Andreea-Laura Ionescu, I. Grăjdeanu, M. Baltă, A. Stănescu
In the current conditions of life, the analysis of mental illness must be defined through the lens of human relationships with environmental, social, cultural, and dynamic factors that substantially impact human mental balance. The study aims to analyze the correlations between depression and anxiety and different socio-demographic factors such as age, sex, background, occupation, identification of the medical impact (number of hospitalizations and number of days of hospitalization), presence of comorbidities and different methods of therapy, from the point of view of the therapeutic response. All these bio-psycho-social indicators translate relevant aspects of the disease on the population's quality of life.
{"title":"The impact of socio-demographic factors on depression and anxiety in the context of quality of life","authors":"Andreea-Laura Ionescu, I. Grăjdeanu, M. Baltă, A. Stănescu","doi":"10.37897/rmj.2022.2.6","DOIUrl":"https://doi.org/10.37897/rmj.2022.2.6","url":null,"abstract":"In the current conditions of life, the analysis of mental illness must be defined through the lens of human relationships with environmental, social, cultural, and dynamic factors that substantially impact human mental balance. The study aims to analyze the correlations between depression and anxiety and different socio-demographic factors such as age, sex, background, occupation, identification of the medical impact (number of hospitalizations and number of days of hospitalization), presence of comorbidities and different methods of therapy, from the point of view of the therapeutic response. All these bio-psycho-social indicators translate relevant aspects of the disease on the population's quality of life.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89930984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rodica Urs, I. Anghel, Adriana Oana Rajput Anghel, A. Anghel
Introduction. Rhinoseptoplasty is considered the most challenging operation because many techniques have to be taken into consideration to achieve an optimal aesthetic and functional results. Rhinoseptoplasty techniques have been perfected over time, following two main surgical approaches: structural rhinoplasty (resection/ reconstruction) and conservative (preservation rhinoplasty). Methods. The authors present the risks and complications in a comparative study of 100 cases with patients in primary rhinoseptoplasty performed between 2019-2021: 50 cases in Structural Rhinoplasty and 50 cases in Preservation Rhinoplasty. The study presents two surgical concepts of rhinoplasty regarding the main advantages, disadvantages and indications of each type of rhinoseptoplasty surgery. Results and conclusions. Complications post-rhinoseptoplasty can be considered as perioperative, functional, anatomic (aesthetic) and psyhological. In this study 10 cases (10%) of primary rhinoplasty required revision surgery. The most frequent postoperative deformity is the “pollybeak” when a deep naso-frontal angle, cartilaginous hump and reduced tip projection are present preoperatively. The pollybeak was the indication in 4 cases (40%) of all revision rhinoplasties. Other frequent postoperative deformities are: wide nasal tip, retractions of the columella base and irregularities of the nasal dorsum. These deformities are very often combined and caused by a loss of septal support. Septorhinoplasty is a difficult procedure and the surgeon must have accurate anatomical knowledge and rich clinical experience. The risks for rhinoplasty-complications can be reduced with increasing experience. It is very important to make distinction between complication and mistake.
{"title":"Risks and complications in rhinoplasty. A comparative study in structural vs preservation rhinoplasty","authors":"Rodica Urs, I. Anghel, Adriana Oana Rajput Anghel, A. Anghel","doi":"10.37897/rmj.2022.2.7","DOIUrl":"https://doi.org/10.37897/rmj.2022.2.7","url":null,"abstract":"Introduction. Rhinoseptoplasty is considered the most challenging operation because many techniques have to be taken into consideration to achieve an optimal aesthetic and functional results. Rhinoseptoplasty techniques have been perfected over time, following two main surgical approaches: structural rhinoplasty (resection/ reconstruction) and conservative (preservation rhinoplasty). Methods. The authors present the risks and complications in a comparative study of 100 cases with patients in primary rhinoseptoplasty performed between 2019-2021: 50 cases in Structural Rhinoplasty and 50 cases in Preservation Rhinoplasty. The study presents two surgical concepts of rhinoplasty regarding the main advantages, disadvantages and indications of each type of rhinoseptoplasty surgery. Results and conclusions. Complications post-rhinoseptoplasty can be considered as perioperative, functional, anatomic (aesthetic) and psyhological. In this study 10 cases (10%) of primary rhinoplasty required revision surgery. The most frequent postoperative deformity is the “pollybeak” when a deep naso-frontal angle, cartilaginous hump and reduced tip projection are present preoperatively. The pollybeak was the indication in 4 cases (40%) of all revision rhinoplasties. Other frequent postoperative deformities are: wide nasal tip, retractions of the columella base and irregularities of the nasal dorsum. These deformities are very often combined and caused by a loss of septal support. Septorhinoplasty is a difficult procedure and the surgeon must have accurate anatomical knowledge and rich clinical experience. The risks for rhinoplasty-complications can be reduced with increasing experience. It is very important to make distinction between complication and mistake.