Homeopathic treatment for prolonged postoperative coma: a case report.

Coma is the state of unrousable unconsciousness. There are variations in the degree of coma and the findings and signs found on the patient's clinical examination depend on the underlying cause of the disorder. The Glasgow Coma scale evaluates the best motor, verbal and eye answers of the patient. A patient is considered to be in a coma if his Glasgow Coma Scale is below 8 points. The progress that we have made throughout the years has also led to complications that can culminate in a major catastrophe like death, permanent brain damage, coma. A study performed reached the conclusion that prior comorbidity, older age, intraoperative hypotension, and cardiovascular surgery may predispose patients to postoperative coma. The article presents a case of postoperative coma treated successfully with homeopathy. Although a rare complication, postoperative coma is a severe, death-leading condition, causing immense suffering on both the patient and the patient's family. A multidisciplinary and thorough approach is necessary for these patients, but even after a well-conducted therapy, this condition leads to the death of the patient.

Salivary cortisol and α-amylase: subclinical indicators of stress as cardiometabolic risk.

Currently, the potential for cardiovascular (CV) stress-induced risk is primarily based on the theoretical (obvious) side effects of stress on the CV system. Salivary cortisol and α-amylase, produced respectively by the hypothalamus-pituitary-adrenal (HPA) axis and the sympathetic-adrenomedullary (SAM) system during stress response, are still not included in the routine evaluation of CV risk and require additional and definitive validation. Therefore, this article overviews studies published between 2010 and 2015, in which salivary cortisol and α-amylase were measured as stress biomarkers to examine their associations with CV/CMR (cardiometabolic risk) clinical and subclinical indicators. A comprehensive search of PubMed, Web of Science and Scopus electronic databases was performed, and 54 key articles related to the use of salivary cortisol and α-amylase as subclinical indicators of stress and CV/CMR factors, including studies that emphasized methodological biases that could influence the accuracy of study outcomes, were ultimately identified. Overall, the biological impact of stress measured by salivary cortisol and α-amylase was associated with CV/CMR factors. Results supported the use of salivary cortisol and α-amylase as potential diagnostic tools for detecting stress-induced cardiac diseases and especially to describe the mechanisms by which stress potentially contributes to the pathogenesis and outcomes of CV diseases.

Salivary cortisol and alpha-amylase: subclinical indicators of stress as cardiometabolic risk

Currently, the potential for cardiovascular (CV) stress-induced risk is primarily based on the theoretical (obvious) side effects of stress on the CV system. Salivary cortisol and α-amylase, produced respectively by the hypothalamus-pituitary-adrenal (HPA) axis and the sympathetic-adrenomedullary (SAM) system during stress response, are still not included in the routine evaluation of CV risk and require additional and definitive validation. Therefore, this article overviews studies published between 2010 and 2015, in which salivary cortisol and α-amylase were measured as stress biomarkers to examine their associations with CV/CMR (cardiometabolic risk) clinical and subclinical indicators. A comprehensive search of PubMed, Web of Science and Scopus electronic databases was performed, and 54 key articles related to the use of salivary cortisol and α-amylase as subclinical indicators of stress and CV/CMR factors, including studies that emphasized methodological biases that could influence the accuracy of study outcomes, were ultimately identified. Overall, the biological impact of stress measured by salivary cortisol and α-amylase was associated with CV/CMR factors. Results supported the use of salivary cortisol and α-amylase as potential diagnostic tools for detecting stress-induced cardiac diseases and especially to describe the mechanisms by which stress potentially contributes to the pathogenesis and outcomes of CV diseases.

[Binaural cochlear implant--good choice in the treatment of deep sensorinural hearing loss]. / Implantul cohlear binaural--optiune avantajoasa în tratamentul surditatii profunde neuro-senzoriale.

