Category Archives: Original Research

Epidemiological study on a Wilson disease group of patients

Isabela Raluca Musteață1, Septimiu Toader Voidăzan2, Mihaela Alexandra Budianu2, Liviu Moraru3

1. Resident physician, family medicine, Heart Institute “Niculae Stancioiu”, Cluj Napoca
2. Department of Epidemiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
3. Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2025-0026

Wilson disease is a disorder of copper metabolism caused by genetic mutations in the ATP7B gene which lead to the accumulation of copper in the body. This study was conducted using an online questionnaire consisting of 32 questions in a group of patients suffering from Wilson disease. The study included 67 people aged 7 to 56 with Wilson disease. The most common symptoms of the participants were hepatic and neurological in 22 cases (32.8%). The most common neurological symptom in the assessed cases was muscle stiffness (49.5%), followed by tremor (45%), and speech disorders (40.5%). The Kayser-Fleischer ring was present in 50.7% of the participants. The most commonly used drug treatment in the participants was D-penicillamine (77.61%).

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Does surgical treatment improve diabetes in pheochromocytoma patients? A comparative study before and after tumor resection in a series of 23 patients

Ramona Cătană1,2, Adela Nechifor-Boilă1,3, Sorina Moica4, Angela Borda1,5

1. Department of Histology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu-Mureş, Romania
2. Department of Endocrinology, Târgu-Mureş Emergency County Hospital, Târgu-Mureş, Romania
3. Department of Pathology, Târgu-Mureş County Hospital, Târgu-Mureş, Romania
4. Faculty of Engineering and Information Technology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu-Mures, Romania
5. Department of Pathology, Târgu-Mureş Emergency County Hospital, Târgu-Mureş, Romania

DOI: 10.2478/amma-2025-0028

Objective: The present study aimed to assess the prevalence of diabetes in a cohort of pheochromocytoma patients registered at the Pathology Departments of two County Hospitals. Additionally, diabetes status was re-evaluated following tumor resection to determine whether surgery had an impact on improving or alleviating the condition.
Methods: We performed a retrospective study including all patients who underwent adrenalectomy and were diagnosed with pheochromocytoma based on histopathological findings in Mureș County (2017-2022) Hospital and Mureș County Emergency (2000-2022), Romania, respectively. All patients that were alive and whose contact details were available, participated in a phone survey and provided clinical data. Information on the presence of diabetes at the time of pheochromocytoma diagnosis and their diabetes status after tumor resection was recorded. The follow-up period ranged from 24 to 216 months.
Results: We identified 35 patients with a histopathological diagnosis of pheochromocytoma. Complete histopathological and clinical data were obtained for 23 patients; 13/23 (56.5%) were women and 10/23 (43.59%) were men; the mean age at surgery was 52.73 ±14.22 years-old (range 24-78). Of these, eight patients (n=8/23; 34.7%) were diagnosed with diabetes prior to surgery. All diabetic patients showed improvements in their carbohydrate metabolism and 5 (62.5%) of them revealed a restored normal glucose tolerance after surgery.
Conclusions: Our study highlights that overt diabetes mellitus is present in more than one-third of patients with pheochromocytoma. Tumor removal improves dysglycemia in all diabetic pheochromocytoma patients and cures diabetes in a significant proportion of them.

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Exploring attitudinal shifts in students’ lifestyle and dietary habits: The impact of formal education in nutrition and dietetics

Francisc-Andrei Boda1, Erzsébet Májai2, Johanna Baricsán3, Hajnalka Boda4, Béla Kovács5

1. Department F1, General and Inorganic Chemistry, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Department F2, Toxicology and Biopharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
3. Nutrition and Dietetics Program, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
4. SC Dianthus Pres SRL, Sangeorgiu de Mures, Romania
5. Department F1, Biochemistry and Environmental Chemistry, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2025-0022

Objective: The study aimed to evaluate the lifestyle and dietary habit changes among students enrolled in the Nutrition and Dietetics program at the George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș. Specifically, we examined the influence of academic progression on stress levels, dietary choices, purchasing habits, and physical activity.
Methods: A cross-sectional questionnaire-based pilot study was conducted among 55 Nutrition and Dietetics students across different academic years. Data were collected using a structured questionnaire assessing dietary habits, lifestyle factors, and stress levels. The responses were analyzed for trends across academic years and body mass index categories, with statistical comparisons performed to determine significant differences.
Results: Final-year students demonstrated healthier dietary habits, increased water consumption, and more fruit and vegetable intake compared to their younger peers, while also exhibiting higher stress levels. Differences in nutritional behaviors were also observed based on BMI categories, with normal-weight students more likely to adopt healthier eating patterns. An overall increased dietary awareness was observed, which was correlated with the accumulated nutritional knowledge.
Conclusions: The findings suggest that formal education in nutrition plays a significant role in shaping healthier behavior. However, challenges remain regarding stress management, physical activity, and unhealthy dietary habits. Targeted interventions and institutional policies may be beneficial in supporting sustainable lifestyle changes among students.

