Category Archives: Number

Efficacy and Safety of Percutaneous Nephrolithotomy in Patients Over 70 Years with Kidney Stones

Ciprian Todea-Moga, Radu Boja, Daniel Porav-Hodade, Adrian Maier, Veronica Ghirca, Orsolya Mártha

University of Medicine and Pharmacy Tirgu Mures, Romania, Clinic of Urology

DOI: 10.1515/amma-2016-0024

Introduction and objectives: Percutaneous nephrolithotomy represent the main indication for patients with kidney stones, even in the presence of various comorbidities. In our clinic open surgery for this pathology is less than 0.5% of allprocedures for renal stones. The objective of this paper is to assess the safety and efficacy of this procedure in patients over 70 years.
Material and methods: A retrospective study was performed for a period of 16 years (1997-2012). A totally of 323 patients entered in this study (162 women, 161 men), aged over 70 and with renal stones They were treated endoscopically by percutaneous nephrolithtomy or anterograde ureteroscopy. 85 patients (26.31%) had comorbidities that were preoperatively diagnosed and treated where necessary.
Results: Overall status of “stone free” at the end of surgery was present in 263 patients
(81.42%). 60 patients (18.58%) had residual fragments. Residual stones were solved by a new percutaneuos nephrolithtomy session, spontaneous elimination or extracorporeal shock wave lithotripsy. The most common complications were bleeding and infection. We had no deaths. No hemostasis nephrectomy was necessary.
Conclusions: Recognized preoperative comorbidities do not represent risk factors in elderly patients, but it requires a rigorous evaluation in the preoperative period. The number, size and complexity of stones directly influences the state “stone free” at the end of surgery.

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The Osteoprotegerin – Von Willebrand Factor Complex: Protagonist Or Bystander In Atherothrombosis?

Nagy Elod*

University of Medicine and Pharmacy of Tirgu Mures, Romania, Faculty of Pharmacy

DOI: 10.1515/amma-2016-0012

Two important cardiovascular risk factors, osteoprotegerin and Von Willebrand Factor form complex in endothelial cells and in circulating blood. The pathophysiological role of the complex is unknown. We give a brief review of the relevant literature and confront it with some of our recent findings regarding the OPG-VWF correlation.

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Deep Venous Thrombosis Associated With Inferior Vena Cava Abnormalities And Hypoplastic Kidney In Siblings

Duicu Carmen*, Bucur Gabriela, Simu Iunius, Tripon Florin, Marginean Oana

University of Medicine and Pharmacy of Tirgu Mures, Romania

DOI: 10.1515/amma-2016-0011

Congenital inferior vena cava anomalies have a reduced frequency in general population, many times being an asymptomatic finding. Patients caring such anomalies are at risk to develop deep vein thrombosis. In this paper, we present 2 siblings with deep venous thrombosis and inferior vena cava abnormalities, with a symptomatic onset at similar age. The inferior vena cava abnormality was documented by an angio-CT in each case. The thrombophilic workup was negative. Patients were treated with conservative therapy: low molecular weight heparin anticoagulants converted later to oral anticoagulant with resolution of symptoms and disappearance of the thrombus. Finally, in the absence of any risk factor in a young patient admitted with deep vein thrombosis investigations to exclude inferior vena cava anomalies are mandatory.

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Ethical Considerations In Dental Care For People With Developmental Disabilities

Biris Carmen, Bud Eugen, Ormenian Alina, Lazar Ana Petra*, Pop Diana, Yero Eremie Lia Maria, Lazar Luminita

Universitatea de Medicina si Farmacie Tirgu Mures, Romania

DOI: 10.1515/amma-2016-0010

Developmental disabilities exist in children and adolescents, enabling them to live an independent and self-governing life, requiring special health related services. We are intended to inform dental professionals in planning and implementing a dental treatment for people with developmental disabilities. Cerebral palsy is defined as being a group of motor abnormalities and functional impairments that affect muscle coordination, and characterized by uncontrolled body movements, intellectual disabilities, balance-related abnormalities or seizure disorders. These patients can be successfully treated in normal dental practices, but because they have problems with movements, care must be tailored accordingly. Down syndrome, a very common genetic disorder, is usually associated with different physical and medical problems, intellectual disabilities, and a developmental delay. These patients can be treated with success in dental offices, this way making a difference in the medical care for people with special needs. Autism is a neurodevelopmental disorder characterized by impaired social interaction, verbal and non-verbal communication and by restricted and repetitive behavior. Self-injurious behavior, obsessive routines and unpredictable body movements can influence dental care. Because of the coexisting conditions (epilepsy or intellectual disability), one can find this people among the most challenging to treat. There is a need of greater awareness, focus and education in the field of the unique and complex oral health care that people with disabilities need. Making a difference their oral health positively influences an already challenged existence. According to the ethical principles, patients with developmental disabilities should be treated equitably depending on their necessities.

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Intracoronary Imaging for In-Stent Restenosis – Ready for Clinical Routine?

Benedek Theodora*

University of Medicine and Pharmacy Tirgu Mures, Romania

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]

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Bulk Fill Resin Composite Materials Cured with Single-Peak versus Dual-Peak LED LCUs

Aldossary Mohammed1,2, Roebuck Elizabeth M1, Santini Ario3*

1 Department of Paediatric Dentistry. The University of Edinburgh, Edinburgh Dental Institute, Lauriston Place, Edinburgh EH3 9HA, United Kingdom
2 King Salman Hospital, Ministry of Health, Riyadh, Kingdom of Saudi Arabia
3 The University of Medicine & Pharmacy, Tg-Mures, Romania

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.

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Role of Transurethral Resection of the Prostate in the Management of Prostate Cancer

Szollosi Attila, Martha Orsolya, Denes Lorand, Vida Arpad Oliver, Maier Adrian, Pavai Zoltan

University of Medicine and Pharmacy Tirgu Mures, Romania

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.

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