Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
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Takotsubo cardiomyopathy or "heart broken syndrome" or transient apical ballooning syndrome is an increasingly reported syndrome characterized by the fact that most patients are women aged over 65 years. The most common electrocardiographic changes are ST-segment elevation and negative T waves in precordial leads. Symptoms at onset are similar to those of acute myocardial infarction; the ventricular dysfunction is shaped like a takotsubo (a Japanese pot for fishing octopus), echocardiography and ventriculography show akinesia, hipokinesia or diskinesia (ballooning) of apical segments of left ventricle and hyperkinesia of the basal; the coronary arteries are normal angiographic; the dysfunction improves rapidly within a few weeks. ⋯ Georgescu" Iasi were hospitalized 4 cases with Takotsubo cardiomyopathy from 2008 to 2011. Their features are presented in this paper. The difference of prognosis and treatment between Takotsubo cardiomyopathy and acute myocardial infarction require an accurate diagnosis, the clinical hypothesis result only after knowledge the clinical and paraclinical peculiarities of this pathological entity.
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Rev Med Chir Soc Med Nat Iasi · Jan 2012
[Study on the association of imaging and clinical anatomic data in the prediction of difficult intubation].
Difficult intubation is a serious challenge for emergency doctors and anesthesiologists. ⋯ The OMLET score proved effective in predicting difficult intubation expressed in its high specificity and sensitivity, and could be used especially in patients with conditions of the cephalic extremity and neck inevitably requiring before surgery investigation of these areas.
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Rev Med Chir Soc Med Nat Iasi · Jan 2012
High-resolution respirometry with multiple substrates titration in permeabilized myocardial fibers.
The present study was purported to standardize the high-resolution respirometry technique for the analysis of oxidative phosphorylation (OXPHOS) in saponin-skinned cardiac fibers. Preparation of permeabilized myocardial fibers allows the assessment of respiratory function of the entire population of mitochondria in their normal intracellular position. ⋯ The following values (expressed in pmol O2 x s(-1) x mg(-1)) were obtained: CI_LEAK, 67.18 +/- 5.12 (CI dependent basal respiration, after glutamate and malate addition); CI_P, 247.37 +/- 49.90 (CI_OXPHOS state after ADP addition); CI_Pc, 252.036 +/- 53.13 (the intactness of the outer mitochondrial membrane assessed after cytochrome c addition); CI+II_P, 342.90 +/- 62.48 (maximum OXPHOS state obtained after succinate addition by activating convergent electron flow from CI+II into the Q junction of the electron transport system (ETS); CII_P, 302.26 +/- 50.16 (CII dependent OXPHOS state obtained after the addition of a CI inhibitor rotenone, with the subsequent entry of electrons from CII only into the Q junction); ETS capacity, 331.11 +/- 62.39 (uncoupled respiration). The standardized technique will allow the systematic characterization of mitochondrial respiratory dysfunction associated with several cardiac pathologies in both animals and humans.
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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.
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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.