Author Archives: administrare

Ulnar-basilic arteriovenous fistula with multilocular gigantic aneurysmal dilatation: a case report

Emil-Marian Arbănași1, Eliza Russu1,2, Adrian Vasile Mureșan1,2, Eliza-Mihaela Arbănași3, Reka Kaller1

1. Clinic of Vascular Surgery, Emergency County Hospital, Târgu-Mureș, Romania
2. First Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
3. Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2021-0035

Introduction: Arteriovenous fistula dysfunction has been associated with a range of problems such as thrombosis, stenosis, dilatation, and infection.
Case presentation: We present the case of a 64-year-old patient with chronic kidney disease on hemodialysis and with aneurysmal dilatation of the ulnar-basilic arteriovenous fistula, having an increased risk of rupture. A temporary dialysis catheter is placed in the left femoral vein, an aneurysmal basilic vein is ligated at the anastomosis, aneurysmal dilatation is emptied by compression, and a right radiocephalic arteriovenous fistula is performed. The patient undergoes hemodialysis on the second day and subsequently three times a week for six weeks until the new arteriovenous fistula develops. He returns for aneurysmal sac resection.
Conclusion: The purpose of this paper is the presentation and management of a 15-year-old ulnar-basilic arteriovenous fistula with multilocular aneurysmal development and an imminent rupture.

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Study of the anxiolytic effect of propranolol and dextromethorphan in mice using a model of psychogenic stress

Radion Garaz, Sorina Cucuiet, Gabriela Garaz-Pislariu, Raluca-Ioana Buliga

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

DOI: 10.2478/amma-2021-0034

Objective: To find the anxiolytic effects in a psychogenic stress model in mice, the present study has investigated the interaction between propranolol and dextromethorphan.
Methods: 50 Albino Swiss male mice were housed in groups of 10 per cage. The beta-adrenergic receptor blocker propranolol (20 mg/kg bw), the N-methyl-D-aspartate (NMDA) receptor dextromethorphan (30 mg/kg bw), and their combination were administered 10 minutes after exposure to predator odor. The treatments included diazepam as positive control and normal saline as negative control. Anxiety-like behaviors were evaluated using the elevated plus-maze test (EPM) 7 days after stress induction.
Results: Regarding the length of stay (F=25.53; p<0.0001)/ number of entries in the open arms (F=3.533; p=0.0416), time (F=6.127; p=0.0045)/ number of entries in the closed arms (F=5.690; p=0.0141), time in center-point (F=3.577; p=0,0295), and total distance traveled (F= 4.711; p=0.0145), there was a significant difference among the treated groups. Propranolol and dextromethorphan treated groups expressed lower time in the closed arms vs Placebo (p=0.0089, respectively p=0.0111). In addition, the time spent in the open arms was higher in propranolol group vs placebo group (p=0.0215).
Conclusions: Considering obtained data, there was a decrease of symptoms in the sympathetic nervous system and the psychological stress disappeared in mice applying a treatment of 20 mg/kg bw propranolol. Our findings indicated that dextromethorphan partially mediated the anxiolytic-like activity. However, the combination of these two drugs did not express anxiolytic effects.

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Relationship between obesity and psychosocial risk factors in hypertensive patients

Enikő Nemes-Nagy, Zoltán Preg, Kinga-Ilona Nyulas, Tünde Pál, Sándor Pál, Mariana Cornelia Tilinca, Márta Germán-Salló

George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2021-0030

Introduction: Unhealthy lifestyle habits, including sedentary behaviour and improper diet are major risk factors for obesity. Overweight is very frequent in hypertensive and type 2 diabetic patients. Psychosocial factors are associated with multiple health behaviors related to overweight/obesity. The aim of the study was to evaluate the relationship between obesity and psychosocial risk factors in hypertensive patients having different levels of education.
Material and methods: 623 hypertensive patients, admitted to the Cardiovascular Rehabilitation Clinic in Tîrgu Mureș were evaluated by weight, height, waist circumference, laboratory analyses and psychosocial risk based on a validated questionnaire on nine topics. Non-paired Student t test was used for statistical evaluation of the obtained data.
Results: Obesity or overweight affected 86.9% of the studied hypertensive patients. Obesity was more frequent in subjects having type 2 diabetes as comorbidity. Mean BMI was significantly higher in the lower education group (p=0.007) compared to those with higher level of education. Average triglyceride and uric acid levels were significantly higher in obese subjects compared to those having lower BMI (p<0.0001). Patients living alone had significantly lower mean BMI (p=0.006) and waist circumference values (p=0.001) compared to those living with their spouse.
Conclusions: Weight excess in very frequent in the studied hypertensive patients, especially in those with type 2 diabetes as comorbidity and having lower educational level. Hypertriglyceridemia and hyperuricemia occurred more frequently in obese subjects compared to non-obese ones. Overweight is less frequent in patients living alone.

