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Open access

Alexandra Lazăr, Anca Meda Georgescu, Alexander Vitin and Leonard Azamfirei

Abstract

In recent years, a new form of medicine has become increasingly significant, namely, personalised medicine (PM). PM is a form of care in which treatment is tailored for an individual patient.

PM is about using multiple data sets to create a digital human mapping. A person’s biological traits are determined by the interactions of hundreds of genes and gene networks, as well as external factors such as diet and exercise. Combining and then investigating these multiple databases with powerful statistical tools, allows a new understanding of how genetic intricacy drives health and disease and so leads to a closer personalised medical approach that targets each individual’s unique genetic make-up.

Sepsis is a systemic inflammatory response to infection, ranging from systemic inflammatory response syndrome (SIRS) to septic shock and multiple organ dysfunction syndromes (MODS). Sepsis is the most common cause of death in intensive care patients. Treatments in an ICU may need to be adapted to the continuous and rapid changes of the disease, making it challenging to identify a single target. PM is thus seen as the future of sepsis treatment in the ICU.

The fact that individual patients respond differently to treatment should be regarded as a starting point in the approach to providing treatment. The disease itself comes secondary to this concept.

Open access

Iwona Pikto-Pietkiewicz, Antoni Okniński, Rafał Wójtowicz and Marlena Wójtowicz

Abstract

Introduction

The current lack of clear guidelines on how to manage cases of brain-dead pregnant patients makes this topic controversial and extremely difficult to deal with for both medical and ethical reasons. This report deals with such a situation.

Case presentation

A twenty-seven years old woman, thirteen weeks pregnant, with a ruptured brain aneurysm was admitted to an Intensive Care Unit. She presented with loss of all brain functions, but somatic support was sustained to enable the delivery of her baby.

Conclusion

The case report gives a detailed account of the management of the mother before the successful delivery of her baby. It indicates the need for ongoing contributions to the debate on this delicate subject area to establish guidelines on how to manage brain-dead pregnant patients.

Open access

Guillaume Giordano Orsini, Giorgios-Emmanouil Metaxas and Vincent Legros

Abstract

Introduction

Vertebrobasilar occlusion poses difficult diagnostic issues and even when properly diagnosed has a poor prognosis. Newer studies highlight a better outcome when thrombectomy was carried out between six and twenty-four hours after an initial diagnosis of stroke. This paper reports a case where a patient suffered a vertebrobasilar stroke secondary to a traumatic bilateral vertebral arteries dissection was treated with late thrombectomy.

Case presentation

A 34-year-old woman was manipulated on the cervical spinal column by a chiropractor. Following three weeks of cervical pain, she presented with severe aphasia and quadriplegia (NIHSS = 28). An MRI scan indicated ischemia of the vertebrobasilar system. Thirty-one hours after the onset of these symptoms, a thrombectomy was performed. After one month, the patient could move her head and the proximal part of her limbs but remained confined to bed (NIHSS = 13).

Conclusion

The current case illustrates the benefit of late mechanical thrombectomy for a posterior cerebral circulation infarct. Although there was a delay in treatment, partial recovery ensued.

Open access

Raluca M. Tat, Adela Golea, Ştefan C. Vesa and Daniela Ionescu

Abstract

Introduction

In an attempt to identify patients who have successfully survived a resuscitated cardiac arrest (CA), attention is drawn to resistin and S100B protein, two biomarkers that have been studied in relation to CA.

Aim

The study aimed to identify the potential cut-off serum values for resistin and S100B in patients who had CA, compared to healthy volunteers, given that, currently, none of the markers have normal and pathological reference range limits for human assay levels related to this pathology.

Materials and Methods

Forty patients, resuscitated after out-of-hospital CA and forty healthy controls, were included in the study. All patients were followed up for seventy-two hours after CA or until death. Blood samples for biomarkers were collected on admission to the ED (0-time interval) and at 6, 12, 24, 48 and 72 hours following resuscitation. Only one blood sample was collected from the controls. The serum concentrations of biomarkers were measured.

Results

For each time interval, median serum levels of resistin and S100 B were ​ significantly higher in patients with CA compared to healthy controls. The cut-of value for resistin in patients with CA, at the 12-hours versus controls, was > 8.2 ng/ml. The cut-of value for S100B in patients with CA versus controls recorded at 6 hours, was > 11.6 pg/ml.

Conclusion

Serum levels of resistin and S100B are higher among resuscitated CA patients compared to controls.

Open access

Mohammad Reza Hasanjani Roushan, Soheil Ebrahimpour, Zeinab Mohseni Afshar and Arefeh Babazadeh

Abstract

Introduction

Human brucellosis, the most prevalent zoonotic disease worldwide, is a systemic infection which can involve several organs. Among musculoskeletal complaints, spondylitis is the most frequent complication of brucellosis and primarily affects the lumbar and thoracic vertebrae. The involvement of the cervical spine is infrequent.

