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Biomedical subjects

S Tănăseanu

Publications and source records attributed to S Tănăseanu.

16 recordsLinked to original sources

Clinical particularities in a Romanian series of Behcet's disease patients.

Behcet's disease (BD) is characterized by a great geographic diversity of clinico-evolutive features. We identify the main clinical characteristics in our series as compared to other data in international literature. We studied 36 patients (16 women and 20 men) with BD fulfilling International Study Group for Behcet's Disease (ISGBD) criteria. We recorded the clinical features and compared the data with other recent statistics. The incidence of clinical manifestations in our group was the following: oral ulcerations -97.4%, genital ulcerations - 55.5%, vascular disease - 50%, antiphospholipid antibodies - 55%, digestive tract lesions - 28.5%, eye disease - 27.7%, pulmonary disease - 8.3%, arthritis - 5.4%, CNS lesions - 2.7%. The clinical course was generally mild. Our patients had a higher incidence of vasculo-thrombotic events, of APLAs and of oral aphthosis, as compared to other statistics. Eye disease, CNS, articular involvement and pathergy were encountered rarer than in other groups. Two cases had atypical onsets: one with a pyoderma gangrenosum-like lesion and the other with severe pulmonary hypertension. BD has protean clinical aspects, with important geographic particularities. Our patients ran a relatively mild course of the disease, more like the Western European than the Asian patients. Vasculothrombotic disease was an important feature, with a subsequent risk for mortality.

Adult↗

Limited Wegener's disease presenting as pharyngolaryngeal tumor.

Wegener's disease (WD) which is mostly a systemic illness rarely presents as isolated, monoorganic, limited disease. Limited pharyngolaryngeal WD is thus a very rare occurrence. We report the case of a 29 years old man who developed a pharyngolaryngeal tumor with clinically benign evolution, histologically showing granulomatous inflammation and small vessel vasculitis, with no signs of: tuberculosis, sarcoidosis, fungal disease, Hodgkin's disease or foreign body aspiration. p-ANCA's were positive. He was considered a limited form of WD and treated with moderate doses of corticoids and cotrimoxazole. One month later, the lesion diminished significantly. The finding of a pharyngolaryngeal tumor with granulomatous inflammation and vasculitis, in the context of p-ANCA positivity and without any evidence for another systemic granulomatous disease, suggested the diagnosis of limited WD. The response to treatment favoured this presumption. Limited pharyngolaryngeal WD is a rare disease, with a potential for life-threatening (even fatal) complications. It should be recognized early and treated promptly. Remissions can be achieved (even without the use of cyclophosphamide).

Adult↗

Coronary heart disease and risk factors in some special type collectivities.

Transversal epidemiologic investigations carried out in different populations from several regions of Romania : Gurghiu Valley (lumberjacks from a mountain region), Danube Delta and Razelm lagoon complex (fishermen), and Bucharest have shown that, in spite of the high caloric value of food and even of a high intake of saturated fats, mean serum cholesterol is lower in the rural areas than in Bucharest, probably owing to the strenuous physical work. However, except myocardial infarction, more frequent in the urban than in the rural regions, the other forms of coronary heart disease have a relatively higher frequency in villages, particularly atrial fibrillation and ECG signs of ischemia. These findings might be explained by a greater prevalence of hypertension in these populations. It is concluded that the risk factors, which act synergically, depend on the complex structure of the "ecologic niche".

Adult↗

Familial lupus anticoagulant.

The antiphospholipid antibody syndrome (APS) is defined by widespread arterial and venous thromboses associated with elevated plasma levels of antiphospholipid antibodies (APLA). The primary antiphospholipid antibody syndrome (PAPS) appear to be a fairly homogeneous disease, and HLA, family and other studies provide new insights into this cause of thrombosis and vascular disease. We describe two patients with PAPS (lupus anticoagulant positive), whose family members were analyzed for clinical and laboratory abnormalities associated with APS. Familial screening seems to be important, in order to prevent the thrombotic events. Low dose aspirin is the first line treatment in asymptomatic subjects with APLA, previous or present thrombosis requiring long-term, possibly life-long anticoagulation.

Adult↗

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↗

The systemic vasculitides.

The systemic vasculitides include a heterogenous group of diseases, characterized by inflammatory and necrotic lesions of the vessel walls, with subsequent ischemic changes in different organs. Various factors are incriminated in the vasculitides etiology, despite the fact that, in most of the cases, the etiologic agents are unknown. The pathogenic mechanisms are generally mediated through circulant immune complexes, which induce the inflammatory reaction at the vessel wall site, accompanied by complex immune reactions. A classification of vasculitides should take into account the type of the injured vessel, the elements of the inflammatory infiltrate and the triggering pathogenic mechanisms. The definition and monitoring of the therapeutic regimen are difficult but, generally, the main elements of medication are represented by corticosteroid and cytotoxic drugs.

Humans↗

Use of angioscintigraphy in the diagnosis of malignant tumors of the liver.

