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1.
J Inflamm Res ; 16: 2783-2800, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37435114

RESUMO

The Coronavirus Disease 2019 (COVID-19) pandemic was declared in early 2020 after several unexplained pneumonia cases were first reported in Wuhan, China, and subsequently in other parts of the world. Commonly, the disease comprises several clinical features, including high temperature, dry cough, shortness of breath, and hypoxia, associated with findings of interstitial pneumonia on chest X-ray and computer tomography. Nevertheless, severe forms of acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) are not limited to the respiratory tract but also may be extended to other systems, including the cardiovascular system. The bi-directional relationship between atherosclerosis and COVID-19 is accompanied by poor prognosis. The immune response hyperactivation due to SARS-CoV-2 infection causes an increased secretion of cytokines, endothelial dysfunction, and arterial stiffness, which promotes the development of atherosclerosis. Also, due to the COVID-19 pandemic, access to healthcare amenities was reduced, resulting in increased morbidity and mortality in patients at risk. Furthermore, as lockdown measures were largely adopted worldwide, the sedentary lifestyle and the increased consumption of processed nutrients or unhealthy food increased, and in the consequence, we might observe even 70% of overweight and obese population. Altogether, with the relatively low ratio of vaccinated people in many countries, and important health debt appeared, which is now and will be for next decade a large healthcare challenge. However, the experience gained in the COVID-19 pandemic and the new methods of patients' approaching have helped the medical system to overcome this crisis and will hopefully help in the case of new possible epidemics.

2.
J Pers Med ; 13(6)2023 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-37373976

RESUMO

Despite being one of the most debilitating conditions encountered in the field of toxicology, there is a lack of neutralization measures for the toxins involved in acute corrosive poisoning, and this promotes progressive contact injury of deep tissues after poisoning has occurred. Multiple controversies still surround management strategies during the acute phase of poisoning and the long-term follow-up of the patient. Here, we report a severe case of intentional poisoning with nitric acid complicated by extensive injury of the upper digestive tract, multiple stricture formation, and complete dysphagia. Serial endoscopic dilation and insertion of a jejunostomy feeding tube were necessary, and underlying psychiatric illness negatively affected the outcome of the patient. We conclude that an interdisciplinary approach is necessary to properly reduce the extent of lesions and sequelae induced by corrosion. Early endoscopic mapping of injuries is of major importance to better predict the evolution and possible complications of poisoning. Interventional and reconstructive surgical procedures may significantly improve the life expectancy and quality of life of patients following intoxication with corrosive substances.

3.
Children (Basel) ; 10(3)2023 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-36980088

RESUMO

The aim of this paper is to describe the temporal progression and clinical picture of a 2-year-old child with infantile Refsum disease, as well as the diagnostic procedures performed; this case presented multiple hematologic, metabolic, and developmental complications and progressive disabilities. Genetic testing revealed a mutation of the PEX6 (Peroxisomal Biogenesis Factor 6) gene, and the metabolic profile was consistent with the diagnosis. Particularly, the child also presented altered coagulation factors and developed a spontaneous brain hemorrhage. The clinical picture includes several neurological, ophthalmological, digestive, cutaneous, and endocrine disorders as a result of the very long chain fatty acid accumulation as well as secondary oxidative anomalies. The study of metabolic disorders occurring because of genetic mutations is a subject of core importance in the pathology of children today. The PEX mutations, difficult to identify antepartum, are linked to an array of cell anomalies with severe consequences on the patient's status, afflicting multiple organs and systems. This is the reason for which our case history may be relevant, including a vast number of symptoms, as well as modified biological parameters.

