Dental caries remains one of the most common oral diseases, with a multifactorial etiology involving biological, behavioral, socioeconomic, and age-related factors. In elderly patients, physiological changes, systemic diseases, polypharmacy, reduced salivary flow, and gingival recession increase susceptibility to root caries. The aim of this study was to evaluate the prevalence of coronal and root caries across different age groups and to identify the etiological factors involved in root caries by comparing caries experience and individual cariogenic risk in adult and geriatric patients. Materials and methods: The study included 293 patients examined at the Clinical Teaching Base of the Faculty of Dental Medicine Iasi between 2022 and 2026. Clinical assessment included the evaluation of coronal and root caries, gingival recession, and DMFT index. Results: Socio-economic factors, systemic diseases, and medication were recorded using a standardized questionnaire. Cariogenic risk was assessed by determining salivary levels of Streptococcus mutans and Lactobacilli, resting and stimulated salivary flow, salivary buffer capacity, and caries susceptibility using the modified Snyder test. Statistical analysis was performed using Chi-square and Kruskal-Wallis tests, with the significance level set at p < 0.05. Coronal caries showed the highest prevalence in the 71-80-year age group, followed by the 51-60-years group. Root caries was also most frequent in the 71-80-years group, followed by patients over 80 years. DMFT values increased with age, mainly due to the "M" component, reflecting cumulative tooth loss. Systemic diseases, xerostomia-inducing medication, gingival recession, reduced salivary parameters, and increased microbial load were associated with higher cariogenic risk. Conclusions: Root caries in elderly patients has a multifactorial etiology, influenced by age-related oral changes, systemic conditions, medication, salivary dysfunction, gingival recession, and cariogenic microorganisms. These findings support the need for individualized preventive and therapeutic strategies in geriatric dental care.
Embryonic chromosomal abnormalities represent a major cause of implantation failure and poor reproductive outcomes in assisted reproductive technologies (ART), particularly in couples of advanced reproductive age. Preimplantation genetic testing for aneuploidy (PGT-A) has been increasingly applied to improve embryo selection; however, clinical outcomes remain influenced by multiple maternal and paternal factors. Materials and methods: This preliminary retrospective study included 31 couples undergoing In Vitro Fertilization-Intracytoplasmic Sperm Injection (IVF-ICSI) with PGT-A. A total of 104 blastocyst-stage embryos were biopsied and analyzed using comprehensive chromosome screening. Maternal and paternal age, serum anti-M & uuml;llerian hormone (AMH) levels, spermogram diagnosis, embryo ploidy status, embryo transfer, clinical pregnancy, and live birth outcomes were assessed descriptively. Results: The mean maternal age was 38.36 years and the mean paternal age was 41.67 years, while the mean serum AMH level was 1.82 ng/mL. Among the 104 embryos analyzed, 50 (48.1%) were euploid and 54 (51.9%) were non-euploid, including aneuploid, mosaic, degenerated, or inconclusive embryos. Male factor infertility, predominantly moderate to severe teratozoospermia, was frequently observed. Nineteen euploid embryos were transferred, resulting in seven confirmed clinical pregnancies and one live birth. Binary logistic regression revealed that both maternal age (p=0.006) and paternal age (p=0.047) were significant predictors of embryo euploidy. Conclusions: This study demonstrates that while a categorical age cutoff at 38 may mask biological trends, using both maternal and paternal age as continuous variables can significantly predict embryo aneuploidy. While PGT-A facilitates the selection of chromosomally normal embryos, reproductive outcomes remain dependent on a complex interplay of maternal age, ovarian reserve, and male factor infertility. Larger prospective studies are required to further clarify the clinical utility of PGT-A in routine IVF practice.