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78716164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives. The study aims to determine the correlation between the presence of heavy metals with intoxication potential (mercury, aluminum, arsenic), increasing the values for the omega 6: omega 3 ratio, decreasing the concentration of omega 3 and it’s impact on health. Another objective of this study is the use of an integrated protocol, developed by an interdisciplinary team, based on a customized alignment program and a treatment plan. Materials and methods. We evaluated in a retrospective observational study, 77 patients who came to the Nutribalance Clinic between September 2017 and December 2019, with specific symptoms of intoxication with toxic metals, especially mercury, aluminum, arsenic and omega 3 deficiencies. The manifested symptoms required a complete set of blood tests for each subject in the study group, tests that showed the presence of one, two and three toxic metals in the case of all 77 subjects. The interdisciplinary team developed a personalized treatment and diet plan, monitoring the evolution on the symptoms initially manifested by each subject. Outcomes. The results of this study shows the beneficial impact of the personalized diet plan and supplements used on the decrease in omega 6:omega 3 ratio, the significant increases in omega 3 which support the detoxification process of heavy metals and a significant improvement in the symptoms of each patient. Conclusions. This study reveals that the process of chelating or detoxifying heavy metals is a complex one and that implies the presence of a complementarity between food and nutritional supplement therapy, avoiding one single direction, as results can be obtained for a short or insignificant period of time.
{"title":"Correlation between the presence of metals with intoxication potential, omega 3 deficiency, increased omega 6:omega 3 ratio and their associated symptoms","authors":"Alina Epure, Veronica Anastasoi, D. Cheța","doi":"10.37897/rmj.2022.2.5","DOIUrl":"https://doi.org/10.37897/rmj.2022.2.5","url":null,"abstract":"Objectives. The study aims to determine the correlation between the presence of heavy metals with intoxication potential (mercury, aluminum, arsenic), increasing the values for the omega 6: omega 3 ratio, decreasing the concentration of omega 3 and it’s impact on health. Another objective of this study is the use of an integrated protocol, developed by an interdisciplinary team, based on a customized alignment program and a treatment plan. Materials and methods. We evaluated in a retrospective observational study, 77 patients who came to the Nutribalance Clinic between September 2017 and December 2019, with specific symptoms of intoxication with toxic metals, especially mercury, aluminum, arsenic and omega 3 deficiencies. The manifested symptoms required a complete set of blood tests for each subject in the study group, tests that showed the presence of one, two and three toxic metals in the case of all 77 subjects. The interdisciplinary team developed a personalized treatment and diet plan, monitoring the evolution on the symptoms initially manifested by each subject. Outcomes. The results of this study shows the beneficial impact of the personalized diet plan and supplements used on the decrease in omega 6:omega 3 ratio, the significant increases in omega 3 which support the detoxification process of heavy metals and a significant improvement in the symptoms of each patient. Conclusions. This study reveals that the process of chelating or detoxifying heavy metals is a complex one and that implies the presence of a complementarity between food and nutritional supplement therapy, avoiding one single direction, as results can be obtained for a short or insignificant period of time.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73524851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ana Maria Huszti, N. Gică, R. Botezatu, G. Peltecu, A. Panaitescu
Hemolytic disease of the fetus and newborn is a consequence of maternal immune response to fetal red blood cells antigens inherited from the father, that the mother does not possess, stimulated by antepartum or intrapartum fetomaternal hemorrhage. As a result, fetal erythrocytes are destroyed, leading to various degrees of anemia and hyperbilirubinemia, with high perinatal morbidity and mortality rates. This review’s purpose is to reveal the importance of the alloantibodies beyond RhD and ABO system, the updated algorithms used in the diagnosis and management of the disease and the importance of RhD universal immune prophylaxis practice. For this purpose, the database from PubMed and UpToDate was searched for literature reviews, case studies, society guidelines and retrospective studies in English regarding hemolytic disease of the fetus and newborn from 2013 to March 2022. Anti D prophylaxis protocols, early diagnosis and proper intrauterine and postpartum treatment help significantly reduce the disease’s burden.