4.
Medicina (Kaunas) ; 59(2)2023 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-36837480

RESUMO

Magnesium is the fourth most common mineral in the human body and the second richest intracellular cation. This element is necessary for many physiological reactions, especially in the cardiovascular and respiratory systems. COVID-19 is an infectious disease caused by SARS-CoV-2. The majority of people who become ill as a result of COVID-19 have mild-to-moderate symptoms and recover without specific treatment. Moreover, there are people who develop severe forms of COVID-19, which require highly specialized medical assistance. Magnesium deficiency may play a role in the pathophysiology of infection with SARS-CoV-2. The primary manifestation of COVID-19 remains respiratory, but the virus can spread to other organs and tissues, complicating the clinical picture and culminating in multiorgan failure. The key mechanisms involved in the disease include direct viral cytotoxicity, endothelial dysfunction, and exaggerated release of inflammatory cytokines. The aim of this review was to summarize the available data regarding the role of magnesium in COVID-19 patients and its particularities in different clinical settings.


Assuntos
COVID-19 , Humanos , SARS-CoV-2 , Magnésio , Pulmão
5.
J Pers Med ; 13(2)2023 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-36836534

RESUMO

Infective endocarditis is a severe infective heart disease, commonly involving native or prosthetic valves. It frequently presents with univalvular involvement and simultaneous double valve or multivalvular involvement is rarely described. The third leading cause of infective endocarditis worldwide is Enterococcus faecalis, which is associated with high mortality rates despite important advances in antimicrobial therapy. It develops secondary to enterococcal bacteremia, with its origin from the gastrointestinal or genitourinary tract and predominantly affecting the elderly population with multiple comorbidities. Clinical presentation is usually less typical, and the treatment is challenging. It can be marked by antibiotic resistance, side effects, and subsequent complications. Surgical treatment can be considered if deemed appropriate. To the best of our knowledge, we present the first case-based narrative review of Enterococcus faecalis double valve endocarditis involving both the aortic native and prosthetic mitral valve, highlighting the clinical characteristics, treatment, and complications of this condition.

6.
J Pers Med ; 13(1)2023 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-36675801

RESUMO

Hyponatremia is commonly encountered in the setting of heart failure, especially in decompensated, fluid-overloaded patients. The pathophysiology of hyponatremia in patients with heart failure is complex, including numerous mechanisms: increased activity of the sympathetic nervous system and the renin-angiotensin-aldosterone system, high levels of arginine vasopressin and diuretic use. Symptoms are usually mild but hyponatremic encephalopathy can occur if there is an acute decrease in serum sodium levels. It is crucial to differentiate between dilutional hyponatremia, where free water excretion should be promoted, and depletional hyponatremia, where administration of saline is needed. An inappropriate correction of hyponatremia may lead to osmotic demyelination syndrome which can cause severe neurological symptoms. Treatment options for hyponatremia in heart failure, such as water restriction or the use of hypertonic saline with loop diuretics, have limited efficacy. The aim of this review is to summarize the principal mechanisms involved in the occurrence of hyponatremia, to present the main guidelines for the treatment of hyponatremia, and to collect and analyze data from studies which target new treatment options, such as vaptans.

7.
J Pers Med ; 12(12)2022 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-36556258

RESUMO

Background: The ongoing COVID-19 pandemic has put a constant strain on hospital resources, so there is a dire need for investigation methods that are widely available and that can predict mortality and the need for critical care. Hematological indices, which can be easily calculated from a complete blood count (CBC), are useful in determining a patient's inflammatory response to infectious diseases. Aim: This was a prospective cohort study that aimed to assess the prognostic value of scores based on CBCs in hospitalized patients with mild or moderate COVID-19 and medical comorbidities regarding the need for intensive care unit (ICU) therapy and short-term mortality. Methods: We included 607 patients with confirmed COVID-19, followed up for the need for ICU admission (15.5%) and 30 day mortality post-discharge (21.7%). CBC-derived scores were tested upon emergency department (ED) admission and after a median of 8 days. Results: In a multivariate model, elevated followed-up neutrophil-to-lymphocyte ratio (NLR) predicted increased odds for ICU admission (OR: 1.14 [95%CI: 1.06−1.22], p < 0.001) and short-term mortality (OR: 1.30 [95%CI: 1.09−1.57], p = 0.005). Monocyte-to-lymphocyte ratio (MLR) predicted 2.5-fold increased odds for ICU admission and 2.2-fold increased odds for mortality. Conclusion: NLR and MLR followed up 8 days post-admission are predictive for adverse outcomes in mild or moderate COVID-19 patients.

