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Honey, considered a functional food with a complex chemical composition, has been revered since ancient times for its nutritional and therapeutic properties. In addition to its high sugar content, honey contains a wide variety of bioactive components, especially phenolic acids and flavonoids, which gives it a high antioxidant and anti-inflammatory activity. In addition, results obtained by in vitro and in vivo testing of different types of honey have demonstrated the potential effects of this product in the prevention, progression and therapy of cancer. The antitumor effects of honey are generally attributed to different mechanisms, such as blocking the cell cycle, activating the mitochondrial pathway, permeabilizing the outer mitochondrial membrane, inducing apoptosis and, on the other hand, modulating oxidative stress, ameliorating inflammation and inhibiting angiogenesis. These aspects have demonstrated excellent preclinical potential in a variety of conditions and physiological systems, an aspect that can guide future research in thoroughly delving into the mechanisms of action of this proven "superfood" that can be optimized for the benefit of humanity.

The biological activity of important honey, one of the most characteristics, which distinguishes it from other natural products and makes it important for the medical and therapeutic field. Its potential health benefits can be influenced both by its composition, which varies between different types of honey, and by the bioavailability of various phytochemical components and how they are absorbed and metabolized. It was found that a series of compounds contained in honey such as phenolic compounds, especially flavonoids, have an inhibitory effect against a wide spectrum of bacterial species, Gram-positive (G+) and Gram-negative (G-), but also an important antifungal and antiviral action. These important properties of honey are due both to the quality of the polyphenols contained, which is more important than their quantity, but also to the high osmolarity, acidity, H2O2 content and the composition of non-peroxidic components.

Objectives: The aim of this study was to evaluate the variation in the size of periapical lesions in patients with ENT cancer before and after radiotherapy by using the imaging examination represented by CT. Materials and methods: our study included 35 cancer patients-34 men and one female, with ENT cancer, under treatment at the Regional Institute of Oncology, Iasi. They were examinated by four endodontist, two radiologists and an ENT doctor. We measured the size of the periapical lesions before and after radiotherapy. Results: We found the change in the dimensions of periapical lesions: their maximum overall size was initially 5.4591 ± 3.88509 mm; after radiotherapy the global maximum size reached 7.0000 ± 3.37510, reaching 14.00 mm. The observed difference was statistically significant, so it could be stated that radiotherapy accentuates the severity of periapical lesions systematically. Before radiotherapy, the most extensive periapical lesions were observed in the case of laryngeal neoplasm ( with an average of 6.6778 ± 4.17246 mm) and nasopharyngeal neoplasm ( with an average of 6.000 ± 2.82843 mm) and the lowest ones were found in the case of the neoplasm of the oropharynx (with an average of 4.0000 ± 3.74166 mm). After radiotherapy, we found an increase in the size of the periapical lesions in the case of all five types of neoplasm investigated. The most extensive lesions were observed in the case of the neoplasm of the oropharynx, with an average of 7.6000 ± 3.84708 mm, followed by the neoplasm of the larynx, with an average of 7.4000 ± 3.33999 and the neoplasm of the oral cavity, with an average of 7.4000 ± 4.33590 mm. Disscusions: In terms of expectancy and quality of life of patients can only be achieved through a multidisciplinary approach. As soon as the dentist diagnoses a pontetially malignant disorder in the ENT sphere, patients should undergo an ENT screening complete for detecting lesions in any area of the upper aerodigestive tract. After radiotherapy an increase in the size of the periapical lesions is observed. The ENT doctor must encourage the patients with ENT cancer to extract their teeth with periapical lesions before the implementation of radiotherapy to avoid the risk of postradiotherapy osteoradionecrosis. Conclusions: By using CT, the increase in the size of periapical lesions after radiotherapy is observed in patients with cancer in the ENT sphere.

Objectives: Our aim was to demonstrate the occurrence of post-radiotherapy side effects- even in the case of using intensively modulated therapy (IMRT) in patients with ENT cancer as its are: radiomucositis, dental caries, osteoradionecrosis, the increase in the size of the existing periapical lesions before radiotherapy, dysphagia, dysgeusia. Materials and methods: Our study included 35 cancer patients age between 32-81 years old with ENT cancer- neoplasm of larynx, oropharynx, oral cavity, nasopharynx, hypopharynx, sinuses; under treatment at the Regional Institute of Oncology, Iasi. They were examinated by one dental generalist, two endodontist, one radiologist, one doctor specialized in radiotherapy and an ENT doctor before and after radiotherapy. We used as irradiation dose between 50-70 Gy. Results: All patients suffered from various forms of cancer; the majority (40%) presented a neoplasm of the larynx, 8 patients (22,9%) presented a neoplasm of oropharynx, 6 patients (17,1%) presented a neoplasm of the oral cavity. Other forms of neoplasm found were nasopharynx, hypopharynx and respectively sinus neoplasm (1 case). The vast majority of the patients presented radiomucositis grade 2 (34,3%) and 3 (45,7%). The distribution of the localization of periapical lesions changed before and after radiotherapy. Osteoradionecrosis was initially diagnosed in 3 of the 35 patients (8,6%); after radiotherapy osteoradionecrosis was diagnosed in 6 patients (17,1%). We did not identify a statistically significant relationship between the dose of radiation administered and the degree of radiomucositis. Disscusions: Our retrospective study reported a frequency of 40% cancer of the larynx, 22,9% cancer of the oropharynx and 17,1% neoplasm of the oral cavity, followed by cancer of the nasopharynx, hypopharynx and sinus neoplasm out of a total of 35 patients taken into account. Taking into account the fact that the patients received an irradiation dose between 70 Gy (65,7%)- 66 Gy (22,9%), the degree of radiomucositis was mainly 2 (34,3%) or 3 (45,7%). We observed an increase in the diameter of the periapical lesions after radiotherapy associated with the dose of radiation administered. Areas with osteoradionecrosis revealed the same tendency of increase in their comparative analysis after the applied irradiation doses. Conclusions: The management of the side effects of radiotherapy can be managed favorably for the oncological patient through a close collaboration between the general dentist, ENT and the radiotherapist.

Acromegaly is a rare endocrine disorder characterized by the excessive production of growth hormone (GH) in adulthood. Currently, it is understood that certain pituitary neuroendocrine tumors (PitNETs) exhibit a hereditary predisposition. These tumors’ genetic patterns fall into two categories: isolated and syndromic tumors. The isolated forms are characterized by molecular defects that predispose exclusively to PitNETs, including familial isolated pituitary adenomas (FIPAs) and sporadic genetic defects not characterized by hereditary predisposition. All the categories involve either germline or somatic mutations, or both, each associated with varying levels of penetrance and different phenotypes. This highlights the importance of genetic testing and the need for a more comprehensive view of the whole disease. Despite the availability of multiple treatment options, diagnosis often occurs after several years, and management is still difficult. Early detection and intervention are crucial for preventing complications and enhancing the quality of life for affected individuals. This review aims to elucidate the molecular, clinical, and histological characteristics of GH-secreting PitNETs, providing insights into their prevalence, treatment nuances, and the benefits of genetic testing for each type of genetic disorder associated with acromegaly.

