiovascular autonomic neuropathy score, and cardiovascular risk calculated using SCORE 2 Diabetes in individuals with T2DM. The methodology involved detailed assessments including Sudoscan tests to evaluate sudomotor function and various cardiovascular reflex tests (CART). The cohort consisted of 211 patients diagnosed with T2DM with overweight or obesity without established ASCVD, aged between 40 to 69 years. Results: The prevalence of CAN in our group was 67.2%. In the study group, according SCORE2-Diabetes, four patients (1.9%) were classified with moderate cardiovascular risk, thirty-five (16.6%) with high risk, and one hundred seventy-two (81.5%) with very high cardiovascular risk. Conclusions: On multiple linear regression, the SCORE2-Diabetes algorithm remained significantly associated with Sudoscan CAN-score and Sudoscan Nephro-score and Ewing test score. Testing for the diagnosis of CAN in very high-risk patients should be performed because approximately 70% of them associate CAN. Increased cardiovascular risk is associated with sudomotor damage and that Sudoscan is an effective and non-invasive measure of identifying such risk.
Full article
(This article belongs to the Special Issue Advances in Clinical Diabetes, Obesity, and Metabolic Diseases)
►▼
Show Figures
Figure 1
Open AccessArticle
Factors Affecting Adherence to Social Distancing among Adults Aged 19–44 Years: Insights from a Nationwide Survey during COVID-19 Pandemic
by
Eun Jung Kim and Mikyong Byun
Medicina 2024, 60(5), 827; https://doi.org/10.3390/medicina60050827 - 17 May 2024
Abstract
Background and Objectives: Before COVID-19 vaccinations became available, adhering to non-pharmaceutical interventions (NPIs), like social distancing (SD), wearing masks, and hand hygiene, were crucial to mitigating viral spread. Many studies reported that younger individuals were more reluctant to follow these measures compared with
[...] Read more.
Background and Objectives: Before COVID-19 vaccinations became available, adhering to non-pharmaceutical interventions (NPIs), like social distancing (SD), wearing masks, and hand hygiene, were crucial to mitigating viral spread. Many studies reported that younger individuals were more reluctant to follow these measures compared with older ones. We hypothesized that it would be worthwhile to find factors that influenced SD compliance among young people during the pre-vaccination phase of a pandemic. Materials and Methods: We analyzed data of adults aged 19–44 from the 2020 South Korean Community Health Survey and compared socio-demographic, health-related behavioral, and psychological factors between compliant and non-compliant cohorts. Results: A total of 59,943 participants were enrolled and we found that older age groups (30–39 and 40–44) and safety concerns (such as viral infection, virus-related death, economic damage, and transmitting virus to vulnerable people) were significantly associated with adherence to SD. Conversely, participants who were not living with a spouse, were unable to stay at home despite symptoms, smoked, drank, and had a negative attitude toward government policy statistically correlated with non-compliance. Conclusions: In times when NPIs were the primary defense against the pandemic, it is essential to identify factors that positively or negatively affect individual compliance with them, especially among young people. Using a large-scale, well-designed national survey, we could gain insights into the early recognition of risk factors for non-compliance and appropriate follow-up interventions (i.e., education campaigns, clear communication of public guidelines, and implementation of guidelines), which will help people to avoid suffering from other waves of future infectious diseases.
Full article
Open AccessArticle
Relationship between Maternal Socioeconomic Factors and Preterm Birth in Latvia
by
Katrīne Kūkoja, Anita Villeruša and Irisa Zīle-Velika
Medicina 2024, 60(5), 826; https://doi.org/10.3390/medicina60050826 - 17 May 2024
Abstract
Background and Objectives: Worldwide, preterm birth (PTB) stands as the primary cause of mortality among children under 5 years old. Socioeconomic factors significantly impact pregnancy outcomes, influencing both maternal well-being and newborn health. Understanding and addressing these socioeconomic factors is essential for developing
[...] Read more.
Background and Objectives: Worldwide, preterm birth (PTB) stands as the primary cause of mortality among children under 5 years old. Socioeconomic factors significantly impact pregnancy outcomes, influencing both maternal well-being and newborn health. Understanding and addressing these socioeconomic factors is essential for developing effective public health interventions and policies aimed at improving pregnancy outcomes. This study aims to analyse the relationship between socioeconomic factors (education level, marital status, place of residence and nationality) and PTB in Latvia, considering mother’s health habits, health status, and pregnancy process. Materials and Methods: A cross-sectional study was conducted using data from the Medical Birth Register (MBR) of Latvia about women with singleton pregnancies in 2022 (n = 15,431). Data analysis, involving crosstabs, chi-square tests, and multivariable binary logistic regression, was performed. Adjusted Odds ratios (aOR) with 95% confidence intervals (CI) were estimated. Results: Lower maternal education was statistically significantly associated with increased odds of PTB. Mothers with education levels below secondary education had over two times higher odds of PTB (aOR = 2.07, p < 0.001, CI 1.58–2.70) and those with secondary or vocational secondary education had one and a half times higher odds (aOR = 1.58, p < 0.001, CI 1.33–1.87) after adjusting for other risk factors. Study results also showed the cumulative effect of socioeconomic risk factors on PTB. Additionally, mothers facing two or three socioeconomic risk factors in Latvia exhibited one and a half times higher odds of PTB (aOR = 1.59, p = 0.021). Conclusions: The study highlights the cumulative impact of socioeconomic risk factors on PTB, with higher maternal education demonstrating the highest protective effect against it. This underscores the importance of education in promoting optimal foetal development. Since the influence of socioeconomic factors on PTB is not a widely studied issue in Latvia, further research is needed to improve understanding of this complex topic.
