Revista Medico-chirurgicala A Societatii De Medici Si Naturalisti Din Iasi[JOURNAL]
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200 papers
HEALTH CARE ECONOMICS IN ROMANIA--DYNAMICS AND EVOLUTION.
Tamba BI, Azoicăi D, Druguş D
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125091
Health economics refers to the analysis of medical institutions considering their economic and social efficacy, but also the regularity and the relationships that govern the phenomena and the processes from the field of...
Health economics refers to the analysis of medical institutions considering their economic and social efficacy, but also the regularity and the relationships that govern the phenomena and the processes from the field of health with the final purpose of achieving better results with the minimum of resources; it represents the study of health price in its complexity. The economics of the population's health needs and in particular the health needs in case of the poor groups of the population, consider health to be the main component of global human vulnerability. Health economics tries to change the simple interpretation of health price and disease cost into a wider consideration of a system administration similar to educational and social economics and the study of health in the context of the multiple specializations of the macro economy of the national group, as it is an instrument in the country's great economics symphony.
REDUCE CHILD MORTALITY AS A MILLENNIUM DEVELOPMENI GOAL IN ROMANIA.
Duma OO, Roşu ST, Petrariu FD … +2 more , Manole M, Constantin B
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125090
AIM: To assess the efforts made in Romania towards achieving the Goal 4 from MDGs--Reduce Child Mortality. MATERIALS AND METHODS: A descriptive study about the deaths among Romanian children under five, between 2002 and...
AIM: To assess the efforts made in Romania towards achieving the Goal 4 from MDGs--Reduce Child Mortality. MATERIALS AND METHODS: A descriptive study about the deaths among Romanian children under five, between 2002 and 2015, from the perspective of the MDGs. To help track progress toward this commitment, following specific targets and indicators were developed: Target 1-Halve the mortality rate in children aged 1-4 years between 2002-2015; Target 2--Reduce infant mortality by 40% between 2002 and 2015; Target 3--Eliminate measles by 2007. The comparison allows establish the status (achieved or not) for each target. RESULTS: From 2002, the under-five mortality rate recorded a continuous descendent trend till now (20.8 to 10.3 under five deaths per 1000 inhabitants in 2013). The infant mortality rates declined from 17.3 to 8.5 deaths per 1,000 live births (2002-2013). Eliminating measles by 2007--was achieved one year later, because of the measles epidemic in 2005 and 2006. High vaccination rates have been maintained, with the proportion of children 1 year old vaccinated against measles reaching and being maintained at between 94-98%. CONCLUSIONS: Substantial progress has been made in Romania, in achieving the Millennium Development Goal no. 4. All the three targets were achieved. However, infant mortality still remains above the average of European Union (4 infant deaths per 1,000 live-births).
DILEMMAS IN THE ATTITUDE TOWARDS SUICIDE.
Carasevici B
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125089
Although apparently easy to define, the suicidal act or attempt raises complex and difficult problems due to the multitude of conditions and situations that can lead to it. In all cases the suicide's definition has alway...
Although apparently easy to define, the suicidal act or attempt raises complex and difficult problems due to the multitude of conditions and situations that can lead to it. In all cases the suicide's definition has always centred on the intention of one person to deliberately cause his or her death in an active manner. Defining suicide has been consecutively the temptation of philosophers, sociologists, theologians, psychologists and psychiatrists. From an epistemological point of view the suicide is an open concept without precise borders, yet not incoherent. Scientists have constantly tried to establish evaluation criteria of suicidal acts but these are variable. One can even assume that there is an infinity of combinations of characteristics that would legit- imize the label of suicide, although none of them can be particularized in any way. Not even death itself represents a necessary condition for the evaluation of an act as suicide.
GIANT INTRALIGAMENTARY UTERINE LEIOMYOMA AND ITS COMPLICATIONS.
