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The International Colloquium of Social Sciences and Communication ACUM (NOW) took place in Brasov in between 17th and 19th of October 2019, over three sunny autumn days. The event was organized by the Faculty of Sociology and Communication of the University Transylvania and by the Society of Sociologists of Romania. The keynote speakers were: Bogdan Voicu (R.I.Q.L.) with a communication about migration as a double osmosis, Robbie Gilligan (University of Dublin), with a paper about working with vulnerable young people, Sylvie Huet, (University of Clermond), who investigated the "glass ceilings", and Mihai Burlacu, from the Bucharest Polytechnic, with a reconsideration of the anthropological space as heterotopia. The colloquium organized by SSR is already part of a local university tradition of national and international openness. Slowly but steadily, a real international character of scientific manifestations in Romania is formed, much less cosmopolitan than similar conferences in the global West, but with a constant presence of foreign guests and participants who bring a much needed diversity of perspectives and research themes. During the works, we received a very careful reception from colleagues in sessions that put together various contributions, from long-term individual research topics to recent exploratory research.The event was one that confirmed its success over the years, thus strengthening Brasov's place on the map of social sciences in Romania. [ABSTRACT FROM AUTHOR]

Copyright of Constructii is the property of General Association of Engineers in Romania and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The paper seeks to look at the present system of recognition of qualifications and vocational competences operating nationally and internationally in an attempt to enhance the recognition of certificates and diplomas. Since the recognition system is, first of all, a twofold process, the study examines, on the one hand, the way the nationally awarded diplomas are recognized by European forums and, on the other, it seeks to consider ways in which diplomas acquired in Europe can be recognized by the Romanian national authorities. The study first looks at the documents that regulate tourism training in Romania and then proceeds to discuss the norms that regulate the 'certification' of qualification and competences acquired in other European countries as a result of formal or non-formal training. The paper provides, finally, a way to acquire European and national recognition. [ABSTRACT FROM AUTHOR]

Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by complex immunological disturbances, rendering individuals susceptible to various infectious complications. Among these, Varicella-zoster virus (VZV) meningitis stands out as a rare yet potentially severe manifestation. This condition poses a significant threat, particularly to individuals with compromised immune systems, where VZV meningitis can manifest as a serious complication of VZV infection. Case Report: This paper presents the case of a 46-year-old female patient diagnosed with systemic lupus erythematosus (SLE) in 2022, exhibiting manifestations including pericarditis, arthritis, cutaneous lesions, and renal involvement under treatement with immunosuppressive therapy. The patient initially presented in the Emergency Room for a vesicular eruption surrounding the left eye. The blood test did not find an inflammatory syndrome and was diagnosed as a herpes ophthalmicus treated by Zelitrex. Subsequently, three days later she experienced cephalees, a vomiting episode and persisting ophtalmological sympoms, leading to further investigations. The neurological examination didn't show any clinical sign of meningitis. Cerebrospinal fluid analysis revealed a clear aspect with 71 elements/mm³, a protein concentration of 0.32g/L and a glycorachia higher than 0.4, being suggestive for a Varicella-Zoster Virus (VZV) Meningitis, dyagnosis confirmed later by the PCR. Additionally, imaging examinations were made: a TEP Scan not presenting any anomalities, but not excluding a herpetic encephalo-meningitis and an IRM not showing any sign of encephalitis and no visible sign of meningitis. The patient was treated with Aciclovir 15 mg/kg every 8 hours for 14 days and also a hyperhydratation and received close renal monitoring to prevent complications. Discussions : This case highlights the importance of considering atypical presentations of VZV infection in immunocompromised individuals, such as those with SLE, and underscores the need for prompt diagnosis and management to prevent serious complications. Conclusions: In conclusion, this paper serves as a reminder to maintain a high index of suspicion for VZV-related complications in immuno-compromised patients, particularly those with underlying autoimmune diseases like SLE. Early recognition, intervention and multidisciplinarity are paramounts in preventing serious morbidity and optimizing outcomes in such cases. [ABSTRACT FROM AUTHOR]

Background: The mesolimbic-mesocortical system has dopamine as a prominent neurotransmitter and plays a key role in emotional behavior (amygdala), eating, sex, and in the learning-memorization process (by regulating plasticity - Sahp). Its release is controlled by interactions with other neurotransmitters (serotonin, glutamic acid, GABA, catecholamines). Excessive dopamine release in the nucleus accumbens is linked to psychotic phenomena such as schizophrenia, along with drug addiction, gambling, eating disorders, and sexual behavior disturbances. Addiction manifests itself at several levels respectively: expression of genes (increased FoSB) and dopamine receptors, synaptic remodeling (excess glutamate, neuroplasticity), stress (hyperpolarization), and choices (determined by the PFC). This paper aims to evaluate and present pharmacological interventions that facilitate cognitive processes related to memorization-learning and how to escape the addiction trap. Objective: This paper aims to evaluate and present pharmacological interventions that facilitate cognitive processes related to memorization-learning and how to escape the addiction trap. Material and methods: A selection was made from the main databases (Pubmed, ScienceDirect, Scopus) using keywords: dopamine, reward system, nucleus accumbens, memory, and learning. 54 articles considered representative of the selected topic were selected and information relevant to the learning process and psycho-pedagogical implications was classified into several categories based on both experimental studies and clinical experience: the process of memorization, adaptation, prediction, and error. Also, the risks linked to excessive dopaminergic stimulation are highlighted. Results : D1-like (Gs) receptors in the cortex are primarily located in perisynaptic or extrasynaptic areas, while D2-like (Gi) receptors are found more synaptically and differ in their affinity for dopamine and transduction mechanism. The learning process modifies the repeated activation of action potentials, with D1 activation being correlated with maladaptive neuroplasticity processes. Conclusions: The reward system is involved in the addiction and memorization processes that underlie social adaptation processes. The extent to which overstimulation produces pathological disturbances may also be key to pharmacological intervention. The article highlights the possibilities of influence-behavioral reeducation in addictions and their associated pathologies (obsessive-compulsive behaviors). [ABSTRACT FROM AUTHOR]

Introduction: Among diseases, cancer has the second highest mortality rate worldwide. Among cancers, colorectal cancer (CRC) is the third most diagnosed cancer and the second most common cause of cancer-related deaths worldwide. Hereditary non-polyposis CRC syndrome or Lynch syndrome (LS) accounts for 1%-3% of all CRC diagnoses. Knowledge of genetic susceptibility and a better understanding of the genotype/phenotype relationship in patients with LS is leading to more individualized surveillance recommendations. The aim of this paper is to emphasize the importance of genetic testing in the diagnostic process of hereditary CRCs, especially Lynch syndrome. Case Report: The present paper is a case report of a 55-year-old male patient who was diagnosed with synchronous CRC, presenting two different types of cancer appeared independently. One of the tumours was located proximally, at the level of transverse colon: a 5/4 cm cribriform adenocarcinoma pT3N0(0/15)M1aL0V1Pn0Ro stage IVA, the other one distally, at the level of sigmoid colon: a 7/6 cm mucinous adenocarcinoma pT3N2a(5+/18)M0L0V0Pn0Ro stage IIIB. The patient presented a 1.7/1/0.5 cm metastasis in the liver originated from the proximal tumour. Initially, a left hemicolectomy was performed. The immunohistochemical (IHC) profile, taken three weeks after the diagnosis, showed microsatellite instability with positive test for MLH1, PMS2 and MSH6 and Lynch syndrome was suspected. Repeated IHC test after six months showed positive test also for gene PMS2 which confirmed diagnosis of Lynch syndrome. Treatment included alternating different types of chemotherapy medicines and constant administration of Bevacizumab. Tumour markers decreased in a year: CA 19-9 from 106.5 U/ml to 59.13 U/ml and CEA from 74.76 U/ml to 29.08 U/ml. Pulmonary affection was observed due to treatment. Liver metastasectomy was performed. After two years the patient had cancer recurrence. Discussions : Molecular profiling of patients with LS has been shown to guide targeted therapies, such as immunotherapy. We mention that definitive surgical treatment for patients with LS is total colectomy which reduces the appearance of metachronous tumours. Specialists involved in the care of patients with CRC should be familiar with the main hereditary cancer syndromes and refer patients to specialized cancer genetic units for adequate genetic counseling. Conclusions: In conclusion, genetic testing has a key role in identification and management of patients with LS and other hereditary CRCs. Although hereditary CRCs represent a small part of CRC syndromes, healthcare providers should be conscious about them and the importance of their early diagnosis. [ABSTRACT FROM AUTHOR]

Background: Histone deacetylases (HDACs) are a class of proteins which catalyze the removal of acetyl groups from lysine residues from both histone and nonhistone proteins, playing a key role in gene transcriptions as well as in all biological processes involving chromatin. Apart from their catalytic activity, HDACs also control other cellular processes such as apoptosis, angiogenesis, or chaperone function. Several classes of HDACs inhibitors have been synthesized and assessed using in silico or in vitro methods. The interest in HDACs inhibitors synthesis is increasing due to their potential anticancer activity. Objective: The study aims to cover relevant published literature from the last years, focusing on the important discoveries of HDAC6 inhibitors. Material and methods: Using PubMed, Wiley, Springer, ScienceDirect, and Reaxys database, we have reviewed the most relevant papers covering HDAC6 inhibitors, as well as some in silico docking studies for different ligands to get the best fit for HDAC6 inhibitors. Results : Before 1996, fewer than 100 papers were published in the field of HDACs. Since then, the number of articles has increased dramatically, with over 10,000 papers published on the topic, including more then 700 papers addressing HDAC6 and their inhibitors by 2023 and 2024. Conclusions: However, despite significant interest for the topic, challenges remain in optimizing their efficacy and minimizing off-target effects. New inhibitors are being designed using rational algorithms and even AI platforms. Nonetheless, the cumulative data from the last 15 years underscore the potential of HDACs as valuable tools in both basic research and clinical applications, emphasizing the need for ongoing exploration and refinement of these compounds for improved therapeutic outcomes.Acknowledgements: This work was supported by the University of Medicine, Pharmacy, Science and Technology "George Emil Palade", Târgu Mureş, Research Grant number 293/14.01.2020 [ABSTRACT FROM AUTHOR]

