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Astrid Hendriks and Tamás Szili-Török
Diana Opincariu, Szilamér Korodi and Annabell Benedek
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Lennart de Vries, Zsuzsanna Kis and Sing-Chien Yap
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Diana Opincariu, Daniel Cernica, Marius Orzan, Monica Chițu, Zsuzsanna Suciu, Nora Rat, Theodora Benedek and Imre Benedek
Coronary computed tomography angiography (CCTA) has evolved notably over the last decade, gaining an increased amount of temporo-spatial resolution in combination with decreased radiation exposure. The importance of CCTA is emerging especially in vulnerable and young patients who might not have developed a viable collateral vascular network to sustain the circulation to an infarction area during a major adverse coronary event. There are a few well-known markers by which a vulnerable plaque can be assessed and that can predict the subsequent events of sudden myocardial ischemia, such as an increased positive remodeling index (cut-off >1.4), low-attenuation plaque (cut-off <30 HU), plaque burden (cut-off >0.7), and napkin-ring sign (NRS). This manuscript presents a series of 3 clinical cases of young patients experiencing symptoms and signs of myocardial ischemia who underwent CCTA in order to assess the composition and functional characteristics of atherosclerotic plaques and their repercussion in developing an acute coronary syndrome.
Loredana Luca, Alexandru Florin Rogobete and Ovidiu Horea Bedreag
Traumatic Brain Injury (TBI) is one of the leading causes of death among critically ill patients from the Intensive Care Units (ICU). After primary traumatic injuries, secondary complications occur, which are responsible for the progressive degradation of the clinical status in this type of patients. These include severe inflammation, biochemical and physiological imbalances and disruption of the cellular functionality. The redox cellular potential is determined by the oxidant/antioxidant ratio. Redox potential is disturbed in case of TBI leading to oxidative stress (OS). A series of agression factors that accumulate after primary traumatic injuries lead to secondary lesions represented by brain ischemia and hypoxia, inflammatory and metabolic factors, coagulopathy, microvascular damage, neurotransmitter accumulation, blood-brain barrier disruption, excitotoxic damage, blood-spinal cord barrier damage, and mitochondrial dysfunctions. A cascade of pathophysiological events lead to accelerated production of free radicals (FR) that further sustain the OS. To minimize the OS and restore normal oxidant/antioxidant ratio, a series of antioxidant substances is recommended to be administrated (vitamin C, vitamin E, resveratrol, N-acetylcysteine). In this paper we present the biochemical and pathophysiological mechanism of action of FR in patients with TBI and the antioxidant therapy available.
Zsuzsánna Ágnes Szász, Gyopár Horváth, Enikő Székely-Vass and Mădălina Hozoi
Introduction: Our article offers a deeper insight into an important occupational disease — coal workers' pneumoconiosis, with all its diagnosis difficulties, treatment steps, and strategies.
Case presentation: A 33-year-old male patient, smoker, with 16 years of outside exposure to coal dust, presents shortness of breath and cough, which existed 4 months prior to presentation and progressed in time. The first chest X-ray has raised differential diagnosis difficulties with miliary tuberculosis, despite the patient’s exposure history. All the investigation procedures performed afterwards (clinical examination, fibrobronchoscopy with microlavage and cytological examination, chest computed tomography, and routine laboratory investigations) were not enough to provide a certain and final diagnosis. Exploratory thoracotomy with lung biopsy was needed, and its findings started to sustain the professional disease diagnosis that had already taken shape. To exclude a disease which can evolve hand in hand, but also as a therapeutic application, we decided that a whole lung lavage was needed.
Conclusion: Although whole lung lavage could not be accomplished completely, the performed right middle lobe bronchoalveolar lavage had a huge impact, not only on the patient’s symptomatology, but also on the paraclinical results.
Anca Chiriac, Cristian Podoleanu and Simona Stolnicu
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István Kovács, András Mester, Lehel Bordi, Alexandra Stănescu, Sebastian Condrea, Monica Chiţu, Annabell Benedek and Imre Benedek
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