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Lawrence Chukwudi Nwabudike,1 Ana Maria Oproiu,2,3 Ioana Mihaela Dogaru,2,3,* Mariana Costache,3,4,* Alin Laurentiu Tatu5– 7 1Outpatient Dermatology, N. Paulescu National Institute of Bucharest, Bucharest, Romania; 2Department of Plastic Surgery, Emergency University Hospital, Bucharest, Romania; 3Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; 4Department of Pathology, Emergency University Hospital, Bucharest, Romania; 5Clinical Medicine Department, Faculty of Medicine and Pharmacy, Dunarea de Jos University of Galati, Galati, Romania; 6Dermatology Department, St Parascheva Clinical Hospital of Infectious Diseases, Galati, Romania; 7Multidisciplinary Integrated Center for Dermatologic Interface Research (MIC-DIR), Galati, Romania*These authors contributed equally to this workCorrespondence: Lawrence Chukwudi Nwabudike, N. Paulescu Institute of Bucharest, 5-7 Ion Movila Street, Sector 2, Bucharest, Romania, Email Chukwudi.nwabudike@live.com Ana Maria Oproiu, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Email anamariaoproiu@gmail.comAbstract: Spontaneous regression of malignant melanoma was first reported over a century ago. Clinically, areas of blue or grey colouration in lesions may be indicative of regression. Dermoscopy is a very useful tool for diagnosing regression. An important criterion is the blue-white scar. About 10– 35% of excised melanomas show features of regression histopathologically. We present a case of regressing melanoma, with clinical and dermoscopic features suggesting a collision tumour, diagnosed histopathologically. This case might improve our knowledge of the potential clinical manifestations, and the biology, of regressing melanoma.Keywords: regressing melanoma, collision lesion, blue-white scar, pepper-like granules, milia-like cysts, pseudofollicular openings

Lawrence Chukwudi Nwabudike,1,* Ana Maria Oproiu,2,3,* Ioana Mihaela Dogaru,2,3,* Mariana Costache,2,4,* Cristian Onisor,5 Alin Laurentiu Tatu5– 7 1N. Paulescu National Institute of Diabetes, Bucharest, Romania; 2Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; 3Department of Plastic Surgery, Emergency University Hospital, Bucharest, Romania; 4Department of Pathology, Emergency University Hospital, Bucharest, Romania; 5Clinical Medical Department, Faculty of Medicine and Pharmacy, Dunarea de Jos University of Galati, Galati, 800008, Romania; 6Dermatology Department, ’Sf. Cuvioasa Parascheva’ Clinical Hospital of Infectious Diseases, Galati, Romania; 7Multidisciplinary Integrative Center for Dermatologic Interface Research MIC-DIR, Galati, Romania*These authors contributed equally to this workCorrespondence: Lawrence Chukwudi NwabudikeN. Paulescu National Institute of Diabetes, 5-7 Ion Movila Street, Sector 2, Bucharest, RomaniaEmail Chukwudi.nwabudike@live.comCristian OnisorDunarea de Jos University of Galati, Faculty of Medicine and Pharmacy, 47 Domneasca Str., Galati, 800008, RomaniaEmail cristi.onisor@gmail.comAbstract: Malignant melanoma is a deadly form of skin cancer, and prompt diagnosis is a key factor in providing adequate, life-saving therapy. A 75-year-old man, with long-standing type 2 diabetes mellitus, presented with a 2- to 3-year history of right heel ulcer. He had received various therapies for a diagnosis of diabetic foot ulcer, to no avail. Physical examination showed a black, fungating ulcerated lesion on his right heel, with minimal bleeding. No inguinal lymphadenopathy was palpated. A biopsy was done, which revealed BRAF-negative malignant melanoma, with a vertical growth phase, Breslow 3.1 mm, ulceration, 11 mitoses/mm2, Clark level IV, no lymphatic or vascular invasion observed. Right inguinal lymph node sampling suggested no involvement, but PET-CT suggested pulmonary, right inguinal lymph node and bone involvement. The patient was referred to the oncologists. Written informed consent for publication was given by the patient. Diabetic foot ulcers are a frequently encountered, but serious complication of diabetes mellitus. Delayed healing is often seen, despite adequate therapy. The differential diagnosis of diabetic foot ulcers is vast and includes neoplasia. When a foot ulcer fails to heal, other differential diagnoses must be considered, in order for the patient to receive adequate therapy. Here specialist consultations, including dermatology consultations, could improve chances of delivering the right therapy promptly. This is a factor underlying the emphasis on a multidisciplinary approach to foot ulcer therapy. Our presentation – reported according to the CARE guidelines – also illustrates the fact that failure to reach a timely diagnosis may deny the patient the opportunity to receive adequate treatment. In such cases, “delayed therapy becomes denied (or failed) therapy”, paraphrasing the old adage “Justice delayed is justice denied”.Keywords: malignant ulcer, case report, acral malignant melanoma, diabetic foot ulcer, type 2 diabetes mellitus, delayed therapy