Background: As digital landscape proliferates with a multitude of cyber threats the urgency for resilient cybersecurity solutions escalates. Within this digital fortress, Virtual Private Networks serve as the vanguard, providing secure conduits for data transit. By harnessing the power of tunneling and encryption, VPNs deliver an imperative layer of security across the volatile terrains of the internet. This study delves into a detailed examination of major VPN protocols and will introduce the fundamental necessity of VPNs, their evolution, and their significance in the current cybersecurity framework. Objective: The core objective of this paper is to provide a systematic and comparative analysis of established VPN protocols - specifically, IPSec, OpenVPN and SSL. The intent is to dissect their conceptual frameworks, scrutinize their strategic implementations, and evaluate their operational performance in authentic cybersecurity contexts. A spotlight is cast on their distinctive strengths, potential weaknesses, and their suitability for various cybersecurity requirements. Material and methods: A literature review was conducted, pulling from academic databases, technical whitepapers, and cybersecurity reports. A comparative framework was established, focusing on protocol architecture, encryption standards, and reported vulnerabilities. Practical case studies regarding the deployment of these protocols in heterogeneous environments enriched our research with empirical insights. Results : The results reveal distinct trade-offs among the protocols. IPSec stands out for its strong encryption and authentication features but present challenges in configuration complexity. OpenVPN is revered for its versatility and robust security offerings, balanced with reasonable resource demands. In contrast, SSL, renowned for securing web transactions, is acknowledged for its user-friendly approach but is not without potential susceptibilities to cipher vulnerabilities. The detection of vulnerabilities is largely dependent on relentless monitoring, periodic audits, and the implementation of patches in a timely fashion. Conclusions: The paper concludes that the selection of a VPN protocol is not a trivial pursuit but one that demands a detailed comprehension of each protocol's operational mechanisms, strengths, and frailties. While IPSec is well-suited for extensive corporate networks demanding high-security protocols, OpenVPN shines with its adaptability and scalability. SSL, conversely, is ideal for scenarios prioritizing ease and speed. In the face of ever-evolving cyber threats, it is imperative that encryption technologies and vulnerability management practices advance in tandem. This study provides a strategic blueprint for entities aiming to tailor their VPN deployments to fulfill specific cybersecurity imperatives, thereby enhancing their resilience against cyber adversities. [ABSTRACT FROM AUTHOR]

Background: Military organizations struggle with efficiency in operations, logistics, and administration due to complex systems and data management needs. Traditional methods are error-prone and insecure. Emerging technologies like blockchain offer potential solutions. Blockchain, known for cryptocurrencies, is a secure and transparent way to record data across a network. This technology could revolutionize military operations by improving efficiency and security. Objective: This paper investigates how blockchain technology can improve efficiency in military operations, logistics, and administration. It analyzes the challenges in these areas and explores how blockchain's secure and transparent data recording capabilities can streamline processes, increase transparency, and potentially reduce costs within the military. Material and methods: The current paper details a literature review across various sources (academic, government, industry) and case studies with military personnel to understand current challenges and opportunities for blockchain implementation. Statistical analysis and data visualization techniques were employed to identify trends, patterns, and correlations that could inform the findings and conclusions of the study. Results : Supply Chain Management: Blockchain can track goods and equipment movement in real-time using smart contracts to automate transactions and reduce fraud.Asset Management: Blockchain can create transparent and auditable records of military assets, improving accountability and reducing mismanagement.Personnel Management: Secure, blockchain-based identity systems can store and verify personnel credentials, streamlining management processes and enhancing security.Healthcare Management: Blockchain can improve healthcare data management, including electronic health records and medical supply chains, to ensure data integrity and enhance healthcare quality for military personnel. Conclusions: In conclusion, blockchain technology holds tremendous potential for enhancing operational efficiency within military organizations. By leveraging blockchain solutions in military operations, logistics, and administration, military organizations can improve transparency, streamline processes, and enhance security. However, successful implementation of blockchain technology requires careful consideration of factors such as interoperability, scalability, and regulatory compliance. Further research and pilot projects are needed to fully realize the benefits of blockchain in military contexts. [ABSTRACT FROM AUTHOR]

Copyright of Tyragetia is the property of National Museum of History of Moldova and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Freud defined the id as the oldest and the most primitive psychic agency, representing the biological foundations of personality. It is a reservoir of basic instinctual drives, particularly sexual (libidinal) drives, which motivate the organism to seek pleasure. More recently the field of affective neuroscience identified seven emotional systems common in the brains of humans and animals. The seven emotional affects are 1) seeking, 2) rage/anger, 3) fear, 4) care, 5) panic/sadness, 6) play and 7) lust. Homeostatic affects, such as hunger or thirst, are in a different category from emotional affects, since they are less relevant to mammalian psychopathology and personality. This paper examines the instinctual life of individuals with histrionic and dependent personality disorders from a biological perspective. Drawing on the theories of Freud and affective neuroscience, the paper explores the seven emotional systems common in the brains of humans and animals and their role in motivating behavior. By comparing the differences and similarities between histrionic and dependent personalities, the paper aims to contribute to our understanding of these complex disorders and their underlying biological mechanisms. [ABSTRACT FROM AUTHOR]

The article looks at the progress of the "Journal of Microwave Power and Electromagnetic Energy" (JMPEE). During 2007, JMPEE published 5 full issues and part of the sixth issue online. In addition to the routine editorial and publication activity, the most significant development has been the establishment of the www.jmpee.org website, which provides the basic needs of its readers. It presents the preprints of new papers to be published in the next printed issue. For 2008, the journal is planning two special issues dedicated to the AMPERE-11 Conference held in summer 2007 in Oradea, Romania.

Introduction: Depression, a worldwide spread mental health issue, entails enduring emotions of sadness, and a diminished interest in previously enjoyable activities. It can lead to physiological changes in the body contributing to cardiovascular problems. Chronic stress associated with depression can lead to increased levels of cortisol, having adverse effects on the cardiovascular system, as increased inflammation and arterial damage, potentially leading to a myocardial infarction. Case Report: This paper presents the case of a 51-year-old active male pacient without any major cardiovascular risk factors. He presented an important episode of depression in the recent past and reported a high stress level at his job. He was admitted in the Emergency Room with important retrosternal started 3 hours prior the admission. Upon investigations, the ECG revealed a 2-5 mm ST elevation in V1-V6, D1, aVL territories sugessting an antero-extensive ST-elevation myocardial infarction (STEMI). Transthoracic echography showed a left ventricular ejection fraction of 25-30%. Coronarography highlighted a distal occlusion in the left coronary artery, prompting angioplasty with two active pharmaceutical stents. The circumflex artery was passed by a balance middle weight guidewire (BMW guide) and the pre-stenosis dilatation was performed with a 1.5/15 balloon, resulting in the revascularization of the left anterior descending and the circumflex arteries. The left ventriculary artery and the left anterior descending artery were angioplastied with pharmaceutical active Onyx 3.5/30 stent. Proximal optimisation technique (POT) was executed on the left ventricular artery with a NC 5/15 mm balloon, followed by kissing with the left ventriculary artery and circumflex artery balloons with good angiographic outcomes. During the procedure the patient experienced an episode of ventricular tachycardia requiring electrical cardioversion. Under double antiplatelet, anticoagulant, beta-blocker, statine, antialdosteronic, diuretic therapy, the patient showed satisfactory progress in the intensive care unit with no recurrence of angina or arrhythmias. Discussions : Similarly, in the military context, a soldier may face significant stressors. These can lead to mental health issues, including depression, which can have implications for cardiovascular health. The demanding nature of military service, combined with exposure to high-stress environments, result in physiological changes similar to those seen in depression, potentially increasing the risk of cardiovascular events like myocardial infarction. Conclusions: By acknowledging the relationship between stress, depression, and cardiovascular health, healthcare providers can optimize outcomes and improve overall quality of life for individuals affected by these conditions, whether in civilian or military populations. [ABSTRACT FROM AUTHOR]

Introduction: Proximal humerus fractures are frequently observed in older patients with osteoporosis following lowenergy impacts, such as falls from the same level. Extra-articular two-part surgical neck fractures are unifocal humeral fractures with displaced metaphysis. Case Report: This paper aims to follow the case of a 71-year-old patient, who presented to the Emergency Department of the hospital, experiencing high levels of pain regarding the right shoulder along with a limitation of mobility in the right upper limb. These symptoms manifested following a same-level fall. A combination of pathological antecedents may have led to increased bone fragility, making such a fall result in a severe fracture. Some of the risk factors associated with our patient included the chronic administration of antidepressants, type 2 diabetes, female gender, and also glaucoma which could have heightened the probability of a fall by significantly narrowing the field of view. After a clinical examination that revealed a shorter right upper limb, a discontinuity of the bone margin, bone crepitus, and deformation of the limb, contrasted by a radiological examination, the definitive diagnosis of a displaced humeral surgical neck fracture was assessed. Due to its unstable nature, the decision for surgical treatment was promptly made. The patient underwent an Open Reduction and Internal Fixation procedure, chosen for its advantages in facilitating a quicker return to normal daily activities and reducing the required time in plaster. Because of the medial displacement of the humeral diaphysis and the risk of axillary nerve injury associated with lateral access, the deltopectoral approach was selected. An angular stable plate, secured with locking-head screws, additional calcar screws, and two bicortical screws for enhanced stability, was utilized. The surgery proceeded without further complications, resulting in a rapid improvement in the patient's medical status. Discussions : Falls serve as markers of immobility, and health impairment in older persons, reducing function through injury. According to the Downton fall scale, our patient obtained a score of 4, indicating a high risk of falling. This implies that careful consideration and caution may be necessary in the long-term treatment of this patient. Conclusions: The prevention of falls must include a wide range of ages and health states within the older population, addressing the diverse causes of falls without compromising quality of life and independence. A low-energy fall can be disabling, particularly in association with older age or risk factors that decrease bone density or reduce the awareness of the environment. [ABSTRACT FROM AUTHOR]

