Pathogenesis, Prophylaxis, and Treatment of Candida auris.

Candida auris poses a serious threat to infection control and patient care since it can produce invasive infections that have a high fatality rate, has been linked to outbreaks in hospital environments, and is typically resistant to several antifungal medications. Since its first description in 2009, six clades have been described. The emerging fungal pathogen possesses adhesins that allow it to adhere to host tissues and medical devices, can form biofilms, produces various hydrolytic enzymes, employs several strategies to evade host immune responses, and exhibits high genetic diversity, which may contribute to its ability to adapt to different environmental conditions and evade host defenses. C. auris is very resistant to various disinfectants and may be difficult to detect.

Advances in Alpha Herpes Viruses Vaccines for Human.

Alpha herpes simplex viruses are an important public health problem affecting all age groups. It can produce from common cold sores and chicken pox to severe conditions like encephalitis or newborn mortality. Although all three subtypes of alpha herpes viruses have a similar structure, the produced pathology differs, and at the same time, the available prevention measures, such as vaccination. While there is an available and efficient vaccine for the varicella-zoster virus, for herpes simplex virus 1 and 2, after multiple approaches from trivalent subunit vaccine to next-generation live-attenuated virus vaccines and bioinformatic studies, there is still no vaccine available. Although there are multiple failed approaches in present studies, there are also a few promising attempts; for example, the trivalent vaccine containing herpes simplex virus type 2 (HSV-2) glycoproteins C, D, and E (gC2, gD2, gE2) produced in baculovirus was able to protect guinea pigs against vaginal infection and proved to cross-protect against HSV-1. Another promising vaccine is the multivalent DNA vaccine, SL-V20, tested in a mouse model, which lowered the clinical signs of infection and produced efficient viral eradication against vaginal HSV-2. Promising approaches have emerged after the COVID-19 pandemic, and a possible nucleoside-modified mRNA vaccine could be the next step. All the approaches until now have not led to a successful vaccine that could be easy to administer and, at the same time, offer antibodies for a long period.

Open and Laparoscopic Surgical Approache in Incisional Hernias: A Descriptive Analysis.

Background: Incisional hernias, occurring in 10-20% of patients post-abdominal surgery, significantly affect patient quality of life and healthcare systems. This study analyses two hernia repair methods: laparoscopic intraperitoneal onlay mesh (IPOM) and open on-lay hernioplasty. Key analysis factors include operative time, postoperative pain, complications, length of hospital stay, recovery speed, and recurrence rates, with the goal of identifying the most effective and beneficial approach for patients. Methods: We conducted a retrospective study on 70 patients with postoperative parietal defects at the Dr Carol Davila Clinical Nephrology Hospital, Bucharest, from January 2018 to December 2021. Patients underwent either laparoscopic IPOM (42 patients) or open hernioplasty (28 patients) for uncomplicated incisional hernia repair. We analyzed demographic data, comorbidities, defect size and location, previous surgeries, and surgical outcomes. Results: The laparoscopic group had a slightly shorter operative time and significantly lower postoperative pain levels, as assessed by the Visual Analog Scale. The laparoscopic approach also resulted in shorter hospital stays and quicker return to routine activities. Complications, such as seroma and hematoma, were more common in the open surgery group, but no wound infections or prosthesis rejections were observed in either group. Notably, the open surgery group showed a higher recurrence rate (11 %) compared to none in the laparoscopic group within a one-year follow-up. Conclusion: Laparoscopic IPOM for incisional hernia repair shows benefits over open hernioplasty, with less pain, shorter hospitalization, faster recovery, and lower recurrence. Its growing preference and potential for further research are highlighted.

COVID-19 Parental Vaccine Hesitancy in Romania: Nationwide Cross-Sectional Study.

BACKGROUND: COVID-19 vaccination started in Romania in December 2020. Child vaccination started in 2021 with children aged 12-15 years in August. For children aged 5-11 years, vaccination started in January 2022. The aim of our study was to describe COVID-19 vaccination hesitancy in Romanian children and vaccine acceptability in the general population. As parental consent is required for child vaccination in Romania, these aspects have a significant association. METHODS: An analytical cross-sectional survey was conducted in October and November 2021 during the peak of the 4th COVID-19 wave. RESULTS: After validation, 1645 participants formed the main study group: median age 35 years, 72.83% women, and 35.44% from the medical domain. In total, 1311 (79.70%) participants were vaccinated against COVID-19 and 188 (11.42%) had vaccinated their 12-18-year-old children against COVID-19. Parents' level of education, geographic area of residence, and COVID-19 vaccination status were significantly associated with COVID-19 vaccination. The hesitancy factors of child vaccination included the novelty of COVID-19 vaccines (62, 47.32%), fear of adverse reactions (32, 24.42%), and anti-vaccinism in general (29, 22.13%). In the studied group, only 188 (11.42%) participants recommended vaccination of 5-11-year-old children. Vaccine acceptability was higher in the general population (1311, 79.70%) than in the medical domain (326 out of 583, 55.91%). General vaccine hesitancy was based mainly on beliefs regarding inefficiency (131, 39.22%) and fears about the side effects of the vaccine (76, 22.75%). CONCLUSIONS: Overall, the acceptability of COVD-19 vaccines in the Romanian population was influenced by the level of education, area of residence, and being a COVID-19-vaccinated parent. Public health intervention programs are essential.

Early COVID-19 Vaccination of Romanian Medical and Social Personnel.

