Category Archives: Original Research

Course and Stability Diagnosis over Time in Functional Psychosis

Durla Anca1, Lăzărescu M2, Ienciu Monica2, Bredicean Cristina2,3, Papava I2,3, Popovici Z4, Cristanovici Madalina4

1 Mental Health Center, Satu-Mare, Romania
2 Department of Psychiatry, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania
3 Mara Institute, Timișoara, Romania
4 Timișoara Psychiatric Clinic, Timișoara, Romania

Introduction: Diagnosis stability and clinical course of functional psychoses are complex phenomena and represent an important aspect for clinical practice and research. Diagnosis stability is the degree to which a diagnosis remains constant between a baseline and a follow-up subjects assessments.
Material and method: This work is part of a project developed in Timisoara Psychiatric Clinic (PTTEP) starting with 1985 and is a longitudinal study of functional psychosis. Subjects (59) were selected based on inclusion criteria. The following parameters were analyzed: socio-demographic characteristics of each subject, the average duration of evolution, diagnosis of the first episode of psychosis and diagnosis after 5 and 10 years of evolution.
Results: Sample study analysis shows that most subjects have changed their diagnosis after a period of between 5 to 8 years after the first episode of psychosis. Usually, after a period of about 10 years since the first episode of psychosis the diagnosis remains stable with the appearance of the same kind of episodes. It can be noticed that the most stable diagnosis was of delusional disorder followed by schizophrenia. On the opposite side – the most unstable diagnosis was of acute and transient psychotic disorder.
Conclusion: The clinical diagnosis changes during the first 5 to 7 years of evolution after the first episode of psychosis and becomes stable after about 10 years.

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Evaluation of the Presence of Volatile Organic Compounds in the Outdoor Air in Tîrgu Mureş

Croitoru MD, Ţepeş Veronica, Kincses Ajtay Mária, Fülöp Ibolya

Department of Toxicology and Biopharmacy, Faculty of Pharmacy, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Objectives: Many toxic compounds are present in automobiles exhaust gases. Concentration of these compounds is markedly increased when a defective engine is running. Presence of exhaust gases was linked with asthma, neurotoxicity, cancer and other serious health hazards. The goal of this work was to measure the concentration of volatile organic compounds that are present in the atmosphere when a defective vehicle passes by.
Methods: A head space gas chromatographic technique coupled with flame ionization detection was used to measure total concentration of volatile organic compounds into the air.
Results: Unexpectedly high concentrations of volatile organic compounds, up to 1.04 mg C/L of air, were measured in outdoor air. Every day high number of children is passing through these tested areas when they go to school or back home from school being exposed to such high concentrations of pollutants.
Conclusions: Faulty cars are the major source of volatile organic compounds and children can be affected by exposure to peak concentrations of such substances.

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Anthropometric Assessment of Children with Malignant Disease

Chinceșan Mihaela¹, Baghiu Despina¹, Grama Alina¹, Urtila Patricia², Răduț Ioana³

1 Pediatric Clinic No. I, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
² Louis Țurcanu Pediatric Clinic No. III, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania
³ Student, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Introduction: The nutritional evaluation of the children with cancer includes medical history, physical examination, anthropometric measurement and laboratory data.
Objective: To assess the anthropometric parameters in children with malignant disease compared to children with a non-oncologic disease.
Material and method: A prospective study was performed on 73 children hospitalized in the Pediatric Clinic I Tg. Mures, between November 2009 – January 2011. The children were divided into two groups: group 1, children with malignant disease (27 children) and group 2-control group, children with different pediatric disease (46 children). Anthropometric measurements: weight, height, body mass index, middle upper arm circumference, tricipital skin fold thickness were performed. The values of parameters were converted in Z score for age and sex using Switzerland Growth Chart 1989. We studied the anthropometric parameters compared to the two groups and performed statistical correlations.
Results: We observed a low weight at group I (-0.86 SD), but not in group II (0.2 SD), with a statistically significant difference p=0.002. The height of children in group I was much lower (-0.74 SD) from group II (0.4 SD) with p=0.0019. We also found a statistically significant difference among the anthropometric parameters of the arm: middle upper arm circumference (-1.5 SD versus -0.55 SD) with p=0.0311 and tricipital skin fold thickness (-1.22 SD versus -0.32 SD) with p=0.0093.
Conclusions: Weight, height, MUAC and TSF are significantly lower at children with cancer compared to children with nononcological diseases. The arms anthropometry better identify malnutrition in children with cancer than simply assessing weight or height measurements.

