Current health sciences journal最新文献

Non-small cell lung carcinomas (NSCLC) are common lung tumors with numerous growth patterns associated with lesion types, which are frequently diagnosed late and are associated with a reserved prognosis. In this study, we analyzed histopathologically and statistically 52 cases of NSCLC, for which the growth types/patterns were described and compared with tumor grade, the presence of vessels invasion and stage of tumor. We observed the predominance of adenocarcinomas (ADK) and acinar, cribriform, solid and papillary growth patterns, frequent mixed transitional areas, while for squamous cell carcinomas (SCC) the non-keratinized aspect was dominant. Vascular invasion was identified in 38.5% of cases, most NSCLC being in advanced stages, respectively 57.7%. ADK with cribriform, solid, and micropapillary patterns, as well as nonkeratinized SCC (NKSCC) and large cell carcinoma (LCC) were significantly associated with high grade, vessels invasion, and advanced stage of tumos. Transitional areas of ADK and focal keratinizations in SCC suggest the presence of specific lung tumor histological lesions, which in evolution acquire aggressive patterns.

Pulp capping is a vital pulp therapy that aims to prolong the life of a tooth by protecting it after pulp exposure occurred. Pulp capping biomaterials are intended to induce odontoblasts to deposit a natural tertiary dentin barrier to protect the pulp-dentin complex. Two pulp capping agents with calcium silicates in their composition, but with different mechanisms of the setting reaction were tested in vivo with the main objective of comparing their effect on the pulp-dentin complex. The specific aim was to evaluate the preservation of pulp vitality following in vivo direct and indirect pulp capping on eight human third molars. TheraCal LC, a light-cured calcium silicate-based material, was tested both by direct and indirect pulp capping, while the mineral trioxide aggregate (MTA) cement was tested by direct pulp capping. The molars were assessed by micro-computed tomography (micro-CT) and by light microscopy and stereo-microscopy following histological processing of the teeth. Dental pulp vitality testing was performed before tooth extraction. Inflammatory pulp status was performed on light microscopy images and it was investigated the presence of inflammatory infiltrate, edema, vascular congestion and pulp necrosis. Following pulp capping, the MTA cement showed more favorable results, generating the formation of complete or incomplete dentin bridges in all treated teeth, while TheraCal LC induced the formation of dentin bridges in only two teeth. Tooth vitality was preserved in all tested teeth. In conclusion, both materials stimulated neodentinogenesis, with the MTA cement being more effective and presenting a much more favorable biological pulpal response.

Introduction: Lung cancer represents a major health issue of the modern world, accounting for both most new cases and highest mortality rates worldwide. Early diagnosis and treatment remain essential in managing the disease; therefore, developing novel computer-assisted tools for processing large quantities of imaging data can prove indispensable. Our aim was to develop a novel convoluted neural network (CNN) to classify lung computed tomography (CT) images of suspect nodules.

Materials and methods: After obtaining ethical clearance, we included consenting patients with a lung mass found on a chest radiography, visible lung tumor on computer tomography and positive pathology or follow-up. After data augmentation, we trained a deep learning model to classify input images into two classes, malignant or benign. We evaluated the model by calculating accuracy, recall and precision.

Results: We successfully enrolled 176 patients from a total of 192 cases. Most were male (135 cases, accounting for 76.7%) and came from urban areas (111 cases, 63%). Most tumors were found on the right lung (103 cases). The model performed well on an imbalanced dataset, with recall values at 79.31%, while precision reached 62.16%, a training accuracy of 76.34% and a validation accuracy of 77.01%.

Conclusions: We proved that a CNN model can easily be implemented on regular hardware to successfully classify malignant and benign lung lesions on CT images. Future CNN implementations can greatly improve the imaging diagnosis of lung lesions; however, the physicians should always decide the medical management.

