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Detalles de la revista
Formato
Revista
eISSN
2284-5623
Publicado por primera vez
08 Aug 2013
Periodo de publicación
4 veces al año
Idiomas
Inglés

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Volumen 26 (2018): Edición 1 (January 2018)

Detalles de la revista
Formato
Revista
eISSN
2284-5623
Publicado por primera vez
08 Aug 2013
Periodo de publicación
4 veces al año
Idiomas
Inglés

Buscar

12 Artículos
Acceso abierto

Innate Immune Mechanisms in Myocardial Infarction - An Update

Publicado en línea: 30 Jan 2018
Páginas: 9 - 20

Resumen

Abstract

Acute myocardial infarction (AMI) is a disease associated with high morbidity and mortality. Currently there are no available treatments specifically targeting the post-ischemic myocardial processes that lead to heart failure and recurrent coronary events. The innate immune system plays a central role in the two consecutive phases that follow an acute ischemic event: the inflammatory phase and the reparatory phase. The inflamatory phase involves a massive infiltration of neutrophils and inflammatory Ly6Chi monocytes into the injured myocardium. The reparatory phase is orchestrated by reparatory Ly6Clo macrophages that clear necrotic and apoptotic cells through efferocytosis, secrete anti-inflammatory mediators and stimulate fibrosis and repair. Important recent studies provided proof that Ly6Chi monocytes that enter the myocardium in the inflammatory phase upregulate the orphan nuclear receptor Nr4a1 and switch phenotype to Ly6CloNr4a1hi reparatory macrophages. Additionally, neutrophils have been shown to promote cardiac recovery by upregulating expression of the efferocytosis receptor MerTK on reparatory macrophages. A finely tuned balance between the inflammatory and the reparatory phases is thus essential for limiting myocardial damage and promoting efficient recovery. Treatment strategies targeting only the inflammatory phase have so far failed to improve prognosis in AMI patients. A detailed understanding of the interplay between the two phases of the innate immune response is paramount for designing efficient therapies able to improve post- AMI prognosis. In the current review, we summarize the state-of-the-art of the field and discuss previous therapeutic attempts and currently ongoing clinical trials targeting innate immune mechanisms in AMI patients.

Palabras clave

  • myocardial infarction
  • innate immune system
  • monocytes/macrophages
  • neutrophils
  • myocardial repair
Acceso abierto

Is galectin-3 a promoter of ventricular dysfunction?

Publicado en línea: 30 Jan 2018
Páginas: 21 - 36

Resumen

Abstract

Heart failure is nowadays a common condition associated with high mortality and increased healthcare-related costs. Over the years, the research on heart failure management has been extensive in order to better diagnose and treat the condition. Since the progression of left ventricular dysfunction is a consequence of myocardial inflammation, apopotosis, and fibrosis leading to myocardium remodelling, several molecules that are involved in the inflammation pathways have been explored as possible biomarkers for the condition. The study of biomarkers and their key roles in inflammation could allow early identification of patients with heart failure, improve prognostic assessment, and provide a target for future therapies. Among currently studied biomarkers, extensive research has been conducted on galectin-3, a galactoside-binding lectin, which is synthetised and secreted when cardiomyocytes and fibroblasts are submitted to mechanical stress. Accordingly, it has been hypothesised that galectin-3 could be a promoter of left ventricular dysfunction. Galectin-3 has been shown to mediate inflammation by several different pathways which are further detailed in the current review. Also, we aimed to provide a comprehensive overview of existing evidence on the utility of galectin-3 in clinical settings associated with heart failure.

Palabras clave

  • Galectin-3
  • biomarker
  • heart failure
  • dyspnea
  • ventricular dysfunction
  • ventricular remodelling
Acceso abierto

