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Romanian Journal of Internal Medicine

Caterina Delcea, Cătălin Adrian Buzea, Gheorghe Andrei Dan
INTRODUCTION: Heart failure (HF) and systemic inflammation are interdependent processes that continuously potentiate each other. Distinct pathophysiological pathways are activated, resulting in increased neutrophil count and reduced lymphocyte numbers, making the neutrophil to lymphocyte ratio (NLR) a potential indirect marker of severity. We conducted this comprehensive review to characterize the role of NLR in HF. METHODS: We searched the PubMed (MEDLINE) database using the key words neutrophil", "lymphocyte", "heart failure", "cardiomyopathy", "implantable cardioverter defibrillator", "cardiac resynchronization therapy" and "heart transplant"...
July 12, 2019: Romanian Journal of Internal Medicine
Razvan Peagu, Roxana Sararu, Ana Necula, Alexandru Moldoveanu, Ana Petrisor, Carmen Fierbinteanu-Braticevici
INTRODUCTION: Current guidelines recommend that all patients with cirrhosis undergo upper gastrointestinal endoscopy (UGE) screening for esophageal varices (EV). Unfortunately, UGE has a lot of disadvantages, consequently various non-invasive methods of diagnosing EV have been proposed. We evaluated if spleen stiffness measured by Acoustic Radiation Force Impulse (ARFI) is a viable technique in diagnosing EV. METHODS: We recruited 178 patients with cirrhosis caused by Hepatitis B and C who underwent biochemical tests, abdominal ultrasound, UGE, LS and SS measurements using ARFI elastography...
July 12, 2019: Romanian Journal of Internal Medicine
Afshin Shafaghi, Faeze Gharibpoor, Zahra Mahdipour, Ali Akbar Samadani
INTRODUCTION: Management of Upper gastrointestinal bleeding (UGIB) is of great importance. In this way, we aimed to evaluate the performance of three well known scoring systems of AIMS65, Glasgow Blatchford Score (GBS) and Full Rockall Score (FRS) in predicting adverse outcomes in patients with UGIB as well as their ability in identifying low risk patients for outpatient management. We also aimed to assess whether changing Albumin cutoff in AIMS65 and addition of Albumin to GBS, add predictive value to these scores...
July 2, 2019: Romanian Journal of Internal Medicine
Stamatis Karakonstantis, Ifigeneia Kassotaki, Dafni Korela, Despoina Arna, Kalliopi Milaki, Maria Tsigaridaki, Charalampos Lydakis, Angelos Pappas
BACKGROUND: Screening inpatients for diabetes mellitus may be a good opportunity to detect undiagnosed cases and several studies have demonstrated the feasibility and usefulness of this practice. HbA1c has been suggested as the method of choice due to the effects of acute illness on glucose. The aim of this study was to evaluate a screening protocol based on HbA1c to identify inpatients with undiagnosed diabetes mellitus in an internal medicine department. METHODS: We conducted a prospective study of all admissions in the internal medicine department of a 412-bed community hospital in Greece during a 6-month period...
June 28, 2019: Romanian Journal of Internal Medicine
Minodora Onisâi, Ana-Maria Vlădăreanu, Andreea Spînu, Mihaela Găman, Horia Bumbea
Immune thrombocytopenia is an autoimmune hematological disorder characterized by severely decreased platelet count of peripheral cause: platelet destruction via antiplatelet antibodies which may also affect marrow megakaryocytes. Patients may present in critical situations, with cutaneous and/or mucous bleeding and possibly life-threatening organ hemorrhages (cerebral, digestive, etc.) Therefore, rapid diagnosis and therapeutic intervention are mandatory. Corticotherapy represents the first treatment option, but as in any autoimmune disorder, there is a high risk of relapse...
June 13, 2019: Romanian Journal of Internal Medicine
Andra Chiriac, Camelia Badea, Cristian Băicuş
Giant cell arteritis is a common systemic vasculitis affecting the elderly, with maximum prevalence in the 7th decade of age, targeting aortic derived medium and large vessels of the neck and head. Diagnosis is established on a biopsy specimen of the temporal artery wall, through pathological confirmation of panarteritis, typically characterized by mononuclear cell infiltrate, with the 1990 ACR criteria often used in clinical practice. We present the case of a patient with a new onset headache and systemic inflammation, did not fulfil the classical diagnostic criteria, nor did the temporal artery biopsy (TAB) provide a positive result...
