Archive issue


Current Health Sciences Journal

vol. 42 no. 3, 2016

1. Role of Metabolites of Nitric Oxide and Arginase in the Pathogenesis of Glomerulonephritis

ANGELA CIUNTU

Purpose: The aim of the study is to assess the level of nitric oxide metabolites and arginase in the urine of children with glomerulonephritis depending on clinical evolutional stages of the disease. Materials and methods: The prospective study included 65 children with primary glomerulonephritis, 25 children with steroid-sensitive nephrotic syndrome (SSNS) and 20 children with steroid-resistant nephrotic syndrome (SRNS), 20 children with mixed form of chronic glomerulonephritis(CGN). Results: Thus in the SRNS group, during relapse period the concentration of NO metabolites in urine was increased by 4,2 times, while in SSNS by 3,0 times in comparison with the control group. The concentration of NO metabolites in the urine increased by 4,8 times during relapse CGN mixed form in comparison to the control values. During remission, the levels of NO metabolites in the urine remain increased in both groups. In relapse of SSNS arginase levels in the urine increased by 4,5 times in comparation to SRNS, thus the concentration of arginase was reduced. During remission period arginase levels in the urine were practically reduced to the levels of the control group. In the mixed form of CGN, relapse period arginase levels in the urine were increased by 2,9 times and during remission were decreased by almost 1,9 times in comparision to the control group. Conclusions: Assesment of NO metabolites and arginase in urine can be used as a diagnostic method in order to monitor renal disease process, evolution and effectiveness of the applied treatment.

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2. Upper Gastrointestinal Bleeding in Chronic Kidney Disease Patients

DANIELA MARINESCU, M. LAZAR, S. ZAHARIE, COSMINA COMANESCU, CLAUDIA TUDORAN, M. BICA, L. BARBU

Aim: To investigate upper GI bleeding as a particular complication in chronic kidney disease patients. Material and methhod: 30 chronic kidney disease patients admitted to the Nephrology Department for upper gastrointestinal bleeding over a period of 5 years. Results: 16 patients were undergoing hemodialysis (53.3%) and 14 patients were not in a hemodialysis program. There were no patients undergoing peritoneal dialysis. Very high comorbidity rate for all patients, most important being cardiovascular diseases. Only 10% of patients had oral anticoagulant treatment prior to GI bleeding. Conservative treatment was successful for all patients; no endoscopic or surgical haemostasis was needed. Conclusion: Although chronic disease kidney patients have a high risk of upper GI bleeding compared to the general population, the conservative treatment applied has a very high rate of success in stopping the bleeding without the need for endoscopic or surgical haemostasis treatment.

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3. Abdominal Obesity and Type 2 Diabetes Mellitus are Associated With Higher Seric Levels of IL 4 in Adults

IOANA DANIELA BINISOR, RALUCA MOLDOVAN, I. MOLDOVAN, ANA MARINA ANDREI, MONICA ILEANA BANITA

Aims: Study of IL4 in relation to the anthropometric, biochemical and immunological parameters in patients with obesity and/or diabetes. Methods: The relationship between IL4 and clinical and biological parameters was studied in 76 patients divided into 4 groups: obese diabetics (OD), n = 25; obese without diabetes (O), n = 25; non obese diabetics (NOD), n = 11; controls (M), n = 15. IL4 was determined using the ELISA method. Statistical analysis was done using the MedCalc statistical software, version 16.1. Results: Serum IL4 was 0.38 ±0,40 pg / mL in the Control group, 0.366 (0,100-2,35) pg / ml in group O, 4.66±3.73 pg / ml in group OD, 0.30 (0.10-1.35) pg / ml in NOD. When IL4 levels were compared between the four groups, statistical significance was reached for the comparison between groups OD and M. Statistically significant correlations were detected between IL4 and age, waist circumference and hip circumference, blood glucose, glycated hemoglobin (HbA1c), VLDL, triglycerides and serum protein fraction β1. In univariate regression, the IL4 level predictors were age, height, BMI, abdominal circumference, hip circumference, beta 1% glucose, HbA1c, total lipids, total cholesterol, VLDL triglycerides, CRP. In multivariate regression, waist circumference and glycemia were significant predictors of levels of IL4 (p = 0.0001).

