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

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Monday, October 23 2017 @ 05:29 EEST

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Breast Reconstruction Particularities after Radiotherapy - Case Report

2017-01

Iulia Gabriela Marcu, Ovidiu Stefanescu, Cristian Radu Jecan, Laura Raducu, Tiberiu Paul Neagu, Ioan Lascăr

Postmastectomy radiation therapy decreases the incidence of locoregional disease recurrence in patients with invasive breast cancer and has been proven to reflect a survival advantage for patients with node positive disease[1,2]. The optimal timing and technique of breast reconstruction procedures in patients requiring post-mastectomy radiation therapy are controversial[1] . Patients undergoing postmastectomy breast reconstruction, with a history of prior radiation therapy, present a particular clinical scenario. This is because of their well-documented higher complication rates, secondary to deleterious effects of irradiation on the soft tissue envelope of the remaining breast. [...]

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Multivisceral Resection for Pancreatic Adenocarcinoma. Case Report and Literature Review

2017-01

Sebastian Valcea, Octavian Enciu, Cosmin Pantu, Mihaela Vartic, Tiberiu Paul Neagu, Mircea Beuran

Pancreatic cancer (PC) remains a deadly disease with a dismal prognosis in which the mortality rate nearly equals its incidence [1,4]. Despite advances in modern chemoradiotherapy, the best and only chance of cure for patients with PC is an oncological surgical resection aimed at complete removal of all gross and microscopic disease[5]. Early disease and curative-intent surgery are the best predictors of outcome. Locally advanced cancer of the pancreatic tail involving adjacent organs is often considered unresectable. Radical distal pancreatectomy with en bloc resection of the invaded viscera with or without vascular reconstruction was introduced to treat these tumors[2,3]. Tumors of the body and tail have evidence of involvement of surrounding structures either by tumor infiltration or inflammatory adhesions. In such circumstances, it is advisable to perform en bloc resections to obtain negative surgical margins[6]. According to Shoup, multivisceral resections are technically feasible and, based on the limited data available, these resections are associated with improved survival (5-year survival rates of 16-22%) [7,8]. Given the high morbidity and mortality associated with these procedures, they should be performed only when the possibility of achieving R0 seems distinctly feasible[3,6,8]. [...]

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A Retrospective Forensic Study in Head Trauma Patients with Undiagnosed Skull Fractures at Computerised Tomography (CT) Scans

2017-01

Roxana-Maria Duncea, Relu-George Calota, Alec Cosmin Moldovan, Vladimir Belis

Computerized tomography (CT) scan is the primary screening modality of investigations in head trauma victims[1]. Since 1971 when it was invented, CT scan has advanced significantly from time-intensive single-section scanning to multi-detector row CT[2]. Nowadays, rapid and accurate assessment of injuries in emergency departments is based on CT scans. Th ere is a high degree of difficulty in terms of causal link, between the injury and the death causing mechanism in patients, with multiple affections and head trauma[3]. [...]

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The Effect of Allopurinol on Endothelial Function, Serum Uric Acid and NT-proBNP in Acute Decompensated Heart Failure

2017-01

Madalina Sorina Ababei, Alexandru Campeanu, Diana Cornelia Nistorescu, Ondin Zaharia, Gabriela Gheorghe, Ileana Peride, Andrei Niculae, Ioan Tiberiu Nanea

Acute decompensated heart failure has an increasing incidence and poor prognosis, being a major cause of death and hospital readmission and requiring urgent optimized therapy[1]. Under the influence of some decompensation risk factor, such as infections, arrhythmias, decompensation of some comorbidities, lack of adherence to the treatment, patients with a history of heart failure may suffer a progressive symptomatology worsening; therefore, more than 70% of cases of acute heart failure represent the clinical worsening of chronic heart failure - ADHF[2]. [...]

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Contrast Enhanced Ultrasonography in Diagnosis of Hypertensive Nephrosclerosis

2017-01

Liliana Albusoiu, Alexandru Campeanu, Marina Budau, Viorel Jinga, Ileana Peride, Andrei Niculae, Cristiana David, Ioan Tiberiu Nanea

The link between kidney damage and HT remains a challenge in medical research from a century when HT concept was defined, taking in consideration than HT is a major risk factor for cardiovascular disease morta-lity worldwide, due to the increasing prevalence, poor compliance to treatment and many complications[1-3]. The hypertensive nephrosclerosis is currently diagnosed in the latest stages of the disease because, for a long period of time, the injuries are compensated by kidney and therefore the clinical presentation is not specific[4]. The current diagnostic methods are non-specific, especially for early diagnosis of hypertensive nephrosclerosis, except the renal biopsy which is considered the gold standard but is rarely indicated in clinical routine due to its invasiveness and possible severe complications[5]. The pathogenic mechanism is complex and not very well understood but renal microcirculation impairment seems to be responsible for the onset and progression of this disease[6]. Therefore, any method that can accurately assess the early microvasculature changes of renal cortex, easy to use, simple and safe, with no invasiveness, could be an important diagnostic tool in hypertensive nephrosclerosis approach. [...]

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