Identification of Predictive Factors for Pathologic Complete Response in Rectal Cancer Patients Undergoing Neoadjuvant Treatment: A Retrospective Study.

Background: Colorectal cancer is a serious illness, with rectal cancer accounting for thirty percent of all cases. For patients diagnosed with rectal cancer, neoadjuvant downstaging chemoradiotherapy is often necessary due to advanced disease at presentation. However, for certain patients, neoadjuvant chemotherapy can result in a complete response, leading to the possibility of overtreatment during subsequent definitive surgery. Methods: In order to identify predictors for clinical or pathologic complete response, we conducted a retrospective study on 231 patients diagnosed with locally advanced rectal cancer who underwent neoadjuvant treatment. Results: Our results indicate that tumor characteristics remain the primary predictive factors for treatment response in rectal cancer patients. Specifically, we found that a complete pathologic response was more likely in patients with stage I/II disease compared to stage III/IV. However, we did not identify any statistically significant associations between radiotherapy characteristics (such as fractionation, treatment technique or total dose) and complete response rates. Conclusions: In conclusion, our study highlights the importance of tumor stage in predicting pathologic complete response following neoadjuvant chemoradiotherapy for rectal cancer patients. Other clinical and pathologic factors, such as tumor size, may also be important predictors of treatment response and should be explored in future studies.

Specific Septic Complications after Rectal Cancer Surgery: A Critical Multicentre Study.

The postoperative septic complications in gastrointestinal surgery impact immediate as well as long-term outcomes, which lead to reinterventions and additional costs. The authors presented the experience of three surgery clinics in Romania regarding the specific septic complications occurring in patients operated on for rectal cancer. The study group comprised 2674 patients who underwent surgery over a 5-year period (2017-2021). Neoplasms of the middle and lower rectum (76%) were the majority. There were 85% rectal resections and 15% abdominoperineal excisions of the rectum. In total, 68.54% of patients were operated on laparoscopically, and 31.46% received open surgery. Without taking wound infections into account, 97 (3.67%) patients had abdominal-pelvic septic complications. The aim was to evaluate the causes of the complications. The percentage of suppurations after surgery of the rectum treated by radiochemotherapy was considerably higher than after surgery of the non-radiated upper rectum. The fatality rate was 5.15%. The risk of fistulas was significantly associated with the preoperative treatment, tumour position and type of intervention. Sex, age, TNM stage or grade were not significant at 0.05 the threshold. The risk of fistulas is reduced with low anterior resection, but the gravity of these complications is higher in the lower rectum compared with the superior rectum. Preoperative radiochemotherapy is a contributing factor to septic complications.

Death by SARS-CoV 2: a Romanian COVID-19 multi-centre comorbidity study.

Evidence regarding the relation between SARS-CoV-2 mortality and the underlying medical condition is scarce. We conducted an observational, retrospective study based on Romanian official data about location, age, gender and comorbidities for COVID-19 fatalities. Our findings indicate that males, hypertension, diabetes, obesity and chronic kidney disease were most frequent in the COVID-19 fatalities, that the burden of disease was low, and that the prognosis for 1-year survival probability was high in the sample. Evidence shows that age-dependent pairs of comorbidities could be a negative prognosis factor for the severity of disease for the SARS-CoV 2 infection.

Burden of influenza in Romania. A retrospective analysis of 2014/15 - 2018/19 seasons in Romania.

INTRODUCTION: Influenza is a seasonal epidemic with a heavy negative impact both on population health, and healthcare system utilization; until now, there are only two burden of disease studies in the Romanian context. This study aims to quantify the burden of influenza for the Romanian population for the seasons 2014/15 to 2018/19, using health administrative databases. METHODS: Incidence, hospitalization and mortality rates attributable to influenza as well as total number of influenza cases and deaths were estimated, for each season in the analyzed period, by combining the new cases reported by General Practitioners, Emergency Department presentations, hospitalizations, number of deaths, positivity rate of influenza, and probability to be consulted by a physician. Years of life lost due to premature death attributable to influenza complications were also computed. RESULTS: On average, 591,151 cases/season attributable to influenza were estimated during the period 2014/15 - 2018/19. The highest rates for incidence, hospitalization and presentation to emergency department were found in the age groups 0-4 years and 65 years and above. Influenza mortality rate was estimated at 3 per 100,000 persons and the 65 and above age group had the highest rate. CONCLUSIONS: About 3% of the total Romanian population is estimated to develop an influenza attributable disease in a non-pandemic season. An overall increasing trend of the mortality rate attributable to influenza may be also underlined. On average, a person loses 12 years due to premature death caused by complications of influenza.

