Congenital Epulis: A Two-Case Report

Congenital epulis is a rare benign tumor of the newborn that could be detected in the prenatal period. Females are more often affected than males and the premaxillary region is usually the predilection site for this oral mass. Excision is the treatment of choice and no recurrences have been reported so far. We present our experience with two cases of congenital epulis, detected in the second trimester of gestation and treated shortly after birth with no further complications. Histopathology should differentiate between congenital epulis and other congenital oral tumors even if its clinical appearance is usually enough to make a tentative diagnosis. A multidisciplinary assessment in the management of this tumor can avoid unwanted complications such as airway obstruction or bleeding

Non-anticommutative Supersymmetric Field Theory and Quantum Shift

Non-anticommutative Grassmann coordinates in four-dimensional twist-deformed N=1 Euclidean superspace are decomposed into geometrical ones and quantum shift operators. This decomposition leads to the mapping from the commutative to the non-anticommutative supersymmetric field theory. We apply this mapping to the Wess-Zumino model in commutative field theory and derive the corresponding non-anticommutative Lagrangian. Based on the theory of twist deformations of Hopf algebras, we comment the preservation of the (initial) N=1 super-Poincar\'e {\it algebra} and on the consequent super-Poincar\'e invariant interpretation of the discussed model, but also provide a measure for the violation of the super-Poincar\'e symmetry.Comment: 17 pages, references added, correction made, minor changes made and discussion added in section

Models for testing regenerative therapies – focus on explants as models for osteoarthritis

Background. Osteoarthritis (OA) is a degenerative disease that progressively involves all joint compartments leading to destruction and loss of function. Regenerative medicine (RM) aims to introduce revolutionary therapies dedicated to drastically improve the way we treat degenerative diseases including OA. Explanted cartilage tissue has been proposed as a modality to study cartilage ontogeny and to understand cartilage repair as well as modality to screen new drug/therapies for the treatment of OA. Objectives. To establish a working protocol for obtaining human osteochondral tissue explants in co -culture with synovial tissue to be used as ex vivo models for OA and to demonstrate explantreactivity to conditioned media (CM) from adipose mesenchymal cells (ADSC) tested as a modality for bone and cartilage rescue. Methods. Human osteochondral samples were collected from patients undergoing total knee replacement were kept in incomplete chondrogenic media (ICM) or in serum free DMEM.Explantreleased cytokines were quantified by. ELISA for Human tumor necrosis factor alpha(TNFα) and interleukin -6 (IL-6) and qPCR-based immunoassay for Human IL-17A and Human IL-1β (Proquantum™ immunoassay kit Invitrogen). Histology, Western blot and Immunohistochemistrystudies to detect Collagen type II (Col II) matrix metalloprotease 1 and 13 (MMP I, MMP-13),Perlecan and beta galactosidase (BGAL) are going on. Results. We found that culture media as well as synovial tissue presence influences the level ofdetectable IL-6, IL-17A CM increased IL-6 presence up to 29 days in culture; TNF α and IL1B levelsdecrease after 7 days in culture; CM treatment significantly decrease TNF α in both synoviumcontaining DMEM and ICM cultured explants Histology revealed presence of active chondrocytewith enlarged hyperchromatic nuclei in CM treated explants. Conclusion. Time in culture, type of culture media and synovial presence influence explant reactivity. Presence of synovial tissue increase explant reactivity especially for situation when an antiinflammatory effect is expected. Histology and immunohistochemistry can detect markers of tissue regeneration. Explant culture can serve as a reliable ex vivo model for testing both antiinflammatory as well as tissue remodeling intervention for articular joint repair

