Epidermolysis bullosa (EB) is a rare, serious genetic disease, incurable through the current means. Apart from this initial definition, there was later some ease in the definition of the disease, including the manifestations of toxic epidermal necrolysis and Stevens Johnson syndrome in this entity. In medical practice, there are cases that do not overlap with the description in the literature, thus the treatment must be adapted and personalized to the particularities. We present the case of a female new-born, with "de novo" mutation for the early-onset antenatal epidermolysis and our personalized therapeutic management, based on collagen from bovine corneas by enzymatic process. The histological examination showed that the collagen membranes serve as a support for the epithelial cells that formed a surface monolayer after 48 hours. Therefore. this case report shows that collagen-based biomaterials could be used to accelerate the dermal-epidermal healing in various conditions of the child, such as Stevens Johnson syndrome, bullous epidermolysis and widespread burns.

Antituberculotic treatment has the purpose to rapidly stop transmission and to prevent relapse, in order to further reduce the tuberculosis (TB) burden and development of resistant bacterial strains. Romania had the highest TB incidence among EU countries and since 2018, an active TB screening program has been introduced among vulnerable populations. The aim of this study was to identify all the patients diagnosed with TB in Dolj County, Romania, in 2018 and to evaluate their characteristics, as well as to estimate the amounts reimbursed by the National Health Insurance Fund, based on the data reported by the hospitals from Dolj, Romania. The treatment was analysed through descriptive statistics for hospitalized cases based on a principal diagnosis of TB which received continuous care in 2018. In Dolj County, 6378 people, with a mean age of 39 ± 30.42 years, were infected with Mycobacterium tuberculosis in 2018. More than a half were males (3,723 58%) and 2,655 42% were females. The prevalence of TB in Dolj County in 2018 was 1.01%. The treatment outcomes of TB patients were: 1,441 (22.6%) cured, 5,036 (78.9%) treatment completed, 25 (0.4%) died, 47 (0.7%) failed and 163 (2.6%) interrupted. The number of those with treatment failed and treatment interrupted represents an unfavourable treatment outcome and it was less than 210 patients (3.3%) in 2018, which is a very good indicator compared with the 85% World Health Organization (WHO) target of TB treatment success. In order to evaluate TB control strategies, it is essential to trace TB incidence, prevalence and mortality, but also to comprehend treatment outcomes.

Transmission of SARS-CoV-2 infection is done by: - Pflügge drops, produced by the infected person when he coughs or sneezes - through close contact with the infected person - non-hygiene of hands, by touching contaminated objects In the body, the virus attaches to the cells of the nasal mucosa, multiplying until it reaches the lungs, then spreading in the body According to some cases in China, plausible community transmission was more common from adult to child, or vice versa Age-related differences in nasopharyngeal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) levels in patients with mild to moderate coronavirus disease 2019 (COVID-19)

CONCLUSIONS COVID-19 infection, in addition to the actual polymorphic damage in children (respiratory, digestive, skin, cardiovascular damage - Kawasaki disease, etc ) has a side effect - mental damage, remains to be seen and determined later if the "ostracization" itself, causes behavioral disorders or even asymptomatic COVID-19 infection of the child includes manifestations in the clinical picture of the disease Early detection of any behavioral disorder determines the possibility of its rapid elimination, without risk of chronicity 6 Department of Cell and Molecular Biology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania REFERENCES 1 Han J W , Lee H Effects of parenting stress and controlling parenting attitudes on problem behaviors of preschool children: latent growth model analysis

Background and Objectives: Rheumatoid arthritis (RA) is a severe autoimmune disease characterized by chronic inflammation of the joints accompanied by the progressive deformation and destruction of cartilage and joint bones. This study aims to gain insight into the outcomes related to adherence in patients with rheumatoid arthritis. Predicting the medication adherence in RA patients is a key point to improve the treatment outcome. Materials and Methods: A number of 119 Romanian patients with RA were included and divided into two groups: first group included 79 patients treated with conventional therapy and second group included 40 patients treated with biologic therapy. A CQR-9 (compliance questionnaire rheumatology with nine items) and PDSQ (psychiatric diagnostic screening questionnaire) were performed to assess correlations between medication adherence, patient sociodemographic variables, 11 psychiatric scales (major depressive disorder, posttraumatic stress disorder, obsessive-compulsive disorder, panic disorder, psychosis, agoraphobia, social phobia, drug abuse/dependence, generalized anxiety disorder, somatization disorder, hypochondriasis) and lifestyle (bulimia, alcohol intake). Results: Whilst modelling factors associated with adherence, it was found that women and patients with higher education are more adherent. From the psychiatric indicators, only major depressive disorder and post-traumatic stress disorder were found to be positively correlated with therapeutic adherence. None of the assessed lifestyle factors influenced the adherence of RA patients. Conclusion: The knowledge of factors that impact on treatment adherence can be useful for clinicians to guide patient-centred care.

