Reconstruction of the phreno-esophageal ligament (R-PEL) prevents the intrathoracic migration (ITM) after concomitant sleeve gastrectomy and hiatal hernia repair.

BACKGROUND: Laparoscopic Sleeve Gastrectomy (LSG) is the most attractive bariatric procedure, but the postoperative intrathoracic gastric migration (ITM) and "de novo" GERD are major concerns. The main objective of our study was to evaluate the efficiency of the concomitant HHR with or without partial reconstruction of phreno-esophageal ligament (R-PEL) to prevent ITM after LSG. The secondary objectives focused on procedure's metabolic and GERD-related outcomes. PATIENTS AND METHOD: Consecutive patients who underwent primary LSG and concomitant HHR were included in a single-center prospective study. According to the HHR surgical technique, two groups were analyzed and compared: Group A included patients receiving crura approximation only and Group B patients with R-PEL. The patients' evolution of co-morbidities, GERD symptoms, radiologic, and endoscopic details were prospectively analyzed. RESULTS: Two hundred seventy-three patients undergoing concurrent HHR and LSG were included in the study (Group A and B, 146 and 127 patients) The mean age and BMI were 42.6 ± 11.3 and 43.4 ± 6.8 kg/m2. The 12-month postoperative ITM was radiologically found in more than half of the patients in Group A, while in group B, the GEJ's position appeared normal in 91.3% of the patients, meaning that R-PEL reduced 7 times the rate of ITM. The percentage of no-improvement and "de novo" severe esophagitis (Los Angeles C) was 4 times higher in group A 3.4% vs. 0.8% with statistical significance, and correlated to ITM. The GERD symptoms were less frequent in Group B vs Group A, 21.3% vs 37%, with statistical significance. No Barrett's esophagus and no complication were recorded in any of the patients. CONCLUSION: Concurrent LSG and HHR by crura approximation only has a very high rate of ITM in the first postoperative year (over 50%). R-PEL is an innovative technique which proved to be very efficient in preventing the ITM after HHR.

Fertility options after chemotherapy in young premenopausal patients.

Context: Infertility affects more and more younger patients nowadays. Life-saving cancer treatments - chemotherapy and radiation therapy unfortunately damage oocytes and reduce the window of fertility in women. There were an estimated 14.1 million cases of cancer worldwide in 2012, of which 6.7 million were in women. Aim: We are reviewing fertility options and treatments for women fighting oncological diseases. It is important to promote that there is a possibility for these patients to know all they can do in order to preserve their fertility and our government should help all these young patients.The trend of delayed childbearing has increased worldwide duet o increased life costs, difficulty of finding a suitable partner and carier options, while the number of women facing a cancer diagnosis is rising. Material and methods: We describe a review regarding the impact of these treatments for the fertility of these patients. Results: Show that informed patients can better cope with their diagnostic and have a better prognosis. Conclusions: Improving survival rates and current data have created a new medical field oncofertility. The term was first introduced in 2015 and is being used all over clinics that treat young patients nowadays.

The effects of Sambucus nigrapolyphenols on oxidative stress and metabolic disorders in experimental diabetes mellitus

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The paper focuses on certain natural polyphenolic extracts from common elder fruit (Sambucus nigra), and also on their effects in diabetes mellitus. The results reveal that the glycosylated hemoglobin values are much higher in the diabetic group and they are significantly lower in the group protected by polyphenols. The natural polyphenol compounds reduce the lipids peroxides, neutralize the lipid peroxil radicals and inhibit the LDL oxidation. Following the perturbation of the lipid metabolism in the diabetic rats, atherogen risk has significantly increased values in comparison to the rats from the witness groups. It is found that due to the polyphenolic protection of the rats from the diabetic group treated with polyphenols, the atherogen risk is preserved at normal limits. The serum activity of glutathione-peroxidase and superoxide-dismutase has significantly lower values in the diabetic group as compared to the group protected by polyphenols. Through the hypoglycemiant, hypolipemiant and antioxidant effects,Sambucus nigra represents a possible dietary adjunct for the treatment of diabetes and a potential source for the discovery of new orally active agent(s) for future diabetes therapy. Understanding the mechanism through which the natural polyphenols have effects on the functionality of the endothelium cells, including on the membrane sensitivity and intracellular signalling, could represent a new way of therapeutically approaching chronic metabolic diseases and cardiovascular illnesses (AU)

The effects of Sambucus nigra polyphenols on oxidative stress and metabolic disorders in experimental diabetes mellitus.

