Category Archives: Number

Assessment of Periodontal Status of Surgically Exposed and Orthodontically Aligned Impacted Maxillary Canines

Coșarcă Adina¹, Păcurar Mariana², Petrovan Cecilia¹, Ormenișan Alina¹

1 Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
2 Department of Pedodontics and Orthodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

DOI: 10.2478/amma-2014-0002

Aim: The aim of this study was to compare the periodontal status of impacted canines after 5 years following completion of the combined surgical and orthodontic treatment.
Materials and methods: We examined 20 labially impacted canines and 20 palatally impacted canines at 5 years after the end of treatment. We assessed the periodontal status of these teeth.
Results: Different outcomes were found regarding the probing depth and the amount of keratinized gingiva in the two mentioned groups of teeth.
Conclusions: The assessed periodontal indices may signal the appearance of a periodontal disease around the teeth that were surgically and orthodontically treated.

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Anastomotic Leaks after Colorectal Surgery: a Prognostic Score

Caziuc Alexandra1, Mironiuc A2

1 First Surgical Clinic, ”Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
2 Second Surgical Clinic, ”Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj Napoca, Romania

DOI: 10.2478/amma-2014-0001

Introduction: Anastomotic leaks are one of the most dreaded complications in colorectal surgery. At the ground of this problem remain the nefarious prognostic over the patient’s life, the difficulties in early diagnosis and the optimal choice of therapeutical methods. The goal of our research was to evaluate the significance of possible risk factors in the postoperative evolution of patients following colorectal interventions and to design a prognostic score.
Material and methods: We performed a retrospective study on 298 cases of patients with inflammatory, neoplastic or traumatic lesions for which there was chosen a digestive anastomosis including the colon. The presumed risk factors in our analysis were: age, comorbidity evaluated by Charlson Score, etiology, toxics, use of nonsteroidal anti-inflammatory substances or corticoids, parameters such as leucocytes, hemoglobin, urea, total seric bilirubin, glycaemia, albumins, neoadjuvant therapy, type of suture, quantity of fluids received intraoperatory. All data were analyzed using R-Commander.
Results: All parameters for which we demonstrated a statistical significance (p <0.05) for an unfavorable evolution were included in a prognostic score, designed in correlation with the statistical relation between the factors. We obtained values that certified a strong association (0.75) between a high prognostic score and an increased number of anastomotic leaks.
Conclusions: The practical utility of the score is mainly for the anticipation of postoperative complications. A high level score underlines that prior to surgery it is essential to balance the biochemical abnormalities and to choose properly the moment and type of surgical intervention.

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Surgical Management of Renal Hyperparathyroidism: Case Series and Review of the Literature

Neagoe Radu Mircea1, Mureșan Mircea1*, Văcar Smaranda2, Hossu Ioan3, Pașcanu Ionela4, Borda Angela5, Sala Daniela1

1 Second Department of General Surgery, University of Medicine and Pharmacy Tîrgu Mureş, Romania
2 Centrul de Dializă B Braun Avitum Tîrgu Mures
3 Nephrology Department, University of Medicine and Pharmacy Târgu Mureş, Romania
4 Endocrinology Department, University of Medicine and Pharmacy Târgu Mureş, Romania
5 Department of Histology, University of Medicine and Pharmacy Târgu Mureş, Romania

DOI: 10.1515/amma-2015-0083

Secondary hyperparathyroidism (sHPT) occurs most commonly in the setting of chronic renal failure (CRF) being frequently referred to as “renal” hyperparathyroidism The “classical” medical treatment with oral calcium and vitamin D supplementation is generally sufficient to lower parathyroid hormone levels in the majority of these patients. However, we frequently encounter cases of severe refractory sHPT, a state in which even recently available therapeutic agents, i.e. calcimimetics, new phosphate binders, vitamin D analogues, remain inefficient, thus parathyroidectomy and/ or renal transplant becoming necessary. Three types of surgeries have been proposed in sHPT: two of them are grouped as remnant-conserving techniques, i.e. subtotal parathyroidectomy (sPtx) and total parathyroidectomy with autotransplantation (tPtx+AT), the third one being total parathyroidectomy without autotransplantation (tPtx). There was a continuous debate concerning the best surgical approach in renal hyperparathyroidism, starting very soon after those techniques were described; without pretending to solve these controversies, this paper aims to review the surgical treatment options in sHPT, based on our 5-year experience in dealing with the disease.

