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Therapeutic plasmapheresis is a therapeutic procedure in which the patient's blood is passed through a medical device which separates out plasma from other components of blood. The plasma is removed and replaced with a replacement solution. Studies on the use of plasmapheresis in critically ill patients are scarce. The aim of this study was to review all therapeutic plasmapheresis sessions carried out in the Hospital Beatriz Ângelo intensive care unit.An observational retrospective study was conducted between April 2012 and March 2019. All patients who underwent therapeutic plasmapheresis in the intensive care unit were included, and plasmapheresis sessions held outside the intensive care unit were excluded.Of 46 patients, 63% were men (n = 29), with a median age of 53 years. The most frequent diagnoses were hypertriglyceridemia-induced pancreatitis, vasculitis, autoimmune haemolytic anaemia, and atypical haemolytic-uremic syndrome. A total of 198 plasmapheresis sessions were carried out in the intensive care unit. Most of the used replacement solutions were fresh frozen plasma (34.4%), albumin/crystalloid (24.2%), and albumin/fresh frozen plasma (19.2%). The most common complications were hydroelectrolytic changes (84; 42.4%) and coagulation disorders/thrombocytopenia (65; 32.8%). There was no need to interrupt any plasmapheresis session due to complications related to the patient.Therapeutic plasmapheresis is an urgent procedure that can reduce morbidity and mortality in critically ill patients. This justifies that 37% of patients started the technique before the diagnostic confirmation. The indications for plasmapheresis and the choice of replacement solution were in agreement with the guidelines. Despite the risk of bleeding, no haemorrhagic complications were recorded.Therapeutic plasmapheresis is a complex technique that requires specific training. The indications are diverse, and some are not consensual. Complications were frequent, but they did not increase morbidity.Introdução: A plasmaferese terapêutica é um procedimento em que o sangue passa por um circuito extracorpóreo que separa o plasma dos outros componentes do sangue. O plasma removido é substituído por soluções de reposição. Os estudos sobre a utilização de plasmaferese terapêutica no doente crítico são escassos. O objetivo do estudo foi rever todas as sessões de plasmaferese realizadas no serviço de Medicina Intensiva do Hospital Beatriz Ângelo. Material e Métodos: Estudo observacional retrospetivo de todos os doentes admitidos no serviço de Medicina Intensiva entre abril de 2012 e março de 2019. Foram selecionados os doentes submetidos a plasmaferese e excluídas as sessões realizadas fora do serviço de Medicina Intensiva. Resultados: No período de estudo foram incluídos 46 doentes. A maioria eram homens (n = 29; 63%) com uma idade mediana de 53 anos. Os diagnósticos mais frequentes foram pancreatite secundária a hipertrigliceridemia, vasculite, anemia hemolítica autoimune e síndrome hemolítica urémica atípica. Foram realizadas 198 sessões de plasmaferese no serviço de Medicina Intensiva. As soluções de substituição mais utilizadas foram plasma fresco congelado (34,4%), albumina/cristalóide (24,2%) e albumina/plasma (19,2%). As complicações mais comuns foram alterações hidroeletrolíticas (84; 42,4%), e distúrbios da coagulação/plaquetas (65; 32,8%). Em nenhum dos casos a técnica teve que ser interrompida por complicações relacionadas com o doente. Discussão: A plasmaferese terapêutica é um procedimento urgente capaz de reduzir a morbilidade e mortalidade no doente crítico. Isto justifica que 37% dos doentes tenham iniciado a técnica antes da confirmação diagnóstica. As indicações e soluto de reposição escolhido foram de acordo com as recomendações. Apesar do risco hemorrágico, nenhuma complicação desta natureza foi reportada. Conclusão: A plasmafere terapêutica é uma técnica complexa que requer treino específico. As indicações são diversas e algumas não consensuais. As complicações foram frequentes, mas não condicionaram morbilidade associada.

Purpose To explore the anatomy, etiopathogenesis, diagnosis and classification, current evidence on intervention and the surgical management of orbital roof fractures and defects (ORFD) for oculoplastic surgeons presented with such cases. Methods A review of the current literature through the MEDLINE database using the following search terms: "orbital roof fracture (+treatment/management)," "orbital roof defect (+treatment/management)," "orbital roof erosion (+treatment/management)," "orbital roof repair," "orbital roof," "orbital fracture," "pediatric orbital roof (defect/fracture/erosion)," "orbital anatomy," and "orbital roof anatomy" was conducted. As relatively little has been published on this topic, inclusion criteria were broad and peer-reviewed articles judged to be of clinical importance, relevant to the aims of this review, were included. Non-English abstracts were also included if relevant. Year of publication was not a strict exclusion criterion, and older articles were judged for their suitability based on clinical importance and relevance to current practice. Additional references were obtained from citations in key articles and recommendations from the coauthors based on their areas of expertise. Results The etiopathogenesis of ORFD varies. Classification systems have been formulated to guide management decisions and can range from conservative management to complex neurosurgery. Eyelid approaches have also been described. This review provides a summary of the evidence for each and a management framework oculoplastic surgeons can use when presented with ORFD. Conclusion Oculoplastic surgeons can be involved, either alone or as part of a multidisciplinary team, in the management of ORFD, and for some, conduct orbital approach reconstructive surgery.

