Archive issue

1. The Cellular Source of IL-17A in the Pathogenesis of Inflammatory Joint Diseases

COJOCARU-GOFITA I.R.(1), CIUREA PAULINA(1), YEREMENKO N.G.(2)

Abstract Inflammatory joint diseases comprise a various range of maladies such as: rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis. One of their common  pathogenical features is the implication of TH1/2 cytokines(1). In addition to the well-established TH1 and 2 cytokines there has been  found a new family of cytokines and their receptors – IL-17 - which was thought to be produced mainly by the TH17 subset(1, 2). Recent findings suggest that this highly pro- inflammatory cytokine could be produced by various other cell subtypes such as mast cells(3) (4)and neutrophils. The novelty brought by the intensive research upon IL-17 in human inflammatory joint diseases may bring into clinical practice a broader therapeutical range of options for these patients(5, 6)

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2. Ovary Lessions Evolution in Menopause

LORENA DIJMARESCU, CARMEN GHETA, FLORENTINA TANASE, COMANESCU A ,MAGDA MANOLEA, LILIANA NOVAC

Background. In the past, any detection of adnexal cystic masses was considered abnormal and would result in routine surgery.  But the results of several studies concluded that ovarian cysts, especially those smaller than 5 cm in diameter, are hardly malignant. Such cysts constitute an important source of false-positive results in any ovarian screening program. Patients and Method In our study there were included 51 patients who met the following criteria: menopausal status, whether surgical or natural, for at least 1 year (defined as cessation of menses or positive hormonal diagnosis), had at least one ovary, were asymptomatic. Results. Ovaries were more readily visualized when women were less than 5 years postmenopausal (78%),  than when they were 10 years beyond menopause (64%), probably because of the progressive decrease in ovarian size. Of the 21 cases included in the study based on ultrasound appearance and / or elevated CA125, in 2 cases (8%) the cyst has completely disappeared, in 7 cases (35.28%) the cysts have decreased in diameter by more than 3 mm, in 4 cases (21 %) the cysts increased in size, and  in 8 cases (45.19%) they remained the same size. Conclusions. Ovarian cysts is a surprisingly common condition in postmenopausal women .Such cysts are dynamic in character, in their vast majority changeable in size, between two successive evaluations.  We have no proof that all cysts under study and observation were of benign type, but their involution and their very extinction is an element of positive diagnosis.

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3. Impaired Arterial Stiffness in Systemic Lupus Ertythematosus - Correlations with Inflammation Markers

A.L. BARBULESCU(1), F. VREJU(2), I.R COJOCARU-GOFITA(2), A.E. MUSETESCU(2), P.L CIUREA(2)

