Mihai BERTEANU

Latest posts by Mihai BERTEANU (see all)

Idiopathic Normal Pressure Hydrocephalus – What We Know - July 19, 2019
Disability in COPD and Chronic Heart Failure – Is the Skeletal Muscle the Final Common Pathway? - July 3, 2015
The Consumption of Alanerv® Nutritional Supplement and the Dynamic of Some Inflammatory Markers in Post-Acute Stroke Patients Undergoing Rehabilitation - July 3, 2015

Articles signed on MÆDICA, JCM:

Idiopathic Normal Pressure Hydrocephalus – What We Know

MÆDICA - a Journal of Clinical Medicine | Vol. 14, No. 2, 2019

Dumitru BALTATANU and Mihai BERTEANU

ABSTRACT

Idiopathic normal pressure hydrocephalus is a neurological disorder with clinical diagnosis and imaging confirmation that benefits from a neurosurgical therapeutic solution in the vast majority of cases. Prevalence among the general population is not well defined at this time, but prevalence and incidence in developed countries is certainly steadily increasing due to increased life expectancy and evolution of diagnostic methods. Early diagnosis and appropriate treatment contribute to improving living conditions and can significantly reduce the cost of medical care for the elderly.
Keywords: normal pressure hydrocephalus, clinical diagnostic triad, dementia, neurosurgical treatment

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Disability in COPD and Chronic Heart Failure – Is the Skeletal Muscle the Final Common Pathway?

Luminita DUMITRU, Alina ILIESCU, Horatiu DINU, Ruxandra BADEA, Simona SAVULESCU, Simona HUIDU and Mihai BERTEANU

ABSTRACT

Chronic Obstructive Pulmonary Disease (COPD) and Chronic Heart Failure (CHF), two major causes of worldwide morbidity and mortality have important systemic components, affecting additional tissues, other than the lung or the heart, such as the skeletal muscle. Muscle function (or dysfunction) may not only influence the symptoms that limit exercise, but may contribute directly to the poor exercise performance, health status and increased healthcare utilization.

The present review tries to summarize the muscular abnormalities in COPD and CHF and the mechanisms underlying these alterations, which are strikingly similar, despite the obvious differences concerning the primary impairment in these two chronic diseases.

The muscles therefore represent a potential site to improve patients’ functioning level and quality of life of COPD and CHF. Only one practical therapeutic intervention currently exists that can reverse some of the muscle abnormalities observed in COPD and CHF, namely exercise training, which becomes nowadays the “cornerstone” of the whole rehabilitation.

Keywords: chronic Heart Failure, chronic obstructive pulmonary disease, skeletal muscle, disability, rehabilitation

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The Consumption of Alanerv® Nutritional Supplement and the Dynamic of Some Inflammatory Markers in Post-Acute Stroke Patients Undergoing Rehabilitation

Delia CINTEZA, Mihai BERTEANU, Suzana VLADOIU, Bogdan Nicolae MANOLESCU and Horatiu DINU

ABSTRACT

Objectives: Stroke is followed by an inflammatory response lasting up to several months. Moreover, many of the stroke-related comorbidities (i.e., diabetes mellitus, dyslipidemia, cardiovascular disease, and atherosclerosis) are characterized by an pro-inflammatory status.

Material and Methods: We designed this pilot study to evaluate the relation between the consumption of a nutritional supplement (ALAnerv®) and the dynamic of the inflammatory status in post-acute stroke patients undergoing rehabilitation. The study population comprised 28 patients which were assigned into two study groups, named (-) ALA and (+) ALA. All subjects followed the same rehabilitation program. There were no significant differences in respect to the standard medication between the groups. Moreover, patients from the (+) ALA group received ALAnerv® for two weeks (2 pills/day). We assessed IL-1α, IL-6, TNF-α, sICAM-1, and myeloperoxidase in blood samples taken at the beginning and at the end of the study period.

Outcomes: In the (+) ALA group only IL-1α (- 9.9% ± 3.7, P = 0.013) and IL-6 (- 26.5% ± 8.2, P = 0.003) significantly decreased during the study period. The multiple regression analysis indicated that the ALAnerv® treatment was responsible for the significant decrease of IL-6 level (P = 0.008). Moreover, the percentage of IL-6 variation between the study groups reached statistical significance (8.4% ± 11.5 vs. – 26.5% ± 8.2, P = 0.034).

Conclusions: These results indicate that ALAnerv® could be beneficial for the correction of the inflammatory status in post-acute stroke patients and underline the need of a longer treatment period with a higher dose.

