Suspicion of lead poisoning is confirmed by its concentration in blood and protoporphyrin red blood cells. At low concentrations, lead influences the synthesis of the heme in the sense of lowering it. Acute and chronic lead intoxication is extremely polymorphic in regards to its clinical manifestations, with digestive, hematological, cardiovascular, renal hepatic and neurological features. The aim of the study was to evaluate the presence of lead in human whole blood and urine harvested before and during chelation treatment in the case of lead poisoning. An atomic absorption spectroscopic method for the analysis of lead was developed using graphite furnace atomic absorption spectrophotometer (GF-AAS), Varian Spectra AA-880 with a hollow cathode lead lamp and a deuterium lamp for background correction, coupled to a GTA-100 atomizer and a programmable sample dispenser. Standard calibration solutions were used for the range 10-100 µg/l. The linearity range was 10.0 to 100.0 µg/l with the correlation coefficient of 0.999. We established that the method can be applied for the determination of lead in whole blood and urine, and the results obtained are useful for monitoring chelation therapy in cases of acute lead poisoning, a neglected cause of abdominal colic pain in an emergency situation.
The majority of studies concerning Helicobacter pylori ( H. pylori ) are oriented towards the implication of infection with H. pylori in processes that end in the formation of neoplasia, without assessing the impact of the bacterium in triggering acute gastroduodenal hemorrhagic episodes. The present study includes 166 patients with upper digestive hemorrhage, admitted to the ATI Clinic, the Gastroenterology Clinic or to the Surgery II Clinic of the County Emergency Clinical Hospital in Craiova, Romania between 2017 and 2019. All patients were monitored for evolution and received treatment according to current guidelines, and hemorrhagic lesions were biopsied. In the study group, 56.8% of the patients with upper gastrointestinal bleeding (UGIB) were positive for H. pylori and 43.2% were negative. In patients less than 50 years of age, non-steroidal anti-inflammatory drug (NSAID) use and H. pylori infection had a cumulative effect in causing bleeding lesions, but in patients older than 50 years of age, the use of NSAIDs was replaced by therapies with oral antiplatelet or anticoagulant agents. The need for hemostasis surgery was more common in patients who exhibited H. pylori -positive UGIB compared to H. pylori -negative (16 vs. 9.7%). In patients with H. pylori -positive hemorrhagic lesions, gastric resection was frequently required to obtain hemostasis. Persistence of H. pylori infection in patients with a history of gastric resection (4.1%) still predisposes to a hemorrhagic or neoplastic complication.
Objective. The purpose of this study is to analyse histopathological and clinical characteristics of EOCRC. Colorectal cancer was formerly considered as a disease of senescent age; in the last years, it is a noticeable trend of growing incidence among young people (aged between 20 and 45 years). Few of newly diagnosed cases are inherited and most of them are sporadic. Material and method. The authors studied retrospectively a series of 33 cases of early onset colorectal cancer, 17 men and 16 women, with ages below 45 years, admitted between January 2009 and January 2015 in II and IV Surgical Wards of Emergency University Hospital Bucharest. Results. Colorectal cancer in young adults tends to be an aggressive disease with dominant distal location (68.5% of all cases), mostly adenocarcinomas (96.6%) with moderate to poorly differentiated types (51.4% G2 and G3), diagnosed in advanced stages (57.6% stages III and IV), with high frequency of complications (33% presented with peritoneal carcinomatosis and 9% died during hospitalization). Conclusions. EOCRC is a heterogenous group regarding etiopathogeny, localization and histopathological features of the tumor, with aggresive histopathological types, diagnosed in advanced stages. It may be necessary to elaborate new screening protocols for colorectal cancer in young adults and to fi nd clinical and biological markers that are indicating high-risk patients.
In the last century, foot and ankle related traumatic pathology became more and more frequent. A 75 years old male with associated peripheral arterial disease presented himself in ER with an infected, contusive wound at the left foot sole and calcaneum. After local treatment (debridement, hyaluronic acid derivatives and antibiotics), the wound evolution was good. During the extensive clinical and paraclinical investigations preceding cardiovascular surgery for the pre-existing peripheral arteriopathy), a pulmonary tumor in resectable stage was discovered. So, the patient underwent pulmonary bilobectomy and afterward a cutaneous free groin flap reconstruction of the foot. The local wound evolution was good, and the patient could stand and walk after a month. He is currently under oncological supervision. Although skin grafts are recommended in lesions affecting weightbearing zones, in this case, given the arteriopathy, it was preferred a free skin flap. In this case with complicated, intricated pathology, the traumatic episode played also a beneficial role by helping the early diagnosis of an operable lung cancer.
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