Category Archives: Number

Tradition in Competition to Food Safety, or “Archaic Science” against Brand Name Products

Traditionally, the homemade beverages or concentrated alcoholic drinks are produced by distilling different types of organic raw materials, most of them from biological sources as cereals grains, fruits and juices (these being the starch sources) [1] but even from wood sources. All these sources produce both ethanol and methanol in different proportions, by fermentation process. The serious health risk of methanol poisoning becomes higher when using wood sources [2].
The European and national regulations for Food Safety do specify strict requirements for producing alcohol drinks, and here are the brand name products, but homemade beverages with over 30% ethanol obtained by repeated distillation in manufactured copper vessels will contain small amounts of methanol. In case that fruit juice is used this amount reaches about 0.2-0.3%, however from fruit pulp the amount may rise to 0.6-0.9% [3].
As the metabolism of methanol is much slower than the one of ethanol, the most common effects caused by exposure to methanol by drinking alcohol beverages become apparent only after several hours. [More]

Full text: PDF

Treatment Evaluation with Mometasone Furoate, Alone or in Combination with Desloratadine/Montelukast in Moderate Severe Allergic Rhinitis

DOI: 10.2478/amma-2014-0022

Introduction: Allergic rhinitis is one of the most common allergic diseases, characterized by the inflammation of the nasal mucosa. Eosinophils play a predominant pro-inflammatory role in allergic inflammation. This study assesses the effect of mometasone furoate alone or in combination with desloratadine/montelukast in patients with moderate-severe allergic rhinitis.
Material and method: This is a prospective study that took place over 8 weeks on 70 patients diagnosed with moderate-severe allergic rhinitis with sensitization to the pollen of Ambrosia elatior. The patients were evaluated on the basis of their symptoms using the total score of nasal symptoms, the score of individual nasal symptoms and the number of eosinophils in the nasal secretion.
Results: All 3 groups of patients had an improvement on the total nasal symptoms score. However, the combination of mometasone furoate with desloratadine provided statistically significant benefits on the total score of symptoms and on nasal itching as compared with mometasone furoate alone.
Conclusions: The association of mometasone furoate with desloratadine should be considered first-line treatment of moderate-severe allergic rhinitis due to the benefit both on the total symptom score and on of nasal itching.

Full text: PDF

Correlation of Serum and Synovial Osteocalcin, Osteoprotegerin and Tumor Necrosis Factor-Alpha with the Disease Severity Score in Knee Osteoarthritis

DOI: 10.2478/amma-2014-0021

Objectives: Study of circulating and synovial levels of osteocalcin, osteoprotegerin and tumor necrosis factor-alpha (TNF-α) in patients with different stages of knee osteoarthritis and correlation analysis of these parameters with disease severity.
Methods: We enrolled 20 patients with different stages of knee osteoarthritis. The IKDC score (International Knee Documentation Comittee, 2000) was determined for each patient. Based on these data patients were divided into two groups: group I (advanced osteoarthritis) and group II (early osteoarthritis). Serum and synovial fluid levels of osteocalcin, osteoprotegerin, TNF-α were determined.
Results: For the entire group the level of osteocalcin in the serum showed higher values than in the synovial fluid. We found statistically significant differences in the serum levels of osteocalcin between the two groups (group I: 2.18 ± 0.54 ng/ml, group II: 6.07 ± 1.98 ng/ml, p = 0.019). Serum and synovial osteocalcin in the whole study lot could not be correlated with the disease score, however we observed a tendency towards significant negative correlation between the serum osteocalcin and IKDC score for group I and between synovial osteocalcin and IKDC score in group II. In the entire group, synovial osteoprotegerin concentration was six times higher than the serum osteoprotegerin level (p <0.0001) and TNF-α showed higher circulating levels than local concentrations.
Conclusions: In the advanced osteoarthritis group the serum and synovial osteocalcin show lower values than in the early osteoarthritis group, which means that as the disease progresses, bone anabolism decreases. In the case of osteoprotegerin, no significant difference between the two groups was detected.

Full text: PDF

The Loss of Correction in Thoracolumbar Burst Fracture Treated by Surgery. Can We Predict It?

DOI: 10.2478/amma-2014-0020

Objective: This paper aims to differentially depict potential patterns of the loss of correction in surgically treated thoraco-lumbar burst fractures. These may eventually serve to foreseeing and even forestalling loss of correction.
Methods: The study focused on 253 patients with surgically treated thoraco-lumbar fractures. This cohort of patients was clustered in four subgroups according to the fracture spine segment (T11–L1 or L1–L2) and surgery type (short segment fixation or anterior approach). Relevant recorded and processed data were the fracture level, post-operative (Kpo) and last follow-up (Kf) kyphosis angle values. Correlation, regression and determination testing were performed for the last follow-up kyphosis angle and post-operative kyphosis angle, and regression equations were determined for each subgroup of patients.
Results: The patterns of loss of correction were described through the following equations: Kf = 0.95*Kpo + 3.2° for the T11–L1 level fractured vertebrae treated by posterior short segment fixation; Kf = 0.98*Kpo + 3.4° for the L1–L2 level fractured vertebrae treated by posterior short segment fixation; Kf = 1.1*Kpo + 1.6° for the T11–L1 level fractured vertebrae treated by anterior approach; and Kf = 0.7*Kpo + 2.8° for the L1–L2 level fracture vertebrae treated by anterior approach.
Conclusions: The loss of correction may be predicted, to a certain extent, for thoraco-lumbar fractured vertebrae treated surgically. The best-fit equations depicted for both type of surgery (short segment fixation and anterior approach) and both spinal segments (T11–L1 and L2–L3) are significantly different than the equations delineated for the collapse of non-surgically treated fractures.

