List of Registered Papers

Paper title Author Details Validation status
CLINICAL ASPECTS IN REFLUX ESOPHAGITIS Pritcan Natalia View abstract

CLINICAL ASPECTS IN REFLUX ESOPHAGITIS

First author: Pritcan Natalia

Coauthors: Burianov Alina , Gheata Irina Paraschiva

Coordinator(s): Macarie Melania

Keywords: esophagitis cardiovascular disease associated diseases

Background: Reflux esophagitis is a common disorder affecting approximately 10-20% of western populations and is an increasing incidence in Asian countries. It is accompanied by impaired quality of life and predispose the patients to the development of Barrett's esophagus and esophageal adenocarcinoma. Objective: The aim of this study was to establish the frequency of esophagitis and its associated  diseases. Material and Method: We performed a retrospective study of 1272 patients hospitalized in Gastroenterology Clinic of Targu Mures County Clinical Emergency Hospital between 01.01.2012 -31.12.2012. Results: During the studied period there were diagnosed 117 (9.1%) patients with reflux esophagitis. The average age of patients was 56.2 years, with a male predominance with a ratio of M/F  1.78/1. It was also noticed a slight predominance of the urban environment. The most common associations in patients with reflux esophagitis were with the cardiovascular diseases: hypertension was present in 48 (41%) patients, followed by ischemic heart disease present in 45 (38.4%) patients and atrial fibrillation in 14 (11.9%) patients. Other problems encountered were: dyslipidemia in 44 (37.6%) patients, obesity in 25 (21.3%) patients, diabetes in 18 (15.3%) patients and liver disease (steatosis in 32 (27.3%) patiens,cirrhosis in 20 (17%) patiens, hepatitis in 13 (11.1%) patiens) . Conclusions: Reflux esophagitis is a frequent pathology. From all the co-morbidities associated with this disease prevail the cardiovascuar.

validated
FSH 1 or FSH 2: the importance of differential diagnosis Teodorescu C View abstract

FSH 1 or FSH 2: the importance of differential diagnosis

First author: Teodorescu C

Coauthors: Ţolescu R S , Tiţa Cristina-Iuliana , Bivolan Ana Maria Corina , Teoteoi P A

Coordinator(s): Dobrescu Amelia , Tache Daniela

Keywords: facio-scapular-humeral dystrophy differential diagnosis muscular atrophy SMCHD1 gene mechanism

Background: Facio-scapular-humeral dystrophy (FSH), myopathy with genetic origin, which affects over 500,000 people globally is considered the second myopathy, frequent for adults. 95% of patients are diagnosed with FSH1, the rest of 5% presenting FSH2, recently identified. Similar symptomatology is an important diagnostic obstacle, the only method of making a difference is genetic diagnosis. Objective: The aim of this study is to present the differential diagnosis of FSH disease subtypes. Material and Method: This paper presents the case of a patient with the diagnosis of FSH2, set at 12 years from clinical onset because of the inability to continue genetic diagnosis (mutation responsible for the disease discovered in 2012). The suggestive clinical symptomatology and the paraclinical results: CK, EMG and muscular biopsy confirm the FSH susspicion, requiring confirmation by molecular diagnosis. Results: Clinical presentation supports the supposition of FSH by muscular atrophy asymmetry of scapular girdle with Conclusions: Although the clinical presentation of the two types of FSH dystrophy, shows major similarities, the differential diagnosis made only by genetic analysis.Furthermore, given the recent discovery of the gene involved in producing FSH2 and the low global number of patients with this form, the association genotype-phenotype, in each case, will lead to a better understanding of the mechanism involved in this type of pathology, and, thus, to a subsequent development of some potential therapies.

validated
Child sexual abuse in Mures County Rocas Florina Elena View abstract

Child sexual abuse in Mures County

First author: Rocas Florina Elena

Coordinator(s): Hadareanu V , Butiu Otilia

Keywords: sexual abuse lesions child

Background: Under the law, the term “child sexual abuse” describes both criminal and civil offence in which an adult engages in sexual activity or exploits a minor for sexual gratification. Sexual abuse is an important medical and social issue, though underappreciated throughout the world.  Aspects related to this problem are not covered by results due to few studies done in our country. Objective: To investigate child abuse in Mures County from 2010 to 2011. Material and Method: We compiled this retrospective, descriptive study based on the casuistry of the Forensic Medical Institute of Mures County. From 3239 legal documents, we selected 115 of child sexual abuse. The study included subjects between 1 and 18 years of age with sexual abuse validated by the Forensic Institute. We excluded subjects that reached 18 years old, or with proper age but with few arguments to sustain a diagnostic of clinical abuse. Results: From  115 cases of sexual abuse, 97(84.34%) are girls and 18(15.65%)are boys. 80 subjects(69.56%)come from rural area, the majority of them being girls, 65 (81.25%), most affected being the ones between 11-14 years, 31(47.69%); 15(18.75%) are boys with ages between 3-10, 11(73.33%). 35(30.43%) come from an urban area, from which 32(91.42%) are girls, most affected between age of 11-14, 16(50.00%) and in 3(8.57%) cases, boys, most affected between 15-18 years, 2(66.67%). The lesions encountered in girls were:  deflowering, over 14 days, 57(58.76%), recent deflowering with hemorrhage 8 (8.24%), anatomic virgin with elastic hymen 13(13.40%), virgins 18(18.55%), vaginal virgin with anal modifications 1(1.03%). In boys, in 8(44.44%) cases, anal lesions were encountered. Conclusions: The forensic data highlighted an important number or sexual lesions in the genito- anal area and body lesions that required an average of 6 days of medical care. The highest risk of child sexual abuse have the girls between the age of 11 and 14.

validated
ASSESSMENT OF RISKS AND BENEFITS OF HUMANIZED MONOCLONAL ANTIBODIES TREATMENT IN RR MULTIPLE SCLEROSIS Barcutean Laura Iulia View abstract

ASSESSMENT OF RISKS AND BENEFITS OF HUMANIZED MONOCLONAL ANTIBODIES TREATMENT IN RR MULTIPLE SCLEROSIS

First author: Barcutean Laura Iulia

Coordinator(s): Balasa Rodica

Keywords: Multiple Sclerosis Natalizumab Monoclonal Antibodies, Relapse

Background: A chronic, devastating autoimmune disease, MS, at least in the early stages is characterized by inflammation in the brain and the spinal cord and destruction of the myelin sheath, subsequently impairing the neuronal signal transmission, leading to various neurological disabilities. Objective: To analyze the effects of a new disease modifying therapy for relapsing remitting MS (RRMS). Material and Method: We compiled this open, non-randomized clinical trial, started in 2010, in which 12 patients were assigned to receive Natalizumab (300 mg intravenously each month), a humanized monoclonal antibody that binds to alpha4beta1-integrin, thereby interrupting the lymphocyte adhesion to the blood- brain barrier. Prior to the administration, the patients were  assessed according to the Expanded Disability Status Scale and three ambulatory tests, Maximum Walking Distance Questionnaire, Time for 100 meter  walk and Timed  25 foot walk. The primary objectives were the progression of disability, according to EDSS and the relapse after the treatment. Results: During the study, 2 patients withdrew, one accusing allergic reaction and the other severe progression of the disease, with positive antibodies against Natalizumab; in total, 6 (50.00%) of the patients presented with side effects, 2  (33.33%) had a relapse with the pyramidal syndrome symptoms. Data analysis revealed that, from the total of 10 patients that continued the study, in 5 (50.00%) cases, the EDSS subsided. At one year, from 10 patients that remained under observation, 1(10.00%) presented with a relapse, the other 9(90.00%) showing significant neurological improvement. Conclusions: If correctly screened, RRMS patients can benefit from the effects of disease modifying drugs such as Natalizumab. We have seen a definite improvement in patient’s both neurological status and number of MS relapses over the past years, and if thoroughly assessed, MS progression can be minimized and the side effects of the therapy can be kept to a bare minimum.

validated
Rehabilitation protocol after anterior cruciate ligament reconstruction Pop Ş View abstract

Rehabilitation protocol after anterior cruciate ligament reconstruction

First author: Pop Ş

Coauthors: Poruţiu M , Macec Adelina

Coordinator(s): Russu O

Keywords: Anterior cruciate ligament ACL reconstruction hamstring autografts

Background: Anterior cruciate ligament (ACL) reconstruction must be followed by a proper rehabilitation protocol in order to restore full range of motion and both muscle strength and proprioception, while helping patients return to the same activity level as before the injury. Objective: In this prospective study we aimed to assess if a well conducted rehabilitation protocol can influence the results after ACL reconstruction with hamstring autografts. Material and Method: Our study included a number of 30 patients who had ACL reconstruction with hamstring autografts between May 2012 and August 2012 in our facility (Clinic of Orthopaedics and Traumatology Târgu Mureș). Mean age was 33 years (range 17 to 42 years), with 22 male and 8 female patients. All patients had a normal physical activity level preoperatively, with occasional recreational sports. All interventions were done with a femur-first technique and close braided loop fixation on the femoral side with biocomposite screw fixation on the tibial side. Weight bearing was prohibited in the first two postoperative weeks, with the rehabilitation protocol started on the first day after surgery. For clinical assessment we used the Tegner Lysholm Knee Scoring Scale, that was administered to all the patients before surgery, at 12 weeks postoperatively (by phone interview) and at the last follow-up at 6 months after the intervention. Results: We lost 1 patient to follow-up. The Tegner Lysholm Knee Scoring Scale values increased from a mean of 64 preoperatively to 85 at the 12 weeks follow-up and 95 at the last follow-up. Conclusions: The principal goal of rehabilitation after ACL surgery is to minimize post-procedure complications and protect the graft, while allowing a rapid return to normal daily/ sports activities. We consider that when followed correctly, our rehabilitation protocol can offer good results after ACL reconstruction.

validated
The efficacy of dietary supplements in the treatment of knee osteoarthritis Poruţiu M View abstract

The efficacy of dietary supplements in the treatment of knee osteoarthritis

First author: Poruţiu M

Coauthors: Pop Ş , Pavel M

Coordinator(s): Russu O

Keywords: knee osteoarthritis dietary supplements OrthomolArthro

Background: Characterised by the progressive destruction of the articular cartilage, knee osteoarthritis is a highly prevalent disease that has a moderate-to-severe impact on daily life, and thus presents a significant health care burden. A chronic disease, knee osteoarthritis is potentially a pathologic condition in which treatment could be addressed by nutrition. Objective: The aim of our study was to assess the results of using a complex dietary supplement in moderate knee arthritis. Material and Method: We evaluated the effects of administering 1 capsule/ day of OrthomolArthro, a dietary supplement developed for the management of osteoarthritic joint changes that contains both glucosamine and chondroitin, with a complex blend of vitamins, minerals and essential fatty acids. The study included 53 patients diagnosed with mild to moderate knee osteoarthritis in our clinic (Clinic of Orthopaedics and Traumatology of TârguMureș) based on clinical and radiologic evaluation (Kellgren-Lawrence grades 2 and 3). The supplements were administered for 3 months and we assessed knee pain with the Visual Analog Scale (VAS) both before the initiation of treatment and at 3 months afterwards (at the end of treatment). During treatment patients were allowed to take NSAIDs as necessary for pain management, and we recorded monthly anti-inflammatory medication usage by phone interview. Results: All patients completed the study. There were no reported adverse reactions to supplement intake. Algic symptomatology was alleviated in all cases, with VAS values decreasing from a mean of 5.5 pre-treatment to 3.7 at 3 months. NSAIDs intake also decreased in the last two months of the supplement administration. Conclusions: We concluded that the administration of complex supplements for the dietary management of osteoarthritis can decrease both pain and the need for anti-inflammatory pain medication in mild to moderate knee arthrosis.

validated
VALIDATION OF OPERATIONAL PROCEDURE “MEASUREMENT OF HCV ANTIBODIES LEVEL FROM HUMAN SERUM BY CHEMICAL FLUORESCENCE METHOD ON BIOMERIEUX VIDAS” Langhaus T View abstract

VALIDATION OF OPERATIONAL PROCEDURE “MEASUREMENT OF HCV ANTIBODIES LEVEL FROM HUMAN SERUM BY CHEMICAL FLUORESCENCE METHOD ON BIOMERIEUX VIDAS”

First author: Langhaus T

Coordinator(s): Toma Felicia

Keywords: validation procedure HCV uncertainty

Background: Every medical laboratory must have a method to check and control the quality of medical services  in order to ensure the fact that sample result are correctly performed. Objective: This procedure aims to describe the method of HCV antibody level determination by chemical fluorescence on Biomerieux Vidas automatic analyzer, to confirm that the level of performance and responsability required for serum sample measurments at Best Test medical laboratory are met. Material and Method: HCV Stripes, SPR - biosensor-based assay, HCV positive control serum , HCV negative control serum, Standard serum Master Lot Entry card. Required steps. Activation of the equipment, calibration, testing, internal and external quality control, validation (data entry, uncertainty source identification, quantification of uncertainty components, conversion in standard deviation, calculation of combined uncertainty, calculation of extended uncertainty, calculations in expression steps of uncertainty for specific medical analysis, calculation of uncertainty for medical tests to be performed at Best Test medical laboratory). Results: Positive and negative control samples were analyzed consecutively 3 day (Inter-day samples), twice a day and on second day 6 positive and 6 negative controls (Intra-day samples). After introducing sample results in calculation software. This software calculates the extended uncertainty and gives the result in percent. The extended uncertainty obtained by laboratory must be under 5% as validation to be statistically significant. Our extended uncertainty for control1 (positive control) was 3.97% and for control2 (negative control)  0%. Conclusions: Due to the fact that both control values were lower than 5%, we can conclude that the validation of this particular measurement, on this particular analyzer, is correct and statistically significant.

validated
the social and forensic impact of traffic casualties in mures county between 2008-2010 Anghelus Diana Iulia View abstract

the social and forensic impact of traffic casualties in mures county between 2008-2010

First author: Anghelus Diana Iulia

Coordinator(s): Hadareanu V

Keywords: traffic casualties number of victims social and forensic impact

Background: Road traffic casualties are a major public health problem globally.About 1.3 million of people die in road accidents and more than 50 million are injured every year .In Romania  3000 persons die annually in traffic casualties.Among mortality causes traffic casulaties rank second after myocardial infarction.In terms of social costs an increase traffic casualties rate would mean a higher social burden and also a higher financial burdan for health and social assistance. Objective: I was interested in the number of victims between 2008-2010 in Mures county in the forensic and social impact of traffic casualties in that period and to see if road accidents represents the main cause of death at young age. Material and Method: My study was made by analyzing the forensic reports of traffic casualties produced between 2008-2010 in the urban as well as in the rural enviroment on a group of 287 victims. Results: There is an increasing number of road accidents year by year , most of them happen in the rural enviroment almost 70%,most of the victims were men aproximately 80%  aged between 20-60 years old and as victim`s status the majority of the victims were pedestrians(47%),passengers(21%) and drivers(12%). Conclusions: Romania as member state of EU needs to develop efficient measures to decrease the number of traffic casualties according to the European Road Safety Charter and to reduce the impact on public system that must support the biggest part of expenses.The solution to save such resources would be a better driving informing system,road infrastructure development and public education in general using all available ways.

validated
THE THERAPEUTIC INDICATION IN PATIENTS WITH ECG MODIFICATIONs IN RECOVERY PERIOD AFTER THE EXERCISE STRESS TESTING Iordache Anca View abstract

THE THERAPEUTIC INDICATION IN PATIENTS WITH ECG MODIFICATIONs IN RECOVERY PERIOD AFTER THE EXERCISE STRESS TESTING

First author: Iordache Anca

Coordinator(s): Fărcaş D M , Ţilea I

Keywords: Exercise stress testing Drug therapy Myocardial revascularization

Background: The exercise stress testing primary detects signs of cardiac ischemia and coronarography shows coronary artery disease. The therapeutic indication in these patients depends of the severity of coronary lesion evidenced at coronarography and of the patients symptoms. Objective: To evaluate the concordance between therapeutic indication and results of exercise stress testing and coronarography. Material and Method: We performed a retrospective study in Medical Clinic No.3 of Tirgu Mures between January 1 st 2010 - December 31 st 2012 that analyses the ECG and Protocols of exercise stress test and Coronarography at 63 patients with ECG modification in recovery period after the exercise stress testing. Results: Out of 63 patients with ECG modification in recovery period after the exercise stress testing: 32 were women (50.79%) and 31 were men (49.20%) with mean age 57.63 years. 50 patients (79.36%) received drug therapy and 13 patients (20.63%) received myocardial revascularization. Conclusions: We observed a statistically significant concordance between therapeutic indication and ECG modification after ending the exercise stress test and coronarography.

validated
Hypoglycemia due to an insulin binding antibody in a patient with an IgA-kappa myeloma. Zinger D A I View abstract

Hypoglycemia due to an insulin binding antibody in a patient with an IgA-kappa myeloma.

First author: Zinger D A I

Coauthors: Zinger Claris Ioanela Anamaria , Andriescu-Stroie C A

Coordinator(s): Fintzescu A , Bogdan C

Keywords: hypoglycemia antibodies IgA insulin myeloma

Background: Hypoglycemia is an abnormally diminished content of glucose in the blood. Insulin is a peptide hormone, produced by beta cells of the pancreas, and is central to regulatingcarbohydrate and fat metabolism in the body. An autoantibody is an antibody manufactured by the immune system that is directed against one or more of the individual's own proteins. Autoantibodies to insulin have been described to cause spontaneous hypoglycemia in nondiabetic subjects. There have been occasional reports of spontaneous hypoglycemia due to monoclonal anti-insulin antibodies. Objective: The aim of this study was to describe the occurrence of profound hypoglycemia in a patient with IgA-kappa myeloma, characterize biochemically the nature of the IgA:insulin complex present, and place this case in the context of the published literature on hypoglycemia resulting from autoantibodies to insulin. Material and Method: We present the first report of a patient with an IgA-kappa myeloma in whom frequent hypoglycemia resulted from the ability of the monoclonal IgA-kappa to bind insulin. Results: Polyethylene glycol precipitation and gel filtration chromatography were used to demonstrate high-molecular weight insulin immunoreactivity in the patient's plasma. This was characterized as an insulin binding IgA-kappa paraprotein present at 4200 mg/dl (42 g/liter) with a relatively high insulin dissociation constant of 0.32 microm/liter using radiolabelled insulin binding studies. Conclusions: We present a case of hypoglycemia due to IgA binding insulin antibodies in a patient with an IgA-kappa paraprotein myeloma. The hypoglycemia was associated with high-plasma insulin levels and relatively low C-peptide levels. A plausible mechanism for the hypoglycemia is the delayed clearance of insulin. This case broadens the spectrum of monoclonal gammopathies that have been associated with anti-insulin reactivity and spontaneous hypoglycemia.

validated
Intraoperative accidents during maxillary third molar extraction Rudzik Alexandra View abstract

Intraoperative accidents during maxillary third molar extraction

First author: Rudzik Alexandra

Coordinator(s): Iacob Alina

Keywords: accident extraction maxillary third molar

Background: Wisdom tooth extraction is a complex and various process that depends on a series of factors such as age, root morphology, tooth position on the dental arch, it's relationship with adjacent structures, maxillary morphology, and the technical procedure of the dental practitioner. The ideal age for maxillary wisdom tooth removal is between 15 and 20 years, when maxillary bone is spongious , and has a relative elastic structure. The most common intraoperative accidents during upper third molar extraction are: maxillary tuberosity fracture, dental alveolus fracture, root fracture, dislocation or fracture of maxillary second molar, oro-antral communication and displacement of the tooth into adjacent maxillary spaces. Objective: The purpose of this study is to identify the most frequent and difficult to treat accidents during upper third molar extraction, as well as their management. Material and Method: The study was based on a questionnaire, by inviting dentists to expose their experience in the field, according to maxillary third molar extractions and odontectomies. The results were comparable to the medical literature. Results: The results were comparable to the medical literature. Most of the accidents occurred during extractions, when the third molar was partially erupted followed by odontectomies. Doctors who had encountered intraoperative accidents during upper third molar extraction, claim  the most frequent  accident as root fracture, and the most difficult to treat  the displacement of the tooth into the maxillary spaces, followed by the opening of the maxillary sinus. Conclusions: Intraoperative accidents occur in maxillary third molar extraction because of the complex and various morphology of the tooth, along with age, extraction technique, but also due to the relation with the adjacent anatomical structures.

validated
The Evolution of the Spiritual Dimension of Medicine Students’ Personality Paduraru T View abstract

The Evolution of the Spiritual Dimension of Medicine Students’ Personality

First author: Paduraru T

Coauthors: Tataru Andreea

Coordinator(s): Nirestean A

Keywords: Spirituality Personology Personality Dimensions Transcendence Stress relief

Background: Lately, more and more attention has been paid to spirituality as a personological concerned variable on the socio-cultural and relational plan, as a method of coping during high level stress periods, and also medically covering its effects in morbidity and its assistance in the healing process. Objective: The study’s objective was to determine the efficiency of the spiritual component as a control method against stress in such situations, and to establish spiritual and moral attributes for that particular survey lot. Material and Method: The study has been performed by means of the Daily Spiritually Experience Scale (survey provided by Lynn Underwood) via The World Wide Web, the survey lot consisted of medicine students from Romania, and was performed in two stages which we considered to be representing two different periods concerning the stress level. Results: The first stage, performed during a period considered to be a low level stress one, was dedicated to a survey lot of 262 people, among which 45 men and 217 women, with a global result per group (on a scale from 1 to 6) of 3.43 and a score (on a scale from 1 to 4) of 2.25, representing the desire for transcendence. The second stage performed during a period of a higher level stress on a survey lot containing 362 people, 61 men and 301 women, recorded scores of 3.74 and 2.43 respectively. Conclusions: On the scale from 1 to 6, “1” representing (as a spiritual experience) “never or almost never” and “6” representing “several times a day”, a relative equilibrium can be noticed for values registered in the first period, while they grow in the stressful period, which proves the use and efficiency of spirituality as a relief method for stress and coping during difficult times or events.

validated
Investigation of food-borne illness outbreaks in Mures County Răduţ Silvana Dumitra View abstract

Investigation of food-borne illness outbreaks in Mures County

First author: Răduţ Silvana Dumitra

Coordinator(s): Monica Tarcea

Keywords: food-borne illness outbreaks pathogen Salmonella

Background: In recent years, the frequency of registered food-borne ilness cases rose, directly related to the precarious socio-economic conditions in our country and negligence in monitoring programs, control and health education. Objective: Evaluation of characteristics of food-borne illness outbreaks of Mures County, in the last years. Material and Method: We sought retrospective epidemiological data on cases of food-borne illness recorded in Mures County for a period of three years (2008-2010) in relation to the characteristics of the outbreak investigation. We have associated the data from the observation sheets of cases hospitalized in the Clinic of Infectious Diseases II, during this period of time. Results: During these three years, 192 cases were hospitalized, from the entire county, from 9 outbreaks. Of this group 58% were women, 57% were from urban areas and regarding age, there were no noticeable differences. Compared to other counties, we are situated in an average area regarding the incidence of the disease while the predominance of these diseases is associated with warm season. The main pathogen detected was Salmonella (61%), followed by Shigella (11.45%) and Escherichia Coli (2.6%). Following epidemiological investigations, in these outbreaks, the main food sources incriminated that were detected were of animal origin (eggs, dairy, meat) and only in 64.5% of these cases the sources were known. At 1/3 of these cases, were involved sick/carrier persons who prepared and handled foods. Conclusions: It is recommended a closer monitoring of food quality on the market, along with nutritional education of the population regarding food safety in order to reduce the incidence of these diseases.

validated
The orbicularis oris muscles behaviour during conventional prosthetic rehabilitation in complete edentation. An electromyography study Hanca Maria Andreea View abstract

The orbicularis oris muscles behaviour during conventional prosthetic rehabilitation in complete edentation. An electromyography study

First author: Hanca Maria Andreea

Coordinator(s): Popșor S , Șoaită Claudia

Keywords: neutral zone electromyography orbicularis oris muscle dentures

Background: The "neutral zone" concept is an essential one in order to assure the stability of the complete dentures.It involves a balance between the tongue and the buccinators and orbicularis oris muscles, on the others hand. Objective: The aim of this investigation was to assess the changes in orbicularis oris muscles activity if any, before and after the insertion of complete dentures, by means of electromyography (emg) investigation. Material and Method: We made seven pairs of conventional prostheses for seven edentulous patients, during clinical activities at the Department of Prosthetic dentistry and Oral rehabilitation. For all of them, using the BioEMG II surface electromyography device, the electromyography activity of the orbicularis oris muscles at rest, sucking and whistling, before and after the insertion of the prostheses, was recorded. All the subjects were asked for written informed consent. The obtained data were statistically analyzed for differences in emg activity, before and after the insertion of the prostheses, using the Wilcoxon matched-pairs signed rank. Results: In all three conditions, a significant difference (p= 0.0156) between the superior and inferior orbicularis muscles before treatment was found. No statistically significant difference in emg activity, before and after insertion of the dentures, could be observed. Conclusions: a.) In terms of electromyography at rest and during function, no significant changes in orbicularis oris muscle tone, before and after treatment, could be recorded; b.) further late emg evaluation after 6 months, when the patients adaptation to dentures may manifest as changes in muscle tone, could be useful.

validated
Surgical Approaches to the Treatment of Breast Cancer Gabor Larisa Andrada View abstract

Surgical Approaches to the Treatment of Breast Cancer

First author: Gabor Larisa Andrada

Coordinator(s): Molnar C , Rosca C

Keywords: breast cancer modified radical mastectomy breast conserving therapy

Background: Recent decades have been marked by significant conceptual changes regarding  the treatment of  breast cancer. A first remark is that although breast cancer benefits from important discoveries made in the field of chemotherapy, surgery remains the mainstay of breast cancer therapeutic algorithm. Objective: The main objective was the assessment of surgical treatment using modified radical mastectomy or breast preservation surgery, establishing the frequence, advantages and limitations of these techniques. Secondary objectives were determination of epidemiological characteristics encountered in breast cancer, determination of risk factors, determination of the clinical expression of breast cancer and establishing the correlation between the symptomatology and the stage of the tumour, identification of the predominant location of the tumour, presentation of histopathological types identified, identification of postoperative complications. Material and Method: Following the experience of the Surgery Department of the Clinical County Hospital Targu-Mures, we undertook in the present study, a retrospective analysis of  225 patients who were diagnosed with breast cancer, between 2009-2011. Results: The average age of the patients was 59,2 years. 85% underwent modified radical mastectomy and the remaining, 15% received breast preservation surgery. Over the 3 year period, mastectomy showed a decline trend while breast conserving surgeries increased. Still the modified radical mastectomy was the primarily surgical treatment, while breast conserving surgeries were rather used in early stages. Conclusions: Once a breast cancer diagnosis has been established, appropriate pre-operative evaluation to assess the extent of disease (locally and sometimes systemically) helps guide surgical management and decisions on adjuvant therapy. Modified radical mastectomy was the most common choice of operation in this study. Breast conserving surgery has been less popular but had been showing an increasing trend.

validated
STOMATIZED PATIENTS : PARTICULAR CARE OR ABANDONED? Berki Madalina View abstract

STOMATIZED PATIENTS : PARTICULAR CARE OR ABANDONED?

First author: Berki Madalina

Coauthors: Calin Camelia Irina

Coordinator(s): Panţiru A , Muth Emilia

Keywords: surgical Stoma Stomatherapy

Background: The high number of patients shedding stoma and medical society efforts to combat this disability are certainties of the XXI century.  The improvement of  prosthetic procedures  and stoma  care and the effort of medical body to  reintegration of these patients in the family and society are prerequisites for a new medical specialty: Stomatherapy. Objective: The paper examines modern stomatheray principles and their application in patients hospitalized and treated in the Surgery  Clinic I  Targu Mures for a period of 7 years who have practiced various stoma. Material and Method: The retrospective study is based on observation sheets and operatory protocols, preoperatory preparation, the  immediate postoperatory evolution, the results of different  types of prosthetic devices in patients in Surgery Clinic I Targu Mures between 01.01.2006-31.12.2012. Results: As cancer patients in general, bran, with reduced degree of medical education, with social and family variable individually activity , stoma care is complex requiring much tact and professionalism. Conclusions: Stoma carrier must become an active member in his relationship  and not a social abandoned.

validated
Reprogramming of human fibroblasts toward a cardiac fate Pop Claudia View abstract

Reprogramming of human fibroblasts toward a cardiac fate

First author: Pop Claudia

Coordinator(s): Bud I

Keywords: health fetal surgery

Background: Reprogramming of mouse fibroblasts toward a myocardial cell fate by forced expression of cardiac transcription factors or microRNAs has recently been demonstrated. Material and Method: The potential clinical applicability of these findings is based on the minimal regenerative potential of the adult human heart and the limited availability of human heart tissue. An initial but mandatory step toward clinical application of this approach is to establish conditions for conversion of adult human fibroblasts to a cardiac phenotype. Results: Toward this goal, we sought to determine the optimal combination of factors necessary and sufficient for direct myocardial reprogramming of human fibroblasts. Here we show that four human cardiac transcription factors, including GATA binding protein 4, Hand2, T-box5, and myocardin, and two microRNAs, miR-1 and miR-133, activated cardiac marker expression in neonatal and adult human fibroblasts. After maintenance in culture for 4-11 wk, human fibroblasts reprogrammed with these proteins and microRNAs displayed sarcomere-like structures and calcium transients, and a small subset of such cells exhibited spontaneous contractility. These phenotypic changes were accompanied by expression of a broad range of cardiac genes and suppression of nonmyocyte genes.The potential clinical applicability of these findings is based on the minimal regenerative potential of the adult human heart and the limited availability of human heart tissue. Conclusions: These findings indicate that human fibroblasts can be reprogrammed to cardiac-like myocytes by forced expression of cardiac transcription factors with muscle-specific microRNAs and represent a step toward possible therapeutic application of this reprogramming approach.

validated
CHOICE OF CHIRAL SELECTORS FOR THE SEPARATION OF PHARMACEUTICAL SUBSTANCES BY CAPILLARY ELECTROPHORESIS Sămărghițan Ana-Claudia View abstract

CHOICE OF CHIRAL SELECTORS FOR THE SEPARATION OF PHARMACEUTICAL SUBSTANCES BY CAPILLARY ELECTROPHORESIS

First author: Sămărghițan Ana-Claudia

Coordinator(s): Hancu G

Keywords: capillary electrophoresis chiral selector enantiomer separation

Background: The stereochemistry characteristics of pharmaceutical substances are closely linked with their pharmacologic activity, as usually there are differences between the pharmacologic activities of the two enantiomers. Elaboration of new methods regarding enatioseparation is a necessity and also a considerable challenge, as tendency of using pure enantiomers in therapy is constantly increasing. Objective: The aim of our paper was to characterize the advantages and disadvantages of different chiral selectors frequently used in the electrophoretic separation of pharmaceutical substances. Material and Method: Capillary electrophoresis (CE) is an officinal method of separation in the 7th edition of the European Pharmacopoeia, being regarded as an alternative and also a complementary method to the more frequently use high performance liquid chromatography (HPLC). The advantages of CE in chiral separations include: rapid method development, relatively short analysis time, low amount of samples, reagents and chiral selectors and especially the high selectivity in choosing and changing the chiral selector. There are some options regarding the choice of the chiral selector used in CE, options that include: cyclodextrines, macrocyclic antibiotics, crown ethers, proteins and polysaccharides. Results: As object of study we chose the group of beta-blockers, substances frequently prescribed in modern therapy, and known as exhibiting stereoselective pharmacologic and pharmacokinetic activity. The chiral separation of the selected substances was evaluated by capillary zone electrohoresis using natural (alpha, beta, gama - CD) and derivatized cyclodextrines (hydroxypropyl-beta-CD, randomly methylated beta-CD) and also macrocyclic antibiotics (vancomycin hydrochloride). Conclusions: Although through different separation mechanism, chiral resolution in CE results from stereospecific interactions between the chiral selector and the enatiomers; the selector displaying different affinities towards the enantiomers, giving rise to differences between their electrophoretic mobilities under an applied voltage.

validated
The pharmacist's role in patient’s adherence to treatment with NSAIDs Dan Roxana View abstract

The pharmacist's role in patient’s adherence to treatment with NSAIDs

First author: Dan Roxana

Coordinator(s): Rusu Aura , Hancu G

Keywords: counseling pharmaceutical practice NSAIDs coxibs

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are a class of pharmaceutical substances that provide analgesic, antipyretic and anti-inflammatory effects. Most NSAIDs act as nonselective inhibitors of the enzyme cyclooxygenase (COX) inhibiting both COX-1 and COX-2 izoenzymes, and thus interfering with prostaglandin synthesis. Coxibs are a group of NSAIDs recently introduced in therapy that selectively targets COX-2. Adherence to treatment, patient cooperation and compliance is reflected by the usage of the prescribed drug by the patient, in accordance with the prescription and the medical advice. Objective: Our objective was the evaluation of the pharmacist role in patient counseling, the realization of a review regarding the use of NSAIDs medication in community pharmacies and to appreciate the degree of patient’s adherence during the treatment with NSAIDs. Material and Method: Our survey was conducted in 6 community pharmacies from Târgu Mureş, and involved a number of 262 patients diagnosed with chronic diseases (arthritis, osteoporosis) or with acute diseases (bronchitis, tonsillitis) that required the use of NSAIDs for their therapy. Results: The method used was the questionnaire. Through the questionnaire items we analyzed omissions in medication, compliance regarding number of doses and indicated concentration, compliance regarding the periods between administered doses, administration of the medicines in concordance with main meals, the main source of information about de medication. However, the analysis of the questionnaires revealed that the non-adherence to therapy is a worrying aspect at patients receiving treatment with NSAIDs, including coxibs. The study showed that a pharmacist emphasize only the administration of medication at the expense of information about possible drug interactions, dietary habits or a healthy lifestyle. Conclusions: The pharmacist should be more patient-oriented increasing the quality of his consultancy. It is necessary to apply new standards of pharmaceutical practice to enable a more significant contribution in order to obtain adequate and efficient medical therapy in the patients benefit.

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Surgical treatment for incisional hernias.Classic or synthetic mesh reconstruction? Ciulic S A View abstract

Surgical treatment for incisional hernias.Classic or synthetic mesh reconstruction?

First author: Ciulic S A

Coordinator(s): Bancu Ș , Mureșan M

Keywords: abdominoplasty substitution mesh onlay

Background: The incisional hernias represents an abdominal wall disorder who especially affects women;the abdominal wall can be reconstructed by using meshes in different positions or using different types of sutures without meshes. Objective: The aim of the study is to evaluate  which are the trends of  the abdominal wall reconstruction using the clasic procedures and also the modern procedures with meshes. Material and Method: This is an longitudinal and retrospective study between the years 2007-2011, including 722 patients operated in Surgical Clinic No.2 Tg.Mures.The followed parameters were:age, sex, diagnosis, comorbidities and the abdominoplasty type. Results: From those 722 patients  524 were women and 198 men. Also 435 had comorbidities. Simple suture was used for 196 patients, and the overlapping suture for 50 patients; the onlay procedure was performed for 194 patients. For 234 patients the mesh was put in a retromuscular position and the substitution mesh was used for 48 patients. Conclusions: The number of simple and overlapping sutures decrease,and increase the number of procedures wich use meshes in different positions for the reconstruction of the abdominal wall. The substitution mesh has an oscillating increase,the onlay procedure has slowly decresed and the retromuscular position of the mesh after the peak of utilisation in 2009, begun to decrease.

validated
Perception of medical act by the little pupil in rural environment Coca Ana Luciana View abstract

Perception of medical act by the little pupil in rural environment

First author: Coca Ana Luciana

Coauthors: Iacob Andreea Elena

Coordinator(s): Pasca Dorina Maria

Keywords: little pupil physician relationship communication education

Background: This work aims to illustrate the importance of the little pupil from the rural environment in respect to the medical act by itself, being known the fact that the existence of some reticences in this case have repercussions on the maintenance of the health condition of people to whom we report ourselvs. Objective: Our study was axed on: the communication and the relationship between the little pupil and the physician, the overcoming of fears related to the medical act, the importance of the education for health in the instructive - educational process. Material and Method: Conversation, explanation and inquiry. Results: The target group was built from 217 pupils - preparatory class and classes I - IV from rural environment which were involved in the answer of items included in two inquiries applied: preparatory class and class I  5 items, and classes I-IV 7 items. From data processing it resulted the fact that the pupils included in the preparatory class and in classes I-IV, in their relationship with the psychian, rely on game and intuition, the closeness being needed, and at classes I-IV, the confidence and the respect are at the base of the relationship psychian - pupil patient. This data show the need, especially in the rural environment, of the existence of a viable communication and relationship between psychian and patient - little pupil, fact which would create an attitude related to the health and also the first step towards a permanent education regarding the medical prevention and intervention act. Conclusions: The existence, in curriculum, of primary classes of education for health makes that our study certify the need of the positive perception of the medical act in the rural environment, being necessary to maintain the health of people with ages bwtween 6 - 10 years, starting from the communication and the relationship with the physician.

validated
Evaluation of the nutritional status and lifestyle risk factors of a group of Mures town healthy people Radu Ioana View abstract

Evaluation of the nutritional status and lifestyle risk factors of a group of Mures town healthy people

First author: Radu Ioana

Coauthors: Fistic Daniela , Boariu-Ruta Florina

Coordinator(s): Tarcea Monica

Keywords: health nutritional status risk factors clinical and laboratory examinations

Background: The identification, the quantification and the upstream monitoring of risk factors should be an important objective of the medical system, so that the frequency of diseases related to life style could be reduced. Objective: The purpose of this work is the evaluation of the nutritional status and lifestyle risk factors of a group of Mures town healthy people. Material and Method: We started from a survey based on a questionnaire applied on a group of 131 individuals from Mures town in 2012, taken place in the offices of the attending physicians; in addition to the questionnaires, clinical examinations as well as laboratory ones have been performed. Results: From the total number of persons, 4.58% were diagnosed with hypertension, 1.52% with gastric ulcer, 0.76 with diabetes or myocardial ischaemia and 4.58% with dermatological diseases. 12.97% presented hypercholesterolemia and 1.52% high cholesterol levels. 87.78% from the questioned persons prefer omnivorous food, 31.29% do not consume whole grains at all, 64.88% admitted high white bread and a low vegetables/fruits consumption daily. 22.90% believes that they are submitted to stress, 12% are sedentary and 17% are heavy smokers. Conclusions: A more careful monitoring of the risk factors of the healthy population is recommended, complemented as well by community interventions in educational purposes, so that the risk of chronic diseases can be reduced.

validated
Risk of smoking during pregnancy Goglea S C View abstract

Risk of smoking during pregnancy

First author: Goglea S C

Coauthors: Korodi S , Kolcsar Imola , Gabriella Gabos

Coordinator(s): Tarcea Monica

Keywords: risk smoking pregnancy

Background: Smoking is a major risk factor for health, mostly for vulnerable groups like pregnant women and children Objective: Monitoring a group of 170 nursing mothers in Mures County on smoking and other risk factors present during pregnancy and adjacent risks involved. Material and Method: We relied on a transversal epidemiological study based on a questionnaire assessing lifestyle during pregnancy, in a group of 170 nursing mothers of Mureş County in 2012. The research was focused on the prevalence of smoking related to other risk factors present during pregnancy. Results: We observed significant differences between socio-economic status and living area in terms of knowledge level in pregnant women, lifestyle, risk factors and the prenatal addressability to the general practitioner. Smoking is present as a risk to pregnant women (especially in urban areas) and 9% are active smokers during pregnancy, 17% were passive smokers, and one third of them had children with low birth weight. 77.3% have tried to quit smoking during pregnancy and 60% knew the risks induced by exposure to cigarette smoke. Conclusions: Analysis of the characteristics of this study draws attention to some aspects that should be taken into account in the future community interventions, in order to reduce risks associated with smoking, which involves both mother and baby.

validated
THEORETIC AND CLINIC APPROACHES OF THE WOUND HEALING BIOLOGY Boțan Adriana View abstract

THEORETIC AND CLINIC APPROACHES OF THE WOUND HEALING BIOLOGY

First author: Boțan Adriana

Coordinator(s): Boțan A , Cozma D V

Keywords: wound healing wound bed granulation autolytic debridement synthetic dressings

Background: Wound healing is one of the most important processes of the living world through which the living organisms try to restore their injured function and morphology. This topic will deal only with skin injuries; therefore cutaneous wound healing will be the template for our presentation. Material and Method: Cutaneous wound healing has the following phases: haemostasis, inflammation (early and late), proliferation (fibroblast migration, collagen and ECM synthesis, angiogenesis and formation of the granulation tissue and wound contraction) and maturation or remodeling. There are presented three cases of chronic wounds (two leg ulcers and a diabetic gangrene) that have been debrided on behalf of several synthetic dressings in order to improve the natural autolytic debridement. Results: All three cases presented here demonstrate the great importance of the so called wound bed preparation, using each adequate synthetic dressing, according with the wound healing phase of the corresponding injury. Conclusions: Adequate WBP is the most important step in the local wound care, giving the best support either for spontaneous wound healing or for skin grafting, the two main ways a chronic wound may be healed by surgical treatment.

validated
SOME METHODS OF THE SURGICAL TREATMENT OF CUTANEOUS MELANOMA Bratu Ruxandra Monica View abstract

SOME METHODS OF THE SURGICAL TREATMENT OF CUTANEOUS MELANOMA

First author: Bratu Ruxandra Monica

Coordinator(s): Botan A , Cozma D V

Keywords: malignant melanoma melanocyte surgical excision Clark & Breslow scale

Background: Cutaneous melanoma is one of the most dangerous, invasive and weird malignancies which can spread very soon in the target organs, but also can spontaneously heal. Material and Method: Skin melanoma arises from epidermal melanocytes dispersed among the keratinocytes of the epidermal basal layer. There are several ways to deal with a malignant melanoma: surgery (the most important), immunotherapy and chemotherapy. This topic will deal only with the surgical treatment, which is always the first step. There are presented three cases of MM of the trunk, lower limb and head treated either by large excision and direct suture, or by skin grafting (in every case SN has been removed several weeks later). Results: Every MM has to be excised as far as possible from the tumor margins (2-5 cm), the remaining defect being closed  by direct suture when possible or better by skin grafting (this last one allowing a better survey of the local evolution). Conclusions: MM needs early surgical treatment and diagnosis (Clark & Breslow scale). Surgical treatment must be followed and completed by chemotherapy and immunotherapy. A permanent survey of every dark mole (using the A, B, C, D, E formula) is mandatory.

