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Détails du magazine
Format
Magazine
eISSN
2284-5623
ISSN
2284-5623
Première publication
08 Aug 2013
Période de publication
4 fois par an
Langues
Anglais

Chercher

Volume 21 (2013): Edition 4 (December 2013)

Détails du magazine
Format
Magazine
eISSN
2284-5623
ISSN
2284-5623
Première publication
08 Aug 2013
Période de publication
4 fois par an
Langues
Anglais

Chercher

12 Articles
Accès libre

Major editorial changes of Romanian Review of Laboratory Medicine

Publié en ligne: 31 Dec 2013
Pages: 377 - 380

Résumé

Abstract

Starting with the first issue of 2013, the Romanian Review of Laboratory Medicine has implemented a new editorial and publishing system. By this editorial, we try to clarify to all the readers and authors the major changes and their outcome in the journal’s evolution. Thus, we present details related to the current internal organization of the editorial board and the editorial workflow of the submitted manuscripts.

Mots clés

  • editorial policy
  • editorial workflow
  • scientific review
  • publishing

Cuvinte cheie

  • politică redacţională
  • flux redacţional
  • recenzie ştiinţifică
  • publicare
Accès libre

Distribution of Paraoxonase 1 polymorphisms and activities in obese patients

Publié en ligne: 31 Dec 2013
Pages: 381 - 389

Résumé

Abstract

Study objective. The objective of this study was to investigate PON1 phenotype and genotype in Romanian patients with abdominal obesity. Materials and methods. The study groups consisted of 88 patients with abdominal obesity and 46 subjects with normal waist circumference, matched for age and gender. For each patient, we determined the clinical parameters that may influence PON1 activities. Q192R and L55M polymorphisms analysis in the PON1 gene were performed by PCR-RFLP using specific primers and restriction enzymes. PON1 lactonase, paraoxonase and arylesterase activities were assayed by spectrophotometric methods. Analysis of PON1 genotypes and activities distribution in the obese and non-obese individuals was performed with Med- Calc Software (Version 12.4.0.0). Results. There was no statistically significant difference between obese and controls in regards to age and gender. The study revealed that PON1 activities were not influenced by gender. Of all PON1 activities, only the paraoxonase activity was inversely correlated with age, being significantly reduced in patients with abdominal obesity compared to non-obesity (p=0.009). Abdominal circumference independently influenced only the variation of arylesterase activity (R2=6.5%, p=0.003). Distribution of PON1 genotypes in the study groups was significantly different (p=0.007) only for the Q192R but not for the L55M genotypes. The QR genotype had the highest influence on paraoxonase activity (R2=40.6; p<0.001). The MM genotype had the greatest influence on arylesterase (R2=11.3%, p<0.001) and lactonase activities (R2=7.4%, p<0.001). Conclusions. Q192R genotypes distribution was significantly different in obese patients and the QR genotype influenced greatly the paraoxonase activity. The MM genotype had the most important independent influence on the lactonase and arylesterase activities .

Mots clés

  • paraoxonase
  • arylesterase
  • lactonase
  • activity
  • genotype
  • obesity

Cuvinte cheie

  • paraoxonază
  • arilesterază
  • lactonază
  • activitate
  • genotip
  • obezitate
Accès libre

The number of PON1 mutant alleles, but not PON1 phenotype, is associated with Gensini score of coronary damage

Publié en ligne: 31 Dec 2013
Pages: 391 - 398

Résumé

Abstract

Objectives. The aim of this study was to examine the effects of single nucleotide polymorphisms (SNPs) of PON1 gene at the level of promoter region (‒909 and ‒832) and of first exon (+575, A20352G, resulting Q192R substitution) on paraoxonase-1 (PON1) activities in 53 patients with angiographycally proven coronary heart disease (CHD) and 17 free-CHD subjects. Methods and Results. Serum PON1 arylesterase (Ar-ase) and salt-stimulated paraoxonase (ssPO-ase) activities were assessed with manual spectrophotometric methods, by using phenyl acetate and paraoxon as substrates. Common serum biochemical markers were assayed by enzymatic methods using commercial kits, on a Roche/Hitachi 912 Auto Analyzer. PON1 genotypes were determined by PCR and nucleotide sequencing of the amplicons with an ABI PRISMTM 310 Genetic Analyzer and a BigDye® Terminator v3.1 Cycle Sequencing Kit. The severity of coronary artery stenosis was assessed and classified using the Gensini score. We found no significant differences in the PON1 activities and -909(G→C), -832(G→A) and +575(A→G) PON1 polymorphisms between CHD and CHD-free groups. Considering all investigated subjects, we found that -909(G→C) and +575(A→G) SNPs had statistically significant effects on Ar-ase activity and PO-ase activity, respectively. In a multiple regression model we found that diabetes, LDL-cholesterol and the number of mutant alleles were significant independent determinants of the Gensini score. A significant positive correlation was observed only between the Gensini score and the number of mutant alleles. Conclusions. There are no differences between CHD and CHD-free groups regarding PON1 genotypes and phenotypes but the increasing number of PON1 mutant alleles is an important factor in determining the severity of coronary damage.

