Pub Date : 2019-02-20DOI: 10.12680/balneo.2019.231
M. Catană, C. Roman-Filip
Abstract Twenty percent of strokes occurring in young patients are represented by posterior ischemic strokes. Acute basilar occlusion is a devastating, life-threatening condition, with the highest mortality in young patients. We present the case of a 33-year-old female patient, without vascular risk factors or oral contraceptive treatment, admitted to our department through the emergency ward for comatose state – Glasgow Coma Scale (GCS) 11 points, headaches, right-sided hemiparesis, dizziness and vomiting, with acute onset. CT angiography was performed, which showed left vertebral artery with no flow in the intradural section and absent flow in the basilar artery. After more than 12 hours from onset, endarterectomy was excluded; initiation of treatment with heparin 1000 IU/hour was decided. MRI performed after 24 hours revealed: subacute median and left paramedian pontine ischemic stroke, subacute stroke in the base of the left midbrain peduncle. The following diagnosis was established: pontine ischemic stroke caused by two autoimmune diseases: thrombophilia and antiphospholipid antibody syndrome. Our patient started rehabilitation very early and was discharged with the following neurological sequelae: tetraparesis with the predominance of left hemiparesis: 4/5 on the Medical Research Council strength scale (MRC) – right limbs, 3/5 on the Medical Research Council strength scale (MRC) – left limbs, and dysphagia for liquids.
{"title":"Neurorehabilitation in basilar artery occlusion in a young patient with thrombophilia and antiphospholipid antibody syndrome – a case report","authors":"M. Catană, C. Roman-Filip","doi":"10.12680/balneo.2019.231","DOIUrl":"https://doi.org/10.12680/balneo.2019.231","url":null,"abstract":"Abstract Twenty percent of strokes occurring in young patients are represented by posterior ischemic strokes. Acute basilar occlusion is a devastating, life-threatening condition, with the highest mortality in young patients. We present the case of a 33-year-old female patient, without vascular risk factors or oral contraceptive treatment, admitted to our department through the emergency ward for comatose state – Glasgow Coma Scale (GCS) 11 points, headaches, right-sided hemiparesis, dizziness and vomiting, with acute onset. CT angiography was performed, which showed left vertebral artery with no flow in the intradural section and absent flow in the basilar artery. After more than 12 hours from onset, endarterectomy was excluded; initiation of treatment with heparin 1000 IU/hour was decided. MRI performed after 24 hours revealed: subacute median and left paramedian pontine ischemic stroke, subacute stroke in the base of the left midbrain peduncle. The following diagnosis was established: pontine ischemic stroke caused by two autoimmune diseases: thrombophilia and antiphospholipid antibody syndrome. Our patient started rehabilitation very early and was discharged with the following neurological sequelae: tetraparesis with the predominance of left hemiparesis: 4/5 on the Medical Research Council strength scale (MRC) – right limbs, 3/5 on the Medical Research Council strength scale (MRC) – left limbs, and dysphagia for liquids.","PeriodicalId":43815,"journal":{"name":"Balneo Research Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46804529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-20DOI: 10.12680/balneo.2019.230
Ioana Para, C. Pharmacy, L. Ciumărnean, T. Alexescu, E. Domsa, M. Milaciu, A. Albu
Abstract Non-steroidal anti-inflammatory drugs (NSAIDs) are extensively used worldwide due to their analgesic, antipyretic and antiinflammatory effects. NSAIDs (both non-selective NSAIDs and selective cyclooxygenase-2 inhibitors) have nephrotoxic potential, particularly when used chronically.The principal mechanism of action of NSAIDs is cyclooxygenase inhibition, which prevents the conversion of arachidonic acid to prostaglandins, prostacyclins and thromboxanes. In the kidney, prostaglandins induce vasodilation and counter the action of the renin-angiotensin-aldosterone system and the sympathetic nervous system, ensuring optimal renal perfusion. Inhibition of this mechanism by NSAIDs can result in renal damage: acute kidney injury through hemodynamic mechanism, acute interstitial nephritis, glomerular disease, papillary necrosis, water and electrolyte imbalances, HTN. Chronic NSAID use may lead to chronic kidney disease.The nephrotoxic effect is reduced in young patients without renal disease or other comorbidities, but increases significantly in elderly patients with pre-existing kidney disease, nephrotic syndrome, diabetes mellitus, severe congestive heart failure, volume depletion, cirrhosis with ascites, HTN, atherosclerosis, or in patients under treatment with diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor inhibitors.
