ARS Medica Tomitana Feed

Evaluation of Diet Supplementation with a Product Based on Honey and Sea Buckthorn (Hebe - Melinis) on Quality of Life and Gastrointestinal Dysfunction in Patients with Parkinson’s Disease

Sat, 11 Jul 2026 00:00:00 GMT

This study aimed to evaluate the impact of a dietary supplement based on a honey and sea buckthorn mixture (Hebe–Melinis) on quality of life, the gut–brain axis, and both motor and non-motor symptoms, including gastrointestinal dysfunction, in patients with Parkinson’s disease. Despite advances in conventional therapeutic approaches, there remains a need to identify adjunctive interventions capable of enhancing clinical outcomes and complementing existing treatments. A total of 30 patients with Parkinson’s disease receiving the Hebe mixture were evaluated at baseline and after three months of administration. Quality of life changes were analyzed using the Wilcoxon signed-rank test. Disease severity was assessed using the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), while gastrointestinal dysfunction was measured using the Gastrointestinal Dysfunction Scale for Parkinson’s Disease (GIDS-PD). Functional disability staging was performed using the Hoehn and Yahr scale. The median age of participants was 71.5 (68.3–73.0) years. Statistically significant improvements were observed in both MDS-UPDRS and GIDS-PD scores following the intervention. These findings suggest that the Hebe mixture is a safe and effective adjunct therapy for improving quality of life in patients with Parkinson’s disease.

Standardized Functional Assessment Tools in Stroke Rehabilitation: Clinical Applicability and Functional Outcomes

Sat, 11 Jul 2026 00:00:00 GMT

Introduction. Stroke represents a major public health issue, being one of the leading causes of mortality and morbidity both globally and nationally. According to the World Health Organization, stroke affects millions of people each year, a significant proportion of whom remain with severe motor, cognitive, and functional impairments, which profoundly impact quality of life. Assessing the consequences of stroke on patients’ functional independence and quality of life is essential for understanding the multidimensional impact of the disease on the individual.Materials and Methods. The literature describes numerous validated clinimetric instruments, easily applicable in clinical practice. The present study was conducted on a patient diagnosed with stroke, evaluated at three distinct stages: before initiation of treatment, immediately after its completion, and at a later follow-up. The evaluation was carried out using clinimetric scales, with the purpose of quantifying neurological, functional, and quality of life changes throughout the recovery process.Results. The patient’s evaluation revealed a significant reduction in the severity of neurological deficit and an improvement in functional independence. The post-treatment assessment demonstrated notable improvements in motor functions and self-care capacity, while the follow-up evaluation confirmed the maintenance of these gains and a trend toward stabilization of the achieved benefits.Conclusions. The systematic use of clinimetric instruments in the evaluation of stroke patients contributes to the objectification of the diagnostic process and the monitoring of clinical evolution, while also facilitating the individualization of therapeutic and rehabilitation strategies. These scales may be applied individually or in combination, depending on the evaluation objectives and the specific characteristics of each patient.

Direct-in-Tube Rapid Papanicolaou Staining (PAPR) for Serous Effusions: Cytomorphological and Diagnostic Performance Evaluation

Sat, 11 Jul 2026 00:00:00 GMT

Background. Serous effusion cytology is essential for evaluating inflammatory and neoplastic processes. Conventional Papanicolaou staining, although considered the reference standard in cytopathology, requires multiple processing steps and substantial reagent consumption.Objective. To validate a rapid modified Papanicolaou staining method applied directly in tube (PapR) for serous effusions and compare its diagnostic and operational performance with the conventional technique.Materials and Methods. Eighty serous effusion samples (28 pleural, 26 peritoneal, 26 pericardial) were processed in parallel using conventional Papanicolaou staining (PAP) and PapR. Cytological interpretation followed TIS 2020 guidelines. Concordance analysis, Cohen’s Kappa coefficient, and diagnostic performance parameters were calculated. Slide adequacy was assessed using a structured Degree of Suitability for Interpretation (DSI) score.Results. Global diagnostic concordance was 97.5% (κ = 0.95, p < 0.001) for the five-category TIS classification. When AUS and SFM categories were grouped as cytologically positive for atypia, PapR demonstrated 100% sensitivity and 98.1% specificity, with a false-positive rate of 1.25% and no false-negative cases identified. Two cases were discordant between methods: one case initially classified as NFM on conventional PAP was reclassified as SFM on PapR (single false-positive result), while the second discordance represented a minor categorical variation that did not modify the positive/negative diagnostic grouping. Cytomorphological features were preserved, and approximately 71% of cellular sediment remained available after staining. When analyzed using binary grouping (negative vs positive for atypia), concordance increased to 98.75% (79/80 cases).Conclusion. PapR represents a rapid, reliable, and resource-efficient alternative to conventional Papanicolaou staining for serous effusions, demonstrating excellent diagnostic performance while optimizing laboratory workflow and preserving biological material.

