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Statin Use in Cervical Artery Dissection and Subsequent Ischemic Stroke
O. U. H. LODHI; S. YAGHI; L. SHU; N. CHUNG; C. R. LEON GUERRERO; J. E. KAUFMAN; S. ENGELTER; C. Traenka; W. KAM; A. S. ZUBAIR; M. ALMAJALI; J. P. MARTO; M. AFFAN2025/06/3010.12865/CHSJ.51.02.10MedicineBackground and purpose: The role of statins in preventing recurrent ischemic strokes in the setting of non-traumatic cervical artery dissection remains unclear. This study, a secondary analysis of Antithrombotic Treatment for Stroke Prevention in Cervical Artery Dissection (STOP-CAD) study, investigates the impact of statin therapy on subsequent ischemic stroke. Methods: STOP-CAD, a multicenter retrospective observational study, included 4023 patients with non-major trauma-related CAD. For this sub study, we included 2610 patients with ischemic stroke, excluding those with non-ischemic presentations and missing statin information. Patients were stratified based on statin use at hospital discharge and a sensitivity analysis was conducted based on intensity: high-intensity, moderate-intensity, low-intensity, or no statin. Primary outcome was the incidence of subsequent ischemic stroke after hospital discharge. Secondary outcomes included major hemorrhage, mortality and 90-day functional outcomes. Statistical analyses included univariate analyses, Cox regression models to evaluate odds and hazard ratios. Results: There was no significant difference in subsequent ischemic strokes after hospital discharge between the statin group (3.1%) and no statin group (3.3%) (aHR 0.73 95% CI, 0.43-1.24, p=0.25). Similarly, the incidence of major hemorrhage, mortality and 90-day functional outcomes showed no significant differences between the groups. Conclusion: Statin therapy did not significantly reduce the risk of subsequent ischemic stroke, major hemorrhage, functional outcome, or mortality. While statins are beneficial in reducing vascular events and improving outcomes in ischemic stroke, its benefits in CAD-related ischemic strokes are less clear. These findings highlight the need for individualized treatment strategies and further research to optimize secondary prevention in CAD-related stroke. -
Biosafety and Selective Cytotoxicity of Kojic and Ellagic Acids in Salivary Gland Carcinoma: A Preclinical Perspective
F. IACOB; D. H. ALI; D. CHIORAN; L. C. RUSU; S. DINU; I. MUNTEAN; C. V. TIGMEANU2025/06/3010.12865/CHSJ.51.02.09MedicineSalivary gland carcinomas (SGCs) are rare, aggressive tumors with high histopathological diversity and resistance to conventional therapies. The need for novel therapeutic approaches has drawn attention to natural compounds with antitumor potential. Objective: This study aims to investigate the in vitro and in ovo cytotoxic and safety profiles of two natural agents, kojic acid (KA) and ellagic acid (EA), on human submandibular salivary gland carcinoma (A253) cells and human immortalized keratinocytes (HaCaT), as well as to assess their irritant potential via the HET-CAM assay. The cytotoxicity and morphological changes of A253 and HaCaT cells were evaluated using the MTT assay and brightfield microscopy. The HET-CAM assay was applied to evaluate the irritant effects of the compounds in ovo. Both KA and EA reduced A253 cell viability in a dose-dependent manner, with the highest cytotoxicity observed at 100 µM. In contrast, HaCaT cells maintained high viability and exhibited no notable morphological alterations post-treatment, supporting the selectivity of the compounds. HET-CAM scores for both KA and EA fell within the non-irritant range (IS=0.07), further confirming their biosafety. KA and EA exhibit promising antitumor activity against A253 salivary gland carcinoma cells, with minimal toxicity toward normal epithelial cells and no significant irritation potential. These findings justify further investigation of these compounds for their potential use as adjuvant agents in the treatment of salivary gland carcinoma (SGC). -
Purine Derivatives in the Management of Antiresorptive Drug-Related Osteonecrosis of the Jaw