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Oral manifestations in endocrine pathology Grancea Claudia View abstract

Oral manifestations in endocrine pathology

First author: Grancea Claudia

Coauthors: Dragus V , Cucea Larisa

Coordinator(s): Gliga Camelia , Pascanu Ionela Maria

Keywords: dentistry study endocrine disorders oral manifestation frequent

Background: The endocrine system is responsible for hormonal secretion and is closely related to the central nervous system, forming together the neuroendocrine system, which controls psysiological processes and maintains homeostasis. Many endocrine disorders cause changes in the oral cavity, such as: accelerated or delayed teeth eruption, micro- or macrognathia, malocclusions, development abnormalities etc. Objective: The aim of the study was to perform a literature review about endocrine disorders with oral manifestations and to determine the most common dento-maxillary abnormalities caused by endocrine diseases. Material and Method: For the literature review, we carried out a lot of articles with this theme(PubMed/Medline). Using a questionnaire, we examinated a sample of pacients with endocrine diseases, trying to identify which are the most common dento-maxillary anomalies related  or caused by these affections. We chose the next more frequent hormonal disorders to be examinated: dwarfism, acromegaly, hypothyroidism, hyperparathyroidism and diabetes. The pacients introduced in this study belong to the Endocrinology Clinic of Targu Mures. We also tried to observ which are the oral modifications in a group of pacients without the pathology we mentioned and compared the results. Results: The results show that the most frequent oral manifestations in the endocrine disorders are,  in this order: periodontal disease and decay, malocclusions, mycrognathia and mycrodontia, gingivitis, smaller roots, delayed teeth eruption and retarded mandible growth. Conclusions: In the group of healthy pacients, the frequency of malocclusions and crowded teeth, decay and tartar is also high. Agenesis of the third molar is also frequent, especially among girls, even if they don’t have associated endocrine pathology. Other affections, such as mycrodontia, macroglosia, thick lips appear rarely at this type of pacients, which means that they are more likely to appear related to other pathology- endocrine, in our case.

validated
ADOLESCENT PREGNANCY AND CHILDBIRTH Nagy Melinda-Tünde View abstract

ADOLESCENT PREGNANCY AND CHILDBIRTH

First author: Nagy Melinda-Tünde

Coordinator(s): Mărginean C

Keywords: adolescent pregnancy neonatal outcomes socioeconomic conditions

Background: Adolescents are inappropriate developed anatomic and physic to procreate without risk.Social and psychological conditions  vary widely of the occurrence of pregnancy in adolescence, but most times this happens in an environment of poverty and ignorance. Objective: The objective of this study was to characterize the association between adolescent pregnancy and specific adverse maternal, obstetrical, and neonatal outcomes(such as prematurity and low birth weight). Material and Method: A retrospective study based on 119 hospital case records taking into account pregnancies and childbirth from adolescents under age of 18 in Obstetrics and Gynecology Department  at Emergency County Hospital Targu-Mures, between 06.2011-06.2012. Results: The major ages from the examinated cases are 17-18. 78% of the pregnancies was at term, 20% premature and only 2% postmature. 79% delivered by spontaneous vaginal delivery from wich 24% received Oxytocin and 21% underwent a cesarian section. Concerning the pelvic bone dimension I have found significant differences: 78% eutocic pelvic bone, 6% pelvic bone at limit and respective 16% have undeveloped pelvic bone  structure. Low birth weight of less than 2,500 grams accounted for up to 20%. 5% of the newborns had Apgar scores between 4-6, 72% had Apgar scores between 7-9 and 24% had Apgar score of 10. Conclusions: The unwanted pregnancies are more frequent among students in primary cycle from rural area, mostly because of the low and poor socioeconomic conditions wich do not allow an appropiate sexual education. On the other hand an insufficient  multidisciplinary prenatal managment can not support an efficient briefing to ensure healthy pregnances and to reduse adverse perinatal consequences such as prematurity,low birth weight and the need for reanimation.

validated
SURGICAL TREATEMENT OF THE COARCTATION OF THE AORTA Bentz Oana View abstract

SURGICAL TREATEMENT OF THE COARCTATION OF THE AORTA

First author: Bentz Oana

Coordinator(s): Suciu H

Keywords: The coarctation of the aorta, procedures, Reanastomosis T-T, Enlargement Aortoplasty with heterologous pericard Bypass Ao Ao with Dacron prosthesis

Background: The coarctation of the aorta is a congenital cardiac malformation that can be diagnosed on a large age spectrum and with a various range of symptoms. Objective: The purpose is to present our surgical experience in the Reanastomosis T-T, Enlargement Aortoplasty with heterologous pericardium patch, Bypass Ao Ao with Dacron prosthesis procedures. Material and Method: I have studied the observation sheets  for the period of 2010-2012 where I looked at: comorbidities, the type of procedure, the average duration of: the operation, anaesthesia, mechanical ventilation, postsurgical complications, mortality. In the department of cardiovascular surgery of the Targu Mures County Clinical Hospital, during 2010-2012, there have been treated 44 patients with ages from 11 days to 15 years, average age: 2 years and 6 months. Results: Associated pathologies have been encountered at 36 patients (80%). There have been performed 44 surgeries: Reanastomosis T-T 24 (55%), Enlargement Aortoplasty with heterologous pericardium patch 13 (30%), Bypass Ao Ao with Dacron prosthesis 2 (5%). Four re-interventions have been performed: Enlargement Aortoplasty with heterologous pericardium patch 2 (5%); Enlargement of descent Plasty of Ao Ao with heterologous pericardium patch 2 (5%). In our lot of patients the mortality was zero. Conclusions: 1. Co Ao resection with termino-terminal anastomosis is the chosen surgical intervention for the 0-1 year patients. 2. CAP and DSA are the most frequent associated malformations in Co Ao. 3. The anomalies of the aortic valve (bicuspid aortic valve, congenital aortic stenosis frequently accompany the coarctation of the aorta). 4. The coarctation of the aorta represents a surgical rectifiable cardiac malformation with great results in centers with experience in pediatric cardiac surgery.

validated
Anthropometric indicators and nutritional status on a group of healthy people from Tirgu-Mures city Fistic Daniela View abstract

Anthropometric indicators and nutritional status on a group of healthy people from Tirgu-Mures city

First author: Fistic Daniela

Coauthors: Radu Ioana , Boariu-Ruta Florina

Coordinator(s): Tarcea Monica

Keywords: Nutritional status Anthropometric indicators Diseases risk

Background: The body mass index and waist circumference correlates with an increased risk of developing hypertension, diabetes, metabolic syndrome, coronary artery disease, sleep apnea, osteoarthritis and even certain type cancers. Objective: The purpose of this paper is the evaluation of the nutritional status in correlation with anthropometric indicators and assessing the diseases risk in a group of people from Tirgu-Mures city. Material and Method: We relied on a survey based upon the lifestyle of 131 persons from Mures county in 2012, check-in on the general practitioners offices; complementary to this survey both clinical and laboratory reviews were performed. Results: In our group, we identified the following risk factors: 31.29% were overweight and 8.39% obese, 6.87% of the women had waist circumference greater than 88 cm and 19.84% of the men had over 90 cm, 12% were sedentary and 34.6% have irregular diet with caloric excess. Starting from these general indicators, we made correlations with their current health and assessed the risks of contracting a chronic disease in the future. Conclusions: We support the importance of constant monitoring of the healthy populations risks factors completed with community nutrition education programs in order to reduce diseases risk.

validated
Pseudomonas aeruginosa- bacteremia Bivolan Ana-Maria-Corina View abstract

Pseudomonas aeruginosa- bacteremia

First author: Bivolan Ana-Maria-Corina

Coauthors: Teoteoi-Popa A

Coordinator(s): Turculeanu Adriana

Keywords: Pseudomonas aeruginosa bacteremia nosocomial mortality fever

Background: Pseudomonas aeruginosa is a common bacterium that can cause disease in animals, including humans. It is a Gram-negative, aerobic, coccobacillus bacterium with unipolar motility who secrets a variety of pigments. An opportunistic, nosocomial pathogen of immunocompromised individuals, P. aeruginosa typically infects the pulmonary tract, urinary tract, burns, wounds, and also causes other blood infections. Among the nosocomial pathogens, Pseudomonas aeruginosa is recognized as a major cause of morbidity and mortality. Objective: The aim of this study was to prove the decreasing of mortality in case of P. aeruginosa bacteremia. Material and Method: We made a retrospective study on 56 pacients with Pseudomonas aeruginosa bacteremia for five months (september 2012- january 2013) at Laboratory Section of SCJU Craiova. Only the first bacteremic episode for each patient was included in the analysis. The average age of the 56 patients was 49 years, and only four pediatric patients were seen. We identificated P. aeruginosa with a lot of laboratory-microbiology testes. Results: Data obtained from a total of 56 patients with P. aeruginosa bacteremia were analyzed. Of these patients, 59% were men and and as living environment, urban leads with 55%. The most common primary site of infection, excluding patients for whom the primary site of infection was unknown, was the respiratory tract (19 [41.5%] of 56); 25% of the patients had neutropenia;75% of the infections were nosocomial. Fever was the predominant sign of infection-73%. The 30-day mortality rate among all patients was 14% (comparative to the last study-31%). Conclusions: Bacteremia due to Pseudomonas aeruginosa is associated with grave clinical outcomes. In this study, the predominant source of Pseudomonas aeruginosa bacteremia was respiratory tract and fever was the dominant sign. P. aeruginosa bacteremia is associated with a clinically relevant attributable mortality. The results of this study are encouraging. The frequency of Pseudomonas bacteremia is decreasing.

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THE INTERACTION OF TRAMADOL WITH ANTIDEPRESSANTS IN THE HOT PLATE TEST Hurghis Corina Ionela View abstract

THE INTERACTION OF TRAMADOL WITH ANTIDEPRESSANTS IN THE HOT PLATE TEST

First author: Hurghis Corina Ionela

Coauthors: Coca Ana Luciana

Coordinator(s): Cucuiet Sorina

Keywords: analgesics tramadol antidepressants hot plate test

Background: Tramadol hydroloride is a centrally acting synthetic analgesic used to treat moderate to moderately sever pain. The drug has wide range of applications, including treatment of rheumatoid arthritis, retless legs syndrome, motor neurone disease and fibromyalgia. Tramadol is very weak u -opioid receptor adonist, induces serotonin release, and inhibits the reuptake of norepinephrine. Its weak efficacy could be improved by using the simultaneous administration of other drugs, suhc co - analgesics. Objective: In this research we studied the interaction of tramadol with 2 antidepressants (amytriptilin and escitalopram), in order to improve its efficacy. Material and Method: We used the hot plate test on 100 albino mice. Results: Tramadol 5 mg/kg bw did not showed antinociceptive activity, amitriptiline 10 mg/kg bw and 20 mg/kg bw had antinociceptive effect, but escitalopram 5 mg/kg bw and 10 mg/kg bw not presented analgesic effect. The combinations tramadol 5 mg/kg bw + amytriptiline 10 mg/kg bw, tramadol 5 mg/kg bw + amytriptiline 20 mg/kg bw, tramadol 5 mg/kg bw + escitalopram 5 mg/kg bw and tramadol 5 mg/kg bw + escitalopram 10 mg/kg bw prolonged the reaction time statisticaly significant at 30 and 60 minutes after administration. Conclusions: The association of tramadol with this 2 antidepressants could improve the weak efficacy of tramadol, demonstrating the existence of a synergistc aditive interaction.

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Marginal discrepancies of four types of full veneer crowns depending on gingival finish line forM Kulcsar Edit-Anna View abstract

Marginal discrepancies of four types of full veneer crowns depending on gingival finish line forM

First author: Kulcsar Edit-Anna

Coordinator(s): Popşor S

Keywords: Crowns Marginal discrepancy Gingival finish line

Background: One of the main request of a fixed partial denture is the close fit against the finish line of the preparation in order to minimize the width of exposed cement. Objective: The aim of this in vitro study was to assess the marginal discrepancies of four types of restorations currently used in dental practice, against three forms of gingival finish lines: shoulder, beveled shoulder and chamfer. Material and Method: Three premolar teeth were prepared for full veneers crowns according to three configurations of the finish line. After the impression of the three preparations, foe each of these four duplicate dies were performed on which a resin and three metal crowns (Cr-Ni, Cr-Co, aluminium bronze) were made. These crowns attached to the dies were photographed, and the images processed by a computerized measurement program, in order to assess the gap between the edge of the crown and the finish line. The obtained results were statistically processed. Results: In the limits of this study, the less marginal discrepancy can be observed for the Cr-Ni crowns restorations on shoulder finish line (p<0,001). The resin made restorations showed the greater marginal discrepancies, regardless the type of finish line (p=0,3378). Conclusions: All the cast metal alloys used in this study showed an important shrinkage, close to those of the resin. Therefore, for this kind or restorations the knife-edge finish line, instead a shoulder, seems to be the choice to obtain the best marginal seal.

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EXPERIMENTAL RESEARCHES ON THE EFFECTS OF AMINO ACID TAURINE IN VISCERAL NOCICEPTION IN MICE Popescu Simina View abstract

EXPERIMENTAL RESEARCHES ON THE EFFECTS OF AMINO ACID TAURINE IN VISCERAL NOCICEPTION IN MICE

First author: Popescu Simina

Coordinator(s): Liliana Tartau , Catalina Lupusoru

Keywords: taurine nociception capsaicin inflammation colon

Background: Taurine is a amino acid derivative- 2-aminoethane sulfonic acid. An amino acid that isn't incorporated into proteins, taurine is involved as a neurotransmitter and neuromodulator in a host of biological and physiological processes and is a conditionally essential nutrient in humans. Objective: The aim of our study was the experimental research of the effects of taurine in a visceral pain model in mice. Material and Method: The experiment was carried out with white male Swiss mice (20-25g), treated intraperitoneally with the same volume of solution as follows: Group 1 (Control): saline solution 0,3ml, Group 2 (TAU 100): taurine 100mg/kbw, Group 3 (TAU 200): taurine 200mg/kbw. The effects of taurine were studied in capsaicin colon inflammation test. This model of visceral pain consists of chemical stimulation of the colon with capsaicin. Intracolonic administration of capsaicin triggered visceral pain-related nociceptive behavior manifestations. These manifestations (licking abdomen, stretching, or contractions of the abdomen) were observed, scored every 5 minutes for 20 minutes and data were statistically analyzed with SPSS for Windows version 13.0 and ANOVA method. P-values less than 0.05 are considered statistically significant comparing with those of control group. Experimental protocol was implemented, according to recommendations of the University Committee for Research and Ethical Issues. Results: In our experimental conditions the administration of taurine resulted in a dose-dependent decreasing of behavioral manifestations induced by irritant agent capsaicin. Conclusions: In capsaicin chemical colon inflammation model, taurine exhibited dose-dependent (100mg/kbw and 200mg/kbw) significant antinociceptive effects in mice.

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The polymorphism of NPHS2 R229Q gene in young nephrotic syndrome patients from Tîrgu Mureş-Romania Tripon F View abstract

The polymorphism of NPHS2 R229Q gene in young nephrotic syndrome patients from Tîrgu Mureş-Romania

First author: Tripon F

Coauthors: Crauciuc G A , Merlan I

Coordinator(s): Banescu Claudia , Duicu Carmen

Keywords: nephrotic syndrome proteinuria NPHS2-R229Q

Background: The nephrotic syndrome(NS) is defined as the occurrence of proteinuria (>40 mg/h/m² or >3g/24h), hypoalbuminemia(<2.5g/dl), edema and hypercholesterolemia.Mutations of NPHS2 gene, encoding podocin, is a cause for NS. Objective: This study was made to highlight the relationship between mutation of NPHS2 R229Q gene and NS. Material and Method: Our study included a number of 42 young NS patients. Genetic DNA was extracted from peripheral leukocytes according to the protocol described by manufacturer.NPHS2 exon 5 was subject to polymerase chain reaction-restriction fragment length polymorphism technique (PCR-RFLP).Three microliters of unpurified PCR-RFLP products were diluted to 10 microliters of recommended restriction buffer containing 5U of ClaI and digested at 37 Celsius degrees for 10 minutes. The PCR-RFLP products were visualized by electrophoresis. Results: Mutations NPHS2 R229Q were found in two patients. The mutations was found only at children with congenital NS. Because of this, the polymorphism of NPHS2 gene has a clinical importance (patients fail to respond to steroid treatment and may progress to end-stage renal failure). Conclusions: Our results show a low prevalence (4.76%) of disease causing mutations in the NPHS2 gene at romanian NS children, as compared to other European populations (approximately 40% at germans, italians and spanish). To our knowledge, this is the first comprehensive screening of the NPHS2 gene mutations from Romania.

validated
The relationship between the resistance to treatment and T315I, T351C mutations on patients with chronic myeloid leukemia from Tîrgu Mures, Romania. Crauciuc G A View abstract

The relationship between the resistance to treatment and T315I, T351C mutations on patients with chronic myeloid leukemia from Tîrgu Mures, Romania.

First author: Crauciuc G A

Coauthors: Tripon F , Merlan I

Coordinator(s): Banescu Claudia , Duicu Carmen

Keywords: chronic myeloid leukemia T315I T351C

Background: Chronic myeloid leukemia (CML) is defined by the presence of Philadelphia chromosome, after translocation t(9;22)(q31;q11),with occurrence of BCR-ABL1 gene. The gold standard for first-line therapy is with Imatinib mesylate but recent data showed, however, that some patients developed treatment resistance.Thus,these patients may benefit from treatment with new tyrosine kinase inhibitors, such as Dasatinib and Nilotinib. Objective: The purpose of the study was to establish the relation between T3151 and T351C mutations and resistance to CML treatment to 52 patients sample with CML. Material and Method: Genomic DNA was extracted from peripheral blood according to the manufacturer's recommendations, then it was submitted to chain polymerase reaction with alleles specific oligonucleotides (ASO-PCR). The PCR-ASO result was seen by electrophoresis in 2% agarose gel. Results: T351C mutation was found in 24 patients, who represent 46.15%, from which 75% were resistant to Imatinib mesylate and treated with Dasatinib, 12.5% was recently diagnosed and the other 12.5% didn't develop treatment resistance. T3151I mutation was observed only in one patient (1.92%) compared with other study (12.5%). Conclusions: It has been noticed an increased incidence of T351C mutation (46.15%) compared with others international studies (12%), as well as variable results of  treatment resistance. T315I gene mutation is associated with the resistance to all last generation drugs, so we can prove the importance of genetic tests in a predictable purpose. According to our information the association of these mutations and CML have not been studied in Romania.

validated
DETECTION OF DNMT3 MUTATION IN ACUTE MYELOID LEUKEMIA AND MYELODYSPLASTIC SYNDROME Merlan I View abstract

DETECTION OF DNMT3 MUTATION IN ACUTE MYELOID LEUKEMIA AND MYELODYSPLASTIC SYNDROME

First author: Merlan I

Coauthors: Crauciuc G A , Tripon F

Coordinator(s): Banescu Claudia

Keywords: DNMT3A acute myeloid leukemia myelodysplastic syndrome

Background: The evidence of mutations in the de novo methyltranferase 3A (DNMT3A) gene in patients with acute myeloid leukemia (AML) is associated with a poor outcome concerning overall survival. Detection of this mutation in patients newly presenting with AML could supply with important diagnostic and prognostic information. Objective: The goal of this study was to recognize the mutations occurring at the R882 codon (which represent almost 60% of all DNMT3A mutations) using an effective method with high sensitivity and specificity. Material and Method: In our study were included a total of 87 patients of which 48 diagnosed with acute myeloid leukemia (AML) and 39 diagnosed with myelodysplastic syndrome (MDS). The method involves detection of DNMT3A mutation using PCR-RFLP assays. Results: Analyzing our data we found several DNMT3A mutations in patients with AML associated with a poor outcome and no mutations in patients with MDS. Conclusions: In conclusion, we can perform a rapid detection of DNMT3A mutations, which could facilitate stratification of this category of patients for better clinical outcomes.

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H1-antihistamines - A Century of Progress Goga Roxana View abstract

H1-antihistamines - A Century of Progress

First author: Goga Roxana

Coordinator(s): Rusu Aura , Hancu G

Keywords: histamine H1-antihistamine mechanism of action rupatadine, bilastine, alcaftadine, bepotastine allergies, urticaria

Background: Beginning with phenbenzamine introduced in 1942, the first generation of H1-antihistaminergic drugs have been used till the mid 1980s (e.g. clemastine, chlorpheniramine, cyclizine and promethazine). The second generation (e.g. terfenadine, astemizole, cetirizine, acrivastine, ebastine, and loratadine) is relatively free from side effects that might include sedation or fatalities after overdose. The recent improvements of new molecules (e.g. levocetirizine, carebastine, desloratadine and fexofenadine) led to the use of the term "third-generation antihistamines". Objective: A century of progressis highlighted since the initial description of role of histamine and 70 yearsof progress since the introduction of H1-antihistamines for clinical use. Material and Method: For more than 50 years, antihistamines mechanism of action was described as H1-receptor antagonists or H1-receptor blockers. Nowadays these mechanism of actions seems to be out-of-date because do not accurately reflect their molecular mechanism. A new theory seems to be validated in the scientific word: H1 antihistamines are not receptor antagonists as previously thought, but are inverse agonists. Despite the fact that they had been progressively studied for a century, H1-antihistamines still request additional studies of the mechanisms of action, and randomized controlled trials of new generations in order to improve the efficacy and safety. Results: There are six structural classes of antihistamines: ethylendiamines, ethanolamines, alkylamines, piperazines, phenothiazines and other structures like loratadine. Also there are important differences in the pharmacodynamics, pharmacokinetics and adverse effects of the antihistamines. New H1-antihistamines recently introduced in therapy are bilastine, rupatadine, alcaftadine and bepotastine. Conclusions: In the future the H1-antihistamines class will continue to be an important therapeutic tool of treatment in patients with allergies. Other new classes like H3 antihistamines and H4 antihistamines might be used with or without H1-antihistamines. Some cyanoguanidine derivatives of loratadine were synthesized and screened for antitumor and antiinflammatory activity.

validated
Surgical revascularization of the myocardium in the left main coronary artery stenosis Al Hussein H View abstract

Surgical revascularization of the myocardium in the left main coronary artery stenosis

First author: Al Hussein H

Coauthors: Balog Ioana Diana , Câmpian Andrada , Al Hussein Stela Mariana , Braniște A

Coordinator(s): Moraru L , Suciu H

Keywords: left main coronary artery disease autolog venous saphen graft (AVSG) coronary artery bypass grafting (CABG) internal mammary artery ejection fraction

Background: Coronary Artery bypass surgery (CABG) has been being the gold standard for the treatment of patients with coronary artery disease. Significant LMCA stenosis was defined as a reduction of at least 50% in the luminal diameter of the LMCA. Objective: The aym of this study is to demonstrate the efficiency of surgical tratment and the importance of this procedure in for reducing mortality and morbidity caused by "Left Main"stenosis. Material and Method: We retrospectively reviewed 52 cases of coronary artery bypass grafting at IBCvT Târgu-Mureș, on a period of 12 months, from January 2011 to December 2011.  All procedures were performed in patients with significant (≥50%) left main coronary artery stenosis. We analyzed patients who underwent CABG including those with associated procedures, such as valvular repair or replacement. Further on, we highlighted the preoperative variables, operative data and the early postoperative evolution. Results: The data we collected from the 52 cases indicated that male pacients  who underwent surgery represented the largest number of cases (73%),  whereas female patients were (27%). In 58% of patients AVSG was used in combination with left internal mammary artery, in 40% only AVSG, while in one case was used only the left internal mammary artery. Of the 52 cases, in 4 cases (7.7%) surgery was performed "off pump". Eight cases (15%) had postoperative complications, including 2 deaths (3.8%), 2 cardiac tamponades (3.8%), one case of atrial fibrillation (1.9%) and 3 cases of minor sternal wound complications (5.7%). The average duration of surgeries was 251 minutes, the average bypass time was 106 minutes, the average duration of aortic cross clamping was 62 minutes and the average quantity diuresis during surgeries was 1015 ml. Conclusions: Data analysis shows that mortality and the risk of postoperative complications is very low, which demonstrates the effectiveness of surgical treatment in "Left Main"stenosis.

validated
Clinicopathological features of lung cancer - a retrospective study of cases registered between 2003-2012 Roman Adina View abstract

Clinicopathological features of lung cancer - a retrospective study of cases registered between 2003-2012

First author: Roman Adina

Coauthors: Andone S , Ceamburu A , Simu Patricia

Coordinator(s): Mezei T

Keywords: lung cancer pathological staging

Background: Lung cancer remains one of the most common causes of cancer-related deaths all over the world, despite sometimes early warning signs of the disease. Symptoms such as coughing, fatigue, dyspnea or chest pain often are ignored by patients, rendering early diagnosis quite rare. Objective: To review and study lung cancer incidence and clinicopathological features of cases registered at Pathology Department. Material and Method: From the 1199 cases of lung pathology cases registered in the Pathology Department of Targu Mures County Clinical Emergency Hospital between 2003-2012, we focused our study on cases diagnosed between 2008-2012. Studied parameters were: tumor location, size, extension, histological type and pathological staging. Results: In the 5 year period (2008-2012) a number of 354 lung surgical specimens were registered. 191 (55,8%) were malignant tumors. Common histological types: adenocarcinoma (72 cases, 37,6 %),  squamous carcinoma (69 cases, 36,1 % of all cancers), small cell carcinoma (13 cases, 6,8%) and large cell carcinoma (3 cases, 1,5%). Squamous cell carcinoma is more frequent among the male patients (40% of malignant tumors), while adenocarcinoma among female patients (37%). Average age distribution is 61 years, small cell carcinoma occurs at a slightly younger age (55 years). Pathological stages distribution: 56 pT2 (29.3%), 23 pT3(12%), 15 pT1 (7,8%) and 4 pT4(2%) and 94 cases (49,2%) with pTx stage. Average tumor diameter increases with pathological stage. Conclusions: Processing lung pathology related surgical specimens represents a significant part of the Pathology Department ’s workload. Our study shows the significance of lung cancer among other diseases by analyzing its clinico-pathological features. Early stages of lung cancer are rarely diagnosed, it is therefore important to increase self awareness of people at maximum for this type of cancer.

validated
The incidence of b-lACTAM AND TETRACYCLINE ANTIBIOTICS IN RAW MILK FROM tRANSYLVANIA AREA Roiban Marcela Feliciana View abstract

The incidence of b-lACTAM AND TETRACYCLINE ANTIBIOTICS IN RAW MILK FROM tRANSYLVANIA AREA

First author: Roiban Marcela Feliciana

Coordinator(s): Tero-Vescan Amelia , Nistor Cristina

Keywords: milk, farms, tetracycline, b-lactam,colecting centre

Background: The incidence of antibiotics in milk samples shows great importance for milk processors because antibiotic residues can inhibit the starter cultures used for the production of dairy, for farmers due to the severe penalties imposed for positive samples and for consumer because they can cause allergens, awareness and antibiotic resistance. Material and Method: 864 samples of raw milk were analyzed for the presence of tetracycline and B-lactam residues for a period of 18 months. 432 samples came from farms and 432 samples came from milk collections centers. For the analysis we used the Beta STAR Combo test, a rapid test based on receptor for fast determination of antibiotics in milk. Results: During the 18 months we analyzed a total number of 864 samples, of which, 576 were analyzed in 2011 and 288 in 2012. Of the total, 239 samples analyzed were positive, mining 27.3%, of which 166 came from the collection centers and 73 from farm. Conclusions: Small farmers should receive veterinary assistance for the treatment of animal diseases and for the rest period required after completion of treatment to decrease the incidence of positive samples from milk collection centers.

validated
Iatrophobia Chirales Cristina-Ioana View abstract

Iatrophobia

First author: Chirales Cristina-Ioana

Coauthors: Stanciu Liana

Coordinator(s): Pasca Dorina Maria

Keywords: iatrophobia manifest psychologist

Background: Nowadays, iatrophobia, a social fear of doctor / going to a  doctor  is common due to the fact that more complications of diseases appear at each step.This paper aims visualization /analysis of iatrophobia’s existence among patients. Objective: The study  was made on 80 patients from surgery, orthopedics and cardiology’wards, Tg Mures County Hospital in order to illustrate the causes and manifestations produced by this phobia. Material and Method: It has been used the questionnaire and conversation with the patient as a method of psychological investigation. Results: Following analysis, it was confirmed the existence of iatrophohia at a rate of 65%. Majority, 54% of pacients, rural people have this fear. In addition, 56% women face this fear more than men, so the study can be expanded on departments of gynecology, endocrinology,etc. Most often, the patients are afraid of going to the doctor  because it may be necessary a surgical exploration-41%; the  fear appears  after the first medical consultation in 21% of cases  or after the first surgical exploration- 25%. This phobia is manifested, often, through agitation, palpitations- 34%, sweaty hands and forehead- 15% and leads to insomnia in  29% of  cases and ,all the way, to  the worsening of the  situation in which the patient is- 29%.It may be handled by changing his own attitude- 26% or with the psychologist’s help- 34%. Conclusions: Iatrophobia is an important fear which needs to be removed as quickly as possible, even with the psychologist’s help, in order not to endanger the pacient’s health. This way, access to health care will be faster, easier and will help improve the medical care system.

validated
Morphological changes in hard dental tissues prepared using a chemo-mechanical method – a SEM study Ursut H G View abstract

Morphological changes in hard dental tissues prepared using a chemo-mechanical method – a SEM study

First author: Ursut H G

Coauthors: Ostace Ioana Aurelia

Coordinator(s): Monea Adriana

Keywords: SEM analysis chemo-mechanical chemo-mechanical method, carious dentine, SEM

Objective: The objective of the present in vitro study was to evaluate by SEM the ultrastructural changes in hard dental tissues treated with several alternative systems for caries removal and preparation. Material and Method: For this study we used 30 human teeth, freshly extracted because of advanced periodontal disease. The preparation involved natural carious lesions. The teeth were divided in three groups, according to the preparation technique: group 1 (n=10) – mechanical rotary preparation with diamond burs/air turbine; group 2 (n=10) – chemo-mechanical preparation with Carisolv and hand excavators; group 3 (n=10) – chemo-mechanical preparation with Carisolv and smart-burs/micromotor. After preparation dentine surfaces were examined by the mean of high performance photography and SEM. Results: SEM photomicrographs of tooth surfaces prepared with diamond burs showed dentine surface covered with a layer of debris, smear-layer, and dentinal tubule orifices were not visible. For teeth treated with Carisolv gel and excavators, dentinal surfaces were clean, rough, granular and highly retentive, with many exposed, open dentinal tubules. Dentine surfaces of teeth treated with Carisolv and smart-burs were covered with a thick layer of carious dentine and dentinal tubules were not visible. Conclusions: Although the time needed for proper preparation is prolonged for Carisolv, the dentinal surface remains clean, highly retentive, without smear-layer, and sound tooth structures are conserved. The method is minimally-invasive, with clinical application especially for children, elderly patients and for those who present dental anxiety.

validated
Population pharmacokinetics of midazolam in neonates Fintzescu - Vaidă Roxana View abstract

Population pharmacokinetics of midazolam in neonates

First author: Fintzescu - Vaidă Roxana

Coauthors: Fintzescu - Grozav A L

Coordinator(s): Grozav L , Bogdan C I

Keywords: Midazolam Infants pharmacokinetic parameters sedation

Background: Midazolam clearance is reduced in neonates compared with clearance in children, and the doses currently in use, which are derived from pediatric studies, are excessive. Objective: To describe the pharmacokinetics of midazolam in critically ill neonates. Material and Method: This population study was conducted in 111 neonates requiring intravenous sedation for artificial ventilation. The 334 midazolam concentration measurements obtained were analyzed and a two-compartment model with four parameters: clearance (CL), central volume (Vc), peripheral volume (Vp), and intercompartmental clearance (Q). The influence of birth weight, gestational age, postnatal age and comedications were investigated. Results: CL and Vc were found to be directly proportional to birth weight (CL = 0.040  0.009 L/kg/hr; Vc = 0.294  0.035 L/kg). The CL was 1.2 times higher in neonates with a gestational age of more than 34 weeks. It was 0.4 times lower in neonates receiving inotropic support. The postnatal age had no apparent effect on midazolam kinetics. The Vp and Q were not influenced by any of the covariates studied. There was a large interindividual variability for the pharmacokinetic parameters. Conclusions: The mean midazolam doses required for critically ill neonates are lower than those required for older infants.

validated
STUDY OF THE EFFICIENCY OF THERMOFORMED TRANSFER MASKS IN BRACKETS POSITIONING Bechir E S View abstract

STUDY OF THE EFFICIENCY OF THERMOFORMED TRANSFER MASKS IN BRACKETS POSITIONING

First author: Bechir E S

Coauthors: Mariș M , Curt-Mola Farah

Coordinator(s): Păcurar Mariana , Bechir Anamaria

Keywords: Brackets Dental plaque Thermoformed masks

Background: Precise brackets placement is important in labial and lingual orthodontic treatments. The development of numerous orthodontic techniques permit today the achievement of orthodontic appliances with high standards. Objective: The aim of this paper is to demonstrate that the indirect technique for positioning and bonding of the brackets is more efficient than the direct method.The two bonding techniques of brackets were compared with regard to (1) clinical and laboratory time involved in the two procedures and (2) the accumulation of dental plaque. Material and Method: The batch of ten patients was divided into two groups: in the first group of five patients, the brackets were bonded by the direct method, and in the five patients belonging to the second group, the brackets were positioned and bonded by using thermoformed transfer masks.  The accumulation of dental plaque around the brackets was measured at each of the four bracket sides for every bonded tooth and was recorded monthly. We realized 8 determinations of accumulated plaque index (PI), in both groups of patients. Results: Average time needed for completion of the direct bonding technique was 46.21 minutes. In the indirect technique, the clinical and laboratory procedures required 51.31 minutes, of which 19.71 minutes represented actual clinical time.In the patients of both groups, the highest value of PI was determined at first determination, and progressively decreased during the treatment.Several advantages of the indirect bonding method are represented by an improved precision in the positioning of the brackets, a reduced chair time and less stress to the orthodontist. Conclusions: The technique of indirect bonding, which allows a correct and precise positioning of the brackets, is an efficient and facile procedure, accessible to all professionals.This bonding technique also enables a reduction of dental plaque accumulation around brackets

validated
Total Hip Replacement - A comparison of life conditions between diabetic and non-diabetic patients with total hip replacement Coman Oana View abstract

Total Hip Replacement - A comparison of life conditions between diabetic and non-diabetic patients with total hip replacement

First author: Coman Oana

Coordinator(s): Russu O

Keywords: total hip replacement diabetes THR SF-36 life conditions

Background: Diabetes, called by the World Health Organization the epidemic of the 21st century, is a common disease, hyperglycemia having adverse effects on infection, fracture healing and bone remodeling. Objective: The purpose of this study is to evaluate the quality of life of diabetic and non-diabetic patients who underwent total hip replacement (THR), which involves removing a diseased hip joint and replacing it with an artificial joint, called a prosthesis. Material and Method: This is a short term retrospective study undertaken between 19 March 2010 and 22 October 2010 at the Orthopaedics and Traumatology Clinic in Tirgu Mures, involving 30 patients, 18 females and 12 males, aged between 37 and 72 (mean age 60.3), 10 diabetics and 20 non-diabetics. All the patients underwent total hip replacement with the above mentioned technique. The patients were questioned by telephone using the SF-36 survey in order to evaluate the life conditions after the surgery. The data regarding the THR surgeries were collected from the hospital register. The SF-36 survey uses 8 scale scores: Physical Functioning (PH), Role Physical (RP), Bodily Pain (BP), General Health (GH), Vitality (VT), Social Functioning (SF), Role Emotional (RE) and Mental Health (MH). The scales range from 0 to 100, a higher value means a better health status. Results: The scales used in the questionnaire showed the next results (diabetic – non-diabetic patients): mean norm based PF: 32.42 – 34.41; RP: 35.14 – 35.38; BP: 42.27 – 39.77; GH: 35.89 – 38.17; VT: 46.97 – 46.1; SF: 37.54 – 37.86; RE: 43.72 – 41.09; MH: 40.66 – 41.01. The Physical Component (diabetic – non-diabetic patients) showed a mean of: 31.87 – 33.13 and the Mental Component a mean of: 45.87 – 44.94. Conclusions: Diabetic patients who underwent total hip replacement tend to have a quality of life similar to patients without diabetes who underwent the same surgery.

validated
ANALYTICAL APPROACH TO PREROGATIVE MANAGEMENT OF PATIENTS WITH CESAREAN SCAR FACING A SECOND DELIVERY Sivanand S View abstract

ANALYTICAL APPROACH TO PREROGATIVE MANAGEMENT OF PATIENTS WITH CESAREAN SCAR FACING A SECOND DELIVERY

First author: Sivanand S

Coauthors: M Jee Poh Hock , Rida Gallaby , Wisam Z , Bastos Silva J A

Coordinator(s): Iolanda Blidaru , Costachescu G

Keywords: Uterine rupture Scar of the Uterus NBAC - Natural Birth After C-section C-section Criteria for NBAC

Background: Uterine scar represents a problem regarding the prognosis of the future pregnancy and delivery. Objective: Comparing protocols used in several countries in managing patients with past history of Cesarean section regarding the route of delivery for the next pregnancy in Parallel with the incidence of uterine rupture in these cases Material and Method: The pertinent literature on the management of pregnant patients with a previous C-section were collected and screened by retrieving from Romanian, Portuguese, Chinese, Indian, United Arab Emirates, Israeli and English databases, such as PubMed  reduces the size of the scar. Dissolvable stitches are used so there are none to remove afterwards. Recovery time is usually one week Results: We made a comparative study between standard protocols used in these countries respectively. Vaginal birth after cesarean delivery is performed in certain cases, which include: One prior low-transverse cesarean section, clinically adequate pelvis, No other uterine scars or previous rupture, physician immediately available throughout active labor capable of monitoring labor, performing an emergency cesarean delivery, availability of anesthesia and personnel for emergency cesarean delivery. Depending on several factors in which the most important is the type of prior uterine incision, the risk for uterine rupture varies. The Classical and T-shaped incisions have a higher risk for uterine rupture in contrast with the low vertical (outdated technique) and low transverse incisions. Complication such as bleeding is controlled much more efficiently through cesarean section. Postpartum hospitalization time is reduced. Conclusions: Over the past decade, the cesarean section rate has increased exponentially worldwide, It has become a rule to be followed ‘’Once a Cesarean, Always a Cesarean’’ like in the cases in many counties in Europe and America, but as for Middle East its quite dependent on the criteria (stated above), which has to be met in order decide what procedure is of most benefit to the patient.

validated
Diet and other risk factors present in patients with diabetes in Ludus city Salcudean Maria Gentiana View abstract

Diet and other risk factors present in patients with diabetes in Ludus city

First author: Salcudean Maria Gentiana

Coauthors: Zalar Ioana Delia

Coordinator(s): Tarcea Monica

Keywords: health nutrition diabetes diet

Background: The purpose of this paper study was to estimate the incidence of risk factors in patients with diabetes from Ludus. Material and Method: Methodology: The study included a total of 105 patients with diabetes, monitored by general practitioners from Ludus, in the last 3 years. We relied our methodology on monitoring of diabetes main risk factors registered in our sample, starting from: historical data, laboratory data and detailes obtained from a life style questionnaire used. Results: Results: Most of our patients were female (76.1%), with age between 51-60 years, retired, and half the patients had below-average incomes. The incidence of type II diabetes was 80% in males and 91.2% in females. Smokers were 18.6% in our group, 15.2% used to drink alcohol daily, 57% had associated hypertension and dyslipidemia and also on 70.4% diet was unadequate with excess in fats and carbohydrates. Conclusions: Conclusions: Diabetes education is quite low monitored in our group, with no gender differences, raising the alarm about the need for nutritional intervention in this community.

validated
AGE- AND GENDER-SPECIFIC TEMPORAL TRENDS IN UNDERLYING CAUSES OF DEATH IN ADOLESCENTS AND YOUNG ADULTS IN A PERIOD OF 61 YEARS Costache T View abstract

AGE- AND GENDER-SPECIFIC TEMPORAL TRENDS IN UNDERLYING CAUSES OF DEATH IN ADOLESCENTS AND YOUNG ADULTS IN A PERIOD OF 61 YEARS

First author: Costache T

Coauthors: Meliţ Lorena

Coordinator(s): Gurzu Simona , Jung I

Keywords: causes of death young adolescent temporal trend

Background: Over the past six decades the pattern of death causes has significantly changed due to improvement of diagnostic techniques and therapeutic possibilities. To our best knowledge, the temporal trend in romanian adolescent and young patients’ causes of death was not well investigated in the literature. Objective: To compare the mortality pattern  in patients aged 10 to 40 years old between two time periods, 1950-1990 respectively 1991-2011, and to emphasize the changes of morbidity and mortality structure. Material and Method: From 1950 to 2011 the necropsy data were collected from the Pathology Department of the Emergency County Hospital of Tîrgu-Mures, Romania. Using the statistical methods we tried to estimate the mortality rates in this period of time, in patients aged 10 to 40 years old. Results: During 1950-1990 (first period) a number of 3282 necropsies were performed in patients aged 10 to 40 years old, compared to 302 during 1991-2011 (second period). In the first period, the commonest cause of death was endocarditis in both males and females (14.11%) followed by non-tumor brain (12.49%) and lung lesions (9.32%). The maternal-related deaths represented a significant percentage during 1950-1960 (9.58%) that decreased until 5.26% during 1981-1990. In the second period, the commonest cause of death was liver cirrhosis (29.82%) followed by non-tumor brain lesions and hematologic disorders in males respectively non-tumor brain lesions (27.45%) and hematologic disorders in females. Conclusions: This up-to-date statistical study proves a significant change in trend of causes of death in young patients, the endocarditis and tuberculosis being replaced in the last years by cirrhosis and hematologic disorders.

validated
CORRELATIONS BETWEEN FACTORS THAT MIGHT INFLUENCE THE CONSUMPTION OF ETHNOBOTANICAL DRUGS Mihaly Andrea-Blanka View abstract

CORRELATIONS BETWEEN FACTORS THAT MIGHT INFLUENCE THE CONSUMPTION OF ETHNOBOTANICAL DRUGS

First author: Mihaly Andrea-Blanka

Coordinator(s): Mihai Adriana , Buţiu Otilia

Keywords: Ethnobotanical Psychogenic plant Addiction

Background: Ethnobotanicals, the most famos XXIth century drugs, are a mixture of powders of dried plants (Amanita Muscaria, Cannabis, Datura) with hallucinogenic properties which are sprayed with various chemical substances such as Ketamine, Lysergic Acid, etc.They are a group of psychogenic compounds that alter the consciousness, making the subject susceptible to auditory, visual and tactile hallucinations and mood swings.These new age drugs can become addictive after the first use. Objective: To observe the correlation between the factors that influence ethnobotanical use. Material and Method: We performed a prospective study in one high school in Targu Mures City, in 2013, where we evaluated drug usage in teenagers based on 139 self made questionnaires. Results: From 139 teenagers interviewed, with ages between 14 and 19, 27 (19.42%) were tempted to use ethnobotanical drugs. Out of these, 13 (48.15%) have experienced with them, 6 (46.15%) were girls and 7 (53.85%) were boys. Conclusions: We noticed that entourage, curiosity and dysfunctional family relations were the primary leading causes for drug use in teenagers.

validated
IS the Cardiovascular Risk Predictable in Patients Diagnosed with Polymyositis or Dermatomyositis? Matei Georgeta View abstract

IS the Cardiovascular Risk Predictable in Patients Diagnosed with Polymyositis or Dermatomyositis?

