rss_2.0Sciendo RSS Feed for Romanian Journal of Internal Medicinehttps://sciendo.com/journal/RJIMhttps://www.sciendo.comhttps://sciendo-parsed.s3.eu-central-1.amazonaws.com/647365c84e662f30ba53c97b/cover-image.jpghttps://sciendo.com/journal/RJIM140216https://sciendo.com/article/10.2478/rjim-2024-0028<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Hepatocellular carcinoma (HCC) patients undergoing transarterial chemoembolization (TACE) have a diverse range of outcomes due to their high degree of heterogeneity. Therefore, different predictive scoring systems have been created to assist in decision-making regarding retreatment with TACE. We compared the predictive capabilities of different scoring systems, such as ART, ABCR, and SNACOR, for prediction of the outcome of subsequent TACE in HCC patients.</p> </sec> <sec><title style='display:none'>Method</title> <p>In this retrospective study, the three scoring systems were compared for their capability of predicting the outcome of repeating TACE in 149 HCC patients treated at the National Liver Institute, Egypt, between January 2017 and December 2019. We used the likelihood ratio to select the model with the highest predictive capability for overall survival (OS).</p> </sec> <sec><title style='display:none'>Results</title> <p>According to our data, the amount of tumor, the change in Barcelona Clinic Liver Cancer (BCLC) stage following TACE, and the SNACOR score (with a 95% confidence range for HR 1.0305-1.256 and p-value = 0.0106) were the most predictive variables. It was also shown that the ABCR score was a good predictor of survival (90 patients had an ABCR score ≤ 0 with a P- value &lt;0.0001, 56 patients had 0 &lt; ABCR &lt; 4 with a P-value &lt;0.0001, and the ART score was not useful in predicting OS (P-value = 0.18).</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>The SNACOR score is the most predictive score for OS and would be the most helpful scoring system in decision-making regarding retreatment with TACE.</p> </sec> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00282024-08-29T00:00:00.000+00:00https://sciendo.com/article/10.2478/rjim-2024-0026<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p> Solitary extramedullary plasmacytomas (SEPs) are disease entities characterized by the local proliferation of neoplastic plasma cells, representing less than 6% of plasma cell tumors. They typically produce monoclonal immunoglobulin and are usually found in the head, neck, and, less commonly, in the lungs. SEP, in rare instances, can transition to multiple myeloma (MM) with an estimated risk between 8 and 31%.</p> </sec> <sec><title style='display:none'>Case Presentation</title> <p> We report the case of a 72-year-old woman who sought medical attention at the emergency department due to acute onset dyspnea and syncope. Laboratory results revealed elevated creatinine, hypercalcemia, and anemia, all of which were absent at a hospitalization three months prior for tuberculosis. A chest x-ray showed a right upper lobe opacity, and a computed tomography (CT) scan demonstrated an apical lung mass with calcifications. A CT-guided needle aspiration of the mass indicated SEP. Bone marrow biopsy subsequently confirmed MM. The patient was admitted to the intensive care unit and treated with chemotherapy; however, following a complicated hospital course, she died.</p> </sec> <sec><title style='display:none'>Discussion</title> <p>SEPs are an exceedingly rare form of malignancy with the potential for conversion to MM. Although the likelihood of transformation to MM in months is rare, we call for attention to the possibility of such transition and the clinical prognosis of patients with SEP. Prompt and aggressive treatment is essential, and this, to our knowledge, is the first case of conversion to MM in less than four months following the initial diagnosis of SEP of the lung.</p> </sec> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00262024-08-21T00:00:00.000+00:00https://sciendo.com/article/10.2478/rjim-2024-0027<abstract> <title style='display:none'>Abstract</title> <p>Fabry disease (FD) is an X-linked rare disorder caused by mutations in the GLA gene. Women with FD have been less enrolled in studies and less treated compared with men. The aim of the present study is to describe the complete phenotype of the women cohort with FD diagnosed and evaluated in Romania and compare it to the male population.</p> <p>This study included all consecutive patients diagnosed with FD referred to the Expert Center for Rare Genetic Cardiovascular Diseases between 2014-2023 which included 73 consecutive Romanian FD patients: 41 women (56.2%) and 32 men (43.8%) from 33 unrelated families.