Sergiu Chirila,1,* Tony Hangan,2,* Leonard Gurgas,1,* Monica Georgiana Costache,2,* Marinela Anisoara Vlad,3,* Bogdan-Florentin Nitu,3,* Sara Melek Bittar,4,* Aurora Craciun,5,* Laura Condur,6,* Geir Bjørklund7,* 1Department of Medical Informatics and Biostatistics, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania; 2Department of Dermatology, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania; 3Doctoral School of Medicine, Ovidius University of Constanta, Constanta, Romania; 4Department of Dermatology, County Clinical Emergency Hospital of Constanta, Constanta, Romania; 5Department of Biochemistry, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania; 6Department of Family Medicine, Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania; 7Council for Nutritional and Environmental Medicine, Mo i Rana, Norway*These authors contributed equally to this workCorrespondence: Tony Hangan, University Alee nr. 1, Department of Dermatology, Faculty of Medicine, Campus B, Ovidius University of Constanta, Constanta, 900470, Romania, Email tony@medcon.roBackground: This study explores patient acceptance of influenza vaccination administered by pharmacists in Romania during the 2023 season, considering it a novel strategy to address gaps in knowledge. Pharmacy-based vaccination deviates from traditional methods, providing high-risk patients with full reimbursement and others with 50% reimbursement, allowing a choice between family doctors and pharmacies for vaccine administration.Material and Method: The survey includes 15 questions covering socio-demographic data, health information, vaccination preferences, and perceptions of pharmacy-based vaccinations.Results: Respondents showed a positive inclination toward pharmacy-based vaccination, with 68% expressing favorable sentiments, but an awareness gap exists, as only 36% were aware of pharmacy-based vaccination availability.Conclusion: Challenges include a lack of patient awareness and understanding of benefits, emphasizing the need for structured pharmacist-patient dialogues. Legal changes, a defined funding mechanism, and collaboration are crucial for successful implementation. The study provides valuable insights into patient perceptions, contributing to discussions on optimizing influenza vaccination coverage in Romania and beyond and recognizing pharmacies’ potential in achieving broader vaccination goals.Keywords: pharmacy, vaccine, influenza, vaccination

Introduction and objectives. Renal cell carcinoma (RCC) is one of the most important urological pathologies, being correlated with high morbidity, poor prognosis and outcome. Kidney tumors can be heterogeneous comprehending several histological types. Diagnosis of RCC usually results in most cases from incidental findings, although in some cases, due to paraneoplastic syndromes, patients present with symptoms caused by hormones or cytokines excreted by the tumor cells or by a systemic immune response against the tumor. The treatment of choice for RCC is mainly surgical, involving partial or radical nephrectomy, either open or laparoscopic, while the oncological results depend on a series of prognostic factors among which the tumor pathological stage, the presence of lymphovascular or perineural invasion, presence of tumor necrosis or sarcomatoid and rhabdoid changes. The objective of our study was to try and determine correlations between the clinical and the histopathological aspects of renal cell carcinoma patients that might be used as prognostic factors for the evolution of the disease. Materials and Methods. We conducted a retrospective study involving 50 patients treated for renal cell carcinoma, who underwent radical or partial nephrectomy in 2019 in a urology tertiary care center. The demographic data, clinical and histopathological data were gathered into a database for the study group. Our goal was to determine key prognostic factors that could be related to the oncological outcomes and the surgical results for patients with renal cell carcinoma who underwent curative intent treatment. Results. The mean patient's age was 65 years, ranging from 46 to 81 years. In the study groups, there were 32 laparoscopic nephrectomies and 18 through an open approach. In most of the cases the tumor size varied between 4 and 7 cm. In terms of pathological prognosis factors, tumor necrosis was found in 21 cases, 14 of them had Fuhrman grade 3 and 5 cases presented with Fuhrman grade 4. Only 2 cases found to have low Fuhrman grade (2) associated with tumoral necrosis. Patients with larger tumors tended to present with a higher Fuhrman grade. Fatty tissue involvement was found in 15 cases, from which 12 presented with Fuhrman grade 3 and 3 cases with grade 4. Capsular invasion was found in 9 cases and 7 cases had positive lymph nodes. Only one case presented sarcomatoid changes. In terms of intraoperative surgical decision making out of 24 cases of tumors measuring 7 cm or less, 15 of them had the tumor situated at one of the poles, 12 of them without touching the renal collecting system feasible for partial nephrectomy. Due to intraoperative complications and aspects, regarding the surgical dissection and the increased bleeding, in seven of these cases, the surgeon's decision was towards radical nephrectomy. Out of these seven cases the histopathological report following radical nephrectomy revealed a Fuhrman grade 3, with five tumors with a diameter of less than 5.5 cm and two cases with tumor dimensions below 4 cm, all situated at one of the poles. Conclusion. Patients with larger tumors presented with higher Fuhrman grades and more tumor necrosis, most of them invading the collecting system (p<0,05). Small tumors, less than 4 cm, were more likely to be feasible for nephron sparing surgery. Although 15 cases in our study were suitable for partial nephrectomy, in 7 cases the decision of radical nephrectomy was made intra-operatively and found to have Fuhrman grade 3 and tumor necrosis, in three cases the renal collective system was involved. Modern approach regarding surgical treatment of RCC depends on the tumor location, size, the relationship with urinary tract, blood vessels and the surrounding organs. Although novel oncologic markers emerge every year and become available for RCC patients, the use of predictive biomarkers for clinical stratification and management still awaits validation studies. [ABSTRACT FROM AUTHOR]

