bluuebunny/crossref_metadata_2025 huggingface dataset:
An attempt to assess the monetary value of carbon absorbed in the Polish forest sector
Authors: Jabłoński Krzysztof , Stempski Włodzimierz
Published: May 2018

Forests and forest management play a vital role in capture and storage of carbon dioxide, which contributes to mitigation of climate change. Forests are not only a natural carbon sink. Proper forest management can enhance biomass production, providing wood to be converted into e.g. construction timber, paper and furniture as well as wood fuels and, as a result, considerably enlarge this carbon sink. Poland, being a party of the Climate Convention and Kyoto Protocol and a member of the EU is obliged to provide yearly reports on carbon emissions and sequestration, including the Land Use, Land Use Change and Forestry (LULUCF) sector, of which forestry is the leading constituent. Forests, with the sequestration rate at a level of 3.93 t CO2·ha−1 form practically the only important carbon sink in the LULUCF category. Unfortunately the LULUCF sector has not been yet included in the current climate policy framework. The purpose of the study was an attempt to estimate the hypothetical value of carbon stored in forestry, resulting from the reported quantities of the emitted and sequestered carbon. The calculations were based on figures included in the National Inventory Report for Poland, reported yearly to the Secretariat of the Climate Convention. Among the forestry carbon sources/sinks, reported annually, the sequestration resulting from forest management significantly exceeds the net sequestration from afforestation/deforestation activities. Average data from recent years show that forest management is a net CO2 sink, with 12 Mt CO2·y−1 (above the forest management reference level, FMRL), and when combined with the carbon pool change resulting from afforestation/deforestation activities, it can be regarded as a net carbon sink sequestering nearly 15 Mt CO2·y−1. That value, when multiplied by the price of carbon emission allowance (e.g. EUA), could be a source of over 80 mill Euros per year, if used as a commodity on the emissions market. Due to high price volatility of CO2 emission allowances, the calculated profits are hypothetical, and the EU Emissions Trading System does not include forestry. These potential gains can become realistic after the LULUCF sector has been included in the emissions trading system.
Impact of Financing Instruments and Strategies on the Wind Power Production Costs: A Case of Lithuania
Authors: Bobinaite V. , Konstantinaviciute I.
Published: May 2018

The paper aims at demonstrating the relevance of financing instruments, their terms and financing strategies in relation to the cost of wind power production and the ability of wind power plant (PP) to participate in the electricity market in Lithuania. The extended approach to the Levelized Cost of Energy (LCOE) is applied. The feature of the extended approach lies in considering the lifetime cost and revenue received from the support measures. The research results have substantiated the relevance of financing instruments, their terms and strategies in relation to their impact on the LCOE and competitiveness of wind PP. It has been found that financing of wind PP through the traditional financing instruments (simple shares and bank loans) makes use of venture capital and bonds coming even in the absence of any support. It has been estimated that strategies consisting of different proportions of hard and soft loans, bonds, own and venture capital result in the average LCOE of 5.1–5.7 EURct/kWh (2000 kW), when the expected electricity selling price is 5.4 EURct/kWh. The financing strategies with higher shares of equity could impact by around 6 % higher LCOE compared to the strategies encompassing higher shares of debt. However, seeking to motivate venture capitalists, bond holders or other new financiers entering the wind power sector, support measures (feed-in tariff or investment subsidy) are relevant in case of 250 kW wind PP. It has been estimated that under the unsupported financing strategies, the average LCOE of 250 kW wind PP will be 7.8–8.8 EURct/kWh, but it will reduce by around 50 % if feed-in tariff or 50 % investment subsidy is applied.
Non-Wovens as Sound Reducers
Authors: Belakova D. , Seile A. , Kukle S. , Plamus T.
Published: May 2018

Within the present study, the effect of hemp (40 wt%) and polyactide (60 wt%), non-woven surface density, thickness and number of fibre web layers on the sound absorption coefficient and the sound transmission loss in the frequency range from 50 to 5000 Hz is analysed. The sound insulation properties of the experimental samples have been determined, compared to the ones in practical use, and the possible use of material has been defined. Non-woven materials are ideally suited for use in acoustic insulation products because the arrangement of fibres produces a porous material structure, which leads to a greater interaction between sound waves and fibre structure. Of all the tested samples (A, B and D), the non-woven variant B exceeded the surface density of sample A by 1.22 times and 1.15 times that of sample D. By placing non-wovens one above the other in 2 layers, it is possible to increase the absorption coefficient of the material, which depending on the frequency corresponds to C, D, and E sound absorption classes. Sample A demonstrates the best sound absorption of all the three samples in the frequency range from 250 to 2000 Hz. In the test frequency range from 50 to 5000 Hz, the sound transmission loss varies from 0.76 (Sample D at 63 Hz) to 3.90 (Sample B at 5000 Hz).
Dilemmas of Transfer Pricing Comparability Analysis in Manufacturing Entities. Polish-Czech Case Study
Authors: Sulik-Górecka Aleksandra
Published: May 2018

