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Open access

Dorin Sarafoleanu and Raluca Enache

Abstract

Whiplash syndrome is a quite common pathology and can be defined as a neck injury produced by a sudden acceleration-deceleration, the consequence of which is a sudden forward and backward movement of the head and neck. The main production mechanism is a sudden acceleration-deceleration process that has as a consequence the sudden extension/flexion of the neck. Starting from the many structures involved, the whiplash syndrome is an interdisciplinary challenge (ENT specialist, neurologist, orthopedist, ophthalmologist, psychologist) and can be described by multiple signs and symptoms.

Whiplash syndrome is a complex pathology both through the mechanism of production and symptoms, and through the forensic implications that it has. The interdisciplinary medical collaboration, the implementation of stricter rules on wearing the seat belt and the development by car manufacturers of chairs and head restraints that protect the head and neck of passengers, would be the preventive step in the occurrence and especially the chronicization of these lesions.

Open access

Elena Patrascu, Violeta Melinte, Carmen Paraschiv-Ferariu and Codrut Sarafoleanu

Abstract

Salivary gland cancers are represented by a heterogeneous histologic group of tumors, with low incidence, which may appear both in major and minor salivary glands. This article presents a review of the difficulties which may be encountered in this pathology during the treatment. The diagnosis of salivary gland cancers is often delayed, due to the histopathologic and immunohistochemistry results given in different period of times. There can be several difficulties in following the oncologic pre-treatment protocols, in terms of imaging technique, as MRI, useful for disease staging.

The treatment of salivary gland cancers is complex, due to the local anatomy and their aggressive potential. Because of their decreased incidence, there are few data that investigate the treatment in the case of these diseases. The current therapy available for the patients with salivary gland cancers is represented by complete surgical resection. Several treatment difficulties in cancers of the salivary glands may come from the surgical limitations and the insufficient data for adjuvant and palliative treatment. Due to the limitations of the local health system, there is a heterogeneous distribution of the oncologic centers, lack of equipment, prolonged time to follow general protocols, despite the aspect of case-individualized therapy according to the guidelines. We must not forget the tumor behaviour and individual reactivity of different patients to the same treatment protocol.

Open access

Cornelia Nitipir, Cristina Orlov-Slavu and Lucian Alecu

Abstract

The second most frequent malignant tumor of the bone after osteosarcoma, chondrosarcoma is subdivided in conventional type, mesenchymal, clear cell, and the dedifferentiated subtype. Each of these pathological entities has a particular clinical behavior. For most, surgery remains the sole valid option. However, efficient systemic therapy options for advanced and metastatic cases are scarce. This short review is aimed at describing the latest options presented by current literature in these cases. Most of the data is derived from preclinical trials, but some drugs were also included in clinical research as far as phase two trials. After reviewing this data, it could be concluded that the future in unresectable or metastatic chondrosarcoma is personalized medicine and that more specific biomarkers to aid the choice are necessary.

Open access

Bilgin Emre, Vincenten Cornelis, Kati Yusuf Alper, Kose Ozkan and Kalenderer Onder

Abstract

Bilateral extensor tendon ruptures of the knee are not uncommon. However, simultaneous ruptures of the patellar tendon (PT) and contralateral quadriceps tendon (QT) are relatively rare injuries. These ruptures are frequently associated with chronic renal failure and minor trauma. However, they can occur spontaneously in healthy individuals. In this case report, a 43-year-old male with chronic renal failure who sustained bilateral extensor tendon ruptures (right knee: QT rupture, left knee: PT rupture) following an alternating current electrical shock was reported. To our knowledge, simultaneous quadriceps and contralateral patellar tendon rupture following an electric shock have not been reported yet. Etiology, mechanism of injury and treatment options of this rare injury are discussed together with a thorough literature review.

Open access

Ala Istratenco

Abstract

Chronic rhinosinusitis with nasal polyps (CRSwNP) is considered a multifactorial pathology with negative impact on the quality of life and considerable socio-economic effects. The pathogenesis of CRSwNP has not yet been fully elucidated despite remarkable studies in this field. This limits the pathogenic treatment and, therefore, the pathological process is expressed by a greater tendency of recurrence. Patients with recurrent CRSwNP remain in a severe state and therapeutically uncontrolled. In recent studies, the involvement of oxidative stress (OS) in the pathogenesis of CRSwNP has been more frequently mentioned. CRSwNP is considered a response of the sinonasal tissue on the inflammatory state, associated with OS and production of reactive oxygen species, causing injury to sinonasal tissues. It was demonstrated that the amount of ROS in the nasal polyp tissue corresponds to the severity of CRSwNP.