Microbial resistance is a rapidly escalating phenomenon worldwide, with complex mechanisms and important involvement in the determinants of healthcare-associated and in-hospital infections. At European level, it is estimated that 80.000 hospitalised patients have at least one HAI every day with multi-antimicrobial resistant germs, leading to an extension of hospital stay by 16 million days every year. In high-income countries, the prevalence is around 7.5%, and in low- and middle-income countries, the prevalence ranges from 5.7% to 19.2%. Material and method. Through a retrospective, descriptive study carried out in the Clinc Emergency Hospital ,,Prof.Dr. Nicolae Oblu” in Iasi, Romania in the period 2020-2021, the 602 identified and reported intra-hospital infections were investigated, focusing on the etiology and microbial resistance of the pathogens involved.Results. The most frequent etiological agents of HAI identified in our study were K. pneumoniae (13.45%), A. calcoaceticus (10.11%), S. aureus (8.45%), E. coli (7.62%), P. aeruginosa (5.47%), noting the predominance of Gram-negative bacteria (GN) and the fact that they are part of the ESKAPE group of pathogens, the percentages obtained being similar to the European average. Klebsiella pneumoniae (13.45 %) was the most common in the aetiological palette of HAIs, allowing us to highlight certain peculiarities regarding its antimicrobial resistance.Conclusions. The present study provides useful data for monitoring the resistance of pathogens involved in HAIs at hospital level, for guiding antibiotic therapy in healthcare-associated infections and for substantiating the implementation of a set of measures related to antibiotic therapy and antibiotic prophylaxis.

Background: Plants have long been recognized for their potential to influence neurological health, with both neuroprotective and neurotoxic properties. This review explores the dual nature of plant-derived compounds and their impact on the human brain. Discussion: Numerous studies have highlighted the neuroprotective effects of various phytoconstituents, such as those found in Ginkgo biloba, Centella asiatica, Panax ginseng, Withania somnifera, and Curcuma longa. The neuroprotective compounds have demonstrated antioxidant, anti-inflammatory, and cognitive-enhancing properties, making them promising candidates for combating neurodegenerative diseases and improving brain function. Polyphenolic compounds, triterpenic acids, and specific phytocompounds like the ones from EGb 761 extract have shown interactions with key enzymes and receptors in the brain, leading to neuroprotective outcomes. However, this review also acknowledges the neurotoxic potential of certain plants, such as the Veratrum species, which contains steroidal alkaloids that can cause DNA damage and disrupt neurological function, or Atropa belladonna, which interfere with the normal functioning of the cholinergic system in the body, leading to a range of symptoms associated with anticholinergic toxicity. Conslusions: This review also emphasizes the need for further research to elucidate the complex mechanisms underlying the neuroprotective and neurotoxic effects of plant-derived compounds, as well as to identify novel phytoconstituents with therapeutic potential. Understanding the complex relationship between plants and the human brain is crucial for harnessing the benefits of neuroprotective compounds while mitigating the risks associated with neurotoxic substances. This review provides a comprehensive overview of the knowledge on the neurological properties of plants and highlights the importance of continued research in this field for the development of novel therapeutic strategies targeting brain health and neurological disorders.

Chronic threatening limb ischemia of the inferior limbs (CLTI) is the final stage of peripheral arterial disease (PAD) and is one of the most feared atherosclerotic manifestations because if left untreated, in time, it can lead to amputation. Although there are currently numerous treatment techniques, both open and endovascular, it is a pathology that has no underlying treatment. Therefore, current studies are very much focused on new therapeutic possibilities that can be applied in the early stages of the atherosclerotic process. In numerous studies in the literature, miRNAs have been identified as important markers of atherosclerosis. The present study aims to identify the expression of three miRNAs—miR-199a, miR-20a, and miR-30c—in patients with chronic limb-threatening ischemia in the pre- and post-revascularization periods. The aim of the study is to identify whether these three markers play a role in critical ischemia and whether they have the potential for future use in new treatments of this pathology.

Background: Acromegaly is a rare disorder caused by excessive growth hormone (GH) secreted from a pituitary tumor. High levels of GH and insulin growth factor-1 can lead to renal hypertrophy, as well as to diabetes mellitus and hypertension, which negatively impact kidney function. It is believed that high GH may also be involved in the onset of diabetic nephropathy, the main cause of end-stage kidney disease in developed countries. Material and methods: This case–control study was conducted on 23 acromegalic patients and on a control group represented by 21 healthy subjects. The following parameters were determined for all the subjects: serum creatinine, serum urea, estimated glomerular filtration rate (eGFR), urinary albumin/creatinine ratio (UACR), nephrin and kidney injury molecule 1 (KIM-1). Results: Patients with acromegaly showed higher levels of UACR and lower levels of eGFR as compared to healthy subjects. No significant correlations were found between clinical or biochemical parameters associated with acromegaly and nephrin or KIM-1. Conclusions: There was no glomerular or proximal tubular damage at the time of the study, as proven by the normal levels of the biomarkers nephrin and KIM-1. Studies including more patients with uncontrolled disease are needed to clarify the utility of nephrin and KIM-1 for the detection of early kidney involvement in acromegalic patients.

Worldwide, breast cancer (BC) is one of the most common cancers in women and is responsible for the highest number of cancer-related deaths among women, with a special clinical behavior and therapy response. Triple-negative breast cancer (TNBC) is seen as a highly invasive BC, characterized by a short survival, higher mortality, recurrence, and metastasis when it is compared to the other BC subtypes. The molecular subtyping of TNBC based on mRNA expression levels does not accurately reflect protein expression levels, which impacts targeted therapy effectiveness and prognostic predictions. Most TNBC cases exhibit a high frequency of homologous recombination (HR) DNA repair deficiency (HRD) signatures and are associated with a complex genomic profile. Biomarker research in TNBC includes investigating genetic mutations, gene expression patterns, immune system-related markers, and other factors that can provide valuable information for diagnosis, treatment selection, and patient outcomes. Additionally, these biomarkers are often crucial in the development of personalized and precision medicine approaches, where treatments are customized to each patient’s unique characteristics. This ongoing research is essential for improving the management and outcomes of TNBC, which is a challenging and heterogeneous form of breast cancer. The findings of this research have practical implications for refining treatment strategies, particularly in selecting appropriate systemic therapies and integrating traditional treatment modalities like surgery and radiotherapy into comprehensive care plans for TNBC patients.

