bluuebunny/crossref_metadata_2025_split huggingface dataset:
Romanian Registry of Hypertrophic Cardiomyopathy – overview of general characteristics and therapeutic choices at a national level
Authors: Ionilă Paula , Jurcuţ Ruxandra , Ferariu Nicoleta , Roşca Monica , Chivulescu Monica , Mursă Adriana , Militaru Sebastian , Ionescu Alin A. , Căldăraru Cristina , Fruntelată Ana G. , Goanţă Silvia F. , Crişan Simina , Ionac Adina , Avram Ana-Maria , Frigy Attila , Sascău Radu , Arsenescu-Georgescu Cătălina , Coman Ioan M. , Popescu Bogdan A. , Ginghină Carmen , Apetrei Eduard 
Published: May 2018

Abstract

Introduction. Hypertrophic cardiomyopathy (HCM) is a disease with increased left ventricular (LV) wall thickness not solely explained by abnormal loading conditions, with great heterogeneity regarding clinical expression and prognosis. The aim of the present study was to collect data on HCM patients from different centres across the country, in order to assess the general characteristics and therapeutic choices in this population.

Methods. Between December 2014 and April 2017, 210 patients from 11 Romanian Cardiology centres were enrolled in the National Registry of HCM. All patients had to fulfil the diagnosis criteria for HCM according to the European Society of Cardiology guidelines. Clinical, electrocardiographic, imaging and therapeutic characteristics were included in a predesigned online file.

Results. Median age at enrolment was 55 ± 15 years with male predominance (60%). 43.6% of the patients had obstructive HCM, 50% non-obstructive HCM, while 6.4% had an apical pattern. Maximal wall thickness was 20.3 ± 4.8 mm (limits 15-37 mm) while LV ejection fraction was 60 ± 8%. Heart failure symptoms dominated the clinical picture, mainly NYHA functional class II (51.4%). Most frequent arrhythmias were atrial fibrillation (28.1%) and non-sustained ventricular tachycardia (19.9%). Mean sudden cardiac death risk score (SCD-RS) was 3.0 ± 2.3%, with 10.4% of the patients with high risk of SCD. However, only 5.7% received an ICD. Patients were mainly treated with beta-blockers (72.9%), diuretics (28.1%) and oral anticoagulants (28.6%). Invasive treatment of LVOT obstruction was performed in a small number of patients: 22 received myomectomy and 13 septal ablation. Cardiac magnetic resonance was reported in only 14 patients (6.6%).

Conclusions. The Romanian registry of HCM illustrates patient characteristics at a national level as well as the gaps in management which need improvement – accessibility to high-end diagnostic tests and invasive methods of treatment.
Out of Borders for Radical Gynecologic Surgery
Authors: Brătilă P. , Brătilă E. 
Published: May 2018

Abstract
Advances in several medical disciplines have resulted in greatly improved outcome and reduced morbidity and mortality in the management of complex gynecologic tumors. Early reports of central pelvic exenteration were discouraging and associated with high mortality (28%) and major complications (100%). Preoperative medical assessment, expert anesthesia, and postoperative intensive care have reduced perioperative mortality to less than 5%. For patients with recurrent cervical and endometrial cancer, who already had surgery, and for a minority of primary or recurrent sarcomas without distance metastases, the contemporaneous surgery offers a chance by bone extended resections.
Congenital Fibrosarcoma – Case Presentation
Authors: Dobre L. , Vreme C. , Chirițoiu A. , Dorobanțu G.I. , Ionescu N.S. , Vlad C. 
Published: May 2018