Cărăuleanu A, Socolov R, Lupaşcu IA … +2 more , Rugină V, Socolov D
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125088
Uterine leiomyomas are benign tumors arising from uterine smooth muscle. Although their pathogenesis remains unclear, they are the most common tumor of the female reproductive tract, occurring in as many as half of women...
Uterine leiomyomas are benign tumors arising from uterine smooth muscle. Although their pathogenesis remains unclear, they are the most common tumor of the female reproductive tract, occurring in as many as half of women older than 35 years. Uterine leiomyomas represent the most common benign tumors of the female reproductive tract. Giant uterine leiomyomas are very rare and represents a great diagnosis and therapeutic challenge. Uterine leiomyoma is one of the most frequent types of tumours and it is diagnosed in 20-40% of the women of reproductive age. Until the age of 50, approximately 70% of the white women and less than 80% of the black women will have had at least one leiomyoma. The frequency of the emergence of uterine leiomyoma in black women is significantly higher than in white women.
OUTCOME OF INTERNAL HEMIPELVECTOMY IN A PATIENT WITH MULTIPLE MYELOMA--CASE REPORT.
Andronic O, Alexa O, Veficeasa B
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125087
A patient treated for thyroid cancer was diagnosed with multiple myeloma in the context of trauma. After the pelvic tumor devascularization she underwent internal hemipelvectomy Type I + IIA Enneking Classification using...
A patient treated for thyroid cancer was diagnosed with multiple myeloma in the context of trauma. After the pelvic tumor devascularization she underwent internal hemipelvectomy Type I + IIA Enneking Classification using polymerizing bioneutral gel embolization, "Glubran 2". The purpose of this case report is to demonstrate the importance of careful selection of treatment methods, together with adequate physical therapy in order to obtain favorable long-term results.
EFFECT OF TRANEXAMIC ACID USE ON POSTOPERATIVE BLOOD LOSS IN TOTAL KNEE ARTHROPLASTY.
Savin L, Mihăilescu D, Grierosu C … +1 more , Botez P
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125086
AIM: To monitor the effect of tranexamic acid use (Exacyl) on postoperative bleeding (aspiration), autologous blood transfusion (autotransfusion), allogeneic blood transfusion and postoperative anemia (difference between...
AIM: To monitor the effect of tranexamic acid use (Exacyl) on postoperative bleeding (aspiration), autologous blood transfusion (autotransfusion), allogeneic blood transfusion and postoperative anemia (difference between preoperative and immediate postoperative hemoglobin levels) in total knee arthroplasty. MATERIALS AND METHODS: This retrospective observational study was conducted on a sample of 457 patients who underwent endoprosthetic knee arthroplasty in the interval January 1, 2008-July 3O, 2014 at the Traumatology-Orthopedics Clinic of the Iasi Rehabilitation Hospital. The mean age of the study group was 66 years (range 32-84 years), 74.4% were female, 39.8% presented varus and 6.1% valgus malalignment. The study group was subdivided into two groups: Group 1 served as controls and underwent surgery without the administration of tranexamic acid and Group 2 received tranexamic acid. RESULTS: In group 1 the average amount of blood lost was significantly higher than in group 2, 1168.94 ml vs. 452.9 ml (p < 0.001). The use of a cell saver was required in 70% of group 1 patients with an average amount of auto transfused blood of 480.70 ml, significantly more frequent and in greater amounts than in group 2 (below 10%) with an average of 15.05 ml (p < 0.001). In this study tranexamic acid had not a statistically significant favorable effect on blood transfusion requirements and anemia syndrome. CONCLUSION: Tranexamic acid has a favorable effect on postoperative blood loss and its associated complications, with a favorable impact on both early clinical and functional recovery.
TREATMENT OF PUBIC DISJUNCTION IN YOUNG-BURGUESS TYPE II AND III PELVIC RING FRACTURES.
Malancea RI, Malancea R, Veliceasa B … +2 more , Chirilă D, Alexa O
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125085
AIM: To present the personal experience in assessing the treatment of pubic disjunction in Young-Burguess type II and III pelvic ring fractures. MATERIAL AND METHODS: Included in the study were 30 patients with type II a...
