Digging in real-word electronic database for assessing CDK 4/6 inhibitors adherence in breast cancer patients from Romania

Introduction: It is imperative for patients to respect the prescribed treatments to achieve the anticipated clinical outcomes, including the outpatients receiving oral anti-cancer drugs such as selective cyclin-dependent kinase 4/6 inhibitors (CDK 4/6i). With the introduction of three CDK 4/6i drugs in the Romanian pharmaceutical market in 2018, our study aimed to evaluate medication adherence and the influencing factors among patients undergoing treatment with palbociclib, ribociclib, or abemaciclib for advanced or metastatic breast cancer. Methods: Medication adherence was assessed using the Proportion of Days Covered (PDC) method, and Spearman correlation analysis was conducted to explore the relationships between adherence, age, gender, and follow-up duration. Results: The study enrolled 330 breast cancer patients, with an average follow-up period of 14.6 ± 12.5 months for palbociclib, 10.6 ± 7.1 months for ribociclib, and 8.6 ± 6.4 months for abemaciclib-treated patients. A small proportion of patients demonstrated non-adherence: 12.8% for palbociclib, 14.6% for ribociclib, and 14.7% for abemaciclib. Among patients receiving palbociclib, there was no significant correlation between adherence, age (rho = 0.07, p = 0.35), or gender (rho = -0.144, p = 0.054). However, a significant correlation was found with the duration of follow-up (rho = -0.304, p < 0.0001). Similar results were observed for patients receiving ribociclib or abemaciclib. Most patients received combination therapy with letrozole (46%) and exemestane (13%) for palbociclib, letrozole (48%) and fulvestrant (19%) for ribociclib, and fulvestrant (39%) and letrozole (27%) for abemaciclib, Discussion: High adherence rates were observed among patients treated with CDK 4/6i drugs, with no significant differences noted among the three drugs in this class. However, the collected patient data was limited, lacking information on adverse reactions that could potentially lead to treatment discontinuation, as determined by the oncologist's decision not to prescribe. Consequently, a comprehensive understanding of all factors contributing to the low adherence levels is hindered.

Analysis regarding the impact of 'fake news' on the quality of life of the population in a region affected by earthquake activity. The case of Romania-Northern Oltenia

Purpose

The study aims to examine the impact of the wave of seismic activity in the northern region of Oltenia (Gorj County, Romania) in February 2023 and the belief in 'fake news' (circulated regarding causality, manifestations, and future developments of the seismic activity) on the quality of life of the affected population. It was considered opportune to conduct this study, given the novelty of such a situation, as the mentioned geographical area is not known to have a high seismic risk.

Methods

The study was built based on the questionnaire to which 975 respondents, present/residing in Gorj County during the earthquakes and at least 14 days after, and with a minimum age of 18 years, responded. The data was collected between February 27, 2023, and March 31, 2023, at a reasonable time interval from the recording of the first seismic event in the region, assuming that the respondents' opinions regarding the negative impact of seismic events on societal life are well crystallized. The aim was to obtain information and analyze it in order to establish the respondents' perception regarding the negative effects of seismic activity and the elements of "fake news" promoted in this context on the quality of life of individuals in the region.

Results

Our study indicates that individuals who are not concerned, due to their disbelief in "fake news" information, about the possibility of new strong earthquakes in the mentioned area feel the best physically, having an average satisfaction level of 82.80 (with a standard deviation of 19.70) on the WHOQOL-BREF scale. On the other hand, those who believed in the fake news experienced the lowest levels of psychological well-being, with an average satisfaction of 60.80 (and a standard deviation of 21.98). The WHOQOL-BREF is an instrument that assesses the quality of life across four distinct domains, and this study emphasizes the importance of accurate and trustworthy information for people's well-being.

Conclusion

The results of the study highlight that the quality of life indicators of people in the geographic area affected by the wave of seismic movements are negatively impacted due to the release of "fake news" in the public domain regarding the cause of seismic movements in Gorj county (and the previous earthquakes in Turkey) and their future manifestations and developments (the possibility of high magnitude seismic movements), as well as the lack of information provided by the public authorities on the issue at hand (causes, effects, future manifestations, management measures).

Exploring the Prevalence of PTSD in Hand Trauma: A Comprehensive Study

Hand trauma is a common and debilitating condition that can have significant physical, functional, and psychological effects on individuals. This study used a case-control design to investigate the frequency and factors associated with symptoms of post-traumatic stress disorder (PTSD) in a sample of individuals with complex hand and forearm injuries. Our hypothesis suggests that demographic data, among other factors, influences the intensity of PTSD symptoms measured by the PCL-5 scale three months post-surgery. This study included 166 individuals, 142 males and 24 females, with an average age of 42.14 years (SD = 12.71). Our study found significant associations between symptoms of PTSD and various demographic and clinical factors. PTSD symptoms were observed in females, individuals from specific regions, and certain socio-professional groups. Furthermore, educational attainment and personal background have been identified as significant factors in the development of PTSD. The role of trauma type was crucial, amputees and fractures were more prone to developing PTSD. A strong link was found between increased symptoms of PTSD and negative postoperative outcomes, including amputation of necessity and the need for additional surgery. The absence of family support exacerbates the psychological distress of trauma survivors. The findings highlight the intricate nature of PTSD development and underscore the significance of a comprehensive postoperative treatment strategy encompassing psychological assessment and support.

Bone Injuries in the Hand and Forearm: Prevalence and Psychological Ramifications

Complex bone injuries in the hand and forearm pose considerable physical and psychological challenges to patients. However, there is limited research on the psychological effects of these injuries. This study seeks to clarify the psychological impact and frequency of injuries in various hand bones. This cross-sectional study included 166 patients with complex hand and forearm injuries. Injuries were classified based on amputations and fractures involving phalanges, fingers, and other bones. Psychological assessments utilised standardised tools to gauge post-traumatic stress disorder (PTSD) levels. Our findings suggest that injury rates differ among the phalanges and individual fingers. The intermediate phalanx (P2) of the thumb had the most injuries, while no injuries were found in the proximal phalanx (P1) of the small finger. Amputations and fractures were found to be positively associated with increased symptoms of PTSD. This study emphasises the importance of recognising the psychological effects of hand and forearm bone injuries. The data indicate the need for a multi-disciplinary treatment approach that includes psychological interventions for optimal patient care. The study emphasises the necessity for additional research to further investigate these matters.

