Polysaccharide Composite Alginate-Pectin Hydrogels as a Basis for Developing Wound Healing Materials.

This article presents materials that highlight the bioengineering potential of polymeric systems of natural origin based on biodegradable polysaccharides, with applications in creating modern products for localized wound healing. Exploring the unique biological and physicochemical properties of polysaccharides offers a promising avenue for the atraumatic, controlled restoration of damaged tissues in extensive wounds. The study focused on alginate, pectin, and a hydrogel composed of their mixture in a 1:1 ratio. Atomic force microscopy data revealed that the two-component gel exhibits greater cohesion and is characterized by the presence of filament-like elements. The dynamic light scattering method indicated that this structural change results in a reduction in the damping of acoustic modes in the gel mixture compared to the component gels. Raman spectroscopy research on these gels revealed the emergence of new bonds between the components' molecules, contributing to the observed effects. The biocompatibility of the gels was evaluated using dental pulp stem cells, demonstrating that all the gels exhibit biocompatibility.

Improving the Hydrophobicity of Plasticized Polyvinyl Chloride for Use in an Endotracheal Tube.

An endotracheal tube (ETT) is a greatly appreciated medical device at the global level with widespread application in the treatment of respiratory diseases, such as bronchitis and asthma, and in general anesthesia, to provide narcotic gases. Since an important quantitative request for cuffed ETTs was recorded during the COVID-19 pandemic, concerns about infection have risen. The plasticized polyvinyl chloride (PVC) material used to manufacture ETTs favors the attachment of microorganisms from the human biological environment and the migration of plasticizer from the polymer that feeds the microorganisms and promotes the growth of biofilms. This leads to developing infections, which means additional suffering, discomfort for patients, and increased hospital costs. In this work, we propose to modify the surfaces of some samples taken from commercial ETTs in order to develop their hydrophobic character using surface fluorination by a plasma treatment in SF6 discharge and magnetron sputtering physical evaporation from the PTFE target. Samples with surfaces thus modified were subsequently tested using XPS, ATR-FTIR, CA, SEM + EDAX, profilometry, density, Shore A hardness, TGA-DSC, and biological antimicrobial and biocompatibility properties. The obtained results demonstrate a successful increase in the hydrophobic character of the plasticized PVC samples and biocompatibility properties.

Successful management of chronic migraine through manual therapy. A case report.

Migraine is the second most debilitating condition affecting a significant portion of the general population, particularly young adults under 50. Despite extensive research, the etiology of migraine remains diverse and often multifactorial, with limited clarity on the specific underlying pathogenic processes. Consequently, the treatment of migraine lacks a mechanism-based approach. We present the case of a young female patient suffering for 8 years of chronic migraine and tension-type headaches. The manual therapy techniques successfully released the muscular tensions, considerably improving her quality of life in terms of pain and emotional well-being.

The Golgi Apparatus: A Voyage through Time, Structure, Function and Implication in Neurodegenerative Disorders.

This comprehensive review article dives deep into the Golgi apparatus, an essential organelle in cellular biology. Beginning with its discovery during the 19th century until today's recognition as an important contributor to cell function. We explore its unique organization and structure as well as its roles in protein processing, sorting, and lipid biogenesis, which play key roles in maintaining homeostasis in cellular biology. This article further explores Golgi biogenesis, exploring its intricate processes and dynamics that contribute to its formation and function. One key focus is its role in neurodegenerative diseases like Parkinson's, where changes to the structure or function of the Golgi apparatus may lead to their onset or progression, emphasizing its key importance in neuronal health. At the same time, we examine the intriguing relationship between Golgi stress and endoplasmic reticulum (ER) stress, providing insights into their interplay as two major cellular stress response pathways. Such interdependence provides a greater understanding of cellular reactions to protein misfolding and accumulation, hallmark features of many neurodegenerative diseases. In summary, this review offers an exhaustive examination of the Golgi apparatus, from its historical background to its role in health and disease. Additionally, this examination emphasizes the necessity of further research in this field in order to develop targeted therapeutic approaches for Golgi dysfunction-associated conditions. Furthermore, its exploration is an example of scientific progress while simultaneously offering hope for developing innovative treatments for neurodegenerative disorders.

The Brain's Glymphatic System: Drawing New Perspectives in Neuroscience.