Ischemic modified albumin increases in acute kidney injury

Publicado en línea: 30 Jan 2018
Páginas: 37 - 43

Resumen

Abstract

Purpose: Acute kidney injury (AKI) is a severe kidney disease carrying high morbidity and mortality. An ischemic process, at the cellular level, has been detected prior to the full-blown AKI. An elevated ischemic modified albumin (IMA) was also found to be increased fast at several minutes following an ischemic process in the body. In this connection, we have investigated, in advance, the changes of IMA concentrations in patients with possible AKI. Methods: IMA and other biochemical and haematological parameters were measured in sera of thirty nine patients with AKI and of thirty eight healthy controls. AKI is defined by an increase in serum creatinine by ≥ 0.3 mg/dl in 48 hours or an increase by ≥ 1.5-fold from a known or assumed baseline. The results in the two groups were compared. Results: IMA, creatinine, blood urea nitrogen, white blood cell, neutrophil, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and mean platelet volume were found to be higher in patients with AKI than in healthy controls. In contrast, total protein, albumin, lymphocyte, and haemoglobin were lower in patients with AKI than in healthy controls. No significant difference was recorded in platelet counts between the two groups. Conclusion: Our results indicate that increased levels of NLR and PLR play a central role in a systemic inflammation in AKI. Monitoring serum IMA could be a useful tool in the assessment of AKI.

Palabras clave

  • Acute kidney injury
  • ischemic modified albumin
  • neutrophil-lymphocyte ratio
  • platelet-lymphocyte ratio
  • mean platelet volume
Acceso abierto

Diagnostic accuracy of red blood cell distribution width-to-lymphocyte ratio for celiac disease

Publicado en línea: 30 Jan 2018
Páginas: 45 - 50

Resumen

Abstract

Background. Celiac disease (CD) is significantly underdiagnosed, despite significant efforts made in the last decades to increase its diagnostic rate. This has lead to a high need for developing new diagnostic strategies. Our aim was to evaluate the diagnostic performance of two routine hematologic indices for CD. Methods. In a prospective observational study, 34 newly diagnosed CD patients, 34 age-sex matched controls with irritable bowel syndrome (IBS) and 16 treated CD patients were assessed regarding the differences in mean lymphocyte count (LY), red blood cell distribution width (RDW) and their ratio (RDW/LY). Results. Elevated RDW (>14) and lymphopenia (<1.5 x 10e9/L) were more frequently seen in newly diagnosed CD patients compared to IBS control group and treated CD patients. Newly diagnosed CD patients had significantly higher mean values of RDW/LY - 10.09, compared to 7.72 in the CD-treated group and 6.79 in IBS controls (p<0.01). Subgroup analysis revealed that RDW/LY was higher in patients with destructive histology (Marsh≥3a), 10.54 vs. 7.99. For a value over 7, RDW/LY had a sensitivity of 88.24% (95% CI 72.55-96.70%) and AUROC of 0.785 (95% CI 0.683- 0.887). Conclusions. RDW/LY ratio is a widely available tool which could be used routinely in clinical practice for CD screening.

Palabras clave

  • celiac disease
  • screening
  • red blood cell distribution width
  • lymphopenia
Acceso abierto

Elevated Urinary Methylmalonic Acid/creatinine ratio and Serum Sterol levels in Patients with Acute Ischemic Stroke

Publicado en línea: 30 Jan 2018
Páginas: 51 - 58

Resumen

Abstract

Introduction: Sitosterolemia, defined as phytosterolemia, is a rare autosomal recessive disease characterized by elevated blood sterol levels. Our aim was to investigate serum plant sterols, methylmalonic acid, vitamin B12, oxidized-LDL and homocysteine levels in ischemic and hemorrhagic stroke patients and healthy subjects. Material and Methods: 50 healthy subjects (without a family history of coronary artery disease) and 89 patients hospitalized in the Selcuk University neurology clinic or intensive care unit with a diagnosis of stroke were included in this study. Serum plant sterols, homocysteine and methylmalonic acid, oxidized-LDL, total cholesterol, triglycerides, HDL-Cholesterol and vitamin B12 levels were analyzed by gas chromatography-mass spectrometry, liquid-chromatography tandem mass spectrometry, commercially available ELISA kit, spectrophotometry and chemiluminescence methods, respectively. Results: Urinary methylmalonic acid/creatinine ratio (p< 0.05), serum β-sitosterol levels and β-sitosterol/ cholesterol ratio were significantly higher (p <0.01) in patients compared to the control group. There was a significant positive correlation between the serum OxLDL- methylmalonic acid, serum homocysteine- urinary methylmalonic acid /creatinine ratio, serum methylmalonic acid - Urinary methylmalonic acid (p<0.05), serum homocysteine- urinary methylmalonic acid, urinary methylmalonic acid-methylmalonic acid/creatinine ratio, serum methylmalonic acid- methylmalonic acid/creatinine ratio, serum beta-sitosterol- beta-sitosterol /cholesterol, total cholesterol-HDL, total cholesterol-LDL (p <0.01) levels and negative correlation between vitamin B12- serum methylmalonic acid (p<0.05), cholesterol-stigmasterol/cholesterol, LDL- stigmasterol/cholesterol (p <0.01) levels in the patient group. Conclusion: Our findings presented that the serum sitosterol levels were significantly higher in stroke patients compared to controls.

