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Mitroi RM, Roșu MM, Clenciu D, Pădureanu V, Mitrea A, Grigore MA, Mazilu ER, Rădulescu D, Vladu IM. Vasculitis and infectious risk in a patient with type 2 diabetes mellitus: A case report. Exp Ther Med 2024; 27:234. [PMID: 38628659 PMCID: PMC11019656 DOI: 10.3892/etm.2024.12522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 01/16/2024] [Indexed: 04/19/2024] Open
Abstract
The connection between vasculitis and infection is complex. The present study described a typical situation for a patient with unbalanced type 2 diabetes and chronic complications, in which a lack of adherence to the protection and care measures ultimately led to the appearance of some of the worst consequences of the condition, namely, ulceration, gangrene and amputation. In the context of an unstable condition with significant metabolic imbalance there was an impaired response to infections in the present patient, and the amputation resulted in wound persistence and ulcer development, followed by superinfection with methicillin-resistant Staphylococcus aureus according to the antibiogram performed. In this case, an episode of vasculitis was triggered without evidence of bacteraemia. The present case report highlighted the importance of proper hygiene and good metabolic control in patients with diabetes that suffer from amputations and conditions that expose them to certain complications, including vasculitis.
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Affiliation(s)
- Roxana Mădălina Mitroi
- Department of Diabetes, Nutrition and Metabolic Diseases, County Clinical Emergency Hospital of Craiova, 200642 Craiova, Romania
| | - Maria Magdalena Roșu
- Department of Diabetes, Nutrition and Metabolic Diseases, County Clinical Emergency Hospital of Craiova, 200642 Craiova, Romania
- Department of Diabetes, Nutrition and Metabolic Diseases, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Diana Clenciu
- Department of Diabetes, Nutrition and Metabolic Diseases, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Diabetes, Nutrition and Metabolic Diseases, Clinical Municipal Hospital ‘Philanthropy’ of Craiova, 200143 Craiova, Romania
| | - Vlad Pădureanu
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Adina Mitrea
- Department of Diabetes, Nutrition and Metabolic Diseases, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Diabetes, Nutrition and Metabolic Diseases, Clinical Municipal Hospital ‘Philanthropy’ of Craiova, 200143 Craiova, Romania
| | - Maria Andreea Grigore
- Department of Diabetes, Nutrition and Metabolic Diseases, County Clinical Emergency Hospital of Craiova, 200642 Craiova, Romania
| | - Emilia Roxana Mazilu
- Department of Diabetes, Nutrition and Metabolic Diseases, County Clinical Emergency Hospital of Craiova, 200642 Craiova, Romania
| | - Dumitru Rădulescu
- Department of General Surgery, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ionela Mihaela Vladu
- Department of Diabetes, Nutrition and Metabolic Diseases, County Clinical Emergency Hospital of Craiova, 200642 Craiova, Romania
- Department of Diabetes, Nutrition and Metabolic Diseases, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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Pădureanu V, Drăgoescu AN, Pădureanu R, Rośu MM, Rădulescu D, Dop D, For£ofoiu MC. Treatment approaches in autoimmune pancreatitis (Review). Biomed Rep 2024; 20:26. [PMID: 38259589 PMCID: PMC10801350 DOI: 10.3892/br.2023.1714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Autoimmune pancreatitis (AIP) is a rare disease. There are two distinct types of AIP: AIP type 1 (AIP-1), a pancreatic manifestation of a multi-organ disease linked to immunoglobulin (Ig)G4, and AIP type 2 (AIP-2), a pancreas-specific disease unrelated to IgG4. The usual course of treatment for AIP is oral corticosteroid medication. Rituximab has also been recommended for recurrent AIP-1 in order to initiate remission and provide ongoing treatment. Immunomodulators such as azathioprine are used to keep certain patients in remission. Evaluation also takes into account a number of pharmacological alternatives, including biologic drugs like anti-tumor necrosis factor therapy, a safe and efficient second-line treatment for AIP-2 relapse or steroid dependence. Corticosteroids and immunosuppressants, which are poorly tolerated due to considerable side effects, are being replaced by other biologic drugs, which may offer a beneficial therapeutic alternative.
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Affiliation(s)
- Vlad Pădureanu
- Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Alice Nicoleta Drăgoescu
- Department of Anaesthesiology and Intensive Care, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Rodica Pădureanu
- Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Maria Magdalena Rośu
- Department of Diabetes, Nutrition and Metabolic Diseases, County Clinical Emergency Hospital of Craiova, Craiova 200642, Romania
| | - Dumitru Rădulescu
- Department of Pediatrics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Dalia Dop
- Department of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Mircea Cătălin For£ofoiu
- Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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3
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Boldea GJ, Caragea DC, Nicolcescu P, Pădureanu V, Rădulescu D, Boldea AM, Georgescu I, Georgescu EF. Effect of the COVID‑19 pandemic on the management and outcomes of patients with traumatic injuries (Review). Biomed Rep 2023; 19:76. [PMID: 37746590 PMCID: PMC10511947 DOI: 10.3892/br.2023.1658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/10/2023] [Indexed: 09/26/2023] Open
Abstract
During the COVID-19 pandemic, ~10% of the global population was officially affected, resulting in diverse changes, ranging from shopping habits to stringent hospital protocols. This article sought to provide a concise summary of relevant data concerning the interplay between COVID-19 and trauma, encompassing the entire trajectory from presentation to hospital discharge. Throughout the pandemic, there was a noticeable reduction in trauma presentations, while the ranking of injury mechanisms remained largely unchanged. To ensure essential surgical support, protocols were adjusted accordingly. Although there were some less significant changes in injury severity score, hospital length of stay, intensive care unit stay and mortality, the overall patient outcomes appeared to improve. In conclusion, the COVID-19 pandemic led to a decline in trauma cases and an enhancement in patient outcomes. However, regrettably, certain mechanisms of injury saw an increase in frequency. To cope with the epidemiological context, management strategies were adapted, and unutilized resources were redirected to cater to the care of COVID-19 patients.