Keywords

  • paraoxonase-1
  • arylesterase
  • atherosclerosis
  • Gensini score
  • genotyping

Cuvinte cheie

  • paraoxonaza 1
  • arilesteraza
  • ateroscleroza
  • scorul Gensini
  • genotipare
Accès libre

The predictive value of serum intercellular adhesion molecule 1 for the progression of diabetic kidney disease in type 2 diabetic patients

Publié en ligne: 31 Dec 2013
Pages: 399 - 406

Résumé

Abstract

In type 2 diabetes, the progressive nature of diabetic kidney disease (DKD) induces high risk of morbidity and mortality. The aim of our study was to assess the predictive value of serum intercellular adhesion molecule 1 (ICAM 1) for the increasing of albuminuria in early stages of type 2 DKD. Consecutive type 2 diabetic patients with a one year followed up were included in this study. Outcome measurement for assessing the progression of diabetic kidney disease was the change in urinary albumin to creatinine ratio (ΔuACR). 93 type 2 diabetic patients were enrolled in the study, of which 58 were normoalbuminuric and 35 patients were albuminuric. Their mean urinary albumin excretion was in microalbuminuric stage and had a close to normal estimated glomerular filtration rate. ΔuACR disclosed a positive correlation to baseline serum ICAM 1 (p=0.003, r= 0.31) and serum creatinine (p=0.026, r=0.23). In multiple regression, ICAM-1 (p=0.002) was the main determinant of ΔuACR. The correlation was even stronger in albuminuric patients (p=0.0003, r=0.57). In our type 2 diabetic patients, the main predictor of increase in uACR over one year of follow-up is baseline ICAM -1 level, with a particular role in albuminuric patients. It seems that ICAM-1 might be useful non-invasive biomarker in predicting the progression of DKD.

Keyword

  • Intercellular adhesion molecule 1
  • diabetic kidney disease
  • progression

Cuvinte cheie

  • molecula de adeziune intercelulară ICAM 1
  • boala renală diabetică
  • progresie
Accès libre

Assessment of microalbuminuria in hypertensive patients with established coronary artery disease

Publié en ligne: 31 Dec 2013
Pages: 407 - 414

Résumé

Abstract

Objectives. Cardiovascular risk assessment is continuously improving due to a better understanding of the atherosclerotic pathomechanism by investigating new risk factors. Microalbuminuria is known as a predictor of renal, as well as cardiovascular morbidity and mortality in patients with hypertension. The aim of this study was to determine the clinical relevance of microalbuminuria and its relationship with traditional cardiovascular risk factors in hypertensive high-risk patients with established coronary artery disease. Methods. We have collected clinical and laboratory data from 94 hypertensive patients (currently treated or newly diagnosed) with known coronary artery disease (angiographically documented) admitted in the Institute of Cardiovascular Diseases. From January 2012 to April 2013 they were screened for microalbuminuria. For the diagnosis of microalbuminuria, a first-morning urine sample was analyzed by immunoturbidimetry (MAU range: 20-200 mg/l, the microalbuminuric group). Patients with urinary albumin excretion >200 mg/l were excluded. Patients with values <20 mg/l were considered the normoalbuminuric group. Results. A large percentage (53.2%) of the study group was found with microalbuminuria. Patients with microalbuminuria were older, mostly male, with a longer duration of hypertension, and with a higher prevalence of left ventricular hypertrophy (LVH). None of the traditional cardiovascular risk factors - age, male gender, obesity, smoking, diabetes mellitus, dyslipidemia - indicated a statistical significance in relation with MAU. Although left ventricular ejection fraction (LVEF) didn't influence the level of microalbuminuria, a strong correlation was achieved with the presence of LVH (p=0.005) and duration of hypertension (p=0.046). Conclusion. Hypertensive high-risk patients should be routinely screened for microalbuminuria and when confirmed they may need a more aggressive medical therapy to lower the cardiovascular risk.

Keywords

  • microalbuminuria
  • hypertension
  • coronary artery disease

Cuvinte cheie

  • Microalbuminurie
  • hipertensiune arterială
  • boală coronariană ischemică
Accès libre

Basophil activation test versus radio-immunoassay in the diagnosis of β-lactam immediate-type hypersensitivity reactions

Publié en ligne: 31 Dec 2013
Pages: 415 - 422

Résumé

Abstract

Background and aims: to assess the sensitivity and specificity for the basophil activation test (BAT) and the detection of drug-specific antibodies (IgE) in the retrospective diagnosis of β-lactam allergy by using assay- specific thresholds as resulted from the performance of receiver operating characteristics curve (ROC) analysis and to describe a sequential algorithm that might increase diagnostic sensitivity and reduce the number of patients that should undergo drug challenge tests by the joint use of in vivo and in vitro diagnostic tests. Methods: 37 patients with suspected β-lactam immediate-type hypersensitivity reactions were tested for the culprit drug. 31 healthy controls were similarly tested. BAT was performed with Flow2Cast technique (Bühlmann Laboratories, Switzerland). Drug-specific IgE antibodies were detected using “sandwich”-type radio-immunoassay (RIA) with sepharose as solid phase (Pathologie Université „H. Poincare”, France). Results: ROC curve analysis identifies an optimal threshold>1.9 for RIA positivity, with 70.3% sensitivity and 90.3% specificity. For BAT, an optimal threshold>1.97 yields 51.4% sensitivity and 90.3% specificity. 89.18% of the patients were diagnosed by the combined use of skin tests and in vitro tests results, while 10.82% of the patients had negative tests results. Conclusions: RIA seems to have higher sensitivity than BAT (70.3% versus 51.4%) for β-lactams. The joint use of allergy diagnostic tests has 89.18% sensitivity. A combination of allergologic skin tests, detection of antibiotic- specific antibodies, followed by BAT may be suitable for investigating β-lactam hypersensitivity reactions since no diagnostic test has absolute diagnostic accuracy.