Palabras clave

  • sterol
  • stroke
  • oxidized LDL
  • methylmalonic acid
  • creatinine
Acceso abierto

Plasma phosphorylated neurofilament heavy chains as a potential marker for ischemic stroke patients

Publicado en línea: 30 Jan 2018
Páginas: 59 - 64

Resumen

Abstract

Background: The aim of the study was to determine the utility of plasma NfH in correlation with serum hsCRP for severity and short-term functional outcome prediction after ischemic stroke. Methods: 124 patients and 40 healthy controls were enrolled, serial plasma neurofilament heavy chains and hsCRP concentrations were measured and evaluated for TOAST subtype, stroke severity and functional outcome at discharge. Results: Serum level of hsCRP was significantly higher in patients versus controls (p<0.05) with no difference between TOAST subtypes. Plasma NfH concentration on day 5 was higher in CE stroke compared to LAA group and SVO group. A positive correlation between NfH levels on day 5 and mRS at discharge (r=0.304, p=0.001) and a gender stratification of hsCRP and mRS at discharge was found. Values of 6.04 mg/l for hsCRP and 46.4 ng/ml for NfH were found predictive for unfavorable short-term outcome, but after adjusting for age, sex and stroke severity, the prediction power was lost. Conclusions: Plasma concentration of NfH shows a significant increase over the first five days after ischemic stroke, in correlation with inflammatory status and short-term evolution.

Palabras clave

  • phosphorylated neurofilament heavy chains
  • ischemic stroke
Acceso abierto

Administration of valine, leucine, and isoleucine improved plasma cholesterol and mitigated the preatherosclerotic lesions in rats fed with hypercholesterolemic diet

Publicado en línea: 30 Jan 2018
Páginas: 65 - 75

Resumen

Abstract

Hypercholesterolemia has a major contribution to the occurrence and progression of atherosclerotic lesions. Recent studies report the involvement of branched-chain amino acids in cholesterol methabolism. The aim of this research was to evaluate the role of valine, leucine and isoleucine on the occurrence and progression of atherosclerosis in rats receiving hypercholesterolic diet. Material and methods: 50 male Wistar rats distributed into five groups with the following type of diets: group I (control) received standard diet; group II - cholesterol; group III - cholesterol and valine; group IV - cholesterol and leucine; group V - cholesterol and isoleucine. The experimental study was conducted over a period of 2 months. The animals were evaluated for the serum levels of total cholesterol at the beginning of the experiment, after 1 month and after 2 months. The collected tissue fragments of heart and aorta were prepared for the examination by optical microscopy in order to identify the atherosclerotic changes. Results: The most increased values of serum cholesterol were recorded in rats from group II (p=0.001), for the second and third evaluation. The histological examination showed early histopathological lesions on the vascular intima for the groups treated with cholesterol, valine, leucine, and isoleucine. These early changes (the occurrence of some superficial endothelial erosions, adhesion of erythrocytes and platelets) were correlated with the degree of the arterial wall damage, of the leukocytes adhesion to the arterial intima, and the discontinuities of the internal elastic lamina. Conclusion: The comparative study of the effects of the three essential amino acids revealed that valine induced a faster response than leucine and isoleucine on the improvement of biochemical parameters, but there were no significant differences between the three amino acids in terms of their protective ability, demonstrated by the histopathological lesion assessment.

