Clinica privata de gastroenterologie si hepatologie in Bucuresti

Dr AV Ditoiu, specializat in gastroenterologie, hepatologie endoscopie digestiva, colonoscopie, medic primar la spitalul Fundeni , secretar general al Asociatiei Romane pentru Studiul Ficatului

November 25, 2015
by Dr Ditoiu

Creating Any Descriptive Dissertation

Selecting an intention

The essence description is to help make sensory particulars vividly show your viewer. Although it usually is just inside college that you’ll be enquired to write down the particularly detailed article, information can be an essential take into account a lot of sorts of producing. Outline inlayed in the discussion paper, by way of example, could possibly be designed to make a placement far more convincing. Sensory facts are generally details of aroma, style, texture, and also appear along with look. In case you choose “showing” words, those that offer vivid physical particulars appropriate to your subject matter in addition to purpose, you’ll succeed inshowing instead of showing. “Telling” text are generally fuzzy as well as unclear; they might be construed in several ways. These very first case in point mainly creates assertions as to what will be with a lack of the bedroom, while the next case describes this points of interest, textures, odors, along with seems in the unfilled place: Revealing to: The empty place smelled old along with was without requiring furniture or floor; the one eye-port was lacking curtains or blinds connected with any sort. Demonstrating: The condo smelled of outdated food preparation odors, cabbage, and also mould; our own shoes squeaked deliberately contrary to the scuffed solid wood flooring, that returned a new haze connected with dusty sun light from your one cobwebbed, gritty window. When you’re prepared to give up the particular seek to reveal or to say to about, review your theme when it comes to image, auditory, as well as other sensory information. Imagine in concrete floor phrases. The harder you are interested in in addition to associated with this issue, the more it’ll be to be able to attention your current readers, when you describe someone, go with a individual in whose qualities be noticed to you.

Paying attention to specifics

When you describe an area or a factor, pick the one which is actually important for you. In the same manner, in the event the main topic of ones explanation is usually an thing or maybe a location, you could possibly incorporate not merely its physical appearance but also it is geographic, traditional, or perhaps emotive relevance-as very long when you show or maybe recommend this employing sensory particulars, and steer clear of telling you. Possibly description regarding description’s reason needs to have a motive. Possibly there is an essential all round impression you would like to express? Some sort of middle design or common level? That is your own thesis; arrange the essay all-around the idea. By way of example, you could possibly explain your car or truck as the house out of the house, rich in snack foods, adjustments of apparel, previous troubles of the Chico Information & Examine, references, along with your favorite tunes. Or perhaps, you might identify your automobile for pristine, lovely, fussed over female in whom people huge focus in addition to money. Only do not explain your vehicle with wintry, specialized medical fine detail, front to back (or base to help best, or perhaps on the inside to be able to outside) with no at heart the reason, the complete effect you would like to build. In achieving this effect, it’s not necassary to always include things like most facts; only use those that match your function.

November 25, 2015
by Dr Ditoiu

Leading Essay Posting Professional services. Choosing the ideal the best quality

Customized essay making products on your massive supply pupils with educational newspapers night and day. Anything you want being composed you can find a system for all of your crafting must have. The fact is, top notch essay authoring providers ought to contend for successful customer’s particular attention.

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The screening progression is basically complex by many opportunities. The online sites claim that they know their items in relation to posting. But how could you make sure that your task is fine wrists and hands? It is the best inquiry. Look at evaluations, study the gives obtainable and evaluation them.

In some cases it appears that you can actually cope with it by yourself. That is good. Even so, if qualified essay formulating seems like pulling pearly whites to you, there are lots of techniques for buying it created by some other individual.

November 15, 2015
by Dr Ditoiu

Cum afli daca problemele cu scaunul sunt date de o boala sau nu

Scaun normal, scaun cu sange, scaun cu mucus..

In momentul in care crezi ca ai probleme cu scaunul este normal sa te intrebi cum Continue Reading →

November 15, 2015
by Dr Ditoiu

Scaunul cu mucus, scaunul cu sange

Este normal sa ai mucus in scaun?

In mod normal scaunele contin o cantitate de mucus de Scaun mucusconsistenta jeleului, care este secretata de unele glande colonice, ajutand la progresia bolului fecal. De aceea, prezenta mucusului in scaun in cantitate normala,nu constituie de obicei un semnal de alarma, dar daca apar si alte simptome, cantitatea de mucus este mare, sau a aparut recent, este nevoie de lamurirea situatiei.

Cand poti sa ai mucus in scaun mai mult decat este normal?

Continue Reading →

November 12, 2015
by Dr Ditoiu

Autodiagnosticul bolilor de ficat online – hepatolog automat?