First author: Matei Georgeta

Coordinator(s): Copotoiu Monica

Keywords: cardiovascular risk polimyositis dermatomyositis

Background: Dermatomyositis and polimyositis are associated with an increased risk of cardiovascular events who constitute a major cause of death. Objective: To provide evidence of  the predictable cardiovascular value of specific antibodies in dermatomyositis or /and polymyositis. Material and Method: A retrospective and prospective observational study was performed between the First of January 2003 till thirty-one of december 2012 in the Departament of Rheumatology of Tirgu-Mures. One hundred and thirty two patients diagnosed with dermatomyositis and  polimyositis were enrolled in the study.The antinuclear antibodies(ANA), the anti jonctional antibodies( anti Jo1) and the anti signal recognition  antibodies (anti SRP) were assessed alongside with the cardiovascular manifestations before and after the onset of the desease. Results: The mean age of the patients was 55.52 +/- 10.11 years old with the desease duration of 7.742 +/- 4.636 . There were no differences  between the female patients group versus male group concerning the age and the desease onset (p: 0.2447; p: 0.9947).Overall , we couldn't  find a significant statistical correlation between the ANA, anti-Jo1, anti-SRP atb. and the cardiovascular manifestations(p> 0.05 ) instead we did observe  a tendency (not significant statistically) of the anti Jo1 atb. to correlate with the pulmonary fibrosis(p: 0.074, r: -0.156). Conclusions: We weren't able  to establish a predictable cardiovascular  pattern in patients diagnosed with polymyositis or dermatomyositis and the presence the ANA, anti Jo1 and  anti SRP antibodies.

validated
Serum concentration of uric acid in polyuric-polydipsic syndrome Cojocaru Valentina View abstract

Serum concentration of uric acid in polyuric-polydipsic syndrome

First author: Cojocaru Valentina

Coauthors: Morozan Tatiana , Chiheri A V

Coordinator(s): Pascanu Maria Ionela

Keywords: uric acid central diabetes insipidus primary polydipsia

Background: The differential diagnosis of polyuric-polydipsic syndrome includes usually primary polydipsia (PP) and central diabetes insipidus (CDI). In the first situation, there is excessive water ingestion rather than its excretion, in the second case is the lack of vasopressin. Material and Method: In this study, we analyzed the cases of patients with polyuria-polydipsia during 1995-2012.There were 48 patients, 33 patients with CDI and 15 with PP according to the results of dehydration test. Serum uric acid concentration was available during normonatremia without treatment with desmopressin.  In the case of four patients, we analysed the concentration of uric acid before and during treatment with desmopressin. Results: The CDI patients presented increased uric acid levels (5.43±1.62mg/dl). In the PP group the value of uric acid was decreased (4.35±1.57mg/dl). This difference of means is statistically significant, p 5 mg/dl. The explanation for this fact is the metabolic syndrome in the case of three of them. Also, 12 patients with CDI presented a value of serum uric acid concentration < 5 mg/dl. During treatment with desmopressin, the concentration of uric acid was variable. Conclusions: Concentration of serum uric acid can be used to differentiate CDI from PP. The maximum incidence of CDI in population based on age groups is between 10-29 years and 40-59 years. For PP the maximum incidence is in the fourth decade.

validated
Usage of the covered self-expandable metallic stent(CSEMS) For Palliative Treatment of Malignant AERO-DIGESTIVE Fistulas Ong Wee Liam View abstract

Usage of the covered self-expandable metallic stent(CSEMS) For Palliative Treatment of Malignant AERO-DIGESTIVE Fistulas

First author: Ong Wee Liam

Coauthors: M Jee Poh Hock , Kaisser Gallaby

Coordinator(s): Dimofte G , Cozorici I A

Keywords: Oncology Surgical palliative treatment TRACHEOESOPHAGEAL FISTULA ESOPHAGEAL CARCINOMA STENT

Background: A study conducted in the Clinic of Surgery of UMF G.R.T Popa Iasi, concerning the use and application of the covered self-expandable metallic stent(CSEMS) in advanced esophageal cancer complicated by a fistula at the level of tracheoesophageal septum(aero-digestive fistulas). A Tracheoesophageal Fistula(TOF) emergence during end-stage esophageal cancer is major emergency due to complications of aspiration of digestive content, pneumonia, abscess formation and asphyxiation alike, leading to respiratory failure. Among all these, the risk of contracting pneumonia is especially increased. This would lead to the further suffering of the patient. Objective: This study is focused on the usage of the CSEMS as a palliative treatment to reduce the risk involved and to secure a better prognosis for patients with advanced esophageal cancer complicated by a TOF. Material and Method: A retrospective study that conducted in the Clinic of Surgery of UMF G.R.T Popa Iasi comprising the statistical values and comparison between different patients with advanced esophageal cancer complicated by a TOF with their outcomes of stenting at our institution. The surgical procedure involved is known as Placement of CSEMS, which is inserted via wire-guided endoscopic under fluoroscopy. All patients had poor respiratory status due to TOF. We retrospectively assessed the results of  stenting as the improvement of disphagia and grades of respiratory symptoms, regarding stent-related complications and clinical course and survival. Results: As the stents were placed. Placement of CSEMS is a safe and cost effective treatment modality that improve the quality of life, as compared with other palliative techniques, for patients with advance esophageal cancer complicated by TOF. In cases of  however, the overall survival of these patients is poor. But placing of covered self-expanding metallic stent significantly improves dysphagia and allows for oral nutrition. Conclusions: Application of the CSEMS as a palliative treatment is proved to be an effective  procedure to reduce the risk involved and therefore secure a better prognosis for patients suffering from advanced esophageal carcinoma complicated by a (TOF).

validated
THE MEDICINE STUDENT’S INVOLVEMENT IN VOLUNTEERING CAMPAIGNS Armean Iulia View abstract

THE MEDICINE STUDENT’S INVOLVEMENT IN VOLUNTEERING CAMPAIGNS

First author: Armean Iulia

Coordinator(s): Pasca Dorina Maria

Keywords: student medicine volunteering experience public health

Background: The present thesis is meant to emphasize the necessity of the volunteering actions in a would-be doctor’s professional development. Objective: The study was focused on  the acknowledgement of the concept of volunteering by the student, the acquiring of the quality of a volunteer by the medicine student, the young medicine students’ involvement in volunteering, the importance of volunteering in maintaining  the public health and in developing a medical career. Material and Method: The following methods of psychological investigation were used to fulfill the proposed purpose: conversation, observation , questionnaire. Results: The results were based on a study conducted on 563 medicine students in the years  I-V , using a questionnaire with 10 items which decoded the elements referring to identity, importance, involvement and the positive impact of volunteering upon the medicine students . From the structural analysis it was revealed that it is important to have the quality of a volunteer in order to succeed in educating and prevention of diseases and maintaining the public health , as well as to build a medical career. The most involved in the volunteering programmes are , so far, the students from the first, second and third years,  representing 75 % (per cent )of the total  respondents. This could be a good start in the utilization of the human potential for achieving the proposed purpose . Conclusions: In this study I managed to prove that volunteering can be a trial in the professional  development of the medicine student . He” she can be,  in a near future, the very initiator of some projects in volunteering  in the public health domain.

validated
Aspects regarding the etiology and clinical matters of the urinary tract infections in children Marian Iulia - Anca View abstract

Aspects regarding the etiology and clinical matters of the urinary tract infections in children

First author: Marian Iulia - Anca

Coauthors: Popa Alina - Stefania , Tecu Elena - Ionela

Coordinator(s): Dop Dalia

Keywords: Urinary tract infection children antibiotics medical records pediatrics

Background: Urinary Tract Infection (UTI) is the most common and serious bacterial infection in childhood. Our paper represents a retrospective study of the patients diagnosed with this type of infection, admitted in the Pediatrics Clinic of the Hospital No.1, in Craiova.   Objective: The aim of our study was to determine the incidence of urinary tract infections in children and also whether or not they associated other pathologies or symptoms. Material and Method: Our research’s materials consisted of the medical records of the patients admitted in the Pediatrics Clinic between January and December 2012. Results: Only 2.3% of all the admitted patients had a urinary tract infection, 20% of these being accidentally discovered, the patients being admitted for other pathologies.The symptomatology respected, basically, the semiological features of  pediatric UTI, but we came across quite frequently with agitation, common also for the classical urinary syndrome. Conclusions: Being a serious and common infection for children, UTI should be investigated more thoroughly, putting an emphasize on the doctor - patient's parents talk, for we discovered a lot of cases with negative urocultures, the patient's being "blindly" treated with antibiotics at home. An early identification of these children would allow the use of a "targeted" antibiotherapy, with better chances in sterilizing the infection.

validated
Hepatobiliary complications of Crohn’s disease Ajlouni Rakan A M View abstract

Hepatobiliary complications of Crohn’s disease

First author: Ajlouni Rakan A M

Coauthors: Mitrut R

Coordinator(s): Mitruţ P

Keywords: Crohn Liver Nodular Cell

Background: In rare cases the liver and gall bladder are found to be involved in the bowel inflammation in Crohn’s diseas. Nodular cell proliferation, known as granulomas, also develop in the liver tissue and the antibodies present in Crohn’s disease may also react with the surface of the bile ducts. Objective: To investigate the incidence and the profile complications’ liver and gall bladder in Crohns disease. Material and Method: The study was performed in Second Medical Department of Emergency District Hospital of Craiova on a group of 51 patients known with Crohn’s disease. Statistics analysis pointed out the prevalence of male 74,5% (38 patients); median ages 49 ani; range 21-69 ani. The diagnostic of Crohn’s disease was made in all cases by colonoscopic and bioptic examination. The research protocol contained a clinical, biological, histological and a complete imagistic evaluation of the liver and port system. Results: The liver determination was present at 23,5% (12 patients) of cases with the folowing ethyological spectrum: primary sclerosing cholangitis 2 cases, pericholangitis 3 cases, primary biliary cirrhosis 1 case, steatofibrosis 3 cases, colangiocarcinom 1 case and liver cirrhosis 2 cases. In this cases the diagnostic was confirmed by bioptic and histologic examination and  RMN cholangiography. Conclusions: The liver determination in Crohn’s disease is frecquently. Specifically was primary sclerosing cholangitis, pericholangitis, steatofibrosis and liver cirrhosis. At patients with Crohn’s disease is necessary completely evoluation (biological and histological) of the liver.

validated
Study on Influence of cardiovasular risk factors on atherosclerosis localization Oltean A View abstract

Study on Influence of cardiovasular risk factors on atherosclerosis localization

First author: Oltean A

Coauthors: Sofilca Gabriela Cristina , Fofiu A

Coordinator(s): German Sallo Marta

Keywords: Cardiovascular Rehabilitation risk fctors, atherosclerosis

Background: Cardiovascular disease is the leading cause of morbidity and mortality worldwide, due to atherosclerotic disease which is with multiple localisations:  coronary, peripheral and / or carotid arteries can be involved. Objective: Aim of this study was finding correlations between traditional cardiovascular risk factors and site of atherosclerosis. Material and Method: We included 217  patients (55.3% men and 44.7% women) from Cardiovascular Rehabilitation Hospital Tg. Mures, diagnosed with coronary artery disease, peripheral and/or carotid atherosclerosis. Study was retrospective. We evaluated the following risk factors: sex, age, positive cardiovascular family history , smoking, body mass index, blood pressure values, heart rate, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride, uric acid, fibrinogen, glucometabolic disturbances. Statistical analysis have been made with SPSS v17.0. Results: Distribution of atherosclerosis localisation was: ischaemic heart disease: 90.8%, peripheral atherosclerosis: 24.9% , carotid atherosclerosis: 38.7%,   ischaemic heart disease and peripheral atherosclerosis: 17.51% , ischaemic heart disease and carotid atherosclerosis: 34.56%, peripheral atherosclerosis and carotid atherosclerosis: 13.82%. Frequency of risk factors in descending order was the following:  hypertension-91,7% ,male gender-55,3%,smoking-48,4%,family history-46,2%,  carbohydrate-metabolism disorders 44,7%, hypertrigliceridaemia-36,9%, hypercholesterolaemia-36,7%; obesity-34,2%, 30% mixed dyslipidemia. We have found statistically significant correlations between age(p=0,026), total cholesterol level (p=0,05)and coronary artery disease, HDL cholesterol(p=0,031) , fibrinogen(p=0,026) level and peripheral atherosclerosis , between systolic(p=0,005), diastolic blood pressure(p=0,008), triglycerides(p=0,009) and carotid atherosclerosis. Conclusions: Traditional risk factors may have different influence regarding localisation of atherosclerosis. Thus hypercholesterolaemia correlate better with coronary localisation, high blood pressure and hypertriglyceridaemia with carotid atherosclerosis while low HDL level and inflammatory markers like fibrinogen with peripheral atherosclerosis.

validated
Recombinant factor VII in the treatment of coagulation disorders in cardiac surgery Câmpian Andrada View abstract

Recombinant factor VII in the treatment of coagulation disorders in cardiac surgery

First author: Câmpian Andrada

Coauthors: Oltean Alina , Al Hussein H

Coordinator(s): Judit Kovacs , Suciu H

Keywords: cardiac surgery novoseven coagulation disorders postoperative hemorrhage

Background: NovoSeven, a recombinant factor VIIa (rFVIIa)  can be used in cardiac surgery for the treatment of coagulation disorders caused by cardiopulmonary bypass and prevention of surgical bleeding. Recombinant factor VIIa has been advocated as a possible off-label rescue therapy for those individuals, in whom conventional blood component therapy alone is inadequate. While early results were promising, a paucity of data leaves many questions about its safety profile. Objective: The aim of this study is the clinical evaluation of efficacy of rFVIIa in the treatment of bleeding during and after cardiac surgery and its possible complications. Material and Method: Data were collected from all patients who underwent open-heart surgery and received Novoseven in the intraoperative or postoperative period at Cardiovascular Surgery Targu-Mures between 14.06.2011 and 15.03.2013. Novoseven was indicated in patients with severe intraoperative or postoperative bleeding, with coagulopathy induced by cardiopulmonary bypass (CPB) circuit. Results: We included 25 patients between 1 day and 82 years old, 12 children and 13 adults.The most common diagnosis were Transposition of the great vessels and Tetralogy of Fallot in children and Acute aortic dissection and Coronary heart disease in adults. Intra-or postoperatively they presented severe bleeding and multiple coagulation disorders like: thrombocytopenia,hypofibrinogenemia,increase INR,or aPTT,and high levels of D-dimer. After the administration of small doses of Novoseven we observed the normalization of coagulation and the stop of bleeding. We also observed serious thrombotic side effects, associated with the use of NovoSeven, like blood clots formation in arteries and veins, particularly in children, which lead to postoperative complications and death. Postoperative hemorrhage was accompanied more frequently by other complications like: severe hypovolemia,hemodynamic instability,cardiac tamponade(for which reintervention was performed),atrial fibrillation,hepatic and renal disorders,anemia,infections or death. Conclusions: NovoSeven produces a potent hemostatic effect in bleeding events refractory to the conventional therapy complicating cardio surgical interventions, and substantially decreases the demand for blood transfusion.

validated
The attitude and behavior of the women from Mures county towards the risks of pregnancy Stoica A View abstract

The attitude and behavior of the women from Mures county towards the risks of pregnancy

First author: Stoica A

Coauthors: Szilamer K , Kolcsar Imola , Gabos Gabriella

Coordinator(s): Tarcea Monica

Keywords: Pregnancy Risk factor Lifestyle

Background: During the period of pregnancy, the woman is the most sensitive group towards the risk factors of lifestyle. That’s why the attitude to the doctor and the knowledge in this area are very important as prevention measures. Objective: The assessment of women’s from Mures county behavior towards the period of pregnancy and associated risks. Material and Method: We’ve studied a group of newborn babies mothers, from Mures County, hospitalized to Tg. Mures maternity clinics in 2012, who completed a questionnaire regarding their behavior during the pregnancy time and their attitude towards the existing risk factors. Results: Both smoking and alcohol drinking are presented in the studied group of pregnant women, but fortunately the percent wasn’t so big.  Only 8% of them didn’t  breastfeed, the rest of them being well instructed regarding the importance of natural nutrition for the child. The eating risk behavior during pregnancy was linked by an insufficient intake of diary, iron, folic acid and vitamin D, and also by an excess of sweets and food with additives, presented at a third part of the group; this tendency can be improved by proper education, especially to those persons with low financial and educational resources. This study also revealed that there is almost no good interest towards specialized medical visits or dental prenatal ones, and also towards the moderate physical activity during pregnancy. Conclusions: We recommend a constant monitoring of the possible exposure risk factors during pregnancy and also efficient interventional measures for the community regarding the reducing the risk factor’s impact on mother and the child’s health.

validated
The incidence of arrhythmias in patients with coronary heart disease and dyslipidemia Galbeaza Andreea Alexandra View abstract

The incidence of arrhythmias in patients with coronary heart disease and dyslipidemia

First author: Galbeaza Andreea Alexandra

Coauthors: Cirstea Iuliana

Coordinator(s): Cozlea D L , Cozlea L

Keywords: dyslipidemia heart disease Holter monitoring arrythmias

Background: Is a known fact that in ischemic cardiomyopathy, dilated cardiomyopathy and valvular heart disease, the prevalence of arrhythmias is high, which is caused by changing myocardial substrate (cavity dilation, myocardial fibrosis),ischemia and neuro-humoral activation. Specialized studies are low regarding the correlation between arrhythmias and cardiovascular risk factors. Objective: This study aims to demonstrate the connection between underlying pathologies ( ischemic heart disease and dyslipidemia ), and the onset of arrhythmias. Material and Method: This is a retrospective study , which includes 50 patients admitted at Medical Clinic 3, Targu-Mures,between January and December  2012, both female and male, aged over 50 years old. The main inclusion criterion was the existence of a history of ischemic heart disease, aged over 50 years and their subjective complaints that raise suspicion of arrhythmia. The patients were monitored with 24-hour Holter ECG. Were also monitored triglycerides and cholesterol values in order to reveal a possible interdependence between their growth and the background cardiac disease. Results: From a 50 patients group, 32% from the rural area, 68% from urban areas, all with a history of ischemic heart disease, 34% had triglyceride levels above 1.71mmol / l, 48% had cholesterol values more than 5.2 mmol / L. After Holter monitoring have been revealed ventricular ectopic frequency, using the Lown classification, supraventricular ectopic frequency and episodes of atrial fibrillation. Also have been revealed maximum and minimum heart rates during 24 hours. Conclusions: Myocardial excitability and conduction disturbances are the most worrying tanatogenerator complication after developing coronary heart disease, favoring the occurrence of ectopic outbreaks.

validated
Multiligamentary injuries of the knee (combined MCL + ACL) - short to medium term follow-up Chiorean Bianca View abstract

Multiligamentary injuries of the knee (combined MCL + ACL) - short to medium term follow-up

First author: Chiorean Bianca

Coauthors: Matei Claudia

Coordinator(s): Fleaca S R

Keywords: combined MCL and ACL injuries follow-up outcomes

Background: Soft-tissue injuries of the knee, mainly involving the anterior cruciate ligament (ACL) and/or the medial collateral ligament (MCL) are some of the most common knee injuries. Objective: To evaluate the short to medium term results in the treatment of combined MCL and ACL injuries. Material and Method: Retrospective analysis including 14 patients (18 to 54 years old) treated in Orthopaedic and Trauma Department of SCJU Sibiu, between 2008-2012,  with combined MCL and ACL knee injuries.  Including criteria: combined MCL and ACL injuries. Excluding criteria: renal failure – dialysis, corticosteroids, politrauma, open knee lesions. Patients were evaluated clinically and using Tegner activity score, Lysholm knee scoring scale and IKDC knee score at the admission, 6 months and 1 year after injury. Results: Tagner activity score reveals  that 66,6% of patients  returned to their preinjury activity level. Lysholm average  score was medium in 100% of conservative treated patients after 1 year, and excellent/good in 66.6% of surgical treated  patients at 1 year. IKDC score was  also inferior in conservatively treated patients, compared to operated patients at 1 year. Conclusions: Most patients return to the level of activity before injury. The indication for surgical / conservative treatment depends on the grade of injury, the level of activity of the patient. It appears that patients with ACL reconstruction and MCL repair have better outcomes than the patients treated conservatively. There is low statistical significance in the conclusions due to the reduced number of patients.

validated
evolutive patterns of Ulcerative colitis Sava Cristina Tamara View abstract

evolutive patterns of Ulcerative colitis

First author: Sava Cristina Tamara

Coordinator(s): Dobru E. Daniela , Brusnic Olga

Keywords: ulcerative colitis evolutive patterns pancolitis proctitis

Background: Ulcerative colitis (UC), is an idiopathic chronic inflammatory disorder of colonic mucosa, which affects the rectum and rest of colon in a variable degree, and is characterized by relapsing and remitting course. Objective: The goal of this study is to determine demographic characteristics, clinical profile and evolutive patterns of UC, during January 2007-December 2011. Material and Method: A retrospective study of 114 patients admitted to the Gastroenterology Clinic Targu Mures between January 2007 and December 2011 with UC at onset.Studied parameters: gender, the enviroment arising, age at onset, extension and severity of UC at onset  in the period 2007-2011. Results: Results of the study show the predominance of disease in urban area-81(71%) cases, and 33(29%) in rural areas. Regarding sex distribution, it is more often seen in female patients(62) than male patients(52). The female/male ratio is 1,2/1. The age of diagnostic is more frequent in 30-39 years(29%). Frequent symptoms are diarrhea(80%), rectal bleedings(91%), and abdominal pain(62%). Regarding extension at onset, forms of proctitis are falling and forms of pancolitis are increasing. Regarding severity, mild to moderate forms are decreasing and severe forms are increasing. Conclusions: UC is a inflammatory chronic disease of the colon, characterized by periods of activity and remission. It mainly affects young adults, in urban areas. Both sex are affected, there is still a predominance in female subjects. Symptoms include diarrhea, rectal bleeding, abdominal pain, tenesmus, weight loss. During this five years there is an evolutionary trend toward large forms of disease. Mild, moderate disease are falling, and severe forms are increasing.

validated
Esophageal plasty with gastric tube Niculiseanu Stela View abstract

Esophageal plasty with gastric tube

First author: Niculiseanu Stela

Coauthors: Dan Anamaria , Redea Maria Andreea

Coordinator(s): Popa D , Rosca C

Keywords: Post-caustic stenosis. Esophageal cancer. Esophageal plasty.

Background: The esophageal cancer is one of the most aggressive forms of digestive cancer with a high postoperative mortality rate. Objective: To study the possibilities of esophageal plasty in benign and malignant esophageal stenosis. Material and Method: A retrospective study on 123 patients hospitalised between 2007 and 2011 in the first Surgical Clinic, County Clinical Hospital, Targu Mures. We have analyzed the annual esophageal cancer incidence by age group, treatment modalities, complications and postoperative mortality. Results: In the study group of 123 patients, 112 (91%) had esophageal neoplasm with different localizations, 11 (9%) had benign post caustic esophageal stenosis. The maximal incidence of the neoplastic pathology was in the V-VIth decades of life; the post-caustic was in the IIIrd decade. Squamous cancer was present in 34 (30%) patients and 21 (18%) had adenocarcinoma. Esophagectomy with esophageal plasty was possible in 52 (41.27%) cases. From the patients with malignant stenosis (48 (42.85%)) which received esophageal plasty with gastric tube:  7 patients (14.58) had the triple access McKewon; 11 (22.91%) had cervico-abdominal access with Akiyama stripping; in 14 (29.16%) cases it was used the cervico-abdominal access Orringer  method; and in 16 (33.33%) patients the Ivor – Lewis method thoraco-abdominal access. Palliative interventions were: feeding gastrostomy (13 patients), feeding jejunostomy (34) and exploratory laparotomy (17).   In the post-caustic esophageal stenosis patients, 3 had the Akiyama procedure, one benefited from Ivor – Lewis method, 4 patients had feeding jejunostomy, and 3 didn’t have surgical intervention. Anastamosis fistula occurred only in 4 cases (3.57%) of malignant esophageal stenosis and the postoperative mortality rate was 15%. Conclusions: The analyzed patients with malignant esophageal stenosis were diagnosed at advanced stages TNM (pT2; pT3; pT4). Esophageal plasty with gastric tube tends to become the main modality of esophageal reconstruction, being continuously associated with serious complications.

validated
Nutritional behavior of a medical student Fişuş Laura Ruxandra View abstract

Nutritional behavior of a medical student

First author: Fişuş Laura Ruxandra

Coordinator(s): Pasca Dorina Maria

Keywords: Nutrition and Dietetics nutritional health, fast food, cooked meal, sports nutritional health, fast food, cooked meal, sports

Background: Students who study this feald of expertese, acquire a nutritional base over the years, becoming increasingly aware that it is very important that they apply in their personal life, the saying „Mens sana in corpore sano”  in order to have  a healthy personal life and  to give maximum efficiency in their future careers, being a role model. The purpose of this work: the analysis of a correct nutritional behavior and its evolution, in case of the medical student as well as the time alloted for physical activity. Objective: Demostrating the evolution of the nutritional behavior at medical students. Material and Method: Psychological investigation, questionnaires distributed among general medicine students of Ist and final year. This questionnaire aimes two aspects: student nutrition and the amount of time alloted to physical activity. Results: From the data obtained on the base of the applied questionnaire  (165 subjects) it resulted that: 25% of those interviewed have 2 meals per day; 51,51% have 3 meals per day and the rest of 23,49% have more then 3 meals per day;Of those interviewed 18% have a certain type of diet;21,21% prefer fast food and the rest of 78,79% prefer a cooked meal;Time alloted to sports: 61,18% choose to dedicate a significant amount of time for practicing a sport.At the personal health evaluation 44,24% graded themselves with marks from 8 to 10 and the remaining 55,76% evaluated themselves with grades unde 8. Conclusions: Even if medical students have areas of their lives that have to be improved, they are more and more aware of the risks that an unbalanced life has.Therefor knowing the causes, the effects of an unbalanced life can be avoided.

validated
Odontogenic keratocyst- clinical, radiologic and therapeutic aspects Podolyak Monica Maria View abstract

Odontogenic keratocyst- clinical, radiologic and therapeutic aspects

First author: Podolyak Monica Maria

Coauthors: Anghel Diana Margareta

Coordinator(s): Iacob Alina , Mocan Simona

Keywords: Odontogenic keratocyst histology radiography surgery

Background: Odontogenic keratocyst (OKC) is a distructive developmental odontogenic jaw cyst characterized by a parakeratinized, stratified, squamous epithelial lining. The radiographic features are not pathognomonic and the presentation can be similar to other developmental cysts and tumors. Objective: The aim of the study is to make a differential diagnosis between OKC and other entities based on radiologic features and pathologic findings. Material and Method: Our study is based upon some cases of patients hospitalized at the Oral maxillo-facial surgery Clinic in Targu Mures, who suffered of large mandibular odontogenic cysts with long evolution . We followed the clinical aspects, radiologic features and pathologic findings. Results: The clinical and  radiologic features which appear in the OKC are not specific for this kind of disease, the only certainty in the diagnose is represented by the pathologic findings, which are first made from a biopsyc sample, may guide to a  subsequent surgery. Conclusions: The OKC is a relatively rare cystic tumor, with an important osteolytic evolution in the mandible, with a high risk of recurrence and possible malignization. Even if the clinical and radiologic features are impressive, when the cystic tumor reaches gigantic measures,pathologic findings are the only certain way to find out the diagnose.

validated
The treatment of anemia in Chronic Kidney Disease - is there a delay in progression? Bârsă D A View abstract

The treatment of anemia in Chronic Kidney Disease - is there a delay in progression?

First author: Bârsă D A

Coordinator(s): Gliga Mirela , Dogaru G

Keywords: chronic kidney disease renal anemia erythropoietin

Background: Although progress has been made in slowing the progression of chronic kidney disease to the final stage of evolution, the overall CKD prevalence is increasing in Romania and worldwide. Objective: The aim of the study is to analyze the effects of hemoglobin values on the progression of the CKD by monitoring serum creatinine and estimated glomerular filtration rate and to find correlations between other characteristics of the patients and the progression of the disease. Material and Method: We studied patients with CKD from the Nephrology departament from the County Hospital of Târgu-Mureș during 2010-2012. 67 patients fulfilled the inclusion criteria divided in two groups. EPO group: 33 pacients that were on treatment with erythropoietin and non-EPO group: 34 pacients that were on treatment only with iron. Parameters studied were: hemoglobin, hematocrit, mean corpuscular hemoglobin, serum iron, serum urea, serum creatinine, eGFR, Na+, K+, the value of serum proteins and albumin. The studied parameters were taken between two admissions a year apart. Results: Mean values ​​of the two admissions a year apart of the EPO group were: Hgb 10,2g/dl(±1,2)/10,4g/dl(±1,2), creatinine 3,2mg/dl(±1,2)/3,4mg/dl(±1,4), eGFR 20,7ml/min/1.73m2(±7,6)/21,1ml/min/1.73m2(±9,7). Mean values of the non-EPO group were: Hgb 10,9g/dl(±1)/10,6g/dl(±1,4), creatinine 2,1mg/dl(±1,1)/2,3mg/dl(±1,2), eGFR 38,6ml/min/1.73m2(±18,1)/33,8ml/min/1.73m2(±16,2). There were no significant differences between parameters in the same group after a year (p>0.05). Hgb, Htc, eGFR and creatinine values were significantly correlated in the two groups. Conclusions: Patients on treatment with EPO had an increase in the levels of the hemoglobin and hematocrit, while eGFR remained constant and serum urea decreased. The non-EPO group had a decrease in the levels of the hemoglobin, hematocrit and eGFR, while the MCH and serum urea increased, which indicates an aggravation of the CKD and possibly anemia. Administration of EPO has a beneficial effect in slowing the progression of CKD and has to be initiated early in all cases with renal secondary anemia.

validated
Evaluation of complications in children with nephrotic syndrome Racovan Laura Alexandra View abstract

Evaluation of complications in children with nephrotic syndrome

First author: Racovan Laura Alexandra

Coordinator(s): Duicu Carmen

Keywords: nephrotic syndrome children complications treatment corticosteroids

Background: A nephrotic syndrome is a clinic and biological entity that can be found in a number of renal diseases, clinically characterized by generalized edema and biologically by massive proteinuria,hypoalbuminemia and hyperlipidemia.The complications of this disease can be grouped in two categories: complications related with the disease and complications due to prolonged treatment with corticosteroids and immunosuppressive drugs. Objective: The purpose of the study is to evaluate the complications by gender,age and treatment in children with nephrotic syndrome. Material and Method: We conducted a retrospective observational analytic study on a group of 77 patients with the age between 0 - 17 years, hospitalized in the Pediatric Clinic II of Targu Mures being diagnosed with nephrotic syndrome. Results: The results showed that 39% presented complications, from these 47% were boys and 53% were girls.Concerning the age group 70% were between 0 - 5 years. 57% had just one complication and the remaining children presented 2,3 or 5 complications.Regarding the cause of the complications 30% had complications related with the disease and 47% due to the treatment. Conclusions: Less than half percent of the cases had complications. Most of the complications occur before the age of 6, without any differences between genders. Most of the children had just one complications, and complications occur mainly due to the treatment of and secondly due to the evolution of the disease.

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METABOLIC AND ENDOCRINE DISORDERS IN OVERWEIGHT AND OBESE FEMALE PATIENTS Siclitaru Andreea Mariana View abstract

METABOLIC AND ENDOCRINE DISORDERS IN OVERWEIGHT AND OBESE FEMALE PATIENTS

First author: Siclitaru Andreea Mariana

Coauthors: Stan M C , Simtea Manuela , Vladulescu Cristiana , Raileanu S

Coordinator(s): Raducanu-Lichiardopol Corina

Keywords: Obesity Women Metabolic risk factors Thyroid Menstrual disorders

Background: Recently it has been shown that adipose tissue not only stores lipids,but also secretes numerous hormones, adipose tissue being the largest endocrine organ,equivalent of 10 to 60% of  total weight of a person according to body composition and BMI. Objective: The aim of our study was to detect endocrine and metabolic disorders in obese and overweight female patients. Material and Method: We studied a group of 50 overweight and obese patients hospitalised in Endocrinology Clinic of Craiova County Clinical Emergency Hospital,  with mean BMI=33.12kg/m2(SD=4.45 kg/m2) and ages between 15 and 46 years with a mean of 31.98 years (SD=7.69 years). Results: 24% of patients had PCOS,18% of patients had oligomenorrheea,24% had polymenorrheea, 16% had amenorrheea,2% menometrorhagia and 2% underwent hysterectomy.Unlike other endocrine tissue, adipose mass is variable and may increase or decrease progressively depending on the age,dietary intake,physical activity,perinatal programming and genetic predisposition.Unopposed estrogen stimulation consequences – cystic and fibrocystic breast disorder was present in 32% of patients and uterine fibromatosis was present in 14% of patients,10% of patients had primary infertility and 4% had spontaneous abortions.Mean age at menarche was 12.06 years,44% of patients had thyroid disorders:18% hypothyroidism,34% non toxic goiters,diffuse or nodular.Metabolic disorders were represented by abnormal glucose levels(32%), hypercholesterolemia(54%),hyperuricemia(2%).32% of the patients were hypertensive Conclusions: Our study demonstrates that obese women have a wide variety of endocrine and metabolic disorders representing risk factors for premature cardiovascular disease, decreased fertility, thyroid, breast and uterine disorders. The main and easiest way to reduce these risks and improve metabolic and endocrine status is weight loss in case of overweight and obese patients, or maintaining a normal weight. This can be achieved by lifestyle intervention: healthy nutrition and physical activity.

validated
Preoperative and immediate postoperative ecographical comparative study of different types of mitral valvuloplasty procedures Graezer F View abstract

Preoperative and immediate postoperative ecographical comparative study of different types of mitral valvuloplasty procedures

First author: Graezer F

Coauthors: Balan R , Balog Ioana Diana , Gergelyfi T

Coordinator(s): Suciu H , Matei M

Keywords: Valvuloplasty Quadrangular Resection Ejection Fraction Pulmonary Artery Pressure

Background: Open heart valvuloplasty is a surgical procedure, performed on the valves of the heart, with the intention of correcting the defects of the valve without replacing the original tissue with a prosthetic valve. There are a number of valvuloplasty procedures used on the mitral valve to correct the stenosis, insufficiency and prolaps of the valve. At the Cardiovascular Surgery Clinic from Targu Mures the most commonly used mitral valvuloplasty procedures are the “Alfieri”-,  “Wooler” techniques, partial resection of the leaflets, sliding plasty, heartvalve chordal plasty and annuloplasty ring reinforcements. Objective: To evaluate the immediate ecographical outcomes of different valvuloplasty procedures and to compare them for efficacy. Material and Method: I have performed a retrospective, comparative, ecographical study on a number of 111 adult patients, in the period of 01.01.2010. and 31.12.2012. The study looks at the preoperative and immediate postoperative results of the different types of operations preformed. Results: 72.9% of the pacients were males, female gender was represented in 27.02%, the pacients were in average 58 years old. Preoperative ejection fraction (FE) was in average 50.28%, which declined to 45,69%, as expected, due to the traumatical nature of open-heart surgery. Immediate positive results were observed in the majority of pacients, in which the regurgitation stage was reduced by one or two stage steps compared to the original, pulmonary pressure was reduced too, from 48,34 mmHg to 35.7 mmHg in average. Conclusions: All of the studied procedures had a positive ecographical outcome, but the method of quadrangular or triangular posterior leaflet resection had the highest seuccessrate and the implanting of mitral annuloplasty rings increased the efficacy of the procedures.

validated
5 YEAR RETROSPECTIVE STUDY OF GASTRIC CANCER PATIENTS UNDERGOING SURGICAL TREATMENT AT THE 2ND SURGERY CLINIC, TARGU MURES Bartha Csilla- Katalin View abstract

5 YEAR RETROSPECTIVE STUDY OF GASTRIC CANCER PATIENTS UNDERGOING SURGICAL TREATMENT AT THE 2ND SURGERY CLINIC, TARGU MURES

First author: Bartha Csilla- Katalin

Coordinator(s): Bara T , Bara T Jr.

