Management of thyroiditis in the context of Covid-19: cause-effect and beyond.

Background: The COVID-19 pandemic hit the world in late 2019, and by 2020, everyone was affected. Severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) belongs to the beta-coronavirus genre and uses the angiotensin-converting enzyme 2 (ACE2) receptor to penetrate cells. Thyroid cells are rich in such receptors. Therefore, this gland is frequently involved alongside other organs in the COVID-19 disease. Aim: To describe COVID-19 inflammation and, eventually, dysregulations of normal thyroid function in a case series of patients diagnosed in a tertiary endocrinology care centre. Patients and Methods: We described subacute thyroiditis cases related to COVID-19 infection or vaccination against SARS-CoV2 infection (clinical manifestations and evolution). We also reviewed the literature data regarding COVID-19 infection or vaccination implications in thyroid pathology. Results: The literature describes two types of thyroid involvement in SARS-CoV2 infection or vaccination: subacute thyroiditis (SAT) and non-thyroidal illness syndrome (NTIS). In our case series, 5 patients (3 males), aged 41-54 years, developed the classical clinical manifestation of SAT related to COVID-19 infection (3 patients, concomitantly to upper respiratory infection or a few weeks apart) or anti-SARS-CoV2 ARNm vaccination (1-2 weeks after the vaccine administration). Clinical, laboratory and imaging findings and the evolution (steroid anti-inflammatory treatment used in 4/5 cases) were unremarkable compared to other SAT etiologies. Conclusion: We found no differences between the "typical" viral and post-COVID-19 SAT regarding clinical presentation, severity, response to treatment, and thyroid function alteration. The only remarkable difference is the association of SAT with anti-SARS-CoV2 ARNm vaccination.

Circle of Willis: anatomical variations of configuration. A magnetic resonance angiography study.

BACKGROUND: The main scope of this paper is to investigate the prevalence of the anatomical variants of the circle of Willis (CoW) in the Romanian population through magnetic resonance angiography. MATERIALS AND METHODS: Magnetic resonance angiography images were obtained for 126 individuals and the configurations of the anterior and posterior CoW were identified, and classified. The prevalence of each variant and the number of complete anterior or posterior parts of the circle were determined. RESULTS: A classical configuration of the CoW was found in 39 (30.9%) cases. The most common posterior variation was the unilateral absence of a posterior communicating artery (n = 28) while in the anterior circle it was the unilateral absence of the precommunicating segment of an anterior cerebral artery (n = 17). A complete entire CoW was found in 63 cases, while the anterior and posterior parts yielded complete configurations in 108 and 73 cases, respectively. Eight cases did not present complete configurations. A foetal posterior communicating artery was identified unilaterally in 14 cases and bilaterally in 6 cases. CONCLUSIONS: Unilateral variations were the most common changes found in CoW configuration. The correct assessment of the CoW configuration may prove useful in the planning and follow-up of brain surgery and interventional procedures, as well as in estimating the prognosis of patients suffering from stroke or other related cerebral vascular events.

Altered shapes, same people: Scaphocephaly in the early modern Bucharest.

Premature sagittal suture synostosis was identified in eight specimens dated between the 18th and 20th centuries CE, of which seven are kept within the Rainer Osteological Collection in Bucharest and one was retrieved from the archaeologically investigated Saint Sava Church Cemetery. Our study focused on metric measurements, aiming to compare these specimens with three other samples comprising normal and scaphocephalic individuals, with both a Romanian and worldwide distribution. In total, 374 individuals were used in this study. However, although metric measurements clearly show that these individuals were different in their appearance, the socio-cultural data point to them being normal members of the society, as suggested by the funerary features of the archaeological specimens and their position within the Rainer Osteological Collection.