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Introduction Lung cancer (LC) is the most common cause of cancer-related deaths worldwide. Its early detection can be achieved with a CT scan. Two large randomised trials proved the efficacy of low-dose CT (LDCT)-based lung cancer screening (LCS) in high-risk populations. The decrease in specific mortality is 20%–25%.Nonetheless, implementing LCS on a large scale faces obstacles due to the low number of thoracic radiologists and CT scans available for the eligible population and the high frequency of false-positive screening results and the long period of indeterminacy of nodules that can reach up to 24 months, which is a source of prolonged anxiety and multiple costly examinations with possible side effects.Deep learning, an artificial intelligence solution has shown promising results in retrospective trials detecting lung nodules and characterising them. However, until now no prospective studies have demonstrated their importance in a real-life setting.Methods and analysis This open-label randomised controlled study focuses on LCS for patients aged 50–80 years, who smoked more than 20 pack-years, whether active or quit smoking less than 15 years ago. Its objective is to determine whether assisting a multidisciplinary team (MDT) with a 3D convolutional network-based analysis of screening chest CT scans accelerates the definitive classification of nodules into malignant or benign. 2722 patients will be included with the aim to demonstrate a 3-month reduction in the delay between lung nodule detection and its definitive classification into benign or malignant.Ethics and dissemination The sponsor of this study is the University Hospital of Nice. The study was approved for France by the ethical committee CPP (Comités de Protection des Personnes) Sud-Ouest et outre-mer III (No. 2022-A01543-40) and the Agence Nationale du Medicament et des produits de Santé (Ministry of Health) in December 2023. The findings of the trial will be disseminated through peer-reviewed journals and national and international conference presentations.Trial registration number NCT05704920.

Background and Objectives: Hypertensive disorders, particularly pre-eclampsia, pose significant risks during pregnancy, affecting both maternal and neonatal health. The study aims to analyze short- and long-term health implications for mothers and their children, comparing those with pre-eclampsia to those without, to improve understanding of risk factors, diagnostic markers, and outcomes. Materials and Methods: This retrospective observational study involved 235 patients, 98 with pre-eclampsia and 137 without, monitored from 2015 to 2018 at the Obstetrics and Gynecology Department of the "Pius Brînzeu" Emergency County Clinical Hospital in Timișoara, Romania. Results: Women with pre-eclampsia were older, had higher BMIs, and more frequently had a family history of pre-eclampsia, hypertension, and diabetes. They also had lower educational and socioeconomic levels and fewer prenatal visits. Biochemical markers such as higher proteinuria, elevated sFlt-1, and lower PlGF were significant in diagnosing pre-eclampsia. Short-term maternal complications like eclampsia, HELLP syndrome, and acute kidney injury were more prevalent in the pre-eclampsia group. Neonatal outcomes included higher rates of preterm birth, low birth weight, and NICU admissions. Long-term mothers with a history of pre-eclampsia had higher incidences of chronic hypertension, cardiovascular disease, kidney problems, diabetes, and mental health disorders. Their children faced increased risks of neuropsychological delays, chronic respiratory issues, behavioral disorders, learning difficulties, and frequent infections. Conclusions: The study highlights the significant short- and long-term health impacts of pre-eclampsia on both mothers and their children. Early monitoring, intervention, and comprehensive management are crucial in mitigating these risks. These findings underscore the need for personalized care strategies to improve health outcomes for affected individuals. [ABSTRACT FROM AUTHOR]

In March 2023, we identified a Salamandra salamandra individual in the Getic Piedmont, southwestern Romania. This finding confirms the presence of the species in the Getic Piedmont, where it was recorded only once, 13 years ago, and is only subsequently reconfirmed now. Even if the new distribution record is at only 350 m from a previous record, it is important because we have identified an adult in an atypical habitat, represented by a dry grassland at the top of a hill. However, there are forest and water courses in the vicinity, which are favorable habitats for the species. The new distribution record confirms the presence of S. salamandra in the Getic Piedmont, outside its Carpathian main range, and pleads for new studies in the region. [ABSTRACT FROM AUTHOR]