Introduction: Calcitonin measurement is important for the diagnosis and monitoring of medullary thyroid carcinoma. Unfortunately, in clinical practice, different detection systems assays are used in the follow-up of the patients, which can be misleading. Objective: To identify the correction factor for calcitonin measurement on two different immunoanalysers: DiaSorin-LiaisonXL (immunochemiluminescence) and CobasE601 (electro-immunochemiluminescence). Methods: We selected 89 registered CT samples (28-from men; 61-from women), that were analysed on CobasE601 with reported values between 0.5 pg/ml and 2812 pg/ml (128.5±513.98). These CT samples were selected randomly to cover as wide a range of values as possible, and represented either basal CT (n=38) or selected from CT stimulation tests (n=51). Samples were evaluated subsequently on DiaSorin-LiaisonXL. All patients gave their informed consent. Results: Between the two assays a segmented linear correlation was noted. We identified the following general linear regression equation: 1.108x+19.337 (p Conclusions: Calcitonin correction factors are highly important in the dynamic follow up of a patient suffering from medullary thyroid carcinoma when different detection systems assays are used to determine calcitonin. We identified the correction factors for calcitonin determination between two different frequently used chemiluminescence immunoanalysers: DiaSorin-LiaisonXL and CobasE601. However, it is strongly advisable to use the same analyser in order to establish biochemical evolution of calcitonin.

Oncological diseases are the most common cause of death worldwide, it is estimated that 25% of the population will face the diagnosis of cancer during life. Phytochemicals such as cannabinoids (CBs) have been used in various branches of medicine for their properties, and the discovery of the anti-tumor, anti-emetic and anti-inflammatory effects of some of these substances has encouraged their use in oncology. Phytocannabinoids, cannabidiol (CBD) and Δ-9-tetra-hydrocannabinol (THC), have numerous anti-emetic, analgesic, orexigenic, anti-inflammatory / immunosuppressive pharmacodynamic effects. In recent years, studies have been aimed at evaluating their efficacy as antineoplastic agents. Much in vivo and in vitro research has demonstrated the efficacy of CBs on certain tumor cell lines, highlighting their potential role in the complementary treatment of cancer. This paper suggests that exploring the molecular mechanisms induced by CBs in cancer cells may contribute to the development of effective treatments in oncological diseases.

The new coronavirus pandemic has brought into the light-on top of the strain it put on the medical services around the world-a variety of ethical issues in relation to how the treatment is being administered to the patients. Understanding the priority of treating COVID-19 patients, we still ask ourselves how effective these antiviral/immunomodulatory molecules are recommended by national/international protocols and which is the benefit/risk ratio in different categories of patients. To solve these dilemmas, we present the case of a 36-year-old patient, admitted to our clinic in April 2020, with mild symptomatic SARS-CoV-2 infection. Given the suggestive clinical and paraclinical elements, we recommended treatment with lopinavir/ ritonavir according to national protocol, and we explained to patient the benefits of this treatment, as well as the possible side effects. The patient refused this treatment, but later accepted an alternative therapy, hydroxychloroquine. The evolution of clinical and paraclinical parameters allowed the patient to be discharged after 19 days. This apparently simple and solvable medical case becomes complicated when the patient complained about the violation of her rights and of certain articles from deontological code. Beyond the elements of subjectivism, it is necessary an ethical approach of this problem. After 9 months of pandemics, we can say that some anti-COVID -19 therapies have proven a practical effectiveness and others have been partially invalidated by clinical trials and removed from the guidelines, but can we say every information regarding anti - SARS-CoV-2 medication is absolutely clear or that ethical aspects are solved?

The main objective of inserting dental implants in various clinical situations is to avoid mobile prosthetic restorations or to obtain a better stability. In this way, patients are offered increased comfort and better integration of prosthetic restorations into the stomatognathic complex. The purpose of this case presentation is to highlight a case of complex oral rehabilitation in which the Sky Fast and Fixed system (Bredent GmbH, Senden, Germany) was chosen, in the case of maxillary restoration, thus avoiding a mobile prosthetic restoration. The result demonstrates a superior aesthetic rehabilitation than the initial situation, obtaining a significant improvement from the first treatment session.

The aim of this study was to identify by classification and regression tree (CART) analysis groups of patients with different survival patterns in a population of patients with heart failure and reduced left ventricular ejection fraction (HFrEF) by using standard methods of heart function assessment, as well as well as utilizing non-traditional approaches for determining hydration and nutritional status in HF patients—lung ultrasonography (LUS) and bioimpedance spectroscopy (BIS) analysis. Eligible patients with a left ventricular ejection fraction (LVEF) below 45% were identified via the daily echocardiography assessments. LUS was performed with patients in the supine position, for a total of 28 sites per complete examination. The hydration state and the body composition were assessed using a portable whole-body BIS device. Our study included 151 patients (69.2% males) with a mean age of 67.1 years. During the follow-up 53 (35.1%) patients died. Using the CART algorithm, we identified five groups based on serum sodium, the severity of NYHA class, serum urea and systolic blood pressure. When comparing the two models, the model derived from the CART analysis showed better predictive power than the conventional Cox model (c-index 0.790, 95% CI 0.723–0.857 vs. 0.736, 95%CI 0.664–0.807, p

