Publications by authors named "Constantin Căruntu"

76 Publications

Cannabinoids and Inflammations of the Gut-Lung-Skin Barrier.

J Pers Med 2021 May 31;11(6). Epub 2021 May 31.

Department of Oral and Maxillofacial Surgery, "Carol Davila" Central Military Emergency Hospital, 010825 Bucharest, Romania.

Recent studies have identified great similarities and interferences between the epithelial layers of the digestive tract, the airways and the cutaneous layer. The relationship between these structures seems to implicate signaling pathways, cellular components and metabolic features, and has led to the definition of a gut-lung-skin barrier. Inflammation seems to involve common features in these tissues; therefore, analyzing the similarities and differences in the modulation of its biomarkers can yield significant data promoting a better understanding of the particularities of specific signaling pathways and cellular effects. Cannabinoids are well known for a wide array of beneficial effects, including anti-inflammatory properties. This paper aims to explore the effects of natural and synthetic cannabinoids, including the components of the endocannabinoid system, in relation to the inflammation of the gut-lung-skin barrier epithelia. Recent advancements in the use of cannabinoids as anti-inflammatory substances in various disorders of the gut, lungs and skin are detailed. Some studies have reported mixed or controversial results, and these have also been addressed in our paper.
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http://dx.doi.org/10.3390/jpm11060494DOI Listing
May 2021

Assessment of Histological Features in Squamous Cell Carcinoma Involving Head and Neck Skin and Mucosa.

J Clin Med 2021 May 27;10(11). Epub 2021 May 27.

"Cantacuzino" National Medico-Military Institute for Research and Development, 050096 Bucharest, Romania.

Background: squamous cell carcinoma (SCC) is the second most common type of malignancy worldwide. Skin and mucosa of the head and neck areas are the most frequently affected. An aggressive behavior in SCC is not easily detected, and despite all efforts, mortality in these types of cancer did not show major improvements during recent decades. In this study, we aim to determine the role of histological features available through standard pathology assessment in SCC and their relation with tumor behavior and patients' survival.

Method: in a group of one hundred patients diagnosed with SCC involving the head and neck areas, we assessed the presence of four histological features (tumor/stroma ratio, immune infiltration at the front of invasion, tumor-budding activity, and tumor necrosis), their correlations with tumor type (mucosal or cutaneous), tumor clinicopathological characteristics, and their prognostic potential.

Results: the comparison between histological features in cutaneous versus mucosal SCC reveals no significant differences for any of the four parameters assessed. We found significant correlations between tumor/stroma ratio and lymphatic metastasis ( = 0.0275), perineural invasion ( = 0.0006), and clinical staging ( = 0.0116). Immune infiltration at the front of invasion revealed similar correlations with lymph node involvement ( = 0.002), perineural invasion ( = 0.0138), and clinical staging ( = 0.0043). Tumor budding and tumor necrosis correlated with the size of the tumor ( = 0.0077 and = 0.0004) and the clinical staging ( = 0.0039 and = 0.0143). In addition, tumor budding was significantly correlated with perineural invasion ( = 0.0454). In mucosal SCC, patients with improved outcome revealed high values for the tumor/stroma ratio ( = 0.0159) and immune infiltration at the front of invasion ( = 0.0274). However, the multivariate analysis did not confirm their independent prognostic roles.

Conclusions: extended histological assessments that include features such as tumor/stroma ratio, immune infiltration at the front of invasion, tumor budding, and tumor necrosis can be an easy, accessible method to collect additional information on tumor aggressiveness in skin and mucosa SCC affecting the head and neck areas.
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http://dx.doi.org/10.3390/jcm10112343DOI Listing
May 2021

Neuroendocrine Factors in Melanoma Pathogenesis.

Cancers (Basel) 2021 May 10;13(9). Epub 2021 May 10.

Department of Physiology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Melanoma is one of the most aggressive skin cancers with a sharp rise in incidence in the last decades, especially in young people. Recognized as a significant public health issue, melanoma is studied with increasing interest as new discoveries in molecular signaling and receptor modulation unlock innovative treatment options. Stress exposure is recognized as an important component in the immune-inflammatory interplay that can alter the progression of melanoma by regulating the release of neuroendocrine factors. Various neurotransmitters, such as catecholamines, glutamate, serotonin, or cannabinoids have also been assessed in experimental studies for their involvement in the biology of melanoma. Alpha-MSH and other neurohormones, as well as neuropeptides including substance P, CGRP, enkephalin, beta-endorphin, and even cellular and molecular agents (mast cells and nitric oxide, respectively), have all been implicated as potential factors in the development, growth, invasion, and dissemination of melanoma in a variety of in vitro and in vivo studies. In this review, we provide an overview of current evidence regarding the intricate effects of neuroendocrine factors in melanoma, including data reported in recent clinical trials, exploring the mechanisms involved, signaling pathways, and the recorded range of effects.
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http://dx.doi.org/10.3390/cancers13092277DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8126040PMC
May 2021

Prognostic Potential of Tumor-Infiltrating Immune Cells in Resectable Oral Squamous Cell Carcinoma.

Cancers (Basel) 2021 May 8;13(9). Epub 2021 May 8.

Department of Pathology, "Carol Davila" University of Medicine and Pharmacy, 020125 Bucharest, Romania.

(1) : The immune microenvironment plays an important role in carcinogenesis and has prognostic potential in many types of cancer. In this study we assess the prognostic character of tumor-infiltrating immune cells CD4, CD8 and CD56 in resectable oral squamous cell carcinoma (OSCC); (2) : We have evaluated the densities of CD4, CD8 and CD56 in two distinct compartments, intratumor and invasion front, in 90 patients with OSCC; (3) : Significant differences were found between the tumor compartments for the CD4 and CD8 lymphocytes. An improved outcome (OS) was seen in patients with high densities of intratumor CD8 lymphocytes ( = 0.0086), CD8 lymphocytes at the front of invasion ( = 0.0011) and for intratumor CD56 cells ( = 0.0016). Multivariate analysis confirmed the independent prognostic role of CD8 at the front of invasion (OR = 3.75, CI95% 1.17-12.35, = 0.026) and for intratumor CD56 cells (OR = 3.669, CI95% 1.09-15.37, = 0.035); (4) : Tumor-infiltrating CD8 lymphocytes at the front of invasion and CD56 in the intratumor compartment display predictive traits in OSCC. A reach immune infiltration with these types of cells is associated with an improved patient outcome.
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http://dx.doi.org/10.3390/cancers13092268DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8125877PMC
May 2021

Species: Bridging Phytochemistry Knowledge, Pharmacological Properties and Toxicological Safety for Health Benefits.

