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Gireada A.,Carol Davila Central Military Emergency Hospital | Balescu I.,Ponderas Hospital | Bacalbasa N.,Carol Davila University of Medicine and Pharmacy | Balalau C.,St. Pantelimon Clinical Emergency Hospital | And 2 more authors.
Gineco.eu | Year: 2016

Ovarian cancer represents one of the most important health problems all over the world, being responsible for a high number of deaths annually. Serum level of cancer antigen125 is one of the most often used methods for screening, monitoring the response to treatment, the eventual relapse and disease progression in these patients. This is a review of the most important studies conducted on these themes in order to assess an improvement in the management of this aggressive malignancy. © 2016 Romanian Society of Ultrasonography in Obstetrics and Gynecology.


Radu P.,Carol Davila Nephrology Clinical Hospital | Bratucu M.,Carol Davila Nephrology Clinical Hospital | Garofil D.,Carol Davila Nephrology Clinical Hospital | Pasnicu C.,Carol Davila Nephrology Clinical Hospital | And 3 more authors.
Chirurgia (Romania) | Year: 2013

Incisional hernias occur as frequent as they did 20 years ago even if we use modern technologies in terms of suture. Sutures techniques, either primary repair or applied after failure of primary repair are characterized by high rates of recurrence. Using the hernia mesh has become mandatory in repairing of all types of hernias - inguinal, ventral or incisional. Implantation of the mesh is a relatively well-coded surgical procedure. But surgery is only the first step in the process of healing. Implantation starts a strong response with haematological mechanisms: protein absorption, complement activation, coagulation, platelet activation, neutrophil activation and tissue mechanisms: proliferation, adhesion, fibrosis. Recurrence rates are consistently lower when replacement meshes are used and a variety of meshes have been developed for this purpose. How the mesh is embedded by the human body and how the biomechanical limits of the abdominal wall are restored is still a subject of debate for surgeons. Histopathological studies and progress in design and materials are the only keys to solve this problem. Also pathological studies should determine the right material for personalized repair according to each patient's biology. This paper attempts to analyze the molecular failure factors in incisional hernia surgery, different from errors in surgery procedures. Complications can be avoided or reduced by an appropriate selection of the type of place in a particular case, and by performing a meticulous technique. Incisional hernias are considered at this moment a biological progressive phenomenon, and not only a strictly technical one, a "simple hole in the abdominal wall" that has to be firmly sutured. Copyright © Celsius.


Ionescu C.,Carol Davila University of Medicine and Pharmacy | Tircomnicu I.,St. Pantelimon Clinical Emergency Hospital | Dimitriu M.,Carol Davila University of Medicine and Pharmacy | Bratila E.,Carol Davila University of Medicine and Pharmacy | And 2 more authors.
Gineco.eu | Year: 2015

Polycystic ovarian syndrome (PCOS) is a heterogeneous condition, is present in 12-21% of women of reproductive age. The Rotterdam Criteria for PCOS require the presence of two of the following criteria: oligo/anovulation, hyperandrogenism antral follicle count (AFC) on ultrasound. The purpose of this paper is to bring new information from recent studies regarding the diagnosis of this disease using anti-Mullerian hormone (AMH) vs. AFC. AMH levels accurately reflect the ovarian follicular reserve and could be considered as an extremely sensitive marker of ovarian aging. Special reference is made to the possible implications of AMH in the pathogenesis of PCOS. The measurement of AMH was made by some clinicians the gold standard for diagnosis of PCOS. Because the serum concentrations of AMH is increased in most patients with PCOS and it is an association between the performance of serum AMH and AFC, has led to compare the performance of AMH levels and AFC in diagnosis of PCOS. With evolving progress in ultrasound device, recent studies have suggested increasing the threshold of AFC to 19 or even 26. The real-time interpretation of two-dimensional ultrasonography may underestimate the absolute number of follicles compared with three-dimensional ultrasound. © 2015 Romanian Society of Ultrasonography in Obstetrics and Gynecology.


Radu P.,Carol Davila Nephrology Clinical Hospital | Bratucu M.,Carol Davila Nephrology Clinical Hospital | Garofil D.,Carol Davila Nephrology Clinical Hospital | Goleanu V.,Agripa Ionescu Clinical Hospital | And 2 more authors.
Chirurgia (Romania) | Year: 2015

Despite the continuous development of synthetic prosthetic meshes and their wide use, recurrent incisional hernias still appear in 5 to 20% of cases, with a linear incidence curve over the years, suggesting a multifactorial process rather than a simple failing technical repair as the underlying cause. Recent molecularbiological research provide increasing evidence of connective tissue alterationssuch as a defective wound healing with impaired scarring process in patients withincisional hernia. Although there are some promising results, at present, in-depth understanding of the pathophysiological mechanisms and of the role that collagens play in the development and recurrence of incisional hernia is rather scarce.The aim of this systematic review is to summarize and evaluate the biochemical mechanisms involved in incisional hernia formation and recurrence, with a primary focus on collagen I to III ratio. Also, the consequences for surgical practice are discussed. © Celsius.


Strambu V.,Carol Davila Nephrology Clinical Hospital | Garofil D.,Carol Davila Nephrology Clinical Hospital | Pop F.,Carol Davila Nephrology Clinical Hospital | Radu P.,Carol Davila Nephrology Clinical Hospital | And 6 more authors.
Chirurgia (Romania) | Year: 2013

Background: Up-to-date it is unclear whether stage II colorectal cancer patients should receive adjuvant chemotherapy. The presence of high risk features (T4, CEA>5 ng/dl, less than 12 lymph nodes examined) is an indication for Oxaliplatin based treatment. In their absence, there is no consensus, 5 Fluorouracil regimens, or observation only being equally recommended by oncologists. Microsatellite instability is associated with good prognosis in stage II colorectal cancer and also with poor response to 5 Fluorouracil and should be used as a predictive marker. Methods: We performed a prospective descriptive study on 115 consecutive patients who received surgical resection for colorectal cancer in our clinic during 2011 and 2012 using a risk stratification algorithm based on TNM staging, clinicopathologic and molecular markers. Results: From the 44 stage II colorectal cancer patients, 10 cases were classified as high risk, in 26 cases we performed Immunohistochemical analysis that identified 8 patients with low risk microsatellite instability phenotype, with no indication for adjuvant chemotherapy; 26 intermediate risk patients received 5-FluoroUracil regimens. Conclusion: We believe that microsatellite instability testing provides a useful tool in the goal of better characterizing patients with stage II colorectal cancer in matters of risk of recurrence and likelihood of benefit from chemotherapy.

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