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“Eachpatientisunique.Wehavetopracticeapersonalizedmedicine”

“Semiologyisawindowthatopenstotheuniverseofinternalmedicine”

GENERALMEDICAL SEMIOLOGYGUIDE PARTII

ConsultantInternalMedicine

PhD,AssistantProfessor UniversityofOradea FacultyofMedicineandPharmacy MedicalDisciplinesDepartment Romania

AbouttheAuthor

MANUELASTOICESCU

ConsultantInternalMedicinedoctor,PhD,AssistantProfessoratUniversityofOradea,FacultyofMedicineand Pharmacy MedicalDisciplinesDepartment, Romania

Education:Philology-HistoryHighSchool,Oradea,Chemistry Biology fieldHighschooldiploma

UniversityofMedicineandPharmacy“IuliuHatieganu”Cluj-NapocaFacultyofMedicineandPharmacy Romania-PhysicianUniversityofMedicineandPharmacy“IuliuHatieganu”Cluj-NapocaRomania-ResidencyInternalMedicine5years-Certificate-InternalMedicineSpecialistFeb1996 Oct2001

Pe ´ dagogietrainingdepartment,Cluj Napoca,Romania Psychope ´ dagogieCertificate. CertificateofEnglishlanguageproficiency

Residency InternalMedicineClujNapoca UniversityofMedicineandPharmacy”IuliuHatieganu” Cluj-NapocaRomania,DepartmentofMedicalSemiology,MedicalIIClinic ClujNapoca CityInternalMedicine Department,MedicalIIClinicClujNapocaCity.

AssistantProfessorattheUniversityofOradea MedicalSemiologyDepartment 2002 present.

ConsultantInternalmedicinedoctor 2006

Ph.D.thesis:"Hypertensionintheyoungpeople-clinicalfeatures", -publicationdateJul28,2010publicationdescriptionObtainedthetitleofdoctorofmedicineaccordingtothe OrderoftheMinisterofEducation,ResearchNr.4542on28.07.2010.publicationdescriptionPh.D.Thesis: "Hypertensionintheyoungpeople-clinicalfeatures",originalwork,Obtainedthetitleofdoctorofmedicine accordingtotheOrderoftheMinisterofEducation,Research,YouthandSportsNr.4542on28.07.2010.PhD

ConsultantInternalMedicinedoctor.PhD,AssistantProfessor,UniversityofOradea,FacultyofMedicineand Pharmacy,MedicalDisciplinesDepartment

DatesEmployed:Jan2001 Present2019;EmploymentDuration:18years8months;Location:Oradea-Romania

Shehasbeenaninvitedspeakerat56InternationalConferencesinUSandEurope,isOrganizingCommittee Member(OCM)inInternationalConferencesinUSandEurope,published20articlesinprestigiousjournalsinUS andisEditorialBoardMemberintwoprestigiousISSNjournalsinUS: JournalofDevelopingDrugs and Surgery: CurrentResearch.

Publications51

ScientificActivity

ACCOMPLISHMENTS

InvitedasspeakerandOrganizingCommittingMember(OCM)atthe24thAnnualCardiologistsConferenceat Barcelona,SpainfromJune11 13,2018-ManuelaStoicescu-“ThecauseofayoungpatientwiththirddegreeAV block”

InvitedasspeakerandOrganizingCommittingMember(OCM)atthe25thAnnualCongressonCardiologyand MedicalInterventionsJuly16 17,2018Atlanta,Georgia,USA-ManuelaStoicescu “Thehiddencardiovascular diseaseatapatientwithpaininthelefthypochondrium“

InvitedasspeakerManuelaStoicescuat17thAnnualConferenceonNephrology”onDecember04 05,2017 Dallas,USA, publicationdates04December,2017publicationdescription:” Atypical urinarytractinfectiontoa patientwithuniquekidney“.

InvitedasspeakerManuelaStoicescuat“InternationalConferenceonBiomarkers&ClinicalResearch” November27 28,2017Atlanta,USA, publicationdateNovember27,2017,publicationdescription: ”Noncorrelationbetweentumorbiomarkerslevelsinperitonealcarcinomatosis”-volume2,Issue4.

InvitedasspeakerManuelaStoicescuandCommittingOrganizingMemberat“21stInternationalConferenceon Clinical&ExperimentalCardiology”November06 07,2017LasVegas,USA, publicationdateNovember06,2017 publicationdescription: “TheriskofantidepressantsdrugsinpatientswithprolongedcongenitalQTsyndrome“, volume8,Issue11,ISSN2155 9880.

InvitedasspeakerManuelaStoicescuandCommittingOrganizingMemberat“19thAnnualCardiology Conference”August31-September01,2017Philadelphia,USA publicationdateAugust31,2017publication description:“Silentischemicheartdisease-anignoredproblem?!”

InvitedasspeakerManuelaStoicescu“15thInternationalConferenceonNephrology”28 30August2017 PhiladelphiaUSA. PublicationdateAugust30,2017publicationdescription: “Asimplerenalcystisreallyan innocentissue?”Volume3, Issue3:ISSN:2472-1220.

• EditpublicationTheriskofnitroglycerindrugadministrationinchronicdiabeticpatients

InvitedasspeakerManuelaStoicescu“4thAnnualCongressonDrugDiscovery&Designing”July03 05, Bangkok,Thailand2017Publicationtitle:“Theriskofnitroglycerindrugadministrationinchronicdiabetic patients” publicationdateJuly3,2017,Volume6,Issue3,ISSN:2169-0138.

