Psoriasis is a chronic, inflammatory, immune-mediated skin disease affecting 1-3% of the adult population. It mainly involves the skin, nails, and joints. However, psoriasis can be associated with several comorbidities, including ocular complications. The most frequently reported pathologies are dry eyes syndrome, blepharitis, and uveitis. Being a systemic inflammatory disease, psoriasis also has the potential to directly affect the retina. It has been reported that ocular manifestations tend to appear much later than skin and joint involvement. Eye complications begin insidiously, and progress asymptomatically. This can lead to a decrease in the quality of life and even permanently compromised visual function if not treated properly. Thus, the present review aimed to present current pathological explanations between psoriasis and ocular manifestation, and to evaluate the prevalence of ocular changes in patients with psoriasis, in order to be diagnosed and managed appropriately.
Ultrasonography (US) is one of the most widely utilized imaging methods in contemporary medical practice. Unlike other imaging techniques primarily within the radiology domain, ultrasonography has been adopted by various medical and surgical specialties and tailored to the specific needs of each. This adaptability has contributed to ultrasonography's rapid diversification and remarkable evolution over recent decades. Ultrasonography was first employed in dermatology in 1979 when Alexander et al. used it to measure skin thickness. However, due to the limitations of conventional ultrasound devices at the time, which had resolutions and frequencies below 15 MHz, detailed elements of the skin could not be analyzed, tempering enthusiasm for the technique [2]. Modern dermatologic ultrasonography began with the development of fixed-frequency devices operating above 20 MHz, enabling detailed visualization of skin structures. Numerous studies on skin physiology and pathophysiology were conducted using this approach. Modern ultrasonography enables us to visualize skin structures, at times surpassing the detail provided by traditional anatomical dissections in educational settings. Given that patient safety and quality medical care remain fundamental priorities, ultrasonography, with its safety profile and versatility, represents the next step in modern dermatology. Ultrasonography represents a rapidly evolving diagnostic tool that holds the promise of significantly improving diagnostic accuracy and the quality of medical dermatology practice.
Background/Objectives: Sepsis and septic shock are critical conditions associated with high mortality rates and substantial impacts on healthcare systems. Accurate and rapid diagnosis is essential for the management of these conditions. The objective of this study is to assess the accuracy of contemporary and traditional methods for diagnosing sepsis and to determine whether improvements have been made concerning the integration of novel diagnostic approaches, to facilitate a prompt diagnosis, taking into account the rapid progression of complications associated with this disease. For this purpose, studies published between 2014 and 2024 were examined to highlight the benefits and limitations of each approach. Methods: A systematic literature review was conducted, including randomized clinical trials, observational studies, and retrospective studies assessing both conventional diagnostic methods (blood cultures and clinical scoring systems) and modern methods (rapid molecular tests, specific biomarkers, and machine learning algorithms). The studies included were selected based on strict design and methodology criteria to ensure a rigorous comparative evaluation of the interventions and technologies used in diagnosing and monitoring patients with sepsis. Results: A total of 23,822 patients were reviewed across the studies included in this systematic analysis. Modern methods, such as continuous monitoring through integrated biosensors and the use of molecular panels for pathogen detection, demonstrated high potential for the early and accurate diagnosis of sepsis. The reviewed studies suggest that these methods can significantly reduce diagnostic time and improve the ability to stratify mortality risk compared to conventional methods. Conclusions: Integrating modern diagnostic technologies, such as rapid pathogen identification tests and specific biomarkers, may complement traditional methods and bring significant benefits in the management of sepsis.
With the increase of the medium lifespan in developing countries, skin aging rise attention more and more. In 2007, Kaya and Saurat rebranded the extreme expression of skin fragility under the name of ‘‘dermatoporosis’’ or chronic cutaneous insufficiency/fragility syndrome. Dermatoporosis is still underused in medical literature and nurses and wound specialists know also about this condition, but they call it “skin tears”. There is obvious confusion cause the nursing literature talks about skin tears while dermatologists write about dermatoporosis. Clinical aspects comprise atrophy, purpura, and pseudo-stellate scars. Firstly, the British dermatologist Thomas Bateman described senile purpura in 1818 as purpuric patches arising in elderly people after minimal trauma, especially on the dorsum of the hands. Furthermore, between 1970 and the full documentation of Kaya and Saurat in 2007, we found medical papers about senile purpura, pseudoscars, skin tears, and so on. Starting from this historical data, they bring valuable information according to clinical aspects, histopathology, ultrasonographic aspects, pathophysiology, and therapeutics. This paper aims to analyze published data for improving the diagnosis and management of dermatoporosis.
