Background: This study aimed to assess the feasibility of conducting a prospective study to evaluate histological changes in skin and muscle tissues after two weeks of balneotherapeutic intervention, as described in Romanian medical regulations. Methods: Thirty-five patients participated in this study, thirty of whom received balneotherapy (a cold mud ointment or a mud pack, or a mud bath, and/or a salted water bath) and five received hydrotherapy (the witness plot). Inclusion and exclusion criteria were applied. Twenty-four hours after discharge, a tegument and muscle biopsy were performed, and fragments were histologically prepared. Results: In the blade evidence analysis, the increased caliber and number of open capillaries and the presence of angiogenesis vessels were statistically significant (p = 0.001 < α = 0.05) for the cold mud ointment and mud pack compared with the witness and mud bath plots. The number of angiogenesis blood vessels was higher in the dermis (p < 0.05 *) with the mud pack plot and in the muscle with the mud cold ointment (p < 0.05). The histological study showed that two weeks of therapeutic intervention produced evidence-based proof in the dermis and muscle tissues, which was persistent at least twenty-four hours after the completion of the balneal course. The results encourage the team to continue the histological approach using modern techniques.

Objective: This narrative review aims to summarize current evidence on the epidemiology, risk factors, clinical patterns, and therapeutic strategies for urinary incontinence in menopausal women. Background: Urinary incontinence (UI) is a common, multifactorial condition that disproportionately affects women, with prevalence rising during pregnancy and post menopause. While stress urinary incontinence (SUI) predominates in younger and early postmenopausal women, urgency urinary incontinence (UUI) and mixed urinary incontinence (MUI) become increasingly prevalent with age and duration following menopause. Additional determinants, such as obesity, comorbidities, polypharmacy, and menopausal symptoms, burden further contribute to symptom severity and persistence. Materials and Methods: For the materials and methods, we used over 150 specialized studies and meta-analyses published in the specialized literature on this subject, of which 99 are mentioned in the bibliography of this narrative review. These materials are some of the most significant and up-to-date that address this complex topic. Content: This narrative review discusses the impact of menopause-related hormonal decline on the genitourinary tract, highlighting the role of estrogen deficiency in genitourinary syndrome of menopause (GSM). It addresses distinct patterns of UI across life stages, including pregnancy and the early and late postmenopause periods, and explores modifiable risk factors such as body mass index. Specific attention is given to nocturnal incontinence, medication-related effects, and coital incontinence, which significantly impair sexual health and quality of life. Therapeutic strategies are presented in a stepwise manner: conservative measures (pelvic floor muscle training), hormonal approaches (local vaginal estrogen), combination regimens, and surgical interventions, including midurethral slings, colposuspension, bulking agents, and neuromodulatory techniques. Future perspectives: Emerging modalities such as balneotherapy and energy-based therapies show promise but require further investigation. Conclusions: Urinary incontinence in menopausal women is best addressed through an individualized, multimodal approach that integrates conservative, hormonal, minimally invasive, and surgical options. Combination therapies demonstrate superior efficacy in addressing both continence and GSM-related symptoms. Future research should refine patient selection, optimize multimodal treatment algorithms, and prioritize long-term outcomes and quality-of-life measures in clinical decision-making.

Background: Nasal high-frequency oscillatory ventilation (nHFOV) has emerged as an effective initial and rescue noninvasive respiratory support mode for preterm infants with respiratory distress syndrome (RDS); however, little is known about nHFOV use in Romanian neonatal intensive care units (NICUs). Objectives: We aimed to identify the usage extent and clinical application of nHFOV in Romania. Methods: A structured web-based questionnaire was designed to find the rate of nHFOV use and knowledge of this new method of noninvasive respiratory support in Romanian level III NICUs. Using multiple-choice, open-ended, and yes/no questions, we collected information on the NICU’s size, noninvasive respiratory support modes used, nHFOV use, indications, settings, nasal interfaces, secondary effects, and equipment used. Descriptive statistics and comparisons were performed using IBM SPSS Statistics 26.0. Results: A total of 21/23 (91.3%) leaders from level III NICUs (median [IQR] number of beds of 10 [10–17.5]) responded to the survey. The most frequently used noninvasive ventilation modes were CPAP mode on mechanical ventilators (76.2%), followed by NIPPV (76.2%); heated, humidified high-flow nasal cannula (HHHFNC) (61.9%); and nHFOV (11/21 units; 52.4%). A total of 5/11 units reported frequent nHFOV use (in two or more newborns/month) in both term and preterm infants. The main indications reported for nHFOV use were CPAP failure (90.9%), hypercapnia (81.8%), and bronchopulmonary dysplasia (72.7%). Face/nasal masks and short binasal prongs are the most commonly used nasal interfaces (90.9% and 72.7%, respectively). Air leaks at the interface level (90.9%), thick secretions (81.8%), and airway obstruction (63.6%) were the most frequently mentioned adverse effects of nHFOV. Only three of the NICUs had a written protocol for nHFOV use. Most units not yet using nHFOV cited lack of equipment, experience, training, or insufficient information and evidence for the clinical use and outcome of nHFOV use in neonates as the main reasons for not implementing this noninvasive respiratory mode. Conclusions: Our survey showed that nHFOV is already used in more than half of the Romanian level III NICUs to support term and preterm infants with respiratory distress despite a lack of consensus regarding indications and settings during nHFOV.

Background: Sapropelic mud from Techirghiol Lake has been used therapeutically under medical supervision for more than 170 years; however, its comprehensive physicochemical characterization under application-relevant conditions remains insufficiently documented. This study aimed to evaluate the physicochemical properties, mineral and organic composition, ion-exchange capacity, and potential therapeutic mechanisms of Techirghiol sapropelic mud. Methods: Mud samples were analyzed using standardized physicochemical and analytical techniques to determine pH, water content, granulometry, mineral composition, organic fraction, and trace elements. Results: The results indicate that Techirghiol mud is a highly hydrated alkaline peloid characterized by a complex mineral–organic system. Major elements included sodium, calcium, and magnesium, while trace elements such as manganese, iron, and zinc were present in relevant concentrations. The organic fraction, composed of humic substances, lipids, and proteins, reflected advanced but incomplete humification processes. Conclusions: The findings demonstrate the complex physicochemical composition of Techirghiol sapropelic mud and provide a scientific basis for further studies regarding its properties and applications.