The accurate grading of cutaneous squamous cell carcinoma (cSCC) is crucial for effective treatment and patient care, but the current method, relying on pathologist visual assessment, can be subjective.

The study presents a novel approach to bone regeneration using bioactive nanocomposites. The research focuses on creating hydroxyapatite (HAp) and zinc oxide (ZnO) nanocomposites functionalized with rosemary and thyme essential oils (EOs) to enhance osteogenic and antimicrobial properties. The findings reveal that the incorporation of EOs not only improves biocompatibility by reducing Zn-induced cytotoxicity but also enhances antimicrobial activity, particularly against Gram-negative and Gram-positive bacteria. Additionally, thyme EO exhibits a more potent effect in enhancing cell viability and antibacterial efficacy compared to rosemary EO. Structural analyses through X-ray diffraction (XRD), scanning electron microscopy (SEM), and Fourier-transform infrared (FT-IR) spectroscopy confirm the successful synthesis of well-integrated HAp-ZnO structures with the EOs. This study offers promising insights into the potential of functionalized nanocomposites for biomedical applications, especially in bone regeneration and infection prevention.

Cervical intraepithelial neoplasia 2 (CIN2) evolution is controversial, and some of them regress spontaneously in a two-year follow-up. The purpose of this work was to evaluate the percentage of CIN2 progression or persistence during a 24-month follow-up, using clinical predictors such as human papillomavirus (HPV) genotype and cytology results.

Orthopedic screws are subjected to high mechanical stress, corrosive environment, and microbial colonization, which may cumulatively lead to implant failure and periprosthetic joint infections. To overcome these issues, this study has focused on modifying the surface chemistry and topography of screws utilized in knee intervention toward enhancing their mechanical and biological behaviors. Specifically, this study has explored the optimization of composite coatings made of polycaprolactone (PCL), graphene oxide (GO), and Meropenem (MRP) via the matrix-assisted pulsed laser evaporation (MAPLE) technique. The PCL∕GO∕MRP coatings aimed to upgrade the surfaces of the implantable fixation devices, offering superior antimicrobial properties, reduced biofilm formation, and better mechanical characteristics. Comprehensive physicochemical analyses, including Fourier-transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), and Raman microscopy, confirmed uniform deposition, efficient material transfer, and preservation of functional groups. The developed coatings displayed significant antibacterial activity against Staphylococcus aureus and Escherichia coli, with a marked reduction in biofilm formation compared to uncoated surfaces. Thus, this work highlights the potential of the designed PCL∕GO∕MRP coatings as a strategy to enhance the biocompatibility and longevity of orthopedic screws, minimize complications related to implant-associated infections in knee surgeries, and ultimately improve post-surgical outcomes to increase patients' quality of life.

Eosinophilic fasciitis (EF) remains a diagnostic challenge due to its rarity and resemblance to scleroderma. This case report aims to provide a cohesive exploration of EF's clinical nuances, emphasizing the importance of accurate diagnosis and effective management. A 52-year-old male developed bilateral forearm and calf hardening, along with erythema, pruritus, and pain four months prior to the presentation in our Clinic. The symptoms initially debuted bilaterally in the forearms and progressed to involve the calves, distal arms, and thighs. Clinical examination revealed symmetrical plaques on forearms and calves, featuring erythematous, hyper, and hypopigmented elements extending proximally, a positive "groove sign" and a moderate difficulty in knee joint flexion. Despite these findings, the patient was generally in good condition, without any other notable clinical signs. Initial laboratory findings showed slightly increased percentual eosinophil levels, elevated C-reactive protein (CRP), normal erythrocyte sedimentation rate (ESR), and negative antinuclear and scleroderma specific antibodies. Magnetic resonance imaging (MRI) demonstrated enhanced fascial signal and thickening while the fascia-muscle biopsy revealed marked edema and inflammatory lymphoplasmacytic infiltrate, consistent with the diagnosis of EF. The patient showed a favorable response to systemic corticosteroids. EF predominantly affects males aged 30 to 60 and is characterized by a sudden onset and unclear etiological factors. Differential diagnosis requires careful exclusion of scleroderma and other mimicking conditions. Diagnostic modalities such as skin-muscle biopsy and MRI reveal characteristic findings like inflammatory infiltrate and fascial thickening. Accurate diagnosis and differentiation from scleroderma are crucial, with early intervention involving glucocorticoids and immunosuppressive agents improving long-term outcomes.

