Medicine and Health Sciences Commons^™

Histopathology Report On Colon Cancer Specimens; Measuring Surgical Quality, An Increasing Stress For Surgeons, Stefan Morarasu, Tudor Frunza, Karina Bilavschi, Ana Maria Patrascu, Sorinel Lunca, Gabriel Dimofte

Journal of Mind and Medical Sciences

Introduction. Improving the quality of surgical resections by evaluating surgical specimens is probably the most important feedback a surgeon can receive. Moreover, prognosis of patients with colon cancer is based on achieving appropriate resection margins and assessment of lymph node status. For these reasons we aim to provide a retrospective analysis on colon cancer specimens operated by a single surgical team.

Materials and Methods. 88 patients operated between 2013 and 2016 were included in the study. Data were gathered prospectively and assessed by multivariate analysis for the main variables (age, gender, tumor staging, specimen length, distance to closest resection margin, …

Management Of Deep Space Infections Of The Neck, Emil Mărginean, Sargarovschi Egor, Ciprian Venter, Alina Pantiș, Oana Vălenaș, Ildiko Sorban, Maria Domuța, Cristian Bălălău, Razvan V. Scaunasu Md, Bogdan Popescu

Journal of Mind and Medical Sciences

Infections of the deep neck spaces often present a clinical challenge for the ENT surgeon. Management of these complex suppurations of the neck requires in fact a multidisciplinary approach due to possible complications like mediastinitis, septic shock and MSOF, life threatening bleeding and ICU management. The spread of infection from the primary site to other regions is possible through the lymphatic, arterial and venous vessels, or directly along the fasciae. There are several classifications for the etiology, pathogenic mechanism and site of evolution, the most frequently encountered clinical forms being peritonsillar abscess, retropharyngeal abscess, lateropharyngeal abscess, and the deep cervical …

Mandatory Multidisciplinary Approach For The Evaluation Of The Lymph Node Status In Rectal Cancer, Marian Diaconescu, Cosmin V. Obleaga, Cecil S. Mirea, Mihai C. Ciorbagiu, Emil Moraru, Ionica D. Vilcea

Journal of Mind and Medical Sciences

Colorectal cancer is the third most frequently reported malignancy and also the third leading cancer-related cause of death worldwide. Lymph node evaluation, both preoperatively and postoperatively, represents an important aspect of the diagnosis and therapeutic strategy in colorectal cancer, such that an accurate preoperative staging is required for a correct therapeutic strategy. Treatment of rectal cancer with positive lymph nodes, a very important predictive prognostic parameter, is currently based on neoadjuvant chemoradiotherapy followed by total/ surgical mesorectal excision and adjuvant regimen.

Preoperative evaluation of the lymph node status in rectal cancer is based on endoscopic ultrasound and magnetic resonance imaging, …

Emergency Surgery On Mentally Impaired Patients: Standard In Consenting, Mihai Paduraru, Ahmed Saad, Krystian Pawelec

Journal of Mind and Medical Sciences

Emergency surgery is often performed on the elderly and susceptible patients with significant comorbidities; as a consequence, the risk of death or severe complications are high. Consent for surgery is a fundamental part of medical practice, in line with legal obligations and ethical principles. Obtaining consent for emergency services (for surgical patients with chronic or acute mental incapacity, due to surgical pathology) is particularly challenging, and meeting the standards requires an up-to-date understanding of legislation, professional body guidelines, and ethical or cultural aspects. The guidance related to consent requires physicians and other medical staff to work with patients according to …

Necrotizing Fasciitis Of The Neck: Case Presentation, Emil Marginean, Ciprian Venter, Maria Domuta, Oana Valenas, Ildiko Sorban, Alina Pantis, Bogdan Popescu, Razvan V. Scăunașu

Journal of Mind and Medical Sciences

Necrotizing fasciitis represents a severe and rare infectious disease, which is accompanied by extended necrosis of subcutaneous tissues and fascia layers, having as a result gangrene of the teguments. To reduce mortality associated with this disease, a rapid diagnosis is necessary as well as aggressive surgical treatment, accompanied by adequate, aggressive antibiotic therapy. As a rule, etiology is teeth related, with the condition more common in immunology-depressed patients. This article presents the experience of the authors regarding a case presentation of necrotizing fasciitis with typical clinical expression and management of the disease in an immunological-depressed patient. Further data on diagnosis, …

Zenker’S Diverticulum And Squamous Esophageal Cancer: A Case Report, Ion Dina, Octav Ginghina, Corina D. Toderescu, Cristian Bălălău, Bianca Galateanu, Carolina Negrei, Claudia Iacobescu

Journal of Mind and Medical Sciences

Zenker’s diverticulum represents a rare esophageal lesion developed especially in the elderly population due to herniation of esophageal mucosa above the cricopharyngeus muscle. The condition leads to food retention, regurgitation, aspiration, and dysphagia in affected patients. Progressive dysphagia also characterizes malignant diseases of the esophagus like squamous esophageal carcinoma that typically appears in male patients in the seventh decade of life, with a history of cigarette smoking and alcohol abuse. We report a case of a male patient who presented with dysphagia for both solids and liquids along with significant weight loss, and who was diagnosed with medium esophageal cancer …

