22 research outputs found
Obesity, Osteoarthritis, and Myokines: Balancing Weight Management Strategies, Myokine Regulation, and Muscle Health
No full textObesity and osteoarthritis (OA) are increasingly prevalent conditions that are intricately linked, with each exacerbating the other’s pathogenesis and worsening patient outcomes. This review explores the dual impact of obesity on OA, highlighting the role of excessive weight in aggravating joint degeneration and the limitations OA imposes on physical activity, which further perpetuates obesity. The role of muscle tissue, particularly the release of myokines during physical activity, is examined in the context of OA and obesity. Myokines such as irisin, IL-6, and myostatin are discussed for their roles in metabolic regulation, inflammation, and tissue repair, offering insights into their potential therapeutic targets. This review emphasizes the importance of supervised weight management methods in parallel with muscle rehabilitation in improving joint health and metabolic balance. The potential for myokine modulation through targeted exercise and weight loss interventions to mitigate the adverse effects of obesity and OA is also discussed, suggesting avenues for future research and therapy development to reduce the burden of these chronic conditions
Obesity, Metabolic Syndrome, and Osteoarthritis Require Integrative Understanding and Management
No full textOsteoarthritis (OA) is a progressive chronic disease affecting the articular joints, leading to pain and disability. Unlike traditional views that primarily link OA to aging, recent understanding portrays it as a multifactorial degenerative disease of the entire joint. Emerging research highlights metabolic and immune dysregulation in OA pathogenesis, emphasizing the roles of obesity, dyslipidemia, and insulin resistance in altering joint homeostasis. Recent studies have increasingly focused on the complex role of white adipose tissue (WAT) in OA. WAT not only serves metabolic functions but also plays a critical role in systemic inflammation through the release of various adipokines. These adipokines, including leptin and adiponectin, have been implicated in exacerbating cartilage erosion and promoting inflammatory pathways within joint tissues. The overlapping global crises of obesity and metabolic syndrome have significantly impacted joint health. Obesity, now understood to contribute to mechanical joint overload and metabolic dysregulation, heightens the risk of developing OA, particularly in the knee. Metabolic syndrome compounds these risks by inducing chronic inflammation and altering macrophage activity within the joints. The multifaceted effects of obesity and metabolic syndrome extend beyond simple joint loading. These conditions disrupt normal joint function by modifying tissue composition, promoting inflammatory macrophage polarization, and impairing chondrocyte metabolism. These changes contribute to OA progression, highlighting the need for targeted therapeutic strategies that address both the mechanical and biochemical aspects of the disease. Recent advances in understanding the molecular pathways involved in OA suggest potential therapeutic targets. Interventions that modulate macrophage polarization, improve chondrocyte function, or normalize adipokine levels could serve as preventative or disease-modifying therapies. Exploring the role of diet, exercise, and pharmacological interventions in modulating these pathways offers promising avenues for reducing the burden of OA. Furthermore, such methods could prove cost-effective, avoiding the increase in access to healthcare
Rifampicin-Loaded PLGA/Alginate-Grafted pNVCL-Based Nanoparticles for Wound Healing
No full textThe topical therapy with rifampicin (RF)-based formulations is beneficial for treating postoperative wound infections and to accelerate healing. Despite recent research highlighting the antibiotic’s significant anti-inflammatory properties, limited topical wound healing products are currently available. The present study aimed to prove that the newly synthesized nanoparticles based on grafted alginate and poly(N-vinylcaprolactam) (pNVCL) and poly-lactic-co-glycolic acid (PLGA) contribute to the healing process of a wound. The methods used were at first the synthesis of the copolymer of alginate and pNVCL via grafting from technique and radical polymerization followed by water-in-oil-in water (W/O/W) emulsification; as oil phase PLGA dissolved in dichloromethane (DCM) was used. The formed nanoparticles were than characterized. The loaded RF was determined to be 160 µg/mL for a 20 mg formulation and within a four-hour time frame approximately 10% of the total loaded amount was released. The inhibitory concentrations (IC50) were 192.1 µg/mL for the nanoparticle, 208.8 µg/mL for pure rifampicin, and 718.1 µg/mL for the rifampicin-loaded nanoparticles. Considering the double role rifampicin was used for, the result was considered satisfactory in the way that these formulations could be used predominantly for postoperative wound irrigation in order to avoid infections and to improve healing
Dexketoprofen-Loaded Alginate-Grafted Poly(N-vinylcaprolactam)-Based Hydrogel for Wound Healing