During the coronavirus disease 2019 (COVID-19) pandemic, the infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presented quite a diverse symptomatology, in addition to respiratory symptoms, while other clinical signs such as thrombosis, postoperative hemorrhages, acute kidney or liver failure, digestive disorders (vomiting and diarrheal stools) were also reported. We present the case of a patient diagnosed with transverse colon neoplasm and asymptomatic SARS-CoV-2 infection, who presented to the Emergency Room (ER) of the Emergency County Clinical Hospital, Craiova, Romania, with a clinical picture of low intestinal occlusion. Surgery was decided and a right hemicolectomy extended to the left, with terminal ileostomy performed. The postoperative evolution was favorable, with the resumption of intestinal transit and discharge on the third postoperative day. The patient returned to the ER Department on the fifth day after surgery, with diffuse abdominal pain, absence of intestinal transit and flatulence. Clinical examination of the abdomen revealed the presence of bloating sounds on palpation. Emergency laparotomy was again performed with the suspicion of postoperative occlusion and five perforations were found in the small bowel, associated with fecaloid peritonitis and mechanic-inflammatory occlusion. The perforations were without any obvious lesion substrate, four of them being located on the jejunum and one on the terminal ileum. The histopathological examination revealed hemorrhage and recent transmural thrombosis on the intestinal wall, most likely caused by COVID-19. Without any respiratory symptoms, the COVID-19 infection caused multiple intestinal lesions, leading to peritonitis and septic shock, followed by the patient's death.

Metastases are the most common tumors of the spine. As an important increase in the annual incidence of spinal metastases (SMs) has been observed in the last decade, the aim of this study was to describe the epidemiology and histopathological types of SMs surgically treated in the Neurosurgery Clinics of a Regional Hospital in North-Eastern Romania over a period of five years, in order to define a certain tumor profile that would benefit from an early screening. We retrospectively evaluated 115 adult patients, searching for demographic data (gender and age of the patients), primary tumor characteristics (location and histological type), topography of the SMs, and the time interval between the diagnosis of the primary tumor and the surgery for the SMs. The patients were elderly (average age: 58.96 years), with a male predominance (67.82%). Main location of SMs was in thoracic region (44.34%), with multiple vertebral metastases in 30.43% of patients. Only 33.04% of the patients had a known cancer at the time of admission. Primary tumor was located mainly in lung (47.82%), gastrointestinal tract (15.65%), breast (11.30%), prostate (10.43%) and kidney (9.56%). SMs from lung cancer (LC) mostly expressed squamous cell carcinoma (19.13%), probably due to patients' smoking habits, and those from the digestive system mostly exhibited a moderately/poor colorectal adenocarcinoma (8.69%). Our data suggest the need for close surveillance of patients diagnosed with LC and colorectal cancer because these malignancies most frequently develop SMs. Smoking prevention actions and screening programs for the detection and removal of precancerous colorectal lesions must be developed and expanded.

Collected, primary resources enabled us to extract data that are scarcely present in medical literature of the two Breslauer morphologists of both the human body and - metaphorically - the society: Wilhelm Ebstein (1836-1912) and Sigismund Asch (1825-1901), particularly the latter, who described morphology of melanosis in his doctoral dissertation in 1846, to switch on reshaping social morphology of Wrocław (Breslau) in Virchow-like manner. In contrast to the main perspective of Ebstein's anomaly that has been finely described in past biographical papers, a primary aspect of infectious diseases is highlighted here in Ebstein's heritage. In 1869, his habilitation on recurrent typhus provided professional support for Asch. As Ebstein cared for the poor in shelters of Wrocław, Asch admitted poor patients from early morning hours to gain such a great esteem to be elected alderman. Asch's mentality corresponded to Ferdinand Lassalle's philosophy of the social democratic movement. In front of cholera epidemics, Asch contributed to medical control of meat, development of city canalization, establishment of green areas as well he deeply got involved in charity institutions for widows and orphans and was a model medical doctor to follow for much more famous Janusz Korczak who perished together with children from his orphanage in Nazi Concentration Camp in Treblinka. Asch was immortalized as "Doctor Klaus" in the popular play by Adolf L'Arronge and united people in progress from feudal discrimination to democracy and in fight for civil rights in industrial society to gradually replace aristocracy with meritocracy in the mainstream of development of modern society.