Orice om normal, atunci cand are ceva defect, apeleaza la un specialist.
De exemplu, atunci cand ai o problema la masina, frigider, aspirator sau .. acoperis, apelezi la un specialist.
Pentru repararea unei .. masini este nevoie sa mergi la service la un specialist, sa-i povestesti mecanicului ce ai observat anormal la masina, acesta o vede, o pune pe un tester, constata defectul si apoi o repara.

De sute de ani lucrurile stau la fel in orice situatie in care vrei sa vezi daca exista ceva anormal, si care este cauza acestei anormalitati.
Pentru a evalua cauza simptomelor unui pacient, trebuie sa mergi la consult la un specialist, iar procedura normala este la fel ca in cazul oricarui defect Continue Reading →

November 1, 2015
by Dr Ditoiu

Un nou forum in hepatita c 2015

Intrebarile sunt luate de pe forumurile de pe site.

Mentionez ca raspunsurile sunt generale, teoretice, iar aplicare lor automata la o anumita persoana poate fi complet eronata, deci este nerecomandabila

Recent am descoperit ca am hepatita c as dori sa stiu daca voi ramane toata viata cu ea?va multumesc.

Aeasta intrebare trebuie adresata medicului hepatolog sau gastroenterolog care are toate datele dvs medicale – anamneza, examinare medicala-consult- si toate analizele.

Teoretic o persoana cu virus C poate scapa de el sau poate ramne toata viata cu virusul, sau poate face hepatita cronica, ciroza heapatica sau cancer de ficat. Continue Reading →

October 24, 2015
by Dr Ditoiu

Hepatita C – diagnostic

Cum se pune diagnosticul de hepatita cu virus C?

In hepatita cronica cu virus C diagnosticul este imposibil de pus pe baza simptomelor, pentru ca ele sunt nespecifice, se pot intalni si in alte boli, diagnosticul de hepatita cu virus C se pune pe baza unor analize biochimice, a determinarilor virusale si biopsiei hepatice sau testelor echivalente – fibrotest, fibromax, fibroscan, etc.

Analize de sange in hepatita C

Daca exista suspiciunea de hepatita cu virus C medicul gastroenterolog care v-a consultat va poate prescrie unele dintre urmatoarele analize de sange

  • Transaminazele, ALT si AST, sunt crescute de 1-5 ori peste limita normala, cresterea lor fiind persistenta tip de cel putin sase lun
  • Alaninaminotransferaza (ALT) este de obicei mai crecuta decat aspartat aminotransferaza (AST) in hepatita cronica, raportul lor apropiindu-se de normal la evolutia catre ciroza hepatica
  • Fosfataza alcalina si gamma glutamil transpeptidaza (GGT) sunt de obicei normale; daca sunt crescute poate fi un indicator de colestaza (creste si colesterolul si eventual bilirubina) sau de ciroza.
  • Lacticodehidrogenaza (LDH) si creatinfosfokinaza (CPK) sunt de obicei normale
  • Fierul seric si feritina serica pot fi usor crescute
  • Trombocitele, leucocitele, albumina serica si protrombina sunt normale, scaderea lor fiind un semn de ciroza
  • Cresterea gamaglubulinelor serice, a imunoglobulinelor nu este prezenta in hepatita cronica, dar sunt prezente in ciroza hepatica.

Care sunt markerii pentru virusul C

In mod obisnuit medicul gastroenterolog sau hepatolog se foloseste pentru diagnosticul hepatitei C de urmatorii markeri virali

  • Ac VHC = anticorpii impotriva virusului hepatitic C, semnifica faptul ca ati avut virusul C si organismul a reactionat prin producerea de anticorpi; nu insemna neaparat ca virusul mai exista in organism si si ca se inmulteste

Continue Reading →

October 18, 2015
by Dr Ditoiu

Ecografia de ficat si cai biliare

Sunt frecvente situatiiile in care un pacient vrea sa faca o ecografie, ca sa se vada “toate modificarile si bolile” de care sufera.
Ecografia este o metoda de explorare utila, dar care are anumite limite, nefiind utila in toate situatiile.

Ce se vede la ecografia ficatului?

