Arad County Clinical Hospital

ABSTRACT Aim Illuminating the evolutionary history of Austropotamobius crayfish by uncovering patterns of biodiversity and biogeographical processes, thereby providing a foundation for accurate taxonomy and targeted conservation strategies. Location Europe. Time Period Miocene to present. Major Taxa Studied The crayfish genus Austropotamobius . Methods We synthesised existing knowledge and conducted additional analyses to resolve uncertainties in lineage divergence and distribution. Genetic variation across geographical regions was assessed using mitochondrial COI haplotypes, paired with accurate geolocation data from literature. Divergence times were estimated using a genus‐specific molecular clock calibrated to the tectonic‐driven separation of Austropotamobius bihariensis from its Dinaric relatives, based on 936 base pairs of concatenated COI and 16S mitochondrial sequences. To reconstruct historical connectivity and gene flow direction among regional populations, we applied coalescent‐based models comparing alternative scenarios. Results Our analysis suggests the common ancestor of Austropotamobius diverged ~30 Ma, coinciding with the temporary fragmentation of Balkanatolia from Western Europe, forming two major evolutionary lineages. In the west, between the Alps and Pyrenees, A. pallipes showed low genetic diversity and broad distribution. From this lineage, A. fulcisianus emerged around 14 Ma during an Alpine embayment, colonising the forming Italian Peninsula and later expanding into the southern Dinarides during the Messinian Salinity Crisis. Human‐mediated translocations further extended its range into Western and Northern Europe. The second major lineage, A. torrentium , spans Central and Eastern Europe and includes eight ancient, monophyletic and endemic lineages concentrated in the north‐central Dinarides (NCD), except for the most basal branch, A. bihariensis , located in the Apuseni Mountains. Two younger lineages expanded across the Balkans and Central Europe, likely beginning around 6.8 Ma with the formation of the Palaeo‐Danube system. Main Conclusions This study refines the evolutionary trajectory of Austropotamobius , highlights taxonomic clarification and underscores the need to reassess several lineages to support genuine, evolutionarily informed conservation strategies.

AimsWe aim to assess the efficacy of congestion relief and safety associated with adding SGLT2i (viz., dapagliflozin 10 mg) to intravenous loop diuretics within 24 h of hospital presentation in patients with acute heart failure (AHF).Methods and resultsA single‐centre open‐label clinical research study enrolled 98 patients admitted with an episode of AHF who were randomized into two groups: (a) receiving SGLT2i once daily in addition to structured intravenous furosemide therapy; (b) receiving structured intravenous furosemide therapy alone. In‐hospital congestion relief was evaluated by body weight change, EVEREST score, lung ultrasound B‐lines, inferior vena cava ultrasound measurement, NT‐proBNP and CD146. Safety was assessed by changes in renal function and serum electrolyte abnormalities. Secondary endpoints included diuresis and natriuresis, hospital care indices and echocardiographic changes in cardiac function at 1‐month. ANCOVA analysis was performed to adjust for imbalance between the two groups regarding chronic kidney disease status and baseline values. The analysis followed an intention‐to‐treat approach. The mean age ± standard deviation in the SGLT2i and control group was 63.63 ± 10.95 years and 65.31 ± 10.82 years, respectively, with 40/49 and 42/49 males. No death occurred in hospital; 1/49 and 2/49 deaths at 30 days were recorded. The adjusted mean change ± standard error (SE) in body weight was −4.90 ± 0.93 kg versus −4.28 ± 0.81 kg in the SGLT2i and control group, respectively. The adjusted mean change ± SE in B‐lines at discharge and at 1 month was −19.93 ± 0.87 versus −18.64 ± 0.79 (P = 0.227) and −19.65 ± 1.54 versus −14.82 ± 1.43 (P = 0.012), respectively. The proportion of worsening renal function was 15/49 and 6/47 (P = 0.048) in the respective treatment groups (SGLT2i and control). The adjusted mean ± SE of 24‐h urinary Na was 248.03 ± 23.69 mmol/day versus 173.83 ± 20.76 mmol/day (P = 0.009). One‐month changes in ultrasound parameters were significantly improved in the SGLT2i group, with median (inter‐quartile range) values of left ventricular ejection fraction and end‐diastolic volume equal to 5% (0.35% to 11.5%) versus 0 (−1% to +5%) and −6.5 mL (−27.5 to +3) versus 4 mL (−11.5 to +10), respectively.ConclusionsEarly initiation of SGLT2i administration in addition to intravenous loop diuretics in patients with AHF would optimize congestion relief and improve clinical outcomes.

