Bulletin of Medical Sciences Feed

Assessment of the prevalence of obesity among the Gábor Roma population in comparison with the surrounding non-Roma population

Sat, 11 Jul 2026 00:00:00 GMT

Obesity is a major global public health challenge, particularly affecting ethnic groups that have undergone rapid lifestyle transitions in recent decades, such as the Gabor Roma population in our region. The aim of this study was to assess the current prevalence of obesity in this population. In this cross-sectional study, Roma and non-Roma adults were randomly recruited from settlements in Mureș and Harghita counties. Data collected included participants’ sex, age, height, body weight, birth weight, body weight at 14 years of age, physical activity, number of siblings, and personal and family medical history. Participants were categorized according to ethnicity, age group, body mass index (BMI), and sex. Independent-samples t-tests and chi-square (χ²) tests were used for statistical analysis. A total of 453 adults were included, of whom 228 were Gabor Roma. No underweight individuals were identified among the Roma participants, whereas significant differences were observed across the remaining BMI categories (Gabor Roma vs. non-Roma: normal weight, 10.53% vs. 30.6%, p<0.001; overweight, 23.6% vs. 35.6%, p=0.02; obesity, 65.7% vs. 31.1%, p<0.001). Participants younger than 25 years and those aged 25-40 years had comparable BMI values in the two populations, whereas Gabor Roma participants aged 40-55 years and those older than 55 years had significantly higher BMI values (35.9 vs. 27.3 kg/m², p<0.001, and 33.2 vs. 29.3 kg/m², p=0.02, respectively). A sedentary lifestyle was significantly more common among the Gabor Roma population (52.9% vs. 47.5%, p=0.02). Our findings demonstrate a significantly higher prevalence of obesity among the Gabor Roma population than among the surrounding non-Roma population, although no significant difference was observed in the younger age groups.

Diagnostic value of insulin resistance-based biomarkers in arterial hypertension

Sat, 11 Jul 2026 00:00:00 GMT

Insulin resistance (IR) is a key cardiometabolic abnormality involved in the development and progression of hypertension and is closely associated with diabetes mellitus, metabolic syndrome, and cardiovascular disease. Surrogate markers derived from routinely available laboratory parameters that do not require insulin measurement are gaining increasing importance in the assessment of metabolic risk among patients with hypertension. In this retrospective study, we evaluated the associations between insulin resistance indices calculated from routine laboratory parameters (TyG index, TyG-BMI, TG/HDL ratio, and METS-IR) and clinical characteristics in patients with essential hypertension and in those with both essential hypertension and type 2 diabetes mellitus. The investigated indices differed significantly between the study groups and proved useful for identifying metabolic abnormalities. Among these markers, METS-IR demonstrated superior performance in reflecting cardiometabolic risk, whereas the simpler indices, particularly the TyG index, appear to be more suitable as screening tools. These findings suggest that insulin resistance-based indices may facilitate the early identification of metabolic risk and improve cardiometabolic risk stratification in patients with hypertension.

The Impact of Health Education on Secondary School Students’ Knowledge and Attitudes Regarding HPV and HPV Vaccination

Sat, 11 Jul 2026 00:00:00 GMT

Human papillomavirus (HPV) infection is the most common sexually transmitted infection worldwide. Oncogenic HPV types can cause cervical cancer and several other malignancies. Vaccination and screening are both essential components of HPV prevention. This study investigated the effect of a 30-minute health education session on secondary school students’ knowledge of HPV, as well as their attitudes toward HPV vaccination and their intention to be vaccinated. The study was conducted in Harghita County among students in grades 9–12. Data were collected using a pre-test/post-test design, with a health education session delivered between the two assessments. Data were recorded electronically and analysed using the Wilcoxon signed-rank test (p < 0.05). A total of 125 students (mean age: 16 years; 62.4% female) participated in the study. Baseline HPV knowledge was limited: only 9.6% had completed the HPV vaccination series, and 32% had never heard of HPV before the educational session. Significant differences in baseline knowledge were observed according to sex (female > male; 7.50 vs. 6.00; p < 0.0001) and place of residence (urban > rural; 8.0 vs. 6.0; p < 0.0001). Following the educational intervention, the median knowledge score increased significantly (from 7.00 to 9.00; p < 0.0001). The greatest improvement was observed among groups with lower baseline knowledge (students attending rural schools and unvaccinated students). Fear of vaccine side effects decreased significantly (median: from 3 to 2; p < 0.0001), misconceptions became less prevalent, and the intention to receive HPV vaccination within the next 6–12 months increased, provided that the vaccine was free of charge and readily available (p = 0.0001). These findings demonstrate that health education effectively improves HPV-related knowledge and promotes positive attitudes toward HPV vaccination. The systematic implementation of health education programs is essential for the long-term reduction of HPV infections and HPV-related cancers in Romania.

