Spitalul Clinic Colentina

Background: Sleep disturbances are common in occupational settings and may impair health, safety, and work performance. Professional drivers represent a safety-critical occupational group, whereas information technology (IT) workers are frequently exposed to prolonged screen use and high cognitive workload. Methods: A cross-sectional study was conducted during 2023-2025 among 488 workers, including professional drivers and IT workers. Participants completed the Pittsburgh Sleep Quality Index, STOP-Bang questionnaire, Epworth Sleepiness Scale, and Athens Insomnia Scale. Age, sex, body mass index, and total work experience were recorded. Group comparisons and multivariable logistic regression analyses adjusted for demographic and occupational factors were performed. A predefined subgroup analysis was conducted among night-shift workers (n = 113). Results: IT workers were younger and reported poorer subjective sleep quality and more frequent insomnia symptoms compared with professional drivers. In contrast, moderate-to-high OSA risk was more prevalent among drivers. Excessive daytime sleepiness did not differ significantly between groups. In multivariable models, occupational group independently predicted poor sleep quality and insomnia, whereas age and body mass index were the strongest predictors of OSA risk. Conclusions: Sleep-related outcomes differ across occupational groups. Professional drivers appear more vulnerable to OSA-related risk, while IT workers experience a higher burden of insomnia and poor subjective sleep quality. Occupational context should be considered when designing sleep screening and prevention strategies.

Abstract Background Histologic activity has emerged as an aspirational therapeutic goal in IBD management. It is not yet a formal treatment-target in either CD or UC. However, it could be used as an adjunct to mucosal healing to represent a deeper level of healing. We investigated histologic remission (HR) rates and potential predictors of achieving histologic remission in a prospective IBD cohort. Methods We conducted a retrospective subgroup analysis of data collected from IBD patients enrolled in an ongoing prospective cohort study. Clinical, biological, endoscopic data (including the Mayo endoscopic subscore and SES-CD score) and histopathology results were available at multiple time-points for the enrolled patients (annual visits). Mucosal healing (MH) was defined as SES-CD <3 or Mayo endoscopic score=0[i]. Results 219 patients (88 CD, 131 UC) were enrolled in our study and were prospectively followed for a median length of 2 years (range 0-5 years), totaling 452 study visits. MH was recorded for 51 (27 UC, 24 CD, 23,2%) patients at 76(16%) different study visits. Overall, only 35(15%) patients achieved HR. In the MH subgroup, histologic remission was achieved in 30(58%) patients. After logistic regression analysis, none of the investigated factors (diagnosis, disease fenotype, gender, smoking status, disease duration, ongoing biologic treatments,corticosteroids, C-reactive protein, SIBDQ score) was associated with histologic remission. Conclusion Mucosal healing and endoscopic remission rates are low in real-life settings. Frequently used patient and disease related factors, including mucosal healing are not reliable predictors for histologic remission. Well validated, reliable, and accepted measuring tool as well as predictor factors for this potential therapeutic target should be investigated in further studies. Reference: 1. Turner D, Ricciuto A, Lewis A, D’Amico F, Dhaliwal J, Griffiths AM, Bettenworth D, Sandborn WJ, Sands BE, Reinisch W, Schölmerich J, Bemelman W, Danese S, Mary JY, Rubin D, Colombel JF, Peyrin-Biroulet L, Dotan I, Abreu MT, Dignass A; International Organization for the Study of IBD. STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD. Gastroenterology. 2021 Apr;160(5):1570-1583. doi: 10.1053/j.gastro.2020.12.031. Epub 2021 Feb 19. PMID: 33359090. Conflict of interest: Bardasu, Sebastian: No conflict of interest Bengus, Andreea: No conflict of interest Voiosu, Andrei: No conflict of interest Voiosu, Theodor: No conflict of interest Mateescu, Radu Bogdan: No conflict of interest Mrs. State, Roxana Monica:

Histological healing is increasingly recognized as a sensitive marker of disease remission in ulcerative colitis (UC). However, the dynamics of mucosal T lymphocytes and proinflammatory cytokines during healing remain incompletely understood. In this paired, within-subject observational study (retrospective analysis of paired biopsies), colonic biopsy sets from 20 adult UC patients were analyzed during active inflammation and at a subsequent time point of histologic healing. Immunohistochemistry was performed for CD3, CD4, CD8, and IL-6. Lymphocyte densities were quantified in intraepithelial and lamina propria compartments, while IL-6 expression was scored semi-quantitatively. Histological activity was assessed using the Geboes score. Intraepithelial CD4+ T cells significantly decreased during histologic healing (mean 6.8 → 3.75 cells/100 epithelial cells, p < 0.05), whereas lamina propria CD4+ cells remained variably persistent, suggesting ongoing immune regulation. Intraepithelial CD8+ cells increased during remission, indicating a potential reparative or surveillance role. IL-6 expression markedly declined in epithelial and stromal compartments during healing, reflecting resolution of mucosal inflammation. Correlation analyses revealed enhanced coordination between CD4+ and CD8+ cells in the healing phase, consistent with immune homeostasis. Histologic healing in UC involves compartment-specific shifts in T lymphocyte populations and a marked reduction in IL-6 expression, reflecting coordinated immune regulation beyond clinical remission. These findings highlight the potential of combined cellular and cytokine biomarkers to monitor mucosal healing and guide immunomodulatory therapies.

