Category Archives: Original Research

Studies Concerning the Synthesis and Characterization of Hydroxyapatite Powder

Gurgui-Ionescu Cătălina1, Balosache Oana2, Mocanu Adriana2, Flori Cornelia2, Moga S.3, Ducu C.3,
Neamțu J.2

1 University of Craiova
2 University of Medicine and Pharmacy, Craiova
3 Research Centre for Advanced Materials, University of Pitesti

Introduction: Recently, a special attention was given to the growth of some biomaterials with the goal of renewal and/or reconstruction of bone tissue. Of these biomaterials, hydroxyapatite (HA) presents a series of properties such as biocompatibility and bioactivity, being frequently used for bone grafts realization and to cover some metallic components of some prosthesis used in orthopedics. Although HA is available on the market as synthetic material for more than 15 years, being used for ceramic implants for more than 10 years, new solutions are looked for the inclusion in its structure of some anionic or cationic substitutes in order to bring its composition closer to the biologic apatite.
Aim: The aim of this study was to synthetise and characterize hydroxyapatite powder.
Method: Of the synthesis methods of HA, we used the wet-precipitation method. The obtained compound using this method was characterized by X-ray diffraction (XRD), FTIR microspectroscopy and laser difractometry.
Results: The XRD spectra showed that the obtained material is HA and we managed to establish the optimum parameters for obtaining HA uncontaminated by impurities and crystalline.
Conclusions: Using a method of chemical synthesis through precipitation, we obtained a HA powder, crystalline and stoechiometric.

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The Role of Sonoelastography in the Differential Diagnosis of Breast Lesions

Gheonea Ioana1, Popescu Camelia2, Bondari A.1

1 Radiology and Imaging Department, University of Medicine and Pharmacy Craiova
2 ENT Department, Emergency Hospital Craiova

Background: Tissue elasticity imaging technology is expected to be a new modality for breast diagnosis, based on hardness as a tissue characteristic that is affected by tissue disease such as cancer.
Aim: To assess the value of sonoelastography in the differential diagnosis of breast lesions.
Patients and method: We included in this prospective study 59 patients diagnosed with breast lesions between January 2009 and January 2010. All the patients were examined in the supine position and the B mode ultrasound image was displayed alongside the elastography strain image. An EUS Hitachi EUB 8500 ultrasound system with an embedded elastography module (Hitachi Medical Systems Europe Holding AG, Zug, Switzerland) and a 6.5-MHz linear probe was used to obtain the B mode and elastography strain images. The elastography strain images were scored according to the Tsukuba elasticity score.
Results: For assessment of sonoelastography role in differential diagnosis of breast lesions, we performed ROC analysis, and we obtained a sensitivity of 89.7%, and a specificity of 92.9% (area under the ROC curve = 0.924, 95% CI = 0.822–0.977 and p = 0.0001).
Conclusions: Elastography is a fast, simple method which can complement the conventional US. Elastography is promising, and with future improvements in the technology, this imaging modality will become an invaluable tool for the diagnosis of breast diseases in the clinical setting.

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Depression and Quality of Life in Elderly Patients with Cluster C Personality Disorder

Echim Iulia1, Nireştean A.1,2, Toma Mirela1, Roșu Codruța1

1 Psychiatric Clinic No II, Târgu Mureş
2 University of Medicine and Pharmacy, Târgu Mureş

Introduction: Health-related quality of life (HRQoL) is an accepted outcome measure in patients with depression.
Aim: Our study aimed at assessing QoL in depressed elderly patients with cluster C PDs, admitted to Psychiatric Clinic No II Targu Mures. Cluster C PDs is the most frequent diagnosis on axis II for depression.
Material and method: A sample of thirty elderly in-patients with cluster C PDs and depression was studied. Mental disorders were assessed based on DSM IV criteria, Hamilton scale of depression and SCID II (structured clinical interview for DSM). QoL was assessed with the aid of the World Health Organization Quality of Life instrument (WHOQoL-Bref), and the Global Assessment of Functioning scale (GAF).
Results: We formed high co-morbidity among depression and cluster C PD, especially dependent PD, which was associated with poor QoL. The WHOQoL physical health and social functioning were significantly associated with GAF. Conclusion and Discussion: PD symptoms in elderly patients appear to operate as co-factor that amplify or exacerbate the impact of depression on long-term functioning and QoL. We conclude that if co-morbid personality disorder is not treated, patients will respond less well to treatment for depression than do those without PD.

