Volume 61, Number 3, 2015
Keywords:
Category Archives: Number
Intracoronary Imaging for In-Stent Restenosis – Ready for Clinical Routine?
Since the first human coronary stent implantation in 1986, the number of coronary stenting procedures rapidly increased and many different types of coronary stents have been introduced in the market of cardiovascular products [1]. Despite the introduction of new generation stents with superior quality (drug eluting or bioabsorbable stents) and despite the increasing experience in performing stenting procedures, the restenosis within the implanted stent, known as in-stent restenosis (ISR), continues to represent a major healthcare problem. ISR was noted in approximately 30% of cases following implantation of bare metal stents, however its incidence significantly decreased after introduction of new drug eluting stents (DES) in the recent years. [More]
Keywords:
Full text: PDF
Bulk Fill Resin Composite Materials Cured with Single-Peak versus Dual-Peak LED LCUs
DOI: 10.1515/amma-2016-0009
Introduction: Manufactures claim that recently introduced bulk fill materials (BFM) can be cured adequately in 4 mm increments. This requires adequate light energy to be transmitted through the material to ensure adequate polymerization at the bottom of the increment.
Aim: To compare the total light energy transmission through three BFMs and bottom/top (B/T) surface Vickers hardness (VH) when cured with single-peak versus dual-peak LED LCUs.
Methods and Materials: Samples (n=5) of two viscous BFMs, Tetric EvoCeram® Bulk Fill X-tra fil® [XF] flowable SureFil, were prepared. A conventional RBC, Tetric EvoCeram® was used as a control. Using MARC® RC, the irradiance delivered to top surface of samples was adjusted to 1200 mW/cm2. Samples were cured with singlepeak EliparTM S10 or dual-peakBluephase® G2 for 10 seconds and irradiance transmitted to the bottom surface measured. Samples were stored for 24 hours, prior to VH measurements B/T VH ratios were calculated.
Statistically analysed used oneway ANOVA (α=0.05).
Results: There was no statistically significant difference for B/T total energy transmission between materials except XF with EliparTM S10 (P<0.001). Total energy transmission ranged from 0.7 J/cm2 to 1.5 J/cm2. There was no statistically significant difference for B/T VH ratios between materials (P>0.05) when materials were cured with single-peak versus dual-peak LCU’s, XF>SDR>TEC>TBF. TBF alone, did not reach the generally accepted B/T VH of 80%.
Conclusions: Both single-peak and dual-peak LCU’s were equally effective for curing the studied bulk fill materials. Manufacture’s recommended total energy delivered to the top surface may not always be sufficient for effective curing.
Full text: PDF
Role of Transurethral Resection of the Prostate in the Management of Prostate Cancer
DOI: 10.1515/amma-2016-0008
Introduction: Prostate cancer is the second most diagnosed cancer in men, after lung cancer. The gold standard procedure in prostate cancer (PCa) diagnosis is the ultrasound guided prostate biopsy. Transurethral resection of the prostate (TURP) used in solving the bladder outlet obstruction, can have a role in detection of PCa. The aim of this retrospective study is to examine the role of transurethral resection of the prostate in the diagnosis and therapy of prostate cancer.
Materials and methods: At the Urology Clinic of Targu Mures we performed a total of 474 TURP over a two year period (2011-2013). The patients had a mean age of 71.857 years, and the indications were PCa with bladder outlet obstruction or bladder outlet obstruction with unknown causes but some with suspicion of PCa.
Results: In case of 474 patients with TURP performed for bladder outlet obstruction, the histopathology findings were the following: 61 cases with newly diagnosed PCa, some in spite of normal PSA values, 23 cases with already hormone treated prostate cancer, while in 50 cases TURP was preceded by prostate biopsy (in 8 cases with increased PSA and several negative biopsies, we could confirm PCa of the peripheral zone of the prostate).
Conclusion: TURP remains the elective surgical therapy of the bladder outlet obstruction, caused by BPH and even prostate cancer. Obtaining a greater volume of prostate tissue can help in the detection of prostate cancer in its early stages, especially in the transitional zone.
