Introduction: The hallux rigidus is a term that signifies a mobility limitation of the metatarsophalangeal joint of the big toe due to osteoarthritic degeneration. Several factors are incriminated in the appearance of this pathology but without being able to establish the cause. The cartilaginous erosion of the metatarsal head and / or the base of the phalange, the dorsal osteophyte of the head of the first metatarsal were found during cadaveric studies. The main reason for consultation is pain and limitation of the dorsiflexion of the big toe during the step. Hypothesis: Arthroscopic debridement of the first metatarsophalangeal joint improves the early postoperative clinical score compared to isolated percutaneous treatment. Material and method: 11 patients divided into 2 groups were assessed clinically at 3 months postoperatively. All patients were hospitalized on an outpatient basis. Results: There was a gain in mobility at 3 months compared to the preoperative assessment in both groups, as well as an improvement in pain without being able to demonstrate the superiority of the additional arthroscopy to the percutaneous debridement. Hypothesis reversed..
Public health is the most important power factor of a nation, from which all other factors derive. Infectious diseases are the most important cause of morbidity and mortality in humans. Vaccination is the most important method of prophylaxis of infectious-contagious diseases. Mass implementation of vaccination prevents the occurrence of epidemics, epizootic diseases or homonymous pandemics, and at the individual level ensures the specific active immunity (total or partial). So the vaccination of the population and/or the risk groups is of strategic importance to the nation, both in peacetime and in time of war. The national antidote production along with anti-infectives (vaccines, therapeutic serums, immunomodulators, antimicrobial chemotherapies and pesticides) has a strategic importance for the health of the population and of the troops. Biological crisis situations are cases of force majeure, where the Medicines Law provides the exception for manufacturing and use, even without a "marketing authorization". The military scientific research could make micro-production of specific drugs (antidotes, antiinfectives) for the needs of the army and the risk groups of the population. An example would be the preparation of vaccines for the prophylaxis of diseases caused by BWA and bioterrorism as niche products. Nothing hinders the preparation of any medication, such as magistral and galenical preparations, or pilot batch, provided there is adequate space, equipment, staff and procedures according to the law or the exception.
Objective: The goal of this paper is to present the management of cases of deep endometriosis that affects the bladder, the ureters and the kidney. Materials and method: In this review we analyzed the sensitivity and specificity of imaging techniques for diagnosing deep infiltrating endometriosis, the optimal surgical technique and the surgical approach. Results: In patients with pelvic endometriosis in advanced stages the urinary tract is frequently involved. Preoperative work-up of patients with deep infiltrating endometriosis is aimed at evaluating the extension of the lesions in order to assess the complexity of the intervention and to choose the optimal approach. Conclusions: Laparoscopic and robotic management of these cases are good therapeutic alternatives. Ultrasound, sonovaginography with gel and MRI are useful imaging techniques for evaluating patients with deep infiltrating endometriois. The surgical management of patients with deep infiltrating endometriosis that involves the urinary tract consists of partial bladder resections, ureterolysis, ureteral resection and anastomosis and ureteral reimplantation..
The interdisciplinarity of the marketing department is due to the application of concepts, methods and marketing technics specific both to service and to social marketing. In addition to this fact, the attempt of the social services to satisfy the patient’s needs places the health care domain at the border between social and economic, between profit and non-profit orientation. However a lot of the notions from the marketing field (competition, promotion, strategy, need, supply, cost etc.) acquire new meaning when used for defining the rivalry between the distinct medical organizations, the advance of the health care services, the development and implementation policies in medical marketing, the increasingly acute demand for treatment, the use and the supply of health care services as well as the cost that it requires.. Conclusion: These above described microscopy method can be used to distinguish between benign and malignant thyroid nodules, based on different degree of the capsular collagen fibers orientation.
Colorectal cancer prevalence is increasing worldwide. Modifiable risk factors are responsible for almost 50 % of cases and this could imply a huge potential of preventability. Among these factors the level of physical activity is of paramount importance. Physical activity has a positive impact on health status in general and it decreases the prevalence of various cancers including colorectal cancer. Physical activity decreases the prevalence of benign colorectal adenomas and it prolongs the disease free interval after surgery in colorectal cancer, thus increasing survival. The mechanisms involved are multiple: decreasing bowel transit time, regulating energy balance, decreasing peripheral insulin resistance, decreasing hyperinsulinism, antiinflamatory effects, increasing vitamin D production.
