Stoleriu Gabriela MD

Stoleriu Gabriela MD
Faculty of Medicine and Pharmacy, “Dunarea de Jos” University, Galati

Current status and perspectives in the management of malignant melanoma
Authors: Gabriela Stoleriu, Cătălina Maria Voicu, Florina Mihaela Filip-Ciubotaru, Nicuța Manolache, Daciana Elena Brănișteanu

Melanoma is a malignant skin tumor that has a steadily increasing incidence over the past few years, predominantly placed on sun exposed areas. If the patient presents himself to the dermatologist at onset, the total surgical excision of the tumor may lead to complete healing, but in the case of metastases the prognosis is dark. The role of dermatologist and dermoscopy is essential in the correct and rapid diagnosis of melanoma. Our study, conducted over a period of 12 years, on a batch of over 6000 patients admitted to dermatology, plastic surgery, ophthalmology, ENT, orthopedics, as well as gastro-enterology, vascular surgery. The role of the interdisciplinary approach of skin carcinomas is evidenced by the good collaboration of physicians from different departments and the long-term survival of the treated patients. Current knowledge in the field of molecular and genomic medicine has led to new valences in correct diagnosis, selection of appropriate treatment, following up and monitoring of cutaneous carcinoma treatment. Both surgical and oncological therapies must be taken into account because the association of excision with oncogenic and immune targeted treatments are effective in many cases resulting in the growth of the survival survival rate.

The Nd: YAG 1064nm LASER efficiency on vascular lesions: possibilities and limitations
Authors: Gabriela Stoleriu, Cătălina Maria Voicu, Florina Mihaela Filip-Ciubotaru, Nicuța Manolache, Daciana Elena Brănișteanu

LASER (Light Amplification by Stimulated Emission of Radiation) are optical devices that generate a coherent parallel light beam with a narrow spectrum of wavelengths and high energy. The gain medium of a laser can be: liquid, solid, gas (nucleus: diode, CO2, Argon, Alexandrite, Nd: YAG etc), each with a limited range of indications. In recent years, the LASER device chosen by us to treat vascular lesions is Nd:YAG (Neodymium-doped Yttrium Aluminum Garnet) with a wavelength of 1064 nm. Oxyhemoglobin is a chromophore for the Nd: YAG LASER and the therapeutic principle of this type of laser is to create vascular endothelium lesions, the ultimate endpoint being the venous lumen obturation. The LASER emitted and transmitted transcutaneously is absorbed by oxyhemoglobin and transformed into thermal energy, which coagulates and then destroys the target blood vessel without affecting the above tissue structures. We chose a specific type of LASER Nd: YAG device, after more than 10 years experience with three devices from different manufacturers. Patients selected for LASER treatment presented telangiectasia, venectasias and various types of hemangiomas. A wavelength of 1064 nm was used, with a pulse duration of 10-40 ms and an energy varying between 160-190 J/ cm2, with a spot size of 3-7 mm. The 100% effectiveness of this method of treating vascular lesions consisted in the disappearance of LASER treated blood vessels, with no sequels in most cases. In 20% of cases, transient residual hyperchromic spots resulted.

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