Abdominal Wall Reconstruction–Diagnostic and Therapeutic Algorithm

Due to its complex structure, the abdominal wall is vital as it serves to protect the internal organs, maintain the upright position and regulate the intraabdominal pressure. Complex abdominal defects are a major health problem, with challenging treatment, many complications and risks. It is not a completely elucidated pathology as there is no consensus in literature regarding the definition and classification. Although there are various reconstruction techniques, there is no sistematic protocol in literature that allows the surgeon to choose the best treatment suitable for each patient. Therefore, the first step to manage these patients is a carefull assesment of the patient background and only after that, a complete analysis of the actual wound should be made. Second step is appropriate abdominal wall closure. After the analysis of current data from international literature, we identified a decision-making algorithm to offer guidance in surgical management in order to obtain an optimal functional outcome. The foundation of the algorithm is the idea of gradually improving the local tissue status, in order to deal with a clean wound as much as possible. This way, the success rate of the surgical reconstruction improves

Nerve compression due to benign tumors or ganglion cysts in the upper limb – case series

Tumor nerve compressions in the upper limb are relatively rare, usually involving ganglion cysts and benign tumors. We present a case series of five patients with peripheral nerve compression in the upper limb due to tumor or cystic masses- ulnar nerve compression in the Guyon’s tunnel due to a ganglion cyst, large median nerve schwannoma compressing anterior interosseous nerve and median nerve, voluminous lipoma compressing median nerve in the proximal forearm, superficial branch of radial nerve compression by a synovial cyst and elbow region lipoma compressing radial nerve. In the beginning, those benign lesions are asymptomatic but, as they continue to grow adjacent to a peripheral nerve clinical manifestations appear progressively as compressive neuropathies. After a preoperative imagistic analysis, tumor resection with careful dissection, in order to preserve the neurovascular structures, is the elective surgical procedure in order to obtain an optimal functional recovery

Optimizing Non-living Models for Effective Microsurgical Training

Microsurgery, a pivotal surgical field that changed medical perspectives in the 20th century, presents numerous technical challenges due to the precision it requires from the surgeon. To acquire the requisite skills, comprehensive training is imperative. Initiation into microsurgical training on experimental models is a prerequisite before translating these skills to clinical applications. The employment of non-living models in medical training offers a myriad of advantages, notably characterized by their accessibility and cost-effectiveness. Non-living models, such as latex gloves, leaves, flower petals, silicon tubes and chicken legs, provide aspiring microsurgeons an opportunity to train the essential technical skills required in microsurgical practice. Such models significantly alleviate ethical concerns associated with the use of live specimens and human cadaveric models. Furthermore, they exhibit a satisfactory emulation of human vascular properties, providing a realistic context for medical practice. Although the primary focus of this paper is on non-living models, it is important to highlight the transition to living models, specifically small animal models, as a mandatory and advanced phase in microsurgical training, before translating to clinical practice

A 2500-yr late holocenemulti-proxy record of vegetation and hydrologic changes from a cave guano-clay sequence in SW Romania

We provide sedimentological, geochemical, mineral magnetic, stable carbon isotope, charcoal, and pollen-based evidence froma guano/clay sequence in Gaura cuMuscă Cave (SWRomania), fromwhichwe deduced that from ~1230 BC to ~AD 1240 climate oscillated betweenwet and dry. From ~1230 BC to AD 1000 the climate was wetter than the present, prompting flooding of the cave, preventing bats fromroosting, and resulting in a slowrate of clay accumulation. The second half of the MedievalWarm Period (MWP) was generally drier; the cave experienced occasional flash flooding in between which maternity bat roosts established in the cave. One extremely wet event occurred around AD 1170, when Fe/Mn and Ti/Zr ratios show the highest values coincident with a substantial increase of sediment load in the underground stream. The mineral magnetic characteristics for the second part of the MWP indicate the partial input of surface-sourced sediments reflecting agricultural development and forest clearance in the area. Pollen and microcharcoal studies confirm that the overall vegetation cover and human land use have not changed much in this region since the medieval times

Little climate optimum in the Carpathian-Danubian-Pontic space

Our knowledge of climate during the Little Climate Optimum (VIII-XIV centuries) in our country comes from some historical studies on climatic events occurring in countries around Romania: Hungarian, Italian peninsula, Ukraine, the Balkan peninsula and the region around Constantinople, from foreign chronicles, French, German, Russian, from some notes of foreign travelers in that territory. Were record mostly harsh winters, especially in the early interval, with frozen rivers and the Black Sea, or rainy summers, with floods, but also some very warm winters, with the flowering of trees in January, and summers long, hot and dry. Some of these events led to famine, pestilence, high morbidity

Little Ice Age in Romania in the Vision of a Syrian Traveler

Archdeacon Paul of Aleppo of Damascus accompanied the Patriarch Macarios of Antioch, in Moldavia, Wallachia, Dobrogea for nearly seven years (1652-1659), just in time considered one of the coldest during the Little Ice Age, Maunder Minimum namely (1645-1715). His journey is recorded in his travel diary, written in Arabic and translated into Romanian in 1900. Romanian historians were particularly concerned with the information provided by the passenger about the towns, monasteries, and farmhouses, aspects of daily life, customs, habits and Romanian economy countries. But Paul of Aleppo describe and climate issues, particularly cold winters with frost Danube, snowy, storm at sea, rain, floods, etc. It is a very rich source of information in this area, so far little taken into consideration, showing that the Little Ice Age was also evident in Eastern Europe