Background and Objectives: This study investigated and compared with European literature data the incidence, severity, and perinatal risk factors of retinopathy of prematurity (ROP) in preterm infants admitted to the Premature Department of Mureş County Clinical Hospital over a two-year period (January 2022-December 2023). Materials and Methods: ROP screening was performed in 96 infants (76.8%) according to professional guidelines. A literature review was conducted to compare our findings with national and European data. Significant differences were identified in comparisons with studies from Cluj-Napoca (p = 0.0125), Timișoara, and Bucharest (p < 0.0074), as well as Serbia and Croatia when stratified by gestational age limits. The variations in GA thresholds (32 vs. 34 weeks) between studies required stratified analyses to ensure meaningful comparisons. The included European studies provided data on screening criteria, prevalence, and associated risk factors, offering a comprehensive perspective on screening effectiveness. Results: Among the 149 admitted patients, 125 were preterm (n = 125). Of the screened patients, 20 (20.83%) infants were diagnosed with ROP, including 13 boys (65%) and 7 girls (35%), all requiring prolonged respiratory support, and 55% of them needed blood transfusion. The average birth weight of affected infants was 1030.5 g (550-1700 g ), and the mean gestational age was 28.3 weeks (25-34 weeks). In those found to have stage 2 and 3 ROP in zone II with plus disease (n = 6), intravitreal anti-VEGF injections and/or retinal laser treatments were performed. Notably, no cases of ROP-related blindness were recorded. Conclusions: To our knowledge, this is the first study to compare ROP prevalence and screening outcomes across Romanian national centers. Identified risk factors in this cohort, such as respiratory distress syndrome, oxygen therapy, blood transfusion, and intraventricular hemorrhage, are consistent with the existing literature data. These findings underscore the importance of standardized screening criteria and effective management protocols to prevent ROP-related blindness. The comparative approach of this study highlights the necessity of harmonized internationally applied criteria to facilitate robust comparisons and, more importantly, improve patient care outcomes.

BackgroundThere are no studies belong NOTCH2 gene polymorphism in relation to reproductive and productive traits in Holstein cattle. The objective of the present study was to investigate the effect of NOTCH2 gene polymorphisms on productive and reproductive performance of fertile and anestrum cattle.MethodsThe cattle were classified into anestrus for 3–12 months postpartum (n = 115, 37.7%) and normal cyclic fertile (n = 190, 62.3%). Age at 1st calving, calving interval, calf birth weight, milk yield and days of milking data were obtained from the farm records for all animals. Blood samples were collected from fertile and anestrum animals for DNA extraction and the PCR as well as single-strand conformation polymorphism techniques (SSCP) were performed for detection of the NOTCH2 gene polymorphism.ResultsThe sequencing results showed that NOTCH2 gene in cattle is polymorphic with 5 genotypes AA, AG, GG, CC and CT. Four novel SNPs as transition single base substitution mutations were detected at 3: 23,192,033 (A/G), 3:23192149 (C/T), 3:23192071 (C/T) and 3:23192143 (G/A). GG genotype of NOTCH2 gene was associated with shorter calving interval and heavier calf birth weight in both fertile and anestrum cattle.ConclusionsNOTCH2 gene in cattle could be used as a genetic marker involved in reproductive traits in both fertile and anestrum cattle.

Background: Central and branch retinal artery occlusion (CRAO and BRAO) are critical causes of acute vision loss, predominantly affecting older adults with systemic vascular pathology. These occlusions typically result from embolic events, leading to partial or complete retinal ischemia. Methods: This retrospective case series report details of our 10-year experience using the 1064 nm Nd:YAG laser for Transluminal Nd:YAG Embolysis (TYE) in order to lyse visible emboli within the retinal arteries. Results: We conducted a retrospective case series involving 18 patients treated by TYE for different retinal arteries occlusions between 2014 and 2024. TYE effectively restored blood flow in the occluded arteries, with variable but generally favorable visual outcomes. Our article highlights significant clinical and interventional aspects of three treated patients: a BRAO case with multiple transluminal emboli, a case of double BRAO and a CRAO case. We also report the successful use of TYE for intraluminal lysing of an embolus located outside the optic disc. The procedures were well-tolerated, with minor complications such as preretinal or vitreous hemorrhages resolving spontaneously. Conclusions: TYE is a minimally invasive therapeutic option for retinal artery occlusion with visible emboli, particularly when intervention occurs shortly after the onset of symptoms. Compared to observation, TYE can improve visual outcomes and reduce the risk of permanent vision loss, presenting a significant advancement in the management of this ophthalmic emergency. The worldwide experience with TYE is continuously increasing. Further research with larger cohorts is recommended to validate these results and refine the treatment protocol.

