Severe Acute Ischemia of Glans Penis after Achieving Treatment with Only Hyperbaric Oxygen Therapy: A Rare Case Report and Systematic Literature Review.

Acute ischemia of the glands is a severe complication after circumcision. We outline the challenging case of a seventeen-year-old boy with glandular ischemia (GI) that appeared shortly after circumcision. Methods: We present a case report and literature review related to glans ischemia, and the complications of circumcision are reviewed. We note that there are very few cases described in the literature. Our patient was successfully treated with hyperbaric oxygen therapy (HBOT) after four days of no positive effect after all medical and surgical treatments written in the literature: Subcutaneous enoxaparin, local application of a glyceryl trinitrate, continuous epidural perfusion, intravenous pentoxifylline, alprostadil, intraoperative drainage, and aspiration with saline solution and epinephrine. Clinical improvement was noted at the first session of HBOT. A number of days after the operation, the penis looked normal and was healing. Complete healing of the penile glans was successfully realized one month after surgery. Conclusion: Based on the review and the case presented, we conclude that HBOT is the treatment of choice for acute ischemia of the penile glans, especially when other treatments do not work.

Applications and Limitations of Dendrimers in Biomedicine.

Biomedicine represents one of the main study areas for dendrimers, which have proven to be valuable both in diagnostics and therapy, due to their capacity for improving solubility, absorption, bioavailability and targeted distribution. Molecular cytotoxicity constitutes a limiting characteristic, especially for cationic and higher-generation dendrimers. Antineoplastic research of dendrimers has been widely developed, and several types of poly(amidoamine) and poly(propylene imine) dendrimer complexes with doxorubicin, paclitaxel, imatinib, sunitinib, cisplatin, melphalan and methotrexate have shown an improvement in comparison with the drug molecule alone. The anti-inflammatory therapy focused on dendrimer complexes of ibuprofen, indomethacin, piroxicam, ketoprofen and diflunisal. In the context of the development of antibiotic-resistant bacterial strains, dendrimer complexes of fluoroquinolones, macrolides, beta-lactamines and aminoglycosides have shown promising effects. Regarding antiviral therapy, studies have been performed to develop dendrimer conjugates with tenofovir, maraviroc, zidovudine, oseltamivir and acyclovir, among others. Furthermore, cardiovascular therapy has strongly addressed dendrimers. Employed in imaging diagnostics, dendrimers reduce the dosage required to obtain images, thus improving the efficiency of radioisotopes. Dendrimers are macromolecular structures with multiple advantages that can suffer modifications depending on the chemical nature of the drug that has to be transported. The results obtained so far encourage the pursuit of new studies.

Contribution of mechanical and electrical cardiovascular factors in patients with ischemic stroke.

Stroke represents the third - leading cause of death after heart and neoplastic is ease and is one of the biggest cause of disability worldwide. Cardioembolism, through its principal mechanism - atrial fibrillation - constitute an important cause of ischemic stroke. Otherwise, left ventricular hypertrophy (LVH) has been associated with a twofold increase in stroke risk. The study aims at highlighting significant associations between several risk factors of stroke -LVH and atrial fibrillation (AF), respectively LVH and cardiac stenosis contributeng to ischemic stroke. The study comprised of 256 patients with stroke, hospitalized in the County Clinical Emergency Hospital, Sibiu, Romania; they were examined by ultrasound by echocardiography and carotid Duplex echography. The patients were divided in subgroups that were later compared to one another: 167 patients had atrial fibrillation (group A), 89 patients did not have atrial fibrillation (group B). Then both groups were divided in 2 subgroups (with or without LVH). It has been identified another two groups (66 patients with carotid stenosis <50%) and 116 patients with carotid stenosis >50% and each group was divided in 2 subgroups (with or without LVH). LVH is an important contributing factor in ischemic stroke in patients also presenting carotid stenosis > 50%.