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Screening programs using Papanicolaou smear along with human papillomavirus (HPV) testing led to a significantly decrease of cervical cancer rates. Nevertheless, both assessments have limited specificity for revealing cervical high-grade lesions. The main problem is how to identify the real precursor of cervical squamous cell carcinomas (SCC), namely high-grade squamous intraepithelial lesions (HSIL).The aim of our study was to conclude if ProEx C might be used as a marker for high-grade cervical intraepithelial neoplasia (CIN).In this study, we detected the immunochemical expression of anti-ProEx C antibody in liquid-based cytology (LBC) samples. We analyzed a total number of 125 cervical cytology specimens.In 48% of all cases, ProEx C was found to be positive. The percentage increased from 0% in negative for intraepithelial lesion or malignancy (NILM) cases to 100% in SCC cases.ProEx C may be utilized to improve the accuracy of cytological diagnosis on cervical smears, according to the findings of this study. This marker is also useful in detecting unrevealed high-grade lesions on atypical squamous cells of undetermined significance (ASC-US), low-grade squamous intraepithelial lesions (LSIL) smears, being very useful in establishing the conduct of these cases.

Hemophilia is a hereditary coagulopathy caused by factor VIII (hemophilia type A) or by coagulation factor IX (hemophilia type B) dysfunction, characterized by an increased bleeding predisposition, which is either spontaneous or secondary to minimal trauma. Currently, hemophilia may also be considered an 'orthopedic' condition, due to the fact that it affects the musculoskeletal system of most hemophilic patients. In recent years, constant prophylaxis using coagulation factors has led to a significant improvement in the hemophilic patient's quality of life, by reducing both life-threatening hemorrhagic phenomena, as well as the occurrence of chronic complications. Nevertheless, progressive joint bleeding remains unavoidable in this category of patients, and the onset of chronic arthropathy with secondary motor deficiency remains the main complication with an invalidating character. In such cases, orthopedic management is imperative; osteoarticular complications being managed most often with the help of conservative or surgical techniques. The purpose of this review is to provide an overview of modern orthopedic practices which are useful in the management of hemophilic patients suffering from osteoarticular disorders.

Background and Objectives: Considering atherosclerosis as one of the more challenging threats to healthcare worldwide, any novel therapy that counteracts the risks for developing it, provides new opportunities for the management of this process. Material and methods: We performed an experimental research in which we induced a hypercholesterolemia via a cholesterol-rich diet. Our aim was to demonstrate the antiatherogenic potential of two essential amino acids (valine and leucine). The experimental study was carried out over a period of 60 days. Male Wistar rats weighing between 250–280 g were used and divided into 4 groups, each group including 8 animals. Group I—control was fed with a standard diet. Group II received cholesterol, group III cholesterol and valine and group IV cholesterol and leucine. Blood samples were collected from the retro-orbital plexus, under anesthesia with 75 mg/kg of intraperitoneal ketamine, in three different moments (R0—1st day, R1—the 30th day, R2—the 60th day) in order to measure the levels of triglycerides. Results: In R0, there were no significant differences between the average levels of triglycerides across all the groups (p &lt, 0.05). Compared to the group I, in R1 and R2, the average levels of triglycerides were significantly higher in all groups (p &lt, 0.001). Also, in R1 and R2, the average triglycerides in group II receiving cholesterol (C) were significantly higher than those in group III receiving valine (C + V) as well as in group IV receiving leucine (C + L) (p &lt, 0.001, p &lt, 0.05). In R2, the average triglycerides in group III were significantly lower than in group IV (p &lt, 0.001). Conclusions: Our data provides evidence that valine and leucine have a direct impact on the lipid metabolism parameters by lowering the level of triglycerides. The comparison of the two essential amino acids indicates that valine acts more promptly and rapidly than leucine.

