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Copyright of Romanian Journal of Nutrition is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Diabetes is a burden on diagnosed people, not only from the perspective of the disease itself and its complications, but also the implications on personal and professional life. On the other hand, as family doctors, we have the obligation to prevent, diagnose early and monitor patients with diabetes. But this monitoring is not limited to reaching therapeutic targets with the aim of preventing the occurrence of complications, another goal is to follow to what extent the patient with diabetes retains the ability to drive a motor vehicle. In this article, I have analyzed the existing legislative provisions in Romania regarding the situation of patients with diabetes about the ability to drive motor vehicles, respectively the provisions regarding the obligations of primary care physicians to intervene when there are diagnosed pathologies that may be incompatible with the person’s ability to drive motor vehicles. [ABSTRACT FROM AUTHOR]

Access to quality healthcare service is a challenge for many patients, especially in situations which impose movement restrictions, such as the COVID-19 pandemic. Although it has the disadvantage of lacking a physical consultation, high accessibility makes telemedicine alongside teleconsultation preferred in numerous situations, contributing to high treatment adherence in patients. An important pathology addressed through telemedicine is diabetes mellitus, due to its possible commorbidities and negative impact. This study consisted of the analysis of the electronic files of 260 patients, between April and December 2020. A high adherence in prescription days covered was observed (89.91%). The increase of teleconsultations which was maintained even after the ease of lockdown measured suggested a good adherence to this method. Teleconsultation is an efficient method, with future prospects for providing healthcare. [ABSTRACT FROM AUTHOR]

Introduction. Diabetic cardiomyopathy is a distinct condition in diabetes and is independent of atherosclerotic coronary disease, having as an effect over time the onset of heart failure. Objective/Aims: This paper aims to analyze, based on the existing data in the specialized literature, the main myocardial structural changes in the diabetic patients as well as the specific electrophysiological changes and their clinical impact Materials and Methods: The study is based on articles published in MEDLINE/PubMed and Google Scholar. Results. Discussion. It has been shown that even from the pre-diabetic stage there is cardiometabolic damage followed by myocardial hypertrophy and progression to heart failure. However, in the early stage of diabetes, myocardial damage is discrete. As the metabolic disease progresses, the myocardial structural damage becomes irreversible Conclusion: The active self-monitoring of glycemic values as well as the imaging evaluation by cardiac ultrasonography of all patients with metabolic syndrome even in the presence of normal glycemic values, in order to initiate the early initiation of specific antidiabetic therapy in order to prevent the occurrence of cardiovascular complications specific to this metabolic pathology. [ABSTRACT FROM AUTHOR]

Diabetes is today a great challenge for the medical world, forcing an interdisciplinary approach and active involvement of the diabetic patient in his therapeutic algorithm by assuming behavioral and medical changes in his life plan, once the diagnosis of this disease has been performed. As a result of consulting several meta-analyses and some research on the psychiatric pathology associated with diabetes, by far the most common psychiatric conditions involved are depression and anxiety disorders, with needle and hypoglycemia phobia. The relationship between psychiatric disorders and diabetes is a two-way one, both potentiating each other. The appearance of a mental suffering in the context of a diabetic disease will impair the prognosis of the latter and will decrease the glucose control, leading to the appearance of specific complications of a chronic hyperglycemia. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Psychology / Revista de Psihologie is the property of Romanian Academy Publishing House / Editura Academiei Romane and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We are presenting the case of a 50 year-old patient whose symptoms started over an year ago with hiposmia and epistaxis. Multiple ENT surgeries were performed for a frontal maxillary sinusitis. The patient also developed polydipsia, reaching up to 15 liters of liquid intake per day and, soon after, inflammatory and migratory arthralgia, Raynaud phenomenon, conjunctivitis and eyelid edema. The biological and imagistic investigations showed intense inflammatory syndrome, c-ANCA antibodies, nodular cavitary lesions in both lungs, pericarditis, pituitary micro adenoma. Infectious and neoplastic causes were excluded. The final diagnosis was granulomatosis with polyangiitis with upper and lower airway, cardiac, skeletal, and endocrinological involvement. Remission of induction therapy with cyclophosphamide and pulse glucocorticoids was started with a good clinical and biological outcome and a gradual decrease of fluid intake. The presence of pituitary granuloma leading to central diabetes insipidus is a rare clinical manifestation of granulomatosis with polyangiitis, and it is reversible if the treatment is prompt, before pituitary necrosis. [ABSTRACT FROM AUTHOR]

