Current health sciences journal最新文献

The premise of this paper starts from the fact that a more precise definition related to the intensity of the lesions on the ADC sequence can lead to a new subclassification of PI-RADS 3 lesions in the transitional zone and to an improvement of the specificity of the PI-RADS classification. The study was retrospective and included only patients who, based on prostate MRI examinations, contained exclusively PI-RADS 3 lesions, without other PI-RADS 4 or 5 lesions. The number of cases that meet all these conditions was reduced to 18, where a series of characteristics were noted for each one: PI-RADS 3 lesion area on the ADC sequence, the minimum and average ADC value of the lesion, the average ADC value of the transitional zone outside the lesion, PSA, prostatic volume, PSA density and biopsy result. The average ADC value of the negative lesions was 865(165) m2/sec, and of the positive ones was 869(118) m2/sec, which denies the hypothesis that there could be a value limit ADC to delimit PI-RADS 3 from PI-RADS 2 or 4 in this sample of patients. Furthermore, we reported the average ADC value of each such lesion to the adjacent unchanged transitional zone and obtained a greater difference of 432(163) m2/sec between the negative lesions and their adjacent transitional zone, compared to the difference of 399(127) m2/sec between the positive lesions and their adjacent ones.

Adenoid cystic carcinoma (ACC) is an uncommon malignant tumor that accounts for less than 5% of head and neck cancers. ACC is characteristic for its indolent nature and its propensity for late distant metastases. Late diagnosis, tendency to perineural invasion, periosteal infiltration and local recurrence are factors of poor prognosis. Although studies still discuss the ideal treatment, the initial therapy consists of surgical resection, followed by postoperative radiotherapy.

Decompressive craniectomy has been increasingly used in recent decades for the treatment of uncontrollable intracranial hypertension caused by trauma, malignant strokes, cerebral venous thrombosis, among others. Sinking flap syndrome (SFS) is a rare complication characterized by neurological deterioration after craniectomy. Here, we report the case of a 73-year-old female patient who presented with disorientation, lip rhyme deviation to the right and left hemiparesis after cardiac catheterization. In view of the presence of a malignant stroke, as well as the willingness of the family members to make a total investment to save the patient's life, decompressive hemicraniectomy was indicated. Subsequently, due to occasional headache attacks, nausea and vomiting, in addition to progressive depression of the subcutaneous flap, the possibility of SFS was suggested and cranioplasty was indicated, which occurred without perioperative intercurrences. Although the patient maintained a stable neurological status, a post-surgical computed tomography (CT) scan of the head showed a right intraparenchymal hemorrhagic lesion, associated with parenchymal expansion and midline deviation. To the best of our knowledge, intraparenchymal hemorrhages are not common complications after performing cranioplasty, and additional studies are needed to understand the reasons why this occurs. The mechanisms responsible for this type of injury are not well understood, but involve reperfusion damage and loss of brain compliance. Despite representing an uncommon complication, post-cranioplasty hemorrhage can cause severe morbidity to the patient, and early diagnosis and intervention are of great importance in these cases.

Since stroke has limited treatment options, an active search for new therapeutic approaches is required. Initial excitement of using cell-based therapies to stimulate recovery processes in the ischemic brain turned into a more measured perspective, acknowledging obstacles related to the unfavorable environments associated in part with aging. Given the predominance of stroke in older populations, evaluating the effectiveness of cell therapies in aged brain environments is essential and clinically relevant. Despite a common perception of the aged brain being resistant to regeneration, recent research with neural precursor cells and bone marrow-derived mesenchymal stem cells indicates that cell-based therapy can promote plasticity and remodeling in the aged rat brain. However, significant differences in the aged brain compared to the young brain, such as expedited progression of ischemic injury to brain infarction, decreased rate of endogenous neurogenesis, and delayed onset of neurological recovery, must be noted. The effectiveness of cell-based therapies may further be connected to age-related comorbidities such as diabetes or hyperlipidemia, potentially leading to maladaptive or impaired brain remodeling. These age-related factors need careful consideration in the clinical application of restorative therapies for stroke.

Melanoma, a deadly form of skin cancer, poses significant challenges to the host immune system, allowing tumor cells to evade immune surveillance and persist. This complex interplay between melanoma and the immune system involves a multitude of mechanisms that impair immune recognition and promote tumor progression. This review summarizes the intricate strategies employed by melanoma cells to evade the immune response, including defective immune recognition, immune checkpoint activation, and the role of regulatory T-cells, myeloid-derived suppressor cells, and exosomes in suppressing anti-tumor immunity. Additionally, we discuss potential therapeutic targets aimed at reversing immune evasion in melanoma, highlighting the importance of understanding these mechanisms for developing more effective immunotherapies. Improved insights into the interactions between melanoma and the immune system will aid in the development of novel treatment strategies to enhance anti-tumor immune responses and improve patient outcomes.