Keywords

  • drug allergy
  • antibiotic
  • flow cytometry
  • basophil activation test

Cuvinte cheie

  • alergie medicamentoasă
  • antibiotic
  • citometrie de flux
  • test de activare a bazofilelor
Accès libre

Spread of VIM-2 metallo-beta-lactamase in Pseudomonas aeruginosa and Acinetobacter baumannii clinical isolates from Iaşi, Romania

Publié en ligne: 31 Dec 2013
Pages: 423 - 430

Résumé

Abstract

Our study investigated the type of acquired metallo-β-lactamases (MBLs) produced by carbapenem-resistant clinical isolates of Pseudomonas aeruginosa and Acinetobacter baumannii from five hospitals in Iasi, Romania and the genetic relatedness of the strains carrying MBL genes. Of 106 carbapenem-resistant strains, 50 were positive for MBL production after screening with Etest MBL. PCR analysis showed that 46 isolates (44 P. aeruginosa and 2 A. baumannii) carried a blaVIM gene. By DNA sequencing we identified two class 1 integrons carrying the blaVIM gene in the P. aeruginosa: IntI1-aacA7-blaVIM-2-qacEΔ1 in 43 strains, and IntI1-aacA7- ΔblaVIM-ΔcmlA1-qacEΔ1 in one strain. In A. baumannii isolates the blaVIM-2 gene was not associated with a class 1 integron. Random amplified polymorphic DNA typing of VIM-2-producing P. aeruginosa strains revealed the presence of a major RAPD type in all five hospitals. Early detection and surveillance of such strains must be accompanied by rigorous infection control measures in order to limit the spread of MBLs in our clinical settings

Keywords

  • VIM-2
  • metallo-beta-lactamase
  • Pseudomonas aeruginosa
  • Acinetobacter baumannii

Cuvinte cheie

  • VIM-2
  • metalo-beta-lactamaze
  • Pseudomonas aeruginosa
  • Acinetobacter baumannii
Accès libre

Rickettsia conorii specific Ig G antibodies: a seroepidemiologic survey in Constanta and Tulcea counties and Bucharest, Romania, 2009

Publié en ligne: 31 Dec 2013
Pages: 431 - 436

Résumé

Abstract

Introduction. Boutonneuse fever (BF) is an emerging infectious disease in Romania evolving in the southern part of the country, as revealed by the incidence rates registered in our previous epidemiological descriptive studies performed during last years. We aimed to evaluate the presence of Rickettsia conorii specific IgG antibodies in a population sample from the affected area. Methods. An ELISA serological survey was performed on 301 serum samples collected from the general population, living in an area most affected by BF, in southern Romania. One of the selection criteria was the absence of signs and symptoms of the disease during the seasonal development of BF. Data were processed in SPSS V.19 (indicators of central tendency, dispersion, frequency and benchmarking). Results. Serological results showed a general positivity rate of 25.2%, with the highest rate in the population group aged over 60 years, this age group accounting for 34.21 % of the whole sample (55.6% for Bucharest area and 63.16% for Tulcea district). Conclusions. By confirming the hypothesis based on our previous descriptive epidemiological studies that BF is fitting an endemic pattern in southern Romania, our study results strongly support the need to set up a national surveillance program, aiming at improving BF prevention, management and control in our country. To our knowledge, this is the first study on Rickettsia conorii specific IgG antibodies seroprevalence in Romania.

Mots clés

  • Boutonneuse Fever
  • seroprevalence
  • southern Romania

Cuvinte cheie

  • Febră butonoasă
  • seroprevalenţă
  • sudul Romaniei
Accès libre

Mutation analysis of the MECP2 gene in Romanian females with Rett syndrome

Publié en ligne: 31 Dec 2013
Pages: 437 - 445

Résumé

Abstract

The discovery of the methyl-CpG binding protein 2 (MECP2) gene located on Xq28 as being involved in Rett syndrome (RTT) has been followed by a broad spectrum of phenotypes being associated with mutations in MECP2. The distribution of MECP2 mutations has been studied in many populations, but only recently in Romania. We started the first local study searching for MECP2 mutations using PCR (polymerase chain reaction) - based methods and Sanger sequencing. We have investigated 9 patients, all girls, 7 with classical RTT and 2 with atypical RTT from the Western part of Romania. Mutation screening revealed 3 different mutations present in 4 patients and 5 nonpathogenic genetic variations. One of the frameshift mutations has not been previously described: c.225delG (p.P75fs). The detection rate for missense and frameshift mutations was 44 %. In this study we focused on a practical approach necessary for the molecular geneticist in the process of screening RTT patients for MECP2 mutations. The aim is to extend this protocol for screening MECP2 mutations in all cases of MECP2-related Disorders, to offer prenatal diagnosis, and subsequently complete it with techniques which can detect large rearrangements of this gene.