The pandemic has changed the way patients are hospitalized in accordance with the new rules of protection and isolation.The rules entered into force with the state of emergency, extended during the alert period provided for the isolation of the child in a ward,

Two novel 1,4-naphthoquinone derivatives containing salicylic acid and procaine moieties were synthesized and evaluated for their anticancer activity in vitro. The antiproliferative effect was assayed against MDA-MB-231 cells, a human breast adenocarcinoma cell line, using CellTiter-Glo® Luminescent Cell Viability Assay. Both compounds tested proved a growth inhibition effect on this cell line in a dose-dependent manner. Our results showed that the compound with procaine effectively reduces breast cancer MDA-MB-231 cells viability and proliferation at higher concentration while that with salicylic acid had an inhibitory effect at lower concentrations and might be tested as an anticancer agent.

In this study, we performed microscopic qualitative analyses of the oral epithelium cytological smears in potential early phase of diabetes and in type 1 and 2 diabetic patients versus a healthy control group. The cytological assessment of the oral changes was realized on superficial and profound smears, from jugal and ventral tongue mucosa and it was based on the comparison between three staining methods [Papanicolaou, APT (polychrome tannin blue)-Dragan and Hematoxylin-Eosin (HE)]. Cytological changes of oral cells population were correlated with the type, duration and complications of diabetes. Oral flora was also evaluated. Irrespective the staining used, we found a clear dividing line between the control group and the real diabetic patients. In all diabetes cases (independently of the type of smear, harvest site, clinical form of disorder and present complications), cells presented alterations both at the level of cytoplasm and nucleus. Dyschromasia, cytolysis, different degrees of fatty degenerescence, binucleated cells, hyperchromasia, nuclear enlargement with modified nuclear÷cytoplasmic ratio, were the most frequent findings. There were no discrepancies in the cellular aspects of type 1 or 2 diabetic patients' smears or between the control group and the potential prediabetic status patients. Findings were interpreted as oral epithelium reactive changes induced by the disease. We concluded that exfoliative cytology alone is of low value as a diagnostic and prognostic tool in the diagnosis of diabetes mellitus (DM); it detects the reactive changes induced by the disease, but it makes no differences between DM types or degree of severity and does not allow by qualitative analysis alone to detect abnormalities in early diabetes.

INTRODUCTION:Central nervous system (CNS) germ cell tumors are very rare, accounting for 0.3-3% of primary intracranial neoplasms; of these, the teratomas are even more uncommon. The immature variant of teratomas, defined by the presence of incompletely differentiated components resembling fetal tissues is considered as having a low, almost borderline malignancy state.CASE PRESENTATION:A 35-year-old male presented with a left fronto-basal tumor. At surgery, a grey white tumor, mostly solid, was excised. The histopathological examination revealed an infiltrating teratoma. The histological spectrum varied from epithelial and mesenchymal mature to immature tissues. These structures were intimately mixed with significant areas of primitive neuroepithelial tubules and÷or primitive neuroectodermal tissues. The diagnosis was that of an immature intracranial teratoma, with high histological grade WHO (World Health Organization) (Norris grade III). After surgical resection, a rapid infratentorial contralateral subarachnoid extension followed. The second tumor was largely formed by primitive neuroectodermal tumor (PNET)-like structures and rare mature epithelial tissues, meaning a PNET-like overgrowth or "malignant transformation" of an immature teratoma. After specific oncological treatment, the patient had a favorable evolution with no signs of relapse (2016).CONCLUSIONS:The present case highlights the value of the Norris grading system (mostly used in grading ovarian immature teratomas) in a very rare case of intracerebral immature teratoma with rapid subarachnoid extension caused by an unexpected secondary "malignant transformation".

Lung cancer is currently one of the major health problems, being considered one of the most common causes of death by cancer worldwide. That is why establishing as early as possible a diagnosis in order to start an appropriate therapy still a challenge. The studied group consisted of 64 patients who were investigated following the next algorithm: chest X-ray, bronchoscopy, guided bronchial brushing and/or bronchoalveolar lavage followed by cytological examination and if possible, endobronchial biopsy followed by histopathological examination. Patients were usually men, aged over 60 years coming from an urban area, smokers and with symptoms evoking the presence of neoplasia. Tumors presented as large tumoral masses, placed centrally and with obvious local spread, protruding or pushing intraluminally with subsequent bronchial stenosis, usually complicated with ulceration and bleeding, which proved to be, when histopathological examination was possible, firstly squamous carcinomas and then small cell carcinomas. The imagistic investigation in conjunction with the cytological evaluation can establish the diagnosis of malignancy of centrally located lung tumors in almost 80% of cases. The diagnosis can be improved by increasing the number of biopsy sampling and/or by the immunohistochemical marking of the cytological samples.

