5 articles
MONOGRAPH REVIEW “Psoriatic arthritis – from pathogenetic mechanisms to pharmacological management” Author: Eugeniu Russu, MD, PhD, associate professor Discipline of Rheumatology and Nephrology, Department of Internal Medicine, Nicolae Testemițanu State University of Medicine and Pharmacy, Republic of Moldova Monograph details: Russu E. Artrita psoriazică – de la mecanisme patogenetic
MONOGRAPH REVIEW “Ankylosing spondylitis – an old disease with new perspectives” Author: Lia Chișlari, MD, PhD, associate professor Discipline of Rheumatology and Nephrology, Department of Internal Medicine, Nicolae Testemițanu State University of Medicine and Pharmacy, Republic of Moldova Monograph details: Chișlari L. Spondilita anchilozantă – boală veche, cu viziuni noi [Ankylosing spondy
Proteus syndrome is an extremely rare congenital multisystem disorder characterized by highly variable clinical manifestations. Its exact prevalence remains unknown, with fewer than 200 cases reported in the medical literature worldwide.
We report the case of an 18-year-old African woman diagnosed with Proteus syndrome, presenting with marked asymmetrical overgrowth affecting the upper limbs, trunk, and lower limbs. The distribution of the deformities resembled the appearance of a tree trunk with multiple stumps. Additionally, the patient exhibited soft tissue tumor-like formations at the left oral commissure and in the left retroauricular region.
The detailed phenotypic description of individuals with Proteus syndrome is essential due to the extreme rarity and clinical complexity of this disorder. Improved awareness and diagnostic acumen among healthcare professionals are critical for the early identification and appropriate multidisciplinary management of affected patients. Given the high risk of life-threatening complications, such as the development of malignant tumors and thromboembolic events, a structured and dynamic follow-up protocol is required. Moreover, the psychosocial dimension of the disease must not be overlooked. Many patients experience profound emotional distress, stigmatization, and moral suffering, which can significantly impact their quality of life. An integrated approach that combines medical surveillance with psychological and social support is imperative for optimizing long-term outcomes in Proteus syndrome.
Prolonged premature rupture of membranes predisposes to intrauterine infection and chorioamnionitis, both of which have significant implications for neonatal outcomes. While chorioamnionitis has been linked to accelerated surfactant production and reduced respiratory distress syndrome, it is also associated with long-term pulmonary injury, including bronchopulmonary dysplasia and pulmonary hypertension. The objective of the study is to investigate the association between prolonged premature rupture of membranes, chorioamnionitis, and respiratory outcomes among preterm infants ≤34 weeks of gestation.
A prospective cohort of 108 preterm infants admitted to the Neonatal Intensive Care Unit of the Mother and Child Institute, Chișinău, between October 2023 and July 2024, was divided into two groups: infants born to mothers with clinical/histological chorioamnionitis (n = 54) and controls (n = 54). Maternal risk factors, incidence of prolonged premature rupture of membranes incidence, Apgar scores, type and duration of respiratory support, and pulmonary complications were analyzed. Statistical significance was tested using chi-square and logistic regression.
Prolonged premature rupture of membranes was significantly more frequent in chorioamnionitis group (67% vs. 22%, p<0.001). Infants exposed to chorioamnionitis had lower 1-minute Apgar scores, greater need for invasive ventilation (5.9 ± 10.6 vs. 2.2 ± 4.8 days, p<0.05), and prolonged hospitalization. BPD incidence was higher in the chorioamnionitis group (25.9% vs. 3.7%, p<0.05). Mortality did not differ significantly between groups (27.8% vs. 22.2%).
Prolonged premature rupture of membranes is strongly associated with chorioamnionitis, which in turn significantly increases the risk of long-term pulmonary complications in preterm infants. Early recognition of prolonged premature rupture of membranes, antibiotic prophylaxis, antenatal corticosteroids, and interdisciplinary obstetric–neonatal management are essential to reduce the burden of bronchopulmonary dysplasia.
Juvenile idiopathic arthritis is a persistent type of arthritis with no defined cause that develops before the age of 16 years and lasts for at least 6 weeks. The aim of the study was to evaluate cardiovascular risk factors (homocysteine, total cholesterol, and triglycerides) in juvenile idiopathic arthritis.
The study was carried out in the Rheumatology Department of the Mother and Child Institute,Chisinau, Republic of Moldova. The patients’ parents signed the written consent to participate in the study. The study was approved by the Ethics Committee of the Nicolae Testemițanu State University of Medicine and Pharmacy. The study included 90 children with JIA. The number of painful and swollen joints, the global evaluation of the disease by both the physician and patient, as well as the Childhood Health Assessment Questionnaire, were determined. Paraclinical tests included a complete blood count, acute-phase markers of inflammation (erythrocyte sedimentation rate, C-reactive protein) and the cardiovascular risk factors of interest (homocysteine, total cholesterol, and triglycerides).
Patients with JIA exhibit a relatively higher risk of hyperhomocysteinemia compared to controls. Additionally, individuals with JIA display a relatively moderate risk of hypercholesterolemia and a relatively lower risk of hypertriglyceridemia. Thus, a correlation was noted between JIA and hypercholesterolemia, with a slight inclination towards increased triglyceride levels in these children.
Patients with juvenile idiopathic arthritis are at risk for hyperhomocysteinemia, hypercholesterolemia, and hypertriglyceridemia.