Revista Medico-chirurgicala A Societatii De Medici Si Naturalisti Din Iasi[JOURNAL]
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200 papers
VITAMIN D AND TISSULAR EXPRESSION OF VITAMIN D RECEPTOR IN OBESITY.
Haliga R, Zugun-Eloae F, Oboroceanu T … +2 more , Pînzariu A, Mocanu V
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483726
Vitamin D (VitD), a lipid-soluble hormone, is able to regulate the transcription of many genes through vitamin D receptor (vitD receptor-VDR). It has been shown that VitD deficiency is associated with obesity, characteri...
Vitamin D (VitD), a lipid-soluble hormone, is able to regulate the transcription of many genes through vitamin D receptor (vitD receptor-VDR). It has been shown that VitD deficiency is associated with obesity, characterized by a low degree inflammatory state, which contribute to the pathogeny of metabolic syndrome and type 2 diabetes mellitus. VitD deficiency is a public health problem, at the same time the global prevalence of obesity and cardiovascular diseases is continuously growing. Evidence from recent studies on animal models suggest that VitD or VDR deficiency promotes cardiomyocyte hypertrophy, which can be one of the mechanisms for increasing cardiovascular risk. The heart is one of the target organs of action for VitD, because VDR is expressed in cardiomyocytes. Also, previous in vitro studies have shown that VitD is able to inhibit the production of monocyte chemotactic factors (MCP-1) and other pro-inflammatory mediators in human preadipocytes and mature adipocytes. Inflammation is an important factor in the pathogenesis of atherosclerosis. In obesity there are not known data about correlations between plasma levels of VitD and VDR expression in the subcutaneous fat tissue, epicardial visceral adipose tissue, and in particular in myocardium. Also, there are still no studies to test VDR expression in myocardial cells and to investigate the results of dietary VitD supplementation on the expression of VDR in the epicardial adipose tissue and myocardium.
MITOCHONDRIAL MYOPATHY: A NEW THERAPEUTIC APPROACH.
Hagiu BA, Mungiu C
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483725
Restoration of deoxyribonucleic acid in mitochondrial myopathies may occur after a mechanical or chemical injury of striated muscle or by endurance training. Therapies with enzymes, gene therapies, or treatments with sub...
Restoration of deoxyribonucleic acid in mitochondrial myopathies may occur after a mechanical or chemical injury of striated muscle or by endurance training. Therapies with enzymes, gene therapies, or treatments with substances that stimulate mitochondrial biogenesis are used at the moment. Genesis of mitochondria may also come from myonuclei by releasing the nuclear respiratory factor-1/2 during muscle contractions. Multiplying of myonuclei depends on muscle satellite cell activation. Since the electromyostimulation increase the number of circulating stem cells that may participate in the genesis of new muscle fibers (adding to the deposit of specific stem cells of the muscle), and intermittent hypoxia stimulates the proliferation of muscle satellite cells, we propose to combine the two processes for the treatment of mitochondrial myopathies. Respective combined therapy may be useful for restoring damaged mitochondria by drug side effects.
PELVIC ACTINOMYCOSIS MIMICKING A LOCALLY ADVANCED PELVIC MALIGNANCY--CASE REPORT.
Velenciuc N, Velenciuc I, Makkai Popa S … +3 more , Roată C, Ferariu D, Luncă S
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483724
We present the case of a former user of an intrauterine contraceptive device (IUD) for 10 years, diagnosed with a bulky, fixed pelvic tumor involving the internal genital organs and the recto sigmoid, causing luminal nar...
We present the case of a former user of an intrauterine contraceptive device (IUD) for 10 years, diagnosed with a bulky, fixed pelvic tumor involving the internal genital organs and the recto sigmoid, causing luminal narrowing of the rectum, interpreted as locally advanced pelvic malignancy, probably of genital origin. Intraoperatively, a high index of suspicion made us collect a sample from the fibrous wall of the tumor mass, large Actinomyces colonies were thus identified. Surgery consisted in debridement, removal of a small amount of pus and appendectomy, thus avoiding a mutilating and useless surgery. Specific antibiotic therapy was administered for 3 months, with favorable postoperative and long-term outcomes. Pelvic actinomycosis should always be considered in the differential diagnosis of pelvic tumors in women using an IUD. The association of long-term antibiotic treatment is essential to eradicate the infection and prevent relapses.
