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Ioan Lascar

Bio: Ioan Lascar is an academic researcher from Carol Davila University of Medicine and Pharmacy. The author has contributed to research in topics: Medicine & Surgery. The author has an hindex of 14, co-authored 83 publications receiving 484 citations. Previous affiliations of Ioan Lascar include Clinical Emergency Hospital Bucharest.


Papers
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Journal ArticleDOI
TL;DR: A protocol based on the rat femoral arterial anastomoses was used to provide an objective representation of the microsurgical skills progress and a slight or a plateau learning curve was found among the experienced group.
Abstract: This article presents a comparison of microsurgical training of groups with different background A protocol based on the rat femoral arterial anastomoses was used to provide an objective representation of the microsurgical skills progress The performance is assessed by consistent (x4) patency of a standardized anastomosis Three groups of beginner residents with progressive microsurgical experience and one group of experienced surgeons were observed The patency curve of the beginner-groups was as an abrupt learning curve, and then a plateau was reached There was no statistically significant difference in the patency rate between the beginner-groups after their first 32 anastomoses No statistically significant difference was noted when the patency of the advanced group was compared with beginner-groups after different numbers of anastomoses (inverse proportional with their training experience) A slight or a plateau learning curve was found among the experienced group The learning curve is a useful adjunct in the assessment of training

71 citations

Journal Article
TL;DR: The reverse sural island flap should no longer be regarded as a flap of secondary choice to free tissue transfer, but as an equally valuable alternative for small and midsized defects around the ankle and heel.
Abstract: Introduction: The potential of the medial calf integument, as donor site for a free flap based on musculocutaneous branches of the medial sural artery, was first identified by Taylor and Daniel, following cadaver investigation. In 1981, Ponten described the fasciocutaneous sural flap as a reconstructive option for soft tissue loss of the lower extremity, particularly around the knee. Two years later, Donski and Fogdestram presented the distally based fasciocutaneous flap from the sural region followed by Montegut and Allen who considered the sural artery perforator flap as a viable alternative for the gastrocnemius myocutaneous flap. The sural flap proved a considerable versatility at the level of the lower leg (from the knee to the ankle and heel) as well as for other anatomical regions. The most common usage of the flap is for the distal-third defects of the leg. Materials and method: A group of 10 patients with soft tissue losses at the ankle or heal due to a various etiopathogeny represented by cancer excision, trauma, unstable scars, chronic osteomyelitis, in which a microsurgical free transfer had no indication or was not wanted, was presented. Our group reported a 30% complication rate in a high-risk patient population, including patients with diabetes mellitus, peripheral vascular disease, and venous insufficiency. Results: All the defects were covered successfully, without major complications. Usually, only a minor margin of the tip of the flap was lost, which was easily solved with a guided secondary healing. Most flaps showed a slight venous congestion, which cleared in a few days. The functional result was very good in all the patients, while the aesthetic appearance was acceptable even in female patients. Discussion: An ideal indication of a reverse sural flap may be a defect over an intact but partially exposed Achilles tendon. Conclusions: The sural reverse flap is useful in the ankle and foot soft tissues reconstruction whenever we have reasons not to use a microsurgical free transfer. Venous congestion with consecutive partial or complete flap loss is a common complication, so this would not be recommended in patients with obvious acute or chronic venous stasis. The reverse sural island flap should no longer be regarded as a flap of secondary choice to free tissue transfer, but as an equally valuable alternative for small and midsized defects around the ankle and heel.

28 citations

Journal Article
TL;DR: Perineural invasion is an under-recognized way of metastatic spread via tumoral invasion of the nerves that is encountered in malignancies located in the head and neck but also in cancers involving the pancreas, colon and rectum, prostate, biliary tract and stomach.
Abstract: Rationale: perineural invasion is an under-recognized way of metastatic spread via tumoral invasion of the nerves. It is encountered in malignancies located in the head and neck but also in cancers involving the pancreas, colon and rectum, prostate, biliary tract and stomach. For some tumors, it may be the only way of metastatic spread. It represents a marker for poor outcome, with increased risk for locoregional recurrence and reduced survival rates. The molecular mechanisms behind this process are not yet fully understood; research is done to identify new therapeutic targets in order to achieve disease control. Objective: to make a rigorous analysis of this phenomenon and to highlight the best therapeutic approach. Method and results: a review of the current literature in order to harmonize the international protocols to our local pathology. Discussions: the surgical intervention is decisive to defeat the malignant process but must be associated with modern therapeutic methods, such as the image-guided radiation therapy and immunotherapy.

