Search Results (134)

Wild carnivores play an important role in maintaining Trichinella spp. infection in the sylvatic environment and may contribute to the transmission of the parasite to domestic animals and humans. Northeastern Romania hosts a large population of red foxes (Vulpes vulpes), a species not routinely included in trichinellosis surveillance programs. This study aimed to determine the geographical distribution and prevalence of Trichinella infection in red foxes and to identify the species involved. Between 2023 and 2025, muscle samples (tongue, diaphragm, and intercostal muscles) were collected from 617 red foxes culled as part of epidemiological surveillance activities. Samples were examined by direct trichinelloscopy, and positive specimens were further analyzed by multiplex PCR at the European Union Reference Laboratory for Parasites in Rome, Italy, for species identification. Trichinella infection was detected in foxes from all investigated counties of northeastern Romania, regardless of landforms. The overall prevalence was 24.3% (150/617). Of the 148 isolates subjected to multiplex PCR, 120 yielded positive amplification, all of which were identified as Trichinella britovi. The widespread distribution and high prevalence of T. britovi confirm the role of the red fox as an important natural reservoir, supporting the maintenance and circulation of the parasite in the sylvatic environment and highlighting the need for continued surveillance and further epidemiological studies. Full article

This study analyzes land use dynamics in Fălticeni Municipality over four decades (1985–2025), examining the influence of major political, socio-economic, and demographic changes on urban development. The transition from a centrally planned economy to a market economy, Romania’s democratic transformation and European integration, together with migration and population dynamics, have driven largely unregulated urban expansion at the expense of agricultural land and natural landscapes. Recent urban growth has also extended into areas with varying geomorphological vulnerability, increasing exposure to landslide hazards, while the city continues to face challenges related to abandoned industrial areas and insufficient forested land and green spaces. By integrating land use change analysis with physical vulnerability indicators, this study highlights the need for risk-informed and sustainable urban planning in medium-sized cities. It proposes a planning framework based on ecological zoning, controlled urban expansion on suitable terrain, brownfield redevelopment, the establishment of peri-urban forests, and the implementation of essential infrastructure supported by comprehensive geomorphological susceptibility assessments. The proposed approach provides practical guidance for enhancing urban resilience and can be replicated in other cities facing similar environmental and development challenges. Full article

This study evaluated potentially toxic element (PTEs) contamination (As, Cd, Co, Cr, Cu, Ni, Pb, and Zn) in soil and grapevine leaves across 36 sites in a historical vineyard near Iași, Romania, transitioning toward residential development. Soil samples were analyzed using energy-dispersive X-ray fluorescence (ED-XRF), while leaf tissues collected during the véraison stage (mid-August) underwent microwave-assisted acid digestion followed by inductively coupled plasma mass spectrometry (ICP-MS). Soil analyses revealed that average concentrations of Cr, Ni, and Pb exceeded national normal legal thresholds, while Cu and As surpassed alert permissible limits. Contamination factor ($CF$) and Geoaccumulation Index ($I_{geo}$) metrics confirmed significant anthropogenic Cu enrichment from historical viticultural treatments. Soil-to-leaf transfer factors ($TF$) approached or exceeded 1 for Cu and Zn, though grapevine was not identified as a hyperaccumulator. Spearman correlation modeling demonstrated a statistical decoupling between soil concentrations and foliar tissue levels for Cu ($r_s=-0.21$) and Zn ($r_s=0.075$), confirming that canopy accumulation is governed by historical agrochemical spraying and atmospheric deposition rather than root-driven uptake. Conversely, Pb ($r_s=0.43$) exhibited a moderate direct soil-to-leaf pathway. The potential ecological risk ($PER$) index indicated moderate-to-considerable cumulative risk, primarily driven by Cu ($E_{Cu}=68.64$) and Cd ($E_{Cd}=59.17$). Human health risk assessments established direct ingestion as the primary exposure pathway, with current non-carcinogenic hazards remaining within tolerable limits ($HI<1$). However, the proposed residential conversion increases exposure risks for vulnerable cohorts, underscoring the necessity of systematic soil screening and remediation prior to land redevelopment. Full article

