Search

Introduction. Fecaluria and pneumaturia are the patognomonic signs of an abnormal communication between the bladder and the intestinal tract. Therefore, when a history of digestive signs, symptoms or digestive diseases is missing, this borderline pathology leads the patients in the care of urologists. From diagnosis to treatment the management of these cases can be difficult and challenging. Materials and Methods. A 48 year old patient, without any significant medical history, presented to the emergency room for fecaluria, pneumaturia and an episode of haematuria. He had no prior digestive symptoms. The contrast enhanced abdominal and pelvic CT scan revealed a pelvic mass involving the sigmoid colon and the dome and the posterior wall of the bladder. The cystoscopy objectifies a tumor mass involving the right postero-lateral bladder wall, with extravasation of faeces. A biopsy was taken and the frozen section found mainly uncertain inflammatory type tissue. A colonoscopy couldn’t be done because of an impassable obstacle at 15 cm from the anus. Together with general surgeons we decided for en bloc resection of the tumor with partial cystectomy, right ureterocystoneostomy and rectosigmoid resection with mechanic end to end anastomosis. Results. The postoperative period was uneventful. The histopathological examination revealed an abscessed sigmoid diverticulum with vesico-sigmoid fistula and perilesional inflammatory tissue. Two years after the surgery the patient is asymptomatic with a normal function of the right kidney and restored bladder capacity. Conclusions. Being a borderline pathology, patients with fecaluria and pneumaturia and lack of digestive symptoms are referred and managed by the urologists. Despite extensive investigations, even when preoperative biopsies reveal inflammatory tissue the patients should be treated as oncologic cases. A close cooperation with general surgeons for en bloc multiorgan resection within oncologic safety margins is mandatory.

CDKN2A at chromosome positon 9p21 is a tumour suppressor gene encoding the cell cycle regulators p16 and p14ARF. While melanoma is associated with variants affecting both transcripts, families with mutations involving the p14ARF-specific exon 1B may be predisposed to central nervous system tumours. We describe a family with a deletion of exon 1B in CDKN2A, who had multiple cutaneous melanomas, neural tumours and various malignancies.

În articol se discută importanța siguranței pacientului în cadrul unei organizații medicale. Prin intermediul unei revizuiri a literaturii și a interviurilor cu personalul medical, au fost cercetate provocările moderne și măsurile de asigurare a siguranței în domeniul medical, inclusiv cultura siguranței, educația și formarea personalului, utilizarea tehnologiei și participarea activă a pacienților. Rezultatele subliniază faptul că siguranța pacientului necesită o abordare sistemică și eforturi constante din partea tuturor participanților în organizația medicală.

Cutaneous melanoma results from the malignant transformation of melanocytes in skin and accounts for 75% of deaths related to skin cancer. Between 5 to 12% of melanoma cases can be attributed to hereditary melanoma, melanoma caused by inherited germline mutations in melanoma predisposition genes. Although several inherited melanoma predisposition syndromes have been identified, a subset of melanoma families lack pathogenic mutations in known highly penetrant predisposition genes, including CDKN2A, CDK4, and BAP1. Here we report the case of a woman with a history of melanoma and multiple primary tumors with one pathogenic germline mutation in BUB1B

This review aimed to present Chlamydomonas reinhardtii as an alternative for heterologous protein production, especially for biopharmaceuticals, and its general characteristics when compared with other expression systems. The need to produce heterologous proteins for industrial interest, therapeutic ends, and diagnostic kits has led to the development of recombinant microalgal technology. This technology presents some interesting features, such as rapid growth and low transgene dispersion compared to plants, the ability to fold complex proteins compared to bacteria, and low production costs compared to other expression systems, such as yeast and mammalian cells. Overall, C. reinhardtii heterologous protein expression is coming of age with several research groups focused on developing an optimal producer strain.

Abstract Background The deficiency of adenosine deaminase 2 (DADA2) is an autosomal recessively inherited disease resulting from loss‐of‐function mutations in ADA2, formerly named CECR1 (cat eye syndrome chromosome region, candidate 1) gene. Disease manifestations could be separated into three major phenotypes: inflammatory/vascular, immune dysregulatory, and hematologic; however, most patients presented with significant overlap between these three phenotype groups. Case Presentation We present a case of DADA2 deficiency with disease onset at 3 years old, not recognized till the age of 18 with severe gastrointestinal vasculitis and recurrent episodes of neutropenia associated with a new CECR1 mutation.

