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.

Optoelectronic method for determining platinum in biological products

Abstract: Of all platinum metals, platinum has the most uses and it’s the most abundant and most easily to be processed. Its use in auto catalysts results in environmental contamination of crowded cities and high-traffic roads. In medicine, Pt is used as a cytostatic drug. In order to study the degree of contamination of the population with Pt or the correctness of treatment with Pt, it has been developed a method for its determination from urine or blood samples with a system Graphite Furnance - Atomic Absorption Spectrometer, (GF-AAS) Varian. There are presented the methods of sampling processing for blood or urine that followed the digest of the organic matrix. In the determination of the operating parameters for the system GF-AAS, was aimed the reducing of the nonanatomic absorbance by optimizing the drying temperatures, the calcination and atomization temperatures and the removal of the nonanatomic absorbance with D2 lamp. As a result of the use of the method are presented the concentrations of Pt in the blood or urine of a group of patients in Bucharest, a city with heavy traffic of vehicles. GF-AAS method presented is sensitive, reproducible, and relatively easy to apply with an acceptable cost. With this method, the concentration of Pt can be determined from blood and urine, both in order to establish the degree of contamination with Pt and for monitoring cancer therapy with platinum compounds.

Guidance and Guideline-recommendations for the treatment of femoral neck fractures Romanian Society of Orthopaedics and Traumatology- SOROT 2018

Abstract: Abstract Two types of femoral neck fractures are nowadays identified: those resulting from low energy trauma, usually by direct by falling on the hip, in patients with affected bone stock (the so-called “fragility fractures”) and those produced by high energy trauma, even in younger people, with normal bone stock. These recommendations are addressed to the first category. for which impaired mineral bone density (MBD), osteopenia, and osteoporosis represent major enabling factors. These recommendations refer to classification-based local and general treatment of femoral neck fractures (excluding the basilar neck ones). The presumptive and definitive diagnoses include the precise description of the fracture pattern, by complete imagistic evaluation. The treatment depends on the type of the patient (demanding or non-demanding), on the type of the fracture (stable or unstable), as well as on the facility of early treatment, in certain cases. The main therapeutic goal in femoral neck fractures is early social and professional reinsertion of the patient, by gaining a status as close as possible to the one before the trauma; stable stabilization allowing early mobilization has a key role in fulfilling this objective Therefore, complete evaluation and monitoring of the patient by a multidisciplinary team is mandatory in order to perform a proper evaluation of the anaesthetic and surgical risk ( as these patients usually have pre-existing health problems, sometimes severe) , a safe and adapted (form the point of view of invasivity) surgery and an appropriate post-operative local and general treatment. Therefore, these recommendations have numerous connections with those involving the intervention of physicians from other specialities with whom orthopaedic surgeons must cooperate in these cases

Evolving Concepts on the Basic Mechanisms of Heart Failure

Abstract: Heart failure (HF) syndrome is the result of the interaction of multiple mechanisms which act interdependently. The hemodynamic impairment secondary to the low cardiac output is closely linked to the neurohormonal activation and to the renal disturbances which contribute to HF pathophysiology. These multisystem anomalies are in close relationship with local myocardial anomalies represented by alterations of the myocardial extracellular matrix, abnormal cytoplasmic Ca2+ homeostasis and cell death. The magnitude of each of these mechanisms seems to be genetically programmed and current research focus on the identification of the genetic variants responsible for the various models of HF. Heart failure with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF) are two distinct entities, each characterized by different myocardial structure, myocardiocyte function and intramyocardial signaling. Heart failure with mid-range ejection fraction (HFmEF) is a new term for patients with ejection fraction that ranges from 40 to 49 %, and have characteristics between HFrEF and HFpEF. The new paradigm regarding HFpEF pathophysiology states that this syndrome is the consequence of a cluster of comorbidities which promotes a proinflammatory systemic state; this in turn, results in coronary microcirculation endothelial inflammation leading to myocardial stiffness and increased collagen synthesis. Both HFpEF and HFrEF may result in pulmonary hypertension and right ventricular dysfunction in some patients, while other patients seem to be protected against right heart failure (RHF). The factors that promote progression or protect against RHF in the context of left HF are not currently known. Noncardiac comorbidities contribute also to HF pathophysiology, and furthermore interfere with HF medication and worsen the prognosis of HF patients.

