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Volume 56 (2018): Edition 3 (September 2018)

Volume 56 (2018): Edition 2 (June 2018)

Volume 56 (2018): Edition 1 (March 2018)

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Volume 53 (2015): Edition 1 (March 2015)

Détails du magazine
Format
Magazine
eISSN
2501-062X
Première publication
30 Mar 2015
Période de publication
4 fois par an
Langues
Anglais

Chercher

Volume 56 (2018): Edition 2 (June 2018)

Détails du magazine
Format
Magazine
eISSN
2501-062X
Première publication
30 Mar 2015
Période de publication
4 fois par an
Langues
Anglais

Chercher

11 Articles
access type Accès libre

The immunopathogenesis of Zika virus: an overview

Publié en ligne: 17 May 2018
Pages: 128 - 129

Résumé

access type Accès libre

Impact of dermatologic adverse reactions on QOL in oncologic patients: results from a single-center prospective study

Publié en ligne: 17 May 2018
Pages: 96 - 101

Résumé

Abstract

Introduction. Skin toxicity in patients receiving novel therapeutic cancer agents has become a very important marker in determining drug activity, but it can also severely impact their quality of life. About half of the patients receiving this type of oncologic treatment will develop cutaneous reactions, that is why adequate understanding and management of these side effects is very important for drug adherence and patients’ quality of life.

Materials and methods. We conducted a prospective study of consecutive patients who received oncologic treatment in our institution and presented with dermatologic side effects. The severity of skin toxicity was assessed using the DLQI score and patients were prospectively followed to evaluate response to therapy. Univariate analysis of factors influencing the impact of skin toxicity on patient QOL was conducted.

Results. 52 patients were enrolled in the study. Patients who developed grade 3 and 4 skin toxicity had a higher DLQI score, with a greater impact on quality of life, but with better clinical outcome at 3 months follow-up, based on RECIST. Patients with moderate or severe cutaneous AE were more likely to achieve complete or partial response to therapy than those with mild AE (16/33 vs. 3/19, p = 0.035). Interestingly, female patients had a significantly poorer quality of life than male patients as assessed by the DLQI score (7.28 ± 7 vs. 3.7 ± 3.6, p = 0.038).

Conclusion. Cutaneous side effects are often encountered in cancer patients and their severity can be a surrogate marker for a positive clinical tumor response to therapy.

Mots clés

  • exanthema
  • toxicity
  • EGFR tyrosine kinase inhibitor
  • quality of life
  • chemotherapy
access type Accès libre

Sarcopenia in diabetic nephropathy: a cross-sectional study

Publié en ligne: 17 May 2018
Pages: 102 - 108

Résumé

Abstract

Objective. To investigate the relationship between sarcopenia and diabetic nephropathy.

Methods. 56 diabetic patients without complications, 50 diabetic patients with nephropathy, 53 healthy controls included in this present study. Demographic characteristics such as sex, age, anthropometric measurements such as weight, body mass index [BMI], hip circumference, waist circumference and upper arm circumference were measured. Sarcopenia diagnosis was based on European Working Group on Sarcopenia in Older People [EWGSOP] criteria which consist of hand grip strength, 6-meter walking test and muscle mass.

Results. The frequency of sarcopenia increased gradually from 15.1% in healthy control group to 21.4% in the diabetes group, and 34% in diabetic nephropathy group (X2 for trend, p = 0.029). The frequency of sarcopenia was similar in diabetes and diabetic nephropathy group. However, the frequency of sarcopenia was higher in diabetic nephropathy than healthy controls (OR = 2.89, CI [1.11-7.51] in logistic regression).

Conclusion: In the present study, the prevalence of sarcopenia was higher in patients with diabetic nephropathy compared to healthy controls.

Mots clés

  • Sarcopenia
  • Diabetes Mellitus
  • Diabetic Nephropathies
access type Accès libre

Therapeutic adherence in patients with systemic lupus erythematosus: a cross-sectional study

Publié en ligne: 17 May 2018
Pages: 109 - 115

Résumé

Abstract

Introduction. The aim of the research was the study of the adherence to treatment in patients with systemic lupus erythematosus.