Background: Labia minora hypertrophy can lead to aesthetic dissatisfaction and functional discomfort among women, affecting their quality of life and sexual self-esteem. Traditional surgical labiaplasty techniques are effective but are associated with higher complication rates and longer recovery times. This study aims to evaluate the efficacy, safety, and patient satisfaction of laser labiaplasty as a minimally invasive alternative for labia minora reduction. Methods: A retrospective analysis was conducted on 60 female patients who underwent laser labiaplasty. Preoperative assessments included medical history, gynecological examination, and patient-reported concerns. The procedure utilized a CO₂ laser for tissue excision without the need for sutures. Postoperative outcomes were evaluated through follow-up visits and telephone interviews, focusing on complications, recovery time, and patient satisfaction measured by the Subjective Global Aesthetic Improvement Scale (sGAIS). Results: The primary motivations for surgery were aesthetic concerns (85%) and functional discomfort (55%). The mean age was 34.7 years. Minor complications included transient postoperative bleeding (10%) and mild discomfort (25%), with no major complications reported. High satisfaction rates were observed, with 92% of patients reporting significant improvement (sGAIS scores of 4 or 5). Conclusions: Laser labiaplasty is an effective, minimally invasive procedure with high patient satisfaction and low complication rates. It offers a viable alternative to traditional surgical methods for women seeking labia minora reduction due to aesthetic or functional concerns.
Ethnomedicine and ethnobotany have been at the forefront of current scientific focus. The focus of this review is Piper nigrum, for which there exists a wide host of traditional ethnomedical and ethnobotanical applications, recorded mostly from India and the surrounding regions where black pepper is native. These applications cover a wide range of pathologies, including cardiovascular, pulmonary, gastrointestinal, gynaecological, endocrine, integumentary and neurological, and viral diseases and colds. While some of these applications are confirmed by modern research, the majority have not been tested using modern scientific methods, and perhaps many more applications remain to be documented. Finally, it must be noted that some interesting non- medical applications comprise the application of black pepper, as an insecticide/larvicide, are worth further consideration, especially given the newer policies at a European and international level.
Psoriasis is a chronic and complex disease that consists of characteristic cutaneous lesions and is frequently accompanied by systemic comorbidities caused by the chronic inflammatory state. The most common such comorbidities are hypertension, diabetes mellitus, dyslipidemia, inflammatory bowel diseases, depression, anxiety, neoplasia, and non-alcoholic fatty liver disease. Therefore, it is of utmost importance to simultaneously treat both psoriasis and the associated conditions with the best therapies available to improve patients’ life quality. Therefore, this review aims to evaluate the effects of biological therapies on both psoriasis and its comorbidities and also to highlight other future options.
Acupuncture is one of the main components of Traditional Chinese Medicine and has been applied as a therapeutical method for centuries. As a therapeutical system, it is based on the use of specific lines in the human body, called meridians, and specific acupuncture points, for choosing the locations where the needles will be applied, depending on the specific problem. In the last few decades, there have been increasing efforts to detect and document the existence of such meridians and points based on at least some of their electrical properties being different when compared to the surrounding skin. A number of researchers have designed experiments, which have had varying degrees of success. Since different researchers have used different experimental setups, and the sample size is usually low, there are issues of validity and comparison between different research results. On the other hand, the majority of available evidence is in favor of there being points and lines characterised by distinct electrical properties, corresponding to acupuncture points and meridians respectively. At the same time, several other theories have been proposed to explain the biological basis of acupuncture points and meridians, while their connection to specific cellular components or neural sequences is an intriguing possibility. While comprehensive research is required to fully document the electrical properties of acupuncture points and meridians, a connection between such properties and their biological basis must also be established.
