Revista Medico-chirurgicala A Societatii De Medici Si Naturalisti Din Iasi[JOURNAL]
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200 papers
ETHICAL AND DEMOGRAPHICAL ISSUES IN SCREENING FOR CERVICAL CANCER--AN OUTLINE IN NORTH EASTERN REGION OF ROMANIA.
Chelaru L, Amihaesei CI, Trandafirescu MF … +2 more , Matei Mioara Calipsoara, Manole A
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793857
AIM: This study complements the national screening program for cervical cancer, implemented in Romania. MATERIAL AND METHODS: Inclusion criteria for this program of active detection of cervical cancer are women aged 25 t...
AIM: This study complements the national screening program for cervical cancer, implemented in Romania. MATERIAL AND METHODS: Inclusion criteria for this program of active detection of cervical cancer are women aged 25 to 64 years and exclusion criteria were other age groups and the diagnosis confirmed of cervical cancer. The testing was free and used the method of colored cervical smear Pap. RESULTS: In 2013, 23.680 women were tested, that means only 10.13% of the total female population eligible for screening. In 2014, the test group was 6337 (one smear required retesting), of which 5852 were negative results and 484 positive results. Squamous cell abnormalities were detected in 433 women (6.84% of total group who attended the screening). Cervical smears with atypical squamous lesions were present at the most women included in the screening, regardless of age group (67.43%). The screening detected 21 lesions HSIL (4.84%), 2 HSIL with suspicion of invasion (0.46%) and 5 lesions of squamous carcinoma (1.15%). CONCLUSIONS: The presence of a small number of people compared to the female population eligible to the test screening may show the need for a better spread of notions about the screening and the afferent national program, for the population in northeastern Romania, considering the ethical issues that this test assumes.
MANIFESTATIONS OF SELF-HARM IN RELATION WITH BINGE DRINKING TO STUDENTS FROM TIMIS COUNTY, ROMÂNIA.
Bagiu I, Putnoky S, Tuţă-Sas I … +4 more , Miloicov CB, Popa M, Vlaicu B, Bagiu R
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793856
AIM: The research investigated the feeling of sadness, suicidal thoughts and plans associated with binge drinking among students in Timis County, Romania. MATERIAL AND METHODS: We applied a transversal population study t...
AIM: The research investigated the feeling of sadness, suicidal thoughts and plans associated with binge drinking among students in Timis County, Romania. MATERIAL AND METHODS: We applied a transversal population study to the representative sample of 2076 students, 62.49% girls and 37.51% boys with a mean age of 21.09 years with SD 1.48. RESULTS: The boys practice binge drinking significantly more often than girls, the difference is small to medium: prevalence of 22.1% for boys and 8.7% girls, 1-2 times in the last month. CONCLUSIONS: Only girls who practice this behavior, increased frequency of engaging in binge drinking is associated with feelings of sadness, suicidal thoughts and suicide plans in a small measure, but significant.
VACCINATION--COLLECTIVE RESPONSIBILITY OR VIOLATION OF RIGHTS?
Florescu L, Rugina A, Temneanu OR … +4 more , Paduraru DT, Matei MC, Safta C, Mindru DE
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793855
Vaccination is considered to be the most effective and the cheapest medical intervention through which individual and collective immunisation is achieved. Statistics show that, at present, immunisation annually saves 400...
Vaccination is considered to be the most effective and the cheapest medical intervention through which individual and collective immunisation is achieved. Statistics show that, at present, immunisation annually saves 400 million lives and protects approximately 750,000 children against disabilities of varying degrees. Approximately 80% of worldwide children are vaccinated against diphtheria, tetanus, pertussis, polio, measles, etc.; these diseases used to be considered incurable in the past. Vaccines help the body to produce antibodies; they help the immune system to detect germs and inactivate their cells. The immunological protection is installed after a variable period of time following the inoculation and is long lasting. Immunisations can be achieved in several ways: through national immunisation campaigns with general recommendation--they may be compulsory, optional or prophylactic (for the diseases for which a vaccine is available); vaccinations not included in the compulsory immunisation programmes; they may also be targeted to the contagious infectious outbreaks or to groups of population in certain situations. There is no guarantee that a vaccine will provide 100% protection. However, it will significantly reduce the risk of getting an infection. Vaccines have side effects which can be divided into reactions triggered by the vaccine or reactions exacerbated by it, without a causal relationship to the vaccine.