Palabras clave

  • valine
  • leucine
  • isoleucine
  • hypercholesterolemia
  • atherosclerosis
Acceso abierto

The impact of immunological and biomolecular investigations on the outcome of children with acute lymphoblastic leukemia - experience of IIIrd Paediatric Clinic Timisoara

Publicado en línea: 30 Jan 2018
Páginas: 77 - 85

Resumen

Abstract

Introduction. The unsatisfactory results of the survival in patients with acute lymphoblastic leukemia (ALL) until 2000 in our center have led us to improve the approach of diagnosis and therapy. Since 2003 in all patients the following have been performed: flow cytometry, conventional genetic diagnosis, FISH (fluorescent in situ hybridization), and molecular biology. Objectives. Our aims were to identify solutions to increase patients’ survival. Patients and method. It is a single-center, retrospective study of 136 patients with ALL treated at 3rd Pediatric Clinic of Timisoara, over a period of 10 years (2003-2012), where survival was assessed. Results. Morphologically, 86% of the patients were L1 type, 13% L2 type and 1% L3 type. Flow citometry revealed that 68% were ALL with B precursors, and 19% with T immunophenotype. Acute leukemia with mixed phenotype (biphenotypic) was identified in 2.3% of patients and 10.7% of the forms were acute leukemia with myeloid markers. In 27.7% of patients, mutations were detected by the RT-PCR method, the most commonly identified was TEL-AML1 (ETV6- RUNX1) accounting for 12.7% of the cases. Relapse-free survival at 5 years for the entire group was 59%, and for the group treated between 2008 and 2012 it was 72%. Conclusion. Our analysis confirms the decisive value of laboratory investigations for the prognosis and improvement of supportive therapy.

Palabras clave

  • leukemia
  • immunophenotyping
  • fusion genes
  • children
Acceso abierto

FLT-3 ITD Positive Acute Basophilic Leukemia with Rare Complex Karyotype Presenting with Acute Respiratory Failure: Case Report

Publicado en línea: 30 Jan 2018
Páginas: 87 - 94

Resumen

Abstract

Background: Acute basophilic leukemia is a rare subtype of acute myeloid leukemia, as categorized by the 2008 World Health Organization classification of myeloid neoplasms. Acute basophilic leukemia diagnosis requires thorough morphological, cytochemical, immunophenotypic, molecular, and cytogenetic studies and exclusion of other hematological neoplasms associating basophilia. The disease course is defined by histamine driven, occasionally life-threatening respiratory, cardiovascular, cutaneous or digestive complications, as well as primary refractoriness to standard therapy. Clinical presentation: We herein report a case of a 63-year-old asthmatic female patient diagnosed with acute basophilic leukemia, associated with previously unpublished cytogenetic features and FLT-3 ITD mutation, pulmonary leukostasis and spontaneous pulmonary capillary leak syndrome, which worsened immediately following chemotherapy initiation. Respiratory complications were successfully managed, but recrudesced upon emergence of refractory disease and were ultimately fatal. We highlight the likelihood of pulmonary complications induced by basophil degranulation and tumor lysis in hypercellular acute basophilic leukemia and the potential benefit of histamine receptor blockade in this setting.

Palabras clave

  • Acute Basophilic Leukemia
  • FLT-3 ITD
  • leukostasis
  • acute respiratory failure
Acceso abierto

Myelodysplastic syndrome with myelofibrosis in a 12-year-old patient – A case report

Publicado en línea: 30 Jan 2018
Páginas: 95 - 103

Resumen

Abstract

Myelodysplastic syndromes are a heterogeneous group of clonal disorders characterized by peripheral blood cytopenia and normal or hypercellular bone marrow with dysplasia in more than one blood cell lineage, unfavorable prognosis, and lack of response to treatment. We present the case of a 12-year-old male patient who was referred to the Hematology and Oncology Department of Pediatric Clinic I Târgu- Mures in May 2016, with splenomegaly and pancytopenia. The osteomedullary biopsy revealed myelofibrosis, discrete dysplasia of the myeloid series and megakaryocytes, blasts CD34+ approximately 10%, which led to the diagnosis of myelodysplastic syndrome with myelofibrosis. The myeloid precursors indicated a high risk of transformation into acute myeloid leukemia, so chemotherapy associated with corticosteroids was started, leading to slight improvements. Although myelodysplastic syndrome associated with myelofibrosis is rare at this age, despite the treatment and favorable progression in the case presented, in the absence of hematopoietic stem cell transplantation the prognosis remains unfavorable.