</p> <p>Women with FD were diagnosed later and had a later symptom onset. Comparing with men, women were less often symptomatic, but with similar symptom severity. They had similar ophthalmologic and ENT involvement, but less angiokeratomas. Both women and men had similar heart failure symptoms, which were usually mild to moderate, with no difference between the age of developing of the heart failure symptoms. There were also similar rates of acroparesthesia and stroke between sexes, but women presented less renal involvement, with less requirement for renal transplant.</p> <p>This study demonstrates that women with Fabry disease are not just carriers of the disease, they can present symptoms as severe as men, and they have less or later access to pathogenic therapy. Further studies with more female participations are needed to better understand the burden of Fabry disease in women.</p> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00272024-08-21T00:00:00.000+00:00https://sciendo.com/article/10.2478/rjim-2024-0025ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00252024-07-24T00:00:00.000+00:00https://sciendo.com/article/10.2478/rjim-2024-0024<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title><p>On the cardiovascular system, obesity accelerates atherosclerosis progression, inducing pathophysiological changes that are detectable already from young adults. Endothelial dysfunction is one of the earliest vascular alterations observed in obesity. In this study, we aimed to determine endothelial functions and carotid intima-media thickness in patients with obesity without overt cardiovascular disease.</p> </sec> <sec><title style='display:none'>Methods</title> <p>The study was conducted with 112 individuals with obesity without overt cardiovascular disease and any chronical diseases (BMI&gt;30 kg/m²) (84 female, 28 male, mean age: 46.3±11.2 years) and 49 healthy individuals with no diseases (33 female, 16 male, mean age: 44.6±10.2 years). All patients were examined for endothelial functions by the flow-mediated dilatation (FMD) method and carotid intima-media thicknesses (CIMT). All measurements were performed by the same imaging specialist, averaging 3 different measurements. In addition to the body mass index and waist circumference visceral adiposity index (VAI) and triponderal mass index (TPI) also calculated.</p> </sec> <sec><title style='display:none'>Results</title> <p>The percentage of FMD obtained by brachial artery ultrasound was significantly lower, visceral adipose tissue, perirenal adipose tissue thicknesses measured by abdominal ultrasound and CIMT were significantly thicker in Group 1 compared to Group 2. FMD had a negative significant correlation with body mass index, visceral adipose tissue thickness, perirenal adipose tissue thickness, and waist and hip circumferences, and carotid intima-media thickness and CIMT had a significant correlation with visceral adipose tissue thickness, perirenal adipose tissue thickness, VAI, TPI and waist, hip circumferences.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>Individuals with obesity have impaired endothelial functions and greater carotid intima-media thicknesses compared to healthy individuals. This impairment in endothelial functions is proportional to the amount of visceral and perirenal fat accumulation. Parameterss reflecting visceral fat distribution such as VAI and TPI are also related with these impairment.</p> </sec> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00242024-07-09T00:00:00.000+00:00https://sciendo.com/article/10.2478/rjim-2024-0022<abstract> <title style='display:none'>Abstract</title> <p><bold>Introduction</bold>: Hepatocellular carcinoma (HCC) is a leading global cause of cancer-related deaths. Thermal ablation techniques, especially radiofrequency ablation (RFA) and microwave ablation (MWA), have become pivotal treatments for HCC. This systematic review and meta-analysis aim to compare these modalities, highlighting their efficacy, strengths, and limitations in treating HCC.</p> <p><bold>Methods</bold>: A comprehensive literature search was conducted across major databases (PubMed, MEDLINE, Springer, ProQuest, EBSCOhost, Cochrane, and EMBASE) targeting studies on hepatocellular carcinoma with RFA and MWA. Heterogeneity analyses and pooled outcomes using random-effect models with were evaluated to compare both thermal ablation methods.</p> <p><bold>Results</bold>: Nine studies, which consists of 368 patients underwent RFA and 387 patients underwent MWA, were included in review. The findings showed no significant differences in pooled analysis of volume of ablation, complete ablation rate, local tumor progression, survival rates, major complications, and adverse events. Subgroup analysis showed significantly higher risk of local tumor progression in RFA in African populations.</p> <p><bold>Conclusion</bold>: No statistically significant difference was seen between outcomes across studies. MWA may offer a potential for longer therapeutic response with comparable risk of complications and adverse outcomes.