Category Archives: Original Research

The Prevalence of Supernumerary Teeth in a Group of Patients in Western Romania

Bratu Dana Cristina1, Bratu E2, Păcurar Mariana3, Popa G1, Pop Silvia3

1 Department of Paedodontics and Orthodontics, Faculty of Dentistry, “Victor Babes” University of Medicine and Pharmacy, Timişoara, Romania
2 Department of Implant Supported Restorations, Faculty of Dentistry, “Victor Babes” University of Medicine and Pharmacy, Timişoara, Romania
3 Department of Paedodontics and Orthodontics, Faculty of Dentistry, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Objective: The objective of this article is to study the types of supernumerary teeth and their prevalence in a group of patients in Western Romania.
Material and methods: The study group consisted of various patients, who attended the Department of Paedodontics and Orthodontics, Faculty of Dentistry, Timişoara, Romania. The number, location, classification, bilateral symmetry and impaction of supernumerary teeth were evaluated. Furthermore, we evaluated the development of these teeth and we also established the therapeutic decision for each clinical case. Final diagnosis was based upon clinical examination, occlusal radiographs, panoramic radiographs or cone beam CT.
Results: From a total of 700 examined patients, with mixed and permanent dentition aged between 6 and 13 years, 21 (3%) patients had supernumerary teeth. A total of 25 supernumerary teeth were recorded. The distribution of supernumerary teeth according to jaws showed a higher prevalence in the maxilla: 80% (n=20) were located in the upper jaw, while 20% (n=5) were found in the mandible. In the upper arch, the most frequent supernumerary teeth were the lateral incisors 45% (n=9), followed by the central incisors (mesiodentes) 35% (n=7). Smaller percentages were located in the premolar region 15% (n=3) and distomolar region 5% (n=1). The distribution of supernumerary teeth according to bilateral symmetry was 24% (n=6) bilaterally and 76% (n=19) unilaterally. Regarding their status, the majority of the supernumerary teeth, 96% (n=24) were erupted and only 4% (n=1) were impacted, being associated with the failure of eruption of the left central incisor. Tooth extraction was the treatment of choice in 100% of the cases. Most of the supernumerary teeth, 96% (n=24) were completely developed and only 4% (n=1) showed an incomplete root.
Conclusions: The prevalence of supernumerary teeth in this study was 3%. This result is comparable to similar studies in the literature, among Caucasians. Future research is required to evaluate a larger group of patients.

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The Use of Surgical Lasers in the Treatment of Oral Leukoplakia

Bögözi B1, Bocskay I2

1 Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Department of Odontology and Parodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

Introduction: Surgical lasers are more and more often used in our days in medicine, including oro-maxillo-facial surgery. Because of their many advantages the application of surgical lasers became the elective method in the surgical treatment of oral leukoplakia – according to the recomandation of the WHO.
Material and method: In this paper two clinical cases are presented showing the methods and advantages of using surgical lasers in the treatment of oral leukoplakia. For the surgery a 15 W maximum power Biolitec diode laser was used.
Results and conclusions: The ideal haemostasis during surgery; the shortened intervention (and through this the reduction of physical an psychological stress of the patient); minimal scar tissue formation; the unnecessity to cover sometimes important postoperative defects, reduced risk of dissemination of modified cells are such advantages of the use of surgical lasers, that eliminate the difficulties of classic surgical techniques and lead to spreading of a new concept in the surgical treatment of premalignant lesions of the oral mucosa.

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Clindamycin — an Option for Antibiotic Prophylaxis In Arthroplasty

Bod P, Kurtus I, Incze S, Moldovan Rodica, Vâlcu A, Nagy Ö

Orthopaedics and Traumatology Clinic, Emergency County Hospital, Tîrgu Mureş, România

Introduction: Generally joint arthroplasties, but especially hip arthroplasties, are perhaps the most widespread types of orthopedic surgeries. These types of interventions are special because of the possibility of bacterial complications occurring due to the implant.
Material and method: Between 2008–2009 a total of 48 patients were administered Clindamycin 600 mg iv, as antibiotic prophylaxis, specifying that administration was performed according to the international protocol. During follow-up we monitored the efficiency of perioperative antibiotic prophylaxis in patients by determining the C-reactive protein and the erythrocyte sedimentation rate.
Results: The patients’ postoperative evolution at the site of the surgical wound presented no complications, except two cases of wound dehiscence caused by superficial hematoma which were subsequently solved with a secondary suture.
Conclusions: Clindamycin is used for preventive purposes especially in those protocols where beta-lactam allergy occurs. Clindamycin can also be used instead of cephalosporins in perioperative antibiotic prophylaxis. Our results are in accordance with those met in the speciality literature.

