Acute viral encephalitis. Experience of the Iaşi Infectious Disease Clinic between January 2000 and March 2003

We analyzed the patients files suffered from acute viral encephalitis in 39 months period: January 2000-march 2003. According to our data there was a total of 33 patients; one of them died. The most involved patients were male and of the 8-14 year group of age; for the first three month in 2003 were admitted 11 patients. Coma and seizures were the most frequent clinical signs. LCR had the usual abnormalities for the above mentioned disease; the treatment was mainly performed with corticosteroids; 28 cases were admitted more than 8 days period. The evolution of the clinical status was satisfactory for all 32 patients.     

Epidemiologic and clinical aspects of acute hepatitis B in the past decade

To study the clinical and epidemiological aspects of acute B hepatitis during the last 11 years. We retrospectively studied 1712 patient files, admitted in the Department of Infectious Diseases Ia?i, with acute B hepatitis between 1992-2002. The majority of the patients (69%) had an urban origin. Teenagers and young adults were predominantly affected (59% had between 15 and 34 years). A point of entry of the pathogen was identified only in 20% of the patients. The mean incubation period was 4 month. 24% of the patients had a prolonged form of the disease (over 30 days of jaundice). A fulminant evolution was noted in 1.2% of cases. Extrahepatic involvement was described in 25% of the patients. The global mortality was 1.15%. The number of patients with acute B hepatitis decreased by half during the last 11 years.     

Risk factors for poor renal prognosis in children with hemolytic uremic syndrome

Many factors have been proposed as predictors of poor renal prognosis in children with hemolytic uremic syndrome (HUS), but their role is still controversial. Our aim was to detect the most reliable early predictors of poor renal prognosis to promptly identify children at major risk of bad outcome who could eventually benefit from early specific treatments, such as plasmapheresis. Prognostic factors identifiable at onset of HUS were evaluated by survival analysis and a proportional hazard model. These included age at onset, prodromal diarrhea (D), leukocyte count, central nervous system (CNS) involvement, and evidence of Shiga toxin-producing Escherichia coli (STEC) infection. Three hundred and eighty-seven HUS cases were reported; 276 were investigated for STEC infection and 189 (68%) proved positive. Age at onset, leukocyte count, and CNS involvement were not associated with the time to recovery. Absence of prodromal D and lack of evidence of STEC infection were independently associated with a poor renal prognosis; only 34% of patients D^–STEC^– recovered normal renal function compared with 65%–76% of D⁺STEC⁺, D⁺STEC^– and D^–STEC⁺ patients. In conclusion, absence of both D and evidence of STEC infection are needed to identify patients with HUS and worst prognosis, while D^– but STEC⁺ patients have a significantly better prognosis.     

Determination of allopurinol by micelle-stabilised room-temperature phosphorescence in real samples

A very simple, rapid and highly sensitive method has been developed for the determination of allopurinol. The method is based on the room temperature phosphorescence of allopurinol in sodium dodecylsulphate (SDS) micelles, with thallium (I) providing the external heavy atom and sodium sulphite acting as the oxygen scavenger. Under the optimum experimental conditions, the range of application is 0.25-7.0 microg ml(-1) and the limit of detection is 0.014 microg ml(-1). The most relevant characteristic of this method is its great selectivity, e.g. allopurinol can be determined in the presence of its metabolite, oxypurinol. The results of the analysis of several pharmaceutical preparations were satisfactory. The clinical applicability of this procedure has been tested by analysing allopurinol in urine samples.     

Ion channel structures: a review of recent progress

Several ion channel structures have recently been determined, including MthK (a bacterial K+ channel in an open state), KirBac (a bacterial homolog of mammalian inward rectifier K+ channels), KvAP (a bacterial voltage-activated K+ channel) and the pore domain of the nicotinic acetylcholine receptor. Analysis of these structures has increased our understanding of the molecular mechanisms underlying channel gating. A hydrophobic gate appears to operate in a number of channels. Structures of ligand binding domains provide some clues as to how ligand-induced conformational changes control channel gating, but further experimental and computational studies are required before a full picture emerges.     

Evaluation of the Functional Assessment of Cancer Therapy-General (FACT-G) Spanish Version 4 in South America: Classic Psychometric and Item Response Theory Analyses

Background

The FACT-G has gone through many validation studies. However, little research has been conducted in South American Spanish speaking patients. The present study aimed to evaluate the FACT-G Spanish Version 4 in Uruguayan cancer patients.

Methods

The data analyzed were collected from 309 patients, with various tumor sites, at different stages of disease and receiving different treatments.

Results

Reliability was evaluated using Cronbach's coefficient alpha and showed high internal consistency for each of the subscales and its total scale (range = .78 – .91) of the FACT-G. The FACT-G total score also showed significant mean differences among known groups (performance status, in vs. outpatients) when tested by ANOVA and t-test. When the tumor stage (Local and Regional vs. Metastatic disease) was used as a clinical anchor, the FACT-G total score, the Physical Well-being (PWB), and Functional Well-being (FWB) subscale scores showed mean differences, ranging from 5 to 10 points in a scale from 0–108 (effect sizes = 0.30–0.60). Item response theory (IRT)-based evaluation using mean square fit statistics (.60–1.4) criteria showed that only two items misfit: "Estoy satisfecho(a) con mi vida sexual" (I am satisfied with my sex life) and "Estoy satisfecho(a) de cómo estoy enfrentando mi enfermedad" (I am satisfied with how I am coping with my illness).

Conclusion

The results indicated that, using both traditional and IRT approaches, the Spanish FACT-G has good reliability and validity to be used as a QOL instrument among Uruguayan cancer patients.

     

Prevalence of diabetic retinopathy in insulin-dependent diabetes mellitus, in the Dolj district

260 patients with type I diabetes treated in Diabetes and Nutrition Diseases Clinic of Emergency District Hospital Dolj, were included in the selective screening program, for evaluation the incidence of diabetic retinopathy. The results of this screening were determine both including all new cases and reevaluating all the old cases, because the progression of ocular lesions under treatment. The retrospective study of 156 patients revealed the incidence of diabetic retinopathy in 35.2% at the time of implementation of the screening program, being 50.2% after 5 years of continuous surveillance. From 10,000 followed-up patients, the type I of insulin-dependent diabetes represents 13.3%. The incidence of new cases is minimal in the age group 0-10 years (1.9%) and the retinopathy was absent. The maximal prevalence was after 25 years old, being present in 69 cases from 164.