Methods. Cross-sectional study including 132 consecutive patients with systemic lupus erythematosus (SLICC, 2012 classification criteria). We collected clinical and socio-demographic data, socio-economic status; we assessed SLEDAI-2k disease activity, and estimated the adherence to treatment by Morisky questionnaire.

Results. Our results demonstrated that low adherence to treatment in patients with systemic lupus erythematosus was in only 11.36% of patients, while 43.18% and 45.46% of the patients were scored as moderate and high adherence, respectively. A moderate/high adherence to treatment was associated to a high level of education (r = −0.51, p < 0.05, 95% CI = −0.25 to −0.66), low disease activity (r = 0.38, p < 0.05, 95% CI = 0.25 to 0.53) and low indices of physician global assessment (r = −0.31, p<0.05, 95% CI = −0.23 to −0.71). The sub-analysis of the adherence to each drug demonstrated that the highest adherence was to treatment with glucocorticosteroids – 92.85%, followed by hydroxychloroquine and aspirin – 92.15% and 89.79%, respectively.

Conclusion. In our cohort, the adherence to treatment was high in 45.46%, moderate in 43.18% and low in only 11.36% cases. High adherence to treatment was associated to low disease activity. The adherence was positively influenced by the age at the onset of the disease and a high educational level.

Mots clés

  • adherence
  • compliance
  • systemic lupus erythematosus
  • treatment
  • Morisky
access type Accès libre

Liver disease symptoms in non-alcoholic fatty liver disease and small intestinal bacterial overgrowth

Publié en ligne: 17 May 2018
Pages: 85 - 89

Résumé

Abstract

Introduction. It seems that there is a relationship between small intestinal bacterial overgrowth (SIBO) and non-alcoholic fatty liver disease (NAFLD). The main objective of this study was to evaluate the prevalence of SIBO among NAFLD patients.

Methods. In this descriptive-analytical cross-sectional study, 98 eligible NAFLD patients were evaluated for SIBO using hydrogen breath test (HBT). They were divided into SIBO-positive and SIBO-negative groups. Demographic, clinical, and laboratory data were obtained.

Results. Based on the HBT, 38 patients (39%) had bacteria overgrowth. There were no significant differences between SIBO-positive and SIBO-negative regarding demographic data and BMI classification (P > 0.05). Biochemical variables, the results of abdominal ultrasound, and liver elastography did not show any significant difference between SIBO-positive and SIBO-negative patients (P > 0.05). Patients with SIBO were found to have higher rates of bloating, while abdominal pain was more prevalent in SIBO-negative patients (P < 0.001).

Conclusions. SIBO is prevalent in NAFLD and associated with bloating in these patients. Further studies are necessary to elucidate if therapeutic manipulation of gut microbiota reduces the risk of NAFLD, fibrosis, and liver cirrhosis.

Mots clés

  • Non-alcoholic fatty liver disease
  • Small intestinal bacterial overgrowth
  • Breath tests
  • Abdominal pain
access type Accès libre

Macrophage activation syndrome associated with systemic lupus erythematosus treated successfully with the combination of steroid pulse, immunoglobulin and tacrolimus

Publié en ligne: 17 May 2018
Pages: 117 - 121

Résumé

Abstract

Macrophage activation syndrome (MAS), a variant of secondary hemophagocyticlymphohistiocytosis, is a potentially life-threatening complication of inflammatory and autoimmune diseases. We present a case of MAS as a rare manifestation of systemic lupus erythematosus. Although initial treatment with corticosteroid, with or without cyclosporine A, is justified in patients with MAS, evidence regarding the effectiveness of this treatment protocol remains to be clarified. Our patient was successfully treated with a combination of intravenous immunoglobulin therapy and intravenous methyl predonisolone pulse therapy, which was followed by a course of oral prednisolone and oral tacrolimus. Based on our experience, we propose tacrolimus to provide a more useful adjuvant treatment to corticosteroid therapy than cyclosporine A.