Modern manufacturing entities often operate in capital groups, and their role is sometimes limited to the function of cost centers. From the legal point of view, however, they are separate entities obliged to apply transfer pricing regulations. Meeting the requirements of the arm's length principle can be very difficult at this time, given the relationships and conflicts of interest in the capital group. Complexity increases in capital groups operating in different countries, due to differences in tax regulations. The main purpose of the paper is to demonstrate that the need to valuate the sale of finished goods to a manufacturing entity, which is a subject to a different tax jurisdiction, may lead to a problem of compliance with the arm's length principle. In addition, the paper proposes a methodology for comparability analysis that may be used by manufacturing entities to defend conditions of setting transfer pricing. The paper presents the different functional profiles of manufacturing entities and points out the difficulties that they may encounter when preparing the comparability analysis. It has also been noted that there are differences in transfer pricing regulations in different countries, for example by analyzing Polish and Czech regulations. The lack of uniform benchmarking legislation can cause inconsistencies in the selection of comparable data, resulting in differences in transfer pricing. The paper uses the method of legal regulation review and analysis of results of published studies concerning the scope of transfer pricing and comparability analysis. The paper also adopts a case study analysis.
Optimization and Improvement of Test Processes on a Production Line
Authors: Sujová Erika , Čierna Helena
Published: May 2018

The paper deals with increasing processes efficiency at a production line of cylinder heads of engines in a production company operating in the automotive industry. The goal is to achieve improvement and optimization of test processes on a production line. It analyzes options for improving capacity, availability and productivity of processes of an output test by using modern technology available on the market. We have focused on analysis of operation times before and after optimization of test processes at specific production sections. By analyzing measured results we have determined differences in time before and after improvement of the process. We have determined a coefficient of efficiency OEE and by comparing outputs we have confirmed real improvement of the process of the output test of cylinder heads.
Global Perspective for Protecting Intellectual Property – Patenting in USA and Poland
Authors: Grebski Michalene Eva , Wolniak Radosław
Published: May 2018

Paper addresses the different methods for protecting intellectual property in modern knowledge-based economies. The focus of the paper is a comparison between the procedures for applying for patents in Poland and the United States. The comparison has been made from the perspective of the cost of obtaining and maintaining a patent in Poland, the United States and some other countries. The comparison has also been made from the perspective of the procedures for applying for a patent in different countries based on the Patent Cooperation Treaty. The paper also includes a comparison of the time needed for processing the patent application. Low cost provisional twelve-month patent pending protection available in the United States is also being discussed. The paper also provides some guidance and recommendations for conducting a patent search in order to validate the originality of the invention.
The health locus of control and health behaviours declared by students of health sciences
Authors: Deluga Alina , Bogdańska Paulina , Dobrowolska Beata , Ślusarska Barbara , Bartoszek Agnieszka , Szczekala Katarzyna
Published: May 2018

Introduction. Health locus of control is an essential factor affecting lifestyle which plays a major role in choosing health behaviours by individuals including young ones.

Aim. The aim of the study was the determination of selected conditions of health control and health behaviours in students of health sciences.

Material and methods. The study encompassed 175 students of health sciences at the Medical University of Lublin. The multidimensional health locus of control scale (MHLC), version B, by Z. Juczyński was applied as it measures expectations in three dimensions of health control: internal, external (influence of others) and chance. A special authors’ questionnaire compiled for the purpose was used to assess health behaviours.

Results. The results of the study show that the internal dimension of health control (25.86 points) has the greatest impact on health in the group studied. The oldest study participants dwelling in the countryside gave this dimension a higher ranking than other study participants. For the students health behaviours included fastening seat belts, healthy nutrition and doing sports.

Conclusions. The internal dimension of health control constitutes an essential factor determining health behaviours of the study participants. The students who are not able to assess whether they are healthy individuals, significantly more frequently perceive the greatest influence of others on their health.
Nurses’ knowledge of the medication management at intensive care units
Authors: Heczková Jana , Bulava Alan
Published: May 2018

Introduction. The medicine management is considered an important area of health care, which is ensured by various healthcare professionals including nurses. Nurses gain the competence of medicines administration immediately after graduation. This competence can be applied to any area of healthcare. Even in specialized settings such as intensive care units, any additional qualification e.g. specialized education is not required. On the contrary, appropriate education is considered an important factor that could help to reduce the risk of adverse events related to medication management.

Aim. The aim of this study was to analyse the students’ knowledge in this field at the end of nursing studies at bachelor level (n = 67) and specialized intensive care nursing studies at master level (n = 42).

Methodology. Knowledge was assessed using a written test, which was related to the management of medicinal products administered commonly at intensive care units by qualified nurses as well as nurse specialists without distinction. From the point of view of the formal competencies of healthcare professionals, the questions were divided into three categories.