Front Pharmacol 2021 11;12:600139. Epub 2021 May 11.

Department of Physiology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

The genus includes a number of plant species largely used as food, food additives and spices for a long time. Different traditional healing systems have used these plants as herbal remedies to cure diverse ailments. The aim of this comprehensive and updated review is to summarize the biodiversity of the genus , its bioactive compounds, the mechanisms that underlie the pharmacological activities and molecular targets and toxicological safety. All the data in this review have been collected from databases and recent scientific literature including Web of Science, PubMed, ScienceDirect etc. The results showed that the bioactive compounds of species possess antimicrobial, antidiabetic, antioxidant, anti-inflammatory, anticancer and neuroprotective effects. The preclinical (/) studies provided the possible molecular mechanisms of these action. As a novelty, recent clinical studies and toxicological data described in this paper support and confirm the pharmacological importance of the genus In conclusion, the obtained results from preclinical studies and clinical trials, as well as reduced side effects provide insights into future research of new drugs based on extracts and bioactive compounds from plants.
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http://dx.doi.org/10.3389/fphar.2021.600139DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8144503PMC
May 2021

Adaptive SNN for Anthropomorphic Finger Control.

Sensors (Basel) 2021 Apr 13;21(8). Epub 2021 Apr 13.

Faculty of Automatic Control and Computer Engineering, Gheorghe Asachi Technical University of Iasi, 700050 Iasi, Romania.

Anthropomorphic hands that mimic the smoothness of human hand motions should be controlled by artificial units of high biological plausibility. Adaptability is among the characteristics of such control units, which provides the anthropomorphic hand with the ability to learn motions. This paper presents a simple structure of an adaptive spiking neural network implemented in analogue hardware that can be trained using Hebbian learning mechanisms to rotate the metacarpophalangeal joint of a robotic finger towards targeted angle intervals. Being bioinspired, the spiking neural network drives actuators made of shape memory alloy and receives feedback from neuromorphic sensors that convert the joint rotation angle and compression force into the spiking frequency. The adaptive SNN activates independent neural paths that correspond to angle intervals and learns in which of these intervals the rotation the finger rotation is stopped by an external force. Learning occurs when angle-specific neural paths are stimulated concurrently with the supraliminar stimulus that activates all the neurons that inhibit the SNN output stopping the finger. The results showed that after learning, the finger stopped in the angle interval in which the angle-specific neural path was active, without the activation of the supraliminar stimulus. The proposed concept can be used to implement control units for anthropomorphic robots that are able to learn motions unsupervised, based on principles of high biological plausibility.
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http://dx.doi.org/10.3390/s21082730DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8069700PMC
April 2021

Skin endometriosis: A case report and review of the literature.

Exp Ther Med 2021 May 23;21(5):532. Epub 2021 Mar 23.

Department of Dermatology, Dermatology Clinic, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540139 Târgu Mureș, Romania.

Skin endometriosis is a rare disease with variable clinical and histopathological characteristics that depend on hormonal stimuli. The skin is not a common location, as most cases of endometriosis involve pelvic sites, such as the ovaries, peritoneum and bowel. However, the most common extrapelvic site affected is the abdominal wall and this location of the disease is frequently associated with obstetric and gynecologic surgery. Here we report a case of skin endometriosis emerged as a painful subcutaneous nodule located near to the left side of an obstetrical surgery procedure scar. The patient affected was a woman in her reproductive age, with a history of right ovary endometriotic cyst laparoscopically removed and histologically confirmed as a primary endometriosis. Dermatologists should be aware of this condition in any woman with a painful lump located in the proximity of a pelvic surgery-induced scar. Its non-specific clinical appearance may confuse the clinician and may delay the diagnosis and management.
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http://dx.doi.org/10.3892/etm.2021.9964DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8014966PMC
May 2021

Complex Interaction Among Immune, Inflammatory, and Carcinogenic Mechanisms in the Head and Neck Squamous Cell Carcinoma.

Adv Exp Med Biol 2021 Mar 2. Epub 2021 Mar 2.

Faculty of Dental Medicine, "Titu Maiorescu" University, Bucharest, Romania.

Inflammation is deeply involved in the development of most types of cancer. Many studies focus on the interaction between immune-inflammatory mechanisms and tumorigenesis in the head and neck squamous cell carcinoma (HNSCC). In this chapter, we emphasize the complexity of processes underlying this interaction and discuss the mechanisms of carcinogenesis in HNSCC with a special focus on metabolic changes, inflammation, and the immune landscape. Unveiling complex connections between immuno-inflammatory processes and tumor initiation, promotion, and progression will open new directions in the reliable identification of predictive factors and therapeutic targets in HNSCC.
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http://dx.doi.org/10.1007/5584_2021_626DOI Listing
March 2021

Pharmacological Properties of Chalcones: A Review of Preclinical Including Molecular Mechanisms and Clinical Evidence.

Front Pharmacol 2020 18;11:592654. Epub 2021 Jan 18.

Department of Pharmacy, Faculty of Health Sciences, Universidad San Jorge, Zaragoza, Spain.

