Introduction:The pseudo aneurysm is an accumulation of blood between the muscle and the adventitia of an artery, while a genuine aneurysm is "a permanent and localized dilation which determines an increase of more than 50% in the normal diameter of the respective vessel" [1], [2]. Aneurysms are more common in the aorta and most frequently occur in male patients aged between 65-85 years, representing 1-3% of the total death causes in this group of age. [3], [4]. Material and methods:The paper presents the case of a 53-year old patient with incomplete paraplegia, AIS/Frankel D with a T11 neurologic level, acute post-ischemia due to a hemorrhagic shock. The patient was diagnosed in 2017 with ruptured right iliac aneurysm which required surgery. A right iliac exograft was inserted, which later became infected, thus requiring multiple surgical interventions, the patient remaining a chronic carrier of Enterococus Faecium. Subsequently, multiple pseudo aneurysms begin appear in the right and left iliac artery and aortic bifurcation. Multiple surgical inetervention ware performed. In January 2018, the patient presented himself with an emergency to the hospital, with a hemorrhagic shock. He was diagnosed with anastomotic pseudo aneurysm which communicated through a very long path with a fistula at the level of the sigma, showing small amounts of a periprosthetic collection with purulent aspect. Surgery is reinitiated by insertion of an axillo-bifemoral bypass and Hartman resection with colostomy. Another important element in the pathological history of the patient is operated pulmonary neoplasm with hepatic and bone metastases. The patient was clinically and functionally evaluated, according the standardized protocols implemented in our clinic, through the assessment scales (AIS, FIM, QoL-Quality of Life, Asworth, Penn, FAC, WISCI II) and also paraclinically, in order to evaluate his biological reserve and his bearing availability of the recovery program. Results: The patient presented a slowly favorable evolution (slowed down by his multiple above mentioned comorbidities) from an algo-dysfunctional point of view, with the improvement of the walking program and the increase of muscle force and individual autonomy. Conclusion: Although aortic aneurysms are common between 65-85 years of age, they can also appear at younger ages. The aortoenteric fistula is a rare cause of massive gastrointestinal bleeding, many of them leading to the death of the patient before presentation to the doctor. Although medullary ischemia can lead to neurologic deficit of the paraplegic type, it can be corrected through a complex recovery program.

Background: Obstructive chronic diseases are a continuous challenge for healthcare perfusionists all over the world. Asthma and Chronic Obstructive Pulmonary Disease (COPD) are the most frequent of these diseases. Respiratory or pulmonary rehabilitation started to gain momentum and it is more frequently used to improve muscle strength, cardiac and respiratory endurance and joint flexibility. The objective of this paper is to establish the current programs of physical activity or kinesiotherapy used in the past year and to reveal if there are any gaps or mismatches in the development of the program or in the instruments used to quantify the results of the rehabilitation programs. Materials and methods: We reviewed a total number of 12 articles, randomized control trials using the search words kinesiotherapy, physical therapy, COPD and asthma from the last year on PubMed.gov, from 11 different countries in order to establish which have similar types of exercises, parameters used in order to compare results and which were the outcomes. Results: The final results are positive, although it is hard to determine a unity because there were so many different parameters used to monitor the patients. The most frequent parameter was the 6MWT used to compare the effectiveness of the physical program in 6 studies. Discussion and conclusions: This review had its limitation in comparing the 12 articles researched because of the different number of patients, the various physical activity and rehabilitation exercises used, but especially because of the many varieties of scales and scores used to monitor the effectiveness of the treatment. In order to successfully compare such papers, an international guideline is necessary to relay specific rehabilitation programs for every type of respiratory pathology and also which are the most recommended scales or scores or parameters in general to asses such rehabilitation programs. Keywords: kinesiotherapy; physical activity; physical therapy; COPD, asthma

