Introduction

Oxidative stress can be defined as the imbalance of the redox state of a certain system including living one (organelle, cell, organ/tissue), which excessively produces reactive oxygen and/or reactive nitrogen species (ROS/RNS) that exceed the capacity of the antioxidant defense system, which have the ability to slow down or even prevent the oxidative damage of macromolecules. Oxidative stress is a pathogenic mechanism of a large variety of diseases, including pulmonary one.

Material and methods

81 preterm born children included in the study were divided into the main group – preterm children with bronchopulmonary dysplasia (BPD), and the control group – preterm children without BPD. The comparison groups were prospectively evaluated clinical, instrumental and laboratory (TPA, prooxidant-antioxidant balance, nitric oxide metabolistes and MDA). Data were statistically analyzed using Microsoft Excel, MedCalc and SPSS and Contingency Table Analysis as a way to evaluate the performance of a diagnostic test.

Results

In preterm children with BPD were found to be decreased by 29% (p < 0.001) the prooxidant-antioxidant balance (PAB) and the nitric oxide metabolistes (NO) level by 12% (p < 0.001) compared to children in the control group. The assessment of tissue oxidative damage markers revealed a significant 62% (p < 0.001) increase in malonic dialdehyde (MDA) content and a 4.86-fold (p < 0.001) increase in total prooxidant activity (TPA) in children with bronchopulmonary dysplasia compared to children in the control group. Our study confirms that TPA, PAB, MDA and NO values are reliable markers of hypoxic tissue damage at children with bronchopulmonary dysplasia and can be recommended for assessing the intensity of oxidative stress.

Conclusions

Pulmonary bronchodysplasia is characterized by the imbalance of prooxidant-antioxidant processes with the exacerbation of prooxidant ones that trigger the oxidative/nitrosative stress and the deterioration of vital chemical compounds.

Introduction

Abdominal breathing is utilized as a non-pharmacological treatment method for various stress-related conditions and autonomic dysfunctions. The objective of the study was to determine the predictors in the modulation of sympathovagal balance, as indicated by the ratio of low frequency to high frequency power of heart rate variability, by utilizing the respiratory pattern parameters recorded during the abdominal breathing model.

Materials and methods

The study involved a group of 101 healthy subjects, where the breathing pattern was recorded using a respiratory induction plethysmograph. Heart activity was estimated through electrocardiography, followed by heart rate variability analysis during both resting and abdominal breathing. Eight parameters of the breathing pattern were recorded in the subjects during resting breathing and abdominal breathing, presumed to be predictors of the ratio of low frequency to high frequency power of heart rate variability. Separate predictive models were created for this ratio for both the resting and abdominal breathing types.

Results

The multilinear regression analysis revealed that the primary predictor with the highest predictive power for determining the balance between sympathetic and parasympathetic cardiac influence, as indicated by the low frequency spectral power to high frequency spectral power ratio, in individuals practicing abdominal breathing is Tidal Volume (unstandardized coefficient = 5.007). This was followed by the duration of expiration (coefficient = -3.831) and respiratory minute-volume (coefficient = 4.415), both of which were recorded during resting breathing. In the abdominal breathing model, the most effective predictors were found to be time-related parameters, specifically the frequency of breathing during abdominal breathing (coefficient = -5.953), the duration of the inspiratory phase (coefficient = -4.037), and the duration of the expiration phase (coefficient = -4.194).

Conclusions

Abdominal breathing has the potential to normalize sympathovagal balance by adjusting the duration of inspiration or expiration. Further studies should be conducted to investigate the practical application of breathing pattern parameters in restoring the low frequency to high frequency (LF/HF) ratio, particularly in disorders characterized by elevated sympathovagal balance.

Introduction

Insects, throughout evolution, have developed a huge arsenal of active compounds, which they use to defend themselves against enemies and diseases, at the same time in recent years insects have shown great interest as a source of food rich in biologically active substances. Research in recent decades has shown that insects produce a variety of proteins and peptides with antibacterial, antifungal, antiviral, immunomodulatory, anti-inflammatory, antioxidant, antitumor, hepatoprotective, antithrombotic, antihypertensive and detoxifying activity during or after contact with the microbial agent or unfavourable factor.  

Materials and methods

The anti-inflammatory effect of imuheptin and imupurin was investigated in a rat model of subacute inflammation induced by subcutaneous implantation of felt discs. The intensity of the exudative and proliferative phase of inflammation, cytokine profile (TNFalpha, IL-6, IL-10), ceruloplasmin and antioxidant enzymes (superoxide dismutase, catalase, glutathione reductase, glutathione peroxidase and glutathione-S-transferase) in the serum of rats were evaluated.

