Best therapeutic practices in the management of obstetric sepsis

Background. Physiological changes that occur during pregnancy make maternal sepsis a difficult condition to diagnose and treat, still having a fairly high mortality rate. Consequently, an early diagnosis and prompt therapeutic management of sepsis can significantly decrease mortality. The purpose of this study is to review literature data that present current practices in the management of obstetric sepsis. Methods. To collect the data required for the study, we performed a search of published articles in the PubMed and Google Scholar databases related to obstetric sepsis. Research paper articles from the period 2012-2022 were included in the analysis. In addition, 145 articles from the period 2012-2022 were evaluated, with the aim of finding out in which situations the risk of maternal death is higher. Thus, the analysis included a total number of 151 articles, which were divided into two distinct stages. Results. The risk of maternal death is higher among patients with the human immunodeficiency virus (HIV), followed by Escherichia coli, genital tract infection, cancer, drug users and in the case of patients with chronic liver disease. Conclusions. After analyzing the data, we found that prompt and focused antibiotic therapy as well as fluid resuscitation are essential to increase the chances of survival of these patients

Functional radical cervical dissection for differentiated thyroid cancer: the experience of a single center

There is ongoing debate regarding the role of neck dissection in differentiated thyroid cancer, about its usefulness in elective settings, and the increased costs regarding morbidity and operative time. This retrospective study aimed to determine the rate of metastases in cervical lymph nodes, to examine the morbidity of this surgery, and to assess whether a pattern of distribution of tumor cells concerning neck lymphatic compartments exists. The most frequent type of cancer to metastasize was papillary cancer, the majority of patients were young with a median of 30 years, predominantly females. Differentiated thyroid cancer frequently metastasizes to the central and lateral compartments of the neck. The morbidity is minimal in a high-volume center. Radical neck dissection is safe and feasible in selected patients with confirmed invaded or enlarged lymph nodes due to differentiated thyroid cancer, and postoperative complications are minimal if the anatomy is correctly identified and the cases strictly selected

Diatoms and their role in aquatic ecosystems

The present article aimed to determine diversity and abundance of diatoms in the river basin of the Cerna River. In order to achieve the objective, samples were taken from the entire course of the river, from 9 specific points (I, II, III, IV, V, VI, VII, VIII, IX) in spring-summer of 2020. 53 species of diatoms classified in 21 genera were determined

Arterial vascularization of the colon; a guide to surgical resection

Background. Colorectal cancer is a commonly diagnosed neoplasia in men and women worldwide. This study aims to rigorously map the arterial distribution of the colon in order to assess the implications of vascular patterns in surgical resection. Methods. Cadaveric dissections were performed to explore the arterial distribution (including collateral blood flow) of the colon. The study used standard dissection tools and photographic documentation to detail the vascular architecture supporting the large intestine. Results. The dissection revealed important arterial branches and anastomoses in the area of the superior and inferior mesenteric arteries, which are able to ensure continuous local blood supply especially in cases of arterial ischemia. An important arterial anastomosis was identified between the right branch of the middle colic artery and the ascending branch of the right colic artery, as well as the specific distribution of the marginal artery of Drummond and Haller-Riolan anastomotic arch. Conclusions. The blood supply of the colon derived from both mesenteric arteries includes redundant arterial anastomoses, but which are critical in specific situations such as the approach and results of surgical resection. Understanding these vascular patterns and collateral pathways, as well as careful intraoperative surgical exploration, are essential for oncologic surgeons to ensure successful colic resections with minimal complications and morbidity

Functional radical cervical dissection for differentiated thyroid cancer: the experience of a single center

There is ongoing debate regarding the role of neck dissection in differentiated thyroid cancer, about its usefulness in elective settings, and the increased costs regarding morbidity and operative time. This retrospective study aimed to determine the rate of metastases in cervical lymph nodes, to examine the morbidity of this surgery, and to assess whether a pattern of distribution of tumor cells concerning neck lymphatic compartments exists. The most frequent type of cancer to metastasize was papillary cancer, the majority of patients were young with a median of 30 years, predominantly females. Differentiated thyroid cancer frequently metastasizes to the central and lateral compartments of the neck. The morbidity is minimal in a high-volume center. Radical neck dissection is safe and feasible in selected patients with confirmed invaded or enlarged lymph nodes due to differentiated thyroid cancer, and postoperative complications are minimal if the anatomy is correctly identified and the cases strictly selected

Functional radical cervical dissection for differentiated thyroid cancer: the experience of a single center

There is ongoing debate regarding the role of neck dissection in differentiated thyroid cancer, about its usefulness in elective settings, and the increased costs regarding morbidity and operative time. This retrospective study aimed to determine the rate of metastases in cervical lymph nodes, to examine the morbidity of this surgery, and to assess whether a pattern of distribution of tumor cells concerning neck lymphatic compartments exists. The most frequent type of cancer to metastasize was papillary cancer, the majority of patients were young with a median of 30 years, predominantly females. Differentiated thyroid cancer frequently metastasizes to the central and lateral compartments of the neck. The morbidity is minimal in a high-volume center. Radical neck dissection is safe and feasible in selected patients with confirmed invaded or enlarged lymph nodes due to differentiated thyroid cancer, and postoperative complications are minimal if the anatomy is correctly identified and the cases strictly selected

Continuous renal replacement therapy in cytokine release syndrome following immunotherapy or cellular therapies?

