Current health sciences journal最新文献

The liver is among the most affected organs in the case of abdominal trauma. In the last decades there have been significant changes in therapeutic protocols, non-operative management is now the first intention in most cases due to good results offered previously. In high-grade or hemodynamically unstable injuries, hepatectomy is the best approach, even though this was viewed with skepticism in the past, technical advances in medicine have proven otherwise. This article presents a case report of a 29-year-old man with blunt abdominal trauma, who initially underwent conservative atypical right hepatectomy without a favourable outcome, later he was transferred to a liver transplant center where he underwent a controlled right hepatectomy, all this in a new epidemiological context, the COVID-19 Pandemic. We want to present the hypothesis that in making a therapeutic decision, the hemodynamic status of the patient must be considered equally along with the injury degree. This case represents an opportunity to review the role of liver resection in the management of complex liver injuries.

Coxarthrosis, or hip osteoarthritis (OA), is one of the main causes of hip pain, which can affect patients of all ages, being one of the most common reasons for patients presenting to the specialized outpatient clinic. The objective of our research was to determine the number of patients with coxarthrosis who presented to the Department of Orthopaedics and Traumatology within the Emergency County Hospital of Drobeta Turnu Severin, between 2017-2019, the sex, age, social environment of the patients. All patients underwent a thorough clinical examination to determine the risk factors, the favouring factors and their correlation with the paraclinical data obtained through imaging investigation (pelvis X-ray, computer tomography and nuclear magnetic resonance). The study included 462 patients, aged between 23 and 89 years old, who were diagnosed with varying degrees of coxarthrosis within the specialized outpatient clinic. The main risk factors were obesity, osteoporosis, chronic smoking, rural environment, female sex, the existence of a hip injury and intense physical exertion. The main purpose of the research was to analyse a series of data, which would bring information on the incidence, distribution by age groups, sex, living environment and professional activity of the population with coxarthrosis, in order to develop a therapeutic management as effective as possible.

The key factors contributing to radiculopathy caused by lumbar disc herniation include mechanical compression. It was commonly believed that the disc herniation causes the compression on the nerve root exiting under the pedicle of the vertebral body at the adjacent inferior level. However, a disc herniation might occasionally result in non-adjacent, isolated radicular symptoms. We report the case of a 74-year-old female who presented with a 2-years history of progressive low back pain associated with L5 radiculopathy and reduced quality of life. The patient had undergone a magnetic resonance image showing a large L2/3 disc herniation. Symptoms had progressively worsened and failed to respond to conservative treatments including pain medication, exercise rehabilitation, and acupuncture at the lower lumbar region. The patient was diagnosed with L5 radiculopathy caused by L2/3 disc herniation. Consequently, her symptoms improved with chiropractic rehabilitation which involved spinal manipulative therapy and intermittent motorized traction at the L2/3 level to reduce herniated disc. Therefore, an L2/3 Disc herniation-related L5 radiculopathy should be considered in the differential diagnosis of cases of inconsistency of level of disc herniation and nerve root pattern.

Arterial dissection is the result of blood entering along the intima-media plane through a breach produced either spontaneously or traumatically. Cervical arterial dissections are an important cause of acute ischemic stroke in children, young adults, and patients with cranio-cervical traumatic injuries. Arterial dissections occur either spontaneously, in genetic diseases, the most important association being with fibromuscular dysplasia. In most of the cases dissection involve the extracranial portions of the internal carotid and vertebral arteries. Magnetic resonance with T1 fat-saturation (T1 FS) sequence of the cervical region or computed tomography (CT) with computed tomography angiography (CTA) shows a very high sensitivity and specificity in the diagnosis of cervical artery dissections. Therapeutic options are still debatable in patients with acute ischemic stroke and vertebral or carotid artery dissection.

Allergic rhinitis is characterized by an acute or chronic inflammation of the nasal mucosa, being frequently associated with other airway conditions such as sinusitis, serous otitis media, nasal polyposis, sleep disorders and asthma in particular. Among the comorbidities of allergic rhinitis it counts asthma, being a risk factor for this disorder, in which, more than 75% of patients develop asthma (either allergic or nonallergic), whereas the patients with allergic rhinitis can be affected up to 40% by asthma. The classic symptoms for allergic rhinitis involves sneezing, nasal mucosal swelling and watery rhinorrhea; whereas the main symptoms which occurred in patients with asthma are wheezing, breathlessness, chest tightness, coughing, fast heartbeat, confusion, exhaustion or dizziness. Avoiding allergens is the first line of treatment for allergic rhinitis, followed by medication and allergen immunotherapy. Due to the strong connection between allergic rhinitis and asthma, one can affirm that the treatment for allergic rhinitis lead to the improvement of asthma symptoms. One can diagnose asthma by recognizing a certain pattern of respiratory symptoms and expiratory airflow restriction, which varies for each patient. In conclusion, accurate identification of the differences between allergic rhinitis and asthma depends on a thorough history, physical examination, and therapeutic treatments. This article provides an overview of the connection between these disorders, as well as of the diagnosis of these conditions and their current management options.

Background: Patients with mitral valve prolapse (MVP) may be prone to ventricular arrhythmias and sudden cardiac death and presence early repolarization pattern (ERP) in electrocardiography may be predict for ventricle arrhythmia. This study aimed to evaluation ERP in Children with MVP.

Methods: In a cross-sectional study, we enrolled ERP in 70 MVP children with 70 age-and sex-matched healthy individuals. After echocardiography procedure for confirmation MVP, standard 12-lead electrocardiography recordings with sweeping rate of 25mm/s and an amplitude of 10mV/cm, and two cardiologists assessed who were blinded to the both groups.

Result: We detected ERP in 17.14% of MVP patient's and seen in 8 case (11.43%) in control group, (P=0.23). the ERP occurred in MVP patient's mild, moderate and severe 4, 6 and 2 cases, (P=0.29). The ERP found in patients with and without chest pain 13 and 7, respectively (P=0.46) and, in patients with and without palpitations 15 and 5 cases, respectively (P=0.24). The ERP occurred 1.6 time more in patient with MVP in comparing with individual without MVP. The ERP occurred more frequently in among patients with moderate MVP in comparing with severe and mild. Chest pain and palpitation occurred more frequently in among patients with severe MVP.

Conclusion: The prevalence of ERP in children with MVP has been at a higher-level incidence, especially among patients with complaining from chest pain. We suggested that children with MVP are in need of follow up considering the occurrence of arrhythmias.