Development and validation of Triticum phytobiological method as an alternative procedure for investigating in vivo acute toxicity on mice

The goal of this study was to validate an alternative method for determining in vivo acute toxicity using vegetal material instead of laboratory animals, starting from the phytobiological method known also as the Triticum technique. We set out to demonstrate that vegetal cells have similar sensitivity to some toxic agents as animal cells, in which case a statistical correlation could be established. A series of new compounds synthesized by the Romanian National Institute for Chemical Pharmaceutical Research and Development as potential β3 adrenergic receptors agonists were tested for their acute toxicity using classic animal exposure models, before investigating possible anti-diabetic and anti-obesity effects. We then determined whether similar conclusions might be reached exposing vegetal material to the same agents. We successfully demonstrated that plants are affected in a very similar way as animals when exposed to some potentially toxic agents, providing new possibilities for ending unethical animal experiments

MANAGEMENT OF PATIENTS WITH PATHOLOGICAL FRACTURES IN THE REPUBLIC OF MOLDOVA

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Fracturile patologice reprezintă o problemă importantă de sănătate publică în Republica Moldova (RM), survenite ca urmare a osteoporozei, metastazelor canceroase sau boala Paget. Managementul pacienților cu fractură patologică în RM implică un proces complex de evaluare, tratament și îngrijire. Scopul lucrării. Evaluarea practicilor naționale de management clinic al pacienților cu fracturi patologice pentru racordarea acestora la practicile internaționale. Rezultate. Evaluarea clinică minuțioasă și imagistică adecvată este primordiala în abordarea clinică a acestor pacienți. În baza datelor obținute (gradul de fractură și stadiul afecțiunii subiacente) se trasează planul de tratament. Abordarea clinică este una multidisciplinară, care implică ortopezi, oncologi, radiologi, fiziokinetoterapeuți și alte cadre medicale specializate. Tratamentul propus poate fi conservator sau chirurgical, incluzând: proceduri minim invazive - vertebroplastia și cimentoplastia și osteosinteza. Alegerea procedurii depinde de localizarea și gradul fracturii, starea generală a pacientului și afecțiunea preexistentă care a condiționat fractura. Conduita post-terapică a pacienților cu fractura patologică implică un program intensiv de reabilitare, cuprinzând terapie fizică, kinetoterapie și alte forme de terapie adjuvantă pentru a asigura restabilirea funcției și a mobilității. Suportul psihologic și școlarizarea pacienților sunt indispensabile pentru prevenția fracturile. Concluzii. Managementul pacienților cu fractură patologică în RM presupune o abordare multidisciplinară și calitativă prin evaluarea riguroasă, tratamentul adecvat și îngrijirile post-tratament care asigura recuperarea rapidă și sigură a pacienților. Dezvoltarea tehnologiilor și asigurarea cu resurse necesare pentru formarea personalului competent este obligatorie.Introduction. Pathological fractures represent an important public health problem in the Republic of Moldova (RM), occurring as a result of osteoporosis, cancer metastases or Paget’s disease. Management of patients with pathological fracture in MR involves a complex process of assessment, treatment and care. Objective of the study. Evaluation of national practices of clinical management of patients with pathological fractures for their connection to international practices. Results. Thorough clinical evaluation and appropriate imaging are paramount in the clinical management of these patients. Based on the obtained data (degree of fracture and stage of the underlying condition) the treatment plan is drawn up. The clinical approach is multidisciplinary, involving orthopedists, oncologists, radiologists, physiotherapists and other specialized medical personnel. The proposed treatment can be conservative or surgical, including: minimally invasive procedures - vertebroplasty and cementoplasty and osteosynthesis. The choice of procedure depends on the location and degree of the fracture, the general condition of the patient and the pre-existing condition that caused the fracture. The post-therapeutic management of patients with pathologic fracture involves an intensive rehabilitation program, including physical therapy, physical therapy, and other forms of adjunctive therapy to ensure the restoration of function and mobility. Psychological support and patient education are indispensable for fracture prevention. Conclusions. The management of patients with pathological fracture in MR requires a multidisciplinary and qualitative approach through rigorous evaluation, appropriate treatment and post-treatment care that ensures rapid and safe recovery of patients. The development of technologies and the provision of necessary resources for the training of competent personnel is mandatory

