Characterization of the Toxicological Impact of Heavy Metals on Human Health in Conjunction with Modern Analytical Methods

Increased environmental pollution, urbanization, and a wide variety of anthropogenic activities have led to the release of toxic pollutants into the environment, including heavy metals (HMs). It has been found that increasing concentrations of HMs lead to toxicity, mineral imbalances, and serious diseases, which are occurring more and more frequently. Therefore, testing has become imperative to detect these deficiencies in a timely manner. The detection of traces of HMs, especially toxic ones, in human tissues, various biological fluids, or hair is a complex, high-precision analysis that enables early diagnosis, addressing people under constant stress or exposed to a toxic environment; the test also targets people who have died in suspicious circumstances. Tissue mineral analysis (TMA) determines the concentration of toxic minerals/metals at the intracellular level and can therefore determine correlations between measured concentrations and imbalances in the body. Framing the already-published information on the topic, this review aimed to explore the toxicity of HMs to human health, the harmful effects of their accumulation, the advantages vs. the disadvantages of choosing different biological fluids/tissues/organs necessary for the quantitative measurement of HM in the human body, as well as the choice of the optimal method, correlated with the purpose of the analysis.

Non-conventional therapeutical approaches to acne vulgaris related to its association with metabolic disorders

The ever-increasing frequency of metabolic syndrome (MetS) is still a major challenge of the public health care system, worldwide. In recent years, researchers have been drawn to the uncommon (at first look) link between skin illnesses and MetS. Because of the pro-inflammatory mechanisms and insulin resistance (IR) that are upregulated in metabolic syndrome, many skin disorders are correlated to metabolic dysfunctions, including acne vulgaris. A comprehensive understanding of the link between MetS and acne vulgaris may contribute to the development of new treatment strategies. The current review focuses on dietary and therapeutic interventions and assesses the effect of various approaches such as improving diet by avoiding certain food products (i.e., milk and chocolate) or increasing the intake of others (i.e., food products rich in omega-3 fatty acids), metformin administration, therapy with plant extracts, plant essential oils, and probiotic supplementation on the improvement of certain acne vulgaris severity parameters. These therapeutic approaches, when combined with allopathic treatment, can improve the patients' quality of life.

Therapeutic dilemmas in addressing SARS-CoV-2 infection: Favipiravir versus Remdesivir

Coronavirus disease 2019 (COVID-19) represents an unmet clinical need, due to a high mortality rate, rapid mutation rate in the virus, increased chances of reinfection, lack of effectiveness of repurposed drugs and economic damage. COVID-19 pandemic has created an urgent need for effective molecules. Clinically proven efficacy and safety profiles have made favipiravir (FVP) and remdesivir (RDV) promising therapeutic options for use against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Even though both are prodrug molecules with an antiviral role based on a similar mechanism of action, differences in pharmacological, pharmacokinetic and pharmacotoxicological mechanisms have been identified. The present study aims to provide a comprehensive comparative assessment of FVP and RDV against SARS-CoV-2 infections, by centralizing medical data provided by significant literature and authorized clinical trials, focusing on the importance of a better understanding of the interactions between drug molecules and infectious agents in order to improve the global management of COVID-19 patients and to reduce the risk of antiviral resistance.

Comorbidities, Associated Diseases, and Risk Assessment in COVID-19-A Systematic Review

It is considered that COVID-19's pandemic expansion is responsible for the particular increase in deaths, especially among the population with comorbidities. The health system is often overwhelmed by the large number of cases of patients addressing it, by the regional limitation of funds, and by the gravity of cases at subjects suffering from this pathology. Several associated conditions including diabetes, cardiovascular illnesses, obesity, persistent lung condition, neurodegenerative diseases, etc., increase the mortality risk and hospitalization of subjects suffering from COVID-19. The rapid identification of patients with increased risk of death from the SARS-CoV-2 virus, the stratification in accordance with the risk and the allocation of human, financial, and logistical resources in proportion must be a priority for health systems worldwide.

