Category Archives: Number

Cannabidiol in the context of sleeping disorders-induced oxidative stress

George Jîtcă, Bianca Eugenia Ősz, Carmen Maria Rusz, Amalia Pușcaș, Amelia Tero-Vescan, Mădălina Georgiana Bătrînu, Ruxandra Emilia Ștefănescu

George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2022-0023

Sleep disorders can be the result of psychiatric or neurological conditions, such as post-traumatic stress disorders, depression, anxiety, Alzheimer’s disease, Parkinson’s disease. At the same time, changes in sleep, known as sleep disorders, are closely related to various metabolic dysfunctions, which in turn are the result of the generation of reactive oxygen species, or otherwise known as oxidative stress. For this reason, cannabinoid derivatives are increasingly used for this purpose. Among the most used are delta-9 tetrahydrocannabinol (THC) and cannabidiol (CBD). These agents interact with the endogenous endocannabinoid system, either by direct action on specific receptors, or by increasing the availability of endocannabinoids, modifying particular mental states (anxiety, depression). The results of the studies specified in this article provide promising evidence regarding the positive effects of CBD, which extend beyond the scope of sleep disorders, with possible applications also in the case of the accumulation of reactive oxygen species.

Keywords: sleep, post-traumatic stress disorder, oxidative stress, cannabidiol, tetrahydrocanabinol

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Digitally designed fixed dental prosthesis with stress breaking effect using non-rigid connector for pier abutment: A case report

Manu Rathee, Santhanam Divakar, Prachi Jain, Sandeep Singh, Sujata Chahal, Sarthak Singh Tomar

Department of Prosthodontics, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India

DOI: 10.2478/amma-2022-0033

Rigid connectors between pontic and retainer are preferred way of fabricating fixed partial dentures for many decades as they provide desirable strength, retention and stability to the prosthesis. However, it is not ideal for cases such as lone-standing abutments (pier abutment), maligned teeth where occlusal stress can extrude the restoration. This may lead to marginal leakage and secondary caries on the abutment teeth. Conversely, it is recommended to use non-rigid connectors which act as a stress breaker, where the tensile stresses are concentrated on the surrounding bone and not on the connectors. With advancement in digital technology in dentistry, the non-rigid connectors can be fabricated using additive manufacturing technology. The present case report discusses the Direct Metal Laser Sintering (DMLS) designed fixed dental prosthesis with key and keyway (Tenon and Mortise) non-rigid connector for rehabilitation of pier abutment in maxillary posterior region.

Keywords: fixed dental prosthesis, non-rigid connectors, 3D printing, pier abutment, direct metal laser sintering

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Alpha adrenergic receptors in clinical practice – Present and future

Patrick Lechsner, Erika-Gyongyi Ban

George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania

DOI: 10.2478/amma-2022-0030

In this review we discuss the adrenergic pathways for alpha 1 and alpha 2 receptors and the current as well as potential future medication targeting these receptors. Overall, there is ongoing research into a multitude of directions with a promising outlook for alpha 1 and alpha 2 adrenergic receptors. The alpha 1-adrenergic receptor subfamily is currently modulating only a modest number of nervous system functions due the fact, that only a relatively small number of selective commercial products are available. Chronic stress can affect the long-term depression of alpha 1 receptors. Recent studies are searching for new molecular targets which might act on these receptors. Presynaptic alpha 2 receptors play an important role in modulating release of several neurotransmitters in the central nervous system. The future of alpha 2 adrenergic receptors in clinical practice looks even more promising and versatile than that of alpha 1 adrenergic receptors. Alpha 2 adrenergic receptors show different responses, especially regarding hypertension and heart failure treatment, and current research suggests a genetic component as a cause, which is being explored further.

Keywords: immunity, noradrenaline, pharmacotherapy, alpha adrenergic receptors, molecular target

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Nano-scale surface modification of dental implants – An emerging boon for osseointegration and biofilm control

Palekar Gouri Sachin, Ashita S. Uppoor, Sangeeta U. Nayak

Department of Periodontology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, India

DOI: 10.2478/amma-2022-0029

Implant therapy is a commonly based method of replacing missing teeth. A range of physical, chemical, and biological modifications have been applied to the surface of titanium implants to improve their biological performance and osseointegration outcomes. Implant surface characteristics play an important function in several peri-implant cellular and molecular mechanisms. Clinicians are commonly placing dental implants with various surface roughness and modifications including plasma-sprayed, acid-etched, blasted, oxidized, hydroxyapatite-coated, or combinations of these procedures. Surface modifications are to facilitate early osseointegration and to ensure a long-term bone-to-implant contact without substantial marginal bone loss can be accomplished. It is apparent that different modifications have a range of beneficial effects, it is essential to consider at what time point and in what conditions these effects occur. This article reviews existing surface modification technologies of mainstream dental implants and the correlation between implant surface coatings and their performance of osseointegration or anti-bacterial ability it needs to be evaluated.

