Category Archives: Original Research

Evaluation of Diagnosing Tuberculosis in Primary Care Medicine in Mureș County, Between 2006 and 2008

Ács Valeria1, Finta Hajnal2, Ianosi Edith Simona3, Sabău Monica4

1 Doctoral School, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Department of Hygiene, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
3 Department of Pulmonology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
4 Department of Epidemiology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

DOI: 10.2478/amma-2013-0003

Aim: Evaluation of the contribution of general practitioners to the early diagnosis of tuberculosis in the studied period. Analysis of cases not diagnosed as active TB, from those suspected by the general practitioner and the real cases with respiratory lesions.
Material and methods: We conducted an observational epidemiologic study aiming at evaluating the diagnosis of pulmonary TB at the level of primary care medicine.
Results: The difference between conformed TB patients that have been referred with the suspicion of TB and those without suspicion is significant (p <0.0001), and the risk of disease estimated by OR was 21.54. More than half of the patients (139), had positive microscopic examination and culturing, representing 62.61%. In 10.36% microscopic examination was positive and culturing was negative (13 patients). Negative microscopic examination and positive culturing were detected in 5.86% of the patients. The majority of suspected/confirmed new patients were living in urban environments. The urban/rural ratio was 1.27. The reasons why the general practitioner suspected tuberculosis, in the order of frequency, were the following: cough/dry cough, sweating/nocturnal sweating, fever/persisting fever. Among the TB types, we noted the large percentage of patients with infiltrating, nodular tuberculosis confined to the volume of one pulmonary segment (30.78%), and 19.87% of the cases were multicavity tuberculosis; also, we noted the presence of caseous tuberculosis with moderate volumes of infiltrates, confined to a pulmonary lobe (18.27%).
Conclusion: Early diagnosis of tuberculosis in the primary healthcare network is a continuous challenge for the general practitioner.

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Finite Element Analysis of the Achilles Tendon While Running

Anițaș R, Lucaciu DO

Department of Orthopedics, ”Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj Napoca, Romania

DOI: 10.2478/amma-2013-0002

Introduction: The Achilles tendon is the most frequent recipient of traumatic injuries. The aim of this study is to identify and describe the varying load at ankle level and especially at the Achilles tendon’s insertion on the calcaneus.
Methods: We conducted a finite element analysis of the Achilles tendon while running, with the aim of revealing maximal loads and strains during a step in a running sequence. A 3D model of the Achilles tendon was built, based on MRI slides of a healthy, injury-free subject, who was asked to run over a force plate in 50 iterations. We used the recorded data to establish maximum loads and strains.
Results: We noticed a quick rise of the intra-tendinous load, from almost negligible while airborne and on first ground contact, to roughly 40 MPa in the pre-airborne phase, with possible implications in both treatment and post-injury recovery of Achilles tendon lesions.
Conclusions: Our results suggest that while early weight bearing and early exercise routines are a modern approach, care must be given in increasing the loads on the recovering region.

 

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A Comparison of Oral Health Status in Active-, Occasional- and Non-Smoker Patients Versus Students

Benedek (Bukhari) Csilla1, Kovács Mónika1, Pop M1, Balog Anita2

1 Department of Conservative Dentistry and Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
2 Dentist, S.C. Ka-Dent Stomatologie S.R.L., Tîrgu Mureș, Romania

DOI: 10.2478/amma-2013-0001

Objective: The aim of this case-control study was to assess the smoker and non-smoker patients’ oral health status versus students.
Methods: The study was based on a clinical examination of 210 young adults (118 women, 92 men) aged between 22–32 years. 105 of these were students in the 5th and 6th grade of the Faculty of Dentistry in Tîrgu Mureș and the control group was represented by patients. Patients and students were classified into three groups: non-smokers, occasional- and active smokers. The clinical examination evaluated the dental caries, fillings, extractions, crowns, root remnants and dental plaque. DMF-S index scores were calculated, and with its help the index of treatment need, dental care index and intensity of caries were determined.
Results: The dental treatment need index, DMF-S index and intensity of caries showed increased values in patients. Root remnants (p <0.0001), decay (p = 0.0473) and dental plaque (p = 0.0363) were much higher in the group of active smoker students as in the non-smoker students. Among active smoker patients the incidence of dental calculus (p = 0.0005), of root remnants (p = 0.0022) and of fillings (p = 0.0441) showed a higher value than in the non-smokers.
Conclusions: This study showed that compared with non-student patients, in dental students, a better oral hygiene was coupled with healthier teeth and periodontal. Poor oral hygiene together with smoking seems to worsen the oral health status.