Post-COVID-19 syndrome encompasses a variety of conditions that can affect people with a history of probable or confirmed SARS-CoV-2 infection, usually within 3 months of the onset of COVID-19, with symptoms that last at least 2 months and cannot be explained by an alternative diagnosis, with a major impact on daily and occupational activities. Material and methods: long-COVID symptoms among healthcare professionals in an emergency clinical hospital and the influence on work activities were assessed. Results: 42% had more than 2 long-standing symptoms. In the majority of cases the symptoms disappeared after 2-3 months, with 10% experiencing persistence of symptoms at 6 months, 5% even at 12 months. The most common symptom reported was fatigue, followed by sensory disorders (parosmia and dysgeusia), arthralgia, sleep disturbances, stress, headache, dizziness. Discussions: The work capacity of employees who experienced long-term symptoms were influenced. Difficulties in performing tasks, maintaining work rhythm and working night shifts led in some cases to temporary work/workplace adaptation measures to allow affected employees to recover. As for post-COVID-19 oral complications, they can affect not only comfort but also general health through their impact on nutrition, oral hygiene and psychological state. Conclusions: In the long term, post-COVID syndrome represents a significant challenge for the whole health system and society, where their health and well-being are essential to ensure the continued availability of quality health care.

Aim of the study: MRI (magnetic resonance imaging) is a non-invasive technique that uses magnetic fields and radio frequency waves to create detailed images of tissues and organs inside the human body. It has become one of the best diagnostic methods in recent decades due to its non-invasive, non- irradiating nature and its ability to detect modifications appeared at the level part mol and structures nervous. Pathology tumor of the glands parotid has a polymorphic appearance, with clinical and imaging similarities between tumoral lesions. In this context, MRI examination with the administration of paramagnetic contrast substance and the use of specific sequences such as DWI and advanced technologies, such as Dynamic contrast-enhanced (DCE)-MRI, show promising results in their differentiation.

Healthcare-associated infections (HAIs), also known under other names such as: nosocomial infections or intrahospital infections, are a major public health problem, affecting both patients, medical personnel involved in their care , and non-medical support personnel. Material and method: The study is retrospective, longitudinal, descriptive, observational, carried out in the Emergency Clinic Hospital, ” Prof.Dr. Nicolae Oblu” from Iași in 2022 and included a batch of 375 hospitalized patients who contracted one or more healthcare-associated infections during hospitalization. Results: The analysis of multiple variables regarding the clinical-epidemiological and statistical data reveals an annual incidence rate of 4.46 %. Wards at risk such as neurosurgery and intensive care showed higher incidence rates (6.58%), with surgical wound infections, mechanical ventilation-associated pneumonia and urinary infections predominating. The etiological palette involved in the genesis of these infections was represented by multidrug-resistant (MDR) bacteria, with increased pathogenicity on immunosuppressed organisms. Conclusions: Our study is comparable to nationally and worldwide recorded data for the neurosurgical profile. Post-operative infections make it difficult for the body to recover in general and the neuromotor level. Our research draws attention to the detection of AIAM, as a permanent concern and responsibility of the entire medical body, as well as to the phenomenon of microbial antibiotic resistance, which is gaining momentum. Correct health management care would definitely lead to a decrease in the incidence of intrahospital infections and the growing phenomenon of microbial antibiotic resistance.

Objective: COVID-19, caused by the SARS-CoV-2 virus, has had far-reaching consequences globally, affecting people of all ages. While children generally experience mild or no symptoms, they can still be affected by the disease, in particular with oral manifestations. The understanding of oral manifestations related to COVID-19 is still limited and inconsistent. This review aims to gather and analyze data on the prevalence and clinical presentations of oral lesions in pediatric patients with SARS-CoV-2 infection, contributing to a better understanding of their relationship and classification within different forms of COVID-19. Material and Methods: A comprehensive search of medical databases was conducted to identify relevant articles published up to June 2023 searched using electronic databases such as PubMed, Medline, and Web of Science. Results: This review encompasses a systematic analysis of 33 relevant articles, with a focused examination of seven studies that specifically address the subject matter. The inclusion criteria involved thorough evaluation, with 15 articles read in their entirety and additional references searched manually for supplementary information. Discussions: Research on oral lesions in pediatric population affected by SARS-CoV-2 infection is limited, leading to potential underestimation or misdiagnosis. Oral mucosa lesions occur in 2-20% of cases, often alongside skin lesions. The most common oral lesions are erosions, ulcers, maculae, petechiae, and changes in the tongue, lips, and gingiva. Oral manifestations are also observed in Multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease associated with SARS-CoV-2. Dental care providers can play a role in identifying and monitoring MIS-C, but accurate diagnosis is crucial to prevent complications. Conclusions: Pediatric patients diagnosed with COVID-19 may not frequently exhibit recognized oral signs and symptoms, necessitating thorough evaluation and consideration of differential diagnoses. Oral healthcare professionals should assess and classify oral manifestations to prevent underestimation and misdiagnosis.

Epicardial adipose tissue (EAT) is a unique fat depot located around the heart, intimately associated with the myocardium and coronary arteries. The secretion of bioactive molecules and their interaction with neighbouring cardiac tissues makes it an active organ with important implications in cardiovascular health and disease. In recent years, omics technologies have provided valuable insights into the molecular characteristics and functional relevance of EAT in patients with coronary atherosclerosis, myocardial infarction, atrial fibrillation and associated metabolic disorders. This review aims to summarize the current understanding of EAT biology through the lens of genomics, transcriptomics, proteomics and lipidomics approaches. We discuss key findings from omics studies on EAT, including gene expression profiles, metabolic activity, signalling pathways and regulatory network, in order to explore in depth the disease mechanisms, possible therapeutic strategies, and cardiovascular risk assessment. Further advances in this field and integrating data from multiple omics platforms hold promise for unlocking personalized cardiometabolic profiles with EAT as a possible biomarker and therapeutic target in cardiovascular disease.

The aim of the present study was to formulate new variants of synthetic and animal-source bone materials coated with different biopolymers, containing antibiotics (ampicillin and oxacillin) and alendronate drugs. Validation consists in establishing mixtures that do not present interactions between components. These materials should act as a drug delivery system alongside the bone base. Natural polymers such as chitosan, alginate, and kappa-carrageenan have been shown to be optimal materials for drug delivery due to their intrinsic biocompatibility. Binary, ternary, and quaternary mixtures between components are analyzed by FT-IR spectroscopy, UV-Vis analysis, thermogravimetry (TGA), and scanning electron microscopy (SEM). The analysis led to the validation of materials suitable for the controlled release of active substances, which have the greatest chance of increasing the speed of bone regeneration, as well as helping in the local administration of antibiotics, which currently must be administered in the form of oral formulations or an injection. According to the FTIR, thermogravimetry, UV-Vis, SEM, and cytotoxicity tests performed in this study, it can be said that it is quite easy to obtain materials that can be used in dental practice that facilitate bone reconstruction through local treatment. At the same time, it was found that both active substances can be incorporated into the material together with Alg and Chit, thus limiting the adverse effects and maximizing the local beneficial effects.

