Cardiac dysfunction evoked by ECG and echocardiography changes and release of cardiac biomarkers in patients with aneurysmal subarachnoid haemorrhage.: Case presentation and literature review

The invisible brain-heart link has been observed and described for centuries now, although a greater interest in the matter has been manifested over the past several decades, especially in patients with aneurysmal subarachnoid haemorrhage (aSAH). We present the case of a patient with aSAH and signs of cardiac injury evoked by ECG changes and elevated cardiac enzymes. Furthermore, we reviewed current medical literature by searching the international database PubMed for recent articles on the subject of cardiac biomarkers, ECG and echocardiography changes in the setting of SAH. Our analysis of the selected articles, published between 2012 and 2018, revealed that 22 are patient population studies, 16 are case studies and 6 are reviews of the literature. The most common ECG changes were prolonged QTc andnonspecific ST/T-wave changes. Echocardiography changes included regional wall-motion abnormalities, typically involving the base of the heart (neurogenic stunned myocardium), yet there was also the scenario of Takotsubo cardiomyopathy (stress cardiomyopathy), which affects the apex of the heart. There is a significant statistical association of elevated levels of troponin and NT-proBNP with a bad outcome after SAH, and we should always keep in mind the dramatic scenario of misdiagnosing the cerebral haemorrhage and treating for a coronary syndrome instead. Therefore, the management of aSAH requires a close cooperation between neurosurgeons, intensivists, cardiologists and radiologists in high volume centres

Subarachnoid hemorrhage mimicking acute myocardial infarction: Case presentation

We present a patient with a subarachnoid hemorrhage (SAH) on the computed tomography and electrocardiogram changes compatible with myocardial infarction. SAH is a medical emergency, but it can be initially misdiagnosed. Diagnosis may be delayed due to atypical presentations of SAH and this may endanger the life of the patient. Electrocardiogram abnormalities have been described previously in SAH and may obscure the correct diagnosis

Extended characteristic polynomial estimating the electrochemical behaviour of some 4-(azulen-1-yl)-2,6-divinylpyridine derivatives

Six derivatives of 4-(azulen-1-yl)-2,6-divinylpyridine were the subject of experimental determination of oxidation and reduction potentials being reported elsewhere. In this paper, a computational study was employed in order to obtain a function of structure for these potentials. The geometry was optimized at three theory levels (MMFF94, B3LYP and M06), and the following analysis was conducted with the separately saved optimum geometry in each instance. Two families of molecular descriptors (FMPI and EChP) were used to derive structure-based descriptors. Simple linear regressions were extracted with the best of descriptors for each family and level of theory for both potentials. The study revealed that the MMFF94 optimum geometries best explained the selected electro­chemical properties. Furthermore, the EChP family of descriptors, much bigger than FMPI (about 64 times), was able to better explain the connection between the structure and the property. Once more, it has been shown that the eigenproblem has deep roots in structural chemistry

Anesthetic challenges in patients with ankylosing spondylitis requiring lower limb surgery – A case report and literature review

Ankylosing spondylitis is one of the global top health burdens and patients affected by it frequently require surgery related to disease progression, such as orthopedic surgery. These patients may prove difficult to manage from an anesthetic standpoint, regardless of the anesthetic technique employed, mainly given the potential for difficult airway access and related comorbidities. We present the case of a 52-year-old male posted for urgent cemented total hip arthroplasty with associated bilateral pulmonary fibrosis and an anticipated difficult airway in whom regional anesthesia was performed with satisfactory results, with a favorable intraoperative and postoperative course. The literature review explores the anesthetic techniques employed when a tailored approach is required in managing patients with ankylosing spondylitis

Considerations regarding the profile of tourists from Baile Felix - Baile 1 Mai Spa Destination, Romania

