Archive issue

1. The evaluation of beta-2-adrenoreceptors’expression in normal peritumoral tissue in patients with colorectal adenocarcinoma

CRISTINA FLORESCU(1), GEORGICA-COSTINEL TARTEA(2), C.T. STREBA(3), NICOLAE-DANIEL PIRICI(4), ILEANA PUIU(5), ELENA-ANCA TARTEA(2), MIRELA GHILUSI(6), MARIA VICTORIA COMANESCU(7), ION ROGOVEANU(3), CRISTIN-CONSTANTIN VERE(3)

Introduction: The aim of this study is to evaluate the expression of beta-2 adrenergic receptors in the normal peritumoral tissue at the colorectal level, just after the front tumor invasion, in patients with colorectal cancer Methods: In this study we analyzed normal peritumoral tissues belonging to 56 patients, who were diagnosed with colorectal adenocarcinoma. These tissues were fixed in paraformaldehyde and paraffinembedded. The immunohistochemical study was done on seriate slides following the hematoxylin and eosin staining, after diagnostic and grading. Correlations were made between beta-2-adrenoreceptors’ expression in the normal peritumoral tissue and the clinical and histopathological parameters of the patients with colorectal cancer. Results: There are positive correlations between the expression of beta-2-adrenoreceptors and feminine gender, age group under 50 years, tumor size under 5 cm, tumor invasion T3-4 and tumor metastasis in regional lymph nodes N?2. By analyzing the expression of beta-2-adrenoreceptors in peritumoral tissue depending on tumor grading one can notice that there are positive correlations between beta-2-adrenoreceptors’ expression and poorly differentiated colorectal adenocarcinoma. Conclusions: Positive correlation between this type of receptors in normal glandular epithelium, in the vicinity of tumor invasion front of colorectal neoplasm, and certain clinicopathological features suggests the involvement of tumor microenvironment, which expresses them, in the pathogenesis of this neoplasm.

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2. Cognitive - Emotional Coping Strategies in First Year Romanian Medical Students

D. NECHITA(1), OTILIA ROGOVEANU(2), D.O. ALEXANDRU(3), FLORINA NECHITA(1)

We have studied the cognitive-emotional coping strategies to a number of 333 students in the first year of the Medicine and Pharmacy University of Craiova, from the Medicine, Pharmacy and Medical Nursing specializations, by using the CERQ (Cognitive Emotion Regulation Questionnaire). The result revealed that the medical students employ these strategies relatively different from the general population, while differences were recorded between this study and the previous research. It has been ascertained that, generally, the students from the different medical specializations use strategies belonging more to the dysfunctional range, such as: rumination, self-blame, catastrophizing.

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3. Prematurity and Sepsis - Features and Approach Difficulties During Neonatal Emergency Transfer

LUCIANA TEODORA ROTARU(1), ANCA RUXANDA(2), OANA SORINA TICA(3), STEFANIA TUDORACHE(3), C. BOERIU(4)

Purpose - We aimed to identify conditions, means and methods of suspecting, certification and stratification of neonatal sepsis, to prioritize and define levels of management during evacuation, and to follow the neonatal sepsis succeeding the transfer. Material and method - An observational study was conducted between 1January 2011 – the 1 January 2015, that included 610 preterm newborns with suspected sepsis transferred by UTIM NN or HEMS Craiova. We statistically studied confirmation rate of suspected sepsis, the sepsis onset condition, severity stratification, and correlate with medical centers performance assisting newborns and planning transfers. A follow up performed two weeks after evacuation. Results - We detected low rate of detection and affirmed sepsis: n=38 (6.25%) - C.I. (95%): 4.454309335 and very high level of founded unsuspected sepsis: n=85 (13.98026316%) C.I. (95%): 4.982552268, 9of them being very low body weight newborns (1.480263158%). High rate of founded, unaffirmed respiratory distress 23.35526316% (n=142), C.I. (95%): 5.383960957, as sign of sepsis. High rate of accidental hypoglycemia/hypothermia founded by emergency evacuation team: n=131 (21.54605263%), especially to VLBW newborns, associate with sepsis, respiratory failure or confounding with. Conclusions - Newborns transfer its self generates multiple additional risks, including sepsis, but not neglected any stress generated by transport conditions, so that ,,in utero’’ transfer has to be extended in current practice for high risk fetus, mother or special medical conditions to limit newborns transfers. Wider use of telemedicine would facilitate refining the transfer criteria.