AIM: To present the personal experience in assessing the treatment of pubic disjunction in Young-Burguess type II and III pelvic ring fractures. MATERIAL AND METHODS: Included in the study were 30 patients with type II and III pelvic ring fractures, aged 32 to 76 years. Of these, 18 patients were treated with external fixation, and 12 patients were treated surgically: type II fractures were treated with open reduction and internal fixation (ORIF) of pubic disjunction and type III fractures underwent additionally posterior fixation. RESULTS: Mean follow-up was 1.6 years. After external fixation we found the persistence of diastasis (1.5 to 4 cm), which was asymptomatic in all cases. Complications included implant failure in 3 patients, and postoperative infection in 2 patients. Among the 5 patients with type II lesions the clinical and radiological scores were excellent in 3, good in 1, and poor in 1. Among the patients with type III lesions the clinical outcomes were excellent in 5 and good in 2. CONCLUSIONS: External fixation has proved a good treatment option for patients who cannot tolerate a more extensive surgery. There is no conclusive clinical evidence favoring the use of two perpendicular plates vs. 1 plate for pubic symphysis fixation. In osteonorotic patients the use of 2 plates is recommended.
CONCENTRATIONS OF VITREAL CYTOKINES IN RHEGMATOGENOUS RETINAL DETACHMENT.
Danielescu C, Zugun-Eloae F, Zlei M
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125084
UNLABELLED: Proliferative vitreoretinopathy (PVR) is one of the most frequent causes of failure of rhegmatogenous retinal detachment (RRD) surgery. AIM: To measure the vitreous levels of granulocyte colony stimulating fa...
UNLABELLED: Proliferative vitreoretinopathy (PVR) is one of the most frequent causes of failure of rhegmatogenous retinal detachment (RRD) surgery. AIM: To measure the vitreous levels of granulocyte colony stimulating factor (G-CSF) and monocyte chemoattractant protein 1 (MCP-1) in eyes with RRD and in a control group. MATERIAL AND METHODS: A prospective study of 40 patients operated for RRD (study group) and 20 patients with epiretinal membrane or macular holes (selected as control group since they needed vitrectomy but had attached retinas). Vitreous samples were collected during vitrectomy and were assessed for the presence of cytokines using a fluorescent bead-based multiplex assay. RESULTS: The concentration of G-CSF (8.59 pg/ml) and MCP-1 (1615.2 pg/ml) were significantly increased in the study group, when compared to the control group (0 and 469.13 pg/ml, respectively). MCP-1 was also significantly increased in the subgroup of patients with PVR compared to the patients with uncomplicated RRD. CONCLUSIONS: The levels of these biomarkers support the idea that proliferative vitreoretinopathy has an inflammatory component.
THE PATIENT-DOCTOR-PSYCHOLOGIST TRIANGLE IN A CASE Of SEVERE IMUNOSUPRESSION IN THE HIV INFECTION.
Manciuc C, Filip-Ciubotaru F, Badescu A … +2 more , Duceag LD, Largu AM
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125083
In the last two years the Romanian adult population infected with the human immunodeficiency virus (HIV) has increased due to sexual transmission, both heterosexual and homosexual. The case presented is that of a 33 year...
In the last two years the Romanian adult population infected with the human immunodeficiency virus (HIV) has increased due to sexual transmission, both heterosexual and homosexual. The case presented is that of a 33 year-old man, admitted to the Infectious Diseases Hospital in Iasi with acute respiratory failure and a confirmation of Kaposi's sarcoma. Tests later proved positive for HIV, the patient being included in the stage AIDS C3 (acute immunodeficiency syndrome). The respiratory failure was suspected to be caused by Pneumocystis carinii and cotrimoxazol therapy, oxygen therapy and anti-retroviral therapy were established. He was also referred to the oncology hospital for treatment of Kaposi's sarcoma. The patient's adherence to therapy was influenced by a strong doctor-patient relationship, as well as by psychological counseling and support. Creating a functional doctor-patient-psychologist team is key throughout the HIV-positive patient's existence, for supporting long term adherence to therapy and acceptance of the diagnosis. This case highlights the need for a strong psychosocial compartment in every medical center that deals with HIV-infected individuals.
