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Li J, Mason C, Hanggi K, Luca V, Ruffell B. Abstract 6398: Targeting ENPP1 to boost anti-tumor immunity during PARP inhibition. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-6398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Homologous recombination (HR) deficiency confers sensitivity to poly (ADP-ribose) polymerase inhibitors (PARPi), which have been approved for use in ovarian and triple negative breast cancers (TNBC) carrying loss-of-function mutations in HR pathway genes, most commonly BRCA1/2. Preclinical studies in BRCA1-deficient tumor models have demonstrated that the immune compartment is required for PARPi efficacy through the ability of PARPi to cause micronuclei formation and activate cGAS in tumors cells. The production of the 2’3’-cGAMP secondary intermediate stimulates STING in neighboring tumor-infiltrating immune cells to promote an anti-tumor response. Despite this evidence of immune stimulation, PARPi does not extend overall survival in TNBC patients, suggesting that immune suppression remains a significant barrier for efficacy. Here we sought to evaluate the role of ectonucleotide pyrophosphatase/phosphodiesterase 1(ENPP1), a type II transmembrane glycoprotein that hydrolyzes extracellular 2’3’-cGAMP. We generated Brca1/Pten/Trp53-deficient TNBC cell lines from a genetically engineered mouse model and found that these expressed higher levels of ENPP1 than Brca1-proficient TNBC and non-TNBC cell lines. Knocking out Enpp1 via CRISPR/Cas9 increased 2’3’-cGAMP production during Niraparib treatment but did not affect cellular proliferation in vitro. Critically, knocking out Enpp1 significantly reduced the growth of orthotopic Brca1-deficient tumors, with no change in growth observed for orthotopic E0771 or PyMT models, suggesting an important role for ENPP1 in HR-deficient tumors. Therapeutic dosing of Niraparib further reduced the growth of Enpp1 knockout tumors in a manner that was dependent upon host STING and correlated with higher CD8+ T cell infiltration and effector function. These findings demonstrate that ENPP1 suppresses anti-tumor immunity in Brca1-deficient tumors, suggesting that blocking the enzymatic activity of ENPP1 may provide therapeutic benefits during PARPi treatment for TNBC patients.
Citation Format: Jie Li, Charlotte Mason, Kay Hanggi, Vincent Luca, Brian Ruffell. Targeting ENPP1 to boost anti-tumor immunity during PARP inhibition. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6398.
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Affiliation(s)
- Jie Li
- 1H. Lee Moffitt Cancer Center, Tampa, FL
| | | | - Kay Hanggi
- 1H. Lee Moffitt Cancer Center, Tampa, FL
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Salahudeen AA, Choi SS, Rustagi A, Zhu J, van Unen V, de la O SM, Flynn RA, Margalef-Català M, Santos AJM, Ju J, Batish A, Usui T, Zheng GXY, Edwards CE, Wagar LE, Luca V, Anchang B, Nagendran M, Nguyen K, Hart DJ, Terry JM, Belgrader P, Ziraldo SB, Mikkelsen TS, Harbury PB, Glenn JS, Garcia KC, Davis MM, Baric RS, Sabatti C, Amieva MR, Blish CA, Desai TJ, Kuo CJ. Progenitor identification and SARS-CoV-2 infection in human distal lung organoids. Nature 2020; 588:670-675. [PMID: 33238290 PMCID: PMC8003326 DOI: 10.1038/s41586-020-3014-1] [Citation(s) in RCA: 209] [Impact Index Per Article: 52.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 11/18/2020] [Indexed: 12/17/2022]
Abstract
The distal lung contains terminal bronchioles and alveoli that facilitate gas exchange. Three-dimensional in vitro human distal lung culture systems would strongly facilitate the investigation of pathologies such as interstitial lung disease, cancer and coronavirus disease 2019 (COVID-19) pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here we describe the development of a long-term feeder-free, chemically defined culture system for distal lung progenitors as organoids derived from single adult human alveolar epithelial type II (AT2) or KRT5+ basal cells. AT2 organoids were able to differentiate into AT1 cells, and basal cell organoids developed lumens lined with differentiated club and ciliated cells. Single-cell analysis of KRT5+ cells in basal organoids revealed a distinct population of ITGA6+ITGB4+ mitotic cells, whose offspring further segregated into a TNFRSF12Ahi subfraction that comprised about ten per cent of KRT5+ basal cells. This subpopulation formed clusters within terminal bronchioles and exhibited enriched clonogenic organoid growth activity. We created distal lung organoids with apical-out polarity to present ACE2 on the exposed external surface, facilitating infection of AT2 and basal cultures with SARS-CoV-2 and identifying club cells as a target population. This long-term, feeder-free culture of human distal lung organoids, coupled with single-cell analysis, identifies functional heterogeneity among basal cells and establishes a facile in vitro organoid model of human distal lung infections, including COVID-19-associated pneumonia.
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Affiliation(s)
- Ameen A Salahudeen
- Division of Hematology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Division of Hematology and Oncology, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, IL, USA
| | - Shannon S Choi
- Division of Hematology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Arjun Rustagi
- Division of Infectious Disease and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Junjie Zhu
- Stanford University School of Engineering, Department of Electrical Engineering, Stanford, CA, USA
| | - Vincent van Unen
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Institute of Immunity, Transplantation and Infection, Stanford University School of Medicine, Stanford, CA, USA
| | - Sean M de la O
- Division of Hematology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Ryan A Flynn
- Stanford ChEM-H, Stanford University, Stanford, CA, USA
- Department of Chemistry, Stanford University, Stanford, CA, USA
| | - Mar Margalef-Català
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - António J M Santos
- Division of Hematology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Jihang Ju
- Division of Hematology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Arpit Batish
- Division of Hematology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Tatsuya Usui
- Division of Hematology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Caitlin E Edwards
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lisa E Wagar
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Institute of Immunity, Transplantation and Infection, Stanford University School of Medicine, Stanford, CA, USA
| | - Vincent Luca
- Department of Molecular and Cellular Physiology, Stanford University School of Medicine, Stanford, CA, USA
| | - Benedict Anchang
- Division of Biomedical Data Science, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Monica Nagendran
- Division of Pulmonary, Allergy and Critical Care, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Khanh Nguyen
- Division of Gastroenterology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Daniel J Hart
- Division of Hematology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | | | | | | | | | - Pehr B Harbury
- Department of Biochemistry, Stanford University School of Medicine, Stanford, CA, USA
| | - Jeffrey S Glenn
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, USA
- Division of Gastroenterology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - K Christopher Garcia
- Department of Molecular and Cellular Physiology, Stanford University School of Medicine, Stanford, CA, USA
- Howard Hughes Medical Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Mark M Davis
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Institute of Immunity, Transplantation and Infection, Stanford University School of Medicine, Stanford, CA, USA
- Howard Hughes Medical Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Ralph S Baric
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Chiara Sabatti
- Division of Biomedical Data Science, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Manuel R Amieva
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, USA
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Catherine A Blish
- Division of Infectious Disease and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
- Chan Zuckerberg Biohub, San Francisco, CA, USA.
| | - Tushar J Desai
- Division of Pulmonary, Allergy and Critical Care, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
| | - Calvin J Kuo
- Division of Hematology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
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Salahudeen AA, Choi SS, Rustagi A, Zhu J, de la O SM, Flynn RA, Margalef-Català M, Santos AJM, Ju J, Batish A, van Unen V, Usui T, Zheng GXY, Edwards CE, Wagar LE, Luca V, Anchang B, Nagendran M, Nguyen K, Hart DJ, Terry JM, Belgrader P, Ziraldo SB, Mikkelsen TS, Harbury PB, Glenn JS, Garcia KC, Davis MM, Baric RS, Sabatti C, Amieva MR, Blish CA, Desai TJ, Kuo CJ. Progenitor identification and SARS-CoV-2 infection in long-term human distal lung organoid cultures. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2020:2020.07.27.212076. [PMID: 32743583 PMCID: PMC7386503 DOI: 10.1101/2020.07.27.212076] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The distal lung contains terminal bronchioles and alveoli that facilitate gas exchange and is affected by disorders including interstitial lung disease, cancer, and SARS-CoV-2-associated COVID-19 pneumonia. Investigations of these localized pathologies have been hindered by a lack of 3D in vitro human distal lung culture systems. Further, human distal lung stem cell identification has been impaired by quiescence, anatomic divergence from mouse and lack of lineage tracing and clonogenic culture. Here, we developed robust feeder-free, chemically-defined culture of distal human lung progenitors as organoids derived clonally from single adult human alveolar epithelial type II (AT2) or KRT5 + basal cells. AT2 organoids exhibited AT1 transdifferentiation potential, while basal cell organoids progressively developed lumens lined by differentiated club and ciliated cells. Organoids consisting solely of club cells were not observed. Upon single cell RNA-sequencing (scRNA-seq), alveolar organoids were composed of proliferative AT2 cells; however, basal organoid KRT5 + cells contained a distinct ITGA6 + ITGB4 + mitotic population whose proliferation segregated to a TNFRSF12A hi subfraction. Clonogenic organoid growth was markedly enriched within the TNFRSF12A hi subset of FACS-purified ITGA6 + ITGB4 + basal cells from human lung or derivative organoids. In vivo, TNFRSF12A + cells comprised ~10% of KRT5 + basal cells and resided in clusters within terminal bronchioles. To model COVID-19 distal lung disease, we everted the polarity of basal and alveolar organoids to rapidly relocate differentiated club and ciliated cells from the organoid lumen to the exterior surface, thus displaying the SARS-CoV-2 receptor ACE2 on the outwardly-facing apical aspect. Accordingly, basal and AT2 apical-out organoids were infected by SARS-CoV-2, identifying club cells as a novel target population. This long-term, feeder-free organoid culture of human distal lung alveolar and basal stem cells, coupled with single cell analysis, identifies unsuspected basal cell functional heterogeneity and exemplifies progenitor identification within a slowly proliferating human tissue. Further, our studies establish a facile in vitro organoid model for human distal lung infectious diseases including COVID-19-associated pneumonia.
