National Institute of Legal Medicine Mina Minovici

Bucharest, Romania

National Institute of Legal Medicine Mina Minovici

Bucharest, Romania
SEARCH FILTERS
Time filter
Source Type

Negoi I.,Emergency Hospital of Bucharest | Hostiuc S.,National Institute of Legal Medicine Mina Minovici | Runcanu A.,Emergency Hospital of Bucharest | Negoi R.I.,Carol Davila University of Medicine and Pharmacy | Beuran M.,Emergency Hospital of Bucharest
Hepatobiliary and Pancreatic Diseases International | Year: 2017

Background The superior mesenteric artery (SMA) first approach was proposed recently as a new modification of the standard pancreaticoduodenectomy. Increasing evidence showed that a periadventiceal dissection of the SMA with early transection of the inflow during pancreaticoduodenectomy associates better early perioperative results, and setup the scene for long-term oncological benefits. The objectives of the current study are to compare the operative results and long-term oncological outcomes of SMA first approach pancreaticoduodenectomy (SMA-PD) with standard pancreaticoduodenectomy (S-PD). Data Sources Electronic search of the PubMed/MEDLINE, EMBASE, Web of Science and Cochrane Library was performed until July 2015. We considered randomized controlled trials (RCTs) and non-randomized comparative studies (NRCSs) comparing SMA-PD with S-PD to be eligible if they included patients with periampullary cancers. Results A total of one RCT and thirteen NRCSs met the inclusion criteria, involving 640 patients with SMA-PD and 514 patients with S-PD. The SMA-PD was associated with less intraoperative bleeding, less blood transfusions and higher rate of associated venous resections. The pancreatic fistula and delayed gastric emptying had a significantly lower rate in the SMA-PD group. There were no differences between the two approaches regarding overall complications, major complication rates and in-hospital mortality. There was no difference regarding R0 resection rate, and one-, two- or three-year overall survival. The SMA-PD was associated with a lower local, hepatic and extrahepatic metastatic rate. Conclusions The SMA-PD is associated with better perioperative outcomes, such as blood loss, transfusion requirements, pancreatic fistula, and delayed gastric emptying. Although the one-, two- or three-year overall survival rate is not superior, the SMA-PD has a lower local and metastatic recurrence rate. © 2017 The Editorial Board of Hepatobiliary & Pancreatic Diseases International


Catana M.,Bagdasar Arseni Emergency Hospital | Francisc A.,National Institute of Legal Medicine Mina Minovici
Romanian Journal of Legal Medicine | Year: 2012

The authors present two cases of traumatic spondylolisthesis operated during the period Jan. 2009 - May 2012, at the Department of Neurosurgery IV of the "Bagdasar Arseni" Emergency Hospital in Bucharest. The traumatic biomechanical conditions were different in the two cases and are presented in the article. Traumatic spondylolisthesis is very rare and usually occurs in competitive sports or road accidents. This has direct forensic implications concerning the analysis of traumatic spondylolisthesis, as well as any traumatic spinal cord injury resulting in neurologic impairment. Symptoms include spinal instability and various neurological syndromes, from simple radiculopathies to cauda equina syndrome. There are usually other thoraco-abdominal injuries associated as well, and treatment generally involves surgical intervention which entails rapid surgical decompression and solid spinal stabilization. © 2012 Romanian Society of Legal Medicine.


Dermengiu D.,National Institute of Legal Medicine Mina Minovici | Ceausu M.,Carol Davila University of Medicine and Pharmacy | Rusu M.C.,Carol Davila University of Medicine and Pharmacy | Dermengiu S.,National Institute of Legal Medicine Mina Minovici | And 2 more authors.
Romanian Journal of Legal Medicine | Year: 2010

We report a case of sudden death in a 20 years old male who colapsed just minues after the beginning of a football training session. The autopsy evidenced the presence of a unique combination of coronary abnormalities: myocardial bridging at the level of both branches of the LCA; abnormal origin of the right coronary artery: 1 mm above the left semilunar valve of aorta; the initial segment of the RCA coursing within the aortic wall (0,7 cm); myocardial bridging at the level of LCX; sinoatrial node artery originated from the LCX. Histological examination revealed the presence of Hypertrophic Cardiomyopathy markers within the left ventricle and interventricular septum and the cumulative effects of the coronary cardiac anomalies on the myocardial blood flow: extensive interstitial and perivascular sclerolipomatosis, dissecting fibrosis at the level of the sinoatrial node, subendocardial hyaline fibrosis. © 2010 Romanian Society of Legal Medicine.


