Chronic liver disease is a late stage of progressive hepatic fibrosis. It consists of functional and structural disruptions in most chronic liver diseases. An accurate diagnosis allows us to establish the degree of fibrosis and the stage of the disease, the prognosis of the patient and to predict a treatment response. Despite the fact that liver biopsy is considered a gold standard, non- invasive methods for diagnosing liver fibrosis have gained more and more importance. Whether we talk about serum biomarkers or imagistic methods from transient elastography to 3-D magnetic resonance elastography, the question remains: are these useful or useless? Serum biomarkers represent blood components that can reflect liver histological changes, thus they can monitor the continuous process of fibrosis. These can be subcategorized in direct (that show extracellular matrix turnover) and indirect markers (that reflect disturbances in the hepatic function). However these markers alone are not as accurate in the staging of fibrosis, only help differentiate patients without or with low grade of fibrosis from those with significant fibrosis and cannot be considered alone in the diagnosis of liver fibrosis. Imagistic methods include: ultrasound-based transient elastography, magnetic resonance elastography (MRE), 2D-shear wave elastography, acoustic radiation impulse imaging (ARFI) and cross sectional imaging, the first being the most used. Using a combination of non-invasive tools allows us to diminish the number of patients in need of liver biopsy. However, the patient must always be informed of the advantages and disadvantages of each method and its limitations.
Da Vinci robotic surgical platform is the result of many years of research of the military physicians from United States Army. This platform was initially intended to operate in close proximity to the battlefield, it was supposed to allow for complex surgeries without threatening medical personnel, but also to ensure a high survival rate among the wounded. Basically, after a soldier was wounded, he was supposed to be taken away from the front line, transported to the first sanitary structure which had this platform available and a surgical team from long distance, satellite connected, performed the surgery. The advantages of this course of action are related to the fact that the team is permanently safe and the injured person benefits from the experience of a welltrained surgical team.
The aim of this paper was to analyze the data obtained from case reports of oral angiolipoma in terms of age and gender distribution, site of occurrence, nature (intraosseous/ extraosseus) and infiltration. an internet search using Google scholar and Pubmed engine was carried out using search terms ‘angiolipoma’ and ‘oral’/‘mouth’. English literature full text articles and abstracts of oral angiolipoma obtained from 1976-2016 were analyzed for clinical data and presented in this article.
Escherichia coli is the species of the genus Escherichia with the greatest epidemiological impact. Escherichia coli infections are found mainly in places with poor hygiene; the infants with ages between 1 and 3 years old are included in the category with the highest risk. It is a "fecal-oral" transmission mechanism as a result of consumption of contaminated food or water, or by "dirty hands". The foods most commonly implicated in the transmission of the infection are unpasteurized milk and milk products, beef, especially the one insufficiently cooked, unpasteurized fruit juice, lettuce and insufficiently washed vegetables. The disease has been reported worldwide, being described numerous episodes of infection with Escherichia coli that caused multiple illnesses and deaths. Escherichia coli has three types of antigens: antigen "O" (somatic), antigen "H" (flagella) and antigen "K" (capsular). Clinical manifestations are present in the form of non-specific diarrhea, a dysentery form of enteritis, choleriform enteritis, hemorrhagic colitis and hemolytic uremic syndrome (HUS). The Escherichia coli infection diagnosis is made by identifying the etiologic agent and/or by highlighting the VTI toxin in the feces. The treatment consists in precautionary antibiotherapy, hydrodynamics and electrolyte rebalancing, blood transfusions and dialysis, if in the case of renal failure. The prevention of infections with Escherichia coli is achieved by personal hygiene, food hygiene and work hygiene.