Introduction. The coronavirus disease 2019 (COVID-19) pandemic has constrained healthcare units to reorganize hospital departments, substantially reducing their capacity to perform oncology-related surgeries. Despite the efforts to reduce the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during hospitalization, COVID-19 has complicated the recovery of many surgical patients. Our objective was to assess the impact of SARS-CoV-2 infection on the postoperative evolution of patients with pancreatic surgery. Cases presentation. We present four patients with pancreaticoduodenectomy for malignant disease, operated in our hepato-biliary-pancreatic surgery department, who presented COVID-19 in the postoperative period, despite initial negative screening. 10% of patients who had pancreaticoduodenectomies were subsequently detected with minimal, moderate to severe forms of COVID-19 in the postoperative period, which led to an extension of the hospitalization period, in some cases, by up to five weeks. Conclusions. The side effects of COVID-19 pandemic are yet to have reached their limits. Pancreaticoduodenectomy is a complex surgery with high morbidity rates, but during the COVID-19 pandemics it has become more challenging.

Stress urinary incontinence affects a large proportion of women in their lifetime. The objective of this review was to describe and compare the latest surgical trends in urinary incontinence and focus on the literature advantages, disadvantages, complications and efficacy of surgical procedures regarding this pathology. Using network meta-analysis, we have identified the most frequently used procedures (Burch surgery, midurethral sling and pubovaginal sling), and we have described and characterized them in terms of effectiveness and safety. Midurethral procedures remain the gold standard for surgical treatment of stress urinary incontinence, although the potential of serious complications following this procedure should be taken into consideration always. There is a clear need for a much more unified evaluation of possible complications and postoperative evolution. This process will help practitioners to adapt and individualize their strategy for each patient.

Discontinuation of tyrosine kinase inhibitors in chronic phase chronic myeloid leukemia is feasible in clinical practice based on recently published international recommendations. Nevertheless, factors predictive of molecular recurrence have not been fully elucidated and long-term follow-up of patients enrolled in clinical studies are required in order to update knowledge on discontinuation attempts particularly in terms of the safety and durability of treatment-free remission (TFR). In the current study, we updated results from the STIM2 study in the light of the consensual criterion of molecular recurrence reported in different international recommendations. Among the 199 patients included in the perprotocol study, 108 patients lost a major molecular response. With a median follow-up of 40.8 months (5.5-111 months), the probability of treatment-free remission was 43.4% [36.3-50.4] at 5 years, 40.9% [32.8-47.3] at 7 years and 34.5% [25.6- 43.3] at 9 years. Molecular recurrence occurred between 0 to 6 months, 6 to 24 months and after 24 months in 75 patients (69%), 15 patients (14%) and 18 patients (17%), respectively. Notably, the kinetics of molecular recurrence differed significantly between these three subgroups with a median time from loss of MR4 (BCR::ABL1 IS≤0.01%) to loss of major molecular response of 1, 7 and 22 months, respectively. Predictive factors of molecular recurrence differed according to the time of occurrence of the molecular recurrence. Durations of imatinib treatment and deep molecular response as well as BCR::ABL1/ABL1 levels at cessation of tyrosine kinase inhibitor treatment, as quantified by reverse transcriptase droplet digital polymerase chain reaction, are involved in molecular recurrence occurring up to 24 months but not beyond. (ClinicalTrial. gov Identifier NCT#0134373).

Background: Currently, bronchodilator medication recommended in the basic treatment of stable chronic obstructive pulmonary disease (COPD) does not have direct anti-inflammatory properties. According to recent researches Fenspiride has a multi-functional effect on various links of the inflammatory process in the respiratory tract. The purpose of this study was to assess the clinical efficacy and safety of Fenspiride in the treatment of COPD in remission. Material and methods: The research was performed on a group of 42 patients with COPD in stages GOLD 1 and GOLD 2. Depending on the treatment applied, patients were divided into 2 groups. The first group received Fenspiride with basic treatment and the second group only basic treatment. The main symptoms, pulmonary ventilation indexes and exercise tolerance were assessed in all patients. Results: The results obtained showed that Fenspiride improves the symptoms of the disease, pulmonary ventilation and increases patients’ exercise tolerance. Conclusions: Fenspiride is an effective and harmless remedy that can be used for the anti-inflammatory treatment of stable COPD in stages GOLD I and II.

