The relevance of inflammatory markers in metabolic syndrome.

OBJECTIVES: To identify how severe is inflammation in metabolic syndrome using as inflammatory markers: C-reactive protein and leukocytes. To asses these markers considering the diversity of metabolic syndrome elements. MATERIAL AND METHOD: We performed a study that enrolled 258 patients registered to a family physician and diagnosed with metabolic syndrome. The subjects included in the study were divided in two groups: group A-137 subjects diagnosed with metabolic syndrome that was defined by 3 elements: abdominal obesity+arterial hypertension+diabetes mellitus; group B-121 patients diagnosed with metabolic syndrome based on 5 elements: abdominal obesity+arterial hypertension+diabetes mellitus+decreased high density lipoprotein cholesterol (HDL-C)+increased triglycerides. RESULTS: We observed increased values of CRP and leukocytes for group B in comparison to group A: 0.9±0.8 mg/dl vs 0.79±0.8 mg/dl (p=0.02, significantly statistic). Leukocytes value was higher for group B, but not significantly statistic. CONCLUSIONS: Inflammation in patients with metabolic syndrome depends on the number and association of elements that define this entity and it is more accentuated for subjects who associate more elements.

Etiology of pneumonia in children in the absence of pneumococcal and antihaemophilus vaccines.

Childhood pneumonia represents an important pathology, a cause of morbidity and mortality worldwide. Our study aims to determine etiology of pneumonia in hospitalized children using several laboratory methods. We performed a prospective study that enrolled 560 children age 1 up to 18 years old all diagnosed with pneumonia by clinical and radiological features. We applied various laboratory methods (serologic, bacteriologic: bronchial aspirate, sputum, pleural effusion and blood culture) in order to identify a pathogen agent that caused pneumonia. Statistics used Statistical Package for Social Science. An etiology was established in 68.92% of all cases included in the study, as follows: in 33.93% viral etiology, in 25.13% we identified Streptococcus pneumoniae, in 20.2% Mycoplasma pneumoniae, Klebsiella pneumoniae in 8.29%, Staphylococcus aureus in 7.51%, Haemophilus influenzae in 4.92%. Mixed bacterial and viral infection was identified in 4.40% of all cases. A potential causative agent of childhood pneumonia was determined in most cases, S. pneumoniae being the main agent involved in community acquired childhood pneumonia in our country.

Difficulties in achieving arterial hypertension control.

OBJECTIVE: Our study aims to examine the effectiveness of arterial hypertension treatment on arterial pressure values in a group of people, by gender and age. MATERIAL AND METHODS: We performed an analytical prospective study, from 2007 to 2009, that included 2266 people; 674 subjects (397 women and 277 men) were diagnosed with essential systemic arterial hypertension, according to ESH (European Society of Hypertension) criteria. Medium age was 49 years. Therapy applied to all diagnosed patients consisted in: general measures (lifestyle modifications) and pharmacological treatment. Medication regimens implied: one agent (single drug therapy: inhibitors of angiotensin converting enzyme or angiotensin receptors blockers), two, three or more combined drugs (we used a combination of inhibitors of angiotensin converting enzyme or angiotensin receptors blockers and diuretics, beta-blockers, calcium channel blockers). Patients were followed up at 1 month, 3 and 6 month from the beginning of the study. Statistics used was EpiInfo6. RESULTS: Hypertension control was obtained for 33.38% of all patients; a better control was noticed for feminine gender (35.52%) over masculine gender (30.33%); distribution on age group showed the best control of the disease for the group aged 41 to 60 years old (19.92%) over those aged under 40 years (1.93%) and over 60 years (12.17%). CONCLUSIONS: Patient's poor compliance to treatment generates a suboptimal hypertension control, emphasizing that efforts for achieving goal blood pressure should continue.

[Prophylactic CPAP versus therapeutic CPAP in preterm newborns of 28-32 gestational weeks]. / CPAP precoce versus CPAP terapeutic la prematurii de 28-32 saptamâni de gestatie.

UNLABELLED: Strategies in ventilation and in exposure to the oxygen that minimise lung injury improved the prognosis of the extremely low weight newborns. Avoiding intubation can prevent the reduction of mucociliary flow, injury of the mucosa and infection. Using early CPAP isn't unanimous; there are differences between studies in what are concerned: the beginning of the treatment, gestational age, methods. CPAP is used in the treatment of respiratory arrest of infants since 1971, initially endotracheal, than with different nasal instruments. The studies evaluate the benefits of prophylactic or curative CPAP. OBJECTIVES: To compare the necessity for mechanical ventilation and surfactant administration, complications and the period of hospitalisation in VLBW and ELBW, that were under prophylactic or curative CPAP. MATERIAL AND METHOD: We made a prospective study on 90 newborns, during january 2004 and june 2006, that were not intubated in the delivery room with no major malformations. Preventive CPAP was applied in the first half an hour after birth. therapeutical CPAP was applied only in infants with the necessity in oxygen over 40%, to maintain the saturation between 90 - 95%. Group A (curative CPAP) - 25 cases, the average for gestational age 30,30+/-2,45 weeks and for birth weight 1588,00+/-573,05. For group B the averages were: 30,08+/-2,30 weeks and 1508,50+/-400,83 grams. RESULTS: Surfactant was necessary in 40% of group A, over 23% in group B (p = 0,269). Mechanical ventilation in first 72 hours of life was necessary in 18 cases (72%) - A and in 35 cases (53,84%) - B. The necessity for CPAP in hours: 92,15+/-3,85 in group A, over 112,25+/-5,75 group B (p = 0,044). Complications we considered: PDA and cerebral hemorrhage. We had 8 cases (38%) of group A with PDA, significantly different of group B: 5 cases (7,69%). Cerebral hemorrhage was absent in 40% of group A and in 73,84% in group B (p = 0,11). CONCLUSIONS: CPAP is a non invasive method with benefits in the treatment of the respiratory arrest in preterm newborn of 28 - 32 gestational weeks. Using early CPAP may reduce: necessity for surfactant, mechanical ventilation and PDA.