FACTORI DE RISC IMPLICAŢI ÎN PATOLOGIA TUMORALĂ CEREBRALĂ LA COPIL

Tumorile sistemului nervos central (SNC) sunt cele mai frecvente tumori solide din patologia tumorală pediatrică şi reprezintă o provocare terapeutică pentru o echipă medicală multidisciplinară. Tumorile cerebrale pot fi diagnosticate la orice vârstă; semnele şi simptomele depind de vârsta pacientului, de sediul tumoral, precum şi de ritmul de creştere al tumorii. Clasifi carea (Bailey şi Cushing, Kernohan, Organizaţia Mondială a Sănătăţii – OMS) şi prognosticul sunt dictate de histologia tumorală. Prezentul studiu îşi propune evidenţierea unor factori de prognostic implicaţi în evoluţia tumorilor SNC la copil. Lotul de studiu a inclus 99 de copii diagnosticaţi cu tumori SNC în perioada 1990-2008, 66 de băieţi şi 33 de fete; 59,6% din mediul rural. Vârsta medie la debut a fost de 8 ani şi 5 luni, fără diferenţe pe sexe. Durata debutului a variat de la 4 ore la 2 ani. Histologic, au fost 46 de astrocitoame, 23 de meduloblastoame, 17 ependimoame, 3 craniofaringioame, un caz de tumoră hipofi zară şi 9 alte tipuri de tumori. Simptomatologia de debut a inclus hipertensiunea intracraniană (70 cazuri), tulburările neurologice (74 cazuri), tulburările vizuale (24 cazuri), convulsiile (7 cazuri), alte simptome (14 cazuri) şi coma în 2 cazuri. Intervenţiile chirurgicale au fost de tipul: ablaţie totală (34 cazuri), subtotală (27 cazuri), parţială (19 cazuri); în 6 cazuri a fost efectuată doar biopsia tumorală, iar în 8 cazuri nu s-a intervenit chirurgical. Investigaţiile biologice efectuate au arătat: VSH – valoarea medianei – 17 mm ⁄ h, Fg – 3,6150 g/L, LDH - 379,5 UI/L. În primii 3 ani de la diagnostic au decedat 50% dintre pacienţi, cu o rată de supravieţuire repartizată astfel: 34 de cazuri mai puţin de 1 an, 19 cazuri între 1 şi 3 ani, 46 de cazuri peste 3 ani. În lotul studiat nu au fost descoperite diferenţe semnifi cativ statistice între valorile VSH, Fg, LDH, vârstă la debut şi supravieţuire; doar sexul masculin şi tipul intervenţiei chirurgicale se corelează statistic cu supravieţuirea şi pot fi considerate de importanţă prognostică

MYELOPROLIFERATIVE NEOPLASMS WITH CONCURRENT BCR-ABL FUSION GENE AND JAK2V617F MUTATION

This study investigates the occurrence of BCR-ABL fusion gene and JAK2V617F mutation in myeloproliferative neoplasms (MPN) patients at diagnosis, in order to evaluate the clinical features, and compare them to the literature data. The study was conducted between January 2012 and February 2014 and included 190 cases of MPN from Regional Institute of Oncology Iasi. Molecular evaluation of BCR-ABL transcript and JAK2V617F mutation by RT-PCR, were assessed for diagnosis and monitorization. Only 2 patients showed simultaneous occurrence of both the JAK2V617F mutation and the BCR/ABL translocation. Pacient 1 presented a complex clinical picture with clinical signs of CML and essential thrombocythemia, while the second patient had a clinical picture suggestive of polycythemia vera. The screening for the JAK2V617F mutation and BCR-ABL should be considered at MPN diagnosis. Following these patients up might provide new data regarding the long term evolution of such cases

L-Asparaginase Toxicity in the Treatment of Children and Adolescents with Acute Lymphoblastic Leukemia

Asparaginase is a basic component of chemotherapy in pediatric acute lymphoblastic leukemia (ALL) and has played a crucial role in improving the long-term survival of this disease. The objectives of this retrospective study were to elucidate the toxicity profile associated with asparaginase in children and adolescents with ALL, to analyze the impact of each type of toxicity on long-term outcomes, and to identify risk factors. We analyzed the medical charts of 165 patients diagnosed with ALL at Sf. Maria Iasi Children’s Hospital from 2010 to 2019 and treated according to a chemotherapeutic protocol containing asparaginase. The median duration of follow-up was 5 years (0.1–11.5 years). Groups of patients with specific types of toxicity were compared to groups of patients without toxicity. We found the following incidence of asparaginase-associated toxicity: 24.1% clinical hypersensitivity, 19.4% hepatotoxicity, 6.7% hypertriglyceridemia, 4.2% hyperglycemia, 3.7% osteonecrosis, 3% pancreatitis, 2.4% thrombosis, and 1.2% cerebral thrombosis. Overall, 82 patients (49.7%) had at least one type of toxicity related to asparaginase. No type of toxicity had a significant impact on overall survival or event-free survival. Being older than 14 years was associated with a higher risk of osteonecrosis (p = 0.015) and hypertriglyceridemia (p = 0.043) and a lower risk of clinical hypersensitivity (p = 0.04). Asparaginase-related toxicity is common and has a varied profile, and its early detection is important for realizing efficient and appropriate management

