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Sergiu Chirila,1,* Tony Hangan,2,* Leonard Gurgas,1,* Monica Georgiana Costache,2,* Marinela Anisoara Vlad,3,* Bogdan-Florentin Nitu,3,* Sara Melek Bittar,4,* Aurora Craciun,5,* Laura Condur,6,* Geir Bjørklund7,* 1Department of Medical Informatics and Biostatistics, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania; 2Department of Dermatology, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania; 3Doctoral School of Medicine, Ovidius University of Constanta, Constanta, Romania; 4Department of Dermatology, County Clinical Emergency Hospital of Constanta, Constanta, Romania; 5Department of Biochemistry, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania; 6Department of Family Medicine, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania; 7Council for Nutritional and Environmental Medicine, Mo i Rana, Norway*These authors contributed equally to this workCorrespondence: Tony Hangan, University Alee nr. 1, Department of Dermatology, Faculty of Medicine, Campus B, Ovidius University of Constanta, Constanta, 900470, Romania, Email tony@medcon.roBackground: This study explores patient acceptance of influenza vaccination administered by pharmacists in Romania during the 2023 season, considering it a novel strategy to address gaps in knowledge. Pharmacy-based vaccination deviates from traditional methods, providing high-risk patients with full reimbursement and others with 50% reimbursement, allowing a choice between family doctors and pharmacies for vaccine administration.Material and Method: The survey includes 15 questions covering socio-demographic data, health information, vaccination preferences, and perceptions of pharmacy-based vaccinations.Results: Respondents showed a positive inclination toward pharmacy-based vaccination, with 68% expressing favorable sentiments, but an awareness gap exists, as only 36% were aware of pharmacy-based vaccination availability.Conclusion: Challenges include a lack of patient awareness and understanding of benefits, emphasizing the need for structured pharmacist-patient dialogues. Legal changes, a defined funding mechanism, and collaboration are crucial for successful implementation. The study provides valuable insights into patient perceptions, contributing to discussions on optimizing influenza vaccination coverage in Romania and beyond and recognizing pharmacies’ potential in achieving broader vaccination goals.Keywords: pharmacy, vaccine, influenza, vaccination

Nodul cordonului ombilical reprezintă o complicaţie rară în sarcină, ce poate determina asfixierea intrapartum a fătului. Diagnosticul antenatal este dificil, în majoritatea cazurilor prezenţa unui nod de cordon fiind o surpriză diagnostică intrapartum. Ecografia antenatală poate sugera diagnosticul, în special în sarcina precoce. În ultimul trimestru de sarcină, diagnosticul este mai dificil, aproape imposibil. Dacă diagnosticul a fost efectuat antenatal, atunci monitorizarea sarcinii şi a naşterii trebuie să fie foarte strictă, fiind preferată naşterea prin operaţie cezariană. Scopul lucrării noastre este de a realiza o recenzie a literaturii şi de a prezenta factorii de risc şi semnele ecografice şi antenatale ce pot ajuta la diagnosticul antenatal al nodului de cordon ombilical. [ABSTRACT FROM AUTHOR]

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Multiple sclerosis (MS) is a chronic autoimmune disorder of the central nervous system characterized by demyelination, neuroinflammation, and neurodegeneration. Recent studies highlight the role of cerebral iron (Fe) accumulation in exacerbating MS pathophysiology. Fe, essential for neural function, contributes to oxidative stress and inflammation when dysregulated, particularly in the brain's gray matter and demyelinated lesions. Advanced imaging techniques, including susceptibility-weighted and quantitative susceptibility mapping, have revealed abnormal Fe deposition patterns in MS patients, suggesting its involvement in disease progression. Iron's interaction with immune cells, such as microglia, releases pro-inflammatory cytokines, further amplifying neuroinflammation and neuronal damage. These findings implicate Fe dysregulation as a significant factor in MS progression, contributing to clinical manifestations like cognitive impairment. Therapeutic strategies targeting Fe metabolism, including Fe chelation therapies, show promise in reducing Fe-related damage, instilling optimism about the future of MS treatment. However, challenges such as crossing the blood-brain barrier and maintaining Fe homeostasis remain. Emerging approaches, such as Fe-targeted nanotherapeutics and biologics, offer new possibilities for personalized treatments. However, the journey is far from over. Continued research into the molecular mechanisms of Fe-induced neuroinflammation and oxidative damage is essential. Through this research, we can develop effective interventions that could slow MS progression and improve patient outcomes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025. Published by Elsevier B.V.)

