Category Archives: Number

Apathy as Non-Motor Manifestation in Amyotrophic Lateral Sclerosis

Anca Moțățăianu1, Ioana Ormenișan2, Rodica Bălașa1

1. Neurology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Neurology I Clinic, County Emergency Clinical Hospital of Targu Mures, Romania

DOI: 10.2478/amma-2021-0041

Although the term of amyotrophic lateral sclerosis (ALS) is often used interchangeably with motor neuron disease, ALS is universally accepted as a multisystem disorder. Cognitive impairment is an acknowledged feature of ALS, affecting language, memory and behaviour, and apathy is considered to be the prevalent behavioural alteration in ALS. It can be divided in three subtypes: executive, emotional and initiation apathy. Out of the three subtypes, initiation apathy is common among patients with ALS. Even in patients that do not meet the criteria for ALS with frontotemporal dementia, low-key neuropsychiatric and cognitive changes can be observed. Apathy has also been found to be systematically associated with disruptions in medial frontal cortex and subcortical structures in several neuroimaging studies that confirm the pre-existing brain lesions in the early stages of this disease. Thus, there is a growing body of evidence that motor signs and symptoms are accompanied or even preceded by cognitive and behavioural alterations, and screening for non-motor signs and symptoms can be clinically relevant.

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Prosthodontic Management of Dentate Maxillectomy Patient: A Clinical Case Report

Vineet Sharma, Jyoti Paliwal, Kamal Kumar Meena, Ramjee Lal Raigar

Department of Prosthodontics and Crown & Bridge, RUHS College of Dental Sciences, Jaipur, India

DOI: 10.2478/amma-2021-0038

Patients with minor defects of the alveolar ridge and hard palate can easily be treated by surgical closure, while patients with larger defects are more amenable to prosthetic restoration. The case report describes the rehabilitation of a dentate maxillectomy patient with a definitive closed hollow bulb cast partial obturator. A tripod retainer design was chosen for direct retention in the case. The tripod design consisted of a T-bar clasp placed on the left first central incisor and two embrasure clasps with buccal retention and palatal bracing components between the right first & second premolar and right first & second molar. A complete palate major connector was designed to ensure uniform distribution of functional load across tissues. The remaining teeth, the palate, and the rest provided support for the prosthesis. Prosthetic rehabilitation of the defect with a definitive obturator thus seals tissue openings in the palate, improves deglutition, speech, mastication, aesthetics, and significantly improves quality of life.

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Soy polysaccharides therapeutic and technological aspects

Robert-Alexandru Vlad1, Paula Antonoaea1, Emoke Margit Redai1, Daniela-Lucia Muntean2, Nicoleta Todoran1, Magdalena Bîrsan1,3, Anamaria Tataru1, Adriana Ciurba1

1. Pharmaceutical Technology and Cosmetology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
2. Analytical Chemistry and Drug Analysis Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
3. Drug Industry and Pharmaceutical Biotechnology Department, “Grigore T. Popa” University of Medicine and Pharmacy from Iaşi, Iași, Romania

DOI: 10.2478/amma-2021-0040

Soy polysaccharides represent a multipurpose class of chemicals that include both therapeutical and technological properties. Since they have been first time introduced in the pharmaceutical field, Soy polysaccharides were used in two different pharmaceutical formulations; sublingual tablets and in colon drug delivery. For the sublingual tablets, Soy polysaccharides under the brand name of Emcosoy© – were used as a superdisintegrant in concentrations between 4-8% showing comparable results with the artificial superdisintegrants (sodium starch glycolate, sodium croscarmellose, and polyvinylpyrrolidone). The second technological field where Soy polysaccharides were used is represented by colon drug delivery where it was used in combination with ethylcellulose showing a prolonged lag time compared to the results found in the literature. The medicinal effect of these polysaccharides consists of treating diarrhea. As it will be presented in the article, these chemical compounds tend to decrease the aqueous stool time in patients with diarrhea and to conduct to a softer stool in healthy patients. In conclusion, these polysaccharides present multiple purposes possessing a medicinal effect and also the possibility of being used as a double-faceted pharmaceutical excipient.

