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Purpose: to realize a comparative analysis of demographic characteristics and outer diameters of the arteries of the circle of Willis (CW) according to the presence/absence of ischemic stroke. Material and methods: We performed a retrospective study on 166 adult patients, hospitalized in „Prof. dr. N. Oblu" Emergency Clinical Hospital from Iaşi, in the period of 12 years, who died during hospitalization and on whom an autopsy was performed in order to determine the cause of death. The subjects were divided into 2 groups: (1). 48 patients without stroke; (2) 118 patients with ischemic stroke. Demographic data, causes of death, and outer diameters of CW arteries were collected and compared between the two groups of patients. Results: Patients with ischemic stroke were older (67.49±12.96 years) compared to those without stroke (60.33±15.67 years). 61.8% of ischemic stroke patients were male, and non-stroke patients were predominantly female (60.4%). 58.5% of those with ischemic stroke and 64.6% of patients without stroke came from rural areas. The median diameter (mD) of the ACoA was statistically significantly lower in patients with ischemic stroke (1.10 mm) compared to the others (1.40 mm); mD of right ACA was lower in patients with ischemic stroke (1.70 mm) compared to patients without stroke (1.80 mm). mD of right and left PCoAs were statistically significantly smaller in patients with ischemic stroke (0.30 mm, each) compared to those without stroke (0.60 mm, each). mD of right and left PCoAs were similar in both groups of patients (1.90 mm). Conclusions: The present research found that ischemic stroke patients were elderly, predominantly of male gender, and expressed a reduction of the external diameters of the anterior communicating artery, right anterior cerebral artery, right and left posterior communicating arteries, while patients without stroke did not show such vascular morphological changes. [ABSTRACT FROM AUTHOR]

Circle of Willis (CoW) is located at the base of the brain, around the optic chiasm and other structures of the interpeduncular fossa. There are other studies in which the „circle of Willis" is not considered a circle, but an arterial polygon with a variable number of sides (from six to ten) depending on the author. Circle of Willis is composed of an anterior arch, which derived from the internal carotid artery and is made of the two paired anterior cerebral arteries and anterior communicating artery, and a posterior arch, made of posterior cerebral artery originating in the vertebrobasilar system, and the two paired posterior communicating arteries, having their origin in the internal carotid system. In this paper we present a comprehensive review of the data regarding the anatomical course and morphological aspects of each of the arteries constituting the circle of Willis, along with their anatomical variants and the pathology that emerged from these anomalies, pointing out their significance for the clinicians. [ABSTRACT FROM AUTHOR]

Circle of Willis is a particular arterial structure that represents an anastomosis between the vertebrobasilar system and the internal carotid system. Many anatomical variants of the constituent arteries of the circle of Willis have been reported so far, both in origin and in length and thickness. In this article we will present the case of an adult male patient with anatomical variants in three of its constituent arteries of the circle of Willis, as well as an anatomical variant of the left vertebral artery, which was associated with the presence of smoking, alcoholism, hypertension and atherosclerosis, who presented a right thalamic hematoma that was followed after 15 months by an ischemic stroke of the brainstem, with a poor prognosis because it cause the patient's death. We will discuss the particular aspects of the case and compare them with the literature. Our case presentation emphasized the fact that the anatomic variants of circle of Willis has significant consequences on its compensatory capacity during stroke, especially in patients with atherosclerotic stenosis and associated hypertension where they can impact patterns of hemorrhagic and ischemic cerebral pathology and in the same time can be crucial in providing effective patient care. [ABSTRACT FROM AUTHOR]