Palabras clave

  • myelodysplastic syndrome
  • pancytopenia
  • myelofibrosis
  • children
Acceso abierto

Spontaneous atrial fibrillation after long-term transesophageal atrial burst pacing in rats. Technical and procedural approach to a new in vivo atrial fibrillation model

Publicado en línea: 30 Jan 2018
Páginas: 105 - 111

Resumen

Acceso abierto

Hemophagocytic Lymphohistiocytosis Secondary to Mycoplasma Pneumoniae Infection in a Trisomy 21 girl

Publicado en línea: 30 Jan 2018
Páginas: 113 - 117

Resumen

12 Artículos
Acceso abierto

Innate Immune Mechanisms in Myocardial Infarction - An Update

Publicado en línea: 30 Jan 2018
Páginas: 9 - 20

Resumen

Abstract

Acute myocardial infarction (AMI) is a disease associated with high morbidity and mortality. Currently there are no available treatments specifically targeting the post-ischemic myocardial processes that lead to heart failure and recurrent coronary events. The innate immune system plays a central role in the two consecutive phases that follow an acute ischemic event: the inflammatory phase and the reparatory phase. The inflamatory phase involves a massive infiltration of neutrophils and inflammatory Ly6Chi monocytes into the injured myocardium. The reparatory phase is orchestrated by reparatory Ly6Clo macrophages that clear necrotic and apoptotic cells through efferocytosis, secrete anti-inflammatory mediators and stimulate fibrosis and repair. Important recent studies provided proof that Ly6Chi monocytes that enter the myocardium in the inflammatory phase upregulate the orphan nuclear receptor Nr4a1 and switch phenotype to Ly6CloNr4a1hi reparatory macrophages. Additionally, neutrophils have been shown to promote cardiac recovery by upregulating expression of the efferocytosis receptor MerTK on reparatory macrophages. A finely tuned balance between the inflammatory and the reparatory phases is thus essential for limiting myocardial damage and promoting efficient recovery. Treatment strategies targeting only the inflammatory phase have so far failed to improve prognosis in AMI patients. A detailed understanding of the interplay between the two phases of the innate immune response is paramount for designing efficient therapies able to improve post- AMI prognosis. In the current review, we summarize the state-of-the-art of the field and discuss previous therapeutic attempts and currently ongoing clinical trials targeting innate immune mechanisms in AMI patients.

Palabras clave

  • myocardial infarction
  • innate immune system
  • monocytes/macrophages
  • neutrophils
  • myocardial repair
Acceso abierto

Is galectin-3 a promoter of ventricular dysfunction?

Publicado en línea: 30 Jan 2018
Páginas: 21 - 36

Resumen

Abstract

Heart failure is nowadays a common condition associated with high mortality and increased healthcare-related costs. Over the years, the research on heart failure management has been extensive in order to better diagnose and treat the condition. Since the progression of left ventricular dysfunction is a consequence of myocardial inflammation, apopotosis, and fibrosis leading to myocardium remodelling, several molecules that are involved in the inflammation pathways have been explored as possible biomarkers for the condition. The study of biomarkers and their key roles in inflammation could allow early identification of patients with heart failure, improve prognostic assessment, and provide a target for future therapies. Among currently studied biomarkers, extensive research has been conducted on galectin-3, a galactoside-binding lectin, which is synthetised and secreted when cardiomyocytes and fibroblasts are submitted to mechanical stress. Accordingly, it has been hypothesised that galectin-3 could be a promoter of left ventricular dysfunction. Galectin-3 has been shown to mediate inflammation by several different pathways which are further detailed in the current review. Also, we aimed to provide a comprehensive overview of existing evidence on the utility of galectin-3 in clinical settings associated with heart failure.

Palabras clave

  • Galectin-3
  • biomarker
  • heart failure
  • dyspnea
  • ventricular dysfunction
  • ventricular remodelling
Acceso abierto

Ischemic modified albumin increases in acute kidney injury

Publicado en línea: 30 Jan 2018
Páginas: 37 - 43

Resumen

Abstract

Purpose: Acute kidney injury (AKI) is a severe kidney disease carrying high morbidity and mortality. An ischemic process, at the cellular level, has been detected prior to the full-blown AKI. An elevated ischemic modified albumin (IMA) was also found to be increased fast at several minutes following an ischemic process in the body. In this connection, we have investigated, in advance, the changes of IMA concentrations in patients with possible AKI. Methods: IMA and other biochemical and haematological parameters were measured in sera of thirty nine patients with AKI and of thirty eight healthy controls. AKI is defined by an increase in serum creatinine by ≥ 0.3 mg/dl in 48 hours or an increase by ≥ 1.5-fold from a known or assumed baseline. The results in the two groups were compared. Results: IMA, creatinine, blood urea nitrogen, white blood cell, neutrophil, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and mean platelet volume were found to be higher in patients with AKI than in healthy controls. In contrast, total protein, albumin, lymphocyte, and haemoglobin were lower in patients with AKI than in healthy controls. No significant difference was recorded in platelet counts between the two groups. Conclusion: Our results indicate that increased levels of NLR and PLR play a central role in a systemic inflammation in AKI. Monitoring serum IMA could be a useful tool in the assessment of AKI.

