Oxidative stress plays a major part in the development of chronic and degenerative diseases such as cancer, arthritis, aging, autoimmune disorders, cardiovascular and neurodegenerative diseases. Cardiovascular disease is the leading cause of death in the United States and Europe and is poised to become the most significant health problem worldwide. Reactive nitrogen species are involved in the regulation of cardiovascular motor tone, modulation of myocardial contractility, control of cell proliferation and inhibition of platelet activation, aggregation, and adhesion. Cellular constituents of our body are altered in oxidative stress conditions, resulting in various disease states. The oxidative stress can be effectively neutralized by enhancing cellular defenses in the form of antioxidants. To understand the mechanism of action of antioxidants, it is necessary to understand the generation of free radicals and their damaging reactions.
Breast carcinoma represents the leading cause of oncologic mortality for women. Due to therapeutic and diagnostic advances, the mortality and morbidity in the last decade declined, but breast cancer still has a great impact on quality of life and also on medical service cost. In the light of these facts, an integrated approach, considering histopathology features, molecular profiles and corroboration with clinical and imagistic data is necessary. A descriptive retrospective one-year study analyzed the breast cancer heterogeneity in 121 cases registered in the Pathology Department of the University Emergency Hospital in Bucharest, Romania. Our purpose was to evaluate histopathological, immunohistochemically, clinical and imagistic aspects of breast cancer considering the current molecular classification (Luminal A, Luminal B, HER2 enriched and triple negative/basal like). Our assay revealed that most prevalent histotype was NST (no special type) followed by invasive lobular carcinoma. Considering the molecular pattern, the most common was luminal B. Triple negative basal like and HER 2-enriched were correlated with an aggressive morphologic pattern and lymph-nodes positivity. Considering the imagistic acquisitions, mammography proved to be the most accurate technique for measuring the dimension of NST. In conclusion, breast carcinoma is a heterogeneous disease that needs an integrated approach and personalized treatment based on the histopathologic and molecular features. Considering the great number of advanced stages as diagnosis, a national screening program for breast cancer is imperiously needed.
Gingival conditions are frequently encountered in dental clinical practice and they can raise diagnosis and treatment problems. The diagnostic is variable from normal conditions to autoimmune diseases or even malignancy. Some of them cause disturbances such as pain, burning sensation and have an impact on patient’s quality of life.
The purpose of this paper is to provide information about mortality rate in patients undergoing primary angioplasty for STEMI. Cardiovascular diseases lead to one third of the deaths worldwide, surpassing the mortality rate produced by neoplasia, acute respiratory failure and diabetes mellitus all together. In the world, approximately 17 million die annually because of cardiovascular disease and every 5 seconds one is suffering from a myocardial infarction. In 2010, in our country was implemented a national program (RO-STEMI) to offer rapid interventional treatment for patients with STEMI, aligned to ESC Guidelines. At the beginning only small parts of the patients were transferred to the hospital in charge for STEMI, so, we chose to study patients from the second year of the program and from last year. We made a retrospective study, including patients with STEMI that reached our hospital for primary angioplasty in the first 12h after the debut of the symptoms, aiming to make a parallel between the in-hospital mortality rates at maximum one month after the primary PCI. In order to be included, the patients must present ST elevation and another 1 out of 3 criteria (clinical, echocardiographic and biological changes suggestive for myocardial infarction). The main target was to evaluate the evolution of early mortality rates post primary PCI after the changes in the ESC Guidelines and the progresses in the medical field. A secondary target was to correlate mortality rates with the presence of comorbidities or risk factors. INTRODUCTION Alexander Muirhead is reported to have attached wires to a feverish patient's wrist to obtain a record of the patient's heartbeat in 1872 at St Bartholomew's Hospital.[1] Another early pioneer was Augustus Waller, of St Mary's Hospital in London.[2] His electrocardiograph machine consisted of a Lippmann capillary electro- meter fixed to a projector. The trace from the heartbeat was projected onto a photographic plate that was itself fixed to a toy train. This allowed a heartbeat to be recorded in real time. in Leiden, working the Netherlands, used the string galvanometer first practical electrocardiograph) he invented in 1901.[2] (the than both This device was much more sensitive the capillary electrometer Waller used and the string Galvano- meter that had been invented in 1897 by the separately engineer Clément French Ader.[3] An initial breakthrough came when Willem Einthoven, Einthoven had previously, in 1 Carol Davila University Central Emergency Military Hospital, Bucharest 2 Titu Maiorescu University, Faculty of Medicine, Bucharest 7
Toxoplasma Gondii is a protozoan parasite which causes multisystem affections and unusual clinical outcomes. Although primo- infection takes place frequently during childhood, there is a possibility for it to be found during pregnancy, when it could lead to congenital toxoplasmosis, with serious ocular and cerebral lesions (that can be identified during ultrasound). The positive diagnostic for the mother is made after a serologic test and for the fetus the parasite can be found in the amniotic fluid during amniocentesis. A prompt treatment can avoid the presence of cerebral lesions (hydrocephalus, ventriculomegaly, intracerebral calcifications).
