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  • 1
    Online Resource
    Online Resource
    The use of osteoclast inhibitors in metastatic breast cancer
    Walter de Gruyter GmbH ; 2022
    In:  Romanian Journal of Orthopaedic Surgery and Traumatology Vol. 5, No. 1 ( 2022-06-01), p. 28-34
    Details
    In: Romanian Journal of Orthopaedic Surgery and Traumatology, Walter de Gruyter GmbH, Vol. 5, No. 1 ( 2022-06-01), p. 28-34
    Abstract: Introduction: In most patients, metastatic breast cancer (MBC) is incurable. Consequently, the goal in this setting is life prolongation and quality of life improvement, although possible long-term effects of anticancer treatment need to be considered. Bone is the most common site of metastasis in breast cancer and its complex management includes minimizing the risk of skeletal-related events (SRE), maximizing pain control, stabilizing or even restoring function, preventing spinal cord compression, hypercalcemia of malignancy and fractures and reducing the need for radiotherapy and orthopedic surgery. Aim: The present paper aims to compare the efficacy and safety of zoledronic acid (and other bisphosphonates) with denosumab in the management of bone metastases in breast cancer patients. Materials and methods: In this article, required information was collected through literature review and keyword query using the PRISMA 2020 guideline. Conclusions: In the metastatic setting, it appears that denosumab is indeed superior to zoledronic acid in delaying and preventing skeletal related events, except for spinal cord compression and risk of surgery, and equally efficient in treatment of already present bone pain and hypercalcemia of malignancy, with similar adverse effects, overall survival and disease progression.
    Type of Medium: Online Resource
    ISSN: 2544-8978
    URL: Article
    DOI: 10.2478/rojost-2022-0006
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2022
    detail.hit.zdb_id: 2977907-8
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  • 2
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    How to choose the bone modifying treatment for early stage and locally advanced breast cancer?
    Walter de Gruyter GmbH ; 2022
    In:  Romanian Journal of Orthopaedic Surgery and Traumatology Vol. 5, No. 1 ( 2022-06-01), p. 22-27
    Details
    In: Romanian Journal of Orthopaedic Surgery and Traumatology, Walter de Gruyter GmbH, Vol. 5, No. 1 ( 2022-06-01), p. 22-27
    Abstract: Introduction: Breast cancer continues to be the most frequent malignancy in women worldwide. Considerable advances in oncology over the years have led to decreased mortality in early stage (EBC) and locally advanced (ABC) breast cancer, but this has raised concerns about possible long-term effects of anticancer treatment nonetheless. Purpose: The present paper aims to describe the efficacy and safety of osteoclast inhibitors, both as antiresorptive agents, reducing osteoporosis and fracture risk, and as adjuvant anticancer agents, potentially improving disease-related outcomes in patients with early stage and locally advanced breast cancer. Materials and methods: In this article, literature sources were selected and evaluated using the PRISMA 2020 guideline. Conclusions: Bisphosphonates are recommended for early stage and advanced breast cancer patients, either premenopausal or postmenopausal, with osteoporosis. Denosumab may also be used for postmenopausal women. Bisphosphonates also showed a statistically significant benefit for overall survival in postmenopausal women only. However, denosumab is not presently used for indications other than prevention or treatment of osteoporosis.
