Anxiety and Depression in Advanced and Metastatic Lung Cancer Patients-Correlations with Performance Status and Type of Treatment.

Background and Objectives: The treatment of advanced and metastatic lung cancer is multimodal, and it is coordinated by a multidisciplinary team. Anxiety and depression occur frequently in patients with lung cancer, creating considerable discomfort in therapeutic management. At the same time, these psychoemotional symptoms affect the patients' quality of life. Objective: This research seeks to identify correlations both between anxiety and depression and the patients' performance statuses, as well as between anxiety and depression and the type of treatment: radiotherapy, chemotherapy, tyrosine kinase inhibitors (TKI), immunotherapy and palliative care. Materials and Methods: The study evaluated 105 patients with lung cancer from two oncologic centers. Patients were assessed for anxiety and depression using the questionnaire Hospital Anxiety and Depression Scale (HADS). The HADS is a self-report rating scale of 14 items. It measures anxiety and depression, and has two subscales. There are seven items for each subscale. There are 4-point Likert scale ranging from 0 to 3. For each subscale, the score is the sum of the seven items, ranging from 0 to 21. Results: The most powerful correlation with statistical significance was observed between the IT type of treatment (immunotherapy) and the normal level of anxiety, PC = 0.82 (p < 0.001) as well as the normal level of depression. Palliative treatment was correlated with anxiety and depression, both borderline and abnormal. For ECOG 3-4 performance status and abnormal anxiety, respectively, abnormal depression was significantly associated. Also, continuous hospitalization was associated with abnormal anxiety and depression. Conclusions: Early assessments of anxiety and depression are necessary in patients with advanced and metastatic lung cancer, with unfavorable performance status, who have been admitted to continuous hospitalization, and who require palliative care.

Correlation Between Serum Procalcitonin Levels and 28-Day Mortality in Patients with Surgical Sepsis and Septic Shock.

Background: Sepsis is a major medical emergency accounting for approximately 48.9 million cases and 11 million deaths worldwide, representing 19.7% of all global deaths. This study was conducted to evaluate the correlation between procalcitonin values and 28-day mortality. Methods: A retrospective study was conducted that included patients with sepsis and septic shock, treated in the surgical departments of the Sf. Apostol Andrei Galati County Emergency Clinical Hospital between January 2020 and December 2021. Results: 125 patients (mean age 65 years), mostly men (56%, n=70) were included. The mean procalcitonin value at admission in the sepsis group (28%, n=35) was 5.98 ng/mL, and in the septic shock group (72%, n=90) was 40.09 ng/mL. The most significant correlation was between procalcitonin at discharge, 28-day mortality (r = 0.437; p 0.0001) and SOFA score (r = 0.356; p 0.0001). Conclusions: Procalcitonin at discharge was positively correlated with 28-day mortality and SOFA score. The procalcitonin value at discharge can be used in the prognosis of the patient with surgical sepsis, but for better results the association between procalcitonin, SOFA score and the clinical status of the patient is recommended.

Mitigation of heat stress effects on laying hens' performances, egg quality, and some blood parameters by adding dietary zinc-enriched yeasts, parsley, and their combination.

