Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences

Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences https://webbut.unitbv.ro/index.php/Series_VI <h2>Aim</h2> This is a medical multidisciplinary journal publishing original research papers, and case presentations. The yearly journal presents the latest results in medical research, focusing on integrated, interdisciplinary approaches. Also, it is committed to publishing work on different fields of the health profession and the history of medicine. The aim of the journal is to promote excellence and is open to research groups all over the world and mostly welcomes scientific papers from groups involving young researchers. The Journal is indexed in EBSCO Publishing DataBase (<a href="http://webbut.unitbv.ro/public/site/documents/admin/a9h-subject.xls">http://www.ebscohost.com/titleLists/a9h-subject.xls</a>), from 2010, ProQuest Central (<a href="https://search.proquest.com/central/" target="_blank" rel="noopener">https://search.proquest.com/central/</a>), from 2008, and in Crossref (<a href="https://search.crossref.org" target="_blank" rel="noopener">https://search.crossref.org</a>), from January 2019. <a href="http://webbut.unitbv.ro/index.php/Series_VI/about" target="_blank" rel="noopener">Read more</a> Transilvania University Press en-US Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences 2065-2216 Pharmacists and Community-Based Pharmacies in an Expanded Role in Patient Care and Public Health in The U.S. https://webbut.unitbv.ro/index.php/Series_VI/article/view/10110 The COVID-19 pandemic catalyzed the rapid integration of telehealth and digital health technologies, presenting both transformative opportunities and profound challenges in healthcare delivery. While these innovations promise to enhance access to care, they have also exposed and, in some instances, exacerbated existing health disparities. In response to these challenges, pharmacists have the potential to function in expanded roles as frontline healthcare providers, transitioning from traditional medication dispensers to key public health leaders. Community-based pharmacies emerged as critical hubs for vaccination campaigns, telepharmacy services, and chronic disease management, offering culturally responsive care in accessible spaces. This perspective paper explores the evolving role of pharmacists and community pharmacies in addressing health disparities through innovative care models that integrate digital health solutions and community-based outreach in roles as primary care pharmacists, health educators, recruiters for clinical trials, and facilitators for telehealth visits. By leveraging their trusted relationships within communities, pharmacists are uniquely positioned to promote digital literacy, increase diverse patient engagement in clinical trials, and advocate for culturally tailored care strategies. The paper underscores the ethical imperative of ensuring digital health equity while offering practical solutions for bridging the digital divide. It advocates for a reimagined pharmacy model that prioritizes access, equity, and innovation, positioning pharmacists and community pharmacies as pivotal change agents in building a more inclusive and just healthcare system. Through this inquiry, the paper calls on policymakers and healthcare leaders to adopt community pharmacy and pharmacist-driven strategies that advance health equity for all populations. Darrell Norman Burrell Copyright (c) 2025 Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences 2025-07-10 2025-07-10 1 22 10.31926/but.ms.2025.67.18.1.3 Perioperative Analgesic Strategies for Long Bone Fractures. Is There a Need for a Standardized Protocol? A Scoping Review https://webbut.unitbv.ro/index.php/Series_VI/article/view/10109 Acute perioperative pain that accompanies limb fractures and exceeds the threshold of tolerability has a high risk of becoming chronic. There are many controversies regarding current pain management options, like opioids and nonsteroidal anti-inflammatory drugs. This study aimed to comprehensively search the literature for ways to achieve perioperative analgesia in patients with long bone fractures. This research was a scoping review that included a systematic search of randomized controlled trials and observational studies in three international databases: MEDLINE, Scopus, and Web of Science. Ten thousand nine hundred forty-three articles were found and screened. After applying the inclusion and exclusion criteria, 77 articles were included in the final descriptive analysis. Peripheral nerve blocks play a significant role in perioperative multimodal analgesia; of the articles described in this review, 46.75% revolved around regional anesthesia. Other findings of pharmacologic agents that are of benefit in improving pain scores in surgically treated long bone fractures and need future research are Gabapentinoids, Magnesium sulphate, Vitamin C, Esmolol, and low-dose Ketamine. M.S. Moldovan A. Mironescu Copyright (c) 2025 Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences 2025-07-10 2025-07-10 23 54 