Biomedical subjects

L Sorodoc

Publications and source records attributed to L Sorodoc.

15 recordsLinked to original sources

PubMed2004

Toxic-induced hypoglycemia in clinical practice.

UNLABELLED: Toxic induced hypoglycemia is usually caused by the anti-diabetic treatment and excessive alcohol consume. Hypoglycemia in diabetics treated with insulin or anti-diabetic oral agents is far the most studied form of hypoglycemia. Less information is available on toxic-induced hypoglycemia in non-diabetic subjects with acute exogenous poisoning. MATERIAL AND METHODS: We retrospectively studied adult non-diabetic patients admitted in Emergency Clinic Hospital of Iaşi with hypoglycemia caused by an acute poisoning, over a period of 10 years. Then we performed a prospective study in those poisoning associated with hypoglycemic risk, to assess the prevalence of toxic-induced hypoglycemia. RESULTS: We identified 15,497 patients with acute poisoning in our retrospective study, 4,005 of whom presented poisoning associated with hypoglycemic risk (40% acute ethanol poisoning, 29% wild mushroom poisoning, 23% beta-blocker poisoning, 7% salicylate poisoning and 1% patients with anti-diabetic agents acute poisoning). The prospective study identified 1,034 patients with acute poisoning, 20.11% of whom had ethanol poisoning, 11.79% had beta-blocker poisoning, 5.89% had wild mushroom poisoning, 1.74% had salicylate poisoning and the rest of 60.47% had other acute poisoning, without hypoglycemic risk. Attempted suicide with anti-diabetic agents in non-diabetic subjects produced the most severe and prolonged form of hypoglycemia in acute poisoning. 23 patients in retrospective study and 6 patients in prospective study died, but in only one situation, the death was the direct consequence of hypoglycemia. CONCLUSIONS: In non-diabetic subjects with acute poisoning, prevalence of toxic-induced hypoglycemia depends on the poison itself, the mechanism of poisoning, also depends on the association between toxics and the severity of toxic- induced liver disease. A useful test to assess toxic-induced hypoglycemia is standard 6 hour oral glucose tolerance test (OGTT). Factors predicting a negative outcome in toxic-induced hypoglycemia are association of toxins, cardiac and hepatic complications, and age (>65 years).

Adolescent↗

PubMed2004

Chronic inflammatory rheumatismal diseases--paraclinical diagnosis.

The rheumatismal diseases constitute a major problem of public health, the pathology of the locomotor system representing today the main cause of invalidity in the world. The inflammatory chronic rheumatisms affect the young population, and, between the onset of the disease and diagnosis (approximately one year), the patient does not accuse major clinical complaints. In this context, the present work proposes a presentation of the main paraclinic methods and techniques, which may direct the clinician in giving a correct and early diagnosis of the main chronic inflammatory rheumatismal disorders. The paraclinic methods and techniques for assessing the intensity and evolution of the chronic rheumatismal inflammatory processes may be classified as follows: genetic, biological, histological, and imagistic. The inflammatory reaction is a nonspecific long-term reaction of the body defense systems, as response to the continuous and recurrent aggression. It is characterized by the predominance of the lymphocytes and macrophages at the level of the focus infectious and an intense process of neoangiogenesis and fibroblastic proliferation accompanies it. The paraclinic methods and techniques for assessing the intensity and evolution of the chronic rheumatismal inflammatory processes may be classified as follows: genetic, biological, histological, and imagistic.

Biopsy↗

PubMedDate not supplied

[The coronary collateral system in man].

The aim of this work is to stand out the anastomotic network between the two coronary arteries. This satisfies the basic myocardiac activity, but it becomes inefficient in an increased cardiac consumption of oxygen. The anastomotic collateral system was confirmed imagistically and by necroptic pieces. The coronarographs in vitro, using BaSO4 as a contrast substance, proved the existence of anastomosis between branches emerging from the same coronary artery or from both sources. In human body, these collateral branches with a diameter less or equal to 40 m have a minor role in cardiac perfusion economy. In case of obstruction of a thick coronary branch, the anastomosis will develop in a few weeks; that is confirmed by the increase of blood-flow at this level. Combined studies of echography and angiography (1992) proved that developed anastomosis induce a decreased frequency of pathological cases related to the dynamics of the myocardiac wall at a lower level from the obstruction.

Adult↗

PubMedDate not supplied

[White-Bland -Garland syndrome: the maximum natural development of the coronary anastomosis ].

The anormalous origin of the left coronary artery from pulmonary artery (White-Bland Garland syndrome) is a very rare coronary malformation, having despite the great mortality in the early childhood, an adult form, characterized by minor symptoms and long course. This paradoxical situation is totally dependant to the complete development of the coronary anastomosis, allowing the right coronary flow to perfuse the left myocardium. The theory of the "terminal arterial perfusion" of the heart, still persistent in some monographs is meeting in this natural situation its strongest opponent argumentation. The coronary anastomosis, clearly visible by coronarography are large enough (in late stages) to inverse the flow in left coronary artery, filling the pulmonary artery. Is the coronary-pulmonary shunt, responsible for the majority of symptoms, in the 5th or 6th decade. The adult form of the White-Bland Garland syndrome is indicative for the maximum result we may hope to reach using the new revascularisation method for ischemic heart disease: new vessels formation and enhancing the coronary anastomosis by growth factors administration therapy.