Keywords: gastric cancer surgical treatment retrospective study gastric resection gastric cancer of epithelial origin

Background: Gastric cancer is the second most frequently occurring gastrointestinal tumor disease. 95% of gastric cancers are of epithelial origin and the remaining 5% of either MALT lymphoma or sarcoma. The incidence of malignant gastric tumors increases with age and occurs most commonly between 50-70 years and more frequently in males. Due to early diagnosis of gastric cancer mortality in most countries is decreasing. Objective: 5 year retrospective study of surgical treatment applied to gastric cancer patients at the 2nd surgery clinic, Targu Mures. Material and Method: We performed a retrospective study based the observation sheets, surgery records and histopathological examination of a 253 patient with gastric cancer during the period of 1 January 2007- 31 December 2012. The acquired data was processed by the aid of an Excel table. Results: Out of the total number of examined patient 67.19% were male and 32.81% female patients. During surgery, the most commonly practiced procedure was gastric resection in 75%, out of which 29% were total gastrectomy and 46% subtotal (partial) gastrectomy. In the rest of the cases 8% of the patients were perfprmed feeding jejunostomy, 5% gastroenteric anastomosis and 12% exploratory laparotomy and biopsy. In 95% of the studied cases gastric cancer was epithelial origin and 5% of non-epithelial origin. Conclusions: Gastric cancer in the study group was more common among men (67,19%). 88% of the cases were operable. The most commonly occurring gastric cancer of epithelial origin is the one which is poorly differentiated.

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PERITONEAL CARCINOMATOSIS: FATALITY OR OPTIMISTIC ATTITUDE? Mihuti Alexandra Diana View abstract

PERITONEAL CARCINOMATOSIS: FATALITY OR OPTIMISTIC ATTITUDE?

First author: Mihuti Alexandra Diana

Coordinator(s): Dorin M

Keywords: peritoneal carcinomatosis peritonectomy intra-abdominal hyperthermia perfusion

Background: Peritoneal carcinomatosis is a final stage in the natural evolution of most abdominal neoplastic diseases, representing a major problem in cancer management. Objective: The study attempts to highlight the concept evolution, from fatality to optimistic attitude. Material and Method: We conducted a multicenter study over a period of 7 years (2006-2012), in which we examined the evolution of a total number of 220 patients with peritoneal carcinomatosis. Results: Despite the evolution of the means of investigation (imaging and laboratory), diagnosis represented an intraoperative surprise (only 10 patients- i.e. 4,55% - had a correct preoperative diagnosis). In most patients (90%), simple exploratory laparatomy was the only "therapeutic option", which indicates the lack of precise operative protocols as well as of teams without experience in complex cancer surgery. Only one patient followed a comprehensive treatment consisting of tumor removal, peritonectomy and intra-abdominal hyperthermia perfusion along with chemotherapy - representing the only patient survival over 2 years. Conclusions: 1. Previously considered an incurable, terminal disease, peritoneal carcinomatosis should be approached as a curable disease.2. Through this study, we demonstrate that the peritoneum as the first line of defense against carcinomatosis, acts as an organ and thus, locoregional treatment should be done by peritonectomy and hyperthermic perfusion with chemotherapy.3. The only patient in the group of 220 patients who was performed peritonectomy and intra-abdominal hyperthermic perfusion along with chemotherapy, survived for 2 years. He died from a regrettable mistake (neglected insulin-dependent diabetes, followed by diabetic coma) and not due to the underlying disease. It should be mentioned that this patient was declared inoperable in another surgical center in the country.

validated
DETERMINATION OF L-ASCORBIC ACID BY UV-VIS SPECTROSCOPY Stacescu Stefana View abstract

DETERMINATION OF L-ASCORBIC ACID BY UV-VIS SPECTROSCOPY

First author: Stacescu Stefana

Coordinator(s): Gaz Florea S A , Mircia Eleonora

Keywords: vitamin c ascorbic acid spectophotometry

Background: Vitamin C, also known as L-ascorbic acid, is an essential nutrient to humans. The vitamin protects the body from oxidative stress and prevents scurvy (a deficiency disease known since the time of the Crusades and which occurs in humans whose diet is deficient in fresh fruits and vegetables). Objective: It is a powerful water soluble antioxidant which protects low density lipoproteins from oxidation, reduces harmful oxidants in the stomach and promotes iron absorption. Material and Method: A significant quantity of plant tissue has been grinded and extracted with the necessary amount of solvent (in acidic medium – using H3PO4). The sample has been centrifuged and the aliquot has been recovered. The exact amount of ascorbic acid (assay) has been determined by UV-Vis spectrophotometry, using pure ascorbic acid as external standard. Results: Analyzing various samples from several plant tissues it has been observed a high quantity of vitamin C in fruits as kiwi, pineapple, lemon etc. Conclusions: Since its discovery, ascorbic acid has been one of the most popular chemical whose benefic effects are almost universally recognized. This popularity relies on common sense since ascorbic acid is associated with fruits and vegetables, known to be healthy.             As a conclusion vitamin C (from different plant tissues) has been extracted and assayed by a simple, fast and inexpensive method. All the results will be used in further inquiries.

validated
CORRELATION STUDY BETWEEN T SCORE AND SERUM LEVELS OF PARATHORMONE IN PATIENTS WITH HYPERPARATHYROIDISM Chiheri A V View abstract

CORRELATION STUDY BETWEEN T SCORE AND SERUM LEVELS OF PARATHORMONE IN PATIENTS WITH HYPERPARATHYROIDISM

First author: Chiheri A V

Coauthors: Morar Teodora Gabriela , Mateiciuc C , Cojocaru Valentina

Coordinator(s): Pascanu Maria Ionela

Keywords: correlation parathormone T score DEXA osteopenia

Background: Increase of the bone resorbtion is a frequent complication of hyperparathyroidism, caused by high levels of parathormone wich mobilizes the calcium stored in bone mass resulting in osteopenia or osteoporosis. The most sensitive method used in determination of bone mass resorbtion is DEXA osteodensitometry. Objective: The purpose of this study is to determine if serum levels of parathormone measured at a random moment are correlated with the severity of osteopenia or osteporosis in patients with hyperparathyroidism. Material and Method: Our study is a retrospective one and includes 21 patients from Endocrinology Clinic Targu-Mures, diagnosed with different forms of hyperparathyroidism. The statistical method used is correlation and regression test, in wich it was compared the T score from DEXA osteodensitometry and serum levels of parathormone. Results: The results at all three types of hyperparathyroidism, at all DEXA osteodensitometry sites, is over the target p value (0.05)for this test, so the positive hypotesis is not accepted. A possible explanation is the maintenance of cancellous bone volume along with cortical thinning as have been demonstrated by histomorphometric analysis of the bone biopsy specimen in primary hyperparathyroidism. The duration of the disease and other factors rather then the level of PTH could be more important in skeletal disease in hyperparathyroidism. Conclusions: In our group of patients with hyperparathyroidism there is no corellation between DEXA osteodensitometry T score and the values of the PTH level.

validated
The study of the effects of the recent alteration of the diagnostic criteria for ARDS Lapusan Carmen View abstract

The study of the effects of the recent alteration of the diagnostic criteria for ARDS

First author: Lapusan Carmen

Coordinator(s): Copotoiu Sanda Maria

Keywords: ARDS ALI SAPS

Background: First standard diagnostic cryteria of ARDS (acute respiratory distress syndrome) were established as part of European-American Agreement Conference in 1994, being acknowledged two separate entities: ALI (acute lung injury)and ARDS. Thanks to discussions regarding correctness and validity of initial definition, in 2011, at Berlin a new definition was made excluding ALI and dividing ARDS in three categories: severe, moderate and mild. Objective: To compare ARDS diagnosis according to the 1994 criteria as opposed to the diagnosis established according to the 2011 criteria Material and Method: It is an  obsevational retrospective study that used the medical data as found in the files of the critically ill patients admitted in the ICU between  1.01.2011 and 31.12.2011. The patients’ source: general surgery, internal medicine, orthopedy and neurosurgery . I have identified those wich fullfiled the diagnostic criteria for ARDS as well as those diagnosed with the newest criteria. I tried to outline the differences encuntered. Results: During  2011,  61 patients with acute  respiratory distress syndrome and nonassociated cardiac problems were admitted in the ICU. 21  of these fulfilled the ARDS diagnosis criteria , in 85.714% of the cases due to major trauma . Using the new criteria of diagnosis we observed an increasing number of cases of ARDS by 14.75percent  compared to older statistics.The survival rate increased by 23.809 %, while in the deceased, the mortality prediction according to the SAPS II score was unrealistically optimistic Conclusions: The 1994 definition led to subdiagnosis of this pathology,  further associated with high mortality. There was also an imbalance between the mortality prediction according to the SAPS II score and reality. Thoracic trauma was the most frequently encountered cause for ARDS.

validated
the onset of affective disorder in adolescents Niță C C View abstract

the onset of affective disorder in adolescents

First author: Niță C C

Coordinator(s): Racos Elisabeta , Buicu Gabriela

Keywords: Depression Adolescence Affective Disorders

Background: Adolescence (14-18 years) is characterized by a large number of changes. On the affective level, it seams that spectacular changes are taking place. Researchers described adolescence as beeing “the age of stress and emotional storms”. Affective disorder in adolescents has captured the full atention of the specialists because of the peculiar evolutive and treatment aspects of the disease. Objective: The aim of the study is the analysis of this complex pathology in regards with the characteristics of the illness onset. Material and Method: This is a retrospective study on a group of 46 patients hospitalized in the Clinic of Pediatric  Psychiatry Targu Mures, between 2010 -2012, with clear diagnosis of affective disorder. For the data processing we  used Micosoft Excel, Graph Pad and the Chi square test. Results: Of the 46 patients aged 12-18 years, 38 were female, 8 male. The majority came from urban areas and from broken families. Conclusions: Affective disorders in adolescent shows many similarities with those in adults. For example, an adolescent can recognize that he is depressed, but in most of the cases the debut can go ignored by the family, who very often consider depression or elation as natural stages of the crisis of adolescence. By analyzing the debut episode, in our study, we noted the tendency of affective disorders to manifest initially as an depressive episode. Most patients had 2 or 3 episodes which represents an evolutionary disease.

validated
Preparation of cytological smears from surgical specimens using fine needle aspiration Contac Anca Otilia View abstract

Preparation of cytological smears from surgical specimens using fine needle aspiration

First author: Contac Anca Otilia

Coordinator(s): Mezei T

Keywords: FNA (fine needle aspiration) Surgical pieces Cytological smears

Background: Fine needle aspiration (FNA) cytology is a well-established diagnostic method, used in many countries as a first-line diagnostic procedure. Diagnosis is based on scant material, therefore good quality smears need to be produced. We studied the usefullness of surgical specimens as a source of cytological material in order to investigate parameters that critically affect smear quality. Objective: The aim of this research is to study preparation conditions that alter smear quality and they prove to be of value for practicing FNA technique including smear preparation. Material and Method: We obtained cytological aspirates from 21 fresh biopsy specimens, from various sites: lung (9), lymph nodes (6), breast (6) and 4 aspirates from autopsy cases. Conventional FNA technique was used (23G needles, 10cc syringe, syringe holder, standard glass slides, one-step spread). Staining kits: Cytocolor and Hemacolor (Merck). Results: We obtained sufficient cellular quantity only from surgical specimens using FNA technique. Drying affects staining quality. Spreading influences both smear thickness and cellular integrity. Conclusions: Surgical specimens may be used as a source of cytological material to study preparation conditions that alter smear quality. Additionaly they proove to be of value for practicing FNA technique including smear preparation. Autopsy specimens offer less good quality material most probably owing to the autolysis of tissues. As with material obtained in vivo, cellular material is very sensible to drying and spreading technique.

validated
The role of alimentation and lifestyle in developing chronic diseases in diabetics and non-diabetics Oltean Claudia Bianca View abstract

The role of alimentation and lifestyle in developing chronic diseases in diabetics and non-diabetics

First author: Oltean Claudia Bianca

Coordinator(s): Voidăzan S

Keywords: diabetes chronic diseases alimentation physical activities

Background: Diabetes is an affection with major impact on the life quality of the patients, which if not well treated and followed the hygienic-dietary regime, leads to severe cardiovascular, neurological, renal and ocular complications. Objective: The aim of this study is to establish if there exists a correlation between lifestyle and alimentation in developing chronic diseases in diabetic persons compared to non-diabetic persons. Material and Method: This is a retrospective study involving 70 diabetics (38 women and 32 men) and 140 non-diabetics (the control group – 81 women and 59 men), in 2013. For both groups, I evaluated: age, abdominal circumference, blood sugar, presence of chronic diseases, type of ingested fat, recent modifications of the diet, use of basal aliments, if they eat between meals and if they are smokers or not. Results: The study showed the following differences (diabetics vs non-diabetics): average age: 57,09 (DS=12,09) vs 47,95 (DS=18,36); average abdominal circumference: 107,0 (DS=21,92) vs 90,11 (DS=17,93); average blood sugar: 138,0 (DS=44,64) vs 109,1 (DS= 31,34); the frequency of some chronic diseases: obesity: (53 patients out of 70, meaning 75,71% vs 10 persons out of 140, meaning 7,14%), high blood pressure: (37 patients out of 70, meaning 52,85% vs 37 persons out of 140, meaning 26,42%), ischemic heart disease: (23 patients out of 70, meaning 32,85% vs 16 persons out of 140, meaning 11,42%); smokers: 10 (14,28%) of the diabetics vs 80 (57,14%) of the non-diabetics; 9 (12,85%) of the diabetics never make physical activities, compared to 40 (28,57%) from the control group. Conclusions: Diabetics have a higher risk of developing other chronic diseases, they have to control their blood sugar more carefully, on the one hand by diet and on the other hand by physical activities, something that diabetics usually pay attention to. Instead, there are significantly less smokers among diabetics than in the control group.

validated
SAFETY AND QUALITY OF MEAT PRODUCTS IN BISTRITA-NASAUD Archiudean Cristina-Diana View abstract

SAFETY AND QUALITY OF MEAT PRODUCTS IN BISTRITA-NASAUD

First author: Archiudean Cristina-Diana

Coauthors: Boariu-Ruta Florina

Coordinator(s): Tarcea Monica

Keywords: food safety meat products nutrition

Background: Food safety is an important issue in preventive medicine, especially in prevention of food poisoning transmitted by meat products. Objective: To evaluate the parameters of quality and food safety of meat products marketed in Bistrita-Nasaud county in the last five years. Material and Method: We relied on physico-chemical analyses of samples of meat and meat products using standard laboratory techniques according to the methodology issued by the Ministry of Health. Results: Two thirds of the sample had inconsistent quality, namely: nutrient content reveals significant inadequate protein in 59% of samples, fat percentage in meat products is characterized by low ranging around 5% in 2008 and in last 3 years with an increasing trend over the standards; variation of food has an increasing humidity values by 2010 when 42.9% of all samples were inappropriate; development is inconsistent in nitrites, large variations recorded over the 5 years, only 14.9% inadequate samples in 2009 to 72.2% in 2011; inadequate bacteriological results were for about one third of the total number of samples and the Coliforms for about 2/3 of all samples; Salmonella pathogens and coagulase-positive Staphylococci did not surpass the limits requested by law. Conclusions: Food poisoning still represent a threat to public health, morbidity records an increasing trend in annual dynamics, which requires closer monitoring and prevention interventions.

validated
The role of CT scan in patients with liver cirrhosis Frîncu Laura Maria View abstract

The role of CT scan in patients with liver cirrhosis

First author: Frîncu Laura Maria

Coauthors: Rusu M , Măceşanu Adelina

Coordinator(s): Simu I

Keywords: liver cirrhosis hepatic carcinoma multislice CT angiography

Background: Liver cirrhosis is , unfortunately, a more and more frequent disease that has several complications. The most common causes are alcoholism, hepatitis B, C and steatosis. One of the most serious complications  is hepatic carcinoma (HCC) but we also should be aware of the lifethreating bleeding from esophageal varices. CT scan is a very useful method for monitoring these complications. Objective: The aim of this study is to highlight the importance of CT scan in diagnosis of hepatocarcinoma. Material and Method: A study of 263 CT scans in patients with liver cirrhosis performed during 2012 in Department of Radiology and Imaging from Emergency Clinical County Hospital was made. To evaluate the liver pathology multiphase CT angiography has been performed. It has been used a single slice CT for a number of 123 patients and  afterwards a multislice 64 channels CT for the other 140 patients. CT scans included unenhanced sequences followed by CT angiography with intravenous administration of 100 ml Optiray at a 2.5- 3 ml per second flow rate. Acquisitions were performed in arterial phase (25 seconds after the start of injection) followed by portovenous phase (60 seconds after the start of injection). For multislice CT scans it has been used contrast bolus tracking. The images were completed with multiplanar reconstructions Results: For the 263 patients examined age range was  between 29 and 81 years. 48 patients  were found suggestive for hepatic carcinoma.29 were male patients and the others 19 were female. Conclusions: The CT scan is a very useful method for the assessment of  hepatic tumors in patients with liver cirrhosis because liver biopsy for HCC has a high risk of bleeding or tumor dissemination.

validated
Therapeutic abortion: correlation between ultrasound, laboratory and pathology Galfi Esztella-Eva View abstract

Therapeutic abortion: correlation between ultrasound, laboratory and pathology

First author: Galfi Esztella-Eva

Coordinator(s): Molnar Varlam C

Keywords: therapeutic abortion maternal diseases fetal malformation

Background: The majority of therapeutic terminations of pregnancy occur for maternal diseases or fetal reasons. Objective: To find a correlation between maternal data (age, gestation, parity, comorbidity, age of pregnancy), maternal diseases and fetal abnormalities wich lead to therapeutic abortion. Material and Method: A retrospective study based on 111 hospital case records of therapeutic abortions during 2008-2012 at Obstetrics and Gynecology Department, Emergency County Hospital Targu-Mures. Results: From the examinated cases only 8.1% are under age of 18, 73.8% between 18-35 years and 18.1% over 35 years.Maternal disease preexisting pregnancy causes 18.9% of therapeutic abortions, the remaining 81.9% had no associated disease. The abortion indications: maternal diseases 9%, complex situs malformations incompatible with life 49.55%, 11.7% ruptured of membranes due oligoanamnios , pregnancy stopped in evolution 23.45% and Down Syndrome 6.3%. Conclusions: To have an acceptable diagnosis ultrasound and laboratory tests are necessary wich trough pathological anatomy analysis are disproven or confirmed.

validated
EVALUATION OF KINDERGARTEN CHILDREN ON NUTRITION AND LIFESTYLE Rus Victoria Ancuta View abstract

EVALUATION OF KINDERGARTEN CHILDREN ON NUTRITION AND LIFESTYLE

First author: Rus Victoria Ancuta

Coauthors: Dobrin Cristina Claudia

Coordinator(s): Monica Tarcea

Keywords: food habits, children, nutrition, health

Objective: This study is aimed at evaluating the characteristics of food consumption and lifestyle in a group of preschool children from the “Omega” Studying Institute in Tg. Mures. Material and Method: We designed a questionnaire with 33 questions that was distributed to all parents who attended meetings at the beginning of the school year; in the questionnaire we evaluated by targeted responses children’s habits and attitudes towards food and personal lifestyle. The sample represented all families with children enrolled in kindergarten. A total of 50 families were present at meetings; the response rate is 80%. Results: The monitored group consisted of 50 children aged 3 to 6 years (average of 5.23 years), predominantly male (61.2%), children from kindergarten within the "Omega" Studying Institute in Tg. Mures. The group of parents surveyed consisted of 50 people aged between 20 and 44. In the first 22 questions of the questionnaire applied we collected personal data about parents and the family's eating habits. The data was interpreted statistically based on the most important questions that had been completed correctly. We watched the children’s food habits and the nutritional value of their menus; the most important questions were represented in graphs. Conclusions: After 6 months of monitoring and teaching kindergarten children, we observed their increasing preference for vegetables, fruits, whole foods, new dishes in their menu, etc. We would further propose that this curriculum be found in other kindergartens, as an education for a healthy diet in young chindren is very important. The curriculum can also can be adapted for schools, by taking into account age specificities.

validated
ASPECTS OF SOCIAL anxiety among students from the university center Targu Mures Savulescu O S View abstract

ASPECTS OF SOCIAL anxiety among students from the university center Targu Mures

First author: Savulescu O S

Coordinator(s): Nirestean A , Buicu Gabriela

Keywords: social anxiety self-esteem students Rosenberg 1965 HAM-A

Objective: The aim of the study is to investigate the level of anxiety at the students during the courses and before session. We assume that the approaching of the session it's an incerasing factor for anxiety aand there is an indirect correlation between anxiety and self-esteem and also we suppose there is a difference between the anxiety level according to the year of college. Material and Method: 60 students participated at the realisation of the study, the prospective research took place in 2 phases: december 2012 and january 2013. The participants completed questionnaires for the assessment of anxiety states - Hamilton Anxiety Rating Scale(HAM-A) and for the self-esteem evaluation - Rosenberg Self-Esteem Scale 1965(SES). Results: There was a greater increase of anxiety in the fifth year group compared to the first year group and also a greater decease on the SES in the fifth year group. Conclusions: The fifth year group showed an increased anxiety and decreased self-esteem comparatively to the first year group which may be due to the accumulation of stress and real life experiences in the previous years of college.

validated
SYNTAX Score and Global Atherosclerotic Burden in Acute ST-segment Elevation Myocardial Infarction Somkereki Cristina View abstract

SYNTAX Score and Global Atherosclerotic Burden in Acute ST-segment Elevation Myocardial Infarction

First author: Somkereki Cristina

Coauthors: Hadadi Laszlo , Mihaela Ispas

Coordinator(s): Dobreanu D , Ţilea I

Keywords: SYNTAX score Intima-media-thickness ST-segment elevation myocardial infarction primary percutaneous coronary intervention global atherosclerotic burden

Background: Intima-media thickness of the common carotid artery (IMT) is considered a surrogate marker of global atherosclerotic burden and predicts the incidence of acute cardiovascular events in the general population. Recently, a significant association was found between IMT and the complexity of coronary atherosclerotic lesions, described by the SYNTAX score (SXS). This relationship has not been studied in patients with acute ST-segment elevation myocardial infarction (STEMI). A higher global atherosclerotic burden could partially explain the worse clinical outcomes observed in case of STEMI and complex coronary artery disease. Objective: to evaluate the relationship between SXS and IMT in patients with STEMI, treated by primary percutaneous coronary intervention (pPCI). Material and Method: a prospective clinical study was performed, including all the patients admitted for pPCI during a one-year period. SXS was calculated with a dedicated on-line software. IMT was measured using B-mode echography in a part of this population. Mean IMT values of the patient tertiles with low, medium and high scores were statistically compared. Correlation analysis was performed between the absolute SXS and IMT values. Results: IMT was measured in 88 of the 137 patients originally enrolled. The mean IMT values were significantly increased in the high SXS tertile (0.96±0.22mm in low vs. 0.99±0.22mm in medium vs. 1.12±0.24mm in high score patients, p=0.02). A weak, but significant positive correlation was found between the absolute IMT and SXS values (r=0.21; p=0.04). Conclusions: Complex coronary artery disease is associated with increased carotid IMT in STEMI patients. The impact of higher atherosclerotic burden on the clinical outcomes of this population requires further research.

validated
Prevalence and correlation between clinical and endoscopic appearance of Helicobacter Pylori infection in children with chronic gastritis Stancu Oana Florina View abstract

Prevalence and correlation between clinical and endoscopic appearance of Helicobacter Pylori infection in children with chronic gastritis

First author: Stancu Oana Florina

Coordinator(s): Marginean Oana

Keywords: Helicobacter Pylori chronic gastritis “paving stone” epigastric pain

Background: Infection with Helicobacter Pylori is a higly topical issue in pediatric practice because it is one of the most important etiological agent of infections in the field of gastroenterology  wordwild. Objective: The purpose of this study was to assess the prevalence of Helicobacter Pylori infection in children with chronic gastritis and at the same time to analyze the correlation between clinical manifestations and  endoscopic appearance in  Helicobacter pylori infection. Material and Method: Prospective study (based on questionnaires, observation sheets, endoscopy) between January 2012 and January 2013, on a group of  92 children between 0-18 years, (mean age 12.4 years) of which 70 girls and 22 boys, all admitted in Gastroenterology Department of 1st  Pediatric Clinic from Targu-Mures. The H.Pylori presence was established using the biopsy  and the rapid urease test. Results: The highest prevalence was found on females (76%) compared with males (24%). Also, based on the variable “age” the  prevalence was at the age group 0-3 years (8.7%), the group 7-13 (44.6%) and the group 14-18 years (46.7%).Symptomatic patients in the study group was represented by: epigastric pain (96.7%), nocturnal pain (73.9), vomiting (43.5%),heartburn (29.3) and weigh loss (10.9%). The endoscopy examination revealed that the most changes occured in the antrum (78%) of which 39,13% had  nodular gastritis,  37,9%  had the specific layout of” paving stone” while the rest pacients  had other types of changes. Analyzing  the symptoms, we concluded that there is a statistical significance between clinical sings and  the presence of  H.pylori infection (p<0.001). Conclusions: The prevalence of H.Pylori infection increases with age and it is more common in females  between 13-18 years and the most common frequently was epigastric pain. Nodular gastritis and “paving stone” layout  are the most common endoscopic appearance in children. Helicobacter Pylori is the most important etiological factor in the development of  chronic gastritis in childhood.

validated
Assessment of the relationship between leptin, adiponectin and anthropometric parameters in obese children Mărginean Maria Oana View abstract

Assessment of the relationship between leptin, adiponectin and anthropometric parameters in obese children

First author: Mărginean Maria Oana

Coauthors: Man Lidia , Fanfareţ I S

Coordinator(s): Pitea Ana Maria

Keywords: leptin adiponectin anthropometric parameters obese children

Background: Obesity is a nutritional state disorder in which, although the leptin level is high, pacients develop resistency to its action. Leptin is a peptide hormone, involved in long-term weight regulation; its increase causes appetite loss and energy consumption.Adiponectin, a hormone which increases insulin sensitivity, plays an important role in the stimulation of fatty-acid oxidation, prevents atherosclerosis and decreases in weight gain. Objective: The evaluation of the seric levels of leptin and adiponectin in obese children and their relation with anthropomeric indicators and biochemical parameters. Material and Method: We conducted a prospective study which includes 39 obese children and 51 children with a normal body weight, evaluated in the Pediatric Clinic nr. 1 in a period of 9 months: 01.07.2012-01.03.2013. The seric levels of leptin and adiponectin have been determined, looking for their corelation with age, body mass index (BMI), triceps skin fold (TSF), mid-upper arm circumference (MUAC), as well as metabolic parameters (glycemia, cholesterol, triglycerides). Results: The lot consists of pacients with ages between 1 and 18 years, with an average age of 10,43±0,74 years in the study group (21 girls and 18 boys) and 8,38±0,63 years in the control group (26 girls and 25 boys). The leptin level was 3,95±0,72 ng/ml in the control group and 17,2±1,41 ng/ml in the obese children. The adiponectin level was 15542,39±816,86 ng/ml in the control group and 10939,78±1024,82 ng/ml in the obese children, with significant differences between the two groups (p<0,0001 and p=0,0006, respectively). Nevertheless, we have found significant corelations between the adipokine levels and BMI, TSF and MUAC. Conclusions: Leptin levels increase in obese children, positively corelated with anthropomeric indicators, as a result of leptin resistance, which is caused by a defective functioning of the leptin receptors located in the hypothalamus. Low adiponectin levels suggest that raised adiposity can lead to cardiovascular diseases in children as well.

validated
CARDIOVASCULAR DISEASE AND RISK FACTORS IN CHRONIC KIDNEY DISEASE Capreanu P C View abstract

CARDIOVASCULAR DISEASE AND RISK FACTORS IN CHRONIC KIDNEY DISEASE

First author: Capreanu P C

Coauthors: Tarta D

Coordinator(s): Dogaru G , Caldararu Carmen

Keywords: cardiovascular CKD nephrology

Background: Cardiovascular (CVS) disease is the main cause of morbidity and mortality in end-stage renal disease. Identification of the cardiovascular risk factors will show us which are the therapeutic measures that must be taken earlier to improve cardiovascular outcome in chronic kidney disease patients. Objective: The aim of the study is to quantify the prevalence of cardiovascular disease and the relationship with cardiovascular risk factors in patients with chronic kidney disease (CKD). Material and Method: 469 patients admitted in the Nephrology Department of County Clinic Hospital between 2009-2011 were retrospectively reviewed. Demographic characteristics, clinical profiles and laboratory test results were noted. Chronic kidney disease was defined as an estimated GFR of less than 60 mL/min per 1.73 m2 based on the abbreviated Modification of Diet in Renal Disease formula (MDRD). Possible cardiovascular risk factors were compared for the patients with or without cardiovascular disease and for CKD stages 3, 4 and 5. Results: A total of 214 chronic kidney disease patients who were not on dialysis were included in the study. The prevalence or cardiovascular disease was 65,42%. In cardiovascular disease patients age, body mass index, systolic and diastolic blood pressure, pulse pressure were significantly higher comparatively with patients without CVS disease (p<0,05). Hemoglobin, total cholesterol and proteinuria had values significantly higher for patients with CKD stage 5. Conclusions: Traditional cardiovascular risk factors have a high prevalence in chronic kidney disease and can explain the incidence of cardiovascular disease.

validated
METABOLIC SYNDROME AND THE RISK FOR CHRONIC KIDNEY DISEASE Nicolae V C View abstract

METABOLIC SYNDROME AND THE RISK FOR CHRONIC KIDNEY DISEASE

First author: Nicolae V C

Coauthors: Carlan Otilia

Coordinator(s): Dogaru G , Caldararu Carmen

Keywords: CKD MS nephrology

Background: The metabolic syndrome and chronic kidney disease are nowadays public health problems with increasing prevalence. The relationship between the diseases is not completely understood. Objective: To examine the prevalence of chronic kidney disease (CKD) in patients with metabolic syndrome (MS) and the relationship between metabolic syndrome and chronic kidney disease. Material and Method: Retrospective study on 583 patients admitted in the Department of Nephrology of the County Clinical Hospital Targu Mures. Metabolic syndrome was diagnosed in conformity with International Diabetes Federation criteria 2005. Chronic kidney disease was defined as an estimated glomerular filtration rate <60 ml/min per 1.73 m2 Results: The prevalence of MS was 26,24%. Eighty six of MS patients were females (56,20%). Chronic kidney disease was found in 214 cases. The prevalence of CKD was higher in MS patients (51,63 % vs 40,03%, p < 0,05, OR = 1,59 with a RR = 1,37, 95% confidence interval 1,05-1,78) Our study demonstrated a graded relationship between the number of MS components and the prevalence of CKD Conclusions: Our study identified a strong semnificative relationship between metabolic syndrome and chronic kidney disease.

validated
Developing an optimal Solid phase extraction method of human hepcidine peptide and quantify it with the help of a LC-nano-chip tandem-MS system Ion V View abstract

Developing an optimal Solid phase extraction method of human hepcidine peptide and quantify it with the help of a LC-nano-chip tandem-MS system

First author: Ion V

Coauthors: Virginie Houbart , Marianne Fillet

Coordinator(s): Curticapean A

Keywords: Hepcidine Solid phase extraction Liquid chromatography Nano-chip-technology Mass spectrometry

Background: Hepcidine, a 25.amino-acid peptide, an important clinical marker, is secreted by the liver in response to iron loading and inflammatory events. Understanding the fully physiological role of the peptide, triggered the events which led to proper quantification methods such as ELISA methods,  LC tandem nano-MS based methods and others. Objective: Isolation of the hepcidine in maximum amount from human plasma and serum, by changing different “SPE” solid phases types and extraction protocols was the main goal. Material and Method: “Oasis” MCX and WCX sorbents in the shape of 96 well plates were used for the isolation of the peptide from human plasma and serum. Vacuum manifold was used to control the speed in the SPE process. An “Agilent 1100 series” LC system equiped with two pumps- a “micro” quaternary pump and a “nano” quaternary pump was linked with an “Agilent 6340 series”  ion trap Mass spectrometer having a nano chip interface separation module. This minituarised system was used for the quantification of the peptide. Results: By changing the type of the sorbents (MCX or WCX), the charge of the peptide, or by modifying the proportions of solvents used in the washing and elution steps of the SPE process, an ideal formula was discovered to maximise the amount of peptide isolated from the plasma and serum. WCX sorbents with a carboxilic group proved to be more efficient in the extraction of the peptide then MCX. Also a 70% methanol-water mixture as washing solvent, and Acetonitrile 90, H2O 10, Trifluor acetic acid 1 as elution solvent were responsible for the extraction of the largest amount of peptide from plasma and also from human serum. Conclusions: Even by trying different sorbents, and finding an optimal formula for the extraction of the peptide, in such amounts that can be used in the quantification process it is hard to obtain fully reproducibillity

validated
Candidal colonization, strain diversity and salivary pH among subjects with type 2 diabetes mellitus Muresan Andreea View abstract

Candidal colonization, strain diversity and salivary pH among subjects with type 2 diabetes mellitus

First author: Muresan Andreea

Coauthors: Csosz Cristina

Coordinator(s): Man A , Monea Adriana

Keywords: Candida Diabetes mellitus Saivary PH

Background: Oral candidiasis is a common opportunistic infection of the oral cavity. It’s incidence varies depending on certain predisposing factors, such as diabetes mellitus, a metabolic disease with a high prevalence and an increasing incidence in the general population. Objective: Evaluation of prevalence of Candida in the oral cavity of diabetics, and of the influence of local and systemic factors on candidal colonization. Material and Method: 41 subjects with type 2 diabetes mellitus and 35 healthy subjects were included in the study. From each individual oral rinse samples were taken, inoculated on Sabouraud dextrose agar with chloramphenicol plate and incubated at 37 degrees for 24 h. The growth of Candida was identified by smooth, white or creamy colored buttery colonies. The candidal isolates were identified and density was expressed in the number of colony-forming units (CFU) per mL of oral rinse. Salivary pH was determined using pH strips. The relationship between specific host factors and candidal colonization was also investigated. Results: The mean values of CFU of Candida found in diabetics were significantly higher than in healthy controls.Candida albicans was the most frequently isolated species, but diabetics had a variety of other candidal species present. Salivary pH was significantly decreased in diabetics versus controls. Although there was a significantpositive correlation between glycemic control and candidal colonization in type2 diabetics, there was a negative correlation between salivary pH and candidal carriage in type 2 diabetics. Conclusions: Diabetic patients not only had a higher candidal carriage rate, but also a variety of candidal species. Oral candidal colonization was significantly associated with glycemic control and salivary pH.

validated
Risk factors for Extended -Spectrum Beta-Lactamase Escherichia coli resistance in patients with urinary tract infections Botoncea M View abstract

Risk factors for Extended -Spectrum Beta-Lactamase Escherichia coli resistance in patients with urinary tract infections

First author: Botoncea M

Coauthors: Burus Larisa

Coordinator(s): Dogaru G , Caldararu Carmen

Keywords: Urinary tract infections Resistance Risk factors Diabetes

Background: Urinary tract infections are a  common reason for hospitalization in general practice. Infections caused by ESBL E. coli are of clinical concern because few antimicrobials are available as therapeutic option and because they are associated with prolonged hospitalization, high costs and mortality. Objective: The aim of the study was to assess the prevalence of ESBL E. coli and the risk factors for ESBL E. coli resistance in hospitalized patients with urinary tract infections. Material and Method: We conducted a retrospective study on urinary tract infections diagnosed in patients hospitalized in the Nephrology Department of County Clinic Hospital between 2010-2011. Data on antimicrobial resistance, antimicrobial use and possible risk factors for UTI were collected. The following risk factors were evaluated in the study: obesity, kidney stones, chronic kidney disease, diabetes, hypertension, cancer, age over 50. Results: Of the 559 patients reviewed only 35 were included in the study meeting the criteria: urinary tract infections with ESBL E. coli (24.30%). Kidney stones was correlated to ESBL E. coli resistance to cephalosporins (odds ratio 0.01528, p=0.0002, 95% confidence interval: 0.0007838 to 0.2977), quinolones (odds ratio 216.33 , p=0.0001, 95% confidence interval: 7.756 to 6034.1) and diabetes was correlated to ESBL E. coli resistance to aminoglycosides (OR 7.389, p=0.0196, 95% confidence interval: 1.441 to 37.899). Aged over 50 was correlated to ESBL E. coli resistance to aminoglycosides (OR=1.389, p=0.0249, 95% CI: 0.02928 to 0.6588 ) and carbapenems (OR=7.778, P=0.0328, 95% CI: 1.373 to 44.058). Conclusions: Patients admitted to Nephrology department carry risk factors for harboring resistant bacteria.

validated
NUtritional evaluation of chemotherapy pacients Oancea Oana View abstract

NUtritional evaluation of chemotherapy pacients

First author: Oancea Oana

Coauthors: Todea Andreea

Coordinator(s): Farr Ana-Maria

Keywords: chemotherapy side effects nutrition interaction hygieno-dietary plan

Objective: The purpose of this research was to analyse the impact of chemotherapy side effects on the nutritional status of the pacient, to establish the hygieno-dietary plan ment to diminish these effects,and also to analyse the pacients perception and knowledge  towards the relation between chemotherapy medication and nutrition. Material and Method: The study included a number of 80 pacients diagnosed with cancer and undergoing chemotherapy.I made one questionnaires with 28 questions. The questions were answered by 30 pacients from the oncology hospital from Tirgu Mures and 50 pacients from the oncology institute from Bucharest. Through the questionaire i found out about the dietary plan evolution of the pacient, the effects of chemotherapy and the pacients involvement,training and knowledge concerning the relation between chemotherapy medication and nutrition. Results: The percentage of side effects that can be diminished through appropriate nutrition was: 42% - vomiting, nausea, weight loss, change of taste; 9% - dysphagia, anemia;9% - diarrhea;11%- constipation;9% - fluid retention.76% of the pacients admited that they didn't receive no nutritional protocol to follow durring the chemotherapy sessions, and 24% admited that they received some information about a nutritional protocol, but they did not follow it. All of the interviewed pacients condsidered that this kind of therapy modified their nutrition habbits and they claimed that they were not told to seek guidance from a nutritionist. 66% of the interviewed pacients modified their diet and nutrition habbits instinctively and 34% followed dietary regimes recomended by unauthorised persons. I created a dietary plan with the purpose of diminishing the side effects of chemotherapy and 71% of the pacients found it easy to follow and 29% of the pacients found it costly. Conclusions: The pacients are not informed enough concerning nutrition and they do not understand the importance and benefit of an appropriate nutrition when they start chemotherapy.

