Author Archives: administrare

Should we screen for sarcopenia in Romanian patients with osteoporosis? An overview of the current knowledge on osteosarcopenia

Gabriela Mihai, Ionela Maria Pascanu

Department of Endocrinology, University of Medicine,Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2023-0014

The combination of osteoporosis and sarcopenia is wider known as “osteosarcopenia”, and it is considered to be a “hazardous duet” for the patient. The clinical consequences of this geriatric syndrome include a higher risk of fractures and mortality compared to osteoporosis or sarcopenia alone. Fractures are considered to be a burden for the patient but also for the health care system from an economic point of view, therefore it is important to prevent them. Emerging evidence shows that osteosarcopenia is an increasingly prevalent disease. The Fracture Risk Assessment Tool (FRAX) is of major importance for the management of a patient, however, muscle weakness is not part of this instrument. It has been suggested to go “beyond the FRAX” and to evaluate muscle mass/strength besides bone mineral density when it comes to the management of a patient with a sustained fragility fracture. In this review we try to answer whether this is feasible or not when it comes to Romanian patients.

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Anatomical variations of nutrient foramina on the long bones of the upper extremities – Importance and application in everyday clinical practice

Lejla Dervisevic1, Amela Dervisevic2, Zurifa Ajanovic1, Eldan Kapur1, Almira Lujinovic1, Alma Voljevica1, Elvira Talović1

1. Department of Anatomy, University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina
2. Department of Human Physiology, University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina

DOI: 10.2478/amma-2023-0011

Objectiv: Anatomic characterization of the nutrient artery of upper extremity long bones differs among the several textbooks on human anatomy. To elucidate the anatomical features of the nutrient foramen (NF) through which the nutrient arteries pass, we examined the morphology and topography of the NF on the diaphysis of the long bones of the upper extremities.
Methods: A total of 150 (50 humeri, 50 radii, 50 ulnae) macerated and degreased adults, long bones of the upper extremities, unknown age, and gender were used as material in this study. The following parameters were determined for each bone: total number of NF, foramina index (FI), total bone length, position of the NF based on the FI value and the surface of the shaft/body of the bones, and obliquity of the nutritional canal (NC).
Results: The largest number of NF was found on the middle third of the anteromedial side of the humerus diaphysis, with NC directed distally, that is, towards the elbow. Radius and ulna had predominantly one NF, on middle third of anterior surface, with NC directed proximally.
Conclusion: This study provides additional and important information on the location and number of NF in the long bones of the upper and lower extremities in the Bosnian and Herzegovinian population.

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Oral cancer chemoprevention: A review

Nanditha Sujir1, Priyanka G2, Junaid Ahmed1, Anindita Saha3, Yogesh Chhaparwal4, Nandita Shenoy1

1. Department Oral Medicine and Radiology, Manipal College of Dental Science Mangalore, Manipal Academy of Higher Education, Manipal, India
2. Department Oral Medicine and Radiology, Chettinad Dental College and Research Institute, Tamil Nadu, India
3. Department Oral Medicine and Radiology, Dr. R. Ahmed Dental College and Hospital, West Bengal, India
4. Department Oral Medicine and Radiology, Manipal College of Dental Science, Manipal, Manipal Academy of Higher Education, Manipal, India

DOI: 10.2478/amma-2023-0010

Oral cancer is increasing in prevalence and its treatment is associated with high degree of morbidity and mortality. Thus, prevention of oral cancer is of utmost importance. Chemoprevention is the use of natural, synthetic, or biologic compounds to halt, reverse, or prevent the initial phases of carcinogenesis or the progression of neoplastic cells to cancer. This modality has been extensively researched in the last two decades for the prevention of oral cancer with the emergence of new information. Retinoids were the first chemopreventive agents to be tested in clinical settings. Since then, a number of new agents such as COX2 inhibitors, EGFR inhibitors, p53 targeted agents, thiazolidinediones and several natural agents have shown promise in oral cancer prevention. Chemopreventive trials in oral cancer tend to be long term studies and are thus challenging. This review article looks into the clinical evidence for the application of chemopreventive agents in clinical settings and also highlights the recent trends in oral cancer chemopreventive trials.

