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Copyright of Farmacia is the property of Societatea de Stiinte Farmaceutice Romania and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. COVID-19 is associated with a significant incidence of bacterial and fungal superinfections and with the exacerbation of pre-existing infections, representing a diagnostic and therapeutic challenge. Case presentation. A 64-year-old woman, confirmed with COVID-19 by the SARS-CoV-2 antigen test, is hospitalized accusing fatigue, nausea, watery stools, cough and vertigo started 10 days ago, aggravated 4 days before the presentation. It also reports recurrent episodes of otalgia and otorrheic pluriantibiotic treatment in the last 2 months. From the personal pathological antecedents we remember: hypothyroidism, dyslipidemia, hypertension, ischemic heart disease, history of deep vein thrombosis (DVT) and secondary pulmonary thromboembolism, in chronic anticoagulant treatment. Pathological clinical signs at admission: bilateral basal crackling rales. Biologically, inflammatory syndrome is detected, and radiologically, interstitial-alveolar infiltrates in the lower lung fields. On day 3 of hospitalization, the patient shows purulent secretion in the right external auditory canal and the ENT consultation confirms chronic suppurative otitis media in acute onset. Bacteriological examination of otic secretion reveals Aspergillus niger. Antiviral treatment with Remdesivir is initiated, antibiotic therapy initiated at home with Azithromycin is continued for one day, then escalated to Ceftriaxone i.v. (in the context of clinical-paraclinical aggravation), systemic corticotherapy, anticoagulation with Dalteparin in the prophylactic regime of DVT, systemic treatment with Voriconazole p.o. (according to the antifungal program) and topical (local) with a slow favorable evolution. Conclusions. The association of COVID-19 with otitis with Aspergillus is a rare and particular clinical picture. [ABSTRACT FROM AUTHOR]

This review discusses the evidence on diabetic retinopathy (DR) in patients with diabetic foot ulceration (DFU). A systematic literature review was performed on PubMed, Medline, Springer Nature, and Scopus, following the PRISMA guidelines, using the following terms, individually or in combination: "diabetic foot ulcer" OR "diabetic foot syndrome" OR "DFU" and "diabetic retinopathy." The initial search yielded 648 articles published between 1975 and 2020. After applying exclusion and inclusion criteria, a total of 9 articles were analyzed, assessing the correlations between DR and DFU. In all cases, DR and especially proliferative diabetic retinopathy were significantly higher in the presence of DFU, though the frequency of DR showed large variability (22.5% to 95.6%). There was a significant correlation between advanced stages of DFU and increased frequency of DR and proliferative diabetic retinopathy. On the other hand, there is a risk of accelerated progression of DR in nonhealing DFUs, possibly related to chronic inflammation and associated infection. Hence, patients with DFUs should be monitored by an ophthalmologist, and those with DR should be promptly referred to a specialized diabetic foot clinic. [ABSTRACT FROM AUTHOR]

Introduction. Although SARS-CoV-2 infection is more common in adults, many cases have been reported in the pediatric population. Case presentation. An 8-month-old infant from twin pregnancy, confirmed with COVID-19, is hospitalized with nasal obstruction, serous rhinorrhea, rare cough and watery stools. The epidemiological link is known, both the parents and the maternal grandparents of the infant being confirmed with COVID-19. Biologically, he presented with thrombocytosis and discrete inflammatory syndrome, and the lung radiograph did not show any lesions. At the same time, the twin sister was hospitalized, who presented a similar symptomatology, with a negative SARS-CoV-2 PCR test, but the lung radiograph showed specific lesions of COVID-19. During hospitalization, 2 more SARS-CoV-2 PCR tests were performed, but with negative results. The evolution of the twins was favorable under symptomatic treatment, respectively antibiotic and symptomatic treatment. Conclusion. SARS-CoV-2 infection may be asymptomatic, especially in infants and newborns, and has a lower prevalence. [ABSTRACT FROM AUTHOR]