Serum Amino Acid Profiling in Children with Autistic Spectrum Disorder: Insights from a Single-Center Study in Southern Romania

The objective of this study was to analyze the serum amino acid profile in children diagnosed with autistic spectrum disorder (ASD) in southern Romania. The analysis aimed to provide insights into the underlying metabolic dysregulations associated with ASD. ASD is a neurodevelopmental disorder characterized by impaired social interaction, communication deficits, and restricted repetitive behaviors. Although the exact cause of ASD is largely unknown, recent evidence suggests that abnormalities in amino acid metabolism may contribute to its pathogenesis. Therefore, studying the amino acid profile in children with ASD could offer valuable information for understanding the metabolic disturbances associated with this complex disorder. This single-center study examined serum samples from children diagnosed with ASD, utilizing advanced analytical techniques to quantify the levels of different amino acids, amino acid derivatives, and amino acid-like substances. The results showed a lower level of taurine and a higher level of asparagine and leucine in the ASD group versus the control group. In the ASD group, we observed significant differences in tryptophan and alpha-aminobutyric acid levels based on age, with higher tryptophan levels in children older than 7 years when compared to children younger than 7 years; however, no significant correlations were found with the ASD group older than 7 years old. Additionally, younger children with ASD exhibited higher levels of alpha-aminobutyric acid than older children with ASD. The findings from this study contribute to the growing body of knowledge on the metabolic aspects of ASD, highlighting potential biomarkers and therapeutic targets for improving the management and treatment of ASD in children.

Uncovering the Impact of Lymphadenectomy in Advanced Gastric Cancer: A Comprehensive Review

Gastric cancer is a significant health concern worldwide, and lymphadenectomy plays a crucial role in its treatment. However, there is ongoing debate regarding the optimal approach-D1 or D2 lymphadenectomy. This paper aims to synthesize the available evidence by conducting a comprehensive literature review and comparing the advantages and disadvantages of both techniques. The analysis includes studies, clinical trials, and systematic reviews that assess survival outcomes, morbidity, and quality of life. The selected studies revealed different outcomes associated with D1 and D2 lymphadenectomy, including lymph node harvest, disease control, recurrence rates, and overall survival. Postoperative complications also varied between the two techniques. These findings highlight the complex considerations involved in selecting the most suitable lymphadenectomy approach for individual patients. Therefore, the decision requires an individualized assessment that considers the potential benefits and risks of D1 and D2 techniques. A collaborative approach involving interdisciplinary teams is crucial for developing personalized treatment plans that optimize both oncological outcomes and postoperative quality of life.

Clinical Outcomes Depending on Sympathetic Innervation in Pancreatic Cancer

BACKGROUND

The aim of our study was to evaluate sympathetic neuronal remodeling in patients with pancreatic cancer, together with its correlation with clinical outcomes.

METHODS

In this descriptive, retrospective study, we analyzed pancreatic cancer specimens and peritumoral pancreatic tissue from 122 patients. We also investigated tyrosine hydroxylase immunoreactivity for the analysis of sympathetic nerve fibers and beta 2 adrenoreceptors immunoreactivity. To investigate the potential interaction between tyrosine hydroxylase (TH), beta 2 adrenoreceptors (B2A) immunoreactivity, and clinicopathological outcomes, we used the median to classify each case as TH+, respectively, B2A+ (if it presented a value higher than the median).

RESULTS

Firstly, the overall survival was analyzed according to TH and B2A immunoreactivity, in both intratumoral and peritumoral tissue. Only B2A immunoreactivity in the peritumoral pancreatic tissue influenced overall survival at 5 years of follow-up; thus, B2A+ patients recorded a 5-year survival of only 3% compared to B2A- patients who recorded an overall survival at 5 years of follow-up of 14% (HR = 1.758, 95% CI of ratio 1.297 to 2.938, p = 0.0004). Additionally, the increased immunoreactivity of B2A in the peritumoral tissue was also associated with other factors of poor prognosis, such as moderately or poorly differentiated tumors, the absence of response to first-line chemotherapy, or metastatic disease.

CONCLUSIONS

The increased immunoreactivity of beta 2 adrenoreceptors in pancreatic peritumoral tissue represents a poor prognostic factor in pancreatic cancer.

Primary PCI and Mental Health: A 12-Month Follow-Up Study

The research article highlights the significance of acute myocardial infarction (AMI) and its impact on depression and anxiety among patients' post-primary percutaneous coronary interventions (PCI). The study aims to determine the frequency of depression and anxiety occurrence in patients with acute myocardial infarction after primary PCI. The objective of this study is to investigate the frequency of depression and anxiety in patients with acute myocardial infarction after primary PCI. The method used in the study involved the collection of data from 88 patients with acute myocardial infarction who underwent primary PCI treatment. The patients were tested before PCI and then at intervals of 1 month, 6 months, and 12 months post-PCI using the Hamilton Depression Scale (HAM-D17) and the Hamilton Anxiety Scale (HAM-A) to identify depression and anxiety symptoms, respectively. The study performed a comprehensive analysis of the collected data to determine the frequency of depression and anxiety occurrence in post-PCI patients. The study found evidence that primary PCI reduces depression and anxiety in patients who have experienced a myocardial infarction. However, mental health issues continue to be a significant psychological concern for patients post-PCI, impacting their lifestyle, self-care, and treatment adherence. The study suggests that healthcare providers should actively screen and manage psychiatric disorders in patients who have suffered from AMI as they are at an increased risk of mental disorders. In conclusion, the study indicates that depression and anxiety are common issues in acute myocardial infarction survivors, and interventions addressing these conditions should be a routine part of care. The study highlights the need for healthcare providers to be aware of the increased risk of mental disorders in individuals who have suffered from AMI. Understanding the impact of anxiety and depression on post-PCI patients is essential for the development of effective interventions that support patients' recovery.

Considerations on Patients' Quality of Life Following Hand and Forearm Trauma in the Oltenia Region

Hand and forearm trauma is a significant public health concern that has notable physical, psychological, and socioeconomic implications. Understanding the variations in occurrence and characteristics of injuries across different regions is crucial for effective implementation of preventive measures, management strategies, and resource allocation. The study involved 86 cases, with a range of ages from 18 to 70 years old. The participant group consisted of 11 females and 75 males. A series of clinical parameters were analyzed, including gender, age, environment, and cause of trauma. The study requested that participants provide information regarding if they reintegrated into their professional lives and complete the WHOQOL-BREF assessment, which is a tool used to evaluate quality of life. The current investigation has determined that the primary etiologies for hand and forearm injuries are crush and sharp cuts. The results of the investigation indicate a noteworthy association among Age and Cause, Gender and Age, Age and Professional reintegration, as well as between WHOQOL-BREF scores and different parameters. The procurement of epidemiological data plays a crucial role in broadening our comprehension of acute hand and forearm injuries in the Oltenia region.

