Comparative efficacy of oral contraceptive versus local treatment versus intense pulsed light combined with vacuum in endocrine acne in women.

Acne is the most common affection of adolescents, although it can be also found in adult women. Our study was aimed at the comparative assessment of three different therapies over a three-month period, applied to women with moderate comedogenic and papulo-pustular endocrine acne. In the study 116 female patients with endocrine localized face acne were included and divided into three groups: group I with 42 patients was treated with a combination of contraceptive pill + local treatment + pulsed-vacuum light; group II with 38 patients was treated with contraceptives and pulsed-vacuum light and group III with 36 patients was treated only with local treatment. The acne evaluation was made using the Global Acne Grading System (GAGS). Statistical data processing was carried out using the STATA software. For the comedogenic form of acne, the good and very good results were superior in group I vs group II and III (83.33% vs 31.58% vs 5.56%) at the end of the three months of treatment. For the papulo-pustulous form of acne, good and very good results were similar in groups I and II (92.86% vs 73.68%) both after the first month of treatment and at the end of the study, well above the local treatment group (13.99%). Our study highlighted the superiority of laser treatment combined with hormonal treatment, compared to hormonal and local treatment in the comedogenic form of acne, and the superiority of hormonal treatment combined (or not) with laser treatment in the papulo-pustular form compared to local treatment.

A comparative mass spectrometric study of fatty acids and metals in some seed extracts.

A major cause of cardiovascular diseases and cancer is diet content, so the optimization of micronutrients in food is very important. Omega-3 fatty acids supplementation for patients had beneficial effects on subjective global assessment score and metabolic profiles. Fatty acids content and the metal ions in different seeds (e.g. linseed, poppy, grape, hemp, nuts, pumpkin, sesame, watermelon, chia) recommended as food supplements, purchased on the Romanian market, were compared. Gas chromatography coupled to mass spectrometry (GC-MS) was used as an excellent technique for fatty acids identification and quantitation, and inductively coupled plasma mass spectrometer (ICP-MS) for analytical measurements of metals.

Giant Esophageal GIST: Diagnostic and Therapeutic Challenge - Case Report.

GIST are rare mesenchymal tumors of the digestive tract (less than 1% of the digestive tract neoplasia). Of these, less than 1% are found in the esophagus. Surgery is the main treatment of GIST and is supported by targeted therapy with tyrosine kinase inhibitors like imatinibmesylate. We present the case of a female patient of 51 years, admitted in our clinic for a bulky tumor in the posterior mediastinum, diagnosed after investigations performed for fatigue for the great efforts. Clinical examination was unspecific. Chest X-ray and thoraco-abdominal CT identified a widening of the mediastinum through a posterior mediastinal tumor mass, determining a deviation to the left of the thoracic esophagus without causing not abledysphagia or respiratory symptoms. It was decided surgery by thoracotomy in V right intercostal space and total excision of the tumor was performed. Histopathology examination confirmed the preoperative suspicion of esophageal GIST. Prognosis is reserved, the risk of relapse is very high given the fact that the tumor was extracted fragmented. Currently the patient is under treatment with imatinib mesylate and entered into clinical and imaging follow-up program, according to clinical guidelines.

Giant uterine leiomyoma.

Uterine leiomyomas represent the most common benign tumors of the female reproductive tract. Giant uterine leiomyomas are very rare neoplasms and represents a great diagnosis and therapeutic challenge. This article illustrates a case of a 45-year old woman presented to our surgery department with a 10-month history of progressive increasing abdominal size, back pain, vague abdominal pressure sensations, weight loss, constipation and urinary frequency. Physical examination, laboratory evaluation, transabdominal ultrasound and computed tomography scanning suggested a giant abdominopelvic mass. Abdominal supracervical hysterectomy with bilateral salpingo-oophorectomy was performed. Histologically, the specimen was a 18.1 Kg uterine leiomyoma measuring 33/28/22 cm. The patient's postoperative course was uneventful and she was discharged from the hospital on the sixth postoperative day.