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Efficacy of oral versus intravenous steroids in the treatment of pediatric immune thrombocytopenic purpura: A single center experience

Essam Ahmed Abdullah, Nabeeha Najatee Akram

Department of pediatrics, College of medicine, Mustansiriyah University, Baghdad, Iraq

DOI: 10.2478/amma-2025-0025

Objectives: This study conducted to assess the response rate to steroid in children with acute primary ITP and compare the relative effectiveness of oral steroid to intravenous dexamethasone.
Methods: A retrospective study involves children with primary ITP and treated by steroids with age below 15 years who were consulted the outpatient hematology clinic at central teaching hospital of pediatric from 1st of January 2024 to 31 December 2024. Patient were divided into two groups based on treatment modality: (1) children treated by oral prednisolone; (2) children treated by intravenous dexamethasone. For each patient recruited in the study, two set of data were collected: clinical data (presentation, severity of bleeding) , demographical data (age, gender), and laboratory data: which included platelets count that obtained from complete blood counts (baseline at presentation, on day 14th, and on day 28th of establishment of either mode of therapy).
Results: A total of 135 children diagnosed with primary ITP was treated by steroid with age range 2 months to 15 years. The severity of ITP was mild –moderate in 71% of patients and those was treated by oral prednisolone, while 29% were presented with severe bleeding and were treated by intravenous dexamethasone. The means of platelet count significantly elevated after the initiation of therapy in both oral prednisolone (P value = 0.03) and intravenous dexamethasone group (P value = 0.001) during 1st and 2nd evaluation. During the first evaluation, children on intravenous steroids show a significantly higher response than those treated by oral steroids P value = 0.001 and this difference maintained in the second evaluation visit with P value =0.021
Conclusion: Intravenous dexamethasone demonstrates greater efficacy than oral prednisolone in managing children with primary ITP, suggesting its preference as the optimal steroid regimen for treatment.

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Outcome comparison between transcatheter closure and surgical closure of atrial septum defect

Mohammed Rasool Hussein1, Noor Yousif Abed2, Maysam Yousif Abed1, Nabeeha Najatee Akram2

1. Pediatric cardiology, Ibn Al-Bitar center, Iraq
2. College Of Medicine, Fallujah University, Iraq

DOI: 10.2478/amma-2025-0023

Introduction: Atrial septal defect (ASD) is a common congenital heart defect found in both children and adults, with potential serious complications if not addressed. Transcatheter device closure is a less invasive alternative to surgical correction, particularly for patients not suitable for the former.
Materials and Method: Patients and Methods: The study included 114 individuals treated at Ibn Al-Bitar Cardiac Surgery Center from June 2023 to July 2024. Patients with secundum ASD could choose between transcatheter or surgical closure, meeting specific defect criteria except for complex cases requiring surgery. Patients received information on risks, outcomes, and selected their preferred method. Surgical closures used cardiopulmonary bypass, while transcatheter procedures utilized the Amplatzer Septal Occluder.
Results: In comparison to surgical intervention, transcatheter closure demonstrated faster procedure times, no requirement for ICU admission, and shorter hospital stays. It achieved a higher success rate (97.8% vs. 91.3%) with fewer complications. Surgical procedures were more prone to complications such as wound infections and pneumonia, whereas device embolization was exclusive to the transcatheter cohort. Additionally, residual ASD occurrences were reduced in the transcatheter group
Conclusion: Transcatheter closure emerges as a safer, more efficient, and minimally invasive alternative to surgical repair for appropriate secundum ASD cases. However, surgical intervention remains vital for complex scenarios, highlighting the importance of meticulous patient selection and tailored interventions to enhance results. Additional research is warranted to evaluate the extended effects over time.

