[A diagnostic algorithm--chronic diarrhea].
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Algorithms↗
Biomedical subjects
E Bălănescu
Publications and source records attributed to E Bălănescu.
Is cardiac involvement in collagen diseases important? A clinical study in 917 patients.
Cardiac involvement in collagen diseases was studied in 917 patients representing all the cases of collagen diseases diagnosed in the "N. Gh. Lupu" Institute of Internal Medicine between 1985 and 1987. The prevalence of the various cardiac disorders was studied within every disease or group of diseases diagnosed according to clinical, ECG, radiologic and when necessary echocardiographic data. Collagen heart disease was diagnosed in 38.2% of the patients. In the case of systemic lupus erythematosus, of polyarteritis nodosa and of progressive systemic sclerosis this proportion exceeds 50%. The most frequent cardiac disorders were the rhythm and conduction disturbances, detected in 112 patients (12.2%). The cardiomyopathies and myocarditis, not infrequent (7.4%) represented an element of severity influencing the evolution and prognosis of disease. Myocardial ischemia secondary to coronary vasculitis syndromes has proved to be an important pathogenic mechanism of cardiac disorders. By their frequency and severity, the cardiac involvements in collagen diseases have proved important, becoming sometimes a central diagnostic, therapeutic and prognostic problem.
Adult↗
Cardiac involvement in progressive systemic sclerosis and polymyositis: a comparative study in 116 patients.
A comparative study was carried out in 116 patients-51 with progressive systemic sclerosis (PSS) and 65 with polymyositis (PM) to detect the cardiac involvements secondary to these two collagen diseases. Different forms of cardiac involvement could be detected in 51% of the patients with PSS and in 18.5% of those with PM. The most frequent cardiac dysfunctions were disturbances of rhythm and conduction probably due to the coronary vascular changes in PSS and to processes of fibrosis and degenerescence of the specific myocardial fibers in PM. Myocardial lesions expressed by myocarditis and cardiomyopathies are not infrequent and have important prognostic implications. In the group of patients studied the valvular cardiopathies and clinically evident pericardites were rare. Cardiac involvement clearly proved more frequent in PSS - in which the pathogenic mechanism is mainly vascular - than in PM. This emphasizes the great importance of coronary circulation disturbances in the pathogenesis of collagen heart diseases.
Arrhythmias, Cardiac↗
Lipid peroxidase and erythrocyte redox system in systemic vasculitides treated with corticoids. Effect of vitamin E administration.
The level of plasma lipid peroxidation was followed up in 66 patients with systemic vasculitides with autoimmune pathogeny (SLE and SV) treated with corticoid compounds. The effect of vitamin E associated to this treatment was also studied. The change of the redox cycle, of the red cell glutathione, and of the glutathione peroxidase activity, an enzyme supplying antioxidant protection, were studied in parallel. The results obtained demonstrated: an increased level of lipid peroxidation in the patients treated with corticoid substances, an increase that can be explained by the dyslipidemias induced by these compounds; a decrease of the red cell G-SH concentration owing to the continuous oxidative stress in this group of diseases. This decrease was associated with a concomitant increase of oxidated glutathione. The decrease of GSH, a substrate for glutathione peroxidase, induces an inhibition of this enzyme activity. The GSH/GSSH ratio may represent a useful marker of the evolution of disease. Administration of vitamin E in association with corticotherapy has a relatively reduced effect due to the complex metabolic disturbances with a continuous character in the autoimmune pathogenic processes. The chronic disturbance of the oxidants-antioxidants balance in patients with systemic vasculitides seems to create favourable conditions for the early onset of a process of atherogenesis with severe vascular effects.
Adolescent↗