Keywords: prostate cancer, transurethral resection of the prostate, prostate specific antigen, bladder outlet obstruction, transrectal ultrasound guided prostate biopsy
Full text: PDF
The Effectiveness of Using Medical Students for Training High School Students in Cardiopulmonary Resuscitation
DOI: 10.1515/amma-2016-0005
Introduction: Training for cardiopulmonary resuscitation is a very important topic for society, trainers and researchers. However it is not yet established who should be trained and by whom nor how the training programmes should be accomplished. We developed a study to evaluate an existing programme where medical students train high school students in cardiopulmonary resuscitation using instrumented mannequins to teach and collect performance data.
Method: The students of four randomly selected high school classes were trained by four randomly selected medical students and were evaluated by an independent evaluator. The level of knowledge provided and the level of technical skills acquired were analysed.
Results: One hour of lecturing was enough to increase the mean of correct answers from 39.52% to 78.48% when we tested knowledge. Testing for skills retention we found that that 92.75% of trained students taped the shoulder; 95.65% asked loudly “Are you all right?” at the right moment; 97.1% shouted for help at the right moment, the entire group remembered to check the breathing at the right moment, and 92.75% executed a correct head tilt chin lift manoeuvre; 86.9% remembered to call 112 at the right moment. Automatic recordings showed that mean flow fraction was 80.74%, mean no flow time was 18.9 seconds, mean frequency of chest compressions was 134.7/min and mean compression depth was 39.06 mm.
Conclusions: The results showed that high school students achieved a good level of knowledge and acceptable cardiopulmonary resuscitation skills when trained by medical students.
Keywords: medical students, training, effectiveness, cardiopulmonary resuscitation, high school students
Full text: PDF
Determination of HMG-CoA reductase inhibitors by micellar electrokinetic chromatography
DOI: 10.1515/amma-2016-0006
Objective: In this study we report the development of a simple, rapid and efficient capillary electrophoresis method for the simultaneous determination of atorvastatin, fluvastatin, lovastatin and simvastin.
Methods: Capillary zone electrophoresis proved to be efficient for the simultaneous separation of atorvastatin and fluvastatin, but could not resolve the determination of lovastatin and simvastatin. The simultaneous separation of all four statins was achieved by applying a micellar electrokinetic chromatographic method, after transforming lovastatin and simvastatin in β-hydroxyl acid forms through alkaline hydrolysis. The optimum electrophoretic conditions and analytical parameters were investigated and the analytical performances of the method were verified with regard to linearity, precision, accuracy, LOD and LOQ.
Results: The optimum electrophoretic separation conditions were: 25 mM sodium tetraborate with 25 mM sodium dodecyl sulphate buffer electrolyte at pH 9.5, applied voltage + 25 kV, separation temperature 25 °C, injection pressure/time 50 mbar/1 minutes, UV detection at 230 nm. Using the optimized electrophoretic conditions we succeeded in the simultaneous determination of the four statins in approximately 3 minutes, the order of migration being: atorvastatin, fluvastatin, lovastatin, simvastatin. The proposed method has been applied to the determination of the analytes in pharmaceutical tablets formulations.
Conclusions: The capillary electrophoretic method developed in the present work proved to be suitable for the routine analysis of statins and can be adopted as quality control protocol in pharmaceutical analysis.
Keywords: pharmaceutical analysis, statins, capillary electrophoresis, micellar electrokinetic capillary chromatography, simultaneous determination
Full text: PDF
The usefulness of narrow band imaging endoscopy for the real time characterization of colonic lesions
DOI: 10.1515/amma-2016-0004
Narrow band imaging represents a promising endoscopic technique which allows real time characterization of colonic lesions by assessment of mucosal and vascular patterns. Due to the ability to make an optical biopsy, NBI could become a useful tool in clinical decisions regarding therapy and surveillance. The aim of this paper is to review the current knowledge on the optical diagnosis of colonic lesions by using NBI endoscopy. We reviewed research articles, reviews and meta-analyses from the PubMed and MEDLINE containing relevant data in this field.
