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Biomedical subjects

D Dragomir

Publications and source records attributed to D Dragomir.

At least 19 recordsLinked to original sources
PubMed2003

Comparison of the efficacy and safety of beclometasone dipropionate suspension for nebulization and beclometasone dipropionate via a metered-dose inhaler in paediatric patients with moderate to severe exacerbation of asthma.

Nebulization simplifies the administration of effective inhaled medications to young asthmatics who experience hand-to-lung co-ordination problems and inspiratory difficulties associated with metered-dose and dry-powder inhalers, respectively. The objective of this double-blind, double-dummy multicentre, randomized, parallel-group study was to compare the efficacy and safety of corticosteroids given by nebulization or metered-dose inhalation in paediatric patients with exacerbation of asthma. Following a 24-h run-in period, 151 patients, aged 6-16years, with moderate to severe exacerbation of asthma were randomized to one of two treatment groups for 4 weeks: beclometasone dipropionate (BDP) suspension for nebulization 1,600 microg day(-1) b.i.d. given via a nebulizer (n = 75), or BDP spray 800 microg day(-1) b.i.d. given via a metered-dose inhaler (MDI) plus spacer (BDP MDI) (n = 76). Superimposable and statistically significant improvements over baseline were noted at study end for the two treatment groups in the various efficacy parameters evaluated (pulmonary function tests, asthma symptoms scores, and the use of rescue salbutamol). The primary efficacy endpoint was the morning pulmonary expiratory flow rate (PEFR). In the BDP nebulization group, mean morning PEFR increased statistically significantly from 233.2 +/- 86.31 min(-1) to 322.0 +/- 101.81 min(-1), while in the BDP MDI group the increase was from 222.9 +/- 87.31 min(-1) to 314.9 +/- 96.61 min(-1). Moreover, an additional 4-week treatment period at half doses, completed by 26 patients, demonstrated that improvements were maintained or further enhanced. The two treatments were equally well tolerated. A total of 25 and 26 patients in the BDP nebulization and BDP MDI groups, respectively reported adverse events during the treatment period, and these were generally mild. In conclusion, the results of this study demonstrate that BDP suspension for nebulization 1,600 microg day(-1) given via a nebulizer and BDP spray 800 microg day(-1) given via an MDI plus spacer are equally effective, with an acceptable safety and tolerability profile, when used in paediatric patients with moderate to severe asthma exacerbation.

Administration, Inhalation↗
PubMed1991

[Infantile spasms (infantile myoclonic encephalopathy with hypsarrhythmia)].

The paper reports on a very important aspect in a pediatric practice, referring to one of the most severe forms of epilepsy of the infant, known in the modern specialty literature as infantile spasms. The paper reviews the etiologic data of the disease in its secondary form, with emphasis on the form of the disease better studied in the last years, i.e. the so-called infantile benign epileptic spasms. The paper also analyzes the clinical and electroencephalographic aspects, discuss the most important aspects of the differential diagnosis that includes some entities recently individualized and appreciates, on the basis of the most topical literature data, the nature of the different treatment means used, and of the evolution and prognosis.

Brain↗
PubMed1991

[Pneumocystis carinii pneumonia].

The paper reports on a theme of important pediatric interest, pneumonia with Pneumocystis carinii (PC), a more widespread affection lately, due to the progress in pediatric reanimation, on the one hand (that allowed the survival for a long time of several biologically handicapped infants) and as a consequence of the more and more common use of immunosuppressing therapy, on the other hand (malignant diseases, transplant of organs, etc.); another important role in the increase of the PC pneumonia is played, recently, both in the adult and the child, by the infection with HIV (acquired immunodeficiency syndrome). The authors discuss largely on the pathogenic agent, PC, proved to be a fungus by molecular genetic studies, and on the biological field (small age, dystrophy, prematurity, "debilitating" chronic diseases, long diarrheic diseases, congenital malformations, hospitalization, some infections with long evolution: tuberculosis, Cryptococcus, infection with cytomegalic virus). The paper also deals with epidemiology, pathogeny and pathologic anatomy of the disease (characteristic macroscopic aspect: nonaired lung of high consistency, with whitish infiltrations alternating with congestive zones and the microscopic aspect of alveolo-interstitial pneumonia). The clinical picture includes the common form, met in the biologically handicapped infant and hypoergic hypoimmune form, appearing in all ages in immunodeficient subjects. Radiological examination, pulmonary scintigraphy and a series of laboratory data (with evidence of parasitic cysts) complete the clinical examination, making easier the diagnosis. The techniques of seroimmunological diagnosis offers great hope for the future. The positive diagnosis shows the clinical elements that suggest the presence of the disease, the contribution of the radiologic examination and mainly the presence of the parasite in the bronchitic secretions; the therapeutic response is a retroactive element in the positive diagnosis. The differential diagnosis is presented in detail. The paper concludes with a series of treatment schemes used, prophylaxis, evolution, complications and prognosis of the disease.