Dynamic hepatic angioscintigraphy, a method of estimation and follow up of the double (arterial and portal) circulation in the liver, was performed in association with static liver scanning in 20 patients with suspicion of primary or secondary tumors of the liver, and in 5 healthy controls, after administration of 113min colloid. This procedure allowed confirmation of primary neoplastic tumors of the liver in 3 patients and of hepatic metastases in 5. The method supplies additional diagnostic information in malignant tumors of the liver and reduces the irradiation of the patients by using a single radiopreparation.

Hepatic Artery↗

The Bucharest multifactorial prevention trial of coronary heart disease. General methodology and risk factor correction after five year follow-up (1971-1977).

Both the intervention and the control group included each 5000 men aged 40-60 years, randomly selected by their home address in five districts of the city of Bucharest. The intervention group underwent an "at entry" examination for risk factor detection (high serum cholesterol, high blood pressure, overweight, diabetes, minor ECG abnormalities, family history) and subsequently a five-year multifactorial intervention aimed to reduce the risk factors. Both groups were followed up in this lapse of time for major end-points: myocardial infarction, stroke, sudden death. The qualitative analysis of the results used ten evolution indices based on a quantal counting and lead to a classification of risk factors which allowed the setting up of a strategy for their correction. The quantitative analysis showed the following decreases between the first and the last examination in the intervention group: for serum cholesterol greater than or equal to 250 mg/dl -17%; for cigarettes/day greater than or equal to 15-53%; for overweight greater than or equal to 30% - 13.57%; for high blood pressure -8%; for the overall risk computed by multiple regression -33.8%.

Adult↗

The Bucharest multifactorial prevention trial. The changes of morbidity and of general and specific mortality.

The paper presents the results of the Bucharest multifactorial prevention trial of coronary heart disease, concerning changes in cardiovascular morbidity and mortality during the first 5-year-period of follow-up. The age adjusted 5-year-rates disclose important reductions in the intervention group in comparison with the control one: for hard events (myocardial infarction, stroke, acute coronary insufficiency)--by 41%; for myocardial infarction--by 35%; for coronary mortality--by 38%; for stroke--by 39%; for cardiovascular mortality--by 30%. The decrease of hard events, myocardial infarction and stroke incidences are statistical significant. The evolution curves of cardiovascular morbidity and mortality show that both groups (the intervention as well as the control one) began with near the same values, but on the way and especially after 5 years they are differently located, those of the control group being higher than those of the intervention group.

Adult↗

Lipid peroxidation in autoimmune systemic vasculitides. Effect of corticoid treatment on lipid peroxidation. Antioxidant protection with vitamin E.

The effect of treatment with prednisone on lipid peroxidation and on lipid metabolism generally and the effect of vitamin E on plasma lipid peroxidation were studied in a group of patients with autoimmune systemic vasculitides. Vitamin E total plasma antioxidant capacity was determined to ascertain the antioxidant efficiency of vitamin E. Treatment with prednisone was found to induce disturbances of the lipid metabolism at the level of total cholesterol and of triglycerides. The increased values of the LDL/HDL ratio showed an increased risk of vascular disturbance in the patients investigated. The high level of lipid peroxides associated with a reduced activity of the endogenous antioxidant system was found to be uninfluenced by treatment with prednisone. Treatment with vitamin E reduced the process of lipid peroxidation but the endogenous deficiency of the antioxidant capacity prevented it to resume its normal values. In spite of the antiinflammatory and antioxidant treatment the high level of lipid peroxides might induce a self-maintained chronic process which, in time, might lead to the aggravation of the degenerative vascular changes.

Adult↗

Lipid peroxidation and the activity of some antioxidant enzymes in patients with systemic vasculitides treated with corticoids.

The level of lipid peroxidation and the activity of superoxide dismutase and of catalase as antioxidant enzymes were studied in 54 patients with systemic vasculitides with autoimmune pathogeny as well as in a control group of patients of the same age and sex. The patients were distributed into a group without treatment, a group treated with prednisone and a group treated with prednisone and vitamin E. Lipid peroxidation is attenuated by the addition of vitamin E while the activity of the antioxidant enzymes studied in the same groups of patients is not significantly changed. The treatment with prednisone did not change the level of peroxides neither the activity of the antioxidant enzymes studied.

Adult↗

Oxidant stress and antioxidant protection in lupus nephropathy.

In a group of 65 patients with lupus nephropathy the level of lipid peroxidation and of the capacity of antioxidant protection was followed up as influenced by the activity of superoxide dismutase (SOD), of catalase (CAT) and of glutathione peroxidase (GSH-Px) as well as of the concentration of glutathione. The determinations were made in total blood and the results were compared with those obtained in a control group of 30 apparently healthy subjects. The degree of lipid peroxidation seemed to be correlated with the extent of proteinuria. As compared with the normal values the activity of the three enzymes studied was decreased and did not correlate with the level of proteinuria. The decreased SOD and GSH-Px seemed to be relatively compensated by CAT activity. The level of GSH was also decreased as compared with the control values and did not correlate with the value of proteinuria. It is concluded that the great variation of individual values could be explained by the multifactorial character of the disease as well as by the metabolic response specific for every patient and by the mechanisms possibly related to the onset of renal disease.

Adolescent↗