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

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Lentigo Maligna - A Scientometric Analysis of Mainstream Scientific Knowledge

2014-04

Alice Brīnzea, B. Geavlete, Magda Mirescu, Roxana Nedelcu, Oliviana Geavlete, Daniela Ion

Lentigo maligna (LM) is a type of melanocytic proliferation, the term being used by clinicians and pathologists for melanoma in situ on chronically sun damaged skin (1) in case that the lesion is confined to the epidermis. The pathology in question is classified as lentigo maligna melanoma (LMM) when it invades the dermis (2), over a protracted period of time (3). They both represent a subtype of malignant melanocytic proliferation according to the World Health Organization criteria (4). Once the dermis is invaded, the prognosis of the lesion is similar to that specific for other types of melanoma (5). Most LM patients display a slowly enlarging pigmented macula or patch which tends to occur in middle aged and older individuals (6), with a slight female preponderance (2).

The preferred method for diagnosing LM is excision (7), secondary to dermatoscopy (8) and biopsy (9). Distinguishing LM from a background of increased melanocytes on chronically sun damaged skin in a small biopsy specimen remains one of the most serious diagnostic challenges for dermatopathologists (10). Histology shows proliferation of atypical melanocytes at the epidermal-dermal junction in small nests or single cells (11).

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Chronic Lymphocytic Leukemia. From Diagnosis to Treatment Decision

2014-04

Ana-Maria Ivanescu, Madalina Oprea, A. Colita, A. Turbatu, Anca Roxana Lupu

Chronic lymphocytic leukemia (CLL), haematological described since the early nineteenth century, is considered a haematological indolence, but of-a-time there was found that its evolution can be extremely varied.

Most of the patients were over 60 years at the time the diagnosis was established, and this may be due to decreased immune competence with age. Males are affected 2 times more frequently than the female, the male percentage: female being 2:1. Fewer than 10% of cases occur in adults and in children below 40 years old have been few reported cases of CLL. (1.2)

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HPV Implications in Benign Prostatic Impairments - A Literature Review

2014-04

D. Spīnu, D. Mischianu, O. Bratu, A. Aungurenci, Ș. Manache, Agnes Ciucă

Benign prostatic impairments are a heterogeneous group of diseases that can coexist or be separate entities. Some of these conditions (prostatitis) are included in the pelvic pain syndrome, while the other is represented by the prostatic adenoma and its implications.

Benign prostatic hyperplasia (BPH) is histologically associated, in most cases, with the presence of inflammatory infiltrate at this level. Histopathological examination of the resected pieces and fragments of prostatic biopsy in many cases reveals stromal inflammatory infiltrate adjacent to the prostatic acini. (1, 2) In addition to the many factors involved in the prostate benign microbial pathology (E. coli, Pseudomonas aeruginosa, Serratia spp., Klebsiella spp., Enterobacter aerogenes and the great family of enterococci), there are numerous data in specialized literature, certifying the presence of viral genomes in both benign and malignant pathology of the prostate. (3, 4) Among them the following stand out: Papilloma virus (HPV), Polyoma viruses, cytomegaloviruses (CMV), Epstein-Barr virus (EBV), Herpes Virus 8 (HHV 8) and xenotropic murine leukemia virus recently (XMRV). (5)

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Innovative Techniques for the Endoscopic Diagnosis in Inflammatory Bowel Diseases

2014-04

Adriana-Corina Andrei, L.S. Andrei, Larisa-Elena Fulger

Inflammatory bowel diseases, Crohn's disease (CD) and ulcerative colitis (UC), are chronic conditions in which idiopathic inflammation of the gastrointestinal tract wall is the characteristic feature.

The etiology of these disorders is not fully elucidated, proposed causes including environmental, immunological and genetic factors. A consensus hypothesis is that in genetically susceptible individuals, both exogenous factors (eg. Intestinal flora) and factors related to the host (barrier function of epithelial cells, innate and acquired immune response function) produce a chronic immune dysfunction in the intestinal mucosa which is further modified by the action of environmental factors (eg. smoking).

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Psychological Aspects of Pain at Patients with Critical Limb Ischemia

2014-04

Liliana Veronica Diaconescu, I. Diaconescu

Peripheral arterial disease is one of the major conditions that affect middle and old aged persons. Its prevalence ranges from 3% (for people aged 37- 69 years old) to 20% (for people aged over 70 years old) (1). In advanced stages (III and IV Leriche) the main symptoms are ulcers and pain- at rest, intolerable, nocturnal increased, needing analgesic treatment (inclusive opiates). Critical limb ischemia (CLI) is characterized by chronic ischemic rest pain, ulcers or gangrene attributable to objectively proven arterial occlusive disease (2,3). CLI is considered like a "malignant" disease - due to generalized atherosclerosis these patients are predisposed to various cardiovascular complications (e.g. myocardial infarction, strokes) which can cause death in few years (4).

The patients affected by CLI are patients generally considered difficult cases, destined to repeated approach to the health care services. Physicians have to take in charge not the pathology but to take in charge the patient. For the control of the pain it turns out essential, near the block of the perception of the pain, to act with psychological participation, in order to interfere with the perception of the pain and the meant one of the pain, modify the feelings associated to the pain, modify the behavior induced by pain (5).

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