Background: Chronic limb-threatening ischemia (CLTI), the advanced stage of peripheral arterial disease, is diagnosed in the presence of ischemic rest pain, non-healing ulcers, or gangrene. Several studies have demonstrated that inflammation and endothelial dysfunction are some of the main substrates of CLTI. Methods: A narrative review was conducted and reported according to PRISMA guidelines. Three databases were searched—Web of Science, Medline, and EMBASE—for the studies assessing CLTI and the biological markers related to it. Results: We included 22 studies, and all the markers identified (C-reactive protein, D-dimers, fibrinogen, cytokines, IL-6, TNF-α, ICAM-1 (Intracellular Adhesion Molecule-1), VCAM-1 (Vascular Cell Adhesion Molecule-1), neutrophile-to-lymphocytes ratio (NLR), IL-8, Pentraxin-3, neutrophil gelatinase-associated lipocalin (NGAL), calprotectin, E-selectin, P-selectin, neopterin, High-Mobility Group Box-1 protein (HGMB-1), Osteoprotegerin (OPG) and Sortilin) were positively associated with advanced CLTI, with major limb or major cardiovascular events in these patients. Conclusions: All the studied markers had increased values in patients with CLTI, especially when associated with diabetes mellitus, proving a very important association between diabetes and major limb or cardiovascular events in these patients. There is a need for more studies to validate these markers in terms of diagnosis or prognosis in CLTI patients and in trying to find new medical strategies that target inflammation or endothelial dysfunction in these patients.

Cerebrovascular disease accounts for major neurologic disabilities in patients with type 2 diabetes mellitus (DM). A potential association of mitochondrial DNA (mtDNA) and inflammation with cerebral vessel remodeling in patients with type 2 DM was evaluated. A cohort of 150 patients and 30 healthy controls were assessed concerning urinary albumin/creatinine ratio (UACR), synaptopodin, podocalyxin, kidney injury molecule-1 (KIM-1), N-acetyl-β-(D)-glucosaminidase (NAG), interleukins IL-17A, IL-18, IL-10, tumor necrosis factor-alpha (TNFα), intercellular adhesion molecule-1 (ICAM-1). MtDNA-CN and nuclear DNA (nDNA) were quantified in peripheral blood and urine by qRT-PCR. Cytochrome b (CYTB) gene, subunit 2 of NADH dehydrogenase (ND2), and beta 2 microglobulin nuclear gene (B2M) were assessed by TaqMan assays. mtDNA-CN was defined as the ratio of the number of mtDNA/nDNA copies, through analysis of the CYTB/B2M and ND2/B2M ratio; cerebral Doppler ultrasound: intima-media thickness (IMT)—the common carotid arteries (CCAs), the pulsatility index (PI) and resistivity index (RI)- the internal carotid arteries (ICAs) and middle cerebral arteries (MCAs), the breath-holding index (BHI). The results showed direct correlations of CCAs-IMT, PI-ICAs, PI-MCAs, RI-ICAs, RI-MCAs with urinary mtDNA, IL-17A, IL-18, TNFα, ICAM-1, UACR, synaptopodin, podocalyxin, KIM-1, NAG, and indirect correlations with serum mtDNA, IL-10. BHI correlated directly with serum IL-10, and serum mtDNA, and negatively with serum IL-17A, serum ICAM-1, and NAG. In neurologically asymptomatic patients with type 2 DM cerebrovascular remodeling and impaired cerebrovascular reactivity may be associated with mtDNA variations and inflammation from the early stages of diabetic kidney disease.

Background: Breast cancer is the most frequently diagnosed cancer among women, responsible for the highest number of cancer-related deaths worldwide. There is limited data available related to serum tumor markers in breast cancer and other blood parameters or other glandular laboratory parameters. This study aims to evaluate the correlation of tumor-specific markers for breast cancer with other blood parameters and how these correlations could impact clinical management. Material and Method: This retrospective study represents a data analysis from 1 January 2020 to 31 May 2023, in the County Hospital of Timisoara, Romania. We reviewed all the cases where, in the laboratory analyses, the serum tumor specific biomarkers for breast cancer were analyzed. Results: A statistical analysis was performed in order to identify a possible relationship between CA 15-3 and the various biomarkers and blood parameters included in the present study. Values were classified according to reference ranges. The tests revealed no statistically significant associations between CA 15-3 values and the levels of CA125 (χ2(1) = 1.852, p = 0.174), CEA (χ2(1) = 1.139, p = 0.286), AFP (Fisher’s exact test, p = 0.341), fT4 (Fisher’s exact test, p = 0.310), TSH (Fisher’s exact test, p = 0.177), or PTH (Fisher’s exact test, p = 0.650). Conclusion: The findings indicate a lack of strong correlation between CA 15-3 and CA125, CEA, AFP, thyroid function markers, or PTH within this cohort.

Aim of the study The aim of the study is to present a particular case of Gorlin-Goltz syndrome (GGS) and to assess the importance of both clinical and radiological findings in the management of this rare disease. Material and methods We studied a GGS case from our hospital and integrated his clinical and radiological findings in order to assess the importance of conventional radiography, computer tomography (CT), magnetic resonance imaging (MRI) and cone beam computer tomography (CB-CT). Results In this particular case we illustrate the role of MRI and CT examination in determining facial BCC extension and respectively GGS skeletal features. Conclusions Even if GGS is a rare chronic condition, if not periodically and properly investigated, it can lead to invasive basal cell carcinomas (BCCs) or other complication like facial deformities, mandibular fractures caused by keratocystic odontogenic cyst (OKCs).

The purpose of this paper was to assess the quality of environmental factors such as soil and water in some protected areas in Romania. The chosen case studies were the Preajba-Facai lake system from Dolj County and the Vanturarita Buila National Park from Valcea County. Highlighting the evolutionary aspects of the analyzed quality parameters (20 physical-chemical indicators) on a spatial-temporal scale aiming at establishing geochemical thresholds, is the final result of a larger project. The results presented in this article were obtained through seasonal monitoring involving water and soil sampling and laboratory analysis. All the results were interpreted in relation to the values in the specific environmental legislation, and following the field visits, additional information was brought, which contributed to a good knowledge of these regions. The areas, although protected, are influenced by the anthropogenic factor, which has a negative impact on the environment. In some cases, non-compliances were identified and validated by the analysis performed.

