Category Archives: Number

Hypolipemiant Treatment: Making the Right Choice for Osteoporotic Patients

Şipoş RS1, Şuş Ioana2, Pap Zsuzsanna1, Szalai Anna Szidónia1, Gabor Anamaria Victoria2, Pávai Z1, Brînzaniuc Klara1

1 Department of Anatomy and Embriology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Faculty of Medicine, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

DOI: 10.2478/amma-2013-0004

Introduction: It has been shown that dyslipidemia is related to bone mineral density and fragility. Hypolipemiant drugs as statins or fibrates seem to increase the bone mineral density and probably to protect against fractures. The question that arises in this context is whether statins or fibrates have a positive effect on bone fracture repair process and which is their behaviour in an osteoporotic context. Our objective was to study the incidence of osteoporosis, dyslipidemia and of the association of these diseases, and to compare the effect of statins and fibrates on fracture repair in experimental conditions.
Material and method: We studied the incidence of dyslipidemia and osteoporosis in the activity of a private family medicine cabinet. In the experimental part we observed from a radiographic point of view the fracture repair process of rats’ femurs. We analyzed 6 subgroups of 12 rats each: (1) ovariectomized control, (2) ovariectomized treated with statins, (3) ovariectomized treated with fibrates, (4) nonovariectomized control, (5) ) nonovariectomized treated with statins, (6) ) nonovariectomized treated with fibrates. The radiographic aspect has been objectified with a score at 2, 4, 6 and 8 weeks.
Results: From the total of 646 patients included in the study, 193 (29.87%) had dyslipidemia while osteoporosis was diagnosed at 152 (23.53%) patients. 301 (46.6%) patients presented the association of these diseases. Comparing the subgroups of the OVX group, we had the following results: subgroup 1 – 5.5 points, group 2 – 11 points and group 3 – 4.5 points. In the case of the NOVX subgroups, the scores were: subgroup 4 – 7.5 points, subgroup 5 – 10 points and subgroup 6 – 6.5 points.
Conclusions: The fact that the incidence of dyslipidemia is higher than that of osteoporosis is an argument for the necessity of choosing a hypolipemiant treatment that has, at the same time, a protective effect on bone. Hypolipemiant treatment influences the fracture repair process. The positive effect of statins on this process is more important on the ovariectomized group, in contrast with fibrates which have an accentuated effect on the nonovariectomized group and this suggests an interference between hypolipemiant treatment and estrogens level. However, the treatment with fibrates delays the fracture repair, groups (3) and (6) scores being inferior to those of the control group. We sustain the helping effect of statins treatment on fracture repair process.

Keywords: , , , ,
Full text: PDF

Evaluation of Diagnosing Tuberculosis in Primary Care Medicine in Mureș County, Between 2006 and 2008

Ács Valeria1, Finta Hajnal2, Ianosi Edith Simona3, Sabău Monica4

1 Doctoral School, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
2 Department of Hygiene, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
3 Department of Pulmonology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
4 Department of Epidemiology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

DOI: 10.2478/amma-2013-0003

Aim: Evaluation of the contribution of general practitioners to the early diagnosis of tuberculosis in the studied period. Analysis of cases not diagnosed as active TB, from those suspected by the general practitioner and the real cases with respiratory lesions.
Material and methods: We conducted an observational epidemiologic study aiming at evaluating the diagnosis of pulmonary TB at the level of primary care medicine.
Results: The difference between conformed TB patients that have been referred with the suspicion of TB and those without suspicion is significant (p <0.0001), and the risk of disease estimated by OR was 21.54. More than half of the patients (139), had positive microscopic examination and culturing, representing 62.61%. In 10.36% microscopic examination was positive and culturing was negative (13 patients). Negative microscopic examination and positive culturing were detected in 5.86% of the patients. The majority of suspected/confirmed new patients were living in urban environments. The urban/rural ratio was 1.27. The reasons why the general practitioner suspected tuberculosis, in the order of frequency, were the following: cough/dry cough, sweating/nocturnal sweating, fever/persisting fever. Among the TB types, we noted the large percentage of patients with infiltrating, nodular tuberculosis confined to the volume of one pulmonary segment (30.78%), and 19.87% of the cases were multicavity tuberculosis; also, we noted the presence of caseous tuberculosis with moderate volumes of infiltrates, confined to a pulmonary lobe (18.27%).
Conclusion: Early diagnosis of tuberculosis in the primary healthcare network is a continuous challenge for the general practitioner.