ATYPICAL FEMORAL FRACTURES AFTER LONG-TERM BISPHOSPHONATES THERAPY: CASE REPORT.
Găleşanu C, Mocanu V, Buzdugă C … +3 more , Florescu A, Zaharia V, Lisnic V
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125082
UNLABELLED: We present a 77-year-old woman with no histor of trauma, or associated with low-energy trauma, admitted to our clinic after three weeks of a left femoral fracture threated in Orthopedic Clinic. The patient wa...
UNLABELLED: We present a 77-year-old woman with no histor of trauma, or associated with low-energy trauma, admitted to our clinic after three weeks of a left femoral fracture threated in Orthopedic Clinic. The patient was in treatment with bisphosphonates over 10 years for osteoporosis. DISCUSSION AND CONCLUSIONS: The causal re lationship between prolonged bisphosphonate use and the occurrence of atypical femora fractures (AFF) has not yet been established. For the patient at high risk of fracture, it may be beneficial to continue bisphosphonate treatment beyond five years. The absolute risk of atypical femoral fractures is low (about 100 cases per 100,000 person-years among long term users). For most people with osteoporosis, the proven fragility-fracture risk-reduction. benefits of bisphosphonates outweigh the risks of AFF.
SEVERE AMIODARONE-INDUCED BRADICARDIA CONCEALES SICK SINUS SYNDROME: CASE REPORT.
Crăcană I, Vasilcu TF, Mardare A … +2 more , Alexa ID, Marcu DT
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125081
Sinus node dysfunction is one of the most common arrhythmias in elderly patients; it is usually associated with intermittent and variable symptoms, thus making it difficult to diagnose. We present the case of an elderly...
Sinus node dysfunction is one of the most common arrhythmias in elderly patients; it is usually associated with intermittent and variable symptoms, thus making it difficult to diagnose. We present the case of an elderly female patient with a personal history of atrial fibrillation treated for the last three years with amiodarone; she was admitted to the Geriatric Clinic for non-specific symptoms with onset two months previously for which she had already sought care in different medical services. Clinical examination showed severe bradycardia; ECG and Holter ECG on admission confirmed severe bradycardia, with a heart rate between 29 and 50 beats/min (bpm). Given her long-term treatment with amiodarone we looked for and found hyperthyroidism; the endocrine examination led to the diagnosis of mixed type Amiodarone-induced thyrotoxicosis and initiation of corticosteroid and antithyroid treatment. The evolution of cardiac arrhythmia was monitored with the help of several Holter ECGs performed after amiodarone washout and return to the euthyroid state, which revealed a tachycardia-bradycardia syndrome initially masked by the side effects of the unsupervised therapy with amiodarone, and properly treated by the implantation of a pacemaker.
COMPLEX MANAGEMENT OF FRAILTY FRACTURES--CASE REPORT.
Costescu EP, Dronic A, Alexa LD … +1 more , Alexa O
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125080
Frailty fractures encompass pelvic ring fractures in the elderly--a condition more frequently encountered in women, usually with pre-existing osteoporosis. The incidence of these fractures is increasing, following the in...
