Upper limb trauma cases vary from simple to high energy impactful injuries, with different etiologies; situations which frequently require unique, demanding and challenging endeavors in order to obtain the most favorable outcome. Experience, good decision-making and knowledge of functional goals are mandatory in order to elaborate a therapeutic plan and execute it accordingly. Although cases differ in nature and prognosis, respecting a set of therapeutic principles whilst dealing with either simple or complex cases, will enhance patient outcome and give the surgeon the confidence to tackle any kind of upper limb trauma. After clearing out vital threat, the emergency surgery represents the first threshold in achieving and restoring normal function and biomechanics, mostly in young and labor active patients, with the mindset to salvage as much tissue as possible, with a thorough debridement and step-by-step approach to different types of tissues. Secondary surgery and reconstructive surgery can be planned timely, with prior discussion with both the therapist and the patient in order to enhance patient’s upper limb function and aesthetic and ensure social reintegration.

Mercury and aluminum poisoning affects the entire human body, the cumulative toxic effects being noticed especially at the cognitive, neurological and metabolic level. Toxicity with heavy metals such as mercury, aluminum, arsenic, lead is one of the biggest threats to our health. The diagnosis of mercury, aluminum and arsenic poisoning is an important step in establishing food and chelation therapy, with an emphasis on the cause, not on the symptoms. We present the case of a 46-year-old patient with symptoms manifested for a period of 2 years, who was exposed to treatments structured according to manifestations, without improving the conditions presented, without performing specific investigations of heavy metal poisoning. The personalized diet and treatment plan, used in the case of this patient, for a period of 3 months were distinguished by a total solution of the manifestations initially presented, no side effects.

Introduction. Complex incisional hernias are a surgical challenge and a current socio-economic problem. In the emergency surgery of this pathology, the surgeon faces the need to obtain a "tension-free" hernia repair being limited in the use of parietal prosthesis due to the frequent needs of opening the gastrointestinal tract and thus contamination of the operating field. Purpose. The aim of this study is to evaluate and adapt emergency surgical treatment in order to reduce the risk of postoperative complications. Material and methods. The present study has a retrospective character and evaluates a group of 390 patients with complex incisional hernias admitted and operated in the General and Emergency Surgery III section of the Bucharest University Emergency Hospital during 2008-2018. Results. We identified 390 patients diagnosed with complex incisional hernias, of whom 95 were presented to the hospital as an emergency.The prosthetic hernioraphy was used in 51 of these patients, and complications were found in 18 patients in the total study group, ranging from wound infection to death. Discussions. The occurrence of postoperative complications was not statistically significantly associated with emergency surgical treatment. Instead, vital complications were much more common in this group. Conclusions. Increasing the degree of information and education of the patient, increasing addressability and avoiding emergency operations for this pathology are long-term objectives in the treatment of complex incisional hernia pathology.

Introduction. In the last 30 years, the incidence of non-melanocytic skin tumors (NMRTs) has increased alarmingly. The most common subtype of TCNM is basal cell carcinoma followed by squamous cell carcinoma. Material and method. This retrospective study was performed on a group of 140 patients. Patients diagnosed with C44 nonmelanocytic malignancy according to ICD-10 were included in the study. Results. Of the 140 patients, 118 (84%) received the presumptive diagnosis of CBC and 17 (12%) the diagnosis of CSC. Histopathological examination confirmed the diagnosis of CBC in 76% of cases and that of CSC in 58% of cases. Regarding the number of lesions, cases with a single lesion predominate (94%). In terms of clinical form, the most common type of basal cell carcinoma in the study group was 75% nodular carcinoma. Conclusions. There is a need for more studies for the application of prevention and proper management from the family doctor to the specialist.

Graves ophtalmopathy (GO), thyroid eye disease (TED) and thyroid - associated orbitopathy (TAO) are terms referring to an autoimmune inflammatory process that affects the adipogenesis of orbital fat and periorbital tissue, associated with dysthyroidism. On imaging, such as computed tomography (CT) thyroid -associated orbitopathy (or thyroid -associated ophtalmopathy) is characterised by symmetrical and bilateral proptosis, secondary to extra-ocular muscle (EOM) enlargement and expansion of orbital fat. Imaging studies ca be useful in identifying patients risk to develop dysthyroid optic neuropathy and initiating early treatment of the condition, avoiding permanent visual loss. The purpose of this study was to reveal the prevalence of thyroid ophtalmopathy imaging considerations in Graves disease patients. A total of 19 patients were evaluated on computed tomography scanning the diameters and density of extra-ocular muscles, muscular index, proptosis, width of the optic nerve, width of superior ophthalmic vein and lacrimal gland position.

The First World War was and is considered the most terrible conflagration of all time. Thus, over 65,000,000 soldiers made up the corps of land armies, naval and air forces, combat armies that participated in the conduct of military operations during the First World War. About 8,500,000 people died and more than 21,000,000 were injured. France was one of the countries most affected by this war, its medical services, including dentistry and oral and maxillofacial surgery, being completely obsolete. Thus, in this material, we tried to describe some important figures of French oral and maxillofacial dentistry and surgery, which were active in French civil and military hospitals during the First World War (1914-1918).

Ovarian cancer represents one of the most aggressive gynecological malignancies affecting women worldwide, associated with significant rates of cancer related death within the first years after the initial diagnostic. The poor survival rates are usually explained by the presence of disseminated lesions even from the beginning. In such situations, the digestive tube is one of the most commonly involved territory, therefore necessitating extended resections in order to achieve complete cytoreduction. The aim of this paper is to report the case of a 53 year old patient who was diagnosed with peritoneal carcinomatosis from ovarian cancer, presenting multiple levels of digestive tract involvement due to the presence of disseminated tumoral masses. Therefore the patients was submitted to multiple digestive resections represented by parcelar gastrectomy, segmental ileal resection and subtotal colectomy. In order to minimize the risks of developing severe postoperative complications – due to the relatively high number of anastomoses – the continuity of the digestive tract was established by a terminal ileostomy, considering that creation of a ileorectal anastomosis would be too dangerous in the context of multiple digestive resections. The postoperative evolution was simple, the patient being further submitted to adjuvant treatment.

An essential aspect of human health is sleep. Sleep, among others, interacts with the immune system, plays a role in restoring the body's energy, healing and brain function. Insomnia is often noticed in medical practice, is considered a public health problem. Acute sleep deprivation can alter cognitive performance, and chronic sleep deprivation can lead to disease development. Lack of sleep affects all major systems in the human body, and the major changes that occur in chronic insomnia have been associated with many conditions such as type 2 diabetes, cardiovascular disease, asthma, thyroid disease and gastroesophageal reflux disease.

The spleen is one of the most vulnerable organs in abdominal injuries by contusive mechanism. The treatment of post-traumatic splenic lesions has constantly evolved from surgery to nonoperative treatment in order to preserve the functions of this organ and especially the immunological one. The development of modern technology has supported the nonoperative approach to spleen trauma with main reference to interventional radiology and its role in the patient with transient hemodynamic instability. The article presents the modern, innovative concepts in traumatology, concepts that allow the ideal treatment of the polytraumatized.

Acute promyelocytic leukemia (APL) is a distinct subtype of acute myeloid leukemia (AML) with a generally good prognosis but characterized by potentially severe hemorrhagic complications due to coagulopathy, and thus possibly high early mortality. We present the case of a young patient with APL, with a complication which was unresponsive to conservative treatment and required surgical resection, namely herpetic lesion complicated with infection and necrosis. This case sustains the importance of teamwork in hematologic patients.