[Effects of internal limiting membrane peeling in epiretinal membrane surgery on OCT-angiography]. / Effets du pelage de la membrane limitante interne sur la microvascularisation maculaire en OCT-angiographie dans la chirurgie des membranes épirétiniennes.

PURPOSE: To assess macular microvascular parameters using OCT-angiography (OCT-A) in idiopathic epiretinal membrane surgery with or without internal limiting membrane peeling. MATERIALS AND METHODS: We retrospectively studied 17 eyes of 17 patients who underwent vitrectomy surgery for idiopathic epiretinal membrane with (n=10) or without (n=7) internal limiting membrane peeling. Patients operated on between July 2020 and June 2022 at the Colmar Hospital (France) by a single surgeon were evaluated before and 1 month after surgery, using OCT-A (Spectralis OCT-A module, Heidelberg Engineering®, Germany). The parameters studied were the area, perimeter and acircularity index of the foveal avascular zone (FAZ), the foveolar (FVD) and parafoveolar (PRVD) perfusion density and the macular vessel density ratio (MVR) in the superficial vascular complex (SVC) and the deep vascular complex (DVC). These parameters were measured using ImageJ software (National Institutes of Health, Bethesda, Maryland, USA). RESULTS: We found no statistically significant difference between the two groups postoperatively in either area, perimeter, or acircularity index of the FAZ, FVD, PRVD, or MVR in either the SVC or DVC. CONCLUSION: Our results with regard to macular microvasculature demonstrate no difference related to peeling of the internal limiting membrane and thus do not argue against this practice during epiretinal membrane surgery.

Anatomical and functional outcomes of ILM interposition in surgery for large macular holes: A retrospective study.

INTRODUCTION: While surgery for small macular holes (<400µm) is well-described, the results are not as clear-cut for larger holes (>400µm). Our purpose is to demonstrate the difference in terms of closure and final visual acuity between 3 techniques: the classical technique, the FLAP technique and internal limiting membrane (ILM) transfer. METHODS: This retrospective non-randomized study included consecutive patients with a macular hole greater than 400µm. Myopic eyes (>26.5mm or >6.50D) and eyes with other retinal comorbidities were excluded. All patients underwent pars plana vitrectomy in combination with one of the 3 techniques. RESULTS: We included 84 eyes of 77 patients between 2005 and 2018; 57 in the classic group (A), 13 in the FLAP group (B) and 14 in the ILM transfer group (C). The closure rate at 3 months was 70.18 % in group A, 100 % in group B and 92.86 % in group C. The closure rate was significantly higher in group B and C compared to group A. There was no significant improvement between pre- and post-operative best corrected visual acuity in any group. The gain in BCVA was 2.90 lines (±2.98) in group A, 3.40 lines (±2.40) in group B, and 1.07 lines (±1.04) in group C. The gain was significantly lower in group C compared to group A and B. CONCLUSION: ILM interposition appears to offer a true anatomical advantage for closing large holes, but the functional recovery does not appear to be better or worse.

[Tuberculosis of the spleen--very rare site of extrapulmonary TB]. / Tuberculoza splenica--localizare extrarespiratorie foarte rara a bolii.

The extrapulmonary tuberculosis (TB) includes all the sites excepting lung, its origin being in the hematogenous disseminating foci within the main infection. The case of a woman, aged 36, is presented suffering of second degree obesity and type II diabetes mellitus under diet. She was admitted in the Surgery Clinics I of Emergency "Floreasca" Hospital (October 21, 2008) for discontinuous pains, relatively strong in the left hypocondrium, vesperal fever, perspirations, symptoms being present for 5 months. The investigations carried out before and after the admission show the presence of a splenomegaly (stage I-WHO), the absence of hypersplenism, portal hypertension, or other objective elements--excepting those mentioned at admittance--as well as the imaging changes (thoracic abdominal CT: spleen with an axis of 17 cm length, multiple solid hypodense lesions with a diameter of 5 cm). The surgical intervention is undergone (laparoscopic splenectomy). The morphological-pathological diagnosis was tuberculosis of the spleen. Considerations are made on this TB rare site.

