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Septimiu Voidăzan,1 Geanina Moldovan,2 Lavinia Voidăzan,3 Ancuța Zazgyva,4 Horațiu Moldovan5 1Department of Epidemiology, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureş, Tîrgu Mureş, Romania; 2Department of Community Nutrition, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureş, Tîrgu Mureş, Romania; 3Pharmacy, Private Practice, Tîrgu Mureş, Romania; 4Department of Cell and Molecular Biology, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureş, Tîrgu Mureş, Romania; 5Department of Occupational Medicine, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureş, Tîrgu Mureş, RomaniaCorrespondence: Geanina MoldovanUniversity of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureş, 38 Gheorghe Marinescu Street, Tîrgu Mureş 540139, RomaniaTel +40754058569Email septi_26_07@yahoo.comBackground: Currently, antibiotic resistance is a complex issue that affects the whole of society. This resistance is influenced by the irrational and excessive use of antibiotics by the general population. This study aimed to gather information about the knowledge, attitudes and behaviours regarding the issues related to antibiotic consumption in the general population of Mureș County in the Central Region of Romania.Methods: This was a cross-sectional study using a questionnaire as its research instrument, which consisted of 33 questions analysing the respondents’ attitude and their knowledge about the use of antibiotics and antibiotic resistance.Results: A total of 996 respondents were eligible for the study. Of the total respondents, 62.65% (624 respondents) considered that antibiotics are used to treat a bacterial infection and 61.45% (612 respondents) used an antibiotic at least once in the previous year, with a distribution of 68.7% and 56.8% of the respondents from rural and urban areas, respectively. Antibiotics were taken by 10.34% of the respondents, following recommendations from family/friends, and 22.9% used antibiotics left over from their last prescription. Of those who consumed antibiotics (868 respondents), 65.9% consulted their physician every time before taking the medication. Furthermore, 82.3% of the total of 996 respondents considered that the use of non-prescription antibiotics has a negative effect, and 85.14% had heard about the antibiotic resistance of bacteria.Conclusion: The majority of respondents had adequate knowledge of antibiotics and their use and were aware of the fact that non-prescription antibiotics can have repercussions both on them as individuals and on the population as a whole.Keywords: antibiotics, bacterial resistance, self-medication, questionnaire

In the context of public health, there is a common misconception that only Romania’s system faces issues and generates societal dissatisfaction. However, globally, there is significant room for improvement, as the performance of the sector is often unsatisfactory. This paper presents findings from an exploratory study on the attitudes of medical personnel in pathology services towards managerial and administrative risks, supported by a survey that provides a wealth of useful information.

Sepsis is still one of the leading causes of maternal mortality and morbidity, being the third most common cause of maternal death, after hemorrhage and hypertensive disorders. Maternal sepsis may appear due to obstetric causes such as: chorioamnionitis, endometritis, abortion-related uterine infections, and wound infections. For non-obstetric causes of maternal sepsis, the most common are urinary tract infections and respiratory tract infections. This mini summary presents the challenges in early diagnosis and prompt management, caused by pregnancy physiological changes. Physiological alterations during pregnancy, like an increase in white cell count, heart rate, and respiratory rate, associated with a decrease in blood pressure are also known signs of infection, making the diagnosis of sepsis during pregnancy more difficult. The three pillars of sepsis treatment are early antibiotics, vital organ support and fluid therapy, the last one being controversial. A more restrictive approach for fluid resuscitation could be more suitable for pregnant women, considering the risk of fluid overload and pulmonary edema. Criteria for early recognition and appropriate management customized for maternal sepsis are mandatory.

Healthcare-associated infections (HAIs) can pose significant risks to patients with cardiovascular disease due to the compromised nature of their health and potential vulnerabilities. In order to reduce the incidence of HAIs and prevent the spread of antibiotic-resistant organisms, it is mandatory to develop surveillance systems.

