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

Anca-Mihaela Pantea Stoian

Anca-Mihaela Pantea Stoian

Alcohol Withdrawal Syndrome: a Review

Alcoholism is a common condition and frequently clinicians are forced to confront its complications in general hospital settings. Within each country, there is an excellent correlation between the level of alcohol consumption and the prevalence of alcohol-related harm. In fact, the consumption in Europe is 10.9 liters of pure alcohol per person per year[1]. There are an estimated 3 million alcohol-dependent people in Romania alone, with episodes of withdrawal severe enough to require pharmacologic treatment[1]. [...]

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Important Aspects to Take Into Consideration When Administering Cytotoxic Chemotherapy. A Review

In the last decade, huge efforts have been made to optimize and personalize oncological treatment. Many novel therapies and better combinations of older ones have been implemented. Even if novelty is always exciting, one has take into consideration that the way a drug is administered is as important as the drug itself. The present review focuses on how the administration of several cancer drugs can minimize the toxicity they induce. It stresses that if enough importance is given to this aspect, patients can tolerate effective doses of treatment with better outcomes and have better quality of life. [...]

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Surgical Attitude Towards the Hepatic Hydatid Pericystic Cavity

There are a variety of anatomoclinical forms of hepatic echinococcosis. This has led to finding and applying a number of surgical procedures which have the same aim, namely the reduction or elimination of the pericystic cavity. Besides, solving the residual pericystic cavity after the elimination of the parasite represents the main problem of the surgical treatment. The postoperative complications of the hydatid cyst are caused by the failure to adapt the surgical procedures to the morphological characteristics of the pericystic cavity.
In the Romanian medical literature, the surgeries performed for the hepatic hydatid cyst are divided into the so-called conservative surgeries, which abandon the pericystic cavity or resect a part of the pericyst, and the so-called radical surgeries, which completely remove the pericystic cavity by sacrificing a smaller or greater area of the parenchyma of the liver.

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Nonsurgical Treatment of Hepatic Hydatid Cyst

Hopes for a medical treatment of the hydatid cyst are old. However, the noninvasive treatments (vaccinotherapy, immunotherapy, chemotherapy) used so far did not lead to a cure. The latest drugs introduced as treatment are albendazole and mebendazole with a parasiticidal effect and praziquantel with a parasitostatic effect. Chemotherapy indications, established by WHO in 1996, are the adjuvant treatment administered preoperatively and postoperatively in the plurivisceral hydatid disease
when surgical treatment is contraindicated. The contraindications for chemotherapy are given by the occurrence of cysts complications or by the death of the parasite (1). The results of chemotherapy as a single treatment are 10-13% cure, 40-60% partial remission, 10-30% failure (1,2). Albendazole is a benzimidazole anthelmintic derivative for roundworms, flatworms and the larval forms of E. Granulosus. It acts at the level of the parasites’ cells, respectively of the proligerous membrane of E. Granulosus by inhibiting the poly-merization of ?-tubulin from which the intracyto-plasmic tubules are formed and through which glucose is absorbed. Blocking glucose absorption causes parasite’s death through a process of vesicula-tion and fibrosis of the proligerous membrane which becomes infertile. Albendazole dosage is 10-15/mg/kgc/day, in two daily doses, over a 30-day course of treatment, which is to be repeated after a two-week pause.

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