Category Archives: Number

Considerations Upon a Case of Hepatocellular Carcinoma Treated with Magnetic Resonance Imaging – Guided Percutaneous Cryotherapy Guidance

Colțescu Camelia¹, Habersetzer F.¹, Oltean G.², Bățagă Simona², Georgescu D.², Garnon J.³

1 Department of Hepatology and Gastroenterology, University Hospital Strasbourg
2 Department of Internal Medicine, 1st Medical Clinic, Faculty of Medicine, the University of Medicine and Pharmacy (UMPh) Targu Mures
3 Department of Radiology, University Hospital Strasbourg

Hepatocellular carcinoma represents 5 % of the cases of death in the world. The recent epidemiological data show a major increase of its incidence in the western countries and USA, the explanation being through the growth in the incidence of viral hepatopathies, especially with hepatitis C virus. Of the patients diagnosed with hepatocarcinoma, 70 % benefit from palliative treatment only. The curative treatment in the case of hepatocarcinoma includes surgical resection, liver transplant, radiofrequency. Magnetic Resonance Imaging-guided percutaneous cryotherapy, the method in progress of evaluation, seems to give spectacular results in the case of small size, non resectable situated very close to the hepatic hylum. The evolution of a patient with viral cyrrhosis C complicated with a hepatocarcinoma and the problems related to hepatocarcinoma treatment while waiting for liver transplantation was the object of an analysis that allowed the emphasis of the lack of tumoral progress and the reduction of tumoral volume until its disappearing from an imagistic point of view.

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Is Psychiatry a Profession Associated with High Anxiety?

Roșu Codruța Maria1, Nireștean A.1,2, Toma Mirela1, Echim Iulia1

1 Acute Psychiatric Clinic II, Targu Mures, Romania
2 Psychiatric Department, University of Medicine and Pharmacy, Targu Mures, Romania

Background: Depending on intensity, anxiety can have an adapting and mobilizing role, or it can represent a serious risk.
Aim: To examine the prevalence of anxiety symptoms for those who work in a clinic of psychiatry.
Material and method: Group consists of 35 persons who work in the Acute Psychiatric Clinic II – Targu Mures. Anxiety was measured as a current emotional state and as a trait by Spielberger’s State-Trait Anxiety Inventory (STAI).
Results: Applying Spielberger’s Inventory 33.3% of the female and 28.5% of the male might be suspected of suffering from significant anxiety symptoms as a state. Also the subject’s predisposition to anxiety as a trait of the subject’s personality is important, 24% of female and 43% of men had levels of anxiety over 60% compared with standards.
Conclusions: An important number of people who work in psychiatry have high scores of anxiety. Further studies are needed to clarify to what extent this relates to a high prevalence of anxiety disorders.

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Lymph Node Harvest in Resected Colon Cancer Specimens

Kiss R.1, Kiss L.1, Chis F.1, Ilie S.3, Porr P.2, Alexe D.2, Maniu D.5, Mitachescu S.6, Zaharia I.4

1 1st Surgical Clinic, County Emergency Hospital of Sibiu
2 1st Medical Clinic, County Emergency Hospital of Sibiu
3 Intensive Care Clinic, County Emergency Hospital of Sibiu
4 Department of Pathology, County Emergency Hospital of Sibiu
5 Radiology Department, County Emergency Hospital of Sibiu
6 Gastroenterology Department, County Emergency Hospital of Sibiu

Background: The number of lymph nodes evaluated may be a measure of quality in colon cancer care and appears to be inadequate in most patients treated for colon cancer. We performed a systematic review of the evidence for the association between lymph node evaluation and oncologic outcomes in patients with colon cancer.
Aim: The adequate lymph node evaluation for cancer involvement, prognosis and adequate treatment of patients with colon cancer.
Method: It included information about diagnosis, patient age at diagnosis, the surgical procedure that was performed, anatomic location of the cancer, histology, tumor size, number of LN identified, number of LN positive for cancer, general stage (local, regional or to distance, TNM stage /A7CC). Rectal cancer was excluded. We analyzed data from the cancer registry of 1st Surgical Clinic of Sibiu including 287 patients with colon cancer. This registry includes follow-up information from 1998 to 2009. Identification of ≥12 LN (lymph nodes) in resected colon cancer specimens has been considered as a quality indicator. In patients with resected colorectal cancer, LN the involvement has particular importance for patient prognosis and adjuvant therapy.
Results: The average number of LN identified increased from 6±3 during 1998–2003, to 14±5 during 2003–2009. The proportion of patients diagnosed with positive LN increased from 31.6% during 1998–2003 to 37% during 2003–2009. No significant change in the proportion of patients diagnosed with just one positive LN (10% versus 10.6%) was observed.
Conclusion: The results suggest a relationship between the survival and identification of 12+ LN for stage I or II, considering the disease.

