A male from rural area, S.M., aged 77 years, was admitted in our department for discontinuous headache. His medical history was irrelevant. He has been experiencing intermittent right parietal-occipital headaches during the last 3 months. Neurologic exam revealed a slight right limb ataxia. Initial laboratory findings revealed a white blood cell count of 6500/mm3 with 75% polymorphonuclear leukocytes, 15% lymphocytes and 8% monocytes. His serum glucose was 90 mg/dL. Non Gadolinium CT scan shows rounded, inhomogenous spontaneous hyperdense area (40-45 UH) between 5-12 mm diameter, localized frontal, temporal, occipital and cerebellar bilaterally. The question was whether the lesions were metastasis or parasitic infection? Cerebral MRI showed unenhanced,well lesions defined,multiple lesions between3-17 mm, with iso- • Active parenchymal stage: the scolex within acyst hyperintensityT1, T2, and FLAIR, spreadout may appear as a hyperdense dot periventriculary, subcortically, infrontal, temporal, • Calcified stage: when the parasite dies, parietal lobes andsubtentorially, right and left nodularparenchymal calcifications are seen. cerebellum(figure 2). After serological testsfrom blood and CSF the diagnosticof neurocysticercosis was certified(an enzyme-linked immunosorbentassay of the CSF was positivefor immunoglobulin G cysticercosisantibody, with 1.32 optical densityunits (OD) (positive result > 0.50OD); his serum IgG cysticercosis antibodywas positive with 5.12 OD). CT findings are depending on the stageof evolution: • Vesicular stage (viable larva): hypodense, nonenhancinglesions • Colloidal stage (larval degeneration): hypodense/isodense lesions with peripheral enhancementand edema • Nodular-granular stage: nodular-enhancinglesions • Cysticercotic encephalitis: diffuse edema,collapsed ventricles, and multiple enhancingparenchymal Our patient has multiple lesions in differentphases of evolution (active and calcified). DISCUSSIONS Neurocysticercosis is a parasitic brain infection,caused by larval cysts of the tapeworm Taenia soliumby accidental ingestion of eggs. It is the most common parasitic disease of the nervous system and it is themain cause of acquired epilepsy mainly in developingcountries. Once in the human intestine, Taenia eggsevolve to oncospheres 1 Carol Davila Central Emergency Military Hospital, Bucharest 2 Carol Davila University of Medicine and Pharmacy, Faculty of Medicine, Bucharest 40
Nonalcoholic fatty liver disease (NAFLD) is defined as the presence of fat in the liver (hepatic steatosis) either on imaging or on liver histology only after the exclusion of secondary causes of fat accumulation in the liver (e.g. high alcohol drinking, drugs and other medical ailments). Considering the fact that there are many causes of hepatic steatosis, the term NAFLD is reserved for the liver disease that is predominantly associated with obesity and metabolic syndrome. The presence of inflammation and cell injury defines steatohepatitis (NASH) which has the potential to evolve into cirrhosis and hepatocarcinoma, being, therefore, the stage of NAFLD most amenable to treatment. Among the treatments available, the most important are: weight loss, vitamin E and, last but not least, probiotics.
Many patients, usually over 60 years old, presenting presenile dementia associated with marked gait disorders, impaired balance, urinary incontinence, have been shown to have enlarged ventricles associated with relatively small cortical atrophy. Intracranial pressure monitoring indicates normal values, or subject to only minor peaks, usually at night. Because some of these patients improve markedly after ventricular shunting procedures it has been suggested that their neurological dysfunction may be caused by a pressure effect on the brain from the increased internal surface of the ventricles. Many of these patients do benefit from surgery, and a lot of them have a history of subarachnoid hemorrhage, traumatic brain injury or meningitis which might have impaired the CSF absorption.
Decontamination after terrorist attacks or industrial accidents with biological and/or chemical agents („bio-chem“) must be fast and efficient, in order to reduce the number of victims and to eliminate the consequent damages. The decontamination of living biological agents (bacteria, viruses) or nonliving ones (toxins, regulators) and toxic chemicals could be accomplished by reactions of hydrolysis in various experimental conditions, in particular in alkaline medium, reactions with amines or ammonia, alcohols, phenols etc. and by their transformation into less toxic degradation products. “Bio-chem” intentional or unintentional contamination is a real risk, towards which an effective management must be available to prevent and control it. Decontamination is an essential measure to protect the personnel and the environment. Synthesis and testing of new „bio-chem“ decontaminants, based on quaternary ammonium salts, complete the arsenal of protection against chemical and biological agents. The most effective selected substances could be produced and used for decontamination in accordance with legal procedures.
Stress is a constant presence in our lives, whether we analyze it in professional, social or family terms. This daily reality creates a state of tension, strain and discomfort, causing significant changes in physical and mental health. Stress at work can affect anyone, at any level, in any sector and in organizations of any size. Stress affects health and safety of individuals and also organizations’ welfare and national economies. There is a definite correlation between the level of stress at work and the changes in organization’s productivity.
Clostridium difficile (C. difficile) is a Gram-positive sporogenous bacillus strictly anaerobic, which in the last decade has became the most important anaerobic bacterium in nosocomial human pathology. Cl.dificile is the etiological agent of more than 20% of diarrhea postantibiotics, over 95% of pseudomembranous colitis and the first cause of nosocomial infectious diarrhea in adults. Although this bacterium usually colonizes the intestine of vertebrates (the normal microbiota), the toxinogenic strains (tcdA and tcdB) are pathogenic in the digestive tract. Given the excessive use of antibiotics and the increased spores resistance, it is possible an environment contamination, with strains which may already be resistant to antibiotics. The main causes of this infection are decreased resistance to antibiotic-induced colonization, contamination with a pathogenic strain of Cl.difficile, secretion of A and/or B toxins and deficient immune response. Due to the increasing worldwide incidence of infections with C. difficile on one hand and to the discovery of new ways of transmitting the infection according with some studies regarding the genetic diversity of bacterium strains on the other hand, a new approach is necessary for C. difficile related topics..
