Category Archives: Number

Assessing the control of the disease on current treatments available in Romania for hereditary angioedema patients

Noemi Anna Bara1,2, Iris Nadasan3, Valentin Nadasan4, Diana Deleanu1,5,6,7

1. Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mureș, Romania
2. Hereditary Angioedema Expertise Centre, Sângeorgiu de Mureș, România
3. General medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mureș, Romania
4. Hygiene Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mureș, Romania
5. Department of Allergology and Immunology, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj Napoca, Romania
6. Department of Allergology, “Professor Doctor Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
7. Department of Internal Medicine, “Professor Doctor Octavian Fodor” Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, România

DOI: 10.2478/amma-2024-0009

Background: Acute treatment must be permanently accessible for every patient diagnosed with hereditary angioedema (HAE). In many cases this type of therapy does not provide/offer sufficient control of the disease, so long-term prophylaxis (LTP) is recommended. In the case of regular and prolonged/extended administration of drugs, the route of administration is essential. The aim of the investigation was to assess the control of HAE among patients in Romania receiving the available medications, while also examining potential correlations within the outcomes.
Material and methods: A phone call was made to all adult patients registered in the Romanian HAE Registry. Patients with confirmed diagnosis of HAE who had at least one angioedema attack in the last three months were asked to complete, online, the angioedema control test (AECT) for one- and three months respectively. AECT scores were calculated according to the authors’ instructions.
Results: A total of 121 patients were contacted. Of these, 83 complies with the eligibility criteria and 56 completed the questionnaires (response rate 67.4%), 18 (32.1%) men and 38 (67.9%) women. Acute, home administered treatment with Icatibant or pdC1-INH was available for every patient during the study time. Nine (14.5%) participants used LTP too, with pdC1-INH. These treatments ensured an adequate control of the disease in only 13 patients (21%) in case of the three-month AECT, of whom 2 used LTP. The one-month questionnaire showed a well-controlled disease in 14 patients (23%), from which only 1 was on prophylactic therapy.
Conclusion: In most Romanian HAE patients, the available drugs do not offer a proper control of the disease. Even though a first-line drug for LTP is available, its administration route by intravenous injections makes it inconvenient for many patients, highlighting the necessity for new, easy-to administer drugs for HAE patients from our country.

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Merkel cell carcinoma- particularities and morphological aspect of a unique and rare entity

Andreea Cătălina Tinca1,2, Bianca Andreea Lazar2, Ovidiu Simion Cotoi1,2

1. Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Pathology Department, Mures Clinical County Hospital, Targu Mures, Romania

DOI: 10.2478/amma-2024-0008

Introduction: Merkel cell carcinoma is a very rare malignant neoplasm which presents high aggressivity, high recurrence rate and has metastatic potential. Our purpose is to present the histological and immunohistochemical particularities of Merkel Cell Carcinoma while reviewing potential differential diagnoses and challenges that we can encounter in daily practice.
Case presentation: We present the case of an 86-year-old female patient who presented with a nodular tumour located in the left forearm, raising suspicion of a soft tissue tumour. The histological appearance of this unique type of cancer is highlighted on the Haematoxylin-eosin stain as a solid tumour composed of nests and chords of monomorphic cells. The nuclei of these tumoral cells appear characteristically as enlarged with dispersed chromatin. The immunohistochemical reactions have been performed and it was observed that the tumoral cells exhibited positivity for synaptophysin, CD56, NSE, EMA, as well as a “dot-like” expression for CK20. These histopathological and immunohistochemical features were consistent with a diagnosis of MCC, stage pT3, based on the assessment of tumour size.
Conclusions: Sometimes, differentiating this tumour from other primary malignant neoplasms of the skin or even cutaneous metastases can be difficult. Immunohistochemistry remains the most important tool of diagnosis, especially for differentiating this neoplasm from metastatic neuroendocrine tumours that can affect the skin.

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Effect of carbamazepine-beta-cyclodextrin inclusion complex on seizure-like events in an in vitro model of temporal lobe epilepsy

Rita-Judit Kiss1, Ágnes Csüdör2, Máté Sárosi2, Zsolt András Nagy2, Ádám Szentes2, Zsolt Gáll3, Tibor Szilágyi1, Károly Orbán-Kis1

