Revista medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti din Iaş̧i
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Chronic Kidney Disease (CKD) is a globally public health problem taking into account its direct role in morbidity and mortality. The essential risk factors that contribute to the development and progression of CKD are hypertension, diabetes and dislipidemy. ⋯ The causes of impaired baroreflex dysfunction control in chronic kidney disease are not fully known. Understanding the mechanisms that contribute to increased blood pressure variability due to baroreflex dysfunction in chronic kidney disease may represent a key element in diminishing the physio pathological processes that contribute to the development and progression of renal injury.
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Rev Med Chir Soc Med Nat Iasi · Oct 2013
ReviewThe quality of medical care during an acute exacerbations of chronic obstructive pulmonary disease.
Chronic obstructive pulmonary disease (COPD) is a significant cause of global morbidity and mortality, with a substantial economic impact. Acute exacerbations of COPD (AECOPD) represent a dramatic event in the course of the disease; is an important cause of morbidity and the fourth cause of mortality worldwide. During the hospitalization for AECOPD mortality is 10%. ⋯ A recently published study done in a Canadian hospital reveals that the treatment of the AECOPD is sub-optimal. The management of the COPD exacerbations prior, during and after the hospitalization showed inadequate adherence of the physicians (respirologists, internists and hospitalists) to the current guidelines. This review outlines the worrisome findings of this study and the proposed measures suggested by the authors in order to optimize the management of AECOPD.
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Obesity has reached global epidemic proportions and is associated with major cardiovascular diseases and reduced overall survival. This paper reviews the metabolic and vascular consequences of dysfunctional adipocytokines in obesity as well as the pathological effects on blood pressure, cardiovascular structure and function. Despite this adverse association, numerous studies have documented an obesity paradox in which overweight and obese population with established cardiovascular disease have a better prognosis. ⋯ For coronary heart disease and peripheral arterial disease the mechanisms are still uncertain. There are discussed a lesser severity of coronary lesions and left ventricular dysfunction, or a reduced prevalence of moderate-severe chronic obstructive pulmonary disease in patients selected for surgery. On the other hand, the constellation of data which supports purposeful weight reduction in the prevention and treatment of cardiovascular diseases, induces a controversial position regarding this new concept.
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Alcoholic ketoacidosis is an acute metabolic acidosis that typically occurs in people who chronically abuse alcohol and have a recent history of binge drinking, little or no food intake and persistent vomiting. Alcoholic ketoacidosis is a result of starvation with glycogen depletion and counter-regulatory hormone production, a raised nicotinamide adenine dinucleotide (NADH) to nicotinamide adenine dinucleotide (NAD+) ratio related to the metabolism of ethanol, and volume depletion resulting in ketogenesis. ⋯ Once the diagnosis of alcoholic ketoacidosis is made, the mainstay of treatment is hydration with 5% dextrose in normal saline. With timely and aggressive intervention, the prognosis for a patient with alcoholic ketoacidosis is good.
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Rev Med Chir Soc Med Nat Iasi · Jul 2007
Review[Noninvasive methods of assessing inflammation in bronchial asthma].
Airway inflammation plays a key role in asthma. Among noninvasive methods as tools to study these inflammatory processes and to monitor airways diseases, the sputum analysis is widely used. As well, the analysis of concentrations of nitric oxide (NO) and the analysis of exhaled breath condensate are alternative methods for assessing the airway inflammation. In addition a treatment strategy directed at normalisation of these noninvasive parameters could led to a better control of the disease.