The effect of levodopa-carbidopa intestinal gel infusion long-term therapy on motor complications in advanced Parkinson's disease: a multicenter Romanian experience.

Chronic treatment with oral levodopa is associated with an increased frequency of motor complications in the late stages of Parkinson's disease (PD). Continuous administration of levodopa-carbidopa intestinal gel (LCIG-Duodopa(®), Abbott Laboratories), which has been available in Romania since 2009, represents an option for treating patients with advanced PD. Our primary objective was to report changes in motor complications after initiation of LCIG therapy. The secondary objectives were as follows: to determine the impact of LCIG therapy on the daily levodopa dose variation before/and after LCIG, to collect patient self-assessments of quality of life (QoL), and to study the overall tolerability and safety of LCIG administration. A retrospective analysis (2009-2013) of LCIG therapy and the experience in nine neurology centers in Romania was performed. The impact of LCIG therapy was evaluated by analyzing changes in motor fluctuations, dyskinesia and the patients' QoL after initiating therapy. The safety of LCIG therapy was estimated by noting agent-related adverse events (AEs) and medical device-related AEs. In the 113 patients included, we observed a significant improvement in PD symptoms after initiation of LCIG therapy. The "on" period increased, with a mean value of 6.14 h, and the dyskinesia period was reduced, with a mean value of 29.4 %. The quantified non-motor symptoms subsided. The patients exhibited significant improvements in QoL scores. There were few AEs and few cases of LCIG therapy discontinuation. LCIG is an important and available therapeutic option for managing patients with advanced PD.

[Age related electrophysiological modifications in rat myocardium]. / Aspecte electrofiziologice miocardice legate de vârsta la sobolan.

During aging the electrical and mechanical phenomena of the heart are impaired. We studied the effect of aging using standard microelectrode technique on action potentials obtained in papillary muscle from 1, 3, 6 and 18 month old rats. The action potential of myocardial cells is significantly prolonged and changes resemble those observed during cardiac overload. The possible cause of the slower action potentials is the alteration of Ca2+ transients due to a reduced rate of Ca2+ sequestration by the sarcoplasmic reticulum associated with a possible alteration of K+ currents. These developmental changes are considered as an expression of adaptation of the heart with aging.

[Retroperitoneal appendicular abscess]. / Abcesul retroperitoneal de cauza apendiculara.

This article presents a 28 years old male patient case with a retroperitoneal collection of apendicular origin. After few comments about clinical and paraclinical aspects, the authors emphasise the particular aspects of differential diagnosis and surgical approach which, finally, lead to a full recovery of the patient.

[Cellular electric potentials in experimental cardiac hypertrophy]. / Potentialele electrice celulare în hipertrofia cardiaca experimentala.

Myocardial hypertrophy is considered as an adaptive mechanism of the heart submitted to mechanical overload manifested by an increase of ventricular mass. For the study of the myocardial hypertrophy different experimental models were proposed although the transposition of the results in clinical conditions is difficult. In the adaptive mechanisms of the heart of great importance are the electro-mechanical interrelations. Mechanical alterations during cardiac hypertrophy are characterized by a reduced shortening velocity and an increase of the time to peak tension. They are due to the prolongation of action potential duration especially of its plateau and a decreased rate of repolarization because of the increase of the peak ICa and ICa density, and the slower inactivations of the maximal ICa. Abnormalities of the K+ currents IK1 and IK may contribute to the prolongation of action potential duration. The instability of Ca2+ transients in hypertrophic myocardium can cause the apparition of cardiac arrhythmias.

Evaluation of a test device to assess X-ray phototimers.

This article describes the evaluation of a commercial device designed to assess the performance of phototimers on x-ray systems. The device consists of a digital readout meter that can be connected to a radiographic or mammographic test cassette. Results showed that the device provided reproducible results with different x-ray generators and processors. The device can be used in acceptance testing and routine quality control inspections, as well as to calibrate or adjust phototimers.

Effect of age on systolic intervals (STI).

Weissler's corrected STI was to be used in the assessment of cardiac performance taking into account only the heart rate and sex. But there are many other determinants of STI, among them an important one is the age. In the present paper, in 422 normal adults (280 men and 142 women) divided according the age into three groups (20-29, 30-39, 40-60 years), we found significant differences concerning STIc with age, especially over 40 years old. On the other hand, in a previous paper we have found in trained athletes similar modifications of STIc as those noticed in cardiac failure. That is why we, like other authors, do not consider Weissler's STIc as valid in the assessment of cardiac performance.

Radiation exposure due to scatter in neonatal radiographic procedures.

Radiation exposure due to scatter from radiographic examinations in the neonatal nursery depends on a number of parameters, such as beam kilovoltage, beam size, and distance from the infant being radiographed. These exposures are much less than those encountered in adult portable radiography. It is shown that, if reasonable precautions are taken, exposure to personnel in the nursery should be well within permissible limits.

Absence of increased cardiac voltage and the importance of Q vectors for the diagnosis of left ventricular hypertrophy in early stages of hypertension in patients over 40 years of age.

The quantitative VCG criteria (VCGer) for left ventricular hypertrophy (LVH) and their diagnostic power were determined in 165 hypertensive men and 86 women over 40 years of age without congestive cardiac failure in comparison with 91 normal men and 108 normal women. The patients were grouped according to the presence or absence of LVH determined by X-ray (men: 96 without and 69 with LVH, women: 41 without and 45 with LVH). The proper statistical methods were used taking into account whether their distributions were symmetrical or asymmetrical. We found some sex differences of VCG criteria. The most striking results were the lack of increased voltage, and the great sensitivity of the orientation of Q vectors to the left (Q left). Q left may be induced by: 1. a septal hypertrophy, alone or accompanied by a hypertrophy of the anterior and posterior paraseptal regions of LV wall, 2. by a subendocardial ischemia at these levels induced by the increase of intraventricular pressure, 3. by possible spatial change of the septum, 4. by all these factors acting synchronously, 5. by other, unknown factors. These VCGcr for LVH found by us are different from those in the literature, but they are valid in Romania.

New mathematical statistical methods for detecting correct echocardiographic (ECG) and vectorcardiographic (VCG) diagnosis criteria by computerization. I. The determination of the upper (Lu) and low (Ll) limits for VCG amplitudes. The multivariate analysis.

The mathematical statistical methods for the determination of the upper (Lu) and low (Ll) limits of the 95 percentile range of symmetrical and asymmetrical frequency distribution curves for electrocardiographic (ECG) or vectorcardiographic (VCG) amplitudes, ECG and VCG diagnostic criteria, and the multivariate analysis as well as the bases of their computerization-program have been presented, in order to find out the ECG and VCG diagnostic criteria. The formulae for the determination of sensitivity, specificity and performance score of the ECG and VCG diagnostic criteria, in both the above mentioned methods are presented.