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E-cigarette and alternative tobacco products consumption among adolescents in Chisinau, Republic of Moldova – A repeated cross-sectional study

Aculina Topada1, Valentin Nădășan1, Monica Tarcea2, Zoltán Ábrám1

1. Department of Hygiene, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
2. Department of Community Nutrition and Food safety, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania

DOI: 10.2478/amma-2021-0039

Objective: The main objective of the study was to evaluate e-cigarette and alternative tobacco product use in ninth-grade students from Chisinau.
Methods: The repeated cross-sectional study collected data using a questionnaire administered in 2015 and 2018 among ninth-grade students in Chisinau, Republic of Moldova. Absolute and relative frequencies of electronic cigarettes and alternative tobacco products ever use were calculated and 2015 data were compared with those collected in 2018.
Results: The percentage of participants ever using electronic cigarettes in 2015 and 2018 respectively was 42.9% and 59.5% (p=0.001), ever using cigars was 14.9% and 15.9% (p=0.684), ever using pipes was 3.3% and 4.9% (p=0.205), ever using hookah was 17.4% and 21.7% (p=0.086), ever using chewing tobacco was 11.6% and 3.9% (p=0.039), ever using snus was 4.1% and 6.2% (p=0.135), and ever using snuff was 0.5% and 1.1% respectively (p=0.518). Exposure of participants to messages promoting electronic cigarettes was 31.0% in 2015 and 65.8% in 2018 (p<0.0001). Consumption of electronic cigarettes was significantly associated with sex (boys 62.8% vs. girls 43.6%), school performance (low grades 61.5% vs. high grades 50.0%), exposure to pro e-cigarette messages (exposed 61.4% vs. not exposed 44.0%), perceived e-cigarettes harmfulness (less harmful 66.9% vs. more harmful 39.7%), and use of conventional cigarettes (ever tried 79.8% vs. never tried 24.6%).
Conclusions: The study showed an important, statistically significant increase in the consumption of electronic cigarettes among ninth-grade students in Chisinau city, from 2015 to 2018 and an increased exposure to electronic cigarette advertising.

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The Gestational Diabetes Mellitus Approach in Clinical Practice – A Narrative Review

Oana Deteșan1, Lucia Mihaela Custură1, Reka Annamaria Schmiedt1, Brigitta Irén Bacso1, Andrew Corneliu Bell2, Maria Alexandra Streza2, Mariana Cornelia Tilinca1,2

1. Compartment of Diabetology, Emergency Clinical County Hospital of Targu Mures, Romania
2. George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2021-0037

Gestational diabetes mellitus (GDM) is an increasingly condition in medical practice. In the absence of an effective therapeutic management, it can lead to significant maternal and neonatal complications with adverse health effects. Reducing the risk of morbidity is the goal achived by screening of all pregnant women and active involvement of health care staff and early medical intervention in case of detection of GDM. The aim of this review is to present the nowadays strategy of GDM approach. The management challenge is to maintain blood glucose levels within the targets recommended by current guidelines, which are in relatively narrow ranges. Nutritional intervention and lifestyle changes are of primary importance. If necessary insulin therapy is initiated, insulin analogues are preferable due to lower risk of hypoglycemia. Oral antidiabetics are not recommended in pregnancy, even if they are used in certain circumstances.

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Mediation of Candida species growth and virulence by the proinflammatory cytokine IL-6

Cristina Nicoleta Ciurea1,2, Irina-Bianca Kosovski1,3, Felicia Toma1, Mihai Mareș4, Bianca Tudor1, Adrian Man1

1. Department of Microbiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
3. Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
4. Laboratory of Antimicrobial Chemotherapy, Ion Ionescu de la Brad University of Life Sciences of Iași, Romania

DOI: 10.2478/amma-2021-0036

Interleukin-6 (IL-6) is a cytokine with pleiotropic effects that might also influence the virulence traits of some microorganisms, but its direct influence over Candida spp. is currently unknown. The objective of the study is to determine the influence of IL-6 (250 pg/ml) on the growth rate and biofilm formation of C. albicans, C. parapsilosis, C. krusei, C. auris, and C. guilliermondii, as well as to analyze the influence of this citokine on the expression of three virulence genes (ALS3, HSP70, SAP2), respectively on the germ tube formation ability of C. albicans. The influence of IL-6 on growth rate was assessed by incubating the fungal cells in presence of IL-6 for 48 hours and assessing the optical density of the samples at five timepoints. The biofilm production in presence of IL-6 was studied in microtiter plates, using crystal-violet assay, the intensity of biofilms being evaluated by spectrophotometry. The expression of ALS3, HSP70, and SAP2 in C. albicans was studied by RT-PCR, reported to ACT1 housekeeping gene. The germ-tube test was performed to assess the influence of IL-6 on the filamentation rate of C. albicans. All test results were normalized against control, without added IL-6. The results showed that IL-6 influences the growth rate of C. albicans, C. parapsilosis, C. krusei, C. auris, and C. guilliermondii in a time-dependent way. Also, IL-6 inhibited the formation of biofilms for C. albicans and C. guilliermondii. In C. albicans cells, IL-6 induced upregulation of ALS3 and HSP70, while it down-regulated the SAP2 gene. IL-6 did not influence the germ-tube formation in C. albicans. In conclusion, IL-6 might exert, in vitro, direct effects on the virulence traits of Candida spp., and its influence is dependent on the exposure time. Non-albicans Candida species presented particular responses to IL-6.

