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Traian Vasile Constantin, Victor Lucian Mădan, Maria-Magdalena Constantin, Silviu-Horia Morariu and Bogdan Braticevici

Abstract

Prostate cancer is, after lung cancer, the most common malignant disease diagnosed in the male population. The introduction into the practice used during the 80’s and 90’s of the determination of serum Prostate-Specific Antigen (PSA) levels, as a component of screening for prostate cancer, was a turning point in the medical practice. Due to this enzyme produced exclusively by the prostate gland, the prostate cancer detection rate (in curative, intracapsular stages) improved significantly. Serum PSA is a better predictive factor for prostate cancer (PC) than digital rectal examination or transrectal prostatic ultrasound.

Open access

Maria-Magdalena Roșu, Sigina Rodica Gîrgavu, Oana Maria Corîci, Cristian Constantin and Maria Moța

Abstract

Type 2 diabetes mellitus (T2DM) is a progressive chronic disease, whose prevalence is steadily increasing worldwide. Although long-term complications of diabetes develop gradually, they cause serious damage or even life-threatening, especially when glycemic values are not controlled over time. In this article, we are presenting the case of a young patient, late diagnosed with T2DM, directly in a stage with chronic complications, which over time did not follow the indications recommended by doctors, leading to an undesired outcome, which may highlight the need for active screening of diabetes mellitus and other cardiovascular risk factors, both in people with diabetes as well as in the general population, to prevent such events.

Open access

Florin Mitu, Alexandra Maștaleru, Clementina Cojocaru, Mihai Roca, Ovidiu Mitu and Maria-Magdalena Leon-Constantin

Summary

Catecholamine tumoral syndrome is caused by lesions of the medulosuprarenal cromafin tissue (pheochromocytoma or pheochromocytoblastoma) or of the neural crest (paraganglioma), from the ganglionar cells (ganglioneurinoma or ganglioneuroblastoma) or from the sympathetic nervous cells (sympathogonia – sympathoblastoma and sympathoblasts – neuroblastoma), tumors that excessively secrete cathecolamines (adrenaline and noradrenaline), but also neuropeptides. Indications for testing are associated with the clinical context. Because the pheochromocytoma means a heterogeneous group of secretory tumours, there is no analysis achieving the 100% accuracy. The diagnosis can be established by hormonal dosages for basal determinations and by dynamic tests or through nonspecific tests. Imagistic explorations like computer tomography, abdominal and pelvic MRI can localise the tumour. Plasma and urinary metanephrines dosage are the first intention tests because have a higher accuracy compared to catecholamines or other metabolites. Considering the low prevalence of catecholamine secreting tumours, we considered it necessary to systematise diagnostic possibilities.

Open access

Maria-Magdalena Leon-Constantin, Alexandra Maștaleru, Ovidiu Mitu, Madalina Zota, Teodor Vasilcu, Radu Gavril and Florin Mitu

Abstract

Coumarin anticoagulants era (warfarin, acenocumarol) seems to be coming to an end with the launch of the novel anticoagulants like dabigatran, rivaroxaban, apixaban and edoxaban. Dabigatran (Pradaxa) is a prothrombin (factor II) inhibitor that doesn't necessitate monitoring by coagulation tests, doesn't have food or drug interactions, except for P-gp inhibitors. Rivaroxaban (Xarelto) is a direct inhibitor of factor X and is approved for the prevention of thromboembolic events in patients with non-valvular atrial fibrillation and for the prevention of deep venous thrombosis in patients undergoing orthopaedic surgery (hip and knee prosthesis). Apixaban (Eliquis) is a direct inhibitor of factor X and is indicated for the prevention of venous thromboembolic events in patients undergoing hip or knee arthroplasty, the prevention of thromboembolic events in patients with non-valvular atrial fibrillation and treatment or prevention of recurrences in patients with deep vein thrombosis or pulmonary embolism. Edoxaban (Savaysa), recently approved is USA, is a direct inhibitor of factor X and is indicated for deep venous thrombosis, pulmonary embolism and for the prevention of thromboembolic events in patients with non-valvular atrial fibrillation. The most recent studies focus on antidotes specifically designed to bind and neutralise the anticoagulant activity of both direct thrombin inhibitors and direct factor Xa inhibitors. The drugs currently being studied are idarucizumab, a specific antidote, andexanet alfa, a class-specific antidote and ciraparantag, a universal antidote. Of these, only idarucizumab was approved by the FDA.