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Blood biomarkers predicting adverse clinical
outcomes in congenital heart disease patients, with consideration for pulmonary valve replacement

Milla Marika Kainlauri1, Irina-Bianca Kosovski2

1. George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2023-0009

Objective: This review aims to make a brief overview of blood biomarkers’ clinical decision limits, possibly aiding in outcome prediction in all-aged Tetralogy of Fallot patients. Potentially, these biomarkers could also assist in necessity and timing of pulmonary valve replacement. Methods: Studies with all-aged patients with Tetralogy or Pentalogy of Fallot and blood biomarkers, BNP, NT-proBNP and hs-cTn, usage in clinical outcome prediction were included. Additionally, pulmonary valve replacement indications were considered. Other congenital heart diseases, biomarkers irrelevant to clinical outcome and associated pathologies or physiological status were the exclusion criteria. Keywords, Tetralogy and Pentalogy of Fallot, pulmonary valve replacement, blood biomarkers, yielded 69 suitable studies from Google Scholar, PubMed and Web-of-Science. 30 studies were selected. Results: Blood biomarkers were increased in TOF patients in comparison to controls; the higher the values, the worse adverse outcomes. Blood biomarkers combined with other biomarkers, imagistic methods or parameters showed promising results in outcome prediction. Conclusions: Blood biomarkers are validated as follow-up predictors in congenital heart disease paediatric patients. Further research is required to establish age-appropriate clinical decision limits. Pulmonary valve replacement timing remains controversial.

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Testosterone deficiency is associated with clinically relevant depression symptoms

Liliana Vartolomei1, Sabin Octavian Tătaru1, Andrei Cotruș2, Camelia Stanciu2, Anca Ileana Sin3

1. IOSUD, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Department of Psychology, Dimitrie Cantemir University, Targu Mures, Romania
3. Department of Cell and Molecular Biology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2023-0008

Objective: To investigate the association between testosterone deficiency and depressive and/or anxiety symptoms.
Methods: A cross-sectional study was conducted at the urology outpatient clinic from Ludus County Hospital. A set of validated questionnaires ((International Prostate Symptoms Score (IPSS), Depression Anxiety and Stress Scale (DASS-21), Zung Self-rating Depression Scale (Zung SDS)) were self-administrated. Inclusion criteria: age > 40 years. Exclusion criteria: any relevant psychiatric, cardiovascular, or cancer comorbidity. Statistical analyzes were performed using the statistical software Statistical Package for Social Sciences (SPSS, version 23, Chicago, IL, USA).
Results: From the total of 55 participants included in the study, 23 (41.8%) had testosterone deficiency. Most were from the 60-69 years decade, 23 participants (41.8%), and the mean age was 59.3 (SD 9.03) years. Eleven (20%) patients had depressive symptoms according to the depression subscale, of these, 7 had mild symptoms and 4 according to Zung SDS. Testosterone deficiency was associated with an increased DASS-21 global score, p=0.021, and depression score, p=0.047.
Conclusions: Patients with testosterone deficiency are presenting symptoms of depression. Therefore, these patients need a multi-disciplinary approach that should include a psychological evaluation before making a further management decision.

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Comparison of two different file systems on postoperative pain after root canal instrumentation: A randomized controlled trial

Saad Shahnawaz1, Nabiya Shahroz2, Muhammad Ahmed Zafar1, Shahroz Sajjad3, Mehwish Pasha4, Arfa Sabir Hussain1

1. Operative and Endodontic Department Islamic International Dental Hospital, Islamabad, Pakistan
2. Operative and Endodontic Department Shifa international hospital, Islamabad, Pakistan
3. Operative and Endodontic Department Armed Forces Institute of Dentistry, Islamabad, Pakistan
4. Dental materials Department, Shifa international hospital, Islamabad, Pakistan