Objective: Finding natural, handy and efficient nutritional solutions to prevent and mitigate negative effects caused by environmental heat stress and to be applied to large-scale laying hen industry. Research design: A 3-weeks trial was conducted on 128 laying hens TETRA-SL LL (50 weeks of age) housed in 8 cages/group, 4 laying hens/cage, 32 laying hens/group, under heat stress conditions (34±1°C). The basal diet on corn and soybean meal was formulated to be isocaloric and isonitrogenic. Compared to Control group diet (C), experimental groups E1 included 1% zinc-enriched yeast; E2 included 2% parsley and E3 included 1% zinc-enriched yeast combined with 2% parsley to minimize the heat stress effects. Methods: The parsley and the zinc-enriched yeast were analysed for their chemical composition, total polyphenols, antioxidant capacity, minerals, vitamin E and incorporated into the ration structure. Production parameters, egg quality, biochemical and haematological profiles of blood samples were analysed during the trial. Results: A statistically significant (p < 0.05) average egg weight was noticed on E2 and E3 compared to Control group, and also during the 1st week compared to the 2nd and the 3rd experimental weeks. Average daily feed intake values were highly significant (p < 0.001) on E3 group compared to C, E1, E2, and on the 2nd week compared to the 3rd experimental week (p < 0.021). Feed conversion rate was highly significant (p < 0.001) during the 2nd and the 3rd experimental weeks compared to the 1st week. The average daily egg production was highly significant (p < 0.001) within 1st week compared to the 2nd and 3rd weeks. A highly significant (p < 0.001) yolk coloration was noticed on E2 and E3 groups. The malondialdehyde (MDA) concentration decreased significantly (p < 0.05) to all experimental groups compared to Control group during the 14th and 28th days of storage. Conclusion: These findings suggest that the two ingredients minimized the heat stress effects on production performance parameters with a demonstrated antioxidant capacity role by delaying the lipid peroxidation during different storage time periods.

Assessing the effects of microencapsulated Lactobacillus salivarius and cowpea seed supplementation on broiler chicken growth and health status.

This study aimed to assess the nutritional quality of cowpea seeds (cv. Doljana - CSD) and the impact of partially replacing soybean meal with CSD, along with the supplementation of microencapsulated Lactobacillus salivarius (LS), on the growth performance, selected carcass traits, biochemical plasma profile, tibia bone quality, and microbial populations in the ceca and excreta of broiler chickens aged 1 to 35 days. A total of 432 mixed-sex Ross 308 broiler chickens, aged one day, were randomly allocated to four groups, with 108 birds in each group, further divided into 6 pens containing 18 birds each. The experimental design featured a 2 × 2 factorial arrangement, with two cowpea seed levels (CSD0 and CSD15%) and the presence or absence (Yes/No) of microencapsulated LS probiotic (0 and 1 g/kg feed). The experimental diets did not significantly influenced (p > 0.05) production performances. However, the production efficiency factor was notably higher in the CSD0 (336.8%) and CSD15 (332.2%) groups with LS compared to CSD0 (322.4%) and CSD15 (320.6%) groups without LS supplementation. Regarding carcass traits, the CSD15 group with LS supplementation exhibited higher dressing (70.69%) and liver (2.47%) percentages compared to the other groups. Plasma profile analysis revealed significant reductions (p < 0.05) in total cholesterol (from 115 mg/dL to 105 mg/dL) and triglycerides (from 54.80 mg/dL to 46.80 mg/dL) in the CSD15 group with LS supplementation compared to the CSD0 group, with or without LS supplementation. Moreover, the CSD15 group with LS had significantly higher total protein, albumin, and calcium levels and significantly lower (p < 0.05) uric acid levels compared to the CSD0 group, irrespective of LS supplementation. Tibia bone traits and minerals showed no significant effects. However, the pH exhibited a linear decrease from 6.90 in the CSD0 group without LS to 6.69 in the CSD15 group with LS supplementation. In terms of cecal microbial populations, Coliforms decreased from 7.14 CFU/g in the CSD15 group without LS to 5.48 CFU/g in the CSD15 group with LS. Significant alterations were also observed in Clostridium spp., E. coli, Enterococcus spp., and Staphylococcus spp. in the ceca and excreta of the CSD15 group with LS supplementation compared to the CSD0 group, with or without LS supplementation. Beneficial bacteria, specifically Lactobacillus spp., significantly increased in the cecal content of CSD0 (9.06 CFU/g) and CSD15 (9.01 CFU/g) groups with LS compared to CSD0 (8.41 CFU/g) and CSD15 (8.11 CFU/g) groups without LS. In summary, this study suggests that cowpea seeds can be used as a partial replacement for soybean meal in broiler chicken diets, and microencapsulated Lactobacillus salivarius can be employed as a probiotic supplement.