Changes in the lipid composition and bioactive compounds of walnut (Juglans regia) under different storage conditions: implications for future research on polycystic ovary syndrome (PCOS)

Sat, 11 Jul 2026 00:00:00 GMT

Juglans regia L., commonly known as walnut and belonging to the Juglandaceae family, is one of the major plant sources rich in polyunsaturated fatty acids (PUFAs) and may have medicinal potential. To utilise walnuts as a functional food, it is essential to investigate the changes that occur in their chemical composition under different storage conditions. The aim of the present study was to evaluate the lipid profile, total phenolic content (TPC), antioxidant capacity, and phytosterol content of Juglans regia walnut samples obtained from different harvest years and stored under various conditions. Samples were examined in both in-shell whole-walnut (WW) and shelled walnut-kernel (WK) forms. Gas chromatography-mass spectrometry (GC-MS) analysis revealed that the fatty acid profile of the walnut samples was characterised by a predominance of linoleic acid. Our results showed that neither storage form nor harvest year caused substantial changes in fatty acid composition. Walnuts harvested in 2024 exhibited a higher total phenolic content than samples collected during the 2025 harvest; in the case of Tree 2, the 2024 WW samples had a significantly higher total phenolic content than the corresponding WK samples. A decrease in total phenolic content was observed in the 2025 samples stored in kernel form. No significant differences were detected in antioxidant activity, although the 2025 samples showed slightly lower values. Although no marked qualitative differences were observed in lipid composition, the thin-layer chromatographic profile suggested the presence of phytosterols. Overall, our findings indicate that the lipid composition of walnuts remained relatively stable under the investigated storage conditions, whereas the effects of storage form and harvest year were evident for certain bioactive constituents. Further studies are required to confirm the clinical relevance of the observed associations.

Assessment of Health Behaviour and Risk Factors among Adults in Transylvania

Sat, 11 Jul 2026 00:00:00 GMT

Lifestyle-related risk factors, such as physical inactivity, unhealthy dietary habits, smoking, and alcohol consumption, play an important role in the development of chronic diseases, particularly cardiovascular diseases. However, there is limited up-to-date information available regarding the lifestyle characteristics of the adult population and the distribution of risk factors in Transylvania. The aim of this study was to assess the lifestyle characteristics of adults in Transylvania, with particular emphasis on body weight, dietary habits, physical activity, smoking, alcohol consumption, and sleep quality. The study was conducted as a cross-sectional questionnaire-based survey involving adults aged 18–60 years. Data collection was anonymous and based on self-report, and the results were analysed using descriptive statistical methods. Our findings indicate a considerable prevalence of overweight and obesity (38.0%), as well as a high prevalence of smoking (30.9%). Regular daily consumption of fruit (9.9%) and vegetables (20.1%) was relatively low. Sedentary behaviour was common, with 38.8% of respondents reporting more than 7 hours of sitting per day. Alcohol consumption was predominantly occasional, most commonly occurring a few times per month (75.8%). Poor or very poor sleep quality was reported by 20.1% of participants. These findings highlight the widespread presence of lifestyle-related risk factors among adults in the studied population and underscore the need for health promotion programmes and preventive interventions aimed at reducing the burden of chronic and cardiovascular diseases.