Results. The mean success rate on the test was 53.4%. The highest range of knowledge was demonstrated by already qualified students at the end of specialised studies with prior work experience in ICU, the lowest by students just before graduation. The highest rating was achieved by all students in the activity-oriented category for which the responsibility lies primarily with the medical doctor, but nurses were expected to have this knowledge and participate at related activities on the basis of a physician’s order. This knowledge included also the area of clinical pharmacology. On the other hand, the lowest score was achieved by all groups of students in the category of activities that are not treated by the physician’s order, and the use of diverse knowledge from different areas was usually necessary.

Conclusions. Clinical practice has an irreplaceable role for nurses in the process of qualifying education as well as lifelong learning. The extent of nursing education in medicine management, the manner of nursing training, as well as the proportion of nursing specialists in the nursing team at specialised workplaces, deserves much greater attention in terms of ensuring safe care in this area. Shifting some competencies and duties in medicine management, especially related to intravenous (IV) therapy, to less qualified healthcare professionals appears to be highly controversial and risky.
Assesment of nurses knowledge about non – Hodgkin’s lymphomas
Authors: Kurek Magdalena , Tatara Tomasz
Published: May 2018

Introduction. Non-Hodgkin lymphomas (NHL) are among the most frequent types of cancer linked with the lymphatic system. The disease, if not diagnosed or treated, may lead to serious health complications and/or death.

Aim. The purpose of the work is to evaluate the level of knowledge of nursing staff about NHL.

Material and methods. There were 100 members of nursing staff aged from 24 to 56 participating in the study. The research method was a diagnostic survey but the measuring tool was an anonymous author’s questionnaire which comprised 25 closed, single-choice questions and 2 filtering questions.

Results. Among the respondents, 48% work at the Clinical Haematology/Oncology Ward, while the remaining 52% work in other wards. The question: “Is it possible for the NHL to be located outside the lymphatic system?”, 55% of respondents responded with an affirmative, 23% with a negative, 22% did not know the answer. Among the respondents, 100% stated that their employers do not designate any financial assets to train medical personnel with respect to expanding their knowledge about non-Hodgkin lymphomas. As many as 46% of respondents expand their knowledge through self-study using their own means. According to the National Cancer Registry, in 2014 there were 874 incidents and 236 deaths noted among men and 862 incidents and 235 deaths among women, linked with the diffused NHL. Comparing the data of the National Cancer Registry with the previous years, we can observe an increasing trend of morbidity and mortality, linked with the NHL. For example, in 2006 there were a total 1207 cases and 315 deaths linked with the diffused NHL.

Conclusions. Results show that the respondents’ awareness with regard to NHL is limited. Employers do not finance NHL training, which may affect the low level of knowledge. NHL patient hospitalization is a long-term process requiring expenses and effort on the side of medical personnel. Nursing and health education are necessary elements of the therapeutic process of an NHL patient.
Providing help to multicultural patients in the context of contemporary population migrations in Europe
Authors: Kiszka Jerzy , Ozga Dorota , Mach Arkadiusz , Krajewski Romuald
Published: May 2018

Introduction. The population migration to the countries of the European Union (EU) of the conflict of war has grown substantially in recent years. According to the Office for Foreigners in Poland are staying 586 thousand foreigners. 279 refugees from Syria arrived in Poland in 2015. The economic development of Poland means that the number of foreigners settling in or crossing Poland and using the services of the Polish health service is constantly growing. Foreigners from outside Europe (the largest groups are Vietnamese – 8.8 thousand and Chinese – 6.2 thousand) were brought up in a different culture, but also people from European countries (the largest group are immigrants from Ukraine – 513 thousand) may differ from Poles perceive health and illness. Health Personnel may encounter difficulties in providing medical assistance and taking care of a culturally different patient. They may result from the language barrier, lack of knowledge about the differences in patients’ expectations or lack of skills in communication with the patient. The result may be improper assistance, violation of patients’ rights and avoiding the use of medical services.

Aim. Presentation of the migration of population in EU countries, analysis of problems arising during the provision of assistance to culturally different patients and an indication of the possibility of developing cultural competences of paramedics, nurses and doctors through education in this area.
An image of nurses and nursing in Poland in the media and in the opinion of various social groups. Systematic review of scientific literature from the years 2010-2017
Authors: Machul Michał , Chrzan-Rodak Agnieszka , Bieniak Monika , Bąk Jadwiga , Chałdaś-Majdańska Justyna , Dobrowolska Beata
Published: May 2018

Introduction. Nursing is a profession of public trust with a fairly high position in various rankings examining the prestige of professions.

Aim. Analysis of published research results on the image of nurses and nursing in Poland in the media and in the opinion of various social groups.

Material and methods. A systematic review of Polish scientific literature from the years 2010-2017 was undertaken. A multi-stage search process was carried out in accordance with the adopted inclusion criteria, and then articles identified and accepted were subjected to a qualitative analysis.

