Suchergebnisse

Background: Head and neck cancers, and particularly, oral cancers have a complex pathogenesis that includes genetic
mutations and epigenetic alterations which interfere with cellular signaling and can trigger tumor development. The purpose of
this study was to reveal whether low-frequency hotspot mutations may be detected in a study lot with histopathological evidence
of squamous cell carcinoma (SCC) of the oral mucosa and skin of the head and neck. Methods: Tumor biopsies from treatment
naïve patients were tested for BRAF V600, NRAS G12/G13, NRAS Q61, KRAS Q61 mutations, and EGFR exon 19 deletions (Ex19Del)
using droplet digital PCR (ddPCR). The tumors were also analyzed for EGFR T790M mutations by RT-PCR, using a CE-IVD validated
kit, with a limit of detection of 0.05%. Results: None of the examined cases exhibited NRAS G12/G13, NRAS Q61, KRAS Q61, BRAF
V600, or EGFR T790M mutations, indicating that these alterations are rare events in SCC pathogenesis. Interestingly, among the
12 specimens tested by ddPCR for EGFR Ex19Del, an HPV-negative cSCC tumor occurring in the parotid region tested positive for
this drug-sensitizing mutation, offering unexplored therapeutic perspectives to the patient from whom it was collected.
Conclusions: Our study highlights the important clinical implications of detecting low-frequency hotspot mutations in tumor
biopsies by ddPCR. We believe that the ddPCR-assisted analysis of these mutations in larger SCC cohorts may provide us with
mechanistic insights regarding their role in SCC pathogenesis and guide the development of novel therapeutic strategies for this
problematic disease.

Neonatal brachial plexus palsy is a complication that occurs during difficult vaginal delivery or due to unexplained causes, probably prenatal in which some or all brachial plexus branches are affected (avulsion, rupture, stretching). A cohort of 28 cases evaluated in our clinic in 6 years and 6 months (Jan 2007-July 2013) from the clinical and paraclinical point of view, treatment, and the outcome were analyzed. 17 (60.7%) of the patients were boys and 11 (39.2%) were girls. 14 (50%) had right brachial plexus palsy, 12 (42.8%) had left brachial plexus palsy and 2 (7.1%) had bilateral involvement. 5 (17.8%) of them had reconstructive surgery done. 11 (39.2%) had good to complete recovery. The purpose of this paper is to underline the importance of early presentation for neurological evaluation and the beginning of physical therapy.

Cătălina Giurgi-Oncu,1,2 Cristina Bredicean,1,3 Mirela FrandeÈ™,4 Virgil Enătescu,1,2 Ion Papavă,1,2 Ioana RiviÈ™,5 Sorin Ursoniu6 1Department of Neuroscience, Discipline of Psychiatry, "Victor BabeÈ™" University of Medicine and Pharmacy, TimiÈ™oara, Romania; 2"Pius Brînzeu" County Emergency Clinical Hospital, TimiÈ™oara, Romania; 3"Dr. Victor Popescu" Military Clinical Emergency Hospital, TimiÈ™oara, Romania; 4Department of Functional Sciences, Discipline of Medical Informatics and Biostatistics, "Victor BabeÈ™" University of Medicine and Pharmacy, TimiÈ™oara, Romania; 5"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; 6Department of Functional Sciences, Discipline of Public Health, Center for Translational Research and Systems Medicine, "Victor BabeÈ™" University of Medicine and Pharmacy, TimiÈ™oara, RomaniaCorrespondence: Cristina BrediceanDepartment of Neuroscience, Discipline of Psychiatry, "Victor BabeÈ™" University of Medicine and Pharmacy, No. 2 Eftimie Murgu Square, TimiÈ™oara, 300041, RomaniaTel +40722424301Email bredicean.ana@umft.roBackground: Depression is an increasingly prevalent chronic mental health condition that involves a range of potentially negative implications, in the long term. Theory of Mind (ToM) serves to form and maintain social relationships, by accurately identifying thoughts and emotions in others. Defective ToM abilities have been noted in people with a history of clinical depression.Purpose: To identify whether impairments of emotion recognition are correlated with a lower subjective feeling of wellbeing in people diagnosed with a chronic depressive illness.Patients and Methods: In a cross-sectional analysis of a recurrent depressive disorder (RDD, as per WHO ICD-10 nosology) cohort (n=57), the BECK depression scale and the "Reading the mind in the eyes" test were employed for the diagnosis of clinical symptoms, and for the evaluation of individual ToM skills, respectively. Wellbeing was quantified using the FANLCT scale.Results: The wellbeing of service-users decreased significantly, in correlation with their defective emotion recognition abilities. Additionally, a low capacity for the correct perception of emotions in other people appears to significantly influence the social relationships status, with scores of 14.00 (10.00– 18.50) at low capacity vs 23.00 (17.58– 24.75) at normal capacity (Mann–Whitney U-test, p < 0.001). Our study findings indicate that a normal ability for a correct recognition of emotions in others is significantly and strongly correlated with adequate social relationships (Spearman r = 0.757, p < 0.05).Conclusion: Wellbeing is significantly correlated with the individual ability for a correct recognition of emotions in others.Keywords: theory of mind, wellbeing, depressive disorder, emotion recognition, social functioning