Long-term endocrine and metabolic outcomes and growth and body mass index dynamics among survivors of childhood hematologic malignancies

Sat, 11 Jul 2026 00:00:00 GMT

Advances in the treatment of childhood hematologic malignancies have markedly improved survival rates, bringing long-term treatment-related complications increasingly into focus. The aim of this study was to evaluate the long-term endocrine and metabolic effects of antineoplastic therapy, together with longitudinal changes in growth and body mass index (BMI). In this retrospective longitudinal study, 22 patients treated for childhood hematologic malignancies were enrolled, all of whom underwent comprehensive endocrinological assessment. Growth and BMI parameters were analysed at four predefined time points using standard deviation scores (SDS). Data were analysed using descriptive statistical methods (Microsoft Excel). The median age was 4.4 years at diagnosis, 7.6 years at the completion of treatment, and 10.9 years at the time of evaluation. The median follow-up duration was 9.6 years. At least two endocrine and metabolic abnormalities were identified in 63.6% of patients, while 40.9% presented with three or more abnormalities. The most frequent disturbances involved bone and mineral metabolism, with vitamin D deficiency observed in 63.6% of patients, hypocalcaemia in 36.4%, and secondary hyperparathyroidism in 31.8%. Dyslipidaemia was present in 36.4% of patients. Overweight/obesity was identified in 36.4%, whereas hypertension and pubertal disorders were each observed in 22.7% of cases. No thyroid hormone abnormalities were detected. Between diagnosis and the completion of chemotherapy, the median height SDS decreased by 0.13, whereas the median BMI SDS increased by 0.91; 59.1% of patients exhibited an increase of at least 0.5 SDS in BMI. During the follow-up period (n = 18), partial catch-up growth was observed (median +0.59 SDS), while the increase in BMI persisted (median +0.79 SDS). These findings indicate that treatment of childhood hematologic malignancies is associated with cumulative endocrine and metabolic disturbances, transient impairment of growth, and a sustained increase in BMI, which may contribute to an elevated long-term cardiovascular risk and underscore the importance of structured long-term follow-up.

Pharmacomicrobiomics: The Gut Microbiome as a Critical Variable in Clinical Drug Response

Sat, 11 Jul 2026 00:00:00 GMT

Pharmacomicrobiomics is a rapidly evolving field of pharmacology that addresses a gap largely overlooked by traditional pharmacokinetics: the role of the microbiome in drug response. This review examines the bidirectional relationship between the commensal gut microbiota and pharmacotherapeutic agents, including the activation of prodrugs and the inactivation of drugs with a narrow therapeutic index. In addition, the review highlights the dual role of enterohepatic circulation, demonstrating how microbial enzymes such as β-glucuronidases can influence both life-saving therapeutic efficacy (e.g., mycophenolate) and severe drug toxicity (e.g., NSAIDs and irinotecan). This highly variable balance is particularly susceptible to iatrogenic disruption, most notably antibiotic-induced dysbiosis, which can rapidly deplete essential bacterial populations and eliminate important metabolic pathways. Such alterations represent a critical yet often overlooked variable in clinical pharmacology, placing vulnerable patients at an increased risk of adverse outcomes. To realize the full potential of personalized medicine, clinical practice must evolve to incorporate the microbiome into pharmacological decision-making. Integrating baseline microbial profiling, also known as metabotyping, alongside traditional pharmacogenetic testing, together with proactive adjustment of therapeutic drug monitoring during periods of antibiotic therapy and dysbiosis, represents an important step toward recognizing the gut microbiome as a dynamic and essential organ of drug metabolism.

The role of the triglyceride-glucose (TyG) index and inflammatory markers in the risk stratification of peripheral arterial disease

Sat, 11 Jul 2026 00:00:00 GMT

In recent years, several simple and readily accessible biomarkers have been identified that may reflect metabolic and inflammatory mechanisms involved in cardiovascular risk. The triglyceride-glucose (TyG) index is considered a surrogate marker of insulin resistance and has been associated with endothelial dysfunction and atherosclerotic disease. Its derived form, the triglyceride-glucose-body mass index (TyG-BMI), integrates metabolic and anthropometric characteristics, although its clinical interpretation may be more complex. Inflammatory markers derived from routine blood tests, such as the neutrophil-to-lymphocyte ratio (NLR) and platelet count, are indirect indicators of systemic inflammation; however, their specificity remains limited. The aim of this study was to compare the metabolic and inflammatory profiles of patients with peripheral arterial disease (PAD) and hypertensive controls and to evaluate the predictive value of the TyG index, TyG-BMI, NLR, and platelet count.

