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Biomedical subjects

G Ungureanu

Publications and source records attributed to G Ungureanu.

At least 19 recordsLinked to original sources
PubMedDate not supplied

[Cardiovascular risk factors in the elderly].

The paper presents a review of recent findings about cardiovascular risk factors in elderly. It becomes important to know that the cardiovascular risk factors we look for in adulthood change in elderly patients. However, we consider that the cardiovascular risk factors in elderly remain hypertension, smoking status, hypercholesterolemia, diabetes mellitus and obesity. Recent studies proved that in elderly high levels of cholesterol are much less found than in adults as well as smoking status. Elderly has specific risk factors: high levels of iron and basic tachycardia. Other possible risk factors are: high levels of homocysteine, low plasmatic levels of HDL-cholesterol, high levels of lipoprotein-A and some coagulation factors.

Aged↗
PubMedDate not supplied

[Drug therapy at the beginning of the genomic era].

The individualisation of drug therapy according to the genetic profile of each patient would allow to avoid the adverse effects and to reach the maximum therapeutic efficiency, therefore an optimum risk/efficiency ratio. This desideratum has become feasible in the genomic era by identifying and mapping a true mononucleotid polymorphism signature DNA (single nucleotide polymorphism fingerprint--SNP) and by using the new technologies. The present day data regarding the polymorphism of the genetic determinants involved in the response to drugs are synthetically shown, as well as the defining of the new fields--pharmacogenetics and pharmacogenomics. Although superposable and interchangeable up to a point, the term of pharmacogenetics rather refers to the study of the variability of response to drugs according to the genetic profile, the term of pharmacogenomics being reserved to the analysis of the genome (DNA and its products, RNA and proteins), in relation with the response to drugs. The differences among the individuals concerning the pharmacokinetics and the pharmacodynamics can be explained through the polymorphism of the substrata (enzymes, carrier proteins, receptors) that explains the genetic stratification of the population. The development strategies of the drug research and of the pharmaceutical industry will certainly be modulated by the new acquisitions in the field of pharmacogenetics and pharmacogenomics, with the inherent bioethical implications. New specific drugs for the patients possessing peculiar genotypes could be synthesized, the starting off of the prealable stratification of the patients according to their genotype.

Drug Therapy↗
PubMedDate not supplied

[Thoracic esophageal neoplasm-therapeutical problems and post-surgery evolution].

The authors are presenting a few considerations on Thoracic Esophageal Neoplasm, as resulted from an 18-cases study performed on patients that were operated between 1994-1999. The esophageal resection rate was of 50%, as follows: 7 Esophageal Resections and 2 Superior Polar Esogastric Resections. The digestive transit was reestablished by means of intrathoracic transposition of the stomach (6 cases) or of the right ileo-colon (2 cases). In one of the cases an Esogastric Anastomosis was performed at the neck level (cervical-right). Immediate post-op mortality after Esophageal Resection (1 case) was due to an acute respiratory distress syndrome (ARDS). The post-op complications were as follow: one anastomotic fistula associated with a purulent pleurisy, 4 non-infectious pulmonary complications and 2 cardiac complications (paroxysmal supraventricular tachycardia). The Discussions and Conclusions of the present work are presenting samples of surgical techniques, post-op complications and prognosis.

Aged↗
PubMedDate not supplied

[Therapeutic means and methods in recurrent pleurisy].

During a 10-year interval (1981-1991), at the IIIrd Medical Clinic of Iaşi 960 cases with pleural effusion, of which 768 (80%) non-recurrent and 192 (20%) recurrent, were diagnosed. The etiology in the latter cases was malignant (40%) and non-malignant (60%). Proper treatment methods for limiting or suppressing the recurrent pleurisies proved to be imperative. Thoracocenteses cause protein and electrolyte depletion which aggravate the general state and hasten the unfavourable evolution of the etiological affection. This is the reason why besides the general etiopathogenic treatment, a local pathogenic treatment (cytostatic, anti-inflammatory) and especially pleurodesis are compulsory. The intrapleural administration of cortisone is efficient in the case of recurrent autoimmune pleural effusions but is worthless in the malignant ones. In the latter situation, the intrapleural cytostatic treatment should be first attempted and, in case of failure, the development of pleural symphysis by external radiotherapy or injecting talc into the pleural space should be made. In the terminal stage of cardiac insufficiency or liver cirrhosis with recurrent pleural effusion, the pleurosymphysation is not indicated; a sever edematous-ascitic attack may occur or become aggravated by the pleural irritative process due to this method.

Biopsy↗
PubMedDate not supplied

[Oxidative stress in atherosclerosis].