The continuously increasing number of medical investigations using radiological methods imposes the strong necessity of informing patients about benefits and risks regarding radiation absorbed doses. Tracking the radiation doses absorbed by patients must be a future challenge of any medical system. The effective doses received by patients in many types of medical investigations must be calculated, transformed, recorded and cumulated. Doctors and patients must be very responsible in prescribing or demanding new radiological medical investigations. Radiological international legislation, guidelines, programmers and practice supervised by standards, commissions on radiology protection must include new specific measures for patients’ cumulated doses. A pilot Romanian project had tried to accomplish some of these tasks. INTRODUCTION Radiation is commonly associated with nuclear accidents or modern irradiative artificial sources such as: mobile phones, great antennas, satellites, food irradiation, and radioactive building materials. Generally, radiation is associated with all kind of human activities. As a huge surprise, in fact, radiation is quite a natural phenomenon in our lives. There are many radioactive substances in air, water and soil that are called natural background radiation. During a long airplane flight one can also receive an important radiation dose. Typically doses from natural sources are measured in mSv. The Sievert (Sv) is the International System of Units (SI) derived unit for radiation dose. There are many other different units for absorbed radiation and transformations can be made in order to compare them. A recent United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) publication [1] estimates worldwide distribution of radiation exposure: • 13% from cosmic sources • 16% from soil • 9% from food • 20% from medical investigations • 42% from radon sources Radon-222 is a radionuclide in the form of a gas that normally emanates from the soil. Radon is a colorless, 1 Polytechnic University, Bucharest 2 Carol Davila Central University Emergency Military Hospital, Bucharest 3 S.C. CERTSIGN S.A. Bucharest 5
Osteoporosis is a major health problem, and the economic costs are expected to rise due to an increase in life expectancy throughout the world. Its major consequence is fractures, and especially hip fractures are associated with institutionalization and increased mortality. Homocysteine is an amino acid intermediate formed during the metabolism of methionine. Homocysteinuria is a rare autosomal recessive biochemical abnormality which causes elevated plasma concentrations of homocysteine and severe occlusive vascular disease. In patients with homocysteinuria, there is an increased prevalence of skeletal deformities, including osteoporosis, which is a primary risk factor for hip fracture. The high prevalence of osteoporosis among patients with homocysteinuria suggests that high levels of plasmatic homocysteine may also increase the risk of fractures. Nutritional factors such as vitamins B12, B6, and folate are cofactors in homocysteine metabolism, and vitamin intakes may inversely affect plasma homocysteine levels.
Intellectual mobility brings change, there is the primary factor in the way of progress and optimal premise of human being development from theoretic and practice regards. Medical Higher Education, worldwide, is generally similar in structure and consistency, but different in typology of presentation, teaching, learning and assessment. In fact, general medicine, as a subject refers to the same biological body, but presented differently depending on culture, space and under various methods of teaching and learning. The idiom of intellectual mobility is not new, but according to globalization, which we live at the present times, brought the mobility in the main plan of Europeanization, a new plan, with continues sustainable development and maybe of success. By institutional mobility, both for students and for academic staff, an exchange means a period of one academic year or a semester, for students and, for two days to several months for academic staff, into a foreign university. These stages of study, practice, and teaching take place most frequently within the Erasmus + framework, have been of 30 years in Europe and 20 years in Romania. Also, there are other programs that can perform intellectual mobility, but the most well-known is Erasmus program, where European Commission has allocated the biggest legal and financial budget framework. Overall activity program features has a variety of tools to be deployed and an inter-institutional framework with qualified staff to manage it.
The international situation requires a strengthening of the national security measures, including in the field of CBRN and public health. The upgraded microbiology laboratories from DM/ MND must be operated at full capacity for the operationalization of an integrated Platform for the research and expertise of biological war and bioterrorism agents. This is necessary for reasons of national security, for CBRN defense and for public health, in the context of biological agents of 3 and 4 risk groups’ epidemics. The existing upgraded objectives should be operationalized in order to meet the established scope: scientific research and expertise of biological agents and biological weapons, a laboratory for in vitro analysis and a bio-base for in vivo analysis. The highly secure lab allows working with any high-risk agents: biological, genetic, chemical, radiological, etc., being provided with a special room for the insertion/removal of equipment and their decontamination. Following an increase in the capability requirements concerning laboratories, we have provided in the design concept new technical parameters of the platform and the integration of new compartments with related activities of toxicology, pathology, neuro-psycho-pharmacology, bio-pharmacy, micro- pharmaceutical, specific testing activities, etc. Creating the integrated platform and its operationalization is necessary in order to meet the requirement of the national security strategy as a collective CBRN defense/protection facility and military-medical scientific research for CBRN medical protection.
Introduction: Tuberculosis (TB) is still one of the most frequent infectious diseases, causing 2 million deaths a year worldwide. The prevalence of TB has increased in both immunocompetent and immunocompromised and virtually, it can affect any organ. Up to 25% of tuberculosis cases present extra-pulmonary involvement. The diagnosis of extra-pulmonary TB (EPTB) is difficult, often requiring biopsy. Material and methods: We present two cases of EPTB in immunocompetent young women. The first case is about a 15-years old female who presented with persistent high fever, ascites and an increased CA-125 serum level. Biochemical analysis of ascites fluid revealed a high value of adenosine deaminase (ADA), negative Ziehl-Neelsen stain and undetectable Mycobacterium tuberculosis at PCR assay. The peritoneal biopsy confirmed the diagnosis of peritoneal TB. The second case, a 29-years old female with a seven-month history of cervical lymph nodes swelling, with drainage and excision biopsy performed, misdiagnosed as cats-scratch disease based on the histological description as granulomatous lymphadenitis, which turned out to be tuberculous lymphadenitis at the second histopathological opinion. In conclusion, these cases highlight the need for tuberculosis consideration in the differential diagnosis of extra-pulmonary involvement, even in immunocompetent individuals, in order to decrease the misdiagnoses and complications rates.
