Use of magnesium implants is a new trend in orthopedic research because it has several important properties that recommend it as an excellent resorbable biomaterial for implants. In this study, the corrosion rate and behavior of magnesium alloys during the biodegradation process were determined by in vitro assays, evolution of hydrogen release, and weight loss, and further by in vivo assays (implantation in rabbits’ bone and muscle tissue). In these tests, we also used imaging assessments and histological examination of different tissue types near explants. In our study, we analyzed the Mg-1Ca alloy and all the hypotheses regarding the toxic effects found in in vitro studies from the literature and those from this in vitro study were rejected by the data obtained by the in vivo study. Thus, the Mg-1Ca alloy represents a promising solution for orthopedic surgery at the present time, being able to find applicability in the small bones: hand or foot.

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Glucagonomas are neuroendocrine tumors (NETs) that arise from the alpha cells of the pancreatic islets. They are typically slow-growing tumors associated with abnormal glucagon secretion, resulting in one or more non-specific clinical features, such as necrolytic migratory erythema (NME), diabetes, diarrhea, deep vein thrombosis, weight loss, and depression. Here, we report the case of a 44-year-old male with a history of diabetes mellitus, presenting with a pruritic and painful disseminated cutaneous eruption of erythematous plaques, with scales and peripheral pustules, misdiagnosed as disseminated pustular psoriasis and treated for 2 years with oral retinoid and glucocorticoids. During this period, the patient complained of weight loss of 32 kg and diarrhea and developed deep vein thrombosis. These symptoms, together with an inadequate response to therapy of the skin lesions, led to the reassessment of the initial diagnosis. Laboratory tests confirmed elevated plasma glucagon levels (>1000 pg/mL) and computed tomography (CT) scans revealed a 35/44 mm tumor in the pancreatic tail. Due to considerable disease complications and the COVID-19 pandemic, the surgical removal of the tumor was delayed for nearly 2 years. During this time, somatostatin analogue therapy efficiently controlled the glucagonoma syndrome and likely prevented tumor progression. As in other functional pancreatic NETs, the early clinical recognition of hormonal hypersecretion syndrome and the multidisciplinary approach are the keys for best patient management.

In case of an orthopedic implant, it would be ideal that resorption to occur by biodegradation and bone remodeling. The main advantage of using resorbable orthopedic implants is eliminating the need for a new surgical procedure. The use of pure magnesium for orthopedic implants shows some drawbacks, which need to be considered and evaluated by in vitro and in vivo assays. One of the main problems encountered when pure Mg is used as biodegradable implant is represented by a high corrosion rate, faster than the rate of bone formation. The aim of this study is testing and evaluation of Mg-1Ca alloy from biocompatibility in vivo point of view. The purpose of in vivo test was to demonstrate good biocompatibility and lack of local and systemic toxicity of implants made by Mg-1Ca alloy. The study was conducted by implanting Mg-1Ca alloy parallelepiped shaped implants in the tibia of rabbits. In our tests related to Mg-1Ca alloy in vivo evaluation, there were no pathological increases in blood levels of Mg and Ca, or other elements, showing that it has no adversely affect to their metabolism. Also it shows a good bone integration, newly formed bone being adherent to the implant surface, with no tissue interposed between it and the bone. In conclusion, magnesium alloy Mg-1Ca represents a promising solution in orthopedic surgery, proving to be safe, with a high degree of biocompatibility and without toxic effects during in vivo testing.

