Landscape of Innovative Methods for Early Diagnosis of Gastric Cancer: A Systematic Review.

From a global perspective, gastric cancer (GC) persists as a significant healthcare issue. In the Western world, the majority of cases are discovered at late stages, when the treatment is generally unsuccessful. There are no organized screening programs outside of Asia (Japan and Republic of Korea). Traditional diagnosis techniques (such as upper endoscopy), conventional tumor markers (CEA, CA19-9, and CA72-4), radiographic imaging, and CT scanning all have drawbacks. The gold standard for the earliest detection of cancer and related premalignant lesions is still endoscopy with a proper biopsy follow-up. Since there are currently no clinically approved biomarkers for the early diagnosis of GC, the identification of non-invasive biomarkers is expected to help improve the prognosis and survival rate of these patients. The search for new screening biomarkers is currently underway. These include genetic biomarkers, such as circulating tumor cells, microRNAs, and exosomes, as well as metabolic biomarkers obtained from biofluids. Meanwhile, cutting-edge high-resolution endoscopic technologies are demonstrating promising outcomes in the visual diagnosis of mucosal lesions with the aid of linked color imaging and machine learning models. Following the PRISMA guidelines, this study examined the articles in databases such as PubMed, resulting in 167 included articles. This review discusses the currently available and emerging methods for diagnosing GC early on, as well as new developments in the endoscopic detection of early lesions of the stomach.

Covid-19 and Its Impact on Colorectal Cancer Diagnosis in Romania: A Single-Centered 5-year Retrospective Cohort Study.

Background: Colorectal cancer, 3rd in incidence and 2nd in mortality among cancers worldwide, represents the most common malignant tumor of the digestive tract. In Romania, it is the most frequently diagnosed type of cancer (approximately 0.06% of the population/year). During the COVID-19 pandemic the legislation preventing the SARS-CoV-2 viral transmission impairing access to outpatient healthcare services combined with patients fear of SARS-CoV-2 infection had consequences on the diagnosis and treatment of all other pathologies. Methods: A 5-year retrospective cohort study was conducted in a tertiary hospital in Arad, Romania, and included 1329 newly diagnosed colorectal cancer patients. For statistical analysis, Fisher's exact test was used for categorical data and the unpaired test with Welch's correction for continuous data. Results: The age on diagnosis decreased during the early COVID-19 pandemic to 68.50 (95% CI [67.90 69.11]) years, with the highest percentage (7.41%) of early onset colorectal cancer patients, a steady post-pandemic increase in the percentage of male (52.71% in 2019 to 62.20% in 2022) and urban (54.18% in 2018 to 70.10% in 2022) patients, admitted to the hospital due to an emergency presentation (peaking at 83.95% in 2020) and requiring a longer hospitalization period (10.03 [95% CI (8.76-11.30)] days in 2020 to 8.37 [95% CI (7.44-9.30)] days in 2022). The most common colo-rectal cancer diagnosis of patients in our reference population was malignant neoplasm of the rectum (ICD-10 code C20.0), while the most common complications were peritumoral adherence-related disorder, occlusion, and perforation, encountered in patients with comorbidities such as arterial hypertension, ischemic cardiomyopathy, diabetes mellitus, obesity, and non-alcoholic steatohepatitis. Conclusions: Regional particularities should be analyzed to better target the population at risk and to better direct the necessary healthcare resources towards the reference population, especially during crisis periods similar to the COVID-19 pandemic.

Study for Evaluation of Hydrogels after the Incorporation of Liposomes Embedded with Caffeic Acid.

Caffeic acid (CA), a phenolic acid, is a powerful antioxidant with proven effectiveness. CA instability gives it limited use, so encapsulation in polymeric nanomaterials has been used to solve the problem but also to obtain topical hydrogel formulas. Two different formulas of caffeic acid liposomes were incorporated into three different formulas of carbopol-based hydrogels. A Franz diffusion cell system was used to evaluate the release of CA from hydrogels. For the viscoelastic measurements of the hydrogels, the equilibrium flow test was used. The dynamic tests were examined at rest by three oscillating tests: the amplitude test, the frequency test and the flow and recovery test. These carbopol gels have a high elasticity at flow stress even at very low polymer concentrations. In the analysis of the texture, the increase of the polymer concentration from 0.5% to 1% determined a linear increase of the values of the textural parameters for hydrogels. The textural properties of 1% carbopol-based hydrogels were slightly affected by the addition of liposomal vesicle dispersion and the firmness and shear work increased with increasing carbomer concentration.