Background and Objectives: This longitudinal study investigated the correlation between imaging findings and self-reported questionnaire outcomes in patients with tibiofibular diastasis, exploring the effects of surgical screw removal versus conservative treatment. This study was conducted at "Victor Babes" University of Medicine and Pharmacy in Timisoara between 2018 and 2023. Materials and Methods: The study involved 85 patients in the screw removal group and 44 in the conservative group, assessed at 2 and 6 months post-surgery, answering the SF-36, HADS, and WHOQOL questionnaires. Results: Significant differences were observed at 2 months post-surgery, with the screw removal group showing lower shear wave velocities in ankle dorsiflexion (8.9 ± 1.4) and anterior talofibular ligament (2.8 ± 0.9), indicating better mobility compared to the conservative group (ankle dorsiflexion: 10.1 ± 1.8, ATFL: 3.2 ± 1.1). Radiographically, lower tibiofibular overlap (8.1 ± 2.1) in the screw removal group suggested improved joint fixation quality. These physical improvements were mirrored in the quality-of-life assessments, where the screw removal group reported higher physical health scores on the SF-36 survey at 2 months, a trend that continued at 6 months. At 2 months, ankle dorsiflexion demonstrated a strong negative correlation with the SF-36 Physical score (r = −0.417) and WHOQOL Physical domain (r = −0.394), and a positive correlation with HADS Anxiety (r = 0.312). Similarly, ATFL and CFL velocities negatively correlated with the SF-36 Physical score (ATFL: r = −0.251; CFL: r = −0.237). Radiographic tibiofibular overlap and clear space positively correlated with WHOQOL Physical domain (TOL: r = 0.291; TCS: r = 0.276), with TCS also negatively correlating with HADS Anxiety (r = −0.228). At 6 months, these correlations persisted, with notable negative correlations between ultrasound ankle dorsiflexion and both SF-36 Physical score and WHOQOL Physical domain. Conclusions: These findings underscore the advantages of screw removal in enhancing physical recovery and reducing anxiety in the short term, while indicating similar long-term mental health outcomes between treatment approaches. [ABSTRACT FROM AUTHOR]

Background and Objectives: While numerous studies have been conducted on syndesmotic screw management following distal tibiofibular diastasis repair, a clear consensus remains unclear. This research aims to evaluate whether the postoperative removal of syndesmotic screws leads to improved patient outcomes, specifically in quality of life, mobility, and daily living activities, and whether it offers a cost-effective solution. Materials and Methods: Patients with a history of unimalleolar or bimalleolar ankle fractures, classified according to the Danis–Weber and Lauge–Hansen systems, were included. Comprehensive evaluations were made via standardized questionnaires like the SF-36 Health Survey, HADS, and WHOQOL-BREF, distributed approximately 2 months post surgery. A total of 93 patients underwent syndesmotic screw removal while 51 retained the screws (conservative approach). Results: Patients who underwent screw removal reported superior satisfaction in mobility, with a score of 7.8, compared to 6.7 in the conservative approach (p = 0.018). Similarly, their ability to perform daily activities scored 8.1, higher than the 6.5 from the conservative cohort (p < 0.001). Pain levels were also more favorable in the screw removal group, with a score of 5.3 against 6.8 in the conservative group (p = 0.003). On the SF-36 physical domain, the screw removal group achieved a mean score of 55.9 versus 53.3 for the conservative group (p = 0.027). Notably, the HADS anxiety subscale highlighted reduced anxiety levels in the screw removal cohort with a mean score of 5.8 against 7.3 in the conservative group (p = 0.006). However, overall quality of life and recommendations to others showed no significant difference between the groups. Conclusions: Syndesmotic screw removal postoperatively leads to marked improvements in patients' mobility, daily activity abilities, and reduced postoperative pain and anxiety levels. However, overall quality of life was similar between the two approaches. The findings offer valuable insights for orthopedic decision making and patient-centered care concerning the management of syndesmotic screws after distal tibiofibular diastasis repair. [ABSTRACT FROM AUTHOR]

It has been observed that injuries, which involve only a part of the joint cartilage thickness, show a partial healing ability, but some healing potential is present in the case of injuries that affect the subchondral osseous tissue. The methods of treatment for chondral defects are nonsurgical: pharmacological chondroprotection (nutraceuticals containing chondroitin sulphate and glucosamine sulphate), viscosupplementation, PRP and cytokine modulation. The surgical options include palliative approaches, marrow stimulation, and cell-based regeneration techniques. The microfracturing technique has started to be used in the ’80s using equine models. The basic principle of microfracturing is to stimulate cartilage repair, not regeneration. It represents the first line of therapy for cartilage defects that affect its full thickness. The advantages of microfracturing are: it is a minimally invasive procedure, technical simplicity, decreased surgical morbidity, and low costs, thus making it a common procedure. However, microfracturing is not a bulletproof technique. There is a high rate of treatment failure after 5 years. Constant decline of the outcome during the 5-year follow-up after surgery is also described. Lesion size represents a better predictor regarding outcome, compared to age. The best results are obtained in young patients, small lesions and low-demand patients. Microfractures can be augmented using BMAC (bone marrow aspirate concentrate) containing 0-0.1% progenitor cells. The matrix aids in the improvement of microfractures, and it also increases the stability of the blood clot, acting as a barrier that avoids the fibroblast invasion of the graft. There is still a place for microfractures in chondral defects. Better results can be achieved with an improved technique, an optimized rehabilitation, and adding several augmentation techniques.