No full textAll acute and chronic wound management strategies have limitations. Therefore, there is an urgent need to develop new treatment options for wound healing. Hydrogels based on natural polymers offer advantages in wound management because they can reduce patients’ pain, fight infection, and carry targeted drugs to speed up the healing process. In this study, we aimed to develop and investigate an alginate-grafted N-vinylcaprolactam-based matrix for a modified release of dexketoprofen (DEX), which is potentially useful in wound healing. Free radical polymerization and grafted techniques were used to prepare thermo-responsive hydrogels. The obtained hydrogels, unloaded hydrogel (HY) and dexketoprofen-loaded hydrogel (DEXHY), were characterized and analyzed. The concentration of DEX encapsulated in the polymer matrix was 4 mg/mL. The IC50 values found for the samples tested by us were 607.4 µg/mL for HY, 950.4 µg/mL for DEXHY, and 2239 µg/mL for DEX. The average value of cell viability (%) after the exposure of cells to DEXHY hydrogel was 75.4%. DEXHY exhibited a very good in vitro wound closure rate, given its ability to modify DEX release kinetics. The hydrogel developed in this study has shown considerable potential to facilitate and even accelerate wound healing, including surgical wounds, by inhibiting the overexpressed inflammation process
Clinicopathological Characteristics of Incidental Papillary Thyroid Microcarcinoma in an Endemic Goiter Area
No full textPapillary thyroid microcarcinoma (PTMC) is a common malignant disease of the endocrine system, which has rapidly increased in incidence and prevalence in recent decades. The aim of our paper was to identify correlations between pathological and clinical features of cases of PTMC. A total of 612 patients of both genders, who were operated on for benign thyroid diseases in the 3rd Surgical Unit of St. Spiridon University Hospital of Iasi, were monitored for a period of 2 years. According to pathological reports, PTMC was diagnosed in 144 cases. Of those cases, 81.2% were female and 18.8% were male, with an overall mean age of 54.77 ± 11.9 years. The mean diameter of tumors was 3.04 ± 2.2 mm (75.7% were under 5 mm), and 35.4% were multifocal tumors. Of all tumors studied, 76.4% were the follicular variant, 13.2% were conventional, and 10.4% of cases included tall cell, hobnail, or columnar variants. The underlying diseases were multinodular goiters (73.6%), adenomas (25%), Hashimoto thyroiditis (17.4%), Basedow’s disease, and other types of hyperthyroidism (4.9%), primarily hyperparathyroidism (7.6%), with a small percentage presenting a combination thereof. Extracapsular invasion was present in 14.6% while 5.6% presented perineural invasion and 0.7% of cases had vascular invasion. Lymphatic emboli were found in 9% of cases and lymph node metastasis in 5.6% of cases. PTMC is not as innocent as believed, and further studies, performed on larger batches, would be necessary in order to identify high oncological risk cases and to determine when a more aggressive surgical approach is indicated
Biological and behavioral aspects regarding combined systemic management of alcohol dependence
No full textAlthough there are numerous ideas on the management of alcohol dependence,
ranging from various schemes of pharmacologic treatment to specific
psychotherapeutic approaches, the reviews and meta-analyses reveal only
modest effects of these approaches. Another approach regarding the problem of
alcohol is based on the behavioral biology, specifying that consumption of
alcohol is actually a type of behavior, a way of life. The results presented
in this report provide evidence to support the idea that the systemic,
ethological approach of alcohol-related and complex problems brings
additional value when complementing the standard medicinal therapy, both in
terms of achieving and maintaining abstinence, as well as in improving the
quality of life for the patients
Biochemical Manifestations of Gastroesophageal Reflux Disease Progression in Children: A Single Center Case-Control Study
No full textGastroesophageal reflux disease (GERD) is a common digestive condition, representing one of the most frequent reasons for medical examination, especially in pediatric gastroenterology departments. GERD could be associated with biochemical alterations representing either its systemic manifestations or markers of complications. The aim of our paper was to evaluate biochemical parameters secondary to GERD in children. Two hundred and sixty-seven children of both genders aged between 1 month and 18 years who displayed suggestive symptoms for this condition were included in the study and were monitored for a period of 5 years. Depending on the range of symptoms and technical possibilities, the following procedures/investigations were performed: esophageal pH monitoring and imagistic or endoscopic examination, besides specific biochemical investigations. The cohort was sub-divided into two groups: one that included 213 children with confirmed GERD who represented the study group and 54 healthy children where GERD had been excluded, the control group. Out of all the investigated children, 39.0% displayed low hemoglobin values, 43.7% displayed low values of erythrocyte indices (MCH), and 68.5% had increased erythrocyte sedimentation rate (ESR) values, while increased eosinophil levels were recorded in 46.9% of the cases. Such parameters were proven to be a biomarker of suspected eosinophilic esophagitis, whereas 32.9% of the cases displayed high blood glucose values that could be correlated with gastroesophageal reflux symptoms. Other measured parameters (such as magnesium, aminotransferases and proteins) remained within the normal limits, without statistically significant differences compared to in the control group. This condition is diagnosed based on invasive investigations, which are often difficult to accept by the patients’ parents. The biochemical modifications correlated to the clinical manifestations can anticipate the progression of the disease, thus limiting the necessity of performing invasive diagnosis tests