Introduction: Post-COVID-19 interstitial lung disease (ILD) is known to be a sequellary, organizing form of the interstitial pneumonia, that can sometimes be progressive. Obstructive Sleep Apnea (OSA) is known to be a risk factor for COVID-19 morbidity and short and long-term mortality. Pulmonary Alveolar Proteinosis is an ultra-rare disease in which surfactant components, that impair gas exchange, accumulate in the alveolae, that only have around 500 reported cases in total. Case Report: The following paper presents the case of a 38-year-old female patient who was admitted in our pneumology department for periodic evaluation, accusing mild exertional dyspnea. Medical history revealed obesity (BMI = 40 kg/m2) CT-confirmed Interstitial Lung Disease (ILD) after a severe episode of COVID-19 infection 3 years ago. She underwent a recent diagnosis of Obstructive Sleep Apnea (OSA) under Continuous Positive Air Pressure (CPAP). Spirometry and plethysmography were performed, indicating the aggravation of the restrictive lung disease comparing to the results from the last check-up. As SpO2 levels lowered significantly, ventilatory polygraphy was performed to evaluate OSA, characterizing it as severe and in need for 24h oxygen therapy. CT scan revealed the diffuse pattern of the Non-Specific Interstitial Pneumonia (NSIP), progressing and starting to differentiate from typical, looking more like "crazy-paving" appearence. Lung biopsy indicated secondary Pulmonary Alveolar Proteinosis (PAP), an extremely rare disease, that was treated using whole lung lavage Discussions : No significant association between post-COVID19 ILD and the development or aggravation of OSA has been described previously. The important desaturations could be caused by the advanced apneic disease overlapping the severe ILD. Studies have shown several connections between ILDs and OSA, including the need to step up the treatment options to oxygen therapy and mechanical ventilation. In the case of PAP, only several case reports associated severe COVID-19 history with PAP and none associating PAP and Post-COVID-19 or any other type of ILD. This data can probably indicate that the ILD in this patient may probably never have been ILD, but PAP from the very beginning. Conclusions: This so-called "trending" virus, COVID-19, among its known ILD complication, may precipitate other comorbidities that decrease the patient's life quality and expectancy. [ABSTRACT FROM AUTHOR]

Introduction: Hypercalcemia, an elevated level of calcium in the blood, is a common medical condition that can arise from various underlying causes. While often associated with hyperparathyroidism (PHPT) or malignancies such as multiple myeloma or certain metastatic cancers, its occurrence in Hodgkin lymphoma is relatively rare. The exact mechanisms underlying hypercalcemia in Hodgkin lymphoma remain incompletely understood, it is believed to involve factors produced by tumor cells that promote bone resorption or calcium release from the bones. This paper's main objective is to emphasize a rare mechanism that causes hypercalcemia in Hodgkin lymphoma patients. Case Report: We present the case of a 78-year-old female patient with valvular heart disease and arrhythmia admitted to Akdeniz University Hospital, Internal Medicine outpatient clinic in September 2023 due to loss of appetite, fatigue, and loss of weight of approximately 30 kg in the last 6 months. Laboratory tests revealed low hemoglobin (6, 6 g/dL), elevated corrected serum calcium levels (14 mg/dL), and also as a result low PTH (10pg/mL5) levels. Because of the frequent association between hypercalcemia and hematological malignancies, the patient underwent endoscopy, colonoscopy, full-body CT scan, mammography, and PET-CT imaging. Diagnostic imaging showed splenic and bone involvement. The patient received steroids and intravenous hydration to correct the hypercalcemia while finding the underlying cause of it. A tru-cut biopsy was performed from a lymph node in the left inguinal area that was visible on the PET-CT scan; the biopsy's findings were compatible with a CD30, CD15, MUM-1 positive classical Hodgkin lymphoma. Discussions : The elderly patient was taken under hematology follow-up for advanced stage cHL, and treatment with Brentuximab-Dacarbazine. After 4 cycles of chemotherapy full remission was observed with PET- CT and calcium levels got back to normal. The patient will receive a total of 12 cycles. Conclusions: This case highlights the importance of thorough evaluation and appropriate management when hypercalcemia is detected in patients with Hodgkin lymphoma, including both the treatment of the lymphoma itself and addressing the elevated calcium levels. [ABSTRACT FROM AUTHOR]

Introduction: Transcatheter aortic valve implantation (TAVI) has become the safer alternative to surgery when it comes to intermediate-to-high-risk patients. A particular challenge is represented by previous mechanical mitral prostheses, on account of their proximity to the aortic situs of implantation. Considering the currently limited literature regarding TAVI in patients with mitral prostheses, the objective of this case presentation is to emphasize that the benefits of these procedures outweigh the associated risks. Case Report: A 78-year-old woman was admitted describing dyspnea, fatigue, and typical chest pain, whose medical history revealed permanent atrial fibrillation, a mechanical bileaflet mitral prosthesis (Cardiamed no. 29) and tricuspid annuloplasty, both implanted 9 years prior. The clinical exam revealed an overweight patient with an aortic systolic murmur and a metallic click, with no further abnormalities. The electrocardiogram revealed atrial fibrillation, along with Q waves in DIII. Echocardiography demonstrated severe degenerative aortic stenosis with a gradient of 85/50mmHg, mild aortic regurgitation, mild tricuspid regurgitation, and a hypertrophic, normal diameter left ventricle with an ejection fraction of 60%. Considering the patient's age, surgical risk (EuroSCORE II of 5.47%), and medical history, TAVI was chosen to treat the aortic stenosis. The doctor performed a femoral transcatheter aortic valve implantation with a balloon-expandable Edwards Sapien 3 no. 26 valve, with good results. Post-TAVI echocardiography revealed a transaortic gradient of 22/11 mmHg with a mild paravalvular leak, a normofunctional mechanical mitral valve and an ejection fraction of 55-60%. Post-TAVI electrocardiogram showed atrial fibrillation, along with intermittent major left bundle branch block. Discussions : Besides the risk of paravalvular leak and potential conduction disorders which were anticipated in a severely degenerated aortic valve, the presence of a mechanical mitral valve implied other complications, such as the interference of the mitral prosthesis with the new valve, its embolization or the increased hemorrhagic risk. Despite those, TAVI achieved its goal of reducing the gradient and, most importantly, relieving the patient's symptoms and hopefully improving her quality of life. Conclusions: Undoubtedly, continuous refinement of TAVI techniques and materials is warranted to further mitigate associated risks. Nevertheless, we believe this case achieves its goal of highlighting the outweighing benefits of TAVI in this patient. Considering the relatively scarce literature regarding TAVI in patients with mitral prostheses, we believe this paper contributes to the growing body of evidence that TAVI is a feasible therapeutical option in patients with mitral prostheses. [ABSTRACT FROM AUTHOR]

Introduction: Enophthalmos is the posterior displacement of the entire eyeball into the orbital cavity. It has a variety of causes and can be classified as primary (congenital) or secondary (post-traumatic). The aim of this paper is to highlight the difficulties of cataract surgery in enophthalmic eyes. Case Report: We present the case of an 82-year-old male patient who came to our clinic for a routine checkup. At the ophthalmological examination BCVA RE-0.3, LE- c.f. IOP (intraocular pressure) RE=11 mmHg, LE= 9 mmHg. The anterior segment for left eye (LE) shows a dense cataract and for the right eye multiple opacities of the lens. Ocular movements were normal in both eyes. The final diagnosis was mature cataract for the left eye and cataract for the right eye; surgical treatment for both eyes was decided in order to improve visual acuity. Unfortunately, due to left eye enophthalmos and dense cataract, optical coherence tomography and specular microscopy could not be performed. Biometry was tried on two different machines. The classic surgical approach was decided due to enophthalmos and mature cataract, with extracapsular lens extraction and artificial intraocular lens implantation, being performed without complications. For the right eye phacoemulsification and artificial intraocular lens implantation was performed without complications, two weeks apart. On the post-operator check-up, BCVA of the left eye was 0.3 and for right eye 0.6, without edema, ocular or periocular pain or hyperemia. Discussions : Although cataract is one of the most common surgeries performed worldwide, being a fast surgery there are many pathologies associated with a patient that increase the difficulty of the surgical approach. Conclusions: The modern procedure of cataract surgery - phacoemulsification and lens implantation- could not be performed on the left eye because of the location of the eyeball in the orbital cavity and mature cataract, resulting in the surgery being longer, the surgical technique more difficult and the healing process taking more time. [ABSTRACT FROM AUTHOR]

Introduction: Sarcoma is a malignant tumor of connective tissue. Frequently involved structures include connective, bone, cartilaginous, muscular, and adipose tissues. Sarcoma can occur both in the trunk and in the limbs, head, or neck Case Report: In this paper, we present the case of a 70-year-old man who was admitted through scheduling with the diagnosis of a right inguinal tumor. The patient reports the onset of a tumoral formation in the right inguinal region 4 months ago. It has grown to 25x20 cm, becoming painful. From the patient's pathological personal history, we note the presence of essential arterial hypertension, bilateral hydrostatic varices, and prostate adenoma. The physical examination reveals a tumoral formation in the right inguinal region, slightly hyperemic, oval, hard, well-defined, fixed to superficial and deep planes, slightly sensitive. Computed tomography examination revealed a tumoral formation in the right inguinal region with a double component - parenchymal, inhomogeneous iodophilic, centrally necrotic, with dimensions of 87/105/130 mm (AP/LL/CC), respectively poliseptate adipose structure, with discreet own wall, microcalcifications and included vascular structures, with dimensions of 102/62/125 mm (AP/LL/CC), several superficial inguinal lymph nodes with maximum dimensions of 13/9 mm. The surgical intervention consisted of elliptical excision of the tumoral formation from cranial to caudal and from medial to lateral. As the tumoral formation penetrated the external oblique muscle aponeurosis and the inguinal ligament, partial excision of these was also necessary. After the removal of the tumoral formation, an external oblique inguinal hernia sac was also identified, which is why inguinal hernia repair and abdominal wall plasty were performed, retrofunicular procedure. The intervention concluded with mobilization of the cutaneoussubcutaneous flaps, their suture, and subcutaneous drainage. The postoperative evolution was favorable, and the patient was discharged on the 5th postoperative day. Histopathological examination revealed a monophasic synovial sarcoma, grade 3 FNCLCC. On section, the tumor presents a multinodular aspect, with areas of necrosis, approximately 40% of the tumor volume. Discussions : Sarcomas are mesenchymal tumors that can be divided into soft tissue sarcomas and primary bone sarcomas, depending on the tumor type, the therapeutic approach being different. Important prognostic factors are grade, size, and location of the primary tumor. Conclusions: Treatment should always address associated lesions, such as the inguinal hernia in the presented case. Surgical treatment with or without radiotherapy remains the first-line treatment for localized soft tissue sarcomas, while chemotherapy may be indicated in cases with high risk. [ABSTRACT FROM AUTHOR]

