Coriolan Emil Ulmeanu

Latest posts by Coriolan Emil Ulmeanu (see all)

INTOXICATIA ACUTA CU TUBERCULOSTATICE: RECUNOASTERE SI TRATAMENT - 20/11/2015
TUBERCULOSTATICS ACUTE POISONING: DIAGNOSTIC AND TREATMENT - 20/11/2015
Toxic nephropathies in children - 27/07/2015

Articole semnate de acelasi autor in Revista Romana de Pediatrie:

INTOXICATIA ACUTA CU TUBERCULOSTATICE: RECUNOASTERE SI TRATAMENT

Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 3, An 2015

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

National Awards “Science and Research”

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ICMJE- Recommendations

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Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

Dora Andreea Boghitoiu and Coriolan Emil Ulmeanu

REZUMAT

Introducere. Deşi frecvenţa intoxicaţiilor cu izoniazidă nu este una foarte mare, reprezintă condiţii ameninţătoare de viaţă care necesită recunoaştere şi instituire promptă a tratamentului.
Material şi metodă. Autorii prezintă cazul unei paciente în vârstă de 15 ani care se internează în clinica noastră prin transfer dintr-o altă unitate medicală pentru convulsii tonico-clinice generalizate, urmate de vărsături şi comă. Pacienta este primită în Unitatea Primiri Urgenţe a spitalului nostru în comă, Glasgow 8, intubată orotraheal. Nu răspunde la stimuli verbali, dar răspunde prin agitaţie marcată la stimuli dureroşi profunzi. Are sondă nazogastrică pe care se exteriorizează lichid portocaliu, iar pe sonda urinară – urini de culoare portocalie. Pupilele sunt egale, intermediare, reactive. Reflexe osteotendinoase sunt prezente bilateral. Nu are semne de iritaţie meningeană şi nici semne neurologice de focar. Din istoricul medical al pacientei, obţinut de la mamă, am reţi nut că pacienta se afla de 4 luni în tratament cu medicamente tuberculostatice (izoniazidă, rifampicină şi vita mina B6). Pacienta îşi administra singură medicamentele.
Rezultate. Pe baza manifestărilor clinice: convulsii tonico-clonice generalizate, vărsături incoercibile şi comă, a aspectului roşu-portocaliu al lichidului gastric şi al urinii la mai mult de 6 ore de la debut, a istoricului medical al pacientei şi al analizelor paraclinice care decelează acidoză metabolică se ridică suspiciunea de intoxicaţie acută cu tuberculostatice. S-a început administrarea de tratament antidotic cu vitamina B6 cu evoluţie favorabilă.
Concluzii. Intoxicaţia acută cu izoniazidă trebuie suspectată la orice pacient care prezintă triada clasică: convulsii refractare, acidoză metabolică severă şi comă, iar tratamentul antidotic cu piridoxină trebuie sa fie disponibil în orice serviciu de urgenţe.

Cuvinte cheie: izoniazidă, acidoză metabolică, convulsii generalizate, intoxicaţie, vitamina B6

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Dora Andreea Boghitoiu

TUBERCULOSTATICS ACUTE POISONING: DIAGNOSTIC AND TREATMENT

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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Promoting Global Health

Dora Andreea Boghitoiu and Coriolan Emil Ulmeanu

ABSTRACT

Introduction. Although the frequency of isoniazid poisoning is not very high, there are life threatening conditions which require a swift diagnosis and treatment.
Material and method. We present the case of a female patient, aged 15 admitted in our clinic, by means of transfer, from another medical unit, due to tonic-clonic generalized seizures, followed by emesis and coma. The patient arrived at the Emergency Admissions Unit of our hospital, in coma, Glasgow 8, orotracheally intubated. She did not respond to verbal stimuli, but she did respond to deep, painful stimuli with marked agitation. The patient has a nasogastric tube, on which an orange liquid is visible on the outside and on the urinary catheter – orange coloured urine. From the patient’s medical history, which was obtained from the patient’s mother, we noticed that the patient had been, for the past 4 months, under treatment with tuberculostatic drugs (Isoniazid, Rifampicin and vitamin B6). The patient administered the medication herself.
Results. Based on clinical manifestations, i.e. tonic-clonic generalized seizures, incoercible emesis and coma, reddish-orange colour of the gastric fluid and urine, at over 6 hours after the onset, on the patient’s medical historyand based on laboratory results which revealed metabolic acidosis the suspicion of acute tuberculostatic poisoning arose. We started antidotal therapy with vitamin B6 with favourable clinical evolution.
Conclusion. Acute isoniazid poisoning must be suspected in the case of any patient who presents the classic triad: refractory seizures, severe metabolic acidosis and coma and the treatment with the specific antidotepyridoxine, must be available at any emergency unit.

