[Metabolic effects of hypolipemic drugs on aged type 2 diabetes]. / Influenta terapiei hipolipemiante în reglarea metabolica a diabetului tip II la vârstnic.

There are multiple lipids anomalies on diabetes. IDDM has, because of insulin lack, increased levels of triglycerides and afferent lipoproteins. NIDDM, especially obese one, linked by insulinoresistance and hyperinsulinemia, has different and complex anomalies by quality and quantity. There is a specific shape for this anomalies named "B phenotype" with high cardiovascular risk: rise LDL-chol charged with TG and low level of HDL-chol. We searched lipoproteins levels and the effects of simvastatin on aged persons (after 60 years). We randomised 158 cases with obese type II diabetes on a case control study. We concluded that only 28% had high TG levels and 71.8% had low levels of HDL-chol. For HDL-chol this percent is higher over 60 years old group (88.75%) (p < 0.001). Cholesterol has no significant high levels (28.55%) (p < 0.5), and aged group has almost normal levels of cholesterol and triglycerides (p < 0.0001). We administered simvastatin (Zocor) on 86% cases, therapeutically doses, during a period of 6 months to one year. Making lipidograms initially, after 6 months and a year, we proved good effects of Zocor, on lipoproteins levels: rise levels of HDL-chol (p < 0.005), moderate effect on LDL-chol (p < 0.01). At the same time the treatment improving the glucose tolerability to both groups (p < 0.002).

[The consensus of outpatient physicians on the diagnosis and treatment of EHT]. / Consensul medicilor de ambulator privind diagnosticul si tratamentul HTAE.

Essential arterial hypertension is a wide spread disease, about 10% of general population. Represents a high risk for cardiovascular diseases with renal, cerebral complication. About 50% of deaths are because of AH last decade. This is a problem of ambulatory care. Practitioners have to diagnosis and treat AH for realized a good primary and secondary prevention. For a good management it has to use TEME program.

[Antilipemic therapy in dyslipidemias in obese non-insulin-dependent diabetics (ONIDDM)]. / Terapia hipolipemianta în dislipidemiile diabetului noninsulinodependent obez (DNIDO).

There are multiple lipids anomalies on diabetes. IDDM has, because of insulin lack, raised levels of triglycerides and afferent lipoproteins. NIDDM, especially the obese one, directly linked with insulin-resistance and hyperinsulinemia, has different and complex anomalies. There is a specific type named "B phenotype" with high cardiovascular risk: raised LDL chol charged with TG and low level of HDL chol. Our study on 58 cases with NIDDM obese concluded that only 28% had high TG levels but 71.8% had low levels of HDL chol. We administered fibrates, therapeutical doses, 3 months. We made lipidograms from the beginning and after one and three months. So we proved the good effect of fibrates on lipids: rise of HDL chol., moderate effect on LDL chol. for reduced cardio-vascular risk. There were good results on glucose tolerability (improving 65.8%, p < 0.01).

[Insulinemia and its evolution over time in obesity]. / Insulinemia si evolutia în timp a obezitatii.

There is a steady-state metabolism of adipose tissue ("adipose state") with a "metabolic signal" significance. It consists of: seric levels of glucose, insulin, free fatty acids. We studied 45 cases with uncomplicated obesity and we correlated seric level of insulin, basal and reactive, with DAM (mean adipocyte diameter), insulin receptor activity and obesity evolution length (age of obesity). Level of insulin has high influence on insulin receptor function (p < 0.01). Reactive insulin level are higher with obesity age (p < 0.0001). Hyperinsulinemia is a constant, continuous and early reference point of obesity.

[Hypersensitivity reactions to antilipemic drugs]. / Reactii de hipersensibilizare ale medicatiei hipolipemiante.

Chronic utilization of hipolipemiants drugs makes possible the onset of hypersensitivity reactions like a part of secondary reactions. From the point of our experience the most frequent hyperreactivity appears on fibric acid derivates. Al the cases we treated, were skin manifestations (angioedema) and about 29%, were digestive manifestations (dyspepsia, vomiting, diarrhoea). At the same time, chronic utilization of nicotinic acid derivates favored skin rash due to congestive intrinsic effect of nicotinic acid.

[Apolipoproteins-a cardiovascular risk factor within the context of syndrome X]. / Apolipoproteinele--factor de risc cardiovascular în contextul sindromului X.

Apolipoprotein is now a new biochemical marker for evolution of atherosclerosis, even better than lipid fraction. We studied seric apolipoprotein A and B (Apo A, B) on 50 cases with complicated obesity, with ages between 37-52 years, and 15 males and 35 females. Selection criteria were: android constitution, obesity, essential hypertension (EHT). We also made statistical correlations on IBM PC compatible computer using chi-square test. We correlated glycoregulation abnormalities with body mass index (BMI > 25) with meaningfully value (p < 0.005) or with complicated EHT less meaningfully (p < 0.2). On this background, we appreciated the predictive value of seric levels of Apo A, B and Apo B/A ratio > 1. EHT correlates with low levels of seric Apo A very meaningfully (p < 0.0001) and this association is higher correlated when added ICD (P < 0.00001). There is no significant relationship between high levels of seric Apo B and EHT in our study, but it is significant for Apo B/A > 1 (p < 0.0001). EHT with seric cholesterol are not correlated (p:NS). Our conclusion is that seric Apo A and Apo B/A are statistical predictive risk factors for complicated EHT on android obese persons (X syndrome).

[Bronchial asthma in old people]. / Astmul bronsic la batrîni.

Bronchial asthma in old people is defined, according to a number of Anglo-Saxon authors, as a disease which occurs for the first time (de novo) at an advanced age (i.e. over 70 years). The present follow-up study had been carried out in the Diagnostic Division of the Outpatient Department--Polyclinic no. 1 of Iasi--and has in view only the patients who had the first attack of disease at the time they were over 60. Clinical examination was complemented by the following tests: spirography, X-ray, allergological cutaneous tests, and test for the identification of eosinophils in sputum. A certain pattern was identified: the first asthmatic symptoms followed rhinobronchial episodes persistent spasmodic cough and continuous dyspnea induced by effort were frequent complaints; typical crises were uncommon. The allergic aetiology was supported by a positive anamnesis, while the cutaneous tests confirmed the presence of an allergen in only 20% of the cases; chronic and recurrent infections were present in 85% of the cases. At the same time, the presence of gastroesophageal reflux was searched as its frequency in the elderly as well as its role in inducing the bronchial asthma have often been reported. It is expected the identification of the characteristic pattern might lead to a correct diagnosis of bronchial asthma in old people and contribute to better therapy.