May 22, 2019: Romanian Journal of Internal Medicine
Larisa Pinte, Cristian Băicuș
BACKGROUND: Over the past years, eosinophil infiltration involving the gastrointestinal tract and pancreas leading to eosinophilic pancreatitis, eosinophilic gastroenteritis and hypereosinophilic syndrome, has been reported in the literature. We aimed to analyze and compare the features involving patients with eosinophilic pancreatitis and pancreatitis associated with eosinophilic gastroenteritis and to determine ifthere is a connection between the two disorders or if they in fact meet the diagnostic criteria for hypereosinophilic syndrome...
May 22, 2019: Romanian Journal of Internal Medicine
Agam Bansal, Mohit Gupta
BACKGROUND: Deposition of calcium pyrophosphate crystals in the cervical spine around the odontoid process may lead to neck pain and fever. This condition is called crowned dens syndrome (CDS). CASE REPORT: An 89-year-old female presented with complains of fever for one-month duration and recent onset neck pain. During her admission, she developed right knee pain with evidence of chondrocalcinosis on X-ray. Considering her clinical presentation in setting of pseudogout, she had a CT scan of her neck that revealed erosion of the dens and hyperdense soft tissue surrounding the odontoid process...
May 9, 2019: Romanian Journal of Internal Medicine
Hasan Haci Yeter, Ipek Gonul, Ertugrul Demirel, Berfu Korucu, Ulver Derici
INTRODUCTION: More than 50% of glomerular crescent formation is required for a diagnosis of crescentic glomerulonephritis in a kidney biopsy. Although treatment protocols have been established for diffuse crescentic glomerulonephritis, there is no standard treatment for patients with fewer crescents in renal biopsies. In this study the importance of crescent percentage and clinical features on renal survival independent of underlying disease, was investigated. METHODS: This retrospective observational study was conducted between 2013 to 2017...
May 9, 2019: Romanian Journal of Internal Medicine
Alana Murphy, Seth Teplitsky, Akhil K Das, Joon Yau Leong, Andrew Margules, Costas D Lallas
A significant workforce shortage of urologists available to serve the US population has been projected to occur over the next decade. Accordingly, much of the management of urologic patients will need to be assumed by other specialties and practitioners. Since primary care physicians are often first evaluate common urologic complaints, it makes sense that these physicians are in an excellent position to intervene in the management of these patients when appropriate. One of the most common complaints in urology is voiding dysfunction...
April 12, 2019: Romanian Journal of Internal Medicine
Marina Ruxandra Otelea
No abstract text is available yet for this article.
March 16, 2019: Romanian Journal of Internal Medicine
Mile Bosilkovski, Marija Dimzova, Marija Cvetkova, Kostadin Poposki, Katerina Spasovska, Ivan Vidinic
INTRODUCTION: The study aimed to compare the etiologic spectrum of diseases causing fever of unknown origin (FUO) and methods for definitive diagnosis in a tertiary care hospital in Republic of North Macedonia during two different time periods. PATIENTS AND METHODS: retrospectively were analysed the causes for FUO and final diagnostic approaches in 185 patients with classic FUO that were treated at the University Hospital for Infectious diseases in Skopje during two time periods...
March 11, 2019: Romanian Journal of Internal Medicine
Stamatis Karakonstantis, Mina Koulouridi, Kyriakos Pitsillos, Eirini Kalokyri, Anna Kozyri, Galateia Gourniezaki, Charalampos Lydakis
INTRODUCTION: Several diagnoses have been associated with leukemoid reaction (LR). In patients with LR the diagnostic and prognostic value of detailed manual blood smear counts (such as the percentage of band cells or grading of neutrophil toxic changes) has not been studied previously. METHODS: We prospectively recorded all hospitalized adult (>18 years old) patients with LR (≥30000/ul) of neutrophilic predominance, excluding patients with pre-existing leukocytosis due to hematological malignancies...
March 11, 2019: Romanian Journal of Internal Medicine
Gabriel E Pérez Baztarrica, Leonardo P Armijos Carrion, Juan H Abarca Real, William A Paredes Lima, Otto P Giler Saltos, Rafeal Porcile
There are few case reports of cases of carotid and aortic dissection related to the ergotamine abuse, but the cases that affect the coronary arteries is a very rare coronary. We present a patient of a 48-year-old female with an ST-segment elevation myocardial infarction attributable to chronic ergotamine use. The coronary angiography showed dissection of right coronary artery proximal.
March 1, 2019: Romanian Journal of Internal Medicine
Mojtaba Hedayat Yaghoobi, Abbas Taher, Mohamad Ali Seifrabie, Mohammadmahdi Sabahi, Farshid Rahimi-Bashar
BACKGROUND AND OBJECTIVE: Vitamin D deficiency is considered one of the most common nutritional deficiencies associated with weakened immune system and increased likelihood of sepsis. The current study was conducted to investigate the association between serum vitamin D level and the severity and prognosis of ventilator associated pneumonia (VAP) in inpatients in intensive care unit (ICU). METHODS: Eighty-four consecutive patients with VAP were enrolled in this observational, prospective study conducted in the ICU of Besat Hospital, Hamadan...