ADENOCARCINOMA AND TUBERCULOSIS OF THE SIGMOID COLON AND FALLOPIAN TUBE--A RARE ASSOCIATION. A CASE REPORT AND REVIEW OF THE LITERATURE.
Ionescu L, Dănilă R, Ciobanu D … +3 more , Ciortescu I, Livadariu R, Timofte D
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483723
Association of adenocarcinoma and tuberculosis (TB) of the sigmoid colon is a rare clinical condition even in an endemic country as Romania, with challenging diagnosis and treatment. Case report. We present the case of a...
Association of adenocarcinoma and tuberculosis (TB) of the sigmoid colon is a rare clinical condition even in an endemic country as Romania, with challenging diagnosis and treatment. Case report. We present the case of a 57-year-old female patient who was admitted on emergency basis for a diagnosis of obstructive sigmoid adenocarcinoma. The patient was operated on and it an obstructive sigmoid tumor with serosal invasion, adherent (invading) to the body of uterus and left adnexa and urinary bladder serosa, no liver or peritoneal metastases. A sigmoidectomy was performed "en bloc" with subtotal hysterectomy, left adnexectomy and extramucosal cistectomy. The histopathological exam showed a moderately differentiated, ulcerated adenocarcinoma, widely infiltrating the colon wall invading the myometrium. Ziehl Neelsen (ZN) stain identified the presence of metachromatic bacillary structures in the colonic wall, lymph nodes and adnexal areas. Postoperative course was uneventful and the patient was discharged 10 days postoperatively in good clinical condition. After one year when the patient completed the full course of anti-tubercular drugs, a thorough work-up was performed. Colonoscopy, CT of the thorax, abdomen, pelvis showed no signs of recurrence while tumoral marker CEA (1.62 ng/ml - n<3.4) and QFT (Quantiferon-TB Gold) test were within normal range. Discussion and conclusion. Although digestive tuberculosis is included in differential diagnosis for those patients presenting abdominal pain or obstructive digestive symptoms in endemic regions, in this case the absence of TB infection criteria and positive endoscopic biopsy for colonic adenocarcinoma did not allow a complete pre- or perioperative diagnosis.
SURGICAL TREATMENT OF POSTPARTUM ILIOFEMORAL DEEP VEIN THROMBOSIS--CASE REPORTS.
Cazan I, Strobescu C, Baroi G … +3 more , Cazan S, Lefter G, Popa RF
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483722
The writing committee for Antithrombotic Therapy for Venous Thromboembolic Disease of the 2008 ACCP guidelines made the following recommendations for thrombus removal strategies in patients with deep vein thrombosis (DVT...
The writing committee for Antithrombotic Therapy for Venous Thromboembolic Disease of the 2008 ACCP guidelines made the following recommendations for thrombus removal strategies in patients with deep vein thrombosis (DVT): open surgical thrombectomy is recommended in patients with acute iliofemoral DVT to reduce symptoms and post-thrombotic morbidity; whenever available, catheter-directed thrombolysis is preferred to surgical venous thrombectomy, the risk of hemorrhage being diminished; surgical venous thrombectomy is recognized to be efficient in cases where catheter-directed thrombolysis is unavailable or the patients are not suitable candidates for such a procedure. Randomized studies comparing surgical thrombectomy and anticoagulant therapy in patients with iliofemoral DVT (IFDVT) showed that at 6 months, 5 years, and 10 years the patients in the thrombectomy group presented increased permeability, lower venous pressure, less edema, and fewer postthrombotic symptoms compared to the patients receiving anticoagulant therapy. In this article we present 3 cases of IFDVT in postpartum patients diagnosed by Doppler ultrasound of the deep venous system. The 3 patients received anticoagulant therapy prior to surgery. Surgery consisted in thrombectomy of the common, superficial and deep femoral veins, external and internal iliac veins, and femoral-saphenous arteriovenous fistula. The patients received postoperative antithrombotic therapy and were followed-up at 3, 6 and 9 months by Doppler ultrasound of the deep venous system.
