Category Archives: AMM 2015, Volume 61, Number 3

Specific Characteristics of Head and Neck Squamous Cell Carcinoma in Mures Area

Fejér Enikő Réka1*, Bodi Andrea1, Egyed-Zsigmond Imre2, Jung Ioan2, Voidăzan Septimiu3, Ábrám Zoltán4

1 University of Medicine and Pharmacy of TarguMureş
2 University of Medicine and Pharmacy of TarguMureş. Anatomopathological Department
3 University of Medicine and Pharmacy of TarguMureş, Epidemiology Department
4 University of Medicine and Pharmacy of TarguMureş, Hygiene Department

DOI: 10.1515/amma-2015-0048

Although head and neck cancers have a rising incidence, these diseases are less investigated because of their localisations’ heterogenity. The major risk factors susceptible to influence the evolution of the disease are smoking, alcohol consumption and infection with human papilloma virus. Using data from Mures County Emergency Hospital’s histopathology register, we made a retrospective study of 190 cases from the last two years. Factors of interest included age, sex, localization, histopathological subtype and differentiation grade. Median age at diagnosis was 61.31 years, the disease presenting highest incidence in the 51-60 age subgroup and a clear male predominance (5.75:1). The most frequent localization is lower lip (28%) and the dominant histopathological subtype is cheratinised squamous cell carcinoma (83,8%) and G2 differentiation grade (48,1%). This study supports the finding of increased incidence of cheratinised squamous cell carcinoma in this region. However the literature emphasizes rising incidence of head and neck cancer in younger, we observed that increase in Mures area occurred in 51-60 age group. Lower lip most frequent localization makes possible an early diagnosis.

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How Far We Should Go with Pelvic Lymph Node Dissection on the Controlateral Side in Unifocal Muscle Invasive Bladder Cancer

Vartolomei Mihai Dorin, Chibelean Calin Bogdan*, Voidazan Septimiu, Martha Orsolya, Borda Angela, Boja Radu Mihail, Dogaru Grigore Aloiziu

University of Medicine and Pharmacy of Tirgu Mures, Romania

DOI: 10.1515/amma-2015-0047

Objectives. The purpose of this study was to determine the evolution of patients with unifocal lateral wall MIBC (muscle invasive bladder cancer) after cystectomy with PLND (pelvic lymph node disection) at the Urology Clinic in Tirgu Mures, and to determine tumor stage and lymph node status before and after radical cystectomy with PLND.
Methods. This is a prospective study, conducted between 1 August 2012 to 31 July 2014 at Urology Clinic, with a median follow-up of 14 months (range 7-25). Inclusion criteria were: patients undergone cystectomy with PLND, and unifocal MIBC on the lateral wall of the bladder; exclusion criteria were: multiple bladder tumor, other location and clinical T stage > 3.
Results. Forteen patients met the inclusion criteria, median age was 61 (range 55-72), 85.71 % were male. An increase in T3 patients was noticed from 1 to 5 cases, we noticed a decrease of N0 lymph nodes from 78.6% to 57.1% postoperatively and on the controlateral side the kappa coefficient between the preoperatively and postoperatively negative lymph nodes was 0.63. On the tumor side the most common location for positive lymph nodes was external iliac with 3 nodes (21.4 %) and obturator fossa with 4 nodes (28.6 %) and on the contralateral side 2 positive nodes (14.3 %, obturator fossa, external, internal and common iliac nodes).
Conclusions. In unifocal bladder tumors, located on the lateral wall, PLND could be an alternative with comparable results with extended PLND especially in T1 and T2 patients associated with N0 before and after surgery.

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The Grade of Left Ventricular Diastolic Dysfunction as a Predictive Factor for Permanent Atrial Fibrillation

Cerghizan Anda, Keresztesi Arthur Atilla*, Bataga Simona, Tilea Ioan

University of Medicine and Pharmacy of Tirgu Mures, Romania

DOI: 10.1515/amma-2015-0046

The objective of this study was to find a link between the grade of left ventricular diastolic dysfunction (LVDD) and the progression to permanent non-valvular atrial fibrillation (AF), in a group of patients with left ventricular diastolic dysfunction and paroxysmal or persistent atrial fibrillation.
Methods: A bidirectional study on 57 patients meeting the inclusion criteria was conducted; each patient was admitted in a university -based hospital between January 1st – June, 30, 2013, with a follow up 3 and 6 months later. Permanent atrial fibrillation development was followed.
Results: Out of the 57 patients, 23 had paroxysmal AF and 34 were with persistent AF. After six months, 21 patients progressed to permanent AF, representing 36.84% of the total patients. Female patients with age over 65 had more often atrial fibrillation, but more men progressed to a sustained form of AF. No statistically significant difference regarding the grade of diastolic dysfunction, the left atrial size or volume, or the left ventricular ejection fraction was observed between the patients with progression, compared to those without progression.
Conclusions: The grade of left ventricular diastolic dysfunction did not prove to be a predictive factor for permanent atrial fibrillation, neither the left atrial size or volume, or the left ventricular ejection fraction.

