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Ceasovschih A, Șorodoc V, Covantsev S, Balta A, Uzokov J, Kaiser SE, Almaghraby A, Lionte C, Stătescu C, Sascău RA, Onofrei V, Haliga RE, Stoica A, Bologa C, Ailoaei Ș, Şener YZ, Kounis NG, Șorodoc L. Electrocardiogram Features in Non-Cardiac Diseases: From Mechanisms to Practical Aspects. J Multidiscip Healthc 2024; 17:1695-1719. [PMID: 38659633 PMCID: PMC11041971 DOI: 10.2147/jmdh.s445549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/10/2024] [Indexed: 04/26/2024] Open
Abstract
Despite the noteworthy advancements and the introduction of new technologies in diagnostic tools for cardiovascular disorders, the electrocardiogram (ECG) remains a reliable, easily accessible, and affordable tool to use. In addition to its crucial role in cardiac emergencies, ECG can be considered a very useful ancillary tool for the diagnosis of many non-cardiac diseases as well. In this narrative review, we aimed to explore the potential contributions of ECG for the diagnosis of non-cardiac diseases such as stroke, migraine, pancreatitis, Kounis syndrome, hypothermia, esophageal disorders, pulmonary embolism, pulmonary diseases, electrolyte disturbances, anemia, coronavirus disease 2019, different intoxications and pregnancy.
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Affiliation(s)
- Alexandr Ceasovschih
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- 2nd Internal Medicine Department, “Sf. Spiridon” Clinical Emergency Hospital, Iasi, Romania
| | - Victorița Șorodoc
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- 2nd Internal Medicine Department, “Sf. Spiridon” Clinical Emergency Hospital, Iasi, Romania
| | - Serghei Covantsev
- Department of Research and Clinical Development, Botkin Hospital, Moscow, Russia
| | - Anastasia Balta
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- 2nd Internal Medicine Department, “Sf. Spiridon” Clinical Emergency Hospital, Iasi, Romania
| | - Jamol Uzokov
- Department of Cardiology, Republican Specialized Scientific Practical Medical Center of Therapy and Medical Rehabilitation, Tashkent, Uzbekistan
| | - Sergio E Kaiser
- Discipline of Clinical and Experimental Pathophysiology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Abdallah Almaghraby
- Department of Cardiology, Ibrahim Bin Hamad Obaidallah Hospital, Ras Al Khaimah, United Arab Emirates
| | - Cătălina Lionte
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- 2nd Internal Medicine Department, “Sf. Spiridon” Clinical Emergency Hospital, Iasi, Romania
| | - Cristian Stătescu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- Department of Cardiology, “Prof. Dr. George I.M. Georgescu” Cardiovascular Diseases Institute, Iasi, Romania
| | - Radu A Sascău
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- Department of Cardiology, “Prof. Dr. George I.M. Georgescu” Cardiovascular Diseases Institute, Iasi, Romania
| | - Viviana Onofrei
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- Department of Cardiology, “Sf. Spiridon” Clinical Emergency Hospital, Iasi, Romania
| | - Raluca Ecaterina Haliga
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- 2nd Internal Medicine Department, “Sf. Spiridon” Clinical Emergency Hospital, Iasi, Romania
| | - Alexandra Stoica
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- 2nd Internal Medicine Department, “Sf. Spiridon” Clinical Emergency Hospital, Iasi, Romania
| | - Cristina Bologa
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- 2nd Internal Medicine Department, “Sf. Spiridon” Clinical Emergency Hospital, Iasi, Romania
| | - Ștefan Ailoaei
- Department of Cardiology, “Prof. Dr. George I.M. Georgescu” Cardiovascular Diseases Institute, Iasi, Romania
| | - Yusuf Ziya Şener
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkiye
| | - Nicholas G Kounis
- Department of Internal Medicine, Division of Cardiology, University of Patras Medical School, Patras, Greece
| | - Laurențiu Șorodoc
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
- 2nd Internal Medicine Department, “Sf. Spiridon” Clinical Emergency Hospital, Iasi, Romania
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Diaconu AD, Pomîrleanu C, Russu M, Strugariu G, Ancuța E, Ciortescu I, Bologa C, Morărașu BC, Constantin M, Ceasovschih A, Șorodoc V, Șorodoc L, Ancuța C. Drug Survival, Effectiveness and Safety of Secukinumab in Axial Spondyloarthritis up to 4 Years: A Real-Life Single Center Experience. J Pers Med 2024; 14:417. [PMID: 38673044 PMCID: PMC11051172 DOI: 10.3390/jpm14040417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 03/28/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
(1) Objective: The main aims of our study were to explore the drug survival and effectiveness of secukinumab in patients with axial spondyloarthritis (axSpA). (2) Methods: We underwent a retrospective analysis of consecutive axSpA treated with secukinumab as a first line of biologics or at switch in a biologic-experienced population. Efficacy data, indicating improvement in inflammation parameters (such as C-reactive protein and erythrocyte sedimentation rate) and disease activity scores (such as Ankylosing Spondylitis Disease Activity Score [ASDAS-CRP], Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]), and patient-reported outcomes (pain), were assessed at 6, 12, 24, 36 and 48 months. The drug survival rate, dropout rate and discontinuation reasons (efficacy versus safety) of secukinumab were assessed in subgroup analysis (axSpA with and without exposure to biologics). (3) Results: In total, 46 patients were exposed to the IL-17A inhibitor secukinumab. The drug survival for axSpA patients 59.7% at 12 months and 31.3% at 24 months. There were no statistically significant differences in the median drug survival between biologic-naïve versus biologic-experienced subgroups. (4) Conclusions: Secukinumab has demonstrated effectiveness and safety in treating a cohort of axSpA patients in real-world settings, with a notable retention rate of the drug.
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Affiliation(s)
- Alexandra-Diana Diaconu
- Department of Internal Medicine, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (A.-D.D.); (C.B.); (B.C.M.); (M.C.); (A.C.); (V.Ș.); (L.Ș.)
- Internal Medicine 2nd Department, ‘‘Sfântul Spiridon’’ Emergency Clinical County Hospital, 700111 Iasi, Romania
| | - Cristina Pomîrleanu
- Department of Rheumatology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (C.P.); (M.R.); (C.A.)
- Rheumatoloy 2nd Department, Clinical Rehabilitation Hospital, 14 Pantelimon Halipa Street, 700661 Iasi, Romania
| | - Mara Russu
- Department of Rheumatology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (C.P.); (M.R.); (C.A.)
- Rheumatoloy 2nd Department, Clinical Rehabilitation Hospital, 14 Pantelimon Halipa Street, 700661 Iasi, Romania
| | - Georgiana Strugariu
- Department of Rheumatology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (C.P.); (M.R.); (C.A.)
- Rheumatoloy 2nd Department, Clinical Rehabilitation Hospital, 14 Pantelimon Halipa Street, 700661 Iasi, Romania
| | - Eugen Ancuța
- Research Department, Elena Doamna Clinical Hospital, 700398 Iasi, Romania;
| | - Irina Ciortescu
- Gastroenterology Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
- Institute of Gastroenterology and Hepatology, “Sfântul Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
| | - Cristina Bologa
- Department of Internal Medicine, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (A.-D.D.); (C.B.); (B.C.M.); (M.C.); (A.C.); (V.Ș.); (L.Ș.)
- Internal Medicine 2nd Department, ‘‘Sfântul Spiridon’’ Emergency Clinical County Hospital, 700111 Iasi, Romania
| | - Bianca Codrina Morărașu
- Department of Internal Medicine, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (A.-D.D.); (C.B.); (B.C.M.); (M.C.); (A.C.); (V.Ș.); (L.Ș.)
- Internal Medicine 2nd Department, ‘‘Sfântul Spiridon’’ Emergency Clinical County Hospital, 700111 Iasi, Romania
| | - Mihai Constantin
- Department of Internal Medicine, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (A.-D.D.); (C.B.); (B.C.M.); (M.C.); (A.C.); (V.Ș.); (L.Ș.)
- Internal Medicine 2nd Department, ‘‘Sfântul Spiridon’’ Emergency Clinical County Hospital, 700111 Iasi, Romania
| | - Alexandr Ceasovschih
- Department of Internal Medicine, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (A.-D.D.); (C.B.); (B.C.M.); (M.C.); (A.C.); (V.Ș.); (L.Ș.)
- Internal Medicine 2nd Department, ‘‘Sfântul Spiridon’’ Emergency Clinical County Hospital, 700111 Iasi, Romania
| | - Victorița Șorodoc
- Department of Internal Medicine, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (A.-D.D.); (C.B.); (B.C.M.); (M.C.); (A.C.); (V.Ș.); (L.Ș.)
- Internal Medicine 2nd Department, ‘‘Sfântul Spiridon’’ Emergency Clinical County Hospital, 700111 Iasi, Romania
| | - Laurențiu Șorodoc
- Department of Internal Medicine, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (A.-D.D.); (C.B.); (B.C.M.); (M.C.); (A.C.); (V.Ș.); (L.Ș.)
- Internal Medicine 2nd Department, ‘‘Sfântul Spiridon’’ Emergency Clinical County Hospital, 700111 Iasi, Romania
| | - Codrina Ancuța
- Department of Rheumatology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania; (C.P.); (M.R.); (C.A.)