A tracheoesophageal fistula (TEF) is a communication between the trachea and esophagus that is acquired or congenital. Congenital TEF, without other conditions like esophageal atresia, is usually diagnosed after birth or during infancy, as the baby will develop respiratory symptomatology, mostly severe, due to fluid/food aspiration in the trachea. In adults, TEFs can be caused by malignant conditions, blunt trauma, iatrogenic injury, prolonged mechanical ventilation and excessive inflation pressure of the endotracheal tube. We report a male patient of 86 years of age who presented at the "St. Spiridon" Emergency County Hospital in January 2022, accusing breathing difficulty, productive cough and occasional stabbing pain in the posterior thorax, within the previous week. Clinical exam was typical for pneumonia, but since the patient mentioned coughing episodes during eating/drinking since December 2021, together with a history of general anesthesia for abdominal surgery in mid-November 2021, a CT scan was performed. It confirmed a TEF of 7/16 mm (transverse/cranio-caudal) in size, located at the level of T2 vertebral body. The particularity of the case resides in the uncertain etiology of the fistula. If this patient had a clear iatrogenic injury, aspiration pneumonia should have occurred within days after the intubation event. However, after the surgery the patient was fine and discharged home without any symptomatology relevant for TEF. Only after one month, he started experiencing coughing during eating, that leads us to the assumption that he might have been born with a very small and asymptomatic tracheoesophageal defect, and the intubation for general anesthesia, even if done in a correct manner, represented a trigger event which led to development of a TEF. There are very few cases reported in literature with adult patients presenting a minor structural defect that remained unnoticed for a very long time. [ABSTRACT FROM AUTHOR]

The green microalga Chlamydomonas reinhardtii is a model microorganism for several areas of study. Among the different microalgae species, it presents advantageous characteristics, such as genomes completely sequenced and well‐established techniques for genetic transformation. Despite that, C. reinhardtii production is still not easily commercially viable, especially due to the low biomass yield. So far there are no reports of scientometric study focusing only on C. reinhardtii biomass production process. Considering the need for culture optimization, a scientometric research was conducted to analyze the papers that investigated the growth regimes effects in C. reinhardtii cultivation. The search resulted in 130 papers indexed on Web of Science and Scopus platforms from 1969 to December 2022. The quantitative analysis indicated that the photoautotrophic regime was the most employed in the papers. However, when comparing the three growth regimes, the mixotrophic one led to the highest production of biomass, lipids, and heterologous protein. The production of bioproducts was considered the main objective of most of the papers and, among them, biomass was the most frequently investigated. The highest biomass production reported among the papers was 40 g L−1 in the heterotrophic growth of a transgenic strain. Other culture conditions were also crucial for C. reinhardtii growth, for instance, temperature and cultivation process. [ABSTRACT FROM AUTHOR]

Sensitive real-time detection of vapors produced by the precursors, reagents and solvents used in the illegal drugs manufacture represents a priority nowadays. Acetic anhydride (AA) is the key chemical used as acetylation agent in producing the illegal drugs heroin and methaqualone. This study was directed towards quick detection and quantification of AA in air, using two fast and very sensitive analytical techniques: photoionization detection (PID) and ion mobility spectrometry (IMS). Results obtained indicated that both PID and IMS can sense AA at ultra-trace levels in air, but while PID produces a non-selective response, IMS offers richer information. Ion mobility spectrometric response in the positive ion mode presented one product ion, at reduced ion mobility K0 of 1.89 cm2 V−1 s−1 (almost overlapped with positive reactant ion peak), while in the negative ion mode two well separated product ions, with K0 of 1.90 and 1.71 cm2 V−1 s−1, were noticed. Our study showed that by using a portable, commercial IMS system (model Mini IMS, I.U.T. GmbH Berlin) AA can be easily measured at concentrations of 0.05 ppmv (0.2 mg m−3) in negative ion mode. Best selectivity and sensitivity of the IMS response were therefore achieved in the negative operation mode.