A. Forray, Anca-Georgiana Gologan, M. Coman, R. Cherecheș, Dumitru Petreus, Sveatoslav Vizitiu, C. Borzan
Abstract The prevalence of Non-Communicable Diseases (NCDs) is an important public health problem in Romania, where, nutrition transition has taken place and has resulted in a more westernized dietary pattern, especially among children and adolescents. WHO has identified schools as the ideal place to educate children and adolescents efficiently in Food and Nutrition Literacy (FNLIT). The present research consisted of a pilot study to determine the effectiveness of a nutrition education programme implemented among lower secondary school children by investigating whether students tended to score higher in several FNLIT domains at post-test compared to the pre-test average. The implementation of the intervention consisted of five lessons in online or physical classes. Even if the intervention period had a relatively short period of implementation improvements in understanding, interactive food and nutrition literacy, critical food and label literacy were observed. Future research should focus on expanding the intervention in other schools.
{"title":"A Pilot Study to Examine the Effects of a School-Based Intervention for Promoting Food and Nutrition Literacy (FNLIT) in Romanian School Children","authors":"A. Forray, Anca-Georgiana Gologan, M. Coman, R. Cherecheș, Dumitru Petreus, Sveatoslav Vizitiu, C. Borzan","doi":"10.2478/amtsb-2021-0041","DOIUrl":"https://doi.org/10.2478/amtsb-2021-0041","url":null,"abstract":"Abstract The prevalence of Non-Communicable Diseases (NCDs) is an important public health problem in Romania, where, nutrition transition has taken place and has resulted in a more westernized dietary pattern, especially among children and adolescents. WHO has identified schools as the ideal place to educate children and adolescents efficiently in Food and Nutrition Literacy (FNLIT). The present research consisted of a pilot study to determine the effectiveness of a nutrition education programme implemented among lower secondary school children by investigating whether students tended to score higher in several FNLIT domains at post-test compared to the pre-test average. The implementation of the intervention consisted of five lessons in online or physical classes. Even if the intervention period had a relatively short period of implementation improvements in understanding, interactive food and nutrition literacy, critical food and label literacy were observed. Future research should focus on expanding the intervention in other schools.","PeriodicalId":7091,"journal":{"name":"Acta Medica Transilvanica","volume":"26 1","pages":"12 - 17"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49569988","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}
Nicoleta-Alina Popa, Adina-Marieta Sipos, M. Popescu
Abstract Chronic obstructive pulmonary disease (COPD) is a chronic disease of the respiratory airways due to the partially reversible obstruction of the airflow caused by an abnormal inflammatory response to toxic substances, most often to cigarette smoke.(1) COVID-19 is a mild to severe respiratory disease caused by a coronavirus from the genus Betacoronavirus.(2) Patients with COPD have a major risk of COVID-19 infection. Treating patients with COPD, chronic cor pulmonale and COVID-19 is a current challenge.
{"title":"Evolutionary and Prognostic Particularities in Patients with COPD, Chronic Cor Pulmonale and COVID-19","authors":"Nicoleta-Alina Popa, Adina-Marieta Sipos, M. Popescu","doi":"10.2478/amtsb-2021-0046","DOIUrl":"https://doi.org/10.2478/amtsb-2021-0046","url":null,"abstract":"Abstract Chronic obstructive pulmonary disease (COPD) is a chronic disease of the respiratory airways due to the partially reversible obstruction of the airflow caused by an abnormal inflammatory response to toxic substances, most often to cigarette smoke.(1) COVID-19 is a mild to severe respiratory disease caused by a coronavirus from the genus Betacoronavirus.(2) Patients with COPD have a major risk of COVID-19 infection. Treating patients with COPD, chronic cor pulmonale and COVID-19 is a current challenge.","PeriodicalId":7091,"journal":{"name":"Acta Medica Transilvanica","volume":"26 1","pages":"34 - 36"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43112384","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}
Lucia Mihaela Custură, Oana Deteșan, R. Tilinca, Reka Annamaria Schmiedt, Brigitta Irén Bacso, M. Tilinca
Abstract Latent autoimmune diabetes in adults (LADA) is a frequently encountered condition in medical practice. It should be suspected in patients where the type of the diabetes mellitus is not certain. LADA consists of features from both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), being a condition which is often unnoticed. Considered as type 1.5 diabetes mellitus, the lack of insulin requirement at disease onset makes it initially to be included in T2DM in terms of therapeutic management. The improvement of the screening methods allows the detection of LADA at an early stage, therefore medical intervention should be effective in preserving beta-cell function and to delay the progression of the disease.