DOI: 10.2478/amma-2023-0006

Introduction: In this study post instrumentation pain is evaluated between rotary hyflex CM files and conventional k-files at different time intervals.
Methodology: fifty patients were equally assigned into two groups and instrumented using hyflex cm or conventional files. VAS for pain was noted before the start of a root canal and after the procedure at 12, 24, and 48 hours.
Results: There was no significant difference at 12, 24, and 48 hours with P values being 0.127, 0.867, and 0.846 respectively.
Conclusion: There is no significant difference in causing post-instrumentation pain between hyflex CM and conventional files at different time intervals. However, when accessing preop pain of the conventional file group, it had more pain mean score compared to hyflex group. According to this study, Conventional files may be able to slightly decrease the chances of post-instrumentation pain more than hyflex CM instrumentation.

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Prevalence of human Papillomavirus associated oropharyngeal and oral squamous cell carcinoma in Asian countries: A systematic review and large-scale meta-analysis

Yy Jean Tan1, Ken Wong Siong Hou2, Galvin Sim Siang Lin3, Jasmine Lim Suk Wun4, Wan Nor Amira Wan Ahmad Abdul Nasir1, Lynn Wei Linn Ko5

1. Oral and Maxillofacial Surgery Department, Dental Specialist Clinic, Sarawak General Hospital, Jalan Tun Ahmad Zaidi Adruce, Kuching, Sarawak, Malaysia
2. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
3. Department of Dental Materials, Faculty of Dentistry, Asian Institute of Medicine, Science and Technology (AIMST) University, Bedong, Kedah, Malaysia.
4. Batu Kawa Dental Clinic, Ministry of Health Malaysia, Kuching, Sarawak, Malaysia
5. Department of Paediatric Dentistry & Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia

DOI: 10.2478/amma-2023-0005

Human Papillomavirus (HPV) associated with oropharyngeal and oral squamous cell carcinoma (OPSCC and OSCC) is escalating over the years. Hence, the present review aims to determine the prevalence of HPV-OSCC and HPV-OPSCC in Asian countries over the last decades. An electronic search was conducted using nine online databases to identify English-language articles on the prevalence of HPV-OPSCC and HPV-OSCC in Asian countries from January 2011 to June 2022. The risk of bias was assessed using the JBI critical appraisal checklist and the level of evidence was determined based on the OCEBM guideline. Single-arm meta-analysis was used to estimate the weighted mean prevalence of HPV-OPSCC and HPV-OSCC among patients in Asia. Subgroup analysis meta-regression and Egger’s tests were also conducted. 59 eligible studies were included with a higher prevalence of HPV-OPSCC (32.6%-37.4%) as compared to HPV-OSCC (10.9%-23.5%). Subgroup analysis revealed that the weighted mean prevalence of HPV-OPSCC was significantly higher (P<0.001) among East Asians, while the weighted mean prevalence of HPV-OSCC was significantly higher (P<0.001) among South Asians. All studies showed a low to moderate risk of bias with the level of evidence ranked between 2 and 3. The diagnostic tools utilised and geographical locations significantly affect the findings.

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Management of denture stomatitis: An overview

Nader Navabi1, Parham Shakibaei2, Alireza Ranjbar Hassani2

1. Oral Medicine Department, Kerman Dental School, Kerman University of Medical Sciences, Kerman, Iran
2. Student Research Committee, Dental School, Kerman University of Medical Sciences, Kerman, Iran

DOI: 10.2478/amma-2023-0007

Denture stomatitis is a common inflammation of the palatal mucosa beneath removable dentures. The objective of this article was to examine the systematic reviews and clinical trials pertaining to the treatment of denture stomatitis. For this research, electronic databases (PubMed, Embase, Scopus, and ISI Web of Science) were searched from January 2000 to June 2021 using specified MESH keywords. Irrelevant articles were eliminated in three steps based on their titles, abstracts, and body texts. In the final analysis, 47 papers were selected, which included 12 systematic reviews and 35 clinical trials. Herbal compounds and denture disinfection were the interventions most commonly indicated. We concluded that, possibly due to the complex nature of this lesion’s etiology, there is no present definitive therapy guideline for this prevalent lesion.

