Category Archives: Number

Obesity Treatment Strategies

Ianosi Edith Simona*, Comes Alexandra, Jimborean Gabriela

University of Medicine and Pharmacy of Tirgu Mures

DOI: 10.1515/amma-2015-0076

Obesity is a disease with severe health consequences and increased risk of mortality. The most commonly used criteria to assess the presence and the severity of obesity are body mass index, waist circumference, waist-to-height ratio and the presence of the health conditions caused or worsened by obesity. Worldwide obesity has more than doubled in the last 4 decades. Obesity is the second of the leading preventable causes of death worldwide (after smoking). Obesity has a plurifactorial pathogenesis. The central perturbation consists in the imbalance between calories intake and calories consumption (by inappropriate diet and sedentary lifestyle). Identification of all the ethiological factors is important for treatment and prophylaxis. Weight loss benefits are multiple and important: improvement in glicemic control and in plasma lipid levels, blood presure control, obstructiv sleep apneea reduction, improvement in management of daily activities and profesional performances, increase quality of life, reduction in mortality. Overweight or obese patient will complete a diagnostic and a treatment program. Treatment of obesity claims a targeted multidimensional therapy: weight and lifestyle management, diet, sustained physical activity in daily life, exercise, decrease life stressors, smoking cessation, drug therapy, bariatric surgery psichological, familial and social suport. Weight loss program must be carefully planned, adapted to the patient’s abilities and comorbidities and supervised by a nutritionist and a physiotherapist.

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Links Between Surgical Landmarks of the Temporal Bone and Cochlear Implant Approaches

Lostun Gabriel1*, Gușavan Diana Elena2, Genes Ionela1, Lostun Alexandra3, Brînzaniuc Klara4

1 Department of Otorhinolaryngology, University of Medicine and Pharmacy, Tîrgu-Mureș, Romania
2 Department of Radiology, Emergency County Hospital Tîrgu-Mureș, Romania
3 Department of Forensic Medicine, University of Medicine and Pharmacy, Tîrgu-Mureș, Romania
4 Department of Human Anatomy, University of Medicine and Pharmacy, Tîrgu-Mureș, Romania

DOI: 10.1515/amma-2015-0075

Objective: We aimed to underline the surgical importance of the distances between the landmarks of the temporal bone, important for quantifying the benefits and disadvantages of two different cochlear implant techniques.
Methods: We have gathered all data from the Radiology Department in Emergency County Hospital in Tîrgu Mureș, namely computed tomography imagistic studies in order to perform the required measurements, according to pre-defined inclusion/exclusion criteria. The time interval was 5 months.
Results: The comparison between the sets of data shows a good match for the risk/benefit ratio for the two types of technique for cochlear implantation.
Conclusions: The middle cerebral fossa approach for the electrode insertion into the cochlea is a viable and needed surgical technique as the classic approach has reached its boundaries and new challenges appear. As surgical decisions are largely based on radiology data, our work underlines the importance of solving the borderline pathology, the extreme cases and the role of surgery in improving the quality of life for every patient with cochlear implant indication.

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First Study of the Prosthesis Indication Deafnesses in Mureș County

Lostun Gabriel1*, Lostun Alexandra2, Brînzaniuc Klara3

1 Department of Otorhinolaryngology, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
2 Department of Forensic Medicine, University of Medicine and Pharmacy Tîrgu Mures, Romania
3 Department of Human Anatomy, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

DOI: 10.1515/amma-2015-0074

Objective: The aim of this study was to asses the frequency of the deafness pathology in the Ear, Nose and Throat Clinic of the Emergency County Hospital in Tîrgu Mureș and two other private institutions that have an ear linked profile, with a special interest on those with indication for prosthesis. This is a pilot study, being conceived as a part of a larger one used to measure the number of possible cochlear implant recipients nationwide.
Methods: We gathered data from the interval 2011-2013, including in the study all the patients for which an audiometry testing was performed in this time interval. This was followed by a process of selection/exclusion applied to the original group in order to obtain significant statistical data.
Results: The most important part of the study was to quantify the different types of hypoaccusia and the relative number of candidates for various prosthesis available these days.
Conclusions: This study quantifies the rising need for hearing prosthesis and triggers a signal.

