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Advanced Echocardiographic Assessment of Ebstein Anomaly in Children
Open access
Aplasia Cutis Congenita with Unusual Localization – Case Report

Abstract

Congenital skin aplasia, known more as aplasia cutis congenita (ACC), is a rare congenital disease, characterized by absence of the skin, observed since birth, more often affecting the scalp and rarely the trunk or limbs. We report here for the first time a non-syndromic localized ACC, characterized by a small solitary area of skin atrophy on the cervical area in a healthy 3-day-old female infant.

Open access
Assessment of Inflammatory Status Based on Total Blood Count and Its Relationship to Cardiovascular Diseases

Abstract

Background: Inflammation seems to be the most important trigger for atherosclerosis. Lower extremity artery disease (LEAD) and hypertension (HTN) are the most important atherosclerotic diseases. Total blood count-derived neutrophil-lymphocyte ratio (NLR) and red cell distribution width (RDW) have been proposed as inflammatory biomarkers in cardiovascular diseases. The aim of this study was to assess the correlation with LEAD and HTN.

Material and methods: In total, 134 subjects were included in the study, divided into 2 groups as follows: group 1 – patients with LEAD and HTN; group 2 – subjects with HTN, without LEAD. Complete blood count (CBC) and lipid profile were determined. To assess peripheral artery disease, the ankle-brachial index (ABI) was measured with a handheld Doppler device (BiDop ES100V3 Hadeco®). We compared the inflammatory status between the groups with the use of white blood cell count (WBC), red cell distribution (RDW), and neutrophil-lymphocyte ratio (NLR).

Results: In group 1, there was a significant negative correlation between the ABI and RDW (p = 0.04, r2 = –0.24, 95% CI: 0.4647–0.0013), as well as between the ABI and NLR (p = 0.001, r2 = –0.38, 95% CI: 0.5801–0.1592). In group 2, there was a positive correlation between NLR and total serum cholesterol levels (p = 0.003, 95% CI: 0.1274–0.5472, r2 = 0.12), as well as between NLR and triglyceride levels (p = 0.002, 95% CI: 0.1387–0.5552, r2 = 0.13).

Conclusion: NLR and RDW could represent first-line investigations in patients with cardiovascular disease due their cost efficiency. They can also play a role in triaging patients with atherosclerotic disease, monitoring treatment response and prognosis of the disease.

Open access
Coronary Artery Aneurysms Due to Kawasaki Disease – a Rare Cause of Acute Myocardial Infarction

Abstract

Kawasaki disease, also known as Kawasaki syndrome or mucocutaneous lymph node syndrome, is a pathology that causes inflammation in the walls of medium sized arteries causing symptoms such as fever, lymphadenopathy, rash, and erythema of eyes, lips, nose, palms and feet. The cause is unknown, although clinical features strongly suggest an infectious etiology. We present the case of a 53-year-old woman, known with Kawasaki disease since childhood, with different associated pathologies, that presented with acute inferior ST elevation myocardial infarction.

Open access
Study of Survival in Gastric Cancer with Emphasis on Lymph Node Status as an Independent Prognostic Factor

Abstract

Background: Lymph node status in gastric cancer is known as an independent prognostic factor that guides the surgical and oncological treatment and independently influences long-term survival. Several studies suggest that the lymph node ratio has a greater importance in survival than the number of metastatic lymph nodes.

Aim: The aim of this study was to evaluate the clinical and morphological factors that can influence the survival of gastric cancer patients, with an emphasis on nodal status and the lymph node ratio.

Material and methods: We conducted a retrospective study in which 303 patients with gastric cancer admitted to the Department of Surgery of the Mureș County Hospital between 2008 and 2018 were screened for study enrolment. Data were obtained from the records of the department and from the histopathological reports. The examined variables included: age, gender, tumor localization, T stage, histological type, grade of differentiation, surgical procedure, lympho-vascular invasion, excised lymph nodes, metastatic lymph nodes, lymph node ratio. After screening, the study included a total number of 100 patients, for which follow-up data was available.