Keywords: osseointegration, surface topography, coatings, dental implants, nano level implant modification

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An evaluation of concordance between linear measurements obtained from conventional, digital and reconstructed three-dimensional printed orthodontic models: an in vitro study

Shravan Shetty¹, Srikant Natarajan², Supriya Nambiar¹, Prithvi Shetty³, Kavery Chengappa⁴, Mukul Shetty⁵

1. Department of Orthodontics and Dentofacial Orthopaedics, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
2. Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
3. Department of Public Health Dentistry, A.J.Institute of Dental Sciences, N.H.17, Kuntikana, Mangalore, Karnataka, India
4. Department of Public Health Dentistry, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
5. Department of Orthodontics and Dentofacial Orthopedics, A B Shetty Memorial Institute of Dental Sciences; NITTE Deemed to be University, Mangalore, Karnataka, India

DOI: 10.2478/amma-2022-0028

Objective: To evaluate the potential use of digital and reconstructed three-dimensional printed models as an alternative to conventional plaster models by assessing the accuracy of their linear measurements.
Methodology: Pre-treatment plaster models of 45 patients were selected from the archives of the Department of Orthodontics. Each physical plaster model was scanned and digitized using a three-dimensional (3D) laser surface scanning system (inEOS X5, Dentsply Sirona, Bensheim, Germany). The scanned STL files were later used to reconstruct models by 3D printing using Figure4® standalone 3D printer (3D systems, Rock Hill, South Carolina). Measurements of teeth 11 and 16, the transverse width of the upper jaw between the first molars (MM – intermolar width) and canines (CC – intercanine width) were done manually using a digital vernier caliper (Mitutoyo, Kawasaki, Japan), and the CAD Assistant software (Open cascade, Guyancourt, France). Intra examiner data, Intraobserver variability, and measurement accuracy were evaluated using Intraclass Correlation Coefficient (ICC) analysis was done using SPSS 20.0.
Results: The intraclass correlation coefficients were >0.8 indicating high reproducibility and reliability. Significant differences were found between the physical and the digital models but to a small proportion which were deemed not clinically relevant.
Conclusion: Both the digital models and reconstructed three-dimensional printed models using Figure4® technology were clinically permissible in terms of accuracy and reproducibility. The digital storage, transmission, and treatment planning in an environmentally friendly manner should promote digital over conventional records.

Keywords: dental models, digital technology, three-dimensional printing

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Single-plaque psoriasis: a single-clue diagnostic challenge

Luminita Emilia Decean¹, Roxana Flavia Ilies², Andreea Sasu³, Iulia Barsan⁴, Adriana Mihai¹

1. George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
3. First Psychiatric Clinic, Targu Mures County Hospital, Romania.
4. Elitemed Anatomical Pathology Laboratory, Targu Mures, Romania

DOI: 10.2478/amma-2022-0019

Introduction: Psoriasis is a chronic, common immune inflammatory condition of the skin, affecting 2-3% of the population, with regional variability. Classically, psoriasis presents as one of the following types: plaque, guttate, inverse, pustular or erythrodermic psoriasis. Typically, the patient will present with several symmetric psoriatic plaques on typical areas of the body, leading the clinician towards the diagnosis of psoriasis.
Case report: The present case report series focuses on an atypical presentation of psoriasis noted in 2 patients who presented to our office with a single large, erythematous plaque located on the lower leg. Due to poor response to previous treatment, a biopsy was performed and upon analysis, revealed a diagnosis of psoriasis. The lesions showed significant improvement under local therapy.
Conclusion: In spite of significant research on such a common and seemingly well-understood dermatosis, the present case reports plead for further study with regards to atypical presentations of psoriasis.

Keywords: psoriasis, histopathology, single plaque, unilateral

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Clear or White? A RT-PCR plate comparison for SARS-CoV-2 diagnosis

Elena Cristina Preda¹, Valeriu Moldovan¹, Oana Roxana Oprea²

1. County Emergency Clinical Hospital, Târgu Mureș, Romania
2. George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2022-0024

