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Biomedical subjects

R Robeva

Publications and source records attributed to R Robeva.

At least 19 recordsLinked to original sources
PubMed2006

Low testosterone levels and unimpaired melatonin secretion in young males with metabolic syndrome.

The interrelations between testosterone, insulin and melatonin levels in males with metabolic syndrome (MS) are still not clarified, especially in young age groups. The aim of the present study was to compare the testosterone serum levels in young men with MS to those in healthy controls, and to determine the possible changes in their melatonin rhythm, as well as the relation between melatonin, insulin and lipid profile. Fasting insulin and testosterone concentrations were measured in 10 healthy nonobese and 10 MS patients. Blood samples for melatonin, insulin and luteinizing hormone (LH) were collected at 19.00, 03.00 and 11.00 hours. A significant difference was found between the testosterone levels in controls and patients. Luteinizing hormone levels in both groups were similar, however, higher night LH levels in MS patients were observed. No changes in the melatonin concentrations of the two groups were found. In conclusion, total testosterone levels were significantly lower in young men with MS compared with healthy age-matched controls. Mild hypoandrogenia in hyperinsulinaemic patients was not related with changes in their melatonin levels. No alterations in the endogenous melatonin rhythm of the MS patients were found.

Adult↗
PubMed2003

Bone mineral density changes in women with systemic lupus erythematosus.

The aim of this study was to analyse the heterogeneity of bone mineral density (BMD) reduction across measurement sites in female systemic lupus erythematosus (SLE) patients on glucocorticoid (CS) treatment. The study population consisted of two subgroups: 32 women at a mean (SD) age of 43.2 (12.0) years, SLE duration of 13.4 (6.2) years, treated with a mean cumulative prednisone dose of 34.4 g; and 16 women at a mean age of 36.1 (9.0) years, SLE duration of 3.2 (2.0) years, never treated with glucocorticoids (control group). The participants underwent a standardised interview, medical record review, blood sampling and BMD examination of the lumbar spine, femoral neck and distal forearm by dual-energy X-ray absorptiometry. CS-treated participants were supplemented with daily calcium (1200 mg) and vitamin D (500 UI). During the study mean daily glucocorticoid dose was 10 mg prednisone equivalent. The controls did not receive either corticosteroids or calcium and vitamin D. BMD and laboratory parameters were re-examined at the end of the second year. At baseline 22 (68.7%) of the CS-treated participants had osteoporosis at least at one major site, compared to 18.8% of the controls. The BMD reduction was proportional to the trabecular bone content at the specific measurement site. At baseline mean T scores in the CS-treated group were the highest at the forearm (-1.03 +/- 1.13), followed by the hip (-1.32 +/- 1.26), AP spine (-1.87 +/- 1.46) and lateral spine (-2.90 +/- 1.50). At follow-up lateral spine bone loss was 5.54% per year, the total hip and the forearm lost 3.59% and 0.33%, respectively, compared to annual losses of 1.02% (AP spine), 1.30% (lateral spine), 0.83% (total hip) and 0.11% (forearm) in the control group. The heterogeneity of BMD reduction in our SLE population emphasises the need for the targeted use of bone densitometry in steroid-treated patients. Attention should be paid to trabecular-rich sites, and fracture risk should be specifically determined.

Absorptiometry, Photon↗
PubMed2001

A psychophysiological marker of attention deficit/hyperactivity disorder (ADHD)--defining the EEG consistency index.

This study continues our research to further validate the idea that ADHD (Attention Deficit/Hyperactivity Disorder) interferes with transition from one task to another and this interference can be quantified by a Consistency Index (CI) derived from a specific mathematical representation of EEG data. We reanalyze 32 previously reported data sets present new data for 35 boys and girls, ages 7-12, ADHD or control. Each data set contains EEG, recorded and digitized while participants perform consecutive 10-min tasks: video, reading, and math. For boys, the CI in ADHD was four times lower than in controls, p < .005, for girls this difference was two times, p < .05. ADHD/control classification based on the CI coincided with the DSM-IV criteria for 88% of the boys and for 67% of the girls. Post hoc analysis indicated that the classification utility of the CI diminished with age. A CI below 40% could be a discriminating, reliable, and reproducible marker of ADHD in young boys.

Attention Deficit Disorder with Hyperactivity↗
PubMed1999

Pharmacokinetic variability of nimodipine disposition after single and multiple oral dosing to hypertensive renal failure patients: parametric and nonparametric population analysis.