Child↗
PubMed1991

[Staphylococcal pneumonia].

In spite of the great advances of the antibiotherapy and of the respiratory resuscitation techniques, the staphylococcal pneumonia continues to be one of the most severe bacterial pneumonias of the child, fact which may be explained not only by the poor immunogenic capacity of the infection, but especially by the virulence characteristics of the staphylococcus: necrotizing capacity, toxigenicity (complex), resistance to antibiotics, diffusion capacity of the infection (percontiguum or at distance), resistance to phagocytosis and bacterial lysis etc. The etiology (bacteriology and immunity), the epidemiological data (the disease represents 1/3 of the primitive bacterial pneumonias occurring during the first two years of life), data regarding the pathogenesis and the pathological anatomy are reviewed. The clinical picture, the radiological examination and the laboratory data are extensively analysed, after which the positive diagnosis, based on the correlation of anamnestic, clinical, radiological and bacteriological data, is discussed. Authors point out the contribution of the radiological examination that detects the typical lesions, the aspect of which changes characteristically very rapidly (from day to day), namely: aspect of frank pleurisy (common and very evocative), pyopneumothorax, pneumatocele, excavated staphylomas (abscesses), less frequently mediastinal pneumothorax or emphysema. The clinical differential diagnosis with a number of diseases: suppurative pneumonias, solitary pulmonary cyst, polycystic lung, infected pulmonary sequestration etc., and the radiological differential diagnosis with bilateral diffuse alveolar pulmonary opacities, excavated pulmonary opacities, images under the form of pulmonary "bullae" and "cysts" are discussed. The final part contains a detailed description of the treatment and its basic components: etiological (antibacterial) treatment, treatment by decompression and pleural drainage, resuscitation treatment, as well as of the course, complications and prognosis of staphylococcal pneumonia.

Child↗
PubMedDate not supplied

[Urticaria in children--the current etiopathogenetic and clinico-therapeutic aspects].

The authors present actualized data regarding urticaria, which is frequently encountered in children. The first part presents the etiology, pathogenesis and pathological aspects of urticaria. Next, are discussed clinical and paraclinical data, useful for the diagnosis. An important step in the diagnosis work-up is to establish the etiology. A large space is dedicated to the therapeutical aspects, insisting upon the superiority (the advantages, the efficacy) of last generation antihistaminic drugs.

Child↗
PubMedDate not supplied

[The neuropsychic manifestations of HIV infection in children].

The authors analyse the frequency, the significance for prognosis and the localisation of the neuropsychological manifestation concerning the steps of evolution of the HIV infection in children. The pathogenetic aspects, the principal histopathological lesions and clinical corresponding aspects are also presented. The text refers to the modern neuroimaging investigations and to the new treatment possibilities.

AIDS Dementia Complex↗
PubMedDate not supplied

[The respiratory manifestations of the acquired immunodeficiency syndrome in children].

The authors present the pulmonary complications (infectious and non infectious) in children with AIDS. It is shown that in this group of children the pulmonary complications are the first cause of death, and among them, the most frequent are the interstitial lymphoid pneumonia and Pneumocystis carinii pneumonia.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[Drug-induced pulmonary lesions].

The problem of the drug induced pulmonary toxicity (cytotoxic and non-cytotoxic drugs) is discussed. This domain of modern pathology is in continuous development, although yet insufficiently delineated. The essential pathogenic mechanisms are presented as well as the main histopathological lesions (i.e., interstitial pneumonia and pulmonary fibrosis). The usual lesional aspects specific to certain drugs are also reviewed. For the principal chemical substances in this category, the clinical and radiological aspects are given, also the various treatment indicated, the evolution and the prognosis of the drugs induced pulmonary disease.

Antineoplastic Agents↗
PubMedDate not supplied

[Ataxia].

Explore the source record for details and available documents.

Algorithms↗
PubMedDate not supplied

[The hematological manifestations in human immunodeficiency virus (HIV) infection in children].

The hematologic disorders that occur in HIV infected children are analysed by the authors, on the basis of some recent studies from current literature. There are emphasized the importance of the frequency of anemia, leukopenia and granulocytopenia. There are also stressed the pathogenic mechanisms of these disorders, their predictive significance and the rationale basis for therapeutics (actual and future treatment methods).

Anemia↗
PubMedDate not supplied

[The diagnostic difficulties in a case of a hemorrhagic syndrome in an infant].

The authors present a case of cystic fibrosis in a 3 months old infant. Clinically, the first manifestation was a severe anemia secondary to iron deperdition through a hemorrhage due to an acquired trouble of thrombin formation. The late was explained by the vitamin K malabsorption and by the hepatocellular insufficiency.

Anemia, Hypochromic↗