Results. Searching the Google Scholar database by accepted key words resulted in 10,663 records. After analyzing the titles and abstracts of these papers, 19 articles were subjected to further analysis. As a result of searching journals included in the Arianta database according to established key words, 10 articles were identified, 8 of which were qualified for further analysis. After removing duplicates, 17 articles were approved for the final analysis. Qualitative analysis of the research results published in these papers allowed to distinguish the following categories: an image of nurses and nursing in various social groups, elements of nurses’ image in the media and society, actions aiming at improving the image of nurses and nursing in Poland, changes in the image of nurses and nursing in Poland over the years and the direction of these changes.

Conclusions. The issue of an image of nurses and nursing in the media and in the society has been a frequent subject of research of nurses in Poland in the recent years. These studies concern primarily opinions on the image of nurses and nursing, factors which determine the image of nurses and nursing in Poland, constitutive elements of the image, the possibility of improving the image and people/ institutions responsible for it.
The inhibitors – a challenge for the management of patients with hereditary haemophilia A
Authors: Mihăilă Romeo-Gabriel
Published: May 2018

Introduction. Our research strategy was aimed at evaluating the possible implication of the type of factor VIII product administered as substitution treatment to haemophilia A patients in the occurrence of inhibitors and their consequences on the management.

Methods. Scientific articles from July 2015 to July 2017 were searched using the PubMed and PubMed Central databases. The used search terms included “haemophilia A”, “inhibitors”, “plasma-derived factor VIII” and “recombinant factor VIII”.

Results. The risk factors for inhibitors occurrence may be patients-related (genetic and nongenetic) and treatment-related. The possibility of a correlation between the increased purity of factor VIII given as substitution treatment and the occurrence of inhibitors is discussed in the light of literature data. Plasma-derived factor VIII is less immunogenic, but not entirely safe from the point of view of the possibility of transmitting biological agents. It is obvious that there is not enough plasma-derived factor VIII for the planet’s needs. Recombinant factor VIII products have revolutionized the treatment of patients with haemophilia A over the past 3 decades by the disappearance of transfusion-related infections and their complications. They are safer in terms of pathogens and the new long-acting factor VIII products are based on recombinant DNA technology.

Conclusion. Plasma-derived or recombinant factor VIII products must co-exist on the market for the benefit of haemophilic patients. Future solutions could be: less immunogenic factor VIII products, nonfactor replacement strategies, or bispecific antibody that mimics the function of coagulation factor VIII.
Malignancy in a retrospective cohort of 17 patients with Dermatomyositis or Polymyositis in southern Tunisia
Authors: Sellami Khadija , Mseddi Madiha , Snoussi Mouna , Gharbi Hela , Frikha Faten , Salah Rayda Ben , Jallouli Moez , Marzouk Sameh , Masmoudi Abderrahmen , Bahloul Zouhir , Turki Hamida
Published: May 2018

Introduction. The prognosis of dermatomyositis (DM)/ polymyositis (PM) in adults is partly related to their association with neoplasia. The aim of our study was to report the epidemiologic, clinical, paraclinical, therapeutic and evolutionary aspects of DM associated with malignancy in patients from Sfax, south eastern of Tunisia. Methods. A retrospective cohort study of patients with DM or PM admitted in Dermatology and Internal Medicine Departments of Hedi Chaker University Hospital of Sfax between 1996 and 2015. Cases of DM or PM associated with malignancy were retained. Results. Seventeen cases (13.5%) of DM or PM associated with malignancy were noted. Fourteen patients had DM and 3 patients had PM. The Sex ratio M / F was 0.3 and the mean age at diagnosis was 56.5 years. In DM patients, malignancy preceded the myositis in 64.2% of cases. In PM patients, only one patient was known to have breast cancer and the myositis revealed the cancer for 2 others. Treatment consisted of corticosteroids associated with methotrexate in 4 cases. Outcome was fatal in 5 cases (29.4%), due to the underlying cancer in 3 cases. Swallowing disorders related to DM/PM were responsible for death in 2 cases. Conclusion. There are no specific clinical or biological features in paraneoplastic DM. In our series, breast neoplasm represented the first cancer associated with DM. Cancers of nasopharynx, colon and urinary tract had the second position.
Multiple Metastases Gestational Choriocarcinoma - A Case Report
Authors: Mehedințu C. , Cîrstoiu M.M. , Brătilă E. , Plotogea M. , Antonovici M. , Cazachevici A. , Berceanu C.
Published: May 2018

Introduction. Gestational choriocarcinoma (GC) is a malignant condition that develops form trophoblastic cells originating from a previous pregnancy, eutopic or ectopic. Metastatic choriocarcinoma is often diagnosed in the absence of a primary uterine or ovarian tumor, presumably because the latter has undergone complete necrosis. GC rapidly metastasizes spreading to lungs, brain, bones, bone marrow, liver, and other organs, but responds well to chemotherapy. Material and methods. We present the case of a 25-year-old woman with critical evolution after being diagnosed with choriocarcinoma following a complete hydatidiform mole pregnancy. Even though the patient initially received proper treatment, due to poor follow-up compliance, the condition led to invasive metastases. When it spread to the musculoskeletal system and other organs, doctors were able to link symptoms to the choriocarcinoma diagnosis and chemotherapy was initiated. Unfortunately, the patient succumbed due to intracranial hemorrhage. Discussions. GC is a highly and fast invasive malignancy, with rapidly growing tumors. It is often associated with hemorrhage, ischemic necrosis, and secondary inflammation. Often, by the time the tumor is discovered, X-rays of the chest and bones already show metastatic lesions. Chemotherapy success depends on early detection and diagnosis of tumors after pregnancy. Conclusions. Even though the initial diagnosis and treatment should have led to a favorable outcome, the patient’s poor compliance was followed by rapid progression of the disease and, finally, exitus.
Multidisciplinary Treatment of Voluminous Pelvic Tumor With Gluteal Development - Case Presentation
Authors: Brătilă E. , Cârstoiu C. , Comandaşu D.E.
Published: May 2018

