Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
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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.
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To identify the occupational risks in an ambulance service and to assess their impact on the health of employees. ⋯ The specific risk factors for ambulance service employees directly related to musculoskeletal disorders have been established.
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Ebstein's anomaly is a rare congenital heart disease, accounting for less than 1% of all congenital heart diseases, characterized by a wide clinical, electrocardiographic, echocardiographic, anatomic and prognostic polymorphism. The disease can be fatal since birth or may remain asymptomatic until adulthood, sometimes being associated with septal defects, transposition of great vessels, preexcitation syndromes, or left ventricular noncompaction. The genetic changes underlying this syndrome are not fully known, but in the cases associating left ventricular nonompaction a mutation in MYH7 gene encoding the beta-myosin heavy chain was recently detected. The authors present 2 cases of Ebstein's anomaly with different onset and course and discuss the current clinical, electrocardiographic and echocardiographic criteria used for prognostic stratification of Ebstein disease in relation to international literature.
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Rev Med Chir Soc Med Nat Iasi · Jul 2013
Some observations on the optimization of pre-hospital emergency medical services from the city of Iasi, Romania.
In the lasi City, with a population of 825,100 inhabitants, the number of requests for ambulance service has increased steadily for the past 17 years. One of the determining factors could be the development of the primary health care prevention. ⋯ The analysis of optimization concept of Medical Services in a city like lasi is about the challenge to understand the impact of the population health towards the development and organizing the territory, and, interrelated, how we can improve the population health by the best possible organization.
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Rev Med Chir Soc Med Nat Iasi · Jul 2013
Comparative StudyCorrelations between state anxiety and quality of life in metastatic breast cancer patients.
to evaluate the correlations between perceived state anxiety during chemotherapy and quality of life in metastatic breast cancer patients. ⋯ Higher state anxiety correlates with certain quality of life items, suggesting that psychological counselling and appropriate therapy induced side effects management should be a priority in the palliative care for metastatic breast cancer patients.