Our policy in intraventricular colloid cysts. Experience of 31 operated cases.

The colloid cyst of the third ventricle is abenign tumor situated in the anterior partof the third ventricle. This lesion representsless than 1% of the primary brain tumorbeing more common in young adults.Because of its particular location, thecolloid cyst can obstruct the Monroforamen, producing intermittentintracranian hypertension with headache,vomiting and visual disturbances. Thirtyonecases of colloid cysts have beenoperated using the microsurgical approachin the First Neurosurgical Department ofEmergency Clinical Hospital “Bagdasar-Arseni” between January 1995 andDecember 2008. The age of the patientswas between 17 and 46 years, with amedium age of 31 years. The follow-upperiod was between 9 months and 7 years.In three cases TTA approach has beenperformed. One of the cases developed avenous cerebral infarct after this procedure,but the patient had finally a good outcome.For 28 patients the transcortical approachhas been performed. In all cases the totalresection of the colloid cyst has beenperformed. Of all 31 cases, one casepresented a transitory hemiparesis, twocases showed negativist behavior, and threecases had transitory memory disturbances.There was no intraventricular hemorrhageafter colloid cyst resection in our series. Inconclusion, according to our policy, themicrosurgical approach is the besttreatment for third ventricular colloid cystsbecause of its main advantages comparedwith the endoscopic approach: thepossibility of total resection of the cyst, thegood control of the bleeding source duringthe procedure, and a better exposure of theanatomical landmarks

Cost Analysis on Imaging Diagnostic Techniques in Cerebral and Abdominal Neonatal Pathology

Background: Improvement of health care quality and cost control are the main aims of the health care reform in Romania. Objective: The aims of the research are to analyse the trend of costs for imaging techniques used as diagnostic tools for cerebral and abdominal neonatal pathology and to study the relationship between cost and diagnostic benefits. Design: This is a retrospective observational study design without a control group, conducted in the Radio-Imaging Department, Cluj District University Hospital, Romania, from October 2000 to February 2006. Patients: The study population was represented by neonates investigated in the Radio-Imaging Department, Cluj District University Hospital. Intervention: Five imaging diagnostic techniques used in the diagnosis of cerebral and abdominal neonatal pathology were investigated. Measurements: The costs of the investigated techniques were calculated. The concordance between clinical and imaging diagnostic was recorded. Results: Magnetic resonance proved to be the most expensive investigation. The rate between the raising of costs on investigation type on year was constant. The average cost of imaging investigations for patients with identified pathological aspects (€ 42.72) was not statistically significant (p > 0.05) compared with the average cost for patients with no pathologic imaging aspects (€ 37.62). The concordance between the clinical suspicion and the radio-imaging diagnosis was of 52.35%. Conclusions: The raise of radio-imaging investigation costs had a decreasing tendency over the years studied, decrease explained by the stabilization of the Romanian monetary market. The results on concordance analysis lead to the necessity of training of both clinicians and radiologists

Triple valve infective endocarditis - a late diagnosis

Behcet\u27s disease is a systemic vasculitis of unknown aetiology with cardiac involvement as well as damage to other organs. Whether the sterile valvular inflammation which occurs in this autoimmune disease predisposes to bacterial adhesion and infective endocarditis is not yet established. We present the case of a patient with Behcet disease in which transthoracic echocardiography showed mobile masses on the aortic, tricuspid, and mitral valves, leading to multivalvular infective endocarditis diagnosis, possibly in the context of valvular inflammation. The case presented in this article confirms observation of other studies, namely that ultrasonography plays an important role in the diagnosis and evaluation of rheumatic diseases and permits optimal management in daily practice

