Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
-
Rev Med Chir Soc Med Nat Iasi · Oct 2011
Multicenter Study[Procalcitonine--early marker of neonatal infection].
Neonatal infection represents the third most important cause of mortality in Neonatal Intensive Care Units (NICU), following perinatal asphyxia and respiratory distress syndrome. The incidence varies according to the level of care, between 5% in level II neonatal wards and 20% in the NICUs. The lack of specific early markers for infection could be partially responsible for the lack of antibiotic treatment or unnecessary treatment. In this context, many variables were examined as markers for sepsis. Large concentrations of C-reactive proteine (CRP) and procalcitonine (PCT) were positively correlated with the severity of the infection and generally indicated a poor outcome. ⋯ High serum levels of PCT in studied lots plead for the usage of PCT for the fast and early diagnostis of neonatal infection. In those cases with positive PCT and negative blood cultures or positive CRP and clinical symptoms of infection, PCT would be a useful tool, aiding in the initiation or termination of antibiotic treatment, which would ultimately lead to lowering costs. PCT as a screening tool for cases with risk factors for infection is still to be analysed in terms of costs versus benefits and the longterm implications of neonatal sepsis and antibiotic treatment.
-
to assess the profile and the characteristic of oncological patients, establishing management in patients with neoplasia presented in the emergency department (ED), the analysis of short-term movements in patients with neoplasia whilst in the ED. ⋯ 1315 oncological patients presented in ED, almost a quarter of which presented high suspicion of neoplasia (still without histopathological confirmation) when in ED (23.12%). Most of them were aged male patients (over 65 years old), with tumors of the digestive system. A significant proportion (almost 60%) of these patients ended up in emergency due to complications and the therapy intended life support and pain management. Some of these patients were directed to further exploring and emergency outpatient therapy while 75% of patients were hospitalized after stabilization. Although we expected that the frequency of complications to be higher in patients previously diagnosed with cancer, data analysis showed no statistically significant differences (p = NS) between the rate of complications in patients previously diagnosed with neoplasia and those with high-suspicion neoplasia first diagnosed in the ED.