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Introduction: Balloon-expandable (BE) and self-expandable (SE) prostheses are the main types of devices currently used in transcatheter aortic valve implantation (TAVI). Despite the different designs, clinical practice guidelines do not make any specific recommendation on the selection of one device over the other. Most operators are trained in using both BE and SE prostheses, but operator experience with each of the two designs might influence patient outcomes. The aim of this study was to compare the immediate and mid-term clinical outcomes during the learning curve in BE versus SE TAVI. Methods: The transfemoral TAVI procedures performed in a single center between July 2017 and March 2021 were grouped according to the type of implanted prosthesis. The procedures in each group were ordered according to the case sequence number. For each patient, a minimum follow-up time of 12 months was required for inclusion in the analysis. The outcomes of the BE TAVI procedures were compared with the outcomes of the SE TAVI procedures. Clinical endpoints were defined according to the Valve Academic Research Consortium 3 (VARC-3). Results: The median follow-up time was 28 months. Each device group included 128 patients. In the BE group, case sequence number predicted mid-term all-cause mortality at an optimal cutoff value ≤58 procedures (AUC 0.730; 95% CI: 0.644–0.805; p < 0.001), while in the SE group, the cutoff value was ≤85 procedures (AUC 0.625; 95% CI: 0.535–0.710; p = 0.04). A direct comparison of the AUC showed that case sequence number was equally adequate in predicting mid-term mortality, irrespective of prosthesis type (p = 0.11). A low case sequence number was associated with an increased rate of VARC-3 major cardiac and vascular complications (OR 0.98 95% CI: 0.96–0.99; p = 0.03) in the BE device group, and with an increased rate of post-TAVI aortic regurgitation ≥ grade II (OR 0.98; 95% CI: 0.97–0.99; p = 0.03) in the SE device group. Conclusions: In transfemoral TAVI, case sequence number influenced mid-term mortality irrespective of prosthesis type, but the learning curve was longer in the case of SE devices. [ABSTRACT FROM AUTHOR]

Aim. To achieve extensive information (regional) in relation with the tuberculosis identified in current clinical practice in patients with inflammatory rheumatic diseases treated with biological agents. Patients and methods. Twenty seven rheumatologists from 11 Romanian medicale center agreed to participate voluntarily and provide required data on tuberculosis (TB) occurring between January 1999 and June 2011 in their patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthropathy (PsA) in relation with anti-TNFα agent. This observational research included 693 patients (RA n=492, SA n=137, AP n= 64). All patients were screen for latent Mycobacterium tuberculosis infection (LTBI) before they start anti-TNFα treatment. Chemoprophylaxis with isoniazid before anti-TNFα therapy is recommended if the diameter of tuberculin skin test reaction is more than 5 mm (before 2005 only if indurations was more than 10 mm). We recorded the demographic characteristics, and complex information about disease, treatment, tuberculosis diagnosis and the comorbidities. Incidence rate of TB are presented as events/1,000 person-years with associated 95% confidence interval [95%CI]. Results. Fifteen patients were diagnosed with TB, most (60%) were born in rural areas and 40% in areas with higher incidence (≥ 80%ooo) of TB. The incidence of TB was 1.65‰ (IC95% [11.54-34.63]). The extra pulmonary sites were present in 53.3% of the cases. Cultures were positive for Mycobacterium tuberculosis in 11 cases (73.3%). Suspicion of TB was confirmed histological in 6 cases (40%). The average duration of developing TB after initiation of TNF inhibitor was 23.26 months (range one month to 120 months). In 7/12 TB cases treated with IFX the incidence appeared in the first year of treatment. Any of known risk factors don't have a significant influence in our cohort. Conclusions. The risk of reactivation of a latent TB during biologic therapy is greater in patients with rheumatic inflammatory diseases living in geographical areas with high endemicity of TB infection. Reduced compliance to chemoprophylaxis may be responsible for the occurrence of these cases. [ABSTRACT FROM AUTHOR]

A genetic algorithm for structure-activity relationships optimization was developed and implemented. The genetic algorithm was designed to be feed with families of molecular descriptors, and was tested on Molecular Descriptors Family. The objective of the genetic algorithm was to optimize the multiple linear regressions with four descriptors for prediction of octanol-water partition coefficient (expressed in logarithmic scale) of a series of 206 polychlorinated biphenyls. Relevant factors for evolution were parameterized in the implementation of the evolutionary program. The configuration file allows running of the genetic algorithm under different settings of parameters. The defined parameters were parameters used to characterize the adaptation to the environment (three parameters), to characterize the breading sample (four), the reproduction (four), the evolution objective (two), the selection (ten), the survival (four), and the program execution (three). [ABSTRACT FROM AUTHOR]

