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Cardiac interventions in the setting of a ST-elevation myocardial infarction (STEMI) often require complex decision-making, especially when confronted with coronary bifurcation lesions. Although provisional stenting is the first choice regarding revascularization, bailout or upfront two stents may be required.

Catalin Pestrea,1– 3 Ecaterina Cicala,1 Alexandra Gherghina,1 Florin Ortan,1 Dana Pop2,3 1Department of Interventional Cardiology, Brasov County Clinical Emergency Hospital, Brasov, 500326, Romania; 2 5th Department of Internal Medicine, Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, 400012, Romania; 3Department of Cardiology, Clinical Rehabilitation Hospital, Cluj-Napoca, 400347, RomaniaCorrespondence: Catalin Pestrea, Brasov County Clinical Emergency Hospital, Brasov, 500326, Romania, Tel +40745003637, Email pestrea.catalin@gmail.comPurpose: Although feasibility studies have included older patients, specific data for His bundle pacing (HBP) in this population is scarce. The aim of this study was to evaluate the feasibility and mid-term performance of HBP in the elderly (70 to 79 years old) versus the very elderly (80 years old and above) patients with conventional indications for pacing.Patients and Methods: About 105 patients older than 70 years of age with attempted HBP from the 1st of January 2019 to the 31st of December 2021 were reviewed. Clinical and procedural characteristics were recorded at baseline, and after a mid-term follow-up period.Results: The procedural success rate was similar in both age groups (68.49% vs 65.62%). There was no significant difference in pacing or sensing thresholds, impedance, and fluoroscopy times. For both age intervals, patients with a baseline narrow QRS maintained a similar QRS duration after pacing, while in patients with a wide QRS, the paced QRS was significantly shorter. Baseline QRS duration, left bundle branch block morphology, and ejection fraction, were significantly associated with HBP procedural failure. The mean follow-up period was 830.34 days for the elderly and 722.76 days for the very elderly. After the follow-up period, both sensing and pacing thresholds were similar between the groups. Compared to the baseline values, there were no significant changes in both pacing and sensing parameters, irrespective of the age interval. During follow-up, no lead dislodgements were recorded. There were two cases of significant pacing threshold rise in the elderly (4%) and three cases in the very elderly group (14.2%) which were managed conservatively, without lead revision.Conclusion: In elderly and very elderly patients, HBP is a feasible procedure associated with constant pacing and sensing parameters and with low complication rates over mid-term follow-up.Keywords: conduction system pacing, elderly and very elderly, feasibility study, mid-term follow-up

Langerhans cell histiocytosis is known as a rare childhood disease. In this case, we wanted to share our patient’s experience whose first symptom was an epileptic seizure, which attracted attention at an advanced age and revealed bilateral temporal lobe involvement. Our case was a 51-year-old male, who had been having seizures with focal onset, autonomic characteristics, impaired awareness, and occasionally secondary generalized seizures for 5 years, was admitted due to an increase in the frequency of seizures over the past 6 months. The patient was diagnosed with Langerhans cell histiocytosis as a result of pathological examination of the bronchoalveolar lavage. In cranial magnetic resonance imaging, bilateral temporal regions are hyperintense on T2 and Fluid Attenuated Inversion Recovery (FLAIR)-weighted images and hypointense and partially enhanced contrast on T1-weighted images. Additionally, central involvement of Langerhans cell histiocytosis was supported by hyperintensity in the optic chiasm, pituitary gland, and around the third ventricle on T2 and FLAIR-weighted images. Elect roenc ephal ograp hy showed sharp slow wave activity in the left anterior temporal region. After controlling our patient’s seizures, we referred him to the oncology and hematology departments to regulate his treatment for primary disease. It should be noted that in late-onset Langerhans cell histiocytosis, epileptic seizures may occur as the first symptom rarely, due to secondary involvement of the central nervous system.