Gologan S.,Carol Davila University of Medicine and Pharmacy | Iacob R.,Carol Davila University of Medicine and Pharmacy | Iacob R.,Fundeni Clinical Institute | Iancu D.,National Institute of Legal Medicine Mina Minovici | And 10 more authors.
Journal of Crohn's and Colitis | Year: 2013

Background and aims: Cytokines and their receptors play a critical role in the pathogenesis of the inflammatory bowel disease (IBD). The aim of this study was to investigate the expression profiles of inflammatory genes in inflamed and non-inflamed colonic tissue samples in patients with Crohn's disease (CD) and ulcerative colitis (UC), and to identify molecular signatures for different IBD phenotypes. Methods: Seventy-one patients diagnosed with IBD (38 CD, 33 UC) and 15 non-IBD controls have been included in the study. For each patient, biopsy samples were obtained during colonoscopy from inflamed (L) and healthy (N) mucosa. We investigated by commercially available reverse-transcriptase multiplex ligation-dependent probe amplification (RT-MLPA) kit the mRNA expression of a set of 40 genes involved in inflammation: cytokines, chemokines, receptors, signal transduction molecules and transcription factors. Results: In L biopsies from patients with CD, higher expression levels were found for IL-4 (p= 0.009) and IL-12p35 (p=0.0005), whereas in L biopsy samples from patients with UC higher expression levels were found for IL-8 (p= 0.03), chemokines SCYA3 (p= 0.05), SCYA4 (p= 0.01) and glutathione S-transferase P1 (p= 0.01). In N biopsies of patients with CD higher expression levels were found for IL-1R (p= 0.01) and IL-12p35 (p = 0.007), whereas in N biopsies of patients with UC higher expression levels were found for IL-15 (p = 0.009) and SCYA8 (p= 0.001). The logistic regression analysis has indicated that low expression levels of IL-2 and IL-10, together with higher ASCA IgG titers were independently associated with penetrating/stricturing CD. Conclusions: RT-MLPA is a sensitive and effective method for the evaluation of the profiles of inflammatory genes in IBD, with potential future applications for diagnosis, phenotypic stratification and targeted therapy. © 2012 European Crohn's and Colitis Organisation.


Vasalos E.,National Institute of Legal Medicine Mina Minovici | Dermengiu D.,National Institute of Legal Medicine Mina Minovici | Salem A.,National Institute of Legal Medicine Mina Minovici | Hostiuc S.,National Institute of Legal Medicine Mina Minovici
Romanian Journal of Legal Medicine | Year: 2010

Plastic and cosmetic surgery covers a wide range of medical interventions, dealing with either restoration of form and function or enhancing morphological characteristics. Objective complications in plastic surgery are rare as the mortality is very low, vital organs are rarely affected, and the patients are usually healthy (the purpose being usually corporal enhancement not repair). Recently an increasing number of malpractice cases had gained mass-media attention, leading to a nationwide and even international debate about the standards of healthcare in Romania. The purpose of this study is to determine the main characteristics of plastic surgery malpractice cases in Romania. Malpractice claims in plastic surgery were analyzed on a four year period (2006-2010); the cases found (13) were analyzed by using descriptive statistical methods. The study group included eight males and five females, with a medium age of 40 years; cases were divided into traumatic, cosmetic and non-traumatic. The main reason for malpractice claims was related to a medical care deficit followed by procedure deficit. Most malpractice claims were in agendo only three being ommissive and are usually due to medical negligence. © 2010 Romanian Society of Legal Medicine.


