Category Archives: Number

Tissue Integration of Synthetic Grafts and the Impact of Soft-Tissue Infection – An Experimental Model

Russu Eliza1*, Mureșan Adrian Vasile1, Cordoș Bogdan Andrei2, Cotoi Ovidiu Simion3, Copotoiu Constantin1

1 Department of Surgery, University of Medicine and Pharmacy of Tirgu Mures, Romania
2 Experimental Research Station, University of Medicine and Pharmacy of Tirgu Mures, Romania
3 Pathophysiology Department, University of Medicine and Pharmacy of Tirgu Mures, Romania

DOI: 10.1515/amma-2015-0097

Objective: Starting with the ‘Vinyon-N-revolution’ of the 50’s, there has been a constant interest in understanting tissue integration, or the so-called graft healing process, as well as its relationship with infection. In this study we present an experimental animal model designed to assess tissue integration of different graft materials, and their reaction to the presence of infection. Methods: Synthetic grafts (knitted Dacron®, woven Dacron®, silver-impregnated Dacron® and Gore-Tex®) were implanted subfascially in the interscapular region of Wistar rats. Animals were divided into a control group and an infected group, with infection induced using bacterial suspensions of standard strains of Staphylococcus aureus, Staphylococcus epidermidis, and Escherichia coli. Implants were retrieved at 2 and 4 weeks postoperatively in the control group and at 1, 2 and 3 weeks postoperatively in theinfected group. Retrieved grafts were assessed bacteriologically and morpho-pathologically. Results: All microorganisms produced clinically evident infections, with positive blood cultures in case of E. coli. Staphylococci produced more massive infections on Dacron® grafts, except for the silver-impregnated version, while E. coli produced more significant infections on Gore-Tex® grafts. Morpho-pathologically Dacron® grafts behaved poorly, with ocassional complete structural compromise, and no difference between the conventional and the silver-impregnated type. The Gore-Tex® graft showed a consistent structural resistance throughout the study period. Conclusions: Although the silver-impregnated graft inhibited bacterial growth, it was poorly tolerated by the host tissue. In contrast, Gore-Tex® grafts showed more massive infection, especially with E. coli, but kept their structural integrity surprisingly well.

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Determination of Secondary Bile Acids in the Mice Feces. Controversies on their Involvment in the Pathogenesis of Colorectal Cancer

Saracut Claudiu1,2, Molnar Calin1,2, Farczádi L3, Vlase L4,5, Tero-Vescan Amelia6,1, Todoran Nicoleta7,1, Copotoiu Constantin1,2

1 University of Medicine and Pharmacy Tirgu Mures, Romania
2 Surgical Clinic 1, Tirgu Mures Emergency County Hospital, Romania
3 Vim Spectrum SRL, Romania,
4 Department of Pharmaceutical Technology and Biopharmaceutics Faculty of Pharmacy, Cluj-Napoca, Romania
5 University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania
6 Department of Pharmaceutical Biochemistry and the chemistry of environmental factors, Tirgu Mures, Romania
7 Department of Pharmaceutical Technology, Tirgu Mures, Romania

DOI: 10.1515/amma-2015-0096

Objectives: The aim of the study was to determine the level of secondary bile acids (SBA) in the diets and feces of mice and the variation of amount ingested/excreted if these SBA are administered as monotherapy or in 1:1 dose. Methods: The mice were divided into 4 groups and fed for 140 days with different diets. The control lot received a normal diet and the others received diets supplemented with 0.25% deoxycholic acid (DCA), 0.25% lithocholic acid (LCA) and 0.125% DCA+0.125% LCA. After 140 days, the mice feces were collected and homogenized to obtain a mixture for each lot from which the determinations of the studied SBA were performed. For the mice food evaluation, portions of 10 g from each of the 4 diets were subjected to the SBA determination. Results: The daily ingestion over more than 4 months of DCA or LCA added to the diet and administered as monotherapy determine a significantly increase of the SBA eliminated into the feces (the DCA level was 11x higher, and of the LCA 233x higher). If half of the LCA dose is replaced with DCA, the level of LCA in the feces gets comparable with that of the DCA (their combined amounts represents only 13x higher increase of these two bile acids in feces). Conclusions: The simultaneous ingestion and excretion of DCA and LCA can be considered as a particular situation ruled by endogenous mechanisms. This behavior represents an important observation, knowing that the bile acids effects in the colorectal cancer are dose dependent.