Keywords

  • MECP2 mutation
  • Rett syndrome
  • sequencing
  • protocol

Cuvinte cheie

  • mutatii
  • MECP2
  • sindrom Rett
  • protocol
Accès libre

FISH in Burkitt lymphoma diagnosis: a single Romanian center experience

Publié en ligne: 31 Dec 2013
Pages: 447 - 452

Résumé

Abstract

The goal of this study, part of the PERSOTHER project, is the implementation a new ancillary technique - fluorescent in situ hybridization (FISH) - in Burkitt lymphoma (BL) diagnosis, for the first time in our country. BL is a B-cell lymphoma with a highly aggressive clinical course. Three clinical variants of BL are recognized: endemic BL (in equatorial Africa), sporadic (throughout the world) and immunodeficiency-associated BL. The 2008 World Health Organization (WHO) Classification described a new category of B-cell lymphoma, unclassifiable, with intermediate features between diffuse large B-cell lymphoma (DLBCL) and BL. Because the treatment of BL is very aggressive, with high doses chemotherapy, an accurate diagnosis is required. Cytology, morphology and immunophenotype (CD20+, CD10+, BCL6+, BCL2-, Ki67 98-100%) are typical for BL. Most of the cases have MYC translocation at band 8q24 to the IgH region, 14q32. The demonstration of MYC translocation is necessary for BL diagnosis and differential with DLBCL and borderline cases. 22 cases of BL were evaluated by FISH for MYC translocation. 17 cases were positive, one case was negative and 4 cases were inconclusive. The results are concordant with the literature: the authors report about 10% MYC negative cases. In this cases micro-RNA (MiRNA-s) alterations may be implicated. The present study highlights the importance of FISH in BL diagnosis. It also identifies some of the technical difficulties of this method and it represents a basis for future routine diagnosis of selected BL cases.

Keywords

  • Burkitt lymphoma
  • FISH
  • MYC rearrangement

Cuvinte cheie

  • Limfom Burkitt
  • FISH
  • rearanjare MYC
Accès libre

Hepatocellular carcinoma a retrospective clinico-pathologic and immunohistochemical study of 15 cases

Publié en ligne: 31 Dec 2013
Pages: 453 - 463

Résumé

Abstract

Hepatocellular carcinoma (HCC) is the fifth most frequently diagnosed cancer worldwide, and the third most frequent oncological cause of death. Being detected at an advanced, non-resectable stage, HCC is associated with a low 5-year survival and poor prognosis. Recently some studies have demonstrated that the prognosis of HCC correlates to various molecular markers. In this view, we have studied here the immunohistochemical reactivity of 15 HCC cases diagnosed in the last three years for some biomarkers with prognostic value such as p53, alpha-fetoprotein (AFP) and CXCR4, in correlation with the major clinicopathological parameters of these patients. In our casuistry the most prevalent architectural pattern was the trabecular (53.4%), followed by the pseudoglandular pattern (20%), while the less common diagnosed were the solid and pleomorphic variants. More than 80% of these tumors were well to moderate differentiated; developed in the six decade, twice more common in men and diagnosed in advance stages (80% of cases in stages ≥III). Markers such as CK18, CK7 and CEA were usefully in order to certify the primary liver origin and the hepatocellular differentiation of these tumors. Moreover, biomarkers as p53, AFP and CXCR4 were positive especially in more advance stages suggesting the possibility of their utilization as prognostic factors and in the therapeutically stratification of such patients.

Keywords

  • hepatocellular carcinoma
  • immunohistochemistry
  • pleomorphic
  • pseudoglandular
  • solid
  • trabecular

Cuvinte cheie

  • carcinom hepatocelular
  • imunohistochimie
  • pleomorfic
  • pseudoglandular
  • solid
  • trabecular
Accès libre

Serum tumor markers for screening and early diagnosis of ovarian cancer

Publié en ligne: 31 Dec 2013
Pages: 465 - 472

Résumé

Abstract

Discovery of new biomarkers or panels of biomarkers for early diagnosis of ovarian cancer is one of the great challenges of modern medicine. The use of determination of CA125 (the most commonly used biomarker) was improved by taking into account the dynamic values available in the context of screening. Currently, the highest sensitivity of screening tests performed for early diagnosis of ovarian cancer is 96% and was obtained using a panel of serum biomarkers composed of apolipoprotein A1, transthyretin, transferrin and CA125. This paper presents different types of serum proteins that are currently studied, and should be proposed as new biomarkers for detecting ovarian cancer. Future research needs to be conducted in order to find a new tumor marker panel that is quantitative, reproducible, and fast and has an even higher sensitivity and specificity for the early detection of ovarian cancer.