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4. Clinical, Histological and Prognosis Correlations in Diagnosis and Treatment of Gastric Cancer

ANDA CRISAN, F. BADULESCU, ADRIANA BADULESCU, CRISTIANA SIMIONESCU, I. ANDREI, RALUCA CIMPEANU

Purpose The study authors have proposed to highlight the mainepidemiologic and prognostic aspects of digestive malignancies in the Dolj county population, justifying the need for permanent and detailed estimate of this phenomenon. Methods The authors of the study have proposed to outline adescriptive epidemiological panel,characteristic for the population groups at risk of developing gastric cancers and establishing clinical factors (tumor location, disease stage, type of surgery) and histological factors (histopathological type, degree of tumor differentiation) with prognostic significance having as landmark, survival rate at 5 years or disease-free survival of 5 years. Results The study was conducted on a sample of 458 patients with gastric tumors endoscopically detected,histologically confirmedand treated between 2000-2010. The epidemiological study allowed us to outline the descriptive epidemiological panel characteristic for the group of patients at risk of developing gastric cancer. Analysis of correlation between clinical parameters and histopathological parameters reached statistical threshold in multivariate statistical analysis of the localization of tumor, disease stage and histological type (p <0.0001) and the degree of differentiation of gastric carcinomas (p <0.005). Multivariate statistical analysis has detected statistically significant differences in terms of survival rate at 5 years (p> 0.001) and free interval of disease at 5 years (p> 0.001), depending on the location of the tumor, correlated with other clinical factors (disease stage, type of surgery) and histological factors (histopathological type, tumor differentiation grade), which allowed us to outline clinical,histological and prognostic groups. Conclusions Defining the clinical,histological and prognostic groups, allows an accurate assessment of patient prognosis from the time of randomization and initiation of treatment, type of surgery in advanced locoregional, reconverted to oper

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5. Plant Growth Regulating Activity of Some N-Substituted Chloroacetylanilines

GABRIELA RAU, CATALINA PISOSCHI, O. CROITORU, DENISA CONSTANTINA AMZOIU, G.D. MOGOSANU, ELENA CAMELIA STANCIULESCU

Purpose. The synthesis and physico-chemical characterization of six N-substituted chloroacetylanilines and testing their plant growth regulating activity. Material/Methods. The synthesis of the six N-substituted chloroacetylanilines was accomplished by condensation of N-substituted anilines, in an acidic medium, with chloroacetylchloride. Purified compounds obtained were physico-chemical characterized by elemental analysis and spectral analysis. Five different concentrations (0.1%, 0.5%, 0.75%, 1% and 5%) of the compounds solubilized in chloroform were used to analzyed their effects on the germination and mainly on the radicular elongation of wheat caryopses, Triticum aestivum subsp. aestivum (Poaceae), Dropia variety. Results. The N-substituted chloroacetylanilines were solid, differently colored, with high melting temperatures and high yields. Their structure was confirmed both by elemental analysis and by the spectral methods (UV–Vis, FTIR, 1H–NMR, 13C–NMR, GC–MS). Conclusions. For the six analyzed compounds, at five different concentrations (0.1%, 0.5%, 0.75%, 1% and 5%), the experimental data obtained by the method of linear measurement, in the Triticum assay, showed the inhibition of mean radicular elongation compared with the reference

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6. Ultrasonography Role in Evaluation of Achilles Tendon Enthesis in Reactive Arthritis Patients

SIMONA COVEI-BANICIOIU, PAULINA LUCIA CIUREA, CRISTINA DORINA PARVANESCU, BEATRICE ANDREEA CHISALAU, ANDREEA BARBULESCU, MONICA CEPAREANU, SINETA FIRULESCU, A.F. VREJU

