Assessing O.K.N.V.I. RESIST­5 performance for post­mortem biological samples: A prospective pilot study.

In recent years, the emergence of carbapenem-resistant strains has been increasing worldwide, including in Romania. Rapid tests for post-mortem examinations have been researched and currently have several applications. In the present study, we aimed to test the performance of O.K.N.V.I. RESIST-5 tests on impure post-mortem biological samples compared with a standard of pure cultures. When a death occurs during hospitalization and the issue of malpractice arises, the medico-legal practice would benefit from rapid tests applicable to post-mortem samples. Thus, detection and differentiation of the five targeted carbapenemases, namely oxacilinase-48, Klebsiella pneumoniae carbapenemase, New Delhi metallo-ß-lactamase, Verona integron-encoded metallo-ß-lactamase and imipenemase, could be useful in guiding sampling for third-party microbiological assessment and could also be an asset from an epidemiological standpoint. The present prospective and observational pilot study included medico-legal autopsy cases performed at Mina Minovici National Institute of Legal Medicine (Romania) between June and July 2022. A total of two sets of O.K.N.V.I. RESIST-5 tests were performed: Test I, which was performed on-site from biological samples obtained during autopsy; and Test II, which was performed on pure cultures after sample inoculation and incubation. Total of 39 O.K.N.V.I. RESIST-5 rapid tests were performed on 19 biological samples, at least one sample per case. The O.K.N.V.I. RESIST-5 tests performed on-site showed an overall sensitivity of 92.3% with a 100% specificity. The results obtained through rapid tests using post-mortem impure samples were comparable to the results obtained from sample cultures with good sensitivity and specificity. Through post-mortem screening for carbapenem resistance, it would be possible to narrow down the number of cases that require further bacteriological assessment.

Postmortem Bacteriology in Forensic Autopsies-A Single Center Retrospective Study in Romania.

Postmortem bacteriology examinations have been a controversial topic over the years, though the value of postmortem bacteriology cultures remains promising. The aim of this study was to review the postmortem bacteriological sampling procedures and results in a single centre in Bucharest over a period of 10 years. Material and methods: The present study was a retrospective, single-center study, performed at the Mina Minovici National Institute of Legal Medicine in Bucharest, Romania, from 2011-2020. Results: Postmortem bacteriology was requested 630 forensic autopsies, 245 female (38.9%) and 385 male (61.1%), age range 0 and 94 years, median age of 52 years. Deaths occurred in hospital for 594 cases (94.3%) and out-of-hospital for 36 cases (5.7%-field case). Blood cultures were requested in the majority of cases, followed by tracheal swabs and lung tissue. In-hospital and out of hospital deaths did not differ significantly regarding the number of microorganisms identified in a positive blood culture. Postmortem bacteriology cultures of the respiratory tract showed a statistically significant association to microscopically confirmed lung infections. Conclusions Postmortem sampling for bacteriology testing in our center in Bucharest is heterogeneous with a high variation of patterns. A positive blood culture result for Staphylococcus species without the identification of a specific microorganism is more likely due to postmortem contamination.

Ectopia lentis surgery in Marfan's syndrome: from "couching" to the use of intracapsular tension rings.

In the course of time, correction of the ectopia lentis in Marfan's syndrome has been approached through quite many surgical techniques. They addressed the iris, or the lens and aimed at increasing the aphakic zone, the opacification or removal of the lens. Although associated to many complications, the first techniques proved the courage and imagination of pioneer surgeons and are worth mentioning. They were steps towards the invention of current techniques and devices that make surgery of ectopia lentis safe, easy, and having a favorable prognosis.

Antimicrobial resistance trends - a single-center retrospective study of healthcare-associated pathogens - postmortem sampling from medico-legal autopsies in Bucharest.