In principiu modificarile care se vad la ecografia ficatului pot fi descrise ca:

  • Formatiuni hipoecogene (adica cu ecogenitate mai mica decat ficatul  normal)
    • metastazele hepatice
    • limfoamele hepatice,
    • abcesul hepatic,
    • hematomul hepatic
    • chistele hepatice complicate
    • adenomul hepatic
    • hiperplazia nodulara focala
    • hemangioamele hepatice atipice
    • focare de steatoza hepatica
    • vasele sau caile biliare,
    • cancerul de ficat
    • lipomul hepatic
  • Zone hiperecogene (cu ecogenitate mai mare decat structura normala a ficatului)
    • metastaze hepatice
    • carcinom hepatocelular
    • colangiocarcinom
    • hemangion hepatic
    • tumori pseudoinflamatorii
    • focar de steatoza
  • Imagini izoecogene (cu aceasi densitate ecografica cu ficatul)

Cand este indicata ecografia abdominala in general?
Explorarea ecografica  a abdomenului este utila in principiu pentru: Continue Reading →

September 19, 2015
by Dr Ditoiu

Tratamentul nou fara interferon in hepatita C

In Romania va fi introdus – speream in cateva zile sau saptamani- tratamentul pentru infectia cu virusul hepatitei C fara interferon. Este posibil ca prescrierea acestui medicament sa inceapa dupa data de 1 noimebrie 2015.

Deoarece prescrierea acestui medicament nu se va face in acest moment pentru orice bolnav cu infectie cu virus C, voi posta unele precizari lamuritoare,

De la inceput mentionez ca tratamentul NU este impotriva cirozei hepatice ci impotriva VIRUSULUI C, deci chiar daca virusul dispare, ciroza ramane, nu se vindeca,  dar prin disparitis virusului riscul de evolutie scade, mai ales cel de cancer de ficat

Medicamentul se numeste Viekirax-Exviera, iar costul tratamentului va fi acoperit de CNAS

Voi posta cele mai frecvente intrebari pe care le primesc de la pacientii mei

Ce bolnavi vor fi acceptati pentru acest nou  tratament  impotriva virusului C al hepatitei?

Continue Reading →

September 19, 2015
by Dr Ditoiu

Bolile ficatului – forum

Ce se intimpla cand analizele hepatice sant mari?

Cand analizele pentru ficat sunt mari, inseamna ca o parte din celulele ficatului sunt bolnave sau distruse de.. ceva – alcool, virusuri, ceaiuri, sistemul imunitar, etc

De ce apare trombocitopenia in ciroza?

In ciroza hepatica se mareste splina, deoarece iesirea sangelui din splina catre ficat este blocata. Incetinirea circulatiei sangelui in splina face ca trombocitele sa fie distruse aici, si astfel scad in sange, aparand trombocitopenia.

Daca iti scoti fierea, poti sa mai ai .. fiere?

Daca iti scoti fierea – adica colecistul- desigur  ca nu mai ai colecist, dar ai fiere- fierea fiind lichidul galben si amar secretat de ficat permanent, fie ca ai sau nu fiereș acest lichid se inmagazineaza in colecist – daca ai colecist.

Ce inseamna colecist cu peretii ingrosati, fiere cu peretii ingrosati?

Insemna ca… colecistul are peretii ingrosati, mai grosi, din diferite mtice, de obicei infectie sau inflamatie

Am citit undeva ca nu este bine sa te tratezi de ficat la boli infectioase. de ce?

Ati retinut corect.Medicul de boli infectioase nu este medic de .. boli de ficat, deci este normal ca de hepattia (care este o boala de ficat) se te tratezi la un medic de boli de ficat, care poate sesiza mai usor modificarile care pot duce la ciroza, decat un medic care nu este obisnuit cu ciroza hepatica.Este adevarat ca uneori hepatita poate fi de cauza infectioasa, dar daca te tratezi la un medic de boli infectioase, ulterior tot trebuie sa ajungi la un doctor de ficat, caci evolutia bolii nu mai este dependenta de evoutia infectiei. Apendicita  de exemplu sau colecistita, sau amigdalita este de cauza infectioasa, si nu te tratezi la boli infectioase mai intai, apoi cand merge prost ajungi la chirurgi, ci mergi direct la chirurg, care poate rezolva problema indiferent de evolutia bolii. Nici in cazul altor infectii  – infectie urinara, puroi la ochi, abces dentar, peritonita, abces cerebral, etc, nu te tratezi la boli infectioase.

Am hepatita cu virus C am fost tratat la boli infectioase 4 luni, acum nu imi mai dau nimic, ce fac, astept sa fac ciroza?

Daca v-ati fi tratat la un medic gastroenterolog si hepatolog, el v-ar fi spus si ce sa faceti ca sa nu avanseze boala de ficat -regim tratament.

Deci, cred ca cel mai bine ar fi sa va adresati unui medic gastroenterolog sau hepatolog, care sa va monitorizeze si trateze boala de ficat.

Daca articolul de mai sus v-a ajutat pentru lamurirea problemelor dvs de sanatate, este foarte bine si ma bucur ca v-am fost de folos.

Daca au rams lucruri nelamurite, va puteti programa pentru consult, va asteptam.

Dr AV Ditoiu