Incidence and Clinical Implications of Autoimmune Thyroiditis in the Development of Acne in Young Patients

Autoimmune thyroiditis (AIT) is on the rise among the population, and is frequently associated with patients with acne vulgaris, especially females aged between 18–55 years old. The connection between the two is not fully elucidated. In this study, 236 patients diagnosed with acne in the dermatological office of the private Pelican Hospital and in few private dermatological offices from Oradea, Romania, during January 2018–December 2020, aged between 12 and 55 years old, were endocrinologically investigated to determine AIT and its influence on the severity of the acne. The values for the thyroid antibodies and thyroid-stimulating hormone (TSH) were determined for all of the subjects. The frequency of AIT in the study group was 72% and was associated with severe acne (p < 0.001). Patients with AIT with normal or hypofunction had more frequent severe acne than those with hyperfunction (p < 0.001, p = 0.002). The TSH and anti thyroidperoxidase (TPO) values did not influence the severity of the acne (p = 0.494; p = 0.111), while the anti-TG values were associated with severe acne (p = 0.007). The risk analysis indicated that raised values of anti-TPO (2.91 times greater) correlated with high anti-thyroglobulin (TG) values (4.36 times greater) doubled the risk of developing severe acne in patients. In acne evolution, the existence of AIT involves significant modifications.

Incidence and Clinical Implications of Autoimmune Thyroiditis in the Development of Acne in Young Patients

Autoimmune thyroiditis (AIT) is on the rise among the population, and is frequently associated with patients with acne vulgaris, especially females aged between 18–55 years old. The connection between the two is not fully elucidated. In this study, 236 patients diagnosed with acne in the dermatological office of the private Pelican Hospital and in few private dermatological offices from Oradea, Romania, during January 2018–December 2020, aged between 12 and 55 years old, were endocrinologically investigated to determine AIT and its influence on the severity of the acne. The values for the thyroid antibodies and thyroid-stimulating hormone (TSH) were determined for all of the subjects. The frequency of AIT in the study group was 72% and was associated with severe acne (p < 0.001). Patients with AIT with normal or hypofunction had more frequent severe acne than those with hyperfunction (p < 0.001, p = 0.002). The TSH and anti thyroidperoxidase (TPO) values did not influence the severity of the acne (p = 0.494; p = 0.111), while the anti-TG values were associated with severe acne (p = 0.007). The risk analysis indicated that raised values of anti-TPO (2.91 times greater) correlated with high anti-thyroglobulin (TG) values (4.36 times greater) doubled the risk of developing severe acne in patients. In acne evolution, the existence of AIT involves significant modifications.

Anti-HIV / HCV Activity of Cyanobacterial Phycobiliproteins by a New Standardized Method Using Bacteriophage Surrogates

The control of the viral infections requires efficient, rapid and safe testing procedures. We tested the efficiency of a quick and reliable alternative assay to the standard plaque assay (PA) in the detection of viral inhibition. Using MS-2 and FX-174 phages, the developed assay was used to evaluate the potential of cyanobacterial phycobiliproteins (PBS) as natural antiviral bioactive molecules against HIV and HCV. The antiviral activity was examined by mixing the phage with crude aqueous extracts in a 1:1 (v/v) ratio for 1hr at 4oC. The viral titer of MS-2 and FX-174 was reduced by 0.92 LR and 1.19 LR, respectively. In the case of the crude PBS extract of Spirulina platensis, similar result trends were obtained by virion titration which indicated that a strong correlation between the two assays was verified (�90 %). The morphological characteristics of both phages were severely affected when treated with the extract, whereas the characteristic features of their hosts seem unaffected. The PBS was found to affect the adsorption of the phages on their bacterial hosts and consequently viral reproduction. In conclusion, MS-2 and FX-174 can be used in drug evaluation by the well standardized method developed in this study.

Effects of combining modern recovery techniques with neurotrophic medication and standard treatment in stroke patients

Stroke is the main cause of disability after age 65, leaving survivors with sequels that require care and recovery treatment lasting years. It is estimated that by the year 2030 this pathology will be leading cause of mortality. To determine the efficacy of Lokomat training combined with neurotrophic medication and balneo-physiotherapeutic treatment in rehabilitation of post-stroke patients, a prospective study of 3 parallel groups was conducted: Group I (n = 22) - Lokomat, balneo-physiotherapy, and Cerebrolysin; Group II (n = 18) - Lokomat associated with balneo-physiotherapy; and Group III (n = 30) - balneo-physiotherapy alone (Control group). Patients were evaluated physically, neurologically, and functionally, according to the evolution of their motor deficiency, spasticity, functional independence and health-related quality of life. Patient improvement is significantly better (p < 0.05) in the group with associated therapies, especially during the first 6 months. Evolution was significantly better in all groups at 12 months than initially (p < 0.05), for all studied parameters and with the best effects in Group I (the three therapies combined). Association of Lokomat training with neurotrophic factors and classic recovery techniques improves the rehabilitation process in stroke patients.