: Systemic lupus erythematosus is a multi-organ autoimmune disease of unknown etiology characterized by widespread
inflammation and significant morbidity and mortality. Organ affection includes joint and cutaneous involvement, pulmonary,
neurological, and cardiac problems, renal and hematological involvement as well as ocular comorbidities, both posterior but
mostly anterior ocular involvement. Therefore, we aimed to evaluate dry eye involvement in lupus patients. A cross-sectional
study was performed with the aid of a web-based, anonymous questionnaire that was distributed to both patients diagnosed
with lupus erythematosus and to a control group. A total number of 123 patients diagnosed with lupus and 200 responders in the
control group completed the questionnaire. Dry eye disease has already been diagnosed in 25 lupus patients (28.9%) compared
to 44 (21.9%) individuals in the control group. Dry eye-related symptomatology was reported in 43 (34.60%) patients compared
to 57 (28.35%) healthy responders. Upon statistical analysis, more symptoms were reported in the lupus group (p=0.01), in
responders diagnosed with dry eye syndrome (p 0.01), and in responders using lubrication (p 0.01) but no association was
obtained between the incidence of dry eye symptoms and the presence of the disease. The number of episodes of lupus
reactivation since diagnosis was correlated with dry eye syndrome (p=0.15) and the use of lubricating tear drops (p 0.01). Dry
eye symptoms and disease are more frequent in lupus patients and further research should be performed to understand the
connection between these two disease entities.

The biological agent most likely to be used as a biological weapon is Bacillus anthracis, which causes the anthrax infectious disease. During the Cold War, it was present in large quantities in the military arsenals of some states, and at the beginning of the 21st century was used in a series of small bioterrorist attacks. In case of occurrence of events using Bacillus anthracis, urgent and adequate qualitative and quantitative response measures are needed to manage the consequences of the attack and to reduce the effects on public health. These include complex and well-coordinated activities to ensure medical intervention for the prophylaxis, treatment and recovery of patients. General prophylaxis is achieved by vaccination, individual and collective CBRN protection, decontamination, partial and total sanitary treatment, microbiological analysis for the detection, identification and confirmation of the biological agent. Therapy for disease induced by weaponized B. anthracis differs from classic antrax disease regarding antibiotics, doses and time, resulting a large antibiotic consumption per case. Complete recovery of the patients is achieved not only in terms of restoring normal biological parameters, but also in terms of the organism's "sterilisation" regarding the causal biological agent.

Introduction: The gastrointestinal stromal tumors (GIST) are dominated by KIT and PDGFRA mutation. The immunohistochemical detection of CD117, a protein express by KIT gene, is essential for the diagnosis and those that are negative always represented a diagnostic challenge Case reports: In this article we present a series of 4 cases of CD117 negative GIST tumors, diagnosed and surgically resected in Fundeni Clinical Institute and an overview of the histogenesis, diagnostic problems and management of c-kit negative GIST. All patients were males and the tumors were located in the stomach and small bowel. Conclusion: It is important for the pathologists to beware of the fact that a CD117 negative in the context of a typical morphological appearance does not exclude a GIST tumor and also the oncologist must be aware not to exclude the therapy with imatinib based on the negativity of CD117.

Purpose – Combined airway burns with cutaneous burns is a further negative prognostic factor in burn patients. In this study we tried to identify the most relevant negative prognostic factors at admission in a relatively homogeneous population. Methods – In this study, ten young patients who suffered from skin and airway burns following a fire in a club, admitted to our ICU department, were included. At the intake, ABSI and APACHE II scores were calculated, and a series of biomarkers were also collected. The correlation and associations between gravity scores and biomarkers was then calculated using the Spearman correlation and Chi square tests. Results – Based on data analysis, we found very high values of ABSI 8.9 ± 1.4 and APACHE II 25.4 ± 2.79 scores, procalcitonin (46.16 ± 68.18 ng/ml), white blood cells (41.26 ± 15.66 × 103/mm3), hematocrit (51.6 ± 7.31 %), and low corrected albumin values (22.08 ± 4.66 g/l). The statistical analysis revealed a good correlation between gravity scores and values of PCT and low albumin levels (p< 0.05). The mortality was also associated with the need for vasopressor support from the beginning (p < 0.05). Conclusions – Adverse prognostic factors that we have identified in this group of young patients with skin burns and airway include: increased values of the severity scores and PCT, low values of corrected albumin and vasopressor support necessary at admission.

