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Isabela Popa, Diana Protasiewicz, Cristina Muntean, Simona Georgiana Popa and Maria Mota

Abstract

Phisical activity, regularly performed, give us a lot of health benefit, especially in preventing cardiovascular disease, diabetes mellitus (DM) and obesity. Physical exercise, defined as a controlled, progressive, supervised, requires muscular activity, involving energy consumption through metabolic and thermoregulatory processes. It can be classified as aerobic and anaerobic, according to the metabolic processes that take place. The metabolic equivalent (MET) represents the body’s energy consumption during rest and it is used for quantifying fhisical activity (for example, a MET value of 3 would require 3 times the energy that is consumed at rest). Muscle contraction has two different phases: the isometric one (usually during the first part of the contraction) and the isotonic one. This article presents the interrelation of phisical activity with with the complexity of metabolic patwais, bringing the arguments for the necessity of performing regular and controlled phisical activity.

Open access

Adela-Gabriela Firănescu, Adina Popa, Maria-Magdalena Sandu, Diana Cristina Protasiewicz, Simona Georgiana Popa and Maria Moţa

Abstract

Diabetes Mellitus (DM) and Tuberculosis (TB) are two chronic diseases which have a major impact on the population health in developing countries. DM is a chronic, noncommunicable disease, characterized by hyperglycemia, caused by insulin-resistance, inadequate insulin secretion or both. TB is a disease caused by Mycobacterium tuberculosis, an airborne bacteria. DM implies a three times greater risk of developing TB and their association can be considered one of the most important challenges regarding TB control. TB can cause a temporary impaired glucose tolerance, which is a risk factor for DM development. The possibility of relapse or death of a patient with TB is significantly higher when the patient also has DM. The DM-TB association represents an important threat to the population health and requires the implementation of adequate programs in order to reduce the prevalence and incidence of the two diseases.

Open access

Simona Popa, Cristina Văduva, Maria Moţa and Eugen Moţa

Abstract

Background and Aims. Peritoneal dialysis (PD) is accompanied by a multitude of factors that influence glycemic variability, and HbA1c does not detect dynamic glucose changes. In this study we wanted to assess glycemic variability, using a 72-hour continuous glucose monitoring system (CGMS), in 31 patients stratified according to the presence of type 2 diabetes and PD. Materials and Methods. The study included 31 patients (11 type 2 diabetic PD patients, 9 non diabetic PD patients and 11 type 2 diabetic patients without PD). Glycemic variability was assessed on CGM readings by: Mean Amplitude of Glycemic Excursion (MAGE), Mean of Daily Differences (MODD), Fractal Dimensions (FD), Mean Interstitial Glucose (MIG), Area Under glycemia Curve (AUC), M100, % time with glucose >180/<70 mg/dl. Results. The PD diabetic patients presented AUC, MIG and inter-day glycemic variability (MODD) significantly higher than diabetic patients without PD. In PD patients, the type of dialysis fluid in the nocturnal exchange and peritoneal membrane status did not significantly influence glycemic variability. Conclusions. CGMS is more useful than HbA1c in quantifying the metabolic imbalance of PD patients. PD induces inter-day glycemic variability and poor glycemic control, thus being a potential risk factor for chronic complications progression in diabetic patients.

Open access

Cristina Căldăraru, C. Popa, Ana Fruntelată and Ş. Bălănescu

Abstract

Management of antithrombotic therapy in elderly patients with unstable atherothrombotic disease and increased risk of bleeding is a major clinical challenge. We report the case of a 79 year-old diabetic man with rheumatoid arthritis on both oral corticosteroids and NSAID therapy with mild renal dysfunction, who presented to our hospital because of disabling claudication. Prior to admission he had several episodes of TIA. He also had recurrent small rectal bleeding and mild anemia attributed to his long-standing hemorrhoid disease. Angiography showed a sub-occlusive left internal carotid artery stenosis associated with a significant LAD stenosis and complex peripheral artery disease. Cataclysmic bleeding and hemorrhagic shock occurred in the third day post admission. Withdrawal of all antithrombotic treatment, blood transfusion and emergency sigmoidectomy were performed for bleeding colonic diverticulosis. Subsequently antiplatelet therapy was reinitiated and the patient successfully underwent left carotid artery endarterectomy and LAD stenting. He was discharged from hospital on the 21st day post admission and is doing well at 24 months follow-up.

Open access

Cornelia Nitipir, Ana Maria Popa and Cristina Orlov-Slavu

Abstract

Giant cell tumors of the bone are tumors whose malignant character has long been debated. Lung metastases have been reported in some cases. They usually represent osteolytic, locally aggressive bone tumors for which surgery is the standard of care. Denosumab is the most effective systemic treatment in these cases, but both the timing and the duration are a matter of debate. The aim of this short review was to describe the most important trials that treated patients with this drug and to discuss both advantages and long-term toxicity. It can be concluded from the presented data that the choice of adding denosumab in the treatment sequence of giant cell tumor of the bone has to be taken in a personalized manner for each patient.

