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

Mihaela Vilcu

Mihaela Vilcu

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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Split-thickness Skin Grafting in the Treatment of Surgically Operated Diabetic Foot. A Retrospective 2-Year Study (2010-2011)

Diabetes mellitus is a major health problem with significant impact on the quality of life, due to both its complications and comorbidities and due to the costs it generates. There is widespread agreement that the incidence of the disease has increased over the last years, both due to better population monitoring and improvements in diagnosing methods.
Thus, the number of cases of diabetes mellitus worldwide was 382 million in 2013 and the number is rising
there are 75 million cases of diabetes mellitus which go undiagnosed, as the majority of diabetic patients are discovered only when complications set in. (1)

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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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Revascularization - A Key Element for Obtaining Granulation Tissue in a Patient with Diabetes and Arteriopathy

The morbidity of the patients with diabetes is generated - besides the renal, occular, cerebral, cardiac impairment - to a great extent by the diabetic foot infections. The infection develops due to the ulcerations whose etiology (neuropathy or arteriopathy) is particularly important for the approach of the therapeutic algorhythm, which often involves an interdisciplinary collaboration. Diabetes mellitus is the risk factor associated with the highest rate of critical ischemia of the lower limbs. [1]
The association of peripheral arterial disease with infection represents the determining binomial of major amputations in the patient with diabetes and, in 80% of the cases, the gateway is an ulceration of the foot. [1].

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