Magnesium is the fourth most common mineral in the human body and the second richest intracellular cation. This element is necessary for many physiological reactions, especially in the cardiovascular ...and respiratory systems. COVID-19 is an infectious disease caused by SARS-CoV-2. The majority of people who become ill as a result of COVID-19 have mild-to-moderate symptoms and recover without specific treatment. Moreover, there are people who develop severe forms of COVID-19, which require highly specialized medical assistance. Magnesium deficiency may play a role in the pathophysiology of infection with SARS-CoV-2. The primary manifestation of COVID-19 remains respiratory, but the virus can spread to other organs and tissues, complicating the clinical picture and culminating in multiorgan failure. The key mechanisms involved in the disease include direct viral cytotoxicity, endothelial dysfunction, and exaggerated release of inflammatory cytokines. The aim of this review was to summarize the available data regarding the role of magnesium in COVID-19 patients and its particularities in different clinical settings.
Classic polyarteritis nodosa (PAN) is a vasculitis with systemic manifestations that is characterized by inflammatory and necrotizing lesions affecting medium and small muscular arteries, most ...frequently at the bifurcation of the vessels. These lesions lead to the formation of microaneurysms, hemorrhaging ruptured aneurysms, thrombosis, and, consequently, ischemia or organ infarction.
: We present a complex clinical case of a patient with a late diagnosis of polyarteritis nodosa with multiorgan involvement.
: The 44-year-old patient, in an urban environment, presented on her own in the emergency room for acute ischemia phenomena and forearm and right-hand compartment syndrome, requiring surgical decompression in the Plastic Surgery Clinic.
: Significant inflammatory syndrome is noted, alongside severe normocytic hypochromic iron deficiency anemia, nitrogen retention syndrome, hyperkalemia, hepatic syndrome, and immunological disturbances: absence of cANCA, pANCA, anti Scl 70 Ac, antinuclear Ac, and anti dDNA Ac, as well as a low C3 fraction of the plasmatic complement system. The morphological aspect described in the right-hand skin biopsy correlated with the clinical data supports the diagnosis of PAN.
: The viral form of PAN seems to be individualized as a distinct entity, requiring early, aggressive medication.
Background In Romania, as in other parts of the world, the family doctor is the first to make contact with a healthy patient and is also the first to notice even the smallest pathological changes. In ...the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the patient's communication with the family doctor became even closer and some behavioral changes could be easily noticed. Objective To assess the symptoms of anxiety and depression in the Romanian population using social media platforms in the context of the COVID-19 pandemic. Methods We conducted an anonymous, web-based cross-sectional survey consisting of 31 questions related to general characteristics (age, gender, education, inhabitancy, residence, smoking status, and alcohol consumption) and adapted GAD-7 (7-item General Anxiety Disorders questionnaire) and PHQ-9 (9-item Patient Health Questionnaire). This questionnaire was sent to volunteers in an electronic format through a social network (Facebook, Twitter). The data collected were statistically processed using IBM SPSS v25.0 (IBM Corp., Armonk, NY). The inclusion criteria were age over 18 years and no history of chronic disease. The exclusion criteria consisted of the absence of a mental illness diagnosis. Results From the 1254 respondents, 1232 cases were selected for statistical analysis after applying the exclusion criteria. The mean age was 35.94 (SD = 11.4, 95%CI=10.9-11.9) with a minimum of 18 years and a maximum of 97 years. Eighty-four point nine percent (84.9%; N=1046) of all study participants are female and 79.13% (N= 975) live in the urban area. A total of 188 (15.25%) were diagnosed with COVID-19 of which 31 (16.66%) were male and 157 (15%) were female. N=170 (13.8%) reported moderate symptoms of anxiety during the last two weeks before the survey while N=96 (7.8%) had severe anxiety. Twenty-two point two percent (22.2%; N=274) of the participants reported moderate symptoms of depression while 10.1% (N=125) had moderately severe symptoms and 6.6% (N=81) could be diagnosed with severe depression. A greater likelihood of screening for depression diagnosis was associated with ages between 25 and 34 years (OR=0.90, 95%CI=0.86-0.94,
001), 35 and 44 years (OR=0.88, 95%CI=0.84-0.93,
001), and 45 and 54 years (OR=0.87, 95%CI=0.82-0.92,
001). Also, a tendency was observed for women to be more prone to high levels of anxiety (OR=1.21, 95%CI=1.08-1.35,
001) and depression (OR=2.16, 95%CI=1.51-308,
005). Conclusions Regarding the high prevalence of depression and anxiety, especially in women, appropriate measures for the risk categories should be applied. In the new social context created by the COVID-19 pandemic, screening for psychiatric and psychological disorders should be performed by telemedicine.
The aim of this paper is to describe the temporal progression and clinical picture of a 2-year-old child with infantile Refsum disease, as well as the diagnostic procedures performed; this case ...presented multiple hematologic, metabolic, and developmental complications and progressive disabilities. Genetic testing revealed a mutation of the
(Peroxisomal Biogenesis Factor 6) gene, and the metabolic profile was consistent with the diagnosis. Particularly, the child also presented altered coagulation factors and developed a spontaneous brain hemorrhage. The clinical picture includes several neurological, ophthalmological, digestive, cutaneous, and endocrine disorders as a result of the very long chain fatty acid accumulation as well as secondary oxidative anomalies. The study of metabolic disorders occurring because of genetic mutations is a subject of core importance in the pathology of children today. The PEX mutations, difficult to identify antepartum, are linked to an array of cell anomalies with severe consequences on the patient's status, afflicting multiple organs and systems. This is the reason for which our case history may be relevant, including a vast number of symptoms, as well as modified biological parameters.
