Background: Tumour volume percentage (TVP) is considered an important pathological parameter, particularly in prostate cancer, representing the ratio of tumour volume to the total gland, and it can be used to measure the quantity of malignancy. Previous reports have already demonstrated that an elevated tumour volume percentage is associated with unfavourable factors, including extraprostatic extension, positive surgical margins, and lymph node metastasis. The independent value of TVP, especially in high-risk prostate cancer treated by radical prostatectomy, remains an area of active research, despite established prognostic factors such as PSA, ISUP grade, and TNM stage. Materials and Methods: We retrospectively analyzed the records of 159 high-risk prostate cancer patients who underwent open or laparoscopic radical prostatectomy between January 2016 and January 2025 at the Clinic of Urology of Targu Mures. High-risk patients were defined as those with ISUP grade 4-5 or PSA >20 ng/mL or clinical stage ≥T2c or stage cT3-4 and/or lymph node metastasis. Tumour volume percentage was calculated from the final pathology result and was determined as the proportion of prostate cancer volume relative to the total prostate volume. Clinical and pathological features, including PSA, ISUP grade, TNM stage, surgical margin, and lymph node involvement, were reported. To assess TVP as an indicator of tumour aggressiveness, univariate and multivariate regression analyses were performed. A p-value < 0.05 was considered statistically significant. Results: A total of 159 high-risk prostate cancer patients (100%), with a median age of 66 years, who underwent open or laparoscopic radical prostatectomy were included. The median tumour volume percentage was 7.6%, and the median prostate volume was 43.8 cc. On univariate analysis, patients with extraprostatic extension (p < 0.001), positive surgical margins (p = 0.005), a higher ISUP grade (p < 0.001), and lymph node metastasis (p = 0.006) exhibited higher TVP compared to their counterparts. A significant correlation was also observed between TVP and the number of positive biopsy cores (p < 0.001), a higher PSA value (p = 0.005), and a younger age (p = 0.041). Conversely, no correlation was identified between TVP and perioperative factors such as hospital stay, surgery duration, ICU days, type of approach, or positive urine culture. Two regression models on multivariate analyses were performed with TVP as the dependent variable. In the continuous variable model (Adjusted R2 = 0.43, p < 0.001), independent predictors of higher TVP were the number of positive biopsy cores (B = 0.54, p < 0.001), the number of positive lymph nodes (B = 2.59, p < 0.001), and surgical margin dimension (B = 1.19, p < 0.001). Age, PSA, and perioperative variables showed no significant correlation with TVP on multivariate analysis. In the categorical regression model (Adjusted R2 = 0.438), statistical significance was confirmed (F-test, p < 0.001). Independent predictors of increased tumour volume percentage included ISUP grade 5 in the effect-coded model (B = +6.60, 95% CI: 0.96-12.25, p = 0.022), and pathological TNM stage pT4 (B = +24.70, 95% CI: 17.69-31.70, p < 0.001). ROC analysis showed limited-to-moderate discrimination for positive surgical margins (AUC = 0.655; 95% CI 0.565-0.744; p = 0.001) and stronger discrimination for pN1 (AUC = 0.793; 95% CI 0.650-0.936; p = 0.002). The Youden-derived cut-offs were 4.90% for positive surgical margins and 5.77% for lymph-node metastasis. Conclusions: Tumour volume percentage is significantly associated with several adverse pathological features in high-risk prostate cancer. Rather than a standalone biomarker, its association with adverse pathological features underscores its potential role in risk stratification models, and the incorporation into pathology reports and prognostic nomograms may improve clinical decision-making.

