http://repository.usmf.md:80/handle/20.500.12710/23915 2026-04-08T21:07:45Z 2026-04-08T21:07:45Z Cojocaru, Cristina http://repository.usmf.md:80/handle/20.500.12710/24129 2023-04-27T10:59:45Z 2022-01-01T00:00:00Z

Title: Thyroidectomy volume selection for patients with thyroid nodules Authors: Cojocaru, Cristina Abstract: Background. Thyroid nodules with a high prevalence in the general population require surgical treatment due to the risk of malignancy, hyperplasia with compression of adjacent structures, and hyperfunction with induction of thyrotoxicosis. The objective of the study. Optimization of surgical treatment in patients with thyroid nodules. Material and Methods. The study included 124 patients (104 women and 20 men), with a mean age of 46.88 years, clinically and paraclinical confirmed with thyroid nodules that represented indications for surgical treatment. Results. In the case of bilateral multinodular goiter of gr. III and IV, autoimmune thyroiditis with thyrotoxicosis, total (12) and subtotal (4) thyroidectomy was chosen. Thyroid nodules classified in Bethesda II, III, IV, and nondiagnostic categories were solved by unilateral thyroidectomy (25). In 83 patients with malignant suspected nodules, the decision on the volume of surgery was made intraoperatively by performing the extemporaneous histological examination. According to the results obtained, in confirmed benign cases were limited to ablation of the affected area (unilateral lobectomies - 56; isthmectomies - 2; combined - 9), and in the malignant ones, total thyroidectomy was performed (16). Postoperative monitoring of the patients was conducted in the course of twenty-four months, and recurrence of the disease has not been determined. Conclusion. Selection of thyroidectomy volume in patients with thyroid nodules should be individualized. An important intraoperative diagnostic tool is the extemporaneous histological examination, which provides data of diagnostic certainty, determining the volume of surgery with the avoidance of total thyroidectomies in inappropriate cases and performing organ-preserving surgeries.; Introducere. Nodulii tiroidieni, având o prevalență înaltă în populația generală, impun tratament chirurgical datorită riscului de malignitate, hiperplaziei cu compresia structurilor adiacente și hiperfuncționalității cu inducerea tireotoxicozei. Scopul lucrării. Optimizarea tratamentului chirurgical al pacienților cu noduli tiroidieni. Material și Metode. Studiul a inclus 124 pacienți (104 femei, 20 bărbați), cu vârsta medie 46.88 ani, confirmați clinic și paraclinic cu noduli tiroidieni ce au prezentat indicații la tratament chirurgical. Rezultate. În cazul gușei multinodulare bilaterale de gr. III și IV, tiroiditei autoimune cu tireotoxicoză s-a optat pentru tiroidectomie totală (12) și subtotală (4). Nodulii tiroidieni clasați în categoriile Bethesda II, III, IV și nondiagnostici au fost rezolvați prin tiroidectomie unilaterală (25). La 83 pacienți cu noduli suspecți la malignitate, decizia asupra volumului intervenției chirurgicale a fost luată intraoperator prin efectuarea examenului histologic extemporaneu, astfel conform rezultatului obținut, în cazurile confirmate benigne s-a limitat la ablația porțiunii afectate (lobectomii unilaterale - 56; istmectomii - 2; combinate - 9), iar în cele maligne s-a recurs la tiroidectomie totală (16). Recidive ale maladiei în monitorizarea postoperatorie de 24 luni a pacienților nu s-au determinat. Concluzii. Selectarea volumului tiroidectomiei la pacienții cu noduli tiroidieni trebuie să fie individualizată. Un important instrument de diagnostic intraoperator este examenul histologic extemporaneu, care oferă date de certitudine diagnostică, stabilirea volumului intervenției chirurgicale cu evitarea tiroidectomiilor totale în cazurile nepotrivite și efectuarea intervențiilor chirurgicale organomenajante.

2022-01-01T00:00:00Z Cojocaru, Cristina Bour, Alin http://repository.usmf.md:80/handle/20.500.12710/24128 2023-04-27T10:57:58Z 2023-01-01T00:00:00Z

Title: The current assessment and management of thyroid nodules Authors: Cojocaru, Cristina; Bour, Alin Abstract: Introduction. The widespread use of diagnostic imaging favored the increasing incidence of thyroid nodules. Although most of nodules are benign, their clinical importance lies in the need to exclude malignancy. In assessing and managing thyroid nodules may occur the phenomenon of overdiagnosis and overtreatment on one hand and the risk of missing an aggressive thyroid cancer on the other hand. The equilibrium that has to be reached by health care providers. Materials and methods. We conducted a PubMed, MEDLINE, ISI Web of Science, Cochrane databases search for the relevant and recent guidelines, meta-analysis, randomized controlled trial, reviews articles related to „thyroid nodules assessment”, „thyroid nodules management”, „thyroid nodules guidelines”, „thyroid nodules surgery”. Results. The initial assessment of thyroid nodules includes an evaluation of clinical, laboratory and sonographic risk factors. Due to the sonographic features and size, the nodules are selected for biopsy. Cytologically benign nodules are usually followed-up, minimally invasive techniques may be required in certain cases. In suspected or confirmed malignancy, the treatment options of thyroid nodules include surgery or active surveillance. The main controversies appear in management of nodules with inconclusive cytology, low-risk cancers, multinodular goiters, hyperfunctioning nodules, and thyroid incidentalomas. Conclusions. Thyroid nodules due to the high incidence and heterogeneity of background diseases cannot be evaluated and managed in one standardized approach. In the existing literature, there are discussed multiple options for diagnosis and treatment of thyroid nodules. We have reviewed the guidelines recommendations, novel published data, and controversial questions for health care professionals, to understand and provide efficient, personalized, and cost-effective management of patients with thyroid nodules in order to avoid automatic intensive testing and intervention and balancing each case from the patient expectations and demands.

2023-01-01T00:00:00Z http://repository.usmf.md:80/handle/20.500.12710/23974 2023-03-28T09:05:47Z 2023-01-01T00:00:00Z

Title: The Moldovan Medical Journal. Vol. 66, No 1, March 2023 Abstract: The Moldovan Medical Journal is an international scientific double-blind peer-reviewed periodical edition, 4 per year, of the Scientific Medical Association of the Republic of Moldova designed for specialists in the areas of medicine, dentistry, pharmacy, social medicine, and public health. From its debut, the journal has striven to support the interests of Moldovan medicine concerning the new concepts of its development. The Editorial Board warmly welcomes both the readers of and the authors of the journal, all those who are enthusiastic about searching for new and more effective ways of solving numerous medical problems. We hope that those who want to make their contribution to the science of medicine will find our journal helpful and encouraging.

2023-01-01T00:00:00Z Sandru, Serghei http://repository.usmf.md:80/handle/20.500.12710/23973 2023-03-28T08:54:05Z 2023-01-01T00:00:00Z

Title: The monograph “Aspects of patient safety in anaesthesia. Medication errors in anaesthesia and intensive care”. Authors: Sandru, Serghei

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