Abstract Background and aim. Modern society is experiencing an accelerated increase in the number of elderly people, to the detriment of children and young adults, in the context of declining birth rates, high adult mortality and increasing life expectancy due to advances in medicine. Cardiovascular diseases are becoming more common in the general population, representing the leading cause of death, being responsible for a third of the total number of deaths worldwide, and heart failure is the most common cause of hospitalization in patients over 65 years. Depression is one of the most common mental illnesses, presents different clinical pictures, which vary from person to person and in relation to age, being shown that there are somatic disorders due to depression, including cardiovascular disease. Materials and method. We studied 127 patients hospitalized in the Geriatrics Department of the Calarasi County Emergency Hospital, diagnosed with heart failure (HF), being divided into 2 groups: the first group, which included 63 patients with heart failure with mildly reduced ejection fraction and the second, which included 64 patients with heart failure with preserved ejection fraction. Results. The main risk factor present in the studied patients was dyslipidemia, which is present in 90% of patients with a mildly ejection fraction and in 88% of patients with a preserved ejection fraction. Hypertension was also present in 75% of patients in the first group and in 63% of those in the second group. Depression was present in 67% of patients with mildly reduced ejection fraction and in 64% of those with preserved ejection fraction. The degree of depression was higher among women, 11% of those with HF with mildly reduced ejection fraction and 14% of those with preserved ejection fraction had major depression. The degree of depression increases with age, patients over 80 years presented predominantly moderate-severe depression (41% of patients in the first group, and 50% in the second). Patients with NYHA class III heart failure had predominantly moderate-to-severe depression: 50% of patients with mildly reduced ejection fraction and 67% of those with preserved ejection fraction. Conclusion. Depression is an important independent risk factor for heart failure in the elderly patients. Due to the fact that the symptoms of the two pathologies are often similar, the diagnosis of depression can be difficult to make, which is why it should be investigated in all patients with heart failure. It is important to understand the peculiarities of the polypathology of the elderly, which often poses problems for the diagnosis and treatment of the clinician.
{"title":"The Association Between Heart Failure with Preserved and Mildly Reduced Ejection Fraction and Depression in the Elderly Patient","authors":"I. Ispas, A. Munteanu, A. Stoica","doi":"10.2478/inmed-2022-0214","DOIUrl":"https://doi.org/10.2478/inmed-2022-0214","url":null,"abstract":"Abstract Background and aim. Modern society is experiencing an accelerated increase in the number of elderly people, to the detriment of children and young adults, in the context of declining birth rates, high adult mortality and increasing life expectancy due to advances in medicine. Cardiovascular diseases are becoming more common in the general population, representing the leading cause of death, being responsible for a third of the total number of deaths worldwide, and heart failure is the most common cause of hospitalization in patients over 65 years. Depression is one of the most common mental illnesses, presents different clinical pictures, which vary from person to person and in relation to age, being shown that there are somatic disorders due to depression, including cardiovascular disease. Materials and method. We studied 127 patients hospitalized in the Geriatrics Department of the Calarasi County Emergency Hospital, diagnosed with heart failure (HF), being divided into 2 groups: the first group, which included 63 patients with heart failure with mildly reduced ejection fraction and the second, which included 64 patients with heart failure with preserved ejection fraction. Results. The main risk factor present in the studied patients was dyslipidemia, which is present in 90% of patients with a mildly ejection fraction and in 88% of patients with a preserved ejection fraction. Hypertension was also present in 75% of patients in the first group and in 63% of those in the second group. Depression was present in 67% of patients with mildly reduced ejection fraction and in 64% of those with preserved ejection fraction. The degree of depression was higher among women, 11% of those with HF with mildly reduced ejection fraction and 14% of those with preserved ejection fraction had major depression. The degree of depression increases with age, patients over 80 years presented predominantly moderate-severe depression (41% of patients in the first group, and 50% in the second). Patients with NYHA class III heart failure had predominantly moderate-to-severe depression: 50% of patients with mildly reduced ejection fraction and 67% of those with preserved ejection fraction. Conclusion. Depression is an important independent risk factor for heart failure in the elderly patients. Due to the fact that the symptoms of the two pathologies are often similar, the diagnosis of depression can be difficult to make, which is why it should be investigated in all patients with heart failure. It is important to understand the peculiarities of the polypathology of the elderly, which often poses problems for the diagnosis and treatment of the clinician.