Category Archives: Number

Particularities of Depressive Disorders Installed in Perimenopause

Crişan R, Gabos Grecu I, Buicu Gabriela, Ţăran Livia, Gaboş-Grecu Marieta, Nireştean A, Gliga Florina

University of Medicine and Pharmacy, Tg.Mures

Background: The risk of woman to present a depressive clinical picture increases in parallel with the approaching age of perimenopause.
Aim: The main purpose of the paper is to study correlations between symptoms of perimenoapuse and depressive episode occurance, taking into consideration the severity and the frequency of symptoms of perimenopause.
Material and methods: We have selected the cases by performing a screening to pacients with major depressive disorder, hospitalized in No. 1 Psychiatric Clinic, between 01.01.2007–31.12.2009.
Results: From the total patients admitted (1342) only 160 patients aged 34–55 years, voluntarily wanted to participate, representing 11.92% of all patients. Analyzing the severity of psychological symptoms we have obtained statistical significance in the age group 46–50 years: p = 0.0303. Analyzing the frequency of vasomotor symptoms by age group, we have obtained statistical significance in the age group 34–40 years: p = 0.006. Analyzing the frequency and severity of somatic symptoms by age groups, we have obtained statistical significance in the age group 34–40 years.
Conclusions: The rural environment proved to be a protective factor in the emergence of depressive disorders (P = 0.0189). Estimating the role of hormonal decline at patients aged over 40 years, helped us to understand that the emergence and evolution of clinical manifestations during perimenopause and menopause may be caused by fluctuations of central secretion of pituitary hormones and sex steroids.

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Issues on Malnutrition in Children with Cancer

Chinceșan Mihaela¹, Baghiu Despina¹, Mărginean Oana¹, Horváth Adrienne¹, Eșianu Andrea²

1 University of Medicine and Pharmacy of Tîrgu Mureș, Pediatric Clinic No 1
2 Emergency County Hospital Tîrgu Mureș, Pediatric Clinic No 1

Introduction: Malnutrition is present in a high percentage in children with cancer. It can be evaluated by anthropometric measurements and laboratory data.
Aims: 1. To determine the prevalence and severity of malnutrition at diagnosis in children with cancer. 2. To define the best modalities to assess nutritional status.
Material and methods: A prospective study was performed on 27 children hospitalized and diagnosed with various type of cancer in the Pediatric Clinic No.I Targu-Mures, between November 2009–January 2011. We evaluated anthropometric and biochemical parameters: weight, height, body mass index (BMI), middle-upper arm circumference (MUAC), triceps skin fold thickness (TSF), total protein, albumin, Insulin-like growth factor-1 (IGF-1). We divided patients into three categories depending on nutritional parameters: severely malnourished, risk of malnourished and adequately nourished. We correlated anthropometric parameters with biochemical parameters.
Results: Our group consisted of 20 males (74.04%) and 7 females (25.96%). Of the 27 children with cancer, 14 children were severely malnourished, 8 children were with risk of malnourished and only 5 children with normal nutritional status. At the onset of malignant disease, 16 patients (59.25%) had low serum protein values and 10 patients (37.03%) had low levels of serum albumin. IGF-1 was decreased in 18 children (66.66%). We found a good correlation, statistically significant between TSF and serum proteins (r = 0.41; p = 0.02), between TSF and IGF-1 (r = 0.44; p = 0.02), and between MUAC and IGF-1 (r = 0.39; p = 0.04).
Conclusions: 1. The prevalence of malnutrition in children with cancer is high. 2. Arm anthropometry in conjunction with serum protein and IGF-1 most accurately characterizing the nutritional status.

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Quantifying Human Enamel Erosion Caused By Freshly Squeezed Juices

Borş Andreea1, Fazakas Zita2, Molnar-Varlam Cristina1, Cămărăşan Alina1, Mucenic Simona1, Kerekes-
Máthé Bernadette¹, Székely Melinda1

1 Department of Morphology of Teeth and Dental Arches; Technology of Dental Prosthesis and Dental Materials, Faculty of Dentistry, University of Medicine and Pharmacy, Târgu-Mureş
2 Department of Biochemistry, University of Medicine and Pharmacy, Târgu-Mureş