Investigating the Neuroprotective and Neuroregenerative Effect of Trazodone Regarding Behavioral Recovery in a BL6C57 Mice Stroke Model

Stroke is a major cause of death and disability worldwide. Between 1990 and 2010, its global burden increased notably with reference to the absolute number of incident events, number of deaths, and disability-adjusted life-years lost. Trazodone is a triazolopyridine derivative that was approved for more than 40 years as monotherapy or in combination with other antidepressant drugs for the treatment of major depressive disorder in adult patients. The aim was investigated if trazodone can improve behavioural outcome after stroke in a mice model of middle cerebral artery occlusion (MCAo) due to the potential neuroprotective and neurodegenerative effects by using three behavioural tests: adhesive tape test, beam test and hole board test. Trazodone administration show modest improvements regarding the motor-sensorial function after stroke especially in the acute post-stroke phase in aged and young animals. The antidepressant effect of the drug was observed in the post-stroke period in aged animals and to a lesser extent in young animals. Future research is needed to evaluate the effects of trazodone at the cellular level to be sure that it has no benefit in stroke patients who do not suffer from depression.

A Review of Psychological Outcomes in Patients with Complex Hand Trauma: A Multidisciplinary Approach

This systematic review aimed to assess the psychological outcomes in patients with complex hand trauma and explore the importance of a multidisciplinary approach in addressing both physical and mental health needs. The study employed a rigorous methodology, including a comprehensive search of relevant databases, strict inclusion and exclusion criteria, and data synthesis from the included studies. The results demonstrated the significant negative psychological impact of complex hand trauma on patients' overall health and quality of life. This trauma affected patients emotionally, psychologically, and physically, highlighting the essential role of hand function in performing daily activities. The findings emphasize the need for continued research aimed at identifying effective psychological interventions to support the rehabilitation of patients with complex hand trauma. Providing these patients with multidisciplinary care, addressing both the physical and mental health components of recovery, can result in a more favorable long-term outcome.

Diagnostic Accuracy of Machine-Learning Models on Predicting Chemo-Brain in Breast Cancer Survivors Previously Treated with Chemotherapy: A Meta-Analysis

We performed a meta-analysis of chemo-brain diagnostic, pooling sensitivities, and specificities in order to assess the accuracy of a machine-learning (ML) algorithm in breast cancer survivors previously treated with chemotherapy. We searched PubMed, Web of Science, and Scopus for eligible articles before 30 September 2022. We identified three eligible studies from which we extracted seven ML algorithms. For our data, the χ² tests demonstrated the homogeneity of the sensitivity's models (χ² = 7.6987, df = 6, p-value = 0.261) and the specificities of the ML models (χ² = 3.0151, df = 6, p-value = 0.807). The pooled area under the curve (AUC) for the overall ML models in this study was 0.914 (95%CI: 0.891-0.939) and partial AUC (restricted to observed false positive rates and normalized) was 0.844 (95%CI: 0.80-0.889). Additionally, the pooled sensitivity and pooled specificity values were 0.81 (95% CI: 0.75-0.86) and 0.82 (95% CI: 0.76-0.86), respectively. From all included ML models, support vector machine demonstrated the best test performance. ML models represent a promising, reliable modality for chemo-brain prediction in breast cancer survivors previously treated with chemotherapy, demonstrating high accuracy.

Analysis of the impact of the armed conflict in Ukraine on the population of Romania

Purpose

The study aims to highlight the behavior of people in a state in the vicinity of a military conflict zone. Specifically, it highlights the psychological behavior of Romanian citizens after the invasion of Ukraine by the Russian Federation. It was considered appropriate to carry out this study, given the novelty of such a situation, since, after the end of the Second World War, Europe has no longer faced major problems of insecurity caused by armed conflicts of this magnitude.

Methods

The study was based on the questionnaire applied to a number of 1,193 people with permanent residence in Romania and a minimum age of 18 years. The data were collected in the beginning phase of the invasion of Ukraine by the troops of the Russian Federation, i.e. between March 1–17, 2022. The aim was to obtain information that would allow the observation of re-spondents' opinions on the conflict in Ukraine and its potential escalation, and on the other hand, to allow the assessment of quality of life, using the WHQOL-BREEF measurement instrument.

Results

Based on the results of the study, the highest average satisfaction among the four domains of WHOQOL-BREF is represented by the “Psychological” domain, of the category of people with the lowest fear about a potential future war between Romania and the Russian Federation (83.62 ± 17.48). On the contrary, the lowest average is represented by the “Environment” domain, for the category of persons who do not feel protected by the fact that Romania is a NATO member state (61.77 ± 20.96).

Conclusions

The results of the study show that the indices of the quality of life of the people in Romania, as a state in the proximity of a military conflict with the potential to escalate, are negatively influenced by the fears of people who believe that the war in Ukraine will escalate into a regional or global conflict, or that the Russian Federation is going to use its nuclear arsenal against Ukraine or another NATO member state.

The Pandemic’s Impact on Patients with Bipolar Affective Disorder in a Non-COVID Medical Unit

Introduction

Bipolar disorder or manic-depressive illness is a mental disorder which consists of abnormal and long-lasting changes in a person’s mood, energy, and ability to function. The ongoing COVID-19 pandemic restrictions precipitate the condition of those with bipolar affective disorder.

Objectives

We searched for significant differences before and during the pandemic by analyzing socio-demographic data.

Methods

We carried out a research activity at the I Psychiatry Clinic of the Clinical Hospital of Neuropsychiatry Craiova. We formed two groups of hospitalized patients during 2019 and during 2020, when the pandemic broke out. The inclusion criterion was the presence of bipolar affective disorder as a primary diagnosis.

Results

The number of cases and the total number of hospitalization days was higher during the pandemic, 101 cases versus 94 cases, 1667 days versus 1184 days. We identified a predominance of females during the pandemic, whereas in the previous year the distribution by sex was approximately equal. Regarding environment, the number of patients from urban and rural areas was approximately equal in 2019, while during the pandemic those in urban areas predominated, possibly due to easier access to psychiatric services. The ages of patients maintained a Gaussian distribution with a concentration of cases between 35-55 years.