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Use of Dentifrices and Fluoride Supplements by Preschool Children – a Pilot Study

Cămărăşan Alina1, Székely Melinda1, Borş Andreea1, Mucenic Simona1, Kerekes-Máthé Bernadette¹, Cerghizan Diana2

1 Department of Morphology of Teeth and Dental Arches; Technology of Dental Prosthesis and Dental Materials, Faculty of Dental Medicine, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Department of Prosthetic Dentistry and Oral Rehabilitation, Faculty of Dental Medicine, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

Aim: The purpose of this pilot study was to collect information about tooth brushing habits of preschool children in Targu-Mures and to identify the usage of fluoride (F) supplements.
Material and methods: A structured questionnaire was completed by the parents of 81 children aged 3 to 6 years (37 girls and 44 boys) regarding the tooth cleaning habits of their children and use of F supplements. Chi-square test for independence and trend was used to determine the relation between age of children and quantity of toothpaste used and frequency of tooth brushing, respectively.
Results: All parents claimed that fluoride dentifrices were used and tooth brushing of children was supervised. 24.69% of the children have started tooth brushing before the age of 2 years. Most of the children brushed their teeth at least twice a day (59.25%) and used more than an optimal amount of toothpaste (60.49%). A statistically significant association between children’s age and amount of dentifrice used (p = 0.0496) and also a significant linear trend (p = 0.0216) was found. We also found a significant association (p = 0.0246) and a significant linear trend (p = 0.0029) between the age of children and frequency of tooth brushing. Only 13.58% of the children received F supplements.
Conclusion: Special attention should be given to the amount of toothpaste used by children younger than 6 years in order to avoid uncontrolled fluoride ingestion. Before administration of F supplements, the fluoride intake from other sources should be investigated.

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Family Insertion in Endogenous Psychoses

Bărănescu Ramona1, Lăzărescu M1,2, Ienciu Monica1,2, Bredicean Cristina1,2, Giurgi-Oncu Cătălina1, Mihalcea Roxana1, Popovici Z1

1 Eduard Pamfil Psychiatric Clinic, Timişoara, Romania
2 Department of Psychiatry,Victor Babeş University of Medicine and Pharmacy, Timişoara, Romania

Background: This paper is an early study of a larger project conducted in Psychiatric Clinic Timişoara which aims to provide new light on family insertion of patients with endogenous psychosis. The purpose of the paper is to analyze patients diagnosed with endogenous psychosis by socio-demographic and psychopathological parameters with emphasis on family, regarding three dimensions (family of origin, their own family and their offspring).
Material and methods: The study is based on 4 groups of patients known as group A (which includes patients diagnosed with schizophrenia), group B (patients diagnosed with schizoaffective disorder), group C (patients with persistent delusional disorder) and group D (which includes patients with a diagnosis of bipolar disorder).
Results: There were no significant differences related to psychiatric history in family of origin. Patients with schizophrenia and schizoaffective disorder rarely found a family, and their fertility is less compared to other forms of psychosis. Most endogenous psychosis women are married, and the family stability is higher among men with schizophrenia and schizoaffective disorder. More frequent own family occurrence in patients with endogenous psychosis is correlated with average age of 33 years, high school education and employment status. Social and family inclusion is increased in the patients with bipolar affective disorder.
Conclusions: There are differences between groups of endogenous psychoses, both in terms of socio-demographic characteristics, their correlation to family insertion and to their own family and offspring of psychotic patients.