8.
J Pers Med ; 12(12)2022 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-36556289

RESUMO

Serotonin syndrome (SS) is a clinical toxidrome with high variability in clinical practice. It develops due to increased serotonin levels in the central nervous system. With an underestimated frequency, SS can develop following an overdose, a therapeutic dose increase, or drug to drug interaction of at least one serotonergic agent. It can present with autonomic signs, neuromuscular changes and an altered mental status. However, history and clinical examination are key features to formulate the diagnosis. Treatment options consist of supportive measures, discontinuation of the offending agent and certain therapeutic agents previously reported to improve outcomes. Physicians have limited experience with SS, partially due to the lack of its identification in clinical practice. Therefore, we have integrated, in a narrative review, the case of a young male with SS following an atypical antipsychotic overdose superimposed on chronic treatment with agents previously known to produce SS.

9.
Diagnostics (Basel) ; 12(6)2022 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-35741183

RESUMO

BACKGROUND: Biomarkers were correlated with mortality in critically ill COVID-19 patients. No prediction tools exist for noncritically ill COVID-19 patients. We aimed to compare the independent prognostic value of inflammation and cardiac biomarkers for post-acute COVID-19 patients and the 30-day mortality rate in noncritically ill COVID-19 patients, as well as the relation with the virus variant involved. METHODS: This observational cohort study was conducted at an emergency clinical hospital between 1 October 2020 and 31 December 2021. We included consecutive patients with biomarkers determined within 24 h of presentation, followed up at least 30 days postdischarge. RESULTS: Post-acute COVID-19 was diagnosed in 20.3% of the cases and the all-cause 30-day mortality rate was 35.1% among 978 patients infected with variants of concern. Neutrophil-to-lymphocyte ratio (1.06 [95%CI, 1.01-1.11], p = 0.015) and NT-pro BNP were correlated with 30-daymortality, while the monocyte-to-lymphocyte ratio (2.77 [95%CI, 1.10-6.94], p = 0.03) and NT-pro BNP (1.68 [95%CI, 1.00-2.84], p = 0.05) were correlated with post-acute COVID-19. High-sensitivity to troponin was associated with 30-day mortality (1.55 [95%CI, 1.00-2.42], p = 0.05). A Cox proportional-hazards model confirmed that NT-pro BNP was independently associated with mortality. NT-pro BNP remained independently associated with 30-day mortality during follow-up (1.29 [95%CI, 1.07-1.56], p = 0.007) after adjustment for confounders. CONCLUSION: Inflammation and cardiac biomarkers, determined upon admission and predischarge, in a cohort of hospitalized noncritically ill COVID-19 patients throughout successive pandemic waves, showed a predictive value for post-acute COVID-19 and 30-day mortality.

10.
Exp Ther Med ; 23(3): 189, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35126692

RESUMO

Chronic pruritus is a major and distressing symptom of many diseases of dermatological, neurological, psychogenic or systemic origin. This chronic itch could be a presenting sign of malignancy; therefore, paraneoplastic pruritus has also been associated with neuroendocrine tumors (NETs). This article focuses on a patient presenting with chronic pruritus for the past 12 months and who received numerous treatment schemes with very poor clinical improvement, that presented in the hospital for worsening of the chronic pruritus associated with skin rash and significant weight loss (approximately 6 kg over a 2-month period). The laboratory tests showed iron deficiency anemia, eosinophilia and negative tumor markers. In order to investigate the hypoanabolic and anemic syndromes, upper gastrointestinal endoscopy and colonoscopy, which showed no lesions or tumors, were employed. Skin biopsy was performed and antihistaminic and local steroid treatment was initiated. The patient's status worsened within a week and the patient was started on systemic steroid treatment with poor results. Computer tomography was performed to identify any tumor(s) located either in the pelvis or abdomen. A lesion was found in the terminal ileum, identified as a hypervascularized associating bulky lymphadenopathy. The patient was transferred to the surgical ward where right hemicolectomy with manual ileotransverse anastomosis L-L was performed. The histopathological result confirmed NET G2. The patient clinically improved, the skin lesions resolved and the itchiness disappeared. The general status improved significantly. NET G2 diagnosing was possible due to the atypic paraneoplastic sign: chronic pruritus. This case study highlights the association between itch and malignancy and presents an atypical way of NET presentation when all tumor markers remain negative.