This paper delves into the intricate structure and functionality of the brain's glymphatic system, bringing forth new dimensions in its neuroscientific understanding. This paper commences by exploring the cerebrospinal fluid (CSF)-its localization, production, and pivotal role within the central nervous system, acting as a cushion and vehicle for nutrient distribution and waste elimination. We then transition into an in-depth study of the morphophysiological aspects of the glymphatic system, a recent discovery revolutionizing the perception of waste clearance from the brain, highlighting its lymphatic-like characteristics and remarkable operations. This paper subsequently emphasizes the glymphatic system's potential implications in Alzheimer's disease (AD), discussing the connection between inefficient glymphatic clearance and AD pathogenesis. This review also elucidates the intriguing interplay between the glymphatic system and the circadian rhythm, illustrating the optimal functioning of glymphatic clearance during sleep. Lastly, we underscore the hitherto underappreciated involvement of the glymphatic system in the tumoral microenvironment, potentially impacting tumor growth and progression. This comprehensive paper accentuates the glymphatic system's pivotal role in multiple domains, fostering an understanding of the brain's waste clearance mechanisms and offering avenues for further research into neuropathological conditions.

Antimicrobial Solutions for Endotracheal Tubes in Prevention of Ventilator-Associated Pneumonia.

Ventilator-associated pneumonia is one of the most frequently encountered hospital infections and is an essential issue in the healthcare field. It is usually linked to a high mortality rate and prolonged hospitalization time. There is a lack of treatment, so alternative solutions must be continuously sought. The endotracheal tube is an indwelling device that is a significant culprit for ventilator-associated pneumonia because its surface can be colonized by different types of pathogens, which generate a multispecies biofilm. In the paper, we discuss the definition of ventilator-associated pneumonia, the economic burdens, and its outcomes. Then, we present the latest technological solutions for endotracheal tube surfaces, such as active antimicrobial coatings, passive coatings, and combinatorial methods, with examples from the literature. We end our analysis by identifying the gaps existing in the present research and investigating future possibilities that can decrease ventilator-associated pneumonia cases and improve patient comfort during treatment.

Unraveling Molecular and Genetic Insights into Neurodegenerative Diseases: Advances in Understanding Alzheimer's, Parkinson's, and Huntington's Diseases and Amyotrophic Lateral Sclerosis.

Neurodegenerative diseases are, according to recent studies, one of the main causes of disability and death worldwide. Interest in molecular genetics has started to experience exponential growth thanks to numerous advancements in technology, shifts in the understanding of the disease as a phenomenon, and the change in the perspective regarding gene editing and the advantages of this action. The aim of this paper is to analyze the newest approaches in genetics and molecular sciences regarding four of the most important neurodegenerative disorders: Alzheimer's disease, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis. We intend through this review to focus on the newest treatment, diagnosis, and predictions regarding this large group of diseases, in order to obtain a more accurate analysis and to identify the emerging signs that could lead to a better outcome in order to increase both the quality and the life span of the patient. Moreover, this review could provide evidence of future possible novel therapies that target the specific genes and that could be useful to be taken into consideration when the classical approaches fail to shed light.

Intracranial arteriovenous malformation (AVM) or meningothelial meningioma (MM)? Outlining the similarities and differences on imaging studies for an accurate diagnosis, case report.

INTRODUCTION AND IMPORTANCE: AVM and MM represent neurosurgical challenges, not only when involving eloquent brain, but also by posing a significant intraoperative haemorrhagic risk. It is a challenge in itself to establish a proper differential diagnosis between the two lesions, especially since they require distinct interventional plan of action. We present the case of a patient initially diagnosed by specialists with an intracranial AVM, which was revealed intraoperatively to be in fact an MM. CASE PRESENTATION: A 29-years patient, transferred to our department by urgency. The patient symptoms started two weeks prior admission with severe headache and vomiting. A cerebral computer tomographic angiography (CTA) was performed and interpreted by radiologists, as a large left frontal AVM. CLINICAL DISCUSSION: Upon through review the majority of surgical team believed the mass to be AVM. However, during surgery it turned out to be Meningioma. The patient underwent a left pterional craniotomy with removal of the tumour, classified as Simpson grade II. The pathological exam confirmed the lesion to be an MM. CONCLUSIONS: Acquiring neuro-radiological expertise is vital for the neurosurgeon, as well as fast ability for adjusting the initial action plan with the intraoperative discoveries. An experienced eye can benefit the patient by obtain a correct diagnosis in most difficult cases.

