Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
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Rev Med Chir Soc Med Nat Iasi · Oct 2013
ReviewThe quality of medical care during an acute exacerbations of chronic obstructive pulmonary disease.
Chronic obstructive pulmonary disease (COPD) is a significant cause of global morbidity and mortality, with a substantial economic impact. Acute exacerbations of COPD (AECOPD) represent a dramatic event in the course of the disease; is an important cause of morbidity and the fourth cause of mortality worldwide. During the hospitalization for AECOPD mortality is 10%. ⋯ A recently published study done in a Canadian hospital reveals that the treatment of the AECOPD is sub-optimal. The management of the COPD exacerbations prior, during and after the hospitalization showed inadequate adherence of the physicians (respirologists, internists and hospitalists) to the current guidelines. This review outlines the worrisome findings of this study and the proposed measures suggested by the authors in order to optimize the management of AECOPD.
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Rev Med Chir Soc Med Nat Iasi · Oct 2013
Evaluation of student perception of the lecture "oral functional medical rehabilitation: balneophysiotherapy".
Th aim of the study was to assess this course as perceived by the 6th year dentistry students. ⋯ The DREEM test showed that the assessment and treatment of pain in dental-maxillary pathology and TMJ dysfunctions through medical rehabilitation by means of balneophysiotherapy is of interest to final year dental medicine students. As a student-teacher partnership, modern education cannot ignore the practical needs of students and should add to their theoretical training with courses and practical training programs necessary in their future profession.
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Rev Med Chir Soc Med Nat Iasi · Oct 2013
Randomized Controlled TrialEffect of oral low dose clonidine premedication on postoperative pain in patients undergoing abdominal hysterectomy: a randomized placebo controlled clinical trial.
This study evaluated the effect of oral low dose clonidine premedication on postoperative pain and hemodynamic status of the patients during abdominal hysterectomy under general anesthesia. ⋯ A single oral 100 microg dose of clonidine administered 2 hours before abdominal hysterectomy significantly reduces the severity of postoperative pain.
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Rev Med Chir Soc Med Nat Iasi · Oct 2013
Metformin induced lactic acidosis--particularities and course.
Diabetes mellitus is a widespread disease with many serious chronic complications. An improvement in the oral antidiabetic medication in respect to its mechanism of action and toxicology was needed in order to have effective therapies with high compliance and minimum side effects. In this context, metformin is a widely used oral antidiabetic drug, which, through its mechanism of action, has no risk of hypoglycemia. ⋯ This paper presents a number of 13 cases of metformin-associated lactic acidosis, which outline the circumstances triggering the adverse event and the clinical therapeutic measures applied in the poisoned patients. The main situations that favor metformin-associated lactic acidosis are renal impairment and tissue hypoxia, and the intervention is adapted to the particular patient condition and symptoms, such as marked hypotension and cardiac arrest. Although there are commonalities in describing the consulted patients, the final prognosis is not dependent on the dose or metformin plasma levels, but rather on the associated pathologies and medication.