Aim: A survey was conducted in undergraduate medical students enrolled in 3 or 4-year degree programs in Nursing, Midwifery, Radiology and Medical Imaging (technician), Physiotherapy and Kinetotherapy (technician) and Clinical laboratory (technician) in order to identify their perception of the medical informatics and statistics curriculum. Material and Method: A qualitative study was carried out in 1st year undergraduate students at the "Iuliu Hatieganu" University of Medicine and Pharmacy Cluj-Napoca, Romania during the 2008- 2009 academic year. A questionnaire containing 10 categories of items for assessing lectures and 19 for assessing practical activities was developed as an online tool with a database connection using Google Docs. Results: Students' attendance to lectures proved not to be statistically related with their final mark. The mean final mark obtained by students (6.02±1.57) proved to be statistically lower compared to the expected mean (6.58±1.23; t = -2.76, DF = 54, p = 0.0078). The teacher, the problems solved during lectures, the lecture summaries as well as the course web page proved to statistically influence the learning process. The results revealed that all students were satisfied with the materials used within lectures and practical activities as well as with the objectiveness of the final evaluation. Most students classified the difficulty of the practical activities as reasonable (p < 0.05) and their pace as just about right (p< 0.05). The overall quality of the practical activities was classified as easy by 13% of respondents, pretty easy by 30%, reasonable by 29%, and difficult by 25%. Conclusions: Overall, undergraduate students were satisfied with the materials used within lectures and practical activities as well as with the teacher's attitude and support in the learning process. [ABSTRACT FROM AUTHOR]

Background: Improvement of health care quality and cost control are the main aims of the health care reform in Romania. Objective: The aims of the research are to analyse the trend of costs for imaging techniques used as diagnostic tools for cerebral and abdominal neonatal pathology and to study the relationship between cost and diagnostic benefits. Design: This is a retrospective observational study design without a control group, conducted in the Radio-Imaging Department, Cluj District University Hospital, Romania, from October 2000 to February 2006. Patients: The study population was represented by neonates investigated in the Radio-Imaging Department, Cluj District University Hospital. Intervention: Five imaging diagnostic techniques used in the diagnosis of cerebral and abdominal neonatal pathology were investigated. Measurements: The costs of the investigated techniques were calculated. The concordance between clinical and imaging diagnostic was recorded. Results: Magnetic resonance proved to be the most expensive investigation. The rate between the raising of costs on investigation type on year was constant. The average cost of imaging investigations for patients with identified pathological aspects (€ 42.72) was not statistically significant (p > 0.05) compared with the average cost for patients with no pathologic imaging aspects (€ 37.62). The concordance between the clinical suspicion and the radio-imaging diagnosis was of 52.35%. Conclusions: The raise of radio-imaging investigation costs had a decreasing tendency over the years studied, decrease explained by the stabilization of the Romanian monetary market. The results on concordance analysis lead to the necessity of training of both clinicians and radiologists. [ABSTRACT FROM AUTHOR]

Together with stars and paths, b-ary trees are one of the most studied acyclic graph structures. As any other structure, a b-ary tree can be seen as containing information. The aim of the present research was to assess through informational entropy the structural information changes in b-ary trees after removal of an arbitrary vertex. [ABSTRACT FROM AUTHOR]

The study integrates knowledge resulting from structure–activity relationships analysis of amino acids with respect to the characterization of α1 and α2 type I collagen chains. Specifically, 15 amino acids and 14 properties were investigated and their structure–activity relationship models were obtained. The models were integrated into a web application and were used to predict the properties of a set of six amino acids. The similarities in α1 and α2 type I collagen chains has been investigated starting from the observed and predicted properties of amino acids by using two-step cluster analysis. [ABSTRACT FROM AUTHOR]

Review: 117 refs. [ABSTRACT FROM AUTHOR]