Introduction: Healthcare-associated infections are a major concern for healthcare systems around the world. Microorganisms developing resistance to potent antibiotics are an urgent threat to public health. Methods: The present study is a retrospective, single-center study performed at the Mina Minovici National Institute of Legal Medicine, Bucharest, Romania, over a period of ten years (2011-2020). Autopsies for deaths occurring in the hospital setting for which postmortem bacteriological examination was solicited were screened and the recovered data consisted of demographics, hospital stay duration, autopsy data, and postmortem microbiology. Results: In the 516 autopsies recovered we found that carbapenemase-producing Enterobacteriaceae (CPE) isolates from postmortem bacteriology results increased in 2019. Positive postmortem microbiology results were associated with histological infection in over 80% of cases. Positive results for healthcare-related pathogens were associated with prolonged hospital stay. In our data vancomycin-resistant enterococci were isolated from 2015. Conclusions: Postmortem bacteriology results from medico-legal autopsies mirror antimicrobial resistance trends from hospital settings with several limitations due to the scarcity of solicitations.

Enhancing rotational stability of toric intraocular lenses using a type 2L Cionni capsular tension ring in patients with high myopia.

We present the technique used in a patient with high myopia to obtain rotational stability of a plate-haptic multifocal toric intraocular lens (IOL) (AT LISA tri toric 939MP). Both of the patient's eyes had long axial lengths and large capsular bags. The first operated eye experienced consecutive toric IOL malpositions. In the fellow eye, toric IOL alignment was preserved by implanting a type 2L Cionni capsular tension ring. This was reversely inserted so the two eyelets, which are positioned slightly anterior to the ring, pressed the IOL on the posterior capsule. This unsophisticated technical artifice provided rotational stability of the IOL, even at 12 months postoperatively.

Cardiac telocytes. From basic science to cardiac diseases. I. Atrial fibrillation.

INTRODUCTION: Atrial fibrillation (AF) is nowadays considered to be one of the most important causes of heart failure, stroke, cognitive decline, vascular dementia, sudden death and overall cardiovascular morbidity. Recently were published a few articles suggesting a possible involvement of telocytes in the development of atrial fibrillation. The purpose of this article is to analyze the results obtained in the field systematically, and to see if there is enough data to support a possible involvement of telocytes in arrhythmogenesis. MATERIALS AND METHODS: To this end, we performed a systematic review of the relevant scientific literature, indexed in PubMed, Web of Science, and Scopus. RESULTS AND DISCUSSIONS: Our systematic review of the published data identified five articles containing original data, based on which the association between telocytes and atrial fibrillation was inferred in later studies. We analyzed the usefulness of the information contained in the original articles to support this association, showing a lack of definite proofs correlating telocytes with atrial fibrillation. CONCLUSIONS: Even if a few articles implied a potential association between AF and telocytes, the current data is not enough to support it. Moreover, even an association between the morphology, characteristics, or density of the telocytes in the atrium/pulmonary veins and AF is potentially speculative, and more studies should be performed before implying it with a reasonable degree of certainty.

GSK-3 Inhibitors and Tooth Repair: An Ethical Analysis.

Tideglusib®, a GSK-3 inhibitor, was initially tested for the treatment of Alzheimer's disease. However, a recent report has suggested its potential off-label use for the treatment of dental cavities. Even if this effect is not yet confirmed, this off-label use can have significant public/dental health consequences, mainly because of the large number of patients with cavities. The purpose of this mini-review is to perform an ethical analysis of the use of Tideglusib in dentistry. The ethical analysis identified three main areas in which ethical breaches could be significant: 1) respect for the autonomy of the patient, 2) issues raised by horizontal shifts in the translational research process, and 3) the conflict between dental beneficence and general non-maleficence. In conclusion, the use of Tideglusib in dentistry should respect the same strict ethical and regulatory criteria from clinical medicine. A translation of the potential risks should be done only after large-scale, phase-III/IV clinical trials, explicitly designed to test the usefulness of this drug in dental medicine.