A literature review on the role of OS in the pathogenesis of CRSwNP was undertaken. The relevant information was identified using a search of electronic databases. Keywords used to highlight relevant papers were a combination of “chronic rhinosinusitis with nasal polyps” and “oxidative stress”.

This review demonstrates that there is a strong relationship between OS and CRSwNP pathogenesis. It is hypothesized that antioxidants may have a preventive role in CRSwNP. Nevertheless, additional research is required to further evaluate the effectiveness of antioxidant therapy.

Open access

Monica Cirstoiu, Alexandru Baros, Florina Paulet, Delia Gradinaru-Fometescu, Bogdan Șerban, Bogdan Cretu and Cătălin Cirstoiu

Abstract

This article analyses a series of 22 confirmed cases of ovarian cancer throughout a period of 14 months (January 2018 - February 2019), in which we assessed the incidence of osseous metastases, in correlation with their histological features. This retrospective study, based on medical imaging techniques, demonstrates that bone metastases are not uncommon in ovarian cancer.

Open access

Vlad Budu, Tatiana Decuseara, Ioan Alexandru Bulescu, Lavinia Ilinca and Alexandru Panfiloiu

Abstract

Inverted papilloma is a rare benign sinonasal tumor with a still unclear etiology. In the last decades, HPV implication in inverted papilloma etiopathogeny has been studied and demonstrated in some scientific research papers, but with no causality proven. Imagistic investigations and the Krouse classification establish the surgical approach. Endoscopic surgery represents the golden standard treatment for most cases of inverted papilloma, while external or combined approaches present limited indications.

The authors present a case and therapeutic plan of an inverted papilloma located in the ethmoid sinus, with origin in the lamina papyracea and high-risk HPV implication.

Open access

Lucian Lapusneanu and Alina Neacsu

Abstract

Lacrimal stents were used in the past to preserve the caliber of the lacrimal pathways after surgery, trauma, reconstruction, etc. Recently, their role in preventing functional epiphora has also been highlighted. Over the years, the stents have evolved and different models, materials and surgical techniques for positioning have appeared. Extensive and accurate knowledge of the type and design of the stent, the correct insertion technique offer optimal results depending on the anatomical area and the type of disorder of the lacrimal pathways. We will present the advantages of a simple catheterization technique for the lacrimal sac, endoscopic post-dacryocystorhinostomy.

Open access

Traian Ciobanu, Ioan Mihau Japie, Octavian Nutiu, Alexandru Papuc, Dragos Radulescu and Radu Radulescu

Abstract

Periprosthetic joint infection is the most common reason for a failed TKA, with a septic TKA reported rate of 1 to 4% of primary TKA patients. Septic TKA has a various number of treatment options which include chronic-suppressive antibiotics, irrigation and debridement, single or staged revision arthroplasty. The goal is to eradicate the periprosthetic joint infection and reimplant a sterile and fully functional total knee prosthesis. In case the infection becomes uncontrollable, there is only one option to eradicate the infection: knee arthrodesis or above-knee amputation.

We report the case of a 63-year-old patient who in 2009 underwent TKA, the 1 year follow-up showed periprosthetic infection. At first stage, the prosthetic implants were removed and a solid cement spacer was shaped to occupy the remaining space. In 2011, after achieving complete clinical and biological remission of the infection, the cement spacer was removed and LCCK revision prosthesis was inserted.

In 2013 reinfection occurred leading to removal of the prosthetic implants and reinsertion of an antibiotic impregnated cement spacer.

Since the patient suffered significant bone loss and the local conditions were unfavorable, being prone to infection, there were 2 options to evaluate: knee arthrodesis or above knee amputation. We chose knee arthrodesis using Ilizarov external fixation technique.

Many surgical techniques are available to achieve knee arthrodesis: internal fixation with plates or intramedullary nails and external fixation. The Ilizarov method is a very effective technique that could be taken into consideration when knee arthrodesis is required.

Open access

Daniel Ion, Dan Nicolae Păduraru, Florentina Mușat, Octavian Andronic and Alexandra Bolocan

Abstract

The clinical signs and symptoms of an acute in increase intraabdominal pressure (IAP) are subtle, especially in the conditions of the polytraumatized patient. Thus, abdominal compartment syndrome (ACS) can brutally occur and can have a major impact on the body’s main organs and systems. The purpose of our research was to identify the influence of intraabdominal pressure, intra-abdominal hypertension, and abdominal compartment syndrome, in the evolution of polytraumatized patients. Our study analyzed the patients admitted in the IIIrd Department of General Surgery of University Emergency Hospital in Bucharest between 1st of January 2010 and 31st of December 2018. The value of intraabdominal pressure, on admission, correlated with the risk of IAH/ ACS in patients with abdominal trauma - being major causes of morbidity and mortality. IAP monitoring should become a mandatory part of the management plan for patients with abdominal trauma.