The "Viral" Form of Polyarteritis Nodosa (PAN)-A Distinct Entity: A Case Based Review.

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. Background and Objectives: We present a complex clinical case of a patient with a late diagnosis of polyarteritis nodosa with multiorgan involvement. Materials and Methods: 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. Results: 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. Conclusions: The viral form of PAN seems to be individualized as a distinct entity, requiring early, aggressive medication.

The Effects of the COVID-19 Pandemic on Mental Health: A Web-Based Study Among Romanian Adults.

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, P<.001), 35 and 44 years (OR=0.88, 95%CI=0.84-0.93, P<.001), and 45 and 54 years (OR=0.87, 95%CI=0.82-0.92, P<.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, P< .001) and depression (OR=2.16, 95%CI=1.51-308, P< .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.

Epidemiological study of metabolic syndrome and risk of diabetes mellitus in a rural family medicine practice in Bacau County.

AIM: This descriptive epidemiological study included 615 subjects investigated by their family doctor in the interval October 2011- August 2012. MATERIAL AND METHODS: Patients were selected according to 2012 IDF diagnostic criteria resulting 304 patients. RESULTS: There was a Gaussian distribution of waist circumference (WC) with a maximum in age-group 70-80 years (46.3%), followed by age- groups 50-60 years (37.8%) and 60-70 years (41.6%). Waist circumference measurement showed an average of 100.76 +/- 11.59 cm, ranges 72 cm - 134 cm, without statistical significance. Mean body mass index (BMI) was 28.25 +/- 4.72 kg/m2 vs. 27.79 +/- 4.48 kg/m2. The difference is statistically significant (p = 0.05). Considering categorical the patients with hypertension (AHT) according to the definition, we found that only 7 cases did not have AHT (4.4%) as compared to a prevalence of AHT of 13.7% in the MS (metabolic syndrome) group. Mean serum triglyceride level was 123.11 +/- 68.55 mg/dl versus 113.75 +/- 65.62 mg/dl in the MS group, significantly higher (p < 0.003). Mean HDL cholesterol was 57.58 +/- 17.11 mg/dl versus 58.54 +/- 15.02 mg/dl, statistically significant difference (p < 0.05). CONCLUSIONS: The prevalence of glucoregulation disorders is higher in the MS group. Proportional relationships were found between BMI, WC, and SBP and high blood glucose. Comparison of blood glucose levels at baseline and at 1 year follow up showed significant differences.

Epidemiology of B/C virus infection hepatitis in the Northern Moldavian correctional facilities risk factors.

AIM: To identify the specific risk factors for chronic hepatitis B/C virus infections in the correctional system in Moldova (Romania). MATERIAL AND METHODS: The study included 533 subjects imprisoned in three correctional facilities located in the Northern region of Moldova. The subjects were divided into 2 groups: HBV/HBC group--108; Control group--425. RESULTS: The risk factor for transfusion-contracted HBV/HCV was 3.73; the empirical treatment of the HBV/HBC group resulted in a relative infection risk of 2.62; syringe sharing in the HBV/HBC group accounted for a risk factor of over 4 (OR = 4.33); tattooing induced a relative risk factor of 1.25, and piercing was a risk factor of approximately 2 (OR = 1.97); sharing personal care items represented a risk factor of over 2 (OR = 2.02). Injection drugs induced a relative risk of over 4 (OR = 4.33). In the HBV/HCV group, self-aggression represented a risk factor of 1.65. CONCLUSIONS: Prison environment, by its specific and nonspecific contamination modalities (shared with the rest of the population but more common) causes that inmates to be 2-4 times more exposed to hepatitis B/C infection.