Objective: Endoscopy is an essential and invaluable diagnostic tool in the arsenal of every gastroenterologist. ESGE presented additional guidelines for standardized image documentation in upper and lower gastrointestinal endoscopy. Clinical disagreement is a common challenge in most, if not all, fields of medicine. Settling disagreements is important so as to find ways to minimize it. Clinical disagreement in gastroscopy may be demonstrated by studying the observer variability.

Introduction: Acute abdominal pain persists in defying modern diagnostic procedures. Inflammatory response variables in urine and blood tests can help rule out other disorders and support a clinical diagnosis of acute appendicitis (AA), but there is no specific blood test that can diagnose AA. In order to address this, our study sought to establish the value of (NLR) as a prognostic and severity predictor in patients with AA.

Following the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, design, development, validation, verification and implementation of diagnostic tests were actively addressed by a large number of diagnostic test manufacturers. This paper deals with the biases and sources of variation which influence the accuracy of diagnostic tests, including calculating and interpreting test characteristics, defining what is meant by test accuracy, understanding the basic study design for evaluating test accuracy, understanding the meaning of Sensitivity, Specificity, Positive Predictive Value and Negative Predictive Value, and evaluating them numerically, and the ROC curve (or Receiver Operating Characteristic ) and the Area under the Curve (AUC).

The COVID-19 outbreak has placed substantial pressure on the medical systems worldwide. This study aimed to investigate the influence of the prepandemic vs. pandemic period on the activity of the Vascular Surgery Unit of a large emergency hospital in Eastern Europe. We performed a retrospective review of the vascular surgery cases admitted, comparing the statistics from the two time periods. We examined data of a total of 1,693 patients over the two periods. We report a 34.51% decrease in the surgical procedures performed during the pandemic period, with a disproportionate 80.6% decrease in the number of cases admitted with a diagnosis of venous insufficiency diagnosis and an increase of 67.21% in the number of patients admitted with acute arterial ischemia. Furthermore, individuals not classed as emergencies were delayed or denied surgical care. The number of nonurgent procedures conducted by our Vascular Surgery Unit decreased significantly, whereas the number of emergency surgeries increased. COVID-19′s effect is projected to have a long-term impact on how surgical treatments are provided in Romania.

Introduction: A dramatic increase of infections induced by carbapenemase-producing Enterobacterales (CPE) has been registered worldwide. The aim of this study was to evaluate the molecular epidemiology and the clinical impact of CPE strains isolated from adult inpatients.

Background: Heart transplantation is still the treatment of choice in patients with end-stage heart failure, refractory to medical treatment, in NYHA class III and IV, with dilated cardiomyopathy of various etiologies, including post-myocardial infarction.

Background: Although the clinical evolution of a patient with heart failure is initially improved by transplantation, a number of potential complications may occur in the post-transplant period, which may be directly related to the effects of chronic immunosuppression. The purpose of this study was to analyze the occurrence and frequency of post-transplant complications related to immunosuppressive treatment in the Institute of Cardiovascular Diseases and Transplantation of Târgu Mureș, Romania.

Introduction: Our study investigated the importance of inflammation markers – ratio of platelets and lymphocytes (PLR), ratio of neutrophils and lymphocytes (NLR) and ratio of lymphocytes and monocytes (LMR) – as predictive markers in the occurrence of fistula or stenosis in patients diagnosed with gastric adenocarcinoma who underwent gastric resections.

Background: The additional benefits of certain frequently used chronic drugs such as statins or aspirin are investigated for their possible effect of influencing various types of cancer, including gastric cancer. The possible role of statins in the occurrence of pre-neoplastic gastric lesions has not been investigated.

Background: Twenty-four hours dynamic blood pressure (BP) behaviour displays dipper profile defined as nocturnal systolic BP (SBP) reduction>10% compared to daytime. Non-dipper profile, nocturnal absence of SBP fall, associates an increased cardiovascular risk. We investigated the concomitant association of inflammatory bio-markers - high-sensitivity- C-reactive protein (hs-CRP), Human Chitinase3-like1 (YKL-40) and autonomic nervous system (total brain-derived neurotrophic factor, BDNF) with respect to non-dipping blood pressure status.