Introduction This study evaluated the feasibility of His bundle pacing (HBP) in consecutive, unselected patients with advanced atrioventricular block (AVB) over a medium-term follow-up period, comparing procedural characteristics between nodal and infranodal sites of the conduction block.Materials and methods Seventy-five consecutive patients with second-degree or third-degree AVB in which HBP was attempted were prospectively included in this study. The clinical and procedural-related characteristics of the patients were recorded at baseline and over a mid-term follow-up.Results 72% of the patients had normal QRS duration at baseline. Intracardiac electrograms revealed nodal AVB in 46 patients (61.3%). The permanent HBP procedural success was significantly higher in nodal AVB (84.8%) vs infranodal AVB (31%). There was no statistical difference between paced QRS duration, impedance, pacing and sensing thresholds and fluoroscopy time in the two groups. Infranodal block, baseline QRS duration, left bundle branch block morphology and ejection fraction were significantly associated with HBP procedural failure. The patients were followed for a period of 627.71±160.93 days. There were no significant differences in parameters at follow-up. An increase of >1 V in the His bundle (HB) capture threshold was encountered in one patient with infranodal AVB (11.1 %) and in four patients with nodal AVB (10.25%).Conclusion Permanent HBP is a feasible pacing technique in nodal AVB with a high success rate and stable thresholds in the medium term. Most infranodal blocks are located within the HB, so there is still the possibility to capture the conduction system, although with lower success rates.

The aims of the present study were to evaluate for the first time the chemical composition and antioxidant, antibacterial, antifungal and antiproliferative potentials of the Romanian George 90 lavender species, as well as parental species, L. angustifolia and L. latifolia. The L. angustifolia, L. latifolia and George 90 essential oils were analyzed by GC-MS/MS and the L. angustifolia, L. latifolia and George 90 hydroalcoholic extracts were analyzed by HPLC-DAD. The antioxidant, antibacterial, antifungal and antiproliferative assays revealed that all the investigated species showed significant activities. The results highlighted the chemical composition and the promising biological potentials of the L. angustifolia, L. latifolia and George 90 lavender species, validating their ethnomedicinal value, which offers potential applications as natural drugs.

This study presents the phytosynthesis of silver-based nanoparticles using tomato flower waste extracts for the first time in the literature. The determination of total polyphenolic and flavonoid contents in the extracts showed high gallic acid equivalents (6436–8802 mg GAE/kg dm) and high quercetin equivalents (378–633 mg QE/kg dm), respectively, dependent on the extraction method. By the Ultra Performance Liquid Chromatography technique, 14 polyphenolic compounds were identified and quantified in the tomato flower waste extracts. The abundant phenolic compounds were caffeic acid (36,902–32,217 mg/kg) and chlorogenic acid (1640–1728 mg/kg), and the abundant flavonoid compounds were catechin (292–251 mg/kg) and luteolin (246–108 mg/kg). Transmission electron microscopy of the nanoparticles revealed a particle size range of 14–40 nm. Fourier Transform infrared spectroscopy and X-ray diffraction studies confirmed the phytosynthesis of the silver/silver oxide nanoparticles. These findings hold significant results for the antibacterial and antitumoral potential applications of the obtained nanoparticles, opening new areas for research and development and inspiring further exploration. The impact of this research on the field of metallic nanoparticle phytosynthesis is substantial, as it introduces a novel approach and could lead to significant advancements in the field. [ABSTRACT FROM AUTHOR]

Introduction: There is an increasing interest in the past decade for more physiological pacing strategies due to detrimental long-term right ventricular pacing. His bundle pacing is the most physiological one, but it has some drawbacks, mainly an increased pacing threshold. Left bundle branch area pacing (LBBAP) emerged in the recent years as the next step in conduction system pacing. We present our initial experience and learning curve with this latter procedure. Material and methods: During January 2019 and February 2021, 20 patients with pacing indications that failed initial permanent His bundle pacing underwent successful LBBAP. Results: The mean age was 65.9 ± 12.7 years. The indications for cardiac pacing were AV block in 14 patients(70%) and cardiac resynchronization therapy in 6 patients (30%). At baseline, normal QRS complex was noted in 9 patients, a left bundle branch block pattern in 10 patients and a right bundle branch block in one patient. A total of 18 dual-chamber and one single chamber pacemakers were implanted and a cardiac resynchronization therapy defibrillator (CRT-D) device. The acute pacing threshold was 0.56±0.2 V at 0.4ms, the sensing threshold was 10.3±3.9 mV and the impedance was 684.9±112.2 Ω. The overall QRS duration decreased after LBBAP from 128.5 ± 27ms to 103.6 ± 17.4ms (p= 0.001). In patients with baseline wide QRS complex there was a highly significant decrease from 148.2 ± 11.6 ms to 104.7 ± 19.4 ms (p

