Category Archives: Number

Evaluation of Early Postoperative Cognitive Dysfunction Incidence and Involved Neurocognitive Functions in Patients with Cardiac and Noncardiac Surgery Under General Anesthesia

Carmen Sircuţa1, Tunde Lucza2, Mihaly Veres1, Ildiko Szomoru3, Leonard Azamfirei1

1 University of Medicine and Pharmacy Tirgu Mures, Romania
2 Emergency Institute for Cardiovascular Diseases and Transplantation Tirgu Mures, Romania
3 Emergency Clinical County Hospital of Tirgu Mures, Romania

DOI: 10.1515/amma-2017-0012

Objective: To analyse postoperative cognitive dysfunction’s (POCD) incidence and cognitive areas involved, in patients with cardiac and general surgery.
Material and Methods: Prospective observational study on 130 patients undergoing general or heart surgery on cardiopulmonary bypass, under general anesthesia. Two groups, 65 members each. Group A had a heart surgery and group B a noncardiac surgery. The same type of anesthetic drugs were used. All patients completed the Montreal Cognitive Assesment (MoCA) questionnaire: preoperative, 24 hours after stopping any medicine acting on central nervous system and 7 days postoperative. We compared the MoCA scores obtained on different cognitive domains in this moments for each group of patients, for neurocognitive functions: visuo-spatial executive, naming, attention, verbal fluency, abstraction, recall, orientation, final score. We compared the scores between the two groups at 24 hours and 7 days postoperatively for the same domains.
Results: POCD was found at 24 hours testing in both groups. At 7 days postoperatively POCD was not found in any of the groups. There was no statistically significant difference in total final score between two groups at 24 hours nor at 7 days postoperative testing. There are significant differences between the two groups, with lower score in cardiac group in 5 of 7 fields at 24 hours testing, with the persistence of difference in 2 of 7 fields at 7 days.
Conclusions: Overall POCD was present at 24 hours but was not found at 7 days testing for none of the groups. POCD is present in some neurocognitive domains and this depends on surgery type.

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The Risk of Using Poppy Seed Tea Made from Several Varieties Available on the Romanian Market

Mircea Dumitru Croitoru, Ibolya Fülöp, Maria-Raluca Irimia-Constantin, Erzsébet Varga, Hajnal Kelemen, Erzsébet Fogarasi, Luana-Maria Faliboga

University of Medicine and Pharmacy of Tîrgu Mureș, Tîrgu Mureş, Romania

DOI: 10.1515/amma-2017-0013

Objective: the number of alkaloids like morphine and codeine found in poppy seeds used in food industry are monitored by a directive given by European Food Safety Authority. Based on this regulation the aim of the study was to determine the quantity of morphine and codeine from several brands of poppy seeds.
Methods: an HPLC-UV method (205 nm) was developed to measure the quantity of morphine and codeine. Sample preparation was made using recipes posted on Drugs Forum by some users. Limits of detection were not determined because the lowest concentration from the reference (0.1 µg/ml) detected morphine concentrations that are far lower than a limit of toxicological concern.
Results: The concentrations, which were found, ranged between Below the Level of Toxicological Concern (BLTC) – 243.26 mg/kg for morphine and BLTC – 88.58 mg/kg for codeine using several methods of preparation.
Conclusions: one can observe that there are some brands of poppy seeds which do not respect the regulation about the amount of morphine and codeine. The high amount of morphine in some samples suggests that there are different varieties of poppy seeds, which can be used for an illicit purpose and can lead to addiction or even overdose in some cases.

