Category Archives: Original Research

Precursor Synthesis of Some New Macrocyclic Compounds

DOI: 10.1515/amma-2017-0005

Objective: Development of new electronic devices with applications in computer science as well as new medical devices pushed the researcher to find new technologies. Based on those new techniques we have designed and synthesized compounds with possible application in the field of advanced materials.
Material and method: Compounds were analyzed by TLC and NMR. Routine 1H NMR (250 MHz) spectra were recorded at room temperature in deuterated acetone, unless stated otherwise. Thin-layer chromatography (TLC) was carried out on aluminum sheets coated with silicagel 60 F254 Merck TLC plates.
Results: Starting from commercial available compounds intermediates were obtained in a good yield. 4,4′-(2,4,8,10-tetraoxaspiro[5.5]undecane-3,9-diyl)diphenol was obtained starting from pentaerythritol and p-hydroxy-benzaldehyde in the presence of catalytic amounts of APTS (p-toluensulfonic acid). The product was purified by recrystallization and characterized by NMR spectroscopy. The structure exhibit 2 different signals for equatorial and axial position. Furthermore di, tri and tetra ethylene glycol were obtained by microwave assisted synthesis in a matter of minutes. Compounds were separated by recrystallization.
Conclusions: In conclusion, several intermediates were synthesized and characterized from spectroscopic point of view. Further analyses should be carried out and the compounds should be tested as advanced materials.

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Kinetics and Mechanism of Drug Release from Loratadine Orodispersible Tablets Developed without Lactose

DOI: 10.1515/amma-2017-0004

Objective: The aim of this study is to develop lactose-free orodispersible tablets with loratadine for patients with lactose intolerance.
Materials and methods: Seven compositions (F1-F7) of 10 mg loratadine were prepared in form of orally disintegrating tablets, by direct compression, using croscarmellose sodium and pre-gelatinized starch in various concentrations as superdisintegrants, diluted with microcrystalline cellulose and combined with mannitol and maltodextrin as binder agents. The tablets had been studied in terms of their pharmacotechnical characteristics, by determining: the weight uniformity of the tablets, their friability, breaking strength and disintegration time, drug content and the dissolution profile of loratadine. The statistical analyses were performed with GraphPad Prism Software Inc. As dependent variables, both the hardness of the tablets and their disintegration ability differ between batches due to their compositional differences (as independent variables). DDSolver were used for modeling the kinetic of the dissolution processes by fitting the dissolution profiles with time-dependent equations (Zero-order, First-order, Higuchi, Korsmeyer-Peppas, Peppas-Sahlin).
Results: All proposed formulas shows rapid disintegration, in less than 15 seconds, and the dissolution loratadine spans a period of about 10 minutes. Akaike index as well as R2 adjusted parameter have demonstrated that the studied dissolution profiles are the best fitted by Zero-order kinetic.
Conclusion: In conclusion, association of croscarmellose sodium (7.5%) with pre-gelatinized starch (6%) as superdisintegrants and mannitol as the binder agent (35%), positively influences the dissolution properties of loratadine from orally fast dispersible tablets.

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Characteristics of Sleep Apnea Assessed Before Discharge in Patients Hospitalized with Acute Heart Failure

DOI: 10.1515/amma-2017-0003

Objectives. Evaluation of the characteristics of sleep apnea (SA) in patients hospitalized with acute heart failure, considering that undiagnosed SA could contribute to early rehospitalization.
Methods. 56 consecutive patients (13 women, 43 men, mean age 63.12 years) with acute heart failure, in stable condition, underwent nocturnal polygraphy before hospital discharge. The type and severity of SA was determined. Besides descriptive statistics, correlations between the severity of SA and clinical and paraclinical characteristics were also analyzed (t-test, chi-square test, significancy at alpha < 0.05).
Results. 12 (21.4%) subjects were free of SA (AHI – apnea-hipopnea index <5/h), 15 (26.7%) had mild SA (AHI=5-14/h), 17 (30.3%) had moderate SA (AHI 15-30/h), and 12 (21.4 %) had severe SA (AHI>30/h). The apnea was predominantly obstructive (32 cases vs. 12 with central SA). Comparing the patients with mild or no SA with those with severe SA, we did not find statistically significant correlations (p>0.05) between the severity of SA and the majority of main clinical and paraclinical characteristics – age, sex, BMI, cardiac substrates of heart failure, comorbidities. Paradoxically, arterial hypertension (p=0.028) and atrial fibrillation (p=0.041) were significantly more prevalent in the group with mild or no SA.
Conclusions. Before discharge, in the majority of patients hospitalized with acute heart failure moderate and severe SA is present, and is not related to the majority of patient related factors. Finding of significant SA in this setting is important, because its therapy could play an important role in preventing readmissions and improving prognosis.

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The Prevalence of Dysphotopsia in Patients with Recent Cataract Surgery

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

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

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

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

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

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

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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