Conclusions

While other psychiatric disorders were less present in the clinic during the pandemic, the number of bipolar affective disorder cases increased. Bipolar affective disorder is a major challenge due to the wide range of symptoms which cross with comorbidities that increase the likelihood of a SARS-CoV-2 infection.

Disclosure

No significant relationships.

Identification of transcriptome alterations in the prefrontal cortex, hippocampus, amygdala and hippocampus of suicide victims

Suicide is one of the leading causes of death globally for all ages, and as such presents a very serious problem for clinicians worldwide. However, the underlying neurobiological pathology remains to a large extent unknown. In order to address this gap, we have carried out a genome-wide investigation of the gene expression in the amygdala, hippocampus, prefrontal cortex and thalamus in post-mortem brain samples obtained from 20 suicide completers and 7 control subjects. By KEGG enrichment analysis indicated we identified novel clusters of downregulated pathways involved in antigen neutralization and autoimmune thyroid disease (amygdala, thalamus), decreased axonal plasticity in the hippocampus. Two upregulated pathways were involved in neuronal death in the hippocampus and olfactory transduction in the thalamus and the prefrontal cortex. Autoimmune thyroid disease pathway was downregulated only in females. Metabolic pathways involved in Notch signaling amino acid metabolism and unsaturated lipid synthesis were thalamus-specific. Suicide-associated changes in the expression of several genes and pseudogenes that point to various functional mechanisms possibly implicated in the pathology of suicide. Two genes (SNORA13 and RNU4-2) involved in RNA processing were common to all brain regions analyzed. Most of the identified gene expression changes were related to region-specific dysregulated manifestation of genetic and epigenetic mechanisms underlying neurodevelopmental disorders (SNORD114-10, SUSd1), motivation, addiction and motor disorders (CHRNA6), long-term depression (RAB3B), stress response, major depression and schizophrenia (GFAP), signal transduction at the neurovascular unit (NEXN) and inhibitory neurotransmission in spatial learning, neural plasticity (CALB2; CLIC6, ENPP1). Some of the differentially expressed genes were brain specific non-coding RNAs involved in the regulation of translation (SNORA13). One, (PARM1) is a potential oncogene and prognostic biomarker for colorectal cancer with no known function in the brain. Disturbed gene expression involved in antigen neutralization, autoimmunity, neural plasticity, stress response, signal transduction at the neurovascular unit, dysregulated nuclear RNA processing and translation and epigenetic imprinting signatures is associated with suicide and point to regulatory non-coding RNAs as potential targets of new drugs development.

The Relations Between Non-motor Symptoms and Motor Symptoms in Parkinson Disease

The aim of this study was to evaluate the correlation between motor and non-motor symptoms in patients diagnosed with Parkinson. We included in our study 72 patients diagnosed with Parkinson disease:28 female and 44 males. Each patient was evaluated using Non-motor Symptoms Questionnaire for Parkinson Disease, for motor status we used Unified Parkinson Disease Rating Scale (UPDRS) part 3 (motor part). The results of our study indicated that there is a correlation between the non-motor state and the motor symptoms but not in all non-motor domains. The study indicates that the digestive symptoms, the, cardiovascular, sleep and miscellaneous correlate with the motor symptoms but urinary symptoms, memory, hallucination, depression and sexual dysfunction does not show an interdependence with the motor state.

Immunohistochemical analisys in Breast Carcinoma Treated with Conservative Surgery

Breast cancer is the most common type of cancer in women worldwide and the second most common cancer overall, making it a major international concern from both socio and economical point of view. World Health Organisation (WHO) estimated that worldwide over 508.000 women died in 2011 due to breast cancer. American Cancer Society�s (ACS) study conducted in 2017 showed important numbers about the burden of breast cancer. Therefore, they estimated a number of 252,710 new breast cancer to be diagnosed in women and 2,470 in men in 2017- only in America. On 1st of January , there were about 3.5million US women with a history of breast cancer. The paper presents the correlations between recurrences of the tumor in breast cancer trated with conservative surgery and their immunohistochemical expression.

Prognostic Value of Ejection Fraction in Patients Admitted with Non-ST-Segment Elevatin Myocardial Infarction

Despite the progress in correcting cardiovascular risk factors and pharmacological and interventional therapy, acute myocardial infarction continues to be a major cause of mortality and morbidity worldwide.In literature exist limited information about the factors that affect the outcomes of acute myocardial infarction at patients with a different degree of left ventricular dysfunction. Our aim was to identify the factors associated with LV ejection fraction (LVEF) at first admission to patients with non-ST-segment elevation myocardial infarction.

Assessing the Risk Factors of Patients with Non-ST-Segment Elevation Myocardial Infarction

Cardiovascular risk management decisions are based on the full profile of cardiovascular risk factors.It is important not only the number of cardiovascular risk factors accumulated by a patient but the magnitude of each factor, both being proportional to cardiovascular risk.

Correlation Between the Age, Motor Subtypes and the Necessity of Advanced Therapy in Parkinson Disease

Levodopa (L-dopa), a precursor of dopamine, remained the gold standard among antiparkinsonian drugs and virtually, in different stages, all patients will require the more powerful symptomatic effect of L-dopa. In addition, continuous Levodopa/Carbidopa intestinal gel (LCIG) infusion therapy, via a percutaneous endoscopic gastrostomy (PEG) and a portable infusion pump, is well established for the treatment of advanced Parkinson�s disease (PD), substantially improving motor symptoms and quality of life in these patients. This study aimed to evaluate the necessity of LCGI depending the PD motor subtypes and age at onset of the disease. Seventy patients diagnosed with PD were included in our study. The Unified Parkinson�s Disease Rating Scale (UPDRS) was performed in on state. The patients were classified as tremor-dominant type (TDT), akinetic-rigid type (ART) and mixed type (MT). Depending on form of levodopa, thirty-six patients were on L-dopa orally and thirty-four patients were on LCIG. The results of our study showed that there was a statistically significant correlation between the age at onset of PD and the motor subtype of the disease. Also, we observed that the lower the age at diagnosis, the more our patients have reached the need for LCGI. Regarding the motor subtype, our study showed that the mixed typed request more frequent LCGI. Our data show that age and motor profile at onset can predict the necessity of advanced therapy.