"Chronic venous disease has been pathology of great interest over time. With its large prevalence among the world population (10-33% adult woman and 10-20% of men) through profound socio-professional implications that affect the quality of life of patients, chronic venous disease is a real public health problem, being an important cause of morbidity and disability, a permanent area of research in the medical-pharmaceutical field. Special attention is now given to identifying the mechanisms and stages of disease development. From studies that have highlighted the importance of venous hypertension as an essential element in the development of the disease, to this day it has come up to demonstrating the fundamental role of the venous endothelium and glycocalyx in triggering and progressing of chronic venous disease. Biochemical, immunohistochemical, and functional investigations have allowed the evaluation of changes that occur in cellular metabolism and evidence of some immune-vascular factors responsible for vascular alterations in chronic venous disease: specialized receptors, adhesion molecules, cytokines, matrix and metalloproteinases. The analysis of the pathophysiology of chronic venous disease is still a vast area open to scientific research."

Understanding COVID-19 vaccination attitudes is of paramount importance in order to estimate and influence the willingness to vaccinate. A cross-sectional study was performed in the spring of 2021 in Romania by sending a web-based questionnaire to patients with rheumatic autoimmune diseases in order to assess their willingness to vaccinate against SARS CoV-2 and to identify factors that might influence their decision. Variables derived from the questionnaire were analyzed in univariable and multivariable analysis. 71 patients, of which 60 (84.5%) women, were included in the study, with a 53.5% (38 subjects) willingness to vaccinate. A positive association was observed between the willingness to vaccinate and the patients' trust in authorities, trust in the healthcare system and the choice of scientific sources of information in their decision making. A positive correlation was observed between the intention to vaccinate and the global VAX score, as well as the subscale VAX scores (p0.05). Global VAX score emerged as a predictive factor for the intention to vaccinate on logistic regression (p0.05). The present study underlines the importance of reliable scientific sources of information for pa-tients with autoimmune diseases and how the general attitude about vaccination becomes a pre-dictive factor for accepting COVID-19 vaccine. Understanding COVID-19 vaccination attitudes is of paramount importance in order to estimate and influence the willingness to vaccinate. A cross-sectional study was performed in the spring of 2021 in Romania by sending a web-based questionnaire to patients with rheumatic autoimmune diseases in order to assess their willingness to vaccinate against SARS CoV-2 and to identify factors that might influence their decision. Variables derived from the questionnaire were analyzed in univariable and multivariable analysis. 71 patients, of which 60 (84.5%) women, were included in the study, with a 53.5% (38 subjects) willingness to vaccinate. A positive association was observed between the willingness to vaccinate and the patients' trust in authorities, trust in the healthcare system and the choice of scientific sources of information in their decision making. A positive correlation was observed between the intention to vaccinate and the global VAX score, as well as the subscale VAX scores (p0.05). Global VAX score emerged as a predictive factor for the intention to vaccinate on logistic regression (p0.05). The present study underlines the importance of reliable scientific sources of information for pa-tients with autoimmune diseases and how the general attitude about vaccination becomes a pre-dictive factor for accepting COVID-19 vaccine. Understanding COVID-19 vaccination attitudes is of paramount importance in order to estimate and influence the willingness to vaccinate. A cross-sectional study was performed in the spring of 2021 in Romania by sending a web-based questionnaire to patients with rheumatic autoimmune diseases in order to assess their willingness to vaccinate against SARS CoV-2 and to identify factors that might influence their decision. Variables derived from the questionnaire were analyzed in univariable and multivariable analysis. 71 patients, of which 60 (84.5) women, were included in the study, with a 53.5% (38 subjects) willingness to vaccinate. A positive association was observed between the willingness to vaccinate and the patients' trust in authorities, trust in the healthcare system and the choice of scientific sources of information in their decision making. A positive correlation was observed between the intention to vaccinate and the global VAX score, as well as the subscale VAX scores (p0.05). Global VAX score emerged as a predictive factor for the intention to vaccinate on logistic regression (p0.05). The present study underlines the importance of reliable scientific sources of information for pa-tients with autoimmune diseases and how the general attitude about vaccination becomes a pre-dictive factor for accepting COVID-19 vaccine.