• EditpublicationTheLiver-AvictimattheMiddle-duetoAssociationoforalAntidiabeticsDrugswithStatin Publicationtitle-article“TheLiver-AvictimattheMiddle-duetoAssociationoforalAntidiabeticsDrugswith Statin”ManuelaStoicescu PublicationdateMay11,2017publicationdescriptionJournalofDevelopingDrugsISSN 2329-6631USAIF ¼ 0,97

• Editpublication“Surgicaltreatmentofatrialfibrillationbetweenbenefitandrisk”-ManuelaStoicescu-invitedas speaker-“15thWorldCardiacSurgery&AngiologyConference”December08 09,2016inPhiladelphia,USA. InvitedasspeakerManuelaStoicescu“15thWorldCardiacSurgery&AngiologyConference”December08 09, 2016inPhiladelphia,USA.Publicationtitle“Surgicaltreatmentofatrialfibrillationbetweenbenefitandrisk” PublicationdateDec8,2016publicationdescriptionDecember2016,Volume7Issue10,ISSN:2155-9880.

• Editpublication “Thesurpriseofdiagnosisofafluidcollectionaroundthespleen” -ManuelaStoicescu-Invited asspeaker-5thInternationalConferenceandExhibitiononSurgery-November7 8,2016Alicante,Spain

InvitedasspeakerManuelaStoicescu“5thInternationalConferenceandExhibitiononSurgery”-November7-8, 2016Alicante,SpainPublicationtitle“Thesurpriseofdiagnosisofafluidcollectionaroundthespleen”PublicationdateNovember7,2016,AlicanteSpain.

• Editpublication “EarlyPredictiveMarkersOfAtherosclerosisInTheYoung” ManuelaStoicescu

Publicationtitle-article-“EarlyPredictiveMarkersOfAtherosclerosisInTheYoung”ManuelaStoicescu publicationdateSeptember30,2016publicationdescriptionInternationalJournalofDevelopmentResearchThomsonReuters-Impactfactor4,25publicationdescriptionVolume06Issue09,September2016,ISSN:2230-9926

• Editpublication “TheRiskofSuddenDecreaseofSevereArterialHypertension” ManuelaStoicescu

Publicationtitle article-“TheRiskofSuddenDecreaseofSevereArterialHypertension”ManuelaStoicescu PublicationdateJuly31,2016publicationdescriptionJournalofClinical&ExperimentalCardiology.USA,ISSN: 2155-9880JournalImpactFactor1.219*;1.97*(5YearImpactFactor)

• Editpublication “AcanthosisNigricans-earlymarkerincancer ” ManuelaStoicescu

Publicationtitle article-“AcanthosisNigricans-earlymarkerincancer”ManuelaStoicescu Publicationdate July15,2016publicationdescriptionAsianAcademicResearchJournalofMultidisciplinaryISSN:2319-2801 ThomsonReuters-IF ¼ 2,015publicationdescriptionVolume3,Issue7,July2016

• Editpublication “ControversialinMenopausalHormoneReplacementTherapy”ManuelaStoicescu

Publicationtitle article-“ControversialinMenopausalHormoneReplacementTherapy”ManuelaStoicescu publicationdateJuly11,2016publicationdescriptionJournalofDevelopingDrugs-USA.ISSN2329-6631,IF ¼ 1,32

• Editpublication “TheUnusualCauseofDangerousArrhythmiasattheYoung” ManuelaStoicescu

Publicationtitle-article-“TheUnusualCauseofDangerousArrhythmiasattheYoung”ManuelaStoicescu publicationdateApril30,2016publicationdescriptionJournalofClinical&ExperimentalCardiologyUSA,ISSN: 2155-9880JournalImpactFactor1.219*;1.97*(5YearImpactFactor)

• Editpublication“AcutePancreatitisaftertherapywithGABARAN”ManuelaStoicescu

Publicationtitle-article-“AcutePancreatitisaftertherapywithGABARAN”ManuelaStoicescu publicationdate December24,2015publicationdescriptionJournalofDevelopingDrugs-USA.ISSN2329-6631,IF ¼ 1,32

• EditpublicationLAUNCHBOOK: “ Suddencardiacintheyoung” -ManuelaStoicescu

InvitedasspeakerManuelaStoicescu“8thGlobalCardiologistsandEchocardiographyAnnualMeeting”-July 18-20,2016Berlin,Germany-LAUNCHBOOK:“Suddencardiacintheyoung”-ManuelaStoicescu:publication dateDecember15,2015publicationdescriptionbook“ Suddencardiacintheyoung”LAMBERTACADEMIC PUBLISHING-LAP-GERMANYISBN:978-3-659-81,073-2Berlin,GermanyJuly2016Volume7,Issue6,ISSN:21559880.

InvitedasspeakerManuelaStoicescuandCommittingOrganizingMemberat“6thInternationalConferenceon Clinical&ExperimentalCardiology”November30-December02,2015SanAntonio,USA,-“TheChestPainwith NormalEKG”, publicationdateNovember30,2015,SanAntonio,USA.

• EditpublicationTheChestPainwithNormalEKG

InvitedasspeakerManuelaStoicescuandOrganizingCommitteeMemberat”4thInternationalConferenceand ExhibitiononSurgery”-October05 07,2015Dubai,UAE

• Publicationtitle“NodularFormationsFromTheHairSkinOfTheHead”,publicationdateOctober3,2015Dubai, UAE.

https://www.linkedin.com/in/manuela-stoicescu-07974841/edit/publication/1478911795/

InvitedasspeakerManuelaStoicescu-Workshop-OrganizingCommitteeMemberat”4thInternational ConferenceonNephrology&Therapeutics”-September14 16,2015Baltimore,USA,PublicationWorkshop title:”HowWeCanProtectTheKidneyAboutTheSideEffectsOfDrugs?- publicationdateSeptember14,2015,

• EditpublicationAnUnusualRiskFactorintheBreastCancer

InvitedasspeakerManuelaStoicescuandOrganizingCommitteeMember-“WorldCongressonCancerand PreventionMethods”-August27 29,2015,Dubai,UAE,Publicationtitle“AnUnusualRiskFactorintheBreast Cancer”, publicationdateAugust27,2015,Dubai,UAE.