This article proposes the synthesis and characterization of (triethylene glycol dimethacrylate-N,N-dihydroxyethyl-p-toluidine) TEGDMA-DHEPT self-healing microcapsules for their inclusion in dental composite formulations. The obtaining method is the in situ emulsion polymerization of the (poly urea-formaldehyde) (PUF) coatings. The microcapsules were characterized by Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), atomic force microscopy (AFM), high-performance liquid chromatography (HPLC), and low-field nuclear magnetic resonance (NMR) techniques. The optimal formation of uniform microcapsules is achieved at a stirring speed of 800 rpm and centrifugation is no longer necessary. HPLC demonstrates that the microcapsules formed at 800 rpm show a better control of liquid release than the heterogeneous ones obtained at a lower stirring speed. The centrifuged samples have rounded shapes, with dimensions between 80 and 800 nm, while the non-centrifuged samples are more uniform, with a spherical shape and dimensions of approximately 800 nm.

NT-proBNP levels with a wide range at admission play both a diagnostic and a prognostic role in patients with HF. The differences regarding the clinical profiles and demography in decompensated HF patients according to NT-proBNP levels at admission are not clear. This study aimed to analyze and compare clinical profiles and demographics in patients hospitalized for decompensated heart failure according to levels of NT-proBNP at admission. The study included 302 patients hospitalized for decompensated HF who were divided into three groups based on admission NT-proBNP levels: group A (n = 46, with NT-proBNP level < 3000 pg/mL), group B (n = 130, NT-proBNP level between 3000-10,000 pg/mL), and group C (n = 126, NT-proBNP level > 10,000 pg/mL). Patients hospitalized with decompensated HF and very high levels of NTproBNP, above 10,000 pg/mL at admission, are older, have a lower LVEF, higher NYHA class, more renal dysfunction, and longer hospital stay, resulting in a more severe clinical profile. The presence of very high levels of NT-proBNP may identify a category of patients with a more severe prognosis that requires more aggressive management and closer follow-up.

Introduction: Skin pathology presents a rising incidence worldwide. Squamous cell carcinoma linked to UV radiation exposure may present a favorable evolution if diagnosed early and appropriately approached. Aimes: The purpose of this paper is to highlight the role of Cemiplimab as a unique treatment in squamous cell carcinoma. Discussion: Recent studies demonstrate promising results of immunotherapy in squamous cell carcinoma, both as a treatment in advanced locoregional and metastatic disease. Conclusion: Remission can be obtained after immunotherapy even in older patients and advanced disease stages. Rezumat Introducere: Leziunile tegumentare prezintă o incidență în creștere la nivel global. Carcinomul cu celule scuamoase ce se dezvoltă în legătură cu expunerea la radiații UV poate avea o evoluție favorabilă dacă este diagnosticat timpuriu și tratat corespunzător. Imunoterapia a câștigat în ultimele decenii un rol semnificativ în terapia cancerului cu celule scuamoase. Scop: Scopul acestei lucrări este evidențierea răspunsului la terapia cu Cemiplimab ca tratament unic în cazul cancerului cu celule scuamoase. Discuții: Studiile recente demonstrează rezultate promițătoare ale imunoterapiei în cazul carcinoamelor cu celule scuamoase, atât ca tratament în boala avansată loco-regională cât și metastatică. Concluzii: Remisia poate fi obținută cu ajutorul imunoterapiei chiar și în cazul vârstei înaintate și a prezentării în stadiu avansat.

Geriatric dentistry is a specialized field within dentistry focusing on the oral healthcare needs of the aging population, particularly those individuals experiencing chronic physiological, physical, and/or psychological changes or morbid conditions/diseases. The World Health Organization (WHO) has highlighted the importance of adopting 'active ageing' policies and programs to enhance the health, independence, and productivity of older adults. The imperative to plan and implement such initiatives is underscored by the WHO's assertion that "the time to plan and act is now". This review aims to provide an overview of age-related changes affecting the oral cavity and to explore interdisciplinary approaches for the treatment and prevention of oral diseases and disabilities among the elderly. The main aim of the research is to evaluate the management of elderly patients in dental medical services and to find solutions to improve case management for them.