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FLT3 Internal Tandem Duplication and D835 Mutations in Acute Myeloid Leukemia

Bănescu Claudia1, Dobreanu Minodora2, Duicu Carmen3, Benedek I4, Macarie I5, Köpeczi Judit4

1 Department of Genetics, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Department of Clinical Biochemistry, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
3 Pediatric Clinic, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
4 Hematology Clinic 2, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
5 Hematology Clinic 1, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

Introduction: FLT3 is a member of receptor tyrosine kinases expressed in leukemic cells. Internal tandem duplications (ITDs) and D835 mutations in FLT3 tyrosine kinase receptor have been shown to confer a bad prognosis in acute myeloid leukemia (AML). The aim of the present study was to determine the incidence of both ITD and D835 mutations in the FLT3 gene, in patients with AML from Tg-Mures, Romania.
Materials and methods: DNA was obtained from peripheral blood samples. ITDs were investigated by polymerase chain reaction (PCR). D835 mutations were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), with the digestion of restriction endonuclease EcoR V. The amplified and restricted products were finally electrophoresed on agarose gel stained with ethidium bromide.
Results: Alterations in the FLT3 gene were detected in 8 patients out of the 23 cases analyzed. These aberrations included ITD in 4 cases, D835 mutations in 2 cases and both types of alteration (ITD + D835) in 2 patients.
Conclusion: In this study we demonstrated that FLT3 mutations are frequent molecular abnormalities in AML patients with an incidence of 34.8%. Although our data do not support its value as a prognostic factor in AML patients because of the small cohort, further investigation is required.

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Extracranial Jugular Venous Insufficiency in Multiple Sclerosis Patients Treated with Interferon Beta

Bălaşa Rodica, Bajkó Z, Stan Camelia

First Neurological Department, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

Background: The term „vascular immunology” was created when recent studies have suggested that topographic perivenous pattern of demyelinated MS plaques may be caused by venous congestion. This condition termed as „chronic cerebrospinal venous insufficiency” has raised important issues. Our objective was to investigate the haemodinamics of the internal jugular vein (IJV) using extracranial Color-Doppler (ECD) sonography in MS patients treated with IFN-β.
Methods: 140 patients with MS (mean age: 41.1±9.2, mean EDSS: 2.73±1,96, 68.6 % RRMS and 31.4 % SPMS, mean relapses in the past 12 months: 0.43±0.61 with at least 18 months of IFN-β treatment as unique DMT, underwent ECD with detection of four parameters: A – reflux present in IJV; B – evidence of proximal IJV stenosis; C – flow not Doppler detectable in IJV; D – negative difference in the cross sectional area in IJV supine/sitting postures. We studied which criteria correlate significantly with EDSS, number of relapses, form of MS and time to initiation of therapy.
Results: Thirty patients (21.8 %) had at least 2 unilateral parameters present on IJV. This patients had significantly more frequent SPMS (p=0.02), higher EDSS (p=0.04) and started later IFN-β therapy (p=0.03). Taken separately, the number of parameters C+D correlates significantly with EDSS (p=0.04) and form of MS (p=0.01).
Conclusions: ECDS is non-invasive, repeatable, cost-effective and permits to investigate the cerebral venous outflow. The frequency of ECDS criteria in our patient group is significantly lower compared with the results published by Zamboni et al. The absence of IJV flow and negative difference in the cross sectional area in IJV supine/sitting postures correlates significantly with the patient’s clinical characteristics.

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Terephthaldiamides Class Synthesis. III. Synthesis of Some N-monosubstituted Terephthaldiamides

Avrigeanu Veronica1, Imre Silvia2, Mircia Eleonora1, Muntean Daniela-Lucia2

1 Departament of Organic Chemistry, Faculty of Pharmacy, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
2 Department of Drug Analysis, Faculty of Pharmacy, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Introduction: The aim of this experimental paper was the synthesis of some terephthaldiamides, with potential analgesic action.
Material and methods: The reaction consists of acilation of some primary amines, ethanolamine, allylamine, benzylamine, aniline and orthotoluidine, with terephthaloyl chloride. The purified synthesis products were analysed by thin-layer chromatography, mass, IR and UV spectrometry.
Results: The molecular structure of the obtained N-monosubstitute terephthaldiamides was confirmed by spectral analysis.
Conclusions: Five N-monosubstituted terephtaldiamides were synthesized in good yields by condensation of terephtha¬loyl chloride with primary amines.