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Tabbene O, Azaiez S, Di Grazia A, Karkouch I, Ben Slimene I, Elkahoui S, Alfeddy MN, Casciaro B, Luca V, Limam F, Mangoni ML. Bacillomycin D and its combination with amphotericin B: promising antifungal compounds with powerful antibiofilm activity and wound-healing potency. J Appl Microbiol 2016; 120:289-300. [PMID: 26669801 DOI: 10.1111/jam.13030] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 11/10/2015] [Accepted: 12/04/2015] [Indexed: 12/31/2022]
Abstract
AIMS In this study, we evaluated the ability of the lipopeptide bacillomycin D and the antifungal drug amphotericin B as well as their combination, to inhibit Candida albicans biofilm formation and to accelerate keratinocyte cell migration. METHODS AND RESULTS The antibiofilm activity of bacillomycin D and its combination with amphotericin B was carried out by crystal violet colorimetric method. Our results have shown that, when combined together at low concentrations nontoxic to mammalian cells, corresponding to 1/32 MIC (0·39 μg ml(-1) ) and 1/4 MIC (0·06 μg ml(-1) ) for bacillomycin D and amphotericin B, respectively, a clear antibiofilm activity is manifested (95% inhibition of biofilm formation) along with a clear inhibition of germ tube formation. Moreover, the effect of both drugs on preformed biofilm of C. albicans strain was determined using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) reduction assay. The combination of the two antifungal compounds at 0·39 and 1 μg ml(-1) for bacillomycin D and amphotericin B, respectively, resulted in a clear enhancement of biofilm eradication compared to the results obtained with each drug alone. Furthermore, this combination was found to promote the closure of a gap produced in a monolayer of human keratinocytes. CONCLUSIONS Bacillomycin D and its combination with amphotericin B display impressive anti-biofilm and wound-healing activities. SIGNIFICANCE AND IMPACT OF THE STUDY Application of the lipopeptide bacillomycin D and the antifungal drug amphotericin B in medical devices may offer a promising alternative for topical treatment of Candida-associated infections in the setting of a wound.
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Affiliation(s)
- O Tabbene
- Laboratoire des Substances Bioactives, Centre de Biotechnologie de Borj-Cedria, Hammam-Lif, Tunisia
| | - S Azaiez
- Laboratoire des Substances Bioactives, Centre de Biotechnologie de Borj-Cedria, Hammam-Lif, Tunisia
| | - A Di Grazia
- Dipartimento di Scienze Biochimiche, Istituto Pasteur-Fondazione Cenci Bolognetti, Universita' La Sapienza, Rome, Italy
| | - I Karkouch
- Laboratoire des Substances Bioactives, Centre de Biotechnologie de Borj-Cedria, Hammam-Lif, Tunisia
| | - I Ben Slimene
- Laboratoire des Substances Bioactives, Centre de Biotechnologie de Borj-Cedria, Hammam-Lif, Tunisia
| | - S Elkahoui
- Laboratoire des Substances Bioactives, Centre de Biotechnologie de Borj-Cedria, Hammam-Lif, Tunisia
| | - M N Alfeddy
- Laboratoire de Phytobactériologie, UR Agrobiotechnologie, Institut National de Recherches Agronomiques, Marrakech, Morocco
| | - B Casciaro
- Dipartimento di Scienze Biochimiche, Istituto Pasteur-Fondazione Cenci Bolognetti, Universita' La Sapienza, Rome, Italy
| | - V Luca
- Dipartimento di Scienze Biochimiche, Istituto Pasteur-Fondazione Cenci Bolognetti, Universita' La Sapienza, Rome, Italy
| | - F Limam
- Laboratoire des Substances Bioactives, Centre de Biotechnologie de Borj-Cedria, Hammam-Lif, Tunisia
| | - M L Mangoni
- Dipartimento di Scienze Biochimiche, Istituto Pasteur-Fondazione Cenci Bolognetti, Universita' La Sapienza, Rome, Italy
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Granato F, Blackhall V, Alessandra R, Spina D, Luca V, Piero P, Mohiyaddin S, Asif M, Kirk AJB, Giuseppe G. Outcome in excised thymomas: role of prognostic factors and impact of additional malignancies on survival. Scott Med J 2014; 59:22-9. [DOI: 10.1177/0036933013518147] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background and aims: Although the management of thymomas has been extensively evaluated, the value of prognostic factors in the outcome of these patients remains unclear. Methods and results: The medical records of all patients who underwent resection of thymoma between January 1985 and September 2010 at a single thoracic unit were reviewed. Patients were followed up with reference to disease recurrence and development of additional malignancies (AM). Total thymectomy was performed in all 68 cases. Mean follow-up time was four years. Mean survival was 63.9 months. Mean disease-free interval was 13 months. Factors affecting prognosis were Masaoka staging and WHO histological sub-type. Patients with thymomas had a higher risk of developing AM when compared with a control population of individuals with other tumours ( p = 0.0002). Among thymomas, the cortical subtype was associated with a higher risk of AM ( p = 0.047) and mortality ( p = 0.001). Conclusions: This data confirms that Masaoka staging and WHO histologic sub-type are the most important prognostic factors in patients with thymoma. Moreover, thymomas predominantly arising from the thymic cortex are associated with a higher risk of developing other malignancies and with poorer survival. The cortical origin of thymoma could therefore be considered as a significant prognostic factor.
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Affiliation(s)
- F Granato
- Professor of Genetics, Department of Cardio-Thoracic Surgery, Golden Jubilee National Hospital, Scotland
- Professor of Genetics, Doctorate School of Oncology and Genetic, University Hospital of Siena, Italy
| | - V Blackhall
- Professor of Genetics, Department of Cardio-Thoracic Surgery, Golden Jubilee National Hospital, Scotland
| | - R Alessandra
- Professor of Genetics, Doctorate School of Oncology and Genetic, University Hospital of Siena, Italy
| | - D Spina
- Consultant Pathologist, Department of Pathology, University Hospital of Siena, Italy
| | - V Luca
- Professor of Thoracic Surgery, Department of Thoracic Surgery, University Hospital of Siena, Italy
| | - P Piero
- Professor of Thoracic Surgery, Department of Thoracic Surgery, University Hospital of Siena, Italy
| | - S Mohiyaddin
- Professor of Genetics, Department of Cardio-Thoracic Surgery, Golden Jubilee National Hospital, Scotland
| | - M Asif
- Professor of Genetics, Department of Cardio-Thoracic Surgery, Golden Jubilee National Hospital, Scotland
| | - A JB Kirk
- Professor of Genetics, Department of Cardio-Thoracic Surgery, Golden Jubilee National Hospital, Scotland
| | - Gotti Giuseppe
- Professor of Thoracic Surgery, Department of Thoracic Surgery, University Hospital of Siena, Italy
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Petrovici CG, Dorobăt C, Bejan C, Juganariu G, Simiraş E, Filip O, Luca V, Miftode E. [Epidemiology and clinical features in diabetic patients with invasive infections treated at the Clinical Hospital of Infectious Diseases of Iaşi, Romania, between 2008-2010]. REVISTA MEDICO-CHIRURGICALA A SOCIETATII DE MEDICI SI NATURALISTI DIN IASI 2011; 115:1035-1041. [PMID: 22276442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED Infections in the diabetic population can be severe and life threatning at least for two reasons: clinical signs are often torpid, masqued by chronical complications of diabetes leading to late recognition and medical adresability and also because of the inability to control established infection due to complex cell-mediated and humoral immunity deffects. The aim of the study was to evaluate the etiology, clinical features and outcome in diabetic patients with invazive disease. MATERIAL AND METHODS A retrospective study was conducted between January 2008 and December 2010 at The Clinical Hospital of Infectious Diseases Iaşi among 75 diabetic patients with sepsis of microbiologically confirmed etiology (positive cultures from normally sterile sites) and sepsis with clinically suspected etiology (positive cultures from pus). Cases with positive urocultures and coprocultures only, were excluded. RESULTS From 75 diabetics, 56% were males, 90,7% being over 50 years. Severe cases of sepsis (33/75, 44%) were associated more often with insulin-treated diabetes than non-insulin treated group (40% vs. 4%, p<0,005) probably because of multiple comorbidities associated as suggested by a high Charlson score (6,09 vs. 4,09, p<0,05). There were 64 cases with confirmed etiology and 11 cases with clinically suspected etiology. Staphylococcus aureus and Escherichia coli were the most common agents isolated, being involved in 16 (21,3%) cases each, followed by coagulase negative Staphylococci (14/18,66%), Enterococcus spp.(6/8%), group B Streptococcus (3/4%), Streptococcus pneumoniae, Enterobacter spp., Salmonella spp. (2/2,66% each), Aerococcus viridans, Streptococcus equi, Klebsiella pneumoniae, Neisseria meningitidis, Sphyngomonas paucimobilis, Pseudomonas aeruginosa, Proteus mirabilis (1/1,33%). Multiple septic disseminations occured in 17(22,6%) cases and meningeal involvment was doccumented in 10(15,6%) cases. Meticillin resistance was noted in 53,3% for invasive isolates of S. aureus. Among 16 invazive strains of E. coli, 25% were resistant to 3rd generation cephalosporins, 17% to ciprofloxacin and 6,6% to aminoglycosides and colimycin. There were no E. coli strains resistant to imipenem, piperacillin-tazobactam and aztreonam. The mean mortality rate was 14,66%. CONCLUSIONS The high level of resistance of S. aureus and E. coli to commonly used antibiotics and meningeal involvement imposes a multidisciplinary approach of the diabetic patient. Proper knowledge of the pathogers involved in the potential invazive diseases is an important tool for successful treatment with appropriate empirical broad-spectrum antimicrobial agents.