Background: Systemic lupus erythematosus (SLE) is an inflammatory disease caused by autoimmune dysregulation, which mainly affects young women, usually free from atherosclerosis. Accelerated atherosclerosis is a well established complication of SLE and it cannot be explained by Framingham risk factors alone, and has been attributed to complex interactions between traditional risk factors and factors associated with the disease per se, or its treatment. Arterial stiffness and endothelium function may serve as a valuable measure to be counted in the follow-up of these patients prior to a potential cardiovascular event. The aim of the study was to evaluate atherosclerosis, inflammatory process, immune mediated, using imaging techniques and to identify the role of molecules known to be involved in inflammation, hsCRP, homocysteine, IL-6, ESR and fibrinogen, in the development and perpetuation of atherosclerosis in patients with systemic lupus erythematosus. Methods Our prospective study included 53 patients diagnosed with systemic lupus erythematosus and fulfilled the revised ACR (American College of Rheumatology) criteria for the classification of SLE. Exclusion criteria were <18 years of age, history of CVD, infections, diabetes mellitus, dyslipidemia. Results: We enrolled 53 patients with SLE, 50 (94%) women and 3 (6%) men, with a mean age of 31,92 years (SD 5,55; limits 22-44) with no significant difference between sex (31,65±3,4 years in women and 37,33±4,05 years in men). The measurement of inflammation markers revealed increased values for all the variables: ESR had a mean value of 69,19± 14,18mm, fibrinogen 445,66 ±4,56mg%; IL-6 had a mean value of 11,209 ±1,56pg/ml; homocysteine  17,721±2,5374 µmol/l and for hs CRP the mean value was 3,493±1,12 mg/l. The assesement of arterial stiffness showed a mean value of 23,32% (SD 5,82; 95%CI 21,716 - 24,925) for AIx and 9,1m/s (SD 0,49; 95%CI 8,971 - 9,244) for cfPWV. There was a positive, significant correlation between AIx and hsCRP (r=0,612; 95%CI 0,4104 - 0,7576; p<0,001), (r=0,526; 95% CI 0,2979 to 0,6971; p=0,0001), for AIx and homocysteine (r=0,526; 95%CI 0,2979 to 0,6971; p=0,0001). The correlation coefficient with AIx was similar for ESR and fibrinogen (r=0,63 and 0,60). IL-6 and AIx correlated correlated positively, (r=0,369; 95%CI 0,1097 - 0,5813), statistically significant (p=0,006), but the correlation was not powerful. hsCRP and cfPWV were related (r=0,652; 95%CI 0,4677-0,7862; p<0,001); cfPWV also correlated with IL-6 (r=0,6552; 95%CI 0,4677- 0,7862; p<0,0001), homocysteine (r=0,9174; 95%CI 0,8606- 0,9517; p<0,0001), ESR (r=0,74) and fibrinogen (r=0,64). Conclusions: In summary, our data suggest that arterial stiffness is related to the level of systemic inflammation, and that inflammation is involved in the early alteration of arterial wall. Increase in arterial stiffness can be detected by applanation tonometry, and may serve as an important predictor of future cardiova

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4. Post-Myocardial Infarction Arrhythmia Risk Stratification Using Microvolt T-Wave Alternans

DONOIU I., MIREA OANA CRISTINA, GIUCA ALINA, MILITARU C., IONESCU D.D.

ince its initial description, a number of studies have described the use of microvolt T-wave alternans (MTWA) as a predictor of the primary or secondary occurrence of ventricular arrhythmic events. These studies, however, have been limited by small sample sizes and disparate patient populations. Studies of MTWA in post-myocardial infarction (MI) patients are few in number, but hold predictive value for risk of ventricular arrhythmias. We performed a study of MTWA in post-myocardial infarction patients to clarify the predictive accuracy and usefulness of MTWA compared to other invasive and non-invasive techniques. We enrolled 120 patients (74 men, 46 women, mean age 62.3 ± 15.2 years in men, and 64.2 ± 13.8 years in women) with a history of myocardial infarction but no prior sustained ventricular arrhythmias. Patients were assessed by echocardiography, Holter, signal averaged ECG, MTWA, and electrophysiology study. Mean follow-up was 14 months. The MTWA test had a good negative predictive value for arrhythmic events in post-MI patients and can be used for risk stratification. We consider that in patients with positive MTWA further invasive evaluation, respectively electrophysiology study, is necessary

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5. The Contribution of the Video Capsule Endoscopy in Establishing the Indication of Surgical Treatment in the Tumoral Pathology of the Small Bowel

VERE C.C., STREBA C.T., ROGOVEANU I., GEORGESCU M., PIRVUD., IORDACHE SEVASTITA, GHEONEA D.I, SAFTOIU A., CIUREA T.

Background and aims: Capsule endoscopy (CE) represents a novel method which allows safe, non-invasive and rapid exploration of the small bowel. Our aim was to determine the feasibility CE has in assessing tumoral pathology of the small bowel and aiding surgical teams in determining appropriate treatment. Material and Method Our study was conducted on 11 patients who presented tumoral pathology of the small bowel, from a total of 50 patients investigated by VCE. Malignancy was determined on the surgical resection piece, by histological exam. Statistic analysis of the data was conducted using Fisher’s Exact Test. Results Tumoral pathology was represented by: 3 intestinal polyps, 2 benign stromal tumors, 2 malign stromal tumors, 2 adenocarcinomas, one neuroendocrine malign tumor and one duodenal papilla carcinoma. We followed the presence of malign tumors in regards to age. All malign tumors (n=6) were recorded in patients over 60 years old, while benign tumors were recorded in most cases (80%, n=4) in people under 60 years old. One case of benign tumor (intestinal polyp) was observed above 60 years old. Conclusion Capsule endoscopy represents a real help for the surgeon, as it allows identification of small bowel pathology, giving information regarding the approximate localization of lesions, their size and orienting on their nature. Tumoral pathology is encountered mainly with the old age population and can be presented under a multitude of forms. We believe that an efficient method for incipient detection and a protocol to establish malignity is necessary

