Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
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Rev Med Chir Soc Med Nat Iasi · Oct 2010
[MecA and pvl genes detection in Staphylococcus aureus strains isolated from lower respiratory tract infections].
Although community-acquired Staphylococcus aureus pneumonia with highly virulent Panton-Valentine leukocidin (PVL)-positive strains, a severe disease with significant lethality, is rare, especially in adult and adolescent patients, recent reports highlight that these infections are on the rise. On the other hand, methicillin-resistant S. aureus (MRSA) is one of the high-risk and potential multi-drug resistant microorganisms. ⋯ Glicopeptides and linezolid are therapeutic options indicated in the treatment of staphylococcal pneumonia produced either by MRSA strains or pvl positive S. aureus strains.
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Tamoxifen is a non-steroid antiestrogen, used as adjuvant therapy for breast carcinoma in women with positive estrogen receptor (ER+). In this report we evaluated endometrial histological changes in women treated with Tamoxifen for ER+ breast carcinoma. ⋯ Endometrial pathology was more likely to be diagnosed in gynecological symptomatic postmenopausal and premenopausal women with breast carcinoma treated with Tamoxifen. Therefore, it is necessary that these patients to be supervise, first, with transvaginal ultrasonography for endometrium, and after, with biopsy of endometrium. All patients on long-term Tamoxifen therapy should be annually screened by endometrial biopsy for endometrial pathology.
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Rev Med Chir Soc Med Nat Iasi · Jul 2010
Case Reports[Amyand hernia--a rare anatomic and clinical entity diagnosed intraoperatively].
The Amyand hernia is an uncommon variant of the inguinal hernia, rarely recognised before the surgical treatment because of the confusion with a strangled hernia. In spite of this, the clinical presentation seems to follow a well determined pathway, so it is possible to state that the uncorrect diagnosis is to be attributed to the ignorance of this variant of hernia. We present two consecutive case reports of acute appendicitis founded in an inguinal hernia sac. ⋯ We conclude that amyand hernia must be considered as differential diagnosis of apparently strangled inguinal hernias. Technical precautions and antibioprophylaxy applied during surgery may prevent septic complications after hernioplasty. The hernia repair must be performed without prosthetic material and using exclusively resorbable sutures.
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Rev Med Chir Soc Med Nat Iasi · Apr 2010
[Pharmacologic therapy in peripheral diabetic polyneuropathy].
Neuropathy is one of the many complications of diabetes mellitus, along with micro- and macroangiopathy. Chronic sensorimotor distal symmetric polyneuropathy is the most common form between neuropathies; more than 30% of the diabetic patients are affected by this complication. Treatment is based on three cornerstones: (1) multifactorial intervention aimed at normoglycemia; (2) drugs that target pathogenic mechanisms and (3) symptomatic treatment. ⋯ More recently, significant pain relief has been reported using agents such as duloxetine, a dual selective serotonin noradrenaline reuptake inhibitor, and pregabalin, an anticonvulsant, a specific modulator of the alpha2delta subunit of the voltage-dependent calcium channels. Until now, at least 50 new molecular entities have reached clinical stage of development. Strategies that may show promise over existing treatments include topical therapies, analgesic combinations and, in future, gene-related therapies.
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Rev Med Chir Soc Med Nat Iasi · Apr 2010
[Effect of cpap therapy on sleep quality in patients with OSAS].
For an adequate analysis of sleep quality was assessed a new composed index wich objectively approached variate polisomnographic parameters. We used this new concept--sleep disturbances index-SDI in patients with obstructive sleep apnea (OSAS), before and after the beginning of CPAP therapy. ⋯ The severity of OSAS is correlated with increased SDI, but can be seen interindividual variability. The effect of CPAP therapy is reflecting also in sleep quality.