Introducere. Aproximativ 12 milioane de copii mor anual ȋn țările ȋn curs de dezvoltare, iar o treime din aceste decese sunt cauzate de pneumonii. Evaluarea modificărilor radiologice în dinamică are un rol major în stabilirea diagnosticului de pneumonie stafilococică. Scopul lucrării este de a sublinia dificultățile de diagnostic și tratament într-un caz de pneumonie stafilococică la copil. Prezentarea cazului. Prezentăm cazul unui pacient, de sex masculin, în vârstă de 2 ani și 6 luni, internat în clinica noastră pentru hiperpirexie, tuse productivă, rinoree și inapetență. Examenul clinic la internare a pus ȋn evidență stare generală influențată, facies palid, suferind, febră, tuse productivă, rinoree, murmur vezicular diminuat pe partea dreaptă, saturație ȋn oxigen 97%, și inapetență, iar analizele de laborator leucocitoză marcată cu neutrofilie, anemie și markeri inflamatori intens crescuți. Radiografia toracică a pus ȋn evidență un focar congestiv la nivelul lobului inferior drept. Hemocultura a fost negativă. S-a inițiat tratament simptomatic și antibiotic (Ceftriaxonă), dar datorită evoluției nefavorabile, radiografia de control a arătat o zonă de condensare bazal drept asociind o colecție pleurală ȋnchistată bazal și laterotoracic drept. Am efectuat și computer tomografie (CT) toracică, evidențiindu-se un proces pneumonic bisegmentar ȋn lobul inferior drept, cu câteva pneumatocele grupate subpleural, asociind ȋn ambii plămâni arii de hiperinflație lobulară. Astfel, se ridică suspiciunea unei pneumonii verosimil stafilococice, motiv pentru care se asociază Vancomicină iv, cu evoluție favorabilă. Concluzii. Pneumonia stafilococică este o patologie bine definită şi cunoscută ȋn literatură, dar rămâne totuşi o patologie contemporană, impunând multiple dificultăţi legate de diagnosticul şi managementul cazurilor pediatrice.

The coronavirus disease 2019 (COVID-19) has seen a violent and fast spread worldwide. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a predominantly respiratory transmission through droplets and aerosol with serious implications for dental settings. This article is based on recent research, guidelines issued by relevant authorities, as well as on the authors’ experience acquired through their involvement in setting up an emergency dental care hub in Cluj-Napoca, Romania, during the COVID-19 lockdown. The present article aims to provide a brief description of COVID-19 implications in dental office and to recommend preventive protocols for dental practitioners to ensure a safe and healthful workplace. The recommendations for infection control presented in this article address the specific risks of exposure to SARS-CoV-2. The article provides a special customized guideline covering patient triage and entrance into the dental practice, personnel protection, dental treatment, and after-treatment management. The implementation of strict preventive measures has been found to be efficient in the prevention of SARS-CoV-2 contamination because no infections have been reported among our staff or patients. COVID-19 is a major emergency worldwide marked by a rapid evolution and warranting a need for further assessment of the implications of COVID-19 outbreak in dental practice.

Several clinical studies have reported a double dissociation between abstract and concrete concepts, suggesting that they are processed by at least partly different networks in the brain. However, neuroimaging data seem not in line with neuropsychological reports. Using the ALE method, we run a meta-analysis on 32 brain-activation imaging studies that considered only nouns and verbs. Five clusters were associated with concrete words, four clusters with abstract words. When only nouns were selected three left activation clusters were found to be associated with concrete stimuli and only one with abstract nouns (left IFG). These results confirm that concrete and abstract words processing involves at least partially segregated brain areas, the IFG being relevant for abstract nouns and verbs while more posterior temporoparietal-occipital regions seem to be crucial for processing concrete words, in contrast with the neuropsychological literature that suggests a temporal anterior involvement for concrete words. We investigated the possible reasons that produce different outcomes in neuroimaging and clinical studies.

In the paper are presented the results of tests on the evaluation of the level of noise and chemical air pollution in two distinct urban areas: an industrial area and an area characterized by heavy road traffic, with a focus on the novelty elements introduced by the regulations in force on the measurement and management of the level of ambient and industrial noise by periodically developing specific noise maps. The results of direct tests and noise maps developed in the case of the studied areas indicated higher values of the indicators measured near the road artery compared to the other measuring points, highlighting the influence of vegetation in urban areas to reduce noise levels and reduce air pollution.

The aim of this paper is to present the implementation of a method for data acquisition, processing and interpretation of the electrical activity associated with the muscle fiber membrane, generated as a result of the ionic pumps� action. By using a biofeedback shield (EKG/EMG shield) for differential amplification and analog signal filtering, an Arduino development board for analog to digital conversion and an external processing unit, a series of experiments were carried out. These referred to medical diagnosis and research, human-machine interfaces (control of a robotic joint which could be used for prosthetic limbs or industrial robots, as well as control of the computer � for video games, virtual reality, interaction with other devices), and monitoring and increasing sports performance. Due to its noninvasive characteristics, this technique, known as surface electromyography, proves to play a significant role in areas such as medical research, rehabilitation, ergonomics, sports etc.

The aim of this study was to produce a prognostic model to help predict posttransplant survival in patients transplanted with grade-3 acute-on-chronic liver failure (ACLF-3). Patients with ACLF-3 who underwent liver transplantation (LT) between 2007 and 2017 in 5 transplant centers were included (n = 152). Predictors of 1-year mortality were retrospectively screened and tested on a single center training cohort and subsequently tested on an independent multicenter cohort composed of the 4 other centers. Four independent pretransplant risk factors were associated with 1-year mortality after transplantation in the training cohort: age ≥53 years (P = .044), pre-LT arterial lactate level ≥4 mml/L (P = .013), mechanical ventilation with PaO2 /FiO2 ≤ 200 mm Hg (P = .026), and pre-LT leukocyte count ≤10 G/L (P = .004). A simplified version of the model was derived by assigning 1 point to each risk factor: the transplantation for Aclf-3 model (TAM) score. A cut-off at 2 points distinguished a high-risk group (score >2) from a low-risk group (score ≤2) with 1-year survival of 8.3% vs 83.9% respectively (P

