[Lamivudine and alpha-IFN treatment of a severe case of acute hepatitis B]. / Lamivudina si alpha-interferonul în tratamentul unei forme severe de hepatita acuta cu virus B. Caz clinic.

In order to enhance the viral clearance we used a combined antiviral therapy in an 18 year old patient, hospitalized in the Infectious Diseases Hospital-Iasi, in June 2002. The evolution under standard therapy was unsatisfactory, with the aggravation of the icteric syndrome and a constant cytolytic syndrome. At this point we used the combination of Lamivudine (Zeffix) 100 mg/24 h + alpha-IFN 3 milUI x 3/week for the duration of 8 weeks. The improvement in both clinical and biochemical condition of the patient was obvious. At the end of the treatment (8 weeks) none of the signs or symptoms were present, the patient became AgHBs negative, AgHBe negative and anti-HBe positive. The combined antiviral therapy was useful (with the clearance of the HBs antigen) in a severe case of acute hepatitis B.

[Epidemiologic and clinical aspects of acute hepatitis B in the past decade]. / Aspecte epidemiologice si clinice ale hepatitei acute B în ultimul deceniu.

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 Iasi, 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.

[Acute viral encephalitis. Experience of the Iasi Infectious Disease Clinic between January 2000 and March 2003]. / Encefalite acute virale. Experienta Clinicii de Boli infectioase Iasi în perioada ianuarie 2000-martie 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.

[Leptospirosis-clinico-biological and therapeutical aspects-study of 256 cases]. / Leptospiroza--aspecte clinico-biologice si terapeutice (studiu pe 256 cazuri).

Leptospirosis is a zooantroponosis manifested as an infectious disease with a severe evolution, with liver and renal failure and hemorrhagic manifestation. The aim of this study was to present the clinico-biological investigation and the therapeutical aspects of 256 cases of leptospirosis admitted in the Infectious Diseases Hospital Iasi during 4 years (1998-2001). The diagnosis was based on the study of clinico-biological and therapeutical parameters (risk factors, fever, mialgia, headache, algic, eruptive, meningeal, hepatorenal, hemorrhagic syndromes with the serological evidence of the serotypes of leptospirosis); most of the cases were registered in 1998 (23% cases), in adults (31.2%) and male (75.22%). All the patients were serologic confirmed with leptospirosis (RAL and RFC), and L. icterohaemorhagiae was isolated most frequently. The standard anti-leptospirosis treatment was administered with favorable evolution; 6 deaths were registered from the severe forms of the disease. The leptospirosis is an emergent disease with the possibility of severe evolution in some forms, with liver and renal failure.