{"title":"Lada or Type 2 Diabetes Mellitus - A Challenging Diagnosis in Clinical Approach","authors":"Lucia Mihaela Custură, Oana Deteșan, R. Tilinca, Reka Annamaria Schmiedt, Brigitta Irén Bacso, M. Tilinca","doi":"10.2478/amtsb-2021-0052","DOIUrl":"https://doi.org/10.2478/amtsb-2021-0052","url":null,"abstract":"Abstract Latent autoimmune diabetes in adults (LADA) is a frequently encountered condition in medical practice. It should be suspected in patients where the type of the diabetes mellitus is not certain. LADA consists of features from both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), being a condition which is often unnoticed. Considered as type 1.5 diabetes mellitus, the lack of insulin requirement at disease onset makes it initially to be included in T2DM in terms of therapeutic management. The improvement of the screening methods allows the detection of LADA at an early stage, therefore medical intervention should be effective in preserving beta-cell function and to delay the progression of the disease.","PeriodicalId":7091,"journal":{"name":"Acta Medica Transilvanica","volume":"26 1","pages":"55 - 58"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43831038","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}
Andreea Sălcudean, Bianca-Eugenia Ősz, E. Strete, Monica Kiss, M. Pașca, C. Bodo, Maria-Melania Lica, Andreea-Georgiana Nan, Marius-Cătălin Cosma, M. Tilinca
Abstract Schizophrenic patients have a life expectancy shorter than that of the general population. The multisystemic implication of the psychotic disease is evidenced by the high prevalence of somatic comorbidities associated with the illness. Patients with schizophrenia have a higher risk to develop somatic comorbidities due to their lifestyle changes, medication intake and poor medical assistance. We conducted a retrospective descriptive study in order to determine the prevalence of certain somatic conditions associated with schizophrenia as well as the characteristics of this particular group of patients.
{"title":"Somatic Implications in Hospitalized Patients with Chronic Schizophrenia","authors":"Andreea Sălcudean, Bianca-Eugenia Ősz, E. Strete, Monica Kiss, M. Pașca, C. Bodo, Maria-Melania Lica, Andreea-Georgiana Nan, Marius-Cătălin Cosma, M. Tilinca","doi":"10.2478/amtsb-2021-0047","DOIUrl":"https://doi.org/10.2478/amtsb-2021-0047","url":null,"abstract":"Abstract Schizophrenic patients have a life expectancy shorter than that of the general population. The multisystemic implication of the psychotic disease is evidenced by the high prevalence of somatic comorbidities associated with the illness. Patients with schizophrenia have a higher risk to develop somatic comorbidities due to their lifestyle changes, medication intake and poor medical assistance. We conducted a retrospective descriptive study in order to determine the prevalence of certain somatic conditions associated with schizophrenia as well as the characteristics of this particular group of patients.","PeriodicalId":7091,"journal":{"name":"Acta Medica Transilvanica","volume":"26 1","pages":"37 - 41"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41619876","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}
Abstract This article presents the clinical case of IgA nephropathy of a patient hospitalized in order to investigate a nephritic syndrome, apparently with acute onset, discovered in the following circumstances: recurrent macroscopic hematuria, decreased urinary volume, the first episode occurring about a month ago in the context of an acute infection of upper airways, remitted under antibiotic therapy, with reappearance every 2 weeks, also accompanied by odynophagia and decreased urinary volume.
