State of art in hernia surgery - results of our recent experience

Introduction. Minimally invasive surgery (MIS) has gained popularity in all surgical fields, and hernia surgery is one of the most recent. Inguinal, umbilical, and incisional hernias benefit from laparoscopic procedures. Short hospitalization, reduced return-to-work time, and fast recovery after surgery recommend MIS as the new standard for hernia surgery. Methods. In this review, we analyzed our experience in the period 2019-2023, including patients with hernia defects who underwent MIS. The procedures performed were as follows: intraperitoneal onlay mesh (IPOM) and extended total extraperitoneal (eTEP) for umbilical hernias; total extraperitoneal (TEP) and trans-abdominal preperitoneal (TAPP) for inguinal hernias; and eTEP, IPOM, and trans-abdominal retromuscular (TARM) for incisional hernias. Surgeries were performed laparoscopically under general anesthesia. The study included 236 procedures:49 for incisional hernias (20.76%), 52 for umbilical hernias (22.03%), and 135 for inguinal hernias. (57.21%). eTEP was predominant in incisional hernias (61.22%), followed by IPOM (20.42%), and TARM (18.36%). Inguinal hernias were treated using TEP (88.89%) and TAPP (11.12%). Umbilical hernias were operated on using IPOM (23.08%) and eTEP (76.92%). Emergent surgery was performed in 38 cases (16.11%):7 cases of umbilical hernias, 26 cases of inguinal hernias, and 5 cases of incisional hernias. Results: The conversion rate was 5.08% (12 cases), which was related to difficulties in dissection (eTEP) and peritoneal tear (TEP). The complication rate was 11.86% and included 12 hematomas, 10 bleeding events, 3 intestinal fistulas, and 2 bowel obstructions. Of these, 75% required a reoperation. One patient died of postoperative pulmonary thromboembolism. Seromas were observed in 7.2% of patients. Four recurrences (1.7%) have been reported to date. Conclusion: Our results show reduced complication rates, reduced recurrences, and wound-related occurrences and support MIS as a valuable tool in hernia surgery

USE OF MODERN TECHNIQUE IN PREPARING THE TECHNICAL DOCUMENTATION FOR THE REGISTRATION IN THE LAND BOOK OF A PROPERTY

The paper presents the way of drawing up the cadastral documentation for the first registration in the Land Book of a property. The total station and GNSS receivers were used as topographic devices for measurements, which offered a high accuracy of the measured data and a shortening of the time spent in the field. The data processing and the elaboration of the documentation was done through specialized programs (Toposys, Autocad). As the surveying method was used the method of closed planimetric traverse supported on known coordinate points (previously determined with GNSS technology), combined with the method of polar coordinates

Distal Versus Conventional Radial Access for Coronary Angiography and Intervention The DISCO RADIAL Trial

BACKGROUND Currently, transradial access (TRA) is the recommended access for coronary procedures because of increased safety, with radial artery occlusion (RAO) being its most frequent complication, which will increasingly affect patients undergoing multiple procedures during their lifetimes. Recently, distal radial access (DRA) has emerged as a promising alternative access to minimize RAO risk. A large-scale, international, randomized trial comparing RAO with TRA and DRA is lacking. OBJECTIVES The aim of this study was to assess the superiority of DRA compared with conventional TRA with respect to forearm RAO. METHODS DISCO RADIAL (Distal vs Conventional Radial Access) was an international, multicenter, randomized controlled trial in which patients with indications for percutaneous coronary procedure using a 6-F Slender sheath were randomized to DRA or TRA with systematic implementation of best practices to reduce RAO. The primary endpoint was the incidence of forearm RAO assessed by vascular ultrasound at discharge. Secondary endpoints include crossover, hemostasis time, and access site-related complications. RESULTS Overall, 657 patients underwent TRA, and 650 patients underwent DRA. Forearm RAO did not differ between groups (0.91% vs 0.31%; P = 0.29). Patent hemostasis was achieved in 94.4% of TRA patients. Crossover rates were higher with DRA (3.5% vs 7.4%; P = 0.002), and median hemostasis time was shorter (180 vs 153 minutes; P < 0.001). Radial artery spasm occurred more with DRA (2.7% vs 5.4%; P = 0.015). Overall bleeding events and vascular complications did not differ between groups. CONCLUSIONS With the implementation of a rigorous hemostasis protocol, DRA and TRA have equally low RAO rates. DRA is associated with a higher crossover rate but a shorter hemostasis time. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation

Neovascularization of lung carcinoma originating from single coronary artery

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Neovascularization of lung carcinoma originating from single coronary artery

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

ROMANIAN DENTAL STUDENT’S KNOWLEDGE TOWARD HIV/AIDS INFECTION

The aim of the present study was to evaluate the knowledge of the students attending the Faculty of Dental Medicine in Iasi regarding the HIV/AIDS infection. Material and method: The cross-sectional study included 124 students from the 4th and 6th years who filled in a specially designed questionnaire consisting of 20 questions on two aspects: the first one refers to HIV transmission pathways and the risk of transmission in the dental office, and the second one refers to the oral lesions associated with this disease. The results demonstrate that some of the issues are correctly assimilated by the students of both years of study, as more than 80% of them marked the correct answer (concerning blood, sexual, maternal-fetal transmission routes, as well as the association between fungal infections, Kaposi’s sarcoma and AIDS). However, there were questions with a very low correct response rate (below 50%), concerning the transmission via the saliva or via the contact of infected blood with the nasal, oral or ophthalmic mucosa, as well as the herpetic and cytomegalovirus-associated infections as oral lesions manifest in the HIV infected patient. Surprisingly, only 29.5% of the interviewed subjects knew the post-exposure prophylaxis method. In conclusion, the study underlines the need of introducing new programs and lectures on this topic, with an accent on the practical aspects specific to the dental office activity

Application of Polypodiopsida Class in Nanotechnology–Potential towards Development of More Effective Bioactive Solutions

The area of phytosynthesized nanomaterials is rapidly developing, with numerous studies being published yearly. The use of plant extracts is an alternative method to reduce the toxic potential of the nanomaterials and the interest in obtaining phytosynthesized nanoparticles is usually directed towards accessible and common plant species, ferns not being explored to their real potential in this field. The developed nanoparticles could benefit from their superior antimicrobial and antioxidant properties (compared with the nanoparticles obtained by other routes), thus proposing an important alternative against health care-associated and drug-resistant infections, as well as in other types of applications. The present review aims to summarize the explored application of ferns in nanotechnology and related areas, as well as the current bottlenecks and future perspectives, as emerging from the literature data

Clinical Validation of a New Enhanced Stent Imaging Method

(1) Background: Stent underexpansion is the main cause of stent thrombosis and restenosis. Coronary angiography has limitations in the assessment of stent expansion. Enhanced stent imaging (ESI) methods allow a detailed visualization of stent deployment. We qualitatively compare image results from two ESI system vendors (StentBoost™ (SB) and CAAS StentEnhancer™ (SE)) and report quantitative results of deployed stents diameters by quantitative coronary angiography (QCA) and by SE. (2) Methods: The ESI systems from SB and SE were compared and graded by two blinded observers for different characteristics: 1 visualization of the proximal and distal edges of the stents; 2 visualization of the stent struts; 3 presence of underexpansion and 4 calcifications. Stent diameters were quantitatively measured using dedicated QCA and SE software and compared to chart diameters according to the pressure of implantation. (3) Results: A total of 249 ESI sequences were qualitatively compared. Inter-observer variability was noted for strut visibility and total scores. Inter-observer agreement was found for the assessment of proximal stent edge and stent underexpansion. The predicted chart diameters were 0.31 ± 0.30 mm larger than SE diameters (p p p < 0.001). (4) Conclusions: SE provides an enhanced visualization and allows precise quantitative assessment of stent expansion without the limitations of QCA when overlapping coronary side branches are present