[Contributions to the assessment of hemodynamic status in metabolic syndrome]. / Contributii la evaluarea statusului hemodinamic în sindromul metabolic.

UNLABELLED: The concept of normohemodynamics is based on the fact that the main function of the cardiovascular system is the transport of oxygen. The cardiovascular system is adapting to a new hemodynamic status with every heartbeat. Only one class, called the normohemodynamic state, containing a simultaneous normotension and normodynamic flow, can serve as therapeutic goal. Metabolic syndrome includes a constellation of clinical and biological features that confer an increased cardiovascular risk. Clutter hemodynamic modulators in metabolic syndrome and assessment of hemodynamic status both overall and by its components, open new perspectives in the management of patients with hypertension and metabolic syndrome. MATERIAL AND METHODS: In the current study were included 32 patients meeting the criteria for metabolic syndrome and hypertension and 32 controls. Patients were monitored and assessed for the global hemodynamic status and for the modulators of hemodynamics, intravascular volume, vasoactivity and inotropy, respectively. RESULTS AND CONCLUSIONS: There are no significant differences in the global hemodynamic status between the study group and the control group; in the study group there is a clear weathering of hemodynamic modulators. The improvement of these factors opens a new perspective in the global cardiovascular assessment and therapeutic directions.

[Study of several factors influencing antioxidant enzyme defense in obese patients]. / Studiul unor factori ce pot influenta defensiva enzimatica antioxidanta la pacientii obezi.

UNLABELLED: The notion of "oxidative stress" was introduced by Sies, in 1985, and designates all the oxidative damages caused by the free radicals of oxygen. Oxidative stress represents the imbalance of pro-oxidant and antioxidant ratio, in favor of the former, following the excessive action of the "aggressor" and/or the decrease of the "defender's" capacity to oppose. MATERIAL AND METHOD: In the current study we had 82 overweight patients (42 patients less than 65 years old and 40 patients over 65). The criteria for inclusion was weight over 80 Kg and BMI > 30. Patients were monitored and assessed every three, six, nine months and each year. RESULTS: Obesity together with dyslipidemia, smoking, diabetes and high blood pressure intensifies oxidative stress. The improvement of these factors determines the growth of antioxidant enzyme level (SOD and GPX) and the reduction of malondialdehyde level.

[Prevalence of metabolic syndrome in a population of transport workers--prospective study]. / Prevalenta sindromului metabolic într-o populatie de lucratori în transporturi--studiu prospectiv.

UNLABELLED: The metabolic syndrome is a problem which regards public health this phenomenon being explined by the world -wide obesity epidemy.The metabolic syndromes prevalence varies with the studied populations.The unhealthy lifestyle which is defined by peoples sedentary character and unhealthy diets is being significantlly asociated with the metabolic syndromes prevalence growth. MATERIAL AND METHODS: The study was performed on 836 individuals with ages between 25 and 65 years, who have a questionnare based interview.Their blood pressure was measured, some anthropometric measures were taken and several laboratory test were made. The diagnosis of metabolic syndrome was established according to the consensual deffinition that was published in October 2009. RESULTS AND CONCLUSIONS: The metabolic syndrome is a compilation of clinical and biological elements which cause the individ to have a higher cardiovascular risk. The metabolic syndrome increased prevalance in the study is significantlly asociated with the growth of the obesitys and hypertensions prevalance. The lifestyle of the individuals from the study is based on unhealthy diets and sedentarism.

[The effects of ethanol on the evolution of the acute benzodiazepine poisoning]. / Efectele etanolului asupra evolutiei intoxicatiilor acute cu benzodiazepine.