Full article
(This article belongs to the Section Epidemiology & Public Health)
►▼
Show Figures
Figure 1
Open AccessCase Report
Uterine Leiomyomas with Specific Histology Features of Two Fumarate Hydratase/Succinate Dehydrogenase-Deficient Tumors: A Double Case Report
by
Ljubiša Jovanović, Svetlana Milenković, Luka Andrić, Radomir Stefanović, Branislav Milošević, Jelena Micić, Igor Pilić, Aleksandra Beleslin, Olga Mihaljević and Milan Dokić
Medicina 2024, 60(5), 825; https://doi.org/10.3390/medicina60050825 - 17 May 2024
Abstract
Background and Objectives: Mutations in succinate dehydrogenase (SDH) and fumarate hydratase (FH) give rise to various familial cancer syndromes, with these alterations being characteristic of certain types of histomorphologically specific leiomyomas that hold significant predictive value. Materials and Methods: This study
[...] Read more.
Background and Objectives: Mutations in succinate dehydrogenase (SDH) and fumarate hydratase (FH) give rise to various familial cancer syndromes, with these alterations being characteristic of certain types of histomorphologically specific leiomyomas that hold significant predictive value. Materials and Methods: This study presents two cases of uterine leiomyomas exhibiting rare histomorphological and genetic characteristics, which are crucial for prognosis and further treatment. Results: Distinct histopathological features such as marked nuclear atypia, intracellular eosinophilic globules, and abnormal intratumoral vessels raise suspicion for specific leiomyoma subtypes, which carry predictive significance for additional hereditary cancer syndromes. Immunohistochemical analysis confirmed FH/SDH deficiency in both patients, who underwent careful follow-up. Conclusions: This study describes two cases involving unusual leiomyomas, the histopathological characteristics of which may easily go unrecognized. These features hold predictive significance because their specific mutations point to additional hereditary cancer syndromes, highlighting the need for further examinations.
Full article
(This article belongs to the Special Issue Uterine Smooth-Muscle Tumors)
►▼
Show Figures
Figure 1
Open AccessArticle
Demographic and Socioeconomic Predictors of Prehypertension and Hypertension in the Adult Population: Serbian National Health Survey
by
Igor Dimitrijev, Snezana Radovanovic, Zoran Vesic, Goran Colakovic, Viktor Selakovic, Ana Lackovic, Slavica S. Djordjevic, Maja Pesic, Danijela Nesovic, Radomir Lazarevic, Ognjen Djordjevic, Olgica Mihaljevic, Aleksandra Obradovic, Verica Vukicevic, Nikoleta Janicijevic and Jovana Radovanovic
Medicina 2024, 60(5), 824; https://doi.org/10.3390/medicina60050824 - 16 May 2024
Abstract
Background and Objectives: Prehypertension and hypertension are the most common cardiovascular disorders worldwide and are increasingly considered one of the most serious public health problems, particularly in developing countries. The objective of this study was to determine the frequency and demographic and
[...] Read more.
Background and Objectives: Prehypertension and hypertension are the most common cardiovascular disorders worldwide and are increasingly considered one of the most serious public health problems, particularly in developing countries. The objective of this study was to determine the frequency and demographic and socioeconomic predictors of prehypertension and hypertension in the adults in Serbia, and to examine the relationship between prehypertension and hypertension and health behavior determinants (smoking, alcohol use, physical activity) and individual aspects of health (a health self-assessment, multimorbidity, BMI, depressive symptoms). Materials and Methods: The research is part of the fourth National Population Health Survey conducted in 2019, which was conducted by the Republic Institute of Statistics, in cooperation with the Institute of Public Health of Serbia and the Ministry of Health of the Republic of Serbia. As a research instrument, questionnaires were used in accordance with the methodology of the European Health Survey. For the purposes of this research, data on the adult population aged 20 and over were used. Results: Women are at a reduced risk for both prehypertension (OR = 0.328) and hypertension (OR = 0.349) by nearly 70%. Similarly, those aged below 60 years have a lower risk for prehypertension and those younger than 40 years have a lower risk for hypertension (OR = 0.995), whereas people with a lower education have a 4.3 times higher risk of prehypertension (OR = 4.323) and a 1.6 times higher risk of hypertension (OR = 1.614). The poor have a 1.4 times higher risk of prehypertension (OR = 1.413) and a 1 times higher risk of hypertension (OR = 1.035). People with multimorbidity have a 1.2 times higher risk of both prehypertension (OR = 1.218) and a 4.8 times higher risk of hypertension (OR = 4.867). Conclusions: Male gender, lower education, poverty, age and the presence of multimorbidity are significant predictors of prehypertension and hypertension in the Serbian adult population, so preventive strategies should be aimed at these sensitive population groups.