AN EXPLORATORY PSYCHOLOGICAL ANALYSIS (Abstract). Financial well-being is a multidimensional construct that reflects perceived financial control and security. While it is not directly measured in this study, money attitudes represent an important cognitiveaffective component associated with financial well-being. Materials and methods: This cross-sectional study examined the relationship between personality traits and money attitude dimensions among 172 schoolteachers from northeastern Romania. The Big Five (c) plusshort and the Money Attitude Scale (MAS) were applied to assess personality traits and the dimensions of power-prestige, retention-time, distrust and anxiety toward money. Results: showed that emotional stability was negatively associated with financial anxiety and distrust, while gender and emotional stability influenced the perception of money as power-prestige. Extraversion, conscientiousness and openness predicted retention-time attitudes. Although the observed correlations were of low intensity, they align with previous research indicating subtle but consistent personality influences on financial cognition. Conclusions: These findings suggest that personality traits may shape teachers' money attitudes, with potential relevance for psychological screening and financial awareness programs in educational settings.
Aim: Asthma is a chronic airway inflammatory disease with significant social and economic impacts, being associated with a high annual rate of premature deaths. Asthma severity and response to inhaled corticosteroids therapy can be assessed by spirometry parameters and fractional exhaled nitric oxide (FeNO) evaluation. The aim of this study was to evaluate the relationship between spirometry parameters and FeNO values in a group of asthmatic patients. Materials and methods: We performed a retrospective analysis on 124 patients with history of asthma of different degrees of severity. All patients have been classified according to the last Global Initiative for Asthma (GINA) criteria and had a complete spirometry and a FeNO measurement. Results: The analyzed cases showed a female predominance (62.9%) and a mean patient age of 50.6 +/- 16.0 years. A significant association between Forced Expiratory Volume in one second (FEV1) values (F = 231.167, p < 0.001) or FEV1/FCV ratio (F = 52.630, p < 0.001) and the degree of asthma control was observed in all patients, regardless of inhaled corticosteroids administration. An inverse correlation between FEV1 and FeNO values (r = -0.52, p < 0.01) was registered. Conclusions: Spirometry parameters and FeNO represent valuable tools in the management of asthma, with higher FeNO values being associated with impaired lung function.
The aim of this study was to characterize the nanoscale surface topography of a three-dimensional porcine collagen matrix under hydrated conditions, simulating a physiologically relevant environment. Materials and methods: Atomic force microscopy (AFM) was performed in hydrated conditions to evaluate surface topography, deflection signal, three-dimensional reconstruction, surface profile, and quantitative roughness parameters. Results: The collagen matrix exhibited a continuous, moderately undulating surface without detectable structural defects. Topographic analysis revealed a homogeneous distribution of elevations and depressions, consistent with an isotropic collagen network. Deflection imaging enhanced the visualization of local slope variations, indicating microstructural heterogeneity. Three-dimensional reconstruction confirmed uniform spatial organization with gradual height transitions. Quantitative analysis demonstrated moderate roughness (Sa = 0.1179 & micro;m; Sq = 0.1765 & micro;m) and limited maximum height (Sz = 1.541 & micro;m), suggesting the absence of pronounced irregularities. Height distribution showed a centered dispersion around the mean plane. Conclusions: The hydrated collagen matrix presents a stable, continuous, and moderately rough surface morphology, which may support favorable biological interactions and its potential application in soft tissue and periodontal regeneration.
This study investigated the longitudinal dynamics of brain-derived neurotrophic factor (BDNF) and arachidonate 12-lipoxygenase (ALOX12) during antidepressant treatment in patients with major depression. Materials and methods: Twenty-six patients were assessed at baseline, 4 weeks, and 8 weeks. Depressive and anxiety symptoms were measured using HAM-D and HAM-A, and plasma BDNF and ALOX12 levels were quantified using ELISA. Results: HAM-D decreased from 31.0 to 23.0 and HAM-A from 28.0 to 18.0. BDNF increased from 0.87 to 5.33, while ALOX12 decreased from 1.39 to 0.22 (p<0.001), with the largest change between weeks 4 and 8; ALOX12 at 8 weeks correlated inversely with HAM-D (r = -0.416; adjusted r = -0.515). Conclusions: BDNF and ALOX12 showed distinct temporal patterns. BDNF increase and ALOX12 reduction occurred without significant associations between their changes.