Mots clés

  • hemophagocyticlymphohistiocytosis (HLH)
  • intravenous immunoglobulin (IVIG)
  • macrophage activation syndrome (MAS)
  • systemic lupus erythematosus (SLE)
  • tacrolimus (Tac)
access type Accès libre

Treating malignant melanoma when a rare BRAF V600M mutation is present: case report and literature review

Publié en ligne: 17 May 2018
Pages: 122 - 126

Résumé

Abstract

Recent years have brought major advances in the treatment of malignant melanoma. One such an advance is the treatment with BRAF tyrosine-kinase inhibitors in metastatic malignant melanomas that harbor mutations in the BRAF gene. The trials that have been performed in this setting have demonstrated superior response rates and increased overall survival, however, they mostly included patients with melanomas carrying the more common V600E and V600K mutations, not being able to assess the benefit of these treatments in situations where more rare mutations of the BRAF gene are present. We present the evolution of a patient with malignant melanoma with a rare V600M mutation in the BRAF gene, that was eventually treated with vemurafenib. Also we present a brief review of the major phase III trials that showed benefit with tyrosine-kinase inhibitors in BRAF mutated melanoma, with respect to the BRAF mutations included.

Mots clés

  • melanoma
  • cutaneous malignant
  • melanoma
  • protein-tyrosine kinases
  • vemurafenib
  • dabrafenib
access type Accès libre

Biological therapies in psoriasis - revisited

Publié en ligne: 17 May 2018
Pages: 75 - 84

Résumé

Abstract

Psoriasis is a chronic, immune mediated disorder affecting approximately 2% of the population. Even in our days, patients with psoriasis are confronted with stigmatization and social rejection. As a result, their quality of life is significantly impaired. Biological therapies have revolutionized the treatment of moderate to severe psoriasis. The aim of this paper is to look over the most important biological therapies available for the management of plaque-type psoriasis.

Mots clés

  • psoriasis
  • biological therapies
  • TNF-α
  • IL-17
  • anti-IL-12/23
access type Accès libre

NLR and microalbuminuria: Are these markers significantly associated?

Publié en ligne: 17 May 2018
Pages: 127 - 127

Résumé

access type Accès libre

In memoriam Professor Ioan Matei (1939–2017)

Publié en ligne: 17 May 2018
Pages: 131 - 132

Résumé

access type Accès libre

Comparison of coronary risk factors and angiographic findings in younger and older patients with significant coronary artery disease

Publié en ligne: 17 May 2018
Pages: 90 - 95

Résumé

Abstract

Background. Coronary artery disease (CAD) is uncommon among young adults and may have certain characteristics that are different from those in older patients. The aim of the current study was to determine the risk factors of CAD, important laboratory data and angiographic findings in young patients with CAD and to compare them with the old patients.

Methods. Patients with typical chest pain whose CAD was confirmed by coronary angiography were included in the study. These patients were divided into 2 groups: ≥ 45 and < 45 years old; the risk factors of CAD and angiographic findings were determined in each group and further compared.

Results. Finally, 231 patients with CAD were included in the study. Thirty-five (30.4%) of patients younger than 45 years and 58 (50.0%) aged ≥ 45 had diabetes mellitus (P = 0.002). Statistically remarkable differences were observed between the two groups regarding hypertension (P < 0.001), myocardial infarction (P < 0.001), Gensini score Median (P < 0.001), ejection fraction in echocardiography (P < 0.001) and fasting blood sugar in laboratory data (P = 0.006). The older group, compared with the younger one, had higher left anterior descending (LAD) artery (P < 0.001), right coronary artery (RCA) (P < 0.001), 3 vessel disease (P < 0.001) and 2-vessel disease (P = 0.044); on the other hand, 1-vessel disease was higher in patients aged < 45(P < 0.001).