Keywords

  • ovarian cancer
  • early diagnosis
  • serum biomarkers or serum tumor markers
  • sensitivity
  • specificity

Cuvinte cheie

  • cancer ovarian
  • diagnostic precoce
  • markeri tumorali serici
  • sensibilitate
  • specificitate
12 Articles
Accès libre

Major editorial changes of Romanian Review of Laboratory Medicine

Publié en ligne: 31 Dec 2013
Pages: 377 - 380

Résumé

Abstract

Starting with the first issue of 2013, the Romanian Review of Laboratory Medicine has implemented a new editorial and publishing system. By this editorial, we try to clarify to all the readers and authors the major changes and their outcome in the journal’s evolution. Thus, we present details related to the current internal organization of the editorial board and the editorial workflow of the submitted manuscripts.

Mots clés

  • editorial policy
  • editorial workflow
  • scientific review
  • publishing

Cuvinte cheie

  • politică redacţională
  • flux redacţional
  • recenzie ştiinţifică
  • publicare
Accès libre

Distribution of Paraoxonase 1 polymorphisms and activities in obese patients

Publié en ligne: 31 Dec 2013
Pages: 381 - 389

Résumé

Abstract

Study objective. The objective of this study was to investigate PON1 phenotype and genotype in Romanian patients with abdominal obesity. Materials and methods. The study groups consisted of 88 patients with abdominal obesity and 46 subjects with normal waist circumference, matched for age and gender. For each patient, we determined the clinical parameters that may influence PON1 activities. Q192R and L55M polymorphisms analysis in the PON1 gene were performed by PCR-RFLP using specific primers and restriction enzymes. PON1 lactonase, paraoxonase and arylesterase activities were assayed by spectrophotometric methods. Analysis of PON1 genotypes and activities distribution in the obese and non-obese individuals was performed with Med- Calc Software (Version 12.4.0.0). Results. There was no statistically significant difference between obese and controls in regards to age and gender. The study revealed that PON1 activities were not influenced by gender. Of all PON1 activities, only the paraoxonase activity was inversely correlated with age, being significantly reduced in patients with abdominal obesity compared to non-obesity (p=0.009). Abdominal circumference independently influenced only the variation of arylesterase activity (R2=6.5%, p=0.003). Distribution of PON1 genotypes in the study groups was significantly different (p=0.007) only for the Q192R but not for the L55M genotypes. The QR genotype had the highest influence on paraoxonase activity (R2=40.6; p<0.001). The MM genotype had the greatest influence on arylesterase (R2=11.3%, p<0.001) and lactonase activities (R2=7.4%, p<0.001). Conclusions. Q192R genotypes distribution was significantly different in obese patients and the QR genotype influenced greatly the paraoxonase activity. The MM genotype had the most important independent influence on the lactonase and arylesterase activities .

Mots clés

  • paraoxonase
  • arylesterase
  • lactonase
  • activity
  • genotype
  • obesity

Cuvinte cheie

  • paraoxonază
  • arilesterază
  • lactonază
  • activitate
  • genotip
  • obezitate
Accès libre

The number of PON1 mutant alleles, but not PON1 phenotype, is associated with Gensini score of coronary damage

Publié en ligne: 31 Dec 2013
Pages: 391 - 398

Résumé

Abstract

Objectives. The aim of this study was to examine the effects of single nucleotide polymorphisms (SNPs) of PON1 gene at the level of promoter region (‒909 and ‒832) and of first exon (+575, A20352G, resulting Q192R substitution) on paraoxonase-1 (PON1) activities in 53 patients with angiographycally proven coronary heart disease (CHD) and 17 free-CHD subjects. Methods and Results. Serum PON1 arylesterase (Ar-ase) and salt-stimulated paraoxonase (ssPO-ase) activities were assessed with manual spectrophotometric methods, by using phenyl acetate and paraoxon as substrates. Common serum biochemical markers were assayed by enzymatic methods using commercial kits, on a Roche/Hitachi 912 Auto Analyzer. PON1 genotypes were determined by PCR and nucleotide sequencing of the amplicons with an ABI PRISMTM 310 Genetic Analyzer and a BigDye® Terminator v3.1 Cycle Sequencing Kit. The severity of coronary artery stenosis was assessed and classified using the Gensini score. We found no significant differences in the PON1 activities and -909(G→C), -832(G→A) and +575(A→G) PON1 polymorphisms between CHD and CHD-free groups. Considering all investigated subjects, we found that -909(G→C) and +575(A→G) SNPs had statistically significant effects on Ar-ase activity and PO-ase activity, respectively. In a multiple regression model we found that diabetes, LDL-cholesterol and the number of mutant alleles were significant independent determinants of the Gensini score. A significant positive correlation was observed only between the Gensini score and the number of mutant alleles. Conclusions. There are no differences between CHD and CHD-free groups regarding PON1 genotypes and phenotypes but the increasing number of PON1 mutant alleles is an important factor in determining the severity of coronary damage.