validated
TOTAL THYROIDECTOMY WITH SMALL JAW LIGASURE Nistor ( Ignat) Mariana-Iuliana View abstract

TOTAL THYROIDECTOMY WITH SMALL JAW LIGASURE

First author: Nistor ( Ignat) Mariana-Iuliana

Coauthors: Cristea(Boier) Monica , Taran(Zeces) Claudia

Coordinator(s): Molnar C , Pantiru A

Keywords: Thyroid LigaSure Small Jaw Total thyroidectomy

Background: More than a millennium after the first total ablation of the thyroid gland (958 - Abulcasis), thyroid surgery underwent important changes in surgical technique. Appearance of LigaSure  Small Jaw, in surgical arsenal,  bring intraoperative and postoperative benefits. Objective: The paper aims to highlight the value of LigaSure Small Jaw forceps in total thyroidectomy without ligatures. Material and Method: LigaSure Device Small Jaw efficiency concerning tactical and operative technique on a total of 10 consecutive cases of total thyroidectomy performed Surgical Clinic I Târgu  Mureș. Followed parameters were: efficiency of haemostasis, shorter operating time, immediate postoperative complications. Results: Using LigaSure Small Jaw forceps contributes to a better intraoperative hemostasis (no peroperator bleeding), reduces operating time by about 26 minutes compared to traditional surgery, duration of anesthesia, the amount of analgesia and postoperative complications decreases (2 cases). Conclusions: LigaSure Small Jaw instrument is a reliable and easy to use alternative in the hands of a experienced surgeon in thyroid surgery.

validated
450 Steps- A fitness Assessment Study Costin Mădălina View abstract

450 Steps- A fitness Assessment Study

First author: Costin Mădălina

Coordinator(s): Pop Raluca

Keywords: Harvard Step Test Fitness Score Anthropometric Parameters

Background: According to the Eurobarometer (2010), 60% of EU citizens say that they either never practice sport or only do so rarely. Also, 61% of 15-24 year-olds practice sport at least once a week. Objective: The main objective was to determine the fitness score (FS). Secondary objectives consisted in the evaluation of anthropometric and general cardiac parameters, common food habits and possible corelations with the results of the Harvard step test. Material and Method: The type of study is cross-sectional. The target population is represented by the students of the UMF Tîrgu Mureş. The convenience sample consisted of 57 students. The subjects filled in a questionnaire and underwent the Harvard step test. The statistical analysis was performed using M.O. Excel and GraphPad. Results: The subjects having at least 3 meals/day have statistically significant better results than those having less than 3 meals/day (p=0,01). Furthermore, people who never eat breakfast have significantly lower FS values (p=0,04). Smoking significantly decreases the FS values (p=0,02); also, none of the persons with good FS (28.57%) was a smoker. An important aspect to emphasize is that only 8,9% of subjects consume the recommended number of fruit and vegetable servings/day. For the subjects respecting the normal physical activity frequency, its difficulty didn’t influence the value of the FS (p=0,57). None of the other analysed parameters had a significant influence on the FS. Conclusions: Physical activity frequency does not influence the fitness score for this sample. In order to improve their FS, students should respect the general nutritional recommendations. The results cannot be extrapolated to the target population due to the sample size. By surveying volunteers, there is the chance that only the most fitted students attended. As future perspective we consider randomized trial to assess the fitness score and to evaluate the need for extending the mandatory sport classes.

validated
Factors associated with bilateral pulmonary thrombembolism Guşu Rodiana View abstract

Factors associated with bilateral pulmonary thrombembolism

First author: Guşu Rodiana

Coauthors: Marian Cosmina , Miler Georgiana , Bârsan Ioana

Coordinator(s): Sîrbu Ileana Voichița , Opriș Mihaela

Keywords: bilateral pulmonary thrombembolism deep venous thrombosis ECG changes

Background: Pulmonary thrombembolism (PTE) is a blockage of an artery in the lungs by a blood clot, commonly originating in the lower extremities (deep venous thrombosis – DVT). Objective: The aim of this study is to identify the factors determining bilateral PTE and changes that occur more often in paraclinical explorations in bilateral rather than in unilateral PTE. Material and Method: A retrospective study was performed on 65 patients with acute PTE admitted in Cardiology Clinic I from Tîrgu Mureș between 2011-2012. For diagnosis CT-scan of chest done with contrast material and venous ultrasound were used. Results: We formed two groups: the first group including 17 patients diagnosed with unilateral PTE and the second group including 38 patients with bilateral PTE. The distribution by gender was 28 (43%) females and 37 males (57%), with a mean age of 65 years. In the first group three patients had DVT and 14 other risk factors compared to the second group where 18 cases had DVT and 20 other risk factors. No CT-scan was performed on 10 pacients because of the increased creatinin values, iodine allergy, pregnancy or unique kidney. For statistical analysis .X² test was used with a result of p=0,03. ECG changes (S1Q3T3, negative T waves in V1-V4 derivations, Right Bundle Branch Block) appeared in 29 cases in the second group and in 5 cases in the first group (p=0,0009). During the winter there were two times more diagnosed cases (27) than in the spring (14). Summer was the season with the lowest incidence of PTE (7 cases). Conclusions: Pacients with bilateral pulmonary thrombembolism had DVT when they were diagnosed. ECG changes occur in bilateral PTE rather than in monolateral PTE. Winter is the season with the highest incidence of PTE.

validated
TUBERCULOSIS ASSOCIATED WITH HIV/AIDS IN MURES COUNTY (2004 – 2012) Popa Oxana View abstract

TUBERCULOSIS ASSOCIATED WITH HIV/AIDS IN MURES COUNTY (2004 – 2012)

First author: Popa Oxana

Coauthors: Smochină Alina

Coordinator(s): Gabriela Jimborean

Keywords: Tuberculosis HIV TB in patients with HIV/AIDS

Background: Human immunodeficiency viral (HIV) infection is a major risk factor for tuberculosis (TB). The growth of HIV epidemic has determined a dramatic rise of new TB cases. Severe immunosuppression produces marked changes in location, clinical evolution, radiographic presentation and prognostic of TB. Although TB is a leading preventable cause of death among HIV patients, at least one in four deaths can be attributed to TB. Objective: To assess the epidemiology, clinical status and evolution of patients with TB and HIV co-infection. Material and Method: We performed a retrospective study on patients with TB and HIV infection, between 2004 - 2012 in Mureş County. Results: The study group included 67 patients with TB and HIV infection (33 males, 34 females, 58.2% from rural areas). Most of the patients lived in very poor conditions and overcrowded domiciles (1-2 rooms for 4-12 people). At the time of the diagnosis 22.38% were HIV positive and 77.62% of these had AIDS (82.69% very advanced AIDS: CD4 cell<200/mm3). 77.61% of the patients had pulmonary TB, 5.97% extra-pulmonary TB, 16.41% both. 20 patients (29.85%) developed complications, more common being pleural effusion (7 cases) and miliary TB (4 cases). The source of TB remained unidentified in 79.1% of the cases. 26.85% had more than one episode of TB; 52.23% required prolonged treatment (>6 months). Drug-resistant TB was registered among 22 patients. We noticed a high rate of fatality: 44.77%. Conclusions: Most of the patients suffering with TB and HIV infection are from rural areas and live in very poor condition. Patients with severe AIDS are prone to develop severe TB. TB associated with HIV/AIDS is more likely to have complications, relapses, treatment failure, drug resistance and a high rate of fatality.

validated
The INCIDENCE OF GASTROINTESTINAL DISORDERS DIAGNOSED IN THE EMERGENCY ROOM BY GASTROSCOPY Demeny Andrea View abstract

The INCIDENCE OF GASTROINTESTINAL DISORDERS DIAGNOSED IN THE EMERGENCY ROOM BY GASTROSCOPY

First author: Demeny Andrea

Coauthors: Mitre Cristina , Munteanu L

Coordinator(s): Simona Bataga

Keywords: gastroscopy emergency room UGIB

Background: The upper GI endoscopy is an investigation that can radically change a presumptive diagnosis, particularly in emergencies, where it can provide an accurate final diagnosis in most cases. Objective: Proving the clinical utility of gastroscopy in the diagnosis of gastrointestinal diseases. Material and Method: The retrospective study was conducted between 28.01.2013 -23.02.2013, after endoscopy in the SMURD emergency service was available. It included  89 patients who underwent upper endoscopy  in the emergency room, out of which 56 were men, with a mean age of 59 years. Of these, 9 were known with digestive disorders presenting a previous acute episode. The remaining patients had no history of gastrointestinal disease. Chief complaints for which gastroscopy was performed were abdominal pain, cramps and / or upper gastrointestinal bleeding(UGIB). Endoscopy was performed using a Pentax endoscope in the SMURD service. Results: Most of the examined patients had been diagnosed with stomach diseases: gastritis (25%), duodenal diseases: bulbar / antral ulcer (20%), or diseases of the esophagus: reflux esophagitis (22%), esophageal varices (15%), HH (13%). 60 patients only had abdominal pain and in 29 patients it was associated with UGIB. In 9 cases the endoscopy did not detect the cause of the bleeding or the pain, requiring further investigation. Of the 29 patients with UGIB, the cause of bleeding was: bulbar ulcer in 27% of the cases, antral ulcer in 13% of the cases, esophageal lesions in 13% of the cases and gastric cancer in 7% of the patients. Conclusions: Performed in emergency, upper gastrointestinal endoscopy ensures a precise and quick diagnosis, allowing the appropriate treatment and emphasizing the fact that round-the-clock endoscopy should be available in any acute-care hospital in the same way as other emergency investigations.

validated
CEPHALIC DUODENO-PANCREATECTOMY - TECHNIQUE WITH LIGASURE Cristea (Boier) Monica View abstract

CEPHALIC DUODENO-PANCREATECTOMY - TECHNIQUE WITH LIGASURE

First author: Cristea (Boier) Monica

Coauthors: Nistor (Ignat) Mariana , Taran (Zeces) Claudia

Coordinator(s): Molnar C , Rusu C

Keywords: cephalic duodeno-pancreatectomy LigaSure lymphadenectomy

Background: The cephalic duodeno pancreatectomy operation performed for the first time in 1909 by Kausch in two stages,becomes standard therapy until 1940, when Whipple performed the first duodenopancreatectomy in a single surgical time. Recent acquisitions in the field ofsealing-cutting equipment, LigaSure type, bring real benefits for the surgeonand patient. Objective: This paper aims to highlight the efficiency of  LigaSure Atlas 10 mm Device in achieving cephalic duodeno pancreatectomy. Material and Method: To seeks clinical efficacy and reliability of LigaSure Atlas device 10 mm in technical and tactical implementation of the cephalic duodeno pancreatectomy, highlighting its contribution in various key points of intervention:pancreatic resection and detachment from vascular support, extended lymphadenectomy  (3 patients ). Results: Analyzing the advantages of using LigaSure Atlas 10 mm in cephalic duodeno pancreatectomy without ligature was found:Significantly reducing of intraoperative bleedingFewer blood transfusionsshortening surgical timeCombating thread pathologyFewer instruments - "airy kits" Conclusions: Efficacy and safety of 10 mm LigaSure Atlas in cephalic duodeno pancreatectomy, enables technical achievement without ligature and a reduced operating time.

validated
The applicability of the European Guidelines in renal bone disease – study in predialysis Matei Ioana Natalia View abstract

The applicability of the European Guidelines in renal bone disease – study in predialysis

First author: Matei Ioana Natalia

Coauthors: Latcu Alexandra

Coordinator(s): Gliga Mirela , Dogaru G

Keywords: chronic kidney disease phosphate-calcium parameters SHPT

Background: The chronic kidney disease (CKD) is a global health problem. One of the complications of CKD is renal bone disease which has a powerful potential cardiovascular risk and mortality due to perturbations of the phosphate-calcium metabolism. The European Renal Association Guidelines established the criteria for biological limits of the serum calcium, phosphate and parathormone (PTH), but studies for the applicability of these guidelines were done partially and incomplete. Objective: The purpose of this study is to evaluate phosphate-calcium parameters in a predialysis population according to the European guidelines. Material and Method: Our study includes 22 patients with stage 3 CKD having different etiologies from the Nephrology Department of the Regional Clinical Hospital of Tirgu-Mures, treated for secondary hyperparathyroidism (SHPT). The phosphate – calcium parameters were analyzed and compared with the guidelines values. Medium values, standard deviation and percent value. Results: In the study group 15(68,18% ) were men and 7(31,82%) were women, with a mean age of 65. The following average levels of calcium, phosphate, calcium-phosphate product and PTH were found: Ca 9,62mg/dl (± 0,47), Ca×P 34,02 mg%(± 7,42), P 3,55 mg/dl(±0,78 ), PTH 96,35 pg/ml (±55 ). Compared with the values set by European guidelines, we have reached very good levels of phosphocalcic parameters, phosphocalcic product in 100% of patients, serum calcium 72,73%, serum phosphate 86,36% and PTH levels in 40,01%. Conclusions: It is very important to control the plasma levels of the phosphocalcic parameters which can be obtained after a proper treatment with vitamin D analogs ensuring the renal and cardiovascular protection.

validated
small scale study regarding bacterial flora found on common surfaces Ianosi-Andreeva-Dimitrova F View abstract

small scale study regarding bacterial flora found on common surfaces

First author: Ianosi-Andreeva-Dimitrova F

Coauthors: Fărcaș Andrada-Melania , Irimia Adriana-Irina

Coordinator(s): Felicia Toma

Keywords: bacterias gadgets toilets surfaces

Background: Microorganisms are  constituents  part of human life. These can be found  on human skin, on electronic devices and many other surfaces with which we interact daily. Mobile phones, gadgets, lecture halls and toilets play an important role in students’ and teachers’ life, but are significat sources of bacterias. Objective: The study aimed to identify the bacteria which colonize random surfaces which are most likely to be used by the academic staff  as well as by the students. Surfaces like doorknobs, taps, toilet lids, classroom tables and electronics including the coffe maker, PC keyboards, and mobile phones at the University of Medicine and Pharmacy Târgu-Mureș. Material and Method: There were 20 samples collected from the toilets, university library, a lecture hall and gadgets used by the students. The bacterias were identified using lactose agar, blood agar, manitol salt plates and some of the basic biochemical tests. Results: The most frequently encountered bacteria were from the Staphylococcus genus, followed closesly by the Bacillus genus. Both summed  up more than  half of the identified bacterias. Other bacteria were from the Neisseria, Enterococcus and Micrococcus genus. Conclusions: The samples collected from the mentioned surfaces were mainly contaminated with commensal flora which can be hardly involved in infections regarding the usual academic enviroment but in some cases were identified as conditonally pathogenic and pathogenic bacterias that can cause specific diseases.

validated
Occupational Risk factors in a medium size footwear factory and impact on its workers’ health status Croitoru Cristina-Georgiana View abstract

Occupational Risk factors in a medium size footwear factory and impact on its workers’ health status

First author: Croitoru Cristina-Georgiana

Coauthors: Marginean Alexandra , Popa Smarandita , Lapusneanu Diana Ionela

Coordinator(s): Constantin Brandusa , Croitoru Liliana-Carmen

Keywords: occupational risk factors medium size footwear factory aromatic hydrocarbons polymorph pathology

Background: Mass production in the shoe industry started in the late 1850's, however, changes in working conditions did not improve, related occupational health problems, among shoemakers being until present time a mandatory problem, particulary in less developed countries. Some studies report chemical exposures, noise, vibration, stress and ergonomic problems as main causes of health problems, including various cancers, musculoskeletal injuries and neuropsychiatric disorders. Objective: As shoe manufacturing is a traditional industry in Iasi County, the authors attempt to study the relationship between professional risk factors and workers' health status in a medium size footwear factory. Material and Method: A cross-sectional study was performed. All workers (60, 82 percent women; average age: 35.3+/-9.2 years; average exposure: 10.3+/-8.9 years) were submitted to a well established protocol that included: the filling of a form regarding social data, professional route, family and personal medical history, life-style; physical examination; electrocardiogram; spirometry; biochemical, immunological, hematological and biotoxicological tests. Working conditions were assessed. Also, a personal interview was filled up, regarding different aspects of the work environment. Results: The profesional risk factors are represented by manipulation of different aromatic hydrocarbons in two small inadequate rooms without effective ventilation systems and personal protective equipment, prolonged seated position in non-ergonomic workplace. The processed data revealed a low prevalence of healthy subjects and a polymorph pathology that might be connected to accupational risk factors. Conclusions: Improving working conditions, providing personal protective equipment and training and implementing engineering controls to lower exposure levels will significantly affect the health and productivity of shoemakers.Well planed longitudinal studies with objective measures of exposure and disease are important for future control of workers' health status evolution.

validated
the modern treatment techniques in the case of bone atrophy followed by prosthetic-implant rehabilitation Ciumbrudean Andreea Maria View abstract

the modern treatment techniques in the case of bone atrophy followed by prosthetic-implant rehabilitation

First author: Ciumbrudean Andreea Maria

Coordinator(s): Markovics Emese

Keywords: atrophy sinus lifting bone addition implant prosthetic rehabilitation

Background: The successful prosthetic-implant is dependant on the quality and quantity of the bone where the implant will be performed.Disorders caused by the lack of teeth are sometimes so severe that only prosthetic surgery re-establish the functionality of the dental -maxillary aparatus. Material and Method: I have examined imagery from 4 cases where the vertical height of the bone in the back maxillary area was 4-8 millimetres,consistent with third type of Misch's classification.Therefore out of the cases examined all of them require a treatment plan including a sinus lifting and bone addition and also a prosthetic-implant rehabilitation plan. Results: After completing the sinus lifting ,bone addition and the insertion of dental implants,immediately after surgery,x-rays have showed a reduced boned to implant contact surface,subsequently mature bone has formed,capable to bear occlusal forces. Conclusions: The modern treatment techniques in the case of bone atrophy consist in the restoration of the atrophied alveolar ridge with reconstruction,bone addition and augmentation techniques followed by prosthetic-implant rehabilitation.

validated
The incidence and clinical manifestations in immune thrombocytopenic purpura Craciun Adriana Maria View abstract

The incidence and clinical manifestations in immune thrombocytopenic purpura

First author: Craciun Adriana Maria

Coauthors: Ungureanu Loredana Iustina

Coordinator(s): Oltean G

Keywords: autoimmune disorder thrombocytopenia symptoms

Background: Immune Thrombocytopenic Purpura, an autoimmune disorder with an unknown  etiology, results from accelerated platelet destruction after the binding of autoreactive antibodies to platelets. Objective: This study aims to analyze the incidence in ITP and the way of establishing the diagnosis. Material and Method: We performed a retrospective study comprising 50 patients treated in Haematology Clinic No 1 between the years 2008-2012. The data obtained was statistically processed considering variables like:residence, gender, age, platelet count and its correlation with the symptoms. The necessary evaluation included history, physical examination, complete blood count and peripheral blood smear. Results: Immune Thrombocytopenic Purpura was found to be more common in females (90%) from the rural area. The statistic showed that the disease occurs more often at patients aged between 20 to 40 years old (40%). 12% of the cases were asymptomatic and discovered incidentally and 88% showed from mild to severe symptoms. Conclusions: The diagnosis of Immune Thrombocytopenic Purpura is a process of exclusion which implies taking into serious consideration the overall evaluation of the patient. The clinical manifestations are correlated with the number of platelets but not in all cases the same number of platelets can cause symptoms with the same severity.

validated
COMPARATIVE STUDY CONCERNING SMOKING INFLUENCE UPON PREGNANT WOMEN AND THEIR NEWBORNS AMONG ROMA AND NON-ROMA MOTHERS Pinter Edina-Magdalena View abstract

COMPARATIVE STUDY CONCERNING SMOKING INFLUENCE UPON PREGNANT WOMEN AND THEIR NEWBORNS AMONG ROMA AND NON-ROMA MOTHERS

First author: Pinter Edina-Magdalena

Coauthors: Bohonyi Noemi

Coordinator(s): Voidăzan S

Keywords: smoking pregnancy newborns Roma

Background: Pregnancy is a dynamic, anabolic state including a series of changes in the anatomy and physiology of the maternal body to support the growth and the development of the fetus by maintaining homeostasis and preparing it for lactation. Objective: The aim of our study is to determine smoking influence upon pregnant women between Roma and non-Roma mothers and on their birth outcomes. Material and Method: Our prospective study includes 180 questionnaire addressed mothers at the Department of Obstetrics and Gynecology II, Targu-Mures. The information were collected from hospital records (mother:-weight, height, age, gestational age, new-born:-weight, height, Apgar score) and questionnaires (socio-demographic data, living conditions, smoking behavior, nutritional status and health behavior during pregnancy). Results: Consequently of the 180 patients enrolled in the study 55 (30.5%) were Roma and 125 were non-Roma with an average gestational age of 34 weeks at Roma and 35 weeks at non-Roma mothers with a p>0.05. Approximately 17% of Roma mothers comparing to 6.7% of non-Roma mothers were smoking over 10 cigarettes per day during pregnancy. According to our research there was no statistically significant difference (p-0,24) between the average weight of smoker Roma mothers’ and non-smoker Rome mothers’ outcomes, however there was a significant difference (p-0.005) between the average weight of newborns in the case of non-smoker and smoker non-Roma mothers. Conclusions: As long as in the case of non-smoker mothers there is no significant difference, in the case of Roma mothers it is. Unlike at non-Roma mothers there is a higher rate of smoking at Roma mothers. Reducing of the amount of active smoking and the time being exposed to passive smoke in the environment represent key factors in overcoming morbidity and mortality of newborns.

validated
subclavian steal phenomenon: clinical and diagnostical features Purcaru Madalina View abstract

subclavian steal phenomenon: clinical and diagnostical features

First author: Purcaru Madalina

Coordinator(s): Rodica Balasa , Bajko Z

Keywords: subclavian steal phenomenon retrograd vertebral artery flow diagnostics

Background: The subclavian steal phenomenon is a relatively rare vascular disorder. It is characterized by retrograd vertebral artery flow associated with significant stenosis or occlusion of the ipsilateral subclavian artery proximally to the vertebral artery origin. In symptomatic cases (subclavian steal syndrome) appear clinical signs suggestive for vertebro-basilar hypoperfusion or brachial ischaemia. Objective: To analise the clinical and diagnostical features of the subclavian steal phenomenon. Material and Method: The ultrasonographical database of the Neurology Clinic I , Tg Mures was rewiewed. In the 2008-2012 period were identified 15 patients with subclavian steal phenomenon. The clinical and epidemiological data of these cases were analysed based on the discharge files. The obtained data was statistically analysed with descriptive statistical methods. Results: The mean age of the patients was 63,6+/- 11,8 years (min 38, max 77). The male sex more frequently affected  (80%of the cases). The mean age of the female patiens was 61,6+/- 20,5 years, the mean age of the male patients was 64+/-10. The most important risk factors were the followings: hypertension, smoking, dyslipidemia. 80% of cases were symptomatics (cerebral infarction of transient ischaemic attack in the vertebro-basilar territory or brachial ischaemic symptoms). 20% of the patiens were asymptomatics. The diagnosis in the majority of the cases was based on the ultrasonographical examination, the ultrasound findings were confirmed angiographically in 5 cases. Conclusions: The subclavian steal phenomenon is rare but not neglijable cause of the vertebro-basilar ischaemic stroke. In some cases, can remain asymptomatic or causes only local ischaemic signs. The main diagnostic method is the ultrasound examination.

validated
EFFICACY OF INTRA-ARTICULAR INJECTIONS WITH POLYNUCLEOTIDES VERSUS HYALURONIC ACID IN EARLY KNEE OSTEOARTHRITIS Mihalcut Biatrice View abstract

EFFICACY OF INTRA-ARTICULAR INJECTIONS WITH POLYNUCLEOTIDES VERSUS HYALURONIC ACID IN EARLY KNEE OSTEOARTHRITIS

First author: Mihalcut Biatrice

Coauthors: Selegeanu Cristina

Coordinator(s): Pop T S , Roman C O

Keywords: knee osteoartrits acid hyaluronic polynucleotides

Background: Hyaluronic acid is a component of the extracellular matrix of the articular cartilage and of the synovial fluid wich has the ability to enhance the viscosity and lubricating properties and by that to protect the cartilage from mechanical stress. Polynucleotides, based on the same characteristics as hyaluronic acid, bind a large amount of water and form a 3D gel of water molecules, deeply moisturizing articular surfaces. Objective: The purpose of this study is to make an analogy between the clinical aspects of intra-articular injections with polynucleotides and the tradional references with hyaluronic acid supplementation in the treatment of early knee osteoarthritis. Material and Method: Using a randomized, double-blind clinical trial during 4 months, we observed 40 patients between 32 and 79 years old, in the Orthopedic and Traumatology Department of Mures County Hospital, with persistent knee pain caused by osteoarthritis, to appreciate the efficacy and safety of intra-articular injections with polynucleotides. Patients from Group A (20 pacients) received weekly, during 3 weeks, one intra-articular injection of 2 ml polynucleotides/40 mg (Condrotide), and those from Group B (20 pacients) hyaluronic acid (Synocrom). Pain levels were assessed using a 0-10 cm Visual Analogue Scale (VAS). Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaires were completed by each patient, ranking each of the 5 possible answers from every question with a score from 0 to 4 in order to ascertain the quality of life, the efficiency of clinical treatments, examining the pain and other disease specific symptoms, the function during daily activities or physical efforts. Results: The VAS mean decreased from 6,70 cm (T0) to 2,63 cm (T16) in group A and from 5,45 cm to 2,70 cm in group B. KOOS between T0 and T16 were improved in both groups, with better values in the group injected with Condrotide. Conclusions: This new therapeutic method offers an improvement in the affected knee, and although no adverse effects were related, it should be observed the long term effects in the process of replacing the hyaluronic acid therapy.

validated
CLINICAL AND RADIOLOGIC MIDDLE-TERM OUTCOMES AFTER SCARF OSTEOTOMY IN HALLUX VALGUS DEFORMITY Selegeanu Cristina View abstract

CLINICAL AND RADIOLOGIC MIDDLE-TERM OUTCOMES AFTER SCARF OSTEOTOMY IN HALLUX VALGUS DEFORMITY

First author: Selegeanu Cristina

Coauthors: Mihalcut Biatrice

Coordinator(s): Pop T S , Roman C O

Keywords: Scarf osteotomy Hallux valgus Forefoot

Background: Hallux valgus represents a common deformity of the great toe, which deviates outward, especially in young and active patients. The surgical treatment for it developed considerably over the last decades, more than 130 procedures being described until now. Objective: The aim of our study is to analyse medium-term outcomes after Scarf osteotomy in hallux valgus, a large method which has gained popularity in the correction of moderate and severe hallux valgus deformity. Material and Method: Between 2003 - 2007 in our Clinic of Orthopaedics and Traumatology Târgu Mureş, the same surgical team had perfomed a successive sequence of Scarf osteotomies on 42 feet (28 patients) for hallux valgus correction. Some of the patients (14) underwent concomitant bilateral procedures. There were 25 females and 3 males, with an average age of 50,96 years (19-67), followed for a mean interval of 81,75 months (60-108). In this study only the subjects which did not respond to the conservative treatment (orthopaedic devices for hallux valgus correction, nonsteroidal anti-inflamatory and accommodating shoes) were included. The patients with severe osteoporosis and/or osteoarthritis, hallux rigidus, infections and absent pedal pulses were excluded. Results: The average preoperative global American Orthopaedic Foot and Ankle Society (AOFAS) score was 51,27 points and the postoperative average AOFAS was 89,36 points. In 11 feet (26,19 %) the mobility of the first metatarsophalangeal joint was improved, in 29 (69,04%) cases was unchanged and it decreased in 2 cases (4,76%). Radiographic evaluation measures which include the intermetatarsal and hallux valgus angle improved from a mean preoperative value of 16,35° and 33,07° to 8,89° and 12,21° immediate postoperatively. Reposition of sesamoids was acquired in 35 situations (83%). Conclusions: The Scarf osteotomy provides great outcomes in more than 86% of situations and has minimum postoperatory complications (reflex sympathetic algodystrophy, superficial thrombosis and skin necrosis). This technique assures a fast union and early mobilisation of metatarsophalangeal joint with complete wieght-bearing of the forefoot. This study confirms Scarf osteotomy’s efficiency for treatment of hallux valgus.

validated
Is it really necessary for nitrate to be present in high amounts in lettuce? Modroiu Adriana View abstract

Is it really necessary for nitrate to be present in high amounts in lettuce?

First author: Modroiu Adriana

Coordinator(s): Croitoru M D , Fülöp Ibolya

Keywords: nitrate nitrite lettuce aquaculture

Background: There are many cases of children being poisoned with vegetable borne nitrate published in the scientific literature. In such cases even an emergency treatment was necessary to avoid death. Despite the risk of nitrate toxicity, some recent papers suggest the existence of health benefits of high nitrate consumption, but exceeding the accepted daily intake (3.7 mg/kg) is not recommended even by such authors. Unfortunately, European regulations are extremely permissive in this field accepting lettuce concentrations of 4000 mg/kg nitrate; this means that the consumption of only 65 g of lettuce alone will exceed the accepted daily intake for this toxin. Objective: Finding possibilities to reduce the content of nitrate in a widely consumed vegetable: the lettuce. Material and Method: Lettuce was grown using an aquaculture system with different nitrate concentrations, while maintaining the cations concentrations unchanged. Nitrate replacement was made with the physiologically inactive sulfate anion.  Measurements of nitrate and nitrite in lettuce were made using a previously published HPLC method. In order to assess the quality of lettuce measurements of chlorophyll, dry weight and residue on ignition were made. Results: Significant changes of nitrate concentrations were obvious in lettuces grown on nutritive solutions with different concentrations of nitrate. Recorded differences between lettuces reached in some cases the order of magnitude of 3. Even if changes in nitrate content were astonishing, changes in chlorophyll, dry weight and residue on ignition were insignificant in most of the cases, suggesting that reduction in nitrate concentration does not affect the plant metabolism and its nutritive value. Conclusions: Nitrate concentration can be significantly reduced to values far lower than those accepted by the European regulations. Such reduction makes lettuce safe for consumption in high amounts by children and vegetarians without the risk of exceeding the ADI.

validated
Effectiveness of different tooth whitening methods : an in vitro study Runcan Alexandra Maria View abstract

Effectiveness of different tooth whitening methods : an in vitro study

First author: Runcan Alexandra Maria

Coauthors: Guşeilă Alexandra Ioana , Rusu Monica , Borş Andreea , Molnar-Varlam Cristina

Coordinator(s): Szekely Melinda

Keywords: extrinsec staining tooth whitening questionnaires

Background: Studies revealed that a diet rich in pigments and tobacco use, can cause extrinsec staining of the teeth, that is why, frequently, people appeal to whitening procedures. Objective: The purpose of the study was to assess aesthetic efficacy, duration effects of whitening-products: toothpaste whitening, bleaching materials with carbamide on human extracted teeth immersed in different solutions. We were also aimed to identify methods of whitening offered by dentists and views related to dental bleaching. Material and Method: We created a questionnaire adapted to our needs. Patients questionnaire included a total of 9 questions: with 5 open-ended, respectively, for the doctors, 6 open-ended questions. Then the questionnaires were offered to dentists (n1=40) and a group of patients (n2=250) in Tîrgu-Mureş, Făgăraş, Bistriţa. In the practical part we used 20 extracted teeth, which we immersed in dye solutions after establishing the initial color with shade-guide. The teeth were grouped according to the solution used: coffe, black-tea, fruit-tea and red wine, a control group and were bleached using whitening toothpaste, brushed professionaly and whitened with gels that are commonly used in offices. Results were compared visually and with digital photography. Results: Extracted teeth immersed in order of their resistance to bleaching were: in red wine, coffee, fruit-tea, black-tea. Initial tooth color A reacted better to whitening-treatment, was more stable compared with initial color D. Group A shade A3,5 more reactive than A3. Based on questionnaires we noticed that the side effects were more common and more obvious when whitening materials had a higher concentration of active ingredient and side effects disappeared after bleaching treatment. Even if the patient is dissatisfied with some parts of whitening procedure, finally, only aesthetic effect matters. Conclusions: The most powerful aesthetic effect was obtained using whitening gel with high concentration of carbamide, but the results depend on extrinsic staining and bleaching treatment duration.

validated
SURGICAL APPROACH OF HEMORRHOID DISEASE WITH LIGASURE Taran (Zeces) Claudia View abstract

SURGICAL APPROACH OF HEMORRHOID DISEASE WITH LIGASURE

First author: Taran (Zeces) Claudia

Coauthors: Cristea (Boier) Monica , Nistor (Ignat) Mariana

Coordinator(s): Molnar C , Gherghinescu M

Keywords: Hemorrhoids LigaSure Precise hemorrhoidectomy LigaSure Hand Switching

Background: Hemorrhoidectomy is a surgical procedure practiced since ancient times (1882). Currently due to equipment procurements in the sphere of LigaSure sealing-cutting  type, it may be an option in the surgical treatment of hemorrhoidal disease. Objective: This paper aims to highlight the  effectiveness of using the LigaSure Precise and LigaSure Switching Hand in surgical treatment of hemorrhoidal disease. Material and Method: It monitors the effectiveness of two types of LigaSure device in technical and tactical implementation of hemorrhoidectomy, emphasizing their contribution in various key points of intervention (51 cases). Results: Analyzing aspects, intra- and immediate postoperative of 51 patients who received treatment using LigaSure Precise and LigaSure Switching Equipment, were noted: minimal intra-and postoperative bleeding use both for internal and for external haemorrhoids reduced operator time Minimum postoperative analgesia and quick recovery. Conclusions: Hemorrhoidectomy with LigaSure proves to be a beneficial alternative for the patient and surgeon, providing safety and comfort both intra- and postoperatively.

validated
Role of iodine in induction of hyperthyroidism Rus Alexandra Loredana View abstract

Role of iodine in induction of hyperthyroidism

First author: Rus Alexandra Loredana

Coordinator(s): Gliga Camelia

Keywords: thyroid excess iodine hyperthyroidism

Background: Excess of iodine it's generally good tolerated by the organism, but, individually in the presence of an pre-existing thyroid disease or some risk factors, an chronic or acute exposure of iodine can induce thyroid disfunction. Objective: The objective of this study is to identify what percentage of patients are diagnosed with hyperthyroidism have like triggering agent the exposure at iodine, if this patients presented in antecedents thyroid affections or different risk factors for onset of hyperthyroidism and which one was most frequently involved sources of iodine in causing disease. Material and Method: The study is retrospective and it's developed on a group of 212 patients with hyperthyroidism in different etiologies, recruited from casuistry Clinic of Endocrinology from Tîrgu Mureş over a period of three years. In this study it follows the prevalence of hyperthyroidism started by exposure to iodine on age, sex, environment of origin, sources of iodine were exposure the patients, type of thyroid affections pre-existed or absence of affections in patients antecedents. Results: An number of 15 patients, representing 7,08% of study group was diagnosticated with hyperthyroidism induced by iodine. Of 15 patients, 13 (86,67%) were female and 2 (13,33%) were male. The most common cause is antiarrhythmic treatment (73,34%)- 7 cases of Amiodarone- induced and 4 of Cordarone; the rest of hyperthyroidism are triggered by multi-vitamins and iodine from food. Conclusions: It is very important to know the source of iodine (certain medicines, multi-vitamins, dietary supplements) in order to prevent a possible endocrine disfunction.

validated
cerebral malignant tumors in mures county between 2007 and 2012 Ruset Irina View abstract

cerebral malignant tumors in mures county between 2007 and 2012

First author: Ruset Irina

Coordinator(s): Demian R F

Keywords: cerebral malignant tumors survival ratio age area

Objective: I have focused on the evolution of the malignant cerebral tumors in Mures county between 2007 and 2012. Material and Method: This retrospective study is based upon the data received from the Oncology Clinic of Mures County. Results: From the time frame mentioned above we gathered data about 178 registered cases of brain tumors, from which 143 were primary brain tumors and 35 were metastatic tumors.In 2010 there were 31 registered cases of primary  brain tumors. During the year 2012 the reported cases of primary brain tumors were 15.There were 8 reported cases for metastatic brain tumors during 2009 non for 2007.The statistics shows us also the ratio between the rural/urban population has a minimum number of reported cases during 2008(0.73).During the year 2010 the ratio was increased to 3.45. The ratio between women/men was maximum between 2007 and 2011(1).During 2012 this ratio was decreased to 0.5. The most reported cases were from people between the age of 51 to 60 and the most metastatic tumors were also reported from this age group. The 6 months survival rate during 2007 was 85.71% and in 2011 it was 68.75%.The 1 year survival rate was 65.38% in 2008 and 50% during 2011.The 2 year survival rate was 57.69% in 2008 and 33.33% during 2009. Conclusions: This study reveals that there are more reported cases of primary brain tumors compare to those of the metastatic origin during this time frame.This also shows us that the brain tumors were more frequent in men and in the patients from the rural area between the age of 61 to 70 years old.The survival rate has not a very good prognosis with a 2 years survival rate 33% to 57%.The statistics also shows a better survival rate between 2007 and 2008.Were not reported cases with metastatic tumors under 40 years old.

validated
contribution of Ngo Destine Comune in Breast Cancer Popa Andreea View abstract

contribution of Ngo Destine Comune in Breast Cancer

First author: Popa Andreea

Coordinator(s): Pasca Maria

Keywords: Breast cancer, NGO, Support, Relationship, Intervention.