Patient Satisfaction and Perceived Quality of Care in the Pulmonology Iii Department of the Pneumoftiziology Hospital, Galați, Romania

Sat, 11 Jul 2026 00:00:00 GMT

We conducted a retrospective study evaluating the satisfaction level of inpatients admitted to the Pulmonology Department III of the Pneumoftiziology Hospital Galați, comparing the years 2023 and 2024.The paper highlights a significant improvement in patients’ perceptions of the quality of medical services provided.This study is based on the analysis of patient satisfaction questionnaires from 2023–2024, descriptive statistical methods, and the independent sample T-test to assess the significance of observed differences.Key dimensions evaluated included communication, hygiene, staff availability, transparency of information, and willingness to recommend the institution.The results indicate an increased level of satisfaction, but also reveal clear areas for improvement regarding facility infrastructure and interpersonal communication.The conclusions emphasize the positive impact of enhancements in infrastructure, organization, and doctor–patient interaction, while offering concrete recommendations for continuous improvement of care quality.The study supports the sustained application of the “3S rule”: a healthy, satisfied, and safe patient.

Non-Invasive Diagnosis of Glioblastoma Using Micro-Rna and Tumor-Educated Platelets: A Review of Emerging Biomarkers

Sat, 11 Jul 2026 00:00:00 GMT

Glioblastoma (GB) represent a dynamic and prevalent form of cancer in the central nervous system. Its diagnosis typically relies on physical examination and imaging techniques, often complemented or confirmed by a surgical biopsy. Given the highly invasive nature of these procedures, there is an urgent need to develop non-invasive diagnostic and therapies for GB patients. In this context, liquid biopsy has emerged as a promising alternative, offering tumor-derived information from minimally invasive samples. Platelets, which can absorb or internalize tumor-derived molecules like microRNAs (miRNAs) during tumor progression, undergo changes in their own RNA expression profiles. These miRNAs not only regulate platelet reactivity but, when influenced by tumor signals, also serve as indicators of tumor presence. Such changes in platelet profiles develop tumor-educated platelets (TEPs). TEPs are implicated in cancer progression and metastasis according to their interplay with tumor cells. This review focuses on the potential of TEPs and miRNAs as tumor biomarkers in GB, providing new insights for the development of strategies aimed at cancer prevention and therapy.

Non-Hodgkin Lymphoma with Fulminant Evolution in a Patient with HIV Infection Initially in Stage A3 – Case Presentation

Sat, 13 Jun 2026 00:00:00 GMT

HIV infection is associated with an increased risk for the development of hematological malignancies, especially non-Hodgkin lymphoma (NHL), which continues to present aggressive forms despite therapeutic advances.We present the case of a 49-year-old patient, originally from Ukraine, diagnosed in January 2023 with HIV infection stage A3 according to the Centers for Disease Control and Prevention (CDC) classification. Clinical, paraclinical and histopathological data were retrospectively analyzed to highlight evolutionary and therapeutic peculiarities.Although the patient promptly initiated antiretroviral therapy (ART), the oncological risk associated with persistent immunosuppression remains significant, according to data in the literature. Eleven months after the diagnosis of HIV infection, he developed systemic symptoms, and investigations confirmed the presence of an aggressive NHL, an entity described as being among the most common HIV-associated malignancies. Despite the rapid institution of specific treatment, the evolution was fulminant, with progressive deterioration and death, a scenario also documented in other cases of aggressive NHL associated with immunosuppression.This case reflects the severe evolutionary potential of NHL in HIV patients, even in early stages of infection. Early identification of symptoms, prompt evaluation and multidisciplinary management are crucial to improve prognosis, according to international recommendations.