{"title":"Hemolytic disease of the newborn, beyond the Rhesus disease","authors":"Ana Maria Huszti, N. Gică, R. Botezatu, G. Peltecu, A. Panaitescu","doi":"10.37897/rmj.2022.2.1","DOIUrl":"https://doi.org/10.37897/rmj.2022.2.1","url":null,"abstract":"Hemolytic disease of the fetus and newborn is a consequence of maternal immune response to fetal red blood cells antigens inherited from the father, that the mother does not possess, stimulated by antepartum or intrapartum fetomaternal hemorrhage. As a result, fetal erythrocytes are destroyed, leading to various degrees of anemia and hyperbilirubinemia, with high perinatal morbidity and mortality rates. This review’s purpose is to reveal the importance of the alloantibodies beyond RhD and ABO system, the updated algorithms used in the diagnosis and management of the disease and the importance of RhD universal immune prophylaxis practice. For this purpose, the database from PubMed and UpToDate was searched for literature reviews, case studies, society guidelines and retrospective studies in English regarding hemolytic disease of the fetus and newborn from 2013 to March 2022. Anti D prophylaxis protocols, early diagnosis and proper intrauterine and postpartum treatment help significantly reduce the disease’s burden.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86979762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Chetroiu, M. Beuran, P. Filip, S. Diaconu, C. Orban, C. Pop, A. Chiotoroiu
Background. The treatment of stage II colon cancer has been a subject of debate for a long time. In the last years, a few risk factors have been proposed in order to guide any treatment decision more accurately. One of these risk factors is the number of resected lymph nodes, and according to the latest guidelines, it is recommended that at least 12 lymph nodes should be resected for optimal staging. The aim of this study is to evaluate the role of lymph node resection, in stage II colon cancer and the implication of suboptimal lymph node resection on disease free survival and overall survival. Patients and methods. This was a prospective study that included 130 patients with stage II colon cancer who were monitored between October 2014 and October 2016. The relation between patients’ tumour characteristics that include number of lymph node resection and the use of adjuvant chemotherapy using Chi test and multiple logistic regression was analyzed. The disease-free survival and overall survival were estimated with the Kaplan-Meier method and compared with the log-rank test. Results. 130 patients with stage II colon cancer were recruited. 56 patients were treated with surgery alone and 74 patients received fluorouracil- based chemotherapy after surgery. Patients' age varied from 37 years to 81 years. According to the number of resected lymph nodes, patients were divided into two groups - with less than 12 lymph nodes resected and at least 12 lymph nodes resected. The number of resected lymph nodes varied from 2 to 32 lymph nodes. Median follow up was 36 months. Suboptimal resections of lymph nodes confirmed to be a negative prognostic factor for survival without disease recurrence. Conclusion. Data results confirmed the importance of lymph node resection as a prognostic factor for stage II colon cancer and the role of chemotherapy for patients with suboptimal lymph node resection.
{"title":"Prognostic impact of Lymph node resection in stage II colon cancer: a prospective study from a tertiary hospital center","authors":"D. Chetroiu, M. Beuran, P. Filip, S. Diaconu, C. Orban, C. Pop, A. Chiotoroiu","doi":"10.37897/rmj.2022.2.3","DOIUrl":"https://doi.org/10.37897/rmj.2022.2.3","url":null,"abstract":"Background. The treatment of stage II colon cancer has been a subject of debate for a long time. In the last years, a few risk factors have been proposed in order to guide any treatment decision more accurately. One of these risk factors is the number of resected lymph nodes, and according to the latest guidelines, it is recommended that at least 12 lymph nodes should be resected for optimal staging. The aim of this study is to evaluate the role of lymph node resection, in stage II colon cancer and the implication of suboptimal lymph node resection on disease free survival and overall survival. Patients and methods. This was a prospective study that included 130 patients with stage II colon cancer who were monitored between October 2014 and October 2016. The relation between patients’ tumour characteristics that include number of lymph node resection and the use of adjuvant chemotherapy using Chi test and multiple logistic regression was analyzed. The disease-free survival and overall survival were estimated with the Kaplan-Meier method and compared with the log-rank test. Results. 130 patients with stage II colon cancer were recruited. 56 patients were treated with surgery alone and 74 patients received fluorouracil- based chemotherapy after surgery. Patients' age varied from 37 years to 81 years. According to the number of resected lymph nodes, patients were divided into two groups - with less than 12 lymph nodes resected and at least 12 lymph nodes resected. The number of resected lymph nodes varied from 2 to 32 lymph nodes. Median follow up was 36 months. Suboptimal resections of lymph nodes confirmed to be a negative prognostic factor for survival without disease recurrence. Conclusion. Data results confirmed the importance of lymph node resection as a prognostic factor for stage II colon cancer and the role of chemotherapy for patients with suboptimal lymph node resection.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81041872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Maioru, L. Pop, V. Rădoi, R. Ursu, N. Bacalbaşa, I. Bălescu, Ioan Dumitru Suciu
Checkpoint kinases (Chks) are serine/threonine kinases that are involved in the control of the cell cycle. Two subtypes have so far been identified, Chk1 and Chk2. They are essential components to delay cell cycle progression in all cells and act at all three cell cycle checkpoints. Here we provide more information regarding the CHEK2 gene and its role in breast cancer as well as known mutations that present a higher cancer risk.