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Medico-legal and Social Aspects of Mechanic Asphyxias

Hădăreanu V.1, David Ramona Eliza2

Forensic Medicine Discipline, University of Medicine and Pharmacy, Medical Biochemistry Discipline, University of Medicine and Pharmacy

Background: In the last years, in Mureş county there was ascertained a significant growth of deaths due to anoxias caused by violence.
Aim: This study is an assessment concerning the prevalence and incidence of mechanical asphyxia in Mures county over three years, from 2005 to 2007.
Methods: The study took place at the Forensic Medicine Institute, Tg. Mures, including the analysis of 1926 medico-legal necropsies, 434 cases being violent deaths caused by mechanical asphyxias like: hanging, drowning in water and asphyxia with food bolus.
Results: In the analyzed casuistry was found that there were prevalent the deaths caused by hanging (343 cases), these being followed by the drowning ones (84 cases) and then the mechanical asphyxias caused by food bolus (7 cases). Distribution by sex showed a predominance of deaths in males (352 cases) compared to females (82 cases). Depending on location, deaths in rural location were prevalent to the ones from the urban location.
Conclusions: Concerning mechanical asphyxias predominates the mechanical asphyxia by hanging, which also represents suicide method, the other 2 types of asphyxias (drowning in water and mechanical asphyxia caused by food bolus) being seldom. Death by drowning in water represents a rarer method of suicide and the accidental form is met more during the warm season. Asphyxia with food bolus is produced totally accidental in persons under alcohol influence or total edentate.

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Assessment of the Risk Factors for Deceased Patients in Pediatric Clinic I

Baghiu Despina Maria1, Man Lidia2, Marinescu Simona3, Man A.4

1 Pediatrics Clinic I, UMPh Tg.Mureş
2 Emergency County Hospital Tg.Mureş, Pediatric Clinic I
3 Emergency County Hospital Tg.Mureş, ICU Clinic
4 Microbiology Department, UMPh Tg.Mureş

Purpose: The evaluation of the risk factors in patients deceased in Pediatric Intensive Care Unit (PICU) during January 1 to December 31, 2009.
Material and method: This is a retrospective study in which we evaluated the risk factors of the 29 deceased patients admitted in PICU. We followed the age groups, gender, environment, prior treatments, number of hospitalization days, the patient flow, the associated comorbidities, the mothers’ age and the anatomico-pathological concordances.
Results: From all 29 deceased patients, 34.48% were between 3–12 months, the average age being 27.3 months. 79.31% came from rural areas. The number of deaths was almost equally distributed between sexes. Etiological, nosological, location-related and complication-related consistencies were found. The main cause of death was the respiratory disease. In the cold season, the number of deaths was increased. Most children were admitted in Pediatric Clinic I from other clinics, were hospitalized for more than 72 hours and presented at least one comorbidity.
Conclusions: The main risk factors that concluded in children’s death were: association with at least one comorbidity, the age group of less than 1 year, as well as the patient’s flow through multiple sections. The main cause of death was respiratory infection. Etiological, nosological, location-related and complication-related consistencies were present.

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Vascular Complications – Poor Prognostic Factors in Severe Acute Pancreatitis

Popa D1, Grigorescu Bianca2, Hoffner S1, Copotoiu C1

1 1st Clinic of Surgery, University of Medicine and Pharmacy of Tg. Mures, Tg. Mures Emergency County Hospital Mures
2 Clinic of Anesthesiology and Intensive Care, Tg. Mures Emergency County Hospital