The aim of this paper is to present the morphological aspects identified on head CT scans and on autopsy in an adult patient with a ruptured aneurysm located on the Anterior Communicating Artery (ACoA) and associated with an asymmetric circle of Willis (CW) due to the numerous anatomical variants of its constituting arteries. We pointed out that even though there are authors who are in favor of one or the other of the three theories regarding the mechanism of aneurysm development, i.e. the genetic predisposition, the congenital abnormalities, or the hemodynamic vascular stress, we consider that all these theories could be taken into consideration in the same patient with an intracranial aneurysm as in the case presented here we identified four different anatomical variants of the constituting arteries of the CW that were associated with a ACoA aneurysm. Our case presentation could have practical significance for anatomists from a teaching point, as well as for neurosurgeons treating a patients with a sudden subarachnoid hemorrhage as an angio - CT should be employed as early as possible to identify not only the site of a possible aneurysm, but also the possible anatomical vascular variants of CW in order to provide a better prognosis and the best chance of survival for the patient. [ABSTRACT FROM AUTHOR]

To date, many studies investigated cerebral circulation due to the clinical significance of circle of Willis (CW) anatomical abnormalities. Various techniques have been used to study the anatomical variants of CW, but non-autopsy investigations have some certain limitations in detecting anatomical variants. Studying morphology of CW constituent arteries on specimens taken during the autopsy allows a direct and wide view of the vessels at the base of the brain. The purpose of this study is to investigate the clinical significance of anatomical abnormalities/variants of CW arteries in the population sample from the North-East region of Romania by assessing the causes of cerebral vascular mortality. This study included patients who died of various medical causes in the Emergency Clinical Hospital "Prof. dr. N. Oblu" Iaşi, in a period of 30 months (01.01.2014-30.06.2016), and who were subjects of a rutine autopsy. Out of the total of 96 available human brains, 28 cases (29.17%) were classified as "abnormal" or "anatomical variants" and these were the cases that were analysed in this research. In this group, 53.57% were males, and the mean age of the cases was 61.78 years. 60.71% of patients with anatomical variations of CW died of cerebrovascular diseases, and 39.29% died of other medical causes, on the first rank being acute myocardial infarction (17.85%). Knowing the frequency of anatomical variations of CW arteries in the population of Moldova can be useful in planning surgery for cerebral aneurysms, to avoid accidental vascular trauma during surgery and can be reported in current anatomy treatises. [ABSTRACT FROM AUTHOR]

This article explores the intricate anatomy of the thyroid gland, highlighting its structure, vascular supply, and lymphatic drainage. The thyroid gland, a crucial endocrine organ, is situated in the anterior neck and plays a vital role in regulating metabolism through hormone production. The anatomy is characterized by its relationship with surrounding structures, including major arteries such as the superior and inferior thyroid arteries, and important veins that drain into the internal jugular vein. Special attention is given to the recurrent laryngeal nerve and superior laryngeal nerve, which are critical in surgical considerations. Additionally, the lymphatic drainage pathways are discussed, emphasizing their significance in the context of thyroid cancer metastasis. Understanding the detailed anatomy of the thyroid gland is essential for healthcare professionals, particularly in surgical and oncological practices. [ABSTRACT FROM AUTHOR]

Developmental abnormalities and malformations of the breast are uncommon and include a range of genetic, acquired, and sporadic conditions. These abnormalities can lead to irregularities in the nipple-areolar complex and/or the underlying glandular tissue, resulting in either underdevelopment or overdevelopment of the breasts. The age at which these abnormalities present and their clinical severity depend on the underlying biological cause. Such abnormalities can affect either one or both breasts, particularly in conjunction with syndromic conditions or endocrine disorders. Disordered development may also be localized, giving rise to tumor-like lesions such as hamartomas, pseudoangiomatous stromal hyperplasia, and gynecomastia. This review will explore the various disorders of breast development. [ABSTRACT FROM AUTHOR]