- Rheumatoloy 2nd Department, Clinical Rehabilitation Hospital, 14 Pantelimon Halipa Street, 700661 Iasi, Romania
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Morarasu BC, Sorodoc V, Haisan A, Morarasu S, Bologa C, Haliga RE, Lionte C, Marciuc EA, Elsiddig M, Cimpoesu D, Dimofte GM, Sorodoc L. Age, blood tests and comorbidities and AIMS65 risk scores outperform Glasgow-Blatchford and pre-endoscopic Rockall score in patients with upper gastrointestinal bleeding. World J Clin Cases 2023; 11:4513-4530. [PMID: 37469720 PMCID: PMC10353516 DOI: 10.12998/wjcc.v11.i19.4513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/14/2023] [Accepted: 05/30/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Upper gastrointestinal (GI) bleeding is a life-threatening condition with high mortality rates.
AIM To compare the performance of pre-endoscopic risk scores in predicting the following primary outcomes: In-hospital mortality, intervention (endoscopic or surgical) and length of admission (≥ 7 d).
METHODS We performed a retrospective analysis of 363 patients presenting with upper GI bleeding from December 2020 to January 2021. We calculated and compared the area under the receiver operating characteristics curves (AUROCs) of Glasgow-Blatchford score (GBS), pre-endoscopic Rockall score (PERS), albumin, international normalized ratio, altered mental status, systolic blood pressure, age older than 65 (AIMS65) and age, blood tests and comorbidities (ABC), including their optimal cut-off in variceal and non-variceal upper GI bleeding cohorts. We subsequently analyzed through a logistic binary regression model, if addition of lactate increased the score performance.
RESULTS All scores had discriminative ability in predicting in-hospital mortality irrespective of study group. AIMS65 score had the best performance in the variceal bleeding group (AUROC = 0.772; P < 0.001), and ABC score (AUROC = 0.775; P < 0.001) in the non-variceal bleeding group. However, ABC score, at a cut-off value of 5.5, was the best predictor (AUROC = 0.770, P = 0.001) of in-hospital mortality in both populations. PERS score was a good predictor for endoscopic treatment (AUC = 0.604; P = 0.046) in the variceal population, while GBS score, (AUROC = 0.722; P = 0.024), outperformed the other scores in predicting surgical intervention. Addition of lactate to AIMS65 score, increases by 5-fold the probability of in-hospital mortality (P < 0.05) and by 12-fold if added to GBS score (P < 0.003). No score proved to be a good predictor for length of admission.
CONCLUSION ABC score is the most accurate in predicting in-hospital mortality in both mixed and non-variceal bleeding population. PERS and GBS should be used to determine need for endoscopic and surgical intervention, respectively. Lactate can be used as an additional tool to risk scores for predicting in-hospital mortality.
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Affiliation(s)
- Bianca Codrina Morarasu
- Department of Internal Medicine and Toxicology, Saint Spiridon University Regional Emergency Hospital, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700111, Romania
| | - Victorita Sorodoc
- Department of Internal Medicine and Toxicology, Saint Spiridon University Regional Emergency Hospital, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700111, Romania
| | - Anca Haisan
- Department of Emergency Medicine, Saint Spiridon University Regional Emergency Hospital, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700111, Romania
| | - Stefan Morarasu
- Second Department of Surgical Oncology, Regional Institute of Oncology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700111, Romania
| | - Cristina Bologa
- Department of Internal Medicine and Toxicology, Saint Spiridon University Regional Emergency Hospital, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700111, Romania
| | - Raluca Ecaterina Haliga
- Department of Internal Medicine and Toxicology, Saint Spiridon University Regional Emergency Hospital, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700111, Romania
| | - Catalina Lionte
- Department of Internal Medicine and Toxicology, Saint Spiridon University Regional Emergency Hospital, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700111, Romania
| | - Emilia Adriana Marciuc
- Department of Radiology, Emergency Hospital “Prof. Dr. N. Oblu”, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700309, Romania
| | - Mohammed Elsiddig
- Department of Gatroenterology, Beaumont Hospital, Dublin D09V2N0, Ireland
| | - Diana Cimpoesu
- Department of Emergency Medicine, Saint Spiridon University Regional Emergency Hospital, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700111, Romania
| | - Gabriel Mihail Dimofte
- Second Department of Surgical Oncology, Regional Institute of Oncology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700111, Romania
| | - Laurentiu Sorodoc
- Department of Internal Medicine and Toxicology, Saint Spiridon University Regional Emergency Hospital, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700111, Romania
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4
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Pașa V, Popa E, Poroch M, Cosmescu A, Bacusca AI, Slanina AM, Ceasovschih A, Stoica A, Petroaie A, Ungureanu M, Popa AE, Avram RI, Bologa C, Poroch V, Coman EA. The "Viral" Form of Polyarteritis Nodosa (PAN)-A Distinct Entity: A Case Based Review. Medicina (Kaunas) 2023; 59:1162. [PMID: 37374366 DOI: 10.3390/medicina59061162] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/07/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023]
Abstract
Classic polyarteritis nodosa (PAN) is a vasculitis with systemic manifestations that is characterized by inflammatory and necrotizing lesions affecting medium and small muscular arteries, most frequently at the bifurcation of the vessels. These lesions lead to the formation of microaneurysms, hemorrhaging ruptured aneurysms, thrombosis, and, consequently, ischemia or organ infarction. Background and Objectives: We present a complex clinical case of a patient with a late diagnosis of polyarteritis nodosa with multiorgan involvement. Materials and Methods: The 44-year-old patient, in an urban environment, presented on her own in the emergency room for acute ischemia phenomena and forearm and right-hand compartment syndrome, requiring surgical decompression in the Plastic Surgery Clinic. Results: Significant inflammatory syndrome is noted, alongside severe normocytic hypochromic iron deficiency anemia, nitrogen retention syndrome, hyperkalemia, hepatic syndrome, and immunological disturbances: absence of cANCA, pANCA, anti Scl 70 Ac, antinuclear Ac, and anti dDNA Ac, as well as a low C3 fraction of the plasmatic complement system. The morphological aspect described in the right-hand skin biopsy correlated with the clinical data supports the diagnosis of PAN. Conclusions: The viral form of PAN seems to be individualized as a distinct entity, requiring early, aggressive medication.
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Affiliation(s)
- Victoria Pașa
- 2nd Rheumatology Department, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Elena Popa
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
- Department of Family Medicine, Preventive Medicine and Interdisciplinary, "Grigore T. Popa" University of Medicine and Pharmacy, Universitatii Str. 16, 700115 Iasi, Romania
| | - Mihaela Poroch
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
- Department of Family Medicine, Preventive Medicine and Interdisciplinary, "Grigore T. Popa" University of Medicine and Pharmacy, Universitatii Str. 16, 700115 Iasi, Romania
| | - Adriana Cosmescu
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
- Department of Family Medicine, Preventive Medicine and Interdisciplinary, "Grigore T. Popa" University of Medicine and Pharmacy, Universitatii Str. 16, 700115 Iasi, Romania
| | - Agnes Iacinta Bacusca
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
- Department of Family Medicine, Preventive Medicine and Interdisciplinary, "Grigore T. Popa" University of Medicine and Pharmacy, Universitatii Str. 16, 700115 Iasi, Romania
| | - Ana Maria Slanina
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
- Department of Family Medicine, Preventive Medicine and Interdisciplinary, "Grigore T. Popa" University of Medicine and Pharmacy, Universitatii Str. 16, 700115 Iasi, Romania
| | - Alexandr Ceasovschih
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Alexandra Stoica
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Antoneta Petroaie
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
- Department of Family Medicine, Preventive Medicine and Interdisciplinary, "Grigore T. Popa" University of Medicine and Pharmacy, Universitatii Str. 16, 700115 Iasi, Romania
| | - Monica Ungureanu
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
- Department of Family Medicine, Preventive Medicine and Interdisciplinary, "Grigore T. Popa" University of Medicine and Pharmacy, Universitatii Str. 16, 700115 Iasi, Romania
| | - Andrei Emilian Popa
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
| | - Raluca Ioana Avram
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
| | - Cristina Bologa
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Vladimir Poroch
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
| | - Elena Adorata Coman
- Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
- Department of Family Medicine, Preventive Medicine and Interdisciplinary, "Grigore T. Popa" University of Medicine and Pharmacy, Universitatii Str. 16, 700115 Iasi, Romania
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
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5
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Stoica A, Lionte C, Palaghia MM, Gîrleanu I, Şorodoc V, Ceasovschih A, Sîrbu O, Haliga RE, Bologa C, Petriş OR, Nuţu V, Trofin AM, Bălan GG, Catana AN, Coman AE, Constantin M, Puha G, Morăraşu BC, Şorodoc L. Severe Intentional Corrosive (Nitric Acid) Acute Poisoning: A Case Report and Literature Review. J Pers Med 2023; 13:987. [PMID: 37373976 DOI: 10.3390/jpm13060987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/02/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Despite being one of the most debilitating conditions encountered in the field of toxicology, there is a lack of neutralization measures for the toxins involved in acute corrosive poisoning, and this promotes progressive contact injury of deep tissues after poisoning has occurred. Multiple controversies still surround management strategies during the acute phase of poisoning and the long-term follow-up of the patient. Here, we report a severe case of intentional poisoning with nitric acid complicated by extensive injury of the upper digestive tract, multiple stricture formation, and complete dysphagia. Serial endoscopic dilation and insertion of a jejunostomy feeding tube were necessary, and underlying psychiatric illness negatively affected the outcome of the patient. We conclude that an interdisciplinary approach is necessary to properly reduce the extent of lesions and sequelae induced by corrosion. Early endoscopic mapping of injuries is of major importance to better predict the evolution and possible complications of poisoning. Interventional and reconstructive surgical procedures may significantly improve the life expectancy and quality of life of patients following intoxication with corrosive substances.