COMBINED APPROACH FOR LARGE TUMORS OF THE NOSE AND PARANASAL SINUSES--CASE REPORT.
Palade OD, Severin F, Toader M … +2 more , Cobzeanu MD, Toader C
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483721
Due to the insidious onset and common symptoms, the diagnostic of sinonasal tumors is late in the evolution. Usually, at that time, the preferred endoscopic approach alone is not recommended, therefore a mixed openendosc...
Due to the insidious onset and common symptoms, the diagnostic of sinonasal tumors is late in the evolution. Usually, at that time, the preferred endoscopic approach alone is not recommended, therefore a mixed openendoscopic approach appears to be the best choice in terms of exposure of the tumor and a clear margin resection. The purpose of this case report study is to demonstrate the necessity of careful preoperative assessment and the advantages of combined approach for a complete resection and favorable long-term results.
MANAGEMENT OF BILATERAL FEMORAL NECK FRACTURE IN A NONAGENARIAN PATIENT--CASE REPORT.
Popescu D, Trandabaţ C, Puha B … +2 more , Veliceasa B, Alexa O
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483720
Simultaneous bilateral femoral neck fracture is rare injury. Cases with this type of fracture have been reported in the literature since the 1950s, following the introduction of electroconvulsive therapy which generates...
Simultaneous bilateral femoral neck fracture is rare injury. Cases with this type of fracture have been reported in the literature since the 1950s, following the introduction of electroconvulsive therapy which generates violent hip muscle contractions. In young patients' simultaneous bilateral femoral neck fracture results from high energy trauma (car accident or fall from height) in a normal bone. Pathological changes in bone structure occurring in chronic kidney disease, vitamin D deficiency, osteomalacia, osteoporosis, metabolic imbalances and administration of corticosteroids explain the occurrence of this particular type of fracture following low-energy trauma. We present the case of a 90-year-old female patient who suffered a simple fall from her own height resulting in a Garden IV bilateral femoral neck fracture. Our therapeutic option in this patient was bilateral uncemented bipolar hemiarthroplasty in a single session using a single tray of sterile surgical instruments and two sterile drapes. Postoperative outcome was very good, allowing the initiation of functional recovery on the first postoperative day. Uncemented hemiarthroplasty proved to be a good choice in such a patient in the associated diseases may trigger the risk of cardiovascular disturbances specific to bone cement implantation syndrome.
PANCREATIC CANCER CT IMAGING: COMPARISON WITH SURGERY.
Jari I, Ursaru M, Naum AG … +3 more , Gheorghe L, Manea P, Negru D
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483719
AIM: To establish the best protocol for pancreatic computer tomography and criteria for staging (mainly for vascular invasion). MATERIAL AND METHODS: Our research included 49 consecutive patients with pancreatic cancer e...
AIM: To establish the best protocol for pancreatic computer tomography and criteria for staging (mainly for vascular invasion). MATERIAL AND METHODS: Our research included 49 consecutive patients with pancreatic cancer examined at the Iasi "Sf. Spiridon" Hospital between January and December 2014 with a Siemens 16 Emotion CT unit. CT protocol included no enhanced CT and pancreatic phase of the superior abdomen, portal venous phase of the abdomen and pelvis. RESULTS AND DISCUSSION: The study patients were stratified into 5 age groups and the most frequently affected by pancreatic cancer were the patients aged 60 to 79 years. For T staging the extension in the per pancreatic fat tissue, into surrounding organs (5 patients had extension in other organs) and vessels was evaluated. We determined the degree of contact between the tumor and the artery, thrombosis and deformity of the veins and we have found 8 resettable lesions, 28 tumors in stage T3 and 13 pancreatic cancers in stage T4. Thirty-three patients had lymphadenopathies and 31 of them had distant metastases. CONCLUSIONS: Our study proved that computed tomography is a good method of examination for pancreatic cancer when the right imaging protocol is used; during the pancreatic phase the arteries and the tumor are well depicted, liver metastases are best evaluated during the portal venous phase. The best criterion for arterial invasion is tumor contiguity with more than half of vessel circumference, and for vein invasion deformity or thrombosis. Comparison with surgical staging was o good backup for the radiologist and depicted several differences with imaging staging, more often understating than over staging.
