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Irina-Mihaela Ciomaga

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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

Child with oncological diseases in intensive care unit

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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

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National Awards “Science and Research”

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Child with oncological diseases in intensive care unit

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ABSTRACT

Recently made advances in oncology have significantly improved the prognosis of children with neoplastic disease. Improvement of survival is accompanied by an increased risk of severe complications which may require intensive care. The aim of this study is the retrospective evaluation of the frequency of comorbidities that led to the transfer of patients from hematology- oncology department to intensive care unit in a period of 3 years. The study group consisted of 54 children (aged 9 month-17 years), representing 1,2 % from all admissions in hemato-oncology department during this period. LAL was the most frequent of hematologic malignancies admitted to intensive care unit (31% of cases). Respiratory failure was the main reason for transfer (23 cases-42,5%), followed by sepsis and shock (17 cases-31,4%). Oxygen (21 cases), electrolyte balancing (9 cases) and administration of inotropic agents like dopamine and / or dobutamine (6 cases) were the main specific treatments performed in intensive care. The mortality rate recorded in this group, in the intensive care unit was 27.7%, being smaller for solid tumors. Early recognition of signs of deterioration and admission to intensive care unit in a timely manner may improve prognosis, but the decision to transfer is delicate, involving the intensivist, the oncologist, the family and the patient, when he is able to.

Key words: neoplasia, intensive care, child

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COPILUL CU AFECTIUNI ONCOLOGICE IN TERAPIA INTENSIVA

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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

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DOI - Crossref
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DOAJ
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HIGHLIGHTS

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

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.

COPILUL CU AFECTIUNI ONCOLOGICE IN TERAPIA INTENSIVA

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REZUMAT

Progresele făcute în oncologie în decursul ultimilor ani au ameliorat considerabil prognosticul copiilor cu afecţiuni neoplazice. Ameliorarea supravieţuirii se însoţeşte însă de o creştere a riscului de complicaţii severe pentru care pacientul poate necesita îngrijiri în terapie intensivă. Scopul acestui studiu constă în evaluarea retrospectivă, într-o perioadă de 3 ani, a frecvenţei unor comorbidităţi care au determinat transferul bolnavilor din secţia de hemato-oncologie în cea de terapie intensivă. Lotul de studiu a cuprins 54 de copii (vârsta 9 luni-17 ani) reprezentând 1,2% din totalul inernărilor în hemato-oncologie în intervalul menţionat. Dintre hemopatiile maligne admise în terapie intensivă a predominat LAL (31% din cazuri). Insuficienţa respiratorie a constituit principalul motiv de transfer (23 de cazuri – 42,5%), urmat de sepsis şi şoc (17 cazuri – 31,4%). Principalele tratamente specifice efectuate în terapie intensivă au fost oxigenoterapia (21 de cazuri), reechilibrarea hidroelectrolitică (9 cazuri) şi administrarea de agenţi inotropi tip Dopamină şi / sau Dobutamină (6 cazuri). Mortalitatea înregistrată la acest lot, în secţia de terapie intensivă a fost de 27,7%, fiind mai mică pentru tumorile solide. Recunoaşterea precoce a semnelor de agravare şi internarea în terapie intensivă în timp util pot duce la îmbunătăţirea prognosticului, însă această decizie de transfer este delicată, la ea trebuind să participe medicul de terapie intensivă, hemato-oncologul, familia şi pacientul, când acesta este capabil.

Cuvinte cheie: neoplazie, terapie intensivă, copil

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ACCIDENT VASCULAR CEREBRAL ISCHEMIC LA UN COPIL CU CARDIOPATIE CONGENITALA CIANOGENA COMPLEXA

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Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 3, An 2014
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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HIGHLIGHTS

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

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.

ACCIDENT VASCULAR CEREBRAL ISCHEMIC LA UN COPIL CU CARDIOPATIE CONGENITALA CIANOGENA COMPLEXA

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REZUMAT

Accidentul vascular cerebral (AVC) este rar la copil comparativ cu adultul. Cauzele cele mai comune de AVC la copil sunt cardiopatiile emboligene pentru infarctul cerebral şi malformaţiile arteriovenoase pentru hemoragiile cerebrale, dar un număr de cazuri rămân idiopatice, fără a li se putea afi rma etiologia precisă. Autorii prezintă cazul unui copil diagnosticat în perioada de sugar cu malformaţie congenitală de cord cianogenă complexă, dar neoperată, internat cu semne clinice şi radiologice de pneumonie, care a evoluat favorabil sub tratament antibiotic şi simptomatic. În timpul perioadei rezolutive a pneumoniei, copilul devine brusc somnolent, prezentând hemiplegie dreaptă cu absenţa refl exelor de aceeaşi parte. Examenul clinic corelat cu CT cranio-cerebral au stabilit diagnosticul de AVC ischemic sylvian bilateral. Evoluţia a fost favorabilă sub tratament conservator (antiagregante plachetare, fi zioterapie), persistând însă hemiplegia dreaptă.