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Affiliation(s)
- Gheorghe-Jean Boldea
- UMF Craiova Doctoral School, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Daniel Cosmin Caragea
- Department of Nephrology, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Pantelie Nicolcescu
- Department of Anesthesiology and Intensive Care, Faculty of Medicine and Pharmacy, Sibiu 550169, Romania
| | - Vlad Pădureanu
- Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Dumitru Rădulescu
- Department of Surgery, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Ana Maria Boldea
- UMF Craiova Doctoral School, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Ion Georgescu
- Department of Surgery, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Eugen Florin Georgescu
- Department of Surgery, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
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4
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Rădulescu PM, Căluianu EI, Traşcă ET, Mercuţ D, Georgescu I, Georgescu EF, Ciupeanu-Călugăru ED, Mercuţ MF, Mercuţ R, Padureanu V, Streba CT, Călăraşu C, Rădulescu D. The Impact of the COVID-19 Pandemic on Outcomes in Acute Pancreatitis: A Propensity Score Matched Study Comparing before and during the Pandemic. Diagnostics (Basel) 2023; 13:2446. [PMID: 37510190 PMCID: PMC10378087 DOI: 10.3390/diagnostics13142446] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
We aimed to evaluate the outcomes and survival of patients with acute pancreatitis who shared the same clinical form, age, and sex before the pandemic, during the pandemic, and among those with confirmed COVID-19 infection upon hospital admission. This consideration used the sparse data in the existing literature on the influence of the pandemic and COVID-19 infection on patients with acute pancreatitis. To accomplish this, we conducted a multicentric, retrospective case-control study using propensity score matching with a 2:1 match of 28 patients with SARS-CoV-2 infection and acute pancreatitis, with 56 patients with acute pancreatitis pre-pandemic, and 56 patients with acute pancreatitis during the pandemic. The study outcome demonstrated a six-fold relative risk of death in patients with acute pancreatitis and SARS-CoV-2 infection compared to those with acute pancreatitis before the pandemic. Furthermore, restrictive measures implemented during the pandemic period led to a partial delay in the care of patients with acute pancreatitis, which likely resulted in an impairment of their immune state. This, in certain circumstances, resulted in a restriction of surgical treatment indications, leading to a three-fold relative risk of death in patients with acute pancreatitis during the pandemic compared to those with acute pancreatitis before the pandemic.
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Affiliation(s)
| | - Elena Irina Căluianu
- General Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Emil Tiberius Traşcă
- General Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Dorin Mercuţ
- General Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ion Georgescu
- General Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Eugen Florin Georgescu
- General Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | | | - Maria Filoftea Mercuţ
- Department of Ophthalmology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Răzvan Mercuţ
- Department of Plastic and Reconstructive Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Vlad Padureanu
- Internal Medicine Department, Country Hospital of Craiova, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Costin Teodor Streba
- Department of Pneumology, University of Pharmacy and Medicine Craiova, 200349 Craiova, Romania
| | - Cristina Călăraşu
- Department of Pneumology, University of Pharmacy and Medicine Craiova, 200349 Craiova, Romania
| | - Dumitru Rădulescu
- General Surgery Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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5
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Pădureanu V, Caragea DC, Florescu MM, Vladu IM, Rădulescu PM, Florescu DN, Rădulescu D, Pădureanu R, Efrem IC. Role of the SARS‑COV2 infection in the evolution of acute pancreatitis (Review). Biomed Rep 2023; 19:49. [PMID: 37383680 PMCID: PMC10293881 DOI: 10.3892/br.2023.1632] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/10/2023] [Indexed: 06/30/2023] Open
Abstract
Acute pancreatitis is characterized as an inflammatory illness that is life-threatening and causes necrosis as well as simple edema when pancreatic enzymes are activated intraglandularly. It is not known whether severe acute respiratory syndrome coronavirus 2 causes acute pancreatitis. Patients with acute pancreatitis who test positive for coronavirus disease 2019 (COVID-19) frequently have biliary or alcoholic causes. It is unclear how common acute pancreatitis is in patients with COVID-19. By contrast with patients without COVID-19, however, COVID-19-positive patients with acute pancreatitis have a higher mortality as well as a higher risk of necrosis and admission to an intensive care unit. The most common cause of mortality in COVID-19-positive individuals with concurrent severe pancreatitis is acute respiratory distress syndrome. The present study discussed research on the link between COVID-19 infection and acute pancreatitis.
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Affiliation(s)
- Vlad Pădureanu
- Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Daniel Cosmin Caragea
- Department of Nephrology, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Mirela Marinela Florescu
- Department of Morphology, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Ionela Mihaela Vladu
- Department of Diabetes, Nutrition and Metabolic Diseases, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Patricia Mihaela Rădulescu
- University of Medicine and Pharmacy of Craiova Doctoral School, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Dan Nicolae Florescu
- Department of Gastroenterology, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Dumitru Rădulescu
- Department of Surgery, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Rodica Pădureanu
- Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Ion Cristian Efrem
- Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
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Boldea GJ, Georgescu EF, Georgescu I, Rădulescu D, Pîrșcoveanu M. Hepatectomy During the Pandemic, a Curative Treatment in High-Grade and/or Hemodynamically Unstable Blunt Liver Trauma. Curr Health Sci J 2023; 49:123-128. [PMID: 37786764 PMCID: PMC10541509 DOI: 10.12865/chsj.49.01.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 12/12/2022] [Indexed: 10/04/2023]
Abstract
The liver is among the most affected organs in the case of abdominal trauma. In the last decades there have been significant changes in therapeutic protocols, non-operative management is now the first intention in most cases due to good results offered previously. In high-grade or hemodynamically unstable injuries, hepatectomy is the best approach, even though this was viewed with skepticism in the past, technical advances in medicine have proven otherwise. This article presents a case report of a 29-year-old man with blunt abdominal trauma, who initially underwent conservative atypical right hepatectomy without a favourable outcome, later he was transferred to a liver transplant center where he underwent a controlled right hepatectomy, all this in a new epidemiological context, the COVID-19 Pandemic. We want to present the hypothesis that in making a therapeutic decision, the hemodynamic status of the patient must be considered equally along with the injury degree. This case represents an opportunity to review the role of liver resection in the management of complex liver injuries.