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The Prevalence and Correlates of Eating Between Meals in a Cross-Sectional Study of a Health Oriented Adult Population

Nadasan Valentin*, Gabos Gabriella, Tarcea Monica, Abram Zoltan

University of Medicine and Pharmacy Tirgu Mureș, Romania

DOI: 10.1515/amma-2015-0095

Objectives: To assess the prevalence of snacking and to explore the relationship between snacking and several demographic, anthropometric, functional and biochemical factors. Methods: The study included 756 individuals over 18 years of age from Medias, Romania. Demographics and data about snacking were collected by trained volunteers. Height, weight, waist circumference, blood pressure were measured with standard equipment according to accepted procedures. Blood glucose and cholesterol were measured by experienced nurses using portable devices. Associations between variables were checked with the Pearson Chi-square test. Odds ratios and 95% confidence intervals were calculated to measure the association between binary variables. Results: About half of the subjects in the studied sample reported snacking less than 2 times / week, 34.5% between 3-4 times / week and 14.8% more than 4 times / week. Statistical analysis found that snacking was associated with gender (males being less likely to snack than females), ethnicity (non-Romanians being less likely to snack than Romanian ethnics), marital status of the subjects (not married people being less likely to snack than married people ), systolic blood pressure (people consuming more often snacks being less likely to have high systolic blood pressure values), and blood sugar level (people eating more frequently between meals being more likely to have higher blood glucose levels). Conclusions: Snacking was a widespread eating habit among the study participants and was significantly associated with gender, ethnicity, marital status, systolic blood pressure and blood glucose levels.

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Determination of Omega-3/Omega-6 Ratio in Swine Brain Homogenate as an Animal Model for Human Nervous Tissue

Tero-Vescan Amelia1, Osz Bianca-Eugenia2*, Vari Camil-Eugen2, Imre Silvia3, Hancu Gabriel4

1 Department of Pharmaceutical Biochemistry, University of Medicine and Pharmacy Tîrgu Mures, Romania
2 Department of Pharmacology and Clinical Pharmacy, University of Medicine and Pharmacy Tîrgu Mures, Romania
3 Department of Analytical Chemistry and Drug Analysis, University of Medicine and Pharmacy Tîrgu Mures, Romania
4 Department of Pharmaceutical Chemistry, University of Medicine and Pharmacy Tîrgu Mures, Romania

DOI: 10.1515/amma-2015-0093

Objectives: The purpose of the study was to determine the omega-3/omega-6 ratio in swine brain homogenate by HPLC with UV detection and to discuss the values obtained by comparison to the human species. Materials and methods: Determinations were performed by HPLC method using as mobile phase an isocratic mixture (A:B – 5:95) of mobile phase A = 25% acetonitrile in water and B = acetonitrile with a flow-rate of 1.2 mL/min and UV detection at 205nm. Chromatographic column: Phenomenex C8 150×4.6 mm 5μm. 50 g swine brain was hydrolyzed with 100 mL 0.5N HCl, the organic phase was extracted in 50 mL hexane, concentrated by evaporation and resumed in 200 μL acetonitrile. Results: Polyunsaturated fatty acids were separated as follows arachidonic acid (AA) – Rt = 2.69 min, docosahexaenoic acid (DHA) – Rt = 3.12 min and eicosapentaenoic acid (EPA) – Rt = 3.97 min. The following omega-3/omega-6 ratios were calculated (DHA + EPA)/AA = 0.572 ± 0.451, EPA/AA = 0.027 ± 0.015 and DHA/AA = 0.689 ± 0.612. Conclusions: The values obtained for these ratios should be balanced, but in reality they are in favor of the ratio denominator. Considering the physiological and nutritional similarities and that an accurate diagnosis of neurodegenerative disease is set in post-mortem, swine brain homogenate could serve as an animal model for human nervous tissue.

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Mass Casualty Incidents and Disasters Participation in Real versus Simulated Events in Romania