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Analytical Performance of an HPLC and CZE Methods for the Analysis and Separation of Perindopril Erbumine and Indapamide

Ion Valentin*, Imre Silvia, Cârje Anca Gabriela, Muntean Daniela Lucia

Department of Analytical Chemistry and Drug Analysis, Faculty of Pharmacy, University of Medicine and Pharmacy of Tîrgu Mureș, Romania

DOI: 10.1515/amma-2015-0073

Introduction: Perindopril, as an angiotensin converting enzyme inhibitor and indapamide, as a thiazide like diuretic, can be administrated together for the treatment of high blood preasure and other cardiovascular diseases. The aim of this study was to develop two simple and reliable separation methods for perindopril and indapamide by high performance liquid chromatography and capillary zone electrophoresis in order to evaluate their behaviour under separation conditions, for simultaneous separation.
Materials and methods: Standard solutions of perindopril erbumine and indapamide in proper solvents were analized. An Agilent 1100 series HPLC system was used for the separation of the two analytes on a C18 stationary phase (Zorbax Stable Bond 3.5 µm), under an isocratic elution. As a comparative method, an Agilent 7100 series capillary electrophoresis system was used for the development of the electrophoretic method.
Results: Both developed methods turned to comply to the separation performance parameters such as resolution and selectivity, with low limits of detection, wide range of liniarity. No statistical difference concerning precision of the qualitative parameters was observed. Time analysis less than 5 minutes both for chromatographic and electrophoretic separations proved to generate cost and time effective analysis methods.
Conclusions: Two analytical methods, HPLC and CZE respectively, for the separation of perindoprile erbumine and indapamide have been successfully developed, both recording satisfactory analytical parameters.

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Amisulpride – an athypical antipsychotic?

Echim George2, Sorina Cucuiet3*, Bianca Osz1, Alexandra Grosan4, Gal Zsolt1,2, Maria Dogaru1

1 Department of Pharmacology and Clinical Pharmacy, University of Medicine and Pharmacy of Tîrgu Mureș, Romania
2 Doctoral School, University of Medicine and Pharmacy of Tîrgu Mureș, Romania
3 Department of Pharmacology, Faculty of Medicine, University of Medicine and Pharmacy of Tîrgu Mureş, Romania
4 Pharmacy of The University of Tîrgu Mureş, Romania

DOI: 10.1515/amma-2015-0072

Aim: the purpose of the present study was to determine the effects of amisulpride at different doses on body weight, glucidic and lipidic metabolism.
Material and method: Thirty-six white Wistar rats were treated daily for 9 weeks with amisulpride 1mg/kg and 10mg/kg body weight. Another group received distilled water and served as control group. At the end of the treatment period blood samples were collected and the follow biochemical parameters were determined: serum cholesterol, triglycerides, blood glucose, GOT, GPT. Body weight gain was also assessed weekly.
Results: After treatment with amisulpride in doses of 1mg/kg and 10 mg/kg for a period of nine weeks, weight gains were recorded for both groups compared with the initial weight and the control group. Blood glucose concentrations in the group treated with 1 mg amisulpride/kg body weight were significantly increased (p<0.05 vs control group), but in the group treated with 10 mg/kg body weight glucose levels were not statistically significant increased compared to controls. Other biochemical parameters (cholesterol, triglycerides, GOT, GPT) showed no statistically significant differences compared to control group.
Conclusions: amisulpride administered over a period of 9 weeks, in doses of 1mg/kg and 10mg/kg showed a slight increase of body weight regardless of gender, increased blood glucose only when was administered in the low dose, and does not affect lipid metabolism, even though decreased cholesterol and triglycerides levels. This results highlight a real benefit of treatment with amisulpride, comparatively with other athypical antipsychotics.

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Preparation of Biological Samples Containing Metoprolol and Bisoprolol for Applying Methods for Quantitative Analysis

Mahu Ștefania Corina1*, Hăncianu Monica2, Agoroaei Luminița1, Coman Băbușanu Anda Cristina1, Butnaru Elena1

1 ”Grigore T. Popa” University of Medicine and Pharmacy Iaşi, Faculty of Pharmacy, Department of Toxicology, Iași, România
2 ”Grigore T. Popa” University of Medicine and Pharmacy– Iaşi, Faculty of Pharmacy, Department of Pharmacognosy, Iași, România

