N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean, C. Grigoriu
Granulosa cell tumors of the ovary represent a rare subtype of ovarian malignancies which is usually associated with low recurrence rates due to the fact that is usually diagnosed in early stages of the disease. The aim of the current paper is to report the case of a 50 year old patient diagnosed with such a recurrence at four years after the initial diagnostic. Case report: the 50 year old patient was initially submitted to surgery for an ovarian tumor at that moment radical surgery being performed. Four years later she self referred to our service for diffuse abdominal pain and was diagnosed with a presumptive hematoma at the level of the mesosigmoid loop in association with increased values of serum inhibin. The patient was submitted to surgery, intraoperatively a ruptured tumor in association with mesosigmoidian hematoma being discovered; therefore the lesion was resected en bloc with the rectosigmoidian loop. The histopathological studies confirmed the presence of negative resection margins. In conclusion, although granulosa cell tumors of the ovary rarely develop distant metastases, isolated recurrences might occur and in such cases radical resection seem to be an effective therapeutic option.
{"title":"Atypical presentation as large ruptured tumor with associated mesosigmoid hematoma of an ovarian granulosa cell tumor recurrence","authors":"N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean, C. Grigoriu","doi":"10.37897/rmj.2022.s4.1","DOIUrl":"https://doi.org/10.37897/rmj.2022.s4.1","url":null,"abstract":"Granulosa cell tumors of the ovary represent a rare subtype of ovarian malignancies which is usually associated with low recurrence rates due to the fact that is usually diagnosed in early stages of the disease. The aim of the current paper is to report the case of a 50 year old patient diagnosed with such a recurrence at four years after the initial diagnostic. Case report: the 50 year old patient was initially submitted to surgery for an ovarian tumor at that moment radical surgery being performed. Four years later she self referred to our service for diffuse abdominal pain and was diagnosed with a presumptive hematoma at the level of the mesosigmoid loop in association with increased values of serum inhibin. The patient was submitted to surgery, intraoperatively a ruptured tumor in association with mesosigmoidian hematoma being discovered; therefore the lesion was resected en bloc with the rectosigmoidian loop. The histopathological studies confirmed the presence of negative resection margins. In conclusion, although granulosa cell tumors of the ovary rarely develop distant metastases, isolated recurrences might occur and in such cases radical resection seem to be an effective therapeutic option.","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":"78672953","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
Ovarian cancer is characterized through a high capacity of spread via multiple pathways such as peritoneal, hematogenous or lymphatic route. Therefore, upper abdominal involvement might be encountered; in such cases extended visceral resections might be needed in order to achieve radical cytoreductive surgery. The aim of the current paper is to report the cases of three patients diagnosed with extended upper abdominal lesions and in which distal gastrectomy was successfully associated. Postoperatively a single case developed a postoperative leak which was successfully treated in a conservative manner. In all cases the histopathological studies demonstrated the presence of tumoral involvement of the gastric wall. In conclusion, gastrectomy can be safely associated as part of debulking surgery for advanced stage ovarian cancer in order to increase the chances to obtain long term survival.
{"title":"Distal gastrectomy as part of debulking surgery for advanced stage ovarian 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.s4.7","DOIUrl":"https://doi.org/10.37897/rmj.2022.s4.7","url":null,"abstract":"Ovarian cancer is characterized through a high capacity of spread via multiple pathways such as peritoneal, hematogenous or lymphatic route. Therefore, upper abdominal involvement might be encountered; in such cases extended visceral resections might be needed in order to achieve radical cytoreductive surgery. The aim of the current paper is to report the cases of three patients diagnosed with extended upper abdominal lesions and in which distal gastrectomy was successfully associated. Postoperatively a single case developed a postoperative leak which was successfully treated in a conservative manner. In all cases the histopathological studies demonstrated the presence of tumoral involvement of the gastric wall. In conclusion, gastrectomy can be safely associated as part of debulking surgery for advanced stage ovarian cancer in order to increase the chances to obtain long term survival.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"88 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90669144","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
Uterine cancer represents a common gynecological malignancy affecting women worldwide which can lead to the apparition of distant metastases through different patterns of spread such as direct contiguity, peritoneal, lymphatic or hematogenous route. When it comes to the hematogenous pattern of spread, the most commonly encountered viscera in which metastatic lesions can be found are represented by liver and lung. Meanwhile, breast metastases from uterine cancer represents a very scarce event, only few cases being reported so far. The aim of the current study is to review the case reports published so far on this issue.