Full text: PDF

Evaluation of Inflammatory Markers in Pregnant Women at Risk, for the Prediction of Preeclampsia

DOI: 10.2478/amma-2014-0019

Introduction: A low degree of inflammation has been associated with complications in pregnancies, including preeclampsia (PE). The aim of our study was to determine the serum values of high sensitivity C Reactive Protein (hs-CRP) and Interleukin-6 (IL-6) in the first and second trimesters of pregnancy in pregnant women with risk factors for the development of PE, and to evaluate their relevance for the prediction of this disorder.
Material and methods: We performed a prospective longitudinal study on 120 pregnant women, who were divided based on the pregnancy evolution, into two groups: group I – 26 pregnant women who developed preeclampsia and group II – 94 pregnant women with physiological evolution of pregnancy.
Results: Our study has shown an increase in serum levels of hs-CRP and IL-6 in the first and second trimester of pregnancy in patients from group I, significant values being revealed only in the second trimester of pregnancy. The predictive power of the selected inflammatory markers was significant only for values of hs-CRP in the second trimester of pregnancy, while the association with IL-6 increased the prediction.
Conclusions: Increased values of hs-CRP and IL-6 in the second trimester of pregnancy are associated with higher risk for preeclampsia, however the study provided only a modest efficiency of the prediction capacity.

Full text: PDF

Etiology of Bacteremic Syndromes and Bacterial Susceptibility of Blood Culture Isolates in a Romanian County Hospital

DOI: 10.2478/amma-2014-0018

Aim: To present the etiology of bacteremic syndromes and antibiotic susceptibility of blood culture isolates from a Romanian county hospital, as well as their distribution within different wards.
Methods: We retrospectively analyzed the blood culture data collected from patients hospitalized in the County Emergency Clinical Hospital of Tirgu Mures over a period of two years. We followed aspects regarding the identified bacterial species, their distribution by sex, age groups and wards, the spectrum of resistance to antibiotics and main resistance phenotypes.
Results: Most positive samples came from ICU, nephrology and urology. The most isolated bacteria were coagulase-negative staphylococci, Escherichia coli, and Staphylococcus aureus. All isolates showed a high resistance to most classes of antibiotics, staphylococci being susceptible to glycopeptides, oxazolidinones and glycylcyclines, and the enterobacteria to aminoglycosides and carbapenems. The resistance in non-fermentative bacilli exceeded 80% to most classes of antibiotics. The methicillin-resistance was 36% for coagulase-negative staphylococci and 82% for Staphylococcus aureus; the percentage of extended-spectrum beta-lactamase producing strains was 30%.
Conclusions: The etiology of bacteremic syndromes is specific to the ward profile, the Staphylococcus spp. being primarily isolated from wards where invasive procedures are frequently performed, while the enterobacteria from urology and nephrology wards. The level of antibiotic resistance is higher in surgery and ICU wards, with also higher percentage of resistance phenotypes than in medical wards.

Full text: PDF

The UV and IR Comparative Spectrophoto-metric Study of Some Saturated and Lacunary Polyoxometalates

DOI: 10.2478/amma-2014-0017

Objectives: The polyoxometalates are a class of inorganic compounds with controllable shapes and sizes, and with excellent properties that make them attractive for various applications. This study is aimed at the comparative UV and IR spectra of Keggin type polyoxometalates.
Methods: Compounds under (UV and IR) investigations were divided into several groups to highlight similarities between compounds or classes of compounds for the same category. There are four types of saturated Keggin structures and six lacunar compounds included in this study. The study begins with the UV investigations on aqueous solutions with 10-5 M concentration for these compounds. IR spectra were recorded as KBr pressed pellets.
Results: The UV spectras presents large strong peaks between 185–195 nm corresponding to W = Od bonds, between 251–268 nm for W-O-W bridge bonds, depending on heteroatom types (As, Sb). The unsaturated cryptand ligand having Co2+ coordinated presents the most intense peak, due to the involvement of oxygen atoms from terminal W = Od coordinative bonds with high electronic densities in coordination of W-O-Co bond. The IR spectra present many peaks that are associated as follows: for terminal bonds W = Od, 955–970 cm-1; for W-O-W bridging bonds, 790–910 cm-1; for W-O-As/Sb bonds to heteroatom, 690–760 cm-1. Vibrations of the bonds between heteroatoms and oxygen (As/Sb-O) appear around 620–660 cm-1.
Conclusions: Similarities appear from the recorded spectra, between compounds of the same class, by category association. Very fine displacements of peaks that occur explain the influence of heteroatoms, addenda atoms or coordinated cations.

