27 research outputs found

    The Role of Methotrexate in Psoriatic Therapy in the Age of Biologic and Biosimilar Medication: Therapeutic Benefits versus Toxicology Emergencies

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    Used in the psoriasis therapy for over 30 years, methotrexate belongs to the non‐biological medication class. Its continued use must be studied in the context of the modern unprecedented powerful pharmacological and medical development, due to the particularly, even uniquely fast development of biologicals, which assume an extremely important role in cutting‐edge medicine. This status has turned biosimilars and all related matters into an outstanding challenge not only for researchers worldwide but also for other medicinal product‐associated fields such as development of regulatory standards and pharmacovigilance, to mention the most important. However, against a comparable high‐risk background, compounded by the additional danger of serious cumulative toxicity, methotrexate therapy continues to be recommended mainly for patients suffering from severe psoriasis, seriously affecting their quality of life

    Alcohol Withdrawal – Therapeutical Management in Surgical Patients with Upper Intestinal Bleeding

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    Psychological dependence involves a desire to use a drug to avoid the unpleasant withdrawal syndrome that results from cessation of exposure to it. Alcohol withdrawal syndrome is one of the most feared complications of alcohol addiction and sometimes can be fatal if not treated properly. Withdrawal syndrome is characterized by neurological hyperexcitability, which can lead to severe psychological and neurological symptoms. A survey was conceived in order to monitor the efficiency of several drug associations (Clonidine, Midazolam, IV ethanol), which were administered at the beginning of intensive therapy admission of achohol addicts. By comparing the postoperative evolution parameters and complications incidences for these patients (such as the hospitalization duration in AIT department, the tracheobronchitis incidence, complications as sepsis, pneumonia and cardiac complications), we managed to determine which treatment is the most beneficial for these cases. Benzodiazepines are frequently used for pharmacological therapy of alcohol addicted patients. In our study Midazolam was very efficient, compared to other therapies. When administered for a maximum of 7 days, the inccidence of side effects remains minimal

    Toxicological Analysis of Some Drugs of Abuse in Biological Samples

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    Consumption of drugs of abuse is a scourge of modern world. Abuse, drug addiction and their consequences are one of the major current problems of European society because of the significant repercussions in individual, family, social and economic level. In this context, toxicological analysis of the drugs of abuse in biological samples is a useful tool for: diagnosis of drug addiction, checking an auto-response, mandatory screening in some treatment programs, identification of a substance in the case of an overdose, determining compliance of the treatment. The present paper aims to address the needs of healthcare professionals involved in drugs addiction treatment through systematic presentation of information regarding their toxicological analysis. Basically, it is a tool that help you to select the suitable biological sample and the right collecting time, as well as the proper analysis technique, depending on the purpose of analysis, pharmacokinetic characteristics of the drugs of abuse, available equipment and staff expertise

    Current Concepts on Drug Abuse and Dependence

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    Drug addiction is a complex disease characterized by compulsive and uncontrollable desire to seek and consume the drug. In time, drug-related terminology has undergone many changes, arising from the deepening of the mechanisms of action, but also about the need for a greater precision in the definition. Drug dependence can be assigned not only to pharmacological effects of the drugs of abuse, but also to their interaction with each particular neurological and psychological constitution. The research on the neurobiological mechanisms of addiction processes allows both a better understanding of current pharmacotherapy and the development of new treatment strategies in drug abuse and dependence. In this review we intend to present the current concepts related to drug abuse and dependence

    Zenker’s diverticulum and squamous esophageal cancer: a case report

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    Zenker’s diverticulum represents a rare esophageal lesion developed especially in the elderly population due to herniation of esophageal mucosa above the cricopharyngeus muscle. The condition leads to food retention, regurgitation, aspiration, and dysphagia in affected patients. Progressive dysphagia also characterizes malignant diseases of the esophagus like squamous esophageal carcinoma that typically appears in male patients in the seventh decade of life, with a history of cigarette smoking and alcohol abuse. We report a case of a male patient who presented with dysphagia for both solids and liquids along with significant weight loss, and who was diagnosed with medium esophageal cancer associated with Zenker’s diverticulum