Keywords

  • paraoxonase-1
  • arylesterase
  • atherosclerosis
  • Gensini score
  • genotyping

Cuvinte cheie

  • paraoxonaza 1
  • arilesteraza
  • ateroscleroza
  • scorul Gensini
  • genotipare
Accès libre

The predictive value of serum intercellular adhesion molecule 1 for the progression of diabetic kidney disease in type 2 diabetic patients

Publié en ligne: 31 Dec 2013
Pages: 399 - 406

Résumé

Abstract

In type 2 diabetes, the progressive nature of diabetic kidney disease (DKD) induces high risk of morbidity and mortality. The aim of our study was to assess the predictive value of serum intercellular adhesion molecule 1 (ICAM 1) for the increasing of albuminuria in early stages of type 2 DKD. Consecutive type 2 diabetic patients with a one year followed up were included in this study. Outcome measurement for assessing the progression of diabetic kidney disease was the change in urinary albumin to creatinine ratio (ΔuACR). 93 type 2 diabetic patients were enrolled in the study, of which 58 were normoalbuminuric and 35 patients were albuminuric. Their mean urinary albumin excretion was in microalbuminuric stage and had a close to normal estimated glomerular filtration rate. ΔuACR disclosed a positive correlation to baseline serum ICAM 1 (p=0.003, r= 0.31) and serum creatinine (p=0.026, r=0.23). In multiple regression, ICAM-1 (p=0.002) was the main determinant of ΔuACR. The correlation was even stronger in albuminuric patients (p=0.0003, r=0.57). In our type 2 diabetic patients, the main predictor of increase in uACR over one year of follow-up is baseline ICAM -1 level, with a particular role in albuminuric patients. It seems that ICAM-1 might be useful non-invasive biomarker in predicting the progression of DKD.

Keyword

  • Intercellular adhesion molecule 1
  • diabetic kidney disease
  • progression

Cuvinte cheie

  • molecula de adeziune intercelulară ICAM 1
  • boala renală diabetică
  • progresie
Accès libre

Assessment of microalbuminuria in hypertensive patients with established coronary artery disease

Publié en ligne: 31 Dec 2013
Pages: 407 - 414

Résumé

Abstract

Objectives. Cardiovascular risk assessment is continuously improving due to a better understanding of the atherosclerotic pathomechanism by investigating new risk factors. Microalbuminuria is known as a predictor of renal, as well as cardiovascular morbidity and mortality in patients with hypertension. The aim of this study was to determine the clinical relevance of microalbuminuria and its relationship with traditional cardiovascular risk factors in hypertensive high-risk patients with established coronary artery disease. Methods. We have collected clinical and laboratory data from 94 hypertensive patients (currently treated or newly diagnosed) with known coronary artery disease (angiographically documented) admitted in the Institute of Cardiovascular Diseases. From January 2012 to April 2013 they were screened for microalbuminuria. For the diagnosis of microalbuminuria, a first-morning urine sample was analyzed by immunoturbidimetry (MAU range: 20-200 mg/l, the microalbuminuric group). Patients with urinary albumin excretion >200 mg/l were excluded. Patients with values <20 mg/l were considered the normoalbuminuric group. Results. A large percentage (53.2%) of the study group was found with microalbuminuria. Patients with microalbuminuria were older, mostly male, with a longer duration of hypertension, and with a higher prevalence of left ventricular hypertrophy (LVH). None of the traditional cardiovascular risk factors - age, male gender, obesity, smoking, diabetes mellitus, dyslipidemia - indicated a statistical significance in relation with MAU. Although left ventricular ejection fraction (LVEF) didn't influence the level of microalbuminuria, a strong correlation was achieved with the presence of LVH (p=0.005) and duration of hypertension (p=0.046). Conclusion. Hypertensive high-risk patients should be routinely screened for microalbuminuria and when confirmed they may need a more aggressive medical therapy to lower the cardiovascular risk.

Keywords

  • microalbuminuria
  • hypertension
  • coronary artery disease

Cuvinte cheie

  • Microalbuminurie
  • hipertensiune arterială
  • boală coronariană ischemică
Accès libre

Basophil activation test versus radio-immunoassay in the diagnosis of β-lactam immediate-type hypersensitivity reactions

Publié en ligne: 31 Dec 2013
Pages: 415 - 422

Résumé

Abstract

Background and aims: to assess the sensitivity and specificity for the basophil activation test (BAT) and the detection of drug-specific antibodies (IgE) in the retrospective diagnosis of β-lactam allergy by using assay- specific thresholds as resulted from the performance of receiver operating characteristics curve (ROC) analysis and to describe a sequential algorithm that might increase diagnostic sensitivity and reduce the number of patients that should undergo drug challenge tests by the joint use of in vivo and in vitro diagnostic tests. Methods: 37 patients with suspected β-lactam immediate-type hypersensitivity reactions were tested for the culprit drug. 31 healthy controls were similarly tested. BAT was performed with Flow2Cast technique (Bühlmann Laboratories, Switzerland). Drug-specific IgE antibodies were detected using “sandwich”-type radio-immunoassay (RIA) with sepharose as solid phase (Pathologie Université „H. Poincare”, France). Results: ROC curve analysis identifies an optimal threshold>1.9 for RIA positivity, with 70.3% sensitivity and 90.3% specificity. For BAT, an optimal threshold>1.97 yields 51.4% sensitivity and 90.3% specificity. 89.18% of the patients were diagnosed by the combined use of skin tests and in vitro tests results, while 10.82% of the patients had negative tests results. Conclusions: RIA seems to have higher sensitivity than BAT (70.3% versus 51.4%) for β-lactams. The joint use of allergy diagnostic tests has 89.18% sensitivity. A combination of allergologic skin tests, detection of antibiotic- specific antibodies, followed by BAT may be suitable for investigating β-lactam hypersensitivity reactions since no diagnostic test has absolute diagnostic accuracy.

