The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

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The Dietary Adjustment to the Digestive Systemís Alterations Induced by the Anticancer Therapy

2014-01

T. Mogoș, Andra Evelin Iacobini

The nutrition of patients in which the cancerous disease has already spread does not cure the disease [1]. This statement is radically contrary to multiple theories supported by some followers of these cancer specific diets (ex. the shark cartilage diet, the distilled water and wheat seeds diet, etc.). This situation is also encountered in the neoplasm of the digestive system [1].

The objectives of the cancerous diseaseís nutrition are represented by the ability to provide the caloric and nutritional requirements which are able to improve the patientís clinical status, to increase the effort capacity, to extend the survival duration and to amplify the capacity to tolerate chemotherapy and radiation therapy [2].

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Clinical Characteristics and Outcomes of Patients with Heart Failure Hospitalized in the Clinical Emergency Hospital ofBucharest

2014-01

Camelia C. Diaconu, Bianca Paraschiv, Daniela Bartoș

Heart failure is a complex clinical syndrome that can be determined by any structural or functional cardiac disease that impairs the ability of the left ventricle to fill or eject blood. In developed countries, heart failure is a main cause of morbidity and mortality for adults older than 65 years, the risk of developing heart failure being increased with advancing age. Heart failure hospitalizations are associated with substantial morbidity and mortality. Understanding factors that influence clinical outcomes of patients hospitalized for heart failure, particularly the modifiable ones, may be useful for identifying strategies to improve the outcomes of these patients.

The aim of the study was to investigate the clinical characteristics, management and outcomes of patients with chronic heart failure consecutively admitted in the Internal Medicine Clinic of the Clinical Emergency Hospital of Bucharest, during a period of 8 months (1st of January - August 31, 2012).

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Contributions to the Study of Psychosocial Aspects in Hematologic Malignancies

2014-01

Amelia Maria Găman, M. A. Găman

Hematological malignancies are severe diseases, fatal when untreated, with a profound psychosocial impact on the patient, family members, friends and society. Scientific discoveries from the last years about the understanding of the pathophysiological mechanisms of hematological malignancies and the innovative modern treatment options (including bone marrow transplantation) have changed in a favourable way the evolution and the prognosis of patients with these diseases, but brought along other consequences on the quality of life, psychoemotional aspects and social insertion. The psychological manifestations are variable, occuring at each transitional point of illness: establishment and communication of diagnosis of the hematological malignancy, beginning of treatment, evolution and disease progression. The factors which influence the psychosocial response are the emotional stability of the person before diagnosis and the existence of a social support (family members, friends, colleagues).

The communication of diagnosis determined an acute emotional stress of the patient, family members and friends, because they associated the hematological malignancy with a severe disease, a specific aggressive long-term treatment, frequent and unpleasant side effects (nausea, vomiting, hair loss, sexual dysfunction, neurological complications, neutropenia etc), lenghty hospitalisation, family separation, temporary or definitive loss of social insertion, financial burden. The emotional response of the patient and family to the diagnosis of the hematological malignancy is characterised by shock, disbelief, denial, anxiety, depression, sleep and appetite disturbances, difficulty in performing everyday activities (1, 2, 3).

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The Importance of Aortic Arch Plaque Characteristics in Patients with Ischemic Stroke

2014-01

Mihaela Marian, Ana C‚mpeanu, C. Popa

Stroke is the fourth leading cause of death inUnites States and the leading cause of adult morbidity and disability in Europe (1). Ischemic stroke represents approximately 88% of all strokes; however, in NINDS (National Institute of Neurological Disorders and Stroke) database almost 40% of ischemic strokes are listed as cryptogenic strokes (2). In the context of secondary prevention, establishing an etiological diagnosis is essential when it comes to prescribing the optimal treatment for every patient. Routine evaluation of a stroke patient includes evaluation of cervico-cerebral vessels and also cardiological evaluation in order to rule out an atrial arrhythmia with embolic potential in cerebral circulation (3,4).

Between the heart and the carotid and vertebral arteries lies the aorta, an area difficult to explore. Latest data from the literature suggest an association between aortic arch atheromas and ischemic stroke, thus aortic atheromatosis may be the missing link, responsible for most of the cerebral infarctions of undetermined cause (5,6).

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Arterial Hypertension Epidemiology: Romania among the Balkan Countries - Data from SEPHAR Surveys

2014-01

Maria Dorobanțu, S. Onciul, Roxana Darabont, Oana Tautu, S. Ghiorghe, Maria Vasilescu, I. Manitiu, C. Pop, D. Lighezan, E. Apetrei

Cardiovascular disease prevention showed its utility and efficiency in developed countries, where it lowered the cardiovascular morbidity and mortality. Instead, in Balkan countries, the mortality due to this pathology displayed an ascendant, worrying curve [1], diagnosis and control of arterial hypertension (HT) representing efficient methods for lowering cardiovascular mortality. Though recent studies didnít show any significant differences between hypertension prevalence in developed versus developing countries [2], stroke mortality (the best surrogate marker of hypertension effects) was much higher in developing countries. Since modifying genetics was a target impossible to reach for the moment, the only solution was represented by the evaluation and correct treatment (pharmacological and non pharmacological) of arterial hypertension.

As international scientific organisations recom-mend, cardiovascular disease prevention must be implemented in an individualized way in each geo-graphical region, being inappropriate and impossible to apply the same prevention methods globally [3,9]. In this context, the Balkan Peninsula aggregates a number of countries with common geographical and social characteristics, many of them sharing economical transition.

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