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Assessing hs-Troponin T and NT-proBNP in acute heart failure and cardiorenal syndrome: Diagnostic, prognostic, and functional interrelationships

Redha Dawud Abd Alredha1, Krarr Haider Haddawi2, Hussein Fadil Ibrahim3

1. Department of Medical Laboratory Techniques, College of Health and Medical Techniques, Kufa, Al Furat Al Awsat Technical University, Al-Kufa, Iraq
2. Department of Clinical Biochemistry, College of Medicine, University of Al-Qadisiyah, Iraq
3. DNA Research Center, University of Babylon, Hilla, Iraq

DOI: 10.2478/amma-2025-0024

Background: Acute heart failure (AHF) is frequently complicated by renal dysfunction, leading to cardiorenal syndrome (CRS), and poses significant management challenges.
Objective: This study aimed to elucidate the interrelationships between cardiac function, renal impairment and key biomarkers: high-sensitivity troponin T (hs-Troponin T) and N-terminal pro-brain natriuretic peptide (NT-proBNP), in patients with AHF with and without CRS.
Methods: In this prospective observational study, 60 adult patients admitted with AHF were stratified into two groups based on renal function. Baseline clinical data, laboratory measurements, and echocardiographic assessments were performed within 48 h of admission.
Results: Patients with CRS exhibited a significantly lower left ventricular ejection fraction (34.73 ± 2.49% vs. 41.70 ± 5.08%, p<0.001), elevated serum creatinine levels, and a more deranged lipid profile than patients with AHF alone. Both hs-Troponin T and NT-proBNP levels were markedly higher in the CRS group, with significant inverse correlations between these biomarkers and the ejection fraction. Multivariate analysis revealed that elevated NT-proBNP levels (OR 9.465, p<0.01) were strong predictors of prolonged hospitalization.
Conclusion: These findings highlight the complex interplay between cardiac and renal dysfunction in patients with AHF. Elevated levels of hs-troponin T and NT-proBNP, particularly NT-proBNP, underscore their potential as valuable diagnostic and prognostic tools for early risk stratification and management in high-risk patients.

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Laparoscopic total nephrectomy – Our local experience

Ioan Alin Nechifor Boilă1, Steffen Holker2, Andrada Loghin3, Ciprian Todea4, Orsolya Martha4, Călin Chibelean4

1. Department of Urology, Mureș County Hospital, Department of Anatomy and Embryology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Department of Neurology, St. Katharinen Hospital in Frechen, Germany
3. Department of Pathology, Mureș County Hospital, Department of Histology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
4. Department of Urology, Mureș County Hospital, Department of Urology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2025-0017

Introduction: Laparoscopic total nephrectomy (LTN) is nowadays the gold standard excision modality for both tumor and non-tumor renal pathology. With a more than 7-year presence in our department, laparoscopy is gaining more and more ground in our everyday urological practice. We aimed to analyze our experience with LTN, including learning curve analysis, in order to assess our gain in surgical experience with the new procedure.
Methods: We performed a retrospective cohort study in the Department of Urology, Mureș County Hospital and included all patients that benefited from laparoscopic total nephrectomy in the period 2017-2022. A total of 109 patients were included and their corresponding clinical and histopathological information was obtained from clinical records. Data was stratified according to patient demographics, histopathological diagnosis and operating surgeon.
Results: Age pyramid analysis revealed a predominance in male patients (62, 56,9%), whose age distribution was mostly in the intervals 60-65 (11, 10.09%) and 70-75(11, 10.09%). Most procedures were performed for tumor pathology (94, 86.2%), the most frequent histopathological diagnosis being clear cell carcinoma (71, 65.1%). Learning curve analysis was restricted to pT1 RCCs and performed for the two surgeons with the most experience for accuracy. A non-linear decrease in operative time was found for both surgeons, although not statistically significant.
Conclusion: Although limited in sample size, our study demonstrated a decreasing trend in operative time for laparoscopic total nephrectomy with the gain in experience, although inconsistent. Further studies with larger cohorts spanning on larger time intervals are necessary for a more thorough appreciation of surgical experience.