The paper presents the results obtained in the experiments carried out to control fungal infestations during the incubation of carp eggs. Experiments were carried out between 15 -24 May 2020 at the artificial fish breeding station at F.C.R.D.S. Nucet. Several concentrations of formalin (1 ml / l, 1.67 ml/l and 2 ml/l) and table salt (NaCl) (1 g / l, 3g /l, 5 g/l) were used to determine the duration and frequency of treatment for carp embryonated eggs. The effectiveness of formalin solutions was evaluated compared to that of table salt solutions by comparing the rate of hatching and larval survival. The results showed that formalin treatments, at a concentration of 1.67 ml / l for 15 minutes, inhibited fungal growth on the surface of embryonated eggs, resulting an incubation survival rate of 79.1% compared to untreated control samples. [ABSTRACT FROM AUTHOR]

In this project, four different poultry species have been selected, for each two different commercial parts further on being included in the study: breast and thigh. The analysis included nutritive quality parameters such as: free fat, protein (nitrogen), water, ash, and collagen. The project used the following standardized methods of analysis: SR ISO 1442:2010, SR ISO 3496:1997/A1:1999, SR ISO 936:2009, SR ISO 1444:2008 and SR ISO 937:2007. Also, the statistical analysis was performed using the IBM® SPSS® Statistics 20 (comparison between species and commercial parts). The results were mostly similar to the ones found in the scientific literature. The difference between the fat content of goose meat and turkey meat was statistically significant (p < 0.0001) (for both commercial parts). Also, the water content was lower for goose meat compared to the other commercial parts of the species selected for the study. The ash content was not different between the parts and species included in the study, and the same could be observed for the collagen. As for the chicken meat commercial parts, it can be confirmed what the scientific literature was mentioning in different other studies: the protein content (nitrogen percentage) of the breast meat part is higher compared to the thigh part, for the same species. The main conclusion of this study could be that these preliminary results are valuable and may be followed through with a thorough analysis of the amino acids and fatty acids profiles, for further comparisons. [ABSTRACT FROM AUTHOR]