One of the most common problems encountered in a world characterized by demographic ageing is Alzheimer's disease (AD) with an estimated number of 35.6 million people affected in 2010 to 65.7 million in 2030. Under recognition and delayed diagnose create problems for people diagnosed with dementia, for their families and for entirely health system. Although there have been many breakthroughs and new insights into AD etiopathogeny in the last two decades, few steps have been made toward an accurate diagnosis but all steps point into one major direction namely "personalized medicine" that could represent a future perspective for AD patients. Starting with a more accurate diagnosis not of the clinical syndrome, but of underlying molecular defects, that may eventually lead to a personalized, more effective treatment.

UNLABELLED Pleural effusions are still representing a challenge in daily practice. MATERIALS AND METHODS This retrospective study on 221 patients with pleurisies hospitalized in our unit is focused on the contribution of different types of pleural fluid morphological evaluation in setting a correct etiological diagnosis. The algorithm of investigation included: gross aspects assessment on X-ray records and by direct observation of pleural liquid obtained by thoracentesis and microscopic assessment on cytology slides of pleural fluid and on histopathological samples obtained by pleural needle biopsies. RESULTS Mycobacterial etiology was the most frequent, with 72% of all cases, followed by tumoral etiology. Cytologic examination of pleural fluid was useful in establishing the final diagnosis in 66.1% of cases, histopathological assessment being imposed for the rest of cases. DISCUSSION Imagistic investigation offered appropriate information concerning the site and extention of pleural effusions and guided, in certain cases, the needle biopsy. Gross aspect of pleural fluid oriented quite well the suspicion diagnosis. The use of a set of cytological formulas was useful in filtering subsequently the suspicion diagnosis. Histopatholgical examination of pleural tissue samples established the final diagnosis in cases where etiology was still uncertain after laboratory and cytological examination and subtyped further the pathologic processes within each main category of etiology. CONCLUSIONS A correct diagnosis of pleural effusions could be achieved only by going through a precise algorithm of investigation where, besides thorough clinical examination and laboratory tests especially of pleural liquid, morphological assessment and in particular cytologic examination of pleural liquid and histopatological examination of pleural tissue samples are essential.

Pseudoxanthoma elasticum (PXE) is an autosomal recessive disorder of connective tissue, characterized by elastic fibers mineralization and fragmentation, and affects the skin, eyes, cardiovascular system, and gastrointestinal system. PXE is caused by mutations in the ABCC6 gene, located on chromosome 16p13.1. We investigated clinical and laboratory three patients with pseudoxanthoma elasticum. All the patients present on dermatological examination yellowish papules, located especially on the neck and axillary area. In case no. 2 the patient presents "cutis laxa" in the axillary area. In case no. 3 the patient presents hyperpigmented spot on right forearm and another maculo-pigmented oval spot located at the base of the left posterior hemithorax. In two cases, the ophthalmologic examination shows angioid streaks. The modifications of elastic fibers (thickened or fragmented) are present in all cases.

Hereditary spastic paraplegia (HSP) or Strümpell-Lorrain syndrome is a heterogeneous group of inherited disorders, with prevalence ranged from 4.3 to 9.6 cases per 100,000 population. A common feature of these disorders is the slowly progressive and often severe spasticity, noticeably especially in the low limbs. Conventionally, HSP is divided into two clinical groups, uncomplicated (pure spastic paraplegia) or complicated HSP depending on the presence of other neurological features in addition to spastic paraparesis. Inheritance may be autosomal dominant, autosomal recessive or rarely X-linked, but autosomal dominant inheritance is most commonly associated with pure forms of the disease, whereas autosomal recessive HSP shows greater phenotypic variability, including several well-defined syndromes. Genetic studies have revealed as many as 31 different chromosomal HSP loci. We investigated two subjects, brother and sister, who were diagnosed using the criteria for a diagnosis of HSP proposed by Fink (1996), as "definitely affected" with HSP. As some particularities, we noticed an iliopsoas pseudohypertrophy in male patient and a mild atrophy in female, maybe due to degeneration of anterior columns. Family history recorded the presence of same manifestations in relatives. The pedigree of patients revealed some anomalies that could be related with the pathology. Our findings supported the diagnosis of complicated form of HSP in both cases.

