Identification of novel candidate targets for suppressing ovarian cancer progression through IL-33/ST2 axis components using the system biology approach

Background: Cancer-associated fibroblasts (CAFs) of ovarian cancer (OvC) are the most prevalent element of the tumor microenvironment (TM). By promoting angiogenesis, immunological suppression, and invasion, CAFs speed up the growth of tumors by changing the extracellular matrix’s structure and composition and/or initiating the epithelial cells (EPT). IL-33/ST2 signaling has drawn a lot of attention since it acts as a pro-tumor alarmin and encourages spread by altering TM.Methods: Differentially expressed genes (DEGs) of the OvC tumor microenvironment were found in the GEO database, qRT-PCR, western blotting, and immunohistochemistry, and their presence and changes in healthy and tumor tissue content were examined. Primary cultures of healthy fibroblasts and CAFs obtained from healthy and tumor tissues retrieved from OvC samples were used for in vitro and in vivo investigations. Cultured primary human CAFs were utilized to investigate the regulation and the IL-33/ST2 axis role in the inflammation reactions.Results: Although ST2 and IL-33 expression was detected in both epithelial (EPT) and fibroblast cells of ovarian cancer, they are more abundant in CAFs. Lipopolysaccharides, serum amyloid A1, and IL-1β, the inflammatory mediators, could all induce IL-33 expression through NF-κB activation in human CAFs. In turn, via the ST2 receptor, IL-33 affected the production of IL-6, IL-1β, and PTGS2 in human CAFs via the MAPKs-NF-κB pathway.Conclusion: Our findings suggest that IL-33/ST2 is affected by the interaction of CAFs and epithelial cells inside the tumor microenvironment. Activation of this axis leads to increased expression of inflammatory factors in tumor CAFs and EPT cells. Therefore, targeting the IL-33/ST2 axis could have potential value in the prevention of OvC progression

Quality of Life in Pediatric Patients with Continent Urinary Diversion—A Single Center Experience

Background and Objectives: The advancement of surgical strategies in various types of urological conditions has resulted in improved functional outcomes, but the issues of patient perception and life quality remain difficult to assess, particularly in pediatric populations. We aimed to critically analyze the outcomes of urinary continent diversion in pediatric patients treated in our institution for various bladder conditions. Materials and Methods: We conducted a cross-sectional study, reviewing the records of patients treated for bladder evacuation problems between 2003 and 2014, and analyzing the data of those with continent urinary diversion. We used two types of questionnaires to assess the impact on life quality: the Qualiveen-30 and the SF-36 Health Survey. Results: The study included one hundred thirty-four patients with bladder conditions, and eight underwent urinary diversion, at a median age of 6.5 years. Seven of them, aged 10–23 years, completed questionnaires, with all seven scoring high on physical functioning scale but low on the social functioning scale. Conclusions: Continent urinary diversion remains the treatment of choice in well selected patients, but the results must be considered both in terms of functional outcomes and the impact on these patients’ emotional and mental health

Fertility of Cryptorchid Testis—An Unsolved Mistery

Cryptorchidism (undescended testis) is one of the most common diagnoses in the pediatric urologist office. Even in the modern era, there still are a lot of debates regarding the optimal time for surgery related to the expected results in relation with the testicular function, including fertility. The review below intends to clarify issues regarding the impact of cryptorchidism on testicular histology and function, semen analysis, the relation between hormonal and surgical treatment, future fertility, and paternity rate

Pediatric and Adolescent Oncofertility in Male Patients—From Alpha to Omega

This article reviews the latest information about preserving reproductive potential that can offer enhanced prospects for future conception in the pediatric male population with cancer, whose fertility is threatened because of the gonadotoxic effects of chemotherapy and radiation. An estimated 400,000 children and adolescents aged 0–19 years will be diagnosed with cancer each year. Fertility is compromised in one-third of adult male survivors of childhood cancer. We present the latest approaches and techniques for fertility preservation, starting with fertility preservation counselling, a clinical practice guideline used around the world and finishing with recent advances in basic science and translational research. Improving strategies for the maturation of germ cells in vitro combined with new molecular techniques for gene editing could be the next scientific keystone to eradicate genetic diseases such as cancer related mutations in the offspring of cancer survivors

Unusual Presentation of Celiac Disease in a Toddler from a Pediatric Surgery Unit

