Conceptul de abordare sistematizată a diagnosticului de laborator şi implementarea lui în evaluarea insuficienţei renale cronice

Analiza literaturii de specialitate a permis standardizarea evaluării de laborator a pacienţilor care s-au adresat de novo. Diagnosticarea unor astfel de pacienţi se propune a fi efectuată în 3 etape: screeningul (general sau pe sisteme), diagnosticul sindromologic şi diagnosticul maladiei în cauză/ evaluarea riscului. În lucrare este prezentat algoritmul de diagnostic de laborator al insufi cienţei renale cronice, care permite determinarea prezenţei şi severităţii uremiei, caracterizează gravitatea modifi cărilor secundare în diferite sisteme, asociate cu intoxicaţie uremică (riscul cardiovascular, anemia şi dereglările metabolice)

Laboratory diagnostic algorythm of the primary and secondary glomerulopathies

Centrul Dializă şi Transplant Renal IMSP Spitalul Clinic Republican, Centrul Medical de Diagnostic MODUS VIVENDI”, Al V-lea Congres de Urologie, Dializă şi Transplant Renal din Republica Moldova cu participare internaţională (1-13 iunie 2011)Summary. This scientifical work presents a new model of laboratory positive and differential diagnosis of primary and secondary glomerulopathies. Presented algorithms suppose 3-staged diagnostic activity which contains evidence-based fundamentation of the recommended biological probes, biochemical analyses and immunological tests, which offers the possibility of renal lesion character identification as well as the determination of the glomerulopathy etiology, pathogenetic mechanism and severity

Managementul aplicării eritropoetinei umane (Eprex) la pacienţii dializaţi

Summary. A frequent and hazardous complication of endstage renal diseases ESRD is anemia. In our study we administered recombinant human erythropoietin (Eprex), Epoetin-, Janssen Cilag, to 65 anemic patients with ESRD, who were undergoing hemodialysis. Eprex was given subcutaneously three times weekly after dialysis, and Ht, Er, Hb; predialysis levels of creatinine and blood urea nitrogen, blood protein level, ferrokinetics, and blood pressure were monitored. Our results demonstrate that Eprex is effective, can restore the Ht to normal in many patients with the need for transfusions with their risks of immunologic sensitization and infection. The treatment with Eprex permit to include and maintain the patients in the waiting list for transplantation in a good conditio

Diszkrét matematika = Discrete mathematics

A pályázat résztvevői igen aktívak voltak a 2006-2008 években. Nemcsak sok eredményt értek el, miket több mint 150 cikkben publikáltak, eredményesen népszerűsítették azokat. Több mint 100 konferencián vettek részt és adtak elő, felerészben meghívott, vagy plenáris előadóként. Hagyományos gráfelmélet Több extremális gráfproblémát oldottunk meg. Új eredményeket kaptunk Ramsey számokról, globális és lokális kromatikus számokról, Hamiltonkörök létezéséséről. a crossig numberről, gráf kapacitásokról és kizárt részgráfokról. Véletlen gráfok, nagy gráfok, regularitási lemma Nagy gráfok "hasonlóságait" vizsgáltuk. Különféle metrikák ekvivalensek. Űj eredeményeink: Hereditary Property Testing, Inverse Counting Lemma and the Uniqueness of Hypergraph Limit. Hipergráfok, egyéb kombinatorika Új Sperner tipusú tételekte kaptunk, aszimptotikusan meghatározva a halmazok max számát bizonyos kizárt struktőrák esetén. Több esetre megoldottuk a kizárt hipergráf problémát is. Elméleti számítástudomány Új ujjlenyomat kódokat és bioinformatikai eredményeket kaptunk. | The participants of the project were scientifically very active during the years 2006-2008. They did not only obtain many results, which are contained in their more than 150 papers appeared in strong journals, but effectively disseminated them in the scientific community. They participated and gave lectures in more than 100 conferences (with multiplicity), half of them were plenary or invited talks. Traditional graph theory Several extremal problems for graphs were solved. We obtained new results for certain Ramsey numbers, (local and global) chromatic numbers, existence of Hamiltonian cycles crossing numbers, graph capacities, and excluded subgraphs. Random graphs, large graphs, regularity lemma The "similarities" of large graphs were studied. We show that several different definitions of the metrics (and convergence) are equivalent. Several new results like the Hereditary Property Testing, Inverse Counting Lemma and the Uniqueness of Hypergraph Limit were proved Hypergraphs, other combinatorics New Sperner type theorems were obtained, asymptotically determining the maximum number of sets in a family of subsets with certain excluded configurations. Several cases of the excluded hypergraph problem were solved. Theoretical computer science New fingerprint codes and results in bioinformatics were found

