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Iaşi, Romania

Grosz C.,Rehabilitation Hospital | Poanta L.,University of Medicine and Pharmacy, Cluj-Napoca
Medical Ultrasonography

Ruptured sinus of Valsalva (RSOV) is a rare disease with a wide range of clinical manifestations, from asymptomatic murmur to cardiogenic shock and death. We present the case of a young woman known with dextrocardia and pulmonary agenesia; she was diagnosed with RSOV and during follow-up, with endocarditis. Her evolution was good despite the association of severe heart conditions and the refusal of surgical intervention. Source

Rebuzzi M.,University of Rome La Sapienza | Vinicola V.,Rehabilitation Hospital | Taggi F.,National Institute of Health | Sabatini U.,IRCCS Santa Lucia Foundation | And 2 more authors.

Introduction: Bone mineral density (BMD) result has a low predictive value on patients' risk for future fractures. Thus, new approaches for examining patients at risk for developing osteoporosis would be desirable. Magnetic resonance (MR) investigations in cancellous bone have been shown to yield useful quantitative information on both trabecular-bone microstructure and bone marrow composition.This work was undertaken to address the hypothesis that the effective internal magnetic field gradient (IMFG), a new MR parameter, discriminates between healthy, osteopenic and osteoporotic postmenopausal women, classified on the basis of bone mineral density (BMD) criteria. The work builds on preliminary results indicating that IMFG, measured in trabecular-bone pores and quantified by spin-echo decay and water diffusion MR near the bone-bone marrow interface depends on both the bone marrow water rate of diffusion and the magnetic susceptibility difference (δX) between water and bone. Materials and methods: MR relaxometry, MR spectroscopy and diffusion-weighted MR imaging of the heel was performed in fifty-five women (mean age, 62.9±6.6years) at 3T. Moreover, in order to study the reproducibility of IMFG measurement, five young women (mean age 31.0±3.2years; age range, 28-36years) were scanned and rescanned. The study protocol was approved by the local Ethics Committee. Quantitative Computer Tomography (QCT) of the L1-L3 vertebral segments was performed to classify the postmenopausal women into three groups according to QCT BMD: healthy (n=8); osteopenic (n=25); and osteoporotic (n=22). In all subjects, BMD T-scores, marrow fat content (Mfc), T2*, apparent diffusion coefficient (ADC) and IMFG (estimated from the additional spin-echo decay due to diffusion of water in local magnetic field gradients), were assessed in the whole calcaneus as well as in three calcaneal subregions: subtalar, tuber calcaneus, and cavum calcaneus. Between-group comparisons to assess group differences and Pearson correlation analysis were performed. Short and long-term coefficients of variation (CVS and CVL, respectively) were evaluated in young subjects. Results: Reproducibility of the IMFG measurement was satisfactory. No significant difference was found in the IMFG measurement performed in both calcaneus and subtalar calcaneal region between the two separate sessions comprised of five young women. Mfc did not significantly differ between groups. The IMFG in the subtalar region was significantly different between all three groups (. P<. 0.01), being greatest in healthy women, intermediate in those with osteopenia, and lowest in osteoporotic subjects. Conversely neither T2* nor ADC is able to discriminate healthy subjects from those with osteopenia and osteoporosis. Increased inter-trabecular space, as it typically occurs in patients with osteoporosis, modifies water diffusion, conferring higher ADC values, thereby lowering the IMFG. Conclusion: The IMFG measured in the calcaneal subtalar region shows a high ability in identifying healthy subjects. The new quantitative MR method based on measurement of the IMFG may provide a new means for assessing patients with osteoporosis. © 2013 Elsevier Inc. Source

Sale P.,IRCCS San Raffaele Pisana | Juocevicius A.,Vilnius University | Giustini A.,Rehabilitation Hospital | Negrini S.,ISICO Italian Scientific Spine Institute | Franceschini M.,IRCCS San Raffaele Pisana
American Journal of Physical Medicine and Rehabilitation

Sale P, Zampolini M, Juocevicius A, Lains JM, Giustini A, Negrini S, Franceschini M: The Role of the European Physiatrist in Traumatic Brain Injury. Am J Phys Med Rehabil 2011;90:83Y86. Copyright © 2011 by Lippincott Williams & Wilkins. Source

Muresan C.,University of Medicine and Pharmacy, Cluj-Napoca | Muresan L.,Rehabilitation Hospital | Grigorescu I.,University of Medicine and Pharmacy, Cluj-Napoca | Dumitrascu D.L.,University of Medicine and Pharmacy, Cluj-Napoca
Lung India

Pseudochylothorax, also known as chyliform effusion rich in cholesterol crystals, is a rare entity that sometimes occurs in long-standing rheumatoid arthritis (RA) and is usually associated with thickened pleura. There have only been a few case reports in the literature on pseudochylothorax unassociated with pleural thickening and with a short duration of articular symptoms in patients with RA. We report the case of a 70-year-old male patient with a history of RA and heart failure due to severe aortic stenosis, who presented with signs and symptoms of decompensated heart failure due to a moderate right-sided pleural effusion that was consequently proved to be pseudochylothorax unassociated with pleural thickening on chest computed tomography (CT) scan. The patient's outcome was favorable after thoracocentesis was carried out and leflunomide was added to the standard heart failure treatment. Source

Pop D.,University of Medicine and Pharmacy, Cluj-Napoca | Sitar-Taut A.,Babes - Bolyai University | Bodisz G.,Rehabilitation Hospital | Zdrenghea D.,University of Medicine and Pharmacy, Cluj-Napoca | And 2 more authors.
Indian Journal of Medical Research

Background & objectives: Secretory phospholipase A2 (sPLA2), a member of the phospholipase A2 superfamily of enzymes that hydrolyses phospholipids, is a potentially useful plasma biomarker for atherosclerotic cardiovascular disease. Cardiovascular diseases are the leading cause of mortality in women. The purpose of this study was to investigate the correlation between cardiovascular risk factors and the sPLA2 levels in women with metabolic syndrome as compared to women without metabolic syndrome and men with metabolic syndrome. Methods: Patients (n=100) with various cardiovascular risk factors consecutively evaluated at the Rehabilitation Hospital-Cardiology Department, Cluj-Napoca, Romania were enrolled during 2011, of whom 10 were excluded. The patients were divided in three groups: group 1 (37 women with metabolic syndrome), group 2 (27 men with metabolic syndrome), and group 3 (26 women without metabolic syndrome). Body weight, smoking habits, glycaemia, hypertension, and serum lipids fractions were analysed as cardiovascular factors. Serum sPLA2 activity was measured using the chromogenic method. Results: There were no statistically significant correlations between sPLA2 levels and the investigated risk factors, irrespective of patient groups. However, there were significant positive correlations between sPLA2 and hsCRP in all three groups (P<0.05). In women with no metabolic syndrome an negative correlation was found between sPLA2 levels and HDL-C- r=-0.419, P=0.03. In men with metabolic syndrome there was a direct correlation between sPLA2 levels and HOMA, r=0.43, P<0.05, 95% CI (-0.098; 1.15). Interpretation & conclusions: Women with metabolic syndrome did not display different sPLA2 levels as compared to men with metabolic syndrome and women without metabolic syndrome. However, women with metabolic syndrome demonstrated a low but positive correlation between sPLA2 and hsCRP levels. Source

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