The validity of endoscopic criteria for the differentiation of adenoma and hyperplastic polyps, as well as of invasive cancer, has been evaluated in recent studies. Based on the prediction of polyp histology, new potential cost saving strategies have been proposed. Many reports are focused on the accuracy of optical biopsy by using NBI for predicting colonoscopy surveillance intervals and adenomatous histology in diminutive polyps, according to the Preservation and Incorporation of Valuable Endoscopic Innovations statement. Optical diagnosis is still under evaluation, and cannot yet be endorsed in routine practice. The high level of performance achieved by expert endoscopists needs to be replicated in the community utilizing reliable and standardized endoscopic criteria.
Full text: PDF
Diet, Smoking and Family History as Potential Risk Factors in Acne Vulgaris – a Community-Based Study
DOI: 10.1515/amma-2016-0007
Objective. This study aimed to evaluate the effects of practices and attitudes towards lifestyle in adolescence as risk or protective factors, for both the acne occurrence and lesions’ severity.
Methods. A cross-sectional study based on a self-reported questionnaire was conducted during 4 months on 148 high school students, aged 16-20 years, in a high school community of Tîrgu Mureș. Acne prevalence and severity, demographic and anthropometric characteristics, the family history of acne vulgaris, smoking behavior and the weekly intake of certain food categories supposed to increase the risk of acne vulgaris were evaluated. Statistical analysis was performed in terms of Odds ratio, Confidence Interval and Chi-square (p<0.05) methods.
Results. In the investigated community, acne prevalence was found of 47.30%, while 78 subjects (control group) had no facial acne lesions. In acne group: 57.1% had family history of acne, 62.9% were smokers, 22.9% were overweight or obese and 84.3% did not receive any dietary information from specialists. 41.4% were not fish consumers, while 74.3% rarely or never were eating fruits and vegetables. Statistically significant differences between the two analyzed groups were found in terms of sweets, carbonated drinks, dietary fat, white bread, fish, fruits and vegetables weekly intake.
Conclusions. Family history, smoking behavior, excessive dietary fat, sweets, carbonated drinks and white bread could be considered as risk factors in acne vulgaris. An increased weekly intake of fish, vegetables and fruits, may have a protective effect in acne development or severity.
Full text: PDF
Endocrine dysfunction in neurofibromatosis type 1 – an update
DOI: 10.1515/amma-2016-0003
Background: Neurofibromatosis type 1 is an autosomal dominant disorder associated with multiple neoplasms particularly those of ectodermal origin. Various endocrine pathologies are often present, among them, hyperparathyroidism and follicular thyroid lesion are very rare described and their coincidence in the same patient has not been described in the literature reviewed.
Subject: A 59-years-old woman with clinical manifestation of neurofibromatosis type 1 developed dysphagia, dysphonia, choking sensation. Physical and imagistic examination revealed a multinodular goiter with microfollicular lesion on fine needle aspiration biopsy (FNAB), elevated parathormone levels and severe osteoporosis. The surgically removed thyroid contained a nodule with follicular architecture of uncertain malignant potential; the parathyroid tissue appeared normal.
Discussion and conclusion: This case serves as a reminder to look for non-neurogenic tumors in patients with neurofibromatosis. Clinicians must be aware of the diverse clinical features of this genetic disorder.
Full text: PDF
Volemic resuscitation in a patient with multiple traumas and haemorrhagic shock. Anti-oxidative therapy management in critical patients. A Case Report
DOI: 10.1515/amma-2016-0002
A patient with multiple traumas is usually found in severe haemorrhagic shock. In 40% of the cases, the patient with multiple traumas and haemorrhagic shock cannot recover due to secondary injuries and complications associated with the shock. In this paper we present the case of a male patient 30 years old, who suffered a car accident. The patient is admitted in our hospital with haemorrhagic shock due to femur fracture, acute cranial-cerebral trauma and severe thoracic trauma with bleeding scalp wound, associated with lethal triad of trauma. The clinical and biological parameters demand massive transfusion with packed red blood cells (PRBCs), fresh frozen plasma (FFP), cryoprecipitate (CRY) and colloidal solution (CO) sustained with vassopresor for the haemodynamic stabilisation. During his stay in the ICU, the patient benefits from anti-oxidative therapy with Vitamin C, Vitamin E and Vitamin B1. After 14 days the clinical state of the patient improves and he is transferred in Polytrauma Department.
Full text: PDF