PECULIARITIES OF PHARMACOTHERAPY IN ARTERIAL HYPERTENSION AND COMORBID PATHOLOGY.
Tofan N, Marish M, Shtanko V
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793854
UNLABELLED: In patients with arterial hypertension (AH) pharmacotherapy often remains ineffective because of comorbid pathology. Research of haemodynamic and metabolic processes in such patients allows prescribe effectiv...
UNLABELLED: In patients with arterial hypertension (AH) pharmacotherapy often remains ineffective because of comorbid pathology. Research of haemodynamic and metabolic processes in such patients allows prescribe effective antihypertensive medicines, improve life quality and prognosis. MATERIAL AND METHODS: 60 patients with AH, coronary artery disease and obesity were divided into three groups: 1st group was treated with lisinopril + atorvastatin + aspirin (regimen I); 2nd group was treated with lisinopril + atorvastatin + bisoprolol + aspirin (regimen II); 3rd group was treated with lisinopril + bisoprolol + indapamide + atorvastatin + aspirin (regimen III). Laser correlation spectrometry (LCS) was used to evaluate the homeostatic alterations. RESULTS: All regimens were equally effective in normalization of systolic blood pressure and did not influence the ejection fraction. Only in the 3rd group was determined significant increase of glomerular filtration rate (92.73 ± 2.12 vs 79.62 ± 13.62 ml/min/1.73m2). The LCS test showed that these patients had high level of light scattering particles IV, which may be caused by activation of anabolic processes. In other groups, spectral alterations were not so expressive. CONCLUSIONS: Prescription of antihypertensive therapy cause homeostatic and metabolic alterations, which may influence the efficacy of treatment.
HEAD CIRCUMFERENCE REFERENCES FOR SCHOOL AGE CHILDREN IN WESTERN ROMANIA.
Chirita-Emandi A, Doros G, Simina IJ … +2 more , Gafencu M, Puiu M
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793853
AIMS: To provide head circumference references for school-aged children in western Romania, and compare them with references from other European countries. METHODS: A total of 2742 children, aged 6-19 years, from Timis c...
AIMS: To provide head circumference references for school-aged children in western Romania, and compare them with references from other European countries. METHODS: A total of 2742 children, aged 6-19 years, from Timis county, were examined by medical students, between February 2010-June 2011. Head circumference references were constructed by Cole's LMS method with LMSChartMaker software. The Romanian 3rd, 50th and 97th percentiles for head circumference were compared with recent references from Belgium and Germany. RESULTS: Generally, boys show significantly larger head circumference compared to girls at any age. The head circumference increments between 6 and 19 years are < 1 cm/year. Head circumference increments decrease in increasing age of the children. In girls, adult head circumference is reached at the age of 16 years, whereas head circumference growth continues, in boys, slowly until 18 years. The comparison of Romanian head percentiles with those from Belgium and Germany revealed a smaller head circumference in Romanian children (both girls and boys). CONCLUSIONS: Comparing head circumference references from Romania to those from Germany and Belgium, we found lower median head circumference in Romanian boys and girls, that could be explained by a taller stature of boys and girls in Germany and Belgium compared to Romania.
POSTOPERATIVE ARTERIAL RELAXATION AND INTRAOPERATIVE VENOUS DILATION AS INTERCONNECTED PROGNOSTIC FACTORS FOR THE MATURATION OF ARTERIOVENOUS FISTULAS.
Roată CE, Moroşanu C, Makkai-Popa ST … +2 more , Bosânceanu ML, Covic AC
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793852
AIM: To investigate if immediate arterial distention can be used as a predictive factor for the development of a good fistula. MATERIAL AND METHODS: Over a 5-months period (January- May 2015) all the patients who underwe...