Type 1 diabetes is one of the most common chronic diseases in children and adolescents, with an increasing incidence globally. Major variations in serum glucose cause severe ketoacidosis and ...hypoglycemia, acute metabolic complications of the disease. We performed a retrospective study on a group of 119 children and adolescents with type 1 diabetes in whom only the cases with ketoacidosis and severe hypoglycemia that required emergency hospitalization were quantified. At the same time, we identified the causes and determinants of these acute complications. According to the case study, 28.6% of patients (34 cases) presented severe hypoglycemia, the most common causes of hypoglycemia being intense physical activity without additional carbohydrate intake, delayed carbohydrate intake, and excess insulin. 15.3% of patients (18 cases) had ketoacidosis, of which 55.55% were recurrent ketoacidosis. Ketoacidosis has been detected in patients with poor glycemic balance and poor treatment compliance by not following a diet and skipping insulin doses. Among the additional risk fac-tors, we identified age over 13 years and the age of diabetes greater than 5 years, for both acute complications.
Irritable bowel syndrome (IBS) is one of the most common diseases of gastro-enterology, associating abdominal pain, transit disorders and changes in the consistency of the stools. Material and ...method. The study included 200 patients suffering from IBS, selected from a total of 2,300 patients of a family medicine practice in urban area. For diagnosis and classification, Rome III criteria and Bristol scale were used. For a subgroup was applied a questionnaire for the evaluation of quality of life, QoL. Treatment was initiated on three levels. Results. The incidence of the disease during the 3 years of study (2013-2016) was 2.9%. The type of IBS most often encountered was the one with dominance of constipation (IBS-C 32.5%), followed by the alternating form (IBS-A 26%), mixed (IBS-M-24%) and the dominance of diarrhea (IBS-D 18.5%). Form with more severe impact on the quality of life is IBS-C – 52.24 score, and most easily tolerated IBS-A – 69 score. Treatment was initiated at the on level I at 33% of the patients at the on level II to 36 %, and on level III to 31% of the patients. Maximum efficiency of treatment scores were obtained from patients on treatment level III. Complete remission of symptoms is obtained only in 9.5% of total patients. Conclusions. SII is a common condition in family medicine practice, due to changes in the modern diet. The diagnosis can be facilitated by the application of questionnaires, and treatment is based on changes in lifestyle and on pharmacological agents.
The aim of this paper is to describe the temporal progression and clinical picture of a 2-year-old child with infantile Refsum disease, as well as the diagnostic procedures performed; this case ...presented multiple hematologic, metabolic, and developmental complications and progressive disabilities. Genetic testing revealed a mutation of the PEX6 (Peroxisomal Biogenesis Factor 6) gene, and the metabolic profile was consistent with the diagnosis. Particularly, the child also presented altered coagulation factors and developed a spontaneous brain hemorrhage. The clinical picture includes several neurological, ophthalmological, digestive, cutaneous, and endocrine disorders as a result of the very long chain fatty acid accumulation as well as secondary oxidative anomalies. The study of metabolic disorders occurring because of genetic mutations is a subject of core importance in the pathology of children today. The PEX mutations, difficult to identify antepartum, are linked to an array of cell anomalies with severe consequences on the patient’s status, afflicting multiple organs and systems. This is the reason for which our case history may be relevant, including a vast number of symptoms, as well as modified biological parameters.
Postpartum depression (PPD) is a major health problem, and in recent years its prevalencehas been increasing. The physiological changes and mood disorders associated withpregnancy and the postnatal ...period are mainly due to a hormonal imbalance. Destabilizingthe mother's hypothalamic pituitary adrenal (HPA) axis increases the susceptibility todepression, probably by significantly increasing plasma cortisol. Stress and inflammation playa key role in postpartum. Also, lactogenic hormones have antidepressant and anxiolyticeffects, the low concentration of oxytocin in the perinatal period being a triggering factor ofPPD.Natural nutrition, ideal for every newborn and infant, positively influences the mother'smental health and may reduce the risk of developing PPD, possibly by attenuating cortisolresponse to stress. The link between breastfeeding and PPD has not been thoroughlyapproached. PPD is associated with early termination of breastfeeding, while long-termbreastfeeding reduced the risk of PPD. The mother's willingness to breastfeed, her confidencein the ability to breastfeed, her mental health during pregnancy, her family's support, andtrained medical staff are some of the mediators that can contribute to the maintenance ofnatural nutrition in PPD.
Postpartum depression (PPD) is a major health problem, and in recent years its prevalence has been increasing. The physiological changes and mood disorders associated with pregnancy and the postnatal ...period are mainly due to a hormonal imbalance. Destabilizing the mother's hypothalamic pituitary adrenal (HPA) axis increases the susceptibility to depression, probably by significantly increasing plasma cortisol. Stress and inflammation play a key role in postpartum. Also, lactogenic hormones have antidepressant and anxiolytic effects, the low concentration of oxytocin in the perinatal period being a triggering factor of PPD. Natural nutrition, ideal for every newborn and infant, positively influences the mother's mental health and may reduce the risk of developing PPD, possibly by attenuating cortisol response to stress. The link between breastfeeding and PPD has not been thoroughly approached. PPD is associated with early termination of breastfeeding, while long-term breastfeeding reduced the risk of PPD. The mother's willingness to breastfeed, her confidence in the ability to breastfeed, her mental health during pregnancy, her family's support, and trained medical staff are some of the mediators that can contribute to the maintenance of natural nutrition in PPD. KEYWORDS: Postpartum depression, breastfeeding, mental health.
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