Immunohistochemical Expression of KI-67 and P53 in Cervical Carcinoma: Correlation with Prognostic Clinicopathological Features

Sat, 13 Jun 2026 00:00:00 GMT

Cervical carcinoma remains a critical public health issue, especially in developing regions despite advances in HPV vaccination and screening programs. This study evaluates the prognostic significance of Ki-67 and p53 immunohistochemical markers in cervical carcinoma and explores their correlation with FIGO stage, histological grade, and lymphovascular space invasion (LVSI). Fifty cases of cervical carcinoma were analyzed retrospectively using WHO 2020 classification and FIGO 2018 staging. The expression patterns of both Ki-67 and p53 were assessed for all cases and significant associations were found between high Ki-67 index and older age, poor differentiated tumors and LVSI. Similarly, mutated p53 patterns correlated strongly with advanced clinical stage, poor differentiation andlympho-vascular positivity. The presence of a high proliferation rate of expression of Ki-67 alongside a mutated pattern or p53 immunostaining indicated a synergistic molecular phenotype linked with aggressive disease biology. These findings support the integration of Ki-67 and p53 biomarkers into diagnostic workflows and highlight their potential role for guiding personalized treatment strategies. Future large-scale studies with follow-up data are needed to substantiate their utility as routine prognostic biomarkers.

Vitamin B12 Deficiency- A Rare Case of Myelitis

Sat, 13 Jun 2026 00:00:00 GMT

Vitamin deficiencies are a common problem worldwide, and vitamin B12 deficiency has been identified as a health concern for nearly a century. People all over the world are frequently deficient in vitamin B12. A number of 30–50% of patients with cobalamin deficiency a kind of neurological involvement, for example neuropathy, myelopathy, dementia or optic neuropathy. We present the case of a 56 years old female patient, who suddenly developed gait difficulty due to motor deficit in the lower limbs. After hospitalization in the neurology ward and specialized investigations, thoracic myelitis and axonal sensorimotor polyneuropathy due to vitamin B12 deficiency are diagnosed. The patient underwent functional evaluation at Techirghiol Rehabilitation Sanatorium, where she received individualized treatment for her motor deficit. Despite longstanding recognition of vitamin B12 deficiency, accurately diagnosing the condition and determining the most appropriate management strategy remain challenging.

Beta-Blocker Medication: Between Cardiovascular Benefits and Functional Limitations in Medical Rehabilitation

Sat, 13 Jun 2026 00:00:00 GMT

Introduction: With multiple indications in both cardiovascular and non-cardiovascular diseases, beta-blockers exert complex effects on the cardiovascular system and energy metabolism, potentially impacting functional performance in medical rehabilitation programs. While their efficacy in controlling cardiac function is well-documented, the literature reports inconsistent results regarding the effects of this drug class on metabolic parameters and exercise tolerance. In the context of medical rehabilitation, these aspects justify the evaluation of the potential impact of beta-blockers on functional response.Materials and Methods: The study had a prospective design and included 320 patients hospitalized between January and December 2025 at the Techirghiol Balneary and Rehabilitation Sanatorium. The antihypertensive medication used was analyzed, with patients grouped based on the administration of beta-blockers or other classes of antihypertensive drugs. Clinical observations regarding exercise tolerance were noted according to the timing of beta-blocker medication administration. Body Mass Index (BMI) was calculated to compare the weight status between groups. Functional evaluation was performed at the beginning and at the end of the rehabilitation program using the Visual Analog Scale (VAS) and the Six-Minute Walk Test (6MWT).Results: Of the included patients, 179 were under treatment with beta-blockers, with metoprolol being the predominantly used active substance. In this group, 72% had BMI values above 25 kg/m², with a gender distribution of 59.7% females and 40.3% males. Comparative analysis revealed higher average BMI values in women treated with beta-blockers compared to those receiving other classes of antihypertensive drugs. Dynamic evaluation indicated a more limited functional improvement in the group of patients treated with beta-blockers.Conclusion: Differences were observed between patients treated with beta-blockers and those treated with other classes of antihypertensive drugs regarding metabolic and functional parameters. These findings highlight the importance of considering antihypertensive therapy and monitoring exercise tolerance in the context of medical rehabilitation programs.