Pancreatic agenesis is a rare condition that occurs when the pancreas fails to develop before birth. The severity depends on how much functional pancreatic tissue is present. Children with this pathology experience neonatal diabetes due to lack of insulin. Pancreatic agenesis may occur in association with a number of other birth defects. Martinez-Frias syndrome is an extremely rare, autosomal recessive disorder, characterized by the combination of multiple malformations: duodenal atresia, biliary atresia, hypoplastic pancreas, intrauterine growth restriction. There are only 6 cases presented so far in the literature. We present the case of a child diagnosed at birth with complex cardiac malformations (interrupted aortic arch, VSD, pulmonary artery hypoplasia, tricuspid valve dysplasia), agenesis of the pancreas, gallbladder agenesis and hypospadias. The child underwent cardiac surgery when he was 2 days old and, three days afterwards, he presented with ketoacidosis. Pancreatic insufficiency was controlled initially with continuous intravenous insulin therapy and subsequently with subcutaneous insulin, associated with pancreatic enzymes, maintaining a HbA1c value between 6% and 7%, with favorable outcome, which allowed the child a normal physical and neuropsychological development until the age of 2. As for the cardiac disease, he developed severe heart failure with cardiac fibroelastosis demonstrated during the surgery, which subsequently led to death. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a chronic disease characterized by elevated blood glucose levels. According to recent studies, about two million Romanians have diabetes, while another three million people have prediabetes, and they will develop the disease over the next ten years. There are vascular and neurological complications of long-term diabetes, and diabetic foot syndrome is one of the most serious consequences, with extensive implications for the health complications it generates and the impact on the quality of life. The diabetic foot syndrome refers to all the changes caused by diabetes in the foot. In the most advanced stages, diabetic gangrene may occur, most commonly located in one or more toes, and it can extend to the entire leg. Preventive hygiene and care rules must be strictly followed, and early diagnosis of the possible lesions and appropriate treatment at the earliest signs of ulceration can avoid amputation (total or partial) of the affected leg. Modern treatment with hydroactive dressings is an efficient and well-tolerated alternative to hospitalization. [ABSTRACT FROM AUTHOR]

Older patients with diabetes need a special approach, taking în consideration a comprehensive assessment (medical, psychological, functional, and social). Diabetes complications screening needs to be completed with the screening for depression, functional and cognitive impairement. Therapeutic targets and medication will be individualized according to different factors such aş comorbidities, functional status and expected life duration. Education for life style changes and therapy monitoring, a key factor for therapeutic succes, has to be adressed to both patient and his family, periodically. [ABSTRACT FROM AUTHOR]

Depression increases the risk of diabetes but depressive symptoms are more common in type 1 and type 2 diabetes patiens with micro- and macrovascular complications. Women with diabetes should be also closely monitored for signs of postpartum depression that may be difficult to distinguish from the normal sequelae of childbirth. For people who have diabetes and depression, treating depression can raise quality of life and increase blood glucose control. Comorbid depression and diabetes represent a major public health challenge through increased health care consumption and health care expenditure. Coordinated clinical care requires the implementation of effective strategies to increase the recognition of depression and the adoption of evidence-based interventions. Studies examining mechanisms and interventions are necessary. [ABSTRACT FROM AUTHOR]

Objective. To determine a correlation between severity of diabetic peripheral neuropathy (PN) and some type 2 diabetes mellitus (DM) complications. Methods. The data was analyzed from 93 type 2 diabetic patients, with average age 61.67± 10.81 years and diabetes duration 9.18 ± 7.63 years. We followed the presence of chronic DM complications refer in medical records, body mass index (BMI) (kg/m²), HbA1c and lipid profile. Severity of diabetic neuropathy were estimated by Toronto clinical scoring system (TCSS). Results. Chronic macroangiopathy complications were present in 86%, while chronic microangiopathy complications were present in 82% of patients with type 2DM. Prevalence ofPN assessed by TCSS was: 24% milde neuropathy, 22% moderate neuropathy, 36% severe neuropathy. Prevalence of PN increased with severity of diabetic retinopathy (DR) (p=0.002). The group of patients without retinopathy had a significant lower score than that with milde retinopathy (p=0,002) and proliferative retinopathy (p=0.002). We found a statistically significant correlation between Toronto score and severity of nephropathy (τ=0.19, p=0.036, r2=0.04). Conclusions. The presence ofPN, estimated by TCSS, indicates the utility in assessment the risk and severity of other type 2 diabetic microvascular complications. [ABSTRACT FROM AUTHOR]