The paper focuses on certain natural polyphenolic extracts from common elder fruit (Sambucus nigra), and also on their effects in diabetes mellitus. The results reveal that the glycosylated hemoglobin values are much higher in the diabetic group and they are significantly lower in the group protected by polyphenols. The natural polyphenol compounds reduce the lipids peroxides, neutralize the lipid peroxil radicals and inhibit the LDL oxidation. Following the perturbation of the lipid metabolism in the diabetic rats, atherogen risk has significantly increased values in comparison to the rats from the witness groups. It is found that due to the polyphenolic protection of the rats from the diabetic group treated with polyphenols, the atherogen risk is preserved at normal limits. The serum activity of glutathione-peroxidase and superoxide-dismutase has significantly lower values in the diabetic group as compared to the group protected by polyphenols. Through the hypoglycemiant, hypolipemiant and antioxidant effects,Sambucus nigra represents a possible dietary adjunct for the treatment of diabetes and a potential source for the discovery of new orally active agent(s) for future diabetes therapy. Understanding the mechanism through which the natural polyphenols have effects on the functionality of the endothelium cells, including on the membrane sensitivity and intracellular signalling, could represent a new way of therapeutically approaching chronic metabolic diseases and cardiovascular illnesses.

Protecting antioxidative effects of vitamins E and C in experimental physical stress

Like every redox-active compound vitamin E may exert pro-oxidative and antioxidativeeffects depending on the reaction partners present. In this work we evaluatedthe intensity of oxidative stress produced by a physical exercise through swimmingas well as of protecting action of antioxidant vitamins E and C. Antioxidantsystems include antioxidant enzymes: superoxide-dismutase (SOD), catalase (CAT),glutathion peroxidase (GSH-Px), as well as of components with an antioxidant actionof the reduced glutathion type (GSH) and vitamins E and C. We determine the activitiesof these enzymes in the erythrocytes and heart homogenate. Our results pointsout a protective effect against oxidative stress produced by swimming in animalstreated with vitamins E and C, which are expressed through the diminution of themalondialdehyde (MDA) quantity both in erythrocytes and in the heart, and throughthe conservation of GSH content in both products. CAT and GSH-Px activitiesdecrease while that of SOD increases on both tissues, but with different intensities inaccordance with the variation of protection degree performed by the vitamin coupleon these tissues. The obtained data underline the necessity of intensifying the meansof endogenous antiradical defence with exogenous antioxidant vitamins C and E.This study highlights the need of a proper vitamin supplement in organism understress (AU)

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Protecting antioxidative effects of vitamins E and C in experimental physical stress

Like every redox-active compound vitamin E may exert pro-oxidative and antioxidativeeffects depending on the reaction partners present. In this work we evaluatedthe intensity of oxidative stress produced by a physical exercise through swimmingas well as of protecting action of antioxidant vitamins E and C. Antioxidantsystems include antioxidant enzymes: superoxide-dismutase (SOD), catalase (CAT),glutathion peroxidase (GSH-Px), as well as of components with an antioxidant actionof the reduced glutathion type (GSH) and vitamins E and C. We determine the activitiesof these enzymes in the erythrocytes and heart homogenate. Our results pointsout a protective effect against oxidative stress produced by swimming in animalstreated with vitamins E and C, which are expressed through the diminution of themalondialdehyde (MDA) quantity both in erythrocytes and in the heart, and throughthe conservation of GSH content in both products. CAT and GSH-Px activitiesdecrease while that of SOD increases on both tissues, but with different intensities inaccordance with the variation of protection degree performed by the vitamin coupleon these tissues. The obtained data underline the necessity of intensifying the meansof endogenous antiradical defence with exogenous antioxidant vitamins C and E.This study highlights the need of a proper vitamin supplement in organism under stress (AU)

No disponible

No disponible

Protecting antioxidative effects of vitamins E and C in experimental physical stress.