Correlations Between Distinct Ras Mutations and Response to Bevacizumab in Patients with Colo-rectal Cancer

CRC is currently ranked third among frequently diagnosed malignancies. Mutations in exons 2,3 and 4 of the KRAS and NRAS genes were detected using a targeted resequencingassay from paraffin embedded tissue from patients� biopsies samples. The following data was recorded for each patient: baseline information - age and sex � as well as diagnosis, cancer localization, disease stage and laboratory parameters.In our study group we could not find statistically significant differences regarding distinct mutations and the progression free survival (p=0.34]0.05) for patients treated with an anti-angiogenic therapy.

Anorexia, a First Sign of Diagnosis in Severe Pediatric Disorders

Anorexia, as a symptom, is part of the complex picture of a large pediatric pathology. Through attentive observation, anorexia as a single sign, may announce the onset of serious and particular affections. In all 4 cases, anorexia was a singular sign for a period of time before the complete illness was established. Whether adenoid cyst, cerebral abscess, pontocerebellar atrophy, Wilms tumor, neuroendocrine system of hunger regulation, satiety, complex control achieved through interactions of the limbic-hypothalamus-cortex system, come into operation with the occurrence of organic anorexia, different of the psychogenic anorexia (usually common in adolescents). The study is an alarm signal on the importance of a symptom in early diagnosis, and the rapid establishment of therapy in severe life threatening conditions.

The Influence of Digestive Dysfunctions on Quality of Life in Parkinson Disease

As a part of non-motor symptoms in Parkinson�s disease (PD), the dysfunctions of the gastrointestinal tract are frequent, being a major complain in the majority of the patients. The aim of our study was to assess the impact of digestive dysfunctions on quality of life in Parkinson�s disease. We included in this study 60 patients with PD, with a disease severity which varied between 2 and 5 on Hoehn and Yahr Scale. Our results showed a low correlation between digestive dysfunctions and the severity of the disease, but a statistically significant correlation between quality of life and the stage of the disease. Also, we observed a statistically significant correlation between digestive dysfunctions and quality of life. Our study revealed that the frequency of digestive dysfunction has correlated with a poor quality of life in any stage of the disease.

Clinical and Biochemical Changes Induced by Alcohol at the Patients with Mental Illness

Alcoholism use disorders are very frequent present all over the world. The use of alcohol is responsable for many behavioral symptoms like impulsivity, violence, depressive mood and anxiety. The aim of our research was to find the clinical and the biochemical changes induced by alcohol at the patient with mental illness.

Diabetic Retinopathy in Relation with eGDR Value in Patients with Type 1 Diabetes Mellitus

Type 1 diabetes mellitus (T1DM) is a chronic disease which represents a major issue for public health. Type 1 diabetes is occurred most frequently in childhood and adolescence, although in recent years due to the increase in the prevalence of obesity in this category of population has been registered a growing number of cases of type 2 diabetes among children and adolescents (1, 2).

Statistical Analysis Between the Routes of Administration of L-Dopa and Digestive Dysfunctions in Parkinson Disease

The aim of this study was to evaluate possible correlation between routes of administration of levodopa in patients diagnosed with Parkinson�s disease and the presence of digestive symptoms. We included in this study 31 patients diagnosed with Parkinson�s disease:14 patients were on oral levodopa and 17 patients were on intrajejunal administration of levodopa/carbidopa. Each patient was assessed using Non-motor Symptoms Questionnaire for Parkinson�s Disease regarding the dysfunction of gastrointestinal tract. The results of our study indicated that there is a different distribution of the digestive dysfunction between the two groups of patients. The study indicate that the constipation was more frequent in those patients with oral medication.

Raspunsul gazdei la hepatita cronica virala B

This review discusses and tries to demonstrate the importance of proinflammatory and antiinflammatory cytokines in HBV infection. Hepatitis B virus is a virus that is both hepatotropic and non-cytopathic. It causes the development of liver diseases which could progress into both acute and chronic versions. The virus is very widespread and results in the death of quite a number of people each year. The outcome of the viral infection is a result of immunologically mediated event. This means that the outcome is determined by the response of the immune system of the host. The infection can lead to several different liver diseases as well as fibrosis and cirrhosis. When an infection occurs, there is an attempt by the body to fight it via the use of several mechanisms. One of these is the use of cytokines (which are proteins). There exist different kinds of cytokines of which interleukin-10 and interferon gamma are very important. Interleukin-10 is an anti-inflammatory cytokine which inhibits the effector mechanism of Th1 cytokines. It performs hepatoprotective and anti-inflammatory functions and also upregulates Th2 cytokines. The function and relevance of this cytokine in the pathogenesis of liver diseases cannot be underemphasized. Interferon gamma, on the other hand, is a pro-inflammatory cytokine which seeks to eliminate and expunge the virus from the liver upon infection. It does this by congregating at the site of infection which subsequently results in inflammation and eventually liver fibrosis. This effect could be reversed by administering another type of interferon; interferon alpha.

Arrhythmia Risk in Patients with ChronicHepatic Disease

Cardiac affectation is one of the leading causes of death in the world. Rhythmic disorders such as ventricular extrasystoles, atrial extrasysoles, atrial fibrillation, atrial flutter represent a major risk factor with a gloomy progression and prognosis. Our goal was to analyze the existing arrhythmia risk in patients with chronic hepatic disease. Being known the alteration of the somatic status of the patient with liver cirrhosis or other chronic liver disease in the presence of comorbid cardiac symptoms, we consider vital to prevent arrhythmia risk in hepatic pathology.

Blood Parathyrin and Mineral Metabolism Dynamics. A clinical analyze

Circulating parathyrin (PTH or parthormon) is increased in primary hyperparathyroidism (PHP) in association with high total/ionic calcium (T/I Ca) and others mineral metabolism anomalies. This is a clinical cross-sectional and case-control study analyzing these changes after PHP surgical correction in menopausal women. Baseline parameters were: mean age at diagnosis (59.63�9.6 years), TCa of 10.9�0.7 mg/dL, PTH of 138.02�59.36 pg/mL. Longitudinal data showed: final TCa p[0.00001, ICa p[0.00001, phosphorus p[0.0001, magnesium p=0.9, 24-h urinary calcium p=0.4, 25-hydroxycholecalciferol p=0.01, PTH p[0.00001. High circulating parathyrin values due to PHP normalized after surgery in addition to statistical significant changes of TCa, ICa, P, lumbar Bone Mineral Density provided by Dual-Energy X-Ray Absorptiometry; Mg and 24-h Ca might not be a marker of general mineral metabolism improvement.

