Publications by authors named "Vlad Constantin"

Postoperative complications are an important problem that all surgeons face. Among all possible complications, local and systemic infections are one of the most prevalent postprocedural adverse events. It is difficult to assess whether or not a patient will develop a surgical site infection (SSI), but there are certain basic investigations that can suggest the probability of such an event.

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Acute pancreatitis (AP) is a severe disease that usually involves hospitalization and a customized therapy. To date, remarkable progress has been made in establishing the etiology, diagnosis and therapy of this condition. For example, it is well documented that the AP course consists of two distinct pathophysiological phases.

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Mechanical ventilation is a last resort solution for patients presenting with acute respiratory distress syndrome produced by SARS-CoV-2. Spontaneous pneumomediastinum is a rare pathology associated with invasive mechanical ventilation. The objective of our research was to highlight the increased incidence of spontaneous pneumomediastinum during the COVID-19 pandemics in our hospital.

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The COVID-19 pandemic has led to a marked decrease in surgical procedures performed worldwide and to numerous other changes in medical practice. We investigated the effect of these changes on surgical trainees. Method: We searched medical records and asked a total of 67 surgical residents from different specialities (general surgery, obstetrics-gynecology, orthopedics-traumatology, neurosurgery) to answer a questionnaire investigating how the total number of surgical procedures and operative role varied for each respondent during the pandemic, the number of medical congresses and handson courses they attended during this time, how much study time was available to them and how the changes in their training modules affected them.

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  • The large bowel, particularly the colon, is commonly injured in penetrating abdominal trauma, second only to the small bowel, especially noted in wartime scenarios.
  • This research analyzes data from a single trauma center over 18 years, focusing on 11 male patients with colon injuries and observing a high mortality rate of 27.2%.
  • The study emphasizes the stark differences in colon trauma management between civilian settings and war zones, highlighting the need for more comprehensive data to inform treatment decisions in low-caseload civilian environments.
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Gastrointestinal stromal tumors (GISTs) are the most common malignant mesenchymal lesions of the gastrointestinal tract. They originate from the interstitial cells of Cajal and are characterized by overexpression of the tyrosine kinase receptor, protein product of c-KIT gene (KIT). In this retrospective study, conducted over a period of 10 years, we retrieved from our database, a total number of 57 patients, admitted and operated in the surgical department of 'Sf.

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Gastric cancer is a widely geographically distributed malignancy with high prevalence, therefore being a serious health problem that needs standardized methods for early diagnosis and treatment. The aim of the study was to evaluate the correlation of some epidemiological and clinical data with the histological features. The study group was made up of 66 patients that underwent surgical removal of the gastric neoplasm, and the pathological exam showed the morphological features of the tumor, as well as the ones of the unaffected mucosal tissue.

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Stem cells represent an old niche with various new potential therapeutics. Besides drug treatment, reperfusion procedures and surgical revascularization, stem cell therapy could be a good option in ischemic cardiac diseases. A study was performed on a small group of cases who died of cardiac arrhythmia secondary to scarring myocardial infarctions.

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  • - Ogilvie syndrome, or acute colonic pseudo-obstruction (ACPO), involves significant dilation of the large bowel without any mechanical blockage, primarily affecting patients in intensive care with severe underlying conditions.
  • - The exact cause of ACPO is not fully understood, but it's believed that disturbances in the autonomic nervous system can impair the colon's motor function.
  • - Early detection and treatment are crucial to prevent serious complications like ischemia or perforation, and the study aims to provide insights into effective management strategies for critically ill patients at risk of developing this condition.
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  • Burnout is a critical issue for resident doctors, particularly heightened during the COVID-19 pandemic due to increased stress and workload.
  • The article reviews literature on burnout in medical residents and explains its prevalence across different specialties, revealing that some are at higher risk.
  • It also discusses a study conducted in a non-Covid emergency hospital in Romania, exploring the impact of burnout and suggesting potential solutions to alleviate this growing concern.
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The abdominal wall hernias in patients with liver cirrhosis have a significant higher prevalence than those in non- cirrhotic patients. The best surgical treatment option and the optimal operative time still represent a subject of debate. Material and method: We have retrospectively analyzed the cases of abdominal wall hernias in patients with liver cirrhosis admitted in the Surgical Department of the Sfantul Pantelimon Clinical Emergency Hospital from Bucharest, undergoing surgical treatment between January 2012 and December 2016.

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Endometrial stromal tumors are very rare, representing approximately 0.2% of uterine malignancies, having an incidence of one to two from a million of women. The diagnosis cannot be established by imaging, it is histopathological only, often necessitate supplementary immunohistochemistry tests.

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Neuroendocrine neoplasms (NENs) of the digestive system are composed of cells with a neuroendocrine phenotype. These tumors produce and secrete peptide hormones and biogenic amines and they are called neuroendocrine neoplasms because of the marker proteins that they share with the neural cell system. The classification and nomenclature used to designate NENs have undergone changes over the past decades due to the accumulation of evidence related to the biological characteristics and their evolution.