Compared with conventional right ventricular septal pacing (RVSP), several studies have shown a net clinical benefit of left bundle branch area pacing (LBBAP) in terms of ejection fraction preservation and reduced hospitalizations for heart failure. The purpose of this study was to compare acute depolarization and repolarization electrocardiographic parameters between LBBAP and RVSP in the same patients during the LBBAP implant procedure. We prospectively included 74 consecutive patients subjected to LBBAP from 1 January to 31 December 2021 at our institution in the study. After the lead was placed deep into the ventricular septum, unipolar pacing was performed and 12-lead ECGs were recorded from the distal (LBBAP) and proximal (RVSP) electrodes. QRS duration (QRSd), left ventricular activation time (LVAT), right ventricular activation time (RVAT), QT and JT intervals, QT dispersion (QTd), T-wave peak-to-end interval (Tpe), and Tpe/QT were measured for both instances. The final LBBAP threshold was a 0.7 ± 0.31 V at 0.4 ms duration with a sensing threshold of 10.7 ± 4.1 mV. RVSP produced a significantly larger QRS complex than the baseline QRS (194.88 ± 17.29 ms vs. 141.89 ± 35.41 ms, p < 0.001), while LBBAP did not significantly change the mean QRSd (148.10 ± 11.52 ms vs. 141.89 ± 35.41 ms, p = 0.135). LVAT (67.63 ± 8.79 ms vs. 95.89 ± 12.02 ms, p < 0.001) and RVAT (80.54 ± 10.94 ms vs. 98.99 ± 13.80 ms, p < 0.001) were significantly shorter with LBBAP than with RVSP. Moreover, all the repolarization parameters studied were significantly shorter in LBBAP than in RVSP (QT—425.95 ± 47.54 vs. 487.30 ± 52.32; JT—281.85 ± 53.66 vs. 297.69 ± 59.02; QTd—41.62 ± 20.07 vs. 58.38 ± 24.44; Tpe—67.03 ± 11.19 vs. 80.27 ± 10.72; and Tpe/QT—0.158 ± 0.028 vs. 0.165 ± 0.021, p < 0.05 for all), irrespective of the baseline QRS morphology. LBBAP was associated with significantly better acute depolarization and repolarization electrocardiographic parameters compared with RVSP.

Cultural heritage represents the link between past and present civilizations, contributing to the right appreciation of the present-day by understanding the historical evolution of different human communities that are shaping our world. Preservation of the cultural heritage and mitigating potential risks on invaluable artifacts or objectives is key to conserving the identity of present and future generations. Our complex project is dedicated to monitoring, conservation, protection and promotion of the Romanian cultural heritage. It addresses the challenge of better safeguarding the cultural heritage by developing a multidisciplinary approach.The combined use of Synthetic Aperture Radar and multispectral satellite imagery represent a non-invasive investigation instrument that enable multitemporal analysis, contributing with valuable insights regarding cultural heritage sites. Remote sensing techniques were used to generate geospatial products such as displacement maps, urban sprawl evolution maps, urban heat island maps and many more.For protecting important artifacts, innovative recipes based on nanotechnologies were developed. In order to promote these artifacts, 3D photorealistic models were created using 3D reconstruction technology. For selected cultural heritage objectives, an integrated LiDAR aerial mapping system has enabled the creation of a high accuracy 3D model.This paper illustrates how different technologies, ranging from remote sensing to nanotechnology, could be used for safeguarding and promoting the Romanian cultural heritage and represents a first step in establishing and consolidating a multidisciplinary team involved in this domain.

Following the fall of communism in 1989, the R&D sector started a modernization process. By establishing in 1995 a structure dedicated to the space activities – Romanian Space Agency (ROSA) – the Government recognized the importance of this innovative strategic domain. The National Space Strategy defined by means of the RTD policy, with effects on both academia and industry, had three objectives since the 90’s: Participation to international space missions and programmes, Development of specific national projects and Capacity building at national level. In time, the experience acquired in the implementation of CIS, LCCS and LPIS/IACS projects offered the possibility to establish new certitudes for the evolution of the domain. The main development directions had been oriented towards the implementation of dedicated applications to answer problematics concerning smart agriculture, traceability, better agro-environmental practices and the relation with other scientific domains (e.g. cultural heritage). The partnership between a strong Governmental R&D structure – ROSA – and the University of Agronomic Sciences and Veterinary Medicine of Bucharest (USAMVB) demonstrates the capacity to find solutions for promoting space EO technologies and adapt the higher education curricula in synergy with the development of the ambitious European space programme evolution.