{"title":"Renal damage induced by non-steroidal anti-inflammatory drug treatment","authors":"Ioana Para, C. Pharmacy, L. Ciumărnean, T. Alexescu, E. Domsa, M. Milaciu, A. Albu","doi":"10.12680/balneo.2019.230","DOIUrl":"https://doi.org/10.12680/balneo.2019.230","url":null,"abstract":"Abstract Non-steroidal anti-inflammatory drugs (NSAIDs) are extensively used worldwide due to their analgesic, antipyretic and antiinflammatory effects. NSAIDs (both non-selective NSAIDs and selective cyclooxygenase-2 inhibitors) have nephrotoxic potential, particularly when used chronically.The principal mechanism of action of NSAIDs is cyclooxygenase inhibition, which prevents the conversion of arachidonic acid to prostaglandins, prostacyclins and thromboxanes. In the kidney, prostaglandins induce vasodilation and counter the action of the renin-angiotensin-aldosterone system and the sympathetic nervous system, ensuring optimal renal perfusion. Inhibition of this mechanism by NSAIDs can result in renal damage: acute kidney injury through hemodynamic mechanism, acute interstitial nephritis, glomerular disease, papillary necrosis, water and electrolyte imbalances, HTN. Chronic NSAID use may lead to chronic kidney disease.The nephrotoxic effect is reduced in young patients without renal disease or other comorbidities, but increases significantly in elderly patients with pre-existing kidney disease, nephrotic syndrome, diabetes mellitus, severe congestive heart failure, volume depletion, cirrhosis with ascites, HTN, atherosclerosis, or in patients under treatment with diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor inhibitors.","PeriodicalId":43815,"journal":{"name":"Balneo Research Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43770696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-20DOI: 10.12680/BALNEO.2019.237
T. Alexescu, R. Cluj-Napoca, A. Maierean, L. Ciumărnean, C. Budin, G. Dogaru, D. Todea, student Pharmacy Cluj-Napoca, C. Pharmacy
{"title":"Rehabilitation therapies in stable chronic obstructive pulmonary disease","authors":"T. Alexescu, R. Cluj-Napoca, A. Maierean, L. Ciumărnean, C. Budin, G. Dogaru, D. Todea, student Pharmacy Cluj-Napoca, C. Pharmacy","doi":"10.12680/BALNEO.2019.237","DOIUrl":"https://doi.org/10.12680/BALNEO.2019.237","url":null,"abstract":"","PeriodicalId":43815,"journal":{"name":"Balneo Research Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42860508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-20DOI: 10.12680/balneo.2019.233
A. Bulboacă, A. Bulboacă, I. Stanescu, M. Blidaru, A. Bulboacă, C. Nicula, G. Dogaru, I. Hațieganu, C. Pharmacy
{"title":"Post-stroke visual rehabilitation - the impact on life quality of the stroke survival patients - a brief review","authors":"A. Bulboacă, A. Bulboacă, I. Stanescu, M. Blidaru, A. Bulboacă, C. Nicula, G. Dogaru, I. Hațieganu, C. Pharmacy","doi":"10.12680/balneo.2019.233","DOIUrl":"https://doi.org/10.12680/balneo.2019.233","url":null,"abstract":"","PeriodicalId":43815,"journal":{"name":"Balneo Research Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45736197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-20DOI: 10.12680/BALNEO.2019.241
S. Kardeş
{"title":"Nullius in verba: \"Canakinumab for the Treatment of Autoinflammatory Recurrent Fever Syndromes\" in NEJM","authors":"S. Kardeş","doi":"10.12680/BALNEO.2019.241","DOIUrl":"https://doi.org/10.12680/BALNEO.2019.241","url":null,"abstract":"","PeriodicalId":43815,"journal":{"name":"Balneo Research Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49162350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-20DOI: 10.12680/BALNEO.2019.239
Catalin Ionite, R. P. Iași, M. Rotariu, M. Turnea
{"title":"A statistical study on the recovery of pubalgic syndrome in football players","authors":"Catalin Ionite, R. P. Iași, M. Rotariu, M. Turnea","doi":"10.12680/BALNEO.2019.239","DOIUrl":"https://doi.org/10.12680/BALNEO.2019.239","url":null,"abstract":"","PeriodicalId":43815,"journal":{"name":"Balneo Research Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44858533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-20DOI: 10.12680/balneo.2019.234
Dana Marieta Fodor, M. Fodor, I. Stanescu, G. Dogaru, L. Perju-Dumbravă
{"title":"The influence of circadian variation in ischemic stroke onset on the evolution of the severity of the clinical picture and disability","authors":"Dana Marieta Fodor, M. Fodor, I. Stanescu, G. Dogaru, L. Perju-Dumbravă","doi":"10.12680/balneo.2019.234","DOIUrl":"https://doi.org/10.12680/balneo.2019.234","url":null,"abstract":"","PeriodicalId":43815,"journal":{"name":"Balneo Research Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42131928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-20DOI: 10.12680/balneo.2019.240