Introduction. Pucioasa is one of the greater and sadly, almost forgotten balneological resort of Romania. Known since the 18th century, where it was discovered a record of this area on the Austrian map in 1791 with sulphurous streams, the healing waters of the “Pe Pucioasa” hill enters the therapeutic balneological circle when the first water analysis occurred – 1821-1828 by Dr. Trangot von Schobel. In 1878, Ion Ghica, a prominent figure in Romania at that time initiated the exploitation of 14 wells from the 30 known streams of sulphurous and ferruginous waters, thus obtaining enough healing mineral water for a capacity of 60 beds of the balneological establishment. Since 1841, the Resort developed, transformed into a Rehabilitation Clinic (1969) and the number of patients treated there increased from 20 in the beginning to 1000 patient per day. Many of the patients included foreign elite society members who came regularly to benefit from the waters’ healing properties, both external and internal cures, setting Pucioasa on a high level of not only balneology treatment, but also of balneological tourism. Matherials and methods: Studying local industrializations and water analysis, we concluded that there were many factors that contributed to the decline of this great and international renowned balneological resort. The first wrong step in this direction was made when building and extending de gypsum carrier, the peek being between 1970 and 1975, when the industrial forging process made the sulphurous streams to migrate, and the waters from the wells diminished in its sulphur and iron concentration. Another possible factor for the decline can be the modernisation of the medical world, development of anti-inflammatory drugs and modern medical equipment which reduced the need for the elite society to come a long distance for the balneological treatment. Results: Whichever of the reasons, the once prosperous Balneological Resort of Pucioasa fell into an unknown, unimpressive place, known and frequented only by the locals. The Rehabilitation Clinic still has 60 beds, which are occupied to the maximum each month, it still prospers on a local level, but lost its glory from almost a century ago. Conclusions: The Romanian general population and the government must take an interest to one of the many once prosperous balneological resorts in order to revive the national treasure of Romania which is balneology, which many of the developed European countries only wish that they can possess. Keywords: Balneary Resort, Pucioasa,

Introduction: This paper presents an extremely complex case of quite light spastic paraparesis, with a medical history from childhood (at 12 years), encephalomyelitis (remission?), which in adulthood (at 22 years) was diagnosed and treated as multiple sclerosis 1 year and 6 months (this diagnosis has been subsegmently deniend with IRM in 2017: reducing the size of the medullary cord in the vertebrae plane T5-T7 sequelae aspect) and the afferent neuro-rehabilitative actual management approach, respectively. Materials and methods: 43 year old female patient admintted in our Clinic s Division for a AIS/ Frankel D motor deficiency, pain with mechanical carcass at the spine, disturbances of balance , bladder dysfunction (incontinance), dorsal plantar flexion deficit bilateral (left > right), gait with a broad base of support with external unilateral support, with hip flexural , knee flexion, and dorsal flexion deficiency while walking, attack digitigrad (left > right), and sensibility impairment from T12 level downwards. The patient was clinical and functionally evaluated, according to the standard implemented protocols of our Unit , through the following measurament evalution scales: AIS, Functional Independence Measure (FIM), QQL (Quality of life), Ashworth, Penn, FAC International Scale, and investigate paraclinic: IRM brain, cervical and thoracic spine, radiographic cervical spine , abdominal ecography. Results: Following optimal treatment including pharmacological, and complex neuro-rehabilition program the patient had a favorable evolution with increased values of the measurament scales (motor AIS with 4 points, FIM motor with 5 points, QQL with 6 points, and FAC with 2 points)), remission of ataxic / vertiginous phenomena, quaremision of urinary incontinence (controlling micturitions for at least 10 minutes after urge to urinate); in addition and also very important: diminished spasticity and significantly improved of the gait pattern.Now shie can walk without support on short / medium distances and also very important it can rise without sitting support (in a relatively low position) to orthostatism, and also climbs and descends stairs with the support of the bar and only with the supervision of another person. Conclusion: From the etiologic point of view, multiple sclerosis, uterine apoplexy as well arterio-venous malformation has been recently refuted. The present case represents the importance of building a complete diagnosis (etiologic and of stage) and particular neuro-rehabilitative therapy approuch with both clinical, psihological and scientific impact.