A Prospective Viewpoint on Neurological Diseases and Their Biomarkers.

Neurodegenerative diseases (NDDs) are disorders that affect both the central and peripheral nervous systems. To name a few causes, NDDs can be caused by ischemia, oxidative and endoplasmic reticulum (ER) cell stress, inflammation, abnormal protein deposition in neural tissue, autoimmune-mediated neuron loss, and viral or prion infections. These conditions include Alzheimer's disease (AD), Lewy body dementia (LBD), and Parkinson's disease (PD). The formation of ß-sheet-rich aggregates of intra- or extracellular proteins in the CNS hallmarks all neurodegenerative proteinopathies. In systemic lupus erythematosus (SLE), numerous organs, including the central nervous system (CNS), are affected. However, the inflammatory process is linked to several neurodegenerative pathways that are linked to depression because of NDDs. Pro-inflammatory signals activated by aging may increase vulnerability to neuropsychiatric disorders. Viruses may increase macrophages and CCR5+ T cells within the CNS during dementia formation and progression. Unlike medical symptoms, which are just signs of a patient's health as expressed and perceived, biomarkers are reproducible and quantitative. Therefore, this current review will highlight and summarize the neurological disorders and their biomarkers.

SARS-COV-2 - the pandemic of the XXI century, clinical manifestations - neurological implications.

In December 2019, in Wuhan, China, the first cases of infection with SARS-CoV 2 responsible for COVID-19 disease were identified. SARS-CoV 2 was declared a pandemic on March 11, 2020, and since then has attracted the medical world's attention. The threat to humans' health that this emerging pandemic could leave raises awareness on the importance of understanding the mechanisms that underlie the developing conditions. The epidemiology, clinical picture, and pathogenesis of COVID-19 show that this virus presents new strategies to overcome the past defensive medicine. While all the current data has focused on the pulmonary and cardiovascular manifestations, little has been written about the neurological implications of the disease. This review updates new clinical aspects that SARS-CoV 2 expresses in humans by focusing primarily on neurological manifestations. The damage to the nervous system became more apparent - anosmia, ageusia, polyneuritis, meningitis, meningoencephalitis, stroke, acute necrotizing encephalopathy. Oxygen therapy is vital for those in critical health situations. Finally, prevention is the most important element in breaking the epidemiological chain.

Cranioplasty after Two Giant Intraosseous Angiolipomas of the Cranium: Case Report and Literature Review.

Angiolipomas are rare, benign tumors resulting from the proliferation of adipose tissue and blood vessels, most frequently encountered subcutaneously at the upper limbs and trunk level. Due to their rarity, few cases of intraosseous angiolipomas are presented in the literature. The paper reports a 50-year-old female case with intracranial hypertension syndrome, frontal and parietal headache, nausea, and vomiting symptoms increasing in intensity. A CT exam revealed two hypodense expansive intraosseous formations/lesions. The first one was located in the projection of the frontal bone and the second one was placed on the left parietal bone. After further investigations, a two-stage procedure was considered. A frontal craniotomy with excision of the intraosseous tumor was performed in the first stage. In the second stage, a left parietal craniotomy was done with excision of the intraosseous tumor combined with a cranioplasty procedure. The patient had a favorable postoperative evolution with no symptoms or neurological deficits. This is among the few reported cases of intraosseous angiolipoma located at the cranium level and the first case report of two intraosseous angiolipomas situated on the same site. The medical recommendation was a complete surgical excision of the lesion followed by cranioplasty.

Wilhelm von Waldeyer: Important Steps in Neural Theory, Anatomy and Citology.

Heinrich Wilhelm Gottfried von Waldeyer-Harz is regarded as a significant anatomist who helped the entire medical world to discover and develop new techniques in order to improve patient treatment as well as decrease death rates. He discovered fascia propria recti in 1899, which is important in total mesorectal excision which improves cancer treatment as well as outcomes. He played an important role in developing the neuron theory which states that the nervous system consists of multiple individual cells, called neurons, which currently stands as the basis of the impulse transmission of neurons. Waldeyer was also interested in cytology, where he made a substantial contribution, being the first who adopted the name "Chromosome". Therefore, he accelerated the progress of what it is now known as Genetics. In conclusion, starting from the Fascia propria recti and continuing with great discoveries in cytology and neuron theory, Wilhelm von Waldeyer represents a key person in what we today call medicine.

