Search Results (130)

Background: Oxidative stress (OS) and inflammation are interconnected processes with significant roles in various chronic diseases, particularly those associated with aging, such as metabolic syndrome (MetS). Recent evidence suggests that walnuts (from Juglans regia L.), due to their rich content of phytochemicals, have antiaging potential by attenuating OS and chronic low-grade inflammation, known as inflammaging. Objectives: We aimed to assess the impact of daily walnut consumption for 4 weeks on biomarkers of OS and inflammation in a cohort of middle-aged individuals at risk of developing MetS. Methods: In this crossover randomized controlled trial (RCT), 22 participants (mean age: 48.81 ± 4.3 years) underwent two 28-day dietary interventions separated by a one-month washout period. One intervention period included daily consumption of 45 g of walnuts, while the other (control period) involved a normal-calorie diet without walnuts. Catalase (CAT) and glutathione peroxidase (GPx) activities, total antioxidant capacity (TAC), and interleukin (IL-1β, IL-6, IL-8) and tumor necrosis factor alpha (TNF-α) levels were determined from serum before and after each intervention period. Results: Assessment of changes obtained for the selected biomarkers following the walnut and control-diet periods (final-baseline) showed slight changes, but without any statistical significance, among the 20 participants included in the analysis. Conclusions: This first RCT targeting a group of middle-aged adults at risk of developing MetS shows that short-term (4 weeks) daily walnut consumption did not significantly alter oxidative stress and inflammation parameters, thus potentially contributing to the maintenance of cellular homeostasis. Further research is needed to investigate the impact of daily walnut consumption over a longer period (>3 months) on oxidative and inflammatory status in the middle-aged population and its potential to positively impact MetS biomarkers. Full article

Background: With growing evidence regarding long-term clinical results of left main angioplasty, it has become clear that the gap between percutaneous coronary interventions (PCIs) and bypass surgery can be narrowed only by improving the PCI technique. While intravascular ultrasound (IVUS) has become routinely used for this subset of lesions, there is still insufficient data regarding the role of optical coherence tomography (OCT) in left main PCI. Aims: The aim of this study was to investigate the long-term results of OCT-guided PCI in comparison to angiographical guidance alone. Material and methods: We conducted a retrospective single-center high-volume analysis of patients with left main disease treated by PCI. The primary endpoint was all-cause death. Results and discussion: Between January 2013 and January 2024, we enrolled 221 eligible patients with unprotected left main coronary artery disease treated by PCI; among these, 13.1% were treated by OCT-guided PCI and 86.9% by angiographic-guided PCI. At a median follow up of 30.16 months (interquartile range: 14.3–60 months), Kaplan–Meier survival analysis revealed a significantly higher survival probability in the OCT group compared to the non-OCT group (log-rank p = 0.034), with no significant differences between the groups regarding procedural success rate. In the multivariable Cox proportional hazards model, adjusting for other relevant covariates, OCT was borderline non-significantly independently associated with a 63% reduction in mortality (HR = 0.37, p = 0.063). Conclusions: In our study, OCT-guided PCI was associated with early procedural distinctions and a trend toward improved unadjusted survival in LM PCI. The findings highlight the potential procedural advantages of OCT, as well as the need for larger prospective studies to establish its long-term clinical benefits in left main interventions. Full article

Background/Objectives: Differentiating between benign and malignant cervical lymph nodes (LNs) is a critical challenge in the clinical setting. We assessed the ability of shear wave elastography (SWE) to distinguish between lymphomas and solid tumor metastases presenting as cervical adenopathy. Methods: We performed a single-center, prospective, observational study in adults with clinically suspicious cervical lymph nodes. The ultrasound examination included conventional ultrasound and SWE with quantitative assessment (tissue stiffness in kPa). Pathology examination was the definitive confirmation method. Simple univariate binary logistic regression and multiple univariate binary logistic regression were used. Results: The maximum shear wave velocity (SWV) in patients with benign pathologies was 35 kPa, lower than the minimal values for lymphoma (40 kPa) and metastases (50 kPa). Furthermore, squamous cell carcinoma and distant metastases were more prevalent among men. Independent from other factors used in the statistical model, we found a positive association between sex and the presence of metastatic lymph nodes. Finally, each 1 kPa from SWE measurement was associated with a 3% increase in the risk for LNs to present metastatic adenopathy. Conclusions: This study highlights the potential of SWE for the preoperative assessment of nodal status in patients with various malignancies affecting the head and neck region, thyroid, and other areas. Full article