Sepsis remains a leading cause of morbidity and mortality worldwide, with certain high-risk populations—including elderly patients, neonates, immunocompromised individuals, those with chronic diseases, and pregnant women—experiencing worse outcomes. These groups exhibit distinct pathophysiological responses, which complicate diagnosis, treatment, and prognosis. Despite advancements in sepsis management, challenges persist in early risk stratification, individualized therapeutic strategies, and long-term recovery. Aim: This study aims to evaluate the impact of sepsis on high-risk populations, identify prognostic factors influencing clinical outcomes, and explore personalized treatment approaches to optimize patient management. Methodology: A systematic narrative review was conducted, following PRISMA guidelines, by analyzing peer-reviewed literature from 2015 to 2025. This study included the analysis of 80 scientific articles from eight international databases. Studies focusing on sepsis pathophysiology, microcirculatory dysfunction, diagnostic techniques, therapeutic interventions, and post-sepsis outcomes in high- risk populations were included. Results: Elderly patients demonstrated the highest sepsis-related mortality rates (>40%), while neonates and immunocompromised individuals exhibited delayed inflammatory responses, complicating diagnosis. Prognostic biomarkers such as IL-6 and IL-10 showed potential utility in these populations. Personalized fluid resuscitation, antimicrobial stewardship, and immune-modulating therapies were identified as critical to improving outcomes. Post-sepsis syndrome (PSS) was prevalent, particularly in survivors with chronic comorbidities and prolonged ICU stays. Conclusions: Optimizing sepsis management in high-risk populations requires a multidisciplinary, personalized approach, incorporating early biomarker-based diagnostics, precision-guided hemodynamic support, and tailored rehabilitation programs. Future research should focus on novel immunotherapies, antimicrobial resistance strategies, and long-term functional recovery in sepsis survivors.
Preventive medicine plays a crucial role in ensuring the efficiency of healthcare systems, and laboratory investigations represent one of its main pillars. However, achieving an optimal balance between the benefits and costs of testing remains a challenge. Caught between public expectations, appropriate test utilization, and the need for adequate physician training in test ordering, enhancing patients’ understanding and knowledge becomes essential. To explore this aspect, a general online survey was conducted, completed by 321 respondents. The results show that, while respondents generally followed physicians' recommendations, many also sought laboratory testing on their own initiative. Direct access to laboratory services - facilitated by the widespread availability of private laboratories - has become a common practice. This raises concerns about the potential overuse of laboratory testing and underscores the importance of further investigating the factors driving patient self-empowerment. Enhancing shared decision-making between patients and physicians is essential to optimize the benefits of testing, minimize unnecessary costs, and reducing the risk of health-related anxiety.
Introduction: Non-melanoma skin cancers (NMSC) represent a significant global public health burden, particularly in highincome countries. The increasing incidence of head and neck NMSC contributes to rising morbidity and necessitates multi-disciplinary management. Objectives: This study aims to evaluate the incidence, demographic distribution, histological subtypes, and seasonal variation of NMSC over a five-year period at a tertiary center in Romania. Materials and Methods: A retrospective observational study was conducted from January 2020 to December 2024, including 180 patients diagnosed and treated for malignant skin lesions. Data were extracted from clinical and histopathological records. Chi-square tests assessed seasonal distribution, and Mann-Whitney U tests compared lesion depth and surface area between demographic groups. Results: A total of 388 malignant lesions were recorded. Basal cell carcinoma (BCC) was the most common subtype (n = 168), followed by squamous cell carcinoma (SCC) (n = 25). Most patients resided in urban areas, particularly Bucharest. Males presented with significantly deeper lesions (mean: 1.5 mm) compared to females (mean: 1.25 mm; p = 0.009). Seasonal analysis revealed a significant variation in incidence, with the lowest number of cases in spring (χ² = 10.31, p = 0.016). Conclusion: The incidence of malignant skin lesions increased from 2020 to 2023, followed by a decline in 2024. Seasonal and sex-related differences were observed, with the face being the most frequent site of involvement. While the sex distribution was relatively balanced, males exhibited significantly greater lesion depths compared to females.