• EditpublicationTheCauseOfTheLeftBundleBranchBlockataYoungPatient InvitedasspeakerManuelaStoicescuatthe“5thInternationalConferenceonClinical&Experimental Cardiology“-April27 29,2015Philadelphia,USA,Publicationtitle“TheCauseOfTheLeftBundleBranch BlockataYoungPatient:publicationdateApril29,2015Philadelphia,USA

InvitedasspeakerManuelaStoicescuandOrganizingCommitteeMember-“GlobalConferenceonVaccines”April13 15,2015,Dubai,UAE,Publicationtitle:“TheVitalImportanceofBCGVaccinationattheNewborns”: publicationdateApril13,2015,Dubai,UAE.

• EditpublicationBeta-HumanChorionicGonadotrophin(B-HCGtotal)asatumormarkerinpregnancy

InvitedasspeakerManuelaStoicescu“5thWorldCongressonCell&StemCellResearch”-March23 25,2015 DoubleTreebyHiltonChicago NorthShore,USA,Publicationtitle:“Beta-HumanChorionicGonadotrophin (B-HCGtotal)asatumormarkerinpregnancy”, publicationdateMarch23,2015Chicago NorthShore,USA.

• Editpublication“Therealcauseofapatientwithabdominalpain”

InvitedasspeakerManuelaStoicescuandOrganizingCommitteeMemberofthe“3rdInternationalConference onSurgeryandAnesthesia”fromNovember17 192014atChicago NorthShoreUSA,Publicationtitle:“The realcauseofapatientwithabdominalpain”, publicationdateNovember17,2014atChicago NorthShoreUSA

InvitedasspeakerManuelaStoicescuat“4thWorldCongressonCellScience&StemCellResearch“ June 24 16,2014ValenciaConferenceCentre,Valencia,Spain.

s”-Invitedasspeaker InPublicationtitle:“Diagnosistrapsinararehematologicdisease”-publicationdateJune24, 2014Valencia,Spain.

• Editpublication-“Theriskofcoarctationoftheaortainpregnancy”InvitedasspeakerManuelaStoicescuat “4thInternationalConferenceonClinical&Experimental Cardiology”-April14 16,2014HiltonSanAntonioAirport,TX,USA.

Publicationtitle-“Theriskofcoarctationoftheaortainpregnancy”-, publicationdateApril14,2014San Antonio,TX,USA.

Publicationtitle-article-“OsteogenesisImperfecta”-ManuelaStoicescu-JournalofMolecularandGenetic Medicine, USA.,PublishedDate:February26,2014,ISSN:1747-0862

InvitedasspeakerManuelaStoicescuat“3rdWorldCongressonCancerScience&Therapy”October21-23,2013 DoubleTreebyHiltonHotelSanFranciscoAirport,CA,USAPublicationtitle:“Theriskofexcessivevaccination inmedullarthyroidcarcinoma”, publicationdateOctober21,2013,SanFranciscoUSA.

• Editpublication“OnsetofacutepancreatitiswithtransitorytypeIIINdiabetesmellitus”

InvitedasspeakerManuelaStoicescuat“2ndInternationalConferenceonSurgeryandAnesthesia,September 16-18,2013,HamptonInnTropicana,LasVegas,NV,USA.Publicationtitle“Onsetofacutepancreatitiswith transitorytypeIIINdiabetesmellitus”, publicationdateSeptember16,2013,LasVegas,Nevada,USA,

• Editpublication“TheRiskofadministrationplasma”

Publicationtitle-article-“TheRiskofadministrationplasma”-ManuelaStoicescu,publicationdateJuly23,2013 publicationdescriptionJOURNALOFDEVELOPINGDRUGS-ISSN2329 6631,2:106. https://doi.org/10.4172/ 2329-6631.1000106 PublishedJuly23,2013USA.

• Editpublication“DiagnosisTrapsinPolyarteritisNodosa”

Publicationtitle-article-“DiagnosisTrapsinPolyarteritisNodosa”-ManuelaStoicescu, publicationdateJuly 2013,publicationdescriptionJOURNALOFLIFESCIENCES”-DavidPublishingCompany July2013,Vol.7,No. 7,pp.749 753ISSN1934-7391,USA

• Editpublication“TheRiskofBreastCarcinomawithInterferonPlusRibavarinTherapyduringTreatmentof ChronicHepatitisCVirusInfection”

Publicationtitle-article-“TheRiskofBreastCarcinomaaftertherapywithInterferonPlusRibavarinduring TreatmentofChronicHepatitisCVirusInfection”-ManuelaStoicescu PublishedMay27,2013.USA.JOURNAL OFDEVELOPINGDRUGS-ISSN:2329 6631,Volume2,Issue1,2:102. https://doi.org/10.4172/2329-6631.1000102.

• Editpublication“Uncommoncardiacmalformationinararegeneticdisease”

Publicationtitle-article-“UncommonCardiacMalformationinaRareGeneticDisease”-ManuelaStoicescu publicationdateApr15,2013:publicationdescriptionJOURNALOFCLINICAL&EXPERIMENTAL CARDIOLOGYSCOPUSU.S.A.JClinExpCardiolog2013,4:51,000,244,ISSN:2155 9880JCEC,.4:5 https://doi. org/10.4172/2155-9880.1000244,Volume4,Issue5,1000244,ISSN:2155 9880JCEC.

