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Mihaela Andreescu,1,2,* Cosmin Moldovan,3,4,* Delia-Andreea Lespezeanu,5,6,* Adela-Ioana Mocanu,5,7 Mihai-Adrian Schipor,8 Horia Mocanu9,10,* 1Department of Hematology, Faculty of Medicine, “Titu Maiorescu” University, Bucharest, 031593, Romania; 2Department of Hematology, Colentina Clinical Hospital, Bucharest, 01171, Romania; 3Department of Medical Surgical Disciplines, Faculty of Medicine, “Titu Maiorescu” University, Bucharest, 031593, Romania; 4Department of General Surgery, Witting Clinical Hospital, Bucharest, 010243, Romania; 5Doctoral School, Faculty of Medicine, “Titu Maiorescu” University, Bucharest, 031593, Romania; 6“Ion Pavel” Diabetes Center, National Institute of Diabetes, Nutrition and Metabolic Diseases “Prof.Dr.N.C. Paulescu”, Bucharest, 030167, Romania; 7Department of ENT&HNS, Polimed Medical Center, Bucharest, 040067, Romania; 8Institute of Space Technology and Space Applications, University of the Bundeswehr, München, 85579, Germany; 9Department of ENT&HNS, Faculty of Medicine, “Titu Maiorescu” University, Bucharest, 031593, Romania; 10Department of ENT&HNS, Găești City Hospital, Găești, Dâmbovița, 135200, Romania*These authors contributed equally to this workCorrespondence: Adela-Ioana Mocanu, Polimed Medical Center, Bloc 67, Calea Văcărești 280, Bucharest, 040063, Romania, Tel +40723400435, Email adela.ioana.mocanu@gmail.com Mihaela Andreescu, Faculty of Medicine, “Titu Maiorescu” University, Str. Gheorghe Petrașcu 67A, Bucharest, 031593, Romania, Tel +40744559730, Email tevetmihaela@gmail.comAbstract: With the advent of COVID-19, the number of patients diagnosed with mucormycosis has increased, especially in developing countries. The reason behind this increase is that COVID-19 causes hypoxia that promotes the growth of fungus. To identify the association between mucormycosis and COVID-19, in critically ill or immunocompromised COVID-19 patients. The literature included in the review was researched from October 1, 2021, to November 1, 2022, by using the Google Scholar database as the search engine. Of the 20 articles included, there were 4 case reports, 2 case series, 10 narrative reviews, and 4 quantitative studies. Mucormycetes growth is caused by several factors, including hyperglycemia owing to previously existing diabetes or excessive use of steroids, increased ferritin levels owing to the inflammatory cascade initiated by COVID-19, and immunosuppression caused by the use of steroids or other immunosuppressive therapy. Reduced white-cell count and activity in COVID-19 leads to increased germination of fungal spores hence developing a catastrophic picture of rhinocerebral mucormycosis. Considering that the hematological patient is frequently treated with cortisone, immunosuppressed due to the underlying condition, but also through the administered therapy, the association with a possible diabetes makes this patient susceptible to developing rhinocerebral mucormycosis during COVID-19 infection. Despite being severe, the association between mucormycosis and COVID-19 is specific and treatable. Development of mucormycosis in hematological patients suffering from severe COVID-19 disease is dangerous, yet not compulsory and can be prevented. Using a common steroid-dose protocol with hyperbaric oxygen and necessary preventive measure reveals the disease as a superadded infection. Hypoxia, poor glycemic control and overuse of steroids or immunosuppressive drugs cause it.Keywords: COVID-19-associated mucormycosis, immunocompromised, critical, COVID-19, mucormycosis, fungal infection

Adela-Ioana Mocanu,1,* Horia Mocanu,2 Cosmin Moldovan,3,4,* Ioana Soare,3,* Elena Niculet,5,6 Alin Laurentiu Tatu,6,7,* Claudiu Ionut Vasile,7,* Daniela Diculencu,8 Paraschiva A Postolache,9,* Alexandru Nechifor7 1Department of ENT & HNS, Polimed Medical Center, Bucharest, Romania; 2Department of ENT & HNS, Faculty of Medicine, “Titu Maiorescu” University, Bucharest, Romania; 3Faculty of Medicine, “Titu Maiorescu” University of Bucharest, Bucharest, Romania; 4General Surgery Ward, ‘Witting’ Clinical Hospital, Bucharest, Romania; 5Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania; 6Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania; 7Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania; 8Medical Analysis Laboratory, Clinical Pneumoftisiology Hospital, Iasi, Romania; 9Clinical Medical Department, Faculty of Medicine, “Grigore T Popa” University of Medicine and Pharmacy, Iasi, Romania*These authors contributed equally to this workCorrespondence: Adela-Ioana Mocanu, Department of ENT&HNS, Polimed Medical Center, Bucharest, Romania, Tel +40 751 209 060, Email adela.ioana.mocanu@gmail.com Elena Niculet, Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galați, Romania, Tel +40 741 398 895, Email helena_badiu@yahoo.comAbstract: Tuberculosis is a disease of global outreach that may affect the entire human body but is most commonly located in the lungs. Otorhinolaryngological manifestations of tuberculosis are rare, mostly occurring secondary to pulmonary disease but nevertheless represent significant diagnostic challenges. Nasopharyngeal tuberculosis is rare, representing around 1% of all upper air-way localizations and the most common presentation is in the form of adenoids. Tuberculous glossitis (oral tuberculosis) is even scarcer and may present in various clinical forms, usually mimicking a malignant neoplasm, or, less often, trauma or other infectious lesions. Oropharynx tuberculosis is usually misdiagnosed as hypertrophic chronic tonsillitis. We present four rare cases of ENT tuberculosis, primary adenoiditis and tonsillitis in a 13-year-old girl, a curious case of tuberculous glossitis in a 65-year-old woman, clinically diagnosed as a lingual neoplasm and two cases of tuberculous lymphadenopathy uncommonly located in the submandibular and supraclavicular regions. A comprehensive review of literature follows the case presentations. Tuberculous manifestation in the ear, nose and throat area remains a difficult diagnosis to establish, particularly because of its rarity and non-specific clinical appearance, and should be included in the differential diagnosis of pharynx lesions. An early diagnosis is essential to avoid occurrence of complications.Keywords: case report, tuberculosis, nasopharynx, oral tuberculosis, head and neck, extra nodal