This study provides a comprehensive assessment of water infrastructure, consumption management, and educational practices across all public pre-university educational institutions in Cluj County, Romania. The research addresses the increasingly urgent imperative of sustainable water resource management within educational settings, in alignment with both European and global priorities. This analysis is based on a comprehensive data set collected in June 2025 from all 392 public pre-university educational institutions in Cluj County, encompassing both urban and rural areas, all educational levels, and all types of institutions. Data was gathered using a standardized questionnaire, which was validated with the official support of the Cluj County School Inspectorate. The quantitative analysis highlights significant urban–rural disparities: 95.566% of urban institutions are equipped with modern meters and connected to public water networks, compared to only 68.254% in rural areas. Water consumption monitoring relies predominantly on invoice data (69.388%), while the adoption of advanced monitoring technologies remains limited. Reported water losses are minimal (1.531%), and only 0.765% of educational institutions have indicated non-compliance issues related to water quality in the past three years. Educational measures and water-saving awareness campaigns are present in 65.562% of institutions, yet only about one-third (32.908%) have implemented dedicated projects or partnerships. The financial analysis reveals that 90.487% of annual water and sewerage costs are borne by urban institutions. The study highlights both the progress achieved and the persistent challenges, particularly in rural infrastructure and the expansion of educational interventions. The results provide a robust empirical basis for informing regional and national policies, supporting targeted investments, integrated educational programs, and continuous monitoring to ensure sustainable water resource management in the Romanian educational system. Full article

Background/Objective: To assess vulnerable Romanian children’s knowledge, attitudes, and beliefs regarding the HPV vaccination. Methods: Vulnerable children (ethnic minorities, high social vulnerability index, or low socioeconomic status) from three schools in Cluj County, Romania, were enrolled in a short educational presentation regarding HPV and were delivered a physical questionnaire consisting of 26 items. Results: 199 vulnerable school students concluded the questionnaire with a mean age of 14.62. Most participants were unaware of the HPV infection or the HPV vaccine. Following the educational program, most participants exhibited a reasonably elevated level of knowledge, which positively correlated with the intention to vaccinate. Fifty-three per cent of respondents would vaccinate in school if the vaccine were available, fifty-four per cent would vaccinate if the product were free of charge or at minimal cost, and over sixty-four per cent would vaccinate at their doctor’s recommendation. Several knowledge items, beliefs, and attitudes towards vaccination were disclosed to influence children’s preference to participate in vaccination campaigns. Conclusions: This analysis unveiled the pivotal role of knowledge about HPV in the immunization uptake within underserved, vulnerable populations of Romanian children. An intricate interplay between vulnerability, knowledge, accessibility, and the willingness to vaccinate was impacted by several beliefs and attitudes towards HPV vaccination. Most children were willing to participate in HPV immunization campaigns, whether school-based, reimbursed, or at the doctor’s recommendation. These findings act as pillars for assembling future educational campaigns in vulnerable Romanian communities of children, aiming to enhance awareness and coverage of HPV vaccination and ensure inclusive health policies. Full article

Background and Clinical Significance: Neuroleptic malignant syndrome (NMS) is a life-threatening condition usually caused by the exposure to antipsychotics. This case report presents a catatonia syndrome that may have developed in the context of a moderate NMS. Case Presentation: An 18-year-old male patient presented with a treatment-resistant catatonia syndrome that debuted 2 weeks prior to the presentation (creatin kinase levels = 4908 U/L, maximum temperature = 38.9°C, white blood count = 13.20 × 10⁹/L, Bush–Francis Catatonia Rating Scale = 30 points). Possible organic causes of catatonia were ruled out, according to the negative results obtained. The patient’s condition improved under benzodiazepine treatment and he was later discharged. After discharge, the catatonia was attributed to a possible NMS with moderate severity. The diagnosis was supported by NMS Diagnosis Criteria Score = 85 points and the presence of Levenson’s triad. Conclusions: This case highlights the concomitant manifestation of both catatonia and NMS in the same patient and the difficulty of establishing a correct diagnosis involving both entities. Full article