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":" ","pages":"7 - 15"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49302409","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}
Stefan Duca, F. Mitu, A. Timofte, Adriana Chetran, M. Ureche, D. Crișu, O. Mitu, A. Costache, I. Costache
Abstract Thrombophilia is a blood coagulation disorder, in which blood has an increased tendency to clot, with both arterial and venous localization, being responsible for multiple manifestations: secondary arterial hypertension, stroke, acute pancreatitis or intracardiac masses. We are presenting the case of a 21-year-old male patient, hypertensive, known with thrombophilia, who was sent for the echocardiographic evaluation of an intracardiac mass attached to the posterior leaflet of the mitral valve. The echocardiography and transesophageal echocardiogram showed a hyperechogenic, homogeneous intracardiac mass, attached to the posterior leaflet of the mitral valve, the clinical context and the echocardiographic appearance being suggestive for a thrombus. Given the context of thrombophilia and the hypertension’s characteristics, we considered a secondary form of hypertension, the incriminated mechanism being represented by microthrombosis in the renal arterial circulation. There were two complications in the evolution of the patient: stroke and the recurrent acute pancreatitis, both being explained in the context of thrombophilia. The discharge echocardiography showed a favorable evolution, with a complete resolution of the thrombus under the anticoagulant treatment.
{"title":"Thrombophilia: An Amalgam of Never Ending Clinical Manifestations","authors":"Stefan Duca, F. Mitu, A. Timofte, Adriana Chetran, M. Ureche, D. Crișu, O. Mitu, A. Costache, I. Costache","doi":"10.2478/inmed-2022-0218","DOIUrl":"https://doi.org/10.2478/inmed-2022-0218","url":null,"abstract":"Abstract Thrombophilia is a blood coagulation disorder, in which blood has an increased tendency to clot, with both arterial and venous localization, being responsible for multiple manifestations: secondary arterial hypertension, stroke, acute pancreatitis or intracardiac masses. We are presenting the case of a 21-year-old male patient, hypertensive, known with thrombophilia, who was sent for the echocardiographic evaluation of an intracardiac mass attached to the posterior leaflet of the mitral valve. The echocardiography and transesophageal echocardiogram showed a hyperechogenic, homogeneous intracardiac mass, attached to the posterior leaflet of the mitral valve, the clinical context and the echocardiographic appearance being suggestive for a thrombus. Given the context of thrombophilia and the hypertension’s characteristics, we considered a secondary form of hypertension, the incriminated mechanism being represented by microthrombosis in the renal arterial circulation. There were two complications in the evolution of the patient: stroke and the recurrent acute pancreatitis, both being explained in the context of thrombophilia. The discharge echocardiography showed a favorable evolution, with a complete resolution of the thrombus under the anticoagulant treatment.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"19 1","pages":"41 - 48"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49269463","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}
C. David, P. Popescu, D. Radulescu, I. A. Vacaroiu
Abstract With their high prevalence and predisposition to recurrence, urinary tract infections are important contributors to antibiotic prescription worldwide. Studies involving alternative urinary tract infections treatments emerged as a priority in the last years, developing as a response to rapid global dissemination of multi-drug resistant uropathogens. One of these non-antibiotic strategies is based on the hypothesis that recurrent and severe forms of urinary tract infections have a genetic susceptibility pattern, involving the variability of the innate immune response to germs aggression. Yet insufficient studied, the immunology of urinary tract infections is still a subject for new bold researches. By focusing the precise defect that leads to predisposition towards severe or recurrent evolution of the disease and by targeting to correct them, these new therapies examples outlined in our review can bring a ray of hope in the treatment of UTI and the burden they represent.