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Determination of Valproic Acid in Human Plasma by High-Performance Liquid Chromatography with Mass Spectrometry Detection

Vancea Szende1, Imre Silvia1, Vari C1, Dogaru Maria Titica1, Muntean Daniela-Lucia1, Căldăraru Carmen2, Dogaru G2, Donáth-Nagy Gabriella1

1 Faculty of Pharmacy, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Faculty of Medicine, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Background: Free valproic acid is shows no characteristic absorption in the ultraviolet region (above 235 nm), therefore its direct quantification and also the quantification of the corresponding metabolites from human plasma has proven to be challenging. Aim: The aim of our study was to develop and validate an effective LC-MS method for the determination of valproic acid in human plasma without using solid phase extraction as sample preparation, with a short analysis time and high sensitivity.
Materials and methods: Valproic acid was analyzed on a reversed – phase column (Zorbax SB – C18, 100 mm x 3 mm I.D., 3.5 μm) under isocratic conditions using a mobile phase of a 40:60 (v/v) mixture of acetonitrile and 0.1% (v/v) acetic acid in water. The flow rate was 1 mL/min and the column temperature 45 ºC. In these chromatographic conditions, the retention time was 2.3 minute for valproic acid. The detection of the analyte was in single ion monitoring mode using a triple quadrupole mass spectrometer with electrospray negative ionization. The monitored ion was 143.1 m/z derived from 144.2 m/z valproic acid. The sample preparation was very simple and consisted in plasma protein precipitation from 0.2 mL plasma using 0.6 mL methanol.
Results: Calibration curves were generated over the range of 2–200 µg/mL with values for coefficient of determination greater than 0.996 and by using a weighted (1/x) quadratic regression. The values of precision and accuracy for valproic acid at quantification limit were less than 3.3% and 7.2%, for within- and between-run assays, respectively. The mean recovery of the analyte was 104%. Valproic acid samples demonstrated good short-term, post-preparative and freeze-thaw stability.
Conclusion: The method is very simple and allows obtaining a very good recovery of the analyte. The validated LC-MS/MS method could be applied to pharmacokinetics and therapeutic drug monitoring study regarding valproic acid in humans.

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Cerebral Haemodynamic Changes in Symptomatic Patent Ductus Arteriosus — Doppler Ultrasonographic Evaluation

Simon Márta, Cucerea Manuela, Gáll Zsuzsanna, Suciu Laura Maria

Clinic of Pediatrics IV, Department of Neonatology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

Objectives: Patent ductus arteriosus (PDA) is a relatively frequent finding in destressed newborns, especially premature infants. It’s importance is due to hemodynamic changes that take place in the systemic circulation, influencing cardiac output, and in cerebral blood flow due to blood steal at the level of the patent ductus. This can rise the risc of brain injury among infants with hemodynamically significant left to right shunting. Our goal was to evaluate transfonatnellar eco-Doppler appearance in these babies, interpreating measurements from the clinical point of view.
Materials and methods: We measured by transfontanellar ultrasonography the eco-Doppler parameters of cerebral blood flow (CBF) at the level of the Anterior Cerebral Artery (ACA) in 15 prematures with demonstrated haemodynamically significant ductus arteriosus, and compared the resuslts with normal values for the age measured in 30 healthy prematures with the same gestational age.
Results: We found in all infants with semnificative left to right shunt at the level of the PDA low levels of end-diastolic velocities, even negative values in 4 cases due to blood steal in the PDA. Later clinical symptoms showed a direct corelation with the grade of left-to-right shunt and cerebral cahnges.
Conclusions: Our results demonstrate the importance of monitoring the effects of PDA on CBF in the indication for medical or surgical closure of the ductus arteriosus, due to the correlation between the severity of the PDA and decrease of CBF, transfontanellar Doppler assessment being a usefull tool in centers where echocardiography is not available.

