Ozone therapy – a rare and avoidable source of infectious pathology of the spine

Ozone therapy is considered by many as an effective therapy for spinal degenerative pathologies. Despite its possible favorable results, we present a series of serious infectious complications, clearly related to ozone therapy and their treatment. The authors discuss their results compared with the literature and advocate for prudence when recommending ozone therapy

Extensive spinal epidural abscess complicated with hydrocephalus

Spinal epidural abscess is a rare but severe infection requiring prompt recognition in order to have a favorable outcome and appropriate treatment, mainly surgical. We present one of the largest extensions of such abscess in literature, involving the whole spine. No surgical treatment was tempted due to the involvement of 19 levels but antibiotics. The evolution of the lesion was complicated with hydrocephalus, by mechanism of cervical block of CSF flow, and needed first external derivation and later ventriculo-peritoneal drainage

Nasal polyps with atypical stromal cells – a histopathological diagnostic dilemma

Department of Morphofunctional Sciences I-Histology, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania, The 8th International Medical Congress for Students and Young Doctors, September 24-26, 2020Background. Nasal polyps represent inflammatory non-neoplastic masses of the nasal mucosa that affect 1% to 4% of the general population. They typically occur in individuals older than 20 years, having a higher incidence in males and frequently accompany rhinosinusitis. Case report. We report a case of a 67-year-old woman with a known sleep apnea syndrome, persistent right nasal obstruction, seromucous rhinorrhea, symptomatology with an insidious evolution of about 6 months before the examination. The clinical exam showed a translucent, polypoid appearance, which extended from the level of the right to the left choanal orifice. Gross examination of the surgical specimen revealed a large, firm, white, polypoid mass. Microscopic examination showed large stromal bizarre appearing cells with elongated, hyperchromatic nuclei, surrounded by apparently normal epithelium. In this case, atypical stellate cells scattered throughout myxomatous or edematous stroma can be easily mistaken for a malignant process. Histological changes of spindle shape fibroblasts might be erroneously interpreted as certain pseudosarcomatous changes, low-grade sarcomas, rhabdomyosarcoma, sinonasal myxomas, neurofibroma, and nasopharyngeal angiofibroma. We want to emphasize that the major diagnostic problem could derive from the difficulty of differentiating an allergic or infectious reactive process from mesenchymal or neural origin lesions, due to an extensive proliferation of histiocytes, fibroblasts or irregular myofibroblasts. Another differential diagnosis that could have been considered is a long history of a previously biopsied mass with reactive proliferative stromal cells that can mimic malignancy, represented in our case by the reactive nature of the identified fibroblasts and histiocytes atypia. Conclusions. Although the need for histopathological examination of nasal polyps is controversial, this diagnosis is encouraged, given that there are entities more severe than polyps, requiring examination to avoid a misdiagnosis of mesenchymal malignancy. Rigorous medical history associated with clinical data is important for appropriate patient management

Antibiotics and antibiotic resistant genes in water - environmental and human health risks

Introduction. Antimicrobial resistance is a worldwide problem that is both pressing and challenging due to the rate at which it is spreading, and the lack of understanding of the mechanisms that link humans, animals and environmental sources contributing to its proliferation. Antibiotic pollution is becoming an increasingly serious threat across different countries. Potential risks associated with release of human antibiotics into the environment have become an increasingly important issue of the environmental health. This concern has been driven by the widespread detection of antibiotics in all aquatic compartments. Antibiotics are ubiquitous in the environment and significant concentrations have been detected in water sources. The prevalence of antibiotics and antibiotic resistant genes in water has drawn attention in recent years, due to their potential public health risks. Material and methods. The purpose of the study was to carry out an analysis of the literature related to antibiotics and antibiotic resistant genes in groundwater, based on 61 bibliographic scientific research across the country and abroad using Academic Google and PubMed databases for articles published between 2016- 2021. Results. Antibiotics play a significant role in the induction and dissemination of antibiotic resistance genes in water that has recently become the primary environmental concern. Over the recent decades, antibiotics and antibiotic resistance genes have been regarded as emerging pollutants. The abuse of antibiotics can increase their residual amount in the water environment, which causes the enhancement of antibiotic resistance, being recognized as a new type of pollutant. Various types of normal bacterial genes that become activated under severe antibiotic stress, produces resistant enzymes even under normal conditions. Therefore, the resistance genes are being transferred horizontally from one bacterial cell to another, thus, increasing resistance to antibiotics. The distribution of antibiotics in water sources varies significantly in time and space, corresponding to the amount of antibiotics used locally. The main source of this contamination in the aquatic environment is the wastewater from antibiotic manufacturers, large scale animal farming, and hospitals. Environmental antibiotics pose a range of risks and have significant effects on human health. Conclusion. Antibiotics have greatly polluted the environment globally. The anti-infectives in environmental waters is of interest because of their potential role in the dissemination of anti-infective resistance in bacteria. Finally, scientific guidance on drug use is still required to discourage and prevent antibiotic abuse. A careful literature review was conducted in order to understand the sources, fate and occurrence of antimicrobials in the aquatic environment. In this context, a broad and specialized background was obtained, enabling a complete overview of the state-of-the-art in these subjects. Acknowledgment.This paper has been written within the framework of the project: 20.80009.8007.09 "Studying the mechanisms of antimicrobial resistance in gram-negative bacilli in order to strengthen the national surveillance system"

Bronchopulmonary dysplasia in the premature child and the impact of COVID-19 infection

