Archive issue

Current Health Sciences Journal

vol. 36 no. 4, 2010

1. Early Diagnosis And Screening In Colorectal Cancer Patients

Al. Mihalache, Liliana-Elvira Donoiu, I. Rogoveanu

The utility of a population screening program for colorectal cancer was demonstrated, but there are unresolved issues: to whom the program addresses, which are the methods to be used, when are they to be used and what are the costs. For an efficient screening we must identify the patient’s level of risk by asking simple questions about personal and family medical history. The current screening methods are: the hemoccult test, rectosigmoidoscopy, colonoscopy, irigography, virtual colonoscopy and fecal DNA tests. Although there are many new methods of screening for colorectal cancer, they are still under evaluation.

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2. Helicobacter Pylori And Gastric Carcinogenesis

Diana Stanculescu , Rodica Taslica, Cristiana Simionescu

Gastric cancer is the fourth most common cancer worldwide, with a frequency that varies greatly across different geographic areas. The Lauren classification of gastric carcinomas recognizes the intestinal and diffuse types that differ substantially in epidemiology and pathogenesis. The most important etiological factor associated with both intestinal and diffuse type of carcinoma is Helicobacter pylori, recognized as a definite carcinogen for gastric cancer. The complex interrelation between Helicobacter pylori strain, inflammation and host characteristics may directly promote diffuse type gastric cancer or induce a cascade of morphological events, i.e. atrophy, intestinal metaplasia and dysplasia, leading to intestinal type gastric cancer. The sequential process of carcinogenesis involves mutations in oncogenes, tumour suppressor genes and cell cycle and mismatch repair genes.

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3. The Mechanisms Of Urothelial Carcinogenesis: A Literature Review

A.E.Stepan, Corina Maria Dochit, C. Albita, Cristiana Simionescu

The present direction of research activities in bladder cancer case is that to find practical applications of biomarkers utility. Urothelial carcinogenesis represents a complex process which implicates a lot of abnormal biomechanisms, like proliferation, angiogenesis, lymphangiogenesis, apoptosis, loss of the cellular phenotype, extracellular matrix alteration. Every of them can be investigated starting from histopathological features and finishing with biomolecular analysis.

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4. Renal Artery Stenosis Due To Ischemic Nephropathy

Alina-Gabriela Pauna

This paper approach a relatively old problem: renovascular hypertension in atherosclerotic renal artery stenosis, and a relatively new one: ischemic nephropathy. In recent years, ischemic nephropathy has been recognized as a cause of increasingly frequent chronic renal failure that requires initiation of alternate therapy failure. This has led to the develop-ment of new methods of diagnosis and treatment of vascular stenosis, such as Duplex ultrasonography, spiral CT, MRI angiography, selective renal angio-graphy that provide morphological and functional proper diagnosis in all cases. Were followed 386 patients with renal failure (203 with acute renal failure and 183 with rapidly progressive renal failure) hospitalized in Depart-ment of Nephrology, “St. John” Emergency Hospital Bucharest between 2006 and 2009. Of these, 85 patients had hypertension and were investigating the direction of possible secondary hypertension, renal origin. Only 16 were found to have renovascular hypertension and were the group of interest in this article. Have been performed screening tests for possible renal artery stenosis: with and without renal scintigraphy, Doppler ultrasound, renal arteriography. Scintigraphy changes were present in 11 of the 16 patients before Captopril administration. At four of them, the changes occurred after Captopril administration. Doppler ultrasound was performed at seven of the 16 patients watching the morphology of renal arteries, blood flow aspect, velocity and resistivity indices. Only five of the seven patients had changes suggestive, the two could not be performed because of obesity. Arteriography has been performed at all patients and showed atherosclerotic lesions at 11 patients (five of them with bilateral lesions), fibromuscular dysplasia in three patients (one with bilateral lesions), one case of abdominal aorta with dissection extended to the renal arteries and one with renal artery hypoplasia. Corrections artery stenosis was performed in seven patients: angioplasty – one case, angioplasty with stent implantation – five cases and unilateral nephrectomy with angioplasty and contralateral stent – one case. In long term were followed only six patients. Normalization of blood pressure was obtained at one patient (angioplasty on single stenosis without poststenotic dilatation), with normalization of renal function; at the other six, arterial hypertension has improved slightly, with reduction of antihypertensive drugs and stops the deterioration of renal function.

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5. Clinical, Epidemiological And Histopathological Prognostic Factors In Oral Squamous Carcinoma

L. P. Dragomir, Cristiana Simionescu, Luminita Daguci, Monica Searpe, Manuela Dragomir

he study that was carried out was comprised of 117 cases of oral squamous carcinomas, selected in two years interval, between 2007-2008. The tumors were diagnosed especially at patients between the ages of 50 and 79 years, 96,6% being over 40 years old. It came out a clear predominance of the male sex in approximatively 90% of the cases. The main localisation was the lower lip and the tongue ( 67,5% ), in approximatively equal proportions ( 35% and 32,5% ). The histopathologically analisys releaved that 37,6% were well differentiated squamous carcinomas, 27,4% were moderately differentiated squamous carcinomas and 35% were poorly differentiated squamous carcinomas. Out of these 3,3% were microcarcinomas, 91,9% were non-metastatic invasive carcinomas and 4,8% were invasive carcinomas with metastatic adenopathy.