AIM: To investigate if immediate arterial distention can be used as a predictive factor for the development of a good fistula. MATERIAL AND METHODS: Over a 5-months period (January- May 2015) all the patients who underwent an arteriovenous fistula between the radial artery and the cephalic vein of the forearm at the Second Surgical Clinic of the Iasi Regional Cancer Institute and were willing to participate were enrolled in the study. The diameters of the vessels were measured 1 hour and 8 weeks after surgery. RESULTS: We found statistically significant differences for all measured diameter variations between the calcified artery and normal artery groups (p < 0.001 for the arterial distention at 1 hour and 8 weeks after surgery and p = 0.002 for the venous distention 8 weeks after surgery). A linear regression also showed that the degree of arterial distention immediately after surgery and the venous distention 8 weeks after surgery were statistically correlated. CONCLUSIONS: Arterial distention immediately after surgery and therefore the lack of it due to the presence of arterial calcifications can be used to predict whether or not a good fistula can be achieved at a 1% statistical significance level.
PREDISPOSANT FACTORS FOR INTIMAL HYPERPLASIA AND THEIR MECHANISMS OF ACTION IN OPEN VASCULAR SURGERY. A REVIEW.
Pătruţ GV, Ionac M
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793851
BACKGROUND: Intimal hyperplasia is a multifactorial process that determines local stenosis and subsequent ischemia after revascularisation procedures. It is controlled by a plethora of cytokines, growth factors and prote...
BACKGROUND: Intimal hyperplasia is a multifactorial process that determines local stenosis and subsequent ischemia after revascularisation procedures. It is controlled by a plethora of cytokines, growth factors and proteases that interact through multiple mechanisms, empowering or inhibiting their hyperplasic action. Although the elements involved are the same, the resulted degree of vascular stenosis varies. METHODS: To highlight the predisposing conditions which enhance the vascular response to injury we consulted articles from Pubmed database, searching for the keywords "intimal hyperplasia", "neointimal hyperplasia" and "risk factor". RESULTS: 101 articles were included in the study. Risk factors analyzed are classified into local and systemic and the mechanisms by which they augment the process are explained. CONCLUSION: Knowledge of risk factors and their control when possible is a key element in increasing revascularization patency.
INFLAMMATORY ABDOMINAL AORTIC ANEURYSM--A FORM OF CHRONIC PERIAORTITIS.
Pop C, Nemeş RM, Jantea P … +2 more , Tomescu A, Postolache P
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793850
Chronic periaortitis represents a unique pathogenic concept for three entities: Inflammatory Abdominal Aortic Aneurysm, Idiopathic Retroperitoneal Fibrosis and Perianeurysmal Retroperitoneal Fibrosis. The fundamental mea...
Chronic periaortitis represents a unique pathogenic concept for three entities: Inflammatory Abdominal Aortic Aneurysm, Idiopathic Retroperitoneal Fibrosis and Perianeurysmal Retroperitoneal Fibrosis. The fundamental meaning of an inflammatory reaction to advanced atherosclerosis has been developed on the bottom of clinical and histological features. The triad of abdominal pain, weight loss and elevated inflammatory markers: erythrocyte sedimentation rate/C-reactive protein in patients with abdominal aortic aneurysms revealed on contrast-enhanced computer tomography is highly suggestive for inflammatory aneurysm. We report a case of a heavy-smoker adult male presented with suddenly abdominal symptoms suggestive for mesenteric ischemia which have proved to be due to inflammatory abdominal aortic aneurysm. The most favorable management of patients with inflammatory aneurysm is ambiguous. Surgical approach seems reasonable even supposing inflammatory aneurysm emerges less likely to rupture than the atherosclerotic variant. Corticosteroids are used in inoperable inflammatory aneurysm, even if is well known that this treatment does not change the long-term outcome of the disease. Surgical-open or Endovascular Repair of the aneurysm is the elective treatment.
A CASE OF POLYMYOSITIS WITH INTERSTITIAL LUNG DISEASE ONSET.
