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Biomedical subjects

G Ungureanu

Publications and source records attributed to G Ungureanu.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

[Descriptive epidemiologic study of nosocomial infections in "C.I. Parhon" hospital of Iaşi].

Nosocomial infections (NI) represent a major public health problem. The descriptive study was carried out during one year, based on a lot of 12,731 in-patients from "C.I. Parhon" hospital. The objectives of the study were assessment of NI incidence and risk factors as well as monitoring resistance to antimicrobial drugs of bacterial pathogens from the hospital. The results of the study show lower NI incidence rates: 0.27%, most of them (91.5%) being urinary tract infections in the age group 65 y and over. 42.8% of cases were associated with risk factor of diabetes mellitus, neoplasm, skin or cardiovascular chronic conditions. The main etiological agent found for the NI was pseudomonas pyocyanea resistant to antibiotics. The antibiotic sensitivity analysis for the other gram negative rods illustrates gradually acquired resistance to the third or fourth generation of cephalosporins.

Adult↗
PubMedDate not supplied

[Treatment with hydroxymethylglutaryl coenzyme-A-reductase inhibitors in elderly patients: is it necessary?].

OBJECTIVE: To study the benefit of the therapy with hydroxymethylglutaryl coenzyme A reductase inhibitors (simvastatin) associated with diet in treating dyslipidemia in elderly patients, considering that they are more exposed to sudden death, myocardial infarction and stroke. Efficient and long-term serum cholesterol concentration lowering has beneficial effects on the risk for coronary heart disease as well as on other major cardiovascular risk factors such as hypertension and diabetes. METHODS: A retrospective study of 84 patients aged > or = 65 years, admitted in the last 6 months in Medical Clinic IV, was conducted. Admission criteria in the study were: age > or = 65 years old and high serum levels of cholesterol, triglycerides and LDL-C/HDL-C ratio. The patient population was divided into two groups: Group I of 40 patients treated for dyslipidemia only with diet and Group II with 44 patients in which was associated treatment with hydroxymethylglutaryl coenzyme A reductase inhibitors, 10 mg/day. The patients were controlled when admitted in the study and then at 3 and 6 weeks afterwards. RESULTS: Serum cholesterol and triglycerides concentration lowering was modest in Group I at 3 and 6 weeks, maybe because we registered a progressively lowered compliance of patients to hypocholesterolemic diet. In Group II the results were much better as we obtained significant serum cholesterol and triglycerides levels lowering after 3 weeks of treatment, and in 32 cases (72%) we had a normal lipid profile after 6 weeks of treatment. The other 12 patients (28%) abandoned treatment after 4 weeks of therapy because of financial reasons. There were no side effects during the treatment with hydroxymethylglutaryl coenzyme A reductase inhibitors. CONCLUSIONS: The therapy with hydroxymethylglutaryl coenzyme A reductase inhibitors associated to hypocholesterolemic diet controlled efficiently dyslipidemia in elderly patients. Diet alone could not control cholesterol and triglycerides levels, mainly because of lack of adherence of the patients to the diet. Based on the fact that dyslipidemia is a major, independent cardiovascular risk factor, we consider that therapy with hydroxymethylglutaryl coenzyme-A-reductase inhibitors is beneficial in elderly patients because of their efficacity, minimal side effects and protection against sudden death, myocardial infarction and stroke.

Aged↗
PubMedDate not supplied

[The effect of cardioversion in sinus rhythm on the systolic dynamics in atrial fibrillation and flutter].

In 60 cases of atrial fibrillation and flutter the systolic time intervals, haemodynamic ratios (PEj/PPE, PPE/PEj and PEj/TCIV) and ejection fraction before and after cardioversion in sinus rhythm were determined. The cardiac performance was markedly improved in all cases regardless the etiology and the degree of ventricular efficiency, pleading for the use of cardioversion anytime there is a chance to restore and maintain the sinus rhythm. The persistence of anticreased venous pressure, as well as the absence or late resumption of atrial mechanic activity usually indicate that arrhythmia soon recurs. In atrial fibrillation and atrial flutter, the inclusion in calculation only of those systoles preceded by R-R higher than 800 ms permits a better estimation of the degree of cardiac performance deterioration consecutive to the existing cardiopathy, the obtained data being very close to the postconversion values.

Adult↗
PubMedDate not supplied

[The association of ventricular pre-excitation--acute myocardial infarct. The dysrhythmic outcomes].

The clinical manifestations of ventricular preexcitation, generally considered benign, may sometimes show the most unpredictable and severe evolution. Although ventricular tachyarrhythmias (those of ventricular aspect excepted) are extremely uncommon in ventricular preexcitation, cases of sudden death were nevertheless reported, their mechanism being the ventricular fibrillation. The authors have followed up the evolution of 12 patients (11 males, age between 38 and 72 years with a mean of 56 years) with acute myocardial infarction and coexistent ventricular preexcitation, previously depressed or newly detected, admitted during the last 10 years at the Coronary Unit of Iaşi. It is concluded that the association ventricular preexcitation--acute myocardial infarction represents a severe risk factor by sensibly increasing the arrhythmogenic potential.

