RevistÄ de MedicinÄ Åi Farmacie - Clujul Medical - Iuliu HaÅ£ieganu
RevistÄ de MedicinÄ Åi Farmacie - Clujul Medical - Iuliu HaÅ£ieganu RevistÄ de MedicinÄ Åi Farmacie - Clujul Medical - Iuliu HaÅ£ieganu
Patologie infecţioasă Kroemer G., Halle A., Weber J.R., Tuomanen E.I., Cleveland J.L.: Apoptosis-Inducing Factor Mediates Microglial and Neuronal Apoptosis Caused by Pneumococcus, The Journal of Infectious Diseases, 2001, 184: 1300-9 5. Brouwer M.C., de Gans J.,Heckenberg S.G.B., Zwinderman A.H., van der Poll T.,van de Beek D.:Host genetic susceptibility to pneumococcal and meningococcal disease:a systematic review and meta-analysis,Lancet Infectious Diseases,2009,9:31-44 6. Carrol E.D., Thomson A.P.J., Moobs K.J., Hart C.A. : The role of RANTES in Meningococcal Disease, The Journal of Infectious Diseases 2000, 182: 363-6 7. Cheung A.L., Bayer A.S., Zhang G., Gresham M., Xiong Y.Q: Regulation of virulence determinants in vitro and in vivo in Staphylococcus aureus, FEMS Immumunology and Medical Microbiology 2004, 40, 1-9 8. Emonts M., Hazelzet J.A., de Groot R., Hermans P.W.M. : Host genetic determinants of Neisseria meningitidus infections, Lancet Infectious Diseases, 2003, 3: 565-77 9. Ginsbutg I. : Role of lipoteichoic acid in infection and inflamation, Lancet Infectious Diseases 2002, 2:171-79 10. Hammerschmidt S.: Adherence molecules of pathogenic pneumococci,Current Opinion in Microbiology,2006,9:12-20 11. He X.,McDaniel L.:The genetic background of Streptococcus pneumoniae affects protection in mice immunized with PspA,FEMS Microbiology Letters 2007,269:189-195 12. Hirst R.A.,Gosai B.,Rutman A.,Guerin C.J.,Nicotera P.,Andrew P.W.,O’Callaghan C.:Streptococcus pneumoniae Deficient in Pneumoysin or Autoysin Has Reduced Virulence in Meningitis,The Journal of Infectious Diseases,2008,197:744-51 13. Hollinhshead S.K., Briles D.E. : Streptococcus pneumoniae: new tools for an old pathogen, Current Opinion in Microbiology, 2001, 4:71-77 14. Huang S.H., Jong A.Y. : Cellular mechanisms of microbial proteins contributing to invasion of the blood-brain barrier, Cellular Microbiology, 2001, 3(5), 277-287 15. Koedel U., Bayerlein I., Paul R., Sporer B., Pfister H.W. : Pharmacologic Interference with NF-KB Activation Attenuates Central Nervous System Complications in Experimental Pneumococcal Meningitis, The Journal of Infectious Diseases, 200, 182, 1437-45 16. Koedel U., Scheld W.M., Pfister H.W.: Pathogenesis and pathophysiology of pneumococcal meningitis, Lancet Infectious Diseases, 2:721-36 17. Lorber B. : Listeria monocytogenes in Douglas, Mandell and Bennett’s Principles and Practice of Infectious Diseases, 6 th ed., Churchill Livingstone, 2005, vol II, 2478-2480 18. Mc Donald D.R.,Jansen R.,Geha R.:Lessons learned from molecular defects in nuclear factor KB dependent signaling, Microbes and Infection,2006,8:1151-1156 19. Moens L.,Verhaegen J.,Pierik M.,Vermeire S.,De Boeck K.,Peetermans W.E.,Bossuyt X.:Toll-like receptor 2 and Tolllike receptor 4 polymorphisms in invasive pneumococcal disease,Microbes and Infection,2007,9:15-20 20. Moll H. : Dendritic cells and host resistance to infection, Cellular Microbiology, 2003, 5(8), 493-500 21. Moreillon P., Que