The correlation between histopathological and ultrasound findings regarding Cesarean section scars – A three-year survey study

The cesarean operation represents a major surgery, with a higher risk of postoperative complications and longer postoperative recovery than vaginal delivery. Due to the increasing frequency of cesarean sections, the ultrasound imaging of the uterine scar has become a particularly useful tool in identifying its potential long-term complications. This should be done pre-conceptively and quarterly or whenever necessary during pregnancy. Currently, there are only few histopathological studies on the uterine scar, trying to assess the myometrial repair and certain factors that influence the quality of the scar. The study was performed on a batch of 123 patients with previous C-sections, with multiple ultrasound exams during pregnancy and post-operative pathologic evaluation of the uterine scar in order to assess the possibility of a new prognostic score by correlating these two factors. Our study found solid evidence related to possible correlations between histopathological and ultrasound data on the cesarean section scar, which could lead to a possible predictive algorithm with implications for both prognostic and therapeutic fields

The risk of bleeding and encephalopathy in surgical patients with liver cirrhosis

Liver cirrhosis is a disease with an increasing incidence. Surgical procedures in patients with cirrhosis are also increasing, due to a longer life expectancy in these patients and also to the improvement of therapeutic and diagnostic resources. Digestive hemorrhage in the cirrhotic patient requires emergency medical intervention (intensive therapy, endoscopic or even surgical approaches), being at the same time a factor that precipitates episodes of encephalopathy, i.e. the conventional complication of cirrhosis. Hepatic encephalopathy represents one of the most severe clinical events of cirrhosis, being associated with high morbidity and mortality. The causes of hepatic encephalopathy are briefly presented in this paper. Therapeutic approaches currently available consist in the administration of non-absorbable disaccharides such as lactulose and non-absorbable antibiotics such as rifaximin. New therapeutic perspectives are under evaluation, e.g. ammonia scavengers and the modulation of gut microbiota. Clotting disorders in patients with liver cirrhosis are more severe as the disease progresses and involves complex mechanisms, as presented in this review. The correction of possible disorders of hemostasis should be promptly made as a sine qua non condition prior to surgery

Modern management of diabetic foot complications

Diabetes mellitus comprises a heterogeneous group of metabolic abnormalities, characterized by chronic hyperglycemia, resulting from a deficiency in insulin secretion, a deficiency in action, or from both situations. In its evolution, diabetes can lead to acute or chronic complications, which can be avoided or whose progression can be slowed by optimal glycemic control, provided by the effective treatment, diet, physical activity and glycemic monitoring. One of the most common complications of diabetes is diabetic neuropathy which, in combination or not with peripheral arterial disease, may result in leg changes (ulcers, gangrene, amputations), changes that are known under the heading of diabetic foot. The risk of developing leg ulcer is 25% in the life of a patient with type 1 or 2 diabetes, and amputations of varying degrees may sometimes be necessary. These can, however, be prevented by active screening characterized by the neurological examination for neuropathic signs, and the vascular examination to highlight the presence of peripheral arterial disease. Therefore, in order to prevent the appearance of leg ulcers and to reduce the morbidity associated with it, it is important to diagnose and manage risk factors

The correlation between histopathological and ultrasound findings regarding Cesarean section scars – A three-year survey study

The cesarean operation represents a major surgery, with a higher risk of postoperative complications and longer postoperative recovery than vaginal delivery. Due to the increasing frequency of cesarean sections, the ultrasound imaging of the uterine scar has become a particularly useful tool in identifying its potential long-term complications. This should be done pre-conceptively and quarterly or whenever necessary during pregnancy. Currently, there are only few histopathological studies on the uterine scar, trying to assess the myometrial repair and certain factors that influence the quality of the scar. The study was performed on a batch of 123 patients with previous C-sections, with multiple ultrasound exams during pregnancy and post-operative pathologic evaluation of the uterine scar in order to assess the possibility of a new prognostic score by correlating these two factors. Our study found solid evidence related to possible correlations between histopathological and ultrasound data on the cesarean section scar, which could lead to a possible predictive algorithm with implications for both prognostic and therapeutic fields

ISO 14000 - the purpose of environmental standard and its implementation

International Organization for Standardization was founded with the aim to develop and introduce international trade using harmonized international standards in the field of manufacturing, trade and communications. The organization has its members in more than 120 countries whose representatives can participate in the creation of standards. ISO standards are voluntary and consensual. Countries often include these standards in their regulation and business sector (industry) often define them in the request of the market, and in both cases the use of standard becomes mandatory