Aim: Less than 5% of pancreatic masses represent metastases and differentiation from primitive tumors using endo-scopic ultrasound (EUS) is difficult. The aim of our work was to assess the diagnostic value of contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) for pancreatic metastases.Material and Methods: We retrospectively analyzed patients with pancreatic metastasis identified during a 8 year period in a tertiary medical center.Results: We included in the study 20 patients evaluated with EUS and CH-EUS. The primary tumor was localized in the kidney (6 cases), lung (5 cases), colon (3 cases), skin (2 patients) and stomach, breast, ovary and liver (1 patient each). Only 11 patients (55%) (kidney, lung, liver, ovary or skin metastases), presented hypervascularity at EUS and arterial hyperenhancement on CH-EUS, with similar diag-nostic value. All renal metastases were hyperenhanced (the negative predictive value 100%) and the stomach, colon and ovary metastases were hypoenhanced. The fast wash-out of contrast substance was encountered in all cases or renal, pulmonary and digestive metastases, but with 53.3-64.3% specificity for the different origin of pancreatic metastases.Conclusions: The vascularity assessments on conventional EUS or CH-EUS are similar for pancreatic metastases of different origin. EUS tissue acquisition remains mandatory for the diagnosis. [ABSTRACT FROM AUTHOR]

Purpose The aim of the study was to explore the diagnostic value of three different sonoelastographic scoring systems (labeled S1–S3) for the differentiation between benign and malignant cervical lymph nodes. Materials and method The authors propose a six pattern scoring system of the elastographic images with pattern 1 – representing purely soft nodes, pattern 2 – predominantly soft nodes, pattern 3 – predominantly soft nodes with focal had area, pattern 4 – predominantly hard node, pattern 5 – entirely hard node and pattern 6 – node with necrosis. The sonoelastographic images of 50 benign and 70 malignant lymph nodes were assessed. The area under the ROC curve (AUROC) for the differentiation between benign vs. malignant and benign vs. metastatic nodes were analyzed for the three scoring systems. Results When all the malignant lymph nodes were considered, the S1 score showed an AUROC = 0.873 (95%CI [0.805–0.918], where CI = confidence interval; p < 0.001), sensibility (Se) = 58.57%, and specificity (Sp) = 96%. For S2 score the AUROC was 0.890 (95%CI [0.824–0.933], p < 0.001), Se = 92.86%, and Sp = 72%. For S3 score, the AUROC was 0.852 (95%CI [0.778–0.902], p < 0.001), Se = 64.29%, and Sp = 94%). When lymphomatous nodes were excluded, for S1 the AUROC was 0.884 (95%CI [0.809–0.932], p < 0.001), Se = 64%, and Sp = 96%. For S2 the AUROC was 0.894 (95%CI [0.818–0.939], p < 0.001), Se = 92%, and Sp = 72%. For S3, the AUROC was 0.856 (95%CI [0.771–0.911], p < 0.001), Se = 66%, and Sp = 94%. In the S3 scoring system, setting the benign vs. malignant cut off at pattern 3 increases the sensibility (41–65%) with minimal loss of specificity (96–94%). From the gray-scale and Doppler criteria, changes of the nodular margins and the presence of the vessels in the cortical part of the lymph node showed both very high sensibility and specificity, the others criteria taken into account had either very good sensibility with low specificity or high specificity and low sensibility. Conclusions Our study suggests that there are no significant differences between the three scoring systems in terms of overall diagnostic value. [ABSTRACT FROM AUTHOR]

Objectives: To find preoperative predictive signs for better surgical planning of the facial nerve in parotid tumors. Methods: Prospective study in patients with primary parotid malignancies. Patients with primary parotid malignant tumor were investigated for preoperative clinical signs in correlation with histological findings and surgical management of the facial nerve. Outcomes: The study included 47 patients. Several clinical findings as facial pain, paresthesia, and rapid growth of tumor might suggest the risk of malignancy. Paresis/palsy of the facial nerve was correlates with direct neural involvement. Conclusion: There are several predictive clinical signs that might suggest malignancy of a parotid tumor. [ABSTRACT FROM AUTHOR]

Objectives: To find preoperative predictive signs for better surgical planning of the facial nerve in parotid tumors. Methods: Prospective study in patients with primary parotid malignancies. Patients with primary parotid malignant tumor were investigated for preoperative clinical signs in correlation with histological findings and surgical management of the facial nerve. Outcomes: The study included 47 patients. Several clinical findings as facial pain, paresthesia, and rapid growth of tumor might suggest the risk of malignancy. Paresis/palsy of the facial nerve was correlates with direct neural involvement. Conclusion: There are several predictive clinical signs that might suggest malignancy of a parotid tumor. [ABSTRACT FROM AUTHOR]

Subgraphs can results through application of criteria based on matrix which characterize the entire graph. The most important categories of criteria are the ones able to produce connected subgraphs (fragments). Theoretical frame on graph theory, a series of three molecular fragmentation algorithms on pair of atoms, and construction of four square matrices (Szeged, Cluj, MaxF, and CMaxF) containing the fragment's size are presented. New theoretical results on fragment's size and the order based on sizes are presented. The obtained matrices were used to obtain the counting polynomials for two series of regular structures. The informational analysis on the obtained distinct counting polynomials was performed by using informational entropy and energy. Structure-property relationship analysis has been also conducted on the obtained counting polynomials. The obtained results are discussed and the main conclusions are highlighted. [ABSTRACT FROM AUTHOR]