Peripheral artery disease (PAD) progressing to chronic limb-threatening ischemia (CLTI) is associated with high morbidity and limb loss. Diabetes mellitus (DM) significantly influences disease distribution and clinical outcomes. The Bollinger score, GLASS classification, and WIfI staging are complementary tools for assessing anatomical burden and limb threat. This study aimed to analyze the relationships between these scoring systems in diabetic CLTI, with particular focus on infra-popliteal versus global anatomical evaluation. Materials and methods: This single-center retrospective study included 136 patients with CLTI undergoing endovascular revascularization between May 2021 and May 2023. Baseline characteristics, angiographic severity, WIfI stage, Bollinger scores (whole limb, above-and below-knee), GLASS staging (global, femoropopliteal and infra-popliteal), and outcomes (technical success, bypass conversion, major amputation, and one-year mortality) were analyzed. Results: Patients were divided into diabetic (DM, n=85) and non-diabetic (NDM, n=51) groups. Diabetic patients more frequently presented with infra-inguinal stenoses >50% (55.3% vs. 35.3%, p=0.024) but fewer complete occlusions (83.5% vs. 96.1%, p=0.028). WIfI stage 1 was more common in the DM group (54.1% vs. 33.3%, p approximate to 0.08). Bollinger scores were lower in diabetics for the whole limb (30.07 +/- 16.34 vs. 36.78 +/- 16.09, p=0.018) and below-knee segment (20.53 +/- 15.88 vs. 26.86 +/- 13.93, p=0.015). Conclusions: Diabetic CLTI is characterized by a distal angiographic pattern with predominant infra-popliteal stenoses and lower additive Bollinger scores. Segmental infra-popliteal assessment showed stronger clinical relevance than global evaluation, with below-knee Bollinger and GLASS infra-popliteal stages most closely associated with WIfI severity. These findings support a segment-focused approach in endovascular planning for diabetic patients.
This study aims to compare the quality of root canal obturation achieved using different obturation techniques and to evaluate the adaptation of the interface between epoxy resin- based sealants and gutta-percha to the dentin walls of the root canal. Materials and methods: Thirty-six extracted single-rooted human teeth were used, prepared according to a standardized protocol and filled with gutta-percha using different techniques (lateral condensation and vertical hot condensation), to evaluate, through radiological analysis (retro-dento-alveolar radiography) and optical microscopy, the following aspects: the quality and homogeneity of the root fillings, the adhesion of the sealer to the dentin root walls, and the apical and coronal seal of the endodontic filling. The data were statistically analyzed to identify differences between techniques (p < 0.05), using the F-test and ANOVA. Results: Radiographic analysis revealed significant differences in the homogeneity of the filling and the presence of voids between techniques, with vertical hot condensation yielding the best results, particularly in the apical third. Optical microscopy confirmed better adaptation of the sealants in the case of thermoplasticized gutta-percha techniques, while lateral condensation showed a higher incidence of marginal voids at the apical level. Conclusions: The obturation technique significantly influences the quality of root canal obturation. Vertical hot condensation ensures homogeneity and optimal adaptation. Combined radiographic and optical microscopy evaluation provides a comprehensive method for assessing obturation results.