Keywords

  • drug allergy
  • antibiotic
  • flow cytometry
  • basophil activation test

Cuvinte cheie

  • alergie medicamentoasă
  • antibiotic
  • citometrie de flux
  • test de activare a bazofilelor
Accès libre

Spread of VIM-2 metallo-beta-lactamase in Pseudomonas aeruginosa and Acinetobacter baumannii clinical isolates from Iaşi, Romania

Publié en ligne: 31 Dec 2013
Pages: 423 - 430

Résumé

Abstract

Our study investigated the type of acquired metallo-β-lactamases (MBLs) produced by carbapenem-resistant clinical isolates of Pseudomonas aeruginosa and Acinetobacter baumannii from five hospitals in Iasi, Romania and the genetic relatedness of the strains carrying MBL genes. Of 106 carbapenem-resistant strains, 50 were positive for MBL production after screening with Etest MBL. PCR analysis showed that 46 isolates (44 P. aeruginosa and 2 A. baumannii) carried a blaVIM gene. By DNA sequencing we identified two class 1 integrons carrying the blaVIM gene in the P. aeruginosa: IntI1-aacA7-blaVIM-2-qacEΔ1 in 43 strains, and IntI1-aacA7- ΔblaVIM-ΔcmlA1-qacEΔ1 in one strain. In A. baumannii isolates the blaVIM-2 gene was not associated with a class 1 integron. Random amplified polymorphic DNA typing of VIM-2-producing P. aeruginosa strains revealed the presence of a major RAPD type in all five hospitals. Early detection and surveillance of such strains must be accompanied by rigorous infection control measures in order to limit the spread of MBLs in our clinical settings

Keywords

  • VIM-2
  • metallo-beta-lactamase
  • Pseudomonas aeruginosa
  • Acinetobacter baumannii

Cuvinte cheie

  • VIM-2
  • metalo-beta-lactamaze
  • Pseudomonas aeruginosa
  • Acinetobacter baumannii
Accès libre

Rickettsia conorii specific Ig G antibodies: a seroepidemiologic survey in Constanta and Tulcea counties and Bucharest, Romania, 2009

Publié en ligne: 31 Dec 2013
Pages: 431 - 436

Résumé

Abstract

Introduction. Boutonneuse fever (BF) is an emerging infectious disease in Romania evolving in the southern part of the country, as revealed by the incidence rates registered in our previous epidemiological descriptive studies performed during last years. We aimed to evaluate the presence of Rickettsia conorii specific IgG antibodies in a population sample from the affected area. Methods. An ELISA serological survey was performed on 301 serum samples collected from the general population, living in an area most affected by BF, in southern Romania. One of the selection criteria was the absence of signs and symptoms of the disease during the seasonal development of BF. Data were processed in SPSS V.19 (indicators of central tendency, dispersion, frequency and benchmarking). Results. Serological results showed a general positivity rate of 25.2%, with the highest rate in the population group aged over 60 years, this age group accounting for 34.21 % of the whole sample (55.6% for Bucharest area and 63.16% for Tulcea district). Conclusions. By confirming the hypothesis based on our previous descriptive epidemiological studies that BF is fitting an endemic pattern in southern Romania, our study results strongly support the need to set up a national surveillance program, aiming at improving BF prevention, management and control in our country. To our knowledge, this is the first study on Rickettsia conorii specific IgG antibodies seroprevalence in Romania.

Mots clés

  • Boutonneuse Fever
  • seroprevalence
  • southern Romania

Cuvinte cheie

  • Febră butonoasă
  • seroprevalenţă
  • sudul Romaniei
Accès libre

Mutation analysis of the MECP2 gene in Romanian females with Rett syndrome

Publié en ligne: 31 Dec 2013
Pages: 437 - 445

Résumé

Abstract

The discovery of the methyl-CpG binding protein 2 (MECP2) gene located on Xq28 as being involved in Rett syndrome (RTT) has been followed by a broad spectrum of phenotypes being associated with mutations in MECP2. The distribution of MECP2 mutations has been studied in many populations, but only recently in Romania. We started the first local study searching for MECP2 mutations using PCR (polymerase chain reaction) - based methods and Sanger sequencing. We have investigated 9 patients, all girls, 7 with classical RTT and 2 with atypical RTT from the Western part of Romania. Mutation screening revealed 3 different mutations present in 4 patients and 5 nonpathogenic genetic variations. One of the frameshift mutations has not been previously described: c.225delG (p.P75fs). The detection rate for missense and frameshift mutations was 44 %. In this study we focused on a practical approach necessary for the molecular geneticist in the process of screening RTT patients for MECP2 mutations. The aim is to extend this protocol for screening MECP2 mutations in all cases of MECP2-related Disorders, to offer prenatal diagnosis, and subsequently complete it with techniques which can detect large rearrangements of this gene.