Relationships Between Glial Enteric Cells, Beta-cell Signaling and Tumor Proliferative Activity in Patients with Colorectal Neoplasia

The aim of our study was to evaluate the expression of glial enteric cells at different stages of differentiation of colorectal neoplasms and to correlate these changes with the tumor proliferation index and with the sympathetic influences evaluated by the expression of beta-2 adrenoreceptors. Given that nowadays colorectal neoplasm is a major public health problem and that the molecular mechanisms responsible for malignant transformation are not fully yet elucidated, more studies are needed in order to establish other intracellular signaling pathways in such a neoplasm. By this study we concluded that the proportional decrease in the density of glial enteric cells in colorectal cancer with the degree of tumor differentiation and also their inverse correlation with the tumor proliferation index and with the expression of the adrenergic beta-2 adrenoreceptors can be considered a negative prognostic factor in this type of cancer.

Benefit of Cardiac Resynchronization Therapy in Patients with Heart Failure

Heart failure is a disease characterized by cardiac remodeling or progressive dilation of left ventricle and a consequent reduction in contraction. Ventricular remodeling has been shown to be a negative prognostic factor alone, and therefore the most beneficial drugs are those that prevent or reduce left ventricular dilation. The pharmacological therapy of heart failure, although maximal, has proven to be not fully effective. The aim of our research was to evaluate resynchronization therapy in a lot of patients, monitoring their cardiac performance before and after cardiac resynchronization therapy.

Alteration of Glucidic Metabolism in Relation with Visceral Adiposity Index

Obesity is has become a major problem worldwide. Since 1975, the prevalence of obesity nearly trippled, and nowadays we are facing an obesity epidemic. Obesity is a major risk factor for many diseases such as cardiovascular ones (mainly heart disease and stroke) -being the leading cause of death worldwide, musculoskeletal disorders or type 2 diabetes mellitus (DM).

Incidence of Osteoporosis and the Risk of Fracture in Patients with Rheumatoid Arthritis Undergoing Corticosteroid Treatment

Rheumatoid arthritis (RA) is the most widespread inflammatory rheumatic disease with about 10% of all rheumatic diseases and a global prevalence of about 1%. Through its features - joint proliferation, articular panic, articular cartilage degradation and bone erosion � RA has a destructive and disabling character and a major socio-economic impact. Osteoporosis is a bone system disease characterized by loss of bone mass and alteration of bone architecture, with consequences on bone fragility correlated with an increased fracture risk. With a major socio-economic impact, the World Health Organization (WHO) has declared osteoporosis as a public health problem, third on cardiovascular and oncological.

Correlation Between Liver Cirrhosis and Risk of Cardiac Arrhythmias

There are few studies analyzing the correlation between liver cirrhosis and cardiac arrhythmias. Still, factors triggering cardiac arrhythmias occur in many instances in liver cirrhosis.We studied a cohort with patientsdiagnosed with liver cirrhosis hospitalized to Cardiology Department, to the County Hospital of Craiova, between January 2017 and January 2018. We wanted to study the frequency of cardiac arrhythmias at the patients diagnosed with liver cirrhosis and also to evaluate several associated factors.The frequency of cardiac arrhythmias in the presence of risk factors was analysed using x2 test and statistical models.We analized multiple variable including demographics and clinical and biochemical characteristics, frequency of type of arrhythmias and evaluation of the associated factors like diabetes mellitus, hypertension, hypercholesterolemia, hypertriglyceridemia ,hyper/hypokalemia and hyper/hyponatremia. From our group, after exclusion criteria, we have a total of 34 patients with alcoholic liver cirrhosis, 37 patients with chronic HCV infection and 36 patients with HBV infection. From 34 patients with alcoholic liver cirrhosis, 23 patients presented atrial fibrillation(67.65%), from 37 patients with chronic HCV infection 21 were diagnosed with atrial fibrillation(56.76%) and from the patients with HBV infection 19 patients were known with atrial fibrillation(52.78%).We have encounter atrial flutter at 2 patients (5.56%) with chronic HBV infection. Atrial extrasystole was found at 7 patients with chronic HBV infection (19.44%), 4 patients with chronic HCV infection (10.81%) and 1 patients with alcoholic liver cirrhosis (2.94%). Ventricular extrasystole was found at 12 patients with chronic HBV infection (33.33%), 3 patients with chronic HCV infection (8.11%) and 5 patients with alcoholic liver cirrhosis (14.71%).We have also correlate the arrhythmias with different biochemical variables from our cohort. In our study there were many association between hepatic cirrhosis and cardiac abnormalities, which is concordant to reports from literature. Compared to population without liver cirrhosis, the prevalence of arrhythmias was increased in our cohort.

QT Interval Analysis in Patients with Chronic Liver Disease

The prevalance of QT prolongation in chronic viral liver disease is high and the risk of complications is increased. We wanted to study the QT interval prolongation at the patients diagnosed with chronic hepatic disease and also to evaluate some of clinical and biochemical variables. We studied a cohort with 126 patients diagnosed with chronic viral hepatic diseases hospitalised to Cardiology Department, to the County Hospital of Craiova, between Octomber 2016 and January 2018. We aimed to determine the occurrence of QT interval prolongation in a large series of patients with chronic hepatic disease of viral etiology. We wanted to evaluated the QT prolongation to clinical and biochemical variables. The QT interval was measured by a standard 12-lead ECG for each patient, with prolongation defined as 460 ms. Multiple clinical and biochemical variables were evaluated including sex, age, areas (rural/urban) the frequency of arrhythmic events (PACs, PVCs, Atrial fibrillation, Bradycardia, Tachycardia), NT proBNP, Hb,uric acid, creatinine, alanine aminotransferase (ALT), aspartate aminotransferase (AST) , cholesterol, triglyceride, etc. The group of patients was composed by 43 woman and 83 men. From 43 women, representing 65.06% (461.56 �42.03) and from 83 men, means 66.67% (461.14 � 45.10) presented interval QT prolongation. Studing the distribution of hepatic etiologies we can see that 34 patients had hepatitis B, 35 patients hepatitis C, 5 patients B and C dual virus infection and 52 patients with chronic liver disease of etiology other than viral. We registered close results about QT interval prolongation on group, sex and origine group of patients. The value of QT interval to our patients was higher compared to other values recorder in other studies, at the patients with chronic hepatic disease, despide the fact we chose a higher value of QT prolongation. The highest value of QT interval was in the group of age between 60 and 69, even if in other studies we notice a prolonged QT interval at patients over 70 years old. The biological and biochemical profile of chronic hepatic disease of the subjects included in our study showed no statistical difference between male and female patients.We found a higher incidence of arrhythmic events, at patients with chronic hepatic disease of viral etiology, especially to premature atrial contraction and atrial fibrillation.We found a couple of correlation between QT interval prolongation and the evolution of chronic hepatic disease of viral etiology. It is very important to develop a strong and complex strategies to prevent and to treat the arrhythmic event presented at the patients diagnosticated with hepatic disease, because of the higher risk of developing life-threatening arrhythmias, includen sudden cardiac death.