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Study of Cyclodextrin/Fluoroquinolone Inclusion Complexes by Capillary Electrophoresis

Székely-Szentmiklósi Blanka1, Tőkés B2

1 Gedeon Richter Romania S.A., Tîrgu Mureş, Romania
2 Department of Physical-Chemistry, Faculty of Pharmacy, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

 

DOI: 10.2478/amma-2013-0026

Introduction: In the present work we evaluated the complexation role of cyclodextrins toward fluoroquinolones in an attempt to assess their potential as new formulation additives for more efficient fluoroquinolone delivery and as selectors in capillary electrophoresis.
Material and method: Guest-host interactions of two second generation quinolones, ciprofloxacin and norfloxacin with four cyclodextrins, beta-cyclodextrin (β-CD), gamma-cyclodextrin (γ-CD) and two beta-cyclodextrin derivatives, 2-hydroxypropyl beta-cyclodextrin (HP-β-CD) and randomly methylated beta-cyclodextrin (RAMEB), were tested by capillary electrophoresis in borate running buffer. Experimental parameters like buffer concentration, pH, organic modifier, voltage and cyclodextrin concentration have been varied for a better resolution.
Results: In capillary zone electrophoresis ciprofloxacin and norfloxacin are migrating together, a difference in their migration times and thus separation occured by the addition of cyclodextrins.
Conclusion: Our results suggest formation of inclusion complexes between fluoroquinolones and cyclodextrins. Differences in their affinity to host molecules resulted in separation of the two fluoroquinolones.

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Approaches to Scoring Translation in the PROFEX EMP Exam

Hegedűs Anita

Department of Languages for Specific Purposes, Faculty of Medicine, University of Pécs, Pécs, Hungary

DOI: 10.2478/amma-2013-0025

Introduction: This paper undertakes to investigate the connection between two approaches to scoring translation by examining 115 test papers of the translation component of the C1 level PROFEX English for Medical Purposes (EMP) exam. The main objective of the study is to reveal whether, and to what extent, the method of assessment influences the score.
Material and method: The test papers were scored independently by two experienced raters according to the marking scale of the PROFEX EMP exam, then holistic scoring was carried out by a third rater, who was uninformed of the official scores for the test papers. Correlations were calculated, first between the holistic scores and the official scores based on the combined holistic and discrete point approach, then between other components of the written part of PROFEX EMP exam (reading comprehension and writing) and the holistic scores and the scores reached with the combined method, respectively.
Results: A strong correlation has been revealed between the scores achieved by the purely holistic method and those assessed with the combined holistic and discrete point approach. The holistic method was shown to be slightly more reliable than the combined approach.
Conclusion: The study has revealed that the method of assessment does not significantly influence the score in the evaluation of translation in the PROFEX EMP exam.

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Soft Tissue Injuries in Hungarian and Austrian Clinical Diagnostic Reports

Fogarasi-Nuber Katalin, Rébék-Nagy G

Department of Languages for Specific Purposes, Faculty of Medicine, University of Pécs, Pécs, Hungary

DOI: 10.2478/amma-2013-0024

Introduction: In addition to providing first aid, primary treating doctors are required to describe and register injuries acquired in accidents and assaults. They should do this with the highest possible accuracy, as this official document is often the only documentary evidence of soft tissue injuries in case a lawsuit is filed later. Characteristics of injuries may disappear faster with the healing process of the soft tissue, making it impossible for forensic experts to deduce the weapon involved. Consequently, terminological accuracy is a prerequisite for the appropriate reconstruction of the type and severity of injuries. This study aims at analysing reports on soft tissue injuries in Hungary and Austria from the terminological point of view. It is meant to reveal inaccuracies in the use of noun phrases impairing objective and accurate forensic assessment.
Material and method: A corpus-based analysis was conducted on 200 Medical Diagnostic Reports (MDRs) from Hungary and Austria (100 from each country) with the linguistic software WordSmith 5.0. Results were processed in Microsoft Excel and demonstrated in graphs.
Results: The analysis showed that terminology describing soft tissue injuries is not consistent. Comparatively few characteristics of injuries were recorded in both sub-corpuses. Due to inconsistent use of terms and missing characteristics, 17 % of the Hungarian and 18% of the Austrian MDRs were not completely assessable by forensic experts.
Conclusions: Describing injuries for legal purposes needs standardisation.

 

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Hedging in Popular Scientific Articles on Medicine

Csongor Alexandra, Rébék-Nagy G

Department of Languages for Specific Purposes, Faculty of Medicine, University of Pécs, Pécs, Hungary

 

DOI: 10.2478/amma-2013-0023

Introduction: The aim of this study is to investigate the process of rewriting medical research papers for the lay public. The latest findings of medical research often appear in the popular media. It is interesting to see what happens to a scientific text when it is transmitted to a new audience. Hedging is usually interpreted as a characteristic feature of scientific discourse. This study focuses on hedging, which also tends to be applied in popularized articles in the field of medicine.
Material and method: Five medical research articles on prenatal vitamins and their online popularizations were examined by means of a text analyzing software, focusing on lexical items considered as hedges. The frequency and the overall percentage of hedging devices with respect to the total number of words were recorded in the five popularizations.
Results: The results of the present study suggest that the linguistic strategy of hedging is applied in popular articles. Approximators, auxiliaries, epistemic verbs and adverbs expressing tentativeness, possibility and politeness were used in the corpus. The overall percentage of the lexical items commonly regarded as hedges, with respect to the total number of words, was 1-2.2% in the five articles. The writers also use linguistic techniques that can be interpreted as attribution shields. These defense tools convey the meaning that it is the researcher, rather than the writer, who is responsible for the truth of the information.
Conclusions: Hedging as a means of uncertainty and negative politeness technique is used in the popularizations analyzed. The present study should be extended to investigate tendencies in popularization of scientific information.

