rss_2.0Bulletin of Medical Sciences FeedSciendo RSS Feed for Bulletin of Medical Sciences of Medical Sciences Feed importance, general and endocrine adverse effects of immune checkpoint inhibitors I: mechanism of action and therapeutic use<abstract> <title style='display:none'>Abstract</title> <p>The tumor microenvironment has a fundamental role in the escape phenomenon of cancerous cells from the immune surveillance, the immunological protective mechanisms of the host. These cells produce active substances that can bind to and stimulate the inhibitory immune checkpoints (CTLA-4, PD1 etc.) expressed on the cytotoxic T-lymphocytes and other immunocompetenT-cells, thus inhibiting the immune defense. The immune checkpoint inhibitors (ICIs), introduced in therapeutic use in 2011, are human or humanized monoclonal antibodies (mAbs) that block the immune checkpoints, and thus release the inhibition, restoring the antitumoral immune defense. After the description of their mechanism of action, the clinical applications of anti-CTLA-4 mAbs ipilimumab and tremelimumab, anti-PD1-antibodies nivolumab and pembrolizumab, and the anti-PD-L1-antibodies are presented. The ICIs are used mainly in inoperable and advanced tumors, but this fact is not a rigorous rule, and their therapeutic indications have been and will continue to expand. The next section summarizes new research directions that are also needed, because primary and adaptive resistance to ICIs exists, the latter developing during therapy. In an unselected population, ICIs are therapeutically efficient only in about 20-30% of patients, but these will be long-term survivors. Not rarely the therapeutic effect is preceded by a transient pseudoprogression. Tumors with high mutation burden (melanoma, lung, and bladder cancers) respond much better to ICI therapy, because they produce more neoantigens; this is the case in the “hot” tumors, too, because in these tumor-infiltrating immune cells are markedly present. Their application would require reliable predictive biomarkers, but there are few of them so far, e.g., investigation of PD-L1 expression, and diagnostic tests associated to ICIs. This first part of the review ends with problems regarding therapy resistance and their possible solutions.</p> </abstract>ARTICLEtrue comparison of IOTA Simple Rules, ADNEX Model, and RMI prediction models used in the diagnosis of ovarian tumours<abstract> <title style='display:none'>Abstract</title> <p>A correct diagnosis of any ovarian mass is essential to ensure that patients receive the right treatment. A number of scoring systems have been set up to make diagnosis easier. The aim of this study is to evaluate and compare the accuracy and limitations of three different diagnostic methods, IOTA Simple Rules, ADNEX Model, and RMI. In our prospective study, we investigated patients with ovarian pathology admitted for surgery to the Obstetrics and Gynaecology Clinic I, Târgu Mures, in 2022. All patients underwent vaginal ultrasound examination before surgery. The diagnostic scoring systems mentioned above were used for the clinical evaluation of the ovarian screenings, which were compared with the results of the histological specimens obtained during surgery. We applied the IOTA Simple Rules method to our patients, in 111 out of the total 127 cases (87.41%). The sensitivity of the method was 91.67% and the specificity was 89.66%. The ADNEX Model and RMI provided interpretable results in all cases. The first method had a sensitivity of 89.19% and a specificity of 86.67%, while the second one had a sensitivity of 75.68% and a specificity of 88.89%. All three of the tested methods are simple to use and have good efficacy. However, the results of RMI are strongly influenced by the serum CA-125 level, which makes the IOTA Simple Rules and the ADNEX Model more reliable.</p> </abstract>ARTICLEtrue study of food plants<abstract> <title style='display:none'>Abstract</title> <p>The aim of this study is to investigate the phytochemistry of two food and herb plants that are commonly consumed. They are the beetroot and the celery, which are commercially known and have been grown for a long time in our country and in Europe. The beetroot (<italic>Beta vulgaris var. rubra</italic>) belongs taxonomically to the order Magnoliopsida, family Amaranthaceae, subfamily Chenopodiaceae, within which it is a member of the subgenus Beta. Celery (<italic>Apium graveolens var. dulce</italic>) is a plant of the order Magnoliopsida, Apiales, and of the family Apiaceae. Beetroot is one of the vegetables that owes its antioxidant activity partly to its phenolic components. The active substances include various vitamins, minerals, phenolic components, anthocyanins, fibers, carotenoids, ascorbic acid. Celery stalks contain phenolic components, furanocoumarins, and essential oils. The widespread use of celery stalk is due to its antioxidant, anti-inflammatory, antitumor, antimicrobial, antifungal and serum