Pancreatic Elastography

Pancreatic elastography represents a challenging new procedure for inflammatory pathology or tumour masses. There are technical difficulties for accurate assessment of pancreatic stiffness due to deep localization. But the new software for both conventional and endoscopic ultrasound are promising techniques for differential diagnosis between malignant tumours and different forms of chronic pancreatitis (groove pancreatitis or autoimmune pancreatitis). Early diagnosis of chronic pancreatitis, noninvasively by transabdominal shear wave elastography, is actively studied nowadays. Elastography might offer a predictive tool for the occurrence of pancreatic fistula after pancreatoduodenectomy. This chapter introduces the recent innovation of pancreatic elastography and makes recommendations for its use

Endoluminal Ultrasonography of the Rectum and the Anal Canal

Ultrasonography of the anal canal, the rectum and the surrounding tissues using intraluminal transducers with transanal/rectal imaging provides high-resolution imaging with clearly distinguishable tissue‐dependent echo signals. Endorectal ultrasonography depicts rectal wall layers and adjuvant structures with a high degree of precision. Anal endosonography is carried out to examine the sphincter muscles and the pelvic floor

Specific features of diagnosis and treatment in cronic apical granulating periodontites

Rezumat Periodontita apicală reprezintă o patologie frecvent întîlnită în Republica Moldova practice la toate vîrstele.Periodontitele apicale cornice granulante se dezvoltă de obicei cînd dintele în cauză a fost tratat endodontic incorect sau ca urmare a unei pulpite netratate.Pacienții de obicei se adresează la medic cînd procesul inflamator capătă caracter cronic, din care cauză tratamentul complet necesită un timp mai îndelungat.Summary Apical chronic periodontitis represents a pathology that is frequently met in the Republic of Moldova at all ages.This disease develops when the tooth was treated endodontically incorrect or as a consequence of non-treted pulpitis. Patients usually addresses to dentist when the inflammatory process transforms in chronic that is a reason for a long-termed treatement

Harmonic Contrast-Enhanced Ultrasound (CEUS) of Kidney Tumors

Nowadays, kidney tumor diagnosis benefits from large and highly accurate imagistic methods. A new imagistic method is contrast-enhanced ultrasound (CEUS) that accurately depicts the circulatory pattern of tumors. In kidney pathology, any mass or even capsular deformation depicted by B mode ultrasound represents an indication for CEUS. The kidney is completely and uniformly vascularized. In cystic tumors, there is a lack of contrast loading. In “impure” cystic masses (Bosnian 3 and 4), CEUS reveals vascularized septa and walls. In malignant tumors, accelerated and heterogeneous loading of contrast agent is observed in arterial phase followed by early, inhomogeneous washout of the contrast agent compared to normal renal parenchyma. In the abscesses, the appearance is the early loading of the walls associated with moderate hyperemia of the normal circulatory bed. This chapter details the CEUS in kidney tumor pathology, emphasizing the accurate information for the circulatory pattern of renal masses. It requires correlations with clinical data and information provided by other imaging explorations to make a final diagnosis

Abdominal Tumor Characterization and Recognition Using Superior-Order Cooccurrence Matrices, Based on Ultrasound Images

The noninvasive diagnosis of the malignant tumors is an important issue in research nowadays. Our purpose is to elaborate computerized, texture-based methods for performing computer-aided characterization and automatic diagnosis of these tumors, using only the information from ultrasound images. In this paper, we considered some of the most frequent abdominal malignant tumors: the hepatocellular carcinoma and the colonic tumors. We compared these structures with the benign tumors and with other visually similar diseases. Besides the textural features that proved in our previous research to be useful in the characterization and recognition of the malignant tumors, we improved our method by using the grey level cooccurrence matrix and the edge orientation cooccurrence matrix of superior order. As resulted from our experiments, the new textural features increased the malignant tumor classification performance, also revealing visual and physical properties of these structures that emphasized the complex, chaotic structure of the corresponding tissue

