Category Archives: Original Research

How Far We Should Go with Pelvic Lymph Node Dissection on the Controlateral Side in Unifocal Muscle Invasive Bladder Cancer

Vartolomei Mihai Dorin, Chibelean Calin Bogdan*, Voidazan Septimiu, Martha Orsolya, Borda Angela, Boja Radu Mihail, Dogaru Grigore Aloiziu

University of Medicine and Pharmacy of Tirgu Mures, Romania

DOI: 10.1515/amma-2015-0047

Objectives. The purpose of this study was to determine the evolution of patients with unifocal lateral wall MIBC (muscle invasive bladder cancer) after cystectomy with PLND (pelvic lymph node disection) at the Urology Clinic in Tirgu Mures, and to determine tumor stage and lymph node status before and after radical cystectomy with PLND.
Methods. This is a prospective study, conducted between 1 August 2012 to 31 July 2014 at Urology Clinic, with a median follow-up of 14 months (range 7-25). Inclusion criteria were: patients undergone cystectomy with PLND, and unifocal MIBC on the lateral wall of the bladder; exclusion criteria were: multiple bladder tumor, other location and clinical T stage > 3.
Results. Forteen patients met the inclusion criteria, median age was 61 (range 55-72), 85.71 % were male. An increase in T3 patients was noticed from 1 to 5 cases, we noticed a decrease of N0 lymph nodes from 78.6% to 57.1% postoperatively and on the controlateral side the kappa coefficient between the preoperatively and postoperatively negative lymph nodes was 0.63. On the tumor side the most common location for positive lymph nodes was external iliac with 3 nodes (21.4 %) and obturator fossa with 4 nodes (28.6 %) and on the contralateral side 2 positive nodes (14.3 %, obturator fossa, external, internal and common iliac nodes).
Conclusions. In unifocal bladder tumors, located on the lateral wall, PLND could be an alternative with comparable results with extended PLND especially in T1 and T2 patients associated with N0 before and after surgery.

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The Grade of Left Ventricular Diastolic Dysfunction as a Predictive Factor for Permanent Atrial Fibrillation

Cerghizan Anda, Keresztesi Arthur Atilla*, Bataga Simona, Tilea Ioan

University of Medicine and Pharmacy of Tirgu Mures, Romania

DOI: 10.1515/amma-2015-0046

The objective of this study was to find a link between the grade of left ventricular diastolic dysfunction (LVDD) and the progression to permanent non-valvular atrial fibrillation (AF), in a group of patients with left ventricular diastolic dysfunction and paroxysmal or persistent atrial fibrillation.
Methods: A bidirectional study on 57 patients meeting the inclusion criteria was conducted; each patient was admitted in a university -based hospital between January 1st – June, 30, 2013, with a follow up 3 and 6 months later. Permanent atrial fibrillation development was followed.
Results: Out of the 57 patients, 23 had paroxysmal AF and 34 were with persistent AF. After six months, 21 patients progressed to permanent AF, representing 36.84% of the total patients. Female patients with age over 65 had more often atrial fibrillation, but more men progressed to a sustained form of AF. No statistically significant difference regarding the grade of diastolic dysfunction, the left atrial size or volume, or the left ventricular ejection fraction was observed between the patients with progression, compared to those without progression.
Conclusions: The grade of left ventricular diastolic dysfunction did not prove to be a predictive factor for permanent atrial fibrillation, neither the left atrial size or volume, or the left ventricular ejection fraction.

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Food Consumption Frequency at Students from Rural Areas from Moldova Republic

Zepca Victor1, Tarcea Monica2*, Zaporojan Aculina1

¹ Department of Hygiene, National Center for Public Health, Chisinău, Republic of Moldova
² Department of Community Nutrition and Food safety, University of Medicine and Pharmacy Tirgu Mures, Romania