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The Monitoring of Immunosuppressive Therapy with Tacrolimus in Patients with Kidney Transplant, Based on the Pharmacokinetic Criteria

Stoica Ciprian Mihai1, Căldăraru Carmen Denise2*, Vari Camil Eugen3, Tarța Dorin Ionuț1, Dogaru Maria Titica3, Carașca Emilian4, Dogaru Grigore Aloiziu1

1 Department of Nephrology, University of Medicine and Pharmacy, Târgu-Mureş, România
2 Department of Physiology, University of Medicine and Pharmacy, Târgu-Mureş, România
3 Department of Pharmacology and Clinical Pharmacy, University of Medicine and Pharmacy, Târgu-Mureş, România
4 Department of Internal Medicine IV, University of Medicine and Pharmacy, Târgu-Mureş, România

DOI: 10.1515/amma-2015-0082

Background: Therapeutic drug monitoring (TDM) in patients with Chronic Kidney Disease (CKD) with kidney transplant, represents a major post transplant concern due to the characteristics of this special category of patients, particularities which can generate changes of the pharmacokinetic profile of the administered medication.
Material and methods: The current study is a retrospective pharmacokinetic study, over a period of 50 months, including a group of 36 kidney transplanted patients with CKD. Tacrolimus blood concentration was determined by a validated high-performance liquid chromatography method (HPLC), at a 12 hour time interval from the last administration of the immunosuppressive medication and before the following dose (Residual concentration, Cmin(trough)).
Results: During the monitoring of therapy, based on the pharmacokinetic criteria, 252 measurements of blood concentration were determined, 58 of these being outside the therapeutic window.
Conclusions: The results obtained show that it is mandatory to continue to monitor closely medical therapy based on the pharmacokinetic criteria in view of improving drug administration. The other ways of monitoring therapy: the clinical and biochemical criteria should not be overlooked. In addition, the interindividual variability of patients should be considered, as well as drug interaction which can alter the pharmacokinetics of tacrolimus.

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Imaging Findings of Bisphosphonates-Associated Osteonecrosis of Jaw: Literature Review and Report of 3 Cases

Lazar Adela Cristina¹, Hedesiu Mihaela², Ilea Aranka¹, Baciut Grigore³, Pacurar Mariana4*, Campian Radu-Septimiu¹

¹ Department of Oral Rehabilitation, Oral Health and Dental Office Management, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
² Department of Dental Radiology, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
³ Department of Oral and Maxillofacial Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
4 Faculty of Dental Medicine, University of Medicine and Pharmacy Targu-Mures, Romania

DOI: 10.1515/amma-2015-0081

Purpose: The present study aims radiological aspects of the occurrence of osteonecrosis of the jaw age groups both in receiving i.v bisphosphonates tratment Imaging assessment of bisphosphonates therapy-induced osteonecrosis of the jaw it is important to differentiate neoplastic invasion, osteomyelitis, osteoradionecrosis induced by radiation or bone related pathology of general diseases.
Material and method: We conducted a retrospective clinical study including 22 patients (8 men and 14 women) with various stages of osteonecrosis of the jaw.
Results: Radiological examinations using CBCT are required in all therapeutic approach of osteonecrosis of jaw cases providing accurate informations of position, dimension and the link with anatomical structures.Our study showed that the prevalence of osteonecrosis of mandibular growth is higher in women than in men and the risk of osteonecrosis of the jaw in appearance is depending on age factor witch occurs more often between age 52-59 and 73-80 years old.
Conclusion: The multitude of complications due to treatment with bisphosphonates bind to an early and specialized therapeutic approach. Radiological examinations is a first choice in the detection and early diagnosis of osteonecrosis of the jaw, patients requiring a permanent supervision by the physician and dentist.

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Prevalence of Physiological, Pathological and Behavioral Risk Factors in Patients Treated with Antidiabetic Sulfonylureas

Confederat Luminita*, Stefan Roxana, Constantin Sandra, Hăncianu Monica, Profire Lenuta

University of Medicine and Pharmacy “Grigore T. Popa”, Iași , Romania

DOI: 10.1515/amma-2015-0080

Diabetes mellitus is an important public health problem because of its increased incidence and its devastating complications. In addition to this, it was observed an increase in prevalence for diabetes risk factors. The aim of this study was to evaluate the frequency of the pathophysiological and behavioral risk factors among patients treated with oral hypoglycemic sulfonylureas.
Material and methods: It were analyzed the observation sheets of 200 patients ambulatory treated at the “Providența” Medical Center.
Results and discussions: Most of the patients were aged over 65 years, being 48.5% women and 51.5% men. The obesity was the most frequent (88%) risk factor in patients; the majority of them were included in the “overweight” and “first- degree obesity” class (72%). Regarding associated comorbidities, hypertension was found in 77% of cases, followed by dyslipidemia. In terms of physiological and behavioral aspects, age and alcohol consumption were predominant.
Conclusions: A significant percentage of diabetic patients treated with hypoglycemic sulfonylureas present a high prevalence of the risk factors and even two or three factors associated.