{"title":"Targeted Immunomodulation Therapies as New Options to Cure Urinary Tract Infections","authors":"C. David, P. Popescu, D. Radulescu, I. A. Vacaroiu","doi":"10.2478/inmed-2022-0215","DOIUrl":"https://doi.org/10.2478/inmed-2022-0215","url":null,"abstract":"Abstract With their high prevalence and predisposition to recurrence, urinary tract infections are important contributors to antibiotic prescription worldwide. Studies involving alternative urinary tract infections treatments emerged as a priority in the last years, developing as a response to rapid global dissemination of multi-drug resistant uropathogens. One of these non-antibiotic strategies is based on the hypothesis that recurrent and severe forms of urinary tract infections have a genetic susceptibility pattern, involving the variability of the innate immune response to germs aggression. Yet insufficient studied, the immunology of urinary tract infections is still a subject for new bold researches. By focusing the precise defect that leads to predisposition towards severe or recurrent evolution of the disease and by targeting to correct them, these new therapies examples outlined in our review can bring a ray of hope in the treatment of UTI and the burden they represent.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"19 1","pages":"17 - 22"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43179645","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 : 2022-08-30DOI: 10.47363/jccsr/2022(4)227
M. Stoian, A. Turbatu, Bianca Procopiescu, S. Seitan, Gabriel Scarlat
Abstract Background. Myeloproliferative disorders define a vast and heteregenous group of neoplastic entities, characterized by malignant proliferation of blood cells. These may affect multiple tissues, some of these malignancies involving organs in which there is lymphoid tissue. Case report. A 81-year-old female patient was admitted to the Department of Internal Medicine with moderate-to-intense spontaneous pain in the left hypochondrial and in the left abdominal flank, associated with generalized fatigue and loss of appetite. According to the personal medical history, the patient is known with type II diabetes mellitus, being under treatment with oral antidiabetics (metformin 1000 mg), and arterial hypertension under treatment with candesartan. Upon admission, the physical examination revealed cutaneous and mucosal pallor and marked physical weakness. Abdominal palpation revealed pain in the left hypochondrial and in the left abdominal flank, associated with firm and massive splenomegaly, descending towards the umbilicus. Abdominal ultrasound confirmed massive splenomegaly, associated with moderate hepatomegaly. Blood analysis revealed several modifications, indicative of hypochromic normocytic anemia, associated with lymphocytosis, thrombocytopenia and neutropenia. C-reactive protein (CRP) serum levels were in normal range upon admission. All of these modifications suggested a possible leukemogenous or lymphoid malignancy, which resulted in the patient's transfer towards the Department of Hematology, for further investigations. Conclusions. Massive splenomegaly, associated with anemia and thrombocytopenia in elderly patients, should always indicate a leukemogenous or lymphoid malignancy and a thorough differential diagnosis and collaboration between internists and hematologists is required.
{"title":"Myeloproliferative Syndrome - A Diagnosis on the Border Between Medical Specialties","authors":"M. Stoian, A. Turbatu, Bianca Procopiescu, S. Seitan, Gabriel Scarlat","doi":"10.47363/jccsr/2022(4)227","DOIUrl":"https://doi.org/10.47363/jccsr/2022(4)227","url":null,"abstract":"Abstract Background. Myeloproliferative disorders define a vast and heteregenous group of neoplastic entities, characterized by malignant proliferation of blood cells. These may affect multiple tissues, some of these malignancies involving organs in which there is lymphoid tissue. Case report. A 81-year-old female patient was admitted to the Department of Internal Medicine with moderate-to-intense spontaneous pain in the left hypochondrial and in the left abdominal flank, associated with generalized fatigue and loss of appetite. According to the personal medical history, the patient is known with type II diabetes mellitus, being under treatment with oral antidiabetics (metformin 1000 mg), and arterial hypertension under treatment with candesartan. Upon admission, the physical examination revealed cutaneous and mucosal pallor and marked physical weakness. Abdominal palpation revealed pain in the left hypochondrial and in the left abdominal flank, associated with firm and massive splenomegaly, descending towards the umbilicus. Abdominal ultrasound confirmed massive splenomegaly, associated