Background/Objectives: Diabetic neuropathy is a prevalent complication of type 2 diabetes mellitus (T2DM), but the contribution of dietary factors to neuropathy severity remains insufficiently characterized. This study investigated associations between dietary patterns, nutrient intake, and neuropathy severity in 300 adults with T2DM from Northeastern Romania. Methods: Dietary intake was assessed using a validated food frequency questionnaire, and five dietary patterns were derived using principal component analysis. Neuropathy severity was analyzed as an ordinal outcome using logistic regression models adjusted for age, sex, HbA1c, diabetes duration, and treatment. Results: Higher adherence to Western/fast-food and alcohol and animal fat dietary patterns was associated with greater neuropathy severity in unadjusted analyses, whereas a healthy/prudent pattern showed inverse associations; however, these relationships were attenuated after multivariable adjustment. In contrast, higher intakes of protein (OR = 0.98, 95% CI: 0.97–0.99), magnesium (OR = 0.99, 95% CI: 0.98–1.00), zinc (OR = 0.80, 95% CI: 0.69–0.94), vitamin B3 (OR = 0.94, 95% CI: 0.89–0.99), and vitamin B12 (OR = 0.76, 95% CI: 0.62–0.93) remained independently associated with lower neuropathy severity after adjustment. Conclusions: These findings suggest that specific nutrient intakes may be more strongly associated with diabetic neuropathy severity than overall dietary patterns, highlighting potential nutritional targets for neuropathy risk reduction and clinical management in patients with T2DM. Full article

Acromegaly is a rare chronic endocrine disorder characterized by delayed diagnosis, multisystem comorbidity, and heterogeneous therapeutic response. We aimed to describe the clinical characteristics, tumor profile, treatment patterns, biochemical control, pituitary insufficiencies, and comorbidity burden in an endocrinology tertiary center in northeastern Romania. This observational retrospective study included 87 adult patients admitted for general inpatient evaluation between December 2023 and November 2024, with retrospective data collected from diagnosis and follow-up assessed through the last available hospital visit at St. Spiridon Clinical Emergency Hospital. Clinical, hormonal, imaging, and therapeutic data were analyzed using descriptive statistics and inferential statistical tests. Most patients were diagnosed in middle adulthood, with a female predominance. Macroadenomas and extrasellar extension were common, consistent with advanced tumor stage at presentation. Treatment was predominantly multimodal, with surgery as the main therapeutic intervention and somatostatin receptor ligands as the main medical treatment backbone. Biochemical improvement was observed over time, although complete remission was achieved only in a subset of patients. These findings describe the clinical and therapeutic complexity of acromegaly in a single tertiary-center inpatient cohort and support the need for individualized long-term monitoring. Full article

This article explores the specificity of social assistance conducted by the Romanian Orthodox Church (ROC) compared to Faith-Based Organizations (FBOs) in the UK, USA, and France. The article is a secondary qualitative analysis of a circumscribed subset of the interview material assembled in a wider mixed-methods study on the professionalization of charity in the ROC, pursuing a different research question—the configurational specificity of the Orthodox model—than the parent study itself. Using Grounded Theory methodology on the corpus of nineteen interviews with clergy, social workers, and experts from Northeastern Romania, the analysis develops the category of the sacralization of social assistance—a configuration of practices and meanings in which the spiritual dimension is structurally integrated, sacramentally obligatory, and clerically authorized. While each of these features has been documented individually in Protestant and Catholic faith-based organizations, their joint configuration in the Romanian Orthodox case differs in degree and arrangement from patterns reported in the Western literature. A theoretically informed contrast with that literature highlights six dimensions along which the ROC configuration, as articulated by providers, diverges from the patterns most frequently reported in that literature: (1) the spiritual dimension is structurally integrated in ROC versus optional in UK/USA or institutionally absent in France; (2) leadership remains predominantly clerical versus secularly professionalized in the West; (3) the beneficiary is conceptualized as a living icon of Christ versus a person with civil rights; (4) the purpose of interventions is soteriological versus immanent social reintegration; (5) professionalization generates anxiety about secularization versus comfortable normalization; (6) volunteerism remains informal-communitarian versus formalized-systematic. The research proposes a dual-axis typology that differentiates between the presence and the nature of the spiritual dimension. Full article