Background: Environmental factors are known to influence the clinical presentation of patients with multiple sclerosis. This study aims to compare the demographic and clinical characteristics of multiple sclerosis patients treated at two diverse geographical settings. Methods: A cross-sectional, observational cohort study was conducted in two MS centers: the Danish Multiple Sclerosis Center (DMSC) in Copenhagen, Denmark and the Regional MS Center in Târgu Mureș, Romania. We compared patients' demographic and clinical characteristics between MS centers, including sex distribution, current age, MS onset age, latest EDSS scores, symptomatology at disease onset, MS phenotype and type of ongoing DMT. Results: In both cohorts, sex distribution was similar, with females constituting 69.2% in DMSC, and 65.7% in Târgu Mureș. Pyramidal symptoms at MS onset were predominant among Targu Mures patients (32.7%), while sensory symptoms were more frequent among DMSC patients (33%). Progressive forms of MS were more prevalent in Târgu Mureș (22.6%) compared to DMSC (9.9%). High-efficacy DMTs were on use by 58.3% patients in DMSC and only by 29.4% patients in Târgu Mureș, who were mostly on low-efficacy DMTs (54.4% vs. 12.4% in DMSC). Conclusions: The study highlights both shared and distinct characteristics of MS patients treated in these two centers. These findings underscore the importance of regional considerations in the management and treatment of MS.

Polytrauma is a major cause of morbidity and mortality, yet formal training in its management is often absent from undergraduate medical curricula. This study aimed to assess the knowledge and perceptions of Romanian medical students regarding polytrauma management and evaluate the need for dedicated curricular courses. A cross-sectional survey was conducted among medical students from seven major universities in Romania. The questionnaire included demographic data, knowledge about polytrauma, skills related to first aid, and perceptions on introducing polytrauma courses. The study took place at several prominent medical universities across Romania, including Bucharest, Craiova, Timisoara, Iasi, Cluj-Napoca, Targu Mures, and Sibiu. Overall, 413 students participated in the survey and were recruited through online platforms and direct interaction. All participants completed the survey voluntarily. Of all the participants, 78.7% had heard about polytrauma primarily through clinical rotations in General Surgery, Emergency Medicine, and Orthopedics. However, only 31% of the participants who heard about polytrauma accurately defined it. No correlation was found between confidence in providing first aid and actual knowledge (p=0.097). Almost 80% believed that polytrauma management should be a mandatory subject in the curriculum. The study highlights a significant gap in Romanian medical education regarding polytrauma management skills among students. It supports the introduction of mandatory courses on trauma care to enhance practical skills and knowledge retention among future healthcare professionals.

Background and objectives. There are many studies which reveal the burden faced by parents of children with autism. In this case, a critical fact is for parents not only to understand the disease the child has, but also to persist in the long and sometimes complicated recovery, along with acceptance. The aim of this study is to evaluate the psycho-emotional state and level of caregiver burden experienced by parents of children with autism. Materials and methods. We evaluated, in a pilot study, 40 parents of children with autism spectrum disorder who were at the pediatrics neurology and psychiatry clinic in Targu Mures during the period May–June 2025, using a questionnaire with general sociodemographic questions. The questionnaire included the following variables: age, sex, marital status, education level, area of origin, number of family members, number of children, whether they know their family doctor, whether they were informed about the diagnosis, and the medical caregiver burden test, “The Caregiver Burden Inventory,” developed by Young in 1989. Results. We observed that the majority of parents (48%; n = 19) who presented during the May–June 2025 period are aged between 30–39 years. The educational level of these parents is mostly at the high school and vocational level (77%; n = 17). Using the caregiver burden test, only a quarter of them reported feelings of overwhelm or stress related to caregiving. Parents with a high school or vocational education level are 71% less likely to experience stress compared to parents with higher education (p = 0.0122; RR = 0.29; 95% CI: 0.123–0.682). Conclusions. It is important to conduct studies which assess the psycho-emotional state of parents of children with autism, in order to help parents to take care of their child and also to take care of themselves.

