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Bucharest, Romania

Helicobacter pylori was recognized in 1994 as a class I carcinogen by the International Agency for Research on Cancer (IARC). The prevalence of H. pylori infection varies from 20 to 50% in industrialized countries to over 80% in developing countries. The cagA strains are more virulent than others, being able to induce morphological changes, vacuolization and degeneration of in vitro cultured cells. During this study we investigated the possible correlations between the presence of H. pylori cagA (cytotoxin associated gene antigen)-IgG antibodies and the severity of clinical and endoscopical findings. Anti-cagA IgG was screened by ELISA in 104 selected patients exhibiting resistance to first line therapy for H. pylori, bleeding gastroduodenal ulcers, non cardia gastric cancer and gastric polyps. A statistically significant association between resistant cases to first line therapy for H. pylori, bleeding gastroduodenal ulcers, non cardia gastric cancer, gastric polyps and cag A Ig G antibodies (p value 0.02 calculated by T-Test) was observed. As Cag A antibodies titer persist up to four months, their level could be an useful marker in detecting previous long-term H pylori infection especially in gastric cancer patients. CagA positive H. pylori are virulent strains and the cagA IgG antibodies titer is associated with persistence of infection after treatment, upper gastroduodenal ulcers or gastric cancer. The presence of these antibodies, associated with positive biopsy for H. pylori, indicates the need of H. pylori treatment. Source


Maniu A.,University of Medicine and Pharmacy, Cluj-Napoca | Damian L.,Emergency Hospital
American Journal of Otolaryngology - Head and Neck Medicine and Surgery | Year: 2013

We report on a patient with Lyme disease who presented with chronic bilateral otitis media and cranial neuropathy with rapid progresive hearing loss. After ceftriaxone and high-dose intravenous immunglobulins, the disease was controlled only with methylprednisolone and cyclophosphamide. The relationship between Lyme disease and granulomatous vasculitis is discussed. Lyme disease should be kept in mind in the differential diagnosis of various otolaryngological and neurological presentations. © 2013 Elsevier Inc. All rights reserved. Source


Ilie M.,Emergency Hospital
Roumanian archives of microbiology and immunology | Year: 2011

Helicobacter pylori is one of the most common among the numerous bacterial species of the stomach. It is classified as a class 1 carcinogen because of its causal relationship to gastric adenocarcinoma. The epidemiology of H. pylori infection is characterized by a marked difference between developing and developed countries. Treatment of H. pylori still remains a challenge due to the high rate of antibiotic resistance. The aim of this study was to investigate the susceptibility of H. pylori strains isolated from gastric biopsies to different antibiotics currently used in the H. pylori infection treatment schemes. Upper gastrointestinal GI endoscopy was performed, followed by the rapid urease test on gastric biopsies. The positive samples were cultivated on specific media under microaerophilic conditions and the antibiotic susceptibility assay was performed on the isolated strains. A positivity rate of 70% was obtained for cultures performed from the biopsy samples positive for the urease test. The resistance rates for the antibiotics used in the classic triple therapy proved to be high, i.e. 92.8% for metronidazole, 50% for amoxicillin and 32% for clarithromycin. The isolated strains proved to be sensitive to ciprofloxacin and levofloxacin. The role of gastric microbiota and its contribution to the H. pylori associated pathology need to be established. The problem of antibiotic treatment failure in case of resistant H. pylori strains can be surpassed by routine culture and antibiotic susceptibility testings. Source


Beuran M.,Emergency Hospital
Chirurgia (Bucharest, Romania : 1990) | Year: 2012

There are many controversies related to the trauma patient care during the pre-hospital period nowadays. Due to the heterogeneity of the rescue personnel and variability of protocols used in various countries, the benefit of the prehospital advanced life support on morbidity and mortality has been not established. Systematic review of the literature using computer search of the Library of Medicine and the National Institutes of Health International PubMed Medline database using Entre interface.We reviewed the literature in what concerns the basic and advanced life support given to the trauma patients during the prehospital period. Although the organization of the medical emergency system varies from a country to another, the level of patient'scare can be classified into two main categories: Basic Life Support (BLS) and Advanced Life Support (ALS).There are many studies addressing what to be done at the scene.The prehospital care can be divided into two extremes: stay and play/treat then transfer or scoop and run/load and go. A balance between "scoop and run" and "stay and play" is probably the best approach for trauma patients. The chosen approach should be made according to the mechanism of injury (blunt versus penetrating trauma), distance to the trauma center (urban versus rural) and the available resources. RevistaChirurgia. Source


Nicolau A.E.,Emergency Hospital
Chirurgia (Romania) | Year: 2011

Introduction: Laparoscopy, as a minimally invasive diagnostic and therapeutic tool in blunt abdominal trauma (BAT), is not commonly used and has been shown to be controversial. The aim of this study is to assess the role of laparoscopy in the diagnosis and therapy of BAT. Methods: A systematic review and a comprehensive literature search was performed at the U.S. National Library of Medicine site in Medline and PubMed from January 2000 to 31 December 2007. This article attempts to outline the efficacy, the indications, contraindications, surgical technique and therapeutic possibilities of laparoscopy in B AT. Pediatric surgery articles and those addressing penetrating abdominal wounds, nontraumatic abdominal emergencies and iatrogenic injuries were excluded from this review. Results: Sixty-six articles were reviewed, which included 22 case studies, 27 case reports, 17 reviews and 2 guidelines. The reviewed articles comprised 343 patients with BAT and laparoscopic approach. Therapeutic laparoscopy was possible in 168 cases (48,98%), 51 cases were converted (14,87%), overlooked injuries were absent, 6 patients had complications (1,75%), no mortality laparoscopy-related. The main indications for laparoscopy in BAT include the confirmation of suspected diaphragmatic defects, suspected hollow viscus and mesenteric injuries, in patients with inconclusive clinical exams and abdominal imaging. Diagnostic laparoscopy (DL) is also indicated in patients with suspected intra-abdominal injuries when advanced emergency imaging investigations are unavailable. Laparoscopy allows the surgeon to perform hemostasis, resections, suturing, autotransfusion, etc. Conclusion: Although is not widely used, laparoscopy could still be useful in selected patients with BAT who have equivocal findings on clinical exam and imaging investigations in order to clarify the lesional diagnosis, thus avoiding unnecessary laparotomies. Multicenter prospective studies are needed to better assess the role of laparoscopy in blunt abdominal trauma. Source

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