Frailty fractures encompass pelvic ring fractures in the elderly--a condition more frequently encountered in women, usually with pre-existing osteoporosis. The incidence of these fractures is increasing, following the increase in average life expectancy. Most of the times, they are the result of a minor injury, of which the patient has little or no recollection; the clinical signs and symptoms, radiological changes and the degree of fracture stability vary greatly. As such, there is a wide range of therapeutic options and one of the most important decisions for the physician is choosing between surgery and conservative treatment. We present the case of an elderly female patient with multiple pelvic ring fractures, and a medical history of cardiovascular disease and osteoporosis; the orthopedic examination recommended conservative treatment which was carried out in the Geriatric Clinic of the "Dr. C.I. Parhon" Hospital. Following the complete physical examination and through geriatric evaluation, a complex therapeutic plan was devised, which included: recovery through physiotherapy, adequate nutrition, psychological support, treatment of the cardiovascular comorbidities and prevention of the consequences of extended bed rest. The treatment lasted for 60 days and the outcome was favorable: decreased bone frailty, mainly through preserving muscle tone and osteoarticular function, correction of malnutrition, improvement of depression and partial recovery of patient's mobility; the results of our therapy made it possible for the patient to return home, where she leaves alone. She will need help with daily household chores, but she intends to continue the recovery therapy as means of increasing her quality of life and independence.
PROLONGED FEVER WITHOUT OBVIOUS ETIOLOGY FINALLY DIAGNOSED AS HIGH-GRADE SOFT TISSUE SARCOMA.
Doroftei NA, de Visscher N
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125079
Sarcomas represent a challenge t clinicians as they are rare and diagnosis is often delayed. Soft tissue sarcomas are relatively uncommon cancers, the incidence is estimated about 1% from all malignant tumors. Due to agg...
Sarcomas represent a challenge t clinicians as they are rare and diagnosis is often delayed. Soft tissue sarcomas are relatively uncommon cancers, the incidence is estimated about 1% from all malignant tumors. Due to aggressive biological behavior of pleomorphic undifferentiated sarcoma diagnosis must hi made as quickly as possible. MRI is the standard imaging modality for investigating possibl3 malignant masses. Excisional biopsy appears to be necessary for differentiating soft tissus sarcoma from expanding hematoma. FDG PET scans may be helpful in specific circum. stances (as was the situation in our case, because the lesion is composed from two components: an area without precise edges and a necrotic-cystic area).
THE ACUTE SCROTUM IN CHILDREN.
Tarcă E, Crişcov IG, Savu B … +1 more , Aprodu SG
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125078
The acute scrotum syndrome is a medical-surgical emergency and the recognition of this condition by both healthcare professionals and the general population may result into the patients' coming in earlier for medical exa...
The acute scrotum syndrome is a medical-surgical emergency and the recognition of this condition by both healthcare professionals and the general population may result into the patients' coming in earlier for medical examination and into the preservation of the gonad in case of torsion. The purpose of this retrospective analytical research is to point out specific epidemiological aspects in pediatric patients suffering from acute scrotum, and to review the existing diagnosis and treatment options. The study included 208 patients, of whom 16 with vanishing testis and 192 with acute scrotum (torsion of testis 25.5%, torsion of the hydatid of Morgagni 68.2%, epididymoorchitis 5.2%). The torsion of the hydatid of Morgagni occurs in boys with a mean age of 10 years and it involves both testes equally, whereas the torsion of testis usually occurs around the age of 13 and is twice more common in the left gonad. Another significant difference between the two conditions is the inflammatory syndrome, which occurs in 45.4% of the children with torsion of testis versus only 18.2% in the torsion of hydatid. Only one out of six testes torted during the neonatal period could be saved (16.6%); the gonad preservation rate was as high as 68.2% in the group of patients with testis torsion occurring outside the neonatal period. These alarming data are accounted for by the non-recognition of the severity of the condition and by the delayed surgical therapy, which occurs on the average 20 hours after the testis torsion has set in. If the asepsis and antisepsis standards are observed, patients with torsion of the hydatid of Morgagni or torsion of testis require neither fluid sampling from the tunica vaginalis for culture, nor antibiotic therapy.
SHORT TERM EVALUATION OF PERIMETRIC PROGRESSION IN PATIENTS WITH OPEN ANGLE GLAUCOMA AND DIABETES.