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4. Assessment of Oxidative Stress Genes SOD2 and SOD3 Polymorphisms Role in Human Colorectal Cancer

CRISTINA MARGINEAN(1), IOANA STREATA(1), M. IOANA(1), O.M. MARGINEAN(1), V. PADUREANU(1), A. SAFTOIU(1), ILEANA PETRESCU(1), STEFANIA TUDORACHE(1), OANA SORINA TICA(1), F. PETRESCU(1)

Purpose: The aim of this study was to ascertain the oxidative stress genes SOD2 and SOD3 polymorphisms in patients with colorectal cancer and to assess the possible involvement of these polymorphisms that might increase the risk for patients to develop malignant intestinal tumors. Material and methods: A total number of 306 subjects were divided into two groups (109 colorectal cancer patients as the study group and 197 normal healthy individuals as the control group).We genotyped two polymorphisms, SOD2 – 201A>G (rs4880) and SOD3 – 896C>G (rs1799895), by allelic discrimination, with TaqMan RT-PCR specific probes. Results: No significant differences were found with either of the polymorphisms when comparing the association between them and an increased risk of developing colorectal tumors. Conclusion: In Romanian population, the risk of developing colorectal cancer is not increased by SOD2 and SOD3 polymorphisms.

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5. In Vivo Experimental Study of an Endoscopic Ultrasound Multifunctional Radiofrequency Ablation Probe

B.S. UNGUREANU(1), S.I. DUMITRASCU(1), C. MARGARITESCU(2), D. PIRICI(2), IOANA ANDREEA GHEONEA(3), LARISA SANDULESCU(1), STEFANIA TUDORACHE(4), OANA SORINA TICA(4), V. SANDRU(5), A. SAFTOIU(6)

The aim of our study was to test the feasibility of a new developed RFA probe made especially for EUS use and also capable of injecting iron oxide nanoparticles within the targeted liver area. The procedures were performed on domestic pigs, divided in groups: A.liver RFA was performed; B –IONs were injected in the liver followed by EUS-RFA in the same area; C.local EUS-guided liver IONs injection were performed. After EUS measurements for the ablation areas, group A had a mean of 4.9 cm, while group B had a mean of 5.2 cm (Fig.3, 4). IONs exposure was on a median area of 3.1 cm. EUS imaging pointed out a regular oval shape in group A, and a slightly irregular outline on group B, with more echo bubbles around. MRI sections revealed different patterns for each group separately. In group A and B, RFA lesions were easily identified with specific liver parenchyma changes. Group B revealed few deposits of nanoparticles further away from the targeted point. The last group pointed out a large amount of IONs within the injection region and a larger amount of dispersed IONs within the liver than group B.

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6. Study of the Etiological Spectrum of Spontaneous Bacterial Peritonitis in a Group of Patients Suffering from Liver Cirrhosis

DIANA RODICA TUDORASCU(1), ANDREEA LILI BARBULESCU(2), ELENA TATIANA CARTANA(3), ILEANA OCTAVIA PETRESCU(4), RALUCA NICULINA CIUREA(5), DANIELA CIOBANU(1), M.C. FORTOFOIU(1), V. PADUREANU(1), OANA SORINA TICA(6), STEFANIA TUDORACHE(6), F. PETRESCU(1)

Introduction. Spontaneous bacterial peritonitis (SBP) represents the most severe and common infectious complication in patients suffering from liver cirrhosis. The objectives of the study were the evaluation of the risk factors responsible for the occurrence of the spontaneous bacterial peritonitis in a group of patients suffering from liver cirrhosis, the identification of the bacterial spectrum and assessing the response to antibiotic therapy. Material and method - The studied group included 64 patients suffering from liver cirrhosis, with an episode of SBP, who were admitted to the IInd Medical Clinic of the County Hospital of Craiova, within a period of 24 months. The control group included 61 patients with liver cirrhosis with an episode of decompensation of liver disease. The diagnosis of liver cirrhosis was established by using clinical, biological and imagistic criteria, and the SBP’s diagnosis was based on cytological and bacteriological analysis of the ascites fluid. Patients suffering from hepatocellular carcinoma, portal vein thrombosis and other infectious conditions were excluded. The anamnesis, the duration of the disease, the alcohol intake, the complete clinical examination, the clinical, biological and imagistic evaluation were monitored. Results and conclusions - The most frequent etiology of SBP is represented in 67% of the cases by Gram negative germs, and thus, the antibiotic therapy will be orientated against this etiological segment. In what antibiotic sensitivity is concerned, most of the germs were sensitive to third generation cephalosporins, quinolones, carbapenems and vancomycin.

