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Just like the Treaty of Brest-Litovsk (March 3, 1918), The Treaty of Buftea (Bucharest), signed on May 7, 1918, translated into international law a state of affairs brought into existence by the collapse of the former Tsarist Empire. The revolutions of 1917, which shook the huge Tsarist Empire from its very foundations, and the disintegration of the administrative and military structures made impossible any resistance on the eastern front, which stretched from the Baltic Sea to the Black Sea. On the Romanian front, where there were deployed almost one million Russian soldiers, the situation was even more serious, given that the Romanian government faced not only the presence of foreign troops on its national territory, but also the possibility of a war on two fronts due to the disorganization, anarchization and communization of Russian military units. In this context, the Armistice of Focșani (December 1917) and the beginnings of the negotiations for a separate peace represented unavoidable steps. [ABSTRACT FROM AUTHOR]

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One of the main markers of arterial stiffness is pulse wave velocity (PWV). This parameter is well studied as a marker for end-organ damage in the adult population, being considered a strong predictor of major cardiovascular events. This study assessed PWV in children with chronic kidney disease (CKD) as a marker of cardiovascular risk. We conducted a prospective observational single-center cohort study of 42 consecutively pediatric patients (9–18 years old) with terminal CKD and dialysis, at the Hemodialysis Department of the "M. S. Curie" Hospital, Bucharest. We measured PWV by echocardiography in the ascending aorta (AscAo) and the descending aorta (DescAo), and we correlated them with left ventricular hypertrophy (LVH). Fifteen patients (35.7%) presented vascular dysfunction defined as PWV above the 95th percentile of normal values in the AscAo and/or DescAo. Cardiac disease (LVH/LV remodeling) was discovered in 32 patients (76.2%). All patients with vascular damage also had cardiac disease. Cardiac damage was already present in all patients with vascular disease, and the DescAo is more frequently affected than the AscAo (86.6% vs. 46.9%). Elevated PWV could represent an important parameter for identifying children with CKD and high cardiovascular risk. [ABSTRACT FROM AUTHOR]

Introduction. Superior mesenteric artery syndrome is a rare cause of upper gastrointestinal tract obstruction. Case presentation. A 17-year-old adolescent is admitted in the Pediatrics Department of "Grigore Alexandrescu" Hospital in Bucharest in July 2018 for episodes of vomiting associated with epigastric pain. The patient started presenting persistent abdominal pain since five years before, apparently after an appendectomy. In the last year, he associated heartburn, dysgeusia, food vomiting and postprandial plenitude. A diagnosis of H. pylori acute gastritis was initially set and he received triple therapy with temporary relief. Due to chronic digestive symptoms, the adolescent presented anxiety related to food intake with extremely reduced appetite, food selectivity and lack of weight gain. The clinical examination revealed marfanoid phenotype, low weight, chest deformity, excavated abdomen, epigastric pain and clapotage. Laboratory investigations were within normal limits. Esogastroduodenal barium examination showed an important gastric stasis with an elongated stomach, dilation of the second part of the duodenum with delayed distal passage. Abdominal ultrasound revealed reduced aorto-mesenteric distance at the third part of the duodenum. Upper gastrointestinal endoscopy found barium residue in the stomach 24 hours after the contrast study and a spastic pylorus, with impossible safe duodenal passage. Abdominal computed tomography confirmed obstruction of the third part of the duodenum by vascular compression at the aorto-mesenteric angle, a specific image for superior mesenteric artery syndrome. The patient underwent laparoscopic surgery with a good outcome. Conclusions. Although a rare entity, duodenal obstruction by aorto-mesenteric clamp must be taken into account in the differential diagnosis of vomiting. An early radiologic diagnostic spares the patient of chronic digestive disease with negative impact on nutritional status and quality of life. [ABSTRACT FROM AUTHOR]