Volume 61, Number 4, 2015
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Category Archives: AMM 2015, Volume 61, Number 4
Resin-Based Composite and LCU-related Factors Affecting the Degree of Cure. A Literature Review: Part 2. Light Curing Units & Related Factors
DOI: 10.1515/amma-2015-0127
In parallel with developments in resin based composite technology, there have been changes in light curing units (LCU). Broadly, there are four categories of LCUs available in the market, with the two commonest used in Dentistry being quartz tungsten halogen (QTH) lamps and light emitting diode (LED) units, though now, QTH is infrequently used in most developed countries.
Argon-ion lasers and Plasma-arc lamps (PALs) had many disadvantages limiting their use. Argon-ion lasers were large devices with increased cost compared to QTHs, [1] PALs had low curing efficiency, increased shrinkage and micro leakage due to fast curing, [2] increased cost, heat and power consumption and decline of lights power output over time compared to QTHs [1,3,4]. [More]
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Scientific Gatekeeping and Exposure
When reading some of the main medical journals, one realizes that the tasks of the editors imply also an activity known as “scientific gatekeeping”. It basically means a triage of the submited articles to dispose of those who do not comply with the rigours of correct medical research or to strategically avoid alien fields of interest to the journal. Editors are supposed to master clinical and/or basic research in order to fit to the job position and thus take responsibility for these operations. They are also accountable for their actions.
Facts speek for themselves: fraudulent, fabricated articles sieved by the gatekeepers’ selection process; shallow peer-review process; pression exerted in the intent of using influence to promote publication; loading by dues to authors, moods’ driven unfair rejections. Other facts could be added to the list, emerging as mushrooms fueled by frustration. One of them is mannerism in scientific writing. An impeccable form of written study, correct statistics, conforming IRBs end up in being published and often cited when appearing in important journals. Still, not all of them contain significant clinical findings. The package is attractive, the content dull. It is selling though. The terminal phrase “… further studies are needed to confirm our findings” is sometimes just a defensive tool to prevent challenge. I wonder how many of these studies are included in meta-analyses and/or cited and an analysis of this issues would be a step forward in enlighting the scientific writing process. [More]
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The Role of Urodynamic Investigations in Management of Stress Urinary Incontinence
DOI: 10.1515/amma-2015-0115
Objective: The aim of this study is to establish the importance of urodynamic investigations in women diagnosed with stress urinary incontinence (SUI) who have indication of surgical treatment.
Methods: We performed a retrospective study over a period of 3 years (January 2012-December 2014) in Clinic of Urology from Tirgu Mures. The inclusion criteria were: female patients diagnosed with SUI having indication of surgical treatment and the existence of urodynamic investigations (uroflowmetry and pressure-flow study). We evaluated 118 patients with SUI. From this patients, 24 cases (20.3%) accomplished the criteria from above.
Results: We included in this study 24 patients aged 64.25+/-8.25 (standard deviation). Pressure-flow study revealed an impaired detrusor contraction in 13 cases. Statistical anaysis pouved a relation between existence of post void residual urine (PVR) and underactive detrusor (UD) (p=0.01). There is no correlation between maximum flow rate (Qmax) and UD, r=0.18 (CI= -0.2-0.5), p=0.3 and between normal value of Qmax and normal detrusor pressure (Pdet), r= 0,28(CI=-0.6-0.8), p=0.58. Also there is no relation between a low Qmax and UD, p=0,5. There is a statistical relation between increased abdominal pressure (Pabd) and UD, p=0.02.
Conclusions: Uroflowmetry has the role to guide us concerning the micturition process Pressure-flow study is indicated in management of SUI, in selected cases, in patients with voiding symptomatology, the suspicion of a detrusor contractility dysfunction, abnormal uroflowmetry results, existence of PVR, in prediction of the surgical treatment outcome or if we think that the findings can change the choice of treatment.
Keywords: post-void residual urine, pressure-flow study, stress urinary incontinence, Urodynamics, uroflowmetry
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A Short Review of the Experience of the University of Medicine and Pharmacy of Tîrgu Mureş in Medical Simulation
DOI: 10.1515/amma-2015-0109
Medical simulation is used in a growing number of medical education institutions all over the world. Since 2013, the University of Medicine and Pharmacy of Tîrgu Mureş has introduced a number of simulation methods into the curriculum of certain subjects, the number of which is expanding. This article sums up some of the knowledge available in the literature regarding medical simulation and presents the general framework under which it is used in medical learning in our University.
Keywords: medical simulation, curriculum
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Percutaneous Revascularization in a Case of Vasospastic Angina Associated with Polymorphic Ventricular Tachycardia
DOI: 10.1515/amma-2015-0106
Introduction: Coronary vasospasm is a possible cause of ventricular tachyarrhythmias and is frequently associated with atherosclerotic lesions. The revascularization of mild to moderate coronary artery stenosis which causes symptoms only due to associated vasospasm is still a matter of debate, as the standard treatment of Prinzmetal angina is represented by the long term administration of calcium-channel blockers.