UNLABELLED: The depressing effects on the nervous central system (NCS) induced by benzodiazepines and ethanol are similar. The complications are rare in the benzodiazepine poisoning, but are a lot more frequent in association with other depressing drugs for the NCS (especially alcohol). MATERIAL AND METHODS: We analyzed retrospectively patients with benzodiazepine poisoning admitted in the Internal Medicine Clinic - Toxicology during 2003 - 2009.The study attempted a complex evaluation of the consequences of acute and chronic alcoholism on the evolution of acute benzodiazepinepoisoning and the description of the clinic evolution and paraclinical particularities of the patients under investigation. RESULTS: 343 patients with benzodiazepine poisoning were admitted, 150 were tested through measurement of alcohol level, leading to values between 1 - 415 mg/dl. Chronic alcoholism in personal pathological antecedents of the patients determined a relative risk of intoxication 1.46 times higher. The hospitalization period varied from 1 to 8 days for patients with chronic alcoholism and from 1 to 14 days for patients with acute alcoholism, a statistically important difference. CONCLUSIONS: During the period under investigation, from the total of patients admitted for acute benzodiazepine poisoning, 2 deaths were registered. Of the two deaths, one patient showed ethanol coingestion.

[Sudden death in organophosphoric poisoning--an unaccountable pathophysiologic mechanism?]. / Moartea subita din intoxicatia cu organofosforice. Un mecanism fiziopatologic neexplicabil?

UNLABELLED: Sudden death related in literature to appear in IV-th - VIII-th day from organophosphoric intoxication does not have an unanimous accepted physiopathologic explanation. PURPOSE: Pharmacodynamic study of myocardial trichlorfon level in acute experiment. MATERIAL AND METHOD: Gas chromatographic determination of myocardial trichlorfon quantity in an experiment on white, male Wistar rats, daily sacrificed for the heart, until the tenth day from an digestive administration of a dose of 200mg/kg trichlorfon. RESULTS (mcg/g myocardial tissue): I day = 8, II day = 13.63, III day = 15, IV day = 18.96, V day = 19.6, VI day = 20.83, VII day = 21.21, VIII day = 21.33, IX day = 19.69, X day = 19.41. CONCLUSIONS: An organophosphoric direct toxic mechanism is suggested, through accumulation over time of a certain level of myocardial concentration.

[Role of calcium and magnesium ions in cerebrospinal fluid in alcoholic-traumatic coma]. / Rolul determinarii ionilor de calciu si magneziu în LCR în coma etilico-traumatica.

The goal of investigation was to determine the role of calcium and magnesium ions in the cerebrospinal fluid in ethylic-traumatic coma. We measured the level of calcium in the cerebrospinal fluid within simple photometric test and the magnesium level within xylidyl blue photometric test. We found a high mortality in patients with high level of calcium in cerebrospinal fluid and low level of magnesium in cerebrospinal fluid. At patients with ethylic-traumatic coma high levels of calcium in cerebrospinal fluid are caused by the excitatory amino acids cascade and increased of hematoencephalic barrier permeability. Decreased levels of magnesium in cerebrospinal fluid are associated with convulsions and a poor prognosis of the patients. These analyses are very important for establishment of prognosis in patients with ethylic-traumatic coma.

[Recent data about the LDL-atherogenesis relationship]. / Date recente asupra relatiei LDL-aterogeneza.

The steps în pathophysiology of ATS make easier the understanding of waves of processes that lead to the disfunction of the endothelial cells, hypertrophy of the arterial wall and în the end to the complication which drawn from this process. Atherogenic process which is characterised by proaterofenethic and atherogenetic mechanism imbalance suppose three phases: early, transition and terminal phase. The initial phase involve the focal influx and LDL-cholesterol accumulation în the arterial intima, the ROS (reactive oxygen species) and azot generation by smooth muscular cells, macrophages and endothelial cells and oxidative modification of LDL. Scientific data revealed that LDL oxidation is mediated by peroxinitrite (ONOO) anion which could act directly over the thiol groups or indirectly through OH and NO radicals from peroxinitrous acid breakdown and who initiate the polyunsaturated fatty acids peroxidation and the oxidation of apolipoprotein B-100. LDL completely oxidated are recognised by scavenger receptors which are not regulated by up and down regulation. The last event of the early atherogenic process is the formation of foam cells from macrophages through LDL modified captation by scavenger receptors.

[Apolipoproteins-a cardiovascular risk factor within the context of syndrome X]. / Apolipoproteinele--factor de risc cardiovascular în contextul sindromului X.