N. FARAJOLLAH; O. M. DINCA; M. B. BUCUR; V. G. VLADAN; A. BUCUR2025/06/3010.12865/CHSJ.51.02.08MedicinePurinic derivatives has recently attracted attention as a potential therapeutic agent, with preliminary evidence suggesting its utility in the management of osteonecrosis of the jaw. work aims at providing an update of the current literature, shedding light on the purinic derivatives treatment for patients who received intravenous antiresorptive drugs and developed osteonecrosis of the jaw. A retrospective study was conducted at the Oral and Maxillofacial Surgery Department of ”Prof. Dr. Dan Theodorescu” Clinical Hospital in Bucharest, Romania, involving 160 consecutive patients diagnosed with refractory, established antiresorptive drug-related osteonecrosis of the jaw between 2022 and 2024. A study group of 23 consecutive patients was selected to receive adjunctive therapy with pentoxifylline (800 mg/day) and vitamin E (1000 IU/day) for six months, while the remaining 137 patients who were not eligible for pentoxifylline tretament formed the control group. Bone healing outcomes were assessed based on the extent of exposed necrotic bone. The study results indicate the fact that 100% of patients in the study group experienced symptomatic improvement, despite a higher prevalence of stage III medication-related osteonecrosis of the jaw, provides strong evidence supporting the therapeutic efficacy observed in this sample population. Post-hoc power analysis showed that the study was strongly powered to detect the observed differences, supporting the reliability of the results. Treatment with purine derivatives demonstrates significant therapeutic potential in the management of antiresorptive drug-related osteonecrosis of the jaw and should be considered as complementary to the standard therapy, particularly in advanced stages of the disease. -
Correlation between Early Life Exposure to Regulatory Relevant Doses of Herbicide Mixtures Based on Glyphosate and Development of Liver Dysfunction
V. DINCA; A. M. HBOUS; A. O. DOCEA; L. CERCELARU; R. MESNAGE; C. MARGINEAN; O. ZLATIAN; V. RAKITSKII; R. MITRUT; M. ANTONIOU; A. TSATSAKIS; D. CALINA2025/06/3010.12865/CHSJ.51.02.07MedicineHuman exposure to low-level mixtures of herbicides is widespread, yet regulatory assessments still rely on single-compound, high-dose studies. This study aimed to determine whether prenatal-to-adolescent exposure to regulatory doses of glyphosate (GLY) alone or combined with 2,4-D and dicamba (COMB) alters liver function in rats. Pregnant Wistar dams (n=5/group) received drinking-water containing (i) no herbicide (BLANK), (ii) GLY at the EU acceptable daily intake (ADI, 0.5mg/kg bw/day; GLY 1), (iii) GLY at the EU NOAEL (50mg/kg bw/day; GLY 2) or (iv) the COMB mixture (each herbicide at its EU ADI). Offspring (?10/sex/group) continued the same exposure until 90 days post-weaning. Serum lipids and liver enzymes were quantified; livers were weighed and examined histologically. In COMB-exposed males, ALAT, ASAT and ALP increased significantly; females showed elevated ALAT, ASAT, cholesterol and triglycerides. GLY 2 reproduced this pattern in males, while GLY 1 heightened ALAT and ALP in males and triglycerides in females. Liver weight was unchanged, but histology revealed dose-related centrilobular vein dilation, granular degeneration, micro-vacuolar change and focal necrosis, most severe in the COMB group. Continuous exposure from gestation to young adulthood to herbicide doses at or below current “safe” limits produced clear biochemical and structural liver injury, amplified by the glyphosate plus 2,4-D and dicamba mixture and with sex-specific sensitivity. These findings challenge the adequacy of single-chemical risk assessments and underscore the need to re-evaluate mixture toxicity, particularly for vulnerable populations. -
Basic and Descriptive Spectrum of Tuberculosis in a Large Cohort of Hospitalized Patients
After 143 years from the discovery of Koch bacillus, the natural history of tuberculosis (TB) is characterized by heterogeneity and gaps of staging defining. The aim of the study consists in assessing the prevalence and characteristics of TB stages, from infection to disease, from acute to chronic disease, among inpatients of Constanta Clinical Pneumophthisiology Hospital. A cross sectional 8-year study, performed, from January 2017 to March 2025, among 630 inpatients, mean aged 58.23 years+/-13.812 std dev, mostly men (n=436; 69.2%) and smokers (n=414; 65.71%), enrolled with a positive diagnosis of TB infection (75 cases, based on positive QuantiFERON TB Gold Plus, 4% progressive forms), or disease (424 infectious, 410 new cases and 178 relapses, 35 multi drug resistant, 17 with mono or poly drug resistance). Subclinical TB was significantly more infectiousness than clinical forms (p=0.000). Active TB