Intra et parasellar chordoma: Case report

A rare case of giant intra and parasellar chordoma, mimicking a pituitary prolactinoma is presented. The tumor involving pituitary fossa and surrounding structures was removed via a bifrontal approach. The pathology exhibited the typical histological patterns of a chordoma. The authors present a rare case of a giant sellar and parasellar chordoma and review the literature on that

Comparison of Digital and Conventional Measurements of the Morphometric Prognostic Parameters in Cutaneous Melanoma

Introduction/ Background Measurements for Breslow and TNM staging on proliferations naevi and melanomas are required both by surgeons and patients, with direct interest in terms of prognosis and therapy. The advantages of digital measurements are: less time consuming, the ability to measure longer distances easy, as the possibility to extract meaningful images for clinicians, as they raise the question on the accuracy of the data supplied compared with those obtained in traditional transmission microscopy. Aims Cross comparison between conventional optical micrometer measurements versus whole scanned histological sections on paraffin tissue with malignant melanoma or naevi. Methods Digital measurements were performed on a series of cases of melanoma and nevi (n = 15) quantifying peripheral margins, deep margin, maximum tumor thickness, including the degree of invasion. Measurements were performed on standard HE staining sections, using Leica equipment (Aperioscan 2) and AperioImageScope 12.2 as software. Data were compared pursuing the gap between the two types of measures and the impact on TNM staging. Results The median numerical differences between the two measurements was low (between 0.003 and 0.023mm), the maximum registered was for depth of invasion. The variability was interpreted as human factor and training variability in taking measurements (most fluctuating - maximum invasion point). They have no significant impact in TNM staging scale Breslow and digital measurements allow quantification of border areas, but with uncertain impact if we consider the tissue processing techniques induced changes. Digital measurements are advantageous because of its simplicity and speed, as well as calibration and standardization opportunities to reduce reading errors

Analysis of risk factors for default and failure treatment among patients with pulmonary tuberculosis under DOTS strategy

Department of Pneumophtysiology, Chiril Draganiuc Institute of Phtysiopneumology, Nicolae Testemitanu State University of Medicine and Pharmacy Chisinau, the Republic of MoldovaBackground: The biggest incidence of tuberculosis (114.3/100.000) in the Republic of Moldova correlates with the lowest success treatment rate (52.3%), the biggest default rate (10.9%) and failure rate (3.5%) in new pulmonary TB cases among European region countries. Material and methods: We studied social, economical, epidemiological risk factors and case-management features of a total amount of 457 pulmonary tuberculosis cases, distribuited in 1-st study group, consisting of 201 cases who failed the anti-tuberculosis treatment, 2-nd study group, consisting of 142 cases, who defaulted the treatment, and a control group of 105 successfully treated patients under Directly Observed Treatment Short Course Chemotherapy. Statistic evaluation was performed using T Student criteria and Odds Ratio, calculated through the two by two table. Results: According to the predictible value, high risc factors for failure were: chronic alcohol consumption, detention releasing and for default were: male sex, economic disadvantage, single civil state, chronic alcohol consumption, detention releasing. Conclusions: Default and failure antituberculosis treatment refers to the patients belonging to economicaly and social disadvantaged groups, with harmful habits (alcoholosm, drug injection using, active smoking), low living conditions, belonging high risk epidemiological groups. Migrations, homelessness and detention releasing imperil the continuing of antituberculosis treatment, predisposisng to failure and default of the antituberculosis treatment. Social, educational support and withdrawl techniques for harmful habits must be implemented to high risk groups to minimise the risk of non-adherence to the disease

High-grade versus low-grade serous carcinoma of the ovary – current differential diagnosis and perspectives

Introduction. Serous carcinoma is responsible for 47% of all ovarian cancers, and from these cases, only 5% are represented by low-grade serous carcinoma, the rest of them accounting for high-grade serous carcinoma. Objective. The aim of this study is an observational approach of the differences and similarities of the two types of serous carcinoma of the ovary, that must be seen as different forms of cancer and rendered with care. Methods. We performed a retrospective study using three cases of ovarian high-grade serous carcinoma and three cases of ovarian low-grade serous carcinoma, diagnosed at the University Emergency Hospital Bucharest. We analyzed patients’ age, clinical symptoms, macroscopic and microscopic features together with immunohistochemistry tests. Results. Mean age for HG carcinoma was 71.3 years old and for LG carcinoma 47.6 years old. Average tumor diameter was with 5.67 cm higher for LG carcinoma. The most encountered stage for HG tumors was pT2a and for LG tumors was pT1a. Mean value for Ki67 was with 36.33% higher for HG carcinoma. AR expressed diffuse positivity in two cases of LG and only focal positivity in two cases of HG. CD44 expressed focal positivity in all cases of LG and had different patterns in HG. Conclusions. We found considerable differences between patients’ mean age, macroscopic and microscopic features, together with immunohistochemistry expression for Ki67, AR, CD44