Loss of skin elasticity and youthful appearance is closely linked to reduced hyaluronic acid (HA) levels in the dermis. While topical HA products offer temporary effects, they do not address the root cause of HA depletion. The present study aims to describe how to induce HA synthesis through fibroblast stimulation. Twelve sows were divided into two groups. One group (n = 9) received four consecutive Radiofrequency (RF) and Targeted Ultrasound (TUS) treatments, the other group (n = 3) received four RF treatments only. Samples were collected via punch biopsy from the treated area of each animal at the baseline, 1-month, and 2-month follow-up. Samples were then processed and prepared for enzyme-linked immunosorbent assay as well as hyaluronic acid binding protein with diaminobenzidine (HABP-DAP) staining, which allows for visualization of HA within tissue. The group receiving RF + TUS treatment has demonstrated an increase from an average of 83.0µg/g at the baseline to 163.0µg/g at the 2-month follow-up of HA concentration in the skin. Histology samples clearly demonstrate higher tissue density with an increase of brown pigment due to the HABP-DAP stain, representing HA in the skin. In comparison, the RF standalone treatment group has shown no significant increase in HA concentrations. Study results show no significant increase in HA production following the RF stand alone treatment. Whereas the RF + TUS treatment group induced a significant HA production response as well as histophysiological changes in the dermis.

Ageing is sustained by a complex network of cellular and molecular mechanisms. The main mechanisms are cellular senescence, telomere attrition, gene expression changes, metabolic dysregulations, oxidative stress and epigenetic modifications such as DNA methylation. All these networks can harbor the initiation of age-related diseases, skin cancer included. The studies published in the last years linking ageing and skin cancers focus on basal and squamous carcinomas, melanomas and Merkel cell carcinomas. Our review will focus on skin melanomas as one of the aggressive skin cancers along with Merkel cell carcinomas. Several long-term studies conducted on large populations have shown that in elderly individuals melanoma related to photo-exposure has doubled in the last decade. The clinic-pathological pattern of skin melanomas is different in aged patients and is guided also by immune-related mechanisms. Besides sun exposure, metabolic deregulations and obesity can be risk factors in melanomas. Controversial results were published on obesity risk in melanomas; however, the adipose tissue favors increased cytokines and growth factors production contributing to melanoma aggressiveness. Moreover, immunotherapy that is not offered in geriatric patients as often as in young ones has proven to be as efficient as in younger ones, although the aged-related co-morbidities can impede the immunotherapy choice. Without being exhaustive, our review has synthesized current research and critically assessed the links between aging as a normal physiological process to the initiation and propagation of skin cancers, focusing on cutaneous melanoma. The review highlights the differences at various levels of skin melanoma developed in aged patients compared to younger one and gives the general outlines for diagnosis, prognosis and therapeutical approaches in aged patients.

Background: Traditional tumor markers used in testicular cancer diagnosis, such as alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (hCG), and lactate dehydrogenase (LDH), present limitations due to variable expression across tumor subtypes. Inflammatory markers derived from complete blood count (CBC), along with C-reactive protein (CRP), have emerged as potential adjuncts for diagnosis and prognosis. This study aimed to evaluate the diagnostic and prognostic utility of CBC-derived inflammatory indices and CRP in patients with testicular cancer. Methods: We retrospectively analyzed testicular cancer patients, assessing baseline CBC parameters, inflammatory ratios (including neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], and systemic immune-inflammation index [SII]), and CRP levels. Their diagnostic accuracy was compared with classical tumor markers, while prognostic implications were assessed through survival outcomes and disease progression. Results: Inflammatory markers, particularly NLR and SII, demonstrated significant associations with tumor burden and advanced disease stage. Elevated CRP levels correlated with poorer prognostic features and worse outcomes. While classical tumor markers remained essential in diagnosis and staging, the integration of inflammatory indices provided additional discriminatory power, especially in patients with normal or equivocal AFP and hCG values. Conclusions: CBC-derived inflammatory markers and CRP represent promising, cost-effective, and easily accessible tools that complement classical tumor markers in testicular cancer. They offer both diagnostic and prognostic value, particularly in cases where traditional biomarkers are insufficient. Prospective multicenter studies are warranted to validate these findings and incorporate inflammatory indices into routine clinical algorithms for testicular cancer management.

