Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
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Rev Med Chir Soc Med Nat Iasi · Oct 2015
Case ReportsTHE AUTOIMMUNE CONSTELLATION IN LICHEN AMYLOIDOSIS.
Localized cutaneous amyloidosis is a rare disease among white people, being more common in South-Asia, China and South America. The disease is characterized by deposition of amyloid material in the papillary dermis without visceral involvement. Nevertheless, there is a growing list of immune-mediated disorders that have been linked to cutaneous amyloidosis. We present two cases of concomitant occurrence of lichen amyloidosis and autoimmune thyroiditis/atopic dermatitis in two Caucasian women.
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Rev Med Chir Soc Med Nat Iasi · Oct 2015
ETIOLOGY AND RESISTANCE PROFILE OF ISOLATED STRAINS FROM SEVERE SYSTEMIC INFECTIONS IN PATIENTS WITH IMMUNODEPRESSION--EXPERIENCE OF THE IASI INFECTIOUS DISEASES HOSPITAL 2011-2014.
Microbial resistance is an increasingly serious threat to global public health and it is linked to patient's age, immune status, and also antibiotic overuse or misuse and repeated hospitalizations. The high incidence of infections caused by multidrug-resistant bacteria requires rethinking the first-line therapeutic schemes. ⋯ The etiological agents implicated in the occurrence of severe sepsis in patients with acquired immunosuppression were Gram-positive bacteria (GPB) as well as Gram-negative bacteria (GNB) with moderate resistance to usual antibiotics. The infections caused by GNB were predominant in immunocompromised patients, but also in those with associated urinary and respiratory tract infections and chronic indwelling urinary catheters. In our severe sepsis patients Gram positive bacteria caused mainly skin and joint infections.
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To determine the correct therapeutic approach to the different grades of liver trauma. ⋯ Hepatic traumas are often severe, and frequently associated with multiple injuries. The non-operative management is indicated in liver lesions grade I, II and III according to the American Association for the Surgery of Trauma (AAST), if abdominal cavity organs are not injured. Higher grade liver lesions (over IV) in which the hemorrhagic risk persists or reappears require surgical intervention as soon as possible, and according to the type of lesion, the right procedure should be chosen.
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Rev Med Chir Soc Med Nat Iasi · Apr 2015
ETHICAL MODELS OF PHYSICIAN--PATIENT RELATIONSHIP REVISITED WITH REGARD TO PATIENT AUTONOMY, VALUES AND PATIENT EDUCATION.
The present paper revisits the ethical models of patient--physician relationship from the perspective of patient autonomy and values. It seems that the four traditional models of physician--patient relationship proposed by Emanuel & Emanuel in 1992 closely link patient values and patient autonomy. On the other hand, their reinterpretation provided by Agarwal & Murinson twenty years later emphasizes the independent expression of values and autonomy in individual patients. ⋯ However, the deliberative model of patient-physician interaction represents an adequate alternative to the two unsatisfactory approaches by promoting shared decision making between the physician and the patient. It has also been suggested that the deliberative model would be ideal for exercising patient autonomy in chronic care and that the ethical role of patient education would be to make the deliberative model applicable to chronic care. In this regard, studies have indicated that the use of decision support interventions might increase the deliberative capacity of chronic patients.
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Diabetes mellitus is a major health problem due to its increasing prevalence and life-threatening complications. Antidiabetic sulfonylureas represent the first-line drugs in type 2 diabetes even though the most common associated risk is pharmacologically-induced hypoglycemia. In the development of this side effect are involved several factors including the pharmacokinetic and pharmacodynamic profile of the drug, patient age and behavior, hepatic or renal dysfunctions, or other drugs associated with a high risk of interactions. If all these are controlled, the risk-benefit balance can be equal to other oral antidiabetic drugs.