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Surviving acquired severe nonmalignant hemophagocytic syndrome

binding inhibitors in the blood circulation of patients with adult-onset still disease. Arthritis Rheuma. 2001; 44:550-60. 20. Srichaikul T, Punyagupta S, Mongkolsritrakul W, Peutpol S, Leechawengwongs M, Chanokovat C. Hemophagocytic syndrome with fulminant multi-organ failure after tasting raw monkfish liver: the patient survived by immunomodulators and plasma exchange therapy. J Hematol Transfus Med. 2011; 21:261-6. 21. Srichaikul T, Mongkolsritrakul W. Hemophagocytic Syndrome in Textbook of Hematology-Diagnosis and Treatment of Common

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SURVIVE: let the dead help the living—an autopsy-based cohort study for mapping risk markers of death among those with severe mental illnesses

Abstract

Background: Forensic autopsy strategies may improve differential diagnostics both post-mortem and ante-mortem and aid in clinical settings concerning preventive efforts for premature mortality. Excess mortality and reduced life expectancy affect persons with severe mental illnesses (SMI) for multi-faceted reasons that remain controversial. Somatic conditions, medical treatment and lifestyle diseases, which are primarily examined in the living, contribute to premature deaths. The underlying pathophysiological mechanisms are unclear, though, and the benefits of a focused, standardised autopsy remain unproven. We have developed and implemented an optimised molecular–biological autopsy for deceased persons with SMI. Our aim is to map the occurrence of 1) somatic diseases and organ changes; 2) metabolic syndrome; 3) use and abuse of alcohol, pharmaceuticals and psychoactive substances; 4) pharmacokinetic and pharmacodynamic factors in the metabolism of pharmaceuticals; and 5) genetic variations (acquired and/or congenital) in sudden cardiac death. Additionally, we hope to contribute to diagnostic treatments and preventive measures to benefit those living with SMI. Methods: SURVIVE: let the dead help the living is a prospective, autopsy-based study on 500 deceased persons with SMI subjected to forensic autopsies under the Danish Act on Forensic Inquests and Autopsy. The autopsies followed an extended, standardised autopsy protocol comprised of whole-body computed tomography scanning, magnetic resonance imaging of the heart and brain and an extended forensic autopsy, including a wide panel of analyses (toxicology, microbiology, genetics, histology and biochemical analysis). Additionally, post-mortem data were linked to ante-mortem health data extracted from Danish national health registers.

Discussion: The SURVIVE autopsy procedure, including tissue sampling and bio banking, has been shown to be effective. We expect that the SURVIVE study will provide unique opportunities to unravel the mechanisms and causes of premature death in persons with SMI. We also expect that identifying prognostic biomarkers for comorbidities will contribute to prevention of premature deaths and comorbidities in persons with SMI.

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C Reactive Protein and Procalcitonine as Diagnostic Markers in Critically Ill Patients with Suspected Sepsis

Care Med. 2000; 26(7): 883-92. 15. Joo K, Park W, Lim MJ, Kwon SR, Yoon J. Serum procalcitonin for differentiating bacterial infection from disease flares in patients with autoimmune diseases. J Korean Med Sci. 2011; 26(9): 1147-51. 16. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013; 41(2): 580-637. 17. Sallah JI, Japiassu AM, Soares M, Assis EF, Gomes RN, Bozza MT, et al. Cytokine profiles as markers

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Qualitative studies investigating the effectiveness of stroke rehabilitation - methodological approaches and perspectives / Qualitative Studien zur Wirkung therapeutischer Interventionen – methodische Zugänge und Perspektiven am Beispiel Schlaganfallrehabilitation

exercise and relaxation classes for persons surviving a stroke. Canadian Journal of Occupational Therapy, 76(2), 73-80 Cherney, L.R., Halper, A.S. & Kaye, R.C. (2011). Computer-based script training for aphasia: emerging themes from post-treatment interviews. Journal of Communication Disorders. 44(4), 493-501. doi: 10.1016/j. jcomdis.2011.04.002 Fox, L., Poulsen, S., Bawden, K.C. & Packard, D. (2004). Critical elements and outcomes of a residential family-based intervention for aphasia caregivers. Aphasiology, 18(12), 1177-1199. doi: 10

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Postpartum midwifery care and familial psychosocial risk factors in Switzerland: A secondary data analysis / Hebammenbetreuung im Wochenbett und familiäre psychosoziale Risikofaktoren in der Schweiz: eine Sekundäranalyse

Introduction Human infants are born completely dependent and require care from adults for many years in order to survive and thrive. Parental psychosocial and material resources facilitate a healthy development of their children, most importantly through a warm and caring relationship ( Grossmann & Grossmann, 2012 ; Masten & Coatsworth, 1998 ). However, a lack of such familial resources can hinder the child’s development. Indeed, among the risk factors for a healthy infant development, many are related to the health and resources of its parents ( Zeanah

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Enzymatic Parameters at Admission and the Risk of Death in Politrauma Patientrs with Associated Thoracic Trauma

Abstract

Polytrauma patients represent one of the most challenging medical conditions. Developing methods of assessing the risk of death in these patients is a continous effort for the medical field. In this study we evaluate the creatine kinaze isoenzyme MB (CK-MB) and troponin as markers of increased risk of death in the first 24 hours after admission in polytrauma patients with associated thoracic trauma.

The study was conducted on 33 patients treated in the emergency department of County Clinical Emergency Hospital Constanta between 2014 and 2017.