DOI: 10.1515/amma-2015-0071

Arterial hypertension is a complex disease with many serious complications, representing a leading cause of mortality. Selective beta-blockers such as metoprolol and bisoprolol are frequently used in the management of hypertension. Numerous analytical methods have been developed for the determination of these substances in biological fluids, such as liquid chromatography coupled with mass spectrometry, gas chromatography coupled with mass spectrometry, high performance liquid chromatography. Due to the complex composition of biological fluids a biological sample pre-treatment before the use of the method for quantitative determination is required in order to remove proteins and potential interferences. The most commonly used methods for processing biological samples containing metoprolol and bisoprolol were identified through a thorough literature search using PubMed, ScienceDirect, and Willey Journals databases. Articles published between years 2005-2015 were reviewed. Protein precipitation, liquid-liquid extraction and solid phase extraction are the main techniques for the extraction of these drugs from plasma, serum, whole blood and urine samples. In addition, numerous other techniques have been developed for the preparation of biological samples, such as dispersive liquid-liquid microextraction, carrier-mediated liquid phase microextraction, hollow fiber-protected liquid phase microextraction, on-line molecularly imprinted solid phase extraction. The analysis of metoprolol and bisoprolol in human plasma, urine and other biological fluids provides important information in clinical and toxicological trials, thus requiring the application of appropriate extraction techniques for the detection of these antihypertensive substances at nanogram and picogram levels.

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Is the Oxidative Stress Really a Disease?

Fogarasi Erzsébet1, Croitoru Mircea Dumitru1*, Fülöp Ibolya1, Muntean Daniela-Lucia2

1 Department of Toxicology and Biopharmacy, University of Medicine and Pharmacy Tîrgu Mureș, Romania
2 Analytical chemistry and analysis of medicines, University of Medicine and Pharmacy Tîrgu Mureș, Romania

DOI: 10.1515/amma-2015-0070

Oxidative stress is an imbalance between free radicals or other reactive species and the antioxidant activity of the organism. Oxidative stress can induce several illnesses such as cardiovascular disease, neurodegenerative disorders, diabetes, cancer, Alzheimer and Parkinson. The biomarkers of oxidative stress are used to test oxidative injury of biomolecules. The indicators of lipid peroxidation (malondialdehyde, 4-hydroxy-2-nonenal, 2-propenal, isoprostanes), of protein oxidation (carbonylated proteins, tyrosine derivatives), of oxidative damage of DNA, and other biomarkers (glutathione level, metallothioneins, myeloperoxidase activity) are the most used oxidative stress markers. Diseases caused by oxidative stress can be prevented with antioxidants. In human body are several enzymes with antioxidant capacity (superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase) and spin traps. Antioxidants are synthetized in the organism (glutathione) or arrive in the body by nutrition (ascorbic acid, vitamin E, carotenoids, flavonoids, resveratrol, xanthones). Different therapeutic strategies to reduce oxidative stress with the use of synthetic molecules such as nitrone-based antioxidants (phenyl-α-tert-butyl-nitrone (PBN), 2,4-disulphophenyl-N-tert-butylnitrone (NXY-059), stilbazulenyl nitrone (STAZN)), which scavenge a wide variety of free radical species, increase endogenous antioxidant levels and inhibits free radical generation are also tested in animal models.

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Predictive Factors in the Onset of Epilepsy in Children with Cerebral Palsy

Todoran Butilă Anamaria*, Sin Anca, Micheu Cristian, Csep Katalin, Voidăzan Septimiu, Racos Szabo Elisabeta

University of Medicine and Pharmacy of Tirgu Mures, Romania

DOI: 1515/amma-2015-0069

Objectives: the aim of the study was to identify predictive risk factors of the development of epilepsy in patients with cerebral palsy (CP).
Materials and methods: We performed a bidirectional study in wich 177 patients diagnosed with CP with and without epilepsy have been selected for characteristics and risk factor comparison. We analyzed the history related to pregnancy and birth, gestational age, birth weight, fetal distress, the presence of neonatal convulsion, age of onset for the epilepsy, associated types of seizures, the response to anticonvulsant therapy and brain changes identified by Computer tomography and Magnetic resonance imaging examination.
Results: epilepsy was found in 91 (51.4%) patients, most frequently in quadriplegic form (76.2% vs 23.8%), OR:3.04, 95% CI:1.42-6.52, p-0.005. In this group, the most common were partial seizures (34.4%), epileptic encephalopathy like Lennox Gastaut and West type (62.5%), and also neonatal seizures. Eighty percent of on-term infants with neonatal seizures later developed epilepsy. Factors like fetal distress, low birth weight, cytomegalovirus infection, history of pathological pregnancy were associated with an increased risk of developing epilepsy. Imaging change, especially cerebral atrophy had the highest frequency (37.5% vs 16%) in pacients with epilepsy. 28 (30.8%) patients had resistance epilepsy, 13 (46.4%) of them having quadriplegia. Early onset of epilepsy constitutes a sign of severity of epileptic forms (OR:3.09, 95% CI:1.187-8.061, p-0.01).
Conclusions: The data are consistent with those in literature but is necessary following this study to clarify and support the assumption on preddictive factors and prognosis of epilepsy in this population.

