Category Archives: Review

The Usefulness of White Light Endoscopy, Narrow Band Imaging, and Magnification for the Optimization of Diagnosis in Barrett’s Esophagus

Boeriu Alina1*, Brusnic Olga1, Onișor Danusia1, Pascarenco Ofelia1, Boeriu C2, Dobru Daniela1

1 Department of Gastroenterology, University of Medicine and Pharmacy Tirgu Mures, Romania
2 University of Medicine and Pharmacy Tirgu Mures, Tirgu Mures County Emergency Hospital, Tirgu Mures, Romania

DOI: 10.1515/amma-2015-0002

The diagnosis of dysplasia and early neoplasia in Barrett’s esophagus by conventional endoscopy is based on a four- quadrant random biopsies protocol that is prone to sampling errors. Novel endoscopic techniques have been developed to enhance the detection of premalignant and malignant lesions by real time assessment of microvasculare architecture and mucosal structure. Chromoendoscopy with magnification has improved the visualization of lesions, but the dye application impairs a clear evaluation of vascular network. Narrow band imaging endoscopy enhances vascular imaging by using narrow bandwidth lights, with penetration to superficial mucosal structures. Different classification systems of mucosal and vascular patterns have been developed to improve the diagnostic accuracy of non-dysplastic and dysplastic BE, as well as of early esophageal cancer. This article is focused on both the clinical benefits and controversies surrounding conventional and advanced endoscopic methods used for screening and surveillance of patients with Barrett’s esophagus. Current evidence shows that the adoption of new technology in routine practice requires a high level of performance as well as the standardization of various classification systems.

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The inner representation of the external world – from conditioned reflexes to high level mental functions in the light of Nobel Prizes

Szilágyi T*, Orbán-Kis K

Department of Physiology, University of Medicine and Pharmacy of Târgu Mures, Romania

 

DOI: 10.1515/amma-2015-0001

In this paper the seminal results of the 2014 Nobel Prize in Physiology or Medicine Laureates are presented. First, a historical review of the development of our knowledge is provided along with the major paradigm shifts, by looking at the Nobel prizes awarded in the field of neuroscience in the last 110 years. We outline the major discoveries that were necessary for humankind to pass through the road leading to the remarkable understanding of high-level mental functions, which led to this year’s Nobel Prize award. Next, the ground breaking discoveries of this year Nobel laureates are presented, which provide insights how neural representations of the environment are formed in the association cortices. These cortical areas are many synapses away from sensory receptors and motor outputs, and their activity do not reflect directly the activation patterns of the receptor population, but depends more strongly on intrinsic cortical computations. We also present how ensembles of specialized cells work together to compute complex cognitive functions and behaviour.

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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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