with moderate hepatomegaly. Blood analysis revealed several modifications, indicative of hypochromic normocytic anemia, associated with lymphocytosis, thrombocytopenia and neutropenia. C-reactive protein (CRP) serum levels were in normal range upon admission. All of these modifications suggested a possible leukemogenous or lymphoid malignancy, which resulted in the patient's transfer towards the Department of Hematology, for further investigations. Conclusions. Massive splenomegaly, associated with anemia and thrombocytopenia in elderly patients, should always indicate a leukemogenous or lymphoid malignancy and a thorough differential diagnosis and collaboration between internists and hematologists is required.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"20 1","pages":"81 - 96"},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44179438","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}
Objective Coronavirus disease 2019 (COVID-19) has caused a collapse of the medical care system, with effective triage proving vital. The Kanagawa admission priority assessment score, version-1 (KAPAS-1) and version-2 (KAPAS-2), was developed to determine the need for hospitalization. Patients with a high KAPAS (≥5) are recommended for hospitalization. We retrospectively investigated the correlation between the KAPAS and oxygen requirement during hospitalization. Methods We collected the clinical data of COVID-19 patients admitted between February 5 and December 6, 2020. Patients were divided into two groups: those who required oxygen therapy during hospitalization (OXY) and those who did not (NOXY). We assessed the correlations between the groups and KAPAS-1 and KAPAS-2. Results Overall, 117 COVID-19 patients were analyzed, including 20 OXY and 97 NOXY and 54 high KAPAS-1 and 63 high KAPAS-2. The median KAPAS-1 and KAPAS-2 were significantly higher in OXY than in NOXY (6.5 vs. 3, and 9 vs. 4, respectively). The areas under the receiver operating characteristic curves of KAPAS-1 and KAPAS-2 for oxygen requirement were 0.777 and 0.825, respectively, and the maximum values of Youden's index were 4 and 6, respectively. The proportions of high KAPAS-1 and high KAPAS-2 were significantly higher in OXY than in NOXY (90.0% vs. 37.1%, and 90.0% vs. 46.4%, respectively). Conclusion The KAPAS was significantly correlated with oxygen requirement. Furthermore, the KAPAS may be useful for deciding which patients are most likely to require hospitalization and for selecting non-hospitalized patients who should be carefully monitored.
2019冠状病毒病(COVID-19)导致医疗体系崩溃，有效的分流至关重要。制定了神奈川入院优先评估评分版本1 (KAPAS-1)和版本2 (KAPAS-2)，以确定是否需要住院治疗。KAPAS评分高(≥5)的患者建议住院治疗。我们回顾性研究KAPAS与住院期间需氧量的相关性。方法收集2020年2月5日至12月6日收治的新冠肺炎患者的临床资料。患者分为住院期间需氧治疗组(OXY)和不需氧治疗组(NOXY)。我们评估各组与KAPAS-1和KAPAS-2之间的相关性。结果共分析117例COVID-19患者，其中OXY 20例，NOXY 97例，KAPAS-1高54例，KAPAS-2高63例。OXY患者KAPAS-1和KAPAS-2的中位数明显高于NOXY患者(分别为6.5 vs. 3和9 vs. 4)。KAPAS-1和KAPAS-2的受者工作特征曲线下需氧量面积分别为0.777和0.825，约登指数最大值分别为4和6。高KAPAS-1和高KAPAS-2的比例在氧组显著高于氧组(90.0% vs. 37.1%， 90.0% vs. 46.4%)。结论KAPAS与血氧需要量显著相关。此外，KAPAS可用于决定哪些患者最有可能需要住院治疗，并可用于选择应仔细监测的非住院患者。
{"title":"A Convenient Risk Prediction Score for COVID-19 for Determining Whether or Not Hospitalization Is Recommended: Kanagawa Admission Priority Assessment Score.","authors":"Nobumasa Tamura, Shota Uchiyama, Saiko Nishioka, Kentaro Tamura, Masahiro Yoshida, Zenya Saito, Kazuyoshi Kuwano","doi":"10.2169/internalmedicine.9262-21","DOIUrl":"10.2169/internalmedicine.9262-21","url":null,"abstract":"<p><p>Objective Coronavirus disease 2019 (COVID-19) has caused a collapse of the medical care system, with effective triage proving vital. The Kanagawa admission priority assessment score, version-1 (KAPAS-1) and version-2 (KAPAS-2), was developed to determine the need for hospitalization. Patients with a high KAPAS (≥5) are recommended for hospitalization. We retrospectively investigated the correlation between the KAPAS and oxygen requirement during hospitalization. Methods We collected the clinical data of COVID-19 patients admitted between February 5 and December 6, 2020. Patients were divided into two groups: those who required oxygen therapy during hospitalization (OXY) and those who did not (NOXY). We assessed the correlations between the groups and KAPAS-1 and KAPAS-2. Results Overall, 117 COVID-19 patients were analyzed, including 20 OXY and 97 NOXY and 54 high KAPAS-1 and 63 high KAPAS-2. The median KAPAS-1 and KAPAS-2 were significantly higher in OXY than in NOXY (6.5 vs. 3, and 9 vs. 4, respectively). The areas under the receiver operating characteristic curves of KAPAS-1 and KAPAS-2 for oxygen requirement were 0.777 and 0.825, respectively, and the maximum values of Youden's index were 4 and 6, respectively. The proportions of high KAPAS-1 and high KAPAS-2 were significantly higher in OXY than in NOXY (90.0% vs. 37.1%, and 90.0% vs. 46.4%, respectively). Conclusion The KAPAS was significantly correlated with oxygen requirement. Furthermore, the KAPAS may be useful for deciding which patients are most likely to require hospitalization and for selecting non-hospitalized patients who should be carefully monitored.