The toxicity of thirty para-substituted phenols on Tetrahymena pyriformis was modelled using an original methodology that uses the complex structural information of the compounds. Two models were built. The methodology allows atomic properties to be assigned to toxicity based on the selection of pairs of descriptors from the entire family, which is called Molecular Descriptors Family (MDF). One model has two independent structural descriptors and the other has four. The model with four descriptors proved to have high estimated and predictive abilities (over 97% of toxicity could be explained by structural information). The partial charge distribution by bonds (molecular topology) and space (molecular geometry) interaction proved to be related with the toxicity of para-substituted phenols on Tetrahymena pyriformis. The predictive ability of the model was tested by using the following methods: the cross-validation leave-one-out and the training versus test experiments. The comparisons among the models were performed using the correlated correlations method. The embedding of the complex information from the structure using MDF methodology can lead to further investigations of the mechanism of chemicals toxicity on Tetrahymena pyriformis. [ABSTRACT FROM AUTHOR]

Aim: High resolution imaging methods detect a spectrum of inflammatory-like and structural modifications at joint and tendon level in healthy subjects. The knowledge of their extent and degree is important when subclinical disease activity (implying therapy reassessment) must be differentiated from normality. Musculoskeletal ultrasound (MSUS) evaluation may be challenging even for experts when borderline or low grade lesions are present. Our objective was to analyse the frequency of inflammatory-like lesions in hand joint and tendons in healthy young subjects and to evaluate the concordance between MSUSand magnetic resonance imaging (MRI) findings.Material and Methods: Ten healthy young women (age range 24-32 years) clinically asymptomatic (joints and tendons) were selected to have bilateral hand MSUS and MRI evaluation. Based on current definitions, synovitis/tenosynovitis-like lesions, erosions, osteophytes and bone edema were quantified and concordance between the two imaging methods was calculated.Results: Overall, both imaging evaluation methods showed a low frequency of inflammatory-like and structural lesions. No joint presented power Doppler signal or erosions. No abnormalities suggestive for inflammatory or structural pathology were detected at the tendon compartments level. No erosions and no signs of osteitis were detected. The concordance between MSUS and MRI findings was high except for the wrist area.Conclusion: MSUS was demonstrated to be a very accurate imaging method, mostly for hand tendon evaluation. This would allow a better discrimination between normality and pathologic findings, adding supplementary information. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to evaluate the use of pre and post-therapy transrectal and transvaginal ultrasonography (TRUS, TVUS) with contrast enhancement and strain elastography compared with clinical examination and magnetic resonance imaging (MRI) in the assessment of advanced stage cervical cancer.Material and Methods: This was a prospective study, carried out over a period of nine months on subjects with advanced-stage cervical cancer (stage >/= IIB). All included patients were examined clinically and underwent abdomino-pelvic contrast enhanced MRI and multimodal US examinations (TRUS with strain elastography and contrast enhanced TVUS) at the time of diagnosis and after radiochemotherapy. Tumor size and staging at TRUS and TVUS was compared with the same data obtained by clinical examination and MRI. Pathology was the golden standard.Results: Eight patients accomplished the inclusion criteria. In five cases the tumor stage was identical on clinical and MRI examinations. In all cases parametrial infiltration was diagnosed by all pre-treatment examinations. No significant differences were observed in tumor size between clinical, US and MRI exams either at baseline or post-therapy, in native or post-contrast examinations. The size of the tumor evaluated pre-treatment proved to be significantly smaller post-contrast in both US and MRI examinations compared with the native images. Post-therapy, no significant differences were observed on US measured tumor dimensions when comparing native with post-contrast images. Oppositely, significant smaller dimensions were observed on post-contrast MRI compared with native scans.Conclusions: TRUS is accurate in the estimation of pre-therapy cervical cancer dimension. The post therapy tumor evaluation is better performed with MRI. The use of intravenous contrast agents on both examinations did not improved the accuracy of tumor evaluation pre or post-therapy. [ABSTRACT FROM AUTHOR]