{"title":"Breast metastases from uterine cancer – literature review","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.s4.4","DOIUrl":"https://doi.org/10.37897/rmj.2022.s4.4","url":null,"abstract":"Uterine cancer represents a common gynecological malignancy affecting women worldwide which can lead to the apparition of distant metastases through different patterns of spread such as direct contiguity, peritoneal, lymphatic or hematogenous route. When it comes to the hematogenous pattern of spread, the most commonly encountered viscera in which metastatic lesions can be found are represented by liver and lung. Meanwhile, breast metastases from uterine cancer represents a very scarce event, only few cases being reported so far. The aim of the current study is to review the case reports published so far on this issue.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"138 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79848082","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, C. Grigoriu
The correct diagnostic of a cystic lesion at the level of the right iliac fossa in women can be hard to be established in certain cases, different pathological lesions having similar imagistic aspects and being associated with similar biological modifications. In such cases the final diagnostic is established intraoperatively and the type of surgery can be significantly modified. The aim of the current paper is to report a 63 year old woman with preoperative diagnostic of right ovarian mass who was submitted to surgery in order to have a total hysterectomy and bilateral adnexectomy; however intraoperatively the cystic lesion developed at the level of the right iliac fossa proved to be an appendicular tumor and was successfully resected by performing a radical right hemicolectomy.
{"title":"Appendicular mucocele mimicking a right adnexal mass – a case report and literature review","authors":"N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean, C. Grigoriu","doi":"10.37897/rmj.2022.s3.7","DOIUrl":"https://doi.org/10.37897/rmj.2022.s3.7","url":null,"abstract":"The correct diagnostic of a cystic lesion at the level of the right iliac fossa in women can be hard to be established in certain cases, different pathological lesions having similar imagistic aspects and being associated with similar biological modifications. In such cases the final diagnostic is established intraoperatively and the type of surgery can be significantly modified. The aim of the current paper is to report a 63 year old woman with preoperative diagnostic of right ovarian mass who was submitted to surgery in order to have a total hysterectomy and bilateral adnexectomy; however intraoperatively the cystic lesion developed at the level of the right iliac fossa proved to be an appendicular tumor and was successfully resected by performing a radical right hemicolectomy.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85366173","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}
R. Ursu, Radu Alexandru Truica, Alexandra Cojocaru, Diana Prepelita, L. Pop, V. Rădoi, N. Bacalbaşa, I. Bălescu
Ovarian cancer is the most frequent type of gynecologic malignancy and is currently on the fifth place among different cancers worldwide. According to the estimations, ovarian cancer accounts for 1.3% of all new cancer cases. Ovarian cancer is considered a heterogeneous class of malignancies with a poor prognosis due to late diagnose and low treatment response. There are few types of ovarian cancer: epithelial ovarian cancer, germline cell ovarian cancer and stromal cell ovarian cancer. Epithelial ovarian cancers represent more than 90% of ovarian malignancies, and comprise high-grade serous carcinoma (HGSOC), low-grade serous carcinoma (LGSOC), endometrioid carcinoma, mucinous carcinoma, and clear cell carcinoma. Of these, HGSOC is the most frequent histological subtype. The diagnosis of most of OC cases, at an advanced disease stage is one of the reasons for high fatality rate and carries poor prognosis with current therapies. Several aspects can increase the risk of developing ovarian cancer, including genetic factors, such as age, postmenopausal hormonal therapy use, infertility and nulliparity. Among the genetic factors, most commonly we encounter BRCA1 and BRCA2, at approximately 17% of patients. Also these mutation rise the risk for another cancers like breast cancer, pancreatic cancer, prostatic cancer and melanoma. BRCA1 and 2 are genes involved in DNA repair and maintenance. Other genes that have a similar function are RAD511C, RAD51D, BRIP1, PALB2, CHEK2, MRE11A, RAD50, ATM and TP53.
