Berceanu D.,Clinical Emergency Hospital of Bucharest |
Bucur D.,Clinical Hospital Colentina |
Diaconu C.,Clinical Emergency Hospital of Bucharest |
Diaconu C.,Carol Davila University of Medicine and Pharmacy
Archives of the Balkan Medical Union | Year: 2016
Patients with diabetes have a high prevalence of liver disease. The entire spectrum of liver disease is seen in patients with type 2 diabetes. Non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2DM) are common conditions that regularly co-exist and act synergistically to drive negative outcomes. The classical pathway consists of initial insulin resistance, increased lipolysis, lipid accumulation in the hepatocytes, oxidative stress, and cell damage followed by fibrosis. Insulin resistance is a characteristic feature of NAFLD, as a result of increased secretion of specific proinflammatory cytokines such as TNF- . NAFLD does not always progress to NASH, and the precise pathological events leading to steatohepatitis are yet to be determined. There is an under-recognized role of diabetes in many patients with cryptogenic cirrhosis. The prevalence of hepatocellular carcinoma is increased in patients with diabetes as well the prevalence of diabetes in patients with hepatocellular carcinoma. Patients with chronic hepatitis C are more likely to develop diabetes; all patients with type 2 diabetes and persistently elevated serum ALT should be screened for HCV testing. The majority of patients with NAFLD do not require a specific treatment. The treatment of NAFLD consists of lifestyle modification as well as pharmacological therapy. Hepatic steatosis diminishes in parallel with weight loss. Thiazolidinediones are emerging as the treatment of choice even in the absence of diabetes. © 2016 CELSIUS.
Niaa G.R.,Chronic Disease Hospital St Luke |
Omer S.,St Ioan Emergency Hospital |
Radoi M.,Bagdasar Arseni Emergency Hospital |
Popescu M.,Clinical Hospital Colentina |
And 3 more authors.
Archives of the Balkan Medical Union | Year: 2015
Background: Numerous studies have focused on evaluating illness perceptions in patients with cancer and its influence on cope and disease adaptation, observing that changing the cognitive representation of the disease may lead to increase the patients quality of life. Objective: Illness perception may differ in young patients compared to elderly patients, the latter being influenced by the affective memory or associated chronic diseases and their outcomes. Materials and methods: Elderly patients with cancer were evaluated on admission in Oncology-Palliative Care Departement, using Brief Illness Perceptions Questionnaire. Results and discussions: The results showed that the majority of elderly patients shows an average perceptions of the disease, very few shows low illness perceptions and identified as causal factors: stress, smoking and food. Conclusions: To increase the quality of life of elderly patients with cancer may require early assessment of illness perceptions and early psychoemotional, social and spiritual interventions.
Rasanu T.,CMI |
Alexianu M.,Clinical Hospital Colentina |
Damian I.,CF Clinical Hospital |
Romanian Journal of Neurology/ Revista Romana de Neurologie | Year: 2010
Mitochondrial diseases can present at any age and include a combination of multisystemic symptoms. Major manifestations of muscle involvement include infantile hypotonia, weakness, and lactic acidosis;l severe exercise intolerance and easy fatigability, variable fi xed weakness, often involving the extraocular muscles. Additionally, infantile or childhood encephalomyopathies have been identifi ed in which CNS (e.g., seizures, ataxia, stroke-like episodes) and muscle symptoms coexist. Paraclinical investigations support the diagnosis and help in categorizing the mitochondrial myopathies (MM). Serum CK level may be mildly elevated in MM but are often normal; blood lactate concentration is usually elevated at rest. Electroneuromyographic features are not pathognomonic: myopathic EMG findings and reduced sensory response amplitudes. Muscle biopsy is a more specific test of mitochondrial myopathies, tipically showing the presence of ragged red fi bers, COX negative and SDH positive, with ultrastructurally ab-normal mitochondria (electron microscopy). Enzymatic and genetic tests are sometimes useful. After overviewing the current literature, a brief clinical case report is presented.
Trifu V.,Central Emergency Clinical Military Hospital Dr Carol Davila |
Tiplica G.-S.,Clinical Hospital Colentina |
Naumescu E.,Clinical Hospital Of Dermato Venerology Prof Dr Scarlat Longhin |
Moro L.,Cosmo Oil Co. |
Celasco G.,Cosmo Research and Development S.p.A.
