The idea of using mobile hospitals - a fully functional hospital is a system with a high degree of complexity - in case of a pandemic crisis, is not new, but shows how much they are needed. Solutions belonging to the category of mobile architecture are increasingly common, technical and logistic difficulties are solved in more perfect way. This applies mostly to objects with simple layouts and functional relationships, with relatively little technical equipment. In the case of healthcare facilities there are several factors increasing the difficulty: multitude of functional connections, sanitary requirements, technical equipment, and internal infrastructure. The Romanian military and civilian specialists from Bucharest Central Military Emergency University Hospital (SUUMC) showed that is possible to build a hospital as a modular and mobile structure in order to fight COVID 19, but the strategic actions and the effort needed to organize and run mobile hospital far exceeds the expenditure, protocols and specialized M.D.s necessary to run the stationary hospital.
Background and aim. The presence of acute kidney injury (AKI) in subjects diagnosed with acute coronary syndromes (ACS) represents a major predictor of a negative outcome.The purpose of this study is to reveal the incidence of AKI in ACS subjects and to illustrate the prognosis of these subjects, using special models for mortality prediction, based on the creatinine values and the presence of acute heart failure (AHF). Methods. Using multiple linear regression, several models were designed to predict the mortality including: comorbidities of the subjects, initial and highest value of the serum creatinine (sCr) during hospitalization, presence of theAHF and Killip class compared with sCr values, the last model illustrating the influence of all the previous variables. Results. AKI had a significant incidence in the chronic kidney disease (CKD) group (53.11%). The mortality rate and the hospital readmission were higher in the CKD subjects (41.14%) versus the patients with normal kidney function (21.23%, p<0.01). The association of AKI and AHF, known as cardio-renal syndrome, was related to a negative outcome in the CKD group. The models for prediction of mortality emphasize that the age, dyslipidaemia, worst sCr, Killip class and AHF presence can be used to assess the mortality risk of patients with AKI and ACS. Previous pathological conditions such as diabetes, peripheral artery disease, coronary artery disease (CAD) and obesity, failed to achieve statistically significance for prediction of death. Conclusions. AKI represents a serious pathological condition with a high prevalence in subjects with CKD; the association with AHF increases the risk of hospital readmission and fatal outcome.
Orthodontic treatment and periodontal disease can have an inter-conditional relationship, particularly when the accumulation of bacterial plaque, favoured by orthodontic appliances and poor oral hygiene can cause periodontal inflammation. The objective of the study is to highlight the influence of the risk factors’ polymorphism on the therapeutic response in periodontal disease. 64 patients with mixed or definitive dentition and poor oral hygiene were included in the study, of whom 22 patients followed treatment with fixed orthodontic dispensers, 22 patients were treated with mobile orthodontic braces and 20 were non-attendants. From all patients gingival crevicular fluid was collected and assessed, before and after applying a chlorhexidine-based gel antiseptic agent.
Neurotoxic chemical agents induce complex toxicological effects with major adverse effects for those who are exposed to them. Medical countermeasures include administering atropine, a cholinesterase reactivating oxime and an anticonvulsant. The purpose of this reseach is the optimization of an antidote-based treatment in the intoxication with organophosphates through the synthesis and toxicological testing of new compounds with a pyridin-isonitrosoacetanilide structure and their comparison with obidoxime as reference. The objective of this study was the in vitro/in vivo assessment of the antidote properties and acute toxicity of synthethic oximes active in the exposure to neuroparalytic organophosphates. The CT50 value for obidoxime was estimated, through calculus, to be 3.24 mg/ml and 9.33 ×10 -6 M respectively. The CT50 value for Bis1,3[2-hydroxyimino-N-(pyridyl)acetamide]oxapropandichloride (HIN 2) was estimated to be 2.72 mg/ml and 6.29 ×10 -6 M respectively. The studied compounds showed values close to cellular viability at low and moderate equimolecular concentrations, administered in vitro to a cellular culture of fibroblasts. Bis1,3[2-hydroxyimino-N-(piridyl)acetamide]oxapropandichloride (HIN 2) showed an in vitro cellular viability value smalled than obidoxime at higher equimolecular concentrations, proving itself to be more toxic than obidoxime at high concentrations. Taking into account the close values of CT50, the newly synthethized compound, having this particular characterization from a toxicological standpoint, qualifies for further studies as an antidote.
