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Biomedical subjects

I Coman

Publications and source records attributed to I Coman.

8 recordsLinked to original sources

[Signet-ring cell carcinomatous meningitis complicating esophageal neoplasia].

Leptomeningeal invasion is an uncommon complication of systemic solid cancers. We describe a patient with such an infiltration caused by a signet-ring cells esophageal adenocarcinoma. The diagnosis required repeated cytologic examinations of cerebrospinal fluid while clinical signs and biological data were not conclusive, mimicking acute infectious meningoencephalitis. Magnetic resonance imaging was highly contributive in establishing the diagnosis. Nevertheless this is a very rare complication of esophageal cancers as this metastatic location occurred in advanced stages of the disease and as we know the poor prognosis of those cancers.

Carcinoma, Signet Ring Cell↗

Pasteurella infections in respiratory diseases of young cattle.

Bacteriological examinations performed on 545 extracts of pneumonia-affected lungs and on nasal secretions collected from pneumopathy diseased young cattle led to the isolation of 176 (32.2%) Pasteurella (p.) multocida strains and of 125 (22.9%) P. haemolytica strains. P. multocida was isolated in 46.2% of the lung lesions and in 22.5% of the nasal secretions, P. haemolytica in 26.6% and 20.3%, respectively. Pathogenicity in mice was detected in 81.9% of the P. multocida strains and in 19% of the P. haemolytica strains. Pasteurella strains were very susceptible to chloramphenicol (82.3%), tetracycline (68%), penicillin (47%), and ampicillin and resistant to oxacillin, streptomycin and kanamycin. P. multocida and P. haemolytica strains in the respiratory tract and lung lesions of young cattle affected by pneumopathies represent the main ethiologic agent accounting for the clinical symptoms, anatomic lung lesions and finally for the death of the animal.

Animals↗

[Infectious endocarditis in mitral valve prolapse].

The paper reports on 13 cases of infectious endocarditis in the patients with prolapse of the mitral valve admitted for a period of 10 years (1979-1989) into the Clinic of Cardiology of the Fundeni Hospital. These cases stand for 3.6% of the cases with prolapse of the mitral valve admitted during that period, and 5% of the patients with infectious endocarditis. Our study dealt only with the cases of the prolapse of the mitral valve, clinically and echographically documented before the appearance of the septic graft. The hemocultures were positive in all the patients (viridans streptococci in 84.61% cases). The symptomatology, the clinical objective data and the paraclinical results (phonocardiographic, echocardiographic, electrocardiographic, radiologic, investigations with isotopes), the response to the treatment (medical, surgical) and the evolution in time were analyzed. An increase was found during endocarditis in the number of patients with holosystolic murmurs (30.7% cases) versus those with click-telesystolic murmur, the appearance in 41.15% of the cases of valvular vegetations at the Echo examination, and in 15.38% cases of ruptures of cordages. Mitral insufficiency secondary to endocarditis became worse, in 30.76% cases. The treatment with antibiotics resulted in the healing of the infection in all the cases. The surgery was not necessary in any patient during the evolution of endocarditis. The surgery (valvular prosthesis) was made in 23.07% cases, which presented, after curing the septic graft, important mitral regurgitation with cardiac insufficiency refractory to the medical treatment. Prophylaxis of the infectious endocarditis in the prolapse of mitral valve with mitral regurgitation is necessary.

Adult↗

[Mitral valve prolapse. An echocardiographic study of 456 cases].

The prolapse of the mitral valve is an affection arousing much interest from the clinical and echocardiographical viewpoints. The present paper reports on the analysis of 456 cases (322 women--70% and 134 men--29.39%), suffering from prolapse of the mitral valve, selected out of 15,714 echocardiographic examinations (2.93%). All the patients were examined echocardiographically--Echo) in the M mode and bidimensionally; 256 cases underwent an Echo-Doppler examination, too and in 90 cases the phonocardiogram was also used. 983 cases were diagnosed as clinically suffering from prolapse, confirmed by Echo in 291 cases (29.62%), and in 165 cases the diagnosis was established only clinically. Phonocardiographically, the most frequent were recorded the mesotelesystolic click (40%), followed by click + holosystolic murmur (31.11%), telesystolic murmur (19.70%), holosystolic murmur (6.66%). The prolapse of the mitral valve was evidenced in 394 cases, both by M-Echo and by 2D-Echo; in 28 (6.1%) cases it was evidenced only by M-Echo, and in 34 cases (7.4%) only by 2D-Echo. In 62 cases (13.4%) the prolapse was better evidenced when the patients stood. The most affected was the anterior mitral valve, 203 cases (44.5%). The conclusion was drawn that the prevalence of the prolapse of the mitral valve is of 2.93% according to the Echo examination. A correct diagnosis requires the use of a rigorous examination technique and the observance of the clinical and Echo diagnosis criteria.

Adolescent↗

Assessment of hypertension levels control and management (hypertension "AUDIT" project). Study in a population of workers.

The hypertension AUDIT project (WHO) was used for the study of large populations of workers in two Romanian industrial centers, Slatina and Sibiu, constituted into two main groups. The objects of the study were: the detection of new cases of arterial hypertension (AH) and of their proportion as compared with older cases, the assessment of the quality of diagnosis control and treatment methodology as well as the estimation of the patient's attitude regarding the conditions of treatment and of the physician's knowledge and attitude regarding AH. Group I (Slatina) included 22,839 workers and the program was applied in 15,740 randomly chosen subjects. Group II (Sibiu) included 14,874 workers of whom 2,838 were randomly chosen for study. From a total of 606 (6.20%) subjects aged 35 to 64 years with AH in both groups, 494 (81.51%) were older cases and 112 (18.48%) were newly detected. The prevalence of AH was found to increase with age and to be higher in women aged 55 to 64 years. The treatment in older cases from both groups was considered effective in 232 cases (46.96%) (of which 26 (11.2%) with overtreatment) and insufficient in 262 (53%). The reasons alleged by the patients for the late detection of AH were the absence of symptoms and a casual interest for their state of health. The risk factors were systematically checked. Smoking was found in 30.36% of the subjects in group I and in 31% of those in group II. The use of diagnostic laboratory procedures was corresponding to the present recommendations. The nonpharmaceutic therapy was frequently recommended, especially reduction of salt consumption. Besides that, pharmaceutic treatment was indicated in most of the patients (63% in group I and 90% in group II). Diuretics (41.26% in group I and 75% in group II), and beta blocking drugs (35.3% in group I and 70% in group II) were the most frequently administered and in a lesser proportion vasodilators with central or peripheral action, calcium blockers, Rauwolfia and angiotensin conversion enzyme inhibitors. The consumer inquiry showed satisfactory compliance of patients, most of them took their tablets regularly, were satisfied with the medical assistance and preferred to consult the same physician. The data of the physician inquiry regarding diagnosis treatment of AH and professional training also proved satisfactory. The use of the AUDIT project has allowed a complex estimation of AH in the groups studied and will prove useful for a more efficient control of AH in the whole population.

Adolescent↗