It is well known that patients with diabetes mellitus are at increased risk of infectious diseases, experiencing frequent metabolic decompensation episodes. The aim of the study was to investigate the prevalence of diabetes mellitus related to different etiologies of infectious diseases. A retrospective study was conducted on patients admitted to „Dr. Victor Babes" Clinical Hospital for Infectious and Tropical Diseases Bucharest between January - December 2009. Very high probability of diabetes mellitus association was found în patients with sepsis and lung abscess. High probability of diabetes mellitus association was found in bacterial and viral pneumonia, endocarditis, urinary tract infections, chronic hepatitis C, chronic obstructive pulmonary disease and asthma. Compared toother published data în our study we didn't find a high prevalence of diabetes mellitus in patients with pulmonary tuberculosis, probably because of the socio-economic status that is the main risk factor and reason for this endemic infectious disease in Romania. Low probability of diabetes mellitus association was found in HIV infection, chronic hepatitis B, acute hepatitis A, herpes Zoster virus infection. [ABSTRACT FROM AUTHOR]

Among the main factors responsible for the actual epidemic of obesity, metabolic syndrome, diabetes and cardiovascular diseases, a particularly role is played by lifestyle modifications with its two branches: the decrease in physical activity and the profound modification in food intake. Apart the increase in intake of saturated animal lipids and decrease of vegetables, an important disequilibrium was induced by the high amount of carbonated soft drinks, rich in calories but without the essential nutritional factors present in the traditional alimentation. In order to prevent the metabolic pathology, there is need for special national and global programs for awareness and education, targeting mainly young ages which are prone and vulnerable to a such trend of consumption. Already the most important organizations of the World are aware and ready to act to stop this epidemic. [ABSTRACT FROM AUTHOR]

Vascular accident (CVA) is a sudden onset of focal neurological deficit with a vascular mechanism and is the third cause of death in developed countries. This study evaluates known risk factors of AVC and their effects on vascular episodes for the patients on cases of hospitalization continues, reported at national level for 2008, 2009 and 2010. Descriptive strategy of this study was conducted on a total of 468,635 patients with primary diagnosis of stroke (codes I60-I69, G45, the classification ICD 10-AM version 3). Information about patients is collected from their discharge. Most patients are aged between 50 and 80 years (80%). 36.6% of the cases have the diagnosis of secondary hyperlipidemia, 14.63% had a history of diabetes, hypertension 66.4%. Also 7% of the population has all three risk factors considered. Determining the validity of these risk factors and the population of Romania is an important part for scientific accuracy and to guide clinical medical practice, public health policies and prioritize research efforts. In addition patients and doctors can better understand the impact of prevention and modify specific risk factors on risk of AVC stroke in the future. [ABSTRACT FROM AUTHOR]

Background – The cardiovascular disease is the principal cause of death and disability in people with diabetes which imposes a cardio-diabetological approach of these patients. Objective – To evaluate the particular features of the ischemic heart disease in women with diabetes mellitus. Materials and methods – A retrospective study created by comparative analysis of anamnestical, paraclinical and coronarographycal datas of 156 women angiographycally investigated for ischemic heart disease that were divided depending of the diabetic status into 2 groups with similar age distribution. Results – We have noted a high prevalence of ischemic heart disease among women with diabetes mellitus of 55-59 years of age (23%). The diabetic population had more frequently obesity, hypertension, hypertriglyceridemia and low HDL cholesterol (53,85% versus 39,74%, 80,77% versus 61,54%, 62,82% versus 42,31% and 37,18% versus 15,38% respectively). The women with diabetes mellitus had more frequently coronary lesions (84,62% versus 74,36%) and more vessels were usually affected (three vessel disease - 34,62% versus 19,23%). Conclusions – In women with diabetes mellitus, the atherosclerosis risk factors (obesity, hypertension and dyslipidemia) were better expressed and the coronary disease was more severe and often required surgical myocardial revascularization techniques. [ABSTRACT FROM AUTHOR]

