Florin Mihălțan, Ruxandra Ulmeanu and Beatrice Mahler
incidence in Romania in 2016 being five times the EU average (20% of all cases reported in the EU being attributed to Romania, who has only 4%
of the EU population ( 1 )), the current efforts have managed to bring a substantial decrease in the burden of this disease.
Substantial support from authorities will allow the project integration and, at the Press Conference, Health Minister and National Institute representatives mentioned other measures endorsing the project, like: financial support for this sample population, anti-TB medication in resistant TB forms and
Cristina Călărașu, Mimi Niţu, Mădălina Olteanu, Andreea Loredana Golli, Florentina Dumitrescu and Mihai Olteanu
antiretroviral drugs during tuberculosis therapy. The New England Journal of Medicine 2010;362(8):697–706. 10.1056/NEJMoa0905848 20181971 Abdool Karim SS Naidoo K Grobler A Padayatchi N Baxter C Gray A Gengiah T et al Timing of initiation of antiretroviral drugs during tuberculosis therapy The New England Journal of Medicine 2010 362 8 697 706
18 Abdool Karim SS1, Naidoo K, Grobler A, Padayatchi N, Baxter C, Gray AL, et al. Integration of antiretroviral therapy with tuberculosis treatment. N Engl J Med 2011;365(16):1492–1501. 10
integration of imaging, bronchoalveolar lavage findings, identification of serum precipitins and, sometimes, lung biopsy ( 2 ).
Because of the evolution to irreversible lung involvement ( 3 ), the treatment principles include the cessation of the antigen exposure and, in severe cases, association of pharmacological treatment ( 4 ).
A 16-year-old male patient, recreational breeder of 70 pigeons, presented moderate exercise dyspnoea, productive cough with mucous-purulent sputum and episodes of acute dyspnoea, symptoms that started two and a half
Andreea Ruxandra Ilina, Andra Elena Gorun, Camelia Georgeta Badea and Cristian Răsvan Băicuș
The purpose of this paper is to present a case of congenital pseudohypoparathyroidism, late diagnosed in a 22-year-old patient.
The patient’s history revealed hypocalcaemia, diagnosed at birth and persistent despite the treatment with calcium. At 8 years old, the patient is diagnosed with epilepsy and receives treatment with Levetiracetam and Oxcarbazepine; at 12 years old she is diagnosed with dilatative cardiomyopathy and receives treatment with Spironolactone and Glycosides. At 22 years old, she visits our Internal Medicine Department with the suspicion of polymyositis and psoriasis. Clinical examination shows armonic short stature, fourth finger hypoplasia, laboratory findings show severe hypocalcaemia, the hand X-ray - third and fourth metacarpal hypoplasia, immunological tests were negative. All data leads to the diagnosis of congenital disease, and given the history of the patient and the evolution of the clinical manifestations we presume hypoparathyroidism or pseudohypoparathyroidism, therefore PTH is dosed – with normal values, and the diagnosis of congenital pseudohypoparathyroidism is established. The patient was referred to endocrinology, where genetic tests were performed to confirm the diagnosis.
In conclusion, in the absence of multiple pathology integration into a single disease, the diagnosis of the genetic disease is delayed. Therefore, it is important to have a comprehensive approach and collaboration between different specialties to establish the correct diagnosis.
Adina Rusu, Ionuţ-Ovidiu Rusu, Amalia Loredana Călinoiu, Lăcrămioara Aurelia Brîndușe and Dana Galieta Mincă
epidemiological data. Journal of Hepatology 2013, vol. 58, issue 3, 593-608.
5. Fitzpatrick R, Davey C, Buxton MJ, Jones DR. Evaluating patient based outcome measures for use in clinical trials. Health Technol Assess. 1998;2:i–iv. 1–74.
6. Costanza R, Fisher B, Ali A, et al. An integrative approach to quality of life measurement, research, and policy, S.A.P.I.EN.S, 1.1 | 2008, (Online), Online since 19 décembre 2008. URL: http://sapiens.revues.org/index169.html . Connection on 03 août 2010.
7. Werner, S., Edwards, M., Baum, N., Brown, I., Brown, R. I. and