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Bucharest, Romania

Sarafoleanu C.,Sfanta Maria Hospital
Oftalmologia (Bucharest, Romania : 1990) | Year: 2010

To evaluate the outcomes of endoscopic LASER assisted dacryocystorhinostomy without stenting, a total of 39 patients (41 eyes) with complains of epiphora and diagnosed with nasolacrimal duct obstruction were included in a prospective study. All the patients had the same preoperative assessment, including radiological and ophthalmologic evaluation, with repeated lacrimal washouts, to confirm the postsacal obstruction. The surgical technique's goal was to create a wide opening of the medial wall of the sac, using drilling of the frontal process of the maxillary bone and some of the lacrimal bone, incision of the lacrimal sac and the radial vaporisation of the incision margins performed with Diode LASER, in order to create a 0.7 - 1 cm opening in the medial wall of the sac. Patients were examined endoscopically, at postoperative intervals of 1 month, 3 month, 6 and 9 month minimum (follow-up period ranged between 9 to 21 months, average 11, 8 months). We obtained a good permeability of the opening of the lacrimal sac in 87.8% of our cases (36 eyes). 5 patients (12.2%) required re-evaluation of the medial sac wall area and re-intervention using different methods. The success criteria were considered the patient's relief of symptoms and the endoscopic visualization of a patent stoma. In conclusions, in the hands of an experienced surgeon, endoscopic LASER assisted dacryocystorhinostomy without stenting compares favourably with other techniques. Source


Negrila-Mezei A.,Sfanta Maria Hospital
Journal of medicine and life | Year: 2011

Tinnitus is a common health problem that affects between 10 - 30% of the population, approximately 3 - 4% presenting to the doctor at least once in their life. There are many causes that lead to tinnitus in elderly population, including otology, metabolic, neurologic or cardiovascular conditions. The aim of this study was to determine the association of tinnitus with these chronic comorbidities among elderly community and its impact upon their quality of life. We performed a clinical retrospective study on 471 ENT patients hospitalized for various diseases, up to 60 years old, for a period of 24 months. All subjects were assessed for subjective tinnitus, neuro-vascular comorbidities and QoL by use of the brief version of the World Health Organization QoL instrument. Tinnitus was reported in 114 patients, giving a prevalence of 24,2%. Variables like gender, residence, economic status, alcohol or smoking were not significantly associated with tinnitus. On the other hand, otic and sinonasal pathology, dizziness, hypertension, arteriosclerosis or diabetes were significantly correlated. All patients with tinnitus presented a more negative perception of their overall health and a poorer QoL, compared to those without. Tinnitus is a common pathology among elderly community. Its association with chronic treatable health comorbidities reduces QoL and highlights the need of cooping strategies among this group population. Source


Lupu I.,University of Bucharest | Neicutescu P.,Sfanta Maria Hospital | Sarafoleanu C.,University of Bucharest
Romanian Journal of Legal Medicine | Year: 2012

Presence of a foreign body in the vascular space of the neck is a very rare pathology. Long lasting metallic objects in this area induce significant changes in a vital zone, whose damage can cause high morbidity. This metallic foreign body - a nail was purely accidental discovered at a neurological consultation in a patient working as a carpenter. The metallic foreign body was removed from the cervical region without complications. Anamnesis identified a traumatic event, with no complications encountered, that took place 20 years ago. © 2012 Romanian Society of Legal Medicine. Source


Micu M.C.,Rehabilitation Clinical Hospital | Vlad V.M.,Sfanta Maria Hospital | Bolboaca S.D.,University of Medicine and Pharmacy, Cluj-Napoca | Carlig M.,The Surgical Center | And 3 more authors.
Medical Ultrasonography | Year: 2014

Background: In daily rheumatology clinical practice, routine interventional musculoskeletal ultrasound (MSUS) guided maneuvers such as aspiration, intraarticular or periarticular drug injections require efficient cleaning and disinfection methods for both transducer and patient's skin. Aim: To study the efficacy of probe and skin disinfection measures after using simple protocols, to identify the prevalence of septic and other drug related side effects after MSUS guided interventions and to quantify the total procedure time. Material and methods: Recruitment of consecutive patients with different joint/ periarticular MSUS guided interventions was made in 3 medical centers. Bacterial load was determined on the transducers footprint after dry cleaning with the removal of any gel trace and on patient's skin after rigorous skin disinfection with either Bethadine or alcohol 70° and Bethadine. Non-sterile gel was used as an ultrasound transmission medium. The time spent for some of the invasive procedures was quantified. Results: Nine hundred and ninety eight MSUS guided interventional maneuvers were performed in 945 patients with inflammatory and degenerative musculoskeletal pathologies. Staphylococcus epidermidis was identified in 13.33% cases of the skin bacterial load analysis and in 37.50% cases of the footprint analysis. In two patients pathogenetic germs were detected on the skin. No septic post-procedural complications were reported. In 0.6% of the cohort other side effects occurred: aseptic osteonecrosis, skin depigmentation at injection site and iatrogenic microcristaline reactions. The median time frame dedicated to the intervention was 6 minutes. Conclusion: Rigorous transducer dry cleaning and Bethadine/ Bethadine and alcohol 70° skin disinfection are efficacious methods. The risk for septic complications and other drug related side effects related to MSUS guided injections is very low in this context. A correct injection technique must accompany the previous requests. Rapid and safe interventional maneuvers reduce the risks and control the costs of the healthcare system. Source


Mazilu D.,Sfanta Maria Hospital | Mazilu D.,University of Bucharest | Opris D.,Sfanta Maria Hospital | Opris D.,University of Bucharest | And 22 more authors.
BioMed Research International | Year: 2014

Clinical response in patients with rheumatoid arthritis (RA) treated with biologic agents can be influenced by their pharmacokinetics and immunogenicity. The present study evaluated the concordance between serum drug and antidrug levels as well as the clinical response in RA patients treated with biological agents who experience their first disease exacerbation while being on a stable biologic treatment. 154 RA patients treated with rituximab (RTX), infliximab (IFX), adalimumab (ADL), or etanercept (ETN) were included. DAS28, SDAI, and EULAR response were assessed at baseline and reevaluated at precise time intervals. At the time of their first sign of inadequate response, patients were tested for both serum drug level and antidrug antibodies level. At the next reevaluation, patients retreated with RTX that had detectable drug level had a better EULAR response (P=0.038) with lower DAS28 and SDAI scores (P=0.01 and P=0.03). The same tendency was observed in patients treated with IFX and ETN regarding EULAR response (P=0.002 and P=0.023), DAS28 score (P=0.002 and P=0.003), and SDAI score (P=0.001 and P=0.026). Detectable biologic drug levels correlated with a better clinical response in patients experiencing their first RA inadequate response while being on a stable biologic treatment with RTX, IFX, and ETN. © 2014 Diana Mazilu et al. Source

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