Abstract
Introduction. Congenital fibrosarcoma is a rare soft tissue neoplasm, distal extremities being more commonly involved. This tumor has a rapid growth and extensive local invasion, but metastasis is rare. It is usually observed in children younger than two years old and is present at birth in up to 30% of the cases. Purpose. Evaluation of the methods of diagnosis and treatment in a case of a newborn known from intrauterine life, with a large tumor of the right arm. Materials and methods. We present the case of a 1-day-old patient, who was transferred from maternity in our clinics with the following diagnostics: large tumor of the right thoracic member, cardiac insufficiency, prematurity, severe respiratory distress. The tumor was visible at ultrasonography from intrauterine life, and the evolution was the increase in volume with necrosis areas and hair presence on its surface. After imagistic investigation, taking into account the tumoral extension with neurovascular involvement, without the possibility of a tumoral resection, but also the imminent danger of spontaneous rupture, we decided to perform a shoulder disarticulation without a biopsy in advance. Results. Postoperative evolution and the treatment of the cardiac insufficiency were good under antibiotics. The histopathological results advocate for the diagnosis of congenital fibrosarcoma, also confirmed by immunohistochemical tests. Conclusions. Soft tissue tumors are very rare and they need a multidisciplinary evaluation for the establishment of the right treatment. Imagistic and laboratory investigations can guide the diagnosis and the therapeutical conduct. The certainty diagnosis is established only after the histopathological results.
Reconstruction in Malignant Tumors of the Calf After Tumoral Resection in Children
Authors: Vlad C. , Dobre L. , Hamei Ș.A. , Gavriliu Ş. 
Published: May 2018

Abstract
Purpose. Evaluation of reconstructive procedures after oncologic resection of malignant bone tumors of the calf in children. Materials and methods. The study contains 4 patients with ages between 5 and 18 years, 2 of the cases being diagnosed with osteosarcoma, respectively 2 with Ewing sarcoma of the tibia. In 3 of the cases, the surgical treatment consisted of en bloc tumoral resection and reconstruction with metal acrylic spacer and, in the 4th case, the tumoral resection was followed by endoprosthetic replacement. In all cases, the surgical treatment was preceded by biopsy and chemotherapy. Results. In 3 of the patients we used a gastrocnemius flap and one patient needed a negative pressure dressing for 11 days after surgery. The follow-up varied between 8 and 17 months after surgery. The patient who underwent endoprosthetic replacement was immobilized in a mobile orthosis and partial weight bearing at 2 weeks PO. The patient who underwent endoprosthetic replacement needed a surgical revision at 10 months PO consisting in the reinsertion of a locking screw of the patellar tendon fixation device. 2 of the presented cases are waiting for replacement of the metal acrylic spacer with a definitive reconstruction procedure, 1 case is proposed for amputation. Conclusions. Malignant bone tumors of the calf in children represent a pathology with high complexity giving the possible complications that can occur, a redoubtable risk being implant loss due to lack of coverage. The discussion remains open regarding the right time for definitive surgical procedure with modular endoprosthesis in children, and other reconstructive techniques available in these cases.
The Role of Imagistics in the Diagnosis of Chondrosarcomas
Authors: Marinescu A.N. , Nicula A.I. , Bratu M.A. , Iana G. 
Published: May 2018

Abstract
Chondrosarcomas are malignant cartilaginous tumors, with many histological subtypes and three grades based on cellularity. They are the second most common primary malignant tumors of the bone. From the histopathologically proved clinical cases, we are reviewing the imaging semiology - size, type of calcifications, cortical breach, endosteal scalloping, permeative or moth eaten bone appearance, and revealing other differentiation elements like location, age, and pain. A special point is the frequent difficulty in distinguishing between enchondromas and low grade conventional chondrosarcomas - as the lesions are very similar both histologically and radiographically. The radiologist should point the area to aim on the biopsy - at areas that may harbor foci of high-grade tumor, such as the ones of endosteal scalloping, soft-tissue components, or diffusely enhancing areas with minimal mineralization. It is known that with cartilaginous tumors, histopathologic examination of the biopsy specimen alone does not permit an accurate classification of the tumor. We emphasized the role of imaging in positive and differential diagnosis, management, and therapy of these bone tumors.
Limb Salvage and Major Reconstruction Surgery for Patients with Malignant Bone Tumors
Authors: Dragosloveanu Ș. , Dragosloveanu C. , Cotor D. , Creţu B. , Stoica C. I. 
Published: May 2018