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Affiliation(s)
- Gheorghe-Jean Boldea
- Ph.D. Student, Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania
| | | | - Ion Georgescu
- Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania
| | - Dumitru Rădulescu
- Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania
| | - Mircea Pîrșcoveanu
- Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania
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Forțofoiu M, Vladu I, Forțofoiu MC, Pădureanu R, Clenciu D, Rădulescu D, Pădureanu V. New strategies of diagnostic and therapeutic approach to emergencies in the evolution of patients with diabetes mellitus (Review). Exp Ther Med 2021; 23:178. [PMID: 35069859 PMCID: PMC8764581 DOI: 10.3892/etm.2021.11101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/29/2021] [Indexed: 11/16/2022] Open
Abstract
Diabetes mellitus, known as the most widespread disease in the world, along with four other chronic diseases, involves major expenditures and significant human resources for care, thus representing a burden on any type of health care system especially due to its rapid evolution of acute and chronic complications. For the emergency department (ED), the requirements of patients with acute complications of diabetes, determine expenses which are three times higher than those for non-diabetic patients and their hospitalizations are four times more frequent. The acute complications for which patients with diabetes most frequently require the ED are hypoglycemic, hyperosmolar, or ketoacidosis coma as well as alterations of the general condition that is typical of hypoglycemia, diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state and new-onset hyperglycemia. Hypoglycemia and the Somogyi phenomenon are the most common complications of type 1 diabetes but they can also occur in patients with type 2 diabetes who are treated with insulin through its overdose. DKA can occur in type 1 and 2 diabetes either by administering inadequate doses of insulin or due to the existence of precipitating factors such as stress, acute myocardial infarction, infections, sepsis, and/or gastrointestinal bleeding. Hyperosmolar hyperglycemic status is the most common complication in patients with type 2 diabetes and DKA. Treating the acute complications of diabetes in the ED involves, besides taking immediate measures to assess and maintain vital functions, monitoring patients, assessing blood sugar, electrolytes, urea, creatinine, and bicarbonate, and applying appropriate immediate therapeutic measures for each type of acute diabetes complication.
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Affiliation(s)
- Maria Forțofoiu
- Department of Emergency, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ionela Vladu
- Department of Diabetes and Nutritional Diseases, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova
| | - Mircea-Cătălin Forțofoiu
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Rodica Pădureanu
- Department of Internal Medicine, Emergency Clinical County Hospital of Craiova, 200642 Craiova, Romania
| | - Diana Clenciu
- Department of Diabetes and Nutritional Diseases, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova
| | - Dumitru Rădulescu
- Department of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Vlad Pădureanu
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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Pomacu MM, Trașcă MD, Pădureanu V, Bugă AM, Andrei AM, Stănciulescu EC, Baniță IM, Rădulescu D, Pisoschi CG. Interrelation of inflammation and oxidative stress in liver cirrhosis. Exp Ther Med 2021; 21:602. [PMID: 33936259 PMCID: PMC8082585 DOI: 10.3892/etm.2021.10034] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 02/22/2021] [Indexed: 12/11/2022] Open
Abstract
Recently, the trend of research has been focused on the role of hematological indicators in assessing the activities of various diseases. The aim of the present study was to determine the usefulness of such hematological indicators for assessment of the relationship between inflammation and oxidative stress in order to provide new predictive tools for a non-invasive investigation of disease outcome for liver cirrhosis patients. A total of 35 subjects with compensated or decompensated liver cirrhosis and 10 age-matched healthy volunteers were included in this study. The patients were divided into two groups: Group 1, patients with toxic metabolic cirrhosis due to ethanol consumption; group 2, patients with liver cirrhosis following hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. Using hematological data obtained after the complete counting of peripheral blood cells, the monocyte/lymphocyte (MLR), neutrophil/lymphocyte (NLR) and platelet/lymphocyte (PLR) ratios as well as systemic immune inflammation biomarkers were determined. The erythrocyte sedimentation ratio (ESR), C-reactive protein (CRP), fibrinogen and biochemical parameters related to liver function were also registered. Thiobarbituric acid reactive substances (TBARS), protein carbonyl content (PCARB), and total antioxidant capacity (TAC) were also investigated in the peripheral blood samples of healthy subjects and liver cirrhosis patients. The results revealed that NLR, MLR and PLR were significantly increased in group 2. PLR was significantly increased in group 1 compared with that noted in the control group. TBARS and PCARB were increased in patients from group 1 compared to patients from group 2 and the control group. However, no difference in TAC was found between the liver cirrhosis groups and the control. We showed that the pro-inflammatory status of liver cirrhosis patients can be easily appreciated by NLR, MLR but not PLR. However, the increase in these ratios was not significantly associated with a decrease in the antioxidant capacity and an augmentation of oxidative stress markers for the patients diagnosed with cirrhosis included in the two groups of study.
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Affiliation(s)
- Mihnea Marian Pomacu
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.,4th Department-Medical Specialties, First Clinic of Internal Medicine, Clinical City Hospital 'Filantropia', University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Maria Diana Trașcă
- 4th Department-Medical Specialties, First Clinic of Internal Medicine, Clinical City Hospital 'Filantropia', University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Vlad Pădureanu
- Department of Internal Medicine, County Hospital of Craiova, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ana Maria Bugă
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ana Marina Andrei
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | | | - Ileana Monica Baniță
- Department of Histology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Dumitru Rădulescu
- Department of General Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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Pătru S, Pădureanu V, Rădulescu D, Mititelu RR, Pădureanu R, Băcanoiu M, Matei D. A nontraumatic myositis ossificans case of the forearm: Case report and literature review. Exp Ther Med 2021; 21:531. [PMID: 33815604 PMCID: PMC8014871 DOI: 10.3892/etm.2021.9963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/12/2020] [Indexed: 12/19/2022] Open
Abstract
Myositis ossificans (MO) is a rare, benign ossifying lesion characterized by focal formation of heterotopic bone and cartilage in extraskeletal soft-tissue that most commonly occurs in young adults. In most cases, no causative factor can be identified. The diagnosis of MO is usually based on the patient's history of trauma, clinical signs, on imaging appearance and histological examination. We present a non-traumatic MO case of the forearm in a 40-year-old man with weakness in left finger motion, a decrease in prehension for more than three weeks, without any weight loss, malaise, anorexia or fever. The clinical symptoms and radiological findings can be easily confused with malignant lesions. Treatment is usually conservative but, due to the limited strength and range of motion of the left hand, the tumor was extirpated and the diagnosis of MO was made by biopsy. The patient had no neurological deficits after surgical treatment and was discharged on the fifth day after the surgery in good condition with the recommendation to begin a rehabilitation program.
