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The Prussian carp represents a valuable food resource in Danube Delta, and also, it is a well-known bioindicator for monitoring the pollution of the aquatic environment. The aim of the present paper is to apply the neuro-adaptive techniques, to obtain fast and economic sustainable results for the prediction of magnesium (Mg) and calcium (Ca) concentrations in the muscle and hepatic tissues of Carassius gibelio. Adaptive Neuro-Fuzzy Inference Systems (ANFIS) require validated data sets for the development of intelligent models. Thus, within this paper the prediction of Ca and Mg in the muscle tissue of the Prussian carp has been generated. Model training, testing and validation was realized based on results obtained after samples analysis in the laboratory. The results registered in this study confirm the efficiency of ANFIS models use for the fast prediction of macro-elements in fish tissues. Further investigation is required in order of optimize the prediction methodology.

In order to respond positively to fish market demands and to improve its sustainability, the aquaculture sector need to be upgraded with techniques and technologies that can be included in the segment of environmentally preferable procurement (EPP) or green procurement products. Since both aquaculture and agriculture are considering key food production industrial sectors, implementing integrated systems as aquaponics, which combines both and generates more sustainability, must be considered. However, know-how information must be disseminated among the fish farm owners, as well as potential investors. Aquaponics ready-to-use packages must be considered in order to facilitate the integration within EPP process.

Despite known association of these malignancies, the incidence of a synchronous appearance of breast and ovarian cancer is low and the current literature does not directly address an approach to this clinical problem. We report 1year disease-free survival in a patient treated for serous carcinoma with solid genital pattern and invasive ductal carcinoma with trabecular pattern pT2N2Mx. The prolonged disease-free survival in our case may provide some guidance in this unusual clinical situation. [ABSTRACT FROM AUTHOR]

This study aims to identify proper solutions that can improve the sustainability of cyprinids pond aquaculture in terms of nitrogen releases to the environment. Therefore, two experimental variants, based on polyculture, respectively integrated multi-trophic aquaculture (IMTA) concept were tested, as follows: PCP – polyculture of common carp (CC) + grass carp (GC) + bighead carp (BC) + silver carp (SC); CP-PP – net divided pond with CC monoculture in CP part and CC+GC+BC+SC polyculture in PP part. In order to determine the nitrogen accumulation at the pond level, samples of water, sediments, fish meat and reed were analyzed. The results indicate that the highest nitrogen compounds concentrations in pond water were registered at CP part of CP-PP pond. However, the nitrogen concentration in pond effluents was significant higher in case of CP-PP pond, compared with PCP pond. The nitrogen compounds concentration of sediments registered the highest values in the ponds outlet area. Also, CP-PP pond recorded higher nitrogen concentration in sediments, compared with PCP pond. The CC registered the highest nitrogen compounds concentration in case of PP pond area, followed by CP pond area and PCP pond. Not significant correlation was found between reed and pond water/ fish meat/ sediments in terms of nitrogen compounds concentration. It can be concluded that the CP-PP pond feeding management, together with the tested technical solution (pond dividing) generated better water conditioning performances.

Self-harm is a frequent pathology amongst psychiatric patients and in the penitentiary environment. Multiple self-aggression types are described, but, by far, the practice most frequently met inside the Romanian penitentiary environment is foreign body (FB) ingestion. The paper aims to show aspects pertaining to the presence of intraduodenal foreign bodies, both in simple cases and in cases that ended with a perforation, using a number of 47 cases registered between 2003 and 2010 in "Rahova" Penitentiary Hospital. The paper also focused on particular aspects linked to intraduodenal foreign body surgical accessibility. [ABSTRACT FROM AUTHOR]