Purpose: Our study focuses on elucidating if two common inflammatory biomarkers, easily performed in any laboratory - high-sensitivity C-reactive protein (hsCRP), as well as fibrinogen - could be used to assess the personal health risk of workers exposed to a complex occupational exposure to ultrafine particles (UFP) and a mixture of organic solvents. Methods: To assess the inflammatory response on the body, laboratory determinations were performed by testing the serum levels of hsCRP and fibrinogen, in exposed and unexposed groups. Results: There are no statistically significant differences for hsCRPs (p-0.25), medians were similar in groups. The mean values of fibrinogen in the three groups were: in the workers group (1st group): 346.2 mg/dl, in the office staff group (2nd group): 328.7 mg/dl, and in the control group (3rd group): 284.8 mg/dl, with significant differences between 1st group vs 3rd group and between 2nd group vs 3rd group (p-0.002). UFP levels differ between the groups, as follows: 1st group were exposed to the highest levels, ranging from 48349 to 3404000 part/cm3; 2nd group, ranging from 17371 to 40595 part/cm3; and 3rd group, ranging from 213 to 16255 part/cm3. Conclusions: Our study demonstrates that fibrinogen is a useful inflammatory biomarker for exposure to a mixture of UFP and organic solvents. On the other hand, hsCRP is not a useful inflammatory biomarker in occupational exposure to UFP and organic solvents. Further studies are needed to demonstrate the extent to which fibrinogen is more or less influenced by organic solvents or UFP alone.

Ioan Tilea,1 Dorina Petra,1 Septimiu Voidazan,2 Elena Ardeleanu,3 Andreea Varga1 1Department M3-Internal Medicine, Family Medicine Discipline, Faculty of Medicine, University of Medicine and Pharmacy, Tirgu Mures, Mures, Romania; 2Department M2-Functional and Complementary Sciences, Epidemiology Discipline, Faculty of Medicine, University of Medicine and Pharmacy, Tirgu Mures, Mures, Romania; 3Department XVI-Balneology, Medical Rehabilitation and Rheumatology, Family Medicine Discipline, Faculty of Medicine, University of Medicine and Pharmacy, Timisoara, Timis, Romania Purpose: This study was performed to elucidate the level of adherence to antihypertensive treatment in adult subjects attending a family medicine clinic in a city in central Romania.Patients and methods: A cross-sectional, retrospective study was performed on a cohort of hypertensive adults. A total of 525 participants were selected from 1,714 adults attending a single urban family medicine practice. Assessment of adherence to therapy was performed by a chart review of prescription and clinical records over a 4-year study period.Results: The results showed that 69.8% of the patients had high adherence (>80% with therapy); 20.3% had medium adherence (20%–79%); and 9.9% had low adherence (

Background: The aim of the study was to determine the utility of plasma NfH in correlation with serum hsCRP for severity and short-term functional outcome prediction after ischemic stroke. Methods: 124 patients and 40 healthy controls were enrolled, serial plasma neurofilament heavy chains and hsCRP concentrations were measured and evaluated for TOAST subtype, stroke severity and functional outcome at discharge. Results: Serum level of hsCRP was significantly higher in patients versus controls (p

Background: Differentiation between normal and pathological fetal growth may be difficult and a regular fetal biometry is required, with ultrasound examination of the placenta, amniotic fluid index assessment and Doppler velocimetry of pregnancies with fetal growth disorders, even in the absence of a clear etiologic factor. Material and method: This is an observational study and includes two groups: one with 24 pregnancies with FGR confirmed postpartum (SGA+) and another with 42 pregnancies with normal birth weight (SGA-). The database contained personal data, several parameters of fetal biometry, amniotic fluid index, placentation and velocimetric indices, birth-related data. Statistical analysis of obtained data was carried out using Microsoft Excel and Graphpad Prisma programs. We used the Student test, Z test and Chi square test and Fisher when needed. P <0.05 was considered statistically significant. We also used Pearson correlation index. Results: Between the two groups there were statistically significant differences regarding fetal biometry parameters, especially AC and ultrasound estimated weight and birth weight, infant length, Apgar score at 5' and days of hospitalization. Velocimetric indices were significantly higher in placental uterine and umbilical artery in SGA+ group. There was a negative correlation between umbilical RI and AFI in SGA+ group but without statistical significance. Conclusions: Fetal biometry, umbilical artery Doppler examination (when RI <0.6) and AFI calculation (>10) are the most used methods in the assessment of normal fetal growth and intrauterine fetal wellbeing. [ABSTRACT FROM AUTHOR]