Pantalon A, Feraru C, Chiseliţa D
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125077
AIM OF STUDY: Progression rate in patients with glaucoma and diabetes. MATERIAL AND METHOD: cohort prospective study in Ophthalmology Clinic "Sf. Spiridon" University Hospital Iasi. We recruited patients with positive hi...
AIM OF STUDY: Progression rate in patients with glaucoma and diabetes. MATERIAL AND METHOD: cohort prospective study in Ophthalmology Clinic "Sf. Spiridon" University Hospital Iasi. We recruited patients with positive history for diabetes and of open angle glaucoma (OAG). The control group included subjects with OAG (74 eyes from 74 patients) and the study group (44 eyes, from 44 patients) included subjects with OAG and diabetes. At enrollment all patients had a complete ophthalmologic evaluation along with full metabolic status assessment. There were included only incipient and moderate forms of glaucoma, with mild or no diabetic retinopathy changes. Perimetric progression was assessed at 24 months with automated methods. RESULTS: globally, from 118 investigated eyes, 56.40% cases had primary open angle glaucoma, 41.03% normal tension glaucoma and 2.36% pseudoexfoliative glaucoma. Glaucoma severity classification showed early defects (mean deviation < -6 db) in the study group of 77.27% vs. 83.78% in control group, whereas moderate defects (mean deviation > -6 db) were found in 22.63% in study group vs. 16.21.0% in control group. Mean age of the patients was higher in absolute value in the open angle glaucoma group (64.31 +/- 1.66 years), vs. diabetes + open angle glaucoma (62.69 +/- 1.8 years), with comparable visual acuities (0.91 +/- 0.15 vs. 0.89 +/- 0.16), CID ratios and other clinical pa- rameters (p > 0.05). Mean baseline lOP in the study group was 18.18 +/- 3.55 mrnHg vs. 17.08 +/- 2.4 nimHg in controls (p > 0.05). Analysis of visual field parameters at baseline showed a significant difference (p = 0.48) between groups in MD levels -3.63 +/- 3.35 db (control group) vs. -4.40 +/- 5.78 db (study group), but no difference (p > 0.05) in PSD levels: 3.71 +/- 3.06 db (control group) vs. 4.05 +/- 3.04 dB (study group). Perimetric progression was estimated at 24 months by Glaucoma Progression Analysis software (GPA-Humphrey Visual Field Analyzer II) using 6 reliable visual field (VF) exams. Progression rate was similar between groups--0.19 +/- 0.78 dB/year (OAG) vs. -0.18 +/- 0.05 dB/year (OAG+DM), p > 0.05 and no other risk factor could have been linked to an increased progression rate, except visual field parameters at final and baseline evaluation, in both groups. CONCLUSIONS: On short term, functional deterioration in open angle glaucoma patients having early or moderate stages, occurs similarly in the presence or absence of diabetes.
CORRELATIONS BETWEEN ARTERIAL HYPERTENSION INDUCED BY ANGIOTENSIN II AND SYSTEMIC INFLAMMATION IN RAT.
Mărănducă MA, Cojocaru E, Carasevici E
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125076
UNLABELLED: Angiotensin II has articularly shown to play a key role in the regulation of inflammatory processes in hypertension. AIM: The present study aims to correlate the angiotensin II-induced hypertension 4th system...
UNLABELLED: Angiotensin II has articularly shown to play a key role in the regulation of inflammatory processes in hypertension. AIM: The present study aims to correlate the angiotensin II-induced hypertension 4th systemic inflammation. MATERIAL AND METHODS: We conducted an experimental study on Wistar male rats who received Ang II via subcutaneous miniosmotic pumps for 2 weeks. Rats were exposed to a 12h light /12h dark cycle. Sham rats were used as control. Systolic load pressure measurements and a flow cytometric analysis of lymphocyte surface markers were performed. After 14 days, the animals were euthanized under anesthesia with ylazine/ketaniine. RESULTS: Systolic BP progressively and significantly increased in rats 4th Ang II chronic infusion. We observed a statistical significant difference (p = 0.00001), in terms of T lymphocytes percentage between control rats plasma and Ang H treated rats lasma, in 14 days. CONCLUSIONS: Angiotensin II is an important mediator of hypertension and directly promotes inflammation by noticeably increasing the quantity of T cells in kidney tissue.