Background/aim: Ovarian cancer remains a major cause of death in women worldwide, mainly due to late diagnosis and the lack of a reliable screening test for early detection of the disease. In this context, attention has been focused on the identification of other prognostic factors that might allow a better identification of cases with worse long-term outcome., Patients and Methods: Data of patients who underwent cytoreductive surgery between 2014-2019 were retrospectively reviewed and 57 patients were considered eligible for this study. These cases were further classified according to preoperative platelet count, with a cut-off value of 335,000/μl as a positive predictive value for long-term survival., Results: According to this value, there were 27 cases with a preoperative platelet count lower than 335,000/μl and 30 cases with a preoperative platelet count higher than 335,000/μl. Cases in the second group had a significantly higher peritoneal carcinomatosis index (p=0.002), a higher proportion of digestive serosa involvement (p<0.001), and a higher proportion of mesenteric lymph node involvement and hematogenous metastases (p=0.005 and p=0.001, respectively). When analyzing long-term outcomes, all these factors had a significant impact on overall survival., Conclusion: Preoperative thrombocytosis appears to be positively associated with gastrointestinal serosa involvement, mesenteric lymph node invasion, and the presence of hematogenous metastases, thus significantly influencing the long-term outcome of patients with advanced ovarian cancer., (Copyright © 2024, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Introduction: intrahepatic cholangiocarcinoma (ICCA) are rare, aggressive cancers that develop in second order or smaller bile ducts. The aim of this review is to systematically review the most important prognostic factors affecting the long-term outcomes of these patients. Material and Methods: articles conducted on this issue, written in English, published between from January 2000 to December 2023 in Cochrane Library, PubMed, Embase, MedLine, Web of Science, Elsevier, Google Scholar were systematically researched and reviewed. Results: ICCA are usually late diagnosed cancers because of the asymptomatic character, and curative procedures are often not feasible, only 20 to 30% of patients being fit for surgery. With the prognostic of this aggressive malignancy being baleful, the most important risk factors but also prognosis factors seem to be represented by socioeconomic factors, morphological presentation, dimensions, number and extension of the tumor as well as resection margins. Conclusions: once these factors are widely recognized and identified in each case, the clinician will be able to find the best treatment for these patients in order to improve the long-term outcomes., (Celsius.)

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.)

Background : Gallbladder cancer (GBC) is a rare entity with a poor prognosis, usually discovered late due to nonspecific symptoms; therefore, over the last years, attention has been focused on identifying the risk factors for developing this malignancy in order to provide an early diagnosis, as well as new prognostic factors in order to modulate the long-term evolution of such cases. The aim of this review is to discuss both major risk factors and prognostic factors in GBC for a better understanding and integration of relevant and currently available information. Methods : A literature search was performed using Cochrane Library, PubMed, Google Scholar, Elsevier, and Web of Science; studies published after the year of 2000, in English, were reviewed. Results : Over time, risk factors associated with the development of GBC have been identified, which outline the profile of patients with this disease. The most important prognostic factors in GBC remain TNM staging, safety margin, and R0 status, along with perineural invasion and lymphovascular invasion. Both the technique and experience of the surgeons and a pathological examination that ensures final staging are particularly important and increase the chances of survival of the patients. Conclusions : improvements in surgical techniques and pathological analyses might provide better and more consistent guidance for medical staff in the management of patients with GBC.

Background: Despite improving surgical techniques and achieving more often complete debulking procedures, certain patients with advanced-stage ovarian cancer still have a very poor prognosis. The aim of the current paper is to investigate whether inflammatory and nutritional status can predict the long-term outcomes of ovarian cancer patients., Methods: A retrospective analysis of 57 cases diagnosed with advanced-stage ovarian cancer submitted to surgery as first intent therapy was carried out. In all cases, the preoperative status was determined by calculating the CRP/albumin ratio, as well as the Glasgow score, the modified Glasgow score and the prognostic nutritional index., Results: Patients presenting higher values of the CRP/albumin ratio, with a higher Glasgow score, modified Glasgow score and prognostic nutritional index (PNI), were more frequently associated with incomplete debulking surgery, a higher peritoneal carcinomatosis index and poorer overall survival (20 months versus 9 months for the CRP/albumin ratio p = 0.011, 42 versus 27 versus 12 months for the Glasgow score p = 0.042, 50 versus 19 versus 12 months for the modified Glasgow score, p = 0.001, and 54 months versus 21 months, p = 0.011 for the prognostic nutritional index)., Conclusions: A strong relationship between the nutritional and inflammatory status in advanced-stage ovarian cancer seems to exist.

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.)

Once the techniques of hepatobiliopancreatic surgery improved, liver transplantation widely extended in different hospitals; therefore, the need of grafts and automatically of liver donors reported a significant increase in the last decade. In this respect, attention was focused on increasing the liver donor pool. The aim of this review is to study the benefits of using marginal grafts in liver transplantation. With the advent of multiple methods of liver preservation, the use of grafts previously considered unsuitable has become possible. Thus, extended allocation criteria have emerged. However, the allocation of these grafts must be carefully considered and analyzed in the context of both recipient and donor factors., (Celsius.)

