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.

Safety of drotrecogin alfa (activated) treatment in patients with severe sepsis on renal replacement therapy without additional anticoagulation

Abstract: Patients with sepsis-induced acute renal failure on continuous renal replacement therapy (CRRT), who receive heparin, may be at higher risk of bleeding when drotrecogin alfa activated (DAA) is administered in addition to standard anticoagulation, especially surgical patients. There are some previous observations that no additional anticoagulation is necessary during simultaneous DAA infusion and CRRT. The aim of this study was to evaluate the safety of CRRT during DAA infusion without additional anticoagulant therapy.

Prediction factors for breast reconstruction postoperative complications.

Abstract: Breast cancer is a major health problem that requires multiple forms of treatment, including surgery, adjuvant chemotherapy and radiotherapy and more recently, reconstructive surgery. The aim of this study is to determine the factors that can predict the chances of a patient having postoperative complications after breast reconstruction.

Pb2259: monocyte’s involvement in inflammatory response in covid-19 infection in chronic renal disease

Abstract: Background: COVID-19 infection is known to associate an important inflammatory response with high risk for organ damages and thrombotic events. Monocytes are found to play an important role in inflammatory response against various antigens and are classified in three subsets: Classical, Non-classical, Intermediate. Aims: The aim of our study is to analyse monocyte subsets in patients with advanced renal failure and COVID-19 infection. Methods: We present a case-control study with paired samples: 5 patients from 15 suffering from advanced renal failure treated by hemodialysis, before, during developing a medium severity form of COVID-19 infection, and in follow-up (mean time 10 months), in which we analyzed monocytes subsets distribution and activation markers by flowcytometry from whole blood samples. Monoclonal antibodies used: CD14, CD16, CD300e, HLA-DR, CD64, CD38, CD45. Statistical analysis was performed with the Jasp and NCSS software. Results: Decreasing number of leukocytes (p=0,023), lymphocytes (p=0,029) and monocytes (p=0,167) during the infection was found, decreasing of the percentage of classical monocytes subset (p=0,295), and nonclassical monocytes subset (p=0,001), increasing in intermediate monocytes subset (p=0,115). HLA-DR and CD300e during the disease generally was increased without statistical significance (p=0,119, p=0,625), conventional monocytes had a lower CD300e (p=0,188) and HLA-DR expression is in fact unchanged with a slight tendency to increase (p=0,745), nonclassical monocytes had a higher percentage of HLA-DR (p=0,033) and CD300e (p=0,654), and intermediate monocytes had a slight elevated percentage of HLA-DR expression (p=0,332) and CD300e expression is in fact unchanged with a slight tendency to decrease (p=0,690). The percentage of classical monocytes increased (p=0,05), with a slight tendency of increasing in CD300e and HLA-DR expression after versus before infection. Nonclassical monocytes and intermediary monocytes percentage decreased after COVID-19 infection (p=0,001 respective p=0,049), but intermediary monocytes show a higher level of HLA-DR expression (p=0,012) versus before infection. CI was 95%. Boxplots in figure. Image:Summary/Conclusion: Apparently, advanced renal failure treated by hemodialysis does not dramatically change the inflammatory response medium form of COVID-19 infection. Distribution of inflammatory response consist in decreasing of percentage of classical and nonclassical monocytes, similar to severe forms of COVID-19 infection but the percentage of intermediate monocytes subset is increased. Elevation of HLA-DR and CD300e expression seems to occur especially in nonclassical monocytes, suggesting that this subset of monocytes is more activated. These changes suggest a higher inflammatory activity in nonclassical monocytes despite their lower percentage and a higher percentage of inflammatory and phagocytic intermediate monocytes. After a mean time of one year from infection resolution classical monocytes increased, and other two subtypes decreased, in nonclassical monocytes with the loss of inflammatory activity, but in intermediary monocytes with the persistence of important inflammatory activity similar during the infection, suggesting that the inflammatory response is more durable in intermediary monocytes after COVID-19 infection. The total monocytes expression of CD300e and HLA-DR after COVID-19 infection is statistically significant increase than before infection suggesting that the monocytes remain with a significant proinflammatory status after COVID infection.

Cutaneous Leiomyomatosis – Case Report and Literature Review

Abstract: Cutaneous leiomyomas are uncommon benign smooth muscle tumors that comprise of three distinct types such as piloleiomyoma, angioleiomyoma, and genital leiomyoma. The discovery in 2001 of the association between cutaneous leiomyomas, uterine leiomyomas in women, and an aggressive form of renal cell cancer (RCC) underscores the importance of accurate dermatologic diagnosis of CL so that appropriate cancer screening and counseling of patients and at-risk relatives can be instituted. The present case report will discuss the pathogenesis, clinical manifestations, diagnosis, and management of a piloleiomyoma.