11.
Medicina (Kaunas) ; 57(2)2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33572732

RESUMO

Background and Objectives: During the coronavirus disease 2019 (COVID-19) pandemic, patients with chronic diseases suffering exacerbations have required acute medical care. The purpose of our study was to determine useful criteria for the differentiation of patients with acute clinical syndromes and suspicion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Materials and Methods: This was an observational retrospective study, conducted in an internal medicine clinic from April to May 2020. We collected clinical, biological, and computed tomography (CT) data on patients with exacerbations of chronic diseases and clinical suspicion of SARS-CoV-2 infection. Patients with an already-positive real-time reverse-transcription polymerase chain reaction (RT-PCR) test for SARS-CoV-2 on presentation at the emergency department were excluded from our study. Results: Of 253 suspected cases, 20 were laboratory-confirmed as having SARS-CoV-2 infection by RT-PCR, whereas COVID-19 diagnosis was ruled out in the remaining 233. Venous thromboembolism (VTE) correlated significantly with COVID-19 diagnosis in suspected patients, while laboratory markers were not significantly different between the two groups. Of the suspected patients, significantly higher percentages of dry cough, fever, myalgias, sore throat, loss of smell and appetite, and ground-glass opacities (GGOs) on CT were found in SARS-CoV-2-positive individuals. Conclusions: The study demonstrated that, until receiving the result of an RT-PCR test for SARS-CoV-2 (usually 12-24 h), association with VTE as a comorbidity, fever, dry cough, and myalgia as clinical features, and GGO on CT are the main markers for the identification of COVID-19 patients among those suspected with acute clinical syndromes. Our results also provide evidence for doctors not to rely solely on biological markers in the case of suspected SARS-CoV-2 infection in patients with exacerbations of chronic diseases. These data are useful for faster decision-making with regard to suspected COVID-19 patients before receiving RT-PCR test results, thus avoiding keeping patients in crowded emergency departments.


Assuntos
COVID-19/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/fisiopatologia , Teste para COVID-19/métodos , Tosse/fisiopatologia , Diagnóstico Diferencial , Feminino , Febre/fisiopatologia , Humanos , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pandemias , Faringite/fisiopatologia , Estudos Retrospectivos , Romênia/epidemiologia , SARS-CoV-2 , Síndrome , Tomografia Computadorizada por Raios X , Adulto Jovem
12.
Rev Med Chir Soc Med Nat Iasi ; 118(3): 772-9, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25341300

RESUMO

AIM: This descriptive epidemiological study included 615 subjects investigated by their family doctor in the interval October 2011- August 2012. MATERIAL AND METHODS: Patients were selected according to 2012 IDF diagnostic criteria resulting 304 patients. RESULTS: There was a Gaussian distribution of waist circumference (WC) with a maximum in age-group 70-80 years (46.3%), followed by age- groups 50-60 years (37.8%) and 60-70 years (41.6%). Waist circumference measurement showed an average of 100.76 +/- 11.59 cm, ranges 72 cm - 134 cm, without statistical significance. Mean body mass index (BMI) was 28.25 +/- 4.72 kg/m2 vs. 27.79 +/- 4.48 kg/m2. The difference is statistically significant (p = 0.05). Considering categorical the patients with hypertension (AHT) according to the definition, we found that only 7 cases did not have AHT (4.4%) as compared to a prevalence of AHT of 13.7% in the MS (metabolic syndrome) group. Mean serum triglyceride level was 123.11 +/- 68.55 mg/dl versus 113.75 +/- 65.62 mg/dl in the MS group, significantly higher (p < 0.003). Mean HDL cholesterol was 57.58 +/- 17.11 mg/dl versus 58.54 +/- 15.02 mg/dl, statistically significant difference (p < 0.05). CONCLUSIONS: The prevalence of glucoregulation disorders is higher in the MS group. Proportional relationships were found between BMI, WC, and SBP and high blood glucose. Comparison of blood glucose levels at baseline and at 1 year follow up showed significant differences.