Chalcones are among the leading bioactive flavonoids with a therapeutic potential implicated to an array of bioactivities investigated by a series of preclinical and clinical studies. In this article, different scientific databases were searched to retrieve studies depicting the biological activities of chalcones and their derivatives. This review comprehensively describes preclinical studies on chalcones and their derivatives describing their immense significance as antidiabetic, anticancer, anti-inflammatory, antimicrobial, antioxidant, antiparasitic, psychoactive, and neuroprotective agents. Besides, clinical trials revealed their use in the treatment of chronic venous insufficiency, skin conditions, and cancer. Bioavailability studies on chalcones and derivatives indicate possible hindrance and improvement in relation to its nutraceutical and pharmaceutical applications. Multifaceted and complex underlying mechanisms of chalcone actions demonstrated their ability to modulate a number of cancer cell lines, to inhibit a number of pathological microorganisms and parasites, and to control a number of signaling molecules and cascades related to disease modification. Clinical studies on chalcones revealed general absence of adverse effects besides reducing the clinical signs and symptoms with decent bioavailability. Further studies are needed to elucidate their structure activity, toxicity concerns, cellular basis of mode of action, and interactions with other molecules.
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http://dx.doi.org/10.3389/fphar.2020.592654DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7849684PMC
January 2021

Preoperative Evaluation through Dermoscopy and Reflectance Confocal Microscopy of the Lateral Excision Margins for Primary Basal Cell Carcinoma.

Diagnostics (Basel) 2021 Jan 14;11(1). Epub 2021 Jan 14.

Department of Dermatology, "Prof. N.C. Paulescu" National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania.

Complete removal of malignant skin lesions with minimal impact on the aesthetic and functional aspects is the ideal of every dermatologic surgeon. Incomplete surgical excisions and tumor recurrences of basal cell carcinomas (BCC) commonly occur due to the subclinical extension of tumor lateral margins. Presently, the lateral excision margins for BCC cannot be objectively assessed preoperatively, dermoscopy proving to be relatively inefficient in this respect. The question is whether BCC lateral excision margins can be precisely determined preoperatively through the use of complementary non-invasive imaging techniques such as dermoscopy and reflectance confocal microscopy (RCM), thus permitting the complete removal of the lesion in a single stage, estimation of the post-excisional defect, and planning an appropriate reconstruction, especially in medical centers where Mohs micrographic surgery is not available. We present the results of a prospective, histopathologically controlled study designed to determine the feasibility of preoperative, non-invasive, in vivo evaluation of the lateral excision margins for primary basal cell carcinoma, through dermoscopy and RCM.
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http://dx.doi.org/10.3390/diagnostics11010120DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828674PMC
January 2021

Effects of Exogenous Androgens on Platelet Activity and Their Thrombogenic Potential in Supraphysiological Administration: A Literature Review.

J Clin Med 2021 Jan 4;10(1). Epub 2021 Jan 4.

Division of Physiology and Neuroscience, Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Anabolic androgenic steroids (AAS), simply called "androgens", represent the most widespread drugs used to enhance performance and appearance in a sporting environment. High-dosage and/or long-term AAS administration has been associated frequently with significant alterations in the cardiovascular system, some of these with severe endpoints. The induction of a prothrombotic state is probably the most life-threatening consequence, suggested by numerous case reports in AAS-abusing athletes, and by a considerable number of human and animal studies assessing the influence of exogenous androgens on hemostasis. Despite over fifty years of research, data regarding the thrombogenic potential of exogenous androgens are still scarce. The main reason is the limited possibility of conducting human prospective studies. However, human observational studies conducted in athletes or patients, in vitro human studies, and animal experiments have pointed out that androgens in supraphysiological doses induce enhanced platelet activity and thrombopoiesis, leading to increased platelet aggregation. If this tendency overlaps previously existing coagulation and/or fibrinolysis dysfunctions, it may lead to a thrombotic diathesis, which could explain the multitude of thromboembolic events reported in the AAS-abusing population. The influence of androgen excess on the platelet activity and fluid-coagulant balance remains a subject of debate, urging for supplementary studies in order to clarify the effects on hemostasis, and to provide new compelling evidence for their claimed thrombogenic potential.
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http://dx.doi.org/10.3390/jcm10010147DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7795962PMC
January 2021

The Effects of Capsaicin on Gastrointestinal Cancers.

Molecules 2020 Dec 28;26(1). Epub 2020 Dec 28.

Department of Physiology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Gastrointestinal (GI) cancers are a group of diseases with very high positions in the ranking of cancer incidence and mortality. While they show common features regarding the molecular mechanisms involved in cancer development, organ-specific pathophysiological processes may trigger distinct signaling pathways and intricate interactions with inflammatory cells from the tumoral milieu and mediators involved in tumorigenesis. The treatment of GI cancers is a topic of increasing interest due to the severity of these diseases, their impact on the patients' survivability and quality of life, and the burden they set on the healthcare system. As the efficiency of existing drugs is hindered by chemoresistance and adverse reactions when administered in high doses, new therapies are sought, and emerging drugs, formulations, and substance synergies are the focus of a growing number of studies. A class of chemicals with great potential through anti-inflammatory, anti-oxidant, and anti-tumoral effects is phytochemicals, and capsaicin in particular is the subject of intensive research looking to validate its position in complementing cancer treatment. Our paper thoroughly reviews the available scientific evidence concerning the effects of capsaicin on major GI cancers and its interactions with the molecular pathways involved in the course of these diseases.
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http://dx.doi.org/10.3390/molecules26010094DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794743PMC
December 2020

Antiganglioside Antibodies and Inflammatory Response in Cutaneous Melanoma.

J Immunol Res 2020 13;2020:2491265. Epub 2020 Aug 13.

"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania.

Introduction: Endogenously produced antiganglioside antibodies could affect the evolution of cutaneous melanoma. Epidemiological and experimental evidence suggest "chronic inflammation" to be one of the hallmarks in skin cancers. The aim of the study was to characterize the relation between antiganglioside antibodies and inflammation in cutaneous melanoma focusing on gangliosides GM1, GM2, GM3, GD1a, GD1b, GT1b, GQ1b. . We performed an observational study that included 380 subjects subdivided into three groups: patients with metastatic melanoma (170 cases), patients with primary melanoma (160 cases), and healthy subjects (50 subjects). The assessment of antiganglioside antibodies, IgG, and IgM classes, against -GM1, -GM2, -GM3, -GD1a, -GD1b, -GT1b, -GQ1b was performed using immunoblot technique (EUROLine kit).

