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Biomedical subjects

C Pop

Publications and source records attributed to C Pop.

At least 19 recordsLinked to original sources
PubMed2004

Epidemiology of acute myocardial infarction in Romanian county hospitals: a population-based study in the Baia Mare district.

UNLABELLED: The epidemiological characteristics, the methods used in treating the patients, as well as the evolution of the myocardial infarction are not known in the Romanian county and municipal hospitals. MATERIAL AND METHODS: Six hundred and fifty one cases of acute myocardial infarction were retrospectively recorded in the Emergency County Hospital of Baia Mare from 1.01.1999 till 30.09.2003. Data on treatment delay, therapeutic strategies, duration of hospitalization and outcome were collected. The study was completed by a postal investigation which was carried out from the 1st of October until the 31st of December 2003. This investigation consisted in one application form (multiple choice answers were requested) which had been handed out to the patients who survived the acute episode and left the hospital. RESULTS: The first medical care took place for 60.9% of the patients in hospital. About 72% of these patients were male and the mean age was 66 +/- 12 years. The types of myocardial infarction with ST-segment elevation STE-MI represented 67%, followed by 29.5% with no ST-segment elevation NSTE-MI, and 3.5% with undetermined ECG. The maximum values of Killip class during the first 48 hours were: I in 55% of the patients, II in 23%, III in 14% and IV in 9% of them. The thrombolytic therapy was done in 31% of the patients who were recommended to receive a reperfusion treatment. During their first period in hospital, 37% of the patients had an effort test and 2.45% were transferred to a tertiary care hospital for invasive procedures. The overall median hospital stay was 9 days. The mortality in hospital was 13.6%, respectively 8.1% in the study group who received the reperfusion therapy and 15.2% among those who had followed the standard care. The results of the mail survey revealed that only 62% of the patients who answered the questionnaire (N=498) had regular cardiologic check ups and 43% underwent a treatment with beta-blockers and 12% a treatment with statins. Out of these patients 16% had a revascularization procedure that was performed in a specialised University Hospital. The overall mortality in the responder group was 35.5% with an estimate 7.5% year rate. CONCLUSIONS: The analysis of the present data and especially the rate of mortality suggest until two times higher values in comparison to the European average. These results demonstrate the fact that it is imperative to generalize the thrombolytic therapy in all the hospitals in Romania and give a wider access to the myocardial revascularization therapies.

Aged↗
PubMed2001

Removal of the pro-domain does not affect the conformation of the procaspase-3 dimer.

We have investigated the oligomeric properties of procaspase-3 and a mutant that lacks the pro-domain (called pro-less variant). In addition, we have examined the interactions of the 28 amino acid pro-peptide when added in trans to the pro-less variant. By sedimentation equilibrium studies, we have found that procapase-3 is a stable dimer in solution at 25 degrees C and pH 7.2, and we estimate an upper limit for the equilibrium dissociation constant of approximately 50 nM. Considering the expression levels of caspase-3 in Jurkat cells, we predict that procaspase-3 exists as a dimer in vivo. The pro-less variant is also a dimer, with little apparent change in the equilibrium dissociation constant. Thus, in contrast with the long pro-domain caspases, the pro-peptide of caspase-3 does not appear to be involved in dimerization. Results from circular dichroism, fluorescence anisotropy, and FTIR studies demonstrate that the pro-domain interacts weakly with the pro-less variant. The data suggest that the pro-peptide adopts a beta-structure when in contact with the protein, but it is a random coil when free in solution. In addition, when added in trans, the pro-peptide does not inhibit the activity of the mature caspase-3 heterotetramer. On the other hand, the active caspase-3 does not efficiently hydrolyze the pro-domain at the NSVD(9) sequence as occurs when the pro-peptide is in cis to the protease domain. Based on these results, we propose a model for maturation of the procaspase-3 dimer.

Caspase 3↗
PubMed2001

[Stress cardiomyopathy: report of 2 cases].

The authors reported two cases of acute catecholamines cardiomyopathy expressed clinically by chest pain and dyspnea, without any previous cardiac history. The diagnosis of human stress cardiomyopathy is established on: typically rapid onset aftermath of intense emotional stress, left ventricular apical akinesis and hyperkinetic motion of basal walls imaged by two-dimensional echocardiography. Rapid reversal clinical course and normal coronary arteriography. Similar finding have been observed in conjunction with pheochromocytoma who have been excluded by normal levels of urinary catecholamines metabolites.

Cardiomyopathies↗
PubMed2000

[Reversible pulmonary hypertension in Basedow's disease].

BACKGROUND: An association between pulmonary hypertension and hyperthyroidism has been described. An autoimmune mechanism is usually advocated but a direct effect thyroid hormones on the pulmonary vascular system is also suggested. CASE REPORT: A 49-year-old woman with a history of Graves' disease was admitted for sudden dyspnea. There was no evidence of ischemic stroke and the electrocardiogram and cardiac enzymes were normal. The lung scintiscan did not show any sign of pulmonary embolism. The chest computed tomography was normal. Doppler echocardiography found pulmonary hypertension with systolic pulmonary artery pressure of 68.7 mmHg. Thyroid function tests showed hyperthyroidism with recurrent Graves' disease. Pulmonary hypertension markedly decreased after the euthyroid state was achieved with antithyroid therapy. DISCUSSION: This patient had pulmonary hypertension associated with hyperthyroidism due to Graves' disease. The rapid reversibility of pulmonary hypertension in this case after the achievement of the euthyroid state suggest a pathogenic link between these two disorders and a possible direct effect of thyroid hormones on the pulmonary vascular system.