Background and Objectives. Uterine fibroids are relatively common in reproductive-age women and are directly linked to pregnancy. There are many debates about performing a myomectomy at the same time as a caesarian section (CS) in such cases due to the risk of a hemorrhage. Our study aims to investigate fibroid features and their evolution in pregnancy, complications of a myomectomy during CS and maternal and fetal obstetric outcomes of pregnancies with fibroids. Materials and methods. We realize a prospective study that includes 57 patients with fibroids in pregnancy diagnosed in January 2017–June 2019. We analyze the number, the location and the growth of fibroids during pregnancy and the maternal and fetal outcome. We appreciate the bleeding in patients with a myomectomy and without a myomectomy during CS, using hemoglobin values before and after birth. Results. Most of the patients present single fibroids that are 30–160 mm in size, located on the anterior uterine wall. Vaginal delivery is used in 7% of women, whereas 85.96% deliver by CS. In addition, 68% of fibroids are diagnosed in the first trimester. In most cases, the fibroid has maximum growth in the second trimester of pregnancy. The myomectomy rate for fibroids during CS is 24.48. Hemoglobin values showed no statistically significant difference between the two groups with and without myomectomy. The operating time is double for the group with a myomectomy associated with a CS. The results of the obstetric outcomes are abortion in 7% of all patients, whereas premature delivery and births at term are 9.43% and 90.57%, respectively. Conclusions. The decision of performing a myomectomy during pregnancy can be a challenge and must be performed for selected cases. This procedure may have several benefits, such as avoiding another operation to remove fibroids.

ATR / FTIR and DSC techniques have been used to evaluate the thermal stability of some ageing paint materials by heat treatment while immersion in natural ester-based electro-insulating oil. Experimental determinations have highlighted the fact that the investigated paint materials (epoxy resins) have a high oxygen affinity and thus, in closed systems (such as power transformers), they oxidize before coming into contact with the transformer oil. This behavior indicates that the paint layer (suitably chosen) applied on the inside of the transformer vat functions as an antioxidant and results in increasing the thermal stability of the oil.

This paper describes the evaluation of the aging process of some polymeric painting materials subjected to a thermal treatment in electro insulating fluids, based on natural esters (vegetable oils). The paint layers surface morphology was comparatively characterized by FESEM technique, prior to the exposure, and after 1000 h of exposure to vegetable oil, heated at 130oC. The results show a substantial increase in the pulling resistances for all the painting materials subjected to this investigation, especially in the presence of the Kraft insulating paper and copper foil (inserted compulsory to emulate the actual working environment), due to an increase in the painting material adhesion, as well as an increase of the tensile strength of the paint layer. These findings may open new theoretical and practical research prospects, particularly in the field of preliminary treatments for materials used for heavy duty industrial transformers.

Struma ovarii is a rare condition with scarce published data regarding clinical, morphological, and therapeutic approaches. This study reports the experience of 25 patients with struma ovarii who received surgical treatment in a gynecology department in Romania. The study was conducted from January 1999 to September 2021 and included patients with confirmed struma ovarii whose medical records were retrospectively reviewed and evaluated. Struma ovarii represented 2.8% of the total number of benign ovarian tumors treated by surgery. The age of the patients was between 24 and 71 years. The tumor was unilateral in 24 cases, 13 cases on the left ovary, 11 on the right side, and bilateral in 1 case. Tumor dimensions ranged between 1 cm and 20 cm. In two cases, the patients had symptoms of hyperthyroidism. The procedure was performed on four women for diagnoses other than an ovarian tumor. In another five situations, there was suspicion of ovarian malignancy. In addition, struma ovarii was associated with other clinical conditions in 22 cases. These lesions represent a diagnostic challenge with heterogeneous clinical and imaging manifestations. Complete information of clinical, morphologic, and surgical findings may improve the diagnostic algorithm and better predict patient outcomes.

Ovarian malignant germ cell tumors (OMGCT) represent less than 10% of all ovarian tumors. Dysgerminoma is the most common malignant primitive germ cell tumor in young women, known for its curability and low propensity to invade and metastasize when diagnosed early. Herein, we report an unusual type of ovarian dysgerminoma (OD) metastasis with a brief review of the literature, lacking similar reported cases. To our knowledge, although there are several case reports of dysgerminoma metastases with variable anatomic location and presentation, vaginal metastasis has not been previously described. The local or systemic relapse together with local and distant metastasis is considered as an independent predictor of poor survival in patients with OD. In light of the absence of mutations status, our patient successfully responded to therapy. Currently, the patient remains in clinical remission. A specific follow-up plan is ongoing knowing that ovarian dysgerminomas tend to recur most often in the first 2–3 years after treatment.