Results: The presence of IgG and IgM antiganglioside antibodies in primary melanoma was (%), as follows: anti-GM1 (5.0 and 13.1), -GM2 (1.8 and 18.1), -GM3 (0.6 and 5.6), -GD1a (0.6 and 15.0), -GD1b (3.7 and 10.7), -GT1b (0.0 and 13.1), -GQ1b (0.0 and 5.0). In metastatic melanoma, the level of antiganglioside antibodies was significantly lower compared with primary melanoma ( < 0.05), while in the control group they were absent. Antiganglioside antibodies anti-GM1 and -GD1a were positively correlated, while anti-GM3, -GD1b, and -GT1b were negatively associated with the inflammatory markers, interleukin 8 (IL-8), and C reactive protein (CRP).

Conclusions: Tumour ganglioside antigens generate an immune response in patients with primary melanomas. The host's ability to elaborate an early antiganglioside response could be considered as a defence mechanism, directed toward eliminating a danger signal from the tumour microenvironment. Antiganglioside antibodies associated with inflammation markers could be used as diagnostic, monitoring, and treatment tools in patients with cutaneous melanoma.
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http://dx.doi.org/10.1155/2020/2491265DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7443004PMC
June 2021

The Treatment of Cognitive, Behavioural and Motor Impairments from Brain Injury and Neurodegenerative Diseases through Cannabinoid System Modulation-Evidence from In Vivo Studies.

J Clin Med 2020 Jul 27;9(8). Epub 2020 Jul 27.

Toxicology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.

Neurological disorders such as neurodegenerative diseases or traumatic brain injury are associated with cognitive, motor and behavioural changes that influence the quality of life of the patients. Although different therapeutic strategies have been developed and tried until now to decrease the neurological decline, no treatment has been found to cure these pathologies. In the last decades, the implication of the endocannabinoid system in the neurological function has been extensively studied, and the cannabinoids have been tried as a new promising potential treatment. In this study, we aimed to overview the recent available literature regarding in vivo potential of natural and synthetic cannabinoids with underlying mechanisms of action for protecting against cognitive decline and motor impairments. The results of studies on animal models showed that cannabinoids in traumatic brain injury increase neurobehavioral function, working memory performance, and decrease the neurological deficit and ameliorate motor deficit through down-regulation of pro-inflammatory markers, oedema formation and blood-brain barrier permeability, preventing neuronal cell loss and up-regulating the levels of adherence junction proteins. In neurodegenerative diseases, the cannabinoids showed beneficial effects in decreasing the motor disability and disease progression by a complex mechanism targeting more signalling pathways further than classical receptors of the endocannabinoid system. In light of these results, the use of cannabinoids could be beneficial in traumatic brain injuries and multiple sclerosis treatment, especially in those patients who display resistance to conventional treatment.
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http://dx.doi.org/10.3390/jcm9082395DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464236PMC
July 2020

In Vivo Reflectance Confocal Microscopy-Diagnostic Criteria for Actinic Cheilitis and Squamous Cell Carcinoma of the Lip.

J Clin Med 2020 Jun 25;9(6). Epub 2020 Jun 25.

Department of Dermatology, "Prof. N.C. Paulescu" National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania.

Actinic cheilitis (AC) is one of the most frequent pathologies to affect the lips. Studies show that the most commonplace oral malignancy, squamous cell carcinoma (SCC), often emerges from AC lesions. Invasive diagnostic techniques performed on the lips carry a high risk of complications, but reflectance confocal microscopy (RCM), a non-invasive skin imaging technique, may change the current diagnostic pathway. This retrospective study was aimed at consolidating the RCM diagnostic criteria for AC and lip SCC. The study was conducted in two tertiary care centers in Bucharest, Romania. We included adults with histopathologically confirmed AC and SCC who also underwent RCM examination. Of the twelve lesions included in the study, four were AC and eight were SCC. An atypical honeycomb pattern and the presence of target cells in the epidermis were RCM features associated with AC. SCC was typified by the presence of complete disruption of the epidermal architecture and dermal inflammatory infiltrates. The mean blood vessel diameter in SCC was 18.55 µm larger than that in AC ( = 0.006) and there was no significant difference ( = 0.64) in blood vessel density, as measured by RCM, between SCC and AC. These data confirm that RCM can be useful for the distinction between AC and lip SCC.
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http://dx.doi.org/10.3390/jcm9061987DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356181PMC
June 2020

The Role of Beta HPV Types and HPV-Associated Inflammatory Processes in Cutaneous Squamous Cell Carcinoma.

J Immunol Res 2020 6;2020:5701639. Epub 2020 Apr 6.

"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania.

Cutaneous squamous cell carcinoma (cSCC) is a common form of skin cancer with a complex but not fully understood pathogenesis. Recent research suggests the role of beta human papillomavirus (HPV) types and HPV-associated inflammatory processes in cSCC development. Beta HPV types are components of the normal flora; however, under the influence of certain cofactors, the virus may trigger a malignant process. Dysregulation of the immune system (chronic inflammation and immunosuppression), environmental factors (ultraviolet radiation), and genetic factors are the most important cofactors involved in beta HPV-related carcinogenesis. In addition, the oncoproteins E6 and E7 of beta HPV types differ biochemically from their counterparts in the structure of alpha HPV types, resulting in different mechanisms of action in carcinogenesis. The aim of our manuscript is to present an updated point of view on the involvement of beta HPV types in cSCC pathogenesis.
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http://dx.doi.org/10.1155/2020/5701639DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7165336PMC
February 2021

Cannabinoids in the Pathophysiology of Skin Inflammation.

Molecules 2020 Feb 4;25(3). Epub 2020 Feb 4.

Department of Oral and Maxillofacial Surgery, "Carol Davila" Central Military Emergency Hospital, 010825 Bucharest, Romania.