DOI: 10.1515/amma-2015-0044

Objective: Our study aim to evaluate the characteristics of nutrition behavior at teenagers from Moldova’s rural area schools in order to make a profile of risk behavior related to diet and to implement efficient community intervention programs.
Methods: We studied in 2014 the daily frequency consumption of the main food groups, in a sample of 1236 students of 7th-12th class, from rural localities of the Republic of Moldova, using the questionnaire method.
Results: The teenagers had consumed on the day preceding the interview, cereals and bakery products – 99.2%, fruits – 86.7%, cooked vegetables – 72.6%, meat dishes – 72.1%, potatoes – 50.3%, dairy products – 46.9%, raw vegetables – 44.7%, eggs – 25.3%, fish – 19.4%, raw fruits juice – 14.8%, legumes – 12.5% of students. From those investigated 52.6% have consumed food with high fat content higher than recommended levels. Regarding the food groups present in the menu we registered a satisfactory level of consumption by the students for cereals and bakery products, fruits, cooked vegetables and meat dishes; relatively satisfactory – the consumption of dairy products, raw vegetables and potatoes; unsatisfactory level for the consumption of eggs, fish and legumes.
Conclusions: We sustain the idea that it is important to constantly evaluate the risk factors related to the inadequate diet at teenagers and to implement efficient community intervention in order to prevent nutrition related diseases that can occur.

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Maximizing the Amount of Deposited Particles During a Severe Asthma Attack Using the Stochastic Lung Model

Sarkany Zoltan

University of Medicine and Pharmacy, Tîrgu Mures, Romania

DOI: 10.1515/amma-2015-0043

Background: The aim of this study was to use a computerized lung model to simulate the deposition of inhaled particles in the human airways during a severe asthma attack, in order to find the combination of breathing- and particle-related parameters which leads to the highest deposited fractions in the target areas of the airways.
Material and Method: A stochastic lung model was used to simulate the deposition of 1 nm – 100 µm particles during a severe asthma attack in bronchial generations 9-16. Breathing parameters were chosen to reflect the use of a therapeutic inhalation device, with a 10 s symmetrical breathing cycle and 2000 ml tidal volume. To maximize the deposited fraction in the target areas, further simulations were carried out changing the tidal volume (750-3000 ml), the length of the breathing cycle (2-20 s) and the length of breathing pause following inhalation (0-10 s).
Results: The highest deposited fraction of 51.50% in bronchial generations 9–16 was obtained in the case of 0.01 µm particles, this value being more than4 times higher compared to the highest deposition of 3–6 µm particles currently used in inhalation devices (11.81% in the case of 5 µm particles). Modifying breathing-related parameters did not lead to valuable increases in the deposited fractions in the investigated region.
Conclusions: Deposition fractions in the therapeutically important areas of the airways may be more than4 times higher in the case of 0.01 µm particles, compared to particles currently used in the treatment of asthma bronchiale.

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Smoking Habits of Children Institutionalized in Family Care Homes in Mures and Harghita County

Ferencz Lorand1*, Finta Hajnal1, Schmidt Lorand2, Balint Iosif1, Nadasan Valentin1, Abram Zoltan1

1 Department of Hygiene, University of Medicine and Pharmacy, Targu Mures, Romania
2 DGASPC Tîrgu Mures, Romania

DOI: 10.1515/amma-2015-0042

Background: Smoking is a problem of the modern world and annually produces more victims, and due to ignorance and lack of health education in our country the disease diagnosis is made at an advanced stage. Many studies show that, young people aged between 10 and 18 are smokers and start smoking at an increasingly early age. Objective: The purpose of this study was to assess the smoking habits of institutionalized children in family care homes from Harghita and Mures county.
Methods: The method chosen was a sociological survey based on questionnaires. Our study included 254 children institutionalized in family care homes in Mures county and 254 children from Harghita county. Statistical analysis was performed using the Statistical Package for Social Sciences.
Results: A statistically significant difference was obtained analyzing the number of smokers from the group of children under 12 years in Mures compared to the Harghita county. More than half of children smoked their first cigarette after they entered in family care homes in both counties and the most common setting in which the children were smoking was when being together with their friends.
Conclusions: In Mures county the number of smokers under the age of 12 was significantly higher than in Harghita county. Despite the educational classes and institutional regulations of smoking, more than half of children smoke. The decisive role in testing of smoking are the friends. Due to the very high number of underage smokers, the prevention and education hours have an unquestionable importance.