With recent advances in the understanding of psoriatic disease, it is increasingly considered a systemic inflammatory condition rather than limited to the skin and joints. A variety of biologics are available today for the treatment of psoriasis, but with them, characteristics such as rapidity of onset, long-term efficacy, safety profile, and effects on comorbidities differ. We designed an observational, non-interventional, retrospective study of patients with severe psoriasis receiving biologic treatment with IL-17 inhibitors and aimed to investigate the correlations between etiopathogenic factors and the efficacy and persistence of these therapies in a group of psoriasis patients from Romania. Study results show that patients treated with ixekizumab had better persistence and high adherence compared to those treated with secukinumab. In this study, ixekizumab demonstrated lower risks of non-persistence, discontinuation, and switching and a higher likelihood of high adherence compared with secukinumab. This study contributes to the understanding of the persistence of anti-IL17 biologic therapies in psoriasis and the factors that may influence it.
Chronic pelvic pain syndrome (CPPS) presents a diagnostic challenge due to its multifactorial nature, often involving urological, gynecological, and psychological components. This study focuses on the effectiveness of prophylactic phytotherapy in preventing CPPS recurrence, aiming to mitigate symptoms and psychosocial impact. The study includes 74 patients following a six-month treatment regimen with Graminex, Seronoa Repens, Curcuma Longa, and Acediboswellic ke-to-acetyl-11. Symptom assessment employs the IPSS and NIH-CPSI questionnaires, conducted at 3, 6, 8, 9, and 12 months. Patients exhibit significant improvements in IPSS scores, with maintenance of treatment impact observed at 3, 6, and 9 months. Interruption of therapy leads to symptom recurrence, but upon resumption, responses are more effective. The third group, under observation for three months, reports positive outcomes. Both IPSS and NIH-CPSI scores show a consistent impact on urinary symptoms and pelvic pain, indicating the therapy's effectiveness. The study demonstrates a concordance in the positive effects of phytotherapy across different age groups, emphasizing its efficacy in alleviating urinary symptoms and pelvic pain in CPPS patients. Symptom remission or improvement in quality of life is reported, with a notable tropism for symptom reduction in the cold season. Patient adherence to treatment is high, and even after treatment interruption, resumed therapy yields significant improvements. The observed benefits include the absence of pelvic pain, dysuria, and enhanced sexual competence, contributing to an overall improvement in the quality of life for patients with CPPS.
Objective: The study subject approaches a topic of cerebral pathology, namely the development of a pathological diagnosis that is as accurate as possible for the cerebral tumors and the metastases, using a new method that complements the optical microscopic examination and immunohistochemistry to correctly diagnose cerebral malignancies. Methods: Two-photon excitation (TPE) microscopy techniques are non-linear optical imaging methods that are gaining momentum in the investigation of fixed tissue sections, fresh tissue, or even for in vivo experiments. This method can be used for offering complementary information on the tissue architecture. We argue that using non-linear optical microscopy (which includes TPE microscopy) images collected on this category of brain tissue samples, can facilitate the interpretation of brain tumors and metastases, thus it is a solution worthy to explore. Scanning large areas of the lesions is important to avoid false-negative diagnoses because lesions are often non-uniform. Finding potential invasion sites is also restricted when using a narrow field-of-view imaging method. Results: Our study demonstrated that TPE microscopy can detect specific cellular features of cerebral tumors and metastases in good correlation with histopathological results. This approach can improve the accuracy of the cerebral tumors diagnosis and possibly other neoplasms. Conclusion: TPE microscopy is very important for future research because it could prevent the false or inadequate diagnosis of specific lesions and differentiate a primary tumor from a metastasis. The significance of the findings is attributable to cross-disciplinary cooperation and the constant use of a working standard across all of the experiments in this study.
Psoriasis is a chronic inflammatory skin condition with genetic determinism characterized by the presence of well- defined, erythematous plaques, covered by white, pearly, stratified scales, located on the extension areas, the skin of the scalp, intertriginous regions. The origin of psoriasis is multifactorial, involving hereditary and environmental pathogenic mechanisms. It is triggered by various risk factors involving a variety of processes, such as inflammation, antigen presentation, cell signaling, and transcriptional regulation.