This study explored the link between orchard-derived cherry quality and circular food innovation through the valorization of dried cherry pomace. Sweet cherry fruits from the cultivars Van and Stella, grown under the pedoclimatic conditions of north-eastern Romania, were evaluated for physicochemical traits, phytochemical profile, antioxidant activity, and heavy metal content. In parallel, cherry pomace obtained during juice processing of cultivar Van was freeze-dried, characterized, and incorporated into dairy-based spreadable formulations at 5% and 10% addition levels in order to assess its bioactive potential. The results showed clear cultivar-dependent differences, with Van exhibiting a superior bioactive profile, including higher total polyphenols, flavonoids, anthocyanins, and antioxidant activity than Stella. Heavy metal concentrations in fruits remained below the maximum allowable limits, while health-risk indices indicated no significant non-carcinogenic risk (HI = 3.18 × 10⁻²). The dried cherry pomace powder was characterized by high dietary fiber content (49.83 g/100 g dw), substantial total polyphenols (1046.80 mg GAE/100 g dw), anthocyanins (123.27 mg C3G/100 g dw), and antioxidant activity (21.43 μM TE/g dw). Its incorporation into dairy-based spreadable products significantly improved ash, carbohydrate, fiber, phytochemical content, and antioxidant activity, with the 10% level showing the highest functional enhancement. Sensory evaluation indicated that the 5% formulation achieved the most balanced and preferred overall sensory profile. Overall, the findings support dried cherry pomace as a valuable functional ingredient and highlight a practical circular strategy for reconnecting cherry by-products with value-added food applications. Full article

Background: Omphalocele is a congenital defect of the anterior abdominal wall frequently associated with additional anomalies that substantially influence neonatal outcomes. Cardiovascular and pulmonary abnormalities are among the most clinically relevant factors affecting survival, yet their relative prognostic contribution remains incompletely characterized in smaller regional cohorts. Methods: This retrospective observational study included 50 neonates with omphalocele treated at a tertiary pediatric surgery center in Northeastern Romania between 2000 and 2025. Demographic characteristics, associated congenital anomalies, surgical management, and clinical outcomes were analyzed. Comparisons were performed between isolated and non-isolated omphalocele cases and according to the presence of cardiac and pulmonary anomalies. Univariate logistic regression was used to evaluate associations between associated anomalies and mortality. Results: Associated congenital anomalies were present in the majority of patients. Cardiac malformations were identified in 68% of cases, pulmonary anomalies in 22%, and combined cardiopulmonary anomalies in 20%. Overall mortality was substantial. Mortality was higher in non-isolated compared with isolated omphalocele, although this difference did not reach statistical significance. Univariate analysis showed that pulmonary anomalies were significantly associated with increased mortality (OR = 4.31, 95% CI: 1.20–15.50, p = 0.025), whereas cardiac anomalies alone were not significantly associated with mortality. Combined cardiopulmonary anomalies were associated with an increased mortality risk without reaching statistical significance. Conclusions: In this cohort, pulmonary anomalies were strongly associated with increased mortality among neonates with omphalocele. These findings suggest that detailed prenatal and postnatal pulmonary assessment may contribute to improved risk stratification and multidisciplinary management in affected neonates. The results should be interpreted in the context of the study’s retrospective design and limited sample size. Full article

Background and Objectives: Romania reported the highest measles incidence in the European Union during the 2023–2024 epidemic, largely driven by declining vaccination coverage. We aimed to characterize the epidemiological, clinical, and laboratory profile of hospitalized measles patients and to identify age-related differences, with particular emphasis on systemic and hepatic involvement. Materials and Methods: We conducted a retrospective observational study including 360 consecutive patients with laboratory-confirmed measles admitted to a tertiary infectious disease hospital in northeastern Romania between 1 January and 31 December 2024. Demographic, clinical, laboratory, therapeutic, and outcome data were collected. Pediatric (<15 years) and adult patients were compared using appropriate statistical tests. Results: Children accounted for 71.4% of cases, including 16.1% infants under one year. Over 90% of patients were unvaccinated or incompletely vaccinated. Household transmission represented the most frequent identifiable source. Adults presented significantly higher inflammatory markers and more pronounced hepatic involvement than children. ALT elevation occurred in 63.1% of adults versus 34.2% of children (p < 0.001), with moderate-to-severe cytolysis predominantly observed in adults (34.9% vs. 1.9%, p < 0.001). Pulmonary complications were documented in 28% of cases, mainly viral interstitial pneumonia. Thrombocytopenia was significantly more frequent in adults (p < 0.001). Overall mortality was 0.27%, occurring in an unvaccinated infant with secondary bacterial pneumonia. Conclusions: The 2024 measles epidemic in our area was characterized by sustained transmission among unvaccinated individuals and frequent systemic involvement. Hepatic dysfunction emerged as a prominent feature in adults, suggesting a shifting clinical phenotype in contemporary outbreaks. Strengthening vaccination coverage and early recognition of systemic complications remain critical to reducing measles-related morbidity and mortality. Full article

