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Introduction: Surgical and non-surgical facial procedures have gained immense popularity thanks to their aesthetic benefits. Understanding the vascularization of the face and assessing potential risks is crucial to ensure patient safety and optimal outcomes. This study aims to evaluate the utility of thermal scanning and Doppler ultrasonography in evaluating the vascular risk for facial procedures. Material and Methods: A cohort of 60 patients were included in this prospective study. Preoperative thermal scanning and Doppler ultrasonography were performed in order to visualize the facial vasculature and identify potential areas of risk. Results: For 30 patients, we performed preprocedural Doppler ultrasound imaging and thermal scanning at the injection site. Only 6.66% of them suffered vascular complications, whilst 23.33% among those who didn’t undergo ultrasound and thermoscanning suffered vascular injuries. The combined use of these tools proved to be valuable in assessing the vascular risk for facial procedures. The findings emphasize the importance of preoperative assessment to identify patients at risk for vascular complications. Conclusions: Thermal scanning and Doppler ultrasonography offer a comprehensive approach to assessing the vascular risk for facial procedures. By ensuring the identification of abnormal vascular patterns and altered blood flow dynamics, these techniques enhance patient safety and procedure planning.

(1) Background: A quarter of maternal deaths are caused by post-partum hemorrhage; hence obstetric bleeding is a significant cause of morbidity and mortality among women. Pelvic artery embolization (PAE) represents a minimally invasive interventional procedure which plays an important role in conservative management of significant bleeding in Obstetrics and Gynecology. The aim of this study was to evaluate the effect and the complications of PAE in patients with significant vaginal bleeding with different obstetrical and gynecological pathologies. (2) Methods: We conducted an observational, retrospective study on 1135 patients who presented to the University Emergency Hospital of Bucharest with vaginal bleeding of various etiology treated with endovascular therapy. All the patients included in the study presented vaginal hemorrhage that was caused by: uterine leiomyomas, genital tract malignancies, ectopic pregnancy, arterio-venous mal-formations and other obstetrical causes. We excluded patients with uncontrolled high blood pressure, severe hepatic impairment, congestive heart failure, renal failure or ventricular arrhythmias. (3) Results: Bleeding was caused in 88.19% of cases by uterine leiomyomas (n = 1001), 7.84% (n = 89) by cervical cancer, 2.29% by ectopic pregnancy (n = 26), 1.23% by arteriovenous malformation (n = 14) and 0.52% by major hemorrhage of obstetrical causes. Endovascular procedures were used in all the cases. In patients with uterine leiomyomas, supra-selective uterine arteries embolization was used. In 97% (n = 1101) of patients, bleeding was stopped after the first attempt of PAE. 3% (n = 34) needed a second embolization. In 12 of 14 cases of AVM, PAE was successful, two other cases needed reintervention; (4) Conclusions: Endovascular procedures represent a major therapy method for both acute and chronic hemorrhage in Obstetrics and Gynecology. It can be used in post-partum or post-traumatic causes of vaginal bleeding, but also in patients with chronic hemorrhage from uterine leiomyomas or inoperable genital malignancies or even as a preoperative adjuvant in cases of voluminous uterine fibroids or invasive malignant tumors, aiming to reduce intraoperative hemorrhage.

Limb amputation has a severe somatic and psychological impact, that can furthermore have complications, which lead to increased morbidity, mortality, hospitalization days, health care costs, delay prosthetic application, and social reintegration. Proper therapeutic management must be initiated in cases with amputation stump complications to ensure the best result. This paper aims to present the therapeutic management of a patient with sepsis after above–the–knee amputation, performed after acute limb ischemia. The patient presented in our clinic 10 days postoperatively with local infection, wound dehiscence, and sepsis.

The recent introduction of immunotherapy and targeted therapy has substantially enriched the therapeutic landscape of metastatic melanoma. However, cerebral metastases remain unrelenting entities with atypical metabolic and genetic profiles compared to extracranial metastases, requiring combined approaches with local ablative treatment to alleviate symptoms, prevent recurrence and restore patients’ biological and psychological resources for fighting malignancy. This paper aims to provide the latest scientific evidence about the rationale and timing of treatment, emphasizing the complementary roles of surgery, radiotherapy, and systemic therapy in eradicating brain metastases, with a special focus on the distinct response of intracranial and extracranial disease, which are regarded as separate molecular entities. To illustrate the complexity of designing individualized therapeutic schemes, we report a case of delayed BRAF-mutant diagnosis, an aggressive forearm melanoma, in a presumed psychiatric patient whose symptoms were caused by cerebral melanoma metastases. The decision to administer molecularly targeted therapy was dictated by the urgency of diminishing the tumor burden for symptom control, due to potentially life-threatening complications caused by the flourishing of extracranial disease in locations rarely reported in living patients, further proving the necessity of multidisciplinary management.

The diabetic foot syndrome is the most common cause of diabetic patients hospitalization, being a challenging complication of diabetes. This is a case report of a diabetic patient who presented a silent myocardial infarction after partial foot amputation. The patient presented normal troponin at admission, but after 21 days of hospitalization he acused a very slight pain in the chest and breathing difficulty. The troponin was 682 ng/l. He was transfered immediately in the intensive care unit for specific treatment. The evolution of the surgical intervention was favourable even under the poor general status. The patient fully recovered after 10 days and left the cardiology department in a good clinical condition. A silent myocardial infarction seems to occur with increased frequency in patients with diabetes, due to the cardiac autonomic dysfunction. It is highly important a quick diagnosis and a good management of the patient.