Publicationtitle article-“KidneyTumorinPregnancy”-ManuelaStoicescu publicationdate:July29,2013publicationdescriptionJOURNALOFNEPHROLOGY&THERAPEUTICS3:138, https://doi.org/10.4172/2161-0959.1000138 2013USA.ISSN:2161-0959.

• Editpublication“LeydenVSyndromeandHashimotoThyroiditis”-originalcasereport InvitedasspeakerManuelaStoicescuat“AsianClinicalCongress”-Bangkok,Thailand, January28 2013, Publicationtitle:“LeydenVSyndromeandHashimotoThyroiditis”- publicationdate:January28,2013 InvitedasspeakeronlineConference - ManuelaStoicescu.at”Targetmeeting,DraftConferenceProgram,TM’S 2sworldonlineConference,January8-112013,Innsbruckst,Bellaire,Texas,USA.-Publicationtitle:”Thereal causeofaseverelyanemiasyndrome”, PublicationdateJanuary8,2013

Publicationtitle-article-“Therealintraoperativediagnosisofapatientwithlipothymiaandarterial hypotension”-ManuelaStoicescu, publicationdateNovember26,2012publicationdescriptionJOURNALOF TRANSPLANTATIONTECHNOLOGIES&RESEARCH-ISSN2161-0991.USA

• Editpublication-“AvoidingNephrectomyinanUnexpectedDiagnosisinCaseofUrographicLackofKidney Function”

Publicationtitle-article-“AvoidingNephrectomyinanUnexpectedDiagnosisinCaseofUrographicLackof KidneyFunction”-ManuelaStoicescu- publicationdateNovember22,2012,USA.

• Editpublication“Highbloodpressureintheyoung aignoredproblem?!”

Publicationtitle“Highbloodpressureintheyoung aignoredproblem?!“ManuelaStoicescu publicationdate October29,2012publicationdescriptionUniversityofOradeaPublishingHousepublicationdescription Monographypublished:“Highbloodpressureintheyoung aignoredproblem?!”.ISBN:978-606-10-0755-4.

• Editpublication“Carcinogenicriskofanabolicsteroidsinyoungathletes”

Invitedasspeaker-ManuelaStoicescu-“Montreal2012InternationalAnticancerForum” August27 30,2012., Publicationtitle:“Carcinogenicriskofanabolicsteroidsinyoungathletes”, Publicationdate:August27 30,2012, Montreal,Canada

Invitedasspeaker-ManuelaStoicescu-“8thInternationalStrokeSummit(ISS8)WorldStrokeOrganization (WSO)”,July6-82012Nanjing,China,Publicationtitle“Neurologicalmanifestationsinsystemicvasculitis” PublicationdateJuly6,2012Nanjing,China.

Publicationtitle:“Clinicalmanifestationsinprimaryerythrocytosis“-ManuelaStoicescu PublicationdateJune9, 2012Xuzhou2012InternationalForumonModernMedicine June9 102012,XuzhouChina.

Invitedasspeaker-ManuelaStoicescuat“MontrealInternationalEndoscopyForum-InternationalForumon BiotechnologyandMedicine”-May24 25,2012Montreal,Quebec,Canada,Publicationtitle “Theroleof endoscopyinthediagnosisofVonRecklinghausendissease” publicationdateMay24,2012.

• Editpublication-“Transietischaemicstrokeattackatyoungage”-originalcasereportPublicationtitle-“Transientischemicstrokeattackatyoungage” publicationdateMarch15,2012,publication descriptionInternationalNeuroscienceConferenceMarch15 16,2012,TohoUniversityOmoriMedicalCenter Tokyo,Japan.PublicationdescriptionInvitedasspeaker ManuelaStoicescu -“Transientischemicstrokeattackat

youngage”-originalcasereport-InternationalNeuroscienceConferenceMarch15 16,2012,TohoUniversity OmoriMedicalCenterTokyo,Japan.

• Editpublication-“TheAbusiveUtilizationofParaclinicalInvestigationsatLimitsbetweenMethodsof DepistationsandIatrogenicRiskFactorsforCancer”-originalcasereport-

Publicationtitle-“TheAbusiveUtilizationofParaclinicalInvestigationsatLimitsbetweenMethodsof DepistationsandIatrogenicRiskFactorsforCancer”-ManuelaStoicescu, PublicationdateJanuary13,2012 publicationdescriptionHongKong2012InternationalMedicalSummit,January13 14,HongKongCommunity HealthcareandHealthcareManagementForumHongKong,China,January13 14,2012.Publicationdescription Invitedasspeaker ManuelaStoicescu -“TheAbusiveUtilizationofParaclinicalInvestigationsatLimitsbetween MethodsofDepistationsandIatrogenicRiskFactorsforCancer”-originalcasereport-HongKong2012International MedicalSummit,January13 14,HongKongCommunityHealthcareandHealthcareManagementForumHong Kong,China,January13 14,2012.

• Editpublication“Thedosageofplasmareninlevel-earlymarkerindiagnosisofkidneycarcinomaand pheochromocytomaintheyoung”-originalresearch

Publicationtitle“Thedosageofplasmareninlevel-earlymarkerindiagnosisofkidneycarcinomaand pheochromocytomaintheyoung”-originalresearch PublicationdateJanuary12,2012publicationdescription Targetmeeting,DraftConferenceProgram,TM’S1stworldonlineConference,January12 14,2012,Innsbruckst, Bellaire,Texas,USA.publicationdescriptionInvitedasspeakeronlineConference- ManuelaStoicescu -“The dosageofplasmareninlevel-earlymarkerindiagnosisofkidneycarcinomaandpheochromocytomaintheyoung”originalresearch Targetmeeting,DraftConferenceProgram,TM’S1stworldonlineConference,January12 14, 2012,Innsbruckst,Bellaire,Texas,USA.