{"title":"Tonsillectomy in IgA Nephropathy - Clinical Case","authors":"L. Popa, L. Popa, Cătălin-Bogdan Osalciuc","doi":"10.2478/amtsb-2021-0053","DOIUrl":"https://doi.org/10.2478/amtsb-2021-0053","url":null,"abstract":"Abstract This article presents the clinical case of IgA nephropathy of a patient hospitalized in order to investigate a nephritic syndrome, apparently with acute onset, discovered in the following circumstances: recurrent macroscopic hematuria, decreased urinary volume, the first episode occurring about a month ago in the context of an acute infection of upper airways, remitted under antibiotic therapy, with reappearance every 2 weeks, also accompanied by odynophagia and decreased urinary volume.","PeriodicalId":7091,"journal":{"name":"Acta Medica Transilvanica","volume":" ","pages":"59 - 61"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44468572","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}
Abstract Aim: This study aimed to investigate the impact of more than one year of COVID-19 pandemic on the quality of life and mental health (in terms of depression, anxiety, stress, fear, burnout – workload) among Frontline Health Care Workers (HCWs). Subjects and methods: This is a cross-sectional survey based on 1,479 frontline HCW participants aged 20-65 years in Turkey who completed a survey including the 21-item Depression, Anxiety, Stress Scale (DASS-21), Burnout, Fear of COVID-19 Scale (FCV-19S), and WHO (World Health Organization) Quality of Life instruments during March-July 2021. Bivariate, factorial and multivariate statistical analyses were performed. Results: Statistically significant differences were found between three frontline groups of HCWs (Physicians, Nurses, Others) including: age (p<0.001), gender (p<0.001), educational level (p<0.001), income (p<0.001), number of calls per week (p<0.001). There were significantly high scores of fear of COVID-19 for all items among physicians. The findings also showed that the prevalence of depression (p=0.002), anxiety (p<0.001), and stress (p<10.005) and Pittsburgh Sleep Quality Index (p=0.011) were significantly different among the three groups of frontline HCWs. The work-related burnout was over 30% in general. The Kaiser-Meyer-Olkin Measure was 0.840 and indicated that the data of the study were suitable for a factor analysis. The factor analysis found out three factors with eigenvalue greater than one. These factors were consistent with the original scale. The multiple linear regression analysis revealed anxiety (p<0.001), stress(p<0.001), fear of COVID-19 and Burnout (p=0.008), depression (p=0.004), lack of sleeping- Pittsburgh Sleep Quality Index (p=0.014) and feeling exhausted (p=0.025) were associated with the quality of life during the COVID-19 pandemic after adjusting for the age and gender. Conclusion: The findings of this study show that fear and burnout related to COVID-19 were significantly associated with high scores of depression, anxiety, stress, and burnout after one year of pandemic among frontline-HCWs, with poor quality of life and sleep.
{"title":"Mental Health and Quality of Life of Frontline Health Care Workers After One Year of Covid-19 Pandemic","authors":"A. Bener, D. Bhugra, A. Ventriglio","doi":"10.2478/amtsb-2021-0040","DOIUrl":"https://doi.org/10.2478/amtsb-2021-0040","url":null,"abstract":"Abstract Aim: This study aimed to investigate the impact of more than one year of COVID-19 pandemic on the quality of life and mental health (in terms of depression, anxiety, stress, fear, burnout – workload) among Frontline Health Care Workers (HCWs). Subjects and methods: This is a cross-sectional survey based on 1,479 frontline HCW participants aged 20-65 years in Turkey who completed a survey including the 21-item Depression, Anxiety, Stress Scale (DASS-21), Burnout, Fear of COVID-19 Scale (FCV-19S), and WHO (World Health Organization) Quality of Life instruments during March-July 2021. Bivariate, factorial and multivariate statistical analyses were performed. Results: Statistically significant differences were found between three frontline groups of HCWs (Physicians, Nurses, Others) including: age (p<0.001), gender (p<0.001), educational level (p<0.001), income (p<0.001), number of calls per week (p<0.001). There were significantly high scores of fear of COVID-19 for all items among physicians. The findings also showed that the prevalence of depression (p=0.002), anxiety (p<0.001), and stress (p<10.005) and Pittsburgh Sleep Quality Index (p=0.011) were significantly different among the three groups of frontline HCWs. The work-related burnout was over 30% in general. The Kaiser-Meyer-Olkin Measure was 0.840 and indicated that the data of the study were suitable for a factor analysis. The factor analysis found out three factors with eigenvalue greater than one. These factors were consistent with the original scale. The multiple linear regression analysis revealed anxiety (p<0.001), stress(p<0.001), fear of COVID-19 and Burnout (p=0.008), depression (p=0.004), lack of sleeping- Pittsburgh Sleep Quality Index (p=0.014) and feeling exhausted (p=0.025) were associated with the quality of life during the COVID-19 pandemic after adjusting for the age and gender. Conclusion: The findings of this study show that fear and burnout related to COVID-19 were significantly associated with high scores of depression, anxiety, stress, and burnout after one year of pandemic among frontline-HCWs, with poor quality of life and sleep.","PeriodicalId":7091,"journal":{"name":"Acta Medica Transilvanica","volume":"26 1","pages":"6 - 11"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44859445","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}