Keywords: isoniazid, metabolic acidosis, generalized seizures, poisoning, vitamin B6

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Dora Andreea Boghitoiu

Toxic nephropathies in children

Revista Romana de PEDIATRIE | Volumul LXI, Nr. 4, An 2012

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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Promoting Global Health

Alexandru-Ioan Ulmeanu and Coriolan Emil Ulmeanu

ABSTRACT

Toxic nephropathies in children are rare entities but important to diagnoze early due to severe evolution and the need for rapid treatment. In the face of toxic acute renal failure the primary objective is to specify whether the ARF is organic or functional. Although serum creatinine remains the main laboratory test for diagnosis and monitoring toxic acute renal failure, new markers can be used for rapid and early detection of renal injury. In this paper the authors present the renal involvement in acute poisoning in children, classifi cation and etiopathogenesis of toxic nephropathies, and practical approach in assessing nephrotoxicity.

Key words: toxic nephropathy, acute renal failure, nephrotoxicity

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Alexandru-Ioan Ulmeanu

NEFROPATIILE TOXICE LA COPIL

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

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Promoting Global Health

Alexandru-Ioan Ulmeanu and Coriolan Emil Ulmeanu

REZUMAT

Nefropatiile toxice ale copilului reprezintă entităţi rare, dar important de recunoscut precoce datorită evoluţiei severe şi necesităţii instituirii rapide a tratamentului. În faţa unei insuficienţe renale acute toxice, obiectivul principal iniţial este de a recunoaşte în primul rând caracterul organic sau funcţional al acesteia. Deşi creatinina serică rămâne principalul test de laborator pentru diagnosticul şi urmărirea insuficienţei renale acute toxice, noi markeri poti fi utilizaţi pentru detecţia rapidă şi precoce a injuriei renale. Autorii prezintă implicarea renală în intoxicaţiile acute ale copilului, clasificarea şi etiopatogenia nefropatiilor toxice, evaluarea nefrotoxicităţii şi principii de abordare practică ale acestora.

Cuvinte cheie: nefropatie toxică, insuficienţă renală acută, nefrotoxicitate

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Alexandru-Ioan Ulmeanu

Toxic crystalluria – prevalence study in children poisoning

Revista Romana de PEDIATRIE | Volumul LXII, Nr. 1, An 2013

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Viorela Gabriela Niţescu, Alexandru-Ioan Ulmeanu and Coriolan Emil Ulmeanu

ABSTRACT

Crystalluria is a rare entity in children poisoning, but can produce obstructive renal failure with potentially severe outcome. The authors present the classification and etiopathogenesis of toxic crystalluria the management of ethylene glycol poisoning, the approach in a case of severe vitamin D poisoning and the prevalence of ethylene glycol poisoning in two pediatric poison centers.

Key words: toxic crystalluria, ethylen glycol, vitamin D, nephrotoxicity

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Viorela Gabriela Niţescu

CRISTALURIILE TOXICE – PREVALENTA IN INTOXICATIILE ACUTE LA COPIL

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Viorela Gabriela Niţescu, Alexandru-Ioan Ulmeanu and Coriolan Emil Ulmeanu

REZUMAT

Cristaluriile sunt entităţi rare în intoxicaţiile acute la copil, dar prin posibilitatea producerii insufi cienţei renale obstructive ele au un potenţial foarte grav, chiar ameninţător de viaţă. Autorii prezintă clasifi carea şi etiopatogenia cristaluriilor toxice, abordarea practică a intoxicaţiei cu etilenglicol şi a intoxicaţiei severe cu vitamina D, precum şi prevalenţa intoxicaţiei cu etilenglicol din două centre antitoxice pediatrice.

Cuvinte cheie: cristalurie toxică, etilenglicol, nefrotoxicitate, vitamina D

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Viorela Gabriela Niţescu

Severe acute propafenone poisoning – diagnosis and therapeutic approaches

Revista Romana de PEDIATRIE | Volumul LXII, Nr. 3, An 2013

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Cristina Iolanda Vivisenco and Coriolan Emil Ulmeanu

ABSTRACT

Propafenone is an antiarrhythmic drug which blocks myocardial sodium channels as the main mechanism of action. Ingestion of a toxic dose of propafenone induces through the membrane stabilizing effect a clinical presentation with cardiovascular, neurological and metabolic expression, sometimes life-threatening. The authors present the case of a 13 year old female patient admitted for cardiac conduction abnormalities, seizures and coma after intentional ingestion of a toxic dose of propafenone. The patient was successfully treated with intravenous sodium bicarbonate therapy and supportive measures. The authors mention also the latest information from the literature regarding the management of propafenone poisoning.