THE RELEVANCE OF CYTOLOGICAL DIAGNOSTIC IN THE MAMMARY GLAND CANCER.
Anton E, Ancuta E, Doroftei B … +2 more , Ioanid N, Anton C
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483718
UNLABELLED: Breast cancer is the second leading cause of cancer death in women, while in Eastern Europe the most common form of diagnosed cancer. Out of the multiple possibilities of early detection of mammary neoplasia...
UNLABELLED: Breast cancer is the second leading cause of cancer death in women, while in Eastern Europe the most common form of diagnosed cancer. Out of the multiple possibilities of early detection of mammary neoplasia that have been elaborated, only mammography has proved to be a simple, efficient method and of a high sensitivity, almost 90% However, the cytological confirmation of diagnosis allows us to perform the preoperative radiotherapy treatment or poly chemotherapy. MATERIAL AND METHODS: we analyzed the informative value of these diagnosis methods in stage I mammary gland cancer (MGC). In this way, in the present paper we demonstrated that collecting samples through fine-needle aspiration biopsy allows the cytological confirmation of the diagnosis of stage I MGC in 30.7% cases. RESULTS AND DISCUSSION: In stage I MGC young patients, under 35 years, the cytological confirmation rate is 22.2% and is lower as compared to the cytological confirmation rate in patients older than 35 years which is 37.9% Also, for a tumor diameter < 0.5 cm, the prevalence of cytological confirmation was only 10.3%, while for the diameter of 0.6-1.0 cm the cytological confirmation was around 40.0%. Therefore, in order to improve the cytological diagnosis confirmation rate the tumor biopsy through the USG of the mammary glands is required. Moreover, the cytological investigation of the smear obtained by the first and second puncture was instrumental in confirming the diagnosis in 41.3% and 17.4% cases; the subsequent repetition of the punctures was not useful as it helped to confirmation of the diagnosis only in 9.3% cases. The frequency of diagnosis cytological confirmation depends on the tumor histopathological form and type of growth. CONCLUSIONS: Thus, the lowest prevalence was in the mixed forms--12.5% cases, lobular cancer--24.4% cases, while regarding the type of growth, for the rare forms the cytological confirmation rate was 7.7% and 31.5% cases for the schiros growth type.
IMMUNOHISTOCHEMISTRY IN ENDOMETRIAL HYPERPLASIA AND ENDOMETRIAL ADENOCARCINOMA.
Socolov D, Socolov R, Lupascu IA … +4 more , Rugina V, Gabia O, Garauleanu DM, Carauleanu A
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483717
AIM: Endometrial hyperplasia is a proliferation of endometrial glands due to the prolonged stimulation with estrogens of the endometrium that occurs in women receiving exogenous estrogens, with anovulatory cycles, or in...
AIM: Endometrial hyperplasia is a proliferation of endometrial glands due to the prolonged stimulation with estrogens of the endometrium that occurs in women receiving exogenous estrogens, with anovulatory cycles, or in patients with ovarian tumours with estrogen secretion. MATERIAL AND METHODS: The study performed by the authors included 575 patients with endometrial hyperplasia and 163 patients with endometrial adenocarcinoma admitted to the "Cuza-Vodă" Obstetrics and Gynaecology Clinical Hospital of Iasi, between 2005-2007. RESULTS: There were selected, for these immunohistochemistry reactions, 22 cases of simple hyperplasia without atypia, 26 cases of complex hyperplasia without atypia, 23 cases of endometrial adenocarcinoma of endometrioid type, well differentiated, 22 cases of endometrial adenocarcinoma of endometrioid type, moderately differentiated, and 19 cases of non-endometrioid adenocarcinomas represented by nine clear cells and 10 serous endometrial adenocarcinomas. Estrogen receptors have been positive in about 85-90% of the tumour cells of the well-differentiated endometrial adenocarcinomas of endometrioid type (GI). In endometrioid-type endometrial adenocarcinomas moderately differentiated (GII), the estrogen receptors were positive in approximately 70-85% of the tumour cells. CONCLUSIONS: Endometrial hyperplasia, especially complex endometrial hyperplasia with atypia, increase the risk for endometrial adenocarcinoma, and their early detection becomes mandatory under cancer prevention. Well-differentiated endometrioid endome- trial adenocarcinomas were ER and PR-positive, so that the ER expression correlated with the PR expression. Well-differentiated endometrioid endometrial adenocarcinomas (GI) in the studied group also showed a higher content of ER and PR compared to the endometrial moderately-differentiated endometrioid endometrial adenocarcinomas (GII). In nonendometrioid adenocarcinomas, represented by clear-cell endometrial adenocarcinomas, the ER content was reduced and the PR expression was negative. Serous adenocarcinomas failed to show an immunohistochemically expression for ER and PR.