Full article
(This article belongs to the Special Issue Health Risk Factors, Prevention, and Inequalities)
Open AccessArticle
Colliding Challenges: An Analysis of SARS-CoV-2 Infection in Patients with Pulmonary Tuberculosis versus SARS-CoV-2 Infection Alone
by
Camil Mihuta, Adriana Socaci, Patricia Hogea, Emanuela Tudorache, Monica Simina Mihuta and Cristian Oancea
Medicina 2024, 60(5), 823; https://doi.org/10.3390/medicina60050823 - 16 May 2024
Abstract
Background and Objectives: The concurrent occurrence of tuberculosis and COVID-19 coinfection poses significant clinical complexities, warranting a nuanced approach to diagnosis, management, and patient care. Materials and Methods: A retrospective, cross-sectional study was conducted on two groups: one comprising 32 patients
[...] Read more.
Background and Objectives: The concurrent occurrence of tuberculosis and COVID-19 coinfection poses significant clinical complexities, warranting a nuanced approach to diagnosis, management, and patient care. Materials and Methods: A retrospective, cross-sectional study was conducted on two groups: one comprising 32 patients with pulmonary TB (PTB) and COVID-19 co-infection, and one including 100 patients with COVID-19 alone. Data was collected from medical records, including patient history, clinical parameters, laboratory, imaging results, and patient outcome. Results: A lower BMI emerges as a significant marker suggesting underlying PTB in patients with SARS-CoV-2 co-infection. Type 2 diabetes mellitus increases the risk of death in PTB-SARS-CoV-2 co-infection. Co-infected patients show lymphocytopenia and higher neutrophil levels, CRP, transaminases, and D-dimer levels. Elevated CRP and ALT levels are linked to increased co-infection likelihood. Certain parameters like SpO2, CRP, ALT, AST, and D-dimer effectively differentiate between co-infected and COVID-19 patients. Platelet-to-lymphocyte ratio is notably higher in co-infected individuals. Lesion severity on imaging is significantly associated with co-infection, highlighting imaging’s diagnostic importance. Longer hospital stays are linked to co-infection but not significantly to death risk. Conclusions: Certain clinical and biological factors may serve as potential indicators of PTB co-infection in patients with SARS-CoV-2.
Full article
(This article belongs to the Special Issue Advances in Infectious Diseases and Clinical Microbiology during and after the COVID-19 Pandemic: 2nd Edition)
►▼
Show Figures
Figure 1
Open AccessArticle
Laser Forced Dehydration of Benign Vascular Lesions of the Oral Cavity: A Valid Alternative to Surgical Techniques
by
Margherita Gobbo and Luca Guarda-Nardini
Medicina 2024, 60(5), 822; https://doi.org/10.3390/medicina60050822 - 16 May 2024
Abstract
Background and Objectives: Low-flow vascular lesions are commonly encountered in the oral cavity and may require removal due to aesthetic concerns, repeated bleeding or a cluttering sensation. Laser devices represent an excellent aid due to their affinity with blood and to their
[...] Read more.
Background and Objectives: Low-flow vascular lesions are commonly encountered in the oral cavity and may require removal due to aesthetic concerns, repeated bleeding or a cluttering sensation. Laser devices represent an excellent aid due to their affinity with blood and to their biostimulating properties and have been substituting traditional excision in selected cases. Materials and Methods: In this study, 30 patients presenting with low-flow oral vascular lesions were included. The lesions were clinically evaluated as follows: lesion’s site, reason for treatment, lesion’s dimensions, confirmation of positive diascopy via compression with a glass slide and photograph. The lesions were treated with laser forced dehydration (LFD) and then followed-up after 3 weeks, 6 months and 1 year. The laser source was a K-Laser Blu Derma (Eltech, K-Laser S.r.l., Via Castagnole, 20/H, Treviso, Italy). In the case of incomplete healing, a further protocol was performed at the three-week follow-up, and a further follow-up was scheduled for three weeks after. The following aspects were evaluated at each appointment: pain, using a Numeric Rating Scale (NRS) from 0 to 10 (0 = no pain, 10 = worst pain ever); the need to take painkillers (day of intervention and during follow-up); bleeding (yes/no); scar formation. Results: Complete regression was obtained in all patients, with no side effects. Only one patient required a second LFD protocol. NRS was 0 for all patients for the whole duration of the follow-up. None of the patients took painkillers on the day of the intervention and during the follow-up. One patient declared slight bleeding the day of the intervention, which she easily managed at home. One patient showed a small non-retracting and non-painful scar at the three-week follow-up. No recurrences were found after six months and one year. Conclusions: LFD targets endogenous chromophores, minimizing damage to adjacent tissue and limiting side effects. LFD is effective and could be considered a conservative alternative to traditional excision in low-flow lesions.
Full article
(This article belongs to the Special Issue Medicine and Dentistry: New Methods and Clinical Approaches)
►▼
Show Figures
Figure 1
Open AccessArticle
Altered Arterial Stiffness, Ventricular–Arterial Coupling and Troponin Levels in Patients with Systemic Lupus Erythematosus
by
Nikolaos P. E. Kadoglou, Alexandriani Dimopoulou, Evangelia Gkougkoudi and Konstantinos Parperis
Medicina 2024, 60(5), 821; https://doi.org/10.3390/medicina60050821 - 16 May 2024
Abstract
Introduction: Systemic Lupus Erythematosus (SLE) is an autoimmune disease associated with an increased risk of cardiovascular diseases (CVDs), leading to elevated mortality rates among patients. We aimed to evaluate the levels of cardio–ankle vascular index (CAVI), global longitudinal strain (GLS), ventricular–arterial coupling
[...] Read more.
