With time, medical and pharmaceutical research has advanced significantly. However, one of the major issues is how to administer the active substance. Among these, it counts over- or under-dosage of the active substance, low response to treatment, or increased clinical risk of the patient. An innovative method able to avoid these obstacles is represented by controlled release systems for active substances. The interest for these systems came with allowing encapsulation in the antibiotic release matrices, local anesthetics, protein or other substances. Moreover, a number of such vehicles are now available to release controlled substances used predominantly in the anesthesia and intensive care unit.
Hemofiltration National Registry is one of the patient registries implemented lately in Romania, currently in use, in response to increased clinical and research needs. The registries of patients with extracorporeal support of vital functions were developed with the support of Romanian Society of Anesthesia and Intensive Care. The registry contains data on over 200 hemofiltration procedures that were per formed in the last 3 years in multiple Romanian hospitals. A sample of data containing records of 2018 was analyzed by K-means clustering, revealing patterns that are potentially useful for healthcare improvement. Among the 6 clusters identified, 3 contain patients with a high mortality rate (90-100%), 1 is defined by intermediate mortality (72%) and 2 by a lower mortality rate (62%). Further research is needed in order to refine the clustering criteria, by using a larger number of cases and potentially examining more outcomes.
The emergence of multi-drug resistant Acinetobacter spp involved in hospital-acquired infections, once considered an easily treatable pathogen, is troublesome and an immense burden for the modern medical systems worldwide. In the last 20 years the medical community recorded an increase in the incidence and severity of these infections as therapeutic means tend to be less and less effective on these strains. The ability of these bacteria to rapidly develop resistance to antimicrobial agents by continuously changing and adapting their mechanisms, their ability to survive for long periods of time in the hospital environment and the multitude of transmission possibilities raises serious issues regarding the management of these complex infections. The future lies in developing new and targeted methods for the early diagnosis of A. baumannii, as well as in the judicious use of antimicrobial drugs. This review details the evolution of the pathogenicity of this microorganism, together with the changes that appeared in resistance mechanisms and the advancements in molecular testing for the early detection of infection.
Drowning in freshwater kills many people around the world. Complications are multiple and sometimes impossible to treat. Fluid and electrolyte resuscitation is difficult because of all the physiological, biophysical and biochemical changes that decrease the rate of survival. Extreme lung injury and cardiovascular disorders are responsible for tissue hypoxia, increased production of inflammation markers, biosynthesis of reactive oxygen species and finally, multiple organ damage. Hypothermia, frequently associated with drowning, provides multiple benefits to this type of patients. Various studies have developed the idea that hypothermia protects the brain from biochemical mediators, thereby preventing neuronal cell destruction. In this case report we present the biological parameters and evolution of a patient drowned in freshwater, and also the benefits of hypothermia to the clinical picture.
The current practice in the field of forensic medicine imposes the use of modern investigation techniques. The complexity of laboratory investigation methods needed for a final result of the investigation in forensic medicine needed new biomarkers of higher specificity and selectivity. Such biomarkers are the microRNAs (miRNAs), short, non-coding RNAs composed of 19–24 nucleotides. Their characteristics, such as high stability, selectivity, and specificity for biological fluids, differ from tissue to tissue and for certain pathologies, turning them into the ideal candidate for laboratory techniques used in forensic medicine. In this paper, we wish to highlight the biochemical properties and the usefulness of miRNAs in forensic medicine.