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Affiliation(s)
- Alexandra Stoica
- Internal Medicine Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Cătălina Lionte
- Second Internal Medicine Clinic, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Mădălina Maria Palaghia
- General Surgery Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- First General Surgery Clinic, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Irina Gîrleanu
- Internal Medicine Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Gastroenterology Clinic, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Victoriţa Şorodoc
- Internal Medicine Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Second Internal Medicine Clinic, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Alexandr Ceasovschih
- Internal Medicine Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Second Internal Medicine Clinic, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Oana Sîrbu
- Internal Medicine Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Second Internal Medicine Clinic, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Raluca Ecaterina Haliga
- Internal Medicine Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Second Internal Medicine Clinic, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Cristina Bologa
- Internal Medicine Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Second Internal Medicine Clinic, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Ovidiu Rusalim Petriş
- Second Internal Medicine Clinic, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
- Nursing Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Vlad Nuţu
- General Surgery Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- First General Surgery Clinic, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Ana Maria Trofin
- General Surgery Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Second General Surgery Clinic, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Gheorghe G Bălan
- Internal Medicine Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Gastroenterology Clinic, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Andreea Nicoleta Catana
- Infectious Diseases Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Adorata Elena Coman
- Second Internal Medicine Clinic, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
- Preventive Medicine and Interdisciplinary Team Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Mihai Constantin
- Internal Medicine Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Second Internal Medicine Clinic, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Gabriela Puha
- Internal Medicine Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Second Internal Medicine Clinic, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Bianca Codrina Morăraşu
- Internal Medicine Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Second Internal Medicine Clinic, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Laurenţiu Şorodoc
- Internal Medicine Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Second Internal Medicine Clinic, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
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6
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Popa IL, Bălgrădean M, Costin M, Bobircă A, Bologa C, Armășelu T, Bobircă F, Croitoru A. Posterior Reversible Encephalopathy Syndrome in a Pediatric Patient with End-Stage Renal Disease. Children (Basel) 2023; 10:children10040731. [PMID: 37189980 DOI: 10.3390/children10040731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 04/03/2023] [Accepted: 04/13/2023] [Indexed: 05/17/2023]
Abstract
Posterior reversible encephalopathy syndrome (PRES) is a clinical and neuroimaging syndrome that can affect both children and adults and has variable etiology. It is clinically defined by headaches, consciousness disorders, seizures and visual disturbances. Early recognition (clinical and imaging) can lead to appropriate general measures to correct the underlying cause of PRES. In this paper, we report a case of PRES in an eight-year-old boy with bilateral renal hypoplasia and end-stage renal disease (ESRD).
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Affiliation(s)
- Ionela-Loredana Popa
- Department of Pediatric Nephrology, "M.S. Curie" Emergency Clinical Hospital for Children, 077120 Bucharest, Romania
| | - Mihaela Bălgrădean
- Department of Pediatric Nephrology, "M.S. Curie" Emergency Clinical Hospital for Children, 077120 Bucharest, Romania
- Department of Pediatrics, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mariana Costin
- Department of Pediatric Nephrology, "M.S. Curie" Emergency Clinical Hospital for Children, 077120 Bucharest, Romania
- Department of Pediatrics, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Anca Bobircă
- Department of Internal Medicine and Rheumatology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Internal Medicine and Rheumatology Department, Dr. Ion Cantacuzino Clinical Hospital, 011437 Bucharest, Romania
| | - Cristina Bologa
- Department of Pediatric Nephrology, "M.S. Curie" Emergency Clinical Hospital for Children, 077120 Bucharest, Romania
| | - Teodora Armășelu
- Department of Pediatric Nephrology, "M.S. Curie" Emergency Clinical Hospital for Children, 077120 Bucharest, Romania
| | - Florin Bobircă
- Department of Surgery, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Surgery Department, Dr. Ion Cantacuzino Clinical Hospital, 011437 Bucharest, Romania
| | - Anca Croitoru
- Department of Pediatric Nephrology, "M.S. Curie" Emergency Clinical Hospital for Children, 077120 Bucharest, Romania
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7
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Haliga RE, Sorodoc V, Morarasu BC, Coman AE, Ceasovschih A, Sirbu O, Lionte C, Bologa C, Stoica A, Constantin M, Puha G, Petris OR, Badescu MC, Crisu D, Catana AN, Haliga IB, Sorodoc L. Native and Prosthetic Simultaneously Double Valve Infective Endocarditis with Enterococcus faecalis-Case-Based Review. J Pers Med 2023; 13:jpm13020300. [PMID: 36836534 PMCID: PMC9964386 DOI: 10.3390/jpm13020300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 02/04/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023] Open
Abstract
Infective endocarditis is a severe infective heart disease, commonly involving native or prosthetic valves. It frequently presents with univalvular involvement and simultaneous double valve or multivalvular involvement is rarely described. The third leading cause of infective endocarditis worldwide is Enterococcus faecalis, which is associated with high mortality rates despite important advances in antimicrobial therapy. It develops secondary to enterococcal bacteremia, with its origin from the gastrointestinal or genitourinary tract and predominantly affecting the elderly population with multiple comorbidities. Clinical presentation is usually less typical, and the treatment is challenging. It can be marked by antibiotic resistance, side effects, and subsequent complications. Surgical treatment can be considered if deemed appropriate. To the best of our knowledge, we present the first case-based narrative review of Enterococcus faecalis double valve endocarditis involving both the aortic native and prosthetic mitral valve, highlighting the clinical characteristics, treatment, and complications of this condition.
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Affiliation(s)
- Raluca Ecaterina Haliga
- Faculty of Medicine, Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- 2nd Internal Medicine Clinic, “St. Spiridon” Emergency Clinical County Hospital, 700111 Iași, Romania
| | - Victorita Sorodoc
- Faculty of Medicine, Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- 2nd Internal Medicine Clinic, “St. Spiridon” Emergency Clinical County Hospital, 700111 Iași, Romania
| | - Bianca Codrina Morarasu
- Faculty of Medicine, Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- Correspondence: (B.C.M.); (A.E.C.); (A.C.)
| | - Adorata Elena Coman
- Preventive Medicine and Interdisciplinary Team Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Correspondence: (B.C.M.); (A.E.C.); (A.C.)
| | - Alexandr Ceasovschih
- 2nd Internal Medicine Clinic, “St. Spiridon” Emergency Clinical County Hospital, 700111 Iași, Romania
- Correspondence: (B.C.M.); (A.E.C.); (A.C.)
| | - Oana Sirbu
- Faculty of Medicine, Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Catalina Lionte
- Faculty of Medicine, Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- 2nd Internal Medicine Clinic, “St. Spiridon” Emergency Clinical County Hospital, 700111 Iași, Romania
| | - Cristina Bologa
- Faculty of Medicine, Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- 2nd Internal Medicine Clinic, “St. Spiridon” Emergency Clinical County Hospital, 700111 Iași, Romania
| | - Alexandra Stoica
- Faculty of Medicine, Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- 2nd Internal Medicine Clinic, “St. Spiridon” Emergency Clinical County Hospital, 700111 Iași, Romania
| | - Mihai Constantin
- Faculty of Medicine, Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- 2nd Internal Medicine Clinic, “St. Spiridon” Emergency Clinical County Hospital, 700111 Iași, Romania
| | - Gabriela Puha
- Faculty of Medicine, Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- 2nd Internal Medicine Clinic, “St. Spiridon” Emergency Clinical County Hospital, 700111 Iași, Romania
| | - Ovidiu Rusalim Petris
- 2nd Internal Medicine Clinic, “St. Spiridon” Emergency Clinical County Hospital, 700111 Iași, Romania
- Nursing Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Minerva Codruta Badescu
- Faculty of Medicine, Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- 3rd Internal Medicine Clinic, “St. Spiridon” Emergency Clinical County Hospital, 700111 Iași, Romania
| | - Daniela Crisu
- Department of Cardiology, “St. Spiridon” Emergency Clinical County Hospital, 700111 Iași, Romania
| | - Andreea Nicoleta Catana
- Department of Infectious Diseases, “St. Spiridon” Emergency Clinical County Hospital, 700111 Iași, Romania
| | - Ioana Bianca Haliga
- Faculty of Medicine, Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Laurentiu Sorodoc
- Faculty of Medicine, Department of Internal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- 2nd Internal Medicine Clinic, “St. Spiridon” Emergency Clinical County Hospital, 700111 Iași, Romania
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8
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Coman AE, Ceasovschih A, Petroaie AD, Popa E, Lionte C, Bologa C, Haliga RE, Cosmescu A, Slănină AM, Bacușcă AI, Șorodoc V, Șorodoc L. The Significance of Low Magnesium Levels in COVID-19 Patients. Medicina (Kaunas) 2023; 59:medicina59020279. [PMID: 36837480 PMCID: PMC9965430 DOI: 10.3390/medicina59020279] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/22/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023]
Abstract
Magnesium is the fourth most common mineral in the human body and the second richest intracellular cation. This element is necessary for many physiological reactions, especially in the cardiovascular and respiratory systems. COVID-19 is an infectious disease caused by SARS-CoV-2. The majority of people who become ill as a result of COVID-19 have mild-to-moderate symptoms and recover without specific treatment. Moreover, there are people who develop severe forms of COVID-19, which require highly specialized medical assistance. Magnesium deficiency may play a role in the pathophysiology of infection with SARS-CoV-2. The primary manifestation of COVID-19 remains respiratory, but the virus can spread to other organs and tissues, complicating the clinical picture and culminating in multiorgan failure. The key mechanisms involved in the disease include direct viral cytotoxicity, endothelial dysfunction, and exaggerated release of inflammatory cytokines. The aim of this review was to summarize the available data regarding the role of magnesium in COVID-19 patients and its particularities in different clinical settings.