Can non-small cell lung cancer histologic subtypes predict survival? A single institution experience

Introduction. The latest histological classification of lung adenocarcinoma includes lepidic, acinar, papillary, micropapillary, and solid as subtypes. Testing these subtypes for their prognostic and predictive value is an ongoing scientific challenge. The present research article aims to describe the influence this classification has on patient survival. Materials and Methods. Thirty-three patients were included in the trial. The most important enrollment criterion was the clear specification of the adenocarcinoma subtype in the pathology report. Patients were stratified into three groups which included the adenocarcinoma pathological subtypes as follows: lepidic (LEP), acinar and papillary (ACN/PAP), and micropapillary/solid (MIP/SOL). The primary endpoint was progression-free survival. Other endpoints included overall survival. Results. The lepidic subtype of ADC had superior PFS and OS, regardless of stage. Papillary and acinar subtype showed an intermediate prognosis, whereas micropapillary and solid subtypes were the most aggressive. Conclusions. The experience of this single center confirmed data in the literature. Further studies are needed to demonstrate all the possible implications of this pathology classification

Diagnostic dilemma: Multiple Autoimmune Syndrome versus incomplete Graham-Little-Piccardi-Lassueur Syndrome overlap mixed connective tissue disease

Objectives. We present a very rare case of incomplete Graham-Little-Piccardi-Lassueur syndrome (GLPLS) overlap with Mixed Connective Tissue Disease (MCTD) versus Multiple Autoimmune Syndrome (MAS). Case Presentation. A 53- year-old female with a long history of more than two years of patchy hair loss on scalp like “footprints in the snow”, partial loss of eyebrows' hair, face erythema, scaly atrophied red/brown patches on face, grouped follicular papules 2-3 mm in diameter with a pointed or hair-like horny spine extending approximately 1-2 mm around the tip of the follicle on lumbar area. The histopathological results from biopsies of scalp and lumbar areas confirmed the clinical diagnosis of cicatricial alopecia induced by lichen plan pilaris (LPP) and also presence of lichen spinulosus (LS) on lumbar area. The description provided by pathologist is however borderline regarding so called interface dermatosis like chronic cutaneous lupus erythematous (CCLE) or Pseudopelade of Brocq (PPB) as the end stage of CCLE or LPP. Blood tests showed both Antinuclear antibodies and U1-nRNP in high titers and the absence of anti-Sm, anti SS-A, anti SS-B and anti-dsDNA antibodies, and also peculiar antibody patterns of MCTD. Outcome. After thorough investigation, MCTD was proven by antibodies results. After one year of treatment a lot of clinical features dramatically responded under therapy. Conclusions. Clinical manifestations in the pathology with strictly cutaneous or systemic localization in conjunction or overlap with other autoimmune diseases (grouped in the MAS) represent a rare diagnostic in daily practice

How opportune is multigene testing in metastatic colorectal cancer? A review

Personalized treatment in oncology is the most innovative method of care. The best method to establish personalized treatment is by genetic characterization of the malignant cell. Theoretically, the more detailed the characterization, the more effective the choice of treatment becomes. Currently, there are fast and relatively low-cost options that allow such genetic characterization. However, test results sometimes do not detect targetable alterations and, even if they do detect, the use of the treatment-alteration combination does not always generate a satisfactory oncological response. The present paper aims to answer two questions. First, how targetable can the most common gene alterations in colorectal cancer be. Second, whether it makes sense to use broad molecular testing as a standard in all metastatic patients

Determination of pyrrolizidine alkaloids in dietary sources using a spectrophotometric method

Pyrrolizidine alkaloids (PAs) are a class of toxic compounds found in the composition of more than 6000 plants. People can be exposed to PAs by consuming phytotherapeutic products, food from crops contaminated with seeds of some species with high content of PAs, and/ or contaminated animal products like bee products. For this reason we developed and validated a method for quantitative determination of PAs, from the most frequently contaminated food sources, honey and flour. Colorimetric Ehrlich reagent method was used with standard addition (1mg/kg senecionine). The extraction solvent was methanol 50% acidified with citric acid to pH 2-3, as this solvent can be used for alkaloids and N-oxides. We found that, in extracting the alkaloid only once from the dietary sources, the percent of recovery is low (52.5% for honey, and 45.75% for flour). Using successive extractions, three times with the same solvent, the senecionine retrieval percentage increased to 86.0% for honey and 76.0% for flour. The method was validated using the following parameters: selectivity, linearity (0,25- 20 mg/ mL senecionine), accuracy (average recovery 93.5 - 107.93%) and precision (RSD 3,26-4.55%.). The calculated limit of quantification (0.174 mg/ mL) makes this method applicable for determining Pas occurring at toxic levels for consumers