Y.A., Glauser M.P. : Staphylococcus aureus in Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases, 6 th ed. Churchill Livingstone, 2005, vol. II, 2321-2329 22. Musher D.M. : Streptococcus pneumoniae in Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases, 6 th ed., Churchill Livingstone, 2005, vol. II, 2392-2396 23. Niemann H.H., Schubert W.D., Heinz D.W. : Adhesins and invasins of pathogenic bacteria: a structural view, Microbes and Infection, 2004, 6, 101-112 24. Quin L.R.,Onwubiko C.,Carmicle S.,Mc.Daniel L.S.: Interaction of clinical isolates of Streptococcus pneumoniae with human complement factor H, FEMS Microbiology Letters,2006,264:98-103 25. Paterson G.K.,Nieminen L.,Jefferies J.M.C.,Mitchell T.J.: PclA, a pneumococcal collagen-like protein with selected strain distribution,contributes to adherence and invasion of host cells,FEMS Microbiology Letters,2008,285:170-176 26. Takeda K., Akira S. : Toll receptors and pathogen resistance, Cellular Microbiology, 2003, 5(3), 143-153 27. Timothy F.M. : Haemophilus Infections in Mandell Douglas and Bennett’s Principles and Practice of Infectious Diseases, 6 th ed., Churchill Livingstone, 2005, vol. II, 2661-2663 28. Tunkel A.., Scheld S.M. : Acute Meningitis in Mandell Douglas and Bennett’s Principles and Practice of Infectious Diseases, 6th ed., Churchill Livingstone, 2005, vol. I, 1085-1088, 1090-1098 29. Winkler F., Koedel U., Kastenbauer S., Pfister H.W. : Differential Expression of Nitric Oxide Synthases in Bacterial Meningitis: Role of the Inducible Isoform for Blood-Brain Barrier Breakdown, The Journal Of Infectious Diseases, 2001, 183: 1749- 59 352 Clujul Medical 2009 Vol. LXXXII - nr. 3
OBEZITATEA ŞI SINDROMUL METABOLIC. EPIDEMIOLOGIE ŞI ETIOPATOGENIE Articole de orientare TEODORA ALEXESCU¹, MARIUS MOTOCU², VASILE NEGREAN¹, SIMINA TARMURE¹, MONICA LENCU¹ 1 Clinica Medicală IV, UMF “Iuliu Hațieganu” Cluj-Napoca 2 Facultatea de Medicină, Universitatea Oradea Rezumat Obezitatea și sindromul metabolic reprezintă două patologii din ce în ce mai frecvent întâlnite în diagnosticele secolului XXI, suferințe ce produc rate înalte de morbiditate și mortalitate în populația generală, mai ales prin complicațiile asociate. Dacă insulinorezistența este binecunoscutul mecanism patogenetic al sindromului metabolic, studii tot mai multe demonstrează leptinorezistența ca verigă primordială a obezității, încercându-se să se stabilească legătura leptinorezistenței cu insulinorezistența și hiperinsulinismul. Cuvinte cheie: obezitate, sindrom metabolic, epidemiologie, etiopatogeneză. Obesity and metabolic syndrome. epidemiology and etiopathogeny Abstract Obesity and metabolic syndrome are two of the most popular diseases in the 21th century, patologies with high rates of morbidity and mortality among general population, frecvently through its asociating complications. If the insulin resistance is the wellknown’s pathogenetic mechanism of metabolic syndrome, the most recently studies releaves the leptin resistance like pathogenetic mechanism of the obesity, tring to stabilishing a conection between leptin resistance, insulin resistance and hiperinsulinism. Keywords: obesity, metabolic