Background/Objectives: Cancer Therapy-Related Cardiac Dysfunction (CTRCD) is a major complication in patients with non-Hodgkin lymphoma (NHL), potentially leading to heart failure and other severe cardiovascular events. Early identification of patients at risk is crucial for timely interventions. Methods: A prospective analytical cohort study was conducted on 127 adult NHL patients to evaluate chemotherapy-related cardiac dysfunction over a 6-month period, with the aim of assessing early adverse cardiac effects. Assessments included echocardiography, cardiorespiratory exercise testing, 24-h Holter monitoring, and measurement of cardiac-specific biomarkers (troponin I and NT-proBNP) to identify early subclinical cardiac changes. Results: A predictive model for CTRCD was developed using clinical, serological, echocardiographic, cardiopulmonary, and treatment-related parameters in patients with non-Hodgkin lymphoma. The model demonstrated high overall accuracy (94.2%) and strong discriminative ability (AUC 0.95; precision-sensitivity AUC 0.824) for 6-month cardiotoxicity. SHAP analysis identified the most influential predictors as baseline SDNNi, mean daily heart rate, total doxorubicin dose, NT-proBNP, QT corrected interval, hemoglobin, age, left atrial volume, and diastolic function indices (E/e′, E/A). Lower cardiopulmonary reserve was also associated with increased risk. Conclusions: The predictive model developed in this study serves as a practical and robust tool for assessing the risk of cancer therapy-related cardiac dysfunction.

Introduction. Oxygen-ozone therapy stands as a medically endorsed practice confirmed by numerous international clinical studies. Various authors have illustrated the beneficial clinical outcomes of ozone therapy in terms of its capacity to regulate redox balance, cellular inflammatory responses, and adaptation to ischemia/reperfusion processes. Ozone therapy extends to encompass a range of viral infections, inflammatory disorders, and degenerative ailments, used as both monotherapy and as an adjunct to unified conventional therapies. Material and methods. Narrative literature review study. Bibliographic search was conducted using the PubMed, Hinari, and SpringerLink databases, as well as the National Center of Biotechnology Information and Medline. Articles published between 1990 and 2022 were selected using various combinations of keywords, including “ozone”, “ozone therapy”, “mechanisms of ozone action”, “biological effects of ozone”, “antioxidant effect”, “anti-inflammatory effect” and “immunomodulatory effect.” Information regarding ozone’s mechanisms of action was identified and processed. Following the database information processing and search criteria, a total of 475 full-text articles were found. The final bibliography consists of 52 relevant sources that were deemed representative of the materials published on the topic of this synthesis article. Results. The effects of ozone on oxygen metabolism are explained by changes in the rheological properties of blood, including inhibition of erythrocyte aggregation and stimulation of 2,3-diphosphoglycerate in erythrocytes, favoring the transport and delivery of oxygen to tissues while facilitating the substantial elimination of nitric oxide and increasing blood flow. Intracellular triatomic oxygen enhances the oxidative carboxylation of pyruvate, stimulating ATP production, which also contributes to reducing peripheral vascular resistance. Conclusions. Ozone generates a moderate oxidative stress. Yet, it can set off several beneficial biochemical mechanisms that reactivate both the intra- and extracellular antioxidant systems and reverse chronic oxidative stress in various inflammatory and degenerative processes. Ozone induces a mild activation of the immune system by triggering neutrophil activation and stimulating the synthesis of certain cytokines (IL-2, TNF-α, IL-6, and IFN-γ), thereby initiating a complete cascade of immune responses. Ozone therapy yields the following biological reactions: optimization of blood circulation and oxygen delivery to ischemic tissue, regulation of cellular antioxidant enzymes, initiation of a slight immune system activation, and enhancing the release of growth factors.

Aim of the study. The objective is to study cellular spaces, as compartments lined with lax connective tissue, bounded by fascia, muscle, bone and other anatomical structures. They may contain different anatomical elements such as vessels, nerves and lymph nodes. According to their anatomic-topographic localization we distinguish: subcutaneous, interfascial, sub and interserosal, subfascial, osteo-fascial, parafascial, paravasosal, paraneural, paraarticular and paravisceral. Terminal branches of peripheral nerves are also located in them, thus there is the possibility to perform loco-regional blocks by injecting AL into the respective compartments. Material and Methods. This study is based both on the bibliographic analysis of the literature in the field of topographic anatomy and loco-regional anesthesia, and on our own experience within the ITA section of the Oncological Institute of Moldova. The chosen resources included fundamental textbooks and papers from recognized scientific journals published in the last 15 years. Results. Subfascial cellular spaces are located beneath the fascia propria (deep fascia) surrounding one or groups of muscles, between which are located intermuscular fascial septa or bony surfaces. According to recent research (including imaging methods) of the cellular space (interfascial plane), it is considered to be the space between two septa of the fascia propria (deep) and is presented by adipose tissue, elastin and reticular fibers. It may contain nerves, blood vessels, bone and muscle, and has a fixating, cushioning and lubricating role. Injecting AL into the interfascial space can block both the peripheral branches of nerves within the interfascial space and the nerve endings that distribute into the fascial fascia. Localization of the interfascial space to external landmarks alone is uncertain. Hence the advent of ultrasound with live, real-time visualization of anatomy has revolutionized both medical diagnosis and the technique of loco-regional anesthesia. Elsharkawy et al. suggested that the biomechanical properties of the fascia might play an important role in the diffusion of local anesthetics, and ultrasound can detect changes in the interfascial space during monitoring of LA dispersion. Conclusions. The knowledge of the anatomic-topographic particularities of the interfascial spaces allows us to understand the mechanism of action, indications, technique and complications of fascial plane anesthesia. With the widespread introduction of ultrasonography (especially hand-held ultrasonography), it became possible to visualize the anatomy in vivo: needle-layer relationship, nerves, vessels, local anesthetic spread. In this aspect the fascial plane blocks have shifted from techniques based on anatomic landmarks to ultrasonographic guidance, and their utilization is increasing.

