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The objective of this paper was to analyze the metabolic model for the monitoring and management of gestational diabetes. This is a descriptive, retrospective and observational study, based on the medical records from the database of the “Alessandrescu-Rusescu” Institute for Maternal and Child Health, Bucharest. There were included 157 patients who showed up for consult in every trimester of pregnancy. Fat accumulation during pregnancy is variable and may depend on the woman’s pre-pregnancy metabolic status and other lifestyle variables such as diet and physical activity. Pregnancy represents a critical period of growth, development and physiological change, providing an opportunity for early lifestyle intervention. The goal of identifying an effective lifestyle program for the gestational period that leads to healthy fetal development and subsequent normal weight offspring less likely to develop obesity and its comorbidities is unique and could mitigate the intergenerational cycle of obesity. The main objective in the management of obesity during pregnancy is prevention. Basically, apart from pre-conceptional weight loss in the management of obese pregnant women, glucose screening should be considered in obese women in early pregnancy to rule out undiagnosed pregestational diabetes. [ABSTRACT FROM AUTHOR]

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Introduction. Due to the high incidence, morbidity, mortality and high costs for the health system, sepsis stands out, among other things, by the firm indication of hospitalization in an intensive care unit. Dysfunction of microcirculation plays a central role in the genesis and maintenance of septic syndrome, as it represents a pathophysiological milestone of this syndrome. Videocapillaroscopy opens up the possibility of detecting microvascular anomalies in the early stages, allowing for new diagnostic and research opportunities. Material and method. Our unrandomized, prospective, multicenter, analytical study analysed a group of 51 patients with various ethology of septic shock, a clinical condition that was diagnosed on the basis of standard clinical and biological criteria, hospitalized in three ICU clinical wards, over the course of 15 months (August 2019 - November 2020), where the parameters of the oral mucosa microcirculation were monitored with the help of a videocapillaroscope, the resulting prototype of an invention patent already implemented by the authors. Objectives. The main objective of our study was to validate, on a clinical level, the possibility of using videocapillaroscopy of the oral mucosa, as an efficient means of early detection of the changes that predict the early onset of septic shock in patients in ICU patients. Results. Videocapillaroscopy was performed with a prototype device, recording 357 images of the microcirculation of the oral mucosa in the patients that had already been confirmed, via classical clinical and paraclinical means, with the diagnosis of sepsis. Discussions. The statistical analysis of the essential 5 elements detected by videocapillaroscopy (capillary density, incidence in normal and parallel disposition, diameter and microhemorrhage) corroborated with the clinical and paraclinical elements of the sepsis state path clearly highlights the correlation power of these determinations. Conclusions. Given the completely non-invasive nature of this imaging method, the very low costs associated with the method, the ease in collecting and interpreting data as well as the results that bear strong statistical correlation, we can conclude that it can successfully be considered a method of prediction with high reliability and specificity in the early detection of sepsis, regardless of its etiology. [ABSTRACT FROM AUTHOR]

Introduction. COVID-19 pandemic is caused by SARS-CoV-2 and it has an important but often overlooked impact on surgical current activity. The reports about its implications in obstetrical and gynecological surgical side are accumulating. The purpose of our study was to reveal the surgical challenges during pandemic period. Methodology. We reviewed the main medical databases, such as PubMed, Medline and Web of Science, searching for publications about SARS-CoV-2 in surgery and we focused on reports about the challenges that medical staff had to endure during patients’ care. Results. Our research revealed more than 4500 publications about SARS-CoV-2 and medical staff. At onset, there was a lack of information. The virus spread so fast, and the medical professional providers had different challenges. At the beginning, everybody was discussing about the way of transmission among individuals. The deficit of equipment was a major reason of concern. The instructions of using correctly the PPE were contradictory. All the medical staff was stressed, and they must face more stressed patients with different pathologies. In time, the reasons of concern changed so that that surgical procedures can be performed in safety conditions for both surgeon and patient. The characteristic of each pandemic wave raised peculiar discussions. Conclusions. COVID-19 in gynecologic operating room represents a challenge because the physician has to perform usual surgical steps in special conditions. The literature experience and the personal one in COVID-19 hospital represent the subject of this report. [ABSTRACT FROM AUTHOR]

Introduction. The protective role of the placental barrier to bacterial and viral infections, the immune tolerance of the fetus still represents a medical challenge and subject of research. The impact of COVID-19 in pregnancies is continuously discussed especially because COVID-19 maternal infection has been the cause for unfavorable pregnancy outcomes. Materials and method. We performed database research with the terms: “COVID-19”, “placenta”, and “pathology” in PubMed, Embase, Scopus, ScienceDirect, Web of Science and Cochrane. Results. The research revealed 457 results. Even though there are published numerous reports, the effect of SARS-CoV-2 on the developing fetus remains unclear. Most publications admit that vertical transmission is unusual; but there is evidence that placental and fetal infection may occur. Placentas from patients with COVID-19 are inflammatory, thrombotic, and vascular changes that have been found in other inflammatory conditions. Peculiar lesions such as chorangiosis where identified. It may be considered that the inflammatory impact of SARS-CoV-2 infection during pregnancy could justify adverse obstetrics and neonatal events. The impact of vaccine against SARSCoV-2 on placental represents another subject of debate. Conclusions. This presentation will expose the known literature and self-experience about the placenta in SARS-CoV-2 infection and possible outcomes of prenatal exposure to the virus. [ABSTRACT FROM AUTHOR]