(1) Background: Human papillomavirus (HPV) E6 and E7 oncoproteins are vital for developing HPV induced penile carcinoma. The viral oncoproteins play a central role in oncogenesis by interacting with several cellular regulatory proteins, such as p16INK4a and p53. Many studies suggest that these proteins showed clinical utility in predicting nodal disease, cancer specific survival, overall survival and even tumor grade. Understanding the molecular mechanism involved in the carcinogenesis of penile cancer could offer biomarkers for disease progression, treatment response and potential targeted therapies; (2) Methods: This paper is a prospective study on a group of 100 patients who underwent prostate surgery during 2013 and 2014 in the Urology Clinic of “Carol Davila” Central Military Emergency University Hospital Bucharest. They were tested for HPV by PCR and IHC (p16) methods; (3) Results: 11 cases (22%) of HPV were found in the cluster of patients tested. PCR and P16 were the HPV diagnostic tests used. In order to determine the consistency of the 2 tests, the Cohen’s kappa coefficient was used at a p level < 0.05. The PCR method had a sensitivity of 81.8% and a specificity of 94.9%. The P16 method had a sensitivity of 63.6% and a specificity of 89.7%.
Chronic venous disease has been pathology of great interest over time. With its large prevalence among the world population (10-33% adult woman and 10-20% of men) through profound socio-professional implications that affect the quality of life of patients, chronic venous disease is a real public health problem, being an important cause of morbidity and disability, a permanent area of research in the medical-pharmaceutical field. Special attention is now given to identifying the mechanisms and stages of disease development. From studies that have highlighted the importance of venous hypertension as an essential element in the development of the disease, to this day it has come up to demonstrating the fundamental role of the venous endothelium and glycocalyx in triggering and progressing of chronic venous disease. Biochemical, immunohistochemical, and functional investigations have allowed the evaluation of changes that occur in cellular metabolism and evidence of some immune-vascular factors responsible for vascular alterations in chronic venous disease: specialized receptors, adhesion molecules, cytokines, matrix and metalloproteinases. The analysis of the pathophysiology of chronic venous disease is still a vast area open to scientific research.
Psoriasis is a chronic inflammatory disease, with multisystemic implications and genetic predisposition, characterized by the development of erythematous, scaling plaques on the skin. Management of moderate to severe psoriasis vulgaris may involve a biological treatment that suppresses the immune system. Because of this, the patients with psoriasis on an immunosuppressive treatment are theoretically at an increased risk of infections, including SARS-CoV- 2 infection. SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) is responsible for the current pandemic. In Romania, COVID-19 (Coronavirus Disease 19) was first reported on February 26, 2020, by confirming the first patient with SARS-CoV-2 by RT-PCR method. COVID-19 progression was divided into three phases: early infection, pulmonary phase, and hyperinflammatory phase. Although the inhibition of pro-inflammatory cytokines by biologic therapy is detrimental in the viral phase, it seems to be beneficial in the hyperinflammatory phase, by protecting the patients with psoriasis in progressing towards extra-pulmonary manifestations and death. Analyzing the evolution of the 8 cases of patients from our dermatology department – Colentina Clinical Hospital, with generalized psoriasis vulgaris on biologic immunosuppressive treatment and SARS-CoV-2 infection, we observed that they did not develop a more severe form of COVID-19 than the general population. Patients on biologic immunosuppressive treatment are more susceptible to the development of infections, including by SARS-CoV-2, but it was found that the biologic therapy can protect against a more severe type of COVID-19.
Non‑melanoma skin cancer (NMSC) comprises squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and severalrare skin tumors (i.e., Extramammary Paget’s disease), being the most common malignancy-affecting people worldwide. Itrepresents the majority of skin cancers and a significant percentage of all malignancies. Despite increasing public awarenessand scientific interest, the incidence of NMSC is constantly increasing. Even though most NMSC`s are associated with lessaggressive behavior, they can still be invasive locally and cause extensive damage to neighboring structures, inducingsignificant morbidity. In addition, different types and subtypes of NMSC tend to have frequent recurrences and may have significantmetastatic potential. As a direct consequence, NMSC has become an important issue for healthcare systems with a significantsocio‑economic impact.