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7. Therapeutical Attitude and Analysis of Results in Brain Metastases

ANDA CRISAN(1), F. BADULESCU(1), M. POPESCU(2), I. ANDREI(3)

Objectives - The aim of this study is to assess therapeutic outcomes in patients presenting with brain metastases as the first manifestation of malignancies either as a final stage in the evolution of malignancies. Materials and methods - We’ve performed a complex retrospective study on a total of 81 patients with brain metastases treated in Medical Oncology Clinic of the Emergency County Hospital Craiova between 1 January 2005-31 December 2010. Results - The average age of women (55 years) was statistically significantly low compared to men (64 years) (p = 0.000). The most affected age group was 51-60 years in women with maximum frequency of breast cancer and 61-70 years for men, with predominance of lung cancer. Most cases were presented with multiple metastases (90.12%) and the average latency-free interval from primary tumor detection to onset of symptoms was 29.8 months. Clinical manifestations, in most cases, occurred in less than 6 months after diagnosis of the primary tumor being a consequence of the evolution of disease at distance (36 patients / 62 patients in oncological evidence 58.06%) and 12 months after diagnosis survival rate was low being detected in patients with a controlled primary tumor and distant resumption of the disease (14 patients / 62 patients in oncological evidence-22.58%).Median survival in patients with irradiated brain metastases was 7 months. Multivariate statistical analysis of the survival rate has detected statistically significant differences depending on the type of the primary tumor (p = 0.000) and the manner of the onset of brain metastases as the first manifestation or evolution of neoplastic disease (p = 0.000).Survival was affected, without statistical significance threshold, by the number of metastases, patient gender and the loco-regional status of the primary tumor.

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8. Evoked Potentials in Multiple Sclerosis Diagnosis and Management

LIDIA CALUGARU(1), G.T. CALUGARU(2), O.M. CALUGARU(2)

Purpose: We high lightened the changes in Visual Evoked Potentials (VEP) and Brainstem Auditory Evoked Potentials (BAEP) in Multiple Sclerosis (MS). The recordings of evoked potentials were repeated at an interval of 2 months for a total of 12 months. Results: Prolonged latencies of the VEP waves (mostly P100) gas confirmed the multifocal character of MS lesions. The positive effect of corticostheroids in MS flare and the changing course of the disease following administration of interferon. The BAEP recordings have not shown reproducible modifications. Conclusions: Succesive VEP monitoring brings on valuable information by highlighting infraclinical lesions and monitoring the evolution of the disease.

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9. Pattern and Frequency of Short Stature in Albanian Children

AGIM GJIKOPULLI(1), LINDITA GRIMCI(1), LAURANT KOLLCAKU(1), PASKAL CULLUFI(2), AFERDITA TAKO(3)

Introduction:Short stature is defined as a standing height more than 2 standard deviations (SDs) below the mean for age and sex. While there are many medical causes for being short and having poor growth, including growth hormone deficiency, hypothyroidism, Turner syndrome, inflammatory bowel disease, kidney problems, malnutrition, etc., most children who are short are normal. Objectives: The identification and analysis of causes and factors leading to short stature in Albanian children. Patients & methods: Subjects enrolled in our study were admission with “Short stature” or “Slow growth velocity” from January 2001 to January 2011 and met the criteria: length < -2 z- score and/or height velocity <-2 z- score for age and sex. They were evaluated by anthropometric measurements; biochemical panel; hormonal balance; radiological studies; and hormonal provocative tests. Statistical processing was done with Epi-Info CDC 2000 and SPSS accordingly. Results: The age of the 564 children was from 0.65-18.74 years (11.08 ± 3.28 years). M / F: 221/343 (39% /61%) respectively. The frequency of diagnoses resulted as follows: the "constitutional short stature" 211children (37.4%), "GH deficit" 155(27.5%), "genetic syndrome" 67(11.9%), "familiar short stature” 38(6.7%), "others pathology" 38(6.7%), "idiopathic short stature" 31(5.5%), “i-uterine short stature” 16(2.8%). Conclusions:The fact that 46% of the explored children resulted positive in terms of a pathology that had caused primary or secondary growth failure, makes it necessity careful monitoring of growth and reference of the children to a specialist as fast as possible. Evidently great age of exploration indicates a weak surveillance on growth monitoring in Albania. Recommendations: Assessment of the child’s growth must be a routine procedure. The early identification of stature growth delay will significantly increase the early detection of any pathology.