Stănescu Adrian*, Boeriu Cristian, Copotoiu Sanda-Maria

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

DOI: 10.1515/amma-2015-0092

Background: 
The current study outlines some of the main particularities of both real and simulated mass casualty incidents (MCI) and disasters in Romania as reported by medical and paramedical participating personnel.
Methods:
 A non-profit organization in Romania trained 1250 doctors, nurses and paramedics for proper MCI interventions through a dedicated programme for the last part of the year 2013. Half a year later, an email with a unique link to an online questionnaire was sent to each participant to assess their opinion over the participation on real or already simulated MCI or disasters. The questionnaire consisted of 25 specific topics, out of which only a fraction were considered for the current study.
 Results: 
Out of all participants, 145 doctors, 184 nurses and 115 paramedics provided valid answers, totaling 444 responders. Most of the participants were satisfied with the information about the location and type of the incident they would respond to. The amplitude of a given event is generally well anticipated under simulation conditions as compared to real events, where the amplitude tends to be higher rather than lower than expected (p=0.0082). About three quarters of participants under real or simulated events repeated or demanded repeating the information trafficked through mobile radios, almost a quarter misinterpreted the information, and almost a half reported delayed operations due to miscommunication. Conclusions: 
Simulations are a proper method of communication evaluation for mass casualty incidents and disasters, which can also stress the common communication issues encountered during a real MCI unfolding.

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Ambulatory Blood Pressure and Arterial Stiffness in Obese Children and Adolescents

Duicu Carmen1*, Mărginean Cristina Oana1, Pitea Ana Maria1, Melit Lorena Elena2

1 University of Medicine and Pharmacy Tirgu Mureș, Romania, 1st Department of Pediatrics
2 Emergency Clinical County Hospital of Tirgu Mureș, Romania, Pediatrics Clinic 1

DOI: 10.1515/amma-2015-0090

The aim of the present study was to investigate differences regarding 24-hour blood pressure and arterial stiffness in a cohort of office normotensive obese and non-obese children and adolescents, and to evaluate correlations of these parameters with some anthropometric indices.
We retrospectively evaluated ABPM records in 71 children (42 boys); 31 obese compared with 40 normal-weight children.
Results: Mean 24-hour, day-time and night-time SBP was significantly higher in the obese group than in the control group (p <0.01 during the entire period). Significantly higher AASI values were found in obese children compared to controls (0.45 vs. 0.41, p <0.05), the difference being more obvious for day-time AASI (p <0.001). Conclusions: This research confirms that SBP and AASI are increased in obese children. AASI is a useful index of arterial stiffness that can be easily measured under ambulatory circumstances in children.

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Graham Little-Lassueur Syndrome with Hypertrophic Lichen Planus in a Patient with Chronic Hepatitis C

Badea Mihail Alexandru1, Buicu Florin2*, Ţilea Anton Mihai3, Badea Iudita Maria4, Chiotoroiu Andreea Luciana5, Mureșan Vasile Adrian5, Morariu Silviu Horia6

1 Dermatology Clinic, County Hospital of Tîrgu Mureș, Romania,
2 Department of Public Health and Medicines Management, Tîrgu Mureș,
3 Dermatology Clinic, Emergency Military Hospital, Bucharest, Romania
4 Anesthesiology and Intensive Care medicine Clinic, Emergency County Hospital of Tîrgu Mureș
5 University of Medicine and Pharmacy Tîrgu Mureș, Romania
6 Department of Dermatology, University of Medicine and Pharmacy Tîrgu Mureș, Romania

DOI: 10.1515/amma-2015-0089

Graham Little-Lassueur Syndrome (GLLS) is considered a form of lichen planopilaris which associates follicular lichen planus, cicatricial alopecia of the scalp and noncicatricial alopecia of the axillary and/or pubic regions. We present the case of a 47 years old female patient, known for 5 years with chronic hepatitis C and a poor therapeutic control of the disease due to Interferon intolerance. She presented to our clinic for the occurrence on the shins of some well-defined, intensely pruritic erythematous plaques, covered with thick scales, with a verrucous appearance, accompanied by excoriations. The skin biopsy reveal hypertrophic lichen planus on the shins and lichen planopilaris on the scalp. The patient was treated with systemic antihystamines, topical corticosteroids and salicylic acid under occlusion, emollients, phototherapy UVB narrow band 4 sessions/week for 3 weeks, cryotherapy. From our knowledge this is the first case of GLLS associated with chronic viral hepatis C.

