8 articles
Metabolic risk factors for non-communicable chronic diseases develop from an early age, while the clinical manifestations of cardiovascular diseases associated with these risk factors appear later in life. Dyslipidemia is a modifiable risk factor for cardiovascular diseases. The purpose of the study was to evaluate the lipid profile in young people as an early risk factor for cardiovascular disease.
The study was conducted on 693 healthy young individuals: 71.4% (495) women and 28.6% (198) men, aged between 17 and 30 years. The measured parameters included total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides, measured using the spectrophotometric method. Non-HDL cholesterol was calculated with the formula: non-HDL-C = TC – HDL-C (mmol/l).
A total of 8.2% of young people had total cholesterol levels above the normal threshold (5.0 mmol/l). HDL-cholesterol below the gender-specific threshold values was recorded in 52.5%. Among women, 58.8% had HDL-cholesterol levels ≤ 1.29 mmol/l, and among men, 36.9% had levels below 1.03 mmol/l. Non-HDL cholesterol exceeded the threshold value (3.8 mmol/l) in 5.9% of young people. For 21.4% of participants, LDL-cholesterol was above the threshold (2.59 mmol/l), and 8.2% had triglyceride levels above the normal threshold (1.7 mmol/l).
The study demonstrated that over half of the young people (52.5%) had HDL-cholesterol below the gender-specific thresholds. Deviations in the lipid profile increase the atherogenic potential of plasma, highlighting the need for early preventive interventions in this age group.
Despite worldwide decreasing trends in the incidence of gastric cancer, the disease remains a significant global health burden, one of the leading causes of cancer death worldwide, and its prevention is a priority for the health system. Intestinal-type gastric carcinoma originates in dysplastic epithelium, which, in turn, develops in the environment of chronic atrophic gastritis and gastric intestinal metaplasia.
Narrative literature review. A bibliographic search was conducted in the databases PubMed, Hinari, SpringerLink, National Center for Biotechnology Information, and Medline. Articles published between 2000-2024 were selected based on the following keywords: "gastric intestinal metaplasia" and "gastric epithelial dysplasia", used in different combinations with the terms "epidemiology", "clinical picture", "risk factors", "classification", "diagnosis", and "management" to maximize the search yield. After processing the information from the databases according to the search criteria, 215 full articles were found. The final bibliography contains 34 relevant sources, considered representative of the materials published on the subject of this summary article.
Gastric intestinal metaplasia represents the replacement of the gastric epithelium with two types of intestinal-type epithelium (enteric or colonic) as an adaptive response to chronic injury, while gastric epithelial dysplasia is defined as unequivocal neoplastic change of the gastric epithelium (intraepithelial neoplasia) without evidence of stromal invasion. Gastric intestinal metaplasia and gastric epithelial dysplasia are preneoplastic lesions of gastric cancer. The estimated annual risk of gastric adenocarcinoma in patients with gastric intestinal metaplasia is 0.13-0.25%, and in patients with gastric epithelial dysplasia it is 1.36%, depending on the extent and type of the lesion.
Despite the lack of a specific treatment for gastric intestinal metaplasia, the management strategy, according to current clinical guidelines, includes eradication of Helicobacter pylori infection, screening for early detection of gastric cancer, and control of other risk factors. Appropriate management of high-grade gastric epithelial dysplasia requires endoscopic resection due to its potential for progression to carcinoma and the possibility of coexisting carcinoma. For low-grade gastric epithelial dysplasia, which has a lower risk of malignant transformation, scientists recommend annual endoscopic surveillance with biopsy and histological examination.
Axial spondylitis is a chronic inflammatory disease primarily affecting the axial skeleton but can also involve peripheral joints. Axial spondylitis is often associated with extra-articular manifestations, such as inflammatory bowel diseases, emphasizing the need for rigorous monitoring and personalized therapeutic approaches. The interactions between axial spondylitis and inflammatory bowel diseases fall under the concept of “immune-mediated inflammatory diseases”, sharing common pathogenetic mechanisms. This study analyzes the prevalence and characteristics of inflammatory bowel diseases in patients with axial spondylitis.
The objective of this study was to describe the baseline characteristics of patients with axial spondylitis, evaluate the prevalence of inflammatory bowel diseases in this population, and identify correlations between the two conditions, contributing to a better understanding of their pathogenetic and clinical interactions.
This prospective observational study included 257 axial spondylitis patients followed over two years. Patients were selected according to ASAS criteria for axial spondylitis and clinical guidelines for inflammatory bowel diseases. Analyses included clinical evaluations, laboratory tests, and imaging studies. Data were processed using SPSS v22.0. Continuous variables were expressed as mean ± standard deviation or median and interquartile range, and categorical variables as percentages. Correlations were assessed using Spearman’s coefficient, with results considered significant at p<0.05.
