Introduction: The infection caused by H. pylori appears secondary after a bacterial colonization of the stomach and the initial portion of the small bowel. H. pylori –infected patients can develop gastritis, peptic ulcer, stomach cancer or MALT lymphoma. H. pylori infection is defined by WHO like a type I carcinogen, its role in gastric carcinogenesis being supported by the greatest researchers. Objectives: In this study our purpose was to determine the endoscopic appearances in H. pylori infection quoted in medical literature until now and the frequency of their appearance in our group of interest. Materials and methods: In this study it was made an analytic study in which it was realized a retrospective cohort investigation at the Emergency Central Military and University Hospital “Dr. Carol Davila” Bucharest, gastroenterology branch –endoscopic department between 18.12.2012- 21.08.2013 on 1694 patients between 18 and 92 years old, with the medium age of 55 years old. As a diagnostic method for H. pylori infection we used superior digestive endoscopy during which were taken biopsies and it was made a fast urease test. Results: Regarding the variation of the endoscopic aspects at the population of study, we have found gastritis with all its aspects (which was Sidney classified) in the biggest percentage meaning 59.3% of the cases, followed with a percentage of 18.8% by those without any endoscopic abnormality, and then in 10,33% of the cases we have found peptic ulcer. With a smaller percentage, under 10%, we have found duodenitis at 8.67% of this patients, and finally the most severe lesions represented by gastric cancer and lymphoma were found at 2,7% of the H.pylori infected patients.
Background: Neuroendocrine tumors of the pancreas (NTP) comprise a unique and relatively rare group of tumors, of which gastrinoma and insulinoma are the most common types. Insulinomas tend to be small, solitary and benign, with surgical resection curable in most cases. Introduction: Insulinomas are localized preoperatively using conventional imaging studies as transabdominal ultrasonography (US), computed tomography (CT), and/or magnetic resonance imaging (MRI). Purpose: Endoscopic ultrasound (EUS) is a valuable tool in the diagnosis of insulinomas. Goals & methods: We performed a retrospective study on 21 patients with insulinoma (6 male and 15 female, 25 to 73 years of age), who were hospitalized and operated on between 2003 and 2012 at “Dr. Carol Davila” Central Military Emergency University Hospital, Bucharest. Results: US view was positive in 10% of patients (2 of 20), that presented proximal location. The sensitivity of CT was unsatisfactory, 21.05% (4 positive results of 19). CT failed to detect liver metastases, but identified nodal metastasis in one patient. MRI was performed in 18 patients and was diagnostic in 11 of them, recording a detection sensitivity of 61.11%, including infra- centimetric tumor size. EUS has a high resolution which allows detection of lesions with very small diameter is safe and minimally invasive. EUS was performed in all patients, being able to identify formations in 17, was inconclusive in 3, showing a diagnosis sensitivity of 81%. Liver metastases were demonstrated in 3 patients, one by US and all 3 by MRI. Conclusions: - CT with intravenous iodinated contrast agent had a poor sensitivity in detecting the primary tumors, was insensitive in detecting liver metastases, but showed metastases in lymph nodes. - MRI has higher sensitivity than CT in detecting primary tumors, including insulinomas with infracentimetric size, and is the imaging test of choice for possible liver metastases. - EUS is the preoperative imaging test of choice.
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