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Acute Kidney Injury after Cardiac Surgery

Balos S1, Kovács Judit2, Szabó Kincső3, Sebestyén A3, Balos Monica2

1 Clinic of Cardiovascular Surgery, County Emergency Clinical Hospital, Tîrgu Mureș, Romania
2 Department of Anesthesia Intensive Care and Emergency Medicine, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
3 County Emergency Clinical Hospital, Tîrgu Mureș, Romania

Background: Renal dysfunction is one of the most common complications after cardiac surgery. The major concern is that despite advances in bypass techniques, intensive care and delivery of hemodialysis, mortality and morbidity associated with renal failure have not markedly changed in the last decade. The purpose of this work was to study the incidence of renal dysfunction after cardiac surgery, analyzing the possible causes, associated risk factors and treatment methods used.
Material and methods: In this prospective observational study we analyzed patients undergoing open-heart surgery between October 1, 2010 – December 15, 2010 at the Clinic of Cardiac Surgery Târgu Mureș. Blood urea nitrogen and creatinine level were recorded for all patients before and after surgery, patients age, sex, type of surgical intervention, length of cardiopulmonary bypass, and the degree of intraoperative hypothermia, hemodilution and postoperative hemodynamic function were noted.
Results: In this period 89 patients underwent cardiac surgery. Renal dysfunction developed in 20.2% of the patients and was more common in patients with complex surgery with prolonged cardiopulmonary bypass (p<0.0167), in patients with intraoperative hemodynamic instability. Other intraoperative factors, such as hemoglobin level lower than 8 g/dl (p=0.0103), postoperative hemodynamic dysfunction and use of vasoconstrictor agents also influenced the development of renal dysfunction.
Conclusions. Cardiac surgery is associated with a relative high incidence of renal dysfunction. Risk factors for this syndrome are varied and involve hemodynamic and inflammatory changes, but factors such as the body temperature and hemoglobin level during extracorporeal circulation could have a significant contribution.

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Immunomorphometric Study of E-caderin Expression in Malignant Skin Tumors

Varo Eniko1, Egyed-Zsigmond I2

1 PhD student, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
2 Department of Pathology, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Objective: Cadherins are transmembrane glycoprotein molecules, which interact with the cytoskeleton and their role is in cell recognition, tissue morphogenesis and tumor suppression. Our aim is to evaluate cell adhesion behavior in the main forms of skin cancer.
Methods: Between 2003–2007, we made a retrospective study on 150 cases of skin biopsies of basal cell, squamous cell carcinomas and malignant melanomas. In the Laboratory of Pathology of the Clinical Emergency County Hospital Tîrgu Mureș, the formalin-fixed paraffin-embedded tumoral tissues were studied with immunohistochemical (for E-cadherin) and morphometrical methods using a digital technique and statistical evaluation.
Results: Average percentages of immunopositive areas (APMIS) were obtained for both basal cell and squamous cell carcinomas, as well as for malignant melanoma. We showed a rising percentage of disorganization in the cell membrane, with decreased APMIS values, with the increasing degree of tumor malignancy evidenced by immunohistochemical reaction of cadherins.
Conclusion: Cell adhesion decreases with increasing malignancy in all three studied malignant tumors, especially in malignant melanomas.

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Nutritional Status Assesment in Overweight and Obese Children

Pitea Ana Maria, Baghiu Maria Despina, Mărginean Oana, Eșianu Andreea

Pediactrics Clinic 1, Faculty of Medicine, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Background: Obesity represents the abnormal/excessive accumulation of fat in adipose tissue. Anthropometry takes a person’s body measurements, especially for use on a comparison or classification basis to establish his/her nutritional status. Nutritional condition also includes clinical examination and laboratory findings. Our aim was to assess the nutritional status in a group of obese children versus normal-weight children.
Material and methods: Our prospective study, conducted between October 1, 2010 and April 15, 2011, included a study group with 20 obese children and a control-group with 35 healthy children; we performed antropometric measurements, we calculated some anthropometric indices and performed laboratory tests, abdominal ultrasound and real-tyme elastography; statistical analysis involved Graph PadPrisma and Graph Pad InStat Demo programme; Student’s t test and correlation coefficient Pearson were used.
Results: Children weight and weight-for-age z-score significantly differed between the study-group and controls, at each age group, stature and height-for-age z-score was not significantly different. Medium upper-arm circumference (MUAC) had higher values than Body Mass Index, (BMI), while Tricipital Skin-fold (TSF) recorded the highest values, reflecting the fat deposits of obese children (in controls these indices were between -2SD and +2SD). The laboratory findings were generally within normal limits; total cholesterol values were higher in obese and triglycerides were incresed in a part of children in which they were determined. Liver elasticity was lower in obese than in the control-group.
Conclusion: Overweight alters the nutritional status, disturbs lipid metabolism and decreases the elasticity of the liver, highlighting the risks related to obesity and the importance of prevention and treatment of this disorder.