Introduction: Systemic Lupus Erythematosus (SLE) is an autoimmune disease associated with an increased risk of cardiovascular diseases (CVDs), leading to elevated mortality rates among patients. We aimed to evaluate the levels of cardio–ankle vascular index (CAVI), global longitudinal strain (GLS), ventricular–arterial coupling (VAC), and high-sensitivity cardiac troponin I (hsTnI) in SLE patients and to explore their relationship with clinical parameters. Methods: This cross-sectional study enrolled 82 SLE patients without evident cardiac or kidney impairment and 41 age- and sex-matched healthy controls. We comparatively evaluated CAVI, GLS, VAC, and hsTnI between SLE patients and controls, and we assessed their association among SLE patients with disease activity based on the SELENA–SLEDAI Activity Index. Multivariate regression analysis was performed to identify independent predictors of CAVI and hsTnI within the SLE cohort. Results: In comparison to healthy controls, SLE patients presented with significantly higher CAVI, GLS, and hsTnI levels, while VAC was significantly reduced (p < 0.001). Furthermore, SLE patients with active disease (SELENA–SLEDAI ≥ 4) exhibited higher levels of CAVI and troponin than those with inactive disease (p < 0.001). SLEDAI was an independent predictor of CAVI, while VAC and SLEDAI were independent determinants of hsTnI in the SLE cohort. Conclusions: SLE patients displayed abnormal levels of CAVI, VAC, GLS, and troponin compared to healthy individuals. Our findings implicate the potential of those CV novel CVD risk factors to refine screening and therapeutic strategies for this specific population.
Full article
(This article belongs to the Special Issue Novel Echocardiographic Techniques for the Assessment of Cardiovascular Disease)
Open AccessCase Report
Penoscrotal Edema as a Rare Complication of Acute Pancreatitis: A Case Report
by
Ivana Jukic, Visnja Kokic Males, Antonija Zanic and Ivan Zaja
Medicina 2024, 60(5), 820; https://doi.org/10.3390/medicina60050820 - 16 May 2024
Abstract
Background and Objectives: Scrotal swelling or hydrocele is a rare complication of acute pancreatitis described in the literature. We present a case of penoscrotal swelling caused by the first attack of acute interstitial edematous alcohol-induced pancreatitis in a young male patient. Case
[...] Read more.
Background and Objectives: Scrotal swelling or hydrocele is a rare complication of acute pancreatitis described in the literature. We present a case of penoscrotal swelling caused by the first attack of acute interstitial edematous alcohol-induced pancreatitis in a young male patient. Case report: A 22-year-old man was admitted to the emergency unit due to diarrhea and vomiting since morning which was followed by severe abdominal pain. Urgent abdominal multislice CT scan showed steatosis, pancreatic swelling and acute peripancreatic fluid collection (interstitial edematous pancreatitis). Also, scan showed fluid between small bowel loops and along the anterior renal fascia, while there was minimal amount of fluid in the Douglas space. There was no sign of penoscrotal swelling. On the second day of admission, the patient developed left scrotal swelling and mild pain without erythema. On the fourth day, a control CT scan showed progression to moderately severe pancreatitis (CT severity index 4). Dilated scrotal veins of the pampiniform venous plexus with an increased caliber of the testicular veins were present on both sides, from the scrotum to the level of the inguinal canal. Penoscrotal swelling was significantly reduced on discharge. Conclusions: Penoscrotal swelling is a rare complication or manifestation of acute inflammation of the pancreas. It is important to identify scrotal swelling caused by pancreatitis because in severe cases it can be related to possible infertility in the future.
Full article
(This article belongs to the Special Issue Gallbladder, Bile Duct and Pancreas Disorders: Current Challenges, New Perspectives and Innovative Techniques)
►▼
Show Figures
Figure 1
Open AccessReview
Contemporary Advances in Cardiac Remote Monitoring: A Comprehensive, Updated Mini-Review
by
Alberto Preda, Raffaele Falco, Chiara Tognola, Marco Carbonaro, Sara Vargiu, Michela Gallazzi, Matteo Baroni, Lorenzo Gigli, Marisa Varrenti, Giulia Colombo, Gabriele Zanotto, Cristina Giannattasio, Patrizio Mazzone and Fabrizio Guarracini
Medicina 2024, 60(5), 819; https://doi.org/10.3390/medicina60050819 - 16 May 2024
Abstract
Over the past decade, remote monitoring (RM) has become an increasingly popular way to improve healthcare and health outcomes. Modern cardiac implantable electronic devices (CIEDs) are capable of recording an increasing amount of data related to CIED function, arrhythmias, physiological status and hemodynamic
[...] Read more.
Over the past decade, remote monitoring (RM) has become an increasingly popular way to improve healthcare and health outcomes. Modern cardiac implantable electronic devices (CIEDs) are capable of recording an increasing amount of data related to CIED function, arrhythmias, physiological status and hemodynamic parameters, providing in-depth and updated information on patient cardiovascular function. The extensive use of RM for patients with CIED allows for early diagnosis and rapid assessment of relevant issues, both clinical and technical, as well as replacing outpatient follow-up improving overall management without compromise safety. This approach is recommended by current guidelines for all eligible patients affected by different chronic cardiac conditions including either brady- and tachy-arrhythmias and heart failure. Beyond to clinical advantages, RM has demonstrated cost-effectiveness and is associated with elevated levels of patient satisfaction. Future perspectives include improving security, interoperability and diagnostic power as well as to engage patients with digital health technology. This review aims to update existing data concerning clinical outcomes in patients managed with RM in the wide spectrum of cardiac arrhythmias and Hear Failure (HF), disclosing also about safety, effectiveness, patient satisfaction and cost-saving.