To understand the formation and evolution of massive cosmic structures, studying them at high redshift, in the epoch when they formed the majority of their mass, is essential. The One-hundred-deg ^2 DECam Imaging in Narrowbands (ODIN) survey is undertaking the widest-area narrowband program to date, to use Ly α -emitting galaxies (LAEs) to trace the large-scale structure (LSS) of the Universe on the scale of 10–100 cMpc at three cosmic epochs. In this work, we present results at z = 3.1 based on early ODIN data in the COSMOS field. We identify protoclusters and cosmic filaments using multiple methods and discuss their strengths and weaknesses. We then compare our observations against the IllustrisTNG suite of cosmological hydrodynamical simulations. The two are in excellent agreement, identifying a similar number and angular size of structures above a specified density threshold. We successfully recover the simulated protoclusters with log( M _z _=0 / M _⊙ ) ≳ 14.4 in ∼60% of the cases. With these objects, we show that the descendant masses of our observed protoclusters can be estimated purely based on our 2D measurements, finding a median z = 0 mass of ∼10 ^14.5 M _⊙ . The lack of information on the radial extent of each protocluster introduces a ∼0.4 dex uncertainty in its descendant mass. Finally, we show that the recovery of the cosmic web in the vicinity of protoclusters is both efficient and accurate. The similarity of our observations and the simulations implies that our structure selection is likewise robust and efficient, demonstrating that LAEs are reliable tracers of the LSS.

We describe the survey design and science goals for One-hundred-deg ^2 DECam Imaging in Narrowbands (ODIN), a NOIRLab survey using the Dark Energy Camera (DECam) to obtain deep (AB ∼ 25.7) narrowband images over an unprecedented area of sky. The three custom-built narrowband filters, N 419, N 501, and N 673, have central wavelengths of 419, 501, and 673 nm and respective FWHM of 7.5, 7.6, and 10.0 nm, corresponding to Ly α at z = 2.4, 3.1, and 4.5 and cosmic times of 2.8, 2.1, and 1.4 Gyr, respectively. When combined with even deeper, public broadband data from the Hyper Suprime-Cam, DECam, and in the future, the Legacy Survey of Space and Time, the ODIN narrowband images will enable the selection of over 100,000 Ly α -emitting (LAE) galaxies at these epochs. ODIN-selected LAEs will identify protoclusters as galaxy overdensities, and the deep narrowband images enable detection of highly extended Ly α blobs (LABs). Primary science goals include measuring the clustering strength and dark matter halo connection of LAEs, LABs, and protoclusters, and their respective relationship to filaments in the cosmic web. The three epochs allow for the redshift evolution of these properties to be determined during the period known as Cosmic Noon, where star formation was at its peak. The narrowband filter wavelengths are designed to enable interloper rejection and further scientific studies by revealing [O ii ] and [O iii ] at z = 0.34, Ly α and He ii 1640 at z = 3.1, and Lyman continuum plus Ly α at z = 4.5. Ancillary science includes similar studies of the lower-redshift emission-line galaxy samples and investigations of nearby star-forming galaxies resolved into numerous [O iii ] and [S ii ] emitting regions.

Background: Hepatic encephalopathy (HE) caused by cirrhosis has severe consequences on an individual’s lifespan, leading to long-term liver complications and potentially life-threatening outcomes. Despite recent interest in this condition, the effectiveness of secondary prophylaxis involving rixafimin, lactulose, or L-ornithine L-aspartate (LOLA) may be hindered by the unique microbial profiles each patient possesses. Methods: Thus, in this manuscript, we aimed to search, identify, and gather all randomized controlled trials (RCTs) published between 2000–2023 (November) in four major academic databases such as PubMed, ISI Web of Science, Scopus, and ScienceDirect by using a controlled terminology and web strings that reunite six main keywords. We complementarily retrieved data on the ongoing RCTs. Results: Regardless of the relatively high number of results displayed (n = 75), 46.66% (n = 35) were initially deemed eligible after the first evaluation phase after removing duplicates, n = 40 (53.34%). At the second assessment stage, we eliminated 11.42% (n = 4) studies, of which n = 22 finally met the eligibility criteria to be included in the main body of the manuscript. In terms of RCTs, otherwise found in distinct stages of development, n = 3 target FMT and n = 1 probiotics. Conclusions: Although we benefit from the necessary information and technology to design novel strategies for microbiota, only probiotics and synbiotics have been extensively studied in the last decade compared to FMT.

Zinc (Zn), copper (Cu), iron (Fe), manganese (Mn), cadmium (Cd), and lead (Pb) levels were measured in the Bor City water supply system (control) and two watercourses exposed to mining wastewaters, i.e., the Lutarica River (one site) and the Kriveljska River (two sites). The same parameters were determined in the brain, heart, lungs, stomach, liver, spleen, kidneys, and testes of male Wistar rats given water from these sources for 2 months. Water Cu, Fe, Cd, and Pb were outside the safe range, excepting the reference site. Significant impacts on intra-organ metal homeostasis were detected, especially in the brain, stomach, kidneys, and testes. The dynamics and magnitude of these changes (versus controls) depended on the target organ, analyzed metal, and water origin. The greatest number of significant intra-organ associations between essential and non-essential metals were found for Cd-Zn, Cd-Cu, and Cd-Mn. A regression analysis suggested the kidneys as the most relevant organ for monitoring water manganese, and the stomach and brain for lead. These results highlight the environmental risks associated with mining wastewaters from the Bor area and could help scientists in mapping the spatial distribution and severity of trace metal contamination in water sources.

Nowadays, worldwide neoplastic pathology is a major public health problem. Despite the many therapeutic strategies currently available in chemotherapy and radiotherapy, the number of new cancer cases and cancer deaths is increasing. An inexpensive alternative without adverse effects is the development of therapeutic strategies using herbal compounds obtained from various natural sources. On the other hand, the development of therapeutic alternatives involves testing their cytotoxic effects on healthy human cells. In this study, we tested Ocimum basilicum extracts (in butanol and acetonitrile), in concentrations between 5mg/ml and 40mg/ml, in order to evaluate the cytotoxic potential on colon (Caco2), liver (HepG2) and blood cancer (K-562). We analysed the biocompatibility of the products in vitro on healthy cell lines (MSC-mesenchymal STEM cells and HDFA- human fibroblasts). Cell proliferation was analyzed by the MTT assay. The obtained results revealed that the tested extracts do not significantly modify the multiplication of healthy human cells. Instead, it causes a decrease in the cell growth rate for liver and colon neoplastic cells, and less so for leukemic cells.