OBJECTIVES: To explore the contribution of renal failure to nimodipine overall pharmacokinetic variability after single and multiple oral dosing and to develop a population pharmacokinetic model by means of the nonparametric expectation maximization (NPEM2) algorithm based on sampled individual drug concentrations close to the estimated patients' C(SS)avs (NPEM2-C(SS)av). PATIENTS, MATERIALS AND METHODS: 24 hypertensive patients with normal and reduced renal function, without clinical and laboratory data for hepatic dysfunction, were enrolled in the study and their nimodipine plasma levels were analyzed by means of a parametric and nonparametric population pharmacokinetic modeling using a maximum a posteriori Bayesian (MAPB) estimator in an iterative two-stage Bayesian population modeling program and NPEM2-algorithm. RESULTS: Comparison of parameter dispersion revealed higher variability of nimodipine disposition after the first dose than at steady-state except for apparent volume of distribution at steady-state, V(SS)/F, whose variability increased from 98% to 223%. The most variable was mean residence time, MRT, whose coefficient of variation (CV) was 288% after the first dose and decreased by more than 2 times at steady-state, followed by terminal elimination half-life, t(1/2el), with CV = 171% after the first dosing and decreasing by more than 3 times at steady-state. Concerning the impact of renal failure on disposition parameters variability, patients with slightly to moderately reduced renal function, creatinine clearances between 51 to 80 and 25 to 50 ml/min, resp., stated higher variation than patients with more definitively altered renal function. The validation of NPEM2-C(SS)av population model was performed by using a set of 272 individual plasma drug concentrations, including trough levels as well as concentrations belonging to mono-exponential elimination phases after single and multiple dosing. Bayesian forecasting, using 4 trough levels per patient as Bayesian priors, revealed highly significant correlation between observed and population model predicted drug concentrations (r = 0.526, p < 0.0001). The predictive performance of NPEM2-C(SS)av population model was characterized by low bias (mean error = -0.48 microg/l, 95% CI = -0.99-0.04 microg/l), and good precision (root mean squared error = 4.32 microg/l, 95% CI = -2.53-11.17 microg/l). CONCLUSIONS: As predicted for high hepatic clearance drugs [Rowland 1985], nimodipine parameters variability decreased after reaching steady-state. NPEM2-C(SS)av population model demonstrated high accuracy and precision in predicting drug levels from terminal exponential phase including trough levels at steady-state.

Administration, Oral↗
PubMed1991

[Drug disease related to the use of nonsteroidal anti-inflammatory agents].

A case is presented of a woman with drug disease related to the use of non-steroid antiinflammatory drugs. The disease was manifested by combined impairment of several organs and systems: arthralgia, febrility, anorexia, fibroscopic data for superficial gastritis, iron deficiency anemia, angiospastic syndrome, impairement of the liver and the kidneys. The renal lesions differed from the usual for such cases tubulointerstitial changes and a mild mesangioproliferative glomerulonephritis without manifested clinical symptoms was found. Discontinuance of the treatment with the non-steroid antiinflammatory drugs lead to the disappearance of the complaints and normalization of all laboratory indices.

Adult↗
PubMed1991

[Proteinuria selectivity index: prognostic value in idiopathic nephrotic syndromes].

In INS, the histological appearance constitutes a classical prognostic element: minimal-change nephropathy (MCN) responds better to treatment than focal glomerulosclerosis (FGS) or IgM nephropathy (IgMN). However, this criterion is not consistent. We evaluated the prognostic value of the proteinuria selectivity index (SI): the ratio of IgG clearance to transferrin (Tf) clearance. Proteinuria was selective for an SI less than or equal to 0.01. In the 39 MCN, the SI ranged from 0.01 to 0.39 (median 0.10) and proteinuria was selective in 21 cases. In the 13 FGS and IgMN, the SI varied from 0.05 to 0.40 (median 0.22) and proteinuria was selective in 1 case (p less than 0.01 between these two groups). The SI ranged from 0.01 to 0.17 (median 0.07) for the 25 corticosensitive (CS) forms and from 0.08 to 0.40 (median 0.20) for the 27 corticoresistant (CR) ones (p less than 0.001). Twenty-four of the 30 MCN patients and 19 of 22 cases of selective proteinuria were CS. Multivariant analysis enabled the identification of variables predictive of the response to steroids. Age, sex and level of proteinuria had no such value. The predictive value of the SI was greater than that of the histological appearance (McFadden's R-square, 47 versus 22%, p less than 0.001). When the histological aspect was known, the SI provided additional precision, but the reverse situation was not true. The predictive curve of CS as a function of the SI was sigmoidal, therefore reflecting a homogeneous distribution, despite their different histological types.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[Benign monoclonal gammopathy in a female patient with Schönlein-Henoch glomerulonephritis and liver cirrhosis].