Full text: PDF

An unusual Case of Cardiac Syncope and Acute Coronary Syndrome – A Case Report

DOI: 10.1515/amma-2015-0011

Introduction: We aimed to present a case of acute coronary syndrome with unexpected etiology complicated by syncope and arrhythmias, confirmed by imagistic examinations as cardiac parasitosis. Cardiac parasitic diseases are rare diseases, whose diagnosis and therapy should be adapted to each case. Imaging techniques allow precise diagnosis of cardiac echinococcosis, providing essential structural details on the damage degree of heart structures, allowing optimization of complex treatment in these cases.
Case presentation: A 67-year old, obese and diabetic woman presented with cardiac syncope, arrhythmias and acute chest pain. Imagistic examinations excluded intracoronary thrombosis and confirmed a severe structural damage of myocardial tissue, consisting in replacement of the myocardial structure by many cysts caused by parasitic infestation with echinococcus multilocularis and echinoccocus granulosus originating from the liver. CT scan confirmed severe distruction of the left ventricular myocardium by policysts, that led to thinning of inferior and apical left ventricle wall without any possibility of surgical excision. Therefore a specific chemotherapy with albendazole was initiated. Follow up at 2 months indicated a favorable evolution, with serological decrease of echinococcal antibodies and reduction of cysts volume.
Conclusion: In cases of angina and arrhythmias with non-atherosclerotic etiology, imaging techniques can diagnose the anatomopathological substrate of the disease and represent a valuable tool for the follow up.

Full text: PDF

Mirror, Mirror on the Ward

  1. Germs, ironically nicknamed “bugs” continue to be our concern, for they are a real threat. But when it comes for “bad bugs”, what are we going to do?
    Adrian Man et al studied the etiology of bacteriemic syndromes and bacterial susceptibility of blood culture isolates in a Romanian county hospital, namely, the County Emergency Clinical hospital of Tîrgu Mureș, Romania. They analyzed for three years all the blood cuture isolates [1].
    For any speciality besides microbiology, the process of understanding the general picture of microbiological results is painful. Denominations change, fresh insights into the bugs’ metabolism are paramount, bacteria seem to be more inteligent than predicted. Thus a whole arsenal has to be used to defeat bugs, strategies were developed, even the media and the patients are very sensitive to “killer bugs”.
    The workload to come up in time with reliable results seems to be considerable. Useful results mean for me: a result you can trust discriminating contamination from infection and information received within short time (better in less then 6 hours from admission). This could make a difference in outcome.
    When looking at the reported results, we learn that:
    1.The rate of blood culture positivity is 8%, which is quite low compared to other reports [1].
    2.For blood cultures, discrimination between contamination and etiological involvement is “still a problem” [1].
    For the severe septic patient, lack of reliable results as decribed is a real challenge. While contamination needs not to be treated with antibiotics, infection on the contary, requires target oriented medication. Only that the target is blurred. One can see it in 8% of the blood cultures, and less than this figure has an evidence-based suppport. Thus roughly >90% of the septic patients are exposed to empiric antimicrobials based on suspicions or on previously described local epidemiologic patterns.
    At the end of the day we can get a delayed bacterial result that cannot explain the critical condition of the patient. The identified germ may be a “bad bug”, still an epiphenomenon to a patient with multiple system organ failure of onother origin then septic.
    Bacterial results from blood culture imply a disproportionate workload for maginal benefits. Should we give up then to attempt bug identification, or should we reconsider our practcie? I have no doubts that strict adherence to sampling and handling blood protocols is mandatory. Otherwise, we will continue to escalate misunderstandings between microbiologists and clinicians. These snapshots of blood culture results will continue to be of limited use, a genuine waste of means. And yes, please handle everything with clean hands!

The value of Histopathological Diagnosis in Rupoid Psoriasis Accompanied by Fever. A Case Report and a Review of the Literature

DOI: 10.1515/amma-2015-0010

Psoriasis is a common dermatosis, however the rupoid type is considered as an exceptional form of this disease. Rupoid scabs are very rare in dermatological daily practice, usually being seen as secondary to syphilis in immunosuppressed patients. Rupoid psoriasis is characterized by thick and multilayered crusts that are resistant to local therapy and present a sudden onset. Severe arthropathy is a common manifestation. We did not found in literature any association of rupoid psoriasis with intermittent fever. We present the case of a patient who exhibited a rush of rupoid boards with severe arthralgia accompanied by intermittent fever. The suspicion of malignant syphilis was raised considering the clinical signs and symptoms and the specific social context of STDs. This suspicion was unconfirmed by TPHA negative reaction and histopathological appearance that showed changes typical of psoriasis. Clinical manifestations were successfully controlled with methotrexate.

Full text: PDF