CERVICAL SPINE LESIONS IN RHEUMATOID ARTHRITIS PATIENTS.
Macovei LA, Rezuş E
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125075
AIM OF THE STUDY: to gather clinical and laboratory data on rheumatoid arthritis patients with cervical spine damage (incidence and prevalence, correlation between duration of disease and the time of lesion onset, to ass...
AIM OF THE STUDY: to gather clinical and laboratory data on rheumatoid arthritis patients with cervical spine damage (incidence and prevalence, correlation between duration of disease and the time of lesion onset, to assess signs and symptoms and the role of laboratory investigations). The spine is an axial organ with an important role in support and resistance. It is a pillar with a very complex morphological and functional structure. The vertebral column is crossed by many kinematic chains. The main problem of the cervical spine caused by rheumatoid arthritis is cervical instability which describes all cervical lesions that can lead to neurovascular damage or major disturbance of pain generating statics at movement. The evolving disease shows chronic inflammation of the synovium, which is a self-maintained process and an immunologically induced phenomenon. The chronic inflammation of the synovium forms granulation tissue that invades peripheral joints towards the center and causes ligament cartilage and bone damage. MATERIAL AND METHODS: The present paper investigated cervical spine lesions in 107 rheumatoid arthritis patients who were admitted to the 1st Rheumatology Clinic of Iasi Rehabilitation Hospital between January 2013 and December 2014. Our study focused on assessing signs and symptoms seen in spine affected by rheumatic disease. RESULTS AND DISCUSSIONS: the disease causes destructive lesions due to granulomatous infiltration of rachidian structures and medullary sheaths. These lesions lead to damaged discs and instability that produces subluxations and dislocations. The suboccipital region is most affected; in other regions of the spine, high lesions of C4-C5 prevail, where osteolysis damage of spinal apophyses are found. In atlas and axis joints, rheumatoid arthritis causes the inflammation of bursa, synovium and joint capsule and leads to synovial pannus formation. This causes the destruction of cartilage and subchondral bone. Atlantoaxial dislocation is caused by erosive synovitis of atlanto-epistrophic joint, atlanto-odontoid joint and serous bursitis separating the odontoid process from the transverse ligament. CONCLUSIONS: The dominant symptom of cervical spine damage was pain associated with stiffness and limited joint mobility, muscle stiffness, poor posture.
THE MALFUNCTIONS OF A NATIONAL TRANSPLANTATION SYSTEM: MULTI-LAYERED EXPLANATIONS FROM WITHIN.
Holman A, Beatrice I
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125074
UNLABELLED: Romanja has one of the lowest posthumous organ donation and transplantation rates in Europe. AIM: To explore the perspectives on the national transplantation system deficits shared by the physicians responsib...
UNLABELLED: Romanja has one of the lowest posthumous organ donation and transplantation rates in Europe. AIM: To explore the perspectives on the national transplantation system deficits shared by the physicians responsible for the identification and referral of potential posthumous organ donors. MATERIAL AND METHODS: The study consists of semi-structured interviews with the key informants (ICU physicians, neurologists and neurosurgeons) in county hospitals in Moldavia. RESULTS: The explanations for the current Romanian organ transplantation rate, as emerged from the participants' answers, are multi-layered. Overall, the national transplantation system is accused of being plagued with serious problems: it is underfunded, understaffed, its resources have been distributed unevenly among medical centers, the communication between its elements is disrupted, leaving the majority of the transplant professionals practically detached from its upper layer and affecting their motivation to perform their transplantation-related tasks. Furthermore, some of the participants point to the strong reluctance of the population to donate their deceased relatives' organs. CONCLUSIONS: The results suggest a set of possible multi-level interventicrnq that could alleviate these problems.