Rotational malalignment complication following TKA, is common but can be avoided with proper surgical technique. This paper reviews the literature regarding rotational alignment during TKA, femoral and tibial rotation, and highlights the techniques prior in obtaining proper rotational positioning, nevertheless correct positioning in all three planes is important. Proper femoral component positioning in the axial plane is done using as landmarks the posterior condylar line (PCL), surgical transepicondylar axis (sTEA), anatomical transepicondylar axis and the trochlear anteroposterior (AP) axis. The paper describes the angular relationships between these landmarks and the distal femur. Axial tibial positioning is done when using intraarticular landmarks, the combination of more than one landmark could be a solution for solving this problem. The consensus is that femoral component should be positioned according to TEA but the interobserver variability of this land mark is very high. The rotation of the tibial component remains an open subject, most studies suggesting a point between half of the distance of patellar ligament and 1/3 of the internal tuberosity as optimal landmark.
Background and aim: Minimally invasive surgery represents the actual tendency in many medical domains including urology. Gaining practical skills for these procedures becomes essential when preparing the future resident physicians in urology. The purpose of this study is to demonstrate that using medical simulation as an education tool improves the practical skills of the urology house officers in laparoscopy by using an accessible tool such as a box trainer. Methods: The study includes the objective and subjective evaluation of the practical skills of 54 students with no experience in laparoscopy. Each participant was evaluated before doing the practical activity on the simulator both in a subjective manner by filling a self-evaluation form and also objectively by timing the duration of doing laparoscopic basic tasks, knot tying and realizing a continuous suture. The participants were divided in two groups (A-28 participants, B-26 participants). Each group executed the same procedures with the same instruments, but with a different teaching technique. Results and conclusions: Medical education with the help of a laparoscopic box trainer simulator is a useful tool for improving practical abilities and the time of execution of general procedures.
Background and aim: Ombitasvir/Paritaprevir/Ritonavir+Dasabuvir in association with ribavirin was the only interferon-free regimen available in 2015 in Romania for compensated HCV cirrhosis. The aim of our study is to reveal our experience with interferon-free therapy in compensated HCV cirrhosis. Materials and methods: We conducted a multicenter prospective study including 90 patients with compensated (Child-Pugh A) HCV cirrhosis treated with Ombitasvir/Paritaprevir/Ritonavir + Dasabuvir and Ribavirin regimen for twelve weeks. The HCV infection was diagnosed using clinical, biological, and FibroMax tests. Each patient had follow-up visits at four, eight, twelve and twenty-four weeks after the initiation of the treatment. Results: 44 (49% of) patients were female and 46 (51 % of) were male. The mean age of patients in the study was 61 years old. All the patients had HCV genotype 1b infection. 22 patients were naive and 68 had previous antiviral therapies based on pegylated IFN-α and ribavirin. At the initiation of treatment 64 (71%) of patients had cytolysis, 38 (42%) had thrombocytopenia, 19 (21%) patients had hyperbilirubinemia and 11 (12%) patients had anemia. It was noticed a decreasing of cytolysis, only 10% of 64 patients still having cytolysis after four weeks of treatment. One patient (1%) died after four weeks of treatment by complications of cirrhosis. 89 (99%) of patients had a virologic response (VR) at the end of treatment (EOT) and sustained virologic response (SVR) twelve weeks after the last dose administration. Conclusion: The most common side effect among the patients in the study group was anemia (47% cases). Cytolysis disappeared after four weeks of treatment in 61% of patients. The interferon-free combination treatment was safe and highly effective in compensated HCV cirrhosis.
Two major trials, EMPA-REG OUTCOME trial (with Empagliflozin) and CANVAS trial (with Canagliflozin) have demonstrated the beneficial effects of SGLT2 inhibitors in patients with type 2 diabetes at risk for heart failure. SGLT2 inhibitors possess a unique pharmacological profile and have shown a significant reduction of hospitalization for heart failure in diabetic patients, immediately after treatment commencement. It seems that their effects are beneficial both in heart failure with reduced ejection fraction and heart failure with preserved ejection fraction. SGLT2 inhibitors reduce cardiovascular endpoints in patients with diabetes and high cardiovascular risk, most likely through a reduction of heart failure-related events. Empagliflozin treatment exerts beneficial effects on vascular function and central haemodynamics. Various mechanisms seem to contribute to the beneficial effects of SGLT2 inhibitors in heart failure. Taking into consideration their cardiovascular benefits and the number of ongoing trials with these drugs, there is a possibility to expand their indication to nondiabetic patients with heart failure. This review focuses on the newest insights into the beneficial effects of SGLT2 inhibitors on the cardiovascular system.
According to literature the primary retroperitoneal malignant pathology is rare, representing less than 0.5% of all malignancies. In spite of its low incidence, this pathology often proves challenging in terms of diagnosis and treatment. The most com¬mon retroperitoneal malignancy is represented by lymphoma that accounts for approximately 33 % of the retroperitoneal malignancies. Other frequent retroperitoneal tumors are sarcomas: leiomyosarcomas and malignant fibrous histiocytoma (in order of incidence). We have analyzed the existing data regarding the most common primary retroperitoneal tumors in order to realize a brief classification and their differential diagnosis considering their clinical, imagistic, histopathological and molecular characteristics. The technological developments that have been made over the years in terms of imaging investigations, as well as in biomelecular and cytogenetic studies have offered new possibilities for of assessing a retroperitoneal mass in order achieve more precise informations that can guide physicians to better distinguish between different types of retroperitoneal tumors and therefore their therapeutical protocol. liposarcomas,