Numerous studies have reported positive associations between certain biologically active compounds, with pharmacological properties, such as nutraceuticals, contained in some foods and various pathologies. The term "nutraceutical" currently varies from country to country, referring to a number of valuable molecules, derived from organic sources (plants) or foods such as polyphenols, essential amino acids, antioxidants, soluble fiber, polyunsaturated fatty acids ( PUFA), prebiotics, prebiotics, which act at the cellular level, in combating oxidative stress and inflammatory processes and / or in altering the expression of some genes. The discovery of the many benefits attributed to these products and the ever-changing lifestyle have contributed to increasing consumer confidence in nutraceutical and functional foods around the world, and there is a growing interest in improving the quality of life and adopting a healthy lifestyle. to prevent or reduce the risk of disease. Based on these considerations, this paper aims to review some scientific evidence obtained from in vitro / in vivo studies, which supports the beneficial effects of some nutraceuticals and their medical implications in various pathologies.

The milk intended for human consumption must meet the terms of safety and human security. The purpose of this paper was to evaluate the raw milk quality from the food markets of Timisoara, in relation with pasteurized milk. The microbiological studies included the following assays: total number of germs (TNG) and coliform bacteria. From milk samples were made dilutions which later were distributed on the surface of the solid medium poured in Petri dishes. The incubation was carried out at 37º C for 48 h, after which it was determined the number of colony forming units. The obtained values for each sample were compared with the values in existing legislation noticing that the total number of germs is within normal values but towards the upper limit of normality, except the milk samples from Sacos village where UFC/ml exceed the maximum value admitted (300.000 UFC/ml milk). In coliform bacteria case is observed that in all analyzed milk samples the values obtained exceed the maximum values admitted (0.1 UFC/ml) indicating the existence of inappropriate sanitary and hygienic conditions of milking, transporting and marketing.

The delivery of nucleosides represents an interesting research trend in recent years due to their application in various viral infections. The main aims of this study were to develop and to characterize polyurethane particles that are intended to be used for the transport of nucleosides. Three samples have been prepared using aliphatic diisocyanates, a mixture of polyethylene glycol, polycaprolactone, and diols, respectively. The samples were characterized through refractivity measurements, drug loading efficacy, release and penetration rate investigations, FTIR and Raman spectroscopy, thermal analyses, Zetasizer, SEM, HDFa cells viability, and irritation tests on mice skin. The results indicate the obtaining of particles with sizes between 132 and 190 nm, positive Zeta potential values (28.3–31.5 mV), and a refractivity index around 1.60. A good thermal stability was found, and SEM images show a medium tendency to agglomerate. The samples’ color, pH, and electrical conductivity have changed only to a small extent over time, and the evaluations indicate an almost 70% encapsulation efficacy, a prolonged release, and that around 70% of particles have penetrated an artificial membrane in the first 24 h. The synthesized products should be tested in further clinical trials, and the current tests on cell cultures and mice skin revealed no side effects.

Background: Helicobacter pylori antibiotic resistance has increased worldwide and affects the effectiveness of current therapies. The recommended first-line empiric treatment should be tailored to the local clarithromycin resistance rate. This study aimed to determine the pediatric patient profile and rate of clarithromycin resistance for patients diagnosed with Helicobacter pylori by gastric biopsy. Methods: We studied 84 positive gastric samples for Helicobacter pylori. Positive results were confirmed by a rapid urease test and histopathological examination, with the type of gastritis established according to the Sydney System. Gastric biopsy samples were stored in RNA saver. Clarithromycin resistance was determined by a real-time polymerase chain reaction-based molecular assay after RNA-DNA extraction. Results: Of the 84 biopsy samples analyzed, 35 (41.6%) were resistant to clarithromycin. Clarithromycin resistance was found mainly in girls (80%) with a mean age of 15 years (range 6–17 years). The history of prior exposure to clarithromycin was 91.6%. The concordance between the histopathological examination and the PCR test was 100%. Conclusions: One in 2.4 children infected with Helicobacter pylori had a strain resistant to clarithromycin. This resistant strain may be a reason for treatment failure in Romanian children, yet this is uninvestigated. The high rate of bacterial resistance to this antibiotic among children indicates the need for susceptibility testing before therapy.

Due to the fact that, for a few years now, our focus is more and more concentrated on safety and security of meat and vegetable products, this study’s aim is to evaluate the quality of certain well - known meat products (sausages, dry salami, and half-dried salami), purchased in a supermarket, from Timisoara. Microbiological tests were made especially on sanitary microbiological indicators (Escherichia, Enterobacter, Klebsiella). These tests emphasize hygiene in processing ang handling of products. In some cases, it higtlights how various heat treatments (pasteurization type) apply to food products. It also establishes the microbial load on the microscopic field and the colony forming units, by a culture method in plates, at 37º C for 48 hours. Based on the obtained results, it has been established that, concerning the microbial load and the presence or absence of coliform bacteria, studied products fall into the quality permitted by applicable law.

Silybin is a flavonoid extracted from the herb Armurariu (Silybum marianum) and has the potential efficacy in the treatment of liver disease. The aims of this study were to investigate the effect of alcohol and CCl4 on liver histology and the capacity of silybin to ameliorate the hepatotoxicity. Thirty adult male Wistar rats were used in the study. Liver toxicity was induced by dietary alcohol administration and CCl4 intra-peritoneal injection. The protective effect of silibin was investigated by co-administration of silybin with these toxic agents. Hepatocellular and extracellular matrix integrity was determined by histopathological and immunohistochemical study. Hematoxylin-Eosin and trichrome stains sections were studied in each case. For immunohistochemistry we used monoclonal anti-collagen IV primary antibody. Light microscopic evaluation of liver tissues shows that control and silibin treated groups has normal liver structure. In the toxicity groups, HE and trichromic staining showed hepatocellular necrosis, inflammatory infiltrate and proliferating collagen fibers. Immunoexpression of collagen IV was variable. In the control group, we found negative expression. Collagen IV displays positive immunoreaction in hepatotoxicity groups, at the level of the areas rich in inflammatory infiltrate and with degenerative aspect. After this study, we can conclude that silybin, in rats, has protective effects.

The ionic liquids have attracted a great of attention in the scientific community due to their potential pharmaceutical such as antimicrobial. In this paper, the main objective was the assessment of the cytotoxic effect of tetrabutylammonium chloride against HCT 8 human colon carcinoma cell line. The cells were cultured in 75 cm2 culture flasks using RPMI medium supplemented with 10% inactivated fetal bovine serum (FBS), penicillin (100 IU/mL) and streptomycin (100 μg/mL) and maintained at 37 °C and 5% CO2. Before achieving viability test, the cells were harvested using trypsin solution (0.25%). Then, the cells were seeded in 24 – well plates at a density of 5 x 105 cells/mL in 100 µL medium/well in order to reach confluence. After 24 h, the medium was replaced with fresh medium containing different concentrations of ionic liquid, respectively, 0.085, 0.17, 0.34, 0.68 and 1.36 mg /mL. Control group contained cells without treatment. Cell proliferation kinetics have been studied at 24 and 48 h after IL treatment, following trypsinization and counting total cells per plate by using a Trypan blue dye and a hemocytometer. Data obtained from the growth kinetics assay shows that the tetrabutylammonium chloride (TBAC) had an inhibitory effect on the growth of cells in a concentration dependent manner. The maximum inhibitory effect on HCT 8 cells it was obtained at 1.36 mg TBAC/mL.

