Search

Background and Objectives: Maternal–fetal gestational pathology is one of the biggest challenges in the field of health at this moment. The current study is designed to determine the effects of vitamin D on pregnancy, starting with the idea that impairment of vitamin D status is thought to be correlated with impairment of the newborn's health. Materials and Methods: In this retrospective study, we tried to establish the link between vitamin D deficiency and maternal characteristics and also how it impacted the clinical status of the newborn. We analyzed a group of 260 patients: 130 pregnant women and 130 newborns, in whom vitamin D status was detected using the serum levels of 25-hydroxyvitamin D (25-(OH)D). Results: The results showed that vitamin D deficiency has a high incidence among pregnant women, as was presented in many important international studies. Our study also showed a positive, direct correlation between the mother's and newborn's vitamin D status. Conclusions: Taking into consideration that vitamin D deficiency has been correlated with many complications, both in maternal and newborn health, a serum level determination of 25-(OH)D is necessary in the first trimester of pregnancy, and after that, adequate supplementation is necessary in order to prevent any negative effects. [ABSTRACT FROM AUTHOR]

Malignant melanoma is a melanocytic neoplasm with a steadily increasing incidence worldwide. In order to define a proper diagnostic protocol and to establish an accurate prognostic method for the disease, specific biomarkers are of notable importance. Their contribution is also significant in the treatment of melanoma for the improvement of newer and more targeted therapeutic approaches. To emphasize the importance of specific immune markers in the diagnosis of melanoma, immunohistochemical analysis was performed on 56 formalin-fixed paraffin-embedded cutaneous melanomas. Besides the traditional prognostic factors, depth of invasion and mitotic rate, the markers tested in the present study were S100 protein family, Melan A, Ki67 and HMB-45. The present results indicated that immunocytochemistry represents a valuable test in the diagnosis and treatment of malignant melanoma and each biomarker had different associations with the progression and prognosis of the disease. Patients with S100 expression were 4.83 times (95% CI=1.2-20.8) more likely to suffer a relapse, whereas patients with a Ki67 expression of >30% had a 5.41-fold higher risk (95% CI=1.3-22.0). The correlation between S100 and the Breslow depth was statistically significant (r-value: 0.43; P=0.027). In addition, the importance of a multidisciplinary team including a plastic surgeon, anatomopathologist and oncologist was highlighted. [ABSTRACT FROM AUTHOR]

The modern principles in pelvic surgery imply the preservation of the nervous structures that are involved in the physiological functioning of the pelvic and genital organs. The main pelvic nervous element is represented by the inferior hypogastric plexus. This plexus receives sympathetic afferent fibres from the hypogastric nerve, parasympathetic afferent fibres from the pelvic splanchnic nerves and also sympathetic afferent fibres coming from the sympathetic sacral chain via the sacral splanchnic nerves. We aimed to demonstrate the anatomy of these structures through dissection and we exposed the origins, pathway and manner of distribution of the splanchnic nerves of the pelvis. We managed to clarify the main anatomical relations of these nerves, among which we highlighted the relation to the branches of the internal iliac artery. The parasympathetic fibres reach the pelvis by running through the anterior rami of the spinal nerves, which are the origin of the sacral plexus. We managed to exhibit the way in which the parasympathetic fibres emerge from the sacral nerves and form the pelvic splanchnic nerves. Pelvic surgery nowadays is focused on nerve-sparing, which essentially means the conservation of the integrity of splanchnic nerves, hypogastric nerves and inferior hypogastric plexuses in order to maintain the normal functioning of the anatomical sphincters and genital organs. In this respect, it is crucial for the surgeon who performs pelvic procedures to be more than well-acquainted to the anatomy of the pelvic splanchnic nerves, which are considered to be the erectile nerves, and to that of the sacral splanchnic nerves. [ABSTRACT FROM AUTHOR]

The diabetic foot syndrome is the most common cause of diabetic patients hospitalization, being a challenging complication of diabetes. This is a case report of a diabetic patient who presented a silent myocardial infarction after partial foot amputation. The patient presented normal troponin at admission, but after 21 days of hospitalization he acused a very slight pain in the chest and breathing difficulty. The troponin was 682 ng/l. He was transfered immediately in the intensive care unit for specific treatment. The evolution of the surgical intervention was favourable even under the poor general status. The patient fully recovered after 10 days and left the cardiology department in a good clinical condition. A silent myocardial infarction seems to occur with increased frequency in patients with diabetes, due to the cardiac autonomic dysfunction. It is highly important a quick diagnosis and a good management of the patient. [ABSTRACT FROM AUTHOR]

The pre-lacrimal recess approach is modernly used for lesions of the anterior maxillary wall and for reaching paramedian cranial base regions. In this computed-tomography study, we assessed the pre-lacrimal recess types as well as the angles between the anterior and medial maxillary walls and between the anterior maxillary wall and the lateral margin of the nasolacrimal canal to show the feasibility of the pre-lacrimal recess approach in reaching lesions of the infratemporal and pterygopalatine fossae, using 30 computed-tomography studies (60 sides). A type I pre-lacrimal recess was identified in 22 cases (35%), type II was identified in 31 cases (53.30%), and type III in 7 cases (11.66%). We found that angle 1 (the angle between the anterior maxillary wall and the medial maxillary wall) had a mean value of 80.8° (minimum 75.5°, maximum 85.8°), while angle 2 (the angle between the anterior maxillary wall and the lateral margin of the nasolacrimal canal) had a mean value of 59.1° (minimum 57.6°, maximum 60.1°). We consider the pre-lacrimal recess approach a very good option for the anterior maxillary wall, the alveolar recess, and in reaching the infratemporal fossa and lateral part of the pterygopalatine fossa. In cases where direct visualization of the medial part of the pterygopalatine fossa is needed, the pre-lacrimal recess approach could not be the perfect option., Competing Interests: The authors declare no conflict of interest., (©2022 JOURNAL of MEDICINE and LIFE.)

Elements that comprise the inferior hypogastric plexus are difficult to expose, intricate, and highly variable and can easily be damaged during local surgical procedures. We aimed to highlight, through dissection, the origin, formation, and distribution of the hypogastric nervous structures and follow them in the female pelvis. We performed detailed dissections on 7 female formalin-fixed cadavers, focusing on structures surrounding the pelvic organs. For each hemipelvis, we removed the peritoneum from the pelvic floor, and after we identified the hypogastric nerves, we continued our dissection towards the inferior hypogastric plexuses, following the branches of the latter. Laterorectally, the hypogastric nerves form the inferior hypogastric plexus, a variable structure - nervous lamina, neuronal network (more frequently), or sometimes a combination of them. We identified three components of the inferior hypogastric plexus. The anterior bundle travels towards the base of the urinary bladder, the middle part innervates the uterus and the vagina, and the posterior segment provides the innervation of the rectum. The plexus can be identified after removing the pelvic peritoneum and the subperitoneal adipose tissue. Intraoperatively, the structures can be preserved by using an immediately-subperitoneal dissection plane. The variable branches are relatively well-organized around the pelvic vessels, supplying the urinary bladder, the genital organs, and the rectum. The ureter is surrounded by some branches, especially in its last segment, and it also receives innervation directly from the hypogastric nerve. Close to the viscera, the nerves enter neurovascular plexuses, making the intraoperative separation of the nerves and the vessels virtually impossible., Competing Interests: The authors declare no conflict of interest., (©2022 JOURNAL of MEDICINE and LIFE.)