Aims: The present in vitro study intended to investigate minimal erosive effects of different freshly squeezed fruit juices on human enamel during short time incubation by determination of calcium and phosphate dissolution.
Material and methods: Healthy adult human molars and premolars were cut in 160 blocks (5 mm x 6 mm x 2 mm) and divided randomly in sixteen groups of 10 samples each (n = 10). Each group was assigned for immersion at 37 oC in 5 ml juice, for different spot times 3, 6, 9 and 12 minutes, respectively. The freshly squeezed juices analyzed were orange juice, apple juice, orange mixed with carrot juice (1:1) and apple mixed with carrot juice (1:1). Amount of titratable acid and pH was measured for the tested solutions. Calcium and phosphate release were determined photometrically using VIS-UV/VIS spectrophotometer. ANOVA test compared the data generated (p < 0.05).
Results: The apple juice showing the lowest pH and a high value for buffering capacity had the most pronounced erosive effect. The orange juice was less erosive (p < 0.001). The least erosive was the orange mixed with carrots (1:1) (p < 0.001), which has the highest pH. The enamel demineralization increased when prolonging the immersion time (p < 0.0001).
Conclusions: All freshly squeezed juices caused the dissolution of calcium and phosphate in human enamel. Erosive capacity is mainly determined by pH and to a lesser extent by the buffering capacity. The amount of demineralization is directly correlated with the exposure time. Absorption spectroscopy allows detection of very small mineral loss using standardised human enamel samples.

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Clinical Presentation and Precipitating Factors for Acute Heart Failure Hospitalization

Baricz Emőke, Szakács O, Toma L, Szabados Cs, Baricz J, Gyalai Zs, Carașca E

Cardiology Department, Internal Medicine Clinic, Faculty of Medicine,University of Medicine and Pharmacy, Târgu Mureș

Introduction: Acute heart failure syndromes are the most common cause of hospitalization in patients over 65 year. The number of hospitalizations for heart failure has tripled over the last three decades and it is expected to grow further.
Matherials and methods: We followed 390 patients, with an average age of 69.2 yrs, admitted in the Cardiology Department of Internal Medicine Clinic IV of Târgu Mureș, from January 2009 till January 2010 for treatment of the acute heart failure. The aim of this study was the analization of the clinical presentation and the precipitating factors of the heart failure at these patients.
Results and discussions: The most common clinical presentation at this category of patients is decompensated heart failure (peripherial oedema/congestion). In this particular case over two thirds of patients have history of heart failure (p < 0.0001). Hypertensive heart failure is a common finding in the novo cases (p = 0.0004). Cardiogenic shock is relatively rare form at this group but with very high hospital mortality. The most common trigger is infection, that frequently causes acute heart failure syndromes, mostly right heart failure in patients with pulmonary cardiopathy (p < 0.003). It is the most frequently identified trigger, both, in worsening chronic heart failure (p = 0.0002) and de novo heart failure group (p = 0.251).
Conclusions: The prevalence of triggers varies considerably depending on the target population, but infections, arrhythmias, elevated blood pressure and non-compliance remain frequent causes of acute heart failure syndromes.

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Plagiarism – a Societal Contagious Disease or Just a Means for Opportunists to Reach for a Better Position?

Sanda-Maria Copotoiu, Dan Dobreanu

The amount of medical articles retracted by editors is escalating alarmingly. Accessed on May the 3rd 2011, the Pub Med site displayed 644 articles retracted. The dimensions of the phenomenon mirrored by other data source are impressing: ”of the 9 398 715 articles published between 1950 and 2004, 596 were retracted. This wave of retraction impacts highly respected journals.” [1]. And the increase even if limited to the period comprised between 1990 and 2006 is significant with a p = 0.002 [1].
It would be insane to read them all in order to identify the reasons they were sieved, it would be unprofessional since nobody is qualified enough to assess them in a reliable way and obviously it would be impossible to fulfill such an unrealistic task. Nobody would benefit of it.
The editors always make a formal statement as to the reasons of retractions: inquires unveiling the lack of ethics committees’ approval of research, the inability to provide the documents relevant to the research published, unintentional alteration of the data, inappropriate use of statistics, any form of trespassing the ethical conduct of research, to name a few.
Sometimes, plagiarism is committed involuntarily. For instance, a prominent lecturer recently paraphrased a statement omitting to quote the author, failing to acknowledge the paraphrasing, and still pointing out on research fraud. Seated in the audience, somebody next to me showed me a book purchased at the airport bookstore. The book contained an example promoted by the lecturer. I can only imagine that taken by the wave of rhetoric, he forgot to credit the author and involuntarily committed plagiarism while vituperating against it. Is it then so easy to misbehave, or are the definitions of plagiarism too tight? [More]

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Eco Doppler Examination in Pregnancies with Fetal Growth Restriction

Grif Caterina-Miladi

University of Medicine and Pharmacy, Department of Obstetrics and Gynecology 2, Tîrgu Mureș

Fetal growth restriction remains a major cause of perinatal morbidity and mortality in modern obstetric practice. Doppler velocimetry provides a wide array of information on maternal, fetal, and placental aspects of intrauterine growth restriction (IUGR). Delivery is the only practical treatment option, and the timing of delivery must be aimed to maximize gestation while minimizing the risks of continued intrauterine life. The investigation of the fetal circulation using eco Doppler ultrasonography has become more sophisticated, with greater attention being played to the venous circulation, particularly that unique to the fetus: ductus venosus and the umbilical vein.