Full article
(This article belongs to the Special Issue Latest Advances in Catheter Ablation)
►▼
Show Figures
Figure 1
Open AccessArticle
Clinicopathologic Analysis and Prognostic Factors for Survival in Patients with Operable Ampullary Carcinoma: A Multi-Institutional Retrospective Experience
by
Nebi Serkan Demirci, Eyyup Cavdar, Nuriye Yildirim Ozdemir, Sinemis Yuksel, Yakup Iriagac, Gokmen Umut Erdem, Hatice Odabas, Ilhan Hacibekiroglu, Mustafa Karaagac, Mahmut Ucar, Banu Ozturk and Yakup Bozkaya
Medicina 2024, 60(5), 818; https://doi.org/10.3390/medicina60050818 - 16 May 2024
Abstract
Background and Objectives: In ampullary cancer, 5-year survival rates are 30–50%, even with optimal resection and perioperative systemic therapies. We sought to determine the important clinicopathological features and adjuvant treatments in terms of the prognosis of patients with operable-stage ampullary carcinomas. Materials and
[...] Read more.
Background and Objectives: In ampullary cancer, 5-year survival rates are 30–50%, even with optimal resection and perioperative systemic therapies. We sought to determine the important clinicopathological features and adjuvant treatments in terms of the prognosis of patients with operable-stage ampullary carcinomas. Materials and Methods: We included 197 patients who underwent pancreaticoduodenectomy to treat ampullary carcinomas between December 2003 and May 2019. Demographics, clinical features, treatments, and outcomes/survival were analyzed. Results: The median disease-free survival (mDFS) and median overall survival (mOS) were 40.9 vs. 63.4 months, respectively. The mDFS was significantly lower in patients with lymphovascular invasion (p < 0.001) and lymph node involvement (p = 0.027). Potential predictors of decreased OS on univariate analysis included age ≥ 50 years (p = 0.045), poor performance status (p = 0.048), weight loss (p = 0.045), T3–T4 tumors (p = 0.018), surgical margin positivity (p = 0.01), lymph node involvement (p = 0.001), lymphovascular invasion (p < 0.001), perineural invasion (p = 0.007), and poor histological grade (p = 0.042). For the multivariate analysis, only nodal status (hazard ratio [HR]1.98; 95% confidence interval [CI], 1.08–3.65; p = 0.027) and surgical margin status (HR 2.61; 95% CI, 1.09–6.24; p = 0.03) were associated with OS. Conclusions: Nodal status and a positive surgical margin were independent predictors of a poor mOS for patients with ampullary carcinomas. Additional studies are required to explore the role of adjuvant therapy in patients with ampullary carcinomas.
Full article
(This article belongs to the Special Issue Advances in Cancer Multimodal Approaches: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies, 2nd Edition)
►▼
Show Figures
Figure 1
Open AccessReview
Recurrences after Pulsed Field Ablation of Atrial Fibrillation: Incidence, Mechanisms, Predictors, and Comparison with Thermal Energy
by
Riccardo Vio, Enrico Forlin and Paolo China
Medicina 2024, 60(5), 817; https://doi.org/10.3390/medicina60050817 - 16 May 2024
Abstract
Pulsed Field Ablation (PFA) is the latest and most intriguing technology for catheter ablation of atrial fibrillation, due to its capability to generate irreversible and cardiomyocytes-selective electroporation of cell membranes by delivering microsecond-lasting high-voltage electrical fields, leading to high expectations. The first trials
[...] Read more.
Pulsed Field Ablation (PFA) is the latest and most intriguing technology for catheter ablation of atrial fibrillation, due to its capability to generate irreversible and cardiomyocytes-selective electroporation of cell membranes by delivering microsecond-lasting high-voltage electrical fields, leading to high expectations. The first trials to assess the clinical success of PFA, reported an arrhythmia-free survival at 1-year of 78.5%, while other trials showed less enthusiastic results: 66.2% in paroxysmal and 55.1% in persistent AF. Nevertheless, real world data are encouraging. The isolation of pulmonary veins with PFA is easily achieved with 100% acute success. Systematic invasive remapping showed a high prevalence of durable pulmonary vein isolation at 75 and 90 days (range 84–96%), which were significatively lower in redo procedures (64.3%). The advent of PFA is prompting a reconsideration of the role of the autonomic nervous system in AF ablation, as PFA-related sparing of the ganglionated plexi could lead to the still undetermined effect on late arrhythmias’ recurrences. Moreover, a new concept of a blanking period could be formulated with PFA, according to its different mechanism of myocardial injury, with less inflammation and less chronic fibrosis. Finally, in this review, we also compare PFA with thermal energy.
Full article
(This article belongs to the Section Cardiology)
►▼
Show Figures
Figure 1
Open AccessArticle
Evaluation of Neuromuscular Morphometry of the Vaginal Wall Using Protein Gene Product 9.5 (Pgp 9.5) and Smooth Muscle α-Actin (Sma) in Patients with Posterior Vaginal Wall Prolapse
by
Mustafa Çetin, Güven Güney, Özer Birge, Emine Arslan, Burcu Timur and Hakan Timur
Medicina 2024, 60(5), 816; https://doi.org/10.3390/medicina60050816 - 16 May 2024
Abstract
Background and Objectives: This study aims to compare the neuromuscular structure of the vagina in women with posterior vaginal wall prolapse with the neuromuscular structure of the vagina in women without prolapse, to determine the difference, and to demonstrate the role of
[...] Read more.