Objective: To compare HOPE and NRP in liver transplantation from cDCD. Summary of Background Data: Liver transplantation after cDCD is associated with higher rates of graft loss. Dynamic preservation strategies such as NRP and HOPE may offer safer use of cDCD grafts. Methods: Retrospective comparative cohort study assessing outcomes after cDCD liver transplantation in 1 Swiss (HOPE) and 6 French (NRP) centers. The primary endpoint was 1-year tumor-death censored graft and patient survival. Results: A total of 132 and 93 liver grafts were transplanted after NRP and HOPE, respectively. NRP grafts were procured from younger donors (50 vs 61 years, P < 0.001), with shorter functional donor warm ischemia (22 vs 31 minutes, P < 0.001) and a lower overall predicted risk for graft loss (UK-DCD-risk score 6 vs 9 points, P < 0.001). One-year tumor-death censored graft and patient survival was 93% versus 86% (P = 0.125) and 95% versus 93% (P = 0.482) after NRP and HOPE, respectively. No differences in non-anastomotic biliary strictures, primary nonfunction and hepatic artery thrombosis were observed in the total cohort and in 32 vs. 32 propensity score-matched recipients Conclusion: NRP and HOPE in cDCD achieved similar post-transplant recipient and graft survival rates exceeding 85% and comparable to the benchmark values observed in standard DBD liver transplantation. Grafts in the HOPE cohort were procured from older donors and had longer warm ischemia times, and consequently achieved higher utilization rates. Therefore, randomized controlled trials with intention-to-treat analysis are needed to further compare both preservation strategies, especially for high-risk donor-recipient combinations.

Many prognostic factors for HL have been proposed in the past and some of these were included in several prognostic scores. Tumor stage and spread, age, gender and various biological parameters are considered to have an effect on disease evolution, with the prognostic scores stratifying patients into risk groups and guiding the course of treatment. In the present study we have enrolled 54 patients with Hodgkin�s lymphoma admitted in the Hematology Department within the City Emergency Clinical Hospital Timisoara over a 4-year period. We aimed to see if a statistically significant correlation can be made between hemoglobin, white blood cell, lymphocyte, eosinophil, monocyte and platelet levels at the time of diagnosis on the one hand, and response to treatment and patients� survival, on the other hand. Patients� response to treatment was evaluated according to Cheson criteria, with best response to the combination of ABVD(doxorubicin C27H29NO11, bleomycin C55H84N17O21S3, vinblastine C46H58N4O9, dacarbazine C6H10N6O) and radiation therapy. Response to treatment was also influenced by eosinophil levels at diagnosis and this has effects on survival. Finally, lymphocyte and platelet levels at diagnosis correlated with survival times in our study group. Therefore, eosinophil, lymphocyte and platelet levels at diagnosis could be considered as prognostic factors for HL, although further studies are needed to validate our findings.

This study aimed at assessing the ability of the foodborne pathogenic bacterium Listeria monocytogenes to resist high pressure processing when present in cucumber juice and evaluating its capacity to recover during post-processing storage at 8°C for 72 hours. Two L. monocytogenes strains were selected, Scott A and RO15, a reference and a food isolated strains, respectively. The cucumber juice was inoculated with either Scott A or RO15 strain at a concentration of approximately 7 log CFU/mL and treated at 300 and 400 MPa, 8°C, for 8 minutes. The behavior of L. monocytogenes populations was studied by employing both quantitative and qualitative approaches: enumeration of L. monocytogenes viable cells by plate counting on a selective growth medium and measuring the fluorescence intensity emitted by the cells when stained with propidium iodide (PI). The treatment at 300 MPa, 8°C, for 8 minutes determined a reduction rate of less than 1 log CFU/mL for both L. monocytogenes strains, while treatment at 400 MPa led to a significantly higher reduction in cells number, 6 and 5 log CFU/mL for Scott A and RO15 strain, respectively. L. monocytogenes viable cells counting at each time point (0, 24, 48 and 72 hours) revealed no multiplication of survivors during storage at 8°C. However, the fluorescence method suggested a possible cellular membrane recovery process, since fluorescence intensity emitted by the HP treated L. monocytogenes cells decreased continuously over the storage period compared to time 0. The results of this experiment emphasize the necessity of employing other barriers against L. monocytogenes in combination with HPP, to ensure its consumption safety during storage for periods longer than 72 hours.

The purpose of this study was to analyze the phenolic compounds and the antioxidant activity of the aqueous extract obtained from the fruit of Prunus spinosa L.. The aqueous extract of 10% concentration was obtained from the pulp of dried fruits, harvested from Tulcea county, Romania. The tannin content was 3.38g % and the total polyphenols 6.95g %. Based on the HPLC analysis, the identified polyphenolic acids were chlorogenic acid, caffeic acid and gallic acid and the concentrations in mg per 100g of fruit pulp powder were 15.174, 10.93 and 81.468, respectively. The 100 mg/mL aqueous extract had a high DPPH radical scavenger ability (87.30%) which correlated with the polyphenol content and supports the possibility of using rich bioactive aqueous extracts for oxidative stress related conditions.

