Author Archives: administrare

Abdominal wall metastases due to a squamous cell carcinoma of the lung: case report and literature review

DOI: 10.2478/amma-2022-0010

Introduction: At the time of diagnosis, most patients with lung cancer are in an inoperable stage, with distant metastases. Most often, these patients have metastases to the brain, adrenal glands, liver, or bones. This article presents the case of a patient with non-small-cell lung cancer (NSCLC) metastases in the abdominal wall.
Case presentation: A 67-year-old patient came to our service reporting the existence of a tumor 5 cm in diameter, located at the level of the abdominal wall, without other clinical symptoms. Surgical excision of the tumor was performed. The postoperative evolution was favorable, with the patient discharged on the third postoperative day. Histological examination of the resected specimen revealed metastasis of squamous cell carcinoma of the lung.
Conclusions: The appearance of a tumor in the abdominal wall of patients with NSCLC may raise the suspicion of metastasis at this level.

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Prosthetic Management of Acquired Dentate Maxillectomy Defects: A Clinical Case Series

DOI: 10.2478/amma-2022-0009

Acquired maxillectomy defects produce hypernasal speech, food, and liquid regurgitation into the nasal cavity, impaired deglutition and mastication, and cosmetic deformity. Furthermore, patients with acquired maxillary defects face psychosocial stigma, which has a negative impact on their quality of life. Prosthetic rehabilitation of such defects is required for stomatognathic system restoration and oroantral communication obturation. This case series discusses the fabrication of surgical, interim, and definitive obturator prostheses to restore the acquired dentate maxillectomy defects of three cancer patients. All patients had their treatment in the prosthodontics department of the RUHS College of Dental Sciences. The surgical obturator prosthesis was made before surgery, whereas the interim and definitive obturators were made one month and six months after surgery, respectively. The surgical obturator formed a shield between the surgical pack and the oral cavity. After the surgical obturator and packing were removed, an interim obturator was inserted for three to six months to allow the surgical site to heal. After the surgical site had healed, the fabrication of the definitive obturator began. Prosthetic rehabilitation with obturator prostheses sealed the acquired tissue defects of the palate and restored swallowing, speaking, chewing capacity, and cosmetic value, as well as significantly improved the quality of life of these patients.

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Ethanolic Extract of Edamame (Glycine max L. merril) Enhance Second Degree Burn Wound Healing trough Modulating of Hydroxiproline Levels and Increasing Epithelial Thickness

DOI: 10.2478/amma-2022-0007

Objective: Burns has become a global health problem because it causes about 180.000 deaths worldwide every year. In developing countries, silver sulfadiazine cream is usually used as drug management for second-degree burns, but it is expensive, so several herbal treatments have developed recently. The seed of edamame has genistein compounds that can increase collagen synthesis. The antioxidant component also enhances the burn wound healing process. The study aims to prove the effectiveness of ethanolic extract of edamame’s seed in the second-degree burn wound healing process.
Methods: Burn wound was made by applying hot aluminum (70 °C) coin on the skin rat. The negative control group (C-) was given Na-CMC 0.5%, the positive control group (C+) was given cream silver sulfadiazine, the treatment groups T1, T2, T3, and T4 were given an ethanolic extract of edamame with the concentration of 20%, 40%, 60%, and 80% for 15 days. Hydroxyproline levels were evaluated by hydroxyproline biochemistry assay, the epithelial thickness was observed on histopathological preparations with HE staining.
Results: The results showed that the hydroxyproline levels on the 16th were modulated, while epithelial thickness was higher in the treatment group than in the control group (P<0.05).
Conclusions: We conclude that the certain concentration of ethanolic extract of edamame (Glycine max L. Merril) was effectively enhanced the second-degree burn wound healing by modulating hydroxyproline levels and increasing epithelial thickness.

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Pier Abutment: Bridge the gap with Non rigid connector – A clinical case report

DOI: 10.2478/amma-2022-0008

Pier abutment is defined as a freestanding abutment with edentulous space on both sides. This case report described the rehabilitation of a patient who presented to the department with the primary complaint of missing teeth and difficulty in mastication. Intraoral examination revealed missing right maxillary canine and the second premolar, with the lone standing first premolar acting as a pier abutment. To reduce the stress transferred to the abutment and prosthetic assembly, a non-rigid (Tenon-mortise) connector was used in the case, with a keyway (mortise) distal to the pier abutment and a key (Tenon) mesial to the distal pontic.

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Chest wall secondary chondrosarcoma caused by malignant degeneration of an enchondroma: case report and literature review

DOI: 10.2478/amma-2022-0006

Introduction: Enchondromas are benign tumors originating in the cartilaginous tissue of the hyaline gristle, rarely located in the chest wall. They sometimes undergo a sarcomatous transformation, becoming secondary chondrosarcomas.
Case presentation: We present the case of a 53-year-old patient who, following a chest computed tomography scan performed after a thoracic trauma, was diagnosed with an osteolytic tumor at the chondrocostal junction of rib 4. Surgery was performed, with partial straight resection of ribs 3–5. Histopathological examination of the resection piece identified the existence of a chest wall chondrosarcoma on the background of malignant degeneration of an enchondromatosis lesion. The postoperative evolution was favorable, and the patient was discharged on the eighth postoperative day.
Conclusion: In patients with even asymptomatic chest wall enchondromas, periodic clinical evaluation of these lesions is required, given their risk of malignant degeneration.

