Maternal–fetal infectious pathology—notably the TORCH panel (Toxoplasma gondii, rubella, Cytomegalovirus, and herpes simplex viruses)—critically impacts maternal and neonatal health. This review collates data on the seroprevalence of IgG and IgM antibodies against TORCH agents in Romanian women, aiming to discern regional and population differences and identify risk factors. Twenty studies were included in the review, revealing variable seroprevalence rates across the country. Regions such as Moldavia and Banat showed higher anti-T. gondii IgG seroprevalence rates than Bihor, with notable declines in Banat. Rural, older, and multiparous women showed elevated T. gondii IgG rates. Anti-rubella vaccine introduction significantly reduced the prevalence of anti-rubella IgG antibodies, but recent vaccination coverage decreases raise concerns. CMV and HSV seroprevalence varied geographically, with rural areas generally showing higher CMV rates and HSV influenced by factors like education level and number of sexual partners. Concurrent seroprevalence of multiple TORCH components in some cases underscores potential common risk factors. This study highlights the importance of continuous monitoring and preventive measures such as vaccinations and awareness campaigns to mitigate the health impact on the pregnant population.
The COVID-19 pandemic has significantly accelerated the adoption of telemedicine and digital health technologies, revealing their immense potential in managing cancer patients effectively. This article explores the impact of recent technological developments and widened consumer perspectives on personalised healthcare and patient awareness, particularly in oncology. Smartphones and wearable devices have become integral to daily life, promoting healthy lifestyles and supporting cancer patients through remote monitoring and health management. The widespread use of these devices presents an unprecedented opportunity to transform clinical trials and patient care by offering convenient and accessible means of collecting health data continuously and non-invasively. However, to fully harness their potential, it is crucial to establish standardised methods for measuring patient metrics to ensure data reliability and validity. This article also addresses the challenges of integrating these technologies into clinical practice, such as cost, patient and professional reluctance, and technological oversaturation. It emphasises the need for continuous innovation, the development of robust digital infrastructures, and the importance of fostering a supportive environment to integrate these advancements permanently. Ultimately, the convergence of technological innovation and personalised healthcare promises to enhance patient outcomes, improve quality of life, and revolutionise cancer management in the post-COVID era.
The study aimed to determine liver fibrosis in human immunodeficiency virus (HIV) positive individuals using transient elastography (FibroScan®), Fibrosis-4 (FIB-4) score, and aspartate aminotransferase (AST) to Platelet Ratio Index (APRI) in the HIV Department from Infectious Diseases Hospital “Victor Babeș” Craiova, Romania. Of the analyzed HIV-positive subjects (n = 161), 93 (57.76%) had HIV mono-infection, and 68 (42.24%) had Hepatitis B Virus (HBV) co-infection. The prevalence of advanced liver fibrosis was higher (F2: 11.76% and F3: 13.24%, F4: 4.41%) in the HIV-HBV co-infected group compared to the HIV mono-infected group. The univariate and multivariate analysis identified HBV co-infection (OR = 5.73) male sex (OR = 5.34), serum aspartate amino-transferase levels (Pearson’s rho = 0.273), low platelet count (Pearson’s rho = −0.149) and erythrocyte sedimentation rate (OR = 1.030) as risk factors for the presence of liver fibrosis. Body mass index (OR = 1.08), serum lipid levels (OR = 0.96), viral load at diagnosis (OR = 1.00005), and low CD4+ cell count (OR = 0.977) were also correlated with liver fibrosis. The FIB-4 and APRI scores were strongly correlated with each other. In conclusion, HBV co-infection seems to be a determinant factor for liver fibrosis development in people living with HIV, together with other risk factors.
Sepsis is an uncontrolled reaction of the body to an infection, and if not effectively treated, it can progress to septic shock, multiple organ failure, and ultimately, death. Objective: To determine the resistance profile of Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) strains isolated in sepsis cases diagnosed at the Infectious Diseases Clinic in Craiova, Romania. Methods: The bacteria responsible for sepsis cases were identified using the Vitek 2 Systems version 06.01, which was then employed to assess their antimicrobial susceptibility (Global CLSI and Phenotypic 2017). Results: We have identified 989 patients diagnosed with bacterial sepsis. Among these, 953 cases were caused by Gram-negative rods, with 415 attributed to E. coli and 278 to K. pneumoniae. High levels of resistance to ampicillin were recorded for E. coli strains isolated in sepsis cases (64.6%); adding sulbactam lowers the level of resistance to 41.8%. Resistance to 3rd generation cephalosporins varied between 7.47 and 14.6% and another 3.41 to 11.1% are dose-dependent susceptibility strains. Resistance to carbapenems (i.e., ertapenem, meropenem) is low—2.18–2.42%. More than 95% of the tested K. pneumoniae strains were resistant to ampicillin and adding sulbactam as a β-lactamase inhibitor only halves that level. Resistance to 3rd generation cephalosporins varied between 20.7% and 22.5%; resistance levels for K. pneumoniae were notably higher than those for E. coli. Over 95% of K. pneumoniae strains showed resistance to ampicillin, and resistance to 3rd generation cephalosporins varied between 20.7% and 22.5%. Additionally, K. pneumoniae exhibited higher resistance to carbapenems (13.7–19.5%) compared to E. coli (2.18–2.42%). Conclusions: Antimicrobial resistance levels are generally lower than continental and national data, except for ampicillin and carbapenems (meropenem and ertapenem). K. pneumoniae strains are significantly more resistant than E. coli strains.
Bacillus anthracis is the causative agent of anthrax, primarily a disease of herbivorous animals, which can be accidentally transmitted to humans. Three cases of cutaneous human anthrax were recorded in August 2020 in Dolj county, Romania. These cases included livestock farmers (husband and wife, as well as a man from their entourage). The women presented malignant edema, which required surgery for compartment syndrome; and the men presented the common form of cutaneous anthrax. According to the laboratory investigation, two cases complied with the criteria in the case definition. All cases were successfully treated with antibiotics and the women received reconstructive plastic surgery of the skin defects, restoring normal hand function. The contact with sick animals was ruled out by the health authorities concluding that it was the contamination of pre-existing skin lesions with B. anthracis spores from the soil, the anthracogenic area.
Toxoplasmosis, caused by the obligate intracellular protozoan parasite Toxoplasma gondii (T. gondii), is a globally prevalent zoonotic disease with potentially severe implications for immunocompromised individuals, pregnant women, and their fetuses/children. This study examined the prevalence of anti-T. gondii IgM and IgG antibodies in two groups of childbearing age women, including 653 participants in Group 1 (2013–2016) and 3221 participants in Group 2 (2019–2022). Our results revealed a decrease in the overall positivity rate of anti-T. gondii IgM antibodies from 2.32% to 1.06%, suggesting improved public health interventions over time. However, there were variations among different age groups and between rural and urban environments, with a significant decrease in urban areas across all age groups from Group 1 to Group 2. Regarding anti-T. gondii IgG antibodies, we did not observe a significant change in the seropositivity rate between the two groups. In the rural population with an age group over 35 years, we observed the highest positivity rate in Group 2. This study provided information on the risk factors and burden of toxoplasmosis in women of childbearing age with data that can be valuable to public health policies and the planning of healthcare measures for effective toxoplasmosis management.