Introduction. Approximately 12 million children die every year in developing countries and one third of these deaths are caused by pneumonias. The assessment of radiological changes in dynamics owns a major role in establishing the diagnosis of staphylococcal pneumonia. The aim of this paper was to underline the diagnostic and treatment difficulties in a child with staphylococcal pneumonia. Case report. We present the case of a 2 years and 6-month-old male patient admitted in our clinic for hyperpyrexia, productive cough, rhinorrhea and anorexia. The clinical exam at admission pointed out influenced general status, pale ailing face, pallor, fever, productive cough, rhinorrhea, diminished breath sound on the right side, oxygen saturation 97% and anorexia, while de blood tests revealed severe leukocytosis with neutrophilia, anemia, and severely increased inflammatory biomarkers. The chest X-ray showed an opacity within the right inferior lobe. The blood culture was negative. We initiated symptomatic and antibiotic treatment (Ceftriaxone), but due to the unfavorable evolution, the control chest X-ray showed a consolidation area within the right inferior lobe and secluded basal pleural effusion as well as on the right lateral side. We performed also a chest computed tomography (CT), noticing a pneumonic process within two segments of the inferior right lobe, several grouped pneumatocele below the pleura, associating within both lungs areas of lobular hyperinflation. Thus, we raised the suspicion of staphylococcal pneumonia, and we initiated Vancomycin by vein, with favorable evolution. Conclusions. Staphylococcal pneumonia is a well-defined and described pathology in the literature, but still remains a contemporary pathology imposing multiple difficulties related to the diagnosis and management in pediatric patients.

Simple Summary Prostate cancer (PCa) represents a very important health problem worldwide. Used as the main screening method for almost four decades, PSA (Prostate Specific Antigen) has proven its limitations. In this review, the authors try to make an evaluation of the biomarkers commercially available and used to improve the PCa detection in patients with elevated PSA. The authors also present the current PCa screening and diagnosis protocols in Romania. Abstract The prostate is one of the most clinically accessible internal organs of the genitourinary tract in men. For decades, the only method of screening for prostate cancer (PCa) has been digital rectal examination of 1990s significantly increased the incidence and prevalence of PCa and consequently the morbidity and mortality associated with this disease. In addition, the different types of oncology treatment methods have been linked to specific complications and side effects, which would affect the patient’s quality of life. In the first two decades of the 21st century, over-detection and over-treatment of PCa patients has generated enormous costs for health systems, especially in Europe and the United States. The Prostate Specific Antigen (PSA) is still the most common and accessible screening blood test for PCa, but with low sensibility and specificity at lower values (

Background: Bladder cancer (urothelial cancer of the bladder) is the most common malignancy affecting the urinary system with an increasing incidence and mortality. Mouse models of bladder cancer should possess a high value of reproducibility, predictability, and translatability to allow mechanistic, chemo-preventive, and therapeutic studies that can be furthered into human clinical trials. Objectives: To provide an overview and resources on the origin, molecular and pathological characteristics of commonly used animal models in bladder cancer. Methods: A PubMed and Web of Science search was performed for relevant articles published between 1980 and 2021 using words such as: “bladder” and/or “urothelial carcinoma” and animal models. Animal models of bladder cancer can be categorized as autochthonous (spontaneous) and non-autochthonous (transplantable). The first are either chemically induced models or genetically engineered models. The transplantable models can be further subclassified as syngeneic (murine bladder cancer cells implanted into immunocompetent or transgenic mice) and xenografts (human bladder cancer cells implanted into immune-deficient mice). These models can be further divided—based on the site of the tumor—as orthotopic (tumor growth occurs within the bladder) and heterotopic (tumor growth occurs outside of the bladder).

International audience; In France, the program of controlled donation after circulatory death (cDCD) was established with routine use of in situ normothermic regional perfusion (NRP). There is currently no consensus on its optimal duration. The purpose was to assess the impact of NRP duration on liver graft function and biliary outcomes. One-hundred and fifty-six liver recipients from NRP-cDCD donors from six French centers between 2015 and 2019 were included. Primary endpoint was graft function assessed by early allograft dysfunction (EAD, according to Olthoff's criteria) and MEAF (model for early allograft function) score. Overall, three (1.9%) patients had primary non-function, 30 (19.2%) patients experienced EAD, and MEAF score was 7.3 (+/- 1.7). Mean NRP duration was 179 (+/- 43) min. There was no impact of NRP duration on EAD (170 +/- 44 min in patients with EAD vs. 181 +/- 42 min in patients without, P = .286). There was no significant association between NRP duration and MEAF score (P = .347). NRP duration did neither impact on overall biliary complications nor on non-anastomotic biliary strictures (overall rates of 16.7% and 3.9%, respectively). In conclusion, duration of NRP in cDCD donors does not seem to impact liver graft function and biliary outcomes after liver transplantation. A 1 to 4-h perfusion represents an optimal time window.

A rapid, simple, and precise electrochemical method was developed for the determination of the total content of antibiotics containing a 5-nitrofuran ring with antibacterial activity including furazolidone, nitrofurazone, nitrofurantoin, and furaltadone in several samples. Boron-doped diamond electrode was used as the working electrode. The electrochemical properties of these compounds were evaluated by cyclic voltammetry. A differential pulse voltammetric method based on the cathodic reduction at high potentials was used for the determination of the total nitrofuran content in a mixture at pH 6.47. The voltammetric measurements showed that the proposed electrochemical method was able to identify the nitrofurazone from a mixture of antibiotics based on its anodic oxidation in alkaline medium (pH 10.6). This method presented good accuracy (between 94.5 and 102.5%) and precision (less than 3.94%), with calibration graphs starting from 50 nmol L−1. The method was applied with success for the determination of total content of compounds with 5-nitrofuran ring and for the selective determination of nitrofurazone in pharmaceutical tablets and food products (milk and honey) without pretreatment of the samples.