Introduction: Reconstruction of anterior thoracic wall are considered a challenge regarding restoration of form and function. Sternum dehiscence represents a possible complication after cardiac surgery especially in non-compliant, multiple-operated patients. Muscular flaps provide an excellent option for stable soft tissue defects coverage as well as a well vascularised surface. Case Report: This paper presents the case of a 75-year-old male patient with a complex medical record of multiple cardiovascular and lung diseases who was transferred from IUBCvT to Plastic and Reconstructive Surgery Compartment of Târgu-Mureş for a post sternotomy wound dehiscence. Previous interventions that required this maneuver consisted in aortic valve replacement and coronary artery bypass followed by sternal osteosynthesis using stainless steel wires. The first intervention was minimal due to patient post-surgical complications (osteitis, mediastinitis, bilateral pachypleuritis) and consisted in soft tissue debridement, eschilectomy, thoracentesis for bilateral pneumothorax performed by thoracic surgeon and sutures inanatomical planes. Reintervention was required due to poor post-operative care after hospital discharge and recurrence of the initial dehiscence. Reconstruction of the thoracic wall was tempted using two local advancement cutaneous flaps with unfavourable results and flaps necrosis. Substantial debridement of the necrotising tissue with sternal osteotomy were necessary to create a favourable ground for reconstructive methods. For proper coverage of the exposed mediastinum a rectus abdominis muscle flap rotated on its proximal pedicle was placed over the sternum. After a midline incision was performed, the muscle was dissected from its fascial layer with the visualisation of superior epigastric artery and deep inferior artery, the latest being ligatured after suprapubic muscle sectioning. After rising the flap over the defect, coverage was ensured by a skin graft harvested from the anterior aspect of the left tight and the abdominal fascia was reinforced using a polypropylene surgical mesh. Postoperative the patient is admitted to the ICU for supportive treatment. Discussions : After a 5-day follow-up the muscular flap was viable, with minimal 4/2cm marginal skin graft necrosis for which negative pressure wound therapy (Vivano) was applied. Sutures were removed progressively at 2-3 weeks after the surgery without any further complications and spontaneous epithelization of skin graft necrosis site. Conclusions: A notable improvement in clinical results and patient improving health condition was made possible by the effective use of a multimodal therapy strategy. The significance of proper reconstructive techniques and preparation in the management of intricate postoperative complications is demonstrated by the notable final result of the presented case. [ABSTRACT FROM AUTHOR]

Introduction: Intraoperative neuromonitoring (IONM) has become an essential component in ensuring optimal results of the cerebellopontine angle tumor resection. It implies continuous evaluation of the electrical activity of various neural pathways in an anesthetized patient. This innovation has allowed neurosurgeons to have a better understanding of the distorted CPA anatomy, preventing permanent damage to the cranial nerves and subsequent impairments of the patient. Case Report: The subject of this paper is a 67 years old female patient with a right vestibular schwannoma, complaining about hypoestesia in the right trigeminal teritory, progressive hearing loss, persistent headaches and vestibular syndrome. The retrosigmoidian path was chosen for tumor resection, thus the fundamental need of IONM usage. Moreover, the necessity of neuromonitoring was justified due to the normal function of the facial nerve (House-Brackman grade 1/6), which had to be preserved. The inaugural step was the placement of electrodes designed to register free-running recordings and a series of evoked potentials (EP) including the somatosensory ones (SSEPs) for the median, ulnar and tibialis posterior nerves and transcranial motor evoked potentials (MEPs) of arms, legs, and muscles with corticobulbar innervation of head and face. Electrodes were placed in a routine fashion and following the device calibration and anesthesia, the surgery commenced. After the CPA angle was reached and the tumor was identified, the IONM was used to identify the cranial nerves in the region: trigeminal and facial nerve. Constant monitoring of the neural activity of these nerves was performed, facilitated by permanent communication between the neurosurgical team and the neurophysiologists in charge of the signal interpretation. The surgery unfolded impeccably, without any peri- and early postoperative complications or sequelae. Discussions : Despite the immense beneficial impact of IONM on the outcome of CPA angle surgeries, outcome data of its use is rather unclear. Moreover, due to the interference of anesthesia with the physiological function of the monitored neural pathways, alarm thresholds are disputed. Enhancement of the technique and future research are needed to eliminate ambiguities. Conclusions: IONM is undisputedly an excellent adjuvant in numerous neurosurgical approaches, including CPA angle tumors. It functions as an 'alarm' that enables neurosurgeons to prevent or decrease the risk of irreversible neurological damage. A key component for success is, without a doubt, a professional team comprising neurophysiologists, specifically trained to analyse and interpret the signals displayed on the neuromonitor. [ABSTRACT FROM AUTHOR]

Introduction: The traumatic pulmonary hernia is a rare and uncommon encounter in trauma care. Most traumatic lung hernias have been reported secondary to falls, motor vehicle accidents, and penetrating chest trauma. Early surgical repair offers the best results with a low morbidity, and the long-term prognosis is excellent. Case Report: Our paper aims to discuss the surgical management of a 52-year-old male patient who presented at the emergency room with acute respiratory insufficiency. Upon examination, he was diagnosed with a right thoracic penetrating wound associated with a suffocating pneumothorax, subcutaneous emphysema, and two rib fractures adjacent to the penetrating wound. The injuries were sustained during a biking accident, where the handlebar penetrated the right hemithorax.The contrast-enhanced thoracic CT scan revealed on the right hemithorax fine fracture line of the 5th rib (inferior edge), an open fracture of the 6th rib (the lateral arch), a 1 cm herniation area of the pulmonary parenchyma in the 5-6th intercostal space, a small pneumothorax (6 mm) and subcutaneous emphysema. The surgical treatment involved two hemostatic subcutaneous sutures with reintroduction of the lung in the pleural cavity and placement of a right passive pleural drain. Discussions : The patient's postoperative early status faced no complications; control thoracic x-rays were performed with fluid secretions monitorization. On day three, the drainage was clamped with a 24-hour monitoring of saturations and a thoracic X-ray at the end. The pleural drainage was removed on day four, together with the discharge. Postoperative controls revealed no modifications to the patient's respiratory function. Conclusions: This case underscores the importance of considering uncommon etiologies in patients presenting with thoracic symptoms and the critical role of prompt surgical correction to prevent potential complications such as respiratory compromise or organ dysfunction. The best imaging technique for such cases is trauma control computed tomography, which better defines the hernia dimensions and associated thoracic and pleural damage. [ABSTRACT FROM AUTHOR]

Introduction: Small bowel volvulus(SBV) is the torsion of the small bowel and its mesentery, and it is a medical emergency. It is categorized as primary or secondary type. Primary SBV is defined as torsion of a segment of the small bowel at the mesentery basis without any evident underlying cause; secondary SBV occurs in the presence of an acquired condition, such as congenital malrotation, postoperative adhesions, and diverticular disease. Case Report: In this paper, we present the case of an 80-year-old male patient who came to the emergency department with diffuse abdominal pain, nausea, and vomiting. From the personal pathological history, we note the cholecystectomy in 2009, hypertension, and peripheral polyneuropathy. The objective examination revealed a distended abdomen, above the xipho-pubic plane, very sensitive at palpatory examination. Abdominal CT examination revealed intestinal jejunal loops depleted of semifluid content with a luminal diameter of 3 cm and only minimal aerial content, sketching 2 small hydroaeric levels; diverticulums on a small segment of the jejunum, and multiple colonic diverticulosis throughout. It was decided that the patient needed medical-surgical care. The surgical intervention began with exploratory laparotomy followed by the sectioning of the bridle that was caused by post-operatory adhesions. The adhesions contributed to the formation of SBV. Since the intestine was viable detorsion was needed. During the intervention, a compact foreign body of spherical shape was discovered in the small intestine and removed. The foreign body revealed itself after extraction as chicken bones. Discussions : The fibrous adhesions may have originated from previous surgery and/or inflammation induced by the multiple diverticulum found along the patient's bowel. The adhesion bands caused obstruction in the small bowel and promoted the unusual formation of the mass of bones that fortunately did not perforate the intestine. Clinical presentation of volvulus is usually nonspecific unless an acute small bowel obstruction occurs, which in this case was most likely caused by the foreign body. Conclusions: In summary, we presented a case of small bowel volvulus that may be categorized as the secondary type. Early surgical treatment is essential for small bowel volvulus and we should raise suspicion for small bowel volvulus when a patient displays symptoms such as upper abdominal pain, vomiting, and tenderness. [ABSTRACT FROM AUTHOR]

Background: Chronic gastritis is one of the most common gastrointestinal disorders, affecting millions of people worldwide. Among the various therapeutic strategies and symptom management approaches associated with this condition, adopting a balanced diet has been recognized as playing a crucial role in maintaining gastrointestinal health and improving the quality of life for patients. Objective: This paper aims to identify both non-modifiable risk factors (such as age) and modifiable ones (such as dietary habits, perception of a balanced diet, and consumption of carbonated beverages) through responses obtained from the surveyed participants. These factors are associated with various digestive conditions, including gastroesophageal reflux disease, gastric ulcer, chronic gastritis, and Helicobacter pylori infection. Material and methods: Data were collected through structured questionnaire analysis involving a total of 152 individuals. Microsoft Excel and IBM SPSS v26, IL, Chicago, were used for statistical analysis of the results, employing chi-square statistical tests suitable for categorical variables. For interpretation, the significance level considered was less than 5% (0.05). Inclusion criteria were as follows: adult population (≥ 18 years old) who consented to data processing for research purposes. Exclusion criteria included pediatric patients or those who did not agree to the processing of personal data after completing the questionnaire. Results : The study includes 152 participants, of whom 122 are female and the rest are male, investigating how foods influence their digestive health. Regarding the incidence of symptoms within the cohort, 35% of respondents reported postprandial fullness, followed by patients reporting diffuse abdominal pain (29%). Other identified symptoms include gastroesophageal reflux (11%), heartburn (10%), nausea or vomiting (3%). Approximately 29% of respondents reported no digestive symptoms. Most commonly, symptoms occur in relation to fast-food consumption (42%), while in 16% of cases, symptoms occur postprandially. Lastly, in 7% of participants, symptoms are subsequent to alcohol or coffee consumption, and in fewer cases (5%), symptoms occur in relation to pasta or cheese consumption. Conclusions: The majority of study participants believe that a balanced diet ensures a healthy lifestyle. Patients age was statistically correlated with processed meat consumption, fiber and whole grain consumption, fruit and vegetable consumption (in short, dietary habits). [ABSTRACT FROM AUTHOR]