    The risk of bleeding and encephalopathy in surgical patients with liver cirrhosis

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    Liver cirrhosis is a disease with an increasing incidence. Surgical procedures in patients with cirrhosis are also increasing, due to a longer life expectancy in these patients and also to the improvement of therapeutic and diagnostic resources. Digestive hemorrhage in the cirrhotic patient requires emergency medical intervention (intensive therapy, endoscopic or even surgical approaches), being at the same time a factor that precipitates episodes of encephalopathy, i.e. the conventional complication of cirrhosis. Hepatic encephalopathy represents one of the most severe clinical events of cirrhosis, being associated with high morbidity and mortality. The causes of hepatic encephalopathy are briefly presented in this paper. Therapeutic approaches currently available consist in the administration of non-absorbable disaccharides such as lactulose and non-absorbable antibiotics such as rifaximin. New therapeutic perspectives are under evaluation, e.g. ammonia scavengers and the modulation of gut microbiota. Clotting disorders in patients with liver cirrhosis are more severe as the disease progresses and involves complex mechanisms, as presented in this review. The correction of possible disorders of hemostasis should be promptly made as a sine qua non condition prior to surgery

    The correlation between histopathological and ultrasound findings regarding Cesarean section scars – A three-year survey study

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    The cesarean operation represents a major surgery, with a higher risk of postoperative complications and longer postoperative recovery than vaginal delivery. Due to the increasing frequency of cesarean sections, the ultrasound imaging of the uterine scar has become a particularly useful tool in identifying its potential long-term complications. This should be done pre-conceptively and quarterly or whenever necessary during pregnancy. Currently, there are only few histopathological studies on the uterine scar, trying to assess the myometrial repair and certain factors that influence the quality of the scar. The study was performed on a batch of 123 patients with previous C-sections, with multiple ultrasound exams during pregnancy and post-operative pathologic evaluation of the uterine scar in order to assess the possibility of a new prognostic score by correlating these two factors. Our study found solid evidence related to possible correlations between histopathological and ultrasound data on the cesarean section scar, which could lead to a possible predictive algorithm with implications for both prognostic and therapeutic fields

    Modern management of diabetic foot complications

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    Diabetes mellitus comprises a heterogeneous group of metabolic abnormalities, characterized by chronic hyperglycemia, resulting from a deficiency in insulin secretion, a deficiency in action, or from both situations. In its evolution, diabetes can lead to acute or chronic complications, which can be avoided or whose progression can be slowed by optimal glycemic control, provided by the effective treatment, diet, physical activity and glycemic monitoring. One of the most common complications of diabetes is diabetic neuropathy which, in combination or not with peripheral arterial disease, may result in leg changes (ulcers, gangrene, amputations), changes that are known under the heading of diabetic foot. The risk of developing leg ulcer is 25% in the life of a patient with type 1 or 2 diabetes, and amputations of varying degrees may sometimes be necessary. These can, however, be prevented by active screening characterized by the neurological examination for neuropathic signs, and the vascular examination to highlight the presence of peripheral arterial disease. Therefore, in order to prevent the appearance of leg ulcers and to reduce the morbidity associated with it, it is important to diagnose and manage risk factors

    The correlation between histopathological and ultrasound findings regarding Cesarean section scars – A three-year survey study

    Get PDF
    The cesarean operation represents a major surgery, with a higher risk of postoperative complications and longer postoperative recovery than vaginal delivery. Due to the increasing frequency of cesarean sections, the ultrasound imaging of the uterine scar has become a particularly useful tool in identifying its potential long-term complications. This should be done pre-conceptively and quarterly or whenever necessary during pregnancy. Currently, there are only few histopathological studies on the uterine scar, trying to assess the myometrial repair and certain factors that influence the quality of the scar. The study was performed on a batch of 123 patients with previous C-sections, with multiple ultrasound exams during pregnancy and post-operative pathologic evaluation of the uterine scar in order to assess the possibility of a new prognostic score by correlating these two factors. Our study found solid evidence related to possible correlations between histopathological and ultrasound data on the cesarean section scar, which could lead to a possible predictive algorithm with implications for both prognostic and therapeutic fields
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