Introduction: Solar exposure is a major causative factor for multiple skin pathologies. Even though UV radiation is the most important factor implicated in skin cancer pathogenesis, still, few European countries recognize UV occupational-induced skin cancer as an occupational disease, Romania not being part of this category. The objectives of this study were to evaluate the UV exposure doses in agriculture and construction workers and to establish efficient protective measures. Materials and methods: In our Department, a prospective, observational, analytical study was conducted, including six outdoor workers (in construction and agriculture), over a period of three summer months (July, August, September). Subjects were asked to wear personal dosimeters and the following parameters were analyzed: profession, duration of exposure, UV exposure doses, skin aspect, preexisting preventive measures. Results: The wearing of dosimeters was well tolerated by all subjects, without any interference with daily professional activities. Daily UV radiation doses ranged from 1.79 SED (tractor driver) to 19 SED (agriculture worker). Maximum UVR doses were recorded between 10:00 am and 4 pm. Clinical examination was made after measurements, with no detectable skin changes. Conclusion: Even though workers in agriculture and construction in Romania are exposed to significant UV doses, with 40% more than the general population, these professions are not recognized as high-risk professions for developing skin tumors. More prospective and retrospective studies are necessary for more significant statistical results and for demonstrating the necessity of introducing primary, secondary and tertiary preventive measures.
Unlike the therapy of primary BMS, the treatment of secondary BMS benefits, in addition to symptomatic therapy, from the possibility of using means and methods to correct biological disturbances and/or morphological, psycho-emotional changes respectively. The use of these therapeutic means in secondary BMS is recommended to be established as a first step of therapeutic conduct. Their success is reflected in homeostasis restoring, correcting morphological and functional changes of the field, which frequently leads to no longer use prescription of symptomatic treatment. DEFINITION The International Association for the Study of Pain (IASP) defines burning mouth syndrome (BMS) as a “distinct nosological entity” characterized by “oral sensation of burning or pain, persistent and non- remitting in time in the absence of clinical objective changes of the mouth mucosa” [1]. A relatively similar vision is supported by Grushka (2014). BMS defining a sensory sensation, the author admits that this is manifested mainly by: a) subjective characteristics: taste perception; bilateral burning changes sensation associated with altered taste mouth; sensation of “dry mouth”, although salivary flow is not reduced; perceived foreign body in the oropharynx and b) objective criterion: the oral tissues with clinically normal aspect. The author specifically mentions that the 4 subjective lists, encountered in BMS come forth from the absence of results after an in Corresponding author Bogdan I. Coculescu bogdancoculescu@yahoo.fr objective clinical exam, a defining element for this condition [2]. EPIDEMIOLOGY Setting the epidemiology of BMS is difficult and imprecise because there is no universally accepted definition. The various epidemiological studies often refer to different clinical entities in which oral mucosal lesions lack [3]. This disease has a high rate that varies according to the studies from 0.7% to 14.8 - 15% [3,4,5]. The prevalence of painful syndrome in the Service of Oral Pathology of the Faculty of Dental Medicine - “Carol Davila” University of Medicine and Pharmacy, Bucharest (Romania) is 16.23% [6]. 1 Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest 2 Titu Maiorescu University, Faculty of Medicine, Bucharest, Romania 3 Center for Military Medical Scientific Research, Ministry of National Defence, Bucharest, Romania 43
Background and Aim: Psoriasis is an inflammatory skin disorder with important influence on the lipid profile, insulin resistance and cardiovascular disease. The aim of this study is to compare the lipid profile of classical therapy versus anti-TNFs patients and asses the associated diseases. Methods: We conducted a prospective study. Patients’ data were collected from two Romanian Dermatology Clinics, during the period January 2015 – June 2016. The patients were divided into two groups: study group (on TNF inhibitors) and control group (on classical treatment). Results: The subjects in the study group had more associated diseases and much more patients suffered from dyslipidemia. There were not statistically significant differences in the lipid profile between the two groups. But eliminating patients treated with Acitretin and Methotrexate, a p- value of 0.0259 (significant statistically) was observed when comparing the values of triglycerides in the two groups. Conclusions: We did not observe a beneficial effect of the TNF inhibitors therapy in psoriatic patients on the lipid profile. Subjects on biological treatment suffer from a more severe form of psoriasis vulgaris and associate much more comorbidities.