Suicide is a phenomenon with a global impact, with 726,000 cases recorded annually, according to the World Health Organization. It represents the 3rd leading cause of death in the 15-30 age group. Material and Method: Our study identified suicide cases through a retrospective analysis of all death cases recorded in the archives of the Institute of Legal Medicine Iaşi, over a period of 10 years. According to current legislation, all suicide cases must involve a mandatory medico-legal autopsy to differentiate between a possible homicide or an accident. Results: Our group consisted of 1,301 completed suicide cases, with an average of approximately 130 cases per year. The incidence was higher in rural areas (69%) and among males (81%). In terms of method, hanging was the most frequently method used in both urban and rural areas. Suicidal motivation varied, but mood disorders, especially depression, were the most common psychiatric disorders, triggered by various reasons: abandonment, loss of a loved one, family conflicts, other health issues (disability - leg amputation, cancer history, alcohol or drug addiction, gambling). Conclusions: In our study, one of the most frequent risk factors for suicide was mood disorder, especially depression and anxiety, triggered by various factors. It is crucial to detect psychiatric patients with suicidal ideation and treat these conditions appropriately to prevent the global phenomenon of suicide. [ABSTRACT FROM AUTHOR]

The craniopharyngeal canal, occupied by the hypophyseal diverticulum, passes through the pair of pituitary cartilages. The pituitary cartilages join on the anterior midline to form the presphenoid. Dorsally, the pituitary cartilages also join on the midline to form the basisphenoid that forms the sella turcica on the midline. In anatomical terms, the sella turcica lies posterior to the jugum sphenoidale. Basically, a chiasmatic groove is first noticed posterior to the jugum sphenoidale, because the optical chiasm is located at this level. Behind the chiasmatic groove there is a round or oval prominence called the tuberculum sellae. Posteriorly, the sella turcica is closed by a squareshaped plate of bone called the dorsum sellae which contains the posterior clinoid apophyses on its upper edge. [ABSTRACT FROM AUTHOR]

The electric power systems together with the entire energy sector are rapidly evolving towards a low-carbon, secure, and competitive economy facing revolutionary transformations from technical structure to economic value chain. Pathways to achieve sustainability led to the development of new technologies, accommodation of larger shares of unpredictable and stochastic electricity transfer from sources to end-users without loss of reliability, new business models and services, data management, and so on. The new technologies and incentives for local energy communities along with large development of microgrids are main forces driving the evolution of the low voltage energy sector changing the context and paradigm of rigid contractual binding between utilities and end-user customers (now progressing to flexible prosumers with generation and storage capabilities). The flexibility and operation of a prosumer can be enhanced by a non-intrusive time-frequency analysis of distorted power quality waveforms for both generation and demand at the point of common connection. Therefore, it becomes of importance to discriminate among successive quasi-steady-state operation of a given local system using only the aggregated waveforms information available in the PCC. This paper focuses on the Hilbert–Huang method with modifications such as empirical mode decomposition improved with masking signals based on the Fast Fourier Transform, Hilbert spectral analysis, and a post-processing method for separating components and their amplitudes and frequencies within distorted power signals for a low-voltage prosumer operation. The method is used for a time-frequency-magnitude representation with promising localization capabilities enabling efficient operation for prosumers. [ABSTRACT FROM AUTHOR]

Chronic neuropathic pain secondary to previous surgery causes a significant decrease in quality of life. Objectives: This study aims to evaluate the effectiveness of spinal neurostimulator in patients with chronic neuropathic pain refractory to treatment. Methods: We analyzed the Visual Analogue Scale (VAS) pain score before and after spinal neurostimulator implantation, as well as the optimal anatomical location of the electrode, where the intensity of pain experienced by the patient is minimal. Results: This study included 60 eligible patients, with a mean age of 53.87 ± 12.033 years. The patients suffered between 1 and 9 spinal surgery prior to spinal implant, the most frequent cases (36.7%) having 3 prior interventions. In 26/60 (43.3%) cases, the neuropathic chronic pain started within the first year from the surgical intervention. Considering the causes of the neuropathic chronic pain, four main categories have been identified: herniated disk, lumbar stenosis, spondilolistezis, and spine fractures, as well as other pathologies. Before the implant, the highest mean VAS score was 10.00 in the cervical spinal region (C3) and thoracal region (D12). Patients showed a significant decrease of pain after the implant in the same regions, with a mean VAS score of 2.00. The pain intensity, determined by VAS score, was significantly reduced (p = 0.032) after implant, mainly when it registered high values (9 or 10). Conclusions: The results demonstrate that the spinal cord stimulator located in the cervical C3 and thoracal D12 is an effective therapeutic option for patients with chronic neuropathic pain refractory to treatment. [ABSTRACT FROM AUTHOR]

