Pediatric patients with polyuria polydipsia syndrome (PPS) represent a diagnostic challenge for clinicians because of the technical difficulties in performing the gold standard water deprivation test (WDT). Copeptin, a stable biomarker representing the C-terminal portion of the polypeptide chain of the antidiuretic hormone, is a reliable diagnostic tool. To assess the diagnostic accuracy of baseline copeptin dosing, arginine/hypertonic saline copeptin stimulation tests, and WDT. This study aimed to establish the diagnostic utility of copeptin in pediatric patients by distinguishing between central diabetes insipidus, nephrogenic diabetes insipidus, and primary polydipsia. Comparative and non-comparative primary studies published between January 2018 and August 2024 focusing on children were searched and included in PubMed, Cochrane Library, Web of Science, ScienceDirect, Scopus, and Google Scholar. The QUADAS-2 tool was used to assess the risk of bias and applicability. Meta-analyses used fixed effects models because of low heterogeneity and the HSROC model. Eleven studies were included with an overall low bias and no significant applicability concerns. The mean pooled sensitivity = 0.98 (95% CI: 0.936–1.025), pooled specificity = 0.947 (95% CI: 0.920–0.973), and AUC = 0.972 (95% CI: 0.952–0.992), indicating excellent diagnostic accuracy. Stimulation methods for copeptin dosing represent an effective and less invasive diagnostic test for children with PPS, and future development of standard copeptin testing protocols is needed.
Background: Given the increasing rate of infections following hip arthroplasty, one of the current options is the application of a biocomposite at the site of the infection. One of the products used is Stimulan, a completely resorbable calcium sulfate, designed to treat acute and chronic infections. This biocomposite has a controlled purity, is easy to mix with liquid, powder, and antibiotics, and can be applied directly to the site of infection, or it can be injected. Methods: We analyzed data from 76 patients, who were admitted to the County Clinical Hospital of Emergency “St. Apostol Andrei” in Galati during January 2017–September 2023, with a diagnosis of infection associated with hip arthroplasty. Results: In 69.73% of cases (52 patients), we decided to keep the implant in place. In this subgroup, Stimulan was applied in 26 cases (57.78%). Of these, 100% were cured—compared to the subgroup in which Stimulan was not applied, where this percentage was lower. All patients underwent chemical and mechanical toileting, and for 24 patients (20.27%), it was necessary to ablate the implant with or without the application of Stimulan, then reimplantation of the prosthesis. Conclusions: The patients with Stimulan had a longer average length of hospitalization, almost half of them required intervention in two periods, and a quarter required the implantation of spacers. However, the cure rate was higher, only in three people could we not control the infection, and there was no death. This study confirms the effectiveness of the treatment when using a biocomposite in addition to the classical treatment for both acute and chronic cases.
1 March 2025 in Electronic Journal of General Medicine
Introduction: Skin cancer registers worldwide high morbidity and mortality rates, with costly medical services, its major histopathology subtypes being basal and squamous cell carcinoma, melanoma. Materials and method: This 5-year retrospective study included 84 patients admitted to the “Sfântul Apostol Andrei” Emergency Clinical Hospital of Galați in the oncology and radiotherapy clinic during January 2018-October 2022. Results: Skin malignancies represented 3.56% of the oncological cases admitted from January 2018 to October 2022. The most prevalent etiological factors were sun exposure and light-colored skin (84.52%). Most cases registered discomfort due to local and persistent itching (59.52%). Histopathologically, most cases were squamous cell carcinomas (51.19%). The most frequent treatment methods were surgical intervention (100%), radiotherapy (100%), chemotherapy (7.14%), immunotherapy (7.14%), with a 5-year survival rate of 95.23%. Conclusions: The available screening programs help with skin cancer early diagnosis, leading to favorable outcomes and reducing complication risks.
Psoriasis is one of the most frequent immune-mediated chronic inflammatory cutaneous disease that exerts a considerable psychological impact, including low self-esteem, stigmatization, and depression. In recent years, biologic therapies have substantially transformed the therapeutic landscape for individuals with moderate-to-severe psoriasis, shifting treatment towards a more targeted and personalized approach. Seborrheic keratoses (SKs) are common benign skin lesions, and their association with psoriasis and biologic therapy remains poorly understood. Our retrospective study evaluated a small cohort of patients with moderate-to-severe psoriasis undergoing biologic therapy at a tertiary dermatology center in Southeastern Europe to evaluate potential correlations with SK development. Smokers had fewer SKs, whereas postmenopausal women and osteoporosis patients had significantly higher SK counts, implicating hormonal influences. PUVA therapy was linked to an increased SK count, whereas UVB and methotrexate treatments had a lesser effect. These findings suggest that biologic therapy and systemic factors may influence SK development, emphasizing the need for further prospective research.
Background and Objectives: Retinopathy of prematurity (ROP) persists as a major global cause of preventable childhood blindness. While early diagnosis and timely intervention can significantly mitigate visual loss, research is increasingly focused on identifying novel prognostic factors, with hematological markers emerging as a promising avenue for refining ROP risk prediction. This study aimed to assess the association of hemoglobin levels, red blood cell count, platelet count, and blood transfusions with the risk of developing ROP. Materials and Methods: We conducted a retrospective study involving 140 preterm infants (gestational age ≤ 34 weeks) admitted to a neonatal intensive care unit between 2021 and 2024. Hematological parameters were monitored sequentially during the first 28 days of life, and ROP screening was performed in accordance with international guidelines. Statistical analyses evaluated associations between hematological markers and the risk of developing ROP. Results: Anemia prevalence was significantly higher in infants who developed ROP (83.1%) compared with those who did not (60.3%), conferring an increased risk of ROP (OR = 3.239; p = 0.001). Red blood cell transfusions were linked to a higher likelihood of developing ROP (OR = 3.088; p = 0.001), while platelet transfusions showed a similar association (OR = 2.807; p = 0.027). Platelet counts were significantly lower on days 7, 14, and 21 in the ROP group, and thrombocytopenia was associated with an elevated risk of disease (OR = 3.542; p = 0.001). Conclusions: Early hematological imbalances (anemia, thrombocytopenia) and the requirement for blood product transfusions are significantly associated with an increased risk of ROP. Integrating the monitoring of these specific parameters into existing ROP screening protocols could enhance early identification of vulnerable preterm infants, enabling more targeted surveillance and potential preventative strategies.
11 March 2026 in Electronic Journal of General Medicine
A rare renal-adrenal pathology found in an anxious and achondroplastic patient. The aim is to explore renal-adrenal fusion and to find a link between achondroplasia, anxiety and this extremely rare diagnosis, which was associated with another rare finding, an ectopic adrenal gland. Emphasis was put on the patient’s medical decision having devastating results. Only 18 medical literature reports were found up until 2023 regarding renal-adrenal fusion, a diagnosis which is made mostly incidentally, in imaging studies. The case-based analysis was focused on the patient’s background concurrent pathologies–achondroplasia and anxiety disorder, with literature insights on the renal-adrenal fusion (identified as a 1.8 × 1.7 × 0.7 cm mass on the superior renal pole) with ectopic adrenal gland. The patient’s evolution from the initial uncertain diagnosis to the rash and anxiety-induced surgical decision (against medical advice), to the final diagnosis revealed by pathology examination. The rarity of this pathology and the complexity of the patient’s case have important implications in clinical practice.