The potential association between aluminum-containing deodorants/antiperspirants and breast cancer has been investigated and debated. This paper comprehensively analyzes existing literature to examine the evidence and provide insights into this relationship. This comprehensive review discusses aspects related to the absorption and distribution of aluminum compounds, its effects on the induction of oxidative stress, the estrogenic activity of aluminum, and potential disruption of hormonal pathways, and the potential role in breast cancer induction. Currently, available research, consisting of epidemiological studies as well as clinical trials, together with meta-analyses and previously published reviews conducted on identifying the relationship between aluminum-containing deodorants/antiperspirants and the risk of breast cancer were also analyzed and discussed. Societal factors, personal hygiene considerations, and lifestyle changes contribute to the increased usage of antiperspirants, but they do not establish a direct causal connection with breast cancer. Further research employing larger-scale studies and rigorous methodologies must validate the existing findings and explore the underlying mechanisms involved. Continued multidisciplinary research efforts and collaboration between researchers, regulatory bodies, and public health authorities are vital to developing a more definitive understanding of this complex topic., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background/Objectives : Tobacco smoking is the most important cause of chronic diseases and premature death worldwide. Very brief advice (VBA) and brief advice (BA) represent evidence-based interventions designed to increase quit attempts. These are appropriate for all smokers, regardless of their motivation to quit, and involve several steps regarding the assessment, advice, and action. This review aimed to evaluate the effectiveness of these brief interventions offered by general practitioners (GPs) in smoking cessation. Methods : A systematic search for articles that presented these interventions as an aid to support smoking cessation was conducted. The rate of successful smoking cessation was evaluated following interventions offered by general practitioners, regardless of the patients' present motivation to quit. Results: We have checked if these interventions can be used as an innovative method to help active smokers make an informed decision regarding their behaviour. Assisted/supported/guided by a general practitioner, current cigarette smokers can decide to quit smoking and identify the best way of cessation. We processed relevant data where brief interventions were used as the main counselling method to aid smoking cessation, regardless of using nicotine replacement therapy (NRT), heated tobacco products (HTPs), or vaping.

Background: Propolis and its major phenolic compound, caffeic acid phenethyl ester (CAPE), have garnered considerable scientific interest due to their anti- inflammatory properties and potential therapeutic applications., Objectives: This narrative review explores the potential utility of CAPE in cancer treatment., Methods: We comprehensively reviewed relevant studies from scientific databases (PubMed and Web of Science) from 2000 to 2022. Our search focused on keywords such as cancer, natural drugs, caffeic acid phenethyl ester, CAPE, cancer cell lines, antitumor effects, and propolis., Results: CAPE exhibits diverse biological benefits, including antimicrobial, antioxidant, antiviral, anti-inflammatory, cytotoxic, and potentially anti-carcinogenic properties. Numerous studies have demonstrated its wide-ranging antitumor effects on various cancer cell lines, including growth inhibition, apoptosis induction, tumor invasiveness prevention, malignancy suppression, and anti-angiogenic activity., Conclusion: Following comprehensive preclinical toxicity assessments, further evaluation of CAPE's efficacy and safety through clinical trials is highly recommended to elucidate its potential health benefits in diverse forms of human cancer., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Iron (Fe) is a necessary trace element in numerous pathways of human metabolism. Therefore, Fe deficiency is capable of causing multiple health problems. Apart from the well-known microcytic anemia, lack of Fe can cause severe psychomotor disorders in children, pregnant women, and adults in general. Iron deficiency is a global health issue, mainly caused by dietary deficiency but aggravated by inflammatory conditions. The challenges related to this deficiency need to be addressed on national and international levels. This review aims to summarize briefly the disease burden caused by Fe deficiency in the context of global public health and aspires to offer some hands-on guidelines., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Viral diseases have a significant impact on human health, and three novel coronaviruses (CoV) have emerged during the 21st century. In this review, we have emphasized the potential of herbal substances with antiviral effects. Our investigation focused on the features and prospects of viral disease treatment, with a particular emphasis on proinflammatory cytokines. We conducted comprehensive searches of various databases, including Science Direct, CABI Direct, Web of Science, PubMed, and Scopus. Cytokine storm mechanisms play a crucial role in inducing a pro-inflammatory response by triggering the expression of cytokines and chemokines. This response leads to the recruitment of leukocytes and promotes antiviral effects, forming the first line of defense against viruses. Numerous studies have investigated the use of herbal medicine candidates as immunomodulators or antivirals. However, cytokine-storm-targeted therapy is recommended for patients with acute respiratory distress syndrome caused by SARS-CoV to survive severe pulmonary failure. Our reviews have demonstrated that herbal formulations could serve as alternative medicines and significantly reduce complicated viral infections. Furthermore, they hold promising potential as specific antiviral agents in experimental animal models., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Lead (Pb) does not have any biological function in a human, and it is likely no safe level of Pb in the human body. The Pb exposure impacts are a global concern for their potential neurotoxic consequences. Despite decreasing both the environmental Pb levels and the average blood Pb levels in the survey populations, the lifetime redistribution from the tissues-stored Pb still poses neurotoxic risks from the low-level exposure in later life. The growing fetus and children hold their innate high-susceptible to these Pb-induced neurodevelopmental and neurobehavioral effects., Objective: This article aims to evaluate cumulative studies and insights on the topic of Pb neurotoxicology while assessing the emerging trends in the field., Results: The Pb-induced neurochemical and neuro-immunological mechanisms are likely responsible for the high-level Pb exposure with the neurodevelopmental and neurobehavioral impacts at the initial stages. Early-life Pb exposure can still produce neurodegenerative consequences in later life due to the altered epigenetic imprints and the ongoing endogenous Pb exposure. Several mechanisms contribute to the Pb-induced neurotoxic impacts, including the direct neurochemical effects, the induction of oxidative stress and inflammation through immunologic activations, and epigenetic alterations. Furthermore, the individual nutritional status, such as macro-, micro-, or antioxidant nutrients, can significantly influence the neurotoxic impacts even at low-level exposure to Pb., Conclusion: The prevention of early-life Pb exposure is, therefore, the critical determinant for alleviating various Pb-induced neurotoxic impacts across the different age groups., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