Diurnal variation in total plasma tryptophan in controls and in depression.

Circadian rhythms of total tryptophan were investigated by assays of hourly blood samples over 25 h. The study population consisted of four endogenously depressed patients investigated in the absence of any treatment and six healthy controls. The abnormalities detected by statistical analyses in untreated depression consisted mainly of amplitude reduction; the phase positions of the depressed patients were similar to those of the controls.

Circadian variation in total plasma tryptophan. Antidepressant treatment: drugs and phase advance.

The authors investigated hourly total plasma tryptophan concentrations over a 24 hour period in 3 patients with bipolar depression during 2 types of treatment: a phase advance process and conventional antidepressant therapy. Both treatment modalities increased the 24 hour mean tryptophan levels and the amplitude of circadian tryptophan concentrations. By contrast, in a previous study, moderately decreased tryptophan levels and a blunted amplitude in the circadian rhythm were observed in these same patients in a depressive phase.

L-carnitine in dialysed patients: the choice of dosage regimen.

Although carnitine levels and carnitine therapy have been extensively studied in dialysis patients, the pathophysiology of L-carnitine is poorly understood. The usual therapeutic dose is 20-30 mg/kg, resulting in dramatic increases of circulating levels above the normal values. Guided by studies on its lipidic effect and by our experience of its action on haematocrit, we propose the use of 2-3 mg/kg of L-carnitine in future prospective studies.

[Angiotensin-converting enzyme and diabetes mellitus]. / Enzyme de conversion de l'angiotensine et diabète sucré.

Elevation of serum angiotensin-converting enzyme (ACE) has been reported to occur in 25 p. 100 of diabetic patients. This finding would decrease the specificity of increased ACE level in sarcoidosis. We measured serum ACE in 90 diabetic patients with simultaneous analysis of various parameters including those appreciating the degree of metabolic control. Serum ACE values, observed in diabetics are not different from values measured in controls, respectively 22,3 +/- 6,4 and 21,1 +/- 6,7 U/ml (means +/- SD). Only 5,5 p. 100 of diabetic patients had (slightly) increased serum ACE levels, i.e.: levels above mean +/- 2 SD of values observed in controls. Serum ACE levels were higher in insulin-dependent diabetics: 24,7 +/- 6,7 (n = 34) than in non insulin-dependent diabetics: 20,8 +/- 5,9 (n = 56) (p = 0,01). In the diabetic group, there is a positive linear correlation between serum ACE level and 24h-glycosuria or glycosylated A1c hemoglobin. These are parameters appreciating middle or long-term metabolic control. In the other hand, no correlation was observed between serum ACE and glycemia, triglyceridemia, serum creatinin, blood pressure or the presence of diabetic retinopathy. These findings do not show an elevation of serum ACE in diabetic patients. However, they suggest that long-term metabolic control of diabetes influence serum ACE level.

Singular case of third ventricle metastasis of colorectal carcinoma--case report.

Third ventricle tumors are uncommon central nervous system lesions and unusual locations for metastatic colorectal cancer. We present a case of a 68 year old woman with a solitary 3rd ventricle lesion found on a computed tomography scan of the brain and the synchronous mass of the right colon. The aim in this case was local control of cerebral lesion with pathological diagnosis. Surgery was followed by a short-term good evolution but with sudden death.

Comparative analysis of different surgical procedures for female stress urinary incontinence. Is stem cell implantation the future?