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

DOI: 10.2478/amma-2024-0007

Objective: Pharmacoresistant epilepsy represents a significant global health challenge, necessitating novel therapeutic approaches. Despite advances in antiseizure medications, many patients remain treatment-resistant partially due to complex pharmacokinetic issues. Beta-cyclodextrin, known for enhancing drug solubility and stability, offers potential solutions by forming inclusion complexes, thereby improving anti-seizure medication’s efficacy. This study aimed to investigate the effect of beta-cyclodextrin and beta-cyclodextrin-complexed carbamazepine on epileptiform activities, using an in vitro model of temporal lobe epilepsy.
Methods: Seizure-like neuronal activity was induced using the low-magnesium model. Local field potentials were recorded from transverse rat hippocampal slices immersed in epileptogenic artificial cerebrospinal fluid, followed by the administration of either beta-cyclodextrin or carbamazepine, the latter in 100 micromolar concentration.
Results: Beta cyclodextrin, applied alone, significantly reduced the duration of interictal and ictal phases while increasing the frequency of seizure-like events. Carbamazepine exhibited an important anticonvulsant effect, significantly reducing ictal and postictal phase durations. However, the frequency of seizure-like events was increased. Notably, in some of the slices, carbamazepine completely suppressed epileptiform activity.
Conclusions: Beta cyclodextrin had an effect on its own; it shortened seizure durations and increased their frequency. Carbamazepine in complexed form, as used in our study, exhibited anticonvulsant efficacy, emphasizing the feasibility of solubility enhancement by this method. This study provides insights into potential therapeutic strategies for pharmacoresistant temporal lobe epilepsy, improving the pharmacological properties of the drugs. As cyclodextrins emerge as promising excipients for antiepileptic drugs with poor solubility, more effort is needed in order to elucidate the underlying mechanisms of their effects.

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Co-infection with Mycobacterium tuberculosis and Mycobacterium avium in an HIV-positive patient – Case Report

Aura-Alisia Roman1, Ioana Tripon1, Bianca Tudor2

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

DOI: 10.2478/amma-2024-0006

Introduction: The association between Mycobacterium tuberculosis and the Human Immunodeficiency Virus can accelerate the deterioration of immunological functions. The risks are even more accentuated in the situation of a Non-tuberculous Mycobacterium and Mycobacterium tuberculosis co-infection.
Case presentation: We present the case of a 59-year-old male patient, who was admitted at the hospital with non-specific symptoms. Further investigations reveal a remarkable particularity about the case: The infection with Mycobacterium tuberculosis was urogenital, whereas the one with Non-tuberculous mycobacteria was pulmonary.
Conclusion: Both Mycobacterium tuberculosis and Non-tuberculous strains can exist within the same infection, posing great difficulties for diagnosis, as well as the treatment scheme.

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Anti-obesity and Antioxidant Effects of Ethanol Extract of Fingerroot Rhizomes (Boesenbergia pandurata Roxb.) on High-Carbohydrate Diet-induced Mice

Ari Yuniarto1, Abdul Aziz Setiawan2, Wulan Safitri1, Emir Rizky Taptajani2

1. Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Muhammadiyah A.R. Fachruddin University, Tangerang, Indonesia
2. Department of Pharmaceutical Technology and Natural Products, Faculty of Pharmacy, Muhammadiyah A.R. Fachruddin University, Tangerang, Indonesia

DOI: 10.2478/amma-2024-0005

Objective: Obesity is defined as the abnormal and excessive accumulation of fat. Enlargement of white adipose tissue due to obesity activates the sympathetic nervous system to stimulate lipolysis to break down fat extensively. This causes a lot of free fatty acids to circulate in the body. Excessive circulating free fatty acids affect many cells and produce oxidative stress, which spreads throughout the body. This research purpose is to determine the anti-obesity and antioxidant activities of ethanol extract of B. pandurata rhizome (EEBP).
Methods: Fingerroot rhizomes were extracted using maceration and the extract was used for in vivo, antioxidant, and total flavonoid concentration tests. Anti-obesity test was carried out by dividing mice into 6 groups such as normal controls, obese controls, standard groups, and extract-treated groups (100, 200, 400 mg/kg b.w). The in vivo test parameters observed included measurement of body weight and also liver, kidney, spleen, and retroperitoneal fat index measurement. Furthermore, in this research antioxidant test was performed using the DPPH method.
Results: In vivo test showed that the giving of EEBP at a dose of 400 mg/kg b.w. effectively decreased body weight and retroperitoneal fat, but slightly affected the organ index of mice such as the liver, renal, and spleen. Furthermore, the antioxidant test showed that the IC50 EEBP results obtained were 37,05 µg/ml. In addition, the total flavonoid content found in the EEBP is 15,775 mgQE/g.
Conclusion: The present study showed that EEBP may have a considerable potential anti-obesity agent and also has a very strong antioxidant effect.

