Jurnal Medical Brasovean

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Authors: Maria-Elena Cocuz

Introduction and aims: Chickenpox, infectious and contagious disease, characteristic to childhood, with good evolution to healthy child, may develops severe complications to special groups of patients (new-borns and pregnant women).The aim of this study was to analyse some clinical aspects of chickenpox to pregnant women and new-borns. Material and methods: Retrospective study, based on medical data from medical documents of new-borns and pregnant women hospitalized with chickenpox in Infectious Diseases Hospital of Brasov between 2010-2011. Results: There were hospitalized 6 new-borns (with good condition and without nervous or pulmonary complications to admission in hospital) and 3 pregnant women (with bad condition to admission, two patients without complications and one with viral pneumonia).With etiological treatment (Aciclovir) and against symptoms, promptly applied, the evolution was favourable to all patients, without complications of the disease and of the pregnancy. Conclusions: In period 2010-2011 in Infectious Diseases Hospital of Brasov was hospitalized a reduced number of new-borns and pregnant women with chickenpox. Evolution was favourable in all cases with specific treatment, without severe complications.

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Authors: Alexandra Gheorghe, Maria-Mirabela Mihăilescu-Marin

We are referring to the case of a 62 year old man, who came to our service after suffering to syncope at home. The clinical examination revealed dyspnea with tachypnea, hypotension, tachycardia, right ventricular gallop and right leg (calf) edema. Given the serious condition of the patient, clinical and paraclinic hinted a pulmonary embolism, spiral CT was performed proving the presence of massive pulmonary thromboembolism. Patient received electrolyte rebalancing, anticoagulant therapy and trophic brain. During hospitalization, the patient experienced cardiac arrest, but he was successfully resuscitated.

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Authors: Dorin Codarcea-Munteanu

We present a clinical case, particular through the severe clinical evolution of a rheumatoid polyarthritis to severe obstructive respiratory failure, requiring an intervention of tracheostomy of necessity. The obstruction of the superior airways represent an entity with a vital risk, which should be correctly recognized and evaluated, both by the ENT specialist and by doctor of other specialities.

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Authors: Madalina Buzescu

The research presented in this paper is aiming to review the situation of complementary and alternative medicine (CAM) in Europe, regarding legal reglementations, needs of the population, situation and reliability of research methods in this field, as well as the degree in which the demands of the patients can be fulfilled by practitioners. Several European studies are focused on these research issues and the present general paper is trying to concentrate their conclusions in order to be able to adapt the efforts in the right direction, to meet the patients’ needs and requests for this kind of medical approach. As medical practitioners, we meet patients with increasing interest to complementary medical methods, especially in the last decade. It is our subsequent duty to research if these methods are effective and if the findings are positive, to do our best to become competent to fulfil the medical needs of our patients.

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Authors: Diana Ţînţ, Călin Fleancu, Fleancu Andreea, Ovidiu Florin Orţan

Background: Acute myocardial infarction (AMI) represents a major health problem with increasing incidence among young adults. Aim: The purpose of the study was to analyse the angiocoronarographic particularities in patients with AMI and the age below 45 years admitted in ICCO Clinics in Brasov between February 1st 2009 and March 31, 2012. Results: The study population consisted of 152 patients, mean age 39.1±5.1 year, most of them male (90.9%). Most of the patients have had multiple vessel lesions (56%) and most of them have had the culprit lesion localized in the left descending artery (50.7%). The coronary artery atherosclerosis aetiology was the dominant aetiology, documented in 92% patients while in the remaining minority, other aspects were depicted. The number of affected vessels correlated well with the older age. Patients with permeable coronary arteries represented a considerable percentage of the study population (7.9%). Conclusions: The vast majority of the young patients with AMI were male. The main aetiology of the AMI in young was coronary atherosclerosis. Coronary multi-vessel disease was present in more than half of the study population and the severity was correlated with the age.

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Authors: Nanu Andrei, Daniel Leucuţa

be discussed knowledge, attitude and behaviour change achieved through risk communication. The target population consists of 88 overweight and obese patients which are divided in two groups one which received information about risk and another with no information. Risk communication where done through one by one counselling, group discussion, support group and educational material offer. Study results shows that health risk communication increase knowledge awareness and interest among overweight persons regarding the health risk of obesity. Risk communication doesn’t have any influence on treatment components: initiation, compliance and treatment monitoring. The most effective communication method is the one to one discussion among patient and medical staff. Additional factors as age, gender and educational level may have a positive impact on treatment initiation in obese patient.

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Authors: Jibu Carmen, Codruţa Nemet, Liliana Rogozea

Background: Everyone can get in the position of being a patient and everybody have the right to decide for him. Numerous study related with patient satisfaction are made in the world, but only few was realised in Romania, in the last years. Methods: This research is focus on the results of a response of patients from Surgical Department at Brasov County Hospital to a questionnaire with 35 questions. Results: The articles are based by the results of a questionnaire and demonstrate the quality of satisfaction of our patients. Conclusion: In this study we succeed to evaluate the satisfaction of patients related with the information and the ability of communication between doctors and patients.