Apolipoprotein is now a new biochemical marker for evolution of atherosclerosis, even better than lipid fraction. We studied seric apolipoprotein A and B (Apo A, B) on 50 cases with complicated obesity, with ages between 37-52 years, and 15 males and 35 females. Selection criteria were: android constitution, obesity, essential hypertension (EHT). We also made statistical correlations on IBM PC compatible computer using chi-square test. We correlated glycoregulation abnormalities with body mass index (BMI > 25) with meaningfully value (p < 0.005) or with complicated EHT less meaningfully (p < 0.2). On this background, we appreciated the predictive value of seric levels of Apo A, B and Apo B/A ratio > 1. EHT correlates with low levels of seric Apo A very meaningfully (p < 0.0001) and this association is higher correlated when added ICD (P < 0.00001). There is no significant relationship between high levels of seric Apo B and EHT in our study, but it is significant for Apo B/A > 1 (p < 0.0001). EHT with seric cholesterol are not correlated (p:NS). Our conclusion is that seric Apo A and Apo B/A are statistical predictive risk factors for complicated EHT on android obese persons (X syndrome).

[The evaluation of a method for determining apolipoproteins as a sensitive indicator in assessing lipid metabolic disorder in a population at risk for essential arterial hypertension (EAHT)]. / Validarea metodei de dozare a apoliproproteinelor ca indicator sensibil de apreciere a dismetabolismului lipidic la populatia cu risc pentru hipertensiunea arteriala esentiala (HTAE).

The increased efficiency of epidemiological screening tests in determining the prevalence of risk factors carriers required the use of highly sensitive markers able at detecting early, in reversible stages, the disturbances in the lipid metabolism genetically induced or acquired during lifetime, known as major risk factors for essential hypertension and other cardiovascular diseases. The authors report the preliminary results of some investigations on the predictive value of apolipoproteins. Immunokits manufactured by BioMérieux--France were used. In 50 admitted patients with essential hypertension and family history of risk, high levels of apoA1 and apoB were recorded although cholesterol and other biological markers were within the normal. At the same time, in our case the apoB/apoA ratio was supraunitary, fact proving the validity of the method.

[Epidemiological observations on the significance of the relations between elevated values of essential arterial pressure in schoolchildren and their parents]. / Observatii epidemiologice asupra semnificatiei unor relatii între cresterea valorilor tensiunii arteriale esentiale la elevi si parintii acestora.

The results of an epidemiological screening of 1,228 parents and 614 children, pupils in the V-XII forms of 12 schools of different types, are presented. It is suggested that when parents present elevated blood pressure values their children, although normotensive, are at high risk, especially in case more risk factors are present. The relation hypertensive parents--hypertensive offsprings was strongly significant. In the hypertensive children with normotensive parents the high frequency of some life-style dependent risk factors is discussed. The relationship between risk factors and morbidity by essential hypertension both in parents and their offsprings and the need of primary and secondary prevention programs for pupils are underlined.

[Essential arterial hypertension in patients with non-insulin-dependent diabetes mellitus during and after balneotherapy followed-up for 6 years]. / Hipertensiunea arteriala esentiala (HTAE) la bolnavi cu diabet zaharat noninsulinodependent urmariti în perioadele de cura balneara si post-cura, de-a lungul a 6 ani.

The statistical correlations between body weight, glycemia, total lipids, cholesterol in 200 patients with essential hypertension, especially borderline essential hypertension, followed up for 6 years indicate that the complex environmental factors in Slanic-Moldova Health Resort associated with balneotherapy may induce a return to normal values of the above mentioned parameters. Good results were also obtained in the patients with essential hypertension and non-insulin dependent diabetes mellitus, their treatment including reduction diets (1200-1400 calories/day).

[Bronchial asthma in old people]. / Astmul bronsic la batrîni.