COMBINATORIAL EFFECT OF D-AMINOACIDS AND TETRACYCLINE AGAINST PSEUDOMONAS AERUGINOSA BIOFILM

Objective: The present study attempted to evaluate the anti-biofilm activity of D-amino acids (D-AAs) on Pseudomonas aeruginosa and determine if the combination of D-AAs with tetracycline enhances the anti-biofilm activity in vitro and ex vivo.Methods: Different D-AAs were tested for antibiofilm activity against wild type P. aeruginosa PAO1 and two multidrug resistant P. aeruginosa clinical strains in the presence of sub inhibitory concentrations of tetracycline using crystal violet microtitre plate assay. Results were further validated using in vitro wound dressing and ex vivo porcine skin models followed by cytotoxicity and hemocompatibility studies.Results: D-tryptophan (5 mmol) showed 61 % reduction in biofilm formation of P. aeruginosa. Interestingly combinatorial effect of 5 mmol D-tryptophan and 0.5 minimum inhibitory concentration (MIC) (7.5µg/ml) tetracycline showed 90% reduction in biofilm formation. 5 mmol D-methionine shows 28 % reduction and combination with tetracycline shows 41% reduction in biofilm formation of P. aeruginosa. D-leucine and D-tyrosine alone or in combination with tetracycline did not show significant anti-biofilm activity. D tryptophan-tetracycline combination could reduce 80 % and 77 % reduction in biofilm formation in two multi drug resistant P. aeruginosa clinical strains. D-tryptophan-tetracycline-combination could also reduce 76% and 66% reduction in biofilm formation in wound dressing model and porcine skin explant respectively. The cytotoxicity and hemocompatibility studies did not show significant toxicity when this combination was used.Conclusion: The results established the potential therapeutic application of D-tryptophan alone or in combination with tetracycline for treating biofilm associated clinical problems caused by P. aeruginosa

Clinico‑morphological aspects and new immunohistochemistry characteristics of ovarian high‑grade serous carcinoma

Introduction. High‑grade serous carcinoma of the ovary is an aggressive form of cancer, with unknown precursor lesions and often delayed diagnosis because of non‑specific, mild symptoms. Objective. We performed a clinical‑pathological study of ovarian high‑grade serous carcinomas, in order to evaluate morphological and new immunohistochemistry characteristics of this malignancy. Methods. This is a retrospective study of 10 cases of ovarian high‑grade serous carcinoma. We evaluated patients’ age, symptoms at presentation, macroscopic aspects, bilateral involvement, microscopic features: papillary/solid areas, mitotic index, psammoma bodies, tumoral extension, lymph node metastasis, immunohistochemistry markers: CD44, ER, AR, Ki67 index. Results. Mean age was 56.9 years old. Tumors were bilateral in 50% of cases. Only 30% were limited to the ovary. Maximum tumor diameter was 16 cm. Solid component in a proportion of 50‑95% was more characteristic. Most tumors had a mitotic index of 30‑50 mitosis/10HPF (70% of cases). 20% of cases contained psammoma bodies. 2 cases out of 7 had lymph node metastasis. We noticed one case with pleural metastasis (M1). We observed AR80% was noticed in 30% of cases. CD44 was positive in 50% of cases and one case had diffuse positivity of CD44 in corpus luteum cells near the tumoral bed. Conclusions. The majority of patients with ovarian high‑grade serous carcinomas presented with extraovarian extension and were characterized by high mitotic index, rare presence of psammoma bodies, AR expression <10%, novel marker CD44 positive in 50% of cases and curious positivity in corpus luteum cells associated with the tumor