Introduction and Objectives. Renal cell carcinoma represents an important surgical disease. In the present times, in case of an imagistic suspicion of a renal cell carcinoma, a total nephrectomy or a radical nephrectomy should be performed when the tumor formation is not suitable for partial nephrectomy. Renal cell carcinoma is the third most common type of cancer after prostate and bladder cancer in the field of uro-oncology. Its incidence has known a rapid increase in the last years, thanks to the well spread use of the new imagining techniques, that also improved the mortality and morbidity rate caused by this malignancy. We performed a comparison between open versus laparoscopic nephrectomy, regarding the treatment of renal cell carcinoma, in order to assess if the laparoscopic nephrectomy for renal tumors is by any means superior to the "old-school" open approach, and if it can, indeed, replace the open surgical intervention. Materials and Methods. 63 cases of patients with renal cell carcinoma who underwent nephrectomy were studied in a retrospective manner. The surgeries were performed in the Urology Clinic of "Prof. Dr. Theodor Burghele" Clinical Hospital, between January 2011 and September 2013. The subjects were divided into two study groups by means of the surgical approach used, open or laparoscopic nephrectomy and several parameters were analyzed. Results. Of the total 63 patients with RCC, 28 underwent laparoscopic nephrectomy, while the rest of 35 underwent open nephrectomy. The mean age of patients with laparoscopic nephrectomy was 59.39±12 years, compared to 63.31±11 years for the open approach. The male patients were statistically significantly older than the female patients in our population (p=0.017). Clear-cell carcinoma accounted for approximately 70% of all adult epithelial kidney tumors, in the nephrectomy series. Papillary renal cell carcinoma was the second most common type of renal cell carcinoma and it accounted for 10-15% of all types of renal cell carcinomas. Mean length of hospitalization was significantly higher for patients receiving open surgery than for those receiving laparoscopy (8.26 days versus 5.81 days, respectively) (p=0.0001). Blood loss has been lower for the laparoscopically operated patients, compared to the other group of open nephrectomies: average blood loss was 93 ml versus 202 ml in the open nephrectomy group (p=0.002). Complications were more frequent after open surgery compared to laparoscopic surgery (p=0.015). Conclusions. The laparoscopic approach in the surgical treatment of the renal cell carcinoma has the advantage of a reduced rate of complications, decreased postoperative pain, shorter hospital- stay and therefore more rapid socio-professional reintegration. In terms of success rates and oncological results, both techniques presented with similar results, only minor differences were observed, with no statistical significantly difference. [ABSTRACT FROM AUTHOR]

Introduction. Imaging has a decisive role in the diagnosis and staging of pancreatic cancer, the most used imaging methods being computed tomography, magnetic resonance imaging and endoscopic ultrasonography. Material and method. They were studied retrospectively over a 3 years period, 140 patients with pancreatic cancer. Aim of the study: This study aims to determine the effectiveness of CT, MRI and EUS in diagnosis and staging of panceatic cancer. Results. CT showed a diagnostic accuracy of 83.3%, with sensitivity and specificity of 81.4% and 43% respectively. MRI showed superior diagnostic accuracy compared to CT (89,1%). However, EUS demonstrated the best diagnostic value in PC (accuracy of 92,7%). Concerning the locoregional staging, the 3 diagnostic methods showed similar result. There were no significant differences concerning the diagnosis of intra-abdominal metastases. Differences have appeared in the case of extra-abdominal. Thus, there were 4 cases of lung metastases which have been identified only on CT and MRI. Conclusion. EUS is the most effective technique used in the diagnosis of pancreatic cancer, the present study demonstrating an accuracy of 92.7%. Moreover, EUS offers the possibility to collect samples for cytological examination by EUS guided fine needle aspiration. However, there are some limitations of EUS in identifying extra-abdominal metastases. Thus, the assessment of tumor extension must be completing by performing CT or MRI. [ABSTRACT FROM AUTHOR]

This study aims to identify proper solutions that can improve the sustainability of cyprinids pond aquaculture in terms of nitrogen releases to the environment. Therefore, two experimental variants, based on polyculture, respectively integrated multi-trophic aquaculture (IMTA) concept were tested, as follows: PCP – polyculture of common carp (CC) + grass carp (GC) + bighead carp (BC) + silver carp (SC); CP-PP – net divided pond with CC monoculture in CP part and CC+GC+BC+SC polyculture in PP part. In order to determine the nitrogen accumulation at the pond level, samples of water, sediments, fish meat and reed were analyzed. The results indicate that the highest nitrogen compounds concentrations in pond water were registered at CP part of CP-PP pond. However, the nitrogen concentration in pond effluents was significant higher in case of CP-PP pond, compared with PCP pond. The nitrogen compounds concentration of sediments registered the highest values in the ponds outlet area. Also, CP-PP pond recorded higher nitrogen concentration in sediments, compared with PCP pond. The CC registered the highest nitrogen compounds concentration in case of PP pond area, followed by CP pond area and PCP pond. Not significant correlation was found between reed and pond water/ fish meat/ sediments in terms of nitrogen compounds concentration. It can be concluded that the CP-PP pond feeding management, together with the tested technical solution (pond dividing) generated better water conditioning performances.

