Category Archives: Original Research

The Prevalence of Dysphotopsia in Patients with Recent Cataract Surgery

Andreea Dana Fişuş1*, Zoltán Madaras1, Karin Ursula Horváth1,2

1 Tîrgu Mureş County Hospital, Ophthalmology Clinic
2 University of Medicine and Pharmacy Tîrgu Mureş

DOI: 10.1515/amma-2017-0002

Pseudophakic dysphotopsia are becoming increasingly important as unwanted side effect after cataract surgery. Objective: The purpose of this study is to compare the photic symptoms experienced by patients after cataract surgery.
Material and method: This is a prospective study that included 105 eyes from 99 patients, which underwent uncomplicated phacoemulsification and IOL implantation, between June 2015 and June 2016, performed at Ophthalmology Clinic Tg Mureș. Patients without visually consequential ocular co-morbidity completed a questionnaire, designed to assess subjectively perceived visual functioning and identify symptoms of dysphotopsia.
Results: From the total number of patient, hydrophobic lenses were implanted in 95 patients and 10 patients received hydrophilic lenses. Photic effects were reported in 18% of treated eyes. Although the percentage of dysphotopsia is higher in the hydrophobic lenses category, there was no significant statistical difference between the two categories.
Conclusion: The incidence and significance should not be overlooked, thus visual acuity is not enough for evaluating postoperative visual function.

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Comparative Analysis of Hepcidin-25 and Inflammatory Markers in Patients with Chronic Kidney Disease with and without Anemia

Carmen Denise Căldăraru1, Dorin Ionuţ Tarta1*, Mirela Liana Gliga1, Cristina Tarta2, Emilian Caraşca3, Sorin Albu3, Adina Huţanu4,5, Maria Dogaru6, Grigore Dogaru1

1 Department of Nephrology, University of Medicine and Pharmacy of Targu Mures, Romania
2 Department of Internal Medicine, County Clinical Hospital Targu- Mures, Romania
3 Department of Internal Medicine, University of Medicine and Pharmacy of Targu Mures, Romania
4 CCAMF of University of Medicine and Pharmacy of Targu Mureș, Romania
5 Department of Laboratory Medicine, University of Medicine and Pharmacy of Targu Mureș, Romania
6 Department of Pharmacology, University of Medicine and Pharmacy of Targu Mureș, Romania

DOI: 10.1515/amma-2017-0001

Introduction: Hepcidin is a regulatory protein in iron metabolism; we do not know the role in chronic kidney disease anemia.
Methods: 22 patients with CKD anemia and 15 patients with CKD without anemia were investigated. CKD anemia-inclusion criteria: over 18 years, hemoglobin ≤12 g/dl for women and ≤13 g/dl for men, no treatment for anemia 6 months before enrollment, glomerular filtration rate (eGFR) <60 ml/min/1.73m² and stable creatinine three months before enrollment. Exclusion criteria: infection, bleeding, malignancy, systemic or liver disease, immunosuppression, renal replacement therapy. CKD without anemia-inclusion criteria: over 18 years, no anemia or treatment for anemia, CKD with stable creatinine values three months before enrollment. Exclusion criteria: medical conditions known to have a role in the development of polycythemia. Hepcidin-25 and ferritin were measured by ELISA method. Erythropoietin (EPO), tumor necrosis factor (TNF)-α, interleukin (IL)-6 were evaluated using chemiluminescent enzyme immunometric assays. Unpaired T test, Pearson correlation and multiple regression were used for statistical analysis.
Results: Hemoglobin values were significantly lower in anemia group. There were no differences in terms of eGFR, age, body mass index, serum hepcidin, erythropoietin, fibrinogen, IL-6, and TNF-α between CKD patients with and without anemia. Serum hepcidin correlated positively with ferritin (r=0.45 p<0.05), TNF-α (r=0.54, p<0.05) and negatively with erythropoietin (r=-0.51, p<0.05). Multiple linear regression analysis demonstrated that TNF-α is an independent predictor of serum hepcidin in our patients (p=0.003, R=0.71).
Conclusion: We found no differences in serum hepcidin, erythropoietin and inflammatory markers in non-dialysis CKD patients with and without anemia.

