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Croteau D, Buckley M, Mantay M, Brannan C, Roy A, Barbaro B, Griffiths S. A Novel Dehydrated Human Umbilical Cord Particulate Medical Device: Matrix Characterization, Performance, and Biocompatibility for the Management of Acute and Chronic Wounds. Bioengineering (Basel) 2024; 11:588. [PMID: 38927824 PMCID: PMC11200885 DOI: 10.3390/bioengineering11060588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/28/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
Chronic wounds present a significant socioeconomic burden forecasted to increase in prevalence and cost. Minimally manipulated human placental tissues have been increasingly employed and proven to be advantageous in the treatment of chronic wounds, showing improved clinical outcomes and cost-effectiveness. However, technological advances have been constrained by minimal manipulation and homologous use criteria. This study focuses on the characterization of a novel dehydrated human umbilical cord particulate (dHUCP) medical device, which offers a unique allogeneic technological advancement and the first human birth tissue device for wound management. Characterization analyses illustrated a complex extracellular matrix composition conserved in the dHUCP device compared to native umbilical cord, with abundant collagens and glycosaminoglycans imbibing an intricate porous scaffold. Dermal fibroblasts readily attached to the intact scaffold of the dHUCP device. Furthermore, the dHUCP device elicited a significant paracrine proliferative response in dermal fibroblasts, in contrast to fibrillar collagen, a prevalent wound device. Biocompatibility testing in a porcine full-thickness wound model showed resorption of the dHUCP device and normal granulation tissue maturation during healing. The dHUCP device is a promising advancement in wound management biomaterials, offering a unique combination of structural complexity adept for challenging wound topographies and a microenvironment supportive of tissue regeneration.
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Affiliation(s)
| | | | | | | | | | | | - Sarah Griffiths
- Research and Development, Stimlabs LLC, 1225 Northmeadow Parkway, Suite 104, Roswell, GA 30076, USA
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2
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XiaoMing X, Yan C, JiaMing G, LiTao L, LiJuan Z, Ying S, Lu Y, Qian S, Jian D. Human umbilical cord mesenchymal stem cells combined with porcine small intestinal submucosa promote the healing of full-thickness skin injury in SD rats. Future Sci OA 2024; 10:FSO955. [PMID: 38817375 PMCID: PMC11137796 DOI: 10.2144/fsoa-2023-0123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 12/13/2023] [Indexed: 06/01/2024] Open
Abstract
Aim: To assess the therapeutic potential of human umbilical cord mesenchymal stem cells (hUCMSCs) combined with porcine small intestinal submucosa (SIS) on full-thickness skin injuries in rats. Methods: We established full-thickness skin injury models in Sprague-Dawley rats, dividing them into blank control, SIS, hUCMSCs and hUCMSCs combined with SIS. We monitored wound healing, scores and area, and analyzed inflammatory cells, microvessel density and collagen fibers after 12 days. Results: The blank group showed no healing, forming a scar of 0.6 × 0.5 cm2, while SIS and hUCMSCs groups exhibited incomplete healing with 0.4 × 0.5 cm2 scabs. Wound healing was significantly better in the hUCMSCs combined with the SIS group. Conclusion: Local application of hUCMSCs combined with SIS enhances full-thickness skin injury wound healing in rats.
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Affiliation(s)
- Xu XiaoMing
- Yunnan Tumor Research Institute, The Third Affiliated Hospital of Kunming Medical University, Yunnan Provincial Tumor Hospital/Yunnan Cellular Therapy & Quality Control System Engineering Research Center, Kunming, Yunnan, 650118, China
| | - Chen Yan
- Yunnan Tumor Research Institute, The Third Affiliated Hospital of Kunming Medical University, Yunnan Provincial Tumor Hospital/Yunnan Cellular Therapy & Quality Control System Engineering Research Center, Kunming, Yunnan, 650118, China
| | - Gu JiaMing
- Yunnan Tumor Research Institute, The Third Affiliated Hospital of Kunming Medical University, Yunnan Provincial Tumor Hospital/Yunnan Cellular Therapy & Quality Control System Engineering Research Center, Kunming, Yunnan, 650118, China
| | - Liang LiTao
- Department of Obstetrics, The Second Affiliated Hospital of Kunming Medical University,Kunming,Yunnan, 650101, China
| | - Zhang LiJuan
- Department of Pathology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Provincial Tumor Hospital, Kunming, Yunnan, 650118, China