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Minimally Invasive Treatment With Platelet Rich Plasma In Patients With Knee Osteoarthritis

Albu Daniel–Emil1*, Copotoiu Monica2, Jeremias Cristina2, Susca Mihaela2, Melinte Răzvan1, Bățagă Tiberiu1, Copotoiu Sanda-Maria3

1 Department of Orthopedic Surgery and Traumatology I, County Emergency Clinical Hospital, Tirgu Mures, România
2 Department of Rheumatology and Physiotherapy, County Emergency Clinical Hospital, Tirgu Mures, România
3 Department of ICU and Anesthesiology I, County Emergency Clinical Hospital, Tirgu Mures, România

DOI: 10.1515/amma-2015-0094

Background: The main target of the structural damage in osteoarthritisis the hyaline cartilage. New options such as PRP (platelet rich plasma) may cause structural improvement of the cartilage. Objective: The aim of ourstudywas to evaluate the evolution of the patients with knee osteoarthritis on PRP treatment. Material and method: The patients with osteoarthritis were evaluated at enrolment and every three months by ultrasound knee ecography. A semi-quantitative knee ultrasound score was applied to monitor changes before and after the treatment. The score was composed by the presence of the following: bursitis (1 point), hypoechogenic changes at the level of the hyaline cartilage in the anterior transversal window (1 point), asymmetrical narrowing of the cartilage (1 point), the involvement of the medial cartilage in the longitudinal approach (1 point), the involvement of lateral cartilage in the longitudinal approach (1 point) and the presence of step up lesions – osteophytes (1 point The evaluation was performed independently by two separate physicians. Another ultrasound – trained doctor was analysing all the images. Results: Twenty – nine patients were included in our study; with one patient excluded due to masive bursitis. No differences were found concerning the pathological findings between the first two evaluators (p: 0.1250). So far, only nine patients have been evaluated at three months, and we were unable to find any improvements or worsening concerning the ultrasound alterations (p: 0.0625). The ultrasound lack of modifications was not correlated with the functional status of the subjects. Conclusions: In the short term, the local treatment showed no improvement on structural damage, but it improved the overall status of the patients (less pain, improved mobility, a better quality of life).

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Radial Nerve Injury After Brachial Nerve Block- Case Series

Szederjesi Janos, Lazar Alexandra, Rad Paul, Almasy Emoke

Department of Anaesthesiology and Intensive Care, University of Medicine and Pharmacy, Tirgu-Mures, Romania

DOI: 10.1515/amma-2015-0088

Adding epinephrine to local anesthetics is recommended to extend the duration of peripheral nerve blocks. We describe in this article two cases of radial nerve injury possible due to coadministration of epinephrine during brachial plexus block.

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The Assessment of Reperfusion Inflammatory Injury in Ischemic Preconditioned Diabetic Rats

Grigorescu Bianca-Liana1, Fodor Raluca Ştefania2, Scridon Alina3, Perian Marcel3, Badea Iudita2, Cioc Adrian Dan1, Cotoi Ovidiu Simion4, Copotoiu Sanda-Maria2, Azamfirei Leonard2

1 Department of Anaesthesiology and Intensive Care, Emergency County Hospital, Tirgu-Mures, Romania
2 Department of Anaesthesiology and Intensive Care, University of Medicine and Pharmacy, Tirgu-Mures, Romania
3 Department of Physiology, University of Medicine and Pharmacy, Tirgu-Mures, Romania
4 Department of Pathophysiology, University of Medicine and Pharmacy, Tirgu-Mures, Romania

DOI: 10.1515/amma-2015-0087

Objective: The assessment of systemic reperfusion injury and the contractile force of the peripheral muscles post-acute ischemia of the hind limbs in healthy versus diabetic ischemic preconditioned rats. Method: The study included 16 Wistar rats divided into two groups: the control group and the diabetic ischemic preconditioned group. Acute ischemia was induced, followed by reperfusion. The assessment of reperfusion injury used biochemical, histopathological and functional determinations (peak tetanic tension-PTT, specific tension-ST). Results: Ischemia-reperfusion injury was more severe in control group regarding creatine-kinase (CK) (CK1=470.13 IU/L versus CK2=230.88 IU/L, p=0.0001) and myoglobin (390.25 ng/mL versus 47.99 ng/mL, p=0.025). Cytolysis enzymes were significantly increased in diabetic preconditioned rats (Alanine aminotransferase ALAT1=46 IU/L, ALAT2=167.8 IU/L, p=0.02; Aspartate aminotransferase ASAT1=106 IU/L, ASAT2=237.5 IU/L, p=0.016). Functional assessment (PTT and ST) highlighted roughly equal values. A paradoxical response occurred in diabetic rats (the contractile force increased during the period of the stimulation). Histopathological findings showed that rhabdomyolysis was more severe in the control group, while inflammatory systemic response due to reperfusion injury was less expressed in diabetic ischemic preconditioned rats. Conclusions: Ischemic preconditioning reduces the severity of reperfusion injury and allows the preservation of contractile muscle function in diabetic rats.

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