    Type of Medium: Online Resource
    ISSN: 2544-8978
    URL: Article
    DOI: 10.2478/rojost-2022-0005
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2022
    detail.hit.zdb_id: 2977907-8
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  • 3
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    Extraperitoneal pelvic packing in trauma of the pelvis: A standard practice? A general review
    Walter de Gruyter GmbH ; 2019
    In:  Romanian Journal of Orthopaedic Surgery and Traumatology Vol. 2, No. 2 ( 2019-12-01), p. 120-124
    Details
    In: Romanian Journal of Orthopaedic Surgery and Traumatology, Walter de Gruyter GmbH, Vol. 2, No. 2 ( 2019-12-01), p. 120-124
    Abstract: Introduction: Pelvis fractures that associate bleeding with hemodynamic instability warrant immediate treatment. The therapeutic options in these cases vary from angioembolization to extraperitoneal pelvic packing. Material and method: The P.I.C.O.S guidelines were used to structure the questions and the research topic as to attain clinical validity. The results of the research were filtered in accordance with the PRISMA checklist. Results: 38 papers were identified. After screening, 27 papers were used to complete the analysis. Discussion: Frequently, bleeding has a venous source in the pelvis. In the case of pelvic fractures with hemodynamic instability, extraperitoneal pelvic packing is one of the core treatments but not a stand-alone treatment, as it needs to be coupled with a pro-efficient trauma resuscitation protocol. Its intended use is as a bridge therapy until conclusive investigations regarding the place of bleeding can be obtained. Angiography is recommended if hemodynamic instability exists after pelvic packing and effective hemodynamic resuscitation. Conclusion: Even with all these recent efforts, the wide-use of this therapy is precluded due to the absence of a standardized evaluation of these patients and large multicentric studies.
    Type of Medium: Online Resource
    ISSN: 2544-8978
    URL: Article
    DOI: 10.2478/rojost-2019-0022
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2019
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  • 4
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    Online Resource
    Trauma of the pancreas. A hidden disaster
    Walter de Gruyter GmbH ; 2020
    In:  Romanian Journal of Orthopaedic Surgery and Traumatology Vol. 3, No. 1 ( 2020-06-01), p. 49-54
    Details
    In: Romanian Journal of Orthopaedic Surgery and Traumatology, Walter de Gruyter GmbH, Vol. 3, No. 1 ( 2020-06-01), p. 49-54
    Abstract: Due to its anatomical position, traumatic lesions of the pancreas are rare and difficult to diagnose. Diagnosis time is paramount as an increase in duration translates into an increase in morbidity and mortality. Duct lesions are hard to identify on CT, ERCP being the investigation of choice but it is difficult to obtain as it requires highly specialized staff and equipment. Intraoperative macroscopic and palpatory evaluation of the pancreas in a trauma patient should be elective no matter what other lesions are present. The treatment is mainly dictated by this evaluation and is defined as it follows: stage I and II usually require a conservative approach; stage III, IV, and V usually imply resection of the pancreas although recent advances in conservative management have been made through ERCP and pancreatic duct stenting. In these stages, intraoperative evaluation should ensure the ampulla is intact if the head of the pancreas is not resected. Serum amylase and lipase levels do not offer a concrete direction towards a pancreatic lesion. Currently, there is no standard surgical treatment for these stages thus making intraoperative evaluation mandatory. One must remember that post-traumatic pancreatitis exists, which becomes apparent days after the accident.
    Type of Medium: Online Resource
    ISSN: 2544-8978
    URL: Article
    DOI: 10.2478/rojost-2020-0008
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2020
    detail.hit.zdb_id: 2977907-8
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  • 5
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    Online Resource
    Trauma of the mesentery. Anatomy and diagnosis
    Walter de Gruyter GmbH ; 2020
    In:  Romanian Journal of Orthopaedic Surgery and Traumatology Vol. 3, No. 1 ( 2020-06-01), p. 64-69
    Details
    In: Romanian Journal of Orthopaedic Surgery and Traumatology, Walter de Gruyter GmbH, Vol. 3, No. 1 ( 2020-06-01), p. 64-69
    Abstract: Mesenteric lesions in abdominal trauma are encountered in 3% of the cases. Diagnosis of these lesions is difficult, which translates into important delays until surgery that affects patient survival. The short-term consequences of mesenteric lesions translate in bowel ischemia or important blood loss. If a lesion is confirmed after imagistic investigations, one must have complete knowledge of the anatomy and the particular distribution of the main arterial and venous trunks to predict the region of the small bowel that will have to be observed or resected if surgery is required. The aim of our study was to demonstrate this particular distribution of blood vessels through cadaver dissection and to note the resources available to diagnose such lesions.