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Affiliation(s)
- Adorata Elena Coman
- Preventive Medicine and Interdisciplinarity Department, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Alexandr Ceasovschih
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
- Correspondence: (A.C.); (C.L.)
| | - Antoneta Dacia Petroaie
- Preventive Medicine and Interdisciplinarity Department, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Elena Popa
- Preventive Medicine and Interdisciplinarity Department, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Cătălina Lionte
- Internal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
- Correspondence: (A.C.); (C.L.)
| | - Cristina Bologa
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
- Internal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Raluca Ecaterina Haliga
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
- Internal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Adriana Cosmescu
- Preventive Medicine and Interdisciplinarity Department, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Ana Maria Slănină
- Preventive Medicine and Interdisciplinarity Department, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Agnes Iacinta Bacușcă
- Preventive Medicine and Interdisciplinarity Department, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Victorița Șorodoc
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
- Internal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Laurențiu Șorodoc
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
- Internal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
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9
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Şorodoc V, Asaftei A, Puha G, Ceasovschih A, Lionte C, Sîrbu O, Bologa C, Haliga RE, Constantin M, Coman AE, Petriș OR, Stoica A, Şorodoc L. Management of Hyponatremia in Heart Failure: Practical Considerations. J Pers Med 2023; 13:jpm13010140. [PMID: 36675801 PMCID: PMC9865833 DOI: 10.3390/jpm13010140] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 01/12/2023] Open
Abstract
Hyponatremia is commonly encountered in the setting of heart failure, especially in decompensated, fluid-overloaded patients. The pathophysiology of hyponatremia in patients with heart failure is complex, including numerous mechanisms: increased activity of the sympathetic nervous system and the renin-angiotensin-aldosterone system, high levels of arginine vasopressin and diuretic use. Symptoms are usually mild but hyponatremic encephalopathy can occur if there is an acute decrease in serum sodium levels. It is crucial to differentiate between dilutional hyponatremia, where free water excretion should be promoted, and depletional hyponatremia, where administration of saline is needed. An inappropriate correction of hyponatremia may lead to osmotic demyelination syndrome which can cause severe neurological symptoms. Treatment options for hyponatremia in heart failure, such as water restriction or the use of hypertonic saline with loop diuretics, have limited efficacy. The aim of this review is to summarize the principal mechanisms involved in the occurrence of hyponatremia, to present the main guidelines for the treatment of hyponatremia, and to collect and analyze data from studies which target new treatment options, such as vaptans.
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Affiliation(s)
- Victoriţa Şorodoc
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Andreea Asaftei
- 2nd Rheumatology Department, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
- Correspondence: (A.A.); (A.C.); (C.L.)
| | - Gabriela Puha
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Alexandr Ceasovschih
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
- Correspondence: (A.A.); (A.C.); (C.L.)
| | - Cătălina Lionte
- Internal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
- Correspondence: (A.A.); (A.C.); (C.L.)
| | - Oana Sîrbu
- Internal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Cristina Bologa
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Raluca Ecaterina Haliga
- Internal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mihai Constantin
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Adorata Elena Coman
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Ovidiu Rusalim Petriș
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Alexandra Stoica
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Laurenţiu Şorodoc
- 2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, 700111 Iasi, Romania
- Internal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
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10
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Chelariu AC, Coman AE, Lionte C, Gorciac V, Sorodoc V, Haliga RE, Petris OR, Bologa C, Puha G, Stoica A, Constantin M, Sirbu O, Ceasovschih A, Sorodoc L. The Value of Early and Follow-Up Elevated Scores Based on Peripheral Complete Blood Cell Count for Predicting Adverse Outcomes in COVID-19 Patients. J Pers Med 2022; 12:jpm12122037. [PMID: 36556258 PMCID: PMC9781715 DOI: 10.3390/jpm12122037] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/20/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
Background: The ongoing COVID-19 pandemic has put a constant strain on hospital resources, so there is a dire need for investigation methods that are widely available and that can predict mortality and the need for critical care. Hematological indices, which can be easily calculated from a complete blood count (CBC), are useful in determining a patient’s inflammatory response to infectious diseases. Aim: This was a prospective cohort study that aimed to assess the prognostic value of scores based on CBCs in hospitalized patients with mild or moderate COVID-19 and medical comorbidities regarding the need for intensive care unit (ICU) therapy and short-term mortality. Methods: We included 607 patients with confirmed COVID-19, followed up for the need for ICU admission (15.5%) and 30 day mortality post-discharge (21.7%). CBC-derived scores were tested upon emergency department (ED) admission and after a median of 8 days. Results: In a multivariate model, elevated followed-up neutrophil-to-lymphocyte ratio (NLR) predicted increased odds for ICU admission (OR: 1.14 [95%CI: 1.06−1.22], p < 0.001) and short-term mortality (OR: 1.30 [95%CI: 1.09−1.57], p = 0.005). Monocyte-to-lymphocyte ratio (MLR) predicted 2.5-fold increased odds for ICU admission and 2.2-fold increased odds for mortality. Conclusion: NLR and MLR followed up 8 days post-admission are predictive for adverse outcomes in mild or moderate COVID-19 patients.
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Affiliation(s)
- Andrei-Costin Chelariu
- Hematology Department, Regional Institute of Oncology, 700483 Iasi, Romania
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
| | - Adorata Elena Coman
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Preventive Medicine and Interdisciplinarity Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Catalina Lionte
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
- Correspondence: (C.L.); (V.S.)
| | - Victoria Gorciac
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
- Rheumatology Department, Clinical Rehabilitation Hospital, 700661 Iasi, Romania
| | - Victorita Sorodoc
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
- Correspondence: (C.L.); (V.S.)
| | - Raluca Ecaterina Haliga
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Ovidiu Rusalim Petris
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
- Nursing Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Cristina Bologa
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Gabriela Puha
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Alexandra Stoica
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Mihai Constantin
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Oana Sirbu
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Alexandr Ceasovschih
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
| | - Laurentiu Sorodoc
- Second Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinical County Hospital, 700111 Iasi, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
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11
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Cobilinschi C, Melente OM, Bologa C, Cotae AM, Constantinescu L, Bacruban S, Grinţescu IM. Cardiac tamponade - an unexpected "long COVID-19" complication. Germs 2022; 12:112-117. [PMID: 35601952 PMCID: PMC9113679 DOI: 10.18683/germs.2022.1313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/08/2022] [Accepted: 01/11/2022] [Indexed: 08/29/2023]
Abstract
INTRODUCTION Year 2020 has been a cornerstone in medical research due to the COVID-19 pandemic outbreak. The process of understanding the condition brought to light certain organ involvement like pulmonary or kidney damage or endocrine disbalances, while connection to other types of organ impairment remain unclear. SARS-CoV-2 has previously been incriminated in cardiac involvement, ranging from mild symptoms to more severe occurrences such as myocarditis, arrythmias or heart failure, thus complicating the acute-phase management and worsening patients' prognosis. Despite being reported as an acute manifestation in critical COVID-19, cardiac tamponade seems to also occur as a "long- COVID19" complication. The latter is a distinct yet unclear entity associated with remanent fatigue or cough, but more severe sequelae like vasculitis or polyneuropathy can occsur. CASE REPORT We report the case of a 42-year-old patient admitted in the intensive care unit for severe respiratory and renal dysfunction one month after an initial mild episode of COVID-19. RT-PCR for SARS-CoV-2 on admission was negative. Initial imaging through CT and heart ultrasound revealed the presence of pericardial effusion but no signs of tamponade were initially obvious. Twelve hours later, the patient's state deteriorated with cardiocirculatory failure and signs of obstructive shock. Agents responsible for severe acute respiratory infection (SARI) such as influenza A and B, adenovirus, Bordetella pertussis, Mycoplasma pneumoniae, coxsackie virus, Chlamydia pneumoniae or parainfluenza viruses were ruled out. Surprisingly, RT-PCR testing for SARS-CoV-2 came back positive, although the initial test was negative. Repeated imaging confirmed massive circumferential pericardial effusion for which emergency pericardiocentesis was performed. Fluid was an exudate and histopathology reported chronic inflammation. RT-PCR testing for Mycoplasma tuberculosis in the pericardial tissue came back negative. CONCLUSIONS The case is to our knowledge among the first to report cardiac tamponade one month after mild COVID-19 infection. The aim of this case report is to raise awareness in the medical community on the possibility of severe complications targeting major organs in the long-COVID-19 phase.
