Vitamin D Levels in COVID-19 and NonCOVID-19 Pediatric Patients and Its Relationship with Clinical and Laboratory Characteristics.

25-hydroxyvitamin D [25(OH)D] is a marker with an important role in regulating the inflammatory response. Low concentrations of this vitamin are often found among the population, correlated with increased risk of respiratory tract infections. The aim of the study is to evaluate the relationship between vitamin D levels and clinical and laboratory markers in children and adolescents hospitalized with and without COVID-19. A retrospective study, including all patients tested for SARS-CoV-2 and having vitamin D measured, was performed. All included hospitalized cases, 78 COVID-19 patients and 162 NonCOVID-19 patients, were divided into subgroups according to their 25(OH)D serum levels (<20 ng/mL-deficiency, 20-30 ng/mL-insufficiency, ≥30 ng/mL-normal or <30 ng/mL, ≥30 ng/mL) and age (≤2 years, >2 years). Vitamin D deficiency and insufficiency increased with age, in both COVID-19 and NonCOVID-19 groups. All symptoms were encountered more frequently in cases of pediatric patients with COVID-19 in comparison with NonCOVID-19 cases. The most frequently encountered symptoms in the COVID-19 group were fever, loss of appetite, and nasal congestion. In the NonCOVID-19 group, serum 25(OH)D concentrations were positively correlated with leukocytes, lymphocytes, and LMR and negatively correlated with neutrophils, NLR, and PLR while no significant correlation was observed in the case of COVID-19 group. Differences between vitamin D status and clinical and laboratory parameters were observed, but their clinical significance should be interpreted with caution. The results of this study may offer further support for future studies exploring the mechanisms of the relationship between vitamin D and clinical and laboratory markers as well as for studies investigating the implications of vitamin D deficiency/supplementation on overall health/clinical outcomes of patients with/without COVID-19.

Lumbar Paravertebral Muscle Pain Management Using Kinesitherapy and Electrotherapeutic Modalities.

BACKGROUND: Low back pain is considered a public health problem internationally. Low back pain is a cause of disability that occurs in adolescents and causes negative effects in adults as well. The work environment and physical and psychosocial factors can influence the occurrence and evolution of low back pain. METHODS: The purpose of this paper is to highlight the physiological and functional changes in young adults with painful conditions of the lumbar spine, after using exercise therapy. The study was of the longitudinal type and was carried out over a period 6 months in an outpatient setting. The rehabilitation treatment included electrotherapeutic modalities and kinesitherapy. RESULTS: The results obtained when evaluating each parameter, for all moments, show statistically significant values in both groups. The results obtained regarding the relationship between the therapeutic modalities specific to rehabilitation medicine and low back pain are consistent with those reported in studies. CONCLUSIONS: Depending on the clinical-functional status of each patient, kinesitherapy can accelerate the heart rate and increase the blood pressure and oxygen saturation of the arterial blood, values that can later return to their initial levels, especially through training.

Severe Acute Ischemia of Glans Penis after Achieving Treatment with Only Hyperbaric Oxygen Therapy: A Rare Case Report and Systematic Literature Review.

Acute ischemia of the glands is a severe complication after circumcision. We outline the challenging case of a seventeen-year-old boy with glandular ischemia (GI) that appeared shortly after circumcision. Methods: We present a case report and literature review related to glans ischemia, and the complications of circumcision are reviewed. We note that there are very few cases described in the literature. Our patient was successfully treated with hyperbaric oxygen therapy (HBOT) after four days of no positive effect after all medical and surgical treatments written in the literature: Subcutaneous enoxaparin, local application of a glyceryl trinitrate, continuous epidural perfusion, intravenous pentoxifylline, alprostadil, intraoperative drainage, and aspiration with saline solution and epinephrine. Clinical improvement was noted at the first session of HBOT. A number of days after the operation, the penis looked normal and was healing. Complete healing of the penile glans was successfully realized one month after surgery. Conclusion: Based on the review and the case presented, we conclude that HBOT is the treatment of choice for acute ischemia of the penile glans, especially when other treatments do not work.

SARS-CoV-2 Antibody Responses in Pediatric Patients: A Bibliometric Analysis.

The characteristics, dynamics and mechanisms/determinants of the immune response to SARS-CoV-2 infection are not fully understood. We performed a bibliometric review of studies that have assessed SARS-CoV-2 antibody responses in the pediatric population using Web of Science online databases, VOSviewer and Bibliometrix tools. The analysis was conducted on 84 publications, from 310 institutions located in 29 countries and published in 57 journals. The results showed the collaboration of scientists and organizations, international research interactions and summarized the findings on (i) the measured titers of antibodies (total antibody and/or individual antibody classes IgG, IgM, IgA) against different antigens (C-terminal region of N (N CT), full-length N protein (N FL), RBD, RBD Alpha, RBD Beta, RBD Gamma, RBD Delta, spike (S), S1, S2) in the case of different clinical forms of the disease; and (ii) the correlations between SARS-CoV-2 antibodies and cytokines, chemokines, neutrophils, C-reactive protein, ferritin, and the erythrocyte sedimentation rate. The presented study offers insights regarding research directions to be explored in the studied field and may provide a starting point for future research.