Abstract
Introduction. Osteosarcoma and chondrosarcoma are the most common bone neoplasms. The most frequent localization of the osteosarcomas is the lower extremity around the knee and the pelvis and proximal femur for chondrosarcomas. In such cases, the amputation is a common procedure but the limb salvage surgery has become more popular due to the development of chemotherapy and improved diagnostic techniques. Methods. In the present study, the authors performed a retrospective study of patients diagnosed with osteosarcoma and chondrosarcoma around the knee and hip joint, treated with resection and reconstruction surgery. We evaluated the patients preoperative and postoperative using MRI and scintigraphy. The preoperative planning was made using Cedara I-View. Follow-up was between 1 and 4 years. Patients. We included 2 patients with chondrosarcoma and 4 patients with other types of sarcomas. All tumors were localized in the lower limb area except for one case, which presented a fast growing fibroblastic sarcoma in the supraspinatus fossa. Using MRI, the tumors were staged Enneking IIa and IIb. Patients with tumor infiltration of nerves or vessels, massive soft tissue infiltration, or pathologic bone fractures were excluded from our study. All the cases included were diagnosed based on incisional biopsy. Results. We recorded difficulties encountered in resection of the tumor, matching the preoperative planning with the intraoperative findings, rate of recurrence and soft tissue management. Our paper followed our results using GMRS type implants or straight reconstruction in the upper limb. Only one patient presented with lumbar metastatic disease after osteosarcoma after 2 years. Conclusion. Reconstructive surgery seems a good choice for careful selected patients. This type of surgery is demanding and experience is needed. We believe that a longer follow-up is needed for young patients to better evaluate the implant stability for mid-to long term.
Radiotherapy in Osteosarcomas
Authors: Mitrică R. , Şerbănescu L. , Trifănescu O. 
Published: May 2018

Abstract
Osteosarcoma represents a rare primary tumor of the bone, but it ranks 5th among children and adolescents. When diagnosed, many patients already have a disseminated disease at subclinical level. Current treatment includes surgery and chemotherapy. Radiotherapy is not commonly indicated, especially given the radioresistant characteristic of this type of cancer and it is usually administered for residual disease after surgery, inoperable tumors or in palliation, such as whole lung irradiation. The purpose of this paper was to identify the real contribution of radiotherapy in osteosarcomas, with solutions to improve local control and survival. We reviewed clinical studies, starting with the period before chemotherapy, in order to identify treatment techniques related criteria that may influence local control, survival, and secondary toxicity. Modern radiotherapy techniques are outlined with their dosimetric advantages. Following the 1990s, the combination between proper surgery and chemotherapy has eliminated the need for pre-operative radiotherapy. Most clinical studies have used adjuvant radiotherapy for patients with positive resection margins, with good results but hard to dissociate from those of the concurrently administered chemotherapy. Proton therapy is frequently indicated for these patients, due to the healthy tissue sparing characteristics. Studies have pointed out the correlation between radiotherapy response and tumor size, total administered dose, chemo sensitivity. Whole lung irradiation for patients with lung metastases is inferior to chemotherapy. Radiotherapy associated complications include joint fibrosis with reduced functional capabilities, bone fracture, allograft loss and carcinogenic risk. Currently, radiotherapy is not the first choice when treating osteosarcomas, but new evidence is emerging for combining modern techniques, such as proton therapy with surgery and chemotherapy for patients with incomplete resections or inoperable tumors.
Comparison In The Oral Status Among 123 Smoking And Non-Smoking Premenopausal And Menopausal Patients
Authors: Lescai I. , Lescai D. , Cîrstoiu M. 
Published: May 2018