The first edition of this book was judged by many to be the best available atlas of upper gastrointestinal and hepato-pancreato-biliary surgery. The second edition builds upon this success by covering all of the significant intervening developments, including both new procedures and adaptations of established techniques. The atlas opens with an introductory section on the basic principles of operative surgery. All of the important surgical techniques are then presented in a series of sections devoted to the esophagus, stomach, and duodenum, the liver, the biliary system, portal hypertension, the pancreas, and the spleen. General, oncologic, and transplantation surgical procedures are described step by step with the aid of more than 900 superb illustrations drawn by a team of artists with extensive experience. The contributors were selected on the basis of their extensive experience in the procedures discussed and most are established educators. Pierre-A. Clavien, MD, PhD, FACS, FRCS (Eng), FRCS (Ed), gained his medical degree from the Geneva Medical School, Switzerland, and his PhD from the Institute of Medical Science and Department of Immunology, University of Toronto, Ontario, Canada. He subsequently served as Director of the Division of Transplantation and the Liver Transplant Program and Chief of Hepatobiliary Surgery at Duke University, Durham, NC, USA. Dr. Clavien is currently Professor of Surgery at the University of Zurich, and Chairman of the Department of Surgery and Chief of the Division of Visceral and Transplantation Surgery at the University Hospital of Zurich. He has been the recipient of numerous research grants and in 2008 received the prestigious Otto Naegeli Prize for research. He is President of the Association for Research in Surgery and of the European Hepato-Pancreato-Biliary Association, President Elect of the Swiss Transplantation Society, and Secretary General of the European Surgical Association. Dr. Clavien has served on many journal editorial boards and was Editor of the section Liver Transplantation in the Journal of Hepatologyfrom 2004 to 2009. He is also current Editor of Patient Safety in Surgeryand an Associate Editor of the American Journal of Transplantation. He has edited several books and published more than 400 articles in peer-reviewed journals. Michael G. Sarr, MD, graduated from the Johns Hopkins School of Medicine, Baltimore in 1976 and was elected a member of the Alpha Omega Alpha Honor Medical Society. In 1992 he became Chairman of the Division of Gastroenterologic and General Surgery at the Mayo Clinic, Rochester, MN, and was appointed Professor of Surgery in 1995. In 2004 he was appointed James C. Masson Professor of Surgery at Mayo Clinic College of Medicine. He is currently Chair of the Division of Experimental Surgery at the Mayo Clinic. From 2001 to 2007 Dr. Sarr was Director of the American Board of Surgery, andfrom 2007 to 2009 he served as President of the International Surgical Society. He is Co-editor of both Surgeryand International Surgeryand has been a member of many other journal editorial boards. Dr. Sarr has published more than 450 full papers in peer-reviewed journals as well as more than 100 book chapters. He has also edited ten previous books. Masaru Miyazaki, MD, PhD, studied at Chiba University in Japan before becoming first Assistant Professor and then Associate Professor in the First Department of Surgery at the University. Since 2001 Dr. Miyazaki has been Professor and Chairman of the Department of General Surgery at Chiba University and in 2006 he became Vice-Director of Chiba University Hospital. In 2011 Dr. Miyazaki was appointed Director of the Hospital. Dr. Miyazaki has been a Visiting Professor at a number of universities, including the University of Toronto, Yonsei University (Seoul), and the University of Cincinnati. He is an Honorary Member of the Egyptian Society of Surgeons and in 2007 was appointed a full professor at the Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. Dr. Miyazaki is a member of many professional bodies and is on the Executive Committee of the International Association of Surgeons, Gastroenterologists and Oncologists (IASGO).

Introduction. The primary tonsillar neoplasm is a common malignancy of the head and neck, alcohol and/or cigarette smoke and Human Papilloma Virus is the main etiological agent. This study offers a retrospective analysis of the tonsillar neoplasm cases in a tertiary medical center from Romania. Patients and methods. We present a 4-year (2015-2018) retrospective study on 72 patients diagnosed with tonsillar neoplasm in our clinic, previously untreated patients. The study was included only the patients diagnosed through histopathological evaluation with tonsillar neoplasm. We searched the cases in our clinic database, and we collected data about age, gender, symptoms on admission, findings of the objective physical examination, oro-pharyngoscopy, medical imaging examination results, histopathological results, stage of the disease, therapeutic management. Results. The group composition is: 75% men and 25% women, 62.5% of them are smokers. Dysphagia/swallowing discomfort was the most common symptom identified, and the non-keratinized squamous cell carcinoma was the most common histopathological form. Stage I tonsil carcinoma was diagnosed in 25% of the cases, stage II in 15.3%, while 47.2% of the cases had stage III or IV. None of the patients presented distant metastases. Lymphoma was diagnosed in 12.5% of the cases. We performed for all patients in stages I and II underwent total unilateral tonsillectomy. For the patients in stages III and IV, we performed surgery after radiotherapy-chemotherapy treatment or only radiotherapy-chemotherapy. Conclusions. In Romania, smoking is still the most important risk factor for tonsil cancer. The majority of patients have visited a doctor only when dysphagia and, above all, palpable cervical adenopathy, were present, and the tumor was in the advanced stage. In Romania, the ENT-oncology integrated medical services are few, in most cases patients are lost from otorhinolaryngological follow-up.