Role of in the triggering and evolution of hemorrhagic gastro-duodenal lesions.

The majority of studies concerning () are oriented towards the implication of infection with in processes that end in the formation of neoplasia, without assessing the impact of the bacterium in triggering acute gastroduodenal hemorrhagic episodes. The present study includes 166 patients with upper digestive hemorrhage, admitted to the ATI Clinic, the Gastroenterology Clinic or to the Surgery II Clinic of the County Emergency Clinical Hospital in Craiova, Romania between 2017 and 2019. All patients were monitored for evolution and received treatment according to current guidelines, and hemorrhagic lesions were biopsied.

Outcomes of Multidetector Computed Tomography Pulmonary Angiography in Pregnant and Postpartum Women With Suspected Pulmonary Embolism.

Purpose: Verify whether there is a difference in likelihood of developing pulmonary embolism (PE) between pregnant women, nonpregnant women of reproductive age, and postpartum (up to 6 weeks) women, by comparing their outcomes on computed tomography pulmonary angiography (CTPA) done for suspicion of PE.

Materials And Methods: Retrospective cohort study of 1463 CTPA done for suspicion of PE in females of reproductive age (18-40 years), nonpregnant, pregnant (antepartum), and postpartum, from 2 tertiary-care academic hospitals between October 2006 and September 2015. Primary outcome was diagnosis of PE on imaging.

T4 Colon Cancer - Current Management.

Colorectal cancer is the third most often encountered type of cancer and represents the third leading cause of cancer related deaths, on both sexes. One of the most important prognostic parameters is the tumor's stage at the time of the diagnosis. T4 cancers represent advanced tumors associated with penetration of the visceral peritoneum (T4a) and/or direct invasion in adjacent structures (T4b).

Parathyroid Adenomas in Adults and Adolescents. Critical Appraisal and Surgical Strategy in 18 Cases.

Unlabelled: Our study underline scarcity of isolated case reports or small case series of parathyroid adenoma (PA) published in autochthonous medical literature,their variable clinical expression among the "historic" varieties but also the diagnostic difficulties and delays of diagnosis as well consecration of surgery as the golden therapeutic standard of this disorder.

Patients And Method: Demographic, clinical presentations, laboratory and imaging data, operative findings and procedures together with pathology account and outcome from the case reports of 18 patients with documented PHP were retrospectively analyzed. The male/female ratio was 1/5, with ages ranging from 16 to 58 (mean 46) years.

An Unwonted Clinicopathological Subtype of Thyroid Primary Lymphoma.

Primary thyroid lymphomas account for less than 5% of all thyroid malignancies and the majority of cases concern non- Hodgkin's lymphoma of B and T-cell origin as well as Hodgkin's lymphoma. Mucosa-associated lymphoid tissue (MALT) lymphoma are a relatively recently described subset of low grade B-cell non-Hodgkin's lymphoma representing between 6 and 27% of the patients with thyroid lymphomas. These cases occur usually in patients with Hashimoto's thyroiditis having a long indolent course and delayed diagnosis, actually benefit from several therapeutic opportunities among them even surgery and a favorable prognostic.

Clinical Features and Surgical Treatment of Thyroid Pathology in Patients Over 65 Years.

Introduction: The significant increase in the average lifespan of the general population lead to a proportional enhacement in the prevalence of benign and malignant thyroid conditions and equally the number of surgeries for this pathology.

Patients And Method: In a personal series of 464 thyroid disorders undergoing surgery over a two decades period we registered 51 patients (10.9%) aged over 65 years of which 11 (2.

Diagnostic Difficulties in a Pediatric Insulinoma: A Case Report.

Insulinomas are functional neuroendocrine pancreatic tumors rarely encountered in pediatric pathology. Insulinomas are usually solitary and sporadic, but may occur in association with multiple endocrine neoplasia type 1. Whipple's triad-hypoglycemia, simultaneous compatible adrenergic and/or neurological signs, and relief of symptoms upon the administration of glucose-remains the fundamental diagnostic tool.

Thyroglossal Duct Cyst Carcinoma in Child and Adult. Two Case Reports.

Thyroglossal duct cyst carcinoma is rarely mentioned in literature representing only 0,7-1,6% of cases with these embryonic remnants. Two patients with thyroid duct cyst carcinoma, a 14-year-old girl and a 44-year-old man operated on in our department, both diagnosed postoperatively are described. In the first one a classical Sistrunk operation was performed removing a 3 cm asymptomatic mass, a milimetric papillary carcinoma being incidentally discovered at paraffin section pathology.

Cardiothyreosis: Pathogenic Conjectures, Clinical Aspects and Surgical Approach.