Background: The evolution of equipment technology in the military field has been marked by continuous advancements driven by the need for enhanced capabilities, increased efficiency, and improved safety. Militaries around the world often employ a wide range of specialized equipment, including various forms of input devices for controlling electronic systems and machinery. Objective: A device like this is MouthPad. Its potential application in the military field is significant. While this is a brand-new technology and apparatus, an examination of its design and practical uses in civilian life allows us to believe that it may find its way into military personnel's standard equipment. Material and methods: Even though more research is required, by examining recent papers and publications, we may make some assumptions about this device's potential future. Results : Using Bluetooth, MouthPad is a tongue-driven interface that can be used to operate electronic systems and machinery using the movements of your tongue on the device. The touchpad is placed on the hard palate and it is held in place by a clear dental retainer and has attached a battery on the vestibular side of the molars that will be situated in the maxillary vestibule. It could be used in situations where soldiers need to control drones for surveillance or reconnaissance purposes while on the move or in a confined space, a mouth pad with a trackpad could allow for hands-free control of the UAV's flight path, camera orientation, and other functions. Another possibility of using MouthPad is while military personnel may use Robotics and Unmanned Ground Vehicles for tasks such as bomb disposal, reconnaissance, or search and rescue in hazardous environments. A mouth-operated trackpad could enable operators to navigate and manipulate these vehicles remotely while keeping their hands free for other tasks, such as handling equipment or weapons. Furthermore, MouthPad could be used for mapping and navigation, as well as for tactical communication. Conclusions: : In specific scenarios where conventional input methods are risky or unfeasible, military forces may adopt hands-free input devices, such as MouthPads. [ABSTRACT FROM AUTHOR]

Background: Saliva is crucial for defending the oral cavity naturally, primarily due to its composition of antimicrobial elements and diverse ions that serve as a buffer, regulating salivary pH within a neutral range. Maintaining a neutral salivary pH is essential because after eating, acidity levels plummet significantly due to the acid produced by food. This drop triggers the demineralization of teeth, a process that can be effectively managed through the buffering capacity of saliva and regular tooth brushing. Objective: The objective of this study was to assess the oral fluid's alkalinity following the use of specific toothpaste brands to compare their efficacy. Additionally, we examined whether PRANOYA toothpaste exhibits a greater antimicrobial effect compared to similar toothpaste varieties. Material and methods: The study comprised eighty participants, evenly divided into two groups: forty smokers and forty non-smokers. Five distinct toothpaste brands were evaluated, with each brand tested on eight smokers and eight non-smokers. Saliva samples were collected before and after tooth brushing using 1.5 ml containers. Upon collection, the pH of the saliva samples was promptly measured using pH test paper. Results : The pH test results indicate that each toothpaste increases salivary pH by 4-18%, with measurements falling within the range of 7.2-8.1. There was no statistically significant difference between different brands in increasing salivary pH levels. Additionally, it was observed that smokers exhibit slightly more acidic saliva compared to non-smokers. Conclusions: This study confirms that every toothpaste assists in alkalizing saliva, consequently mitigating the potential imbalance between demineralization and remineralization of dental hard tissues after exposure to acidic conditions. This mechanism significantly enhances cavity protection for the teeth. Furthermore, Pranoya exhibits effectiveness as an antibacterial toothpaste, comparable to other brands tested in the study. [ABSTRACT FROM AUTHOR]

Background: Given the increased incidence of breast cancer cases among the female population worldwide (665,684 deaths, with a higher rate in Belgium and well-developed countries), as well as its presence among males, I consider this topic to be both important and timely. According to numerous epidemiological and laboratory studies, it has been clearly demonstrated that using more screenings and modern diagnostic methods is helpful in the early detection of the disease and can reduce mortality, as well as morbidity. Currently, this pathology represents the most common form of cancer among women and the second leading cause of death, induced by malignant tumors. Despite increasingly frequent free screening programs and modern diagnostic methods, the fiveyear survival rate remains low. Objective: The aim of my paper was to determine which classic prognostic factors are important by analyzing the trajectory and routine control that a patient with breast carcinoma should undergo. Material and methods: The study included 259 patient analysis reports from the Pathological Anatomy department of the "Targu Mures County Clinical Hospital", admitted between 2018-2023. The first step to begin the study, whithin the mentioned time period, was to search and filter patients from the hospital database who were diagnosed upon discharge with breast carcinoma. Based on these results, data was collected from the observation sheets in electronic format,that had an anonimous character. For each patient, primarily a tru-cut biopsy and an immunohistochemical examination were performed, providing the necessary data regarding the studied parameters: Age, Localization, Histological type, Investigations, Nottingham Grade, tumor stage, type of intervention, and treatment used. Results : In this current study, it was observed that the most affected age group was in the sixth and seventh decades (with a percentage of over 50%) and predominantly localized in the right breast, specifically in the supero-external quadrant. The incriminated histological type was NST (no specific type) with a number of 212 cases and a predominant classification in Nottingham Grade 2 (163 patients). In terms of TNM classification, stages T1, N0, Mx, were the most frequent characteristics describing breast carcinomas. The use of sector resection with or without axillary clearance was the preferred management in 50% of cases, and regarding neoadjuvant therapy, 91 out of 119 patients were directed towards chemotherapy. Conclusions: Periodic checkings in adult women performed at least annually can prevent diagnosis in advanced stages. [ABSTRACT FROM AUTHOR]

Backgound: In Romania Roma women are vulnerable to pregnancy-related events, unwanted pregnancies, stillbirth, abortion and cervical cancer. This paper aims to analysis the use of reproductive health services, family planning, prenatal care and screening for cervical cancer by Roma women. Methods: A secondary analysis was performed on the data of the Reproductive Health Survey in Romania 2016, of a subsample of 314 Roma women, aged 15-44 years. Results: 2/3 of Roma women had their first pregnancy in adolescence, 66.9% between 15-19 and 8.4% under 15 years of age. 65.4% Roma adolescent girls had their first child at 15-19 years, and 2.8% at ages under 15 years. During pregnancy, 24.1% of Roma women do not use prenatal care services, three times more than the women from the reference population (7.1%) (p < 0.01). 73% of Roma women have never benefited from cervical cancer screening compared to 42.7% in the general fertile female population. 46, 7% of Roma women use any type of contraceptive method and 38.1% modern methods, a closed prevalence of contraception in the general population of fertile women (48.4% of any method and 38.7% modern methods) Conclusions: Roma women have their first pregnancy in adolescence. There are inequalities in the use of preventive services for prenatal care and cervical cancer screening of the Roma female population compared to the reference female population in Romania. Public health policies should include specific active measures for Roma women to improve their access to preventive services. In order to prevent unwanted pregnancies, public health policies in Romania should include family planning measures addressed towards all women, but using methods culturally adapted to the Roma population. Key messages: • There are inequalities in sexual reproductive health services use of Roma minories women I Romania. • Services and active preventive mesures should be adressed to Roma populationtion. [ABSTRACT FROM AUTHOR]

People with dependent personalities are characterized by their wish of being protected and their dependent behavior can have a negative impact on themselves and on others. Dependent personalities can have a great impact on the parent-child relationship. People of all ages seek guidance and support from their parents but when a parent has dependent traits, the boundaries can become unclear. Parents can depend on their children and this role switch can deprive the youngsters of proper development, in this case, the caretaker becomes the cared for. The aim of our paper is to emphasize how people with dependent personalities can influence parental reports. [ABSTRACT FROM AUTHOR]

Information about several papers discussed at the 5th edition of the European Teaching Course on NeuroRehabilation held at the University of Medicine and Pharmacy in Romania on June 1-14, 2015 is presented. Topics include premature brain aging, traumatic brain study, and neurorehabilitation. The conference featured several speakers including Johannes Vester, Albert Ludolph, and Amos D. Korczyn.

Introduction: Ankle fractures are common injuries with a wide variety of potential causes, ranging from a trivial twisting injury, in elderly frail patients to high-energy trauma in young patients. Bimalleolar fractures involve both lateral and medial malleoli at the distal ends of the fibula and tibia, and they frequently result from high-energy injuries. Eversion is considered the most common mechanism capable of causing various types of damage. Case Report: The objective of this paper is to present a case study of a 45-year-old patient, who presented at the Emergency Department complaining of pain in the ankle with movement limitation in a pre-immobilized inferior limb by another hospital service after a minor sledding accident. During the clinical examination, perimalleolar ecchymosis, local edema, and a discontinuity in the bone margin with bone crepitus and abnormal mobility were observed. Positive prognostic signs were also noted as peripheral pulse was present, and no trophic, neurological, or vascular disturbances were found. Following the radiologic exam, the diagnosis of bimalleolar fracture associated with tibial posterior pilon fracture and tibio-astragalian subluxation of the inferior right limb was established. By the anterior mentioned diagnosis, and after a paraclinical examination, surgical treatment was initiated as quickly as possible. A lateral approach at the level of the lateral malleolus was undertaken, involving an open reduction of the fracture. Osteosynthesis was attempted using an inter-fragmentary compression screw and an anatomical plate with titanium screws, all under radiological control. Additionally, an open reduction and internal malleolus osteosynthesis was performed with a stainless steel traction screw. However, for the tibial pilon fracture, osteosynthesis was considered unnecessary due to the size of the fractured fragment at this level. After the surgery, the limb had to be immobilized in a plaster cast, with the addition of resting in bed and elevating the affected foot. The patient's progress was favorable, with no signs of infection or suppuration. Discussions : Surgery is the primary treatment of bimalleolar fracture due to its unstable nature, which can lead to complications such as damage to the neurovascular bundles and malunions or nonunions of the fractured bones. These types of consequences can result in a significant reduction in the patient's quality of life. Conclusions: In this case, a lack of resources and the haste of the first medical team could have caused severe complications. As in other cases, treatment should be targeted at the underlying issue rather than just addressing the signs and symptoms. [ABSTRACT FROM AUTHOR]