Enache A, Bădulescu M, Burlui A … +4 more , Cardoneanu A, Stamate IG, Mihăescu T, Rezuş E
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793849
Polymyositis is an idiopathic inflammatory myopathy of unknown aetiology that affect skeletal muscles causing symmetrical, proximal muscle weakness, and also other internal organs. The investigations reveal elevated skel...
Polymyositis is an idiopathic inflammatory myopathy of unknown aetiology that affect skeletal muscles causing symmetrical, proximal muscle weakness, and also other internal organs. The investigations reveal elevated skeletal muscle enzyme levels and characteristic electromyography (EMG) and muscle biopsy findings. Pulmonary involvement in polymyositis includes respiratory muscle weakness, aspiration pneumonia, interstitial lung disease, infection and drug-induced pneumonia. We expose the case of a young woman (47 years old) who presented to the Pulmonology Clinic with fever, cough, purulent sputum, discrete myalgia, being diagnosed at that moment with interstitial lung disease and treated with antibiotics, low dose of corticosteroids and symptomatic drugs. The evolution was slowly favorable for the respiratory impairment, but the patient developed exacerbated myalgia, muscle weakness, reaching even the impossibility of maintaining orthostatism, and also joint pain. Biological investigations revealed an important hepatocytolysis syndrome and also increased levels of muscle enzyme. The hypothetical diagnosis was polymyositis and to sustain this theory it was performed a muscle biopsy. The patient was transferred afterwards to the Rheumatology Clinic, in order to perform other specific investigations. In our clinic the patient maintained elevated levels of skeletal muscle enzymes and the muscle biopsy revealed polymyositis findings. Also immunological investigations objectified the presence of Jo1 antibodies. Therefore we pleaded for the diagnosis of idiopathic polymyositis, acute form. A multidisciplinary approach is needed in order to establish an accurate diagnosis and to institute a proper treatment.
PSYCHOTIC DISORDERS GENERATED BY AUTOIMMUNE ENCEPHALITIS (CLINICAL CASE).
Craciun G, Cucoş L, Ungureanu E … +3 more , Pendefunda L, Petrariu FD, Nechita P
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793848
Encephalitis is a brain inflammation, which could involve also the meninges. The etiology of encephalitis could be: viral, bacterial, fungal or autoimmune. Anti-NMDAR encephalitis is an immune disorder, easy to diagnose...
Encephalitis is a brain inflammation, which could involve also the meninges. The etiology of encephalitis could be: viral, bacterial, fungal or autoimmune. Anti-NMDAR encephalitis is an immune disorder, easy to diagnose and is a treatable condition. Most patients with anti-NMDAR encephalitis develop a multistage illness that progresses from psychosis, memory deficits, seizures, to catatonic state and breathing instability. We present a case report of a 20-year old woman, who presented: amnesia, visual hallucination, illusions, seizures after that occurred following autoimmune encephalitis. The exact incidence of anti-NMDAR encephalitis is unknown, but it seems to be more frequent than any other known paraneoplastic encephalitis. The present case is important considering that autoimmune encephalitis is a rare frequency disorder in Romania, with patients presenting resounding psychiatric and neurological manifestations.
THE AUTOIMMUNE CONSTELLATION IN LICHEN AMYLOIDOSIS.
Andrese E, Vâţă D, Ciobanu D … +2 more , Stătescu L, Solovăstru LG
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793847
Localized cutaneous amyloidosis is a rare disease among white people, being more common in South-Asia, China and South America. The disease is characterized by deposition of amyloid material in the papillary dermis witho...
Localized cutaneous amyloidosis is a rare disease among white people, being more common in South-Asia, China and South America. The disease is characterized by deposition of amyloid material in the papillary dermis without visceral involvement. Nevertheless, there is a growing list of immune-mediated disorders that have been linked to cutaneous amyloidosis. We present two cases of concomitant occurrence of lichen amyloidosis and autoimmune thyroiditis/atopic dermatitis in two Caucasian women.