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6. Imaging Assessment Of The New Vasculature Of The Prostate Cancer – A Non-Invasive Tool Of Diagnostic And Prognostic

R. Berisha , Aristida Georgescu , A. Bondari , N. Boutsiadis, K. Boutsiadis

More than 46% of men older than 50 years could have at least microscopic cancer in their prostate glands. Because the morbidity of treatment may outweigh its benefits, in Europe it is common not to treat for prostate cancer (CaP) asymptomatic men older than 70 years. CaP screening is based on the serum concentration of prostate specific antigen (PSA) and digital rectal examination, which have a low sensibility and are followed by “blind” systematic biopsy with negative results in the most cases. Purpose: To illustrate and present an analysis of the new vasculature features of CaP on Doppler Ultrasound, multidetector enhanced CT and MRI. Materials and methods: We performed a prospective study between June 2008 and July 2010 of the prostate vasculature demonstrated on Doppler US in 53 consecutive patients (range 28-77 years); among them 21 performed MRI exam and/or multislice CT. Results: 21/53 patients presented clinical, biological and/or US abnormal findings and underwent further imaging exams; among them 18 were finally diagnosed with CaP. Another 3 patients with abnormal Doppler US were directly biopsied with malignancy proved in 2 cases. The PPV of Doppler US was 83%. The MRI findings in 19 patients confirmed the abnormal vasculature and further targeted/ surgical biopsies proved malignancy in 17 cases (PPV 89%). Conclusion: CaP presented more vasculature as compared with the non-cancer areas in Doppler US, spiral CT and MRI on the same patient. Even in early stages, when no evident tumor mass was present on the imaging exams, we suspected cancer when the pericapsular vessels were enlarged or presented high flow (Doppler, MRI). MRI had better sensibility, but we agree the Full Prostate Ultrasonography, including Doppler exam and Sono-Elastography, will be soon the best non-invasive, available and low cost imaging method of detection, follow-up and guided targeted biopsy of the CaP.

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7. Anatomical Variation of The Origin, Course And Distribution Area Of The Radial Artery

Ileana Dinca,O. M. Marginean, Th. Dumitrescu, M.V. Baluta

The study of the anatomical variations draws the attention of the surgical medical practice on the fact the vessels may differ from the classic description, regarding their origin, trajectory and distribution territory. Dissection performed for didactic purpose was made upon 7 subjects; this revealed a case where the radial artery had high origin, was distributed to the anterior brachial space, with a superficial course into the upper half of the forearm. In the same subject, the variation described above was found only in one arm.

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8. Therapeutical Approach Of Facial Hemangiomas

T. N. Sas, K. Boutsiadis

Cutaneous hemangiomas and complex vascular malformations are the most frequent benign vascular tumors of childhood. The frequency of up to 10% of children under one year, affecting of young ages, and the disabling effects of physical and mental, infantile hemangioma (IH) is a real public health problem. Seldinger technique involves approach of percutaneous puncture of the artery followed by the introduction of guide wire through the needle but thinner than that, after extraction needle is drag coaxial catheter size larger than guide wire or needle. Selective carotid arteriography involves selective opacification of the common carotid artery and its branches. The way the approach is currently used by catheterization transfemural using Seldinger technique. This allows exploration of both carotid and vertebral artery, possibly via the same catheter. Most diagnosed hemangiomas showed a segmental distribution. According to studies by Haggstrom, identifies four facial segments: frontotemporal (SI), Jaw (S2), mandibular (S3), Frontonazal (S4). Most hemangiomas are diagnosed interested in two or more regions of facial anatomy (78 cases). Mandibular region was most affected (32 cases), followed by zygomatic region (29 cases) and frontal (24 cases). Hemangiomas in early stage growth can be rapid and unpredictable. Prompt therapeutic intervention can prevent the evolution phase of rapid progress, preventing the emergence of large Hemangiomas. In terms of locoregional extension, HI mass can be complicated by ulceration, necrosis or infection. The evolution of modern anesthesia techniques, laser therapy, surgical and medical methods allow effective intervention to treat those lesions considered in recent years as having unacceptable results, allow safe treatment of hemangiomas preventing unnecessary psychological sequelae of children due to the presence of facial hemangiomas.