Being familiar with the clinical evaluation of the breast, as well as being able to understand breast conditions, is important to many medical specialties. The most effective way to handle management is by employing a multidisciplinary team approach. Precisely timed surgical interventions play a crucial role in maximizing psychological, aesthetic, and functional results. Familiarity with the embryology and anatomy of the female breast is essential for a thorough clinical examination and the application of suitable surgical treatments. This article aims to explore the typical embryology and anatomy of the adolescent female breast. [ABSTRACT FROM AUTHOR]

Deposition of bioactive coatings composed of zinc oxide, cyclodextrin and cefepime (ZnO/CD/Cfp) was performed by the Matrix Assisted Pulsed Laser Evaporation (MAPLE) technique. The obtained nanostructures were characterized by X-ray diffraction, IR microscopy and scanning electron microscopy. The efficient release of cefepime was correlated with an increased anti-biofilm activity of ZnO/CD/Cfp composites. In vitro and in vivo tests have revealed a good biocompatibility of ZnO/CD/Cfp coatings, which recommend them as competitive candidates for the development of antimicrobial surfaces with biomedical applications. The release of the fourth generation cephalosporin Cfp in a biologically active form from the ZnO matrix could help preventing the bacterial adhesion and the subsequent colonization and biofilm development on various surfaces, and thus decreasing the risk of biofilm-related infections. [ABSTRACT FROM AUTHOR]

Most therapeutic agents primarily target cells and tissues in an area of specific pathology. The key to therapeutic success is the targeted release of different drug species at the cellular and subcellular level. The most important obstacle to achieving drug efficacy is the nonspecific distribution of the biologically active substance after administration. By understanding the various factors that can affect oral absorption, there is an opportunity to develop safe and effective nanosystems to improve the oral delivery of therapeutics, alleviating many of the challenges of oral therapy and ultimately benefiting patients. Achieving comprehensive knowledge about the penetration mechanism and biological fate of ingested nanoparticles is very challenging due to intra- and inter-individual variations in gastric emptying time, pH, gastrointestinal flora GI tract composition and mucus layer thickness. [ABSTRACT FROM AUTHOR]

Gliomas are primary brain tumors that grow from glial cells. These include about 50-55% of all brain tumors. The notion of glial formation incorporates a heterogeneous group of tumors, biological features, treatment and prognosis of which can vary significantly. Currently, glial tumors are tumors that originate from oligodendroglial and astrocytic cells. Glioblastomas and gliomas are the most common brain tumors, with an annual incidence of 5.5 per 100,000 population or 18,000 new diagnoses per year. These tumors are usually associated with a poor prognosis and poor quality of life. The brain is the major organ of the central nervous system that controls and processes most of the body activities. Therefore, the most aggressive brain tumor, namely glioblastoma but also the metastases of other tumors with brain location have a reserved prognosis and a short survival time. Brain tissue has peculiarities compared to other tissues in the body, and the specific microenvironment comprising stem cells and blood-brain barrier, significantly influencing the low rate of glioblastoma metastasis outside the brain. The clinical manifestations of astrocytic tumors depend on the location and pace of tumor development. Well-differentiated diffuse astrocytomas may remain without manifestations for a relatively long period of time. At the same time, people who have developed a glioblastoma may show a rapid deterioration of the general condition. It is very important to understand the morphological classification of glial tumors because complete knowledge of tumor structures and the degree of malignancy can help optimize treatment for each tumor. [ABSTRACT FROM AUTHOR]