Postvaccination immunization assessment may be accomplished by serological methods, which indicates the types, quantity and specific antibody persistence in serum, antibodies correlated with protection against the disease by cellular mediation immunization. The purpose of this study was the investigation of seroprevalence against measles in children of up to the age of 18; identifying low protection groups and correlating the antibody level with the vaccination. 91 children were included in the research, with their age ranking between 2 months and 18 years, anti-measles antibodies level being determined by ELISA method. The level of IgG anti-measles antibodies varied extensively between 0.1 UA/ml and 679.4 UA/ml. The antibody titre was quoted up to 44.4% out of the number of children of 1-12 age group, and for the other age groups the protective level was upper unprotective level (p=0.003). For the age group of >12-24 months and >2-5 months, the protection level was estimated to be 57.2% or 81.2 % of the children. The older children were dosed a second vaccin and in their case they noticed a concentration of protective antibody titre of 86.4 % for the ones with their age ranking between 5 and 10 years, as well as 94.6 % for those older than 10 years of age. There was no significant statistical difference regarding to gender (p=0.99), in urban areas the rate of protected ones was 91.6 %, those who had their place of origin in a rural area presented statistically insignificant differences (p=0.09) meaning 76.4 %. [ABSTRACT FROM AUTHOR]

Background: During the acute inflammatory process, the CXCL13 chemokine plays an important role in B cell recruitment within the central nervous system (CNS).

Objectives: The goal of the study was to investigate the correlations between the interleukin-6 IL-6 -174 G/C and IL-6 -572 G/C gene polymorphisms and sepsis risk and severity in adult ICU patients.

Background. The study aimed to evaluate the correlations of cognitive function with metabolic, nutritional, hormonal and immunologic parameters in patients with type 2 diabetes (T2D), in order to identify markers of cognitive impairment.

Depression remains an underdiagnosed comorbidity which significantly decreases the quality of life in amyotrophic lateral sclerosis (ALS) patients. We aimed to investigate the prevalence of depression in a cohort of ALS patients with more than one year of disease evolution. A total of 50 ALS patients were evaluated with the Beck Depression Inventory II (BDI-II) and cognition, using the Mini-Cog Standardized Instrument (MCSI). The clinical disability was evaluated using the ALS Functional Rating Scale (ALSFRS). The prevalence of depression was 42.8%. A lower BDI-II score was significantly correlated with a higher education level, the spouse as a caregiver, spiritual devotion, and employment status (p < 0.05). A multiple linear regression analysis between the BDI-II score as the dependent variable and various independent variables such as spirituality, caregiver status, educational level, and occupational status revealed that only the type of caregiver (spouse or parent/child) significantly affected the BDI-II total score (p = 0.006). The functional disability significantly correlated with loss of appetite and loss of libido (p < 0.001). A high education, spiritual devotion, high ALSFRS, and the presence of the spouse as the caregiver were associated with the absence of depression.

Background: P-glycoprotein (P-gp), a drug efflux transporter, encoded by the gene MDR1 ABCB1 multidrug resistant, reduces the penetration through the brain by the AEDs. Overexpression of Pgp in blood-brain barrier in epileptic patients play an important rol in pharmacoresistance. The aim of this study was to evaluate a possible association between C1236T and G2677T ABCB1 gene polymorphisms and drug-resistant epilepsy in Romanian children.