Introduction: Romania has the highest incidence and mortality rate of cervical cancer in Europe. The objective was to estimate the prevalence of high-risk human papillomavirus (hrHPV) genotypes and to evaluate the role of certain socio-behavioral factors in acquiring viral infection, in a cohort of Romanian women with negative Pap. Methodology: In a prevalence study 611 women (aged 17-58 years) with negative Pap, with no known history of atypical cytology and valid HPV test were included. Each participant completed a questionnaire containing data on socio-behavioral factors. From 344 women aged between 30-58 years, 63 were randomly selected for a second examination (conventional cytology and HPV detection and genotyping) after twelve months. Results: Of the 611 women, 19.80% were HPV positive, 14.73% infected with hrHPV. Differences in the prevalence of hrHPV (17.60% versus 12.50%) as single (13.01% vs 9.01%) and multiple infections (9.71% vs 3.49%) were noted between women under the age of 30 and above. Among socio-behavioral factors, marital status and multiple sexual partners correlate with HPV and hrHPV infection. At follow-up, from 34 HPV negative cases, 10 changed to positive (5 hrHPV), while 2 developed abnormal cytology. Out of the 29 HPV positive cases, 12 cleared the HPV infection and 17 retested positive of which 4 worsened their cytology. Conclusions: In Romania, HPV infection is common in women with negative cytology. HPV genotyping is of epidemiological importance because the distribution of hrHPV types can determine the impact of prophylactic vaccines and the necessity of HPV testing as screening method.

Objective: Reactive oxygen species (ROS) are involved in the endothelial-mediated disorders within atherosclerosis. Considering that an oxidant/antioxidant imbalance might be a key factor in the damaging ROS-mediated effects, the present study intends to determine the influence of a high-fat diet, associated with essential amino acids—valine and leucine, upon the experimental animals, through evaluation of plasmatic level of some antioxidant enzymes. Material and Methods: The study was conducted on 32 male Wistar rats, which were fed with cholesterol, valine and leucine, for 60 days. The animals were divided into four groups, according to the received diet: the first group—standard diet; the second group—cholesterol (C); the third group—cholesterol and valine (C + V); the fourth group—cholesterol and leucine (C + L). Evaluations of the oxidative status, through plasma levels of the antioxidant enzymes: superoxide dismutase (SOD) and glutathione peroxidise (GPx), were made for the four mentioned groups of animals, at the beginning of the study (R0), after one (R1) and two months (R2). Results: The average values of SOD and GPx in group of animals fed exclusively with cholesterol (C) were significantly higher compared to the third group where cholesterol was supplemented with valine (C + V) or fourth group fed with cholesterol and leucine (C + L) (p < 0.001), after one month as well at the end of the experiment (two months). There were no significant differences in the levels of SOD and GPx between group III and group IV (p < 0.05) at the end of the experiment. Conclusion: Our results showed that valine and leucine decreased the serum levels of SOD and GPx and therefore they were useful antioxidants, which could improve the endothelial dysfunctions associated with atherosclerosis. Moreover, analysis of the oxidative status in the context of atherosclerotic mediated endothelial damage suggests that deviation from normal to alter endothelial status may be conditioned by an oxidants/antioxidants imbalance.

