ARS Medica Tomitana
vol. X - nr. 4 (39) october - december 2004

Relationships between PFT Data and Clinical Characteristics in Children with Asthma
Mireille Bellet, Nicole Beydon, Isabelle Pin, Matran Régis, Michèle Chaussain, Michèle Boulé, Beurey Alain, Francis Amsallem, Corinne Alberti, André Denjean, Claude Gaultier

ABSTRACT. The aim of this multicenter study in preschool children with asthma was to evaluate pulmonary function using tests that do not require active cooperation, as PFTs. The authors evaluated and compared pulmonary function in 74 preschool children with asthma (height of 90–130 cm) and 84 healthy control subjects. Functional residual capacity (helium dilution technique) and expiratory interrupter resistance (interrupter technique) were measured. As compared with control children, children with asthma had a significantly higher resistance (0.77 ± 0.20 vs. 0.92 ± 0.22 kPa • L-1 • second, p < 0.001) and significantly lower specific expiratory interrupter conductance (p < 0.005) values. Resistance values were significantly higher in children with asthma with than without symptoms on exertion (p < 0.05). The effect of bronchodilator administration, expressed as the percentage of baseline and predicted resistance values, was significantly greater in children with asthma than in control subjects (-18.6 ± 13.6% vs. -11.2 ± 15.2%, p 0.001, and -23.2 ± 19.2% vs. -12.6 ± 17.8%, p < 0.001), respectively. A 35% decrease in resistance after bronchodilation expressed as the percentage of predicted values had a likelihood ratio of 3 for separating the bronchodilator response in children with asthma from that in healthy control subjects. Pulmonary function tests that do not require active cooperation may help in the management and follow-up of preschool children with asthma who are unable to perform forced expiratory maneuvers. estimating airflow resistance in healthy and in preschool children who have asthma or who are wheezing. We recently reported prebronchodilator and postbronchodilator expiratory interrupter resistance (Rintexp) values in healthy preschool children and then used these normative data to study preschool children with respiratory disorders.cases, an unique superior polar artery supplied the entire superior pole of the kidney.

Considerations anatomo-clinique concernant un nouvel cas de Syndrôme de Smith-Lemli-Opitz
L. Chircor, P. Parent, P. Laselve, L. De Parscau, P.Bordei

ABSTRACT. The authors described one case of Smith-Lemli-Opitz Syndrome caracterised by common congenital anomalies: low birth average, cleft palate, blepharophimosis, cardiac defects, post-axial polydactyly, and 2-3 syndactyly of the toes. The medical literature is rapidly reviewed and various ethiological hypotheses are discussed.

Studiu privind localizarea regiunilor de maxima variabilitate a formelor suprafetelor articulare ale atlasului
H. Varlam, D St Antohe, Raluca-Ozana Chistol

ABSTRACT. The aim of our study was to determine the areas with maximum variability of the superior and inferior articular surfaces of the lateral masses of atlas. Our study was based on 50 atlases from specimens of different sex and ages. Photos were realized under a perpendicular incidence using a digital camera. Landmarks that define articular surfaces where set with TPSDig digitizing software. The resulting landmarks configurations were superimposed by global least squares Procrustes analysis and an average landmarks’ configuration was generated. This was further used as reference for the thin plate spline analysis allowing us to identify a pattern of articular surfaces’ shape variability. For the superior articular surface there was a global tendence of compression in the region corresponding to the union of anterior 2/3 with posterior 1/3 of its medial and lateral borders as well as an enlargement and forward displacement of anterior pole. Inferior articular surface didn’t present any significant shape variation excepting a shallow notch on its medial border.