    Type of Medium: Online Resource
    ISSN: 2544-8978
    URL: Article
    DOI: 10.2478/rojost-2020-0010
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2020
    detail.hit.zdb_id: 2977907-8
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  • 6
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    Online Resource
    A case report of blunt liver trauma in times of COVID-19 pandemic
    Walter de Gruyter GmbH ; 2020
    In:  Romanian Journal of Orthopaedic Surgery and Traumatology Vol. 3, No. 2 ( 2020-12-01), p. 90-94
    Details
    In: Romanian Journal of Orthopaedic Surgery and Traumatology, Walter de Gruyter GmbH, Vol. 3, No. 2 ( 2020-12-01), p. 90-94
    Abstract: The liver is one of the most affected organs in abdominal trauma mostly because of its considerable dimensions, the fragility of the liver parenchyma. We present the case of a 29-year-old patient who sustained an abdominal trauma after an accidental fall from a 3 m height. The patient tested positive at RT-PCR for SARS-CoV-2 at admission, without any symptoms of viral infection. The emergency CT scan revealed a blunt liver trauma with an expanding hematoma (grade III). The patient was initially hemodynamically stable but shortly after admission became unstable and required surgical treatment that initially consisted of damage control and liver packing. Reintervention was decided 36 hours later, after reevaluation unpacking and hepatorrhaphy were done. The postoperative evolution was uneventful. The case indicated the importance of continuous monitoring of the traumatic patient. In liver trauma, hemodynamic instability guarantees an emergency laparotomy. The time of operations in trauma patients with SARS-CoV-2 must be reduced to the maximum both as an objective of damage control and also to minimize the risk of contagion.
    Type of Medium: Online Resource
    ISSN: 2544-8978
    URL: Article
    DOI: 10.2478/rojost-2020-0014
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2020
    detail.hit.zdb_id: 2977907-8
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  • 7
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    Online Resource
    A contemporary view on plate fixation in thoracic wall trauma
    Walter de Gruyter GmbH ; 2019
    In:  Romanian Journal of Orthopaedic Surgery and Traumatology Vol. 2, No. 2 ( 2019-12-01), p. 96-101
    Details
    In: Romanian Journal of Orthopaedic Surgery and Traumatology, Walter de Gruyter GmbH, Vol. 2, No. 2 ( 2019-12-01), p. 96-101
    Abstract: Flail chest in a trauma patient presents itself with a number of problems. The mainstay treatment in the past was analgesia with non-operative observation but due to the increased rate of complications, new treatment modalities have been researched. Chest wall plate fixation has emerged as the go-to solution for these patients but consensus lacks regarding when it should be applied, to what category of trauma patients, which technique and which surgical specialty should be the promoter of this technique. All these problems have arisen due to the lack of large prospective studies. A number of these studies are ongoing with results to be published in the near future. Until then, preliminary data have demonstrated the superiority of plate fixation in flail chest in comparison with the non-operative management.
    Type of Medium: Online Resource
    ISSN: 2544-8978
    URL: Article
    DOI: 10.2478/rojost-2019-0019
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2019
    detail.hit.zdb_id: 2977907-8
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  • 8
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    Online Resource
    Radical hysterectomy for locally advanced cervical cancer with Para-Aortic lymphadenectomy: case presentation
    Walter de Gruyter GmbH ; 2022
    In:  Romanian Journal of Orthopaedic Surgery and Traumatology Vol. 5, No. 1 ( 2022-06-01), p. 7-11
    Details
    In: Romanian Journal of Orthopaedic Surgery and Traumatology, Walter de Gruyter GmbH, Vol. 5, No. 1 ( 2022-06-01), p. 7-11
    Abstract: Pelvic lymphadenectomy with radical hysterectomy is the basic treatment in locally advanced cervical cancer, but, for carefully selected cases, this intervention can be extended and high Para-Aortic lymphadenectomy can be performed to the site of emergence of the renal arteries. The mortality of the procedure has decreased significantly since the 1900s when it was introduced by Wertheim, while the 5-year DFS reached rates of over 90%.
    Type of Medium: Online Resource
    ISSN: 2544-8978
    URL: Article
    DOI: 10.2478/rojost-2022-0003
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2022
    detail.hit.zdb_id: 2977907-8
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