Effect of religious rules on time of conception in Romania from 1905 to 2001.

STUDY QUESTION: Does the interdiction of sexual intercourse during Nativity and Lent fasting periods have any effect on when babies are conceived in Romania, in the 20th century? SUMMARY ANSWER: Based on date of birth records from the 20th century, Lent had a greater effect than the Nativity fast on conception within the Eastern Orthodox (ORTHD) population. WHAT IS KNOWN ALREADY: Seasonality of births (and therefore of conception) is affected by geographical factors (latitude, weather, day-length). Other demographic, economic and socio-cultural characteristics (education, ethnicity, religion) have been proved to have an influence on conception. STUDY DESIGN, SIZE, DURATION: The analyzed data consists of registered daily birth records for a long time series (35 429 points = 365 (days/year) × 97 years + 24 leap years), with 24 947 061 births in Romania over the period 1905-2001. The data were obtained from the 1992 and 2002 censuses. PARTICIPANTS/MATERIALS, SETTING, METHODS: Based on the reported birth date of each person, the estimated date of conception is computed using a standard gestation period of 280 days. The population was grouped into two categories (ORTHD and Non-Orthodox (NORTHD)) based on religious affiliation. Data analysis is performed in the same manner for both groups. Preliminary data analyses regarding seasonal variations in conception are considered first. Econometric models are applied and tested. The dependent variable in these models is the calculated date of conception, while the independent variables are: (i) religious affiliation; (ii) dates of Nativity and Lent fasts (the latter varies slightly from year to year); (iii) rural versus urban residence; (iv) length of day-light; (v) non-working days and (vi) trend. The models are tested for validity using analysis of variance while the regression coefficients are tested by the Student t-test. MAIN RESULTS AND THE ROLE OF CHANCE: All models are statistically valid (P < 0.01); all regression coefficients for the ORTHD group are valid (P < 0.01, except for rurality between 1990 and 2001, with P < 0.05). The data analysis indicates smaller standard error bars on the parameters for the ORTHD group as compared with the NORTHD group. The conclusion is that religious affiliation is an important factor in date of conception. LIMITATIONS, REASONS FOR CAUTION: The data do not refer to all births during the analyzed period, but only to those persons still alive at the 1992 and 2002 censuses. The date of conception was estimated assuming 280 days for gestation, which is a medically accepted time interval but will undoubtedly vary. However, the primary independent variables (Lent and Nativity fast at 48 and 40 days, respectively) are long enough to overlap the uncertainty in the conception date following the sexual intercourse event. We also must assume that the religious affiliation of the parents is well defined, based on the information given by their offspring at census time, and is the same for both parents. WIDER IMPLICATIONS OF THE FINDINGS: Our findings are consistent with other studies, which show differences between religious groups on date of conception, although we reach different conclusions regarding the influence of weather on fertility in Romania. STUDY FUNDING/COMPETING INTERESTS: B.V.I., M.A. and G.R. have no competing interests to declare. There is no connection to the current paper, but C.H. declares that (i) he is currently conducting a research titled 'Chronic Diseases' Direct Costs within the Romanian Health System' funded by Local American Working Group; (ii) his wife is employed to a Romanian company (A&D Pharma) that does business in the pharmaceutical sector. This paper is a part of G.R. and M.A. scientific activities in COST Action TD1210. This work by C.H. was co-financed by the European Social Fund through project number POSDRU/1.5/S/59184.