Skin Cancer Screening: Individual Decision or Collective Responsibility? The Role of Information in Population Participation

Sat, 11 Jul 2026 00:00:00 GMT

Introduction: The incidence of skin cancer is increasing worldwide, including in Romania. Although early detection is crucial for prognosis, public willingness to participate in screening programs and adopt preventive behaviors remains suboptimal. Objective: This study aimed to assess skin cancer-related knowledge and sun-protection practices among the Romanian population, as well as the motivations and barriers influencing participation in specialist skin cancer screening examinations. Methodology: A quantitative, cross-sectional questionnaire-based survey was conducted between November 2025 and January 2026. The analysis included responses from 399 Romanian residents. Data were analyzed using descriptive statistics, Chi-square tests, and odds ratio (OR) calculations. Results: Only 29.07% of respondents had undergone a specialist skin cancer screening examination at least once in their lifetime. Although women and younger participants (18–39 years) demonstrated significantly higher levels of knowledge, the actual screening rate was higher among men (34.59% vs. 26.32%). The main reasons for non-participation were the absence of symptoms (29.33%) and lack of information (27.56%). A positive family history was associated with a 4.63-fold increase in the odds of screening participation (p < 0.0001), while having a high number of moles was associated with a 2.30-fold increase (p = 0.0005). Regular sunscreen use was low during summer (29.8%) and even lower during winter (22%). Conclusions: The findings confirm that theoretical knowledge alone does not necessarily translate into preventive behavior. Willingness to participate in screening is primarily driven by personal involvement and subjective risk perception. Future interventions should focus on educating asymptomatic individuals and promoting targeted, risk-based screening programs.

Posterior reversible encephalopathy syndrome

Sat, 11 Jul 2026 00:00:00 GMT

Posterior reversible encephalopathy syndrome (PRES) is a subacute condition characterised by a variety of neurological manifestations, most commonly visual disturbances, seizures, and altered consciousness. Despite its name, the syndrome is not invariably reversible, and the radiological lesions indicative of vasogenic oedema may occur in several brain regions rather than being confined to the posterior cerebral hemispheres. The most frequently affected areas are the dorsal parieto-occipital regions, with white matter always being more severely affected than the cortex. The underlying pathophysiology is based on endothelial dysfunction, most commonly resulting from a rapid increase in blood pressure that exceeds the upper limit of cerebral autoregulation. However, approximately 20% of cases occur in normotensive patients. In such cases, endothelial injury is thought to be mediated by circulating cytokines released in response to direct endothelial damage caused by drugs, toxins, or various systemic diseases. Successful treatment and the potential reversibility of the syndrome depend on prompt diagnosis and immediate therapeutic intervention. Management is directed toward the underlying pathogenic mechanism and may include blood pressure control or withdrawal of the offending drug or toxin. In addition to therapeutic approaches, this review also discusses the clinical course and prognosis of the disease.

Lifestyle medicine in the prevention and adjunctive treatment of chronic non-communicable diseases

Wed, 08 Jul 2026 00:00:00 GMT

Abstract: Lifestyle medicine is a structured, evidence-based approach to the prevention and treatment of chronic non-communicable diseases. Available epidemiological, clinical, and meta-analytic evidence indicates that nutrition, physical activity, smoking avoidance, adequate sleep, stress management, and social connectedness collectively exert a major influence on morbidity and mortality. This narrative review aimed to summarise, on the basis of landmark studies and recent meta-analyses, the role of lifestyle interventions in the primary and secondary prevention of cardiovascular disease, type 2 diabetes mellitus, and selected malignancies. The available evidence suggests that lifestyle-oriented care is not merely a preventive strategy but also a therapeutically meaningful, cost-effective approach that is essential for the long-term sustainability of healthcare systems.