Clinical and Laboratory Characteristics of Pediatric COVID-19 Population-A Bibliometric Analysis.

The literature on the COVID-19 landscape has rapidly expanded in the pandemic period. The current study undertakes a bibliometric analysis of research in the topic of the clinical and laboratory characteristics of pediatric COVID-19 cases. Our aim is to perform a comprehensive bibliometric review of current research trends and patterns of this research domain. Publications retrieved from the Web of Science Core Collection and VOSviewer were used for analysis and network visualization. We analyzed geographical distribution and temporal trends, collaboration and citation patterns of authors, institutions, and countries, and core research themes from co-occurrence of keywords and terms. The analysis showed that contributions in the research field were from 302 publications, 1104 institutions, 62 countries, and 172 journals. Many publications were authored by American and Chinese authors, and many were published in the Pediatric Infectious Disease Journal, Pediatric Pulmonology, and Frontiers in Pediatrics. The top cited and co-cited journals were the New England Journal of Medicine, Nature, JAMA, Lancet Infectious Diseases, and BMJ. The network visualization maps of keywords and terms offered a global overview of the clinical and laboratory characteristics of pediatric COVID-19 patients. The bibliometric profile of the researched domain, based on analyzing a large collection of publications/data, could (i) enrich the researchers and non-researchers understanding of the field existing patterns and trends, and (ii) be useful in clinical practice (diagnostic and management) and public health policy.

Borderline Personality Disorder "Discouraged Type": A Case Report.

Borderline Personality Disorder (BPD) is a mental illness associated with a significant degree of distress and impairment because of the difficulties in effectively regulating emotions. BPD is frequently associated with Depressive Disorders, most commonly Major Depressive Disorder and Dysthymia. Here, we present a case report of an 18-year-old female patient hospitalized with a severe depressive episode and psychotic symptoms. A few months after discharge, the interpersonal difficulties, unstable self-image, fear of chronic abandonment, feeling of emptiness, paranoid ideation, helplessness, obsessive-compulsive elements, perfectionism, and social retreat led to the patient's impaired functionality. The spectrum of signs and symptoms presented were characteristic of BPD. The specific presentation of mixed dependent/avoidant pattern of personality, with persistent feelings of guilt and shame, social anxiety, emotional attachments, obsessions, and feelings of inadequacy have further narrowed the diagnosis to discouraged BPD, as described by Theodore Millon. In our case, this particular subtype of personality disorder can be understood as BPN associated with social perfectionism. Both BPD and perfectionism, as a trait personality, were thought to exacerbate issues with self-conception and identity formation in this patient.

The Impact of COVID-19 on Behavior and Physical and Mental Health of Romanian College Students.

Background and Objectives: The COVID-19 pandemic caused by SARS-CoV-2 significantly marked people's lives with respect to their behavior, and their physical and mental health. Materials and Methods: This is a cross-sectional study that was conducted in 2021 for a period of 5 months. The study sample included 218 students from the College of Physical Education and Sports of the University of Suceava who filled in a questionnaire on mental, physical and behavioral symptoms caused by the COVID-19 pandemic, as well as the Anxiety Assessment Questionnaire (STAI). Results: The responses indicated increased anxiety, physical symptoms, altered behavior, and increased perception of social restrictions. Regression analyses indicated that the levels of anxiety during the COVID-19 outbreak were strongly correlated with cognitive, physical and behavioral symptoms of the students. These were influenced by the living arrangements, location (urban vs. rural), age group and study year. Conclusions: The results show that first-year students did not exhibit significant physical and cognitive symptoms despite reporting anxiety, probably due to their enthusiasm as beginners. The 3rd year students were prone to anxiety and reported cognitive symptoms, possibly due to the prospects of an uncertain future.

Dendrimers as Non-Viral Vectors in Gene-Directed Enzyme Prodrug Therapy.

Gene-directed enzyme prodrug therapy (GDEPT) has been intensively studied as a promising new strategy of prodrug delivery, with its main advantages being represented by an enhanced efficacy and a reduced off-target toxicity of the active drug. In recent years, numerous therapeutic systems based on GDEPT strategy have entered clinical trials. In order to deliver the desired gene at a specific site of action, this therapeutic approach uses vectors divided in two major categories, viral vectors and non-viral vectors, with the latter being represented by chemical delivery agents. There is considerable interest in the development of non-viral vectors due to their decreased immunogenicity, higher specificity, ease of synthesis and greater flexibility for subsequent modulations. Dendrimers used as delivery vehicles offer many advantages, such as: nanoscale size, precise molecular weight, increased solubility, high load capacity, high bioavailability and low immunogenicity. The aim of the present work was to provide a comprehensive overview of the recent advances regarding the use of dendrimers as non-viral carriers in the GDEPT therapy.