Cannabinoids are increasingly-used substances in the treatment of chronic pain, some neuropsychiatric disorders and more recently, skin disorders with an inflammatory component. However, various studies cite conflicting results concerning the cellular mechanisms involved, while others suggest that cannabinoids may even exert pro-inflammatory behaviors. This paper aims to detail and clarify the complex workings of cannabinoids in the molecular setting of the main dermatological inflammatory diseases, and their interactions with other substances with emerging applications in the treatment of these conditions. Also, the potential role of cannabinoids as antitumoral drugs is explored in relation to the inflammatory component of skin cancer. In vivo and in vitro studies that employed either phyto-, endo-, or synthetic cannabinoids were considered in this paper. Cannabinoids are regarded with growing interest as eligible drugs in the treatment of skin inflammatory conditions, with potential anticancer effects, and the readiness in monitoring of effects and the facility of topical application may contribute to the growing support of the use of these substances. Despite the promising early results, further controlled human studies are required to establish the definitive role of these products in the pathophysiology of skin inflammation and their usefulness in the clinical setting.
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http://dx.doi.org/10.3390/molecules25030652DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7037408PMC
February 2020

Tumour Microenvironment in Skin Carcinogenesis.

Adv Exp Med Biol 2020 ;1226:123-142

Immunology Department, "Victor Babes" National Institute of Pathology, Bucharest, Romania.

Tumour microenvironment is a complex system comprising cells and molecules that will provide the necessary conditions for tumour development and progression. Cells residing in the tumour microenvironment gain specific phenotypes and specific functions that are pro-tumorigenic. Tumour progression is in fact a combination between tumour cell characteristics and its interplay with tumour microenvironment. This dynamic network will allow tumour cells to grow, migrate and invade tissues. In the present chapter, we are highlighting some traits that characterise tumour microenvironment in basal cell carcinoma, squamous cell carcinoma and cutaneous melanoma. In skin cancers, there are some common tumour microenvironment characteristics such as the presence of tumour-associated macrophages and regulatory T lymphocytes that are non-tumour cells promoting tumorigenesis. There are also skin cancer type differences in terms of tumour microenvironment characteristics. Thus, markers such as macrophage migration inhibitory factor in melanoma or the extraordinary diverse genetic make-up in the cancer-associated fibroblasts associated to squamous cell carcinoma are just a few of specific traits in skin cancer types. New technological advances for evaluation of tumour environment are presented. Thus, non-invasive skin imaging techniques such as reflectance confocal microscopy can evaluate skin tumour inflammatory infiltrates for density and cellular populations. Analysing tumour micromedium in depth may offer new insights into cancer therapy and identify new therapy targets.
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http://dx.doi.org/10.1007/978-3-030-36214-0_10DOI Listing
February 2020

The Role of Matrix Metalloproteinases in the Epithelial-Mesenchymal Transition of Hepatocellular Carcinoma.

Anal Cell Pathol (Amst) 2019 26;2019:9423907. Epub 2019 Nov 26.

Immunology Department, Victor Babes National Institute of Pathology, Bucharest 050096, Romania.

The epithelial-mesenchymal transition (EMT) is a transformation process mandatory for the local and distant progression of many malignant tumors, including hepatocellular carcinoma (HCC). Matrix metalloproteinases (MMPs) play significant roles in cellular regeneration, programmed death, angiogenesis, and many other essential tissular functions, involved in the normal development and also in pathological processes, such as the EMT. This paper reviews the roles of MMPs in the EMT involved in HCC invasion, as well as the ancillary roles that MMP cross-activation and tissue inhibitors play in modulating this process. While gelatinases MMP-2 and MMP-9 are the MMPs commonly cited in the EMT of HCC, MMPs belonging to other classes have been proven to be involved in this process, favoring not only invasion and metastasis (MMP-1, MMP-3, MMP-7, MMP-10, MMP-11, MMP-13, MMP-14, MMP-16, MMP-26, and MMP-28) but also angiogenesis (MMP-8 and MMP-10). There is also data suggesting that other MMPs with a suspected or demonstrated role in the EMT of other cancers may also have some degree of involvement in HCC. The auto- and cross-activation of MMPs may complicate this issue, as pinpointing the extent of implication of each MMP may be extremely difficult. The homeostasis between MMPs and their tissue inhibitors is essential in preventing tumor progression, and the disturbance of this stability is another entailed factor in the EMT of HCC, which is addressed herein.
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http://dx.doi.org/10.1155/2019/9423907DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6899323PMC
May 2020

Paraneoplastic pityriasis rubra pilaris in association with prostate carcinoma: A case report and literature review.

Exp Ther Med 2019 Dec 7;18(6):5052-5055. Epub 2019 Nov 7.

CMI Dermamed, 530540 Târgu Mureş, Romania.

Pityriasis rubra pilaris (PRP) is a chronic papulosquamous disorder of unknown etiology, characterized by reddish orange scaly plaques, islands of sparing, palmoplantar keratoderma, and keratotic follicular papules. The disease can be acquired or inherited, being divided into 5 categories: classic adult type, atypical adult type, classic juvenile type, circumscribed juvenile type, and atypical juvenile type. More recently, an HIV-associated type has been added to this classification. The cases of PRP associated with malignancy are unusual. We present a case of a 58-year-old man, with the typical clinical aspect of PRP with a four-month onset of the disease. The histopathological and dermatoscopical findings confirmed the PRP diagnosis. The routine laboratory results were in normal limits, except the number of eosinophils, which was elevated and the number of lymphocytes, which was lower. After a thorough examination within a hematological consultation, the cause of hypereosinophilia remained unknown. An imagistic examination was performed and a prostate hypertrophy was noted. The prostate-specific antigen (PSA) level was found to be increased. The urologic consultation based on clinical, imagistic and microscopic features diagnosed an early stage prostate carcinoma. The conclusion was a paraneoplastic PRP in association with prostate carcinoma. The search in international databases revealed twelve published cases regarding the association of PRP with malignancies. The presented case represents a rare coexistence of PRP with malignancy, particularly with prostate carcinoma, and indicates that PRP can occur as paraneoplastic dermatosis, heralding a malignancy. This case is the first one to present PRP associated with prostate carcinoma. Nonetheless, in the authors' opinion, PRP can be considered a paraneoplastic syndrome; therefore, tumor screening is mandatory in cases presenting this disease.
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http://dx.doi.org/10.3892/etm.2019.8169DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880360PMC
December 2019

Reinforcing involvement of NK cells in psoriasiform dermatitis animal model.