Background and Objectives: This study aims to compare the neuromuscular structure of the vagina in women with posterior vaginal wall prolapse with the neuromuscular structure of the vagina in women without prolapse, to determine the difference, and to demonstrate the role of neuromuscular structure in the physiopathology of prolapse. Materials and Methods: In this prospective study, women aged between 40 and 75 years who had not undergone any vaginal surgery and had not undergone any abdominal prolapse surgery were included. Thirty-one women diagnosed with rectocele on examination were included in the study group. Thirty-one patients who underwent vaginal intervention and hysterectomy for reasons other than rectocele (colposcopy, conization, etc.) without anterior or posterior wall prolapse were included in the control group. Biopsy material was obtained from the epithelium of the posterior wall of the vagina, including the fascia that fits the Ap point. Immunohistochemical staining with Protein Gene Product 9.5 and smooth muscle α-actin was performed in the pathology laboratory. The epithelial thickness measurement and smooth muscle density parameters obtained with these immunohistochemical stainings were compared between the two groups. The collected data were analyzed using the SPSS 23 package program. p values less than 0.05 were considered statistically significant. Results: In the control group, muscle thickness and the number of nerves per mm2 of fascia were statistically significantly higher than in the study group (p < 0.05). Conclusions: We found that smooth muscle tissue and the number of nerves per mm2 of fascia were decreased in posterior vaginal wall prolapse compared to the general population. Based on the correlation coefficients, age was the parameter that most affected the degree of prolapse, followed by parity, number of live births, and number of vaginal deliveries.
Full article
(This article belongs to the Special Issue New Advances in Female Pelvic Floor Dysfunctions Management: 2nd Edition)
►▼
Show Figures
Figure 1
Open AccessReview
Psoriasis and Psoriatic Arthritis—Associated Genes, Cytokines, and Human Leukocyte Antigens
by
Marek Zalesak, Lubos Danisovic and Stefan Harsanyi
Medicina 2024, 60(5), 815; https://doi.org/10.3390/medicina60050815 - 16 May 2024
Abstract
In recent years, research has intensified in exploring the genetic basis of psoriasis (PsO) and psoriatic arthritis (PsA). Genome-wide association studies (GWASs), including tools like ImmunoChip, have significantly deepened our understanding of disease mechanisms by pinpointing risk-associated genetic loci. These efforts have elucidated
[...] Read more.
In recent years, research has intensified in exploring the genetic basis of psoriasis (PsO) and psoriatic arthritis (PsA). Genome-wide association studies (GWASs), including tools like ImmunoChip, have significantly deepened our understanding of disease mechanisms by pinpointing risk-associated genetic loci. These efforts have elucidated biological pathways involved in PsO pathogenesis, particularly those related to the innate immune system, antigen presentation, and adaptive immune responses. Specific genetic loci, such as TRAF3IP2, REL, and FBXL19, have been identified as having a significant impact on disease development. Interestingly, different genetic variants at the same locus can predispose individuals to either PsO or PsA (e.g., IL23R and deletion of LCE3B and LCE3C), with some variants being uniquely linked to PsA (like HLA B27 on chromosome 6). This article aims to summarize known and new data on the genetics of PsO and PsA, their associated genes, and the involvement of the HLA system and cytokines.
Full article
(This article belongs to the Special Issue Exploring Novel Biomarkers of Musculoskeletal Diseases)
Open AccessArticle
Major Bleeding Events in Hospitalized COVID-19 Patients: A Retrospective Observational Study
by
Andrea Poloni, Giacomo Casalini, Giacomo Pozza, Andrea Giacomelli, Marta Colaneri, Giorgia Carrozzo, Beatrice Caloni, Cosmin Lucian Ciubotariu, Martina Zacheo, Andrea Rabbione, Margherita Pieruzzi, Federico Barone, Matteo Passerini, Anna Lisa Ridolfo, Giuliano Rizzardini, Andrea Gori and Spinello Antinori
Medicina 2024, 60(5), 814; https://doi.org/10.3390/medicina60050814 - 15 May 2024
Abstract
Thromboprophylaxis/anticoagulation treatment is often required in hospitalized COVID-19 patients. We aimed to estimate the prevalence of major bleeding events in hospitalized COVID-19 patients. This was a retrospective observational study including all COVID-19 hospitalized patients ≥18 years of age at one reference center in
[...] Read more.
Thromboprophylaxis/anticoagulation treatment is often required in hospitalized COVID-19 patients. We aimed to estimate the prevalence of major bleeding events in hospitalized COVID-19 patients. This was a retrospective observational study including all COVID-19 hospitalized patients ≥18 years of age at one reference center in northern Italy. The crude prevalence (between February 2020–2022) of major bleeding events was estimated as the number of major bleeding episodes divided by patients at risk. Uni- and multivariable Cox models were built to assess factors potentially associated with major bleeding events. Twenty-nine (0.98%) out of 2,945 COVID-19 patients experienced a major bleeding event [prevalence of 0.55% (95%CI 0.37–0.79)], of which five were fatal. Patients who experienced a major bleeding event were older [78 years (72–84 IQR) vs. 67 years (55–78 IQR), p-value < 0.001] and more frequently exposed to anti-aggregating therapy (44.8% vs. 20.0%, p-value 0.002) when compared to those who did not. In the multivariable Cox model, age [per 1 year more AHR 1.05 (CI95% 1.02–1.09)] was independently associated with an increased risk of major bleeding events. A strict monitoring of older hospitalized COVID-19 patients is warranted due to the risk of major bleeding events.
