Dr Carol Davila Clinical Central Military Emergency Hospital

Vadu Crişului, Romania

Dr Carol Davila Clinical Central Military Emergency Hospital

Vadu Crişului, Romania
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Rusu E.,Prof N Paulescu National Institute Of Diabetes | Rusu E.,Carol Davila University of Medicine and Pharmacy | Rusu E.,Healthy Nutrition Foundation | Jinga M.,Carol Davila University of Medicine and Pharmacy | And 23 more authors.
Nutrition Journal | Year: 2013

Background: In patients with chronic hepatitis C (CHC), obesity is involved in the pathogenesis of insulin resistance, fatty liver disease and progression of fibrosis. The objective of this study was to compare a normoglucidic low-calorie diet (NGLCD) with a low-fat diet (LFD) among participants with CHC. Aimed to measure the impact of dietary changes in reduction of insulin resistance, obesity but also in steatosis and fibrosis. Methods. Randomized, controlled trial in three medical centers with assessments at baseline, 6 months and 12 months. Participants were patients over 35 years with chronic hepatitis C (n = 120) with BMI over 25 kg/m§ssup§2§esup§. We evaluated the effects of NGLCD vs. LFD in weight management and metabolic improvement. The primary endpoint was to measure the impact of dietary changes through nutritional intervention in reversibility of insulin resistance, obesity, steatosis, and fibrosis. We performed anthropometric measurements, fasting glucose profile, serum lipids, liver profile, blood count at baseline, 6 and 12 months. Steatosis was evaluated using ultrasonographic criteria. Liver fibrosis was non-invasively assessed. Results: After 6 and 12 months of intervention, both groups had a significant decrease in caloric consumption. At 6 months, weight loss was greater in the NGLCD group (-5.02 ± 3.43 kg vs. -4.1 ± 2.6 kg; p = 0.002) compared to the LFD group. At 1-year, however, weight loss was similar in both groups (-3.9 ± 3.3 kg vs. -3.1 ± 2.6 kg; p = 0.139). At 12 months, fasting plasma glucose, fasting plasma insulin, and HOMA-IR had significant improvements in both groups. With both diets aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (GGT) decreased with significant differences; also there were significant improvements in AST/ALT ratio, Forns fibrosis index. The two diets were associated with reduction of both the prevalence and the severity of steatosis (all p < 0.001). At 12 months, total cholesterol, HDL-cholesterol, triglycerides improved in both groups (all p < 0.05). Conclusions: The present study establishes the benefits of low-calorie diet and low-fat diet in management of patients with hepatitis C regarding improvement of insulin resistance, steatosis and also fibrosis.Overweight or obese patients with CHC undergoing a lifestyle intervention (specific dietary intervention and physical activity) for 1-year had significant improvements in body weight, lipid and hepatic profile. Trial registration. PNCI2-3343/41008/2007. © 2013 Rusu et al.; licensee BioMed Central Ltd.

Rusu E.,Prof N Paulescu National Institute Of Diabetes | Rusu E.,Healthy Nutrition Foundation | Rusu E.,Carol Davila University of Medicine and Pharmacy | Radulian G.,Prof N Paulescu National Institute Of Diabetes | And 15 more authors.
Romanian Journal of Diabetes, Nutrition and Metabolic Diseases | Year: 2011

Aims: The aims of this study was to indentify independent predictive factors of liver steatosis in patients with hepatitis C and to examine the correlations between ultrasound-diagnosed HS and anthropometric, clinical, biochemical and sonographic measurements. Materials and methods: We included 173 patients with CHC. HS has a high prevalence in diabetes mellitus patients, and we considered patients with CHC and diabetes as a separate subgroup for analysis: 113 patients (54 men/59 women) with hepatitis C - group A and 60 patients (28 men/32 women) with hepatitis C and T2DM - group B. We performed anthropometric measurements (weight, height, BMI (body mass index), as well as laboratory analysis and ultrasonography. All patients signed an informed consent before inclusion in the study. Results: In all patients with CHC, in univariate analysis triglycerides, hypertension, MetS, HOMA-IR >2, T2DM, AST/ALT ratio >1, and BMI >30kg/m2 was associated with HS. Logistic regression analysis revealed five factors independently related with ultrasound-diagnosed HS: the triglyceride levels, hypertension, the BMI, AST/ALT ratio, and T2DM. Conclusions: This study revealed a high prevalence of ultrasound-diagnosed HS in patients CHC and CHC and T2DM. Identification of risk factor for HS has therapeutic importance, because targeted therapies might prevent the progression of HS to fibrosis and cirrhosis.

