Category Archives: Review

Blood biomarkers predicting adverse clinical
outcomes in congenital heart disease patients, with consideration for pulmonary valve replacement

Milla Marika Kainlauri1, Irina-Bianca Kosovski2

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

DOI: 10.2478/amma-2023-0009

Objective: This review aims to make a brief overview of blood biomarkers’ clinical decision limits, possibly aiding in outcome prediction in all-aged Tetralogy of Fallot patients. Potentially, these biomarkers could also assist in necessity and timing of pulmonary valve replacement. Methods: Studies with all-aged patients with Tetralogy or Pentalogy of Fallot and blood biomarkers, BNP, NT-proBNP and hs-cTn, usage in clinical outcome prediction were included. Additionally, pulmonary valve replacement indications were considered. Other congenital heart diseases, biomarkers irrelevant to clinical outcome and associated pathologies or physiological status were the exclusion criteria. Keywords, Tetralogy and Pentalogy of Fallot, pulmonary valve replacement, blood biomarkers, yielded 69 suitable studies from Google Scholar, PubMed and Web-of-Science. 30 studies were selected. Results: Blood biomarkers were increased in TOF patients in comparison to controls; the higher the values, the worse adverse outcomes. Blood biomarkers combined with other biomarkers, imagistic methods or parameters showed promising results in outcome prediction. Conclusions: Blood biomarkers are validated as follow-up predictors in congenital heart disease paediatric patients. Further research is required to establish age-appropriate clinical decision limits. Pulmonary valve replacement timing remains controversial.

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Prevalence of human Papillomavirus associated oropharyngeal and oral squamous cell carcinoma in Asian countries: A systematic review and large-scale meta-analysis

Yy Jean Tan1, Ken Wong Siong Hou2, Galvin Sim Siang Lin3, Jasmine Lim Suk Wun4, Wan Nor Amira Wan Ahmad Abdul Nasir1, Lynn Wei Linn Ko5

1. Oral and Maxillofacial Surgery Department, Dental Specialist Clinic, Sarawak General Hospital, Jalan Tun Ahmad Zaidi Adruce, Kuching, Sarawak, Malaysia
2. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
3. Department of Dental Materials, Faculty of Dentistry, Asian Institute of Medicine, Science and Technology (AIMST) University, Bedong, Kedah, Malaysia.
4. Batu Kawa Dental Clinic, Ministry of Health Malaysia, Kuching, Sarawak, Malaysia
5. Department of Paediatric Dentistry & Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia

DOI: 10.2478/amma-2023-0005

Human Papillomavirus (HPV) associated with oropharyngeal and oral squamous cell carcinoma (OPSCC and OSCC) is escalating over the years. Hence, the present review aims to determine the prevalence of HPV-OSCC and HPV-OPSCC in Asian countries over the last decades. An electronic search was conducted using nine online databases to identify English-language articles on the prevalence of HPV-OPSCC and HPV-OSCC in Asian countries from January 2011 to June 2022. The risk of bias was assessed using the JBI critical appraisal checklist and the level of evidence was determined based on the OCEBM guideline. Single-arm meta-analysis was used to estimate the weighted mean prevalence of HPV-OPSCC and HPV-OSCC among patients in Asia. Subgroup analysis meta-regression and Egger’s tests were also conducted. 59 eligible studies were included with a higher prevalence of HPV-OPSCC (32.6%-37.4%) as compared to HPV-OSCC (10.9%-23.5%). Subgroup analysis revealed that the weighted mean prevalence of HPV-OPSCC was significantly higher (P<0.001) among East Asians, while the weighted mean prevalence of HPV-OSCC was significantly higher (P<0.001) among South Asians. All studies showed a low to moderate risk of bias with the level of evidence ranked between 2 and 3. The diagnostic tools utilised and geographical locations significantly affect the findings.