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadRecently, an increasing number of novel drugs were approved in oncology and hematology. Nevertheless, pharmacology progress comes with a variety of side effects, of which cytokine release syndrome (CRS) is a potential complication of some immunotherapies that can lead to multiorgan failure if not diagnosed and treated accordingly. CRS generally occurs with therapies that lead to highly activated T cells, like chimeric antigen receptor T cells or in the case of bispecific T-cell engaging antibodies. This, in turn, leads to a proinflammatory state with subsequent organ damage. To better manage CRS there is a need for specific therapies or to repurpose strategies that are already known to be useful in similar situations. Current management strategies for CRS are represented by anticytokine directed therapies and corticosteroids. Based on its pathophysiology and the resemblance of CRS to sepsis and septic shock, as well as based on the principles of initiation of continuous renal replacement therapy (CRRT) in sepsis, we propose the rationale of using CRRT therapy as an adjunct treatment in CRS where all the other approaches have failed in controlling the clinically significant manifestations.School of Doctoral Studies - Iuliu Hatieganu University Romanian Government Ion Chiricuta Oncology Institute Cluj Napoca Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca European Economic Spac

Risk factors for infections caused by carbapenem-resistant Enterobacterales: an international matched case-control-control study (EURECA)

Cases were patients with complicated urinary tract infection (cUTI), complicated intraabdominal (cIAI), pneumonia or bacteraemia from other sources (BSI-OS) due to CRE; control groups were patients with infection caused by carbapenem-susceptible Enterobacterales (CSE), and by non-infected patients, respectively. Matching criteria included type of infection for CSE group, ward and duration of hospital admission. Conditional logistic regression was used to identify risk factors. Findings Overall, 235 CRE case patients, 235 CSE controls and 705 non-infected controls were included. The CRE infections were cUTI (133, 56.7%), pneumonia (44, 18.7%), cIAI and BSI-OS (29, 12.3% each). Carbapenemase genes were found in 228 isolates: OXA-48/like, 112 (47.6%), KPC, 84 (35.7%), and metallo-beta-lactamases, 44 (18.7%); 13 produced two. The risk factors for CRE infection in both type of controls were (adjusted OR for CSE controls; 95% CI; p value) previous colonisation/infection by CRE (6.94; 2.74-15.53; <0.001), urinary catheter (1.78; 1.03-3.07; 0.038) and exposure to broad spectrum antibiotics, as categorical (2.20; 1.25-3.88; 0.006) and time-dependent (1.04 per day; 1.00-1.07; 0.014); chronic renal failure (2.81; 1.40-5.64; 0.004) and admission from home (0.44; 0.23-0.85; 0.014) were significant only for CSE controls. Subgroup analyses provided similar results. Interpretation The main risk factors for CRE infections in hospitals with high incidence included previous coloni-zation, urinary catheter and exposure to broad spectrum antibiotics

Gender marking in L1 and L2 French: Syntactic complexity, lexical category and phonological expression

Very little is known about the accuracy of grammatical inflection in written language. In this study we investigated the effects of syntactic complexity, lexical category and phonological expression on gender marking in L1 and L2 French. Native speakers of French (n = 40) and Dutch learners of French (n = 45) completed a fill-in-the-gap task in which the test items were controlled for the linguistic factors under investigation. The results showed main effects for syntactic complexity and lexical category. For phonological expression we only observed moderation effects. We conclude that syntactic complexity and lexical category affect the accuracy of gender marking in written L1 and L2 French more than phonological expression

Gender marking in L1 and L2 French: Syntactic complexity, lexical category and phonological expression

Very little is known about the accuracy of grammatical inflection in written language. In this study we investigated the effects of syntactic complexity, lexical category and phonological expression on gender marking in L1 and L2 French. Native speakers of French (n = 40) and Dutch learners of French (n = 45) completed a fill-in-the-gap task in which the test items were controlled for the linguistic factors under investigation. The results showed main effects for syntactic complexity and lexical category. For phonological expression we only observed moderation effects. We conclude that syntactic complexity and lexical category affect the accuracy of gender marking in written L1 and L2 French more than phonological expression