Background: The management of acute surgical pathology implies not only the diagnosis–treatment sequence but also an important preventive component. In the surgical hospital department, wound infection is one of the most frequent complications which must be managed both in a preventive and a personalized manner. To achieve this goal, several factors of negative local evolution, contributing to the slowdown of the healing processes, such as the colonization and contamination of the wounds, need to be emphasized and controlled from the first moment. In this context, knowing the bacteriological status at admission ensures the distinction between the colonization and infection processes and could help to manage in an efficient way the fight against bacterial pathogen infections from the beginning. Methods: A prospective study was performed for 21 months on 973 patients hospitalized as emergencies in the Plastic and Reconstructive Surgery Department within the Emergency University County Hospital of Brasov, Romania. We analyzed the bacteriological profile of the patients from admission to discharge and the bidirectional and cyclic microorganism dynamics both in the hospital and the community microbial environment. Results: Of the 973 samples collected at admission, 702 were positive, with 17 bacterial species and one fungal, with a predominance of Gram-positive cocci at 74,85%. The most frequently isolated strains were Staphylococcus species (86.51% of the Gram-positive/64.7% of the total isolated strains), while Klebsiella at 8.16% and Pseudomonas aeruginosa species at 5.63% were mainly emphasized in the case of Gram-negative bacilli. Two to seven pathogens were introduced after admission, suggesting that the community microbial environment is in a process of evolution and enrichment with hospital pathogens. Conclusions: The high level of positive bacteriological samples and the complex associations of the pathogens found at the admission bacteriological screening sustain the new idea that the pathogenic microorganisms existing in the community microbial environment have started to increasingly influence the hospital microbial environment, in contrast with the previous consideration, which emphasized only the unidirectional relationship between hospital infections and the changing bacteriological characteristics of the community environment. This modified paradigm must become the basis of a new personalized approach to the management of nosocomial infections.

The association between Megaloolithus cf. siruguei eggs and hadrosaurid (Telmatosaurus transsylvanicus) hatchlings that was reported 25 years ago in Maastrichtian mudstone from Tuştea (Haţeg Basin, Romania) is reviewed in this paper. Subsequent to the original descriptions of this association, eggshell micro- and ultrastructure have been compared with M. siruguei from northern Spain and southern France which allowed a safe assignment of the Tustea eggs to this oospecies. Although the eggshell correspondence with M. siruguei from southern Europe is well-sustained by microstructural features, SEM analysis of the Tustea eggs has revealed Y-shaped pore canals, now considered diagnostic to Megaloolithus patagonicus. Thus, in addition, the controversial embryonic tooth, associated with undetermined incompletely calcified remains inside a broken egg from Tustea, not clearly presented before is discussed here as a conclusive proof allowing the referral of the M.siruguei eggs from Tustea to Telmatosaurus transsylvanicus. Some taphonomic aspects related to the eggs hatchling are interpreted on the basis of high-resolution computed tomography images.

Carpal tunnel syndrome is a common entrapment neuropathy that can occur in the upper limbs during pregnancy. However, it is often undervalued and underdiagnosed because the symptoms can be mistaken for regular changes during pregnancy. Delay or absence of diagnosis and treatment can lead to permanent nerve damage, which can affect a woman’s quality of life during and after pregnancy. Although the treatment protocols are well established for carpal tunnel syndrome in patients from the general population, there is a different situation among pregnant and postpartum women that requires a preventive and personalized approach to manage this pathology. Unfortunately, the range of available treatment options is limited due to the pregnant woman’s physiological status and influenced by the high possibility of the complete resolution of this pathology in the postpartum period without any treatment. To limit the possibility of unfavorable evolution of this syndrome during pregnancy, an early diagnosis and personalized approach are mandatory in each case involving a multidisciplinary team of general practitioners, obstetricians, hand surgeons, rehabilitation physicians, physiotherapists, and occupational therapists.

Agache I, et al. Allergy Asthma Immunol Res. 2023 May;15(3):290-302. https://doi.org/10.4168/aair.2023.15.3.290