Background: Over the past decade, antibiotic consumption has substantially increased, leading to a corresponding rise in their presence in the environment. While some antibiotics, like penicillins and cephalosporins, break down quickly due to hydrolysis, others such as fluoroquinolones and tetracyclines exhibit high chemical stability, allowing them to persist in the environment and accumulate over time. Because antibiotics are present at high levels in the environment, they are classified as a contaminant of emerging concern. The current water treatment technologies do not remove all traces of antibiotics in wastewater, therefore the monitoring of their occurrence in surface and wastewater becomes very important. Objective: This paper aims to provide a brief overview and summarise the main chromatographic methods described in the literature for the determination of fluoroquinolones from different water samples. Material and methods: The analysis of scientific literature published in the last 10 years in PubMed, Science Direct, Medline and Google Scholar using the following keywords: "fluoroquinolones", "wastewater", " environment", "chromatography" and "contamination". Results : Fluoroquinolones are a family of broad-spectrum antibiotics, being bactericides used against a wide range of aerobic and anaerobic gram-positive and gram-negative microorganisms. High-performance liquid chromatography (HPLC), ultra-performance liquid chromatography (UPLC) with UV detection and liquid chromatography coupled to mass spectrometry (LC-MS) are the main methods used to analyze fluoroquinolones in wastewater. Surface water receives water from various sources along with pollutants such as RAbs (residual antibiotics) and ARGs (Antimicrobial Resistance Genes). Data reviewed from the literature indicate that ofloxacin, norfloxacin and ciprofloxacin, some of the most prescribed antibiotics in the class, are the most commonly encountered fluoroquinolones as water contaminants. The results showed that ciprofloxacin and levofloxacin were detected in the raw water, while ciprofloxacin and levofloxacin were also detected in the finished water. Conclusions: Although analytical methods for the simultaneous detection and quantification of different antibiotic contaminants in the environment have been extensively researched over the last decade, to facilitate ongoing monitoring and enhance understanding of the fate of antibiotics in the environment, it is essential to develop standardized analytical techniques for the analysis of antibiotic residues from as many classes as possible and to implement more restrictive legislation on the monitoring and destruction of antibiotics. [ABSTRACT FROM AUTHOR]

Introduction: Intensive care specialists navigate a treacherous terrain, where the convergence of multiple pathologies presents formidable challenges. This paper aims to underscore the importance of prompt recognition, comprehensive evaluation, and aggressive management of critically ill patients presenting with complex and multisystem pathology Case Report: Our case report presents a 49-year-old patient admitted to the emergency department accusing diffuse abdominal pain refractory to opioid administration. He was transferred to the intensive care unit in a critical state, being hemodynamically unstable, cold, pale, cyanotic teguments and bilateral edema of the lower limbs. The handover diagnosis comprised of toxic hepatic cirrhosis, severe metabolic acidosis, unknown substance intoxication and dilatative cardiomyopathy with severely depressed ejection fraction (25%). He was orotracheally intubated, double inotrope positive and vasoactive maximal doses of medication (Dobutamine 250mg/50ml, Noradrenaline 16mg/50ml) were administrated and . A central venous catheter and a dialysis catheter were placed in the right jugular vein and femoral vein, the patient undergoing emergency dialysis. Discussions : Each of these diagnoses presents significant challenges and complications on its own, and their convergence in this case amplifies the complexity of the clinical scenario. Unknown substance intoxication, with its erratic manifestations aggravates the preexisting hepatic cirrhosis, also representing the main cause of sever metabolic acidosis. Amidst this confluence of ailments, severe dilatative cardiomyopathy emerges as a formidable adversary, its relentless assault on the cardiovascular system exacerbating the precarious state of the patient. The decision to perform emergency dialysis reflects the urgency in addressing the underlying metabolic derangements and renal insufficiency contributing to the patient's clinical deterioration. This intervention aims to mitigate the systemic consequences of severe metabolic acidosis and renal dysfunction, potentially stabilizing the patient's condition and improving overall prognosis. Conclusions: For the intensive care specialist, the management of such cases requires a blend of expertise, empathy, and unwavering vigilance. Each decision is fraught with the weight of [ABSTRACT FROM AUTHOR]

Introduction: Meningitis is a dangerous medical disorder caused by inflammation of the meninges which are the protective membranes that cover the brain and the spinal cord. Bacterial meningitis, specifically, is often severe and can lead to significant complications if not promptly treated. Several bacteria are known to cause bacterial meningitis, with some of the most common pathogens being Neisseria meningitidis, also known as meningococcus, Streptococcus pneumonia, and Haemophilus influenzae type b. Acinetobacter baumannii and organisms producing extended-spectrum beta-lactamases (ESBL) are responsible for a wide range of diseases, including pneumonia, cholangitis, urinary tract infections, intra-abdominal abscesses, and in rare instances meningitis. This paper's main objective is to illustrate a complicated case of meningitis caused by unusual agents and the challenges associated with high resistance to treatment. Case Report: We present the case of a 65-yearold male patient with ventriculoperitoneal shunt (VPS) placement for normal pressure hydrocephalus (NPH) ten years ago, who presented to the Emergency room in February 2024 with nausea, vomiting, and ataxia. He was hospitalized in Akdeniz University Hospital, Neurosurgery Department for VPS revision. A week later pneumocephalus was detected on a CT scan and an external ventricular drainage (EVD) was placed. After the patient's general condition got worse, the Glasgow Coma Score decreased from 15 to 5, he was taken to Reanimation Intensive Care Unit and intubated. Meningeal irritation tests were positive and the laboratory tests revealed Leukocytosis (26500/ mm3) and increased CRP (89.6/mm3). Blood culture revealed extended-spectrum beta-lactamase Klebsiella pneumoniae which was sensitive to Meropenem. Discussions : After 3 days of Meropenem 3 gr/day, cerebrospinal fluid was taken from EVD and revealed Acinetobacter baumannii, a gramnegative bacterium that typically causes infections in hospitalized patients, particularly those with compromised immune systems or prolonged stays in intensive care units. Treatment with Colistin started 3x120mg/day. The patient's condition is improving under ICU, and repeated laboratory tests showed decreased leukocytes(16550/ mm3) and CRP (59/mm3). Conclusions: Meningitis caused by Acinetobacter baumannii or ESBL-producing organisms presents a significant challenge in terms of treatment due to their resistance to many commonly used antibiotics. Management typically involves the use of alternative antibiotics, often in combination therapy, guided by susceptibility testing. [ABSTRACT FROM AUTHOR]

Introduction: Atypical Kawasaki Disease (KD), also known as incomplete Kawasaki, is a systemic vasculitis primarily affecting the pediatric population. It is characterized by a prolonged unexplained fever lasting five or more days, with fewer than four classical KD symptoms, such as conjunctival injection, oral mucosal changes, cervical lymphadenopathy, polymorphous rash, and extremity changes. Atypical KD often presents with laboratory indicators of systemic inflammation and may show abnormalities in the coronary arteries on echocardiography. Case Report: The aim of this paper was to provide a comprehensive description of a 34-month-old male patient who developed atypical KD following exposure to COVID-19. The case highlighted clinical presentation, diagnostic challenges, management strategies, and outcomes. Despite being fully vaccinated and having no significant medical history, the patient experienced persistent fevers that did not improve with antipyretic treatment. Laboratory tests revealed elevated markers of inflammation, including leukocytosis, CRP, ESR, Ferritin, and GOT. Cardiological evaluation was required due to coronary artery dilation observed on echocardiogram. Early intervention was crucial to prevent serious cardiac complications in KD. Discussions : The case report brought attention to the difficulties involved in diagnosing atypical KD within the context of post-viral multisystem inflammatory syndromes, specifically Multisystem Inflammatory Syndrome in Children (MIS-C), which can occur after exposure to COVID-19. The patient's clinical presentation of unexplained fever, systemic symptoms, and laboratory markers of systemic inflammation raised suspicion for incomplete KD. Echocardiography played a crucial role in confirming the diagnosis by demonstrating coronary artery dilation, a characteristic finding in KD. The absence of classical symptoms in atypical KD lead to challenges in distinguishing it from other post-viral inflammatory syndromes. In this case, the patient's exposure to COVID-19, along with the temporal relationship between the viral infection and symptom development, raised suspicion for atypical Kawasaki Disease. Elevated inflammatory markers and echocardiographic findings supported the diagnosis. Early intervention with IVIG treatment resulted in positive outcomes and reduced long-term cardiac complications. The association between COVID-19 and Kawasaki-like syndromes, such as MIS-C, was increasingly acknowledged. Healthcare providers should consider Kawasaki disease in pediatric patients with fever and systemic inflammation after COVID-19 exposure. Conclusions: This case emphasized the challenges in diagnosing atypical KD in post-viral inflammatory syndromes, highlighted the importance of early recognition and intervention to prevent cardiac complications, and underscored the role of echocardiography in confirming the diagnosis and guiding management. [ABSTRACT FROM AUTHOR]

Introduction: The ovarian fibroma is the most common benign stromal ovarian tumor. It is associated with ascites in 40% of cases and, in a small percentage, with hydrothorax. The symptoms mimic a neoplastic condition, with imaging examinations being very useful in diagnosis. Case Report: In this paper, we present the case of a 66-year-old patient who was admitted by appointment on October 25, 2023, with a diagnosis of an abdominal tumor, likely of right adnexal origin. The patient reports the onset of lower abdominal pain approximately 4 months ago, associated with abdominal bloating. The symptoms worsened, with the patient noticing a progressive increase in the size of her abdomen. From the patient's medical history, we note: hydrostatic varices of the lower limbs, essential hypertension, NYHA II congestive heart failure, obesity, hepatic steatosis, gallbladder lithiasis, basal cell carcinoma of the face excised in 2020, recurrent and reoperated on October 11, 2023. The physical examination reveals a distended abdomen, with palpation revealing an indistinctly delimited tumor formation, approximately 40x30 cm in size, firm, slightly sensitive, occupying almost the entire abdominal area. Computed tomography reveals a space-occupying process, relatively well-defined, originating from the right adnexa, with a mixed component (tissue and fluid), measuring 18.2/29/22.6 cm (AP/LL/CC). The described formation is located in the mesogastrium, hypogastrium, flanks, and pelvic area, causing a mass effect on the intestinal loops, ascending colon, and sigmoid colon. Significant abdominal-pelvic fluid accumulation is noted, along with a 3.6 cm umbilical hernia, marked infiltration of subcutaneous tissue. On October 26, 2023, surgical intervention was performed, including total hysterectomy with bilateral salpingo-oophorectomy, greater omentum resection, cholecystectomy, omphalectomy, Douglas and subhepatic drainage, abdominal wall repair, and skin closure, for the intraoperative diagnosis of right adnexal tumor adherent to the small intestine loops and greater omentum, ascites, chronic calculous cholecystitis, adhesive syndrome. The postoperative course was favorable, and the patient was discharged on the 7th postoperative day. Histopathological examination revealed right ovarian fibroma, uterine leiomyoma without atypia, and chronic cholecystitis. Discussions : The association of ovarian fibroma, ascites, and hydrothorax is termed Demons-Meigs syndrome. The association of ovarian fibroma solely with hydrothorax or solely with ascites is called pseudo-Meigs syndrome. Ovarian fibroma accounts for 2-5% of surgically removed ovarian tumors. The preferred treatment is surgical intervention. Conclusions: The surgical treatment of the patient, who underwent surgery for basal cell carcinoma of the face 15 days ago, resulted in the resolution of [ABSTRACT FROM AUTHOR]