British Journal of Dermatology | Year: 2011
Background Acne vulgaris is a disorder of the pilosebaceous unit in which the androgens contribute to its onset and persistence. The use of antiandrogens is therefore potentially effective; however, antiandrogens for topical use are not available on the market. Cortexolone 17α-propionate (CB-03-01; Cosmo S.p.A, Lainate, Italy) is a new potent topical antiandrogen potentially useful in acne vulgaris. Objectives To evaluate the safety and the topical efficacy of CB-03-01 1% cream in acne vulgaris as compared with placebo and with tretinoin 0·05% cream (Retin-A®; Janssen-Cilag). Methods Seventy-seven men with facial acne scored 2-3 according to Investigator's Global Assessment (IGA) were randomized to receive placebo cream (n = 15), or CB-03-01 1% cream (n = 30), or tretinoin 0·05% cream (n = 32) once a day at bedtime for 8 weeks. Clinical efficacy was evaluated every 2 weeks including total lesion count (TLC), inflammatory lesion count (ILC), acne severity index (ASI) and IGA. Safety assessment included local irritancy score, laboratory tests, physical examination, vital signs and recording of adverse events. Results CB-03-01 1% cream was very well tolerated, and was significantly better than placebo regarding TLC (P = 0·0017), ILC (P = 0·0134) and ASI (P = 0·0090), and also clinically more effective than comparator. The product also induced a faster attainment of 50% improvement in all the above parameters. Conclusions This pilot study supports the rationale for the use of topical antiandrogens in the treatment of acne vulgaris. CB-03-01 1% cream seems to fit with the profile of an ideal antiandrogen for topical use. © 2011 The Authors. BJD © 2011 British Association of Dermatologists 2011.
Croitoru A.,National Institute of Pneumology |
Ionita D.,Spitalul Universitar Of Urgenta Elias |
Stroescu C.,National Institute of Pneumology |
Pele I.,National Institute of Pneumology |
And 5 more authors.
Pneumologia | Year: 2013
Background: Respiratory rehabilitation programs (RR) are essential tools in the management of COPD. Aim: We present the results of a 7-week outpatient rehabilitation program in terms of dyspnea, exercise tolerance and quality of life. Material and method: The following parameters were evaluated before and after RR: dyspnea (mMRC scale), pulmonary function (FEV1, RV - residual volume), exercise tolerance (6MWT - 6 minutes walk test, CPET - cardiopulmonary exercise test), quality of life (SGRQ questionnaire). The RR program was outpatient, hospital based (7 weeks, 3 sessions/week) and included: exercise training, therapeutic education, and psychological support. Results: 25 patients, COPD stage II-IV GOLD (mean FEV1 44.5 ± 13% predicted), mean age 60.4 ±12 years, 7 females, average BMI 27.14±4 kg/m2, average RV residual volume 221.55±86% predicted. Mean 6MWT distance: 407.48 ± 84 m and mean maximum power (Pmax) obtained on CPET: 75.67±30 Watts. All patients were symptomatic with significant dyspnea (3.06±0.7 on mMRC scale) and showed a significant impairment of quality of life: SGRQ score 46.23±14. At the end of RR program: dyspnea decreased with 0.67 points on mMRC scale (p = 0.000), 6MWT distance increased with 58.5 m (p = 0.001), Pmax obtained during CPET increased with 11.2 W, without reaching statistical significance (p>0.05). SGRQ score decreased by 5.59 points (p = 0.02). There were no significant improvements in FEV1 and RV values (p>0.05). Conclusion: In our COPD patients, the 7 week outpatient rehabilitation program was effective, leading to improvement of symptoms, exercise tolerance and quality of life.