D. Matei, R. P. Iași, C. Luca, D. Andritoi, R. Fuior, D. Zaharia, Ilie Onu, C. Corciova
Abstract Introduction: Parkinson’s disease (PD) is a chronic illness which damages central and peripheral nervous system. The presence of peripheral neuropathy (PN) in PD, it has been suggested to be the effect of treatment. The aim of this study was to investigate autonomic cardiac control in PD patients with normal serum levels of vitamin B12 by means of spectral analysis of short-term heart rate variability (HRV) and also to assess the prevalence of PN using electrophysiological examinations. Methods: 30 (18 male and 12 female) with PD were compared to 20 ageand sex-matched control subjects. Short-term ECG was used to calculate time domain and spectral parameters of HRV. The stimulodetection examination was realized in the motor fibers of median, peroneal and tibial nerves, and in the sensitive fibers of median and sural nerve according to the standard procedures. Results: Low and high frequency were lower in PD patients than in controls (LF: 332.±288.4 ms2 PD vs 723.9±348.2 ms2 C; HF: 283.72±241.97 ms2 PD vs 530.54±226.5 ms2 C, p<0.01). No differences between LF/HF ratio of PD and controls appeared. Sensory nerve action potential in sural nerve was reduced in PD patients. No differences between sensory and motor nerve conduction velocities of PD and controls appeared. Conclusions: PD causes dysfunction of autonomic cardiovascular regulation and peripheral nerve involvement.
摘要简介：帕金森病是一种损害中枢和外周神经系统的慢性疾病。帕金森病患者存在周围神经病变（PN），这被认为是治疗的效果。本研究的目的是通过短期心率变异性（HRV）的频谱分析，研究血清维生素B12水平正常的PD患者的自主心脏控制，并通过电生理检查评估PN的患病率。方法：将30例帕金森病患者（男18例，女12例）与20例年龄性别匹配的对照组进行比较。短期心电图用于计算HRV的时域和频谱参数。根据标准程序对正中神经、腓神经和胫神经的运动纤维以及正中神经和腓肠神经的敏感纤维进行刺激检测。结果：PD患者的低频率和高频率均低于对照组（LF:332.±288.4ms2 PD vs 723.9±348.2ms2 C；HF:283.72±241.97ms2 PD vs 530.54±226.5ms2 C，p<0.01）。帕金森病患者腓肠神经的感觉神经动作电位降低。帕金森病患者和对照组的感觉和运动神经传导速度没有差异。结论：帕金森病可引起自主心血管调节功能障碍和周围神经受累。
{"title":"Autonomic dysfunction and peripheral nerve involvement in patients with Parkinson's disease","authors":"D. Matei, R. P. Iași, C. Luca, D. Andritoi, R. Fuior, D. Zaharia, Ilie Onu, C. Corciova","doi":"10.12680/balneo.2019.240","DOIUrl":"https://doi.org/10.12680/balneo.2019.240","url":null,"abstract":"Abstract Introduction: Parkinson’s disease (PD) is a chronic illness which damages central and peripheral nervous system. The presence of peripheral neuropathy (PN) in PD, it has been suggested to be the effect of treatment. The aim of this study was to investigate autonomic cardiac control in PD patients with normal serum levels of vitamin B12 by means of spectral analysis of short-term heart rate variability (HRV) and also to assess the prevalence of PN using electrophysiological examinations. Methods: 30 (18 male and 12 female) with PD were compared to 20 ageand sex-matched control subjects. Short-term ECG was used to calculate time domain and spectral parameters of HRV. The stimulodetection examination was realized in the motor fibers of median, peroneal and tibial nerves, and in the sensitive fibers of median and sural nerve according to the standard procedures. Results: Low and high frequency were lower in PD patients than in controls (LF: 332.±288.4 ms2 PD vs 723.9±348.2 ms2 C; HF: 283.72±241.97 ms2 PD vs 530.54±226.5 ms2 C, p<0.01). No differences between LF/HF ratio of PD and controls appeared. Sensory nerve action potential in sural nerve was reduced in PD patients. No differences between sensory and motor nerve conduction velocities of PD and controls appeared. Conclusions: PD causes dysfunction of autonomic cardiovascular regulation and peripheral nerve involvement.","PeriodicalId":43815,"journal":{"name":"Balneo Research Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48162716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-20DOI: 10.12680/balneo.2019.236
M. Mocan, C. Pharmacy, B. Mocan
Abstract In the last decades, we have witnessed a drastic increase in the proportion of elders in the western countries, and more than a third of worldwide population dies because of cardiovascular diseases. The elderly patients with cardiovascular diseases, but not only, are frail and need constant assistance, and so the healthcare system will slowly become incapable of properly address all the patients’ medical problems and rehabilitation issues, while aiming towards a continuous increase of the life quality. The rehabilitation robotic systems have the potential to stimulate and support the re-learning of the functional motor pattern of over-ground walking in an optimal manner while increasing patient’s motivation, which constitutes a crucial element in the subject's cardiac recovery. Thus, the present article aims at reviewing the robotic systems available for cardiac rehabilitation in elders with cardiac pathology.