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Insulin resistance as risk factor for the development of type 2 diabetes mellitus: a systematic approach

Reka Annamaria Schmiedt1, Robert Aurelian Tiuca2,3, Raluca Maria Tilinca2, Lucia Mihaela Custura1, Oana Detesan1, Brigitta Iren Bacso1, Bianca Larisa Abalasei2, Andrew Corneliu Bell2, Maria Alexandra Streza2, Mariana Cornelia Tilinca1,2

1. Compartment of Diabetology, Emergency Clinical County Hospital of Targu Mures, Romania
2. George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
3. Department of Endocrinology, Mures County Clinical Hospital, Romania

DOI: 10.2478/amma-2021-0033

Insulin resistance is a heterogenous condition with high prevalence in medical practice. As diabesity reaches epidemic levels worldwide, the role of insulin resistance is getting great importance. Contribution of risk factors like sedentary lifestyle, diets high in saturated fats and refined carbohydrates leads to this state with significant consequences. Besides its role in diabetes, insulin resistance is also associated with other several endocrine diseases, having not only a role in their development, but also to their treatment approach, evolution and even prognosis. The present review summarizes the current literature on the clinical significance of insulin resistance, as well as the possible underlying mechanisms and treatment options in order to achieve a high quality of life of these categories of patients. Deepening the role of inflammatory cytokines involved in insulin resistance paves the way for future research findings in this continuously evolving field.

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Emotional disorders associated to multiple sclerosis and psychological interventions: a literature review

Alina Schenk1, Cosmin Octavian Popa2, Cristiana Manuela Cojocaru1

1. The Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Department of Ethics and Social-Sciences, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2021-0042

Multiple sclerosis is an unpredictable neurologic disease affecting 2.8 million people worldwide. Individuals with MS experience multiple physical and psychological symptoms such as depression, anxiety, fatigue, and pain that impact their general functioning and quality of life. The aim of this review is to highlight the importance of psychological interventions in reducing depression and anxiety symptoms associated with the diagnosis of multiple sclerosis. Cognitive and behavioral techniques are also useful in relieving the specific symptoms of multiple sclerosis. However, few studies have captured the psychological processes involved in reducing the symptoms of depression and anxiety, which is why greater concern is recommended in future studies in order to develop better psychological interventions tailored for patients with multiple sclerosis.

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The antibacterial potential of biosynthesized silver nanoparticles using beech bark and spruce bark extracts

Anca Delia Mare1, Adrian Man1, Felicia Toma1, Bianca Tudor1, Lavinia Berța2, Corneliu Tanase3, Cristina Nicoleta Ciurea1

1. Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Department of General and Inorganic Chemistry, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
3. Department of Pharmaceutical Botany, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2021-0043

Introduction: Lately, nanotechnology focuses on the green synthesis of AgNPs, using different plant materials, as this method is accessible, cost-efficient, and ecological. The study aimed to investigate the antibacterial potential of AgNPs synthesized using beech/spruce bark extracts (BBE/SBE) and silver salts (acetate/nitrate).
Method: The growth rates of Staphylococcus aureus ATCC 25923 and Escherichia coli ATCC 25922 were evaluated in the presence of the AgNPs solutions. The checkerboard method was performed to evaluate if these solutions exert synergistic activity with gentamicin.
Results: For E. coli, synergistic effects were observed for the combination of gentamicin 0.25mg/L with AgNP BBE Nit (0.145mg/mL) and with AgNP SBE Ac (0,09mg/mL). For S. aureus, no synergistic effects were observed. Overall, the AgNP BBEs solutions combined with gentamicin presented lowest values of fractional inhibitory concentration than the ones registered for the combination of AgNP SBEs with gentamicin, for both bacterial strains. The growth rate of S. aureus was inhibited by all the tested AgNPs at the measured time points. For E. coli, after 24 hours of incubation, the growth rate was inhibited only in the presence of AgNP SBE Ac. After 6 hours of incubation, the growth rate of E. coli was almost stationary in the presence of AgNP BBE Nit.
Conclusions: The biosynthesis of AgNPs is a valuable choice for obtaining substances with antibacterial potential.