The aim of the paper was to present the case of a 64-year-old patient with no significant pathological history, accusing the significant increase in volume of her left buttock, accompanied by sciatic compression and pelvic pain phenomena. Clinical evaluation revealed a large, left gluteal tumor, of regular shape and medium consistency, painless at palpation, causing hyperesthesia in the sciatic territory by compression. The IRM with contrast enhancement described a heterogeneous tumor, measuring about 25 centimeters in diameter, isointense in the T1 and T2 signals, with hypointense areas and imagistic aspect suggesting differential diagnosis between liposarcoma and fibrolipoma. From the imagistic point of view, the origin of the tumor was pelvic, with a threadlike tract in the sciatic hole and development in the gluteal region for the most part. Surgery was decided on a multidisciplinary team including a gynecologist, orthopaedist, and general surgeon, using a double approach through laparotomy and gluteal incision. The first operative step consisted in laparotomy with pelvic tumor dissection at the level of the iliac vessels and its prolongation at the level of the sciatic hole. The large gluteal incision was used during the second step in order to mobilize the tumor form between the gluteal fibers. Subsequent thorough hemostasis was performed with postoperative aspect inspection through both approaches. The postoperative evolution was favorable without immediate or late complications. The histopathological result was fibrolipoma, with good prognosis for the patient. In conclusion, the multidisciplinary surgical approach in this patient presenting with a pelvic tumor with transischial gluteal development was the optimal choice, which led to a favorable outcome in a complex case.
Statistically Based Survival Rate Estimation in Patients with Soft Tissue Tumors
Authors: Şerban B. , Panti Z. , Nica M. , Pleniceanu M. , Popa M. , Ene R. , Cîrstoiu C.
Published: May 2018

Introduction. Although most soft tissue tumors are benign, with a high healing rate after surgical excision, there is a variety of malignant tumors with differences in progression and prognosis. The study aims to assess the survival rate in patients diagnosed with this pathology, based on the patient’s characteristics (age, gender, race), as well as the tumor’s (histological type, differentiation degree, location and size). Materials and methods. The retrospective study included a group of 103 patients diagnosed in our department during 2010 and 2017. Considering the high healing rate of benign tumors, only the group of neoplastic patients (45 cases) was involved in the survival rate estimation, assessing tumor characteristics and individual comorbidities. Within this lot, we emphasized a predominance of neoplasm in patients aged over 50 years (32 cases), men (29 cases), and localization of the neoplasm in the thigh (23 cases). The predominant histopathological type, liposarcoma, was diagnosed in 67% of the cases, with dimensions over 6 cm and with local extension. Results. There have been significant variations in mortality between the different histological subtypes (liposarcoma vs. synovial sarcoma). Local recurrences were shown in 18 cases of liposarcoma in the first 2 years after the surgical excision, with an increased aggressiveness of this neoplasm in men over 50 years. 12 cases developed distant metastasis, and, until the end of the study, 7 deaths were reported in 3 cases involving associated comorbidities. Conclusions. The five-year survival is inversely proportional to the extent of the tumor and the local invasion, as well as to the age of the patient. It is difficult to appreciate an overall survival rate in the context of a heterogeneous group of tumors so it must be evaluated for every histological subtype taking into account the patient’s particularities.
Femoral Giant Cell Tumor in a Patient with Surgically Treated Femoral Condyle Fracture: Misdiagnosis or Coincidence?
Authors: Japie I.M. , Bădilă A. , Ciobanu T. , Manolescu R. , Rădulescu D. , Japie E.M. , Bujdei A. , Cîrstoiu C.
Published: May 2018