Psoriasis is a chronic immune-mediated skin condition that goes beyond the cutaneous symptoms, often affecting patients' mental health and social interactions. Psychiatric comorbidities like depression, anxiety, and sleep disorders are prevalent and can be worsened by stigma and discrimination. The psychology of psoriasis is discussed in this article based on a 2023 study that used a questionnaire to investigate discrimination, treatment expectations, sleep, and perceived psychosocial effects of psoriasis. Materials and methods: A questionnaire of 101 questions was given to psoriasis patients via social media (n = 155). The responses were assessed descriptively and using multivariable regression. Correlations between discrimination, sleep disturbances, expectations, and side effects on family life, work, and relationships were the focus of the study. Results: Almost half of the participants (43.2%) had experienced discrimination or stigma. Discrimination was strongly related to self-reported negative effects on family life (52.3%), work performance (49.0%), and interpersonal relationships (54.2%), with a moderate effect size (chi (2) = 32.26, p < 0.001). Sleep issues were less frequently reported (6.5%) and were not strongly related to discrimination. Conclusions: Psoriasis is inextricably linked with mental health, not just a cause of biological inflammation but also social stressors such as stigmatization. The results identify the fact that discrimination plays an underlying part in reducing quality of life, and problems with sleep may be less centrally involved. An integrated medical, psychological, and social treatment approach is needed for overall treatment.
Craniopharyngiomas (CPs) are rare benign epithelial tumors of the sellar-suprasellar region that remain surgically challenging. Aim: To evaluate the clinical, imaging, pathological and surgical aspects of CPs diagnosed in adult patients as such previous analyses are rare. Materials and methods: We performed a retrospective study that included adult patients (>= 18 years) with surgical treated and pathologically confirmed CP between January 2016 and December 2021. Eligible cases were analyzed regarding demographic data, clinical presentation, and surgical approach. Results: Eleven adult patients were included (mean age 46.6 +/- 12.6 years), with a slight female predominance (54.5%). Two peaks in patients' age were noted: one in the fifth decade of life (40-to 49-year-olds) and another in the seventh decade of life (60-to 69-year-olds). Visual disturbances were the most frequent presenting symptom (81.8%), but headache (54.5%), endocrine disfunctions (36.36%), and neurocognitive symptoms (27.3%) were also identified. Open craniotomy was performed in 72.7% of cases, while extended endoscopic endonasal approach was realized in the rest of the cases. Subtotal resection was achieved in 63.6% of all cases. Conclusions: The findings of our study align with published data, while highlighting specific diagnostic peculiarities in Romanian adult patients with craniopharyngiomas.
Systemic inflammatory indicators obtained from standard blood tests have garnered heightened interest as prospective diagnostic and prognostic instruments in oncological urology. Materials and methods: This study assessed the diagnostic efficacy of complete blood count-derived inflammatory indices and C-reactive protein (CRP) in individuals with penile cancer. A total of 38 individuals with penile cancer were compared to 38 control participants receiving surgery for benign scrotal conditions. Results: Notable disparities were identified between the two groups for baseline characteristics. Patients with penile cancer were much older and had reduced blood hemoglobin levels and elevated serum creatinine values in comparison to controls. All assessed inflammatory markers were markedly enhanced in the cancer cohort, suggesting an increased systemic inflammatory load. Mean CRP levels were significantly elevated in patients with malignancy, accompanied by markedly higher neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI). An examination of the ROC curves for inflammatory markers revealed statistically significant differences between groups. The NLR exhibited strong discriminating capacity for penile cancer, with an area under the curve (AUC) of 0.829. CRP had significant diagnostic efficacy (AUC 0.700). Conversely, composite indices such as SIRI and AISI showed relatively little discriminatory ability, with AUC values of 0.694 and 0.697, respectively. Conclusions: Individuals with penile cancer exhibit markedly increased systemic inflammatory markers in comparison to controls. Among the assessed indices, NLR and CRP demonstrated the greatest diagnostic efficacy, whereas more complex composite indices provided minimal additional differentiation.