SELENIUM STATUS IN AUTOIMMUNE THYROIDITIS.
Vasiliu I, Preda C, Serban IL … +7 more , Strungaru SA, Nicoară M, Plăvan G, Stoica B, Ciobanu DG, Bredeţean O, Vulpoi C
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793846
UNLABELLED: Selenium (Se) is an important element that exerts its effects through selenoproteins. The thyroid gland has the highest Se concentration and specific selenoprotein enzymes families are crucial in the thyroid...
UNLABELLED: Selenium (Se) is an important element that exerts its effects through selenoproteins. The thyroid gland has the highest Se concentration and specific selenoprotein enzymes families are crucial in the thyroid hormone metabolism. There is little evidence on the link between Se and thyroid autoimmune disease, therefore future studies are required to elucidate the nature of this associ ation. AIM: To evaluate the Se status in euthyroid subjects with autoimmune thyroiditis. MATERIAL AND METHODS: From January 2014 to January 2015 we recruited 100 consecutive euthyroid subjects with autoimmune thyroiditis, living in the same region and with normal iodine intake. Serum concentrations of Se, thyroid antibodies (antithyroperoxidase--TPOAb--and antithyroglobulin--TgAb), thyroid-stimulating hormone (TSH), and thyroid ultrasound were performed in all patients. RESULTS: Mean age of the study group was 48.87 ± 12.83 years, range: 18-82 years. Since thyroid pathology is more frequent in the 5th - 6th decades of life we selected the age of 50 for the comparative analysis of the results (51% of patients were under 50). No statistical age-group differences in antibody levels were found: mean TPOAb = 420.95 IU/ml, p = 0.840; mean TgAb = 327.98 IU/ml, p = 0.977. TSH mean was 2.14 [μIU/ml, with no significant age-group differences (p = 0.176). Se levels ranged between 8.05 - 998.50 μg/ with a mean value of 294.96 μg/L and no significant differences between age groups (p = 0.158). Thyroid ultrasound showed inhomogeneity in 89%, nodules in 35% of patients, and a mean thyroid volume of 11.72ml, with no significant age-group differences (p = 0.366). The low TSH levels were associated with low Se levels in 11.6% of cases, but the direct correlation was statistically insignificant (r = 0.116; R2 = 0.0161; p = 0.371). Depend ing on TSH percentiles, mean Selevels showed no significant differences, however pointing out the highest mean value at the 25th percentile (F = 0.441, df = 61, p = 0.646). A negative correlation trend was found between Se and TPOAb (r = -0.2276) or TgAb (r = -0.2190) but lacking statistical significance (p=0.099). CONCLUSION: Our results showed a weak negative correlation between Se and antithyroid antibodies, suggesting that selenium supplementation may improve the course of thyroid autoimmunity.
EGFR MUTATIONS IN NON-SMALL CELL LUNG CANCER: LOCAL EPIDEMIOLOGY AND CLINICAL IMPORTANCE.
Rusu-Cordunean F, Berlea ML, Cernomaz AT … +4 more , Marinca MV, Peter S, Pavel I, Grigoriu BD
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793845
INTRODUCTION: Lung cancer's dismal prognosis led to new therapeutic approaches among which TKIs being among most promising; MATERIAL AND METHOD: Retrospective study at the Regional Institute of Oncology Iasi of non small...
INTRODUCTION: Lung cancer's dismal prognosis led to new therapeutic approaches among which TKIs being among most promising; MATERIAL AND METHOD: Retrospective study at the Regional Institute of Oncology Iasi of non small cell lung cancer patients which underwent molecular investigations between November 2013 - September 2014. EGFR mutation status (positive, negative, undetermined) was assessed with an Entrogen EGFR kit using DNA extracted from paraffin embedded samples (surgical or endobronchial biopsies) with the Macherey-Nagel "NucleoSpin FFPE DNAkit" and then amplified on a Applied Biosystem 7500 Real Time PCR System. RESULTS: There were 63 adenocarcinoma samples (17 females, mean age 60,9 +/- 9 years): 49 primary lung tumors and 14 secondary lesions (brain, lymph nodes, pleural). There was insufficient bioptic material for three cases. TTF1 status was determined for 46 patients--six were negative. There were twelve mutations identified (7 female subjects, 5 male)--six L858R, five Del 19 and one G719X; ten were TTF1 positive for the remaining two TTF1 status was unknown. Female sex predominance was statistically significant (p = 0.02, chi squared). Mean age for mutation positive patients was 64 +/- 10 years; there were three never smokers, three active smokers and no data on smoking status was available for six subjects. CONCLUSION: Although small dimension of the study group precludes statistical significance EGFR mutations seem to correlate with TTF1 status.
