The prevalence of high dysplastic colonic adenomatous polyps in a 3 year endoscopic retrospective study from a single clinical center

Introduction: Many colon neoplastic tumors come from the malignancy of adenomatous polyps (70%-90%) that were not timely diagnosed in order to be resected. Materials and Methods: We conducted a retrospective study regarding the incidence of adenomatous polyps during 1.000 consecutive colonoscopies performed in our Upper and Lower Digestive Endoscopy Laboratory during a three-year period. Results: During these colonoscopies, some targeted polyps were biopsied or completely removed and the samples had been sent to a complete anatomopathological examination. Taking into consideration the results, the polyps were classified after the histological type and the form of dysplasia, in order to determine the polyp forms that present a high risk of malignancy. Conclusion: Given the rather high frequency of malignant polyps discovered during our study, we highly recommend colonoscopy as a method of choice for routine monitoring of selected cases

A proposed therapeutic algorithm for colorectal cancer prevention, based on endoscopic polypectomies in patients with multiple colonic polyps

Introduction. Results from single medical centers having large numbers of patients with multiple colonic polyps that have undergone colonoscopy management are rare. Material and method. The present study is based on 2,000 cases enrolled during 2009 and 2017, including patients that underwent colonoscopy for various reasons in the Department for Upper and Lower Endoscopy of Witting Clinical Hospital, Bucharest, Romania. Results. Of the 2,000 patients examined during 2009 - 2017, 594 tumor formations were detected; 148 (24.9%) patients had colorectal malignancies, and 446 (75%) polypoid formations in 313 patients who had one or more colon polyps were found. Discussions. After performing statistical analyses on several general parameters (such as age, sex, overall clinical outcome of the patient) and polyp-related characteristics (such as: dimensions, location, histological type), we developed a stepwise algorithm for clinical management (with endoscopic polypectomy) of patients with multiple polyposis, with the goal of reducing unnecessary colorectal surgeries. Conclusions. We believe that this type of stepwise algorithm-based approach in the clinical management of patients with multiple polyposis can lead to a substantial decrease in unnecessary colectomies (no matter the approach, via laparotomy or laparoscopic procedures), with the accompanying benefit of avoiding the complications and negative long-life impact that they impose

Traumatic rupture of the right atrium with haemopericardium due to blunt car crash accident thoracic trauma, resolved in department of general surgery (Case report)

Secţia Chirurgie, Secţia ATI, Spitalul Judeţean de Urgenţă, Drobeta-Turnu Severin, România, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Caz clinic: Autorii prezintă un caz de ruptură de atriu drept în urma unui traumatism toracic închis fără fracturi costale şi fără marca traumatică tegumentară, ca urmare a unui accident rutier. Bolnava în vârstă de 31 de ani este adusă la Spitalul Judeţean de Urgenţă Tr-Severin la circă 30 de minute de la producerea accidentului, prezentând stare generală gravă, colaps vascular periferic, stare comatoasă. Investigaţiile imagistice (ecografie, CT) evidențiază numai hemopericard. S-a intervenit chirurgical prin toracotomie stângă şi sternotomie parţiala. S-a găsit ruptura de auricul drept, pentru care s-a practicat ligatura plăgii auriculare. Perioada postoperatorie a fost fără complicaţii, pacienta a supravieţuit.Clinical case: The authors present a case of the right atrium rupture following a blunt chest injury as a result of a car crash accident, without rib fractures and traumatic marks of skin. The patient aged 31 years is transported to Emergency County Hospital Tr-Severin approximately 30 minutes after trauma, presenting poor general condition, peripheral vascular collapse, and coma. Imaging studies (ultrasound, CT) reveal haemopericardium only. Left thoracotomy and partial sternotomy was performed. Auricle rupture was found, which required ligation of auricle wound. Postoperative period was uneventful, and the patient survived

Characteristics and tendencies in the steel industry, globally and regionally

The objective of this paper is to highlight the current state of the steel industry at the global and regional level, in terms of its level of important indicators, such as: production capacity, production volume, level of consumption, exports and imports. The data used are systemized on time intervals, resulting in that the steel industry remains an attractive sector for investors in terms of large profits generated, but extremely sensitive to economic fluctuations and measures taken by the authorities. In this regard, the disparities and trends of the analyzed periods at global and regional level highlight the different ways of managing the situation in the steel sector, overcapacity representing a highly controversial element nowadays