Stan C.,National Institute of Legal Medicine Mina Minovici | Stan C.,Titu Maiorescu University
Interventional Medicine and Applied Science | Year: 2012

Torture and death in custody have incurred rapid development as juridical subject in recent years in Europe, with the implementation of the European Convention of Human Rights. Evaluation of sufferance severity, which is the consequence of pathology with chronic evolution, the predictability of decompensation of a subclinical pathology, and translating these medical information on a scale measuring the severity of detention consequences, are all challenges for the modern detention healthcare system, in which most allegations of torture are due to lack of appropriate medical treatment administered to inmates. Where ethics are concerned, the main data difficulties are addressed in ethical conflicts between officials and experts of the parties and also between experts and judiciary officials who handle cases of torture or death in detention; this is why standardization is very important in such cases both in clinical expertise and in autopsies or exhumations. © 2012 Akadémiai Kiadó, Budapes.


Dermengiu D.,National Institute of Legal Medicine Mina Minovici | Dermengiu S.,National Institute of Legal Medicine Mina Minovici | Curca C.G.,National Institute of Legal Medicine Mina Minovici | Ceausu M.,National Institute of Legal Medicine Mina Minovici
American Journal of Forensic Medicine and Pathology | Year: 2011

A 20-year-old woman complained for several weeks before her death of unspecific epigastric pains. Such episodes were labeled as ''dyspeptic episode.'' A month later, once again she started to complain about stomach pains, then she collapsed unconscious. She was rushed to a hospital, where she was admitted in cardiorespiratory arrest. An electrocardiogram revealed a ventricular fibrillation. All resuscitation efforts were unsuccessful. The autopsy revealed nonspecific general changes (subpleural petechiae and blood pooling). Dissection of the coronary arteries revealed a normal topography of coronary arteries but a marked hypoplasia of all the subepicardial coronary arteries (maximum diameter of left anterior descending coronary artery = 1.9 mm, maximum diameter of right coronary artery = 1.43 mm). Furthermore, the left anterior descending coronary artery was slightly compressed by a fibrous bridge at about 1.5 cm of its origin; a fibrinoleukocytic thrombus has formed immediately above this bottleneck, obstructing the entire lumen of the artery. Microscopic examination revealed an area of recent myocardial necrosis; diffuse subendocardial fibrosis, with extension into the subjacent myocardium, disorganizing the myocardial fibers; and variable thickening of the vascular walls with periarteriolar fibrosis. Weigert stain has shown marked intimal hyperplasia, either focal or diffuse, in different segments of vascular wall, accompanied by disruption of the internal elastic lamina due to subintimal cellular proliferation, in the medium branches of coronary arteries. The micrometric measurements showed that intimal thickening was at least the size of the media (È358 vs 356.8 Km) and sometimes double. © 2011 by Lippincott Williams & Wilkins.


Dermengiu D.,National Institute of Legal Medicine Mina Minovici | Curca G.C.,Carol Davila University of Medicine and Pharmacy | Sarbu N.,National Institute of Legal Medicine Mina Minovici | Hostiuc S.,National Institute of Legal Medicine Mina Minovici | Ceausu M.,National Institute of Legal Medicine Mina Minovici
Romanian Journal of Legal Medicine | Year: 2010

Non-atherosclerotic and non-inflammatory intimal cellular proliferations are considered a nonhomogenous group of pathological diseases usually affecting small and medium caliber arteries; they are mostly idiopathic and it is believed that some types are precursor processes in the pathogenic chain of atherosclerosis. Fibromuscular dysplasia is defined as an idiopathic, segmentary, non-inflammatory and non-atherosclerotic condition of the arterial walls, leading to stenosis in small and medium arteries. Although the etiology is unknown, potential causes may include platelet derived growth factor, fibroblastic growth factor, epidermal growth factor, kinins, angiotensin type II anomalies. The correlation between fibromuscular dysplasia and sudden cardiac death isn't often found, only nine cases being reported in the scientific literature in the last years. We present in this article five cases of sudden cardiac death associated with fibromuscular dysplasia and discuss some of its characteristics. © 2010 Romanian Society of Legal Medicine.