Introduction: Tumor intussusception in transverse colon cancer involves the telescoping of a segment of the colon into an adjacent part, often triggered by a tumor acting as a lead point. It is more common in pediatric cases, while in adults, it frequently indicates an underlying malignancy such as transverse colon cancer. Case Report: Our paper aims to present the case of a 39-year-old female patient diagnosed with intestinal occlusion caused by neoplasia of the transverse colon. The patient was admitted to First Surgical Clinic -SCJU Tg. Mures via UPUSMURD were she accused of severe abdominal pain with the absence of intestinal transit. The abdominal CT scan indicates significant hydroaeric levels measuring 10 cm in the ascending and right half of the transverse colon. Additionally, there is evidence of obstructive syndrome of the left transverse colon characterized by a double wall invagination of the transverse colon extending over a length of 9 cm (intussusception). The surgical procedure performed was a right hemicolectomy with ileocolic mechanical anastomosis. Discussions : The patient's postoperative recovery proceeded smoothly without early or delayed surgical complications. She was discharged after eight days of hospitalization without encountering any complications. The histopathological postoperative report revealed mucinous adenocarcinoma of the transverse colon with high-grade malignancy (MSI-H). Conclusions: This case underscores the complexity of diagnosing and treating intussusception in adults, where such occurrences often indicate an underlying malignancy. Furthermore, this case highlights the necessity for vigilance in evaluating adult intussusception as a potential sign of serious underlying conditions, including malignancy. [ABSTRACT FROM AUTHOR]

Introduction: Increasing the use of total elbow arthroplasties challenges conventional contraindications, as demonstrated in our case study of a type III C open fracture. Despite potential complications, our approach prioritized patient comfort and limb functionality, emphasizing the importance of infection prevention, soft tissue coverage, and timely intervention. This paper highlights the feasibility and outcomes of elbow prostheses in complex fractures, advocating for flexible surgical strategies. Case Report: In an intricate case of severe upper extremity trauma resulting from a car accident, a 50-year-old patient underwent a comprehensive treatment culminating in total elbow arthroplasty (TEA) using an endoprosthesis, one-year post-injury. Initial injuries included type III C open fractures of the left distal humerus and proximal forearm, with substantial bone loss and nerve damage. Following initial wound debridement and stabilization, the focus shifted towards restoring elbow function through arthroplasty. The TEA procedure was meticulously planned to address the challenges posed by previous trauma and the extensive loss of bone. A significant aspect of this surgery was the utilization of a prosthetic device, which obviates the need for condylar reconstruction, thus simplifying the integration into the existing bone structure. Preparation involved careful rasping of the humerus and ulna, ensuring a precise fit for the prosthesis. The surgical strategy included the use of high-viscosity cement for securing the prosthesis, reinforced by a cerclage band for added stability. Moreover, a bone allograft compensated for the pronounced bone deficit, highlighting the adaptability of the chosen prosthesis to complex cases. Postoperative results demonstrated a substantial improvement in elbow functionality. Despite a permanent limb shortening, the patient achieved significant gains in motion range and muscle function, underscored by a notable increase in the Mayo Elbow Score from 30 to 80. Radiographic follow-up confirmed the successful integration of the prosthesis, without evidence of radioulnar synostosis. Discussions : Our case report emphasizes the effective application of TEA in managing a complex open fracture with significant bone loss and nerve damage, challenging traditional contraindications. It underscores the importance of timely, multidisciplinary intervention, meticulous initial osteosynthesis, and postoperative rehabilitation, highlighting TEA's expanding therapeutic indications despite potential complications such as ulnar nerve palsy. Conclusions: This case exemplifies the critical role of TEA in the rehabilitation of severe elbow injuries. The use of a prosthetic device, alongside strategic surgical interventions, facilitated remarkable functional recovery, offering insights into managing challenging orthopedic cases. [ABSTRACT FROM AUTHOR]

Background: Battlefield trauma management represents an essential aspect of military medical care, as well as a major challenge which impacts directly the soldiers involved in armed conflicts regarding their surviving and recovering. Ultrasound is a non-invasive imagistic technique with potential in the initial evaluation and the triage of the wounded, especially in the environments with limited resources and restricted access to complex equipment. Objective: The present paper aims to evaluate the benefits of using ultrasound in managing battlefield trauma, considering its role in quickly diagnosing internal injuries, guiding the therapeutic interventions and optimizing the decisions regarding both the treatment and the evacuation. Material and methods: With a view to achieving these objectives, we accomplished a systematic review of the relevant literature, examining reports and scientific articles on the use of ultrasound in the management of battlefield trauma. Results : Ultrasound is a rapid, non-invasive and portable method for assessing traumatic injuries, allowing for the quick identification of internal hemorrhage, pneumothorax, vascular injuries, or even musculoskeletal injuries. The use of ultrasound in battlefield trauma management has demonstrated a significant improvement in diagnosis and therapeutic guidance, as it reduced the time from assessment to intervention, contributing consequently to life-saving. Conclusions: In conclusion, echography represents a valuable tool among the military medical means for managing the trauma on the battlefield. Integrating it in the clinical practice can significantly improve the capacity of diagnosis and treatment for the traumatic injuries, thereby leading to a more effective medical care, as well as to improved results both for the soldiers and the civilians involved in armed conflicts. [ABSTRACT FROM AUTHOR]

Background: The tabacco is know in history as a recreative or a curative plant, although it has well-known adverse effects as, cardiac or pulmonary disease, even a carcinogenetic impact. Also, in dental field, tobacco is associated with low salivary flow, bacterial plaque and tartar, carious processes, parodontitis and oral cancer. Objective: This study aims to appreciate the connection between biological and psycho-social factors in using of tabacco, to evaluate if socio-economical and demographic factors in association with tabacco can lead to oral disease, to observe the degree of dento-periodontal damage and also to highlight the possible complications related to single exposure of tabacco or in combination with other factors. Material and methods: This paper is a questionnair-type study, that includes a number of 130 subjects. The inclusion criteria is represented by tobacco consumers and the following characteristics are evaluated: age and gender, level of education, standard of living, age of starting regular smoking, the presence of general or dental conditions, the process of quitting smoking, the degree of losing teeth and dental sensibility, the presence of other smokers in familiy, the degree of oral hygene. Results : We have demostrated that tobacco is a major determinant of dento- periodontal disease, alone but also in association with poteating factors. We find that urban subjects are more prone to this harmful habit, resulting a much higher rate of loss of dental structures. Smoking is considered as important as procuring basic food, but more important than dental interventions. Women have a lower rate of quitting smoking compared to men. The act of quitting smoking also increase proportionally with age. People with a higher level of education were more likely to try to quit smoking. The subjects who have one/both parents who smoke, have a significant potential to start smoking before the age of 18. The link between gastro-esophageal reflux and smoking has been confirmed. The subjects with this pathology have an exponentially higher degree of dental sensitivity compared with,,healty smokers". Tartar deposits are directly proportional with the number of cigarettes and the absence of teeth. We manage to prove the corelation between the degree of dental hygene and the occurrence of dento-periodontal pathology, which was inversely proportional. Conclusions: The goals of this study have been achived, but some aspects require a much more detailed analysis because of the large widespred of this practice and the considerable number of factors that can be associated with. [ABSTRACT FROM AUTHOR]

Background: Sphenoorbital meningiomas (SOMs) represent a relatively rare tumor group with complex anatomical features and considerable morbidity for the patient. Along the decades, numerous approaches have been refined in order to ensure maximal resection and preservation of the structures comprising the intricate anatomy of the orbit. Objective: The aim of this paper is to evaluate the significance of classical transcranial corridors considering the variety of other less invasive approaches to this pathology. Material and methods: A search was performed with all possible combinations of MESH terms such as "Sphenoorbital," "Meningioma", "Transcranial", "Endoscopic Transorbital" using acknowledged medical research databases (Pubmed, ScienceDirect). Studies in English providing insight into the effectiveness of transcranial and endoscopic approaches to SOMs were selected and analyzed. Secondary and tertiary literature sources were additionaly consulted. The case of a patient with sphenoorbital meningioma and reactive hyperostosis referred to and operated in the neurosurgery department of the Emergency County Hospital Târgu Mureş was also included. Results : Despite the implementation of endoscopic resection techniques, transcranial approaches such as the pterional one remain a landmark in the field of sphenoorbital meningiomas. They ensure excellent exposure of the tumor when arising from the lateral and middle sphenoid wing. Moreover, reactive hyperostosis of the surrounding bone and lateral compression of the optic canal can be tackled satisfactorily by approaching the meningioma from the pterion. However, problems occur when the sphenoorbital meningioma originates from the clinoidal process, compressing the optic canal medially and/or inferiorly. In this situations, other approaches should be adopted. Conclusions: Transcranial approaches of sphenoorbital meningiomas have yet to lose their importance, despite the existence of other surgical corridors associated with better esthetic outcomes. A point to be kept in mind is that improvement of symptoms and overall postoperative evolution of the patient are associated not only with the chosen approach, but also with the extent of resection, degree of optic canal compression and extension into the periorbit. [ABSTRACT FROM AUTHOR]

