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Background and Objectives: The ponticulus posticus (PP) is a bony bridge that emerges from the posterior aspect of the superior articular process, to connect the posterior arch of the atlas. It is often associated with neurological symptoms. The aim of this study was to obtain an insight into this malformation, and prevalence in the North East region of the Romanian population. Materials and methods: This anatomical variant was analyzed through an observational and retrospective study which was carried out in St. Spiridon Hospital Iasi. The duration of the study was 10 months and, a number of 487 patients who presented neurological symptoms without cranio-cerebral traumatisms were enrolled and a computed tomography (CT) scan was performed. We proposed a new classification of PP in five types. The prevalence of PP was calculated and Skewness test, ANOVA test with Bonferroni correction, and Student’s t-test were used for statistical analysis. Results: Among the sample of 487 patients, PP was found in 170 cases (34.90%) in an age group of 8–90 years (mean age = 59.52 years, SD ± 19.94 years). Type I was found in 11.29%, followed by Type II—8.21%, Type III—5.13%, Type IV—5.54%, and Type V—4.72% (p = 0.347). It was 19.5%, mirroring the incomplete type, whereas the complete type was reported in 15.40% of cases (p = 0.347), the highest prevalence, namely 41.17% was found in the “41 to 60 years” age group, followed by 36.95% in the “21 to 40 years” group (p = 0.00148). The mean age was higher in patients with PP Type III (61.16 years, SD ± 19.98), while patients with PP Type V recorded the lowest mean age (56.48 years, SD ± 22.13). The differences between the comparative average ages on types were not statistically significant (p = 0.411). The gender and age were not good predictors of PP Type V (AUC < 0.600). Conclusion: according to our study, incomplete types of PP were found to be more prevalent as compared to complete types. No difference between males and females was detected. PP is more frequent in adults and young adults than in the elderly population. It is confirmed that gender and age were not good predictors of the bilateral complete type of PP.

We are presenting a case of mechanical jaundice caused by a pancreatic head cancer in a 72-year-old patient. The clinical examination suspected this diagnosis based on the characteristics of jaundice and the Courvoisier-Terrier sign that was present in the clinical exam. Laboratory and imagistic exams confirm this suspicion. After a short preoperative preparation, a cephalic pancreatoduodenectomy was made using the Whipple procedure. The postoperative evolution was complicated by the appearance of a biliary fistula, which closed after the resuming of intestinal transit. The patient left the surgery department after 25 days of hospitalization. Technological advancement, adequate preoperative rebalancing and especially the emergence of surgical centers specialized in pancreatic resections, have reduced mortality after CPD below 5%. However, an unresolved issue is the long-term survival after CPD for pancreatic cancer (0 – 24%), which is considered by some authors disappointing.

Pulmonary veins carry oxygenated blood from lungs to the left atrium of the heart. The anatomy of the pulmonary veins is variable with some anatomic variants. In clinical practice the difference between the normal anatomy of pulmonary veins with its variants and abnormal anatomy is very important for clinicians. Variants of pulmonary veins may occur in number, diameter and normal venous return. We present a case report and a review of the literature with the pulmonary venous return that deviates from the usual anatomical configuration and ranges from normal variant drainage to anomalous pulmonary—systemic communication. Initially, it was considered as an anatomical variant of the pulmonary venous return associated with the persistence of the left superior vena cava. Upon detailed exploration it was established that it was an anomaly of the pulmonary venous return which led in time to the installation of its complications. Diagnosis can be difficult, sometimes missed, or only made late in adulthood when complications were installed. Knowledge of variant anatomy and anomalous pulmonary venous return play a crucial role in the diagnostically challenging patient.

Fecal incontinence is a health problem that leads to serious quality of life disturbances in the elderly, much greater than the ones generated by micturition disturbances. When physical therapy, habit changes and medication fail to control the disease, electrical stimulation of the sacral nerves at the level of the third sacral foramen represents a solution for eligible patients. Our research done on 29 patients, operated by the first author at Klinikum Bielefeld, Germany, revealed statistically significant improvements, slightly superior to the ones in the literature. As many as 82.75% of the patients experienced more than 70% reduction in the number of weekly incontinence episodes, correlated with a robust increase in the quality of life and level of daily physical activity. The aim of the present paper is to present our results after the intervention, and at 1-year follow-up, and to describe the surgical technique, hoping for an increased awareness and adoption in Romania.

The aim of our study was to evaluate the effects of some antibiotics on hepatic and renal integrity in rats with acute paw inflammation. Acute inflammation was induced after sub-plantar administration of carrageenan in rats. The substances: prednisone (PDN), indomethacin (IND), cefotaxime (CEF), gentamicin (GEN) and sulfamethoxazole (SMT) were injected intraperitoneally, 30 min before carrageenan administration. Saline was intra-paw administered in control group. Prednisone and indomethacin were injected in a single daily dose, and the antibiotics every 12 hours, during 3 days. Specific biochemical parameters, liver and kidney tissues were examined after 3, 24 and 72 hours. Experimental protocol was conducted according to the recommendation of our University Committee for Research and Ethical Issues. The use of GEN, SMT and CEF resulted in exacerbation of hepatic enzymes activity, increasing in serum creatinine, blood urea and uric acid levels, statistically significant comparing with control group. Histopathological examination revealed the alteration of liver and kidney architecture in groups treated with GEN and SMT. The effects of GEN were more accentuated than those of SMT and CEF. The treatment with GEN and SMT manifested hepatic and renal toxicity in rats with experimental carrageenan-induced acute paw inflammation.