Among the 257 patients included (168 men and 89 women, mean age 48.2 ± 13.1 years), 13.2% were recently diagnosed with axial spondylitis. Of these, 5.1% had inflammatory bowel diseases, distributed as follows: Crohn's disease (3.1%), ulcerative colitis (1.2%), and indeterminate colitis (0.8%). In 53.8% of cases, the diagnosis of inflammatory bowel diseases preceded axial spondylitis. Multivariate analysis identified the absence of a family history of axial spondylitis as a significant risk factor for inflammatory bowel diseases (OR = 3.4; p = 0.025). The prevalence of inflammatory bowel diseases increased with axial spondylitis duration, reaching 6.5% in patients with disease progression over eight years.
The study highlights a high prevalence of inflammatory bowel diseases in axial spondylitis patients, indicating the need for rigorous clinical monitoring. The absence of a family history of axial spondylitis was identified as a major risk factor for inflammatory bowel diseases. These findings emphasize the importance of a multidisciplinary clinical approach, including active screening for inflammatory bowel diseases and collaboration between rheumatologists and gastroenterologists, to improve patient prognosis and quality of life.
Osteoporosis remains a major public health issue, particularly affecting the elderly, and is characterized by decreased bone mass and deterioration of bone structure, increasing the risk of severe fractures. The development of specific and precise tools that allow for the identification and estimation of the influence of modifiable factors on the development of osteoporosis is an important step in early intervention for at-risk individuals.
The initial version of the questionnaire was created to identify modifiable factors contributing to the development of osteoporosis, including the type and frequency of drinking water consumption, water quality, knowledge about its mineral composition, dietary preferences, alcohol and tobacco use, physical activities, and stressful situations. The questionnaire initially contained 65 questions, organized into three sections. Five experts reviewed the content validity, evaluating the clarity, cultural and linguistic relevance, structure, and coherence of the questions. The feedback led to adjustments, reducing the questionnaire to 52 questions. A pre-test was conducted with 30 adults from the Republic of Moldova, confirming the validity and internal consistency of the questionnaire, with a Cronbach’s Alpha coefficient of 0.768.
To ensure content validity, experts evaluated the questionnaire, and based on their comments and suggestions, semantic and syntactic reformulations and modifications were made. As a result, 13 questions were eliminated, reducing the second version of the questionnaire to 52 questions. During the pre-testing stage, the order and content of the questions were deemed appropriate by the respondents. The average time required to complete the questionnaire was 14.19 minutes (SD ± 1.567), with a minimum of 11.90 minutes and a maximum of 17.33 minutes. The sample used in the pre-testing stage included 30 respondents, the majority of whom (93.3%) were women. The respondents’ ages ranged from 25 to 72 years, with a mean age of 50.37 ± 2.6 years. The distribution of respondents was balanced between urban (53.3%) and rural (46.7%) areas. Regarding education level, 56.6% had higher education, 26.7% had secondary vocational education, and 16.7% had no higher education.
The study demonstrated that the new questionnaire is a valid and reliable instrument for assessing the impact of modifiable risk factors on morbidity due to osteoporosis. Ongoing research is necessary to refine and further validate the questionnaire within the broader population.
Umbilical cord pathology can contribute to neonatal asphyxia, stillbirth, and postnatal death in numerous cases. However, the diagnosis of umbilical cord pathology remains imperfect, and its impact on pregnancy course and outcome is often underestimated. Therefore, prenatal diagnosis of umbilical cord pathology is becoming increasingly important in preventing intra- and postnatal morbidity and mortality. Early detection of these abnormalities enables the development of necessary strategies for optimal pregnancy and delivery management.
The study included 190 patients divided into 2 groups: L1 – 95 patients with UC abnormalities, and L0 – 95 with a normal UC. A p-value of less than 0.05 was regarded as statistically significant.
The development of umbilical cord pathology was frequently observed in pregnant women exposed to harmful workplace factors (psychological and emotional stress, p=0.01), harmful habits (smoking, p=0.04), and primiparas (p=0.005) with complicated gynecological and somatic histories, as well as those with a history of UC pathology in previous pregnancies (p<0.0001). Pregnancy and labor progression in patients with cord pathology showed a high rate of complications compared to control group, including urinary tract disorders (p=0.02), preterm labor at 27-28 weeks (p=0.01), polyhydramnios, which was ten times more frequent (p=0.002), and fetal growth restriction (p=0.02). In the study group, a prolonged second stage of labor was observed (p=0.01), along with acute fetal hypoxia, which required urgent pregnancy termination (p=0.01) through vacuum extraction (p=0.0009) or C-section (p=0.04).
The analysis of the anamnestic and clinical peculiarities of the perinatal period in patients with UC pathology, compared to pregnant women without this pathology, confirmed that this commonly encountered obstetric condition represents a considerable risk factor for perinatal complications.
Ensuring perioperative urination maintenance can often be challenging, as postoperative urinary retention is frequently overlooked in favor of more clearly defined goals such as successful surgery, comprehensive postoperative pain control, reducing the risk of postoperative cardiorespiratory complications and shortening the patient's overall hospital stay. However, the inability to initiate urination and empty the bladder in the early postoperative period may negatively affect each of the listed success criteria.