Metformin was a revelation in the treatment of patients with type 2 diabetes, being widely used, with remarkable outcomes. Lately, research has greatly expanded the indications of metformin treatment, which can be used not only in diabetes but also in many other conditions. Although still debatable, several studies have shown the beneficial effects of metformin treatment in patients with psoriasis. This article is a review of the latest data of scientific literature about the effects of metformin administration in patients with diabetes and psoriasis, but also in nondiabetic patients with psoriasis
The diagnosis of pigmented basal cell carcinoma can bring significant distress to patients and physicians alike. However, astute clinicians that can employ correctly the clinical and dermatoscopical clues can reach a correct preoperative diagnosis, and as such can avoid unnecessary worry for the patient, additional work-up, or overtreatment. We present a case series of pigmented basal cell carcinomas and a comparative case with pigmented cutaneous melanoma, together with a literature review, that will highlight these aspects of the management of pigmented tumours of the skin.
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Uncomplicated and small lesions (under 5cm) CE1,2 and 3 can be treated with oral albendazole (10- 15mg/kg/day) and close monitoring. However, large CE1 and CE3 cysts need treatment with both albendazole and PAIR (percutaneous aspiration, introduction of scolicide and reaspiration), performed after initiation of albendazole. Primary surgical treatment has been replaced with less invasive methods since the relapse rate can reach 20%. In patients with complicated cysts, surgery is the treatment of choice. CE4 and 5 only need to be monitored [1][3].
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Chronic liver disease is a late stage of progressive hepatic fibrosis. It consists of functional and structural disruptions in most chronic liver diseases. An accurate diagnosis allows us to establish the degree of fibrosis and the stage of the disease, the prognosis of the patient and to predict a treatment response. Despite the fact that liver biopsy is considered a gold standard, non- invasive methods for diagnosing liver fibrosis have gained more and more importance. Whether we talk about serum biomarkers or imagistic methods from transient elastography to 3-D magnetic resonance elastography, the question remains: are these useful or useless? Serum biomarkers represent blood components that can reflect liver histological changes, thus they can monitor the continuous process of fibrosis. These can be subcategorized in direct (that show extracellular matrix turnover) and indirect markers (that reflect disturbances in the hepatic function). However these markers alone are not as accurate in the staging of fibrosis, only help differentiate patients without or with low grade of fibrosis from those with significant fibrosis and cannot be considered alone in the diagnosis of liver fibrosis. Imagistic methods include: ultrasound-based transient elastography, magnetic resonance elastography (MRE), 2D-shear wave elastography, acoustic radiation impulse imaging (ARFI) and cross sectional imaging, the first being the most used. Using a combination of non-invasive tools allows us to diminish the number of patients in need of liver biopsy. However, the patient must always be informed of the advantages and disadvantages of each method and its limitations.
As the medical sciences advances, so does the volume of information which becomes more and more consistent. The health care system is one of the most complex systems encountered in our society. Today, knowledge management practices have been adopted in many Romanian business sectors. However, Romanian health care system is slowly adopting such principles and concepts. This fact is created mainly because of the organizational culture. In the sanitary industry, this barrier is composed both from an organizational perspective and also, from an individual perspective. Through the knowledge management practices, doctors could benefit from the amount of data spread in different geographical regions.
Introduction. Management of moderate-severe psoriasis is challenging in the presence of severe systemic comorbidities, such as HIV infection, recent history of cancer, latent tuberculosis infection, or advanced liver disease. These patients are almost invariably excluded from randomized clinical trials, an aspect that limits the availability of standardized therapeutic options. Material and methods. This narrative review summarizes the current literature on immunomodulatory therapeutic strategies in patients with psoriasis and severe systemic comorbidities, integrating existing evidence in the literature with relevant clinical observations from real-world practice. Results. Available data suggest that therapeutic decisions should be individualized according to the type of comorbidities and severity of the disease. In well-controlled HIV infection, conservative strategies may be preferred. In patients with a history of cancer, systemic therapies may be used with caution and in interdisciplinary collaboration. In latent tuberculosis infection, prophylaxis is necessary, but isoniazid-induced hepatotoxicity is an important limitation. In liver disease, biological therapies may constitute a safer alternative to conventional systemic therapy. Conclusion. In this context, patients with psoriasis and severe associated systemic comorbidities require a personalized, multidisciplinary approach and close monitoring. Real-world data play an essential role in guiding therapeutic decisions in this patient population.