A female child, 1 year-old and 2 months, diagnosed with multiple neurological conditions, including myelomeningocele and operated hydrocephalus, was diagnosed with SARS-CoV-2 in October 2020 and hospitalized in our clinic. At the time of the onset of the disease, the patient had a febrile episode, laboratory blood tests showed a slightly increased biological inflammatory syndrome, and mixed pneumonia was described radiologically. Thus, antibiotic treatment was initiated, with laboratory tests and control imaging within normal limits after several days of admission. Being an institutionalized child, according to the epidemiological recommendations of that time, she was hospitalized in our clinic during the 14 days of the illness. Thus, on the 15th day of the disease she was discharged, with negative SARS-CoV-2 control RT-PCR, with good general condition, afebrile over 10 days. [ABSTRACT FROM AUTHOR]

Introduction. SARS-CoV-2 virus infection affects all age groups. In children, the infection mainly causes asymptomatic or mildly symptomatic forms of the disease, regardless of their immune status. Case presentation. We describe the case of a 7-year-old male child, known to have Fanconi anemia, scheduled for bone marrow transplantation. The patient comes from a family outbreak of COVID-19, which is why he was tested for SARS-CoV-2 infection. He is asymptomatic at the time of admission to our clinic. The clinical examination performed at the time of admission shows a patient in good general condition, afebrile, with pale skin and mucous membranes, without respiratory changes. Para-clinically, severe neutropenia, severe normochromic normocytic anemia and severe thrombocytopenia are detected, for which transfusions of erythrocyte mass and platelet mass are performed. Due to the immunocompromised status, antibiotic therapy is instituted. If necessary, symptomatic treatment is administered. The evolution is favorable, and the SARS-CoV-2 RT-PCR control test is negative on the eighth day of hospitalization. Conclusions. Immunocompromised status is not a major risk factor for severe COVID-19 in children. [ABSTRACT FROM AUTHOR]

Infecţia cu virusul varicelo-zosterian (VVZ) este o cauză importantă de morbiditate, cu răspândire la nivel global, ce determină două forme clinice distincte de boală: varicela şi herpesul zoster. Infecţia primară cu VVZ în timpul sarcinii poate avea consecinţe importante atât asupra sănătăţii materne, cât şi fetale. Datele epidemiologice arată că vaccinarea a redus semnificativ numărul infecţiilor cu VVZ atât la mame cât şi la nounăscuţi. Strategiile de vaccinare diferă în funcţie de individul la risc (mamă, nou-născut, copil), de momentul cu riscul cel mai mare de infectare (primul trimestru de sarcină, ultimul trimestru de sarcină sau postnatal) şi de durata imunităţii protectoare după vaccinare. Cea mai frecventă complicaţie a varicelei la mamă în timpul sarcinii este pneumonia variceloasă, care se manifestă cu tuse, dispnee, febră şi tahipnee. Efectele infecţiei VVZ asupra fătului pot fi: sindromul de varicelă congenitală, prematuritate sau avort spontan, varicela neonatală. Varicela congenitală a fost descrisă pentru prima dată în 1947. Ratele de avort spontan, naşterile premature şi decesul intrauterin nu sunt mai mari la mamele cu varicelă în sarcină comparativ cu cele fără varicelă. Infecţia neonatală rezultă din transmisia VVZ de la mamă la făt în perioada perinatală. [ABSTRACT FROM AUTHOR]