Full article
(This article belongs to the Section Infectious Disease)
Open AccessArticle
High ADMA Is Associated with Worse Health Profile in Heart Failure Patients Hospitalized for Episodes of Acute Decompensation
by
Anamaria Vîlcea, Simona Maria Borta, Romana Olivia Popețiu, Rus Larisa Alexandra, Luminița Pilat, Dragoș Vasile Nica and Maria Pușchiță
Medicina 2024, 60(5), 813; https://doi.org/10.3390/medicina60050813 - 15 May 2024
Abstract
Background and Objectives: episodes of acute decompensation in chronic heart failure (ADHF), a common health problem for the growing elderly population, pose a significant socio-economic burden on the public health systems. Limited knowledge is available on both the endothelial function in and
[...] Read more.
Background and Objectives: episodes of acute decompensation in chronic heart failure (ADHF), a common health problem for the growing elderly population, pose a significant socio-economic burden on the public health systems. Limited knowledge is available on both the endothelial function in and the cardio-metabolic health profile of old adults hospitalized due to ADHF. This study aimed to investigate the connection between asymmetric dimethylarginine (ADMA)—a potent inhibitor of nitric oxide—and key health biomarkers in this category of high-risk patients. Materials and Methods: this pilot study included 83 individuals with a known ADHF history who were admitted to the ICU due to acute cardiac decompensation. Selected cardiovascular, metabolic, haemogram, renal, and liver parameters were measured at admission to the ICU. Key renal function indicators (serum creatinine, sodium, and potassium) were determined again at discharge. These parameters were compared between patients stratified by median ADMA (114 ng/mL). Results: high ADMA patients showed a significantly higher incidence of ischemic cardiomyopathy and longer length of hospital stay compared to those with low ADMA subjects. These individuals exhibited significantly higher urea at admission and creatinine at discharge, indicating poorer renal function. Moreover, their lipid profile was less favorable, with significantly elevated levels of total cholesterol and HDL. However, no significant inter-group differences were observed for the other parameters measured. Conclusions: the present findings disclose multidimensional, adverse ADMA-related changes in the health risk profile of patients with chronic heart failure hospitalized due to recurrent decompensation episodes.
Full article
(This article belongs to the Section Cardiology)
Open AccessArticle
Pharmaceutical Management of Secondary Hyperparathyroidism and the Role of Surgery: A 5-Year Retrospective Study
by
Christina Sevva, Dimitrios Divanis, Ariti Tsinari, Petros Grammenos, Styliani Laskou, Stylianos Mantalobas, Eleni Paschou, Vasiliki Magra, Periklis Kopsidas, Isaak Kesisoglou, Vassilios Liakopoulos and Konstantinos Sapalidis
Medicina 2024, 60(5), 812; https://doi.org/10.3390/medicina60050812 - 15 May 2024
Abstract
Background and Objectives: Secondary hyperparathyroidism (SHPT) poses a common condition among patients with chronic kidney disease (CKD) due to the chronic stimulation of the parathyroid glands as a result of persistently low calcium levels. As a first option for medical treatment, vitamin D
[...] Read more.
Background and Objectives: Secondary hyperparathyroidism (SHPT) poses a common condition among patients with chronic kidney disease (CKD) due to the chronic stimulation of the parathyroid glands as a result of persistently low calcium levels. As a first option for medical treatment, vitamin D receptor analogs (VDRAs) and calcimimetic agents are generally used. Apart from cinacalcet, which is orally taken, in recent years, another calcimimetic agent, etelcalcetide, is being administered intravenously during dialysis. Materials and Methods: In a 5-year retrospective study between 2018 and 2023, 52 patients undergoing dialysis were studied. The aim of this study is to highlight the possible effects and/or benefits that intravenously administered calcimimetic agents have on CKD patients. A total of 34 patients (65.4%) received cinacalcet and etelcalcetide while parathormone (PTH) and calcium serum levels were monitored on a monthly basis. Results: A total of 29 out of 33 patients (87.9%) that received treatment with etelcalcetide showed a significant decrease in PTH levels, which rose up to 57% compared to the initial values. None of the included patients needed to undergo parathyroidectomy (PTx) due to either extremely high and persistent PTH levels or severe side effects of the medications. It is generally strongly advised that parathyroidectomies should be performed by an expert surgical team. In recent years, a significant decrease in parathyroidectomies has been recorded globally, a fact that is mainly linked to the constantly wider use of new calcimimetic agents. This decrease in parathyroidectomies has resulted in an important decrease in complications occurring in cervical surgeries (e.g., perioperative hemorrhage and nerve damage). Conslusions: Despite the fact that these surgical complications cannot be easily compared to the pharmaceutical side effects, the recorded decrease in parathyroidectomies is considered to be notable, especially in cases of relapse where a difficult reoperation would be considered based on previously published guidelines.