The maxillary sinus is the largest of the paranasal sinuses and is situated in the body of the maxilla. Pyramidal in shape, the base (medial wall) forms part of the lateral wall of the nose, while the apex extends into the zygomatic process of the maxilla. The floor is formed by the alveolar process and part of the palatine process of the maxilla, and the roof contributes the major part of the floor of the orbit. Ous study is made on 58 patients investigated at the hospital „Prof. Dr. N. Oblu" in 2006 which realised CT of the head and presented head pain, naussea and vertiginous syndrom but not another obvious modifications at the level of the head. Our results demonstrate that the maxillary sinus presents a lot of anormal or anusual situations, most of them associated with acut or chronic sinusitis. [ABSTRACT FROM AUTHOR]

The Holy Bible includes descriptions of the spine with both neurosurgical and neurological implications and most spinal disorders presented have been briefly described and display a mystical nature. The Holy Bible is a book full of sacred precepts and not a medical encyclopedia as it was written in the context of that age, and in a language that had to be understood by people of that era. This paper aims to give a short presentation of several diseases of the spine mentioned in the Holy Scripture in order to identify the most common disease among the Jews during biblical times and attempts to provide their diagnosis. [ABSTRACT FROM AUTHOR]

As products of human imagination, anatomical terms tell us unwritten stories and represent the joy of random or unceasing discoveries of anatomical structures for which anatomists coin names and which they bring to life. This paper proposes an incursion into the history of the anatomy of the cribriform plate of the ethmoid bone, from its first likeness to the Roman sieve made by Galen, to the advancements made in anatomy in the 16thcentury by the Italian anatomist Gabriel Fallopius. [ABSTRACT FROM AUTHOR]

Bartter's syndrome is a rare condition, described for the first time by Bartter and coauthors in 1962. It currently represents a group of interrelated inherited renal tubular disorders, characterized by hypokalemia, hypochloremia, metabolic alkalosis and hyperreninemia with normal blood pressure and no associated edema. We present the case of a 51-year-old woman with Bartter's syndrome who presented to our clinic complaining of polyuria, polydipsia, dehydration, night sweats, cough episodes, chills,fever, and weight loss, that had been present for about three weeks. Surprisingly, the laboratory tests revealed the presence of Mycobacterium Tuberculosis by positive microbiological smears and positive cultures. It is a therapeutic challenge to treat a patient with Bartter's syndrome complicated with end-stage renal failure, being on nephrotoxic antibiotics for tuberculosis. The case is distinct first of all because of the late diagnostic time at the age of 39, and the long course of the disease namely 12 years with proper therapy throughout all of this period. On the other hand, the long follow tip of our case was characterized by multiple admissions the last one being very important as the patient had been diagnosed with pulmonary tuberculosis. The presentation of this case is a good opportunity to highlight the immunodepression caused/associated with renal tubulopathies, respectively Bartter's syndrome. We consider that additional studies are welcome and further more, essential in understanding the complex mechanisms that characterize tins rare disorder. [ABSTRACT FROM AUTHOR]

One of the main challenges in smart city models is consumer behaviour, namely guiding the efforts to promote optimal use of energy in the dynamics of the developing cities, through lower energy consumption without impact on the comfort level. This relates to all energy vectors and can be done through different means. The uptake stage of smart metering and information and communication technologies (ICT) varies in different countries, creating the need for tailored innovative approaches in motivating behavioural change. This paper presents the work carried out within the joint research project ITCity (an ICT platform for sustainable energy ecosystem in smart cities) between the European Union and Latin American Countries. Cooperation of energy researchers and experts in ICT and application developers facilitates adoption of a multipurpose interdisciplinary approach. This work aims at providing the smart city and energy research and innovation community broader understanding of factors influencing adoption of energy efficiency technologies. Different ways of guiding optimal energy use are addressed elaborating on the building blocks for a smart city which consider load patterns based on high resolution, high reporting rate measurements, extensive consumer surveys, available communication solution analysis and end-user interaction with the ICT tool based on gamification principles. [ABSTRACT FROM AUTHOR]