Sellar and parasellar meningiomas (spMs) represent a rare but clinically challenging subgroup of intracranial tumors due to their proximity to critical neurovascular and endocrine structures. This study aimed to provide a comprehensive clinicopathological and statistical evaluation of spMs, with particular emphasis on biological markers associated with tumor aggressiveness. Materials and methods: We retrospectively analyzed 15 patients with histologically confirmed spMs treated surgically at Prof. Dr. N. Oblu Emergency Clinical Hospital, Iasi, between 2021 and 2025. Demographical, clinical, radiological, surgical, and immunohistochemical data [Ki-67 labeling index (Ki67 LI), progesterone receptor (PR), and p53 expression] were evaluated. Statistical analysis included comparative tests and logistic regression modeling for predictors of WHO grade. Results: The cohort showed a marked female predominance (80%), with a mean age of 60.3 +/- 13.2 years. Most tumors originated in the sellar region (66.7%). Gross total resection was achieved in 66.7% of cases. Histopathologically, WHO grade 1 spMs predominated (73.3%), while grade 2 spMs accounted for 26.7%. Ki-67 LI values were significantly higher in grade 2 tumors (12.0 +/- 2.2 vs. 3.4 +/- 1.3; p=0.003), whereas PR expression was significantly reduced (42.5 +/- 18.9 vs. 81.4 +/- 14.8; p=0.010). Logistic regression identified Ki-67 LI (OR=1.85) as an independent risk factor and PR (OR=0.92) as a protective factor for higher tumor grade. Conclusions: These findings highlight the central role of tumor biology in sellar and parasellar meningiomas. Ki-67 LI and PR expression represent complementary and clinically relevant biomarkers that improve risk stratification and may guide surgical and postoperative management
Along with total neoadjuvant therapy (TNT), surgical resection is the cornerstone of rectal cancer treatment. Minimally invasive techniques include: laparoscopic, robotic, transanal total mesorectal excision and transluminal local excision. In this study, we evaluated the feasibil-ity and outcomes of laparoscopic surgery for rectal cancer in a single-center cohort. Materi-als and methods: We conducted a retrospective analysis of consecutive patients, who un-derwent surgical treatment for primary rectal cancer at a tertiary institution. A total of 99 pa-tients were included and divided in two groups: laparoscopic (66 patients) and open (33 pa-tients). Clinical and perioperative variables analyzed included age, sex, body mass index, comorbidities, tumor location, surgical technique, length of hospital stay, and postoperative complications. Results: The mean age was 68.9 years. Laparoscopy was performed in 66.7% of the patients (conversion to open resection-15.1%) and was applicable across all age groups. Approximately half of the cases were cancers of the upper rectum. Patients under-went low anterior resection in 61.61%, 24.24% underwent abdominoperineal resection, 14.14% underwent resection with colostomy, and all cases were elective. The median length of hospital stay was 10 days in the laparoscopic group and 11 days in the open surgery group; however, no significant differences were observed between the two groups (p=0.287). According to the Clavien-Dindo classification, for the laparoscopic group, the complications were distributed as grade I (n = 12), grade II (n = 5), and grade III (n = 4); for the open group, grade I (n = 5). Anastomotic leakage (AL) was present in <10 % of cases. Conclu-sions: Rectal cancer is a complex disease that presents oncological, anatomical and func-tional challenges, which are addressed using a variety of surgical modalities. Our study demonstrates that the laparoscopic approach in rectal cancer is feasible regardless of age and tumor location, and showed a trend toward shorter hospital stay, the difference was not sta-tistically significant.