</p> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00222024-06-21T00:00:00.000+00:00https://sciendo.com/article/10.2478/rjim-2024-0023<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p>Colonoscopy is regarded as a safe diagnostic and therapeutic procedure, nevertheless, some patients may still encounter post-colonoscopy gastrointestinal symptoms. This study aimed to evaluate the utilization of probiotics before and after colonoscopy to relieve those symptoms.</p> </sec> <sec><title style='display:none'>Methodology</title> <p>This study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines. Included studies were all interventional studies examining the effects of probiotics use before and after colonoscopy. Articles were retrieved from MEDLINE, EBSCO-Host, Cochrane, ProQuest, and Google Scholar electronic databases, utilized specific keywords <italic>(</italic><italic>“</italic><italic>Probiotic</italic><italic>” OR “</italic><italic>Probiotics</italic><italic>”</italic>) <italic>AND</italic> (<italic>“</italic><italic>Colonoscopy</italic><italic>” OR “</italic><italic>Colonoscopies</italic><italic>”</italic>). The Cochrane Risk of Bias (RoB) 2 and Joanna Briggs Institute (JBI) Critical Appraisal tools were used for study quality assessment, as well as Review Manager (RevMan) 5.4 to perform the meta-analysis.</p> </sec> <sec><title style='display:none'>Results</title> <p>A total of ten studies were included in this systematic review. Six studies assessed the effect of probiotics consumption after colonoscopy, three examined the impact before colonoscopy, and one study assessed both. The most common type of probiotics used were <italic>Lactobacillus</italic> and <italic>Bifidobacterium</italic>. Quantitative synthesis of probiotics before colonoscopy showed no significant differences among bloating, abdominal pain, nausea, and vomiting symptoms (p=0.49, p=0.14, p=0.30, and p=0.42, respectively). Similarly, quantitative synthesis of probiotics after colonoscopy showed no significant differences in bloating and abdominal pain (p=0.16 and p=0.63, respectively).</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>Probiotic administration pre- and post-colonoscopy exhibited preliminary evidence for reducing gastrointestinal symptoms, but a quantitative synthesis revealed non-significant findings, necessitating further investigations.</p> </sec> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00232024-06-18T00:00:00.000+00:00https://sciendo.com/article/10.2478/rjim-2024-0021<abstract> <title style='display:none'>Abstract</title> <p>Eosinophilic Esophagitis is a widely-recognized immune-mediated esophagus disease with distinct clinical and histopathological features, exhibiting an increased global incidence. Therapeutic options encompass either dietary measures or pharmacological approaches, including proton pump inhibitors and topical corticosteroids. The use of monoclonal antibodies is currently under comprehensive evaluation, with a plethora of ongoing clinical trials designed to determine their clinical efficacy. The present case report demonstrates an exceptional case of refractory Eosinophilic Esophagitis, unresponsive to conventional treatment, achieving both clinical and histopathological remission subsequent to initiation of benralizumab treatment. Concurrently, our case underscores the necessity for continued research in the field of monoclonal antibodies for their use as a future treatment approach against Eosinophilic Esophagitis.</p> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00212024-06-07T00:00:00.000+00:00https://sciendo.com/article/10.2478/rjim-2024-0020<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p>Human immunodeficiency virus (HIV) is no longer considered a contraindication for kidney transplantation (KT). KT management in HIV patients is a complex process with challenges, such as drug interactions between immunosuppression and antiretroviral (ARV) therapy. In our country, no KT has been performed thus far in this category of patients.</p> </sec> <sec><title style='display:none'>Case presentation</title> <p>We present the case of a 29-year-old female patient with HIV and end-stage renal disease (ESRD) who performed a KT from a related living donor in March 2022. KT immediate evolution was favorable. No transplant-related complications were reported. HIV viral load remained undetectable and CD4+ T cells were constantly &gt; 500 cell/ μL, during the 18 months of follow-up. The main challenge in our case was the drug interaction between the protease inhibitor-based regimen and tacrolimus. This led to tacrolimus overdose, and, subsequently, change in ARV therapy. ARV switching was performed on a regimen based on integrase inhibitor and nucleoside reverse transcriptase inhibitors. After the ARV change, the therapeutic level of tacrolimus was easily reached and maintained. Kidney graft function remained normal during follow-up, despite tacrolimus overexposure, and no rejection or anti-HLA antibodies were observed. Another challenge was related to the donor's hepatitis C virus status (positive antibodies, negative nucleic acid test). The recipient did not develop seroconversion or detectable viremia at 3-, 6-, 12- and 18-months post-KT.