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Experimental Evaluation of Dental Implant Biomechanics Given Certain Stages of the Fixing Substrate Deterioration by Video Image Correlation Method

Száva Dániel Tamás1*, Száva Ioan2, Gálfi Botond2, Iacob Alina1, Petrovan Cecilia1, Ormenișan Alina1, Székely Melinda3

1 Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy, Tîrgu Mureș, România
2 University of Transilvania, Faculty of Mechanical Engineering, Brașov, România
3 Department of Morphology of The Teeth, Faculty of Dental Medicine, University of Medicine and Pharmacy, Tîrgu Mureș, România

DOI: 10.1515/amma-2015-0068

Background: Dental implants are useful tools and represent a widely spread technique for oral rehabilitation. Their long standingness is highly influenced by the mechanical and geometrical properties of the surrounding osseous tissue in which they are placed. In some unsuccessful cases though, the dental implant is exposed to masticatory forces and other functional acts, and osseous tissue may resorb near its vicinity, leading to the dental implants loss. We investigated the strain distribution inside the fixating substrate, given certain stages of its deterioration near the dental implants.
Material and methods: For our investigations we used cilindro-conical screw-type dental which were submitted to vertical forces between 0-1000 N. The dental implants were fixed inside a plastic material used in photo-elastic measurements. To evaluate the strain distribution inside the fixing substrate, we used a non-contact, experimental investigation tool, the Video Image Correlation (VIC-3D) optical system. This system allows the implementation in the dental implants optimisation from stress-strain state point of view.
Results: The strain field distribution inside the fixating substrate was measured at three different levels of the dental implant, when it was loaded alone and in the case when there were loaded two dental implants simultaneously.
Conclusions: The most stresses are concentrated in the neck-area of the dental implant. If there are loaded two or more dental implants simultaneously, the distance between them influences strain distribution. The measurements were conducted in vitro and do not represent the in vivo conditions, but serve further important facts regarding biomechanical properties of dental implants.

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Is NAFLD a Risk Factor for Colorectal Polyps? An Analysis of Single Romanian Centre

Kozma Bela*, Pop Crina, Petrut Madalina, Drasovean Silvia, Dobru Daniela

Department of Gastroenterology, Mures County Hospital, University of Medicine and Pharmacy of Tîrgu Mureş,  Romania

DOI: 10.1515/amma-2015-0065

Background and Aim: Non-alcoholic fatty liver disease (NAFLD) is considered to be the most common of all liver disorders, and its prevalence is almost certainly increasing. Because of the presence of NAFLD in metabolic syndrome and of latter’s role in the appearance of colorectal polyps, many studies have tried to find a link between the liver disease and colorectal polyps. The aim of the study was to determine whether NAFLD is a risk factor for colorectal polyps.
Material and Methods: We examined 560 patients diagnosed with NAFLD who underwent colonoscopy at Mures County Hospital, between January 2011 and June 2014. Fatty liver disease was assessed by abdominal ultrasound, with NAFLD defined as fatty liver disease in the absence of alcohol use of > 40 g/week or other secondary causes. We divided the 560 patients into two groups, according to the presence or absence of polyps. Data were collected from patient’s history, physical exam, laboratory tests and abdominal ultrasound.
Results: The prevalence of colorectal polyps was 16.6% (93) in the NAFLD patients. 51 (54.8%) of them were female, and the Chi2 test identified a statistically significant association between the female gender and the appearance of polyps (p=0.028; OR=1.652; CI= 1.052-2.596). No statistical association was found between the smoking status and the development of colorectal polyps (p=0.245) and only 18 of 93 patients were smokers. Of 93 patients with polyps, 68 (73.1%) have associated diabetes mellitus, but without statistical correlation (p=0.214). According to family history of colorectal polyps none of the patients have data about a possible polyposis pathology.
Conclusions: Our study demonstrates a relationship between some characteristics of NAFLD and the development of colorectal polyps. Further studies are required to confirm whether NAFLD is a risk factor for the appearance of polyps.

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