PubMed | Ilfov Medico Legal Service, National Institute of Legal Medicine Mina Minovici and Al. I. Cuza University
Type: | Journal: Forensic science international | Year: 2015

Peroxisomal diseases are rare (1:50,000), genetically determined disorders (autosomal recessive), systemic, multiorgan illnesses with prominent involvement of the nervous system, caused either by the failure to form or to maintain the peroxisome, or by a defect in the function of a single or multiple peroxisomal enzymes. Peroxisomes contain approximately 50 enzymes which are responsible for many metabolic reactions, and play an important role in the oxidation of saturated very-long-chain fatty acids (VLCFA). The authors present the case of a Romanian boy, who died at the age of 1.6 of one of the peroxisomal diseases-Zellweger syndrome. Newborn infants with Zellweger syndrome have a typical dysmorphic facies, neonatal seizures, profound hypotonia, and eye abnormalities. Major abnormalities are present in the liver (fibrotic), kidney (cortical cysts), and brain (lipid-laden macrophages and histiocytes in cortical and periventricular areas, demyelination, centrosylvian polymicrogyria and pachygyria)-cerebro-hepato-renal syndrome (CHRS) (Zellweger). Infants with Zellweger syndrome rarely live more than a few months, but in this case the survival was longer, and the cause of death was not directly the peroxisomal disease but a violent cause of death-mechanical asphyxia with tracheo-bronchial food aspiration. The authors present the results of investigations carried out during the childs life, but also data collected at the autopsy and hystopathological postnecroptic investigations. By presenting this case, the authors wish to bring to your attention a rare pathology in forensic practice by the paradox of finding a common violent cause of death, asphyxia with food aspiration, in a rare metabolic-genetic disease, which is usually fatal by itself.


Beuran M.,Emergency Hospital of Bucharest | Beuran M.,Carol Davila University of Medicine and Pharmacy | Negoi I.,Emergency Hospital of Bucharest | Negoi I.,Carol Davila University of Medicine and Pharmacy | And 7 more authors.
Pancreatology | Year: 2015

Background/Objectives The present article summarizes and analyzes the current knowledge about the role of the epithelial to mesenchymal transition (EMT) in the systemic invasiveness of pancreatic cancer. Method An electronic search of PubMed/MEDLINE, EMBASE, and the Web of Science was used to identify relevant original articles and reviews. Results The EMT represents a key step during normal embryogenesis. However, increasing evidence reveals its essential role in the local progression and metastasis of pancreatic cancer. Areas of interest are the cross-linking between cells undergoing the EMT and pancreatic cancer stem cells, and the correlation between the EMT and chemoresistance to standard therapies. During carcinogenesis, malignant pancreatic cells at the primary site acquire the ability to undergo the EMT, a transformation associated with increased mobility. The reverse process at secondary sites, the mesenchymal to epithelial transition (MET), has devastating consequences, allowing neoplastic epithelial cells to invade surrounding tissues and spread to distant sites. Consequences of the EMT are the loss of E-cadherin expression and the acquisition of mesenchymal markers including fibronectin or vimentin. Detailed knowledge of the molecular processes underlying the EMT has opened possibilities for new therapeutic agents. These include an EMT approach for patients with early cancers, to prevent invasion and dissemination, and anti-MET therapy for patients with established metastasis. Conclusions The current literature shows a strong correlation between the EMT and the systemic aggressiveness of pancreatic tumors. Individualized therapy, targeting the process of EMT and its cross-linking with cancer stem cells, may increase survival of patients with pancreatic cancer. © 2015 IAP and EPC.

Loading National Institute of Legal Medicine Mina Minovici collaborators
Loading National Institute of Legal Medicine Mina Minovici collaborators