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Clinical Outcomes after Regenerative Periodontal Therapy with Emdogain

Gabriela Felicia Beresescu1, Alina Ormenisan2, Melinda Szekely3, Monica Monea4, Adriana Monea4

1 University of Medicine and Pharmacy Tirgu Mures, Romania
2 Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy Tirgu Mures, Romania
3 Department of Tooth and Dental Arch Morphology, Faculty of Dental Medicine, University of Medicine and Pharmacy Tirgu Mures, Romania
4 Department of Odontology and Oral Pathology, Faculty of Dental Medicine, University of Medicine and Pharmacy Tirgu Mures, Romania

DOI: 10.1515/amma-2017-0015

Objective: Regeneration is defined as a reconstruction of a lost part of the body in such a way that the structure and function of the lost tissue are completely restored. The aim of this study is to compare the clinical outcomes of intrabony defects treatment using regenerative periodontal therapy with enamel matrix proteins (Emdogain, EMD) with a control group.
Methods: Ten patients with chronic periodontitis were included in this randomized, controlled clinical study. Two groups received conservative periodontal therapy. In the test group, different teeth received regenerative treatment with EMD. In the control group teeth received solely conservative periodontal therapy. Pocket depth probing (PD) and bone reduction (based on X rays) were registered at baseline and after eight months in both groups. In the control group
Results: Both groups showed a significant reduction of PD. The teeth treated with EMD showed a significant attachment gain. Within the test group, the radiographic examination of the teeth treated with EMD showed no significant change, whereas the teeth in the control group showed significant bone reduction.
Conclusions: Intrabony defects in teeth treaded with EMD exhibit a substantially higher gain in clinical attachment and defect filling. The use of EMD in dental practice can prevent further bone loss.

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Preparation and Characterization of Levofloxacin-Loaded Nanofibers as Potential Wound Dressings

Noémi Pásztor, Emőke Rédai, Zoltán-István Szabó, Emese Sipos

University of Medicine and Pharmacy of Tîrgu Mureș, Romania

DOI: 10.1515/amma-2017-0014

Objective: The study aimed at obtaining and characterizing levofloxacin-loaded, poly(ε-caprolactone) electrospun nanofiber formulations to be used as antibacterial wound dressings.
Methods: Drug-loaded nanofibers were obtained by the electrospinning process and their morphology was determined using scanning electron microscopy. Structural analysis of the prepared nanofibers was carried out using differential scanning calorimetry and dissolution testing was performed in order to determine drug release.
Results: Both nanofiberous formulations (containing 20 % and 50 % w/w levofloxacin) showed dimensions in the range of few hundred nanometers. Thermograms indicated that the formulation containing 20% levofloxacin was totally amorphized, showing a rapid release of the active, in 20 minutes.
Conclusions: The poly(ε-caprolactone)-based electrospun nanofibers, containing levofloxacin presented suitable characteristics for obtaining potential antibacterial wound dressings.

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Short Period Storage Impact on Bioactive Constituents from Bilberries and Blueberries

Ruxandra Emilia Ştefănescu1, Sigrid Eșianu2, Eszter Laczkó-Zöld2, Anca Mare3, Bianca Tudor3, Maria Titica Dogaru4

1 University of Medicine and Pharmacy Tîrgu Mureș
2 University of Medicine and Pharmacy Tîrgu Mureș, Faculty of Pharmacy, Department of Pharmacognosy and Phytotherapy
3 University of Medicine and Pharmacy Tîrgu Mureș, Faculty of Medicine, Department of Microbiology, Virology, and Parasitology
4 University of Medicine and Pharmacy Tîrgu Mureș, Faculty of Pharmacy, Department of Pharmacology and Clinical Pharmacy

DOI: 10.1515/amma-2017-0010

Objectives: The aim of this study was to assess storage effects on anthocyanin and total polyphenol content in different bilberry and blueberry extracts and to evaluate the antioxidant and antibacterial activity of these extracts.
Materials and methods: Total phenolic content, total monomeric anthocyanin content and antioxidant activity were determined in the first month and after three months storage of berries at either -20 °C or -50 °C. Two different solvents were used (methanol and 50% ethanol). Antibacterial activity was determined for the 3 months stored fruits using a microdilution method and was expressed as the minimum inhibitory concentration.
Results: There were significant differences between the concentration in the first month and after three months storage in both types of fruit extracts. Regarding the extracting solvent, we noticed that total phenols were better extracted with 50% ethanol, while the total monomeric anthocyanin content was higher in the methanolic extracts. No significant or slightly significant differences were observed between the fruits stored at -20 °C or -50 °C. Ethanolic extracts showed the highest scavenging activity. Good antibacterial activity was observed on gram-positive bacteria.
Conclusions: Storage conditions are an important factor that can influence chemical composition of fruits. Although freezing is a good option for preservation, our study showed a high decrease in the concentration of total phenols and anthocyanins after only three months. The fruits have shown a high antioxidant activity and a good antibacterial effect. Further studies are needed for better understanding the changes that can appear during the storage.