The case of 73 years - old male patient with inferior crossed renal ectopia diagnosed upon imaging workup using a GE LightSpeed 16 Slice CT, with urothelial carcinoma, at the level of the left kidney, nephrolithiasis and thrombosed aneurysm at the level of the origin of right common iliac artery. The upper lobe of the right kidney fused with the lower lobe of the left kidney, on the left side of the midline. There were 6 renal arteries (4 on the left and 2 on the right) originating from the left side of the abdominal aorta, at the level of the termination of the abdominal aorta, the left common iliac artery and the right internal iliac artery. The patient presented with 6 renal veins (3 on the left and 3 on the right) that drained anteriorly on the left side of the inferior vena cava into the left common iliac vein and into the right internal iliac vein.
Moyamoya disease is a rare affliction, which progressively affects cerebral arteries, more frequently those in the circle of Willis and the internal carotid arteries. This condition has a genetic component, but the cause of the disease is unknown. It usually affects children but can affect adults as well, representing a health issue due to its mortality. Not in a few cases, Moyamoya disease has been difficult to recognize as a cause of ischemic or hemorrhagic strokes. In this article, we present the case of a young patient, with a medical history of cerebral hemorrhage, which was diagnosed with Moyamoya disease after clinical and cerebral angiographic corroboration in a specialized vascular center. The patient entered the Emergency Receiving Unit with a sudden comatose state. Paraclinical tests revealed massive intraparenchymal hemorrhage, with movement in the medial line and ventricular flooding.
Given the continuous growth of the bacterial resistance phenomenon, the appropriate choice of antibiotherapy represents an important step in the treatment and prophylaxis of infectious diseases. Depending on the symptomatology, the dose required for the effective treatment of an infection may vary. Inadequate dosing not only reduces the effectiveness of the antibiotic, but also promotes the emergence of resistant bacterial strains. Also, too high of a dose increases the toxic side effects of antibiotics. Therefore, a personalised antibiotherapy according to: the patient's clinical status, body mass, associated chronic diseases, etc. represents a promising approach in the treatment of infectious diseases. The purpose of this study is to present the most important current affairs regarding the emergence of new antibiotics, the maximum doses recommended by the latest version of the "European Committee on Antimicrobial Susceptibility Testing" (EUCAST - version 9/2019) and providing an indication on whether these antibiotics are used in Romania.
This article was written because of the necessity of clarifying the recent biomedical selection criterion for the medical exam of the students who are applying for higher military education. In order to screen for or monitor liver disorders or hemolytic anemia the bilirubin is measured. The increased values of the bilirubin can be caused by multiple factors and they are presented in the following chapters.
Background and Aim: Various studies have reported that 4-7 percent of adults with palpable thyroid nodules that 50-70 percent of it’s diagnosed with high-accuracy sonography. Although most thyroid nodules are non-cancerous and do not require treatment, a small percentage of them are associated with a potential risk of malignancy, which is an important early diagnosis by ultrasound or pathology. The present study aimed to compare the ultrasound with the pathologic results of fine-needle aspiration (FNA) of thyroid nodules for the rapid diagnosis of thyroid malignancies in patients referred to Baqiyatallah Hospital. Methods: The study population consisted of 100 (80 female, 20 male) patients with thyroid nodules in the age range of 19-82 years referred to the radiology ward of Baqiyatallah Hospital who were studied by the cross-sectional method. All patients were first scoring by ultrasound, then fine needle aspiration with thyroid nodule ultrasound was performed, and the specimens were referred to the pathology department for further evaluation. Results: The pathologic results from fine-needle aspiration showed that only 8 of the 100 patients studied had malignant nodules that, by ultrasound scoring, 7 patients had 4 scores and 1 patient had 3 scores. However, the other 92 patients with benign nodules 57.60% of patients had score 1, 30.43% of patients had score 2 and 11.97% of patients had score 3. Conclusion: According to the results of this study, it seems that ultrasound scoring is useful in the rapid diagnosis of thyroid nodules and prevent unnecessary thyroid nodule FNA.
Gastrointestinal infections are among the most common infectious diseases found all over the world, varying depending on the etiological agent. Symptoms usually include diarrhea, vomiting, and abdominal pain. Water and electrolyte imbalance is the main consequence of gastrointestinal infections. Most of them are cured or self-limited in few days, but at the same time, for a specific population such as immunocompromised, elderly patients or new-borns, these infections are potentially severe. In this context, it is very important to identify the etiological agents of acute diarrhea for the appropriate treatment and infection control measures. While routine laboratory diagnosis of parasitic diarrhea still depends largely on microscopic examination of fecal samples, immunological and molecular methods are becoming increasingly commercially available and, in well-resourced settings, will ultimately displace traditional methods. The present paper presents some of the most common and well-known pathologies of this type, being a brief presentation of the variety of gastrointestinal diseases, each with characteristic clinical manifestations and diagnosis.
