Serum lipoprotein (a) levels in patients with arterial hypertension.

UNLABELLED: Lp(a) is capable of deleteriously altering the balance between the procoagulant and anticoagulant, proinflammatory and anti-inflammatory, and vasorelaxing and vasoconstricting properties of the endothelium. MATERIAL AND METHOD: The purpose of this study was to investigate the serum concentration of Lp(a) and the main parameters of lipid profile in three groups of subjects: a control group that included 16 healthy subjects, 20 patients with arterial hypertension and dyslipidemia and 20 patients with arterial hypertension without dyslipidemia. Using B-mode ultrasonography, we evaluated carotid intima-media thickness (IMT) and flow mediated vasodilation (FMD) on brachial artery. RESULTS: We found significant higher Lp(a) concentrations in hypertensive patients with dislipidemia (70 +/- 55.95 mg/dL, p < 0.001) and in hypertensive patients without dislipidemia (69 +/- 52.33 mg/dL, p < 0.001), comparative with the control group (19 +/- 14.64 mg/dL). In hypertensive patients with dislipidemia we found a strong negative correlation between Lp(a) and carotid IMT (R2 = -0.75, p < 0.001) and a moderate negative correlation between Lp(a) and FMD (R2 = -0.38, p < 0.001). Lp(a) level wasn't correlated with the main parameters of lipid profile. CONCLUSIONS: These results indicated that serum Lp(a) values could play an important role in essential hypertension pathogenesis and could be considered as an individual risk factor in hypertensive patients.

Reflux nephropathy in adults.

Reflux nephropathy (RN), the main complication of the vesico-ureteral reflux (VUR), relatively frequent in adults, is often the consequence of recurrent urinary infections in the child, hood or during pregnancy. Unilateral RN has generally a benign course but the bilateral one, with important nephron destruction, leads to focal and segmental glomerulosclerosis, manifested by high levels of proteinuria. A certain degree of cicatrization and renal failure are followed by progressive impairment of the remaining renal function, even if VUR is cured. An early diagnosis, treatment of the acute bacterial infection, adequate ingestion of liquids, regulation of the intestinal transit and complete bladder voiding by miction, associated with hypotensive and antiinfectious drug therapy lead to VUR disappearance in 80% of the cases, avoiding renal failure. Surgery is indicated only in the patients with severe reflux and with congenital or obstructive anomalies, as well as in the case of recurrent infection resistant to antibiotherapy.

Conventional spectral Doppler and color Doppler ultrasound imaging. Principles, limitations, artifacts and clinical indications in hepatology.

The physical principles, limitations, errors and indications of conventional Doppler and color encoded Doppler sonography are reviewed and their applications in the investigation of liver, spleen, portal and suprahepatic portal venous circulation are analysed. The actual possibilities and advantages of Doppler imaging, both in normal conditions and in pathologic ones, such as portal hypertension, portal venous thrombosis or cavernous transformation, liver cirrhosis, hepatoma and liver transplantation are discussed.

[A periventricular tumor associated with acute kidney failure and bilateral renal cortical necrosis]. / Tumora periventriculara asociata cu insuficienta renala acuta si necroza corticala renala bilaterala.

The authors present a case in which the clinico-evolutive particularity was an association between a periventricular tumour (multiform glioblastoma) and acute renal failure. Considerations are made on clinical signs determined by the neoplastic process (apraxia-agnosia hyperthermia, etc.), and on the disseminated intravascular coagulation syndrome related to the acute renal failure.