lipid-lowering properties. It is also used in food, cosmetics, and pharmaceuticals. Beetroot and celery stalk were used to prepare methanolic, ethanolic (50%) and aqueous extracts. For the determination of total polyphenols, ethanol (50%) proved to be the better solvent for both beetroot and celery. The total polyphenol content of beetroot was significantly lower than that of celery. In the determination of flavonoids in celery, the highest concentrations were obtained in the aqueous extracts. When anthocyanin concentrations were determined in cooked and raw beetroot, almost identical but surprisingly low concentrations were obtained. In case of the ABTS method used for antioxidant measurements, ethanolic extracts (50%) are the best free radical scavengers for beetroot, while methanolic extract of frozen stem part is the most effective in case of celery.</p> </abstract>ARTICLEtrue of hospital length of stay and mortality with the osteoporotic hip-fracture type, treatment, the sociodemographic and hospital variables<abstract> <title style='display:none'>Abstract</title> <p>Introduction: Diseases related to the elderly, including osteoporosis and the resulting fractures have a high incidence and are characterized by a high risk of early death. Most hip fractures are treated surgically. Its cost projections vary widely depending on the region, the level of institutional care, and the surgical solutions used.</p> <p>Material and method: We performed a retrospective study using hospital data from 2018-2019. The study included patients whose main diagnosis was: S72.0 - femoral neck fracture, S72.1 - pertrochanteric fracture, S72.2 - subtrochanteric fracture. We used hospital data from seven Romanian counties, Arad, Arges, Bucharest, Szilágy, Temes, Tulcea and Vaslui.</p> <p>Results: Women were significantly more affected (68.3%) than men, however the risk of mortality was 1.7 times higher among men. The average age was 77.2 years, 86% of the patients were over 65 years old. Most patients (69.3% ) were urban residents, but they were also characterized by a higher LOS and mortality.</p> <p>Discussion: Fracture types, gender distribution and correlation with urbanization of the fractures are consistent with international epidemiological data. Regression analysis shows a significant correlation between the length of hospital stay and the following variables: gender, environment, age, diagnosis, type of hospital and death. Regarding the average time of hospital stay, the shortest duration of hospitalization was in Vaslui and Tulcea (9.59 and 9.79 days), while the longest (13.42 and 14.61 days) were in Arad and Arges counties.</p> <p>Conclusions: On average, the patient hospitalization time in the examined counties is higher (13 days) than the Romanian average (11 days). Mortality is significantly higher among men, urban residents and those who suffer subtrochanteric fractures. Regarding the costs per patient of fractures, it can be said that Arad is the most economical, while Salaj county is the least cost-effective.</p> </abstract>ARTICLEtrue and mycophilately<abstract> <title style='display:none'>Abstract</title> <p>Alexander Fleming, the Scottish bacteriologist, discovered penicillin 95 years ago, which has been an important drug used in the therapy of bacterial infections for eight decades. This event can be interpreted as one of the greatest scientific achievements of the 20th century. The significance of this life-saving medicine is often reflected in various artworks. The portrait of the discoverer as well as the illustration of Penicillium mould is frequently met on postage stamps.Mycophilately is a distinct area in the thematic collection of stamps, with increasing interest, encompassing the collection of stamps that illustrate fungi. Stamps with penicillin-related themes can be utilized as resources to study the cultural history of penicillin.The purpose of this paper is to present the illustration of this significant scientific discovery on postage stamps.</p> </abstract>ARTICLEtrue body composition is associated with reduced steatosis in non-alcoholic fatty liver disease, a systematic review and meta-analysis of longitudinal studies<abstract> <title style='display:none'>Abstract</title> <p>Background: Based on cross-sectional studies, there is a link between body composition parameters and steatosis in non-alcoholic fatty liver disease (NAFLD). However, whether long-term changes in different body composition parameters will result in NAFLD resolution is unclear. Therefore, we aimed to summarize the literature on longitudinal studies evaluating the association between NAFLD resolution and body composition change.</p> <p>Methods: Based on the recommendations of the Cochrane Handbook, we performed a systematic search on September 26th, 2021, in four databases: Embase, MEDLINE (via PubMed), and Cochrane Central Register of Controlled Trials (CENTRAL). Eligible studies reported on patients with NAFLD (liver fat &gt;5%) and examined the correlation between body composition improvement and a decrease in steatosis. We did not have pre-defined body composition or steatosis measurement criteria. Next, we calculated pooled correlation coefficient (r) with a 95% confidence interval (CI).