Child diabetes affects life-style and inter-personal relations inside the family. Anxiety and guilt are common in parents. Similar feelings, mixed with denial and rejection are being manifested by the child as well, especially in adolescence. Neurocognitive studies show that young diabetic patients have a higher risk of developing information use and learning disorders. The social support of the parents and other family members is very important to the diabetic child. When the family reacts in a negative manner to the disease, treatment acceptance decreases and the glycemic control worsens. The individual perception of the disease has been associated with psychological disorders, so that the big impact of diabetes led to an increase in the anxiety level, while the trust in the efficiency of the treatment led to a balanced diet. The frequency of nervous bulimia and anorexia varies between 1 and 6,9% in diabetic female adolescents. The prevalence goes up to 14% and about 11% of the diabetic girls inject less insulin in order to lose weight. The psycho-social and behavioral interventions in diabetic children and adolescents are effective and include the family as an important part of the treatment. Behavioral therapy like choosing objectives, auto monitoring, positive thinking, supportive intrafamilial communication and the proper assumption of responsibilities in the management of the disease have improved treatment acceptance and the metabolic control. [ABSTRACT FROM AUTHOR]

Aims/hypothesis. The aim of the study was to evaluate the diabetic patients from Maramures County from diabetic retinopathy point of view. Methods. We investigated dates obtained from hospital records, medical notes in diabetic patients from Maramures County. We analyzed different parameters: age, gender, smoking, alcohol, areas, and socioeconomic conditions. We evaluated diabetes characteristics: type, duration, complications, treatment. We analyzed concomitant disease. We search for body mass index, abdominal circumference. We analyzed different laboratory measurement: HbA1c, cholesterol, HDL-cholesterol, triglycerides. Kidney function was assessed using glomerulary filtration rate by MDRD. We interpreted digital retina photography from funduscamera Nidek AFC-210. We compared patients with and without diabetic retinopathy. Results. From a total of 12917 patients with diabetes registrated in Maramures County, only 1269 patients were available for interpretation. Patients with diabetic retinopathy (number 246), comparative with patient without diabetic retinopathy (number 1023) have significantly higher proportion of hypertension: 80.1% (95%CI; 75.1%-85.1%), comparative with 71.9% (95%CI; 69.1%-74.7%) (p=0.02). Patients with diabetic retinopathy, comparative with patients without diabetic retinopathy have significantly higher proportion of hyperlipidemia: 79.7% (95%CI; 77.2%-82.2%) to 72% (95%CI; 66.4%-77.6%), (p=0.031). Patients with diabetic retinopathy, comparative with patients without diabetic retinopathy have significantly higher proportion of polineuropahy: 28.5% (95%CI; 22.9%-34.1%) to 10.9% (95%CI; 9.0%-12.8%) (p=0.000). [Patients with diabetic retinopathy have also diabetic nephropathy in proportion of 11.8 % (95%CI; 9.7%-13.9%), comparative with patients without diabetic nephropathy 5.1% (95%CI; 4.4%-5.8%0 (p=0,002)]. Patients with diabetic retinopathy, comparative with patients without diabetic retinopathy have significantly higher poor glucose control (HbA1c>7%): 70.3% (95%CI; 64.6%-76.0%), comparative to 51.2% (95%CI; 48.1%-54.3%0 (p=0.000). Conclusions. Patients with diabetic retinopathy comparing with patients without diabetic retinopathy have a poor glucose control. Patients with diabetic retinopathy comparing with patients without diabetic retinopathy also have more frequently hypertension and hyperlipidemia. Patients with diabetic retinopathy comparing with patients without diabetic retinopathy have also more frequently diabetic polineuropathy [and diabetic nephropathy.] [ABSTRACT FROM AUTHOR]

Background - Th e metabolic syndrome is a series of cardiovascular risk factors, with major implication in cardiovascular morbidity and mortality. Aims - The retrospective study which covered an 18 months period had the purpose to establish the prevalence of various risk factors within the metabolic syndrome, which can head both profilaxy and treatment for these patients. Material and method - 712 subjects were enroled in this study, who met diagnostic criteria for metabolic syndrome. They were divided by sex, age (20-39 years, 40-59 years, 60-79 years, 80-99 years), living environment (urban, rural) and number of met clinical criteria at the moment of diagnosis (3, 4, 5 criteria). Conclusions - Th e study reveals an increased prevalence of cardiometabolic syndrome among patients from Cardiovascular Recovery Clinic, especially for those who had major cardiac events. Th e identification of at least 3 criteria for metabolic syndrome enables early diagnosis, pursuit of markers for subclinical atherosclerosis and deployment of lifestyle changes, elements that can also be the key in improving clinical and paraclinical parameters. [ABSTRACT FROM AUTHOR]