disease is characterized by delayed diagnosis (58.57%) and advanced extensive cavitary lesions (73.17%). Post treated lung TB disease (PTLD) occurred in 74.91% of cases, after a mean interval of almost 17 years (205.68 months+/-214.00 std dev), calculating from the first episode of treated TB disease. TB mortality rate was 16.66%o. In conclusion, landscaping tuberculosis? new stages is very complex and challenging. TB infection and subclinical TB are intricated through progressive forms of infection. PTLD must be considered a part of the basic triangle of TB spectrum, standing near infection and active disease, states in a continuous dynamic relation, overlapping through reinfections and relapses, causing PTLD and death. -
Esophageal Stenting Using Laparogastroscopy Compared With Esophageal Endoscopic Stenting: Retrospective Analysis
Esophageal stenosis is a debilitating condition that impairs swallowing and markedly reduces quality of life. Its etiology is multifactorial, including gastroesophageal reflux, radiation, caustic and surgical injuries, benign and malignant tumors. Endoscopic stenting represents a modern, minimally invasive treatment, yet some cases remain refractory to such approaches. Surgical options in benign strictures are limited, often leading to feeding enterostomies that compromise patient outcomes. Laparo-gastroscopic esophageal endoprosthesis, introduced in 1997, bridges endoscopy and surgery, reducing morbidity. This hybrid technique offers a reliable alternative for patients unfit for conventional surgical repair. Our study evaluates its role compared to standard endoscopic stenting, focusing on patient selection, outcomes, and dysphagia improvement. -
Underutilization of Respiratory Assessment and Management in Chronic Neck Pain: Exploring Physiotherapists' Practice Patterns
Background: A significant link has been reflected between the respiratory dysfunction and chronic neck pain. Patients with chronic neck pain (CNP) experience various symptoms related to respiratory dysfunction due to its close relationship between muscular attachments and thoracic cage movements. Therefore, it is essential to include respiratory assessment and management while treating patients with CNP. Hence, the present study aims to determine whether physiotherapists incorporate respiratory assessment and management in their practice while treating patients with CNP. Methodology: It was a cross sectional, observation study, carried out using a Google form, which included a self-structured questionnaire inquiring about the current practice pattern of physiotherapists for managing patients with CNP. Total of 141 Physiotherapists managing patients with CNP were recruited through personal contacts and snowball sampling. Frequency and proportions of responses were analyzed. Results: Of 141 responses collected, only 3 physiotherapists (2.13%) included respiratory assessment and management in their practice for CNP patients, while majority focus on neuro-musculoskeletal system to be addressed while assessing and managing patients with CNP. Conclusion: A notable awareness and knowledge gap is revealed by the low number (2.13%) of physiotherapists who treat respiratory dysfunction in CNP patients. This highlights the necessity of better instruction and training in order to understand the importance of respiratory assessment and care for patients with CNP. -
Genistein: A Preliminary In Vitro Evaluation on IMR-32 Neuroblastoma Cells
A. HEGHES; A. SEMENESCU; G. MOISE; I. PREDESCU; C. TRANDAFIRESCU; D. S. ANTAL; D. C. VLAD; S. ARDELEAN2025/06/3010.12865/CHSJ.51.02.03MedicineNeuroblastoma (NB) is a frequent pathology among children with a serious prognosis. Although there is currently a chemotherapeutic treatment, over the years resistance to existing therapy has developed, necessitating new therapeutic approaches. The current study aimed to evaluate in vitro genistein (GEN) on human neuroblastoma cells-IMR-32, a possible candidate for treating NB. The results indicated that GEN does not affect healthy cells (HaCaT), but has a cytotoxic effect on tumor cells, at concentrations of 50 and 75µM, significantly reducing viability. Moreover, depending on the dose, GEN degraded the cell membrane by releasing LDH and caused changes in the cell shape as well as at the nuclear level similar to apoptosis. The data provide an important perspective on the therapeutic effect of GEN at the NB level, opening the way to new directions in treating this pathology with natural compounds. -
