Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
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Rev Med Chir Soc Med Nat Iasi · Oct 2009
[Quantification of the acute respiratory insufficiency of laryngo-tracheal origin].
Acute respiratory insufficiency defines that status in which the respiratory system is not able to supply the metabolic requirements of the organism. The laryngo-tracheal segment plays an important role in the respiratory function, an obstruction at this level inducing an important limitation of oxygen intake. Due to the requirement of fast repermeabilisation of this segment, it is necessary to define all criteria (clinical and laboratory examination) required to diagnose and to evaluate the respiratory failure. The present paper depicts the clinical aspects, the acid-base equilibrium impairment induced by high level airway obstruction and the functional investigations available by ventilation tests.
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Acute kidney injury is a common complication in hospitalized patients, and its incidence has risen significantly in the past 15 yr. Despite significant technical advances in therapeutics, the mortality and morbidity rates associated with acute kidney injury remain dismally high and have not appreciably improved during the past four decades. ⋯ The major types of urinary biomarkers fall into three classes: 1) inflammatory; 2) renal tubular proteins that are excreted into the urine after injury; 3) surrogate markers of tubular injury. There has been increasing interest in the identification and validation of novel biomarkers of acute kidney injury that permit earlier and more accurate diagnosis.
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Obesity has reached global epidemic proportions and is associated with major cardiovascular diseases and reduced overall survival. This paper reviews the metabolic and vascular consequences of dysfunctional adipocytokines in obesity as well as the pathological effects on blood pressure, cardiovascular structure and function. Despite this adverse association, numerous studies have documented an obesity paradox in which overweight and obese population with established cardiovascular disease have a better prognosis. ⋯ For coronary heart disease and peripheral arterial disease the mechanisms are still uncertain. There are discussed a lesser severity of coronary lesions and left ventricular dysfunction, or a reduced prevalence of moderate-severe chronic obstructive pulmonary disease in patients selected for surgery. On the other hand, the constellation of data which supports purposeful weight reduction in the prevention and treatment of cardiovascular diseases, induces a controversial position regarding this new concept.
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Rev Med Chir Soc Med Nat Iasi · Oct 2009
Multicenter Study[Aflatoxin contamination of food: additional risk factor for chronic liver diseases].
Aflatoxins are over all spread toxic metabolites of fungi, able to induce chronic liver damages. ⋯ FFQ revealed a high risk of ingestion of aflatoxin contaminated foodstuff in general population, greater in rural areas. The risk of aflatoxin intake seems unreleated with the gravity of chronic liver disease.
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Rhabdomyolysis, meaning "disintegration of striated muscle", is a potentially life-threatening syndrome resulting from release of muscular cell constituents into the circulation. The aim of this study is to determine frequence and causes of rhabomyolysis in internal medicine practice, as well as diagnostic and therapeutic discussions, based on a retrospective study in patients addressed to a medical clinic of an universitary emergency hospital. ⋯ The most common causes of rhabdomyolysis in general practice are represented by muscular trauma, muscle enzyme deficiencies, electrolyte abnormalities, infections, drugs, toxins and endocrine disorders. Frequent encountered clinical manifestations are weakness, myalgia and tea-colored urine, and the most sensitive laboratory finding of muscle injury is an elevated plasma creatine kinase level. The management of patients with rhabdomyolysis includes early vigorous hydration, together with specific measures (urine alkalinization, mannitol, hemodialysis).