Keywords: , ,
Full text: PDF

Finite Element Analysis of the Achilles Tendon While Running

Anițaș R, Lucaciu DO

Department of Orthopedics, ”Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj Napoca, Romania

DOI: 10.2478/amma-2013-0002

Introduction: The Achilles tendon is the most frequent recipient of traumatic injuries. The aim of this study is to identify and describe the varying load at ankle level and especially at the Achilles tendon’s insertion on the calcaneus.
Methods: We conducted a finite element analysis of the Achilles tendon while running, with the aim of revealing maximal loads and strains during a step in a running sequence. A 3D model of the Achilles tendon was built, based on MRI slides of a healthy, injury-free subject, who was asked to run over a force plate in 50 iterations. We used the recorded data to establish maximum loads and strains.
Results: We noticed a quick rise of the intra-tendinous load, from almost negligible while airborne and on first ground contact, to roughly 40 MPa in the pre-airborne phase, with possible implications in both treatment and post-injury recovery of Achilles tendon lesions.
Conclusions: Our results suggest that while early weight bearing and early exercise routines are a modern approach, care must be given in increasing the loads on the recovering region.

 

Keywords: , , , ,
Full text: PDF

A Comparison of Oral Health Status in Active-, Occasional- and Non-Smoker Patients Versus Students

Benedek (Bukhari) Csilla1, Kovács Mónika1, Pop M1, Balog Anita2

1 Department of Conservative Dentistry and Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
2 Dentist, S.C. Ka-Dent Stomatologie S.R.L., Tîrgu Mureș, Romania

DOI: 10.2478/amma-2013-0001

Objective: The aim of this case-control study was to assess the smoker and non-smoker patients’ oral health status versus students.
Methods: The study was based on a clinical examination of 210 young adults (118 women, 92 men) aged between 22–32 years. 105 of these were students in the 5th and 6th grade of the Faculty of Dentistry in Tîrgu Mureș and the control group was represented by patients. Patients and students were classified into three groups: non-smokers, occasional- and active smokers. The clinical examination evaluated the dental caries, fillings, extractions, crowns, root remnants and dental plaque. DMF-S index scores were calculated, and with its help the index of treatment need, dental care index and intensity of caries were determined.
Results: The dental treatment need index, DMF-S index and intensity of caries showed increased values in patients. Root remnants (p <0.0001), decay (p = 0.0473) and dental plaque (p = 0.0363) were much higher in the group of active smoker students as in the non-smoker students. Among active smoker patients the incidence of dental calculus (p = 0.0005), of root remnants (p = 0.0022) and of fillings (p = 0.0441) showed a higher value than in the non-smokers.
Conclusions: This study showed that compared with non-student patients, in dental students, a better oral hygiene was coupled with healthier teeth and periodontal. Poor oral hygiene together with smoking seems to worsen the oral health status.

Keywords: , , ,
Full text: PDF

Congenital Malformations of the Renourinary System — Risk Factors for the Development of Urinary Tract Infections, a Screening That is Required to Be Performed

Mărginean Oana

Pediatric Clinic 1, County Emergency Clinical Hospital, Tîrgu Mureș, Romania

Urinary tract infection (UTI) is the most commonly diagnosed bacterial infection in infants and children, with a significant consequence on the quality of life and health [1]. Congenital urinary tract abnormalities are the most common cause of UTI in children. The most frequent kidney abnormalities encountered during childhood are: obstructions of urinary tract (urethral valves, ureteropelvic and ureterovesical junctions’ obstructions), and dysfunctional voiding (vesicoureteral reflux) [2]. Primary vesicoureteral reflux (VUR) has an incidence of 20–60% among children with urinary tract infection. An early diagnosis of VUR is very important, as its missing recognition or a delayed diagnosis can lead to reflux nephropathy (RN) referring to renal scarring, as a cause of chronic renal failure in 5–40% of children aged below 16 years [3]. An antenatal screening with an accurate diagnosis followed by an immediately postnatal abdominal ultrasound made that these malformations to be diagnosed early [4] and decrease the number of urinary tract infections and their recurrences. Thus, since the neonatal period we can decide which child will be further monitored, which will receive medical treatment and which will require surgery [4].[More]

Keywords:
Full text: PDF

Nutritional Approach of Pediatric Patients Diagnosed with Congenital Heart Disease