π\pi-Electron Ferromagnetism in Metal Free Carbon Probed by Soft X-Ray Dichroism

Elemental carbon represents a fundamental building block of matter and the possibility of ferromagnetic order in carbon attracted widespread attention. However, the origin of magnetic order in such a light element is only poorly understood and has puzzled researchers. We present a spectromicroscopy study at room temperature of proton irradiated metal free carbon using the elemental and chemical specificity of x-ray magnetic circular dichroism (XMCD). We demonstrate that the magnetic order in the investigated system originates only from the carbon $\pi$-electron system.Comment: 10 pages 3 color figure

Partial intestinal obstruction due to tumoral form of actinomycosis (Case report)

Secția Chirurgie, Secția ATI, Spitalul Județean de Urgență, Drobeta-Turnu Severin, România, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Caz clinic: Se prezintă cazul unui bolnav în vârstă de 65 de ani cu sindrom subocluziv intestinal cronic, scădere ponderală cca 20 de kg în ultimul an. La examenul obiectiv: formațiune tumorală palpabilă în fosa iliacă stângă de cca 15/20 cm. Colonoscopia evidențiază stenoza sigmoidiană la cca 15 cm de la orificiul anal. Nu s-a prelevat fragment pentru biopsie. S-a intervenit chirurgical. S-a găsit un bloc tumoral sigmoidian mare și un mic abces între acesta și vezica urinară. S-a practicat colectomie segmentară pe sigmoid. Evoluție postoperatorie favorabilă. Surpriză la examenul anatomo-patologic: actinomicoză.Clinical case: We present the case of a patient aged 65 years with the syndrome of chronic bowel obstruction, and about 20 kg of weight loss during last year. On physical examination: palpable tumoral mass in the left iliac fossa of about 15/20 cm. On colonoscopy sigmoid stenosis at approximately 15 cm from anus is detected. No tissue was taken for biopsy. On surgery was found a large sigmoid tumor and a small abscess between it and the urinary bladder. Segmental sigmoid colectomy is performed. Postoperative evolution was favorable. Surprise on histopathological examination: actinomycosis

Asymptotic harvesting of populations in random environments

We consider the harvesting of a population in a stochastic environment whose dynamics in the absence of harvesting is described by a one dimensional diffusion. Using ergodic optimal control, we find the optimal harvesting strategy which maximizes the asymptotic yield of harvested individuals. To our knowledge, ergodic optimal control has not been used before to study harvesting strategies. However, it is a natural framework because the optimal harvesting strategy will never be such that the population is harvested to extinction-instead the harvested population converges to a unique invariant probability measure. When the yield function is the identity, we show that the optimal strategy has a bang-bang property: there exists a threshold [Formula: see text] such that whenever the population is under the threshold the harvesting rate must be zero, whereas when the population is above the threshold the harvesting rate must be at the upper limit. We provide upper and lower bounds on the maximal asymptotic yield, and explore via numerical simulations how the harvesting threshold and the maximal asymptotic yield change with the growth rate, maximal harvesting rate, or the competition rate. We also show that, if the yield function is [Formula: see text] and strictly concave, then the optimal harvesting strategy is continuous, whereas when the yield function is convex the optimal strategy is of bang-bang type. This shows that one cannot always expect bang-bang type optimal controls

A proposed therapeutic algorithm for colorectal cancer prevention, based on endoscopic polypectomies in patients with multiple colonic polyps

Introduction. Results from single medical centers having large numbers of patients with multiple colonic polyps that have undergone colonoscopy management are rare. Material and method. The present study is based on 2,000 cases enrolled during 2009 and 2017, including patients that underwent colonoscopy for various reasons in the Department for Upper and Lower Endoscopy of Witting Clinical Hospital, Bucharest, Romania. Results. Of the 2,000 patients examined during 2009 - 2017, 594 tumor formations were detected; 148 (24.9%) patients had colorectal malignancies, and 446 (75%) polypoid formations in 313 patients who had one or more colon polyps were found. Discussions. After performing statistical analyses on several general parameters (such as age, sex, overall clinical outcome of the patient) and polyp-related characteristics (such as: dimensions, location, histological type), we developed a stepwise algorithm for clinical management (with endoscopic polypectomy) of patients with multiple polyposis, with the goal of reducing unnecessary colorectal surgeries. Conclusions. We believe that this type of stepwise algorithm-based approach in the clinical management of patients with multiple polyposis can lead to a substantial decrease in unnecessary colectomies (no matter the approach, via laparotomy or laparoscopic procedures), with the accompanying benefit of avoiding the complications and negative long-life impact that they impose