Assessment of STI screening in Romania using a multiplex PCR technique.

INTRODUCTION: Most sexually transmitted infections (STIs) are curable, but inappropriate treatment can lead to serious complications. The importance of setting up STI screening programs has been highlighted in various studies, the absence of such national programs accounting for the lack of STI statistics in Romania. The purpose of our study was to evaluate multiplex PCR as a screening method for the most common 6 STIs and establish their frequency in a group of symptomatic and asymptomatic patients. We aimed to highlight STI associations and correlations between STI pathogens and symptomatology, demographic status, antecedents or sexual partners. METHODOLOGY: A total of 249 patients, both symptomatic and asymptomatic, were included in this study. Chlamydia trachomatis (CT), Neisseia gonorrhoeae (NG), Trichomonas vaginalis (TV), Ureaplasma urealyticum (UU), Mycoplasma hominis (MH) and Mycoplasma genitalium (MG) were all identified in urine samples via multiplex Polymerase Chain Reaction (PCR). The SPSS IBM program was employed for statistical analysis. RESULTS: 32.12% of the patients were found positive, some presenting multiple infections. The results are representative for the Romanian male population. 107 STI pathogens were identified, most frequent being CT, UU and NG. Several statistical correlations between patient characteristics and the presence of STIs have been demonstrated. CONCLUSIONS: The results suggest that multiplex PCR meets all the prerequisites for a screening method, allowing the use of multiple specimens and enabling simultaneous detection of multiple pathogens in a short period of time. STI identification via multiplex PCR proved to be an effective method for quantifying their frequency in Romania.

High-frequency ultrasonography of psoriatic skin: A non-invasive technique in the evaluation of the entire skin of patients with psoriasis: A pilot study.

Psoriasis is a chronic, systemic, inflammatory disorder which accelerates the life process of skin cells, based on a genetically induced deviant immune response. High-frequency ultrasonography (HF-USG) is a painless, non-invasive imaging technique that can be performed and repeated whenever the need arises. We evaluated lesional and non-lesional skin of psoriatic patients with the use of HF-USG, focusing on the immune-induced inflammation and skin thickness. Previous studies suggested that HF-USG, being a non-invasive technique, is useful as an aid to clinical evaluation of the severity of psoriatic plaques. Our goal was to determine whether the skin of psoriatic patients is influenced by the background or habits of the patients. The study included a total of 27 patients affected by psoriasis vulgaris. The thickness of the epidermis and dermis and the skin echogenicity were documented for the active plaques, as well as for the non-affected skin of all the patients included in the study, using a high-frequency ultrasonographic system. The patient's local background, sex, family history of psoriasis, smoking habits and sun exposure were analyzed. HF-USG of the psoriatic plaques exposes a three-band structure that is easily distinguished from the surrounding unaffected skin, due to a hypoechoic band in the upper dermis. Although not specific for psoriasis, it is a strong marker of inflammation. The obtained results confirm that, indeed, skin thickness is greater in lesional skin compared to non-lesional skin, by a mean of 1,180 µm (±340 µm). We consider that skin HF-USG should be used as a quantitative method in the clinical evaluation of the patients with psoriasis and may help as an objective means of assessing inflammation in lesional skin.

Combined effect of propranolol, vincristine and bevacizumab on HUVECs and BJ cells.

Infantile hemangioma is one of the most common benign tumors affecting children, with ~10-15% requiring medical treatment. These tumors consist of endothelial cells and stromal components, including fibroblasts, pericytes and mast cells. Effects of propranolol treatment in combination with bevacizumab or vincristine on cell growth were compared in the current study using human umbilical vein endothelial cells (HUVECs) and BJ human normal fibroblasts (BJs) to determine potential synergic effects in vitro. Inhibition of cell growth was investigated using MTT assays and cytotoxicity of the drugs in various combinations was expressed as half inhibitory concentration (IC50). Apoptosis was investigated using flow cytometry, with Alexa Fluor 488 and propidium iodide. Propranolol inhibited BJ and HUVEC growth in a dose-dependent manner, with increased response observed in BJs (IC50, 148,32 µg/ml; standard error logIC50, 0.07). Treatment with vincristine induced the strongest growth inhibition in HUVECs (IC50, 17,89 µg/ml; standard error log IC50, 0.07) and BJs (IC50, 24,81 µg/ml; standard error log IC50, 0.08) compared with propranolol (HUVEC IC50, 81,94 µg/ml; standard error log IC50, 0.06; BJ-IC50, 148,32 µg/ml; standard error logIC50, 0.07) or bevacizumab (HUVEC IC50 96,91 µg/ml; standard error log IC50, 0.06; BJ IC50, 182,70 µg/ml; standard error log IC50, 0.09) alone. Bevacizumab was the weakest cytotoxic agent. Combination treatment of vincristine with bevacizumab induced the highest levels of apoptosis in HUVECs compared with all other treatments and triple-drug therapy induced the levels of apoptosis in BJs. Single treatment with vincristine, propranolol or bevacizumab induced apoptosis in BJs and HUVECs. In BJs, triple treatment exhibited the greatest influence on apoptosis, compared with single and dual treatments and in HUVECs, vincristine and bevacizumab combination treatment induced apoptosis to the highest level. The present study offers novel perspectives in drug repurposing studies for the three drugs, particularly in diseases where the pathogenesis is based on healthy endothelial cell proliferation, including hemangiomas.