Abstract Patients realize how care was provided, but it is difficult for them to know when expectations were reasonable or when unwanted outcomes were caused by inadequate care or special circumstances. Research in the field shows that satisfaction is related to the perception of technical skills, intelligence and qualification of medical staff, but, in general, the perception of interpersonal communication skills of medical staff is more important. A number of studies have shown that patients tend to be more satisfied with the care provided if the behaviour of the service provider (doctor, nurse, etc.) “conforms” their expectations. Communication skills, empathy, the care offered, attention to personal issues influences how a patient will evaluate the care received.(1,2,3)
{"title":"Annual Report on the Evaluation of Patient Satisfaction at a Pneumophthisiology Hospital","authors":"Violeta Frâncu","doi":"10.2478/amtsb-2021-0044","DOIUrl":"https://doi.org/10.2478/amtsb-2021-0044","url":null,"abstract":"Abstract Patients realize how care was provided, but it is difficult for them to know when expectations were reasonable or when unwanted outcomes were caused by inadequate care or special circumstances. Research in the field shows that satisfaction is related to the perception of technical skills, intelligence and qualification of medical staff, but, in general, the perception of interpersonal communication skills of medical staff is more important. A number of studies have shown that patients tend to be more satisfied with the care provided if the behaviour of the service provider (doctor, nurse, etc.) “conforms” their expectations. Communication skills, empathy, the care offered, attention to personal issues influences how a patient will evaluate the care received.(1,2,3)","PeriodicalId":7091,"journal":{"name":"Acta Medica Transilvanica","volume":"26 1","pages":"27 - 29"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44355105","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}
M. Dina, M. Perieanu, R. Costea, M. Burlibașa, I. Beuran, D. Bodnar, C. Ionescu, Ș. Milicescu, N. Măru, G. Tanase, E. Marcov, Iuliana Babiuc, N. Marcov, M. Butucescu, L. Moraru
Abstract Post and core devices are elements that contribute to the complete restoration of the coronary abutment, over which the final prosthetic restoration will be created. Their role is to retain the coronary portion of the restoration and to protect the remaining coronary structures. The retention function is dictated by the major indication of the method, massive coronary destruction that does not provide conditions for coronary aggregation of the restoration. Thus, this material is approaching two unique methods of making post and core devices totally metallic and/or hybrid (metal + totally ceramic component), using both classical technology, modern technologies, but also combinations of them.
{"title":"Modern Applications in Technology of Post and Core Restorations","authors":"M. Dina, M. Perieanu, R. Costea, M. Burlibașa, I. Beuran, D. Bodnar, C. Ionescu, Ș. Milicescu, N. Măru, G. Tanase, E. Marcov, Iuliana Babiuc, N. Marcov, M. Butucescu, L. Moraru","doi":"10.2478/amtsb-2021-0056","DOIUrl":"https://doi.org/10.2478/amtsb-2021-0056","url":null,"abstract":"Abstract Post and core devices are elements that contribute to the complete restoration of the coronary abutment, over which the final prosthetic restoration will be created. Their role is to retain the coronary portion of the restoration and to protect the remaining coronary structures. The retention function is dictated by the major indication of the method, massive coronary destruction that does not provide conditions for coronary aggregation of the restoration. Thus, this material is approaching two unique methods of making post and core devices totally metallic and/or hybrid (metal + totally ceramic component), using both classical technology, modern technologies, but also combinations of them.","PeriodicalId":7091,"journal":{"name":"Acta Medica Transilvanica","volume":"26 1","pages":"67 - 70"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47922724","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}
Abstract Defined as a tumour with increased malignancy potential in childhood, medulloblastoma was first reported in the literature by Percival Bailey and Harvey Cushing in 1925. Scientific studies over the years have shown that this type of tumour represents about 20% of all intracranial tumours encountered in childhood, their percentage decreasing with advancing age. The genetic factor plays an important part in the appearance of medulloblastoma; there are certain diseases, in the patient’s history, that can be associated with this type of tumour. Here, we can specify Turcot syndrome (an autosomal recessive disease, rarely encountered) or basal cell carcinoma syndrome. This article presents the case of a young patient (41-year-old) suffering from a cerebellar tumour formation that turned out to be, after histopathological examination, a medulloblastoma. In practice we can find several types of medulloblastoma (desmoplastic or nodular, anaplastic, classical or undifferentiated). In what follows I will try to highlight a few aspects of a classic medulloblastoma.
