Factori determinanți ai obezității la copil

Institutul Inimii de Urgență pentru Boli Cardiovasculare „Niculae Stăncioiu” Cluj-Napoca, județul Cluj, România, Universitatea „Lucian Blaga” din Sibiu, județul Sibiu, RomâniaIntroduction. The usual approach when defining the fundamental etiology of obesity is to consider the energy imbalance between calories consumed and calories expended as the main determinant factor in the pathogenesis of weight excess [1]. In recent times, considerable scientific efforts have been made, however, to provide nuance regarding the inner workings of the exact mechanisms that lead to the development of obesity [2]. One direction for research has revolved around the factors regarding childhood obesity – an illness which is escalating globally [3, 4]. There is a well-documented relation between developing a weight excess in childhood and adult obesity [5], as a majority of overweight adults have in fact retained this status since childhood [6]. Preventive action against obesity is dependent upon the understanding of its determinant factors. These factors represent targets upon which to act in order to attempt to minimize the impact of this global disease. Aim of the study. To provide an overview of the current literature regarding the main determinant factors of childhood obesity and identify potential targets for preventive measures in this respect. Material and methods. We performed literature searches using the Medline/ PubMed databases and referred to international guidelines where applicable. Results and conclusions. The intricate interactions between environment and genotype can reveal a series of crucial points where decisive preventive actions could have a significant impact on the reduction of the burden of obesity

Giant Sternal Chondrosarcoma in a 50-Year-Old Patient

Chondrosarcomas represent approximately 20% of primary malignant bone cancers, being known as the most frequent neoplasia of the anterior thoracic wall. In our case, we present a case of a primary sternal chondrosarcoma in a 50-year-old female patient that has been polychemiotherapy and radiotherapy treated for breast cancer. Despite the initial treated malignancy of breast cancer in the personal pathologic history of the patient, it was discovered that the sternal tumor was not a metastatic disease from the breast neoplasm. After multiple investigations, the patient was successfully treated for the sternal chondrosarcoma after a radical sternal resection with a chest wall reconstruction completed with two titanium plates that were anchored on the ribs and with the placement of methyl methacrylate mesh

Biomaterials as Haemostatic Agents in Cardiovascular Surgery: Review of Current Situation and Future Trends

Intraoperative haemostasis is of paramount importance in the practice of cardiovascular surgery. Over the past 70 years, topical haemostatic methods have advanced significantly and today we deal with various haemostatic agents with different properties and different mechanisms of action. The particularity of coagulation mechanisms after extracorporeal circulation, has encouraged the introduction of new types of topic agents to achieve haemostasis, where conventional methods prove their limits. These products have an important role in cardiac, as well as in vascular, surgery, mainly in major vascular procedures, like aortic dissections and aortic aneurysms. This article presents those agents used for topical application and the mechanism of haemostasis and offers general recommendations for their use in the operating room

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population