Antithyroid Agents↗
PubMed1999

[Dobutamine doppler echocardiography in severe aortic stenosis with left ventricular dysfunction. Comparison with postoperative examination].

The association of left ventricular dysfunction with aortic stenosis worsens the spontaneous prognosis and increases operative mortality. The aim of this prospective study was to assess the predictive value of dobutamine Doppler echocardiography on the indices of left ventricular contractile function in patients with aortic stenosis and left ventricular dysfunction (LVEF < 0.45) undergoing aortic valve replacement. Eighteen patients, including 9 with coronary artery disease, were included in a protocol consisting of analysis of left ventricular function and of the severity of aortic stenosis before, during dobutamine infusion, and after valvular replacement. The dobutamine was given in progressive increments of 5 micrograms/Kg up to a maximum of 20 micrograms/Kg. During pharmacological stress, the functional aortic valve area increased from 0.46 +/- 0.15 to 0.56 +/- 0.23 cm2. Tolerance of the procedure was good. All but 2 patients improved their postoperative ejection fraction with values equivalent to those observed during the last increment of dobutamine (r = 0.73; p < 0.003). The patients with initial mean pressure gradients > 50 mmHg normalised their LVEF after valve replacement. The authors conclude that dobutamine echocardiography is useful for predicting the values of postoperative left ventricular contractile indices when severe aortic stenosis is associated with systolic dysfunction. It allows evaluation of the expected short term benefits to these indices after aortic valve replacement.

Adult↗
PubMed1998

[Postpartum myocardial infarction induced by Parlodel].

The authors report the case of a 28 year old woman who developed antero-septoapical myocardial infarction in the post-partum period. This was detected by surface ECG and echocardiography performed after a systemic embolism. The infarction followed treatment with Parlodel for inhibition of lactation. Coronary angiography, performed one month post-partum, was normal and the methergin test was negative. The physiopathological mechanism of myocardial infarction resulted from the association of an iatrogenic spastic phenomenon favourised by the patient restarting to smoke and the physiological arterial hyperactivity of the post-partum period. This mechanism raises the question of preventive measures in cases of inhibition of lactation in the post-partum period, notably stopping smoking.

Adult↗
PubMed1997

Ventricular fibrillation in preconditioned pig hearts: role of K+ATP channels.

ATP-dependent potassium (K+ATP) channels play a role in the infarct size-limiting effect of preconditioning in pigs. We previously demonstrated that preconditioning shortens monophasic action potential duration (MAPD) and accelerates the time to ventricular fibrillation (VF) during a prolonged ischemia in pigs. We sought to determine whether the mechanism of the reduced time to VF in preconditioned pigs is a consequence of K+ATP, channel activation. Pigs underwent 40 min of coronary occlusion and 2 h of reperfusion. Before this, animals received either no intervention (control), 10 min of ischemia and 10 min of reperfusion (preconditioned), or an intravenous infusion of nicorandil, a K+ATP channel opener. Additional control, preconditioned, and nicorandil-treated pigs were pretreated by glibenclamide, an antagonist of K+ATP channels. Because 1) the K+ATP channel activator nicorandil did not produce shorter time to VF, 2) the K+ATP channel inhibitor glibenclamide did not block the acceleration of VF by preconditioning, and 3) there was no relationship between time to VF and infarct size or MAPD, the major conclusion is that reduced time to VF in preconditioned animals is not a consequence of K+ATP channel activation.

Action Potentials↗
PubMed1995

The risk of infective endocarditis after cardiac surgical and interventional procedures.

The risk of infective endocarditis after cardiac surgery relates mainly to the risk of infective endocarditis on prosthetic valves. The frequency of prosthetic infective endocarditis varies according to the criteria used in the literature, ranging from 0.4 to 1.3% for early infective endocarditis, with an annual linear risk of late infective endocarditis of 0.5%. This figure seems to be independent of either the type or the location of prostheses, but it does nevertheless increase if more than one valve has been replaced. The most commonly isolated microorganisms in early infective endocarditis are staphylococci. The bacteriological findings in late prosthetic infective endocarditis are similar to those seen in the native disease. The portal of entry is more easily identified in early than in late infective endocarditis (50%). The risk of infective endocarditis in surgically treated congenital heart disease is very low when the patient has a left-to-right shunt or valvar stenosis; it increases amongst patients with tetralogy of Fallot and patients with complex cyanotic congenital heart disease, mainly when there is a residual ventricular septal defect or prior palliative surgery. The risk of infective endocarditis in patients with intracavitary electrodes such as pacemakers and defibrillators, after the interventional procedure itself and after heart transplant, is very low. This leads us to conclude that antibiotic prophylaxis is only warranted in those patients with a prosthetic valve and after surgical treatment of tetralogy of Fallot and other complex cyanotic congenital heart diseases.