| | - Song Ying
- Department of Obstetrics, Kunming Maternal & Child Health Hospital, Kunming, Yunnan, 650011, China
| | - Yuan Lu
- Yunnan Tumor Research Institute, The Third Affiliated Hospital of Kunming Medical University, Yunnan Provincial Tumor Hospital/Yunnan Cellular Therapy & Quality Control System Engineering Research Center, Kunming, Yunnan, 650118, China
| | - Song Qian
- Yunnan Tumor Research Institute, The Third Affiliated Hospital of Kunming Medical University, Yunnan Provincial Tumor Hospital/Yunnan Cellular Therapy & Quality Control System Engineering Research Center, Kunming, Yunnan, 650118, China
| | - Dong Jian
- Yunnan Tumor Research Institute, The Third Affiliated Hospital of Kunming Medical University, Yunnan Provincial Tumor Hospital/Yunnan Cellular Therapy & Quality Control System Engineering Research Center, Kunming, Yunnan, 650118, China
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3
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Van Schoor K, Bruet E, Jones EAV, Migeotte I. Origin and flow-mediated remodeling of the murine and human extraembryonic circulation systems. Front Physiol 2024; 15:1395006. [PMID: 38818524 PMCID: PMC11137303 DOI: 10.3389/fphys.2024.1395006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 04/16/2024] [Indexed: 06/01/2024] Open
Abstract
The transduction of mechanical stimuli produced by blood flow is an important regulator of vascular development. The vitelline and umbilico-placental circulations are extraembryonic vascular systems that are required for proper embryonic development in mammalian embryos. The morphogenesis of the extraembryonic vasculature and the cardiovascular system of the embryo are hemodynamically and molecularly connected. Here we provide an overview of the establishment of the murine and human vitelline and umbilico-placental vascular systems and how blood flow influences various steps in their development. A deeper comprehension of extraembryonic vessel development may aid the establishment of stem-cell based embryo models and provide novel insights to understanding pregnancy complications related to the umbilical cord and placenta.
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Affiliation(s)
- Kristof Van Schoor
- Institut de Recherche Interdisciplinaire Jacques E. Dumont, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Emmanuel Bruet
- Institut de Recherche Interdisciplinaire Jacques E. Dumont, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Elizabeth Anne Vincent Jones
- Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology, Katholieke Universiteit Leuven (KU Leuven), Leuven, Belgium
- Department of Cardiology CARIM School for Cardiovascular Diseases Maastricht University, Maastricht, Netherlands
| | - Isabelle Migeotte
- Institut de Recherche Interdisciplinaire Jacques E. Dumont, Université Libre de Bruxelles (ULB), Brussels, Belgium
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Ávila-Fernández P, Etayo-Escanilla M, Sánchez-Porras D, Blanco-Elices C, Campos F, Carriel V, García-García ÓD, Chato-Astrain J. A Novel In Vitro Pathological Model for Studying Neural Invasion in Non-Melanoma Skin Cancer. Gels 2024; 10:252. [PMID: 38667671 PMCID: PMC11049316 DOI: 10.3390/gels10040252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/26/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
Neural Invasion (NI) is a key pathological feature of cancer in the colonization of distant tissues, and its underlying biological mechanisms are still scarcely known. The complex interactions between nerve and tumor cells, along with the stroma, make it difficult to reproduce this pathology in effective study models, which in turn has limited the understanding of NI pathogenesis. In this study, we have designed a three-dimensional model of NI squamous cell carcinoma combining human epidermoid carcinoma cells (hECCs) with a complete peripheral nerve segment encapsulated in a fibrine-agarose hydrogel. We recreated two vital processes of NI: a pre-invasive NI model in which hECCs were seeded on the top of the nerve-enriched stroma, and an invasive NI model in which cancer cells were immersed with the nerve in the hydrogel. Histological, histochemical and immunohistochemical analyses were performed to validate the model. Results showed that the integration of fibrin-agarose advanced hydrogel with a complete nerve structure and hECCs successfully generated an environment in which tumor cells and nerve components coexisted. Moreover, this model correctly preserved components of the neural extracellular matrix as well as allowing the proliferation and migration of cells embedded in hydrogel. All these results suggest the suitability of the model for the study of the mechanisms underlaying NI.