The aim of this study was to investigate the role of methylenetetrahydrofolate reductase (MTHFR) polymorphisms and MTHFR methylation pattern in cervical lesions development among women from Romania, a country with high prevalence of human papillomavirus (HPV) cervical infections. To achieve this goal, blood samples and cervical cytology specimens (n = 77)/tumour tissue specimens (n = 23) were investigated. As control, blood and negative cytological smears (n = 50) were used. A statistically significant association was found between T allele of C677T polymorphism and cervical lesions, heterozygote women presenting a threefold increased risk (normal/cervical lesions and tumours: wild homozygote 34/41 (0.68/0.41), heterozygote 14/51 (0.28/0.51), mutant homozygote 2/8 (0.04/0.08); OR = 3.081, P = 0.0035). Using χ square test for the control group, the HPV-negative and HPV-positive patients with cervix lesions, a significant correlation between viral infection and T allele of C677T polymorphism (P = 0.0287) was found. The MTHFR promoter was methylated in all HGSIL and tumour samples, significant differences being noted between HPV-positive samples, control group and cases of cervical dysplastic lesions without HPV DNA (P < 0. 0001) and between samples from patients with high-risk (hr)HPV versus low-risk (lr)HPV (P = 0.0026). No correlations between polymorphisms and methylation were observed. In Romania, individuals carrying T allele are susceptible for cervical lesions. MTHFR promoter methylation is associated with cervical severity lesions and with hrHPV.

Genital HPV infections are extremely common but most of them are spontaneously cleared by the host immune response. The main problem is how to identify the HPV-HR positive patients who are at risk of progressive disease.The purpose of this study was to investigate the uterine cervix lesions concerning the HPV status appreciated through the immunocytochemical expression of the L1 HPV and p16INK4a proteins.76 women who tested positive for HPV were selected from a cohort of 374 patients. In this study were detected the immunochemical expression of HPV L1 capsid protein and p16INK4a in LBC samples.The p16INK4a positive rate was expressed in 56.57% of all the cases. The percentage grew from 0% in NILM cases to 100% in SCCs cases (p-value0.00001). The HPV L1 capsid protein positive was expressed in 12.50% of NILM cases, 33.33% of ASC-US, 50% of LSIL, 18.51% of HSILs cases, but 0% in the SCC group (p-value = 0.01). The L1-/p16+ pattern was found in 21.87% of LSIL, 81.48% of HSIL, and 100% of SCC cases (p-value0.00001). The association of these two markers (L1 and p16INK4a) raises the accuracy of the diagnostic from 64% for HPV L1 capsid protein and respectively 87% for p16INK4a to 91% when they are associated.The combination of L1 capsid protein and p16 appears to be useful for an early diagnosis and may be able to identify the patients with risk of lesion progression.

Cervical cancer remains one of the most important mortality causes worldwide. It is already known that high risk HPV (HR-HPV) has the main role in the development of pre- or cancerous lesions. Despite the fact that many studies focused on the HR-HPV viral loads as possible biomarkers, the viral load quantification utility for all HR-HPV genotypes is still a controversy. The purpose of our study was to determine if HPV16 and 18 viral load values might be a potential marker for HPV infection clearance versus of pre- and cancerous lesions development.80 women who tested positive for HPV16 and 18 were selected from a cohort of 250 patients. The samples, consisting in cervical smears, were collected in transport media ESwab (Copan). The patient's average age was 36.26 years. HPV DNA detection, genotyping and viral load determination were performed twice for each patient (within one year follow-up).HPV 16 viral load was significantly higher in normal cytology samples and in HGSIL patients than in ASCUS/LGSIL (p value0.0312). HPV 18 viral load was also significantly higher in HGSIL cases than in ASCUS/LGSIL (p = 0,038). Independently of cervical cytology, HPV 18 viral load was lower (7.93 x 10(4) copies/microL) than HPV 16 viral load (5 x 10(13)) copies/microL).For HPV types 16 or 18 positive patients with LGSIL cytology the viral load might have predictive value. Our study suggested that patients with elevated viral loads are at disease risk progression and should be carefully evaluated.

Cohesion Policy is one of the tangible examples of how it should be a European policy: modern, flexible, proactive, adaptable to rapid economic and social environment changing and having a substantial contribution to achieving the Union's key policy objectives, such as the Lisbon Agenda Cohesion Policy is one of the tangible examples of how it should be a European policy: modern, flexible, proactive, adaptable to rapid economic and social environment changing and having a substantial contribution to achieving the Union's key policy objectives, such as the Lisbon Agenda. In the context of current debate on the future of cohesion policy, a reflection on this topic was initiated by the Romanian authorities, involving the most relevant institutions responsible for implementing cohesion policy in Romania and management of structural instruments. The analysis presented below reflects the first results of the consultation and reflection.