Cyclin D1 expression as a diagnostic biomarker in lymphoid neoplasms

Wed, 08 Jul 2026 00:00:00 GMT

Cyclin D1 is a key regulator of cell cycle progression and a well-established diagnostic marker in mantle cell lymphoma (MCL). However, its expression has also been reported in a subset of other B-cell lymphoproliferative disorders, potentially creating diagnostic challenges. We performed a retrospective analysis of Cyclin D1-positive lymphoid neoplasms diagnosed between 2016 and 2025 at a single tertiary care centre. Expression patterns were evaluated according to tumour type, staining intensity, distribution, and co-expression with lineage-specific immunohistochemical markers. A total of 41 Cyclin D1-positive cases were identified, including MCL (65.85%), plasma cell neoplasms (19.51%), diffuse large B-cell lymphoma (DLBCL) (7.31%), hairy cell leukaemia (HCL) (4.88%), and chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL) (2.43%). MCL cases demonstrated strong, diffuse nuclear expression with high concordance with CD5 and SOX11. In contrast, non-MCL neoplasms exhibited variable, frequently weaker, and more heterogeneous expression patterns. In CLL/SLL, Cyclin D1 positivity was minimal and restricted to proliferation centres, whereas HCL showed moderate and heterogeneous expression. DLBCL cases demonstrated moderate nuclear staining with limited overlap between Cyclin D1-positive and CD20-positive tumour cells. Although Cyclin D1 remains a highly sensitive marker for MCL, its expression in other B-cell neoplasms limits its diagnostic specificity. Accurate interpretation requires integration of morphological, immunophenotypic, and molecular findings to avoid diagnostic pitfalls, particularly when distinguishing MCL from other Cyclin D1-positive lymphoid neoplasms

Investigation of the psychosocial impact of orthodontic treatment among young adults

Wed, 08 Jul 2026 00:00:00 GMT

A smile is one of the first features people notice in others and therefore plays an important role in appearance and social integration. Orthodontic treatment not only improves dental aesthetics but also has a significant psychosocial impact on patients. The aim of this study was to investigate the psychosocial aspects of dental aesthetics among individuals aged 18-30 years, to assess the influence of dental appearance on self-esteem, social relationships, and emotional well-being, and to evaluate the effect of orthodontic treatment on these factors. The study was conducted using a Google Forms questionnaire incorporating the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) supplemented with several additional questions. A total of 266 volunteers participated, of whom three were excluded because they did not meet the inclusion criteria. Data were processed in Microsoft Excel and grouped according to gender, age group, educational level, and orthodontic treatment status. Additional subgroup analyses were performed according to gender, age group, and educational level within the orthodontic treatment categories. Statistical analysis was carried out using Social Science Statistics software and one-way Analysis of Variance (ANOVA). Responses were classified according to a scoring system developed by the authors to determine whether participants had low, moderate, or high self-esteem. A significant difference was observed between age groups (p = 0.04), with participants aged 22-25 years demonstrating higher self-esteem than those in the other age groups. A significant difference was also found according to orthodontic treatment status (p = 0.001). Self-esteem was highest among individuals who had completed orthodontic treatment, followed by those who had never undergone treatment, and lowest among those currently receiving treatment. Significant differences were also found among participants with secondary school education (p = 0.02), in the 18-21-year age group (p = 0.03), among males (p = 0.01), and among females (p = 0.04). In each case, self-esteem was highest among those who had completed orthodontic treatment and lowest among those currently undergoing treatment. Similar trends were observed in the remaining groups. Most respondents had high self-esteem. Overall, the results indicate that individuals who have undergone orthodontic treatment have better self-esteem. These findings highlight the importance of orthodontic treatment in improving patients' psychosocial well-being.

Obstetric characteristics of primiparous women at the First Department of Obstetrics and Gynecology in Târgu Mureş