Cervical Cancer in the Current Age: Quo Vadis?

Sat, 13 Jun 2026 00:00:00 GMT

The recognition of human papillomavirus (HPV) as the main cause for cervical cancer transformed prevention and management, leading to widespread HPV vaccination and a change from Pap smear to HPV-based screening. Therapeutic progress includes advances in image-guided radiotherapy, concurrent chemoradiation, and the integration of targeted biologic agents such as anti-angiogenics and immune checkpoint inhibitors. Emerging technologies, including digital pathology, artificial intelligence–assisted diagnostics, and immunohistochemistry-based profiling, are improving accuracy and enabling personalized treatment. New immunotherapeutic approaches, including tumor-infiltrating lymphocyte therapy, offer new options for advanced or recurrent disease. Despite these advances, global disparities persist in access to vaccination, early detection, and comprehensive care. Achieving the World Health Organization’s elimination targets will require coordinated efforts to expand preventive strategies and ensure timely, equitable treatment.

Socio-Behavioral Dynamics: Pretty Privilege’s Effect on Social Relationships in Contemporary Society

Tue, 14 Oct 2025 00:00:00 GMT

Pretty privilege” refers to the social and professional advantages enjoyed by physically attractive individuals, regardless of their actual competence. This study examined the phenomenon through an international online survey completed by over 100 participants from diverse cultural and social contexts. The main objectives were to identify which social relationships are most influenced by attractiveness bias and to explore the dynamics that increase this vulnerability. Findings indicated that professional relationships, especially employer–employee interactions, were perceived as most affected, followed by friendships and client–server relationships. Demographic analyses revealed variations by nationality, gender, work experience, and relationship status, showing that perceptions of attractiveness are culturally and contextually shaped. Furthermore, 71.4% of respondents admitted using attractiveness as a basis for assumptions, linked to the halo effect and self-fulfilling prophecy. Social comparison emerged as an ambivalent factor: it facilitates relationship initiation for attractive individuals but also generates intimidation and jealousy, undermining authenticity. The conclusions highlight two directions: targeted awareness campaigns in different social domains and early educational interventions to equalize expectations toward children regardless of appearance. Addressing pretty privilege therefore requires both immediate measures and long-term strategies to promote equity and ensure that merit, rather than appearance, drives social progress.

Acquired Cystic Disease Associated Renal Cell Carcinoma Clinically Manifested as a Retroperitoneal Hematoma – Brief Presentation and Review of the Literature

Tue, 14 Oct 2025 00:00:00 GMT

Acquired cystic disease associated renal cell carcinoma is an entity first described in 2006 and recognized in the WHO (World Health Organization) guidelines of 2016, also present in the current edition, which develops in the context of chronic kidney disease. We present the case of a 61 years old patient with significant comorbidities, on hemodialysis for 15 years, who was admitted to the hospital’s Emergency Department for a retroperitoneal hematoma. The histopathological examination of the left nephrectomy specimen revealed polycystic kidney disease, chronic pyelonephritis, and a malignant neoplastic proliferation. Immunohistochemical tests established the diagnosis of acquired cystic disease associated renal cell carcinoma. The particularity of this case consisted in its clinical presentation, the incidental finding of the malignant renal tumor in the context of polycystic kidney disease, and the variable immunoexpression of the CK7 marker within the tumor tissue.

