Category Archives: Original Research

Particularities of Depressive Disorders Installed in Perimenopause

Crişan R, Gabos Grecu I, Buicu Gabriela, Ţăran Livia, Gaboş-Grecu Marieta, Nireştean A, Gliga Florina

University of Medicine and Pharmacy, Tg.Mures

Background: The risk of woman to present a depressive clinical picture increases in parallel with the approaching age of perimenopause.
Aim: The main purpose of the paper is to study correlations between symptoms of perimenoapuse and depressive episode occurance, taking into consideration the severity and the frequency of symptoms of perimenopause.
Material and methods: We have selected the cases by performing a screening to pacients with major depressive disorder, hospitalized in No. 1 Psychiatric Clinic, between 01.01.2007–31.12.2009.
Results: From the total patients admitted (1342) only 160 patients aged 34–55 years, voluntarily wanted to participate, representing 11.92% of all patients. Analyzing the severity of psychological symptoms we have obtained statistical significance in the age group 46–50 years: p = 0.0303. Analyzing the frequency of vasomotor symptoms by age group, we have obtained statistical significance in the age group 34–40 years: p = 0.006. Analyzing the frequency and severity of somatic symptoms by age groups, we have obtained statistical significance in the age group 34–40 years.
Conclusions: The rural environment proved to be a protective factor in the emergence of depressive disorders (P = 0.0189). Estimating the role of hormonal decline at patients aged over 40 years, helped us to understand that the emergence and evolution of clinical manifestations during perimenopause and menopause may be caused by fluctuations of central secretion of pituitary hormones and sex steroids.

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Issues on Malnutrition in Children with Cancer

Chinceșan Mihaela¹, Baghiu Despina¹, Mărginean Oana¹, Horváth Adrienne¹, Eșianu Andrea²

1 University of Medicine and Pharmacy of Tîrgu Mureș, Pediatric Clinic No 1
2 Emergency County Hospital Tîrgu Mureș, Pediatric Clinic No 1

Introduction: Malnutrition is present in a high percentage in children with cancer. It can be evaluated by anthropometric measurements and laboratory data.
Aims: 1. To determine the prevalence and severity of malnutrition at diagnosis in children with cancer. 2. To define the best modalities to assess nutritional status.
Material and methods: A prospective study was performed on 27 children hospitalized and diagnosed with various type of cancer in the Pediatric Clinic No.I Targu-Mures, between November 2009–January 2011. We evaluated anthropometric and biochemical parameters: weight, height, body mass index (BMI), middle-upper arm circumference (MUAC), triceps skin fold thickness (TSF), total protein, albumin, Insulin-like growth factor-1 (IGF-1). We divided patients into three categories depending on nutritional parameters: severely malnourished, risk of malnourished and adequately nourished. We correlated anthropometric parameters with biochemical parameters.
Results: Our group consisted of 20 males (74.04%) and 7 females (25.96%). Of the 27 children with cancer, 14 children were severely malnourished, 8 children were with risk of malnourished and only 5 children with normal nutritional status. At the onset of malignant disease, 16 patients (59.25%) had low serum protein values and 10 patients (37.03%) had low levels of serum albumin. IGF-1 was decreased in 18 children (66.66%). We found a good correlation, statistically significant between TSF and serum proteins (r = 0.41; p = 0.02), between TSF and IGF-1 (r = 0.44; p = 0.02), and between MUAC and IGF-1 (r = 0.39; p = 0.04).
Conclusions: 1. The prevalence of malnutrition in children with cancer is high. 2. Arm anthropometry in conjunction with serum protein and IGF-1 most accurately characterizing the nutritional status.

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Quantifying Human Enamel Erosion Caused By Freshly Squeezed Juices

Borş Andreea1, Fazakas Zita2, Molnar-Varlam Cristina1, Cămărăşan Alina1, Mucenic Simona1, Kerekes-
Máthé Bernadette¹, Székely Melinda1

1 Department of Morphology of Teeth and Dental Arches; Technology of Dental Prosthesis and Dental Materials, Faculty of Dentistry, University of Medicine and Pharmacy, Târgu-Mureş
2 Department of Biochemistry, University of Medicine and Pharmacy, Târgu-Mureş