Wed, 08 Jul 2026 00:00:00 GMT

For primiparous women, first childbirth represents not only a physiological process but also a profound life transition, during which the first experiences of motherhood are intertwined with responsibility, joy, and the anticipation of a new beginning. The aim of this study was to investigate changes in the characteristics of first childbirth over the past two decades. In this retrospective study, we statistically analysed data related to primiparous women who delivered in 2003 and 2023 at the First Department of Obstetrics and Gynaecology in Târgu Mureş. Data from 1,048 deliveries in 2003 and 651 deliveries in 2023 were analysed, all involving primiparous women. Our findings revealed a substantial decline in the number of births between 2003 and 2023. Although the overall rate of preterm births decreased over the two decades, the proportion of preterm deliveries among primiparous women increased significantly. In addition, maternal age at first childbirth increased over time. The caesarean section rate rose markedly, from 9.25% in 2003 to 27.75% in 2023. The mean birth weight of new-borns increased from 3,344.85 g to 3,546.47 g. The frequency of episiotomies performed in term primiparous women decreased from 92.6% to 82.5%. An increase was also observed in the prevalence of preeclampsia (from 1.24% to 2.61%) and diabetes during pregnancy (from 0.19% to 1.22%) among primiparous women. The number of births decreased significantly over the study period, reflecting a broader demographic trend. The overall rate of preterm births declined, which may be attributable to improvements in medical care, including advances in prevention, treatment, and the use of more effective tocolytic therapies. Maternal age at first delivery and the prevalence of associated pathologies, such as preeclampsia and diabetes, increased among primiparous women. A substantial rise in the caesarean section rate at first birth was also observed, which may have important obstetric, demographic, and social implications in the future.

Obstetric complications of primiparity at advanced maternal age

Wed, 08 Jul 2026 00:00:00 GMT

Primiparity at advanced maternal age has become an increasingly common phenomenon in modern obstetrics. The rising maternal age is associated with a higher prevalence of comorbidities and raises important questions regarding its impact on obstetric and perinatal outcomes over time. The aim of this study was to analyse temporal changes in maternal characteristics, comorbidities, and obstetric and perinatal outcomes among older primiparous women by comparing two periods separated by a decade. A retrospective comparative study was conducted at the Obstetrics and Gynaecology Clinic in Târgu Mureș. A total of 592 older primiparous women were included in the analysis (2010–2014: n = 299; 2020–2024: n = 293). Descriptive statistics and comparative analyses were performed using Microsoft Excel and GraphPad software, and effect sizes were calculated for statistically significant findings. During the later period, both maternal age and the prevalence of comorbidities increased significantly, with thrombophilia showing the most pronounced rise. The proportion of primigravid women also increased, whereas the rates of assisted reproduction and twin pregnancies remained unchanged. Median gestational age increased, and post-term pregnancy became more frequent, while the incidence of preterm birth showed no significant change. Overall, the prevalence of obstetric complications remained stable; however, the pattern of individual complications shifted, accompanied by greater medicalization of labour management. The rate of caesarean delivery decreased significantly. Perinatal outcomes also remained stable overall, although heterogeneous changes were observed across individual outcomes. Over the past decade, the risk profile of older primiparous women has become less favourable; nevertheless, this was not accompanied by an overall increase in obstetric or perinatal complications. Instead, temporal changes were reflected in a redistribution of complication patterns, suggesting a compensatory effect of advances in perinatal care.

Obesity in pregnancy

Thu, 02 Jul 2026 00:00:00 GMT

Obesity during pregnancy is becoming increasingly prevalent and poses significant risks to both the mother and the foetus. Common complications include gestational diabetes, hypertensive disorders, preterm birth, foetal macrosomia, and increased rates of caesarean delivery. This study aimed to assess the distribution of obesity classes within our cohort and to compare pregnancy and perinatal complications across these groups. We analysed the medical records of 131 pregnant women with obesity over the past three years. Based on body mass index (BMI ≥ 30 kg/m²), participants were classified into three obesity classes (class 1: n = 16, class 2: n = 43, class 3: n = 72). The complications investigated included gestational diabetes, hypertensive disorders such as preeclampsia and eclampsia, preterm birth, caesarean delivery, and foetal outcomes, including gestational age, Apgar score, birth weight, and macrosomia. In our cohort, 71.76% of pregnancies were complicated by at least one of the studied conditions. Hypertension was identified in 40.45% of cases, with no statistically significant differences among obesity classes (p = 0.1591). Severe preeclampsia occurred in 3.05% of cases, while eclamptic seizures were observed in 0.76%. Diabetes mellitus was diagnosed in 20.61% of patients and showed a statistically significant increase across obesity classes (p = 0.0159), with a threefold higher risk in class 3 obesity compared with classes 1 and 2 combined (p = 0.0112; OR = 3.07; 95% C1 = 1.28–7.13). Gestational diabetes was diagnosed in 15.27% of cases; however, the increase across obesity classes did not reach statistical significance (p = 0.1012). Preterm birth occurred in 12.98% of cases, the caesarean delivery rate was 35.88%, and foetal macrosomia was observed in 18.42% of new-borns. None of these outcomes showed a statistically significant increase across obesity classes (p = 0.5687, p = 0.1044, and p = 0.1685, respectively). Although most complications did not reach statistical significance between obesity classes, women with obesity exhibited a higher tendency toward adverse maternal and perinatal outcomes compared with the general obstetric population. These findings underscore the importance of achieving weight reduction before pregnancy and ensuring close monitoring throughout gestation.