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Affiliation(s)
- Cristian Cobilinschi
- MD, PhD, Department of Anaesthesiology and Intensive Care, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, Bucharest, 014461, Romania, Department of Anaesthesiology and Intensive Care II, Carol Davila University of Medicine and Pharmacy, Bulevardul Eroii Sanitari 8, Bucharest, 050474, Romania
| | - Oana Maria Melente
- MD, Department of Anaesthesiology and Intensive Care, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, Bucharest, 014461, Romania
| | - Cristina Bologa
- MD, Department of Anaesthesiology and Intensive Care, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, Bucharest, 014461, Romania
| | - Ana-Maria Cotae
- MD, Department of Anaesthesiology and Intensive Care, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, Bucharest, 014461, Romania
| | - Laura Constantinescu
- MD, Department of Anaesthesiology and Intensive Care, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, Bucharest, 014461, Romania
| | - Sonia Bacruban
- MD, Department of Anaesthesiology and Intensive Care, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, Bucharest, 014461, Romania
| | - Ioana Marina Grinţescu
- MD, PhD, Department of Anaesthesiology and Intensive Care, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, Bucharest, 014461, Romania, Department of Anaesthesiology and Intensive Care II, Carol Davila University of Medicine and Pharmacy, Bulevardul Eroii Sanitari 8, Bucharest, 050474, Romania
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12
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Ceasovschih A, Voloc G, Șorodoc V, Vâță D, Lupașcu CD, Preda C, Lionte C, Stoica A, Sîrbu O, Grigorescu ED, Haliga R, Coman A, Bologa C, Vâță L, Petriș O, Puha G, Dumitrescu G, Constantin M, Șorodoc L. From chronic pruritus to neuroendocrine tumor: A case report. Exp Ther Med 2022; 23:189. [PMID: 35126692 PMCID: PMC8794552 DOI: 10.3892/etm.2022.11112] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 11/15/2021] [Indexed: 11/09/2022] Open
Abstract
Chronic pruritus is a major and distressing symptom of many diseases of dermatological, neurological, psychogenic or systemic origin. This chronic itch could be a presenting sign of malignancy; therefore, paraneoplastic pruritus has also been associated with neuroendocrine tumors (NETs). This article focuses on a patient presenting with chronic pruritus for the past 12 months and who received numerous treatment schemes with very poor clinical improvement, that presented in the hospital for worsening of the chronic pruritus associated with skin rash and significant weight loss (approximately 6 kg over a 2-month period). The laboratory tests showed iron deficiency anemia, eosinophilia and negative tumor markers. In order to investigate the hypoanabolic and anemic syndromes, upper gastrointestinal endoscopy and colonoscopy, which showed no lesions or tumors, were employed. Skin biopsy was performed and antihistaminic and local steroid treatment was initiated. The patient's status worsened within a week and the patient was started on systemic steroid treatment with poor results. Computer tomography was performed to identify any tumor(s) located either in the pelvis or abdomen. A lesion was found in the terminal ileum, identified as a hypervascularized associating bulky lymphadenopathy. The patient was transferred to the surgical ward where right hemicolectomy with manual ileotransverse anastomosis L-L was performed. The histopathological result confirmed NET G2. The patient clinically improved, the skin lesions resolved and the itchiness disappeared. The general status improved significantly. NET G2 diagnosing was possible due to the atypic paraneoplastic sign: chronic pruritus. This case study highlights the association between itch and malignancy and presents an atypical way of NET presentation when all tumor markers remain negative.
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Affiliation(s)
- Alexandr Ceasovschih
- Department of Internal Medicine, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Giorgiana Voloc
- Department of Internal Medicine, ‘Sf. Spiridon’ Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Victorița Șorodoc
- Department of Internal Medicine, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Dan Vâță
- Department of Internal Medicine, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Cristian-Dumitru Lupașcu
- Department of Internal Medicine, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Cristina Preda
- Department of Internal Medicine, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Cătălina Lionte
- Department of Internal Medicine, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alexandra Stoica
- Department of Internal Medicine, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Oana Sîrbu
- Department of Internal Medicine, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Elena-Daniela Grigorescu
- Department of Internal Medicine, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Raluca Haliga
- Department of Internal Medicine, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Adorata Coman
- Department of Internal Medicine, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Cristina Bologa
- Department of Internal Medicine, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Luminița Vâță
- Department of Internal Medicine, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ovidiu Petriș
- Department of Internal Medicine, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Gabriela Puha
- Department of Internal Medicine, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Gabriela Dumitrescu
- Department of Internal Medicine, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mihai Constantin
- Department of Internal Medicine, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Laurențiu Șorodoc
- Department of Internal Medicine, Faculty of Medicine, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
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Ceasovschih A, Sorodoc V, Onofrei V, Tesloianu D, Petris A, Tuchilus C, Jaba E, Lionte C, Statescu C, Stoica A, Haliga R, Dumitrescu G, Sirbu O, Vata L, Petris O, Bologa C, Constantin M, Grigorescu D, Alexa R, Barcan S, Jaba I, Sorodoc L. A six-mounth evaluation of inflammatory biomarkers prognostic predictability in patients with peripheral artery disease. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Dumitrescu G, Alexa R, Vata L, Ceasovschih A, Bologa C, Sorodoc V, Lionte C, Petris O, Haliga R, Stoica A, Sirbu O, Constantin M, Coman A, Puha G, Khoury S, Sorodoc L. Gender and obesity-related atherosclerotic events in a cohort of adult pacients from emergency clinical hospital “SF. spiridon” IASI. Atherosclerosis 2021. [DOI: 10.1016/j.atherosclerosis.2021.06.579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Toma D, Toma TE, Bologa C, Lionte C. Unusual aetiology of a type 2 myocardial infarction: a case-based review. Arh Hig Rada Toksikol 2021; 72:80-87. [PMID: 33787179 PMCID: PMC8191432 DOI: 10.2478/aiht-2021-72-3502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/01/2020] [Accepted: 03/01/2021] [Indexed: 11/20/2022] Open
Abstract
Organophosphate pesticide (OP) poisoning is quite common and can cause cardiovascular complications and even direct myocardial injury. However, no guideline has included an acute poisoning as a potential cause for a type 2 myocardial infarction (MI) so far. Here we present a case of a 61-year-old woman brought by ambulance to emergency department one hour after accidental ingestion of an unknown quantity of a solution she used against flea infestation. The patient presented with dizziness, myosis, excessive sweating, hypersalivation, sphincteric incontinence, muscle fasciculation, tremor of the extremities, pale skin, alcoholic and pesticide breath odour. Even though we had no guidelines to fall back on, we successfully treated the patient with low-molecular-weight heparin, antiplatelets, statin, diltiazem, antidote therapy, and supportive care. Physicians should be aware that OP poisoning can induce type 2 MI as a complication within a few hours since exposure, and emergency management should always include close cardiac monitoring.
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Affiliation(s)
- David Toma
- Sf. Spiridon Emergency County Hospital, Emergency Department, Iași, Romania
| | - Tania-Emima Toma
- Sf. Maria Emergency Children’s Hospital, General Paediatrics, Iași, Romania
| | - Cristina Bologa
- “Grigore T. Popa” University of Medicine and Pharmacy, School of Medicine, Internal Medicine and Clinical Toxicology Department, Iași, Romania
- Sf. Spiridon Emergency County Hospital, 2 Internal Medicine Clinic, Iași, Romania
| | - Cătălina Lionte
- “Grigore T. Popa” University of Medicine and Pharmacy, School of Medicine, Internal Medicine and Clinical Toxicology Department, Iași, Romania
- Sf. Spiridon Emergency County Hospital, 2 Internal Medicine Clinic, Iași, Romania
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Lionte C, Bologa C, Agafiti I, Sorodoc V, Petris OR, Jaba E, Sorodoc L. Association of Multiple Glycemic Parameters at Hospital Admission with Mortality and Short-Term Outcomes in Acutely Poisoned Patients. Diagnostics (Basel) 2021; 11:diagnostics11020361. [PMID: 33672765 PMCID: PMC7924603 DOI: 10.3390/diagnostics11020361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/06/2021] [Accepted: 02/18/2021] [Indexed: 12/15/2022] Open
Abstract
The prognostic value of multiple glycemic parameters in poisoned patients was never assessed. We aim to explore the effects of glucose variability on short-term outcomes in nondiabetic and diabetic patients acutely poisoned with undifferentiated xenobiotics. We performed a prospective observational study in a tertiary center for toxicology in northeastern Romania. Over the course of 3 years, we included 1076 adults, older than 18 years, admitted for acute poisoning with a xenobiotic. The mortality rate was 4.1%. The admission blood glucose level (BGL) predicted mortality (OR 1.015, 95% CI 1.011–1.019, p < 0.001) and complications (OR 1.005, 95% CI 1.001–1.009, p 0.02). The mean glucose level (MGL) after admission (OR 1.007, 95% CI 1.000–1.013, p 0.034) and coefficient of glucose variability (CV) were predictive for complications (OR 40.58, 95% CI 1.35–1220.52, p 0.033), using the same multivariable model. The receiver operating characteristic curve (ROC) analysis revealed that BGL had good predictive value for in-hospital mortality (area under the curve (AUC) = 0.744, 95% CI = 0.648–0.841, p < 0.001), and complications (AUC = 0.618, 95% CI = 0.584–0.653, p < 0.001). In patients acutely poisoned with xenobiotics, the BGL, MGL and CV can be useful as mortality and short-outcome predictors.