Alterations in Essential Fatty Acids, Immunoglobulins (IgA, IgG, and IgM), and Enteric Methane Emission in Primiparous Sows Fed Hemp Seed Oil and Their Offspring Response.

This study shows the effects of dietary hemp seed oil on the milk composition, blood immunoglobulins (Ig), and enteric methane (E-CH4) production of primiparous sows, and their offspring's response at three time points. A bifactorial experiment was conducted for 21 days (d) on 18 primiparous sows (195 ± 3 days old). The sows were fed two diets: (i) a control diet (SO) based on soybean oil (1.6%), with an 18.82 n-6:n-3 polyunsaturated fatty acids (PUFA) ratio; (ii) an experimental diet (HO) based on hemp seed oil (1.6%), with a 9.14 n-6:n-3 PUFA ratio. The milk contained an elevated level of linoleic acids (LA), n-3 FA, and especially alpha-linolenic acids (ALA), while the n-6:n-3 ratio declined using hemp oil. The Ig concentration was higher in colostrum than in milk. In the first few hours, the IgG in the plasma of piglets was more than double that of maternal plasma IgG (+2.39 times). A period effect (p < 0.0001) for IgG concentration in the plasma of piglets was recorded (40% at 10 d, respectively 73% lower at 21 d than 12 h after parturition). However, the sow diet did not affect Ig (p > 0.05). The frequency of diarrhoea declined after about 7 d. The value of the rate of diarrhoea was 6.2% lower in the PHO group. We found a 4.5% decline in E-CH4 in the HO group. Applying multiple linear regression, feed intake, n-6:n-3 ratio, ALA, and lean meat were potential indicators in estimating E-CH4. In conclusion, sow dietary hemp seed oil increased lean meat %, milk EFA, and milk IgM. Significant changes in the other dependent variables of interest (body weight, plasma Igs in sows and offspring, E-CH4 production) were not recorded. There was reduced diarrhoea which shows that EFA could play a therapeutic role in the incidence of diarrhoea and in lowering of E-CH4 emission in sows and progeny. All dependent variables were significantly altered at different time points, except for fat concentration in milk and sow plasma IgG.

Clinical, histological and therapeutical aspects in the management of uterine and extrauterine stromal sarcomas: Case reports.

Endometrial stromal sarcoma (ESS) is a rare tumor, predominantly occurring as a primary tumor of the uterus. Rare cases of primary extrauterine ESS (EESS) have been reported. Low-grade ESS (LG-ESS) is more common than high-grade ESS (HG-ESS). We present five cases of ESS and one case of EESS. All cases received external radiotherapy (EBRT) at the Radiotherapy Department of the Emergency Clinical Hospital 'Sfantul Apostol Andrei' Galati, during 2004-2020. Five cases underwent EBRT in two-dimensional (2D) technique and only one patient received EBRT with three-dimensinal conformational radiotherapy (3DCRT) technique with a linear accelerator, Elekta Synergy. Five patients were referred to postoperative radiotherapy after hysterectomy. The median age of the patients was 57.4 years. One patient was referred to radiotherapy with palliative intent. EESS localized in the retroperitoneum, in the para-aortic region, was identified in one 64-year-old patient with a personal history of hysterectomy and bilateral salpingo-oophorectomy in 1997; EESS was complicated with vertebral extension at the L1-L2 level and spinal cord compression syndrome. ESS represents a rare diagnosis and a high- or low-grade tumor profile is distinguished by immunohistochemistry (IHC) tests. Up to 30% of patients have EESS at presentation. The treatment of ESS is multimodal, its management requiring a multidisciplinary team, and it is different according to the primary tumor location and tumor staging. The role of adjuvant radiotherapy remains controversial in high-grade EESS and due to the rarity of these cases there are limited data concerning the efficacy of adjuvant EBRT available from prospective randomized control clinical trials.

Skin spiradenocarcinoma - case presentation.