</p> <p>Results: We identified 15 eligible studies, of which 5 five studies were included in our quantitative synthesis. Based on two studies with 85 patients, we found a pooled correlation coefficient of r=0.49 (CI: 0.22-0.69, Spearman’s correlation) between the change of visceral adipose tissue and liver steatosis. Similarly, based on three studies with 175 patients, the correlation was r=0.33 (CI: 0.19-0.46, Pearson’s correlation). On the other hand, based on two studies with 163 patients, the correlation between subcutaneous adipose tissue change and liver steatosis change was r=0.42 (CI: 0.29-0.54, Pearson’s correlation).</p> <p>Conclusion: Based on the included studies, body composition improvement is associated with a decrease in liver fat content in NAFLD.</p> </abstract>ARTICLEtrue Hungarian naturalists of Transylvanian origin: course of life of Vilmos Hankó – from Parajd to the Hungarian Academy of Sciences<abstract> <title style='display:none'>Abstract</title> <p>In our series, we have commemorated a number of Transylvanian-born scientists who have made a mark in the field of chemical and pharmaceutical sciences. One of them was Vilmos Hankó (1854-1923), born in Parajd, who had a unique career. He graduated as a chemistry teacher and received his doctorate from the University of Cluj-Napoca. His activities were extremely rich and varied. After Déva, he was a teacher and then director of one of the most famous high schools of Budapest for 36 years. In addition to his teaching activities, he has made significant contributions to the analysis and description of natural treasures (minerals, mineral waters) and to the modernization of science. He is the author of numerous books and has a very rich publication, textbook and editorial output. He was elected a corresponding member of the Hungarian Academy of Sciences in recognition of his work. He died 100 years ago in Budapest.</p> </abstract>ARTICLEtrue by design-based method development for the determination of related substances of ezetimibe by high performance liquid chromatography<abstract> <title style='display:none'>Abstract</title> <p>The pharmaceutical industry is one of the fastest developing industries, and therefore, the chromatographic methods used to ensure the quality of products are constantly evolving, based on current regulatory requirements. Relevant guidelines state that a good understanding of the effects of all parameters on method performance should be predicted and controlled to ensure that test methods are safe and reliable. This quality by design-based approach is increasingly applied in chromatography. One of the pillars of this method development is the design space that results from pre-designed and systematically realized experiments, which contributes to a better understanding of the separation processes and provides flexibility and robustness to the final method. Modeling softwarewares can be used to experimental design and data evaluation, providing possibilities that empirical development does not allow, such as predicting optimal operating conditions or <italic>in silico</italic> robustness testing, to understand the separation process. This paper describes the steps of chromatographic method development according to the ICH Q14 guideline, keeping in mind the quality by design principles and taking advantage of the possibilities offered by the DryLab chromatographic modeling software. As an example, the development of an analytical method for the determination of the related substances of ezetimibe is presented, including the design of experiments, method optimization, robustness testing, validation, method specification and lifecycle management, and finally testing of the method applicability. We have demonstrated that experimental design-based retention modeling is an effective way of method development, and the <italic>in silico</italic> robustness testing is a reliable approach to identifying critical method parameters and setting up control strategies. In chromatographic method development, instead of using a rigid system based on strict and fixed rules, the understanding of separation processes offers higher flexibility. This paper aims to present and promote this new approach to those involved in chromatographic method development.