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>We reported the first case of a successful KT in an ESRD patient with HIV in Romania, in whom the post-transplant evolution was favorable.</p> </sec> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00202024-06-07T00:00:00.000+00:00https://sciendo.com/article/10.2478/rjim-2024-0018<abstract> <title style='display:none'>Abstract</title> <p>Background: Respiratory allergies mostly allergic rhinitis and asthma represent an important and increasing public health problem and one of the priorities for the European health systems. There is an increasing public concern regarding the persistence and severity of allergic diseases and many difficulties of health systems in providing prompt specialized medical assistance. Our study aims to highlight the main results of the Alliance 4Life project focused on the evaluation of the burden and management of respiratory allergies in primary care from Romania and comparative health-related data from four Central and Eastern European countries.</p> <p>Method: We developed a questionnaire focused on patients with allergic rhinitis and asthma directly addressed to general practitioner (GP) specialists from Romania who attended the annual national conference in Bucharest.</p> <p>Results: The main results showed that patients with respiratory allergies are frequently encountered in primary care practice, only a few patients are evaluated by allergists and there is a clear need for education in this field.</p> <p>Conclusions: This preliminary study confirms that respiratory allergies represent a considerable burden in primary care and the questionnaire may be a useful tool in further studies considering the experience of other healthcare systems. More advanced studies integrating epidemiology with data on air pollution and environmental conditions should be envisaged.</p> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00182024-04-24T00:00:00.000+00:00https://sciendo.com/article/10.2478/rjim-2024-0019<abstract> <title style='display:none'>Abstract</title> <p>Background: Metabolic-associated fatty liver disease and liver fibrosis are intimately linked to insulin resistance, type 2 diabetes, obesity, and metabolic syndrome. Transient elastography (TE) and point shear wave elastography (pSWE) were used to measure liver stiffness in patients who met the ultrasound criteria for steatotic liver diseases (SLD). This study compared two methods for estimating liver stiffness in patients with SLD, which in turn correlated with liver fibrosis. Method: Ultrasound B-mode imaging was used to identify SLD. In total, 250 MAFLD patients were recruited. Patient characteristics, laboratory investigations, and liver stiffness measurements using TE and pSWE were assessed on the same day.</p> <p>Results: In the study, 56.0% of the patients were male, with a mean age of 41.5 ± 10.7 years. The correlation between TE and pSWE was significant (Spearman’s r = 0.867*, p &lt; 0.001). The Bland-Altman Plot analysis confirmed this, with 97.5% of variations in LSM falling within 95% agreement ranges. Cohen’s κ was used to assess the agreement between TE and pSWE fibrosis stages, showing almost perfect agreement (83.5% kappa agreement) and a strong association between pSWE and TE in the assessment fibrosis stages.</p> <p>Conclusion: In patients with MAFLD, TE, and SWE are reliable methods for measuring liver stiffness and can be used as non-invasive screening tools for the assessment of fibrosis in SLD.</p> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00192024-04-24T00:00:00.000+00:00https://sciendo.com/article/10.2478/rjim-2024-0017<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Introduction:</title> <p>The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection represented a disruptive pathology that emerged in late 2019 with profound implications ranging from individual health to health systems and world economy. Our study aimed to evaluate clinical, biochemical and computerized tomography (CT) parameters values in determining the severity of pulmonary embolism (PE) associated with COVID-19.</p> </sec> <sec> <title style='display:none'>Methods</title><p>We performed an observational cohort study evaluating demographic, clinical, biochemical, coagulation markers, as well as CT imaging parameters.