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

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The Use of Coblation in the Surgery of the Juvenile Angiofibroma

2014-03

R. Hainăroșie, M. Hainăroșie, O. Ceachir, Irina G Ioniță, Cătălina Pietroșanu, V. Zainea

Coblation is a surgical technology which consists in delivering radiofrequency energy to soft tissue. This technology uses radiofrequency in a bipolar mode with a conductive solution, such as saline (1). It energizes the ions in the saline to form localized plasma near the tissue placed in the area of surgical interest. Plasma’s energy dissociates water molecules from saline solution thus providing the optimal chemical conditions for breaking the tissue’s molecular bonds (2).

The application of this technology has three effects: tissue ablation, localized removal and tissue volumetric reduction (2). The dissipated heat by using this type of radiosurgery is significantly lower than common radiofrequency techniques. This is due to intrinsic of the chemical process and the continuous cooling of the tissue from the surrounding saline solution at the level of the instrument’s tip (3). In this way the temperature rises to 45-85°C (1, 2). The decreased thermal effect of coblation, better than classic radiosurgery, induces a gentle but efficient surgical effect in the target area. Thus the surgeon can gently remove tumors, small organs (tonsils) and can melt some anatomical structures (turbinate, palate, base of tongue). There is a large field of surgical applications in the pathology of the upper aero digestive tract.

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Narrow Band Imaging - From Technological Progress to Superior Urothelial Cancer Diagnostic

2014-03

M. Jecu, P. Geavlete, I.A. Checheriță, C. Ene, B. Geavlete

Bladder cancer represents the most common malignancy of the urinary tract and the 7th most frequent cancer in men and 17th in women. The prevalence of this malignancy varies between regions and countries. In Europe for example, the highest age-standardized incidence rate has been reported in Spain and the lowest in Finland (1). In the United States, the incidence and mortality due to bladder cancer is also high (more than 60,000 new cases and up to 13,000 deaths annually) (2). Therefore, in the last decades, it has been noticed an increased prevalence of bladder cancer, probably caused by tobacco abuse, industrial carcinogens risk factors and overall aging process of the population (3).

75-85% of all newly diagnosed bladder tumors is represented by non-muscle-invasive bladder cancer (NMIBC), a multifocal disease, that includes stages pTa, pT1 and carcinoma in situ (CIS) (4). Furthermore, this pathology has a high recurrence rate within the first 5 years after the initial diagnosis (5), despite the recent technological advances (6).

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Multiple Benefic Effects of the Systemic Exposure to the Hydroxychloroquine Sulfate

2014-03

Aida (Pancă) Geamănu, Alina Popa-Cherecheanu, B. Marinescu, D.C. Geamănu, Liliana Voinea

In the twentieth century, the widespread use of quinacrine by the U.S. military as malaria prophylaxis was accompanied by other observations suggesting efficacy for treatment of rheumatologic diseases [1].

During the 1950s, the hydroxychloroquine (HCQ) derivative of quinacrine showed a favorable usage profile with less eye toxicity than chloroquine itself, and the use of this agent in the treatment of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) has become common. In RA, HCQ is usually a component of a drug combination, including triple drug therapy with methotrexate and sulfasalazine, a formula which was claimed as a safe alternative, well tolerated compared to expensive biological therapies [2].

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HYPONATREMIA IN PREDIALYSIS HOSPITALIZED PATIENTS: AN UPDATE ON CLINICAL DATA AND MANAGEMENT

2014-03

Alice Bălăceanu, I.A. Checheriță, A. Niculae, Ileana Peride, Camelia Diaconu, Gheorghița Aron

Hyponatremia, with an incidence of 15 - 22%, is considered when serum sodium levels are < 135 mEq/L (in institutionalized geriatric patients, in 1 - 4% to 7 - 53% cases there have been reported values below 130 mEq/L) [1-3]. Additionally, according to expert panel recommendations the frequency of hyponatremia in hospitalized patients depends on the detected level of hyponatremia [2]. This special condition is highly important to be detected on time because it represents a recognized risk factor of morbidity and mortality, even in asymptomatic patients [1]. Furthermore, it was noticed that a swift correction can induce severe neurological disorders and even death [1]. Therefore, for an adequate treatment management (prophylaxis and therapy) is vital for understanding hyponatremia main causes and the incriminated pathophysiological mechanisms [1].

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PERFORATORS OF THE CALF ARTERIES - ANATOMICAL STUDY

2014-03

Crenguța Coman, D.M. Enescu, Iulia Iacob, S. Dumitrache, C. Bejinariu, Carmen Giuglea

In reconstructive surgery, perforator flaps have a short history. Not more than 27 years ago, Nakajima et al. described the six types of perforator vessels known at present: direct cutaneous, direct septocutaneous, direct cutaneous branch of muscular vessel, perforating cutaneous branch of muscular vessel, septocutaneous perforator and musculo-cutaneous perforator [1]. (Fig. 1)

The knowledge about these perforator vessels continuously grew, by identifying the vascular networks of the entire body, formed by the perforator vessels. Therefore, it became possible to create a lot of perforator flaps based on these perforator vessels [2]. Thus, perforator flaps can be considered the latest milestone in the evolution of reconstructive flap surgery. Many methods are used for investigating the exact location of the perforators, such as imaging methods: computed tomography, magnetic resonance angiography and lately thermal imaging that became also reliable [3]. The exact knowledge of the location and caliber of perforators became a real help for plastic surgeons, especially in the calf area, where the reconstructive method has to accomplish the functional and aesthetic needs for both reconstructed and donor areas.

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