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Petrovici CG, Dorobăţ C, Matei M, Teodor A, Luca V, Miftode E. [Aspects of the antimicrobial resistence profile in infections with Escherichia coli and Klebsiella pneumoniae in diabetic patients]. Rev Med Chir Soc Med Nat Iasi 2011; 115:769-775. [PMID: 22046785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED Infections in diabetic patient remains an important cause of morbidity and mortality, triggering and maintaining a prolonged metabolic imbalance. Emergence of extented spectrum beta-lactmase (ESBL) in Escherichia coli and Klebsiella pneumoniae is a major concern, because of the atypical manner infection acts in this group of imunodepressed patients and also for the limited therapeutic solutions. For this reason we have evaluated the profile of antimicrobial resistance of these pathogens in both diabetic and non diabetic patients. MATERIAL AND METHOD The aim of this study was to evaluate, in a retrospective case control study, the antibiotic susceptibility pattern in isolates of E. coli and Klebsiella spp. from different biological products in 49 diabetics and 150 non-diabetics admitted in The Clinical Hospital of Infectious Diseases Iaşi over a period of two years. RESULTS Most of strains of E. coli and Klebsiella spp. ESBL positive were found in uroculture. Significant differences in E. coli resistance rate between diabetics and nondiabetics were noted for amoxicillin-clavulanic acid and ciprofloxacin (31,4% vs.13,98%, p=0,04, respectively 52,9% vs. 24,46%, p=0,004). More isolates of ESBL positive K. pneumoniae were found in diabetic patients (50% vs. 24%). Ciprofloxacin resistance of K. pneumoniae was significantly higher in diabetics (75% vs 39%; p=0,05). There was no resistance in E. coli and K. pneumoniae isolates to imipenem in the diabetic group. CONCLUSIONS The high resistance rate to quinolones and 3rd generation cefalosporins limits their use for the treatment of Escherichia coli and K. pneumoniae infections. Other alternatives for empiric therapy in community and nosocomial-acquired infections in diabetic patient remains carbapenems, aminoglycosides and colimycin.
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Affiliation(s)
- Cristina G Petrovici
- Universităţii de Medicină şi Farmacie "Gr. T. Popa" Iaşi, Facultatea de Medicină
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Antoniu E, Luca V. [Clinical and epidemiological aspects of patients with acute viral hepatitis in Bacau county, from 1996 TO 2005]. Rev Med Chir Soc Med Nat Iasi 2010; 114:376-380. [PMID: 20700971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
UNLABELLED The purpose of the study is to emphasize the clinical and epidemiological peculiarities of acute viral hepatitis in the last decade. MATERIAL AND METHOD We studied retrospectively the files of 2014 patients, hospitalized with the diagnosis of acute viral hepatitis in the Bacău County Hospital, from 1996 to 2005. RESULTS We saw that the only type the incidence of which lowered in time was the B-type hepatitis. The A acute hepatitis witnessed two epidemic peaks. The clinical cases of the male young patients prevailed. In 91.6% of cases, the infection source could not be established. The average incubation period was 21 days for viral hepatitis A, 65 for B and 80 for C. Hospitalized anicteric forms represented 2.8% of total. Extended forms were recorded with 3.6% patients (50.9% of them with B virus) and severe forms with 10.3% (among these, 66.7% with B virus). A fulminate evolution was noticed with 0.65% of cases. The global mortality was 0.4% and 0.95% for B type. CONCLUSIONS We noticed several peculiarities and changes regarding the clinical and epidemiological aspects of acute viral hepatitis in the last
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Affiliation(s)
- Elvira Antoniu
- Universităţii de Medicina şi Farmacie Gr.T. Popa Iaşi Spitalul Judeţean Bacău, Secţia de Boli Infecţioase
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Antoniu E, Luca V. [Features of clinical evolution of severe acute viral hepatitis. Series of 72 cases]. Rev Med Chir Soc Med Nat Iasi 2010; 114:95-100. [PMID: 20509283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
UNLABELLED The fulminant hepatic failure is a dramatic complication of acute viral hepatitis. Despite therapeutical efforts, the mortality of these forms of acute hepatitis is rated in most studies from 60 to 90%. MATERIAL AND METHOD We made a retrospective study that included 2014 patients hospitalized at the Bacau County Hospital from January 1996 to December 2005 with the diagnosis of acute viral hepatitis. Among these, 72 patients presented severe forms of hepatitis. RESULTS 13 patients presented fulminant hepatic failure. In most cases, etiology was represented by the B-type virus (66.7%). Defining for the fulminant form of hepatitis are the Quick index under 50%, the increase of total serum bilirubine and the leucocitosis associated with neutrophilia. CONCLUSIONS Mortality in fulminant forms of hepatitis was of 61.5%, respectively 75% in the case of the B-type viral hepatitis. Key words: SEVERE
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Affiliation(s)
- Elvira Antoniu
- Universităţii de Medicină şi Farmacie Gr. T. Popa Iaşi, Spitalul Judeţean Bacău Secţia Boli Infecţioase adulţi
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Miftode E, Vâţă A, Leca D, Hurmuzache M, Dorneanu O, Manciuc C, Luca V, Dorobăţ C. [Community acquired acute bacterial meningitis--a 10 year review]. Rev Med Chir Soc Med Nat Iasi 2009; 113:402-409. [PMID: 21495344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
UNLABELLED Bacterial meningitis is still an important topic for the infectious diseases specialist, due to it's high incidence, severity and it's high mortality rate. MATERIAL AND METHOD We retrospectively studied 679 patients diagnosed with community acquired bacterial meningitis in the Infectious Diseases Hospital Iaşi, Romania between 1998 and 2007. RESULTS The annual number of admissions slightly decreased in the last years. Most patients were males (62.1%). Predisposing factors were present in 34.9% of cases. Seizures were described in 19.6% of cases, more frequent in children. The CSF was purulent only in 69.4% of patients, 29.6% of them receiving antibiotics prior to admission; the albumin level in the CSF of pneumococcal meningitis was higher than in other meningitis. The etiology was established in 51.6% of cases, more frequent in sucklings (68.1%). N. meningitidis was the most common cause of community acquired acute bacterial meningitis (CABM) (28.5%) followed by S. pneumoniae (14%). S. pneumoniae was susceptible to penicillin in 79% of cases. The mean mortality rate was 13.1%. CONCLUSION Factors associated with a poor prognosis were: pneumococcal etiology, age over 60, and the presence of seizures or coma at admission.
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Affiliation(s)
- Egidia Miftode
- Disciplina de Boli Infecţioase, Facultatea de Medicină, Universitatea de Medicină si Farmacie Gr.T. Popa Iaşi
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11
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Petrache SM, Miftode E, Vâţă A, Petrovici CM, Dorneanu O, Luca V. [Sepsis with Staphylococcus aureus in immunocompromised patients]. Rev Med Chir Soc Med Nat Iasi 2009; 113:410-415. [PMID: 21495345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
UNLABELLED The aim of our study was to analyze clinical and biological characteristics of immunocompromised patients with staphylococcal sepsis and to compare with the same data in non-immunocompromised patients. MATERIAL AND METHOD The diagnosis of sepsis was made based on Bone criteria. MiniAPI system ID 32 STAPH was used for identification and antibiotic susceptibility was assessed by ATB STAPH method and by E-test for oxacillin and vancomycin. RESULTS Among the 147 patients with Staphylococcus aureus sepsis--66.67% had concomitant immunosuppressive conditions (diabetes mellitus, liver diseases, renal failure, corticotherapy, etc). We have found a significant correlation between the immunosuppressed status and MRSA (methicillin-resistant Staphylococcus aureus) involvement (p = 0.0018) and also, between this group of patients and treatment failure (p = 0.0012). CONCLUSION Because of the high rate of MRSA involvement in systemic infections in the Eastern region of Romania first intention treatment of patients with staphylococcal infections and conditions of immunosuppression must include antibiotics effective against methicillin-resistant strains.
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Affiliation(s)
- Simona Magdalena Petrache
- Disciplina de Boli Infecţioase, Facultatea de Medicină, Universitatea de Medicină si Farmacie Gr.T. Popa Iaşi
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Petrache SM, Miftode E, Leca D, Dorneanu O, Luca V. [Clinical and microbiological characteristics of Staphylococcus aureus infections in infectious diseases hospital Iaşi]. Rev Med Chir Soc Med Nat Iasi 2009; 113:192-196. [PMID: 21495317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
UNLABELLED We assessed clinical and microbiological characteristics of Staphylococcus aureus (SA) infections in hospitalized patients during a period of three years (October 2005 - October 2008) in the Clinic Hospital of Infectious Diseases Iaşi. MATERIAL AND METHODS The study included 169 patients with SA infections (sepsis, meningitis, skin infections and urinary tract infections). MiniAPI system ID 32 STAPH was used for identification and antibiotic susceptibility was assessed by ATB STAPH method and by E-test for oxacillin and vancomycin. RESULTS The rate of methicillin resistance (MR) was 48%, all strains being susceptible to linezolid, vancomycin, teicoplanin. In our study MRSA was susceptible in approximately 94% of cases to clindamycin and cotrimoxazole. Infections were defined as nosocomial in 51% of patients with a rate of MR of 52% and community-acquired in 49% with a rate of MR of 23% (p = 0.001). Clinical profile was: localized infection in 41% of patients with MRSA and systemic infection (sepsis with at least one organ involvement or bacteremia) in 59% of patients with MRSA infections (p = 0.53). Initial treatment was inadequate in 46% of MRSA infections. One third of strains had MIC of vancomycin 2 mg/mL. CONCLUSIONS The high level of methicillin resistance of S. aureus straints isolated from infections (48 %) justifies a particular approach of initial antistaphylococcal therapy.