• Editpublication”Determinationofrenin earlymarkerinthediagnosisofcancerathypertensiveyoungpatients isimportanttobecomeascreeningtest.”-originalresearch

Publicationtitle”Determinationofrenin earlymarkerinthediagnosisofcancerathypertensiveyoung patientsisimportanttobecomeascreeningtest.”-Originalresearch PublicationdateOctober28,2011publication descriptionEPSGlobalInternationalForumofRegional&TargetedCancerTherapiesShanghai,China.Publication description ManuelaStoicescu -”Determinationofrenin earlymarkerinthediagnosisofcancerathypertensive youngpatientsisimportanttobecomeascreeningtest.”-originalresearch-3rdEPSGlobalInternationalForumof Regional&Targeted Cancer TherapiesShanghai,China.October28 30,2011

• Editpublication-“Theroleofincreasedplasmaticreninlevelinthepathogenesisofarterialhypertensionin youngadults.”-originalresearch

Publicationtitle“Theroleofincreasedlevelofplasmarenininetiopathogenicarterialhypertensionintheyoung “publicationdate2011publicationdescriptionVolume52Number1ISSN1220-0522.publicationdescription ManuelaStoicescu, S.Bungau,C,Csepento,M.Gabriela:“Theroleofincreasedlevelofplasmareninin etiopathogenicarterialhypertensionintheyoung”ROMANIANJOURNALOFMORPHOLOGYAND EMBRYOLOGYVolume52Number1 Supplement(newseries)-2011,ISSN1220 0522

PhD.thesis:“Hypertensionintheyoungpeople-clinicalfeatures”, PublicationdateJuly28,2010publicationdescriptionobtainedthetitleofdoctorofmedicineaccordingtotheOrder oftheMinisterofEducation,ResearchNr.4542on28.07.2010.PublicationdescriptionPhDthesis:“Hypertensionin theyoungpeople-clinicalfeatures”,originalwork,ObtainedthetitleofdoctorofmedicineaccordingtotheOrderof theMinisterofEducation,Research,YouthandSportsNr.4542on28.07.2010.PhD.

BOOKS7

“ClinicalCasesforStudentsoftheFacultyofMedicine”-

Publicationdate2010publicationdescriptionUniversityofOradeaUniversityassistantPublishingHouse.

Publicationdescription“ClinicalCasesforStudentsoftheFacultyofMedicine”-author:DrManuelaStoicescu InternalMedicineMD,PhD,UniversityofOradeaUniversityassistantPublishingHouse,2010-ISBN978-606-100198-9/publicationinEnglishlanguages-andRomanian.LanguageISBN:978-606-10-0132-3.

Bookpublished:ManuelaStoicescu:“SuddenCardiacDeathintheYoung”InternationalEditureLAMBERT AcademicPublishing Germany ISSN:978-3-659-81,073-2-2015.

ManuelaStoicescu “Sideeffectsofantiviralhepatitistreatment”InternationalEditureLAMBERTAcademic Publishing GermanyISSN978-3-659-47,428-6-2013.

Bookpublished:ManuelaStoicescu:“TumorMarkersinHypertensiveYoungPatients” OMICSPUBLISHING HOUSE,USAISBN:978-1-63,278-041-6 March2015.

Cardiovasculardiseases:Causes,Risks,ManagementCVD1 CausesofCardiovascularDiseasesManuela StoicescuMD,PhD1.5,1.6-onAmazon,USA.

Highbloodpressureintheyoung-anignoredproblem?! ManuelaStoicescu-monographpublishedPublishing HouseOradea,Romania2012ISBN:978-606-10-0755-4.

“AcuterenalfailureaftertherapywithInterferon”

PublicationdescriptionspeakerandCo-chair ManuelaStoicescu -MemberinCommittingOrganizingofthe3rd InternationalConferenceonNephrology&Therapeutics(Nephro-2014)June26 27,2014ValenciaConference Centre,Valencia,Spain.

PublicationdescriptionInvitedasspeakerandCo-chair ManuelaStoicescu -MemberinCommittingOrganizingof theConference “AcuterenalfailureaftertherapywithInterferon”-3rdInternationalConferenceonNephrology& Therapeutics(Nephro-2014)June26 27,2014ValenciaConferenceCentre,Valencia,Spain.

MemberinmanesCommittingOrganizingInternationalConferencesUSA

MemberinCommittingOrganizingInternationalConferenceDUBAI

MemberinCommittingOrganizingInternationalConferenceSPAIN

EditorialBoardMemberInternationalConferenceCardiology

PUBLICATIONS56 CONFERENCES2018

Invitedasspeakeratthe 27thWorldOncologistAnnualConferenceonDecember07-08,2018,Chicago,USA, Theme:“Believethereishopeforacure” ManuelaStoicescu “Thepesticides carcinogenicriskfactor!“

Invitedasspeakeratthe 12thInternationalConferenceonHematologyandHematologicalOncologyonOctober 29-30,2018,SanFrancisco,USA ManuelaStoicescu “Thequantificationofirradiantinvestigationsimportant roleinprophylaxisofhematologicdiseases”

Invitedasspeakeratthe 4th"InternationalConferenceonGastrointestinalCancerand Therapeutics“ "TerminationofGICancerbyNovelandInnovativeTechnologies"onOctober29-30,2018,San Francisco,USA ManuelaStoicescu “Thepatientswithhyperuricemianeedsscreeningcolonoscopy”

InvitedasspeakerandOrganizingCommittingMember(OCM)at theAmericanHeartCongress CVD27th InternationalConferenceonClinical&Experimental,CardiologyResearchonOctober05-06,2018,LosAngeles, California,USA ManuelaStoicescu “Hormonereplacementtherapyreallyprotectsawomanagainst myocardialinfarction?”