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10. Brucellosis in Nepal - A Potential Threat to Public Health Professionals

KRISHNA PRASAD ACHARYA(1)

Brucellosis is a prominent zoonotic disease affecting humans and animals which with the lack of proper diagnosis and treatment remains dangerous in third world countries like Nepal. Currently, Brucellosis poses a public health concern, whose incidences among entire herds of animals can present substantial economic and health burdens for herders and health professionals. Additionally, factors such as close contact with animals, poor animal husbandry, and unhygienic feeding habits can exacerbate the spread of Brucella and related zoonotic agents. In Nepal, serious cases of bovine and even human brucellosis have been reported, although the topic is yet to be extensively reviewed. This paper evaluates the literatures on human and animal brucellosis in Nepal and other countries, with an emphasis on the impact of Brucella outbreaks on public health professionals. Herein, we summarize the current status of the disease, the mechanism of infection, pathogenesis, zoonotic potential, diagnostic advances, treatment regimens, and the preventive measures that can be adopted in managing human brucellosis in under-developed countries such as Nepal.

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11. Subtotal splenectomy in hereditary spherocytosis - advantages and disadvantages

CATALINA BICA(1), LIANA CISMARU(1), LIGIA STANESCU(1), MARIUS BICA(2), DANIELA MARINESCU(2)

Hereditary spherocytosis (HS) represents the most frequent hemolytic anemia in Central and Northern Europe consisting in an inherited abnormality of the red blood cell (RBC) membrane. It is usually transmitted as an autosomal dominant disorder; 25% of cases are without family history. Splenectomy is the classical conception and it can cure hemolysis, being the treatment of choice for moderate to severe forms of HS. A new approach is accepted nowadays, subtotal splenectomy, thus eliminating the lifelong risk of postsplenectomy infections. We present two cases of HS treated by subtotal splenectomy, alongside the advantages and disadvantages of this therapy.

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12. Severe Toxocariasis in Children-Diagnostic Difficulties

CRISTINA SINGER(1), DANIELA NEAGOE(2), SIMONA COSOVEANU(1), ILEANA PUIU(3), GABRIELA OANCEA(4)

We present the case of an 18-month-old girl, from rural area, admitted to our clinic for fever and cough. The anamnestic data and the clinical and radiological examinations initially suggested the diagnosis of acute interstitial pneumonia. During hospitalization, she repeatedly presented exacerbations with acute respiratory failure, but without fever. Paraclinic examinations revealed anemia, leukocytosis, inflammatory tests with highly increased values, low values of serum iron and serum calcium, hyperproteinemia with hypergammaglobulinemia, the values of IgE and IgG being highly increased. Repeated pulmonary x-rays-peribronchovascular interstitial thickening, at the level of peri-and right infrahilar area. Medullary puncture-increased percentage of eosinophils in several stages of maturity, approximately 20%, normal values for the other medullary series, without atypical cells; the fingertip hemogram showed anemia, leukocytosis, eosinophilia. The diagnosis turned to a possible toxocariasis-atc anti toxocara canis=55.6 NTU. In the third week of hospitalization, the patient presented short crises of nonfebrile seizures. Normal CT and EEG brain. The child was discharged after 5 weeks, the diagnosis being severe toxocariasis with pulmonary and neurological manifestations; she was recommended an antiparasitary treatment and remained in our clinic’s records.

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13. Histiocytosis X and Pericarditis - A Rare Association and a Difficult Diagnosis

IRINA TICA(1), MIHAELA SECELEANU(2), A.A. TICA(3), V.I. TICA(4)

Histiocytic disorders are a group of rare diseases with systemic involvement and with multiple clinical manifestations. We present the case of a 51 years old patient investigated for dyspnea with orthopnea, dry cough, asthenia, muscular weakness and ataxia. The association of previous symptoms with skin lesions, diabetes insipidus, partial hypophyseal insufficiency and pericarditis induced many diagnostic debates. The diagnosis is Histiocytosis X must be sustained by tissue biopsy with immunohistochemical assay or genetic testing. The particularity of our patient is the presence of pericarditis, rarely associated with histiocytosis. Collaboration between medical specialties is mandatory in order to treat this disorder.

