Purpose. Nontraditional cardiovascular risk factors as apolipoprotein A (ApoA), apolipoprotein B (ApoB), and the proprotein convertase subtilisin/kexin type 9 (PCSK9) increase the prevalence of cardiovascular mortality in chronic kidney disease (CKD) or in end-stage renal disease (ESRD) through quantitative alterations. This review is aimed at establishing the biomarker (ApoA, ApoB, and PCSK9) level variations in uremic patients, to identify the studies showing the association between these biomarkers and the development of cardiovascular events and to depict the therapeutic options to reduce cardiovascular risk in CKD and ESRD patients. Methods. We searched the electronic database of PubMed, Scopus, EBSCO, and Cochrane CENTRAL for studies evaluating apolipoproteins and PCSK9 in CKD and ESRD. Randomized controlled trials, observational studies (including case-control, prospective or retrospective cohort), and reviews/meta-analysis were included if reference was made to those keys and cardiovascular outcomes in CKD/ESRD. Results. 18 studies met inclusion criteria. Serum ApoA-I has been significantly associated with the development of new cardiovascular event and with cardiovascular mortality in ESRD patients. ApoA-IV level was independently associated with maximum carotid intima-media thickness (cIMT) and was a predictor for sudden cardiac death. The ApoB/ApoA-I ratio represents a strong predictor for coronary artery calcifications, cardiovascular mortality, and myocardial infarction in CKD/ESRD. Plasma levels of PCSK9 were not associated with cardiovascular events in CKD patients. Conclusions. Although the “dyslipidemic status” in CKD/ESRD is not clearly depicted, due to different research findings, ApoA-I, ApoA-IV, and ApoB/ApoA-I ratio could be predictors of cardiovascular risk. Serum PCSK9 levels were not associated with the cardiovascular events in patients with CKD/ESRD. Probably in the future, the treatment of dyslipidemia in CKD/ESRD will be aimed at discovering new effective therapies on the action of these biomarkers.
Methicillin-resistance phenomenon regarding Staphylococcus aureus which is often met as etiologic agent of severe systemic infections with oral-maxillofacial portal of entry imposes the first-line therapeutic schemes readjustment in patients with significant risk factors. Minimum inhibitory concentration (MIC) determination for every isolated S.aureus strain is useful for the antibiotherapy guiding, in order to choose the appropriate antimicrobial substances and to avoid the selection of resistant mutants. There have been studied and tested 9036 bacterial strains isolated from patients hospitalized in the Sf.Spiridon Emergency County Hospital between 2013-2016. Minimum inhibitory concentrations (MIC), MIC 50 and MIC 90 values were determined for the following antibiotics: Penycilline, Erithromycin, Oxacylline, Tetracycline, Gentamycin, Tobramycine, Kanamycin, Ryfampicyn, Trimethoprim-Sulfamethoxazole, Ofloxacine, Ciprofloxacine and Vancomycin.The classification of each identified bacterial strain into sensitive or resistant was accomplished according to the breakpoints recommended by CLSI 2016 (Clinical and Laboratory Standard Institute). We considered intermediately susceptible isolates as being resistant. S.aureus antibioresistance was high to tetracycline, erythromycin and kanamycin, with elevated MIC 90 values (64�g). The rate of resistance to penicillin in the case of S.aureus was 94.7%. The lowest MIC values regarding Pseudomonas aeruginosa were for imipenem, meropenem and colistin and the highest ones for piperacillin-tazobactam, ceftazidime and amikacin. Third generation cephalosporins demonstrated their inefficiency in the staphylococcal infections� treatment as a consequence of an increasing resistance to this category of betalactams. Vancomycin remains a saving in-hospital therapeutic option in the case of MRSA implication, next to teicoplanin and linezolid.
