Introduction: Our objective is to review current international guidelines for Helicobacter Pylori treatment and our department`s experience in this field. Materials and methods: Helicobacter pylori is a Gram-negative, microaerophilic bacterium that can be found mainly in the gastric mucus or on the inner surface of the gastric epithelium, infecting up to 50% of the population. Colonization with this bacterium is not a disease in itself, but can cause chronic gastritis, peptic ulcer, gastric cancer and MALToma. Because of this, infection with H. pylori continues to be a major healthcare burden, especially in less-developed countries. A multitude of non-invasive tests are available for the diagnosis of Helicobacter pylori infection (blood antibody, stool antigen or urea breath test), but the most reliable method of diagnosis is histological examination from two sites after endoscopic biopsy, combined with either a microbial culture or rapid urease test. Treatment of Helicobacter pylori infection is becoming a challenge, as eradication following standard triple therapy is decreasing worldwide due to increased bacterial resistance against antibiotics, which has led to the development of newer therapies such as the sequential treatment in which a PPI and amoxicillin is given for 5 days followed by a PPI, clarithromycin and metronidazole for another 5 days, or the quadruple therapy based on a PPI, bismuth subcitrate, metronidazole and tetracycline for 10 days. Results and conclusion: H. pylori infection remains one of the most challenging infectious diseases, causing high morbidity and mortality, mainly because none of the actual antibiotic therapies can provide successful eradication.
This study analyzes the satisfaction of the patients with radical prostatectomy according to the signs and symptoms included in the EORTC QLQ – C30 and EORTC QLQ – PR25 questionnaires, including their relation with the health state that influences the pre and postoperative life quality. Fifty patients with prostate cancer in a localized stage were studied and analyzed in a prospective manner and for a period of 12 months, before and 6 months after the radical prostatectomy. In choosing the patients, the common denominator was the use of the same postoperative plan and the lack of postoperative complications, as well as the lack of chronic diseases. Erectile dysfunction, urine incontinence were quite frequent after radical prostatectomy, while the urinary obstruction and the weak urinary stream were less frequent. In this regard, people noticed a significant decrease of life quality. Although the study addressed a small group of patients, the results are similar to those belonging to other clinical studies. Even if the aspect of life quality is more rarely taken into account, the questionnaires regarding the life quality are specific, useful and quite cheap in evaluating different therapies.
Background and objective: Contrast-enhanced ultrasound, used to assess atherosclerotic carotid plaques, improves visualization of vessel wall irregularities and depicts intraplaque neovascularization. This article illustrates the use of contrast-enhanced ultrasound in the risk assessment of carotid atherosclerotic lesions, especially in challenging plaques evaluation. Materials and methods: For 23 patients with difficult duplex ultrasound examination due to carotid tortuosity or calcifications we assessed plaque morphology (contour, echogenicity and stenosis degree) using contrast substance (Sonovue, Braco) with dedicated vascular low mechanical index CPC software. Conclusion: Contrast-enhanced ultrasound is a new, noninvasive, and safe procedure for imaging carotid atherosclerotic lesions. It is a valuable tool for evaluating the vulnerable plaque at risk for rupture and for the diagnostic of the development and severity of systemic atherosclerotic disease
Introduction: Current diagnosis of prostate cancer is based on transrectal ultrasound guided random biopsies. These procedures alongside with the discovery of PSA lead to a tremendous improvement of prostate cancer diagnosis rate in the last decades. Random ultrasound guided biopsy has its minuses and several attempts were made to improve the detection rate of the disease. MRI-US fusion targeted biopsies is one of them. Aim: This paper is a literature review of several important European studies and tries to draw a conclusion for the usefulness of MRI-US image fusion prostate biopsy in improving prostate cancer detection Material and methods: We have analyzed 5 papers published since 2013 which compare random ultrasound biopsies with MRI-US fusion. The analyzed parameters were clinical significant cancer detected as described by the study and any cancer detected Results: All 5 papers show superiority in cancer detection rates for both clinically significant and any cancer. Conclusions: MRI-US is a useful tool for improving detection rate of clinically significant prostate cancer. INTRODUCTION in general Prostate cancer is a serious public health matter, being the first cancer in men in terms of incidence and the second cause of cancer death in the U.S. in the Cancer, following year cardiovascular diseases as the leading cause of mortality. Prostate cancer, in particular is becoming more and more important due population aging. [1] is taught to surpass While throughout the history prostate cancer was poorly understood, with few cases recorded due to the low life expectancy, during the XXth century groundbreaking understanding, diagnosing and treating the disease. discoveries were made in Early diagnosis methods included open transperineal biopsies, blind transperineal needle biopsy and finger guided transrectal biopsy. First attempts to use transrectal ultrasound for prostate imaging were made by Takahasi and Ouchi in 1963 but they in 1968 obtained poor performed first clinical useful TRUS. In 1989 Hodge and al. started the modern era of standard sextant [2]. Watanabe images 1 Carol Davila Central University Emergency Military Hospital, Bucharest 2 Saarbrucken, Germania 3 Carol Davila University of Medicine and Pharmacy, Bucharest 5
The major practical advantage of the direct oral anticoagulants (DOACs), comprising the thrombin inhibitor dabigatran and the factor Xa inhibitors apixaban, edoxaban, and rivaroxaban, over vitamin K antagonists is their fixed dosing without the need for laboratory monitoring. With the recent, rapid introduction of the DOACs for the treatment of acute venous thromboembolism (VTE), clinicians are now faced with various questions regarding the efficacy and safety of these compounds overall and in specific high-risk populations. The collective evidence from 6 large clinical trials involving 27,000 patients has demonstrated that DOACs are as effective as vitamin K antagonists (VKA) in preventing recurrent VTE while being associated with a significantly lower risk of major bleeding. These findings are consistent in subgroups of patients with pulmonary embolism, the elderly, and those patients with a high body weight or moderate renal insufficiency, making these agents suitable for a broad spectrum of patients with VTE. DOACs are also an attractive treatment option in patients with VTE and concomitant cancer, thrombotic antiphospholipid syndrome, or heparin-induced thrombocytopenia, but the currently available clinical data is insufficient to make evidence-based recommendations on the use of DOACs in these settings. Several studies evaluating the efficacy and the safety of DOACs in these high-risk populations are underway.