LEFT ATRIAL, LEFT ATRIAL APPENDAGE AND PULMONARY VEINS ANATOMICAL VARIANTS IN PATIENTS WITH ATRIAL FIBRILLATION VERSUS PATIENTS IN SINUS RHYTHM.
Tinică G, Furnică C, Anghel D … +1 more , Chistol RO
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483716
The aim of the study is to evaluate by multidetector computed tomography (MDCT) the prevalence, location and size of LA (left atrial) diverticula and accessory appendages, the prevalence of PVs anatomical variants and LA...
The aim of the study is to evaluate by multidetector computed tomography (MDCT) the prevalence, location and size of LA (left atrial) diverticula and accessory appendages, the prevalence of PVs anatomical variants and LAA (left atrial appendage) shapes in patients with atrial fibrillation (AF) compared to patients in sinus rhythm (SR). Images obtained by MDCT in a group of 100 patients with <1 year paroxysmal or persistent AF prior to radiofrequency catheter ablation and in a group of 100 patients in SR with unconfirmed or insignificant (<50%) coronary arteries stenoses were compared. The prevalence of LA diverticula (22% in AF group, 19% in SR group) and accessory appendages (6% in AF group, 5% in SR group) was not significantly different between the two groups. Similar sizes of LA diverticula and accessory appendages were registered in patients with AF and in SR. The prevalence of a common left venous trunk was significantly higher in patients with AF (30%) compared to patients in SR (18%) (p=0.047) and proved to be an independent predictor for AF (odds ratio (OR) 1.32; 95% confidence interval (CI) 0.93-1.51; p=0.002) at multivariate logistic regression. LAA had a complex shape but no significant differences concerning the prevalence of the 4 major types were registered between the groups. In conclusion, the only parameter associated with AF was the presence of a left common trunk suggesting that it is either a consequence or a predisposing factor for the development of AF.
INFLUENCE OF GLAUCOMA ON DIABETES-INDUCED CHANGES IN THE ANTERIOR OCULAR SEGMENT.
Anton N, Cantemir A, Chiseliţă D
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483715
AIM: To monitor the influence of glaucoma on the changes caused by diabetes in the anterior ocular segment. MATERIAL AND METHODS: Prospective, comparative clinical study, which included the patients with glaucoma and dia...
AIM: To monitor the influence of glaucoma on the changes caused by diabetes in the anterior ocular segment. MATERIAL AND METHODS: Prospective, comparative clinical study, which included the patients with glaucoma and diabetes assessed at the Iaşi "Sf. Spiridon" Hospital, "Euro Medi Center" Clinic and "Oftaprof" Clinic. The study included a number of 142 patients, divided into two groups: 67 patients with glaucoma and diabetes (study group) and 75 patients with diabetes mellitus (control group). Upon enrollment the patients were subjected to a complete assessment of their ophthalmologic and metabolic status. Monitored aspects: prevalence of lens changes, extent of ocular surface disease and identification of the changes in corneal biomechanical parameters in the patients with glaucoma and diabetes. RESULTS: In both monitored groups, the cortical lens changes prevailed, both at the beginning and at the end of the study, with no statistically significant differences between groups (p>0.05). The risk of developing lens changes reaches 50% in the patients who have had diabetes for 20 years. In the patients in the study group, tear secretion was significantly lower at the end of the study (Schirmer's test values 11.61 vs. 10.67 mm, p=0.045). Tear film instability was present in 37.3% of the patients. Corneal hysteresis (CH) and comeal resistance factor were significantly reduced in the group with glaucoma and diabetes, as compared to the group with diabetes (p=0.001). CONCLUSIONS: There is significant ocular surface disease in the patients with glaucoma and diabetes, as compared to those with diabetes alone. Glaucoma and the number of antiglaucoma drugs are associated with a significant reduction in tear secretion. The association of glaucoma resulted in the reduction in CH and corneal resistance factor in the patients with glaucoma and diabetes as compared to the healthy ones.