Involuntary urinary leakage due to stress urinary incontinence in women represents a widespread health condition that reduces quality of life. Background: Treatment with tension-free vaginal tape (TVT) remains the most used procedure, although its impact on quality of life, specifically regarding sexual function effects, has not been thoroughly investigated. The aim of our study is to achieve a broader understanding of the full range of outcomes after surgery, emotional well-being, and sexual function. Materials and Methods: The present prospective cohort study was conducted between 15 July 2023 and 15 June 2024 in the Emergency County Clinical Hospital Targu Mures, Department of Obstetrics and Gynecology. This is an investigation of TVT surgery and its impact on urinary incontinence, conducted by evaluating bladder dysfunction and sexual function before and after surgical intervention, as well as considering physical and psychological outcomes using specific questionnaires. Results: There was a 91.7% objective cure rate for incontinence, while urinary symptoms, sexual function, and emotional health significantly improved, urine leakage associated with strong urgency (p = 0.0002), urine leakage associated with coughing, sneezing, or laughing (p ≤ 0.0001), and patient sexual activity and emotional health also improved after surgery (p ≤ 0.0001). Furthermore, colorectal symptoms improved. Conclusions: This study emphasizes that for the best recovery of sexual and emotional health post-surgery, complete symptom removal is a requirement. Additionally, the significance of combined questionnaires in assessing treatment efficacy is highlighted. A larger sample size of patients and a longer follow-up are required before recommending this procedure as a standard treatment.

The International Normalized Ratio (INR) is a laboratory test used to monitor and adjust medication with vitamin K antagonists. The alert values of the INR obtained in the laboratory must be managed efficiently to provide the best management for the patient. The aim of the study was to evaluate the risk levels associated with INR alert values for the laboratory in a tertiary care hospital and compare the findings with the established benchmarks. The study was conducted from September 2023 to August 2024 at the Clinical Laboratory from Emergency County Clinical Hospital of Targu Mures. Both risk levels associated with the occurrence of alert values for INR > 4.5 and underlying causes of these values were assessed. Plasma samples collected in all wards were analyzed using Sysmex CS-2500 instrument. The sample's journey through the laboratory was analyzed. The risk was assessed and a daily probability of alert value occurrence for INR was calculated. A total number of 42,799 plasma samples were analyzed, out of which 347 (0.81%) had INR alert values and were collected from 246 patients, some having more than one sample collected. This study showed that INR alert values > 4.5 represent an Unacceptable risk level, with an expected daily occurrence of λ = 0.95 (61% probability of ≥ 1 event per day). The consequence is critical in the risk assessment matrix that corresponds to a frequent probability. The laboratory considered the risk of INR values > 4.5 to be unacceptable both as frequency and consequences. Incomplete documentations of phone communications and resampling delays (> 6h in 30% of the samples) were identified as potential failure modes. Therefore, laboratories are expected to implement strict control measures to effectively mitigate this risk.

Medical education is the paradigm of 21st century education and the current changes involve the adoption of integrative and comprehensive patient-centered teaching and learning approaches. Thus, curricular developers from George Emil Palade University of Medicine, Pharmacy, Sciences, and Technology of Targu Mures (G.E. Palade UMPhST of Targu Mures) have recently designed and implemented an innovative medical curriculum, as well as two valuable assessment tools for both theoretical knowledge and practical skills. Thus, during the first three preclinical years, the students will benefit from an organ- and system-centered block teaching approach, while the clinical years will focus on enabling students to achieve the most important practical skills in clinical practice, based on a patient bedside teaching system. In terms of theoretical knowledge assessment, the UNiX center at G.E. Palade UMPhST of Targu Mures, a recently designed center endowed with the latest next-generation technology, enables individualized, secured multiple-choice question-based assessments of the student’s learning outcomes. Moreover, an intelligent assessment tool for practical skills was also recently implemented in our branch in Hamburg, the Objective Structured Clinical Examination (O.S.C.E). This system uses direct observations for testing the student’s practical skills regarding anamnesis, clinical exams, procedures/maneuvers, the interpretation of laboratory tests and paraclinical investigations, differential diagnosis, management plans, communication, and medical counselling. The integrative, comprehensive, patient-centered curriculum and the intelligent assessment system, implemented in G.E Palade UMPhST of Targu Mures, help define innovation in education and enable the students to benefit from a high-quality medical education.