Green tea, derived from Camellia sinensis, contains polyphenolic active compounds that exhibit diverse pharmacological effects including anticancer, anti-inflammatory, antioxidant, and immunomodulatory properties. Employing various concentrations of green tea polyphenols (GTPs; 0, 100, 200, 300, 400, 500 μg∕mL), human normal lung epithelial cells (BEAS-2B) and non-small cell lung cancer (NSCLC) cells (A549) underwent treatment. The cell viability was assessed using the cell counting kit-8 (CCK-8) assay, proliferation was examined through the colony formation assay, apoptosis was monitored via flow cytometry, cell migration, and epithelial-mesenchymal transition (EMT)-associated proteins (E-cadherin, N-cadherin) were determined by Western blot. A549 cells were subjected to Cisplatin (0, 0.5, 1, 1.5 μM) and X-ray irradiation (0, 2, 4, 6 Gy) for treatment to probe the influence of GTPs on A549 cells in response to chemoradiotherapy. The functioning mechanism of GTPs in the context of NSCLC was validated using lithium chloride (LiCl) [a glycogen synthase kinase-3 beta (GSK-3β) inhibitor], which activates the Wnt∕β-catenin pathway. GTPs suppressed NSCLC cell viability in a concentration-dependent pattern, with a half-maximal inhibitory concentration (IC50) of 362.5 μg∕mL, while showing little impact on BEAS-2B cells' viability (at concentrations not exceeding 500 μg∕mL). Treatment with GTPs dampened colony formation of NSCLC cells, while promoting apoptosis. LiCl treatment vigorously attenuated the inhibitory impact of GTPs on the malignant phenotype of NSCLC cells. Mechanistic studies suggested that GTPs strengthened GSK-3β stability, thereby impeding the Wnt∕β-catenin pathway. Tea polyphenols (TPs) in conjunction with concurrent radiochemotherapy (CRCT) enhance the stability of GSK-3β and dampen the Wnt∕β-catenin pathway, hence exerting anticancer effects in NSCLC.

In this secondary analysis, we aimed to characterize the lymphocytes population and placental inflammation in pregnant women with moderate and severe coronavirus disease 2019 (COVID-19) forms.

The odontogenic maxillary sinus disease (endo-antral syndrome; EAS) is directly related to the spread of endodontic infections from upper premolars and molars with necrotic pulp. Cone-beam computed tomography (CBCT) images proved to be a reference diagnostic aid for detecting the etiological relationship between chronic apical periodontitis and maxillary sinusitis. There were retrospectively evaluated a total of 109 CBCT images (47 males and 62 females) from a pool of CBCT scans taken for routine diagnosis and treatment planning in consecutive 353 patients. The CBCT images were acquired with Veraviewepocs 3D P (R100) equipment (J. Morita MFG Corp., Kyoto, Japan). The scan parameters were 90 kV, 5 mA, 9.4 s exposure time, 125 μm spatial resolution and 40×40 mm field of view (FoV). The aim of this CBCT study was to find out the influence of space separating apical lesions and sinus floor on subsequent EAS. There were observed four categories of anatomical rapports, such as tangent contact, protruding contact, 1-2 mm separating interval, and over 2 mm separating interval. The highest incidence was recorded in molars for tangent contact (47.69%) and in premolars when the apical lesions were situated at 1-2 mm distance from sinus floor (7.69%). The abnormalities revealed on CBCT scans of maxillary sinus have been mucosal hyperplasia, dome-shaped opacification, periostitis, and sinus opacification with air-bubbles. A four class classification related to the anatomical distance between the chronic apical lesions and sinus floor was suggested.

Lower third molars are frequently extracted due to pathologies of the dental follicle, pericoronitis, advanced carious lesions, orthodontic reasons (risk of anterior tooth crowding) or causing periodontal or carious lesions in the distal area of the second molar. The case presented here is of a male patient that came to our Clinic experiencing pain in the distal area of one of his old bridges. The clinical examination revealed a malpositioned, but unusually functional third molar; it is a very rare situation for an initially impacted third molar to erupt in an almost horizontal position and not only to remain on the arch for a very long period of time, but also to contribute to mastication efficiency and occlusion, despite the fact that masticatory forces are distributed at a right angle on its long axis and that mastication takes place on the distal surface of the crown and root, and not on the usually occlusal cusped surface. The horizontal mandibular right third molar contributed to maintaining the vertical dimension of occlusion and the masticatory efficiency for a very long period of time; it also ensured a proper distribution of forces trough the long axis of the second premolar, since the distal contact of the third's molar crown with the second premolar helped it to resist masticatory forces and to remain on the arch, despite the prolonged absence of any mesial contact.