Association of Visual Impairment and Falls in Elderly Individuals-A Cross-Sectional Study
J. GEETHA; S. GOVINDHAN; M. R. H. M. KALIFA; A. GAUR; S. VARATHARAJAN2025/06/3010.12865/CHSJ.51.02.02MedicineBackground: Falls are considered to be the most frequent and significant cause of unintentional harm and mortality among the elderly. Impaired vision is a significant risk factor for falls. Aim: To analyse the relationship between visual impairment and falls in the elderly. Methodology: This hospital-based cross-sectional study included 270 participants after obtaining informed consent. Details of demographic profile, lifestyle, gait and balance deficits, ophthalmic and systemic condition were collected. The identification of independent risk variables for falls in the elderly was performed by logistic regression analysis. Results: Among 270 participants, 115 participants had falls. The mean age of fallers was 72.97 years. Females had significant falls. 87.8% of participants had visual impairment. Visual risk factors like cataract (80.9%), uncorrected refractive error (59.1%), glaucoma (24.3%), age-related macular degeneration (20.2%), and corneal opacity (13%) were very strongly associated with fall (P<0.001). On multivariate logistic regression analysis visual risk variables like Cataract, uncorrected refractive error and glaucoma had a significant association with falls (P<0.05) with an adjusted odds ratio (aOR) of less than 1. Diabetic retinopathy had strong association of fall (P<0.001) with aOR of 41.8 (95% CI 4.27-409.2). Conclusion: Falls and visual impairment are public health concerns that require attention. Since many causes of visual impairment in the elderly are reversible, lowering the risk of falls in this population may be a controllable goal. -
Family Doctors’ Perception of Patient Safety Issues in Rural Versus Urban Primary Healthcare Facilities
Background: The Republic of Moldova is an Eastern European country with the capital in Chisinau and 2,5 million inhabitants (57% rural areas). Aim: To identify differences between rural, urban and Chisinau family doctors’ perception of patient safety culture and to benchmark the results. Methods: This cross-sectional study is based on 776 responses gathered with the AHRQ MOSOPSC in 2020. Percent of positive responses (PPRs) by item and administrative area were analyzed and benchmarked against other countries. Results: PPRs based on responses from Chisinau (45%), rural (33%) and urban (22%) primary healthcare facilities (PHFs) were ? 75% for 80% items and ?50% for tree items: rush when taking care of patients, high ratio patient/personnel, inadequate capacity to handle everything effectively. Five items in urban areas had PPRs significantly lower than in the other areas: exchanging accurate, complete and timely information with hospitals (70%); level of disorganization in the office (64%); workflow problems in the office (60%), difficulty to voice disagreement (56%), insufficient staff to handle the patient load (36%). Conclusion: Significant differences were only found in urban PHFs. High shortage of resources in rural areas and free choice of family doctors by rural residents increase affluence to urban or Chisinau PHFs. Urban PHFs have less resources to cope with patient number and workflow than Chisinau and this is likely to lead to significant differences in the family doctors’ perception of patient safety culture. -
Pineal cyst asociated with apoplexy and hydrocephalus: a case report
D. M. KIELING; A. Hedel KOERICH; R. A. DOS SANTOS JUNIOR; P. M. Mesquita FILHO2025/03/3110.12865/CHSJ.51.01.19MedicinePineal cysts (PCs) are common findings on (Magnetic resonance Imaging) MRI, often incidental in females and asymptomatic throughout life. Rare complications, like pineal apoplexy with acute hydrocephalus, require differential diagnosis and urgent intervention. We report a 19-year-old male with a progressive headache and visual decline. MRI showed a 2.3 cm pineal cyst with hemorrhagic features (apoplexy) causing hydrocephalus. He underwent endoscopic third ventriculostomy and microsurgical resection, both successful. Postoperatively, symptoms resolved completely. Though often benign, complicated PCs can be life-threatening. This case highlights their management, aiding understanding of etiologies, differential diagnoses, and treatments, enhancing medical knowledge. -