Indicatiile si rezultatele terapiei endoscopice cu argon plasma in patologia colonului
E. Dumitru, Luana Alexandrescu, A. Suceveanu, Andra Suceveanu, F. Voinea

ABSTRACT. Argon beam coagulation is an innovative no-touch electrocoagulation technique in which high-frequency monopolar alternating current is delivered to the tissue through ionized argon gas. The aim of this study was to evaluate the indications, efficacy and safety of argon plasma coagulation (APC) for the treatment of rectal and large bowel pathologic conditions. From 1st of March 2002 through 1st of March 2004, we used endoscopic APC (ERBE, argon gas source ICC 300, high-frequency electrosurgical generator ICC 200, gas flow 1.2-2 l/min, power setting 50 W) to treat 56 consecutive patients (mean age 58.3 ± 12 years). The efficacy of APC treatment was evaluated on symptoms, transfusion requirement, bleeding recurrence, hemoglobin value before and 6 months after APC therapy. The indications for treatment were colonic angiodysplasia (38 patients), radiation proctitis (7 patients), bleeding after endoscopic polipectomy (8 patients), and tumoral tissue destruction (3 patients). Definitive haemostasis of digestive angiodysplastic lesions was achieved in one session in all patients. No bleeding recurrence was observed during the follow-up period of 6 months. Average hemoglobin levels recorded before and 6 months after APC therapy were 8.7 ± 1.8 and 11.8 ± 0.9 g/dL, respectively (p<0.05). Two or three sesions were required to treat radiation induced proctosigmoiditis. Endoscopic control was performed 6 months after APC therapy and showed complete dissappearance of lesions in 6 from 7 patients. Mild and transient abdominal distension and pain were recorded in some cases without any serious complications. APC appears to be a simple, safe, and effective technique in the management of large bowel pathologic conditions such as angiodysplasia, hemorrhagic radiation-induced proctosigmoiditis, bleeding after polipectomy and tumoral tissue destruction.

Studiu experimental al uveitelor induse la iepuri
D. Denislam, Farah Constantin, T. Mehedinti

ABSTRACT. Infusion of the streptococcus hemolytic group A in the anterior chamber of the rabbits brings about acute uveitis appearance. Histological researches try to explain clinical and morphopatological phenomenon. After 21 days before infusion the microscopic examination underlines an acute inflammatory process with edema and inflammatory infiltration. The local treatment which consists in antibiotics and corticosteroids reduced the exudative process, especially due to cortisone, with a tendency for chronicity, but without healing the uveitis.

Studiu anatomo-radiologic privind originea arterelor renale in raport cu coloana vertebrala
Elena Sapte, Steliana Popescu, P. Bordei

ABSTRACT. In the curent publications the majority of autors describe the origin of the renal arteries, from the abdominal aorta to be slighty distanced, despite of the clasic description that stipulates the origin of the two renal arteries to be at the same level. The present study was made on a lot of 252 x-ray pictures, represented by renal angiographies (98 global and 154 selective), on witch I studied the origin of the renal arteries related withw the vertebral column. This origin we found it to be very variable, between the middle 1/3 of the last dorsal vertebra and the intervertebral disc of the second and third lumbar vertebrae. In most of the cases the right and the left renal arteries had the origin next to the first lumbar vertebra. Related to the origin of the renal arteries on the two halfs of the human body we observed that in 32.65% cases the arteries had the origin next to the same vertebra. In the other 67.34% cases in witch the origins were different on a side to the other, we found a difference of 0.5 – 3 cm.

Aspecte radio-anatomo-semiologice in explorarea prin rezonanta magnetica a leziunilor traumatice ale meniscurilor articulatiei genunchiului
Baz R., Onciu M., Popescu Steliana

ABSTRACT. The knee joint, the greatest articulation of the human body, is frequently exposed to traumatisms. It is very much demanded in statics and locomotion this leading to a high level of wastage. Our study follows the marking of radioanatomic and radiosemiologic aspects when exploring through MR the menisci of the knee’s articulation using a mass of 74 patients examined after a standard protocol during a whole year. The achievement of the results reveals the value of the magnetic resonance imaging when appreciating the knee’s anatomy and its accuracy in diagnosis of the meniscus lesions

Aspecte moderne diagnostice si terapeutice in umarul dureros acut
Ioana Ureche, Madalina Iliescu, S. Ureche