Bronchial asthma in old people is defined, according to a number of Anglo-Saxon authors, as a disease which occurs for the first time (de novo) at an advanced age (i.e. over 70 years). The present follow-up study had been carried out in the Diagnostic Division of the Outpatient Department--Polyclinic no. 1 of Iasi--and has in view only the patients who had the first attack of disease at the time they were over 60. Clinical examination was complemented by the following tests: spirography, X-ray, allergological cutaneous tests, and test for the identification of eosinophils in sputum. A certain pattern was identified: the first asthmatic symptoms followed rhinobronchial episodes persistent spasmodic cough and continuous dyspnea induced by effort were frequent complaints; typical crises were uncommon. The allergic aetiology was supported by a positive anamnesis, while the cutaneous tests confirmed the presence of an allergen in only 20% of the cases; chronic and recurrent infections were present in 85% of the cases. At the same time, the presence of gastroesophageal reflux was searched as its frequency in the elderly as well as its role in inducing the bronchial asthma have often been reported. It is expected the identification of the characteristic pattern might lead to a correct diagnosis of bronchial asthma in old people and contribute to better therapy.

[Epidemiology of essential arterial hypertension in collectives of schoolchildren. The prevalence of blood pressure changes]. / Unele aspecte din epidemiologia hipertensiunii arteriale esentiale în colectivitati scolare. Prevalenta modificarilor tensiunii arteriale.

7,917 pupils in schools, between 10-19 years old, of both sexes, were investigated within an epidemiologic screening, performed in the school milieu, for detecting the prevalence of some risk factors (RF) and of the AT modifications with a view to work out the programmes for the essential arterial hypertension (EAHT) primary prevention. 84.4% of all the pupils in the Vth--VIIIth forms and 93.9 pupils in the IXth--XIIth forms were included in the screening. 422 cases of labile arterial hypertension (LAHT) (5.1%) and 457 of benign arterial hypertension (BATH) (54%) were found. In the children with normal arterial hypertension (NAHT) the following were recorded: 46.5% increases only of the diastolic tension: 44.0% of the systolic-diastolic and 7.1% of the systolic tension respectively. Although present, the differences between the LAHT and BAHT prevalence in the gymnasiums (4.3% and 5.4%) and lyceums (5.5% and 6.4%) are not significant and might be functions of: age, sex, psychomotor development, structure of the respective collectivities, the momentary psychoemotional reactions, lability of the blood pressure, specific to the childhood, several screening difficulties etc. The observations made on the prevalence of the growth of the AT values were correlated with the occurrence at some significant levels of the RF, suggesting the measures to be taken for the steady improvement of the primary and secondary prophylaxis of EAHT in schools.

[Intervention associated with risk factors for essential arterial hypertension. II. Epidemiologic observations of schoolchildren]. / Interventia asociativa a unor factori de risc pentru hipertensiunea arteriala esentiala. II. Observatii epidemiologice la scolari.

Based on an epidemiological screening of 6411 pupils from 7 schools of different types, the frequency and intensity of the association of 8 risk factors for essential hypertension in a series with increased blood pressure values and in a normotensive one was compared. The frequency of the various studied risk factors was significant especially in the pupils with increased blood pressure values. The average number of risk factors in the two series was unsignificant. The intensity of 2, 3 or 4 risk factors different associations was more marked in the pupils with increased blood pressure values than in the controls. Some risk factors proved to be more frequently involved in multifactorial associations. The importance of such studies for the elaboration of prevention programmes in underlined.

[Interventions associated with some risk factors for essential arterial hypertension. I. Epidemiologic observations in adults]. / Interventia asociativa a unor factori de risc pentru hipertensiunea arteriala esentiala. I. Observatii epidemiologice la adulti.

The results of an epidemiological screening followed by the investigation of 9 risk factors for essential hypertension in 1218 individuals with increased values of blood pressure are presented. Stress, overweight and dietary preferences for fats and eggs had the incidence especially in, the age groups over 40 years. Both the individuals with borderline hypertension or arterial hypertension and the controls presented 2, 3 or more associated risk factors of variable intensity, the higher values being recorded in the greater than or equal to 40 years age group. When more than 3 risk factors were associated, the increases in systolic and diastolic pressures were significant. The investigation of 7 biochemical constants revealed that 50% of 190 cases with arterial hypertension presented cholesterol levels higher than 220 mg%. Increased total lipids, free fatty acids and triglycerides levels were also recorded. The results plead for multifactorial prevention programmes.