Category Archives: Volume 66

The Efficacy of Rational Emotive Behavior Therapy Intervention in Generalized Anxiety Disorder

DOI: 10.2478/amma-2020-0027

Background: Generalized Anxiety Disorder is one of the anxiety disorders which presents excessive anxiety and worries as central elements that are difficult to control in many situations or activities. Rational Emotive Behavior Therapy is one of the most important orientations among psychological intervention in the psychotherapy field. This approach is based on a transdiagnostic perspective. Additionally, this therapy has a strong research foundation especially in the treatment of anxiety disorders and depression.
Objective: The present study aims to establish the efficacy of Rational Emotive Behaviour Therapy in medical students who are suffering from generalized anxiety disorder.
Method: The sample of this study consisted of N = 40 first-year medical students (33 women and 7 men) and the average age for the entire group was Mage= 19.22, SD= 1.04. Each student participated at eight therapy sessions. The level of anxiety and irrational beliefs were measured at pre-intervention and post-intervention using psychological questionnaires.
Results: Our findings indicate a statistically significant difference between the pre-intervention and post-intervention phase for the level of anxiety with a value of t = 20.31, df =78, P < 0.001, for irrational cognitions with t = 2.44, df =78, P < 0.05, for irrational beliefs with t = 3.45, df =77, P < 0.01, as well as low frustration tolerance with t = 2.57, df =77, P < 0.05 and awfulizing specifically.
Conclusion: The Rational Emotive Behavior Therapy intervention is an extremely efficient psychological treatment for improving emotional functioning in medical students.

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Factors Influencing the Choice of a Pharmacy in Romania: Comparation between Studies Performed in 2012 and 2020

DOI: 10.2478/amma-2020-0029

The main factors perceived by patients as important in selecting a pharmacy were studied for many years. Selected studies mentioned primarily factors such as location, pharmacist competence and attitude, pharmacy services and premiums, and prices. We compared the results from our study in June 2012 with the results of the most recent study conducted in April 2020 focusing on the main factors influencing the patient’s option for a specific pharmacy. Respondents were asked an open question about what is the most important factor they consider when choosing a pharmacy and then answers were grouped into main categories. The urban population has been considered for both studies. The results tell us that the factors influencing the choice of a pharmacy remained unchanged over the time: i) prices, ii) availability of medicine, iii) professionalism of the pharmacist and iv) pharmacy proximity is the most mentioned by our respondents in both studies. However, the rank between these factors changed. Prices remain the top factor while the Availability of medicine (products) has been overcome by the Professionalism of the pharmacist (Attitude of the pharmacist) and Proximity. Using the logistic regression and Odds Ratio, we tried to identify socio-demographic segments significantly associated with these factors. Persons with low income are very likely to indicate Price as the most important factor in choosing a pharmacy in 2012 (OR = 2.088, p=0.018), while respondents aged 65 years and older are more likely not to indicate Price as the most important factor compared with other age groups, in both 2012 and 2020 studies (OR = 0.4, p=0.009, respective OR= 0.325, p=0.010). For this type of respondent, 65 years old and above, the attitude of the pharmacist is the most important factor influencing their choice of a pharmacy in 2020, while products availability has been the most frequent answer for this segment back in 2012. Results in Romania are similar to the ones collected from other countries as reported by other studies. However, particularities of the local market and regulations are influencing the ranking.

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Genitourinary Bacterial Infection: a Cause of Infertility in Men? A Cases Series and Short Review of Literature

DOI: 10.2478/amma-2020-0024

Introduction: The role of bacterial infections on the onset and the development of male infertility is still highly controversial, as the clinical cases have different outcomes and the practitioners have no guidelines that will help them select the cases that could better benefit from antibiotic treatment.
Case presentation: Four case reports are presented in order to emphasize the possible clinical implications of genitourinary bacterial infections on male infertility. The first patient had two bacterial strains isolated from the semen culture, Escherichia coli, and then Enterococcus faecalis. The antibiotic treatment was not effective. The second patient had a semen culture positive with Enterococcus faecalis. The treatment was successful: the bacteria were eradicated and the patient was able to conceive a baby. Enterococcus faecalis was also identified in the third and the fourth case. These patients were able to conceive, despite the different clinical management strategies of the cases.
Conclusion: Bacterial prostatitis might play a role in male infertility, but the clinical cases are still highly unpredictable. Every case presents a different viewpoint and raises awareness of the complexity of the problem.

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Ovarian Endometriosis and Malignant Transformation in Clear Cell Carcinoma

DOI: 10.2478/amma-2020-0023

Atypical endometriosis is considered to be precursors for malignancy. Coexistence of atypical endometriosis and ovarian neoplasm has been found in some studies. We describe the case of a 48-year old women diagnosed with clear cell carcinoma of ovary. The review of histological slide confirms the presence of benign endometriosis in both ovaries, the atypical endometriosis and clear cell carcinoma in the right ovary and the presence of uterine leiomyoma.

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Controls in Real-Time Polymerase Chain Reaction Based Techniques

DOI: 10.2478/amma-2020-0025

From its discovery in the 1980s, Polymerase chain reaction was further developed and is nowadays used as the foundation for the various PCR-based techniques used in molecular diagnosis across different species, and numerous types of samples. Real-Time PCR enables the user to monitor the amplification of a deoxyribonucleic acid (DNA) or complementary DNA (cDNA) target during the PCR run, in real-time, and not at the end, as it is the case in conventional PCR. The most frequent types of applications include gene expression analysis, gene silencing, variant analysis, and fusion temperature analysis. Given its vast field of application, a key question remains, and it is related to the controls (negative controls, positive controls, internal exogenous and endogenous controls) and their purpose in a Real-Time PCR experiment. In this paper, we set out to find how and when to use them, and which type of controls are suitable for certain experiment types, since the use of appropriate controls during Real-Time PCR experiments will reduce the effects of variables aside from the independent variable within the sample, therefore yielding accurate results, be it in research or diagnostic purposes.

