Background. Primary headaches are comprised of three big categories: migraines (with or without aura), the third most common and the 6th most disabling disease worldwide, tension-headaches, and trigeminal autonomic cephalalgias, each with different, complex, and not completely understood pathophysiological, clinical, and neuroimagistic characteristics. Structures like the brain stem, hippocampus, or hypothalamus have been depicted as being the main triggers of these types of headaches, which have a significant impact on the quality of life. Methods. We performed a broad literature review on primary headaches from January 2016 to June 2023, analyzing the latest scientific updates and emphasizing the pathophysiological and neuroimagistic characteristics. Results. We provide a concise review of the main neuroimaging studies that help in differential diagnosis between several types of primary headaches. Conclusions. It is difficult to approach the pathophysiology of these three primary headache categories. Keeping in mind that neuroimagistic methods are rapidly developing (especially in the MRI sphere), the most important endpoint of future studies will be to establish a reliable distinction system for all these types of cephalalgias, thus updating the protocols and guidelines. Currently, imaging studies are indicated only in certain circumstances.
The Human Immunodeficiency Virus (HIV) and the Acquired Immunodeficiency Syndrome (AIDS) remain significant public health concerns worldwide. This review seeks to present an updated perspective on the spread, consequences, and control measures of HIV/AIDS, focusing on military personnel as a particular at-risk group. It starts by outlining general information about the transmission of the virus and summarizing recent global epidemiological trends. This review further explores the difficulties that HIV/AIDS presents in military settings, including policies regarding the management of service members living with the virus. Additionally, it examines several prevention strategies implemented by militaries around the world, such as educational programs, provision of condoms, and efforts to reduce the stigma associated with the infection.
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.
Cardiac amyloidosis (CA) represents the accumulation and deposition of misfolded protein fibrils in the myocardium, resulting in progressive restrictive cardiomyopathy. Light chain (AL) and transthyretin (TTR) amyloidosis are the most common types of CA. While endomyocardial biopsy remains the gold standard for diagnosing cardiac amyloidosis, its invasive nature and associated risk of complications have led to increased reliance on clinical suspicion and noninvasive imaging modalities as alternative diagnostic tools. Over the last decade, radionuclide imaging studies have become a widely accepted tool in diagnosing ATTR CA, whereas its diagnostic utility in AL CA detection remains limited. Recent advances in PET-CT radiopharmaceuticals have further expanded the potential of nuclear imaging as a comprehensive tool for diagnosis, prognostication, and therapy monitoring. This literature review appraises the current applications of nuclear imaging in the clinical management of cardiac amyloidosis.
Malignant melanoma and urological cancers originate from different tissues and organs, yet several studies highlight connections between these malignancies, including common risk factors, genetic predispositions, and immunological pathways. Evidence from recent studies suggests that a prior diagnosis of melanoma may increase the likelihood of subsequently developing renal cell carcinoma (RCC), and, conversely, patients with RCC appear to face a heightened risk of being diagnosed with melanoma. Shared factors such as a personal or family history of cancer, UV radiation exposure, smoking, and obesity have all been linked to an increased incidence of various cancer types. A major link between malignant melanoma and urological cancers is the presence of shared genetic mutations and familial cancer syndromes. Key mutations, including germline mutations in BRCA1, MITF, CDKN2A, TP53, and alterations in the PI3K/AKT pathway, significantly contribute to the risk of both types of malignancies. Personalized medicine, which tailors prevention and treatment strategies to an individual’s genetic, environmental, and lifestyle factors, has significantly improved cancer care. The primary aim is to select the most effective treatment for each patient, maximizing therapeutic outcomes, reducing side effects, and minimizing the risk of drug resistance. Advances in genomics and immunology are driving the development of personalized therapies that target specific molecular pathways and immune responses common to both melanoma and urological cancers. Angiogenesis inhibitors and checkpoint inhibitors have demonstrated notable success in treating these cancers, with tumor mutational burden serving as a valuable biomarker for predicting the efficacy of immune checkpoint inhibitors.
Neuroendocrine tumors (NETs) are a group of rare malignancies characterized by heterogeneous clinical and biological presentations. Their estimated annual incidence ranges from 3 to 6 cases per million inhabitants, with a notable rise in prevalence due to improved diagnostic capabilities and medical awareness. Gastrointestinal NETs predominantly affect the small intestine (~45%), followed by the rectum, appendix, colon, and stomach. Despite advancements in imaging modalities such as CT, MRI, and somatostatin receptor-based PET-CT scans, the diagnosis of small intestinal NETs remains challenging due to nonspecific symptoms, frequently leading to delayed recognition until advanced disease stages. Surgical resection with comprehensive lymphadenectomy remains the cornerstone of curative management for localized disease, offering improved survival outcomes when R0 resection is achieved. Nevertheless, recurrence rates remain high, underscoring the critical importance of postoperative surveillance. This review provides a comprehensive synthesis of recent literature regarding the epidemiology, clinical manifestations, diagnostic methods— including imaging and immunohistochemical markers—and therapeutic approaches, particularly emphasizing surgical management strategies. A clinical case example is integrated into the review to illustrate the real-world complexity and challenges in the diagnosis, treatment, and follow-up of patients with small intestinal NETs.
Colorectal cancer (CRC) ranks third worldwide in terms of morbidity and second in mortality. In Romania, CRC represents the second leading cause of malignancy, accounting for 13.3% of all diagnosed cancers and associated with a five-year survival rate close to 50%. Despite the availability of effective CRC screening programs proven to reduce incidence and mortality, low participation rates contribute to a high occurrence of advanced disease complications. As a result, bowel obstruction develops in approximately 25% of colorectal cancer cases, significantly worsening patient outcomes. This review aims to highlight the role of screening in reducing the incidence of such complications and to assess the outcomes associated with surgical management of malignant bowel obstruction. A comprehensive review of current literature was conducted, focusing on the incidence, clinical presentation, and management of intestinal obstructions in CRC patients. Emphasis was placed on studies evaluating screening programs, risk factors, and surgical interventions. Data indicate a continuous rise in emergency presentations due to obstructive CRC, correlating with low screening uptake. Early detection through organized screening significantly lowers the risk of obstruction and improves outcomes. Enhanced screening programs and early identification of high-risk individuals are crucial in preventing advanced CRC complications. Timely diagnosis not only reduces emergency surgical interventions but also improves prognosis and overall survival rates.
Aseptic bone necrosis (ABN), also known as avascular necrosis (AVN), is a serious and often overlooked complication of systemic lupus erythematosus (SLE), a chronic autoimmune disease with diverse symptoms. AVN in SLE is caused by multiple factors, including blood supply disruption due to clotting disorders, chronic inflammation, and especially prolonged use of moderate to high- dose corticosteroids. This review analyzes 17 out of 62 peer-reviewed European studies (2015–2024) from the PubMed database, focusing on osteonecrosis in lupus. ABN affects between 0.8% and 33% of SLE patients, with a mean symptomatic rate of 9%, while up to 29% may be asymptomatic. The femoral head is most commonly involved. Besides corticosteroid use, other risk factors include antiphospholipid antibodies (especially anticardiolipin IgM), endogenous hypercortisolemia, hypercoagulability, dyslipidemia, and active disease. In Romania, where no national registry exists, a representative case of a 27-year-old woman with undiagnosed SLE and bilateral femoral head necrosis without steroid exposure highlights the role of autoimmune coagulopathy. Misdiagnosis of her facial rash as rosacea delayed proper identification, emphasizing the importance of clinical awareness in atypical cases.
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.
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.