Factorii genetici pot juca un rol important in evaluarea riscului efectelor secundare gastrointestinale ale aspirinei, unul din cele mai folosite medicamente în intreaga lume. Obiectivul studiului a fost identificarea unei posibile corelații între polimorfismul genic al AGT A-20C (rs5050) și ulcerele gastro-duodenale la pacienții tratați cu aspirină în doze antiagregante

Introducere. Validarea unor noi biomarkeri în sepsis poate contribui la diagnosticul mai precoce al acestuia şi la iniţierea mai rapidă a terapiei. Scopul acestui studiu este acela de a evalua capacitatea formei solubile a rolului său în evaluarea prognosticului. Material şi metodă. Am realizat un studiu pilot, prospectiv pe 49 de pacienţi cu sindrom de răspuns inflamator sistemic (SIRS) internaţi în Clinica de Terapie Intensivă, care au fost împărţiţi, în funcţie de existenţa bacteriemiei, în lotul A (SIRS cu bacteriemie, n=14) şi lotul B (SIRS fără bacteriemie, n=35). S-au recoltat în prima zi probe sanguine pentru determinarea suPAR, proteina C reactivă (CRP), procalcitonina (PCT) şi hemocultura. Am urmărit identificarea unor valori de cut-off cu semnificaţie statistică în estimarea bacteriemiei şi a mortalităţii la pacienţii septici. Rezultate. În lotul A valorile suPAR au fost de 14,3 ng/mL (interval 10-45,5 ng/mL) iar în lotul B, de 9,85 ng/mL (interval 3,4-48 ng/mL), p=0,008. Aria de sub curbă (AUC) pentru suPAR a fost de 0,745 (95% CI: 0,600-0,859); pentru CRP, AUC a fost de 0,613 (95% CI: 0,522-0,799); pentru PCT, AUC a fost de 0,718 (95% CI: 0,477-0,769). Valoarea de cut-off a suPAR în predicţia bacteriemiei a fost de 9,885 ng/mL, cu sensibilitate de 100% şi specificitate de 51,43%. Mortalitatea în lotul A a fost de 85,7% (12/14), iar în lotul B de 74,3% (26/39), p>0,05. AUC pentru suPAR a fost de 0,750 (95% CI: 0,455-0,936); pentru CRP, AUC a fost de 0,613 (95% CI: 0,413-0,913); pentru PCT, AUC a fost de 0,618 (95% CI: 0,373-0,888). Valoarea de cut-off a suPAR în predicţia mortalităţii a fost de 11,5 ng/mL, cu sensibilitate de 66,67% şi specificitate de 100%.

Palliative care in Romania is a relatively new emerging field. Challenges of this specialty, its uniqueness and the several problems posed by a particular category of patients, the chronically ill patients, make this medical specialty a particularly complex one in certain situations, requiring a multidisciplinary team well-prepared in terms of theory and practice. Unlike in the case of most medical specialties, particular emphasis is laid on the “human” side of medical care, this specialty introducing the concept of “total pain”.

Introduction: Gallbladder hydrops is an increase in the volume of the gallbladder without any inflammatory sign, bacterial infection or the presence of any abnormalities of the biliary ducts or of the gallbladder.

Inaccurate information on the Internet can adversely influence the effectiveness of public health efforts for controlling the influenza epidemic. The purpose of the present study was to assess the quality of information about seasonal influenza on the Romanian websites as far as completeness, accuracy and potential risks for the general Internet users. We evaluated a sample of 20 relevant sites selected from the Google's search results pages. The average relative completeness score was 5.75 (of the possible 10), the average relative accuracy score was 7.55 (also of the possible 10) and the average risk score was 7.60 (ranging from 0 for the best sites up to 13 for the poorest quality site). Based on our results, we concluded that the overall quality of the information about flu on the Romanian websites is modest and the users have to search methodically the topic to obtain full and accurate information. [ABSTRACT FROM AUTHOR]

