Abstract Vitamin deficiencies are a common problem worldwide, and vitamin B12 deficiency has been identified as a health concern for nearly a century. People all over the world are frequently deficient in vitamin B12. A number of 30–50% of patients with cobalamin deficiency a kind of neurological involvement, for example neuropathy, myelopathy, dementia or optic neuropathy. We present the case of a 56 years old female patient, who suddenly developed gait difficulty due to motor deficit in the lower limbs. After hospitalization in the neurology ward and specialized investigations, thoracic myelitis and axonal sensorimotor polyneuropathy due to vitamin B12 deficiency are diagnosed. The patient underwent functional evaluation at Techirghiol Rehabilitation Sanatorium, where she received individualized treatment for her motor deficit. Despite longstanding recognition of vitamin B12 deficiency, accurately diagnosing the condition and determining the most appropriate management strategy remain challenging.
Abstract Cervical carcinoma remains a critical public health issue, especially in developing regions despite advances in HPV vaccination and screening programs. This study evaluates the prognostic significance of Ki-67 and p53 immunohistochemical markers in cervical carcinoma and explores their correlation with FIGO stage, histological grade, and lymphovascular space invasion (LVSI). Fifty cases of cervical carcinoma were analyzed retrospectively using WHO 2020 classification and FIGO 2018 staging. The expression patterns of both Ki-67 and p53 were assessed for all cases and significant associations were found between high Ki-67 index and older age, poor differentiated tumors and LVSI. Similarly, mutated p53 patterns correlated strongly with advanced clinical stage, poor differentiation andlympho-vascular positivity. The presence of a high proliferation rate of expression of Ki-67 alongside a mutated pattern or p53 immunostaining indicated a synergistic molecular phenotype linked with aggressive disease biology. These findings support the integration of Ki-67 and p53 biomarkers into diagnostic workflows and highlight their potential role for guiding personalized treatment strategies. Future large-scale studies with follow-up data are needed to substantiate their utility as routine prognostic biomarkers.
Abstract HIV infection is associated with an increased risk for the development of hematological malignancies, especially non-Hodgkin lymphoma (NHL), which continues to present aggressive forms despite therapeutic advances. We present the case of a 49-year-old patient, originally from Ukraine, diagnosed in January 2023 with HIV infection stage A3 according to the Centers for Disease Control and Prevention (CDC) classification. Clinical, paraclinical and histopathological data were retrospectively analyzed to highlight evolutionary and therapeutic peculiarities. Although the patient promptly initiated antiretroviral therapy (ART), the oncological risk associated with persistent immunosuppression remains significant, according to data in the literature. Eleven months after the diagnosis of HIV infection, he developed systemic symptoms, and investigations confirmed the presence of an aggressive NHL, an entity described as being among the most common HIV-associated malignancies. Despite the rapid institution of specific treatment, the evolution was fulminant, with progressive deterioration and death, a scenario also documented in other cases of aggressive NHL associated with immunosuppression. This case reflects the severe evolutionary potential of NHL in HIV patients, even in early stages of infection. Early identification of symptoms, prompt evaluation and multidisciplinary management are crucial to improve prognosis, according to international recommendations.
Abstract Introduction: With multiple indications in both cardiovascular and non-cardiovascular diseases, beta-blockers exert complex effects on the cardiovascular system and energy metabolism, potentially impacting functional performance in medical rehabilitation programs. While their efficacy in controlling cardiac function is well-documented, the literature reports inconsistent results regarding the effects of this drug class on metabolic parameters and exercise tolerance. In the context of medical rehabilitation, these aspects justify the evaluation of the potential impact of beta-blockers on functional response. Materials and Methods: The study had a prospective design and included 320 patients hospitalized between January and December 2025 at the Techirghiol Balneary and Rehabilitation Sanatorium. The antihypertensive medication used was analyzed, with patients grouped based on the administration of beta-blockers or other classes of antihypertensive drugs. Clinical observations regarding exercise tolerance were noted according to the timing of beta-blocker medication administration. Body Mass Index (BMI) was calculated to compare the weight status between groups. Functional evaluation was performed at the beginning and at the end of the rehabilitation program using the Visual Analog Scale (VAS) and the Six-Minute Walk Test (6MWT). Results: Of the included patients, 179 were under treatment with beta-blockers, with metoprolol being the predominantly used active substance. In this group, 72% had BMI values above 25 kg/m², with a gender distribution of 59.7% females and 40.3% males. Comparative analysis revealed higher average BMI values in women treated with beta-blockers compared to those receiving other classes of antihypertensive drugs. Dynamic evaluation indicated a more limited functional improvement in the group of patients treated with beta-blockers. Conclusion: Differences were observed between patients treated with beta-blockers and those treated with other classes of antihypertensive drugs regarding metabolic and functional parameters. These findings highlight the importance of considering antihypertensive therapy and monitoring exercise tolerance in the context of medical rehabilitation programs.
Abstract The recognition of human papillomavirus (HPV) as the main cause for cervical cancer transformed prevention and management, leading to widespread HPV vaccination and a change from Pap smear to HPV-based screening. Therapeutic progress includes advances in image-guided radiotherapy, concurrent chemoradiation, and the integration of targeted biologic agents such as anti-angiogenics and immune checkpoint inhibitors. Emerging technologies, including digital pathology, artificial intelligence–assisted diagnostics, and immunohistochemistry-based profiling, are improving accuracy and enabling personalized treatment. New immunotherapeutic approaches, including tumor-infiltrating lymphocyte therapy, offer new options for advanced or recurrent disease. Despite these advances, global disparities persist in access to vaccination, early detection, and comprehensive care. Achieving the World Health Organization’s elimination targets will require coordinated efforts to expand preventive strategies and ensure timely, equitable treatment.