Introduction. COVID-19 pandemic is caused by SARS-CoV-2 and it has an enormous impact on humans’ life. The reports about its implications during pregnancy are increasing. The purpose of our study was to reveal the obstetrical challenges during pandemic period. Materials and method. We reviewed main medical databases such as PubMed, Medline and Web of Science, searching publications about SARSCoV- 2 in pregnancy and we focused on reports about the complications of pregnancy and SARS-CoV-2 infection. Results. Our research revealed more than 3000 publications about SARS-CoV-2 and pregnancy. The majority of the studies highlighted the maternal symptoms, the biological findings, the termination of pregnancy, the fetal outcome and placental pathology. The main characteristic was that newborns with positive mothers were negative at the SARS-CoV-2 PCR test. The incidence of caesarean section increased mostly based on premature induced births. The main indication for caesarean section corelated with SARS-CoV-2 symptoms was maternal acute respiratory distress associated. There were reported cases of COVID-19 pregnancy associated thrombocytopenia or HELLP syndrome. Some studies described significant placental changes in COVID-19 pregnancies. Overall, the usual obstetrical complications with no corelations to SARS-CoV-2 were mentioned as well. Conclusions. COVID-19 in pregnancy represents a challenge for the obstetrician because the physician has to solve both the surgical and medical complications of pregnancy. [ABSTRACT FROM AUTHOR]

The extracellular matrix (ECM) consists of fibrillary and non-fibrillary components in the extracellular zone, and fulfills structural and signaling roles. Cardiac insult can lead to cardiomyocyte death, which subsequently determines dynamic changes of ECM composition and regulates cellular responses, ultimately contributing to cardiac repair. The present retrospective study on a small batch selected from the database of the Pathology Department of 'Sf. Pantelimon' Hospital aimed to determine which molecules may have a role in the dynamics of ECM using histopathology and immunohistochemistry methods. The study batch was composed of cases with cardiac ischemic conditions who died at various ages of myocardial infarcts. Tissue samples were taken from the myocardium of the left ventricle (anterior and lateral walls), and multiple series of histological sections were produced and analyzed using immunohistochemistry for collagen type I (Col-1), tenascin C (Tn-C), matrix metalloproteinase 9, CD34, and CD68. Col-1 and Tn-C showed variable patterns of fibrillar plexiform network, associated with a high micro-vascular density of newly formed capillaries revealed by CD34, and an interstitial infiltrate with histiocytes demonstrated by CD68 presence. The ECM represents therefore a polymorphic microenvironment with its own dynamics that is in continuous change, involving a large spectrum of heterogenous molecules, which play different roles in myocardium remodeling under hypoxic ischemic conditions. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study was to identify the impact of prenatal lectures in breastfeeding and neonatal care in Romania. Methods: We distributed a questionnaire to mothers who gave birth at the Bucur Maternity, Bucharest, Romania. A study group was constituted from women who attended prenatal lectures and their answers were compared with those from women who did not have prenatal education. Results: The study included 122 women. Primiparous women tend to participate in educational lectures to a greater extent than others (p=0.001). Participants in prenatal lectures breastfeed longer than non-participants (=0.001) and they had at least university studies in a higher proportion (94.06%) than non-attenders (52.38%). Women without prenatal lectures live predominantly in rural areas (p=0.003). Most women who attended classes (86.2%) considered that information provided by prenatal lectures was useful. Exclusively breastfeeding was more frequent among participants (47.49%) than non-participants (38.89%). Conclusion: Primiparity, high level of education and living in urban areas are the main characteristics of female participants in prenatal lectures, who tend to breastfeed longer and ensure exclusive human milk feeding for their babies in a higher proportion than non-participants. [ABSTRACT FROM AUTHOR]

Heterotopic pancreas is a rare congenital abnormality. The most common location is the stomach, duodenum and proximal jejunum. Rare locations are represented by the ampulla of Vater, esophagus, ileum, Meckel diverticulum, biliary tract, mesentery and spleen. We present the case of a 49 year old patient investigated for obstructive jaundice and diagnosed with an ampullar heterotopy of pancreas parenchyma, initially considered to be a malignant tumor. A Whipple pancreatoduodenectomy was performed with good postoperative evolution, the serum levels of bilirubin being normal after the first postoperative week., (Celsius.)

Liver transplantation is the last life-saving solution for patients with end stage liver disease. The low number of available liver grafts and the increasing waiting time on transplant lists have led to the appearance of extended donation criteria and the marginal grafs, initially considered suboptimal. Allocation of grafts and identification of the most suitable "donor-recipient" pair is still under development. The fact is that the appearance of marginal grafts has expanded the donation lists and seems to have a prognosis at least comparable to the use of ideal grafts., (Celsius.)