Dan Liviu Dorel Mischianu

Dan Liviu Dorel Mischianu

Inflammatory Bowel Diseases: the Surgical Perspective

Inflammatory bowel diseases (IBD), namely Crohn’s disease and ulcerative colitis, are relatively rare diseases in our country, known as a low prevalence geographic region. IBD are a multidisciplinary problem, that implies gastroenterologists, as well as surgeons. Surgical management in inflammatory bowel disease is often impaired by a high complication rate and a significant recurrence rate, specifi c mostly for Crohn’s disease. Indications for surgery include failure of medical therapy (including delayed puberty for young patients and drug intolerance), toxic megacolon, bowel perforation, obstruction, enteric fi stula and abdominal or perianal abscess. Advances in medical treatment options for IBD are continuously accumulating. However, a large number of patients still require surgical procedures during lifetime.

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Urological Malpractice

Nowadays, doctors face a challenging medico-legal environment. This is also the case of urologists with many legal claims against them. The fact that urology is a surgical specialty is not encouraging, surgical specialties being situated on top of the chain. One of the most important problems is the lack of information from the specialized editorials. This kind of data is hard to find especially since it is often regarded as confidential information. [...]

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Penile Neoplasia Forensic Approach

As in cervix carcinoma the role of HPV has been proved, infact there is a rare type of PC which is directly linked to HPV[3]. As such, the prevalence of penile neoplasia is related to that of HPV in general population. Strains 16 and 18 are the most common findings in penile carcinoma[4]. [...]

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The Use of Tranexamic Acid for Preventing Bloodloss During Percutaneous Nephrolithotomy

Percutaneous nephrolithotomy (PCNL) is a minimally invasive method of treatment used for large kidney stones (>20 mm). It remains the standard procedure for large renal calculi according to EAU (European Association of Urology) guidelines. The stones are extracted from the kidney by a small puncture wound (about 1 cm) through the skin. Since its introduction this technique has replaced almost completely open surgery for renal lithiasis, who nowadays is used only rarely in selected cases. Although this procedure has much lower complications than open surgery, the complications following this procedure can be serious[1] (Table 1). Morbidity and complications following PCNL are dominated by fever (10.5%) and bleeding (7.8%)[2]. [...]

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Iatrogenic Ureteral Injury Following Radical Hysterectomy - Case Presentation

Iatrogenic ureteral injuries represent an important complication of abdomino-pelvic surgery with serio-us consequences in the absence of a prompt diagnostic and adequate treatment. According to literature it has been estimated that over 75% of all ureteral injuries are iatrogenic and that the incidence of ureteral lesions during an abdomino-pelvic surgery ranges from 0.5% to 10%[1-5]. Studies concerning this pathology have shown that obstetric and gynecological surgery accounts for approximately 50-60% or even more, followed by colorectal surgery 10-25%, vascular surgery (aortoiliac and aorto-femural bypass) and urological surgery 15-30% (classic, laparoscopic and endoscopic approach)[5-11]. [...]

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HPV and Bladder Cancer - Is There a Connection?

HPV represents without any doubt one of the biggest health problems nowadys. Since the early days of its discovery by zur Hausen[1] the importance of this pathogen has risen. It is role in cervix neoplasia has been already demonstrated and steps have been made to counter this threat (vaccine). There are proofs that link this virus to other ano-genital neoplasia (here we include the penis, vulva, ano-rectal region and later the laryngeal neoplasia). [...]

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An Unfortunately Surprise of a Renal Cystic Mass - Case Presentation

Cystic renal masses represents a pathology that may rise diagnosis and management difficulties. The differential diagnosis of large renal cystic masses should be made with normal renal cysts, hydronephrosis, renal abscess, renal hematoma, morpho-functional demaged kidney or with a renal tumor with necrosis and abscess. [...]

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Genome-Wide Association Scan for Variants Associated with Early-Onset Prostate Cancer in Romania

Prostate cancer incidence varies more than 25-fold worldwide, largely due to the widespread practice of prostate specific antigen (PSA) testing and subsequent biopsy [1]. It is the second most frequently diagnosed cancer of men (914.000 new cases per year, accounting for 13.8% of total cancer cases) and the 5th most common cancer overall worldwide. The incidence is expected to grow to 1.7 million new cases and 499.000 deaths by 2030, mainly due to the growth and aging of the global population [2]. [...]

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Advanced Genital Prolapse - Mesh Surgical Treatment

Genital prolapse is a frequent pathology in women associated with different urological and gynecological complications affecting women `s normal life [1]. It is defined as pelvic organ slipped from their anatomical position through vagina. The pelvic structures which might slip are uterus, bladder, rectum, small intestine or vaginal vault. Each one of these benefits of a specific surgical procedure [1].

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A History of an Old and Still New Disease: Urinary Lithiasis

We believe that with the apparition of the first settlements and the act of eating also appeared the first potentially urinary lithiasis patients. One of the "leading minds"[1] of the twentieth century, Margaret Mead (1901-1978) (fig. 1), renowned anthro-pologist used to say "it is easier to change a nation religion rather its eating habits".

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Epstein Barr Virus and Cytomegalovirus in Prostate - A Controversial Subject

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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Talking About Malpractice: A Possible Future Case

The medical profession is certainly there for thousands of years, the first documented therapeutic methods being used since prehistoric times. Although to date there has been significant advance in this area, current treatments are not infallible, which means that in medical practice there are certain errors. Sometimes patients may interpret these errors as malpractice, accusing the physician with certain charges related to his work, or rather the lack of his work. In terms of ethical norms, the Medical College of Physicians in Romania’s Code of Ethics has been prepared in accordance with the Geneva Declaration issued in 1948 and has a complementary legislative role stated above, the purpose of regulating the fundamental principles of professional conduct for doctors. All these laws are meant to guide medical staff attitudes in clinical practice and are relevant in a medical malpractice case.

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HPV Implications in Benign Prostatic Impairments - A Literature Review

Benign prostatic impairments are a heterogeneous group of diseases that can coexist or be separate entities. Some of these conditions (prostatitis) are included in the pelvic pain syndrome, while the other is represented by the prostatic adenoma and its implications. Benign prostatic hyperplasia (BPH) is histologically associated, in most cases, with the presence of inflammatory infiltrate at this level. Histopathological examination of the resected pieces and fragments of prostatic biopsy in many cases reveals stromal inflammatory infiltrate adjacent to the prostatic acini. (1, 2) In addition to the many factors involved in the prostate benign microbial pathology (E. coli, Pseudomonas aeruginosa, Serratia spp., Klebsiella spp., Enterobacter aerogenes and the great family of enterococci), there are numerous data in specialized literature, certifying the presence of viral genomes in both benign and malignant pathology of the prostate. (3, 4) Among them the following stand out: Papilloma virus (HPV), Polyoma viruses, cytomegaloviruses (CMV), Epstein-Barr virus (EBV), Herpes Virus 8 (HHV 8) and xenotropic murine leukemia virus recently (XMRV). (5)

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