Results

Imuheptin and imupurin reduced the level of pro-inflammatory cytokines (TNF-alpha, IL-6) and increased that of the anti-inflammatory cytokine (IL-10), as well as ceruloplasmin, glutathione reductase and glutathione peroxidase in subacute inflammation. Additionally, imupurin significantly increased the level of catalase and imuheptin that of glutathione-S-transferase.

Conclusions

Imuheptin and imupurin determined a moderate effect of inhibiting the exudative and proliferative processes, compared to the reference preparation - dexamethasone, but with a favourable effect on the cytokine profile, decreasing the level of pro-inflammatory cytokines (TNF-alpha, IL-6) and increasing the level the anti-inflammatory one (IL-10), as well as the modulation of antioxidant enzyme activity.

Introduction

Acute appendicitis is among the three most frequent surgical diseases. The lifetime likelihood of developing acute appendicitis is around 7%. The incidence of acute appendicitis reduces with age after adolescence. Several studies evaluated the relevance of the current scores to the general population, mostly children, but a limited number of studies have studied the elderly population. This study aims to assess the clinical effectiveness of the new diagnostic score for the elderly population in comparison to both the Alvarado score and the non-standardized score.

Materials and methods

In order to evaluate the effectiveness of the diagnostic score of acute appendicitis, we examined 78 patients who were admitted to emergency unit of the Saint Archangel Michael Municipal Clinical Hospital during 2018-2021 with the presumptive diagnosis of acute appendicitis. Of all patients admitted, Acute Appendicitis was confirmed on pathological examination in 22 (28.2%) patients. The average age of patients was 73.5±13.5 years (minimum - 60 years, maximum - 87 years). The ratio of males to females was 1:1.6.

Results

Comparative evaluation of the new diagnostic score of acute appendicitis and the non-standardized clinical-echographic examination for acute appendicitis diagnosis showed better performance indicators of the new diagnostic score of acute appendicitis compared to the non-standardized clinical method for acute appendicitis diagnosis. The high sensitivity of the new diagnostic score of acute appendicitis was statistically demonstrated (ƛ2 = 4.32; p < 0.05), a lower rate of missed acute appendicitis cases in the new diagnostic score of acute appendicitis (ƛ2 = 4.32; p < 0.05), the „grey area” is lower in the new diagnostic score of acute appendicitis (ƛ2 = 5.28; p < 0.05), than in the non-standardized diagnosis. It was shown to have a lower rate of acute appendicitis cases in the „grey area” of the total number of acute appendicitis cases (ƛ2 = 4.9; p < 0.05). Benchmarking indicators such as specificity and diagnostic accuracy showed no statistically significant differences. At the same time, a definite increase in specificity and accuracy was observed for the new diagnostic score of acute appendicitis compared to non-standardized clinical diagnosis.

Conclusions

Diagnosing acute appendicitis in elderly patients remains challenging due to the numerous potential diagnoses with similar clinical manifestations that are observed in this patient population. It was necessary to utilize clinical risk-scoring systems that could aid in the prompt identification of patients with acute appendicitis. This study concludes that the New diagnostic score has higher clinical efficiency in diagnosing acute appendicitis in elderly patients. It has a sensitivity of up to 93.15%, compared to the unstandardized clinical method and the Alvarado diagnostic score, and is independent of „risk factors” such as obesity and atypical vermiform appendix localization.

Introduction

Open balloon thrombectomy and embolectomy remain the preferred initial option in the management of acute lower limb ischemia (ALI), but various endovascular techniques have become accessible and are growing in popularity. The aim of the study was to assess our early experience with percutaneous vacuum-assisted thromboaspiration using the Penumbra/Indigo® system for non-traumatic ALI.

Material and methods

The study group comprised 13 patients with ALI who received treatment between September 2022 and June 2023; with 7 (53.8%) being males. The median age was 71 years (25%-75%IQR 62.5-77.5). ALI cases were classified according to the Rutherford scale: grade I – 2 (15.3%), grade IIA – 7 (53.8%), and grade IIB – 4 (30.7%). In 10 (76.9%) cases, ischemia was classified as "acute-on-chronic." The occluded native vascular segment, determined through preoperative computer tomography angiography (n=4; 30.7%), duplex scanning (n=5; 38.4%), or both examinations (n=4; 30.7%), were as follows: superficial femoral artery (n=7) and popliteal artery (n=2). In two patients, thrombosis of the below-knee femoropopliteal bypass with autogenous vein was identified, while two others presented with femoral artery stent thrombosis. An embolic etiology of ALI was observed in 4 (30.7%) cases, and thrombotic etiologyin 9 (69.2%) cases. Endovascular access was established via the ipsilateral common femoral artery (n=10), crossover (n=2), or brachial artery (n=1).  Thromboaspiration was carried out using dedicated CAT6™ and CAT8™ catheters.