Aims: The present in vitro study intended to investigate minimal erosive effects of different freshly squeezed fruit juices on human enamel during short time incubation by determination of calcium and phosphate dissolution.
Material and methods: Healthy adult human molars and premolars were cut in 160 blocks (5 mm x 6 mm x 2 mm) and divided randomly in sixteen groups of 10 samples each (n = 10). Each group was assigned for immersion at 37 oC in 5 ml juice, for different spot times 3, 6, 9 and 12 minutes, respectively. The freshly squeezed juices analyzed were orange juice, apple juice, orange mixed with carrot juice (1:1) and apple mixed with carrot juice (1:1). Amount of titratable acid and pH was measured for the tested solutions. Calcium and phosphate release were determined photometrically using VIS-UV/VIS spectrophotometer. ANOVA test compared the data generated (p < 0.05).
Results: The apple juice showing the lowest pH and a high value for buffering capacity had the most pronounced erosive effect. The orange juice was less erosive (p < 0.001). The least erosive was the orange mixed with carrots (1:1) (p < 0.001), which has the highest pH. The enamel demineralization increased when prolonging the immersion time (p < 0.0001).
Conclusions: All freshly squeezed juices caused the dissolution of calcium and phosphate in human enamel. Erosive capacity is mainly determined by pH and to a lesser extent by the buffering capacity. The amount of demineralization is directly correlated with the exposure time. Absorption spectroscopy allows detection of very small mineral loss using standardised human enamel samples.

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Clinical Presentation and Precipitating Factors for Acute Heart Failure Hospitalization

Baricz Emőke, Szakács O, Toma L, Szabados Cs, Baricz J, Gyalai Zs, Carașca E

Cardiology Department, Internal Medicine Clinic, Faculty of Medicine,University of Medicine and Pharmacy, Târgu Mureș

Introduction: Acute heart failure syndromes are the most common cause of hospitalization in patients over 65 year. The number of hospitalizations for heart failure has tripled over the last three decades and it is expected to grow further.
Matherials and methods: We followed 390 patients, with an average age of 69.2 yrs, admitted in the Cardiology Department of Internal Medicine Clinic IV of Târgu Mureș, from January 2009 till January 2010 for treatment of the acute heart failure. The aim of this study was the analization of the clinical presentation and the precipitating factors of the heart failure at these patients.
Results and discussions: The most common clinical presentation at this category of patients is decompensated heart failure (peripherial oedema/congestion). In this particular case over two thirds of patients have history of heart failure (p < 0.0001). Hypertensive heart failure is a common finding in the novo cases (p = 0.0004). Cardiogenic shock is relatively rare form at this group but with very high hospital mortality. The most common trigger is infection, that frequently causes acute heart failure syndromes, mostly right heart failure in patients with pulmonary cardiopathy (p < 0.003). It is the most frequently identified trigger, both, in worsening chronic heart failure (p = 0.0002) and de novo heart failure group (p = 0.251).
Conclusions: The prevalence of triggers varies considerably depending on the target population, but infections, arrhythmias, elevated blood pressure and non-compliance remain frequent causes of acute heart failure syndromes.

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The von Meyenburg Complexes

Turdean S1, Turcu M3, Varga AF1, Unguraş Dana1, Moldovan C4, Sin Anca2

1 “Gheorghe Marinescu” Municipal Hospital, Târnăveni
2 University of Medicine and Pharmacy of Tîrgu Mureș, Department of Cellular and Molecular Biology
3 University of Medicine and Pharmacy of Tîrgu Mureș, Department of Pathology
4 University of Medicine and Pharmacy of Tîrgu Mureș, Department of Histology

Background: Biliary duct hamartomas (the von Meyenburg complexes) is a rare malformation of the hepatic ductal plates usually discovered incidentally during surgery or autopsy.
Case presentation: We present the case of a 66 year-old man who presented symptoms suggestive of a biliary colic. Following an open surgical biopsy from the liver, the sample obtained underwent classic Hematoxylin-Eosin, as well as histochemical and immunohistochemical stains, which allowed establishing the diagnosis of biliary duct hamartoma, using macro- and microscopical criteria (well-defined, subcapsular hepatic lesions and no nuclear atypia).
Conclusion: The recognition of this particular lesion is important due to its macroscopic and microscopic resemblance to multiple liver metastases and other types of multicentric subcapsular hepatic lesions. The mandatory technique in order to diagnose this rare type of hepato-biliary lesion remains the histopathological examination.