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Evaluation of Mechanical Properties of Nonsteroidal Anti-Inflammatory Matrix Type Transdermal Therapeutic Systems

Paula Antonoaea1, Nicoleta Todoran1, Emőke Rédai1, Adriana Ciurba1, Cătălina Bogdan2, Mirela Moldovan2, Daniela Lucia Muntean3

1 Department of Pharmaceutical Technology, University of Medicine and Pharmacy of Tîrgu Mureș, Romania
2 Department of Dermatopharmacy and Cosmetics, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
3 Department of Analytical Chemistry and Drug Analysis, University of Medicine and Pharmacy of Tîrgu Mureș, Romania

DOI: 10.1515/amma-2017-0011

Objective: Transdermal therapeutic systems (TTSs) represent an intensely studied alternative to oral delivery of non-steroid anti-inflammatory drugs (NSAIDs) in the treatment of rheumatic diseases due to its ability of avoiding the side effects of the oral route. This study aims to present the evaluation of the mechanical properties of three NSAIDs (meloxicam, tenoxicam and indomethacin) individually included in four type of polymeric matrixes, as part of new formulations development process.
Methods: 12 products in form of TTS matrixes were prepared by solvent casting evaporation technique, using hydroxypropyl methylcellulose (HPMC 15000, HPMC E5) and/or ethylcellulose as matrix-forming polymers. Each of the resulted products was evaluated by determining the water vapor absorption, desorption or transmission in controlled atmosphere humidity (evaluation of porosity); the elongation capacity, tensile strength and bioadhesiveness (evaluation of mechanical properties).
Results: The analysis of three groups of the experimental data expressed as averages on each group was necessary, in order to identify the parameters which statistically are critically influenced by the ingredients associated in the TTSs matrix compositions. Analysis by normality tests, variance and correlation tests (Anova, Pearson) enabled evaluation of the effect of NSAID type vs. the effect of polymer matrix type on the parameters of the NSAID TTS matrix.
Conclusions: Meloxicam incorporated in the structure of HPMC 15000 polymeric matrix favors its viscoelastic structure. Ethylcellulose functions as plasticizer and supports the matrix bioadhesiveness. HPMC E5 does not meet the requirements for TTS preparation in the used experimental conditions.

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CRISPR and precision medicine

Sanda-Maria Copotoiu*

Editor-in-Chief

The deceiving outcome of Jerry Gelsinger’s volunteer enrollment in a genetic study threatened to put the brakes on genetic research. Instead, despite the hidden risks, unanticipated and obviously unwanted, knowledge continued to evolve. The tragic death of a naïve volunteer on the altar of genetics ended in four lessons written by the leading personality and at that time, culprit for the obviously surprising collateral loss [1]. These were perceived at the time as a lecture behind the firewall the Penn University managed to build between James M. Wilson (the geneticist in cause) and the prosecutors [2]. Nine years have passed between J. Gelsinger’s lethal outcome and Wilson’s mea culpa. His death was preceded by seven years of intense research in genetics at the Penn University in the USA.
Today we are confronted with unacceptable mortality in sepsis and septic shock despite large and intense initiatives to oppose it. Antibiotics are either under optimally used, stewardship is reduced sometimes to a matter of perception. These tools are improperly used or inefficient at the end of the day.  [More]

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The Influence of Some Parameters on Chiral Separation of Ibuprofen by High-Performance Liquid Chromatography and Capillary Electrophoresis

Alina Balint, Anca Gabriela Cârje*, Daniela Lucia Muntean, Silvia Imre

Department of Analytical Chemistry and Drug Analysis, University of Medicine and Pharmacy Tîrgu Mures, Romania

