Category Archives: Online

Case report: Respiratory distress syndrome, recurrent pneumothorax, and multisystem complications in a late preterm neonate

Mihaela-Maria Celsie1, Irina Bachis1, Manuela Camelia Cucerea2,3

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

DOI: 10.2478/amma-2026-0002

Introduction: Pneumothorax in premature neonates remains a significant clinical issue, especially when linked to respiratory distress syndrome and systemic inflammation. Providing early respiratory support and customized interventions is essential to prevent life-threatening complications.
Objective: To present the complex and evolving management of a late preterm neonate with respiratory distress syndrome, bilateral recurrent pneumothorax, congenital pneumonia, and intraventricular hemorrhage.
Methods: A female newborn born at 36 weeks via cesarean due to placenta previa and uterine scarring showed worsening respiratory distress soon after birth. Her condition required various levels of respiratory support, including intratracheal surfactant, high-frequency oscillatory ventilation, and surgical pleural drainage. A suspected congenital infection caused a systemic inflammatory response, leading to extended, targeted antimicrobial treatment.
Results: Despite multiple episodes of respiratory decompensation and radiologically confirmed recurrent pneumothorax, the patient responded well to high-frequency oscillatory ventilation and surgical pleural drainage. Gradual clinical improvement allowed for stopping respiratory support by day twelve, leading to full recovery without additional complications.
Conclusion: This case highlights the critical importance of personalized, step-by-step management in preterm neonates with respiratory distress syndrome complicated by recurrent pneumothorax and infectious comorbidities, emphasizing the therapeutic benefits of early surfactant therapy, high-frequency oscillatory ventilation, surgical pleural drainage, and targeted antimicrobial treatment.

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Preclinical evaluation of an innovative dietary intervention for non-alcoholic hepatic steatosis in Sprague-Dawley rats

Rodica Talmaci1, Irina Mihaela Matran2

1. Master of Clinical and Community Nutrition, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Community Nutrition and Food Hygiene Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2026-0001

Objective: We developed an innovative food designed for special nutritional needs, intended as an adjuvant in the prevention or treatment of non-alcoholic hepatic steatosis. This study evaluates its preclinical effectiveness, with results aimed to inform future clinical trial design in more homogeneous patient populations.
Methods: This preclinical experimental study involved 32 Sprague-Dawley rats divided into four groups: a Control group (standard diet), a High Fat Diet group (30% and 60% fat), Experimental group 1 (high fat diet followed by innovative food), and Experimental group 2 (high fat diet and innovative food administered concurrently). Body weight, urine, blood glucose, and 11 hepatic parameters were measured at the end of the induction and intervention phases.
Results: High fat feeding increased energy intake, weight gain, and fat mass, particularly in males. A decrease in food and water intake was noted during the induction phase in high fat feeding groups. The High Fat Died group showed persistent signs of liver stress. Experimental group 1 showed consistent improvements, with individual variability in response to innovative food intervention. Experimental group 2 showed significant results during induction stages, indicating a stronger protective effect.
Conclusions: A high fat feeding with 30% fat over 10 weeks was insufficient to induce hepatic steatosis, while a 60% fat feeding for additional 5 weeks successfully induced obesity and liver pathology. Post-induction innovative food intervention reduced weight gain and improved liver biomarkers. Blood glucose, transaminases, alkaline phosphatase, and total cholesterol levels suggest that innovative food has protective effects, supporting its potential use in preventing and managing non-alcoholic fatty liver disease.