Assuntos
Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Medicina de Família e Comunidade , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , População Rural/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Glicemia/metabolismo , Índice de Massa Corporal , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Estudos Transversais , Diabetes Mellitus/sangue , Diabetes Mellitus/etiologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Programas de Rastreamento , Síndrome Metabólica/sangue , Síndrome Metabólica/complicações , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Romênia/epidemiologia , Triglicerídeos/sangue , Circunferência da Cintura
13.
Rev Med Chir Soc Med Nat Iasi ; 118(2): 463-70, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25076716

RESUMO

AIM: To identify the specific risk factors for chronic hepatitis B/C virus infections in the correctional system in Moldova (Romania). MATERIAL AND METHODS: The study included 533 subjects imprisoned in three correctional facilities located in the Northern region of Moldova. The subjects were divided into 2 groups: HBV/HBC group--108; Control group--425. RESULTS: The risk factor for transfusion-contracted HBV/HCV was 3.73; the empirical treatment of the HBV/HBC group resulted in a relative infection risk of 2.62; syringe sharing in the HBV/HBC group accounted for a risk factor of over 4 (OR = 4.33); tattooing induced a relative risk factor of 1.25, and piercing was a risk factor of approximately 2 (OR = 1.97); sharing personal care items represented a risk factor of over 2 (OR = 2.02). Injection drugs induced a relative risk of over 4 (OR = 4.33). In the HBV/HCV group, self-aggression represented a risk factor of 1.65. CONCLUSIONS: Prison environment, by its specific and nonspecific contamination modalities (shared with the rest of the population but more common) causes that inmates to be 2-4 times more exposed to hepatitis B/C infection.


Assuntos
Hepatite B/epidemiologia , Hepatite C/epidemiologia , Prisões/estatística & dados numéricos , Estudos de Casos e Controles , Feminino , Hepatite B/diagnóstico , Hepatite B/prevenção & controle , Hepatite C/diagnóstico , Hepatite C/prevenção & controle , Humanos , Masculino , Uso Comum de Agulhas e Seringas/efeitos adversos , Fatores de Risco , Romênia/epidemiologia , Tatuagem/efeitos adversos , Reação Transfusional
14.
Rev Med Chir Soc Med Nat Iasi ; 117(1): 72-7, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24505895

RESUMO

AIM: To evaluate the presence and role of stress in causing diseases. MATERIALS AND METHODS: We conducted a 6-month study in patients who presented for the first time with a series of symptom and tried to look for an organic cause of those symptoms. We wanted to see the impact of stress in everyday life and its role in causing various diseases. RESULTS: The obtained results showed a female predominance in terms of seeking medical advice and that the most affected age group was 20-30 years, accounted for by the start of socio-professional issues. The psycho-behavioural symptoms were the most prevalent, followed by the gastro-intestinal ones. The presence of stress had left its mark on these events, fact proven by the lower rate of organic pathology. CONCLUSIONS: Stress awareness must guide us in medical practice as to avoid under- or over-diagnosis.