Inaccurate information on the Internet can adversely influence the effectiveness of public health efforts for controlling the influenza epidemic. The purpose of the present study was to assess the quality of information about seasonal influenza on the Romanian websites as far as completeness, accuracy and potential risks for the general Internet users. We evaluated a sample of 20 relevant sites selected from the Google's search results pages. The average relative completeness score was 5.75 (of the possible 10), the average relative accuracy score was 7.55 (also of the possible 10) and the average risk score was 7.60 (ranging from 0 for the best sites up to 13 for the poorest quality site). Based on our results, we concluded that the overall quality of the information about flu on the Romanian websites is modest and users have to search methodically the topic to obtain full and accurate information. [ABSTRACT FROM AUTHOR]

Introducere. Hiperparatiroidismul secundar este frecvent întâlnit la pacienţii dializaţi. Paratiroidectomia rămâne o soluţie terapeutică în cazul hiperparatiroidismului secundar refractar şi a celui terţiar. Scopul acestui studiu este de a urmări impactul paratiroidectomiei, indiferent de tehnica chirurgicală utilizată, asupra simptomatologiei şi principalelor constante biologice. Material şi metodă. Am studiat 29 de pacienţi la care s-a efectuat paratiroidectomie pentru hiperparatiroidism secundar şi terţiar, la Clinica Chirurgie II, Spitalul Clinic Judeţean de Urgenţă Mureş, în perioada februarie 2010- mai 2013. Paramentrii urmăriţi au fost clinici şi de laborator (parathormonul, calciul total, fosforul şi fosfataza alcalină serică, hemoglobina şi hematocritul) determinaţi preoperator, imediat postoperator şi pe termen scurt şi mediu de urmărire. Rezultate. Simptomele clinice s-au ameliorat la majoritatea pacienţilor incluşi. Valorile parathormonului seric s-au redus semnificativ, rămânând scăzute pe întreaga perioadă de urmărire; valorile medii ale calcemiei, fosfatemiei, fosfatazei alcaline s-au redus semnificativ statistic în perioada de urmărire după paratiroidectomie. Hemoglobina şi hematocritul au prezentat creşteri semnificativ statistice atât pe termen scurt cât şi mediu de urmărire. Am întâlnit două cazuri de hiperparatiroidism persistent după prima intervenţie (6,89%); 8 pacienţi au prezentat hipocalcemii în prima lună postoperator (sindrom “hungry bones”). Nu am întâlnit mortalitate în seria studiată. Concluzii. Paratiroidectomia, indiferent de tehnica chirurgicală utilizată, rămâne o soluţie fezabilă în tratamentul hiperparatiroidismului secundat şi terţiar

Borrelioza Lyme (BL) este cea mai frecventă infecţie transmisă de căpuşe din genul Ixodes, atât în Statele Unite ale Americii (SUA), cât şi în Europa. Obiectivele studiului au constat în monitorizarea incidenţei şi a manifestărilor clinice ale bolii în judeţul Mureș. Material şi metodă. Studiul s-a efectuat pe o perioadă de 2 ani, 1 ianuarie 2010 - 31 decembrie 2011, pe un număr de 120 pacienţi. Diagnosticul cert sau probabil al BL s-a stabilit pe baza criteriilorCenters for Diseases Control and Prevention (CDC, Atlanta, SUA) şi European Union Concerted Action on Lyme Borreliosis (EUCALB) şi anume epidemiologice, clinice şi serologice. Pentru identificarea anticorpilor antiBb IgM, IgG din ser şi LCR s-au utilizat tehnicile ELISA şi Western-Blot. Rezultate. În anul 2010 s-au înregistrat 44 cazuri, iar în anul 2011, 76 cazuri. Conform definiţiei de caz, 106 cazuri au fost confirmate, 14 probabile. BL a fost evidenţiată cu o frecvenţă mai ridicată la copii, adulţi tineri şi adulţi, comparativ cu grupa de vârstă peste 60 ani. Incidenţa afecţiunii a fost mai ridicată la sexul feminin, 68 pacienţi (56,66%) faţă de sexul masculin 52 pacienţi (43,33%), cu o pondere, mai crescută la persoanele din mediul urban, 78 pacienţi (65,0%), comparativ cu cele din mediul rural 42 pacienţi (35,0%). Manifestările clinice au fost acute de tipul eritemului migrator (EM) la 64,16 din pacienţi, neurologice la 22,50% pacienţi, articulare la 1,66% pacienţi şi cardiace la 0,83% din cazuri. Concluzii. În judetul Mureș s-a constatat o incidenţă în creştere a bolii în anul 2011 comparativ cu anul 2010. Manifestările clinice predominante au fost cele acute dermatologice, neurologice.