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Introduction: Androgenetic alopecia (AGA) is a benign condition with variable psychosocial impact, with some individuals adapting well while others needing therapeutic support. Although 5α-reductase inhibitors like finasteride and dutasteride have proven effective in ameliorating AGA, their use/selection is currently a subject of debate.

Areas Covered: Treatment of AGA with 5α-reductase inhibitors lead to variable adverse effects and relatively unstable results (therapeutic efficacy ending with treatment cessation), so the choice of optimal therapy is not straightforward.

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  • Primary neuroendocrine tumors of the extrahepatic bile ducts are very rare, with only 77 cases documented, representing 0.2-2% of gastrointestinal carcinoid tumors.
  • The report describes a case of a 37-year-old woman with obstructive jaundice due to a tumor in the common bile duct (CBD), which required surgical removal and reconstruction.
  • Histopathological and immunohistochemical tests confirmed it was a well-differentiated neuroendocrine tumor, and the paper discusses diagnosis, treatment methods, and the tumor's prognosis in relation to other bile duct tumors.*
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Appendiceal diverticulitis is a very rare cause for pain in the right iliac fossa. Whether it is simptomatic or discovered randomly during an appendectomy or barium enema, understanding its clinical evolution is important for having a good management. In this report we present the case of a 50 year old female who underwent an open appendectomy during which we discovered appendiceal diverticulitis.

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Finasteride has proved to be relatively safe and effective in the therapeutic management of male androgenic alopecia. However, literature data report several endocrine imbalances inducing various adverse effects, which often persist after treatment cessation in the form of post-finasteride syndrome. Here we present the case of a 52-year-old man receiving finasteride (1 mg/day) who developed an uncommon adverse effect represented by generalized vitiligo 2 months after finasteride discontinuation.

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Nowadays, finasteride is a relatively frequently prescribed drug in the therapeutic management of male androgenic alopecia. The reported adverse effects are notable in some patients, consisting in signs and symptoms that are encountered both during finasteride administration and after treatment cessation. Clinical and imagistic data show that cognition and sexuality are two distinct but interrelated environmental functions, most probable due to lateralization process of the brain.

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  • * The paper details a case of an elderly woman with a NET located in her left upper thigh, along with lymph node metastases in the groin and pelvic area near major blood vessels.
  • * The diagnosis was confirmed through immunohistochemical tests, and the recommended treatment is complete surgical removal, potentially combined with external radiotherapy, as NETs typically grow slowly and have a favorable prognosis.
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Vulvar neoplasia represents 5% of malignancies in female genital tract and 0.6% of all cancers in women. Although it is known to be a rare type of cancer, which occurs especially in elderly women, its incidence is increasing in young females because of its association with the human papillomavirus (HPV).

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Recent clinical and imaging studies suggest that sex hormones modulate sexuality according to a psychophysiologic process of lateralization of the brain, with androgens playing a greater role in sexual functioning of left hemibrain/right handedness and estrogens possibly for right hemibrain/left handedness. Based on this perspective, the current study attempted to specify the relationship between hand preference, estrogens, and sexual function in subjects with male breast cancer, taking into account the sexual side effects of tamoxifen as the agent for inhibiting estrogen action. Twenty-eight Romanian men-17 right-handed and 11 left-handed-undergoing treatment with tamoxifen for male breast cancer participated in this study.

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Traumatic abdominal wall hernias (TAWHs) are rare. Their diagnosis is mostly clinical and can be overlooked in the setting of trauma and distracting injuries or they can be misinterpreted as parietal hematomas. Associated lesions can influence decision making regarding time of operation and surgical technique.

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In this study, we focus our interest on some peculiar infrastructural abnormalities detected in a pancreatic cancer case. Our electron microscopic observations underline the high plasticity of the pancreatic parenchyma cells. Tumor pancreatic exocrine lesions are represented by putative ductal and acinar cells, which proliferate and grow in a haphazard pattern, detrimental to endocrine counterpart.

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The tailored approach to gastrointestinal stromal tumors (GISTs) has led to better prognosis for these types of tumors. Also, finding out GIST's pathology has led to a better understanding of oncogenesis and cancer therapy in general. The rapid expansion of molecular and pathological knowledge of GISTs has given this disease a promising future.

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Objectives: To determine the incidence of computed tomography (CT) identifiable Randall plaques in a CT explored population; to determine the clinical relevance of this radiological finding by a 7-year follow-up; to determine a cut point to identify a population with high risk of developing calcium stone disease (SD).

Materials And Methods: Retrospective study of all patients explored by abdominal CT in our center between January and March 2005.

Inclusion Criteria: age 30-60 years and no SD.

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