Results: The mean age of the study population was 66.43 ± 10 years, and 71% were males. The average survival period was 21.42 months. Statistical analysis showed that the localization of the tumor (p = 0.021), vascular invasion (p ---lt---0.001), T (p = 0.004) and N (p ---lt---0.001) stages, type of surgery (partial gastrectomy 59% vs. total gastrectomy 41%, p = 0.005), as well as the lymph node ratio (p ---lt---0.001) were prognostic factors for survival in patients with gastric cancer undergoing surgical therapy.

Conclusions: The survival of gastric cancer patients is significantly influenced by tumor localization, T stage, vascular invasion, type of surgery, N stage and the lymph node ratio based on univariate analysis. Also, the lymph node ratio proved to be an independent prognostic factor for survival.

Open access
Zinner’s Syndrome – The Value of Clinical Imaging and Morphopathological Findings for Diagnosis

Abstract

Introduction: Cystic congenital malformations of the seminal vesicle are unusual. More than half of them are associated with ipsilateral renal agenesis. This disease was first described by Zinner in 1914, and since then, more than 200 cases have been reported. Most of the patients with this congenital disease present few symptoms until the middle-age.

Case presentation: A 61-year-old male was referred to the Urology Clinic with intermittent pain and sensibility in his lower left abdomen in the last 12 months accompanied by intermittent bowel obstruction. The digital rectal examination could not assess the prostate due to a rectal stenosis. On computed tomography and magnetic resonance imaging (MRI) a cystic tumor with close relations with the bladder wall and prostate, associated with left kidney agenesis was identified. The cystic tumor was surgically removed. The histopathological examination of the tumor revealed a multilocular seminal vesicle cyst, with a muscular wall.

Conclusions: Seminal vesicle cysts combined with ipsilateral renal agenesis are rare urological anomalies. Imaging allows a comprehensive investigation of renal and seminal vesicle anomalies. MRI seems to better visualize cysts and differentiate them from ureteroceles, while the histopathological examination contributes to a correct diagnosis. A multidisciplinary team (urologists, radiologists, and morphologists) is necessary for the proper diagnosis of Zinner’s syndrome.

Open access
A Case of Papular-purpuric “Gloves and Socks” Syndrome Caused by Mycoplasma pneumoniae

Abstract

We present a case of “gloves and socks” syndrome associated with Mycoplasma pneumoniae infection in a 6-year-old child hospitalized for febrile syndrome associated with monomorphic purpuric papular eruption localized on the distal part of extremities, in a “gloves and socks” pattern. Clinical diagnosis was confirmed by positivity of specific IgM against Mycoplasma pneumoniae. Favorable outcome was obtained by administration of oral clarithromycin.

Open access
Endovascular Treatment for Bilateral Carotid Stenosis: a Case Report

Abstract

Carotid artery stenosis is usually a consequence of thromboembolism or atheroembolism, or it can be secondary to a low-velocity status in the carotid circulation. This disease can also represent an important cause of stroke, being responsible for 7% of all stroke cases. Endovascular techniques were recently proposed as alternative interventions for patients with high risk for endarterectomy. We present the case of a 70-year-old patient, accusing headache, vertigo, and fatigue. Angiography indicated bilateral carotid artery stenosis. Interventional surgery and angioplasty were performed, crossing the stenotic lesions of the left internal carotid artery, followed by the implantation of a Carotid WALLSTENT endoprosthesis. Evolution of the patient was favorable after the endovascular intervention, with significant improvement of the symptoms caused by bilateral carotid stenosis. As a conclusion, decision-making must be modulated in each patient, according to the patient’s anatomy and comorbidities, and the experience of the team performing the procedure.

Open access
Epicardial Fat and Coronary Vulnerability
Open access