Diagnostic Pitfalls in a Man with Systemic Lupus Erythematous.

Abstract: Systemic lupus erythematosus (SLE) is a chronic multi-systemic immune-mediated disease with confusing symptoms and delayed diagnosis. We report the case of a 32-year-old man with a persistent Venereal Disease Research Laboratory (VDRL)-positive reaction treated for syphilis 5 years previously, who was admitted for rash, weight loss, pancytopenia, inflammatory syndrome, and an important spontaneous prolongation of activated partial thromboplastin time (aPTT). Antiphospholipid antibodies were identified in the patient and he was diagnosed with SLE. The unrecognized false positive VDRL reaction and the delayed diagnosis of SLE were harmful as the patient had developed renal and cardiac complications by the time of diagnosis. LEARNING POINTS VDRL positive reaction as a diagnostic tool for syphilis must be confirmed by other tests like TPHA and Western Blot reaction, especially in the absence of a clinical context, taking into account the possibility of false positive results. Spontaneous prolongation of aPTT can be related to the presence of antiphospholipid antibodies. In medical practice, the clinician must always consider the uniqueness of a diagnosis that integrates all the clinical and laboratory data, even if the associations might seem confusing. Keywords: Systemic lupus erythematous, antiphospholipid antibodies, aPTT CASE DESCRIPTION A 32-year-old man was admitted for involuntary weight loss (9 kg in 3 months), a maculopapular rash on the feet, face and anterior thorax, and morning joint stiffness. He was a non-smoker. He had a history of (a) Venereal Disease Research Laboratory (VDRL) elevation, interpreted as Treponema pallidum infection and treated with penicillin 5 years previously, (b) moderate normocytic, normochromic anaemia diagnosed 6 months before admission and interpreted as a result of vitamin deficiency, and (c) inflammatory syndrome interpreted as a result of pneumonia treated with ciprofloxacin 2 months prior to admission. The physical examination showed low-grade fever (37.5–38.0°C), skin pallor and a non-pruriginous cutaneous maculopapular rash on the thorax (Fig. 1) and fingertips (Fig. 2). There were no cardiovascular, respiratory or digestive pathological changes. Open in a separate window Figure 1 Macular erythematous cutaneous lesions on the thorax

Obstetrical Soft Tissue Trauma during Spontaneous Vaginal Birth in the Romanian Adolescent Population-Multicentric Comparative Study with Adult Population.

Abstract: Romania is a country with high rates of adolescent births, associating scarce comprehensive obstetrical management with this specific population. This research aims to assess soft tissue trauma after vaginal birth in teenage mothers compared to their adult counterparts. A retrospective case-control study was conducted for one year in two hospitals. All vaginal deliveries were considered; the age cut-off value was considered at 20 years old for case and control groups. Lacerations were divided into three subgroups, considering the involved anatomical region; group I: labial and periurethral lacerations, group II: vaginal and perineal lacerations, and group III: cervical lacerations. There were 1498 women included in the study: 298 young mothers and 1200 adults. Teenagers were more likely to have an episiotomy during vaginal delivery compared to adult women: 56% versus 26.7% (p = 0.00, Pearson Chi-square) and a 1.89 times increased risk for developing additional group II lacerations: p = 0.01, Pearson Chi-square test with Bonferroni correction: OR = 1.89, 95% CI: 1.18-3.02. Group II lacerations were the most frequent type of birth trauma in both study groups. Fetal weight ≥4000 g was associated with a two times higher risk for vaginal and perineal lacerations when age criterion was not considered (OR = 1.98, 95% CI: 1.13-3.47, p = 0.01). The incidence of group I and II lacerations increased with age: from 0% and 9.1% between 10 and 14 years old to 6% and 26.2% between 18 and 19 years old. All groups of lacerations were more often identified in the case group, compared to the adult group. Fetal macrosomia and spontaneously ruptured membranes at admission could not be documented as risk factors for obstetrical injury in young mothers. Episiotomy performed in teenagers was not a protective procedure for group II lacerations.