With their phytoconstituents acting as reducing and capping agents, natural extracts can be considered a viable alternative for the obtaining of metallic nanoparticles. The properties of phytosynthesized nanoparticles are dependent upon size and morphology, which, in turn, can be tailored by adjusting different parameters of the phytosynthesis process (such as the extracts’ composition). In the present study, we aimed to evaluate, for the first time in the literature, the influence of the extraction method and extract concentration on the morphological and biological properties (antioxidant and antibacterial activity) of silver nanoparticles phytosynthesized using Echinacea pupurea L. extracts. The obtained results revealed that the use of the low-concentration Echinacea hydro-alcoholic extract obtained via classical temperature extraction led to the development of nanoparticles with the smallest dimensions (less than 10 nm), compared with the use of extracts obtained with higher concentrations and the extract obtained via the microwave method. The developed nanomaterials exhibited enhanced antioxidant effects (determined via the DPPH assay) and antimicrobial properties (against Escherichia coli and Candida albicans), compared with the parent extracts.

The growing demand for more sustainable, alternative processes leading to production of plant-derived preparations imposes the use of plants waste generated mainly by agri-food and pharmaceutical industries. These mostly unexploited but large quantities of plants waste also increase the interest in developing alternative approaches for sustainable production of therapeutic molecules. In order to reduce the amount of plant waste by further processing, different novel extraction techniques can be applied. Fruits and their industrial by-products are rich sources of different classes of compounds with therapeutic properties. The processed fruits waste can be reused and lead to novel pharmaceuticals, food supplements or functional foods. This review intends to briefly summarize recent aspects regarding the production of different active compounds from fruit by-products, and their therapeutic properties. The potential use of fruits by-products in different industries will be also discussed.

Abstract Background Juniperus communis L. represents a multi-purpose crop used in the pharmaceutical, food, and cosmetic industry. Several studies present the possible medicinal properties of different Juniperus taxa native to specific geographical area. The present study aims to evaluate the genoprotective, antioxidant, antifungal and anti-inflammatory potential of hydroalcoholic extract of wild-growing Juniperus communis L. (Cupressaceae) native to Romanian southern sub-Carpathian hills. Methods The prepared hydroethanolic extract of Juniperus communis L. was characterized by GC-MS, HPLC, UV-Vis spectrometry and phytochemical assays. The antioxidant potential was evaluated using the DPPH assay, the antifungal effect was studied on Aspergillus niger ATCC 15475 and Penicillium hirsutum ATCC 52323, while the genoprotective effect was evaluated using the Allium cepa assay. The anti-inflammatory effect was evaluated in two inflammation experimental models (dextran and kaolin) by plethysmometry. Male Wistar rats were treated by gavage with distilled water (negative control), the microemulsion (positive control), diclofenac sodium aqueous solution (reference) and microemulsions containing juniper extract (experimental group). The initial paw volume and the paw volumes at 1, 2, 3, 4, 5 and 24 h were measured. Results Total terpenoids, phenolics and flavonoids were estimated to be 13.44 ± 0.14 mg linalool equivalent, 19.23 ± 1.32 mg gallic acid equivalent, and 5109.6 ± 21.47 mg rutin equivalent per 100 g of extract, respectively. GC-MS characterization of the juniper extract identified 57 volatile compounds in the sample, while the HPLC analysis revealed the presence of the selected compounds (α-pinene, chlorogenic acid, rutin, apigenin, quercitin). The antioxidant potential of the crude extract was found to be 81.63 ± 0.38% (measured by the DPPH method). The results of the antifungal activity assay (for Aspergillus niger and Penicillium hirsutum) were 21.6 mm, respectively 17.2 mm as inhibition zone. Test results demonstrated the genoprotective potential of J. communis undiluted extract, inhibiting the mitodepressive effect of ethanol. The anti-inflammatory action of the juniper extract, administered as microemulsion in acute-dextran model was increased when compared to kaolin subacute inflammation induced model. Conclusion The hydroalcoholic extract obtained from wild-growing Juniperus communis native to Romanian southern sub-Carpathian hills has genoprotective, antioxidant, antifungal and anti-inflammatory properties.

