Author Archives: administrare

How we did it – an easy and feasible experimental rat model of protective role of Lipid Emulsion in Ropivacaine induced Local Anesthetic Systemic Toxicity – technique presentation and preliminary results

DOI: 10.2478/amma-2021-0014

Introduction: Local Anesthetic Systemic Toxicity (LAST) is the most feared local anesthesia accident. As the cardiac arrest determined by LAST is mostly refractory to known resuscitation protocols, due local anesthetic blockade produced in the cardiac cells, the Lipid Emulsion (L.E) has been proved to be beneficial in resuscitating the cardiac arrest determined by local anesthetic. The aim for this presentation is to ease future studies on this topic, to ensure a starting point for next related research on LAST and LE mechanism of action.
Method: Under genaral anesthesia we induced Local Anesthetic Systemic Toxicity  to a rat model, by injecting Ropivacaine into the inferior vena cava. We monitored the cardiac activity of the subjects during the experiment. We used 4 groups of rats, control group- no intervention, lipid group- lipid emulsion was adminsitered, local anesthetic group- local anesthetic was administered and local anesthetic and lipid emulsion group- a dose of lipid emulsion was adminsitered before administering the local anesthetic.
Results: After a few attemps to incannulate teh peripheral veins we tried the more complex approach of inferior vena cava, which ensured a secure access which allowed us to repetedly adminster the local anesthetic and the lipid emulsion.
Conclusion: The presented experimental animal model of induced LAST and the protective effects of LE is one of the few described in the literature, is a reproducible model, feasible, simple, low cost and can be used as starting point in future LAST research.

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A brief reflection on the role of cholesterol in psychopathology among female psychiatric patients

DOI: 10.2478/amma-2021-0015

Objective: Cholesterol is one of the cardiovascular risk factors, but also a core component of the central nervous system. Moreover, hypercholesterolemia and hypocholesterolemia are directly related to numerous mental illnesses too. This study intends to examine the association between cholesterol level and autolytic behavior among female psychiatric patients.
Methods: The present study involves 123 female subjects, who suffered from suicidal thoughts at the moment of hospitalization. The risk of suicidal intentions was assessed by the Modified Scale for Suicide Ideation (Miller et al) and their total serum cholesterol levels were measured. We performed a case-control, analytical, randomized, observational study at the Clinical Hospital of Neurology and Psychiatry Brasov among adult female psychiatric patients admitted during 2014.
Results: By our results we distinguished 3 categories: 38 patients with low suicide risk, 32 with moderate risk and 53 with high suicide risk. Significant difference can be noticed in the higher suicide risk patients’ blood cholesterol levels: 44 patients having under 4,5mmol/L total cholesterol level (83%). Although, in other two categories, this proportion is minimal: in the moderate-risk category were 8 patients, representing just 25 %, and in the low-risk category only 1 patient had her cholesterol level under 4,5mmol/L (2,6%).
Conclusions: According to our results, proposing cholesterol-level as a biomarker for the determination of high-risk suicide behavior can be important. The presence of other important risk factors (sociodemographic and psychiatric variables) can increase exponentially the suicide behavior. The limitations of this study are the relatively small number of cases and the lack of longitudinal subsequent follow-up. Further investigations are needed on a larger and more heterogenous sample of patients in order to clarify this suggestive correlation.

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Management of late onset recurrent ventricular tachycardia following circumflex artery injury during minimally invasive mitral valve replacement surgery – Clinical case report

DOI: 10.2478/amma-2021-0013

Introduction: A rare complication of mitral valve surgery is the injury of the circumflex artery due to their close anatomical proximity resulting in a perioperative myocardial infarction and subsequent fibrosis with increased risk of developing ventricular arrhythmias.
Case presentation: We hereby describe the case of a 74-year-old male patient who underwent minimally invasive mitral valve replacement surgery for severe mitral regurgitation two weeks prior to presenting to the emergency department with dyspnea, palpitations and slight thoracic discomfort. He was diagnosed with recurrent sustained monomorphic ventricular tachycardia due to inferior wall myocardial infarction. Angioplasty of the culprit lesion was attempted, but the procedure failed due to the elastic recoil of the vessel. Our patient received antiarrhythmic therapy and an implantable cardioverter-defibrillator for secondary prevention of sudden cardiac death, with no further recorded episodes of ventricular tachycardia.
Conclusion: Although injury of the circumflex coronary artery during mitral valve surgery is described as rare, we strongly believe that increasing awareness of the potential risks involved can further prevent fatal complications.

