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Open access

Bogdan Timar and Oana Albai

Abstract

Background.Hyperglycemia is leading to serious chronic and acute complications in diabetes mellitus which are shortening and altering the patient’s life. Objective. The main purpose of the study is to investigate the correlation between HbA1c values and diabetic complications. Material and methods.The study enrolled 2120 diabetic patients, 1174 women (55.4%) and 946 men (44.6%), mean age 58.3 ± 12.3 years, living in Timisoara. Results.We observed the lowest incidence of chronic complications of diabetes mellitus for the group having HbA1c values lower than 6%. Chronic complications are increasing with the HbA1c value, with a significant threshold at 7 % (p<0.0001). Conclusions.Optimizing glycemic control is the key to prevent or delay the occurrence of severe chronic complications of diabetes mellitus, complications which can be significantly reduced by achieving the ADA recommended HbA1c target (<7%).

Open access

Oana Albai, Bogdan Timar, Deiana Roman and Romulus Timar

Abstract

Background and aims Diabetes mellitus (DM) is one of the leading causes of end-stage chronic kidney disease (CKD). Patients with DM and CKD have a 10 or even 20 times higher cardiovascular risk (CVR) than the general population. Lipid metabolism disorders are more frequent in these patients, dyslipidemia being aggravated by the presence of hyperglycemia and insulin resistance. The main purpose of our study was to identify possible correlations between lipid profile parameters and altered renal function in patients with DM. We have also analyzed the correlations between lipid parameters, CKD, quality of glycemic control and CVR.

Material and method: The study was performed on 2732 patients with DM which received medical treatment and care at the Center for Diabetes Timisoara, for a 6-month period from March to October 2016, 1508 women (55.2%) and 1224 men (44.8%), mean age 63.7 ± 9.1 (33-78) years and mean diabetes duration 12.4 ± 6.8 (6-33) years. The study group included 312 patients (11.4%) with T1DM and 2420 patients (88.6%) with T2DM.

Results: The prevalence of CKD (GFR< 60 ml/min) was 12.5%. The levels of total cholesterol (TC), triglycerides (TG) and LDLc were significantly higher in the case of patients with DM and CKD (p<0.0001). Patients with CKD had twice the prevalence of ischemic heart disease and cerebrovascular disease when compared to patients without CKD. Peripheral artery disease was present in 16.9% of those with CKD and in 11% of those without CKD. Hypertension (HTN) was present in 91.8% of patients with CKD and in 67.1% of patients without CKD (GFR > 60 ml/min).

Conclusion: Analyzed data showed a strong correlation between CKD, dyslipidemia and CVR in patients with DM. Impaired renal function was strongly correlated with age, duration of DM and weight status of these patients.

Open access

Oana Albai, Bogdan Timar, Laura Diaconu and Romulus Timar

Abstract

Objective: Despite the diversity of antidiabetic medication currently available, less than half of the patients with type 2 diabetes meet the therapeutic targets recommended by the guidelines: HbA1c <7%, or even <6.5%. This study aimed to investigate the efficacy and safety of sitagliptin in patients with type 2 diabetes mellitus, with inadequate glycemic control, as well as the effects on cardiovascular risk factors. Material and method: The study included 348 patients, 161 men (46.3%) and 187 women (53.7%), with mean age of 56.1 ± 6.2 years, who started treatment with sitagliptin, combined with either metformin, sulphonylurea or both. Results and discussions: Sitagliptin improved glycemic control reducing average HbA1c with 1.1%; the average weight decreased with 1.7 kg after 24 weeks of treatment, and the lipid profile improved significantly. Conclusions: Sitagliptin offers a new therapeutic option in patients with type 2 diabetes mellitus, with the advantage of a single dose oral administration.

Open access

Bogdan Almăjan-Guţă, Ornela Cluci, Alexandra Rusu and Oana Ciuca

Abstract

Traditionally, physiotherapy for cystic fibrosis focused mainly on airway clearance (clearing mucus from the lungs). This still makes up a large part of daily treatment, but the role of the physiotherapist in cystic fibrosis has expanded to include daily exercise, inhalation therapy, posture awareness and, for some, the management of urinary incontinence. The purpose of this study is to demonstrate the necessity and the efficiency of various methods of chest physiotherapy and individualized unsupervised exercise program, in the improvement of body composition and physical performance. This study included 12 children with cystic fibrosis, with ages between 8-13 years. Each subject was evaluated in terms of body composition, effort capacity and lower body muscular performance, at the beginning of the study and after 12 months. The intervention consisted in classic respiratory clearance and physiotherapy techniques (5 times a week) and an individualized unsupervised exercise program (3 times a week). After 12 months we noticed a significant improvement of the measured parameters: body weight increased from 32.25±5.5 to 33.53±5.4 kg (p <0.001), skeletal muscle mass increased from a mean of 16.04±4.1 to 17.01±4.2 (p<0.001), the fitness score, increased from a mean of 71±3.8 points to73±3.8, (p<0.001) and power and force also registered positive evolutions (from 19.3±2.68 to 21.65±2.4 W/kg and respectively 19.68±2.689 to 20.81±2.98 N/kg). The association between physiotherapy procedures and an individualized (after a proper clinical assessment) unsupervised exercise program, proved to be an effective, relatively simple and accessible (regardless of social class) intervention.

