THE EXPLOAITATION OF MOUNTAIN SPACE THROUGH SPORT AND LEISURE ACTIVITIES. CASE STUDIES: THE VIA MARIA THERESIA MARATHON FROM THE CĂLIMANI MOUNTAINS AND THE COLIBIȚA BIKE FEST FROM THE BISTRIȚA ARDELEANĂ GORGE AND THE COLIBIȚA DEPRESSION

The mountain area, through its geographical characteristics, has numerous resources that can be utilized through leisure activities which contribute to the improvement of health and physical condition. Among these activities there are the mountain marathons organized in recent years in numerous locations in the Romanian Carpathians. Such a marathon is the Via Maria Theresia Marathon from the Călimani Mountains organized on a route with historical connotation set in the 18th century under the reign of Empress Maria Theresia and her son, Emperor Josef II. Likewise, there is a mountain bike competition in the Bistrița Ardeleană Gorges which brings together many bikers from all over the country. The present study analyses the geographical conditions which contribute to the organization of these events and their impact on the human body. Valorificarea spațiului montan prin activități sportive și agrementale. Studii de caz: Maratonul Via Maria Theresia din Munții Călimani și Colibița Bike Fest. Spațiul montan, prin caracteristicile sale geografice, deține numeroase resurse care pot fi valorificate prin activități agrementale active care contribuie la menținerea sănătății și la îmbunătățirea condiției fizice. Dintre aceste activității, se remarcă în ultimii ani maratoanele montane, organizate în numeroase locații din Carpații Românești. Un asemenea maraton este și Maratonul Via Maria Theresia care se desfășoară în Munții Călimani pe un traseu cu încărcătură istorică amenajat în secolul XVIII sub domnia împărătesei Maria Theresia și a fiului său, împăratul Ioasif al II-lea. De asemenea, în Cheile Bistriței Ardelene se desfășoară o competiție de mountain bike care reunește mulți bikeri din toată țara. Studiul de față analizează condițiile geografice care contribuie la organizarea acestor evenimente și impactul asupra organismului uman. Cuvinte cheie: Munții Călimani, Cheile Bistriței Ardelene, Colibița, Drumul Mariei Terezia, spațiu montan, maraton montan, mountain biking, agrement acti

Can the Computed Tomographic Aspect of Porto-Systemic Circulation in Cirrhotic Patients Be Associated with the Presence of Variceal Hemorrhage?

Background and objectives: Variceal bleeding is a serious complication caused by portal hypertension, frequently encountered among cirrhotic patients. The purpose of this study was to determine whether the aspect of the collateral, porto-systemic circulation, as detected by CT are associated with the presence variceal hemorrhage (VH). Materials and Methods: 81 cirrhotic patients who underwent a contrast-enhanced CT examination were retrospectively included in the study. Patients were divided into two groups: Cirrhotic patients with variceal hemorrhage during the hospital admission concomitant, with the CT examination (n = 33) and group 2-cirrhotic patients, without any variceal hemorrhage in their medical history (n = 48). The diameter of the left gastric vein, the presence or absence and dimensions of oesophageal and gastric varices, paraumbilical veins and splenorenal shunts were the indicators assessed on CT. Results: The univariate analysis showed a significant association between the presence of upper GI bleeding and the diameters of paraoesophageal veins, paragastric veins and left gastric vein respectively, all of these CT parameters being higher in patients with variceal bleeding. In the multivariate logistic regression analysis, only the diameter of the left gastric vein was independently associated with the presence of variceal hemorrhage (OR = 1.6 (95% CI: 1.17–2.19), p = 0.003). We found an optimal cut-off value of 3 mm for the diameter of the left gastric vein useful to discriminate among patients with variceal hemorrhage from the ones without it, with a good diagnostic performance (AUC = 0.78, Se = 97%, Sp = 45.8%, PPV = 55.2%, NPV = 95.7%). Conclusions: Our observations point out that an objective CT quantification of porto-systemic circulation can be correlated with the presence of variceal hemorrhage and the diameter of the left gastric vein can be a reliable parameter associated with this condition

Liver Phantoms Cast in 3D-Printed Mold for Image-Guided Procedures

Introduction: Image-guided invasive procedures on the liver require a steep learning curve to acquire the necessary skills. The best and safest way to achieve these skills is through hands-on courses that include simulations and phantoms of different complications, without any risks for patients. There are many liver phantoms on the market made of various materials; however, there are few multimodal liver phantoms, and only two are cast in a 3D-printed mold. Methods: We created a virtual liver and 3D-printed mold by segmenting a CT scan. The InVesalius and Autodesk Fusion 360 software packages were used for segmentation and 3D modeling. Using this modular mold, we cast and tested silicone- and gelatin-based liver phantoms with tumor and vascular formations inside. We tested the gelatin liver phantoms for several procedures, including ultrasound diagnosis, elastography, fibroscan, ultrasound-guided biopsy, ultrasound-guided drainage, ultrasound-guided radio-frequency ablation, CT scan diagnosis, CT–ultrasound fusion, CT-guided biopsy, and MRI diagnosis. The phantoms were also used in hands-on ultrasound courses at four international congresses. Results: We evaluated the feedback of 33 doctors regarding their experiences in using and learning on liver phantoms to validate our model for training in ultrasound procedures. Conclusions: We validated our liver phantom solution, demonstrating its positive impact on the education of young doctors who can safely learn new procedures thus improving the outcomes of patients with different liver pathologies