REZUMAT. This paper tries to summarize the results of a clinical trial that estimates the efficiency of a combined treatment - local and general physical, kinetical and anti-inflammatory treatment - of patients with unilateral acute pain in the scapulo-humeral joint, with the diagnosis of SHP-Acute shoulder pain. Our study was performed on 231 patients with the diagnosis of SHP-Acute shoulder pain, evaluated within a period of two years (2002-2003). The patients were divided in two study groups; group 1 of 25 patients and group 2 of 206 patients. Both groups were treated with physical, kinetical and anti-inflammatory treatment; additionally, group 2 benefited of local injection and suprascapular nerve infiltration with bupivacain. The patients evaluation was performed within three steps: initial (T1), after two weeks (T2) of combined treatment and after another ten weeks (T3) that the patients continued the kinetical therapy ambulatory. After 6 months (T4), the entire group was reevaluated and introduced in a complex physical and kinetical support treatment. The clinical evaluation, initial and within the patients evolution revealed a real difference between groups 1 and 2 in favor of group 2 that benefited supplementary of local injection and suprascapular nerve infiltration with bupivacain. The local and general anti-inflammatory treatment, associated with physical and kinetical therapy and suprascapular nerve infiltration with bupivacain leads to a significant improvement of the symptoms, with the diminish of the functional impotence, pain and stiffness of the shoulder joint.

Eficienta utilizarii asocierii glargine plus lispro la adolescentii cu diabet zaharat de tip 1
Doina Catrinoiu

ABSTRACT. OBJECTIVE - To compare blood glucose control and incidence of nocturnal hypoglycemia in adolescents with type 1 diabetes on multiple injection regimens managed with either an insulin analog combination or NPH insulin plus regular human insulin. RESEARCH DESIGN AND METHODS - In a randomized cross-over study, 28 adolescents with type 1 diabetes on multiple injection therapy received either insulin glargine prebedtime plus lispro preprandially (LIS/GLAR) or NPH insulin prebedtime plus regular human insulin preprandially (R/NPH). During each 16-week treatment arm, subjects completed home blood glucose profiles, and at the end of each treatment arm, they were admitted for an overnight metabolic profile. A total of 25 subjects completed the study. RESULTS-Compared with R/NPH therapy, LIS/GLAR was associated with lower mean blood glucose levels (LIS/GLAR versus R/NPH): fasting (8.0 vs. 9.2 mmol/l, P < 0.0001), 2 h postbreakfast (8.1 vs. 10.7 mmol/l, P < 0.0005), prelunch (8.9 vs. 10.1 mmol/l, P < 0.01), and 2 h postlunch (8.0 vs. 9.5 mmol/l, P < 0.002). However, there was no difference in mean blood glucose levels before or after the evening meal. Incidence of nocturnal hypoglycemia on overnight profiles was 43% lower on LIS/GLAR compared with R/NPH therapy; however, there was no difference in rates of self-reported symptomatic hypoglycemia. Total insulin dose required to achieve target blood glucose control was lower on LIS/GLAR (1.16 IU/kg) compared with R/NPH therapy (1.26 IU/kg, P < 0.005), but there was no significant difference in HbA1c levels (LIS/GLAR versus R/NPH: 8.7 vs. 9.1%, P = 0.13). CONCLUSIONS-Combination therapy with insulin glargine plus lispro reduced the incidence of nocturnal hypoglycemia and was at least as effective as R/NPH insulin therapy in maintaining glycemic control in adolescents on multiple injection regimens.

Infectii herpetice asociate cu Candida la persoane infectate HIV
Claudia Simona Cambrea, S. Rugina, Claudia Nina Rugina

ABSTRACT. Disease, including the acquired immunodeficiency syndrome (AIDS) caused by the diabolically unique human immunodeficiency virus (HIV), has profoundly changed contemporary society and medical practice. Through a concerted effort to combat this epidemic, researchers and clinicians have made significant strides in the fields of molecular biology, virology and immunology. These contributions have facilitated an increased understanding of the complexities of HIV infection and the development of more effective therapies; therefore in present we can speak about HIV-AIDS as a chronic controllable disease. Before introduction of antiretroviral therapy the most frequent infections seen in patients HIV infected from Constanta were Candida infections and herpetic infections sometimes in association. The aim of this study realized for a period of 3 years was to see the evolution of these infections before and after initiation of antiretroviral treatment.