Exp Ther Med 2019 Dec 30;18(6):4956-4966. Epub 2019 Aug 30.

Immunobiology Laboratory, 'Victor Babes' National Institute of Pathology, 050096 Bucharest, Romania.

Psoriasis (Ps) is a chronic inflammatory immune-mediated disease with skin and joint manifestations, characterized by abnormal and rapid proliferation of keratinocytes and infiltration of psoriatic lesions with immune cells. Extensive literature suggests that Ps is a T-cell mediated disease its pathogenesis being highly related to innate and adaptative immune cells. Although natural killer (NK) cells are involved in the inflammatory process of Ps through pro-inflammatory cytokine secretion (tumor necrosis factor α, interferon γ), their role in this pathology is not yet fully elucidated. In order to study the involvement of NK subpopulations in the pathogenesis of Ps we used the imiquimod-based mouse model of psoriasiform dermatitis and NK cells complex phenotype patterns from peripheral blood (PB) and spleen were investigated. Skin inflammation and the disease severity were assessed using measurements (erythema, desquamation and induration parameters, PASI modified score), splenomegaly assessment and histopathological evaluation. Phenotypic characterization of NK cells in imiquimod (IMQ)-treated mice was performed by flow cytometry, for both PB and spleen cell suspension. A large panel of surface markers was used: maturation and activation markers [cluster of differentiation (CD)49b, CD11b, CD43, CD27, KLRG1, CD335, CD69, CD28, gp49R, CD45R, CD11c] and markers for cytokine receptors (CD25, CD122, CD132). Our experimental data showed important differences in IMQ-treated mouse NK cell phenotype as compared to control group. The maturation markers (CD11b, CD43, CD27, KLRG1) were found increased on NK cells, in periphery and spleen, while CD49bNK1.1 was significantly lower, and the alterations correlated with the severity of the disease. Our findings reflect the immune engagement toward activatory profile of NK cells and draw attention to evaluating Ps intensity correlated with the mature profile of circulating NK cells.
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http://dx.doi.org/10.3892/etm.2019.7967DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880363PMC
December 2019

Highlights of the 3rd conference of the Romanian Association of Immuno-Dermatology and the 37th conference of the Romanian Society of Immunology held in Bucharest between September 19 and 22, 2019.

Exp Ther Med 2019 Dec 7;18(6):4953-4955. Epub 2019 Nov 7.

Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.

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http://dx.doi.org/10.3892/etm.2019.8174DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880389PMC
December 2019

Proteomic Technology "Lens" for Epithelial-Mesenchymal Transition Process Identification in Oncology.

Anal Cell Pathol (Amst) 2019 29;2019:3565970. Epub 2019 Oct 29.

Faculty of Biology, University of Bucharest, Bucharest 76201, Romania.

The epithelial-mesenchymal transition (EMT) is a complex transformation process that induces local and distant progression of many malignant tumours. Due to its complex array of proteins that are dynamically over-/underexpressed during this process, proteomic technologies gained their place in the EMT research in the last years. Proteomics has identified new molecular pathways of this process and brought important insights to develop new therapy targets. Various proteomic tools and multiple combinations were developed in this area. Out of the proteomic technology armentarium, mass spectrometry and array technologies are the most used approaches. The main characteristics of the proteomic technology used in this domain are high throughput and detection of minute concentration in small samples. We present herein, using various proteomic technologies, the identification in cancer cell lines and in tumour tissue EMT-related proteins, proteins that are involved in the activation of different cellular pathways. Proteomics has brought besides standard EMT markers (e.g., cell-cell adhesion proteins and transcription factors) other future potential markers for improving diagnosis, monitoring evolution, and developing new therapy targets. Future will increase the proteomic role in clinical investigation and validation of EMT-related biomarkers.
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http://dx.doi.org/10.1155/2019/3565970DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6855076PMC
May 2020

The Relationship between the Soluble Receptor for Advanced Glycation End Products and Oxidative Stress in Patients with Palmoplantar Warts.

Medicina (Kaunas) 2019 Oct 20;55(10). Epub 2019 Oct 20.

"Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Background And Objectives: Warts are the most common lesions caused by human papillomavirus (HPV). Recent research suggests that oxidative stress and inflammation are involved in the pathogenesis of HPV-related lesions. It has been shown that the soluble receptor for advanced glycation end products (sRAGE) may act as a protective factor against the deleterious effects of inflammation and oxidative stress, two interconnected processes. However, in HPV infection, the role of sRAGE, constitutively expressed in the skin, has not been investigated in previous studies.

Materials And Methods: In order to analyze the role of sRAGE in warts, we investigated the link between sRAGE and the inflammatory response on one hand, and the relationship between sRAGE and the total oxidant/antioxidant status (TOS/TAS) on the other hand, in both patients with palmoplantar warts ( = 24) and healthy subjects as controls ( = 28).

Results: Compared to the control group, our results showed that patients with warts had lower levels of sRAGE (1036.50 ± 207.60 pg/mL vs. 1215.32 ± 266.12 pg/mL, < 0.05), higher serum levels of TOS (3.17 ± 0.27 vs. 2.93 ± 0.22 µmol H2O2 Eq/L, < 0.01), lower serum levels of TAS (1.85 ± 0.12 vs. 2.03 ± 0.14 µmol Trolox Eq/L, < 0.01) and minor variations of the inflammation parameters (high sensitivity-CRP, interleukin-6, fibrinogen, and erythrocyte sedimentation rate). Moreover, in patients with warts, sRAGE positively correlated with TAS (r = 0.43, < 0.05), negatively correlated with TOS (r = -0.90, < 0.01), and there was no significant correlation with inflammation parameters. There were no significant differences regarding the studied parameters between groups when we stratified the patients according to the number of the lesions and disease duration.

