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V Tudorache

Publications and source records attributed to V Tudorache.

12 recordsLinked to original sources

A clinical description of rifampicin-induced acute renal failure in 170 consecutive cases.

Rifampicin re-administration may cause immunologically mediated acute tubulo-interstitial injury. Retrospectively, 170 consecutive cases with acute renal failure (ARF) following re-treatment with rifampicin (71% males, 29% females, age 21 to 68 years) were analysed, which accounted for 12% of all ARF patients treated by two large dialysis referral centres in Romania, Timisoara and Iasi, between 1974-2001 and 1988-2001, respectively. The most frequent clinical features of rifampicin-induced ARF were: Anuria, gastro-intestinal (abdominal pain, nausea, vomiting and diarrhoea) and "flu-like" symptoms. Urine analysis revealed sterile leucocyturia in 54%, proteinuria in 31%, haematuria in 26% and haemoglobinuria in 7% of cases. Haemolytic anaemia was frequent, found in 66% of the patients; half of these had Hct values of < 30%, thrombocytopenia and also more severe renal damage (a longer anuric phase and a slower recovery of the renal function), thus suggesting a severe multi-target autoimmune aggression. The association of hepatic injury--not explained by prior hepatic disease, B or C hepatitis virus infection or history of alcohol abuse--was encountered in 17% of the cases, without a significant influence on the renal and the general outcome. The outcome of rifampicin-induced ARF is generally favourable, with complete recovery of the renal function within 30 days in 52% of the cases and within 90 days in 92% of the cases. The mortality rate was 3.5%, compared to 21% for the overall ARF population treated during the same period (p < 0.05).

Acute Kidney Injury↗

[Test for determination of attention in patients with sleep apnea syndrome].

To investigate the daytime sleepiness in patients with sleep apnea syndrome, we used a test for measurement of sustained attention. The present study was performed on 65 participants: 10 healthy non-snoring volunteers, 25 snoring volunteers and 30 patients with symptoms of sleep apnea. The error rate (percentage of incorrect responses) appears to be most suitable for the evaluation of the test. The difference between the habitual snorers and the healthy non-snoring volunteers was statistically significant. At the apneic patients, there are significant differences in age, sex, and body mass index; attention decreases significantly in the last 10 minutes of the test. The attention test can be helpful for the measurement of daytime sleepiness in apneic patients.

Attention↗

[Why not to smoke?].

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Arteriosclerosis↗

[Specific features of acute renal failure in patients treated with rifampicin].

This retrospective study was performed on 92 patients diagnosed with acute renal failure (ARF) post discontinuous rifampicin treatment, admitted between 1974-2000, in Hemodialysis Center of 1st Timisoara Clinical County Hospital. The passage from the continuous treatment (7/7) to discontinuous RMP treatment triggered the ARF in 77 patients and the restart of the treatment after one year or more of treatment arrest, lead to ARF in 15 cases. The ARF symptomatology appeared in the first 12 hrs of treatment resumption in 14.13% cases and in 85.87% after 38.5 +/- 8.2 hrs. The most frequent symptoms were lumbar pain in 76.08%, nausea and vomiting in 60.86%, abdominal pain (52.17% of cases) flu-like (fever, chills, myalgia), jaundice, diarrhea, hypotension, confusion and hypertension in only 7.6% of cases. In 94.56% of cases renal symptoms appeared in normal kidneys. The renal injury evolution was favorable, with significant improvements after 20 days in serum and urine biological parameters. The antibodies anti-RMP were present in serum 55.43% of patients, in 80.39% of them, the presence of antibodies was related to high values of gamma-globulins. In 33.69% of patients sterile leukocyturia, considered a marker of interstitial nephritis, was present. The most frequent associated ARF complications were the hemolytic anemia emphasized by high levels of unconjugated bilirubin and positive Coombs' test in 93.3% of patients, and liver injuries, present in 41.69% of cases. Thrombocytopenia was registered in 27.7% of cases, infections in 28.6%, gastrointestinal complications in 11.95%, and cardiovascular complications in 9.78% of cases, these severe forms leading to the death of patients. The ARF post discontinuous rifampicin treatment presents a favorable evolution even when it is associated with other organ or systems complications. The ARF and associated complications are due to the specific immune system activation by rifampicin, and by direct toxic effects of rifampicin at tissues level.

Acute Kidney Injury↗

[Atrial myxoma: a challenge for the pneumologist].

It presents a 59 years old woman with atypical symptoms, which orientated the diagnostic thinking during one year to a reccurrent pneumonitis, bronchial asthma, colagenosis, interstitial pulmonary fibrosis and so on. The appearance of pulmonary edema determined a couple of cardiologic exams which came to obiectivate as the main cause, the existence of a left atrial mixoma who was invaginated in left mitral cusp. Surgical intervention permitted not only specific determination of histological type of tumor, but lead to healing of the patient. It is a discussion over epidemiology, clinical areas of manifestation and methods of diagnostic of atrial tumors.

Female↗

[The evaluation of the measurement of serum fibronectin in pulmonary tuberculosis].

The investigation was carried out in 125 patients with pulmonary tuberculosis in different stages of evolution. The treatment was that granted, used in triple and/or quadruple scheme twice a week. In the greatest part of the patients the concentration of serum fibronectine (sFN) was followed in its dynamics. A reasonable increase (statistical average) of the sFN was found in the patients with tuberculosis (tbc), active at the first treatment. The values regressed slowly, parallel to the favourable evolution under treatment. In the chronic forms, values situated at the normal or at the inferior limit were recorded. They were probably due to the sum of factors often met in these patients: protein-caloric malnutrition, chronic alcoholism with afferent hepatopathies, nonspecific chronic bronchial suppurations. No significant correlation of the sFN concentration was noticed in relation to the radiologic extension of the lesions, to the structure of the chemotherapeutic regimen, or to age. There exists a large variability of the sFN concentration in tbc, both at the beginning and during chemotherapy. The sFN level is not enough for the assessment of the disease stage or evolution; for increasing its informational value, the concentration of the immune circulatory complexes (ICC) and the lymphocytic subsets T were investigated.

Adolescent↗