Angiosarcoma represents a group of rare tumors originating from vascular and lymphatic endothelial cells, characterized by marked aggressiveness, rapid growth and poor clinical outcome. The incidence of breast angiosarcoma accounts for approximately 0.05% of all malignant breast tumors and less than 1% of all sarcomas. In this article, we report the case of a 67-year-old female patient who presented to our Clinic due to a rapidly evolving, non-painful, vegetating mass, encompassing almost her entire left breast. Imaging studies revealed diffuse skin thickening in all quadrants and an intensely opaque axillary lymph node (LN). Interestingly, the patient had prior medical history of breast carcinoma treated conservatively in 2007 with limited breast resection and left axillary lymphadenectomy, followed by post-operative chemotherapy and radiotherapy. At the current presentation, we performed a radical mastectomy with ipsilateral lymphadenectomy. The histopathological examination revealed a secondary angiosarcoma with LN involvement mimicking an atypical vascular lesion. In this article, we report the clinicopathological particularities of this case and discuss the challenge of diagnosing LN involvement in angiosarcoma.

The association between different viruses and cancer is well acknowledged in human pathology. However, the precise understanding of how oncogenic viruses intervene in the development of cancer of salivary glands (SGs) remains incomplete. Our review aimed to explore the current literature regarding SGs cancer to evaluate the potential involvement of human papillomaviruses (HPVs) in their development. Our work hypothesis suggests that viruses may be involved in these tumors' immunogenicity. The literature analysis showed HPV-positive detection in different head and neck malignancies, added to variable risk factors and a constant increasing incidence rate. HPV tumorigenesis mechanism is complex, involving E6 and E7 HPV oncoproteins. Additionally, the reported findings generally support the relationship between SGs cancer and high oncogenic subtypes 16 and 18. However, the pathogenic contribution of HPV subtypes 11, 33, 45, 52, 56, and 59 is controversial and further research may clarify their potential involvement in the SG tumor's development. This literature review may enhance the understanding of the role of viral contribution as an etiopathogenic co-factor in SG carcinogenesis. Thus, these data may add value to innovative concepts and treatment strategies development, given that virus-induced tumors can be prevented by targeted immunization, added to oncolytic or viral therapy.

We studied the influence of maternal hypothyroidism on progeny skin morphogenesis by means of histological, histochemical and lectin-histochemical methods. Hypothyroid conditions in rats were achieved by daily food supplementation with antithyroid drug Mercazolil. The experiment was conducted on 10 control and 10 hypothyroid rats, which delivered 70 and 46 offsprings, respectively. We discovered that maternal hypothyroidism induces the accumulation of mast cells (MCs) in the skin of progeny on the 1st, 10th and 20th postnatal days, with decrease of these cell's count returning to control level on 40th postnatal day. These results indicate that offsprings developing under conditions of maternal hypothyroidism are a risk group for changes in immune status and the occurrence of allergic reactions. The stratum corneum of epidermis, its lipid barrier as well as pilosebaceous units, in both control and experimental group animals, at the early stages of postnatal ontogenesis are enriched with carbohydrate determinants of αDMan, βDGal, βDGal(1-3)DGalNAc, αLFuc, αDGalNAc, αDGlcNAc, Neu5Ac. Galanthus nivalis agglutinin (GNA) is a selective histochemical marker of MCs, while Lactarius torminosus fungus agglutinin (LTFA) is a selective label of Langerhans cells. Maternal hypothyroidism resulted in reduction of lectin binding with the structural components of progeny skin and its derivatives. We speculate that alterations in glycoconjugate processing and degradation sequences have an impact on the cell signaling, formation of adhesive contacts, cellular proliferation and differentiation. The lectin set we used clearly demonstrated specific labeling of cellular subpopulations, monitoring glycoconjugates processing and degradation under physiological and pathological conditions in all skin components.

The paper provides an overview of the current understanding of different cells and structures' biology [e.g., blood-retinal barrier, Bruch membrane, Clara (club) cells, brush cells and tuft cells, Merkel cells, Hofbauer cells, cytokeratins], including their origin, structure, function, and role in disease pathogenesis, and of the latest findings in the medical literature concerning the paracortex of the lymph nodes.

The incidence of renal tumors increased substantially in the past decades, being responsible for 3% of deaths caused by cancer globally. They constitute a diverse group with varying morphological, immunohistochemical, and molecular characteristics. The severity and prognosis are directly correlated with tumor stage, histopathological aspect, sarcomatoid/rhabdoid features, fat or vascular invasion.

