http://repository.usmf.md:80/xmlui/handle/20.500.12710/26645 Tue, 07 Apr 2026 02:31:18 GMT 2026-04-07T02:31:18Z http://repository.usmf.md:80/xmlui/handle/20.500.12710/26928 Post-COVID19 pulmonary complications in infants – clinical-imaging approaches Conica, Corina; Selevestru, Rodica; Șciuca, Svetlana Introduction. COVID-19 infection affects people of any age or gender. It was found that children up to 6 months of age have a major risk of developing a severe form of the infection. Contemporary diagnostic imaging methods of high sensitivity, such as lung CT, allow to establish the degree of lung damage, the volume and the sequelae arising from enduring the COVID-19 infection. The long-term consequences of the COVID-19 infection are still being researched. Pneumonia in the infection of COVID-19 can lead to the long-term development pulmonary fibrosis, atelectasis, bronchiectasis. Case report. The 5-month-old boy is admitted to the Pneumology Clinic with dyspnea, tachypnea, acrocyanosis, agitation, food refusal. It is known from the anamnesis that at the age of 4 months the child suffered a severe form of the COVID-19 infection. Non-contrast lung CT was performed which suggests fibro-atelectatic changes in both lungs, predominantly in the apical and basal segments. Conclusions. Infants show an increased vulnerability to develop bronchopulmonary changes after COVID-19. The case is suggestive from a clinical point of view, emphasizing the connection between the form, the evolution of the disease, and the consequences arising from the COVID-19 infection. Fibrotic pulmonary evolutionary changes are suggestive of SARS-CoV-2 virus infection. Sun, 01 Jan 2023 00:00:00 GMT http://repository.usmf.md:80/xmlui/handle/20.500.12710/26928 2023-01-01T00:00:00Z http://repository.usmf.md:80/xmlui/handle/20.500.12710/26926 Compound Angiotrophic Biphasic Myeloid Sarcoma with JAK2 (V617F) and KRAS (G12C) mutations Abukhiran, Ibrahim; Rosenthal, Nancy; Syrbu, Sergei I. Introduction. Myeloid sarcomas (MS) are extramedullary manifestations of myeloid neoplasms, associated with conditions like acute myeloid leukemia (AML), myelodysplastic syndromes (MDS), and myeloproliferative neoplasms (MPN). MS presents as tumor masses in various body sites, often expressing myeloid or monocytic markers. This case report details an unusual biphasic MS relapse with a significant “intravascular” component. Materials and methods. A 59-year-old male with a history of JAK2-V617F positive MDS/MPN underwent allogeneic hematopoietic stem cell transplantation and presented with abdominal pain, skin lesions, and systemic symptoms. Biopsy of colonic masses was performed, and subsequent analysis was carried out. Results. The biopsy revealed a neoplasm with solid and intravascular components. The solid part was mainly composed of monocytic lineage cells expressing specific markers, with a small population of myeloid blasts. In contrast, the “intravascular” component was mainly myeloid blasts expressing different markers. Genetic analysis uncovered JAK2 (V617F) and KRAS (G12C) mutations. Despite treatment, the disease progressed, and the patient eventually passed away. Conclusions. Myeloid sarcomas are challenging to diagnose, often being mistaken for large cell lymphomas. They can manifest as isolated extramedullary relapses, with a unique molecular profile. This case stands out due to its biphasic nature, featuring distinct components with differing characteristics, which has not been documented previously in English literature. It underscores the intricate and diverse nature of myeloid sarcomas, emphasizing the need for further research to comprehend their biology and behavior effectively. Sun, 01 Jan 2023 00:00:00 GMT http://repository.usmf.md:80/xmlui/handle/20.500.12710/26926 2023-01-01T00:00:00Z http://repository.usmf.md:80/xmlui/handle/20.500.12710/26925 Hypotension in spinal anesthesia: predictive factors, prevention and volemia’s non-invasive estimation methods Gherasim, Olga; Casian, Dumitru; Cîvîrjic, Ivan; Cernei, Natalia; Șandru, Serghei Introduction. Evaluation of patient volemia arriving at a medical service today still represents a challenge for specialists, especially in those who need surgical and anesthetic intervention. One of the most common systemic side effect to anesthesia is hypotension. Spinal Anesthesia-Induced Hypotension (SAIH) because of sympathetic blockade is most frequently cited as a complication of subarachnoid anesthesia, its severity being influenced by the patient’s volemic