Aim: to determin the recurrence rate of benign recto-colonic polyps in a 5-year interval, and compare the development rate of intrapolypoid carcinomatous lesions in polypectomized versus nonpolypectomized subjects., Material and Method: a group of 77 patients diagnosed with recto-colonic polypoid lesions during the period 2014-2019 underwent colonoscopy at the time of study initiation and then annually during a five-year interval. Results: The recurrence rate of polyps increased annually from 5 to 12.5%; the highest rate was noted in the last two years. The five-year cumulative risk of neoplastic lesions was 73% in patients without polypectomy and 20% among those with endoscopic resection (p 0.05). Comparing the recurrence rate of benign lesions (60%) in patients without neoplastic findings with the recurrence rate of adenomas in patients with benign lesions (40%), a higher risk of recurrence was found in the first category, and seemed to be influenced by the personal history of pre-existing adenomatous lesions., Conclusion: an increased risk of colorectal polyps recurrence was reported during five year follow up; moreover, during the first three years an increased risk of malignant transformation was observed among cases in which endoscopic resection was not feasible when compared to those in which complete excision was feasible., (Celsius.)

Ovarian cancer remains one of the most lethal gynaecological malignancies affecting women worldwide; therefore, attention has been focused on identifying new prognostic factors which might help the clinician to select cases who could benefit most from surgery versus cases in which neoadjuvant systemic therapy followed by interval debulking surgery should be performed. The aim of the current paper is to identify whether preoperative inflammation could serve as a prognostic factor for advanced-stage ovarian cancer. Material and methods: The data of 57 patients who underwent to surgery for advanced-stage ovarian cancer between 2014 and 2020 at the Cantacuzino Clinical Hospital were retrospectively reviewed. The receiver operating characteristic curve was used to determine the optimal cut-off value of different inflammatory markers for the overall survival analysis. The analysed parameters were the preoperative level of CA125, monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and systemic inflammation index (SII). Results: Baseline CA125 > 780 µ/mL, NLR ≥ 2.7, MLR > 0.25, PLR > 200 and a systemic immune inflammation index (SII, defined as platelet × neutrophil-lymphocyte ratio) ≥ 84,1000 were associated with significantly worse disease-free and overall survival in a univariate analysis. In a multivariate analysis, MLR and SII were significantly associated with higher values of overall survival ( p < 0.0001 and p = 0.0124); meanwhile, preoperative values of CA125, PLR and MLR were not associated with the overall survival values ( p = 0.5612, p = 0.6137 and p = 0.1982, respectively). In conclusion, patients presenting higher levels of MLR and SII preoperatively are expected to have a poorer outcome even if complete debulking surgery is performed and should be instead considered candidates for neoadjuvant systemic therapy followed by interval surgery.

Intrahepatic cholangiocarcinomas represent rare and aggressive malignancies developing from the second order bile ducts to the smaller biliary branches. The aim of this narrative review is to discuss about the main diagnostic and therapeutic challenges in order to help medical and surgical oncologists to gain familiarity in regard to this subject. Articles discussing about epidemiology, histology, diagnostic, perioperative management and surgery which were published from January 2000 to September 2023 included in Cochrane Library, PubMed, Embase, MedLine, Web of Science, Elsevier, Google Scholar databases were reviewed. Articles reviewed in the current paper came to demonstrate that the main problem in such cases is related to the fact that most cases remain asymptomatic for a long period of time and therefore are diagnosed in advanced stages of the disease when curative procedures are feasible after performing extended visceral sacrifice or even worse, are no longer possible; however, the most efficient therapeutic strategy in order to improve the long term outcomes remains radical surgery. In this respect, attention was focused on improving the accuracy of the diagnostic tools and on identifying non-surgical therapeutic options which might increase the chances of achieving complete resection. Intrahepatic cholangiocarcinoma represent rare aggressive tumors with poor outcomes especially if radical surgery is not feasible., (Celsius.)