Full article
(This article belongs to the Section Surgery)
►▼
Show Figures
Figure 1
Open AccessArticle
Effects of Rehabilitation Robot Training on Physical Function, Functional Recovery, and Daily Living Activities in Patients with Sub-Acute Stroke
by
Se-Young Kim, Mi-Young Lee and Byoung-Hee Lee
Medicina 2024, 60(5), 811; https://doi.org/10.3390/medicina60050811 - 15 May 2024
Abstract
Stroke often results in sensory deficits, muscular weakness, and diminished postural control, thereby restricting mobility and functional capabilities. It is important to promote neuroplasticity by implementing task-oriented exercises that induce changes in patients. Therefore, this study aimed to investigate the effects of rehabilitation
[...] Read more.
Stroke often results in sensory deficits, muscular weakness, and diminished postural control, thereby restricting mobility and functional capabilities. It is important to promote neuroplasticity by implementing task-oriented exercises that induce changes in patients. Therefore, this study aimed to investigate the effects of rehabilitation robot training on physical function, functional recovery, and activities of daily living (ADLs) in patients with subacute stroke. The study participants were patients with subacute stroke receiving treatment at Hospitals A and B. They were selected as research subjects based on selection and exclusion criteria. The experimental group received rehabilitation robot training in sessions of 30 min, five times weekly, for a total of 20 sessions over four weeks. Conversely, the control group underwent standard rehabilitation equipment training with an identical frequency, duration, and number of sessions. Measurements were taken before and after the training period to assess changes in physical function, functional recovery, and activities of daily living using tools such as the MMT, BBS, FBG, FAC, FIM, and MBI. The results were as follows: in the within-group comparison, the rehabilitation robot training group showed significant differences in MMT, BBS, FBG, FAC, FIM, and MBI (p < 0.05), while the control group showed significant differences in FIM (p < 0.05). Statistically significant differences were observed in the time, group, and time × group interaction effects among the MMT, static seated FBG, dynamic seated FBG, FIM, and MBI (p < 0.05). Based on these results, rehabilitation robotic training resulted in significant improvements in physical function, functional recovery, and activities of daily living in patients with subacute stroke. Based on these findings, providing a basic protocol for a rehabilitation program that applies rehabilitation robot training to patients with subacute stroke may offer more effective treatment and outcomes in the future.
Full article
(This article belongs to the Topic New Advances in Physical Therapy and Occupational Therapy)
Journal Menu
► ▼ Journal Menu-
- Medicina Home
- Aims & Scope
- Editorial Board
- Reviewer Board
- Topical Advisory Panel
- Instructions for Authors
- Special Issues
- Topics
- Sections & Collections
- Article Processing Charge
- Indexing & Archiving
- Editor’s Choice Articles
- Most Cited & Viewed
- Journal Statistics
- Journal History
- Journal Awards
- Society Collaborations
- Conferences
- Editorial Office
Journal Browser
► ▼ Journal BrowserHighly Accessed Articles
Latest Books
E-Mail Alert
News
Topics
Topic in
Anatomia, Biology, Medicina, Pathophysiology, Tomography
Human Anatomy and Pathophysiology, 2nd Volume
Topic Editors: Francesco Cappello, Mugurel Constantin RusuDeadline: 31 May 2024
Topic in
Applied Sciences, Dentistry Journal, JCM, JFB, Medicina
Diagnosis and Treatment of Dental Diseases and Tempromandibular Joints
Topic Editors: Rafał Obuchowicz, Małgorzata Pihut, Karolina Nurzynska, Andrzej UrbanikDeadline: 31 August 2024
Topic in
JCDD, JCM, Medicina, Membranes, ARM
Extracorporeal Membrane Oxygenation (ECMO)
Topic Editors: Patrick Honore, Isabelle MichauxDeadline: 30 November 2024
Topic in
Biomedicines, IJMS, JCM, Medicina, Neurology International
Advances in Exercise-Induced Neurogenesis, Neuronal and Functional Adaptations in Neurorehabilitation
Topic Editors: Carlos Bernal-Utrera, Cleofas Rodriguez-Blanco, Maria Livia Carrascal MorenoDeadline: 22 December 2024
Conferences
Special Issues
Special Issue in
Medicina
Development of Gastrointestinal Cancer Surgery
Guest Editors: Justas Žilinskas, Tadas Latkauskas, Saulius ŠvagždysDeadline: 20 May 2024
Special Issue in
Medicina
Updates on Post-mastectomy Breast Reconstruction
Guest Editors: Glenda Giorgia Caputo, Rossella Sgarzani, Pier Camillo ParodiDeadline: 30 May 2024
Special Issue in
Medicina
Current Status and Future Directions of Bone Trauma Surgery
Guest Editors: Ivo Dumić-Čule, Tomislav ČengićDeadline: 15 June 2024
Special Issue in
Medicina
Transcendental Meditation and Treatment for Stress
Guest Editor: Kenneth G. WaltonDeadline: 30 June 2024
Topical Collections
Topical Collection in
Medicina
Interventional Oncology
Collection Editors: François Cornelis, Matthias Barral, Adrian Kastler, Dimitrios Filippiadis
Topical Collection in
Medicina
Frontiers in Breast Cancer Diagnosis and Treatment
Collection Editors: Jimmy T. Efird, Tithi Biswas
Topical Collection in
Medicina
Interdisciplinary Medicine – The Key For Personalized Medicine
Collection Editor: Camelia Diaconu
Topical Collection in
Medicina
Advances in Cornea, Cataract, and Refractive Surgery
Collection Editor: Ivo Guber