Background: Trauma remains a medical-social problem, still having high lethality rate. Indirect lung injury (ILI) occurs in trauma due to systemic neutrophils activation and proteases release into primarily intact tissues. There are no data in the literature regarding ILI predictive models in trauma. Material and methods: In the experimental study (19 traumatized male rabbits), the proteases, antiproteases and the pulmonary morphological changes, assessed according to the SAMCRS score (Semiquantitative Reflected Qualitative Changes Assessment Scale) were followed. There were used two statistical instruments – correlational analysis and multivariate linear regression. Results: Initially, a correlational analysis between the values of the SAMCRS score and the proteases/ anti proteases was performed. The null hypothesis was rejected (F = 7.017, p = .002). The correlation coefficient of the predicted results and the real values of SAMCRSlungs was .854, the determination coefficient being .626. The final model included the following parameters: constant (B = 9.427; 95% CI 7.341, 11.513; p <.001); α2-macroglobulin0 (B = -4.053; 95% Cl -6.350, -1.757; p = .002); AEAMP0 (B = .002; 95% CI .000, .004; p = .075); AEAMP24 (B = -. 006; 95% CI -.010, -.002; p = .003); AECG2 (B = .081; 95% CI .040, .122; p = .001); AEE0 (B = -. 026; 95% CI -.040, -.011; p = .002). Conclusions: In this research, a predictive model for indirect lung injury in experimental trauma was developed, the predictors being some elements of the proteases/antiproteases system. This, in turn, allows the hypotheses emission regarding the pathophysiology, prophylaxis and treatment of ILI.

Introduction. A major role and, at the same time, a question mark, both for patients and doctors, is the possibility that drugs and anesthetic techniques influence cancer metastasis. Cancer is the leading cause of death worldwide. This trend will continue in the future. Most of the deaths of cancer patients are due to complications arising from metastases. The metastasis process of a tumor depends on its intrinsic properties and interaction with the host. The treatment of tumors by performing a surgical intervention, radical or palliative, has a significant impact. For these reasons, the rate of survival and migration of cancer cells in the perioperative period is studied quite insistently and complexly. Thus, surgical intervention and anesthetic support in cancer patients becomes of great importance, because it represents the vulnerable link, both from the point of view of the operation itself, as well as the possibility that drugs, anesthetic techniques may or may not influence tumor metastasis. Material and methods. Primary scientific studies published from 1996 to 2021 dedicated to loco-regional anesthesia and its influence on the perioperative period and on cancer metastasis were studied. To achieve the proposed goal, scientific sources PubMed, Medscape, SCOPUS, MEDLINE were researched. Keywords used for searching: loco-regional anesthesia, fascia plane anesthesia, metastasis. More than 80 reference sources were identified, 67 were selected for analysis. Results and discussions. The surgical procedure, itself, performed for curative purposes, also known as tumor resection – is a risk factor for metastasis by creating an environment with high potential for tumor cell survival. This stimulates tumor growth and angiogenesis, can remodel lymphatic pathways, allowing metastasis of tumor cells. Hemotransfusion is associated with increased risk of metastasis. Regional anesthesia could reduce cancer recurrence through several mechanisms. Conclusions. Regional anesthesia could reduce cancer recurrence by reducing the need for opioids or inhaled anesthetics, or by reducing the stress response during surgery. There is scientific in vitro evidence of a protective effect of systemic lidocaine on recurrent cancer, although relevant clinical data are limited.

Introduction. Currently, extensive research has shown that almost all published prediction models are poorly studied and have significant limitations, leading to their predictive performance often being overestimated. Additionally, there is still no universally accepted scoring system, primarily due to the need for adaptation to heterogeneous patient samples (including patient numbers, clinical profiles, and risk factors) and/or ongoing differences in the organization of healthcare systems across various countries. Materials and methods. This is a narrative literature review. A bibliographic search was conducted in the PubMed, Hinari, SpringerLink, National Center for Biotechnology Information, and Medline databases. Articles published between 2000 and 2024 were selected based on keyword combinations such as “artificial intelligence”, “prediction model”, “algorithm”, “machine learning”, and “COVID-19”. Information on machine learning predictive models was selected and processed to identify characteristics that can be used to predict diagnosis, severity, length of hospital stay, ICU admission, treatment, vaccination, and mortality in COVID-19 patients. After processing the data according to the search criteria, 125 full-text articles were identified. The final bibliography includes 52 relevant sources, which were considered representative of the literature on this synthesis article topic. Results. Artificial intelligence techniques are increasingly being used to predict outcomes in COVID-19 patients, particularly in estimating mortality among individuals infected with SARS-CoV-2, which can rapidly and effectively support clinical decision-making. According to the analysis of multiple studies, strong predictors of mortality in COVID-19 patients include advanced age, male gender, comorbidities, reduced levels of calcium, albumin, red blood cells, and oxygen saturation, as well as lymphopenia, elevated blood urea nitrogen, creatinine, lactate dehydrogenase, D-dimers, neutrophils, interleukin-6, procalcitonin, bilirubin, ferritin, aspartate aminotransferase, and troponin. Conclusions. Artificial intelligence techniques provide potential advantages over conventional assessment methods. The information obtained from machine learning and deep learning algorithms, including easily accessible and interpretable data, can assist healthcare workers in making accurate decisions for the appropriate and timely care of COVID- 19 patients. This can improve patient outcomes, reduce the burden on healthcare systems, and ultimately decrease mortality rates.