Locomotor System Involvement in Patients with Diabetes Mellitus

Catedra Medicină Internă nr.1 FR şi SC USMF “Nicolae Testemiţanu”On the basis of MEDLINE search with key words – diabetes mellitus, locomotor system pathology, osteoporosis, osteoarthritis, diabetic artropathy we selected 48 relevant articles published in the last 15 years. The analysis of these publications disclosed that diabetic arthropathy, humeroscapular periarthritis, osteoporosis, osteoarthritis and Dupuytren’s contracture are the most frequent locomotor system pathologies asociated with diabetes mellitus. În baza MEDLINE search cu cuvintele cheie - diabet zaharat, patologie osteoarticulară, osteoporoza, osteoartroza, artropatie diabetică a articolelor relevante de ultimii 15 ani au fost selectate 48 lucrări de valoare. Analiza publicaţiilor date a apreciat că printre maladiile aparatului locomotor cel mai des întîlnite la pacienţii cu diabet zaharat sunt înregistrate: artropatia diabetică, periartrita humeroscapulară, osteoporoza, osteoartroza deformantă, contractura Dupuytren

Patologia endocrină asociată autoimună

Conferinţa naţională în medicina internă din Republica Moldova cu participare internaţională, 19-20 mai 2011, Chişinău, Republica MoldovaSummary. Autoimmune etiopathogenesis is still most frequently occurring and more common for both rheumatic diseases and endocrine.Actualitate. Etiopatogenia autoimună este tot mai frecvent întâlnită şi este comună pentru mai multe maladii atât reumatice, cât şi endocrine. Material şi metode. În SCM „Sfânta Treime” au fost investigaţi şi supravegheaţi 25 de pacienţi, dintre care: 17 femei şi 8 bărbaţi, cu vârsta cuprinsă între 20 şi 70 de ani. Cea mai frecventă asociere a patologiei autoimune endocrine a fost înregistrată la 11 pacienţi (6 femei şi 5 bărbaţi) cu afecţiunea glandei tiroide şi diabetul zaharat. La 9 pacienţi – asociere de patologie endocrină cu alte maladii autoimune reumatologice. Astfel, la 6 femei şi 3 bărbaţi a fost diagnosticată hipotiroidia autoimună, diabetul zaharat şi artrita reumatoidă seropozitivă. Rezultate. La examenul clinic al pacienţilor s-a constatat frilozitate, lentoare fizică şi în gândire, somnolenţă, constipaţii, dereglări de memorie, tegumente reci, palide cu nuanţă carotenică, bradicardie, mărirea limitelor cardiace, confirmate şi la examenul radiologic. De asemenea, au fost depistate modificări şi la examenul paraclinic: voltaj redus de unde ECG, TSH în ser variind între 15,0 şi 45,0 (N 0,17 – 4,05 mU/1), iar T3 şi T4 totali scăzuţi sau în limite normale, anticorpii antitireoglobulina şi antitireoperoxidaza au depăşit limita normală. La aceşti pacienţi depistarea hiperglicemiei în profilul glicemic şi HbA1c crescută au confirmat diagnosticul de diabet zaharat. La pacienţii investigaţi s-a înregistrat dislipidemie: hipercolesterolemie, scăderea fracţiei HDL şi creşterea LDL-colesterolului, precum şi hipergliceridemie. Hemoleucograma a indicat prezenţa anemiei feriprive la mai mult de jumătate din pacienţi (n14), iar la o treime din aceştia şi anemia B12 şi acid folic – deficitară, fapt ce confirmă geneza autoimună a acestor maladii asociate. La pacienţii cu artrită reumatoidă s-au înregistrat titre crescute ale proteinei C reactive şi a factorului reumatoid depistat prin latex-test şi testul Waaler-Rose. Concluzii. Frecvenţa maladiilor endocrine asociate este impunătoare. La bază se află factorul genetic şi patogenia autoimună. Aceste maladii asociate sunt, de obicei, cu caracter de insuficienţă endocrină, incluzând hipotiroidia, diabetul zaharat, hipocorticismul. Se observă o creştere a incidenţei maladiilor autoimune asociate odată cu înaintarea în vârstă. După 60 de ani asemenea asocieri se întâlnesc şi la pacienţii cu artrită reumatoidă. În diagnosticarea acestor patologii asociate sunt de mare valoare atât anamnesticul, cât şi datele de laborator şi ale investigaţiilor instrumentale