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Update in Haematopoietic Stem Cell Transplantation

Berteanu Cristina1, Stoica Maria2, Stoica GA2, Cernea Daniela2, Tănase Alina3, Copotoiu Sanda-Maria4, Brânzaniuc Klara4, Azamfirei L4, Cirstoiu C1, Rosin A5

1 Fundeni Bone Marrow Transplant Center Fundeni
2 Bucharest Emergency University Hospital
3 University of Medicine and Pharmacy of Tîrgu Mureș
4 Craiova Emergency University Hospital
5 Bucharest Institute of Haematology

The authors review the most important aspects of stem cell transplantation, starting with its objectives, general guidelines and specific issues in rare diseases, and series of complications arising from this complicated therapeutic procedure.
Introduction
In the 40 years since the first bone marrow transplant for the treatment of a patient suffering from a congenital immune deficiency, this therapeutic modality has become an option to be considered in the treatment of several haematologic, immunologic, metabolic and neoplastic disorders. This has been possible thanks to the progress in our knowledge of the major histocompatibility complex, the supportive therapy for patients with severe pancytopenia and the prevention and treatment of infections and other complications associated to transplantation [1].
Today, Haematopoietic Stem Cell Transplantation (HSCT), in its different modalities, is the treatment of choice in several malignant and non-malignant haematological diseases and one of the best options in many others [1].[More]

 

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The von Meyenburg Complexes

Turdean S1, Turcu M3, Varga AF1, Unguraş Dana1, Moldovan C4, Sin Anca2

1 “Gheorghe Marinescu” Municipal Hospital, Târnăveni
2 University of Medicine and Pharmacy of Tîrgu Mureș, Department of Cellular and Molecular Biology
3 University of Medicine and Pharmacy of Tîrgu Mureș, Department of Pathology
4 University of Medicine and Pharmacy of Tîrgu Mureș, Department of Histology

Background: Biliary duct hamartomas (the von Meyenburg complexes) is a rare malformation of the hepatic ductal plates usually discovered incidentally during surgery or autopsy.
Case presentation: We present the case of a 66 year-old man who presented symptoms suggestive of a biliary colic. Following an open surgical biopsy from the liver, the sample obtained underwent classic Hematoxylin-Eosin, as well as histochemical and immunohistochemical stains, which allowed establishing the diagnosis of biliary duct hamartoma, using macro- and microscopical criteria (well-defined, subcapsular hepatic lesions and no nuclear atypia).
Conclusion: The recognition of this particular lesion is important due to its macroscopic and microscopic resemblance to multiple liver metastases and other types of multicentric subcapsular hepatic lesions. The mandatory technique in order to diagnose this rare type of hepato-biliary lesion remains the histopathological examination.

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Giant Abdominal and Penoscrotal Idiopathic Lymphedema

Hintea A1, Botan A2, Coros MF1, Nagy S1, Cozma D1, Kazay Z2

1 County Emergency Clinical Hospital Tîrgu Mureș, Surgical Clinic I
2 County Emergency Clinical Hospital Tîrgu Mureș, Department of Plastic and Reparatory Surgery

The lymphatic system produces and transports fluids, immune cells and fats throughout the body. Abnormal transport and accumulation of lymph fluid may cause swelling (lymphedema).
Lymphedema, occurring quite frequently in the medical practice, may appear in a variety of pathologies such as: allergic reactions, infectious diseases, localized infections, radiotherapy, insect bites, as post-surgery reaction, etc. In all cases, it represents a subsequent effect of the main illness [1].
There is very small number of cases where lymphedema occurs as sole affection, the so-called ”primary or idiopathic lymphedema”. It is considered a genetic disease resulting in agenesis or the insufficient development of the lymphatic system [2].
The FLT4 gene provides instructions for producing a protein called vascular endothelial growth factor receptor 3 (VEGFR-3), which regulates the development and maintenance of the lymphatic system. Mutations in the FLT4 gene interfere with the growth, movement, and survival of lymphatic cells. These mutations lead to the development of small or absent lymphatic vessels. If lymph fluid is not properly transported, it builds up in the body’s tissues and causes lymphedema. It is not known how mutations in the FLT4 gene lead to the other features of this disorder, but many of these patients do not have a FLT 4 gene mutation. In these cases the cause of the swelling is unknown [1,3].[More]

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