Abstract Celiac disease is an intestinal autoimmune disease induced by the ingestion of gluten proteins (wheat, rye, barley) in genetically susceptible individuals. Celiac disease can present with gastrointestinal or extraintestinal manifestations (malabsorbtion, diarrhea, constipation, liver, skin or bones disorders). We present the case of a 14-months-old girl admitted for altered general condition and symptoms of intestinal occlusion (severe abdominal pain, absence of feces, abdominal distension), with associated severe malnutrition. History revealed chronic diarrhea and a lactose intolerance diagnosed 3 months prior to admission. The biochemical and imaging investigations excluded any acute surgical pathology. The serological tests showed high values of anti-tissue transglutaminase antibodies. The intestinal biopsy confirmed celiac disease. In children with suspicion of intestinal obstruction associated with a history of diarrhea or constipation and failure to thrive, testing for celiac disease should be considered

SEMNIFICAŢIA SINDROMULUI DE CITOLIZĂ LA COPIL – STUDIU CAZUISTIC

Determinarea valorilor transaminazelor face parte din protocolul de investigaţii biochimice de rutină care se efectuează la copil, indiferent de simptomatologia clinică. Transaminazele (TGP, TGO) sunt markeri ai leziunilor tisulare care se modifi că atât în afecţiuni hepatice, cât şi extrahepatice. Scopul acestui studiu a fost de a stabili etiologia şi semnifi caţia clinică a sindromului de citoliză hepatică fără colestază la copiii internaţi pentru diverse afecţiuni pediatrice. Lotul de studiu a cuprins 394 de copiii (cu vârsta cuprinsă între 1,5 luni şi 16 ani) la care au fost decelate valori crescute ale transaminazelor. Protocolul de investigaţii a cuprins anamneza, examenul fi zic, investigaţiile biologice complete, markerii virali şi ecografi a hepatică.În funcţie de valoarea transaminazelor faţă de valoarea normală (VN), pacienţii au fost incluşi în trei loturi de studiu: 222 pacienţi cu creşteri uşoare ale TGP, TGO ( 3xVN (lotul III). Valoarea transaminazelor a fost determinată lunar în primele 3 luni, iar ulterior, la interval de 2 până la 6 luni din momentul identifi cării hepatocitolizei. În toate loturile etiologia sindromului de citoliză a fost dominate de afecţiunile acute bacteriene (respiratorii, urinare, digestive) şi virale (infecţia cu virus Epstein Barr, Cito megalovirus). Alte cauze ale sindromului de citoliză au fost bolile nutriţionale şi de metabolism (obezitatea, diabetul zaharat, fenilcetonuria, fi broza chistică, hipotiroidismul congenital). În 20,31% dintre cazuri etiologia nu a fost elucidată, dar valoarea transaminazelor la 6 luni s-a normalizat ca urmare a dietei şi hepatoprotectoarelor. Creşterile uşoare ale valorii TGP, TGO nu necesită învestigaţii laborioase, ele normalizându-se în primele trei luni. Creşterile medii şi severe, persistente după trei luni de tratament, impun continuarea investigaţiilor pentru stabilirea etiologiei (infecţii virale, boli autoimune, nutriţionale şi de metabolism)

Current Epidemiological Trends of Pediatric Traffic Accidents at a Romanian Clinical Hospital