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Rehabilitation of maxillary arch with attachment-retained reinforced single complete denture

DOI: 10.2478/amma-2022-0003

Introduction: Fracture of maxillary complete denture is a common problem for dentists and denture wearers, occurring especially when it is opposing mandibular natural teeth or fixed and implant-sustained restorations; to prevent it, various methods and materials are available.
Case presentation: This case is of a patient losing his old maxillary removable partial denture due to the mobility of the frontal abutments. Considering the age of the patient and the status of the mandibular arch, completely restored and having a mix of natural teeth, fixed and implant-sustained restorations, the functional and esthetic rehabilitation of the maxillary arch, and also the long-term resistance of the denture, are a serious prosthetic challenge. An association between ball attachments, metal-casted reinforcement and masking agents for both are described, underlying their role in the treatment’s succes.
Conclusion: The age and health status of the patient and the situation of the mandibular arch imposed the construction of a functional, strong and stable maxillary denture; the technique described in this article offers a good functional and esthetical result and benefits the patient, even if the implant-prosthetic therapy is not available.

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The influence of transport condition and processing time on plasma ammonia results

DOI: 10.2478/amma-2022-0005

Objective: Ammonia is extremely unstable in blood specimens and has special requirements during transport, processing and storage. The aim of our study was to determine the stability of ammonia in EDTA K3 blood samples and to establish a protocol for sample handling.
Methods: In this study, 36 healthy subjects and 47 inpatients diagnosed with type 2 diabetes mellitus were enrolled. Two peripheral blood samples were collected from healthy volunteers (Sample A1 and A2) and one peripheral blood sample was collected from the inpatients diagnosed with type 2 diabetes mellitus (Sample B). Sample A1 and B were transported in ice bath within 15 minutes of blood collection, centrifuged immediately and processed. The sample was re-centrifuged after 15 minutes and a second ammonia result was obtained. Sample A2 was transported at room temperature and stored between 2 and 4 hours, centrifuged and plasma ammonia measurement was performed. The sample was re-spun after 15 minutes and a fourth ammonia result was obtained.
Results: In our study, in healthy group the difference between sample A2 and set point value (on ice, 15 minutes) is 25.08 µg/dl, showing an increase of 55.29%. After another 15 minutes, an increase of 82.02% was observed compared with the standard value. In diabetes mellitus group, after 30 minutes of blood collection, an increase of 11% over the set point value was observed.
Conclusions: The blood specimen should be transported on ice to the laboratory and analyzed within 15 minutes of blood collection due to plasma ammonia spontaneously increase.

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Unified protocols for transdiagnostic treatment versus the Beckian’s approach of cognitive behavioral therapy for medical students with emotional disorders

DOI: 10.2478/amma-2022-0002

Background: Emotional disorders are highly prevalent among medical students, impacting their academic performance and general quality of life. It was shown that cognitive-behavioral and emotion regulation strategies are efficient for reducing anxiety and depressive symptoms in young people.
Objective: This study aims to compare the efficiency of standard individual Cognitive-Behavioral Therapy (CBT) to a group intervention based on the Unified Protocol for Transdiagnostic Treatment (UPTT) of emotional disorders in two groups of medical students with similar baseline characteristics.
Method: The sample of this research was composed of 64 medical students in total, of which 34 were included in the CBT group (Mage= 19.5 years, SD= 0.96) and 30 were included in the UPTT group (Mage= 19.4 years, SD= 0.93). The level of irrational beliefs and emotional distress were measured before and after the interventions, which were carried out by certificated psychotherapists.
Results: Statistically significant differences were observed between pre-test and post-test in both groups. The level of irrational beliefs dropped after the CBT (M=62.91, SD=21.30, p<0.05) and the UPTT intervention (M=67.33, SD=34.89, p<0.05), respectively. Similarly, the profile of emotional distress changed after the CBT (M=77.62, SD=16.97, p<0.05) and the UPTT intervention (M=68.77, SD=20.06, p<0.01).
Conclusion: Psychological interventions relying on cognitive-behavioral approaches, including standard, individual psychotherapy and a group intervention designed according to a transdiagnostic protocol, are suitable methods for reducing emotional disorders among medical students.

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Risk Assessment of Failures in Generic Drug Development and Approval Procedure under Competitive Generic Drug Therapy and Patent Challenge Exclusivities Provided by the United States Food and Drug Administration

DOI: 10.2478/amma-2022-0004

Objective: The United States Food and Drug Administration implemented two exclusivity programs Competitive generic therapy and Patent Challenge exclusivity to develop generic drugs, which provide a 180-day monopoly market for first generic applicants in the United States of America. The aim of the present study is to find the root cause of failures in developing and filing the first generic drugs under these exclusivities and to compare both the exclusivities to find the merits and demerits.
Methods: We used descriptive statistics for data analysis of both the exclusivities and Risk assessment was conducted on 14 industries to find the root cause of failures in every stage of the approval procedure by FMECA (Failure mode, Effects and Criticality Analysis).
Results: We found 44% of rejections in competitive generic therapy drugs and 30% of rejections in patent challenge exclusivity drugs. The risk analysis conducted on failures found that, in drug selection, 6% of failures are occurred due to rare diseases. In drug development, 9% of failures are occurred due to formulation failures. In pre-approval, 10% of failures are occurred due to secondary patents. In post-approval, 6% of failures are occurred due to product changes after approval.
Conclusion: We hope this study can give an idea for small and medium companies in developing countries for the early development of generic drugs for life-threatening diseases.

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