Background and Objectives: Cardiac transplantation is currently the elective treatment choice in end-stage heart failure, and cellular rejection is a predictive factor for morbidity and mortality after surgery. We proposed an evaluation of the clinicopathologic factors involved in the mechanism of rejection. Materials and Methods: This study included 146 patients who underwent transplantation at the Institute of Cardiovascular Diseases and Transplantation in Targu Mures between 2010 and 2023, and we evaluated the function and structure of the myocardium after surgery by using endomyocardial biopsy. Results: Overall, 120 men and 26 women underwent transplantation, with an approximately equal proportion under and over 40 years old (48.6% and 51.4%). Evaluating the degree of acute cellular rejection according to the International Society for Heart and Lung Transplantation classification showed that most of the patients presented with acute cellular rejection (ACR) and antibody-mediated rejection (AMR) grade 0, and most cases of ACR and AMR were reported with mild changes (13% or 10.3% patients). Therefore, the most frequent histopathologic diagnoses were similar to lesions unrelated to rejection (45.2% of patients) and ischemia-reperfusion lesions (25.3% patients), respectively. Conclusions: Although 82.2% of the transplanted cases showed no rejection (ISHLT score 0), non-rejection-related lesion-like changes were present in 45.2% of cases, and because more of the non-rejection-related criteria could be detected, it may be necessary to adjust the grading of the rejection criteria. The histopathologic changes that characterize rejection are primarily represented by the mononuclear inflammatory infiltrate; in our study, inflammatory changes were mostly mild (71.9%), with myocyte involvement in all cases. These changes are associated with and contribute to the maintenance of the rejection phenomenon.

Background and objectives. Schizophrenia is a chronic psychiatric disorder characterized by complex symptomatology, including both positive and negative manifestations. Depressive symptoms are frequently overlooked in these patients, despite their impact on quality of life and their known association with increased suicide risk. The aim of this study was to assess whether the Patient Health Questionnaire-9 (PHQ-9) is effective as a screening tool to identify depressive symptoms and suicidal ideation among patients with schizophrenia. Materials and methods. We conducted a cross-sectional observational study involving 30 patients diagnosed with schizophrenia, hospitalized in Psychiatric Clinic I, Targu Mures, Romania, between March and May 2025. Each participant completed the PHQ-9, a validated tool assessing the frequency and severity of depressive symptoms over the past two weeks, including a specific item addressing suicidal ideation. Results. Among the 30 patients, the most commonly reported symptoms were: feeling down, depressed or hopeless – 18 patients (60%) nearly every day; feeling bad about themselves – 17 (57%) more than half the time; little interest or pleasure in doing things – 10 (34%) more than half the time; trouble falling asleep – 24 (83%) on several days. Suicidal ideation was reported by 13 patients (43%): 7 (23%) on several days, 4 (13%) more than half the days, and 2 (7%) nearly every day. Conclusions. The PHQ-9 proved to be a practical and efficient tool for screening depressive symptoms in patients with schizophrenia, even in a limited-resource setting. Further research on larger and more diverse populations is needed.

Abstract Background Peripheral artery disease (PAD), traditionally affecting older adults, is increasingly diagnosed in younger patients, highlighting the need for early, non-invasive biomarkers such as the leukocyte glycemic index (LGI) that reflect the inflammatory mechanisms driving atherosclerosis. The aim of this study was to determine whether the LGI can be associated with the presence of symptomatic atherosclerotic disease on patients under 45 years. Methods We conducted a retrospective observational study, enrolling all patients under the age of 45 years who were admitted to the Department of Vascular Surgery of Targu Mures County Emergency Clinical Hospital between January 2019 and May 2024. Patients were categorized into two groups based on the presence or absence of systemic atherosclerosis. Results Patients with systemic atherosclerosis had a higher incidence of cerebrovascular events (p = 0.006) and ischemic heart disease (p = 0.038), as well as elevated counts of white blood cells (WBCs) (p = 0.003), platelets (p = 0.038), neutrophils (p = 0.002), monocytes (p = 0.024), lymphocytes (p = 0.01), and LGI (p = 0,006). At the receiver operating characteristics analysis, we observed a significant correlation between the baseline values of the LGI and systemic atherosclerosis (p = 0.004). The area under the curve (AUC) was determined to be 0.707, with an optimal cut-off value established at 0.683, resulting in a sensitivity of 79.2% and a specificity of 60.6%. Additionally, elevated baseline values for platelets (OR 2.18; p = 0.017), WBCs (OR 2.06; p = 0.020), neutrophils (OR 2.75; p = 0.004), lymphocytes (OR 2.47; p = 0.021), monocytes (OR 2.03; p = 0.021), and LGI (OR 2.90; p = 0.024) were also identified as predictive factors of systemic atherosclerosis. Conclusions Elevated values of LGI are associated with the presence of symptomatic atherosclerotic disease in patients under 45 years.

