Obesity and Overweight have the highest rate of incidence and prevalence in the past 3 decades, as global pathologies. The purpose of this study was to evaluate cardiovascular, classic and modern risk factors in overweight and obese patients by studying lipid metabolism (total cholesterol, HDL-cholesterol, non-HDL-cholesterol, LDL-cholesterol, serum triglycerides), glucose metabolism, insulin resistance and insulin sensitivity, the prevalence of hypertension (HBP) and the prevalence of metabolic syndrome (MS). This analytical study was performed on 111 subjects divided as follows: Group I consisting of 27 normal weight subjects - NW; Group II consisting of 84 overweight and obese subjects - OW + O: 36 overweight patients - OW; 33 patients with grade I obesity - O-I; 13 patients with grade II obesity - O-II; 2 patients with grade III obesity - O-III. The overweight and obese, although unknown with heart disease, have significant metabolic changes, such as atherogenic dyslipidemia, dysglycemia, high insulin resistance and low insulin sensitivity, metabolic syndrome, these being the first steps towards endothelial dysfunction and early atherosclerosis.
The emergence of multidrug-resistant (MDR) pathogens, especially for intensive care unit (ICU) patients is a serious threat to public health. To determine the frequency and antibiotic resistance pattern of bacterial pathogens isolated from tracheal aspirates of the patients admitted in ICU. The retrospective study included endotracheal aspirates from 734 patients admitted to the ICU, from January to December 2017. The analysis of the resistance patterns for the action of the appropriate antibiotics was performed using Vitek 2 Compact system and diffusion method. A total of 985 bacterial isolates were obtained, of which 227 strains of Klebsiella spp. (23.04%), followed by Nonfermenting Gram negative bacilli, other than Pseudomonas and Acinetobacter (NFB) (170- 17.25%), MRSA (134- 13.60%). Isolation rates indicates a higher value for male patients and elderly patients (over 65 years), statistically significant. High rates of MDR were found for Klebsiella spp. (70.04%) and Pseudomonas aeruginosa (66.25%) while almost all of the isolated NFB strains were MDR (98.82%). The study revealed high rates of MDR pathogens in the majority of ICU isolates which may be due to unnecessary use of higher generations of antibiotics, use of mechanical devices, age, comorbidities, and can determine a higher rate of morbidity and mortality among these patients.
Mask is an important prognostic factor in patient�s compliance to positive airways pressure. As there are a lot�s of factors that contribute to a good interface choosing the right mask remains a challenge. The aim of this study was to evaluate the importance of mask and mask materials in treatment compliance to positive airway pressure in a sample of Romanian patients hospitalized for sleep study. Other factors that may have influence on the compliance were also evaluated (severity of sleep apnea, the presence of symptoms, comorbidities and the type of device used (CPAP or BiPAP). 107 patients with newly diagnosed sleep apnea were included. They received positive airways pressure treatment with nasal or oronasal mask depending on their own preference and tolerance and they were followed for one year. After one year 70% of 107 patients were still on positive airway pressure treatment (CPAP or BiPAP). There seemed to be no difference between the two masks when looking at the whole group. When analyzing the subgroups, however there seemed to be a preference for the nasal mask in patients who were treated with CPAP and oronasal mask in patients treated with BiPAP, suggesting that the associated conditions (COPD) might play an more important role than the mask itself. The materials did not influence the compliance.
The justification for choosing and this enzyme marker to investigate the variation in serum concentration is supported by at least two arguments: cytokine myeloperoxidase at the level of the hypocritical myocardium, with or without contractile deficiency, can be secreted by any type of component or resident in the myocardium In cardiac failure, one of the forms that responds to the oxidative stress existing in the disease is MPO secretion that occurs early after some authors even during Class I contractile myocardial deficiency (NYHA classification).
Rosai–Dorfman Disease (RDD), also known as sinus histiocytosis, is included in the group of rare diseases, characterized by proliferation and accumulation of histiocytes in the lymph nodes (lymphadenopathy), most often involving the cervical ganglion chains (nodal form). RDD bone involvement is rare, estimated at 10% of cases, but primary bone involvement (extranodal form), is very rare—2–8%. Usually they are solitary lesions, with multifocal primary bone manifestations being extremely rare. Histopathological analysis is of high value for a correct diagnosis. We present the case of a Caucasian woman, 42 years old, initially treated in another clinic, for an osteolytic tumor formation in the right tibial shaft. An excisional biopsy with bone trepanation was performed, the histopathological diagnosis being the chronic inflammatory tissue. The evolution was atypical, with tumor growth, extraosseous, subcutaneous. A needle biopsy was repeated in our clinic, the result being similar to the original one. Evolution of the tumor, and the radiological and imaging aspect (periosteal reaction, eroded and thin bone cortex) suggested a more aggressive disease, these being in inconsistency with the result obtained. The biopsy was repeated, as an excision type this time. The histopathological result and immunohistochemistry indicated an RDD primary bone lesion. Based on this result, and corroborated with the data from the literature, we initiated the surgical treatment, curettage and grafting with bone substitute plus safety osteosynthesis with locked plaque, the patient registering a favorable evolution. RDD primary bone lesions are in fact an atypical manifestation of a rare disease. The correct diagnosis is very difficult due to the non-specific imaging aspect. Histopathological examination errors, especially in the case of needle biopsies can lead to errors in diagnosis and treatment with negative results for the patient.
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