Objectives: The objective of this study was to evaluate changes in anatomical point position, cranio-cervical posture, and respiratory dimensions following conventional bimaxillary total prosthetic rehabilitation. Methods: A prospective, longitudinal, observational, analytical study was conducted on 12 patients, aged 55 to 75 years, at the Department of Dental Prosthetics at the University of Medicine and Pharmacy in Cluj-Napoca. All patients had complete bimaxillary edentulism and received removable dentures as treatment. Clinical and cephalometric analyses were performed before and after prosthetic treatment to compare changes. The cephalometric analysis was based on the guidelines of Tweed and Rocabado for evaluation. Quantitative data were described using the mean and standard deviation for normal distribution and represented by bar graphs with error bars. A paired samples t-test was used to determine differences between groups, with a significance threshold of 0.05 for the bilateral p-value. Results: When analyzing changes in cranial base inclination, the corresponding angles exhibited an increase, indicating cephalic extension. A statistically significant difference in the anteroposterior diameter of the oropharyngeal lumen with and without bimaxillary complete dentures was identified (p < 0.05). For hyperdivergent patients, modifications in the position of anatomical features on cephalometry slightly reduced the VDO and had a slight compensatory effect on skeletal typology. In contrast, for hypodivergent patients, modifications to the position of anatomical landmarks also had a compensatory effect on skeletal typology, increasing the VDO. Conclusion: Changes in the position of anatomical features on cephalometry generally have a compensatory effect on skeletal typology after complete denture placement. Complete prosthetic treatment with removable dentures can significantly influence respiratory function by reducing the oropharyngeal lumen and body posture by cephalic extension and attenuation of the lordotic curvature of the cervical spine. Full article

Introduction: Traumatic brain injury (TBI) is a leading cause of morbidity worldwide, with the Glasgow Coma Scale (GCS) serving as a tool to measure injury severity. This study aimed to investigate the relationship between GCS admission scores and various socio-demographic, clinical, injury-related, and hospital-related variables in patients with TBI across two tertiary care centers in Eastern Europe, a region that remains underrepresented in the literature. Methods: A retrospective observational study was conducted using data from 119 TBI patients admitted between March 2020 and June 2023 at Cluj County Emergency Hospital (Romania) and Saint Vincent Hospital (Poland). GCS scores were analyzed as both categorical and continuous variables. Statistical analyses included Wilcoxon and Kruskal–Wallis tests for group comparisons and Spearman correlations for continuous variables. Results: Most patients included suffered a mild TBI (GCS score between 13 and 15). There were significant associations between GCS scores and post-traumatic amnesia (p < 0.05), discharge status (p < 0.01), discharge destination (p < 0.01), and education level (p < 0.01). GCS scores at admission were linked to survival, absence of post-traumatic amnesia, higher education levels, and home discharge. No significant differences observed across sex, residence, employment status, injury type, cause, or mechanism of injury. A weak but significant negative correlation was observed between GCS and length of hospital stay (rho = −0.229, p > 0.05), while age showed a non-significant correlation. Conclusions: The GCS score at admission is significantly associated with various clinical and socio-demographic outcomes in TBI patients, supporting the utility of the GCS score as a prognostic tool. The predominance of mild cases and the absence of radiological data, such as cerebral contusions or epidural or subdural hematomas, limit the generalizability of the findings. Further studies with larger samples and comprehensive imaging data are necessary to validate these findings. Full article