Roadmap to Neurosurgery - from Student to Resident.

Neurosurgery is a medical speciality that diagnoses and treats brain and spine pathologies of infants, children, and adults, having 2 components: clinical and surgical activities. The history of neurosurgery dates back to the Prehistoric Period when first trepanations took place. However, the extensive amount of information we use today was discovered and invented thanks to Joseph Lister (1827-1912), William T.G. Morton (1819-1868) and Pierre Paul Broca (1823-1880) who implemented systematic antisepsis rules, anaesthesia and, respectively, the localization of different areas of the brain. Nevertheless, professors such as Harvey Cushing (1869-1939) and Gazi Yasargil (n.1925) are responsible for the definition of neurosurgery as a stand-alone surgical specialty and the significant improvement of the surgical techniques. Moreover, Professor Dumitru Bagdasar (1893-1946) is the one responsible for the introduction of neurosurgery in Romania, training a "golden neurosurgeon team" who are remarked as the first neurosurgeons of Romania. Even though it is such a new medical field, a vast amount of theoretical and practical study is necessary. Therefore, a student needs dedication and lots of effort to achieve perfection in one of the most complex medical speciality, requiring more than 100 exams and over 14,900 hours of practice during the 6 years of medical school and 6 years of neurosurgical residency. Still, even if it seems a lot at first, the moral rewards stand out in the end due to the significant contrast between the preoperative and postoperative condition of the patient. Nevertheless, some of the students might be negatively influenced by family and friends through different myths that neurosurgery is a goal that is almost impossible to be achieved since the amount of practice and sacrifices it requires are a lot bigger than other medical specialities. In conclusion, neurosurgery accomplished to overcome the mystery of the human brain and developed at a fast pace. Today, neurosurgeons around the world treat more and more pathologies that seemed incurable and inoperable 100 years ago.

George Gershwin (1898-1937) - genius composer, malignant brain tumor patient. Malignant glioma: an irritating∕stimulating element in triggering geniality?

George Gershwin (1898-1937) was one of the most influential American composers of the 20th century. Likewise his swift, comet-like, career progress from a high school dropout to an iconic composer of the 20th century: "The man who said he had more notes in his head than he could write down in a hundred years died suddenly ... in Hollywood". His malignant glioma presented symptoms only in his last year of life and even then, the symptoms were masked by other hectic events in his personal life, which typical accompany the life of a famous and handsome composer from Hollywood. Considering new, emerging studies regarding the relationship between gliomas and brain activity, the authors explore the following questions: (i) Is intense neuronal, intellectual activity a cause that can trigger the development of a malignant brain tumor, especially a glioblastoma? (ii) Is glioblastoma and its connections with normal nerve cells, with noble tissue (a fact demonstrated in recent years), a cause that can trigger geniality, a different thought process from most people with a normal-functioning brain?

Characteristics and Surgical Outcomes of Pediatric Intracranial Aneurysms in Romania.

AIM: To analyze the demographic characteristics and surgical outcomes of the largest series of patients with pediatric aneurysms reported in Romania, in consideration of the primary factors that lead to good long-term outcomes. Given that all cases involved ruptured aneurysms, we also investigated the ability of microsurgical clipping to prevent massive hemorrhage andaggravation of neurological deficits. MATERIAL AND METHODS: This multicenter retrospective study included 47 pediatric patients ( < 16 years old) who underwent operation over the 20-year period between January 1999 and January 2019. We analyzed medical records and imaging findings in each patient. Treatment consisted of open microsurgical dissection (clipping) and endovascular embolization (coiling). RESULTS: Mean patient age was 14.3 years, ranging from 5 months to 16 years, with 28 boys (59.5%) and 19 girls (40.4%). In our series, pediatric aneurysms represented 6.1% of all intracranial aneurysms (771 cases). Clinical features were dominated by headache (45 cases, 95.7%), neck stiffness (43 cases, 91.4%) and vomiting (42 cases, 89.3%). The most frequently involved locations were the anterior communicating artery (17 cases, 36.1%), middle cerebral artery (12 cases, 25.5%), and internal carotid artery bifurcation (9 cases, 19.1%). Glasgow Outcome Scale scores at 6 months indicated good recovery in 36 patients (76.5%), moderate disability in ninepatients (19.1%), severe disability in one patient (2.1%), and (preoperative) death in one patient (2.1%). CONCLUSION: Intracranial aneurysms in children are very rare. Early diagnosis based on brain imaging and microsurgical treatment is essential for attaining excellent results.Primary factors such as preoperative status, child profile, aneurysm size, treatment choice, and timing of the operation influence both short and long-term outcomes.