INFORMED CONSENT IN PSYCHIATRIC MEDICAL CARE: A PROSPECTIVE QUANTITATIVE STUDY.
Nechita P, Vicol MC, Pantea AP … +2 more , Petrariu FD, Crăciun G
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793844
UNLABELLED: Respecting fundamental ethics principles entails the process of obtaining an informed consent, which is a necessary requirement for offering good psychiatric medical care and conducting research studies on hu...
UNLABELLED: Respecting fundamental ethics principles entails the process of obtaining an informed consent, which is a necessary requirement for offering good psychiatric medical care and conducting research studies on human subjects, who are regarded as the vulnerable population. Presently, in Romania, the informed consent regarding medical interventions is covered by the law of the patient's rights, Law 46/2003, chapter 3. The aim of this study is to evaluate the medical staff's perception of the need of the informed consent in the practice of psychiatric medical care. MATERIAL AND METHODS: This is a quantitative, inquiry based study, with prospective evaluation, based on the responses of 217 medical staff members involved in treating patients with psychiatric disorders. The study unfolded between July 2012 and July 2013, and the questionnaires were answered by medical staff members (psychiatrists, general practitioners, other clinical specialists, psychologists) from Iasi, Botosani, Vaslui, Suceava counties. RESULTS: The age group distribution of the medical staff involved in the medical care shows statistically significant differences between the groups questioned (χ2 = 227.14; df = 5; p = 0.001). Concerning the answers recorded at question no. 2, regarding informing the psychiatric patient, and comparing the studied groups of medical staff, a majority of affirmative answers was noted. CONCLUSIONS: The medical staff members involved in the patient's treatment recognizes the necessity of a full informed consent when discussing about psychiatric medical care. In psychiatry, the variation of competence raises multiple ethics discussions.
EVALUATION OF PROGNOSTIC FACTORS IN DECOMPENSATED LIVER CIRRHOSIS WITH ASCITES AND SPONTANEOUS BACTERIAL PERITONITIS.
Dănulescu RM, Stanciu C, Trifan A
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793843
UNLABELLED: Mortality in spontaneous bacterial peritonitis (SBP) decreased significantly from 90% in 1970 to 10-30% today, but SBP still remains a complication with a poor prognosis. Although there are new preventive mea...
UNLABELLED: Mortality in spontaneous bacterial peritonitis (SBP) decreased significantly from 90% in 1970 to 10-30% today, but SBP still remains a complication with a poor prognosis. Although there are new preventive measures, such as early diagnosis and treatment with albumin, the introduction of new antibiotics, the prognosis of patients with decompensated cirrhosis and SBP remains poor, with a mortality rate of 20-40%. The installation of an episode of spontaneous bacterial peritonitis reduces the survival rate at 1 year to 30% and to 20% at 2 years. PURPOSE: In this context, the identification of patients with increased risk of death is extremely important in order to improve prognosis. MATERIAL AND METHODS: The prospective study included 153 patients with cirrhosis admitted to the Institute of Gastroenterology and Hepatology Iaşi from 1 January to 31 December 2010, reevaluated during 2 years. Criteria for the diagnosis of SBP were the presence of a number > 250 PMN / mmc. The presence of ascites and/or upper gastrointestinal bleeding (UGB) marks the decompensated cirrhosis. To assess the severity of cirrhosis, there were used Child-Pugh and MELD scores. Diagnostic paracentesis and ascites fluid cultures were performed in all hospitalized patients with ascites and also in case of signs and symptoms of SBP, before and after antibiotic treatment. Lack of response to empirical therapy was considered in those cases with a decrease in the number of neutrophils < 25% from baseline. RESULTS: Identification of patients with increased risk of death is extremely important to improve prognosis. In peripheral leukocytosis and in the ascites fluid, low hemoglobin can be considered predictors of mortality in patients with PBS. Child-Pugh score, increased levels of bilirubin and creatinine and hyponatremia are independent risk factors of mortality in patients with SBP. Bacteremia and lack of therapeutic response are independent risk factors of mortality associated with SBP. Recent history of variceal bleeding, severity of infection and the degree of hepatic and renal impairment influence short-term prognosis of patients with SBP. CONCLUSIONS: Identification of patients with increased risk of death is extremely important to improve prognosis. Therefore, it is important to identify prognostic factors in patients with bacterial infection and cirrhosis, in order to identify high risk patients and to prevent complications and death.