Diareea acuta la sugar– problema sociala
Valeria Stroia, Adriana Balasa, Andreea Ţibuleac

ABSTRACT. In developing countries acute diarrhoeal disease remains an important cause of morbidity and mortality in infancy. The authors present a clinical retrospective study, made in Clinical Emergency County Hospital Constanta, studying a number of 256 infants, for one year period. Acute diarrhoeal disease accounted for one third of infants admissions and associated diseases such as anemia, malnutrition, rickets and respiratory tract infections. Prematurity, poor conditions of life, adolescent mothers and reduced level of scholar studies of the mothers were significantly correlated with the degree of dehydration.

Eficienta resuscitarii cardiorespiratorii in UPU a SCJU Constanta - studiu pe o perioada de 1 an
Rodica Tudoran, Alina Oancea, Laura Grigorov

ABSTRACT. The majority of the cardiorespiratory arrest (>65%) occur in prehospital and neccesitate immediate cardiopulmonary resucitation measures. Knowing the elements which increase the survival chances, determine improvement of medical intervention and efficiency of cardiopulmonary resuscitation. The chance of survival is related with: - the disease which induce cardiac arrest; the moment of beginning the cardiopulmonary resuscitation; - the arrhythmic / nonarrhythmic mechanism of cardiac arrrest; - identification/correction of potential reversible factors of cardiorespiratory arrest during resuscitation. The aim of this paperwork is to analyze the efficiency of cardiopulmonary resuscitation to the patients in cardiorespiratory arrest in Emergency Department of Clinical County Emergency Hospital of Constanta, function etiology and mechanism of cardiac arrest, identification/corection of reversible factors, efficiency of cardiopulmonary resuscitation methods.

Complicatii infectioase la bolnavii cu neutropenie
Tatiana Adam, Doina Tofolean, Liliana Tuta, F. Voinea

ABSTRACT. Neutropenia is one of the major risk factors for infection. The aim of this study is to evaluate the infectious complications in neutropenic patients. We investigated 80 infectious episodes in 49 patients registered in I-th Medical Departement of Clinical County Emergency Hospital Constanta during a 3-year period (01.01.2001-31.12.2003). The respiratory complications induced by the BGN were the most frecvent identified (31,25%). We present prophylactic strategies and curative mesures applied for these neutropenic patients with infection complications, underling the major importance of association between antibiotic treatement and growth factors (G-CSF,GM-CSF).

Posibilitati diagnostice si terapeutice in osteodistrofia renala la pacientii hemodializati
Liliana Tuta, Alina Sburlan, I. Iancu, Fl. Voinea

ABSTRACT. Renal osteodystrophy (ROD), the spectrum of bone disorders that develops in patients with chronic renal failure, continues to be a major long-term complication, with high rates of morbidity. The aimof our study was to evaluate the epidemiology of ROD in thepopulation of hemodialysis patients from Constanta County. We enrolled 90 patients (males/females: 56/34) treated by chronic hemodialysis in the Dialysis Department of Constanta County Hospital. The patients were monitored monthly from the point of view of clinical and paraclinical sign wich may suggest ROD. The most frequent clinical manifestations were: musculo-sckeletal (bone pain - 75,5 cases, muscular weakness – 57,7%) and cardiac. Hyperphosphataemia is seen in 54,4% of cases and hypophosphataemia in only 11,1% cases. Our study revealed the high prevalence of hypocalcemia, that, in association with hyperphosphataemia shows, indirectly, the presence of hyperparatiroidism. The most common radiologic changes noticed in our patients were: osteopenia (57,7% cases), subperiostal resorbtion (31,1% cases), vascular calcifications (23,3% cases). Osteodensitometric changes were osteopenia (54% cases) and osteoporosis (26,6% cases).

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