The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

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Wednesday, December 19 2018 @ 03:15 EET

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Response to Chemotherapy of Paraneoplastic Erythroderma in a Patient with Ovarian Cancer

2015-03

Cornelia Nitipir, Liliana Gabriela Popa, Maria Alexandra Barbu, Irina Radu, Mara Mihai, Calin Giurcaneanu

Erythroderma is an uncommon potentially fatal skin disorder first described by Hebra in 1868. Erythroderma is a definitive term that refers to generalized erythema and desquamation affecting 90% of the body surface. It usually occurs in individuals older than 40, except when the subjacent disease is atopic dermatitis, seborrheic dermatitis or hereditary ichthyosis [1,2]. Erythroderma represents a reaction pattern, a maximal form of skin irritation that may be secondary to certain cutaneous diseases, drug reactions, infections, solid or hematological malignancies, and other conditions. In the absence of a suggestive history, the clinical and histopatho logic distinction between the underlying causes is often problematic and determining the specific etiology is very challenging, an important proportion of cases being classified as idiopathic erythroderma.

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Enhancing the Patency Rates for Native Arteriovenous Access for Dialysis: A Classical Two-Step Superficialization of a Deep...

2015-03

Enhancing the Patency Rates for Native Arteriovenous Access for Dialysis: A Classical Two-Step Superficialization of a Deep Brachiocephalic Arteriovenous Fistula in a Normal Weight Patient

I.A. Checheriță, M. Elfarra, I. Peride, C. David, A. Niculae, M. Găvănescu, A. Cioc‚lteu, R.D. Sinescu, I. Lascăr

Native arteriovenous fistulae (AVF) are the best options for chronic hemodialysis (HD) access. Unfortunately, not every patient fulfils the requirements necessary for this type of vascular access: the artery and the vein implicated in dialysis fistula creation must accomplish some criteria which makes them suitable for this procedure. If these criteria are not fully met, the chances to a successfully intervention and a quick and qualitative maturation of the fistula are dropping [1-5]. An artery that is suitable for AVF creation has an inner diameter > 2 mm, optimal initial flow and elastic walls allowing dilatation to accommodate a supplementary 10 - 20 fold blood flow increase after the AVF is performed [1,2,5-11]. The participating vein must be superficial enough (less than 5 mm from the skin surface), wide enough (a caliber bigger than 2.5 mm) and its walls must allow important dilatation (without fibrosis, injuries, and thickenings). In elderly, diabetics or patients with late initiation of HD some of these demands are frequently absent; we need to adapt surgical procedures, taking advantage of any oppor tunity to overcame shortcomings and create a native dialysis access [1,2,5,9].

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Technical Challenges of Laparoscopic Cholecystectomy in Patients with Cholestasis

2015-03

Sorin Păun, Ioan Tănase, Ionuț Negoi, Bogdan Stoica, Mircea Beuran

Although mainly asymptomatic, patients with biliary gallstones frequently associate common bile duct (CBD) stones. A percent ranging between 10-18% (1,2) from the patients that underwent cholecystectomy for gallbladder stones associate CBD lithiasis. The presence of CBD stones can be anticipated in the presence of jaundice, cholangitis, pancreatits, with altered hepatic function, or directly identified by imagistics (3). The percentage of preoperative undiagnosed CBD reaches almost 25% even for the newest imagistics (4). Acute cholecystitis is the most common infectious complication of gallstones, occuring with a frequency of 6-11% for the patients with 7-11 years of symptomatic gallstones (5). Recent studies are showing indirect signs of CBD stones in 37.7% of patients with acute cholecystitis, these signs being noticed for 72 % of patients with prooved choledocholithiasis (6).

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Arterial Hypertension and Cognitive Decline Is it More than Pure Coincidence?

2015-03

Elisabeta Bădilă, Emma Țintea, Daniela Bartoș

The life-span increase recorded during the past decades across the global population has led to an increase in the number of people suffering from dementia. Recent analyses have estimated the worldwide number of people living with Alzheimerís disease (AD) and dementia at between 27 million and 36 million, and projections by Alzheimerís disease International estimate that 115 million people worldwide will be living with AD/dementia by 2050, less developed countries being more affected by these rising numbers(1). Alzheimerís disease is the most prevalent form of dementia - 60-70% cases, while vascular dementia accounts for another 25% of cases(2). Alzheimerís disease is a neurodegenerative pathology associated with the intraneuronal accumulation of hyperphosphorylated proteins and with the extracellular aggregation of β amyloid precursors(3). These structural modifications lead to a metabolic cascade responsible for neuronal death and, subsequently, dementia.