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Alcohol intake and markers of liver health in patients with type 2 diabetes and metabolic dysfunction–associated steatotic liver disease

Simona Cernea1,2, Danusia Onișor3,4, Andrada Larisa Roiban5,6

1. Department M3/Internal Medicine I, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Diabetes, Nutrition and Metabolic Diseases Outpatient Unit, Emergency County Clinical Hospital, Targu Mures, Romania
3. Department ME2/Internal Medicine VII, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
4. Gastroenterology Clinic, Mureș County Clinical Hospital, Targu Mures, Romania
5. Diabetes Compartment/Mediaș Municipal Hospital, Mediaș, Romania
6. Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2025-0060

Objective: The study evaluated the impact of low-level alcohol intake on liver health in patients with type 2 diabetes (T2DM) and metabolic dysfunction–associated steatotic liver disease (MASLD).
Methods: In this prospective study T2DM patients with MASLD (alcohol intake <20 g/day (women) and <30 g/day (men)) underwent a comprehensive clinical and laboratory evaluation at baseline (v1) and after 12 months (v2). Alcohol consumption was assessed using the AUDIT-C questionnaire and a detailed clinical interview. Markers of liver health were measured, and liver steatosis and fibrosis were evaluated with non-invasive indexes, including the Liver Risk Score (LRS), an indicator of the risk of liver fibrosis and liver-related events. Results: The average alcohol intake was 0.47 [2.77] g/day. Patients with an average intake >10 g alcohol/day showed significantly higher levels of aspartate aminotransferase, gamma glutamyl transpeptidase (GGT), direct bilirubin, ferritin, and higher LRS (7.86±1.64 vs. 6.86 [1.46] vs. 6.49 [1.71]; p=0.0039) at v1 compared to those who consumed <10 g/day or were abstinent. At v2, the aminotransferases and LRS were higher in patients with an alcohol intake >10 g/day compared with the other groups. In the multivariable analyses, GGT (β=0.168;p=0.008) and male sex (β=0.417;p<0.001) were independently correlated with the average alcohol intake. Drinking more than one type of alcoholic beverage significantly increased the LRS (v1: 7.02 [1.38] vs. 6.69 [1.43], p=0.0387; v2: 6.88 [1.25] vs. 6.42 [1.24], p=0.0010).
Conclusions: In patients with T2DM and MASLD, even minimal alcohol consumption is associated with markers of liver injury and higher risk of liver-related outcomes.

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Clinical profile of comorbidities in patients with severe asthma undergoing benralizumab biologic therapy

Corina Mărginean1, Dragoș Huțanu2, Mara Andreea Vultur2, Hédi-Katalin Sárközi2, Edith-Simona Ianoși2, Maria Beatrice Ianoși2, Andreea Safta2, Gabriela Jimborean2, Corina Eugenia Budin3

1. Oncology and Palliative Care Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
2. Pulmonology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
3. Pathophysiology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania

DOI: 10.2478/amma-2025-0059

Objective: This study aims to analyze the comorbidity profile of patients with severe asthma undergoing benralizumab therapy in a Romanian academic center, focusing on the impact of these comorbidities on disease management.
Methods: A retrospective analysis was conducted on 34 adult patients with severe asthma treated with benralizumab between 2020 and 2025 at the Pneumology Department of Mures County Clinical Hospital. Demographic, clinical, functional, and biological parameters were analyzed, including comorbidities, lung function tests, eosinophil counts, fractional exhaled nitric oxide, and Asthma Control Test scores. Non-parametric statistical tests were applied, with significance set at p<0.05.
Results: The study revealed a complex comorbidity profile. Cardiovascular diseases were most prevalent: hypertension was found in 91.2% of patients, ischemic heart disease in 47.1%, and heart failure in 17.6%. Pulmonary comorbidities included bronchiectasis (41.2%), pneumonia (82.4%), and obstructive sleep apnea (8.8%). ENT comorbidities were also frequent, with nasal polyposis in 35.3% and chronic rhinosinusitis in 32.4%. Metabolic conditions such as obesity (26.5%) and type 2 diabetes (29.4%) were common. Despite this burden, benralizumab therapy resulted in significant improvements in lung function, symptom control, and biomarkers, with eosinophil depletion, FeNO reduction, and improved ACT scores (p<0.001).
Conclusions: Patients with severe asthma treated with benralizumab present a high prevalence of cardiovascular, pulmonary, and metabolic comorbidities. Benralizumab therapy proved effective in reducing airway inflammation and improving clinical control, regardless of the comorbidity load. A multidimensional, personalized management approach remains essential for optimizing outcomes in this population.

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