Open access

Alin Albai, Romulus Timar, Bogdan Timar, Corina Hogea, Adrian Vlad, Oana Sdic, Ilie Cristina and Oana Albai

Abstract

Background and aims: Pregnancy in women with type 1 diabetes mellitus (T1DM) is associated with increased risk of maternal and fetal complications. The aim of this study was to examine and to compare pregnancy outcomes between women with T1DM and a control group of non diabetic women. Material and method: The present study included all pregnancies in T1DM women followed at Diabetes Clinic, Emergency County Clinical Hospital, Timişoara, from 1990 to 2010. Results: We found a relative risk of spontaneous abortions of 1.85 (95%CI 1.01-3.39; p=0.05) and a relative risk of major congenital malformations of 4.32 (95%CI 1.55-12; p=0.005) in T1DM pregnancies compared to the control group. We also observed that the rate of stillbirth was more frequent in type 1 diabetic pregnancies (p=0.02). The offspring of T1DM women were more likely to be delivered preterm (32%) compared with the control group (9.5%). The relative risk of preterm delivery was 3.38 higher (95%CI 2.93-5.6; p<0.0001) in T1DM pregnancies compared with non diabetic mothers. There was a statistically significant difference in the proportion of macrosomic offspring between T1DM (17.3%) and non diabetic mothers (6.5%) Conclusions: The present study demonstrated that pregnancy outcome and perinatal complications are still high in T1DM pregnancies.

Open access

Oana Arcan, Alin Ciobica, Walther Bild, Bogdan Stoica, Lucian Hritcu and Dumitru Cojocaru

Summary

It has already been demonstrated that a complete brain renin-angiotensin system (RAS) exists distinctly separate from the peripheral system and is implicated in complex functions such as memory, emotional responses and pain. Regarding the implications of angiotensin II (the main bioactive peptide of RAS) in pain, although there are many studies in this area of research, most of the results are controversial. Also, it seems that oxidative stress follows angiotensin II infusion, but the role of AT1 vs. AT2 receptors is not well established. In this context, we were interested in studying the effects of central RAS on nociception, through the intracerebroventricular administration of losartan and PD-123177 (antagonists for the AT1/AT2 receptors), as well as an ACE inhibitor (captopril) and also angiotensin II in rats, which were subsequently tested using the hot-plate task, a well known behavioral test for pain perception. We present here the analgesic effect of angiotensin II administration, as shown by in creased latency-time in the hot-plate, as well as a nociceptive effect of angiotensin II blockers like AT1 and AT2 specific antagonists (losartan and PD-123177) and an ACE inhibitor (captopril), as their administration resulted in decreased latency-time. Moreover, we demonstrated a significant correlation between the results of the nociceptive behavioral task and the levels of some main oxidative stress markers. This provides additional evidence for an analgesic effect of Ang II administration, as well as for a nociceptive effect of Ang II blockers. Moreover, a significant correlation between the nociception and angiotensin II-induced oxidative stress is presented.

Open access

Oana Bogdan, Dorel Mateş, Aura Emanuela Domil, Marina Adriana Puşcaş, Ancuţa Puşcaş and Ramona Teşu

Abstract

Through this paper, we want to identify the correlations between the benefits and costs of adopting IFRS standards in construction entities in the Western Region of Romania and their performance, using the Pearson correlation coefficient, which measures and describes the direction, degree and form of the association between two variables, thus obtaining high, reasonable, weak and very weak links between the benefits / costs and the performance of the entity.

The tool used in the research undertaken by construction companies is the questionnaire.

The questionnaire “On the Costs and Benefits of IFRS in Construction Companies in the Western Region of Romania” was disseminated among professional accountants in order to identify the perceptions of economists operating in construction companies in the Western Region Romania on the costs and benefits of implementing international standards. Thus, through this paper we aim to identify the correlations between the following benefits and costs:

  • - Benefits of implementation: comparability of information, increased transparency, increased access to capital, cost savings, reduction of informational asymmetry,

  • - Implementation costs: IFRS readiness level, complexity of standards, link between accounting and taxation, existing accounting tradition, costs associated with IFRS conversion, and

  • - Performance of the entity viewed from the perspective of: total revenue and turnover. In the research, we chose to present the analysis of compared to both the total revenues and the turnover, because the difference between the two economic-fiscal indicators is mainly represented by the financial revenues and the incomes from the disposals of assets.

Open access

Alin Albai, Viorel Șerban, Romulus Timar, Adrian Vlad, Bogdan Timar, Cristina Ilie and Oana Sdic

Abstract

Background and aims: A precarious glycemic control in the first 10 weeks of pregnancy, the period defining organogenesis, increases the risk of pregnancy loss. The aim of this study was to estimate the relationship between pregnancy loss and HbA1c values in early pregnancy in type 1 diabetic women.Material and method: The present study included all pregnancies in type 1 diabetic women followed at Diabetes Clinic, Emergency County Clinical Hospital, Timişoara, from 1990-2011. Results: The risk of pregnancy loss was significantly increased compared with the background control group. In our study the relative risk of pregancy loss increased when HbA1c exceeded 6.5%. We found a consistent increasing risk with stepwise increasing levels of HbA1c. Conclusions: A better glycemic control in this period and throughout the pregnancy could reduce the risk of severe adverse outcomes in type 1 diabetic pregnancies.