Adult↗

PubMedDate not supplied

[White-Bland-Garland syndrome: the maximum natural development of the coronary anastomosis(II)].

The anomalous origin of the left coronary artery from pulmonary artery (White-Bland-Garland syndrome) is a very rare coronary malformation, having despite the great mortality in the early childhood, an adult form, characterized by minor symptoms and long course. This paradoxical situation is totally dependent to the complete development of the coronary anastomosis, allowing the right coronary flow to perfuse the left myocardium. The theory of the "terminal arterial perfusion" of the heart, still persistent in some monographs is meeting in this natural situation its strongest opponent argumentation. The coronary anastomosis, clearly visible by coronarography are large enough (in late stages) to inverse the flow in left coronary artery, filling the pulmonary artery. Is the coronary-pulmonary shunt, responsible for the majority of symptoms, in the 5th or 6th decades. The adult form of the White-Bland-Garland syndrome is indicative for the maximum result we may hope to reach using the new revascularisation method for ischemic heart disease: new vessels formation and enhancing the coronary anastomosis by growth factors administration therapy.

Coronary Artery Bypass↗

PubMedDate not supplied

[Anatomic and physiopathologic basis for the diagnosis and treatment of intestinal ischemia].

Changes of circulatory parameters in splanchnic territory lead to gut ischemia in an acute or chronic form (postprandial abdominal stroke). The implicated factors in intestinal ischemia are the timing and kind of onset, countercurrent vascularization and the eventuality of anastomotic subsystems for becoming hypertrophic. Superior mesenteric artery (SMA) is the "key" blood vessel implicated in the production of chronic intestinal ischemia, the atherosclerotic lesion being localized more frequent near SMA's ostium or even at ostium itself. Nonoclusif ischemia is induced by another stimulus that provokes mesenteric vasoconstriction, status that affects more the antimesenteric intestinal border, with a larger expansion at mucosa level. The most reseed diagnostic methods are selective angiographies and ultrasound examination. Usually chronic intestinal ischemia is clinically asymptomatic and becomes clinical evident just in the presence of an acute superposed factor or when at least two digestive arteries are affected. Revascularization methods are different, based on the type, mechanism and site of obstruction, each with its advantages and disadvantages. The most used method is retrograde aortomesenteric by-pass, at infrarenal aortic level (that is more accessible than the supraceliac aorta) and SMA reimplantation.

Humans↗

PubMedDate not supplied

[Mushroom poisoning in an autoimmune hepatitis patient].

Mushroom poisoning is responsible for initiation of severe life threatening syndromes, especially hepatic cytolysis. We are describing a case in which the helvelian syndrome induced by mushroom meal was masking the preexistent autoimmune hepatitis type 1. The course of disease under corticoids was satisfactory after one month of surveillance.

Adult↗

PubMedDate not supplied

[Anatomical and surgical considerations concerning the segmentation of the pancreas].

Pancreatic vascularization, especially the right segment (the head of the pancreas) has great surgical importance, due to its anatomical variety. From this practical point of view, establishing the type of the patient's pancreatic vascular pattern is highly recommended not just diagnosis purposes, but especially for its indispensable role in surgical decision. Selecting the appropriate technique, based on the imagistic evidences must consider the anatomical studies, which propose a systematic vision of the cephalic area vascularization, detecting two major types of arterial distribution. The first type is especially anastomotic; meanwhile the second one is terminal, these two varieties leading to a different surgical technique, best adapted for avoiding hemorrhages or ischemic necroses. Between the classic two segments of the pancreas (cephalic and caudal parts) there is a less vascularized area, which includes just an intersegmentary artery and the pancreatic duct, surgically sectioned during the separation operation of the two pancreatic segments. Vascular variety of the pancreas may be related to both embryological development of the pancreatic tissue, and that of the abdominal aortic branches.

Humans↗

PubMedDate not supplied

[Renal cell carcinoma- diagnosis by computed tomography].

In approximately 10% of cases, renal cell carcinoma (RCC) could present as a fluid- filled cystic mass. There are three mechanisms by which RCC may become cystic: extensive cystic necrosis, intrinsic cystic growth and origin from the epithelium lining a simple renal cyst. Simple renal cysts are very common. Uncommonly these cysts are complicated by hemorrhage, infection and possibly ischemia. The goal of the radiologist in evaluating these cystic lesions is to distinguish malignant neoplastic cystic masses from non-neoplastic complicated cysts so that appropriate management can be undertaken: RCC is best treated by surgical excision while non-neoplastic complicated cysts do not require surgery. The radiologic findings in these cystic masses which must be carefully evaluated include calcification, abnormal density, septations, nodularity, wall thickening and enhancement.