RATIONALE: Stress urinary incontinence (SUI) represents a major public health problem and although there are many treatments available, only a few can restore the anatomical background of this disorder. Injections of stem cells into the middle urethra have the possibility of restoring the contractility of the striated muscles and rhabdosphincters. The aim of stem cell therapy is to replace, repair or enhance the biological function of damaged tissue or organs. OBJECTIVE: Assessing the latest minimally invasive procedures of intra and perisphincterian injection of autologous stem cells and to compare the urodynamic results at one year after different surgical procedures for genuine stress urinary incontinence by measuring their impact on urinary flow rate (Qmax) and bladder pressure at Qmax during micturition. METHODS AND RESULTS: On October 18, 2010, in "Fundeni" Clinic of Urology and Renal Transplantation we performed for the first time in Romania, stem cell implantation in the urethral sphincter in four patients with stress urinary incontinence and compared the results of the urodynamic investigations of female patients operated with pure SUI with other surgical techniques. The analyzed procedures were: Burch colposuspension (11 cases), TVT-like (IVS sling in 26 cases), TOT-like (CYSTO-SWING sling in 41 cases). Followed variables were: Qmax, Pves at Qmax, postvoiding residual (PVR). Clinical examination and voiding diary in six weeks after the surgery revealed a decrease of urine loss with an improvement of the patient' quality of life according to visual analogue scale. For female patients with myoblasts implant, changes in Qmax and Pves at Qmax were minimal and statistically insignificant in the context of inclusion criteria, but we noticed a trend of minimal change in these urodynamic characteristics, namely, an average decrease of Qmax with 2.1 mL/s and an average increase of Pves at Qmax with 0.6 cmH(2)O. CONCLUSIONS: The development of myoblasts implant (if they will pass the time-proof test) could represent a breakthrough in treating this condition. As the pathogenesis of SUI is better understood and the development of tissue engineering technology advances, tissue engineering will play a more important role in the treatment of patients with SUI.

Minimally invasive treatment for female stress urinary incontinence - Romanian highlights.

RATIONALE: Stress urinary incontinence is still a "battlefield" for many minimally invasive therapies, but, unfortunately, few can restore the anatomical and functional background of this disorder. OBJECTIVE: Assessing the latest minimally invasive procedures of intra and perisphincterian injection of autologous stem cells. METHOD AND RESULT: The first stem cell implantation (myoblasts and /or mature fibroblasts grown and multiplied in the laboratory from biopsy samples taken from the pectoralis muscle) in the urethral sphincter was performed on October 18, 2010, in "Fundeni" Clinic of Urology and Renal Transplantation, in Romania. DISCUSSION: The follow-up at six weeks with the quality of life questionnaires, micturition diary and clinical examination revealed a decrease of urine loss from six pads/ day at one per day, which significantly improved the patient's quality of life according to visual analogue scale. Clinical and urodynamic evaluations will continue and will be future scientific topics.

Highlights in the minimally invasive treatment of SUI in women.

OBJECTIVE: Treatment of stress urinary incontinence consists of a wide range of options, from conservative therapies like lifestyle changes, medication, pelvic floor muscles exercises, electro-stimulation, to minimally invasive procedures--injection of collagen, suburethral slings TVT/TOT and last but not least, invasive surgical treatment reserved for recurrent and complex cases. Among the latest minimally invasive procedures reported in literature, the injection of intra-and perisphincterian of autologous stem cell (mioblasts and/or mature fibroblasts grown and multiplied in the laboratory from biopsy samples taken from the pectoralis muscles). MATERIAL AND METHOD: On October 18, 2010, in 'Fundeni' Clinical Institute of Uronephrology and Renal Transplantation was performed the first stem cell implantation procedure in the urethral sphincter, in Romania. RESULTS: Assessment at 6 weeks, the quality of life questionnaires, micturition diary and clinical examination revealed a stunning decrease of urine loss from 6 pads/day at one per day, which significantly improved the patient's quality of life. CONCLUSIONS: Stem-cell-mioblasts therapy may represent in the future an every-day intervention in the urologist's armamentarium. The effectiveness of this treatment can change the course of therapy and last but not least, the accessibility to urological evaluation of patients with stress urinary incontinence. Clinical and urodynamic evaluations will continue and will be future scientific topics.

[Determination of total free erythrocyte carnitine in an ultrafiltrate of hemolysate]. / Dosage de la carnitine libre et totale érythrocytaire dans un ultrafiltrat d'hémolysat.