PLATELET INDICES AND LIVER FIBROSIS EVALUATION IN CHRONIC HEPATITIS C.
Gîrleanu I, Trifan A, Sîngeap AM … +3 more , Stoica OC, Cojocariu C, Stanciu C
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125073
UNLABELLED: Recently, several studies have reported that the mean platelet volume and platelet distribution width may give information about liver fibrosis severity in chronic hepatitis C. The aim of the present study wa...
UNLABELLED: Recently, several studies have reported that the mean platelet volume and platelet distribution width may give information about liver fibrosis severity in chronic hepatitis C. The aim of the present study was to evaluate whether platelet indices correlate with hepatic fibrosis measured by transient elastography in patients with chronic hepatitis C. MATERIALS AND METHODS: Patients with chronic hepatitis C were prospectively enrolled. Samples for complete blood count and routine biochemical parameters were collected and analyzed in the same day with liver fibrosis assessment by transient elastography. Mean platelet volume, platelet large cell ratio and platelet distribution width were compared with stages of liver fibrosis. Statistical analysis was carried out using SPSS 17.0 software. A P-value of less than 0.05 was considered statistically significant. RESULTS: There were 139 patients with chronic hepatitis C (70.5% males, mean age 54.8 +/- 16.7 years). Compared with mild/moderate liver fibrosis patients, those with advanced liver fibrosis had an increased mean platelet volume (10.4 +/- 0.7 vs. 10.9 +/- 0.9, p < 0.002), platelet large cell ratio (28.5 +/- 5.3 vs. 32.5 +/- 7.2, P < 0.0001), and platelet distribution width (12.8 +/- 1.5 vs. 14.1 +/- 2.7, P = 0.003). CONCLUSIONS: Increased platelet indices were associated with advanced liver fibrosis stages evaluated by transient elastography in patients with chronic hepatitis C.
ASSESSMENT OF ADVERSE DRUG REACTIONS AS CARDIOVASCULAR RISK FACTORS.
Gavrilescu CM, Felea MG, Barbu R … +6 more , Duma O, Bodescu MM, Midilina Bodescul M, Ghiuru R, Boerescu C, Paraschiv C
Rev Med Chir Soc Med Nat Iasi · 2016 · PMID 27125072
UNLABELLED: A wide range of pharmaceutical substances can induce side-effects expressed as cardiovascular changes or events, adding to other risk factors or worsening preexisting cardiovascular diseases. AIM: Continuous...
UNLABELLED: A wide range of pharmaceutical substances can induce side-effects expressed as cardiovascular changes or events, adding to other risk factors or worsening preexisting cardiovascular diseases. AIM: Continuous study focused on iatrogenic conditions representing cardiovascular risk factors. METHODS: We developed a descriptive study of patients admitted to the Iasi Vth Internal Medicine and Geriatrics-Gerontology Clinic between 1998-2013, focusing on iatrogenic conditions representing cardiovascular risk factors. RESULTS: We have diagnosed 81 cases of drug-induced hypertension, and 43 patients with hypertensive crises; 72 cases of iatrogenic hyperglycemia; 36 cases of drug-induced hyperuricemia; 50 cases of drug-induced dyslipidemias; and 17 cases of iatrogenic obesity. These iatrogenic diseases were more common in women and the elderly. Twenty-eight patients have developed simultaneous adverse drug reactions induced by the same drug and manifest as different cardiovascular risk factors. CONCLUSIONS: Cardiovascular risk factors can be induced to a significant extent by chronic drug administration. Some medications (e.g., NSAIDs, corticoids, beta-blockers, diuretics, contraceptives) can act on the same patient by multiple pathogenic links. The adverse drug reactions can be cardiovascular risk factors that persist in time, or can be removed (by discontinuing the administration of the implicated drug). The highest importance of their acknowledgment relies on the possibility of their prevention through carefully balancing the benefits and the risk of each new medication.
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