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Sorin Ioan Zaharie, Teodora Daniela Maria, Mirela Zaharie, Maria Moţa and Eugen Moţa

Abstract

Accurate measurement of blood pressure (BP) and evaluation of global cardiovascular risk is crucial for diagnosis and treatment of hypertensive patients. When hypertension and diabetes mellitus are associated, the risk for cardiovascular events is bigger than the sum of the components. Beyond systolic and diastolic BP values as targets for antihypertensive treatment, recent guidelines recognize BP variability as an independent predictor for future cardiovascular events. 24 hours ambulatory BP monitoring (ABPM) and home BP monitoring (HBPM) are two methods used in patient day to day life conditions for BP measurements. Increased variability of systolic and/or diastolic BP within one day (“short-term BP variability”) and also over longer periods (“long-term BP variability”) showed by ABPM and/or HBPM is associated with target-organ damage and cardiovascular events. This review is focused on the prognostic importance of BP variability in hypertensive patients with diabetes mellitus.

Open access

Corina Roman-Filip, Aurelian Ungureanu, Dan Filip, Eugen Radu and Ioan-Sorin Zaharie

Abstract

Creutzfeldt - Jakob disease (CJD) is a rare neurodegenerative disease caused by prions, characterized by a progressive dementia with rapid onset, psychiatric and neurologic symptoms (myoclonus, cerebellar, pyramidal, extrapyramidal and visual signs), with an invariable course to exitus. There are three general forms: sporadic or spontaneous, genetic or familial, and acquired form, including a variant form of CJD. The diagnosis can be confirmed only by histological examination of brain tissue, showing non-inflammatory spongiform changes and neuronal loss. We present the case of a 64 years old male who was admitted in our department for a rapidly progressive cognitive decline, hallucinations and myoclonus. Autopsy brain histology confirmed the diagnosis showing incipient spongiform vacuolization and astrogliosis. This paper illustrates a very rapid course of a sporadic CJD with discussion upon literature regarding the laboratory and pathology biomarkers of diagnosis.

Open access

Mirela - Nicoleta Tudor, Adina Mitrea, Simona Georgiana Popa, Sorin Zaharie, Maria Moţa and Eugen Mola

Abstract

Background and aims. Dyslipidemia (DLP) is a common complication of chronic kidney disease (CKD) and may accelerate its progression. Circulating lipoproteins and their constituent proteins, apolipoproteins, are risk factors for CKD and cardiovascular diseases (CVD). The aim of the study was to determine whether there is a correlation between apolipoproteins and estimated glomerular filtration rate (eGFR) or between apolipoproteins and anthropometrical and laboratory parameters or between evaluated cardiovascular risk (CV) and dyslipidemia/CKD. Material and methods. We performed a study on 51 subjects from the Nephrology Department of Emergency Clinical County Hospital of Craiova, from November 2011 to July 2013. Results. We found statistically significant correlations between eGFR and Apo A1. Also we found a linear correlation between C-reactive protein (CRP) and Apo B. When we evaluated the CV risk using CRP, we found statistically significant differences between the groups (CKD and DLP, only CKD, only DLP and control group), patients with CKD and DLP showing the highest levels of CRP. Conclusions. Elevated levels of Apo A1 are associated with a low rate of CKD. DLP and chronic inflammation play an important role in the progression of CKD. Patients with CKD and DLP had a high cardiovascular risk.

Open access

Iulia-Daniela Vladu, Daniela Cana, Cristina Vaduva, Corina Grauntanu, Sorin Zaharie, Raluca Dina, Ciprian Dina, Roxana Mustafa and Eugen Mota

Chronic Kidney Disease-Mineral Bone Disorder in Diabetes Mellitus Patients

Diabetes mellitus (DM) and chronic kidney disease (CKD) are two diseases with increasing prevalence and adverse outcomes that represent an international health problem. Chronic kidney disease- mineral and bone disorder (CKD-MBD) is defined as a systemic disorder of mineral and bone metabolism due to CKD manifested by either one or a combination of the following: abnormalities of calcium, phosphorus, PTH, or vitamin D metabolism; abnormalities in bone turnover, mineralization, volume, linear growth, or strength and vascular or other soft-tissue calcification. Disturbances in mineral and bone metabolism are prevalent in CKD and are an important cause of decreased quality of life, cardiovascular morbidity and mortality; these disturbances settle in earlier and have a more severe evolution in DM patients.