Palabras clave

  • Acute kidney injury
  • ischemic modified albumin
  • neutrophil-lymphocyte ratio
  • platelet-lymphocyte ratio
  • mean platelet volume
Acceso abierto

Diagnostic accuracy of red blood cell distribution width-to-lymphocyte ratio for celiac disease

Publicado en línea: 30 Jan 2018
Páginas: 45 - 50

Resumen

Abstract

Background. Celiac disease (CD) is significantly underdiagnosed, despite significant efforts made in the last decades to increase its diagnostic rate. This has lead to a high need for developing new diagnostic strategies. Our aim was to evaluate the diagnostic performance of two routine hematologic indices for CD. Methods. In a prospective observational study, 34 newly diagnosed CD patients, 34 age-sex matched controls with irritable bowel syndrome (IBS) and 16 treated CD patients were assessed regarding the differences in mean lymphocyte count (LY), red blood cell distribution width (RDW) and their ratio (RDW/LY). Results. Elevated RDW (>14) and lymphopenia (<1.5 x 10e9/L) were more frequently seen in newly diagnosed CD patients compared to IBS control group and treated CD patients. Newly diagnosed CD patients had significantly higher mean values of RDW/LY - 10.09, compared to 7.72 in the CD-treated group and 6.79 in IBS controls (p<0.01). Subgroup analysis revealed that RDW/LY was higher in patients with destructive histology (Marsh≥3a), 10.54 vs. 7.99. For a value over 7, RDW/LY had a sensitivity of 88.24% (95% CI 72.55-96.70%) and AUROC of 0.785 (95% CI 0.683- 0.887). Conclusions. RDW/LY ratio is a widely available tool which could be used routinely in clinical practice for CD screening.

Palabras clave

  • celiac disease
  • screening
  • red blood cell distribution width
  • lymphopenia
Acceso abierto

Elevated Urinary Methylmalonic Acid/creatinine ratio and Serum Sterol levels in Patients with Acute Ischemic Stroke

Publicado en línea: 30 Jan 2018
Páginas: 51 - 58

Resumen

Abstract

Introduction: Sitosterolemia, defined as phytosterolemia, is a rare autosomal recessive disease characterized by elevated blood sterol levels. Our aim was to investigate serum plant sterols, methylmalonic acid, vitamin B12, oxidized-LDL and homocysteine levels in ischemic and hemorrhagic stroke patients and healthy subjects. Material and Methods: 50 healthy subjects (without a family history of coronary artery disease) and 89 patients hospitalized in the Selcuk University neurology clinic or intensive care unit with a diagnosis of stroke were included in this study. Serum plant sterols, homocysteine and methylmalonic acid, oxidized-LDL, total cholesterol, triglycerides, HDL-Cholesterol and vitamin B12 levels were analyzed by gas chromatography-mass spectrometry, liquid-chromatography tandem mass spectrometry, commercially available ELISA kit, spectrophotometry and chemiluminescence methods, respectively. Results: Urinary methylmalonic acid/creatinine ratio (p< 0.05), serum β-sitosterol levels and β-sitosterol/ cholesterol ratio were significantly higher (p <0.01) in patients compared to the control group. There was a significant positive correlation between the serum OxLDL- methylmalonic acid, serum homocysteine- urinary methylmalonic acid /creatinine ratio, serum methylmalonic acid - Urinary methylmalonic acid (p<0.05), serum homocysteine- urinary methylmalonic acid, urinary methylmalonic acid-methylmalonic acid/creatinine ratio, serum methylmalonic acid- methylmalonic acid/creatinine ratio, serum beta-sitosterol- beta-sitosterol /cholesterol, total cholesterol-HDL, total cholesterol-LDL (p <0.01) levels and negative correlation between vitamin B12- serum methylmalonic acid (p<0.05), cholesterol-stigmasterol/cholesterol, LDL- stigmasterol/cholesterol (p <0.01) levels in the patient group. Conclusion: Our findings presented that the serum sitosterol levels were significantly higher in stroke patients compared to controls.