Adult↗
PubMedDate not supplied

[The experience of the 3rd Medical Clinic with lymph node pathology].

In the last 8 years, 511 patients (267 men and 244 women) were investigated. It was found that 44 cases (8.6%) were false adenopathies (various types of tumoral masses) but placed in the nodes areas (localized, generalized or deep). There were 467 cases of true lymphadenopathies, 58 new cases yearly (2.32% of all admitted patients and 6.9% of those with blood diseases). Out of these 467 cases, 330 (70.6%) were malignant neoplastic diseases: malignant lymphomas--206 cases (62.4% of all malignancies), leukemias--99 cases (30%), carcinomatous metastases--25 cases (7.6%). Nonmalignant lymphadenopathies were found in 137 cases (29.4%): specific infections (tuberculosis) and nonspecific ones in 87 cases (63.5%), nonimmune diseases (SLE, PAN, sarcoidosis) in 50 cases. Generalized adenopathies were recorded in 47% of the cases, the involvement of a single node group in 21.8% of the cases, other types of distribution being rare. The general symptoms were absent in 20.5% of the cases, being present in the remainder of 79.5%, especially in the malignant lymphomas, leukemias, nonimmune diseases. The main complications occurring against the background of the etiological affections of lymphadenopathies were: infections (respiratory, urinary, tegumental) in 19.7% of the cases and cardiovascular disturbances (myocardiopathies, rythm and conduction disturbances) in 9.6% of the cases.

Adolescent↗
PubMedDate not supplied

[The efficacy of electroversion in the treatment of tachyarrhythmia complications of the heart valves].

The results of electric cardioversion in the treatment of tachyarrhythmias in a series of 431 patients with valve diseases of the left heart admitted during the last 10 years are presented. Most patients presented atrial fibrillation (71.4%), the atrial flutter and paroxysmal tachycardia necessitating electric cardioversion in 24.5% and 4.1% of the cases, respectively. The restoration of sinusal rhythm was obtained in 90% of the cases, a single shock being delivered in most of them (74.5%). The patients' age, type of arrhythmia and the causal valvular heart disease did not influence the results, the essential factors of restoration and especially of maintaining the sinusal rhythm failure being the age of the valvular heart disease, the quality of atrial myocardium (which depends on the size of the enlargement and age of arrhythmia) and the association of a coronary or myocardial alcohol induced affection. The importance of estimating the resumption of atrial mechanic activity is underlined. The "regulation" embolism was rare (5 cases), while an embolism occurring during the preparation period raises the possibility of a possible coincidence between the embolic accident and the recurrence of atrial mechanical systole after electric cardioversion.

Adult↗
PubMedDate not supplied

[The cardioprotective action of captopril during atrial electrostimulation].

The presence of R-A-A system components in all organs (heart included) has suggested a possible cardio-protective effect of the angiotensin conversion enzyme inhibitors as a result of coronary flow improvement. This effect would act irrespective of the well-known peripheral vascular effects: vasodilation, blood pressure decrease, pre- and postload reduction. By using the atrial pacing in the quantitative assessment of the anginal threshold and of the associated ECG alterations before and after the i.v. administration of 25 mg of captopril we could immediately evaluate the coronary reserves by estimating the efficiency of captopril in the patients with angina pectoris. The atrial pacing has been performed, by using the method suggested by Sowton, in 18 patients with typical angina. The increase of heart tolerance at exercise, the systolic dynamics improvement and the ejection fraction increase as well as the raising of the anginal threshold have been noticed in 15 of the patients. The blood pressure has evidenced no significant changes. After the administration of captopril, the ischemic ECG alterations have been less marked and their postpacing remains shorter. Our findings plead for a direct action of captopril on cardiac intrinsic R-A-A system in the normotensive patients suffering from angina pectoris.

Adult↗
PubMedDate not supplied

[The effect of captopril on the coronary circulation in a clinical and experimental study].

Taking into account the well-known angiotensin II-induced coronary constriction, in a first series of experiments the effects of captopril were studied upon the rabbit, guinea pig and rat coronary circulation during perfusion with oxygenated Krebs-Henseleit solution at 37 degrees C under constant pressure and variable flow according to the Langendorf technique. The inhibition of angiotensin I to angiotensin II conversion enzyme with captopril (5-500 microgr./ml) resulted in a coronary dose dependent dilation as a consequence of a reduction in the basal coronary tonus. Testing the coronary distensibility by using pressure and flow variations revealed a significantly increased distensibility when the conversion enzyme was specifically blocked with captopril. The anginal threshold of the atrial electrostimulation was increased after captopril (25-50 mg i.v.) in 15 out of 18 patients with coronary insufficiency by a mean value of 17%, white the systolic dynamics was significantly better. The obtained results bring new arguments in favour of the intrinsic renin-angiotensin system participation in maintaining the basal vascular tonus and of the increased coronary distensibility in the presence of captopril as an inhibitor of the local synthesis of the vasoconstrictor angiotensin II.

Adult↗