Rabies is a fatal zoonotic disease once clinical symptoms develop. In Europe, sustained animal rabies control programs have led to a marked decline in animal rabies and subsequently human rabies cases; however, sporadic infections continue to occur. In July 2025, a fatal case of autochthonous (locally acquired) human rabies was confirmed in Romania following a stray dog bite in a patient who did not receive post-exposure prophylaxis (PEP). Here, we report the first molecular characterization of a human rabies virus (RABV) strain isolated in Romania and place it in the context of contemporaneously circulating animal-derived RABV strains. Rabies virus infection was confirmed intra vitam by fluorescent antibody testing and both conventional and real-time RT-PCR on cerebrospinal fluid and saliva, with postmortem confirmation on skin and brain tissue. Whole-genome sequencing was performed on the human isolate and on 22 animal-derived RABV strains collected in northern Romania in 2025. Phylogenetic analyses revealed that all recent Romanian sequences clustered within the North-East European (NEE) rabies virus phylogenetic group and segregated into two geographically distinct genetic clusters: a north-western cluster, closely related to strains from Slovakia and Poland, and a larger north-eastern cluster, linked to viruses circulating in eastern Romania and the Republic of Moldova. The human-derived RABV genome was grouped within the north-eastern cluster and showed the highest genetic similarity to animal viral strains from the same geographical area, supporting a local transmission event. This demonstrates the importance of integrating human viral genomic data into the national rabies surveillance framework. Full article

Glyphosate is the most widely used pesticide globally, raising concerns about its environmental persistence and biological impacts. Therefore, monitoring pesticide use is essential for assessing agricultural practices and the risks to human health associated with chemical use. This research examined glyphosate contamination in water (40 samples) and soil (28 samples) from northeastern Romania, an important agricultural region. Glyphosate concentrations in environmental water and soil samples were quantified using a spectrophotometric method based on ninhydrin derivatization, with good linearity over the concentration range 1–30 µg/mL (R² = 0.9981). Glyphosate was detected at concentrations above the LOQ in one water sample. Also, the study proposes a UHPLC-MS/MS method for the confirmation of glyphosate presence in the analyzed sample. Additionally, this study contributes to the characterization of the toxicity profiles of glyphosate and a commercial glyphosate-based formulation (Roundup^®) in primary human gingival fibroblast (hGF) cell lines. The commercial product Roundup, containing glyphosate, exhibited cytotoxicity similar to that of the active compound at low and intermediate doses; a significant cytotoxic effect was observed at a maximum concentration of 1 mM, with prolonged exposure. These findings demonstrate minimal cytotoxicity under the examined conditions and underscore the need for dose- and time-dependent assessments to evaluate the biological impact of herbicide formulations. Full article

Background/Objectives: There are significant gaps in knowledge regarding the heterogeneity of heart failure (HF) phenotypes, particularly among patients with preserved left ventricular ejection fraction (HFpEF). Our aim was to identify phenotypes within the hospitalized North-Eastern Romanian HFpEF cohort and their impact on short-term outcomes. Methods and Results: We derived a cluster model from 924 patients with HFpEF hospitalized over an 18-month interval in the Internal Medicine II Department of the “Sf. Spiridon” Emergency Clinical County Hospital in Iași, Romania. The median age of the patients was 74 years [range 30–101], 59.8% were women, and the most frequent comorbidities were arterial hypertension (93.2%), valvular heart disease (68.7%), atherosclerotic cardiovascular disease (ASCVD, 64.6%) and atrial fibrillation (43%). Statistical analysis identified five distinct phenotypes: cluster 1 (21.6% of patients) consisted of normal-weight patients with valvular disease predominance; cluster 2 (18.2%) described a severe cardiometabolic phenotype; cluster 3 (19.6%) defined a young, hypertensive, and atherosclerotic phenotype; cluster 4 (21.26%) described a hypertensive–atrial fibrillation phenotype; and cluster 5 (18.9%) included elderly, hypertensive non-diabetic patients with severe vascular burden (ASCVD 100%). Conclusions: This study defines five distinct phenotypes within the HFpEF population in our region which differ in terms of clinical characteristics and heart failure pharmacological therapy. These results confirm the significant heterogeneity of HFpEF. The identified phenotypes were not associated with significant differences in composite short-term outcomes, including in-hospital mortality and 30-day rehospitalization for heart failure. Full article