The medical profession requires continuous knowledge acquisition, effective communication skills, an appropriate level of empathy, and a personality profile that can support high-quality patient care. (1) The purpose of this study was to research whether there are associations or correlations between personality dimensions, empathy, and the attitudes of medical students regarding the learning of communication skills. (2) We conducted a pilot study with 267 first- and sixth-year medical students from the George Emil Palade University of Medicine, Pharmacy, Sciences, and Technology of Targu Mures as the subjects. The students were evaluated using the DECAS personality inventory, the Romanian communication skills ability scale, and Toronto empathy scale. (3) Our results showed that regarding the level of empathy (p = 0.09) and positive attitudes related to communication skills (p = 0.52), there were no statistically significant differences between first- and sixth-year medical students. On the other hand, in the case of negative attitudes, it was observed that there was a statistical significance (p = 0.0003). It was also observed that there was a positive association between agreeableness and empathy (OR = 6.12, p < 0.0001) and a negative association between emotional stability and empathy (OR = 0.45, p = 0.01). Correlations were also found between positive attitudes related to communication skills with patients and the personality dimensions of conscientiousness (r = 0.21, p = 0.0004) and agreeableness (r = 0.15, p = 0.01), as well as between negative attitudes related to communication skills with patients and the agreeableness dimension (r = -0.23, p = 0.0001) and emotional stability dimension (r = -0.13, p = 0.02). Furthermore, the two proposed models confirmed the influence that personality and empathy have on attitudes towards learning communication skills. (4) The findings of this study show that both the personality structure and the empathy of a student are linked to their attitudes about communication.

Background: The objective of our study was to investigate the impact of mineralocorticoid receptor antagonists (MRAs), such as spironolactone, administrated early after cardiac transplantation on the occurrence of acute graft rejection (AGR) in the first 2 years post-transplant. Methods: This retrospective research was conducted in the Emergency Institute for Cardiovascular Diseases and Transplantation of Targu Mures, Romania. After applying the inclusion criteria, between January 2011 and December 2023, 36 patients fit the study design. Using Cox proportional hazards regression and Kaplan-Meier curves, we determined the time-to-event distribution, for which the first episode of AGR was considered an event, with a significance threshold of 0.05. Results: The 1-year rate of AGR was 38.9% and was 47.2% at 2 years, with a 2-year mortality of 11.1%. The interpretation of the Cox regression indicated that early initiation of spironolactone represents a protective factor against the 2-year AGR (HR: 0.263; 95%CI: 0.076-0.922; p = 0.037 by the log-rank test). Conclusions: These results might suggest a possible benefit of the early administration of spironolactone after a heart transplant, but further prospective studies need to be performed for the validation of our findings.

BackgroundInflammatory bowel diseases (IBD), Crohn’s disease and ulcerative colitis, are affecting millions of people around the world with an increasing incidence. Fatigue is an exhausting and highly relevant symptom in patients with inflammatory bowel disease. This study was aimed to investigate the influence of disease activity, paraclinical findings, and level of vitamin B1 on fatigue in patients with IBD. A cross-sectional study including questionnaires was performed on patients with IBD in Gastroenterology Clinic No. 1 in Targu Mures. Additionally, demographic data, laboratory data, IBD history, treatment, and current disease activity were recorded. The blood samples of patients were analyses for level of B1 vitamin. Fatigue severity was assessed using FACIT-F score, a fatigue scale.ResultsA total of 41 patients with IBD were enrolled (43.9% with Crohn’s disease and 56.1% with ulcerative colitis). Fatigue was reported by 41.5% of patients, and 21.95% declared to experience severe fatigue. Thiamine level was not associated with the presence of fatigue. Female sex was associated with the presence of fatigue (p = 0.005). Positive significant correlations were demonstrated between FACIT-F score and level of hemoglobin and (p = 0.006, r = 0.58), hematocrit level (p = 0.0031, r = 0.45), albumin (p = 0.01, r = 0.366), and total proteins (p = 0.033, r = 0.330).ConclusionFatigue was identified at almost half of patients with IBD. The plasma level of thiamine in IBD patients was normal, regardless of the presence of fatigue. Fatigue was positively correlated with female sex, active disease, level of hemoglobin, and albumin.

