Category Archives: Review

Emergency Air Rescue System in Romania

DOI: 10.2478/amma-2018-0007

The helicopter, as a means of transport, has facilitated a significant decrease in intervention time at the site of request, increasing the chances of survival of the critical patient. Since 2003, SMURD has managed to form a fleet composed of nine helicopters and two airplanes. From an operational and strategic point of view, the SMURD intervention unit, set up seven Aeromedical Operational Bases (A.O.B.) equipped with helicopters and materials necessary for their operation. There is a dynamic increase in the number of air rescue missions in Romania, with most missions being carried out by the air rescue bases in Târgu Mureş and Bucharest. Specialty literature has clearly demonstrated the positive impact on the survival of critical patients assisted by airborne crews, so it is necessary for the Romanian air rescue system to grow up. It is necessary to increase the number of air bases, purchase new helicopters and to continue the training programs of both pilots and medical personnel.

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Clinical Conditions and Predictive Markers of Non-Dipper Profile in Hypertensive Patients

DOI: 10.2478/amma-2018-0006

Hypertension remains one of the primary causes of premature cardiovascular mortality representing a major independent risk factor. The importance of ambulatory blood pressure monitoring in clinical evaluation of hypertensive patients, beyond diagnosis, is the identification of circadian dipping/non-dipping profile. The non-dipper pattern in hypertensive and normotensive patients is associated with significant target organ damage and worse outcomes, as an increased cardiovascular risk condition. Non-dipping pattern has been found to be associated with specific clinical conditions. Obesity, diabetes mellitus, metabolic syndrome, obstructive sleep apnea syndrome, chronic kidney disease, autonomic and baroreflex dysfunctions, salt sensitivity, hormonal changes, gender and age were extensively studied. Research efforts are focused on recognizing and exploring predictive markers of abnormal blood pressure circadian pattern. Previous studies acknowledge that red cell distribution width, mean platelet volume, fibrinogen level, C-reactive protein, serum uric acid and gamma-glutamyltransferase, are independently significant and positive associated to non-dipping pattern. Moreover, research on new biomarkers are conducted: Chitinase 3-Like-Protein 1, atrial and B-type natriuretic peptide, brain-derived neurotrophic factor, chemerin, sphingomyelin and the G972R polymorphism of the insulin receptor substrate-1 gene. This review summarizes the current knowledge of different clinical conditions and biomarkers associated with the non-dipper profile in hypertensive patients.

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The early repolarization ECG pattern – an update

DOI: 10.1515/amma-2017-0032

Early repolarization pattern (ERP), a form of J-wave syndromes, was considered long time a benign ECG phenomenon. However, recent data confirmed that certain phenotypes of ERP are related to an increased risk of sudden cardiac death (idiopathic ventricular fibrillation). Our paper gives a short and practical update regarding the main issues related to ERP: epidemiological data, molecular and electrophysiological background, clinical significance and risk stratification. At the end, the future directions of research and clinical management related to ERP are presented.

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Can a Person with Attention Deficit Hyperactivity Disorder be an Athlete?

DOI: 10.1515/amma-2017-0030

Attention-deficit–hyperactivity disorder (ADHD) is a common neuropsychiatric disorder that impairs academic, social and occupational functioning in children, adolescents and adults. It is characterized by excessive activity, restlessness, and nervousness. The disease occurs in general at children before the age of 7 and usually is not easy to be detected, due to various symptoms. When the diagnosis is established the physician can prescribe two types of drugs, stimulants: amphetamine, dexamphetamine, lisdexamphetamine, methylphenidate, and non-stimulants such as: guanfacine, atomoxetine, and clonidine. So what can be done for a person who has ADHD, and wants to be an elite athlete? Due to the rules established by the World Anti-Doping Agency the stimulant drugs are prohibited in competition and if traces of a prohibited substance are detected in the sample of blood of the athlete his access to competition can be blocked from 2-4 years, from that date of the incident. Fortunately for some athletes the disease was acute in childhood but as they grew up the symptoms were reminiscent and they could concentrate at the sporting task that was supposed to be achieved. What about those athletes that still have the symptoms? Well, they can be treated with the non-stimulant drugs, but their doctor must monthly verify if the list of prohibited drugs has been changed. In conclusion we can say that ADHD can be an impediment, but with the help of parents, teachers, and physicians the athlete can achieve very good performances.

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The Wnt Signalling Pathways: A Short Review and Specific Roles in Bone Biochemistry

DOI: 10.1515/amma-2017-0026

As musculoskeletal diseases become an emerging healthcare problem worldwide, profound and comprehensive research has been focused on the biochemistry of bone metabolism in the past decades. Wnt signalling, one of the novel described pathways influencing bone metabolism from the early stages of tissue development, has been recently in the centre of attention. Several Wnt ligands are implied in bone forming pathways via canonical (β-catenin dependent) and non-canonical (β-catenin independent) signalling. Osteoporosis, a catabolic bone disease, has its pathologic background related, inter alia, to alterations in the Wnt signalling, thus key modulators of these pathways became one of the most promising targets in the treatment of osteoporosis. Antibodies inhibiting the activity of endogenous Wnt pathway inhibitors (sclerostin, dickkopf) are recently under clinical trials. The current article offers a brief review of the Wnt signalling pathways, its implication in bone metabolism and fate, and the therapeutic possibilities of osteoporosis through Wnt signalling.