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6. Opportunistic Screening for Ca PVU in Primary Health Care

SEKA MIRCIC

Majority of countries don’t have an organized screening program.It is not conducted or is in form of opportunistic screening. An organized screening for cervical cancer in developed countries is resulted in significant decrease of incidence and mortality. In our country there is no an organized screening program. Even it is carried out,it is in form of opportunistic screening. Consequently,the number of cervical carcinoma (Ca PVU) is the largest in Europe. The goal of this research is accomplishing possibilities and limits of opportunistic screening in Velika Plana

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7. Minimally Invasive Surgical Treatment of Stress Urinary Incontinence in Women - Initial Experience of Craiova Urology Department Using the Transobturatory Tape Procedure (TOT)

STOICA L(1), TOMESCU P(1), DRAGOESCU O(1), PANUS A(1), ENACHE M(1), CERNEA N(2)

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8. Researches on the preparation and characterization of some tinctures from Silene albae herba and Silene pendulae herba

TIRCOMNICU VIORELA (1), GIRD CERASELA ELENA (2), RADU S. (1)

Starting from the varied chemical composition of Silene species (Caryophyllaceae family), the pharmacological utilizations (homeopathy) and the cumulative toxicity for a long time administration, were performed researches concerning the preparation and characterization of tinctures from aerial parts of S. alba and S. pendula species. Tinctures were obtained, according to the Romanian Pharmacopoeia Xth edition, by percolation and characterized from physico-chemical point of view: color, taste, smell, relative density, refractive index, and quality conditions – content in iron and heavy metals, alcohol concentration and evaporation residue. Qualitative and quantitative analyses of tinctures were making for the flavonosids, using thin layer-chromatography, respectively VIS spectrophotometry.

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9. A Comparative Study for Methods of Content Search in Multimedia Databases with Endoscopic Images

D.D. GARAIMAN(1), A. SAFTOIU(2)

This is a comparative study for nerecursive algorithms content search in multimedia databases with endoscopic images are based three methods of deciding the similarities between the models of images: Minkowsky distance, generalized measure Jaccard and correlated measure Pearson. The performance of the search has been measured according to three parameters: reapel, precision and the quality of retrieval. The model of representing the images are the normalized color histogram. The color space of the images are RGB reduced to 125 and 256 colors and HSV reduced to 162 and 256 colors. The study was realized in a database containing 360 images grouped in 23 categories. The results are presented both in tables and graphs

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10. Considerations Regarding the Therapeutic Conduct in Pregnancy Associated Diabetes Mellitus

GHEORMAN LAVINIA MARIA(1), GHEROMAN V. (2)

The consequences of diabetes mellitus on maternal body are evolutive and complex ones. At pregnant women with diabetes mellitus beside hyperglycemia, which is the specific anomaly, there are another risk factors both specific pregnancy factors as general pathologycal factors. This report considers the main classes of medicines used in the treatment of diabetes mellitus associated to pregnancy ( preexisting diabetes or gestational diabetes) . We discuss both about the main oral hypoglycemic agents with their advantages or their risks in the treatment of diabetes mellitus in pregnancy as about insulin therapy  which is the main choice in the treatment of diabetes mellitus in pregnancy. This paper tries to order the treatment of diabetes mellitus according to the particularities of this disease in pregnancy. This report tries an accord between therapeutic points of view of specialists in Diabetes Mellitus and specialists in Obstetrics

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