Abstract
A cohort of 123 patients was split into two main categories, premenopausal and menopausal. Each of the two was also split in smoking and non-smoking. The objective of the study was to find whether there is a difference between smoking and non-smoking, menopausal, and premenopausal patients. Each patient had the oral status stated on the radiological findings for missing teeth, root canal treatments and bone resorption greater than 5 mm. In total, there were 59 premenopausal patients (35 non-smoking and 24 smoking) and 63 menopausal patients (39 non-smoking and 24 smoking). Non-smoking menopausal patients had 273 missing teeth, 212 root canal treatments and 163 bone resorptions greater than 5 mm. In contrast, the smoking menopausal patients had 258 missing teeth, 70 root canal treatments, and 187 bone resorptions greater than 5 mm. The premenopausal non-smoking patients had 128 missing teeth, 139 root canal treatments and 82 bone resorptions greater than 5 mm. In contrast, premenopausal smoking patients had 111 missing teeth, 100 root canal treatments and 144 bone resorptions greater than 5 mm. As a general conclusion, premenopausal patients lost 3.65 teeth, had 3.97 root canal patients and 2.34 bone resorptions in the non-smoking group compared to 4.62 missing teeth, 4.16 root canal treatments and 6 bone resorptions for each one in the smoking group. The menopausal nonsmoking group had 7 missing teeth, 5.43 root canal treatments and 4.17 bone resorptions for every patient compared to 10.75 missing teeth, 2.91 root canal treatments and 7.79 bone resorptions for every patient in the menopausal smoking group.
Post-Operative Complications in Tram Flap Breast Reconstruction after Mastectomy
Authors: Parasca S.V. , Iosif B.F. , Costeschi A. , Popescu O. , Roznovanu M. 
Published: May 2018

Abstract
Introduction. Breast cancer is the main cause of mortality for neoplastic diseases in women worldwide. Since the incidence is increasing every year, the need for reconstructive techniques increases and autologous tissue reconstruction procedures are also gaining ground over the more popular expander/ implant techniques. A hypertensive and obese patient is admitted by SCUCPRA’s Chronic Diseases Service, with a postmastectomy scar on the left breast, with normal aspect. A TRAM Flap is performed through an oblique tunnel for transposing the tissue over the defect. The abdominal defect was covered with polypropylene mesh. Three days post-operatory, the patient presented an umbilical necrotic scar of 6/ 3 cm and a 4/ 3 cm necrotic scar in the medial zone of the TRAM Flap. Materials and method. Four days post-operatory, the patient presented a 10/ 5 cm brown-black colored dehiscent umbilical scar and 2 dehiscent areas of 4/ 1 cm and 5/ 1 cm inferior and superior, on the TRAM Flap. Excisional debridement of the ulceration was performed, and the abdominal defect was covered with a split-thickness skin graft. The TRAM Flap was also debrided and immediate suture was performed. Conclusions and results. Necrosis is an important complication that can occur both at the abdominal level, as well as on the TRAM Flap, after a breast reconstruction, affecting both the general state of the patient and the long-term results of the reconstructive method.
Outcomes and Treatment of Malignant Tumors of Long Bones
Authors: Stan G. , Orban H. , Gheorghiu N. , Drăguşanu M. 
Published: May 2018

Abstract
Introduction. With the advances in chemotherapy, the life expectancy of patients with malignant tumors of bones begins to rise and creates the opportunity for a more conservative treatment of such cases. The main complications after using reconstruction with bone graft are represented by mechanical failure, due to the lack of strong fixation, or biological failure of graft integration. Infection is another complication, patients being usually immunosuppressed. The aim of this study was to investigate a retrospective single center experience of surgically treated malignant bone tumors of long bones, respectively oncological, surgical, and functional outcome differences after biological reconstruction. Materials and methods. Between 2007 and 2017, we conducted a retrospective study, with patients from Elias Orthopaedic Department. 70 patients with malignant tumors were treated. Only in 20 cases, resection-reconstruction was possible. Results. Survival rate at 8-year follow up was 35%. Mechanical failure rate was 20%, graft resorption rate was 25%, and infection rate was 15%. Discussion. Primary malignant tumors of bones are very rare, less than 1% of cancer cases, and yet there is no strict rule for treating these patients in specialized centers. Because of the small sample of patients, the heterogeneity of reconstruction methods and multiple types of grafts, this study also had some limitations. The mechanical or biological complication rate is higher in resectionreconstruction cases. Non-unions, fractures and infections are the most common complications.
The Aneurysmal Bone Cyst - A Case Report
Authors: Petrescu I. , Oproiu A.M. , Tudorache C. , Mitcan A. 
Published: May 2018

