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Search Results: 1 - 10 of 7037 matches for " Daniela Trandafir "
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Bisphosphonates-induced osteonecrosis of the jaws
Daniela Trandafir,,Violeta Trandafir
Jurnalul de Chirurgie , 2012,
Abstract: Bisphosphonates are a group of therapeutic agents with a pyrophosphatelike chemical structure and clinical application related to the antiosteolytic and antiangiogenic effects. Bisphosphonates oral administration regimens are widely used to treat osteoporosis, while intravenous regimens for the treatment of metastatic bone disease complications or primary osteolytic pathology. However, bisphosphonates are known as therapeutic agents that decrease theeffects of hypercalcemia in malignant disease or relieve pain associated with various bone pathologies. Review of medical literature in the last 10 years reveals that osteonecrosis of the jawassociated with bisphosphonate therapy has been described especially in patients who were administered intravenous form and is generally linked with a traumatic factor (tooth extraction). It also shows that there is an increase in cases of bisphosphonates-induced steonecrosis of the jaws in patients using long-term oral preparations, which upports the hypothesis of a cumulative effect of these products involved in disease pathogenesis. Medical literature refers to ifferent treatment regimens of this new clinical entity iscontinuation of bisphosphonate therapy, surgical debridement/resection for longer-term palliation of infection and pain, hyperbaric oxygen therapy,broad-spectrum oral antibiotics) but there is no standardized treatment protocol universally accepted. iven the insufficient knowledge pathogenesis of bisphosphonates-associated osteonecrosis of the jaw and the potency of different types of bisphosphonates used today in medical practice, prevention of this condition is considered superior to treatment, recommendingappropriate procedures are carried out to ensure a good dental-periodontal status before starting treatment with bisphosphonates.
TODAY’S STRATEGIES IN OROPHARYNGEAL CANCER TREATMENT
Daniela Trandafir,Violeta Trandafir,D. Gog?lniceanu
Jurnalul de Chirurgie , 2010,
Abstract: Traditionally, surgery and/or radiation therapy have been the standards for treatment of oropharyngeal cancers. These treatment modalities are frequently complicated by suboptimal control of locoregional disease and significant longterm functional deficits. It is very difficult to define the optimal therapeutic approach to the oropharyngeal cancer, because no single therapeutic regimen offers a superior survival over other regimens. Although specific indications for primary surgical resection exist, there are studies that confirm that the concurrent use of multiagent chemotherapy and radiation has become the standard of care for the management of patients with late-stage disease, and surgery is often reserved for salvage of those patients who fail definitive nonoperative treatment. Aggressive radiation therapy with concurrent multiagent chemotherapy have consistently demonstrated a survival and locoregional control benefit. This treatment approach emphasizes organ preservation and functionality. It is also very important to understand that the ultimate therapeutic choice will depend on a careful review of each individual case, paying attention to the staging of the neoplasm, the general physical condition of the patient, the emotional status of the pacient, the experience of the treating team, and the available treatment facilities.
MALIGNANT SALIVARY GLAND TUMORS
Violeta Trandafir,Daniela Trandafir,Eugenia Popescu
Jurnalul de Chirurgie , 2010,
Abstract: Malignant salivary gland tumors make up 6% of all head and neck tumors. Several types of cancer can develop in these glands. Only malignant tumors of the salivary glands are discussed in this paper. The diagnosis and treatment of salivary gland malignancies remain complex, with challenging problems for maxillo-facial surgeon. Scientists have found few risk factors that make a person more likely to develop salivary gland cancer. Salivary gland cancer is uncommon, and there is no widely recommended screening schedule for this cancer. CT scanning or MRI is useful for determining the extent of large tumors, for evaluating extraglandular extension, for determining the actual depth of parotid tumors, and for discovering other tumors in one gland or in the controlateral gland. Fine-needle aspiration biopsy (FNAB) is a valuable diagnostic adjunct in evaluation of head and neck masses but its role in evaluation of salivary gland tumors is controversial. There are also discussed some histologic findings about mucoepidermoid carcinoma, adenoid cystic carcinoma, acinic cell carcinoma, carcinoma ex-pleomorphic adenoma, squamous cell carcinoma and adenocarcinoma developed in salivary glands. Carefully planned and executed surgical excision is the primary treatment for all malignant tumors of the salivary glands. The principles of surgery vary with the site of origin. The extent of surgery is based on the size of the tumor, local extension and neck metastases. Staging of malignant salivary gland tumors is important for predicting prognosis and for accurate comparison of treatment results.