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Affiliation(s)
- Simona Magdalena Petrache
- Universitatea de Medicina şi Farmacie Gr. T. Popa Iaşi, Facultatea de Medicina, Disciplina de Boli Infecţioase
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13
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Luca MC, Mihalache D, Dorobăţ C, Petrovici CM, Varlan M, Luca V. [Cross-sectional study of leptospirosis cases admitted to the Iaşi Clinic of Infectious Diseases over a 5-years period]. Rev Med Chir Soc Med Nat Iasi 2008; 112:612-615. [PMID: 20201240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
UNLABELLED Leptospirosis is a zooantroponosis manifested as an infection with a severe evolution, with liver and renal failure and haemoragic manifestation. The aim of the study was to present the epidemiologic, clinic and therapeutical aspects of 100 cases of leptospirosis admitted in the clinic of Infectious Diseases of Iaşi, during 5 years (2002-2006). MATERIAL AND METHOD The diagnostic was based on the clinical-biologic study and risk factors with febrile syndrome, mialgic syndrome, headache, meningial, liver and renal failure and hematological syndromes, with the serologic evidence of serotypes of leptospirosis. RESULTS All the patients were serologic confirmed with leptospirosis. Leptospirosis is an emergent disease with the possibility of severe evolution in some forms, with lever and renal failure.
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Affiliation(s)
- Mihaela Cătălina Luca
- Facultatea de Medicină, Clinica de Boli Infectioase, Universitatea de Medicină si Farmacie "Gr.T. Popa" Iaşi
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Miftode E, Leca D, Luca V. [A severe case of infectious mononucleosis associated with ciprofloxacin and salazopyrin administration]. Rev Med Chir Soc Med Nat Iasi 2008; 112:652-655. [PMID: 20201247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We report a case of rash probably induced by ciprofloxacin and/or salazopyrin administration in a patient with infectious mononucleosis. A 22 year woman developed a maculopapular and petechial eruption in the 3-rd day of ciprofloxacin (given for a genital tract infection) and the 32-nd day of salazopyrin (for a spondylodiscitis). Subsequently she developed a severe hepatitis, shock, and very severe leucocytosis (88 000/mmc) that occasioned haematological investigations for a lymphoproliferative syndrome.
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Affiliation(s)
- Egidia Miftode
- Facultatea de Medicină, Disciplina de Boli Infecţioase, Universitatea de Medicină si Farmacie "Gr.T. Popa" Iaşi
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15
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Miftode E, Dorneanu O, Leca D, Teodor A, Mihalache D, Filip O, Luca V. [Antimicrobial resistance profile of E. coli and Klebsiella spp. from urine in the Infectious Diseases Hospital Iaşi]. Rev Med Chir Soc Med Nat Iasi 2008; 112:478-482. [PMID: 19295023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
UNLABELLED The increasing frequency of extended-spectrum beta-lactamases (ESBLs) producing Enterobacteriaceae among nosocomial and community-acquired infections is an important problem for both microbiologists and clinicians, because of the difficulty in correctly detecting, reporting and treating such infections. RESULTS In the Clinical Hospital of Infectious Diseases Iaşi the most frequent etiological agents of urinary tract infections were: E. coli - 64%, Klebsiella spp. 11% and Enterococcus spp - 5%. The resistance rate of E. coli and Klebsiella spp. was 41% and 60%, respectively to amoxicillin-clavulanic acid, 29.6% and 72.5%, respectively to third generation cephalosporins, 26% and 24%, respectively to ciprofloxacin. The most active antimicrobial agents against cephalosporins resistant strains of E. coli and Klebsiella spp were carbapenems (susceptibility rate 99% and 94%, respectively) and colimycin (susceptibility rate 89% and 83%, respectively).
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Affiliation(s)
- Egidia Miftode
- Disciplina de Boli Infecţioase, Facultatea de Medicină, Universitatea de Medicină si Farmacie "Gr.T. Popa" Iaşi
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Dorneanu O, Filip O, Miftode E, Radu I, Nicolau C, Damian I, Luca V. [Cryptococcus meningitis, five years of experience and literature review]. Rev Med Chir Soc Med Nat Iasi 2008; 112:100-103. [PMID: 18677910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
UNLABELLED The aim of this study was to determine the distribution and antifungal susceptibility profile of Cryptococcus spp. isolated from patients in northeast Romania. MATERIAL AND METHOD Fungi isolated from blood and cerebrospinal fluid (CSF) cultures were identified by ID32C strips (bioMerieux, France). Susceptibility testing was performed using ATB FUNGUS2 strips (bioMerieux, France). RESULTS A total of 20 significant strains have been isolated. Overall, Cryptococcus neoformans was the most frequent isolate (95%). We mention the first Cryptococcus albidus meningitis in Romania (strain with multiple resistance). All cryptococci tested were susceptible to amphotericin B with minimal inhibitory concentration (MIC) =1 microg/mL; 90% strains were susceptible to flucytosine. Resistance to fluconazole and itraconazole was observed in 2 and 1 case, respectively. Most of the patients had an associated infection, tuberculosis in 37.5% cases. Despite appropriate therapy 4 patients died (21%). CONCLUSION First choice induction therapy with amphotericin B plus flucytosine followed by fluconazole is highly recommended since resistance to antifungal agents is still very low.
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Affiliation(s)
- Olivia Dorneanu
- Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi, Facultatea de Medicină, Disciplina de Microbiologie
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Luca MC, Petrovici CM, Vâţă A, Dorobăţ C, Năstase E, Luca V, Teodor A, Luca A. [Gamma interferon testing in blood and cerebrospinal fluid--rapid method for the diagnosis of tuberculous meningitis]. Rev Med Chir Soc Med Nat Iasi 2008; 112:108-110. [PMID: 18677912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
AIM To evaluate the benefit of this early method of diagnosis of tuberculous meningitis, gamma-interferon levels comparatively in blood and cerebrospinal fluid (CSF). MATERIAL AND METHOD We have studied 50 patients with tuberculous meningitis admitted in the Clinic of Infectious Diseases Iaşi between 2006-2007, from the epidemiological, clinical, diagnosis and therapeutical points of view. RESULTS Tuberculous meningitis was more frequent in males, with a mean ration of 2.5. The age of patients varied between 2 and 78 years of age, with a mean value of 30.5 years. 35.6% of patients were children. In 32 cases the meningeal infection was secondary, disseminated from a primary site, most frequently from the lungs (68,7%). The bacteriologic confirmation was through culture in 13.3%, with an average of 23.4 days of incubation. In whole blood the sensitivity Quantiferon TB Gold assay (QTF) was 78.57%. In CSF the specificity was higher than in blood (96.1 vs. 88.4%), having a positive prediction value over 90%. Antituberculous therapy prior to QTF testing had a negative impact, 50 to 6 cases having negative QTF results. CONCLUSION The performance indicators of TB Gold Quantiferon Test in serum or CSF are high, being more sensitive and rapid than the direct exam of CSF or BK culture.
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Affiliation(s)
- Mihaela Catălina Luca
- Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi, Facultatea de Medicină, Clinica de Boli Infecţioase Iaşi
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18
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Lindsay M, Blackford M, Attard D, Luca V, Skyllas-Kazacos M, Griffith C. Anodic titania films as anode materials for lithium ion batteries. Electrochim Acta 2007. [DOI: 10.1016/j.electacta.2007.04.027] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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19
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Manciuc C, Dorobăţ C, Hurmuzache M, Luca V, Mihalache D, Grigorescu O. [Leptospirosis in children. Clinico-biological and therapeutic aspects for the cases hospitalised between 1992-2005]. Rev Med Chir Soc Med Nat Iasi 2007; 111:383-385. [PMID: 17983172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
UNLABELLED The aim of the study is that of showing the prevalence of the disease in childhood in our county. MATERIAL AND METHOD We studied the observation files of the patients admitted in our unit in between 1992 and 2005 comprised in the 0-15 year old age bracket, noticing all the epidemiological, clinical and therapeutic aspects. RESULTS In the above mentioned period, 16 patients from the 0-15 year old group (3.12% of all the patients suffering from leptospirosis) were admitted in our clinic. Male (93.75%) and suburban area (60%) were dominant; 11-15 year old group was represented in 87.5% cases; the prevalence was observed during the summer (11 cases) and during 1999 (6 cases); the meningeal signs were noticed in 5 cases and jaundice for 3 children; the most frequent agent was L. icterohaemorrhagiae--7 cases. The etiological treatment was performed for 14 cases with betalactamines for 7.4 days in average; no lethal cases were noticed. CONCLUSIONS In the case of Iaşi County, leptospirosis is a clinico-biological entity considered in the diagnosis of the jaundice, meningeal and febrile syndromes in children.