{"title":"Medulloblastoma in Adulthood","authors":"D. Horșia","doi":"10.2478/amtsb-2021-0051","DOIUrl":"https://doi.org/10.2478/amtsb-2021-0051","url":null,"abstract":"Abstract Defined as a tumour with increased malignancy potential in childhood, medulloblastoma was first reported in the literature by Percival Bailey and Harvey Cushing in 1925. Scientific studies over the years have shown that this type of tumour represents about 20% of all intracranial tumours encountered in childhood, their percentage decreasing with advancing age. The genetic factor plays an important part in the appearance of medulloblastoma; there are certain diseases, in the patient’s history, that can be associated with this type of tumour. Here, we can specify Turcot syndrome (an autosomal recessive disease, rarely encountered) or basal cell carcinoma syndrome. This article presents the case of a young patient (41-year-old) suffering from a cerebellar tumour formation that turned out to be, after histopathological examination, a medulloblastoma. In practice we can find several types of medulloblastoma (desmoplastic or nodular, anaplastic, classical or undifferentiated). In what follows I will try to highlight a few aspects of a classic medulloblastoma.","PeriodicalId":7091,"journal":{"name":"Acta Medica Transilvanica","volume":"26 1","pages":"52 - 54"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41556185","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}
I. Codru, B. Vintilă, A. Bereanu, A. Cătană, M. Sava
Abstract Acquired thrombotic thrombocytopenic purpura (TTP) is a rare thrombotic microangiopathy, affecting preferentially young women in their fourth decade. Intensive care admission is often required due to organ dysfunction development risk and for specific critical care measures (Plasma Exchange-PEX). In this article, we will discuss our experience with PEX in the treatment of TTP. Case report: A previously healthy 13-year-old female presented with neurological impairment, and suspicion of stroke. The head computed tomography (CT) scan revealed absence of acute intracranian pathology, and biological evaluation displayed severe thrombocytopenia and haemolytic anemia. After 24 hours, the neurological symptoms were remitted and suspicion of thrombotic thrombocytopenic purpura was raised. The presence of ADAMTS-13 antibodies and Moschcowitz’s pentad confirmed the diagnosis. Discussions: The distinctiveness of this case lies in the development of the disease in a 13-year-old person, though TTP usually occurs after the age of 40. The exact cause of ADAMTS-13 low activity could not be established. The use of a high dose of steroids and of plasma exchange is considered to be the first line therapy, with the use of monoclonal antibodies in refractory cases, as it was in our case. Conclusions: The primary end points of our management was to prevent organ damage and to achieve a platelet count greater than 150 000 /µL, as well as a normal or an almost normal lactate dehydrogenase. We achieved this by using high dose corticosteroid therapy, filtration of approximately 50 liters of plasma in 14 PEX session and by administration of monoclonal antibodies.
{"title":"Total Plasma Exchange for the Management of Thrombotic Thrombocytopenic Purpura in a 13-Year-Old Female – A Case Presentation","authors":"I. Codru, B. Vintilă, A. Bereanu, A. Cătană, M. Sava","doi":"10.2478/amtsb-2021-0050","DOIUrl":"https://doi.org/10.2478/amtsb-2021-0050","url":null,"abstract":"Abstract Acquired thrombotic thrombocytopenic purpura (TTP) is a rare thrombotic microangiopathy, affecting preferentially young women in their fourth decade. Intensive care admission is often required due to organ dysfunction development risk and for specific critical care measures (Plasma Exchange-PEX). In this article, we will discuss our experience with PEX in the treatment of TTP. Case report: A previously healthy 13-year-old female presented with neurological impairment, and suspicion of stroke. The head computed tomography (CT) scan revealed absence of acute intracranian pathology, and biological evaluation displayed severe thrombocytopenia and haemolytic anemia. After 24 hours, the neurological symptoms were remitted and suspicion of thrombotic thrombocytopenic purpura was raised. The presence of ADAMTS-13 antibodies and Moschcowitz’s pentad confirmed the diagnosis. Discussions: The distinctiveness of this case lies in the development of the disease in a 13-year-old person, though TTP usually occurs after the age of 40. The exact cause of ADAMTS-13 low activity could not be established. The use of a high dose of steroids and of plasma exchange is considered to be the first line therapy, with the use of monoclonal antibodies in refractory cases, as it was in our case. Conclusions: The primary end points of our management was to prevent organ damage and to achieve a platelet count greater than 150 000 /µL, as well as a normal or an almost normal lactate dehydrogenase. We achieved this by using high dose corticosteroid therapy, filtration of approximately 50 liters of plasma in 14 PEX session and by administration of monoclonal antibodies.","PeriodicalId":7091,"journal":{"name":"Acta Medica Transilvanica","volume":"26 1","pages":"48 - 51"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43468158","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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