Chronic cervical radiculopathy (CR) is a common cause of pain and disability in adults. The primary objective of our study was to evaluate the efficacy of a structured, multimodal rehabilitation program, with or without adjunct neurotrophic supplementation, in chronic cervical radiculopathy; secondarily, this study investigates which patients are most likely to benefit from neurotrophic supplementation and aims to assess effects on pain, cervical mobility, disability, and daily activities to guide individualized care. Patients and Methods: In this prospective, randomized controlled trial, 82 patients with chronic CR were allocated to a study group (SG, n = 42) receiving a three-month multimodal rehabilitation program plus daily neurotrophic supplementation (named PHSD) or a control group (CG, n = 40) receiving the same rehabilitation alone. Outcome measures included the Visual Analogue Scale (VAS), Neck Disability Index (NDI), cervical mobility indexes (CSI—Chin-Sternum Index; OWI—Occiput-Wall Index; TAI—Tragus-Acromion Index), and Katz ADL (Activity of Daily Living) Index, assessed at baseline and after three months. Results: Both groups showed significant improvements, but the SG demonstrated greater reductions in pain (median VAS change: 8.16 ± 0.72 vs. 5.11 ± 0.70, p < 0.001) and disability (mean NDI change: 24.71 ± 5.13 vs. 20.90 ± 4.49, p < 0.001). Cervical mobility indexes improved in both groups, with larger gains in the SG (p < 0.01), supporting the potential benefits of adding neurotrophic supplementation. Conclusions: A structured multimodal rehabilitation program significantly improves pain, mobility, and disability in chronic CR, while combining it with PHSD may enhance these effects. Further randomized trials are needed to confirm these findings and establish standardized conservative treatment protocols.

Long COVID is frequently associated with emotional disturbances such as anxiety and depression, which may persist beyond the acute phase and significantly affect quality of life and social reintegration. This retrospective study aimed to investigate the effect of a structured physical therapy program on anxiety and depression symptoms in long COVID patients referred to the Colentina Rehabilitation Department. Thirty-three patients were enrolled and completed ten sessions of kinesiotherapy; high-intensity laser therapy was added in cases with musculoskeletal comorbidities. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS), corroborated by clinical interview and patient-reported perception, at admission, discharge, and one month post-discharge. At baseline, all patients exhibited anxiety symptoms and 24 showed signs of depression, mostly in the mild-to-moderate range. By discharge, a significant improvement was observed in both dimensions, with continued progress at one-month follow-up. Statistical analysis revealed significant differences between the three evaluations. Improvements in anxiety and depression scores were positively correlated with enhanced 6-Minute Walk Test (6MWT) performance. Moreover, depression scores were positively associated with elevated blood glucose levels, while anxiety scores demonstrated a negative correlation with serum 25-hydroxy vitamin D. These correlations emphasize the complex interplay between emotional, physical, and metabolic factors in long COVID recovery and highlight the multidimensional benefits of rehabilitation.

<bold>Introduction:</bold> Data on pulmonary involvement in primary Sjögren's syndrome (pSS) is limited. Interstitial lung disease (ILD) is the main manifestation with various subtypes and variable pulmonary function tests (PFTs) alterations. <bold>Objective:</bold> To characterize pSS subjects with respiratory involvement by clinical, functional and imaging patterns. <bold>Methods:</bold> We reviewed pSS subjects who underwent PFTs in our clinic over the past three years. Pneumology referrals were based on clinical and radiological abnormalities rather than routine evaluationat diagnosis. <bold>Results:</bold> The cohort included 22 subjects, with mean age of 52 and a disease mean duration of 8.3 years. 5 of them had an overlap syndrome, 4 were females, and 5 were smokers. 13 subjects underwent a six-minute walk test (6MWT), 7 exhibiting desaturation. Spirometry indentified 6 cases of restrictive, 1 obstructive and 2 mixed dysfunctions. TLCO was reduced in 13 subjects, 4 of whom had pulmonary hypertension. Among 14 subjects with PFTs reevaluation, 6 showed FVC and TLCO decline, while 7 had TLCO improvement with treatment (mainly micophenolate mofetil and systemic corticosteroids). Only 15 subjects exhibited definite CT patterns most common non-specific interstitial pneumonia (NSIP), less common LIP and UIP. Low PFT values correlated with clinical symptoms, 6MWT desaturation and imagistic ILD patterns. AntiRo antibodies showed no correlation with TLCO reduction or imagistic findings. <bold>Conclusions:</bold> This retrospective study highlights the heterogeneous lung involvement and PFT dynamics in pSS patients under different treatment regimens. DLCO seems to be more sensitive in sensing pulmonary disfunction.