[Postoperative upper gastrointestinal bleeding in patients with cardiovascular surgery]. / Hemoragia digestiva superioara postoperatorie la pacientii cu interventie chirurgicala cardio-vasculara studiu prospectiv.

UNLABELLED: Patients with cardio-vascular surgery are at risk for upper digestive bleeding due to several factors. AIM: To determine the utility of medication and endoscopy in preventing gastrointestinal bleeding (GB) after cardiovascular surgery. MATERIAL AND METHOD: 79 patients (60 males and 19 women, mean age 61 +/- 16.1 years) were prospectively included in the study from the 850 patients operated in the period 2004 - 2006. Inclusion criteria were: patients with digestive symptoms (dyspepsia) and with risk for GB (personal history of peptic ulcer, gastroduodenitis, esophagitis, hiatus hernia, gastric cancer, gastric surgery and GB). All patients with symptoms and partially patients with risk were evaluated by endoscopy. Patients received standard medication for prevention of GB. RESULTS: Prophylactic medication was partially efficient in GB prophylaxis vs. no prophylaxis (7% vs. 11% p < 0.05). Patients with endoscopy examination before surgery had significantly lower incidence of bleeding (6.6% vs. 10.9%, p < 0.05%). CONCLUSIONS: Gastrointestinal bleeding may occur despite prophylactic medication. Gastrointestinal endoscopy prior surgery may be useful in preventing the bleeding.

[Transversal study for the quantification of osteoporosis risk in an urban population]. / Studiu transversal pentru cuantificarea riscului de osteoporoza la o populatie din mediul urban.

UNLABELLED: Multifactorial disease, osteoporosis manifests as a "silent epidemics" characterized by the aggregation of the risk factors, the distribution of which has regional peculiarities. AIM: To determine the demographic, anthropometric, and life style-related factors in relation with T score obtained by measurement of bone mineral density, and the quantification of the detected factors for a correct monitoring of the surveyed population. MATERIAL AND METHOD: The descriptive study was carried out in a series of 364 individuals who underwent outpatient osteodensitometry and were interviewed according to a questionnaire. The risk was quantified by giving a score for each item. Densitometry permitted the calculation of T score, bone mineral density index, and rigidity index. The gathered information was included in a database, then processed and interpreted by using specific tests. RESULTS: The female-male ratio was 29: 1. Mean age was 57.08 +/- 10.03 years and the median 56 years. In 83.6% of the subjects weight was over 60 kg, at a mean height of 1.61 +/- 0.07 m. The prevalence of alcohol, coffee or tobacco consumption was not high, but 69.7% of the subjects were eating a diet low in diary products. The quantification of the global risk revealed that in over half of the subjects under study the score was below the average or dangerous level for developing osteoporosis. T score value showed that over 50% of the subjects had osteopenia, 9.2% manifest osteoporosis, and 39.9% values that include a mineralization deficit. CONCLUSION: The risk for bone changes specific to osteoporosis was low in the urban population under study, a concordance between the reduced probability of osteoporosis resulting from the value of the global score and the results of osteodensitometry being noticed.

[Some aspects regarding the activity analysis of a military hospital]. / Unele aspecte privind analiza activitatii unui spital militar.

Providing secondary health care for military staff and related personnel, Clinical Emergency Military Hospital "Dr. Iacob Cihac" it is the biggest hospital among those having the same profile. There are many factors with influence upon hospital's activities. Some factors can be measured (number of beds, the prevalence of a certain disease in population), but also some of them are subjective, creating pressures in hospitals utilization (costs, status of the professionals and hospital, desires of patients and their families). Good statistical information about hospitalized morbidity provides the basis for planning, control and efficient administration and can also serve as an input into the development of more effective preventive health strategies. There are some important differences between public own hospital and military hospital: for public hospitals, the main cause of morbidity is represented of respiratory disease, while for the military hospital on the top are nervous and psychiatric diseases; also, it is different the proportion of inpatients according to age groups - for public hospitals the main proportion of inpatients is aged more than 45-60 years old, but for the military hospital there are also well represented those aged under 29 years old. The differences between the average length of stay in hospitals is due to hospitalization of psychiatric diseases in public hospitals.