3 articles
Globally, colorectal cancer (CRC) has become one of the top three causes of death from neoplasms. CRC represents a heterogeneous group of tumors, manifested both by clinical signs and the pathogenesis of its development. Most colorectal carcinomas develop from preexisting adenomas. The aim of this article is to assess the histopathological aspects and variants of primary colon neoformations in correlation with their location and morphological characteristics.
Prospective clinical study based on the analysis of treatment outcomes in 255 patients with colonic and rectal neoformations, treated in the Nicolae Anestiadi Surgery Department No.1, Institute of Emergency Medicine, between 2018 and 2022. The mean age was 61.3±1.05 years. There were 145 (56.9%) men and 110 (43.1%) women, with a male to female ratio of 1.31:1. The following qualitative nominal variables were analyzed: location, number, dimensions, tumor appearance, histopathological type, and degree of tumor extension.
Through imaging, colonoscopy, and intraoperative methods, 255 patients with colonic neoformations were identified. Upon analyzing these subjects, 77 (30.2%) patients were diagnosed with malignant neoplasm of the colon or rectum with various histological types, and 178 (69.8%) patients were diagnosed with precursor lesions of malignancy.
The detailed analysis of the morphopathological characteristics of the tumor formations, in addition to confirming the malignancy, provides important information for establishing the therapeutic attitude.
With the complexities of contemporary healthcare systems and the paramount importance of high-quality patient care, Simulation-Based Medical Education (SBME) has emerged as a pivotal innovation in the process of training healthcare professionals. This study explores the integration of SBME in undergraduate medical education to bridge the gap between theoretical knowledge and clinical practice, thereby preparing students with the necessary competencies for effective healthcare delivery.
Employing a narrative review approach, this study meticulously examined relevant literature from multiple databases, including Google Scholar, PubMed, and MedEdPublish. Following objectives, we chose the sources that were best suited to explore our research questions, focusing on keywords such as „simulation”, „undergraduate medical education”, „simulation-based medical education”, „theoretical frameworks”, „procedural framework” „curriculum design”, „training efficacy”, and „training evaluation” with no restriction for the date of publications.
The review identified foundational educational theories underpinning SBME, such as Experiential Learning Theory and Adult Learning Theory, and traced the evolution of simulation methods from simple anatomical models to sophisticated high-fidelity simulators and virtual reality technologies. Various simulation techniques, including task trainers, manikins, and standardized patients, were analyzed for their educational value. Significant benefits of SBME, such as enhanced safety, repeatability, and adaptability, were highlighted alongside challenges like high costs and limited access. Comparative analysis revealed SBME's advantages over traditional clinical education, particularly in learning efficiency and scalability.
SBME represents a transformative approach in undergraduate medical education, offering a dynamic and interactive learning environment that significantly enhances clinical skills, critical thinking, and confidence. Despite its challenges, the integration of simulation-based methodologies into medical curricula is essential for addressing the evolving needs of medical training and improving patient care outcomes. Future research should focus on longitudinal studies to assess the long-term impact of SBME on clinical practice and explore the integration of emerging technologies to enhance the efficacy and accessibility of simulation-based training.
Cholestatic jaundice installed in gallstones is considered a multifactorial pathogenetic process. The correlation of endogenous hepatic intoxication with the reaction of the pro- and antioxidant system, characteristic of various complications of gallstones associated with cholestatic jaundice, remains an undefined subject.
The study included the investigation of 105 patients with complicated gallstones and associated cholestatic jaundice, and the control group – 35 patients with uncomplicated gallstones. The age of the patients varied between 51 and 72 years, with an F/M ratio of 3/1.
The degree of endotoxemia, assessed at hospitalization by peptides with average mass values, was consistent with the inflammation present in groups 2 and 3, reporting a statistically significant difference compared to the control group [p c/2 < 0.001 (t = 11.1); p c/3 < 0.001 (t = 11.07)]. DAM, as the final product of lipid peroxidation, evaluated at hospitalization, shows double marked values in all groups compared to the control group [p < 0.001 (t = 10.7); (t = 10.9); (t = 16.5)]. The antioxidant activity, assessed at hospitalization, shows a statistically significant decrease in superoxide dismutase values [p < 0.001 (t = 6.4); (t = 4.1); (t = 5.7)], as well as catalase [p < 0.001 (t = 6.7); (t = 5.6); (t = 7.2)] in all groups, by 30-40% compared to the control group.
In established cholestatic jaundice, there is an obvious activation of lipoperoxidation processes, contributing to the increase of endogenous intoxication and early suppression of antioxidant activity. There is a direct relationship between the increase in prooxidant activity and the level of endogenous intoxication in all complications of gallstones associated with cholestatic jaundice, but it is more elevated in infectious complications, indicating a need for an early approach.