Changes in the dental pulp calcifications with a lamellar concentric structure and calcifications with an amorphous to finely granular structure

The aim of the study was to inspect change in the pulp with dental calcifications by different structure. Material and method: we carried out the research on 40 pulps after indicated tooth extraction, during which we made a vertical section of the teeth and removed the pulps, and 60 extirpated pulps from teeth with an endodontic diagnosis of pulpitis chronica. With the method of light microscopy, and by using standard differential histo-chemical coloring, results were obtained on the Institute of Pathology of the Faculty of Medicine in Skopje. Results: 2 morphological images of changed pulp were obtained with the method of light microscopy with the application of standard differential histochemical staining: (1) dental pulp with calcifications with a lamellar concentric structure; (2) dental pulp with calcifications present with an amorphous to finely granular structure. In both groups, a reduction of cellularity in the connective tissue is observed, with evident but gradual hyalinization, which takes the form of wider areas or tracks, dissociated from relatively preserved loose connective tissue. Pulps containing nodular calcifications show a certain degree of congestion of blood vessels, in contrast to dispersed and irregularly shaped calcifications. Keywords: dental pulp, dental calcification, hystopathological analysis

Treatment efficiency of Repretine® in patients with terminal chronic kidney failure on hemodialysis

USMF „Nicolae Testemiţanu”, Centrul Dializă şi Transplant Renal, IMSP Spitalul Clinic RepublicanA fost analizată eficienţa tratamentului cu Repretină® în decurs de 12 săptămâni la pacienţii cu insuficienţă renală cronică terminală, trataţi prin hemodializă cronică. Design-ul planificat al trialului a presupus un studiu deschis prospectiv. Lotul de studiu a cuprins 20 de pacienţi, trataţi cu Repretină® în doză de 6000 UI pe săptămână, în decurs de 3 luni. Lotul de control, compus din 10 pacienţi, a fost omogen cu cel de studiu, dar fără administrarea de eritropoietină pe parcursul trialului. Administrarea Repretinei® a fost eficientă la majoritatea pacienţilor trataţi, cu o înregistrare redusă a efectelor adverse. Cu toate că s-a observat o ameliorare statistic veridică a sindromului anemic, valorile-ţintă au fost atinse numai la 10 (50%) pacienţi la finalizarea studiului. Carenţele asociate cu alţi factori ai hematopoiezei, procesele inflamatorii concomitente, precum şi doza insuficientă de eritropoietină pot fi considerate responsabile pentru eficienţa redusă a tratamentului administrat.We have studied the efficiency of 12 weeks Repretine® therapy in patients with end-stage renal disease treated by chronic haemodialysis. The trial was intended as a prospective open-labeled study. The studied group included 20 patients treated with 6000 IU of Repretine® per week during 12 weeks. The control group (10 patients) was homogenous versus the treated group, but did not receive any erythropoietin medication during the same period. Repretine® administration was efficient in the large majority of treated patients, in the same time provoking few adverse events. Although a statistically significant improvement in both erythrocyte count and hemoglobin concentration was achieved, the intended values of hemoglobin and erythropoietin were determined only in 10 (50%) patients by the end of the treatment. Deficiencies associated with other hematopoietic factors, associated inflammatory processes as well as insufficient dose of epoietin might have hindered the efficiency of the treatment

Dinamica unor indici biochimici în tratamentul litiazei urinare cu Shilintong

Summary Urinary enzymes N-acetil-β-D-glucosam inidase (NAG), Lactate dehydrogenase (LDH), β2-microglobulin (β2-M) levels in blood and urine were measured in the 20 patients with urolithiasis treated with Shilintong and in 26 patients treated using alternate drugs for urolithiasis in association with antibacterial treatment. It was found that the levels of β2-M were high in both the groups before the treatment in com parision to the control group. While it was found that after the treatment the high level of β2-M are present only in first group, this indicates the process of tubular damage. The levels of NAG and LDH were found to remain high in both the groups before and after the treatment this indicates cellular dam age to the tubules indicating the development of pyelonephrites. Shellintong has been found not to be nephrotoxic

Identity, accent aim, and motivation in second language users:new Scottish Gaelic speakers’ use of phonetic variation

This paper examines the use of phonetic variation in word-final rhotics among nineteen adult new speakers of Scottish Gaelic, i.e. speakers who did not acquire the language through intergenerational transmission. Our speakers learned Gaelic as adults and are now highly advanced users of the language. We consider variation in their rhotic productions compared to the productions of six older traditional speakers. Previous approaches to variation in second language users have either focussed on how variable production will eventually result in native-like ‘target’ forms (Type 1 study), or have investigated the extent to which second language users reproduce patterns of variation similar to ‘native speakers’ (Type 2 study). We additionally draw on sociocultural approaches to Second Language Acquisition and apply notions of accent aim, identity construction and learning motivation in order to fully explore the data. In doing so, we advocate a ‘Type 3’ approach to variation in second language users