Biological and behavioral aspects regarding combined systemic management of alcohol dependence
No full textThe dynamics of some oxidative stress markers in 3, 6 and 12-months alcohol abstinent patients: possible relevance for the usage of antioxidants in alcohol withdrawal / Dinamica unor markeri ai stresului oxidativ la 3, 6 şi 12 luni de abstinenţă de la alcool: posibila relevanţă a utilizării de antioxidanţi
No full textÎn prezentul articol am fost interesaţi să studiem relevanţa stresului oxidativ în cadrul proceselor legate de abstinenţa de la alcool, având în vedere în special faptul că literatura de specialitate este extrem de controversată în acest domeniu de cercetare. Astfel, am determinat nivelul unor markeri specifici ai stresului oxidativ la pacienţii selectaţi după 3, 6 şi 12 luni de abstinenţă de la alcool. 62 de pacienţi de sex masculin au fost selectaţi pentru studiu. În cadrul studiului s-au prezentat 33 de pacienţi pentru determinările bazale, 14 pacienţi la 3 luni, 14 pacienţi la 6 luni şi 15 pacienţi la 12 luni de abstinenţa de la alcool, în timp ce lotul control a inclus 32 de persoane sănătoase, potrivite ca vârstă si sex-ratio cu celelalte grupuri de studiu. Astfel, în ceea ce priveşte rezultatele, în cazul superoxid dismutazei (SOD) am observat o diferenţă semnificativă între cele trei loturi de studiu (p<0.0001), precum şi o creştere semnificativă din punct de vedere statistic a valorilor SOD la pacienţii aflaţi la 3 luni (p<0.0001), 6 luni (p<0.0001) şi respectiv 12 luni (p<0.0001) de abstinenţa de la alcool, faţă de determinările bazale. De asemenea, în cazul glutation peroxidazei, am observat o diferenţă semnificativă din punct de vedere statistic între grupuri (p=0.0003), plus creşteri importante la 6 luni (p=0.03) şi 12 luni (p=0.006), faţă de determinările bazale. În ceea ce priveşte malondialdehida (MDA), ca şi principal marker al proceselor de peroxidare lipidică, am putut observa de asemenea diferenţe semnificative între grupurile de studiu (p<0.0001). Mai mult, în cazul tuturor celor 3 grupe de pacienţi s-au putut observa scăderi semnificative ale concentraţiei de MDA, în comparaţie cu determinările bazale (p=0.003 pentru 3 luni, p=0.01 pentru 6 luni şi p=0.0002 pentru 12 luni). În concluzie, aceste date confirmă un stress oxidativ crescut la pacienţii consumatori cronici de alcool şi, mai important decât atât, demonstrează o scădere semnificativă şi progresivă a statusului stresului oxidativ la 3, 6 şi 12 luni de abstinenţa de la alcool, aşa cum am putut observa din creşterea progresivă a activităţii specifice a enzimelor antioxidante determinate şi scăderea nivelelor de peroxidare lipidică
Twelve-Month Outcomes in Patients with Obesity Following Bariatric Surgery—A Single Centre Experience
No full textBackground: As obesity rates continue to rise worldwide, many surgeons consider bariatric procedures as a possible cure for the upcoming obesity pandemic. Excess weight represents a risk factor for multiple metabolic disorders, especially for type 2 diabetes mellitus (T2DM). There is a strong correlation between the two pathologies. The aim of this study is to highlight the safety and short-term results of laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB, laparoscopic gastric plication (LGP) and intragastric balloon (IGB) as methods used in the treatment of obesity. We followed the remission or amelioration of comorbidities, tracked metabolic parameters, weight loss curves and hoped to outline the profile of the obese patient in Romania. Methods: The target population of this study was represented by patients (n = 488) with severe obesity who qualified for the metabolic surgery criteria. Starting from 2013 to 2019, patients underwent four types of bariatric procedures and were subsequently monitored over the course of 12 months in the 3rd Surgical Clinic at “Sf. Spiridon” Emergency Hospital Iași. Descriptive evaluation indicators, as well as those of analytical evaluation were used as statistical processing methods. Results: A significant decrease in body weight was recorded during monitoring and was more pronounced for patients who underwent LSG and RYGB. T2DM was identified in 24.6% of patients. Partial remission of T2DM was present in 25.3% of cases, and total remission was identified in 61.4% of patients. Mean blood glucose levels, triglycerides, LDL and total cholesterol levels decreased significantly during monitoring. Vitamin D increased significantly regardless of the type of surgery performed, while mean levels of vitamin B12 decreased significantly during monitoring. Post-operative intraperitoneal bleeding occurred in 6 cases (1.22%) and a reintervention for haemostasis was required. Conclusions: All procedures performed were safe and effective methods of weight loss and improved associated comorbidities and metabolic parameters