Object: The aim of the study is to select the most active new imidazolium-quinuclidinum- oxime, from some similar chemical compounds synthesized in our chemistry department, with sufficient efficacy to decrease the acute toxicity of neurotoxic organophosphates known as nerve agents. Method: The experimental study consist in vivo testing the antidotal efficacy of obidoxime and of selected imidazolium oximes synthesized in our chemistry department. Each oxime was included, by equimolar replacing the obidoxime, in an antidotal formula, which also contains atropine. The above mentioned formula containing atropine and obidoxime was used as reference. The protective ratio, defined as the ratio between the lethal median dose of the poisoned and treated study group and the median lethal dose (LD50) of the poisoned and untreated study groups was one of the used parameters in order to select a new active chemical structure in counteracting the neurotoxic organophosphorus compounds acute toxicity. Another studied parameter was the erythrocyte acetylcholinesterase value measured in whole blood 24 hours after exposure. Results: The protective ratio against an organophosphorus compound were the follow: obidoxime chloride: 2; 1,3- dimethyl-2-hydroxyethyl-imidazolyliodide: 1,75;3-oxime-[3-(2-hidroxyimino-methyl-1-imidazolyl-)- 2oxapropyl]quinuclidin-dichl-oride: 2,5; 1-methyl-quinuclidin-3-iodide: 1,5. The erythrocyte acetycholinesterase main values were the following: the unpoisoned and untreated study group:3,45 ±0,13mmol/dl; the poisoned and untreated study group: 0,89 ±0,09 mmol/dl; the poisoned and 3- oxime-[3-(2-hidroxyimino-methyl-1-imidazolyl-)-2oxapropyl]quinuclidindichloride study group:2,89 ±0,11 mmol/dl; the poisoned and obidoxime treated study group: 2,53±0,15 mmol/dl. Conclusions: quinuclidindichloride synthesized in our chemistry department, has shown a better protective ratio and a more prolonged surviving time than the reference (obidoxime). It has shown the best AChE reactivation of all the synthetized compounds. This compound can be a cheap and good option for replacing obidoxime in the antidotal formula active in nerve agent exposure. 3-oxime-[3-(2-hidroxyimino-methyl-1-imidazolyl-)-2oxapropyl] treated
Introduction: Venous thromboembolism (VTE), in its clinical spectrum, includes both deep venous thrombosis (DVT) and pulmonary embolism (PE). It is a disease with high incidence and morbidity in hospital and community settings. Venous thromboembolism has various risk factors and there are studies proving that the risk of increasing the incidence of the disease is proportional to the risk factors. Diagnosis, treatment and complications of lower limb deep vein thrombosis (DVT) depend on the anatomical location and extent of the process. The post-thrombotic syndrome (PTS) is the most common complication of deep vein thrombosis (DVT) and clinically it is characterized by chronic pain, edema, enlarged veins, skin induration and other signs of the affected limb, while, in severe cases, it can develop venous ulcers. The incidence of peripheral trophic disorders by age and the prevalence of risk factors for deep vein thrombosis of the lower limbs were examined in this regard. Materials and method: A retrospective study (January 2013 - December 2015) was conducted by collecting data from medical documents available in "Floreasca" Emergency Hospital Bucharest, Romania. The patients diagnosed with deep vein thrombosis, on the basis of Doppler ultrasound, were divided into two groups, according to age: group A (59 patients aged ≤50 years) and group B (130 patients aged> 50 years). A number of data from the medical anamnesis, along with clinical and paraclinical data were collected by us and we were interested in the incidence of peripheral trophic disorders caused by deep vein thrombosis of the lower limbs correlated with the risk factors. The study showed the incidence of deep venous thrombosis in a certain age and a certain environment of origin. The incidence of patients who have had a VTE history is half the patients with deep vein thrombosis who have had prophylactic anticoagulant therapy before hospitalization. The incidence of patients who have had prophylactic anticoagulant therapy before hospitalization is 61.1% of the patients with deep vein thrombosis and a VTE history. The incidence of trophic disorders caused by deep vein thrombosis of the lower limbs in patients who have had prophylactic anticoagulant therapy before hospitalization and in patients who also had a history of VTE is higher in those over 50 years old. The study showed the association of some risk factors for venous thrombosis with an age-related factor. Conclusions: Improving preventive strategies and an optimally efficient utilization of these strategies for patients at risk of venous thrombosis can lead to improved clinical outcomes in practice and also to the post-thrombotic syndrome prevention. Taking into consideration the risk factors by age group and a better understanding of epidemiology and the risk factors for the first or recurrent venous thrombosis can lead to optimal use of prophylactic strategies and improved quality of life. DVT affects all age groups and the incidence associated with PTS is high, therefore the prevalence of PTS in general population is considerable. 1 Sanitary Post High School “Fundeni”-Bucharest 2 Carol Davila University of Medicine and Pharmacy, Bucharest 3 Toxicology Clinic, “Floreasca” Emergency Hospital, Bucharest 4 Surgery Clinic, “Sf. Pantelimon” Emergency Hospital, Bucharest 5 Carol Davila University Emergency Military Hospital, Bucharest 37