Primary malignant melanoma of the bladder - case report and literature overview.

Malignant melanoma is one of the common skin cancers but as a primary cancer localized in urinary bladder is a very rare clinical entity, 0.2% of all melanomas. We report the very rare case of primary malignant melanoma of the bladder in an 80-year-old man. According with our knowledge is the first case of primary malignant melanoma reported in Romania. Only a few percent of malignant melanoma have origin outside the skin. Less than 30 cases of primary bladder melanoma have been reported in the literature. The most common metastasis in urinary bladder comes from breast carcinoma and skin melanoma The tissue examination presents the same futures does not matter if is a primary or secondary malignant melanoma. The ancillary tests like immunohistochemistry help us to do an accurate diagnostic but to discriminate primary vs. metastatic tumor remain an important issue. Usually, the bladder melanoma has an aggressive lethal behavior. Histopathological examination, immunohistochemistry, clinical history, and endoscopic evaluation can provide certain diagnostic features.

What antibiotics for what pathogens? The sensitivity spectrum of isolated strains in an intensive care unit.

Antibiotic sensitivity spectrum of isolated strains differs according to hospital departments, the hospitals themselves, and countries. Discrepancies also exist in terms of antibiotic use and dosage. The aim of the present study is to compare the antibacterial agents, the types of infections, the number and type of pathogens, and the sensitivity to antibiotics used in the Intensive Care Unit (ICU) of the Emergency Clinical County Hospital of Oradea, Romania. Over a one-year period, data were gathered from the pharmacy computer system and medical records of inpatients. WHO Anatomical Therapeutic Chemical (ATC)/defined daily doses (DDD) methodology was used to assess drug administration data, and antibiotic use was expressed as DDD/1000 PD (patient days). The antibiotic susceptibility of isolated strains was expressed through the cumulative antibiogram. The overall consumption of antimicrobial agents was 1247.47 DDD/1000 PD. The most common drugs used were cephalosporins and fluoroquinolones (52.97% of the total). Ceftriaxone was the most commonly used, followed by levofloxacin. Infections of the respiratory and urinary tract were the most frequently diagnosed infections. The most commonly isolated bacteria type was Acinetobacter baumannii (22.12% overall), isolated especially from the respiratory tract and resistant to all the ß-lactam antibiotics including carbapenems. Antimicrobials intake at the ICU is much higher compared to medical and surgical wards. After we tested the existence of a possible connection between antibiotic consumption and antibiotic resistance of bacteria, it was revealed that on our sample exists a poor positive association.

Clinical, surgical and morphological assessment of the pyeloureteral syndrome.

Obstruction of the pyeloureteral junction (PUJ) is by far the most common cause of hydronephrosis in children, with an incidence of one in 1000-2000 newborns. Also, the obstruction of the PUJ is the most common cause of prenatal hydronephrosis, accounting for 80% of the cases. The aim of this study is to observe and discuss first the efficacy of described surgery procedures and second the microscopic modifications of the PUJ (abnormalities of smooth muscle tissue, inflammation and fibrosis). One hundred and eleven children with a diverse urological pathology with an average age of 11.57 years were operated between 2011 and 2015 in Urology Clinic of Oradea, Romania. Of these, 20 children (11 boys and nine girls) with congenital hydronephrosis by junction syndrome required surgical correction. The surgical techniques used were Anderson-Hynes dismembered pyeloplasty, non-dismembered Scardino procedure and the Hellström procedure. Operator interventions were performed by subcostal lombotomy with or without partial XII rib resection. The average operator time was between 40 and 50 minutes. None of the patients required blood transfusions. Average hospitalization was seven days. All patients were monitored through the Ambulatory Pediatric and Urological Service. Anderson-Hynes operation is the main procedure to solve the obstructive syndromes of the PUJ. It can be performed without stentings of the ureter as originally described by the author, but also by protecting anastomosis with a urinary diversion, such as JJ catheter, ureteronephrostomy or ureteropyelostomy. Even though clinical and imaging studies are sufficient for diagnose of PUJ syndromes, morphology and histology bring essential data regarding the age of the lesions.