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Introduction: Extra-gastrointestinal stromal tumors (EGISTs) are non-gastrointestinal sarcomas originating from Cajal-like cells. Recent studies show the tumor microenvironment is crucial and highlight the importance of intra-tumoral leukocyte populations in malignancies, which are greatly impacting treatment strategies in EGISTs.

Aim and objectives: This study aims to characterize intra-tumoral leukocyte populations in EGISTs, correlating proliferative index (ki67) with leukocyte density and examining age-related effects on proliferative activity and immune response.

Methods: We conducted a retrospective analysis on 25 patients with EGIST who came at "Victor Babes" National Institute of Pathology and Bucharest University Emergency Hospital between January 2007 and June 2020. After excluding five patients, a total of 19 subjects were included in the present study. Immunohistochemistry utilizing CD5, CD20, CD45 and ki67 antibodies identified and assessed intratumoral lymphocytes, analyzed via QuPath software. Statistical analyses included Pearson correlation, Kruskal-Wallis tests and Bonferroni corrections.

Results: The mean age of patients diagnosed with EGIST was 51 years; ki67 expression varied among morphological types. Immunohistochemistry revealed distinct tumor-infiltrating lymphocytes (TIL) densities with significant associations between ki67 and TIL-CD05/CD20 positive cells. Age-related correlations were noted, which highlighted complexities within the tumor microenvironment.

Conclusion: Our findings emphasize the role of the immune microenvironment in EGISTs, showing significant correlations between ki67 expression and TIL densities as well as age-related associations. This study enhances our understanding of EGIST pathophysiology, urging further exploration for improved therapeutic approaches and comprehensive insights into immune responses in EGISTs.

Introduction: Coronary artery disease (CAD) is a major and multifaceted health problem but also the first cause of death in modern Western societies. Furthermore, myocardial infarction (MI) constitutes a challenge for analysis in the field of molecular mechanisms, early diagnosis and therapeutic approaches, as its incidence increases every year worldwide. Concerning the histopathological diagnosis in the corresponding cases, a variety of immunohistochemistry (IHC) markers and methods are available to support conventional histology diagnosis. Immunohistochemistry techniques are effective for use in forensic pathology, expanding the limits of differential diagnoses in borderline cases, as they can be applied to tissue samples fixed in formalin and embedded in paraffin.

Objective: The purpose of the current review was to explore the role of connexin 43 (gene locus: 6q22.31) as a reliable biomarker of myocardial disease/infarction and its impact on MI pathology.

Material and method: A systematic review of the literature was carried out based on the international database PubMed. The majority of medical data referred to articles published after the year 2020, whereas specific references of great importance and value were also included. The following keywords were used: coronary, artery, myocardial, infarction, connexin and immunohistochemistry.

Results: A pool of 38 significant articles focused on the mechanisms and novel experimental biomarkers was selected for the present study at the basis of combining molecular knowledge with new clinical features in CAD, and MI histodiagnosis.

Conclusions: The role of connexin 43 - as a significant gap junction intermediate protein - in MI pathology, clinical symptoms and prognosis is critical because its dysfunction is involved in myocardial conduction and the onset of ventricular arrhythmias due to a crucial interruption of the intra-cardiomyocyte's conjunction.

Introduction and aim: Identifying the best practices to obtain consent for organ donation involves several strategies. This retrospective analysis of the activity in the field of organ donation identifies the most critical impediments, of which the refusal of families to donate is one of the most frequently encountered. Our main aim was to determine the factors that negatively influence the activity of organ and tissue donations from brain dead donors and to summarize the total number of potential and actual deceased donors, their yearly characteristics, and the organ and tissue donation types performed.

Materials and methods: A retrospective descriptive study, covering data from 1 January 2014 to 31 December 2023, was conducted in the intensive care unit of the Emergency Clinical County Hospital of Bihor, a recognized facility engaged in organ donation and transplantation from Romania. All potential and actual deceased donors were included in our research.

Results: During a period of 10 years, between 2014 and 2023, of the 488 potential and actual deceased donors, 355 (72.7%) were potential donors and 133 (27.3%) actual deceased donors.

Conclusions: From 2014 to 2023, a significant percentage [15.28% (133)] of the total number of actual deceased organ donors registered at the national level (870) were identified by us in the Emergency Clinical County Hospital of Bihor.

Background: Pregnancy related acute renal injury is a challenging diagnosis, mainly due to, among other factors, the physiological decrease in blood nitrogen retention parameters. As a consequence, the criteria required to establish the diagnosis may be first met as a result of the complications that appear, especially hypertension. The maternal and fetal complications which may occur in pregnancies with renal failure can be worsened by the relative immunodeficiency during pregnancy, which represents an elusive mechanism that is associated with a high risk of urinary tract infection (UTI). Therefore, the risk for intensive care unit admission, or developing sepsis, or preterm birth can increase.

Objectives: The present study aims to investigate whether the superimposition of UTI over an altered renal function leads to a worsened maternal and fetal prognosis.