</p> </abstract>ARTICLEtrue of the sun protection factor of sunscreens<abstract> <title style='display:none'>Abstract</title> <p>Proper sun protection plays a key role in protecting against the harmful effects of UV radiation from the sun. Using sunscreen products protects the skin from sunburn, prevents it from ageing and reduces the risk of skin cancer. The aim of this research is to measure the sun protection factor (SPF) of commercially available products and compare it with the SPF value on the packaging. We also looked at whether the ratio and combination of sunscreen ingredients affect the effectiveness of the product. The SPF values of eight sun-screen products were tested. The value was determined using an in vitro method based on absorbance measurements with a UV spectrophotometer. Based on the results obtained, the actual SPF values of the products were calculated using Mansur’s formula. The SPF values we determined differed by 46.82% on average from the values indicated on the packaging of the sunscreen products. For those products where the SPF value on the packaging was higher (SPF 50), a larger deviation from the measured values was observed, but some deviation was observed for all products tested. However, the combination and proportion of substances in the products did not influence the differences obtained.</p> </abstract>ARTICLEtrue’s disease beyond the amyloid accumulation<abstract> <title style='display:none'>Abstract</title> <p>Alzheimer’s disease represents one of the unsolved problems of modern medicine, which assumes a significant financial burden in the research, medical, and social fields as well. Treatments intended for preventing and slowing neurodegenerative processes are the subject of a considerable amount of research and clinical trials, but the results are still insignificant regarding the clinical applicability. Initially, we believed that slow neurodegeneration can be traced back entirely to the accumulation of β-amyloid proteins with atypical structure and behavior in certain areas of the brain. This theory was constantly supplemented by the observation of intracellularly aggregating neurofibrillary tangles and the formulation of neuroinflammatory mechanisms. In this regard Alzheimer’s disease-associated neuroinflammation is an immunological response to the presence of β-amyloid oligomers, which initially leads to microglial activation and inflammatory cytokine release. Over time, this process becomes chronic, extending to astrocytes, neurons, and brain microvascularization, and leading to functional impairment, which is clinically manifested in cognitive and memory deficits. The defined central role of neuroinflammation was overturned by the therapeutic failure of drugs with anti-inflammatory capacity. Subsequently, our knowledge was completed by the recognition of how oxidative stress and the altered brain insulin signaling influences metabolic processes, opening new perspectives for drug development. Despite this, new drug candidates are successively failing, as complex regulatory mechanisms have been identified that question the initial triggering role of the β-amyloid and the final impairing effect of the inflammation. The aim of this study is to summarize and present the biochemical and pathophysiological knowledge that contributed to the currently available more comprehensive picture and a more detailed understanding of the processes of Alzheimer’s disease. Properly planned and executed preclinical experiments are essential to establish further clinical conclusions. By the comparison of the currently used rodent models, we tried to draw attention to the complexity of animal experiments and the importance of their multi-level (behavioral, biochemical, histological) evaluation.</p> </abstract>ARTICLEtrue background radiation measurement in Mureş county<abstract> <title style='display:none'>Abstract</title> <p>From the beginning, there has always been radiation in the Universe. Most people are unaware of it, even though it is around us all the time, and can have many negative effects on our bodies. In the long term, it can lead to the development of various diseases. The natural background radiation includes cosmic radiation, plus radiation from radioactive elements present in the soil, atmosphere, and living organisms. A significant, measurable fraction of this is gamma radiation. Artificial radioactive isotopes can be used in a variety of applications, such as space research, sterilization, and medical diagnostic imaging. Our objective is to measure the dose equivalent rate from the gamma fraction of background radiation in Mureş county, in open and closed spaces, and in frequently visited areas. The measurements were performed with a Gamma Scout dosimeter. The measured average dose equivalent rates are 0.104 µSv/h in Târgu Mureş, 0.111 µSv/h in Reghin, 0.112 µSv/h in Sovata, 0.091 µSv/h in Tarnaveni, 0.095 µSv/h in Ludus and 0.067 µSv/h in the Upper-Mureş Nature Park. Based on the measurements, the calculated mean annual dose is 0.884 mSv/year. According to the data based on the measurements, the dose equivalent rates measured in Mureş county do not pose a risk to our health.