These days marks 30 years since the Chernobyl nuclear accident, followed by massive radioactive contamination of the environment and human in Belarus, Ukraine and Russia, and resulted in many deaths among people who intervened to decrease the effects of the nuclear disaster. The 26 April 1986 nuclear accident contaminated all European countries, but at a much lower level, without highlighted consequences on human health. In special laboratories, the main radionuclides (I-131, Cs-137, Cs-134 and Sr-90) were also analyzed in Romania from environmental samples, food, even human subjects. These radionuclides caused the population to receive a low dose of about 1 mSv in 1986 that is half of the dose of the natural background radiation (2.4 mSv per year). As in all European countries (excluding Ukraine, Belarus and Russia) this dose of about 1 mSv fell rapidly by 1990, reaching levels close to ones before the accident at the nuclear tests.
Military Medical Service is able for detection, identification and confirmation of biological agents; it is part of medical protection against CBRN weapons. We are specialized capabilities for in vitro tests, under construction, the maximum containment laboratory designed for work with Risk Group Microorganisms. An efficient primary containment system must be in place, consisting of one or a combination of the following: Class III safety cabinet laboratory, passage of two doors, suit laboratory, controlled access, controlled air system. Negative pressure in the facility, supply and exhaust air must be HEPA-filtered, decontamination of effluents, sterilization of waste and materials, airlock entry ports for specimens, materials and animals must be provided etc. Complementary is an Animal facility for in vivo tests. This is suitable for work with animals that are deliberately inoculated with microorganisms in Risk Group.
Gut microbiota is a superorganism involved in homeostasis and in pathogenesis. Microbiota composition is influenced by several factors such as: type of birth (cesarean or natural), role of age, role of diet. Pathological consequences of certain type of diet (especially western type of diet) may, in fact, be mediated by gut microbiota alteration. Also few studies have investigated the issue of gut microbiota composition in patients suffering of colorectal cancer, several reports notice relevant differences. Certain pathogenic bacteria in gut microbiota have been extensively studied in relation to their role in colorectal cancer. Thus, Fusobacterium nucleatum, which is abundant in colorectal cancer patient’s colon, may initiate the progression from adenoma to adenocarcinoma. A suggested pattern of oncogenesis in colorectal cancer may be represented by this: dysbiosis-inflammation-oncogenesis. A metanalysis that has been published in 2006 concluded a protective role of probiotics in colorectal cancer and in colonic adenoma.
Heart failure is the final stage of evolution of a large number of cardiovascular diseases and represents a health problem worldwide, due to increased prevalence of cardiovascular diseases. The patients with heart failure with preserved ejection fraction (HFpEF) represent about a half of the patients with heart failure and the prevalence of HFpEF is on the rise. HFpEF is mainly a disease of the elderly patients, who have numerous cardiovascular diseases – hypertension, myocardial ischaemia, atrial fibrillation, valvular disease, and also non-cardiovascular comorbidities, such as obesity, diabetes mellitus, chronic kidney disease, chronic obstructive pulmonary disease, and obstructive sleep apnoea. HFpEF is more prevalent in women than in men, but women have a better prognosis than men. The pathophysiological changes that appear in HFpEF are: ventricular stiffening, cardiomyocite hypertrophy and hypercontractility, myocardial fibrosis and inflammation, which lead to abnormal diastolic function with delayed relaxation and inappropriate filling, in the presence of a normal systolic function of the left ventricle. The diagnosis of HFpEF is based on clinical, echocardiographic and biological criteria. In contrast to HFrEF, there is no effective treatment for HFpEF. The treatment of HFpEF includes diuretics for clinical improvement and treatment of comorbidities. The prognosis of patients with HFpEF is similar with those with HFrEF. Currently, the main objectives of the treatment in patients with HFpEF are to improve clinical status and decrease hospitalizations. Further studies are needed to establish an effective treatment to increase survival in these patients. Therefore, HFpEF continues to be a challenge for clinicians regarding the optimal therapy..