Togănel Rodica

II Pediatric Cardiology Clinic, County Emergency Clinical Hospital, Tîrgu Mureș, Romania

 

DOI: 10.2478/amma-2013-0029

Congenital heart defects are among the most frequent anomalies present at birth, representing a heterogeneous group of malformations, both in terms of pathogenesis and clinical significance of the lesion. Failure to grow is well documented in infants with complex congenital heart defects; the presence of associated chromosomal abnormalities, cyanosis, and cardiac failure adds to the complexity and challenge. Malnutrition etiology can be grouped into the following three categories: inadequate intake, inefficient absorption and utilization, and/or increased energy needs. The consequences of malnutrition are both short and long term, timely nutritional intervention being necessary in order to maintain an adequate nutritional state. Because there are several types of congenital heart defects and multiple mechanisms by which they produce failure to thrive, no single strategy will be adequate to treat all cases. Medical complications such as chylotorax, necrotizing enterocolitis, laryngeal and neurological dysfunction play a major role in the requisite nutrition therapy in infants with congenital heart defect; limited access to human milk and parenteral concerns, as well as stress about feeding are also factors that can contribute to poor outcomes concerning nutrition and growth. Protocols are being considered and designed, and a systematic approach is always needed. The quality of life for patient and family, as well as getting the child back on track for age-appropriate development are always at the fore-front of each care plan.

Keywords: ,
Full text: PDF

Ulcerative Colitis associated with Sclerosing Cholangitis and Autoimmune Hepatitis

Hoduț A, Simedrea I, Sabău I, Belei Oana, Babi Ionela

First Pediatric Clinic, Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, Timișoara, Romania

DOI: 10.2478/amma-2013-0028

Introduction: Ulcerative colitis is a chronic intestinal inflammation, part of inflammatory bowel disease, which also includes Crohn’s disease. Both have extraintestinal manifestations, but those that tend to occur more commonly with ulcerative colitis include chronic active hepatitis, pyoderma gangrenosum and ankylosing spondylitis. Many individuals present with overlapping non-diagnostic features of more than one of these conditions that is referred to in the literature as autoimmune overlap syndrome. Sclerosing cholangitis associated with IBD is often referred to as overlap syndrome.
Material and methods: We present the case of a 15-year-old female, with an association between ulcerative colitis, primitive sclerosing cholalangitis and autoimmune hepatitis. She was admitted for: diarrheic bloody stools, abdominal pain, diminished appetite, headache and aphthous stomatitis. Blood sample analysis revealed: hypochromic anemia, iron deficiency, high levels of transaminase, abnormal protein electrophoresis, positive anti-neutrophil cytoplasmic antibodies and anti–smooth muscle antibodies, high level of faecal calprotectin, modified biliary tract on imaging of digestive system and suggestive modifications of colic mucosa for ulcerative colitis. We administered treatment with Arginine Chloride 5%, Sorbitol 10%, Aspartic acid, Vitamin B6, Ursodeoxycholic acid, 5-aminosalicylic acid.
Results: With the administered therapy the evolution was good, macroscopic blood disappeared from stools, and tests for blood trace in stool were also negative.
Conclusions: The patient had simultaneous onset of diarrhea with bloody stools and extraintestinal manifestations. Immunological markers didn’t fully match any of the associated diseases, so we concluded that there was an overlap syndrome. Budesonide was effective on both hepatic and intestinal disease.

Keywords: , , , , ,
Full text: PDF

A Case of Plasmacytoid Dendritic Cell Leukemia

Köpeczi Judit Beáta1, Benedek I1,2, Benedek Erzsébet1, Kakucs Enikő1, Tunyogi Aliz1, Istrati Monica1, Kurtus Aranka1

1 Clinical hematology and Bone Marrow Transplantation Clinic, Tîrgu Mureş, Romania
2 University of Medicine and Pharmacy, Tîrgu Mureş, Romania