March 1, 2019: Romanian Journal of Internal Medicine
Cristian Baicus, Paul Balanescu, Adriana Gurghean, Camelia Georgeta Badea, Vlad Padureanu, Ciprian Rezus, Florin Mitu, Ruxandra Jurcut, Andra Rodica Balanescu, Ioana Daha, Eugenia Balanescu, Mihai Bojinca, Larisa Pinte, Alexandru Marian Constantin, Nicoleta Dima, Mariana Floria, Maria Magdalena Leon-Constantin, Mihai Roca, Magda Mitu, Silvia Chiriac, Mariana Floria, Codruta Minerva Badescu, Simona Daniela Ionescu, Elena Mitrea, Gabriel Rosu, Georgeta Daniela Ionescu, Ana Maria Visinescu, Gabriela Mihailescu, Emilia Oprisan, Stefan Zeh, Isabelle Scholl, Martin Härter
BACKGROUND: Shared decision making (SDM) is becoming more and more important for the patient-physician interaction. There has not been a study in Romania evaluating patients' point of view in the SDM process yet. Therefore, the present study aims to evaluate the psychometric parameters of the translated Romanian version of SDM-Q-9. MATERIAL AND METHODS: A multicentric cross-sectional study was performed comprising eight recruitment centers. The sample consisted of in- and outpatients who referred to Hospital Units for treatment for atrial fibrillation or collagen diseases...
February 1, 2019: Romanian Journal of Internal Medicine
Larisa Pinte, Daniel Vasile Balaban, Cristian Băicuș, Mariana Jinga
Obesity is a growing health burden worldwide, increasing the risk for several diseases featuring the metabolic syndrome - type 2 diabetes mellitus, dyslipidemia, non-alcoholic fatty liver disease and cardiovascular diseases. With the increasing epidemic of obesity, a new pathologic condition has emerged as a component of the metabolic syndrome - that of non-alcoholic fatty pancreas disease (NAFPD). Similar to non-alcoholic fatty liver disease (NAFLD), NAFPD comprises a wide spectrum of disease - from deposition of fat in the pancreas -fatty pancreas, to pancreatic inflammation and possibly pancreatic fibrosis...
January 1, 2019: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
Kristyn L Lewis, Timothy D Malouff, Alex M Kesler, Dana M Harris
Hypokalemic periodic paralysis (HOKPP) is a rare neuromuscular disorder caused by altered transport of cellular potassium that leads to significant muscle weakness of the extremities. Paralytic attacks are induced by a drop in the serum potassium level and have been associated with specific triggers. This case describes a 21-year-old male who has had recurrent presentations of acute paralytic attacks following vigorous physical activity. At presentation, this patient exhibited flaccid paralysis of all skeletal muscles below the neck, but was alert and oriented with stable vital signs...
January 1, 2019: Romanian Journal of Internal Medicine
Igor Kaidashev, Liudmyla G Savchenko, Nataliia I Digtiar, Liudmyla G Selikhova, Elvira I Kaidasheva, Oksana A Shlykova, Liudmyla E Vesnina
INTRODUCTION: Liraglutide (L) is the analogue of human glucagon-like peptide 1 which stimulates glucose-dependent insulin secretion and can modify a level of inflammatory biomarkers. L can influence NF-kB inflammatory cascade, but the mechanisms of anti-inflammatory activities of L remain to be determined. In animal models L influenced an activity of Sirtuin 1(SIRT1). Moreover, recent evidences strongly suggest that SIRT1 up-regulation may serve as a potent therapeutic approach against development and progression of diabetic complications ...
January 1, 2019: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
Caterina Delcea, Camelia Badea, Ciprian Jurcut, Adrian Purcarea, Silvia Sovaila, Emma Weiss, Elena Alistar, Horia Balan, Cristian Baicus
Quality of care in medicine is not necessarily proportional to quantity of care and excess is often useless or even more, potentially detrimental to our patients. Adhering to the European Federation of Internal Medicine's initiative, the Romanian Society of Internal Medicine (SRMI) launched the Choosing Wisely in Internal Medicine Campaign, aiming to cut down diagnostic procedures or therapeutics overused in our country. A Working Group was formed and from 200 published recommendations from previous international campaigns, 36 were voted as most important...
January 1, 2019: Romanian Journal of Internal Medicine
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