BACKGROUND: In December 2020, the first doses of COVID-19 vaccines arrived in Romania and were made available to medical and social staff. Vaccine hesitancy appeared as a barrier to effectively ending the pandemic. The opinions of medical and social staff influence the opinion of the general population. This study assesess the attitudes, knowledge, and opinion of medical and social personnel toward COVID-19 vaccines and vaccination and the influencing factors. METHODS: 1025 persons participated in an online cross-sectional study from March until July 2021. RESULTS: Out of 1021 eligible responders, 719 (70.42%) had been vaccinated: 227 with one dose (22.23%) and 492 with two doses (48.18%). There were 302 responders who were not vaccinated at all. Out of them, 188 refused vaccinations. The participants showed a good understanding and knowledge of SARScoV-2 transmission and treatment. Geographic area, medical profession, and medical experience influenced COVID-19 vaccination (p < 0.001). There were no associations between willingness to vaccinate and vaccine/virus knowledge. Most of the responders who were vaccinated or wanted to be vaccinated indicated an mRNA vaccine as their first choice. The variables that were significantly associated with reporting COVID-19 vaccine acceptance after logistic regression were: living in an urban area (Ora = 1.58, 95% CI: 0.98-2.56), being female (Ora = 1.59; 95% CI:1.03-2.44), and being a medical doctor (Ora = 3.40; 95% CI: 1.84-6.26). CONCLUSIONS: These findings show that vaccine hesitancy persists in medical and social personnel in Romania, and, hence, it may be reflected in the hesitancy of the general population toward vaccination.

Asthma in children and adolescents: socio-economic and psycho-somatic considerations.

Bronchial asthma, despite the theoretical and experimental medical progress, remains the most frequently seen chronic disease of the children and has a heavy impact on global morbidity and mortality. The inadequate psychological approach to the asthmatic child and his family can be responsible for this failure in asthma control. We present here the psychosomatic characteristics of the child with asthma and his parents. Some suggestions are made, concerning the correct approach to the patient and parents: how to address parents' trust in current diagnostic and therapeutic resources (in steroids, especially), their personal beliefs regarding asthma and how to tackle the drift towards unconventional medicine.

[Comparison of angiofluorography and Heidelberg II retinal tomography of the head of the optic nerve in patients with primary open-angle glaucoma]. / Aspecte comparative la angiofluorografie si tomografie retiniana Heidelberg II ale capului nervului optic, la pacientii cu glaucom primitiv cu unghi deschis.

OBJECTIVE: This prospective study aims to evaluate how the vascular involvement of the optic disc, emphasised by angiofluorography (AFG), correlates with morphologic lesions observed by Heidelberg retinal tomography (HRT) II. METHOD: AFG (Visucam Zeiss) and HRT II (with Moorfields regression and keratometry) have been performed on the study group -50 pts. with POAG- and in the control group -25 healthy subjects. Correlations have been calculated with Student (t) and Fisher tests. The value of p<0,05 was considered statistically significant. RESULTS AND CONCLUSIONS: The number and size of hypo-fluorescent areas are significantly bigger in POAG pts. than in healthy subjects. They correlate with the involvement of retinal nerve fibers and C/D value. In POAG pts., areas of hypo-fluorescence are located mainly on the excavation's walls and the neuroretinal ring. Localization on the excavation's floor is not pathological, since it was also observed in the control group. The vascular involvement shown by angiofluorography significantly correlates with morphologic lesions observed by HRT II.

[Analysis of the national tuberculosis program. Evolution of tuberculosis in Bihor district, Romania]. / Analiza impactului programului national de control al tuberculozei asupra evolutiei tuberculozei în judetul Bihor.

The prevention and control of tuberculosis are made by a special network, covering all the sanitary units and the entire medical staff. Ten years ago, the DOTS strategy (Directly Observed Treatment, Short-course) was enacted and the National Program for tuberculosis control (PNCT) was implemented on "medium terms" (1997-2000 and after that 2001-2005), with results in 2003 when, for the first time after two decades, has been observed a decrease of the incidence of tuberculosis, maintained also during the next years. The national program of health - the Supervising and control of tuberculosis, in Bihor district rolled in good terms, without any problems in achieving the proposed aims, due to the good coordination between institutions and professionals directly involved in the surveillance and control of disease. As a result of PNCT and prophylactic programs, there was a long-term diminish of costs associated to health care and a medium-term improvement of the following variables: incidence, mortality caused by TB, rate of readmissions, rate of therapeutic success of new TB cases with positive microscopy / new culture-positive TB cases, rate of diagnosis of new pulmonary TB cases with positive microscopy.

[Aspects of pleural/pulmonary involvement in systemic lupus erythematosus]. / Aspecte ale afectarii pleuro-pulmonare in lupusul eritematos sistemic.

Systemic lupus erythematosus (SLE) has a wide spectrum of laboratory findings and clinical manifestations. Our objective was to study the pleural/pulmonary involvement in patients with SLE. We have considered 200 patients, diagnosed according to ARA criteria for SLE. Patients were clinically examined, lab test (including immunology) of blood and pleural liquid were performed and also pulmonary biopsies were made. We found that pleurisy was the most frequent involvement, in 12% of patients. More than 50% of necropsies showed a pulmonary involvement; the most frequent aspect was of acute lupus pneumonia, with large hemorrhagic areas. Microscopy showed macrophages loaded with hemosiderin. The alveolar hemorrhage in SLE is due, possibly, to the impairment of coagulation and has a bad prognostic value.