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.
Yolk sac tumor or endodermal sinus tumor is a rare malignant ovarian germ cell tumor (is a borderline tumor) diagnosed in young females up to 25 years old. Histopathological it resembles the mesenchyme of the primitive yolk sac. Microscopically it presents the following triad: Schiller-Duval bodies, reticular aspect and PAS+ hyaline droplets (α-fetoprotein). The diagnosis of Yolk sac tumor is made by dosing serum α-fetoprotein, ultrasound and MRI – DWI imaging. It requires surgical treatment, followed by chemotherapy (new therapies – platin or carboplatin, etoposide, bleomycin) [1]. Survival prognosis at 5 years is of 80% for stage I. Differential diagnosis is with Brenner tumor, ovarian clear cell carcinoma, dysgerminoma, malignant teratomas, androblastoma, dermoid cyst.
From an anatomical perspective, the dental pulp is a connective tissue with a specific microcirculatory system with repairing abilities in order to preserve the vitality of the pulp15. Different therapeutic methods in treating the affected dental pulp can be compromised by different factors and can lead us to failure. Due to disorders emerged in the microcirculatory system, the treatment of the affected dental pulpin patients with type 2 diabetes is an additional challenge. Type 2 diabetes can impact different functions of the patients’ immune system, with a predisposion to chronic inflammation, progressive tissue degradation and reduced tissue repairing15. Regarding the endodontic therapy of the affected dental pulp in patients with diabetes mellitus (DM), an important role in the treatment of pulpal complications is played by the calcium hydroxide which is considered „the golden standard” because of its excellent properties, the very alkaline pH being one of the most important.
Introduction: The gastrointestinal stromal tumors (GIST) are dominated by KIT and PDGFRA mutation. The immunohistochemical detection of CD117, a protein express by KIT gene, is essential for the diagnosis and those that are negative always represented a diagnostic challenge Case reports: In this article we present a series of 4 cases of CD117 negative GIST tumors, diagnosed and surgically resected in Fundeni Clinical Institute and an overview of the histogenesis, diagnostic problems and management of c-kit negative GIST. All patients were males and the tumors were located in the stomach and small bowel. Conclusion: It is important for the pathologists to beware of the fact that a CD117 negative in the context of a typical morphological appearance does not exclude a GIST tumor and also the oncologist must be aware not to exclude the therapy with imatinib based on the negativity of CD117.
Radical prostatectomy is the gold standard treatment for patients with localized prostatic cancer, but often the pathological diagnosis reveals a locally advanced stage. The aim of this paper is to present the oncological follow-up after radical prostatectomy on a group of 42 patients, patients which have been diagnosed after surgery with a more aggressive stage, locally advanced PCa. Over a period of four years 136 patients have undergone radical prostatectomy. The pathological examination has established that 42 patients presented extracapsular invasion and/or lymph node invasion. 18 patients (pT3-4N0M0) have undergone radiotherapy alone and 24 patients (8 pN1 and 16 pT3-4N1M0) have received androgen deprivation therapy in association with radiotherapy. Over the next two years 15 patients presented biochemical recurrence. For these patients chemotherapy was initiated, but in two cases PSA increase has been observed during periodic evaluation. Although it is not uncommon that postoperatively the histopathological examination establishes a more aggressive disease stage than that established before surgery, radical prostatectomy remains the solution for the localized prostate cancer, solution that can be boosted by radiotherapy and/or androgen deprivation therapy.
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
The evolution of the endoscopic skull base surgery in the last ten years had led to the development of new surgical reconstructive techniques. In the endoscopic reconstructive surgery of the CSF leaks both synthesis and natural materials. The advancement of the endoscopic reconstructive surgery was closely linked with the production of new synthesis materials. The aim of the paper is to compare the efficacy of synthesis versus natural materials in the closure of CSF leaks and to point out certain rules of when and where to use a synthesis or natural material. INTRODUCTION In the reconstructive surgery of the skull base, the surgeon can use both natural and synthesis materials. The developments of the endoscopic surgery of the skull base had led to removing bigger tumors from high-risk areas that were not suitable for endoscopic surgical approach up to now. The endoscopic surgical approaches tend to replace the external approaches even in malignant tumors of the skull base in selected cases. Because of that, the surgeon started to encounter more defects at the level of the skull base with or without CSF leaks. New surgical reconstructive techniques started to be developed in close connection with the production of new surgical reconstructive materials and adhesives. [1] The materials used in the reconstruction of the skull Corresponding author: Silviu Pițuru piturus@yahoo.com base defect can be divided in autologous tissue and synthesis reconstructive materials. Autologous tissues that are used in the reconstructive skull base surgery are: fascia, cartilage, bone, fat, free mucosal grafts, vascularize flaps and free flaps with micro anastomosis. Fat can be used to obliterate dead space or to plug a CSF leak.[1] Fascia lata or fascia temporalis can be placed in an underlay technique between the dura and the skull base or overlay technique in the sinus cavities. Multilayered fascia lata was the effective especially management of open cisterns or in cases of another type of high-pressure CSF leak.[2] in Bone or septal cartilage are placed in the underlying tech- 1 The “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania 2 “Prof. Dr. Dorin Hociotă” Institute of Phonoaudiology and Functional ENT surgery, Bucharest, Romania 29
During the COVID outbreak, many hospitals were nominated as a support hospital for the treatment of positive tested patients infected with SARS CoV-2 virus. “Dr. Nicolae Ruşdea” Pneumophtiziology Hospital Baia Mare carried out an exceptional activity compared to the previous year considering the current epidemiological context. Major changes were made in strategies, procedures and protocols. The staff had to adapt to the new epidemiological situation through dedication and devotion. In 2020, there were no COVID outbreaks within the unit, as separate compartments were made, intended to protect the medical personnel, but also to ensure the health of the patients.
Background and Aim: All hospital services are carried out to serve the patient, which is the main axis in the hospital. Patient satisfaction can be indicative of the right performance service delivery and is considered a reliable source for evaluating the quality of health care. The present study was conducted to evaluate the satisfaction rate of discharged patients in a Navy hospital. Methods: The descriptive cross-sectional study was performed on 220 discharged patients selected by convenience sampling in a Navy hospital during 2019. The data gathering tool was the Patient Satisfaction Questionnaire designed by Amerioon in 2009 and its validity and reliability were confirmed in 2016. The questionnaire assessed patient satisfaction in two healthcare sections with 21 questions and three dimensions of hygiene, nursing and physician services, and non- health care with 27 questions and six dimensions of acceptance, staff attitudes, nutrition, welfare, facilities, religious issues, and refines evaluation. Data were analyzed by SPSS software version 18. Results: The patient satisfaction in the medical and non-medical wards was 88.1% and 86.57% respectively. Satisfaction in the medical and non-medical wards was excellent at all dimensions. There was a significant relationship between satisfaction with the cause of referral, and level of education (P 0.05). Conclusion: Considering the high level of patients 'satisfaction in medical and non-medical services, patient satisfaction in medical services was slightly higher than that of non-medical services, this highlights the need for independent research in this area and the actions taken by hospital managers to improve satisfaction in these sectors. It is also suggested to consider patient satisfaction as part of the discharge process in all hospitals