syndrome, epidemiology, etiopathogeny. Ca şi definiţie a obezităţii, cea mai simplă şi totodată cuprinzătoare este cea oferită de OMS, ca un exces de masă grasă ce antrenează consecinţe nefaste pentru sănătate. Toate celelalte definiţii (formula lui Broca, Lorenz), lăsate în desuetudine, sunt practic cuantificări ale obezităţii [1,2,3,4]. Cea mai utilizată în practica curentă medicală rămâne formula indicelui de masă corporală [5]: IMC = greutatea (kg) ⁄ înălţimea (m²), unde IMCindice de masă corporală. World Health Organization (WHO/OMS) recomandă următoarea clasificare a indivizilor în funcţie de IMC (tabelul 1): Clasificare Tabel 1. Clasificarea internațională a greutății corporeale a adultului în funcție de IMC. IMC (kg/m²) Subpondere
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Patologie infecţioasă<br />
Kroemer G., Halle A., Weber J.R., Tuomanen E.I., Cleveland J.L.:<br />
Apoptosis-Inducing Factor Mediates Microglial and Neuronal<br />
Apoptosis Caused by Pneumococcus, The Journal of Infectious<br />
Diseases, 2001, 184: 1300-9<br />
5. Brouwer M.C., <strong>de</strong> Gans J.,Heckenberg S.G.B., Zwin<strong>de</strong>rman<br />
A.H., van <strong>de</strong>r Poll T.,van <strong>de</strong> Beek D.:Host genetic susceptibility<br />
to pneumococcal and meningococcal disease:a systematic review<br />
and meta-analysis,Lancet Infectious Diseases,2009,9:31-44<br />
6. Carrol E.D., Thomson A.P.J., Moobs K.J., Hart C.A. : The role<br />
of RANTES in Meningococcal Disease, The Journal of Infectious<br />
Diseases 2000, 182: 363-6<br />
7. Cheung A.L., Bayer A.S., Zhang G., Gresham M., Xiong<br />
Y.Q: Regulation of virulence <strong>de</strong>terminants in vitro and in vivo<br />
in Staphylococcus aureus, FEMS Immumunology and <strong>Medical</strong><br />
Microbiology 2004, 40, 1-9<br />
8. Emonts M., Hazelzet J.A., <strong>de</strong> Groot R., Hermans P.W.M. :<br />
Host genetic <strong>de</strong>terminants of Neisseria meningitidus infections,<br />
Lancet Infectious Diseases, 2003, 3: 565-77<br />
9. Ginsbutg I. : Role of lipoteichoic acid in infection and<br />
inflamation, Lancet Infectious Diseases 2002, 2:171-79<br />
10. Hammerschmidt S.: Adherence molecules of pathogenic<br />
pneumococci,Current Opinion in Microbiology,2006,9:12-20<br />
11. He X.,McDaniel L.:The genetic background of Streptococcus<br />
pneumoniae affects protection in mice immunized with<br />
PspA,FEMS Microbiology Letters 2007,269:189-195<br />
12. Hirst R.A.,Gosai B.,Rutman A.,Guerin C.J.,Nicotera<br />
P.,Andrew P.W.,O’Callaghan C.:Streptococcus pneumoniae<br />
Deficient in Pneumoysin or Autoysin Has Reduced Virulence in<br />
Meningitis,The Journal of Infectious Diseases,2008,197:744-51<br />
13. Hollinhshead S.K., Briles D.E. : Streptococcus pneumoniae:<br />
new tools for an old pathogen, Current Opinion in Microbiology,<br />
2001, 4:71-77<br />
14. Huang S.H., Jong A.Y. : Cellular mechanisms of microbial<br />
proteins contributing to invasion of the blood-brain barrier,<br />
Cellular Microbiology, 2001, 3(5), 277-287<br />
15. Koe<strong>de</strong>l U., Bayerlein I., Paul R., Sporer B., Pfister H.W. :<br />
Pharmacologic Interference with NF-KB Activation Attenuates<br />
