Category Archives: Number

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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Laparoscopic Greater Curvature Plication for Morbid Obesity: Indications, Results, Perspectives

Bara T Jr, Borz C*, Suciu A, Denes M, Torok A, Borz B, Marian D

University of Medicine and Pharmacy Tîrgu-Mures, Romania

DOI: 10.1515/amma-2015-0041

Morbid obesity is an important health problem of our century. It is managed by diet, lifestyle changes and medication and surgery. Weight-loss surgery is the most effective treatment for morbid obesity, producing durable weight loss, improvement or remission of comorbid conditions and longer life. Bariatric surgery provides the best results in up to 75% of cases of severe obesity and obesity comorbidities. In the United States, over 200 000 patients benefit every year from bariatric procedures. That means there is a continuous evolving of the bariatric surgery. Bariatric surgery is metabolic surgery because it resolves or alleviates Type2 Diabetes, hyperlipidemia and hypertension. The most employed bariatric operations are Roux -en- Y gastric by-pass, adjustable gastric banding, biliopancreatic diversion and sleeve gastrectomy, each of them having shortage of long term results and safety. In the last eight years was introduced a new bariatric procedure, the gastric plication, in an effort to obtain similar weight loss with lesser complications and costs. We present our initial experience with 30 morbid obese patients who undergone laparoscopic gastric plication in our institution. The mean % Excess Weight Loss was 50% at 6 month and 65% at 12 month with important alleviation of comorbidities. The complications rate was 6.6% for major complications (but only in the first 6 cases) and 10% for minor complications.

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Low Molecular Weight Heparin versus Coumadin-Induced Skin Necrosis in a Patient with Superficial Vein Thrombosis – A Case Report

Sala Nicoleta, Burdun Oana-Cristiana*, Botoman Maria, Rab Andrea, Bancu Ligia Ariana, Ureche Corina

University of Medicine and Pharmacy Tîrgu-Mures, Romania

DOI: 10.1515/amma-2015-0040

Introduction: Coumadin and low molecular weight heparin (LMWH) induced skin necrosis are rare clinical conditions.
Case presentation: A 63-years-old female patient, known with hypertension and right-sided hemiparesis, had presented to the emergency departement with pain and erythema of her internal right thigh. Venous Doppler-echography showed internal safenous vein thrombosis, thus she was started on anticoagulant treatment with Dalteparin and Acenocoumarol. On the 5th day of treatment she developed plantar hematoma on her left leg, followed by the appearance of hematomas, on the lower third of her right calf and on coxofemoral regions. Therefore, we raised the suspicion of heparin or coumadin-induced cutaneous necrosis, we stopped the anticoagulation for 5 days and restarted it with the administration of Rivaroxaban, fresh frozen plasma, antibiotics and local, sterile, saline dressings. After four days the patient presented deep vein thrombosis on her left calf.
Results and Discussion: Coagulation abnormalities were suspected, but infirmed by normal values of specific laboratory tests, such as Protein C (472.2%), protein S (77.10%), lupus anticoagulant (LA1-screening 53, 5s, LA-confirmation 38,0s). Hemogram showed normal platelet values. To exclude a malignancy, abdominal CT scan was performed, which revealed a right adnexal inomogenic cystic lesion, CA-125 (6,5U/ml), requiring further gynecological investigations. For the treatment of skin lesions, the patient required necrectomy and skin graft application.
Conclusion: Particularly, considering that the patient was initially anticoagulated with LMWH and coumadins simultaneously, the etiology of her cutaneous lesions remains uncertain.

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Left Ventricular Non-compaction Cardiomyopathy – A Case Report

Szakacs Xantus Timea, Varga Andreea*, Bocicor Andreea Elena, Tatar R, Tilea I

University of Medicine and Pharmacy Tîrgu-Mures, Romania

DOI: 10.1515/amma-2015-0039

Background: Left non-compaction cardiomyopathy (LVNC) or “spongy myocardium” is a relatively rare primary genetic cardiomyopathy, characterized by prominent wall trabeculations and intertrabecular recesses which communicate with the ventricular cavity. It appears in isolated form or coexists with other congenital heart diseases and/or systemic abnormalities.
Material and method: A 28-year-old woman was admitted with exertional dyspnoea, palpitations, non-specific chest pain and progressive fatigue on exertion. In her family history sudden cardiac-related deaths at young age are present. Cardiovascular system examination revealed tachycardia, intermittent extra beats. The rest EKG showed sinusal tachycardia (105 bpm), negative T-waves in DII, DIII, aVF, V4-V6. Consecutive 24 hours Holter EKG monitoring revealed nonsustained ventricular tachycardia, paroxysmal atrial fibrillation, isolated ventricular extrasystoles. Echocardiography showed left ventricular systolic dysfunction (LVEF:30-35%), slight LV enlargement, normal right ventricle and small left ventricle (LV) trabeculae in the apical area. Cardiac MRI demonstrated dilated LV and the presence of the trabeculations of LV walls suggestive for non-compaction cardiomyopathy. A combined treatment for heart failure and cardiac arrhythmias was initiated with good clinical results. Patient was scheduled for an implantable cardioverter defibrillator “life-saving”. Conclusions: The symptoms of heart failure and cardiac arrhythmias should be considered important in apparently healthy young patients. Besides intensive medical treatment is indicated the implantation of an ICD “life-saving” and in advanced cases heart transplantation. Even if the electrocardiographic findings are non-specific for noncompaction, a complete diagnostic evaluation is important, including sophisticated imaging techniques, a screening of first-degree relatives, and an extensive clinical, and genetic appreciation by a multidisciplinary team.

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Piggy-back Hepatic Transplant Technique and Veno-venous Bypass Without Cardiac Arrest: A Multidisciplinary Approach in Borderline T3b/T3c Renal Tumors

Nechifor-Boila IA1*, Suciu H2, Loghin Andrada3, Borda Angela3, Maier A1, Martha Orsolya1, Chibelean C1

1 Department of Urology, Tîrgu-Mureş University of Medicine and Pharmacy, Tîrgu-Mures, Romania
2 Department of Cardiovascular Surgery, Tîrgu-Mureş University of Medicine and Pharmacy, Tîrgu-Mures, Romania
3 Department of Pathology, Tîrgu-Mureş University of Medicine and Pharmacy, Tîrgu-Mures, Romania

DOI: 10.1515/amma-2015-0038

Surgery for renal cell carcinomas with tumor thrombus extending in the Inferior Vena Cava (IVC) can be particularly challenging, especially in the retrohepatic and intraatrial situations (T3b and T3c). Classically, these tumors require the intraoperative use of cardio-pulmonary by-pass (CPB) and deep hypothermic circulatory arrest (DHCA), that can result in specific complications (stroke, platelet dysfunction), with increased postoperative morbidity rates.
In urological practice, a particular IVC preparation method is currently in use, allowing full control both upon the IVC and its tributaries. It is derived from the “piggy-back” liver transplantation technique and implies the resection of all hepatic ligaments, leaving the hepatic vascular connections intact. This procedure is joined by a form of veno-venous bypass (between the right atrium and the infrarenal IVC) that allows a constant central venous pressure (by assuring blood return), with less bleeding and without the need for CPB and DHCA (avoiding, in this way, their inherent complications). All in all, these recently-introduced procedures can offer better thrombus control, improved oncologic outcomes and smaller complication rates. We aim to present a case of borderline T3b/T3c renal tumor that was successfully treated in our university center using these techniques.

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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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