EARLY COMPLICATIONS FOLLOWING ANATOMIC LUNG RESECTIONS--EXPERIENCE OF A THORACIC SURGICAL ONCOLOGY UNIT.
Makkai-Popa ST, Sandu C, Bosînceanu M
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483714
AIM: To analyze the medical and socioeconomic impact of the complications of anatomic lung resections performed at the Thoracic Surgery Unit of the Iasi Regional Cancer Institute. METHODS: This retrospective study includ...
AIM: To analyze the medical and socioeconomic impact of the complications of anatomic lung resections performed at the Thoracic Surgery Unit of the Iasi Regional Cancer Institute. METHODS: This retrospective study included patients who underwent anatomic lung resections between January 2013 and August 2015. RESULTS: Over this interval a total of 172 major lung resections were performed: 31 (18.02%) pneumonectomies, 5 (2.91%) bilobectomies, and 136 (79.06%) lobectomies. Complications occurred in 36 patients, including bronchial stump fistula in 7 patients (4.06%), bronchopneumonia (9/5.23%), pleural empyema without bronchoscopically documented bronchial stump fistula (1/0.58%), chylothorax (1/0.58%), postoperative arrhythmia (3/1.74%), early postoperative stroke (1/0.58%), prolonged air leak (requiring hospital stay longer than 14 days) (11/6.38%), and postoperative hemothorax requiring reintervention (3/1.74%). Secondary to complications, a number of 3 (1.74%) patients died early postoperatively. CONCLUSIONS: The incidence of immediate and early postoperative complications is comparable to those reported by other authors.
OUTCOMES OF SURGERY IN PROLIFERATIVE VITREORETINOPATHY.
Danielescu C, Obadă O, Juverdeanu R … +4 more , Muscalu A, Ionescu-Scarlat A, Dumitrescu R, Untu R
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483713
AIM: To present the anatomical and functional outcomes of surgery in cases of rhegmatogenous retinal detachment complicated (at presentation) by proliferative vitreoretinopathy (PVR). MATERIAL AND METHODS: Retrospective...
AIM: To present the anatomical and functional outcomes of surgery in cases of rhegmatogenous retinal detachment complicated (at presentation) by proliferative vitreoretinopathy (PVR). MATERIAL AND METHODS: Retrospective study of the cases operated upon by a single surgeon between October 2012 and September 2014. RESULTS: A total of 49 eyes of 49 patients had PVR at presentation (12 cases with PVR stage B, 21 with stage C and 16 with stage D). 82% had a VA < or = 0.05 at presentation. Peripheral retinectomy was the primary surgery in 57% of cases. Reinterventions was required in 16.3% of the cases (silicon oil extraction was not considered reintervention). Although at the first postoperative examination 32% of eyes had an IOP > 21 mmHg without medication, only 8% retained a high lOP at the last visit. At the last visit 73.4% of eyes presented attached retina (an additional 6% had an attached macula under silicone oil, but sub retinal fluid in the inferior quadrants). A final VA > or = 0.05 was recorded in 67.3% of eyes (of which half had VA > or = 0.1) CONCLUSIONS: In cases presenting with retinal detachment complicated by PVR the possibility of reinterventions and the risk of intraocular hypertension should be considered. Unfortunately, even some cases with favorable anatomical outcome will not present ambulatory vision. Keywords:
COMPARISONS BETWEEN THE NON-PROLIFERATIVE AND PROLIFERATIVE THERAPY IN FIBROCYSTIC MASTOSIS.