Displazia bronhopulmonară (DBP) este o boală cronică pulmonară a prematurității și una din cele mai extreme complicații a copilului prematur. Până la 15-25% dintre nou-născuții sub 32 săptămîni de gestație și 60% din nou-născuții sub 28 săptămâni dezvoltă DBP, care este asociată cu rata înaltă de mortalitate, consecințe respiratorii și neuronale de lungă durată. DBP este o afecțiune respiratorie severă, ce afectează calitatea vieții copilului pe termen îndelungat. Copilul prematur cu displazie bronhopulmonară necesită îngrijire interdisciplinară pentru a răspunde necesităţilor complexe bronhopulmonare, neurologice, nutriţionale şi de dezvoltare. Scopul lucrării este prezentarea unui caz clinic al copilului cu displazie bronhopulmonară și impactul infecției COVID-19 asupra afectării bronhopulmonare. Datele imagistice CT pulmonare sugestive pentru modificări patologice pneumofibrotice moderate bilateral, care sunt încadrate în DBP de grad moderat. Prezența patologiei pulmonare cronice din displazie bronhopulmonară, reprezintă un factor independent de agravare copiilor născuți prematuri infectați cu COVID-19.Bronchopulmonary dysplasia (BPD) is a chronic lung disease of prematurity and one of the most extreme complications of the premature child. Up to 15-25 % of newborns under 32 weeks of gestation and 60 % of newborns under 28 weeks develop BPD, which is associated with a high mortality rate, long-term respiratory and neurological consequences. BPD is a severe respiratory condition that affects the child’s quality of life in the long term. The premature child with bronchopulmonary dysplasia requires interdisciplinary care to meet complex bronchopulmonary, neurological, nutritional, and developmental needs. The goal of this study is to present a clinical case of a child with bronchopulmonary dysplasia and the impact of the COVID-19 infection on bronchopulmonary impairment. The CT pulmonary imaging data suggest moderate bilateral pneumofibrotic pathological changes which fall into moderate grade BPD. The presence of chronic pulmonary pathology from bronchopulmonary dysplasia represents an independent aggravating factor for premature children infected with COVID-19

Particularităţi imuno-umorale ale pacientelor cu cancer cervical local-avansat, stadiile II-III

Cancerul cervical este a 2-a cauză de cancer ca frecvenţă la femei. Morbiditatea prin cancer de col uterin în Republica Moldova în 2011 a alcătuit 15,5 la 100.000 de populaţie, 288 de cazuri. Modificările imunologice umorale asociate neoplaziilor ginecologice avansate generează alterări ale statutului somatic general al pacientelor, fapt care poate cauza stoparea tratamentului oncologic. Am investigat factorii imunităţii umorale ale pacientelor cu cancer cervical local-avansat pre-, intra- şi postradiant, demonstrând că imunitatea acestor paciente este în descreştere pe parcursul tratamentului radiant. Imunumodulatoarele administrate concomitent cu terapia specifi că ar optimiza posibilităţile şi rezultatele aplicării tratamentului cancerului cervical

Cancerul endometrial. Particularităţi clinice, ultrasonografice şi histologice

Actualmente, cancerul endometrial reprezintă una din problemele stringente abordate în ginecologia oncologică. Ocupând poziţia a 4-a în structura maladiilor genitale feminine, această patologie solicită un interes deosebit reţelei medico- sanitare şi necesită efectuarea unor studii suplimentare în acest domeniu. Investigaţiile clinice au inclus 232 de paciente afectate de cancer endometrial şi 54 de paciente cu patologii benigne ale uterului. Vârsta medie a fost de 53,0±8,2 ani. Concluzii: prezentul studiu a demonstrat întâietatea tipului endometrioid al cancerului endometrial în structura reprezentării histologice a cancerului endometrial (73,3%); tumorile neendometrioide cu pronostic nefavorabil au alcătuit 26,7%

Managementul cancerului cervical în baza protocolului clinic naţional

Elaborarea Protocolului Naţional pentru Cancerul Cervical a avut în vizor, în primul rând, identifi carea unei abordări standard în managementul cancerului cervical. Evident, acest proces este deja efectuat în alte ţări, servind drept bază pentru efectuarea paşilor clar-defi niţi în combaterea acestei maladii oncologice. Necesitatea stringentă a structurării măsurilor întreprinse în cadrul sistemului medico-sanitar al Republicii Moldova în privinţa profi laxiei, depistării, diagnosticului şi tratamentului cancerului cervical este mandatară. Protocolul Naţional al Cancerului Cervical cuprinde capitole cu informaţie amplă despre cancerul cervical care este menită să faciliteze lucrul medicilor ginecologi atât din domeniul oncologiei, cât şi din sistemul medical general, diminuând, în fi ne, indicii morbidităţii şi mortalităţii prin cancer cervica

Management of biliary lithiasis in pregnancy – an updated overview

It is estimated that 2% of pregnant women develop gallstones during pregnancy. Symptoms of biliary lithiasis may vary during pregnancy, from a slight added digestive discomfort to biliary colic of varying intensity, acute cholecystitis, or acute pancreatitis. Ultrasonography is the gold standard for diagnosis of sludge and gallstones, being both highly sensitive and specific. Initial management overlaps with the out-of-pregnancy management, initiating conservative, supportive care, as well as an adequate diet. Laparoscopic cholecystectomy is considered a safe intervention in pregnancy, being the second most common surgery after appendicectomy. If open laparoscopy is preferred, the major risk - perforation of the uterus - is avoided. Important complications of gallstones in pregnancy, jaundice and acute pancreatitis can be resolved safely and quickly by cholangiopancreatography (ERCP) techniques, with stone removal, sphincterotomy or stent mounting. After remission of pancreatic symptoms, laparoscopic cholecystectomy can be performed. Recent scientific data and current practice suggest an increase of biliopancreatic emergencies during pregnancy (probably due to rising incidence of obesity, age of gravida, prolonged use of oral combined contraceptives, dyslipidemia, etc.). Surgeons, as well as obstetricians, should be aware of the prompt modern management of these cases