Polymethyl-Methacrylate Hypersensitivity with Associated Folliculitis Decalvans After Cranioplasty: A Case Report
A. E. MARTIO; O. R. KARAM; L. Zambonato COSTAMILAN; V. BALEN-RONSONI; R. M. FERREIRA-SALTIEL; P. M. MESQUITA-FILHO2025/03/3110.12865/CHSJ.51.01.18MedicinePolymethyl methacrylate (PMMA) has been routinely used as bone cement, being well tolerated by most patients. The authors report the case of a 42-year-old patient that underwent cranioplasty with PMMA prosthesis, that reported progressive and persistent skin symptoms starting 45 days after surgery. Dermatologic evaluation revealed an extensive reddish scar plaque, associated with polytrichia and alopecia, located only in the left parieto-occipital region, above the PMMA cranioplasty. Scalp biopsy and bone cement specific patch test revealed both folliculitis decalvans (FD) and weak PMMA hypersensitivity. The patient was managed with dapsone for FD, and graft removal was not necessary. This is the second case of post-cranioplasty PMMA hypersensitivity, and the first report of potential contact dermatitis induced FD. -
Acute Pancreatitis after Major Spine Surgery: A case study
K. ZYGOGIANNIS; P. C. CHRISTAKAKIS; I. CHATZIKOMNINOS; D. KOULALIS; A. KALAMPOKIS2025/03/3110.12865/CHSJ.51.01.17MedicinePostoperative acute pancreatitis can be a relatively common complication regarding abdominal surgery, especially for general surgeons who have a high suspicion and expertise in the specific field. After spine surgery, on the other hand, it is considered rare, and when it settles, it is non-negligible as it may progress to a life-threatening condition. Although there is a plethora of reports regarding postoperative acute pancreatitis after spine surgery, especially scoliosis correction surgery or extended fusion surgery, many spine surgeons do not acknowledge this rare complication. Factors that may favor the apparition of acute pancreatitis include intraoperative hypoperfusion, hemodynamic instability, correction techniques in spinal deformity conditions, and mechanical abdominal pressure due to the patient's position. We report a case of acute pancreatitis after posterior lumbar fixation and decompression for spinal canal stenosis. -
The Case of the “Double Pylorus”
A. SUTARIA; S. EJAZ; I. M. CAZACU; A. SAFTOIU; M. S. BHUTANI2025/03/3110.12865/CHSJ.51.01.16MedicineA 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. -
Functional Outcome of Intra-Articular Fracture of Distal End Radius Treated with External Fixator; A Prospective Study
Fracture distal end radius is one of the most common fracture treated in orthopedic emergencies. Nearly 1/6th (16%) of all fractures in orthopedic emergencies involve the distal end of the Radius. This is a prospective-interventional study conducted in the department of Orthopedic Surgery, Sanjay Gandhi Memorial Hospital, Mangolpuri, New Delhi with a sample size of the study is thirty patients treated with an external fixator from January 2021 to June 2022. Out of 30 patients, the number of female patients was 16 (53.33%) and the number of male patients was 14 (46.67%). The mean age of the patient was 50.5 years. 27 (90%) out of 30 patients were right-handed people which was a common behavioral finding and thus we expect more right side distal radius fracture in our study. Functional outcome was evaluated with the Gartland & Werley scoring system. 14 patients (46.67%) showed excellent results, 11 patients (36.67%) showed good, 3 patients (10%) showed fair, whereas 2 (6.67%) patients showed poor results. Stiffness was the most common complication seen in 6 patients (20%). From this study, it is concluded that an external fixator is a simple, safe, and cost-effective method for the treatment of distal end radius fracture with a lesser duration of hospital stay. It reduces the fracture by means of ligamentotaxis and maintains the reduction as well as restores the radial length without interfering with the fracture healing process. -
Analysis of Imaging, Pathology and Demographic Data of Lung Cancer Patients Diagnosed in a Tertiary Medical Center in the South-West Region of Romania
O. CIMPEANU; I. M. LILIAC; D. N. PIRICI; M. OLTEANU; C. T. STREBA2025/03/3110.12865/CHSJ.51.01.14MedicineIntroduction: 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. -
Evaluation of the Incidence of Different Types of Malocclusions in Patients with Early Loss of Temporary Teeth