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Apathy as Non-Motor Manifestation in Amyotrophic Lateral Sclerosis

Anca Moțățăianu1, Ioana Ormenișan2, Rodica Bălașa1

1. Neurology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Neurology I Clinic, County Emergency Clinical Hospital of Targu Mures, Romania

DOI: 10.2478/amma-2021-0041

Although the term of amyotrophic lateral sclerosis (ALS) is often used interchangeably with motor neuron disease, ALS is universally accepted as a multisystem disorder. Cognitive impairment is an acknowledged feature of ALS, affecting language, memory and behaviour, and apathy is considered to be the prevalent behavioural alteration in ALS. It can be divided in three subtypes: executive, emotional and initiation apathy. Out of the three subtypes, initiation apathy is common among patients with ALS. Even in patients that do not meet the criteria for ALS with frontotemporal dementia, low-key neuropsychiatric and cognitive changes can be observed. Apathy has also been found to be systematically associated with disruptions in medial frontal cortex and subcortical structures in several neuroimaging studies that confirm the pre-existing brain lesions in the early stages of this disease. Thus, there is a growing body of evidence that motor signs and symptoms are accompanied or even preceded by cognitive and behavioural alterations, and screening for non-motor signs and symptoms can be clinically relevant.

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Prosthodontic Management of Dentate Maxillectomy Patient: A Clinical Case Report

Vineet Sharma, Jyoti Paliwal, Kamal Kumar Meena, Ramjee Lal Raigar

Department of Prosthodontics and Crown & Bridge, RUHS College of Dental Sciences, Jaipur, India

DOI: 10.2478/amma-2021-0038

Patients with minor defects of the alveolar ridge and hard palate can easily be treated by surgical closure, while patients with larger defects are more amenable to prosthetic restoration. The case report describes the rehabilitation of a dentate maxillectomy patient with a definitive closed hollow bulb cast partial obturator. A tripod retainer design was chosen for direct retention in the case. The tripod design consisted of a T-bar clasp placed on the left first central incisor and two embrasure clasps with buccal retention and palatal bracing components between the right first & second premolar and right first & second molar. A complete palate major connector was designed to ensure uniform distribution of functional load across tissues. The remaining teeth, the palate, and the rest provided support for the prosthesis. Prosthetic rehabilitation of the defect with a definitive obturator thus seals tissue openings in the palate, improves deglutition, speech, mastication, aesthetics, and significantly improves quality of life.

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Soy polysaccharides therapeutic and technological aspects

Robert-Alexandru Vlad1, Paula Antonoaea1, Emoke Margit Redai1, Daniela-Lucia Muntean2, Nicoleta Todoran1, Magdalena Bîrsan1,3, Anamaria Tataru1, Adriana Ciurba1

1. Pharmaceutical Technology and Cosmetology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
2. Analytical Chemistry and Drug Analysis Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
3. Drug Industry and Pharmaceutical Biotechnology Department, “Grigore T. Popa” University of Medicine and Pharmacy from Iaşi, Iași, Romania

DOI: 10.2478/amma-2021-0040

Soy polysaccharides represent a multipurpose class of chemicals that include both therapeutical and technological properties. Since they have been first time introduced in the pharmaceutical field, Soy polysaccharides were used in two different pharmaceutical formulations; sublingual tablets and in colon drug delivery. For the sublingual tablets, Soy polysaccharides under the brand name of Emcosoy© – were used as a superdisintegrant in concentrations between 4-8% showing comparable results with the artificial superdisintegrants (sodium starch glycolate, sodium croscarmellose, and polyvinylpyrrolidone). The second technological field where Soy polysaccharides were used is represented by colon drug delivery where it was used in combination with ethylcellulose showing a prolonged lag time compared to the results found in the literature. The medicinal effect of these polysaccharides consists of treating diarrhea. As it will be presented in the article, these chemical compounds tend to decrease the aqueous stool time in patients with diarrhea and to conduct to a softer stool in healthy patients. In conclusion, these polysaccharides present multiple purposes possessing a medicinal effect and also the possibility of being used as a double-faceted pharmaceutical excipient.

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