Patients and methods: We performed an observational retrospective study that included pregnant women with increased serum creatinine levels, both with and without UTI. Thus, we analyzed 47 pregnant women who delivered in our unit between 1 January 2021 and 1 September 2023. Patients were divided into three groups: an acute renal injury (AKI) group (n=16), a chronic kidney disease (CKD) group (n=8) and a control group (n=23) which included patients with serum creatinine levels between 0.80-1 mg/dL. We evaluated the maternal and fetal complications in all three groups, taking into consideration the comparison between maternal and fetal parameters in women with UTI.

Results: Our study highlighted an important difference between fetal weight at delivery by patients with AKI associating UTI and the two remaining groups (1395 ± 992.50 grams compared to 2340 grams in the CKD group and 3103.33±83.86 grams in the control group, respectively). There was no statistically significant difference regarding preterm birth, intrauterine grow restriction, stillbirth or neonatal intensive care unit (NICU) admission. Preterm birth had a higher incidence in all patients with AKI (87.5% compared to 50% and 34.78%, respectively).

Conclusion: Neonatal complications are important in pregnant women with AKI and CKD, irrespective of the UTI diagnosis. Most fetal complications occurred in patients diagnosed with AKI. The correlations highlighted by us should be studied further.

Aim: This placebo-controlled and randomized pilot study aimed to assess the feasibility and impact of tofacitinib/remdesivir combination therapy compared to remdesivir alone on clinical and laboratory findings of severely ill COVID-19 patients for future large-scale studies.

Method: Fifty patients were included in this study. They were randomly allocated into two groups of 25 subjects each. Patients in the treatment group received a five-day course of tofacitinib (10 mg twice daily) in addition to a five-day course of remdesivir, whereas the control group received a 10-day course of remdesivir with a placebo.

Results: There was no significant difference in rates of need for intubation (oxygen saturation level), intensive care unit (ICU) admission, death and length of hospitalization between the two groups (P>0.05). Nevertheless, the PRIEST severity score was significantly reduced in the treatment group compared to the control group (P=0.03, effect size [95% CI]: -0.616 [0.0233-1.1723]). Moreover, the mean level of C-reactive protein after 10 days was significantly decreased in the treatment group but increased in the control group (P=0.006).

Conclusion: Tofacitinib adopted in this pilot study modulate the inflammation and reduce the PRIEST score in severe COVID-19 patients. So, it is feasible and could be applied in future larger-scale trials to precisely determine its effects on coronavirus infections.

Introduction: Women, and mainly pregnant ones, have been always highly vulnerable to domestic violence/intimate partner violence (DV/IPV) throughout their lives. Covid-19 pandemic brought new unprecedented living conditions that raised the rates of DV during pregnancy. Investigating the association between Covid-19 and DV in pregnant women may help government and community groups seeking to reduce DV/IPV in vulnerable populations in order to better understand the prevalence of this phenomenon and its associated factors and thus find ways to ensure control and stop domestic violence, as the society and health care systems are still disorganized in the way they deal with the DV against pregnant women.

Aim: The aim of this study is to investigate the state of DV in pregnant women during the Covid-19 pandemic and to present the incidence rates of domestic violence as well as the possible consequences that can occur for both women and newborns, while also highlighting risk factors connected to Covid-19 that increase DV and attempting to see if there is a way to prevent and address DV through a systematic review of the available literature.

Methods: We searched Google Scholar, Medline and PubMed for relevant articles published between 2019-2023. Out of the total number of 772 returned articles, only 25 were included in the present review after excluding all those which failed to meet one of the critical criteria.

Results: We identified four themes linked to DV during pregnancy in the pandemic era, including the incidence of negative consequences for mother and fetus, Covid-19-associated factors, interventions and solutions. Also, prevalence of DV was found to be higher than before the pandemic. DV/IPV was linked to Covid-19 factors such as lockdown and quarantine, causing spouses to spend more time together, economic strains from loss of incomes and reduced incomes, unintended pregnancies and limited access to healthcare services for antenatal and prenatal clinics and support. The adverse effects of DV/IPV on pregnant women and the fetus include miscarriages, still births, abortions, early fetal loss, maternal anxiety and depression as well as poor development of the child after birth, among others. Critical interventions to manage DV/IPV during the pandemic include, to name just a few, better screening systems during the pandemic, public awareness, maintenance of support and healthcare systems and connections.

Conclusions: Covid-19 created circumstances and measures that increased the risk and incidence of DV/IPV in pregnant women, which led to a higher prevalence of the phenomenon. Sustainable systems can help reduce DV/IPV against women and, in particular women at-risk, such as pregnant ones. Therefore, some interventions, including screening mechanisms and public awareness, healthcare support and interconnections, need to be maintained an

Background: Severe burns pose significant therapeutic challenges due to their complex pathophysiology, the potential for life-threatening complications, long-term sequelae and the need for a multidisciplinary approach. In this retrospective study, we aimed to comprehensively analyze burns involving over 50% of the total body surface area (TBSA) treated in our institution over six years.