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Formulation and evaluation of controlled release ocusert of gatifloxacin and prednisolone

Navneet Nagpal1, Sukhmanpreet Singh1, Guraasdeep Kaur1, Parminderjit Kaur1, Ravi Kumar Dhawan2, Mandeep Singh Chhina3, Manisha Arora3

1. Department of Pharmaceutics, Khalsa College of Pharmacy, Amritsar, India
2. Department of Pharmacology, Khalsa College of Pharmacy, Amritsar, India
3. Department of Pharmaceutical Chemistry, Khalsa College of Pharmacy, Amritsar, India

DOI: 10.2478/amma-2021-0032

Objective: Ocuserts are sterile, solid, or semisolid dosage forms prepared to attain increased contact time between the drug and the conjunctival tissue to keep up a constant release of drug when placed in the lower cul-de-sac or conjunctival sac of the eye. The aim of formulating this delivery system was to treat both inflammatory and infectious conditions of the eye with increased ocular residence time by releasing drugs at a slow and constant rate.
Method: Gatifloxacin, and prednisolone ocuserts were prepared by solvent casting method, and evaluated for physical appearance, uniformity of weight, thickness, folding endurance, drug content, surface pH, in-vitro, and ex-vivo release profile.
Results: All formulated inserts exhibited positive results in terms of their evaluation parameters. Ocuserts were sterile, with no turbidity in selected media during the study, and they were stable throughout six months.
Conclusion: Results suggested that prepared optimized ocusert formulation would be a suitable alternative to eye drops for treating conjunctivitis and other bacterial infections.

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Online pharmacy: customer profiling

Marius Călin Cherecheș1, Cristian Olimpiu Popa2

1. Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Faculty of European Studies, Babeș-Bolyai University, Cluj-Napoca, Romania

DOI: 10.2478/amma-2021-0031

Introduction: Nearly three out of four European citizens purchase goods online. The main advantages of using an online pharmacy are lower prices and convenience. In addition, patients appreciate a higher degree of privacy and access to a wider selection of health products. Study shows that the number of online users is on the rise in major countries like the USA, EU member states or India.
Methods: The study is based on data collected in April 2020 at the country level (Romania) from a sample of 789 adults over the age of 18, using CATI. A simple random sampling procedure was applied, with a confidence interval of 3.5% and a confidence level of 95%.
Results: About 17.7% of Romanians have purchased healthcare products through online pharmacies or drugstores, of those 60% are women, between 30 – 64 years old (84 %), have a monthly income of more than 2700 lei (90%), and a university degree (76%). The most common reasons for choosing an online pharmacy are the ability to compare prices, shop quickly, and have prompt access to items and information, together with a wider range of products.
Conclusions: Respondents’ motivation to use online pharmacies appears to be more related to the benefits of the online media, rather than to some unmet needs in brick-and-mortar pharmacies. Search capabilities, access to more information, price comparison, as well as a larger range of products and availability 24/7 are some reasons why patients utilise online pharmacies to purchase medicines.

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Adenosquamous and squamous cell carcinoma of the pancreas: two histopathological variants of ductal adenocarcinoma

Tiberiu-Bogdan Szekely1, Cornelia Toganel1,2, Zoltan Kadar1,2, Alexandra Daniela Sava1, Tivadar Bara Jr.3, Daniela Roman1, Simona Gurzu4,5

1. Department of Oncology, Clinical County Hospital, Targu Mures, Romania
2. Department of Oncology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
3. Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
4. Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
5. Research Center of Oncopathology and Translational Medicine (CCOMT), George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2021-0025

Introduction: Primary squamous cell carcinoma (SCC) and adenosquamous carcinoma of the pancreas are rare malignancies for which diagnostic and treatment strategy are challenging. In this paper we present a literature review of these tumors based on two case reports.
Case presentation: In the first case, a 55-year-old male presented with an inoperable pancreatic head/body junction tumor. Endoscopic ultrasound-guided fine needle aspiration was practiced, and histopathological examination revealed a squamous cell carcinoma of the pancreas. After exclusion of any another tumor, the diagnosis of cT4N0M0-staged primary pancreatic SCC was made. The patient is under treatment with gemcitabine and oxaliplatin. The second case is represented by a 73-year-old patient in which imagistic examinations highlighted a cystic mass of the pancreatic body. Following coporeo-caudal splenic-pancreatectomy and histopathological-proved diagnosis of adenosquamous carcinoma, the patient started chemotherapy but died at 11 months after surgery. Both tumor components displayed positivity for markers which prove ductal (cytokeratin19, maspin) and squamous differentiation (p63, cytokeratin5/6) same as vimentin, as indicator of epithelial mesenchymal transition (EMT).
Conclusions: SCC and adenosquamous carcinoma of the pancreas are aggressive malignancies which prognosis remains highly reserved. These tumors might be variants of ductal adenocarcinomas which are dedifferentiated through EMT phenomenon.

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