Invitedasspeakerat EuroPharmaceutics2018 17thAnnualCongressonPharmaceutics&DrugDelivery Systems September20-22,2018,Prague,CzechRepublic ManuelaStoicescu “Drugabuse an uncontrollablephenomenon!?”

CONFERENCES2019

InvitedasspeakerandOrganizingCommittingMember(OCM)atthe 31st AnnualCardiologistsConferenceon June17-19,2019,Rome,ITALY,Theme:“InsightsofCardiology&Healthcare ManuelaStoicescu ”The combinationbetweendigoxin,betablockerandcordaroneisdangerous”

Invitedasspeakeratthe27th AnnualCongressonCardiologyandMedicalInterventionsonJuly31-August01, 2019Chicago,USA,Theme:“PredictionandPreventions” ManuelaStoicescu ”Veryseverebradycardia10 bates/minaftercombinationofdrugs“

Iwanttothankallmystudentsbecausetheyexist;inthiswayIcancontinuallyperfectmyself andremainyoungtogetherwiththemthroughtheirenthusiasm.

YOU ARE READY? I AM YOUR LADY TEACHER

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Introduction

TheHistoryofthePatient

Thehistoryofthepatientrepresentsthefirstcontactanddiscussionofthephysicianwiththepatientandisvery important.Takingasuperficialhistorybecauseofalackoftimeisnotexcusablebecauseitcangeneratemistakes.A seriousandcarefulhistoryofthepatientwillaidinasuccessfuldiagnosis.Wemustalwaysaskafewtypicalquestions,whicharepresentednext.

Look at me how carefully I am talking to the patient and take notes!

InthefirstinstanceIwillaskaboutpersonalinformation:name,age,gender.

1.PERSONALDATA

Whatisyourname?

Howoldareyou?

Iobserveifthepatientisamanorawoman,becauseIknowthatsomediseasesaremorecommoninwomenand otherdiseasesappearmoreofteninmen.

2.PLACEOFBIRTHANDHOME(ADDRESS)

Wherewereyouborn? Wheredoyoulive?

Whatisyouraddress?Whatisyourphonenumber?

3.ALLERGY?

Iwillaskmypatientifheorsheisallergictoanydrugs. Iftheanswerisyes,IwillaskwhatdrugshavecausedallergyinthepastandIwillmarkitwithredcolorinthe personalpapersofthepatient.Veryimportant!Theadministrationofthesedrugsmusttobeavoidedtoprevent anaphylacticshock,Quinckeedema,orsuddendeath.

Forexample,Inoticed:

allergytoaspirin

allergytopenicillin

So,Iwillnevergivethispatientaspirinorpenicillin!

4.THEREASONFORHOSPITALIZATION

Thereasonforhospitalizationrepresentsthemainsymptomsaboutwhichthepatientcameforconsultation. Thereisalwaysamajorsymptom;thisistheleadingsymptom.Thepatientmayalsopresentwithothersymptoms. Thesemustbeputinorderperanatomyandsystem.

ExampleNo.1

- Syncopeistheleadingsymptom

- Dyspnea

- Chestpain

- Palpitations

ExampleNo.2

Hematuriaistheleadingsymptom

- Pollakiuria

- Dysuria

- Chills

- Fever

ExampleNo.3

- Hemoptysisistheleadingsymptom

- Dyspnea

- Chills

- Fever

ExampleNo.4

- Abdominalpain

- Nausea

- Vomiting

5.THEHISTORYOFTHECURRENTDISEASE

Inthissectionweneedtodescribeindetailthehistoryofthecurrentdiseaseofthepatient.First,weneedto specify:

Howdidthediseasestart?

Wasitsuddenorinsidious?

Howlongagodiditbegin?

Whatarethesymptoms?

Whatwasthepatient’sattitudetowardthedisease?

Hasthepatientpresentedhim-orherselftoadoctororstayedathome?

Didthepatientbeginmedicaltreatmentontheadviceofaphysicianordidheorshebegintreatmentalone?

Ordidthepatientnotfollowanytreatment?

Didheorshestartadrugtreatmentthathadaninfluenceonthedisease?

Wasthereimprovement,aggravation,oranyinfluence?

Isthisthefirstepisodeorhavetherebeenothersimilarepisodesinthepast?

Inthissectionitisnecessarytodescribeindetailtheactualhistoryofthepatientasregardswhatheorsheisbeing hospitalizedfor,ascompleteaspossible.

Ifthepatientcurrentlyhasmorethanonedisease,wehavetotakeahistoryofeachone,followingthesameelementspresentedbefore.

6.FAMILYHISTORY

Inthissectionweneedtodescribewhatdiseasesareinthepatient’sfamily.Whatdiseaseshavethemother,father, brothers,sistershad?Thisisbecausethereexistsariskforgenetictransmission,forexample,arterialhypertension, diabetesmellitus,cancersatvariouslocations,andgeneticdiseaseswithdominantorrecessivetransmission.These diseasesareimportantbecausethepatenthasageneticriskfordevelopingthesediseasesatanypointintime.