The Carpathian Mountains are one of the most complex orogenetic areas of Europe, with unique fauna, including the brown trout (Salmo trutta). In this study we performed population genetic analysis of 12 different S. trutta populations using two types of molecular markers: nine microsatellites and mitochondrial D-loop sequences. The following working hypothesis was considered: the Romanian Carpathians and their surrounding lowlands can be key relief units based on which the S. trutta genetic diversity, spread, distribution, connectivity, relative isolation and genetic divergence can be at least partially explained. The phylogenetic analysis revealed that the majority of sequences were grouped in the Danubian clade. The high haplotype diversity of the 12 analyzed brown trout populations can be explained by the high nucleotide diversity. The microsatellite analysis revealed an inbreeding event for all the loci and for the populations analyzed. The Romanian Carpathians' shape and geographic orientation play a zoogeographical key role driving force in respect to the S. trutta populations.

This study has assessed the protective efficacy of Silybum marianum seed oil (SMSO) in the context of CCl4-induced injury and oxidative stress in murine liver. Based on the GC-MS analysis, linoleic and stearic acids, tocopherol, ascorbic acid 2,6 dihexadecanoate and other constituents were identified in SMSO. Swiss mice received oral doses of SMSO daily for 21 days (10 g/kg b.w.) and subsequently injected i.p. with CCl4 (50% v/v in olive oil; 1 ml/kg) on the 22nd day. CCl4 administration induced an elevation of serum amino- and glutamyl transferases activities and an increased peroxidation, as well as a decrease of SOD, CAT, GPx, GR and GST activities in liver. SMSO successfully prevented oxidative stress and restored the biochemical parameters, hepatic architecture and expression of TNF-alpha. These findings suggest that SMSO was effective in counteracting the damaging effects of CCl4-induced injury in hepatocytes, probably due to its inherent antioxidant properties.

DNA barcoding is a molecular technique frequently used either for biodiversity monitoring and fish conservation or in the identification of the species of origin for raw and processed food from restaurants or fish markets. The most important aspect of this technique is that it works for all stages of life and can be used to distinguish between closely related taxa. Also, the technique has been used to unmask attempts of frauds in fish markets where more desirable and expensive fish are sometimes substituted with lower valued species. Our study aims to test the utility of the COI barcoding gene in the correct identification of several economically and ecologically valuable fish species, and interspecies hybrids, from Romanian wild fauna, aquaculture and fish markets. By combining the 122 COI sequences generated here with additional barcodes downloaded from GenBank and BOLD we screened several members of Acipenseriformes and Salmoniformes. While COI was able to correctly classify the majority of Salmoniformes, the identification process for Acipenseriformes proved more difficult, especially in the case of hybrids. Although the results show that DNA barcodes present a low degree of interspecies variation making classification possible only at the genus level, this technique is still relatively cheap, fast, and useful in the identification of incorrectly labelled market products.

Background and Objectives: Squamous cell carcinoma (SQCC) represents a significant proportion of human malignancies affecting various anatomical sites, including the lung. Understanding the prognostic factors is crucial for establishing effective risk stratification in these patients, as multiple critical aspects significantly impact overall survival., Materials and Methods: A retrospective study was conducted on 99 patients with operable lung SQCC treated at a tertiary center. The exclusion criteria included patients under 18, those with in situ or metastatic SQCC, and those who received neoadjuvant therapy. The surgical specimens were re-analyzed, and data were collected on multiple variables, including pTNM staging, tumor characteristics, and overall survival (OS). The Kaplan-Meier survival analysis and Cox regression models were used to identify significant prognostic factors., Results: The Kaplan-Meier analysis showed a median survival of 36 months with a 65.65% mortality rate. Significant factors influencing survival included keratinization, histological grading, tumor size and stage, pleural invasion, tumor cell arrangement, tumor budding, spread through air space (STAS), and mitotic index. A multiple Cox regression highlighted the nonkeratinizing tumors, advanced pT stages, single-cell invasion, and high mitotic index as key predictors of poorer outcomes. The nonkeratinizing tumors showed higher mortality and shorter median survival rates compared to keratinizing tumors. The tumor staging, cell arrangement, and tumor budding significantly impacted the survival curves., Conclusions: The study underscores the importance of detailed histopathological evaluations in lung SQCC. The nonkeratinizing tumors, advanced pT stage, single-cell invasion, and high mitotic index were associated with higher hazard rates, emphasizing the need for a comprehensive grading system incorporating these factors to improve prognostic accuracy and guide treatment strategies.