Clinical Emergency Hospital Bucharest

About: Clinical Emergency Hospital Bucharest is a healthcare organization based out in Bucharest, Romania. It is known for research contribution in the topics: Medicine & Internal medicine. The organization has 381 authors who have published 276 publications receiving 2188 citations. The organization is also known as: Floreasca Hospital & Spitalul Floreasca.

Clinical, biological, echocardiographic and therapeutic determinants of the length of hospital stay of patients with acute heart failure.

Abstract: Hypothesis: The length of hospital stay (LOS) is a unanimously accepted measure of risk and treatment efficacy for in-patients. Purpose: Our aim was to identify the parameters with predictive value for the LOS of patients with acute heart failure (AHF). Methods: We analyzed 125 patients consecutively admitted to our clinic with a slight male predominance (54.4%) and a mean age of 71.54 years. Patients were divided into groups according to the clinical form at presentation and left ventricular function. Mean LOS was of 8.74 days. Results: Patients with LVEF 30% (F(2)=6.54, p 140mg (p 160ms (p<0.05) or LBBB. The linear regression equation exposed a single significant statistical model indicating that the need for vasopressor amines, mean diuretic dose and PAAT<90msec explain 56% of the variance of LOS F(3.46)=20.55, p<0.001. The highest contribution to the model was achieved by the need for vasopressor amines (β=0.66), with a unique contribution of 42% to the variance of the number of days of stay. The mean dose of diuretic had β=0.27 and a unique contribution to the model of 7.2%, followed by PAAT<90 msec with β=0.26 and a unique contribution to the model of 7%. Conclusions: LOS is influenced by numerous parameters, some specific to certain clinical forms of AHF while others are independent, which is why evaluations on larger groups of patients are further needed.

Pseudo-Foster Kennedy Syndrome - a case report.

Abstract: Objective: To report a case of Pseudo-Foster Kennedy (PFK) syndrome and describe its clinical and paraclinical particularities, as well as the diagnostic difficulties and established treatment. Methods: The case of a 60-year-old male patient with sudden, painless visual impairment in the left eye (LE), and a medical history of old optic nerve atrophy in his right eye (RE) was described. Results: The diagnosis of nonarteritic anterior ischemic optic neuropathy (NAION) was established based on the medical history, local and general clinical and paraclinical examination, and temporal artery biopsy. Conclusions: Although there is no current generally accepted treatment for NAION, a correct diagnosis and supportive treatment may contribute to the improvement in visual acuity (VA), improvement that in this case remained stable for 6 months after the onset. The patient is still being monitored and no relapses have been noted.

Ectopic pancreas mimicking gastrointestinal stromal tumor in the stomach fundus

Abstract: Ectopic or heterotopic pancreas refers to healthy pancreatic tissue that lacks anatomical, vascular or neural communication with the normal pancreas. However, heterotopic pancreas is seldom considered as a diagnostic hypothesis when symptomatic or when located outside of the gastric antral wall [1]. This case report describes the clinical and paraclinical features of pancreatic heterotopia in the gastric fundus in a previously healthy 25-year-old woman. Initially, a gastrointestinal stromal tumor (GIST) was highly suspected because of its endoscopic (location and shape; ▶Video1), endoscopic ultrasound (emerging layer; ▶Fig. 1, ▶Fig. 2), and computed tomography characteristics; however, the histopathological evaluation revealed pancreatic heterotopia (▶Fig. 3). Although the patient was asymptomatic, we opted for surgical treatment because of the large size of the lesion, the atypical location in a highly vascularized part of the stomach, and the patient’s young age. On postsurgical follow-up, only a small granuloma was found on the suture site, even though the surgery was not curative (R1 with remaining pancreatic tissue on one margin of the resection specimen) (▶Fig. 4). We emphasize the unusual location of the pancreatic heterotopia (gastric fundus – despite up to 95% of cases being found in the antral location), and the layer from which the tissue developed (muscularis propria – which is seen in only 17% of cases) [2]. Moreover, we emphasize the difficulty in making an accurate diagnosis, which can only be obtained after surgery, and the need for regular postoperative follow-up to assess for remaining pancreatic rests, as some studies have shown up to 12.7% malignant transformation in pancreatic rests [3]. Despite the fact that ectopic pancreas is a rare condition, one must consider the differential diagnosis of extramucosal gastric lesions. Even though endoscopic Video 1 Endoscopic appearence of a submucosal lesion, with central ulceration, in the gastric fundus. Narrow-band imagining revealed regular microvascular and surface patterns, except for the central zone, which had irregular surface and vascular patterns.

Acute mercury poisoning from occult ritual use.

Abstract: Mercury exposure is a serious environmental issue that concerns people worldwide. Industrial emissions containing mercury, some pharmaceutical and cosmetic products represent exposure sources. In Romania, as in many other countries, a supplementary cause for mercury exposure is represented by various occult rituals where liquids containing mercury are supposed to be ingested. We present the case of a 28 year old female who was admitted to the hospital for oral paresthesia, nausea, vertigo and sialorrhoea, after ingesting 100 ml diluted liquid mercury during an occult ritual. After the gastrointestinal decontamination, including gastric lavage, activated charcoal and cathartics, the outcome was favourable and 48 hours after admission the patient was discharged. This case report emphasizes the importance of an early digestive decontamination in mercury poisoning and the danger of mercury ingestion during various occult rituals.

Is mucosa-associated lymphoid tissue lymphoma an infectious disease? Role of Helicobacter pylori and eradication antibiotic therapy (Review).

Abstract: Mucosa-associated lymphoid tissue lymphoma (MALT) is seldom considered a diagnosis hypothesis in symptomatic patients. These lymphomas present as a main risk factor for chronic gastritis due to Helicobacter pylori infection. H. pylori leads to chronic inflammation, producing lymphoid tissue in the stomach mucosa (MALT) possibly leading to malignant transformation. Even though H. pylori remains one of the most important factors in the development of MALT lymphoma, it is not mandatory in the evolution of MALT lymphoma since high-grade lymphomas present a lower prevalence of H. pylori. The prevalence of H. pylori is indirectly proportional with the progression into the gastric wall. Mucosal and submucosal MALT lymphomas have a higher prevalence of the bacteria. However, genetic factors remain a risk factor especially if eradication treatment fails. Even though a low percentage of MALT lymphomas are H. pylori-negative, some respond to antibiotic eradication treatment. This can be explained either by the immunomodulatory effect of antibiotics or by other infectious sources such as Helicobacter heilmannii and Campylobacter jejuni (small bowel lymphoma). Treatment in MALT gastric lymphoma was a breakthrough since it was the first time in oncology where tumours were cured by antibiotic therapy, leading us to wonder if MALT lymphomas are infectious disease or not?