R. Uleanu-BICIUSCA; D. Agop-FORNA; D. CIOLOCA; A. ADUMITROAIE; V. TOMA2025/03/3110.12865/CHSJ.51.01.13MedicineThe aim of the study is to identify the dental somato-facial anomalies in young patients with early loss of temporary teeth, with the identification of crowding and other present clinical entities. The study was carried out on a working batch of 635 subjects who referred to the Pediatric Dentistry Clinic in Iasi and the private dental practice for various dental treatments, without any obvious dysfunctional subjective symptomatology. Out of 635 subjects,254were female (40%) and 381 male patients (60%), distributed in the rural area (n=157; 24.7%) and urban area (n=478; 75.3%). By applying the selection criteria, the aim was to avoid issues of differential diagnosis with other disorders of the orofacial system. The mean age of the girls in the group was 8.26±1.840 years and the mean age of the boys was 8.77±1.856 years; the mean age of the rural children was 8.88±1.962 years, with an average of 8.46±1.823 years for the urban children. Dental malocclusions represent complex clinical entity, capable of producing functional, aesthetic and psychological disharmonies. Malocclusions can be caused by a combination of factors, in which the early loss of temporary teeth, the frequency of vicious habits, without excluding genetic determinism, are particularly important. The disorders that occur in the case of malocclusion may be aesthetic, masticatory, speech impairments, temporomandibular joint dysfunctions and social integration disorders. -
Correlations of Peri-Implant Parameters with Plaque and Inflammation Indices in Posterior Fixed Implant-Prosthetic Rehabilitation: A Cross-Sectional Study
A. DAVIDESCU; N. FORNA; D. Agop-FORNA; C. DASCALU; M. M. SCUTARIU2025/03/3110.12865/CHSJ.51.01.12MedicinePurpose. The aim of the study was to analyze the peri-implant clinical and radiological parameters and their correlations with the plaque index (mPI) and the inflammation index (GI) in fixed implant-prosthetic therapy. Materials and method. This research was a retrospective study including 48 patients with posterior partial edentulism (age: mean 63.04±10.723 years) treated by implant-supported metal-ceramic bridges, with a mean 6.19 years follow-up. A total of 166 implants were evaluated by clinical (peri-implant pocket depth-PPD) and radiological (peri-implant marginal bone loss-MBL) examen. Plaque index (mPI) and inflammation index (GI) were recorded for each implant site. Mean values of PPD, MBL (mesial), MBL (distal) were assessed. A comparative analysis was conducted regarding relation between PPD and MBL values (distal and mesial) in relation to the mPI and GI indices using the non-parametric Mann-Whitney and Kruskal-Wallis tests. Correlations between the variables PPD, MBL (mesial), and MBL (distal) for the entire study group were calculated by Pearson linear correlation coefficient. Results. There were very high positive correlations between pocket depth and mesial marginal bone loss (r=0.951, p <0.001; 95% CI: 0.934-0.964); pocket depth and distal marginal bone loss (r=0.961, p <0.001; 95% CI: 0.947-0.971), and mesial and distal bone loss values (r=0.935, p <0.001; 95% CI: 0.913-0.952). Conclusion. The findings indicate that peri-implant bone loss and pocket depth are strongly correlated and significantly influenced by plaque accumulation and inflammation, highlighting the critical role of the patients' oral hygiene in maintaining peri-implant tissue health. -
Histopathological Assessment of Non-Small Cell Lung Carcinomas
D. F. GRECU; M. V. ZORILA; L. STANCA; A. F. GRECU; O. I. CREU; A. M. BADIU; B. C. ANDREIANA; M. M. FLORESCU; A. E. STEPAN2025/03/3110.12865/CHSJ.51.01.11MedicineNon-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 tumors. Transitional areas of ADK and focal keratinizations in SCC suggest the presence of specific lung tumor histological lesions, which in evolution acquire aggressive patterns. -
Tertiary Dentin Barrier Formation: A Comparison Between the Effects of Two Calcium Silicate Based Materials
A. M. COVACI; M. ANDREI; I. DINCA; L. T. CIOCAN; M. N. MATEI; A. C. DIDILESCU2025/03/3110.12865/CHSJ.51.01.10MedicinePulp 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. -
Using Convoluted Neural Networks in Diagnosing Lung Cancer on Computed Tomography Scans
O. CIMPEANU; I. M. LILIAC; M. MAMULEANU; S. V. VOINEA; M. OLTEANU; C. T. STREBA2025/03/3110.12865/CHSJ.51.01.09MedicineIntroduction: 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. -
Complications of Thyroid Surgery-Can We Further Minimize the Risk?