Dental aesthetic restorations of the frontal teeth group

Rezumat Restaurarea estetică a dinţilor este reproducerea formei naturale şi proprietăţilor optice ale dintelui, cum ar fi transparenţa, luciul şi textura. Este o metodă de redare a structurii normale a dinţilor prin imitarea a ţesuturilor dentare cu ajutorul materialelor artificiale cu scop estetic (restabilirea aspectului natural al dintelui) şi funcţional (restabilirea funcţiei masticatorii, deglutiţiei şi fonaţiei). Restaurarea dinţilor reprezintă suplinirea unei cantităţi semnificative de ţesut dentar distrus, cu materiale artificiale fizionomice, şi crearea din nou a arhitecturii dentare. Se practică tehnica de aplicare a materialelor pe straturi care redau proprietăţi optice caracteristice ţesuturilor dure naturale (dentina, smalţul) a dintelui lezat. Restaurarea estetică dentară: reprezintă restaurarea ţesuturilor dentare, care ia în considerare dorinţele estetice şi caracteristicile fiziologice ale pacientului. Acest tip de tratament include: schimbarea formei sau culorii dinţilor, înlăturarea defectelor de etiologie şi localizare diferită.Summary The aesthetic restoration of the teeth is the reproduction of the natural shape and optical properties of the tooth, such as transparency, gloss and texture. It is a method of rendering the normal structure of the teeth by imitating the dental tissues with the help of artificial materials for aesthetic (restoring the natural appearance of the tooth) and functional (restoring the function of the chewing, swallowing and phonation). The restoration of the teeth represents the replacement of a significant amount of destroyed dental tissue, with artificial physiognomic materials, and the re-creation of the dental architecture. It is practiced the technique of applying the materials on layers that give optical properties characteristic of the hard natural tissues (dentin, enamel) of the injured tooth. Dental aesthetic restoration: it represents the restoration of the dental tissues, which takes into account the aesthetic wishes and physiological characteristics of the patient. This type of treatment includes: changing the shape or color of the teeth, removing defects of etiology and different localization

Psychological characteristics of patients with tuberculosis who refuse treatment

Institutul de Ftiziopneumologie „Chiril Draganiuc”The aim was to study the reasons for treatment refusal and the emotional response of patients to the occurrence of pulmonary tuberculosis. The survey was accomplished on 55 patients. The most typical psychological traits were the following: reasons of avoiding failure, dissatisfaction with oneself; tendency to bind to negative experiences; profound experience of negatively stained events; emotional stress, discomfort; vindictiveness, aggressiveness, impulsiveness, resentment, the desire to prove to others that they are “worth something”; tendency of isolation. Scopul studiului a fost studierea motivelor abandonului tratamentului şi răspunsului emoţional al pacienţilor la dezvoltarea tuberculozei. Studiul s-a realizat pe un lot de 55 de pacienţi. Caracteristicile psihologice mai specifice s-au dovedit a fi: motivul omiterii insuccesului; insatisfacţia faţă de ei înşişi, tendinţa de a se plasa pe experienţe negative, retrăirea profundă a evenimentelor negativ colorate; stres emoţional; disconfort; spirit răzbunător si agresivitate; impulsivitate, susceptibilitate; dorința de a dovedi altora că ei sunt "în valoare de ceva", înclinaţia de izolare „în sine”

Clinical features and management of oral lichen planus (OLP) with emphasis on the management of hepatitis C virus (HCV)-related OLP

Oral lichen planus (OLP) is a chronic inflammatory disease characterized by the occurrence of multiple, symmetrical lesions in the oral cavity. Hepatitis C virus (HCV) infection has been suggested as an etiological factor in OLP. The purpose of this review was to summarize the current literature regarding the treatment of OLP in patients with HCV infection. An electronic search of the PubMed database was conducted until January 2018, using the following keywords: OLP, HCV, corticosteroids, retinoids, immunomodulatory agents, surgical interventions, photochemotherapy, laser therapy, interferon, ribavirin, and direct-acting antivirals. We selected the articles focusing on the clinical features and treatment management of OLP in patients with/without HCV infection. Topical corticosteroids are considered the first-line treatment in OLP. Calcineurin inhibitors or retinoids can be beneficial for recalcitrant OLP lesions. Systemic therapy should be used in the case of extensive and refractory lesions that involve extraoral sites. Surgical intervention is recommended for isolated lesions. In patients with HCV, monotherapy with interferon (IFN)-α may either improve, aggravate or trigger OLP lesions, while combined IFN-α and ribavirin therapy does not significantly influence the progression of lesions. Direct-acting antiviral (DAA) therapy appears to be a promising approach in patients with HCV-related OLP, as it can improve symptoms of both liver disease and OLP, with fewer side effects. Nevertheless, for clinical utility of DAAs in OLP patients, further studies with larger sample sizes, adequate treatment duration, and long term follow-up are required

Менеджмент ранней диагностики рака толстой кишки и шейки матки в Республике Молдова.