A case of a woman with Schönlein-Henoch glomerulonephritis and liver cirrhosis and a monoclonal peak in the proteinogram is reported. An attempt is made to differentiate the benign monoclonal gammapathy from Waldenström's disease according to the existing criteria. The conclusion is reached that at present there is no index or a combination of indices which could allow a definite assessment. Only the prolonged systematic observation with repeated examinations could allow a more precise assessment of the pathologic process.

Diagnosis, Differential↗
PubMed1990

[The effect of treatment on the survival rate in chronic glomerulonephritis].

The survival rate of 68 patients with immunoglobulin A glomerulonephritis (IgA GN), 29 patients with membranous glomerulonephritis (MGN), 13 patients with membranous-proliferative glomerulonephritis (MPGN) and 40 patients with lupus glomerulonephritis (LGN) was assessed using the life registration tables. The patients with IgA GN were treated symptomatically, and the remaining patients were treated with a combination of corticosteroids, immunosuppressors and anticoagulants. At the 10th year from the onset of the disease the survival rate was as follows: for the patients with IgA GN--88%, with MGN--94.9%, with LGN--81.0% and with MPGN--61.6%. The comparison with the survival rate established for the respective types of glomerulonephritis without treatment or the presence of mixed groups of treated and nontreated patients shows that the combined pathogenetic treatment improves the prognosis of MGN, LGN and of a number of patients with MPGN and it nears that of the comparatively more benign IgA GN.

Age Factors↗
PubMed1990

[Gordon's syndrome--a combination of hyperkalemia and arterial hypertension with preserved kidney function].

A case of Gordon's syndrome in a 38 years old man is presented--hyperpotassemia and arterial hypertension with preserved renal function, normal supra-adrenal function, no data for hemolysis, normal coagulation state, mild compensated metabolic acidosis. Renal tubular defect, for excretion of potassium and chlorides, sodium reabsorption, tubular resistance to mineralocorticoids are discussed. The combination of hyperpotassemia and arterial hypertension might be due to phenotype manifestations of a single gene.

Adult↗
PubMed1990

[The survival of patients with mesangial immunoglobulin A glomerulonephritis].

68 patients with immunoglobulin A glomerulonephritis (IgA-GN) were studied. 67.4% of them were men. The most frequent clinical manifestation is the microscopical hematuria--in 39.7% of the patients. A single episode of macroscopic hematuria was found in 32.3% of the patients and recurrent macroscopic hematuria--in 25% of the patients. Proteinuria was found in all patients but nephrotic syndrome--only in one patient. At the time of the biopsy 35.5% of the patients were with hypertension, 13.2%--with initial chronic renal failure. The survival of the patients with IgA--GN, assessed according to the registration life tables, was 93% at the 5-th year, 88% at the 10-th year and 70.6% at the 20-th year. It was statistically higher in the patients without hypertension. Among the patients with proteinuria below 1.0/24 h no one reached terminal chronic renal failure. The male sex was a factor for a statistically shorter survival only at the 20-th year. The survival of the patients with insignificant histological changes was 100% for the period of the study, whereas it was significantly lower for the other histological variants. According to the data of the study, the presence of arterial hypertension, proteinuria above 1.0 g/24 h, a more severe histological variant (focal-segment, diffuse proliferative and particularly sclerotic), and to a certain degree the male sex play an unfavorable role in the survival and determine a poorer prognosis for the patients with IgA-GN.

Adolescent↗
PubMed1990

[Hypokalemic nephropathy from the chronic use of diuretics and laxatives].

The cases of two women with morphologically proved hypokalemic nephropathy related to chronic use of diuretics and purgatives are reported. The disease has been detected because of reduced urine quantity, increase of body mass and edema. The serum protein level is low. Sodium and potassium clearances are reduced. There is a metabolic alkalosis, serum renin and aldosterone levels are elevated. The histologic picture is typical with tubule cell vacuolization and sclerotic changes in the interstitium. The timely discovery of the cause of the disease leads to the discontinuance of the use of diuretics and purgatives and to complete recovery.