Oxidative stress is the result of the imbalance between pro-oxidant and antioxidant factors. The participation of oxidative stress in atherosclerosis (ATS) is reflected by lipid peroxidation which is a process initiated and maintained by oxygen reactive species generated by the aterogenic cells themselves. The endothelial aggression in ATS is accompanied by endothelial dysfunction, which is due to the neutralization of nitric oxide by superoxid anion. The key role in the onset and the development of the ATS lesions belongs to oxidated LDL-cholesterol that influence at different levels and by several mechanisms the ATS process. The neutralization of the toxic effects of free radicals is due to the endo and exogen antioxidant systems. It appears that the individual antioxidant status is influenced by environmental factors as well as by a genetic determinant. The antioxidant therapy, which is controversial at the moment, represents an associated therapy in endothelial dysfunction from ATS.

Antioxidants↗
PubMedDate not supplied

[Causes of failure in the treatment of postoperative peritonitis].

The authors analyze a group of 49 postoperative peritonitis, which represent 0.57% of a total of 8550 surgical interventions performed over the last 7 years and 1.19% of 4100 laparotomies carried out in an elective operation orientated general surgery department. The mortality rate was 28.57% (14 patients) among the 49 studied cases, which represents 25% of all deaths recorded in our department over the same time interval. A full account on postoperative peritonitis vital prognostic factors is given, insisting on: specific bacteriology (nosocomial infections), peculiar etiologies (10 out of 14 fatalities were originally operated on for digestive cancers), different associations of postoperative peritonitis with other infectious and noninfectious postsurgical complications (as encountered in all 14 deaths), type of postoperative peritonitis (13 death out of 14 were due to generalized peritonitis), postoperative peritonitis secondary to ignored lesions at the original operation (3 cases--3 deaths), surgical treatment limitation (late operative timing which was responsible of 9 deaths); treatment inadequacies of peritonitis and its cause--5 fatalities.

Adult↗
PubMedDate not supplied

[Guided digestive fistula. Complementary method in prophylactic and curative postoperative peritonitis].

Guided fistula (or sinus tract) techniques, which are a nowadays a controversial topic, comprise a group of simple surgical methods of postoperative peritonitis treatment. This retrospective study is an attempt to bring further insights into the literature debate on the utility of the aforementioned techniques by presenting Craiova C.F.R. General Surgery Department 7 years (from 1991 through 1998) experience with 26 operated on patients, who underwent digestive guided fistulas too. In 16 of our study patients sinus tracts were created for postoperative peritonitis prophylactis purpose, whereas digestive guided fistulas, which were performed in the other 10 patients, were meant to treat peritonitis secondary to anastomosis breakdown. In 87% of pur series of digestive guided fistula patients the postoperative outcome was satisfactory. Three deaths were recorded only among the nonprophylactic sinus tract patients. Guided fistula method is an useful adjunct of the complex, well-codified management of postoperative peritonitis including its efficient prevention.

Adult↗
PubMedDate not supplied

[Esophagoplasty with right ileocolon, technical problems].

The authors present their experience with 14 cases of esophagoplasty by right ileocolon interposition which were performed to re-establish the digestive continuity in 12 patients operated on for caustic burns induced esophageal strictures and 2 patients with esophageal neoplasm managed by esophagectomy. The current study aims to pin/point both the anastomotic risk and the technical difficulties related to the colon interposition graft anatomic trajectory and vascular supply. Given the utmost importance of both the preoperative correction of the nutritional deficit and the improvement of pulmonary function the authors suggest that esophagoplasty should bu preceded by a "preoperative intervention", consisting of ileocolic artery ligation, gastrostomy and pleural drainage. The acute respiratory failure was the immediate main threat following esophagoplasty, whereas cervical anastomotic breakdown was the complication which dominated the early postoperative period in terms of frequency and gravity, but the death rate was nil. When esophagoplasty by right ileocolon interposition simplicity and efficacy are taken into account it appears as the surgical therapy of choice whenever the local and general status of the patients allows it.

Adolescent↗
PubMedDate not supplied

[Relation between arterial compliance and the prematurity of reflected wave on pulse pressure curve evaluated by tonometric sphygmography].

The effect of antihypertensive drugs on the arterial pressure pulse can usually be explained by a change in the timing or intensity of wave reflection or by alteration in the pattern of ventricular ejection. Alteration in timing wave reflection is believed to cause the characteristic changes of pressure wave such: augmentation, augmentation index, "precocity index of second systolic peek" (P2). After calcium channel blockers augmentation decreases from 15 mmHg to 9.4 mmHg, augmentation index P2/P1 (P1 is the first systolic peek) decreases from 132.2 +/- 20% to 129.2 +/- 19.5% and "precocity index of P2" increases from 68.8 +/- 5% ejection duration to 71.8 +/- 4.6% ejection duration.

Adult↗