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Affiliation(s)
- Paula Ávila-Fernández
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (P.Á.-F.); (M.E.-E.); (D.S.-P.); (C.B.-E.); (F.C.); (J.C.-A.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
- Doctoral Program in Biomedicine, University of Granada, 18071 Granada, Spain
| | - Miguel Etayo-Escanilla
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (P.Á.-F.); (M.E.-E.); (D.S.-P.); (C.B.-E.); (F.C.); (J.C.-A.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
| | - David Sánchez-Porras
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (P.Á.-F.); (M.E.-E.); (D.S.-P.); (C.B.-E.); (F.C.); (J.C.-A.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
| | - Cristina Blanco-Elices
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (P.Á.-F.); (M.E.-E.); (D.S.-P.); (C.B.-E.); (F.C.); (J.C.-A.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
| | - Fernando Campos
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (P.Á.-F.); (M.E.-E.); (D.S.-P.); (C.B.-E.); (F.C.); (J.C.-A.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
| | - Víctor Carriel
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (P.Á.-F.); (M.E.-E.); (D.S.-P.); (C.B.-E.); (F.C.); (J.C.-A.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
| | - Óscar Darío García-García
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (P.Á.-F.); (M.E.-E.); (D.S.-P.); (C.B.-E.); (F.C.); (J.C.-A.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
| | - Jesús Chato-Astrain
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; (P.Á.-F.); (M.E.-E.); (D.S.-P.); (C.B.-E.); (F.C.); (J.C.-A.)
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18012 Granada, Spain
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5
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Chato-Astrain J, Roda O, Carriel V, Hita-Contreras F, Sánchez-Montesinos I, Alaminos M, Hernández-Cortés P. Histological characterization of the human scapholunate ligament. Microsc Res Tech 2024; 87:257-271. [PMID: 37767790 DOI: 10.1002/jemt.24428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023]
Abstract
The scapholunate interosseous ligament (SLIL) plays a fundamental role in stabilizing the wrist bones, and its disruption is a frequent cause of wrist arthrosis and disfunction. Traditionally, this structure is considered to be a variety of fibrocartilaginous tissue and consists of three regions: dorsal, membranous and palmar. Despite its functional relevance, the exact composition of the human SLIL is not well understood. In the present work, we have analyzed the human SLIL and control tissues from the human hand using an array of histological, histochemical and immunohistochemical methods to characterize each region of this structure. Results reveal that the SLIL is heterogeneous, and each region can be subdivided in two zones that are histologically different to the other zones. Analysis of collagen and elastic fibers, and several proteoglycans, glycoproteins and glycosaminoglycans confirmed that the different regions can be subdivided in two zones that have their own structure and composition. In general, all parts of the SLIL resemble the histological structure of the control articular cartilage, especially the first part of the membranous region (zone M1). Cells showing a chondrocyte-like phenotype as determined by S100 were more abundant in M1, whereas the zone containing more CD73-positive stem cells was D2. These results confirm the heterogeneity of the human SLIL and could contribute to explain why certain zones of this structure are more prone to structural damage and why other zones have specific regeneration potential. RESEARCH HIGHLIGHTS: Application of an array of histological analysis methods allowed us to demonstrate that the human scapholunate ligament is heterogeneous and consists of at least six different regions sharing similarities with the human cartilage, ligament and other anatomical structures.
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Affiliation(s)
- Jesús Chato-Astrain
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Olga Roda
- Department of Human Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, Spain
| | - Víctor Carriel
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Fidel Hita-Contreras
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - Indalecio Sánchez-Montesinos
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Human Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, Spain
| | - Miguel Alaminos
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Pedro Hernández-Cortés
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Surgery and Surgical Specialties, Faculty of Medicine, University of Granada, Granada, Spain
- Division of Traumatology and Orthopedic Surgery, San Cecilio University Hospital, Granada, Spain
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6
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Sánchez-Porras D, Durand-Herrera D, Carmona R, Blanco-Elices C, Garzón I, Pozzobon M, San Martín S, Alaminos M, García-García ÓD, Chato-Astrain J, Carriel V. Expression of Basement Membrane Molecules by Wharton Jelly Stem Cells (WJSC) in Full-Term Human Umbilical Cords, Cell Cultures and Microtissues. Cells 2023; 12:cells12040629. [PMID: 36831296 PMCID: PMC9954414 DOI: 10.3390/cells12040629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023] Open
Abstract
Wharton's jelly stem cells (WJSC) from the human umbilical cord (UC) are one of the most promising mesenchymal stem cells (MSC) in tissue engineering (TE) and advanced therapies. The cell niche is a key element for both, MSC and fully differentiated tissues, to preserve their unique features. The basement membrane (BM) is an essential structure during embryonic development and in adult tissues. Epithelial BMs are well-known, but similar structures are present in other histological structures, such as in peripheral nerve fibers, myocytes or chondrocytes. Previous studies suggest the expression of some BM molecules within the Wharton's Jelly (WJ) of UC, but the distribution pattern and full expression profile of these molecules have not been yet elucidated. In this sense, the aim of this histological study was to evaluate the expression of main BM molecules within the WJ, cultured WJSC and during WJSC microtissue (WJSC-MT) formation process. Results confirmed the presence of a pericellular matrix composed by the main BM molecules-collagens (IV, VII), HSPG2, agrin, laminin and nidogen-around the WJSC within UC. Additionally, ex vivo studies demonstrated the synthesis of these BM molecules, except agrin, especially during WJSC-MT formation process. The WJSC capability to synthesize main BM molecules could offer new alternatives for the generation of biomimetic-engineered substitutes where these molecules are particularly needed.