Diagnosis and Treatment of Primary Aldosteronism. A Single-Center Study

Thu, 02 Jul 2026 00:00:00 GMT

Primary aldosteronism (PA) is defined as the partial or complete renin-independent secretion of aldosterone. Despite its association with increased cardiovascular risk, PA remains substantially underdiag-nosed, and its recognition in routine clinical practice continues to be challenging. The aim of this study was to retrospectively analyze diagnosed cases of PA, characterize their biochemical and clinical features, and assess the effects of targeted therapy. A total of 19 patients diagnosed with primary aldosteronism were included in this retrospective study. Data distribution was assessed using the Shapiro–Wilk test. Depending on data distribution, parametric or non-parametric statistical tests were used for group comparisons, with statistical significance defined as p < 0.05. The mean age of the patients was 57.26 ± 14.32 years; 7 were male and 12 were female. Baseline systolic blood pressure ranged from 140 to 180 mmHg. Resistant hypertension was present in 89% of patients, and 68.4% required four or more antihypertensive agents to achieve adequate blood pressure control. A positive family history of hypertension, myocardial infarction, or stroke was identified in 11 cases (57.89%). In addition to hypertension, hypokalemia also raised suspicion of PA, occurring in 13 patients, with a mean serum potassium level of 2.38 ± 0.72 mmol/L; in 6 cases (31.58%), hypokalemia was severe (<2.5 mmol/L). The aldosterone-to-renin ratio exceeded the diagnostic threshold in most patients. Computed tomography revealed unilateral or bilateral adrenal abnormalities, with a mean maximum lesion diameter of 21.53 ± 15.97 mm. Surgical treatment was performed in 12 patients. Following surgery, the mean systolic blood pressure measured by ambulatory blood pressure monitoring was 130 ± 11.44 mmHg. Statistical analysis demonstrated a significant reduction in systolic blood pressure compared with preoperative values (p < 0.0001), with a mean decrease of 50.79 mmHg. Our findings suggest that primary aldosteronism is frequently diagnosed only after the development of resistant hypertension and hypokalemia. In our cohort, targeted medical and surgical treatment was associated with favorable clinical outcomes and significant blood pressure reduction. These findings underscore the importance of early recognition and targeted diagnostic evaluation of primary aldosteronism in the management of patients with resistant hypertension.

Medical Surgeon Antal Pfenningsdorf, basic figure of 19th century surgeons’ training in Cluj-Napoca

Thu, 02 Jul 2026 00:00:00 GMT

At the Medical-Surgical Institute of Cluj (established in 1775), a position of assistant professor was created in 1792. The third person appointed to this post, in 1817, was Antal Pfenningsdorf (1786–1871), a master surgeon and obstetrician. He served the institute for 42 years, until his retirement in 1859. During this period, he acted as deputy professor for 17 years. Among his duties was the training of midwives in Hungarian, Romanian, and German. Descended from a German family of Târgu Mureş, he studied surgery in Cluj and Vienna. He became a highly respected surgeon in the city. As second physician at the Carolina State Hospital, he performed high-risk surgical procedures and also served as the family physician of several prominent families. As one of the town’s most respected citizens, he purchased an elegant house on the main street, was elected to the town council, and donated funds both for the maintenance of the Central Park of Cluj and for the demolition of several dilapidated houses surrounding the main church. He was among the founders of the “Kolozsvári Casino” (Club) in 1833 and later served as a member of its board. In 1845, he was elected a member of the Royal Hungarian Society of Natural History in Pest. In 1859, he became one of the founders of the Transylvanian Museum Society, to which he bequeathed his valuable rock collection. His adopted son, Sándor Pfenningsdorf, was among the senior officers of the Hungarian War of Independence of 1848–1849 and, in 1850, was sentenced to twelve years’ imprisonment. He was released on a pardon six years later, physically and emotionally broken. In 1858, Pfenningsdorf and his wife, Anna Czikéli, established a foundation to support graduating surgical students: the Pfenningsdorfiana Fundatio. The administration and awarding of the fund remained under the authority of the Faculty of Medicine of the University until 1919.