Conclusion. The risk profile and angiographic findings are different in young patients with CAD compared to older patients. Young patients with CAD tend to be male with a positive familial history, but with less diabetes or hypertension. The older patients had higher 3 vessel disease, 2-vessel disease and left anterior descending (LAD) artery and right coronary artery (RCA) involvements. In contrast, 1-vessel disease was higher in young patients aged <45.

Mots clés

  • Risk Factors
  • Angiography
  • Coronary Artery Disease
11 Articles
access type Accès libre

The immunopathogenesis of Zika virus: an overview

Publié en ligne: 17 May 2018
Pages: 128 - 129

Résumé

access type Accès libre

Impact of dermatologic adverse reactions on QOL in oncologic patients: results from a single-center prospective study

Publié en ligne: 17 May 2018
Pages: 96 - 101

Résumé

Abstract

Introduction. Skin toxicity in patients receiving novel therapeutic cancer agents has become a very important marker in determining drug activity, but it can also severely impact their quality of life. About half of the patients receiving this type of oncologic treatment will develop cutaneous reactions, that is why adequate understanding and management of these side effects is very important for drug adherence and patients’ quality of life.

Materials and methods. We conducted a prospective study of consecutive patients who received oncologic treatment in our institution and presented with dermatologic side effects. The severity of skin toxicity was assessed using the DLQI score and patients were prospectively followed to evaluate response to therapy. Univariate analysis of factors influencing the impact of skin toxicity on patient QOL was conducted.

Results. 52 patients were enrolled in the study. Patients who developed grade 3 and 4 skin toxicity had a higher DLQI score, with a greater impact on quality of life, but with better clinical outcome at 3 months follow-up, based on RECIST. Patients with moderate or severe cutaneous AE were more likely to achieve complete or partial response to therapy than those with mild AE (16/33 vs. 3/19, p = 0.035). Interestingly, female patients had a significantly poorer quality of life than male patients as assessed by the DLQI score (7.28 ± 7 vs. 3.7 ± 3.6, p = 0.038).

Conclusion. Cutaneous side effects are often encountered in cancer patients and their severity can be a surrogate marker for a positive clinical tumor response to therapy.

Mots clés

  • exanthema
  • toxicity
  • EGFR tyrosine kinase inhibitor
  • quality of life
  • chemotherapy
access type Accès libre

Sarcopenia in diabetic nephropathy: a cross-sectional study

Publié en ligne: 17 May 2018
Pages: 102 - 108

Résumé

Abstract

Objective. To investigate the relationship between sarcopenia and diabetic nephropathy.

Methods. 56 diabetic patients without complications, 50 diabetic patients with nephropathy, 53 healthy controls included in this present study. Demographic characteristics such as sex, age, anthropometric measurements such as weight, body mass index [BMI], hip circumference, waist circumference and upper arm circumference were measured. Sarcopenia diagnosis was based on European Working Group on Sarcopenia in Older People [EWGSOP] criteria which consist of hand grip strength, 6-meter walking test and muscle mass.

Results. The frequency of sarcopenia increased gradually from 15.1% in healthy control group to 21.4% in the diabetes group, and 34% in diabetic nephropathy group (X2 for trend, p = 0.029). The frequency of sarcopenia was similar in diabetes and diabetic nephropathy group. However, the frequency of sarcopenia was higher in diabetic nephropathy than healthy controls (OR = 2.89, CI [1.11-7.51] in logistic regression).

Conclusion: In the present study, the prevalence of sarcopenia was higher in patients with diabetic nephropathy compared to healthy controls.

Mots clés

  • Sarcopenia
  • Diabetes Mellitus
  • Diabetic Nephropathies
access type Accès libre

Therapeutic adherence in patients with systemic lupus erythematosus: a cross-sectional study

Publié en ligne: 17 May 2018
Pages: 109 - 115

Résumé

Abstract

Introduction. The aim of the research was the study of the adherence to treatment in patients with systemic lupus erythematosus.

Methods. Cross-sectional study including 132 consecutive patients with systemic lupus erythematosus (SLICC, 2012 classification criteria). We collected clinical and socio-demographic data, socio-economic status; we assessed SLEDAI-2k disease activity, and estimated the adherence to treatment by Morisky questionnaire.

