Romanian Journal of Military Medicine

2

Authors: Dragos Cuzino

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3

Authors: Argentina Vidraşcu

Several methods have been exercised during the past years, thus offering the surgeon the possibility to choose when planning reconstructive surgery. Among these methods, we recall: the dislocation of a large surface of skin and fasciocutaneous flaps, the transposition of the muscle and its covering with a simple cutaneous flap or a cutaneo-adipose flap, musculocutaneous pediculate flaps, neurovascular flaps. The study was conducted on 292 patients with 3rd and 4th degree decubitus lesions admitted into and operated at the Plastic Surgery and Reconstructive Microsurgery ward during 10 years. Pediculated flaps on septofasciocutaneous perforating arteries or on musculocutaneous perforating arteries are more difficult to harvest (they require a precise knowledge about the localization of the perforating artery) but provide a better post-op result.

5

Authors: Iuliana Guiţă – Alexandru

Stress is a constant presence in our lives, whether we analyze it in professional, social or family terms. This daily reality creates a state of tension, strain and discomfort, causing significant changes in physical and mental health. Stress at work can affect anyone, at any level, in any sector and in organizations of any size. Stress affects health and safety of individuals and also organizations’ welfare and national economies. There is a definite correlation between the level of stress at work and the changes in organization’s productivity.

6

Authors: Claudiu E. Sbârcea, Lucian Lerescu, Mariana Jinga

Bio-terrorism involves using biological agents/toxins with the intent to intimidate or coerce a government or civilian population to further political or social objectives, usually leading to deaths or illnesses of humans but also of plants/animals. Their use would probably initially be considered as a natural or unintentional event, especially in case of live biological agents. Moreover, a natural occurring disease outbreak could have the same destructive outcome as an efficient biological weapon. There is a need for proper differentiation between natural and intentional events although in the first stages the medical response should be similar; however, the course of incident management would take different paths later on. Biological agents’ investigation of dangerous pathogens, from natural unusual outbreaks or bioterrorist attacks/other intentional use, imply the collaboration of different institutions with responsibilities in public health but also in national security and defense. The National Security and the Defense System institutions think mainly in security terms while national health care system institutions think principally` in medical care/prevention terms. These two ways of acting have to be combined in order to deal properly with hazardous biological agents.

6

Authors: Iuliana Guiţă – Alexandru

The success or failure of a therapeutic approach, medical or psychological, are influenced by many factors. Among them we can mention the patient’s insufficient knowledge about the disease, preconceptions of patient or caregiver’s fear of stigmatization, the issue regarding duration and side effects of treatment, cost of medicines and so on. Last but not least, the therapist’s ability to communicate accordingly to the beneficiaries’ comprehension and barriers encountered in the communication between actors directly involved in the therapeutic process (patient caregiver, psychologist, and doctor) can change the opportunity to obtain a suitable therapeutic benefit yet from beginning. Materials and methods: In order to assess the concordance between the messages sent by doctors and how they are received by patients and caregivers, we have applied a different questionnaire for the three categories of respondents mentioned above. These three distinct sets of questions were completed during 100 psychiatric consultations, in ambulatory regimen. Results: Comparative analysis of the questionnaire results has shown major differences between the information that doctors thought they had sent and what was actually received by patients and caregivers. Paradoxically, the more medical explanations were elaborated and detailed, the less volume of adequate information was taken home by beneficiaries. Conclusions: It is necessary for each of us to have a self-assessment of how we communicate with patients and which is the real benefit that we offer through our words. It is also mandatory to adapt the „language of medicine” to the common people understanding abilities (without medical training).

7

Authors: Vasile D. Balaban, Andrei M. Lungu, Dragoș Cuzino, Săndica Bucurică, Bogdan Macadon,Mihăiță Pătrășescu, Raluca S. Costache, Petruț Nuță, Constantin Ştefani, Florentina Ioniță-Radu, Mariana Jinga

Chronic pancreatitis is characterised by progressive and irreversible damage of the pancreatic parenchyma and ductal system, which leads to chronic pain, loss of endocrine and exocrine functions. Clinically, pancreatic exocrine insufficiency becomes apparent only after 90% of the parenchima has been lost. Despite the simple definition, diagnosing chronic pancreatitis remains a challenge, especially for early stage disease. Because pancreatic function tests can be normal until late stages and have significant limitations, there is an incresing interest in the role of imaging techniques for the diagnosis of chronic pancreatitis. In this article we review the utility and accuracy of different imaging methods in the diagnosis of chronic pancreatitis, focusing on the role of advanced imaging (magnetic resonance imaging, endoscopic retrograde cholangiopancreatography and endoscopic ultrasound).

8

Authors: Dragoş Cuzino, Oana M. Baston, Cătălin Blaj

The article presents the main aspects of sectional anatomy, lymph nodes and adjacent structures as well as MRI examination standard protocol for prostate cancer diagnosis. Using MRI multiparametric examination we succeed in classifying efficiently the malignant prostatic tumors using PI- RADS system. Also, using MRI multiparametric examination we can evaluate the effectiveness of prostate cancer treatment.

11

Authors: Felician Chirtes

Introduction: Cisplatin is a well known platinum-based chemotherapeutic agent used for the treatment of diverse malignant tumours. A frequent side effect of cisplatin therapy is ototoxicity. Material and methods: Experimental, clinical studies and reviews from the English language medical literature concerning ototoxicity were selected either from PubMed or printed medical journals, pointing out cisplatin-induced ototoxicity. Molecular mechanisms, clinical audiological and histological marks of cisplatin-induced ototoxicity as well as current experimental and clinical strategies for prevention or treatment of hearing loss were reviewed. Results and discussion: A wide range of otoprotective molecules and efficient strategies against cisplatin-induced hearing loss proved to be helpful in experimental studies whereas only dexamethasone settled a slight otoprotective effect in a clinical study. Conclusion: There is no currently available treatment for cisplatin associated hearing loss and further research is required for future therapeutic options.