state. The aim of this literature review is to analyze if „routine” preanesthetic preloading reduces the incidence of SAIH in patients undergoing spinal anesthesia, also to emphasize the efficacy of preanesthetic assessment of the IVC/Ao (Inferior Vena Cava/ Abdominal Aorta) Index measured by ultrasound in determination of patients’ volemia. Material and methods. Narrative literature review. Bibliographic search in the PubMed, NCBI and Google Academic databases, using the keywords: „hypotension inferior vena cava”, „hypotension spinal anesthesia”, „inferior vena cava/aorta diameter”, „preloading hypotension”, which were combined with each other. The final bibliography included 40 references. Results. The principles of perianesthetic volemia management and prevention of arterial hypotension after the administration of the spinal block were detected in different groups of patients: the elderly, adult patients, anesthesiologic assistance in obstetrics and in various types of surgical interventions. Hypotension incidence data in patients with and without preanesthetic volume repletion were detected. At the same time, the effectiveness of the ultrasonographic assessment of IVC/Ao index in assessing patient’s volume status was determined. The information was analyzed and synthesized in the article. Conclusions. The effectiveness of routine preloading in reducing the incidence of arterial hypotension after spinal anesthesia did not prove its benefits in normovolemic patients, and ultrasonographic assessment of the IVC/Ao Index in assessing the volume status appears to be a simple, rapid, non-invasive, cost-effective volume assessment, which does not require the presence of a specialized imagist, being practically devoid of contraindications. Sun, 01 Jan 2023 00:00:00 GMT http://repository.usmf.md:80/xmlui/handle/20.500.12710/26925 2023-01-01T00:00:00Z http://repository.usmf.md:80/xmlui/handle/20.500.12710/26924 Algorithm of diagnosis and treatment of Gilles de la Tourette syndrome and tic disorder, adapted for the Republic of Moldova: a review Sajin, Valeria Introduction. In the last years the high prevalence of the tic disorder and Gilles de la Tourette syndrome (GTS) was confirmed. The available therapies can temporarily suppress the tics, but not eliminate them definitively, that implies a strict individual assessment of the risks and benefits for every patient. The recent scientific studies confirmed the efficiency of some diagnostic and therapeutic options, and infirmed the other ones. Thus, a qualitative analysis and adjustment of the recommendations to the actual conditions and possibilities of the Republic of Moldova (RM) is required. Material and methods. All the guidelines for the diagnosis and treatment of GTS and tic disorders were found in the PubMed database. The articles containing the keywords „Tourette diagnosis“, „Tourette treatment“, „tic diagnosis“ or „tic treatment“ and published after 2021 were selected. The availability in RM of the medications recommended by the international guidelines was verified on the site of the Medicines and Medical Devices Agency of RM. The final text includes the qualitative analysis and synthesis of the recommendations, adapted to the conditions and possibilities of RM. Results. The diagnosis of tics needs only clinical observation, and usually other investigations are not indicated. It is extremely important to identify patients whose tics do not need treatment, but just monitoring and informing about their nature. There are three main therapeutic methods directed against tics: behavioural therapy, pharmacotherapy, and, in some particular cases, neurosurgical approach (deep brain stimulation). The first two methods are available in RM. The efficiency of other tics treatment had been not confirmed yet. A particular attention is paid to the management of the specific comorbidities of GTS and tics. Conclusions. The diagnosis of tics is based on the recognition of their clinical manifestations and precise anamnesis. Only some patients with tics need treatment but all of them should be informed about the tics’ nature, causes and evolution. The behavioural therapy could be effective in some patients, while in others would be more convenient the pharmacotherapy or the combination of both. The neurosurgical treatment (deep brain stimulation) is reserved to severe tics, that are resistant to other therapies. Sun, 01 Jan 2023 00:00:00 GMT http://repository.usmf.md:80/xmlui/handle/20.500.12710/26924 2023-01-01T00:00:00Z