Some aspects of cycle variability at the Diesel engine fuelled with animal fats

The progressive diminution of the oil reserves all over the world highlights the necessity of using alternative fuels derived from durable renewable resource. The use of the alternative fuels represents a viable solution to reduce the pollutant emissions and to replace fossil fuels. Thus, a viable solution is the use of the animal fats in mixture with the diesel fuel at the diesel engines. A D2156 MTN8 diesel engine was firstly fuelled with diesel fuel and then with different blends of diesel fuel-animal fats (5% and 10% animal fats content). In the paper are presented some results of the experimental investigations of engine fuelled with preheated animal fats. The raw animal fats effects on the combustion process and on the pollutant emissions at different engine loads and 1450 rev/min engine speed are showed. The engine cycle variability increases at the animal fats content increase. The cycle variability for maximum pressure, maximum pressure angle and indicated mean effective pressure is analysed. The cycle variability coefficients values don’t exceed the recommended values of the standard diesel engine

Effects of CNG quantity on combustion characteristics and emissions of a dual fuelled automotive diesel engine

The paper reveals some experimental aspects of compressed natural gas (CNG) use in dual fuel mode at an automotive diesel engine. Brake specific energetic consumption, incylinder pressure, emissions and variability of indicated mean effective pressure are analysed at operating regime of 2000 rpm and 40% load. Using CNG as an alternative fuel reduces brake specific energetic consumption by 50%, the CO2 emission by 10% and sets the in-cylinder maximum pressure 13 bar higher comparative to diesel fuel fuelling. The smoke and hydrocarbons emissions and the variability of indicated mean effective pressure are affected by the injection of compressed natural gas into intake manifold: HC emission grows 24 times, the smoke number and the coefficient of variability of IMEP double their values. The use of compressed natural gas at an automotive diesel engine improves its energetic performances and combustion process, having positive effects on CO2 emission and fuel consumption

The study of the spark ignition engine operation at fuelling with n-butanol-gasoline blends

For conventional internal combustion engines alternative fuels such alcohols (ethanol, methanol and butanol) have attracted more attention. This aspect is due to the fact that alcohols have good combustion properties and high oxygen content. Butanol is a viable fuel for blending with conventional fuels such as gasoline or diesel because of its high miscibility with these conventional fuels. The high combustion speed of butanol compared to that of gasoline ensures a shorter burning process thus the engine thermal efficiency can potentially be improved. Moreover, the additional oxygen content of the alcohol n-butanol can potentially improve the combustion process and can lead to a reduction of carbon monoxide and unburnt hydrocarbons emissions level. Utilizing butanol-gasoline blends can provide a good solution for the reduction of greenhouse gases level (CO2) and pollutants level (CO, HC, and NOx). An experimental study was carried out in a spark ignition engine which was fueled with a blend of n-butanol-gasoline at different volume percentages. The objective of this paper is to determine the effects of butanol on the engine energetic performances and on the emissions (HC, CO and NOx). At first the engine fueled with pure gasoline to set up a reference at the engine load χ=55%, engine speed of n=2500 min-1 and different excess air coefficients (λ). After setting the reference the engine was fueled with butanol-gasoline blend (10% vol. butanol 90% vol. gasoline) with the same engine adjustments. At butanol use the CO, HC and CO2 emissions level decreased, but the NOx emission level increased. The butanol can be considered a good alternative fuel for the spark ignition engines without modifications

Predictors for Estimating Scars’ Internalization in Victims with Post-Traumatic Scars versus Patients with Postsurgical Scars

(1) Background: Scars are the consequence of physiological inherent healing processes of post-traumatic and surgical lesions with a psychological impact. Post-traumatic scarring may induce emotional and behavioral changes through social stigma. In this study we analyze the internalization of scars and their impact on hopelessness, depression, or the perception of social support in subjects with post-traumatic scars compared to people with surgical scars. (2) Methods: to research this suggested model, we analyzed data collected from 110 participants 61 women and 49 men, aged between 18 and 64 years; 55 participants had post-traumatically and 55 surgically acquired scars. They all were examined to assess the characteristics of scars, were asked to complete four psycho-social scales, and the results were compared. (3) Results: our results indicate that people with post-traumatic scars are oriented toward the internalization of scars, depending on their shape and size. We argue that hopelessness, appreciation of scars, age, and how scars are produced are important predictors of internalization. (4) Conclusions: the patient’s attitude toward the appearance of a scar is an indicator of how he/she will react in the future and it could predict the vulnerability to hopelessness. Finally, we nuance the impact of objective bodily harm on the psychological and moral suffering