Clinical and Biochemical Considerations Regarding Stress and Arrhythmic Risk in Patients with Chronic Viral Liver Diseases

The prevalance of depression and anxiety is higher at the patients diagnosticated with viral liver disease. The corelation between stress and chronic liver disease is a natural, implicit one, but still insufficiently studied. The study has the objective of finding out the clinical and also biochemical correlations between stress and chronic viral diseases. Our research was realised on a group of 78 patients with chronic viral liver disease, who underwent an evaluation of the stress level, both from a subjective point of view and based on concrete methods like questionnaires. The patients were asked to espress their state more or less affected by stress, and, subsequently, they were subjected to a questionnaire that was analyzed, followed by establishing the necessary correlations. Our patients were also evaluated by cardiologicaly, psychologicaly and psyhiatricaly examinations. After the first evaluation we had these results :38 patients (49.19%) consider that they have an average stress level, 18 patients (22.58%) have a high stress level. Only 22 patients (28.22%) declared stress was at a low level. We divided the pacients in two groups, function of Qt (questionare total score) results and we observed that a number of 38 patients ( 49.19%) registered �Qt 20 and 40 patients (50.81%) had Qt � 20, 63 patients (50.81%).We found a strong correlation between the patients� subjective evaluation of the stress level and the objective evaluation of stress level according to the used questionnaire, which confirms the objectivity of our study. We found a direct corelation, with a morphological, biochemical and functional support between stress and the arrhythmia risk in the evolution of chronic liver disease. We consider very important a complex examination psychiatricaly, psychologicaly and cardiological of the pacients diagnosticated with viral liver disease in order to help them and to prevent arrhythmic events, depression, anxiety and other mood disorders.

Immunohistochemical Expression of CD8, CDX2, P53, D2-40 and KI 67 in Colorectal Adenocarcinoma, Conventional and Malignant Colo-rectal Polyps

82 patients, who had been diagnosed with colo-rectal adenocarcinoma in our department between 2007 and 2014, were included in our study. Additionally, 31 patients with colo-rectal polyps (20 conventional adenomatous polyps and 11 malignant colo-rectal polyps) were also included in this study. The patients with colo-rectal adenocarcinoma were reevaluated in terms of gender, age, topography of recto-colic tumor, TNM stadialization, vasculo-lymphatic invasion, lymph nodes metastases and distant metastases. The study of CD8, Ki67, p53, CDX2 and D2-40 immunoexpression in colo-rectal cancer patients revealed: an elevated positivity index in patients with pT2 and pT3 stages and in patients with lymph node metastases in case of the CD8; an elevated positivity index in patients with pT2, pT3 and pT4 stage in case of Ki67; an elevated positivity index in patients with pT4 stage in in case of the p53; an increased positivity index in the pT2, pT3 stage, the absence of vasculo-lymphatic invasion, the absence of lymph node and distant metastases in case of the CDX2 and an increased positivity index in patients with the pT2, pT3 stage, the abscence of lymph node and distant metastases in case of the D2-40 Tumoral staging (pT2, pT3 and pT4) has been shown to be correlated with immunoexpression of the following markers: CD8, CDX2 and p53.

The Association Between Stress Level and Laboratory Parameters, Sex, Age and Stage Disease in Patients with Digestive and Bronchopulmonary Neoplasms

We conducted a prospective study to determine whether there is a possible correlation between stress level and age, sex, cancer site, disease stage and to explore whether stress level changed during each visit. Patients diagnosed with digestive or bronchopulmonary neoplasms over a period of 6 months were included in our study. The level of stress for each patient was investigated using a questionnaire developed by an authorized psychiatrist. The questionnaire comprised 10 items and the score for each component ranged from 0 to 3, a higher score indicating a higher level of stress. For the purpose of this study, a score ] 20 indicated a high level of stress. Each patient included in our study completed the questionnaire during three consecutive visits in our department. Our study revealed a statistically significant association between age and stress level, whereas no correlation was found between stress level and laboratory parameters, tumor site and disease stage.

Particularities of associating viral hepatitis with pregnancy and mental disorders

Pregnancy generates particular circumstances for all co-existent conditions. Associating pregnancy with liver diseases has distinct particularities. The authors will perform a presentation of the etiopathogenic, diagnosis and therapeutic conduct particularities regarding the association between pregnancy, chronic liver diseases and mental disorders. The three pathological entities are analyzed separately, followed by a study of a triple association. Associating pregnancy and mental disorders has been better studied due to a higher frequency of mental disorders, especially postpartum, but the triple association pregnancy, chronic hepatitis with viral etiology mainly, and mental disorders has been less analyzed. There is concluded that pregnancy, through the physiological changes it undergoes, as well as its pathology, represents a clearly influencing factor of the association with a chronic liver disease or with a mental disorder.

Current understanding of the neurobiology of major depressive disorder

Depression is highly prevalent worldwide and associated with significant morbidity and mortality. Approximately 340 million people worldwide suffer from depression at any given time. Based on estimates from the World Health Organization (WHO), depression is responsible for the greatest proportion of burden associated with non-fatal health outcomes and accounts for approximately 12% total years lived with disability. Probably no single risk factor can be completely isolated in major depressive disorder (MDD), as interactions between many sources of vulnerability are the most likely explanation. Buttressing the identification of grief, demoralization, hopelessness and styles of psychological coping of the depressed patient are vital, ongoing scientific developments that flow from an increased understanding of this interplay amongst the immune system, endocrine system and brain. The rapidly accumulating body of neurobiological knowledge has catalyzed fundamental changes in how we conceptualize depressive symptoms and has important implications regarding the treatment and even prevention of depressive symptoms in patients.

Endoscopic Ultrasound-guided Drainage of Pancreatic Pseudocysts: Medium-Term Assessment of Outcomes and Complications

Objective:

Endoscopic ultrasound (EUS)-guided drainage is a widely used treatment modality for pancreatic pseudocysts (PPC). However, data on the clinical outcome and complication rates are conflicting. Our study aims to evaluate the rates of technical success, treatment success and complications of EUS-guided PPC drainage in a medium-term follow-up of 45 weeks.

