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Biomedical subjects

I Jipescu

Publications and source records attributed to I Jipescu.

31 records · Page 2Linked to original sources
PubMedDate not supplied

Stroke and hypertension. Antihypertensive therapy withdrawal.

The effect of antihypertensive therapy withdrawal in acute ischaemic stroke patients was assessed in order to establish possible correlations between blood pressure values and the modified Rankin Scale (mRS) outcome. One hundred and twelve consecutive patients with acute ischaemic stroke and hypertension were treated with relatively similar regimen. Seventy-two hours following the onset of stroke, systolic blood pressure decreased to < or = 180 mmHg in 110 patients. Antihypertensive therapy was randomly discontinued in 59 patients. Clinical outcome and mortality were compared in patients with and without antihypertensive therapy withdrawal, no statistically significant differences (p > 0.05) between the two groups being found. Statistically significant positive correlations (p < 0.05) between mRS outcome and the decrease of systolic and diastolic blood pressure values were in patients treated with anticoagulant and antihypertensive therapy. Statistically significant negative correlations (p < 0.05) between mRS outcome and low levels of diastolic blood pressure were noted in patients who discontinued antihypertensive therapy. Our findings emphasize the need to associate antihypertensive and anticoagulant therapy in acute ischaemic stroke patients with hypertension. Spontaneous decrease of diastolic blood pressure values showed poor outcome. The management of hypertension associated with acute ischaemic stroke should be reconsidered.

Aged↗
PubMedDate not supplied

Acetazolamide therapy evaluation in haemorrhagic stroke.

The influence of acetazolamide in patients with hemorrhagic stroke was assessed in 54 patients in comparison with the influence of other therapies in 68 patients included in a control group. Modified Rankin Scale and mortality rate were evaluated at three different moments: onset, 72 hours and control (3 weeks-one month from the onset). A better outcome was seen when acetazolamide was given. Mortality rate was significantly lower in the group of acetazolamide. This therapy may be safely used in haemorrhagic stroke, especially when hydrocephalus is associated.

Acetazolamide↗
PubMedDate not supplied

Hypertension in acute ischaemic stroke: to treat or not to treat.

The reasons for not treating hypertension could be the risk of reducing cerebral blood flow (CBF) which may induce additional cerebral damage in the so-called ischaemic "penumbra". Hypertensive patients have altered autoregulation. A severe hypertension (over 230/120 mmHg) may lead to further damage by cerebral edema which asks for antihypertensive therapy. An antihypertensive therapy was applied in 81 patients within the 72 hours interval from acute ischaemic stroke (AIS) onset. In 42 patients, the antihypertensive treatment was discontinued after the 72-hour interval (the therapy with nifedipine in daily doses of 10-20 mg was not considered as hypotensive). We compared as end points: the survival, death, modified Rankin Scale (mRS). There were no statistically significant differences between end points of patients who discontinued (group C) and those who maintained (group T) the antihypertensive therapy. The mean value of blood pressure was higher in patients who maintained antihypertensive therapy (p < 0.001 for systolic blood pressure (BP); p = 0.001593 for diastolic blood pressure). The mean value of age in patients in whom antihypertensive therapy was discontinued was higher than that found in patients who maintained antihypertensive therapy (p < 0.05).

Acute Disease↗
PubMedDate not supplied

Predictors of outcome in depression.

Several socio-demographic, family and clinical history variables, stressful life events, index episode characteristics, symptom severity, clinically and psychometrically assessed personality type and traits, and treatment were evaluated as potential predictors of multiple outcome criteria in a sample of 157 outpatients and inpatients meeting commonly used criteria for depression episodes. Outcome criteria included: severity scores on the final evaluation, improvement rate, impairment level of functioning, clinically rated treatment response, episode duration and relapse frequency in one year follow-up. Gender, personality structure and type, stressful life event characteristics, prior episode number, clinical status after the last episode, symptom length at intake, initial symptom severity, psychotic and endogenous features emerged as significant predictors of depression outcome in univariate analyses. The combination of independent variables by multivariate regression analyses improved outcome prediction.

Adolescent↗
PubMedDate not supplied

Cognitive and motor retardation in depression.

The study analysed the profile of psychomotor retardation in depression by clinically and psychometrically assessing its motor, speech and cognitive components. Psychomotor performance level of a group of 100 moderately depressed patients was significantly lower than that of controls on most psychometric tests. The interrelations among the variables evaluating various aspects of the depressive psychomotor retardation were examined and factor analyses were performed. Clinical ratings of motor, speech and mental retardation were strongly intercorrelated and a general factor emerged. When psychometric evaluations of depressive psychomotor retardation were factor analysed only separate factors characterizing cognitive and motor slowing were identified. Few and weak correlations were recorded between clinical and psychometric evaluations of depressive psychomotor retardation. Factors responsible for psychomotor slowing in depression were discussed.

Adult↗
PubMedDate not supplied

Postoperative outcome of intracranial meningiomas; long-term prognosis.