Background: hyponatremia represents one of the most commonly encountered conditions in hospitalized patients, multiple mechanisms being cited so far, neoplastic syndromes being an important cause. The aim of the current paper is to analyse the presence and influence of the short- and long-term outcomes of hyponatremia on ovarian cancer patients submitted to surgery for advanced stage ovarian cancer. Method: 57 patients diagnosed with advanced stage ovarian cancer were submitted to surgery between 2014-2020. The patients were further classified according to the preoperative value of sodium into two groups. Results: there were 21 cases with preoperative normal values of sodium and respectively 36 cases with hyponatremia. Patients with preoperative hyponatremia associated a significantly higher rate of early postoperative complications and a significantly poorer long-term outcome. Therefore, cases with hyponatremia reported a mean disease-free survival of 10.8 months and respectively a mean overall survival of 18.5 months while cases with normal natrium levels reported a mean disease-free survival of 31.4 months and respectively a mean overall survival of 49.7 months (p=0.0001 and p 0.001). Conclusions: patients with lower preoperative values of sodium have a higher risk of developing postoperative complications and a significantly poorer outcome when compared to cases presenting normal levels of sodium preoperatively., (Celsius.)

Background: platelet to lymphocyte ratio remains a significant prognostic factor in different malignancies. The aim of the current paper is to study the correlation between the preoperative values of platelet to lymphocyte ratio (PLR) and the postoperative outcomes in ovarian cancer patients. Method: we conducted a retrospective study on 57 patients submitted to cytoreductive surgery between 2014-2020. We determined the optimal cut off value of PLR for predicting survival outcomes by using the Receiver Operating Characteristic curve a value of 350 being obtained. The patients were further classified in two groups according to the PLR value. Results: there were 37 patients with PLR 350 and respectively 20 patients with PLR 350. Patients in the second group were significantly older and presented significantly higher rates of perioperative complications, a significantly higher level of circulating platelets, of CA125 and respectively a significantly lower level of circulating lymphocytes and of preoperative hemoglobin level. Meanwhile, patients in the second group reported a significantly poorer disease free and overall survival. Conclusions: ovarian cancer patients with higher preoperative levels of PLR trend to have a poorer early and long-term postoperative outcome. Therefore, in such cases more aggressive systemic therapies might be needed., (Celsius.)