Cuvinte cheie: accident vascular ischemic, malformaţie congenitală cardiacă, copil, hemiplegie

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ISCHEMIC STROKE IN A CHILD WITH COMPLEX CYANOTIC CONGENITAL HEART DISEASE

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Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 3, An 2014
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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DOI - Crossref
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HIGHLIGHTS

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

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.

ISCHEMIC STROKE IN A CHILD WITH COMPLEX CYANOTIC CONGENITAL HEART DISEASE

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ABSTRACT

Stroke is rare in children compared to adults. Most common causes of stroke in children are heart diseases that cause embolism and cerebral infarction and arteriovenous malformations for the brain hemorrhages, but a number of cases remain idiopathic, without being able to say precise etiology. The authors present the case of a child diagnosed in infancy with complex cyanotic heart malformation, but not operated, admitted with clinical and radiological signs of pneumonia, which evolved favorably with antibiotic and symptomatic therapy. During resolution of the pneumonia, the child becomes suddenly drowsy, presenting right hemiplegia, with absence of refl exes on the same side. Clinical examination correlated with cranio-cerebral CT have established the diagnosis of bilateral Sylvian ischemic stroke. The evolution was favorable under conservative treatment (antiplatelet drugs, physiotherapy), but right hemiplegia persisted.

Keywords: ischemic stroke, congenital heart disease, child, hemiplegia

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BIOPROTEZA VALVULARA MITRALA DEGENERATA PRECOCE

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Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 3, An 2014
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

DOI - Crossref
Similarity Check by iThenticate, worldwide No 1 professional plagiarism checking system
DOAJ
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HIGHLIGHTS

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

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.

BIOPROTEZA VALVULARA MITRALA DEGENERATA PRECOCE

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REZUMAT

Prolapsul de valvă mitrală (PVM) este destul de frecvent întâlnit la copil, fi ind deseori o descoperire întâmplătoare la un copil asimptomatic, dar şi la copii simptomatici, cu boli ale ţesutului conjunctiv. Autorii raportează cazul unei fetiţe de 11 ani, diagnosticată la vârsta de 6 ani cu insufi cienţă mitrală severă prin prolaps de valvă mitrală şi operată la vârsta de 7 ani, când s-a practicat înlocuirea valvei mitrale cu o proteză valvulară biologică. La 4 ani de la protezarea valvulară, fetiţa se prezintă în urgenţă pentru instalarea bruscă a dispneei cu ortopnee, hemoptiziei şi cianozei generalizate. Examenul clinic corelat cu ecocardiografi a au stabilit diagnosticul de edem pulmonar acut şi proteză biologică valvulară degenerată, cu stenoză mitrală severă. Evoluţia a fost favorabilă după înlocuirea în urgenţă a bioprotezei cu o proteză mecanică.

Cuvinte cheie: bioproteză, valvă mitrală, copil

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EARLY DEGENERATED BIOPROSTHETIC MITRAL VALVE

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Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 3, An 2014
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

DOI - Crossref
Similarity Check by iThenticate, worldwide No 1 professional plagiarism checking system
DOAJ
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Ebsco Host - Medline
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HIGHLIGHTS

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

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.

EARLY DEGENERATED BIOPROSTHETIC MITRAL VALVE

, , , , and

ABSTRACT

Mitral valve prolapse (MVP) is fairly common in children, often being randomly found in asymptomatic, as well as in symptomatic patients with conjunctive tissue diseases (CTD). The authors report the case of an 11-yearold girl, diagnosed at the age of 6 with MVP and severe mitral regurgitation (MR). She had surgery at the age of seven, when the mitral valve replacement with a biological valve prosthesis was performed. Four years later, the girl was admitted for sudden onset of dyspnoea with orthopnoea, haemoptysis and generalized cyanosis. The diagnosis of acute pulmonary oedema and degenerated biological valvular prosthesis correlated with severe mitral stenosis was evoked by means of clinical and echocardiographic examinations. The evolution was favourable after the replacement of the bioprosthesis with a mechanical prosthesis.

Keywords: bioprosthesis, mitral valve, child

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