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Affiliation(s)
- Simona Pătru
- Department of Physical and Rehabilitation Medicine, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Vlad Pădureanu
- Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Dumitru Rădulescu
- Department of Surgery, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Radu Răzvan Mititelu
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Rodica Pădureanu
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
| | - Manuela Băcanoiu
- Department of Physical Therapy and Sports Medicine, University of Craiova, Craiova 200207, Romania
| | - Daniela Matei
- Department of Physical and Rehabilitation Medicine, University of Medicine and Pharmacy of Craiova, Craiova 200349, Romania
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10
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Pătru S, Pădureanu R, Dumitrescu F, Pădureanu V, Rădulescu D, Dragoi D, Matei D. Influence of multidisciplinary therapeutic approach on fibromyalgia patients. Exp Ther Med 2021; 21:528. [PMID: 33815601 PMCID: PMC8014964 DOI: 10.3892/etm.2021.9960] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/02/2020] [Indexed: 12/11/2022] Open
Abstract
There is no specific cure for fibromyalgia (FM), but combined non-pharmacologic and pharmacologic treatments may mitigate symptoms and improve quality of life in patients. The aim of the present study was to monitor patient response to several types of therapy, including cognitive-behavioral and occupational therapy, and kinetic therapy, as compared to a control group that was not subjected to any form of therapy. The study included 98 FM patients, all women, out of which 32 received cognitive-behavioral therapy and occupational therapy (CBT+OT), 34 kinetic therapy (KT) and 32 participated as controls. The evaluation protocol comprised two questionnaires developed in order to assess the patient's condition as fully as possible: Fibromyalgia Impact Questionnaire (FIQ) and Fibro Fatigue (FF) scale. At the pre-evaluation there were no significant inter-group differences. At post-evaluation significant differences were observed between the control sample and the group subjected to kinetic therapy (P<0.05). FIQ scores decreased in the CBT+OT group too, but less than that in the KT group. The FF scale registered notable evolutions in time for the group subjected to kinetic therapy. In order to control and improve most of the FM symptoms, besides proper medication, we suggest an interdisciplinary intervention mainly focusing on long-term individualized kinetic therapy. The simultaneous integration of a cognitive-behavioural and occupational therapy intervention could be the element that completes the complex treatment of FM patients.
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Affiliation(s)
- Simona Pătru
- Department of Physical and Rehabilitation Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Rodica Pădureanu
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Florentina Dumitrescu
- Department of Infectious Diseases, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Vlad Pădureanu
- Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Dumitru Rădulescu
- Department of Surgery, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania
| | - Diana Dragoi
- Department of Rehabilitation, Emergency County Hospital Valcea, 240284 Valcea, Romania
| | - Daniela Matei
- Department of Physical and Rehabilitation Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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Elfarra M, Rădulescu D, Peride I, Niculae A, Ciocâlteu A, Checheriţă IA, Lascăr I, Sinescu DR. Thromboangiitis obliterans - case report. Chirurgia (Bucur) 2015; 110:183-187. [PMID: 26011844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2015] [Indexed: 06/04/2023]
Abstract
Thromboangiitis obliterans (Buerger's disease) represents an inflammatory disease of limbs' small arteries and veins causing vascular thrombosis, and partial or total obstruction. It affects mostly male gender aged 40 years old. The peculiarity of our case is underlined by presenting a 62 years, chronic tobacco user and not compliant female patient known with thromb oangiitisobliterans for almost 15 years. The arteriographic and clinical features with concomitant and sever affected upper and lower limbs are highly suggestive, emphasizing the possibility of Buerger's disease development even in female patients.
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12
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Nechita AM, Rădulescu D, Peride I, Niculae A, Bratu O, Ferechide D, Ciocâlteu A, Checheriță IA, Mischianu D. Determining factors of diuresis in chronic kidney disease patients initiating hemodialysis. J Med Life 2015; 8:371-7. [PMID: 26351544 PMCID: PMC4556923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 04/24/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Patients with stage 5 chronic kidney disease (CKD) begin chronic hemodialysis with variable diuresis levels correlated to a comparable low glomerular filtration rate. Residual diuresis influences long-term evolution of the hemodialyzed patient, modifying the prognosis even if optimal Kt/ V is achieved. AIM OF THE STUDY The present study emphasizes the main determining factors of diuresis in a cohort of stage 5 CKD subjects at the beginning of hemodialysis. MATERIAL AND METHODS 216 patients with stage 5 CKD starting chronic hemodialysis were included in the study, and were grouped according to their residual diuresis: group A (urine output ≤ 500 mL/ day); group B (urine output between 500-1200 mL/ day); group C (urine output ≥ 1200 mL/ day). RESULTS Glomerular etiology, cardiac systolic dysfunction, severe malnutrition, emergency dialysis initiation and lack of permanent vascular access were proved to be associated with significant low diuresis. Age, gender, estimated glomerular filtration rate (GFR) and the presence of systemic hypertension did not influence the amount of daily diuresis. CONCLUSIONS In CKD stage 5 patients, residual diuresis presents large variations in conditions of comparable low GFR. Factors influencing residual diuresis may be distinct from those that influence residual GFR.
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Affiliation(s)
- A-M Nechita
- Department of Nephrology and Dialysis, “Sf. Ioan” Clinical Emergency Hospital, Bucharest, Romania
| | - D Rădulescu
- Department of Nephrology and Dialysis, “Sf. Ioan” Clinical Emergency Hospital, Bucharest, Romania
,Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
| | - I Peride
- Department of Nephrology and Dialysis, “Sf. Ioan” Clinical Emergency Hospital, Bucharest, Romania
,Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
| | - A Niculae
- Department of Nephrology and Dialysis, “Sf. Ioan” Clinical Emergency Hospital, Bucharest, Romania
| | - O Bratu
- Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania,Department of Urology, “Dr. Carol Davila” Central Military Emergency University Hospital, Bucharest, Romania
| | - D Ferechide
- Department of Physiology I, Clinical Department No. 2, “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
| | - A Ciocâlteu
- Department of Nephrology and Dialysis, “Sf. Ioan” Clinical Emergency Hospital, Bucharest, Romania
,Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
| | - IA Checheriță
- Department of Nephrology and Dialysis, “Sf. Ioan” Clinical Emergency Hospital, Bucharest, Romania
,Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
| | - D Mischianu
- Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania,Department of Urology, “Dr. Carol Davila” Central Military Emergency University Hospital, Bucharest, Romania
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13
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Checheriţă IA, Smarandache D, Rădulescu D, Peride I, Bratu O, Ciocâlteu A, Sebe I, Lascăr I. Calcific uremic arteriolopathy in hemodialyzed patients. Chirurgia (Bucur) 2013; 108:736-740. [PMID: 24157123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2013] [Indexed: 06/02/2023]
Abstract
In the present article, we discuss the case of 67-year-old female patient diagnosed with inferior limbs calciphylaxis and hemodialyzed since 2006. The clinical manifestations and pathological lab findings are typical for this rare and extremely severe complication in chronic hemodialyzed individuals. The favorable treatment response to sodium thiosulfate, not often used as elected therapy in international studies, represents the particularity of the case.