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Authors: Laura Larisa Dracea

The clinical observation that led to the writing of this article was the encounter of two genetic diseases, Cystic Fibrosis and Juvenile Myoclonic Epilepsy, two chloride channelopathies, in the same patient. This represented the reason why I considered important to briefly describe the main scientific data available at the moment regarding chloride channelopathies in correlation with the observations made in the patient with both diseases. Cystic Fibrosis was first described in 1938 and the affected gene was cloned in 1989. Since then, research and multidisciplinary care improved the life span and quality of life of patients. Myoclonic Juvenile Epilepsy was described in 1957 and since then a lot of genetic research clarified the transmission of disease. The chloride channelopathies were more intensely studied after the 1990’s after the discovery of CFTR (Cystic Fibrosis Transmembrane Conductance Regulator) and CIC-1 gene (cause of congenital myotonia).

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Authors: Foris Orsolya, Florescu Monica, Liliana Rogozea

Glaucoma is one of the leading causes of blindness worldwide [1]. It rarely has any symptoms at all. This very often results in late diagnoses and great visual loss. Because this process is irreversible, treatment can only stop the evolution of the disease, not reverse it. The patient’s lack of knowledge and negligence is an important factor in this result. Therefore, it is essential that every patient to receive a thorough examination from the eye care professional. The article will present all the necessary tests which an eye examination should include for an accurate diagnosis. A retrospective analysis of 90 patients diagnosed with different types of glaucoma in the year of 2011 shows the need for these tests and the great help these offer in the diagnostic procedure. Results showed that over 60% of the patients were diagnosed according to the results of these tests.

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Authors: Dan Moraru, Dana Galieta Mincă, Lăcrămioara Aurelia Brînduşe

We assert that there are approximately 440 000 patients suffering from psoriasis in Romania. The treatment cost for one individual of approximately 1 000 euro/month is covered by the National Fund of Health Insurances and there are no limitations on the number of patients suffering from moderate or severe forms of diseases who may benefit from the health program with state of the art medications, such as the biological medicines. [1] The compliance is behaviour of the patient that plays an important part in the final success or failure of each health program, as it is a prerequisite (naturally not a sufficient condition for the therapy success).

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Authors: Jerzicska Erno, Fărcaş Felix, Gyorbiro Laszlo, Voicu Bianca, Suciu Horaţiu

Introduction Cervical haematoma is one of the local complications of carotid endarterectomy. Cervical haematoma may determine oesophageal compression or tracheal deviation. We evaluated the correlation between the cervical haematoma and preoperative antiagregant treatment. Material and methods We evaluated 100 consecutive patients retrospectively, operated with carotid endarterectomy between 2009 and 2011. Group A of 48 patients had monoantiagregant preoperative treatment; group B of 52 patients had dual preoperative antiagregant treatment. Results We observed cervical haematomas in 16 patients from the overall of 100, 13 in group B. Evaluation of age, sex, surgical technique and local drainage showed no differences between the 2 groups. The group with monoantiagregant preoperative treatment had a lesser chance to develop cervical haematoma (P = 0.022). Conclusions Preoperative antiagregation is crucial for a successful carotid endarterectomy procedure. We sustain the use of monoantiagregant preoperative treatment which is associated with less cervical haematomas as local haemorrhagic complications instead of dual antiagregant preoperative therapy.

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Authors: Jerzicska Erno, Fărcaş Felix, Gyorbiro Laszlo, Voicu Bianca, Suciu Horaţiu

Introduction Carotid endarterectomy (CEA) is the „gold standard” for the treatment of carotid stenosis. In this study we evaluate the results after using an alternative patch material for arteriotomy closure. Material and methods This study is a retrospective, observational study, in which we have compared 2 groups of 8 patients operated on in our clinic in 2008-2012, the first group of 8 patients with CEA and facial vein patch, the second group of 8 consecutive patients with CEA and PTFE patch. Results In the A group there were 6 males, in the B group 5 males. Group A had a median age of 60 years, group B had a median age of 60,5 years. All patients were operated for severe carotid stenosis. We evaluated the time of surgery, which varied for group A between 70 and 85 minutes, with a median of 77 minute, for group B between 75 and 100 minutes, with a median of 88 minutes. We observed a significant difference between the 2 groups regarding the time of surgery, in favour of group A (P = 0.010). Conclusions The advantages of a autologous venous material are represented by endothelised patch, reduction of desendothelised area, higher resistance to infections. The use of facial vein for endarterectomy patch needs the same incision, elevating the cost-efficiency of the procedure, and significantly reduces the operating time compared with PTFE due to a faster achievement of haemostasis.