</p> </abstract>ARTICLEtrue analysis of the predictive factors of mortality in patients with acute mesenteric ischemia<abstract> <title style='display:none'>Abstract</title> <p>Background: The acute mesenteric ischemia is a rare life-threatening surgical condition, followed by high mortality and morbidity rate. Disparate etiologies and nonspecific symptoms make the diagnosis and the surgery delayed, which leads to a higher mortality rate (60-80%).</p> <p>Methods: This research was designed as a retrospective study, including a total of 86 patients operated for acute mesenteric ischemia between 2014 and 2020 at the 2nd Department of Surgery in Mureș County Emergency Clinical Hospital. We recorded and analyzed the demographic, clinical, pre-operative radiological and laboratory, and surgical findings of the patients. Results: We analyzed the findings of 86 patients (59,3% men, 40,7% women), the mortality rate was 77,9% (77% in women, 78% in men), and the average age was 76,81 years. The youngest patient was 39 years old and the oldest was 96 in the moment of the diagnosis. The mortality rate was higher (93%) in patients, who suffered just an explorative laparotomy surgery (in 50% of the cases, p=0,001, Chi-squared test). The presence of the peritonitis (12 cases) had a negative impact on the survival rate, every patient who had peritonitis described on the computed tomography died after the surgical intervention (p=0,047, Chi-square test). Statistically, there was not a positive relationship between the time spent in the Emergency Room and the mortality rate, but this time was much longer in the group of patients who died after the surgery, 408,22 minutes, compared to the group of the patients who survived, 352,47 minutes (p=0,431, T-test). The survival rate was higher in patients who had abdominal surgery in the personal history (p=0,021, Chi-square test).</p> <p>Conclusions: The symptoms and the paraclinical findings of patients with acute mesenteric ischemia are not specific, so the fast radiological examinations and the optimal time for the surgical intervention represent the key of the improvement of the survival rate.</p> </abstract>ARTICLEtrue analysis of histologically confirmed cases of medullary thyroid carcinoma<abstract> <title style='display:none'>Abstract</title> <p>Medullary thyroid carcinoma (MTC) is a rare neuroendocrine malignant tumor of parafollicular C-cell origin of the thyroid gland, whose tumor cells typically produce calcitonin. The serum level of calcitonin produced by tumor cells is a sensitive tumor marker. An elevated serum level of this and the simultaneous presence of a thyroid nodule confirmed by ultrasound raise a reasonable suspicion of MTC. Still, the first-line MTC confirmation method in diagnosing MTC is fine-needle aspiration cytology (FNA). Objective: The aim of our study was the clinicopathological and cytomorphological analysis of histologically confirmed MTC cases obtained with FNA, as well as their comparison with the clinicopathological and cytomorphological characteristics of papillary thyroid carcinoma (PTC). Material and method: In our retrospective study, we analyzed the FNA cytology findings of patients with nodular goiter examined between 2013-2019 and the available clinical data. Results: In the 7-year period, 1,808 fine-needle aspiration examinations were performed, of which we identified 12 MTC and 77 PTC cases. The average age of patients diagnosed with MTC was 53±13 years. There were nine women and three men in examined cases. The average diameter of the nodules was 14±5 mm. All of our cases were of the sporadic type. The average age of patients diagnosed with MTC was greater than that of patients diagnosed with PTC (53 vs. 44 years, p=0.02367). A female predominance is observed in both diseases, although this is more pronounced in PTC. The diameter of the MTC nodules does not differ significantly from the mean size of the PTC nodules (14 vs. 17 mm, p=0.3138). The cytomorphological characteristics of the MTC cases we examined correspond to those described in the international literature, with minor differences. Conclusions: MTC is one of the rarer thyroid cancers, which is often difficult to distinguish from other types of thyroid cancer based on clinical features alone. Average age at diagnosis is greater than patients with PTC. Accurate diagnosis is critical as it requires a different approach than other types of thyroid cancer, it may require a different surgical approach, and may benefit from targeted therapy. Therefore, knowledge of the cytomorphology of MTC is essential for accurate diagnosis and optimal patient care.