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Management of denture stomatitis: An overview

Nader Navabi1, Parham Shakibaei2, Alireza Ranjbar Hassani2

1. Oral Medicine Department, Kerman Dental School, Kerman University of Medical Sciences, Kerman, Iran
2. Student Research Committee, Dental School, Kerman University of Medical Sciences, Kerman, Iran

DOI: 10.2478/amma-2023-0007

Denture stomatitis is a common inflammation of the palatal mucosa beneath removable dentures. The objective of this article was to examine the systematic reviews and clinical trials pertaining to the treatment of denture stomatitis. For this research, electronic databases (PubMed, Embase, Scopus, and ISI Web of Science) were searched from January 2000 to June 2021 using specified MESH keywords. Irrelevant articles were eliminated in three steps based on their titles, abstracts, and body texts. In the final analysis, 47 papers were selected, which included 12 systematic reviews and 35 clinical trials. Herbal compounds and denture disinfection were the interventions most commonly indicated. We concluded that, possibly due to the complex nature of this lesion’s etiology, there is no present definitive therapy guideline for this prevalent lesion.

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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.

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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.

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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.

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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.

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Insulin resistance as risk factor for the development of type 2 diabetes mellitus: a systematic approach

Reka Annamaria Schmiedt1, Robert Aurelian Tiuca2,3, Raluca Maria Tilinca2, Lucia Mihaela Custura1, Oana Detesan1, Brigitta Iren Bacso1, Bianca Larisa Abalasei2, Andrew Corneliu Bell2, Maria Alexandra Streza2, Mariana Cornelia Tilinca1,2

1. Compartment of Diabetology, Emergency Clinical County Hospital of Targu Mures, Romania
2. George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
3. Department of Endocrinology, Mures County Clinical Hospital, Romania

DOI: 10.2478/amma-2021-0033

Insulin resistance is a heterogenous condition with high prevalence in medical practice. As diabesity reaches epidemic levels worldwide, the role of insulin resistance is getting great importance. Contribution of risk factors like sedentary lifestyle, diets high in saturated fats and refined carbohydrates leads to this state with significant consequences. Besides its role in diabetes, insulin resistance is also associated with other several endocrine diseases, having not only a role in their development, but also to their treatment approach, evolution and even prognosis. The present review summarizes the current literature on the clinical significance of insulin resistance, as well as the possible underlying mechanisms and treatment options in order to achieve a high quality of life of these categories of patients. Deepening the role of inflammatory cytokines involved in insulin resistance paves the way for future research findings in this continuously evolving field.

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Emotional disorders associated to multiple sclerosis and psychological interventions: a literature review

Alina Schenk1, Cosmin Octavian Popa2, Cristiana Manuela Cojocaru1

1. The Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Department of Ethics and Social-Sciences, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2021-0042

Multiple sclerosis is an unpredictable neurologic disease affecting 2.8 million people worldwide. Individuals with MS experience multiple physical and psychological symptoms such as depression, anxiety, fatigue, and pain that impact their general functioning and quality of life. The aim of this review is to highlight the importance of psychological interventions in reducing depression and anxiety symptoms associated with the diagnosis of multiple sclerosis. Cognitive and behavioral techniques are also useful in relieving the specific symptoms of multiple sclerosis. However, few studies have captured the psychological processes involved in reducing the symptoms of depression and anxiety, which is why greater concern is recommended in future studies in order to develop better psychological interventions tailored for patients with multiple sclerosis.

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Apathy as Non-Motor Manifestation in Amyotrophic Lateral Sclerosis

Anca Moțățăianu1, Ioana Ormenișan2, Rodica Bălașa1

1. Neurology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Neurology I Clinic, County Emergency Clinical Hospital of Targu Mures, Romania

DOI: 10.2478/amma-2021-0041

Although the term of amyotrophic lateral sclerosis (ALS) is often used interchangeably with motor neuron disease, ALS is universally accepted as a multisystem disorder. Cognitive impairment is an acknowledged feature of ALS, affecting language, memory and behaviour, and apathy is considered to be the prevalent behavioural alteration in ALS. It can be divided in three subtypes: executive, emotional and initiation apathy. Out of the three subtypes, initiation apathy is common among patients with ALS. Even in patients that do not meet the criteria for ALS with frontotemporal dementia, low-key neuropsychiatric and cognitive changes can be observed. Apathy has also been found to be systematically associated with disruptions in medial frontal cortex and subcortical structures in several neuroimaging studies that confirm the pre-existing brain lesions in the early stages of this disease. Thus, there is a growing body of evidence that motor signs and symptoms are accompanied or even preceded by cognitive and behavioural alterations, and screening for non-motor signs and symptoms can be clinically relevant.

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