BACKGROUND Hemorrhoidal disease (HD) is considered a low-severity pathology by both general population and physicians, but the lengthy conservative therapy and postoperative complications suggest otherwise. AIM To assess the effectiveness of different treatment options, both conservative and surgical, in contrast with some preexisting comorbidities. METHODS We conducted a retrospective, 10-yearlong study between January 2011 and December 2021 in two surgical centers, a private and a state-owned hospital. We compared the efficacy and safety of several treatment options, such as open hemorrhoidectomy, stapled hemorrhoidopexy, rubber band ligation and infrared coagulation in terms of complication rates and types and their correlation with different preexisting comorbidities such as inflammatory bowel disease (IBD), use of anticoagulant medication (AM) and liver cirrhosis. We also conducted a 20-years long PubMed research (1.263 articles) for relevant comparisons. RESULTS Our study recorded 10940 patients with HD, 10241 with conservative and 699 with surgical treatment. Out of these, the male-to-female ratio of 1.3, and a peak in age distribution between 59 and 68 years old (32% of patients). For the entire study, we recorded a 90% incidence of immediate pain, immediate bleeding in 1.5% (11 cases), delayed bleeding in 1.0% (7 cases), and 0.6% surgical site infections. Urinary retention was also present, with 0.2% of patients, anal stricture in 1% and fecal incontinence for 0.5% of patients (4 cases). We recorded no severe complications such as Fournier`s gangrene or rectovaginal perforations. IBD accounted for 6% of the patients, with ulcerative colitis in 12% and Chron`s disease in 10.5%. 6.6% of the patients had AM, determining 4% immediate and 2% delayed bleeding, in surgically treated patients. CONCLUSION Our study determined that most common complications (pain, urinary retention, bleeding, and stricture) are correlated with each surgical technique and pre-existing comorbidities.

Knee arthroplasty represents a laborious surgical procedure, involving a high degree of difficulty, concerning the bony tissue as well as soft tissues. Nevertheless, knee arthroplasty represents a procedure frequently used in orthopaedic clinics around the world, and its incidence it keeps growing [1].

Bisphosphonates currently represent the main therapy in the fight against osteoporosis. This is a serious condition, with an increasing incidence, presently affecting about 12 million people in the U.S. mostly women aged over 50 years. Thus, approximately 40% -50% of them suffer an osteoporotic fracture. Bisphosphonates mechanism of action consists in reducing osteoclast-mediated bone resorption, modifying bone turn over, leading to an increase in bone density. This dramatically reduces the risk of fracture. Although bisphosphonates shows a good safety profile, lately emerged some alarm signals that link their long management to some unusual side effects. Bisphosphonates is an effective therapy to combat osteoporosis, their causal relationship with FAF production not being shown. In the absence of other evidence, it is unclear whether BF therapy is directly involved in producing FAF or only a component of a combination of factors, in reality being just an indicator of a severe degree of osteoporosis. In the same time, we must not forget that the FAF are very rare compared to the number of patients in therapy with BF and the number of typical femur fractures, and the risk / benefit ratio it is definitely in favor of the benefit.

IntroductionEmotional face recognition is significant for social communication. This is impaired in mood disorders, such as bipolar disorder. Individuals with bipolar disorder lack the ability to perceive facial expressions.ObjectivesTo analyse the capacity of emotional face recognition in subjects diagnosed with bipolar disorder.AimsTo establish a correlation between emotion recognition ability and the evolution of bipolar disease.MethodsA sample of 24 subjects were analysed in this trial, diagnosed with bipolar disorder (according to ICD-10 criteria), who were hospitalised in the Psychiatry Clinic of Timisoara and monitored in outpatients clinic. Subjects were introduced in the trial based on inclusion/exclusion criteria. The analysed parameters were: socio-demographic (age, gender, education level), the number of relapses, the predominance of manic or depressive episodes, and the ability of identifying emotions (Reading the Mind in the Eyes Test).ResultsMost of the subjects (79.16%) had a low ability to identify emotions, 20.83% had a normal capacity to recognise emotions, and none of them had a high emotion recognition capacity. The positive emotions (love, joy, surprise) were easier recognised, by 75% of the subjects, than the negative ones (anger, sadness, fear). There was no evident difference in emotional face recognition between the individuals with predominance of manic episodes than the ones who had mostly depressive episodes, and between the number of relapses.ConclusionsThe individuals with bipolar disorder have difficulties in identifying facial emotions, but with no obvious correlation between the analysed parameters.Disclosure of interestThe authors have not supplied their declaration of competing interest.