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.

Platelet indices represent useful biomarkers to express the thromboembolic status, inflammatory response, and oxidative stress in preterm newborns. Our study presented platelet count and function changes in prematurity-related morbidities such as respiratory distress syndrome, intraventricular bleeding, and anemia of prematurity in preterm newborn cases reported to healthy full-term newborns by flow cytometry and hematological methods. The platelet volume represents the average size of platelets in the blood samples, showing the significantly increased values in preterm newborns compared with healthy full-term newborns due to increasing activated platelet production. Flow cytometric analysis of immature platelet fractions (IPF) made using thiazole orange staining to detect their mRNA content and a glycoprotein (anti-GPIIIa) antibody for platelet gating. CD61-TO expression from premature newborns was significantly lower compared to healthy full-term neonates. Preterm newborn cases with respiratory distress syndrome and a need for respiratory support (RDS+) were characterized by a significantly increased platelet volume and a decreased immature platelet fraction reported in RDS− cases. Evaluating the platelet function in the newborn is difficult because the laboratory methodologies work with small quantities of newborn blood samples. The immature platelet fractions and platelet volume promise to be diagnostic biomarkers for diseases.

Background: Placenta accreta spectrum (PAS) refers to abnormal placental attachment, categorized into placenta accreta, increta, and percreta, with varying severity. The incidence of PAS has risen alongside the increasing rate of caesarean sections. PAS is a significant cause of maternal complications, including bleeding, hysterectomies of necessity and intestinal or urinary surgical complications, and of foetal complications, preterm birth or foetal anaemia. Early diagnosis is crucial for its management and for improving its outcomes. Materials and Methods: This retrospective study, conducted at the County Emergency Clinical Hospital “Saint Andrew the Apostle”, Constanța, analysed cases of placenta praevia and PAS from 2018 to 2022. Data were collected from observation sheets and operative protocols, involving 13,841 patients. Placenta praevia and PAS were diagnosed using ultrasound and MRI and confirmed by histopathology. Results: Among the 13,841 deliveries, 25 cases of placenta praevia (0.82% incidence) and 17 cases of PAS (0.57% incidence) were identified. Ultrasound demonstrated 88% sensitivity, and MRI 94% sensitivity for PAS detection. Of the 17 PAS cases, 11 were diagnosed as placenta accreta, 3 were diagnosed as placenta increta, and 3 as placenta percreta, with all percreta cases involving bladder invasion. Hysterectomy was the standard surgical treatment. Discussion: The risk factors for PAS included previous caesarean sections (94.1% of PAS cases), smoking, and uterine fibroids. The study confirmed the importance of early imaging and the involvement of a multidisciplinary team in managing PAS, particularly in complex cases with bladder involvement. Caesarean section followed by hysterectomy was the preferred surgical approach. Conclusions: Smoking, uterine scars, and uterine fibroids are significant risk factors for placenta praevia with pathological adhesion. Ultrasound and MRI are highly accurate in diagnosing PAS, with histopathology providing definitive confirmation. Multidisciplinary care is essential in managing complex cases, ensuring optimal maternal and foetal outcomes. The surgical treatment involves caesarean section and hysterectomy, with additional interventions for bladder invasion in percreta cases.