</p>","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"61 1","pages":"2135-2141"},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9381338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47558466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Capnocytophaga species are among the typical zoonotic pathogens causing infections following direct contact with animals. Recently, a putative novel species of zoonotic Capnocytophaga, Capnocytophaga stomatis, was reported. We herein report the first case of bacteremia caused by C. stomatis. A woman in her 80s with multiple myeloma who was receiving bortezomib and dexamethasone therapy was admitted to our hospital with a 2-day history of a fever and right calf redness. She was often licked by her cat. On a blood culture, thin, Gram-negative rods were detected, which were identified as C. stomatis by whole-genome sequencing. The patient was successfully treated with ampicillin-sulbactam treatment. Our case highlights the pathogenic potential of the putative novel Capnocytophaga, C. stomatis, in immunocompromised hosts.
{"title":"Putative Novel Species of Genus Capnocytophaga, Capnocytophaga stomatis Bacteremia in a Patient with Multiple Myeloma after Direct Contact with a Cat.","authors":"Koh Shinohara, Yasuhiro Tsuchido, Michio Suzuki, Kojiro Yamamoto, Yasutaro Okuzawa, Koichi Imaoka, Tsunehiro Shimizu","doi":"10.2169/internalmedicine.7947-21","DOIUrl":"10.2169/internalmedicine.7947-21","url":null,"abstract":"<p><p>Capnocytophaga species are among the typical zoonotic pathogens causing infections following direct contact with animals. Recently, a putative novel species of zoonotic Capnocytophaga, Capnocytophaga stomatis, was reported. We herein report the first case of bacteremia caused by C. stomatis. A woman in her 80s with multiple myeloma who was receiving bortezomib and dexamethasone therapy was admitted to our hospital with a 2-day history of a fever and right calf redness. She was often licked by her cat. On a blood culture, thin, Gram-negative rods were detected, which were identified as C. stomatis by whole-genome sequencing. The patient was successfully treated with ampicillin-sulbactam treatment. Our case highlights the pathogenic potential of the putative novel Capnocytophaga, C. stomatis, in immunocompromised hosts.</p>","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"61 1","pages":"2233-2237"},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9381356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43027347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01Epub Date: 2022-04-23DOI: 10.2169/internalmedicine.9695-22
Takeshi Mochizuki, Takaki Hori, Koichiro Yano, Katsunori Ikari, Ken Okazaki
{"title":"Changes in SARS-CoV-2 Antibody Titers from Three to Nine Months after Administration of the BNT162b2 mRNA Vaccine among Healthcare Workers in Japan: A Prospective Study.","authors":"Takeshi Mochizuki, Takaki Hori, Koichiro Yano, Katsunori Ikari, Ken Okazaki","doi":"10.2169/internalmedicine.9695-22","DOIUrl":"10.2169/internalmedicine.9695-22","url":null,"abstract":"","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"61 1","pages":"2095"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9334243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45177252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Stancu, Bogdan M Sorohan, G. Gherlan, L. Toma, L. Iliescu
Abstract A variety of laboratory tests are used in the evaluation of the hepatic patients. Serum cholinesterase is reduced in liver disfunction in contrast with other enzymes. The aim of this study was to assess the value of serum cholinesterase in evaluation of the liver reserve function in cirrhotic patients. A total of 70 patients were divided into 3 groups according to the Child-Pugh Score. Using corelation analysis, the correlation between serum cholinesterase and albumin and serum plasma prothrombin time was analysed. Cirrhotic patients were grouped into A, B and C grades as per Child-Pugh score. The results showed that cholinesterase levels tend to decrease according to the Child-Pugh score. The cholinesterase correlated with the albumin serum levels, value of Child-Pugh score and MELD-Na score and didn’t corelate to INR. In conclusion, correlated with the damage severity of the liver cells cholinesterase may respond to liver reserve function.
