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

Welcome to ModernMedicine
Thursday, January 18 2018 @ 12:10 EET

View Printable Version

Predictors of Increased Arterial Stiffness in Hypertensive Patients

2014-02

Oana Florentina Tăutu, Roxana Darabont, S. Onciul, A. Deaconu, Ioana Petre, R.D. Andrei, B. Drăgoescu, Maria Dorobanțu

In Romania, a high cardiovascular (CV) risk East European country, where prevalence of hypertension is still high and optimal blood pressure control still represents a doubtfull challange (1-5), adopting a treatment approach strategy based on total cardiovascular risk assessment can maximize the costeffectiveness of hypertensive patinets management, ensuring the best use of the limited resources of our health-care system, to prevent cardiovascular diseses and to decrease CV morbidity and mortality.

Recent research show that increased arterial stiffness represents an independent predictor of fatal and non-fatal CV events in hypertensive patients (6-10).

View full article
View Printable Version

Upper Digestive Tract Lesions in Inflammatory Bowel Diseases

2014-02

Adriana-Corina Andrei, Larisa-Elena Fulger, L.S. Andrei, G. Becheanu, Mona Dumbrava, Carmen-Monica Preda, M.M. Diculescu

Inflammatory bowel diseases, Crohn's disease (CD) and ulcerative colitis (UC), are chronic, idiopathic diseases characterized by the inflamation of the wall tube (1). Ulcerative colitis was first described in the mid-1800s (2), whereas Crohn's disease was first reported later, in 1932, as "regional ileitis" (3). Because Crohn's disease can involve the colon and shares clinical manifestations with ulcerative colitis, these entities have often been conflated and diagnosed as inflammatory bowel disease, although they are clearly distinct physiopathological entities. Ulcerative colitis is the most common form of inflammatory bowel disease worldwide. In contrast to Crohn's disease that can extend in the entire intestinal wall, ulcerative colitis is a disease of the mucosa that is less prone to complications and can be cured by means of colectomy, and in many patients, its course is mild (4).

Until recently, it was considered that, unlike Crohn's disease (whose location can be at any level of the digestive tract), ulcerative colitis is strictly localized in the colon. However, in the recent years, increasingly more studies reveal the existence of a moderate, chronic, diffuse gastroduodenitis in pacient with ulcerative colitis, which normally causes no macroscopical lesions being highlighted only based on histopathologic examination (5). Most of these studies invoke the presence in the duodenum of a diffuse inflamation with neutrophilic infiltration in the glandular crypts, with redness and swelling during an acute exacerbation. In the stomach the predominant lesions are chronic focal gastritis (5,6,7).

View full article
View Printable Version

Left Atrial Function in Patients with Reentrant Paroxysmal Supraventricular Tachycardia with Narrow QRS Complex - The Role of..

2014-02

Left Atrial Function in Patients with Reentrant Paroxysmal Supraventricular Tachycardia with Narrow QRS Complex - The Role of Speckle Tracking Echocardiography

Adriana Alexandrescu, S. Onciul, Ioana Petre, Oana Tautu, A. Scafa, Maria Dorobanțu

The reentrant paroxysmal supraventricular tachycardias with narrow QRS complex are in a large majority represented by atrioventricular reentrant tachycardia (AVRT) and atrioventricular nodal reentrant tachycardia (AVNRT). From an electrophysiological (EP) point of view the difference between the two forms is made by the type of the reentry circuit. That means that the former requires an accessory pathway with retrograde conduction while the latter implies the existence of perinodal pathways.

The left atrium (LA) is a part of the circuit in both types of arrhythmias. In sinus rhythm the left atrium has several functions: it acts as a conduit during protodiastole, it has a contractile function raising the filling pressure during atrial systole but it also has a reservoir function during ventricular systole. (1)

View full article
View Printable Version

The Academy of Medical Sciences - a Short History; National Missions in an International Context

2014-02

M. Ifrim

The Romanian Academy of Medical Sciences, a forum of consecration and lucrative activity, bearing an institutional counterpart in every country on the planet, came into being in 1935 by a Royal Decree issued based on the decision of the bicameral Parliament of the country, upon the initiative of Prof. Dr. Daniel Danielopolu. The Professor held from the very beginning the position of Permanent Executive Secretary of the forum, its Presidents coming from the ranks of personalities such as the Minister of Education at the time, Ion Angelescu, and many others that followed.

By the existent law, the Academy of Medical Sciences bore the responsibility, as a subordinate to the Ministry of Health, of conducting medical research and strategizing health policies. Following the French model, which is in fact a model for most, if not all, Academies spread around the globe, it was composed of Academicians from different specialties of medical activity.

View full article
View Printable Version

Hypopharyngeal defect reconstruction, following extended total laryngectomy, using a myocutaneous sternocleidomastoid flap

2014-01

O. Ceachir, R. Hainăroșie, V. Zainea

Hypopharyngeal cancer represents approximately 7% of all head and neck malignancies, occurring more frequently in men (male / female ratio 3:1) with a maximum incidence in the 6th and 7th decades (1, 2).

The lack of specific symptoms causes late presentation with advanced T-stage disease (T3-T4) which restricts surgical options to total laryngectomy with partial pharyngectomy or total laryngectomy with circular pharyngectomy, associated, in most cases, with bilateral neck dissection (1, 3). Submucosal extension of the tumor is what compels the surgeon to practice an extended resection in order to meet the criteria of oncological resection (4, 5). In order to achieve a primary suture of the pharynx is imperative that the width of the remaining mucosa is at least 2.5-3 cm (2, 6). If this goal is not achieved then the resectional stage is mandatory followed by a reconstructive one, in order to prevent pharyngocutaneous fistula occurrence, pharyngeal stenosis or poor vocal rehabilitation. For lateral pharyngeal wall defects, reconstruction can be performed using regional flaps (myocutaneous pectoralis major flap, lateral island trapezius, deltopectoral flap, latissimus myocutaneous flap, submental island flap) or free flaps (radial forearm fasciocutaneous free flap, lateral arm free flap) (1,2,3,5,6). If a circumferential resection has been performed the optimal reconstruction is the one that re-creates a lumen that can allow normal deglutition so, jejunal free flaps, ileocolic free flaps, radial arm free flaps, anterolateral tigh flap, peroneal flap, gastro-omental free flap, gastric transposition and many other methods were successfully used (3, 5, 6, 7, 8, 9). The reconstructive procedure performed by us used a pediculated, myocutaneous sternocleidomastoid flap harvested from the same side as the lesion and it was addressed to a lateral hypopharyngeal wall defect.

View full article