Conclusions: Our results suggest that sRAGE acts as a negative regulator of oxidative stress and could represent a mediator involved in the development of warts. However, we consider that the level of sRAGE cannot be used as a biomarker for the severity of warts. To the best of our knowledge, this is the first study to demonstrate that sRAGE could be involved in HPV pathogenesis and represent a marker of oxidative stress in patients with warts.
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http://dx.doi.org/10.3390/medicina55100706DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6843152PMC
October 2019

Reactive Carbonyl Species as Potential Pro-Oxidant Factors Involved in Lichen Planus Pathogenesis.

Metabolites 2019 Oct 3;9(10). Epub 2019 Oct 3.

Department of Microbiology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.

The constant generation of reactive carbonyl species (RCSs) by lipid peroxidation during aerobic metabolism denotes their involvement in cell homeostasis. Skin represents the largest organ of the body that is exposed to lipid peroxidation. Previous studies have suggested the involvement of oxidative stress in the development of lichen planus (LP), a chronic inflammatory skin condition with a complex pathogenesis. The aim of our study is to investigate a panel of pro-oxidants (4-hydroxy-nonenal (4-HNE), thiobarbituric acid reactive substances (TBARS), and malondialdehyde (MDA)), the total antioxidant status (TAS), and thiol-disulfide homeostasis parameters (TDHP), including total thiol (TT), native thiol (NT), disulfides (DS), DS/NT ratio, DS/TT ratio, and NT/TT ratio. The comparative determinations of serum levels of 4-HNE, TBARS, and MDA in patients with LP ( = 31) and controls ( = 26) show significant differences between the two groups (4-HNE: 7.81 ± 1.96 µg/mL vs. 6.15 ± 1.17 µg/mL, < 0.05, TBARS: 4.23 ± 0.59 µmol/L vs. 1.99 ± 0.23 µmol/L, < 0.05, MDA: 32.3 ± 6.26 ng/mL vs. 21.26 ± 2.36 ng/mL). The serum levels of TAS are lower in LP patients compared to the control group (269.83 ± 42.63 µmol/L vs. 316.46 ± 28.76 µmol/L, < 0.05). The serum levels of TDHP are altered in LP patients compared to controls (NT: 388.10 ± 11.32 µmol/L vs. 406.85 ± 9.32., TT: 430.23 ± 9.93 µmol/L vs. 445.88 ± 9.01 µmol/L, DS: 21.06 ± 1.76 µmol/L vs. 19.52 ± 0.77µmol/L). Furthermore, a negative association between pro-oxidants and TAS is identified (4-HNE - rho = -0.83, < 0.01, TBARS - rho = -0.63, < 0.01, and MDA - rho = -0.69, < 0.01). Understanding the mechanisms by which bioactive aldehydes exert their biological effects on the skin could help define effective therapeutical strategies to counteract the cytotoxic effects of these reactive metabolic intermediates.
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http://dx.doi.org/10.3390/metabo9100213DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836031PMC
October 2019

A Systematic Review and Meta-Analysis of the Accuracy of in VivoReflectance Confocal Microscopy for the Diagnosis of Primary Basal Cell Carcinoma.

J Clin Med 2019 Sep 13;8(9). Epub 2019 Sep 13.

Department of Dermatology, "Prof. N. Paulescu" National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania.

Basal cell carcinoma (BCC) is the most common cancer worldwide and its incidence is constantly rising. Early diagnosis and treatment can significantly reduce patient morbidity and healthcare costs. The value of reflectance confocal microscopy (RCM) in non-melanoma skin cancer diagnosis is still under debate. This systematic review and meta-analysis were conducted to assess the diagnostic accuracy of RCM in primary BCC. PubMed, Google Scholar, Scopus, and Web of Science databases were searched up to July 05, 2019, to collect articles concerning primary BCC diagnosis through RCM. The studies' methodological quality was assessed by the QUADAS-2 tool. The meta-analysis was conducted using Stata 13.0, RevMan 5.0, and MetaDisc 1.4 software. We included 15 studies totaling a number of 4163 lesions. The pooled sensitivity and specificity were 0.92 (95% CI, 0.87-0.95; I= 85.27%) and 0.93 (95% CI, 0.85-0.97; I= 94.61%), the pooled positive and negative likelihood ratios were 13.51 (95% CI, 5.8-31.37; I= 91.01%) and 0.08 (95% CI, 0.05-0.14; I= 84.83%), and the pooled diagnostic odds ratio was 160.31 (95% CI, 64.73-397.02; I=71%). Despite the heterogeneity and risk of bias, this study demonstrates that RCM, through its high sensitivity and specificity, may have a significant clinical impact on the diagnosis of primary BCC.
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http://dx.doi.org/10.3390/jcm8091462DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780971PMC
September 2019

Lipid Profile Changes Induced by Chronic Administration of Anabolic Androgenic Steroids and Taurine in Rats.

Medicina (Kaunas) 2019 Aug 27;55(9). Epub 2019 Aug 27.

Department of Functional Sciences, Division of Physiology and Neuroscience, "Carol Davila" University of Medicine and Pharmacy, 050470 Bucharest, Romania.