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Authors: Gabriela Sechel, Andreea Fleancu

The study aimed breast lesions correlate with conventional ultrasound and elastography technique, comparing scores Birads with elastography score. Analysis of cases elastography study group brought a special contribution for patients with score 3 Birads which was significantly reduced by 21%, cases have led to increased cases with score 1 and 2 which have doubled and less scores 4 and 5. Elastography score cannot work alone. It must be correlated with conventional ultrasound examination and mammography.

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Authors: S. Andreica, Antoniea Popescu, Corina Corpodean, Gabriela Vasile

Studies indicated that the surfactant replacement therapy is more effective if the lung injures are not present. Objective: to evaluate if early surfactant replacement therapy decreases the duration of both oxygen administration and mechanical ventilation and also improve the surviving rate. Method. This is a retrospective study analysing the respiratory therapy in our unit between 1999 and 2005. The 1st group (study group) consists of 15 patients who received surfactant during the first 2 hours of life (early administration). The 2nd group consists of 22 patients who received surfactant after the first 2 hours of life. Results. The average gestational age and birth weight were 29 weeks and 1252 grams (1st group) respective 29.09 weeks and 1280 grams (2nd group). Mean duration of oxygen administration was 8.7±2.41 days for the 1st group and 9.77±3.11 days for the 2nd group (t= -0.25, p > 0.05). Mean duration af mechanical ventilation was 2.89±2.22 days for the 1st group and 1.97±1.79 days for the 2nd group (t = 1.16, p > 0.05). The surviving rate was better in the 1st group but without statistic difference (p = 0.549). Conclusion: the early surfactant replacement therapy had improved the surviving rate but without statistic difference. We need a more extensive study for more relevant statistic results. Although animals can ingest large amounts of nitrates in feed and water, however, nitrate and nitrite content of meat and eggs is very low. This is explained by the fact that nitrates are absorbed inside the small intestine easily pass into the bloodstream and are excreted through the kidneys. If herbivorous ruminant animals, most of the existing nitrates in feed is used as feedstock for nitrogenous organic substances by organisms that inhabit their stomachs. A small amount of nitrates can secrete the milk. In general concentration does not exceed 40-50 mg / litter.

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Authors: Antoaneta Lucasciuc, Maria-Gabriela Suliman

Ovid’s "Ars amatoria" books (1 BC), a true synopsis of Love’s intricate doings and relationships, also provide an array of advice mostly for women not only in their conduct in Love’s affairs but also regarding the „remedies” they can use to be more seductive. Most of all the third Book of the sequence brings to our days recommendations that have preserved their usefulness in what regards manners and the devious approaches of seduction, presented in unsurpassed elegant irony accompanied by deep understanding of the special psychology of this relationship. But keep your jars away from lover’s sight - thy artful beauty should go unsuspected. Who would but loath to see you smear your cheeks with paint (…) And then, the sick’ning smell that Athens grease Releases, that oily juice they make of fleece of sheep. Moreover, in 2 AD, Ovid added his “De medicamine faciei femineae“, to round up his former anatomy of seduction, offering a few recipes of the day’s most in fashion cosmetic remedies, widely considered to have been versifications from a prose cosmetic treatise: “So that they may mix and be properly smeared on the body, add Attic honey from its golden combs. Although incense pleases the gods and their angry powers, it must not all be offered upon kindled fires” or “A woman have I seen pound up poppies soaked in cold water and rub her cheeks with them. . .“

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Authors: Daniel Ciurescu

Thymidylate synthase (TS) is an important target for 5-Fluorouracil (5-FU) therapy in Head and Neck cancer. In clinical settings, TS levels appear to be a predictive factor in patients’ outcome and long term survival. It is obvious that high levels of TS expressed by tumoral cells are implicated in resistance to 5- FU therapy in colorectal, gastric and other cancer types, while low levels are associated with better response. We evaluated clinical data and laboratory findings existing in the oncologic literature regarding involvement of TS in induced resistance to standard therapy-schemas on basis on 5-FU in Head and Neck cancer. The purpose is to highlight the importance of pre-therapy TS dosage in order to predict treatment response.

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Authors: Varga Mircea, Ionuţ Costache

The aim of the paper was to answer the following aspects of anterior ischemic optic neuropathy (NOIA):  Issues related to the onset of Noia and diagnosis strategy: role and place of laboratory investigations in NOIA Evolution and prognosis of NOIA and the impact on the quality of life of patients The study included 109 patients selected from those who presented NOIA suggestive symptoms. The research was structured as a retrospective, longitudinal investigation of the lot. To be included in the survey was used the selection method based on inclusion and exclusion criteria of the study. The lot of the study included subjects of both sexes, aged between 51 and 78 years, from rural and urban areas. Ischemic optic neuropathy is a formidable disease which can rapidly lead to loss or damaged of the eye function, with major impact on quality of life of the patients.