Complications of cataract surgery in Wistar rats undergoing treatment with tamsulosin.

The aim of the study was to identify if there is a connection between the time of administration of alpha-blocker medication and cataract surgery complications. Furthermore, it was explored whether discontinuation of tamsulosin before cataract surgery influences the manifestations of intraoperative floppy iris syndrome in rats. An experimental study was conducted on 20 male Wistar rats aged 1.5-2 years (body mean weight 357 g), which were divided into four equal groups: Group 1, under tamsulosin hydrochloride 0.4 mg/day for 2 months; group 2, without any treatment in the first month, followed by tamsulosin; group 3, under tamsulosin for 1 month, followed by 1 month without any treatment; and group 4, control. The pupillary diameter was assessed before instillation of 0.5% tropicamide (mydriatic and cycloplegic agent), after 1 or 2 h from instillation and postoperatively. Furthermore, pupil constriction during surgery, the presence of floppy iris and prolapse of the iris following the main incision and during serum injection were also assessed. Other analyzed features included iris rupture, posterior capsule tear, vitreous loss, lens fragments in the vitreous, suprachoroidal bleeding and corneal haze. The iris dilator muscle thickness and the posterior epithelium was measured using light microscopy. In the control group, the largest pupillary diameters were indicated and in group 1, the smallest pupillary diameters were revealed. Statistically significant differences were indicated between group 1 and 2 and group 3 and 4. Floppy iris, iris prolapse in the main incision and during serum injection appeared at maximum frequency for group 1 with continuous treatment and low frequency for the control group. Lens fragments in the vitreous were present in the groups 1-3. Notably, intraoperative miosis had statistical relevance in group 1 and group 2. To conclude, the present findings suggested there is a clear connection between the time of administration of the alpha-blocker medication and most cataract complications. The results indicated that discontinuation of tamsulosin for one month largely reduces the manifestations of intraoperative floppy iris syndrome in rats, which may suggest to change preoperative treatment for benign prostatic hypertrophy with another class of drugs that do not interact with the iris receptors.

Determinants of inadequate weight gain in pregnancy.

AIM: The aim of the study was to explore the anthropometric maternal characteristics and prenatal care as determinants of pregnancy weight gain. MATERIAL AND METHODS: We conducted a cross-sectional study on a total of 400 pregnant women admitted to Cuza-Voda Obstetrics and Gynecology Clinical Hospital, Iasi. Information on demographic characteristics, number of prenatal visits, and education on nutrition and food changes occurring during pregnancy were recorded in a structured questionnaire. Anthropometric parameters analyzed were pregestational BMI (body mass index) and weight gain during pregnancy. RESULTS: Weight gain was associated with pregestational BMI category. An increase in weight more than recommended occured more frequently in overweight (53.1%) and obese women (66.7%) (p < 0.001). Weight gain during pregnancy was related to area of residence, age, APCU (adequate prenatal care utilization) index. The multivariate analysis identified the following variables as significant determinants of pregnancy weight gain: inadequate prenatal care, BMI and changes in diet. CONCLUSIONS: Pregestational BMI and changes in diet during pregnancy identified as determinants of weight gain suggests that overweight and underweight women must carefully be counseled regarding recommendations for weight gain in pregnancy. Tracking diet changes is important to ensure that a weight gain lies within the guidelines recommendations.

Adequate weight gain in pregnancy: an analysis of its determinants in a cross-sectional study.