Like every redox-active compound vitamin E may exert pro-oxidative and antioxidative effects depending on the reaction partners present. In this work we evaluated the intensity of oxidative stress produced by a physical exercise through swimming as well as of protecting action of antioxidant vitamins E and C. Antioxidant systems include antioxidant enzymes: superoxide-dismutase (SOD), catalase (CAT), glutathion peroxidase (GSH-Px), as well as of components with an antioxidant action of the reduced glutathion type (GSH) and vitamins E and C. We determine the activities of these enzymes in the erythrocytes and heart homogenate. Our results points out a protective effect against oxidative stress produced by swimming in animals treated with vitamins E and C, which are expressed through the diminution of the malondialdehyde (MDA) quantity both in erythrocytes and in the heart, and through the conservation of GSH content in both products. CAT and GSH-Px activities decrease while that of SOD increases on both tissues, but with different intensities in accordance with the variation of protection degree performed by the vitamin couple on these tissues. The obtained data underline the necessity of intensifying the means of endogenous antiradical defence with exogenous antioxidant vitamins C and E. This study highlights the need of a proper vitamin supplement in organism under stress.

[Immunoisolation strategies for the transplantation of pancreatic islets]. / Strategii de imunoizolare pentru transplantul insulelor pancreatice.

Several different types of systems employing selectively permeable membranes and matrix supports for cells have been successfully tested in animals. Results in diabetic animals indicate that these systems can function for periods of several months to several years without the use of any of immunosuppression. This approach has the potential not only to allow the transplantation of islets across wide species barriers but that it can be achieved using injectable microreactors fabricated from biodegradable polymers. A new prototype of minimal volume alginate/polyaminoacidic microcapsules which retain immunoisolatory, biocompatibility and functional properties that seem to match those of conventional-size microcapsules was developed. Since coherent microcapsules tightly envelop each islet, any redundant space between membrane and islet is virtually eliminated. Consequently, these microcapsules occupy an extremely this space, thus addressing a major problem associated with conventional size microspheres.

[Occupational stress--risk factor in essential arterial hypertension]. / Stresul ocupational--factor de risc în hipertensiunea arteriala esentiala.

The stress was recorded taking into consideration the epidemiological interview, using a standard methodology by filling in the type card the occupational stress (OS) and the family stress (FS). The constitutional factors (behaviour type A, body weight index > 25 Kg/m2) as well as the consumption in excess of salt, have significantly correlated themselves, both in individuals with OS and FS, and in those with the exclusively OS. The modification of biochemical constants (total cholesterol, triglycerides, total lipids, HDL-cholesterol, LDL-cholesterol) significantly associate themselves in persons to which the presence of OS and FS, of the occupational one, respectively was put into evidence (chi 2 = 94.10 for 5 freedom degrees and p < 0.001, chi 2 = 118.94 and p < 0.001, respectively). The prevalence of persons with pathologic values of total lipids was 58.7%, of triglycerides 35.7%, of total cholesterol 12.7%, of LDL cholesterol 27%, and of HDL-cholesterol 44.4%. Measuring the values of systolic and diastolic arterial hypertension an increase above the normal values of limit systolic arterial hypertension at 23.8% and at 12.3% for illness systolic arterial hypertension was found. The evaluation of association of certain cardiovascular risking factors in individuals with occupational stress has permitted a global understanding, useful for the elaboration of some preventive programmes.

[The significance of desmosomes in pathology]. / Implicarea desmozomilor în patologie.

Considerable progress has been made in our knowledge of desmosomes and their components. Molecular cloning of the desmosomal glycoproteins has established that desmoglein 1 and desmoglein 3 are targets for autoantibodies in the blistering diseases pemphigus foliaceus and pemphigus vulgaris respectively. New evidence suggests that another desmosomal glycoprotein, desmocollin 1, is the major target antigen in the upper epidermal form of intercellular IgA dermatosis. In human cancer there is accumulating evidence which suggests a role for desmosomes in the prevention of the invasion and metastasis. The possibility exists that a mutation in a desmosomal glycoprotein gene is responsible for an inheritable human disease, the striated form of palmoplantar keratoderma.

The diminution of platelet activity in vitamin E-treated diabetic rats.