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Eficacy of trichloroacetic acid peel versus 15% topical azelaic acid gel in the treatment of acne vulgaris – a comparative study

Al Hussein Stela Mariana1, Buicu F2, Maier Dalila3, Al Hussein H5, Ciurba Adriana4, Al Hussein Hamida5, Dogaru Maria Titica1

1 University of Medicine and Pharmacy, Tîrgu Mureş, Pharmacology Departament
2 University of Medicine and Pharmacy, Tîrgu Mureş, Public Health and Management Departament
3 University of Medicine and Pharmacy ”Iuliu Hațieganu” Cluj Napoca, Dermatology Departament
4 University of Medicine and Pharmacy, Tîrgu Mureș, Departament of Pharmaceutical Technology
5 University of Medicine and Pharmacy, Tîrgu Mureș, student

DOI: 10.1515/amma-2015-0014

Objectives: The aim of this study was to compare the efficacy and tolerability of 20% trichloroacetic acid (TCA) peel with 15% azelaic acid gel, a standard antiacne topical treatment.
Materials and methods: 51 patients aged between 16-40 years, with mild and moderate acne, were randomized into two groups. Before the treatment were investigated the patients clinical features and hygienic habits, the previous antiacne treatments and feed-back to them. No cases under treatment with contraceptive pills or antiacne medication that could interfere with the results, were included. For a period of eight weeks, 27 patients (group A) were treated with 15% azelaic acid gel, twice daily, and 24 patients (group B) underwent four sessions of 20% TCA peels, at 14 days interval. The efficacy was evaluated by acne lesions counting, at baseline and at 8 weeks. Adverse effects incidence (erythema, local skin irritation), as well as the satisfaction degree of patients, were investigated.
Results: Was observed a mean reduction in the number of acne lesions of 32,36% for the group A and 69,36% for the group B. There was no statistically significant difference between the average number of acne lesions before treatment between the two groups. The mean number of acne lesions after the treatment was significantly different (p<0,0001), 20% TCA peels showed superior results than 15% azelaic acid gel. Additionally, 96% of patients who underwent TCA peels were very satisfied with the results obtained.
Conclusions: TCA peel is an efficient and well tolerated method for the treatment of acne vulgaris.

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Assesing the Knowledge, Attitudes and Eating Habits of Dietary Fibers in Tîrgu-Mureș Population

Stere Victoria, Tarcea Monica, Ruta Florina*

University of Medicine and Pharmacy of Tirgu Mureș, România

DOI: 10.1515/amma-2015-0037

Background: The aim of the study was to assess the knowledge, attitudes and eating habits upon consumption of dietary fibers in a group of people from Tirgu-Mures area.
Material and Method: We used a transversal descriptive study conducted on a group of 251 subjects from the urban area (76.4%), as well as from the rural area (23.6%), aged between 18 and 62 years, obtained using an online questionnaire consisting of 40 questions related to knowledge and attitude towards dietary fibers and estimated consumption of fiber from whole foods.
Results: In the study group, we observed that 21.28% consumed whole cereals once per week and 18% did not consume cereals at all; regarding fruit consumption 17.44% consumed 6-8 pieces/week, and 3.4% consumed over 18 pieces/week. Frequency of fast food –meals consuming:  67.68% did not  consume fast-food  meals, 25.25% ate fast food  once/week, and 1.1% consumed fast food between 8-10 times/week. Concerning the statement that fibers can prevent and/or treat colon cancer and obesity, 40% fully accepted the statement, 40% agreed, 14.29% were indifferent and 4.7% were against. From the total group of subjects, approximately 37.6% knew the meaning and classification of dietary fiber, 26.8%  knew the recommended amount of fiber to be consumed daily, and 5.9% did not check the fiber content of foods ever.
Conclusions: The inclusion of cereals and whole foods in diet is recommended in all nutrition guidelines worldwide, because of their association with a high health status, and  prevention of chronic diseases. Consumers need to understand  the benefits of whole foods, also to recognize and read the information about it on food labels.

