Cardiac Changes in Overweight and Obese Patients.

BACKGROUND: Obesity and overweight are two pathologies that are more and more frequent in the XXIst century diagnosis and are causing high morbidity and mortality rates in the general population, especially through cardiovascular complications. AIMS: Identification and early diagnosis of cardiac changes in overweight and obese patients. MATERIAL AND METHOD: We carried out a sectional, analytical and observational study on 111 subjects: 27 normal weight subjects and 84 overweight and obese patients, which were submitted to a clinical exam, biochemical exams and 2D ultrasound. RESULTS: The presence of diastolic dysfunction is twice more frequent in overweight patients in comparison to normal weight ones (30% vs 15%) and 5 times more frequent in obese patients than normal weight ones (75% vs 15%). The size increase of the interventricular septum is correlated with the body mass index, there being statistically significant differences between normal weight vs overweight vs obese patients, as well as between overweight and obese ones. Within the whole group and within the groups, both the left ventricle mass (g) as well as the left ventricle mass to body surface ratio (g/m²) are statistically significantly higher in patients with present diastolic dysfunction (E/A < 1). This indicates a relation between the presence of diastolic dysfunction, increased left ventricle mass and body mass index (p < 0.05). CONCLUSIONS: Overweight and obese patients, unlike normal weight ones, present early cardiac changes, such as: a decrease of left ventricle ejection fraction, diastolic dysfunction, thickening of the interventricular septum, increase of the left ventricle mass both per se as well as in ratio to body surface.

Histopathologic and immunohistochemical aspects of the renal parenchyma in patients with glomerulonephritis developed in locked-up spaces.

A number of 38 renal biopsies and 13 necroptic pieces removed from 51 prisoners were available for our study. From 51 cases, 21 patients were diagnosed with actual chronic glomerulonephritis, 19 patients with non-specific chronic glomerulonephritis, four patients with renal amyloidosis, and seven patients with glomerulonephritis lesions associated to pielonephritis.

Glomerulopathies in locked-up persons. Histopathologic and clinic study.

The diseases of the urinary apparatus are frequently-enough inside the locked-up spaces of the penitentiaries. Among them, glomerulonephritis and pyelonephritis take a special place, by their late diagnosis and their lasting evolution. The authors clinically and paraclinically investigated a number of 214 locked-up male persons aged between 18-57 years, presenting various clinical forms of glomerulonephritis. Histopathological exams performed in 51 patients confirmed the diagnosis.

Sialic Acid, possible marker of angiopathic complications at diabetics type 2.

Studies from the last decade emphasize the importance of sialic acid (SA) in general pathology (neoplasic disease, colagenosis), and its implication in appearance and aggravation of atherosclerosis (e.g. appearance of angyopathy like chronic complication in diabetes mellitus). Diabetes is known as a major risk factor for atherosclerosis and has a high incidence in general population. The incidence of diabetes increases from year to year, especially type II of diabetes, the most common type (more than 90% from diabetics are type II). Diabetes mellitus with its chronic degenerative complications like micro and macrovascular angyopathy (coronary disease, nephropathy, retinopathy, arteriopathy) represents a major health and social problem (more than 80% of the mortality to type II diabetics is the result of coronarian and cerebral vascular complications). The early discovery of chronic angyopathic complications to diabetics is a major objective in increasing the hope of life to diabetics. Determination and monitorization of SA could be useful in the early discovering of chronic degenerative complications to patients with diabetes mellitus.

Low insulin secretion in decompensated liver cirrhosis with diabetes mellitus.

The present study aimed to investigate the pathogenesis of altered glucose tolerance frequently observed in liver cirrhosis by means of oral glucose tolerance test (OGTT) and i.v. glucagon followed by determining the immunoreactive insulinemia and insulinogenic index (Seltzer). In these conditions of beta islet cells upper limit stimulation a low insulin secretion was found in decompensated liver cirrhosis with alteration of the glucose tolerance (DM or IGT) and a tendency toward hepatic resistance to i.v. glucagon.

ATP-ase activity of mitochondria isolated from needle-biopsy liver samples of diabetic subjects.

ATP-ase activity in mitochondria isolated from liver needle-biopsy samples was measured in 5 diabetics, aged 30-63 years and in 4 control subjects of similar age. The mitochondrial fraction was isolated by differential centrifugation of the homogenate and the ATP-ase activity was determined in the optimal conditions previously described for human liver mitochondria. The basal and Mg-stimulated ATP-ase activities were higher, while the DNP-stimulated ATP-ase activity was lower in diabetics compared to controls. The ratio of DNP-ATP-ase/Mg2+-ATP-ase was between 1-2 in diabetics and above 5 in controls. This pattern of ATP-ase activity in diabetics is indicative of mitochondrial damage. No quantitative changes in the amount of mitochondria isolated from liver (expressed in micrograms mitochondrial protein/mg wet tissue) could be noticed in diabetics compared to controls. Consequently, the alterations of ATP-ase activity is probably reflective of impairments of functional integrity of liver mitochondria in diabetics.