Background: Gastric cancer remains a major global health burden. Beyond oncologic outcomes, health-related quality of life (HRQoL) is increasingly recognized as a critical endpoint influenced by the reconstruction method after gastrectomy. Methods: A prospective observational study was conducted between December 2021 and December 2024 at the Emergency County Hospital of Targu Mures, Romania, including 150 patients undergoing curative-intent gastrectomy. Patients were divided into two groups: gastroduodenal anastomosis (Billroth I, n=72) and gastrojejunal anastomosis (Billroth II/Roux-en-Y, n = 78). HRQoL was assessed using the EORTC QLQ-STO22 preoperatively and at 3 and 6 months postoperatively. Scores were linearly transformed to a 0 100 scale. Statistical analysis was performed with EasyMedStat Results: The mean age was 61 years, with similar baseline characteristics. Postoperative complications occurred in 32.0% of patients, mostly grade I II. Both groups showed deterioration in dysphagia, pain, reflux, and anxiety at 3 months, followed by partial recovery at 6 months. Reflux scores were consistently higher in the gastrojejunal group at all timepoints (baseline 26.1 vs. 17.6; 3 months 36.5 vs. 24.5; 6 months 27.2 vs. 14.7; p 0.001). Eating restrictions were also greater at 3 and 6 months. Conclusions: Both reconstruction methods impair short-term HRQoL, with partial recovery by 6 months. Gastrojejunal reconstruction is associated with higher reflux and eating restrictions, whereas gastroduodenal reconstruction shows more favorable functional outcomes.

Introduction Transsphenoidal surgery, performed using endoscopic or microscopic techniques, is a safe and effective method for treating neuroendocrine pituitary tumors, including microadenomas. However, the precise location of microadenomas can be challenging to determine, particularly in acromegaly patients, who often exhibit a reduced intracarotid distance. Augmented reality (AR), particularly through heads-up displays (HUD) integrated into surgical microscopes, has been predominantly utilized in transcranial approaches but shows potential in enhancing transsphenoidal procedures. Aim This study aims to present the surgical workflow, techniques, and outcomes associated with using AR in microscopic transsphenoidal surgery for pituitary microadenomas. Material and Methods All procedures were conducted at the Targu Mures Clinical Emergency Hospital’s Department of Neurosurgery between 2019 and 2024. A total of 15 cases were treated using AR-assisted techniques. While the surgical operative time was comparable to non-AR-assisted procedures, the preoperative setup was more time-consuming and required staging to optimize the surgical workflow. In all cases, surgeons successfully identified and resected the microadenomas without complications related to navigation accuracy. Conclusions The findings suggest that integrating AR into transsphenoidal surgery enhances anatomical understanding and precise localization of microadenomas, providing a valuable tool for neurosurgeons. However, AR cannot replace surgical expertise and clinical judgment.

Inside hospitals, there is a trend of increasing levels of air pollutants. However, only the indoor air quality in operating theaters is carefully monitored. Therefore, we set the goal of this study to evaluate the indoor air quality in areas of an orthopedics department and to compare the indoor air quality indices that characterize these areas. We used a monitoring system based on the Internet of Things with uRADMonitor model A3 sensors, with which we prospectively measured indoor air quality in the facilities of the orthopedic emergency hospital of Targu Mures in Romania, between 1 February 2023, and 31 January 2024. The primary target pollutants investigated in the emergency room, outpatient room and ward were carbon dioxide (CO2), nitrogen dioxide (NO2), volatile organic compounds (VOCs) and particles with a diameter smaller than 2.5 μm (PM2.5). We compared the effectiveness of the intervention for emergency rooms where air purifiers were working or not. The concentrations of CO2, VOCs and PM2.5 were significantly higher in the emergency room than in the outpatient room or ward. The indoor air quality was worst in winter, when the CO2, NO2 and VOC concentrations were at their highest. Air purifiers can help reduce the concentration of PM2.5 in emergency rooms. Medical staff and patients in orthopedic hospitals, especially in emergency rooms, are frequently exposed to polluted ambient air, which can affect their health. Orthopedic medical practice guidelines should address issues relating to the protection of personnel through the application of measures to improve indoor air quality.