Sulfonylurea herbicides are frequently used in agricultural crops even if they determine quantitative and qualitative changes in soil microbial communities. In this study it was used increasing doses of two sulfonylurea herbicides, tribenuron-methyl and nicosulfuron, in order to establish their effect on actinomyces communities from soil under laboratory conditions. Using nutritive gelose with soil extract and Gause medium the main species of actinomyces were identified: Streptomyces albus, Streptomyces aureus and Streptomyces chrysomallus. Streptomyces albus is the most abundant species, which could indicate a resistance to used herbicides. Sulfonylurea herbicides, tribenuron-methyl and nicosulfuron, point out a lower value, inhibiting the actinomycete communities from soil.

Liver regeneration after loss of important cell population is a complex process involving all mature liver cell types. We study the response of hepatocytes in 24h and 48h after partial hepatectomy by microscopic and morphometric analysis. Thirty adult male NMRI, 8 week old mice were used in the study. Liver regeneration after partial hepatectomy (68%) in mice is a complex process that is performed on account differentiated mature hepatocyte proliferation, as evidenced by the presence of nuclei hypertrophy, binucleate cells or polyploidy, and numerous mitotic figures. Morphometrical analysis of cell size showed increases in average dimension of the control compared to the experimental groups. After this study, we can conclude that liver regeneration after partial hepatectomy is marked by the proliferation of liver cell population, while reducing the apoptotic process.

Medicinal plants are used in poultry feed due to their beneficial effects on the intestinal microflora, digestibility of nutrients, intestinal morphology, aspects that are found in the quality of meat and eggs. Currently, due to its characteristics, coriander is widely used in the food, pharmaceutical and medical industry, in the cosmetics and perfume industry, but also in the zootechnical field, as an alternative to antibiotics, in raising young animals and birds. In this context, the aim of this study was to evaluate the additional effects of the diet of chickens with coriander powder on intestinal and liver morphology. The study was performed on a number of 24 broilers (ROS 308 hybrids), male, divided into two groups, each group with two replications, 6 individuals / group: Control group (CG) fed only by the basic diet and the experimental group (CoG) in which the basic diet was supplemented with 1% coriander powder. The duration of the experiment was 42 days. Supplementation of the basic diet of chickens with 1% coriander powder led to an increase in the analyzed histomorphometric parameters, the differences compared to the control group (CG) being significant (p0.05) for the width of the villi. In addition, at the hepatic level, dietary supplementation with coriander powder led to vascular hypertrophy, the presence of perivascular leukocyte infiltrates and the manifestation of cytoplasmic vacuolation of hepatocytes in the perilobular territories. Histomorphometric analysis of the data obtained in this study and histological changes in the liver provide new information on the use of coriander seed powder in broiler feed, as a potential promoter of their growth.

Complications due to type 2 diabetes mellitus (T2DM) such as diabetic kidney disease (DKD) and cerebral small vessel disease (CSVD) have a powerful impact on mortality and morbidity. Our current diagnostic markers have become outdated as T2DM-related complications continue to develop. The aim of the investigation was to point out the relationship between previously selected metabolites which are potentially derived from gut microbiota and indicators of endothelial, proximal tubule (PT), and podocyte dysfunction, and neurosonological indices. The study participants were 20 healthy controls and 90 T2DM patients divided into three stages: normoalbuminuria, microalbuminuria, and macroalbuminuria. Serum and urine metabolites were determined by untargeted and targeted metabolomic techniques. The markers of endothelial, PT and podocyte dysfunction were assessed by ELISA technique, and the neurosonological indices were provided by an ultrasound device with high resolution (MYLAB 8-ESAOTE Italy). The descriptive statistical analysis was followed by univariable and multivariable linear regression analyses. In conclusion, in serum, arginine (sArg), butenoylcarnitine (sBCA), and indoxyl sulfate (sIS) expressed a biomarker potential in terms of renal endothelial dysfunction and carotid atherosclerosis, whereas sorbitol (sSorb) may be a potential biomarker of blood–brain barrier (BBB) dysfunction. In urine, BCA and IS were associated with markers of podocyte damage, whereas PCS correlated with markers of PT dysfunction.

Mitochondria are subcellular organelles involved in essential cellular functions, including cytosolic calcium regulation, cell apoptosis, and reactive oxygen species production. They are the site of important biochemical pathways, including the tricarboxylic acid cycle, parts of the ureagenesis cycle, or haem synthesis. Mitochondria are responsible for the majority of cellular ATP production through OXPHOS. Mitochondrial dysfunction has been associated with metabolic pathologies such as diabetes, obesity, hypertension, neurodegenerative diseases, cellular aging, and cancer. In this article, we describe the pathophysiological changes in, and mitochondrial role of, metabolic disorders (diabetes, obesity, and cardiovascular disease) and their correlation with oxidative stress. We highlight the genetic changes identified at the mtDNA level. Additionally, we selected several representative biomarkers involved in oxidative stress and summarize the progress of therapeutic strategies.

The COVID-19 virus frequently causes neurological complications. These have been described in various forms in adults and children. Headache, seizures, coma, and encephalitis are some of the manifestations of SARS-CoV-2-induced neurological impairment. Recent publications have revealed important aspects of viral pathophysiology and its involvement in nervous-system impairment in humans. We evaluated the latest literature describing the relationship between COVID-19 infection and the central nervous system. We searched three databases for observational and interventional studies in adults published between December 2019 and September 2022. We discussed in narrative form the neurological impairment associated with COVID-19, including clinical signs and symptoms, imaging abnormalities, and the pathophysiology of SARS-CoV2-induced neurological damage.