Introducere. Începând cu anul 2016, România se confruntă cu o epidemie importantă de rujeolă apărută pe fondul unui procent tot mai scăzut de vaccinare. Evoluţia epidemiei a fost marcată şi de o creştere alarmantă a numărului de complicaţii şi decese. Materiale şi metode. Am evaluat retrospectiv 632 pacienţi diagnosticaţi cu rujeolă, internaţi în Spitalul Clinic de Boli Infecţioase şi Tropicale „Dr. Victor Babeş“, în perioada ianuarie 2016 - decembrie 2017. Datele epidemiologice, caracteristicile clinice şi rezultatele probelor biologice au fost obţinute din fişele medicale ale pacienţilor. Rezultate. Din cei 632 de pacienţi, 341 (53,9%) au fost de sex masculin. Grupa de vârstă cea mai afectată a fost 1-4 ani (39,2%), urmată de cea a sugarilor cu un procent de 19,6%. O treime din cazuri (31,3%) au avut contactul infectant în cadrul familiei. În ceea ce priveşte statusul vaccinal, aproape jumătate din pacienţi (47,1%) nu au fost vaccinaţi, iar 44,3% nu cunoşteau istoricul de vaccinare (probabil nevaccinaţi sau incomplet vaccinaţi). Complicaţiile virale au fost prezente la majoritatea pacienţilor (84,1%) sub forma unei pneumonii interstiţiale. Pneumonia bacteriană a fost prezentă la 15% dintre pacienţi, iar dintre aceştia 45,2% au asociat şi insuficienţă respiratorie. Şase pacienţi au necesitat transfer în secţia de terapie intensivă pediatrie pentru suport respirator, înregistrându-se 2 decese. Laringita a fost prezentă în 8,2% cazuri, otita în 12% cazuri, în timp ce 61,7% dintre pacienţi au avut afectare gastrointestinală. Paraclinic, a fost evidenţiată citoliza hepatică la 101 (15,9%) pacienţi şi diselectrolitemia a fost prezentă la 94 (14,8%) din cazuri. Concluzii. Studiul prezent arată creşterea alarmantă a incidenţei bolii şi a complicaţiilor sale în ultimii 3 ani, mai ales la vârstele mici. Considerăm imperios necesară aplicarea programului de vaccinare pentru a asigura o acoperire vaccinală optimă, utilă atât în stoparea epidemiei actuale, cât şi în prevenirea unor viitoare epidemii. [ABSTRACT FROM AUTHOR]

Introduction. Starting with 2016 Romania had to face an alarming measles outbreak due to the continuous poor vaccination coverage. The outbreak associated an increased number of complications and deaths. Materials and methods. We performed a retrospective study, on a group of patients with measles, admitted to „Dr. Victor Babes“ Hospital. Epidemiological data, clinical characteristics and the results of the biological samples were obtained from the patient's medical records between January 2016 and December 2017. Results. Out of the 632 patients, 341 (53.9%) were males. Most of them (39.2%) were children, between 1 and 4 year-old, while 19.6% were infants. A quarter of the patients (31.3%) had familial contact with a measles case. The vaccination history was unknown in 44.3% cases; almost half of the patients (47.1%) were unvaccinated. Almost all of them developed viral complications, 84.1% being diagnosed with interstitial pneumonia. Bacterial pneumonia was diagnosed in 15.0% cases, out of which 45.2% were also associated with respiratory failure. Six patients required transfer to the pediatric intensive care unit for respiratory support and 2 died. Other complications were: laryngitis 8.2%, otitis 12.0% of the cases. Also 61.77% of the patients were diagnosed with enterocolitis. There was no case complicated with encephalitis. 101 (15.9%) patients developed liver cytolysis, while dyselectrolytemia was present in 94 (14.8%) cases. Conclusions. The number of patients diagnosed with measles during the last years registered an alarming increase, especially in children under 4 year old, with a high number of complications. We consider it mandatory to apply the vaccination program to ensure an optimal vaccine coverage, useful both in stopping the current outbreak and in preventing future outbreaks. [ABSTRACT FROM AUTHOR]

Varicella-zoster virus infection (VVZ) is an important cause of morbidity, with global spread, which causes two distinct clinical forms of disease: varicella and shingles. Primary infection with VVZ during pregnancy can have important consequences for both maternal and fetal health. Epidemiological data shows that vaccination significantly reduced the number of VVZ infections in both mothers and fetuses. Vaccination strategies vary according to the individual at risk (maternal, fetal, newborn, child), the moment with the highest infection risk (first-trimester of pregnancy, last trimester of pregnancy or postnatal) and the duration of the protective immunity after vaccination. The most common complication of chickenpox during pregnancy is varicella pneumonia that is manifested through cough, dyspnea, fever and tachypnoea. The effects of VVZ on the fetus can be: congenital varicella syndrome, premature or spontaneous abortion, neonatal varicella. Congenital varicella was first described in 1947. Spontaneous abortion rates, premature births and intrauterine death are not higher in pregnant mothers with chickenpox compared to those not infected. Neonatal infection results from the transmission of VVZ from mother to fetus during the perinatal period. [ABSTRACT FROM AUTHOR]