Keywords: blood pressure variability, ventricular dysfunction, diabetes, hypertension

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The Relationship Between Alanerv® Consumption and Erythrocytes’ Glyoxalases I and II Activities and The Level of Some Serum Markers of Carbonyl Stress in Post-Acute Stroke Patients Undergoing Rehabilitation

Eliza OPREA, Delia CINTEZA, Mihai BERTEANU and Bogdan Nicolae MANOLESCU

ABSTRACT

Objectives: Diabetes mellitus is one of the most frequent stroke-related comorbid states, and it is characterized by accumulation of reactive carbonyl compounds (RCOs), leading to “carbonyl stress”. This pilot study was aimed to evaluate the effect of the consumption of the nutritional supplement ALAnerv® on some serum carbonyl stress markers, as well as on the activity of erythrocytes’ glyoxalases in post-acute stroke patients undergoing rehabilitation.

Material and Methods: We created a study population of 28 patients, organized into (-) ALA and (+) ALA groups. Patients from (+) ALA group received ALAnerv® for two weeks (2 pills/day). All the subjects followed the same rehabilitation program. In both groups, blood samples were taken at the hospitalization and at the discharge moments, respectively. On these samples we assessed lactic acid, fructosamine and RCOs concentrations, as well as the activities of glyoxalases 1 and 2 from erythrocytes’ lysates.

Outcomes: In (-) ALA group the concentrations of fructosamine and RCOs significantly increased (0.90 ± 0.04 vs. 1.02 ± 0.04, p = 0.020; 0.19 ± 0.03 vs. 0.28 ± 0.07, p = 0.027) during the study period. Also, glyoxalase 2 activity decreased in this group (27.04 ± 6.10 vs. 14.43 ± 3.02, p = 0.027). In (+) ALA group, the variation of these parameters did not reach statistical significance. Only, the activity of Glo1, which catalyzes the rate-limiting step in the glyoxalase pathway, had an increasing trend in (+) ALA group. The percentage of variation of fructosamine between (-) ALA and (+) ALA groups reached statistical significance (14.8 ± 5.2 vs. – 1.0 ± 13.3, p = 0.047). Regression analysis indicated that the activity of glyoxalase 2 was significantly influenced by the treatment with ALAnerv® (p < 0.001), while the concentration of RCOs was significantly influenced by diabetes mellitus (p = 0.030).

Conclusions: Our preliminary results suggest that ALAnerv® could be useful for the correction of the carbonyl stress status in post-acute stroke patients with diabetes. Also, this study underlines the need of a longer treatment period with a higher dose.

Keywords: stroke, rehabilitation, glyoxalase I, glyoxalase II, fructosamine, ALAnerv®

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Paraoxonase 1 – an Update of the Antioxidant Properties of High- Density Lipoproteins

Bogdan Nicolae MANOLESCU, Carmina BUSU, Daniela BADITA, Ruxandra STANCULESCU and Mihai BERTEANU

ABSTRACT

Paraoxonase 1 (PON1) belongs to a family of enzymes with related functions, being the best studied member. PON1 is a HDL-associated protein of which function is to protect LDL particles from oxidative modifications. The status of PON1 is influenced by different genetic, life style and dietary factors. This short review is aimed to present some new aspects regarding the antioxidant properties of PON1 with emphasis on the influence exerted by different factors. Also, a special attention is paid to the relationship between PON1 and low- and high-density lipoproteins in the context of atherosclerosis which affects the endothelial cells.

Keywords: paraoxonase 1, oxidative stress, HDL

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Usefulness and Importance of Informatics Solution in Evaluating Disability – Starting Point for Physical and Rehabilitation Medicine – Draft Application

Nida-Alexandra COJAN-CARLEA, Cristian Marius COJOCARU, Adrian BIGHEA, Florina POPA and Mihai BERTEANU

INTRODUCTION

Disability is one of the paramount concerns among non-communicable diseases identified by the World Health Organization (WHO) post-2015 agenda (1). Nowadays, disability is recognized as an important but neglected by public-health concern (2). The definition of disability has been a reason to debate among specialists in the medical and social science fields for decades (3). In 2001, the World Health Organization (WHO) published the International Classification of Functioning, Disability, and Health (ICF), which promotes a new vision of health and disability and defines the latter as a “difficulty in functioning at the body, person, or societal levels, in one or more life domains, as experienced by an individual with a health condition in interaction with contextual factors”(4).
The International Society for Physical and Rehabilitation Medicine (ISPRM) defines its role as the world’s direct association in the field of rehabilitation medicine. Consequently, ISPRM defines its mission and aim not only at “the improvement of knowledge, skills and attitudes of physicians”, but also “to help improve quality of life for people with impairments and disabilities” as well to “facilitate rehabilitation medicine input to international health organizations (…)”. This includes the goal “to influence rehabilitation policies and activities of international organizations interested in the analysis of functional capacity and improvement of the individual quality of life (…)” (5). Since 1999 ISPRM has been in official relation with the World Health Organization (WHO) and their purpose together, for the period of 2011-2013, was to establish several subcommittees in order to be able to fulfil the a sets of tasks and to ensure a continuous input at the highest possible level. The topics of the collaboration plan are: the “Strengthening Medical Rehabilitation”; the “Implementation of the International Classification of Functioning, Disability and Health”; the “Community Based Rehabilitation”(6). The crowning work of the WHO was the launch of the World Report on Disability in June 2011, translated into Romanian language in September 2012 by Romanian Society of PRM. Starting from the ideas above it was thought that creating an informatics solution to evaluate disability is not only necessary, but also imposed by the trends and life that we are living.

