Category Archives: AMM 2017, Volume 63, Number 3

Changes in Knee Joint Space Width in Treatment with a New Hyaluronic-Based Hydrogel

Octav Marius Russu, Andrei Marian Feier, Tudor Sorin Pop, Marcela Todoran, István Gergely

University of Medicine and Pharmacy Tirgu-Mures, Romania

DOI: 10.1515/amma-2017-0017

Objective: Our purpose was to assess the effect of a new hyaluronic acid-based (Hymovis®) injections on joint space width narrowing in patients diagnosed with knee osteoarthritis.
Methods: A prospective clinical trial was conducted in the Department of Orthopedics and Traumatology II from the Clinical County Hospital, Tîrgu Mureș, Romania. Thirty-five patients diagnosed with idiopathic knee osteoarthritis received two intraarticular injections with hyaluronic acid-based hydrogel (24 mg of hyaluronic acid/3 ml) at one-week interval. Anteroposterior radiographs were obtained before the injections, at six and twelve months after. Minimum joint space width was measured by two senior orthopaedics surgeons at each follow up. Each radiograph was measured again by the same evaluators two weeks apart.
Results: Thirty-one patients were present at the final follow-up. A minor reduction in mean weight was noticed (from 82.2 kg ± 16.2 kg to 80.9 kg ± 16.0, p > 0.398) without any correlation with joint space width narrowing. There were no major changes at the first follow up (6 months) regarding joint space narrowing. A reduction in joint space width was observed however at 12 months varying from 4.4 mm (SD ± 1.64, range 1.8-7.1) at the first assessment to 4.3 mm (SD ± 1.26, range 0.0-6.8) at the final follow-up but with no statistical difference (p=0.237).
Conclusion: No significant modification in joint space width at the final follow-up secondarily proved that two injections of Hymovis® may slow down narrowing in the knee joint space over a one-year period.

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Reduced Analgesics Consumption and Pain Intensity after Injections with a New Hyaluronic Acid in Patients with Knee Osteoarthritis

Octav Marius Russu, Andrei Marian Feier, Tudor Sorin Pop, Marcela Todoran, István Gergely

University of Medicine and Pharmacy Tîrgu Mures

DOI: 10.1515/amma-2017-0016

Objective: To determine the influence of a new intraarticular hyaluronic acid based hydrogel (Hymovis®) injections on the amount of analgesics consumption in patients diagnosed with primary knee OA.
Methods: A prospective, single-center study that included 35 patients, aged 45-80 years was conducted in our orthopaedics department. Patients received two intraarticular injections of hyaluronic acid (24 mg/3 ml; 500–730 kDa; Hymovis®) at one week apart. Follow-up was scheduled at 2 and 6 months after the injections. Assessment tools included Visual Analogue Scale (VAS) and an in-house designed questionnaire regarding analgesic consumption (quantity, period and product) during the follow-up.
Results: Compared to baseline, a significant amelioration in visual analogue scale was observed at six months’ follow-up (74.2mm ± 11.7 vs. 57.3mm ± 12.1; p < .0001). 28% (n=10) of the patients reduced their total analgesic consumption at two months after the injections. At final follow-up, the analgesic intake was reduced by more than 50% in almost every case.
Conclusions: Intraarticular administered injections with a novel hyaluronan-based hydrogel (Hymovis®) may reduce the amount of analgesic consumption and self-reported pain intensity in patients with knee OA.

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Evaluation of Early Postoperative Cognitive Dysfunction Incidence and Involved Neurocognitive Functions in Patients with Cardiac and Noncardiac Surgery Under General Anesthesia

Carmen Sircuţa1, Tunde Lucza2, Mihaly Veres1, Ildiko Szomoru3, Leonard Azamfirei1

1 University of Medicine and Pharmacy Tirgu Mures, Romania
2 Emergency Institute for Cardiovascular Diseases and Transplantation Tirgu Mures, Romania
3 Emergency Clinical County Hospital of Tirgu Mures, Romania

DOI: 10.1515/amma-2017-0012

Objective: To analyse postoperative cognitive dysfunction’s (POCD) incidence and cognitive areas involved, in patients with cardiac and general surgery.
Material and Methods: Prospective observational study on 130 patients undergoing general or heart surgery on cardiopulmonary bypass, under general anesthesia. Two groups, 65 members each. Group A had a heart surgery and group B a noncardiac surgery. The same type of anesthetic drugs were used. All patients completed the Montreal Cognitive Assesment (MoCA) questionnaire: preoperative, 24 hours after stopping any medicine acting on central nervous system and 7 days postoperative. We compared the MoCA scores obtained on different cognitive domains in this moments for each group of patients, for neurocognitive functions: visuo-spatial executive, naming, attention, verbal fluency, abstraction, recall, orientation, final score. We compared the scores between the two groups at 24 hours and 7 days postoperatively for the same domains.
Results: POCD was found at 24 hours testing in both groups. At 7 days postoperatively POCD was not found in any of the groups. There was no statistically significant difference in total final score between two groups at 24 hours nor at 7 days postoperative testing. There are significant differences between the two groups, with lower score in cardiac group in 5 of 7 fields at 24 hours testing, with the persistence of difference in 2 of 7 fields at 7 days.
Conclusions: Overall POCD was present at 24 hours but was not found at 7 days testing for none of the groups. POCD is present in some neurocognitive domains and this depends on surgery type.

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Clinical Outcomes after Regenerative Periodontal Therapy with Emdogain

Gabriela Felicia Beresescu1, Alina Ormenisan2, Melinda Szekely3, Monica Monea4, Adriana Monea4

1 University of Medicine and Pharmacy Tirgu Mures, Romania
2 Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy Tirgu Mures, Romania
3 Department of Tooth and Dental Arch Morphology, Faculty of Dental Medicine, University of Medicine and Pharmacy Tirgu Mures, Romania
4 Department of Odontology and Oral Pathology, Faculty of Dental Medicine, University of Medicine and Pharmacy Tirgu Mures, Romania

DOI: 10.1515/amma-2017-0015

Objective: Regeneration is defined as a reconstruction of a lost part of the body in such a way that the structure and function of the lost tissue are completely restored. The aim of this study is to compare the clinical outcomes of intrabony defects treatment using regenerative periodontal therapy with enamel matrix proteins (Emdogain, EMD) with a control group.
Methods: Ten patients with chronic periodontitis were included in this randomized, controlled clinical study. Two groups received conservative periodontal therapy. In the test group, different teeth received regenerative treatment with EMD. In the control group teeth received solely conservative periodontal therapy. Pocket depth probing (PD) and bone reduction (based on X rays) were registered at baseline and after eight months in both groups. In the control group
Results: Both groups showed a significant reduction of PD. The teeth treated with EMD showed a significant attachment gain. Within the test group, the radiographic examination of the teeth treated with EMD showed no significant change, whereas the teeth in the control group showed significant bone reduction.
Conclusions: Intrabony defects in teeth treaded with EMD exhibit a substantially higher gain in clinical attachment and defect filling. The use of EMD in dental practice can prevent further bone loss.

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