Groundwater contamination by nitrates (NO₃⁻) and nitrites (NO₂⁻) is an urgent problem in rural areas of Eastern Europe, with profound public health and sustainability implications. This paper presents an integrated assessment of groundwater vulnerability and water quality in rural wells in the Ceanu Mare commune, Cluj County, Romania—a representative area of the Northern Transylvania Basin, characterized by diverse geological structures, intensive agricultural activities, and incomplete public water infrastructure. This study combines detailed hydrochemical analyses, household-level studies, and geological context to identify and quantify key factors influencing nitrate and microbial contamination in rural wells, providing a comprehensive perspective on water quality challenges in the central part of Romania. This study adopts a multidisciplinary approach, integrating detailed geotechnical investigations conducted through four strategically located boreholes. These are complemented by extensive hydrogeological and lithological characterization, as well as rigorous chemical and microbiological analyses of nearby wells. The results reveal persistently elevated concentrations of NO₃⁻ and NO₂⁻, commonly associated with inadequate livestock waste management and the proximity of manure storage areas. Microbiological contamination was also frequent. In this study, the NO₃⁻ levels in well water ranged from 39.7 to 48 mg/L, reaching up to 96% of the EU/WHO threshold (50 mg/L), while the NO₂⁻ concentrations varied from 0.50 to 0.69 mg/L, exceeding the legal limit (0.5 mg/L) in 87% of the sampled wells. Ammonium (NH₄⁺) was detected (0.25–0.34 mg/L) in all the wells, below the maximum allowed limit (0.5 mg/L) but indicative of ongoing organic pollution. All the well water samples were non-compliant for microbiological parameters, with E. coli detected in 100% of cases (5–13 CFU/100 mL). The regional clay–marl substrate offers only limited natural protection against pollutant infiltration, primarily due to lithological heterogeneity and discontinuities observed within the clay–marl layers in the study area. This research delivers a replicable model for rural groundwater assessment and addresses a critical gap in regional and European water safety studies. It also provides actionable recommendations for sustainable groundwater management, infrastructure development, and community risk reduction in line with EU water directives. Full article

Background: Epidemiological research has shown that regular walnut (from Juglans regia L.) consumption is associated with a reduced risk of cardiovascular disease (CVD), potentially attributable to their antioxidant and anti-inflammatory properties. The vascular cellular adhesion molecule-1 (VCAM-1), a protein upregulated in CVD, has been previously examined in relation to walnut consumption. However, the clinical findings regarding the effects of walnuts on endothelial function among middle-aged individuals susceptible to metabolic syndrome (MetS) remain inconclusive. Objective: This study examined the effects of daily walnut consumption over a four-week period on cardiometabolic parameters (lipid and glycemic profiles, as well as soluble VCAM-1 levels) and anthropometric measurements in middle-aged individuals with at least one altered MetS parameter and no medication. Methods: In a randomized controlled cross-over trial, 22 eligible Caucasian participants (48.81 ± 4.3 years) were selected and randomly assigned to receive either 45 g of walnuts per day or no walnuts within a controlled diet. There were two 28-day intervention periods, with a one-month washout period in between. Clinical and biochemical evaluations were conducted at the beginning and end of each intervention period. Results: A total of 20 participants completed the intervention and were analyzed, with walnuts being well tolerated. A significant decrease in waist circumference (p = 0.049) and a slight change in fasting blood glucose (p = 0.089) were noted following walnut intake. Conclusions: Short-term (4 weeks) dietary supplementation with walnuts resulted in a statistically significant reduction in waist circumference while not impacting the overall health status of participants. Longer-term studies are necessary to investigate the benefits of daily walnut consumption and its impact on the onset and development of MetS in this age group. Full article

