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.

Fungal Infections in Major Burns - 2 Years Overview

Abstract: Infections are the most severe and the most frequent complication in major burns requiring adequate diagnosis and treatment. Extensive burned areas, impaired immune system and antibiotic therapy contribute to the development of opportunistic fungal infections. An important aspect is the increased level of antimicrobial resistance in our country. We present a two years study on the burn patients hospitalized in our institution. A total of 355 burned patients were hospitalized during this period, 210 (59%) of them being addmited in Critical Care Burn Unit. We noted the main infectious complications and established a dinamic microbian mapping during patient hospitalization. Fungal infections were noted. We performed microbiological screening: testing at admission and once a week or in case of clinical signs from all potential sites. For the clinical therapy of mycoses, it is mandatory to know whether a fungal colonization or a fungal infection is involved. Unfortunately, often in severe burned patients, clinical presentation is unspecifi c and sensitivity of diagnostic results may be unreliable. Invasive fungal infections due to Candida species and Aspergillus species are important emerging causes of morbidity and mortality. The systemic use of antifungal agents is conducted depending on the general condition of the burn patient, the fungal species involved and the confi rmation of fungemia. In conclusion, specifi c treatment of infectious complications has to be conducted according to the characteristics of the patients in order to reduce morbidity and mortality and avoid the development of antimicrobial resistance.

Combined approach by middle and inferior antrostomy for endosinusal inclavated tooth root

Abstract: Abstract In the recent years, the development of stomatology with emphasis on dental implants procedures has led to an increase in the number of sinonasal complications. Sinonasal complications of dental disease and treatment are an important cause of sinus pathology, being responsible for 10-12% of all causes of chronic maxillary rhinosinusitis. The main etiological factors involved in odontogenic sinusitis are represented by dental fillings, tooth roots in traumatic extraction, dental implants displacement and parts of broken instruments. The diagnostic work-up includes evaluation of the symptoms, history of dental treatment, dental examination, CT scan and nasal endoscopy. The treatment is surgical and can be represented by transnasal endoscopic technique performed by the otorhinolaryngologist or a transoral technique performed by the maxillofacial surgeon when oro-antral fistulas are present. The endoscopic approach is preferred but has its limits when the tooth root is placed in the alveolar recess, or at the level of the anterior, medial and lateral wall of the maxillary sinus. Concurrent middle and inferior antrostomy provides a better view of the sinus and increases effectiveness of the surgical treatment with minimal physiological damage.

The Workload of the Interventional Cardiology Centers from Romania: a 2021 Overview and 2014–2021 Trends

Abstract: Abstract This article provides data on the workload of the interventional cardiology centers in Romania during 2021. Members from all interventional cardiology centers in Romania were requested to fill out a standard form about the total number of various procedures they performed during 2021. The report highlights the total number of coronary interventions, peripheral interventions, and interventions for structural heart diseases that were performed in 2021 in Romania. A comparison of the workload of the interventional cardiology centers from Romania between 2014 to 2021 was completed.

Hernia inguinalis permagna - to the light

Abstract: Giant inguinal hernias are rare, accounting for only 2,8-5% of all inguinal hernias. Neither its exact etiology nor its treatment resemble a consensus, the main challenge being loss of domain. This is the first full review pertaining to this aspect, according to our knowledge. We performed a review of the English literature using PubMed/Medline, Oxford Journal, Elsevier and Springer libraries. The objective is to present an unbiased picture of giant inguinal hernia management and pitfalls. We found 60 articles that treat this condition, with only one death reported. Comparing between the procedures was difficult because the majority of the publications are case reports or small scale case series. Among the differences, there were some common patterns in view of the popularity of open procedures in both developed and severely limited settings, with a favor for Lichtenstein. Evolution analysis was interesting considering laparoscopic procedures and postoperative aims. Among adjunct procedures, preoperative pneumoperitoneum had the most sustained evolution. Preventing abdominal compartment syndrome and considering unexpected hernia sac contents represented an interesting issue. Acknowledging tissue-targeted gene therapies sets further goals. Elective giant inguinal hernia repair must address a well-planned individualized approach, based on all available evidence and experience. The key to success treatment is not strict adherence to any one technique.

Gurvitis syndrome: the dark shade of hematemesis.

Abstract: Gurvitis syndrome, also known as acute esophageal necrosis (AEN) or “black esophagus,” is a rare syndrome characterized by necrotic lesions affecting the mucosa and submucosa, mainly in the distal part of the esophagus. Prevalence is 0.2% and incidence is 0.01%–0.0125% among Caucasians [1, 2]. A 63-year-old man who was a chronic smoker presented with a 12-hour history of hematemesis, increased abdominal girth, and weight loss (5 kg in the previous month). His medical history included biopsy-proven tubular adenocarcinoma liver metastases of unknown origin, which had been diagnosed 9 months prior to presentation and was treated with a 5-month course of chemotherapy with nanoparticles of gemcitabine and cisplatin as part of a clinical trial. Two months prior to presentation, the patient underwent two sessions of FOLFIRI (folinic acid, fluorouracil, irinotecan) as second-line chemotherapy. There was no history of corrosive intake or alcohol in the past. At admission the patient was hypotensive, with palpable liver margin and ascites. Blood work was modified as shown in ▶Table1. Abdominal ultrasound showed ascites, liver metastasis, and splenomegaly. Esophagogastroduodenoscopy showed AEN, circumferential black discoloration with sharp distal transition to normal mucosa at the gastroesophageal junction, starting from the superior esophageal sphincter (▶Fig. 1), which was more severe in the distal third of the esophagus (▶Video 1), and a bulbar ulcer. Esophageal biopsies were not done, as these are not required for diagnosis [2]. The patient was kept nil-per-os, started on aggressive resuscitation with intravenous fluids, and given proton-pump inhibitor and broad-spectrum antibiotics. His condition did not improve, with acute liver failure and severe coagulopathy (international normalized ratio 6.8), worsened neurological status, hypoglycemia, and finally death by cardiorespiratory arrest after 4 days. Mortality rate is high (30%–50%) and related to severe co-morbidities, as the death rate due to AEN is only 6% [3, 4].