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Affiliation(s)
- Carmen Manciuc
- Facultatea de Medicină, Clinica Boli Infecţioase, Universitatea de Medicina si Farmacie "Gr.T. Popa" Iaşi
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Dorneanu O, Miftode E, Vremera T, Filip O, Nastasa E, Luca V. R2138 Resistance to antibiotics in coagulase-negative staphylococci in an infectious diseases hospital, Iasi, Romania. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71977-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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21
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Vâţa A, Hurmuzache M, Duca E, Scripcariu D, Florea D, Petrovici C, Butur D, Luca V. [The co-infection with hepatitis virus B and D--cases admitted in the infectious diseases hospital from Iaşi, Romania (2003-2005)]. Rev Med Chir Soc Med Nat Iasi 2006; 110:856-60. [PMID: 17438888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Despite the major medical advance, over 350 million people worldwide still have chronic infection with hepatitis B virus and HBV-associated liver disease remains a major cause of morbidity and mortality. 15-50% of patient VHB infected have serological markers for VHD co-infection. We retrospectively studied 252 cases of acute hepatitis B (AHB) admitted in our hospital between 2003-2005; 12 of them (4.76%) had a co-infection with hepatitis D virus. Most of the patients were young males with an urban origin. The route of transmission was unknown in 8/12 cases. Abdominal pain was more frequent during the onset of the disease than in AHB (p < 0.05). A cholestatic pattern was noted in 9 cases. The frequency of severe/ fulminant cases was greater then in AHB. The HBsAg was absent in 3 patients, and the HBV-DNA was present at low levels in 3/12 patients tested. Two patients had HBsAg present 6 month later.
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Affiliation(s)
- A Vâţa
- Spitalul Clinic de Boli infectioase, Iaşi
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22
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Maniciuc C, Dorobaţ C, Hurmuzache M, Mihalache D, Luca V. [Varicella-zoster infection--extreme clinical aspects]. Rev Med Chir Soc Med Nat Iasi 2006; 110:852-5. [PMID: 17438887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
UNLABELLED Infections with the varicella-zoster (VZ) virus are a constant of our everyday practice. The aim of the present study is that of underlining unusual aspects of the infection with the VZ virus--primary infection in adults and herpes zoster in children. If varicella, or chickenpox, has been traditionally considered a childhood disease, nowadays, an increased number of adults are affected by primary infections. On the contrary, more and more children present the secondary form of the infection, which appears as herpes zoster, a disease usually diagnosed in adults. MATERIAL AND METHODS We studied the observation papers of adult patients with varicella, hospitalized in our clinic during 2004-2005 and we analyzed the herpes zoster manifestations in non-HIV children, diagnosed with the disease during the same period of time. RESULTS During 2004-2005, 34 adult patients were diagnosed with varicella, while 10 children presented herpes zoster. 16 of the adults with varicella were 25-34 years old. One of the children with herpes zoster was less than one year old. All the adults with varicella were treated with acyclovir; in 14 cases, the therapy was supplemented with rifampicin. All the children with herpes zoster came from rural areas. The pathology that determined the decrease of general immunity was represented by neoplasia (3 cases), malnutrition and rickets (2 cases), associated infectious pathologies--bronchopneumonia (3 cases). CONCLUSIONS Varicella in adults has an increased incidence, which is underestimated, in our opinion. Its loud clinical manifestations impose the therapy with acyclovir. Herpes zoster in children reveals significant subsidiary pathologies and a depressed immune system that impose special medical care and many days of hospitalization.
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Affiliation(s)
- Carmen Maniciuc
- Facultatea de Medicina, Universitatea de Medicina "Gr.T. Popa", Iaşi
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Grecu F, Bulgariu T, Blanaru O, Dragomir C, Lunca C, Stratan I, Manciuc C, Luca V. Invasive amebiasis. Chirurgia (Bucur) 2006; 101:539-42. [PMID: 17278650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Digestive amoebiasis with his invasive form is an unusual pathology encountered in the temperate zone. This could lead to a life threatening complication: systemic amoebiasis. A 55-year-old male was treated successfully of systemic amoebiasis in a third referral hospital. The diagnosis was established based on epidemiology data and microscopical identification of trophozoites of Entamoeba histolytica. The amoebicidal, antibiotic and supportive treatments was firstly administrated. The clinical picture of intestinal amoebiasis raised from dysenteric syndrome to necrotizing enteritis. The bowel perforation with localized peritonitis was followed by chronic enteric fistula. Amoebic liver abscess, as the most frequent extraintestinal complication, was concomitantly diagnosed and treated. Urinary amoebiasis was considered as complication in the context of systemic dissemination: any other location could become a site of an amoebic abscess. Multidisciplinary approach was the successful key in the management of the patient, including antiparasitic therapy and antibiotic prophylaxis, intensive care and multiple surgical approaches. The diagnosis of digestive amoebiasis and systemic complication may be delayed in nonendemic areas, leading to advanced and complicated stages of the disease. The surgical approach is most efficiently to treat a large liver amoebic abscess and intraperitoneal collections.
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Affiliation(s)
- F Grecu
- Third Surgical Unit, St. Spiridon Hospital of Iasi.
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Poiată A, Tuchiluş C, Ambăruş A, Teodor A, Teodorescu I, Luca V, Buiuc D. Antimicrobial susceptibility of Staphylococcus aureus isolated from colonized hospital personnel. Rev Med Chir Soc Med Nat Iasi 2006; 110:723-6. [PMID: 17571573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The present study was performed to investigate the in vitro activity of oxacillin and other antimicrobial agents against S. aureus strains obtained from nursing personnel. We tested 127 S. aureus colonizing nasal mucous and hand skin and isolated from nursing personnel of University Hospital Department of Infectious Diseases, Iaşi, during June 2005 period. Minimum inhibitory concentrations (MICs) were determined by the dilution method in Mueller-Hinton agar. Most of the S. aureus strains were susceptible to tested agents excepted erythromycin and azithromycin. Erythromycin and azithromycin resistance was observed among 29.1% respectively 22% of S. aureus strains. Vancomycin was active against all isolates. Teicoplanin was active against against all MRSA excepted one of the strain, with an reduced susceptibility. Linezolid has very good in vitro activity against staphylococci, with an MIC 90 of 2 mcg/ml and only 0.8% resistance. The MIC values range was between 0.5-2 mcg/ml. In conclusion, the usually hygienic methods (disposable gowns, hygienic hand disinfection after each patients contact, masks use when is a risk of aerosolization of MRSA) are indicate for significantly reducing of these strains.
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Affiliation(s)
- Antonia Poiată
- Gr. T. Popa University of Medicine and Pharmacy, Iaşi School of Medicine
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25
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Luca MC, Dorneanu O, Sabadîş L, Dorobăţ C, Fîntînaru R, Luca V. [Erysipelothrix rhusiopathiae--rare etiology of persistent febrile syndrome]. Rev Med Chir Soc Med Nat Iasi 2005; 109:62-5. [PMID: 16607829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Erysipelothrix rhusiopathiae is a Gram-positive rod, carried by many domestic and pet animals and very resistant in the environmental habitat, causing an anthropo-zoonosis infection in humans. It can determine, most frequently, a skin infection and may cause also septic arthritis or systemic infection, usually associated with aortic endocarditis. Bacteremia without endocarditis is a very rare presentation, generally seen in immunocompromised patients. We report such an unexpected diagnosis in a 75-years old woman, with mitral regurgitation, who was investigated for a persistent febrile syndrome, with no evidence of vegetation on repeated echo examinations and no evidence of the entry portal and who recovered successfully from an E. rhusiopathiae bacteremia with Ampicillin iv. therapy for 14 days.
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Affiliation(s)
- Mihaela Cătălina Luca
- Universitatea de Medicină şi Farmacie Gr T Popa Iaşi, Facultatea de Medicină, Disciplina Boli Infecţioase
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Luca V, Gessner BD, Luca C, Turcu T, Rugina S, Rugina C, Ilie M, Novakova E, Vlasich C. Incidence and etiological agents of bacterial meningitis among children <5 years of age in two districts of Romania. Eur J Clin Microbiol Infect Dis 2004; 23:523-8. [PMID: 15257444 DOI: 10.1007/s10096-004-1169-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
To expand upon the limited comprehensive population-based data for childhood bacterial meningitis in Eastern Europe, the present study was conducted in the Iasi and Constanta districts of Romania. From March 2000 through March 2002, children <5 years of age hospitalized for bacterial meningitis were enrolled in a prospective surveillance study. A total of 56 cases of bacterial meningitis were identified, including 37 due to Neisseria meningitidis (22 per 100,000 per year), 13 due to Haemophilus influenzae type b (7.6 per 100,000 per year), and six due to Streptococcus pneumoniae (3.5 per 100,000 per year). Of the 31 meningococcal isolates that were serotyped, 12 were serogroup A, eight were serogroup B, and 11 were serogroup C. Among all cases of bacterial meningitis, 25 occurred in children <1 year of age, including those due to meningococci (n=14), H. influenzae type b (n=7), pneumococci (n=3), and Klebsiella pneumoniae (n=1). In Romania the incidence of H. influenzae type b meningitis is similar to that found in other areas of Southern and Eastern Europe during the pre-vaccination era, and the incidence of meningococcal meningitis is one of the highest yet found in Europe. An unexpectedly high proportion of these meningococcal meningitis cases is due to serogroup A. Disease burden could be substantially reduced through the introduction of H. influenzae type b conjugate vaccine and, when available, meningococcal conjugate vaccine protective against serogroups A, B and C.
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Affiliation(s)
- V Luca
- Infectious Disease Hospital, University Hospital, Octav Botez Street no. 2, Iasi, Romania
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27
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Manciuc C, Luca V, Duca E, Dorobăţ C, Nicolau C, Vâţă A. [Tetanus in childhood--experience at the Infectious Disease Hospital Iaşi, January 1980-October 2003]. Rev Med Chir Soc Med Nat Iasi 2004; 108:296-8. [PMID: 15688802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The aim of our study is to present the tetanus pediatric cases for almost 24 year period. We analyzed epidemiologically, clinico-biologically and the treatment from the patients' files. In above mentioned period were admitted 8 children with tetanus, 4 cases in 1980-1990; 5 patients were female, mainly came from suburban area; 12-15 year old group of age was mainly involved-3 cases. A point of entry was certified in 7 cases, the mean incubation period was 9.2 days, all the cases had a typical form of the disease. The complications were: bronchopneumonia, ileus (1 case). The performed treatment--antitetanic serum, antibiotics, sedatives, curare for 3 patients; no patient died. A rare disease for the pediatric age, tetanus could be a severe disease, with severe complications.
