Limb amputations; etiopathogenesis, diagnosis and the multidisciplinary therapeutic approach

Despite remarkable advances in medicine, limb amputations remain a therapeutic measure that saves the lives of many patients. Given the varied etiopathogenesis, such operations are performed both as an emergency and as an elective procedure. Such interventions address either only the distal segments of a limb, or even the entire limb, having a great psychological, functional and social impact on the patient. Due to these multiple implications, limb amputations must be performed by specialized teams, in order to achieve the best possible functional and aesthetic results to be compatible with the correction of the remaining deficit with a prosthesis. The main causes leading to amputations and the corresponding preventive measures are presented, as well as the general principles of amputations as a therapeutic solution of last resort. In conclusion, reducing the number of traffic/workplace accidents and effective treatment of chronic diseases affecting the vascular system can contribute to decreasing the need for amputations, a life-saving therapeutic solution, but with a devastating impact on the patient and society

Upper gastrointestinal bleeding during the COVID-19 pandemic; particularities of diagnosis and therapy

SARS-COV 2 recently caused a global pandemic, with the first case being reported in Romania in February 2020. Important restrictive measures were imposed, so that the addressability of patients to medical services decreased. Upper gastrointestinal bleeding had more severe forms of evolution at the time of presentation, which required additional methods of diagnosis and treatment. This is a retrospective study performed on 268 patients, which aims to evaluate the type and effectiveness of different treatment methods for upper gastrointestinal bleeding during the COVID 19 pandemic. Severity assessment was performed by measuring the Rockall score and additional methods of diagnosis. The association of COVID-19 with upper gastrointestinal bleeding can lead to much more severe outcomes for the patient, so treatment must be sustained and fast established. If the initial therapeutic methods fail, the other available therapeutic measures should be introduced progressively and without delay to achieve the best possible outcomes

Modern therapeutic options in diabetic foot ulcer

Diabetic foot is a severe complication of diabetes that occurs as a result of poor glycemic control, being associated with significant morbidity and mortality. Mortality associated with this disease is estimated at 5% in the first 12 months, and about 42% in the next 5 years. On average, it affects about 15% of people with diabetes during their lifetime, including as possible manifestations neuropathy, peripheral vascular disease, and subsequent ulceration which, if treated incorrectly, can lead to amputation. This paper presents a retrospective and descriptive study of patients diagnosed and treated for diabetic foot ulcers in the Proctoven Clinic. The study includes a group of 50 cases diagnosed with diabetic foot over a period of 5 years, from 01.01.2017 to 31.12.2021. In this study, the effectiveness of the modern treatment methods most frequently used in the surgical treatment of the diabetic foot is analyzed based on several parameters

The significance of preoperative thrombocytosis in ovarian cancer patients

The presence of an increased number of platelets has been demonstrated to be significantly associated with the presence of different types of malignancies, especially when it comes to gynecological cancers and seems to be associated with a poorer prognosis. This fact has been widely studied in order to better understand the physiopathology of the phenomenon, the impact on the overall outcomes and to validate new therapeutic lines for such cases. The aim of the current paper is to review the most important studies conducted on this issue

Understanding the relationship between circulating platelets and epithelial to mesenchymal transition – a step towards in discovering new epithelial ovarian cancer targeted therapies

In the last decades understanding the relationship between the circulating platelets and the biological aggressivity of ovarian cancer gave the opportunity to researchers to introduce new therapeutic lines in ovarian cancer patients with promising results. Therefore, this subject has become intensively studied and surprising correlation ships have been observed. One of the most recently investigated issues regards the influence of circulating platelets on epithelial ovarian cancer refers to the platelets’ ability to induce the epithelial to mesenchymal transition. The current paper aims to discuss about this subject and about the clinical implications of the process

The impact of thrombocytosis on the long term outcomes in relapsed ovarian cancer

The presence of thrombocytosis has been widely associated with poor prognostic in patients diagnosed with ovarian cancer at the time of the initial diagnostic. Once this fact has been widely accepted, attention was focused on studying whether this biological parameter could be also a diagnostic tool for identifying patients with poorer outcomes at the time of secondary cytoreduction. Therefore the most commonly encountered questions are whether patients presenting thrombocytosis at the time of primary cytoreduction are expected to have also thrombocytosis at the time of relapse and if thrombocytosis at the time relapse is corelated with lower disease free intervals, with higher rates of incomplete debulking and with poorer rates of overall survival respectively. This is a literature review of the most relevant studies conducted on this issue

Ovarian cancer – where are we today?

Despite progress reported in terms of paraclinical tests and imagistic studies, ovarian cancer represents one of the most lethal malignancies affecting women worldwide. Therefore attention was focused on identifying new prognostic markers in order to better identify candidates for primary cytoreductive surgery versus interval debulking surgery. Moreover, the wide introduction of the concept of personalized medicine gave the opportunity to benefit from more targeted treatments according to each patient needs and particularities. This is a literature review of the current status of ovarian cancer worldwide

Neutrophil to lymphocyte ratio in ovarian cancer – a new prognostic marker?

Neutrophil to lymphocyte ratio represents a novel prognostic marker which is usually associated with the presence of proinflammatory conditions such as obesity, metabolic syndrome or certain benign and even malignant diseases. Moreover, in cases in which a malignant condition is present, the value of the neutrophil to lymphocyte ratio also seems to be positively correlated with the biological agressivity of the tumor. The aim of the current paper is to discuss about the most relevant studies which discuss about the role of this parameter as a new biological marker in ovarian cancer patients

Sarcopenia and ovarian cancer

Defined as the loss of the muscular mass, sarcopenia is a common finding in neoplastic patients, multiple mechanisms such as nutritional deficiency, proinflammatory tumoral related status or physical inactivity being cited. However, the loss of the muscular mass in such cases is associated with significant impact in regard to the type of treatment in such cases; in consequence, as expected the disease-free survival and overall survival might be influenced. The aim of the current paper is to discuss about the most important mechanisms leading to sarcopenia in ovarian cancer patients as well as the impact on the long-term outcomes

Extracellular Vesicles as Intercellular Communication Vehicles in Regenerative Medicine

Extracellular vesicles (EVs) represent cell-specific carriers of bioactive cargos that can be of importance in either physiological or pathological processes. Frequently, EVs are seen as intercellular communication vehicles, but it has become more and more evident that their usefulness can vary from circulating biomarkers for an early disease diagnosis to future therapeutic carriers for slowing down the evolution of different afflictions and their ability to restore damaged tissue/organs. Here, we summarize the latest progress of EVs classification, biogenesis, and characteristics. We also briefly discuss their therapeutic potential, with emphasis on their potential application in regenerative medicine