A traditional aromatic culinary plant, basil (Ocimum spp.) also offers a wide range of potential health benefits, including antioxidant, anti-inflammatory and anticarcinogenic effects. Multiple varieties cultivated around the world, ranging from the traditional Ocimum basilicum - sweet basil to Genovese basil, cinnamon basil, purple basil, holy basil, etc, were investigated for their therapeutic properties due to their high content of antioxidant compounds. The aim of this study was the phytochemical analysis of a lemon-flavored basil, with seeds procured from Kiepenkerl. To promote a circular economy, the lemon basil was grown together with yeast biomass fed fish in an aquaponic system. The samples consisted of basil grown with: different percentages of yeast biomass added to conventional fish feed, regular fish feed, and traditional soil-based technologies. The phytochemical composition of the samples was assessed following microwave-assisted extraction. The evaluation included antioxidant activity (DPPH, FRAP, ABTS assays), as well as total phenolic and flavonoid contents. Among the 14 compounds identified in the UPLC investigation, caffeic acid and rosmarinic acid had the highest content in all the samples. [ABSTRACT FROM AUTHOR]

Introduction: The current study evaluates the effects of COVID-19 infection and the safety of vaccines in patients with epilepsy (PWEs). Method: The study was conducted with PWEs who were vaccinated against COVID-19. The sample was separated into two groups as those with drug-resistant epilepsy (DRE) and those with non-resistant epilepsy, and their seizure frequencies, seizure types, development of status epilepticus, changes in doses and/or types of drugs, electroencephalographs (EEGs) before and after COVID-19 infection, and vaccination with mRNA or inactivated vaccines were monitored and compared. Changes in seizure patterns were also inquired about following the administration of vaccines other than COVID-19. Results: Included in the study were 307 PWEs with a mean age of 42.62±14.74, among whom COVID-19 PCR positivity was detected in 97(31.6%). Those who experienced no increase in seizure frequency while infected with COVID-19 were significantly under monotherapy (p=0.031). The mean seizure frequency was 2.70±5.19 per year before vaccination, but increased to 3.20±5.82 after. A significant relationship was identified between abnormal EEG and increased seizure frequency across the entire sample and the mRNA group (p=0.011, p=0.004). The frequency of seizures increased significantly in the DRE patients after receiving the mRNA vaccine (p=0.023). Overall, increased seizure frequencies were observed in 29.9% of the sample during COVID-19 infection, with increases of 16.4% in those who received the mRNA vaccine, 8.6% after inactivated vaccines and 25% after non-COVID-19 vaccines. Conclusion: COVID-19 infection was found to be associated with a higher increased seizure frequency risk than being vaccinated, and COVID-19 vaccines do not differ from other vaccines in terms of the risk to PWEs. [ABSTRACT FROM AUTHOR]

The search of valuable natural compounds should be directed towards alternative vegetal resources, and to the re-discovery of underutilized plants. Belonging to the Plantaginaceae family, the hoary plantain (Plantago media L.) represents one of the lesser studied species from the Plantago genus. The literature study revealed the under-utilization of the hoary plantain, a surprising aspect, considering its widespread. If the composition of Plantago media L. is rather well established, its applications are not nearly studied as for other Plantago species. The goal of the present paper is to summarize the findings regarding the applications of P. media, and, having as starting point the applications of related species, to propose new emerging areas of research, such as the biomedical applications validation through in vivo assays, and the evaluation of its potential towards industrial applications (i.e., development of food or personal care products), pisciculture or zootechny, phytoremediation and other environmental protection applications, or in the nanotechnology area (materials phytosynthesis). The present work constitutes not only a brief presentation of this plant’s present and potential applications, but also an invitation to research groups world-wide to explore the available vegetal resources.

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Preservation of historic monuments and archaeological sites has a strategic importance for maintaining local cultural identity. [...]

Biodeterioration can be considered as one of the most powerful weapons that can destroy cultural heritage. [...]