Category Archives: Online

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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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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