: Anabolic androgenic steroids (AAS), used as a therapy in various diseases and abused in sports, are atherogenic in supraphysiological administration, altering the plasma lipid profile. Taurine, a conditionally-essential amino acid often used in dietary supplements, was acknowledged to delay the onset and progression of atherogenesis, and to mitigate hyperlipidemia. The aim of the present study was to verify if taurine could prevent the alterations induced by concomitant chronic administration of high doses of AAS nandrolone decanoate (DECA) in rats. : Thirty-two male Wistar rats, assigned to 4 equal groups, were treated for 12 weeks either with DECA (A group), taurine (T group), both DECA and taurine (AT group) or vehicle (C group). Plasma triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), hepatic triglycerides (TGh) and liver non-esterified fatty acids (NEFA) were then determined. : DECA elevated TG level in A group vs. control ( = 0.01), an increase prevented by taurine association in AT group ( = 0.04). DECA decreased HDL-C in A group vs. control ( = 0.02), while taurine tended to increase it in AT group. DECA decreased TGh ( = 0.02) in A group vs. control. Taurine decreased TGh in T ( = 0.004) and AT ( < 0.001) groups vs. control and tended to lower NEFA ( = 0.08) in AT group vs. A group. Neither DECA, nor taurine influenced TC and LDL-C levels. : Taurine partially prevented the occurrence of DECA negative effects on lipid profile, suggesting a therapeutic potential in several conditions associated with chronic high levels of plasma androgens, such as endocrine disorders or AAS-abuse.
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http://dx.doi.org/10.3390/medicina55090540DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780624PMC
August 2019

Capsaicin: Physicochemical properties, cutaneous reactions and potential applications in painful and inflammatory conditions.

Exp Ther Med 2019 Aug 19;18(2):916-925. Epub 2019 Apr 19.

Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, Bucharest 020021, Romania.

Capsaicin is a natural protoalkaloid recognized as the main pungent component in hot peppers ( L.). The capsaicin receptor is highly expressed in the unmyelinated type C nerve fibers originating from small diameter sensory neurons in dorsal root ganglia and cranial nerve ganglia correspondents. Capsaicin and related vanilloids have a variety of effects on primary sensory neurons function, from sensory neuron excitation characterized by local burning sensation and neurogenic inflammation, followed by conduction blockage accompanied by reversible ultrastructural changes of peripheral nociceptive endings (desensitization), going as far as irreversible degenerative changes (neurotoxicity). The main role in capsaicin-induced neurogenic inflammation relies on the capsaicin sensitive, small diameter primary sensory neurons, therefore its evaluation could be used as a diagnostic instrument in functional alterations of cutaneous sensory nerve fibers. Moreover, capsaicin-induced desensitization and neurotoxicity explain the analgesic/anti-nociceptive and anti-inflammatory effects of topical capsaicin and its potential use in the management of painful and inflammatory conditions. In this study, we describe the effects of capsaicin on neurogenic inflammation and nociception, as well as its potential diagnostic value and therapeutic impact in various conditions involving impairment of sensory nerve fibers.
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http://dx.doi.org/10.3892/etm.2019.7513DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6639979PMC
August 2019

Therapeutic management with biological anti-TNF-α agent in severe psoriasis associated with chronic hepatitis B: A case report.

Exp Ther Med 2019 Aug 9;18(2):895-899. Epub 2019 May 9.

The Second Department of Dermatology, Colentina Clinical Hospital, 020125 Bucharest, Romania.

Systemic therapy in patients with concurrent psoriasis and chronic hepatitis B is a challenging task for both dermatologists and gastroenterologists since there is a high risk for hepatitis B virus (HBV) reactivation and hepatic toxicity under biological therapy. The therapeutic management of a patient with psoriasis and infection with the HBV is a challenge as the classical systemic treatment (methotrexate, acitretin, cyclosporine) shows a high risk of immunosuppression and/or hepatic toxicity and the biological therapy is endangered by the possibility of HBV reactivation. We present the case of a patient with moderate-severe psoriasis and chronic hepatitis B for whom we assessed the risk-benefit relation and considered useful to initiate the anti-TNF therapy concomitantly with the antiviral therapy with entecavir. The therapeutic algorithm included initiation of anti-TNF therapy with etanercept 2×50 mg/week combined with entecavir, an antiviral treatment administered continuously since the diagnosis of the HBV hepatitis, with hepatic function and viral load monitoring. After 3 months of therapy with etanercept the patient was given a dose of etanercept of 50 mg/week combined with entecavir 0.5 mg/day which he continued until week 36 when psoriatic lesions had cleared (PASI=0.6; DLQI=0). No adverse effects were registered and there was no evidence of HBV viral replication or changes in viral markers. We wish to emphasize that the use of etanercept in a patient with psoriasis and hepatitis B is a successful therapeutic alternative which may be safely used concomitantly with entecavir, with regular monitoring of viral load and hepatic function tests.
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http://dx.doi.org/10.3892/etm.2019.7567DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6639968PMC
August 2019

A Romanian experience of syphilis in pregnancy and childbirth.

Midwifery 2019 Nov 25;78:58-63. Epub 2019 Jul 25.

"Carol Davila" University of Medicine and Pharmacy, Bd. Eroii Sanitari nr. 8, Sector 5, 050474 Bucharest, Romania; Cantacuzino National Medico-Military Institute for Research and Development, Splaiul Independentei nr. 103, 050096, Sector 5, Bucharest, Romania.

Objective: to establish the incidence of syphilis in a group of childbearing women and their newborn babies in Romania and to identify the major risk factors of materno-fetal transmission in order for midwives to develop strategies to help prevent congenital syphilis.

Material And Methods: a descriptive study of a group of 982 childbearing women who gave birth during a three-month period at an Obstetrics and Gynaecology Hospital in Romania. The women completed a questionnaire, which consisted of three sections: general data, general knowledge of syphilis and birth and pregnancy data. After admission to hospital, the women were investigated for syphilis using serological tests.

Results: there was a syphilis frequency of 0.91649% (n = 9) among the surveyed women. Among the nine infected women, two were not aware that they had a syphilis infection when initially admitted to hospital. The maternal profile with the highest risk of being diagnosed with syphilis was a young woman who had not had adequate prenatal care, who had elementary sex education and who lacked knowledge of personal health and hygiene. A significant percentage of the respondents, namely 11.9% (n = 117), were aged 15 to 20.

Conclusions: in certain population groups, syphilis is still an important health care problem, especially in vulnerable individuals, such as childbearing women and newborns babies. More attention needs to be paid to primary prevention; the number of cases of congenital syphilis could be reduced by more involvement of midwifes and family doctors in antenatal care.
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http://dx.doi.org/10.1016/j.midw.2019.07.018DOI Listing
November 2019