Malignant eccrine spiradenoma is an extremely rare skin tumor of sweat gland origin. The available literature data indicates that spiradenocarcinoma nearly uniformly arises from a benign preexisting spiradenoma. Etiology is unknown but previous trauma is believed being an implicated factor. The article presents the clinical observation of a 34-year-old female patient, diagnosed with cutaneous spiradenocarcinoma of the left thigh, treated multidisciplinary: surgery and chemoradiotherapy. The presentation includes clinical, histopathological and therapeutic diagnosis aspects, arisen difficulties of histological diagnosis and literature data regarding treatment options for this type of tumor. In this case, surgery followed by second surgery intervention was performed due to the continuing development of local disease. After surgery, the patient performed external beam radiotherapy (EBRT) to tumoral bed (total dose of 50 Gy) and inguinal lymph nodes (total dose of 50 Gy), followed by six cycles of chemotherapy (CMT) (Carboplatin + Paclitaxel) with complete response. At the moment, the patient shows no evidence of recurrence or metastatic disease during the follow-up.

Metachronous gastrointestinal stromal tumor associated with other neoplasia - case presentation.

The association of gastrointestinal stromal tumor (GIST), synchronous or metachronous with other tumors is reported in special literature, the most frequent being associated with other gastrointestinal tumors. GISTs are the most common mesenchymal neoplasm of the gastro-intestinal tract with a malignant potential. We present a case of 68-year-old male patient diagnosed with GIST stage IV, unreachable due to liver metastases, treated with Imatinib, diagnosed at 13 months of prostate adenocarcinoma diagnosis [treated with hormonal therapy (HT) and external beam radiotherapy (EBRT)]; at 45 months from the first neoplasia diagnosis, the patient was diagnosed with the third neoplasia - lung squamous carcinoma - right inferior lobe, for which performed EBRT. The coexistence of GIST with other malignancies with different histology, remain a challenge for the clinician from etiological, and also from therapeutically actions point of view.

The effect of foliar fertilization with organic products on some nutritional value during post-harvest storage of tomatoes (lycopersicon esculentum mill)

The aim of this study was to observe the effect of foliar fertilization with organic products on the nutritional quality of fruits stored. The time between harvest and consumption of fruits and vegetables, may be up to several weeks. In this regard, the storage capacity of tomato fruits at three hybrids has been studied: Antalya, Chocolat and Tiger. The culture was founded in a greenhouse in the south-west of Romania. The fruits were stored at a temperature of 15°C ± 0.5°C and a relative atmospheric humidity of 82% for a period of 42 days. In order to assess the nutritional fruit value during storage, biochemical analyzes were carried out at 7, 21, 35 and 42 days. Experimental results have shown that the best variants of organic manure and storage time, which positive influenced the content of carotene and vitamin C were variants with humic acids + Vitis vinifera seeds extract and humic acids + extract from the seeds of Vitis vinifera + Boro(AU)

El objetivo de este estudio fue observar el efecto de la fertilización foliar con productos orgánicos sobre la calidad nutricional en los frutos almacenados. En este sentido, la capacidad de almacenamiento de los frutos de tomates ha sido sometida a tres híbridos: Antalya, Chocolat y Tiger. Los tomates han sido cultivados en un invernadero, en la parte sur-oeste de Rumanía. Los frutos se han guardado a una temperatura de 15°C ± 0.5°C y a una humedad atmosférica relativa de 82%, durante un período de 42 días. Para la evaluación nutricional de los frutos durante el periodo de almacenamiento, se realizaron análisis bioquímicos a los 7, 21, 35 y 42 días. Los resultados de los experimentos mostraron que las mejores fórmulas empleadas en la fertilización orgánica, así como el tiempo de almacenamiento, que han influido positívamente en el contenido de carotenos y vitamina C, han sido: la fórmula con ácidos húmicos + extracto de semillas de Vitis vinifera y la fórmula con ácidos húmicos + extracto de semillas de Vitis vinifera + Boro(AU)