Background: Numerous tools, including inflammatory biomarkers and lung injury severity scores, have been evaluated as predictors of disease progression and the requirement for intensive therapy in COVID-19 patients. This study aims to verify the predictive role of inflammatory biomarkers [monocyte to lymphocyte ratio (MLR), neutrophil to lymphocyte ratio (NLR), systemic inflammatory index (SII), Systemic Inflammation Response Index (SIRI), Aggregate Index of Systemic Inflammation (AISI), and interleukin-6 (IL-6)] and the total system score (TSS) in the need for invasive mechanical ventilation (IMV) and mortality in COVID-19 patients. Methods: The present study was designed as an observational, analytical, retrospective cohort study and included all patients over 18 years of age with a diagnosis of COVID-19 pneumonia, confirmed through real time-polymerase chain reaction (RT-PCR) and radiological chest CT findings admitted to County Emergency Clinical Hospital of Targu-Mureș, Romania, and Modular Intensive Care Unit of UMFST “George Emil Palade” of Targu Mures, Romania between January 2021 and December 2021. Results: Non-Survivors patients were associated with higher age (p = 0.01), higher incidence of cardiac disease [atrial fibrillation (AF) p = 0.0008; chronic heart failure (CHF) p = 0.01], chronic kidney disease (CKD; p = 0.02), unvaccinated status (p = 0.001), and higher pulmonary parenchyma involvement (p < 0.0001). Multivariate analysis showed a high baseline value for MLR, NLR, SII, SIRI, AISI, IL-6, and TSS independent predictor of adverse outcomes for all recruited patients. Moreover, the presence of AF, CHF, CKD, and dyslipidemia were independent predictors of mortality. Furthermore, AF and dyslipidemia were independent predictors of IMV need. Conclusions: According to our findings, higher MLR, NLR, SII, SIRI, AISI, IL-6, and TSS values at admission strongly predict IMV requirement and mortality. Moreover, patients above 70 with AF, dyslipidemia, and unvaccinated status highly predicted IMV need and fatality. Likewise, CHF and CKD were independent predictors of increased mortality.

The bronchial stump fistula shown by patients undergoing adjusted pulmonary resections is an extremely severe condition affecting the prognosis of this patients. Within our study, we have used an innovative technique of closing the bronchial stump for 38 patients undergoing adjusted pulmonary resections. The suture of the bronchial stump was made through an innovative method, by practicing the suture with isolated 2.0 Prolene wires armed with patches of Polypropylene. The incidence of the bronchial stump fistula for the observed lot was of 5.26% (2 cases), smaller than the one reported in the specialty literature. In this respect, we consider that the use of Polypropylene in the techniques of closing the bronchial blunt can be beneficial.

Background: Numerous tools, including nutritional and inflammatory markers, have been evaluated as the predictors of poor outcomes in COVID-19 patients. This study aims to verify the predictive role of the prognostic nutritional index (PNI), CONUT Score, and inflammatory markers (monocyte to lymphocyte ratio (MLR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic inflammatory index (SII), Systemic Inflammation Response Index (SIRI), and Aggregate Index of Systemic Inflammation (AISI)) in cases of deep vein thrombosis (DVT) and acute pulmonary embolism (APE) risk, as well as mortality, in COVID-19 patients. Methods: The present study was designed as an observational, analytical, retrospective cohort study, and included 899 patients over the age of 18 who had a COVID-19 infection, confirmed through real time-polymerase chain reaction (RT-PCR), and were admitted to the County Emergency Clinical Hospital and Modular Intensive Care Unit of UMFST “George Emil Palade” of Targu Mures, Romania between January 2020 and March 20212. Results: Non-Surviving patients were associated with a higher incidence of chronic kidney disease (p = 0.01), cardiovascular disease (atrial fibrillation (AF) p = 0.01; myocardial infarction (MI) p = 0.02; peripheral arterial disease (PAD) p = 0.0003), malignancy (p = 0.0001), tobacco (p = 0.0001), obesity (p = 0.01), dyslipidemia (p = 0.004), and malnutrition (p < 0.0001). Multivariate analysis showed that both nutritional and inflammatory markers had a high baseline value and were all independent predictors of adverse outcomes for all enrolled patients (for all p < 0.0001). The presence of PAD, malignancy, and tobacco, were also independent predictors of all outcomes. Conclusions: According to our findings, higher MLR, NLR, PLR, SII, SIRI, AISI, CONUT Score, and lower PNI values at admission strongly predict DVT risk, APE risk, and mortality in COVID-19 patients. Moreover, PAD, malignancy, and tobacco, all predicted all outcomes, while CKD predicts APE risk and mortality, but not the DVT risk.