Byline: Charlotte. Cohen, Daniel. Pop, Olivier. Aze, Nicolas. Venissac, Jérôme. Mouroux Background: The aim of this study was to report our experience with video-assisted mediastinoscopy (VAM) in patients taking antiplatelet [...]

Transportation networks have a high negative impact on the fauna, impact considered more pronounced on roads than on railways. However, this fact is difficult to verify because most studies have focused on roads and just a few on railways, and comparative studies are exceptionally rare. Thereby, we set out to compare the fauna mortality on 2 km of road and railway parallel to each other to assess which is more deadly for the fauna. The two transportation networks were studied at the same time (in every month of 2021), in the same place (western Romania), and with the same method (pedestrian surveys). The number of corpses was much higher on the railway, yet the number of taxa and their diversity was higher on the road. On the railway, half of the victims were killed before the year of the study, and, by percentage abundance, over 90% of them belonged to a single taxon (Gastropoda with shells). On the contrary, none of the taxa exceeded 20% on the road. Thus, the answer to our question is complex because at least our data show that neither of the two transportation networks is necessarily more friendly to the environment, but each of them affects the fauna in a different way. The railway can be considered a trap (usually an indirect one) for snails, which cannot escape from it, but it kills other animals too. Although most animals seem to be able to avoid railway mortality, they are nevertheless killed on the adjacent road. The two transportation networks affect the fauna in a complementary way, probably having a cumulative negative effect. Nevertheless, the railway preserves the animal corpses for much longer than the road, which shows that the negative impact of roads is probably underestimated compared to railways. [ABSTRACT FROM AUTHOR]

There is still no general agreement about the most effective form of syndesmosis fixation with syndesmotic screws for patients affected by ankle fractures that are accompanied by syndesmotic injuries. In the same manner, no consensus has been reached yet on whether or not the tibiofibular syndesmotic screw is more beneficial if removed or not, as well as the exact timing of removal if this proves superiority. The purpose of this research was to verify whether or not removing syndesmotic screws reduces the risk of developing a diastasis and compare outcomes in patients whose syndesmotic screw was or was not removed at all. A retrospective observational study was carried out to cover a period of five years and a computed sample size of almost 300 cases. Patients were included in the current study if their history was positive for ankle fracture with distal tibiofibular diastasis repair with syndesmotic screws. Loss of reduction was more frequent after screw removal (8.5% vs. 2.1%), although the quality of reduction was generally excellent in both groups. The mean AOFAS score was significantly better in patients who had their tibiofibular screw removed (92.6 vs. 88.4), but the tibiofibular clear space and incisura fibularis depth widened more following the second intervention (3.8 mm vs. 3.6 mm, and, respectively, 4.3 vs. 4.1). Lastly, the same patients with tibiofibular screw removal had a significantly higher cost of total interventions and more days of medical leave (21 vs. 15 days on average). It seems that a strong conclusion in favor of removing or not removing syndesmotic screws after distal tibiofibular diastasis repair cannot be given. However, several radiographic findings lean toward the benefit of those patients whose tibiofibular screws were not removed, although mobility was notably better after the screw was removed. Furthermore, treatment expenses are greatly lowered if a subsequent operation for screw removal is avoided, as well as if individuals who have a single surgery take a shorter medical leave. [ABSTRACT FROM AUTHOR]

Intraoral scanners (IOS) have reached a point where their impact in the dental office cannot be denied. The distance between the tip of the IOS and the preparation may have implications on the accuracy of the digital model. The objective of this study was to evaluate the differences in accuracy between digital impressions in the scenario of different scanning distances. Twenty consecutive scans were performed at five predetermined distances: 5 mm, 10 mm, 15 mm, 20 mm and 23 mm by a single operator. The scanning distance of 10 mm displayed the best accuracy with an overall trueness value of 23.05 μm and precision value of 4.2 μm. The drawn conclusion was that increased scanning distances can decrease the accuracy of a digital impression. [ABSTRACT FROM AUTHOR]

