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

Dragos Radu Marcu

Dragos Radu Marcu

Treatment of Helicobacter Pylori – an Overview of Current Strategies of Diagnostic and Treatment

Helicobacter Pylori infection, responsible for ulcerous disease, atrophic gastritis,gastric cancer and MALT lymphoma (mucosa-associated lymphoid tissue) has a very high prevalence in the general population (approximately 50%). In Romania there are few data related to the prevalence of Helicobacter Pylori infection, as well as the resistance to antibiotic treatment, and the methods of patient surveillance are limited by costs and low accessibility. The aim of our paper is to recall the current possibilities of treatment and supervision of this category of patients, taking into account that the appropiate treatment and good monitoring of the patient can cure the complications of the disease and may prevent the occurrence of malignancies.

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Endoscopic Procedures In Patients Taking Novel Oral Anticoagulants

The use of direct oral anticoagulants (DOAC) for the treatment of atrial fibrillation and prevention of strokes is encouraged by their superior properties compared to vitamin K antagonists: predictable anticoagulant effect, greater patient compliance, few drug interactions, low risk of intracranial hemorrhages. Although practicing gastroenterologists may never prescribe a DOAC, they are likely to encounter DOAC-related GI adverse events (gastrointestinal bleeding), and they will need to manage DOACs around the time of endoscopy. The present paper aims to present the management possibilities of the patient treated with DOAC undergoing endoscopy, most studies performed so far focusing on the risk of spontaneous bleeding in this category of subjects. The current guidelines provided by the British Society of Gastroenterology and the European Society of Gastrointestinal Endoscopy orientate us, but endoscopic maneuvers should be preceded by a detailed analysis of the risks of secondary bleeding and thrombosis associated with DOAC users.

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Endometriosis-Associated Infertility

Endometriosis is definined as the presence of endometrial-like tissue outside the uterine cavity and it presumably affects 10-15% of reproductive aged women. The prevalence of endometriosis appears to be higher in women in Philippines, Indian, Japanese and Korean origin[1]. Clinical manifestations depend upon the site where the ectopic endometrial tissue is located and include dysmenorrhea, dyspareunia, chronic pelvic pain, infertility, but the possibility of being asymptomatic exists. [...]

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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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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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The Impact of Testicular Cancer on Fertility - Literature Review

Testicular cancer has an increased incidence among young males (15-35 years old)[1]. The incidence in testicular cancer for this category of patients is quite high, 7.52 new cases for 100000 people. The predominant histopathological subtypes among fertile-aged young males are embryonal carci-noma and teratocarcinoma[1]. [...]

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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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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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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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