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Experimenting on LAB Rodents - Ethical Principles

2015-03

Elena-Rodica Dragu, Bogdan Liviu Chioaru, Ioana Teona Sebe, Ioan Lascăr, Oana Andreia Coman2

People have reported themselves differently regarding different species of animals and had different reactions about the animal species. The attention paid to them depends on the role held by them in human life, either as pets or as a method of entertainment, either as research subjects.

Some species enjoy privileges as pets (dogs cats, birds, turtles), others are used to satisfy human native instincts as hunting animals.

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Epstein Barr Virus and Cytomegalovirus in Prostate - A Controversial Subject

2015-03

D. SpÓnu, O. Bratu, A. Aungurenci, D. Marcu, C. Ursaciuc, G. Isvoranu, I. Peride, A. Niculae, D. Mischianu

Epstein-Barr virus (EBV) is a member of the Herpes Virus family and is also known as Human Herpes Virus 4. The virus was first isolated in 1964 by the British virologists Michael Anthony Epstein and Yvonne Barr, on a cell line derived from a Burkitt lymphoma. EBV infection is especially common in young individuals with low hygiene standards and also low social and economic status. Thereby it is considered that until the third decade of life, around 80 - 100% individuals have become carriers of infection [1,2]. Although EBV is considered to be a lymphotropic B virus, it can also infect T and NK lymphocytes or some epithelial cells, as it has beenfound in T cell lymphomas, stomach, nose, andthroat carcinomas [2]. The most common host cellfor EBV is B lymphocyte, although in some cases the virus can also be detected in epithelial cells. The role of epithelial cells is likely to permit the replication and amplification of EBV persistence than that of the latent infection [3].

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An Overview of Advanced Multimodal Imaging Techniques in Low Grade Gliomas

2015-03

D. Mariș, A. Mohan, H. Moisa, Alexandru Vlad Ciurea

Diffuse infiltrative low-grade gliomas (LGG) of the cerebral hemispheres in adults are a group of tumors with distinct clinical, histological and molecular characteristics. The management of such tumors is still controversial. (1)

In LGG neuroimaging plays a crucial role. Starting of a "watch and wait" management plan has been frequently based solely on imaging. Conventional MRI is a valuable method in conducting a differential diagnosis, assisting surgery, planning radiotherapy and surveying treatment response, but it focuses on structural changes within tumours and often provides limited information only.

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The Additive Value of 2D Longitudinal Strain During Stress Echocardiography in Coronary Artery Disease Detection in Low Risk...

2015-03

The Additive Value of 2D Longitudinal Strain During Stress Echocardiography in Coronary Artery Disease Detection in Low Risk Acute Coronary Syndrome - A Pilot Study

Roxana Onuț, Sebastian Onciul, Cristina Marinescu, Diana Zamfir, Maria Dorobanțu

Approximately 20% of patients arriving in the crowded emergency departments (ED) present with acute chest pain (ACP) and 60% are admitted in order to rule out an acute coronary syndrome (ACS). In the latter category, the ACS is confirmed only in 15% of patients thus resulting in a huge number of unnecessary admissions and wasted resources. (1) Stratifying ACP as low, moderate or high risk ACS allows physicians to take immediate action, initiate treatment and transfer the patient to the appropriate location.

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Problems with the Monitoring of Patients with Colonic Polyps

2015-03

Csongor Toth, Mircea Ifrim, Ovidiu Hategan, Cris Precup, Gyori Zsolt, Ovidiu Bulzan

Colorectal neoplasm ranks third in incidence and 4th among the most common causes of cancer death worldwide. In Romania, Arad, of all digestive cancers, colorectal cancer is the No. 3, both in incidence - in both men and women - and mortality. Colorectal cancer incidence is estimated to be 10.1 / 100,000 inhabitants in men and 7.3 / 100,000 inhabitants in women.