Managerial and Emotional Challenges for Parents of Children with Bronchiolitis

Tue, 14 Oct 2025 00:00:00 GMT

One of the most common respiratory conditions in infants and young children is bronchiolitis, which, in addition to the medical problems it causes, can have a serious emotional impact on parents. To highlight the psychosocial demands associated with this medical experience, this research examines the emotional and administrative difficulties faced by parents of children with bronchiolitis. The study was conducted on a sample of approximately 2,650 pediatric cases, of which 350 were diagnosed with bronchiolitis. The parents of these children completed a standardized questionnaire on emotional experiences, difficulties in understanding medical information, stress levels, perceived social support, and ability to manage critical situations. To further explore the quantitative data, a subgroup of 50 parents participated in semi-structured interviews, which provided a detailed perspective on the difficulties experienced on a personal and family level. The results showed high levels of stress (82%), anxiety (78%), and feelings of helplessness (65%) among parents. Challenges related to communication with medical staff, lack of social support, and financial difficulties were also identified. Qualitative analysis highlighted recurring themes such as fear of the child’s condition worsening, lack of clarity in medical information, and the emotional impact on family balance. The study emphasizes the importance of a family-centered approach in the care of children with bronchiolitis and highlights the need to integrate psychological support into pediatric medical practice.

Comparative Outcomes of Hyaluronic Acid Versus Platelet-Rich Plasma Infiltrations in Temporomandibular Joint Disorders

Tue, 14 Oct 2025 00:00:00 GMT

Background: Temporomandibular disorders (TMD) are prevalent musculoskeletal conditions that impair function and quality of life. Intra-articular therapies such as hyaluronic acid (HA) and platelet-rich plasma (PRP) have emerged as minimally invasive options, yet comparative real-world evidence remains limited.Methods: A total of 100 patients with TMD were analyzed in two parallel cohorts: 50 treated with HA and 50 with PRP. Baseline characteristics, treatment protocols, and outcomes were extracted from clinical databases. Primary outcomes included changes in mouth opening (mm) and pain intensity (VAS, 0–10). Secondary outcomes included imaging findings and patient-reported improvement. Statistical analysis was performed using SPSS version 29.0.Results: Patients in the HA group were older on average (47.3 ± 17.9 years) compared with PRP patients (38.6 ± 10.8 years). HA-treated patients more frequently presented with degenerative or structural etiologies, whereas PRP was preferred in cases of parafunctional habits and post-traumatic etiologies. HA was associated with greater improvement in mouth opening (+10.7 mm), while PRP provided superior pain relief (VAS reduction: –4.3 vs. –3.6). Imaging revealed more frequent disc displacement in HA patients (16%), whereas PRP patients more often presented with effusion and degenerative changes (24% and 76%, respectively). Patient-reported outcomes favored PRP, with major improvement or remission more commonly reported.Conclusion: Both HA and PRP provided clinically meaningful improvements in TMD management but with distinct therapeutic profiles. HA appeared most effective in improving function in degenerative disease, whereas PRP offered superior analgesia and higher patient satisfaction. These findings support a patient-tailored approach, with future trials needed to confirm long-term comparative effectiveness and the potential role of combination therapy.

Intestinal Gel Infusion Therapy in Advanced Parkinson’s Disease: Practical Insights and Real-World Experience

Tue, 14 Oct 2025 00:00:00 GMT

As Parkinson’s disease (PD) progresses to advanced stages, treatment optimization becomes imperative for managing refractory motor fluctuations and non-motor symptoms. Conventional oral and transdermal therapies demonstrate limited efficacy in >70% of patients after 5-7 years of treatment. Device-aided therapies (DATs) providing continuous dopaminergic stimulation represent an established approach, reducing OFF-time by 4-6 hours/day in clinical trials. The novel levodopa-entacapone-carbidopa intestinal gel (LECIG) formulation, approved in 202X, uniquely combines continuous duodenal levodopa delivery with peripheral COMT inhibition, enhancing bioavailability while reducing dose requirements.This article has two primary aims: firstly to review LECIG’s pharmacokinetic profile and synthesize clinical evidence from real-world experience, including patient-reported outcomes from early adopters (e.g., Swedish cohorts); and secondly to offer practical guidance for clinicians initiating LECIG, covering transitions from oral therapies or other DATs (e.g., LCIG), stepwise dosing titration, and adverse event management. Notably, LECIG demonstrates motor improvements comparable to standard levodopa–carbidopa intestinal gel (LCIG) but achieves therapeutic plasma concentrations at lower doses due to entacapone’s enhancement of levodopa bioavailability. These features position LECIG as a valuable option for personalized advanced PD care.