A Single-Center (Sibiu, Romania), Retrospective Study (March-November 2020) of COVID-19 Clinical and Epidemiological Features in Children.

The aim of this study was to describe and analyze epidemiological and clinical features of children screened for COVID-19 at Sibiu Pediatric Clinical Hospital during the first 9 months (March-November) of coronavirus disease pandemic in Romania. A total of 203 pediatric patients with a confirmed diagnosis of COVID-19 were included in the study. The median age of the patients was 121 (IQR 18-181) months and 52.22% had mild clinical type with pneumonia, 35.47% were moderate cases, 3.94% severe cases, 0.99% critically ill cases and 7.39% were asymptomatic. The most common symptoms were fever (n = 130, 64.03%), nasal congestion (n = 138, 67.98%), cough (n = 128, 63.05%) followed by sore throat (n = 64, 31.52%), rhinorrhea (n = 63, 31.03%), fatigue (n = 57, 28.07%), headache (n = 47, 23.15%), diarrhea (n = 39, 19.21%), vomiting (n = 32, 15.76%), myalgia (n = 24, 11.82%), abdominal pain (n = 22, 10.83%). A higher proportion of infants with severe or critical disease was encountered with lymphopenia (n = 9, 90%), neutrophilia (n = 5, 50%), leukocytosis (n = 5, 50%) compared with asymptomatic infants (n = 10, 66.67%, n = 1, 6.67%, n = 3, 20%) or mild (n = 53, 50%, n = 19, 17.92%, n = 15, 14.15%) and moderate (n = 37, 51.39%, n = 9, 12.50%, n = 6, 8.33%) cases (p = 0.095, p = 0.042, p = 0.034). Pediatric patients generally had mild or moderate type of COVID-19, and the critically ill cases were rare. In our study, frequent symptoms were observed in both the systemic and respiratory systems, ear, nose and throat system, and less from gastrointestinal system, central nervous system or ocular system. Additionally, there is an increase in liver and myocardial enzyme levels with an increase in disease severity. Understanding the clinical and laboratory characteristics of pediatric patients is important for diagnosis, management and effective control of the disease.

Applications and Limitations of Dendrimers in Biomedicine.

Biomedicine represents one of the main study areas for dendrimers, which have proven to be valuable both in diagnostics and therapy, due to their capacity for improving solubility, absorption, bioavailability and targeted distribution. Molecular cytotoxicity constitutes a limiting characteristic, especially for cationic and higher-generation dendrimers. Antineoplastic research of dendrimers has been widely developed, and several types of poly(amidoamine) and poly(propylene imine) dendrimer complexes with doxorubicin, paclitaxel, imatinib, sunitinib, cisplatin, melphalan and methotrexate have shown an improvement in comparison with the drug molecule alone. The anti-inflammatory therapy focused on dendrimer complexes of ibuprofen, indomethacin, piroxicam, ketoprofen and diflunisal. In the context of the development of antibiotic-resistant bacterial strains, dendrimer complexes of fluoroquinolones, macrolides, beta-lactamines and aminoglycosides have shown promising effects. Regarding antiviral therapy, studies have been performed to develop dendrimer conjugates with tenofovir, maraviroc, zidovudine, oseltamivir and acyclovir, among others. Furthermore, cardiovascular therapy has strongly addressed dendrimers. Employed in imaging diagnostics, dendrimers reduce the dosage required to obtain images, thus improving the efficiency of radioisotopes. Dendrimers are macromolecular structures with multiple advantages that can suffer modifications depending on the chemical nature of the drug that has to be transported. The results obtained so far encourage the pursuit of new studies.

Contribution of mechanical and electrical cardiovascular factors in patients with ischemic stroke.

Stroke represents the third - leading cause of death after heart and neoplastic is ease and is one of the biggest cause of disability worldwide. Cardioembolism, through its principal mechanism - atrial fibrillation - constitute an important cause of ischemic stroke. Otherwise, left ventricular hypertrophy (LVH) has been associated with a twofold increase in stroke risk. The study aims at highlighting significant associations between several risk factors of stroke -LVH and atrial fibrillation (AF), respectively LVH and cardiac stenosis contributeng to ischemic stroke. The study comprised of 256 patients with stroke, hospitalized in the County Clinical Emergency Hospital, Sibiu, Romania; they were examined by ultrasound by echocardiography and carotid Duplex echography. The patients were divided in subgroups that were later compared to one another: 167 patients had atrial fibrillation (group A), 89 patients did not have atrial fibrillation (group B). Then both groups were divided in 2 subgroups (with or without LVH). It has been identified another two groups (66 patients with carotid stenosis <50%) and 116 patients with carotid stenosis >50% and each group was divided in 2 subgroups (with or without LVH). LVH is an important contributing factor in ischemic stroke in patients also presenting carotid stenosis > 50%.