Background: In the literature there are a number of studies that suggest a possible correlation between cholelithiasis/cholecystectomy and colorectal cancer. The exposure of the colon mucosa to the action of bile acids that potentially have a carcinogenic effect due to the change in anatomy after cholecystectomy, seems to be the explanation of this association. The purpose of this paper was to search for such a correlation in our study group. Methods: We performed a retrospective cross-sectional study, analyzing the patients admitted to the First Surgical Clinic of the County Emergency Clinical Hospital Tîrgu Mureș, between January 1st, 2005-December 31st, 2010. Analyzing the medical records, operation protocols and histopathological results, we paid attention to demographics, location of neoplasia, the time elapsed since the cholecystectomy to the discovery of neoplasia, histological types, trying to perform correlations between these parameters and the lithiasic factor. Results: Out of the 534 patients admitted and operated with the diagnosis of colorectal cancer, 15.6% (n = 83) showed a history of gallbladder stone affection. Most patients came from urban areas, the average age was 67.2 (range 39-88 years), females were more affected. The most common locations were: the sigmoid colon (26.5%), rectum (36.3%) and the most common histological form was moderately differentiated adenocarcinoma. Conclusions: Similar to other studies, our work suggests a slight increase in the incidence of colorectal cancer in patients that underwent a cholecystectomy, without drawing a firm conclusion. We deem it necessary to see if diet changes of the Romanian population affect this relationship. [ABSTRACT FROM AUTHOR]

Background: Rectal cancer management has as its main component the surgical treatment. The purpose of the paper is to point out the advantages and disadvantages of sphincter saving techniques, respecting the oncological principles. Material and method: A cross-sectional, retrospective study was performed on a group of 69 patients admitted and surgically treated for rectal cancers in the Surgical Clinic I of the County Emergency Clinical Hospital of Tîrgu Mureș, for a period of one year (April 2012-April 2013) and to whom rectal resections were performed. We followed the immediate postoperative evolutions in these patients, making a comparative analysis between those with the sphincter saving surgery and those in which other operations were performed. Results: From the total of 69 patients diagnosed with rectal cancer, sphincter saving procedures with restoration of digestive continuity by coloanal anastomosis were performed in 12 patients (17.39%) using the peranal or transanal approach; in 42 patients (60.86%) anterior rectosigmoidian resections with low and very low colorectal anastomosis („very low” Dixon procedure) were performed. In 15 cases (21.74%) the Miles type of rectal resections, using the abdomino-perineal way, were performed. Out of the 12 cases with peranal or transanal anastomosis, 4 cases had postoperative complications. Conclusions: Rectal resection procedures, which are restoring the digestive tract continuity using low anastomosis (colorectal, coloanal, peranal or transanal), are representing viable and „physiological” alternatives, if they respect the oncologic principles. In well selected cases, the immediate postoperative evolution is favorable, relieving the patient from the psychological and physical trauma due to the presence of a colostomy. [ABSTRACT FROM AUTHOR]