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The Relationship Between Alanerv® Consumption and Erythrocytes’ Redox Status in Post-Acute Stroke Patients Undergoing Rehabilitation

Bogdan Nicolae MANOLESCU, Delia CINTEZA, Mihai BERTEANU, Carmina BUSU and Eliza OPREA

ABSTRACT

Objectives: Stroke is a pathological condition associated with a redox imbalance. Both the acute and the post-acute phases after a stroke are characterized by a pro-oxidant state, which could be corrected through antioxidant supplementation. The aim of the present study was to evaluate the effect of the ALAnerv® upon the redox status of erythrocytes.

Material and Methods: For this pilot study were enrolled 28 post-acute stroke patients. They were randomly divided into a control group [(-) ALA] and a study group [(+) ALA]. Patients were hospitalized for a period of two weeks. Blood samples were taken at the beginning and at the end of this period. Patients from (+) ALA group received the nutritional supplement ALAnerv®. Catalase, SOD, GPx, GRed and GT activities were assessed on erythrocytes’ lysates. Also, the total antioxidant capacity as well as the concentration of total thiols were evaluated.

Outcomes: During the study period only SOD (1393.48 ± 69.14 U/g Hb vs. 1514.06 ± 60.80) and GRed (4.47 ± 0.37 U/g Hb vs. 5.06 ± 0.24) significantly increased in (+) ALA group. Catalase (173.70 ± 14.62 k/g Hb vs. 123.41 ± 8.71) and GT (5.55 ± 0.26 U/g Hb vs. 4.95 ± 0.23) activities significantly decreased during the study period. Multiple regression indicated that only SOD, GT and GRed activities were influenced by the ALAnerv® consumption. There was no significant increase if the total thiols concentration.

Conclusions: ALAnerv® consumption could be associated with a correction of the erythrocytes’ redox status. There is a need to investigate if administration of ALAnerv® over a longer time period could have a more significant influence on the erythrocytes’ antioxidant system.

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Vitamin D Deficiency in Postmenopausal Women – Biological Correlates

Cristina CAPATINA, Mara CARSOTE, Andra CARAGHEORGHEOPOL, Catalina POIANA and Mihai BERTEANU

ABSTRACT

Introduction: Low vitamin D (VD) is associated with secondary hyperparathyroidism and both contribute to deleterious consequences (reduced bone mineral density (BMD), risk of fractures and falls).

Objective: To study the VD status and biological correlates in a group of postmenopausal women.

Material and methods: We studied 123 postmenopausal women evaluated in the C.I.Parhon National Institute of Endocrinology, the Pituitary and Neuroendocrine Diseases department. All cases had been reffered for the evaluation of BMD by the general practitioner. The evaluation included serum measurements of total and ionised calcium, phosphorus, alkaline phosphatase (ALP), 25 hydroxi vitaminD (25OHD), parathyroid hormone (PTH), osteocalcin, betacrosslaps. Central DXA osteodensitometry was performed.

Results: 91.9% of cases had 25OHD serum levels below 30 ng/ml (74.8% had VD deficiency, 17.1% VD insufficiency). Only 8.1% had sufficient VD levels. A history of fragility fractures was present in 45.83% of the osteoporotic patients, 27.27% of the osteopenic ones and 15.15% of the women with normal BMD.

32 women (26%) were on VD supplementation at the time of evaluation. Among these subjects, the 25OHD level was significantly higher in those with prior fragility fractures (p=0.018) and osteoporosis (p=0.008).

25OHD concentration negatively correlated with PTH, alkaline phosphatase (ALP) and osteocalcin. The bone markers evaluated had a significant inverse correlation with the radius BMD, T and Z scores (p=0.004).

27.17% of the cases with VD deficiency had secondary hyperparathyroidism. The 25OHD concentration was significantly lower in these cases (p=0.000).

Conclusions: VD insufficiency is widely prevalent but still under-recognized and under-treated, possibly leading to secondary hyperparathyroidism. The compliance to VD supplementation is lower in subjects without osteoporosis or fragility fractures. Primary prevention measures should be more actively implemented.

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Mihai BERTEANU

Latest posts by Mihai BERTEANU (see all)

Articles signed on MÆDICA, JCM:

Idiopathic Normal Pressure Hydrocephalus – What We Know

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