Category Archives: AMM 2011, Volume 57, Number 6

Surgical Treatment for Sequelae of Infantile Hemangiomas: Its Role Within the Therapeutic Management of These Tumors

Bulea Raluca1, Enescu DM1,2, Giuvelea Steluţa2, Stoicescu Simona1,2, Alexandru Raluca2, Ioniţă D2

1 Plastic and Reconstructive Surgery Chair, “Grigore Alexandrescu” Emergency Clinical Hospital for Children, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
2 Clinic of Plastic Surgery, Reconstructive Microsurgery and Burns, “Grigore Alexandrescu” Emergency Clinical Hospital for Children, Bucharest, Romania

Introduction: Infantile hemangiomas belong to the group of vascular anomalies. They have a unique evolution pattern: at birth they are usually unapparent, then an explosive growth follows (proliferative phase). For the next 5–7 years, the involutive phase develops, marking a slow regression of the tumor. The final stage is the involuted phase, which may present with residual scars or sequelae.
Material and methods: The purpose of the present study is to assess the place and role surgical treatment has within the complex therapeutic management of IHs in the stage of sequelae.
Results: During a period of 30 months, we selected 21 children that met our including criteria; the average follow up was of 9 months. Only three patients received no treatment at all during early childhood. Indications for surgical treatment in the stage of sequelae were alopecia, the presence of bulky masses, unaesthetic facial scars, retractile scars, ectropion, pain and functional impairment on the fingers and foot.
Conclusions: Our study has shown that surgical correction can lead to significant improvement of the patient’s appearance and of the functions affected by the hemangioma’s sequelae. For medium sized sequelae, the lenticular excision is the best way to diminish the residual scar. In the case of large sequelae, seriate excision represents a better approach, using sometimes more specific plastic surgery techniques, like local flaps, Z plasty or tissue expansion.

Keywords: , ,
Full text: PDF

Study on the Resuscitations Performed in the Emergency Department of the Clinical Emergency County Hospital from Târgu Mureș in 2009

Bratu Simona¹, Copotoiu Sanda-Maria2,3

1 UPU-SMURD, County Emergency Clinical Hospital, Tîrgu Mureş, Romania
2 University of Medicine and Pharmacy, Tîrgu Mureş, Romania
3 Department of Anesthesia and Intensive Care, County Emergency Clinical Hospital, Tîrgu Mureş, Romania

Objectives: The study assesses the results of the cardiac arrest resuscitations performed by the medical staff of the Emergency Department of The Clinical Emergency County Hospital from Târgu-Mureş in the year 2009.
Method: We conducted a prospective study between 01.01-31.12.2009, including the cardiac arrest cases occurred in the ED or brought with ongoing resuscitation from the pre-hospital setting. For the statistical study we used SPSS program, version 17; the χ2 tests and p values were determined to compare the data.
Results: We had a total of 186 cases of cardiac arrest, representing 0.47% of the total 39.074 patients assisted in the ED in 2009. The gender distribution of the cases showed a higher incidence in male (61%) and the most affected age groups ranged between 60–80 years. The patients with cardiac arrests presented various diagnosis: the highest incidence is acute coronary syndrome 32 patients (17%), followed by sepsis/MSOF 20 (11%), pneumonia/asthma 17 (9%), pulmonary embolism 17 (9%), stroke 13 (7%), etc. We have resuscitated successfully 42 patients, representing 22.58 % of the total 186 cases. All 42 patients were transferred to the hospitals departments. Out of the hospitalized patients, 25 died later on the wards and 17 (40.47%) survived and were discharged home, 6 from the Intensive Care Department and 11 from the Coronary Unit.
Conclusions: The results are comparable with the reported international data. The cases with cardiac arrest due to acute coronary syndrome, ventricular rhythms and those witnessed and treated early in the ED are having a better outcome.