Featured Application: Degradation of the material used for prosthetic rehabilitation leads to more or less serious problems, namely impairment of aesthetics, craniofacial disorders, discomfort especially during chewing food, which will be increasingly reduced, leading in the end to fatigue of the masticatory muscles. The most harmful for the dental structure is considered gastric juice. This acidic substance produce degradation both enamel, as well as some restorative materials. In this context, the present work consists in evaluating the surface topography and mechanical properties of some CAD/CAM monolithic materials (already existing on the market), used for prosthetic restoration, thus helping dentists to choose those ceramic materials that are resistant to the effects of gastric juice. Gastric acid exposure produces tooth structure demineralization and dental ceramic degradation. The most affected patients are those who suffer from gastroesophageal reflux disease, bulimia nervosa, and pregnant women with prolonged severe nausea. In order to protect this kind of patient, the purpose of this study was to determine whether simulated gastric acid exposure leads to microstructural changes in surface topography, hardness, color changes, and translucency of some ceramic materials, which are already on the market. Forty disks (Triluxe Forte, Cerasmart, Enamic and Empress CAD) were analyzed before and after immersion in simulated gastric acid juice, in terms of microhardness, surface roughness, translucency, and surface morphology using scanning electron microscopy. Color change was assessed by using a spectrophotometer based on CIELab parameters and the results showed that, after exposure, ∆Eab remained under the threshold of acceptability and perceptibility. In terms of microhardness, Cerasmart is the only material that did not undergo changes after immersion. SEM images illustrated observable changes surface topography after acid exposure for all the tested materials. In conclusion, Triluxe Forte suffered the most important changes after simulated gastric acid juice exposure, and Cerasmart proved to be the least affected material. [ABSTRACT FROM AUTHOR]

Synovial sarcoma (SS) is a rare and highly malignant tumor and a type of soft tissue sarcoma (STS), for which survival has not improved significantly in recent years. Synovial sarcomas occur mostly in adolescents and young adults (15–35 years old), usually affecting the deep soft tissues near the large joints of the extremities, with males being at a slightly higher risk. Despite its name, synovial sarcoma is neither related to the synovial tissues that are a part of the joints, i.e., the synovium, nor does it express synovial markers; however, the periarticular synovial sarcomas can spread as a secondary tumor to the joint capsule. SS was initially described as a biphasic neoplasm comprising of both epithelial and uniform spindle cell components. Synovial sarcoma is characterized by the presence of the pathognomonic t (X; 18) (p11.2; q11.2) translocation, involving a fusion of the SS18 (formerly SYT) gene on chromosome 18 to one of the synovial sarcoma X (SSX) genes on chromosome X (usually SSX1 or SSX2), which is seen in more than 90% of SSs and results in the formation of SS18-SSX fusion oncogenes. [ABSTRACT FROM AUTHOR]

In July 2020 we analyzed the terrestrial isopod assemblages from different (mostly abandoned) railway constructions in Dobruja, eastern Romania. We identified 10 terrestrial isopod species, of which the most abundant and frequent were Porcellionides pruinosus (Brandt, 1833) and Armadillidium vulgare Latreille, 1804. We identified species that, in Romania, are present only in Dobruja: Leptotrichus pilosus Dollfus, 1905 and Trachelipus squamuliger (Verhoeff, 1907). Most of the species are common, generalist or synanthropic, connected to dry and open habitats. In abandoned railway-stations the number of species/samples was low (at most two), but at the base of a stone railway bridge in Babadag forest six species were found. [ABSTRACT FROM AUTHOR]