Assuntos
Transtornos Mentais/etiologia , Estresse Psicológico/complicações , Adulto , Distribuição por Idade , Anorexia Nervosa/etiologia , Bulimia Nervosa/etiologia , Complicações do Diabetes/etiologia , Diabetes Mellitus/etiologia , Feminino , Humanos , Hipertensão/etiologia , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Fatores de Risco , Romênia/epidemiologia , Distribuição por Sexo , Úlcera Gástrica/epidemiologia , Úlcera Gástrica/etiologia , Estresse Psicológico/diagnóstico , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Inquéritos e Questionários
15.
Rev Med Chir Soc Med Nat Iasi ; 114(1): 75-9, 2010.
Artigo em Romano | MEDLINE | ID: mdl-20509279

RESUMO

UNLABELLED: Functional diseases of digestive tract are an ubiquitary problem of diagnosis and treatment for ambulatory care services. Its evolution is chronicle but there are no organic lesions for the beginning. Nevertheless, it impairs quality of life and creates many days of incapacity of work. MATERIAL AND METHOD: We studied 1118 cases with digestive malfunctions, selected from the patients consulted on Ambulatory Care Unit--Internal Medicine, 2007-2008. RESULTS: Basal clinical and laboratory explorations classified the type of digestive malfunctions according to international criteria. So we found these types of anomalies: gastro-oesofagial reflux--788 cases; peptic-like syndrome--752 cases; pyloric functional spasm--385 cases; helicobacter pyloridi positive--632 cases; gallblader dysfunction--767 cases; irritable bowel syndrome--872 cases. The treatment was applied pursued the pathological status. Most of cases had un diagnosticated diseases as peptic ulcer, gastritis, gallbladder diseases. CONCLUSIONS: Our conclusions are that the whole tract has continuity and the site of dysfunction is difficult to diagnose from the beginning. Pro-kinetic drugs and inhibitory of gastric secretion have very good results. The same time we must treat the "background"--extra digestive factors (i.e., Helicobacter pylori infection).


Assuntos
Gastroenteropatias/diagnóstico , Gastroenteropatias/terapia , Atenção Primária à Saúde , Quimioterapia Combinada , Doenças da Vesícula Biliar/diagnóstico , Doenças da Vesícula Biliar/terapia , Gastrite/diagnóstico , Gastrite/terapia , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/terapia , Fármacos Gastrointestinais/uso terapêutico , Gastroenteropatias/dietoterapia , Gastroenteropatias/tratamento farmacológico , Gastroenteropatias/fisiopatologia , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/terapia , Humanos , Síndrome do Intestino Irritável/diagnóstico , Síndrome do Intestino Irritável/terapia , Úlcera Péptica/diagnóstico , Úlcera Péptica/terapia , Inibidores da Bomba de Prótons/uso terapêutico , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
16.
Rev Med Chir Soc Med Nat Iasi ; 113(2): 322-9, 2009.
Artigo em Romano | MEDLINE | ID: mdl-21495336

RESUMO

What does obesity mean? One of the people's health markers is the nutritional steady-state, the mean ponderal equilibrium. The normal weight means the longest life expectancy assuring body weight, from all points of view. The body weight increasing means adipose tissue accumulation and the onset of obesity. Obesity quantification could be made by BMI (body mass index)--normal range 22-24 kg/m2- waist to hip ratio--normal range 0.8-0.9--and abdominal perimeter--normal range up to 80 cm. Why should we do obesity prevention? Because obesity means a high risk factor for cardio-vascular disease, cancer, bone diseases, general mortality. By 10 kg weight loss, real benefits are achieved: left ventricle hypertrophy reduction, decreasing of cardio-vascular risk, pulmonary function improve, reducing of atherosclerotic symptoms by 91%, of arterial pressure by 10-20 mmHg, of diabetes mortality by 30%, cancer by 40% and general mortality by 20%. In our country, 53% of population is overweight and obese, predominantly urban population. Obesity costs are high: about 4-8% of health budget are spent for screening, diagnosis and obesity management, including economical losses. When should we do obesity prevention? Primary care physicians must control all health indexes. If the patient passes over normal ranges of body weight, we should take account and intervene efficiently, by specific and non-specific therapeutic methods. How could we do obesity prevention? General care physicians and specialists could prevent efficiently this disease by taking apart obesity causes and risk factors: genetics, life-style, drug intake, smoking, professional and endocrine factors. Primary and secondary care physicians have to screen high risk persons, to analyze professional, familial and social conditions, to appreciate educational and economical status. All these realize an integral obesity management, together with the psychologist and the sociologist. Secondary prevention means obesity treatment, in order to prevent complications and, in the same time, to maintain normal body weight after ponderal excess loss. Obesity prevention is an important and complex social problem to debate. We have to mobilize political and economical factors, food industry, education. Obesity control means protection against one of the most aggressive health risk factors.