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Background: Carotid endarterectomy (CEA) is the first-line surgical intervention for cases of severe carotid stenoses. Unfortunately, the restenosis rate is high after CEA. This study aims to demonstrate the predictive role of carotid plaque features and inflammatory biomarkers (monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory index (SII), Systemic Inflammation Response Index (SIRI), and Aggregate Index of Systemic Inflammation (AISI)) in carotid restenosis and mortality at 12 months following CEA. Methods: The present study was designed as an observational, analytical, retrospective cohort study and included all patients over 18 years of age with a minimum of 70% carotid stenosis and surgical indications for CEA admitted to the Vascular Surgery Clinic, Emergency County Hospital of Targu Mures, Romania between 2018 and 2021. Results: According to our results, the high pre-operative values of inflammatory biomarkers—MLR (OR: 10.37 and OR: 6.11; p < 0.001), NLR (OR: 34.22 and OR: 37.62; p < 0.001), PLR (OR: 12.02 and OR: 16.06; p < 0.001), SII (OR: 18.11 and OR: 31.70; p < 0.001), SIRI (OR: 16.64 and OR: 9.89; p < 0.001), and AISI (OR: 16.80 and OR: 8.24; p < 0.001)—are strong independent factors predicting the risk of 12-month restenosis and mortality following CEA. Moreover, unstable plaque (OR: 2.83, p < 0.001 and OR: 2.40, p = 0.04) and MI (OR: 3.16, p < 0.001 and OR: 2.83, p = 0.005) were independent predictors of all outcomes. Furthermore, AH (OR: 2.30; p = 0.006), AF (OR: 1.74; p = 0.02), tobacco (OR: 2.25; p < 0.001), obesity (OR: 1.90; p = 0.02), and thrombotic plaques (OR: 2.77; p < 0.001) were all independent predictors of restenosis, but not for mortality in all patients. In contrast, antiplatelet (OR: 0.46; p = 0.004), statin (OR: 0.59; p = 0.04), and ezetimibe (OR:0.45; p = 0.03) therapy were protective factors against restenosis, but not for mortality. Conclusions: Our data revealed that higher preoperative inflammatory biomarker values highly predict 12-month restenosis and mortality following CEA. Furthermore, age above 70, unstable plaque, cardiovascular disease, and dyslipidemia were risk factors for all outcomes. Additionally, AH, AF, smoking, and obesity were all independent predictors of restenosis but not of mortality in all patients. Antiplatelet and statin medication, on the other hand, were protective against restenosis but not against mortality.

The thoracic wall resections for tumoral affections are laborious surgical interventions characterized by a high mortality and mobility. In order to create this paper we created a observational retrospective study in which we included 21 patients that have underwent parietal thoracic resections for tumoral affections. In all the patients we practiced the reconstruction of the thoracic wall using polypropylene mesh. The main postoperative complications were: seromas (14.28% of the cases), hematomas (9.52% of the cases), wound infection (4.76% of the cases), pneumonia (23.8% of the cases), respiratory failure (23.8% of the cases), paradoxical movement of the thoracic wall (52.38% of the cases). No deceases were recorded. In conclusion, the use of polypropylene mesh in the reconstructive techniques of the thoracic wall after thoracic wall resection represents a viable method, with good respiratory functional results.

The classical method of teaching human anatomy to students is based on the dissection of human cadavers. Nowadays, there are many ethical controversy regarding the use of human cadavers during anatomy courses. In our study we tried to get undergraduate students� opinion about some different techniques of teaching human anatomy, including the utility of plastic models. We introduced in this study 163 students in the first year of their study at the Faculty of General Medicine from the University of Medicine and Pharmacy, Tirgu Mures. The respondents were asked to fill in a 12-item anonymous questionnaire. Based on the answers provided in the questionnaires we divided the 163 respondents into 2 groups: group A comprising 113 (69.32%) respondents who found that the best method of teaching anatomy is cadaver dissection and group B comprising 50 (30.67%) respondents who found that the best method of teaching is not cadaver dissection. Thus, 20 (12.26%) respondents considered that the best method of teaching anatomy is the use of previously dissected and preserved preparations, 4 (2.45%) indicated the use of plastic models as the best method, 24 (14.72%) would prefer 3D techniques of image reconstruction and 2 (1.22%) respondents found that the best method of teaching anatomy is by Microsoft Office PowerPoint presentations. Even though there are still controversial opinions regarding the use of cadaver dissection in teaching and learning human anatomy, especially ethical and psychological ones, cadaver dissection remains the best method of teaching anatomy to undergraduate students in medical schools.

The incidence of postoperative pain in patients operated for inguinal hernia can reach up to 40% of cases, depending on different authors, and depending on the approach used in the surgical treatment of these patients. Currently, there are two commonly accepted ways of surgical treatment of inguinal hernias, the classic approach with polypropylene mesh (Liechtenstein technique) and the laparoscopic approach. The purpose of this study was to conduct a comparative analysis on the need for analgesic medication in patients treated for inguinal hernia either by classic (group A) or by laparoscopic (group B) approach. Surgical meshes were used in all patients enrolled in our trial. The average age of the patients included in this study was 53.79 years, ranging from 20 to 88 years. Regarding the distribution of cases by gender, we observed in the studied lots that 12 cases were women (11.53%) and 92 cases were males (88.46%). In female patients, the classic inguinal hernia approach was performed in 3 cases (25% of cases), and in 9 cases the laparoscopic approach was performed in the surgical treatment of the inguinal hernia (75% of the cases). In male patients, laparoscopic approach was performed in 33 cases (35.86% of cases), and in 59 cases the surgical approach was performed in a classical manner using the Liechtenstein technique (64.13% of the cases). From the statistical analysis of the data we noticed a statistically significant difference in the need for analgesic medication administered to these patients (p = 0.0001). Although surgical correction of inguinal hernia, both classic and laparoscopic approaches, provide adequate treatment for these patients, in case of the laparoscopic technique, immediately after the operation, the need for analgesic medication is lower compared to the classical technique.