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Clinical Efficiency of Diffusion Weighted Imaging with Background Body Signal Suppression in Magnetic Resonance Mammography — Choosing a Qualitative or a Quantitative Approach

Nechifor-Boila IA1, Buruian M1, Frandeș-Podeanu Daniela1, Charlot Matilde2, Borda Angela3

1 Department of Radiology and Medical Imaging, County Emergency Clinical Hospital, Tîrgu Mureș, Romania
2 Department of Radiology and Medical Imaging, Lyon Sud Hospital Center, Pierre-Bénite, France
3 Department of Histology, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Objectives: Diffusion Weighted Imaging with Background Body Signal Suppression (DWIBS) is a new and promising imaging technique designed to improve diagnostic performance of Dynamic Contrast-Enhanced-Magnetic Resonance Mammography (DCE-MRM). The aim of our study was to assess the diagnostic efficiency of both qualitative and quantitative DWIBS in a retrospective cohort study.
Methods: We performed a registry-based study at the Department of Radiology, Lyon Sud Hospital. All consecutive MRM examinations from 02.2010 to 02.2011 were reviewed. DWIBS was interpreted blindly, both qualitatively (lesion characteristics and signal) and quantitatively (Apparent Diffusion Coefficient – ADC). The ADC cut-off value was determined using Receiver Operating Characteristics (ROC) curve analysis. Clinical efficiency indicators were calculated using either the pathological examination or the disease status after a minimum of 6 months follow-up as gold standard.
Results: The lot consisted of 78 women, with a mean age of 50.3±14 years and a total of 112 breast lesions. Qualitative DWIBS found 73 suspicious and 39 non-suspicious lesions, while the gold standard (pathological diagnosis/follow-up) reported 56 benign and 56 malignant ones. The sensitivity and specificity values for qualitative DWIBS were 84% and 53.37%, respectively. ROC curve analysis revealed the best performance for quantitative DWIBS at an ADC of 1.1×10-3 mm2/s, resulting in a sensitivity of 71.4% and a specificity of 76.8%.
Conclusion: DWIBS is a new and improved diffusion technique with a dual and efficient interpretation system applicable in clinical settings. Moreover, its use as a complement to DCE-MRM offers large potential for improving MRM efficiency in breast cancer diagnosis.

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An Outbreak of Achromobacter Bacteremia in Pediatric Clinic 1 Tîrgu Mureș in 2010

Man Lidia1, Baghiu Despina1,3, Székely Edit2,4, Man A2

1 Pediatric Clinic I, County Emergency Clinical Hospital, Tîrgu Mureș, Romania
2 Microbiology Department, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
3 Pediatric Department I, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
4 Central Clinical Laboratory, Department of Bacteriology, County Emergency Clinical Hospital, Tîrgu Mureș, Romania

Introduction: Achromobacter is a less common pathogen, with implications in patients with immune deficiency. The purpose of this paper is to evaluate the Achromobacter spp. bacteremia outbreaks in the hematology department of Pediatric Clinic I Tîrgu Mureș and to establish the involvement of this species as an etiologic agent of bacteremia/septicemia or solely as a contaminant of blood culture samples.
Material and methods: We analyzed an outbreak of Achromobacter infection from 2010’s summer-autumn season in Pediatric Clinic I. Bacteriological (blood culture, antibiotic susceptibility), laboratory (white cells count, inflammatory tests) and clinical aspects (underlying disease, body temperature, treatments, age, sex) were followed.
Results: A total of 26 blood cultures collected from nine children admitted in this period were positive for Achromobacter spp., other 28 were negative. In febrile patients with positive blood cultures, the leukocyte and neutrophil count was increased. In non-febrile patients with positive blood cultures, changes in the total number of leukocytes and granulocytes did not show significant variations. The antibiotic susceptibility test for Achromobacter strains identified a 100% resistance to ticarcillin, gentamicin, and trimethoprim-sulfamethoxazole, sensitivity to most classes of antibiotics, but an OXA-114 β-lactamase producing phenotype.
Conclusions: An association between the inflammatory syndrome and Achromobacter spp. bacteremia was established. Achromobacter spp. isolated from blood sampled through catheters is most likely a contaminant. The antibiotic susceptibility testing of Achromobacter spp. revealed sensitivity to most classes of antibiotics.

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