PRO (Patient Reported Outcome) is a clinically based questionnaire filled directly by patients, and other variant types of measures, in clinics and hospitals that gather patients’ stance on their conditions in treatment. PRO is different from Patient Based Outcomes whereby the latter addresses the patient’s concerns but do not necessarily enquire from them. However, PRO gather strictly from patients themselves through interviews, self-administered questionnaires and other available measures. The patient’s perspective on issues that is significant in enacting certain particular clinical policies and regulations such as approval of a medication/drug. Most PROM constitutes one (one- dimensional) or more underlying assessments (multidimensional) connoted as constructs, which bear several levels of scale to assess degree.
Patients with schizophrenia are frequently diagnosed with addictive comorbidities, and data in the literature support a 10 to 70% prevalence of this dual diagnosis. Nonetheless, substance use disorders can be missed during the initial interview with a psychotic patient, if the clinician is focused only on the more obvious manifestations. Therefore, using psychometric scales and structured interviews in patients with schizophrenia is strongly encouraged because the case manager will base his/her therapeutic decisions on quantifiable data about these patients’ symptoms and functional status. Clinical management in dual diagnosis cases must address both conditions simultaneously, as the delay in the initiation of substance withdrawal treatment may hinder the recovery from a psychotic episode. An important issue is represented by the potential pharmacologic interactions between drugs administered for schizophrenia and those targeting substance withdrawal and substance dependence. Other important aspects refer to (1) the therapeutic adherence, which can influence the prognosis of both conditions, (2) the negative impact of residual psychotic symptoms and substance-related disorders over the patient quality of life and daily functioning, (3) the necessity to integrate variables like the patient’s specific needs, lifestyle, and psychological resources in the therapeutic decision. These clinical vignettes are focused on clinical, biological, psychometric, and pharmacological dimensions, supporting the formulation of treatment recommendations based on monitoring both psychiatric and biological profiles.
Objective: The purpose of this study is to compare the capsular structure appearing in follicular adenoma and papillary thyroid carcinoma to differentiate the benign and malignant thyroid nodules. Methods: Second Harmonic Generation (SHG) Microscopy was used to image collagen distribution in the capsules of several types of nodules. The tissue fragments were formalin-fixed, paraffin-embedded but without H&E staining, with 4-5 microns thick sections. From the same sample, two consecutive sections were made. The first was colored with H&E and capsule images were acquired with an optical microscope. The second was not colored with H&E. On the uncolored sample, type I collagen from the capsule was visualized by SHG microscopy. In addition, a parameter was used to study the orientation of collagen fibers, obtained from the Fast Fourier Transform (FFT) analysis of 2D-images. Results: SHG microscopy images were acquired to assess the collagen organization of tumoral capsular thyroid nodules previously diagnosed as benign or malignant by conventional H&E staining. Different degree of collagen fibers orientation was observed from the two kinds of capsules and quantified using FFT analysis. Conclusion: These above described microscopy method can be used to distinguish between benign and malignant thyroid nodules, based on different degree of the capsular collagen fibers orientation.
Making medical countermeasures requires documentation to assess vulnerabilities, threats and operational risks and bioterrorism through the collection and processing of specific multidisciplinary data in human medicine, veterinary, phytosanitary, the environment, defense and national security, etc. Based on retrospective data and late information (medical intelligence), we can estimate the prospective risk to public health, respectively for troops and civilian population in a given area, the area of operations. The biological military or bioterrorist attack, whether overtly or masqueraded as human or animal epidemics can cause a major biological crisis for troops and the civilian population, for domestic and wild animals, for crops or wild plants or for the environment, which remains contaminated. Therefore, it is important to constantly monitor the situation of infectious diseases in the area of responsibility (national territory, operations theaters) to assess vulnerability, threat and bioterrorist risk but also for making medical anti-bioterrorist countermeasures, which can only be effective by genuine cooperation between all specialized structures of the Ministry of Defense, other departments and the civil society.
Vasile Voiculescu (1884-1963), besides being a well-known writer, was also a prominent, much respected physician who practiced between the two world wars. He attended the courses of the Faculty of Letters and Philosophy in Bucharest for a year (1902-1903), but gave up on them in order to attend the Faculty of Medicine. The literary debut took place in 1912 in the journal Convorbiri literare. He published the first volume of lyrical poems in 1916 and in 1918 he was granted the Academy Award for lyrical volume From the Aurochs Country and other poems. In 1935 he became a member of the Academy of Sciences of Romania and in 1941 he received the National Poetry Prize. The following volumes of poems are: Ripeness (1921), Poems with Angels (1927), Destiny (1933), Ascent (1937), Gleams (1939). His work also includes a short story: The Demiurge (1943). Shakespeare's last imaginative sonnets in Vasile Voiculescu’s translation (1964), and the novel Zahei-The blind (1966), Sentimental Gymnastics (1972) are published posthumously. The present article is aimed at revealing the world of Voiculescu’s short stories.