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Epidemiology and public health challenges of echinococcosis in the Republic of Moldova

Alexandru Sîrbu, Diana Spătaru

Department of Epidemiology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova

DOI: 10.2478/amma-2025-0016

Objective: This study aims to analyze the current epidemiological trends of echinococcosis in the Republic of Moldova and evaluate the effectiveness of existing surveillance and control measures.
Methods: The research is a descriptive observational epidemiological study that involved several steps, which allowed for achieving the initial goal – analyzing the morbidity of echinococcosis globally and in the Republic of Moldova from 2011 to 2024. The steps of the research include: studying the bibliographic literature on the proposed topic and mastering the research methods; collecting data on echinococcosis globally and in the Republic of Moldova; analyzing the obtained data on echinococcosis; establishing effective control and prevention measures.
Results: Between 2011 and 2024, 985 cases of echinococcosis were reported, with a peak incidence in 2012–2013 and a decline until 2020. However, cases increased again from 2022. The disease predominantly affected adults (51–60 years) and was more prevalent in females (53% of cases). Hepatic involvement was the most common localization (79.4%). The southern regions exhibited the highest burden. Control measures, including deworming programs and public health campaigns, contributed to incidence reduction but require further optimization.
Conclusions: Echinococcosis remains a significant public health concern in Moldova, with fluctuating incidence rates and persistent endemicity. Enhanced surveillance, improved diagnostic strategies, and One Health-based preventive interventions are essential for sustainable control.

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Comparative non-invasive strategies for managing dental white spot lesions: Contribution to the study of enamel remineralization

Alessandro Golia1, Alessandro Stellino1, Nicola D’Andrea1, Oana Elena Stoica2, Kovács-Ivacson Andrea Csinszka3, Monica Dana Monea3, Alexandra Mihaela Stoica3

1. Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Department of Pedodontics, Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
3. Department of Odontology and Oral Pathology, Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2025-0015

White spot lesions (WSLs) are an early sign of enamel demineralization, requiring effective non-invasive treatments to restore esthetics and prevent progression. This study aimed to evaluate the effectiveness of fluoride varnish (GC MI Varnish) and resin infiltration (Icon Vestibular) in terms of esthetic improvement, remineralization, and sensitivity reduction. The study is primarily addressed to general dental practitioners, pediatric dentists, orthodontists, and restorative specialists who routinely encounter white spot lesions (WSLs) in both adolescent and adult patients. It is also relevant to dental researchers and students interested in minimally invasive treatment strategies and advancements in enamel remineralization. A total of 47 patients with non-cavitated WSLs were randomly assigned to two treatment groups: Fluoride Group (n = 24) received topical fluoride varnish applications and Icon Group (n = 23) underwent resin infiltration treatment. Statistical analysis was performed using an independent t-test (p < 0.05). The Icon Group showed an immediate reduction in white spot visibility (p < 0.01), while the Fluoride Group demonstrated gradual esthetic improvement over three months (p < 0.05). Fluoride varnish significantly enhanced enamel remineralization and reduced dentinal hypersensitivity (p < 0.05), whereas resin infiltration primarily stabilized lesion progression without direct remineralization. Both fluoride varnish and resin infiltration are effective non-invasive treatments for WSLs, but their benefits differ. Resin infiltration offers immediate esthetic improvement, while fluoride varnish promotes long-term remineralization and sensitivity reduction.

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Prescription of antibiotics in bone augmentation with dental implant

Omar W. Saleh1, Bashar A. Tawfeeq2, Rawaa Y. Al-Rawee3

1. Department of Dental Basic Sciences, college of Dentistry, Mosul University , Nineveh, Iraq
2. Department of Maxillofacial Surgery, College of Dentistry, Al-Noor University, Nineveh, Iraq
3. Department of Maxillofacial Surgery, Al-Salam Teaching Hospital, Nineveh Health Directorate, Nineveh, Iraq

DOI: 10.2478/amma-2025-0014

Aim: To evaluate the success and failure in bone augmentation with dental implant cases when antibiotics were used with different timing in long follow-up periods.
Material and Method: 120 patients were randomly put into three groups: (1) no antibiotic treatment (NOAB); (2) preoperative and postoperative antibiotic treatment (PPAB) with 1.5 g of amoxicillin an hour before surgery and 500 mg three times a day for five days after surgery; and (3) postoperative antibiotic coverage (POAB) with 500 mg three times a day starting after surgery and continuing for five days after surgery. We conducted a comparison and follow-up of patients to detect antibiotic responses in the context of bone augmentation and dental implants.
Results: We recorded highly significant differences in age groups and gender. We observed highly significant differences (0.000, 0.000, and 0.041) on the third day, the 12th week, and after six months of follow-up. The results indicated that in group 1, 7 implants (11.6%) failed, while in group 3, only 2 implants (3.33%) failed. In contrast, in group two, all implants succeeded (100%).
Conclusion: The use of preventive antibiotics resulted in a very low infection rate. Conversely, the absence of preventive antibiotics significantly increased the infection rate. A higher number of studies were required to analyze the biological factors that contributed to failure in the case of various antibiotic doses and types.

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