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Retraction

By the request of the authors, we are retracting the article entitled “Double biodegradable crosspin fixation in anterior cruciate ligament (ACL) reconstruction”, which was published Acta Medica Marisiensis 2010;56(3). The invoked reason regards high similarity index with a previously published paper. The article was published at that time only in printed form.

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Protocol modification proposed for congenital hypothyroidism screening programme in Romania

DOI: 10.2478/amma-2021-0011

Objective: In Romania, congenital hypothyroidism screening is performed by measuring thyroid-stimulating-hormone levels from dried blood samples. If the initial value is above the recommended cut-off value (10 mUI/L), the newborn is recalled for a second blood collection. The aim of this study was to investigate and report potential improvements on the screening protocol that is currently applied in our country in order to reduce the time between birth and treatment initiation in newborns positive to congenital hypothyroidism screening.
Methods: Blood samples were collected from 41 full-term newborns between February and March 2019 at the maternity ward from Targu Mures Emergency County Hospital. Thyroid-stimulating-hormone values were measured with a chemiluminescent microparticle immunoassay in serum samples from cord blood collected at birth, and with a fluorometric enzyme-linked immunoassay in dried blood spots collected at day 3-5 after birth. To obtain whole blood values, serum values were transformed using a formula supplied by the kit manufacturer. Calculated cord blood values were compared with dried blood spots values using the Wilcoxon test.
Results: After serum-to-whole-blood conversion,  cord blood values ranged from 2.58 to 3.66 mUI/L (95% CI). Dried blood spot values ranged from 6.70 to 7.50 mUI/L (95% CI). The Wilcoxon test p value between cord blood and dried blood spots thyroid-stimulating-hormone levels was statistically significant (p<0.01).
Conclusions: Thyroid-stimulating-hormone levels above the cut-off value were flagged by both techniques. An improvement to the existing protocol is proposed that may reduce time from positive screening results to confirmation of congenital hypothyroidism and treatment initiation.

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Romanian adaptation of Centrality of Religiosity Scale and the utility of this scale in cognitive-behavioral therapy for religious populations

DOI: 10.2478/amma-2021-0010

Background: Cognitive-Behavioral Therapy is a psychotherapeutic intervention that proved to be an efficient treatment for a variety of psychiatric disorders. Religious features can be efficiently integrated within cognitive-behavioral approaches both during the assessment and treatment processes. The use of a specific instrument for measuring religious beliefs and attitudes may improve psychological intervention for a widely spectrum of mental disorders, including anxiety and psychosis.
Objective: The present study aims to establish a Romanian version of the Centrality of Religiosity Scale (CRS).
Method: The sample of this study included 134 undergraduate students from Romania (112 women and 22 men), aged between 18 and 46 years. The questionnaire was translated from English into Romanian by three independent translators, and then from Romanian into English by other three independent translators.
Results: Our findings indicate that the Romanian version of CRS demonstrated high internal consistency for all scales, with Cronbach alpha coefficients ranging from 0.749 to 0.881 for the individual subscales of the instrument.
Conclusion: The CRS is a valid instrument that can be used for assessing religious beliefs in Romanian population.

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Erratum

This is a correction of the abstract “A challenging case report of transtibial amputation due to fibular fracture”, Acta Marisiensis – Seria Medica 2020;66(2):11, published in the February 2020 supplement 2 of Acta Marisiensis – Seria Medica, where the title is wrong, due to errors of the website that hosted submission system for abstracts. The correct title is presented below:
Management of univentricular congenital heart disease in infants: a case report

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The efficacy of cognitive-behavioral therapy for treating major depressive disorder comorbid with chronic disease

DOI: 10.2478/amma-2021-0005

Chronic disease can severely impact an individual’s quality of life, influencing both physical and mental health. Major depressive disorder is one of the most common diagnoses among patients with physical conditions. Cognitive-behavioral therapy is a prominent evidence-based psychological treatment for depression. The objective of the present review is to summarize current research on the efficacy of this intervention in medically ill patients with comorbid depression. First, the relation between chronic disease and depression will be briefly described. Following this introduction, studies examining the efficacy of cognitive and behavioral techniques for reducing depressive symptoms in patients with frequent chronic diseases will be outlined. Subsequently, the effects of the psychological treatment for different patient populations will be analyzed. Finally, a few recommendations for adapting the intervention protocols to various target groups of people with specific characteristics will be provided in order to improve the mental health of patients with chronic medical conditions.

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