The Psychological Influence Of The Diagnosis Of Breast Cancer On Therapeutic Options Selection, Razvan V. Scaunasu, Stefan Voiculescu, Bogdan Popescu, Cristina Cozma, Radu Jecan, Cristian Balalau

Journal of Mind and Medical Sciences

The therapeutic management decision-making process for breast cancer is complex, and is influenced by multiple factors including patient age, comorbidities, ethnicity, education, and availability of immediate or delayed reconstruction options. Our study analysed 276 patients diagnosed with breast cancer in the “Colțea” Clinical Hospital between 2014 and 2015. Mean patients age was 61.24, median 62, with a range of 31 to 89 years. Younger age was associated with a less advanced local disease and younger patients were more likely to choose and benefit from conservative surgery. Most patients (61.76%) came from rural areas. Place of origin had a significant influence …

Emergency Surgery And Limitation Of Therapeutic Effort In Relation To Neurologic Deterioration In Elderly Patients – A Survey Of European Surgeons, Mihai Paduraru, Luca Ponchietti, Isidro M. Casas, Jorge Pereira, Aitor Landaluce-Olavarria, Diego Mariani

Journal of Mind and Medical Sciences

Background. In emergency surgery, a very heterogeneous approach is required in the decision making process, especially when considering the patient’s postoperative quality of life as well as medical, ethical, and legal factors. In some cases, the presence of an Advance Directive (AD) form may potentially help resolve the surgeon’s dilemma. Objectives. The primary objective of this survey was to investigate the opinions of surgeons across a representative cross-section of European countries regarding the decision making process using a specific case scenario so as to identify similarities and differences in practice. A secondary objective was to identify the possibility of establishing …

End-Stage Head And Neck Cancer: Coping Mechanism, Bogdan Popescu, Oana Paun, Razvan V. Scăunaşu, Serban V.G. Berteşteanu

Journal of Mind and Medical Sciences

Coping mechanisms are patients’ means of adapting to stressful situations and involve psychological and physical changes in behavior. Patients adapt to head and neck cancer in a variety of ways. Head and neck cancers are extremely debilitating, especially in advanced stages of the disease or in end-of-life situations. While an oncology team needs to address the needs of all oncology patients, the advanced terminal patients require special attention. Most of these patients do not cope well with their situation and have a tendency to cease social interactions. Pain is the most frequentlyexperienced medical disability in patients having an end-stage illness …

Appendicular Mass – A Rare Form Of Tuberculosis, Petrisor Banu, Vlad D. Constantin, Florian Popa, Mircea Bratucu, Teodora Vladescu, Cristian Balalau

Journal of Mind and Medical Sciences

Tuberculosis is in the top 10 causes of death worldwide, being one of the most deadly infectious diseases. It is estimated that one of three people from the entire earth population has a latent infection with M tuberculosis. This aerobic bacterium possesses the ability to persist in host tissues for years and to begin replication once immunity declines.

The lungs are most frequent site of infection as the Mycobacterium tuberculosis is carried by aerosol droplets and is commonly transmitted by respiratory route. The second way of transmission is by contaminated food.

Intestinal contamination coexists with pulmonary tuberculosis and only 10% …

The Prevalence Of High Dysplastic Colonic Adenomatous Polyps In A 3 Year Endoscopic Retrospective Study From A Single Clinical Center, Alexandru C. Septimiu, Cosmin A. Moldovan, Florin D. Ungureanu

Journal of Mind and Medical Sciences

Introduction: Many colon neoplastic tumors come from the malignancy of adenomatous polyps (70%-90%) that were not timely diagnosed in order to be resected. Materials and Methods: We conducted a retrospective study regarding the incidence of adenomatous polyps during 1.000 consecutive colonoscopies performed in our Upper and Lower Digestive Endoscopy Laboratory during a three-year period. Results: During these colonoscopies, some targeted polyps were biopsied or completely removed and the samples had been sent to a complete anatomopathological examination. Taking into consideration the results, the polyps were classified after the histological type and the form of dysplasia, in order …

An Evidence Based Guide To A Safe Intraoperative Approach Of Avoiding Iatrogenic Lesions During Difficult Laparoscopic Cholecystectomies, Cosmin Alec Moldovan, Roxana M. Duncea, Florin Dan Ungureanu, Vladimir Belis

Journal of Mind and Medical Sciences

Introduction: Although there are many sources for iatrogenic lesions during laparoscopic cholecystectomy, only a few stand out as being one of the most difficult to predict due to their nature of being very hard to diagnose before surgery. Materials and Methods: a short guide of cases with an evidence-based approach to avoid laparoscopic iatrogenic lesions. Results: these cases have been classified and presented into 3 main groups: cases with abnormal arterial layout, cases with heavy alteration of the normal anatomy, and cases with anomalies of the main biliary pathway. Conclusions: while not a complete guide covering …