Background Post-stroke depression (PSD) is among the most frequent neuropsychiatric consequences of stroke, negatively affecting the patient's functional recovery and the quality of life. While pharmacological therapy has limited efficacy and important side effects, new appropriate treatments based on specific physiological mechanisms for PSD remain to be developed. Non-invasive brain stimulation (NIBS) techniques, modulating brain plasticity, might offer valid, alternative strategies. Methods We systematically searched four databases: MEDLINE, PsycARTICLES, PsycINFO and Web of Science, up to December 2017, using definite keywords, to identify studies on TMS and tDCS treatment for PSD. Results Seven studies met the inclusion criteria and the results indicate that both tDCS and rTMS are safe and have very low side effects. The reported positive results, suggesting that these methods can be considered effective therapeutic options, are questionable, and a general statement about their efficacy for PSD is premature due to small sample sizes, heterogeneous methodologies, lack of uniform diagnostic criteria, and divergent data. Limitations The selected articles suffer lack of information about quality of life and daily living performance measures; in addition, the number of randomized controlled trials is small. Conclusion (s) The aim of this review was to analyze current research in the clinical use of noninvasive brain stimulation (NIBS) in PSD treatment in order to verify whether there are alternative perspectives in the treatment of PSD. Given the present evidence, future research is needed to address methodological limitations and evaluate the long-term efficacy of these methods, alone and in combination with pharmacological treatment.

Cutaneous basosquamous carcinoma is a variant of basal cell carcinoma that is characterized by histopathological features of both basal and squamous cell carcinoma. Due to its local invasiveness, high frequency of recurrence, and its metastatic potential, it is considered to be one of the most aggressive subtypes of basal cell carcinoma. We present the case of an 81-year-old male who was admitted to the hospital with incessant hemorrhage arising from a cutaneous tumor that later proved to be a basosquamous carcinoma. Due to the COVID-19 pandemic at the time, the patient did not seek medical attention as soon as the bleeding was observed, although he did present when the symptom increased in intensity and became incessant. To our knowledge, this is the first case report of a cutaneous basosquamous carcinoma that presents with a massive life-threatening hemorrhage tumor, thus endangering the patient's life. The clinical and histopathological features, the behavior and the treatment of cutaneous basosquamous carcinoma are further reviewed in this article.

Psoriasis is an immune-mediated chronic inflammatory skin disease with extracutaneous manifestations, that affects about 1–3% of the world’s population. The disease is not life-threatening, but the disability which comes with it is comparable to the disability caused by other serious chronic diseases, such as oncologic or cardiovascular disease. Several risk factors, such as infections, stress, smoking, excessive alcohol consumption and genetic predisposition have been involved in inducing psoriasis. Smoking status is a risk factor for many chronic diseases, including psoriasis. Moreover, recent studies have tried to answer the question of whether smoking also influences the response to biologic therapy in patients with psoriasis. Through the current study, our intention is to find out how smoking affects the response to biologic treatment. A hospital-based cross-sectional, observational, non-interventional, retrospective study of moderate and severe psoriasis patients receiving biologic treatment was developed. Two groups were defined based on smoking status: group 1 included smokers (more than 10 cigarettes/day) and former smokers, and group 2 included non-smokers. The data that resulted from the analysis of the cohort of patients demonstrate that smoking status does not affect the response of biologic therapy in patients with moderate and severe psoriasis.

Psoriasis is a chronic, immune-mediated inflammatory disease of unknown etiology that may be associated with abnormal T-lymphocyte function. Ocular manifestations associated with psoriasis, particularly artropathic or pustular psoriasis, usually affect men, often during exacerbations of the disease. It has been reported that eye damage tends to occur later compared with cutaneous or joint manifestations, blindness being the most disabling complication. Previous studies have focused on ophthalmic manifestations and identified several etiopathogenic mechanisms. Psoriasis may be associated with eye complications such as lesions of the eyelids, conjunctiva and others, with systemic inflammation being the main contributor. In addition, the treatment used for psoriasis may cause ocular changes. The main ophthalmic manifestations associated with psoriasis are keratoconjunctivitis sicca, blepharitis, conjunctivitis and uveitis. The treatment of uveitis, perceived as one of the most serious eye conditions, is controversial and has yet to be clearly determined. Thus, the aim of the present review was to emphasize the importance of regular eye examination for patients with psoriasis, either those receiving biological treatment or those not receiving treatment, in order to diagnose and manage the disease appropriately.

Nowadays, numerous biomedical studies performed on natural compounds and plant extracts aim to obtain highly selective pharmacological activities without unwanted toxic effects. In the big world of medicinal plants, Usnea barbata (L) F.H. Wigg (U. barbata) and usnic acid (UA) are well-known for their therapeutical properties. One of the most studied properties is their cytotoxicity on various tumor cells. This work aims to evaluate their cytotoxic potential on normal blood cells. Three dry U. barbata extracts in various solvents: ethyl acetate (UBEA), acetone (UBA), and ethanol (UBE) were prepared. From UBEA we isolated usnic acid with high purity by semipreparative chromatography. Then, UA, UBA, and UBE dissolved in 1% dimethyl sulfoxide (DMSO) and diluted in four concentrations were tested for their toxicity on human blood cells. The blood samples were collected from a healthy non-smoker donor, the obtained blood cell cultures were treated with the tested samples. After 24 h, the cytotoxic effect was analyzed through the mechanisms that can cause cell death: early and late apoptosis, caspase 3/7 activity, nuclear apoptosis, autophagy, reactive oxygen species (ROS) level and DNA damage. Generally, the cytotoxic effect was directly proportional to the increase of concentrations, usnic acid inducing the most significant response. At high concentrations, usnic acid and U. barbata extracts induced apoptosis and DNA damage in human blood cells, increasing ROS levels. Our study reveals the importance of prior natural products toxicity evaluation on normal cells to anticipate their limits and benefits as potential anticancer drugs.