</p> </abstract>ARTICLEtrueán Vámossy, versatile and active medical professor of the Institute of Pharmacy<abstract> <title style='display:none'>Abstract</title> <p>Zoltán Vámossy (1868–1953), with Transylvanian roots, became a doctor 130 years ago, in 1891, at the University of Budapest. Later, from 1898, he was appointed a private university professor of Pharmacology, from 1908 a public university professor, and from 1920 to 1938 he was director of the Institute of pharmacology. In the meantime, from 1922 to 1924, he also held the position of dean of the Faculty of Medicine. He was elected a corresponding member of the Hungarian Academy of Sciences on May 5, 1920, but on April 23, 1948 his membership was terminated for political reasons. It was not restored until after his death, on 9 May 1991. Afterwards he taught even in the 1945/46 school year. He was an understanding and helpful instructor for the university students, so he was respected, appreciated, and loved. His professional life was filled with university education, academic work, and editorial duties. He wrote books to promote education, for example he translated into Hungarian a book written by Arnold Cloetta and Wilhelm Filehne in 1881, entitled Lehrbuch der Arzneimittellehre und Arzneiverordnungslehre. This was published in 1894 in Budapest under the title Gyógyszertan tankönyv (Pharmacology Textbook). In 1907 he published his own book Mérgezésekről (On Poisonings), and in 1908 Gyógyszertan orvostanhallgatók és orvosok számára (Pharmacology for medical students and physicians). The latter’s ninth, expanded and revised edition appeared in 1944. Medical students in Hungary and Transylvania learned from this for decades. In 1933 he was appointed chairman of the editorial board of the IV. Magyar Gyógyszerkönyv. His editorial work is also significant. From 1909 to 1944 he was the commissioned editor of the new course of the Magyar Orvosi Archivum (Hungarian Medical Archive), and from 1923 to 1944 he was the editor-in-chief of the Orvosi Hetilap (Medical Weekly). During this time, many of his writings were published here. In December 1927 issue, he announced that certain issues of the Orvosi Hetilap would be supplemented by a permanent supplement entitled Az Orvosi Gyakorlat Kérdései (Questions of Medical Practice). In 1940, in parallel with the Medical Weekly, he founded the monthly Orvostudományi Közlemények (Medical Gazette), which was published until the end of 1944. He strived for the correct use of the Hungarian medical language in all his writings..</p> </abstract>ARTICLEtrue psoas muscle index a modern prognostic factor in the follow-up of patients with rectal cancer who underwent surgery<abstract> <title style='display:none'>Abstract</title> <p>Background: The incidence of rectum cancer is rising worldwide. New prognostic factors need to be applied to improve patients’ prognosis. The incidence of sarcopenia has been observed in various malignancies. The quantity of skeletal muscle mass is reflected in the psoas muscle index (PMI), suggesting the presence of sarcopenia. Our aim is to investigate the association of postoperative prognosis of patients with rectum cancer with the occurrence of preoperative sarcopenia with quantitative and qualitative reduction of skeletal muscle mass.</p> <p>Material and method: We performed a multidisciplinary research and we examined patients diagnosed with rectal cancer. The PMI was determined at the lower edge of the L3 vertebral body, using CT scan. We present our research partial results within three cases.</p> <p>Results: The PMI of three male patients with rectum cancer who received neoadjuvant chemoradiotherapy was: Case 1 has a PMI of 7.378 cm<sup>2</sup>/m<sup>2</sup>, the mean psoas muscle density was 50.14 UH. Case 2 has a PMI of 6,942 cm<sup>2</sup>/m<sup>2</sup> and a mean psoas density of 43.81 UH. Case 3 has a PMI of 8.4885 cm<sup>2</sup>/m<sup>2</sup> and an average density of 43.85 UH in the right and left psoas.</p> <p>Conclusions: The PMI value can be calculated with simple radiologic measurements, thus determining the diagnosis of sarcopenia. Calculations are performed using standard preoperative CT-scans. A PMI value above the threshold limit is promising in the short term, but in the long term it is not responsible for the deterioration of patients’ general condition and tumor recurrence.</p> </abstract>ARTICLEtrue of pulmonary complications in patients referred to the intensive care unit<abstract> <title style='display:none'>Abstract</title> <p>Introduction: Respiratory complications in the intensive care unit are important because of their frequency and their negative impact on the course of the underlying disease. One of the main risk factors for these complications is mechanical ventilation, which is often applied in critically ill patients. Our aim was to determine the incidence, risk factors and the impact of respiratory complications on the prognosis in the patients admitted to the intensive care unit (ICU).</p> <p>Material and method: In our retrospective study we included adult patients who spent at least 5 days in the intensive care unit of the Emergency County Hospital Târgu Mureș between 1st of January- 30th of April 2019, we excluded patients who were referred with any respiratory pathology.