Reactive arthritis is an inflammatory joint disease which develops after 1-4 weeks following an enteral, genital or ORL infection, with a higher frequency in HLA-B27 positive patients. As a group feature, enthesitis is defined as inflammation in bone insertions of tendons, ligaments and muscular fascia. Aims: the main object of this study was to demonstrate the importance of musculoskeletal ultrasonography in Achilles tendon evaluation in patients with reactive arthritis. Patients and methods: we designed a transversal, retrospective study which included 15 patients diagnosed, based on ESSG criteria, with reactive arthritis (ReA), in Rheumatology Department, Emergency County Hospital. From those 15 patients, 9 were positive for a genital infection with Chlamydia trachomatis and 6 patients with enteral infection, 2 with Shigella, respectively 4 with Yersinia. Healthy control group included 15 patients, with no inflammatory joint diseases. After clinical examination, all patients and controls underwent ultrasound (US) evaluation for Achilles tendon changes, using an Esaote MyLab 25 machine, with a linear high frequency probe (10-18 MHz), using EULAR recommendations and OMERACT definitions for enthesitis, tendinitis and erosions. The cutoff value for the Achilles tendon thickness was 5.29mm, as described by Balint et al. Results: We examined 30 Achilles tendons in 15 patients, with a mean age of 35,2years±10,19 standard deviation (SD) and 30 tendons in 15 controls with a mean age of 35,8 years ±12,00 SD. In both groups sex prevalence showed more males than females (66,66% males in controls vs. 60,00% in patients group). We found a statistic significant higher ESR and CRP in patients group, compared to controls (24,86mm/h vs. 11,8mm/h; 18.90mg/dl vs. 6.22mg/dl). Most frequent finding in patients group was retrocalcaneal bursitis (56.66%), followed by tendon thickening (46.66%), compared to control group in which we found more frequently osteophytes (36.66%) and calcif

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7. Histopathological Study on Conservatively Operated Breast Carcinomas

T.S. TENEA-COJAN, CLAUDIA VALENTINA GEORGESCU, OANA-MARIA CORICI, B. VOINEA, DIANA MONICA GEORGESCU, C. VIDRIGHIN, D. ILIE, I. PAUN

In this histopathological study we looked at 303 cases of breast carcinomas, managed though conservative breast surgery and later analysed with the help of a classical histopathological technique, paraffin embedding. The carcinomas were assessed in terms of tumor size, lymph node status, histological type, correlation between invasive tumors and an situ carcinoma component, resection margins, grading and patients age. Following assessment, we looked at associations between above morphological and clinical parameters and ipsilateral local recurrences. We concluded that more than half of our cases were carcinomas, measuring between 2 cm and 5 cm, with no associated lymph node involvement, in keeping with pTNM criteria for stage II. By far, in our study, the most frequent histopathological type was type NOS (63.37%) followed by invasive lobular carcinoma (10.56%) and mixed ducto-lobular invasive carcinoma (6.27%). Other types of invasive carcinoma were rarer, each representing less than 4% of cases. In regards to in situ carcinomas we noted the most common histological types to be both cribriform intraductal carcinoma and comedocarcinoma, each identified in 1.65% of cases. Amongst invasive breast carcinomas, infiltrating ductal carcinoma not otherwise specified (NOS) was found to be most commonly associated with in situ ductal carcinoma lesions. This was seen in 34.9% of cases, and was the only type associated with an extensive in situ component. Analysing the grading of mammary carcinomas in our study showed that the vast majority of cases (63.04%) were grade 3 tumors. In regards to surgical resection margins, ¾ of cases were noted to have negative margins. Tumor recurrences were noted in 12 cases. These cases were most commonly noted to reoccur following initial poorly differentiated, infiltrating ductal carcinomas, not otherwise specified (NOS), with positive resection margins, measuring less than 2 cm. Patiens tended to be under the age of 40 and had positive lymp

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8. Incidence of Pulmonary and/or Systemic Thromboembolism in Pregnancy

R.C. PANA, LOREDANA MARIA PANA, O. ISTRATOAIE, LUIZA MARIA DUTA, LAVINIA MARIA GHEORMAN, VERONICA CALBOREAN, MIHAELA POPESCU, B. VOINEA, V.V. GHEORMAN