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14
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Tăranu T, Vintilă D, Neacşu N, Popa P, Luncă C, Crumpei F, Rădulescu D, Georgescu SO. [Heterotopic accessory pancreas in surgical pathology: review of 23 years experience]. Chirurgia (Bucur) 2010; 105:347-353. [PMID: 20726300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND The abnormal presence of the pancreatic tissue in other digestive organs is rare but sometimes is the cause of some surgical diseases. MATERIAL AND METHOD This retrospective study is focussed on heterotopic pancreas cases diagnosed in 2nd Surgical Clinic of "Sf. Spiridon" Emergency Hospital from Iaşi between Jan. 1986 and Dec. 2008. RESULTS 22 patients (15 males/68.2% and 7 females/31.8%) aged between 23 and 76 years were grouped in A group--clinical symptomatic cases (3 patients/13.6%), group B--coincidental cases (17 patients/77.3%) and group C--incidental cases (2 patients/9%). Group A patients presented with obstructing prepyloric polypoid tumors and recquired antrectomy and gastroduodenal anastomosis. 13 patients of group B (76.4%) recquired surgery for pyloroduodenal stenosis and in 4 cases of this group with severe upper-GI bleeding, a subtotal gastric resection (3 patients) or antrectomy (1 case) was performed. In group C patients jejunal HP was histopathologically diagnosed during extensive intestinal resection for colonic malignancies (ascendant colonic and transverse colonic cancers) with jejunal invasion. HP cases were categorized as type I in 40.9% cases (ducts, acini and pancreatic islets), type II in 45.4% cases (ducts and acini) and type III (exclusively with ducts) in 13.6% cases. In 76% patients HP was localized in mucosal and submucosal layers, in 16% intramucosal and in 8% in subserous layer. CONCLUSION HP is most often an unexpected symptomless coincidental diagnosis during gastrointestinal surgical diseases.
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Affiliation(s)
- T Tăranu
- U.M.E Gr. T. Popa Iasi, Spitalul Clinic Judetean de Urgente "Sf. Spiridon", Clinica II Chirurgie, B-dul Indepenenţei 1, Iaşi, Romania, 700111.
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15
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Rădulescu D, Ferechide D. The importance of residual renal function in chronic dialysed patients. J Med Life 2009; 2:199-206. [PMID: 20108541 PMCID: PMC3018976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
In the last decade, many researches have reached to the conclusion that preservation of residual renal function (RRF) is important after initiating dialysis, as well as in the predialysis period. RRF has been proven to contribue to the quality of life of dialysis patients. Longer preservation of RRF provides a better small and middle molecule removal, improved volemic status and arterial pressure control, diminished risk of vascular and valvular calcification due to better phosphate removal. Deterioration of RRF results in worsening of anemia, inflammation and malnutrition. It is now proven a direct relationship between RRF value and survival in dialysis patient. Several therapeutical intervention have been proven to ameliorate the decline of RRF in dialysis patients. Some of them are identical with those before initiating dialysis: ACE-inhibitors and/or angiotensin-receptor blockers, limiting the use of nephrotoxic drugs, avoiding contrast media procedures, adequate control of blood pressure. Others are specific for dialysis period: adequate dialysis dose, avoiding excessive ultrafiltration, preventing arterial hypotension during dialysis sessions, using biocompatible dialysis membranes, ultrapure water for dialysis, dietary interventions.
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Affiliation(s)
- D Rădulescu
- ‘Carol Davila’University of Medicine and Pharmacy, Nephrology Clinic,‘Sf. Ioan’
Clinical Emergency Hospital, Bucharest
Romania
| | - D Ferechide
- Department of Physiology, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest
Romania
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16
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Brezean I, Catrina E, Aldoescu S, Rahimi M, Mănescu D, Veranu I, Rădulescu D. ["The fate" of a peri-cystic-jejunostomy in the treatment of the hydatid liver cysts]. Chirurgia (Bucur) 2006; 101:81-2. [PMID: 16623382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The persistence of a hepato-jejunal fistula after 9 years from a peri-cystic-jejunostomy in the treatment of hydatid liver cysts is an amazing condition. We discover this kind of fistula during the operation for cholelithiasis. This association between fistula and a "after-hydatid" choledocholithiasis is an opportunity to discuss some pathogenic and evolutive mechanisms about both of two entities.
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Affiliation(s)
- I Brezean
- Clinica de Chirurgie I. Juvara, Spital Dr. I. Cantacuzino.
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17
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Brezean I, Catrina E, Aldoescu S, Rahimi M, Mănescu D, Veranu I, Rădulescu D. [The main utility of trans-anastomosis external drainage in the hydatid liver cysts treatment by peri-cystic-jejunostomy]. Chirurgia (Bucur) 2005; 100:457-9. [PMID: 16372672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
We purpose to make a metanalysis of a external drainage and his role in the treatment of the hydatid liver cysts when it was made a anastomosis between peri-cystic cavity and a isolated loop of jejunum. The paper watch 74 cases which were operated in "I. Juvara" surgical clinic and in which it was used the external drainage of peri-cystic cavity. The drainage roles consist in follow up of peri-cystic cavity evolution, but, more than that, in early diagnosis and treatment of secondary infection of cavity, the main postoperative complication. The drainage excludes the possibility of unfavourable evolution of postoperative infection, in which case the result of operation may be compromised.
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Affiliation(s)
- I Brezean
- Clinica de Chirurgie "I. Juvara", Spital "Dr. I. Cantacuzino", Bucureşti.
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18
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Stefan C, Gafencu O, Nicolae A, Rădulescu D, Balaş M, Neacşu A. [Ophthalmologic involvement of intracranial tumors--report of a case]. Oftalmologia 2002; 51:32-6. [PMID: 11519330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Bilateral papillary edema is considered to be the expression of a tumoral process that reduces the intracranial space resulting in elevation of the intracranial cerebrospinal fluid pressure. The authors present the case of a 21-year-old man consulting for mild visual loss of the left eye. The ophthalmologic examination showed bilateral papilledema and visual field defects in the left eye (enlargement of the blind spot), with no clinic or imagistic signs of increased intracranial pressure. Intracranial pathologic processes that bear like a tumor, reducing the intracranial space are not always associated with papilledema, but papilledema is always associated with intracranial tumor. Increased intracranial pressure is frequently associated with intracranial tumoral processes, but in this case was not showed increasing of intracranial pressure.