Introduction. Giant-cell tumor of bone (GCTB) is a benign tumor with an unpredictable evolution, representing 4-5% of all primary bone tumors and 15% of benign bone tumors usually affecting 20-45 years old adults. The predilect location is the distal femur, proximal tibia, and distal radius. Case presentation. We report the case of a 31-year-old male, regardless of medical history, admitted in the emergency department (ED) for significant pain and functional impairment of the right knee, after suffering a traumatic event. Clinical examination and imaging tests established the diagnosis of lateral femoral condyle fracture. Therefore, osteosynthesis with 4 screws was performed. Postoperative evolution was uneventful until one year later when the patient presented to the ED for pain and inflammatory aspect of the right knee, but with no history of trauma during this time. The imagistic exams of the right knee (X-ray, magnetic resonance imaging and scintigraphy) detected a tumor of the lateral femoral condyle that also affected the osteosynthesis material. Thus, the removal of screws and histopathological exam were performed, the latter establishing the diagnosis of GCTB. Taking into consideration radiological and histological aspects of the tumor and relating them to the clinical findings, the GCTB was classified in stage III Enneking. The patient underwent surgery, segmental resection of the tumor in oncological limits and arthroplasty with modular tumoral prosthesis was performed. Postoperative results at 6 and 12 months according to Musculoskeletal Tumor Society Scoring System were very good. The key feature of this case consists of post-osteosynthesis appearance of the GCTB given the fact that only 3 cases of GCTB affecting the screw site were reported in literature.
Modular Reconstruction Systems – Final Solution for Critical Bone Defects Treatment
Authors: Nica M. , Ene R. , Panti Z. , Popa M. , Pleniceanu M. , Cîrstoiu M.M. , Cîrstoiu C.
Published: May 2018

Introduction. The management of critical bone defects has experienced an unprecedented improvement in the last few decades. A good primary mechanical stability and versatility of the modular reconstruction systems allowed the conversion to universal setups and the expansion of indication. The progression and reliability of the reconstruction possibilities available nowadays are outlined using the experience of our department. Material and method. A retrospective review of critical bone defect cases and the reconstruction management using endoprosthetic systems is presented. Ten reconstruction surgeries performed in the last 18 months in our department were observed. The patients were 3 males and 7 females with a mean age of 45.3 (range 19 to 75). Modular systems were used for the reconstruction of bone defects subsequent to resections of benign or malignant musculoskeletal tumors (76%) and to non-neoplastic conditions (24%). Results. On the latest follow-up, all the patients were alive, with one case of tumoral recurrence. No aseptic loosening, soft tissue or structural failure were recorded following surgery, with one case under treatment for infection after it required an open procedure for a prosthetic hip dislocation. The early functional results were adequate in all cases, with good secondary stability and satisfactory quality of life. Conclusion. The evolution of endoprosthetic reconstruction surgery has improved the prognosis for many patients diagnosed with critical bone defects. Continuous advances in implant design, fixation, and soft tissue attachment combined with the improvement of surgical techniques will ensure a bright future for this type of procedures.
Femur Metastasis Secondary to a Carcinoma of the Uterine Cervix (Case Study)
Authors: Popescu D. , Panaitescu C. , Nedelcu R. , Trifu Şt. , Cîrstoiu C.
Published: May 2018

Purpose. The purpose of this study is to correlate the existence of a unique bone metastasis of the femur, secondary to a carcinoma of the uterine cervix, the treatment plan, and the recovery of the patient. Materials and method. From previous studies, it is known that the prevalence of unique bone metastasis of the femur secondary to carcinoma of the uterine cervix is very low, in most cases the patients having multiple metastases or in other organs. The case presents a 40-year-old patient who had surgery 2 years before for a carcinoma of the uterine cervix. After the surgical treatment, the patient received chemotherapy and radiotherapy. Nowadays, the patient exhibits pain in the left hip. Following the clinical and paraclinical protocols, an incisional biopsy was made. The histopathologic result was metastasis from the uterine cervix squamous cell carcinoma. The surgical treatment consists of segmentary resection and total hip arthroplasty with tumor reconstruction prosthesis. Results. After total hip arthroplasty with tumor reconstruction prosthesis, we were able to make a segmentary resection in oncological limits, with the complete excision of the metastasis, the patient being able to start the recovery the next day after the surgery. Conclusions. As a surgical indication, the tumor prosthesis represents the best option in the segmentary resections of tumors, this allowing a reconstruction and an early recovery.
Scapular Metastasis by Rcc. Case Presentation
Authors: Nicula A.I. , Marinescu A. , Iana G.
Published: May 2018

Bony metastasis is a frequent occurrence in malignancies. We present the case of a 75-year-old male patient who was investigated for a lytic lesion in the right scapula and was eventually diagnosed with metastatic renal cell carcinoma (RCC). The main indications for embolization are reducing the risk of bleeding during and after surgery of hypervascular tumors, simplifying the manipulation of tumors, palliation of pain, bleeding, fever, and hypercalcemia-like symptoms in inoperable tumors, preventing further dissemination of a tumor, and increasing the response to chemotherapy and radiotherapy. Embolization may be a therapeutic alternative to surgery in cases in which surgery is inappropriate or associated with high risk. In the case presented, CT examinations had a crucial role both in the diagnostic orientation and in the subsequent therapeutic decisions and proper monitoring under therapy.
Conventional Radiography and MRI Diagnosis of Bone Tumors Developed at the Knee
Authors: Codorean I. , Codorean I.B.
Published: May 2018