Background: The incidence of obesity has dramatically increased in the last few years, and associated disorders such as non-alcoholic fatty liver disease (NAFLD) constitute a serious threat. The objective of our study was to assess the liver aspect of obese children and adolescents by real-time elastography, ARFI-technique, compared to the liver aspect of normal-weight children. Methods: Eighty-six children, aged 3-18 years, admitted to the County Emergency Clinical Hospital of Tîrgu Mureş between 15 September 2010 and 15 April 2012, were recruited for the study. They were included in two groups: 39 overweight/obese children and 47 normal-weight healthy controls. We evaluated the liver-tissue elasticity by measuring the Shear Wave Velocity (SWV), globally and separately for segments 1 and 8 in order to detect possible differences beetween them, knowing that the caudate-lobe has it's own vasculature; we also evaluated biochemical parameters (transaminases, etc). Correlations between SWV and laboratory tests were established using non-parametric Spearman correlation test. Results: In healty children in the 1st segment SWV was 1.012±0.31 m/s, smaller than in the 8th segment, 1.342±0.32 m/s (p = 0.0316). For obese children, SWV was higher in the 8th segment 1.982±0.85 m/s compared to the 1st segment 1.325±0.27 m/s (p <0.0001). Globally in obese children, the SWV was 1.746±0.49 m/s, significantly higher than in healthy children, 1.080±0.27 m/s (p = 0.0023). Positive statistical correlations have been established between SWV and aspartate-aminotransferase in obese (r = 0.61, Pearson correlation p = 0.025), with no statistically significant differences for other laboratory findings. Conclusion: Elastographic evaluation of liver alterations in obesity by ARFI-method shows higher SWV, which could be translated in fibrosis and necroinflammatory activity. According to our study, these alterations in liver tissue affect mainly the right lobe of the liver. [ABSTRACT FROM AUTHOR]

Background and Objective: Acute lymphoblastic leukemia (ALL), is characterized by uncontrolled precursor lymphocyte proliferation. Chromosomal abnormalities have been found in 60-85% of ALL patients. The aim of our work was to determine the chromosomal abnormalities and to evaluate the prognostic value of cytogenetic findings in a cohort of ALL patients. Method: The study included 36 patients with ALL from Hematology Clinics Tg. Mures, Romania. Cytogenetic analyses were done on bone marrow cultures according to standard methods. Results: We identified 22 cases (71%) with cytogenetic abnormalities. In our study, the frequency of chromosomal abnormalities was 50% in children and 85% in adults. The most common clonal karyotype aberration in ALL patients was numerical chromosomal abnormalities, detected in 62% of cases. Structural chromosomal abnormalities were found in 38% of our cases and were represented by translocations and deletions. We included our patients in different cytogenetic risk groups: 2 patients in low cytogenetic risk group, 23 in intermediate cytogenetic risk and 6 in severe cytogenetic risk group. We did not find a statistically significant difference in the median overall survival (OS) between the three cytogenetic risk groups (p = 0.863).There was a significantly better OS in patients who had a normal karyotype compared to those who had chromosomal abnormalities (p = 0.008). Conclusion: Our study highlights the importance of cytogenetic analysis as an important prognostic factor in ALL [ABSTRACT FROM AUTHOR]

Aim: To investigate the clinicopathological features of liver metastases diagnosed in Mureş County, Romania. Material and method: We performed a retrospective study based on data collected from histopathological reports stored in the archives of the Pathology Laboratories of Emergency Mures County Hospital, Romania. We selected those patients' data that were diagnosed with liver metastases during January 2004 - August 2011. The acquired data were collected and processed statistically by using the GraphPad InStat Demo 3 statistical software. Results: We identified 748 liver tumours out of which 484 were liver metastases. The liver metastases: primary liver tumours ratio was 1.833:1. In cases of liver metastases, the male:female ratio was 1.45:1. The mean age of male patients was 62.13 (±10.79 years) as for female patients it was 61.61 (±10.82 years). In most of the cases (34.71%) the primary tumor was colorectal carcinoma followed by pancreatic carcinomas (16.52%). Conclusions: Most cases of liver metastases are carcinomas, whereof the most frequent ones originate from the digestive area, respectively gastrointestinal tract and pancreas. Independently by the primary tumour, liver metastases occur more frequent in males, in their 7th decade of life. [ABSTRACT FROM AUTHOR]