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Evaluation of effects on hepatocellular carcinoma cell line of Cocos nucifera: In vitro study

Zeynep Tasdan1, Gülçin Alp Avci2, Emre Avci3

1. Department of Molecular Biology and Genetics, University of Hitit, Corum, Türkiye
2. Department of Basic Medical Sciences, University of Health Sciences, Ankara, Türkiye
3. Department of Biochemistry, University of Health Sciences, Ankara, Türkiye

DOI: 10.2478/amma-2023-0004

Objective: Cancer is one of the most important diseases today. The use of chemical drugs, surgical operations, and transplants is very common in its treatment. In addition to these treatment methods, studies include the effects of natural and plant-derived substances. Various substances are used in these studies, which are called phytotherapy. The antioxidant activity and cytotoxic effects of Cocos nucifera on hepatocellular carcinoma HepG-2 and the mouse fibroblast L929 cell line were investigated in this study.
Methods: In this study, in vitro cytotoxic effects of C. nucifera at different concentrations (7.81-500 mg/ml) were investigated on the L929 Mouse Fibroblast cell line and HepG-2 Hepatocellular Carcinoma cell line. In addition to these studies, their antioxidant capacity was evaluated via spectrophotometric methods. In this work, different concentrations of C. nucifera were examined.
Results: According to the results, C. nucifera had a cytotoxic effect in HepG-2 and ensured the proliferative effect of cells in the L929 cell line. Among C. nucifera extracts according to total antioxidant capacity results, C. nucifera extract was found to be the richest in antioxidants with 2.79 mmol/L, while the material with the lowest antioxidant capacity was determined to be C. nucifera milk. DPPH free radical scavenging activity results show the opposite.
Conclusion: In line with the data we obtained, it is thought that C. nucifera can be used in liver cancer studies, and its antioxidant effect may play an important role in balancing against oxidative stress. Simultaneously, the data show that the exposure time and concentrations of the active substance are related to the cytotoxic effect. However, it may be considered that the use of C. nucifera water, extract, and milk in cancer patients may be supported by more comprehensive clinical studies.

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A study of the impact of solid cast removable dentures with silver electroplating on the condition of patients

Andriy Nikonov1, Valeriia Krynychko1, Nataliia Bobrovska1, Nataliia Breslavets1, Olha Smirnova2, Zahar Muhin3

1. Department of Dentistry, Faculty of Medicine, V. N. Karazin Kharkiv National University, Kharkiv, Ukraine
2. National Technical University “Kharkiv Polytechnic Institute”, Kharkiv, Ukraine
3. Department of Pediatric Dentistry and Orthodontics, Faculty of Surgery, Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine

DOI: 10.2478/amma-2023-0002

Objectives: The aim of our study was to determine the effectiveness and biocompatibility of the use of solid clasp dentures with silver plating in the restoration of partial defects of the dentition.
Methods: The study involved 23 patients with partial secondary adontia after oral rehabilitation. At the first stage, before the start of treatment and after a month of using a clasp prosthesis, patients underwent studies of blood biochemical parameters, Schiller-Pisarev’s test and Papillary-marginal-alveolar index. At the second stage of the research, silver electroplating was applied to the metal parts of the clasp prosthesis and after a month of use, its effect on oral hygiene and blood biochemical parameters was assessed.
Results: After installation of the removable prosthesis with solid structures, the PMA index after the use of silver-plated clasp prosthesis decreased to medium severity, which is explained by positive impact on the inflammatory process in the gums. We can see the stability of biochemical parameters of blood in patients with solid removable prostheses can serve as a justification for the administration of silver electroplating for prophylactic and therapeutic purposes.
Conclusions: The effectiveness of the use of silver plating in the treatment of partial defects of the dentition eliminates the clinical manifestations of the pathological condition and prevents possible complications in the oral cavity.

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