Results. Our results demonstrated that low adherence to treatment in patients with systemic lupus erythematosus was in only 11.36% of patients, while 43.18% and 45.46% of the patients were scored as moderate and high adherence, respectively. A moderate/high adherence to treatment was associated to a high level of education (r = −0.51, p < 0.05, 95% CI = −0.25 to −0.66), low disease activity (r = 0.38, p < 0.05, 95% CI = 0.25 to 0.53) and low indices of physician global assessment (r = −0.31, p<0.05, 95% CI = −0.23 to −0.71). The sub-analysis of the adherence to each drug demonstrated that the highest adherence was to treatment with glucocorticosteroids – 92.85%, followed by hydroxychloroquine and aspirin – 92.15% and 89.79%, respectively.

Conclusion. In our cohort, the adherence to treatment was high in 45.46%, moderate in 43.18% and low in only 11.36% cases. High adherence to treatment was associated to low disease activity. The adherence was positively influenced by the age at the onset of the disease and a high educational level.

Mots clés

  • adherence
  • compliance
  • systemic lupus erythematosus
  • treatment
  • Morisky
access type Accès libre

Liver disease symptoms in non-alcoholic fatty liver disease and small intestinal bacterial overgrowth

Publié en ligne: 17 May 2018
Pages: 85 - 89

Résumé

Abstract

Introduction. It seems that there is a relationship between small intestinal bacterial overgrowth (SIBO) and non-alcoholic fatty liver disease (NAFLD). The main objective of this study was to evaluate the prevalence of SIBO among NAFLD patients.

Methods. In this descriptive-analytical cross-sectional study, 98 eligible NAFLD patients were evaluated for SIBO using hydrogen breath test (HBT). They were divided into SIBO-positive and SIBO-negative groups. Demographic, clinical, and laboratory data were obtained.

Results. Based on the HBT, 38 patients (39%) had bacteria overgrowth. There were no significant differences between SIBO-positive and SIBO-negative regarding demographic data and BMI classification (P > 0.05). Biochemical variables, the results of abdominal ultrasound, and liver elastography did not show any significant difference between SIBO-positive and SIBO-negative patients (P > 0.05). Patients with SIBO were found to have higher rates of bloating, while abdominal pain was more prevalent in SIBO-negative patients (P < 0.001).

Conclusions. SIBO is prevalent in NAFLD and associated with bloating in these patients. Further studies are necessary to elucidate if therapeutic manipulation of gut microbiota reduces the risk of NAFLD, fibrosis, and liver cirrhosis.

Mots clés

  • Non-alcoholic fatty liver disease
  • Small intestinal bacterial overgrowth
  • Breath tests
  • Abdominal pain
access type Accès libre

Macrophage activation syndrome associated with systemic lupus erythematosus treated successfully with the combination of steroid pulse, immunoglobulin and tacrolimus

Publié en ligne: 17 May 2018
Pages: 117 - 121

Résumé

Abstract

Macrophage activation syndrome (MAS), a variant of secondary hemophagocyticlymphohistiocytosis, is a potentially life-threatening complication of inflammatory and autoimmune diseases. We present a case of MAS as a rare manifestation of systemic lupus erythematosus. Although initial treatment with corticosteroid, with or without cyclosporine A, is justified in patients with MAS, evidence regarding the effectiveness of this treatment protocol remains to be clarified. Our patient was successfully treated with a combination of intravenous immunoglobulin therapy and intravenous methyl predonisolone pulse therapy, which was followed by a course of oral prednisolone and oral tacrolimus. Based on our experience, we propose tacrolimus to provide a more useful adjuvant treatment to corticosteroid therapy than cyclosporine A.