A 68-year-old female with a history of small cell carcinoma of the lung and peptic ulcer disease presented for evaluation of dysphagia after undergoing radiation and chemotherapy. Esophagogastroduodenoscopy (EGD) revealed a radiation-induced esophageal stricture and incidentally a "double pylorus (DP)" with an adjacent similar opening cephalad to the pylorus. There was no evidence of perforation or traumatic injury leading to this finding and upon intubation, both openings led to the duodenal bulb that appeared to be normal. No endoscopic and surgical intervention was offered as patient was asymptomatic.

Introduction: Lung cancer is the most common type of primary tumor in both males and females, accounting for significant mortality worldwide. Clear evidence regarding comorbidities and aggravating factors exist, with multiple pathways being cited in recent literature.

Patients and methods: Our aim was to review relevant sources and demonstrate through an original statistical study that tumor type, location, comorbidities, as well as demographic factors, may play a limited role in the evolution of lung adenocarcinoma. After obtaining ethical clearance, we enrolled consenting lung cancer patients in an observational cross-sectional study, collecting relevant demographic and medical information. Patients were recruited from a single tertiary medical center in Craiova, Romania, between January 2021 and January 2025. We used the Anova and the chi-square tests, considering p values below 0.05 as statistically significant.

Results: We enrolled 189 patients (143 males, 75.6% of the entire lot), from urban and rural settings (49.7% from urban areas). The mean age was 64.94±10.47 years, with minimal variance when accounting for gender or provenance (Anova test, p>0.05). Most tumors were located in the upper portions of the lungs, with 111 cases, 53.44%. We found that 55.24% of males had tumors of the right lung, while only 39.13% of females had this location. Men had higher COPD rates (79 cases, 55.24%) and only two females (4.34%), p<0.05. However, we found statistically significant more women smokers than men (82.6% women vs. 41.25% of men).

Conclusion: We hereby demonstrated that lung cancer remains a significant medical burden for the medical system, with prevalence in both sexes, irrespective of provenance. Most cases were diagnosed between 40 and 65 years, smoking and toxic exposure being predominant.

Temporary loop ileostomies are common after colorectal cancer surgery to reduce anastomotic leak severity. However, ileostomy takedown carries risks like surgical site infections (SSIs) and incisional hernias. The optimal fascial closure technique during takedown remains debated. This study compared these techniques regarding postoperative complications. This retrospective study analyzed data from 69 patients undergoing scheduled loop ileostomy closure between 2016-2020 at two Romanian surgical departments. Data collected included demographics, clinical variables (ASA score, comorbidities), surgical details (suture type, closure time, skin closure type), and follow-up data including CT assessments for hernia detection. The cohort included 69 patients (mean age 63, 64% male). Fascial closure was used in 17 (24.7%) and interrupted in 52 (75.4%) patients. Running sutures were significantly faster (mean 19 vs. 22 min, p=0.028). Overall SSI rate was 21.7%. Ileostomy site incisional hernias occurred in 13 patients (18.6%) after a mean follow-up of 30.7 months. No statistically significant difference in hernia rates was found between running (3/17) and interrupted (10/52) suture groups (p=1). Significant risk factors for hernia development included longer follow-up (OR=0.87, p=.025), BMI≥30 (OR=176, p=.009), and Clavien-Dindo grade 3 postoperative complications (OR=112, p=.033). While running sutures offer faster fascial closure, this study found no significant difference in ileostomy site incisional hernia rates between running and interrupted techniques. Patient factors like BMI ≥30 and severe postoperative complications are significant predictors of hernia formation. Careful technique is crucial, but primary closure without mesh remains standard.

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system that leads to neurodegeneration and functional disability. Because recent advances in retinal imaging have revealed that the retina is a non-invasive window into the brain, offering valuable biomarkers for MS diagnosis and progression tracking, we explored the integration of artificial intelligence (AI), particularly deep learning (DL), in the analysis of fundus-based imaging techniques such as Optical Coherence Tomography (OCT), fundus photography, and Scanning Laser Ophthalmoscopy (SLO). These investigations allow for the detection of subtle retinal changes, such as thinning of the retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL), which are closely associated with MS pathology with the help of AI-driven models, including convolutional neural networks (CNNs), generative adversarial networks (GANs), and explainable AI approaches and they have demonstrated high accuracy in classifying MS patients, even at early stages, and predicting disease severity. The review also discusses the challenges and future directions of applying AI in ophthalmic diagnostics, including data standardization, model interpretability, and clinical integration. Overall, AI-enhanced retinal imaging is emerging as a powerful, non-invasive tool that can complement traditional neurological assessments and support earlier, more personalized MS care.

