Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disease in humans. It is a multisystemic disorder characterized by progressive cystic dilatation of both kidneys, with variable extrarenal manifestations in the gastrointestinal tract (hepatic cysts), cardiovascular system, reproductive organs and brain. An important issue of patients with hepatorenal cystic disease is the fact that complications can arise due to the growing of the cysts: local kidney complications (intracystic infection, intracystic hemorrhage) and local liver complications (portal hypertension as a result of portal vein compression by cysts, bile duct compression, ruptures and bleedings of the cysts, obstruction of the liver veins).
Objective: The main purpose of our case presentation is to emphasize the fact that ADPKD can be an aggressive disease with multiple complications, which requires an early diagnosis in order to properly avoid possible complications.
Material and Method: We present the case of a 61 years old male, known with polycystic hepatorenal disease, chronic kidney disease (CKD) in chronic hemodialysis since 2010, renal hypertension, hypertensive cardiomyopathy, renal anemia and stage 1 chronic lymphatic leukemia. The patient was diagnosed with hepatorenal polycystic disease 20 years ago and 9 years ago he started undergoing renal replacement therapy by hemodialysis. Three months ago, the patient presented a suddenly installed ascitic syndrome for which an MRI was performed. The imagistic investigation revealed multiple kidney and liver cysts, with secondary compression of the portal vein and a tumoral mass that may suggest an adenocarcinoma.
Results: The investigations performed confirm the diagnosis of portal hypertension secondary to compression due to cystic formations.
Conclusions: Hepatorenal polycystic disease has numerous clinical variations, so it needs to be followed in a multidisciplinary way with rapid therapeutic measures to prevent complications. Further investigations are needed when dealing with suspicious cystic formations with an uncertain substrate.
Obesity, metabolic syndrome, prediabetes and dislipidemia are the major risk factors for developing type 2 diabetes and posible severe complications which can decrese quality of life and increase population mortality.
Due to its epidemic characteristic and high costs of care, diabetes became a major health problem around the world.
It is compulsory to know epidemiological data and possible evolution of diabetes to ensure rational health policies among risk population.
The Metabolic syndrome (MetS) is considered as an association of the abdominal obesity, abnormal metabolism of the lipids and glucose (high level of triglycerides, low level of HDL-cholesterol and high level of glycemia) and high values of blood pressure, determined by an underlying mechanism of insulin resistance. As a result of environmental-gene interaction, MetS is associated with unhealthy nutrition, smoking, alcohol abuse, lack of physical activity, shorter sleep duration and desynchronization of the circadian rhytm caused by working in shifts. The aim of this article is to review the effects of working in shifts on the MetS through the epidemiological evidence and the perspective of the physiopathological mechanisms.
Down Syndrome/Trisomy 21 is the most common chromosomal anomaly, and it represents the most common congenital cause of infants’ intellectual disability. Subjects with this syndrome are affected by degenerative processes caused by accelerated aging or unknown ethyologies. In recent years, accumulating evidence revealed increased potential of amniotic fluid-derived stem cells to be used in regenerative therapy. Our aim was to assess differences in immunophenotype, cell morphology and proliferation of amniotic fluid cells from normal and Down Syndrome pregnancies using a quantitative cytometry approach. Results revealed the emergence of a population of small sized cells in Down Syndrome derived amniotic fluid cells that are readily visible upon microscopic inspection. Hence, the fluorescence–based quantitative image cytometry determinations showed a tendency of decrease in both cell and nuclei size in trisomy, with no significant modification in nuclei circularity, as measured following actin cytoskeleton and nuclei labeling. The propensity of Ki67 positive cells was found to be increased in Down Syndrome derived cells (48.92%) as compared to normal specimens (28.68%). However, cells in S and G2/M cell cycle phases decreased from 32.91% to 4.49% in diseased cells. Further studies are devoted to understanding the molecular basis of the observed differences in the proliferation ability of Down Syndrome amniotic cells, in order to evaluate the potential therapeutic effect of amniotic fluid stem cells for tissue regeneration in subjects with trisomy and to find correlations between amniotic cells phenotype and patient prognosis.