Introduction. Coronavirus disease 2019 (COVID-19) frequently leads to asymptomatic or mild infectious disease evolution in children. Case presentation. We present the case of a 3 year old girl, known with acute lymphoblastic leukemia in chemotherapy treatment at that time. She had an asymptomatic form of COVID-19 but with important paraclinical changes. The evolution was favorable under the treatment initiated with antibiotics, corticotherapy, gastric protector and symptomatic treatment if necessary. Conclusion. Management of children with COVID-19 and other comorbidities remains a challenge given the few data currently in the literature. [ABSTRACT FROM AUTHOR]

Acute mesenteric ischemia is a rare but extremely severe complication of SARS-CoV-2 infection. The present review aims to document the clinical, laboratory, and imaging findings, management, and outcomes of acute intestinal ischemia in COVID-19 patients. A comprehensive search was performed on PubMed and Web of Science with the terms "COVID-19" and "bowel ischemia" OR "intestinal ischemia" OR "mesenteric ischemia" OR "mesenteric thrombosis". After duplication removal, a total of 36 articles were included, reporting data on a total of 89 patients, 63 being hospitalized at the moment of onset. Elevated D-dimers, leukocytosis, and C reactive protein (CRP) were present in most reported cases, and a contrast-enhanced CT exam confirms the vascular thromboembolism and offers important information about the bowel viability. There are distinct features of bowel ischemia in non-hospitalized vs. hospitalized COVID-19 patients, suggesting different pathological pathways. In ICU patients, the most frequently affected was the large bowel alone (56%) or in association with the small bowel (24%), with microvascular thrombosis. Surgery was necessary in 95.4% of cases. In the non-hospitalized group, the small bowel was involved in 80%, with splanchnic veins or arteries thromboembolism, and a favorable response to conservative anticoagulant therapy was reported in 38.4%. Mortality was 54.4% in the hospitalized group and 21.7% in the non-hospitalized group (p < 0.0001). Age over 60 years (p = 0.043) and the need for surgery (p = 0.019) were associated with the worst outcome. Understanding the mechanisms involved and risk factors may help adjust the thromboprophylaxis and fluid management in COVID-19 patients. [ABSTRACT FROM AUTHOR]

Hepatitis C virus (HCV) affects other tissues besides the liver tissue, with the appearance of extrahepatic manifestations such as cryoglobulinemia, lymphoproliferative diseases, metabolic disorders, neuropsychiatric disorders and others. At the basis of their appearance are immune-mediated mechanisms stimulated by the HCV. The antiviral therapy with direct action initiated in all patients with chronic HCV infection acts on these manifestations, contributing to improving the quality of life, but also to eliminating a public health problem. [ABSTRACT FROM AUTHOR]

The paper is a retrospective study on a group of 97 patients admitted to the emergency room between 2012 to 2015 for suspicion of penetrating abdominal trauma. We have analyzed clinical data, paraclinical tests and how they correlate with therapeutic management. Out of the 97 pactients, 78 presented penetrating stab wound. In 62 cases, immediate surgery was decided and 15 cases underwent seriated clinical and imaging follow-up. Of these, 3 patients underwent delayed laparotomy, for developing signs of peritonitis. The rate of non-therapeutic laparotomies was 9.72% (6 cases). Shock, peritonitis and evisceration were indications for immediate laparotomy. When the depth of the wound was uncertain, imaging tests (ultrasound, especially CT) provide valuable information for therapeutic management. Conservative treatment is an option for patients with no signs of hemodynamic instability and peritonitis, under careful clinical and paraclinical surveillance. [ABSTRACT FROM AUTHOR]

