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  • Author: Daniela Dobru x
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Silivastru (Cozlea) Ionela, Cozlea Daniel Laurentiu, Keresztesi Arthur Attila, Asofie Gabriela, Cozlea Laurentiu, Oltean Galafteon and Dobru Daniela

Abstract

Introduction. The purpose of this study is to evaluate the risk and the benefit of oral anticoagulant treatment in nonvalvular atrial fibrillation (AF) patients, using the two scores recommended by the guidelines: the CHA2DS2-VASc score and HAS-BLED score.

Material and method. We conducted a retrospective observational study on 144 patients with nonvalvular atrial fibrillation, admitted between 1st of July 2013 and 30th September 2013 in the 3rd Medical Clinic of Tîrgu Mureș with a prospectiv follow-up at 6 months.

Based on the data collected from the patient charts, the thromboembolic risk was assessed using the CHA2DS2-VASc score and the hemorrhage risk was assessed using the HAS-BLED score. At 6 months, the patients were contacted via telephone and were questioned regarding their state of health, the existence of hospitalizations in the last 6 months, the international normalized ratio (INR) value, the existence of hemorrhagic or thromboembolic events.

Results. The group of patients was composed of 70 female and 74 male with the mean age of 70 ±11 years. From the total number of patients 13 (11.7%) had a history of stroke and the CHA2DS2-VASc score revealed that these 13 were in the high risk class. The presence of arterial hypertension and vascular disease were statistically associated with stroke.

Hemorrhagic events were encountered in 19 patients (13.19%) and 16 of them had a higher than 3 HAS-BLED score. A history of bleeding, anemia and labile INR were the factors statistically associated with bleeding.

Conclusions. The CHA2DS2-VASc score is useful in stratifying patients with AF in risk groups for thromboembolic events while the HAS-BLED score proved to be a useful tool in predicting bleeding events in anticoagulated patients.

Open access

Diac Andreea Raluca, Brusnic Olga, Gabos Gabriella, Onisor Danusia, Drasoveanu Silvia Cosmina, Boeriu Alina and Dobru Daniela Ecaterina

Abstract

Objective. Assessment of the histological and endoscopic features of the colo-rectal polyps is requered for the application of the new diagnostic and therapeutical strategies in the managment of the diminutive polyps.

Methods. This paper is a descriptive retrospective study on 52 pacients reffered for colonoscopy in Gastroenterology Clinic – Clinical County Hospital Targu Mures from January until September 2014. 80 polyps were assessed. Narrow band imaging examination targeted on the protrusive lezions allowed NICE (Narrow Band Imaging International Colorectal Endoscopic) classification and corroboration of the histology prediction and pathological assessment.

Results. Polyp detection rate was 48,58%, given the quality of bowel preparation in hospital fair in 84,5%. The predominant histological type was the tubular adenoma (46,25%), and 40% of the polyps were located in the sigmoid. Among the diminutive polyps, 58,33% were hyperplastic(p<0,0001), mainly in the recto-sigmoid (66,67%); the incidence of high grade displasia or cancer was 0. Real –time prediction of the histology of the colorectal polyps using NBI established: NICE 1: 19 polpyps, histology- 16 hyperplastic, (p<0,0001, sensitivity: 100%, specificity: 95%), NICE 2: 59 polyps, histology- 53 adenomatous, (p<0,0001, sensitivity: 96%, specificity: 76%), NICE 3: 2 polyps- histology-cancer.

Conclusions. We did not observe any distribution pattern in the topography of the diminutive polyps. Histologicaly the predominant type was the hyperplastic type. NBI was accurate in real-time prediction of the histology of the colo-rectal polyps. The results are relevant for application of the new strategies in the managment of the diminutive polyps.