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Affiliation(s)
- Catalina Lionte
- Internal Medicine and Clinical Toxicology Department, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.B.); (L.S.)
- 2nd Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinic County Hospital, 700111 Iasi, Romania; (I.A.); (O.R.P.)
- Correspondence: (C.L.); (V.S.); Tel.: +40-742-082-318 (C.L.); +40-232-267-801 (V.S.)
| | - Cristina Bologa
- Internal Medicine and Clinical Toxicology Department, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.B.); (L.S.)
- 2nd Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinic County Hospital, 700111 Iasi, Romania; (I.A.); (O.R.P.)
| | - Inga Agafiti
- 2nd Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinic County Hospital, 700111 Iasi, Romania; (I.A.); (O.R.P.)
| | - Victorita Sorodoc
- Internal Medicine and Clinical Toxicology Department, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.B.); (L.S.)
- 2nd Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinic County Hospital, 700111 Iasi, Romania; (I.A.); (O.R.P.)
- Correspondence: (C.L.); (V.S.); Tel.: +40-742-082-318 (C.L.); +40-232-267-801 (V.S.)
| | - Ovidiu Rusalim Petris
- 2nd Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinic County Hospital, 700111 Iasi, Romania; (I.A.); (O.R.P.)
- Internal Medicine and Nursing Department, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Elisabeta Jaba
- Statistics Department, FEEA, “Alexandru Ioan Cuza” University, 700506 Iasi, Romania;
| | - Laurentiu Sorodoc
- Internal Medicine and Clinical Toxicology Department, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.B.); (L.S.)
- 2nd Internal Medicine Clinic, “Sf. Spiridon” Emergency Clinic County Hospital, 700111 Iasi, Romania; (I.A.); (O.R.P.)
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Haliga RE, Sorodoc V, Lionte C, Petris OR, Bologa C, Coman AE, Vata LG, Puha G, Dumitrescu G, Sirbu O, Stoica A, Ceasovschih A, Constantin M, Nicoleta Catana A, Jaba E, Sorodoc L. Acute Clinical Syndromes and Suspicion of SARS-CoV-2 Infection: The Experience of a Single Romanian Center in the Early Pandemic Period. Medicina (Kaunas) 2021; 57:121. [PMID: 33572732 PMCID: PMC7911742 DOI: 10.3390/medicina57020121] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 12/29/2022]
Abstract
Background and Objectives: During the coronavirus disease 2019 (COVID-19) pandemic, patients with chronic diseases suffering exacerbations have required acute medical care. The purpose of our study was to determine useful criteria for the differentiation of patients with acute clinical syndromes and suspicion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Materials and Methods: This was an observational retrospective study, conducted in an internal medicine clinic from April to May 2020. We collected clinical, biological, and computed tomography (CT) data on patients with exacerbations of chronic diseases and clinical suspicion of SARS-CoV-2 infection. Patients with an already-positive real-time reverse-transcription polymerase chain reaction (RT-PCR) test for SARS-CoV-2 on presentation at the emergency department were excluded from our study. Results: Of 253 suspected cases, 20 were laboratory-confirmed as having SARS-CoV-2 infection by RT-PCR, whereas COVID-19 diagnosis was ruled out in the remaining 233. Venous thromboembolism (VTE) correlated significantly with COVID-19 diagnosis in suspected patients, while laboratory markers were not significantly different between the two groups. Of the suspected patients, significantly higher percentages of dry cough, fever, myalgias, sore throat, loss of smell and appetite, and ground-glass opacities (GGOs) on CT were found in SARS-CoV-2-positive individuals. Conclusions: The study demonstrated that, until receiving the result of an RT-PCR test for SARS-CoV-2 (usually 12-24 h), association with VTE as a comorbidity, fever, dry cough, and myalgia as clinical features, and GGO on CT are the main markers for the identification of COVID-19 patients among those suspected with acute clinical syndromes. Our results also provide evidence for doctors not to rely solely on biological markers in the case of suspected SARS-CoV-2 infection in patients with exacerbations of chronic diseases. These data are useful for faster decision-making with regard to suspected COVID-19 patients before receiving RT-PCR test results, thus avoiding keeping patients in crowded emergency departments.
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Affiliation(s)
- Raluca Ecaterina Haliga
- Department of Internal Medicine, “St. Spiridon” Emergency Clinical Hospital, 700111 Iași, Romania; (V.S.); (C.L.); (O.R.P.); (C.B.); (A.E.C.); (L.G.V.); (G.P.); (G.D.); (O.S.); (A.S.); (A.C.); (M.C.); (L.S.)
- Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Victorita Sorodoc
- Department of Internal Medicine, “St. Spiridon” Emergency Clinical Hospital, 700111 Iași, Romania; (V.S.); (C.L.); (O.R.P.); (C.B.); (A.E.C.); (L.G.V.); (G.P.); (G.D.); (O.S.); (A.S.); (A.C.); (M.C.); (L.S.)
- Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Catalina Lionte
- Department of Internal Medicine, “St. Spiridon” Emergency Clinical Hospital, 700111 Iași, Romania; (V.S.); (C.L.); (O.R.P.); (C.B.); (A.E.C.); (L.G.V.); (G.P.); (G.D.); (O.S.); (A.S.); (A.C.); (M.C.); (L.S.)
- Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Ovidiu Rusalim Petris
- Department of Internal Medicine, “St. Spiridon” Emergency Clinical Hospital, 700111 Iași, Romania; (V.S.); (C.L.); (O.R.P.); (C.B.); (A.E.C.); (L.G.V.); (G.P.); (G.D.); (O.S.); (A.S.); (A.C.); (M.C.); (L.S.)
- Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Cristina Bologa
- Department of Internal Medicine, “St. Spiridon” Emergency Clinical Hospital, 700111 Iași, Romania; (V.S.); (C.L.); (O.R.P.); (C.B.); (A.E.C.); (L.G.V.); (G.P.); (G.D.); (O.S.); (A.S.); (A.C.); (M.C.); (L.S.)
- Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Adorata Elena Coman
- Department of Internal Medicine, “St. Spiridon” Emergency Clinical Hospital, 700111 Iași, Romania; (V.S.); (C.L.); (O.R.P.); (C.B.); (A.E.C.); (L.G.V.); (G.P.); (G.D.); (O.S.); (A.S.); (A.C.); (M.C.); (L.S.)
- Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Luminita Gina Vata
- Department of Internal Medicine, “St. Spiridon” Emergency Clinical Hospital, 700111 Iași, Romania; (V.S.); (C.L.); (O.R.P.); (C.B.); (A.E.C.); (L.G.V.); (G.P.); (G.D.); (O.S.); (A.S.); (A.C.); (M.C.); (L.S.)
- Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Gabriela Puha
- Department of Internal Medicine, “St. Spiridon” Emergency Clinical Hospital, 700111 Iași, Romania; (V.S.); (C.L.); (O.R.P.); (C.B.); (A.E.C.); (L.G.V.); (G.P.); (G.D.); (O.S.); (A.S.); (A.C.); (M.C.); (L.S.)
- Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Gabriela Dumitrescu
- Department of Internal Medicine, “St. Spiridon” Emergency Clinical Hospital, 700111 Iași, Romania; (V.S.); (C.L.); (O.R.P.); (C.B.); (A.E.C.); (L.G.V.); (G.P.); (G.D.); (O.S.); (A.S.); (A.C.); (M.C.); (L.S.)
- Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Oana Sirbu
- Department of Internal Medicine, “St. Spiridon” Emergency Clinical Hospital, 700111 Iași, Romania; (V.S.); (C.L.); (O.R.P.); (C.B.); (A.E.C.); (L.G.V.); (G.P.); (G.D.); (O.S.); (A.S.); (A.C.); (M.C.); (L.S.)
- Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Alexandra Stoica
- Department of Internal Medicine, “St. Spiridon” Emergency Clinical Hospital, 700111 Iași, Romania; (V.S.); (C.L.); (O.R.P.); (C.B.); (A.E.C.); (L.G.V.); (G.P.); (G.D.); (O.S.); (A.S.); (A.C.); (M.C.); (L.S.)
- Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Alexandr Ceasovschih
- Department of Internal Medicine, “St. Spiridon” Emergency Clinical Hospital, 700111 Iași, Romania; (V.S.); (C.L.); (O.R.P.); (C.B.); (A.E.C.); (L.G.V.); (G.P.); (G.D.); (O.S.); (A.S.); (A.C.); (M.C.); (L.S.)
- Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Mihai Constantin
- Department of Internal Medicine, “St. Spiridon” Emergency Clinical Hospital, 700111 Iași, Romania; (V.S.); (C.L.); (O.R.P.); (C.B.); (A.E.C.); (L.G.V.); (G.P.); (G.D.); (O.S.); (A.S.); (A.C.); (M.C.); (L.S.)
- Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Andreea Nicoleta Catana
- Department of Infectious Diseases, “St. Spiridon” Emergency Clinical Hospital, 700111 Iași, Romania;
| | - Elisabeta Jaba
- Statistics Department, FEEA, “Al. I. Cuza” University, 700506 Iasi, Romania;
| | - Laurentiu Sorodoc
- Department of Internal Medicine, “St. Spiridon” Emergency Clinical Hospital, 700111 Iași, Romania; (V.S.); (C.L.); (O.R.P.); (C.B.); (A.E.C.); (L.G.V.); (G.P.); (G.D.); (O.S.); (A.S.); (A.C.); (M.C.); (L.S.)
- Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
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Sirbu O, Sorodoc V, Stoica A, Ceasovschih A, Vata L, Haliga R, Dumitrescu G, Petris O, Lionte C, Bologa C, Puha G, Constantin M, Floria M, Sorodoc L. Effects of iron therapy in iron deficient patients with heart failure and peripheral artery disease. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ceasovschih A, Sorodoc V, Aursulesei V, Tesloianu D, Jaba I, Petris A, Cozma CD, Mihai B, Statescu C, Lionte C, Vata L, Stoica A, Sirbu O, Tuchilus C, Anisie E, Bologa C, Haliga R, Puha G, Dumitrescu G, Constantin M, Simionov L, Obreja M, Sorodoc L. Peripheral artery disease particularities in women: a prospective study. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ceasovschih A, Sorodoc V, Tesloianu D, Aursulesei V, Jaba E, Jaba I, Petris A, Cozma CD, Mihai B, Statescu C, Lionte C, Petris O, Stoica A, Sirbu O, Tuchilus C, Vata L, Bologa C, Obreja M, Alexa R, Sorodoc L. Life Quality And Psychological Gender Particularities In Patients With Peripheral Artery Disease. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Sirbu O, Sorodoc V, Stoica A, Ceasovschih A, Vata L, Haliga R, Dumitrescu G, Petris O, Lionte C, Bologa C, Puha G, Constantin M, Tuchilus C, Morariu D, Huiban L, Sorodoc L. Impact Of Oral Iron Therapy In Iron Deficient Patients With Heart Failure And Coronary Artery Disease. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bologa C, Lionte C, Ursaru M, Sorodoc L, Coman EA, Puha G, Petris OR. AN UNUSUAL ETIOLOGY OF ACUTE NECROTIC PANCREATITIS IN A COMATOSE PATIENT. Journal of Emergency Medicine Case Reports 2019. [DOI: 10.33706/jemcr.551135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Petris OR, Bologa C, Sorodoc V, Lionte C. Repeated Bronchoscopy - Treatment of Severe Respiratory Failure in a Fire Victim. ACTA ACUST UNITED AC 2017; 3:162-165. [PMID: 29967891 PMCID: PMC5769907 DOI: 10.1515/jccm-2017-0024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 07/30/2017] [Indexed: 11/15/2022]
Abstract
A case of respiratory failure in a domestic fire victim presenting with 1-3-degree skin burns on 10% of the total body surface, is reported. Forty-eight hours after admission to hospital, the patient developed severe respiratory failure that did not respond to mechanical ventilation. Severe obstruction of the airway had resulted from secretions and deposits of soot forming bronchial casts. The patient required repeated bronchoscopies to separate and remove the bronchial secretions and soot deposits. An emergency bronchial endoscopic exam was crucial in the patient’s survival and management. The patient was discharged from the hospital after twenty-four days.
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Affiliation(s)
- Ovidiu Rusalim Petris
- Nursing Department, 2nd Internal Medicine Clinic, "Sf. Spiridon" Clinical County Emergency Hospital, "Gr. T. Popa" University of Medicine, Iasi, Romania
| | - Cristina Bologa
- Internal Medicine Department, 2nd Internal Medicine Clinic, "Sf. Spiridon" Clinical County Emergency Hospital, "Gr. T. Popa" University of Medicine, Iasi, Romania
| | - Victorita Sorodoc
- Internal Medicine Department, 2nd Internal Medicine Clinic, "Sf. Spiridon" Clinical County Emergency Hospital, "Gr. T. Popa" University of Medicine, Iasi, Romania
| | - Catalina Lionte
- Internal Medicine Department, 2nd Internal Medicine Clinic, "Sf. Spiridon" Clinical County Emergency Hospital, "Gr. T. Popa" University of Medicine, Iasi, Romania
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Bologa C, Lionte C, Halit D, Luca C. Case report. Neurosyphilis Masquerading as Stroke in an 84-year-old. J Crit Care Med (Targu Mures) 2017; 3:70-72. [PMID: 29967874 PMCID: PMC5769912 DOI: 10.1515/jccm-2017-0009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 02/13/2017] [Indexed: 11/21/2022] Open
Abstract
The case of an 84 years old woman with uncharacteristic neurologic and cognitive symptoms, suspected of ischemic stroke is presented. Following an extensive assessment in the departments of neurology and internal medicine, the unusual aetiology of stroke was identified as meningovascular neurosyphilis. The patient fully recovered after antibiotic therapy. To our knowledge, this the eldest patient with tertiary neurosyphilis reported in the literature.
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Affiliation(s)
- Cristina Bologa
- Internal Medicine Department, 2nd Internal Medicine Clinic, “Sf. Spiridon” Clinical County Emergency Hospital, “Gr. T. Popa” University of Medicine , Iasi , Romania
| | - Catalina Lionte
- Internal Medicine Department, 2nd Internal Medicine Clinic, “Sf. Spiridon” Clinical County Emergency Hospital, “Gr. T. Popa” University of Medicine, 16 Universitatii Street, 700115 , Iasi , Romania
| | - Diana Halit
- Neurology Department, “Prof. Dr. N. Oblu” Clinical Emergency Hospital , Iasi , Romania
| | - Catalina Luca
- Infectious Disease Department, “Sf. Parascheva” Clinical Hospital, “Gr. T. Popa” University of Medicine , Iasi , Romania
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Lionte C, Sorodoc V, Bologa C, Tuchilus C, Jaba E. Usefulness of Transthoracic Echocardiography Parameters and Brain Natriuretic Peptide as Mortality Predictors in Hospitalized Acutely Poisoned Patients: A Prospective Observational Study. Basic Clin Pharmacol Toxicol 2017; 120:498-504. [DOI: 10.1111/bcpt.12711] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 11/16/2016] [Indexed: 12/28/2022]
Affiliation(s)
- Catalina Lionte
- Internal Medicine and Clinical Toxicology Department; ‘Sf. Spiridon’ Emergency Clinic County Hospital; ‘Gr. T. Popa’ University of Medicine and Pharmacy; Iasi Romania
| | - Victorita Sorodoc
- Internal Medicine and Clinical Toxicology Department; ‘Sf. Spiridon’ Emergency Clinic County Hospital; ‘Gr. T. Popa’ University of Medicine and Pharmacy; Iasi Romania
| | - Cristina Bologa
- Internal Medicine and Clinical Toxicology Department; ‘Sf. Spiridon’ Emergency Clinic County Hospital; ‘Gr. T. Popa’ University of Medicine and Pharmacy; Iasi Romania
| | - Cristina Tuchilus
- Preventive Medicine and Interdisciplinary Department; Central Laboratory; ‘Sf. Spiridon’ Emergency Clinic County Hospital; ‘Gr. T. Popa’ University of Medicine and Pharmacy; Iasi Romania
| | - Elisabeta Jaba
- Statistics Department; FEAA; ‘Al. I. Cuza’ University; Iasi Romania
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Gazzi EN, Sorodoc V, Jaba IM, Lionte C, Bologa C, Lupusoru CE, Lupusoru R, Sorodoc L, Petris O. Profile of adult acute cholinesterase inhibitors substances poisoning - a 30 years analysis. Open Med (Wars) 2015; 10:278-284. [PMID: 28352706 PMCID: PMC5152987 DOI: 10.1515/med-2015-0041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 03/31/2015] [Indexed: 12/02/2022] Open
Abstract
Objectives The objective of this study was to assess the pattern and outcome of acute cholinesterase inhibitors substances (CIS) poisoning cases, in a cohort from a regional tertiary care hospital. Methods cases admitted in the Toxicology Clinic of “Sf. Spiridon” Emergency Clinic Hospital Iasi, Romania between 1983 and 2013 were studied. Results a total number of 606 patients were included. The reason for exposures was intentional in 70% of cases and the commonest route of poisoning was oral in 92.2%. The highest percent of cases was females (56.4), the age group 20–29 (25.4%) and the majority (66.7%) coming from rural areas, 28.2% being agricultural workers. 36.6% of cases were severe clinical forms. Overall mortality rates were 3.8%, more than half of the death patients (65.2%) had concomitant alcohol intake. It was a significant statistical association between decrease level of serum cholinesterase on admittance and severe forms (p 0.000) and between survival and deaths groups (p 0.000). The pattern of poisoning described by our retrospective study suggests that CIS poisoning are mainly preventable. The main effective goals for prevention are restriction in free accessibility to toxic pesticides, together with sustained efforts in education concerning the life-threatening danger of pesticide poisoning.