Vasilescu R.,Clinical Hospital Colentina |
Ifrim S.,Clinical Hospital Colentina |
Ionescu-Tirgoviste C.,National Institute of Diabetes |
Sabau S.,Hokkaido University |
Muresan A.,Intensive Care Unit
Romanian Journal of Diabetes, Nutrition and Metabolic Diseases | Year: 2011
Background: The aim of this study was to evaluate the association between adipokines (adiponectin and leptin), inflammatory markers, insulin resistance and metabolic syndrome in obese, non-diabetic subjects. Methods: Thirty three obese patients (19 men and 14 women) with metabolic syndrome (MetS) defined according IDF criteria, twenty three obese patients (12 men and 11 women) without MetS and eighteen controls (9 men and 9 women) lean subjects without MetS were included. In all individuals were assessed MetS components as well as serum levels of adiponectin, leptin, high sensitive C-reactive protein (hs-CRP), insulin, fibrinogen and leukocyte count (WBC). Results: In both sexes, obese subjects with MetS, compared to obese subjects without MetS had significantly higher systolic blood pressure (SBP), diastolic blood pressure (DBP), HOMA-IR, WBC, plasma concentrations of hs-CRP, leptin, triglyceride and fibrinogen and significantly lower concentration ofHDL-cholesterol. A significantly lower concentration ofadiponectin and a higher concentration of fasting insulin were observed in obese men with MetS compared to obese men without MetS. In all study subjects adiponectin was negatively correlated with BMI, body fat, triglyceride, HOMA-IR and positively correlated with HDL-cholesterol and hs-CRP was positively correlated with BMI, waist, body fat, triglyceride, HOMA-IR and negatively correlated with HDL- cholesterol. Hs-CRP was positively correlated with leptin in obese women and negatively correlated with adiponectin in obese men. Conclusions: In obese, non-diabetic subjects adiponectin, leptin, proinflammatory state andprothrombotic state are strongly correlated with MetS. Obese subjects with MetS had higher levels of hs- CRP and lower levels of adiponectin. These findings are important in clinical practice becausepermit an earlier identification of high risk subjects.
Tanasescu C.,Clinical Hospital Colentina |
Madalina I.,Emergency Hospital |
Carmen C.M.,University of Bucharest |
Marcela P.,University of Bucharest
Therapeutics, Pharmacology and Clinical Toxicology | Year: 2011
Background: Since its discovery in 1982, Helicobacter pylori infection is recognized as a major cause of gastro-intestinal diseases, including chronic gastritis, peptic ulcer disease and gastric malignancy. Its prevalence is connected to socio-economical conditions and most of the individuals are infected during childhood. Regarding Helicobacter pylori treatment, a combination of antibiotics must be given but in certain cases repeated courses of different antibiotics are needed to eradicate H. pylori. Eradicating H. pylori is still a problem because of the rapidly increasing prevalence of multidrug resistant strains worldwide. Aim: In this study we want to emphasize the need for culturing Helicobacter pylori for certain cases and to show the resistance rate to different antibiotics. The samples for culture were obtained either by gastric biopsy taken by upper GI endoscopy or by enterotest - a string test with a small capsule swallowed and removed after 1 hour. For the positive cultures, an antibiotic susceptibility was performed. Some of the empirically used antibiotics showed surprisingly an increased rate of resistance. Materials and methods: We have selected just the patients resistant to the first line therapy (in our case, Clarithromycin 500 mg bid, Amoxicillin, 1g bid and a Pump Proton Inhibitory drug 20 mg bid) dividing them in two groups. For one group gastric biopsy was done and for the other group, enterotest was performed. The samples taken from gastric biopsy and enterotest were put on special media (pylori agar) with microaerophilia for cultivation. Positive culture was obtained after an incubation of three to seven days. To this culture an antibiogram by diffusion method was done. Results: Positive cultures were obtained in 17 patients (out of 20) from gastric biopsy and in 15 patients (out of 20) from enterotest. Increased resistance in Helicobacter pylori strains was observed for Metronidazole and Clarithromycin, commonly used in first line therapy. On the other side, sensitivity was noticed for: Amoxicillin, Ciprofloxacin, Levofloxacin, Furazolidone, Tetracycline. To the patients, a therapy containing an association of two antibiotics from susceptibility testing and a PPI, was given. A good clinical response and a success rate of 93% at one month after finishing the treatment were obtained. The rest of the patients (7%) were retested by rapid urease test or fecal antigen and if they were still positive a second culture was scheduled. Discussions: Many treatment regimens have been proposed for Helicobacter pylori management. The initial approach should be based on the prevalence of drug resistance-especially to Metronidazole and Clarithromycin. Strict adherence to the treatment should be highly recommended to the patient. Reinfection needs to be avoided by respecting basic hygiene rules. Culture seems the best option for cases resistant to classic therapy. Conclusions: Treating Helicobacter pylori can be a challenge when this proves to be resistant to several antibiotics. In these cases, culturing it by gastric biopsy or less invasive, by Enterotest and performing antibiogram afterwards seems an appropriate solution. Cultures have to be examined after at least 72 hours of incubation and negative results can only be certified after seven days of incubation. Metronidazole, a very used antibiotic in first line therapy has a very high resistance and it should be avoided especially if the patient has taken this for other infections. © 2011.