Background/Objectives: The presence of enamel on the tooth surface is crucial for the long-term success of minimally invasive adhesive restorations such as dental veneers. Our study aims to evaluate the enamel thickness in the incisal, middle, and cervical portions of the labial surface of the upper central incisors using cone beam computed tomography (CBCT). This imaging method provides detailed and accurate three-dimensional images with a low radiation dose, allowing an accurate assessment of enamel thickness. The analysis aims to identify variations in enamel thickness depending on the age and different levels of the labial tooth surface. Methods: 800 CBCT scans performed for diagnostic or therapeutic purposes on patients aged 18-60 years were analyzed. The data were gathered from the imaging archives of private practitioners from Targu Mures and the "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Targu Mures. Enamel thickness measurements were conducted using the OnDemand3D Communicator CBCT evaluation program, with subsequent statistical analysis performed using GraphPad Instat Prism software. Results: Results showed significant variation in enamel thickness between the incisal, middle, and cervical segments of the labial surface of the upper central incisors. A decrease in enamel thickness with age has been observed. In patients aged 18-40, mean values of enamel thickness 1 mm and 3 mm above the cementoenamel junction (CEJ) were 0.48 ± 0.092, respectively, 0.819 ± 0.158. In patients over 40, the mean values were 0.454 ± 0.116 and 0.751 ± 0.067 at 1 mm, respectively, 3 mm above the CEJ. Statistically significant differences were found between the two age groups at 1 mm and 3 mm above the CEJ, with p < 0.0001 and p = 0.0214. Conclusions: A statistically significant decrease can be observed in enamel thickness in almost the entire labial surface of the upper central incisors with aging. The varied thickness of the enamel at different tooth levels requires individualized planning for each patient to maximize the long-term aesthetic and functional results.

Background and Objectives: Cardiac transplantation represents the option for patients with end-stage heart failure (HF), providing the best survival rate. However, the postoperative complications of transplant patients remain a challenge for clinicians. The objective of our study was to evaluate the effect of preoperative chronic HF treatment on the occurrence of in-hospital complications. Materials and Methods: We retrospectively included a total of 50 patients who underwent cardiac transplantation between January 2011 and December 2023 from the Emergency Institute for Cardiovascular Diseases and Transplantation of Targu Mures. We correlated the preoperative chronic HF treatment with the postoperative complications by Spearmen's correlation coefficient, respectively. With logistic regression, the associations between the treatment and specific complications were determined. Results: Significant negative correlations were found between Carvedilol treatment with 2-month mortality (r = -0.30; 95% CI: -0.53--0.02; p = 0.03), Ramipril with hospital stay (r = -0.38; 95% CI: -0.60--0.12; p < 0.01) and intensive care unit (ICU) stay (r = -0.37; 95% CI: -0.59--0.11; p = 0.01), and Spironolactone usage with hospitalization duration (r = -0.28; 95% CI: -0.52--0.01; p = 0.04). Furthermore, Carvedilol treatment represented a protective factor against early acute kidney injury (AKI) (OR: 0.22; 95% CI: 0.05-0.91; p = 0.03). Spironolactone treatment was a protective factor against AGR (OR: 0.12; 95% CI: 0.02-0.66; p = 0.01) treatment, in contrast to angiotensin-converting enzyme inhibitor (ACEI) therapy (OR: 5.30; 95% CI: 1.03-27.17; p = 0.04). Conclusions: Pre-transplant Carvedilol treatment was negatively correlated with the 2-month mortality rate. Ramipril and Spironolactone therapy were negatively correlated with hospitalization duration, and Ramipril was additionally correlated with ICU stay. Moreover, Carvedilol therapy represented a protective factor against early AKI. Pre-transplant Spironolactone was associated with lower event rates of AGR, in contrast to ACEI treatment. Prospective studies with larger cohorts are needed in order to draw drastic conclusions.