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Analytical Methodologies for the Stereoselective Determination of Sibutramine: An Overview

DOI: 10.1515/amma-2017-0021

Sibutramine is a chiral anti-obesity drug which decreases food intake and increases energy expenditure. In therapy it is used as a racemic mixture; however both pharmacokinetic and pharmacodynamic data have revealed enantioselective behavior of sibutramine and its major active metabolites. Several chromatographic and electrophoretic analytical methods have been published so far for the chiral determination of sibutramine from pharmaceutical preparations and biological samples. The current paper aims to provide a systematic review of the stereochemical aspects and analytical methods used for the enantiodetermination of sibutramine and its active enantiomers covering the last 15 years.

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Development, Applications, Benefits, Challenges and Limitations of the New Genome Engineering Technique. An Update Study

DOI: 10.1515/amma-2017-0007

We assume that the CRISPR Cas9 theory must be delimited by applicability because the consequences of long-term DNA manipulation remain unknown. Moreover, the irreversibility of this procedure should instigate researchers to reserved opinions. Usefulness as well as benefits of CRISPR Cas9 made it one of the most popular and used genome editing technique. But with its huge potential, ethical and safety concerns emerge. Therefore, before continuing research in this direction, we should have a well-organized system that is able to make that differentiation between research and reproduction. However, we truly believe in the future of genetic engineering and with the CRISPR-Cas9 system, we expect that the opportunity of treating now so called incurable diseases arises. Time is all we need.

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Bulk Fill Resin Composite Materials Cured with Single-Peak versus Dual-Peak LED LCUs

DOI: 10.1515/amma-2016-0009

Introduction: Manufactures claim that recently introduced bulk fill materials (BFM) can be cured adequately in 4 mm increments. This requires adequate light energy to be transmitted through the material to ensure adequate polymerization at the bottom of the increment.
Aim: To compare the total light energy transmission through three BFMs and bottom/top (B/T) surface Vickers hardness (VH) when cured with single-peak versus dual-peak LED LCUs.
Methods and Materials: Samples (n=5) of two viscous BFMs, Tetric EvoCeram® Bulk Fill X-tra fil® [XF] flowable SureFil, were prepared. A conventional RBC, Tetric EvoCeram® was used as a control. Using MARC® RC, the irradiance delivered to top surface of samples was adjusted to 1200 mW/cm2. Samples were cured with singlepeak EliparTM S10 or dual-peakBluephase® G2 for 10 seconds and irradiance transmitted to the bottom surface measured. Samples were stored for 24 hours, prior to VH measurements B/T VH ratios were calculated.
Statistically analysed used oneway ANOVA (α=0.05).
Results: There was no statistically significant difference for B/T total energy transmission between materials except XF with EliparTM S10 (P<0.001). Total energy transmission ranged from 0.7 J/cm2 to 1.5 J/cm2. There was no statistically significant difference for B/T VH ratios between materials (P>0.05) when materials were cured with single-peak versus dual-peak LCU’s, XF>SDR>TEC>TBF. TBF alone, did not reach the generally accepted B/T VH of 80%.
Conclusions: Both single-peak and dual-peak LCU’s were equally effective for curing the studied bulk fill materials. Manufacture’s recommended total energy delivered to the top surface may not always be sufficient for effective curing.

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Resin-Based Composite and LCU-related Factors Affecting the Degree of Cure. A Literature Review: Part 2. Light Curing Units & Related Factors

DOI: 10.1515/amma-2015-0127

In parallel with developments in resin based composite technology, there have been changes in light curing units (LCU). Broadly, there are four categories of LCUs available in the market, with the two commonest used in Dentistry being quartz tungsten halogen (QTH) lamps and light emitting diode (LED) units, though now, QTH is infrequently used in most developed countries.
Argon-ion lasers and Plasma-arc lamps (PALs) had many disadvantages limiting their use. Argon-ion lasers were large devices with increased cost compared to QTHs, [1] PALs had low curing efficiency, increased shrinkage and micro leakage due to fast curing, [2] increased cost, heat and power consumption and decline of lights power output over time compared to QTHs [1,3,4]. [More]

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Resin-Based Composite and LCU-related Factors Affecting the Degree of Cure. A Literature Review: Part 1. Resin-Based Composites

DOI: 10.1515/amma-2015-0126

Resin-Based Composite (RBC) is widely used in Dentistry to restore anterior and posterior teeth. There have been many advances in RBCs development to improve their clinical success rate and overcome the many disadvantages of the first materials. These materials are cured by visible light, and light curing units have also undergone considerable development. Recently, bulk-fill composite materials were introduced to be placed in the cavity in bulk, claiming replacement of the traditional layering technique. In this paper an overview of RBCs, their composition and properties will be presented. [More]

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