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Affiliation(s)
- Carmen Manciuc
- Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi, Facultatea de Medicină, Spitalul Clinic de Boli Infecţioase
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Manciuc C, Vâţă A, Dorobăţ C, Scurtu R, Petrovici C, Luca V. [Lamivudine and alpha-IFN treatment of a severe case of acute hepatitis B]. Rev Med Chir Soc Med Nat Iasi 2004; 108:207-9. [PMID: 15688787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
In order to enhance the viral clearance we used a combined antiviral therapy in an 18 year old patient, hospitalized in the Infectious Diseases Hospital-Iaşi, in June 2002. The evolution under standard therapy was unsatisfactory, with the aggravation of the icteric syndrome and a constant cytolytic syndrome. At this point we used the combination of Lamivudine (Zeffix) 100 mg/24 h + alpha-IFN 3 milUI x 3/week for the duration of 8 weeks. The improvement in both clinical and biochemical condition of the patient was obvious. At the end of the treatment (8 weeks) none of the signs or symptoms were present, the patient became AgHBs negative, AgHBe negative and anti-HBe positive. The combined antiviral therapy was useful (with the clearance of the HBs antigen) in a severe case of acute hepatitis B.
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Affiliation(s)
- Carmen Manciuc
- Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi, Facultatea de Medicină, Clinica de Boli Infecţioase
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Teodor A, Teodor D, Luca V. [Side effects of antiretroviral therapy]. Rev Med Chir Soc Med Nat Iasi 2004; 108:23-6. [PMID: 15688751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Highly active antiretroviral therapy (HAART) has changed the natural history of HIV infection, but the presence of adverse events may limit its efficacy. Nucleoside reverse transcriptase inhibitors can cause mitochondrial toxicity and anemia, non-nucleoside reverse transcriptase inhibitors are associated with rash and central nervous system disturbance; protease inhibitors elicit gastrointestinal adverse effects and metabolic abnormalities including lipodystrophy syndrome, hyperlipidemia and insulin resistance. These complications have the potential to increase morbidity and mortality significantly in those requiring long-term treatment of HIV-infection. The presence of such abnormalities also has an impact on adherence to treatment. Besides providing health benefits, HAART may have a negative impact on patients' quality of life. Identifying and treating these complications has important implications for patient survival.
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Affiliation(s)
- Andra Teodor
- Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi, Facultatea de Medicină, Clinica de Boli Infecţioase
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Manciuc C, Vâţă A, Duca E, Dorobăţ C, Scurtu R, Luca V. [Acute viral encephalitis. Experience of the Iaşi Infectious Disease Clinic between January 2000 and March 2003]. Rev Med Chir Soc Med Nat Iasi 2003; 107:763-6. [PMID: 14756016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
We analyzed the patients files suffered from acute viral encephalitis in 39 months period: January 2000-march 2003. According to our data there was a total of 33 patients; one of them died. The most involved patients were male and of the 8-14 year group of age; for the first three month in 2003 were admitted 11 patients. Coma and seizures were the most frequent clinical signs. LCR had the usual abnormalities for the above mentioned disease; the treatment was mainly performed with corticosteroids; 28 cases were admitted more than 8 days period. The evolution of the clinical status was satisfactory for all 32 patients.
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Affiliation(s)
- Carmen Manciuc
- Clinica de Boli Infecţioase, Facultatea de Medicină, Universitate de Medicină şi Farmacie Gr.T. Popa Iaşi
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Mihalache D, Luca V, Nicolau C, Teodorescu I, Prisăcariu LJ, Macovei S. [Cutaneous and oral manifestations in HIV-infected children and adults--169 cases]. Rev Med Chir Soc Med Nat Iasi 2003; 107:565-9. [PMID: 14756063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
UNLABELLED The aim of the study was to evaluate cutaneous and oral manifestations in infected HIV patients. MATERIALS AND METHODS We retrospectively analyzed 169 cases admitted in Infectiouse Disease Department of Iaşi in 2001-2002 period. RESULTS Cutaneous and oral manifestations were: candidiasis (99 cases), herpes virus infectious (36 cases), scabies and straphylococcal/streptococcal skin disease (26 cases), prurigo nodularis, psoriasis and verruca vulgaris (9 cases). Children of 0-13 year old group was 75.73 percent. Classification of HIV infection was related with CD4 count for 166 cases. Twelve cases with oral pharyngitis candidiasis, scabies and streptococcal skin diseases was 2-3 recurrent episodes of manifestations. Etiotrop treatment was associated with HAART therapy. CONCLUSIONS Cutaneous and oral manifestations are occurred frequently in HIV infected patients, with a various etiology, but the severity, persistence and its evolution did not evaluate.
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Affiliation(s)
- Doina Mihalache
- Facultatea de Medicină, Clinica de Boli Infecţioase, Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi
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32
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Tuchiluş C, Poiată A, Bădicuţ I, Teodor A, Luca V, Grigore L, Buiuc D. [Activity of fourth generation cephalosporins against clinical isolates of Enterobacteriaceae]. Rev Med Chir Soc Med Nat Iasi 2003; 107:595-8. [PMID: 14756068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
Cefpirome and cefepime are a novel group of cephalosporins which contain a positively charged quaternary ammonium at carbon 3 of the dihidrothiazone ring. The antimicrobial agents cefpirome, cefepime, cefotaxime, ceftriaxone, ceftazidime, cefoperazone and imipenem were tested against clinical isolates of Escherichia coli (n = 302) and Klebsiella spp. (n = 62) obtained during september-december 2002 from patients of Galaţi Emergency Hospital. The fourth generation cephalosporins cefpirome and cefepime have similar in vitro activities to the third generation cephalosporins. E. coli showed the comparable resistance rates for all cephalosporins. Against Klebsiella spp. strains cefpirome was less active (35.5% resistance) than cefepime (25.8% resistance). As expected, imipenem had excellent activity (100% susceptibility).
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Affiliation(s)
- Cristina Tuchiluş
- Disciplina de Microbiologie, Facultatea de Medicină, Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi
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33
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Stefănescu C, Prelipcean CC, Mihai C, Drug VL, Luca V. [Digestive implications of human immunodeficiency virus infection]. Rev Med Chir Soc Med Nat Iasi 2003; 107:288-97. [PMID: 14755930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
AIDS, still present with severe prognosis at the beginning of the 3rd Millennium, may present gastrointestinal and hepatic involvement. Even they have not a fatal prognosis, in order to improve the quality of life of AIDS patients we need a broad knowledge of and to treat the gastrointestinal and hepatic manifestation of the disease.
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Affiliation(s)
- Carmen Stefănescu
- Institutul de Gastroenterologie şi Hepatologie Iaşi, Facultatea de Medicină, Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi
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34
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Teodor A, Teodor D, Luca V. [Possibilities and limits of antiretroviral actual therapy]. Rev Med Chir Soc Med Nat Iasi 2002; 106:680-3. [PMID: 14974210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
The therapies now approved for HIV-infection inhibit one of two viral-specific enzymes, reversetranscriptase or protease. Combining this drugs into regimes based on at least three individual drugs--so-called HAART--has resulted in a remarkable reduction in HIV-associated morbidity and mortality. Despite these therapeutic advances, many patients are either intolerant of available agents or develop virologic failure. Problems of adherence, drug-resistance, latent reservoirs and drug-induced toxic effects that compromise effective viral control point to need for new strategies (e.g. structured treatment interruptions--STIs) and new classes of anti-HIV drugs with different modes of action (e.g. blocking HIV entry into human cells or fusion process). The use of adjunctive immune-based therapy such as IL-2 may permit more extensive immune restoration.
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Affiliation(s)
- Andra Teodor
- Facultatea de Medicină, Clinica de Boli Infecţioase, Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi
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35
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Howard CJ, Kennedy BJ, Kisi EH, Knight KS, Luca V. On structural phase transitions in perovskites. Acta Crystallogr A 2002. [DOI: 10.1107/s0108767302093534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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36
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Corcaci C, Luca V, Turcu T, Mihalache D, Dorobăţ C, Oana F. [Hemophilus influenzae meningitis- the experience of infectious diseases department between 1984-2001]. Rev Med Chir Soc Med Nat Iasi 2002; 107:348-51. [PMID: 12638289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Our paper presents a clinico-biological and therapeutical study of the cases admitted in Infectious Diseases Hospital between January 1984-December 2001. We studied the records of all the patients that suffered from meningitis with Haemophilus influenzae. In above mentioned period 40 cases of Haemophilus influenzae meningitis was admitted; 6 patients (15%) died. A number of 13 cases was registered for the first five years, mainly in the childhood-32 cases (80%) for infants. Bacteriological diagnosis was made by bacterioscopia for 16 patients, bacteriological cultures-30 patients, latex test, performed in the last five years, in 8 cases. In patients who died, the bacteriologic culture was positive in 5 cases and bacterioscopia in 4 cases. The therapy was performed in resonance with antibiograme results for the involved strains. The Haemophilus influenzae meningitis is an acute and severe disease of the childhood, with an important risk of death, despite the rigorous therapeutical measures.