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Outcomes in High-risk Patients with Stable Coronary Artery Disease: Four-year Follow-up

Pretorian A1, Borda Angela2, Suciu C3, Pretorian Ana-Maria4, Dobreanu D5

1 Department of Cardiology, Municipal Hospital Gheorgheni, Romania
2 Department of Pathology, Faculty of Medicine, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
3 Department of Cardiology, Nova Vita Hospital, Tîrgu Mureş, Romania
4 Department of Cardiology, Municipal Hospital Gheorgheni
5 Department of Cardiology, County Emergency Clinical Hospital, Tîrgu Mureş, Romania

Introduction: In the past decades there were many studies that compared different therapeutic approaches in stable coronary artery disease. Since then major pharmacological and technical advances occurred on the management of stable angina. It is only in recent years that these advances were widely used. Given the above, the objective of our study was to evaluate the clinical outcome of high-risk patients with stable angina pectoris who received modern treatment — medical therapy, percutaneous revascularization or surgical revascularization.
Material and method: Study included 115 patients with stable coronary disease and high-risk criteria for major adverse cardiac events (MACEs) – left main or proximal left anterior descending artery stenosis > 50%, 2 or 3-vessel disease with impaired left ventricular function. Of these, 39 underwent percutaneous coronary intervention (PCI), 44 underwent coronary artery bypass grafting (CABG), both subgroups with optimal medical treatment (MT), and 32 received optimal MT alone. Primary outcomes were cardiac death and non-fatal myocardial infarction, and secondary outcomes were persistent disabling angina (quality of life) and the need for repeated revascularization. The follow-up period was 4 years.
Results: The primary outcome was 25.00% in the MT group, 5.12% in the PCI group and 4.54% in the CABG group (p=0.006). There was no statistically significant difference in primary events between PCI and CABG group (p=1.00), but the primary events were significantly higher in the MT group vs CABG group (p=0.014) and versus PCI group (p=0.03). Angina persists in 50.00% of patients in MT group versus 20.51% in the PCI group (p=0.01) and 9.09% in the CABG group (p=0.0001). There is no difference between the last two groups (p=0.21). In addition we found a tendency for increased repeated target vessel revascularization in the interventional group (15.38%) versus surgical group (2.27%) (p= 0.04). Drug eluting stents were used in 56.41% of cases.
Conclusions: All patients with stable coronary disease should receive modern medical treatment and aggressive risk factor reduction. Early coronarography represents an important step in risk stratification of these patients. Patients with extensive coronary disease, especially associated with impaired left ventricular function, or left main disease, benefit from CABG. Patients with less severe coronary disease may experience relief of symptoms after PCI, but repeated revascularization is often required.

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Schizophrenia Spectrum Disorders: Similarities and Differences of Social Cognition

Popovici Zs1, Lăzărescu M2, Ienciu Monica3, Bredicean Cristina4, Giurgi Oncu Cătălina5, Bărănescu Ramona5, Cristanovici Mădălina6

1 Psychiatry V, University of Medicine and Pharmacy, Timișoara, Romania
2 Psychiatry Clinic Timișoara, University of Medicine and Pharmacy, Timișoara, Romania
3 Psychiatry Clinic Timișoara, University of Medicine and Pharmacy, Timișoara, Romania
4 Psychiatry Clinic Timișoara, University of Medicine and Pharmacy, Timișoara, Romania
5 Psychiatry IV, University of Medicine and Pharmacy, Timișoara, Romania
6 Psychiatry I, University of Medicine and Pharmacy, Timișoara, Romania

Introduction: The term “social cognition” increased attention especially during the past 15–20 years, being considered a factor that could partly explain the deterioration of social functioning in persons suffering of psychosis. Social functioning represents one of the important domains for estimation the long-term evolution of schizophrenic spectrum disorders. The most important areas of social cognition are: emotion processing, theory of mind, social perception, social knowledge (social schema), and attributional style.
Material and method: In the present study we selected 63 subjects, hospitalized in Psychiatric Clinic of Timișoara between 1985–2005. They were divided into 3 samples of diagnosis according to ICD-10 criteria: A – subjects with schizophrenia, B – subjects with persistent delusional disorder and C – subjects diagnosed with schizoaffective disorder. Socio-demographic features were analyzed and the scales applied were BPRS (Brief Psychiatric Rating Scale) and SCRSP (Social Cognition Rating Scale for Psychosis).
Results: The study revealed deficit of social cognition in the 3 samples, with no significant statistical differences. Socio-demographic aspects are similar with other clinical studies.
Conclusions: deficit of social cognition is revealed both in persistent delusional disorder and in schizoaffective disorder, the highest deficit is detected in schizophrenia.

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