Results

The technical success rate of vacuum-assisted thromboaspiration was 92.3%. Subsequent angiography revealed accompanying occlusive-stenotic lesions in all instances, necessitating transluminal angioplasty, and in 8 (61.5%) patients, additional stenting was required. Catheter-directed thrombolysis was utilized as an adjunct in one patient. There were 2 (15.3%) instances of distal embolization, both addressed within the same surgical session. Survival and limb salvage rates at the 30th-day follow-up stood at 100%.

Conclusions

Utilizing the Penumbra/Indigo® system, percutaneous vacuum-assisted thromboaspiration appears to be a safe and effective minimally invasive technique for treating ALI. This method allows for the concurrent correction of coexisting chronic peripheral arterial lesions.

Introduction

Endothelial dysfunction is a result of complex pathogenic interface involving inflammation, oxidative stress, disorders of endothelization and hemostasis etc., in both arteries and veins, leading to a lot of cardiovascular diseases. Identifying markers with high predictive value has an important diagnostic and prognostic significance.

Material and methods

To create this review article, we conducted a thorough search for relevant references that are current, specific, and aligned with the goals of the article. We utilized databases such as PubMed, MEDLINE, Google Scholar, and Cochrane, going as far back as the year 2000 to gather the necessary information. The identified articles were structured based on the main objectives, comprehensively analyzed, and the key findings have been critically exposed.

Results

A few main markers endothelial dysfunction were revealed, which reflect axial pathogenic events such as inflammation, endothelium lesion and reendothelization, inherent hemostasis disorders and prothrombotic risk. Likewise, some distinct morphophysiological traits of arterial and venous endothelium are disentangled, as well as markers having common and distinct predictive power of endothelial dysfunction in arteries and veins. 

Conclusions

Multi-marker panel is a reliable tool for prediction of endothelial dysfunction in both arteries and veins, as well as the risk of inherent consequences. Noteworthy, majority of markers are common for arteries and veins, but some, like C-reactive protein and von Willebrand factor should be treated distinctly. 

Introduction

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.

Material and methods

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.

Results

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.

Conclusions

Arterial and venous thromboembolisms are serious medical conditions that can be prevented and effectively managed with modern diagnostic and therapeutic techniques.

Introduction

Oxygen-ozone therapy stands as a medically endorsed practice confirmed by numerous international clinical studies. Various authors have illustrated the beneficial clinical outcomes of ozone therapy in terms of its capacity to regulate redox balance, cellular inflammatory responses, and adaptation to ischemia/reperfusion processes. Ozone therapy extends to encompass a range of viral infections, inflammatory disorders, and degenerative ailments, used as both monotherapy and as an adjunct to unified conventional therapies.

Materials and methods

Narrative literature review study. Bibliographic search was conducted using the PubMed, Hinari, and SpringerLink databases, as well as the National Center of Biotechnology Information and Medline. Articles published between 1990 and 2022 were selected using various combinations of keywords, including “ozone”, “ozone therapy”, “mechanisms of ozone action”, “biological effects of ozone”, “antioxidant effect”, “anti-inflammatory effect” and “immunomodulatory effect.” Information regarding ozone's mechanisms of action was identified and processed. Following the database information processing and search criteria, a total of 475 full-text articles were found. The final bibliography consists of 52 relevant sources that were deemed representative of the materials published on the topic of this synthesis article.

Results

The effects of ozone on oxygen metabolism are explained by changes in the rheological properties of blood, including inhibition of erythrocyte aggregation and stimulation of 2,3-diphosphoglycerate in erythrocytes, favoring the transport and delivery of oxygen to tissues while facilitating the substantial elimination of nitric oxide and increasing blood flow. Intracellular triatomic oxygen enhances the oxidative carboxylation of pyruvate, stimulating ATP production, which also contributes to reducing peripheral vascular resistance.

Conclusions

Ozone generates a moderate oxidative stress. Yet, it can set off several beneficial biochemical mechanisms that reactivate both the intra- and extracellular antioxidant systems and reverse chronic oxidative stress in various inflammatory and degenerative processes. Ozone induces a mild activation of the immune system by triggering neutrophil activation and stimulating the synthesis of certain cytokines (IL-2, TNF-α, IL-6, and IFN-γ), thereby initiating a complete cascade of immune responses. Ozone therapy yields the following biological reactions: optimization of blood circulation and oxygen delivery to ischemic tissue, regulation of cellular antioxidant enzymes, initiation of a slight immune system activation, and enhancing the release of growth factors.