Open access

Diana Cristina Protasiewicz, Adina Popa, Maria-Magdalena Roşu, Adela-Gabriela Firănescu, Simona Georgiana Popa and Maria Moța

Abstract

Humans spend almost one third of their life sleeping, thus sleep deprivation or poor sleep quality will have consequences upon the quality of life. Obstructive sleep apnea (OSA) is the most common sleep disorder that represents a respiratory cessation for at least ten seconds, which appears repeatable during sleep and it is accompanied by decreased oxygen saturation. The diagnosis of OSA is possible by filling in the STOP, STOP BANG, BERLIN questionnaires and performing the polysomnography, an accessible and more accurate method but yet very expensive. The prevalence of OSA is continuously increasing, but because of the nonspecific symptoms, the percentage of un-diagnosed cases is further increased. Data from 11 epidemiological studies published between 1993 and 2014 indicated an OSA prevalence of 22% in men and 17% in women. It has been suggested that there is a bidirectional causal relationship between OSA and obesity, and numerous studies have shown association of OSA with insulin resistance, diabetes mellitus, diabetic micro- and macrovascular complications and atrial fibrillation.

Open access

Irina Gradinariu, Ioan Stirbu, Cristina Gheorghe, Nicanor Cimpoesu, Maricel Agop, Ramona Cimpoesu and Cristina Popa

Abstract

An implantable material based on titanium (Ti6Al4V) was sandblasted in order to be deposited with a thin film of hydroxyapatite. Two samples of the alloy, in a shape of a bar with 10 mm diameter and 20 mm length, were subjected to mechanical treatment. After deposition of the hydroxyapatite through electrophoresis process, the samples were analyzed by scanning electron microscopy. The nature and chemical properties of thin films formed on Ti-based substrate were investigated with electrochemical impedance spectroscopy based on the extremely high polarization resistance of the material. The results revealed the formation of a homogeneous layer on the surface of the metallic substrate. The layer composed of TiO2 and hydroxyapatite provided a high corrosion protection.

Open access

Cristina Văduva, Simona Popa, Maria Moţa and Eugen Moţa

Abstract

Background and Aims. In diabetic patients, chronic kidney disease (CKD) requires special attention due to the multitude of factors that determine glycemic variability. We aimed to assess glycemic variability in patients with CKD and type 2 diabetes mellitus (T2DM) using a continuous glucose monitoring system (CGMS) and identify the predictive value of inter-day and intra-day glycemic variability indices for metabolic imbalance. Material and method. We included 20 diabetic patients (10 CKD patients/10 patients without CKD) and 10 healthy volunteers. Anthropometric parameters, glycated hemoglobin (HbA1c), and glycemic variability indices on CGMS readings were registered. Results. CKD diabetic patients presented significantly higher inter-day and intra-day glycemic variability compared to the diabetic patients without CKD. HbA1c was not significantly different between diabetic subjects with/without CKD. ROC curves indicated that just some CGMS parameters had higher predictive value for metabolic imbalance (HbA1c≥6.5%) but only the percentage of time with glucose values>180 mg/dl (p=0.024) was an independent predictor for HbA1c≥6.5%. Conclusions. Subjects with CKD and T2DM had poor glycemic control and significantly higher glycemic variability comparative to those without CKD, and especially to healthy volunteers. Assessment of glycemic variability indices is more accurate than HbA1c for the quantification of glycemic control in CKD diabetic patients

Open access

Cristina Muntean, Maria Mota, Simona Popa and Adina Mitrea

Abstract

Central nervous system, mainly the hypothalamus and the brainstem are important keys in glucose homeostasis. Not only do they use glucose as primary fuel for their functioning but they are part of intricate neuronal circuits involved in glucose uptake and production as was first shown by Claude Bernard. Moreover electrophysiological analysis of hypothalamus revealed the existence of glucosensing neurons whose firing rates are controlled by glucose extracellular level. Further information was obtained regarding the importance of leptin, insulin and free fatty acids as afferent signals received by these neural structures. As for the main efferent pathways, autonomic system is the one connecting CNS with the effector organs (the liver, the pancreas and the adrenal glands).

Open access

Adela-Gabriela Firănescu, Adina Popa, Maria-Magdalena Roşu, Diana Cristina Protasiewicz, Simona Georgiana Popa, Mihai Ioana and Maria Moța

Abstract

Worldwide, tuberculosis (TB) is a major cause of morbi-mortality, about 30% of the population having a Mycobacterium tuberculosis infection. Patients with diabetes mellitus (DM) have a threefold increased risk of developing the disease. The prevalence of DM is rapidly increasing, especially in countries with low and middle income, where TB incidence is also increased, thus baffling the efforts for TB control. The DM-TB co-epidemic is more frequent in married, older men, with reduced level of education, low income, without a steady job, with lifestyle habits such as alcohol consumption, smoking, sedentarism, living in an urban environment, in crowded areas, in insanitary conditions. These patients have a higher body mass index (BMI) compared with those without DM and frequently present family history of TB, family history of DM, longer duration of DM and reduced glycemic control. TB associated with DM is usually asymptomatic, more contagious, multidrug resistant and is significantly associated with an increased risk of therapy failure, relapse and even death. Thus, the DM-TB comorbidity represents a threat to public health and requires the implementation of urgent measures in order to both prevent and manage the two diseases.