{"title":"CHEK2 gene in breast cancer","authors":"O. Maioru, L. Pop, V. Rădoi, R. Ursu, N. Bacalbaşa, I. Bălescu, Ioan Dumitru Suciu","doi":"10.37897/rmj.2022.s3.4","DOIUrl":"https://doi.org/10.37897/rmj.2022.s3.4","url":null,"abstract":"Checkpoint kinases (Chks) are serine/threonine kinases that are involved in the control of the cell cycle. Two subtypes have so far been identified, Chk1 and Chk2. They are essential components to delay cell cycle progression in all cells and act at all three cell cycle checkpoints. Here we provide more information regarding the CHEK2 gene and its role in breast cancer as well as known mutations that present a higher cancer risk.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73018391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Novac, L. Pop, V. Rădoi, R. Ursu, N. Bacalbaşa, I. Bălescu, Ioan Dumitru Suciu
After more than 25 years since its identification in 1995, the mutational faults in the BRCA2 gene is recognized and accepted as a high-penetrance predisposition gene for breast cancer. Besides a large number of pathogenic mutations, there are thousands of VUS (variants of uncertain significance) described, with many of them localized on C-terminus. K3326* is a rare truncating variant on the C-terminus of BRCA2, which is reported in the literature, including ClinVar and Varsome database, as a neutral polymorphism. However, there is some evidence that suggests an elevated risk of breast cancer associated with K3326* variant. We present the case of a K3326* mutation carrier, affected patient aged 42 diagnosed with co-existing breast and ovarian cancer, suggesting that the variant is not neutral for breast and ovarian cancer risk. K3326 may need to be included in SNP panels and further investigated for breast cancer risk estimation.
{"title":"K3326* mutation in breast cancer","authors":"M. Novac, L. Pop, V. Rădoi, R. Ursu, N. Bacalbaşa, I. Bălescu, Ioan Dumitru Suciu","doi":"10.37897/rmj.2022.s3.5","DOIUrl":"https://doi.org/10.37897/rmj.2022.s3.5","url":null,"abstract":"After more than 25 years since its identification in 1995, the mutational faults in the BRCA2 gene is recognized and accepted as a high-penetrance predisposition gene for breast cancer. Besides a large number of pathogenic mutations, there are thousands of VUS (variants of uncertain significance) described, with many of them localized on C-terminus. K3326* is a rare truncating variant on the C-terminus of BRCA2, which is reported in the literature, including ClinVar and Varsome database, as a neutral polymorphism. However, there is some evidence that suggests an elevated risk of breast cancer associated with K3326* variant. We present the case of a K3326* mutation carrier, affected patient aged 42 diagnosed with co-existing breast and ovarian cancer, suggesting that the variant is not neutral for breast and ovarian cancer risk. K3326 may need to be included in SNP panels and further investigated for breast cancer risk estimation.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80298891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Maioru, L. Pop, V. Rădoi, R. Ursu, N. Bacalbaşa, I. Bălescu, Ioan Dumitru Suciu
Breast cancer represents the most commonly encountered form of malignant disease in women worldwide, which has been widely demonstrated to have a strong genetic predisposition. Therefore, it seems that most often it is inherited in an autosomal dominant manner, the most commonly encountered germline gene variant being represented by BRCA 1 and BRCA 2, followed by TP53, CDH1, PTEN and STK1. Recently PALB2 gene has been demonstrated to confer a moderate risk for breast cancer development. In this article the importance and the prevalence of the PALB2 gene is presented as well as the breast cancer risk is analyzed (based on various studies). To better manage and understand the risks we have detailed the newest monitoring and treatment options regarding a mutation in the PALB2 gene that leads to breast cancer.