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SARS-CoV2 Infection in a Multiple Sclerosis Patient Treated with Natalizumab – A Case Presentation

DOI: 10.2478/amma-2020-0022

Introduction: The novel coronavirus, SARS-CoV2, has rapidly spread worldwide and led to an intense collaboration among both physicians and researchers in order to stop its dissemination. Little is yet known about how this virus behaves, but recent studies have suggested the role of integrins in the viral penetration of target cells. Natalizumab is an anti-α4-β1 integrin monoclonal antibody used in the treatment of multiple sclerosis (MS), a neurodegenerative auto-immune disease affecting primarily young adults. MS patients have a greater susceptibility to develop severe infections especially enhanced by the disease-modifying therapies (DMTs) which are currently recommended for their treatment. Natalizumab is considered the safest high-efficacy DMT in times of COVID-19 outbreak.
Case presentation: We hereby describe the first case from Romania of a MS patient treated with Natalizumab who subsequently acquired SARS-CoV2 infection and whose recovery was excellent, with no functional neurological or respiratory sequelae.
Conclusion: The favourable evolution of our patient supports the potential therapeutic effect Natalizumab might have in SARS-CoV2 treatment by specifically blocking integrins and by its immunosuppressant characteristics.

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The Role of Acceptance and Planning in Stress Management for Medical Students

DOI: 10.2478/amma-2020-0020

Objective: The purpose of this study was to analyze the role of two coping mechanisms, namely Acceptance and Planning, in stress management among medical students.
Methods: This research included two groups, a target group consisting of medical students (N = 100; Mage = 22.34) and a control group which was composed of physical education and sports students (N = 100; Mage = 20.11). For the target group, a low level of stress was induced, the students being informed that their overall behavior during an examination would be analyzed later by a group of psychologists, after which they were filmed while taking the exam. The students from the control group performed a physical exercise while they were filmed, and they were told that the correctness of the exercise would be evaluated by experts in physical education and sports on the basis of the recorded images. After completing the tasks, both the students in the target group and those in the control group completed the COPE questionnaire.
Results: The statistical data interpretation revealed a significant statistical difference regarding the two coping mechanisms, namely Acceptance [M = 10.73; t (19) = 3.79, p <0.001; CI -1.91, -0.60], and Planning [M = 9.47; t (19) = 4.70, p <0.01; CI -1.99, -0.81]. According to statistical data analysis, we did not find another significant statistical difference among the remaining 13 coping mechanisms.
Conclusions: To efficiently manage stress during exams, medical students use Acceptance and Planning coping mechanisms, which may increase their emotional regulation abilities and help them focus on problem-solving.

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Ambulatory Treatment of Pressure Sores in a Patient without Neurological Lesions

DOI: 10.2478/amma-2020-0021

Introduction: Pressure sores have been defined as areas of localized soft tissue ischemic necrosis caused by prolonged pressure related to posture, which usually occur over a bony prominence. The most affected areas are those that undergo a lot of tension such as trochanters, sacrum, malleoli, heels and occiput. Most people that are affected by pressure sores have an underlying pathology that makes them immobile, confining them to chairs or bed for longer periods of time. Pressure ulcers may have direct causes (pressure, shear, friction, immobility, loss of sensation) or indirect causes.
Case presentation: This paper will present the case of a 53-year-old male. After about 3 weeks of being immobilized in bed in dorsal decubitus due to an acute respiratory distress which required intubation and mechanical ventilation, the patient developed very large pressure sores on the left sacral and buttock area and left sole. He was treated in the outpatient department using multiple therapeutic protocols based on the alternation of antibiotic creams and modern absorbent dressings.
Conclusions: The evolution of this patient was long but favorable, the left sacral and buttock area eschar closing completely while the sole eschar had a good evolution, but is still undergoing treatment.

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The Anti-tobacco Legislation’s Impact on Air Pollution in Romanian Foster Care Homes

DOI: 10.2478/amma-2020-0019

Objective: The research aimed to investigate the impact of the anti-tobacco legislation (2016) on air quality in Romanian foster care homes.
Methods: The measurements took place in foster care homes situated in three Romanian counties. We recorded data three times (in 2014, in 2016 – six months after the implementation of the anti-tobacco legislation, in 2019). In 41 foster care homes were measured the indoor and outdoor Particulate Matter (PM2.5) level in the air, using the TSI SidePak™ Personal Aerosol Monitor device. Descriptive statistics and t-test were used for data analysis (significant difference if p < 0.05).
Results: The indoor PM2.5 values were higher in every year than outdoor values. Analyzing the anti-tobacco legislation’s impact on air quality, we found no difference between the indoor data measured in 2014 and in 2016, but there was a significant difference in the outdoor values (they were higher in 2016). Comparing the values measured after the implementation of the legislation (2016 vs. 2019) we found no difference in either indoor or outdoor values.
Conclusions: The anti-tobacco legislation has not influenced the indoor air pollution (PM2.5) level. The increased outdoor PM2.5 values suggest that the residents of the foster care homes are smoking more in front of the house after the introduction of the anti-tobacco legislation in 2016.

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