{"title":"Corelations Between the Value of Serum Cholinesterase and Child-Pugh and MELD-NA Scores in Cirrhotic Patients","authors":"G. Stancu, Bogdan M Sorohan, G. Gherlan, L. Toma, L. Iliescu","doi":"10.37897/rjid.2022.2.5","DOIUrl":"https://doi.org/10.37897/rjid.2022.2.5","url":null,"abstract":"Abstract A variety of laboratory tests are used in the evaluation of the hepatic patients. Serum cholinesterase is reduced in liver disfunction in contrast with other enzymes. The aim of this study was to assess the value of serum cholinesterase in evaluation of the liver reserve function in cirrhotic patients. A total of 70 patients were divided into 3 groups according to the Child-Pugh Score. Using corelation analysis, the correlation between serum cholinesterase and albumin and serum plasma prothrombin time was analysed. Cirrhotic patients were grouped into A, B and C grades as per Child-Pugh score. The results showed that cholinesterase levels tend to decrease according to the Child-Pugh score. The cholinesterase correlated with the albumin serum levels, value of Child-Pugh score and MELD-Na score and didn’t corelate to INR. In conclusion, correlated with the damage severity of the liver cells cholinesterase may respond to liver reserve function.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"19 1","pages":"7 - 15"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44488344","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 : 2022-06-15DOI: 10.2169/internalmedicine.8298-21
Jun Nakazawa, Satoru Yamanaka, Shohei Yoshida, M. Yoshibayashi, Miho Yoshioka, Takamasa Ito, S. Araki, S. Kume, H. Maegawa
Objective Evaluating the rate of decline in the estimated glomerular filtration rate (eGFR) may help identify patients with occult chronic kidney disease (CKD). We herein report that eGFR fluctuation complicates the assessment of the rate of decline and propose a long-term eGFR plot analysis as a solution. Methods In 142 patients with persistent eGFR decline in a single hospital, we evaluated the factors influencing the rate of eGFR decline, calculated over the long term (≥3 years) and short term (＜3 years) using eGFR plots, taking into account eGFR fluctuation between visits. Results The difference between the rate of eGFR decline calculated using short- and long-term plots increased as the time period considered in the short-term plots became shorter. A regression analysis revealed that eGFR fluctuation was the only factor that explained the difference and that the fluctuation exceeded the annual eGFR decline in all participants. Furthermore, the larger the eGFR fluctuation, the more difficult it became to detect eGFR decline using a short-term eGFR analysis. Obesity, a high eGFR at baseline, and faster eGFR decline were associated with larger eGFR fluctuations. To circumvent the issue of eGFR fluctuation in the assessment of the rate of eGFR decline, we developed a system that generates a long-term eGFR plot using all eGFR values for a participant, which enabled the detection of occult CKD, facilitating early therapeutic intervention. Conclusion The construction of long-term eGFR plots is useful for identifying patients with progressive eGFR decline, as it minimizes the effect of eGFR fluctuation.