The authors described an assay procedure for the determination of free and total carnitine in red blood cells. This method is based on ultrafiltration of the broken red blood cells in Centrisart filter, by centrifugation. Free and total carnitine in ultrafiltrates is determined by the spectrophotometric method of Cederblad and Coll., adapted to Cobas-Fara. They evaluated the procedure linearity, reproductability and analytical recovery. Comparison with precipitate protein procedure showed that results correlated well. The advantages of this original assay include simplicity, increase rapidity, lower cost of reagents and mainly improved reproductability.

[Application of derivative spectrophotometry for determining plasma hemoglobin and semi-quantitative evaluation of urinary porphyrins]. / Application de la spectrophotométrie dérivée au dosage de l'hémoglobine plasmatique et a l'évaluation semi-quantitative des porphyrines urinaires.

We described a method using second-derivative spectrophotometry with a spectrophotometer Uvikon (Kontron) for the assay of plasma hemoglobin and urinary porphyrins. We evaluated the procedure for sensitivity, linearity, analytical recovery. Non specific interference is not significant and reproductibility is excellent. This simple, rapid, sensitive, not expansive method can be adapted for use in a clinical laboratory.

[Spontaneous intracerebral haemorrhage. An update of conservative treatment]. / Actualitati în tratamentul conservator al hematomului intracerebral spontan.

In our article we analysed the current conservative therapeutic options in spontaneous intracerebral haemorrhage as well as a few controversies regarding the efficiency of some types of treatment. Spontaneous intracerebral haemorrhage represents a major neurosurgical emergency. In spite of the severe prognosis of the disease, there is reason for optimism. There are important improvements in treatment of arterial hypertension, and cerebral lesions. The aim of the conservative medical treatment is to maintain good oxygenation, decreased arterial pressure, control of the intracranial hypertension, cerebral oedema, prevention of seizures. All these contribute to improving the vital and functional prognosis.

[Complications of intracerebral hemorrhage caused by arterial hypertension]. / Complicatiile hemoragice intracerebrale ale hipertensiunii arteriale.

Intracerebral hematoma represent a frequent complication of hypertension. It is accompanied by significant mortality and complications. It is mainly a surgical condition but we prefer conservative therapeutic options in cases where feasible. The conservative treatment gives better results but surgery becomes obsolete in cases when medical treatment fails.

[The ecological accident on the Siret River. A possible cyanide intoxication of children]. / Accidentul ecologic de pe râul Siret. Un episod de intoxicatie cu cianuri la copii.

THE PURPOSE: Of our study is to assess the gravity of cyanide intoxication of children, in the ecological accident in January 2001. MATERIAL AND METHODS: We included in our study 127 children aged between 2 months and 17 years. They were hospitalized in January and February 2001, in the "Sf. Maria" Children's Hospital. Case analysis was based on data of the emergency unit and units where the children were sent after primary care. We evaluated the patients from clinical and paraclinical point of view and we took samples of biological products in order to confirm the diagnosis. RESULTS: Age distribution was 0-1 year (4%), 1-3 years (7.8%), 3-6 years (9.4%), 6-12 years (33.8%), and 12-18 years (42.5%). The lapse of time between the ingestion of contaminated fish and symptomatology was variable. Measures were taken: removal from toxic contact, hospitalization, antidote administration, and treatment of complications. DISCUSSIONS: Although literature data shows that this intoxication appears after the age of three, we found that mother ingestion of contaminated fish, determined intoxication in nursings. Symptoms appeared at 3-12 hours after fish ingestion from the contaminated river and it was suggestive for the diagnosis. First aid measurements were necessary in specialized emergency unit and antidote administration sometimes only in clinical suspicion of intoxication. Correlation between clinical findings and toxic concentrations in urine samples confirm the diagnosis. CONCLUSIONS: Our study tries to highlight those ecological accidents with cyanides present important consequences on people and animal's health. The therapeutic intervention must be fast in order to stop blood distribution of the toxic.