Table of contentsA1 The outcome of patients with recurrent versus non-recurrent pneumococcal meningitis in a tertiary health-care hospital in BucharestCristian-Mihail Niculae, Eliza Manea, Raluca Jipa, Simona Merisor, Ruxandra Moroti, Serban Benea, Adriana HristeaA2 Influence of bacteriophages on sessile Gram-positive and Gram-negative bacteriaAlina Cristina Neguț, Oana Săndulescu, Anca Streinu-Cercel, Dana Mărculescu, Magdalena Lorena Andrei, Veronica Ilie, Marcela Popa, Coralia Bleotu, Carmen Chifiriuc, Mircea Ioan Popa, Adrian Streinu-CercelA3 The utility of inflammatory biomarkers in the prognostic evaluation of septic patients – past, present and futureAlina Orfanu, Cristina Popescu, Anca Leuștean, Remulus Catană, Anca Negru, Alexandra Badea, Radu Orfanu, Cătălin Tilișcan, Victoria Aramă, Ştefan Sorin AramăA4 Etiologic and clinical features of bacterial meningitis in infantsConstanța-Angelica Vișan, Anca-Cristina Drăgănescu, Anuța Bilașco, Camelia Kouris, Mădălina Merișescu, Magdalena Vasile, Diana-Maria Slavu, Sabina Vintilă, Endis Osman, Alina Oprea, Sabina Sandu, Monica LuminosA5 The diagnostic and prognostic role of neutrophil to lymphocyte count ratio in sepsisAlina Orfanu, Victoria Aramă, Ştefan Sorin Aramă, Anca Leuştean, Remulus Catană, Anca Negru, Gabriel Adrian Popescu, Cristina PopescuA6 Whooping cough in a HIV positive patientRamona Georgiana Stanculete, Ana Vaduva Enoiu, Adelina Raluca Marinescu, Voichita LazureanuA7 Cronobacter sakazakii sepsis in varicella patientAdelina-Raluca Marinescu, Alexandru Crișan, Voichița Lăzureanu, Virgil Musta, Narcisa Nicolescu, Ruxandra LazaA8 Anaerobes an underdiagnosed cause of prosthesis joint infectionAnca-Ruxandra Negru, Daniela-Ioana Munteanu, Raluca Mihăilescu, Remulus Catană, Olga Dorobăț, Alexandru Rafila, Emilia Căpraru, Marius Niculescu, Rodica Marinescu, Olivera Lupescu, Vlad Predescu, Adrian Streinu-Cercel, Victoria Aramă, Daniela TălăpanA9 Streptococcus pneumoniae meningitis presenting with normal CSF – case presentationRamona Ștefania Popescu, Luminița Bradu, Dragoș Florea, Adrian Streinu-CercelA10 Extrapulmonary manifestations of infection with Mycoplasma pneumoniae – study on 24 casesDaniela Anicuta Leca, Elena Bunea, Andra Teodor, Egidia MiftodeA11 The molecular diagnosis of severe bacterial sepsis in pediatric populationMădălina Merișescu, Gheorghiță Jugulete, Adrian Streinu-Cercel, Dragoș Florea, Monica LuminosA12 Acute Staphylococcus aureus endocarditis with multiple septic complications in a patient with diabetes mellitus – case presentationRamona Ștefania Popescu, Anamaria Dobrotă, Adina Ilie, Liliana Lucia PreoțescuA13 Is Streptococcus suis meningitis an under-diagnosed zoonosis?Adriana Hristea, Raluca Jipa, Nicoleta Irimescu, Irina Panait, Eliza Manea, Simona Merisor, Cristian Niculae, Daniela TălăpanA14 Klebsiella pneumoniae isolated from blood. Antimicrobial resistance – past and presentLiana Cătălina Gavriliu, Otilia Elisabeta Benea, Șerban Benea, Alexandru Rafila, Olga Dorobăț, Mona PopoiuA15 Antibiotics resistance in Staphylococcus a...
(1) Background: The outbreak of the COVID-19 pandemic represented a real challenge for all of humanity. Characterized by a complex spectrum of signs and symptoms, by various severity degrees, the disease spread rapidly around the world. After more than two and half years since the beginning of COVID-19 pandemic, in the context of a paradoxical, enigmatic, and relentless COVID-19, the objective of the current study was to evaluate the characteristics and evolution of patients with SARS-CoV-2 infection, hospitalized in “St. Parascheva” Clinical Hospital of Infectious Diseases (Iasi, Romania). (2) Methods: This is a retrospective study that used the medical database recorded between July and November 2021 in order to highlight the characteristics of SARS-CoV-2 infection in patients from the northeastern region of Romania. (3) Results: We enrolled in the study a total of 1732 SARS-CoV-2 infected patients, mean age 67 ± 3.4 years, the female gender predominating (987 cases; 56.98%) as well as patients from the urban environment (982 patients; 56.69%). Moderate form of the disease predominated (814 cases; 47%), pulmonary imaging changes were found in 1042 (60.16%) cases, and 1242 (71.71%) patients had at least one underlying disease. After a median length of hospitalization of 9.5 days, 1359 (78.46%) patients were discharged cured, 48 (2.77%) were transferred to other services by decompensating the associated pathologies, 302 (17.43%) patients needed extensive support in the intensive care unit and there were 325 (18.76%) deaths. (4) Conclusions: The epidemiological characteristics of SARS-CoV-2 infection recorded in our study were mostly the same as characteristics of COVID-19 from all over the world.
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