{"title":"Genetic factors involved in ovarian cancer","authors":"R. Ursu, Radu Alexandru Truica, Alexandra Cojocaru, Diana Prepelita, L. Pop, V. Rădoi, N. Bacalbaşa, I. Bălescu","doi":"10.37897/rmj.2022.s3.3","DOIUrl":"https://doi.org/10.37897/rmj.2022.s3.3","url":null,"abstract":"Ovarian cancer is the most frequent type of gynecologic malignancy and is currently on the fifth place among different cancers worldwide. According to the estimations, ovarian cancer accounts for 1.3% of all new cancer cases. Ovarian cancer is considered a heterogeneous class of malignancies with a poor prognosis due to late diagnose and low treatment response. There are few types of ovarian cancer: epithelial ovarian cancer, germline cell ovarian cancer and stromal cell ovarian cancer. Epithelial ovarian cancers represent more than 90% of ovarian malignancies, and comprise high-grade serous carcinoma (HGSOC), low-grade serous carcinoma (LGSOC), endometrioid carcinoma, mucinous carcinoma, and clear cell carcinoma. Of these, HGSOC is the most frequent histological subtype. The diagnosis of most of OC cases, at an advanced disease stage is one of the reasons for high fatality rate and carries poor prognosis with current therapies. Several aspects can increase the risk of developing ovarian cancer, including genetic factors, such as age, postmenopausal hormonal therapy use, infertility and nulliparity. Among the genetic factors, most commonly we encounter BRCA1 and BRCA2, at approximately 17% of patients. Also these mutation rise the risk for another cancers like breast cancer, pancreatic cancer, prostatic cancer and melanoma. BRCA1 and 2 are genes involved in DNA repair and maintenance. Other genes that have a similar function are RAD511C, RAD51D, BRIP1, PALB2, CHEK2, MRE11A, RAD50, ATM and TP53.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85758077","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}
I. Peride, M. Tiglis, Mihai-Emil Gherghina, T. Neagu, A. Niculae, I. Checherita
IgA Nephropathy (IgAN) is one of the most frequent types of glomerulonephritis encountered in adults from Western countries and Asia. IgAN is responsible for approximately 40% of end-stage renal disease (ESRD) mediated by glomerular impairment. The majority of adult IgAN patients present a slowly progressive pattern towards ESRD. Current types of treatment are based mainly on supportive care: i.e., life style risk factors, measures that lower blood pressure and reduce proteinuria, weight loss, smoking cessation or glycaemia control. Because IgAN is an immune complex-mediated disease, immunosuppression therapy gains more and more attention as a modality of treatment. Despite the beneficial effects, the value of immunosuppression remains controversial due to high rates of adverse reactions. The aim of this review is to highlight the benefits and limitations of promoting immunosuppression in IgAN with mild to moderate proteinuria despite supportive antiproteinuric therapy up titrated to maximum tolerated doses.
{"title":"Immunosupression in IgA Nephropathy","authors":"I. Peride, M. Tiglis, Mihai-Emil Gherghina, T. Neagu, A. Niculae, I. Checherita","doi":"10.37897/rmj.2022.1.2","DOIUrl":"https://doi.org/10.37897/rmj.2022.1.2","url":null,"abstract":"IgA Nephropathy (IgAN) is one of the most frequent types of glomerulonephritis encountered in adults from Western countries and Asia. IgAN is responsible for approximately 40% of end-stage renal disease (ESRD) mediated by glomerular impairment. The majority of adult IgAN patients present a slowly progressive pattern towards ESRD. Current types of treatment are based mainly on supportive care: i.e., life style risk factors, measures that lower blood pressure and reduce proteinuria, weight loss, smoking cessation or glycaemia control. Because IgAN is an immune complex-mediated disease, immunosuppression therapy gains more and more attention as a modality of treatment. Despite the beneficial effects, the value of immunosuppression remains controversial due to high rates of adverse reactions. The aim of this review is to highlight the benefits and limitations of promoting immunosuppression in IgAN with mild to moderate proteinuria despite supportive antiproteinuric therapy up titrated to maximum tolerated doses.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74732508","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}
Introduction. Due to the high incidence, morbidity, mortality and high costs for the health system, sepsis stands out, among other things, by the firm indication of hospitalization in an intensive care unit. Dysfunction of microcirculation plays a central role in the genesis and maintenance of septic syndrome, as it represents a pathophysiological milestone of this syndrome. Videocapillaroscopy opens up the possibility of detecting microvascular anomalies in the early stages, allowing for new diagnostic and research opportunities. Material and method. Our unrandomized, prospective, multicenter, analytical study analyzed a group of 51 patients with various ethology of septic shock, a clinical condition that was diagnosed on the basis of standard clinical and biological criteria, hospitalized in three ICU clinical wards, over the course of 15 months (August 2019 - November 2020), where the parameters of the oral mucosa microcirculation were monitored with the help of a videocapillaroscope, the resulting prototype of an invention patent already implemented by the authors. Objectives. The main objective of our study was to validate, on a clinical level, the possibility of using videocapillaroscopy of the oral mucosa, as an efficient means of early detection of the changes that predict the early onset of septic shock in patients in ICU patients. Results. Videocapillaroscopy was performed with a prototype device, recording 357 images of the microcirculation of the oral mucosa in the patients that had already been confirmed, via classical clinical and paraclinical means, with the diagnosis of sepsis. Discussions. The statistical analysis of the essential 5 elements detected by videocapillaroscopy (capillary density, incidence in normal and parallel disposition, diameter and microhemorrhage) corroborated with the clinical and paraclinical elements of the sepsis state path clearly highlights the correlation power of these determinations. Conclusions. Given the completely non-invasive nature of this imaging method, the very low costs associated with the method, the ease in collecting and interpreting data as well as the results that bear strong statistical correlation, we can conclude that it can successfully be considered a method of prediction with high reliability and specificity in the early detection of sepsis, regardless of its etiology.