Abstract Objective Pulmonary complications after thoracotomy are the result of progressive changes in the respiratory status of the patient. A multifactorial score (FLAM score) was developed to identify postoperatively patients at higher risk for pulmonary complications at least 24 hours before the clinical diagnosis. Methods The FLAM score, created in 2002, is based on 7 parameters (dyspnea, chest X-ray, delivered oxygen, auscultation, cough, quality and quantity of bronchial secretions). To validate the FLAM score, we prospectively calculated scores during the first postoperative week in 300 consecutive patients submitted to posterolateral thoracotomy. Results During the study, 60 patients (20%) developed pulmonary complications during the postoperative period. The FLAM score progressively increased in complicated patients until the fourth postoperative day (mean 13.5 ± 11.9). FLAM scores in patients with complications were significantly higher (p < 0.05) at least 24 hours before the clinical diagnosis of complication, compared to FLAM scores in uncomplicated patients. ROC curves analysis showed that the cut-off value of FLAM with the best sensitivity and specificity for pulmonary complications was 9 (area under the curve 0.97). Based on the highest FLAM scores recorded, 4 risk classes were identified with increasing incidence of pulmonary complications and mortality. Conclusion Changes in FLAM score were evident at least 24 hours before the clinical diagnosis of pulmonary complications. FLAM score can be used to categorize patients according to risk of respiratory morbidity and mortality and could be a useful tool in the postoperative management of patients undergoing thoracotomy.

Giant cell tumor (GCT) of bone is a benign aggressive bone lesion with significant recurrence rates following surgical curettage. Historically, these tumors were approached by performing an intralesional curettage of the tumoral tissue by filling the resulting cavity using morselized iliac bone autograft. The major problems of this therapy were the high recurrence rates of up to 40–50%. Several adjuvant treatments have been proposed in order to augment resection margins, including liquid nitrogen (LN), phenol, ethanol, hydrogen peroxide (H2O2) and bone cement (polymethyl methacrylate (PMMA)). LN can be used either to preserve tissues or for controlled necrosis depending on the cycles of freezing and thawing. Usually, a quick freeze followed by a slow thaw will lead to destruction of human cells. This article reviews the results of cryosurgery with LN associated with surgical resection and the additional use of PMMA in a small group of patients with a histopathological confirmation of bone GCT with different localizations (i.e., tibia, distal radius and iliac bone). Cryosurgery with LN of bone GCT proved to be an efficient tool to decrease the recurrence rate for this tumoral type. In our series of cases, there were no complications, oncological or otherwise, at the two-year minimum follow-up, with good and excellent functional results. [ABSTRACT FROM AUTHOR]

Understanding urban biodiversity is an important task in the context of nowadays rapid urban development. Urban expansion affects even areas with high biodiversity; the native fauna related to natural habitats is more sensitive to urbanization. We intended to observe the effect of an old town upon a group of soil-dwelling invertebrates, namely terrestrial isopods, in an area with a unique biodiversity, Herculane Spa, located in southwestern Romania. We identified 23 terrestrial isopod species in this small resort town with geothermal waters. This number is larger than in many regions of Romania, including other urban areas. More than a quarter of the species are endemic to the region or to the Carpathians in general. This fact confirms the biogeographical peculiarity of the Mehedinji Mountains. The old part of the town, built for touristic purposes, has a richer isopod fauna with native and endemic species. Forest and wetland species were also found in this area and in the periurban area. The newly built residential areas have fewer species, generally eurytopic. The presence of the local endemic species Trachelipus trilobntus is limited to natural regions and their vicinity, which proves its native origin. The town, with its special history, and its surrounding natural areas, shelters the native fauna of the region, despite the recent aggressive urban development. The resort areas are more important for the native fauna than the residential ones. [ABSTRACT FROM AUTHOR]

Background Esophageal gastrointestinal stromal tumors (E-GISTs) represent less than 1% of all GISTs. The rarity of this lesion precludes the realization of randomized studies, and its treatment remains a matter of debate. We aimed to evaluate the feasibility of enucleation by video-assisted thoracic surgery (VATS) for low- to intermediate-risk E-GIST. Methods We performed a retrospective review of patients treated by enucleation through VATS between January 2004 and January 2014 and reviewed the literature. Results We included five patients (four men and one woman). Mean age was 53 years (range: 49–79). Three patients were diagnosed because of dysphagia and two others incidentally. The diagnosis was made by immunostaining demonstrating CD117 expression on tumor cells. The mitotic index of all E-GISTs was low (≤ 5 per 50 high-power field). Median postoperative follow-up was 5.5 years, and there was no recurrence. Conclusion Thoracoscopic enucleation of E-GIST seems to represent a valuable option as the postoperative morbidity/mortality is low and the oncological outcome is good for low-to-intermediate grade of malignity tumors. This is a retrospective study focused on minimally invasive treatment of E-GIST. We evaluated the feasibility of VATS enucleation of low-to-medium grade of malignity E-GIST. [ABSTRACT FROM AUTHOR]