Medicina
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Comparative Study
Surgical Challenges During the COVID-19 Crisis: A Comparative Study of Inguinal Hernia Treatment in Romania.
Background and Objectives: The COVID-19 pandemic disrupted healthcare systems worldwide, leading to the postponement of elective surgeries, including inguinal hernia repair (IHR), as healthcare resources prioritized critical care. This study aims to evaluate the impact of the pandemic on the incidence and outcomes of IHR procedures. Materials and Methods: A retrospective review was conducted on 604 patients who underwent IHR over six years, spanning pre-pandemic, pandemic, and post-pandemic periods. ⋯ Although surgeries took longer during the pandemic (p < 0.001), both total and postoperative hospital stays were reduced during and after the pandemic (p < 0.001). Minimal postoperative complications were reported throughout, with only one mortality during the pandemic. Conclusions: This study highlights the need for robust healthcare strategies to maintain elective surgical care during global crises, as delays in IHR may elevate risks for complications like hernia incarceration and strangulation.
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Background and Objectives: Radical prostatectomy (RP) stands as the predominant instigator of postoperative stress urinary incontinence. Techniques such as the preservation of the neurovascular bundles, bladder neck preservation, and ensuring longer postoperative urethral length have shown positive impacts on continence. The posterior reconstruction is another method that aids in early continence recovery. ⋯ Patients who underwent urethral suspension had a four-fold greater likelihood of regaining continence (p = 0.015). Conclusions: Patients who underwent urethral suspension or BNP or posterior reconstruction had higher continence rates. Only the urethral suspension was found to be a significant prognostic factor of continence recovery.
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Background and Objective: The aim of this study was to evaluate cardiorespiratory fitness (CRF) measures, maximal oxygen consumption (VO2 max), and minute ventilation/carbon dioxide production (VE/VCO2 slope and others) among the T2DM population based on glycated haemoglobin (HBA1c). Material and Methods: The present study comprised a cross-sectional design, with two groups, based on HbA1c values (≤7 and ≥7.1). Laboratory samples were taken to evaluate glycated haemoglobin and fasting blood glucose (FBS). ⋯ The independent t-test revealed a significant difference between the two groups in terms of CRF measures. Conclusions: The current research identified the presence of poor glycaemic control and cardiorespiratory fitness measures among the Brazilian population with T2DM. HBA1c, duration of diabetes, age, and BMI can be employed to predict the ventilatory threshold (VT) and VO2 max.
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Review Meta Analysis
Cardiac Rehabilitation for Fontan Circulation Patients: A Systematic Review, and Meta-Analysis.
Background and Objectives: Despite advances in the surgical management of patients with Fontan circulation, their exercise capacity and quality of life remain significantly impaired. Exercise-based cardiac rehabilitation (CR) offers promising improvements in these areas, but the implementation and adherence to these programmes are often inconsistent. This systematic review and meta-analysis aimed to evaluate the safety, efficacy, and optimal exercise modalities for Fontan patients. ⋯ Home-based programmes offer promising results, though the potential for publication bias, especially in smaller studies, warrants cautious interpretation of these findings. Further research is needed to refine protocols, explore long-term outcomes, and determine the underlying mechanisms, particularly for patients with more severe clinical presentations. The low incidence of adverse events across the studies reinforces the safety of these interventions.
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Fibroblast-like synoviocytes (FLSs) are among the main disease-driving players in most cases of monoarthritis (MonoA), oligoarthritis, and polyarthritis. In this review, we look at the characteristics and therapeutic challenges at the onset of arthritis and during follow-up management. In some cases, these forms of arthritis develop into autoimmune polyarthritis, such as rheumatoid arthritis (RA), whereas local eradication of the RA synovium could still be combined with systemic treatment using immunosuppressive agents. ⋯ According to publications from the last decade on clinical studies focused on intra-articular treatment with anti-inflammatory molecules, a range of novel slow-acting forms of steroidal drugs for the local treatment of synovitis have been investigated. As pain is an essential symptom, caused by both inflammation and cartilage damage, various molecules acting on pain receptors are being investigated in clinical trials as potential targets for local intra-articular treatment. We also overview the new targets for local treatment, including surface markers and intracellular proteins, non-coding ribonucleic acids (RNAs), etc.