10.31926/but.ms.2025.67.18.1.2 Advances in the Diagnosis and Management of MASH: The Role of Targeted Therapies and Artificial Intelligence https://webbut.unitbv.ro/index.php/Series_VI/article/view/10405 Advances in the Diagnosis and Management of Mash: The Role of Targeted Therapies and Artificial Intelligence Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) currently represents one of the leading causes of chronic liver disease worldwide, with an estimated prevalence of 25% to 30% in the general population, a figure that rises significantly among individuals with obesity, type 2 diabetes or metabolic syndrome. The pathological spectrum ranges from simple hepatic steatosis to more severe forms such as Metabolic Dysfunction-Associated Steatohepatitis (MASH), advanced fibrosis, cirrhosis, and even hepatocellular carcinoma. Given its asymptomatic progression in early stages, early diagnosis and comprehensive management are essential to avoid serious complications. Currently, there is no approved drug treatment specifically for NASH. However, several therapeutic strategies are under development and investigation. These include drugs that target altered metabolic pathways such as lipogenesis, insulin resistance, inflammation, and fibrosis. FXR (Farnesoid X Receptor) agonists, PPAR (Peroxisome Proliferator-Activated Receptors), GLP-1 (Glucagon-Like Peptide-1), and ACC (Acetyl-CoA Carboxylase) inhibitors are among the most promising agents. Artificial intelligence (AI) has begun to play a pivotal role in this context, facilitating early disease detection, risk stratification, and progression prediction through advanced analysis of images, biomarkers, and clinical data. Integrating personalized predictive models into clinical practice can revolutionize both diagnosis and therapeutic strategies for MASH, bringing us closer to truly effective precision medicine. L. Rivero Ramirez L. Galindo Alonso M. Badea Copyright (c) 2025 Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences 2025-07-10 2025-07-10 55 70 10.31926/but.ms.2025.67.18.1.5 Dermatofibrosarcoma Protuberans, a Challenging Entity – Case Report and Brief Literature Review https://webbut.unitbv.ro/index.php/Series_VI/article/view/9002 Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive soft tissue tumour of mesenchymal origin, commonly arising in the dermis and extending into deeper tissues. This article presents a case of a 52-year-old male with recurrent DFSP affecting the posterior neck region. Initial surgical excision in 2016 revealed a spindle-cell tumour with storiform patterns and a low mitotic index, while recurrence in 2022 exhibited a multinodular, infiltrative mass with increased cellular atypia and a high mitotic rate. Immunohistochemistry confirmed diffuse CD34 positivity in both instances. Complete surgical excision, including re-excision for margin involvement, achieved tumour-free status. The case highlights the importance of histological evaluation, surgical approach and follow-up in these cases. Long-term monitoring remains essential due to DFSP’s high recurrence potential. A.C. Tinca B.A. Lazar E.S. Negovan O.S. Cotoi Copyright (c) 2025 Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences 2025-07-10 2025-07-10 71 78 10.31926/but.ms.2025.67.18.1.1 Acute respiratory distress syndrome in a patient with legionella pneumophila. A case report https://webbut.unitbv.ro/index.php/Series_VI/article/view/10295 Patients suffering from pneumonia caused by Legionella pneumophila may experience severe progression, which can lead to acute respiratory distress syndrome and necessitate intensive care unit admission. The diagnosis of Legionnaires' disease relies on clinical presentation and laboratory tests. The urinary antigen test is a primary diagnostic tool for Legionnaires' disease, providing rapid results with high specificity for L. pneumophila serogroup 1. Employing multiple diagnostic methods enhances diagnostic accuracy, particularly in cases where L. pneumophila serogroup 1 is not the causative agent. Among pro-inflammatory cytokines, IL-6 plays a crucial role in the immune response to Legionella pneumophila infection and is associated with the severity of the inflammatory response in Legionnaires' disease. We report on a patient who was admitted to the intensive care unit due to hypoxemic respiratory failure resulting from Legionnaires’ disease. Although the urinary antigen test came back negative, Legionella was strongly suspected based on clinical, paraclinical, and epidemiological evidence, leading to the initiation of targeted antibiotic treatment. The diagnosis was ultimately confirmed through serology. The severity of the inflammatory response was evaluated by measuring serum biomarkers, among them IL-6 levels. This case report outlines the clinical and laboratory parameters that guide intensive care practices. A. Baracan M. Colac S. Dumitrache A. Capilna R. Gavrilas M. Moldovan S. Malachi W. Kansoun Copyright (c) 2025 Bulletin of the Transilvania University of Brasov. Series VI: Medical Sciences 2025-06-16 2025-06-16 79 86 10.31926/but.ms.2025.67.18.1.4