{"title":"Videocapillaroscopy of the oral mucosa as an non-invasive tool for early detection of sepsis","authors":"G. Gorecki, C. Moldovan, E. Rusu, D. Cochior","doi":"10.37897/rmj.2022.1.4","DOIUrl":"https://doi.org/10.37897/rmj.2022.1.4","url":null,"abstract":"Introduction. Due to the high incidence, morbidity, mortality and high costs for the health system, sepsis stands out, among other things, by the firm indication of hospitalization in an intensive care unit. Dysfunction of microcirculation plays a central role in the genesis and maintenance of septic syndrome, as it represents a pathophysiological milestone of this syndrome. Videocapillaroscopy opens up the possibility of detecting microvascular anomalies in the early stages, allowing for new diagnostic and research opportunities. Material and method. Our unrandomized, prospective, multicenter, analytical study analyzed a group of 51 patients with various ethology of septic shock, a clinical condition that was diagnosed on the basis of standard clinical and biological criteria, hospitalized in three ICU clinical wards, over the course of 15 months (August 2019 - November 2020), where the parameters of the oral mucosa microcirculation were monitored with the help of a videocapillaroscope, the resulting prototype of an invention patent already implemented by the authors. Objectives. The main objective of our study was to validate, on a clinical level, the possibility of using videocapillaroscopy of the oral mucosa, as an efficient means of early detection of the changes that predict the early onset of septic shock in patients in ICU patients. Results. Videocapillaroscopy was performed with a prototype device, recording 357 images of the microcirculation of the oral mucosa in the patients that had already been confirmed, via classical clinical and paraclinical means, with the diagnosis of sepsis. Discussions. The statistical analysis of the essential 5 elements detected by videocapillaroscopy (capillary density, incidence in normal and parallel disposition, diameter and microhemorrhage) corroborated with the clinical and paraclinical elements of the sepsis state path clearly highlights the correlation power of these determinations. Conclusions. Given the completely non-invasive nature of this imaging method, the very low costs associated with the method, the ease in collecting and interpreting data as well as the results that bear strong statistical correlation, we can conclude that it can successfully be considered a method of prediction with high reliability and specificity in the early detection of sepsis, regardless of its etiology.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"88 10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84059895","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. Bacha, W. Ferjaoui, Mohamed Zran, S. Baccouche, S. Ben slama, I. Marzouk, L. Gharbi, A. Lahmar, R. Ennaifer, R. Bayar
Esophageal and anorectal leiomyomatosis association is exceedingly rare. It's characterized by a benign smooth muscle cell proliferation in respectively esophageal and anorectal walls, causing circumferential thickening. To the best of our knowledge, this is the first reported pulmonary BML case associated with esophageal and anorectal leiomyomatosis in a 20-year-old female.