Introduction: The correlation between nonalcoholic fatty liver disease (NAFLD) and depression has already been established, but the relation between the two is insufficiently studied. Various murine models have proven effective in evaluating the mechanisms involved in these pathologies.

Material and methods: In this study we aimed to assess how the chronic unpredictable mild stress (CUMS) protocol impacts the behavior of mice with liver damage induced by a methionine choline deficient (MCD) diet, and also to evaluate the changes in microglial morphology in the cortex of animals with depressive-like behavior and liver injury. Thus, the cortical region was analyzed using confocal microscopy.

Results: Sucrose preference test and open field test revealed induced anhedonia and anxiety-like behavior, but short-term memory was not impaired, as assessed by novel object recognition test. Administration of the MCD diet led to an increase in total branch length and the number of terminal branches, revealing a hyperactivated microglia. The CUMS protocol in combination with MCD diet induced a reduced branching complexity, with fewer tertiary and terminal branches.

Conclusion: Our study highlights the importance of microglial morphology at the cortical level in coexisting depression and liver injury.

Non-small cell lung carcinomas (NSCLC) are the most common histological forms of lung cancer, lesions that by their incidence and associated mortality constitute a health problem worldwide. Alteration of the expression of claudins with a role in the stability of cell adhesion constitutes one of the complex biomolecular mechanisms involved in tumor initiation and progression. In this study, Claudin-4 immunoexpression was investigated in 52 cases of NSCLC in relation to epidemiological and histopathological prognostic parameters of the lesions. Although the staining scores were higher in patients in younger age groups, in women, in smokers and in squamous cell carcinomas (SCC) and large cell carcinoma (LLC) compared to adenocarcinomas (ADK), the aspects were not statistically significant. We found significantly higher differences in micropapillary, cribriform and solid ADK compared to other histological subtypes, in well and poorly differentiated lesions (G1/G3), with vascular invasion and in advanced tumor stages. Reaction analysis indicated translocation of Claudin-4 signals from the membrane level to the cytoplasm and nucleus in aggressive histological subtypes. The study indicated differences in Claudin-4 expression, which can be used to identify aggressive NSCLC and to stratify patients for specific therapy.

Aim of the study: analysis of dental wear variation in subjects with cardiovascular diseases (CVDs), compared to subjects without systemic diseases (SDs).

Method: the study included 84 hospitalized subjects with CVDs and 84 without SDs subjects, who presented to the Dental Emergency Department of the Emergency Clinical Hospital in Drobeta Turnu Severin. The subjects' data were processed descriptively, by analysis of variance and simple and multiple linear regression.

Results: Subjects with CVDs had a mean age±SD:69.49±10.09, and subjects without SDs had a mean age±SD:58.98±5.61. In subjects with CVDs, out of 504 sextants, 360 (174 maxillary and 186 mandibular) were included in the dental wear assessment, and in subjects without SDs, out of 504 sextants, 480 (242 maxillary and 238 mandibular) were evaluated. The number of remaining teeth (NRT) ranged between 2 and 25 (mean±SD 15.54±5.43) for subjects with CVDs, and between 16 and 27 (mean±SD 22.64±2.47) for subjects without SDs. Analysis of variance of the wear score values assigned to the indicated the highest value F (2, 249) =71.09768707, with F (2, 249)> F crit. (3.032064916) for mandibular sextants in the CVDs subjects. Regression models adjusted independently with gender, age, residence and NRT, revealed a coefficient with values between 11.97%-28.72% for CVDs subjects and between 11.90%-20.88% for subjects without SDs.

Conclusion: dental wear varied for both categories of subjects in the mandibular arch, compared to the maxillary arch, in their frontal area, compared to the lateral areas, depending on age, residence and NRT.