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

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Monday, December 18 2017 @ 02:58 EET

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Current Issues in Acute Diarrheal Disease

2014-04

Ruxandra Laza, A. Crișan, Luminița Bădițoiu, Emilia Nicoară, Narcisa Nicolescu, Voichița Lăzureanu, Ruxandra Jurac

The intestinal microflora consists of micro-organisms (bacteria required for normal functioning of the digestive tract), which are interacting with the human body (commensalism), the digestive tract is the habitat required for the development of these bacteria, and these, in turn, produce the constituents necessary for the organism. Disruption of this balance makes some ordinary saprophytic species to become pathogenic.

Clostridium difficile(CD), gram positive bacillus, anaerobic, sporulated, enters into the structure of normal enteric resident flora in a proportion of 60-70% in newborns, 10 to 30% in hospitalized patients, and only 3% in healthy adults (1). If this flora is iatrogenic depressed by antibiotic therapy, chemotherapy, inhibitors of gastric acidity, CD wins "vital space"; by multiplying causes damage to the intestinal mucosa and subsequently, on the background of comorbidities, gives the lead of severity to the clinical evolution.

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Correlations between Hypercalcemia and Endoscopic Findings in HD Patients - A Prospective Study

2014-04

D. Baboi, Cristiana David, Ileana Peride, A. Niculae, I.A. Checheriță, I. Dina

Patients with chronic renal disease frequently display eso-gastro-duodenal associated pathology: anorexia, heartburn, nausea, vomiting, abdominal pain, gastric motility disorder so far as gastroparesis; some of these symptoms decline once the substitution therapy of the renal function is initiated through hemodialysis, and some persist because of the interdialytic metabolic acidosis, used anticoagulant in dialysis or complementary therapies.

The most severe clinical manifestation is superior digestive hemorrhage, with multiple intricate causes (mucosal lesions induced by gastrin, angiodysplasia including GAVE - gastric antral vascular ectasia, treatments with lesion potential - NSAIDs, corticoids, oral iron drugs, mucosa inflammation under uremic toxins or oxygen radicals, gastric and intestinal wall edema due to interdialytic hypervolemia, malnutrition). The gastric hyperacidity induced injuries in renal patients are often esophagitis, gastritis, duodenitis and gastro-duodenal ulcer.

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Bacterial Pneumonia in Children - Epidemiological Study on Nine Years

2014-04

Mirela Luminița Chiru, Daniela Pacurar, D. Oraseanu

Pneumonia can be defined as an inflammation of the pulmonary parenchyma, mainly affecting the alveolar space. Inflammation can be caused by bacteria and viruses, as well as by inhalation of chemical agents or due to thoracic trauma (1,2,6).

Most authors classify bacterial pneumonias depending on the pathogenic agent, this classification including species of Pneumococcus, Hamophillus Influenzae, Klebsiella, Staphylococcus, Legionella and other gram-negative microorganisms. Some germs, especially Staphylococcus may be disseminated in a haematogenous manner.

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Total Lower Lip Reconstruction - What Techniques Should We Choose

2014-04

N. Calcaianu, S.A. Popescu, Daniela Diveica, I. Lascăr

While the incidence of lip cancers incidence in the central Europe is low 0.7% of all malignant tumors compared to the 1-2% generally considered (2-5), they are extremely important from a clinical and surgical point of view because of the morphological and functional changes involved. More than 90% of these tumours are squamous cell carcinomas (SCCs) and, in lesser numbers, basal-cell tumours (BCCs); however, some adenocarcinomas deriving from the minor salivary glands can be observed and, even more rarely, melanomas, sarcomas and lymphomas. BCCs generally occur in the upper lip and do not usually present lymph node metastases (4, 6). In contrast, SCCs develop most often in the lower lip, with a possibility of neck metastases. Lip carcinomas frequently appear on top of precancerous lesions, such as radiodermitis, chronic chelitis and xeroderma pigmentosum. The diagnosis and treatment of these pre-cancerous lesions, facilitated by a direct view of the lesions, is, therefore, crucially important in order to avoid their evolving into actual tumours. The subjects most at risk of this type of tumour are fair-skinned elderly people who work in the open air. Men are more at risk than women, (1.3% men and 0.3% women) (1) probably because the latter use lipstick or lip-salve (2, 7-9).

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Acute Myocardial Infarction in Youngs: Presentation, Treatment and Outcome

2014-04

Anna-Maria Andronescu, A. Nechita, Eugenia Panaitescu, M. Vintilă, Maria Dorobanțu

Coronary Artery Disease (CAD), the world’s leading cause of death and morbidity, it is not anymore an attribute of old age (1). The increase prevalence of atherosclerotic risk factors among the young and very young population is responsible for more premature CAD cases (2). Prior studies highlighted that AMI in young’s is associated with different clinical features and has a better short-term outcome than in older population (3,4,5). However, long-term follow-up revealed a higher mortality and morbidity in young AMI survivors than in general population (6,7). Also, the conclusion of several studies and "real-world" registries was that patients with STEMI and NSTEMI, regardless of age and despite different management, have similar inhospital outcome and longterm survival (8,9).

In our country, RO-STEMI registry is providing the most extensive information on the profile, treatment and inhospital outcome of the STEMI Romanian patients (10) but only few reports about mid and long-term follow up of young Romanian patients with AMI, especially in case of NSTEMI, are available (11,12,13).

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