The thioredoxin system, consisting of thioredoxin (Trx), thioredoxin reductase (TrxR), and NADPH, plays a fundamental role in the control of antioxidant defenses, cell proliferation, redox states, and apoptosis. Aberrations in the Trx system may lead to increased oxidative stress toxicity and neurodegenerative processes. This study reviews the role of the Trx system in the pathophysiology and treatment of Alzheimer's, Parkinson's and Huntington's diseases, brain stroke, and multiple sclerosis. Trx system plays an important role in the pathophysiology of those disorders via multiple interactions through oxidative stress, apoptotic, neuro-immune, and pro-survival pathways. Multiple aberrations in Trx and TrxR systems related to other redox systems and their multiple reciprocal relationships with the neurodegenerative, neuro-inflammatory, and neuro-oxidative pathways are here analyzed. Genetic and environmental factors (nutrition, metals, and toxins) may impact the function of the Trx system, thereby contributing to neuropsychiatric disease. Aberrations in the Trx and TrxR systems could be a promising drug target to prevent and treat neurodegenerative, neuro-inflammatory, neuro-oxidative stress processes, and related brain disorders., Competing Interests: The authors declare no conflict of interest.

Coenzyme Q 10 (CoQ 10 ) is a compound with a crucial role in mitochondrial bioenergetics and membrane antioxidant protection. Despite the ubiquitous endogenous biosynthesis, specific medical conditions are associated with low circulating CoQ 10 levels. However, previous studies of oral CoQ 10 supplementation yielded inconsistent outcomes. In this article, we reviewed previous CoQ 10 trials, either single or in combination with other nutrients, and stratified the study participants according to their metabolic statuses and medical conditions. The CoQ 10 supplementation trials in elders reported many favorable outcomes. However, the single intervention was less promising when the host metabolic statuses were worsening with the likelihood of multiple nutrient insufficiencies, as in patients with an established diagnosis of metabolic or immune-related disorders. On the contrary, the mixed CoQ 10 supplementation with other interacting nutrients created more promising impacts in hosts with compromised nutrient reserves. Furthermore, the results of either single or combined intervention will be less promising in far-advanced conditions with established damage, such as neurodegenerative disorders or cancers. With the limited high-level evidence studies on each host metabolic category, we could only conclude that the considerations of whether to take supplementation varied by the individuals' metabolic status and their nutrient reserves. Further studies are warranted.

Autoimmune polyendocrine syndrome type 1 (APS-1) is an autosomal recessive hereditary pathology that develops with endocrine and non-endocrine manifestations in childhood. The classic triad of APS-1 includes chronic candidiasis of the skin and mucous membranes, adrenal insufficiency, and hypoparathyroidism. APS-1 is often accompanied by hypogonadism, type 1 diabetes, autoimmune thyroiditis, vitiligo, alopecia, asplenia, pneumonitis, gastritis, pernicious anemia, and intestinal dysfunction, nephritis, and hepatitis. The prevalence rate is highest in genetically isolated populations (up to 1:6500-1:9000). APS-1 occurs because of mutations in the autoimmune regulator (AIRE) gene, leading to a disrupted mechanism of normal antigen expression, the formation of abnormal clones of immune cells, and autoimmune damage to various organs. Analysis of the AIRE gene is the main diagnostic method for early detection of APS-1 and the choice of methods for its treatment. Timely genetic counseling makes it possible to identify the disease early, prescribe appropriate treatment and prevent serious complications. This paper analyzes scientific information characterizing clinical manifestations of autoimmune polyendocrine syndrome type 1 in association with its pathogenetic features, epidemiology, and current management., (Copyright © 2022 Elsevier B.V. All rights reserved.)