The Presence of the Golden Ratio in the Morphology of Deciduous Teeth: A Pilot Study

Thu, 02 Jul 2026 00:00:00 GMT

Numerous studies have investigated the presence of the golden ratio in the proportions of the maxillary anterior teeth in permanent dentition; however, data regarding primary dentition remain limited. Given the increasing emphasis on dental aesthetics, it is important to determine whether the golden ratio can also be identified in deciduous teeth. The aim of this study was to measure the width and height of the maxillary primary anterior teeth, including the central incisors, lateral incisors, and canines, using two different measurement methods, and to analyse the ratios calculated from these measurements to assess the presence of the golden ratio. The study included children aged 3–6 years whose parents provided written informed consent. Exclusion criteria included dental caries, restorations, previous orthodontic treatment, dental crowding, and periodontal involvement. Standardized frontal photographs were obtained while ensuring that the occlusal plane was parallel to the floor, the millimetre scale used for calibration was parallel to the interpupillary line, and a constant photographic distance was maintained throughout the study. Subsequently, plaster models were fabricated and used to determine the actual tooth dimensions with a digital calliper. Frontal photographs were analysed using ImagePro Insight software. Data were recorded in Microsoft Excel, and statistical analyses were performed using GraphPad Prism. The mean frontal-view width ratio of the maxillary primary lateral incisors to central incisors was 0.67, whereas the ratio of primary canines to lateral incisors was 1.01. The mean width-to-height ratio of the primary central incisors was 1.20. No significant sex-related differences were observed (p > 0.05). The calculated ratios did not correspond to the ideal golden ratio values in either boys or girls. Based on the findings of this pilot study, the primary dentition of the investigated population does not exhibit the consistent golden ratio relationships described for permanent dentition.

The Limitations of Dopaminergic Therapies in Advanced Parkinson’s Disease

Thu, 02 Jul 2026 00:00:00 GMT

In advanced Parkinson’s disease (APD), the efficacy of conventional oral and transdermal pharmacological therapies gradually declines and becomes increasingly variable. In such cases, the initiation of device-aided therapies may become necessary. The aim of this study was to describe the final dopaminergic treatment regimens used in a cohort of patients with APD for whom current non-invasive therapies no longer provided adequate symptom control. In this retrospective study, the use of dopaminergic medications was analysed based on final clinical recommendations, including discharge summaries, medical reports, and data retrieved from clinical registries. During the four-year study period, levodopa-carbidopa intestinal gel (LCIG) therapy was initiated in 72 patients with APD. The mean age of the cohort was 65.67 ± 8.51 years (mean ± SD), and the mean disease duration was 10.14 ± 4.01 years. The mean duration of levodopa therapy was 9.02 ± 3.81 years. Patients received relatively high doses of levodopa (898 ± 266 mg/day), administered in 5.26 ± 0.63 daily doses (range: 5–7 administrations per day). The majority of patients (83%) were also treated with dopamine agonists: pramipexole (n = 17), ropinirole (n = 15), and rotigotine transdermal patch (n = 28). Rasagiline was prescribed to 62.5% of patients (n = 45). An apomorphine pen was used by nine patients. Amantadine was prescribed to 20 patients, while entacapone was included as an adjunct to levodopa replacement therapy in 40 patients (56%). The dopaminergic treatment regimens used prior to the initiation of device-aided therapy in patients with APD were more complex than those previously reported in the literature. We believe that analyses of this kind may help practicing neurologists recognize the limitations of conventional dopaminergic therapies and facilitate the timely referral of patients with APD for evaluation of eligibility for available device-aided treatment options.