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Dominance Relations in the Light of Repair-mechanisms in Family-doctor-Patient and Hospital Teacher-Student Encounters

Kránicz Rita, Hambuch Anikó, Hamar-Savay Judit, Rébék-Nagy G, Sárkány-Lőrinc Anita

Department of Languages for Specific Purposes, Faculty of Medicine, University of Pécs, Pécs, Hungary

DOI: 10.2478/amma-2013-0022

Introduction: Repair mechanisms, both marked and unmarked, are present in institutional interactions including family doctor-patient and hospital teacher-student encounters. While in most of the cases unmarked repair is carried out by the dominant partner, sometimes marked repair mechanisms are initiated by the client. The present study was undertaken to throw light upon these marked repairs. The aim of the study is to compare two interactions, the first is between a GP and a patient and the second is between a hospital teacher and a student.
Material and method: The dominance relations in the recorded and transcribed dialogues were shown as the first step in the investigation of the repairs. After realising typical repair mechanisms, the focus of the analysis is directed to special occasions, where the initiator is not the dominant participant.
Results: The doctor-patient relationship can be characterized by the dominance of the doctor and in the teacher-student encounter by the dominance of the teacher. Although in most of the cases the dominant participant initiates the turns, the initiation of the non-dominant party can also be observed, in 16–20 % of the encounters.
Conclusions: The relatively frequent repairs of the non-dominant party suggests a diversion from the conventions of the institutional talk, which requires further investigation.

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Autologous Stem Cell Transplantation in Patients with Acute Myeloid Leukemia: a Single-Centre Experience

Kakucs Enikő1, Benedek I1,2, Benedek Erzsébet1, Köpeczi Judit Beáta1, Tunyogi Aliz1, Istrati Monica1

1 Clinical Hematology and Bone Marrow Transplantation Clinic, Tîrgu Mureş, Romania
2 University of Medicine and Pharmacy, Tîrgu Mureş, Romania

DOI: 10.2478/amma-2013-0021

Introduction: Autologous haemopoietic stem cell transplantation (SCT) is an important treatment modality for patients with acute myeloid leukemia with low and intermediate risk disease. It has served advantages over allogenic transplantation, because it does not need a matched donor, there is no graft versus host disease, there are less complications and a faster immune reconstitution than in the allo-setting. The disadvantage is the lack of the graft versus leukaemia effect.
Materials and methods: In the Bone Marrow Transplantation Unit Tîrgu Mureș 14 patients with acute myeloid leukemia received an autologous SCT. Mobilization of the stem cells was performed using chemotherapy and granulocytic colony stimulating factor. The conditioning regimen for SCT consists in monotherapy with busulfan (Bu) 16 mg/kg, BuCy: busulfan in combination with Cyclophosphamide (CY) 120 mg/kg or BuMel: Busulfan in association with Melphalan (Mel) 140 mg/m2.
Results: The median patient age was 36 years (range 20–55), 9 (64%) were males and 5 (36) were females and the median time interval from diagnosis to autologous SCT was 9 months (range 3–25). All the patients were transplanted successfully, all of them achieved a sustained neutrophil count (> 0.5 G/L), median time 11 days (9–15) and platelet count (> 20 G/L) median time 14 days (10–19) after transplantation.
Conclusions: We conclude that autologous stem cell transplantation is an effective treatment in acute myeloid leukemia with the possibility of long survival, particularly in patients with standard risk disease.

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The Management of Cryptorchidism at the Pediatric Surgery Clinic of Tîrgu Mureș

Gozar H, Prișcă R, Derzsi Z

Pediatric Surgery Clinic, County Emergency Clinical Hospital, Tîrgu Mureș, Romania

DOI: 10.2478/amma-2013-0020

Introduction: Cryptorchidism is the most common abnormality of the male sexual development and one of the most common diagnoses in children hospitalized in the Pediatric Surgery Clinic. The diagnosis is mainly clinical: the testis cannot be seen or palpated in the scrotum. For this malformation, the treatment is always surgical: the orchiopexy.
Material and method: This is a retrospective study performed in 2012 in our clinic. The purpose of the study is to report our experience during a year in the management of this abnormality.
Results: There is a standard technique with two incisions (inguinal and scrotal) which was used in 77.12% of cases and a newer technique (Bianchi), with a single incision (scrotal), used in 22.88% of cases.
Conclusion: The results after surgery for cryptorchidism in every case were good, with both techniques.

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