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Biomedical subjects

A Florescu

Publications and source records attributed to A Florescu.

35 records · Page 2Linked to original sources
PubMed1978

Myasthenia in patients with dermatomyositis: clinical, electrophysiological and ultrastructural studies.

In 4 patients with clinical signs of dermatomyositis, confirmed by electromyography and muscle biopsy, a form of muscle fatigue was detected which was expressed clinically by predominantly proximal motor deficit, with phonation and deglutition disturbances, slightly influenced by prostigmine. In all patients, stimulation of the ulnar nerve at 3--10 Hz induced a decrement of muscle-evoked potentials in abductor digiti minimi and at 15--50 Hz an increment at the end of the trains (1.2 sec in duration) of repetitive stimulation (preceded in two cases by a decrement in the response to the fifth stimulus in the train). Stimulation at 30 Hz for 10 sec resulted in a transient facilitation, followed (at 3 Hz stimulation) by postactivation exhaustion which disappeared after 5--15 min. The post-tetanic facilitation, the incremental response and the myasthenic symptoms reverted to normal under treatment with corticosteroids, an immunosuppressor agent and guanidine hydrochloride. A mixed, pre- and postsynaptic mechanism is presumed to underlie the muscle fatigue in our patients. Electron microscopy of muscle biopsies disclosed zones of necrosis and, in incipient stages, large agglomerations of glycogen that had disorganized the structure of myofibrils. The end-plates in the biopsies were larger than normal and the cholinesterase reaction was hyperactive. Serum immunoelectrophoretic and electrophoretic data--increase of IgG and IgM, decrease of IgA and hypergammaglobulinaemia -- point to a possible autoimmune mechanism of the neuromuscular disorders in our patients.

Adolescent↗
PubMedDate not supplied

[Neurolysis of the posterior tibial nerve in the tarsal canal--a new therapeutic approach in chronic painless plantar ulcers].

The paper reports on 14 cases of perforating plantar disease of whom 11 belong to the so-called nonpainful chronic plantar ulceration by compression of the posterior tibial nerve in the tarsal canal. The authors show clinically, neuroelectrically and by neurography with lipiodol that in the case of a diabetic or alcoholic polyneuropathy, the posterior tibial nerve is more vulnerable to the compression existing in the tarsal canal due to the development of a fibrous sclerotic tissue. Exo-endoneurolysis of the posterior tibial nerve associated with a posterior tibial periarterial sympathectomy permitted healing in 7 ulcerations, 2 diminutions of the ulceration dimensions, and only 2 remissions. The four cases of unfavourable results were in patients with old lesions who continued alcohol consumption.

Adult↗
PubMedDate not supplied

Considerations on the pathogenesis of mitral valve prolapse.

Forty patients (11 males and 29 females) with mitral valve prolapse (MVP) were investigated clinically as well as by echocardiographic, phonomechanocardiographic, radiologic, electroencephalographic, electromyographic, psychologic and biologic examinations. Hypomagnesemia was found statistically significant and is assumed to have an important etiopathogenic role particularly in causing the rhythm and neuropsychic disturbances in MVP. A case in which MVP appeared after a prolonged treatment with prednisone, is presented.

Arrhythmias, Cardiac↗
PubMedDate not supplied

[General surgical operations in patients with prior cardiac operations. Anesthetic and surgical risk].

The authors make an analysis of a group of 39 patients with cardiac interventions in their antecedents that later underwent general surgery. Of these 25 underwent planified surgery while 14 were operated as emergency cases. The surgery performed was of variable extension. Nine fatalities were recorded, representing 23,09%. Evaluation of the anesthetic and surgical risk factors revealed their dependence both on the myocardial hemodynamic efficiency (as determined by the previous heart surgery), and on the second intervention, emergencies presenting with a potentially increased risk factor. The authors stress the necessity to adapt the attitude of the anesthetist, as well as the intensive care, to particularities of the patient, and those determined by the second intervention.

Adolescent↗
PubMedDate not supplied

[The Bain circuit. Theoretical aspects and clinical use].

After a concise theoretical presentation of the present stage of semiclosed circuits, the authors assess their personal experience in the use of the Bain system. Under controlled respiration, adminstration of a fresh flow of gases of 70 ml per Kg of body weight-1 per minute-1 (between 4,5 and 6 1 per minute-1) prevents reinchalation. By its characteristics, which include: on optimal control of PaCO2 by a simple variation of the flow of fresh gases, universality, economy, the Bain system has demonstrated its utility in the anesthetics practice.

Anesthesia, General↗
PubMedDate not supplied

Distal metacarpal bone mineral density by dual energy X-ray absorptiometry (DEXA) scan. Methodological investigation and application in rheumatoid arthritis.

Dual energy X-ray absorptiometry scanning was performed along the axis of the third metacarpal bone of the non-dominant hand and including metacarpal bones 2, 3, 4 and 5. The Bone Mineral Density (BMD) was calculated for the distal 1/4 of each metacarpal bone. Ten patients with seropositive, erosive rheumatoid arthritis (RA) and 10 healthy, sex- and age-matched persons were investigated twice. The average BMD in RA patients was 73.6% of the value found in normals. The coefficient of variation on double determinations (in patients and controls) was 0.9-3.0%. We suggest that dual energy X-ray absorptiometry scanning with the scanning procedure proposed here may be an important instrument for the quantification of disease progression.

Absorptiometry, Photon↗