The level of cytokines IL-6, IL-10, IL-1Β, TNF-Α and izoprostan in serum in chronic calculous pyelonephritis

Universitatea de Medicină și Farmacie „Nicolae Testemiţanu”, Chişinău, MoldovaPurpose: Assessment of levels of IL-6, IL-10, IL-1β, TNF-α in serum and izoprostan in chronic calculous pyelonephritis. Material and methods: The study group included 33 patients with chronic pyelonephritis and the control group was 31 healthy subjects. Block indicators of inflammation parameters included: cytokines IL - 1β, IL -6, IL -10, TNF - α and izoprostan in serum assessed by ELISA. Results: The initial values of IL - 1β were 41.26 ± 4.93 pg / ml . TNF - α values were 14.40 ± 2.88 pg / ml. Changes in IL -6 were significant : mean 87.29 ± 27.18 pg / ml . IL -10 media was 19.67 ± 0.88 pg / ml. In the postoperative period these indicators were measured in 29 people. At the end of the monitoring period we found change in all parameters studied: mean values of IL- 1β increased to 48.56 ± 7.19 pg / ml TNF - α media amounted to 17.62 ± 3.30 pg / ml concentration of IL -6 significantly decreased to 81.27 ± 16.20 pg/ml. IL -10 values have changed slightly, reaching 20.00 ± 0.62 pg / ml . Sign test and Wilcoxon analysis showed similar results in assessing changes in studied parameters : p ≈ 1.00 (Sign test) / p ≈ 0.58 (Wilcoxon test) for changing the concentration of IL- 1β , p ≈ 0.14 / p ≈ 0.09 - for TNF - α concentration changes , p ≈ 0.01 / p ≈ 0.02 - for changes in serum levels of IIL -6 ≈ 0.71 p / p ≈ 0.67 - for dynamic changes the concentration of IL -10. Continuing high levels of IL - 1β, IL -10 and TNF - α in the early period after surgery is probably due to short time since surgery and reflects activation of reparative processes in the postoperative period.Obiectiv: Evaluarea nivelelor IL-6, IL-10, IL-1β, TNF-α şi a izoprostanului în ser în pielonefritele cronice calculoase. Material şi metode: Lotul cercetat a inclus 33 pacienţi cu pielonefrite cronice calculoase. Lotul martor a constituit 31 subiecti sanatosi. Blocul indicatorilor inflamaţiei a inclus parametrii: nivelul citokinelor IL-1β, IL-6, IL-10, TNF-α. şi izoprostanului în ser, apreciate prin metoda ELISA. Rezultate: Valorile iniţiale ale IL-1β au fost 41,26±4,93 pg/ml. Pentru TNF-α valorile medii au constituit 14,40±2,88 pg/ml. Modificările IL-6 au fost mai semnificative: media 87,29±27,18 pg/ml. Pentru IL10 media a constituit 19,67±0,88 pg/ml. În perioada postoperatorie aceşti indicatori au fost apreciaţi la 29 persoane. La sfârşitul perioadei de monitorizare am depistat modificarea tuturor parametrilor studiaţi: valorile medii ale Il-1β au crescut până la 48,56±7,19 pg/ml, media TNF-α s-a ridicat până la 17,62±3,30 pg/ml, concentraţia IL-6 a scazut semnificativ până la 81,27±16,20 pg/ml. Valorile IL-10 s-au modificat nesemnificativ, atingând nivelul de 20,00±0,62 pg/ml. Analiza Wilcoxon şi Sign test au demonstrat rezultatele similare în aprecierea modificărilor dinamice ale parametrilor studiaţi: p ≈ 1,00 (Sign-test) / p ≈ 0,58 (testul Wilcoxon) pentru schimbarea concentraţiei IL-1β, p ≈ 0,14 / p ≈ 0,09 – pentru modificările concentraţiei TNF- α, p ≈ 0,01 / p ≈ 0,02 – pentru modificările nivelului seric al iIL-6, p ≈ 0,71 / p ≈ 0,67 – pentru schimbările dinamice ale concentraţiei IL-10. Menținerea nivelului crescut al IL-1β, IL-10 şi TNF-α în perioada precoce după intervenţie chirurgicală este probabil, legată de intervalul de timp prea mic, trecut din momentul intervenţiei chirurgicale şi reflectă activarea proceselor reparative în perioada postoperatorie