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Bicu D.,Neuropsychiatry Hospital | Bondari A.,University of Medicine and Pharmacy of Craiova | Bicu M.,Diabetes | Tapu F.,Clinical County Emergency Hospital
Archives of the Balkan Medical Union | Year: 2010

Background: Multiple sclerosis is the most common neurological disease in young adults characterized by recurrent relapses and/or progression within the central nervous system. Method: The study was realized on a group made up of 26 patients with relapsing - remitting multiple sclerosis, 10 men and 16 women, a man of 35.1 ± 5.1 years, that suffers from a disease for 5.6 ± 3.1 years, clinically and imagistically monitored. MS-related disability was clinically assessed using the Expanded Disability Status Scale and Multiple Sclerosis Functional Composite. The imagistic exploration proved its efficiency in completing these methods, representing a sensitive method in sustaining the assessment and progression of disease. Results: Multiple Sclerosis Functional Composite is a good method for assessing the evolution of the disease, a more sensitive one than the Expanded Disability Status Scale, it can reflect with high sensitivity clinical changes and cognitive dysfunctions. Magnetic resonance imaging points out the activity of the disease, new lesions on T1 or T2-weighted sequences appear more frequently than they are detected clinically, presenting clearer advantages for the assessment and therapeutic monitoring. Conclusions: The imagistic parameters together with the clinical markers represent important criteria to sustain the evolution and the progression of the disease. Copyright © 2010 Celsius. Source


Rogojan L.,Clinical County Emergency Hospital | Seicean A.,University of Medicine and Pharmacy, Cluj-Napoca | Ciuce C.,University of Medicine and Pharmacy, Cluj-Napoca
Journal of Gastrointestinal and Liver Diseases | Year: 2012

Gastrointestinal stromal tumors (GIST) are rare mesenchymal neoplasms of the gastrointestinal tract with a malignant potential and unpredictable behavior. In the literature a few cases of synchronous development of a GIST and another neoplasia with different incidence, etiology, evolution and prognostic have been described. We report a case of a 61 year old male with a simultaneous occurrence of a GIST and a colon adenocarcinoma. Source


Mandl P.,Medical University of Vienna | Mandl P.,National Institute of Rheumatology and Physiotherapy | Baranauskaite A.,Lithuanian University of Health Sciences | Damjanov N.,University of Belgrade | And 12 more authors.
Rheumatology International | Year: 2016

The main aim was to gain structured insight into the use of musculoskeletal ultrasonography (MSUS) in routine rheumatology practices in Central and Eastern European (CEE) countries. In a cross-sectional, observational, international, multicenter survey, a questionnaire was sent to investigational sites in CEE countries. Data on all subsequent routine MSUS examinations, site characteristics, MSUS equipment, and investigators were collected over 6 months or up to 100 examinations per center. A total of 95 physicians at 44 sites in 9 countries provided information on a total of 2810 MSUS examinations. The most frequent diagnoses were rheumatoid arthritis (RA) and spondyloarthritis (34.8 and 14.9 % of cases, respectively). Mean number of joints examined was 6.8. MSUS was most frequently performed for diagnostic purposes (58 %), particularly in patients with undifferentiated arthritis, suspected soft tissue disorders, or osteoarthritis (73.0–85.3 %). In RA patients, 56.3 % of examinations were conducted to monitor disease activity. Nearly all investigations (99 %) had clinical implications, while the results of 78.6 % of examinations (51.6–99.0 %) were deemed useful for patient education. This first standardized multicountry survey performed in CEEs provided a structured documentation of the routine MSUS use in participating countries. The majority of MSUS examinations were performed for diagnostic purposes, whereas one-third was conducted to monitor disease activity in RA. A majority of examinations had an impact on clinical decision making and were also found to be useful for patient education. © 2016, The Author(s). Source