Carcinoma, Renal Cell↗

PubMedDate not supplied

[Staging and diagnosis in accidental hypothermia].

Core body temperature below 35 degrees C is defining arbitrarily hypothermia. There is no worldwide consensus concerning the staging and resuscitation strategies in such a vital emergency, not even in rewarming strategy. Accidental hypothermia has its own "survival chain", modifying some steps or the timing in the common cardiopulmonary resuscitation protocol, according to some particularities of the metabolism in such an accident. Taking into account the two major events during hypothermic conditions (ventricular fibrillation and coma), we have proposed a better borderline between the three severity classes, based on clinical, paraclinical and prognostic arguments. The interest in this special environmental emergency situation is coming not only from its incidence, but especially from its particular long time period in which the resuscitation maneuvers could be effective, so that a literature review mixed with our practical observations may be of didactical and legal benefit also.

Cardiopulmonary Resuscitation↗

PubMedDate not supplied

[Cajal interstitial cells identification].

Cajal interstitial cells are cells that are found in the abdominal digestive system wall, between neurons and smooth muscular tissue. They are considered to be pacemakers for slow intestinal waves. The paper discuss about the electron-microscopic identification of Cajal interstitial cells in the rat small intestine wall, cell morphology, placement of these cells in the muscular layer and the relation between Cajal interstitial cells and the components of the nervous plexus. Fragments of rat small intestine have been prepared for electron microscopy examination. Cajal interstitial cells have been found in different locations: in the circular muscular layer, around the nervous nodes and between the muscular layers (longitudinal and circular). The main morphologic characteristic of these cells is the aspect of cytoplasm, with numerous vacuoles and long extensions, some of them very thin, with a tendency to divide. Some Cajal interstitial cells form a network that surrounds the nervous nodes. Other form junctions with the muscular cells and with the interstitial neurons.

Animals↗

PubMedDate not supplied

[Consideration on serotoninergic syndrome based on a clinical situation ].

The diagnosis criteria for serotoninergic syndrome was first time proposed in 1991 by Sternbach, mixing clinical, biological and historical features. Drugs inducing serotonin accumulation by decreasing the synaptic recapture or increasing the serotoninergic transmission are responsible for the onset of this syndrome even in small amounts. We are describing a case of a young patient developing a comatose stage of serotoninergic syndrome as a result of Amitriptylinum and Sertralinum poisoning.

Adrenergic Uptake Inhibitors↗

PubMedDate not supplied

[Diagnostic problems in a case of chronic expanding hematoma].

We present a case of chronic expanding hematoma occurring in the right medial thigh. The patient was an 86 year-old woman who had this mass with slowly growth 3 years before. Ultrasonography showed a multilocular cyst and computed tomography an image of heterogeneous mass with capsule formation. A diagnose was unable to perform through both methods, which was confirmed by histopathological exam after successful surgical treatment. Microscopically, a fibrous pseudocapsule and in the central cavities blood clot, fibrin and necrotic debris were described.

Aged↗

PubMedDate not supplied

[Respiratory syndromes in acute poisoning].

Respiratory syndromes in acute poisoning can refer to a wide range of specific clinical syndromes, from acute tracheobronchitis to acute pulmonary edema, chemical pneumonia, acute respiratory distress syndrome and respiratory failure, that occur as a result of direct or indirect effect of chemical substances, drugs and toxins on lungs and airways. Our study attempt to identify, during one-year retrospective study on patients diagnosed with acute poisoning, addressed to Medical Clinic of Emergency Clinic Hospital of Iasi, the respiratory syndromes commonly associated with acute poisoning. We found that the association of toxins, inhalation of gases or volatile substances have a high risk for appearance of respiratory syndromes. The outcome of these patients is influenced by the duration of exposure or the delay of presentation to the hospital after ingestion, and depends on the rapid and aggressive measures for basic life support and intensive care.

Acute Disease↗

PubMedDate not supplied

[A rare cause of non-Q myocardial infarction--acute carbon monoxide poisoning].

Myocardial infarction is a rarely reported complication of acute carbon monoxide (CO) poisoning. We report the case of a 77 years old woman who presented to our emergency department with altered consciousness as a consequence of exposure to CO. The patient didn't experience any chest pain, but the electrocardiogram showed a non-Q-wave antero-septal acute myocardial infarction, with typical elevation in troponin T and creatine-phosphokinase MB levels. The patient recovered completely after specific treatment of poisoning with no major cardiac complication. We consider that careful electrocardiographic and enzymatic monitoring of all patients, especially elderly patients, in the first hours after CO exposure is important for early diagnosis and treatment of this rare complication of CO poisoning, and can improve the outcome of these patients.

Aged↗