Search

Background: The prognosis of breast cancer patients is critical for tailored treatment options. While previous observational studies have identified various prognostic markers, a consensus in their clinical application is lacking. This single-center retrospective study aimed to validate the most frequent risk factors associated with increased mortality in breast cancer patients. Methods: Our study spanned an 8-year interval (2014-2020) and included 213 female patients with stage IIA-IIIB breast cancer. Key variables such as age, disease stage, and type of treatment were analyzed in relation to one-year survival as the primary outcome measure. Results: Elevated preoperative levels of tumor markers ACE and CA 15-3, larger tumor size, and advanced lymph nodal invasion were significantly associated with increased mortality. Immunohistochemistry indicated that the presence of Estrogen and Progesterone Receptors (ER and PR) were protective factors, whereas Human Epidermal Growth Factor Receptor 2 (HER2) was a negative prognostic indicator. Among molecular subtypes, Luminal A demonstrated protective effects, whereas HER2-positive and Triple-negative subtypes were identified as risk factors. Conclusion: This study confirms the significant role of tumor size, lymph node stage, and specific molecular markers in predicting breast cancer mortality. These findings contribute to a nuanced understanding of disease prognosis and offer crucial insights for clinicians in managing treatment plans., (Celsius.)

The novel Severe Acute Respiratory Syndrome Coronavirus-2 has put an enormous pressure on health systems around the world. The large number of severe cases that had symptoms seemingly unrelated to the respiratory system, continues to create confusion. The digestive tract is not spared either. The most commonly reported digestive symptoms are nausea, vomiting, anorexia, diarrhea and, less frequently but with significant impact, gastrointestinal bleeding. The elderly population is the one more likely to develop severe anemia clinically expressed by hematemesis, melena or hematochezia. From our experience and as we concluded from literature, men confirmed with COVID-19 have a higher risk of developing digestive haemorrhage. The upper gastro-intestinal tract, defined as the digestive segment above the Treitz angle, is more often affected. The gastro-duodenal ulcers are the main cause found in COVID-19 patients with digestive bleeding. In addition, the patients with SARS-COV2 infection and gastro-intestinal bleeding most commonly associate with other comorbidities such as hypertension and diabetes., (Celsius.)

Introduction: Abdominal injuries are responsible for approximately 20% of all post-traumatic deaths, 45-50% of which occurring in the first 60 minutes. Currently there are several prediction scores for the evolution of these patients, which take into account degrees of anatomical lesion, clinical signs and imaging and paraclinical explorations., Aim: The aim of the study was to develop a scoring system to predict mortality in patients with abdominal trauma by using the usual biological parameters., Method: A retrospective, descriptive, correlational and non-interventional multicenter study was performed on a sample of 157 patients with abdominal traumata, hospitalized between 2015- 2021, in the General Surgery and the Emergency III clinics of the Emergency University Hospital Bucharest, respectively in the Surgery I Clinic of the Mures County Emergency Clinical Hospital. The following biochemical parameters were analyzed: hemoglobin, hematocrit, leukocyte and platelet counts, coagulogram, glycemia, urea, creatinine, AST, ALT with the intent to have the correlation with the ISS and NISS mortality and traumatic scores. Microsoft Excel and MedCalc applications were used for the statistical analysis of the data. Results: The studied sample presented a sex ratio M:F = 2.82:1, the mean age was 47.45 +- 17.37 years. The elements that presented a correlation with a value greater than 0.3 (and p 0.01) were: age, ALT, AST, urea, hemoglobin, platelet count and glycemia. The cut-off values for these parameters in reference to mortality were established by analyzing the ROC curves. This fact allowed the outline of a predictive score that correlates well with the value of ISS and NISS, the obtained ROC curve using as parameters the value of the proposed risk score and mortality highlighting a good predictive power of the mortality with an AUC of 0.930 (p 0.001)., Conclusion: The results of our study showed that a number of biochemical parameters may contribute to shaping a score with predictive value in terms of the evolution of abdominal trauma patients., (Celsius.)