Nanoparticles and Nanostructured Surface Fabrication for Innovative Cranial and Maxillofacial Surgery.

A novel strategy to improve the success of soft and hard tissue integration of titanium implants is the use of nanoparticles coatings made from basically any type of biocompatible substance, which can advantageously enhance the properties of the material, as compared to its similar bulk material. So, most of the physical methods approaches involve the compaction of nanoparticles versus micron-level particles to yield surfaces with nanoscale grain boundaries, simultaneously preserving the chemistry of the surface among different topographies. At the same time, nanoparticles have been known as one of the most effective antibacterial agents and can be used as effective growth inhibitors of various microorganisms as an alternative to antibiotics. In this paper, based on literature research, we present a comprehensive review of the mechanical, physical, and chemical methods for creating nano-structured titanium surfaces along with the main nanoparticles used for the surface modification of titanium implants, the fabrication methods, their main features, and the purpose of use. We also present two patented solutions which involve nanoparticles to be used in cranioplasty, i.e., a cranial endoprosthesis with a sliding system to repair the traumatic defects of the skull, and a cranial implant based on titanium mesh with osteointegrating structures and functional nanoparticles. The main outcomes of the patented solutions are: (a) a novel geometry of the implant that allow both flexible adaptation of the implant to the specific anatomy of the patient and the promotion of regeneration of the bone tissue; (b) porous structure and favorable geometry for the absorption of impregnated active substances and cells proliferation; (c) the new implant model fit 100% on the structure of the cranial defect without inducing mechanical stress; (d) allows all kinds of radiological examinations and rapid osteointegration, along with the patient recover in a shorter time.

Intradiploic epidermoid cysts - a series of three cases and our experience with literature data.

Intracranial epidermoid cysts are rare, representing almost 1% of all primary tumors and when are located in the diploe result from entrapped ectodermal embryonic remnants. Because of frequent complications, imaging studies are mandatory for highlighting erosions of both outer and inner table of the calvaria and treatment preparation. We enlisted three female patients within our study, comparing imaging with histopathology aspects. Even though the bone destruction was evident, no atypia or malignant signs were highlighted in serial sections. The interesting fact that we present is that our patients are all females, opposed to what is written in literature. Although the positive diagnosis can be made by imaging, histopathological examination of these cysts is mandatory for identifying malignant behavior.

100 Years since the birth of Ladislau Steiner. Creativity of Neurosurgery.

Ladislau Steiner (1920-2013) was a Romanian neurosurgeon, born in the historic and picturesque region of Fagaras. He was educated by some of the best doctors and professors in Romania, during the communist regime. After his escape through the communist regime, in 1961, at 41 years old, he started his neurosurgical and radiosurgical career at Karolinska Institute, in Stockholm, under the renown Herbert Olivecrona and Lars Leksell. He worked here for 25 years, until he retired in 1987 as head of 1st and 2nd Departments of Neurosurgery in the institute's affiliated clinic Sophiahemmet Hospital. He is most known in Sweden as the first to introduce microsurgical techniques in neurosurgery, but internationally he is known as "the unofficial emissary of Gamma Knife Surgery". After his retirement, he continued his practice at University of Virginia, USA, for another 23 years and another two years at International Neurosciences Institute, Hannover, Germany, being a Professor of Neurosurgery and Radiology of Gamma Knife Surgery. Thanks to his efforts, Romanian neurosurgery had an accelerated progress after the fall of communism, in 1989. Also, thanks to him, Romania was the first Southeast European country with a Gamma Knife unit. For his efforts, he was appointed Honorary President of the Romanian Society of Neurosurgery. We pay tribute to a great Romanian neurosurgeon who managed to touch the lives of thousands of patients and doctors from almost all countries in the world, in time when the world was divided between east and west, communism and freedom.