Central Nervous System Complications in Experimental<br />
Pneumococcal Meningitis, The Journal of Infectious Diseases,<br />
200, 182, 1437-45<br />
16. Koe<strong>de</strong>l U., Scheld W.M., Pfister H.W.: Pathogenesis and<br />
pathophysiology of pneumococcal meningitis, Lancet Infectious<br />
Diseases, 2:721-36<br />
17. Lorber B. : Listeria monocytogenes in Douglas, Man<strong>de</strong>ll and<br />
Bennett’s Principles and Practice of Infectious Diseases, 6 th ed.,<br />
Churchill Livingstone, 2005, vol II, 2478-2480<br />
18. Mc Donald D.R.,Jansen R.,Geha R.:Lessons learned from<br />
molecular <strong>de</strong>fects in nuclear factor KB <strong>de</strong>pen<strong>de</strong>nt signaling,<br />
Microbes and Infection,2006,8:1151-1156<br />
19. Moens L.,Verhaegen J.,Pierik M.,Vermeire S.,De Boeck<br />
K.,Peetermans W.E.,Bossuyt X.:Toll-like receptor 2 and Tolllike<br />
receptor 4 polymorphisms in invasive pneumococcal<br />
disease,Microbes and Infection,2007,9:15-20<br />
20. Moll H. : Dendritic cells and host resistance to infection,<br />
Cellular Microbiology, 2003, 5(8), 493-500<br />
21. Moreillon P., Que Y.A., Glauser M.P. : Staphylococcus aureus<br />
in Man<strong>de</strong>ll, Douglas and Bennett’s Principles and Practice of<br />
Infectious Diseases, 6 th ed. Churchill Livingstone, 2005, vol. II,<br />
2321-2329<br />
22. Musher D.M. : Streptococcus pneumoniae in Man<strong>de</strong>ll,<br />
Douglas and Bennett’s Principles and Practice of Infectious<br />
Diseases, 6 th ed., Churchill Livingstone, 2005, vol. II, 2392-2396<br />
23. Niemann H.H., Schubert W.D., Heinz D.W. : Adhesins and<br />
invasins of pathogenic bacteria: a structural view, Microbes and<br />
Infection, 2004, 6, 101-112<br />
24. Quin L.R.,Onwubiko C.,Carmicle S.,Mc.Daniel L.S.:<br />
Interaction of clinical isolates of Streptococcus pneumoniae<br />
with human complement factor H, FEMS Microbiology<br />
Letters,2006,264:98-103<br />
25. Paterson G.K.,Nieminen L.,Jefferies J.M.C.,Mitchell T.J.:<br />
PclA, a pneumococcal collagen-like protein with selected<br />
strain distribution,contributes to adherence and invasion of host<br />
cells,FEMS Microbiology Letters,2008,285:170-176<br />
26. Takeda K., Akira S. : Toll receptors and pathogen resistance,<br />
Cellular Microbiology, 2003, 5(3), 143-153<br />
27. Timothy F.M. : Haemophilus Infections in Man<strong>de</strong>ll Douglas<br />
and Bennett’s Principles and Practice of Infectious Diseases, 6 th<br />
ed., Churchill Livingstone, 2005, vol. II, 2661-2663<br />
28. Tunkel A.., Scheld S.M. : Acute Meningitis in Man<strong>de</strong>ll Douglas<br />
and Bennett’s Principles and Practice of Infectious Diseases, 6th<br />
ed., Churchill Livingstone, 2005, vol. I, 1085-1088, 1090-1098<br />
29. Winkler F., Koe<strong>de</strong>l U., Kastenbauer S., Pfister H.W. :<br />
Differential Expression of Nitric Oxi<strong>de</strong> Synthases in Bacterial<br />
Meningitis: Role of the Inducible Isoform for Blood-Brain Barrier<br />
Breakdown, The Journal Of Infectious Diseases, 2001, 183: 1749-<br />
59<br />
352<br />
<strong>Clujul</strong> <strong>Medical</strong> 2009 Vol. LXXXII - nr. 3