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

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Monday, October 23 2017 @ 05:28 EEST

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Charcot Foot Diagnosis - Still an Issue?

2017-02

Ion Cocolos, Tiberiu Paul Neagu, Andrei Tudor Ursache, Ioan Cristescu, Mircea Vasile Ghemigian, Liliana Elena Mirea, Gheorghe Ion Popescu

The†Lisfranc†fracture-dislocation of the foot is uncommon and many cases are misdiagnosed. The†Lisfranc†lesion involves the medial cuneiform and base of the second metatarsal†which are considered to be the keystone of the structural integrity of the midfoot. This joint has a stabilization effect on longitudinal and transverse arches of the foot. A neglected or untreated injury to the†Lisfranc joint can lead to secondary arthritis and significant morbidity with disability. Furthermore, it is well known the correlation between pacients with periferic neuropathy and this type of lesion, also known as Charcot Foot[1]. It has been documented to occur as a consequence of various peripheral neuropathies, but diabetic neuropathy has become the most common etiology[2]. [...]

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A Retrospective on the Treatment of Trochanteric Fractures of the Femur in the Bucharest Clinical Emergency Hospital in 2015

2017-02

Fabian Klein, Ioan Cristescu, Florin Safta, Daniel Vilcioiu

Fractures of the proximal femur are some of the most commonly encountered fracture types, especially when talking about elderly patient[1,2]. Apart from the immediate impact on the patientís health, a more problematic issue is the impact on the quality of life, especially when talking about geriatric patients[3]. Early surgical treatment, combined with early discharge from hospital and a well-tailored rehabilitation program are mandatory for assuring a quick recovery of the patientís autonomy. It is estimated that every person over the age of 65 has a 10% chance to fall once per year, with the possibility of contracting a proximal femur fracture. [...]

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The Use of Tranexamic Acid for Preventing Bloodloss During Percutaneous Nephrolithotomy

2017-02

Raluca Barbilian, Victor Cauni, Bogdan Mihai, Ioana Buraga, Mihai Dragutescu, Dan Mischianu

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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The Value of Computed Tomography in Establishing the Proper Surgical Treatment of a Complex Proximal Humerus Fracture

2017-02

Razvan Turcu, Marius Moga, Mircea Ifrim

Proximal humerus fractures result from indirect trauma, are associated with osteoporosis, and are classified into: humeral head fractures, anatomical cervical fractures, trochiter, trochin, surgical neck, or proximal diaphysis. Types of fracture and displacement are determined by the position of the humerus at the time of trauma, bone quality and the direction of muscle forces on fractured fragments[1,2].

Fractures with two, three or four shifted parts require surgical treatment. The dislocation fractures, except for the simple trohiter fractures, should be analyzed by the orthopedic surgeon, the reduction of the dislocation will precede the treatment of the fracture. It should be emphasized that powerful damping maneuvers can move fractured fragments, so it will be preferable to reduce it under radiological control[14]. [...]

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The Role of Psoas Compartment Block in the Management of Pain During and After Total Hip Arthroplasty

2017-02

Bianca Basgan, Nicolae Iordache, Dragos Cocos

The "Psoas Compartment Block" technique was described for the first time in 1974 by the American doctor Alon P. Winnie, in a revolutionary article for that time[1], that was detailing both the anterior approach of the lumbar plexus (3 in 1 Block or femoral nerve block), and the posterior approach.

Subsequently, doctors Chayen D., Nathan H. and Chayen M. are making a series of additions and practical indications, in an article about the posterior approach, entitled "The Psoas Compartment Block"[2], and the technique presented in this article also constitutes the basis for this study. [...]

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