Evidenzbasierte Therapie des Raynaud-Syndroms

Zusammenfassung: Das Raynaud-Syndrom ist mit einer Prävalenz von 3-5% ein häufiges klinisches Problem. Dennoch ist die Wirkung der meisten Therapiemöglichkeiten nur unzureichend durch kontrollierte Studien belegt. Zu den Therapien mit höherem Evidenzgrad gehört der Kalziumantagonist Nifedipin, für den in Metaanalysen sowohl bei primärem als auch bei sekundärem Raynaud-Syndrom eine verbesserte periphere Durchblutung sowie eine Abnahme der Frequenz und des Schweregrades der Raynaud-Attacken nachgewiesen werden konnte. Ähnliches gilt für intravenös appliziertes Iloprost in der Therapie des sekundären Raynaud-Syndroms bei systemischer Sklerose. Intravenös verabreichtes Iloprost verbessert darüber hinaus das Abheilen von Fingerkuppenulzera bei Patienten mit systemischer Sklerose. Vielversprechende Therapieansätze stellen Angiotensin-II-Rezeptor-1-Antagonisten (Losartan), die Kalziumantagonisten Felodipin und Amlodipin, Serotonin-Reuptake-Hemmer (Fluoxetin) und Phosphodiesterase-V-Hemmer (Sildenafil, Vardenafil) dar, die sich in kontrollierten Einzelstudien als wirksam erwiesen haben. Jedoch fehlen Erfahrungen mit größeren Patientenzahlen und längeren Anwendungszeiten, um diese Therapiemöglichkeiten abschließend zu beurteile

Progress in Haploidentical Hematopoietic Stem Cell Transplantation

Haploidentical hematopoietic cell transplantation (HaploHCT), with cells from HLA-half-matched first degree related donors (siblings, children and parents), could revolutionize hematopoietic transplantation as it expands this form of treatment to approximately 40% of patients who do not have an HLA-matched donor in USA. This need is particularly acute in developing countries, which usually do not have an unrelated donor registry and/or cost is a major issue in acquiring unrelated donor stem cells. Accordingly, the number of haploSCTs done in USA, Europe, China, and developing countries is on the rise. Advantages to HaploHCT include almost universal (more than 95% of patients will have a half-matched related donor) and immediate availability of donor progenitor cells, the opportunity to select the best donor among family members to minimize treatment-related mortality, decrease relapse rate and improve outcomes [2], and the possibility to collect donor cells for cellular therapy post-transplantation, with the goal to enhance the anti-tumor effects of the graft. Despite its potential advantages, until recently, high donor-recipient HLA-histoincompatibility has proven very difficult to overcome

Роль эластографических методов для неинвазивной оценки распространенных хронических заболеваний печени

Centrul de Cercetare în Gastroenterologie şi Hepatologie, Universitatea de Medicină şi Farmacie, Craiova, România, Conferinţa Ştiinţifico-Practică „Medicina modernă, actualităţi şi perspective”, consacrată aniversării de 40 de ani ai Spitalului Clinic al Ministerului Sănătăţii, 27-28 mai, 2010, Chişinău, Republica MoldovaLiver biopsy is considered the procedure of choice at many centers for evaluation of hepatic fibrosis, despite the complications and discomfort suffered by patients. Modern non-invasive imaging methods for assessing liver fibrosis include ultrasound elastography and magnetic resonance imaging (MRI). Since the introduction of magnetic resonance in medical practice, it has become a method of choice for the diagnosis and characterization of liver pathology (tumoral or diffuse type). Unidirectional elastography is the first imaging method for quantifying liver fibrosis introduced in clinical practice and the latest noninvasive method for assessing liver fibrosis. Being a new and promising method for assessing liver fibrosis, it is necessary to prove through extensive studies its real role in noninvasive assessment of hepatic fibrosi; and possibly in association with serological markers, it can completely replace liver biopsyВо многих центрах биопсия печени считается процедурой выбора для оценки фиброза печени, несмотря на сложности и неудобства для пациентов. Ультразвуковая эластография и магнитно-резонансная томография являются современными неинвазивными методами визуализации при оценке фиброза печени. С момента внедрения магнитно-резонансная томография стала методом выбора в диагностике и характеристике диффузных и опухолевых патологий печени. Однонаправленная эластография является первым методом количественной визуализации и оценки фиброза печени в клинической практике. На основе широких исследований остается доказать, что она может играть первостепенную роль в неинвазивной оценке фиброза печени и, возможно, этот метод может полностью заменить биопсию печени