BACKGROUND: Because vitamin E deficiency has been demonstrated in platelets obtained from diabetic subjects, in our research we investigated the platelet activity and the oxidative stress in alloxan diabetic rats supplemented with vitamin E. MATERIAL AND METHODS: The platelet activity was estimated by the adhesion index (AI) and the oxidative stress was correlated with the determined level of malondialdehyde (MDA) an end product of lipid peroxidation. RESULTS: We found that alloxanic diabetes was associated with significant increase in the both MDA level and AI (p < 0.01 and p < 0.05, respectively). The AI was better correlated to the MDA level (r = +0.60) than to the hyperglycemia. The administration of vitamin E before and after alloxan was accompanied by a significant decrease of both MDA level and AI comparing to untreated diabetic rats. CONCLUSIONS: Our study suggests that vitamin E supplementation may improve the increased platelet adhesion as a consequence of an increased oxidative stress and therefore the incidence of diabetic angiopathy may be reduced.

[The involvement of vitamins C and E in changing the immune response]. / Implicarea vitaminelor C si E în modularea raspunsului imun.

Production of reactive oxygen species (ROS) is just one of mechanisms through which activated polymorphonuclear neutrophiles contribute to the myocardium injury in ischemia and infarct. In the employed experimental model, the physical effort through swimming has determined the suppression of neutrophile activity and activation of serum complement. The vitamins E and C have stimulated the phagocytosis capacity of neutrophiles in the peripheral blood but they did not influence the serum complement. Our results suggest that these vitamins with their known antioxidant properties may be used together with other immunomodulators for the adapting defence of organism.

[The effect of the combination of vitamin E and C on the oxidative stress parameters in physical exercise]. / Cercetari privind efectul cuplului de vitamine E si C asupra unor parametri de stres oxidativ în exercitiul fizic.

The paper outlines the modification of some antioxidant enzymes and of reduced glutathione studied on physical training induced oxidative stress model. We also assessed vitamin E and C effect. Biochemical determinations were performed on heart homogenate and erythrocytes. Catalase and glutathione peroxidase activity diminished and superoxide dismutase activity increased to a different extent in both tissue samples, while coupled vitamin E and C protection to these tissues equally varied. The glutathione (GSH) pool decreased in erythrocytes and was moderately enhanced in the heart. Either in red blood cells or heart tissue GSH level constancy was maintained by simultaneous administration of vitamins through the experiment (training period). Malondialdehyde concentration revealed a slightly pro-oxidative behaviour of this couple of vitamins that explained the only partial recovery of enzymatic activity to normal values as well as a moderate lipid peroxidation process. Both phenomena were better expressed in erythrocytes.

[The reduction of dyslipidemia and oxidative stress in experimental diabetes mellitus treated with probucol]. / Reducerera dislipidemiei si a stressului oxidativ în diabetul zaharat experimental tratat cu probucol.

There is considerable controversy regarding the role of oxidative stress in development of macro and microangiopathy in diabetes--a free radical associated disease. Increasing the oxidative glycosylation of plasma lipoproteins by reactive oxygen species (ROS) and reduction of scavenging system under conditions of hyperglycemia may accelerate diabetic vascular disease. We have investigated the effect of Probucol (P) a drug with strong lipophilic radical scavenger action, on plasma lipoproteins variations, malondialdehid (MDA) production, atherosclerotic index (total Cholesterol/HDL Cholesterol), glycemia and glucosuria in Wistar male alloxanic rats with/without enriched cholesterol diet. The inhibition of lipoproteins oxidation, resulting from diminishing MDA, in our study, would furthermore delay the absorption and penetration of lipids and lipoproteins into deeper vascular layers and thereby reduce the risk of atherosclerotic vascular lesion. Our result suggest that treatment with inhibitors of lipoproteins oxidation may reduce the risk of cardiovascular complications in diabetes.

[A clinico-etiopathogenic update on mental stress as a cardiovascular risk factor]. / Actualitati clinico-etiopatogenice privind stresul psihic ca factor de risc cardio-vascular.

In the psychic stress, ADH releases at the same time with CRF which intensifies the effects of it. Endogenous opioids cause above all the analgesia and paradoxical euphoria of stress. Psychic stress needs through the risk of heart frequency a higher capacity and it aggravates the valvular insufficiency and the valvular stenosis. The patient with rheumatic mitral stenosis could have a genetic psychic location predisposed to a higher vulnerability for psychic stress.