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The Assessment of Romanian Customers’ Level of Satisfaction with Pharmaceutical Providers

Cherecheș Marius Călin1*, Timofe Mara Paula2, Oniga Ovidiu1

1 Faculty of Pharmacy, ”Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
2 Cluj School of Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania

DOI: 10.1515/amma-2015-0079

The aim of the current study is to assess the level of satisfaction towards pharmaceutical services among Romanian customers. Moreover, we were interested in building the socio-demographical profile of a Romanian satisfied customer. The study has a transversal design and uses a quantitative approach. Data was collected at the national level in June 2012 by using Computer Assisted Telephone Interviews (CATI) and resulted in 1,478 valid questionnaires. Descriptive statistics were performed in order to properly present the sample of interest according to socio-demographic characteristics, as well as general attitudes towards pharmaceutical market. According to our analysis, only half of the respondents have a favorite pharmacy (50,4%). Regarding their level of satisfaction, the majority of respondents (53%) declared themselves as being quite satisfied with the pharmacy that they usually collaborate with, whereas 42% of respondents are very satisfied with their favorite pharmacies. According to our analysis, the most satisfied customer has the following socio-demographic characteristics: female (N=351), aged between 56 and 70 years old (N=259), having high school as the highest level of education (N=184), living in an urban area (N=343), having a monthly income of 501-1000 RON (N=217), married (N=396), having no chronic disease (N=312), having a family composed of two members (N=185). Customer’s satisfaction represents a personal evaluation on the pharmaceutical services and providers and is an essential part of the quality of health care. Therefore, it is vital to assess the customer’s expectation and satisfaction in order to ensure the success of the pharmaceutical company.

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Association of Heart Failure with Preserved Ejection Fraction and Components of Metabolic Syndrome

Anda-Mihaela Cerghizan1, Simona Bățagă2, L. Cozlea1, I.D. Tarța3, B. Chibelean 4, Carmen Căldăraru5*, G. Dogaru3

1 3rd Internal Medicine Clinic, Faculty of Medicine, University of Medicine and Pharmacy, Tirgu-Mures, Romania
2 1st Gastroenterology Clinic, Faculty of Medicine, University of Medicine and Pharmacy, Tirgu Mures, Romania
3 Department of Nephrology, University of Medicine and Pharmacy, Tirgu-Mures, Romania
4 Department of Urology, University of Medicine and Pharmacy, Tirgu-Mures, Romania
5 Department of Physiology, University of Medicine and Pharmacy, Tirgu-Mures, Romania

DOI: 10.1515/amma-2015-0078

The aim of the current study was to find any possible associations between elements of metabolic syndrome and echocardiographic characteristics (grade of diastolic dysfunction) in normoponderal and overweight patients with heart failure with preserved ejection fraction. A retrospective observational analytical study was performed on 130 patients presenting heart failure with documented ejection fraction over 50%. They were divided into two groups based on their body mass index. The first group included 56 normal weight patients and the second group included 74 overweight patients. Elements of the metabolic syndrome analysed in the current study were arterial hypertension, high triglyceride levels, low HDL-cholesterol and diabetes. None of the components of metabolic syndrome alone had a role in the evolution of diastolic dysfunction in either group. Three or four elements present in obese patients were negatively associated with grade 2 diastolic dysfunction, high values of blood pressure (over 180/110 mmHg) were more often encountered in obese patients with first and second grade of diastolic dysfunction.

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The Importance of Vascular Endothelial Growth Factor as a Marker of Angiogenesis and Lymphangiogenesis in Non-small Cell Lung Cancer

Suciu Bogdan Andrei*, Denes Lorand, Hălmaciu Ioana, Mezei Tibor, Brînzaniuc Klara, Azamfirei Leonard

University of Medicine and Pharmacy of Tirgu Mures, Romania

DOI: 10.1515/amma-2015-0077

Lung cancer is the main cause of cancer death both in men and women. In spite of progress seen in the early diagnosis of lung cancer, and implementation of new treatment principles for these patients, 5 year survival of non-small cell lung cancer patients undergoing surgery is low. Introduction of anti-angiogenic therapy administered concomitantly with conventional chemotherapy agents represented practically the first success seen in the treatment of lung cancer in the last 20 years. The aim of this paper is to review the literature informations about the importance of VEGF (vascular endothelial growth factor) as a marker of angiogenesis in patients with non-small cell lung cancer. Therefore, we practiced a literature review about these topics : the importance of VEGF in tumor angiogenesis and lymphangiogenesis in patients with non-small cell lung cancer and his importance as a prognostic factor at these patients, the prognostic impact of serum levels of VEGF and of the cellular expression of VEGF at these patients and also we reviewed the value of the antiangiogenic therapy.

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