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Affiliation(s)
- David Sánchez-Porras
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, Universidad de Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Doctoral Program in Biomedicine, Doctoral School, Universidad de Granada, 18016 Granada, Spain
| | - Daniel Durand-Herrera
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, Universidad de Granada, 18016 Granada, Spain
- Facultad de Odontología, Universidad Michoacana de San Nicolás de Hidalgo (UMSNH), Morelia 58010, Mexico
| | - Ramón Carmona
- Department of Cell Biology, Faculty of Sciences, Universidad de Granada, 18071 Granada, Spain
| | - Cristina Blanco-Elices
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, Universidad de Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Ingrid Garzón
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, Universidad de Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Michela Pozzobon
- Department of Women and Children’s Health, University of Padova, 35129 Padova, Italy
- Corso Stati Uniti 4, Institute of Pediatric Research Città della Speranza, 35127 Padova, Italy
| | - Sebastián San Martín
- Centro de Investigaciones Biomédicas, Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Valparaíso 2520000, Chile
| | - Miguel Alaminos
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, Universidad de Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Óscar Darío García-García
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, Universidad de Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Correspondence: (Ó.D.G.-G.); (J.C.-A.)
| | - Jesús Chato-Astrain
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, Universidad de Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Correspondence: (Ó.D.G.-G.); (J.C.-A.)
| | - Víctor Carriel
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, Universidad de Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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Borțea CI, Enatescu I, Pantea M, Dima M, Iacob ER, Dumitru C, Popescu A, Stoica F, Heredea RE, Iacob D. The Molecular and Histopathological Assessment of Inflammatory Status in Very and Extremely Premature Infants: A Prospective Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020352. [PMID: 36832481 PMCID: PMC9954862 DOI: 10.3390/children10020352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023]
Abstract
Prematurity comes with a varying range of complications, implying a high prevalence of complications and mortality and depending on the severity of prematurity and the sustained inflammation among these infants, which recently sparked an important scientific interest. The primary objective of this prospective study was to establish the degree of inflammation in very (VPIs) and extremely preterm infants (EPIs) in association with the histology findings of the umbilical cord (UC), while the secondary objective was to study the inflammatory markers in the neonates' blood as predictors of fetal inflammatory response (FIR). A total of thirty neonates were analyzed, ten of them being born extremely premature (<28 weeks of gestation) and twenty very premature (28-32 weeks of gestation). The EPIs had considerably higher levels of IL-6 at birth than VPIs (638.2 pg/mL vs. 151.1 pg/mL). The CRP levels at delivery did not vary substantially across groups; however, after days, the EPIs had significantly higher CRP levels (11.0 mg/dL vs. 7.2 mg/dL). In contrast, the LDH was considerably higher in the extremely preterm infants at birth and four days after birth. Surprisingly, the proportions of infants with pathologically increased inflammatory markers did not differ between the EPIs and VPIs. The LDH increased considerably in both groups, although the CRP levels increased exclusively among the VPIs. The stage of inflammation in the UC did not vary substantially between the EPIs and VPIs. The majority of infants were identified with Stage 0 UC inflammation (40% in EPI vs. 55% in VPIs). There was a substantial correlation link between gestational age and newborn weight and a significant inverse correlation among gestational age and IL-6 and LDH levels. There was a strong negative association between weight and IL-6 (rho = -0.349) and LDH (rho = -0.261). The stage of the UC inflammation demonstrated a statistically significant direct connection with IL-6 (rho = 0.461) and LDH (rho = 0.293), but none with the CRP. Further studies involving a bigger population size of preterm newborns are required to validate the findings and analyze more inflammatory markers, while prediction models on inflammatory markers that are measured expectantly, before the onset of preterm labor, need to be created.
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Affiliation(s)
- Claudia Ioana Borțea
- Department of Neonatology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Ileana Enatescu
- Department of Neonatology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Manuela Pantea
- Department of Neonatology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Mirabela Dima
- Department of Neonatology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Emil Radu Iacob
- Department of Pediatric Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Catalin Dumitru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Correspondence:
| | - Alin Popescu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Florina Stoica
- Department of Ophthalmology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Rodica Elena Heredea
- Department of Pathology, “Louis Turcanu” Children’s Clinical Emergency Hospital, 300041 Timisoara, Romania
| | - Daniela Iacob
- Department of Neonatology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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