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Affiliation(s)
- Carmen Corcaci
- Facultatea de Medicină Clinica de Boli Infecţioase, Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi
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Luca MC, Dorobăţ C, Corcaci C, Scurtu R, Luca V, Mihalache D. [Leptospirosis-clinico-biological and therapeutical aspects-study of 256 cases]. Rev Med Chir Soc Med Nat Iasi 2002; 107:352-5. [PMID: 12638290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Leptospirosis is a zooantroponosis manifested as an infectious disease with a severe evolution, with liver and renal failure and hemorrhagic manifestation. The aim of this study was to present the clinico-biological investigation and the therapeutical aspects of 256 cases of leptospirosis admitted in the Infectious Diseases Hospital Iasi during 4 years (1998-2001). The diagnosis was based on the study of clinico-biological and therapeutical parameters (risk factors, fever, mialgia, headache, algic, eruptive, meningeal, hepatorenal, hemorrhagic syndromes with the serological evidence of the serotypes of leptospirosis); most of the cases were registered in 1998 (23% cases), in adults (31.2%) and male (75.22%). All the patients were serologic confirmed with leptospirosis (RAL and RFC), and L. icterohaemorhagiae was isolated most frequently. The standard anti-leptospirosis treatment was administered with favorable evolution; 6 deaths were registered from the severe forms of the disease. The leptospirosis is an emergent disease with the possibility of severe evolution in some forms, with liver and renal failure.
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Affiliation(s)
- Mihaela Cătălina Luca
- Facultatea de Medicină Clinica de Boli Infecţioase, Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi
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Iancu LS, Pandele GI, Stanciu C, Luca V. Hepatitis C virus serotypes in Romanian patients with chronic hepatitis and cirrhosis. Rev Med Chir Soc Med Nat Iasi 2002; 106:79-82. [PMID: 12635365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
OBJECTIVES To determine the prevalence of hepatitis C virus (HCV) serotypes in Romanian patients with chronic hepatitis infections and the association between them and disease's severity. PATIENTS AND METHODS Anti-HCV antibodies were first investigated by an indirect ELISA (Murex IIIrd generation). From 55 patients positive for anti-HCV, 22 patients (11 female and 11 male) with chronic active hepatitis (CAH--6 cases), chronic persistent hepatitis (CPH--11 cases) and cirrhosis (C--5 cases) were tested for HCV serotypes using an indirect ELISA (Murex HCV Serotypes 1-6 Assay). The average age for the selected group was 47.2 years (range 27 divided by 68). RESULTS In the first study from our region concerning this subject we have found the following serotypes distribution: serotype 1--68.18% (6/11--CPH; 4/6--CAH; 5/5--C); serotypes 2, 3, 4, and 6--4.54% for each of them (all were CPH cases); untypable--13.65% (2 with CAH and 1 CPH respectively). CONCLUSIONS (1) The serotype 1 seems to be predominant in our region in patients with chronic HCV infections and it is associated with the most severe cases. (2) The diversity of serotypes is higher compared with previous study group results (e.g. in haemodialized patients the serotype 1 was determined in almost 100% cases--unpublished data). (3) Untypable strains (13.65%) require the sequence analysis for HCV genome characterization.
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Affiliation(s)
- Luminiţa Smaranda Iancu
- IVth Medical Clinic, School of Medicine, University of Medicine and Pharmacy Gr. T. Popa Iaşi
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39
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Mihalache D, Lefter M, Luca V, Teodor A, Teodorescu I. [Fungal infection in AIDS patients. Consideration for 10 cases]. Rev Med Chir Soc Med Nat Iasi 2002; 106:161-3. [PMID: 12635380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Clinic, etiologic and therapeutic study of fungic infection in AIDS patients. The retrospective clinical study of the 10 AIDS patients admitted between 01.01.1994 and 31.12.2000 in Infectious Diseases Clinical Hospital of Iaşi. The majority of the cases (7) were registered in the last 3 years: 4 children and 6 adults. HIV infection was known only for 4 patients according to their history, and for the other 6 patients this diagnosis was made concomitantly of fungic infection diagnosis. The disease onset was insidious in 7 cases (2 children and 5 adults) being characterized by manifestations of nervous system involvement and consciousness disturbances (6 cases). The etiological diagnosis was established for alive patients by cerebrospinal fluid culture and hemocultures and Cryptococcus neoformans was isolated for 9 patients and Candida to another one. Fungic infection lead to meningeal injuries to 6 patients and the systemic one in for 4 patients. Although, under antifungical and antiretroviral therapy, the disease was lethal for 4 patients. The fungic infection recrudesces in AIDS patients, possessing systemic or/and meningeal manifestation, long evolution that can be lethal for a lot of them.
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Affiliation(s)
- Doina Mihalache
- Clinica Boli Infecţioase, Facultatea de Medicină, Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi
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40
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Turcu T, Luca V, Luca C, Rudnic E. Sensitivity and resistance to antibiotics of Streptococcus pneumoniae involved in severe infections (1990-2000). Rev Med Chir Soc Med Nat Iasi 2001; 105:773-7. [PMID: 12092237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
S. pneumoniae implicated in severe infections presents now a high frequency of the resistant strains to Penicillin G or multiresistance in the whole world. Our study on 136 strains of invasive pneumococcus isolated in the last 10 years showed a medium resistance to penicillin of 22.8% with yearly variations. The resistance to Rifampin, Cloramphenicol and Eritromycin was of 4.4%, 7.8% and 8.0%. The treatment of pneumococcal infections must be adapted to actual antibiotypes. These results present therapeutic implications.
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Affiliation(s)
- T Turcu
- School of Medicine, Clinic of Infectious Diseases, University of Medicine and Pharmacy Gr. T. Popa Iaşi
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41
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Miftode E, Luca V, Mihalache D, Leca D, Stefanidis E, Anuţa C, Sabadis L. Spinal epidural abscess. Rev Med Chir Soc Med Nat Iasi 2001; 105:778-84. [PMID: 12092238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
In a retrospective study, 68 patients with Spinal Epidural Abscess (SEA) were reviewed. Of these, 66% had different predisposing factors such as staphylococcal skin infections, surgical procedures, rachicentesis, trauma, spondilodiscitis. Abscess had a lumbar region location in 53% of cases. Staphylococcus aureus was the most frequent etiological agent (81%). The overall rate of mortality in SEA patients was 13.2%.
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Affiliation(s)
- E Miftode
- School of Medicine, Department of Infectious Diseases, University of Medicine and Pharmacy Gr. T. Popa Iaşi
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42
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Miftode E, Luca V. [Bartonella infection]. Rev Med Chir Soc Med Nat Iasi 2001; 105:486-9. [PMID: 12092178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Bartonella species have been recently recognized as an important human pathogen associated with a wide spectrum of diseases. Four members of the genus are known to cause human infection: Bartonella baciliformis, B. henselae, B. quintana and B. elizabethae. B. baciliformis, the first identified Bartonella species, is the agent of two disease entities, Oroya fever and verruga peruana., B. henselae and B. quintana are two species involved in producing bacteremic syndromes (relapsing fever, trench fever, endocarditis), chronic lymphadenopathy in immunocompetent patients (cat-scrath disease) and chronic vascular lesions in immunocompromised hosts (bacillary angiomatosis and bacillary peliosis hepatis-recognized as new opportunistic infections in HIV-infected patients).
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Affiliation(s)
- E Miftode
- Facultatea de Medicină, Clinica de Boli Infecţioase, Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi
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Luca C, Luca V, Turcu T, Mihalache D, Fîntînaru R, Teodorescu I, Miftode E, Corcaci C, Leca D, Hurmuzache M. [Clinical and biological study of acute diarrhea with mixed etiology in 48 patients]. Rev Med Chir Soc Med Nat Iasi 2001; 105:536-40. [PMID: 12092189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
OBJECTIVES The study of incidence, clinical manifestation and treatment of acute diarrhea with mixed etiology. MATERIAL AND METHOD Study of 48 patients with acute diarrhea with mixed etiology admitted in the Hospital of Infectious Diseases of Iaşi during 1995-1998. RESULTS 12 cases (24%) were mixed bacterial infections with the following microorganisms associations: Salmonella + Shigella (10 cazuri); Salmonella + Yersinia enterocolitica (1 case); Salmonella + Rotavirus (1 case). 16 cases (44%) had mixed digestive infections with parasites, in double or triple associations: Giardia intestinalis + Ascaris lumbricoides (10 cases); Giardia intestinalis + Ascaris lumbricoides + Entamoeba coli (1 case); Giardia intestinalis + Enterobius vermicularis (3 cases); Ascaris lumbricoides + Trichiuris trichiura (2 cases). The rest of 20 cases presented mixed infections with bacteria and parasites: Salmonella + Rotavirus + Giardia (2 cases), Salmonella + Shigella + Giardia intestinalis or Ascaris lumbricoides (6 cases), Salmonella + Giardia intestinalis (8 cases); Salmonella + Entamoeba coli (3 cases); Shigella + Trichiura trichiuris + Entamoeba coli (1 case). The majority was male patients from rural areas with age between 5 month and 56 years, the majority being children, 4 cases were found in immunosupressed patients. The clinical symptomatology was dominated by diarrheal syndrome (100%) and the diagnosis was established by clinical characters and confirmed by coproculture and parasitologic exam. The ethiological therapy was guided by antibiogram, in the majority of cases we used fluorochinolones (associated with ceftriaxone in severe cases), together with antiparasitic medications. CONCLUSIONS In this study predominated the bacterial and parasitic infections, most frequently being isolated Salmonella, Shigella and Giardia intestinalis; the therapy associated fluorochinolones with antiparasitic medication.