7.PERSONALPATHOLOGICALHISTORY

Inthissectionweneedtodescribeallthediseasesthatthepatienthadinthepastandalsosurgicalprocedures,in chronologicalorder,exceptforthecurrentillness.

8.PERSONALPHYSIOLOGICALANTECEDENTS

Inthissectionweneedtodescribeallthephysiologicalantecedentsinwomenregardingmenstrualcyclesand pregnancies.

Atwhatagedidthefirstcycle(menarche)occur?

Normalageisbetween12and14years.

Havemenstrualcyclesbeenregular?Oncepermonth?

Normalcycleis28days.

Howmanydaysdoestheflowtake?

Normalisbetween3and5days.

Howdoyouestimatetheamountofbloodlostduringthemenstrualcycle?

Normalisbetween300and500mLofblood.

Haveyoueverhadcycleslongerthan10days?

Thisiscalledmenorrhagia.Thisisspecificforuterinefibroids.

Haveyoueverhadbleedingbetweenmenstrualcycles?

Thisiscalledmetrorrhagia.Thisisspecificforuterinefibroids

Haveyouhadabnormalmenstrualcycleswithaquantitymorethan500mL?

Thisiscalledhypermenorrhea.Thisisspecificforuterinefibroids

Haveyouhadabnormalmenstrualcycleswithincreasedquantityandwithbloodclotsandprolongeddurationof morethan5days?

Thisisspecificforuterinefibroids.

Howdoyoudescribethecoloroftheblood?

Normalisfreshred.

Haveyoueverhadadarkbleedingthatlookslikecoffeeorcoffeegrounds?

Thisisspecificforuterinecarcinoma.

Haveyoueverhadbleedinglikejuiceinwhichmeatwaswashed? Thisisspecificforuterinecarcinoma.

Areyouinmenopause?Atwhatagedidmenopausebegin?

Normalageformenopauseisbetween45and50years.

Areyouinearlymenopauseorartificialmenopauseafterovariectomy,radiotherapy,orchemotherapy?Thisisa riskfactorforischemicheartdisease,becausethewomanhaslosttheprotectionofestrogenhormonesagainst atherosclerosis.

Haveyouhadbleedinginmenopause? Thisisspecificforuterinecarcinoma.

Haveyoubeenpregnant,andhowmanytimes?

Wasthedeliveryatnormaltime,9months,orearlyorlate?

Haveyouhadanyabortions,andhowmany? Weretheabortionsspontaneousorinduced? Whatdidyourbabiesweighafterdelivery?

Normalweightisbetween3and4kg.

Ababybiggerthan4kgisa“bigbaby”orhasmacrosomiaandrepresentsariskfactorfordiabetesmellitusofthe motherinthefuture.

Ababylessthan3kgispremature.

9.LIFECONDITIONS

Thelifeconditionsofthepatientareveryimportant. Especiallyimportantarethehousingconditions,eating,andtoxicconsumptions.

A.Thehousingconditions

Thehousingconditionsareveryimportantbecausepeoplespendmostoftheirtimeathome.Itisimportantto knowhowmanypersonsliveinaroomandhowmanyroomsareinthehouse.Theinfectiouscontagiousdiseases suchasviruses,pneumonia,andtuberculosisaretransmittedwhenthepeoplecohabit.

Anotherimportantconditionisthecleanlinessofthehouse.Isitacleanhouseornot?Isitanovercrowdedhouse ornot?Arepeoplelivingtogetherwithcats,dogs,aparrot?Becauseanimalscantransmitdiseasestothepersons wholivewiththeanimals.

Roomairconditioningisariskfactorforrespiratorytractinfectionsandallergiesaswell.

B.Eating

Aperson’sdietisveryimportant.Itmustbenutritionallybalancedinaccordancewiththephysicaleffort.A normaldietshouldbevariedandbalancedinthecontentofproteins,carbohydrates,lipids,andvitamins.Aunilateraldietexcessiveinglucosesandcarbohydratesrepresentsariskfactorfordiabetesmellitus.Aunilateraldiet increasedinanimallipidsrepresentsariskfactorfordyslipidemia,atherosclerosis,ischemicheartdiseases,angina pectoris,andheartattack.

Also,excesscaloriestogetherwithsedentaryhabitsareariskfactorforobesity,highbloodpressure,anddiabetes mellitus.Deficiencyindietleadstoweightloss.

Failuretoeatregularmealsisariskfactorfortheoccurrenceofgastritisandgastricorduodenalulcers.

C.Toxicconsumptions

Inthissection,thepatientshouldbeaskedaboutthetoxicconsumptionofalcohol,smoking,coffee,anddrugs.

Alcoholconsumption

Intermsofalcoholconsumptionthepatientshouldbeaskedhowoftenheorsheconsumesalcohol:everydayor occasionally?Thetruthisthatalcoholisoftennotrecognizedbythepersonconcerned;usuallythefamilyistheone whoinformsthedoctoraboutalcoholconsumption.

Itisimportanttoknowtheamountconsumedandwhatkindofalcoholicbeveragesareconsumed,hardalcohol orlightalcohol,likebeerorwine?

Personswithchronicalcoholconsumptionhaverisksformanydiseases,suchaschronicalcoholichepatitis,liver cirrhosis,gastricorduodenalulcers,mentalillnessessuchasalcoholicdementia,andothers.

Smoking

Smokingisanotherriskfactorformanydiseases.Itisreallyimportanttoaskthepatientatwhatageheorshe begansmoking(howlong?).Whattypeofcigarette,withfilterorwithoutfilter?Howoften?Daily?Howmanycigarettesperday?Pipesmokersareatriskforlipcancer.