A single-center, prospective, observational, cohort study was conducted, enrolling elderly patients without severe comorbidities. A total of 127 complete datasets were analyzed. Anthropometric parameters, type of surgery, duration of anesthesia and surgery; and several parameters previously reported as risk factors for postoperative urinary retention were recorded. The main objective wasto identify the prevalence of postoperative urinary retention in a surgical group in the Republic of Moldova. The secondary objective was to test the predictive value of a series of parameters (modifiable and non-modifiable) related to the patient or surgical treatment received as risk factors for urinary retention in the first 24 hours postoperatively. Statistical software used: Social Science Statistics (https://www.socscistatistics.com).
The studied surgical population was homogeneous in terms of body mass, height, duration of surgery and anesthesia; heterogeneous by gender (62.2% male) and type of anesthesia (64% general anesthesia). Depending on the definition criteria, the prevalence of postoperative urinary retention varied between 5.5% and 7.9%. The preoperative unmodifiable risk factors for postoperative urinary retention: positive history for hypertension OR = 9.0 (X2 (1, N = 127) = 5.6, p = 0.017), diabetes mellitus OR = 5.1 (X2 (1, N = 127) = 5.36, p = 0.021) and stroke OR = 4.83 (X2 (1, N = 127) = 2.098, p = 0.148).
The prevalence of postoperative urinary retention in a single-center surgical population from the Republic of Moldova varies between 5.5% and 7.9%, depending on the criteria for postoperative urinary retention applied. This variation highlights the need for a consensus on diagnostic criteria for postoperative urinary retention is needed. Patients with hypertension and diabetes mellitus were more likely to develop postoperative urinary retention. Patients with pre-existing neurological disorders such as positive history for stroke and diabetic polyneuropathy were more susceptible for postoperative urinary retention.
Contemporary society reflects a clear trend towards delayed motherhood, raising significant concerns in the management of pregnancy and childbirth in women of advanced reproductive age. In this context, the mode of delivery and associated risks for this age category require increased attention. Birth methods have been thoroughly examined to identify risks and influencing factors within this specific cohort.
A descriptive cross-sectional study was conducted on a sample of 528 women. Data were collected using a pre-tested semi-structured questionnaire, and respondents were divided into three groups based on the mode of delivery: vaginal delivery, planned cesarean section, and emergency cesarean section. Sociodemographic, anthropometric, medical, and obstetric characteristics were analyzed using linear regression. Statistical analyses included descriptive and inferential statistics (Chi-square), with a 95.0% confidence interval.
The analysis revealed statistically significant variations in the mode of delivery based on maternal age (p=0.013) and paternal age (p=0.001), with an increased rate of cesarean sections at more advanced ages. Significant variations were also found in relation to area of residence (p=0.003), education level (p=0.001), nature of work (p=0.028), GP appointments (p=0.020), number of GP appointments(p<0.001), number of obstetrician appointments (p=0.032), time of informing on risk factors (p=0.005), parity (p<0.001), multiple pregnancies (p=0.016), mode of first delivery (p<0.001), pregnancy complications (p=0.003), delivery complications (p<0.001), gestational age at birth (p=0.017), Apgar scores at 1 and 5 minutes (p<0.001).
Advanced reproductive age has been associated with a higher risk of cesarean section compared to vaginal delivery. The influence of age is modulated by various sociodemographic, medical, and obstetric characteristics, including area of residence, education level, history of cesarean section, parity, pregnancy and delivery complications, pre-existing chronic conditions, antenatal care and provision of information on risk factors.
Premature birth can occur at any age; however, it is important to note that the risk of preterm birth can vary based on several factors, including the mother's medical history, general health, and lifestyle. There is thought to be a relationship between maternal age and the risk of preterm birth, although the exact nature of this relationship may vary. At the same time, it is considered for ages over 35, an increased risk factor for the evolution of pregnancies with complications. Pregnant women over 35 face a higher risk of premature birth. This increased risk may be associated with age-related factors such as underlying health conditions, higher rates of multiple pregnancies (due to fertility treatments), and potential placental dysfunction.
In the given study, the biomarkers IL-6, IL-8, IL-10, IL-12, SDF-1α and VEGF in amniotic fluid (AF) and maternal blood were investigated, considering the above as predictive of premature birth outcome. At the same time, the oxidative stress status of maternal blood and amniotic fluid collected in the second trimester of pregnancy was identified.
In the research, we obtained statistically significant increases in the biomarkers AAT-isopropyl, G-GTP, HPL-isopropyl from the amniotic fluid taken from pregnant women over 35 years of age in the second trimester of pregnancy in those pregnant women who had a preterm birth. In the serum of pregnant women with premature birth, an increase in the concentration of carnosine-histidine peptides, G-GTP, GR and SH (thiol) groups was identified, and the decrease in the values of SDF 1α, HPL – hexane and IL-12 were statistically significant in the serum pregnant women compared to that of the amniotic fluid.
Identifying the values of biochemical mediators during pregnancy can be a method of predictive diagnosis
Our study shows the relationship between some concentrations of oxidative stress biomarkers (AAT-isopropyl, HPL-isopropyl and G-GTP, IL-12) in amniotic fluid, and values of (Carnosine Histidine Peptide, GR and SH and SDF-1α) in the serum of pregnant women, in the second trimester of pregnancy.