This paper presents a retrospective study conducted from December 2014 - December 2015 on patients admitted in emergency in our clinic for traumatic haemoperitoneum. We have analyzed the causes of production, the most common organs affected, the paraclinical investigations and surgical management of these cases. Abdominal ultrasound in emergency and, in selected cases, abdominal CT imaging tests are reliable and largely replaced peritoneal paracentesis. The most common injuries had affected liver (38.7%) and spleen (28.73%)v. Surgical exploration should be careful, often coexisting pathologies requiring multiple surgical solving. [ABSTRACT FROM AUTHOR]

The prevalence of acute appendicitis as the number 1 inflammatory disease, occurring in 1 out of 500-600 inhabitants of the world population, has made it imperative for us to study the pathology of the inflammation in the presurgery stage. The present paper is a retrospective study, conducted on 147 patients diagnosted and operated for acute appendicitis in our clinic, between October, 1st, 2009 and January, 15th, 2012. The pre-surgical stage comprised clinical data, and also an important number of paraclinical data, out of which, for the purpose of this presentation, we selected bilirubin and leukogram. These pre-surgery biological markers were correlated to the post-operatory pathological anatomy results. These results confirmed our hypothesis that the paraclinical stage in diagnosing the acute appendicitis consists in the inflammation prognosis factors, which can be highlighted through a complex paraclinical range of methods, later confirmed by both the clinical stage, and its anatomo-pathological forms. [ABSTRACT FROM AUTHOR]

The study aims that, starting from preoperative clinical and laboratory variables, to identify the most effective predictive multidimensional models for anatomopathological result in acute appendicitis. A prospective study was performed on 147 patients operated for acute appendicitis. The set of potential predictors considered for the selection is as follows: IL6, LBP, Alvarado score, total bilirubin, neutrophils count and WBC, all determined preoperatively. For data analysis we used a variant of a classic sequential analysis discrimination based on linear functions of Discrimination method of Fisher (SPSS). The most effective statistical models with an accuracy of classification of 100% were obtained from the variables: IL6 preop, LBP preop and WBC on admission Model 1) and IL6 preop, LBP preop and score Alvarado (Model 2). These observations lead us to believe that developing a procedure for preoperative diagnosis of appendicitis type is achievable. Defining, validating and assessing the reliability of such a procedure however require further research on a larger volume samples and are representative of both the pathology of appendicitis and population with acute appendicitis. [ABSTRACT FROM AUTHOR]

During 1985-2014 în our Clinic nearly 4,925 gastrostomes were performed, for a large variety of pathologies: benign and malign esophageal stenosis, esophageal fistulas, posttraumatic ruptures, iatrogenic pathology, strokes. Among those, some were definitives and the others were temporary. We used Gavriliu technique with peritoneal collar în 96% of the cases. During those 30 years we managed to establish an immediate and long-term care protocol of the feeding gastrostomes. This protocol contains specific measures for the monitoring of the vital parameters, biological and metabolical ones, but also the close analysis of the gastric stasis, the imposing of the digestive repose during the first 48-72 hours, the continue follow-up of the quality and the rhythm of alimentation and the mechanical protection of the Pezzer tube. The efficiency of this type of nursing consists în the introduction of food after 48-72 hours, with the second stage of efficiency of the gastrostomy în the same time with the long-term care of the associated oncological and metabolical complications. Due to the importance of the moment of the surgical indication, the technique and nursing that has been used, the survival of the patient with definitive gastrostomy has significantly improved. The elimination of the temporary ones didn't involve în most of the cases surgical closing. [ABSTRACT FROM AUTHOR]