Keywords

  • MECP2 mutation
  • Rett syndrome
  • sequencing
  • protocol

Cuvinte cheie

  • mutatii
  • MECP2
  • sindrom Rett
  • protocol
Accès libre

FISH in Burkitt lymphoma diagnosis: a single Romanian center experience

Publié en ligne: 31 Dec 2013
Pages: 447 - 452

Résumé

Abstract

The goal of this study, part of the PERSOTHER project, is the implementation a new ancillary technique - fluorescent in situ hybridization (FISH) - in Burkitt lymphoma (BL) diagnosis, for the first time in our country. BL is a B-cell lymphoma with a highly aggressive clinical course. Three clinical variants of BL are recognized: endemic BL (in equatorial Africa), sporadic (throughout the world) and immunodeficiency-associated BL. The 2008 World Health Organization (WHO) Classification described a new category of B-cell lymphoma, unclassifiable, with intermediate features between diffuse large B-cell lymphoma (DLBCL) and BL. Because the treatment of BL is very aggressive, with high doses chemotherapy, an accurate diagnosis is required. Cytology, morphology and immunophenotype (CD20+, CD10+, BCL6+, BCL2-, Ki67 98-100%) are typical for BL. Most of the cases have MYC translocation at band 8q24 to the IgH region, 14q32. The demonstration of MYC translocation is necessary for BL diagnosis and differential with DLBCL and borderline cases. 22 cases of BL were evaluated by FISH for MYC translocation. 17 cases were positive, one case was negative and 4 cases were inconclusive. The results are concordant with the literature: the authors report about 10% MYC negative cases. In this cases micro-RNA (MiRNA-s) alterations may be implicated. The present study highlights the importance of FISH in BL diagnosis. It also identifies some of the technical difficulties of this method and it represents a basis for future routine diagnosis of selected BL cases.

Keywords

  • Burkitt lymphoma
  • FISH
  • MYC rearrangement

Cuvinte cheie

  • Limfom Burkitt
  • FISH
  • rearanjare MYC
Accès libre

Hepatocellular carcinoma a retrospective clinico-pathologic and immunohistochemical study of 15 cases

Publié en ligne: 31 Dec 2013
Pages: 453 - 463

Résumé

Abstract

Hepatocellular carcinoma (HCC) is the fifth most frequently diagnosed cancer worldwide, and the third most frequent oncological cause of death. Being detected at an advanced, non-resectable stage, HCC is associated with a low 5-year survival and poor prognosis. Recently some studies have demonstrated that the prognosis of HCC correlates to various molecular markers. In this view, we have studied here the immunohistochemical reactivity of 15 HCC cases diagnosed in the last three years for some biomarkers with prognostic value such as p53, alpha-fetoprotein (AFP) and CXCR4, in correlation with the major clinicopathological parameters of these patients. In our casuistry the most prevalent architectural pattern was the trabecular (53.4%), followed by the pseudoglandular pattern (20%), while the less common diagnosed were the solid and pleomorphic variants. More than 80% of these tumors were well to moderate differentiated; developed in the six decade, twice more common in men and diagnosed in advance stages (80% of cases in stages ≥III). Markers such as CK18, CK7 and CEA were usefully in order to certify the primary liver origin and the hepatocellular differentiation of these tumors. Moreover, biomarkers as p53, AFP and CXCR4 were positive especially in more advance stages suggesting the possibility of their utilization as prognostic factors and in the therapeutically stratification of such patients.

Keywords

  • hepatocellular carcinoma
  • immunohistochemistry
  • pleomorphic
  • pseudoglandular
  • solid
  • trabecular

Cuvinte cheie

  • carcinom hepatocelular
  • imunohistochimie
  • pleomorfic
  • pseudoglandular
  • solid
  • trabecular
Accès libre

Serum tumor markers for screening and early diagnosis of ovarian cancer

Publié en ligne: 31 Dec 2013
Pages: 465 - 472

Résumé

Abstract

Discovery of new biomarkers or panels of biomarkers for early diagnosis of ovarian cancer is one of the great challenges of modern medicine. The use of determination of CA125 (the most commonly used biomarker) was improved by taking into account the dynamic values available in the context of screening. Currently, the highest sensitivity of screening tests performed for early diagnosis of ovarian cancer is 96% and was obtained using a panel of serum biomarkers composed of apolipoprotein A1, transthyretin, transferrin and CA125. This paper presents different types of serum proteins that are currently studied, and should be proposed as new biomarkers for detecting ovarian cancer. Future research needs to be conducted in order to find a new tumor marker panel that is quantitative, reproducible, and fast and has an even higher sensitivity and specificity for the early detection of ovarian cancer.

Keywords

  • ovarian cancer
  • early diagnosis
  • serum biomarkers or serum tumor markers
  • sensitivity
  • specificity

Cuvinte cheie

  • cancer ovarian
  • diagnostic precoce
  • markeri tumorali serici
  • sensibilitate
  • specificitate

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