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Correlation Between Helicobacter pylori, Hiatal Hernia and Barrett’s Esophagus

Macarie Melania1, Bățagă Simona1, Crosnoi Daniela3, Macarie I.2, Török Imola1, Georgescu D.1,
Sârbu-Pop Silvia3

1 Clinic of Gastroenterology, Faculty of Medicine, UMPh Târgu Mureş
2 1st Medical Clinic, Faculty of Medicine, UMPh Târgu Mureş
3 Targu Mures County Clinical Emergency Hospital

Background: The incidence of adenocarcinoma of the esophagus has dramatically increased during the last 2 decades and so has the incidence of Barrett’s esophagus, one of the most important risk factors for esophageal adenocarcinoma.
Aim: The aim of this study was to determine whether infection with Helicobacter pylori is associated with a lower risk of Barrett’s esophagus development in our area, and if there is a direct correlation between hiatal hernia and Barrett’s esophagus.
Material and method: We studied a series of 4359 patients who were investigated by upper endoscopy in the Gastroenterology and Endoscopy Unit of Targu Mures County Clinical Emergency Hospital between the 1st of January 2009 and 31st of December 2009. Barrett’s esophagus was defined as the presence of specialized columnar epithelium with goblet cells in the esophagus. We compared the patients with Barrett’s esophagus with a similar serie with patients without reflux disease.
Results: In 33 patients a diagnosis of Barrett’s esophagus was established. There was a strong predominance of males. The mean age at diagnosis was 64.18 years. Helicobacter pylori was present in 17 cases (51.51%) in the control patients compared to 42.42% in patients with Barrett’s esophagus (p 0.622, Odds Ratio: 0.69 95% CI: 0.26-1.83). Hiatal hernia was present in patients with Barrett’s esophagus in 21 cases (63.63%), and in patients without reflux disease only in 5 cases (15.15%) (p<0.001, Odds Ratio: 9.8: 95% CI: 2.99-32.18).
Conclusions: A significant correlation between hiatal hernia and Barrett’s esophagus was demonstrated in our study (p<0.001).

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The Role of SCID II in Diagnosis of Cluster B – Personality Disorders Associated or Not with Affective Comorbidity – a Pilot Study

Toma Mirela1, Nireştean A.1,2, Roșu Codruța1, Echim Iulia1

1 Acute Psychiatric Clinic II, Targu Mures, Romania
2 Psychiatric Departament, University of Medicine and Pharmacy, Targu Mures, Romania

Background: Affective co-morbidities are often associated with Cluster B – personality disorders,so it is very important to pay attention when we put these diagnoses.
Aim: To investigate the applicability of SCID II to patients with personality disorders.
Material and method: We applied the SCID II – The Structured Clinical Interview for DSM IV Axis II Personality Disorders, to a group of 10 patients with cluster B personality disorders with affective disorders as depression, anxiety or both admitted to The Psychiatric Clinic II Targu Mures, Romania at admission, at the end of the hospitalization, and every 3 months for a year (2009), which we compared with a group of 5 patients without affective disorders followed also for a year.
Results: We observed the time needed to complete the test, the way of answering the questions, at both groups, from admission to discharge and every three months for a year.
Conclusion: The diagnosis of personality disorders, with or without affective comordity can be established using this psychometric instrument – SCID II.