Key words: propafenone, poisoning, child, membrane stabilizing effect

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Cristina Iolanda Vivisenco

INTOXICATIA ACUTA GRAVA CU PROPAFENONA – ABORDARE DIAGNOSTICA SI TERAPEUTICA

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Cristina Iolanda Vivisenco and Coriolan Emil Ulmeanu

REZUMAT

Propafenona este un medicament antiaritmic ce are ca mecanism principal de acţiune blocarea canalelor de sodiu din miocard. Ingestia unei doze toxice de propafenonă determină prin intermediul efectului stabilizator de membrană un tablou clinic deosebit de grav cu răsunet cardiovascular, neurologic şi metabolic, uneori cu potenţial letal. Autorii prezintă cazul unei paciente în vârstă de 13 ani internată pentru tulburare de conducere cardiacă, convulsii şi comă, după ce a ingerat voluntar o doză toxică de propafenonă. Pacienta a fost tratată cu succes cu bicarbonat de sodiu administrat intravenos şi măsuri suportive. Autorii menţionează şi cele mai noi informaţii din literatură privind abordarea terapeutică a intoxicaţiei cu propafenonă.

Cuvinte cheie: propafenonă, intoxicaţie, copil, efect stabilizator de membrană

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Cristina Iolanda Vivisenco

HIPERTENSIUNEA ARTERIALA SECUNDARA IN INTOXICATIILE ACUTE LA COPIL SI ADOLESCENT

Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 2, An 2015

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Cristina Iolanda Vivisenco and Coriolan Emil Ulmeanu

REZUMAT

Introducere. Expunerea la diverse medicamente cardiovasculare şi non-cardiovasculare, substanţe de abuz, substanţe chimice sau porţiuni de plante poate genera hipertensiune arterială secundară. Autorii raportează experienţa personală legată de hipertensiunea arterială secundară intoxicaţiilor acute la copil şi adolescent.

Material şi metodă. Am condus un studiu prospectiv pe o perioadă de 24 de luni în care am inclus 151 de copii şi adolescenţi cu afectare toxică cardiovasculară. Pentru depistarea cazurilor de hipertensiune arterială secundară, semnele vitale au fost analizate la internare şi în dinamică ţinând cont de valorile normale pentru vârstă.

Rezultate. 11,1% din totalul cazurilor de intoxicaţie acută internate şi tratate în departamentul nostru au asociat afectare toxică cardiovasculară. Dintre acestea, 18,5% au fost cazuri de hipertensiune arterială secundară. Principala cauză a hipertensiunii arteriale în lotul studiat a fost expunerea la insecticide organofosforice, urmată de expunerea la medicamente simpatomimetice. În cazul insecticidelor organofosforice am constatat un comportament dual. Pacienţii au prezentat la debutul intoxicaţiei o scurtă perioadă de tahicardie şi hipertensiune arterială, ulterior instalându-se tabloul colinergic clasic din intoxicaţia acută cu insecticide organofosforice, cu bradicardie şi/sau hipotensiune arterială. Toate cazurile de hipertensiune arterială identificate au fost creşteri tranzitorii, autolimitate ale valorilor tensiunii arteriale, ce nu au necesitat asocierea agenţilor hipotensori în abordarea terapeutică.

Concluzii. Intoxicaţiile acute ale copilului şi adolescentului se pot complica cu hipertensiune arterială, cel mai adesea uşoară şi tranzitorie. Monitorizarea semnelor vitale este esenţială pentru abordarea acestor cazuri. Personalul medical trebuie să cunoască temeinic particularităţile legate de vârstă, inclusiv intervalele de referinţă pentru valorile tensiunii arteriale la copil şi adolescent.

Cuvinte cheie: hipertensiune arterială secundară, intoxicaţie acută, insecticide organofosforice, copil, adolescent

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Cristina Iolanda Vivisenco

SECONDARY HYPERTENSION IN ACUTE POISONING IN CHILDREN AND ADOLESCENTS

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Cristina Iolanda Vivisenco and Coriolan Emil Ulmeanu

ABSTRACT

Introduction. Exposure to various cardiovascular and non-cardiovascular drugs, drugs of abuse, chemicals and plants may cause secondary hypertension. The authors report their personal experience related to secondary hypertension due to acute poisoning in children and adolescents.

Materials and methods. We conducted a 24 month prospective study that included 151 children and adolescents with acute poisoning who developed cardiovascular abnormalities. In order to detect cases of secondary hypertension, vital signs were assessed on admission and in evolution, considering the normal values by age.

Results. 11.1% of all cases with acute poisoning admitted and treated in our department have associated cardiovascular impairment. Of these, 18.5% were cases of secondary hypertension. The main cause of hypertension in the study group was exposure to organophosphate insecticides, followed by exposure to sympathomimetic drugs. We noticed a dual effect exerted by organophosphate insecticides. At the beginning patients experienced a short period of tachycardia and hypertension, followed by the installation of the classic cholinergic feature of acute poisoning with organophosphate insecticides, with bradycardia and / or hypotension. All cases of hypertension were transient, self-limiting elevations of blood pressure, which did not require association of antihypertensive agents in the therapeutical approach.

Conclusion. In children and adolescents, acute poisoning may be complicated by hypertension, which is mostly mild and transient. Vital signs monitoring is essential to address these cases. Medical staff must know thoroughly age peculiarities, including reference ranges for blood pressure in children and adolescents.
Keywords: secondary arterial hypertension, acute poisoning, organophosphate insecticides, child, adolescent

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Cristina Iolanda Vivisenco

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