BENIGN SYMMETRIC LIPOMATOSIS - LAUNOIS-BENSAUDE SYNDROME OR MADELUNG'S DISEASE
D. Gogalniceanu,Daniela Trandafir,Violeta Trandafir
Jurnalul de Chirurgie , 2005,
Abstract: Benign symmetric lipomatosis (BSL) is a rare proliferative disorder of the adipose tissue, characterized by symmetrical fat deposits, predominantly in the neck and shoulder area, upper back and arms. A classification in three types according to the distribution of the pathological fatty was proposed by Donhauser (1991): type 1 (localized cervical fat proliferation); type 2 (pseudoathletic type); type 3 (gynecoid type). METHODS: This study contains the analyse of a lot of ten patients with BSL, which were treated in our department between 1994 - 2004. The followed parameters were: sex, age, heredo-collateral antecedents, associated organic diseases, the motivation of medical addressability, the sites of first lesions, the length of evolution before the admission, methods for diagnosis, number of surgical sessions necessary to extirpation of fat deposits, the results of the periodic follow-up examination. RESULTS: The followed patients with BSL were treated by surgery (extirpation of the inaesthetical cervical fat masses): one surgical session (8 cases); two sessions (2 cases). The follow-up examinations (clinical and laboratory tests) were accomplished at 3 months, 6 months, 1 year and 3 years (meanly regarding local recurrence). 8 cases: good results; 1 case: the associate peripheral neuropathy due to alcohol abuse made worse; 1 case: in course of pursuit. Recurrence at the site of surgery was not detected in any of the follow-up subjects. All of the patients were satisfied with the surgical result. CONCLUSIONS: The elective treatment in BSL is surgical, by extirpation of the lipomatous masses; a satisfactory, lasting result can be expected only after the most radical possible extirpation (not only for cosmetic intentions ). Our study doesn't take down any local recurrence after the wide extirpations of the cervical disfigurement fat deposits (sometimes was necessary concomitent extirpation of the infiltrative structures - parotidectomy or submaxillectomy ).
SARCOMAS OF THE HEAD AND NECK
D. Gog?lniceanu,Violeta Trandafir,Daniela Trandafir,Eugenia Popescu
Jurnalul de Chirurgie , 2009,
Abstract: Sarcomas of the head and neck are rare malignancies constituting about 0,8% of all head and neck tumors. These tumors can arise from either bony or soft tissue, depending on the mesenchymal cells from which they derive. Aim: The aim of this study is to assess the role of radical surgery, radiotherapy and chemotherapy in sarcomas of the head and neck. Material and method: In the following analysis we present the clinical and pathological aspects, treatment modalities and outcome of head and neck sarcoma patients treated in the Department of Oral and Maxilo-Facial Surgery from Ia i, between 2002 and 2006. Results: 16 cases of sarcomas involving the head and neck were reviewed. The male to female ratio was 2.2. Mean age of occurance was 38.8 years with a range of 8 to 80 years. Soft tissue was the site of origin in 10 cases, maxilla in 3 cases and mandible in 3 cases. Radical surgery with postoperative adjuvant radiotherapy and chemotherapy was the most common mode of treatment. Recurrence occurs in 7 patients during a mean follow-up of 7.8 months. Conclusions: The ability to resect the primary tumor with margins free of disease was a good prognostic factor. The value of adjuvant chemotherapy and radiotherapy for the treatment of patients with sarcomas of the head and neck is equivocal.
A VOLUMINOUS OSSIFYING FIBROMA OF THE MANDIBLE - CASE REPORT
D. Gogalniceanu,Daniela Trandafir,Carmen Vicol,Violeta Trandafir
Jurnalul de Chirurgie , 2006,
Abstract: Ossifying fibroma is a rare, benign fibro-osseous tumor that most commonly occurs in the bones of the craniofacial skeleton. This well-demarcated lesion is composed of fibrocellular tissue and mineralized material of varying appearances. Ossifying fibroma is a slow-growing, asymptomatic neoplasm that can reach a very large size. Differentiation from other forms of fibro-osseous lesions, such as monoostotic fibrous dysplasia, is often quite difficult. This paper presents a rare case of a voluminous mandibular ossifying fibroma which gave us serious problems of diagnosis and treatment. We have performed a bloc osseous resection which has preserved the alveolar border and has permitted (by apical resections) the conservation all the dents which apical roots were included in the tumoral aria. Surgical treatment in this case has also needed (in the same operation) a reconstructive surgery (because of the estetic and functional considerents). The defect created by the excision of this large lesion was reconstructed with an iliac bone graft and a titanium reconstruction's atela.
LIPOMAS: RARE TUMORS OF THE PAROTID GLAND
Daniela Trandafir,D. Gog?lniceanu,Violeta Trandafir,Carmen Vicol
Jurnalul de Chirurgie , 2007,
Abstract: Lipomas are the most commonly encountered benign mesenchymal tumors, arising in any location where fat is normally present. Their occurence in the head and neck area is relatively rare (25% of lipomas). Lipomatous lesions accounted for only 0.6-4.4% of all parotid tumors and, therefore, are often not considered in the initial differential diagnosis of a parotid mass. 14 cases of lipomatous tumors of the parotid glands (1.5% of all parotid tumors) have been diagnosed and treated in our department during 15 year-period (1992-2006); six were focal lesions and eight were diffuse lipomatosis. The most common presentation was that of a slowing enlarging, soft and painless mass. Clinical examination alone is insufficient to identify the nature and location of parotid lipomas. Ultrasonography, high-resolution CT scanning, magnetic resonance imaging (MRI) and fine needle aspiration biopsy (FNAB) may be helpful in diagnosis. None of these preoperative examinations allows an absolute reliable distinction between a lipoma and a liposarcoma. All patients were treated by surgical excision. Superficial parotidectomy was the treatment of choice and no recurrence was detected in 3 years (mean period) of follow-up. Surgical intervention in these tumors is challenging because of the proximity of the facial nerve, and thus, knowledge of the anatomy and meticulous surgical technique are essential. The postoperative aesthetic and functional results were the major concerns. The complete surgical excision will minimize the possibility of a recurrence and will also lead to a definitive diagnosis.