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Primary Cutaneous Melanoma: 7-year Follow-up (2003–2009)

Chifu M. D.1, Sin Anca2, Chifu Madalina3, Milutin Doina1, Mocan Simona1

1 Department of Pathology, University of Medicine Targu Mures Romania
2 Institute of Cardiovascular Diseases Targu Mureş
3 Faculty of Medicine, University of Medicine and Pharmacy, Targu Mureş

Background: Primary cutaneous melanoma constitutes the main cause of skin cancer death in developed countries, and its incidence in recent years has been increasing in a steady, worrisome manner.
Aim: This study evaluated the histopathological aspects of this disease, and correlated them with patient prognosis.
Material and methods: The study included 138 patients with mild to severe primary cutaneous melanoma who were diagnosed in the Laboratory of Pathology Targu Mures during 2003–2009. Data were provided from hospital registers and the statistical analysis was performed by using the computer program called Excel.
Results: We found 76 malignant melanoma in females and 62 in males. The most common lesion areas were: the lower limbs (50), and the trunk (41).
Conclusions: Malignant cutaneous melanoma is still a major clinical challenge because all our patients with advanced tumors were diagnosed with poor prognosis.

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Resonance Frequency Analysis of Dental Implant Stability During the Healing Period (A Clinical Study)

Boeriu S.

PhD Student, Private Practice in Cosmetic and Implant Dentistry, Kitchener, Ontario, Canada

Aim: The aim of this clinical study was to measure the implant stability quotient using a method called resonance frequency analysis of dental implants during the healing period.
Material and methods: A number of 27 patients received 50 internal hexagon implants (Biohorizons) either in the maxillary or in the mandibular arch. Implant stability was measured with an Osstell Mentor device (Osstel, AB, Sweden) using the resonance frequency analysis at the time of implant placement, 15, 30, 60 and 90 days post insertion.
Results: The mean implant stability quotient for all implants placed was 67.06. The lowest value of the implant stability quotient was at 30 days post insertion measuring 62.
Conclusions: In relation to the gender the implants placed in female patients showed a higher mean value of the implant stability quotient. In relation to the location within the dental arch the implants placed in the anterior areas had a higher implant stability quotient than the ones places in the posterior areas of the arch.

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The Influence of Row Soy Diet on Gastrointestinal Tract in Animal Model

Tiulea Corina1, Peev Camelia1, Mureşan Anca2, Feflea Stefana1, Ciurlea Sorina3, Motoc A.4

1 Department of Pharmacognosy, University of Medicine and Pharmacy Victor Babeș Timișoara, Faculty of Pharmacy
2 Department of Morphopatology, University of Medicine and Pharmacy Victor Babeș Timișoara, Faculty of Medicine
3 Department of Toxicology, University of Medicine and Pharmacy Victor Babeș Timișoara, Faculty of Pharmacy
4 Department of Anatomy, University of Medicine and Pharmacy Victor Babeș Timișoara, Faculty of Medicine

Background: Soybean is the vegetal product of soy, Glycine max fam. Fabaceae. It is well known that short-term ingestion of raw soy and plant trypsin inhibitors by mice greatly stimulates the exocrine pancreas, leading to increased enzyme production, organ enlargement and cellular hyperplasia.
The aim of this study is to examine changes that occur in the liver, an organ from the gastrointestinal tract less studied on this topic when row soy is administrated. Short time nutritional studies were conducted on C57BL/6J mice of four weeks.
Results showed a decrees in mice body mass after administration of row soybean. Histological analyze revealed an alteration of the pancreas showing the presence of inflammatory cell infiltrate, the phenomen of vascular congestion and edema of the parenchymal cells and of the liver highlighting fibrosis of the vascular wall, the presence of the intravascular infiltrate represented by fibrin and figurative elements (erythrocytes and leukocytes), of the Kupffer cells phagocyte active, and granulocytes with diapedez trend.
Conclusions: The main conclusion of this study is that row soybean diet has a negative action on the gastrointestinal tract in animal model affecting mostly the pancreas and the liver translated by decreasing body weight in mice.