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The Correlation Between Personality Dimensions and Young People’s Choice of a Medical Career

Popa Cosmin Octavian1*, Rus Adrian2

1 Universitatea de Medicină şi Farmacie din Tîrgu Mureş. Tîrgu Mureş, Romania
2 Southwestern Christian University, The Department of Social and Behavioral Sciences, Bethany, Oklahoma, USA

DOI: 10.1515/amma-2016-0052

Objective: The research assumes that there is a correlation between personality dimensions Extraversion and Conscientiousness which mean autonomy, ambition and consistency of purpose, self-efficacy and determination for young people who want to aspire to a medical career.
Methods: In this study’s target group were included 130 students aspiring to a medical career, that participated in the summer school organized by UMF Tirgu-Mures in 2016, of which 25 (19%) male and 106 (81%) female, average overall age group being 17.23.
Results: Within the female group, the Pearson cross-correlation coefficient of Openness and Conscientiousness is r. Pearson (105) = – .20, p <0.05. The Pearson coefficient of cross-correlation between Extraversion and Conscientiousness is = – .20, p <0.05. The Pearson coefficient of cross-correlation between emotional stability and conscientiousness is r. Pearson (105) = .36, p <.001. In the male group, the Pearson cross-correlation coefficient between the Extraversion and Conscientiousness personality dimensions is r. Pearson (N = 25) = -.39 where p <0.05.
Conclusions: The Extraversion dimension of personality is a dynamic factor and motivator only when it is correlated with the Conscientiousness personality dimension. This indicates dynamism and autonomy, persistence in achieving goals, ambition, high motivation, interpersonal social intelligence and emotional stability, resulting a personality profile that matches one of the aspirants to a medical career.

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Screening the Presence of Amflora Transgenic Potato in Food or Feed Products

Curticăpean Manuela-Claudia*

Cell Biology and Microbiology Department, University of Medicine and Pharmacy, Romania

DOI: 10.1515/amma-2016-0051

Objective. Amflora potato, event EH92-527-1 was genetically modified to produce only the amylopectin component from starch composition. The presence of the transgenic potato in the food on Romanian market should be verified although the Amflora potato uses for industrial purposes and animal feed. The aim of this study was to detect the presence of the Amflora potato in the food or feed products.
Methods. For this purpose, five samples of potato tubers and four samples of chips were analyzed. DNA isolation was performed with E.Z.N.A. ® MicroElute Genomic DNA kit (Omega Bio-Tek, USA). For identification a potential presence of the recombinant DNA in the food samples it was used GMOIdent RT Event EH92-527-1 Potato kit (Eurofins GeneScan, Germany), that is a real-time PCR kit for qualitative event-specific detection of AmfloraTM EH92-527-1 potato.
Results. Amflora transgenic potato was not detected in any of analyzed samples.
Conclusions. The results of real-time PCR method confirm the absence of Amflora event EH92-527-1 in all potato tubers and chips analyzed samples.

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The Role of Smoking in the Development of Colorectal Cancer

Dénes Márton István, Borz Cristian*, Török Árpád, Kántor Tibor, Nădășan Valentin, Csibi Mónika, Ábrám Zoltán

University of Medicine and Pharmacy Tirgu Mures, Romania

DOI: 10.1515/amma-2016-0046

Introduction. Smoking is an important public health issue nowadays. It causes a lot of diseases and represents also a source of carcinogenic substances. Recent studies showed an increased incidence of colorectal cancer in smokers. The aim of our study is to assess the association between smoking and colorectal cancer and to establish the prevalence of heavy smokers among the patients operated on for colorectal cancer.
Methodology. We run a retrospective study of the charts belonging to the patients diagnosed with colorectal cancer and operated on in our department between 2004 and 2013. The patients were classified in smokers, former smokers and nonsmokers. The amount of tobacco was evaluated according to the number of smoked cigarettes per day, the smoking period, respectively the pack-years. The data were corroborated with the location of the tumor and analyzed using the online version of Graphpad.
Results. From 982 patients diagnosed with colorectal cancer, we found 297 smokers (30.24%). Among these, 106 patients (35.69%) have smoked for over 30 years, at least 20 cigarettes per day, more than 30 pack-years. The number of heavy smokers was significantly greater (p=0.0001) in the group with rectal cancer compared to the group with colon cancer. The association of smoking with rectal cancer was also important (p=0.0015) among the former smokers.
Conclusions. Smoking is related to higher incidence of colorectal cancer. Our data sustain the hypothesis of increased risk of developing rectal cancer in heavy smokers. We recommend the screening for colorectal cancer among the heavy smoker population.