Carauleanu A, Socolov R, Rugina V … +4 more , Gabia O, Carauleanu DM, Lupascu IA, Socolov D
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483712
AIM: Fibrocystic mastosis (FCM) is the most frequent benign breast lesion. Most treatments for fibrocystic mastosis are: hormonl, with beneficial results and non-hormonal, with fluctuating results. MATERIAL AND METHODS:...
AIM: Fibrocystic mastosis (FCM) is the most frequent benign breast lesion. Most treatments for fibrocystic mastosis are: hormonl, with beneficial results and non-hormonal, with fluctuating results. MATERIAL AND METHODS: A number of 210 cases were studied, which were divided into 7 groups. The study lasted for 9 months and it was carried out on the basis of a personal examination sheet. The following were monitored: age groups, mastodynia, reducing breast nodules, a significant reduction in the volume of the mastosic cysts, reducion of the fibrous tissue, medication tolerance. RESULTS: Mastodynia has declined by 90% in the cases treated with Tamoxifen and Danazol, by 70% in the case of Lynestrenol and Bromocriptine, by 50% in the 15 patients who were given Utrogestan. Knowing the advantages and disadvantages of drugs (contraindications, side effects), age category, breast pain reduction, antiproliferative activity, tolerability, relapse allow us to assess the benefit-risk. Even in those circumstances that remained incompletely clarified for objective reasons, related to the inaccurate/incorrect reporting by the patients, there is a significant difference (p < 0.05) between the frequency of relapses following the treatment with Tamoxifen and the other categories of drugs who were administered. CONCLUSIONS: Our study shows that in the groups that were administered Logest, Utrogestan and Bromocriptine, only antalgic effects were achieved (disappearance or only decrease of mastodynia) and no anti-proliferative effects were obtained. Basically, hormone treatment should be made based on a histopathological examination.
BILATERAL BREAST CANCER: DIAGNOSIS AND PROGNOSIS.
Ursaru M, Jari I, Gheorghe L … +3 more , Naum AG, Scripcariu V, Negru D
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483711
AIM: To assess bilateral breast cancer patients, initially diagnosed with stage II unilateral breast cancer. MATERIAL AND METHODS: 113 patients with stage 0-II breast cancer diagnosed between 1983 and 2011 were assessed....
AIM: To assess bilateral breast cancer patients, initially diagnosed with stage II unilateral breast cancer. MATERIAL AND METHODS: 113 patients with stage 0-II breast cancer diagnosed between 1983 and 2011 were assessed. Of these, 8 patients had bilateral breast cancer: 7 patients with metachronous bilateral breast cancer and 1 patient with synchronous breast cancer. Breast ultrasound, mammography, computed tomography and magnetic resonance imaging were used to diagnose recurrence, loco regional and distant metastasis. RESULTS: Age at diagnosis ranged from 37 to 59 years, with a maximum age incidence in the 4th decade (age between: 31-40 years). The average time interval between the two breast cancers was 8.125 years. The most common histological type was invasive ductal carcinoma. All eight patients with bilateral breast cancer had at least one type of recurrence/metastasis, mostly in the liver, and statistically the pleuropulmonary and liver metastases were the most frequent causes of death. CONCLUSIONS: Patients in the 4th decade diagnosed with unilateral breast cancer are at risk of developing bilateral breast cancer. In metachronous breast cancer, the time interval between the detection of the second breast cancer and death is directly proportional to the time interval between the two breast cancers. TASTASES, DEATH.
CLASIC VERSUS NOVEL IN REDUCTION OF ACUTE ANTERIOR DISLOCATION OF THE SHOULDER: A COMPARISON OF FOUR REDUCTION TECHNIQUES.
Puha B, Gheorghevici TS, Veliceasa B … +2 more , Popescu D, Alexa O
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483710
AIM: The purpose of our study is to compare four different techniques for reduction shoulder dislocation in term of efficacy, duration until reduction and pain felt by patient during the procedure. MATERIAL AND METHODS:...