CHARACTERISTICS OF HEPATITIS B VIRUS COINFECTION AMONG HIV-INFECTED PREGNANT WOMEN.
Juganariu G, Teodor A, Petrovici C … +2 more , Cristina N, Miftode E
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793842
UNLABELLED: The similar routes of transmission for HIV and HBV place patients with either infection at greater risk for HIV/HBV co-infection. AIM: To determine the particularities of hepatitis B virus (HBV) coinfection i...
UNLABELLED: The similar routes of transmission for HIV and HBV place patients with either infection at greater risk for HIV/HBV co-infection. AIM: To determine the particularities of hepatitis B virus (HBV) coinfection in pregnant women infected with human immunodeficiency virus (HIV) and its influence on pregnancy. METHODS: Retrospective study of 74 HIV-infected women monitored during pregnancy in the Iasi Regional HIV/AIDS Center (Romania) from 2010 to 2013. The subjects were divided into 2 groups according to the presence or absence of HBV coinfection. RESULTS: Most subjects belonged to age group 20-24 years (90% in the HIV group versus 75.5% in the HIV/HBV-coinfected group). HIV infection was most commonly transmitted by parenteral route (65.5% vs. 48.9%). The majority of patients were married (60% vs. 65%) and primiparous at the time of enrollment (71.1% vs. 96.6%). In the HIV/HBV-coinfected group CD4 level was lower and mean plasma viral load higher (1.92 log10 copies/mL vs. 2.31 log10 copies/ml). The proportion of cases with severe immunosuppression was similar in both groups (18.1% vs. 17.9%). HBV-HIV coinfection induced a risk of prematurity of 1.51 times, but did not increase the risk of newborns with low birth weight. CONCLUSIONS: Advanced stages of HIV disease, age group 21-30 years, low CD4 counts, and low levels of education are significant risk factors for preterm birth and low birth weight.
ENDOTHELIAL DYSFUNCTION ASSESSED BY LASER DOPPLER POST-OCCLUSIVE HYPEREMIA IN CHRONIC KIDNEY DISEASE PATIENTS.
Busila I, Onofriescu M, Gramaticu A … +3 more , Hogas S, Covic A, Florea L
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793841
UNLABELLED: This study was intended to investigate the microcirculation endothelial dysfunction through a laser Doppler method (PORH post-occlusive reactive hyperemia) in patients with chronic kidney disease. MATERIALS A...
UNLABELLED: This study was intended to investigate the microcirculation endothelial dysfunction through a laser Doppler method (PORH post-occlusive reactive hyperemia) in patients with chronic kidney disease. MATERIALS AND METHODS: The study included 299 patients diagnosed with chronic kidney disease, which were divided into three groups: hemodialysis patients, peritoneal dialysis patients and patients with chronic kidney disease stages 3-4. Endotelial dysfunction was assesed with the Laser Doppler Perfusion Monitor type device (Periflux System Monitor 5001). RESULTS: The values of the parameters we evaluated with postocclusive reactive hyperemia were altered in all patients with chronic kidney disease. In the dialysis groups there was no statistically significant correlation between parameters we tested by measuring PORH and the method of renal replacement therapy or dialysis duration. The same was observed in patients with pre-dialysis chronic kidney disease. CONCLUSIONS: Post-occlusive reactive hyperemia, a novel method for assessing endothelial dysfunction on the microcirculatory system and early marker of cardiovascular damage requires more studies to validate in patients advanced renal disfunction.
