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Contains fulltext : 202938.pdf (Publisher’s version ) (Closed access) BACKGROUND: Diabetes mellitus (DM) is common among tuberculosis (TB) patients and often undiagnosed or poorly controlled. We compared point of care (POC) with laboratory glycated haemoglobin (HbA1c) testing among newly diagnosed TB patients to assess POC test accuracy, safety and acceptability in settings in which immediate access to DM services may be difficult. METHODS: We measured POC and accredited laboratory HbA1c (using high-performance liquid chromatography) in 1942 TB patients aged 18 years recruited from Peru, Romania, Indonesia and South Africa. We calculated overall agreement and individual variation (mean +/- 2 standard deviations) stratified by country, age, sex, body mass index (BMI), HbA1c level and comorbidities (anaemia, human immunodeficiency virus [HIV]). We used an error grid approach to identify disagreement that could raise significant concerns. RESULTS: Overall mean POC HbA1c values were modestly higher than laboratory HbA1c levels by 0.1% units (95%CI 0.1-0.2); however, there was a substantial discrepancy for those with severe anaemia (1.1% HbA1c, 95%CI 0.7-1.5). For 89.6% of 1942 patients, both values indicated the same DM status (no DM, HbA1c

Background People with diabetes have an increased risk of developing active tuberculosis (TB) and are more likely to have poor TB-treatment outcomes, which may impact on control of TB as the prevalence of diabetes is increasing worldwide. Blood transcriptomes are altered in patients with active TB relative to healthy individuals. The effects of diabetes and intermediate hyperglycemia (IH) on this transcriptomic signature were investigated to enhance understanding of immunological susceptibility in diabetes-TB comorbidity. Methods Whole blood samples were collected from active TB patients with diabetes (glycated hemoglobin [HbA1c] ≥6.5%) or IH (HbA1c = 5.7% to, Our study shows that people with diabetes and tuberculosis have altered peripheral immune profiles compared to people with only tuberculosis, and that these differences also exist in patients with intermediate hyperglycemia.

Face basosquamous or metatypical carcinoma is a rare and controversial form of skin cancer. It is characterized by increased incidence of recurrence and distant metastases. We present the case of a patient of 71 years with an ulcerative lesion of 3/4 cm in the nasal pyramid. The injury occurred due to trauma to the nasal pyramid, produced 13 years ago. After investigation, which included ORL examination, imaging and oncology exam, surgery was decided to completely ablate tumor formation. The resulted defect of 4/5 cm was covered by mobilizing a forehead flap based on right supratrohleare artery pedicle. Histopathological examination revealed the diagnosis of basosquamous or metatypical carcinoma. The patient was referred to the oncology service for treatment.

Incisional hernias are a common complication of abdominal surgery. Research shows that their incidence reaches 10%-11% of the total number of patients subject to laparotomy. Recurrent hernias are the main complication of eventrations and its rate ranges from 5 to 54%, depending on both the surgical procedure used and the follow-up methods. The goal of this study is the comparative cost analysis of two procedures used in the treatment of event rations, tissular versus alloplastic, the former, leading very often to recurrence requiring a new surgical intervention. The analysis comprised 156 cases of surgeries performed for incisional hernia in 2007 in the clinic of Surgery III, SUUB (Bucharest University Emergency Hospital). Tissular procedures were used in 42 cases and prosthetic procedures in 114 cases. The medium-term postoperative follow-up has revealed 17 relapses (40.4%) in the tissular batch and no relapse in the batch where parietal prosthesis was used. If the short-term costs of the tissular procedures are low as compared with the prosthetic procedures, on the medium-term the costs increase by 24.35% due to the high rate of relapses of tissular procedures. Therefore, the tissular procedure must be abandoned due to the high rate of relapse, as this drives additional costs required for the alloplastic repair of the abdominal parietal defects in a subsequent surgical intervention.

The aim of the article is to present an update on the pathophysiology, clinical features and treatment of rhinophyma. A 56 years old patient, living in urban area, presented with a giant rhinophyma which caused him not only upper airways obstruction and difficulty in eating, but also aesthetic and psycho-social disadvantages.The treatment of the patient was a surgical intervention consisting in removal of the nasal tumor and split-thickness skin grafting of the defect. The aesthetic result after surgical intervention was very good, there were no postoperative complications or recurrences.Rhinophyma represents the most advanced form of acne rosacea. The diagnosis is easy to establish based on the clinical features of the disease. In advanced forms of rhinophyma, when the tumor is giant, the main method of treatment is surgery.

The use of laparoscopic techniques in the treatment of rectal cancer was until recently regarded with skepticism, because it did not seem to fulfill the oncologic principles of open surgery. The first report of a rectal cancer case treated by using laparoscopy has been made approximately two decades ago. From that moment on, the laparoscopic technique, progressed thanks to the development of the optical devices that allowed the improvement of the laparoscopic image, as well as the progressive increase of experience of the surgical teams specialized in colorectal laparoscopic surgery. These advantages (the faster recovery of the bowel function, less postoperative pain, lower blood loss, decreased hospitalization period) make the laparoscopic surgery a viable option for the treatment of rectal cancer. Recently published studies prove the similar results between open surgery and laparoscopic surgery for rectal cancer, in terms of mortality and postoperative morbidity, local recurrence, long-term survival or postoperative complications (anastomotic fistulas, bladder dysfunction, and sexual dysfunction), some studies even revealing the superiority of the laparoscopic surgery in preserving the function of the pelvic nerves.

The trap parameters of defects in Si/CaF 2 multilayered structures were determined from the analysis of optical charging spectroscopy measurements. Two kinds of maxima were observed. Some of them were rather broad, corresponding to "normal" traps, while the others, very sharp, were attributed to stress-induced traps. A procedure of optimal linear smoothing the noisy experimental data has been developed and applied. This procedure is based on finding the minimal value of the relative error with respect to the value of the smoothing window. In order to obtain a better accuracy for the description of the trapping-detrapping process, a Gaussian temperature dependence of the capture cross-sections characterizing the stress-induced traps was introduced. Both the normal and the stress-induced traps have been characterized, including some previously considered as only noise features. ©2011 American Institute of Physics.

The temperature dependence of the capture coefficients in trapping phenomena is investigated. It is proved that, besides the dependence induced by the thermal velocity of the carriers, the stress-induced traps at the interfaces of the multi-layered structures present a supplementary temperature dependence. This dependence is found to be of Gaussian type and is in a good agreement with the experimental results. © 2010 IEEE.

Sinusoidal hemangioma is a rare type of cavernous hemangioma with different clinico-pathological aspects. They are usually localized in the extremities with interest in the subcutaneous layer. The new imaging techniques play an important role in diagnosis, evaluation and follow-up of these types of tumors. We describe the case of a 21-year-old patient, four times operated for a recurrent soft tissue tumor, located intramuscularly in the distal third of the upper limb. Plain X-ray and computer tomography (CT) showed a nonspecific mass with calcification. The MRI (magnetic resonance imaging) exam demonstrated a lobulated heterogeneous signal tumor mass in the biceps brachial muscles, with high signal intensity on T2 weighted images and intermediate signal on T1 weighted images. MRI accurately assessed the extent of the tumor and evaluated the recurrence. MRI imagings combined with contrast-enhanced sequences were used to classify the lesions in low flow vascular disorders. CT angiography with multiplanar reconstructions (MPR), maximum intensity projections (MIP) and volume-rendered reconstructions (VR) was useful in confirming the venous origin of the tumor.