Highly effective cystic fibrosis transmembrane conductance regulator (CFTR) modulators have substantially changed the course of pediatric cystic fibrosis (CF) by improving CFTR function, respiratory outcomes, and nutritional status. The extent to which modulator therapy reverses severe exocrine pancreatic insufficiency and chronic low-grade intestinal inflammation in children remains incompletely defined. Aim: To characterize the multidimensional impact of CFTR modulator therapy on CFTR function, respiratory morbidity, nutritional status, exocrine pancreatic function, and intestinal inflammation in a real-world pediatric CF cohort. Materials and methods: In this prospective, single-center observational study (April 2024-January 2026), we included children aged 1-17 years with confirmed CF. The main treatment cohort comprised 32 genetically eligible children who initiated and maintained CFTR modulator therapy (ETI) for at least 12 months. Sweat chloride, anthropometric z scores, respiratory microbiology, liver function, and vitamin D status were assessed at predefined timepoints. In a digestive sub cohort of 31 treated children, fecal elastase, fecal calprotectin, and fecal neutrophil gelatinase-associated lipocalin (NGAL) were measured according to treatment duration and compared with values in 22 age matched healthy controls without digestive disease. Respiratory morbidity was evaluated from the frequency of infectious pulmonary exacerbations, airway microbiology, and lung function; spirometry was performed in children aged >= 6 years and ventilatory impairment was categorized as normal, mild, moderate, or severe. Results: After 12 months of CFTR modulator therapy, mean sweat chloride decreased from 114.1 to 78.3 mmol/L, indicating a marked improvement in CFTR function at cohort level. Weight for age and body mass index (BMI) z scores improved significantly, whereas height for age z scores remained essentially unchanged, consistent with a predominantly weight-driven short-term nutritional recovery. The mean annual rate of infectious pulmonary exacerbations declined from 4.72 at baseline to 0.41 at 6 months, reflecting a rapid and sustained reduction in respiratory morbidity. Diagnosis before 6 months of age was associated with a higher risk of severe exocrine pancreatic insufficiency and vitamin D deficiency, delineating an early onset, severe digestive phenotype. Conclusions: In children with CF, CFTR modulator therapy confers major clinical and biological benefits in terms of CFTR function, respiratory morbidity, and weight-related nutritional recovery. However, established severe exocrine pancreatic insufficiency and persistent low-grade intestinal inflammation appear only partially reversible, suggesting that the digestive phenotype of CF is less amenable to correction once structural damage has occurred. Incorporating fecal elastase and fecal inflammatory biomarkers into routine follow-up, alongside anthropometry, respiratory outcomes, and hepatic monitoring, may enhance multidimensional disease surveillance and more precisely guide long-term nutritional and hepatodigestive management in the era of highly effective CFTR modulators.
Aims: To evaluate the four types of resilience (physical, mental, emotional, and social) and their associations with functional capacity, physical performance, nutritional and cognitive status, muscle strength, and depressive symptoms in older adults. Materials and methods: This prospective study included 110 patients aged >= 50 years admitted to Dr. C.I. Parhon Clinical Hospital, Iasi, with acute conditions or acute exacerbations of chronic diseases who underwent comprehensive geriatric assessment and were evaluated with the Physical Resilience Scale. Data were analyzed using nonparametric tests, Spearman correlations, and univariate/multivariate generalized linear models; significance was set at p<0.05. Results: Median resilience was 10 (IQR 8-13). Resilience showed significant positive correlations with ADL (R=0.218), IADL (R=0.397), SPPB (R=0.458), MNA (R=0.377), MMSE (R=0.322), and upper-limb muscle strength (R approximate to 0.33). Negative correlations were observed with GDS (R=-0.676), Fried phenotype (R=-0.462), and fall risk (R=-0.331). Multivariable analysis identified IADL (IRR=1.032, p=0.043) and GDS (IRR=0.947, p<0.001) as independent predictors of resilience. Resilience did not differ according to heart failure, urinary tract infection, or osteoarticular disease, but was significantly lower in patients with reduced muscle strength. Conclusions: Resilience in older adults is a multidimensional construct closely associated with functional independence and mental health. IADL and depressive symptoms are independent determinants of resilience, underscoring the importance of maintaining autonomy and addressing depression. Multidomain interventions targeting these factors may enhance resilience and reduce vulnerability to adverse outcomes in aging populations. Longitudinal studies are warranted to clarify causal relationships and evaluate the efficacy of resilience-promoting strategies.