In this comprehensive case report, we examine a 29-year-old male who suffered a high-energy vehicular accident, resulting in a type III Hawkins fracture of the talus. This specific fracture type is critically associated with a greater than 90% risk of progressing to avascular necrosis (AVN) of the talus, a severe and debilitating condition. Alongside this, the patient sustained fractures of the medial and lateral malleolus. Due to extensive swelling and severe circulatory disorders, an immediate emergency surgical procedure was necessitated, employing nail fixation as a stabilizing intervention. Over the course of 12 months following the surgery, despite routine post-operative imaging including X-rays and computed tomography (CT) scans, the patient continued to experience significant pain and impairment. This condition led to further investigations, culminating in a magnetic resonance imaging (MRI) that revealed an area of 19.8∕20.9 mm of AVN on the talus dome's upper-lateral facet. Interestingly, earlier CT scans had indicated multiple osteitic lesions, but these findings lacked a clear clinical correspondence, presenting a diagnostic challenge. To resolve this ambiguity and to definitively distinguish between necrosis and infection, a targeted histopathological analysis was deemed necessary. This analysis was conducted on a bone fragment extracted during a follow-up surgical procedure for nail removal. The results from this analysis present an area of bone and myeloid tissue necrosis unequivocally confirming the presence of AVN, effectively ruling out osteitis as a potential diagnosis. This critical diagnostic clarification allowed for a shift in therapeutic strategy, enabling the initiation of a more focused and potentially curative treatment regimen.

This paper represents a retrospective study on 252 patients with acute ischemic stroke (AIS), who received thrombolytic therapy between 2019-2023, in the Department of Neurology at the Emergency County Hospital in Craiova, Romania. We aimed to evaluate treatment complications and short-term outcomes of patients with AIS, treated with intravenous (i.v.) recombinant tissue plasminogen activator (rtPA; Alteplase), within 4.5 hours from onset. We also tried to assess the correlations between classical risk factors, such as diabetes, hypertension, atrial fibrillation, smoking and the outcome of these patients. Two hundred and fifty-two patients were treated with i.v. thrombolysis in our Department between October 2019 and December 2023. Out of the total thrombolysed patients, 146 were men and 106 were women. Our focus was on the clinical evolution of our patients and on the complications, especially on hemorrhagic transformation and death, and we tried to see if there were any correlations between gender, age, vascular risk factors such as diabetes, smoke, obesity, hypertension, atrial fibrillation and the outcome of our thrombolysed patients. Out of the total of 252 thrombolysed patients, only 55 (21.83%) had hemorrhagic transformation. Analyzing the differences between the occurrence of hemorrhagic transformation, respectively death, depending on the location and type of stroke, we did not identify statistically significant differences. The only comparison where a difference close to the significance limit is observed is that related to the frequency of deaths depending on the type of stroke - patients with cardioembolic stroke had a higher death rate.

The first lung transplant (LT) was made in Romania in 2018 at a 36-year-old male patient with chronic obstructive pulmonary disease (COPD). The study follows the first LT rehabilitation by describing the physical therapy program (PTP), the measurements of body mass and appendicular skeletal muscle mass (ASM) by bio-impedancemetry analysis (BIA) and the functional capacity assessment realized by the six-minute walk test (6MWT) and by the functional respiratory tests (FRTs) in order to evaluate the effectiveness of functional respiratory rehabilitation in this case during a period of one year. In parallel, repeated transbronchial biopsies were performed after six weeks, three months, six months and one year since the transplant. Only the first biopsies showed injuries suggesting an acute rejection, all the rest revealing mild, unspecific lesions. The patient followed 15 sessions of respiratory exercises, joints mobilizations and progressive global muscle strength started one month after LT surgery and was also instructed to perform the exercises at home, using a tablet given at discharge and under monthly guidance through telemedicine. All the measurements were performed before and after the rehabilitation cure, and it was repeated at three different evaluations for one year. The results showed that at the end of follow-up, the 6MWT was significantly increased from 59% of predicted distance at the intake in post-acute hospitalization to 166% at one year after LT, without desaturation that represent a very good evolution; the FRTs increased to normal, and the body weight increased with 18 kg (from severe underweight to normal weight) with constant increasement of skeletal muscle mass. The use of PTP after LT surgery significantly improves functional capacity and increases body mass and skeletal muscle mass.

Nonimmune hydrops fetalis (NIHF) is a condition that can occur at any stage of pregnancy and is linked to a variety of disorders, resulting in severe perinatal complications and increased mortality risk. NIHF refers specifically to cases where maternal antibodies against red blood cell antigens are excluded. Early identification of the underlying causes is essential for managing pregnancy and deciding on treatment. The prognosis depends on the causes, both in the short and long term. Each case should be considered individually. We describe a case of severe fetal hydrops first identified at 35 weeks of gestation. In this instance, a definitive diagnosis could not be reached during pregnancy. An accurate diagnosis combined with early prenatal detection of NIHF is vital for reducing neonatal mortality associated with this condition.