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Eco Doppler Investigation of Utero-placental Circulation in High-risk Pregnancies

Túrós J, Szabó B, Puşcaşiu L, Kiss Sz, Bereczky Lujza-Katalin, Rozsnyai F

Emergency Clinical Hospital of Tîrgu Mureș, Obstetrics and Gynecology Clinic I

Introduction: Inadequate trophoblastic invasion of spiral arteries is associated with intrauterine growth retardation, pregnancy induced hypertension, preeclampsia, and abruptio placentae. The ability to accurately identify pregnant women who will develop these complications is limited. Predictive tests are further challenged by difficulty in the timing of the measurements, because the structural and biochemical characteristics of the placenta change with increasing gestational age. Improvements in ultrasound technology provide potentially useful novel tools for evaluating placental structure.
Aim of our study: To develop methods for early screening of high-risk pregnancies (studying the circulation in the utero-placental arteries — impedance to flow).
Material and methods: We have followed-up pregnant women in their first and second trimesters, who presented for pregnancy care in our unit. Results were calculated using Student-test and Chi-test (for the presence or absence of prothodiastholic notch). Results: Impedance to flow and the frequency of the prothodiastholic notch decrease in the uterine arteries with the evolution of pregnancy. Changes in the resistance of uterine arteries during pregnancy show different patterns in certain obstetrical risk groups: obesity, smoking in pregnancy, uterus with previous interventions (scar from C-section) with the placenta on the anterior wall, pregnancies with „Vanishing Twin Syndrome”. In these groups we noticed a greater resistance in the uterine arteries.
Conclusions: These pregnancies should have an intensified follow-up.

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The Results of Allogeneic Stem Cell Transplantation in CML — the Experience of BMT Unit Tîrgu Mureş

Tunyogi Aliz-Beáta1, Benedek I2, Benedek Erzsébet1, Köpeczi Judit Beáta1, Kakucs Enikő1, Istrati Monica1

1 County Emergency Clinical Hospital Tîrgu Mureș, Clinical Hematology and BMT Unit
2 University of Medicine and Pharmacy of Tîrgu Mureș

Introduction: Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder the molecular hallmark of the disease is the BCR-ABL gene rearrangement which occurs as the result of a reciprocal translocation between chromosomes 9 and 22. Imatinib, a small molecule, tyrosine kinase inhibitor (TKI) was the first drug that targeted BCR-ABL. Since the introduction of the first and second generation of TKI the role of allogeneic stem cell transplantation in chronic myeloid leukemia is being reevaluated. With this retrospective analysis our aim was to define the role of allogeneic stem cell transplantation for CML in the tyrosine kinase inhibitor era. The following is a general overview of the role of ASCT in the management of CML.
Material and methods: At the BMT Unit Tîrgu Mureș between 2005–2009 we performed five allogeneic transplantations of high risk CML patients with identical sibling donors.
Results: Two of the patients are at present in complete hematologic and cytogenetic remission with no or minimal immunosuppressive therapy after 6 and respectively 3 years of follow up time. Two of the patients had disease free survival but died from infectious complications appeared in the 3rd and 6th month after the allogeneic stem cell transplantation. One patient had an early relapse with treatment refractory disease and died from the evolution of the disease.
Conclusions: We perform allogeneic stem cell transplantation only in the cases in which we have resistance to first and second generation of tyrosine kinase inhibitors (TKI), intolerance to TKI and if we have a suitable donor.

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A Study Upon the Dissolution Properties of Bifonazole Through Complexation with Cyclodextrins

Trandafirescu Cristina1, Gyéresi Á2, Szabadai Z3, Sbârcea Laura1, Pătruţescu Cristina1, Kata M4, Aigner Z4

1 Victor Babeş University of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Chemistry, Timişoara
2 University of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Chemistry, Tîrgu Mureș
3 Victor Babeş University of Medicine and Pharmacy, Faculty of Pharmacy, Department of Drug Analysis, Timişoara
4 University of Szeged, Faculty of Pharmacy, Department of Pharmaceutical Technology, Szeged, Hungary