The ancient Greek medicine was based on the principle that philosophy influences all natural sciences as a whole. The doctor had, first of all, a humanistic formation followed by study of applied sciences specific to medicine. If humanism is purely theoretical, medicine is an applied science and the two-philosophy and medical knowledge, despite the apparent antinomy are able to create a union to the benefit of humanity. Medicine is the art of treating patients, identifying diseases and malady prevention. In its endeavor, medicine is based on the findings of numerous other fields such as physics, chemistry, anatomy, physiology, etc. Philosophy, on the other hand, can be defined as an attempt to understand human life as a whole. It is inevitable that the two ways of dealing with human beings to have influenced each other and the history of mankind. Both forms of knowledge have a major impact and influence on the world. Philosophy, understood in its older meaning, urged towards the prophylaxis and treatment of diseases of the soul whereas medicine, relying on philosophical teachings is aimed at healing the body and study its psychosomatic features.
Contemporary hybrid war is a novelty in that it is taken to populated conflict zones, with the participation of the population, under the eyes of the international community. Thus, according to many authors, the most serious threats to the United States, including to its NATO dimension and to its partnership with Europe, would come from extremist groups and their ideology, fueled by poor urban areas of the world, where youth faces great economic and social problems, and is militating for a change. These unconventional actors can operate beyond state control by circumventing international borders, norms and agreements. Some of these belong to global terrorist networks, and others co- operate with criminal elements to destabilize certain areas. The hybrid confrontation with these groups will become "a clash beyond the physical elements of the conflict, in which media manipulation, the use of the internet and the integration of information operations with strategic communication programs are as important as weapon systems on the battlefield." Crises generated in the context of a hybrid war are events characterized by low probability and important consequences that threaten an organization for its most profound purposes. Because of their low probability, these events defy any interpretation and require a sustained effort to understand and adapt the reactions. Crises affecting social groups differ in their causes and duration. Obviously, because of the multitude of types of crises, human reason can only play a limited role in their development. However, they trigger human action, which can turn small deviations into major crises. Crisis and conflict management involves very complex systems of political, diplomatic, social, economic, cultural, international, military and other actions. Such a system could be structured on political, diplomatic, social, economic, informational, military, psychological and cultural components and could include the following types of action: on the causes; on effects; on the phenomenon; on value systems; on crisis-generating strongpoints (critical areas); on vulnerable sites; on the leaders. METHODS The analysis of open sources of information and of the experience gained during the activity in the field of communication and public relations, concretized through the elaboration and implementation of both the communication management strategies and of the projects included in the field of defense and national security. In hybrid war, opponents (states, state-supported or independent movements) will exploit access to modern military capabilities and support insurgent, terro- rist and criminal movements as well as the intervention of states that can combine high- tech military capabilities with terrorist actions and cyberwar operations against financial targets. The analysis of available sour- 1 Carol Davila University of Medicine and Pharmacy, Bucharest 33
