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  • Author: Bogdan Șerban x
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Lower Limb Deformity and Total Knee Replacement

Abstract

As the population becomes more active and life expectancy increases, gonarthrosis has proportions of epidemics. Total knee arthroplasty (TKA) is an intervention that decreases pain and gives the patients the possibility of quickly returning to the desired level of activity. It is an intervention with a patient satisfaction rate of about 90-95% with a survival of the implant over 15 years of 90%. When dealing with TKA the following elements should be taken into account: clinical examination (walking analysis), leg deformities and knee alignment (foot deformation management), posterior tibial tendon dysfunction, cavovarus foot, posttraumatic deformity, neuropathic arthropathies, ankle arthrosis, foot deformities and knee arthroplasty. Ankle or foot deformity may be causes of progression of gonarthrosis or a TKA failure. Post-operative alignment of TKA is an extremely important element in the long-term survival of the prosthesis. By improving biomechanical alignment of the complete pelvic limb, TKA survival and patient satisfaction will increase.

Open access
Osseous metastases and ovarian cancer

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
Incidence and location of bone metastases in breast cancer

Abstract

This report represents an analysis of 19 confirmed cases of breast cancer throughout a period of 14 months (January 2018 - February 2019), in which we assessed the incidence and sites of osseous metastases, in correlation with their histopathologic classification. This retrospective analysis is based on medical imaging techniques (X-ray radiography and nuclear medicine functional imaging).

Open access
The Evolution of Mortality and Death Causes in Type 2 Diabetes Patients from Timisoara Diabetes Centre Between 1970 And 1999

Abstract

Background and Aims: Cardiovascular disease represents the principal cause of death in type 2 diabetes (T2DM) patients. The aim of our study was to evaluate the all cause mortality and the main causes of death in T2DM patients and their trend of evolution between 1970 and 1999. Material and methods: 3719 T2DM patients newly diagnosed between 1970-1979 in the Timisoara Diabetes, Nutrition and Metabolic Diseases Centre were followed until 1999. The study group included 2084 women (56.0%) and 1635 men (44%), with a mean age at diagnosis of 58.2±11.5 years. Results: Throughout the analyzed period we noticed a tendency of decrease for all cause mortality, the main causes of death being cardiovascular diseases. Conclusions: The results of the study confirm the tendency of reduced mortality in T2DM patients and maintenance of cardiovascular diseases as the main cause of death in T2DM patients.

Open access
The impact of extreme genu varum and genu valgum on postoperative outcomes using mini-subvastus approach in TKA

Abstract

Increasing interest in using minimally invasive approaches in TKA has led to the question: how much deformity is accepted for using MIS in TKA? A single surgeon performed 87 consecutive TKAs with mini-subvastus approach, using unconstrained prosthesis in 84 knees and constrained prosthesis in 3 knees. We conducted a prospective study in which patients were divided into two groups according to preoperative tibiofemoral axes (TFM), one group with 160°<TFM<195° and the second group with 160°≥TFM≥195°. Clinical and radiographic outcomes were compared. Postoperative ROM and knee score were improved in both groups, with similar results (p<0.01). Postoperative radiographic analyses showed that TFM was improved in both groups (p<0.01) with the coronal alignment inferior in 160°≥TFM≥195° group than the 160°<TFM<195° group. The results of this study suggest that mini-subvastus approach is a proper technique to use in primary TKA in patients with a TFM angle less than 160° and more than 195° with similar results with TFM angle between 160° and 195°, and for the use of constrained prosthesis designs with promising results. Preoperative TFM angle less than 160° and greater than 195° increases the risk of component malposition in coronal plane.

Open access
The relationship between quality of self-monitoring and glycemic control in romanian children with type 1 diabetes mellitus

Abstract

Objectives: Optimal glycemic control is mandatory in diabetic children and adolescents for the prevention of diabetes complications, but it is difficult to be obtained due to a series of factors, including the limited availability of blood glucose self-monitoring tests. The aim of our study was to investigate the relationship between the number of daily self-monitoring tests and quality of glycemic control. Material and method: We enrolled 783 individuals previously diagnosed with Type 1 Diabetes Mellitus and investigated the significance of differences in HbA1c values between groups with distinct number of blood glucose measurements at home for each age group. Results: We found significant improvements of glycemic control with the increase in the number of daily tests, with some particularities among the groups. Conclusions: Among other intrinsic and external factors, blood glucose selfmonitoring has an important role in obtaining a good glycemic control.

Open access
Prediction of fracture risk and prophylactic intervention in metastatic bone disease: a systematic review

Abstract

Pathological fractures occur in an area of bone where either the quantity or quality of bone is modified and the main cause of bone metastases that weaken the structure and will lead to fractures are in high proportion given by visceral tumors or primary hematopoietic tumors like myeloma.