Photodynamic therapy (PDT) is increasingly being recognized as an attractive, alternative treatment modality for superficial cancer, being an emerging method for local destruction of tissue by generating toxic oxygen species using light absorbed by an administered or an endogenously generated photosensitizer (porphyrins, phthalocyanines, khellin, hypericin, riboflavin). A considerable number of PDT research over the past ten years has been devoted to the development of new sensitizers. The development of new photosensitizers for localization and treatment of tumors is a research area or current interest. The data show that, when properly used, PDT is an effective alternative treatment option in oncology. This paper will present a case study of actinic keratosis treated with aminolevulinic acid (ALA) and 5, 10, 15, 20 - tetra (4-sulfophenyl) porphyrin (TSPP) in a photodynamic therapy approach. The clinical data proved the efficacy and safety of the method and the new drug. From skin biopsies we have obtained lower absolute number of keratinocytes compared to control skin. The in vitro tests showed cells having lower viability, lower proliferation capacity, and high apoptosis/necrosis percentages; therefore after applying PDT we have obtained an active destruction of the cells

Keywords: photodynamic therapy (PDT), porphyrins, actinic keratosis, aminolevulinic acid, TSPP Abstract: Photodynamic therapy (PDT) is increasingly being recognized as an attractive, alternative treatment modality for superficial cancer, being an emerging method for local destruction of tissue by generating toxic oxygen species using light absorbed by an administered or an endogenously generated photosensitizer (porphyrins, phthalocyanines, khellin, hypericin, riboflavin). A considerable number of PDT research over the past ten years has been devoted to the development of new sensitizers. The development of new photosensitizers for localization and treatment of tumors is a research area or current interest. The data show that, when properly used, PDT is an effective alternative treatment option in oncology. This paper will present a case study of actinic keratosis treated with aminolevulinic acid (ALA) and 5, 10, 15, 20 - tetra (4-sulfophenyl) porphyrin (TSPP) in a photodynamic therapy approach. The clinical data proved the efficacy and safety of the method and the new drug. From skin biopsies we have obtained lower absolute number of keratinocytes compared to control skin. The in vitro tests showed cells having lower viability, lower proliferation capacity, and high apoptosis/necrosis percentages; therefore after applying PDT we have obtained an active destruction of the cells.

Endocervical lesions may be revealed by the identifying of atypical glandular cells (AGCs), limited by the involvement of the lining columnar epithelium of the cervical canal. The aim of this study was to perform a retrospective and prospective investigation of the AGCs observed on conventional cervical smears, stained with Papanicolaou staining, with subsequent histopathological diagnosis obtained on cervical biopsies and their correlations with immunohistochemical aspect of HPV high-risk type L1 major capsid proteins. We retrieved 87 cases of conventional cervical smears from our files, with AGC suspicions and correlated with their paraffin-embedded and routinely stained cervical biopsies, endocervical and endometrial curettages, during a 3 years follow-up period. Immunohistochemical staining, using high risk antibody VAHP, was performed in a standardized protocol. Biopsy findings of cervical smears were as follows: 62.06 % miscellaneous benign lesions, 22.98 % malignancies: cervical adenocarcinoma in situ; n= 6, cervical adenocarcinoma; n= 10, and cervical adenosquamous carcinomas; n= 4, and 14.94 % squamous intraepithelial lesion: LGSIL; n= 8 and HG- SIL; n= 5. HPV high-risk type L1 major capsid proteins were identified in 47% of AGC cases associated with adenosquamous carcinomas (2) and SILs (4 LSILs and 2 HSILs). In conclusion, biopsy follow-up of conventional cervical smears with diagnose suspicion of AGCs revealed in situ and invasive malignant glandular lesions, and squamous cervical intraepithelial lesions in 37.93 % of investigated cases were malignant type and precursors lesions. HPV infection could be incriminated in 47% of cases diagnosed with AGCs which were associated with low grade and high grade squamous intraepithelial lesions (LSILs and HSILs) and adenosquamous carcinomas, according to HPV high-risk type L1 capsid proteins immunohistochemical positivity of squamous epithelial cells.

Charcot-Marie-Tooth (CMT) disease is a group of genetic peripheral neuropathies that is associated with a broad variety of clinical genetic features. Most CMT syndromes are characterized by a progressive muscle weakness and atrophy with a distally pronounced sensory dysfunction. Bone deformities as pes cavus or hammertoes are frequent. The severity of disability varies considerably between different subclasses. Physical examination, electrophysiological testing and family history are current methods to investigate a patient affected by CMT. We used these methods for clinical assessment of two cases. Whenever available molecular genetic testing establishes the certain diagnosis and defines the type of CMT.