Surgical Management of Esophagogastric Junction Cancer - Retrospective Study

Tue, 14 Oct 2025 00:00:00 GMT

Esophagogastric junction cancer is a boundary oncological pathology characterized by tumors located at the interface between the esophagus and stomach, with proximal and distal limits established according to the Siewert classification, which describes three types (I, II, and III) depending on the position of the tumor center relative to the esophagogastric junction. The surgical approach is determined both by this classification and by the surgeon’s experience and the level of expertise of the center where the procedure is performed. Radical surgery is based on preoperative TNM staging. The types of surgery performed and agreed upon by most centers are: transthoracic esophagectomy (Ivor Lewis), transhiatal esophagectomy (Orrienger), abdominal esophagogastrectomy (Hill), McKeown esophagectomy (triple approach), and total gastrectomy. Restoring digestive continuity usually involves the use of the stomach and jejunum, but when the situation requires it, the colon can also be used. As for lymph node dissection, it is performed either by dissection or by en bloc excision, both approaches being accepted. For the most accurate postoperative staging, at least 15 lymph nodes must be harvested. Splenectomy has a limited indication and is justified only when imaging or intraoperative findings reveal invasion of lymph nodes located along the splenic artery or at the splenic hilum. Neoadjuvant chemoradiotherapy is indicated for patients with locally advanced esophagogastric junction adenocarcinoma (Siewert type I-III), with the aim of reducing tumor volume and increasing the probability of achieving complete resection (R0). In situations where radical surgery is not possible, treatment options include endoscopic esophageal stenting, feeding gastrostomy (PEG or classic), and palliative chemotherapy. In conclusion, the surgical management of esophagogastric junction cancer is complex, guided by the Siewert classification and preoperative staging according to the TNM system -fundamental landmarks in establishing the therapeutic approach.

Diagnosis of Esophagogastric Junction Cancer - Retrospective Study

Tue, 14 Oct 2025 00:00:00 GMT

Esophagogastric junction cancer is a distinct anatomical and oncological entity with specific clinical and therapeutic characteristics. It is a pathology located at the interface between the esophagus and the stomach. It is classified according to the system proposed by Siewert into three types (I, II, III), depending on the location of the tumor center relative to the esophagogastric junction. From an anatomopathological point of view, esophagogastric junction cancer is an adenocarcinoma. The incidence of this type of neoplasm has been increasing in recent decades, especially in developed countries, and is associated with risk factors such as chronic gastroesophageal reflux, obesity, and Helicobacter pylori infection. The clinical diagnosis is based on the appearance of swallowing disorders, which at onset are represented by a feeling of retrosternal discomfort or a foreign body sensation, and in advanced stages by obstructive phenomena, manifested by dysphagia, which also associates general signs: asthenia, fatigue, weight loss. Occult or obvious bleeding may also occur, with secondary anemia. Paraclinically, upper digestive endoscopy assesses the tumor level and degree of obstruction, and biopsy sampling allows for histopathological typing, grading, and immunohistochemical and genetic testing. Computed tomography is still the most widely used investigation for diagnosis, pre-treatment TNM staging, assessment of neoadjuvant treatment efficacy, and detection of recurrence. In conclusion, the diagnosis of esophagogastric junction cancer involves a multimodal approach, which is essential for accurate staging and choice of therapeutic strategy.