DOI: 10.1515/amma-2017-0009

Objective: The aim of the study was to compare the influence of mobile phase composition and temperature on chiral separation of racemic ibuprofen by capillary electrophoresis and high performance liquid chromatography with UV detection.
Materials and methods: Racemic ibuprofen was analysed on a chiral OVM column with an HPLC system 1100 Agilent Technologies, under isocratic elution, by using potassium dihydrogen phosphate 20 mM and ethanol in mobile phase. The flow rate was set at 1 mL/min, UV detector at 220 nm and different column temperatures were tested. For electrophoresis separation an Agilent CE G1600AX Capillary Electrophoresis System system, with UV detection, was used. The electrophoresis analysis was performed at different pH values and temperatures, with phosphate buffer 25 mM and methyl-β-cyclodextrin as chiral selector.
Results: The chromatograhic analysis reveals a high influence of mobile phase pH on ibuprofen enantiomers separation. An elution with a mixture of potassium dihydrogen phosphate 20 mM pH=3 and ethanol, at 25ºC, allowed enantiomers separation with good resolution in less than 8 min.
Conclusions: The proposed HPLC method proved suitable for the separation of ibuprofen enantiomers with a good resolution, but the capillary electrophoresis tested parameters did not allow chiral discrimination.

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Relationship Between High Levels of Salivary Cotinine Test and Demographic Characteristics of Pregnant Smokers from Mures County

Ion Mihai Georgescu1, Monica Tarcea2, Claudiu Marginean3, Florina Ruta2, Victoria Rus2, Remus Sipos4, Zoltan Abram1

1 Department of Hygiene, University of Medicine and Pharmacy Tirgu Mures
2 Department of Community Nutrition, University of Medicine and Pharmacy Tirgu Mures
3 Department of Obstetrics and Gynecology I, County Emergency Hospital Tirgu Mures
4 Department of Anatomy, University of Medicine and Pharmacy TirguMures; Mures county General Practitioners Association

DOI: 10.1515/amma-2017-0008

Objectives: To evaluate the relationship between the frequency of self-declared status regarding smoking in a group of pregnant women from Mures county, Romania and the high levels of Salivary Cotinine (SC) like biomarkers.
Material and methods: It was conducted a retrospective study among 230 pregnant women presented for prenatal care at 50 General Practitioners cabinets in Mures county, Romania, in 2015. Data were collected with a validated questionnaire which included age, level of education, socioeconomic status and ethnicity, also the self-reported smoking status. The Salivary Cotinine level was evaluated using NicAlert Saliva test kits.
Results: Using salivary test we identified a high prevalence of involuntary exposure to cigarette smoke among both non-smokers and those who quit smoking before pregnancy. Also we registered pregnant women that although declared smoking cessation before pregnancy their salivary Cotinine levels were high, almost like to an active smoker, probably because of second-hand exposure or because they didn’t say the truth about their habit.
Conclusions: We underline the importance of implementing more efficient community interventions among this vulnerable group in order to reduce the frequency of smoking and sustain quitting.

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Development, Applications, Benefits, Challenges and Limitations of the New Genome Engineering Technique. An Update Study

Andrei Crauciuc1, Florin Tripon1, Andreea Gheorghiu1, Georgiana Nemes1, Alina Boglis1, Claudia Banescu1,2

1 University of Medicine and Pharmacy Tirgu Mures, Romania
2 Center for Advanced Medical and Pharmaceutical Research, University of Medicine and Pharmacy Tirgu Mureș, Romania

DOI: 10.1515/amma-2017-0007

We assume that the CRISPR Cas9 theory must be delimited by applicability because the consequences of long-term DNA manipulation remain unknown. Moreover, the irreversibility of this procedure should instigate researchers to reserved opinions. Usefulness as well as benefits of CRISPR Cas9 made it one of the most popular and used genome editing technique. But with its huge potential, ethical and safety concerns emerge. Therefore, before continuing research in this direction, we should have a well-organized system that is able to make that differentiation between research and reproduction. However, we truly believe in the future of genetic engineering and with the CRISPR-Cas9 system, we expect that the opportunity of treating now so called incurable diseases arises. Time is all we need.

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