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Affiliation(s)
- Eugen N Gazzi
- "Sf. Spiridon" Emergency Clinic Hospital, Internal Medicine and Toxicology Department, School of Medicine "Gr. T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Victorita Sorodoc
- "Sf. Spiridon" Emergency Clinic Hospital, Internal Medicine and Toxicology Department, School of Medicine "Gr. T. Popa" University of Medicine and Pharmacy, Iasi, Romania, Tel: +40728040582
| | - Irina M Jaba
- Pharmacology - Toxicology Department, Faculty of Medicine, "Gr. T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Catalina Lionte
- "Sf. Spiridon" Emergency Clinic Hospital, Internal Medicine and Toxicology Department, School of Medicine "Gr. T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Cristina Bologa
- "Sf. Spiridon" Emergency Clinic Hospital, Internal Medicine and Toxicology Department, School of Medicine "Gr. T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Catalina E Lupusoru
- Pharmacology - Toxicology Department, Faculty of Medicine, "Gr. T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Raoul Lupusoru
- Physiopathology Department, Faculty of Medicine, "Gr. T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Laurentiu Sorodoc
- "Sf. Spiridon" Emergency Clinic Hospital, Internal Medicine and Toxicology Department, School of Medicine "Gr. T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Ovidiu Petris
- "Sf. Spiridon" Emergency Clinic Hospital, Internal Medicine and Toxicology Department, School of Medicine "Gr. T. Popa" University of Medicine and Pharmacy, Iasi, Romania
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Bologa C, Lionte C, Coman A, Sorodoc L. Lipid emulsion therapy in cardiodepressive syndrome after diltiazem overdose—case report. Am J Emerg Med 2013; 31:1154.e3-4. [DOI: 10.1016/j.ajem.2013.03.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Accepted: 03/06/2013] [Indexed: 11/27/2022] Open
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Lionte C, Sorodoc L, Petriş O, Sorodoc V, Bologa C, Anton G. [Non-traumatic rhabdomyolysis in medical practice]. Rev Med Chir Soc Med Nat Iasi 2009; 113:1025-1033. [PMID: 20191869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
UNLABELLED Rhabdomyolysis, meaning "disintegration of striated muscle", is a potentially life-threatening syndrome resulting from release of muscular cell constituents into the circulation. The aim of this study is to determine frequence and causes of rhabomyolysis in internal medicine practice, as well as diagnostic and therapeutic discussions, based on a retrospective study in patients addressed to a medical clinic of an universitary emergency hospital. RESULTS The most common causes of rhabdomyolysis in general practice are represented by muscular trauma, muscle enzyme deficiencies, electrolyte abnormalities, infections, drugs, toxins and endocrine disorders. Frequent encountered clinical manifestations are weakness, myalgia and tea-colored urine, and the most sensitive laboratory finding of muscle injury is an elevated plasma creatine kinase level. The management of patients with rhabdomyolysis includes early vigorous hydration, together with specific measures (urine alkalinization, mannitol, hemodialysis).
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Affiliation(s)
- Cătălina Lionte
- Facultatea de Medicină, Universitatea de Medicină si Farmacie "Gr.T. Popa" Iaşi
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Avram S, Svab I, Bologa C, Flonta ML. Correlation between the predicted and the observed biological activity of the symmetric and nonsymmetric cyclic urea derivatives used as HIV-1 protease inhibitors. A 3D-QSAR-CoMFA method for new antiviral drug design. J Cell Mol Med 2004; 7:287-96. [PMID: 14594553 PMCID: PMC6741422 DOI: 10.1111/j.1582-4934.2003.tb00229.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The predicted inhibition constant (Ki) and the predicted inhibitor concentration (IC90) of the HIV-1 protease (HIV- 1 PR) inhibitors: symmetric and nonsymmetric - benzyl, ketone, oxime, pyrazole, imidazole, and triazole cyclic urea derivatives, were obtained by the 3D-CoMFA (Comparative Molecular Field Analysis) method. The CoMFA statistical parameters: cross-validate correlation coefficient (q2), higher than 0.5, and the fitted correlation coefficient (r2), higher than 0.90 validated the predicted biological activities. The best predictions were found for the trifluoromethyl ketoxime derivative (log 1/Ki predict = 8.42), the m-pyridineCH2 pyrazole derivative (log 1/Ki predict = 9.77) and the 1,2,3 triazole derivative (log 1/Ki predict = 7.03). We attempted to design a new potent HIV-1 protease inhibitor by addition of o-benzyl to the (p-HOPhCH2) pyrazole 12f derivative inhibitor. A favorable steric area surrounded the o-benzyl, suggesting a possible new potent HIV-1 protease inhibitor.
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Affiliation(s)
- Speranta Avram
- Department of Physiology & Biophysics, University of Bucharest, Faculty of Biology, Romania.
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Petriş O, Gradinariu F, Totolin M, Hurjui J, Frasin M, Lionte C, Bologa C. [Sudden death in organophosphoric poisoning--an unaccountable pathophysiologic mechanism?]. Rev Med Chir Soc Med Nat Iasi 2004; 108:325-8. [PMID: 15688808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
UNLABELLED Sudden death related in literature to appear in IV-th - VIII-th day from organophosphoric intoxication does not have an unanimous accepted physiopathologic explanation. PURPOSE Pharmacodynamic study of myocardial trichlorfon level in acute experiment. MATERIAL AND METHOD Gas chromatographic determination of myocardial trichlorfon quantity in an experiment on white, male Wistar rats, daily sacrificed for the heart, until the tenth day from an digestive administration of a dose of 200mg/kg trichlorfon. RESULTS (mcg/g myocardial tissue): I day = 8, II day = 13.63, III day = 15, IV day = 18.96, V day = 19.6, VI day = 20.83, VII day = 21.21, VIII day = 21.33, IX day = 19.69, X day = 19.41. CONCLUSIONS An organophosphoric direct toxic mechanism is suggested, through accumulation over time of a certain level of myocardial concentration.
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Affiliation(s)
- O Petriş
- Universitatea de Medicină şi Farmacie Gr.T. Popa, Facultatea de Medicină, Clinica Medicală a Spitalului de Urgente
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Bologa C, Rusu M, Ianovici N, Tetraru C, Hurjui J, Petriş O, Lionte C. [Role of calcium and magnesium ions in cerebrospinal fluid in alcoholic-traumatic coma]. Rev Med Chir Soc Med Nat Iasi 2003; 107:809-12. [PMID: 14756024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
The goal of investigation was to determine the role of calcium and magnesium ions in the cerebrospinal fluid in ethylic-traumatic coma. We measured the level of calcium in the cerebrospinal fluid within simple photometric test and the magnesium level within xylidyl blue photometric test. We found a high mortality in patients with high level of calcium in cerebrospinal fluid and low level of magnesium in cerebrospinal fluid. At patients with ethylic-traumatic coma high levels of calcium in cerebrospinal fluid are caused by the excitatory amino acids cascade and increased of hematoencephalic barrier permeability. Decreased levels of magnesium in cerebrospinal fluid are associated with convulsions and a poor prognosis of the patients. These analyses are very important for establishment of prognosis in patients with ethylic-traumatic coma.
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Affiliation(s)
- Cristina Bologa
- Clinica Medicală, Spitalul Clinic de Urgente, Facultatea de Medicină, Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi
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Mracec M, Mracec M, Bologa C, Simon Z. Significance of MTD and other descriptors in lipophilicity models for chlorinated aromatic compounds. SAR QSAR Environ Res 2001; 12:143-158. [PMID: 11697053 DOI: 10.1080/10629360108035376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The lipophilicity of chlorinated benzenes and 20 biphenyls has been modeled using the minimum topological difference method and MTD indices. The MTD descriptor has been optimized on its own or together with nCl (number of chlorine atoms per molecule), 2D- and 3D-descriptors such as van der Waals surface area and volume, solvent accessible surface area and solvent-accessible surface-bounded molecular volume, and the inter-planar angle of the substituted biphenyls. In lipophilicity models of chlorinated aromatic compounds the majority of descriptors, including MTD, contain essentially the information of nCl. MTD is a good lipophilicity descriptor of chlorinated aromatic compounds either alone or in association with other descriptors. For chlorobenzenes it gives r = 0.998, s = 0.069, F = 2281, and for the set of chlorinated biphenyls r = 0.974, s = 0.255, F = 338, a better result than gives the nCl descriptor (r = 0.967). The significance of MTD descriptor in different models is discussed. Beside nCl, the MTD index encodes ortho and para effects.
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Affiliation(s)
- M Mracec
- Inorganic Chemistry Laboratory, Roumanian Academy, Timişoara Branch, Bd. Mihai Viteazu 24, P.O. Box 5/612, 1900-Timişoara, Roumania
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Hadaruga DI, Muresan S, Bologa C, Chiriac A, Simon Z, Cofar L, Naray-Szabo G. QSAR for Cycloaliphatic Alcohols with Qualitatively Defined Sandalwood Odour Characteristics. ACTA ACUST UNITED AC 1999. [DOI: 10.1002/(sici)1521-3838(199907)18:3<253::aid-qsar253>3.0.co;2-s] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Bologa C, Drugărin D, Simon Z. Quantitative structure-activity relations by the MTD-method for binding of nonapeptides to the HLA-A2.1 molecule. Roum Arch Microbiol Immunol 1995; 54:3-14. [PMID: 8993110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Binding of large series of nonapeptides to the HLA-A2.1 molecule was studied by a group of Sette in order to predict strongly binding peptides with possible therapeutic interest. Here we establish QSAR-s for these series. The MTD-method was used for steric requirements concerning amino acidic side chains as well as side chain hydrophobicities. Binding of these peptides to the HLA-A2.1 molecule is favored by a lipophylic character of side chains for the anchor position 2 and 9 and for positions 1,3 and 6 and by steric features that allow predictions for some modified amino acidic residues in these positions that should increase the peptide-HLA-molecule affinity.
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Affiliation(s)
- C Bologa
- Department of Chemistry, University of Timişoara, Romania
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