{"title":"Pulmonary benign metastasizing leiomyoma in patient with esophageal and anorectal leiomyomatosis","authors":"D. Bacha, W. Ferjaoui, Mohamed Zran, S. Baccouche, S. Ben slama, I. Marzouk, L. Gharbi, A. Lahmar, R. Ennaifer, R. Bayar","doi":"10.37897/rmj.2022.1.6","DOIUrl":"https://doi.org/10.37897/rmj.2022.1.6","url":null,"abstract":"Esophageal and anorectal leiomyomatosis association is exceedingly rare. It's characterized by a benign smooth muscle cell proliferation in respectively esophageal and anorectal walls, causing circumferential thickening. To the best of our knowledge, this is the first reported pulmonary BML case associated with esophageal and anorectal leiomyomatosis in a 20-year-old female.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"253 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76117661","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}
T. Neagu, M. Tiglis, I. Sebe, L. Răducu, I. Lascar
The presence of inhalation injury has a negative impact on the evolution of burned patients, being associated with increased mortality. It occurs as a direct consequence of thermal action, or secondary to the presence of respiratory irritants or absorption of toxins, and actual therapeutic management is mainly supportive. Several clinical findings are relevant to raising suspicion and guiding further examinations, fiberoptic bronchoscopy being the gold standard of diagnosis and staging. In burned patients with inhalation injuries, various reports showed that nebulized heparin (5,000 or 10,000 units) with a 4-hour administration regimen leads to improved outcome, reduces the days of mechanical ventilation and consequently the length of hospital stay, reduces pulmonary complications and improves lung function, having a safe profile, with fewer side effects.
{"title":"Nebulized heparin for burned patients with inhalation injury: a review","authors":"T. Neagu, M. Tiglis, I. Sebe, L. Răducu, I. Lascar","doi":"10.37897/rmj.2022.1.1","DOIUrl":"https://doi.org/10.37897/rmj.2022.1.1","url":null,"abstract":"The presence of inhalation injury has a negative impact on the evolution of burned patients, being associated with increased mortality. It occurs as a direct consequence of thermal action, or secondary to the presence of respiratory irritants or absorption of toxins, and actual therapeutic management is mainly supportive. Several clinical findings are relevant to raising suspicion and guiding further examinations, fiberoptic bronchoscopy being the gold standard of diagnosis and staging. In burned patients with inhalation injuries, various reports showed that nebulized heparin (5,000 or 10,000 units) with a 4-hour administration regimen leads to improved outcome, reduces the days of mechanical ventilation and consequently the length of hospital stay, reduces pulmonary complications and improves lung function, having a safe profile, with fewer side effects.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81044080","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. Tiglis, I. Peride, T. Neagu, L. Răducu, I. Lascar
Hydrotherapy represents the use of water for medical purpose, being involved in burn wound care since the 17th century. Burn wound cleansing, performed daily, twice a day, or as needed, as part of standard care, should be scheduled by a burn surgeon and supervised by proper specialists. It can be performed by various methods, like shower, immersion, bedside irrigation or wiping. Due to the high risk of cross-contamination, immersion is no longer recommended. Tap water seems to be superior to saline solution in burn wound care, and adjuvants can be added, especially chlorhexidine, povidone-iodine, or special detergents. Disposable plastic sheets use during showering and the following of cleaning protocols for washing areas have decreased the risk of infection. Apart from the wound-cleansing role, hydrotherapy reduces itching and pain, improves wound healing, favors early mobilization and increases patients’ comfort. Controversy persists around the optimal method and appropriate solutions for cleaning burn injuries and clinical studies are further required to solve this matter. In the absence of standardized recommendations, most burn centers are guided by experience.
{"title":"Hydrotherapy in burn care: Pros, cons and suggestions","authors":"M. Tiglis, I. Peride, T. Neagu, L. Răducu, I. Lascar","doi":"10.37897/rmj.2022.1.3","DOIUrl":"https://doi.org/10.37897/rmj.2022.1.3","url":null,"abstract":"Hydrotherapy represents the use of water for medical purpose, being involved in burn wound care since the 17th century. Burn wound cleansing, performed daily, twice a day, or as needed, as part of standard care, should be scheduled by a burn surgeon and supervised by proper specialists. It can be performed by various methods, like shower, immersion, bedside irrigation or wiping. Due to the high risk of cross-contamination, immersion is no longer recommended. Tap water seems to be superior to saline solution in burn wound care, and adjuvants can be added, especially chlorhexidine, povidone-iodine, or special detergents. Disposable plastic sheets use during showering and the following of cleaning protocols for washing areas have decreased the risk of infection. Apart from the wound-cleansing role, hydrotherapy reduces itching and pain, improves wound healing, favors early mobilization and increases patients’ comfort. Controversy persists around the optimal method and appropriate solutions for cleaning burn injuries and clinical studies are further required to solve this matter. In the absence of standardized recommendations, most burn centers are guided by experience.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83840433","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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