A retro- and prospective study was carried out in 150 patients who underwent surgery for benign (grade I) intracranial meningiomas (ICM). The mean duration of the follow-up was of 4 years. The subjects were divided into 4 groups according to the intervals of follow-up examination. The following variables were analysed: preoperative (clinical and paraclinical diagnosis), operative (macroscopic investigation) and postoperative (complications, sequelae, recurrences). The data were statistically processed. Conclusions are drawn concerning early results as well as predictors of long-term prognosis. Immediate improvement of the neurological and mental status was noted in 51% of patients. Late favourable outcome was found in only 35% of patients, demonstrating a tendency of late worsening. Postoperative morbidity includes complications (21%), sequelae (32%) and recurrence (22%). Predictor criteria in operated ICM patients are: onset type of illness, preoperative score, tumor location, edema and excessive vascularization of the brain as inspected at operation, early and late sequelae. Histological predictors for recurrence are: nuclear pleiomorphism, cellular mitoses, cell agglomerations. The frequency of recurrence, regardless of the operative technique, demonstrates the tendency toward malignancy of many of these tumors.

Adult↗
PubMedDate not supplied

"Spontaneous" recovery in aphasics after single ischaemic stroke.

In a homogeneous group of 75 aphasics after single ischaemic stroke, randomly selected, performance tests were carried out two weeks and one, three and six months post-onset. None of them were systematically treated. Both for the global performance and for repetition, naming, auditory comprehension, reading comprehension, writing under dictation as well as for the communicative value of a standard interview, "spontaneous" recovery was more marked during the first three months and obviously reduced between three and six months post-onset. In 28 of these aphasics, the clinical form changed from a severe to a milder form, the fluent or nonfluent character remaining unchanged. Clinical form influenced recovery by the severity of aphasia or by certain symptoms. Initial severity is quite important in recovery, very severe cases being unfavored, severe and mild cases reacting better, while moderate cases recovered the best. Associated oral apraxia had a negative influence while age had a minor effect and sex a doubtful one.

Adult↗
PubMedDate not supplied

Terminal complement complex in blood of patients with neurological diseases.

The local involvement of complement (C) in the pathophysiology of tissue lesions in several neurological diseases is known, but it has never been studied whether or not in neurological disorders the C activity in the circulation is altered as well. This was the aim of the present investigations. We measured in blood plasma, with an automatic device for analysis and quantitation of the haemolytic activity of the terminal complement complex, the variables T1, T2 and T3 which define the latter quantitatively. We did this, on the one hand, in 100 patients who had 46 neurological disorders systematized in 16 nosological groups, and, on the other hand, in a control group of 40 healthy blood-donors. The mean values of all variables found in the patients have not been statistically different from those found in the controls. This demonstrates that in neurological disorders possible activations of C remain restricted to the local tissue lesions and do not occur in blood, probably due to the opposition against C activation of the known inhibitor system.

Complement Hemolytic Activity Assay↗
PubMedDate not supplied

Carbohydrate metabolism, as reflected by glycosylated hemoglobin, in clinically active definite multiple sclerosis.

In 30 patients with the diagnosis of definite multiple sclerosis (MS) established on clinical criteria (CDMS-A1 patients), who were in a severe clinical state of MS, i.e., in whom one or more MS clinical signs or symptoms had become obvious during the last 10 days, the integrated concentration of plasma glucose over long-term (the last 6-8 weeks) was established by measurement of the percent of the glycosylated fraction of hemoglobin (Hb A1). This was also investigated in two control groups: CG-1, which consisted in 33 registered healthy blood donors matched for sex and age with the MS patients, and CG-2, consisting in 7 patients with diabetic neuropathy. The mean-value of Hb A1 of 5.1% (SD = 0.82) in the MS patients and that of 5.12% (SD = 0.96) in CG-1 controls are not statistically different (t = 0.09). The Hb A1 mean-value of 10.53% (SD = 3.5) found in the CG-2 controls is different (p < 0.001) from both the mean-values in MS patients and CG-1 controls, which validates the reliability of the HB A1 investigation. The findings indicate that clinical activation in definite MS is not associated with disturbances of glucose metabolism.

Carbohydrates↗
PubMedDate not supplied

Predictors of the response to tricyclic antidepressants in major depression.

In a relatively young sample of 108 nonbipolar patients with major depressive disorder and at least moderately severe depression, the contribution of a comprehensive set of socio-demographic, psychosocial, clinical and personality trait variables toward the prediction of short-term, multidimensionally evaluated response to tricyclic antidepressants was investigated by univariate and multivariate analyses. There is a naturalistic study without a standard treatment protocol, but treatment type, duration and dosage were controlled. Only patients who received at least moderate dosages of tricyclic antidepressants for minimum four weeks were included in this study. A relatively low number of predictors emerged. Initial severity of both symptoms and impairment of functioning were the most powerful predictors for all outcome criteria. Illness history was also relevant. Personality traits reflecting vulnerable personality style at the emotional and interpersonal level proved their predictive value. The combination of independent variables by multivariate regression analyses improve the prediction of treatment response.

Adolescent↗