Journal of medicine and life
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Osteogenesis imperfecta (OI) is a very rare disease compared to other afflictions, running the risk of social isolation for children and their parents, due to the problems specific to the disease. All the social, psychological and physical disadvantages must be removed or at least mitigated, all within the society's limited resources. In Romania, this situation has led in the last couple of years to the selection of a number of extremely severe cases, which could not be solved by orthopedic and classic surgical treatment methods. These patients exhibit gracile long bones, which are distorted, often with cystic degeneration at the level of the extremities, pseudarthroses, limb length discrepancies, most of them being unable to walk, being condemned to sitting in a wheelchair. ⋯ The surgical treatment in severe forms of OI must be adapted to each case. No matter the surgical technique used, well known or innovative, it is convenient if it restores the ability to walk of a youngster who has been forced to use a wheelchair for almost 20 years and who has suffered dozens of unsuccessful surgeries. The current paper mainly describes the difficulties the surgeon has to deal with while treating the severe, neglected cases of OI, sometimes incorrectly cared for and labeled as inoperable.
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Cervical disc replacement is an emerging motion-preserving technology in the surgical treatment of the cervical degenerative disc disorders used as an alternative to the classic interbody fusion. We present a case report of a patient diagnosed with C6-7 right disc herniation who underwent anterior discectomy and received a total disc replacement using ProDisc C artificial disc prosthesis.
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Trigeminal neuralgia (TN) is defined as sudden, usually unilateral, severe, brief, stabbing recurrent episodes of pain within the distribution of one or more branches of the trigeminal nerve. It is the most frequent cranial neuralgia, the incidence being 1 per 1,000,00 persons per year. Pain attacks start abruptly and last several seconds but may persist 1 to 2 minutes. ⋯ According to the European Federation of Neurological Societies (EFNS) guidelines on neuropathic pain assessment and the American Academy of Neurology (AAN)-EFNS guidelines on TN management the neurophysiological recording of trigeminal reflexes represents the most useful and reliable test for the neurophysiological diagnosis of trigeminal pains. The present article discusses different techniques for investigation of the trigeminal system by which an accurate topographical diagnosis and profile of sensory fiber pathology can be determined. With the aid of neurophysiological recordings and quantitative sensory testing, it is possible to approach a mechanism-based classification of orofacial pain.
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Anastomotic leakage is a dreaded complication of colorectal surgery, as it greatly increases the morbidity, mortality and has been associated with augmented local recurrence and diminished survival. The frequency of this complication is high in emergency colorectal surgery, especially for bowel occlusion, (13% for emergency vs. 4% in elective), due to visceral distension and, therefore, an incongruence in the size of each of the stumps, combined with the lack of mechanical preparation and risk of fecal contamination during operation. ⋯ In our study, among the clinical and biological factors analyzed, emergency intervention was the most significant factor associated with anastomotic leakage. Surgery performed in emergency settings, on debilitated patients without adequate preoperative preparation, has an increased risk for anastomotic dehiscence.
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Different Utstein based reporting systems are used for research purpose in resuscitative medicine worldwide and resuscitation attempts data are available from different countries. In Romania, the only data available has been from the previous work in the Emergency Department of "Sf. Pantelimon" Emergency Hospital, since 2006. ⋯ The Utstein- based reporting system used provides a standardized, comprehensive method for data collection. Further research is needed in order to obtain valuable data with statistic relevance. Conclusions related to the aspects of the population in the area the hospital serves can be drawn.