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Food Consumption Frequency at Students from Rural Areas from Moldova Republic

Zepca Victor1, Tarcea Monica2*, Zaporojan Aculina1

¹ Department of Hygiene, National Center for Public Health, Chisinău, Republic of Moldova
² Department of Community Nutrition and Food safety, University of Medicine and Pharmacy Tirgu Mures, Romania

DOI: 10.1515/amma-2015-0044

Objective: Our study aim to evaluate the characteristics of nutrition behavior at teenagers from Moldova’s rural area schools in order to make a profile of risk behavior related to diet and to implement efficient community intervention programs.
Methods: We studied in 2014 the daily frequency consumption of the main food groups, in a sample of 1236 students of 7th-12th class, from rural localities of the Republic of Moldova, using the questionnaire method.
Results: The teenagers had consumed on the day preceding the interview, cereals and bakery products – 99.2%, fruits – 86.7%, cooked vegetables – 72.6%, meat dishes – 72.1%, potatoes – 50.3%, dairy products – 46.9%, raw vegetables – 44.7%, eggs – 25.3%, fish – 19.4%, raw fruits juice – 14.8%, legumes – 12.5% of students. From those investigated 52.6% have consumed food with high fat content higher than recommended levels. Regarding the food groups present in the menu we registered a satisfactory level of consumption by the students for cereals and bakery products, fruits, cooked vegetables and meat dishes; relatively satisfactory – the consumption of dairy products, raw vegetables and potatoes; unsatisfactory level for the consumption of eggs, fish and legumes.
Conclusions: We sustain the idea that it is important to constantly evaluate the risk factors related to the inadequate diet at teenagers and to implement efficient community intervention in order to prevent nutrition related diseases that can occur.

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Maximizing the Amount of Deposited Particles During a Severe Asthma Attack Using the Stochastic Lung Model

Sarkany Zoltan

University of Medicine and Pharmacy, Tîrgu Mures, Romania

DOI: 10.1515/amma-2015-0043

Background: The aim of this study was to use a computerized lung model to simulate the deposition of inhaled particles in the human airways during a severe asthma attack, in order to find the combination of breathing- and particle-related parameters which leads to the highest deposited fractions in the target areas of the airways.
Material and Method: A stochastic lung model was used to simulate the deposition of 1 nm – 100 µm particles during a severe asthma attack in bronchial generations 9-16. Breathing parameters were chosen to reflect the use of a therapeutic inhalation device, with a 10 s symmetrical breathing cycle and 2000 ml tidal volume. To maximize the deposited fraction in the target areas, further simulations were carried out changing the tidal volume (750-3000 ml), the length of the breathing cycle (2-20 s) and the length of breathing pause following inhalation (0-10 s).
Results: The highest deposited fraction of 51.50% in bronchial generations 9–16 was obtained in the case of 0.01 µm particles, this value being more than4 times higher compared to the highest deposition of 3–6 µm particles currently used in inhalation devices (11.81% in the case of 5 µm particles). Modifying breathing-related parameters did not lead to valuable increases in the deposited fractions in the investigated region.
Conclusions: Deposition fractions in the therapeutically important areas of the airways may be more than4 times higher in the case of 0.01 µm particles, compared to particles currently used in the treatment of asthma bronchiale.

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Smoking Habits of Children Institutionalized in Family Care Homes in Mures and Harghita County

Ferencz Lorand1*, Finta Hajnal1, Schmidt Lorand2, Balint Iosif1, Nadasan Valentin1, Abram Zoltan1

1 Department of Hygiene, University of Medicine and Pharmacy, Targu Mures, Romania
2 DGASPC Tîrgu Mures, Romania

DOI: 10.1515/amma-2015-0042

Background: Smoking is a problem of the modern world and annually produces more victims, and due to ignorance and lack of health education in our country the disease diagnosis is made at an advanced stage. Many studies show that, young people aged between 10 and 18 are smokers and start smoking at an increasingly early age. Objective: The purpose of this study was to assess the smoking habits of institutionalized children in family care homes from Harghita and Mures county.
Methods: The method chosen was a sociological survey based on questionnaires. Our study included 254 children institutionalized in family care homes in Mures county and 254 children from Harghita county. Statistical analysis was performed using the Statistical Package for Social Sciences.
Results: A statistically significant difference was obtained analyzing the number of smokers from the group of children under 12 years in Mures compared to the Harghita county. More than half of children smoked their first cigarette after they entered in family care homes in both counties and the most common setting in which the children were smoking was when being together with their friends.
Conclusions: In Mures county the number of smokers under the age of 12 was significantly higher than in Harghita county. Despite the educational classes and institutional regulations of smoking, more than half of children smoke. The decisive role in testing of smoking are the friends. Due to the very high number of underage smokers, the prevention and education hours have an unquestionable importance.

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