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Affiliation(s)
- C Stefan
- Clinica de Oftalmologie-Spitalul Clinic de Urgenţă Militar Central, Bucureşti
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19
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Stefan C, Rădulescu D, Cucea R, Nicolae A, Muşat A, Balas M. [Postcontusion glaucoma]. Oftalmologia 2001; 52:41-3. [PMID: 11021138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Secondary posttraumatic glaucoma. Blunt ocular trauma may cause transient or permanent high IOP, occurring immediately or in time after the injury. This study presents some clinical and therapeutical considerations about 16 cases which developed secondary glaucoma. The elevation of IOP was associated with hyphema, iridodialysis, zonular tears (with lens luxation or subluxations), alterations of the iridocorneal angle.
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Affiliation(s)
- C Stefan
- Clinica de Oftalmologie, Spitalul Clinic Militar Central
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20
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Filip M, Stefan C, Cucea R, Popescu A, Rădulescu D, Dima C. [The vitreoretinal complications of cataract surgery]. Oftalmologia 2000; 49:39-42. [PMID: 11021283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
The paper reports a retrospective study performed between January 1996 and January 1999 which comprised 423 patients who underwent eye cataract surgery. Vitreoretinal complications (retinal detachment, cystoid macular edema, choroidal detachment, endophthalmitis, luxation of the lens into the vitreous body) were related to age, sex, other general and local diseases and surgical complications, like disruption of the posterior capsule. The study presents also vitreoretinal complications after Nd:YAG laser posterior capsulotomy. The outcomes of the study show that 18 cases (4.25%) had retinal detachment, 11 (2.60%) had cystoid macular edema, 2 cases had endophthalmitis, while choroidal detachment and luxation of the lens into the vitreous body were reported each in 1 case. Retinal detachment following Neodymium:YAG laser capsulotomy (performed in 109 cases) was found in 2 cases. All of those vitreoretinal complications were reported with a higher incidence in patients with vascular diseases (diabetes mellitus, arterial hypertension, angiosclerosis) and also in patients who had axial lengths of 25 mm or greater.
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Affiliation(s)
- M Filip
- Spitalul Clinic Militar Central, Clinica de Oftalmologie
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21
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Rădulescu D, Stoian M, Sârbu M. Gastric malignant schwannoma. Rev Med Chir Soc Med Nat Iasi 1995; 99:221-5. [PMID: 9455371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
One case of gastric malignant schwannoma is presented, the clinical diagnosis, the morphological particularities and the prognostication of this tumour are discussed. Personal observation. In December 1986, the patient H. R., of female sex, aged 27, was hospitalised in "The Second Medical Clinic" of "St. Spiridon Hospital" for epigastric pains accompanied by melena. After analysing the evolution of the disease, it resulted that the patient had been suffering from epigastric pains, which gave unfavourable prognosis after a symptomatic treatment for 10 years.
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Affiliation(s)
- D Rădulescu
- Department of Morphopathology, University of Medicine and Pharmacy Gr. T. Popa, Iaşi, Romania
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22
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Rădulescu D. Spindle and epithelioid cell nevus (Spitz nevus). Observation on nine cases. Rom J Morphol Embryol 1994; 40:15-8. [PMID: 7640369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Nine cases with spindle and epithelioid cell nevus occurred in children were analysed clinically and morphologically. The results indicate that Spitz nevus is composed of cells resembling those of a malignant melanoma. There are some morphological aspects such as: discontinuous junctional proliferation, the sparse mitotic activity, the process of maturation of the cells with increasing depth, considered as valuable markers for the benign character of this type of tumour.
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Affiliation(s)
- D Rădulescu
- Department of Morphopathology, University of Medicine and Pharmacy, Jassy, Romania
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23
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Rădulescu D, Sârbu M. Giant congenital nevi. A clinical and histopathological study. Rom J Morphol Embryol 1994; 40:19-22. [PMID: 7640370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
17 cases of giant congenital nevi were reported. The lesions were located on the scalp, on the back and on the shoulders. The histopathological study revealed two cellular types of giant nevus; nevus cell type and neuroid type. Two types of neuroid structures were observed in neuroid type: Verocay bodies and pseudo-Meissnerian corpuscles. The congenital nature of a benign nevus includes the presence of nevus cells, single or in nests within the follicular epithelium, eccrine ducts or glands. Essentially, all giant nevi show conspicuous nevic cell permeation not only of the reticular dermis but typically also of the subcutis and even the fascia.
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Affiliation(s)
- D Rădulescu
- Department of Morphopathology, University of Medicine and Pharmacy, Jassy, Romania
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24
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Laky D, Rădulescu D. Extensive cutaneous lymphoma. Rom J Morphol Embryol 1994; 40:55-7. [PMID: 7640378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The case of a 35-years-old patient with a progressive and densely developed subcutaneous tumour comprising the whole right cervical and subcutaneous region is presented. The tumour was painless of pale brown and light red colour, with no adherence on the epidermis and subjacent muscles. The patient has no pathological symptoms. After the histopathological examination we found the dermal infiltration with small, round or oval hyperchromatic cells and the histoenzymological investigation revealed intense positive markers CLA and MB2 pleading for their leukocytic nature while L26 reaction attested the B-cell nature of these lymphocytes and the diagnosis of polymorphous centroblastic malignant lymphoma (K type Working Classification).
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Affiliation(s)
- D Laky
- Victor Babes Institute, Surgery Department of the Cantacuzino Hospital, Bucharest, Romania
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25
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Laky D, Penciu M, Rădulescu D. Retroperitoneal malignant fibrous histiocytoma without histological atypias. Rom J Morphol Embryol 1993; 39:145-7. [PMID: 7849282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A case of a 36-year-old woman suspected of hepatic hydatid cyst with dyseptic symptoms, hepatomegalia, profound pains in the right hypochondrium is presented. During the operation a 15/12/17 cm well-incapsulated tumour is extirpated. The tumour stretched from the upper right renal pole behind the right hepatic lobe as far as the diaphragm and while sectioning it was grey and orange. Histopathologically we found a fibrous histiocytoma with zones of storiform fascicular pattern alternating with areas of histocytic cells with vacuolar-foamy cytoplasm, rich in lipids and without atypias or mitoses. We report the frequency, histological aspects of the fibrous histiocytomas as well as some particularities of their retroperitoneal location.