Lichens represent an important resource for common traditional medicines due to their numerous metabolites that can exert diverse pharmacological activities including anticancer effects. To find new anticancer compounds with fewer side effects and low tumor resistance, a bioprospective study of Usnea barbata (L.) F.H. Wigg. (U. barbata), a lichen from the Călimani Mountains (Suceava county, Romania) was performed. The aim of this research was to investigate the anticancer potential, morphologic changes, wound healing property, clonogenesis, and oxidative stress biomarker status of four extracts of U. barbata in different solvents (methanol, ethanol, acetone, and ethyl acetate), and also of usnic acid (UA) as a positive control on the CAL-27 (ATCC® CRL-2095™) oral squamous carcinoma (OSCC) cell line and V79 (ATCC® CCL-93™) lung fibroblasts as normal cells. Using the MTT assay and according to IC50 values, it was found that the most potent anticancer property was displayed by acetone and ethyl acetate extracts. All U. barbata extracts determined morphological modifications (losing adhesion capacity, membrane shrinkage, formation of abnormal cellular wrinkles, and vacuolization) with higher intensity in tumor cells than in normal ones. The most intense anti-migration effect was established in the acetone extract treatment. The clonogenic assay showed that some U. barbata extracts decreased the ability of cancer cells to form colonies compared to untreated cells, suggesting a potential anti-tumorigenic property of the tested extracts. Therefore, all the U. barbata extracts manifest anticancer activity of different intensity, based, at least partially, on an imbalance in antioxidant defense mechanisms, causing oxidative stress.

Acquired unilateral alacrima as a presenting sign of an intracranial tumor is exceptionally rare, and only described once previously in a case of nasopharyngeal carcinoma. The authors present a 32-year-old female patient who presents with a year-long history of alacrima and arhinorrhea. She was subsequently diagnosed with a petroclival chondrosarcoma extending into Meckel's cave and the cavernous sinus and underwent surgical debulking. To the authors' knowledge, this is the first reported case of acquired unilateral alacrima as a presenting feature of a skull base chondrosarcoma. This case serves to remind general ophthalmologists and oculoplastic surgeons alike that acquired alacrima may be the presenting feature of serious intracranial disease.

The main objective was to identify pregnancy risk factors arising from the behaviour and lifestyle of Mureş county women during pregnancy. The postpartum women monitored in this study were from Mureş county and were interviewed by applying a questionnaire during the period they were in the hospital for postnatal care immediately after birth. The questions aimed at identifying prenatal risk factors and the unhealthy behaviour of women before and during pregnancy, referring to the socio-economic and cultural status (low family income or unemployment, less than high school studies, rural background and marital status), obesity during pregnancy, alcohol consumption, coffee consumption, no physical activity. We identified, among the three major ethnicities in Mureş county (Romanian, Hungarian, Roma), the behaviour and lifestyle components with risk in pregnancy and after comparing profiles of these groups we identified the Roma ethnicity as being at the highest perinatal risk.

International audience; Background/Aim: Preoperative radiochemotherapy (RCT) followed by total mesorectum excision has become the gold standard for locally advanced carcinoma of the low and middle rectum. The aim of the study is to evaluate the short and long-term outcomes of patients in complete pathological response (PR) following this treatment sequence. Patients and Methods: One hundred and thirty patients were retrospectively included between 2005 and 2017 in an expert centre, with 3 groups formed, according to the PR: i) complete PR (absence of tumour cells on the surgical specimen ypT0N0), ii) partial PR (T or N downsizing) and iii) without PR. Results: The complete PR rate was 13.1%. The complete PR group tended to develop less symptomatic fistulas compared to partial PR and without PR groups (5.8% versus 13.5% versus 18.7, respectively; p=0.607). The 5-year disease-free survival was increased for complete-PR patients (93% versus 79% versus 47%, respectively; p=0.0003) without an improvement in overall survival. Conclusion: Complete PR is associated with an improvement in survival without recurrence and without an improvement in the overall survival at 5 years.

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new technology for delivering intraperitoneal chemotherapy. It is generally assumed that with PIPAC, the ratio of peritoneal to systemic drug concentration is superior to liquid hyperthermic intraperitoneal chemotherapy (HIPEC). To date, no direct comparative data are available supporting such an assumption. Twelve 65-day-old pigs were randomly separated into three groups of four pigs each, all of which received intraperitoneal chemotherapy using the following administration methods: PIPAC with oxaliplatin 92 mg in 150 ml dextrose 5% (Group 1); PIPAC with electrostatic aerosol precipitation (ePIPAC; Group 2); or laparoscopic HIPEC (L-HIPEC) with oxaliplatin 400 mg in 4 L dextrose 5% at 42 °C (Group 3). Serial blood and peritoneal tissue concentrations of oxaliplatin were determined by spectrometry. In all three groups, the maximum concentration of oxaliplatin in blood was detected 50–60 min after onset of the chemotherapy experiments, with no significant differences among the three groups (p = 0.7994). Blood oxaliplatin concentrations (0–30 min) were significantly higher in the L-HIPEC group compared with the ePIPAC group (p