Cardiac Surgical Procedures↗
PubMed1993

[Risk of bacterial endocarditis after cardiac surgery].

The risk of infective endocarditis (IE) after intracardiac surgery is dominated by the risk of IE on valvular prostheses. The reported prevalence of IE on prosthetic valves varies according to the chosen diagnostic criteria of IE and its timing. The risk of early IE is 0.4 to 1.3% and the linearized annual risk of late IE is about 0.5%. These values appear to be identical irrespective of the type and site of the prosthesis: the risk is higher in multiple valve replacement. In early IE, the commonest infecting organism is the staphylococcus: the bacteriological spectrum of late IE is the same as that of IE on native valves. The portal of entry is often detected in early IE but more rarely (50%) in late IE. The risk of IE in operated congenital heart disease is very low after surgery of left-to-right shunts or valvular stenosis; it is higher for patients with Tetralogy of Fallot and those with complex cyanotic disease, especially in cases with residual ventricular septal defects and with palliative surgery such as systemico-pulmonary anastomosis. The risk of IE on endocavitary catheters (pace-maker, defibrillator) after interventional cardiac procedures and after cardiac transplantation, seems to be very low. These results show that preventive measures against IE are only routinely required in prosthetic valve patients and after surgery of Tetralogy of Fallot and complex cyanotic cardiac disease.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Clinico-tomographic correlations in acute pancreatitis].

In the surgery ward from Baia Mare, in the period 1989-1997 have been operated yearly, on an average, 16-17 acute pancreatitis, out of which 8-9 were necrotic-haemorrhagic acute pancreatitis. The possibility of carrying out the computerized tomography allowed a more precise pre-surgery diagnosis and after surgery was improved observation of evolution of the inflammatory phenomena from the pancreatic zone so that the volume, the structure and the outline of the pancreas, the abdominal or pleural liquid collections and the aspect of the neighboring tissues have been correlated in dynamics, with the clinic aspect of the acute pancreatitis and the prognostic indexes. Even if the computerized tomography allowed a more correct evaluation of the patients suffering of acute pancreatitis, there have been 4-6 decreases due to this affection and its complications, the post-surgery death rate remaining at 17-21%.

Acute Disease↗
PubMedDate not supplied

Primary aldosteronism and adrenal incidentaloma.

Adrenal incidentaloma are usually found during the assessment of non adrenal disease. In this paper we report the association between a bilateral adrenal hyperplasia and a macronodule of adrenal cortex (adrenal incidentaloma) which is a rare and misleading cause of primary aldosteronism. In the light of this association even if it is likely to remain rare and of those previously published, its existence is an additional reason for suggesting surgical treatment of primary aldosteronism only to patients who satisfy the following criteria: 1) satisfactory control with spironolactone; 2) poor spironolactone tolerance and poor control with other drugs; 3) accept to be operated on and the risk of a possible error.

Adrenal Cortex↗
PubMedDate not supplied

[The primary prevention of arterial hypertension. A meta-analysis of controlled clinical studies].

OBJECTIVE: To assess the efficacy of non pharmacological primary prevention of hypertension. METHODS: Analysis of all the available trials with a minimal one-year follow-up and one recently study with 8 weeks follow-up. The outcomes consisted in blood pressure changes and incidence of hypertension at the end of the study. RESULTS: Five reviewed randomized controlled trials with a minimal one year follow-up and one recently study with eight weeks follow-up assessed the following intervention: advice about sodium restriction, weight reduction, physical exercise and relaxation, a diet rich in fruits vegetables and low fat dairy foods. All the results were available according to the "intention to treat principle". The feasibility appeared to be initially good, but decreased with time, confirming the difficulty of long term prevention. The prevention effect was mild with a decrease in hypertension incidence of a few percent (2%) and blood pressure decrease of only a few mmHg reduction (mean of 3 mmHg). Three community studies were reviewed. The prevention interventions were carried out on entire populations. The feasibility was bad (great number of lost-follow-up). The results on the blood pressure incidence were available in only one study and the blood pressure decrease estimates were heterogeneous, so the results cannot be generalized. CONCLUSION: The primary prevention of hypertension shows disappointing results when the intervention duration is above one year. It leaves little hope for a significant effect on blood pressure dependent cardiovascular events.

Adolescent↗
PubMedDate not supplied

[Surgical treatment of duodenal ulcer].

The medical and endoscopic treatment of duodenal ulcer are decreasing the frequency of surgical treatment in this disease. The authors study the operations performed for duodenal ulcer within the period 1989-1999 in the County Hospital Baia Mare. The decrease of the rate of surgical interventions is the pure effect of the medical treatment, as long as the endoscopic treatment is not yet available in our service. The rate of ulcer--induced perforations remained, however, unmodified (48% of total operatory indications), as well as the postoperative morbidity and--mortality (18% respectively 9%). The last category seems not to be influenced by the type of chosen surgical procedure, but by the patient's age, duration of the disease, and associated pathology.

Adolescent↗