Assuntos
Obesidade/prevenção & controle , Atenção Primária à Saúde , Redução de Peso , Adiposidade , Algoritmos , Índice de Massa Corporal , Peso Corporal , Humanos , Expectativa de Vida , Estilo de Vida , Obesidade/complicações , Obesidade/diagnóstico , Obesidade/economia , Sobrepeso/prevenção & controle , Médicos de Atenção Primária , Pobreza , Fatores de Risco , Romênia , Relação Cintura-Quadril
17.
Rev Med Chir Soc Med Nat Iasi ; 112(3): 630-4, 2008.
Artigo em Romano | MEDLINE | ID: mdl-20201243

RESUMO

UNLABELLED: Lipid metabolism disorders--breast cancer risk association in postmenopausal women was searched in many studies; the HDL-cholesterol value triggered most of controversies. Some authors plead for increased breast cancer risk in overweight/obese postmenopausal women if HDL is higher while others plead for higher risk if HDL is lower then in general population. MATERIAL AND METHOD: We studied a 110 subjects female population aged between 41 and 69, and determined height, weight, body mass index (BMI), abdominal perimeter (AP), lipid parameters (total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides). All women performed mammography and breast echography. Imagery divided the subjects in three groups: 30 breast cancer patients (first diagnosis)--group 1, 50 breast dysplasia women--group 2, and normal breast patients--group 3. RESULTS: HDL-cholesterol proved significantly higher in group 2 compared to group 3 (control group), by the third and the fourth quartile; the same when it came to overweight/obese post-menopausal women. Nevertheless, more lipid disorders clustered in group 1 obese/overweight postmenopausal women. CONCLUSIONS: High HDL in breast dysplasia women is reported in international studies too. High menopause prevalence in group 3, implying abdominal obesity and lipid disorders may explain the small difference between group 1 (breast cancer patients) and group 3 (control group). High clustering in group 1 pleads for increased breast cancer risk in metabolic syndrome postmenopausal women. Comparing HDL values and the clustering phenomenon in group 1 to the other two groups considered as a control population (as done in international published studies), we can conclude that low HDL--abdominal obesity association increases breast cancer risk after the menopausal age.


Assuntos
Neoplasias da Mama/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Doença da Mama Fibrocística/sangue , Síndrome Metabólica/sangue , Síndrome Metabólica/complicações , Pós-Menopausa , Idoso , Biomarcadores/sangue , Estatura , Índice de Massa Corporal , Peso Corporal , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Estudos de Casos e Controles , Feminino , Doença da Mama Fibrocística/diagnóstico , Doença da Mama Fibrocística/epidemiologia , Doença da Mama Fibrocística/etiologia , Humanos , Mamografia/métodos , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Obesidade Abdominal/sangue , Obesidade Abdominal/complicações , Medição de Risco , Romênia/epidemiologia , Triglicerídeos/sangue , Ultrassonografia Mamária/métodos , Circunferência da Cintura
18.
Rev Med Chir Soc Med Nat Iasi ; 111(4): 872-6, 2007.
Artigo em Romano | MEDLINE | ID: mdl-18389772