Вирусные гепатиты В, С и D в Республике Молдова: достижения и проблемы

Agenția Națională pentru Sănătate Publică, IP Universitatea de Stat de Medicină și Farmacie Nicolae Testemițanu, IMSP Centrul Republican de Diagnosticare MedicalăRealizarea primelor trei Programe Naționale de combatere a hepatitelor virale B, C și D în Republica Moldova, începând cu anul 1997, au condus la reducerea semnificativă a morbidității prin hepatitele virale B, C și D acute, dar pe fundalul incidenței sporite a hepatitelor virale cronice, unde indicatorii îi depășesc vădit pe cei din țările Comunității Europene. Studiile realizate demonstrează că contingentele de populație cu risc sporit de infectare continuă să prezinte un potențial înalt ca sursă reală de infectare cu virusurile hepatice nominalizate pentru alte categorii de populație. Ca urmare a utilizării tehnicilor de biologie moleculară, au fost evidențiate genotipurile și subgenotipurile virusurilor hepatitelor B, C și D în special la contingentele de populație cu risc sporit de infectare, demonstrând că unele posedă un potențial înalt de cronicizare, cu evoluție spre ciroză și cancer hepatocelular. Utilizarea produselor antivirale de ultimă generație recomandate de OMS pentru tratamentul hepatitelor virale B și C a demonstrat o eficacitate înaltă nu numai terapeutică, ci și profi lactică, manifestată prin reducerea numărului de bolnavi purtători de virusuri și a noilor focare. Este important de menționat că prejudiciul economic prevenit ca urmare a realizării Programelor Naționale de combatere a hepatitelor virale în perioada 1997-2015 a constituit 822.453 mii lei, pe când cheltuielile din bugetul de stat pentru realizarea acestor programe au alcătuit 84.618,5 mii lei. Realizarea integrală a prezentului Program de combatere a hepatitelor virale B, C și D în contextul Planului Strategic al OMS de eliminare a hepatitelor virale parenterale până în anul 2030 va avea un beneficiu socioeconomic extrem de important pentru Republica Moldova.The implementation of the first three National Programs against viral hepatitis B, C and D in the Republic of Moldova since 1997 has allowed to significantly reduce morbidity of acute viral hepatitis B, C and D, but on the increased background of incidence of chronic viral hepatitis the indicators clearly outweigh those in the European Community. Studies have shown that the contingent of population at high risk of infection continues to show a high potential as a real source of infection with viral hepatitis viruses for other population categories. As a result of the use of molecular biology techniques, the genotypes and subgenotypes of hepatitis B, C and D viruses have been highlighted, particularly in contingent of population at high risk of infection, demonstrating that some have a high potential for chronicization with progression to cirrhosis and hepatocellular cancer. Using of next-generation antiviral drugs in the treatment of viral hepatitis B and C recommended by the WHO has shown a high, not only therapeutic but also prophylactic efficacy manifested by reducing the number of virus-bearing patients, and new outbreaks. It is important to note that the economic prejudice prevented by the implementation of the National Programs against viral hepatitis during the period 1997-2015 amounted to 822.453 thousand lei, while the spending from the State Budget for the implementation of the nominated programs amounted to 84.618.5 thousand lei. The full implementation of the current Program for combating viral hepatitis B, C and D in the context of the WHO Strategic Plan for the elimination of parenteral viral hepatitis by 2030 will have a very important socio-economic benefit for the Republic of Moldova.Реализация первых трех Национальных программ по борьбе с вирусными гепатитами B, C и D в Республике Молдова с 1997 года позволила значительно снизить заболеваемость острыми вирусными гепатитами B, C и D, но на фоне высокого уровня заболеваемости хроническими вирусными гепатитами, показатели явно перевешивают показатели стран Европейского Cоюза. Исследования показали, что среди групп населения с высоким риском инфицирования все еще присутствует высокий потенциал в качестве реального источника заражения вирусами гепатитов для других категорий населения. В результате использования методов молекулярной биологии были выделены генотипы и субгенотипы вирусов гепатитов B, C и D, особенно среди групп с высоким риском инфицирования, демонстрируя, что некоторые имеют высокий потенциал к хронизации и прогрессированию к циррозу и гепатоцеллюлярного рака. Использование противовирусных препаратов последнего поколения для лечения вирусных гепатитов В, C и D, рекомендованных ВОЗ, продемонстрировало не только высокую терапевтическую, но и профилактическую эффективность за счет сокращения числа вирусоносителей и новых очагов инфекции. Важно отметить, что предотвращённый экономический ущерб в результате реализации Национальных программ по борьбе с вирусными гепатитами в период 1997–2015 годов составил 822.453 тысяч леев, а расходы государственного бюд-жета на реализацию указанных программ составили 84.618,5 тысяч леев. Полная реализация текущей Программы по борьбе с вирусными гепатитами B, C и D в контексте Стратегического плана ВОЗ по элиминации парентеральных вирусных гепатитов к 2030 году будет иметь важное социально-экономическое значение для Республики Молдова

Clinical and molecular practice of European thoracic pathology laboratories during the COVID-19 pandemic. The past and the near future.

This study evaluated the consequences in Europe of the COVID-19 outbreak on pathology laboratories orientated toward the diagnosis of thoracic diseases. A survey was sent to 71 pathology laboratories from 21 European countries. The questionnaire requested information concerning the organization of biosafety, the clinical and molecular pathology, the biobanking, the workload, the associated research into COVID-19, and the organization of education and training during the COVID-19 crisis, from 15 March to 31 May 2020, compared with the same period in 2019. Questionnaires were returned from 53/71 (75%) laboratories from 18 European countries. The biosafety procedures were heterogeneous. The workload in clinical and molecular pathology decreased dramatically by 31% (range, 3%-55%) and 26% (range, 7%-62%), respectively. According to the professional category, between 28% and 41% of the staff members were not present in the laboratories but did teleworking. A total of 70% of the laboratories developed virtual meetings for the training of residents and junior pathologists. During the period of study, none of the staff members with confirmed COVID-19 became infected as a result of handling samples. The COVID-19 pandemic has had a strong impact on most of the European pathology laboratories included in this study. Urgent implementation of several changes to the organization of most of these laboratories, notably to better harmonize biosafety procedures, was noted at the onset of the pandemic and maintained in the event of a new wave of infection occurring in Europe