{"title":"Cardiac rehabilitation for older patients with cardiovascular pathology using robotic systems – A survey","authors":"M. Mocan, C. Pharmacy, B. Mocan","doi":"10.12680/balneo.2019.236","DOIUrl":"https://doi.org/10.12680/balneo.2019.236","url":null,"abstract":"Abstract In the last decades, we have witnessed a drastic increase in the proportion of elders in the western countries, and more than a third of worldwide population dies because of cardiovascular diseases. The elderly patients with cardiovascular diseases, but not only, are frail and need constant assistance, and so the healthcare system will slowly become incapable of properly address all the patients’ medical problems and rehabilitation issues, while aiming towards a continuous increase of the life quality. The rehabilitation robotic systems have the potential to stimulate and support the re-learning of the functional motor pattern of over-ground walking in an optimal manner while increasing patient’s motivation, which constitutes a crucial element in the subject's cardiac recovery. Thus, the present article aims at reviewing the robotic systems available for cardiac rehabilitation in elders with cardiac pathology.","PeriodicalId":43815,"journal":{"name":"Balneo Research Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46735259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-20DOI: 10.12680/BALNEO.2019.232
Laszlo Irsay, R. Cluj-Napoca, Alexandra Checicheș, Dănuț Perja, Ileana Monica Borda, G. Dogaru, I. Onac, R. Ungur, V. Ciortea
Chronic kidney disease (CKD) is one of the most frequently seen comorbidities in patients suffering from musculoskeletal conditions; it is defined by a glomerular filtration rate (GFR) under 60 ml/min/1.73 m2. The following paper focuses on providing a dosage adjustment guideline depending on how advanced renal impairment is. A literature search was carried out using the following items: pharmacokinetics, side effects, drug interactions and dosage, pain medication and antirheumatic drugs in renal failure. The use of non-steroidal anti-inflammatory drugs is inadvisable for a GFR < 30 ml/min as they all pose the risk of inducing acute renal damage, as well as worsening of the underlying chronic renal disease. Non-steroidal antiinflammatory drugs (NSAIDs) should be avoided due to the possibility of kidney disease progression. Paracetamol is an analgesic often chosen in this category of patients. As far as opioid analgesics are concerned, methadone is the only one that can be used without dosage adjustment. Physiotherapy remains a good and safe option for treatment in patients with musculoskeletal complaints. The use of analgesics in patients with CKD continues to be a challenge, as more research is needed.
{"title":"Pharmacological pain management in patients with chronic kidney disease","authors":"Laszlo Irsay, R. Cluj-Napoca, Alexandra Checicheș, Dănuț Perja, Ileana Monica Borda, G. Dogaru, I. Onac, R. Ungur, V. Ciortea","doi":"10.12680/BALNEO.2019.232","DOIUrl":"https://doi.org/10.12680/BALNEO.2019.232","url":null,"abstract":"Chronic kidney disease (CKD) is one of the most frequently seen comorbidities in patients suffering from musculoskeletal conditions; it is defined by a glomerular filtration rate (GFR) under 60 ml/min/1.73 m2. The following paper focuses on providing a dosage adjustment guideline depending on how advanced renal impairment is. A literature search was carried out using the following items: pharmacokinetics, side effects, drug interactions and dosage, pain medication and antirheumatic drugs in renal failure. The use of non-steroidal anti-inflammatory drugs is inadvisable for a GFR < 30 ml/min as they all pose the risk of inducing acute renal damage, as well as worsening of the underlying chronic renal disease. Non-steroidal antiinflammatory drugs (NSAIDs) should be avoided due to the possibility of kidney disease progression. Paracetamol is an analgesic often chosen in this category of patients. As far as opioid analgesics are concerned, methadone is the only one that can be used without dosage adjustment. Physiotherapy remains a good and safe option for treatment in patients with musculoskeletal complaints. The use of analgesics in patients with CKD continues to be a challenge, as more research is needed.","PeriodicalId":43815,"journal":{"name":"Balneo Research Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47007685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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