Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
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Rev Med Chir Soc Med Nat Iasi · Jul 2009
[Euthanasia/assisted suicide. Ethical and socio-religious aspects].
Euthanasia/Assisted Suicide are viewed differently by moral and religious references. In a religious way, cardinal confessions (Christianity, Judaism, Islamism, Buddhism) condemn euthanasia/assisted suicide and, in the same time have a more relaxed attitude regarding passive euthanasia. Other aspects of euthanasia regard financial/economic and ethical-medical considerations. All these contradictory standpoints are expressed in some legal acts that make specifications on the concept of "euthanasia"--Oregon's Death with Dignity Act (1994) and Netherlands's Euthanasia Law (2001).
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Rev Med Chir Soc Med Nat Iasi · Jul 2009
Comparative StudyTraining on a virtual reality simulator--is it really possible a correct evaluation of the surgeons' experience?
Laparoscopic simulators provide a safe and efficient means of acquiring surgical skills. It is well known that virtual reality training improves the performance of young surgeons. Most of the virtual reality simulators have construct validity and can differentiate between novice and expert surgeons. However, for some training modules and trainees categories the possibility to distinguish the real surgeon's experience is still discussed. ⋯ Laparoscopic simulators are useful to evaluate the surgeons' experience; the parameters of the instrument navigation and lifting and grasping modules, which require a higher degree of eye-hand coordination, were better for residents with previous surgical experience and revealed a good transfer of training (TOT). The suturing module is less influenced by surgeons' experience. This result is probably explained by a lack of TOT.
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Rev Med Chir Soc Med Nat Iasi · Jan 2009
Case ReportsAcute idiopathic pancreatitis preceding diagnosis of Crohn's disease. Description of three cases.
Acute idiopathic pancreatitis seems to represent a rare extraintestinal manifestation of Crohn's disease usually appearing after the establishment of diagnosis of the intestinal disorder. The aim of this study was to describe the clinicoepidemiological characteristics and clinical course of three patients with Crohn's disease who developed acute idiopathic pancreatitis years before the establishment of diagnosis intestinal disease. ⋯ This case-series suggests that acute idiopathic pancreatitis could precede diagnosis of Crohn's disease. Clinicians must bear in mind the possibility of the existence of Crohn's disease when they are confronting a young patient with clinical and laboratory features of acute idiopathic pancreatitis.
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Tuberculosis and sarcoidosis are two different diseases with different etiology, clinical features and treatment. Both are granulomatous disease, but tuberculosis has a caseating necrosis granuloma as opposed to sarcoidosis witch present noncaseating epithelioid cell granuloma. If chest radiography shows hilar lymphadenopathy and hystopatological features reveal no caseating necrosis granuloma the differential diagnosis might be difficult. ⋯ Pathological findings of chest radiography and CT scan with iv contrast (left upper lobe infiltrate, right lower lobe ill-defined mass, multiple small nodular opacities scattered throughout both lung fields, bilateral hilar and mediastinal adenopathy, lymph nodes near celiac trunk were enlarged) and positive acid-fast bacilli of sputum smears point to the real diagnosis of pulmonary tuberculosis and abdominal lymph nodes tuberculosis. The patient was started on a daily treatment with Isoniazid, Pyrasinamide, Ethambutol, Streptomycine, Cyprofloxacine, Cicloserine and Protionamide (he was allergic to Rifampin). Five months later the clinical and radiological findings were almost normal and the sputum smear for acid-fast bacili was negative.
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Rev Med Chir Soc Med Nat Iasi · Oct 2008
Case Reports[Axillary wound with complete vasculo-nervous section. Functional outcomes].
Axillary wound with complete vasculonervous section are rare in adults, males between 20 and 30 years being more affected. In children these lesions are even more rarely encountered. Immediate surgical repair of vascular and nervous sections is recommended. ⋯ Vascular reconstruction with venous graft and epiperineural nerve reconstruction was done. Kinetotherapy and physiotherapy was part of recovery treatment. Follow up at 15 months confirmed very good functional outcomes with almost complete motor and sensitive function of the limb.