Outcomes in Pediatric Acute Lymphoblastic Leukemia—A Single-Center Romanian Experience

Background: This study evaluates the main (para)clinical aspects and outcomes in a group of Romanian children diagnosed with acute lymphoblastic leukemia (ALL), under the conditions of antileukemic treatment according to an adapted ALL IC Berlin–Frankfurt–Munster (BFM) 2002 protocol. Methods: We performed a retrospective single-center study of 125 children diagnosed with ALL between 2010 and 2016. Standard forms were used for data collection of variate clinical and paraclinical parameters. Results: The children were predominantly male (64.8%) and their median age at diagnosis was 5 years. A total of 107 patients were diagnosed with precursor B-cell acute lymphoblastic leukemia (BCP)-ALL and 18 with T-cell acute lymphoblastic leukemia T-ALL. Multiplex reverse transcription polymerase chain reaction RT-PCR assay for ETV6-RUNX1, BCR-ABL, E2A-PBX1, KMT2A-AFF1, and STIL-TAL1 fusion genes was performed in 111 patients. ETV6-RUNX1 translocation was detected in 18.9% of patients, while BCR-ABL1 and E2A-PBX1 rearrangements were seen in 2.7% and 3.6%, respectively. Complete remission at the end of induction phase was obtained in 89.6% of patients. The overall relapse rate was 11.2%, with 11 early and 3 late relapses. The 5-year overall survival rate in BCP-ALL was 81.6% and in T-ALL 71.4%. Conclusions: The 5-year overall and event-free survival rates in our study were slightly lower than those reported in developed countries, so the patients’ outcomes are encouraging

Otitis Media and Obesity—An Unusual Relationship in Children

Otitis media (OM) represents a public health matter, being the main cause of preventable hearing loss in pediatric patients. Besides well-established risk factors for developing OM, such as craniofacial abnormalities, prematurity, low birth weight, or tobacco exposure, there is evidence that obesity could be associated with a high incidence of OM. Our aim is to perform a literature review on the state of current published research on the relationship between OM and obesity and to discuss the interconnectivity between these two entities. We conducted an electronic search in PubMed and EMBASE databases. Out of 176 references, 15 articles were included in our study. Our findings suggest that obesity and overweight might be risk factors for developing OM, and vice versa. The main mechanisms for developing OM in obese patients include alteration in cytokine profile, increased gastroesophageal reflux, and/or fat accumulation. Conversely, ear infections exposure might increase the risk of obesity, mostly by taste changes through middle ear cavity inflammation

ORAL MANIFESTATION OF RENAL OSTHEODISTROPHY IN CHILDREN

Very rare in children, the brown tumor, or osteoclastoma, is an understudied ectopic entity that causes severe debilitation in patients with chronic renal insufficiency. We report two cases who developed particular forms with different evolutions of severe renal osteodystrophy

Pitfalls of Thrombotic Microangiopathies in Children: Two Case Reports and Literature Review

Thrombotic microangiopathy can present itself in the form of several clinical entities, representing a real challenge for diagnosis and treatment in pediatric practice. Our article aims to explore the evolution of two rare cases of pediatric thrombotic thrombocytopenic purpura (TTP) and atypical hemolytic uremic syndrome (aHUS) with extremely similar clinical pictures, which, coincidentally, presented at approximately the same time in our hospital. These cases and our literature review demonstrate the multiple facets of thrombotic microangiopathy, which can produce various determinations and salient manifestations even among the pediatric population. TTP and aHUS may represent genuine diagnostic pitfalls through the overlap of their clinical and biological findings, although they develop through fundamentally different mechanisms that require different therapeutic approaches. As a novelty, we underline that COVID-19 infection cannot be excluded as potential trigger for TTP and aHUS in our patients and we predict that other reports of such an association will follow, raising a complex question of COVID-19’s implication in the occurrence and evolution of thrombotic microangiopathies. On this matter, we conducted literature research that resulted in 15 cases of COVID-19 pediatric infections associated with either TTP or aHUS. Taking into consideration the morbidity associated with TTP and aHUS, an elaborate differential diagnosis and prompt intervention are of the essence