Background: Metformin (dimethylbiguanide) is part of the biguanide class of antidiabetic drugs. It is a first-line drug in the case of type 2 diabetes. After oral administration is quickly absorbed. Its most common side effects are diarrhea, anorexia, nausea, vomiting. The main mechanism of action of Metformin is through the activation of AMP (adenosine monophosphate)-activated protein kinase, a central pathway in metabolic regulation, cell protection and cell survival. As we age, high blood pressure can occur along with diabetes and rise the risk of renal failure and cardiovascular complications. Objective: This paper aims to evaluate the interactions of Metformin with antihypertensive medication and other types of interactions such as with vitamin B12 and how does vitamin B12 affects the cardiovascular system. Material and methods: This systematic review of literature was shaped trough the usage of databases such as: MedScape, PubMed, UpToDate and Google Scholar. All the literature included in the study was published in English. Results : Metformin interacts with antihypertensive medication as it follows: Verapamil decreases the effect of Metformin by possibly inhibiting hepatic uptake of Metformin via OCT1 or other transporters; Thiazides and loop diuretics may reduce the blood glucose-lowering effect of Metformin by inhibiting the function of the beta-islet pancreas; Angiotensin-converting enzyme inhibitors increase the toxicity of Metformin by an unknown mechanism; Amlodipine decreases the effect of Metformin by pharmacodynamic antagonism; Betablockers and modulators of sympathetic activity cause a decrease in blood glucose by masking the adrenergic symptoms that signal hypoglycemia. Vitamin B12 has two effects on the cardiovascular system: by preventing the conversion of homocysteine to methionine and through the endocrine system. Homocysteine affects the endothelial function and intrinsic thrombolysis. The endocrine system is sensitive to B12 deficiency. The vitamin is needed for the structure of cell membranes, so that the pituitary gland can measure how much of each hormone is in the blood and adjust as needed. A lack of B12 can cause high levels of neurotransmitters, and excitatory hormones, leading to high blood pressure. Metformin may induce hypovitaminosis B12 through different possible mechanisms, such as altered intestinal motility and interaction with the endocytic receptor cubilin. Conclusions: Type 2 diabetes is frequently associated with high blood pressure, especially in the elderly patient. Interactions of Metformin with antihypertensive therapy must be analyzed to maximize the therapeutic effects and minimize the risks. The aim is of increasing the quality of life and life expectancy of patients with complex pathologies. [ABSTRACT FROM AUTHOR]

Background: Some of the most common challenges in medical world are the management of pain, inflammation, as well as various cardiovascular diseases. This is the reason why anti-inflammatory, antiplatelet and anticoagulant drugs are widely used. Concomitantly with the beneficial effects, these drugs increase the risk of nonvariceal upper gastrointestinal bleeding, as they may cause ulceration of the upper gastrointestinal mucosa directly or may cause more abundant bleeding or rebleeding. Objective: The aim of this paper was to investigate outcomes of acute upper gastrointestinal bleeding and to examine the role of drugs potentially associated with hemorrhagic event. Material and methods: This retrospective study, includes a total of 214 patients admitted to the Gastroenterology Department of the Mureş Clinical Country Hospital, between January 2021 and December 2022,with main manifestations of hematemesis and/or melena and endoscopic diagnosis of gastroduodenal lesion (ulcer, erosion).The batch was divided into 6 groups according to the consumption of drugs. We analyzed clinical parameters, comorbid diseases, the need for blood transfusion and duration of hospitalization. Rockall and Blatchford prognostic scoring systems were used to assess the risk of rebleeding and death. Results : Regarding the history of drug consumption, the patients were assigned to an unexposed group consisting of 115 subjects (54 %)(group 1) and an exposed group represented by 99 patients (46%).Of the 99 patients, 14.5% on anticoagulant, whether it is vitamin K antagonists or direct oral anticoagulants (group 2), 10.3% on aspirin only (group 3), 4.2% on dual antiplatelet therapy (group 4), 5.1% on combined antiplatelet-anticoagulant therapy (group 5) and 19.2% consume non-steroidal/steroidal anti-inflammatory drugs (group 5).A prior history of upper gastrointestinal bleeding prevails in the exposed group (p=0.018).Pharmacotherapy potentially associated with upper gastrointestinal bleeding, especially anticoagulant treatment (p=0.017) proved to be an independent predictor for clinically significant bleeding, defined by the presence of clinical signs of hemorrhagic shock, or the need for transfusion (OR=1.908,p=0.017).Among patients on anticoagulant monotherapy and combined antiplatelet-anticoagulant, the Blatchford score was higher than in the other groups (p=0,029).Also, the Rockall score in group 2 was higher than in the unexposed group (p=0.012).The transfusion requirement was higher in exposed group(p=0,018),especially in group 2 (p=0.037).We noticed a higher length of hospitalization among patients on anticoagulant treatment than the unexposed group (p=0.044). Conclusions: Anticoagulants proved to be an independent predictor for a major bleeding event, increasing the need for blood transfusion, the duration of hospitalization, the risk of rebleeding and death. [ABSTRACT FROM AUTHOR]

Background: Placental abruption represents the premature separation of the placenta from its uterine attachment before the delivery of the fetus. It is a pregnancy related complication occurring in 0.6-1.2% of cases. Objective: The aim of the present paper was to report the case of an acute placental abruption in a spontaneous antepartum demise. Material and methods: We report the case of a 34 year old patient in her 38th week of pregnancy who presented to the Emergency Department accusing the absence of fetal movement. No significant risk factors, namely preeclampsia, smoking, drug use or vaginal hemorrhage were encountered. Emergency cesarean section was performed. The female stillborn with umbilical cord entangled around the neck and the placenta were sent to Pathology Department Results: The autopsy report revealed primary pulmonary atelectasis and multiple autolyzed organs (liver, spleen and kidneys). The histopathologic examination of the placenta showed visible signs of passive fetal vascular involution with thrombosis due to acute placental abruption. Meconium staining of the fetal membranes indicated previously fetal distress Conclusions: Placental abruption continues to be an important cause of perinatal mortality and morbidity. The outcome is heavily influenced by the severity and the timing, whether acute or chronic, of the placental separation. Despite the accuracy of medical technology in preventing stillbirth, it still represents a clinical challenge. [ABSTRACT FROM AUTHOR]

Background: The use of bioprosthetic valves (BPV) for severe symptomatic aortic stenosis has been a standard surgical replacement technique for older patients. Due to their limited durability, in the failure of BPVs Valve-in-Valve Transcatheter Aortic Valve Implantation (ViV-TAVI) emerged as the alternative to surgical treatment. Objective: We present the case of a 81-years-old male patient with aortic BPV failure. Material and methods: On admission the patient described dyspnea, fatigue and the medical history revealed aortic BPV (Saint Jude no. 23) implanted 8 years prior, heart failure with mildly reduced ejection fraction (EF), arterial hypertension, permanent atrial fibrillation (AFib), type II diabetes and treated gastric ulcer. The clinical exam revealed an overweight patient with post-sternotomy scar, arhythmic heart sounds and aortic systolic murmur, without signs of congestion. The electrocardiogram revealed AFib and left bundle branch block (LBBB). Echocardiography showed severely degenerated aortic BPV with gradients of 90/55mmHg, moderate mitral and tricuspid regurgitation and a hypertrophic non-dilated left ventricle with EF of 45-50%. No significant epicardial coronary lesions were present on the coronarography. Considering the patient's age, prior heart surgery and surgical risk (EuroSCORE II 10.9%), ViV-TAVI was chosen to treat the failed BPV. Results: Transfemoral ViV-TAVI was performed with an Edwards Sapien 3 no. 23 balloon-expandable valve, with the fracture of the BPV with good results. Post-procedural electrocardiogram was unchanged. Echocardiography showed mild trans-prosthetic regurgitation, trans-prosthetic gradient of 30/15mmHg, moderate mitral and tricuspid regurgitation and normal-diameter left ventricle with EF of 40-45%. Conclusions: Despite the mild trans-prosthetic regurgitation, the procedure achieved its goal without serious complications. However, the complication rate could be higher in ViV-TAVI. Thus, we believe this paper contributes to the growing body of evidence that ViV-TAVI is a feasible therapeutic option for patients with failed BPVs. [ABSTRACT FROM AUTHOR]

The article discusses the highlights of the 2014 International Conference on Formal Concept Analysis (ICFCA) held in Ckuj-Napoca, Romania, from June 10 to 13, 2014. Authors from 14 different countries submitted papers for the conference. Topics discussed during the conference include data visualization, information retrieval, data mining and knowledge discovery.

The article discusses the national congress organized by the "Carol Davila" University of Medicine and Pharmacy that was held at the House of Parliament of Romania building from May 30 to June 1, 2013. Topics discussed in the congress include the relationship of urology and nephrology, pediatric medicine, and arterial pulmonary hypertension. Several medical professors have attended the event including Sorin Oprescu, Martin Burian, and Christopher Bull Granger.

Abstract: Research and technological developments in Enterprise Integration and Networking requires identifying achievements, challenges and trends in order to establish a set of coherent vision and roadmap for future research. This paper analysis and discusses on recent achievements and future trends on research for Enterprise Integration and Networking solutions, identifying principal challenges for this research area. Such challenges are then analysed with regard to the contributions of this special issue, organised with extended papers selected by the IFAC TC 5.3 and presented at the IFAC INCOM 2012 symposium held in Romania on May 2012. [Copyright &y& Elsevier]

The article offers information on CAR 2011 - International Congress Automotive and Environment to be held on November 2-4, 2011 in Pitesti, Romania.

One of the main areas of interest at the end of the 19th century and the begining of the 20th century was an interesting disorder named hysteria. Today this diagnosis is not used anymore under this form by the scientific community as it was meanwhile deconstructed into more diagnoses. As for today, histrionic personality disorder seems to be the basis of this former diagnostic construct as the other component diagnoses (conversion disorder, somatic symptom disorder, and dissociative disorders) can represent decompensations or even manifestations (in milder forms) of the aforementioned personality disorder. While hysteria was so well acknowledged and studied before, histrionic personality disorder does not benefit of the same attention. Experts are even considering removing this diagnosis because of the overlap with other personality disorders. However, this propensity to mimic other personality disorders or even other diseases (by decompensation into the other aforementioned related diagnoses) makes this personality disorder important in the differential diagnosis of the other disorders as it has a better prognosis than most of the disorders it mimics. In conclusion, this paper provides a synthethisation of the differential diagnosis of the histrionic personality disorder and by extension also the differential diagnosis of the other disorders that it can decompensate into. In this way, it tries to emphasize the relevance of this disorder for the medical community. [ABSTRACT FROM AUTHOR]