Case presentation: We present the case of a 46 year old woman with an intermediate severity coronary artery stenosis complicated by vasospastic angina and subsequent polymorphic ventricular tachycardia. Although the functional significance of the fixed coronary artery lesion was equivocal at invasive fractional flow reserve measurement, a combined pharmacologic and interventional treatment strategy was chosen with stent implantation and long acting calcium channel blocker administration with a symptom-free, good clinical outcome.
Conclusion: Patients with vasospastic angina and intermediate severity atherosclerotic coronary artery stenoses are at risk of malignant ventricular arrhythmias, therefore myocardial revascularization should be considered in addition to the standard medical treatment.
Keywords: vasospastic angina, coronary artery stenosis, fractional flow reserve, polymorphic ventricular tachycardia
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The Prevalence and Distribution of High Risk Human Papillomavirus Genotypes in Patients with Dysplastic Lesions: a Population Study
DOI: 10.1515/amma-2015-0107
Background. Cervical cancer (CC) is a major public health problem worldwide. Knowledge of human papillomavirus (HPV) genotype prevalence and distribution is important for the introduction of an effective vaccination program and the corresponding epidemiological monitoring. The aim of this study was to identify and analyze the distribution of high-risk HPV genotypes.
Methods. Data were collected from 136 patients for the detection of circulating HPV genotypes, where Pap test results revealed the presence of koilocytes or high risk (HR) dysplastic lesions, elements that raise the suspicion of HPV infection.
Results. HPV infection was identified in 72 (55.4%) of the patients tested, 34 (47.3%) with single infection, and 38 (52.7%) with multiple infections. Twenty-two different types of HPV were identified: 14 high risk HPV types, 7 low risk HPV types, 1 probable high risk HPV type. HPV 16 was the most frequently detected (55.6%) one, it was involved in single (15 cases) and multiple (25 cases) infections, primarily associated with type 18 (12 cases), and type 52 (11 cases). The presence of HPV 18 (29.2%) and HPV 52 (23.6%) was identified after HPV type 16.
Conclusions. Oncogenic HPV genotypes 16, 18, and 52 were most frequently associated in women with dysplastic lesions, which require the use of polyvalent HPV vaccines when assessing cross-protective effects of specific immunoprophylaxis programs.
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Helicobacter Pylori and its Determinations on Gastric Biopsies
DOI: 10.1515/amma-2015-0066
Background and Aims. Gastric cancer, because of its aggressive evolution and the high mortality associated with it, remains one of the most debated subjects in medical literature with Helicobacter pylori (HP) as a major risk factor. Chronic inflammation caused by HP infection represents the initial site of the predisposing and afterwards premalignant lesions for gastric carcinoma. The purpose of this study was to evaluate the prevalence of HP infection, of predisposing and premalignant lesions on gastric biopsies, as well as to identify the correlations between them.
Material and method. A retrospective cross-sectional study was performed on gastric biopsies collected endoscopically from a single region, antrum or corpus, and from different regions, between January 2012 and July 2014. Incidence of HP infection, of predisposing and premalignant gastric lesions, the correlation of HP infection and these lesions, were evaluated.
Results. HP infection was diagnosed in 32.81%. Predisposing and premalignant lesions were present in 53.64% of biopsies with most of them in the antrum. HP infection stands out for the under 50 yo group (p=0.001). No correlation between frequency of HP infection and predisposing and premalignant lesions was observed.
Conclusions. Prevalence of HP infection in our study suggests that besides HP infection, other factors are also involved in gastric cancer development. Biopsies from different regions of the gastric mucosa do not offer extra information regarding HP infection prevalence but may be helpful in evaluating incidence and extension of predisposing and premalignant lesions.
Keywords: risk factors, Helicobacter pylori infection, epidemiology, precursor lesions, gastric cancer
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Capillary Electrophoresis in the Analysis of Polyunsaturated Fatty Acids
DOI: 10.1515/amma-2015-0103
The aim of this study to inventory the main electrophoretic methods for identification and quantitative determination of fatty acids from different biological matrices. Critical analysis of electrophoretic methods reported in the literature show that the determination of polyunsaturated fatty acids can be made by: capillary zone electrophoresis, micellar electrokinetic chromatography and microemulsion electrokinetic chromatography using different detection systems such as ultraviolet diode array detection, laser induced fluorescence or mass – spectrometry. Capillary electrophoresis is a fast, low-cost technique used for polyunsaturated fatty acids analysis although their determination is mostly based on gas chromatography.
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Tips and Tricks to Manage Vascular Risks Using the Transnasal Endoscopic Approach to Pituitary Adenomas
DOI: 10.1515/amma-2015-0100
Objective: The purely transnasal endoscopic approach has taken in the last decade a paramount importance in the treatment of pituitary adenomas, but some authors have been linked it to an increase in vascular complications. The aim of this paper is to provide a stepwise description of the vascular risks and steps required to avoid them.
Method: We present the minimal invasive technique used by the senior author in over 900 transnasal purely endoscopic approaches focusing on the relevant vascular landmarks, preoperative and operative steps taken in order to avoid vascular injury and the management of vascular injury from a multitude of sources.
Conclusion: Endoscopy has brought a wider field of view, with numerous vascular structures well inside the operating field. This represents control but also higher risk. Solid knowledge of the skull base anatomy and proper preoperative imaging coupled with an experienced surgeon can greatly reduce the vascular risks associated with surgery.
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