Introduction: The aim of this study is to characterize the interaction in solution between the antimycotic bifonazole and two cyclodextrins: random methyl-beta-cyclodextrin and beta-cyclodextrin.
Material and method: The interaction in solution between bifonazole and random methyl-beta-cyclodextrin/beta-cyclodextrin was characterized using dissolution studies and phase solubility studies. The dissolution of bifonazole was characterized through the index of the rate of dissolution and the dissolution efficiency, and from the phase solubility study we calculated the apparent stability constant of the complex.
Results: The bifonazole – random methyl beta-cyclodextrin binary systems revealed better dissolution properties as compared to bifonazole alone, and to the bifonazole – beta-cyclodextrin binary systems. The phase solubility studies revealed the formation of soluble complexes in the cyclodextrin concentration range, and an apparent stability constant of 17956 M-1 for bifonazole – random methyl-beta-cyclodextrin complex, and of 873 M-1 for bifonazole – beta-cyclodextrin complex.
Discussions: The dissolution studies and the phase solubility studies demonstrated an improvement of the wettability of the particles of bifonazole, due to a better contact between bifonazole and cyclodextrin, and the formation of soluble complexes in the dissolution medium.
Conclusions: The complexation with cyclodextrins determined the increase in the dissolution properties of bifonazole. The best results were obtained with random methyl-beta-cyclodextrin, which demonstrates a better interaction within the components in the liquid medium and the better solubilization properties of this cyclodextrin.

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Stem Cells Harvest from Volunteer Donors

Tănase Alina1, Berteanu Cristina2, Călugăroiu Carmen1, Marculescu Alexandra1, Copotoiu Sanda-Maria3, Brânzaniuc Klara3, Azamfirei L3, Cirstoiu C2, Stoica Maria4, Cernea Daniela4, Stoica GA4, Rosin A5

1 Fundeni Bone Marrow Transplant Center Fundeni
2 Bucharest Emergency University Hospital
3 University of Medicine and Pharmacy of Tîrgu Mureș
4 Craiova Emergency University Hospital
5 Bucharest Institute of Haematology

Background: Over the last several decades allogeneic hematopoietic cell transplantation (HCT) has emerged as an important therapeutic option for a number of malignant and non-malignant conditions. The collection of hematopoietic stem cells mobilized from the bone marrow into the bloodstream of healthy donors has now become a routine procedure throughout the world.
Materials and methods: A number of 86 procedures of hematopoietic stem cells (HSC) harvest and cryopreservation from 64 volunteer donors, 54 adults (28 women and 26 men) and 10 children (5 girls and 5 boys) with ages between 6–66 years (on ave-rage 30.5) were carried out in the Bone Marrow Transplant Center from Clinical Institute Fundeni, Bucharest.
Results and discussions: HSC mobilization was achieved for all the 64 volunteer donors by administration of Filgastrim, on an average 8.4 mcg/donor weight (limits: 5–16.64 mcg/donor weight), leukapheresis procedure being realized in day +5 of Filgastrim administration.
Conclusions: In conclusion, a healthy volunteer donor, will undergo in most cases 4 or 5 days of Filgastrim administration. The WBC and the number of CD34+ cells from the periphe-ral blood will be counted beginning with the 4th day. When the number of CD34+ cells from peripheral blood will reach a certain level (usually on the 4th or 5th day), the vo-lunteer donor will be sent to the apheresis unit for harvesting stem cells.

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Aspects of Suicide in Schizophrenia

Sălcudean Andreea1, Gaboș-Grecu I1,2, Buicu Gabriela2, Nireştean A1, Hădărean V2, Moica Th1, Pașca Maria1

1 Psychiatric Clinic 1, Tîrgu Mureș
2 University of Medicine and Pharmacy of Tîrgu Mureș

Introduction: In the literature, autolytic risk in patients with schizophrenia was estimated at 10–40%, and up to 50% in studies that also refer to patients with schizoaffective disorders.
Purpose: To find the risk factors of suicide in this specific group of patients with schizophrenia who comitted suicide.
Material and methods: A retrospective study made on 53 patients with typical history of schizophrenia, who committed suicide in the 2000–2009 period.
Results and discussions: Of the 794 investigated suicide cases, 53 were patients with schizophrenia (6.7%), 54.7% were between 15–30 years and 66% were male. Marital status seems to play a major role in suicide genesis, 72.7% of the subjects being either unmarried, divorced, separated or widowed. Alcohol consumption was present in 26.1% of cases and smoking in 32.2% of cases.
Conclusions: Although the number of studied cases is too small to draw relevant conclusions, our study indicates that male gender, young age, unmarried status and rural origin act as risk factors for committing suicide.

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