RESUMO

UNLABELLED: The 1998 report on the occasion of the 4th anniversary of International obesity Task Force emphasized that overweight (BMI > 25) is also linked to the increasing incidence of some neoplasias--breast, colon, endometer, prostate or kidney. Carmichael and Bates showed an inverse relationship between BMI and perimenopausal breast cancer. MATERIAL AND METHOD: We studied a group of 110 patients divided in three subgroups--30 patients who had just been diagnosed with breast cancer; 50 patients with breast dysplasia diagnosed by mammography and mammary echography; 30 patients with no modifications on mammography or breast echography. Height, weight, abdominal and hip perimeter have been measured. All have performed complete lipidogramme as well as serum estradiol. RESULTS: 15 of the 30 breast cancer patients (50%) were obese with a WHR > 0.8 compared to 23 (46%) in the mastosis group and 20 (66%) in the reference group. The prevalence differences were not significant, but the association between abdominal obesity and increased serum estradiol is highly significant for group I compared to the other groups (p < 0.01). CONCLUSION: Our study confirms that android obesity and estrogens are linked to breast carcinogenesis promotion by synergic or common pathways.


Assuntos
Adiposidade , Neoplasias da Mama/complicações , Doença da Mama Fibrocística/complicações , Obesidade/complicações , Adulto , Idoso , Constituição Corporal , Índice de Massa Corporal , Neoplasias da Mama/diagnóstico , Colesterol/sangue , HDL-Colesterol/sangue , Estradiol/sangue , Feminino , Doença da Mama Fibrocística/diagnóstico , Humanos , Pessoa de Meia-Idade , Obesidade/diagnóstico , Fatores de Risco
19.
Rev Med Chir Soc Med Nat Iasi ; 109(1): 21-8, 2005.
Artigo em Romano | MEDLINE | ID: mdl-16607822

RESUMO

AIM OF THE STUDY: To analyse obesity and metabolical complications (cardiovascular disease) in an obese population, Iasi county compared to the nonobese population of the same locality. MATERIAL AND METHOD: Cross-sectional study on two groups: group 1--the witness group--48 cases normal weight and group 2--the study group--50 obese patients. RESULTS AND CONCLUSIONS: High values of abdominal perimeter (AP) associate with high glycemia, high triglycerides and low HDL-col in obese patients; higher evidence of X syndrome elements association in the obese population; higher global risk for the obesity in modern life conditions; teenagers obesity trigger are small birthweight and perinatal malnutrition in 30% of cases.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Síndrome Metabólica/diagnóstico , Obesidade/diagnóstico , Adolescente , Adulto , Idoso , Glicemia/metabolismo , Índice de Massa Corporal , Peso Corporal , Criança , HDL-Colesterol/sangue , Análise por Conglomerados , Estudos Transversais , Feminino , Humanos , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/complicações , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Obesidade/sangue , Obesidade/complicações , Obesidade/epidemiologia , Romênia/epidemiologia , Triglicerídeos/sangue
20.
Rev Med Chir Soc Med Nat Iasi ; 108(4): 848-55, 2004.
Artigo em Romano | MEDLINE | ID: mdl-16004230

RESUMO

The body mass index (BMI) shows a rate of 17.4% patients suffering from first degree fatness and 56.5% from second degree fatness. The frequency of the illness increases with age, the differences established being statistically important for a p of 0.001. 45.6% persons were diagnosed with HTA, with differences statistically important at a p of 0.01, so the number of cases increases with age. The same situation is to be found in cardiovascular illnesses (angina pectoris, ischaemic cardiopathy). The high level of cholesterol is more frequent at older people, and still the differences established are statistically not significant. In these conditions, the diet must be adapted to the patient's condition. A comparative study was made on groups of age, using the following groups of food: cereal derivatives, vegetables, fruits, dairy product, meat, fish. In most of the cases, the differences established are statistically not significant. So, even if the diagnosis is known, the patient doesn't give up his eating habits.


Assuntos
Inquéritos sobre Dietas , Comportamento Alimentar , Obesidade , Adulto , Algoritmos , Índice de Massa Corporal , Humanos , Pessoa de Meia-Idade , Romênia
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