Gastrointestinal Stromal Tumor (Gist) Of The Treitz’S Angle– A Very Rare Cause Of High Bowel Obstruction, Mădălina Elena Tobă, Dan Florin Ungureanu, Lota Corina Georgescu, Traian Pătraşcu

Journal of Mind and Medical Sciences

Gastrointestinal stromal tumors (GIST) are somewhat rare gastrointestinal tumors - approximately 1% to 3% incidence, but they are the most common mesenchymal neoplasms of the gastrointestinal tract. GISTs are usually found in the stomach or small intestine but can occur anywhere within the gastrointestinal tract, even in extremely uncommon locations like duodeno-jejunal flexure. Only 3% – 5% of GISTs are located in the duodenum and tumors occurring in the angle of Treitz are even rarer, most published studies being case reports. These tumors have a size ranging from small lesions to large masses and can cause digestive bleeding or high …

A Retrospective Surgical Experience Regarding Open And Laparoscopic Procedures Of The Hepatic Hydatid Cyst With An Up To Date Complete Review Of The Literature And A Focus On Original Romanian Techniques, Diana Moldovan, Cosmin Alec Moldovan, Laurentiu Ungurianu, Dan Florin Ungureanu

Journal of Mind and Medical Sciences

Introduction: Even though the development of the recent anti-parasitic drugs has led to a high degree of efficiency, surgical treatment still remains the gold standard for a number of conditions. Material and method. The authors discuss a series of 90 cases in a multicenter and retrospective analysis that stretches over 20 years. Results and discussions. These cases have been diagnosed and treated – through different surgical methods, both classical and laparoscopic – for hepatic hydatid cysts. The paper also presents a short review of the major types of surgical procedures cited in the international literature, with a …

A Proposed Therapeutic Algorithm Based On Multiple Case Analysis Regarding The Repair Options Of Iatrogenic Biliary Lesions Following Open And Laparoscopic Surgery, Cosmin Alec Moldovan, Dan Florin Ungureanu, Vladimir Beliș

Journal of Mind and Medical Sciences

Introduction: the problem of the iatrogenic lesions of the main biliary pathways is far from being completely clarified and still represents a serious surgical situation, during both open and laparoscopic surgeries. The outcome of these situations is closely linked with the actual moment of discovery of the lesion and the surgical methods for repairing such defects and implies a great number of options, such as reconstructive, derivative and substitutive techniques. Objectives: the goal of this paper is to present an algorithm of choices and their consequences for clinical conduit in the case of iatrogenic biliary lesions discovered in …

Helicobacter Pylori: Types Of Diseases, Diagnosis, Treatment And Causes Of Therapeutic Failure, Cosmin Vasile Obleaga, Cristin Constantin Vere, Ionica Daniel Valcea, Mihai Calin Ciorbagiu, Emil Moraru, Cecil Sorin Mirea

Journal of Mind and Medical Sciences

Acute upper gastrointestinal lesions have a multifactorial etiology but, regardless of the cause, they are related to mucosal barrier destruction. Since Helicobacter pylori induces a superficial chronic gastritis with the infiltration of neutrophils in the mucosa, it was speculated that Helicobacter pylori infection could also cause bleeding lesions. The diagnosis, the proper treatment and the revaluation of its effectiveness actually represent the prophylaxis of some diseases such as peptic ulcer, gastric lymphoma or mucosa-associated lymphoid tissue (MALT) and gastric cancer. These diseases and their severe complications are life-threatening for the patient. Periodic renewal of the treatment and knowing the real …

Conservative Surgery Of Breast Cancer In Women; Psychological Benefits, Razvan V. Scaunasu Md, Traean Burcoș, Ștefan Voiculescu, Bogdan A. Popescu, Șerban V. Bertesteanu, Oana-Denisa Bălălău, Nicolae Bacalbasa, Cristian Bălălău

Journal of Mind and Medical Sciences

Breast surgery was one of the most dynamic fields of medicine which benefited from significant progress during the last decades. The transition from aggressive and mutilating amputations to conservative, oncoplastic and reconstructive techniques has been constant, offering improved and rewarding results, viewed from both, oncological and aesthetical perspectives.

Conservative techniques, especially those which preserve the nipple areola complex, are followed by improved patient’s perception of their body image, confidence and sexuality, with the only drawback of increased anxiety linked to recurrence risk.

Perforated Small Intestine In A Patient With T-Cell Lymphoma; A Rare Cause Of Peritonitis, Petrisor Banu, Vlad D. Constantin, Florian Popa, Mihaela F. Nistor

Journal of Mind and Medical Sciences

The nontraumatic perforations of the small intestine are pathological entities with particular aspects in respect to diagnosis and treatment. These peculiarities derive from the nonspecific clinical expression of the peritonitis syndrome, and from the multitude of causes that might be the primary sources of the perforation: foreign bodies, inflammatory diseases, tumors, infectious diseases, etc. Accordingly, in most cases intestinal perforation is discovered only by laparotomy and the definitive diagnosis is available only after histopathologic examination. Small bowel malignancies are rare; among them, lymphomas rank third in frequency, being mostly B-cell non Hodgkin lymphomas. Only 10% of non-Hodgkin lymphomas are with …