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Affiliation(s)
- D Laky
- Victor Babeş Institute, Bucharest, Romania
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26
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Laky D, Rădulescu D. Jejunoileal alveolar rhabdomyosarcoma. A case report. Rom J Morphol Embryol 1992; 38:155-7. [PMID: 1342201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Intestinal localization of rhabdomyosarcoma is exceptional, this case is the first to be published in the world literature. A 35-year-old patient with abdominal pain, fever, was found to have an infiltrative white-grey tumour, involving 20 cm the jejunoileal wall and also the surrounding mesenterium up to the origin of upper mesenterical vessels and lymph nodes. Histologic examination showed an alveolar type of rhabdomyosarcoma intricated with solid undifferentiated tumoral cells. The presence of multinucleated giant cells and the positivity of protein S 100 reaction was important for differential diagnosis, given the alveolar soft part sarcoma, malignant mesothelioma, malignant melanoma or papillary carcinoma.
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Affiliation(s)
- D Laky
- Victor Babeş Institute, Bucharest, Romania
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27
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Rădulescu D, Vereanu I, Bittner J, Andrieş D. [The timely diagnosis of postoperative clostridial infection]. Chirurgia (Bucur) 1992; 41:1-9. [PMID: 1361380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
Authors report a case of clostridial myonecrosis postcholecystectomy. The causes of the occurrence of this severe, frequently lethal complication are reviewed, as well as the difficulties of an early diagnosis, the only factor able to save the patient. The curative treatment of the detected infection requires the initiation of a series of local and general measures and a permanent cooperation between the surgeon, the specialist in resuscitation and the infectionist.
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Affiliation(s)
- D Rădulescu
- Clinica de Chirurgie, Spitalul Clinic Dr. I. Cantacuzino, Bucureşti
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28
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Filimon C, Novac C, Dorneanu GH, Gheorghiu V, Suditu N, Cordun-Tărăbuţă G, Rădulescu D, Mihailovici S, Roznovanu S, Găleşanu MR. [Tumors of the upper urinary tract. Apropos 35 cases]. Rev Med Chir Soc Med Nat Iasi 1991; 95:9-20. [PMID: 1823437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Thirty-five cases of upper urinary tract tumors treated by the authors in an interval of 10 years (1979-1988) are presented. After a detailed analysis of the cases some general considerations on the anatomopathologic forms of upper urinary tract tumors, stage classification, symptoms and clinical and laboratory diagnosis, therapeutical indications are made.
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Affiliation(s)
- C Filimon
- Lab. de anatomie patologică, Universitatea de Medicină şi Farmacie, Iaşi
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29
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Chifan M, Rusu M, Tîrcoveanu E, Dănilă N, Rădulescu D. [A rare neurogenic tumor with thoracic growth]. Rev Med Chir Soc Med Nat Iasi 1991; 95:181-4. [PMID: 1823412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Of 70 operated mediastinal tumors, 15 were neurogenic tumors, one of them clepsydra-shaped, which manifested from the very beginning with spastic paraparesis of the legs. The treatment consisted in a two-steps surgery, the first at the Neurosurgical Clinical of Iaşi (laminectomy and ablation of the rachidian tumor) and the second one, one month later, at the I-st Surgical Clinic of Iaşi (excision of mediastinal tumor and parenchymal bridge within the conjugation hole). The microscopic examination confirmed the diagnosis of neurinoma (schwannoma) Antoni A and B with haemorrhagic areas. Examined at one year interval, the patient was clinically cured with normal thoracic aspect. The clinical peculiarities and therapeutical possibilities of the clepsydra-shaped neurogenic mediastinal tumors are detailed.
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Affiliation(s)
- M Chifan
- Clinica I-a chirurgie, Universitatea de Medicină şi Farmacie Iaşi
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Stanciu C, Cijevschi C, Creţu M, Stan M, Săndulescu E, Gavriliţă L, Rădulescu D. Ranitidine in the treatment of reflux esophagitis in patients with duodenal ulcer. Rev Med Chir Soc Med Nat Iasi 1990; 94:277-80. [PMID: 2100833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- C Stanciu
- IInd Medical Clinic, Medical and Pharmaceutical Institute, Iaşi, Romania
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31
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Buţureanu S, Pricop F, Stratan E, Rădulescu D, Patraş C, Dragomir D, Dumitrache F, Gheorghiţă V, Popovici C, Popovici R. [THe role of biopsy in the early diagnosis of cancer of the cervix uteri]. Rev Med Chir Soc Med Nat Iasi 1990; 94:129-31. [PMID: 2075312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Among the actions of early diagnosis of uterine cervix cancers, the sequence cytologic smear, colposcopy, cervix biopsy is well-known. The authors draw the attention that in some situations the cytologic smear and colposcopy are not sufficient and it is only biopsy that defines the nature of the lesion and may give therapeutic indications. Out of a series of 55 women to whom a cervix biopsy was performed, there were 27 cases in which biopsy was justified, showing either a severe lesion or the presence of koilocytes. The authors plead for a more frequent use of cervix biopsy as a means of early diagnosis of uterine cervix cancer or of its dysplasias.
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Affiliation(s)
- S Buţureanu
- Clinica a III-a obstetrică-ginecologie, Institutul de Medicină şi Farmacie Iaşi
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32
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Cijevschi C, Bălan G, Stanciu C, Gavriliţă L, Rădulescu D. [Chronic nonspecific duodenitis: myth or reality?]. Rev Med Chir Soc Med Nat Iasi 1989; 93:655-7. [PMID: 2636765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
There is much controversy regarding the chronic nonspecific duodenitis as autonomous clinical entity. We have studied 36 patients (16 women, 20 men), aged 24-59 years (mean age 37.8 years), with biliary dyspepsia and endoscopic changes suggesting "duodenitis"; in all patients the following investigations were carried out: gastric secretion, barium X-ray and histological examination of the duodenal mucosa specimens obtained by endoscopic biopsy. There was no significant difference between the patients with duodenitis and normal subjects regarding the maximal acid output. Unspecific radiological changes were noticed in 55.5% of patients with chronic duodenitis. Endoscopy showed varied changes of duodenal mucosa including edema, erythema, erosions and hypertrophic folds. Histology confirmed the presence of inflammation. The patients have been followed-up for three years and none of them developed duodenal ulcer. We conclude that chronic nonspecific duodenitis is an autonomous clinical entity.