Background: Pediatric road traffic accidents (RTAs) have a substantial impact on the worldwide youth population, resulting in a considerable burden of disability. According to the World Health Organization’s (WHO) Global Status Report on Road Safety, around 1.35 million children die each year in RTAs around the world, having a big effect on health and financial costs. Today’s high-income countries like the Netherlands have experienced a decrease in the incidence of fatal traffic accidents (TAs) in children compared to countries with higher-than-average scores, including Romania, where roughly one out of every two minor deaths was a pedestrian; however, there is a lack of comprehensive and up-to-date epidemiological data on non-fatal TAs regarding pediatric patients. The objective of this study is to perform a thorough examination of the epidemiological aspects of Tas in pediatric patients admitted to the Emergency Department (ED) of “St. Mary’s” Emergency Clinical Hospital for Children in Iasi, Romania. Materials and methods: A descriptive retrospective research study was conducted at the “St. Mary’s” Emergency Clinical Hospital for Children in Iasi, Romania, from January 2015 to December 2022. The research population includes all pediatric trauma patients that were between the age range of 1 month and 18 years who were treated by the trauma department. A total of 358 cases met the inclusion criteria and fulfilled fulfilled fulfilled. Data concerning variables such as accident incidents, types of injuries, and length of hospitalization have been gathered. Results: The average age of the patients was 11.43 ± 4.07 years, with patients of both sexes, the representation of the male sex being 78.5%. The incidence occurred during the summer, representing 15.3% in June. Of the patients admitted to the ED, 55.5% (n = 196) did not require surgery. Most of the patients spent from a minimum of one day to a maximum of 28 days in the hospital, with an average of 8.50 hospital days. The most common injuries were fractures (n = 221), and the most frequent anatomical region affected was the upper limbs (n = 55.2%). Conclusion: While the literature on fatal TA cases shows a declining trend, there is a lack of up-to-date information on non-fatal TAs involving children. The results of our study suggest that there is a high incidence of pediatric TAs due to the scale of “St. Mary’s” Emergency Clinical Hospital for Children, from Iasi, which provides medical services to a considerable number of patients coming from both rural and urban areas of the seven counties of Moldova region, in Romania

Prenatally Diagnosed Infantile Myofibroma of Sartorius Muscle—A Differential for Soft Tissue Masses in Early Infancy

Background: Infantile myofibromatosis (IM) is a soft tissue disease with solitary or multiple benign tumors, and an etiology still unknown. IM is a mesenchymal disorder of early infancy and is more frequent in males. IM may present as a solitary lesion of the skin, bone, muscle, subcutaneous tissue, located at the head, neck, and trunk, with good prognosis; or, as a multicentric form, with or without visceral involvement (heart, lung, gastrointestinal tract, kidney), with a poor prognosis. The definitive diagnosis of IM is confirmed by pathology. Treatment may be conservative, surgical, or chemotherapeutical. Case presentation: A two months old female patient, prenatally diagnosed at 30 weeks, presenting with a tumor on the antero-internal aspect of the left thigh. She was admitted due to rapid postnatal evolution, and the patient required surgery for tumor resection. Previously, clinically, biological and imaging investigations were performed, but the final diagnosis was histological and by immunostaining. The patient had a favorable postoperative outcome. Conclusions: Despite its low frequency, IM should be considered in the differential diagnosis of soft tissue masses at an early age. The clinical form (solitary or multicentric), location, and visceral involvement will dictate the treatment and prognosis

THE SIGNIFICANCE OF CYTOLYSIS SYNDROME IN CHILDREN

The measurement of aminotransferases levels has become part of the routine biochemical tests done in children regardless of their clinical symptoms. Aminotransferases (ALT, AST) are tissue necrosis markers which change in both hepatic and extra-hepatic conditions. The aim of this study was to establish the etiology and clinical signifi cance of the cytolysis syndrome without cholestasis in children hospitalized for various pediatric conditions. The study group consisted of 394 children (aged between 1.5 months and 16 years)with elevated values of ALT, AST. The investigation protocol applied included history, full physical examination, complete biological investigations, viral markers and liver ultrasounds.Depending on the aminotransferases values as compared to the normal value (NV), the patients were included in 3 study subgroups: 222 patients with slightlyelevated transaminases values (< 2xNV) (subgroup I), 164 patients with ALT and AST values between 2-3xNV (subgroup II) and 8 patients with TGP, TGO values > 3 x NV (subgroup III). The ALT and AST values were determined monthly during the fi rst 3 months, and then every 2 to 6 months. In all groups the etiology was dominated by acute bacterial (respiratory, urinary, digestive) and viral (Epstein Barr, Citomegalovirus infection) conditions. Other causes of cytolysis syndrome were nutritional and metabolic diseases (obesity, mellitus diabetes, phenylketonuria, cystic fi brosis, congenital hypotiroidism). The etiology remained unclear in 20.31% of the cases, yet the transaminase values returned to normal after 6 months with diet and hepatoprotective therapy. Slightly elevated ALT andASTvalues do not require thorough investigations, as they usually return to normal within the first three months. On the other hand, mildly and severe increases, which persist after three months therapy require further investigation to determine the etiology (viral infections, autoimmune, nutritional and metabolic diseases)