</p> <p>Results: Of the 75 patients included 49% developed respiratory complications, 56% of which were pneumonia. We observed an association between the development of complications and smoking (p= 0.0103) and prolonged mechanical ventilation (p= 0.0255). ICU admission was significantly longer in patients with respiratory complications (p=0.0010).</p> <p>Conclusions: The incidence of pulmonary complications is high among patients referred to intensive care units and has a significant impact on the length of hospital stay.</p> </abstract>ARTICLEtrue up a personalized regenerative diet for Romanian patients with cervical cancer based on a regional preventive screening program<abstract> <title style='display:none'>Abstract</title> <p>Cancer is a common disease that people dread, and most of them fully believe that they will be sentenced to death along with the diagnosis. The aim of the present study was to set up a dietary survey and nutritional therapy pattern that can be used in Romania for patients diagnosed with cervical cancer, that will contribute to a better management of the mentioned disease cervical cancer. This diet therapy can help patients to recover easily from cervical cancer, prevent cancer weakening and weight loss, and to fight strenuous medical treatments that can further worsen their overall condition and quality of life. Furthermore, this nutrition intervention can reduce malnutrition outcomes and establishes a diet plan that makes easier for the patients to endure the symptoms and reduces the side effects of multiple cancer treatments. The backbone of our paper was the National Cancer Institute’s Nutritional PDQ (Physician Data Query), an american institute that conducts cancer screening and daily information of cancer researchers along with other recent literature sources.</p> </abstract>ARTICLEtrue and pharmacological characterization of anthelmintic benzimidazoles<abstract> <title style='display:none'>Abstract</title> <p>Benzimidazoles, which interfere with the complex life cycle of worms, are essential in the treatment of helminthiasis. Four benzimidazole antihelmintics have been used in human therapy: albendazole, mebendazole, thiabendazole, triclabendazole. The history, representatives, synthesis, physicochemical properties, structure-activity relationships of anthelmintic benzimidazoles are presented in the review, as well as the pharmacological properties and mechanism of action of these agents.</p> <p>In the last decade, benzimidazole carbamate-structured anthelmintics have also been studied for their antitumor activity.</p> </abstract>ARTICLEtrue Control: Research, Prevention, Legislation, Human Rights<abstract> <title style='display:none'>Abstract</title> <p>Between 2012–2018 the University of Medicine and Pharmacy from Tirgu Mureș in partnership with American, Hungarian and Romanian scientists from dozen institutions have launched a research entitled Building Capacity for Tobacco Research in Romania composed of seven complementary research studies. In our paper there are highlighted some timely and specific issues inside the research such as the possibility of computer-based online school prevention, smoking habits of residents and employees of social children’s institutions, the adaptation of a proper legislation and tobacco control, right to clean and smoking-free air. It remains very important the support for tobacco smoke-free, the maintenance of anti-smoking campaigns, the extension of prevention to the juvenile population in order to reduce smoking and the use of alternative tobacco products.</p> </abstract>ARTICLEtrue nanofibers obtained by electrospinning<abstract> <title style='display:none'>Abstract</title> <p>The aim of our research was to prepare polymer-free hydroxypropyl-β-cyclodextrin-(HPβCD) and sulfobutylether-β-cyclodextrin (SBEβCD) based nanofibers. For this purpose, four-four viscous, aqueous solutions were prepared with different concentrations from each cyclodextrin derivative, with the following concentrations: 170, 180, 190 and 200% (v/w) from HPβCD and: 210, 220, 230 and 240% (v/w) from SBEβCD.</p> <p>The parameters for the electrospinning process were: 1.5 ml/h flowrate, 22-24 G sized needle, and an applied voltage of 25 kV. The distance between the needle and the collector was 13-15 cm in the case of HPβCD, and 9-11 cm in the case of SBEβCD.</p> <p>The obtained nanofibers were morphologically characterized and their dis-integration process was also tracked. Then, the results obtained were compared within each cyclodextrin group, in order to identify optimal spinning parameters and they were also discussed, based on previous reports.</p> <p>From our results, we concluded that the 200% HPβCD solution is the most effective for nanofiber formation, producing smooth, homogenous fibers with small diameters, which present ideal disintegration properties. At the tested voltages, it was not possible to form ideal nanofibers from SBEβCD, however, we managed to form some nanofibers with acceptable quality, and the ones made out from the 240% solution of the SBEβCD were the most suitable.</p> </abstract>ARTICLEtrue