Case report

This case report concerns an unusual case of cervical spine spondylitis with an epidural abscess due to Brucella in a 43-year-old man. The diagnosis was based on the patient being domiciled in an endemic region, his symptoms and his occupation. Clinical outcomes improved following antimicrobial therapy of rifampin, doxycycline, and gentamycin, and were confirmed radiologically.

Conclusion

Early diagnosis and treatment are crucial for these patients. The timely commencement of medical treatment can help prevent surgery.

Open access

Anca Chiriac, Piotr Brzezinski, Liliana Foia, Horațiu Moldovan, Cristian Podoleanu, Adrian Năznean and Simona Stolnicu

Abstract

Granuloma annulare (GA) is a granulomatous skin condition that can present with a diversity of clinical manifestations and locations, with an unknown etiology and diagnosed on clinical-pathological grounds/correlations. Although many trigger factors have been described and several pathogenic mechanisms proposed, the etiology of GA remains unknown. We report a case of work-related, isolated, unilateral GA localized on the right palmar area of a young worker, possibly induced by work-related direct trauma.

Open access

Zsuzsanna Erzsébet Papp, Mária-Adrienne Horváth, Izabella Kelemen, Adina Hutanu and Minodora Dobreanu

Abstract

Background: Pediatric onco-hematology is not a frequently encountered medical specialty, and it influences everyday life, basic activities, and the immune system, mostly through psychosocial changes, which may affect every individual and their families differently. Anxiety is the most frequently encountered mental health disorder occurring during childhood and adolescence. The effect of stress and anxiety on the immune system is suggested by the fact that stress hormones elevate proinflammatory cytokines and subsequently lower the anti-inflammatory response.

Objective: Our main objective was to analyze the relationship between anxiety disturbance and cytokine levels in oncologic pediatric patients from Târgu Mureș in order to answer the following question: does anxiety influence immunity?

Material and methods: After testing pediatric oncology patients from the Pediatrics Clinic no. 2 of Târgu Mureș, Romania with the SCARED child test, we took blood samples from each participant. IL-6, IL-10, IL-1β, IL-12p40 and TNF-α levels were evaluated with a Human Cytokine Magnetic Panel using the xMAP technique on Flexmap 3D platform (Luminex Corporation, Austin, USA). C-reactive protein levels were determined with the BN Pro Spec nephelometer with CardioPhase hsCRP (Siemens Healthcare Diagnostics, GmbH, Marburg, Germany) reagent.

Results: The 46 pediatric oncology patients had 6 main diagnostic groups, the most frequent pathology was acute leukemia (58.7%) followed by malignant solid tumors (21.74%) and lymphomas (6.52%). In the anxious group (45.65%) we observed 4 of the 5 studied anxiety types: panic disorder, separation, social, and generalized anxiety. We measured the cytokine levels of all the participants from the two main groups: anxious/non-anxious. Statistical analysis (linear regression) showed statistically significant positive correlations in the anxious group related to the IL-1β and IL-6, a moderate/weak correlation related to IL-12p40, as well as a negative moderate correlation between IL-10 values in the anxious group and a positive trend in the non-anxious group.

Conclusions: Psycho-oncology is a relatively young specialty with few studies in the last two decades. IL-1β, IL-6, and TNF-α present high levels in anxious patients, while IL-10 and IL-12p40 have low serum levels in mental disorders. C-reactive protein levels are not influenced by anxiety.

Open access

Oana-Cristina Cînpeanu, Monica Tarcea, Paul Cojan, Daniel Iorga, Peter Olah and Raquel P.F. Guiné

Abstract

Background: Totaling about 60% of all causes of death, chronic illnesses are the main cause of global mortality. Unhealthy behaviors, such as unbalanced eating or insufficient physical activity, can trigger metabolic changes, manifested by hypertension, high blood sugar, hyperlipidemia, obesity. These changes are grouped into the category of metabolic risk factors. Over time, these factors can cause cardiovascular diseases associated with a high mortality rate.

Aim of the study: To evaluate the perception of healthy eating in a Romanian population.

Material and methods: We applied a validated online questionnaire aimed to investigate people’s attitude towards diet and their motivation regarding food consumption in ten countries, based on an international project. For the present paper, we evaluated a Romanian sample of 821 adult respondents.

Results: Most of the subjects (82.82%) were from an urban area, and 68.94% were women. Regarding the prevalence of chronic diseases, 3.53% of participants had cardiovascular disease, 6.69% had high cholesterol levels, 7.18% were obese, and 6.57% were suffering from high blood pressure. Significant correlations have been identified between calorie count, excessive sugar and salt consumption, gender variables, cardiovascular disease, obesity, and high blood pressure. Also, tradition is very important in relation to eating behaviors, being highly correlated with obesity. The general direction of answers was correct, even if half of the questionnaire items were formulated in a ‘negative’ way, and disagreement is needed for a consistent response with a correct perception of healthy diets. The overall perception of healthy eating was consistent with scientific information in the field.

Conclusion: Women are generally better informed than men regarding healthy eating. Also, there is a possible conflict between traditional food-related cultural values and modern nutritional guidelines based on scientific information.