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Influence of General Anesthesia on Impulsivity and Learning Ability-Experimental Study

Sircuţa Carmen*, Veres Mihaly, Azamfirei Leonard

University of Medicine and Pharmacy Tirgu Mures, Romania

DOI: 10.1515/amma-2016-0045

Objective: To investigate the effect of anesthesia on rats’ ability of learning and over their impulsivity.
Material and Methods: We studied eight Wistar adult male rats, test and drug naive subjects. Animals were separated in two groups, group A and B with four members each. Group A included the anesthetized animals. The combination of ketamine, xylazine and piplophen in 2ml/kg body weight dosage was used and testing was done 24 hours after anesthesia. Group B was taken as control. The study was conducted using the ”Delay discounting” apparatus. Experiments assessing impulsive behavior were conducted using automated operant chambers, equipped with two nose-poke holes (holes where pellets of food were released). Rat’s answer was considered touching the nose-poke hole. One answer was rewarded with pellets of food of 45 mg each (small reward), while another hole released five pellets of 45 mg each (high reward). Both types of rewards were presented immediately after rat’s answer and were followed for a period of 25 seconds timeout. During the training phase, rats were placed in operant chambers 30 minutes per day, 5 consecutive days. The growing percent of preference for greater reward indicates learning.For the testing phase the procedure was similar, but a delay was introduced before the release of the big reward. During this phase, the preference for higher reward was indicative for non-impulsive behaviour.
Results: The results didn’t show significant statistically differences between the two groups.
Conclusions: Anesthesia had no effect on learning ability nor on impulsivity.

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Medical Staff’s Opinions Regarding Factors which Influence the Case Management of Children with Insulin-dependent Diabetes Mellitus

Lica Melania Maria1,4*, Jakab Zoltan2, Crainic Maria3,5, Mihai Adriana4,5

1 Clinical Psychology, Paediatric Department, Diabetic Children and Youth Association Mures, Romania
2 Mental Health Centre Tg Mures, Romania
3 University of Medicine and Pharmacy Iuliu Hatieganu, Cluj Napoca, Romania
4 Psychiatric Department, University of Medicine and Pharmacy Tirgu Mures, Romania
5 Institute of Psychotherapy and Personal Development, Tirgu Mures, Romania

DOI: 10.1515/amma-2016-0040

Insulin-dependent diabetes mellitus (IDDM) is a chronic disease with high incidence, especially in children, and for a better outcome the individual case management is required. The patient and his family can experience different levels of anxiety, with negative effects on disease evolution and prognosis.
Objectives: identify relevant factors which influence the case management of children with IDDM. The implementation of the results of this study will help to elaborate an efficient method of intervention for improving the treatment adherence and obtaining a better outcome of IDDM in children.
Methods: A semi-structured interview was done individually to 10 experts in diabetes for collecting their opinion concerning relevant factors that may influence treatment adherence and what are the characteristics of an efficient method of intervention.
Results: Majority of experts considered that the main factor which influences the outcome is doctor-patient relationship. The need of child, to feel that it is understood and protected, was considered that can directly motivate a better self-management and a good outcome. The increase of importance of individual resources of children with IDDM and accent on the quality of life of those children could be considered a starting point for creating a psychological clinic intervention in this field. The results were compared with scientific literature data.
Conclusions: understanding of the causes which have interfered negatively with therapeutic plan is a starting point for develop a clinical – psychological protocol for children with IDDM.

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Maternal Knowledge, Attitudes and Practices Regarding Dietary Fats

Nădășan Valentin*, Sîmpetrean Andreea, Tarcea Monica, Abram Zoltan

University of Medicine and Pharmacy of Tirgu Mures, Romania

DOI: 10.1515/amma-2016-0043

Objective: The purpose of the study was to assess the knowledge, attitudes, and behavior regarding dietary fats among mothers in Romania.
Material and methods: A sample of 305 mothers from Romania were included in a cross-sectional observational study. The online questionnaire addressed their knowledge, attitudes, and practices regarding the dietary fats used in their children’s diet. The frequencies and proportions of the collected variables were calculated based on respondents’ answers.
Results: While almost all the respondents (94.8%) believed that mothers are supposed to know the difference between saturated and unsaturated fats, only less than half of them (39.7%) stated that they know the difference. As far as the types of margarine, although more than half of the respondents (64.7%) believed that mothers should be able to discriminate between the hydrogenated and interesterified margarine, only 11.5% claimed that they are able to discern between them. The actual ability to identify foods rich in saturated fats varied in a great degree from item to item. More common dietary fats such as sunflower oil, corn oil, and lard, were more frequently identified than less common dietary fats such as coconut oil and palm oil. Only 16.4% of the mothers were able to correctly differentiate hydrogenated from interesterified margarine. The most frequently used spreadable fat used in the children’s diet was butter and the most frequently used cooking fats were sunflower oil, olive oil, and butter.
Conclusion: The results of this study might be informative in the development of maternal nutrition education programs.