Anca Chiriac,1–3 Anca E Chiriac,4 Adrian Naznean,5 Cosmin Moldovan,6 Cristian Podoleanu,7 Simona Stolnicu81The Department of Dermato-Physiology, Apollonia University, Iaşi, Romania; 2Department of Dermatology, Nicolina Medical Center, Iaşi, Romania; 3“P. Poni’’ Institute of Macromolecular Chemistry, Iaşi, Romania; 4Department of Epidemiology, University of Medicine and Pharmacy " Grigore T Popa", Iaşi, Romania; 5The Department of Foreign Languages, The University of Medicine and Pharmacy of Tîrgu Mureș, Tîrgu Mureș, , Romania; 6The Department of Applied Simulation in Medicine, The University of Medicine and Pharmacy of Tîrgu Mureș, Tîrgu Mureș, Romania; 7The Department of Cardiology, The University of Medicine and Pharmacy of Tîrgu Mureș, Tîrgu Mureș, Romania; 8The Department of Pathology, The University of Medicine and Pharmacy of Tîrgu Mureș, Tîrgu Mureș, RomaniaAbstract: Herpes zoster usually affects the thoracic and lumbar vertebra (T3–L3), while sacral herpes zoster has been very rarely reported. We present a very rare case of herpes zoster involving S1 dermatome in a 35-year-old healthy man who presented aching pain and typical herpes zoster eruption on the lateral aspect of the calcaneus, lateral plantar area and dorsal aspect of digits III and IV.Keywords: herpes zoster, S1, pain, sacral zoster

Anca Chiriac,1–3 Piotr Brzezinski,4 Cosmin Moldovan,5 Cristian Podoleanu,6 Marius Florin Coros,7 Simona Stolnicu8 1Department of Dermatology, Nicolina Medical Center, Iasi, 2Department of Dermatology, Apollonia University, Iasi, 3Department of Dermatology, P. Poni Research Institute, Romanian Academy Iasi, Romania; 4Department of Dermatology, 6th Military Support Unit, Utska, Poland; 5Department of Histology, 6Department of Cardiology, 7Department of Surgery, 8Department of Pathology, University of Medicine and Pharmacy of Targu‑Mures, Targu-Mures, Romania Background: Basal cell carcinoma (BCC) is the most common form of skin cancer, affecting millions of people worldwide. The treatment concept for BCCs is the surgical one, but it is costly, as such, searching for alternative medical therapeutics is justified. Aim: To highlight the efficacy of high concentration (70%) trichloroacetic acid (TCA) as a choice therapy for low-risk BCC. Method and patient: Authors present, for the first time, the use of a high concentration TCA applied once a week for 2 consecutive weeks with a toothpick, on a patient with BCC on the right preauricular area. Results: On examination 4 weeks later, the lesion was not clinically and dermatoscopically evidenced. Conclusion: High concentration TCA could be an effective and safe, non-invasive choice of therapy for low-risk BCC, easy to perform, not expensive, with good cosmetic results, especially for patients who are not likely to undergo invasive or expensive treatments. Keywords: basal cell carcinoma, therapy, trichloroacetic acid, dermatology

Wine is a product of human creativity, culture, and nature, and therefore it is an intriguing subject for scientific research and admiration. Among its many kinds, white wine stands out oenologically because of its diverse flavours, aromatic attributes, and capacity to mature. In this experiment, we established 3 different bud load levels (25%, 50%, and 75%) on the well-known white wine grape variety ‘Fetească Albă’. The sugar content significantly increased in the 50% and 76% groups, whereas there were no significant changes regarding titratable acid content, must quantity, and cluster weight.

The anaesthetic management of pheochromocytoma is complicated and challenging. However, preoperative pharmacologic preparation, modern anaesthetic techniques and drugs associated with advanced monitoring in conjunction with the evolution of surgical techniques (open laparotomy to laparoscopic surgery and robotic approaches in the present day) improved significantly perioperative outcome, and intraoperative and postoperative hemodynamic stability. Although there are not randomised clinical trials to suggest one approach over another and there is a high international variability amongst intraoperative anaesthetic techniques, most management principles are still universal. [ABSTRACT FROM AUTHOR]