Keywords: , , , ,
Full text: PDF

The Prevalence of Supernumerary Teeth in a Group of Patients in Western Romania

Bratu Dana Cristina1, Bratu E2, Păcurar Mariana3, Popa G1, Pop Silvia3

1 Department of Paedodontics and Orthodontics, Faculty of Dentistry, “Victor Babes” University of Medicine and Pharmacy, Timişoara, Romania
2 Department of Implant Supported Restorations, Faculty of Dentistry, “Victor Babes” University of Medicine and Pharmacy, Timişoara, Romania
3 Department of Paedodontics and Orthodontics, Faculty of Dentistry, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Objective: The objective of this article is to study the types of supernumerary teeth and their prevalence in a group of patients in Western Romania.
Material and methods: The study group consisted of various patients, who attended the Department of Paedodontics and Orthodontics, Faculty of Dentistry, Timişoara, Romania. The number, location, classification, bilateral symmetry and impaction of supernumerary teeth were evaluated. Furthermore, we evaluated the development of these teeth and we also established the therapeutic decision for each clinical case. Final diagnosis was based upon clinical examination, occlusal radiographs, panoramic radiographs or cone beam CT.
Results: From a total of 700 examined patients, with mixed and permanent dentition aged between 6 and 13 years, 21 (3%) patients had supernumerary teeth. A total of 25 supernumerary teeth were recorded. The distribution of supernumerary teeth according to jaws showed a higher prevalence in the maxilla: 80% (n=20) were located in the upper jaw, while 20% (n=5) were found in the mandible. In the upper arch, the most frequent supernumerary teeth were the lateral incisors 45% (n=9), followed by the central incisors (mesiodentes) 35% (n=7). Smaller percentages were located in the premolar region 15% (n=3) and distomolar region 5% (n=1). The distribution of supernumerary teeth according to bilateral symmetry was 24% (n=6) bilaterally and 76% (n=19) unilaterally. Regarding their status, the majority of the supernumerary teeth, 96% (n=24) were erupted and only 4% (n=1) were impacted, being associated with the failure of eruption of the left central incisor. Tooth extraction was the treatment of choice in 100% of the cases. Most of the supernumerary teeth, 96% (n=24) were completely developed and only 4% (n=1) showed an incomplete root.
Conclusions: The prevalence of supernumerary teeth in this study was 3%. This result is comparable to similar studies in the literature, among Caucasians. Future research is required to evaluate a larger group of patients.

Keywords: , , , ,
Full text: PDF

The Use of Surgical Lasers in the Treatment of Oral Leukoplakia

Bögözi B1, Bocskay I2

1 Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Department of Odontology and Parodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

Introduction: Surgical lasers are more and more often used in our days in medicine, including oro-maxillo-facial surgery. Because of their many advantages the application of surgical lasers became the elective method in the surgical treatment of oral leukoplakia – according to the recomandation of the WHO.
Material and method: In this paper two clinical cases are presented showing the methods and advantages of using surgical lasers in the treatment of oral leukoplakia. For the surgery a 15 W maximum power Biolitec diode laser was used.
Results and conclusions: The ideal haemostasis during surgery; the shortened intervention (and through this the reduction of physical an psychological stress of the patient); minimal scar tissue formation; the unnecessity to cover sometimes important postoperative defects, reduced risk of dissemination of modified cells are such advantages of the use of surgical lasers, that eliminate the difficulties of classic surgical techniques and lead to spreading of a new concept in the surgical treatment of premalignant lesions of the oral mucosa.

Keywords: , ,
Full text: PDF

Clindamycin — an Option for Antibiotic Prophylaxis In Arthroplasty

Bod P, Kurtus I, Incze S, Moldovan Rodica, Vâlcu A, Nagy Ö

Orthopaedics and Traumatology Clinic, Emergency County Hospital, Tîrgu Mureş, România

Introduction: Generally joint arthroplasties, but especially hip arthroplasties, are perhaps the most widespread types of orthopedic surgeries. These types of interventions are special because of the possibility of bacterial complications occurring due to the implant.
Material and method: Between 2008–2009 a total of 48 patients were administered Clindamycin 600 mg iv, as antibiotic prophylaxis, specifying that administration was performed according to the international protocol. During follow-up we monitored the efficiency of perioperative antibiotic prophylaxis in patients by determining the C-reactive protein and the erythrocyte sedimentation rate.
Results: The patients’ postoperative evolution at the site of the surgical wound presented no complications, except two cases of wound dehiscence caused by superficial hematoma which were subsequently solved with a secondary suture.
Conclusions: Clindamycin is used for preventive purposes especially in those protocols where beta-lactam allergy occurs. Clindamycin can also be used instead of cephalosporins in perioperative antibiotic prophylaxis. Our results are in accordance with those met in the speciality literature.

Keywords: , , ,
Full text: PDF

FLT3 Internal Tandem Duplication and D835 Mutations in Acute Myeloid Leukemia

Bănescu Claudia1, Dobreanu Minodora2, Duicu Carmen3, Benedek I4, Macarie I5, Köpeczi Judit4

1 Department of Genetics, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Department of Clinical Biochemistry, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
3 Pediatric Clinic, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
4 Hematology Clinic 2, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
5 Hematology Clinic 1, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