A Data-Centric Perspective on Nosocomial Infections Following Surgical Procedures

Tue, 14 Oct 2025 00:00:00 GMT

Background: Postoperative nosocomial infections (NIs) increase morbidity, hospitalisation, and mortality. The emergence of multidrug-resistant organisms (MDROs) complicate care and require strict infection control and antibiotic therapy. This study examined postoperative NIs’ clinical, microbiological, treatment profiles and identified risk factors. Methods: This retrospective observational study included 56 adult surgical patients from two tertiary centers in Constanta, Romania. We analysed demographics, comorbidities, operation type, microbiology, inflammatory indicators, ICU admission, mortality, and antibiotic resistance/sensitivity. Results: Patients had a mean age of 53.21 ± 22.61 years, with a slightly male predominance. The ICU had 26.4% admission and 9.4% death. The most common comorbidities were dementia, obesity, diabetes, and atrial fibrillation. Pseudomonas aeruginosa, Acinetobacter baumannii, and Staphylococcus epidermidis dominated the pathogens spectrum. In particular, 40% of cultures were resistant to tetracycline, ceftriaxone, and erythromycin, while vancomycin and linezolid were effective. Klebsiella pneumoniae, Serratia marcescens, and Bacteroides fragilis polymicrobial infections increased ICU utilisation and hospitalisation. Conclusion: Host, procedural, and microbiological variables affect postoperative NIs. Antimicrobial medicines must be tailored to multidrug resistance patterns, and surveillance and stewardship programs are essential. Early detection of high-risk infections may enhance results with focused therapy.

Dual Therapeutic Pathways in TMJ Disorders: Insights from Hyaluronic Acid and PRP Interventions

Tue, 14 Oct 2025 00:00:00 GMT

Background: Temporomandibular joint (TMJ) disorders are multifactorial conditions characterized by pain, dysfunction, and reduced quality of life. Minimally invasive biologic therapies such as hyaluronic acid (HA) and platelet-rich plasma (PRP) infiltrations have emerged as promising alternatives to conventional management.Methods: Fifty patients treated with HA and fifty patients treated with PRP were analyzed retrospectively. Baseline demographics, etiology, imaging profiles, and adjunctive therapies were recorded. Clinical outcomes were assessed using maximal mouth opening, visual analog scale (VAS) for pain, and patient-reported results.Results: HA patients were older (mean 47.3 years) with predominantly degenerative imaging findings, while PRP patients were younger (mean 38.6 years) with parafunctional or inflammatory etiologies. HA infiltrations improved oral opening by more than 10 mm on average, whereas PRP achieved comparable functional recovery but significantly greater pain reduction (VAS decrease from 5.6 to 1.4). Patient-reported remission was more frequent in the PRP group, while HA provided consistent moderate improvement.Conclusion: Both HA and PRP represent effective therapeutic pathways in TMJ management, with complementary benefits. HA is best suited for degenerative cases requiring improved mobility, while PRP provides superior pain relief in inflammatory and parafunctional disorders.

The Burden of Postoperative Nosocomial Infections: Mortality, ICU Admissions, and Prolonged Hospitalization

Tue, 14 Oct 2025 00:00:00 GMT

Background: Postoperative nosocomial infections are a major cause of morbidity and mortality in surgical patients, increasing ICU admissions, prolonging hospitalization, and driving healthcare costs. The emergence of multidrug-resistant organisms further complicates management.Materials and Methods: We conducted a retrospective observational single-center study at Municipal Hospital Mangalia (January 2019–December 2024). Data collected comprised demographics, comorbidities, surgical site, laboratory values, bacterial cultures, and antibiotic resistance patterns. Outcomes analyzed included ICU admission, in-hospital mortality, and prolonged hospitalization.Results: 56 patients met the inclusion criteria. Gram-negative bacteria predominated, with Pseudomonas aeruginosa (25.0%) most common. Antibiotic resistance was present in 60.7% of isolates, most frequently to tetracycline (19.6%) and erythromycin (16.1%). ICU admission occurred in 14 patients (25.0%), and in-hospital mortality was 10.7%. Median hospital stay was 23.5 days (IQR 15.0–33.25), significantly longer than in non-infected patients (p < 0.05). Multivariate analysis identified SOFA score as an independent predictor of ICU admission (OR 8.29, 95% CI 1.13–60.90, p = 0.038) and qSOFA score as a predictor of mortality (OR 8.67, 95% CI 1.41–53.29, p = 0.020).Conclusions: Postoperative nosocomial infections in this cohort were associated with high ICU admission rates, increased mortality, and prolonged hospitalization. Severity scores were strong prognostic markers, underscoring their utility for early risk stratification in surgical patients.