Introduction: The presence of striking cardiovascular manifestations were noted in the first descriptions of hyperthyroidism owing to Parry (1825) and Basedow (1840) in his famous Merseburg triad. Hyperthyroidism may either cause cardiac complications in individuals with a normal myocardium (genuine form of disorder) or complicate preexisting cardiac troubles.

Material And Method: An homogenous series of 49 cardiothyreosis, 11 males and 38 females, aged 12 - 78 (mean 45) years selected between 138 thyrotoxic patients operated on in a period of two decades is herein presented.

Clinicopathological phenotype of parathyroid carcinoma: therapeutic and prognostic aftermaths.

Parathyroid carcinomas (PC) are rare and "devastating"€ causes of hyperparathyroidism (HP), frequently discovered fortuitously,with not always doubtless pathological confirmation, and dissociate post-therapeutic outcomes and prognosis even after well-performed surgery. We herein report four PT neoplasms,three of them proving to be authentic PCs, and one an atypical parathyroid adenoma. There were three females and one male, aged 32-49 (mean 44) years.

Thyroid and thymic exeresis in surgery of hyperparathyroidism.

Background: Owing to close anatomical and embryological connexions between the thyroid, parathyroids and thymus,manifold coexisting pathology can be identified during the surgery of hyperparathyroidism (Hp).

Material And Methods: In this retrospective study we report the incidence, clinical forms, histology and management of thyroid and thymic synchronous lesions encountered in as eries of 82 consecutive patients with various types of Hp operated on in the last three decades. Demography, clinical records, biochemical data, imaging procedures, pathology reports and surgical protocols were revised.

Unusual malignant tumors of the thyroid gland.

Background: Although situated on the last places among the statistical hierarchy of human malignancies, thyroid cancers (TC) are the most common tumors of the endocrine system. Follicular epithelium neoplasms account for more than 90% of these lesions with a favourable prognosis, while resting tumors (medullary, anaplastic, lymphoma, sarcoma etc) generally present a rapid unfavorable evolution with a low rate of survival.

Patients And Methods: In a series of 464 thyropathies personally treated, 72 cases of TC (15.

Mesenchymal (non-epithelial) "non-GIST" tumors of the digestive tract.

Morphological, immunohistochemical and ultrastructural but also clinical and prognostic differences between multiple types of mesenchimal (stromal, nonepithelial) tumors of the gastrointestinal tract prompted us the remembrance of an anecdotic series of sixteen observations of mesenchymal "nonstromal" gastrointestinal tumors (MNSGIT) encountered in four decades of surgical practice. The diagnosis was mainly established on clinical grounds (dyspepsia, pains, digestive hemorrhage or obstruction, palpable tumor) - some lesions being incidentally discovered - and confirmed by radiology, endoscopy, intraoperative exploration and microscopic pathology examination which revealed 9 schwannomas, three leiomyomas, two lipomas, fibroma and "mixoma" one case each. Our cases were located on the stomach (n=12), small bowell (n=1) and right colon (n=3).

[Indications for surgery in thyroiditis].

Introduction: Inflammatory processes of the thyroid represents a main proportion of the gland's pathology but the majority of them are treated by medical methods, surgery being indicated.

Patients And Methods: In 14 cases (3%) from 464 operations for different thyroid conditions we have encountered authentic inflammatory lesions in 9 cases of Hashimoto's thyroiditis (two associated with papillary thyroid carcinoma and one with malignant lymphoma), two cases of Riedel's thyroiditis and respectively de Quervain thyoiditis, tuberculous thyroiditis and actynomicosis one case each. The common lymphoplasmacytic infiltration in Basedow's disease was not considered likewise as the inflammatory nespecific lesions encountered in benign and malignant pathology of the gland.

[Pancreaticoduodenectomy in surgical treatment of malignant tumors of Vater's region].

Background: The optimal treatment of tumors of Vater's region represents a permanent interest of every physician involved in the treating of malignant diseases with such localization.

Aim: This presentation proposes a pancreaticoduodenectomy (DPC) evaluation in the surgical treatment of tumors of Vater's ampulla.

Materials And Methods: Between 1999 - 2009 our clinic has treated a number of 37 cases with mechanic jaundice by malignant diseases (JMN).

Parathyromatosis coexisting with papillary thyroid microcarcinoma.

Unlabelled: The aim of this report is to describe a fortuitely discovered association between parathyromatosis and papillary thyroid microcarcinoma.