Infantile hemangiomas: a 7-year experience of a single-center.

OBJECTIVES: The aim of the study was to describe the historical and clinical characteristics of hemangiomas in a series of cases of our clinic. METHODS: This is a retrospective study of 36 patients with infantile hemangiomas consulted in our clinic. RESULTS: We had 14 multiple hemangiomas, and 1 kaposiform hemangioendothelioma. Almost two-thirds involved the cephalic extremity, and 76% of the cases were treated. Pregnancy risk factors included prematurity, low-birth weight and respiratory distress syndrome. Propranolol was used in 22 cases, followed by prednisone in 3 cases. Vincristine and interferon were used as associated therapies or as second line therapies. Two hemangiomas had complications, one ulceration and a Kasabach-Merritt syndrome. All the patients had a good evolution. CONCLUSIONS: Our study results regarding the involvement of pregnancy and birth risk factors in developing infantile hemangiomas is similar to literature data. The majority of patients had at least one risk factor suggesting that at least one trigger to develop an infantile hemangioma is necessary. Our study shows that the cephalic extremity is mostly involved, and because of its potential complications they are most likely to be treated. The study shows that propranolol is the leading treatment option with few and mild side effects.

The history of an unknown dermatological wax collection from Cluj-Napoca University "Iuliu Hatieganu", Romania.

Among the dermatological wax collections across Europe, one of the latest created is the collection from Cluj-Napoca University, Romania. The initiator was Professor Coriolan Tataru and the moulage artist employed was Dr. Richard Hoffmann. Between the years 1923 and 1928, around 200 wax moulages were made, all realised after patients hospitalised in the clinic. The majority of cases represent the dermatological infectious pathology of that time: syphilis, cutaneous tuberculosis and mycetomas. Other interesting moulages represent genodermatoses, pelagra, different cutaneous cancers, and atypical aspects of common diseases like psoriasis and eczemas. The models depicting different stages of syphilis won the gold medal at the Ninth International Congress of Dermato-Venereology held in Budapest in 1935. We believe that the collection has a great value from a historical, artistic, didactic and scientific point of view, and it is organised as a museum within the Dermatology Clinic.

VEGF involvement in psoriasis.

Vascular endothelial growth factor (VEGF) is a key growth factor, regulating the neovascularization, during embryogenesis, skeletal growth, reproductive functions and pathological processes. The VEGF receptors (VEGFR) are present in endothelial cells and other cell types, such as vascular smooth muscle cells, hematopoietic stem cells, monocytes, neurons, macrophages, and platelets. Angiogenesis is initiated by the activation of vascular endothelial cells through several factors. The excess dermal vascularity and VEGF production are markers of psoriasis. The pathological role of VEGF/VEGFR signaling during the psoriasis onset and evolution makes it a promising target for the treatment of psoriasis. Antibodies and other types of molecules targeting the VEGF pathway are currently evaluated in arresting the evolution of psoriasis.

Infantile Hemangioma: A Brief Review.

Infantile hemangiomas as frequent infancy tumors have been a controversial issue of medical scientists worldwide. Their clinical aspects are various and their physiopathology is yet to be fully understood. Numerous publications outline the characteristics, causes, evolution possibilities and therapeutic approaches. Deciding whether to treat or not is the main question of this kind of pathology. Hemangiomas that have complications or can cause irreversible damage need therapy. This is a brief review of up-to-date information regarding the presentation of infantile hemangiomas and target-therapies.