Introduction. It is known that bone tumors have a predilection to develop for a certain skeletal bone segment. Also, bone tumors have a predilection for certain age groups. The knee is a common site for bone tumors. Purpose. Presentation of diagnostic parameters of conventional radiography as the first technique in the detection and characterization of bone tumors developed at the knee level and the criteria for differentiation of the malignant substrate from the benign (the type of bone destruction, the type of periosteal response, poorly defined margins) one. The value of MRI is also presented and illustrated as a unique imaging technique that allows the direct visualization of bone marrow with high spatial resolution for local staging of bone tumors. Material and method. The present study aimed to investigate the radiographic and MRI imaging characteristics of bone tumors developed at the knee joint, which were retrospectively analyzed (October 2007 and November 2017) in a selected group of 91 patients. The limit of age between 11 and 67 years, 73(70%) men, 18 (30%) women. Examination protocol: complete clinical examination, radiographic knee examination in anteroposterior and lateral incidents. MRI standard protocol, native, and post paramagnetic contrast. Results. Conventional Radiographic and MRI have been detected and characterized a number of 55 (67%) primary malignant bone tumors confirmed by histopathological diagnosis, ranging from 8 histopathological types and 37 (33%) cases of benign tumors with 9 histopathological types. Conclusions. Radiological examination is the first investigation in the evaluation of knee bone tumors, suggesting the malignant nature expressed by the badly defined margin, bone destruction, discontinuous peristaltic reaction, and extension to the soft parts. MRI is a unique imaging technique that allows direct visualization of bone marrow with high spatial resolution and best tool for local staging of bone tumors.
Late Results after Cement Bone Filling in Treatment of Giant Cell Tumour (GCT) - Retrospective Study
Authors: Prejbeanu R. , Crişan D. , Bălănescu A. , Haraguş H. , Deleanu B.
Published: May 2018

Introduction. Segmental or intralesional excision with curettage or complete resection can be one method of treatment for giant cell tumor (GCT), but the ideal filling material after curettage or resection remains controversial. The purpose of this retrospective study was to follow the latest results and complications regarding the recurrence or degradation of functional status that underwent cementation. Material and methods. We reported 24 cases with GCTs during the last 15 years. All the patients were treated by intralesional excision or segmental resection followed by acrylic cement filling with or no metal augmentation recurrence-free survival proportions were used to evaluate oncological outcomes. Other parameters including surgical complication, general condition, and radiological classification were analyzed. Results. We followed up 20 cases for at least five years postoperatory (from the 5th to the 9th year). The recurrence-free survival proportions showed that the recurrence rate in this group was for 4 patients (2 of them were at second surgery). 2 patients had degradation of implant cement fixation. Parameters including patients’ age, gender, tumor location, and radiological classification did not affect the surgeons’ treatments in cavity filling after GCT curettage. Conclusions. Cementation should be recommended because of easy usage, have long lasting better results, and the better local tumor control than other methods (ex: bone grafting). The risk of recurrence is low and is not related to the cementation and metal augmentation. The cost-benefit is also in favor of this technique.
A Tool in Differential Diagnosis of a “Cystic” Bone Lesion
Authors: Marinescu A.N. , Nicula A.I. , Iana G.
Published: May 2018

It is a power point program, which through a succession of steps, allows the obtaining of one shorter diagnosis, from a long list of possible ones, by choosing a character of the bone lesion. The aim of this program is to facilitate the differential diagnosis of this particular aspect of a bone lesion - the cystic, expansile osteolytic bone lesion - from a radiological point of view, but not only. The location, age, pain and other condition will be considered and will represent the first criteria in the differentiation. In this differential diagnosis, we discovered not only benign tumor lesions but also malign bone lesions or other non-tumoral conditions. We considered that this program could be easily used by the radiologist or the orthopedist in training and useful by also employing a representative photo gallery.
Imaging Diagnosis of a Proximal Tibia Tumor – Case Presentation
Authors: Turcu R. , Barbilian A.
Published: May 2018

Introduction. 30 years ago, the primary role of radiology in tumor pathology was predominant in establishing the diagnosis. A wide range of techniques has been developed, allowing the interventionist radiologist to apply new procedures to patients with tumor pathology. This improved both the diagnosis and the treatment of tumor lesions. Material and method. A 19-year-old male patient, accused pain and functional knee failure, and pain in the ipsilateral ankle, which started about three months before, because of a sprain. Following the clinical examination, a suspicion of a meniscal lesion associated with a lesion of the ankle ligament complex arose. The magnetic resonance imaging revealed the meniscal lesion, but changes in the proximal tibia were observed, which required computed tomography of the knee. The presence of an osseous tumor at the proximal tibia was revealed. Given the unpredictable evolution of tumors in young people, a bone scintigraphy was decided to be performed. Results. The imaging studies commonly used in assessing the patient with musculoskeletal tumor pathology are radiographs, nuclear magnetic resonance, computed tomography, bone scintigraphy. Magnetic resonance imaging is the most sensitive method of diagnosis, allowing the assessment of the extent of the tumor formation in the medullary canal, but also in the adjacent soft tissues. Conclusion. After analyzing the patient’s history, the clinical, paraclinical and imaging examination, and the differential diagnosis will be established and the optimal treatment will be decided in this case.
Bone Metastasis Secondary to Vulvar Cancer
Authors: Berceanu C. , Brătilă E. , Berceanu S. , Tetileanu A.V. , Voicu N. L. , Mehedinţu C.
Published: May 2018

