Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
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Tuberculosis and sarcoidosis are two different diseases with different etiology, clinical features and treatment. Both are granulomatous disease, but tuberculosis has a caseating necrosis granuloma as opposed to sarcoidosis witch present noncaseating epithelioid cell granuloma. If chest radiography shows hilar lymphadenopathy and hystopatological features reveal no caseating necrosis granuloma the differential diagnosis might be difficult. ⋯ Pathological findings of chest radiography and CT scan with iv contrast (left upper lobe infiltrate, right lower lobe ill-defined mass, multiple small nodular opacities scattered throughout both lung fields, bilateral hilar and mediastinal adenopathy, lymph nodes near celiac trunk were enlarged) and positive acid-fast bacilli of sputum smears point to the real diagnosis of pulmonary tuberculosis and abdominal lymph nodes tuberculosis. The patient was started on a daily treatment with Isoniazid, Pyrasinamide, Ethambutol, Streptomycine, Cyprofloxacine, Cicloserine and Protionamide (he was allergic to Rifampin). Five months later the clinical and radiological findings were almost normal and the sputum smear for acid-fast bacili was negative.
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Rev Med Chir Soc Med Nat Iasi · Oct 2008
C-reactive protein, marker for evaluation of systemic inflammatory response in preeclampsia.
Determination by a high sensitivity technique of serum C-reactive protein (CRP), a sensitive marker of inflammation in women with preeclampsia compared to normal pregnancy and investigation of the relationship between CRP and the severity of the preeclamptic syndrome. ⋯ Our results demonstrate that serum CRP is increased in preeclampsia and represents a marker of the severity of the preeclamptic syndrome and of fetal weight at birth. Taking into consideration these observations and the fact that CRP testing is rapid and relatively inexpensive, we recommend the use of this acute phase reagent in clinical practice, in all women with preeclampsia in order to establish the prognosis of the disease.
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Rev Med Chir Soc Med Nat Iasi · Oct 2008
Case Reports[Surgical therapeutic strategy in vital risk polytrauma with multiple organ injuries, case report].
The medical interest for trauma pathology is incresing, due to the gravity of the given injuries. The surgical therapeutic strategy used is directly related to the localization and to the type of the trauma. The supplementary lesions and their vital risk also matter. ⋯ We recently observed an increasing tendency toward the rise of number and variety of patients with trauma, due to the great diversity of the etiopathogenic agents. The most important factor, during the assessment of a politraumatised patient is to diagnose correctly the functional deficits of vital organs and establish the vital prognosis. It is necessary to adopt the best and fast therapeutic strategy in order to obtain rapid life-saving decisions.
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Rev Med Chir Soc Med Nat Iasi · Oct 2008
Case Reports[Axillary wound with complete vasculo-nervous section. Functional outcomes].
Axillary wound with complete vasculonervous section are rare in adults, males between 20 and 30 years being more affected. In children these lesions are even more rarely encountered. Immediate surgical repair of vascular and nervous sections is recommended. ⋯ Vascular reconstruction with venous graft and epiperineural nerve reconstruction was done. Kinetotherapy and physiotherapy was part of recovery treatment. Follow up at 15 months confirmed very good functional outcomes with almost complete motor and sensitive function of the limb.
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Rev Med Chir Soc Med Nat Iasi · Oct 2008
[Prevalence and role of Helicobacter pylori infection in some gastroduodenal and hepatic complications in cirrhotic patients].
It has been clearly established that Helicobacter pylori (H. pylori) infection plays a pivotal role in the pathogenesis of chronic gastritis, peptic ulcer, gastric adenocarcinoma, and gastric lymphoma MALT (mucosa-associated lymphoid tissue) in the general population, but data regarding the prevalence and the role of H. pylori infection in liver cirrhosis are conflicting. Most serological studies estimated a high prevalence of H. pylori infection in patients with liver cirrhosis; however, when other methods (urea breath test, histology, culture, rapid urease test) were used, the overall H. pylori prevalence was similar to that in controls. Although the prevalence of both gastric ulcer (GU) and duodenal ulcer (DU) is higher in cirrhotic patients than in general population, the relationship between H. pylori infection and peptic ulcer in cirrhosis remains controversial. ⋯ The incidence of bleeding peptic ulcer is high in cirrhotic patients and carries an increased risk of complications or death in these patients and therefore eradication of H. pylori infection might be as effective in preventing ulcer relapse and bleeding as it is in noncirrhotic ulcer patients. Hepatic encephalopathy is a frecquent complication of liver cirrhosis, and it is widely accepted that ammonia plays a major role in its pathogenesis. The ammonia production by H. pylori urease does not increase blood ammonia levels during cirrhosis, and eradication of H. pylori infection does not affect hepatic encephalopathy status.