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Affiliation(s)
- C Luca
- Clinica Boli Infecţioase, Facultatea de Medicină, Universitatea de Medicină şi Farmacie Gr. T. Popa Iaşi
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Azoicăi D, Ivan A, Carasievici E, Luca V, Ilcenco D, Scripcaru L, Scripcariu D, Grigoriu-Merchez M. The prevalence of the owner of serologic markers for the hepatitis C virus, in a north-eastern territory of Romania. Rev Med Chir Soc Med Nat Iasi 2001; 105:127-31. [PMID: 12092139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
The paper describes aspects in the natural evolution of hepatitis C virus (HCV) infection with severe outcomes induced by the typical or atypical clinical manifestations or chronic carrier state. In the interval 1995-1999 in the Iasi district morbidity from all types of viral hepatitis ranged from 153.4 cases per 100,000 inhabitants in 1995 to 66.6 in 1999. The features of A viral hepatitis epidemiological process was the multiannual cyclic pattern. From estimating the circulation of HCV in the population of Iasi district, several population categories have been screened for the presence of HCV antibodies (anti-HCV). Testing 87,894 blood samples assessed the prevalence of anti-HCV in blood donors. Different annual values resulted: 1.5% in 1997 and as a result of routine screening, only 0.3% in 1999. The cases of posttransfusion hepatitis (PTH) admitted to the Clinic of Infectious Diseases of Iasi, the diagnosis of which was supported by epidemiological history and confirmed serologically by the presence of anti-HCV were of 12 in 1995 (36.4% of all PTH), 20 in the interval 1996-1999, with an average for the 4 study years of 7.5%. Anti-HCV was found in 24.4% of series of 4,594 patients with viral hepatitis, in 32.1% of 582 individuals with various disorders or at risk, of which those with liver cirrhosis accounted for 37%, and in 9.6% of 94 patients with neurological disorders. Of the 1083 tested physicians and nurses working in health care settings at risk 6.6% were anti-HCV-positive.
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Affiliation(s)
- D Azoicăi
- Gr.T. Popa University of Medicine and Pharmacy Iasi
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Miftode E, Luca V, Dănilă F, Corcaci C. [Difficulties in the diagnosis of prolonged fever in infants]. Rev Med Chir Soc Med Nat Iasi 2000; 104:153-5. [PMID: 12089945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
We report the case of an infant with cytomegalovirus (CMV) infection who developed a nosocomial sepsis of mixed etiology. Fever failed to decrease despite long-time and sustained antibiotic therapy. Treatment with an antiviral agent following the detection of CMV antibody of the IgM class resulted in clinical improvement and subsequent full recovery. We suggest that the diagnosis of CMV infection should be considered even in immunocompetent patients in whom antibiotic therapy fails.
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Affiliation(s)
- E Miftode
- Facultatea de Medicină Clinica de Boli Infecţioase, Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi
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46
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Luca C, Luca V, Mihalache D, Scurtu R, Creţu C. [Neurologic manifestation in mumps virus infection]. Rev Med Chir Soc Med Nat Iasi 2000; 104:83-6. [PMID: 12089932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
OBJECTIVE To study the incidence, clinical manifestations and treatment of mumps virus meningitis. MATERIAL AND METHOD Study of 64 patients with mumps virus meningitis, admitted to the Clinic of Infectious Diseases of Iaşi during 1996-1999. RESULTS The mumps virus meningitis had a high prevalence în 1998 (39%) most patients being males (62.5%) from the urban areas. 39.06% of cases were on the age group of 5-6 years old, 25% were in the age group 10-14 years old and 18.75% were adults patients. The clinical manifestation were dominated by headache (100%), fever (100%), vomiting (89%), photophobia (43.75%) and meningeal syndrome of contracture. The laboratory diagnosis was established by the cerebro-spinal fluid exam, together with the peripheric blood exam. The treatment was in all the cases with pathogenic (corticotherapy) and symptomatics with a very good evolution. CONCLUSIONS All the cases with diagnosis mumps virus meningitis were well going, having good evolution and complete healing under symptomatic and pathogenic therapy.
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Affiliation(s)
- C Luca
- Universitatea de Medicină Gr.T. Popa Iasi Facultatea de Medicină Clinica de Boli Infecţioase Iaşi
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47
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Dorobăţ G, Dorobăţ CM, Luca V. [Hanover intensive score. Study on 218 cases ]. Rev Med Chir Soc Med Nat Iasi 2000; 104:81-7. [PMID: 12089996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
We have performed a prospective study (1990-1996) in our intensive care unit in Hospital "C.I. Parhon" Iassy. Our study has 218 critical patients with ARDS and MSOD. For all of them we have used a new scoring system HIS (Hanover Intensive Score) for: the evaluation of patients with ARDS that have the risk to develop MSOD; determine the prognosis in different moments of evolution. In our opinion this score has the following advantages: it is easy to apply; it can determine the prognosis and the probable status of the patient at the moment of outcome; it can be used in our country with the technical that we have and we propose this score for his performances.
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Mihalache D, Luca V, Teodorescu I, Luca C, Corcaci C, Miftode E, Turcu T. [Nosocomial staphylococcal meningitis]. Rev Med Chir Soc Med Nat Iasi 1999; 103:167-71. [PMID: 10756946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
OBJECTIVE Clinical, bacteriological and therapeutically study on iatrogenic staphylococcal meningitis. METHOD Retrospective analysis of 33 cases of iatrogenic staphylococcal meningitis admitted to the Hospital of Infectious Diseases of Iaşi in the interval 1988-1997. RESULTS In the interval under study the recorded incidence was 1-5 cases per year. The predisposing factors were neurosurgical procedures for endocranial processes (12 cases), operated chronic otomastoiditis (11 cases), ventriculoatrial or peritoneal shunt (5 cases) and neurosurgical assessment (5 cases). The onset was slow, with persisting and mild headache persistence recurrence of fever, vomiting and convulsions followed by meningeal contracture and encephalitic phenomena. In 24 patients cerebrospinal fluid was typical for purulent meningitis. The causal agents were isolated in 25 cases being Staphylococcus aureus (20 cases) and Staphylococcus epidermidis sensitive to usual antistaphylococcal agents. Three therapeutically schemes were used the association cefotaxim î gentamycin proving to be the most effective vancomycin was required in but 2 cases. Three deaths were recorded. CONCLUSIONS The symptoms of iatrogenic staphylococcal meningitis are mild marked by the underlying disease the most effective treatment being the association of cefotaxim with an aminoglycoside.
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Affiliation(s)
- D Mihalache
- Clinica de Boli Infecţioase, Facultatea de Medicină, Universitatea de Medicină şi Farmacie Gr. T. Popa, Iaşi
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Luca C, Mihalache D, Luca V, Turcu T. [The clinical picture, treatment and prognosis of meningitis due to anaerobic and nonfermentative bacteria]. Rev Med Chir Soc Med Nat Iasi 1999; 103:158-60. [PMID: 10756944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
OBJECTIVES The study of incidence, clinical manifestations and prognosis of meningitis with anaerobic and non-fermentative bacteria. MATERIAL AND METHOD Retrospective study of 10 patients with severe forms of purulent meningitis admitted in the Hospital of Infectious Diseases of Iaşi, during 1.01.1990-31.12.1998. RESULTS 3 of them were diagnosed with etiology with polymicrobial flora and the rest had etiology with: Peptostreptococcus (2 cases), Acinetobacter calcoaceticus (4 cases), Eikenella corrodens (1 case). The majority were male sex (8 cases), and from rural area (9 cases). The age of patients ranged from 2.5 to 59 years (the majority being adults of group of age 50-60 years). The gate of entrance was: iatrogenic in the majority of cases (6 cases), posttraumatic (2 cases) and othogen (2 cases); 3 cases being with cerebrospinal fluid fistula and 8 patients being in coma. The factors associated with poor prognosis were: the immunosuppression (chronic etilism--4 cases; bronchopneumonia--2 cases, pulmonary cancer--1 case) and the presence of the focal neurological findings on the noser of illness. The diagnosis was established by clinical characters and confirmed by isolating germs from cerebrospinal fluid. The treatment was done at the beginning with first intervention antibiotic association with a high spectrum and then according to the antibiogramme. The evolution was severe even under treatment with 3 deaths, the mortality being of 30.0%. CONCLUSIONS We wished to present these cases as a general remark on the severity of illness, generally appeared on a suppressed ground, together with the rarity of those germs implicated in the etiology of purulent meningitis.
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Affiliation(s)
- C Luca
- Clinica de Boli Infecţioase, Facultatea de Medicină, Universitatea de Medicină şi Farmacie Gr. T. Popa, Iaşi
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Bohotin C, Leca V, Luca V, Costuleanu M, Vornicu M, Bohotin V, Bădescu M. Hepatic artery hemodynamics in acute viral hepatitis. Rom J Physiol 1999; 36:3-9. [PMID: 11068600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
In order to evaluate the effect of the acute viral hepatitis on arterial blood flow we performed duplex Doppler US on 30 patients with acute viral hepatitis (AVH) and compared the results with those obtained on 20 normal volunteers. Hepatic artery flow (HAF) was significantly increased with the patients suffering from acute viral hepatitis. The data obtained show that the increase of arterial blood flow is not always associated with the increase of arterial velocities. We could put in evidence the presence of the hepatic artery response to altered portal blood flow (arterial buffer) during a AVH. If the increase of HAF is absolutely necessary for recovery from hepatitis, excessive increase of HAF seems to increase the time of recovery. In our study, the evolution of acute viral hepatitis was good when the HAF values did not exceed 65% of liver supply. The increase of arterial blood flow over 65% seems to limit the portal supply of the liver and in this way the amounts of regenerating substances which bathe the liver cells. The HAF value plays an important role in acute viral hepatitis evolution, so that the exploration of HAF and hepatic artery velocities may be a reliable examination in order to monitor the evolution of this disease.
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Affiliation(s)
- C Bohotin
- Department of Pathophysiology, University of Medicine and Pharmacy, Iaşi, Romania
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