Bone metastases from a vulvar cancer are extremely rare with only few reported cases in literature. Some cases were reported, in which patients developed pathologic fractures within eight months following radical surgery for advanced vulvar carcinoma. It is unanimously recognized that metastatic vulvar cancer is a rare condition. Therefore, information on metastatic determinations and corresponding prognosis or therapeutic approaches is very low. This paper is a review on some extremely rare conditions, such as bone metastases in vulvar cancer.
Imaging Diagnosis of a Shoulder Tumor – Case Presentation
Authors: Turcu R. , Barbilian A.
Published: May 2018

Introduction. The most common and used molecular imaging techniques used in tumor pathology are the following: optics such as fluoroscopy, bioluminescence, and spectroscopy, radionuclides such as positron emission computed tomography, magnetic resonance with or without contrast substance, ultrasound and computed tomography. Material and method. A 39-year-old male patient accused having a shoulder tumor beginning 6 months before with a slow increase in volume without symptoms, pain, local temperature changes, and neurological phenomena. The clinical examination revealed the presence of an elastic consistency tumor, adherent to the bone but movable in soft adjacent tissues, without spontaneous and palpation pain, and local swelling. There was a slight functional embarrassment in conducting the abduction maneuver, but without limiting the amplitude of the movement. Results. Radiography of the shoulder did not reveal any significant changes. Magnetic resonance imaging of the shoulder and contrast-enhanced magnetic resonance imaging of the shoulder were performed. The evoked changes required a computed tomography of the shoulder. Conclusion. The thorough analysis of the imaging investigations and the clinical, paraclinical, and biological context of the patient will lead to the indication of the treatment and the optimal surgical time.
Personalized Surgical Planning – The Use of 3D Printing in Oncological Pathology
Authors: Liciu E. , Frumuşeanu B. , Popescu B.M. , Florea D.C. , Niculescu L. , Ulici A.
Published: May 2018

Introduction. Among the cases of malignant tumors, gathering 30% of them, the most frequent is the osteosarcoma. It occurs especially in children and young adults, the mean age being 14 years old. The treatment consists initially in neoadjuvant chemotherapy, followed by the surgical removal of the tumor. Due to aggressive malignant features (rapid increase in size, tendency to invade surrounding tissues, variable location), in multiple cases, the surgical treatment of osteosarcoma becomes a true challenge. Materials and methods. Nowadays, it is possible to create 3D printed models, by using CT and MRI, which are superior to the 3D graphical reconstructions. The 3D printing technique facilitates the production of these 1:1 scale printed models that faithfully embody the patient’s particular features concerning the anatomic pathology. The benefits gained from using such a modern tool allow the orthopedic surgeons to establish the measurements of a precise resection and to simulate the surgical maneuvers, as part of an elaborated modern surgical planning. Results. In this article, we presented the case of a 10-year-old patient diagnosed with femoral osteosarcoma and treated with neoadjuvant chemotherapy followed by GMRS surgical approach based on a preoperative planning involving a 3D printed model. This piece was used to provide precise information regarding the tumor, to allow preoperative measurements and a surgical simulation. Conclusion. The surgical accuracy can be increased by using a personalized preoperative planning based on a 3D printed model, leading to a lower rate of long/ short-term complications, recurrences, or metastases.
Mechanisms of Bone Metastasis of Malignancies of the Genito-Mammary Area
Authors: Bohîlțea R. , Turcan N. , Georgescu T.A. , Cîrstoiu M.M.
Published: May 2018

Bone metastasis is a frequent complication of advanced genito-mammary cancer patients. Skeletal involvement is particularly common in breast cancer. Bone metastases induce a wide range of symptoms, lowering the quality of life and shortening survival. The normal bone remodeling process is deeply affected in all types of metastases: osteolytic, osteoblastic, and mixed. The main mechanisms involved in bone metastatic dissemination are the expression of adhesion tumor molecules and corresponding receptors within bone marrow and bone matrix cells; local growth factors, molecular mechanisms of remodeling the hematopoietic stem cell activity, and alteration of the expression of the post-transcriptional regulatory microRNAs of the gene expression are the new theories developed from recent studies. Abnormalities in the number of copies of the 16q23 gene explain the increased risk of bone metastasis of breast cancer compared to its dissemination to the other organs; the mutual interaction between tumor cells and the bone microenvironment constitutes the element that stimulates both bone destruction and tumor development. Endothelin -1, bone morphogenic proteins, platelet-derived growth factor, Wnt proteins stimulate proliferation and osteoblastic activity. Genomic and proteomic studies underlie the development of new therapeutic agents for the treatment and prevention of bone metastases.