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Oligosymptomatic form of Melkersson-Rosenthal Syndrome possibly triggered by COVID-19 infection: A case report

Nisada Đuzelić1, Nina Čamdžić2, Dževad Durmišević3, Amir Rekić4, Selma Hodžić4, Asja Prohić5

1. Cantonal Hospital “Dr. Irfan Ljubijankić”, Department of Dermatovenerology, Bihać, Bosnia and Herzegovina
2. Department of Pathology, Faculty of Medicine University of Sarajevo, Bosnia and Herzegovina
3. Cantonal Hospital “Dr. Irfan Ljubijankić”, Department of Pathology, Bihać, Bosnia and Herzegovina
4. Cantonal Hospital “Dr. Irfan Ljubijankić”, Department for Ear, Nose and Throat Diseases, Bihać, Bosnia and Herzegovina
5. Department of Dermatovenerology, Sarajevo Medical School, University of Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina

DOI: 10.2478/amma-2024-0004

Introduction: Melkersson Rosenthal syndrome (MRS) is a disease of multifactorial origin typically presented with a triad of symptoms including peripheral facial nerve paralysis, plicated tongue and orofacial edema. Diagnosing MRS requires the exclusion of other granulomatous diseases and the correlation of clinical with histopathological finding.
Case presentation: We present the case of a 56-year-old female with a four-month history of lower lip and right mandible angle swelling together with a plicated tongue that appeared during COVID-19 infection. The patient was successfully treated with intralesional Triamcinolone Acetonide at a dose of 40 mg.
Conclusion: The presented case is specific by its late onset since the patient experienced their first symptoms in fifties, which differs from the majority of cases where the diagnosis is usually established in young adults. Infectious factors are established as possible etiologic factors of MRS, but few cases are described to be triggered or worsened by COVID-19 infection.

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Biological profiles of Q. cerris, Q. dalechampii, and Q. robur bark extracts: A characterization study

Adrian Nisca1, Sanziana Sisea2, Nastaca Alina Coman1, Mihai Babota3, Oleg Frumuzachi3, Corneliu Tanase2,4

1. Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Department of Pharmaceutical Botany, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
3. Department of Pharmaceutical Botany, Faculty of Pharmacy, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
4. Research Center of Medicinal and Aromatic Plants, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania.

DOI: 10.2478/amma-2024-0003

Objective: The main objective of the present study was to characterize the extracts obtained from the bark of three oak species in order to assess their use in potential cosmetic products.
Methods: The extracts were obtained from the oak barks (periderm and rhytidome) using ultrasound-assisted extraction. The total polyphenolic content was assessed afterward, using the Folin–Ciocâlteu method, while the antioxidant capacity was determined using methods based on the neutralization of the 2,2’-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) and 2,2-diphenyl-1-picrylhydrazyl radicals. To assess the tyrosinase inhibitory effect, a protocol using L–DOPA as the substrate of the enzyme was employed.
Results: The extracts presented high levels of polyphenolic compounds, with Q. cerris having the highest content. Because of the high concentration of the extracts in polyphenolic compounds, they revealed a great reducing capacity against both DPPH and ABTS radicals, but unfortunately the tyrosinase inhibitory activity of the tested extracts was very weak compared to the positive control.
Conclusions: The extracts may have beneficial effects when used in cosmetic products because of the antioxidant effects, but more studies must be conducted for the determination of the main phytochemical compounds comprised in the extracts and their correlation to the biological effects.

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Smart science: How artificial intelligence is revolutionizing pharmaceutical medicine

Swapna B V1, Shibani Shetty2, Manjunath Shetty3, Smitha Sammith Shetty4

1. Department of Prosthodontics, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
2. Department of Oral Pathology and Microbiology, MR Ambedkar Dental College and Hospital. Bangalore, Karnataka, India
3. Division of Pharmacology, Department of Basic Medical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
4. Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India

DOI: 10.2478/amma-2024-0002

Artificial intelligence (AI) is a discipline within the field of computer science that encompasses the development and utilization of machines capable of emulating human behavior, particularly regarding the astute examination and interpretation of data. AI operates through the utilization of specialized algorithms, and it includes techniques such as deep (DL), and machine learning (ML), and natural language processing (NLP). As a result, AI has found its application in the study of pharmaceutical chemistry and healthcare. The AI models employed encompass a spectrum of methodologies, including unsupervised clustering techniques applied to drugs or patients to discern potential drug compounds or appropriate patient cohorts. Additionally, supervised ML methodologies are utilized to enhance the efficacy of therapeutic drug monitoring. Further, AI-aided prediction of the clinical outcomes of clinical trials can improve efficiency by prioritizing therapeutic intervention that are likely to succeed, hence benefiting the patient. AI may also help create personalized treatments by locating potential intervention targets and assessing their efficacy. Hence, this review provides insights into recent advances in the application of AI and different tools used in the field of pharmaceutical medicine.

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