AIM: The purpose of our study is to compare four different techniques for reduction shoulder dislocation in term of efficacy, duration until reduction and pain felt by patient during the procedure. MATERIAL AND METHODS: During 2015 year, we conducted a study on 50 chronological patients with anterior shoulder dislocation. After exclusion of four patients, the remaining 46 (74% males, mean age 44.6 +/- 20.03 years, range 18 to 89) were randomly assigned in four groups and reduced by Cunningham (C), Kocher (K), Mothes (M) and Hipocrat (H) techniques. All the patients were sedated using Midazolam (2 mg) and Fentanyl (1 microg/kgbw) except patients who underwent Cunningham technique. RESULTS: The success rate was 76.9% in C group, 98.4% in K group, 90.2% in M group and 87.96% in H group (p>0.05). The level of pain in C group was similar to the other groups in the absence of pain medication (p<0.05). CONCLUSIONS: Cunningham technique is a simple, single person technique, drug free, less painful and safer, comparable with other "classical" methods.
VENOUS ULCER--A NEW THERAPEUTIC APPROACH.
Popa RF, Cazan I, Baroi G … +3 more , Cazan S, Lefter G, Strobescu C
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483709
Trophic leg ulcer is a major health problem affecting approximately 1-2% of the population, the incidence being higher in the elderly (70-80 years). It is a multifactorial condition, but the most common cause is chronic...
Trophic leg ulcer is a major health problem affecting approximately 1-2% of the population, the incidence being higher in the elderly (70-80 years). It is a multifactorial condition, but the most common cause is chronic venous insufficiency. This can be attributed to reflux in the saphenous system and calf perforator vein incompetence. These were first described by Linton, the first intervention designed to correct perforator vein incompetence bearing his name. Today Linton's operation has been abandoned due to the large unaesthetic incision and great postoperative pain. Also, ulcer healing time is long (2 months) and recurrence rate is high. Currently a series of minimally invasive procedures are used to close these perforator veins, such as ultrasound-guided sclerotherapy. The advantages of these techniques are less discomfort to the patients, low rate of complications, short hospital stay.
NEUROPSYCHOLOGICAL GROUNDS IN THE AWAKE BRAIN SURGERY.
Buraga VC, Turliuc DM, Turliuc S … +2 more , Cucu AI, Costea CF
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483708
Traditionally, the awake cerebral neurosurgical interventions are carried out when the primary motor areas and the areas involved in language are concerned. This procedure is also known as mapping (Intraoperative Brain M...
Traditionally, the awake cerebral neurosurgical interventions are carried out when the primary motor areas and the areas involved in language are concerned. This procedure is also known as mapping (Intraoperative Brain Mapping). The intraoperative neuropsychological protocol supposes the setting of a list of steps and tasks that the patient must perform during the surgery, taking into account the lesion localization (both the cortical and the subcortical structures), the cognitive functions involved and the individual particularities of each patient. As a result of the high validity of certain tests, we propose a common minimal set of tests, which can allow a minimal standardization and replicability.
THE "DARK SIDE" OF DEEP VEIN THROMBOSIS--CASE REPORT.
Costache II, Buburuz AM, Fotea V … +2 more , Cozma A, Aursulesei V
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27483707
Venous thromboembolism (VTE) is an increasingly common cause of morbidity and mortality in cancer patients. In various malignancies the incidence of thrombosis ranges from 5% to 60%, that is four times higher in cancer p...
Venous thromboembolism (VTE) is an increasingly common cause of morbidity and mortality in cancer patients. In various malignancies the incidence of thrombosis ranges from 5% to 60%, that is four times higher in cancer patients compared to the general population. Large retrospective studies have shown that in men the tumors which are most commonly associated with VTE are lung cancer and pancreatic cancer and, in women cancer of the genital area, pancreas, colon and rectum. Thromboembolic events may often occur before the cancer diagnosis. We present the case of a 41-year-old female patient with a history of genital cancer which was surgically treated and who is now admitted for clinical signs of ileofemoral deep vein thrombosis (DVT) of the left leg. The diagnosis was confirmed by laboratory data and Doppler ultrasound and the patient received anticoagulant treatment. Given the history of the patient, abdominal and pelvic ultrasound and computer tomography (CT) were performed to detect the cause who predisposed to the thrombotic event. These confirmed the ovarian cancer, this time on the right side, and the presence of hepatic and pulmonary metastasis. This case highlights the importance of screening for a cause of the thromboembolic event in patients, especially in those who have a history of a neoplasia.
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