Pregnancy associate with thromboembolism is one of leading causes of maternal morbidity and mortality. Worldwide the incidence of pregnancy related venous thromboembolism is approximately 1 in 1500 deliveries. The arterial thromboembolism risk is increased from 3 to 4 fold and the risk of venous thromboembolism is five times higher in a pregnant that in a non-pregnant woman. With an appropriate prophylaxis and therapy, prevention of death from systemic thromboembolism in pregnancy necessitates a high index of clinical suspicion succeeded by a timely and accurate diagnostic approach. In pregnancy the clinical diagnosis of systemic thromboembolism is notoriously difficult due to the overlap of signs and symptoms between the pulmonary embolus with or without deep venous thrombosis. We performed a retrospective study of 86 pregnant women with Pulmonary thromboembolism (PTE) and Deep venous thrombosis (DVT) diagnosed between 2009-2015 in Obstetrics-Gynecology Clinic 1 at Emergency County Hospital of Craiova. Our study evaluated these cases considering frequency, maternal and fetus risk associated with thromboembolism. In 6 years we had 35 women diagnosed as PTE, 8 women diagnosed as DVT and PTE, and 43 patients diagnosed as DVT. The underlying disease in our study was hypertension and the most frequent symptoms reported were dyspnea and limb swelling.(100%).During the third trimester of pregnancy the incidence of PTE was 45% and DVT 57%. 12 cases of DVT were related to thrombophilia. Also we found 25 % of PTE that occurred after cesarean and 8 % of PTE after vaginal delivery. We notice that vaginal delivery is safer than cesarean surgery. Also the importance of third trimester of pregnancy and postpartum it is evident.

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9. Edwards Intuity Aortic Bioprosthesis in Patient with Bicuspid Aortic Valve

OANA MARIA CORICI, M. GASPAR, G. LAUFER, MARIA IANCAU

Bicuspid aortic valve (BAV) is generally considered to be a contraindication to sutureless aortic valve replacement (AVR). Implantation of the Edwards Intuity aortic bioprosthesis is an innovative approach associated with superior hemodynamic performance, significantly reduced myocardial ischaemia and cardiopulmonary bypass times and proves to be suitable for type 1 and 2 of bicuspid aortic valves replacement. We report a case of successful AVR using a fast deployment bioprosthesis,the Edwards Intuity Valve System, in a 67-year-old woman with a bicuspid aortic valve and concomitant severe aortic stenosis.

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10. Fatal Evolution in the Pneumonia Caused by Diesel Fuel Aspiration - Case Report

ILEANA OCTAVIA PETRESCU, CARMEN SIMONA COSOVEANU, ADRIANA POPA, LILIANA STANCA, F. PETRESCU, RODICA DIANA TUDORASCU, M.V. BOLDEANU, MARIA FORTOFOIU

Aspiration pneumonia in infants emerges as a result of deglutition disorders, congenital malformations and severe gastroesophageal reflux. Hydrocarbon pneumonitis is caused by the accidental ingestion and aspiration of hydrocarbons into the body. In children, it can be seen as a result of both the lack of monitoring and the tendency for the exploration of the environment. The accidental ingestion of a large quantity is quite rare due to the bad taste of hydrocarbons. Initially, the central nervous system is the one affected, followed by the respiratory system, causing the chemical pneumonia (through direct injury of the lung). Furthermore, we shall present the case of an 18 month infant with severe trauma as a result of the accidental ingestion of diesel, followed by vomiting and who was brought late to the hospital. The pneumothorax that emerged as a complication was remitted after the treatment, but the initially chemical and then mixed pneumonia through bacterial overinfection led to the infant’s death after 12 days of medical attention in the Anesthesia and Intensive Care Unit. The histopathological examination of the analyzed lung fragments did not point out any lipid or foam cells that are characteristic to this type of pathology, but which are not mentioned by the majority of toxicology textbooks and those of pathological anatomy, through the low rate of mortality and numerous factors that can lead to negative false results

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11. The Role of MSCT in Superior Mesenteric Artery Syndrome (SMAS)

SERBEZE KABASHI-MUQAJ, VESA KOTORI, LUANA CORINA LASCU, SIMONA BONDARI, ILIR AHMETGJEKAJ

Superior mesenteric artery syndrome (SMAS) is a rare condition caused by compression of the third part of the duodenum between the superior mesenteric artery (SMA) and the aorta, causing symptoms of duodenal outflow obstruction. We report a case of superior mesenteric artery syndrome in a 48-year-old female associated with severe dehydration and vomiting resulting from duodenal compression that necessitated surgical treatment, undiagnosed for 14 years. The diagnosis was performed with MSCT. Diagnostic evaluation revealed compression of the third portion of the duodenum by the SMA with resultant proximal dilatation. The patient successfully had duodeno-jejunal anastomosis.

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