Background: The aim of my survey is to emphasize what role does  NGO "Destine comune" Targu Mures  plays in the psychosocial support of patients with breast cancer. Objective: The study establish a relationship  between the awareness informing about breast cancer ,the direct involvement of patients in coping,self support as psychosocial basic and support offered by NGO "Destine comune" Material and Method: For my study I used as methods :conversation,observation and questionnaire. Results: To achive my results I used  a questionnaire applied to 50 people from NGO "Destine Comune "Targu Mures,which  contained a number of 13 questions.When I gathered the  data  of my  questions I came upon the following conclusions:             -informing level in  breast cancer  of people and personal involvement  related to this  disease  is a percentage of 84%                    -acceptance behavior and psychosocial support provided by NGO "Destine comune" is a pecentage of 92%.                                -the remaining findings are leading to a relationship based on the  correct breast cancer  intervention and understandind disease. Conclusions: My survey shows that involvement of NGO "Destine comune "Targu Mures   in supporting  patients with breast cancer helps them  pass the emotional impact more easily and move on with their familial,professional and social life!

validated
BUNIONS : PROPER TREATMENT Oniga D View abstract

BUNIONS : PROPER TREATMENT

First author: Oniga D

Coauthors: Coman Oana

Coordinator(s): Incze S

Keywords: Scarf Hallux Valgus Efficiency

Background: Hallux Valgus is a static subluxation of the first metatarsophalangeal joint causing swelling, tenderness, intense pain during gait and if left untreated, ulcerations and other severe complications. Objective: Although surgeons benefit from a wide range of approaching strategies while confronted with this pathology, the Scarf procedure is a popular choice of treatment among those patients that suffer from Hallux Valgus, therefore, the main purpose of this prospective study is to determine the efficiency of this particular procedure. Material and Method: Using foot X-Rays from 37 patients who underwent surgery at Clinica of Ortopedie Nr. II Targu Mures, the Intermetatarsal, Hallux Valgus and Distal Metatarsal Articular angles were measured before and after surgery, comparing the respective values. Results: Following statistical analysis, although surgery rarely offers 100% regression to textbook normal values, highly significant decreases (p<0.05) were observed in the IMA, HVA and DMAA/PASA post operative angles. Conclusions: This type of osteotomy is an effective procedure, improving gait in individuals with abnormal first metatarsal bone and removing pain while engaging in movement or wearing anything but loose footwear. A long term advantage is considered to be a better life quality and a drastic reduction of sedentarism.

validated
Evaluation of the risK factors involved in decay occurrence at population of Hodac rural area Burlacu Lilia View abstract

Evaluation of the risK factors involved in decay occurrence at population of Hodac rural area

First author: Burlacu Lilia

Coauthors: Morar Ioana-Andreea

Coordinator(s): Tohati A

Keywords: tooth decay risk factors epidemiological investigation oral prevention strategies water mineral elements

Background: Tooth decay is a disease with an incompletely elucidated, multifactorial etiology. In order  to prevent it, factors which determine this disease are necessary to be known, as the prevalence of carries into different population groups is inequable. Objective: The objective of this study is to evaluate the risk factors that cause tooth decay at population of Hodac rural area. Material and Method: Of all patients treated in 2 dentistry offices (Toaca and Hodac) during  2012-2013, 211 villagers were involved in this epidemiological investigation. Information has been registered into individual, anonymous patient records that include dental status  and a variety of questions refered to diet habits, frequency and quality of dental hygiene and general health status. On the other hand, we have tried to  emphasize the possibility of the existence of environmental factors able to cause tooth decay. Results: Statistical analysis of the results revealed a DMF index=11.6 and a prevalence of decay index= 100%.  Major risk factors leading to epidemic decay are the deficiency of oral hygiene  means and the inadequate chemical composition of the main sources of drinking water. Conclusions: Environmental factors in association with the individual ones  significantly increase the prevalence of tooth decay. In order to prevent it, oral hygiene programs combined with different methods of supplying the lack of drinking water mineral elements should be implemented.

validated
SURGICAL TREATMENT IN ACUTE PANCREATITIS Cojocaru Ioana Iulia View abstract

SURGICAL TREATMENT IN ACUTE PANCREATITIS

First author: Cojocaru Ioana Iulia

Coauthors: Aron Bianca , Ungureanu Loredana Iustina , Craciun Adriana Maria

Coordinator(s): Popa D

Keywords: Acute Pancretitis age/gender etiology surgical treatement

Background: Acute pancreatitis is an acute abdominal syndrome based on the inflammation of the pancreas. It's manifested  by violent pain in the upper abdominal area with a marked deterioration of the general cndition. Objective: The aim of this study is to highlight the etilogies of acute pancreatitis, disease incidence by age and gender and evolution of patients according to medical and surgical treatement. Material and Method: For this study we used a group of 530 patients who were hospitalized in the Surgical Clinic 1 of The Emergency Hospital of Targu Mures between January 2000 - December 2008. Results: During the study we had observed a predominance of the disease on patients aged between 35-55, namely in 261 (49,15%) patents, 92 (17,35%) were aged under 35 years and 167 (31,5%) were older than 55 years. Concerning the incidence by gender, 329 (62,08%) were males and 201 (37,92%) were females. According to etiology, acute pancretitis was due to alcohol consumptin in 286 (53,96%) cases, in 190 (35,84%) the cause was gallstones and in 54 (10,18%) idiopathic. Among patients with gallstones 130 (68,75%) were females and only 60 (31,25%) were males. From the group of patients only 157 (25,84%) were required surgery, the rest responded favorably to medical treatement. Conclusions: Acute pancreatitis is most commonly caused by excessive ingestion of alcohol or gallstones and only severe forms require surgery.

validated
REOPERATIVE THYROID SURGERY. COMPLETION THYROIDECTOMY IN THE EXPERIENCE OF SURGICAL CLINIC NO. 2 - COUNTY HOSPITAL OF TG. MURES Polexa O F A C View abstract

REOPERATIVE THYROID SURGERY. COMPLETION THYROIDECTOMY IN THE EXPERIENCE OF SURGICAL CLINIC NO. 2 - COUNTY HOSPITAL OF TG. MURES

First author: Polexa O F A C

Coordinator(s): Sala Daniela

Keywords: completion thyroidectomy lymphadenectomy pathology report recurrent thyroid disease

Background: We define reoperative thyroid surgery as the need of additional surgery after initial thyroidectomy.The indication and necessity of the reintervention is bassed on the decision of the surgery team and there is no consensus in this matter. Objective: The aim of this study is to reevaluate the cases that followed a completion thyroidectomy or neck dissection and to summarize the prognostic and the pathology final result caractheristics for this patients. Material and Method: We present a clinical retrospective study from 2008 to 2013, which involves 552 patients treated for different thyroid diagnostics in the Surgical Clinic number 2 from the County Hospital of Târgu-Mureș. We analized all the pathology reports and all the data was included in a chart review.In this study were included only the patients that provided a reintervention . The studied paramaters are: age, sex, clinical preoperative diagnostics, final pathology result, operation type and the localization of recurrent disease. Results: Second look surgery represents in our series 8,1% (n=45) of all 552 operations for a thyroid disease. In 53.33% (n=24) patients simple completion thyroidectomy  was provided, in 35.55% (n=16) cases was associated with neck dissection and in 11.11% (n=5) was provided only a therapeutic neck dissection.  The average age was 50.5 (22 - 85) and the sex ratio was 6.5 (F / M). The pathology results have shown malignacy in 24.4% (n=11) as follows: 3 papillary carcinomas, 1 medullary carcinoma, 2 papillary microcarcinomas and 5 limph nodes metastasis and 75.5% (n=34) benign diagnostics:  4 nodular disease, 5 thyroiditis and 25 normal tissue. Conclusions: Completion thyroidectomy has proved to be a safe procedure realized by specialized surgeons and it should be performed bassed on individual patient’s benefice / risk assessment and not on the concern for risk of complications of the reintervention.

validated
Incidence of primary hyperparathyroidism in the last 2 years in the Endocrinology Clinic of SCJU Sibiu Keil Iulia-Lorena View abstract

Incidence of primary hyperparathyroidism in the last 2 years in the Endocrinology Clinic of SCJU Sibiu

First author: Keil Iulia-Lorena

Coauthors: Chiorean Bianca

Coordinator(s): Totoianu I G , Marcu Ionela-Diana

Keywords: hyperparathyroidism adenoma examinations hypercalcemia

Background: Hyperparathyroidism is caused by excessive secretion of PTH by parathyroid glands, characterized by hypercalcemia, hypophosphatemia and bone resorption. Usually primary hyperparathyroidism due to parathyroid adenoma. Objective: The objectives are to evaluate patients who presented primary hyperparathyroidism establishing disease etiology, incidence and associated manifestations. Material and Method: We analyzed retrospectively  all cases of primary hyperparathyrodism for patients hospitalized in  Endocrinology Department of SCJU Sibiu, between January 2011-December 2012, selected and included in the study were 11 patients. Results: The followed criteria were demographics, diagnosing type of hyperparathyroidism, general  and  endocrine exam, paraclinical examinations, treatment and possible complications of surgery, associated diseases. Diagnostic algorithm was based on anamnesis, clinical examination, biochemical and imagistic examinations. Conclusions: Primary hyperparathyroidism is a result of excessive secretion of PTH, hypercalcemia is the most common biochemical change, with predominance to the female gender. We recommend high intake of fluids, reducing the intake of calcium and po administration of biophosphonates, but the final resolution still remains  parathyroydectomy.The incidence of this disease has been reviewed in the past 2 decades after the introduction of calcium metabolic systematic exploration.The annual incidence is 1/1000 male over 65 yo and 2-3/1000 female over 65 yo. Although this study includes a relatively small number of cases, we hope in the future to a closer approach of this pathology.

validated
The real impact of infection in intensive care units Muresan Ioana Alexandra View abstract

The real impact of infection in intensive care units

First author: Muresan Ioana Alexandra

Coauthors: Botoman Maria , Hutu Simona Loredana , Simon Ionela Anca , Vanga Carmen Adina

Coordinator(s): Copotoiu Sanda Maria

Keywords: infection sepsis Intensive Care Unit Apache II score

Background: Infections represent pathological conditions complicating the vital prognosis of all patients, particularly among critically ill patients. In intensive care units , clinicians are faced with a double chellenge: to diagnose the infection and establish a proper antibiotic therapy. Objective: The aim of this paper is calculating the mortality among patients who were admitted to the  Intensive Care Unit with septic symptoms and highlighting complications occurred during hospitalization Material and Method: We performed a retrospective study in the period January 1st  2012- December 31st 2012,based on the casuistry of  the Emergency County Hospital Targu Mures, in which were included all patients admitted to the Intensive Care Unit, with diagnosis of sepsis, severe sepsis or septic shock. The APACHE II, SOFA and OMEGA-RO scores were calculated for each patient. Results: We used a sample of 155 patients with an average age of 64.94 years. In terms of severity of infection, 75 patients(48.38%) had sepsis on admission, 43(27.74%) severe sepsis and 37(23.87%) septic shock. Of these, 127 patients (81.93%) died, only 28 (18.06%)  survived. We obtained the following scores: an average Apache II score of 25(with a predictive mortality rate of 53.30%), a mean SOFA score of 10 and  mean OMEGA-RO score of 104.52. The main entrance gates of germs were: lung (36.77%), with the main causative agent Acinetobacter baumanii, and skin (14.19%) whose main etiologic agent was Methicillin-resistant Staphylococcus aureus . The most common complications that occurred during hospitalization were: anemia (71.61%), thrombocytopenia (52.25%) and bronchopneumonia (43.22%). Conclusions: Infections remain an important problem of Intensive Care Units, which is associated with increased rates of mortality and complications  after hospitalization.

validated
detection and characterization of pancreatic ductal anomalies and strictures by means of secretin-enhanced mrcp. Mikó Zsuzsanna View abstract

detection and characterization of pancreatic ductal anomalies and strictures by means of secretin-enhanced mrcp.

First author: Mikó Zsuzsanna

Coauthors: Mikó Ágnes

Coordinator(s): Buruian M , Bauer F

Keywords: MRCP SMRCP pancreas pancreatic duct secretin

Background: Secretin is a hormone that stimulates pancreatic exocrine secretion- is described to improve visualization of the pancreatic duct by magnetic resonance cholangiopancreatography (MRCP). Objective: The purpose of this study is to determine whether secretin dilates and improves a better visualization of the pancreatic duct, and to identify the interval in which such an improvement is accomplished. We illustrate findings of normal pancreas and various pancreatic disease on MRCP after secretin stimulation. Material and Method: The study included 40 patients (16 women, 24 men) with suspected pancreatical duct abnormalities on the basis of clinical symptoms. All patients underwent SMRCP. Acquisition in the raw was applied in a clinical unit of secretin per body weight following a series of acquisition at each 30 seconds in 10 minutes. Results: Representation of pancreatic duct has improved significantly after the application of secretin. Before secretin application pancreatic duct could be appreciated in its whole length only in 15 cases. After secretin the duct has expanded and it became totally visible in 37 cases. The bettering in the quality of images occurred in average at the 1,5 minute and it lasted in average until the 19th minute.SMRCP identified chronic pancreatitis in 7 (17,5%) patients with exocrine pancreatic insufficiency. 2 (5%) patients were diagnosed with pancreas anulare, 1 (2,5%) with pancreas divisum, 1 (2,5%) with autoimmun pancreatitis and in 2 (5%) cases choledocholitiasis was noted. Cystic pancreatic tumours were identified in 6 (15%) cases of which 2 were IPMN (intraductal papillary mucinous neoplasm). In 18 (45%) cases we didn't find anatomical abnormalities, in 3 (7,5%) cases the images could not be evaluated. After applying secretin the secondary turnouts of pancreas could be traced. Conclusions: Secretin- enhanced MRCP may represent the best non-invasive diagnostic technique, since it gives a more precise diagnosis with morphological and functional information.

validated
Correlations between impairment of regional contractility and development of left ventricular remodeling following revascularized acute myocardial infarction – a 3D echocardiographic study Opincariu Diana Elena View abstract

Correlations between impairment of regional contractility and development of left ventricular remodeling following revascularized acute myocardial infarction – a 3D echocardiographic study

First author: Opincariu Diana Elena

Coordinator(s): Benedek I , Benedek Theodora

Keywords: revascularized acute myocardial infarction regional contractility left ventricular remodeling 3D echocardiography

Background: Loss of tissue following an acute myocardial infarction (AMI) is a trigger for ventricular remodeling and heart failure, the degree of remodeling being an important postinfarction prognostic marker. Objective: The present study aims to identify 3D echocardiography-derived parameters to predict LV remodeling in post AMI patients, based on 3D assessment of regional and global contractility. Material and Method: 48 subjects with AMI who underwent primary PCI followed by optimum medical therapy were enrolled in the study. All echocardiographic examinations were carried out at the baseline (day 2-3 postinfarction) and during follow-up at 3 months. We followed the correlation between the amplitude of ventricular remodeling and 3D echocardiographic parameters: regional index of contraction amplitude (RICA), and the index of contraction amplitude (ICA). Positive remodeling was defined as an increase in LV end-diastolic volume with >15% compared with baseline. Results: Patients with positive remodeling following AMI presented lower ejection fraction at baseline (44.75% vs 49.95%, p = 0.009), higher end-systolic volume (80.34 ml vs 70.63 ml, p = 0.02), lower values for ICA (3.05 vs 3.53, p = 0.01) and for RICA (1.38 vs 2.78, p <0.0001) than those who didn’t develop ventricular remodeling. The best statistical significance in predicting development of LV remodelling was achieved for RICA, for which the analysis based on ROC curve showed an area under the curve (AUC) of 0.88, being highly statistically significant (p = 0.0001). The cut-off limit of 1.8 for RICA presented a high sensitivity (92%) and a positive predictive value of 90% for the occurrence of LV remodeling in the post-infarction period. Conclusions: This study demonstrates the correlation between changes in global and regional ventricular contractility and the development of left ventricular remodeling following an AMI. Impairment of regional contractility is associated with development of LV remodeling in a more significant extent than the global impairment of ventricular contractility.

validated
Identification of 3D echocardiographic markers in Atrial Fibrillation recurrence after cardioconversion to sinus rhythm Barbu V S View abstract

Identification of 3D echocardiographic markers in Atrial Fibrillation recurrence after cardioconversion to sinus rhythm

First author: Barbu V S

Coordinator(s): Benedek I , Benedek Theodora

Keywords: atrial fibrillation cardioconversion sinus rhythm left atrium 3D echocardiography

Background: 3D echocardiography was established to be superior to 2D echocardiographic means in the assesment of cardiac volumes, being a unique method of visualizing the true and dynamic morphology of the heart. Objective: The aim of this study was to identify markers for atrial remodeling that would indicate the risk of arrythmia reccurence postcardioconversion. Material and Method: 36 pacients with persistent atrial fibrillation that were converted to sinus rhythm were enrolled in the study. They were examined using 3D echocardiographic means. They were divided in 2 separate observational groups, respectively group 1 numbering 21 pacients with sinus rhythm, and group 2 with 15 pacients with relapses of atrial fibrillation, in which we followed contractile remodeling, anterior-posterior diameter, maximum diameter, volume and the amplitude of contraction of the left atrium, respectively the EF of the left ventricle. Results: The average age of the pacients was 62+/-8 years for group 1, and 62+/-6 for group 2, left atrium volume ( 93,24+/-4,1 vs 142,3+/-18,2 ml with p<0,001 ), left atrium maximum diameter ( 42,9+/-3,5 vs 56,5+/-2,2 mm with p<0,001 ), anterior-posterior diameter of left atrium ( 41,4+/-4 vs 40,9+/-4,2 mm with p=0,39), amplitude of atrial contraction ( 2,1+/-0,3 vs 1,62+/-0,21 mm with p<0,001) and EF of left ventricle ( 46,5+/-3,6 vs 45,3+/-2,8 % with p=0,36). Conclusions: Left ventricular function was independent of the dimensions and performance of left atrium. The volume, maximum diameter and amplitude of contraction of the left atrium are parameters linked with the risk of atrial fibrillation recurrence after cardioconversion to sinus rhythm.

validated
Assessment of Culprit Lesions in NSTEMI versus Unstable Angina using 64 Multi-slice Computed Tomography Nyulas T View abstract

Assessment of Culprit Lesions in NSTEMI versus Unstable Angina using 64 Multi-slice Computed Tomography

First author: Nyulas T

Coordinator(s): Benedek Theodora , Benedek I

Keywords: culprit lesions acute coronary syndromes unstable plaque

Background: While several CT plaque features such as positive remodeling, adjacent spotty calcification or the presence of low-density plaque  have been demonstrated to be associated with unstable plaques, it is still unknown whether their severity and extent present any differences between different types of ACS. We studied the characteristics of low density plaque burden in patients with different types of acute coronary syndrome, using 64-slice computed tomographic assessment. Objective: The present study aims to demonstrate the differences between culprit and non-culprit lesions in the same population by using a 64 multi-slice CT evaluation of the presence of LDP burden. The study also aims to compare the different CT characteristics of culprit lesions in an STEMI or UA using the LDP, SP or PR parameters, widely accepted for characterizing vulnerable plaques by CT. Material and Method: In 45 subjects with ACS (22 UA and 23 NSTEMI), 118 coronary plaques were evaluated using a CT multi-slice 64 assessment including the burden with low-density atheroma, remodeling index  and SP. Receiver operator characteristic analysis was performed to calculate the cut-off points for the predictivity of laque characteristics and transform to binominal variable. The sensitivity, specificity, positive and negative predictive values of variables was calculated. Multivariate logistic regression analysis was performed to evaluate the significant predictors for NSTEMI or UA. Results: The presence of a plaque more than 20 mm3 in volume with a CT density <30 HU (p=0.0009) and the presence of all 3 markers of plaque vulnerability (p=0.01) significantly correlated with the presence of an NSTEMI versus UA. ROC analysis of plaque features associated with NSTEMI indicated that the burden with LDP <30 HU, was a good indicator for differentiating between lesions in NSTEMI or in UA. Conclusions: Culprit lesions associated with NSTEMI showed a higher burden with lower density cores than those associated with UA.

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Antimicrobial Quinolones as a Complexant Agents Cucu Roxana Sînziana View abstract

Antimicrobial Quinolones as a Complexant Agents

First author: Cucu Roxana Sînziana

Coordinator(s): Rusu Aura

Keywords: quinolones fluoroquinolones metallic complexes complexation

Background: Quinolones (QNs) are an important group of synthetic antibacterial compounds, with a 4-oxo-1,4-dihydroquinolinic structure, which is based on nalidixic acid model. The major qualitative leap occurred with the introduction of a fluorine atom in the structure, resulting in fluoroquinolones, compounds with an increased potential. The 4-oxo and 3-carboxyl groups confer QNs excellent chelatation properties with metallic ions. The first information about a decrease in the activity of QNs in the presence of different ions (magnesium, aluminum, calcium, iron, zinc - which - components of antacid or multivitamin mixture) emerged in 1985. Objective: The present work would like to review the existing data regarding the complexation phenomenon of QNs. Material and Method: In the last decade, numerous studies have advanced interesting theories about this complexation phenomenon specific to QNs. The presented research data have the tendency sometimes to be rather inconclusive and contradictories. Results: Nowadays, there are several study directions regarding the complexation phenomenon of QNs. The characterization of complexes with metallic ions is still a challenge for many scientists. The antimicrobial activity of QNs complexes is promising, therefore there are many trials regarding bioavailability and further regarding the formulation of new pharmaceutical products. Metal complexes of QNs ought to be examined in term of potential drug resistance; there is a chance those bacteria that are insensitive to pure QNs to be sensitive to metal complexes of QNs. Many studies are focused on the identification of new therapeutic effects (anti-inflammatory, anticancer, insulin-mimetic). Also, the complexations with metals show interest in developing new analytical methods for QNs analysis. Conclusions: The 21st century offers new therapeutic pathways for QNs taking into consideration their still uncovered potential. There is a constant need of continouing research in this area and more reliable and interesting results are expected in the future.

validated
FACTORS THAT INFLUENCE A TEENAGE GIRL TO GO ON A DIET.THE PATH FROM DIETING TO ANOREXIA NERVOSA Banga Adela-Maria View abstract

FACTORS THAT INFLUENCE A TEENAGE GIRL TO GO ON A DIET.THE PATH FROM DIETING TO ANOREXIA NERVOSA

First author: Banga Adela-Maria

Coordinator(s): Mihai Adriana , Buţiu Otilia

Keywords: Anorexia nervosa Diet Teenage girls

Background: Anorexia nervosa is an eating disorder characterised by immoderate food restriction and irrational fear of gaining weight,as well as a distorted body self-perception.It most often has its onset in adolescence and is more prevalent in adolescent females than in adoloescent males. Objective: To observe teenage girls attitude concerneing their body image,weight,dieting and anorexia nervosa. Material and Method: We performed a prospective study in two high schools in Mures County,in 2013,based on 120 self made questionnaires. Results: From 120 teenage girls interviewed, with ages between 14 and 19 years, 6 (5%) were indifferent twords their weight, 45 (37,5%) were satisfied with their weight and 69 (57,5%) wanted to loose weight. Also 64 girls (53,33%) were never on a diet and 56 girls (46,66%) were on a diet at least once. Conclusions: Teenage girls who were on a diet are more strongly influenced by their friends, family and the media that promotes a woman with a perfect siluette than teenage girls who were never on a diet.

validated
In Vitro study: evaluation of penetration capacity and marginal leakage of usual pit-and-fissure sealants Minescu Corina Elena View abstract

In Vitro study: evaluation of penetration capacity and marginal leakage of usual pit-and-fissure sealants

First author: Minescu Corina Elena

Coauthors: Roșu Andreea Alexandra , Bică Cristina , Molnar-Varlam Cristina

Coordinator(s): Tudor Bianca

Keywords: sealants penetration capacity marginal leakage

Background: The use of pit and fissure sealants with very good leakage capacity, that do not require an extended application protocol, neither time consuming nor using complicated technical methods, is considered a real benefit for pediatric dentistry. Objective: The aim of this study was to evaluate in vitro the penetration capacity and marginal leakage of different materials used as pit-and-fissure sealants (conventional resin-based sealant Fissurit F,  Dyract Seal- compomer and Fuji- GIC). Material and Method: 30 teeth extracted for orthodontic purpose  were randomly assigned to 3 groups (n=10). After sealant placement the teeth were isolated, sectioned longitudinally in a buccolingual direction and immersed in 2% buffered blue methylene dye and alkaline fuxin for 4 h. The sections were analyzed for leakage and sealant penetration using an optical microscope (Optech) which was also used to capture pictures of the teeth sections. Results: The marginal leakage was a phenomenon which was observed in different percentages for all types of materials that were compared in this study. The microscopical evaluation demonstrated not only the existence of marginal leakage but also the diverse morphology of the occlusal surfaces ( pits and fissures) of the extracted teeth. The quantitative evaluation of the marginal leakage revealed positive values for all three types of studied dental materials but in significantly different percentages, depending on the consistency of the sealing material. Evaluating the marginal leakage throughout an objective method showed suggestive differences between conventional resin-based sealants, compomers and glassionomers. Conclusions: The findings of this study showed that a flowable composite resin, a flowable compomer and resin-modified glass ionomer placed on occlusal pits and fissures had similar marginal sealing as the unfilled self-cured resin-based sealant. Flowable compomer showed better penetration and less marginal leakage than the light cure glass ionomer.

validated
dermatofibroma versus dermatofibrosarcoma protuberans. Pathological Correlations and diagnosis criteria Culbece Elena-Andreea View abstract

dermatofibroma versus dermatofibrosarcoma protuberans. Pathological Correlations and diagnosis criteria

First author: Culbece Elena-Andreea

Coauthors: Somodi Laura-Ionela

Coordinator(s): Cotoi S O

Keywords: soft tissue dermatofibroma dermatofibrosarcoma protuberants

Background: The most common tumor lesions of the soft tissue are dermatofibroma(M.8832/0), the benign form and dermatofibrosacoma protuberants(M.8832/0), the malignant form according OMS Classification from 2006. They primarily occurred in dermis. The incidence of Dermatofibrosacoma protuberans was only one case in a million per year. Objective: The purpouse of this study was to found out  the incidence, pathological correlations and diagnosis criteria of this pathology. Material and Method: We realized a retrospective study on the Pathological Departement fromTargu Mures County Emergency Hospital and all collected data was from histological records between 2008-2011. We analyzed 46 cases involving 27 females and 19 males and we group them by the year of publication, type, age, gender, location, surgical rezection and relapses. Results: We determined that the highest incidence was in 2008 with 18 patients. The incidence decreased year per year, until 2012 respetively, in 2009 with 14 cases, 2012 with 7 cases, 2011 with 6 cases and 2012 with only 3 cases. The dermatofibroma is met more often than dermatofibrosarcom in a proportion of 39 to 7 cases. The gender distribution shows that females were more affected than the males with 27 to 19 cases. The most frequently  affected location was the thigh: 13 cases followed by the thrunk: 11 cases and other: 3 cases. 33 cases were people aged 30 to 60 old, only 13 cases were people aged between 10 and 30 years old. Surgical excision were no infiltrated in 19 cases and infiltrated in 7 cases. Only 3 cases relapsed after surgical excizion. Conclusions: We observe that dermatofibroma and dermatofibrosarcoma protuberants appears more often at females and the middle aged is more affected. The proximal extremities and the thrunk were the location more affected and a low rate of reccurence if the tumour is well excised.

validated
DIfferential diagnosis problems in septic complicated hip arthroplasties Zeffer T View abstract

DIfferential diagnosis problems in septic complicated hip arthroplasties

First author: Zeffer T

Coordinator(s): Russu O , Bod P

Keywords: hip arhtroplasties C-reactive protein erythrocyte sedimentation rate diagnosis

Background: In the last 20 years hip arthroplasties became an intervention with a very high success rate. The necessity of hip prosthesis is over than 1 million/year. After the intervention can appear complications, as the most feared one: the infection of the prosthesis. Objective: The objective of this paper is to analyze the C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) values in the diagnosis of periprosthetic infection. Material and Method: We made two groups of patients, who were admitted in the Clinical County Hospital from Targu-Mures in 2011 and 2012. The first group was formed by 21 patients with primary arthroplasty and with local healing alteration. The second was composed of 9 patients with revision arthroplasty. The control group was composed of 44 patients with primary arhtroplasty and without changes during the healing process. In the first two groups we were following the CRP and ESR values on the day, when the changes appeared, than in every third day until the discharge. On the control group we have followed these values after 48 hours from the intervention, in the fifth day and on the tenth day (the discharging day). Results: The values of CRP and ESR were significantly elevated in the first group. There were differences in the interval in when the CRP and ESR values returned to normal level: for ESR instead of 6 weeks it returned to normal in 2 months and in case of CRP it returned to normal in 30-40 days instead of 20 days. The absolute values of CRP and ESR were elevated in 8 cases, when we had to do a reintervention because of seromas, which were evacuated and secondary suture was practiced. Conclusions: We all know that the CRP and ESR values are not specific for periprosthetic infections, but in correlation with clinical examinations the specificity can increase significantly.

validated
Pregnancy-contributing factor for gallstones Keil Iulia-Lorena View abstract

Pregnancy-contributing factor for gallstones

First author: Keil Iulia-Lorena

Coauthors: Matei Claudia

Coordinator(s): Constantinescu T

Keywords: gravel pregnancy bile colecistectomy

Background: Cholelithiasis is a condition caused by formation of gallstones in the gallbladder or bile ducts.Pregnancy has the effect of reducing gallbladder evacuation with secondary biliary stasis and infection. Gallstones occurs in 2.5 to 11% of pregnant women, representing the second unobstetrically surgical disease after acute appendicitis in pregnancy. Objective: The purpose of the analysis accomplished is to identify how much pregnancy influences the occurrence of gravel at young women. Material and Method: This retrospective analysis was realized between January 2009 and December 2012 in the two surgery departments of Pitesti county Hospital and it was based on the analysis of the medical history and operational standards. During this period, there were operated 762 cholecystectomys, out of which, 348 through laparoscopics and 414 classical. Results: Out of 605 female patients, 10 patients were operated during the first 6 months after giving birth. The cholecystectomys at 10 patients were realized through laparoscopics. Two patients had postoperatoric icterus. Under medical treatment jaundice was relegated in the 3 postoperator day. The second patient who had icterus, a retrograde endoscopy of common biliary duct was aplied in the 5th day postop. Conclusions: During pregnancy period, profound functional gastro intestinal, gall bladder and pancreas changes occur. Following this changes, there can be formed gravel which can lead the characteristic symptomatology: gall bladder colic, jaundice, fever, vomit.

validated
Antithrombotic therapy in atrial fibrillation Sus Ioana View abstract

Antithrombotic therapy in atrial fibrillation

First author: Sus Ioana

Coordinator(s): Dobreanu D

Keywords: atrial fibrillation CHA2DS2-VASc HAS-BLED Thromboembolic

Background: According to the European Society of Cardiology, atrial fibrillation(AF) is the most frequent sustained cardiac arrhythmia. AF determines a fivefold increase of stroke risk and one out of five strokes is attributed to this arrhythmia. When prescribing an antithrombotic treatment for these patients, the physician must take into account not only the thromboembolic risk, but also the risk of bleeding. Objective: The aim of this study was to evaluate the antithrombotic treatment prescribed to patients with FA in order to observe how it is correlated with thromboembolic and bleeding risks. Material and Method: In this retrospective descriptive study we included all patients discharged from Cardiology I Clinic,Mures County Emergency Clinical Hospital,between January and December 2012,with diagnosis of atrial fibrillation.The thromboembolic risk was assessed by calculating the CHA2DS2-VASc score and the risk of bleeding with the HAS-BLED score. Results: We found 590 patients with AF, 333(56.44%) males. The highest incidence was observed in the sixth decade, 187(31.69%) patients. 434(73.56%) patients had non-valvular AF. From all AF patients, 28(4.75%) had a low risk of thrombembolism(CHA2DS2-VASc=0) and 452(76.61%) patients had a high risk of thrombembolism(CHA2DS2-VASc≥2). 18(64.29%) patients from the low risk group received AVK, and 1 patient did not receive any antithrombotic treatment. In the intermediate risk group, 61(55.45%) patients received AVK and 28(25.45%) of them AVK in association with aspirin. Among the patients with a CHA2DS2-VASc≥2, 150(33.19%) received AVK, 125(27.65%) AVK and aspirin, while 23(5.09%) of them received no antithrombotic treatment. In this group of high thromboembolic risk, 277(61.28%) patients also had a high bleeding risk. Conclusions: In our study, patients with low and intermediate risks of thromboembolism were sometimes over treated, while in patients with a high thromboembolic risk, the bleeding risk might have been insufficiently assessed and taken into account. Calculating the two scores should be a widespread practice in order to perform an evidence-based medicine.

validated
Assessment of anxious personality traits corresponding to career option at UMF Targu Mures students Stanciu Cornelia-Alexandra View abstract

Assessment of anxious personality traits corresponding to career option at UMF Targu Mures students

First author: Stanciu Cornelia-Alexandra

Coauthors: Latcu Alexandra

Coordinator(s): Nirestean A , Lukacs Emese

Keywords: personality anxiety career option

Background: Anxiety is a structural component of character at anxious personalities: avoidant, dependent and obsessive-compulsive personality. In relation with career option and profesional development can have an adaptative or a disadvantage role. Objective: To establish the relation between the presence of some personality traits belonging to Cluster C and the career option. Material and Method: In this study were included 40 students from UMF Targu Mures, whose personality was assessed by a questionnaire SCID II and were interogated regarding their career option. Results: Results confirm the presence of a high percentage of obsessive-compulsive personality traits 35%(14), followed by mixed types (which associate the others types of personalities) 25%(10) and avoidant personalities 10%(4). 30%(12) of students have no personality traits belonging to Cluster C. In a proportion of 95%(38) the career option was a profesional desired option. It's confirmed the adaptative and disadvantage role of anxious personality traits, because anxiety conditions are mobilizing quickly most of the students interrogated by our questionnaires. Conclusions: This study provides data that contributes significantly to the provision of adaptive capacity and school or career performance under presence of Cluster C personality traits.

validated
early postoperative complications in the surgical treatment of fallot tetralogy Murariu Emma Eugenia View abstract

early postoperative complications in the surgical treatment of fallot tetralogy

First author: Murariu Emma Eugenia

Coauthors: Balazs Maria Mihaela

Coordinator(s): Matei M

Keywords: Fallot surgical treatment complications

Background: Fallot Tetralogy is the 5th frequent cardiac malformation in children. It consists in pulmonary infundibular stenosis, overriding aorta, ventricular septal defect and right ventricular hypertrophy. Objective: The aim of this study is to evaluate the frequency of complications occurred after surgical correction of Fallot Tetralogy during the period of 2006-2010. Material and Method: This study evaluates 181 patients operated at the Cardiovascular Surgery Unit of Mures County Hospital. The sex ratio is 108M:73F subjects. The surgical techniques used were Primary Total Correction (52M:35F), Palliative Surgery (systemic-to-pulmonary artery shunt) (22M:16F), Secondary Total Correction (22M:13F) and a number of 19 reinterventions (11M:8F) due to the postoperative complications. The observed parameters consisted of early complications, their frequency and sex distribution. Results: The determined male to female ratio for each type of complications is: cardiac (e.g. low cardiac output, right ventricular failure) 19M(19.79%):12F(18.75%), respiratory (e.g. pneumonia, laryngitis) 23M(30.26%):19F(29.68%), renal (e.g. oliguria) 7M(7.29%):1F(1.56%), neurological (e.g. convulsions) 6M(3.12%):5F(7.81%), hematological (e.g. trombocytopenia) 6M(6.25%):4F(6.25%), infections (e.g. sepsis) 5M(5.2%):1F(1.56%). The postoperative complications that required surgical reintervention consisted in cardiac tamponade, sternal dehiscence, shunt trombosis. There were also registered 2 premature deaths in male subjects due to right ventricular failure. Conclusions: The most frequent complications, in both male and female subjects, were the respiratory ones. More frequent in male patients were the cardiac, renal and infectious complications, while in female subjects occurred more the neurological ones. Hematological complications were as frequent in male as in female.

validated
CLINICAL IMPACT AND MANAGEMENT OF HYPERTROPHIC CARDIOMYOPATHY IN CHILDREN Latcu Alexandra View abstract

CLINICAL IMPACT AND MANAGEMENT OF HYPERTROPHIC CARDIOMYOPATHY IN CHILDREN

First author: Latcu Alexandra

Coordinator(s): Toganel Rodica , Blesneac Cristina

Keywords: hypertrophic cardiomyopathy children symptoms dysrhythmias β-blockers

Background: Hypertrophic Cardiomyopathy(HCM) is a genetic disease characterized by unexplained left ventricular hypertrophy in the absence of another disease that itself would be responsible for the hypertrophy. HCM has an incidence in the adult population that reaches 0.2% and 0.47/100,000 children. Current information on hypertrophic cardiomyopathy in children is limited by disease diversity and small case series. Objective: The main aim is to determinate the clinical profile, the incidence of risk factors and the clinical differences between nonobstructive HCM and obstructive HCM. Secondary objective is to assess the management of patients diagnosed with this disease. Material and Method: We performed a retrospective survey at Pediatric Cardiology Department on all HCM patients, hospitalized in the period 2008-2012. We colected clinicoepidemiological infromations for each patient (age, sex, symptoms). Data from basline laboratory measurements including 12-lead ECG and echocardiography were available. Results: From a total number of 35 children with hypertrophic cardiomyopathy(20 boys, 15 girls) with the average age 8 years, 68,5% were diagnosed with obstructive HCM and 31,4% with nonobstructive HCM. Clinical factors showed a variate phenotypic expresion so that just 21 patients(60%) were affirmative symptomatic, dysrhythmias on ECG were found in 4 cases (14%), although heart systolic murmur was present in all patients. Furthermore, incidence of risk factors in the target group is 25% ( 9 cases) of which 4 have a familial history of hypertrophic cardiomyopathy. 24 patients were on pharmacological treatment( with β-blockers, Ca chanels blockers), while a minimal number of children had been through a surgical septal myectomy( 3 patient). Conclusions: Hypertrophic cardiomyopathy is a disease seen even at pediatric age with an impact on life prognosis in these patients. Findings underscore the role of screening strategies for an early diagnosis, especially of asymptomatic patients with familial backgorund of HCM, and that care regarding prognostication and therapy must be taken given the potential lifelong implications.

validated
Recovery of the spinal cord following amielinic traumas Wellmann N View abstract

Recovery of the spinal cord following amielinic traumas

First author: Wellmann N

Coordinator(s): Ivănescu A

Keywords: spine trauma recovery physiotherapist

Background: Considering the high incidence of amelinic spinal trauma wich can have secondary effects such as deviations of the spine, pain, vicious attitudes, muscular hypotonia and others, the physiotherapist is a necessity in the patient’s recovery team, because by surgery the pacient can not fully recover. Objective: The aim of this study is to develop a recovery sequence for patients with spinal cord injuries. Material and Method: The study included a group of 137 patients aged 15 to 95, admitted in 2012 to the County Emergency Hospital, Department of Orthopaedics I, Tirgu Mures. 93 (66.88% ) were male and 44 (33.12%) women. The patients were grouped into 2 batches: the subject group (118 patients ,15 to 95 years) gathered those who followed only drug treatment, and the experimental group (19 patients ,20 to 30 years) gathered those who attended a recovery program besides drug therapy.The experimental patients  had thoracic vertebral injuries, therefore the recovery protocol focused specifically on that area. Results: It was noticed that spinal injuries are commonly caused by falling from a different level (38.68%), falling from the same level (28.46%), traffic accidents (21.16 %) and others (11.67%). Frequency order of spine regions affected by injuries is: lumbar (47.44%), thoracic (20.43%), cervical (18.24%) and sacral (2.18%), there are also injuries that aim more than one area (10.94%). Conclusions: Vertebro-medullary injuries play an important role in the pathologiy and the recovery protocol should be precise and should aid the treatment, recovery and social readmission of the patient. After submitting this protocol, an improvement was found in the health of the subject group, but motor  functions were not fully recovered. In the experimental group,however, good  functional and psychical recovery was noticed.

validated
IMPORTANCE OF EARLY DIAGNOSIS IN MONITORING ANKYLOSING SPONDYLITIS Smochină Alina View abstract

IMPORTANCE OF EARLY DIAGNOSIS IN MONITORING ANKYLOSING SPONDYLITIS

First author: Smochină Alina

Coauthors: Popa Oxana , Richea Marina-Lorena

Coordinator(s): Pârvu Mirela

Keywords: spondylitis ankylosis early diagnosis

Background: Ankylosing Spondylitis is a chronic progressive inflammatory disease which affects the spine joints, sacroiliac joints, adjacent soft tissues, evolving to fibrosis, ossification and ankylosis. Objective: The assessment of correlation between onset, stage of illness, mobility tests and treatment. Material and Method: We performed a retrospective study on 95 patients who were hospitalized in the Rheumatology Department of the Clinical County Hospital Targu-Mures in 2012 with the diagnosis of ankylosing spondylitis. Results: From 95 patients 34% are women and 66% men. 13% patients had an uncertain onset, 8% were diagnosed until 1980, 7% between 1981-1987, 6%-1988-1994, 19%-1995-2001, 25%-2002-2008 and 22%-2009-2012. Regarding the stage of illness, 13% patients are in stage II, 15% in stage II/III, 26% in stage III, 8% in stage III/IV and 38% in stage IV. We found statistically significant correlations between the onset and the stage of illness (p=0,009) and between the stage of illness and the gender of patients (p=0,042). On mobility tests 72% have limitation of spine movement, 46% have sensitivity slapper spine, 34% have contraction of the trapezius, 38% have paravertebral contracture, 41%  have painful limitation and crackles at knee mobilization, 42% have painful limitation and crackles at scapulohumeral joint mobilization. 19% of the patients are treated using NSAIDs, 4% DMARDs, 4% Biologic therapy, 20% receive NSAIDs and DMARDs,15% NSAIDs and Biologic therapy, 1% DMARDs and Biologic therapy, and 11% NSAIDs, DMARDs and Biologic therapy. 64% are on a diet and 78% are following a respiratory gymnastics program and kinetotherapy. Conclusions: An advanced stage of the disease is associated with decreased mobility in patient’s joints. The majority of the patients are men. There is a favorable outcome at patients under NSAIDs treatment and kinetotherapy.