Nita D.,Dr Carol Davila Clinical Central Military Emergency Hospital | Chiriac L.,Dr Carol Davila Clinical Central Military Emergency Hospital | Cristian G.,Dr Carol Davila Clinical Central Military Emergency Hospital | Tintoiu I.C.,Dr Carol Davila Clinical Central Military Emergency Hospital
Romanian Review Precision Mechanics, Optics and Mechatronics | Year: 2012

Quantitative coronary angiography is a technique directly based on contrast coronary angiography and is commonly used to asses early and late results after percutaneous coronary intervention. It is used to calculate several parameters useful in objective assessment of coronary lesions (continuous end points such as minimal luminal diameter at follow-up, percent diameter stenosis, late loss etc are used to test new stenting methods). Late loss is an angiographic surrogate for neointimal proliferation and has a great importance for drug eluting stent trials. Likewise late loss and percent diameter stenosis are used as surrogates of clinical effectiveness in trials. Of a great interests for researche is the study of coronary bifurcation and the development of three-dimensional techniques.

Vittos O.,Medcenter | Vittos O.,Carol Davila University of Medicine and Pharmacy | Toana B.,Dr Carol Davila Clinical Central Military Emergency Hospital | Vittos A.,Medcenter | And 2 more authors.
Biomarkers | Year: 2012

Objective: To conduct a comprehensive, systematic review of studies assessing the significance of lipoprotein-associated phospholipase A2 in cardiovascular diseases (CVDs). Material and methods: A review of the literature was performed using the search term "Lipoprotein-associated phospholipase A2 (Lp-PLA2)" and each of the following terms: "cardiovascular risk," "cardiovascular death," "atherosclerotic disease," "coronary events," "transient ischemic attack (TIA)," "stroke," and "heart failure." The searches were performed on Medline, Google Scholar and ClinicalTrails.gov. Results: The majority of published studies showed a significant association between Lp-PLA2 levels and cardiovascular events after multivariate adjustment. The association was consistent across a wide variety of subjects of both sexes and different ethnic backgrounds. Conclusions: The role of Lp-PLA2 as a significant biomarker of vascular inflammation was confirmed, and Lp-PLA2 seems to be closely correlated to cardiovascular events. It may be an important therapeutic target and may have an important role in prevention, risk stratification and personalised medicine. © 2012 Informa UK, Ltd.

Rusu F.,Carol Davila University of Medicine and Pharmacy | Rusu E.,Carol Davila University of Medicine and Pharmacy | Radulian G.,Carol Davila University of Medicine and Pharmacy | Enache G.,Carol Davila University of Medicine and Pharmacy | And 6 more authors.
Acta Endocrinologica | Year: 2011

Aims. The aims of our study were to assess the prevalence of prostate tumors in patients with metabolic syndrome. Material and methods. Subjects were patients recruited from three medical centers in Bucharest, Romania. For this study we selected men over 45 years of age with metabolic syndrome. The anthropometric measurements included height, weight, waist circumference and hip circumference. We calculated the body mass index (BMI) and measured the blood pressure. Biochemical tests included fasting plasma glucose (FPG), HbA1c, total cholesterol (TC), TG, HDL-C, fasting plasma insulin (FPI), prostate-specific antigen (PSA) and free-PSA. The prostate gland volume was measured by transrectal ultrasound. The diagnosis of prostatic cancer was based on a positive finding of the histological examination obtained from 14-core biopsy. Results. There was a high prevalence of prostate tumors (benign and malignant) - 82.85% (n=343). Prostate cancer was diagnosed in 7.9% of patients (n=33) using DRE, PSA, free PSA/PSA ratio and TRUS. The prevalence of BHP was 74.9% (n=310). The results of the present study indicate that PSA detects a significant number of prostate tumors missed in DRE. The use of DRE, PSA and TRUS, in combination, provided the highest rate of detection of prostatic tumors in patients with metabolic syndrome without infectious diseases of the prostate. Conclusions. The prevalence of prostatic tumors, prostate cancer and benign prostatic hyperplasia in metabolic syndrome patients is high. Due to its increased prevalence, the BPH can be considered as a feature of metabolic syndrome.

PubMed | Dr Carol Davila Clinical Central Military Emergency Hospital
Type: Case Reports | Journal: Journal of medicine and life | Year: 2010

Urachus diseases represent a relatively rare kind of affliction in child or adult abdominal or urological surgical pathology. The preservation of the urachus lumen leads to rare afflictions, noticed mostly after birth or when they become clinically manifest by various complications. More often than not, these pathological entities require surgical interventions (if the urachal lumen does not close by itself), consisting of partial or total excision of the urachus. Tumor pathology is mostly malign, to a large extent represented by urachus adenocarcinoma. Its initial symptomatology is scarce and confusing. Its treatment is mainly by surgery and consists of the surgical excision of the urachal ligament, of the umbilicus, of a part of the front abdominal wall and partial or total cystectomy, as necessary. The prognosis is unfavourable, since urachal adenocarcinoma is deemed to be a particularly aggressive tumor, strongly influenced by the status of the excision edges, that is by the radicalness of the surgical intervention. Irrespective of the latter, an adjuvant oncological treatment is to be prescribed, mainly systemic cytostatic therapy. Urachus adenocarcinoma is rarely encountered and very often diagnosed in late metastatic stages, when the only solution is at most paleative surgery.

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