The early diagnostics management in colonic and uteri cervix cancer in the Republic of Moldova.Cancerul prezintă o problemă importantă în întreaga lume. Pierderile economice în rezultatul morbidității oncologice și creșterea permanentă a costului de tratament, necesită modificarea situației prin diagnosticare mai precoce a procesului. Scopul studiului ştiinţific a constat în elaborarea managementului depistării precoce a unor maladii oncologice cu elaborarea strategiei de diagnostic timpuriu a cancerului colului uterin şi colorectal pentru ameliorarea situației cu depistarea tardivă a proceselor oncologice menţionate. În IMPS Institutul Oncologic se efectuează fibrocolonoscopia ca metodă de screening. Pentru cancerul colului uterin se recomandă examenul citologic prin testul Babes-Pappanicolau. Reieșind din rezultatele obţinute în studiul efectuat referitor la eficacitatea screening-ului pentru detectarea cancerului colorectal şi al colului uterin, putem conchide: 1. Colonoscopia ca metodă de screening în depistarea timpurie a cancerului colorectal a demonstrat eficacitatea sa înaltă: Eficacitatea screening-ului efectuat, confirmată prin depistarea în 3,65% a patologiei precanceroase și în 0,32% a cancerului de col uterin în populaţia feminina asimptomatica, ne-a permis de a recomanda elaborarea programului implementării screening-ului mai pe larg.Менеджмент ранней диагностики рака толстой кишки и шейки матки в Республике Молдова

Reabilitarea chirurgicală a pacienţilor oncoproctologici cu stome intestinale temporare

Scopul studiului: eficientizarea tratamentului chirurgical reconstructiv la pacienţii oncoproctologici, stomizaţi temporar, apreciind ulterior rezultatele lui. S-a efectuat un studiu retrospectiv pe 282 pacienţi cu cancer colorectal, la care s-a impus aplicarea unei variante de stomă intestinală temporară, cu necesitatea unui tratament chirurgical multietapizat şi reconstructiv (anii 2011-2013). În diferite intervale de timp (2-12 luni, în mediu 3-4 luni) de la operaţia stomizantă, s-a reuşit operaţia reconstructivă la 141(50%) pacienţi. Nu s-a reuşit în 4 (2,83%) cazuri din motivul procesului cicatricialaderenţial postoperator avansat, în 26 (18,4%) cazuri reconstructia s-a refuzat din cauza patologiilor concomitente avansate ale pacienţilor. Restul – 110 (39%) pacienţi nu s-au prezentat pentru reconstrucţie. După operaţiile reconstructive, la 31 (21,9%) pacienţi au survenit diferite complicaţii postoperatorii, în 8 (5,7%) cazuri s-a impus reintervenţia chirurgicală, letalitatea postoperatorie a constituit 3 (2,1%) cazuri. Operaţiile reconstructive s-au realizat şi în următoarele cazuri: la 25 pacienţi - în termen de 2 luni de la operaţiia stomizantă, la 5 pacienţi - în unul din intervalele curelor de oterapie, la 12 pacienţi relativ-compensaţi în stadiul IV de boală (cu focarul primar extirpat). Operaţiile reconstructive reprezintă un compartiment dificil al chirurgiei. Este binevenită concentrarea acestor pacienţi în instituţii specializate de profi l. Este posibilă micşorarea termenilor tradiţional de realizare a operaţiilor reconstructive, la fel şi realizarea ei în intervalele curelor de polichimioterapie. În anumite condiţii, pacienţii oncoproctologici în stadiul IV pot benefi cia de operaţie reconstructivă