Chitosan–hydroxyapatite (CS-HAp) biocomposites, combining the biocompatibility and bioactivity of chitosan with the osteoconductive properties of hydroxyapatite, are emerging as promising candidates for tissue engineering applications. These materials consistently exhibit excellent cytocompatibility, with cell viability rates greater than 95% in MTT and Neutral Red Uptake assays, and minimal cytotoxicity, as demonstrated by low levels of cell death in DAPI and Trypan blue staining. More importantly, CS-HAp biocomposites modulate the immune environment by enhancing the expression of anti-inflammatory cytokines (IL-10 and IL-4) and the pro-inflammatory cytokine TGF-β, while avoiding significant increases in TNF-α, IL-6, or NF-κB expression in fibroblast cells exposed to HAC and HACF scaffolds. In an in vivo dermatitis model, these biocomposites reduced mast cell counts and plasma histamine levels and significantly decreased pro-inflammatory cytokines (TNF-α, IL-1β, IL-6), JAK1/3, VEGF, and AnxA1 levels. Structurally, HACF scaffolds demonstrated larger average pore sizes (95 µm) compared to HAC scaffolds (74 µm), with porosities of 77.37 ± 2.4% and 65.26 ± 3.1%, respectively. These materials exhibited high swelling ability, equilibrium water content, and controlled degradation over a week in culture media. In addition to their immunomodulatory effects, CS-HAp composites promote essential cellular activities, such as attachment, proliferation, and differentiation, thereby supporting tissue integration and healing. Despite these promising findings, significant gaps remain in understanding the underlying mechanisms of immune modulation by CS-HAp biocomposites, and formulation-dependent variability raises concerns about reproducibility and clinical application. Therefore, a comprehensive review is essential to consolidate existing data, identify key knowledge gaps, and standardize the design of CS/HAp composites for broader clinical use, particularly in immunomodulatory and regenerative medicine contexts. Full article

Skin aging is a complex process influenced by several factors, including UV exposure, environmental stressors, and lifestyle choices. The demand for effective, natural skincare products has driven research into plant-based oils rich in bioactive compounds. Rosehip oil has garnered attention for its high content of carotenoids, phenolics, and antioxidants, which are known for their anti-aging, photoprotective, and skin-rejuvenating properties. Despite the growing interest in rosehip oil, limited studies have investigated its efficacy on human skin using advanced imaging technologies. This study aims to fill this gap by evaluating the efficacy of cold-pressed Rosa canina seed oil on facial skin characteristics, specifically wrinkles, ultraviolet (UV) spot reduction, and erythema mitigation, using imaging technologies (the VISIA analysis system). Seed oil pressed from R. canina collected from the Băișoara area of Cluj County has been selected for this study due to its high carotenoid, phenolic, and antioxidant contents. The oil has also been analyzed for the content of individual carotenoids (i.e., lutein, lycopene, β Carotene, and zeaxanthin) using HPLC-DAD (High-Performance Liquid Chromatography—Diode Array Detector), along with lutein and zeaxanthin esters and diesters. After the preliminary screening of multiple Rosa species for carotenoid, phenolic, and antioxidant contents, the R. canina sample with the highest therapeutic potential was selected. A cohort of 27 volunteers (aged 30–65) underwent a five-week treatment protocol, wherein three drops of the selected rosehip oil were topically applied to the face daily. The VISIA imaging was conducted before and after the treatment to evaluate changes in skin parameters, including the wrinkle depth, UV-induced spots, porphyrins, and texture. Regarding the bioactivities, rosehip oil showed a significant total carotenoids content (28.398 μg/mL), with the highest levels in the case of the β-carotene (4.49 μg/mL), lutein (4.33 μg/mL), and zexanthin (10.88 μg/mL) contents. Results indicated a significant reduction in mean wrinkle scores across several age groups, with notable improvements in individuals with deeper baseline wrinkles. UV spots also showed visible declines, suggesting ideal photoprotective and anti-pigmentary effects attributable to the oil’s high vitamin A and carotenoid content. Porphyrin levels, often correlated with bacterial activity, decreased in most subjects, hinting at an additional antimicrobial or microbiome-modulatory property. However, skin responses varied, possibly due to individual differences in skin sensitivity, environmental factors, or compliance with sun protection. Overall, the topical application of R. canina oil appeared to improve the facial skin quality, reduce the appearance of age-related markers, and support skin health. These findings reinforce the potential use of rosehip oil in anti-aging skincare formulations. Further long-term, large-scale studies are warranted to refine dosing regimens, investigate mechanisms of action, and explore synergistic effects with other bioactive compounds. Full article

