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Volume XIX, Number 1, 2015 - Therapeutics Pharmacology and Clinical Toxicology

Review


Chronic kidney disease mineral bone disorder in children

Lungu A.C., Constantinescu Iulia, Stoica Cristina
Abstract: Childhood and adolescence are critical times for the development of all organs and systems. Achievement of optimal bone mass in this period is thought to be the best predictor for bone health in the adult life1. In children, nutrition, physical activity, growth, endocrine and metabolic function is mandatory for a normal skeleton development and cardiovascular system. Disordered mineral and bone metabolism zassociated with chronic kidney disease causes important obstacles to final adult height, bone strength and cardiovascular integrity that may contribute to chronic morbidity[2, 3]. As kidney function decreases, a progressive deterioration in mineral homeostasis emerge, with an abnormal serum and tissue concentrations of phosphorus and calcium, and changes in circulating levels of hormones[4]. Therefore, treatment target of MBD includes maintaining optimal serum parameters for calcium, phosphorus and parathyroid hormone according to stage of CKD, in order to improve growth, high-turnover bone disease and prevent cardiovascular calcifications.

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Diagnosis particularities in dystrophinopathies in women

Pop Anita, Cornitescu M., Plesca Doina Anca
Abstract: Dystrophinopathies are X- linked muscle diseases, more frequently expressed in males, but infrequently also the substrate of muscular pathology in females. Laboratory methods in the diagnosis of dystrophinopathies have been continuously improving, which permits a higher accuracy in the study of the involved genetic alterations and of their modes of transmission and expression.

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Original Papers


The Albendazol treatments efficacy in hydatid cysts

Dumitru Irina Magdalena, Dumitru E., Rugina S., Dumitru A.
Abstract: The evaluation of albendazol treatment's efficacy in hydatid cysts (CH) with different locations and the evaluation of treatment’s efficacy based on: cysts' location, size, type and immunological status of patient. We performed a prospective study on 320 patients, during 5 years. We performed the drugbased treatment in cases of small and medium cysts sizes (< 7 cm). Statistics do not show a significant difference between the hepatic and pulmonary hydatic cysts’ healing rates, p > 0.05 (p = 0.5987). Albendazol treatment’s efficacy is higher in the case of hepatic localization than in other localizations. The efficacy of the albendazol therapy is significantly higher in the case of CH < 7cm in comparison with CH > 7cm, which requests a surgical treatment. The efficacy of the albendazol treatment is higher in the case of type 1 hydatic cysts than in the case of type 2 hydatic cysts. Patients with CD4 > 944 cells/mm3 responded better to treatment in comparison with the patients with CD4 < 944 cells/mm3. The efficiency of the albendazol treatment is lower for the patients presenting co-morbidities. Treating hidatid diseases with albendazol 800mg/day for 4 weeks, in repeated cures separated by free intervals of 2 weeks, had as a result the healing of 91.25% of the cases. The positive predictive factors of the albendazol treatment response were: hepatic or pulmonary localization of the hydatid cysts, small dimensions, below 7cm in diameter, presence of the type1 hydatid cists, absence of co-morbidities and unaltered immunological status (CD4 > 944 cells/mm3).

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Therapeutical Practice


Update on molecular genetics in acute myeloid leukemia post myeloproliferative neoplasms

Coles Elena Constanta, Stanca Oana, Berbec Nicoleta, Lupu Anca Roxana
Abstract: Myeloproliferative neoplasms (MPN) are indolent hematologic cancers that are characterized by excessive production of mature blood cells. Acute myeloid leukemia (AML) is an uncommon, but often deadly c omplication o f t hese c hronic d isorders. In the last years s ignificant p rogress h as been made in the diagnostic algorithm and therapeutic management of AML postMPN

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The management of the autoimmune thrombocytopenia associated with chronic malignant lymphoproliferative diseases

Oprea Madalina Marilena, Ivanescu Ana-Maria, Colita A., Turbatu A., Coles Elena, Lupu Anca Roxana
Abstract: Autoimmune thrombocytopenia is a common immune hematologic complication associated with lymphoproliferative diseases, most frequent with chronic lymphocytic leukemia and non-Hodgkin’s Lymphomas . The relation between autoimmune cytopenias and lymphoproliferative malignancies is well known and the mechanisms are complex. Regarding the ethiology, one or more simultaneously occurring causes could leed to thrombocytopenia. We should make a very riguros clinical and paraclinical judgement in diagnosis of autoimmune thrombocytopenia and then, treat not only the number of platelets but also manage the risk of significant bleeding. Supportive care , corticosteroids and chemoimunotherapy are the currently used treatment , individualized for each pacient. The response to the lymphoma treatment is very good, and significant bleeding is rare.

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The radiologists role in the minimally invasive therapy of residual common bile duct lithiasis

Petrescu Ioana, Bratu Ana Magdalena, Popa B.V., Cristian D., Petrescu S., Zaharia C., Burcos T.
Abstract: Residual lithiasis found in the main bile duct entails the presence, at the site, of one or more calculi, consequent to a surgical procedure for gallbladder or common bile duct lithiasis. Currently, the surgical community is trying to treat this condition via a minimally invasive procedure: endoscopic retrograde cholangiopancreatography. A bile duct obstacle can be diagnosed based on several imagistic methods, the most important ones being: the ultrasound, computed tomography or the cholangio- MRI. These methods aim to detect an obstacle, to establish its nature, location and size. The decision to apply these imagistic diagnostics techniques or different ones, depending on their indications, contraindications or their succession belongs, entirely, to the radiologist. In this sense, we compared the results we have obtained so far to specialised studies and research, in an attempt to establish the highest reliability level in the diagnostic imaging investigation of the common bile duct lithiasis whose absence would make impossible an endoscopic retrograde colangiopancreatography.

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Malaria – a continuous challenge

Stefan I.
Abstract: Malaria, whose history is almost as old as humanity’s itself, constitutes a permanent challenge and reason of concern for the medical community. The involvement of the fifth plasmodium species – Plasmodium knowlesi has become an undeniable reality. Also, expanded choloroquine resistance, mefloquine resistance, the occurrence of artemisinin resistance as well as the lack of an efficient vaccine, the possibility of P. vivax transmission to persons with negative Duffy antigen, resistance of vectors to DDT and derivates represent matters of high relevance for the scientists in the field. However, these threats led to intensified efforts to discover new therapeutic and diagnosis breakthroughs.

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