validated
Fungal contamination of hot spices Irimia Irina View abstract

Fungal contamination of hot spices

First author: Irimia Irina

Coauthors: Ianosi Francisc

Coordinator(s): Man Adrian

Keywords: spices fungi contamination mycotoxins

Background: Fungal contamination of hot spices may lead to thermoresistant mycotoxins production that will accumulate in human body, leading mainly to hepatic toxicity. Objective: Qualitative and quantitative determination of the contamination degree with filamentous fungi in hot spices. Material and Method: We analyzed samples of spices (black pepper, white pepper and chili) from several distribution companies in many major stores in Romania, between 11.01.2012 - 02.28.2013. Ten grams from each sample were weighted and homogenized in 90 ml of sterile saline. Successive dilutions from supernatant were created and from each dilution 200 µl were inoculated on specific culture media. Incubation was carried out for 3-5 days, during which we have followed the development of fungal colonies, both quantitative and qualitative. Finally, the CFU / gram of product was calculated for each sample. We have analyzed the degree to bacterial contamination only quantitatively. Results: We have analyzed samples from 7 manufacturing companies. The degree of fungal contamination varied between 0 and 190 CFU / g, and the number of bacteria/bacterial spores between 0 and 20000 CFU / g, depending on manufacturer. Massive contamination occurred in all products of the same manufacturer. The black pepper was mostly contaminated, followed by chili. In white pepper, no fungi were identified. The diversity of species / product ranged between 1 and 7. The identified species belonged to the genera Aspergillus, Penicillium, Fusarium, Circinella, Mucor, Rhizopus, and Absidia. The highest number of CFU was recovered for Penicillium and Aspegillus. Conclusions: The degree of contamination of hot spices is different, depending on the manufacturer. There are present potentially pathogenic fungal species, possibly mycotoxins producing ones. A massive contamination being found in some manufacturing companies, some questions about storage conditions of spice source or related industrial processing and packaging process are being raised.

validated
Evaluation of coronary artery bypass grafts and native coronary arteries with multislice computer tomography Piros Katalin View abstract

Evaluation of coronary artery bypass grafts and native coronary arteries with multislice computer tomography

First author: Piros Katalin

Coordinator(s): Benedek Theodora , Benedek I

Keywords: multislice computed tomography (MSCT) coronary artery bypass graft (CABG) noninvasive technique

Background: Multislice computed tomography (MSCT) is a new diagnostic modality, which aim is to provide minimally invasive hardware to enhance patient and operator convinience. It can directly visualize both CABG and the native coronary arteries. Objective: The present study was designed to assess the diagnostic accuracy of 64-slice CT in detecting graft disease and in the evaluation of native vessels distally to the grafts. Material and Method: We enrolled 17  patient (12 men, 5 women; mean age 61) who had undergone coronary artery bypass graft surgery and had a clinical indication for angiographic graft assessment. We evaluated 40 bypass grafts using a 64-slice CT scanner and conventional coronarography. In all cases multislice 64 cardio CT was performed using the equipment Somatom Sensation multislice 64 (Siemens). Images were reconstructed using the retrospective modality on a synchronized ECG in a time frame of between 40 and 80% of the R-R interval. Results: A total of 40 grafts were investigated (28 vein and 12 arterial conduits). At MSCT, 10 arterial grafts were classified as patent and free from significant lesions, whereas two appeared diseased (two significant stenoses). Out of 28 vein grafts, 26 appeared free of disease and 2 diseased (occlusion and critical stenosis). An absolute concordance between CT and angiographic findings was documented for all arterial and venous grafts (100% diagnostic concordance). Conclusions: The 64-slice CT is feasible technique for assement of coronary bypass graft patency (with very high accuracy). Moreover, an optimal diagnostic accuracy was also documented in the appraisal of native vessels distal to the graft anastomoses. 64-slice CT can be proposed as a routine test for follow up in post CABG patients, and may represent an effective screening technique to select those patients with indications of new revascularization.

validated
The metabolic effects of Fluoxetine, a Serotonin Re-uptake Inhibitor Lupu Daniela View abstract

The metabolic effects of Fluoxetine, a Serotonin Re-uptake Inhibitor

First author: Lupu Daniela

Coordinator(s): Dogaru Maria , Vari C

Keywords: SSRIs Fluoxetine Metabolic effect Body weight Pref-1

Background: The Metabolic Effects of Fluoxetine, a Serotonin Re-uptake Inhibitor Objective: The aim of this study is to present the mechanism of action and the associated biochemical alterations induced by fluoxetine, an antidepressant with high serotoninergic activity, drug which is related with changes in the metabolism, appetite control and body weight. Material and Method: A large number of articles about drug-induced changes in body weight and metabolism were reviewed. The information presented attempts to eliminate the controversies existing in the scientific literature. Results: Drug-induced alterations in the metabolism represents an area of considerable clinical concern.Even if many articles associate fluoxetine with minimal weight gain, decrease in appetite or even indicate it as a potential therapy for obesity, when used in a long-term therapy, fluoxetine causes considerable metabolic effects.Fluoxetine induces even changes in the structure of the adipocyte, fact related with the study of biochemical markers, such as leptin and tumor necrosis factor, and might also cause insulin-resistance. Conclusions: The effects of SSRIs  on weight have not been systematically explored yet. Clinical experience and more research may clarify the management of fluoxetine-induced metabolic alterations.

validated
Combined effects of maternal prepregnant body mass index and gestational weight gain on obstetric outcome after cesarean deliveries Ferţu Elena View abstract

Combined effects of maternal prepregnant body mass index and gestational weight gain on obstetric outcome after cesarean deliveries

First author: Ferţu Elena

Coordinator(s): Puşcaşiu L

Keywords: Weight gain Body Mass Index (BMI) Cesarean delivery

Background: Although both maternal prepregnancy body mass index(BMI)  and gestational weight gain(GWG) may affect the outcome of pregnancy and birth weight , their separate and joint associations with complications of pregnancy are unclear. Objective: To estimate the effects of high or low GWG among women of varying prepregnancy BMI regarding cesarean deliveries. Material and Method: A retrospective study of 910 singleton cesarean deliveries from the Department of Obstetrics and Gynecology of Tirgu Mures Emergency Clinical County Hospital, admitted between January 2011- December 2012. Demographics and maternal patology has been recorded from patients files. Weight gain was divided in four groups (less than 11.5, 11.5-16.0, 16.1-20.0 kg and more than 20.1). Prepregnancy BMI was calculated as weight divided by height in meters squared and categorised as low (<19.8kg/m²), average (19.8-26.0 kg/m²) and high (>26 kg/m²), according to IOM classification for defining appropiate weight gain during pregnancy. Results: The mean GWG in preganancy was 13.98±5.47 (mean  ± standard deviation). A total of 17.14% of the women developed complications during pregnancy. 13 patients (8.33%) associated a chronic disease with a pregnancy complication and out of them 30.77% had low  GWG, 30.77% average GWG, 7.69% large GWG and 30.77% extra GWG. Women with average or high prepregnancy BMI (23.08%) and low GWG have an increased risk for preeclampsia, bleeding or gestational hypertension. Conclusions: Low GWG was associated with increased risk for developing pregnancy complications, particulary if women had an average or high BMI before pregnancy.

validated
Teratogenicity study of some antidepressants Bora Cezara View abstract

Teratogenicity study of some antidepressants

First author: Bora Cezara

Coauthors: Groşan Alexandra

Coordinator(s): Dogaru Maria , Vari C

Keywords: pharmacology teratogenic effect fluoxetine

Background: The literature reports harmful effects( malformations, fetal toxic or others) related to antidepressant medications use during pregnancy and breastfeeding.There are a few preclilical studies regarding the reproductive toxicity for antidepressants and there are only isolated cases reported by the literature for SSRIs use during pregnancy and these are not statistically significant. Objective: The aim of our study, performed on female Wister rats, is to better understand the reproductive toxicity of SSRIs. Material and Method: We studied the teratogenicity of fluoxetine on 20 female Wister rats.The medication was administred from the first day of gestation and during the entire gestation. We had also a conrtol group in the same conditions. Results: We recorded all changes seen in the fluoxetine group and we compared them with the control group.The differences were significant.In the experimental group treated with fluoxetine, the gestational period was shorter, the number of rats born alive was decreased, and three of the females were sacrificed because they were bleeding during gestation. Conclusions: These studies were made according to the European Union's Directive on the protection of animals used for experimental and other scientific purposes.

validated
Dental students’ self readiness assessment and pliability concerning personal dental prosthesis Vartolomei A C View abstract

Dental students’ self readiness assessment and pliability concerning personal dental prosthesis

First author: Vartolomei A C

Coauthors: Moncea Andreea , Molnar-Varlam Cristina

Coordinator(s): Szekely Melinda

Keywords: Volunteering Dental prosthesis Personal Patient - students

Background: Self critical evaluation of dental prosthesis in own oral cavity implies modifications in accordance with their quality and acquired medical knowledge. Objective: The purpose of this paper is to asses the dynamic emphasis of dental patient-students’ volunteering and pliability willingness to evaluate own dental prosthesis along studentship. Material and Method: The study group included a number of 938 Dentistry students  from the University of Medicine and Pharmacy Targu Mures, divided into years of study. They were required to answer  a questionnaire concerning the presence of dental prosthesis. The questionnaire aim was to rate students’ dental prosthesis and their assessment was matched with their present acquired medical knowledge. The degree of satisfaction was linked to the quality of the prosthesis which was appreciated by 3 evaluators  by direct oral clinical examination.The availability to join the study, to answer certain evaluators’ questions, to expose their personal prosthesis and their attitude as patients have been assessed. The patient-students’ degree of confidence in the therapeutist-student or dental technician-student was also evaluated. Results: 67% answered the questionnaire and  43%have been clinically examined. At the same time, the total number of dental prosthesis was determined and it was remarked that the number increases along with age and year of study, that the volunteering willingness decreases along with the year of study, the correlations between personal evaluation and evaluators increase along with the year of study as the students are more instructed and exacting. Conclusions: Volunteering and pliability are constant in the first three years of study and 5th year and decreases in 4th and 6th year. Objective assessment by acquired knowledge increases towards graduation but collaboration, volunteering and availability decrease considerably in the final year of study. Moreover, the rate of confidence in dental students, wether dentist or technician is actually high.

validated
Correlation between dyslipidemia, ischemic cardiopathy and fractures Orsan Diana Petruta View abstract

Correlation between dyslipidemia, ischemic cardiopathy and fractures

First author: Orsan Diana Petruta

Coauthors: Dodu Roxana Anamaria , Gabor Anamaria

Coordinator(s): Ivanescu A , Sipos R

Keywords: dislypidemia ischemic cardiopathy osteoporosis fractures hepatopathies

Background: We have done a study to observe the linkage between dyslipidemia, ischemic cardiopathy and bone fractures (with or without osteoporosis). Objective: The reasons of those correlations were the high incidence of dyslipidemia in the ischemic cardiopathy and the advantages of the cholesterol lowering treatment on the formation of the new bone tissue. Material and Method: We have effected a statistic study of fracture cases admited to hospital in Orthopaedics I Clinic, Targu Mures, during the period between January-December 2012,observing on these cases of fractures the presence of ostheoporosis, ischemic cardiopathy, dyslipidemia and liver disease. The study was approved by the Head of the Clinic and by the Ethics Department. Results: We have reviewed 715 case files of patients with fractures, 225 of them suffering of ostheoporosis. Dyslipidemia has been investigated only for 18 patients, from whom 10 have been diagnosticated with this diseas. 305 patients were suffering of ischemic cardiopathy and 4 of them were having dyslipidemia. There were performed liver samples for 472 patients, 19 of them having pathological values. From those 10 patients with dyslipidemia, 5 of them had liver samples made, 3 suffering also of ischemic cardiopathy. Conclusions: Interclinic therapeutical boarding of the patients may be a benefit for his recovery. Paraclinical investigations should be corelated with therapeutical indications of the basical disease and the secondary one(fracture). Dyslipidemia investigation should be performed on a larger scale in order to anticipate the ischemic cardiopathy cases that may appear. Liver samples investigations is necessary in order to a safe and correct cholesterol lowering course of treatment.

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Study regarding the effects of atypical antipsychotics on adipose tissue Sabau Ionela View abstract

Study regarding the effects of atypical antipsychotics on adipose tissue

First author: Sabau Ionela

Coauthors: Radu Adina

Coordinator(s): Dogaru Maria , Vari C

Keywords: atypical antipsychotics neuroleptics adipose tissue

Background: Study regarding the effects of atypical antipsychotics on adipose tissue Objective: The modern antipsychotics olanzapine and risperidone are selectively blocking the central 5-HT2 serotonin receptors in far greater extent than they are acting so on the D2 dopamine receptors, thus having a much lower profile of adverse reactions compared to the classical antipsychotics. Their long-term use causes a metabolic syndrome, characterized by weight gain and according to recent studies, by an increase of plasma free fatty acids levels on acute olanzapine and clozapine administration. We have conducted our study on olanzapine and risperidone, using amisulpride as case-control/reference.. Material and Method: Four groups of 10 Wistar rats were used, each receiving 0,5 mg/kgbw of olanzapine, 0,75 mg/kgbw of risperidone and 1 mg/kg bw of amisulpride respectively, the last group being used as an absolute reference. At the end of the experiment, the animals were sacrificed, samples being taken from their adipose tissue to be histopathologically studied (the size and numbers of adipocytes) and these samples could be further used for the determination of the specific preadipocyte factor Pref-1 in comparison with a positive sample from the embryonic rat liver. Results: The results of the study showed significant differences between the samples taken from the treated groups in comparison with the reference group.. Conclusions: We would like to mention that this research was performed according to the EU standards and regulations regarding the ethics of laboratory animals studies. Key words: atypical antipsychotics, neuroleptics, adipose tissue

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Truncus arteriosus Pop Denisa View abstract

Truncus arteriosus

First author: Pop Denisa

Coauthors: Keller Pascal Dominic , Zacharias Cora

Coordinator(s): Suciu H , Stroe V

Keywords: common arterial trunk cardiovascular anomaly congestive heart failure right outflow tract reconstruction

Background: Truncus arteriosus is an uncommon congenital cardiovascular anomaly, characterized by a single arterial trunk arising from the heart by means of a single semilunar valve. Pulmonary arteries originate from the common arterial trunk distal to the coronary arteries and proximal to the first brachiocephalic branch of the aortic arch. Truncus arteriosus typically overrides a large outlet ventricular septal defect. Prevalence ranges from 0.03 to 0.056 per 1000 live births. No striking sex difference in frequency is observed although most series contain more males than females. Neonates with truncus arteriosus present clinical features of congestive heart failure depending on the high volume of pulmonary blood flow and the presence or absence of truncal valve insufficiency. Objective: The purpose of this study is to evaluate the current surgical management of truncus arteriosus at Institutul de Boli Cardiovasculare si Transplant Tirgu Mures. Material and Method: This retrospective study describes our experience in truncus arteriosus based on 12 patients, aged between 6 weeks and 32 months, who underwent surgical treatment between 2005- 2012. 58.33% of the patients were presenting truncus arteriosus type I, 33.33% type II and 1 case (8.33%) type IV. Results: Currently surgical management consists of complete repair with closure of the ventricular septal defect, committing the common arterial trunk to the left ventricle outflow tract. In 83.33% of the cases, right outflow tract reconstruction was obtained by placing a cryo-preserved valved conduit. The REV procedure was used in 1 case (8.33%) and aortic arch reconstruction with pericardial patch aortoplasty was performed in 1 case (8.33%). Conclusions: In the last years there have been clinically significant improvements in treatment with early repair and now truncus arteriosus is ideally repaired in the neonatal period with low mortality.

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Systemic Pulmonary Shunts - Surgical Approach Zacharias Cora View abstract

Systemic Pulmonary Shunts - Surgical Approach

First author: Zacharias Cora

Coauthors: Pop Denisa , Argyriou D

Coordinator(s): Suciu H , Stroe V

Keywords: cyanotic heart disease systemic pulmonary shunts palliation vascular graft

Background: Systemic pulmonary shunt remains a major strategy for the palliation of cyanotic heart disease, despite the associated morbidity and mortality of the procedure. Objective: This report describes our experience with systemic pulmonary shunting, at  “Institutul de Boli Cardiovasculare si Transplant ,Targu-Mures” Material and Method: Our surgical experience is based on  systemic pulmonary shunting in 140  patients underwent the procedure between January 2006 and January  2013 at  “Institutul de Boli Cardiovasculare si Transplant ,Targu-Mures”.The underlying anatomy may vary from  tetralogy of Fallot/Pulmonary atresia to complex univentricular heart malformation. All neonates (40%) were dependent on duct flow and prostaglandin E1 infusion for adequate oxygenation. Results: The systemic pulmonary shunt was performed through a median sternotomy in all patients. We used PTFE vascular graft, because is light, requires no pre-clotting and is easy to suture. It allows rapid fibroblast proliferation and minimises neointimal formation.  Shunt patency remains highly. The optimum size of the PTFE graft has been 4 mm;  mortality at 30-day, in 6 cases. Conclusions: Systemic pulmonary shunt remains an effective palliative measure in cyanotic neonates despite specific complications. Both low weight and preoperative ventilation represent significant risk factors for early mortality

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A Six year histopathological and statistical analysis of renal tumors in the Pathology Laboratory of Mureş County Hospital Fanfareţ I Ş View abstract

A Six year histopathological and statistical analysis of renal tumors in the Pathology Laboratory of Mureş County Hospital

First author: Fanfareţ I Ş

Coauthors: Suba Dora , Fişuş Andreea Dana

Coordinator(s): Borda Angela , Loghin Andrada

Keywords: pathology renal carcinomas

Background: Renal tumors are currently classified by the WHO (2004) based on their histological and cytogenetic characteristics of tumor-specific type. The most important prognostic factors are pathological stage, Fuhrman grade and tumoral type. Objective: To assess the incidence of renal tumors in the Pathology Laboratory of Mureş County Hospital in the last six years, their tumor type, Fuhrman grade and also the pathological stage. Material and Method: 350 cases of renal tumors were included in our study, all of them examined in the Pathology Laboratory of Mureş County Hospital between January 2007 and December 2012. All the specimens were processed following a standardized protocol: fixation in neutral formalin, paraffin embedding, sectioning and staining with hematoxylin-eosin. They were classified according to: gender, age, histopathological diagnosis, tumor type, pathological stage (WHO, 2004), Fuhrman grade (based on nuclear appearance). Results: Out of the 350 cases 89.2% were malignant and 10.8% were benign tumors. In the benign category, 44.7% were oncocytomas, 36.9% cystic lesions and 18.4% angiomyolipomas. In the malignant category 79.2% were clear cell renal cell carcinomas, most with Fuhrman grade 2 (51.8%) and pathological stage pT1b (31.2%); 7.4% were cromophobe renal cell carcinomas, most of them stage pT2 (39.1%); 4.5% were papillary renal cell carcinomas type 1 and 2; 3.2% were unclassified renal cell carcinomas; 2.2% were multilocular cystic clear cell carcinomas; 1.9% sarcomatoid carcinomas, classified as Fuhrman grade 4 and pathological stage pT3a. The other rare entities (0.9%) were Bellini collecting duct carcinomas, Wilms’ tumor and liposarcomas. In 2 cases (0.6%) we found tumor recurrence. Conclusions: The most frequent benign tumors were oncocytomas followed by simple cysts, while the most common malignant tumors were clear cell renal cell carcinomas. The pathological stage in which most malignant tumors were diagnosed was pT2.

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Ozone-therapy - supplemental therapeutic resource Ruzsa P G View abstract

Ozone-therapy - supplemental therapeutic resource

First author: Ruzsa P G

Coauthors: Jerdea B D , Gal Mihaela Alexandra

Coordinator(s): Alecu A , Popa Diana

Keywords: Ozone autohemotherapy insufflations infiltrations gassing bags

Background: Since the 19th century the therapeutic properties of the ozone were noticed but only in the 20th century it started to be used in various treatments. In the past 50 years the apparition of advanced ozone generators made it possible for intrarectal administrations and local subcutaneous infiltrations. Subsequently autohemotherapy was purposed creating the foundations of modern ozone therapy. The most studied therapeutic effects of ozone are immune system modulation, stimulation, suppression, anti-inflammatory and analgetic, germicidal, anti-ischemic, antioxidant, detoxifying, lipolytic. Objective: To assess the effectiveness of ozone therapy and the compliance of patients in various pathologies including: autoimmune diseases, inflammatory diseases, osteoarticular diseases, skin ulcers, degenerative diseases, cancers, infections. Material and Method: We actively participated in the procedures of ozone therapy in patients presented at the “Lotus Life Integrative Medicine Center” in Targu-Mures during 1.10.2012-15.03.2013. This included major autohemotherapies, rectal insufflations, local infiltrations and local administration through gassing bags. We used a Humazon Promedic ozone generator, which is able to provide exact doses of ozone in the form of ozone/oxygen mixture Results: Autohemotherapy was useful for patients with autoimmune diseases, occlusive peripheral arterial disease, viral hepatitis, degenerative diseases, posttraumatic sequelae. Rectal insufflations were useful for inflammatory bowel diseases, pancreatitis, increasing the quality of life in cancer patients. Local infiltrations provided a good anti-inflammatory and analgesic action in patients with spondylosis and gassing bags was used to stimulate epitelisations in leg ulcer patients with good results even in infected ulcers. Conclusions: From the point of view of the therapist the procedures are not complicated, respecting the asepsis measures. According to the patients, most of the procedures are not painful and don’t generate discomfort, except the local infiltrations, which proved to be painful at the moment of application but they prefer it because of the long-term benefits following the procedure.

validated
THE FIRST EXPERIENCE REGARDING THE EFFICACY OF DRUG ELUTING BALLOON ANGIOPLASTY IN FEMORAL ARTERY REVASCULARISATION Berecki Orsolya View abstract

THE FIRST EXPERIENCE REGARDING THE EFFICACY OF DRUG ELUTING BALLOON ANGIOPLASTY IN FEMORAL ARTERY REVASCULARISATION

First author: Berecki Orsolya

Coordinator(s): Benedek I , Kovacs I

Keywords: drug eluting balloon femoral artery peripheral angioplasty

Background: The long therm success rate of percutaneous intervention in peripheral arterial disease is limited by restenosis. The restenosis rate is higher in case of long lesion in patient presenting multiple risk factors. Drug eluting ballons can improve the long therm permeability rate in this cases. Objective: In this study we present the first experience regarding this new interventional method in the Clinic of Cardiology Targu Mures. Material and Method: We enrolled in this study 18 patients with femoral artery lesions. Group A: 9 patients treated with DEB and group B: as control group 9 patients treated with uncoated balloon angioplasty. The Rutherford class in the 2 groups at presentation was 3,7 vs 3,8. Mean ankle brachial index was 0,6 vs 0,56. Medium lesion length located at femoral artery was 13,7 vs 12,9 cm. The 2 groups were similar regarding mean age, sex distribution, risk factor distribution. Results: The immediate success rate was similar in the 2 groups. The number of target lesion revascularizations was 1 patient in the uncoated balloon group. Improvement in Rutherford class was greater in the coated balloon group (1,4 vs 2,4), whereas the improvement in ankle brachial index was not different (0,37 vs 0,34). At 6 month follow up no amputation were recorded. No adverse events were noted related to balloon coating. Conclusions: The first experience using DEB is promising. We will continue to inrole patients in this study and after long therm follow up we will introduce MACE as primary endpoint. Also we extend this method to infrapopliteal lesions, especially for long or multiple lesions in diabetic patients.

validated
Deoxynivalenol and Fumonisine Contamination of Fodder for Animals and Their Determination Schwerin R View abstract

Deoxynivalenol and Fumonisine Contamination of Fodder for Animals and Their Determination

First author: Schwerin R

Coauthors: Gorbai Adel

Coordinator(s): Curticăpean A

Keywords: Deoxynivalenol Fumonisin Grain

Background: Fusarium species are plant pathogens that cause root, stem and fruit rot. Many species are pathogenic to humans and animals. In this way, they are known as producers of mycotoxins in the groups of trichotecenes, zearalenones and fumonizines families, causing the poisoning of humans and animals.Deoxynivalenol (DON or vomitoxine) is produced mainly by Fusarium graminearum and F. culmorum and it contaminates cereals. DON can be produced by other species of Fusarium. The presence of DON in grains induces food intoxications that causes nausea, vomiting and diarrhea. Under certain conditions, the nuclees infected by F. verticillioides or Fusarium proliferatum may become contaminated with fumonisins. Fumonisins (fumonisin B1 and related Fumonisins ) were involved in leukoencephalomalacia ecvina (ELEM), wearing the name of moldy corn disease that causes pulmonary edema in pigs. Objective: Determination and presentation of adverse effects of DON contamination and fumonisins in the terms of safety and food security. Material and Method: Results about the concentration of mycotoxins. Rapid detection test kits are also available to detect toxins. There are commercially available test kits for detecting fumonisin, vomitoxin, and zearalenone in corn. For determination of mycotoxins present in cereal samples can be determined by enzyme immunoassay ELISA. LC-MS is a tool used to confirm analyte. It has become a routine technique in food analysis. The  used methods are based on the determination of mycotoxins, especially Aspergillus, Penicillium, Fusarium, followed by methods for simultaneous determination of Fusarium, Aspergillus, Penicillium, and Alternaria toxins.  Further evolution let to the publication of new methods also  many metabolites of mycotoxins, masked mycotoxins, and ergot alkaloids are reported. Results: Samples are generally analyzed grains contaminated with Fusarium species most frequently isolated are: F. graminearum and F. Culmorum. Such results have been found in corn, in central Romania for the species. Conclusions: There are many other unidentified mycotoxin compounds in products that are toxicologically important.

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Nitrones have the potential to become the next generation of anti-ischemic agents Cotârlan R View abstract

Nitrones have the potential to become the next generation of anti-ischemic agents

First author: Cotârlan R

Coordinator(s): Croitoru M D , Fülöp Ibolya

Keywords: nitrone nitrate nitrite nitric oxide

Background: Ischemic diseases affects a large number of people. Available anti-ischemic agents dilate the constricted blood vessels reestablishing the blood flow. Unfortunately, at this point usually a significant increase in the metabolic rate of ischemic tissue is recorded. This increased metabolic rate associated with over production of free radicals, known as the "metabolic burst" affects negatively the reperfused tissue leading to cell death. Objective: We intended to prove that nitrones, a class of substances known to be effective agents against harmful effects of free radicals, are able to release in vivo nitric oxide, a powerful vasodilating agent. Material and Method: Nitrones were in vitro subjected to the attack of hydroxyl free radical and amounts of released nitric oxide were measured indirectly by determining its oxidation products: nitrite and nitrate. The most active nitrones were studied in vivo using rabbits as experimental animals. Results: After reacting with hydroxyl radical, one of the most dangerous free radicals, nitrones released in vitro significant amounts of nitric oxide. Administered intraperitoneally to rabbits a significant increase in the oxidation products of nitric oxide was also observed. Test animals have shown signs of vasodilatation after administering the most active compounds, but no measurement of blood pressure were made. Conclusions: Nitrones proved to be efficient sources of nitric oxide in vivo. If further test will confirm our results these substances could become a new generation of vasodilating agents that will prevent the reperfusion lesions.

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Viagra in pulmonary hypertension. mistake or solution? Al-Akel K View abstract

Viagra in pulmonary hypertension. mistake or solution?

First author: Al-Akel K

Coauthors: Marian Cosmina

Coordinator(s): Dogaru G , Vari C

Keywords: Sildenafil citrate Solution Pulmonary hypertension off label treatment

Background: Pulmonary hypertension involves a sustained rise of pressure in pulmonary artery with a medium pressure in pulmonary capillaries which may lead to exitus by right ventricular insufficiency or sudden death. It is a disease with a very low incidence and small possibilities of treatment, which affects not only everyday life by dyspnoea and tachycardia, but also the physical effort capacity. Objective: The aim of this study is to point out that in the absence of a first choice medication, Viagra(in the absence of the pharmaceutical form that contains sildenafil citrate which is authorized for this indication) could represent a successful“off label” medication, with long-term improvements of the symptoms. Material and Method: A retrospective clinical study was conducted between March 2008 and January 2012 in Targu Mures, on a group of patients with pulmonary artery hypertension (both primary and secondary). The treatment used a PDE5 inhibitor, Sildenafil Citrate(Viagra), following the parameters of 6 minute walk test, oxygen level saturation and NYHA classification of the disease, at 1,3 and 6 months from the beginning of the treatment. The age, sex of the patients and etiology of their disease were also considered for this research. Results: All patients in the research group responded to the treatment, symptom relief was noticed and a significant improvement of the parameters in the study. After only 1 month of treatment, augmentations could be observed that lasted for 6 months. The 6MWT was improved by a medium of 62%, NYHA class was downgraded at the majority of the group, and the medium oxygen saturation was bettered with only a small percentage. Conclusions: Taking into consideration the symptoms` relief,not only to moderate physical exercise but to the classification of the disease too, Viagra could represent a viable solution in the management of pulmonary arterial hypertension both idiopathic and secondary cause being accompanied by other medication with proper autorisation.

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Coronary lesions in acute Non-ST elevation myocardial infarction-clinical and paraclinical correlations Măceşanu Adelina View abstract

Coronary lesions in acute Non-ST elevation myocardial infarction-clinical and paraclinical correlations

First author: Măceşanu Adelina

Coauthors: Stan R , Frîncu Laura Maria

Coordinator(s): Macarie C

Keywords: non-STEMI stenosis ejection fraction

Background: Non-ST elevation myocardial infarction is a type of infarction that is caused by the partial or almost full occlusion of a coronary artery in the subendocardial region of the heart.Although,initially the non-transmural infarctions have a better prognosis than acute STEMI,the patients age , comorbidities and multiple coronary lesions are a reason for a more reserved long-term prognosis. Objective: In the present study, we attempted to analyze the coronary artery lesion characteristics of acute Non-ST elevation myocardial infarction. Material and Method: We retrospectively studied 50 patients with NSTEMI infarction hospitalized in Cardiology Clinic of Tg.Mures County Clinical Emergency Hospital from 2007 to 2012.We included in the study only the patients who underwent primary coronary angiography.We studied clinical risk factors,ecocardiography and coronarography caractheristics. Results: A significant correlation was found between mitral insufficiency and higher age(p=0,04) and between diabetes mellitus and atrial fibrilation(p=0,02).Regarding coronary lesions, 56% of the patients had multiple coronary lesions and 40% had lesions on one coronary artery.Female sex was more prevalent for single vessel disease (p=0,0352).Also a correlation was found between patients with hypokinesia and multiple vessel disease(p=0,0419) .96% of the patients demonstrated intact systolic function, with an ejection fraction over 45-50%. Conclusions: Patients with acute Non-ST elevation myocardial infarction are elder, have a high cardiovascular risk profile and multiple coronary lesions which contribute to a bad long-term prognosis.

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THE MULTI-PARAMETRIC -BEAT-TO-BEAT- MONITORING DURING THE TILT TEST FOR THE EVALUATION OF PATIENTS WITH ORTHOSTATIC HYPOTENSION Neagu C View abstract

THE MULTI-PARAMETRIC -BEAT-TO-BEAT- MONITORING DURING THE TILT TEST FOR THE EVALUATION OF PATIENTS WITH ORTHOSTATIC HYPOTENSION

First author: Neagu C

Coauthors: Chiotoroiu Andreea Luciana , Ilie T , Varga Andreea , Zolog D

Coordinator(s): Podoleanu C , Carasca E

Keywords: orthostatic hypotension hemodynamic noninvasive monitoring vasovagal syncope tilt test

Background: The orthostatic hypotension is frequently associated with the vasovagal syncope, being emphasized during the tilt test Objective: The identification of the pathophysiological mechanism that underlies the hypotensive response during the tilt test Material and Method: 32 patients of 54 +/- 12 years old average were evaluated in an undergoing tilt test according the Italian protocol (20 minutes in passive orthostatism at 70 deg followed by NTG boosting with continuous monitoring for 10 minutes). The hemodynamic parameters were continuously monitored with a noninvasive method: blood pressure, heart rate, peripheral vascular resistance, stroke volume, cardiac output, using the Osypka Medical monitor Results: The test was positive in 27% of the subjects. The most frequent type of response was mixed: vasodilator and cardioinhibitory. During the vasodilatory phase it has been recorded a significant correlation between the decrease of the systolic arterial blood pressure and the concomitant reduction of the peripheral vascular resistance Conclusions: In the studied group, the multiparametric monitoring proved that the main mechanism that underlies the blood pressure reduction is the reduction of the peripheral vascular resistance

validated
CBCT evaluation of the temporal bone Buiga Petronela View abstract

CBCT evaluation of the temporal bone

First author: Buiga Petronela

Coordinator(s): Hedesiu Mihaela

Keywords: Temporal bone CBCT FOV

Background: Cone beam-beam-computed tomography (CBCT) is used in dental and maxillofacial radiology allowing three dimensional (3D) imaging of a focused area with reasonable radiation dose. Objective: The objectives of this study are to determine the radiological anatomy of the temporal bone and to emphasize the applicability of CBCT in imaging of this area. Material and Method: A number of 20 CBCT radiographs were investigated, from which 5 are with pathological changes.In all cases CBCT was performed using New Tom 3G with a medium FOV (9”).For the assessment of the temporal bone were used axial sections and oblique reformated images on the temporal bone axis.The following  anatomical structures were analysed:  external acoustic meatus, internal acoustic meatus, tympanic cavity, tympanic canaliculus, bony labyrinth, mastoid cells, vestibular aqueduct, cochlear canaliculus, facial canal, carotid canal, semicircular canals.Their visibility were examined by two investigators (a student and an experienced radiologist of head and neck CT) and they agreed to a score. The visibility scale was 0-3:  0- not visible, 1- less visible and with interpretation difficulties, 2- well visible, 3- clear image without dots. Results: The CBCT  visibility of the temporal bone appears  differently, according  to anatomical structures.Clear images were obtained in case of  mastoid cells, carotid canal, cochlear canaliculus.The vestibular aqueduct, semicircular canals and facial canal were well visible. Conclusions: CBCT provides reliable morphologic assessment of temporal bone imaging, thanks to the high spatial resolution with significantly reduced radiation dose. For imaging of temporal bone the radiographs with a small FOV are indicated.

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Cyto-histopathological correlation in thyroid pathology Fişuş Andreea Dana View abstract

Cyto-histopathological correlation in thyroid pathology

First author: Fişuş Andreea Dana

Coauthors: Fanfareţ I Ş , Trif Alexandra Maria

Coordinator(s): Borda Angela

Keywords: FNA Bethesda thyroid cytology histopathology

Background: Fine needle aspiration (FNA) is the best method for the clinical triage of thyroid nodules, thus it became the gold standard procedure in the selection of malignant from benign thyroid lesions. Objective: The aim of this study is to evaluate the accuracy of FNA in the clinical diagnosis of thyroid nodules and to establish its role in limiting the unnecessary surgeries. Material and Method: This is a retrospective study that reviews 4490 FNA and 1926 histopathological charts of patients that underwent thyroid surgery, in Tirgu Mures County Hospital, over a 6 years period (2007 to 2012). The thyroid cytology was evaluated always by the same pathologist, using the Bethesda System for the cytological diagnosis. In 646 FNA the histopathology was available, allowing a cyto-pathological correlation. Results: From 646 cases, 437 (67,6%) were benign, 120 (18,6%) were follicular lesions and 82 (12,7%) were malignant. 197 from 4490 cases (4,38%) were inadequate samples, which is in accordance with the FNA guidelines.   The sensitivity of the method was 56,30%, the specificity 96,48%, the positive likelihood ratio 16,01%, negative likelihood ratio 0,45%, the positive predictive value was 82,7% and the negative predictive value was 88,1% (p< 0.0001). When the follicular lesions were included, the statistical results have changed: the specificity was 80,50%, the sensitivity 66,88%, positive likelihood ratio 3,43%, negative likelihood ratio 0,41%, positive predictive value 53% and negative predictive value 88,1% (p< 0,0001). Conclusions: FNA is a useful tool in the selecting the thyroid malignant from benign lesions, and preventing unnecessary surgery. The most important limitation of the method is the difficulty of evaluating the follicular lesions and differentiating this category into the benign or malignant lesions.

validated
ETHIOLOGICAL,CLINICAL AND THERAPEUTICAL ASCPECTS OF GRAM NEGATIVE BACILI INFECTIONS IN HIV POsITIVE VS HIV NEGATIVE PACIENTS Goia Diana Blanca View abstract

ETHIOLOGICAL,CLINICAL AND THERAPEUTICAL ASCPECTS OF GRAM NEGATIVE BACILI INFECTIONS IN HIV POsITIVE VS HIV NEGATIVE PACIENTS

First author: Goia Diana Blanca

Coauthors: Orbok Tunde

Coordinator(s): Georgescu Anca

Keywords: hiv gram negative bacili infection treatment immunocompetent

Background: Gram negative bacili cause many types of infections.Certain types have become increasingly resistant to available drugs.HIV infected pacients are particularly susceptible to serious bacterial infections including gram negative Objective: To investigate particular aspects of gramn negative bacili infection in HIV pacients compared with immuncocompetent pacients. Material and Method: We performed a retrospective study in Infectious Disease Clinic I of Tg Mures between 2010-2012 that analyses documented gram negative bacili infections,including  57 pacients (22 HIV-positive  and 35 HIV-negative). Results: Gender distribution was imbalanced(68% female and 32% male in HIV+ group vs  31,4% male and 68.6 female in the HIV- group),with an average age of  27 vs 47.2 respectively.72.72% of HIV pacients provenince was rural compared with 20% in HIV- group.In HIV-pacients the clinical manifestations were:31% pneumonias, 27% urinary tract infections,4.5% septicemia and 37% other infections, compared with 62.8% urinary tract infections,14.2% leg ulcer infections,11.4% septicemia and pneumonias 2.8% in immunocompetent pacients . The most common ethiology in HIV+ pacients was Escherichia coli,followed by Pseudomonas 27%,Klebsiella 13.63 %,Acinetobacter and Haemophyllus 9% each, Proteus 4.5%,compared with 37% Escherichia coli,17% Pseudomonas and Klebsiella,8.5% Acinetobacter and 11% Proteus, in HIV- group.The anitibiogram on HIV+ pacients showed 27% resistance to 3rd generation cephalosporins,5% to carbapenems,5% to quinolones,26% to beta-lactamase inhibitors,16% to 3rd generation and 22% to 2nd generation amynoglicosides vs 37% , 10.7%, 42.7% to quinolones, 50 %, 54% and 20.8% respectively in HIV- group.The treatment was similar as classes of antimicrobials,the average treatment period was 12.5 days compared with 10.5 days . Out of 35 HIV- pacients, 2 died durring medical treatment compared to 3 in HIV+ group. Conclusions: In HIV-pacients the infections were more severe,requiring a longer treatment period,despite a highest susceptibility to antimicrobials.The lower susceptibility of the rods isolated in hiv-negative patients may be associated with the severe underlaying conditions that caused recurrent GN infections.

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The incidente of Helicobater Pylori in gastro-intestinal pathology Graur A View abstract

The incidente of Helicobater Pylori in gastro-intestinal pathology

First author: Graur A

Coauthors: Mihalcut Biatrice

Coordinator(s): Bataga Simona

Keywords: Helicobacter Pylori incidence gastro-intestinal pathology

Background: Helicobacter Pylori was discovered in 1982 and it is a very widely spread bacteria with special properties which cannot be found on other microorganisms and it infects half of the world’s population. The source of the infection is the human being, who can be infected and manifesting symptoms or a healthy carrier. The infection can start at the early childhood age, and it is made by fecal-oral, oral-oral and iatrogen transmission. The Helicobacter Pylori infection is associated with swelling of the gastric mucosa, which if not treated in time it can develop into gastric ulcer, duodenal ulcer, atrophic gastritis, gastric adenocarcinoma,  and non Hodgkin gastric lymphoma. Objective: The objectives of this scientific paper are, detecting Helicobacter Pylori infection, the distribution of disease depending on the patient’s living environment, the frequency of Helicobacter Pylori infection according to sex, age, environment and demonstrating the high incidence of Helicobacter Pylori infection. Material and Method: The collecting of the data was carried out over  3 years, from 2009 till 2011 on abatch of 1196 patients undergoing a superior digestive tract examination. The examination was made, based on the symptoms of the pacients. The database contains age,sex,environment, presence or absence of gastric ulcer, duodenal ulcer, Helicobacter Pylori infection and the lack of pathological elements. Results: From the group of patients 51% were female, the most affected age cathegory was between 45 and 60, urban population accounted 57%. Following gastroscopic exploration, 42% had gastric ulcer, 63 % duodenal ulcer, 13 % were infected with Helicobacter Pylori and 9 % had typical symptoms of gastric and duodenal ulcer but lacked organic changes in the stomach and duodenum. Conclusions: The Helicobacter Pylori infection is declining due to greater addressability of the population and easier accesability to medical services.