The results of the study suggest that CK-MB does not offer additional information related to the risk of death in these patients, while in the case of troponin, higher values were observed in the patients that didn’t survive after 24 hours of followup.

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Early Cytokine Profile Changes In Interstitial And Necrotic Forms Of Acute Pancreatitis

ABSTRACT

Acute pancreatitis (AP) is a common, potentially lethal, acute inflammatory process with a highly variable clinical course. The aim of this study was to analyse early changes in the serum concentrations of pro- and anti-inflammatory cytokines in the peripheral blood of patients with the interstitial form of acute pancreatitis (IAP) and necrotic acute pancreatitis (NAP), especially in those patients who had lethal outcomes.

The prospective study enrolled 52 patients who were divided into IAP (65.38% of patients) and NAP (34.62% of patients) groups. The serum levels of interleukins (IL) 6, 8 and 10, together with tumour necrosis factor (TNF)-alpha were measured on the 1st and 3rd day of hospitalisation. Significantly higher values of IL-6, IL-8 and IL-10 were found on day 1 and 3 in NAP than in IAP. IL-6 was significantly higher on both days of measurement, whereas IL-10 on the first day and IL-8 on the third day were significantly higher in the group of patients who did not survive in comparison with patients who had the interstitial form of AP.

In conclusion, the data from this study showed that immune suppression and excessive immune stimulation in the first three days after admission could indicate the development of NAP and a potentially lethal outcome.

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Analysis of Treatment-Related Factors Affecting Mortality in Patients with Severe Necrotizing Acute Pancreatitis

Summary

The aim of the paper was to determine the factors related to the initial therapy that may contribute to death from severe necrotizing acute pancreatitis and to analyze their clinical importance as well as possible additive effects.

A retrospective case-control study included all adult patients treated for severe necrotizing acute pancreatitis in the Clinical Center of Kragujevac, Serbia, during the five-year period (2006-2010.). The cases (n = 41) were patients who died, while the controls (n = 69) were participants who survived. In order to estimate the relationship between potential risk factors and observed outcome, crude and adjusted odds ratios (OR) with 95 % confidence intervals (CI) were calculated in logistic regression models.

Significant association with observed outcome was shown for the use of gelatin and/or hydroxyethyl starch (adjusted OR 12.555; 95 % CI 1.150-137.005), use of albumin (adjusted OR 27.973; 95 % CI 1.741-449.373), use of octreotide (adjusted OR 16.069; 95 % CI 1.072-240.821) and avoiding of enteral feeding (adjusted OR 3.933; 95 % CI 1.118-13.829), while the use of nonsteroidal anti-inflammatory drugs had protective role (adjusted OR 0.057; 95 % CI 0.004-0.805).

The risk of death in patients with predicted severe necrotizing acute pancreatitis could be reduced with avoidance of treatment with colloid solutions, albumin and octreotide, as well as with an early introduction of oral/enteral nutrition and use of nonsteroidal anti-inflammatory drugs.

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Male Breast Cancer – Actuality of Our Days

Abstract

Coming from a female pacient's point of view, breast cancer is a hard to bare diagnosis. But what about the male patient? Although is very rare, male breast cancer does exist, and in the majority of cases, it is diagnosed in a very advanced stage with minimal curative posibilities. The critical medical education in our country along with the absence of a well structured national screening program are both provocative factors for the existence of this kind of disease.

This work is based upon a retrospective study on 976 patients (919 females and 57 males) who were diagnosed and requiring medical treatment for mammary neoplasm between 2008-2013 under the auspices of the Surgery Clinic inside the Clinical and Emergency District Hospital of Constanta.

From all the patient's anamnestic common elements like smoking, liver diseases, stress, radiation exposure, family antecedents that are related to the actual suffering, we can draw a latiogeneral instalation pattern of cancer. This study is meant to point out the similarities and especially the differences between the specialised bibliography and the collected information from the existing pathology concerning the age incidence, the type of neo formation, the location, histo-pathologic diagnosis, the types of surgical procedures and also to make evident the causes producing delay in starting the surgical treatment with visible consequential effects on both surviving and the quality of life.

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The Key Role of the Leading Emerging Bric Markets in the Future of Global Health Care

Abstract

The acronym ‘BRIC’ was coined in 2001 to describe the largest and most promising emerging markets outside the established, post-war, high-income economies. The nominal GDP growth rates of Brazil, Russia, India and China outpaced the growth rates of Western Europe, North America and Japan before, during and after the global economic crisis. Th is global phenomenon will have a significant impact on many branches of the economy, including the global demand for and provision of healthcare services. The key driver of this economic development is the existence of an enormous middle class in each of the BRIC countries. Both health insurance coverage and the package of services covered by health insurance plans are expanding in BRIC countries. Equally important is the overall increase in purchasing power in BRIC nations, which has been followed by the increased affordability of a vast portion of the medical goods and services that are commonly paid for out-of-pocket by ordinary citizens. When considering the changing landscape of global health care, one should also account for the slow and steady economic growth of most mature, saturated markets. Th is supports the notion that although consumer demand for health services remains strong in wealthy countries, the true expansion of the global market is occurring elsewhere. All major market analysis agencies have acknowledged this development and urged multinational healthcare companies to focus on emerging markets, and BRICs in particular, if they want to survive. Investment in emerging markets will remain the key to long-term profits and sustainability for pharmaceutical firms and medical equipment manufacturers across the globe for many years to come.

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