Materials and methods: We performed a retrospective study including 91 patients. The following epidemiological and clinical characteristics were documented: age, sex, comorbidities, admission modality, mechanism of injury, TBSA burned, burn depth, presence of inhalation injury, outcome, length of stay and associated costs.

Results: In the study group, subjects had a mean age of 54.4 years (24-93), with a male-to-female ratio of 2.5:1. The median percentage of TBSA burned was 70% (50-99%) and 93.4% of patients had third-degree burns. Inhalation injury was present in 71.4% of patients. Flame burns occurred in 90.1% of patients. Prediction scores were assessed, with 60.4% of patients having an ABSI score above 12. Mortality in our study group was 84.61% and 39.5% of patients died in the first week after burn injury. The most frequent systemic complications were respiratory complications (95.6%), followed by cardiocirculatory (93.4%), metabolic (84.6%), hematological (74.7%), renal (64.8%), hepatic (59.3%) and infectious complications (38.4%).

Conclusions: Managing major burns is a highly complex process, which requires specialized care and infrastructure to improve outcomes. Extensive burns, especially over 50% TBSA, have high morbidity and mortality, with factors like age, severity and inhalation injury affecting prognosis. A multidisciplinary approach is essential for treatment, addressing not only the burns but also systemic complications to prevent multiple organ dysfunction syndrome and death.

Background and purpose: PECs blocks are usually combined for breast surgery under general anesthesia (GA) to provide postoperative analgesia rather than primary anesthesia technique.

Material and methods: A prospective, interventional, single-center, double-blind, randomized, parallel-group, active-controlled, Helsinki protocol-compliant clinical study was conducted in a tertiary care teaching center after obtaining the Ethics Committee's approval and patients' written informed consent. Forty-eight American Society of Anesthesiologists physical status I/II patients aged 18-60 years, undergoing elective unilateral breast surgery were enrolled. Patients were block-randomized (computer-generated) to two equal groups (24 patients each), with one of them receiving Dexmedetomidine and the other one Ketamine. For concealment, sequentially numbered, sealed, opaque envelopes were used. The study was double-blinded for both the anesthesiologist and outcome assessor anesthesiologist. Obese patients (body mass index > 30), those with infection at block site, coagulopathy and known hypersensitivity to local anesthetics or study medications as well as individuals who refused participation in research were all excluded. The Dexmedetomidine group received a bolus of 0.5 mcg/kg over ten minutes, followed by an infusion of 0.3 mcg/kg/hour, while the Ketamine group received a bolus of 0.5 mg/kg over ten minutes, followed by an infusion of 0.3 mg/kg/hour. Postoperative analgesia was compared using a visual analogue scale (VAS) at regular intervals. When VAS exceeded four, 1 mg/kg intravenous Pethidine was administered as a rescue analgesic.

Results: Sub-anesthetic low-dose Ketamine was more effective than low-dose Dexmedetomidine in prolonging PECs block analgesia, which was statistically significant (p value < 0.001). The Ketamine group had lower rescue analgesic Pethidine consumption and longer first-rescue analgesia demand time. There was no significant hemodynamic difference between the study groups.

Conclusion: Ketamine was more efficient than Dexmedetomidine for postoperative analgesia.

Gastrointestinal cancer represents one of the most encountered oncologic pathologies and research studies are performed thoroughly in order to identify the exact causes and possible novel therapies. Obesity is a complex manifestation associated with numerous physiological and primarily molecular changes capable of tackling the behavior of tumoral cells and the nearby or faraway microenvironment. Adipose tissue has been once considered to have limited physiological roles, but in recent years it has been recognized as an active endocrine organ, secreting substances such as growth factors and adipokines. From an epidemiological perspective, obesity - particularly morbid obesity - is linked to an unfavorable progression of cancer. A key mechanism that may elucidate the association between obesity and cancer involves the insulin and insulin-like growth factor (IGF-1) pathway, sex hormones, and adipokines.

Introduction: Being associated with a systemic infection, SARS-CoV-2 affects multiple organs, including the placenta. SARS-CoV-2 placentitis is a new condition that shows the destructive effects of fibrin deposition in the perivillous area, chronic histiocytic intervillositis and trophoblast necrosis after the placenta is infected with SARS-CoV-2. Until now, there have been no published reports regarding the ultrasound signs of massive perivillous fibrin deposition and the recommended monitoring for these cases.

Aim: Our aim was to analyze the sonographic appearance of the placenta in a series of SARS-CoV-2 infected pregnant women during their third trimester.

Material and method: In all cases included in the present study, we performed serial obstetrical ultrasounds every seven days until delivery, followed by histopathological examination of the placenta postpartum.

Results: In women with intrauterine growth restriction (IUGR), sonographic images of the placentas revealed that they matured faster within three weeks of receiving a COVID-19 diagnosis and reached a more rapid senescence. In all cases, there was a gradual increase in placental calcification from week to week, but only in pregnant women with a grade 3 placenta at the moment of inclusion in the study the deterioration was severe, leading to placental insufficiency and subsequently to IUGR.

Conclusion: The cases who had an increased placental degree at the time of infection were associated with abnormally rapid placental aging. These aspects can be evaluated sonographically.