Serafim A.,Polytechnic University of Bucharest |
Petre D.G.,Polytechnic University of Bucharest |
Moraru L.,Polytechnic University of Bucharest |
Cioflan H.E.,Carol Davila University of Medicine and Pharmacy |
And 5 more authors.
Key Engineering Materials | Year: 2014
This work presents the synthesis and characterization of natural-synthetic hydrogels based on gelatin (Gel) and polyvinylpyrrolidone (PVP), with potential for skin grafts applications. The natural component, Gel insures the biocompatibility and biodegradability of the bicomponent system , while the synthetic counterpart, PVP, is a physiologic inert component, extensively used in medicine due to its water affinity and due to its capacity of confer elasticity to films and membranes with potential applications in skin grafts . The obtained hydrogels were subjected to morpho-structural analysis and rheological and mechanical tests (traction). The water affinity of the systems was estimated and their capacity to generate porous substrates through freeze-drying was evaluated. © (2015) Trans Tech Publications, Switzerland.
Jianu D.M.,Carol Davila University of Medicine and Pharmacy |
Jianu D.M.,ProEstetica Medical Center |
Streinu-Cercel A.,Carol Davila University of Medicine and Pharmacy |
Blidaru A.,Carol Davila University of Medicine and Pharmacy |
And 9 more authors.
GERMS | Year: 2013
Introduction Recent articles have described an endogenous breast flora, particularly in the nipple ducts, with potential implications in the outcome of aesthetic breast surgery. To characterize the ecology of the breast, we designed a study to assess the microbial species identified on the breast skin and parenchyma in patients undergoing breast surgical interventions. Methods After obtaining informed consent and background data on concurrent diseases, previous contact with the hospital system and prior use of antibiotics, samples are collected preoperatively from three areas of the breast skin, bilaterally: the inframammary fold, the areola and the axilla, prior to decontamination. These samples will serve as positive controls and will aid in characterizing the normal breast skin flora. After preoperative decontamination, samples are again collected, to check for any residual bacterial flora and the nipple is sealed with Tegaderm (3M, USA) and betadine ointment, to reduce any putative bacterial load. Intraoperatively, samples are collected from: a) the incision line (dermal level): 1. superficially, 2. medium depth in the breast parenchyma, 3. deep parenchyma, and b) axillary parenchyma (where possible), together with a bioptic fragment. Postoperatively, a second nipple sample is collected. For secondary breast augmentation surgeries, capsular biopsy is also performed (where relevant), and the implants undergo sonication, to allow biofilm identification. In the laboratory, all samples are cultured on blood agar incubated with CO2, cystine lactose electrolyte deficient medium and Sabouraud gentamicin-chloramphenicol agar. For positive culture samples, the number of colonies and their morphologic characteristics are reported. Identification will be carried out with MALDI-TOF and VITEK (bioMérieux, France), yielding automated antibiotic sensitivity profiles. For all germs with sensitivity profiles differing from the wild-type strain, E-tests will be performed. Follow-up information on the postoperative evolution will be collected and analyzed for potential factors predictive of good evolution. Discussion This study will provide important information about the microflora of the breast skin, its sensitivity profile, and the degree of contamination of the nipple ducts and parenchyma, if any, addressing a scientific hypothesis insufficiently explored so far. © GERMS 2013.
Buraga I.,Clinical Hospital Colentina |
Antoce L.M.,Clinical Hospital Colentina |
Baetu C.,Clinical Hospital Colentina |
Dobrescu A.,Clinical Hospital Colentina |
And 2 more authors.
Gineco.eu | Year: 2013
Objective. The main goal of this review is to provide some answers about the best therapy of pregnant women with epilepsy and/or women with epilepsy taking oral contraception. Methods. We have collected information's concerning the problems that may arise before and after a pregnancy, involving the best therapeutically options for a pregnant woman. Results. Women with epilepsy have frequent menstrual disorders, reproductive endocrinological disturbances, ovulatory dysfunction and infertility, presenting a risk of contraceptive failure associated with some antiepileptic. Antiepileptic drugs have some side effects on pregnancy by increasing the rate of abortion, preterm labor and vaginal bleeding, especially in polytherapy. Pregnancy can affect the pharmacokinetics of antiepileptic drugs at any level from absorption, distribution, metabolism, and therefore we have showed a list of the most used antiepileptic and how they can affect a future pregnancy from conceiving until delivery and after. Conclusions. Epilepsy represents a sensible field in relationship with pregnancy that involves contraception, heredity and teratology, especially if we consider that the risk of a convulsive seizure to mother and child is frequently over weighted by a continued therapy.