Introduction: FLT3 is a member of receptor tyrosine kinases expressed in leukemic cells. Internal tandem duplications (ITDs) and D835 mutations in FLT3 tyrosine kinase receptor have been shown to confer a bad prognosis in acute myeloid leukemia (AML). The aim of the present study was to determine the incidence of both ITD and D835 mutations in the FLT3 gene, in patients with AML from Tg-Mures, Romania.
Materials and methods: DNA was obtained from peripheral blood samples. ITDs were investigated by polymerase chain reaction (PCR). D835 mutations were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), with the digestion of restriction endonuclease EcoR V. The amplified and restricted products were finally electrophoresed on agarose gel stained with ethidium bromide.
Results: Alterations in the FLT3 gene were detected in 8 patients out of the 23 cases analyzed. These aberrations included ITD in 4 cases, D835 mutations in 2 cases and both types of alteration (ITD + D835) in 2 patients.
Conclusion: In this study we demonstrated that FLT3 mutations are frequent molecular abnormalities in AML patients with an incidence of 34.8%. Although our data do not support its value as a prognostic factor in AML patients because of the small cohort, further investigation is required.

Keywords: , ,
Full text: PDF

Extracranial Jugular Venous Insufficiency in Multiple Sclerosis Patients Treated with Interferon Beta

Bălaşa Rodica, Bajkó Z, Stan Camelia

First Neurological Department, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

Background: The term „vascular immunology” was created when recent studies have suggested that topographic perivenous pattern of demyelinated MS plaques may be caused by venous congestion. This condition termed as „chronic cerebrospinal venous insufficiency” has raised important issues. Our objective was to investigate the haemodinamics of the internal jugular vein (IJV) using extracranial Color-Doppler (ECD) sonography in MS patients treated with IFN-β.
Methods: 140 patients with MS (mean age: 41.1±9.2, mean EDSS: 2.73±1,96, 68.6 % RRMS and 31.4 % SPMS, mean relapses in the past 12 months: 0.43±0.61 with at least 18 months of IFN-β treatment as unique DMT, underwent ECD with detection of four parameters: A – reflux present in IJV; B – evidence of proximal IJV stenosis; C – flow not Doppler detectable in IJV; D – negative difference in the cross sectional area in IJV supine/sitting postures. We studied which criteria correlate significantly with EDSS, number of relapses, form of MS and time to initiation of therapy.
Results: Thirty patients (21.8 %) had at least 2 unilateral parameters present on IJV. This patients had significantly more frequent SPMS (p=0.02), higher EDSS (p=0.04) and started later IFN-β therapy (p=0.03). Taken separately, the number of parameters C+D correlates significantly with EDSS (p=0.04) and form of MS (p=0.01).
Conclusions: ECDS is non-invasive, repeatable, cost-effective and permits to investigate the cerebral venous outflow. The frequency of ECDS criteria in our patient group is significantly lower compared with the results published by Zamboni et al. The absence of IJV flow and negative difference in the cross sectional area in IJV supine/sitting postures correlates significantly with the patient’s clinical characteristics.

Keywords: , ,
Full text: PDF

Terephthaldiamides Class Synthesis. III. Synthesis of Some N-monosubstituted Terephthaldiamides

Avrigeanu Veronica1, Imre Silvia2, Mircia Eleonora1, Muntean Daniela-Lucia2

1 Departament of Organic Chemistry, Faculty of Pharmacy, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
2 Department of Drug Analysis, Faculty of Pharmacy, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Introduction: The aim of this experimental paper was the synthesis of some terephthaldiamides, with potential analgesic action.
Material and methods: The reaction consists of acilation of some primary amines, ethanolamine, allylamine, benzylamine, aniline and orthotoluidine, with terephthaloyl chloride. The purified synthesis products were analysed by thin-layer chromatography, mass, IR and UV spectrometry.
Results: The molecular structure of the obtained N-monosubstitute terephthaldiamides was confirmed by spectral analysis.
Conclusions: Five N-monosubstituted terephtaldiamides were synthesized in good yields by condensation of terephtha¬loyl chloride with primary amines.

Keywords: , ,
Full text: PDF

Editor’s Expression of Concern

Sanda-Maria Copotoiu

Editor-in-Chief

The chief editor expresses her concern as to the allegations of plagiarism disseminated on a large field of personal e-mails, some of them accessed without permission and thus abused, as well as on certain political sites. The dissemination was not only regional, but national, and when it was immediately spread on the internet, the damage could only be figured out.
The allegations regarded some articles previously published since 2010 in our journal. It is our conviction that prior to taking such actions, the journal should be officially informed. Thus we would have had the opportunity to analyze the issues.
The allegations were viciously and falsely fathered consecutively by a character who styled himself as a prominent researcher and voluntary justice maker, further intoxica-ting the net.
The electronic format of the journal was used without permission. [More]

Keywords:
Full text: PDF