This paper’s objective was to review the actual knowledge in the treatment of fractures secondary to metastases. Spinal lesions were not discussed in this paper.

Literature search was performed using MEDLINE and Web of Science to find literature relevant to fracture risk and prophylactic intervention in metastatic bone disease. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline was used for this review. As results, we identified 30 papers that were suitable for this review. Most of them concluded that it is difficult to assess the amount of bone involvement on radiographs alone. Using the actual guidelines for prophylactic fixation may result in an under treatment or overtreatment of patients with metastatic bone disease. Their ability to determine which metastatic bone lesions will fracture is altered mainly because of the small number of patients included in the studies. The prediction factors for fracture risk are still to be evaluated. CT, FDG-PET or CT scan-based finite element analysis may be useful tools for the identification of impending pathological fractures requiring prophylactic stabilization.

Open access
Optimization of a Density Gradient Centrifugation Protocol for Isolation of Peripheral Blood Mononuclear Cells

Abstract

Objective: Peripheral blood mononuclear cells (PBMC) are extremely important in the body’s immune response. Their isolation represents a major step in many immunological experiments. In this two phase study, we aimed to establish an optimum protocol for PBMC isolation by density-gradient centrifugation.

Methods: During Phase-1, we compared two commercially available PBMC isolation protocols, Stemcell Technologies (ST) and Miltenyi Biotec (MB), in terms of PBMC recovery and purity. Twelve blood samples were assigned to each protocol. Each sample was divided in three subsamples of 1ml, 2ml and 3ml in order to assess the influence of blood sample volume on isolation performance. During Phase-2, a hybrid protocol was similarly tested, processing six blood samples. Additionally, we performed a flow cytometric analysis using an Annexin-V/Propidium-Iodide viability staining protocol.

Results: Phase-1 results showed that, for all subsample volumes, ST had superior PBMC recovery (mean values: 56%, 80% and 87%, respectively) compared to MB (mean values: 39%, 54% and 43%, respectively). However, platelet removal was significantly higher for MB (mean value of 96.8%) than for ST (mean value of 75.2%). Regarding granulocyte/erythrocyte contamination, both protocols performed similarly, yielding high purity PBMC (mean values: 97.3% for ST and 95.8% for MB). During Phase-2, our hybrid protocol yielded comparable results to MB, with an average viability of 89.4% for lymphocytes and 16.9% for monocytes.

Conclusions: ST yields higher cell recovery rates and MB excels at platelet removal, while the hybrid protocol is highly similar to MB. Both cell recovery and viability increase with blood sample volume.

Open access
Postoperative TKA alignment in sagittal and axial plane, a systematic review

Abstract

The aim of this paper was to review the existing described methods for measuring postoperative TKA alignment in sagittal and axial plane and to review the existing literature regarding the axial plane evaluation with the use of the computer tomography. The most frequent mistakes when positioning the total knee arthroplasty (TKA) components are done in the axial plane, so it is necessary to know what the limits of the radiographic evaluation are and, for this evaluation, the CT scan is the most valuable in assessing the rotation of the components.

Open access
Statistically based survival rate estimation in patients with soft tissue tumors

Abstract

Although most soft tissue tumors are benign, with a high healing rate after surgical excision, there is a variety of malignant tumors with differences in progression and prognosis. The study aimed to assess the survival rate in patients diagnosed with this pathology, based on the patient’s characteristics (age, gender, race), as well as the tumor’s histological type, differentiation degree, location and size. The retrospective study included a group of 103 patients diagnosed during 2010 and 2017 in our department. Considering the high healing rate of benign tumors, only the group of neoplastic patients (45 cases) was involved in the survival rate estimation, assessing tumor characteristics and individual comorbidities. Within this lot, we emphasized a predominance of neoplasm in patients aged over 50 years (32 cases), men (29 cases), and localization of the neoplasm in the thigh (23 cases). The predominant histopathological type, liposarcoma, was diagnosed in 67% of the cases, with dimensions over 6 cm and with local extension. There have been significant variations in mortality between the different histological subtypes (liposarcoma vs. synovial sarcoma). Local recurrences were showed in 18 cases of liposarcoma in the first 2 years after the surgical excision, with an increased aggressiveness of this neoplasm in men over 50 years. 12 cases developed distant metastasis, and until the end of the study, 7 deaths were reported in 3 cases involving associated comorbidities. The five-year survival is inversely proportional to the extent of the tumor and the local invasion, as well as to the age of the patient. An overall survival rate is difficult to appreciate in the context of a heterogeneous group of tumors so it must be evaluated for every histological subtype taking into account the patient’s particularities.

Open access