The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

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Thursday, November 23 2017 @ 03:04 EET

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Renal Artery Stenosis - Review Upon Current Diagnosis and Endovascular Treatment in Light of Recent Studies

2015-02

Dana-Oliviana Geavlete, Carmen Beladan, Magda-Ruxandra Zaharia, Alice BrÓnzea, Dan Deleanu, Ionel A. Checheriță, Bogdan A. Popescu, Carmen Ginghină

Renal artery stenosis represents the main cause of secondary hypertension and, due to its progressive profile, leads to end-stage renal disease and important cardiovascular events (1). Despite the large number of trials in this particular field of interest, RAS therapy remains a complex challenge for clinicians with regard to interventional revascularization, eventually resulting in renal function preservation, improved blood pressure control (BP) and prevention of adverse cardiovascular events in selected patients (2).

In fact, the matter of debate is represented by the proper selection of patients which would benefit the most from renal revascularization with stent implantation, while also taking into account the outcomes of the recently emerging large clinical trials that were unable to confirm the clear benefits of endovascular therapy.

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Nutritional Impact on Cardiovascular Risk in Chronic Hemodialysed Patients - A Systematic Review

2015-02

Andra E. Balcangiu-Stroescu, Ileana Peride, Ileana Adela Văcăroiu, Ionel Alexandru Checheriță, Andrei Niculae

Protein-energy malnutrition is a frequent clinical condition in chronic hemodialysis patients (1). The causes of protein-energy malnutrition are: interaction between blood and dialyzer with subsequent activation of the complement, amino acids and peptides losses when undergoing hemodialysis, metabolic acidosis, chronic inflammation and anorexia (2). There are two types of protein-energy malnutrition. Type 1 protein-energy malnutrition is characterized by patientsí poor food intake. This occurs along with slow decrease of serum albumin and loss of muscle mass, the presence of normal levels of C-reactive protein and response to nutritional interventions. The second type of protein-energy malnutrition is characterized by an increased serum level of C-reactive protein and lower serum albumin level than in type 1, even with an optimal food intake. This type of protein-caloric malnutrition is strongly associated with chronic inflammation and does not respond to nutritional intervention (3).

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Experimental Research on the Interactions between Selective COX-2 Inhibitors and Antidepressants

2015-02

Horia Păunescu

Several studies have suggested an association between depression and inflammation (reviewed in 1, 2, 3, 4). Treatment with pro-inflammatory agents (Calmette-Guerin bacillus, endotoxins) causes depressive symptoms (5, 6, 7). Non-steroidal antiinflammatory agents, NSAIDs, particularly the COX-2 selective ones (e.g., celecoxib) showed promising results in the augmentation of the antidepressant effect in clinical studies on major depression or depressive symptomatology. The antidepressant activity of celecoxib was apparent both in the assessment of the frequency of the remissions, and in the assessment of the therapeutic response (reviewed in 8). Contrary to these studies, there is evidence that NSAIDs decrease the antidepressant effects of the antidepressant drugs. Certain NSAIDs showed depressant effects in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) clinical trial (concomitant administration of NSAIDs and antidepressants was shown to decrease the responder percentage to 45% in major depression, vs. 55% responder percentage when antidepressants were given without NSAIDs) (9). There is experimental evidence of antidepressant effects of NSAIDs in laboratory animals, particularly mice and rats, but also two studies showing that certain NSAIDs have depressant activity when given alone or in association with serotonin-specific reuptake inhibitors, SSRI (9, 10, 11, 12).

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Botulinum Toxin Type A - Possible Anti-Nociceptive Effect on Mice

2015-02

Elena-Rodica Dragu, Bogdan Liviu Chioaru, Ioana Teona Sebe, Ioan Lascăr, Oana Andreia Coman

Botulinum neurotoxin has been used in the treatment of various groups of cronic neuromuscular diseases, which include neuromuscular junction signaling, non-neuromuscular transmission, cholinergic, or non-cholinergic.

Having specificity on releasing neurotransmitter vesicles with acetylcholine in the synaptic gap, the main usage of botulinum toxin was as a muscle relaxant drug in painful or painless spastic syndromes.

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Long-terme Evaluation of Primary Syndactyly Treatment in Children, Using a Flatt Modified Technique

2015-02

Doina-Iulia Nacea, D.M Enescu, Simona Stoicescu

Syndactyly is one of the two most common congenital hand abnormalities, the other being polydactyly (1, 2, 3). It occurs in about 1: 2,500 live births, more commonly in males, and is most often seen in the third web space (2, 4). The condition has a strong familial tendency and is bilateral in half of the cases (4, 2, 5). Inheritance is thought to be autosomal dominant with variable penetrance and expressivity, which may explain the male predominance (6).

Unlike secondary syndactyly, which occurs due to abnormal fusion of initially individualized fingers, primary syndactyly mainly occurs due to the failure of differentiation between adjacent digits, caused by the absence of apoptosis in the interdigital mesenchyme during the seventh and eighth weeks of gestation (7,8). Syndactyly may occur as an isolated event or it may be linked to other anomalies in the body, being known as syndromic syndactyly (7).

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