Cr(VI) Ion Reduction Reaction on Nickel and Stainless Steel Electrodes in Acid Medium

The reduction of Cr(VI) ion in 0.5 M H2SO4 deaerated solutions with different concentrations of K2CrO4 on nickel and 18Cr-10Ni stainless steel electrodes have been studied by potentiostatic polarisation technique depending on the chromate concentration in solution. The kinetic parameters -Tafel slope, charge transfer coefficient and limiting current density -were evaluated comparatively. For the solutions containing �5 mM K2CrO4 the Tafel slopes are higher on stainless steel than on nickel (around -135 mV�dec-1 for nickel and -165 mV�dec-1 for stainless steel). Moreover, by increasing the chromate concentration the Tafel slopes increase on nickel and decrease on stainless steel. The low Tafel slope values of -75 mV�dec-1 obtained on stainless steel electrode in the potential region -0.5� -0.75V vs. SCE could be due to a decrease of the charge transfer process rate because of the presence of a physical barrier. The values for the reaction rates are slightly higher for nickel than for stainless steel electrodes on all the studied potential range. The reaction product is soluble trivalent chromium, excepting the solution with 500 mM K2CrO4, when a Cr(OH)3 film may cover the electrode surface that determines the decrease of the reaction rate.

Luminal Versus Non-luminal Breast Cancer CDH1 Immunohistochemical Expression

We investigated the immunohistochemical expression of E-cadherin (product of CDH1 gene) and its correlation with clinical-pathological parameters and survival rate in the molecular groups of breast cancer. Our study included female breast cancer patients diagnosed at the Municipal Emergency Clinical Hospital Timisoara followed up five years since diagnosis using formalin fixed paraffin embedded tissue. The traditional prognostic factors (age, tumor size, histological type, histological grade, anatomical status of the lymph nodes) were abstracted from histopathology reports and we set prognostic index (the Nothingham and lymph-node prognosis index). Molecular classification on selected cases was performed in agreement with data from the literature: luminal A, B, HER2+, triple-negative. We noted positive (membranar) expressions in 43 cases (70.49 %). Negative immunoreactions for E-cadherin have been observed in all cases of lobular carcinomas (4 cases), as well as 6 cases of mixed carcinomas. A significant correlation was found between E-cadherin expression and hormonal status, tumor size, histologic type, tumor grade and molecular subtype. Most of the luminal A and B tumors were E-cadherin positive, while more than half of non-luminal tumors were E-cadherin negative. Survival rates are different in the negative and positive E-cadherin tumor groups respectively and between luminal and non-luminal groups. E-cadherin expression may be a useful prognostic marker for classifying other subgroups of breast cancer.

Chlorate Electrochemical Removal from Aqueous Media Based on a Possible Autocatalytic Mechanism

The electrochemical chlorate reduction at the Pt electrode in 0.5 M H2SO4 deaerated solutions has been studied using potentiostatic steady-state voltammetry. The kinetics parameters (Tafel slope, charge transfer coefficient, current density, and reaction order) were evaluated in function of chlorate concentration (1x10-4 � 0.2 M KClO3). The process of chlorate reduction is a complex one that implies two charge transfer controlled steps with formation of free radicals and an extent potential region controlled by the concentration polarization. The current density dependence of chlorate concentration tends to an exponential growth at concentration � 0.1 M KClO3 and becomes exponential in the conditions of the catalyst system presence. In the second charge transfer, a surface reaction between free radical �Cl-2 and platinum electrode with formation of complex anions PtCL42- and PtCL62- is responsible for the rapid increase of the reaction rate.