The evolution of the endoscopic skull base surgery in the last ten years had led to the development of new surgical reconstructive techniques. In the endoscopic reconstructive surgery of the CSF leaks both synthesis and natural materials. The advancement of the endoscopic reconstructive surgery was closely linked with the production of new synthesis materials. The aim of the paper is to compare the efficacy of synthesis versus natural materials in the closure of CSF leaks and to point out certain rules of when and where to use a synthesis or natural material. INTRODUCTION In the reconstructive surgery of the skull base, the surgeon can use both natural and synthesis materials. The developments of the endoscopic surgery of the skull base had led to removing bigger tumors from high-risk areas that were not suitable for endoscopic surgical approach up to now. The endoscopic surgical approaches tend to replace the external approaches even in malignant tumors of the skull base in selected cases. Because of that, the surgeon started to encounter more defects at the level of the skull base with or without CSF leaks. New surgical reconstructive techniques started to be developed in close connection with the production of new surgical reconstructive materials and adhesives. [1] The materials used in the reconstruction of the skull Corresponding author: Silviu Pițuru piturus@yahoo.com base defect can be divided in autologous tissue and synthesis reconstructive materials. Autologous tissues that are used in the reconstructive skull base surgery are: fascia, cartilage, bone, fat, free mucosal grafts, vascularize flaps and free flaps with micro anastomosis. Fat can be used to obliterate dead space or to plug a CSF leak.[1] Fascia lata or fascia temporalis can be placed in an underlay technique between the dura and the skull base or overlay technique in the sinus cavities. Multilayered fascia lata was the effective especially management of open cisterns or in cases of another type of high-pressure CSF leak.[2] in Bone or septal cartilage are placed in the underlying tech- 1 The “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania 2 “Prof. Dr. Dorin Hociotă” Institute of Phonoaudiology and Functional ENT surgery, Bucharest, Romania 29
Pathologists observed the presence of tumor infiltrating lymphocytes (TILs) in solid tumors many years before the research focus shifted from cancer cells to the tumoral microenvironment. In lung adenocarcinoma TILs vary in number, phenotype and distribution. Our study investigate the type and distribution of TILs regarding the stage of disease and histological subtype in 27 cases of lung adenocarcinoma. By immunohistochemistry we evaluated semi-quantitatively CD3, CD8 and cyclin D1. We have found that CD3+CD8- lymphocytes prevail at the invasive margin and in tumoral stroma. Cyclin D1 was diffusely positive in tumoral cells in all the five cases of lepidic type of lung adenocarcinoma. In other histological types cyclin D1 was focally positive, most at the margin of the tumor irrespective of the presence or absence of TILs.
Introduction: UTI (urinary tract infections) represent a central pathology for a urological service. Antibiotic resistance is growing at a steady and alarming rate worldwide and especially in Romania. Method and materials: We have analyzed all the patients that were admitted to our clinic for continuous hospitalization between January 2015 and October 2015. All patients undergone urine culture and all cultures positive had an antibiogram worked up. We have selected all patients that had antibiotic resistance to at least an antibiotic. Results: From 1745 patients admitted for continuous hospitalization, we had 180 positive urine cultures at admission from which 125 had at least an antibiotic resistance. Conclusions: Antibiotic resistance is a serious phenomenon, with potential lethal complications, which we encounter daily in urological practice INTRODUCTION Uncomplicated UTI are probably the most common urological condition. It is estimated that at least 1 out of 3 females will develop an UTI during their lifetime. UTI frequency at young females is associated with sexual intercourse. When urological malformations, pregnancy, menopause, urolithiasis occur conditions for recurrence of the disease are met. Recurrences are defined as at least 2 episodes of UTI in 6 months or 3 episodes a year. Male patients develop UTI due to different mechanisms and at an elderly age. The most common mechanism that facilitates the development of UTI in men is bladder outlet obstruction caused mainly by prostatic enlargement. UTI are caused mainly by Gram negative enterobacteriacea. Escherichia Coli is the cause for about 80-90 % of community acquired UTI’s. In healthcare related infections E. Coli is still the leading cause but with a more modest percentage. Other pathogens that cause UTI are: Proteus mirabilis, Enterococous, Klebsiella pneumonie, Pseudomonas aeruginosa. METHOD AND MATERIALS Between January and October 2015, 1745 patients were admitted for continuous hospitalization in our Clinic. At admission all of these patients had their urine sent for culture. The urine culture was tested for antibiotic response for the following antibiotics: 1 Carol Davila Central Emergency Military Hospital, Bucharest 2 Carol Davila University of Medicine and Pharmacy, Faculty of Medicine, Bucharest 20