DOI: 10.2478/amma-2013-0027

Introduction: Plasmacytoid dendritic cell leukemia is a rare subtype of acute leukemia, which has recently been established as a distinct pathologic entity that typically follows a highly aggressive clinical course in adults. The aim of this report is to present a case of plasmacytoid dendritic cell leukemia due to its rarity and difficulty to recognize and diagnose it.
Case report: We present a case of a 67 year-old man who presented multiple subcutaneous lesions on his face, neck, chest and upper extremities with reddish-brown, brown colour. In the bone marrow aspirate 83% of the blast cells were found. Immunophenotypically the blasts were positive for CD4, CD56, CD123 (high intensity), CD36, CD22, CD10 (10.42%), CD33, HLA-DR, CD7 (9.24%), CD38 (34.8%) and negative for CD13, CD64, CD14, CD16, CD15, CD11b, CD11c, CD3, CD5, CD2, CD8, CD19, CD20, CD34. The skin biopsy showed lymphohistiocytoid infiltration in the dermis. The patient was diagnosed with acute plasmacytoid dendritic cell leukemia and received polychemotherapy with rapid response of skin lesions and blastic infiltration of the bone marrow. After 3 courses of polychemotherapy the cutaneous lesions reappeared and multiplied. The blast infiltration in the bone marrow increased to 70%. A more aggressive polychemotherapy regimen was administered, but the patient presented serious complications (febrile neutropenia) and died in septic shock 8 months after the initiation of treatment.
Conclusions: Immunophenotyping of blasts cells is indispensable in the diagnosis of plasmacytoid dendritic cell leukemia. The CD4+, CD56+, lin-, CD123 ++high, CD11c-, CD36+, HLA-DR+, CD34-, CD45+ low profile is highly suggestive for pDCL. The outcome of plasmacytoid dendritic cell leukemia is poor. Despite the high rate of initial response to treatment, early relapses occur and the patients die of disease progression.

Keywords: , , ,
Full text: PDF

Study of Cyclodextrin/Fluoroquinolone Inclusion Complexes by Capillary Electrophoresis

Székely-Szentmiklósi Blanka1, Tőkés B2

1 Gedeon Richter Romania S.A., Tîrgu Mureş, Romania
2 Department of Physical-Chemistry, Faculty of Pharmacy, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

 

DOI: 10.2478/amma-2013-0026

Introduction: In the present work we evaluated the complexation role of cyclodextrins toward fluoroquinolones in an attempt to assess their potential as new formulation additives for more efficient fluoroquinolone delivery and as selectors in capillary electrophoresis.
Material and method: Guest-host interactions of two second generation quinolones, ciprofloxacin and norfloxacin with four cyclodextrins, beta-cyclodextrin (β-CD), gamma-cyclodextrin (γ-CD) and two beta-cyclodextrin derivatives, 2-hydroxypropyl beta-cyclodextrin (HP-β-CD) and randomly methylated beta-cyclodextrin (RAMEB), were tested by capillary electrophoresis in borate running buffer. Experimental parameters like buffer concentration, pH, organic modifier, voltage and cyclodextrin concentration have been varied for a better resolution.
Results: In capillary zone electrophoresis ciprofloxacin and norfloxacin are migrating together, a difference in their migration times and thus separation occured by the addition of cyclodextrins.
Conclusion: Our results suggest formation of inclusion complexes between fluoroquinolones and cyclodextrins. Differences in their affinity to host molecules resulted in separation of the two fluoroquinolones.

Keywords: , , ,
Full text: PDF

Approaches to Scoring Translation in the PROFEX EMP Exam

Hegedűs Anita

Department of Languages for Specific Purposes, Faculty of Medicine, University of Pécs, Pécs, Hungary

DOI: 10.2478/amma-2013-0025

Introduction: This paper undertakes to investigate the connection between two approaches to scoring translation by examining 115 test papers of the translation component of the C1 level PROFEX English for Medical Purposes (EMP) exam. The main objective of the study is to reveal whether, and to what extent, the method of assessment influences the score.
Material and method: The test papers were scored independently by two experienced raters according to the marking scale of the PROFEX EMP exam, then holistic scoring was carried out by a third rater, who was uninformed of the official scores for the test papers. Correlations were calculated, first between the holistic scores and the official scores based on the combined holistic and discrete point approach, then between other components of the written part of PROFEX EMP exam (reading comprehension and writing) and the holistic scores and the scores reached with the combined method, respectively.
Results: A strong correlation has been revealed between the scores achieved by the purely holistic method and those assessed with the combined holistic and discrete point approach. The holistic method was shown to be slightly more reliable than the combined approach.
Conclusion: The study has revealed that the method of assessment does not significantly influence the score in the evaluation of translation in the PROFEX EMP exam.

Keywords: , , , ,
Full text: PDF