The role and importance of antidrug educational program in preventing toxicomania in adolescents

If before 1989 the use of drugs in Romania was an exceptional situation, in the last few years our country evolved from a transit area to a potential market. The drug users in Romania a coming from all the social classes (workers, unemployed, students and even medical staff), but more vulnerable are the adolescents and the young unemployed people. There is a certain risk that the drug use in Romania to become a wide spread phenomenon, with a tendency of getting out of control. Thus we need an operational program in the fight against the drug use.     

Cytosolic calcium dynamics and smooth muscle contraction(II): Reticular calcium fluxes

The contractile status of smooth muscle depends upon cytosolic Ca2+, the Ca(2+)-sensitivity of actin-myosin interaction and various calcium-independent mechanisms. This second part of our overview is devoted to the complex involvement of endoplasmic reticulum in the cytosolic Ca2+ signals related to smooth muscle contractile activity, with a focus on the functional structure of reticular membrane proteins that ensure the respective Ca2+ fluxes. Ca2+ release is activated by cytosolic Ca2+, involving reticular channels called inositol triphosphate receptors and ryanodine receptors. Beside calcium and inositol triphosphate, cyclic ADP-ribose and nicotinic acid adenine dinucleotide phosphate have recently emerged as intracellular signals that activate Ca2+ release. The reticular Ca2+ pump is essential both for the control of cytosolic Ca2+ and for the preservation of reticular stores.     

The influence of infection on titres of antiglobulin antibodies

The influence of acute and chronic infection and hypergammaglobulinaemia on the titres of anti-globulin antibodies was studied in 128 patients. Very high titres of serum agglutinators were found to be associated with gram positive septicaemia. This infection had no influence on the titres of rheumatoid factors. Elevated titres of serum agglutinators may be helpful in differentiating `benign' from `malignant' gammopathy.     

High values of soluble cytokeratin 18 in breast carcinomas may have different meanings

We have investigated the cellular and serum CK18 in 26 non-treated primary ductal invasive breast carcinomas. The soluble CK18 (TPS) was detected by chemiluminescent assay, and the cellular CK18 and PCNA expression by immunocytochemistry. Flow-cytometry was used to estimate the amount of DNA in malignant cells. There was a significant correlation between soluble CK18 and the pre-menopausal status (p < 0.05), characterized in our group by a PCNA estimated low proliferation index. We have also found a significant correlation between soluble CK18 and the DNA index (p < 0.01). The intracellular CK18 has correlated with the PCNA expression (p < 0.05), while no correlation could be found between cellular and serum CK18. The values of soluble CK18 may offer information about the treatment-induced cell death, if monitored, while isolated measurements should be interpreted cautiously. Elevated levels of serum CK18 in non-treated carcinomas may rather reflect a high tumor turn-over or perhaps a more intensive tumor cell killing.     

Treatment outcome using prednisone in corticosteroid-responsive primary nephrotic syndrome in children

In children, the nephrotic syndrome is usually corticoid-responsive; approximately 70% of patients experience relapses, frequently triggered by infections. Our paper presents the results obtained using a 4 month prednisone regimen. This retrospective study included 83 children afflicted with nephrotic syndrome over a 10 year span. We analyzed: age at diagnosis, boys/girls ratio, response to corticoid treatment - after one month of prednisone and at the completion of the treatment course, number of relapses and their frequency, complications of prednisone treatment. The median age at diagnosis was 4.8 years, males predominating M:F = 1.5:1. Complete response after 4 weeks of prednisone therapy was noted in 98.79% of cases. We had 116 episodes of relapses during the first year of follow-up, occurring in 67.4% of children (27.9% were frequent relapsers, 11.62% subsequently became corticoid-dependent). Late relapses, after the first year, occurred in 32.55% of cases. We noted mostly mild adverse effects of the prednisone treatment: occurrence of infections during therapy (16.27%), cushingoid facies (37.2%), hirsutism (4.6%), high blood pressure (4.65%), stretch marks (2.32%). In conclusion, the 4 month prednisone treatment regimen is efficient in inducing and maintaining a remission. The incidence of relapses is 32.55%, comparable to the figure cited in larger studies. Serious adverse effects are significantly lower with this regimen compared to other corticoid treatment schemes. Key wo     

Morbid obesity: a surgical perspective

Morbid obesity is a chronic illness of multifactorial aetiology which is defined as Body Mass Index (BMI) greater than 40 kg/sq.m. Non-surgical treatments for this condition have been shown to be ineffective. Surgery is the only effective treatment and obtains the best long-term outcomes. Surgery is indicated when BMI is greater than 40, or BMI is greater than 35 with significant associated co-morbidities. Four types of operations are currently performed: restrictive, malabsorptive, combined procedures (malabsorptive-restrictive) and motility-reducing pro-cedures. With restrictive procedures (adjustable gastric banding and vertical banded gastroplasty), patients can expect a long-term excess weight loss of 44-68%; for combined procedures (Roux-en-Y gastric by-pass) this is 60-70%, whereas for malabsorptive procedures (bilio-pancreatic diversion with or without duodenal switch), this is 75-80%. Intra-gastric stimulation is the least invasive treatment, but induces the lowest excess weight loss (32%) in the first two years after the operation. Gastric banding offers the best results when balancing risks and benefits. All procedures are now performed laparoscopically with comparable results to open surgery. The overall mortality rate in specialized centers is less than 0.3%. Different techniques are indicated according to BMI and the patient's eating habits. Surgery for morbid obesity has proved to improve quality of life and significantly reduce associated co-morbidities.