Oxygen therapy is the main treatment method for acute respiratory failure in children. The method consisting in the administration of oxygen therapy by head box to infants is frequently used in pediatric practice. Objectives. To evaluate the efficiency of oxygen therapy administered by head box to infants suffering from pneumogenic acute respiratory failure by comparing two methods for measuring hemoglobin oxygen saturation: in arterialized capillary blood and by pulse oximetry. Material and method. 30 infants suffering from pneumogenic acute respiratory failure were studied. We used a clinical appraisal score for acute respiratory failure, which appraises respiratory rate, nasal flaring, recession, cyanosis, sensorial, before and after oxygen therapy. In arterialized capillary blood we measured partial pressure of oxygen and hemoglobin oxygen saturation, and we used an Automatic Blood Gas System analyzer. We also measured hemoglobin oxygen saturation using a pulse oximeter. Determinations were made before the initiation of oxygen therapy, and 30 minutes and 60 minutes after the initiation of oxygen therapy. Results. As compared to the baseline values, determined before the initiation of oxygen therapy, we recorded a statistically significant improvement in the clinical score both after 30 minutes and 60 minutes from the initiation of oxygen therapy (p<0.001). The improvement was greater after 60 minutes. The increase in the partial pressure of oxygen was statistically significant both at the 30 minute and 60 minute determination (p<0.001). Both methods of SaO2 measurement recorded statistically significant increases (p<0.001) in this variable after 30 and 60 minutes, respectively. Conclusions. Oxygen therapy administered by head box improves acute respiratory failure appraised by clinical score. The administration of oxygen therapy by head box to infants significantly increases the values of partial pressure of oxygen and hemoglobin oxygen saturation measured in capillary blood, as well as the values of hemoglobin oxygen saturation determined by pulse oximeter both after 30 minutes and after 60 minutes. The increases in the three parameters are larger after 60 minutes. There is statistically significant concordance between the values of hemoglobin oxygen saturation determined in capillary blood and by pulse oximetry at all determinations. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to explore the diagnostic value of sonoelastography for the differentiation between benign and malignant superficial lymph nodes of the neck. In this respect the utility of an original scoring system was explored. Material and Method: Over a period of 30 months the patients examined routinely for the assessment of superficial lymph nodes of the neck were recorded in a data base containing grey-scale, Doppler and sonoelastographic information and images. The sonoelastographic images of 30 benign and 39 malignant lymph nodes were assessed. The images were scored according to a new, eight pattern scoring system proposed by our group. Interobserver agreement and area under the ROC curve (AUROC) for the differentiation between benign vs. malignant and benign vs. metastatic nodes were analyzed. Results: The analysis of the interobserver agreement for the investigated score provided a weighted Kappa = 0.687, 95%CI [0.572 to 0.802] and standard error = 0.059. In the differentiation benign - malignant, the AUROC was 0.846, with sensitivity of 66.67% and specificity of 96.67% for score > 3. In the differentiation between benign and metastasis, the same criterion provided an AUROC of 0.855, with sensitivity of 71.43 and specificity of 96.67%. Conclusions: Our study suggests that applying the proposed score provides good interobserver agreement. The score also provided very good specificity and reasonable sensitivity in the differentiation between malignant and benign lymph nodes in the neck. [ABSTRACT FROM AUTHOR]

Interspecific hybridizations represent one of the apple breeding methods by which a wide variability can be achieved, useful for creating new cultivars. The study of 2190 interspecific hybrids, obtained from 25 combinations among crab apple species (Malus coronaria, M. floribunda, M. niedzwetzkyana, M. zumi, M. prunifolia) and different apple cultivars, points out a large variability of the F1 seedlings for several traits, with significant importance in apple breeding programs. The first year of fructification, as mean per hybrid combination, varied from 6 (M. zumi x 'Jonathan') to 9.3 years; the average hybrid's age for fructification was 7.4 years. The size of fruits among families varied from 1.5 ('Starkrimson' x M. prunifolia) to 4.0 ('Reinette Baumann' x M. zumi), the mean being settled at 2.8 (therefore below mark 3, meaning 'small fruits'). The lowest infection rate both for apple scab and powdery mildew attack was noticed at hybrids from M. coronaria x 'Reinette Baumann'. On the whole, the hybrids with genitors of 'species x cultivars' type have had an early fruiting and a better resistance to scab and powdery mildew, compared to the ones from 'cultivars x species' combinations. The large variability of the studied traits gave the possibility to identify offsprings with desirable characteristics on nine hybrid combinations. Among these, 53 elite plants were selected, with a strength of selection of 2.42%, therefore a relative low value, correlated with the peculiarities of the interspecific population and the selection criteria for dessert apple. [ABSTRACT FROM AUTHOR]