This article is part of a series in this regular feature which looks at new directions in health science libraries. This article provides an updated overview of medical libraries in Romania, with a focus on the academic libraries which function under the patronage of medical schools. Information was collected through a survey questionnaire sent out to Romanian academic medical libraries in March 2017. The responses provide an overall picture of the state of Romanian medical libraries, highlighting the main trends and areas in which progress is evident, as well as the problems confronting these libraries. J.M.

Male breast cancers are uncommon, as men account for less than 1 percent of all breast carcinomas. Among the predisposing risk factors for male breast cancer, the following appear to be significant: (a) breast/chest radiation exposure, (b) estrogen use, diseases associated with hyper-estrogenism, such as cirrhosis or Klinefelter syndrome, and (c) family health history. Furthermore, there are clear familial tendencies, with a higher incidence among men who have a large number of female relatives with breast cancer and (d) major inheritance susceptibility. Moreover, in families with BRCA mutations, there is an increased risk of male breast cancer, although the risk appears to be greater with inherited BRCA2 mutations than with inherited BRCA1 mutations. Due to diagnostic delays, male breast cancer is more likely to present at an advanced stage. A core biopsy or a fine needle aspiration must be performed to confirm suspicious findings. Infiltrating ductal cancer is the most prevalent form of male breast cancer, while invasive lobular carcinoma is extremely uncommon. Male breast cancer is almost always positive for hormone receptors. A worse prognosis is associated with a more advanced stage at diagnosis for men with breast cancer. Randomized controlled trials which recruit both female and male patients should be developed in order to gain more consistent data on the optimal clinical approach.

According to European consensus-based interdisciplinary guidelines for melanoma, cutaneous melanoma (CM) is the most deadly form of dermatological malignancy, accounting for 90% of the deaths of skin cancer patients. In addition to cutaneous melanoma, mucosal melanoma occurs in four major anatomical sites, including the upper respiratory tract, the conjunctiva, the anorectal region, and the urogenital area. As this cancer type metastasizes, a classification used in the current medical literature is the distinction between secondary lesions and primary malignant melanoma of the abdominal cavity. Given that malignant melanoma is the most common cancer that spreads to the gastrointestinal tract, different imaging modalities compete to diagnose the phenomenon correctly and to measure its extension. Treatment is primarily surgery-based, supported by immunotherapy, and prolongs survival, even when performed at stage IV illness. In the end, special forms of malignant melanoma are discussed, such as melanoma of the genito-urinary tract and amelanotic/achromic melanoma. The importance of this present literature review relies on yielding and grouping consistent and relevant, updated information on the many aspects and challenges that a clinician might encounter during the diagnosis and treatment of a patient with intra-abdominal melanoma.

Background. With a long tradition and outstanding contributions over time, medical scientific research in Romania has experienced major changes in the last two decades, marked by an increase in scientific publications, originating especially from university centers and fostered by national regulations on publication standards required for professional promotion. This study is aimed at assessing the literature on surgical oncology in Romania, published by Romanian authors in journals indexed in international databases. Materials and Methods. A literature search was performed, focused on surgical oncology performed in Romania. Two databases, PubMed and Web of Science (WoS), were finally selected and included in the study, which included bibliometric parameters and subject analysis. Results. The PubMed search retrieved 464,295 articles being published in only 3 Romanian journals, Chirurgia, The Medical-Surgical Journal (Iasi), and Romanian Journal of Morphology and Embryology. The search of the Web of Science retrieved 494 records on the subject of surgical oncology in Romania, 449 of which were published after 1989. The 494 articles received 2,102 citations, 4.26 per year, and an overall Hirsch index of 21. Most articles were published in the same 3 Romanian journals as in PubMed. Neoplasms of the digestive system prevailed, followed by articles on general surgical oncology issues, cancer research, and therapy. Bucharest has the highest number of authors, followed by Cluj-Napoca and Iasi. Conclusion. Research originating from Romania in the field of surgical oncology is present and visible at an international level mainly through Romanian journals. Sustained effort is required from surgical oncology authors to be published in international journals on this subject, as it is the only way to increase global visibility and impact.

Tuberculosis (TB) is a public health issue that affects mostly, but not exclusively, developing countries. Abdominal TB is difficult to detect at first, with the incidence ranging from 10% to 30% of individuals with lung TB. Symptoms are non-specific, examinations can be misleading, and biomarkers commonly linked with other diseases can also make appropriate diagnosis difficult. As a background for this literature review, the method used was to look into the main characteristics and features of abdominal tuberculosis that could help with differentiation on the PubMed, Science Direct, and Academic Oxford Journals databases. The results were grouped into three categories: A. general features (the five forms of abdominal tuberculosis: wet and dry peritonitis, lymphadenopathy, lesions at the level of the cavitary organs, lesions at the level of the solid organs), B. different intra-abdominal organs and patterns of involvement (oesophageal, gastro-duodenal, jejunal, ileal, colorectal, hepatosplenic, and pancreatic TB with calcified lymphadenopathy, also with description of extraperitoneal forms), and C. special challenges of the differential diagnosis in abdominal TB (such as diagnostic overlap, the disease in transplant candidates and transplant recipients, and zoonotic TB). The study concluded that, particularly in endemic countries, any disease manifesting with peritonitis, lymphadenopathy, or lesions at the level of the intestines or solid organs should have workups and protocols applied that can confirm/dismiss the suspicion of abdominal tuberculosis.