5 articles
Inflammation is a state driven by pathogenic stimuli. Trauma is one of the causes of acute onset of the inflammatory pathway. Multiple proteases are capable of inducing distant multiple organ lesions (lungs, brain or spinal cord, heart, kidney, liver and systemic vessel endothelium). The onset of corresponding syndromes will complicate the clinical course of that particular patient. These molecules are potential biomarkers in trauma patients.
There were reviewed the PubMed, Elsevier, ResearchGate, Google Scholar, Cochrane Library, medRxiv databases using the keywords “proteases”, “antiproteases” and “trauma”. A total of 114 relevant sources were included. An additional74 papers were selected. Overall there 188 literature sources were reviewed.
There are six classes of proteases: aspartic, glutamic, metalloproteases, cysteine, serine, and threonine proteases of which the glutamic ones are not found in mammals. Multiple processes that involve protein degradation are the fundamental mechanisms through which they mediate tissue and organ destruction after trauma-mediated inflammation. Certain inhibitors of the aforementioned proteases are of importance in these processes – they are vital in the prevention of pathophysiological processes such as fibrosis, although in the case of trauma due to their depletion there is high activity of the proteases system. The release of the protease/antiprotease system is mediated through by leukocytes, thrombocytes, myocytes and endothelium.
In this literature review there was described a high variety of protease and antiproteases. There is an increased complexity for the potential treatment of the distant lesions, thus the necessity for symptomatic treatment is foremost in order to diminish the lesions of the acute phase.
Thrombosis is a frequently underdiagnosed condition associated with high mortality in neglected cases. Many factors, including geoheliophysical and biochemical ones, are responsible for thrombosis modulation. Routine investigations may sometimes be inconsistent and, thus, unreliable in a clinical setting.
Data were collected from patients treated in the Department of Vascular Surgery at the ‘Timofei Moșneaga’ Republican Clinical Hospital, Chișinău, Republic of Moldova. A total of 1,865 patients were initially included in the study. After applying rigorous inclusion and exclusion criteria, 263 eligible patients were identified, and their complete blood counts and biochemical reports were retrospectively analyzed.
The analysis revealed increased mean values for absolute polymorphonuclear neutrophils, absolute monocytes, erythrocyte sedimentation rate (ESR), and glucose. The median values of these indicators, except for absolute polymorphonuclear neutrophils and ESR in female patients, were also elevated above normal ranges. Significant Pearson and Spearman correlations were identified among the analyzed indicators, and a binary logistic regression model was constructed using the most statistically significant variables.
Usual mathematical models that outline thrombosis consider deep vein thrombosis without a sustainable arterial assessment. The sensitivity of our model is lower than that of the D-dimer, while the specificity is almost the same. Platelets and clotting tests are well-known, reliable indicators; however, novel contemporary augmentations to these may, in turn, increase the predictive capability of our model if applied. This study has its limitations due to the lack of variance in the variance inflation factors (VIF), preventing the evaluation of multicollinearity among the included biomarkers.
The mathematical model developed in this study shows potential for further clinical application; however, additional research, validation, and the incorporation of non-biochemical indicators may be necessary to enhance its predictive accuracy.
The superficial circumflex iliac artery (SCIA) is a branch that originates either from the external iliac artery (EIA), or common femoral artery (CFA). Its anatomic variability is particularly relevant in plastic surgery, general surgery, and traumatology/orthopedics.
We retrospectively reviewed 2158 ultrasonographic images of the anterior thigh region from the Republican Medical Diagnostic Center, Functional Diagnosis Department, Chisinau, Republic of Moldova. Rigorous inclusion and exclusion criteria were applied. Additionally, 29 bibliographic sources were reviewed and discussed.
The mean age of the patients was 63.4±10.68 years. In 387 cases (17.93%),SCIA originated from the CFA, while in 1771 cases (82.07%) it emerged from the EIA. SCIA originated from the CFA unilaterally in 194 cases (8.99%) on the left side and 142 cases (6.58%) on the right side, while bilateral origin from the CFA was observed in 51 cases (2.36%)
The results in literature were suggestive for a higher prevalence of SCIA origin from the CFA with only one author suggesting the origin of this branch from the EIA, which aligns with our findings. This information is valuable for clinical applications, including hernia repairs, vascular and endovascular surgical interventions, nerve blocks, and skin grafts transplantation.
The most common origin of the SCIA was from the EIA. No significant sex differences were observed, but laterality showed notable variations. Age was analyzed as a factor.
Pituitary neuroendocrine tumors account for 3.9-7.4/100,000 of central nervous system tumors in the Western world. They are particularly noteworthy, comprising 10-15% of all cases, with a higher prevalence in the 75-79 age group. In the Republic of Moldova, these tumors account for 34% of cases in postmortem examinations while remain an actual theme of discussion in the ENDO WHO congress and are regarded as a factor, which may influence the quality of life (QOL).
We have critically revised 66 literary sources, which were selected using the PubMed library after introducing the keywords “pituitary adenoma surgical approach”.
The main surgical approaches were the transsphenoidal (transnasal, sublabial and endonasal) and transcranial (subfrontal unilateral/bilateral, fronto-lateral, fronto-temporal and median basilar) while the additional surgical approaches were designed for complicated and unusual pituitary neuroendocrine tumors and included combined versions, multiple surgeries or extended approaches. Numerous factors were influential for the selection of a surgical approach concerning the pituitary neuroendocrine tumors. They are not sensible for a type of pituitary neuroendocrine tumor according to the WHO classification while the size of a tumor may dictate its surgical approach.
Each surgical intervention requires a personalized approach and the critical thinking of the surgical team but most of them can be systematically considered before confronting the tumor in an intraoperative environment because most of the preoperative investigations are proven unreliable. There is no established superior surgical approach for each surgical intervention.
Arterial and venous thromboembolism is a disease with a high impact on morbidity and mortality. Their pathological mechanisms of aggregation directed by the clotting factors along with the variations in clinical manifestation are regarded to a high moiety of genetic polymorphisms along with a wide diversity of comorbidities.
A comprehensive literature review was conducted, which included a total of 119 sources. Among these, 60 sources were systematically collected, while the remaining 59 sources were selected through non-systematic methods.
We have identified different treatment options that regard both the venous or arterial thromboembolism in contrast with numerous pathogenetic outcomes, population groups along with biomarkers that significantly modify the clinical aspects of the therapeutical and post-clinical treatment aspect. At the moment its diagnosis is continuously improving worldwide, taking into consideration a high diversity of experts’ opinions with a wide practical experience.
Arterial and venous thromboembolisms are serious medical conditions that can be prevented and effectively managed with modern diagnostic and therapeutic techniques.