Gastric cancer (GC) is the fourth most common cause of cancer death worldwide, with about 769,000 deaths/year worldwide. Recent studies showed a continuous decrease in the incidence and mortality of gastric cancer mainly in developed countries, while the incidence remains increased in some countries in Eastern Asia and Eastern Europe. For the assessment of some parameters of gastric cancer in Gorj county, all the medical records of patients diagnosed with gastric cancer, found in the Archive of the County Emergency Hospital of Tg Jiu, were analyzed, namely the admission records within the Surgery and Oncology departments, the observation sheets of every individual patient, the biological test reports, the histopathological records of the patients with gastric cancer undergoing surgery, the histopathological records of gastric biopsies, the medical imaging records (ultrasound, x-ray, computer tomography and magnetic resonance). The analysis of the medical records showed that the disease mainly affects men, the ratio of men/women being 2/1-3/1. Most cases undergoing surgery within the County Hospital of Tg. Jiu were diagnosed in stages III or IV. The most numerous cases (over 85% of the total group of patients) were identified in people over 61 years old. The most common histopathological form of cancer was adenocarcinoma (95% of all gastric tumors).

Nosebleed or epistaxis is one of the most common forms of presenting an emergency in the ENT field. Since March 11, 2020, the World Health Organisation has proclaimed COVID-19 a global pandemic, and the world has been closed down. The main objective of the study is to analyse and compare the dynamics of epistaxis aetiology among the cases that required hospitalisation in the pre-pandemic period and the period of the COVID 19 pandemic. The study is multicenter retrospective from October 2018 to May 2022, including 380 cases of hospitalised epistaxis, with the mention that March 2020 is considered the beginning of the pandemic period. 60.8% of the patients enrolled in the study in the pre-pandemic period (60.8%) and 39.2% in the pandemic period. Differences between groups were not statistically significant between study entries (pre-pandemic vs. pandemic) and age (p=0.331), gender (p=0.916) or existence of local causes for epistaxis (p=0.895). Patients with general causes for epistaxis were more frequently enrolled in the pandemic period, while patients without general causes for epistaxis were more frequently enrolled in the pre-pandemic period. Patients with a hospitalisation period of more than 5 days were more frequently enrolled in the pre-pandemic period while patients with a hospitalisation period of 3 to 5 days were more frequently enrolled in the pandemic period. Also, patients with idiopathic epistaxis were more frequently enrolled in the pre-pandemic period. Based on the results presented in our study, the period of the Covid 19 pandemic directly influenced both the number of patients and the period of hospitalisation.

In this study, the antimicrobial activity of three Salvia spp. (S. glutinosa, S. splendens, S. verticillata) extracts prepared with different solvents was assessed using the diffusion method and the quantification of the minimum inhibitory concentration for each extract on S. aureus, E. coli and C. albicans standard strains. The results showed that the extracts of the three Salvia spp. are suppressing the growth of the bacteria tested with variable potency. Among the different solvent extracts, n-butanolic extracts of all the three species of Salvia spp. revealed the most important antibacterial activity against S. aureus and E. coli. S. splendens extracts proved to be the most efficient on C. albicans regardless of the solvent used.

Increasing the biocompatibility of some biological implants through tissue engineering is important for regenerative medicine, which recently has a rapid development dynamic. In this study we used tree different washing protocols, respectively with Sodium Lauryl Sulfate (SLS), with Sodium Deoxycholate (SD), and with saline (Sa) to achieve partial decellularization of 2-3mm thick cross-sections through Wistar rat hearts. Pieces of the heart tissue were either histologically analyzed to evaluate the decellularization processes or implanted for 5 days on 9-day-old chick embryo chorioallantoic membrane (CAM) and then histologically analyzed to evaluate CAM-implant interactions. Histological analysis of SLS or SD washed tissues showed different microscopic features of the decellularization processes, SLS-washing leading to the formation of a completely decellularized ECM layer at the periphery of the heart tissue. Both detergents induced changes in the spatial arrangement of collagen fibers of the heart tissue. Histological analysis of the CAM implants shoved that the peripheral zone with complete decellularization induced by SLS increased the biocompatibility of heart tissue implants by favoring neovascularization and cell migration. These results suggested that the biocompatibility of the heart tissue implant can be modulated by the appropriate use of a SLS-based decellularization protocol.

Enchondromas are benign tumors located primarily in long bones, some of which can be accidentally discovered during imaging exams conducted for other pathologies. These benign cartilaginous tumors are hard to differentiate from low grade chondrosarcomas, which require periodic follow ups. The purpose of this study was to identify the incidence of enchondromas in pediatric patients, to determine medical imaging criteria (Computed Tomography-CT and Magnetic Resonance Imaging-MRI) in order to differentiate enchondromas from other atypical cartilaginous tumors, and to identify a potential correlation between imaging aspects and clinical signs. The aim of this study was to review imaging findings of enchondromas in children.