Materials and Methods:

A retrospective review was conducted for 55 patients with symptomatic PPC from December 2005 to August 2010 drained by EUS. Medium-term follow-up data were obtained by searching their medical history or by telephonic interview.

Results:

A total of 61 procedures were performed. The symptoms that indicated drainage were abdominal pain (n = 43), vomiting (n = 7) and jaundice (n = 5). The procedure was technically successful in 57 of the 61 procedures (93%). The immediate complication rate was 5%. At a mean follow-up of 45 weeks, the treatment success was 75%. The medium term complications appeared in 25% of cases, which included three cases each of stent clogging, stent migration, infection and six cases of recurrence. There was no mortality.

Conclusion:

EUS-guided drainage is an effective treatment for PPC with a successful outcome in most of patients. Most of the complications require minimal invasive surgical treatment or repeated EUS-guided drainage procedures.

Embryological, clinical and anatomopathological considerations on a very rare case of a bicephalous fetus (dicephalus dipus dibrachius)

In this paper, we present the very rare case of a 21 weeks pregnant woman, examined clinically and by ultrasound. We could observe the present of two heads and a common trunk and therefore we proceeded to the small caesarian of necessity. We examined the fetus from the clinical and pathological point of view and we could observe a rare case of pregnancy with a bicephalous malformed fetus. During the autopsy, we could reveal the common elements and the devised ones, which are described as it follows. The case is a very rare one and that probably explains the fact that until the 21 weeks examination, even if she was clinically and ultrasound examined there was the appreciation that it was a twin pregnancy with a normal evolution. In this case, it is necessary to underline that the difficulties concerning the diagnosis and the medical behavior are also because the patient was a primipara 34-year-old woman without any pathological or specific family history. This case analysis shows the necessity of a preconception genetic advice together with the extension of the analysis of the genetic risk in all mothers under 35-year-old, mandatory and supported by the medical system. At the same time, an ultrasound examination of great performance proves to be necessary in order not to prolong the development of a pathological pregnancy.

Comparative study of placenta acute fetal distress and diabetes associated with pregnancy

The authors analyze the main histopathological changes of placentas from pregnancies ended with fetal distress at birth and the tasks associated with diabetes. The parallel between the two types of placentas not trying to prove the existence of pathognomonic lesions. Are set out both the similarities between the two titles of placentas lesions (such as changes in microcirculation and so on) as well as particular aspects. The authors analyze a group of 19 pregnant women hospitalized in Obstetrics and Gynecology Clinics of Emergency County Hospital of Craiova, Romania, in September 2010-September 2011, who were born and who were diagnosed with diabetes. In the same period, were studied 21 pregnant women whose pregnancy ended with the birth of a child with fetal distress. Such were identified as placental lesions suggestive of fetal distress as diverse etiology of placental vascular changes and the placenta in pregnancy associated diabetes as immaturity and vascular edema and fibrinoid changes and glycogen stores. The authors have proposed to highlight some lesions suggestive of two groups of diseases but independent groups were analyzed and conclusions were drawn after discussing results. This study is justified by insufficient knowledge of the causes that lead to fetal distress regardless of its etiology. In conclusion, the authors mention both placenta's common changes as specifically changes of the placenta for each type of disorder.

Histopathological considerations of placenta in pregnancy with diabetes

The authors present the results of a study on 19 cases of pregnant women with diabetes who delivered in No. 1 Clinic of Obstetrics and Gynecology, Emergency County Hospital of Craiova, between October 1st, 2009 and September 1st, 2011. After delivery, placentas were harvested for the pathology study. The results of this study reveal: villous immaturity, villous edema, presence of basement membrane thickening, congestion of capillaries called "chorangiosis", intra- and extravillous fibrinoid and a deposit of glycogen. The authors state that although these lesions are not pathognomonic for pregnancy with diabetes, they are very suggestive and specific for this association: diabetes-pregnancy.

Importance of early complex evaluation in high-risk pregnancy associated to diabetes mellitus. Case presentation and review of the literature

We report and analyze a case of pregnancy associated with pre-existent diabetes mellitus and fetal congenital anomalies involving neural tube defect (NTD) and congenital heart defect (CHD). We discuss the early antenatal management of such high-risk pregnancies. The clinical course, maternal paraclinic profile and morpho-sonographic investigation of the fetus are described. A 28-year-old pregnant woman with pre-existing diabetes and a pre-pregnancy BMI 31 kg/m², without preconception counseling for optimization of glycemic control was evaluated in our center for first trimester genetic screening at 12 weeks of gestation. Considering a high-risk pregnancy, careful fetal morphological assessment by ultrasound was performed; the extensive examination using high-resolution probes, both by transabdominal and transvaginal approach, found hypoplastic left heart syndrome (HLHS) and open spina bifida (OSB). Both anomalies present important difficulties regarding first trimester diagnostic. The couple was informed and chose termination of pregnancy (TOP). We consider that an anomaly scan at 12-13 + 6 gestational weeks by expert operators should be offered to high-risk pregnancies, because it provides the chance to detect the majority of fetal anomalies. This offer for couples the option of an early decision about the management of pregnancy in cases of severe fetal anomalies; postnatal treatment could be discussed as well as TOP and if the latter is chosen, the maternal risk and the potential psychological burden are lowered, as compared with TOP performed in the mid-second trimester.

Clinical and histopathological correlations of the modifications of fetal membranes in amniochorial infection

The paper aims at analyzing the histopathological modifications induced by the amniotic infection on present fetal membranes and in the absence of clinical signs of chorioamnionitis. Such an evaluation is important in the context of postpartum fetomaternal complications. The objective was to determine the relation between the microbial invasion in the amniotic cavity and the severity of inflammatory lesions of the placenta, of the membranes and the umbilical chord.

Immunohistochemical aspects of endometrial glands in dysfunctional uterine hemorrhage

The authors present a specific aspect of the modifications of the endometrium in dysfunctional uterine hemorrhages that is the behavior of the endometrial glands. These glands are studied from a immunohistochemical point of view, regarding both the normal endometrium (inclusively at the age of two years) and the endometrium in dysfunctional uterine hemorrhages. The antigens used were VGEF and PCNA. The result was a different reaction of the glandular structures to these antigens in the cases of patients with dysfunctional uterine hemorrhage.