{"title":"PALB2 gene in breast cancer","authors":"O. Maioru, L. Pop, V. Rădoi, R. Ursu, N. Bacalbaşa, I. Bălescu, Ioan Dumitru Suciu","doi":"10.37897/rmj.2022.s3.6","DOIUrl":"https://doi.org/10.37897/rmj.2022.s3.6","url":null,"abstract":"Breast cancer represents the most commonly encountered form of malignant disease in women worldwide, which has been widely demonstrated to have a strong genetic predisposition. Therefore, it seems that most often it is inherited in an autosomal dominant manner, the most commonly encountered germline gene variant being represented by BRCA 1 and BRCA 2, followed by TP53, CDH1, PTEN and STK1. Recently PALB2 gene has been demonstrated to confer a moderate risk for breast cancer development. In this article the importance and the prevalence of the PALB2 gene is presented as well as the breast cancer risk is analyzed (based on various studies). To better manage and understand the risks we have detailed the newest monitoring and treatment options regarding a mutation in the PALB2 gene that leads to breast cancer.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77223302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean
Local recurrences after surgically treated endometrial cancer with associated vesical and rectal fistula represent a particular eventuality in which the only chance for cure is represented by extended pelvic resections. The aim of the current paper is to present the case of a 62 year old patient diagnosed with a local recurrence invading the urinary bladder and the rectum leading to the development of a complex fistula involving both the urinary and digestive tract after surgically treated endometrial cancer. Although initially the patient was not submitted to pelvic radiation therapy, at the time of relapse the presence of this fistula contraindicated any kind of radiation therapy. Therefore the patient was submitted to a total pelvic exenteration with cutaneous ureterostomy and terminal left colostomy. Another particularity of the patient was the fact that she had an ureteral duplication on the right side, both ureters being functional and exteriorized in right ureterostomy. In conclusion, pelvic exenteration might be a good therapeutic alternative for pelvic recurrences with complex fistulas after surgically treated endometrial cancer.
{"title":"Total pelvic exenteration for pelvic recurrence with complex recto-vaginal and vesicovaginal fistula after surgically treated endometrial cancer","authors":"N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean","doi":"10.37897/rmj.2022.s3.20","DOIUrl":"https://doi.org/10.37897/rmj.2022.s3.20","url":null,"abstract":"Local recurrences after surgically treated endometrial cancer with associated vesical and rectal fistula represent a particular eventuality in which the only chance for cure is represented by extended pelvic resections. The aim of the current paper is to present the case of a 62 year old patient diagnosed with a local recurrence invading the urinary bladder and the rectum leading to the development of a complex fistula involving both the urinary and digestive tract after surgically treated endometrial cancer. Although initially the patient was not submitted to pelvic radiation therapy, at the time of relapse the presence of this fistula contraindicated any kind of radiation therapy. Therefore the patient was submitted to a total pelvic exenteration with cutaneous ureterostomy and terminal left colostomy. Another particularity of the patient was the fact that she had an ureteral duplication on the right side, both ureters being functional and exteriorized in right ureterostomy. In conclusion, pelvic exenteration might be a good therapeutic alternative for pelvic recurrences with complex fistulas after surgically treated endometrial cancer.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88665250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Pop, Madalina Piron, V. Rădoi, R. Ursu, B. Danciu, N. Bacalbaşa, I. Bălescu, Ioan Dumitru Suciu
In many cases, doctors looking after pregnant women are not fully informed about particularities of a pregnancy following bariatric surgery. They do not recommend nutritional supplements or organizing multidisciplinary team meeting. In addition many of this patients are not informed regarding possible complications and have high expectations in terms of outcomes.
{"title":"Bariatric surgery: a tool for pregnancy","authors":"L. Pop, Madalina Piron, V. Rădoi, R. Ursu, B. Danciu, N. Bacalbaşa, I. Bălescu, Ioan Dumitru Suciu","doi":"10.37897/rmj.2022.s3.8","DOIUrl":"https://doi.org/10.37897/rmj.2022.s3.8","url":null,"abstract":"In many cases, doctors looking after pregnant women are not fully informed about particularities of a pregnancy following bariatric surgery. They do not recommend nutritional supplements or organizing multidisciplinary team meeting. In addition many of this patients are not informed regarding possible complications and have high expectations in terms of outcomes.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74404205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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