Mots clés

  • hemophagocyticlymphohistiocytosis (HLH)
  • intravenous immunoglobulin (IVIG)
  • macrophage activation syndrome (MAS)
  • systemic lupus erythematosus (SLE)
  • tacrolimus (Tac)
access type Accès libre

Treating malignant melanoma when a rare BRAF V600M mutation is present: case report and literature review

Publié en ligne: 17 May 2018
Pages: 122 - 126

Résumé

Abstract

Recent years have brought major advances in the treatment of malignant melanoma. One such an advance is the treatment with BRAF tyrosine-kinase inhibitors in metastatic malignant melanomas that harbor mutations in the BRAF gene. The trials that have been performed in this setting have demonstrated superior response rates and increased overall survival, however, they mostly included patients with melanomas carrying the more common V600E and V600K mutations, not being able to assess the benefit of these treatments in situations where more rare mutations of the BRAF gene are present. We present the evolution of a patient with malignant melanoma with a rare V600M mutation in the BRAF gene, that was eventually treated with vemurafenib. Also we present a brief review of the major phase III trials that showed benefit with tyrosine-kinase inhibitors in BRAF mutated melanoma, with respect to the BRAF mutations included.

Mots clés

  • melanoma
  • cutaneous malignant
  • melanoma
  • protein-tyrosine kinases
  • vemurafenib
  • dabrafenib
access type Accès libre

Biological therapies in psoriasis - revisited

Publié en ligne: 17 May 2018
Pages: 75 - 84

Résumé

Abstract

Psoriasis is a chronic, immune mediated disorder affecting approximately 2% of the population. Even in our days, patients with psoriasis are confronted with stigmatization and social rejection. As a result, their quality of life is significantly impaired. Biological therapies have revolutionized the treatment of moderate to severe psoriasis. The aim of this paper is to look over the most important biological therapies available for the management of plaque-type psoriasis.

Mots clés

  • psoriasis
  • biological therapies
  • TNF-α
  • IL-17
  • anti-IL-12/23
access type Accès libre

NLR and microalbuminuria: Are these markers significantly associated?

Publié en ligne: 17 May 2018
Pages: 127 - 127

Résumé

access type Accès libre

In memoriam Professor Ioan Matei (1939–2017)

Publié en ligne: 17 May 2018
Pages: 131 - 132

Résumé

access type Accès libre

Comparison of coronary risk factors and angiographic findings in younger and older patients with significant coronary artery disease

Publié en ligne: 17 May 2018
Pages: 90 - 95

Résumé

Abstract

Background. Coronary artery disease (CAD) is uncommon among young adults and may have certain characteristics that are different from those in older patients. The aim of the current study was to determine the risk factors of CAD, important laboratory data and angiographic findings in young patients with CAD and to compare them with the old patients.

Methods. Patients with typical chest pain whose CAD was confirmed by coronary angiography were included in the study. These patients were divided into 2 groups: ≥ 45 and < 45 years old; the risk factors of CAD and angiographic findings were determined in each group and further compared.

Results. Finally, 231 patients with CAD were included in the study. Thirty-five (30.4%) of patients younger than 45 years and 58 (50.0%) aged ≥ 45 had diabetes mellitus (P = 0.002). Statistically remarkable differences were observed between the two groups regarding hypertension (P < 0.001), myocardial infarction (P < 0.001), Gensini score Median (P < 0.001), ejection fraction in echocardiography (P < 0.001) and fasting blood sugar in laboratory data (P = 0.006). The older group, compared with the younger one, had higher left anterior descending (LAD) artery (P < 0.001), right coronary artery (RCA) (P < 0.001), 3 vessel disease (P < 0.001) and 2-vessel disease (P = 0.044); on the other hand, 1-vessel disease was higher in patients aged < 45(P < 0.001).

Conclusion. The risk profile and angiographic findings are different in young patients with CAD compared to older patients. Young patients with CAD tend to be male with a positive familial history, but with less diabetes or hypertension. The older patients had higher 3 vessel disease, 2-vessel disease and left anterior descending (LAD) artery and right coronary artery (RCA) involvements. In contrast, 1-vessel disease was higher in young patients aged <45.

Mots clés

  • Risk Factors
  • Angiography
  • Coronary Artery Disease

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