</p> </sec> <sec><title style='display:none'>Results</title> <p>In our study on 186 patients with COVID-19, we found that 31 patients (16,66%) had pulmonary embolism. Significant correlations for the patients with PE were detected in C-reactive protein, lactate dehydrogenase, serum ferritin, IL-6, serum myoglobin, NT-proBNP, D-dimers, serum proteins, transaminases as well as white cell blood counts. Patients with pulmonary embolism had a more severe lung involvement, with thrombi distribution mainly involving the lower lobes.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>Early identification of PE is an important step for timely and efficient treatment in the intensive care management of COVID-19 patients. Our study showed that high plasmatic values of lactate dehydrogenase, ferritin, IL-6, white blood cells and D-dimers and low proteins serum levels are strongly linked with COVID-19-associated pulmonary embolism.</p> </sec> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00172024-04-19T00:00:00.000+00:00https://sciendo.com/article/10.2478/rjim-2024-0015<abstract> <title style='display:none'>Abstract</title> <p>Research advances in the oncology treatment field have led to the widespread use of immunotherapy. The usage of immune checkpoint inhibitor (ICI) has improved the survival of cancer patients with metastases. This has also led to the rapidly expanding indications for ICI use. However, ICI usage may lead to toxicity, which may be immune-related, in different organ-specific targets. The immune-related adverse events (irAEs) of ICI may lead to increased morbidity, decreased quality of life, and early termination of ICI. The clinical manifestations of irAEs in the gastrointestinal system are variable, ranging from self-limited to life-threatening or fatal events. In this review article, we would like to focus on discussing ICI-induced colitis, which is one of the most common ICI irAEs in the gastrointestinal tract.</p> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00152024-04-09T00:00:00.000+00:00https://sciendo.com/article/10.2478/rjim-2024-0016<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Background</title> <p>Acute pulmonary embolism (APE) is a life-threatening condition with a high mortality rate. The pathophysiology involves various complex processes. The systemic immune-inflammatory index (SII) is a well-known biomarker that reflects the intricate balance between pro-inflammatory and anti-inflammatory immune components. In this systematic review, we aim to determine the significance of SII as a potential biomarker for APE.</p> </sec> <sec><title style='display:none'>Method</title> <p>We utilized PubMed, ProQuest, EBSCOHost, and Google Scholar to search for articles. We assessed bias risk using the Newcastle Ottawa Scale (NOS). The outcomes we examined included in-hospital and long-term mortality, the severity of APE, and the sensitivity and specificity of the SII in predicting APE.</p> </sec> <sec> <title style='display:none'>Results:</title> <p>Four studies, involving 2,038 patients, were included for analysis. These studies discuss the use of SII in predicting APE severity, APE mortality, high-risk APE, and the occurrence of APE. SII demonstrates significant results in predicting each of these variables. Furthermore, each study establishes different SII cut-off values. Specifically, a cut-off of 1161 predicts massive APE events with a sensitivity of 91% and a specificity of 90%. A cut-off of &gt;1235.35 differentiates high-risk APE with a sensitivity of 87.32% and a specificity of 68.85%. A cut-off of &gt;1111x10⁹ predicts overall mortality with a sensitivity of 72% and a specificity of 51%. Finally, a cut-off at 1839.91 predicts APE events with a sensitivity of 75.8% and a specificity of 61.9%.</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>The SII can be employed as a potential new biomarker to predict outcomes in APE patients, particularly the occurrence, severity, and mortality of APE.</p> </sec> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00162024-04-09T00:00:00.000+00:00https://sciendo.com/article/10.2478/rjim-2024-0014ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00142024-04-03T00:00:00.000+00:00https://sciendo.com/article/10.2478/rjim-2024-0013<abstract> <title style='display:none'>Abstract</title> <p><italic>Objectives:</italic> Biomarker-based clinical practice is currently gaining ground and increasingly affects decision making. A variety of biomarkers have been studied through the years and some of them have already an established role in modern medicine, such as procalcitonin (PCT) which has been proposed to reduce antibiotic exposure. We purposed to systematically review all biomarkers examined for guiding the clinical practice in patients with pneumonia.</p> <p>Methods: A systematic review on PubMed was performed on April 2023 by two independent researchers using the PRISMA guidelines. Randomized trials which enrolled patients with pneumonia and compared biomarker-guided strategies to standard of care were included.