[Arrhythmogenic effects of alcohol]. / Efecte aritmogene ale etanolului.

UNLABELLED: Acute or chronic excessive consumption of alcohol can cause cardiac arrhythmias, particularly supraventricular tachyarrhythmias. Experimental and clinical data show that chronic excessive alcohol ingestion has a destructive role on cardiac tissue, which significantly deteriorates the rhythm and contractile activity, manifested by the appearance of cardiac arrythmias and dilated cardiomyopathy. AIM: The aim of this study was to evaluate and analyze the ECG changes and disturbances of cardiac rhythm and conduction in patients after an acute or chronic excessive consumption of alcohol. MATERIAL AND METHODS: The study included 187 patients (184 males and 3 females). Each patient followed biochemical and hematological analysis as well as paraclinical investigation measurements. RESULTS: The most common types of arrhythmia were permanent atrial fibrillation (61%). Paroxysmal atrial fibrillation and supraventricular extrasystoles were found in patients without significant echocardiographic deteriorations. These arrhythmias appeared after an excessive alcohol drinking and paroxysmal atrial fibrillation was converted to normal sinus rhythm after a short period of abstinence or after pharmacologic therapy. Ventricular arrhythmias (ventricular extrasystoles, non-sustained ventricular tachycardia-4.7%, torsada de point-1.5%) were less frequent. Conduction disturbance (left bundle branch-LBBB 6.3%, right bundle branch-RBBB 10%) were found in patients who had a history of consuming >150 g/day of alcohol for >10 years, with dilated heart chambers and systolic ventricular function much more deteriorated (symptomatic stage of heart failure). CONCLUSION: Excessive alcohol consumption may lead to cardiac arrhythmias in patients with existing heart disease as well as in healthy individuals.

[Arrhythmias of exertion]. / Tulburari de ritm la efort.

The exercise testing performed in 1,220 patients in the interval 1976-1988 made possible the analysis of the incidence of rhythm disturbances, their severity and prognostic implications and of their risk in relation with the preexisting cardiac status.

[Chaperone proteins--essential proteins for cellular activity]. / Proteinele chaperone--proteine esentiale pentru activitatea celulei.

Molecular chaperones are an ubiquitous, abundant and highly conserved group of proteins which bind and stabilize proteins at intermediate stages of folding, assembly, translocation across membranes and degradation. They first came to attention because of their specific induction during the cellular response of all organisms to heat shock, but are now known to be constitutively and abundantly expressed in the absence of any stress. Despite the obvious importance of stress responses, only recently has scrutiny focused on the role of heat shock proteins in the control of disease pathology. Knowledge about Hsp functions in bacteria is much further advanced than in eukaryotes, but already some hints of Hsp involvement in mammalian diseases have emerged.

[The heart: bystander or participant in neoplasms? The Hedinger syndrome (carcinoid cardiopathy)]. / Cordul: spectator sau participant în neoplazii? Sindromul Hedinger (cardiopatia carcinoida).

A case of a 38-years-old patient with carcinoid syndrome (paroxysmal skin flush, diarrhoea, abdominal pain) is documented although the search of the primary tumor was not able to localise it (possibly an intestinal one). Confirmatory diagnosis had a biochemical support in 262 mg/24 h urinary elimination of 5 HIAA (metabolic of serotonine). Particular aspects of the case are illustrated through intravitam documentation of the liver metastases (via portal vein) and the damage of the right heart (Hedinger syndrome) resulting from the involvement of the tricuspid valve apparatus (with clinical, phonomechanographic and echocardiographic abnormalities). The fatal evolution of the patient was due to uncontrolled aggravation of the portal high blood pressure syndrome (refractory ascites to diuretic treatment). It was impossible to us to obtain the morphopathological data. The specific elements of the carcinoid syndrome (including a convincing indirect illustration) with right cardiac involvement (known as Hedinger syndrome) are discussed, as well as the hypothetical place in pancreas of the primary carcinoid tumor.

[The heart: a spectator or participant in neoplasms? Neoplastic subacute cor pulmonale]. / Cordul: spectator sau participant în neoplazii? Cordul pulmonar subacut neoplazic.

Neoplastic subacute cor pulmonale is a distinct clinical syndrome that is often not too easily diagnosed. Such rapid development of cor pulmonale is observed in a patient with lymphangitis carcinomatosa of the lung consecutive to a cancer of the stomach with splenic, pancreatic and lymph nodes invasion. Diagnosis was established on transition of the normal ECG to a typical pattern of cor pulmonale and was revealed by chest roentgenographic examination (interstitial syndrome finding) and fatal evolution of severe respiratory failure. Necroptic and pathological studies confirmed histologic lung involvement by tumoral emboli and lymphangitic carcinoma the tosis and documented neoplasm in the stomach.

[Corticotherapy in aggressive chronic hepatitis (ACH)]. / Corticoterapia in hepatita cronica agresiva.

48 patients with the diagnosis of ACH, admitted in the interval 1972-1981 and subjuected to corticotherapy were investigated by hepatic puncture biopsy with Vim-Silverman needls. The dose of prednison was of 15-20 mg daily for 2-4 years, with a mean 20 months. Corticotherapy was efficient in 73% of the cases, stabilization of the clinical and hepatic functional pictures being obtained. In 17% of the cases the hepatic process persited unmodified and in 10% ACH evolved towards cirrhosis.