Palabras clave

  • sterol
  • stroke
  • oxidized LDL
  • methylmalonic acid
  • creatinine
Acceso abierto

Plasma phosphorylated neurofilament heavy chains as a potential marker for ischemic stroke patients

Publicado en línea: 30 Jan 2018
Páginas: 59 - 64

Resumen

Abstract

Background: The aim of the study was to determine the utility of plasma NfH in correlation with serum hsCRP for severity and short-term functional outcome prediction after ischemic stroke. Methods: 124 patients and 40 healthy controls were enrolled, serial plasma neurofilament heavy chains and hsCRP concentrations were measured and evaluated for TOAST subtype, stroke severity and functional outcome at discharge. Results: Serum level of hsCRP was significantly higher in patients versus controls (p<0.05) with no difference between TOAST subtypes. Plasma NfH concentration on day 5 was higher in CE stroke compared to LAA group and SVO group. A positive correlation between NfH levels on day 5 and mRS at discharge (r=0.304, p=0.001) and a gender stratification of hsCRP and mRS at discharge was found. Values of 6.04 mg/l for hsCRP and 46.4 ng/ml for NfH were found predictive for unfavorable short-term outcome, but after adjusting for age, sex and stroke severity, the prediction power was lost. Conclusions: Plasma concentration of NfH shows a significant increase over the first five days after ischemic stroke, in correlation with inflammatory status and short-term evolution.

Palabras clave

  • phosphorylated neurofilament heavy chains
  • ischemic stroke
Acceso abierto

Administration of valine, leucine, and isoleucine improved plasma cholesterol and mitigated the preatherosclerotic lesions in rats fed with hypercholesterolemic diet

Publicado en línea: 30 Jan 2018
Páginas: 65 - 75

Resumen

Abstract

Hypercholesterolemia has a major contribution to the occurrence and progression of atherosclerotic lesions. Recent studies report the involvement of branched-chain amino acids in cholesterol methabolism. The aim of this research was to evaluate the role of valine, leucine and isoleucine on the occurrence and progression of atherosclerosis in rats receiving hypercholesterolic diet. Material and methods: 50 male Wistar rats distributed into five groups with the following type of diets: group I (control) received standard diet; group II - cholesterol; group III - cholesterol and valine; group IV - cholesterol and leucine; group V - cholesterol and isoleucine. The experimental study was conducted over a period of 2 months. The animals were evaluated for the serum levels of total cholesterol at the beginning of the experiment, after 1 month and after 2 months. The collected tissue fragments of heart and aorta were prepared for the examination by optical microscopy in order to identify the atherosclerotic changes. Results: The most increased values of serum cholesterol were recorded in rats from group II (p=0.001), for the second and third evaluation. The histological examination showed early histopathological lesions on the vascular intima for the groups treated with cholesterol, valine, leucine, and isoleucine. These early changes (the occurrence of some superficial endothelial erosions, adhesion of erythrocytes and platelets) were correlated with the degree of the arterial wall damage, of the leukocytes adhesion to the arterial intima, and the discontinuities of the internal elastic lamina. Conclusion: The comparative study of the effects of the three essential amino acids revealed that valine induced a faster response than leucine and isoleucine on the improvement of biochemical parameters, but there were no significant differences between the three amino acids in terms of their protective ability, demonstrated by the histopathological lesion assessment.

Palabras clave

  • valine
  • leucine
  • isoleucine
  • hypercholesterolemia
  • atherosclerosis
Acceso abierto

The impact of immunological and biomolecular investigations on the outcome of children with acute lymphoblastic leukemia - experience of IIIrd Paediatric Clinic Timisoara