In Romania, data on patch testing are lacking and the significance and applicability of the European baseline series (EBS) needs to be evaluated. The aim of the study was to examine the prevalence of contact allergy to the EBS and to determine the most common post-test sensitization occurred in the population of patients with suspected allergic contact dermatitis in Romania. Demographic data were collected from 252 patients with suspected allergic contact dermatitis. Pacients were patch tested with 28-allergen EBS.The positive patch test was observed in 80.16% patients. The most prevalent contact allergens were nickel sulphate (15.08%), fragrance mix I & II (13.10%) and potassium dichromate (9.52%). Differences in sensitization prevalences to some allergens of the EBS compared with other European countries were recognized. The current EBS is a suitable diagnostic tool for contact allergy in Romania.

The aim of this study is bringing phytotherapy back to the spot light, which is widely used in the traditional medicine. In the last decades, the use of plant‑based products has increased, because of the beneficial properties they exert, such as the antioxidant effect, hypoglycemic, anticancer effect, infection treatment etc. The present study approaches the applications of the phytotherapy today in diabetes and its sequels, those applications representing only a small part of the medicinal plants use over time and today.

Multiple myeloma (MM) is typically sensitive to a range of cytotoxic agents, both as initial therapy and as relapsed disease treatment. Unfortunately, the responses are transient, and MM is not considered curable with the current approaches. This paper aims to assess the response to first line treatment of patients included in the study and their correlation with the negative prognostic factors in multiple myeloma: age over 60 years, male gender, anemia, hypercalcemia, elevated levels of creatinine, Beta 2 microglobulin, hypoalbuminemia and Bence-Jones proteins type. The study was conducted on a group of 105 patients admitted to the Hematology Department of the Municipal Emergency Clinical Hospital of Timisoara from 01 January 2013 until 31 December 2017. Twenty-seven patients received VAD regimen, while 78 underwent Bortezomib + Dexamethasone regimen as fist line therapy. When analyzing anthropometrical data, different gender distribution in the two groups of patients is seen, while a higher percentage of patients over 60 years is observed in both groups, with 77.7% in the VAD group (21 out of 27 patients) and 56.4% in the group treated with Bortezomib + Dexamethasone (44 out of 78 patients). Only some of the factors analyzed in our study statistically significantly influenced the response to treatment and the duration of survival, i.e.: age over 60 years, hemoglobin [10g/dL, platelets under 150000/mm3, creatinine ]2mg/dL, serum calcium ]10mg / dL, increased C-reactive protein, low serum albumin levels, high levels of Beta 2 microglobulin, total serum protein, as well as presence of cells in the peripheral smear. Defining a panel of negative prognostic factors that influence the evolution and response to multiple myeloma treatment would allow for tailoring of personalized therapies for each patient.

This paper presents the results of a case study conducted between 2.04 and 24.04.2013 in order to establish the most relevant indicators that characterize the influence of outdoor air pollution, with particulate matter having a nominal diameter less than 2.5 m (PM2.5), on the quality of indoor air from a new building. The tests consisted in simultaneous determination of the daily average PM2.5 concentrations at four indoor sites and at one outside, nearby the building. The average PM2.5 concentration was 38.41 7.4 g/m3, but only 70% of the outdoor performed tests were above the daily limit of 35 g/m3, set by the U.S. Environmental Protection Agency. The indoor air pollution with PM2.5 was lower than outdoor with an average concentration of 21.78 6.22 g/m3. Both Pearson s statistical correlation analysis and linear regression analysis showed a good direct correlation between indoor and outdoor PM2.5 concentrations, the proper insulation of the building and the absence of major indoor sources of PM2.5 particles. The results of this study demonstrated that for a new building the indoor/outdoor (I/O) ratio and infiltration factor (Fin) could give a correct estimation of the outdoor air pollution influence on the indoor air quality. Further information could be provided by statistical correlation and linear regression analysis; the value of the intercept could be a good indicator of the presence of indoor sources.

Background and Objectives: The aim of this study was to evaluate and compare the effects of two different anti-inflammatory drugs (ketoprofen and prednisone) combined with an antibiotic (amoxicillin + clavulanic acid) and periodontal surgery on dental and periodontal parameters in patients with severe chronic periodontitis. In addition, salivary stress expressed by cortisol levels was assessed. Materials and Methods: An interventional study was performed on 22 periodontal subjects and 19 clinical healthy controls. The patients were divided in four groups, depending on treatment planning, as follows: eight patients received prednisone and antibiotherapy, associated with surgical periodontal therapy, seven patients received ketoprofen and antibiotherapy, associated with surgical periodontal therapy (group II), seven patients received only prednisone. Periodontal healthy patients underwent routine scaling and polishing. Bleeding on probing (BOP), dental mobility and salivary cortisol (ng/mL) were assessed before and after treatment. The means and standard deviations for the salivary cortisol levels (SCLs), dental and periodontal parameters were calculated for all groups using each patient as a unit of analysis. Results: Data analyses showed that the two different anti-inflammatory drugs associated with or without surgical therapy were efficient on inflammation periodontal parameters (BOP, dental mobility). Prednisone treatment alone was associated with a significant decrease of SCLs between pretreatment and post-treatment. Conclusions: In the present study, the effects of either of the anti-inflammatory drugs on inflammation evolution and salivary stress were comparable in patients undergoing antibiotherapy and surgical periodontal therapy.