INTRODUCTION: Prenatal care is considered an important tool for promoting a healthy lifestyle, but has not been studied as a predictor for maternal weight gain during pregnancy, especially in Romania, where evidence about pregnancy and nutrition is scarce. OBJECTIVE: This study has aimed to explore the relationship between pre-gestational body mass index (BMI), adequacy of prenatal care and weight gain during pregnancy. METHODS: We carried a cross-sectional study on a sample of 400 pregnant women admitted at the "Cuza Voda" Obstetrics and Gynecology Hospital in Iasi. Information regarding demographic characteristics, number of prenatal visits, date of the initial hospital record, nutritional education during pregnancy were registered throughout a questionnaire filled out by means of a direct interview. The anthropometric indicators analyzed were the pre-gestational BMI and the pregnancy weight gain. Data on caloric intake were obtained using a food frequency questionnaire. RESULTS: Weight gain within the limits of the Institute of Medicine recommendations was noticed at 44.35% of the women who declared that they received nutritional advice compared to 40.7% of those who did not receive advice regarding diet during pregnancy. Overweight (53.1%) and obese women (66.7%) had a larger weight gain than those with a normal pre-pregnancy BMI (29.8%) (p<0.001). The variables that were identified with an effect on weight gain in this sample of pregnant women were: inadequate prenatal care, pre-gestational BMI and energy intake. CONCLUSION: Identifying the pre-gestational BMI and diet changes as predictors of weight gain underline the importance of an individualized prenatal care.

[Neuropad test in evaluation of diabetic foot]. / Testul Neuropad in evaluarea piciorului diabetic.

AIM: Diabetic neuropathy (DN) is the main cause of foot ulceration. One of the earliest modifications is the loss of normal sudomotor function, a sign of autonomic neuropathy. The aim of this study is to evaluate sudomotor dysfunction using a new tool (Neuropad) in diabetic patients with foot ulceration. MATERIAL AND METHODS: We included 58 diabetic patients with foot ulceration admitted in 2010 in the Clinical Center for Diabetes, Nutrition and Metabolic Diseases. We collected data regarding age, gender, type and duration of diabetes, glycated hemoglobin (HbAlc), history of amputations and duration of hospital admission. Peripheral neuropathy was evaluated through the Neuropathy Disability Score (NDS) and autonomic neuropathy was tested through Neuropad. RESULTS: 95% of patients had NDS > or = 6, among which 76% had also positive Neuropad test. Patients with both peripheral and autonomic neuropathy had longer duration of diabetes (p = 0.027) but similar HbA1c as patients with only peripheral neuropathy (p = 0.09). The former also had longer duration of current admission (p = 0.022) and a higher percentage of these patients had history of amputations (p = 0.041). CONCLUSIONS: Neuropad is a reliable, easy to use test for the diagnosis of autonomic neuropathy, which puts patients at greater risk for foot ulceration and amputation.

Vascular and nerve lesions of the diabetic foot--a morphological study.

UNLABELLED: The microcirculation in neuropathic diabetic feet is the subject of the same changes found in other end organs of the diabetic patients. In diabetic neuropathy, abnormal neurogenic regulation of the hemodynamics in the small vessels may contribute to the development of microangiopathy, which is manifested as increased basement thickening. MATERIAL AND METHODS: The study has been made on a group of 25 patients: nine with diabetes mellitus type 1 and 16 patients with diabetes mellitus type 2. All patients were affected by peripheral diabetic neuropathy and showed various degrees of lesions on the foot level. All cases required amputations done at the lower extremity of the limbs. Tissue fragments were processed for the standard histopathological exam, using Hemalaun-Eosin, trichromic Szekely and van Gieson staining. RESULTS: The histopathological examination revealed on the skin level--ulcerations covering large areas, while entire sections showed hyperacanthosis. At the dermis level, the microscopic panel was dominated by the presence of the inflammatory infiltrate. The absence or the degeneration of the sweat glands, the presence of venous stasis and perivascular bleedings completed the morphological panel of the dermis. On the microcirculation level, the endothelial cells have a flat smooth inflated aspect. In the case of the large arterioles and arteries of muscular type, we observed the presence of the fibrous tissue on the level of media, calcium deposits on intima, mediocalcinosis. CONCLUSIONS: The identification of vascular and nervous morphological structures in the complicated diabetic foot allows the extension of the knowledge related to the pathological background of this condition. The vascular lesions, which appeared on the microcirculation level, are consequently involving arterioles and arteries of muscular type and are being accompanied by nervous lesions shown through morphological changes of the peripheral nerves. The overall morphological contest of the complicated diabetic foot involves lesions of the epidermis, dermis, and muscles.