LAUNOIS-BENSAUDE SYNDROME AND THE ROLE OF CERVICOFACIAL SURGERY
Daniela Trandafir,D. Gog?lniceanu,Violeta Trandafir,Eugenia Popescu
Jurnalul de Chirurgie , 2009,
Abstract: Launois-Bensaude syndrome is a rare proliferative disorder of the adipose tissue with onset in adulthood. The disease is characterized by symmetrical fat deposits, predominantly in the neck and shoulder area, upper back and arms. There is a strong association between this disease and moderate to heavy alcohol consumption. During a recent 16 years period (1992-2007), 19 patients with Launois-Bensaude syndrome were treated in our department. A retrospective study had noted: clinical type of disease, the major complaints, biological disorders, radiological features, the associated diseases and the long-term outcomes after lipectomy. In all cases, the adipose deposits were removed by a traditional surgical technique, under intubation anesthesia. The group comprised 19 men aged 35 and 64 years old (median 47 years old). Alcoholism was confirmed in 17 cases. 13 of 19 patients were type I of disease’s clinical classification (Donhauser) and 6 were type II. The most common complaints were: aesthetics (15 cases), respiration disorders (2 cases), and reduced range of movement of the head (2 cases). The diagnosis was established from the clinical picture, but computed tomography and magnetic resonance imaging were of really help, especially in considerable cervical deformity and in deep localization of the fatty masses. We noted the following accompanying diseases: diabetes mellitus (4 cases), glucose impairment tolerance (2 cases), obesity (6 cases), hypertension (10 cases), gout (1 case), dislipidemic syndrome (10 cases), liver steatosis (8 cases), neuropathies (8 cases). The functional and aesthetic results were good in all patients and recurrence was not observed after 4 years of follow-up. There were no serious complications. Our long-term experience with the treatment of benign symmetric lipomatosis indicates that a lasting result can be only obtained after sufficiently radical surgery.
BROWN TUMOR OF THE FACIAL BONES
Violeta Trandafir,Daniela Trandafir,Otilia Boi?teanu,D. Gog?lniceanu
Jurnalul de Chirurgie , 2010,
Abstract: Brown tumor arises as a direct result of the effect of parathyroid hormone on bone tissue in some patients with hyperparathyroidism. The lesion localizes in areas of intense bone resorbtion, and the bone defect becomes filled with fibroblastic tissue that can deform the bone and simulate a neoplastic process. Brown tumors can affect the mandible, maxilla, clavicle, ribs and pelvic bones. Most patients with hyperparathyroidism are asymptomatic. Skeletal changes may represent the first manifestations of the disease. Radiologically, brown tumor in the jaws presents as a well-defined radiolucent osteolytic lesion, making it hard to differentiate it from other maxillary expansive lesions that can present with a similar imaging. Brown tumors exhibit no pathognomonic histologic changes. Differentiating between a brown tumor and other giant-cell tumors may be very difficult, even with histology. A final diagnosis can be defined only by evaluating the radiological findings with histopathological, laboratory and clinical data. At present, brown tumor is considered as a reparative cellular process rather than a real neoplasia. This phenomenon is considered as pathognomonic of hyperparathyroidism secondary to renal failure, especially in patients on long-term hemodialysis. The initial treatment of brown tumor involves control of hyperparathyroidism, regardless of whether it is primary or secondary. The clinical management of brown tumor aims primarily to reduce the elevated parathyroid hormone levels by pharmacological treatment. Surgical treatment is reserved to nonresponders or to patients with painful symptomatology or alteration of normal function. Brown tumor can recur if hyperparathyroidism persists or recurs.
MALT LYMPHOMA ASSOCIATED WITH PRIMARY SJ GREN’S SYNDROME – CASE REPORT
Eugenia Popescu,Daniela Trandafir,Violeta Trandafir,Otilia Boi?teanu
Jurnalul de Chirurgie , 2011,
Abstract: Sj gren’s syndrome is an autoimmune disease characterized by a lymphocytic infiltration of salivary and lacrimal glands leading to a progressive destruction of these glands and by production of autoantibodies. This disorder is either isolated (primary Sj gren’s syndrome) or associated with other systemic diseases (secondary Sj gren’s syndrome). The occurence of B-cell non-Hodgkin’s lymphoma represents the major complication in the evolution of Sj gren’s syndrome patients. We report a case of a female patient with a MALT (mucosa-associated lymphoid tissues) lymphoma associated with primary Sj gren’s syndrome and we review (from the recent literature) some clinical and therapeutic aspects of this combination of pathologies.
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