{"title":"A Long-term Estimated Glomerular Filtration Rate Plot Analysis Permits the Accurate Assessment of a Decline in the Renal Function by Minimizing the Influence of Estimated Glomerular Filtration Rate Fluctuations","authors":"Jun Nakazawa, Satoru Yamanaka, Shohei Yoshida, M. Yoshibayashi, Miho Yoshioka, Takamasa Ito, S. Araki, S. Kume, H. Maegawa","doi":"10.2169/internalmedicine.8298-21","DOIUrl":"https://doi.org/10.2169/internalmedicine.8298-21","url":null,"abstract":"Objective Evaluating the rate of decline in the estimated glomerular filtration rate (eGFR) may help identify patients with occult chronic kidney disease (CKD). We herein report that eGFR fluctuation complicates the assessment of the rate of decline and propose a long-term eGFR plot analysis as a solution. Methods In 142 patients with persistent eGFR decline in a single hospital, we evaluated the factors influencing the rate of eGFR decline, calculated over the long term (≥3 years) and short term (＜3 years) using eGFR plots, taking into account eGFR fluctuation between visits. Results The difference between the rate of eGFR decline calculated using short- and long-term plots increased as the time period considered in the short-term plots became shorter. A regression analysis revealed that eGFR fluctuation was the only factor that explained the difference and that the fluctuation exceeded the annual eGFR decline in all participants. Furthermore, the larger the eGFR fluctuation, the more difficult it became to detect eGFR decline using a short-term eGFR analysis. Obesity, a high eGFR at baseline, and faster eGFR decline were associated with larger eGFR fluctuations. To circumvent the issue of eGFR fluctuation in the assessment of the rate of eGFR decline, we developed a system that generates a long-term eGFR plot using all eGFR values for a participant, which enabled the detection of occult CKD, facilitating early therapeutic intervention. Conclusion The construction of long-term eGFR plots is useful for identifying patients with progressive eGFR decline, as it minimizes the effect of eGFR fluctuation.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"61 1","pages":"1823 - 1833"},"PeriodicalIF":0.0,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43110196","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 : 2022-06-14DOI: 10.2169/internalmedicine.9384-22
Eriko Kashihara, K. Doi, K. Fujita
We herein report a case of multisystem inflammatory syndrome in adults (MIS-A) complicated with Kikuchi-Fujimoto disease (KFD). A previously healthy 41-year-old man presented with painful swelling of the cervical lymph nodes, fever, diarrhea, conjunctivitis, edema, and hypotension one month after the onset of asymptomatic coronavirus disease 2019. Laboratory investigations revealed an elevation of CRP, and echocardiography indicated diastolic dysfunction. We diagnosed the patient to have MIS-A. Histopathology of the lymph nodes showed necrotizing lymphadenitis. After the initiation of hydrocortisone and diuretics, his symptoms resolved immediately. This case suggested that post-viral immune dysregulation in MIS-A could play a role in the etiology of KFD.
{"title":"Multisystem Inflammatory Syndrome in Adults Accompanied with Kikuchi-Fujimoto Disease","authors":"Eriko Kashihara, K. Doi, K. Fujita","doi":"10.2169/internalmedicine.9384-22","DOIUrl":"https://doi.org/10.2169/internalmedicine.9384-22","url":null,"abstract":"We herein report a case of multisystem inflammatory syndrome in adults (MIS-A) complicated with Kikuchi-Fujimoto disease (KFD). A previously healthy 41-year-old man presented with painful swelling of the cervical lymph nodes, fever, diarrhea, conjunctivitis, edema, and hypotension one month after the onset of asymptomatic coronavirus disease 2019. Laboratory investigations revealed an elevation of CRP, and echocardiography indicated diastolic dysfunction. We diagnosed the patient to have MIS-A. Histopathology of the lymph nodes showed necrotizing lymphadenitis. After the initiation of hydrocortisone and diuretics, his symptoms resolved immediately. This case suggested that post-viral immune dysregulation in MIS-A could play a role in the etiology of KFD.","PeriodicalId":77259,"journal":{"name":"Medicina interna (Bucharest, Romania : 1991)","volume":"61 1","pages":"2527 - 2532"},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44797671","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：