Abstract
Introduction. The aneurysmal bone cyst is a benign bone tumor with a low incidence. Its presence within the bone of the hand is quite unusual. When it comes to its evolution, it is known to be an aggressive tumor with a progressive weakening of the bone structure. Objective. This case report aimed to present the importance of keeping the hand function intact for patients who are usually in their first decades of life. As a reconstruction method, a radical surgical approach and grafting are both mandatory for the unit to have the mobility unaltered. Material and methods. It is a case of a 15-year-old male with a giant aneurysmal bone cyst of the fifth metacarpal bone of the left hand. This tumor was surgically removed and the entire bone was rebuilt with an autologous bone graft from the iliac crest. The articular surface was preserved for the distal joint (the head of the metacarpal bone was spared). Results. The surgical procedure concluding the resection and immediate grafting reestablished the function of the hand with no infirmity, and the results for the past 7 years after surgery kept being negative for relapse and the patient had great mobility within the segment. Conclusions: The proper and correct surgical treatment of giant aneurysmal bone cyst located on the fifth metacarpal bone is the mandatory resection of the entire tumor for the high risk of pathological bone fracture with a severe impact on the mobility of the hand.
The Therapeutic Approach of Soft – Tissue Sarcomas. A 12 Cases Analysis
Authors: Georgeanu V. , Atasiei T. , Gartonea D. , Shazam B. , Goleşteanu G. , Cristea Şt. 
Published: May 2018

Abstract
Introduction. Soft Tissue Sarcomas (STS) is a group of rare malignant tumors with mesenchymal tissue origin. At present, over 50 histopathological types with typical chromosome changes are described. Treatment is multidisciplinary, centered on the surgical approach. Method. Between 2014 and 2016, 12 STS cases were treated in our clinic: 3 liposarcomas, 2 synovial sarcomas, 1 angiosarcoma, 2 rhabdomyosarcomas, 2 myxofibrosarcomas, 1 fibroblast sarcoma and 1 clear cell sarcoma. With the exception of angiosarcoma that benefited only from chemotherapy, the other cases were surgically approached, followed by radiotherapy in 7 cases, and chemotherapy in one case. Results. Patient follow-up was for a minimum of 2 years. In 3 cases (fibroblast sarcoma, clear-cell sarcoma, synovial sarcoma), a local recurrence occurred between 3 and 9 months. In 2 cases (fibroblastic sarcoma, synovial sarcoma), pulmonary metastases occurred between 6 and 18 months and the patients died at 8 months and 2 years respectively. The rest of the cases were clinically and imagistically assessed (local MRI, lung CT) at 6 months for at least 2 years and showed no signs of local recurrence or metastasis. Conclusions. The evolution of STS depends on the histological type and to the stage of diagnosis (local extension, degree of differentiation and presence of metastases). Therapeutic approach should be centered on an accurate resection, within the limits of oncological safety even with re-resection. Postoperative radiotherapy is used in most of the cases, and chemotherapy is reserved for special cases with unfavorable local evolution or metastasis.
Optimization of Welding Process using a Genetic Algorithm
Authors: Élesztős Pavel , Jančo Roland , Voštiar Vladimír 
Published: May 2018

Abstract
Welding is a complex technological process in which local heating takes place up to the melting point of the connecting and the additional material. Phase and crystallization processes are a strong non-linear function of the cooling rate. This non-linear function multiplies the complexity of the numerical simulation and optimization of the welding process. Lately, optimization with genetic algorithm has become the trend to optimize systems that behave in a non-linear manner and contain a number of local extremes. Genetic algorithm is therefore a method by which we seek an absolute extreme. It is a method which seeks a solution to near absolute extreme. In this paper the use of the genetic algorithm for welding process optimization is described.
The Use of Optical Methods in the Analysis of the Areas with Stress Concentration
Authors: Pástor Miroslav , Frankovský Peter , Hagara Martin , Lengvarský Pavol 
Published: May 2018

Abstract
Anchoring parts of technical systems are often damaged due to the heavy forces acting on these systems during their operation. For that reason, various modifications are suggested and created on the anchoring screws, which should help to reduce the mechanical stress values in a place of the first load-bearing thread of a female screw. For the determination of stress fields on the surface of a plane model of a threaded joint, two non-contact optical methods were used – conventional transmission photoelasticimetry and modern digital image correlation.