Elena Dantes, Anca Hancu, Madalina Iliescu, Ionela Balasa, Alina Busuioc, Claudia Cambrea and Ariadna Petronela Fildan
Background: Miliary tuberculosis is a haematogenuous dissemination of Mycobacterium Tuberculosis (M. tuberculosis) witch involves especially lungs, central nervous system and lymph node. It is a very severe disease with an increased risk of respiratory failure, extensive neurologic sequelas and high mortality. A rapid diagnosis and specific treatment is tremendous important for outcome. Association of strokeis common in tuberculous meningitis (MTB) and could delay the diagnosis and worse the prognosis.
Case presentation: We present a case of 24 years old male, who present asthenia and 20 kilo weight lossduring the last 2 years before admission in hospital. He came in hospital, directly in Intensive CareUnit (ICU) for left hemiplegia followed within hours of fever, repeated focal seizures and coma, reaching a Glasgow score of 6 about 48 hours after admission. Patient requiredorotracheal intubation. The Chest radiograph reveal micro-nodular opacities compatible with miliary TB and the cerebrospinal fluid (CFS) examination led to suspicion of TB meningitis. The Tb etiology was bacteriologically confirmed in sputum and cerebrospinal fluid. After 24 hors, theCT and angio-MRI detected the ischemic lesion in the middle cerebral arterial territory. The injectable antituberculous treatment with 4 drugs was immediately initiated. Parenteral cortichosteroids, anticoagulant, symptomatictreatments were associated. The patient received a very complex and prolonged nursing intervention followed by neurologic and pulmonary rehabilitation in ICU and in the Pneumophtisiology Department. The rehabilitation team identifies the all subjective and objective demands and plan the nursing process of care. When patient gains consciousness the neurologic and pulmonary rehabilitation were started. The evolution was slow, but favorable, after 6 moths of treatment the impairment of left hand movement being the only remaining sign of the past disease.
Conclusions: Collaboration medical team consisting of a neurologist, pulmonologist, infection disease specialist and physiotherapist increased the success rate, diminish the sequelas and improve the quality of life of the patient.
Elena Dantes, Doina Ecaterina Tofolean, Ariadna Petronela Fildan, Laura Mazilu, Ioana Gogonea, S. Dumitrache-Rujinski and Oana Cristina Arghir
Lung cancer remains one of the most frequent pathologies in Pulmonology Departments. Tumor extension, histopathological types, and treatment influence the prognosis and survival in lung cancer. Five years survival dramatically decreases for the 4th-stage of the disease. Non-small cell lung cancer (NSCLC) represents the vast majority of lung cancers. In the last decades, important findings have been made on identifying standardized molecular biomarkers that control tumor growth in lung adenocarcinoma. The discovery of new drugs led to the increased survival, even in extensive forms of the disease. The greatest advances could be obtained by targeting EGFR genetic mutations or EML4-ALK translocate in patients diagnosed with adenocarcinoma lung cancer
Grigorescu Cristina, Antoniu Sabina Antonela, Oţelea Marina Ruxandra, Ileana Antohe, Fildan Ariadna Petronela, Arghir Ioan Anton and Tofolean Ecaterina Doina
Viral respiratory infections in patients with asthma or chronic obstructive pulmonary disease (COPD) can cause severe exacerbations, increasing the risk of secondary bacterial infections and having a significant impact on disease-related morbidity and mortality. Several antivirals such as oseltamivir and zanamivir evaluated in influenza and other virus-induced respiratory infections are discussed in this review as a starting point of their potential use in improving the outcome of asthma and COPD exacerbations. However, the efficacy of antiviral therapy for asthma/COPD exacerbations needs a further evaluation.