UNLABELLED: Nowadays. cochelar implant is the only choice of treatment in deep bilateral deafness. AIM: To evaluate the benefits of binaural implantation of a single receiver-stimulator device by using audiometric tests at 3 and 6 months intervals. MATERIAL AND METHODS: The study included 3 patients with bilateral sensorineural deafness of cochlear origin. Following implantation they were assessed by pure tone audiometry (PTA), speech audiometry (SA), and sound localization tests (LT). RESULTS: PTA showed a significant decrease in hearing thresholds level during the 6-month interval following implantation. As to the degree of speech discrimination in both quiet and noisy environment, SA showed evident progress at 6 months compared to the results at 3 month. The location tests revealed improved sound localization in both ears at 6 months compared to the results at 3 months. CONCLUSIONS: Compared to unilateral implant, the binaural cochlear implant has the advantage of stereophonic hearing, facilitating the communication through a better understanding of speech in both quiet and noisy environment, and improving the quality of life by the location of sounds similar to natural hearing.

[Peripheral vestibular syndrome intricated pathogenic issues. A case report]. / Sindromul vestibular--aspecte patogenice intricate. Prezentare de caz.

BACKGROUND: Ménière's syndrome appears to be the final common pathway of the mechanisms the inner ear responds to almost any injury. Although the autoimmune disease seems to play a major role, exposure to intense noise can also be a trigger in the appearance and/or aggravation of the disease. MATERIAL AND METHODS: The case of 41 years old musician with a history of ankylosing spondylitis, diagnosed with Ménière's syndrome 5 years ago, is presented. Recently the symptoms became more polymorphic, revealing the association between benign paroxysmal positional vertigo (BPPV), Ménière's syndrome and high frequency hearing loss in an autoimmune background. Besides general, neurological and ENT examination, the diagnostic workup comprised of tonal audiogram, brain stem auditory evoked potentials, computerized dynamic posturography and videonistagmography. RESULTS: The final diagnosis was acute noise trauma, Ménière's syndrome, left horizontal semicircular canal BPPV, bilateral sensorineural sudden aggravated hearing loss in high frequencies (above 9 kHz) and allegedly autoimmune inner ear disease. Treatment with an association of corticosteroids, vasodilators and vitamins combined with Vannucchi's maneuver were followed by a significant relief of the symptoms. CONCLUSION: Although no causal relationship was found between acoustic trauma and increased endolymphatic pressure, both literature data and the case presented show that intense and prolonged noise exposure may aggravate peripheral vestibular syndrome.

[Spinal tuberculosis or bone metastases? Case report]. / Tuberculoza vertebrala sau metastaze osoase? Prezentare de caz.

Tuberculosis remains one of the most important infectious disease worldwide and skeletal form has an incidence between 3% and 10%, depending on geographic area. The thoracolumbar junction is the most commonly involved in vertebral tuberculosis; some radiologic features are specifics, but other could be indistinguishable from that of lymphoma or metastases. We discuss the case of a 80-year-old man presented with a 2-month history of thoracolumbar pain, fatigability and fever. The vertebral radiography showed narrowing of the intervertebral disc space between T1 and T12, adjacent irregularity, erosion and lisis of vertebres, features visibles also on computed tomography. After the exclusion of the other causes of osteolisis, we started a standard regimen of tuberculostatic treatment and after one month of treatment the symptoms of patient improved noticeably. Other problems of diagnostic and treatment modalities of spinal tuberculosis are discussed.

[Seven years of cochlear implant at the ENT Clinic of "Recuperare" Hospital Iasi]. / 7 ani de implant cochlear in Clinica ORL a Spitalului Clinic de Recuperare Iasi.

This paper presents our Cochlear Implant Departments results from the beginning until present time. Our implant list contains 161 candidates. The enlisted was made based on the criteria's for implant candidates' selection and we have implanted already 17 of them (11 children and 6 adults). Surgical interventions were done according to standard procedure - the approach being through mastoidectomy and posterior tympanotomy. We discuss the results obtained with cochlear implantation in each case. The outline idea is that the cochlear implant was a good choice in all our implanted cases and the patients had achieved at least the performances predicted before implantation for every particular situation.