Bilateral hip dislocation in a 79 years patient.

Bilateral simultaneous dislocation of the hip is an unusual occurrence, especially if there is no previous history of hip abnormality or ligamentous laxity. Most of the reports published until now most frequently describe this type of injury in adults. The majority of case reports present patients with ages ranging between 20 and 30 years old, because at this age the bone is strong enough not to suffer a fracture but a dislocation. The oldest patient with bilateral simultaneous dislocation of the hip described in literature (to our knowledge) is 65 years old. We present the case of a 79 year old man that was involved in an agricultural accident in which a heavy load fell on both his feet while he was laying on the ground. Anteroposterior pelvic radiograph reveal bilateral posterior hip dislocation with an associated left-side acetabular fracture and also a minimum displaced anterior left pelvic ring fracture. Both hips were reduced within three hours of presentation by closed manipulation under spinal anaesthesia. Literature search revealed no case presentation that reported a bilateral simultaneous dislocation of the hip in elderly--to our knowledge, this is the first.

[Cardiovascular risk factors in the elderly]. / Factorii de risc cardiovascular la vârstnici.

The paper presents a review of recent findings about cardiovascular risk factors in elderly. It becomes important to know that the cardiovascular risk factors we look for in adulthood change in elderly patients. However, we consider that the cardiovascular risk factors in elderly remain hypertension, smoking status, hypercholesterolemia, diabetes mellitus and obesity. Recent studies proved that in elderly high levels of cholesterol are much less found than in adults as well as smoking status. Elderly has specific risk factors: high levels of iron and basic tachycardia. Other possible risk factors are: high levels of homocysteine, low plasmatic levels of HDL-cholesterol, high levels of lipoprotein-A and some coagulation factors.

Nuclear magnetic resonance spectroscopy in the diagnosis of modifications of the oxidative stress in red blood cell during pre-eclampsia.

UNLABELLED: Our study uses the technique of nuclear magnetic resonance (NMR) spectroscopy to determine the changes of antioxidant (AO) system in red blood cells during pre-eclampsia (PEC) as compared with normal pregnancies 28 and 34 weeks of gestation. MATERIAL AND METHOD: The study was carried out in 30 women divided into 3 groups: Group I included 10 women with pre-eclampsia, Group II A included 10 women with normal pregnancy, 28 weeks of gestation and Group II B included 10 women with normal pregnancy, 34 weeks of gestation. The balance was determined by measuring the glutathione (GSH) levels. GSH is a major scavenger in lipid peroxidation, one of the most important events in oxidative stress. RESULTS: The results are presented as spectra. We found a major decrease of intracellular GSH in PEC compared with normal pregnancies. This decrease correlates well with the severity of the disease. This AO system deficiency leaves the red blood cell completely unprotected versus lipid peroxidation, which will lead to severe damage of the membrane, an onset characteristic to this disease. Our study is the first to use NMR spectroscopy in the diagnosis of PEC. The technique proves to be very useful, especially in detecting those early changes that, if corrected, would prevent the progression to eclampsia.

[The role of lipid peroxidation and of the antioxidant systems in normal pregnancy and in pre-eclampsia]. / Rolul peroxidarii lipidice si al sistemelor antioxidante în sarcina normala si în preeclampsie.

Several recent studies have reported that there is an imbalance between increased oxidant status and decreased antioxidant system in women with preeclampsia; this factor may contribute to endothelial lesion, one of the characteristics of the disease. Our studies has examined serum levels of lipid peroxides and of some of the antioxidants (glutathione and glutathione-peroxidase) in women with preeclampsia compared with normal pregnant women. The study was realised on two groups: Group A consisting of 34 normal pregnant women and group B consisting in 20 women with PEC. Serum levels of lipid peroxides have been found markedly increased and of antioxidants markedly decreased in preeclamptic serum compared with normal gestational serum. Lipid peroxides are toxic compounds that damage endothelial cells, increase peripheral vasoconstriction and increase thromboxane synthesis. Our study has pointed out that in PEC there is a deficiency in the antioxidant system which allow, together with the ischemic placenta and activated neutrophils, the enhancement of lipid peroxides. This deficiency in AO system contribute to the development and aggravation of the clinical manifestation in PEC.

[The role of oxidative stress in the etiology of pre-eclampsia: changes at the GSH and GSH-Px levels in normal pregnancy and pre-eclampsia]. / Rolul stresului oxidative în etiologia preeclampsiei: modificari ale nivelului GSH-ului si GSH-Px în sarcina normala si preeclampsie.

Several recent studies have reported that there is an imbalance of increased oxidant status and decreased antioxidant system in women with preeclampsia and that factor might contribute to the pathogenesis of the disease. The following study examined blood levels of some of the antioxidants (glutathione, glutathione-peroxidase and -SH groups) as markers of lipid peroxidation in women with preeclampsia compared with normal gestation. Blood levels of these antioxidants were found significantly decreased in women with preeclampsia, which allowed us to speculate that there were abnormally increased levels of lipid peroxides. We believe that lipid peroxides are toxic compounds that damage endothelial cells, increase peripheral vasoconstriction and increase thromboxane synthesis and decrease prostacyclin synthesis. We consider that lipid peroxides are not the cause but the effect of oxidative stress induced by ischaemic placenta and leukocytes activation, so the contribute but not induce pathogenesis in preeclampsia.