Necrotizing ulcerative enterocolitis - risk factors, therapeutic interventions

Universitatea de Medicină şi Farmacie “Gr.T.Popa”, Iaşi, Spitalul Clinic de Obstetrică-Ginecologie Cuza-Vodă, Spitalul Clinic de Urgenţă pentru Copii Sf. Maria, IaşiNecrotizing enterocolitis (NEC) is the most frequent digestive emergency in the neonatal period, mainly diagnosed in the premature newborn. In this study, the authors tried to synthesize the correlation among risk factors, stage of disease and outcome. Material and methods: we carried out a retrospective study on 205 neonates with NEC, diagnosed in our NICU over 6 years. We assessed the following parameters: gestational age, birth weight, associated diseases, infection, moment of onset, type of feeding at onset, clinical staging, duration of symptoms, surgical treatment and outcome. Results: the incidence of NEC in the NICU was 3.32%. The mean GA was 33 weeks and the mean BW was 1900 grams. Associated diseases were: PDA – 19.5%, perinatal asphyxia – 13.7%, medium and severe respiratory distress – 67.8%. 39% of the neonates had positive gastric aspirates and infection was correlated with clinical staging. The onset of symptoms was 9 days of age and the mean duration of symptoms was 5 days. Both were correlated with clinical staging. Feeding at onset was predominantly parenteral, with or without enteral supplementation with formula. 16.6% of patients were transferred to Pediatric Surgery, 9.3% were performed surgery and 6.8% were deceased following surgery. Conclusions: Our results show powerful arguments both for the caution regarding nutrition of the premature newborn and for the timely therapeutic intervention in newborns with NEC

Study on the Implementation of Theoretical Notions in the Online PE Lesson during the Covid-19 Pandemic

Objective: The aim of this research is to analyse the use of the practical component within the online PE lesson during the Covid-19 pandemic.Design: A number of 400 PE teachers from 9 counties of Romania were interviewed in connection with the online PE lesson during the Covid-19 pandemic. Thus, the proposed questionnaire contains two parts: one in which demographic data is requested and one containing 14 items requesting the specialized opinion regarding the online PE lesson. The likert scale was used in order to construct 5 answer options for each of the 14 items.Results: Teachers who said they approach these elements "Very Much" or "A lot" are below 3.6%. Those who answered that they approach them "Enough" are still quite few when it comes to learning/strengthening motor skills specific to sports games (8%), but their number increases when it comes to speed (17.3%) and endurance (22.8%). One may also notice that the sum of the percentages “A Little” + “Not at all” of the teachers who answered that they approach these three elements is over 71%. (77.6% speed, 71.5% endurance, 97.3% motor skills specific to sports games).Conclusion: Teachers’ answers indicate the fact that, in the online PE lesson, motor skills are developed, with an increased emphasis on strength, dexterity and flexibility.</p

Toxicity of plant extracts containing pyrrolizidine alkaloids using alternative invertebrate models

Pyrrolizidine alkaloids (PAs) are a widespread class of hepatotoxic heterocyclic organic compounds found in approximately 3% of world flora. Some PAs have been shown to have genotoxic and carcinogenic effects. The present study focuses on the toxicity effects of four dry extracts obtained from medicinal plants (Senecio vernalis, Symphytum officinale, Petasites hybridus and Tussilago farfara), on two aquatic organisms, Artemia salina and Daphnia magna, and the correlation with their PAs content. A new GC‑MS method, using a retention time (TR)‑5MS type capillary column was developed. PAs Kovats retention indices, for this type of column were computed for the first time. The lethal dose 50% (LC50) values for the two invertebrate models were correlated (Pearson 's coefficient, >0.9) and the toxicity was PA concentration-dependent, for three of the four extracts. All tested extracts were found to be toxic in both aquatic organism models. The results can be used to develop a GC‑MS validated method for the assay of PAs in medicinal plants with a further potential application in the risk assessment study of PAs toxicity in humans