Introduction

The clinical concept that would argue that the activity of the lateral pterygoid muscle, being disturbed, would play an important role as an etiological factor in temporomandibular joint dysfunctions is still widely accepted, being also a decisive factor in the correct choice of the treatment plan. However, because of the fact that very few research and clear evidence were conducted and presented to support completely that concept, it continues to remain a very controversial one.

Materials and methods

For this literature review were considered and studied scientific articles published between 2000 and 2023, in the following electronic databases: PubMed, MEDLINE, Google Scholar, BIR Publications, ScienceDirect. Research methods – analysis, synthesis, systematization, and description.

Results

Patients presenting temporomandibular joint dysfunction complain about pain in the temporomandibular joint or/and in masticatory muscles, limitation and sounds during mandibular activity. Temporomandibular dysfunction is a non-specific collective term, used to describe a heterogeneous group of pathological conditions located in the territory of the stomatognathic system. These are considered musculoskeletal conditions that cause pain while performing the function (mastication, speech, swallowing), with increased sensitivity in the masticatory muscles and/or the temporomandibular joint, with possible limitations of the range of motion, the appearance of joint noises and otological symptoms. One of the theories claims that in temporomandibular dysfunction, the lateral pterygoid muscle becomes hyperactive, hypoactive or that there is a lack of coordination between the superior and inferior branches of the muscle, or that there is a disturbance during the performance of the role of the muscle to control and stabilize the temporomandibular joint. However, the in-depth study of the specialized literature indicates that no scientific evidence is yet available that the function of the lateral pterygoid muscles in temporomandibular dysfunction is somehow disturbed. Moreover, the muscle's role during the execution of its normal function has also been questioned and remains a matter of controversy.

Conclusions

The lateral pterygoid muscle obviously plays an important role in the development of temporomandibular dysfunction through the prism of its anatomical and functional particularities, referring to the superior fascicle responsible for the correct anatomical maintenance of the articular disc during function.

Introduction

Pyeloureteral junction stenosis (PUJS) is a condition that affects urinary drainage at level of the renal pelvis and upper ureter. It is found in approximately 1 in 500 newborns, with a higher prevalence in males (2:1 ratio). PUJS is the main cause of congenital hydronephrosis and can also be caused by other specific pathologies. Endoscopic management is the primary treatment for PUJS, particularly in cases of aperistaltic and <2cm intrinsic ureteral stenosis without aberrant vessels. 

Aim of the study

Efficacy assessment of endoscopic retrograde incision of PUJS for urinary drainage recovery and duration of postoperatory effect.

Materials and methods

5 patients were operated, from November 2022 to February 2023. Each patient has been operated by using retrograde LASER endopyelotomy method. There were excluded patients with extrinsic ureteral obstruction, defected segment more than 2 cm, massive hydronephrosis, split renal function <20%, tumor in the obstruction area, high ureteral insertion, patients <18 years of age. Mean follow-up time of patients is 8 weeks. 

Results

One month after intervention patients were recalled for investigations. There were observed way more better results in the patients with grade 1 hydronephrosis than those with grade 2 (p = 0.002). All patients at 3-month postoperative follow-up reported resolution of symptoms.

Conclusions. Efficacy of LASER endopyelotomy is 99.9% in first months of the follow-up, after double J stent extraction. More follow-up time and patients are required to present more statistically significant results.

Introduction

Deep carious lesions are a dental disease widely spread among population of all ages. From clinical point of view, they have little symptoms and go unnoticed by the patients a long time, until they provoke dental pulp inflammations. If diagnosed and treated properly, the tooth can be treated conservatively with certain techniques of pulp vitality preservation. An important role in this process plays the innate capacity of regeneration of the pulp-dentine complex and the enhanced stimulating properties of new biomaterials used in dentistry. The aim of this clinical case report is to describe the clinical manifestations and the diagnostic algorithm used in deep caries and to establish a clinical guideline of treatment of deep carious lesion with a calcium silicate hydraulic cement.

Materials and methods

Description of clinical case of a permanent tooth with a deep carious lesion, treated by indirect pulp capping with mineral trioxide aggregate cement. Clinical and paraclinical methods of investigations were used, the patient was evaluated after 6 and 12 months after the received treatment.

Results

The sensitivity to cold stimuli presented by the patient before the treatment attenuated shortly after he received dental care. After 6 and 12 months, the tooth is asymptomatic, the clinical findings and paraclinical parameters show no evidence of pulp inflammation. 

Conclusions. Mineral trioxide aggregate showed long term successful results when used as a biomaterial for vital pulp therapy.