LEVELS OF MUTANS STREPTOCOCCI AMONG SCHOOLCHILDREN IN IASI, ROMANIA.
Bobu LI, Bârlean L, Bârlean M
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793840
AIM: To evaluate the dental and salivary density of mutans streptococci among Iasi schoolchildren. MATERIAL AND METHODS: This study cross-sectional included 533 schoolchildren aged 7-12 years. The density of mutans strep...
AIM: To evaluate the dental and salivary density of mutans streptococci among Iasi schoolchildren. MATERIAL AND METHODS: This study cross-sectional included 533 schoolchildren aged 7-12 years. The density of mutans streptococci on dental surface (mesial and occlusal surfaces of teeth 1.6 and 3.6) and in saliva was assessed using Dentocult SM Strip mutans kits (Orion Diagnostica Oy) according to manufacturer's instructions. Subjects were given one of the following scores: 0 = < 10(4) CFU/ml; 1 = < 10(5) CFU/ml; 2 = 10(5)-10(6) CFU/ml; 3 = > 10(6) CFU/ml. RESULTS: A mutans streptococci density score 3 was predominant both in saliva and on the mesial and occlusal surfaces of the first permanent molars. Scores 2 and 3 were predominant in younger children, while in 12-year-old children the four scores were in similar percentages. CONCLUSION: High levels of mutans streptococci prevail among Iasi schoolchildren, highlighting the need to implement complex caries prevention programs.
THE PERSONAL REPRESENTATIVE--THE "ACHILLES HEEL" OF THE ROMANIAN MENTAL HEALTH LAW SYSTEM.
Turliuc S, Nechita P, Vicol MC … +2 more , Zatel M, Crăciun G
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793839
The psychiatric law system was created with the sole purpose of protecting patients with mental illnesses, a vulnerable segment of the population. The laws regarding voluntary and non-voluntary admission of mental patien...
The psychiatric law system was created with the sole purpose of protecting patients with mental illnesses, a vulnerable segment of the population. The laws regarding voluntary and non-voluntary admission of mental patients have been reformed in many European countries. After 1989, Romania starts to gradually benefit from a law system that meets the requirements of modern society. From this general context the Mental Health Law takes form, with the main purpose of ratifying the relationship between patient and psychiatrist. This system provides a new, more modern approach but also proves to have certain flaws. One of the most obvious is the aspect regarding the personal representative, which generates both ethical and professional conduit problems, difficult to manage from the standpoint of modern medicine. Minimizing the effects of such an error is possible by simply considering the small number of solutions suggested by the author in the end of this article.
THE NEED FOR HBV GENOTYPING: A COST-EFFICIENT APPROACH.
Luca AS, Ursu RG, Teuşan T … +3 more , Luca CM, Pleşca CE, Iancu LS
Rev Med Chir Soc Med Nat Iasi · 2015 · PMID 26793838
The outcome of chronic HBV infection is variable; approximately one half of individuals transition to an inactive carrier state, 30% progress to cirrhosis, and the remainder to chronic hepatitis. Ten different HBV genoty...
The outcome of chronic HBV infection is variable; approximately one half of individuals transition to an inactive carrier state, 30% progress to cirrhosis, and the remainder to chronic hepatitis. Ten different HBV genotypes and many subtypes have been identified with distinct geographical distributions. Over the years, a lot of studies presented the efficiency of different genotyping methods; for this reason we aimed to present a cost efficient genotyping diagnosis algorithm of CHB infected patients, especially useful to identify those at risk of disease progression and determine optimal anti-viral therapy as useful instrument for physicians.
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