This paper is a retrospective statistical study, carried out over a period of 5 years. This study includes the monitoring of patients recorded with colonic polyps, within the area of 4 family physician practices. This study was conducted because there was a decrease of addressability (adherence) of patients recorded with having colonic adenomatous polyps. (1)

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Particularities and Surgical Treatment of Constriction Band Syndrome Syndactyly, in Children

2015-03

Doina-Iulia Nacea, Dan Mircea Enescu, Simona Ioana Stoicescu, Raluca Teodora Tatar

Constriction band syndrom syndactyly is a sporadic condition, that may be present in association with other congenital anomalies such as musculoskeletal (including total amputation of the limb), craniofacial (like cleft lip and cleft palate) and thoraco-abdominal disorders (such as gastroschisis and extrathoracic heart), neural tube defects, scoliosis and hemangiomas (1, 2, 3, 4, 5, 6). Some of these manifestations are uncommonly noted at birth because they result in spontaneous abortion.

There are two main theories about constriction band syndrome etiology, the first of which is the intrinsic theory proposed by George Streeter, the director of embryology at Carnegie Institute, in 1930 which is called, "Streeterís Dysplasia". Streeter suggested that an intrinsic defect in the subcutaneous germplasm resulted in focal mesenchymal hypoplasia, tissue loss, and scarring (7, 8).

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The Distally Based Superficial Sural Artery Angiosome Flap Concept: Anatomy, Indications, Surgical Technique, Results...

2015-03

The Distally Based Superficial Sural Artery Angiosome Flap Concept: Anatomy, Indications, Surgical Technique, Results, Complications and Technical Aspects to Minimize Complications

Cristian Radu Jecan, Viorel Goleanu, Laura Răducu, Luminița Tomescu, Daniel Hernic, Ioan Lascăr

Located between the popliteal fossa and the midportion of the calf, centered over de midline raphe, between the medial and lateral heads of the gastrocnemius muscle, the sural flap is the best known neurocutaneous flap of the leg. [1,2]

The sural angiosome was first introduced in practice by Ponten in 1981, when he reported the use of 23 fasciocutaneous proximally based flaps for soft tissue defects.[3] Donski and Fogdestam described the anatomy of the distally based sural flap and presented three clinical cases in 1982. [4]

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The Evolution of Electrocardiographic Changes after Revascularization Therapy in Patients with ST Segment Elevation...

2015-03

The Evolution of Electrocardiographic Changes after Revascularization Therapy in Patients with ST Segment Elevation Myocardial Infarction

Magda Ruxandra Zaharia, Oliviana Geavlete, Alice BrÓnzea, Oana Tăutu, Gheorghița Aron, Ioan Tiberiu Nanea

Despite the advanced technologies, the 12 leads electrocardiogram (ECG) remains an important investigation modality for providing a fast diagnostic of acute coronary syndromes (ACS). This method offers data concerning the presence, extension and severity characterizing the ischemic process (1). The ECG interpretation is still essential during the initial evaluation of patients admitted for ischemia suggestive symptoms (2).

Moreover, being a cheap, non-invasive and accessible technique, ECG continues to represent the gold-standard alternative for the differential diagnostic, for determining the appropriate treatment approach, for selecting patients susceptible of benefiting from reperfusion as well as regarding risk stratification (1).

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Predictive Factors for Native AVF Complications in Dialysis Patients - A Prospective Study in a Public Hemodialysis Center

2015-03

Mazen Elfarra, Cristiana David, Ileana Peride, Andrei Niculae, Alexandru Cioc‚lteu, Ruxandra Diana Sinescu4, Ionel Alexandru Checheriță

The prevalence of end stage renal disease (ESRD) is constantly increasing in worldwide population, as is the necessity of renal replacement therapy [1-3]. The improvements in dialysis techniques determined increasing quality and lifetime of dialysis patients and the need for a reliable vascular access that sustains the procedure for long periods of time. On the other hand, the progressive aging of dialyzed population and the emerging complications, as well as the rising prevalence of diabetes as a cause for chronic kidney disease (CKD), hampers the processes of obtaining and maintaining an adequate vascular access [1,4,5].

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Mesenchymal Stem Cells - What is in the Name?

2015-03

Alt Eckhard

Since more than 40 years ago Friedenstein first described cells derived from bone marrow stroma that were plastic adherent and had the ability to differentiate into other lineages, our knowledge about stem cells has constantly been growing over the last decades.

Nearly 10 years ago a definition was given by Dominici et al describing Mesenchymal Stem Cells as being plastic adherent, expressing CD73, CD90, CD105 and having the ability to differentiate into osteoblasts, adipocytes and chondrocytes. Since this time the expression "Mesenchymal Stem Cells" has been used to describe what we believe are multipotent cells.

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