Background/aim: Locally advanced pancreatic cancer has been considered for a long period of time as an unresectable lesion and therefore, all patients have been traditionally addressed to the oncological services for palliative purposes. However, due to the wide usage of newer oncological agents in association with improved surgical techniques, radical surgical procedures became feasible. The aim of this study was to present the different surgical procedures that were performed in locally advanced pancreatic cancer patients in order to achieve radical resections., Patients and Methods: Between 2019 and 2020, six cases were submitted to pancreatic and vascular resections in Fundeni Clinical Hospital., Results: In all cases, surgery with curative intent was attempted; portal vein resection was performed in five cases, whereas arterial resection was performed in three cases. Reconstruction was performed by direct re-anastomosis, by placing cadaveric or synthetic grafts. The postoperative outcomes were favourable in all cases., Conclusion: Vascular resections can be safely associated with pancreatic resections in cases presenting locally advanced pancreatic lesions, with acceptable morbidity rates., (Copyright © 2022, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background/aim: Retroperitoneal sarcomas represent very aggressive malignancies with high capacity of invading the surrounding vital structures., Case Report: We present the case of a 46-year-old patient who had been initially diagnosed with a large retroperitoneal mass 18 months ago. At that moment the mass was resected en bloc with the inferior cava vein, which was reconstructed using a cadaveric graft, the histopathological studies demonstrating the presence of a leiomyosarcoma. One year later she was diagnosed with recurrent disease invading the abdominal aorta and a liver metastasis. This time the recurrence was resected en bloc with the abdominal aorta, which was reconstructed by placing a cadaveric graft; atypical liver resection was also performed. The postoperative course was uneventful., Conclusion: Extended vascular resections and cadaveric graft reconstructions might be needed in order to achieve a good local control of the disease in patients with retroperitoneal sarcomas., (Copyright© 2020, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background: Malignancies have become a leading cause of morbidity and mortality in people living with HIV (PLHIV). The primary endpoint of our study was to describe the epidemiology of acquired immunodeficiency syndrome (AIDS)-defining cancers (ADCs) and non-AIDS-defining cancers (NADCs). Epidemiological disparities, mortality predictors and survival analysis within the two groups of patients were key secondary endpoints., Methods: We retrospectively evaluated all adult PLHIV with histopathologically proven cancers registered from 2010 to 2016 in the "Matei Balș" National Institute for Infectious Diseases, Bucharest, Romania., Results: 110 eligible patients have been included in the study. The incidence of ADCs decreased from 1.6% in 2010 to 0.3% in 2016, unlike NADCs which remained fairly stable over time (0.3%). The higher CD4 count and lower HIV-RNA level at the cancer diagnosis were associated with prolonged survival in ADCs group, but not in NADCs group. The mean CD4 count was 449/mm 3 to survivors and 92/mm 3 to non-survivors (p=0.017). The mean level of HIV-RNA was 64,671 copies/mL to survivors and 1,760,345 copies/mL to non-survivors (p=0.002)., Conclusions: A good therapeutic control of HIV infection at the diagnosis of ADCs was associated with better survival, emphasizing the key role of the effective cART in the management of HIV-associated cancers., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: During the recent years the rate of HIV perinatally exposed children in Romania has increased as a consequence of the expanding number of HIV-infected women. These women belong to Romania's long-terms survivors, aged between 20 and 24 years and to the group of new HIV infection cases (20-24 years), acquired through unsafe sexual contact and use of new psychoactive substance (IV)., Materials and Methods: We focused on 396 HIV perinatally exposed children born between 2008 and 2013, under surveillance in National Institute for Infectious Diseases "Prof. Dr. Matei Bals," Bucharest. Of them, 43 acquired HIV through materno-foetal transmission. Our aim was to observe the characteristics in their evolution under antiretroviral treatment and to emphasize the causes of treatment failure. Children with perinatally acquired HIV infection were followed in a retrospective case series. We assessed maternal characteristics, HIV vertical transmission prophylaxis, timing of diagnosis, immunological and virologic status and features of the evolution under combined antiretroviral therapy (cART)., Results: The rate of mother-to-child HIV transmission was 10.8% versus the national rate registered in 2013, namely <5%. 16% of mothers belonged to the Romanian 1990s cohort and 84% were recently infected with HIV, through unprotected sexual contact (70%) or use of new psychoactive substances (14%). 51% of mothers were diagnosed postnatally as a consequence of their reluctance to access specific health services and in 57% CD4 value was <350 cell/mm. 41% of the monitored children were diagnosed with HIV infection at birth. Their median entry CD4 value was 23% and 49% had a CD4 >25%; median entry viral load was 7 log. 16 patients (37%) had undetectable viral load after six months of treatment. In 87.5% of them the virologic suppression was achieved and maintained with one single regimen (2 NRTIs+1 NNRTI or 2 NRTIs+1 PI/r). 15 children (35%) did not achieve suppression of viral load. 19 children (44%) faced special issues related to adherence to antiretroviral treatment, due to mothers' poor adherence to a basic set of cares destined for their children., Conclusions: Prevention programmes in Romania must be designed on the basis of the new economic context and emerging psychoactive substance use. Hence, women who use drugs should benefit from a wider access to medical and social services.

A recent theory stipulates that during the course of HIV infection, there is a shift in immune response from T-helper 1 to T-helper 2 responses, characterised by elevated secretions of relevant cytokines. Cytokine profiles of 15 asymptomatic (treatment naïve) and 26 symptomatic (undergoing treatment) HIV-1 patients was determined to investigate the validity of this theory. HIV-1 RNA was quantified using the COBAS TaqMan HIV-1 test, CD4 T-cell counts with the FACSCalibur flow cytometer and IL-1, IL-4, IL-6, IL-10 and IFN-gamma cytokine levels by ELISA method. The asymptomatic group had significantly higher RNA levels (p-value; 0.000006) and lower CD4 T-cell counts than the symptomatic group indicating ongoing disease progression in the absence of antiretroviral treatment and a positive response to HIV treatment by the symptomatic group. IL-1, IL-4 and IFN-gamma were undetectable in most study subjects. IL-10 and IL-6 levels was relatively lower in the asymptomatic group (mean value; 206.352 pg/ml, 10.516 pg/ml) than the symptomatic group (mean value; 417.539, 18.387 pg/ml). Lower levels of proinflammatory cytokines (IL-1, IFN-gamma) in both study groups and elevated levels of anti-inflammatory cytokine IL-10, confirms that there is a shift in immune response as HIV infection progress to AIDS. In addition, the presence of a progressive trend of anti-inflammatory cytokine, IL-10 and proinflammatory cytokine, IL-6 in 12 symptomatic patients tested 3 months after antiretroviral therapy indicates an attempt by antiretrovirals to restore immune function.