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The Value of a Simplified Lung Ultrasound Protocol in the Pre-Discharge Evaluation of Patients Hospitalized with Acute Heart Failure

Frigy Attila, Kocsis Ildikó, Fehérvári Lajos, Szabó István Adorján*

University of Medicine and Pharmacy of Tirgu Mures, Romania

DOI: 10.1515/amma-2016-0039

Optimal timing of hospital discharge in patient with acute heart failure (AHF) is an important factor of preventing rehospitalizations.
Aim. To evaluate the value of a simplified lung ultrasound (LUS) protocol in assessing pre-discharge status of patients with AHF, correlating the US findings with the values of NT-proBNP levels.
Methods. 24 patients (18 men, 6 women, mean age 68,2 years) hospitalized with acute heart failure underwent LUS examination in the afternoon of the day before hospital discharge, applying a simplified LUS protocol, using three basal examination areas on the right side (anterior, lateral and posterior) and two basal examination areas on the left side (lateral and posterior). The LUS score was represented by the sum of B lines. In the next morning the value of NT-proBNP was also determined. The correlation between LUS findings and NT-proBNP values was analyzed using Fisher`s exact test (significant if alpha<0,05).
Results. 6 patients had <15 B lines, 16 patients had >15 B lines and 2 patients had pleural effusion on LUS, while 16 patients had the value of NT-proBNP >1000pg/ml at discharge. The results of LUS examination correlated significantly (p=0.0013) with the NT-proBNP values – only one patient not having increased NT-proBNP in the group with >15 B lines.
Conclusions. Despite a relatively good clinical status, the majority of patients had high NT-proBNP values at the time of hospital discharge. LUS proved to be a useful tool in identifying patients with subclinical congestion reflected also by the high NT-proBNP levels. These patients may need a prolongation of hospitalization and/or a more careful follow-up to prevent early readmission.

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Predictors of Postoperative Outcome in Patients with Lower Limb Surgical Revascularization

Carașca Cosmin1*, Carașca Emilian2, Ţilea Ioan³, Voidazan Septimiu4, Incze Alexandru2

1 Department of Forensic Medicine, University of Medicine and Pharmacy of Tîrgu-Mureş, Romania
2 Department of Internal Medicine, Tîrgu Mureș County Hospital, University of Medicine and Pharmacy of Tîrgu-Mureş, Romania
3 Cardiovascular Rehabilitation Clinic, Department M3 Family Medicine, Institute of Cardiovascular Diseases and Transplantation Tîrgu-Mures, Romania
4 Department of Epidemiology, University of Medicine and Pharmacy of Tîrgu-Mureş, Romania

DOI: 10.1515/amma-2016-0037

Objective: In patients with critical limb ischemia who undergone revascularization procedures, the assessment of risk factors that may affect the postoperative outcome is of great importance. The main objective in this study is to assess the utility of two specific risk scores, the Finnvasc score and the modified Prevent III score.
Methods: We evaluated the applicability of these two risk scores in 150 patients who undergone an unilateral infrainguinal surgical revascularization procedure. The receiver operating characteristic curve analysis was used to estimate the predictive value of the scoring methods. A comparison between the risk scores, determine the areas under the curve. Medium-term prediction ability was analyzed for both scoring methods.
Results: The area under the curve of Finnvasc score for predicting amputation was 0.739 (95%CI:0.661-0.807) and of the modified PIII score 0.713 (95%CI:0.633-0.784); for restenosis we obtained 0.528 (95%CI:0.444-0.611), respectively 0.529 (95%CI:0.445-0.612) and for thrombosis 0.628 (95%CI:0.544-0.706) and 0.556 (95%CI:0.472-0.638), demonstrating that the Finnvasc score performs better in overall prediction. Heart failure is a strong independent predictor of amputation (p=0.0001, OR=26.90; 95%CI:5.81-124.2), restenosis (p=0.0003, OR=4.80; 95%CI:1.96-11.8) and mortality (p=0.01, OR=7.16; 95%CI:1.33-38.52).
Conclusions: The accuracy of the two risk scoring methods in predicting the medium-term outcome of patients undergoing surgical infrainguinal revascularization is acceptable. The Finnvasc score is easier to be applied to the characteristics of our patients.

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