Background and Objectives: Head and neck squamous cell carcinomas (HNSCCs) vary significantly in terms of invasiveness, growth rate, and metastatic potential. This study aimed to investigate the expression of several prognostic biomarkers (Ki67, p53, EGFR, COX-2, Cx43, and p16) in HNSCC from various anatomical regions and to correlate these expressions with clinicopathological parameters. Materials and Methods: We performed immunohistochemistry on 91 histologically verified HNSCC cases from the County Emergency Hospital, Targu Mures. Biomarker expression for Ki67, COX-2, and Cx43 was assessed using a standard immunoexpression scoring system: S1: 0–10%, S2: 11–25%, S3: 26–50%, S4 > 50%; EGFR was scored based on membrane staining intensity: 0, 1+, 2+, 3+; we classified p16 as positive or negative; p53 was grouped into mutant and wild-type; and we compared these across histopathological types, tumor grades, anatomical locations, gender, and different age groups. We performed a comparative analysis of Cx43 expression levels in relation to the expression of the rest of the markers. Statistical analysis was conducted using GraphPad InStat 3 software, version 3.06 (GraphPad Software Inc., San Diego, USA). Results: The majority of tumors were in males (95.6%) aged 51–60 years. Mutant p53 expression was prevalent in most cases. Elevated Ki67 and EGFR expression were associated with more aggressive tumors. COX-2 levels varied, with a higher proportion of moderate and high immunoexpression (S3 + S4) observed in patients under 70 years old. Cx43 expression was generally low, especially in extralaryngeal tumors. Conclusions: HNSCC primarily affects older males, with the larynx being the most common site. High levels of Ki-67 and EGFR suggest more aggressive tumors, while low COX-2 levels reflect varying prognoses. Women may develop more aggressive tumors, and extralaryngeal tumors often present with more challenging prognoses. Low Cx43 expression may be more likely to coincide with higher Ki67 and COX-2 levels, possibly indicating a link with more aggressive tumor behavior.

Heart transplantation (HT) remains the ultimate treatment for end-stage heart failure. An endomyocardial biopsy (EMB) is "the gold standard" diagnostic procedure used in HT rejection surveillance. The aim of this study is to provide a detailed analysis of the histopathological characteristics of the EMB and to investigate if there is a correlation between some histopathological changes, such as fibrosis, vasculitis, Quilty effect (Q.E.), myocytes damage, and the presence of episodes of acute rejection. In this retrospective study, 200 EMBs were included, coming from 65 patients transplanted in the Emergency Institute for Cardiovascular Diseases and Transplantation (ICvDT) Targu Mures between 2012 and 2024. Fibrosis, vasculitis, Q.E., myocyte damage, etc., were microscopically evaluated to see if these parameters correlate with rejection episodes. The mean age was 38.18 years (SD 15.67), 25% of biopsies being recorded in the 41-50 age group. 77.14% of total acute cellular rejection (ACR) was of mild rejection, with most registered in the 11-20 age group; the cases of severe rejection being recorded in the 41-50 age group. Antibody-mediated rejection (AMR) was recorded more frequently in women with a representation of 23.4%, compared to 8.5% of men. 86.7% (39 cases) of the total number of EMBs with fibrosis score 3 and 71.4% (15 cases) of the total EMBs with fibrosis score 2 were recorded in men, compared to the 28.6% (6 cases) of fibrosis score 2 recorded in women (p = 0.013). 50.0% of all the EMB recorded in the 61-70 age group showed fibrosis score 3, compared to 34.8% of those from the 21-30 age group. The Q.E. was identified in 13% of the biopsies and, in some patients, it was observed across 3-4 successive biopsies. Mild vasculitis was associated in 34.9% of cases with ISHLT ≥ 1R and moderate vasculitis was associated in 87.5% of cases with ISHLT ≥ 1R. Fibrosis was detected much more frequently in men and in the 61-70 age group. In addition to the histopathological changes specific to acute rejection, there are other pathological changes, such as the Q.E., and vasculitis and myocytes damage and disarray, that seem to suggest a close connection with rejection, but extensive studies are needed to confirm this.