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9. The Impact Of Non-Steroidal Anti-Inflammatories Therapy Applied To Degenerative Diseases Of The Lumbar Spine

T. Miserlis, V. Cirlig, C.I. Taisescu

The lumbar pain caused by degenerative diseases is an extremly common cause of morbisity and incapacity, that determines the patient to address to qualified medical staff. Our study is meant to perform a quantifiable evaluation of lumbo-sacral muscle ligament syndromes and a recuperating programme that consists of stages as well; moreover, the efficiency of this treatment programme is proved, as it prevents the installation of recidives and/or complications, that appear on a frequent basis and determine functional implications that are often important. The study has integrated the patients into a sustained physical programme, in stages, in 3 phases, after 1 month and 306 months respectively, by applying anti-inflammatory medicines +/- decontracturant, sustained thermo-kineto-massoterapic. The obtained results underline the ascending and remanent improvement of clinical parameters, from one stage to another, until the third phase of the treatment takes place, to partially complete functional recuperation of diseases (over 90% as opposed to the initial stage). Therefore we can say that, in the case of patients that present lumbar pain, nonsteriodal anti-inflammatory medicines can lower the severity of the pain, and in the case of patients who present difficulty in turning back in their activity, the clinicians should address personal and psychosocial occupational barriers. Moreover, multidisciplinary programmes may facilitate a shorter incapacity period, at the same time with the lowering of the pain and the improvement of functional performances.

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10. Therapeutic Problems In Complicated Liver Hydatid Cyst Title

M. Pirscoveanu, M. Munteanu, P Manescu, Anca Ruxanda, L Vasile

The treatment of the liver hydatid cyst is by far from being well codified and continues to be the subject of countless medical contradictions. The numerous surgical therapeutic methods proposed are approved or disapproved by various surgeons, so that it is very difficult to appreciate the value of a surgical procedure which appears very efficient in certain statistics but which generates complications and new surgical interventions in other statistics. This is mainly due to the structural and evolutional polymorphism of the liver hydatid cyst. The apparition of the complications in the evolution of the liver hydatid cyst, encountered in more than one third of the cases, raises even more problems concerning the choice of an ideal therapeutic conduct. In the present study we have tried to make an analysis of the surgical treatment types used in complicated liver hydatid cyst and we pursued the morbidity, the mortality and hospitalization duration for each surgical procedure used.

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11. Histo-Anatomical Researches on the Leaf of Fraxinus excelsior L. Species

Monica Gabriela Tita, D. Lupuleasa, G.D. Mogosanu

In this paper, the authors present the results of the histo-anatomical researches on the leaf of Fraxinus excelsior L. species, from which the medicinal product Fraxini folium is obtained.

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12. Determination Of Easily Hydrolysable Nitrogen In Meat Products

Mariana - Luminita Neacsu, L. Chirigiu, Maria - Viorica Bubulica

Growth and fermentation process of meat acidity is favored by muscle glycogen level. Fermented meat or "hot meat" contains a relatively high amount of acid, hydrogen sulfide but has very little alkali or ammonia. But under the influence of bacteria, typical decay processes occur which is actually classical method of altering and insanitary meat. Results depend on the nature of bacterial products, which are acting on anaerobiosis or aerobiosis as septic nature of meat in animals with bacteremia. In general, aerobic bacteria initiate and facilitate the action of the anaerobic and the result is very complex.

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13. Epidemiology And Risk Factors In Carcinomas Of The Large Bowel

Corina Lavinia Gruia, CT Streba, Corina Maria Dochita, CC Vere, AG Ionescu

Colorectal carcinoma (CRC) represents one of the most common types of carcinoma in both males and females, being encountered mainly in developed countries. North America, Australia/New Zeeland, Western Europe and Japan represent geographic regions with the highest incidence. Approximately 10% of the CRC appear as a result of inherited genetic defects. Lifestyle is undisputedly an important risk factor which influences the apparition of CRC. Alimentation, both quantitatively and qualitatively; alcohol, by inducing cellular proliferation and inhibiting DNA repair as well as smoking, are closely connected with an increase in the risk for CRC. Ulcerative colitis represents a major cause of CRC. The risk for malignization is 2% after 10 years and 18% after 30 years of inflammatory affect. Many of the symptoms of CRC are vague and non-specific (abdominal pain, constipations or diarrhea), some of them being the same in benign pathologies. Recent progresses gave birth to several national screening programs, having a positive effect on the increase in survival rate for CRC patients.

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14. Diarrhea with Rotavirus in Children

Cristina Singer, Polixenia Stancu, Simona Cosoveanu, Loredana Osiac, Coca Grigorie, Alina Botu

The rotavirus is the most frequent etiologic agent of the acute diarrheic disease in infants and young children worldwide. It is globally estimated that rotaviruses are annually responsible for more than 111 million cases of infantile gastroenteritis and approximately 600,000 deaths. As a result of the high morbidity and mortality, the diarrhea with rotavirus represents a major health problem. The research in the field of the antirotaviral vaccination revealed new possibilities of reducing the frequency of the diarrhea caused by this virus. The present paper contains the disease epidemiology, morphology, pathogeny, transmission, clinical aspects, diagnosis, treatment and prevention.

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