Background: Various complications occur after the onset of acute pancreatitis. Aproximately 9–11% of the patients with severe acute pancreatitis may develop vascular complications such as haemorrhage, ischaemic visceral lessions, tromboses on the portal venous system and formation of aneurysms.
Aim: To determine the incidence of these complication and to analyze the therapeutic approach for these patients.
Method: We realized a retrospective study on 279 patients with severe acute pancreatitis (SAP), defined by the Atlanta criteria. In this group we annalized the incidence of vascular complications, the therapeutic methods for their solving and the risk for developing complications and mortality.
Results: The incidence of vascular events was 14.33%.Hemorrhagic complications had a higher incidence and were present in 32 patients (80%). Only 8 patients (20%) presented major ischaemic events. The most commonly involved organ in ischaemic lessions was the colon.
Conclusions: Vascular complications, although rare (leading to an increased morbidity and mortality), may jeopardize the patients’ life. Their diagnosis and treatement becomes possible only by the clinician vigilance on their potential occurence using modern investigative methods.

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Is Laparoscopic Appendectomy a Safe Procedure?

Maiershon-Simion I.¹, Ezri T.²,³, Dayan K.¹,³, Muggia-Sullam M.¹,³

1 Department of Surgery, E. Wolfson Medical Center, Holon, Israel
2 Department of Anesthesia, E. Wolfson Medical Center, Holon, Israel
3 The Sackler Faculty of Medicine, Tel-Aviv University

Background: Laparoscopic appendectomy (LA) is a common procedure, considered to be a safe alternative to conventional open appendectomy (OA). LA is known to reduce parietal scarring, offers a shortened hospital stay and an earlier return to normal activities. Acute gangrenous and perforated appendicitis may be associated with an increased risk for postoperative complications following laparoscopic appendectomy.
Objective: To determine the complication rate following LA.
Material and methods: Between January 2000 and November 2003, 323 consecutive emergency appendectomies were performed (311 LA, 5 OA and 7 conversions). A retrospective analysis of LA was performed with evaluation of complication rate (fever, pain, intra-abdominal infection or abscess and abdominal wall infection), duration of preceding symptoms, interval between admission and operation, length of the operation, whether the performing surgeon was a resident or a senior surgeon, and the length of hospital stay (LOS).
Results: Two hundred patients (64.3%) were males and mean age was 35 years. Mean waiting time for surgery was 9.4 hours, mean operating time 48 minutes and conversion rate was 2.2%; mean LOS was 3.05 days. Histology showed acute inflammation in 81% (acute appendicitis in 54.34%, phlegomonous appendicitis – 17.36%, perforated or gangrenous appendicitis – 9.00%). There was a 10.6% overall incidence of infectious complications, 9.64% of readmissions and mortality was 0.
Conclusions: It appears that in the current study, the overall complication rate following LA is higher than expected, and tends to be even higher for complicated appendicitis. This needs further evaluation.

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Sharing Responsibility Does Not Always Make Things Easier

Gabriel M. Gurman

Ben Gurion University of the Negev, Mayney Hayeshuah Medical Center, Israel

Positioning of the patient on the operating table is supposed to be a simple task for the operating room team (surgeon, anesthesiologist, circulating nurse and their aids): once anesthesia induction is performed,in the vast majority of cases in the supine position, and surgical procedure is known, it is simple to decide upon the position the patient during operation.
The main factor for deciding upon the position on the operating table is the need to assure an easy surgical access to the anatomic location of the procedure.
But positioning is sometimes accompanied by complications and most of them are related to nerve injuries.
About 15% of anesthetic malpractice claims in the USA refer to nerve injury during operation [1].
There are two main problems related to nerve injuries during surgery and anesthesia.
First is the fact that in most cases the anesthetized patient is unable to complain about pressure or lack of comfort on his or her limbs.
But the worrying aspect of nerve injury during surgery is that it may occur even when all the precautions have
been taken and the impression is that nothing has been left in order to assure a smooth surgical and anesthetic act. [More]

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Considerations Regarding the Antiinflammatory Action of Soy Total Extract Vs. Soy Isoflavonoid Daidzein on Animal Model

Țiulea Corina1, Peev C1, Feflea S1, Dehelean C2, Mureșan A3, Motoc A4

1 Department of Pharmacognosy, Faculty of Pharmacy, University of Medicine and Pharmacy Victor Babes, Timisoara
2 Department of Toxicology, Faculty of Pharmacy, University of Medicine and Pharmacy Victor Babes, Timisoara
3 Department of Morphopatology, Faculty of Medicine, University of Medicine and Pharmacy Victor Babes, Timisoara
4 Department of Anatomy, Faculty of Medicine, University of Medicine and Pharmacy Victor Babes, Timisoara

