Background Before the advent of fibrinolytic therapy as a gold standard method of care for cases of acute ischemic stroke in Romania, issues regarding legal medicine aspects involved in this area of medical expertise were already presented and, in the majority of cases, the doctors seem to be unprepared for these situations. Main text The present research illustrates some of the cases in which these aspects were involved, that adressed a clinical center having 6 years of professional experience in the application of fibrinolytic treatment for stroke. The following cases report either situations in which the afore mentioned therapy was not rightfully administrated or legal aspects regarding the obtainment of informed consent. Conclusion Obtaining informed consent is a mandatory procedure, which takes time, to the detriment of application of fibrinolytic treatment.
Renal cell carcinoma (RCC) represents the sixth most frequently diagnosed cancer in men and is asymptomatic, being detected mostly incidentally. The apparition of symptoms correlates with advanced disease, aggressive histology, and poor outcomes. The development of the Surface-Enhanced Raman Scattering (SERS) technique opened the way for investigating and detecting small molecules, especially in biological liquids such as serum or blood plasma, urine, saliva, and tears, and was proposed as a simple technique for the diagnosis of various diseases, including cancer. In this study, we investigated the use of serum label-free SERS combined with two multivariate analysis tests: Principal Component Analysis combined with Linear Discriminate Analysis (PCA-LDA) and Supported Vector Machine (SVM) for the discrimination of 50 RCC cancer patients from 45 apparently healthy donors. In the case of LDA-PCA, we obtained a discrimination accuracy of 100% using 12 principal components and a quadratic discrimination function. The accuracy of discrimination between RCC stages was 88%. In the case of the SVM approach, we obtained a training accuracy of 100%, a validation accuracy of 92% for the discrimination between RCC and controls, and an accuracy of 81% for the discrimination between stages. We also performed standard statistical tests aimed at improving the assignment of the SERS vibration bands, which, according to our data, are mainly due to purinic metabolites (uric acid and hypoxanthine). Moreover, our results using these assignments and Student’s t-test suggest that the main differences in the SERS spectra of RCC patients are due to an increase in the uric acid concentration (a conclusion in agreement with recent literature), while the hypoxanthine concentration is not statistically different between the two groups. Our results demonstrate that label-free SERS combined with chemometrics holds great promise for non-invasive and early detection of RCC. However, more studies are needed to validate this approach, especially when combined with other urological diseases.
Lung cancer is the first cause of death worldwide of oncological patients. Most of them are non-small cell lung cancer (NSCLC) and many of them are characterized by different molecular markers that allow the development of personalized treatments. Epithelial growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) are the most frequently tested genes in lung adenocarcinoma and other lung carcinomas with glandular component. The aim of our study is to evaluate the distribution of ALK gene mutation in lung cancer patient from North West part of Romania. We analysed a number of 289 lung biopsies along 18 months. The samples have been incubated with monoclonal ALK antibodies (clone D5F3), according to the manufacturer�s instruction. The interpretation guide provided by manufacturer was used to distinguish the positives vs negative cases. In our study from a total number of 289 lung biopsies, 196 cases were carcinomas. 57.65 % from the total number of lung cancers were adenocarcinomas. A total number of 79 cases have been analysed for ALK gene supra expression. 5.08 % of adenocarcinomas were positive for ALK, but the mean age for this population is higher comparing with the data from other studies.
The study of bacterial pathogeny represents a very important issue for the forensic specialists, clinicians, managers and healthcare policymakers. The purpose of this experimental research is to study the virulence of some infectious microbial agents (Pseudomonas Aeruginosa, Staphylococcus Aureus, Escherichia Coli, Proteus Mirabilis, Erysipelothrix Rhusiopathiae), some of them frequently involved in violent deaths presenting septic states, by inoculating them in white mice Mus Musculus (MMs), in the presence of competing factors of death, reproducing this way a model of human violent death consecutive of septic complications that occur in the evolution of some traumas.The results of the study show that the survival period of the MMs depends on the microbial agent of the inoculated strain, the dilution of the culture suspension, the presence of associated lesions, age. In decreasing order, according to the value of LD50, the most virulent strains are Erysipelothrix Rhusiopathiae, Escherichia Coli, Proteus Mirabilis, followed by Staphylococcus Aureus and Pseudomonas Aeruginosa. The lethality index increases proportionally with the virulence of the etiologic agent and the presence of the associated lesions, confirming once again the similarity with�physiopathological mechanisms that exist in human pathology.
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