Krishnan K.,University of Nottingham | Scutt P.,University of Nottingham | Woodhouse L.,University of Nottingham | Adami A.,Stroke Center | And 18 more authors.
Journal of Stroke and Cerebrovascular Diseases | Year: 2016

Background and purpose More than 50% of patients with acute intracerebral hemorrhage (ICH) are taking antihypertensive drugs before ictus. Although antihypertensive therapy should be given long term for secondary prevention, whether to continue or stop such treatment during the acute phase of ICH remains unclear, a question that was addressed in the Efficacy of Nitric Oxide in Stroke (ENOS) trial. Methods ENOS was an international multicenter, prospective, randomized, blinded endpoint trial. Among 629 patients with ICH and systolic blood pressure between 140 and 220 mmHg, 246 patients who were taking antihypertensive drugs were assigned to continue (n = 119) or to stop (n = 127) taking drugs temporarily for 7 days. The primary outcome was the modified Rankin Score at 90 days. Secondary outcomes included death, length of stay in hospital, discharge destination, activities of daily living, mood, cognition, and quality of life. Results Blood pressure level (baseline 171/92 mmHg) fell in both groups but was significantly lower at 7 days in those patients assigned to continue antihypertensive drugs (difference 9.4/3.5 mmHg, P <.01). At 90 days, the primary outcome did not differ between the groups; the adjusted common odds ratio (OR) for worse outcome with continue versus stop drugs was.92 (95% confidence interval,.45-1.89; P =.83). There was no difference between the treatment groups for any secondary outcome measure, or rates of death or serious adverse events. Conclusions Among patients with acute ICH, immediate continuation of antihypertensive drugs during the first week did not reduce death or major disability in comparison to stopping treatment temporarily. © 2016 The Authors. Source


Serban-Pereteanu A.S.,Colentina Clinical Hospital | Trasca D.,Colentina Clinical Hospital | Stefanescu V.C.,Colentina Clinical Hospital | Bustan M.,Clinical County Emergency Hospital | And 3 more authors.
Romanian Journal of Neurology/ Revista Romana de Neurologie | Year: 2014

A 42-year-old women is admitted in the Psychiatric Department with signs of acute psychosis. She had orolinguofacial dyskinesias, episodes of bilateral rigidity, oculocephalogyric crisis and becomes stuporous. The cerebral MRI highlighted two supratentorial demielination lesions. The CSF examination shows clear CSF with moderate pleocitosis and the predominance lymphocyte. Viral and bacterial cultures were negative. The patient is transferred to our Department of Neurology after 5 days, and runs a fever. Also, orolinguofacial dyskinesias, hypersalivation, puppet’s eye syndrome, swallowing disorders, bilateral jerks osteotendinous reflexes, and coma state (GCS=5) are present. A second cerebral MRI was performed, which suggested two hypersignal lesions, T2, FLAIR and T1 hyposignal present, with no diffusion restriction, one being 0.9 cm, situated subcortically and to the right, the other of 0.5 cm being located on the left subcortical parietal, without gadolinium enhancement. The native pelvic CT scan marked out a 4.9 cm left annex cyst present. Anti-NMDAR antibodies were present in the CSF. As the patient was comatose, an interventional genital procedure is contraindicated. The patient was given iv Immunoglobulis, Methylprednisolone, Cyclophosphamide, anticonvulsives, and large spectrum antibiotics. She manifested multiple oculocephalogyric crisis, in both directions, bronchopneumonia, respiratory failure, requiring mechanical ventilatory support. The patient dies three weeks after the onset of the symptoms. The pathological examination revealed a left mature ovarian teratoma. The anti-NMDAR encephalitis is a life-threatening condition consisting of memory and psychiatric disorder, alteration of consciousness and hypoventilation, common associated with ovarian teratomas. The fast diagnosis and an early specific treatment can strongly influence the antiNMDAR encephalitis’s natural evolution. © 2014 Editura Medicala AMALTEA. All Rights reserved. Source

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