Glomerular diseases are a major cause of chronic kidney disease worldwide, yet epidemiological data from Eastern Europe, and Romania in particular, remain scarce. This study aimed to characterize the spectrum of biopsy-proven glomerulopathies in Romania through a multicenter national registry over a 10-year period. We retrospectively analyzed 4047 native kidney biopsies performed between 2014 and 2023 across four national nephrology reference centers. Patient demographics, clinical presentation, and histopathological diagnoses were collected and categorized into primary and secondary glomerular diseases, glomerulosclerosis, tubulointerstitial nephropathies, hereditary nephropathies, and vascular nephropathies. The mean patient age was 48 years, 54.8% were male, and 51.4% presented with nephrotic-range proteinuria. The most common primary glomerulopathies were membranous nephropathy (16.7%), immunoglobulin A nephropathy (15.6%), focal segmental glomerulosclerosis (8.8%), and membranoproliferative glomerulonephritis (10%). Among secondary glomerular diseases, lupus nephritis (9.3%), diabetic nephropathy (8.5%), and vasculitis (7.7%) were most frequent. Marked inter-center variability was observed, with a notably high prevalence of membranous nephropathy in Iași (31.1%). Over the study period, the incidence of focal segmental glomerulosclerosis increased while immunoglobulin A nephropathy declined. This study provides the first nationwide epidemiological assessment of biopsy-proven glomerular disease in Romania, revealing both similarities and distinctive differences compared to patterns reported in other European countries. Full article

Background/Objectives: Mesenchymal tumors of the gastrointestinal tract are rare and can pose significant diagnostic challenges, particularly when located in atypical sites such as the sigmoid colon. Gastrointestinal stromal tumors (GISTs) are often the primary consideration based on imaging findings; however, other spindle cell neoplasms, such as schwannomas, must also be considered. We present a case of a sigmoid colon schwannoma initially suspected to be a GIST and provide a literature review on the diagnostic and therapeutic challenges associated with these tumors. Methods: A literature review based on articles from 2015 to 2024 was conducted to identify cases of mesenchymal tumors of the colon misdiagnosed as GISTs. The review focused on the role of imaging, endoscopic biopsy, and immunohistochemistry in differentiating these neoplasms. Additionally, treatment approaches, including surgical resection versus targeted therapy, were assessed. Results: The literature review revealed that GISTs and schwannomas share overlapping imaging characteristics, including submucosal location, hyperintensity on T2-weighted MRI, and contrast enhancement. However, immunohistochemical markers remain the gold standard for differentiation. Studies also highlighted the increasing role of minimally invasive diagnostic techniques, such as fine-needle aspiration and molecular profiling, in achieving a definitive preoperative diagnosis. Unlike GISTs, which often require adjuvant therapy with tyrosine kinase inhibitors, schwannomas are typically treated with surgical excision alone, with a low risk of recurrence. Conclusions: Current evidence supports a multimodal diagnostic approach combining imaging, biopsy, and immunohistochemistry to accurately classify mesenchymal tumors of the colon. While imaging can suggest a probable diagnosis, histopathological confirmation is essential before initiating targeted therapy. Full article

With the advancement of interventional coronary procedures, drug-coated balloons have become an increasingly common alternative to drug-eluting stents in the treatment of various lesions. This paradigm shift stems from several advantages that DCBs entail, including a reduction in stent length burden, the possibility of late vessel positive remodeling, and the preservation of bifurcation anatomy. Conversely, several studies compared the efficacy of DCB treatment to stents or POBA in various scenarios. In this review, we will discuss the areas in which a DCB can be of paramount importance. We will begin by examining the role of DCBs in in-stent restenosis, for which the current practice guidelines do not clearly state the role of this technology, as opposed to the previous ones, in which it was mentioned as a first-line armamentarium. We will then discuss the indications and advantages of using DCBs in de novo lesions, concerning both small and large vessels, with growing emphasis on diffuse lesions. Lastly, we will address the current data on the use of DCBs in special scenarios such as the treatment of chronic total occlusion and left main and bifurcation lesions, without forgetting the primordial role of drug-eluting stents in all these lesions. Full article