Background and Objectives. Mother-to-child transmission (MTCT) or vertical transmission of human immunodeficiency virus (HIV) is largely preventable in settings where prevention of MTCT (PVT) strategies are consistently implemented. Romania represents a particular epidemiological context, as individuals from the historical pediatric HIV cohort have now reached reproductive age. This study assessed current PVT outcomes in northeastern Romania and explored the remaining circumstances in which transmission still occurs. Materials and Methods. We performed a retrospective observational analysis at the Regional HIV/AIDS Center of Iași (“Sfânta Parascheva” Clinical Hospital of Infectious Diseases), including all pregnant women living with HIV and their HIV-exposed infants followed between 2023 and 2025. Maternal data comprised age, place of residence, origin from the Romanian pediatric cohort, antiretroviral therapy (ART) adherence, and HIV RNA viral load in the third trimester. Obstetric characteristics, delivery mode, neonatal antiretroviral prophylaxis, and infant HIV RNA PCR results during follow-up up to 18–24 months were also evaluated. Results. A total of 61 HIV-positive pregnant women and 53 HIV-exposed infants were included. Viral suppression during pregnancy was documented in 59 women (96.7%), while two cases of detectable viremia in late pregnancy were linked to poor ART adherence. All women delivered by elective cesarean section, and all infants received neonatal antiretroviral prophylaxis, with Raltegravir added in selected higher-risk situations. Overall, MTCT was 3.8% (2/53). No transmission events were recorded in 2023 or 2024; both cases occurred in 2025 (15.4% of infants born that year) and exclusively in the context of maternal viremia. Women originating from the historical pediatric HIV cohort accounted for 31.1% (19/61) of pregnancies, and no transmission was observed among their infants. Conclusions. In northeastern Romania, PVT programs remain highly effective when maternal viral suppression is achieved. Residual transmission was confined to situations of maternal viremia driven by ART non-adherence, highlighting the continued importance of adherence support during pregnancy. Full article

Background and Objectives: Self-medication and inappropriate use of non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics are major public health concerns, particularly in settings with variable access to healthcare. Understanding patterns of medication use and renal risk perception can inform targeted interventions. This study examined NSAID and antibiotic use, self-medication behaviors, and renal risk awareness among Romanian primary care patients, with attention to urban–rural differences. Materials and Methods: A cross-sectional survey was conducted among 201 primary care patients (101 rural, 100 urban). Data on NSAID and antibiotic use, self-medication practices, sources of recommendation, and renal risk perception were collected using a study-specific questionnaire. Multivariable logistic regression was applied to identify predictors of frequent NSAID use, inappropriate antibiotic use, self-medication frequency, and high perceived renal risk. Results: NSAID use was nearly universal (95%), with frequent use strongly associated with non-professional recommendations. Antibiotic misuse was more common in rural participants and largely driven by informal acquisition. Self-medication patterns differed by residence: rural participants reported system- or access-related reasons and reliance on non-professional sources, while urban participants engaged in frequent, convenience-driven self-medication. Although most participants were aware of potential renal harm, this did not consistently lead to safer behaviors. Higher educational level and trust in healthcare professionals predicted increased perceived renal risk, whereas rural residence was associated with lower risk perception. Conclusions: Medication misuse is influenced more by recommendation sources, access barriers, and trusted information pathways than by knowledge alone. Interventions should focus on improving professional guidance, addressing informal recommendation networks, and tailoring strategies to urban–rural contexts. Full article

This study presents new phytolith data that reconstruct the vegetation patterns and environmental context of medieval sites in northeastern Romania, integrated with previously published archaeozoological evidence. Sediment samples from cultural layers at Târgu Neamț–La Damian and Neamț Fortress were analysed following standard extraction protocols and classified according to the International Code for Phytolith Nomenclature (ICPN 2.0). The newly obtained phytolith assemblages are dominated by morphotypes from the Poaceae family, with diagnostic cereal forms, indicating intensive cereal use. The presence of arboreal and non-grass phytoliths further suggests a mosaic landscape combining grass-dominated open areas, pastures, and nearby woodland. When compared with existing faunal data, characterized by a predominance of domestic species such as cattle, sheep/goat, and pig, the results support the reconstruction of a diversified agro-pastoral economy adapted to local geomorphological and climatic conditions. The integration of new phytolith and existing archaeozoological data highlights the complementary role of plant microremains in reconstructing medieval environments, providing valuable insight into agro-pastoral resources, vegetation dynamics, and human–landscape interactions in the eastern Carpathian region. This approach enhances our understanding of the ecological basis of medieval Moldavian communities and contributes to the reconstruction of Late Holocene anthropogenic landscape dynamics within a Quaternary environmental framework. Full article