Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
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Alcoholic ketoacidosis is an acute metabolic acidosis that typically occurs in people who chronically abuse alcohol and have a recent history of binge drinking, little or no food intake and persistent vomiting. Alcoholic ketoacidosis is a result of starvation with glycogen depletion and counter-regulatory hormone production, a raised nicotinamide adenine dinucleotide (NADH) to nicotinamide adenine dinucleotide (NAD+) ratio related to the metabolism of ethanol, and volume depletion resulting in ketogenesis. ⋯ Once the diagnosis of alcoholic ketoacidosis is made, the mainstay of treatment is hydration with 5% dextrose in normal saline. With timely and aggressive intervention, the prognosis for a patient with alcoholic ketoacidosis is good.
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Rev Med Chir Soc Med Nat Iasi · Apr 2008
[Abdominal wall endometriosis after gynecologic procedures: an under-appreciated diagnosis in general surgery].
Incisional endometriosis is a clinical entity described in the gynecologic literature but it is not well recognized among general surgeons. The preoperative diagnosis is often mistaken for a suture granuloma, abscess, lipoma, cyst or incisional hernia. ⋯ Incisional endometriosis seems to be common in women with a history of cesarean section. Most patients presented with a painful abdominal mass. Three patients presented cyclic changes in pain and size of the mass with menses, but this may be due to physician's lack of awareness and questioning. The management of choice is to remove the lesion completely even if fascial excision is required.
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Rev Med Chir Soc Med Nat Iasi · Apr 2008
[Celiac disease: diagnostic criteria and impact of gluten free diet--patients' perspective].
Clinical, serological and histological remission in celiac disease is strictly related to long life complete exclusion of gluten from the diet. Because celiac disease is an autoimmune systemic disorder the potential complications include a wide spectrum with two severe long-term morbidities: osteoporosis and malignancy. Gluten free diet, easy to be recommended, is difficult to be followed. This study aimed at evaluating the diagnostic criteria and dietary instruction, quality of life issues, impact of the gluten free diet on the celiac patient. ⋯ There is evidence that an educational program is needed to improve knowledge on the atypical forms of disease, diagnostic criteria and tools. The quality of life would be improved by support groups for patients, improved availability, better prices and food labeling.