Background: Amid the exponential development of the tourist industry in general and spa tourism in particular that characterises the beginning of the century, the knowledge of tourists' perception regarding the destination image is of utmost importance in order to enhance competitiveness. In this regard, the purpose of this study is to investigate the perception of tourists from Baile Felix - Baile 1 Mai (Romania) about this spa area, in order to establish the profile of the tourist interested in this destination. Material and methods: Data was collected by applying a questionnaire (face-to-face technique), structured on eleven questions regarding the degree of knowledge of the destination, the habits of tourist consumption and the perception of the quality-price ratio according to tourist consumption. Results: Research results indicate a high degree of satisfaction among tourists regarding the destination. They declare themselves satisfied with most services and this determines their quite frequent return and spending an extended period of time at the destination. Conclusions: As a result, due to the qualitative and quantitative services and tourists' positive perception, Baile Felix - Baile 1 Mai area is one of the most significant spa tourist destinations in Romania.Bihor Destination Management Agenc

CYBERBULLYING – VIOLENŢA ÎN ERA DIGITALĂ

Lucrarea de faţă reprezintă un prim demers de conştientizare cu privire la o dimensiune a violenţei manifestate în special în rândul copiilor şi tinerilor – cyberbullying, violenţa în spaţiul virtual. În contextul erei digitale, al societăţii contemporane care se defineşte şi redefineşte continuu în acord cu evoluţia tehnologiei, într-o lume care se construieşte, se destramă şi se reconstruieşte permanent din spatele monitoarelor, în şcoala nativilor digitali care se formează cu pre­dilecţie prin apel la oceanul de informaţii oferite prin acces la Internet, agresivitatea capătă proporţii nebănuite cu efecte devastatoare. Primul pas în soluţionarea problemei constă în recunoaşterea sa, în definirea corectă a tuturor faţetelor sale, în identificarea factorilor declanşatori.CYBERBULLYING – VIOLENCE IN THE DIGITAL ERAThis paper represents a first approach for raising the awareness regarding a dimension of violence manifested especially among children and youngsters – cyberbullying, violence in virtual environment. In the context of the digital era, of the contemporary society that defines and redefines itself constantly according to the technological evolution, in a world that builds itself, crumbles and rebuilds itself from behind the monitors, in a school of the digital natives that develop themselves especially by using the ocean of information offered through the Internet, the aggressiveness gets enormous proportions with devastating effects. The first step in solving the problem is to admit its existence, to define correctly all its aspects, to identify the triggers.</p

Heat transfer vs environmental impact of modern façade systems

The paper makes an in-sight analysis of four actual steel-intensive envelope solutions existing on the market adaptable to steel structural systems. The solutions enable flexible modular construction, fast fabrication and erection times and easy disassembling. The analyses consider the heat transfer analysis including phase shift, amplitude attenuation and temperature amplitude ratio and the energy balance analysis. Considering the sustainability approach, the study is completed by an environmental impact analysis on Life-Cycle, by considering the production and end-of life stages. Although the selected systems from similar thermal resistances, the results show a certain variation of analysed parameters such as amplitude attenuation and temperature amplitude ratio (TAV). The energy balance analysis shows that the heating, solar gain and hot water preparation are responsible for the supplied energy. The emitted house energy break-down is almost equally shared among transmission, ventilation and sewage energies. The Life-Cycle Assessment (LCA) analysis proves that the end-of-life of the systems play an important role in the environmental impact of analysed systems, reversing the initial ranking of systems

BROWN TUMOR OF THE JAW: A RARE ENTITY

Aim of the study The aim of this study is to present the development of brown tumors in the jaws as a consequence of secondary hyperparathyroidism (HPT). Material and methods We analysed 10 cases with brown tumor of the jaws developed in patients with HPT which presented in our Oral and Maxillofacial Clinic for evaluation and treatment of their disease. The patients were 7 females and 3 males, with ages between 13 and 58 years. Results All patients were symptomatic and bone deformation was noted in all cases. The mandible was involved in 5 patients, the maxillary bone in 4 cases and in one case the tumor was localized in both jaws. The PTH values ranged from 630 pg/ml to 2500 pg/ml. All patients were referred for parathyroidectomy and for 2 patients, local excision was performed. Conclusions Regression of brown tumors may be achieved by performing parathyroidectomy. Multidisciplinary follow-up is essential for the control of brown tumors in order to prevent rapid growth which may lead to severe deformities and functional alterations