28 citations

Journal Article
TL;DR: After one year, the en bloc group presented a significantly lower recurrence rate, superior surgical safety, decreased perioperative morbidity and faster recovery due to the reduced heterotopic NMIBT recurrences up to one year.
Abstract: The aim of the study was to observe similarities and differences regarding surgical safety and prognosis between en bloc bipolar resection and monopolar transurethral resection of bladder tumors (TURBTs) in medium size papillary non-muscle invasive bladder tumors (NMIBTs). A total of 90 patients with papillary bladder tumors presenting a diameter between 1 and 3 cm were equally divided and alternatively assigned for en bloc bipolar ablation (the study group) and conventional TURBT (the control group). During one year, every three months, the follow-up was performed and the protocol included urinary cytology and cystoscopy. Similar mean patients' age and tumor diameter were determined in both groups. In the study group, it was noticed an important reduced rate of obturator nerve reflex adverse event that caused bladder wall perforation. In addition, comparing the results between the two groups, the following aspects were observed in the study arm: decreased mean operation time (13.4 versus 19.7 minutes), hemoglobin level drop (0.28 versus 0.76 g∕dL), catheterization period (1.9 versus 2.8 days) and hospital stay (2.3 versus 3.1 days). A total of 41 and respectively 40 patients completed the 12 months follow-up protocol. After one year, the en bloc group presented a significantly lower recurrence rate, superior surgical safety, decreased perioperative morbidity and faster recovery. Therefore, the en bloc surgery approach presented a better oncological prognosis due to the reduced heterotopic NMIBT recurrences up to one year.

27 citations

Journal Article
TL;DR: In conclusion, burn scar visibility and severity did have a strong relationship with the quality of life in the survivors of a major burn who received allotransplant and more effort must be placed into developing psychosocial interventions that help survivors to accept scars, reduce depression and build a strong supportive system.
Abstract: With the remarkable progress in the field of burns treatment, the outcome of extensive burns improved significantly. The increased likelihood of survival of a burn victim heightens concerns for potential psychological morbidity for the survivors. Hypertrophic scarring is devastating and can result in disfigurement that affects quality of life. To assess the impact of burn scars on the quality of life of the survivors, we used two scales: the WHOQOL-BREF questionnaire to evaluate the quality of life and the POSAS scale for the subjective evaluation of the post-burn scars in 26 patients who suffered extensive burns and received allotransplant. A significant correlation was observed between the WHOQOL-BREF score and POSAS scale (r=-0.93, p<0.001). In conclusion, burn scar visibility and severity did have a strong relationship with the quality of life in the survivors of a major burn who received allotransplant. Therefore, more effort must be placed into developing psychosocial interventions that help survivors to accept scars, reduce depression and build a strong supportive system.

26 citations


Cited by
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Journal ArticleDOI
TL;DR: The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors.
Abstract: The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

6,968 citations

Journal ArticleDOI
TL;DR: This paper presents an overview of the most prominent antibiotic-embedded wound dressings, as well as the limitations of their use, and highlights recent advances in using nanoparticles as platforms to increase the effect of pharmaceutical formulations aimed at wound healing.
Abstract: The treatment of skin wounds is a key research domain owing to the important functional and aesthetic role of this tissue. When the skin is impaired, bacteria can soon infiltrate into underlying tissues which can lead to life-threatening infections. Consequently, effective treatments are necessary to deal with such pathological conditions. Recently, wound dressings loaded with antimicrobial agents have emerged as viable options to reduce wound bacterial colonization and infection, in order to improve the healing process. In this paper, we present an overview of the most prominent antibiotic-embedded wound dressings, as well as the limitations of their use. A promising, but still an underrated group of potential antibacterial agents that can be integrated into wound dressings are natural products, especially essential oils. Some of the most commonly used essential oils against multidrug-resistant microorganisms, such as tea tree, St. John’s Wort, lavender and oregano, together with their incorporation into wound dressings are presented. In addition, another natural product that exhibits encouraging antibacterial activity is honey. We highlight recent results of several studies carried out by researchers from different regions of the world on wound dressings impregnated with honey, with a special emphasis on Manuka honey. Finally, we highlight recent advances in using nanoparticles as platforms to increase the effect of pharmaceutical formulations aimed at wound healing. Silver, gold, and zinc nanoparticles alone or functionalized with diverse antimicrobial compounds have been integrated into wound dressings and demonstrated therapeutic effects on wounds.

346 citations

Journal Article
TL;DR: It seems necessary, seventy five years later, to reconsider the chronology of the history and put Paolesco but also Collip at the right places much before Banting and Best to whom, by a curious misinterpretation of facts, was attributed the priority of this fundamental discovery.
Abstract: When a medical problem is intensively studied by many teams in the world, it is frequent to see the solution found simultaneously in different countries. However that was not exactly the case concerning the extraction of a potent insulin able to cure Diabetes Mellitus. It seems necessary, seventy five years later, when passions are quenched, to reconsider the chronology of the history and put Paolesco but also Collip at the right places much before Banting and Best to whom, by a curious misinterpretation of facts, was attributed the priority of this fundamental discovery.

260 citations

Journal ArticleDOI
01 May 1997-Burns

166 citations