The complications, especially those affecting microcirculation, exhibit great importance in the assessment and follow-up of patients with diabetes mellitus. Blood viscosity plays its most important role in the microcirculation where it contributes significantly to peripheral resistance and may cause sludging in the post capillary venules. The effect of whole blood viscosity in patients whit diabetic nephropaty is still unclear.
The aim of this study was to examine the influence of glicaemic control measured by glicated hemoglobin on rheological parameters, and especially on whole blood and plasma viscosity in patients with diabetic nephropaty. Blood viscosity is an important determinant of local flow characteristics. Blood exhibits shear thinning behavior: its viscosity decreases exponentially with increasing shear rates.
Estimation of whole blood and plasma viscosity was made on 42 patients, comparing different stages of diabetic nephropathy and with different values of glicated hemoglobin.
Depression of the regulatory mechanisms of microvascular blood flow as well as decreased tissue perfusion indicated the restricted blood flow in microcirculatory network in diabetic nephropathy. In conclusion blood viscosity was elevated in the patients with major organ complications and not in the patients without or with early complications, in correlation with poor glicaemic control.
Diabetic nephropathy is the major cause of severe renal impairment and even chronic terminal renal failure requiring dialysis. Blood viscosity is clearly modified in diabetic patients, and particularly in those with severe renal impairment
The purpose of this study is to highlight blood viscosity values at different shear rates in patients with diabetic nephropathy compared to the control group.
There is a significant increase in blood viscosity in patients with definite renal impairment.
Patients with multiple trauma with thoracic trauma have higher death rates compared to multiple trauma patients without thoracic trauma, mainly because of cardiac injury. We investigated the 24 hours prognostic value of NT-proB-type Natriuretic Peptide (Nt-ProBNP) in polytraumatised patients with thoracic trauma.
The study group was composed of 33 patients, 25 males and 8 females. During the study, the endpoint, which was death in the first 24 hours after admission was observed in 33% of the patients (11 patients).
Using a cut-off point of 125 pg/ml, the sensitivity of the test was 100% and the specificity was 59.09%. Accoring to the results of the study, NT-ProBNP proves that it might be useful in detecting patients with a bad prognosis, the analyzed enzyme having the capacity of identifying polytrauma patients with thoracic trauma that have high risk of death in the first 24 hours after admission.
Polytrauma patients represent one of the most challenging medical conditions. Developing methods of assessing the risk of death in these patients is a continous effort for the medical field. In this study we evaluate the creatine kinaze isoenzyme MB (CK-MB) and troponin as markers of increased risk of death in the first 24 hours after admission in polytrauma patients with associated thoracic trauma.
The study was conducted on 33 patients treated in the emergency department of County Clinical Emergency Hospital Constanta between 2014 and 2017.
The results of the study suggest that CK-MB does not offer additional information related to the risk of death in these patients, while in the case of troponin, higher values were observed in the patients that didn’t survive after 24 hours of followup.
Multiple sclerosis is a chronic demyelinating and inflammatory disease affecting the central nervous system. The etiology is unknown. The risk of MS is influenced by genetic and environmental factors. One environmental factor for MS is vitamin D deficiency. (1)
The connection between multiple sclerosis, and vitamin D levels is not completely known.
According to many studies, subjects with insufficient vitamin D intake or low 25- OH vitamin D concentration are at higher risk for MS. The fact that vitamin D is implicated in the course of MS is indicated by the indirect correlation between vitamin D concentration and the activity of the disease, revealed by many studies. (3)
In this study we intend to determin how the concentration of 25-OH vitamin D is correlated with relapsing remitting multiple sclerosis.
The study aims to analyze the health effects caused by chronic exposure to elevated levels of nitrates in the water in order to improve prevention of some diseases. We analyze water quality from two villages of Constanta County in the period 2006-2012 and we take data about chronic diseases from family doctors of these localities. Analyzes on water samples were made in the laboratory of the Public Health Department. We found a significant increase of prevalence for chronic diseases in locality exposed to nitrates.