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Exposure to Aminoglycosides from Flu Vaccines and Susceptibility to Gentamicin Among Escherichia coli Strains in Urinary Isolates from Asthmatic Patients

Ionete Oana Mariana1, Popescu F.D.2, Greblescu Raluca3, Popescu Florica4, Avramescu Carmen1

1 Department of Microbiology, Faculty of Medicine, University of Medicine and Pharmacy Craiova, Romania
2 Department of Allergology, Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
3 Department of Allergology, Hospital “Nicolae Malaxa”, Bucharest, Romania
4 Department of Pharmacology, Faculty of Medicine, University of Medicine and Pharmacy Craiova, Romania

Objective: To evaluate the antimicrobial resistance pattern of Escherichia coli, an important pathogen associated with urinary tract infections, in asthmatic adult patients previously repeatedly exposed to residual amounts of aminoglycosides from flu vaccines.
Material and methods: We determined the antibiotic susceptibility of Escherichia coli strains isolated from the specimens of adult asthmatic subjects with urinary tract infections, hospitalized in an allergy university clinic in Bucharest. All patients were enrolled in the previous six months, are known with persistent asthma treated with controller medication, and received seasonal influenza vaccination annually at least the last two years, with or without a previous A/H1N1 pandemic flu vaccination, with vaccines containing traces of aminoglycosides. A control group included adult patients with a positive history of adverse drug reactions not vaccinated for influenza and not treated with aminoglycosides in the last two years. Antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method.
Results: We found that overall the gentamicin susceptibility rate is high in analysed samples from the enrolled patients (94.82%). Gentamicin resistance is very low in both groups, with evidently no statistical increase in resistance to this antibiotic in the Escherichia coli isolated from the urine of asthmatic patients previously parenteral exposed to influenza vaccines containing residual amounts of neomycin or gentamicin.
Conclusion: The annually administration of injectable flu vaccines containing aminoglycosides in order to protect high-risk groups against the variable influenza virus seems not to influence gentamicin susceptibility pattern of Escherichia coli strains.

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Nutritional Parameters in Children with Acute Leukemia

Chinceșan Mihaela, Baghiu Despina, Horvath Adrienne, Moldovan Diana

University of Medicine and Pharmacy of Tîrgu Mureș; Pediatric Clinic No. I, The Hematooncology Department

Background: Nutritional problems with children suffering from cancer varies from extreme malnutrition to complex nutritional problems due to both disease and treatment.
Aim: In this study we intend to assess the nutritional status of the children with acute leukemia and the malnutrition effect on the evolution of the disease.
Material and method: We have performed a retrospective study on a group of 53 children suffering from acute leukemia who were diagnosed and treated in The Pediatric Clinic No. I Targu-Mures, The Department of Hematooncology within the period of 2001–2009. The nutritional status is assessed through anthropometric, hemathological and biochemical parameters before the initiation of chemotherapy.
Results: The group of study included 32 males and 21 females, with an average age of 7.2 years at the beginning of the malignant disease; out of 53 patients, 46 were diagnosed with acute lymphoblastic leukemia and 7 with acute myeloblastic leukemia.
At the beginning of the malignant disease, 10 patients (18.9%) had the weight under percentage 5 . The height corresponding to the age was, at the beginning of the disease under percentage 5 with 6 patients (11.32%), showing a chronic state of
malnutrition. The hemoglobin is diminished to 88.67% of the patients. Sideremia was lowered to 3.77% of the patients and increased to 45.28%. 35.85% of the children had the serum proteins decreased, from which 28.30% had hypoalbuminemia.
We had in view a period of 6 months since the initation of chemotherapy the response to the treatment by: realising the remission, an occurance of relapse, infectious episodes, those of febrile neuthropenia and the rate of death. In our study we have found that along with the children with a proper nutritional status, the malnourished children show a higher amount of infectious episodes (9.66 versus 7,32 infectious episodes/child); the number of the febrile neutropenia episodes was higher (3.8 versus 2.01 episodes/child). The remission at 6 months was slightly inferior in malnourished children, yet, the rate of mortality has not been influenced.
Conclusions: 1. The prevalence of the assessed severe malnutrition based on the anthropometric indicators was 18.9% at the beginning of the malignant disease. 2. The children’s smaller height at the beginning of the tumoral disease is given by the chronic protein-caloric malnutrition,existing before the disease. 3. Among the malnourished patients, the frequency of the infectious episodes is higher and the remission at 6 months is inferior to those with a normal nutritional status, however the rate of death is not different.

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