A. L. MANDA; S. A. DRACEA; A. L. DIMA; D. V. DAVITOIU; D. VASILE; D. I. VOICULESCU2025/03/3110.12865/CHSJ.51.01.08MedicineThyroid surgery is nowadays a mostly safe and standardized procedure, with low complication and mortality rates. The specific complications of thyroid surgery are lesion of the recurrent laryngeal nerve (RLN), hypoparathyroidism, either transient or permanent, and hemorrhage that can be in some cases life-threatening; even if not, the impact on the quality of life can be negative. The identification of risk factors for complications of thyroid surgery and development of strategies for reducing morbidity are important for the thyroid surgeon. We conducted a retrospective study on a database of 60 patients operated for a thyroid disease in a period of two years in the setting of a non-specialized general emergency hospital in both general surgery department and thoracic surgery department. The main complication was transient hypoparathyroidism (defined by lower than 8mg/dl serum calcium postoperatively)-18.33% of the group, followed by cervical minor hematoma-5.00% of cases and RLN injury in one case-1.67%. Regression analysis showed type of thyroid surgery (p-value 0.0471), histopathology type of disease (p-value 0.0566) and difficulty of surgery defined by operative time (p-value 0.0494) as the risk factors for postoperative complications, of which only the last one can be modifiable by some extent. Identifying and minimizing the risk factors of difficult surgery might improve also complication rates. -
Comparison of Running Versus Interrupted Sutures for Fascial Closure in Ileostomy Takedown
T. TALPAI; B. MARUNELU; V. SURLIN; S. D. PREDA; C. A. PIRVU; S. PANTEA; A. DOBRINESCU2025/03/3110.12865/CHSJ.51.01.07MedicineTemporary 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. -
Chromosome Abnormality Detection Rates of QF-PCR in Early Pregnancy Loss
G. POPESCU-HOBEANU; M. G. CUCU; A. L. RIZA; I. STREATA; R. M. PLESEA; S. DOROBANTU; A. BARBU; L. G. ZORILA; M. DINU; A. L. DIJMARESCU; S. TUDORACHE; D. ILIESCU; F. BURADA2025/03/3110.12865/CHSJ.51.01.06MedicineEarly pregnancy loss (EPL) is the most common form of miscarriage and establishing its exact etiology is vital for the proper prognosis and management of possible future pregnancies. The aim of our study was to assess the incidence and types of chromosome abnormalities in product-of-conception (POC) samples analyzed by Quantitative Fluorescent Polymerase Chain Reaction (QF-PCR). Two hundred fifty-seven POC samples meeting EPL criteria were referred to the Human Genomics Laboratory of the University of Medicine and Pharmacy of Craiova, Romania. DNA was extracted from both POC tissue and maternal blood samples, while PCR products were migrated on the ABI3730xl platform. A total of 124 samples were successfully analyzed, 46 cases (37.1%) showing various types of abnormalities, while no aneuploidies were found in the remaining 78 samples (62.9%). The most common abnormalities were monosomy X, followed by triploidy, trisomy 18, 16 and 15. The basic QF-PCR kit had an overall detection rate of 25.8%, but the detection rate rose to 37.1% when employing the extended kit. Our study proves that QF-PCR can be used as a first approach in the genetic analysis of POC, followed by conventional karyotyping (KT) or Chromosomal Microarray Analysis (CMA) as follow-up. QF-PCR is able to identify maternal cell contamination, as well as provide timely results. -
Blood Donation Attitudes and Knowledge of Medical School Students at the University of Crete, Greece: An Intra-Institutional Exploration
M. T. ATHANASAKI; P. VOLKOS; M. LINARDAKIS; E. K. SYMVOULAKIS2025/03/3110.12865/CHSJ.51.01.05MedicineIn the last decade, demand for blood has been increased internationally, while there is a consistent shortage of regular blood donors. Medical students are a potential pool of regular blood donors. The present study investigated the attitudes and knowledge of undergraduate medical students, regarding blood donation. During the May of 2023 data from 320 medical students of the University of Crete, Greece who were studying from the first to the sixth year were analyzed. It was a cross-sectional observational study and data collection was performed by completing an anonymous questionnaire with socio-demographic items and the Blood Donation Attitudes and Knowledge Scale. Three hundred twenty undergraduate students participated in this study. Sophomores accounted for 20.3% (n=65). Only 25.9% of the participants donated blood repeatedly. Most students (99.4%; p<0.001) believed that donating blood was a good act and 87.5% reported that religious beliefs should not influence blood donation (both p<0.001). The frequency of students in the 4th-6th year who achieved a high score in Attitudes and Knowledge scale was higher compared to the 1st-3rd year students (23.6% vs. 10.6%, p=0.002). Higher score on Attitudes and Knowledge about Donation was significantly associated with increased year of study (r=0.196, p<0.001). Moderate levels of Attitudes and Knowledge Scale about Blood Donation were reported with a significant tendency to increase along the years of study. Perhaps, medical students may mature their perception towards blood donation alongside with their training advancement in Medicine.
ISSN 2067-0656 (print)
ISSN 2069-4032 (online)
Nr.3/2025
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