Objective: During the COVID-19 pandemic, laboratories have used various extraction and amplification kits, associated with different auxiliary materials. This study aims to investigate how different types of plates may affect RT-PCR performance.
Methods: Data on the positive controls (PCs) of RT-PCR runs for SARS-CoV-2 detection between December 2020 and April 2022 was collected retrospectively in the Molecular biology department of the County Emergency Clinical Hospital of Târgu Mureș’s clinical laboratory. The materials used consisted in MOLgen SARS-CoV-2 (Adaltis) and EliGene COVID19 CONFIRM 500 R amplification kits, 96-well full-skirted white and clear plates, and clear films. Microsoft Excel was used for the database and it included information about Cycle threshold (Ct) and maximum fluorescence. Statistical analysis, performed in MedCalc, consisted of Grubbs test, Kolmogorov–Smirnov Test, F test, T student test, and Mann-Whitney test to compare central tendencies. The significance threshold was set at p<0.05.
Results: The Ct comparison for MOLgen kit white plates vs clear plates: FAM channel- U=1052.5, Z=2.07, p=0.038, medians for white plates and clear plates were 22.80 and 23.25, respectively; ROX channel- U=784, Z=3.21, p=0.001, medians 21.93 and 21.43, respectively; Cy5 channel- U=1028.5, Z=1.95, p=0.518, medians 22.12, 21.75, respectively. For EliGene kit: U=848.5, Z=3.27, p=0.001, medians 28.26 (white plates) and 28.0 (clear plates). Comparison of the maximum fluorescence reached on both kits with white and clear plates computed p values <0.0001.
Conclusions: Between white and clear plates there are statistically significant differences considering Ct values and maximum read fluorescence, but with no impact on test outcome.

Keywords: RT-PCR, Cycle threshold, white plates, clear plates

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Is the pulmonary microbiome involved in lung cancer pathophysiology?

Corina Eugenia Budin¹, Iuliu Gabriel Cocuz¹, Hédi Katalin Sárközi¹, Adrian Horatiu Sabau¹, Bianca Liana Grigorescu²

1. George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Department of Anesthesia and Intensive Care, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2022-0021

Bronchopulmonary cancer represents the neoplasms associated with the highest mortality rate, despite diagnostic and therapeutic advances in recent decades. Early diagnosis is often difficult due to the paucity of symptoms or superinfections. Screening subjects at risk of developing lung cancer include clinical, bacteriological, inflammatory status, and genetic profile assessment. The personal microbiome has an essential role in the physiology of the human body. The gut-lung axis plays an essential role in carcinogenesis, being involved in various pathways. The lung microbiome can contribute to the development of lung cancer either directly by acting on tumor cells or indirectly by modulating the tumor-associated immune response. The gut microbiome can directly affect the response to immunotherapy in patients with non-small cell lung cancer.

Keywords: lung cancer, microbiome, genetic alterations

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Reattachment of coronal tooth fragments: Aesthetic management of a complicated anterior maxillary crown fracture

Preethesh Shetty¹, Raksha Bhat¹, Arjun Kini²

1. Nitte (Deemed to be University), AB Shetty Memorial Institute Of Dental Sciences (ABSMIDS), Department of Conservative Dentistry and Endodontics,
Mangalore, India
2. New York University College of Dentistry, New York, NY, USA.

DOI: 10.2478/amma-2022-0027

Keywords: incisors, esthetics, trauma, endodontics, tooth fractures

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Unusual case of infrarenal pheochromocytoma developed on ectopic adrenal tissue: An autopsy case report

Rebeca Chiciudean¹, Ioan Jung², Tivadar Bara³, Simona Gurzu^1,2,4

1. Department of Pathology, Clinical County Emergency Hospital, Targu-Mures, Romania
2. Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu-Mures, Romania
3. Department of Surgery, Clinical County Emergency Hospital, Targu-Mures, Romania
4. Research Center of Oncopathology and Translational Medicine (CCOMT), George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania

DOI: 10.2478/amma-2022-0025

Introduction: Pheochromocytomas are catecholamine-secreting tumors arising from the chromaffin cells of the adrenal medulla. We describe an unusual case of pheochromocytoma located in the infrarenal area and associated with bilateral adrenal hyperplasia.
Case presentation: A 70-year-old patient was admitted for syncope, diaphoresis, and high blood pressure. Computed tomography showed a 73x70x72 mm retroperitoneal mass of the left infrarenal area. High levels of metanephrine and noradrenaline were found in the urine. A tumor resection was performed. A few days after surgery, the blood pressure suddenly decreased and could not be restored, resulting in the death of the patient. Histopathological examination of the surgical specimen revealed a proliferation of monotonous cells, with eosinophilic cytoplasm, round nuclei with prominent nucleoli arranged in clusters, and capsular and vascular invasion. The tumor cells expressed synaptophysin and chromogranin, without positivity for inhibin A or S100 protein. At the autopsy, both adrenal glands showed hyperplasia but unrelated to the tumor mass. The histological aspect, location, and immunophenotype indicated an ectopic infrarenal pheochromocytoma.
Conclusions: In patients with pheochromocytoma developed on ectopic adrenal tissue, clinical management might be difficult, and diagnosis can be sometimes established only based on post-mortem histopathological examination. Autopsy can be extremely useful in such cases with unexplained evolution.

Keywords: pheochromocytoma, metanephrine, adrenal hyperplasia

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