Markers Usefulness in the Melanic Metastatic Cellular Epitops Identification in the Sentinel Lymph Node

Cutaneous melanoma is the most severe skin neoplasia with an increased incidence in the recent decades, particularly due to the intense exposure to sunlight. Our study analyzed the characteristics of malignant melanoma and the role of sentinel node biopsy in the diagnosis and prognosis of the patients with cutaneous melanoma by identifying the regional metastasis. The small or large clusters of circulating cancer cells are expressing epitops identified by some chemical reaction. These reagents are usually monoclonal antibodies with high sensitivity and specificity which are matching with the right receptor from the melanoma cells. The result is an antibody-antigen complex high-light in the microscopic examination by 3,3`-diaminobenzidine (DAB). The study was conducted on a sample of 151 patients diagnosed with melanoma in different developmental stages: 62 had Breslow index between 1-4 mm, 71 patients had Breslow index � 4 mm and 18 patients had Breslow index [ 1 mm. 45 patients (out of 62) with Breslow index between 1-4 mm had SLN positive. The mortality rate was 5% in the case of the patients with SLN positive. Comparing the rate of mortality by considering the Breslow index, 65% of the patients with Breslow index � 4 mm died. The correct identification of the patients with negative sentinel node or positive sentinel node improves staging and can facilitate the subsequent therapeutic decision, which is useful for early identification of the micro metastases and of the patients who require regional complete lymph node dissection.

Transabdominal three-dimensional volume imaging of the fetal brain at 18--24 weeks' gestation

OBJECTIVE

This study was undertaken to determine the quality of the visualization of fetal neuroanatomical structures at 18--24 weeks gestation using three-dimensional transabdominal ultrasound.

METHODS

A retrospective study of 40 stored fetal head volumes obtained from 1 November 1999 to 30 June 2000 was undertaken as part of an institutional review board-approved study. The quality of stored images for three axial planes, the midline sagital plane and three coronal planes was graded using a three tier system (optimal, suboptimal and poor).

RESULTS

Optimal visualization for the seven anatomic planes under study ranged from 38% to 55%.

CONCLUSION

Three-dimensional trans abdominal volume studies of the fetal brain show promise for the diagnosis of structural anomalies of the developing brain. However, technological improvements in the quality of resolution will be required for this technique to be incorporated into routine clinical practice.

Disseminated Tuberculosis Related to Child Acute Cytomegalovirus Infection

The spreading of Mycobacterium tuberculosis (MT) through lymphohematogenous pathways with multi-organ damage is disseminated tuberculosis (DT). The case of a child presenting disseminated tuberculosis and who had an acute cytomegalovirus (CMV) infection at the onset of the disease is described in this study. Patient aged 2 presented to Municipal Clinical Hospital of Oradea, Oradea, Romania area with high fever, generalized lymphadenopathy, multiple abscesses of the skin, poor growth, having a background with numerous hospitalizations for respiratory infections in the paediatric department. Chest and head radiography and computed tomography of the same areas show bilateral pleural effusion and osteolytic lesions. The presence of MT was determined from cultures of gastric aspirate and skin lesions. Serology for CMV-specific IgG and IgM antibodies was positive. The treatment of the patient was recommended following the National Tuberculosis Protocol precisely. The patient`s response to treatment was slow. In order to diagnose DT in children (where this disease is severe and rare), a multidisciplinary approach combined with complex and sometimes invasive paraclinical investigations is required.

Alteration of Hormonal Levels in a Rootless Epiphytic Bromeliad in Different Phenological Phases

Major changes in indole-3-acetic acid (IAA) and cytokinin (CK) levels occur at different phenological phases of Tillandsia recurvata shoots. This epiphytic rootless bromeliad was chosen as suitable material for hormonal analysis because CK synthesis is restricted to the shoots, thus avoiding problems in the interpretation of results caused by translocation and interconversion of CK forms between roots and leaves encountered in plants with both organs. Young plants of T. recurvata have weak apical dominance because side shoots appeared early in development, and branch growth was correlated with a strong increase in the level of zeatin. The flowering phase was characterized by a significant increase in free base CKs, zeatin, and isopentenyladenine compared with the levels found in adult vegetative shoots. In contrast, both free-base CKs declined in the fruiting phenological phase, and the IAA level increased dramatically. It was concluded that in phases characterized by intense organ formation, such as in the juvenile and flowering stages, there was an enhancement of CK content, mainly caused by zeatin, leading to a lower IAA/CK ratio. Higher ratios were correlated with phases that showed no organogenesis, such as adult and fruiting phenologies.