Late intestinal perforation is the most rare and the most serious complication following the repair of abdominal parietal defects with alloplastic material. The authors have gathered in 7 years 6 cases of perforations which occurred between 1 and 10 years after using nonabsorbable synthetic mesh prostheses made of polyester (4 cases) and polypropylene (2 cases) as parietal substitution materials. The perforations were discovered either by the appearance of complete enteric fistulas after exploration of circumscribed parietal suppurations (3 cases) or during surgery of suppurations without external fistulas. All cases involved perforations of the small intestine and in only one case there was also a perforation of the transverse colon. In 4 cases, where eventration relapse co-existed, the polyester prostheses were found partially or totally detached from the abdominal wall. The treatment of enteric perforation consisted of 5 segmental enterectomies (one of those a double one) followed by anastomoses and one enteroraphy. The colic perforation was excised and sutured. The mesh was totally removed in 5 cases and partially removed in 1 case (around the perforation). The postoperative evolution was simple in only 3 cases. In the other 3 cases anastomotic fistulas occurred and one of them (with reduced leakage) was treated by nonoperative management. It did not close spontaneously even after 12 months. The other 2 cases required multiple reinterventions (enterectomies, ileostomies, ileocoloanastomosis). One of these patients has been lost away after 200 days of hospitalization and multiple reinterventions. In all cases, the closure of the abdominal wall was simplificad by cutaneous suture only whereas consecutive relapsed eventrations remain to be treated by subsequent reinterventions.

Background: Kaposi's sarcoma (KS) is commonly associated with the acquired immunodeficiency syndrome (AIDS) in adults. Little is known regarding its occurrence in children., Objective: Our purpose was to report the clinical and epidemiologic characteristics of KS in three Romanian children with AIDS and to compare them with previously reported AIDS-associated KS in children., Methods: This was a clinicopathologic study and computer-based literature review., Results: All three Romanian children had skin involvement; two had involvement of lymph nodes and internal organs. All had acquired human immunodeficiency virus (HIV) infection postnatally. Including these children, 33 cases of AIDS-associated KS in children have been reported. Thirteen of 30 evaluable patients had acquired HIV infection postnatally; nine of these children (69%) had cutaneous involvement by KS. A perinatal route of transmission was present in the remaining 17 cases; only two of these children (12%) with KS had cutaneous involvement. No case was noted in which intravenous drug use was the sole parental HIV risk factor., Conclusion: The data support the contention that KS is caused by a second infectious agent prevalent only in certain HIV-infected populations. Children of parents in high-risk groups for KS and children who acquire HIV via contaminated blood or blood products are at highest risk for KS. The route of acquisition of HIV infection may also be associated with different clinical manifestations of KS in children.

The authors made a quantitative and qualitative vectorcardiographic analysis (Frank lead system) in 47 patients with hypertensive heart disease compared with a control group of 16 normal subjects. The magnitude and the angle of the maximum QRS vector, the sense of rotation of the QRS loop, the magnitude of the maximum posterior deflection (Sz), of the anterior maximum one (Rz), of the maximum leftward one (Rx), and of the maximum rightward one (Qx), the length (L) and the width W) of the QRS loop, as well as the angle of the maximum T vector were measured. A significant difference, in all planes of the maximum QRS magnitude between the normals and the AHT was found, while the maximum QRS angle was not significantly different. The quantitative analysis of the veg made in the horizontal plane revealed significant differences for the Sz, Rx, L, and the relation Rz/Sz. The quantitative analysis made according to Varriale et al. (1966) revealed a prevalence of the cases of type I A (72.3%) and I B (21.3%).

The Romanian product Silimarina (synonym Legalon) was administered in a randomized double-blind trial, to a group of 180 patients with chronic persistent hepatitis (CPH), chronic active hepatitis (CAH) and hepatic cirrhosis (HC). The trial lasted for 40 days. The results showed favourable effects similar with those obtained with other preparations produced by foreign drug industries. The Romanian product proved to have no toxic effect. The authors discuss the present possibilities of estimating the evolution of chronic liver disease.