Case Description: A 56-year-old woman presented with a pyelic relapsed stone, bone pains, neurovegetative com-plaints and iPTH = 348 ng/l as manifestations of recurrent primary hyperparathyroidism after a right inferior parathyroid adenoma exeresis done elsewere six years ago. Ultrasonography showed a 5 mm hypoechoic zone at the lower pole of the right lobe of the thyroid.

[Total parathyroidectomy without autotransplantation in the management of "refractory" renal hyperparathyroidism].

Unlabelled: The optimal surgical treatment in patients with refractory renal hyperparathyroidism (RHP) on hemodialysis for end stage renal disease is still a point of controversy. The high percentage of recurrences after standard surgical procedures i.e.

Surgical management of renal hyperparathyroidism: a preliminary series report.

Background: Renal hyperparathyroidism (RHPT) is a frequent complication of uremic patients on hemodialysis and despite various advances in medical therapy parathyroidectomy is necessary in a semnificative number of cases.

Patients And Methods: We reviewed our experience (first in Romania) regarding fortythree patients with RHPT operated on in our clinic between 1994 and 2009 evaluating the diagnosis methods, surgical indications, techniques and results together with the evolution of our own therapeutical concept. The study included 22 men and 21 women of median age of 48 (range 15-67) years, performing hemodialysis (n=41) or peritoneal dialysis (n=2) from 7,7 (range 3-13) years respectively.

Community pharmacy--ideal location to screen and monitor hypertensive patients.

Unlabelled: The goals of this study were (a) to create a patient electronic database by filling in the specially designed Patient Data Sheets (PDS) after interviewing hypertensive patients and (b) to evaluate pharmacists' opportunities for intervention in order to improve hypertensive patients' outcomes.

Material And Method: Pharmacists from two Romanian chain community pharmacies interviewed all hypertensive patients that entered the pharmacies during the study period (November-December 2008) and selected 106 subjects using several selection criteria. Pharmacists recorded in specially designed Patient Data Sheet relevant information such as: demographic data, additional diagnostics (if any), lifestyle behaviors and therapeutic data.

[Cystic mucinous tumors of the pancreas].

Mucinous cystic tumors (MCTP) are uncommon borderline lesions of the pancreas that may often be misdiagnosed as pseudocysts and have unknown propensity to malignity. During the last two decades in our clinic of 38 patients with cystic lesions of the pancreas two presented MCTP: a 48-year-old woman with a cyst located in the body and tail of the pancreas and a 59-year-old man with a tumor situated in the head of the gland producing an obstructive jaundice. Ultrasonography and computer tomography confirmed the presence of the cystic mass in both patients but the precise diagnosis was made only after the histologic examination of the removed lesions.

Laparoscopic hand-assisted splenectomy for hydatid cyst.

Hydatid cyst of the spleen is a rare location even in endemic areas. From classical splenectomy, surgical treatment has evolved to more conservative and even minimal invasive techniques. The authors report a 44 year old male with a palpable but asymptomatic mass in the left hypochondrium.

[Reoperations of the thyroid gland].

Reoperative thyroid surgery may be necessary in recurrent simple goiters, thyrotoxicosis and especially cancers of the thyroid gland. The present series reviewed 33 cases representing 7.3 % from our experience consisting of 440 thyroid operations.

[Gastrocolic fistulas. Review of three cases].

Gastrocolic fistula (GCF) is a rare and severe lesion appearing traditionally as a complication of inadequate gastric surgery or in the context of stomach or colon malignancy, but actually arising from many different gastrointestinal conditions. Three patients with GCF, admitted and operated in our clinic, are presented. The first case, a man aged 36 years, was a classical one, with a G(jejuno)CF appearing three years after a gastrectomy with Reichel-Polya reconstruction for duodenal ulcer, resolved by a "revision gastrectomy" en block with segmental resection of the jejunum and transverse colon.

[Parathyroid carcinoma in a patient on hemodialysis for renal failure].

Parathyroid carcinoma is a rare endocrine neoplasm with difficult histological diagnostic and unpredictable evolution. More unusual are the cases appearing in the course of end-stage renal disease on maintenance dialysis (22 observations in medical literature). A 46-year-old man suffering of chronic glomerulonephritis and renal failure for 13 years, having been on hemodialysis for three years, complains of asthenia, adynamia, muscle weakness, progressive osteoarticular pains, itching.

[Minimally invasive approach of the cervical endocrine glands].

Improved preoperative functional and topographic diagnostic techniques and availability of intra-operative hormone monitoring, stimulated the introduction of video-assisted minimally invasive operations in parathyroid and thyroid surgical pathology. The first cases of such pathology operated on in our clinic are presented. The first one is a 62 year old man with renal hyperparathyroidism consecutive to a chronic renal insufficiency and hemodialysis from five and three years respectively.