Cardiovascular autonomic neuropathy (CAN) is one of the most overlooked of all complications of diabetes, which encompasses damage to the autonomic nerve fibres that innervate the heart and blood vessels, resulting in abnormalities in heart rate control and vascular dynamics. CAN represents a prevalent and serious complication as it carries an approximately fivefold risk of mortality in the patients with diabetes, but it is one of the least frequently diagnosed. The high mortality rate may be related to silent myocardial infarction, cardiac arrhythmia, cardiovascular and cardiorespiratory instability. Patient's history and physical examination are not effective for the early detection of the autonomic nerve dysfunction, therefore it is important to identify the early stages of CAN with an easily available tool, such as the non-invasive cardiovascular reflex test. Tight glycemic control is the tool for preventing the development and the progression of CAN. [ABSTRACT FROM AUTHOR]

Introduction: Type 2 diabetes mellitus is a well-known cardiovascular risk factor. Diastolic dysfunction is considered a precursor of cardiac failure and can be diagnosed by echocardiography, being common in patients with type 2 diabetes mellitus without clinical manifestations of cardiac disease. The aim of the study was to analyze the diabetes effects on diastolic function in hypertensive patients. Material and method: The study group was composed by 125 patients with arterial hypertension, hospitalized in Ilfov County Hospital between the 1st of October 2009 and 30th of December 2009. All patients had performed transthoracic echocardiography, with the evaluation of the systolic and diastolic function; we analyzed the diastolic dysfunction grade, by evaluating of the specific parameters. Results and discussion: The group of 125 patients was divided in 2 subgroups, one with diabetes (DZ+, 38 patients) and the other without diabetes (DZ-, 87 patients). The prevalence of normal diastolic function was smaller in the DZ+ subgroup than in DZ- subgroup (21,6% vs 32,3%); mild diastolic dysfunction (66,2% vs. 61,1%) and moderate/severe dysfunction were more common in the DZ+ subgroup (15,8% vs 9,4%). Our results suggest that diabetes mellitus affects the diastolic function in men independently from the value of the blood pressure, medication or prevalence of the ischaemic heart disease. Conclusions: Diabetes mellitus negatively affect the diastolic function in hypertensive patients. This effect is more significant in men. [ABSTRACT FROM AUTHOR]

Introduction. In the case of pregnant women with diabetes, with a risk of premature birth up to 34 weeks of gestation, corticosteroid administration is recommended, with evidence that the benefits outweigh the risks of adverse effects that are especially metabolic. There is also taken into account the administration after 34 weeks, without a consensus on this. Objective of the study. Update of data on the benefits and adverse effects of antenatal corticosteroid administration in diabetic pregnant women. Materials and method. The results published in the last 10 years regarding the administration of antenatal corticosteroids in diabetic pregnant women were searched on specialized websites. The quality of the evidence was evaluated using the GRAD approach. Results. Finally, the current meta-analysis included studies totalling 1,700 cases which showed that antenatal corticosteroid treatment up to 34 weeks of gestation (compared to placebo or no treatment) is associated with a significant reduction in perinatal mortality, respiratory distress, intraventricular haemorrhage, necrotizing enterocolitis, and the need for mechanical ventilation. Studies of the impact on the mother's condition have shown that an imbalance of carbohydrate metabolism with increases in blood sugar is expected in the following days, especially on the second and third days. Conclusions. Although the current data confirm the benefits of corticosteroid administration in antenatal diabetic pregnant women before 34 weeks of gestation, we did not find significant studies regarding the administration of antenatal corticosteroids in diabetic pregnant women after 34 to 36 weeks of gestation. [ABSTRACT FROM AUTHOR]

In last 50 years the prevalence of diabetes mellitus has increased dramatically worldwide, resulting in more and more women of reproductive age being affected by either type 1 or type 2 diabetes. Women with diabetes have a higher risk for complications during pregnancy compared to women without diabetes and the current studies indicate that the risk of an unwanted pregnancy is higher then the risks of hormonal contraception. Data from recent studies reported no significant effects on glycemic control and microvascular complications. Thus, oestroprogestative pills is now recognized as a safe and effective option for women with type 1 diabetes without complications. For women with type 2 diabetes will be recommended with caution, due to frequent association with obesity and vascular risk, which increase both the thromboembolic and arterial risk. Progestogen contraceptive and non-hormonal methods are best suited for the patient with diabetes. [ABSTRACT FROM AUTHOR]

CM, patient, features a total maxillary edentation and partly terminal-front-terminal mandible edentation. The teeth have a third degree mobility. He is an insulin-dependent diabetes patient and wants to benefit from a fixed prosthetic work, which requires several implants to be made, preceded by pre-prosthetic surgical interventions. [ABSTRACT FROM AUTHOR]