Category Archives: AMM 2015, Volume 61, Number 1

Chronic Hepatitis and Hepatocellular Carcinoma: A New Perspective for an Old Issue

Bățaga Simona

University of Medicine and Pharmacy of Tirgu Mures, Clinic of Gastroenterology

In the past 30 years a major progress was recorded in the management of the liver diseases. At the beginning of the years 1990 we considered most of the liver cirrhosis as alcoholic, as the viral markers were not available. Later on, when the etiology of liver cirrhosis was better established, the reality showed that viral B and C cirrhosis was prevalent in our country.

After 1990 a rigorous screening was implemented for donated blood, which led to a dramatically decrease in the transmission of the B and C hepatic viruses. Another preventive measure introduced by the health societies was to increase the efforts to educate the general public about hepatitis C and B, so that the number of people infected by tattooing or razors has significantly decreased since a more coherent preventive policy was implemented in this respect. After 1990 the antiviral treatment (interferon and molecules) became available.

The paper “Predictors of hepatocellular carcinoma (HCC) in patients with liver cirrhosis” is addressing a very important topic, the etiology of liver carcinoma. This cancer is now the fifth most common type of cancer (in men) and the second leading cause of cancer-related death worldwide (1).  [More]

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The Carbon Dioxide Absorber Based on Lithium Hydroxide

Zilberman P

Hadassah University Medical Center, Har Hatzofim Campus, Anesthesia Department, Jerusalem, Israel

DOI: 10.1515/amma-2015-0023

Carbon dioxide absorbers have been used in anesthesiology for many years. However, this process is not limited to this field of medicine. Removing carbon dioxide from human environment is used in other areas as well: mining industry, submarines, scuba diving, space travel and many others. The rationale to remove carbon dioxide from confined spaces is that cannot be eliminated otherwise. Anesthesia practitioners are well aware of this component of the circle system, the carbon dioxide absorber. In daily practice, the clinician is less concerned with what kind of substance fills the dedicated canister, as this is usually in the care of the maintenance personnel. The appearance of Sevoflurane and Desflurane, with their own chemical characteristics, prompted the clinician to dedicate new attention to these absorbents. The classical substances used for this purpose are different combinations of limes. The practical concern of the anesthesiologist is to notice when the absorbent is consumed and call for its replacement. Still, many other aspects remain: compound A formation with Sevoflurane, carbon monoxide formation with Desflurane and dry absorbent for instance. The latest member of these products in the medical field is the LiOH carbon dioxide absorbent. Although used for many years in the space exploration, its way into the operating room is a rather recent achievement. Special chemical properties and high absorptive capacity make this new type of absorbent an attractive option for modern anesthesia practice. The article below invites the reader through a short journey on the history of the CO2 absorbents and anesthesia circuits, Lithium as a chemical element and, finally, to this new type of absorbent.

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Sphincter Saving Techniques in Low Rectal Cancer Surgical Treatment: Results, Perspectives

Russu C1, Copotoiu C1, Bud V2, Saracut C2, Gherghinescu M1, Molnar Varlam C3, Molnar C1

1 University of Medicine and Pharmacy of Tirgu Mures, Surgical Clinic no. 1, County Clinical Emergency Hospital Targu Mures, Romania
2 County Clinical Emergency Hospital Targu Mures, Romania
3 University of Medicine and Pharmacy of Tirgu Mures, Obstetrics and Gynecology Clinic no. 1, County Clinical Emergency Hospital Targu Mures, Romania

DOI: 10.1515/amma-2015-0013

Objective: Sphincter saving techniques in low rectal cancer represents a challenge for the surgeons in their attempt to preserve the sphincter function and also to respect the principles of oncological surgery, in order to improve the quality of the patient’s life. The paper’s aim is to compare different sphincter saving techniques in regards to the early postoperative results.
Methods: An observational, retrospective study was performed on 76 patients (N = 76) operated for low rectal cancer in the Surgical Clinic no.1 of the Targu Mures Emergency Clinical County Hospital, between January 2010 and October 2014, to whom the rectal resection was followed by a primary restorative technique for preservation of the sphincter function. The immediate postoperative results after different types of sphincter saving procedures were analyzed and compared.
Results: From the studied patients, in 41 cases (53.94%) an anterior rectal resection with low colorectal anastomosis was done („very low” Dixon procedure), for 29 patients (38.15%) a sphincter saving technique with a peranal anastomosis was performed and in 6 cases (7.89%) an intersphinteric rectal resection with coloanal anastomosis was made.
Conclusions: Sphincter saving techniques, if oncological principles are respected, represents a viable option in the treatment of low rectal cancer and brings hope for improving the quality of the patients’ life.

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