Publicado en línea: 30 Jan 2018
Páginas: 77 - 85

Resumen

Abstract

Introduction. The unsatisfactory results of the survival in patients with acute lymphoblastic leukemia (ALL) until 2000 in our center have led us to improve the approach of diagnosis and therapy. Since 2003 in all patients the following have been performed: flow cytometry, conventional genetic diagnosis, FISH (fluorescent in situ hybridization), and molecular biology. Objectives. Our aims were to identify solutions to increase patients’ survival. Patients and method. It is a single-center, retrospective study of 136 patients with ALL treated at 3rd Pediatric Clinic of Timisoara, over a period of 10 years (2003-2012), where survival was assessed. Results. Morphologically, 86% of the patients were L1 type, 13% L2 type and 1% L3 type. Flow citometry revealed that 68% were ALL with B precursors, and 19% with T immunophenotype. Acute leukemia with mixed phenotype (biphenotypic) was identified in 2.3% of patients and 10.7% of the forms were acute leukemia with myeloid markers. In 27.7% of patients, mutations were detected by the RT-PCR method, the most commonly identified was TEL-AML1 (ETV6- RUNX1) accounting for 12.7% of the cases. Relapse-free survival at 5 years for the entire group was 59%, and for the group treated between 2008 and 2012 it was 72%. Conclusion. Our analysis confirms the decisive value of laboratory investigations for the prognosis and improvement of supportive therapy.

Palabras clave

  • leukemia
  • immunophenotyping
  • fusion genes
  • children
Acceso abierto

FLT-3 ITD Positive Acute Basophilic Leukemia with Rare Complex Karyotype Presenting with Acute Respiratory Failure: Case Report

Publicado en línea: 30 Jan 2018
Páginas: 87 - 94

Resumen

Abstract

Background: Acute basophilic leukemia is a rare subtype of acute myeloid leukemia, as categorized by the 2008 World Health Organization classification of myeloid neoplasms. Acute basophilic leukemia diagnosis requires thorough morphological, cytochemical, immunophenotypic, molecular, and cytogenetic studies and exclusion of other hematological neoplasms associating basophilia. The disease course is defined by histamine driven, occasionally life-threatening respiratory, cardiovascular, cutaneous or digestive complications, as well as primary refractoriness to standard therapy. Clinical presentation: We herein report a case of a 63-year-old asthmatic female patient diagnosed with acute basophilic leukemia, associated with previously unpublished cytogenetic features and FLT-3 ITD mutation, pulmonary leukostasis and spontaneous pulmonary capillary leak syndrome, which worsened immediately following chemotherapy initiation. Respiratory complications were successfully managed, but recrudesced upon emergence of refractory disease and were ultimately fatal. We highlight the likelihood of pulmonary complications induced by basophil degranulation and tumor lysis in hypercellular acute basophilic leukemia and the potential benefit of histamine receptor blockade in this setting.

Palabras clave

  • Acute Basophilic Leukemia
  • FLT-3 ITD
  • leukostasis
  • acute respiratory failure
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Myelodysplastic syndrome with myelofibrosis in a 12-year-old patient – A case report

Publicado en línea: 30 Jan 2018
Páginas: 95 - 103

Resumen

Abstract

Myelodysplastic syndromes are a heterogeneous group of clonal disorders characterized by peripheral blood cytopenia and normal or hypercellular bone marrow with dysplasia in more than one blood cell lineage, unfavorable prognosis, and lack of response to treatment. We present the case of a 12-year-old male patient who was referred to the Hematology and Oncology Department of Pediatric Clinic I Târgu- Mures in May 2016, with splenomegaly and pancytopenia. The osteomedullary biopsy revealed myelofibrosis, discrete dysplasia of the myeloid series and megakaryocytes, blasts CD34+ approximately 10%, which led to the diagnosis of myelodysplastic syndrome with myelofibrosis. The myeloid precursors indicated a high risk of transformation into acute myeloid leukemia, so chemotherapy associated with corticosteroids was started, leading to slight improvements. Although myelodysplastic syndrome associated with myelofibrosis is rare at this age, despite the treatment and favorable progression in the case presented, in the absence of hematopoietic stem cell transplantation the prognosis remains unfavorable.

Palabras clave

  • myelodysplastic syndrome
  • pancytopenia
  • myelofibrosis
  • children
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Spontaneous atrial fibrillation after long-term transesophageal atrial burst pacing in rats. Technical and procedural approach to a new in vivo atrial fibrillation model

Publicado en línea: 30 Jan 2018
Páginas: 105 - 111

Resumen

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Hemophagocytic Lymphohistiocytosis Secondary to Mycoplasma Pneumoniae Infection in a Trisomy 21 girl

Publicado en línea: 30 Jan 2018
Páginas: 113 - 117

Resumen

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