Parkinson’s disease (PD) is an enigmatic neurodegenerative disorder that is currently the subject of extensive research approaches aiming at deepening the understanding of its etiopathophysiology. Recent data suggest that distinct compounds used either as anticonvulsants or agents usually used as dopaminergic agonists or supplements consisting of live active lactic acid bacteria strains might alleviate and improve PD-related phenotypes. This is why we aimed to elucidate how the administration of rotenone (ROT) disrupts homeostasis and the possible neuroactive potential of valproic acid (VPA), antiparkinsonian agents (levodopa and carbidopa – LEV+CARB), and a mixture of six Lactobacillus and three Bifidobacterium species (PROBIO) might re-establish the optimal internal parameters. ROT causes significant changes in the central nervous system (CNS), notably reduced neurogenesis and angiogenesis, by triggering apoptosis, reflected by the increased expression of PARKIN and PINK1 gene(s), low brain dopamine (DA) levels, and as opposed to LRRK2 and SNCA compared with healthy zebrafish. VPA, LEV/CARB, and PROBIO sustain neurogenesis and angiogenesis, manifesting a neuroprotective role in diminishing the effect of ROT in zebrafish. Interestingly, none of the tested compounds influenced oxidative stress (OS), as reflected by the level of malondialdehyde (MDA) level and superoxide dismutase (SOD) enzymatic activity revealed in non-ROT-exposed zebrafish. Overall, the selected concentrations were enough to trigger particular behavioral patterns as reflected by our parameters of interest (swimming distance (mm), velocity (mm/s), and freezing episodes (s)), but sequential testing is mandatory to decipher whether they exert an inhibitory role following ROT exposure. In this way, we further offer data into how ROT may trigger a PD-related phenotype and the possible beneficial role of VPA, LEV+CARB, and PROBIO in re-establishing homeostasis in Danio rerio.

Background and objectives: The postpartum maternal physical and psychological state played a fundamental role in the mother–child relationship at the beginning of the COVID-19 pandemic. The aim of the study is to analyze the influence of maternal psychological manifestations on the mother–child couple through three objectives (briefly expressed): (I) Determination of the main acute and chronic conditions of newborns/infants. (II) Verification of the hypothesis of the existence of a link between the following neonatal variables: gestational age, birth weight, number of days of hospitalization, and specific neonatal therapies (oxygen, surfactant, and blood products’ transfusion). (III) Verification of the influence of postpartum maternal psychological status on the mother–child couple through three hypotheses. Materials and methods: This cross-sectional study was conducted in two hospitals in Timișoara, Romania, between 1 March and 1 September 2020, and included 165 mothers and their 175 newborns. Mothers answered the Edinburgh Postnatal Depression Scale, Spielberger’s Inventory of State-Trait Anxiety, and the Collins and Read Revised Adult Attachment Scale. Results: (I) The acute and chronic pathology of the infants in the study group was polymorphic. (II) Large correlations were identified between the following infant variables: gestational age with birth weight, and number of hospitalization days with birth weight, gestational age, and use of blood product transfusion (all p < 0.001). (III) (1) State anxiety was the only significant predictor of number of hospitalization days (p = 0.037), number of acute disorders (p = 0.028), and number of infant chronic diseases (p = 0.037). (2) Maternal depressive symptoms were the only predictor of postpartum maternal attachment (p = 0.018). (3) Depressive symptoms, state, and trait anxiety were non-significant in all models studied (all p > 0.05). Conclusions: Postpartum maternal physical and psychological state plays a fundamental role on the mother–child relationship in the new social and complex family conditions.

Cardiomyopathies are a challenging pathology and echocardiography is essential for diagnosis and prognosis. The most frequent cardiomyopathies are the dilated cardiomyopathy (DCM) and the hypertrophic cardiomyopathy (HCM), followed by the less frequent restrictive (RCM) and arrhythmogenic right ventricle cardiomyopathies (ARVC). Echocardiography can identify diagnostic features, and guide further testing for a definitive diagnosis. Echographic parameters are involved in risk score computing and prognosis assessment. While the most prevalent hallmark of HCM is the asymmetric left ventricular hypertrophy and systolic anterior motion of the mitral valve with the obstructive phenotype, DCM shows dilated left ventricle with different degrees of systolic dysfunction, and RCM is usually characterized by undilated ventricles associated with atrial enlargement. The aim of this review is to display and compare the most frequent cardiomyopathies encountered in clinical practice and highlight their most characteristic features in a useful way for the practicing clinician.

Pulmonary Alveolar Proteinosis (PAP) is a rare, usually autoimmune, disease, where surfactant accumulates within alveoli due to decreased clearance, causing dyspnea and hypoxemia. The disease is even more rare in pregnancy; nevertheless, it has been reported in pregnant women and can even appear for the first time during pregnancy as an asthma-like illness. Therefore, awareness is important. Similarly to many autoimmune diseases, it can worsen during pregnancy and postpartum, causing maternal and fetal/neonatal complications. This paper offers a narrative literature review of PAP and pregnancy, while illustrating a case of a pregnant patient with known PAP who developed preeclampsia in the third trimester but had an overall fortunate maternal and neonatal outcome.

With the onset of the COVID-19 pandemic, enormous efforts have been made to understand the genus SARS-CoV-2. Due to the high rate of global transmission, mutations in the viral genome were inevitable. A full understanding of the viral genome and its possible changes represents one of the crucial aspects of pandemic management. Structural protein S plays an important role in the pathogenicity of SARS-CoV-2, mutations occurring at this level leading to viral forms with increased affinity for ACE2 receptors, higher transmissibility and infectivity, resistance to neutralizing antibodies and immune escape, increasing the risk of infection and disease severity. Thus, five variants of concern are currently being discussed, Alpha, Beta, Gamma, Delta and Omicron. In the present review, a comprehensive summary of the following critical aspects regarding SARS-CoV-2 has been made: (i) the genomic characteristics of SARS-CoV-2; (ii) the pathological mechanism of transmission, penetration into the cell and action on specific receptors; (iii) mutations in the SARS-CoV-2 genome; and (iv) possible implications of mutations in diagnosis, treatment, and vaccination.

Pregnancy complications such as gestational diabetes (GDM) and hypertensive disorders of pregnancy (HDP) are frequent and influence not only fetal outcomes but also the maternal cardiac function. GDM and HDP may act as a proxy for increased metabolic and cardiovascular risk later in life. Speckle tracking echocardiography (STE) is a relatively new imaging technique that provides more sensitive assessment than conventional echocardiography of the maternal cardiac function. Recent research suggests that STE can be used during pregnancy and postpartum as a useful method of early detection of subclinical maternal cardiac changes related to pregnancy complications, such as GDM and HDP, and as an indicator for future maternal cardiovascular disorders. The aim of this review was to underline the current value of STE in the follow-up protocol of high-risk pregnant women, as a mean for pre- and postpartum monitoring. A review of the literature was conducted in the PubMed database to select relevant articles regarding the association of STE changes and HDP or GDM in the prenatal and postpartum maternal evaluations. Both GDM and HDP are associated with subtle myocardial changes in shape, size and function; these preclinical cardiac changes, often missed by conventional evaluation, can be detected using STE. Left ventricular global circumferential strain might be an important predictor of maternal cardiovascular disorders and might help to define a high-risk group that requires regular monitoring later in life and timely intervention.