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Using transluminal procedures with platelet-rich plasma therapy improves the blood perfusion to the distal portions of the limb in patients with critical ischemia in a short time, which is an informative diagnostic criterion for wound healing after amputation. Plasmatic membranes create an optimal environment for tissue regeneration, thus reducing the wound closure time using an auto-dermal transplant. ©Carol Davila University Press.This study empirically illustrates the mechanism by which epidemiological effect measures and statistical evidence can be misleading in the presence of Simpson's paradox and identify possible alternative methods of analysis to manage the paradox. Three scenarios of observational study designs, including cross-sectional, cohort, and case-control approaches, are simulated. In each scenario, data are generated, and various methods of epidemiological and statistical analyses are undertaken to obtain empirical results that illustrate Simpson's paradox and mislead conclusions. Rational methods of analysis are also performed to illustrate how to avoid pitfalls and obtain valid results. In the presence of Simpson's paradox, results from analyses in overall data contradict the findings from all subgroups of the same data. This paradox occurs when distributions of confounding characteristics are unequal in the groups being compared. Data analysis methods which do not take confounding factor into account, including epidemiological 2×2 table analysis, independent samples t-test, Wilcoxon rank-sum test, chi-square test, and univariable regression analysis, cannot manage the problem of Simpson's paradox and mislead research conclusions. Mantel-Haenszel procedure and multivariable regression methods are examples of rational analysis methods leading to valid results. Therefore, Simpson's paradox arises as a consequence of extreme unequal distributions of a specific inherent characteristic in groups being compared. GF109203X supplier Analytical methods which take control of confounding effect must be applied to manage the paradox and obtain valid research evidence regarding the causal association. ©Carol Davila University Press.Patients with combined coronary heart disease and diabetes mellitus make up a growing segment of the population and require a comprehensive treatment approach. Patients with concurrent diabetes mellitus and coronary heart disease have a worse projection. Under these conditions, the incidence of recurrent myocardial infarction, early disability due to complications, and the risk of coronary death are increased. Therefore, the priority task is to find ways to optimize drug treatment of this category of patients, taking into account the impact of drugs on the pathogenetic links of coronary heart disease progression and the development of cardiovascular complications. One hundred twelve people were examined in the research. The patients had type 2 diabetes with a history of non-Q-myocardial infarction receiving oral antidiabetic therapy and basic therapy, including an ACE inhibitor, a β-blocker, a statin, and an antiplatelet agent. Analysis of the investigated parameters in the leading group after receiving alpha-lipoic acid for 4 months showed a significant decrease in the concentration of C-Reactive Protein, IL-6 and TNF-α. According to the results of our research, taking alpha-lipoic acid for 4 months in patients with type 2 diabetes who underwent non-Q-myocardial infarction reduced the activity of systemic inflammation and did not significantly affect the content of anti-inflammatory IL-10 in patients. In light of the above, it is of interest to administer alpha-lipoic acid to these patients, considering the positive effects of the agent such as antioxidant properties, vasorelaxation, positive metabolic profile, as well as an anti-inflammatory potential. ©Carol Davila University Press.In surgical practice, surgeons request CT scans to rule out acute appendicitis, even in young patients. We aimed to assess the feasibility of using a CT scan to reduce the rate of negative laparoscopies in patients younger than 40 with equivocal signs of acute appendicitis. Therefore, we conducted a retrospective observational study on the patients admitted with a provisional diagnosis of acute appendicitis. Patients younger than 40 and with the Alvarado score between 3 and 6 were included. These were divided into two groups those who had or did not have a CT scan. Each group was further subdivided into patients that had a laparoscopy and those that did not. Out of 204 patients included in the study, 16% were included in the CT group, and 84% in the non-CT group. 71.9% of the patients that underwent a CT scan had appendicitis and underwent an appendectomy. Five patients with a normal CT scan had appendectomy due to persistent signs of acute appendicitis. The histopathology of the 23 patients with positive CT was positive, and 3 of the 5 patients with negative CT that underwent appendectomy had positive histology results. The negative appendectomy rate for patients that had preoperative CT is 7.14% compared to 32.4% in patients without preoperative CT. The rate of negative laparoscopy in patients younger than 40 years old that undergo preoperative CT is significantly lower with a p-value of .00667. ©Carol Davila University Press.Immunopathogenesis of inflammatory and dystrophic diseases of the tissues of the oral cavity is characterized by cellular and humoral factors of specific and nonspecific resistance, the functioning of which is determined by the overall somatic state. This study aimed to study the features of protective mechanisms of the oral cavity due to orthodontic pathology, pathology of periodontal tissues, and odontogenic inflammatory process in children with diffuse nontoxic goiter. Eighty children with diffuse nontoxic goiter aged 12-15 years with different dental status were examined. Evaluation of local immunity of the oral cavity was carried out by determining the content of sIgA, IgA, IgG, lysozyme activity, and levels of IL-1β, IL-4 by enzyme immunoassay. Immunological studies have shown that in children with diffuse nontoxic goiter, the activity of lysozyme in the oral fluid is decreased. The level of sIgА is also reduced by about 20%. Besides, there is an increase in the content of IgG and a growing trend in the level of IgА.
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