Smokingisanimportantriskfactorforcardiovasculardiseasessuchasischemicheartdisease,anginapectoris, acutemyocardialinfarction,cardiacarrhythmias,andsuddendeath;respiratorydiseasessuchaschronictobacco bronchitis,COPD,andbronchus pulmonarycancer;anddigestivediseasessuchasgastriculcerorduodenalulcer.

Wemustconsiderthestateofthepassivesmoker.Thisisrepresentedbypeople innocentvictims who passivelyinhalecigarettesmokebecausetheyarearoundapersonwhosmokes.Themostinnocentvictimsarechildren.Passivesmokersareatriskfortheaforementioneddiseasesinapercentagealmostasgreatasactivesmokers! Theyoungertheageatwhichsmokingstarted,andthehigherthenumberofcigarettesaday,thehigheristherisk forthediseasesmentioned.

Coffee

Coffeeconsumptionhasbeenknownfromtheearliesttimes.Thissmalldailyviceispracticedaroundtheworld. Abuseofcoffeeconsumptioncancausepalpitations,tachycardia,irritability,nervousness,andinsomnia.Itisalsoa riskfactorfortheoccurrenceofhighbloodpressureanddangerousarrhythmias.

Drugs

Drugconsumptionrepresentsariskfactorfordangerousarrhythmias,myocardialinfarctionatayoungage,and suddendeath.Bacterialendocarditisrepresentsanotherriskafterdrugconsumption.Drugconsumptionmusttobe stopped,especiallybecausemanyvictimsareyoungpeople.

10.WORKINGCONDITIONS

Workingconditionsrepresentanotherimportantpartofthehistoryofthepatient.Manyriskfactorsarepresentat theworkplace.Forthisreasonitisveryimportanttoaskandtoknowtheprofessionofthepatient.Howmanyhours areworkedperday?Riskfactorsfromworkincludedust,humidity,andnoise.Doesthepatientworkduringthe night?Worksupplementaryhours?Howarehisorherrelationshipswithcolleagues?Relationshipwiththeboss? Everythingisimportant!

11.GENERALMANIFESTATIONS

Thehistoryofthepatientfinisheswithafewimportantquestionsregardinggeneralmanifestationssuchas:

Appetite

Theweightcurve

- increasing?

- decreasing?

- stationary?

Thestool

Theurine

Frequencyofurinationin24h?

Diuresis?

Sleep

Doyousleepduringthenight?

Doyouhaveinsomnia?

Thehistoryofthepatientisfinishedwiththesegeneralmanifestationquestions.

I'm really happy!
We're done with patient history!

ARE YOU READY?

ARE YOU READY?

WE TALK ABOUT

SKIN LESIONS

SkinLesions OUTLINE

1.1PrimarySkinLesions3

1.1.1TheMacule3

1.1.2ThePapule5

1.1.3ThePlaque62

1.1.4TheNodule68

1.1.5TheVesicle104

1.2SecondarySkinLesions121

1.2.1Squames Psoriasis121

1.2.1Squames Psoriasis122 1.2.2Crusts130 1.2.3Scar131 1.2.4Fissure140 1.2.5Erosion140 1.2.6Ulceration ArterialDiabeticFoot140

DiabeticFootAmputation147 1.2.8Eschar Bedsores164 1.2.9VaricoseUlcers

Skinlesionscanbeprimaryorsecondary.Sometimesskinlesionscanappearinthecontextofskin diseases dermatologicaldiseases orinthecontextofageneraldisease.

Theprimaryskinlesionsareasfollows:macule,papule,plaque,nodule,vesicle,bulla,pustule,andcyst.

1.1.1TheMacule

1.1PrimarySkinLesions

Themaculeisachangeinskincolor,intheplaneoftheskin,smooth,withsizebelow1cm.Amacularrashoccurs invariousdiseasessuchasmeasles,rubella,andtyphoidfever.Measlesisoneofthemostcommonexamplesofthe contagiousinfectiousdiseases;itappearswithamacularrashwithpinkishredcolor,withonsetinthecephalicarea, andthenextendstothewholebody.Atfirst,themacularareasareisolatedandthenthereisaconfluencewithintact areasofskinbetweentherashlesions.

TheKopliksignistheappearanceofawhitespotonahyperemicareaattheleveloftheinnercheek,atthelevelof thegums,andatthelevelofthemolars.Usually,theKopliksignappearsbeforetheskineruption. Inthenextimages,wewillseeaboywithatypicalmacularrashinmeasles.Hedevelopedthisinfectiousdisease duringhisadolescence.Wewillseethetypicalrashasmanymacularlesionspresentattheleveloftheface.

1.1.1.1MacularRashonFace Measles

1.1.2ThePapule

Thepapuleisprominentlysituatedabovetheskinplane;thisisthereasonyoucanfeelapapulewithyourfingertips.Thedimensionsarelessthan0.5cm.Atypicalrashappearsininfectious contagiousdisease scarlet fever andinanallergicreaction hives.

1.1.2.1ScarletFever

Scarletfeverisaninfectious contagiousdiseasewiththeetiologicagent Streptococcus beta-hemolyticgroupB. Therashtypicallyappearsasamacropapularrash,withredcoloronallareasofthebody.Therashisnotpresent ontheface.Onthefacethereisonlyaredcolorofthecheeksandapalecoloraroundtheeyesandaroundthe mouth Filatov’smask.ThePastia Grozovicisignrepresentshemorrhagiclinesinthefoldsoftheupperlimbs andthelowerlimbs.Scarletfeverstartswithanerythematousanginaasintheimagebelow.

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