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Rădulescu D, Pătraşcu T, Cîmpeanu I. [The technical details of the definitive terminal colostomy]. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir 1989; 38:365-70. [PMID: 2534835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Although many surgeons still perform the definitive terminal colostomy using the initial technique--pararectal incision, transperitoneal tract, secondarily retouched excess--this procedure complicates uselessly the surgical technique leading frequently to complications. These drawbacks might be avoided by using transrectal extraperitoneal extemporaneously matured colostomy that simplifies the surgical technique and prevents both precocious complications (peritonitis, occlusions, parietal abscess, necessity of a second "retouch" surgery) and also tardy complications (stomal prolapse, parastomal eventration).
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Rădulescu D, Radu C, Vereanu I, Gavrilescu S, Pătraşcu T, Păcescu E. [The direction and motivation for an evolution in methods of antiulcer surgery]. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir 1989; 38:251-60. [PMID: 2531448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A 23-year retroactive analysis of a heterogeneous series of observations with unfavourable tardy results after antiulcer surgeries showed that the most failures requiring a second surgery appear after large resections with gastrojejunal or gastroduodenal anastomosis and after vagotomies associated with gastric drainage. The most favourable tardy results followed the vagotomy associated with limited gastric resection (hemigastrectomy). This kind of intervention prevents the appearance of the ulcerous relapses and lowers significantly the incidence of the other type of post-surgical iatrogenic complications. The optimal protection against the ulcerous relapse given by vagotomy associated with hemigastrectomy permits a tactical adaptation of the intervention to the lesional and physiopathological characteristics of each case.
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Rădulescu D, Păcescu E. [Primary acute peritonitis in adults]. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir 1989; 38:127-36. [PMID: 2528180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The authors report 12 cases of primary acute peritonitis-that were operated over a period of 10 years, representing 2.8% of the total number of acute cases of peritonitis, with the exclusion of cases of postoperative peritonitis. Since they are so rare it is understandable that primary acute peritonitis of the adult are less well known by the general practitioner in surgery. The particular background of these patients, frequently involving other forms of pathologic features, and the generally depressed immunological background explains the atypical clinical evolution, with attenuated local abdominal signs, a fact which retards the diagnosis, and hence the therapy. As a general rule adults come rather late in surgical departments, usually transferred from another department (diabetes, internal medicine, gynecology, communicable diseases, etc.). The surgeon also has difficulties in making a diagnosis. When the decision to operate has been taken--in most of the cases this happens at a late stage-peritonitis is usually is the purulent phase and careful drainage of the peritoneal cavity is necessary, associated to antibiotherapy that should be applied on the surgical table, and with massive doses. Preoperative etiological diagnosis is difficult. Direct bacterioscopy of the peritoneal exudate is decisive and it should be asked for by the surgeon even in the early stage of surgery. Exhaustive visceral surgical exploration, which should, in principle, eliminate secondary peritonitis is neither easy to perform, nor without risks in these patients, usually aged, obese, with multiple interventions in antecedents. Appendectomy, as a complementary gesture, is contraindicated. The prognosis in the adult, in contrast with that of children, is severe, with very high perioperative morbidity and mortality (above 50% in the authors' experience).
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Gavrilită L, Cotrutz C, Rădulescu D, Constantinov M. [Ultrastructural aspects in colorectal adenocarcinoma]. Morphol Embryol (Bucur) 1989; 35:41-4. [PMID: 2524656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Stanciu C, Gavriliţă L, Bălan G, Cijevscui C, Frasin M, Rădulescu D, Stan M, Stanciu R. Pirenzepine in the treatment of reflux esophagitis. Rev Med Chir Soc Med Nat Iasi 1988; 92:643-7. [PMID: 3253915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Rădulescu D, Pătraşcu T, Budu S. [2 benign proliferative diseases of the stomach with a major surgical solution: hypertrophic gastropathy with giant folds and diffuse gastric polyposis]. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir 1988; 37:379-86. [PMID: 2976963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Gavriliţă L, Stanciu C, Rădulescu D. Carcinoma of the esophagogastric junction. Morphol Embryol (Bucur) 1988; 34:183-7. [PMID: 2972923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Rădulescu D, Gavrilescu S. [Diffuse familial rectocolonic polyposis. Diagnostic and therapeutic aspects]. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir 1988; 37:263-74. [PMID: 2849784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Stanciu C, Cijevschi C, Săndulescu E, Bălan G, Frasin M, Stan M, Gavriliţă L, Rădulescu D. [Optimization of the diagnosis of gastric cancer: cytology via endoscopic fine-needle aspiration]. Rev Med Chir Soc Med Nat Iasi 1988; 92:377-8. [PMID: 3187249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Rădulescu D, Gavrilescu S. [False abdominal surgical emergencies]. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir 1988; 37:107-14. [PMID: 2971244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Rădulescu D, Pătraşcu T. [Internal sphincterotomy in the treatment of anal fissures and hemorrhoids]. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir 1988; 37:5-7. [PMID: 2969126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Mungiu OC, Gavriliţă L, Pavelescu M, Rădulescu D, Botez E, Teslaru E, Rusu M. Experimental data on the antiulcerous action of the pharmaceutical product Gastrofibran. Rev Med Chir Soc Med Nat Iasi 1988; 92:103-5. [PMID: 3393742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Tîrcoveanu E, Rădulescu D, Cotea E. [Melanotic tumor of the ileum]. Rev Med Chir Soc Med Nat Iasi 1987; 91:765-6. [PMID: 3452874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Rădulescu D. Cutaneous malignant melanoma associated with gastrointestinal metastases. Morphol Embryol (Bucur) 1987; 33:141-3. [PMID: 2956509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Rădulescu D, Gavrilescu S, Pătraşcu T. [Re-intervention after gastric cancer surgery]. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir 1987; 36:5-14. [PMID: 2955457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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48
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Găleşanu C, Zbranca E, Dimitriadou M, Gavriliţă L, Rădulescu D. [Hypophyseal nanism caused by craniopharyngioma]. Rev Med Chir Soc Med Nat Iasi 1987; 91:171-4. [PMID: 3659644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Rădulescu D, Gavrilescu S. [Treatment of complicated gastric cancer]. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir 1986; 35:415-24. [PMID: 2951774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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50
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Rădulescu D, Stoica R, Budu S. [Perineal endometriosis]. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Chir 1986; 35:381-6. [PMID: 2949349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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