The complications of thyroidectomy vary from hypocalcemia and recurrent laryngeal nerve lesions to injury of vocal folds, local hematoma, cysts, granuloma. Post-operative hypocalcemia has an incidence of 1.2-40%. Permanent hyoparathyroidism is registered in 3% of cases. This is a brief narrative review focusing on the levels of calcium after performing a thyroidectomy and the need of calcium supplements under these circumstances. This complication, even it seems rather harmless at first, in fact it represents an important contributor to hospitalization delay and, especially for severe forms, to poor quality of life, including the risk of life threatening episodes. Devascularisation of parathyroid glands in addition to injury or dissection causes hypoparathyroidism. Hypocalcemia risk differs with sex (females have a higher risk), lymph node dissection (it increases the risk), it differs with type of thyroidectomy (larger dissections have a higher risk; also the intervention for recurrent goitre and second intervention for post-operatory bleeding increase the risk of hypocalcemia; while Basedow disease is probably at higher risk than multinodular goitre among benign conditions) and the duration of procedure. Pre-operatory low calcium, parathormon (PTH), 25-hydroxivitamin D increases the risk. The calcium drop rate matters as well: a decrease of 1 mg/dL calcium over 12 hours after surgery is independently correlated with the risk of symptomatic hypocalcemia. Early post-operatory PTH and calcium are best predictors for the need of oral calcium supplements. Routine post-operatory calcium and vitamin D supplementation statistically significant decreases the risk of developing transitory hypocalcemia and acute complications compare to calcium alone supplements or no supplements. In cases of hypoparathyroidism calcitriol is preferred., (Celsius.)

Background: Rectal cancer is a public health problem, being one of the most prevalent neoplastic localizations. The current surgical management of this pathology includes low anterior resection with colorectal anastomosis. The presentation as an emergency of these patients and the need for immediate intervention make it impossible to follow the necessary multimodal management. The present study proposes a comparative assessment of a series of cases where the intervention was elective, respectively emergency. Methods: This is a retrospective, observational, descriptive, unicentric study, that took place between 1st of January 2010 and 31st of December 2018 in the 3rd Department of General Surgery of the University Emergency Hospital Bucharest. We included in the study patients with the discharge diagnosis of rectal neoplasm who underwent curative surgical treatment consisting of low anterior resection performed in compliance with oncological safety principles. Conclusion: The emergency nature of the surgery influences whether or not a R0 type resection is obtained due to lack of adequate preoperative assessment (stadialization) and the presence or absence of neoadjuvant treatment rather than a technical defect., (Celsius.)

The purpose of our research is to synthesize the risk factors quoted in the literature which predispose to intra-abdominal hypertension occurrence following surgical repair of incisional hernias. We used for our research the Web of Science, Scopus and PubMed research platforms and we used the following search formula: (Intra-abdominal hypertension OR intra-abdominal pressure OR abdominal compartment syndrome) AND risk factors AND incisional hernia. The results were filtered according to the following criteria: language (English), publish year ( 2000) and access (in extenso). In this context, we chose to classify the risk factors for IAP increase in the following categories: (1) those related body habitus and anthropometry; (2) those associated with the presence of comorbidities; (3) those related to the defect of the abdominal wall; (4) those associated with the surgical management. Among the most important risk factors we mention: elevated BMI, chronic obstructive pulmonary disease, large incisional hernias with loss of domain, surgical technique used, prolonged surgeries and repeated attempts to close the defect., (Celsius.)

We present a retrospective descriptive study targeting the mortality in the European Union's countries during the past 30 years. Data was collected from the WHO (World Health Organization) database of global mortality. The aim of this study was the identification of particularities in the evolution of trauma-related mortality in before-mentioned countries. The results showed patterns of mortality related to socio-geographical conditions at different times in history and a general trend towards its decrease. Age was also an important factor to take into consideration. To conclude, we would like to point out the lack of studies and available research in trauma-related fields and also to underline their necessity and utility, especially in the pediatric department., (Celsius.)

Technological evolution dynamics has led to the exponential increase of the quantity of information published in all the scientific domains. In this context, there has been necessary to develop an objective method of reviewing the journals, articles and respectively the researchers. This paper represents a review of the evolution of traditional metrics based on citations., (Celsius.)