Adult↗
PubMed1990

[The late results of treating membranous glomerulonephritis].

27 patients with membranous glomerulonephritis treated with corticosteroids, anticoagulants and some with immunosuppressors are discussed. Men prevailed. Nephrotic syndrome proved by renal biopsy was found in 88.9%, proteinuria under 3.5 g/24 h--in 11.1%, arterial hypertension--in 18.5%, renal failure--in 14.8% of the patients. At the end of the follow up 15 patients (55.6%) showed a complete remission and 4 patients a partial remission. In 8 patients (29.6%) there was chronic renal failure and three of them had gone through hemodialysis. Comparing the patients with and without chronic renal failure we found that only the presence of impaired renal function as found by renal biopsy and the greated duration of the disease are of statistically significant importance for the prognosis of membranous glomerulonephritis. A 5 year survival of the patients treated actively is 100% and a 10 year survival is 94.9% which allows the assumption that treatment of membranous glomerulonephritis can lead to a permanent remission and preservation of renal function.

Adrenal Cortex Hormones↗
PubMed1990

[Treatment of chronic glomerulonephritis with high doses of intravenous immunoglobulin].

The initial results of the treatment of 8 patients with idiopathic and lupus glomerulonephritis with immunovenin intact are reported. Previously the patients had been treated for a long time with combinations of corticosteroids, immunosuppressors and anticoagulants without effect. All patients had an well expressed nephrotic syndrome, 6 patients had initial chronic renal failure. The immunovenin intact treatment was carried out in three day courses of 85 mg/kg/24 h (a total of 250 mg/kg for one course). All patients received two courses of treatment. The patients were followed up for 3 to 30 months (mean 10.0 +/- 3.29). In 4 patients a full clinical remission was achieved. Two patients, after a satisfactory effect of the treatment, died from non-renal causes. The mechanisms of action of immunovenin intact are discussed.

Azathioprine↗
PubMed1989

[Tubular lesions in the nephrotic syndrome].

The problem of accompanying tubular lesions in nephrotic syndrome (NS) is not yet sufficiently clarified. The tubular changes were studied by the urine excretion of sensitive markers: beta 2-microglobulin (beta 2m), alaninaminopeptidase (AAP) and gammaglutamyltranspeptidase (gamma GTP). Beta 2m was determined by ELISA method and AAP and gamma GTP--electrophoretically. 75 patients were examined--37 patients with idiopathic nephrotic syndrome (INS), 27 patients with membranous glomerulonephritis (MGN), 11 patients with membranous-proliferative glomerulonephritis (MPGN). The most sensitive index AAP was elevated in the urine of 97,4% of the patients with nephrotic syndrome, beta 2m was elevated in 64,3% and gamma GTP--in 46,2% of the patients. There is a positive correlation between the excretion of APP and the quantity of proteinuria (r = 0,73, p less than 0,001). The comparison of the results of the patients with and without nephrotic syndrome established that in the patients with idiopathic nephrotic syndrome as well as in the patients with membranous glomerulonephritis the presence of nephrotic syndrome determines the higher excretion of AAP (p less than 0,02). The presence of nephrotic syndrome increases the frequency and the severity of the tubular impairment in glomerulonephritis. The tubular impairment is independent of the histologic type but is in positive correlation with the proteinuria.

Aminopeptidases↗
PubMed1989

[The diagnostic significance of antibodies to lipid A in patients with chronic kidney infections].

The interest in antilipid A antibodies increases in recent years. By means of an immunoenzyme test developed by the authors the frequency, quantity and characteristic of these antibodies were studied in 46 patients with chronic renal infections and in 36 healthy controls. The frequency of antilipid A antibodies class IgM is 5.7% and of class IgG it is 2.8% in the control group (healthy persons) and it is 41.3% and 19% respectively in the renal patients group. Most frequently their presence and quantity correlate with an active infection or with the convalescent period following antibiotic treatment (62.5%). This allows the use of antilipid A antibodies as a confirming marker for the presence of a heavy Gram negative infection and as a possible index for evaluation the efficacy of the treatment.

Antibodies, Bacterial↗