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The Frequency of Dental Caries in Adult Patients with Gastroesophageal Reflux Disease

Sîmpălean DS*, Ghiga Dana, Petrişor M, Măruşteri M, Bacârea V, Băţagă Simona

University of Medicine and Pharmacy of Tirgu Mureș, România

DOI: 10.1515/amma-2015-0036

Introduction. The aim of the study was to evaluate the frequency of dental caries in adults patients with gastroesophageal reflux disease.
Material and method. A cross-sectional study was performed between November 2013 and October 2014. All subjects who agreed to participate to the study were asked to complete a questionnaire regarding personal information, oral hygiene and dental evaluation. The individuals with complete false teeth (superior and inferior removable prosthetic devices) were excluded from the study. The study included 134 people divided in two groups, based on upper gastrointestinal endoscopy: a group with gastroesophageal reflux disease (71), and a control group (63). Dental evaluation was performed by a dentist blind to the diagnosis of the subjects. Dental caries were evaluated by applying the decayed, missing, and filled teeth index (DMFT index). The statistical significance was defined as p<0.05.
Results. From 71 subjects included in GERD group, 33 (46.48%) were males and 38 females (53.52%) with a mean age of 44.99±11.19 (42, 59.15% from urban area and 29, 40.85%, from rural area). In the control group we included 28 (44.44%) males and 35 (55.56%) females (mean age 43.84±9.48) and 29 (46.03%) subjects were from urban area and 34 (53.97%) from rural area. DMFT index in GERD group was 19.49±4.28 and in control group 18.16±4.54 (p<0.05).
Conclusions. The present study showed that there is no difference between GERD and control group, regarding the frequency of dental caries.

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Comparative Study Regarding Activity of Emergency Dental Offices in Tirgu Mures and Oradea

Dörner Kinga*, Boeriu C, Vass Hajnal, Nagy Melinda, Koszta Zsuzsa, Iurcov Raluca, Székely Melinda

University of Medicine and Pharmacy of Tirgu Mureș, România

DOI: 10.1515/amma-2015-0035

Objective: The purpose of the study was to assess the activity of the Emergency Dental Office of UPU SMURD in Tîrgu Mures since its establishment and also to compare it with the similar unit from Oradea.
Methods: The two-year retrospective and comparative study is a statistical processing of non-personal data regarding the emergency dental services in the UPU SMURD Tîrgu Mures and UPU SMURD Oradea, involving the data collected in the same period at both emergency dental offices. Data based on the records analysis of the patients who were consulted and treated at the Emergency Dental Office in UPU SMURD Tîrgu Mure between February 1, 2012 − February 1, 2014 compared with similar data from Oradea.
Results: Assessing the number of patients presented each month − first and second year − we can see that since the establishment of the Emergency Dental Office in Tîrgu Mure (no=12780), the number of patients showed a linear increase in the first year, and in the second year the constant number of patients present in the studied unit was higher than in the other center from Oradea (no=4886).
Conclusions: The large number of patients and the nature of the cases that were present in the Emergency Dental Office in the UPU SMURD Tîrgu Mure show how necessary the set-up of this unit was.

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Bisphosphonate-Related Osteonecrosis of the Jaws: a real Challenge for Dentists

Albu Ioana-Aurița*, Petrovan Cecilia, Păcurar Mariana, Albu DE, Csinszka K.-Ivacson A, Golu VM, Copotoiu C

DOI: 10.1515/amma-2015-0034

Background: Osteonecrosis of the jaw is a serious complication associated with oral and intravenous bisphosphonate therapy. Its pathogenesis is not well understood and its management is difficult.The aim of ourstudy was to evaluate the awareness of dentists in Târgu Mureș on the possibilities of treating patients who are treated with bisphosphonate in dental offices.
Material and method: We carried out a questionnaire-based study among dentists in Târgu Mureș reaching important issues such as: if the patient is asked if medical history follows / followed treatment with bisphosphonates, if they made surgical treatment in these patients, if they know under what conditions can they perform this treatment, if they deem it is necessary to contact the prescriber before surgical treatment.
Results: Seventy questionnaires were returned. During the medical history most clinicians (60%) asked the patients whether they follow/followed treatment with bisphosphonates and most of them (42.85%) did not perform treatments in these patients. While 85.71% of respondents declared that they do contact the prescriber before performing surgical treatment, 48,57% were not aware under what conditions they could undergone the treatment.
Conclusions: The dentists did not seem to be well informed about this pathological entity, known only since 2003. In the absence of appropriate protocols they could not provide a high quality treatment and in these circumstances they might do more harm than good.

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