Introduction: The aim of this study is to investigate the anti-inflammatory action of daidzein on animal model a less studied isoflavone than genistein on this topic and to compare it’s anti-inflammatory activity with the one of soy total extract.
Material and method: Soybean seeds were grounded and a solvent formed of DMSO-ethanol-water in rapport 5-70-25 v/v/v was prepared. The extraction was made at room temperature using an ultrasonic bath (Falc LCD Series) for 30 minutes, 59 kHz. The solvent was evaporated with a rotary evaporator at 50 ºC. Daidzein was acquired from Extrasynthese (France).Animal studies were conducted on C57BL/6J female mice of 8 weeks. Edema was induced in both ears of each mouse by the topical application of 2 μg TPA dissolved in 20 μL of acetone to both the inner and outer ear surfaces. Thirty minutes after the application of TPA, the inner and outer surface of each ear was treated with 2 mg of soy total extract (group C) and 2 mg of daidzein (group D). Mice were killed after 24 h by cervical dislocation and ears were collected. Ears were weighed and histological analyze were made. For the histological analyze, tissue samples (skin) were fixed in 10% formalin solution and were embedded in paraffin and cut at 4 microns. Finally after deparaffinized the samples were stained with H&E (hematoxylin-eosin) and microscopically analyzed.
Results: The obtained results suggest that both of the samples used for the treatment are active agents against inflammation but with different empowering. Soy total extract is in charge of reducing the massive under epithelial inflammation with numerous granulocytes to a discrete under epithelial inflammatory infiltrate. Daidzein successfully reduced the massive under epithelial inflammation with numerous granulocytes to a discrete under epithelial edema.
Conclusion: Both daidzein and soy total extract present an anti-inflammatory action on animal model but daidzein is a better therapeutic choice since it has a stronger anti-inflammatory action.

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Multiple Sclerosis Brain Lesions: Is Short Tau Inversion Recovery Sequence Suitable in Magnetic Resonance Imaging Evaluation?

Treaba Constantina Andrada1, Buruian M1, Podeanu Maria Daniela1, Macavei I2, Simu IP1

1 Department of Radiology and Imaging, Emergency County Clinical Hospital, Faculty of Medicine, University of Medicine and Pharmacy Targu Mures
2 Department of Neurology, Emergency County Clinical Hospital, Faculty of Medicine, University of Medicine and Pharmacy Targu Mures

Purpose: To compare the sensitivity of Short Tau Inversion Recovery magnetic resonance sequence with Fast Spin-Echo T2-weighted and Fluid-Attenuated Inversion Recovery magnetic resonance sequences in detection and evaluation of multiple sclerosis brain lesions.
Material and method: Fast Spin-Echo T2-weighted, Fluid-Attenuated Inversion Recovery and Short Tau Inversion Recovery sequences were performed in 7 patients with relapsing remitting multiple sclerosis. Qualitative assessment, regarding the number of lesions detected, conspicuity and lesion location was performed on all images in each sequence by two radiologists. Consensus was reached by agreement.
Results: When comparing Short Tau Inversion Recovery sequences with Fast Spin-Echo sequences, Short Tau Inversion Recovery showed 51 lesions more than Fast Spin-Echo sequences and increased the number of lesions detected by 38% in posterior fossa and by 27% in juxtacortical locations. When comparing Short Tau Inversion Recovery sequences with Fluid-Attenuated Inversion Recovery sequences, Short Tau Inversion Recovery sequences showed 72 lesions more than Fluid-Attenuated Inversion Recovery sequences and increased the number of lesion detected by 86% in posterior fossa and by 24% in periventricular areas.
Conclusions: By increasing the sensitivity Short Tau Inversion Recovery sequence might be suitable as an additional sequence in routine magnetic resonance brain examinations in patients with multiple sclerosis. Although Short Tau Inversion Recovery provides essential supplementary information to conventional imaging for the visualization brain lesions in multiple sclerosis, especially in posterior fossa, it is not a substitute for other sequences.

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