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14. Xth Romanian-Serbian Surgery Conference

NOVI SAD (SERBIA), NOVEMBER 26-28, 2015 (1)

ABSTRACT: Selected Abstracts Xth Romanian-Serbian Surgery Conference NOVI SAD (SERBIA), NOVEMBER 26-28, 2015 Under the Patronnage ROMANIAN ACADEMY OF MEDICAL SCIENCES SERBIAN MEDICAL SOCIETY – SURGICAL CHAPTER ROMANIAN SOCIETY OF SURGERY Organizers SERBIAN MEDICAL SOCIETY – SURGICAL CHAPTER CLINIC FOR ABDOMINAL, ENDOCRINE AND TRANSPLANTATIONAL SURGERY, CLINICAL CENTRE OF VOJVODINA, NOVI SAD, SERBIA UNIVERSITY OF MEDICINE AND PHARMACY OF CRAIOVA ASOCIATIA PENTRU MEDICINA „PROF DR FLORIN BOGDAN” 1. LAPAROSCOPIC ANTERIOR AND POSTERIOR SACROCOLPOPEXY FOR TOTAL GENITAL PROLAPSE V. ?urlin, E. Georgescu, D. Margaritescu, Graure Georgiana, D. Radulescu, S. Bordu, Mucenic Suzana, Croitoru Raluca, M. Bica 2. LAPAROSCOPIC SURGERY FOR BENIGN GENITAL DISEASES D. Margaritescu, V. ?urlin, ?. Patra?cu, Marinescu Daniela, CArtu Emilia, L. Barbu, D. Belivaca, Comanescu Cosmina, Popescu Adina, D. CArtu 3. THE FUTURE OF PANCREATIC PSEUDOCYST MANAGEMENT IN REGARD TO THE REVISION OF ATLANTA CLASSIFICATION S. Sandulescu, V. ?urlin, E. Georgescu, Marinescu Daniela, D. Margaritescu, Comanescu Cosmina, Croitoru Raluca, I. Georgescu 4. POSTOPERATIVE EXTERNAL DIGESTIVE FISTULAS AFTER ESOGASTRIC SURGERY D. Radulescu, V. ?urlin, I. Georgescu 5. BILIARY FISTULA IN SURGERY OF HEPATIC HYDATID CYST M. Pir?coveanu, M. Munteanu, L. Vasile, Anca Ruxanda, P. Manescu, ?. Dina, A.C. Munteanu, V. Cirstea, C. Duta, A. Soare, A. Gugila 6. ETHICAL CONSIDERATIONS IN BARIATRIC SURGERY I. C. Puia, Bucerzan Paula, P. Puia 7. LAPAROSCOPIC MANAGEMENT OF SEVERE FORMS OF ACUTE CHOLECYSTITIS T. Bratiloveanu, E. Georgescu, ?. Patra?cu, S. RAmboiu, S. Sandulescu, S. Toma, V. Baleanu, A. Sapunaru, Popescu Adina, D. Belivaca, I. Georgescu 8. UPDATE OF FAST-TRACK APPROACH IN LAPAROSCOPIC VS OPEN COLORECTAL SURGERY M. Bica, V. PArvanescu, V. ?urlin, D. CArtu, F. Cioara, M. Lazar, Radulescu Mihaela, A. Goganau, Popescu Adina, I. Georgescu 9. PLACE OF ND:YAG AND CO2 LASERS IN SURGERY G. Iano?i, Simona Iano?i 10. LAPAROSCOPIC MANAGEMENT OF MESENTERIAL GASTRIC VOLVULUS S. RAmboiu, T. Bratiloveanu, S. Sandulescu, Marinescu Daniela, A. Sapunaru, M. Lazar, A. Goganau, Graure Georgiana, V. ?urlin 11. IMPROVEMENT IN THE AESTHETIC-PSYCHIC RELATIONSHIP IN PATIENTS WITH BARIATRIC SURGERY I. C. Puia, P. G. Cristea, Aida Puia 12. LAPAROSCOPIC ADRENALECTOMY – INITIAL EXPERIENCE V. ?urlin, G. Mitroi, O. Dragoescu, A. Droca?, P. Tomescu 13. LAPAROSCOPIC SURGERY OF COLO-RECTAL CANCER – INITIAL EXPERIENCE I. Georgescu, V. ?urlin, S. RAmboiu, D. Margaritescu, S. Patra?cu, F. Cioara, D. CArtu, S. Bordu, Duica Larisa, M. Bica 14. LAPAROSCOPIC VERSUS OPEN RADICAL NEPHRECTOMY A. Panu?, G. Mitroi, O. Dragoescu, C. Mititelu, A. Droca?, P. Tomescu 15. PERFORATED PEPTIC ULCER – COULD LAPAROSCOPIC SURGERY BECOME “GOLD STANDARD” IN OUR CLINICAL PRACTICE? M. Bica, D. CArtu, S. Sandulescu, D. Margaritescu, E. Georgescu, A. Sapunaru, L. Barbu, A. Goganau, D. Radulescu, V. ?urlin 16. LAPAROSCOPIC TRANSPERITONEAL PYELOPLASTY G. Mitro

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