</p> <p>Results: 1242 studies were recorded, from whom 16 were eligible for this study. 14 studies investigated PCT as a biomarker. From these, 8 studies reported on community acquired pneumonia (CAP), 2 on ventilator associated pneumonia (VAP), 1 on aspiration pneumonia, 1 on hospital acquired pneumonia (HAP) and 2 on exacerbation of chronic obstructive pulmonary disease (ECOPD). There was 1 study, referred to VAP, that investigated interleukin-1β (IL-1β) and interleukin-8 (IL-8) and 1 study that reported the role of C-reactive protein (CRP) in ECOPD. In a total of 4751 patients in 15 studies, the biomarker-based approach did not lead to increased mortality [OR: 0.998 (95%CI: 0.74-1.34, p value: 0.991). I2:19%]. Among different types of pneumonia and time-points of assessment, biomarker-guided practice appeared to improve antibiotic-related outcomes, such as rate of antibiotic prescription, duration of antibiotic therapy and rate of antibiotic exposure, while 5 studies reported a possible decrease in antibiotic-related adverse effects. Biomarker-guided practice did not seem to lead in an increase in other adverse outcomes such as need for hospitalization and duration of hospitalization. However, the included studies have high risk of bias mainly due to improper blinding of participants/personnel and outcome assessors.</p> <p>Conclusion: Biomarker-guided clinical practice improves provided healthcare, in terms of reduced antibiotic consumption with no inferiority to mortality, relapses and exacerbations in patients with different types of pneumonia. Thus, such approaches should be further evaluated to achieve personalized medicine.</p> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00132024-03-27T00:00:00.000+00:00https://sciendo.com/article/10.2478/rjim-2024-0012<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p> In this study, we aimed to compare metabolic risk factors, lipid indices, healthy eating index, and physical activity among premenopausal, menopausal, and postmenopausal women.</p> </sec> <sec><title style='display:none'>Methods</title> <p> In this cross-sectional study, a total of 4,732 women participating in the Hoveyzeh Cohort Study were placed into three groups of premenopausal (n=736), menopausal (n=396), and postmenopausal (n=917) women, according to the inclusion and exclusion criteria .</p> </sec> <sec><title style='display:none'>Results</title> <p> The prevalence of metabolic syndrome was 43.3%, 55.6%, and 62.8% in premenopausal, menopausal, and postmenopausal women, respectively. After menopause, the prevalence of hypertension (50.2%), dyslipidemia (61.2%), diabetes (37.7%), and abdominal obesity according to the Iranian guidelines (75.9%) was higher than before menopause. Based on the results, cardiovascular disease had the highest prevalence after menopause (23%). The weight-adjusted waist index (WWI) had the highest odds ratio (OR) among indices, with values of 2.94 and 1.93 in menopausal and postmenopausal women, respectively (P&lt;0.001). According to the Healthy Eating Index-2015 (HEI-2015), the total consumption of fruits, vegetables, seafood, and protein was higher in premenopausal women than in postmenopausal women, and the consumption of foods containing sugar was higher in menopausal women than in premenopausal women. The results showed that the level of physical activity was the highest and the lowest in premenopausal and postmenopausal women, respectively (P&lt;0.001).</p> </sec> <sec><title style='display:none'>Conclusion</title> <p> Menopause leads to an increase in the prevalence of metabolic syndrome. The Atherogenic Index of Plasma (AIP), Triglyceride Glucose (TyG) index, WWI, and physical activity index increased in postmenopausal women compared to premenopausal women. The TyG index, WWI, and HEI-2015 did not show significant differences between the groups, based on the multiple regression analysis.</p> </sec> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00122024-03-27T00:00:00.000+00:00https://sciendo.com/article/10.2478/rjim-2024-0011<abstract> <title style='display:none'>Abstract</title> <p><bold>Background</bold>: Aldosterone synthase (CYP11B2) is crucial for aldosterone production, and variations in its gene may influence type 2 diabetes mellitus (T2DM) development. This study explores the link between two single nucleotide polymorphisms (SNPs) in the CYP11B2 gene - −344T/C and K173R and T2DM in the Moroccan population .</p> <p><bold>Methods</bold>: The research involved 86 individuals with T2DM and 75 control subjects. Genotyping for the −344T/C and K173R SNPs was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis .</p> <p><bold>Result</bold>: Results indicated significant differences in the genotype and allelic distribution of the CYP11B2 K173R polymorphism between T2DM patients and control subjects, with P-values of 0.02 and 0.04, respectively. The −344T/C polymorphism showed no significant genomic level differences, but its allelic variations were statistically significant (P=0.01), indicating a notable association between the C allele and T2DM. Furthermore, the K173R polymorphism was found to significantly increase T2DM risk, with a 2.34-fold higher risk in individuals carrying the KR genotype. The study also examined the combined effect of these SNPs. The dominant model analysis (TT vs. TC+CC and KK vs. KR+RR) showed significant differences between T2DM patients and controls for both SNPs. Additionally, a haplotype-based analysis revealed that the C-R haplotype was associated with an increased risk of T2DM.</p> <p><bold>Conclusion</bold>: Our study suggests a significant association between the CYP11B2-K173R polymorphism and T2DM in the Moroccan population. Conversely, while the CYP11B2 -344T/C polymorphism exhibits a significant difference in allelic distribution, no significant difference is observed at the genomic level.</p> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00112024-03-13T00:00:00.000+00:00https://sciendo.com/article/10.2478/rjim-2024-0008<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p>Sepsis is one of the most common causes of death in patients admitted to intensive care units (ICUs). The development of sepsis is significantly influenced by genetic predisposition. In this study, we highlight a potential association between a variant of the fat mass and obesity-associated (<italic>FTO</italic>) gene and risk of sepsis in children and adolescents.</p> </sec> <sec><title style='display:none'>Methods</title> <p>We investigated a first-intron tagging <italic>FTO</italic> polymorphism (rs17817449) by comparing a severe condition (SC) group, comprising 598 paediatric patients (ages 0–19 years) admitted to an ICU with fever, systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, septic shock, or multiple organ dysfunction syndrome (MODS), with a control group consisting of 616 healthy young adults.</p> </sec> <sec><title style='display:none'>Results</title> <p>We observed a lower prevalence (<italic>p</italic> &lt; 0.01; OR = 0.59, 95% CI = 0.39–0.87) of the <italic>FTO</italic> TT genotype in febrile and SIRS patients compared to patients with severe illness. There was a borderline trend towards a lower prevalence of the <italic>FTO</italic> TT genotype in the control group compared to the SC group (<italic>p</italic> &lt; 0.09, OR = 0.81, 95% CI = 0.62–1.06).</p> </sec> <sec><title style='display:none'>Conclusions</title> <p>Our findings suggest that rs17817449, a common <italic>FTO</italic> polymorphism, may be a predictor of sepsis in paediatric patients, and that higher body weight is protective against this clinical complication.</p> </sec> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00082024-03-12T00:00:00.000+00:00https://sciendo.com/article/10.2478/rjim-2024-0010<abstract> <title style='display:none'>Abstract</title> <sec><title style='display:none'>Introduction</title> <p>Accidental hypothermia (AH) presents a significant mortality risk, even in individuals with good health. Early recognition of the parameters associated with negative prognosis could save more lives.</p> </sec> <sec><title style='display:none'>Methods</title> <p>This was a pilot, retrospective observational study, conducted in the largest Emergency Hospital in North Eastern Romania, which included all patients with AH (defined as body temperature below 35°C), hospitalized and treated in our hospital between 2019 and 2022.</p> </sec> <sec><title style='display:none'>Results</title> <p>A total of 104 patients with AH were included in our study, 90 of whom had data collected and statistically analyzed. The clinical, biological, and therapeutic parameters associated with negative outcomes were represented by a reduced GCS score (p=0.024), diminished systolic and diastolic blood pressure (p=0.007 respectively, 0.013), decreased bicarbonate (p=0.043) and hemoglobin levels (p=0.002), the presence of coagulation disorders (p=0.007), as well as the need for administration of inotropic or vasopressor medications (p=0.04).</p> </sec> <sec><title style='display:none'>Conclusion</title> <p>In this pilot, retrospective, observational study, the negative outcomes observed in patients with AH hospitalized in the largest Emergency Hospital in North-Eastern Romania were associated with several clinical, biochemical, and therapeutic factors, which are easy to identify in clinical practice. Recognizing the significance of these associated factors empowers healthcare practitioners to intervene at an early stage to save more lives.</p> </sec> </abstract>ARTICLEtruehttps://sciendo.com/article/10.2478/rjim-2024-00102024-03-12T00:00:00.000+00:00en-us-1