The Rotavirus infection represents a worldwide major public health problem through the high level of contagiousness and through the socio-economic problems it creates by affecting in the same way children from poor and rich countries alike. The present article represents a 2 year case control study that was made in „Dr Victor Babes" Hospital of Infectious and Tropical Diseases, Bucharest, during 01.01.2009 - 31.12.2010. The idea of the study appeared after our observations of the increasing numbers of cases with acute diarrheic disease admitted and of their rotaviral etiology. The data was obtained by studying the admittance papers of the patients with the diagnosis of acute rotaviral enteritis (CIM 10 A08.0). The diagnosis was made using the Rotavirus antigen in the stool of the patients using Vikia-rota-adeno kits. Results: in the studied period we have identified 692 cases of infection with Rotavirus, with a slightly higher females affected (1.14/1), the mean age of the patients was of 35 months, the majority of the patients coming from an urban environment. The time frame from the symptoms inset to the time of admittance was, in average, of 44h. Most frequently the first symptom was vomiting, followed by diarrhea and fever. At the time of admittance 94% of patients presented with dehydration signs and 56.7% also had extra digestive symptoms. The average period of hospitalization was of 4.5 days. Out of the studied cases, 20% could be labeled as nosocomial. No death was registered. Conclusions: in the last years we have witnessed an increase in the incidence of acute diarrheic disease, especially Rotavirus related, with a high number of cases (1676/year in only one pediatric unit, 3085 in the whole hospital). Due to high contagiousness, especially in young children and to difficulties in preventing transmission, this disease will continue to represent a public health problem. [ABSTRACT FROM AUTHOR]

Introduction Chronic hepatitis C (CHC) remains a significant public health concern due to both hepatic and extrahepatic manifestations associated with substantial morbidity and mortality. The emergence of SARS-CoV-2 has raised concerns about the outcomes of COVID-19 in CHC patients. Method We conducted a retrospective analysis of patients with CHC and SARS-CoV-2 infection admitted to a tertiary care hospital between 2020 and 2023. We performed a global analysis of the entire batch of patients and, later, we evaluated the patients according to the severity of the SARS-CoV-2 infection Results The cohort included 89 patients (63 females, 26 males) with a median age of 65 years. Most patients were hospitalized in 2021. Common clinical manifestations included fever, cough, digestive symptoms, and headache. The most frequent comorbidities were renal disease, thyroid disorders, and cancer. Univariate logistic regression analysis identified older age, hospitalization in 2021, and respiratory failure as risk factors for severe COVID-19. Elevated lactate dehydrogenase levels were also associated with an increased risk of severe COVID-19. Regarding CHC, detectable hepatitis C virus viremia was associated with more severe liver disease (p<0.01). Conclusion Patients with CHC and SARS-CoV-2 infection have a substantial risk of severe outcomes. Early identification and management of these patients are crucial to improve their prognosis., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutuional Review Board of ”Dr. Victor Babeș” Hospital issued approval 19909. The current study protocol recived the ethical approval of the Institutuional Review Board of ”Dr. Victor Babeș” Hospital with the approval number 19909 from 28th of December 2020. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Lazar et al.)

Introduction Chronic hepatitis C virus (HCV) infection is associated with various extrahepatic manifestations, including depression. This study aimed to determine the prevalence of depression in treatment-naive HCV patients and explore its potential association with liver fibrosis severity. Methodology A consecutive cohort of 50 treatment-naive HCV patients without coinfections was enrolled over six months. Depression was assessed using the Hamilton Depression Rating Scale (HAM-D), and the liver fibrosis stage was evaluated using Fibroscan elastography. Results The cohort comprised 62% females (n=31) and 38% males (n=19), with ages ranging from 27 to 76 years. HAM-D scores indicated mild depression in 78% (n=39) and moderate depression in 16% (n=8) of patients. Notably, patients with mild depression displayed varying degrees of liver fibrosis (F0, F1, and F2), while all patients with moderate depression had advanced fibrosis (F3). Based on the multiple regression model, fibrosis was a statistically significant independent predictor with an unstandardized regression coefficient (B) of 3.115 (p=0.007). Conclusions Our findings point to a high prevalence of depression in treatment-naive HCV patients. Interestingly, there might be a link between depression severity and the stage of liver fibrosis, with advanced fibrosis potentially associated with more severe depression., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Stoenescu et al.)

We report the first two cases of imported Zika virus (ZIKV) infection in Romanian patients returning from areas with ongoing outbreaks and challenges for laboratory diagnostic; first one with a classical pattern of acute flaviviral infection and the second one with an interesting pattern of a secondary flaviviral (ZIKV) infection in a yellow fever-vaccinated child living abroad in an endemic area.