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Are Ultrasound Findings Different in Psoriatic Arthritis versus Psoriasis? Cîmpanu Catalina View abstract

Are Ultrasound Findings Different in Psoriatic Arthritis versus Psoriasis?

First author: Cîmpanu Catalina

Coauthors: Jerdea B D

Coordinator(s): Copotoiu Monica

Keywords: psoriatic artrithis musculoskeletal ultrasound (MSUS) psoriasis

Background: The role of musculoskeletal ultrasound (MSUS) in inflammatory conditions like psoriatic arthritis is on the verge to be acknowledged as well as the ultrasound of the nail changes in psoriasis.The inflammatory pattern of those two diseases involves changes at the site of the enthesis. Objective: The objective of our study was to evaluate the MSUS changes of the bone surface,the bursae,the ligaments and tendons at cvadriceps enthesis,the patella enthesis,the achillian enthesis and the tibialis posterior tendon changes in psoriatic arthritis compared with psoriasis. Material and Method: The first 7 subjects(4-psoriatic arthritis,3-psoriasis),patients of the Rheumatic Department and Dermatological Department,randomized in our prospective study underwent a MSUS protocol that involved the bilateral limbs.The mean age of the patients was 53 +/-9.839 years old.The data (images) were saved on the ultrasound hardware,then reassessed by 2 examinators (one with experience,one without) and finally assessed by the GraphPadPrism 6.0 software. Results: The mean onset of the psoriatic arthritis was 38.67±7.024 with an onset of the psoriatic lesions of 28±6.351 years old.The mean onset of the psoriatic disease was 53±9.839 years old.The changes visualized,for the psoriatic arthritis patients at the level of cvadriceps enthesis were: 2 out of 4 cvadriceps tendinitis,2 out of 4 enthesophites,1 out of 4 suprapatellar bursitis compared with psoriatic patients that encountered 1 out of 3  tendinitis,1 out of 3 erosions and enthesophites and 1 out of 3 suprapatellar bursitis.At the level of the patellar enthesis the ligament was involved in 2 out of 4 patients with psoriatic arthritis and 2out of 3 patients with psoriasis presented erosions.Erosions were the hallmark for the psoriatic patients at the achillian enthesis as well. Conclusions: The bone structures changes are seemed to be the hallmark of the MSUS modifications of the patients diagnosed with psoriasis versus the arthritis patients were the involvement of the tendons is the major enthesis change.

validated
The eternal conundrum: is teaching effective or not? - a case study on the students of the Faculty of Dentistry Hadad M View abstract

The eternal conundrum: is teaching effective or not? - a case study on the students of the Faculty of Dentistry

First author: Hadad M

Coauthors: Csegedi Krisztina , Larionescu Ilinca

Coordinator(s): Molnar-Varlam Cristina

Keywords: exam multiple choice student opinion

Background: The Dental Medicine student is subjected to different kinds of situations where he has to: face certain professional requirements, prove his ability of turning the theoretical knowledge into practice, relate with the patient and take both theoretical and practical examinations as to become a good professional. Objective: Identifying professional stressful events and problem situations in student’s life, analysing the stress factors that he is subjected to, evaluating the level of professional satisfaction that dental-students experience related to the teaching process and professional development, identifying vulnerable areas and suggestions regarding the improvement of the teaching process. Material and Method: We organized the research on three student samples, one of 178 – to assess the level of stress, one of 686  - for evaluating the teaching process and a sample of 170  to evaluate the method of examination. Feedback questionnaires were distributed online (anonymously), there were used multiple/single choice and open ended questions. The results were processed statistically and graphically. Results: Stress (stress factors for dental students)- level of stress in I year students > III and VI years; women are more affected than men. Teaching process - 31% of claim that the teaching method is inefficient, 52.1% of students consider that there is a match between course material and content of teaching. Evaluation methods - 40% students that agree or prefer theoretical exams as multiple choice tests Conclusions: The way in which we react is influenced by a series of controllable and uncontrollable factors. The interaction with the students can have a paramount impact over the teaching activity, not only due to  receiving favourable feedback from them, but also because this would mean support for their professional and personal development and moreover a source of professional satisfaction for the teacher.

validated
EXenatide in treating type 2 diabetes mellitus, for Better glicemic control and weight loss. Motas Anamaria View abstract

EXenatide in treating type 2 diabetes mellitus, for Better glicemic control and weight loss.

First author: Motas Anamaria

Coauthors: Teaca Catalina

Coordinator(s): Arhire Lidia

Keywords: Type 2 Diabetes Mellitus Exenatide GLP-1R HbA1c Weight loss

Background: Exenatide a GLP-1R agonist has recently been added to the European Association for the Study of Diabetes consensus algorithm for the treatment of Type 2 Diabetes Mellitus (T2DM). It is recomendedfor patients for which body weight and glicemic controll are a priority. Objective: Our study aims to evaluate the profile of T2DM patients that have undergone treatment with Exenatide. We followed their glicemic profile and weight fluctuation and compared our findings to those from similar studies in recent literature. Material and Method: We conducted an open label study on patients with T2DM treated with Exenatide in the Clinical Center for Diabetes, Nutrition and Metabolic Diseases from Iasi for a period of 2 years.We included in our study 48 patients, from whom we collected data on: weight, Body Mass Index (BMI), Waist Circumference (WC), glicated hemoglobin A1c levels (HbA1c) and duration of T2DM since diagnosis.We followed these paramethers throughout the 2 years from the intiation of Exenatide treatment. Results: Our study comprised 48 patients that had a mean duration of T2DM since diagnosis of 82,6+/-53,2 months. At initiation of treatment 87,2 of patients were obese (47% of these being morbidly obese), with an average weight of 109, 57+/-22,5 kg, an average BMI of 39,23 +/- 6,8 kg/m2 an average WC of 120,7+/-14 cm and the average HbA1c was 8,34+/-1,24%At 1 year since treatment initiation HbA1c droped to a mean value of 6.76+/-0.94%At the end of the 2 years HbA1c had a mean reduction of 1,9+/-1.7%The average weight after 2 years was reduced by 5,56+/-1,03 kg, the mean BMI was reduced by 2,02+/-1,10 kg/m2 and the mean WC was reduced by 2,38+/-1,53 cm. Conclusions: After 2 years of treatment with exenatide we have found relevant data from which we can deduce that the efficiency of Exenatide treatment is higher closer to diagnosis

validated
Effect of conditioning protocol on the microleakages between glass ionomer cement and dentin - in vitro study Dumea Nicoleta - Beatrice View abstract

Effect of conditioning protocol on the microleakages between glass ionomer cement and dentin - in vitro study

First author: Dumea Nicoleta - Beatrice

Coordinator(s): Sabău Raluca , Pop M

Keywords: polyacrilic acid glass ionomer dentin conditioner microleakages

Background: Glass ionomer cements are characterized by properties such as chemical bonding, fluoride release and uptake, excellent seal against microleakage and biocompatibility. Objective: The purpose of this in vitro study was to evaluate the effect of conditioning protocol on the microleakages between glass ionomer cement and dentin. Material and Method: The study included 23 human teeth extracted because of the advanced periodontal disease: 10 premolars and 13 molars. Class I cavities were prepared. Each molar was sectioned in vestibulo-oral direction into halves and for each premolar the proximal enamel was removed. In this way, 36 preparations with flat proximal surface of dentin were obtained from 23 teeth. This 36 preparations were randomly divided into 6 groups (n=6). Each group was treated as follows: Group 1- no conditioning + Fuji IX(GC), Group 2- glass ionomer liquid (copolymer of acrylic acid) for 20 seconds + Fuji IX, Group 3- GC Dentin Conditioner (polyacrilic acid) for 20 seconds + Fuji IX. Groups 4,5,6 were conditioning in the same way, but restored with Kavitan Plus (SpoftaDental). The teeth were immersed in 0.5% methylene blue and stored at room temperature for 24 hours. Then, each tooth was sectioned in mesio-distal direction and evaluated using an endodontic microscope at 21.25 X magnification. Data were analyzed with Single Factor Analysis of Variance (ANOVA). Results: Statistical analysis showed the greatest decrease of microleakages for groups 3 and 6. There were significant differences between these groups and others (p<0,001). No statistically significant differences were observed between groups 2,3,5,6 (p=0,14), but the microleakages were significantly lower than those of group 1 and 4. Conclusions: Regardless of the quality of the glass ionomer, dentin conditioning, even with the glass ionomer liquid, but especially with polyacrilic acid, significantly reduces microleakages

validated
An in Vitro Comparative Study Regarding the Use of Ultrasonic and Endodontic Microscope for Post Removal Morar Ioana-Andreea View abstract

An in Vitro Comparative Study Regarding the Use of Ultrasonic and Endodontic Microscope for Post Removal

First author: Morar Ioana-Andreea

Coauthors: Burlacu Lilia

Coordinator(s): Torcatoru Anca , Popsor S

Keywords: Post removal, Ultrasonic device, Endodontic microscope, Conservative endodontic retreatment.

Background: Posts are frequently used for endodontically treated teeth reconstruction, especially for those with severe coronal destruction. Endodontic treatment mishaps and coronal microleackage or other undermining tooth restoration factors may lead to failure of the primary endodontic treatment. Ultrasonic (US) is frequently used for removing posts when endodontic retreatment is carried out. Objective: The aim of this study was to evaluate the efficacy of ultrasonic devices and the use of endodontic microscope in different types of post removal. Material and Method: We selected 24 extracted single rooted teeth, performed endodontic treatment and devided them into 3 groups of 8 teeth each: group 1 - cast posts, group 2 - screw posts and group 3 - fiber posts. Digital radiographs were carried out in order to evaluate the endodontic restoration. We removed the posts from the root canals by means of Ultrasonic device. Endodontic microscope was used for 4 teeth of each group. Duration of each procedure was recorded and the canal walls were inspected using the endodontic microscope. Results: 22 posts out of 24 were successfully removed from the root canal using ultrasonic device. Minimum time required for post removal was 5 minutes and the maximum time- 90 minutes. Mean value of time required for cast posts removal was 36.5 minutes, for screw posts 36.25 minutes and for fiber posts 56 minutes. Conclusions: Ultrasonic devices are recommended in conservative endodontic retreatment as they facilitate post removal reducing the possibility of weakening, perforating or fracturing the remaining root structure. Endodontic microscope magnification provides preservation of dental tissue, significantly reduces the time for fiber posts removal and a precise assessment of the dentin root canal walls.

validated
Post Myocardial Infarction Angina – Clinical Correlations Cocor Cristina View abstract

Post Myocardial Infarction Angina – Clinical Correlations

First author: Cocor Cristina

Coauthors: Ţârloiu Georgeana

Coordinator(s): Opriş Mihaela

Keywords: post MI angina LAD anterior MI

Background: Post MI angina is a syndrome of thoracic pain of ischemic cause which appears at rest or minimum effort in the first 24 hours or later after a myocardial infarction. Post MI angina can be the result of ischemia in the infarcted area or distal from that, the later one having a bad prognosis on long term. Objective: Evaluating the correlation between the apparition of post MI angina and the clinical features of the followed patients. Material and Method: Retrospective study, cohort type on 190 patients with post MI angina admitted to the Cardiology Department for grown-ups nr 1 from Spitalul Clinic Judeţean de Urgenţă Targu Mures conducted in the period July 2011 – October 2012. There  were included patients with post MI angina on which we had to evaluate the presence of: cardiovascular risk factors (age, sex, smoking, diabetes, dyslipidaemia, hypertension), localisation of the MI, cardiac insufficiency, ejection fraction and the revascularisation procedure. Results: Are accordingly with the data found in literature: male predominance (M:F ratio is 4,5:1), age average of 61; more than 50% smokers and the majority of them with dyslipidaemia. As a particularity, among the group with monovascular disease, post MI angina appeared mostly where LAD artery was affected (with or without having undergo a revascularisation procedure). Anterior localisation of the myocardial infarction predisposed in 59% of the cases to post MI angina compared to the inferior localisation which was non-significant. Clinically speaking, the presence of cardiac insufficiency, objectified through the ejection fraction < 50% was statistically significant associated with the anterior localisation of the myocardial infarction, with mono or multivascular disease. Conclusions: Anterior localization of the MI, with mono and multivascular disease, the presence of cardiac insufficiency given by the important myocardial necrosis are clinical features that associate frequently post MI angina pectoris.

validated
Totally implantable venous access port in the experience of the First Surgery Clinic from Mures County Hospital Bauer Orsolya View abstract

Totally implantable venous access port in the experience of the First Surgery Clinic from Mures County Hospital

First author: Bauer Orsolya

Coauthors: Poruţiu M , Colcer Ioana , Vass Erzsébet

Coordinator(s): Georgescu R , Coros M

Keywords: venous port chemotherapy sublavian vein

Background: A totally implantable venous access port (TIVAP) has become an essential prerequisite for chemotherapy protocols. It is serving its purpose very well, but its use is not without complications. Objective: The aim of the study was to present our clinic`s experience TIVAP for chemotherapy, and to analyze the possible complications relating to the literature. Material and Method: We conducted a non-randomized retrospective study over a period of 5 years (01. 01. 2009- 28. 02. 2013) The casuistic of our clinic was analyzed, studying the cases of 18 patients whit TIVAP. Results: In 5 years 18 TIVAPs were implanted, in patients aged 27 to 65 years (mid age: 49,22), consisting 10 female and 8 male cases, diagnosed with large bowel cancer in 50%, breast cancer in 27,77% and other neoplasm in 23,33%. The TIVAP was implanted through the right subclavian vein (77, 77%) in 14 cases, and through the left subclavian vein in 4 cases. The mean procedure duration was 48, 61 minutes (range: 20-120 minutes). Using the mini-invasive Seldinger technique a silicone catheter was inserted from the subclavian vein up to the junction of the cranial vena cava and the right atrium. The catheter then was connected to the port previously placed in a subcutaneous pocket over the aponeurosis of the great pectoral muscle. This procedure is followed by chest radiography on the operating table to control the position of the catheter. The complications rate was 16,66%, immediate complication occurred in 1 case (false path of the catheter followed by repositioning), and in 2 cases late complications appeared (local hematoma, wound leakage). There were no major complications like infection, migration of the catheter, thrombosis, described in the literature. Conclusions: TIVAP system is a relatively safe procedure, although several complications do occur.

validated
Evaluation of maternal knowledge about immunization program for children Sofilca Gabriela Cristina View abstract

Evaluation of maternal knowledge about immunization program for children

First author: Sofilca Gabriela Cristina

Coauthors: Oltean A

Coordinator(s): Borka Balas Reka

Keywords: Immunization children Mothers knowledge Hospital

Background: According to the latest Eurostat data, infant mortality in Romania is 9.8 per thousand, nearly double than the European average.Responsible for these deaths are both congenital anomalies and diseases arising before and after birth. Although there are currently 26 preventable diseases by vaccination, Romania continues to be among the countries with high incidence of preventable diseases by vaccination such as measles and hepatitis type B. Objective: Assessing knowledge of mothers about immunizations given in national immunization program and optional vaccinations. Material and Method: To carry out this work I have relied on a prospective study based on a questionnaire of 31 questions addressed to a sample of 100 mothers which where hospitalized both to Pediatric Hospital Nr.1 and to Pediatric Surgery Hospital Targu-Mures in 2013. Results: According statistics we obtained the following results: 100% of all mothers vaccinated their children at least once, 54% of evaluated mother are between 21-30 years, 53% preiv in rural areas, 47% in rural urban, 41% have elementary education. Conclusions: After statistical processing of the data base result  that all mothers, regardless of backgrounds, vaccinated their children at least once, although the predominantly education is primary (8 classes).

validated
Evaluation of Basic Life Support Retention Rate evolution in a two year study Negrea M View abstract

Evaluation of Basic Life Support Retention Rate evolution in a two year study

First author: Negrea M

Coordinator(s): Turucz Emilia , Boeriu C

Keywords: Retention Rate Basic Life Support Medical Education

Background: Nowadays, first aid skills became a basic need for every member of our society and Basic Life Support courses are mandatory for everybody in medical world.  The knowledge of BLS measures deteriorates in a 3-6 months period after being taught if it isn`t refreshed. Periodic testing for identifing the individuals who need  to be trained again or refreshed is advised Objective: Finding out how the retention rate evolves in time for diferent groups of people with similar initial training but different practical skill over time. Material and Method: I have conducted a prospective descriptive study comparing two group of students for a period of two years. They have been participated at Basic Life Support courses organized by the Emergency Medicine Student`s Organization and SMURD training center. The first lot,Marisiensis2011, were tested imediatly after course, at six month,1 year and 2 years time. The second lot, Voluntari, were tested precourse, imediatly after course, six months,1 year after. Both lots were given specific tests and both lots were tested on paper for precourse/aftercourse evalution and online for 6 months,1 year and two years. Results: Imediatly after the BLS course, both lots had good results at the final test,93% average of correct answers for the Voluntari lot and 92.1%  for the Marisiensis2011.  After six month we found out  a statisticaly significant lose of information,75.5% correct answer rate in the Marisiensis lot. For the Voluntari the lost of kowledge was not signifiant. Comparing the 6 month testing and 1 year testing,the results were not significantly difference in both lots. Conclusions: It is clear that the teaching methods for BLS of the Student`s are quite efficient and well developed. A significant part of the information is lost after only six months time if  the trained measures aren’t applyed or refreshed  as it was for the Voluntari lot.

validated
Immunomodulation in allergic respiratory diseases Todor Melita Madalina View abstract

Immunomodulation in allergic respiratory diseases

First author: Todor Melita Madalina

Coauthors: Ionica Lidia Otilia

Coordinator(s): Vasile Loredana , Ghizdavat Eliza

Keywords: immunomodulation allergic diseases immunotherapy

Background: The therapeutic plan available in allergic respiratory diseases includes avoiding the allergen,the education of the patient,farmacotherapy and allergic immunomodulation.This consist the immunological mechanism responsible of the Ig E mediated respiratory diseases(asthma,rhinitis).In medical practice there are 2 classes of immunomodulatory therapy:allergen immunotherapy and Ig E therapy.Allergen specific immunotherapy is of great  importance course of allergic diseases. Objective: The aim of this work is to slow infectious episodes bronchial asthma and allergic bronchitis. Material and Method: The initiation of treatment with immunomodulatory was made after considering anamnestic,clinical and laboratory data sheets noted and tracked based on type allergy. Results: The needs of antibiotics decreased from 2 to maximum monthly administration to six monts or none.Regarding age groups,and young adults after first administration responded slightly less elderly. Conclusions: Specific allergen immunotherapy is the only way to influence the natural course of allergic diseases should no longer be considered just an alternative to conventional treatment.

validated
magnesium,a new perspective in chronic kidney disease Cirstea Iuliana View abstract

magnesium,a new perspective in chronic kidney disease

First author: Cirstea Iuliana

Coauthors: Galbeaza Andreea

Coordinator(s): Gliga Mirela

Keywords: CKD serum Mg2+ dialysis renal disease

Background: Magnesium (Mg2+) is the fourth most abundant cation in the body and it is essential for survival. The kidneys have a vital role in Mg2+ homeostasis, especially by excretion.In chronic kidney disease(CKD) the renal handling of Mg2+ deteriorates as the renal function declines significantly. Objective: The aim of the study is to analyze the serum Mg2+ levels in end stage CKD  and dialyzed patients and to find correlations between the disease progression and serum Mg2+ levels. Material and Method: We presented a retrospective, comparative study of 111 patients admitted to the Nephrology Department from Mures County Emergency Hospital between November 2012 and March 2013. Studied parameters were: age, serum Mg2+, Na+, K+,Iron,Ca2+levels,serum creatinine, urea, glucose leves and glomerular filtration rate (eGFR).We divided the patients in three groups: A control, B predialysis and C dialysis group. We calculated media, standard deviation SD, t-test and Pearson corelation coefficient. Results: Mean values and SD for group B were: age 56,14 (±15.02), Mg2+: 2,14mg/dl (±0,41),  K+4,9mmol/l (±0,92), Na+ 138,6 mmol/l (±4,98),Ca2+:9,46mg/dl (±1,3), creatinine: 4,2mg/dl  (±2,9), urea 123,4mg/dl (±3,99), Iron:12,63µmol/l (±4,18), glucose: 120,4mg/dl (±52,14), eGFR: 26,46 ml/min/1,73 m2 (±16,15). For group C the mean values were: age: 52,08(±13,27), Mg2+: 2,57 mg/dl (±0,49),K+:5,71mmol/l (±0,41), Na+: 144,88mmol/l (±2,51) ,Ca2+:8,91 mg/dl (±0,72) ,creatinine:9,45mg/dl (±2,21),urea: 127,8mg/dl (±27,09),Iron: 14,81µmol/l (±5,4), eGFR:5,58ml/min/1,73 m2 (±1,43). There was a difference between Mg2+levels in the group C, comparing with group B and A. The corelation coefficient was moderately significant between serum Mg2+ and glucose levels in the predialysis group and between serum Mg2+ and Iron (r= 0,39),Mg2+ and serum creatinine (r=0,29), Mg2+and urea (r=0,36) and Mg2+ and eGFR(r= 0,32) in the group C. Conclusions: We found an important statistical significant increase in the Mg2+ levels according to the progression of the CKD  and some corelations partially described in the literature so far. Though other parameters are still to be studied.

validated
Perspectives of parents towards vaccinating their children and correlations between age, living environment and education Ţârloiu Georgeana View abstract

Perspectives of parents towards vaccinating their children and correlations between age, living environment and education

First author: Ţârloiu Georgeana

Coauthors: Cocor Cristina , Runcan Laura

Coordinator(s): Voidazan S

Keywords: vaccine imunization adherence information

Background: Diseases affect annually a large proportion of the population. Therefore, having knowledge and information on immunization/ vaccines are important ways to prevent these diseases. Objective: The objective of this study was to assess parental knowledge on vaccination/ vaccines and finding correlations between age, living environment, education in order to improve the rate of occurrence of diseases. Material and Method: We used as materials 154 questionnaires, which were given to parents from both urban and rural environment. The study was conducted over 3 months (December 2012, January 2012, February 2013). Results: Of the total group of 154 people, 34% are aged between 25-29 years, 24% between 30-34 years; 65% from urban and 35% rural and 62% have one child. In this group, 66% believe that vaccination should be mandatory in children, although an average of 30% didn’t receive information about vaccines from their GP or nurse. Conclusions: The results show that a large proportion of the chosen group (30%) did not receive information about vaccination / vaccines from their GP; 40% do not know that there is a national plan of immunization. 56% of those people would feel guilty if their child will present an adverse reaction after being given a vaccine. All this can have a negative impact on the adherence of parents regarding vaccination in children.

validated
QUALITY OF LIFE IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE IN OUR GEOGRAPHICAL AREA Simon Ionela Anca View abstract

QUALITY OF LIFE IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE IN OUR GEOGRAPHICAL AREA

First author: Simon Ionela Anca

Coauthors: Botoman Maria , Muresan Ioana Alexandra

Coordinator(s): Bataga Simona , Ciorba M I

Keywords: patient questionnaire quality of life inflammatory bowel disease anxiety

Background: Quality of life is a good physical, mental and social condition, and patients' ability to perform activities of daily living. Inflammatory bowel diseases (IBD) represent idiopathic, chronic diseases of the bowels, the major representatives being ulcerative colitis and Crohn's disease. The severe treatment and side effects of these diseases have a major impact on quality of life. Objective: The study aim is to demonstrate that the impact between quality of life and disease can influence the normality of the patient with inflammatory bowel disease. ,,Time'' triggers the emergence of depressive anxiety disorders that might occur as a consequence of the disease. Material and Method: We conducted a retro-prospective study in the period January 1st 2010 - December 31st 2012, respectively October 1st 2012- April 1st 2013, using casuistry of the Targu Mures County Emergency Clinical Hospital. As methods we used: questionnaire, observation, conversation and clinical charts. Thus we identified the most affected age groups, environment source and complications that may worsen the evolution of these diseases. Results: We used a sample of 90 patients, 15 of these were the target group which we pointed out the impact of disease on quality of life. Gender distribution was approximately equal, with a slight increase in males (53,33%) compared to the females (46,66%). Of these, 68,88% were from urban areas, often associated debilitating complications and comorbidities. The analysis revealed that the daily schedule of these patients is disrupted at a rate of 80%, plus fatigue and physical inactivity - 90%, while the need to maintain the relationship with their doctor was 100%. Conclusions: Inflammatory bowel diseases can give a new perspective to patients' quality of life, which is why they need the support of family, friends and especially the doctor, in critical periods of the disease.

validated
THE FACTORS THAT CAUSE A DELAY IN PRESENTATION AND EVALUATION OF ACUTE STROKE Botoman Maria View abstract

THE FACTORS THAT CAUSE A DELAY IN PRESENTATION AND EVALUATION OF ACUTE STROKE

First author: Botoman Maria

Coauthors: Simon Ionela Anca , Muresan Ioana Alexandra

Coordinator(s): Chebut Octavia Claudia

Keywords: acute stroke delay health problem questionnaire prevention

Background: Stroke is a major public health problem in Romania because it's one of the leading causes of death and serious, long-term disability. Early treatment is a critical determinant of successful intervention in acute stroke. Objective: The study purpose was to analyze the factors that cause a delay in the submission and assessment of acute stroke with great importance for prevention programs. Material and Method: We conducted a prospectively study on patients with acute stroke that were hospitalized in Neurology Department of the Targu Mures Country Emergency Clinical Hospital between January 20 to March 20, 2013. The data collection methods used in the study were: questionnaire and conversation. We included the patients that were able to answer a questionnaire or the family members. Results: We found 105 patients with acute stroke and we observed that 90% did not know what is a stroke and what are the symptoms, so 100% of patients found necessary to be informed through the media about these pathology. We observed that 60% of patients delayed presentation to hospital because they live alone and they have not considered serious those symptoms. In terms of gender distribution the delay was slight increase in males than females. Conclusions: The lack of improvement throughout the past decade underscores the need for implementation of effective public health programs designed to minimize the time to evaluation and treatment of stroke.

validated
THE EFFICIENCY AND SAFETY OF LONG-TERM PULMONARY VASODILATOR TREATMENT IN PEDIATRIC PATIENTS WITH PULMONARY ARTERIAL HYPERTENSION Marian Cosmina View abstract

THE EFFICIENCY AND SAFETY OF LONG-TERM PULMONARY VASODILATOR TREATMENT IN PEDIATRIC PATIENTS WITH PULMONARY ARTERIAL HYPERTENSION

First author: Marian Cosmina

Coauthors: Deak Karoly , Guşu Rodiana

Coordinator(s): Șuteu Carmen , Togănel Rodica

Keywords: Pulmonary arterial hypertension 6-minute walk distance Bosentan Sildenafil

Background: Pulmonary arterial hypertension (PAH) is a rare, progressive disease characterized by an increase in the mean pulmonary artery pressure and pulmonary vascular resistance, which, if untreated, leads to right-ventricular failure and death. The availability of newer drugs has resulted in a radical change in the management of this disease with significant improvement in both the quality of life and mortality. Objective: The aim of this study is to analyze if the long-term treatment with pulmonary vasodilators is effective and safe in pediatric patients with PAH. Material and Method: This is a retrospective and prospective study on all pediatric patients over 5 years of age with PAH treated with pulmonary vasodilators (Bosentan, Sildenafil or both) in Pediatric Cardiology Clinic from Tg Mures between July 2009-March 2013. Every patient was followed up for over a 12 months period. We noted the 6-minute walk distance (6MWD), the saturation of oxygen at rest and some laboratory tests at one month after the treatment initiation and then every 3 months.. The functional class was assesed at baseline and after 6 and 12 months. Results: We have observed a significant improvement in the exercise capacity reflected by the 6MWD after 3 months of treatment ( from a mean at baseline 326m to 393m, p<0.01 ) and it was maintained up to 1 year (392m,  p=0.03 ) without any changes in oxygen saturation. There was also a significant improvement regarding the functional class (p<0.001). The treatment was generally well tolerated. No liver function abnormalities or serious adverse drug reactions were noted. Conclusions: The pulmonary vasodilator treatment is considered to be a reliable way to improve the effort tolerance in children with PAH, preventing the worsening of symptoms and in this way improving the prognosis of patients.

validated
the role of cyclooxygenase in bone repair process Toderic Marta View abstract

the role of cyclooxygenase in bone repair process

First author: Toderic Marta

Coauthors: Toderic Ana-Maria , Gabor Anamaria Victoria

Coordinator(s): Sipos R , Pavai Z

Keywords: anti-inflammatory fractures callus

Background: New bone formation takes place in 3 stages well coordinated:production of bone matrix,bone matrix maturation and matrix mineralization.Clinical and preclinical studies have shown that cyclooxygenase plays an important role in the process of marrow recovery.It seeams that COX,particularly COX2 is involved in new bone formation,beside its influence in bone resorbtion. Objective: In a clinical study done in 2012 at the Orthopaedic Clinic 1,Tg. Mures, we investigated the share of anti-inflammatory therapy and type used, in patieunts hospitalized with fractures. Within an experimental trial we observed the effects of anti-inflammatory treatment on the process of callus due to their action on COX. Material and Method: We used 60 rats Albinos Wistar distributed in 3 groups: control group, a group treated with a classic NSAIDs that blocks both forms: COX1 and COX2 ,and a group treated with coxib which is a selective inhibitor of COX2. We produced a middle dyaphysis fracture of the right femur to all the tested rats,which was immobilized with an intramedullary rod. The process of callus has been investigated radiologically and histologically for 8 weeks ,at 2,4,6, and 8 weeks. Results: From 715 patients hospitalised with fracture,for 99% of the patients has been recommended an anti-inflammatory treatment,76% were treated with a classic NSAIDs,18% were treated with coxib and 5%of them recived treatment only when needed. Lower density structures representing the process of callus were radiologically emphasized in the 5th, 6-7th and 4th week in different groups. Conclusions: After analyzing the radiological and histological rezults we can state that the NSAIDs treatment has a negative influence on bone healing. The process of callus is delayed by the NSAIDs treatment with 1 up to 4 weeks, as opposed to the control group. The NSAIDs treatment should be administrated only for a short period of time or removed from the post fracture routine therapy.

validated
Precocious detection and predisposition of young people to alcoholism. Simionescu A V View abstract

Precocious detection and predisposition of young people to alcoholism.

First author: Simionescu A V

Coauthors: Simionescu Alice Ana Maria

Coordinator(s): Gabos Grecu Marieta , Sabau Daniela

Keywords: alcoholism young people risk factor

Background: Alcoholism defines a chronic alcoholic intoxication, a pathological state of excessive alcohol consumption.Alcoholism is a disease, not a vice. It is a progressive illness, physical, mental and spiritual, marked the obsession to drink despite physical evil produced by alcohol. It is a disease of denial, the patient says with conviction, "I am not an alcoholic!" despite all evidance. Objective: Precocious detection and predisposition of young people to alcoholism. The level of awareness to the risks of alcohol consumption Material and Method: Transversal investigation trough questionaries regarding alcohol consumption. The subjects chosen where 271 young people with age between 19 and 30, with high education. Results: In our group we discovered that alcoholism is presents with a freqency of 18.81%. A category that draws attention is that of youngs who consume alcohol frequently in high quantities. The distribution among men and women who consume alcohol in excess is relative equal (19% men and 18% women) Conclusions: Alcohol abuse is an important health risk factor among smoking, an unhealthy diet and stress. These is a factor worthy of being monitored. It is much easier to prevent a disease than to treat it.

validated
Anatomoclinical STUDY OF SURGICAL reconstructive approaches in malignant melanoma Pavel M View abstract

Anatomoclinical STUDY OF SURGICAL reconstructive approaches in malignant melanoma

First author: Pavel M

Coauthors: Dodu Roxana Anamaria , Zolog D , Pop Ş

Coordinator(s): Branzaniuc Klara , Dorobantu D

Keywords: malignant melanoma anatomoclinical study direct suture skin graft flap reconstruction

Background: Surgical approaches used for surgical excision of malignant melanoma should not only consider complete excision and safety margins of the tumor but also aesthetic results. In what follows I will attempt a description of those reconstructive surgical techniques that were true and useful in practice. Objective: The main objective of any comprehensive anatomical study is to combine harmoniously intuition with practice. The second specific objective of the study is the analysis and clinical study. And the last but not the least is to focus on morphological types of malignant melanoma and surgical techniques for reconstruction of defects. Material and Method: We conducted a retrospective study on 53 patients from Clinical Department of Plastic Surgery and Reconstructive Microsurgery in Tg Mures during January 2008-March 2012 analyzing the incidence of malignant melanoma by age groups, by gender, type of melanoma, localization and surgical techniques used to cover skin and soft tissue defects after tumor excision. Results: Depending on the sex,the distribution of patients is approximately equal, 24 female (45.28%) and 29 male (54.72%). Was observed a prevalence of cases in the age group 61-70 years, especially males.The most common interventions performed were: direct suture 37 cases (69.81%), plastic full thickness skin graft 5 cases (9.43%), plastic split skin graft 5 cases (9.43%), flap reconstruction 6 cases (11.32%). Histologically, the infiltrative malignant melanoma is the most common 67.92%,followed by nodular 26.42% and lentiginous 5.66%. Conclusions: Malignant melanoma is a tumor that predominantly affects adults and elderly patients, with a peak incidence around the sixth decade of life. However in recent years, it was discovered an increased incidence in the population of middle-aged and young adults and can be seen cases in children as well.

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Management and outcomes of congenital clubfoot in older children Costin Tereza Irina View abstract

Management and outcomes of congenital clubfoot in older children

First author: Costin Tereza Irina

Coordinator(s): Gozar H , Derzsi Z

Keywords: Dimeglio cast surgery clubfoot

Background: In case of children older than 1.5 years the most common pathology is congenital clubfoot, event if this is characteristic to the age group of newborns. In this case treatment is difficult because the foot is more rigid due to the osteoarticular development. Objective: The main objective of our study was monitoring the treatment outcomes, quantifying them and evaluating classification methods. Material and Method: This study was performed at the Pediatric Surgery and Orthopedics Clinic, Targu-Mures during 1 June 2009 and 30 April 2012, as a cross-sectional study in which we included all children treated at our clinic with congenital clubfoot, who were older than 1.5 years at the time of their first visit and completed the treatment. We present the classification and quantification methods, management and outcomes. Results: The studied group comprised 39 patients between the ages of 1.5 and 12 years old (mean age 3.83 years). 14 patients (35%) had bilateral deformity, out of the total 53 assessed feet. Preoperative Dimeglio score was between 4 and 18 (average 11.82). Almost all cases were category II, III and IV, with a clear indication for treatment. Postoperative score was between 0 and 12 (average 3.90). The mean score of improvement was 7.92. The outcome was somewhat poorer for only 7 case of operated feet (13.2%). Conclusions: Our treatment method brought significant improvement in all cases. In case of the majority of patients we achieved a functional and morphologically esthetic foot. The Dimeglio score is useful, easy to use and relevant even in this age group.

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Gastro-duodenal ulcer in children Ciupu D M View abstract

Gastro-duodenal ulcer in children

First author: Ciupu D M

Coordinator(s): Sigmirean Marcela

Keywords: Gastro duodenal ulcer children

Background: Gastroduodenal ulcer in children is a rare disease and if not enough attention is paid to it , it can aggravate patients health. Because of the impact of the fast-food industry and because of the limited time spent by parents with their young , children may develop the gastro-duodenal disease . Objective: Our purpose for this study was to evaluate the incidence of gastro-duodenal ulcer at the hospitalized children with gastro-duodenal pathology in a pediatric center. Material and Method: The study was performed on patients hospitalized in the Division of Gastroenterology in  Pediatric Clinic in Targu-Mures , between 30 June 2010 and 30 June 2012 . I selected patients demographics and symptoms, age, diagnosis as well as children associated disease . Results: refering to a total of 250 patients , 1.6% were diagnisticated with gastroduodenal ulcer after endoscopic examinations. The symptoms were: 94% ( 235 patients ) had epigastralgy , 80% ( 200 patients ) had nousea , 70% ( 175 ) had los of appetite , 48 % (120 patients ) had vomiting and in small percentage constipation, pallorand gastroesophagial reflux . Beside the principal diagnosis the patients had secondary disease like : Helicobacter Pylori infections ( 28% ) , Gastroesophagial regurgitation ( 15.6 % ) , Acute deshidratation syndrome ( 11.6 % ) ,Anemia ( 7.2% ) Obesity ( 3.6 % ) Dental caries 2.4 % . Conclusions: Although the majority of the patients suffered from different type of gastritis , we also had to take into account the gastro-duodenal disease . It"s important to diagnose the gastroduodenal ulcer as early as possible to avoid complications. All of the patients were recommended to eat healthier .

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Treatment of supracondylar humerus fractures in children: closed versus open reduction Iszlai Melinda View abstract

Treatment of supracondylar humerus fractures in children: closed versus open reduction

First author: Iszlai Melinda

Coauthors: Kiss S L

Coordinator(s): Gozar H , Derzsi Z

Keywords: supracondylar humerus fracture children reduction

Background: : Supracondylar humerus fractures represent a considerable percentage of the most common types of childhood fractures. Treatment can be either conservative or surgical. It is the most difficult fracture to manage in children, after treatment a functional deficit may frequently remain. Objective: Introduction of Quick Dash score for measurement of outcomes of different methods of treatment. We also compare the orthopaedical, closed reduction (with or without percutaneous pinning) with the surgical, open reduction treatment. Material and Method: : This is a retrospective study, for the period between 01.01.2007 and 31.12.2012,for which we included patients diagnosed and treated with supracondylar humerus fracture at the Pediatric Surgery and Ortopaedics Clinic in Targu Mures, whom accepted the participation. We present the Quick Dash score, the Flynn criteria and the treatment protocol. With the use of the Flynn criteria and the Quick Dash Score we compare the outcome of the chosen treatment method. Results: In this study we included 149 patients with supracondylar humerus fracture, 52 without dyslocation, only imobilization needed.This group was our control population, postoperatory QDS was 3.2. We had 97 patients with dislocated fractures,out of which 34 were female and 63 were male patients.The mean age was 5.11 years for the female group,and 7.14 years for the male group. The dominant fractured side was left- 51.55%, right-48.45%. In 48 cases where closed reduction was performed our QDS was 9.5 and in the 49 cases with open reduction and osteosynthesis, our postoperatory QDS was 20.6. Our range of hospitalization period varied from 2 to 13 days,mean for closed reduction was 2.8 days,and 4.2 days for open reduction. Conclusions: QDS is a safe and reliable instrument of outcome monitorization. Closed reduction is a good alternative, QDS is better, outcome is significantly better , shorter period of hospitalization is needed, compared to the open method.

validated
Occlusal matrix for direct composite resin restorations in posterior teeth: a technique for restoring function and esthetics Ostace Ioana Aurelia View abstract

Occlusal matrix for direct composite resin restorations in posterior teeth: a technique for restoring function and esthetics

First author: Ostace Ioana Aurelia

Coauthors: Ursut H G

Coordinator(s): Monea Adriana

Keywords: occlusal matrix occlusal morphology posterior esthetic restoration

Background: Posterior composite restorations are difficult to contour and polish due to their occlusal anatomy and opposing occlusion. Our study describes a technique for duplicating occlusal surface anatomy, using different dental materials that are able to copy anatomic details. Objective: The aim of the study was to evaluate the efficiency of occlusal matrix technique, by comparing technical ease of different dental materials. Material and Method: The study was conducted on extracted teeth (for orthodontic purposes or due to advanced periodontal disease), which had intact occlusal surfaces or initial carious lesions at this level. An impression of the occlusal surface was made prior to cavity preparation, with four different dental materials: a flow composite, a dual-cure resin cement, a temporary acrylic resin (powder and liquid) and a temporary crown and bridge two-component material in a Unidose®. When the last layer of composite has been placed, the occlusal matrix was forced into the uncured composite to replicate the original occlusal surface, instead of performing manual curing and shaping as in the standard approach. Time needed for complete finishing the case, the hardness of each occlusal matrix and the final morphology obtained were evaluated. Results: The occlusal matrix technique offers an easy and accurate reconstruction of the occlusal morphology and the minimal clinical adjustment.The hardest and the most accurate material was temporary acrylic resin but setting time was longer.The occlusal matrix made with dual-cure resin cement and with  temporary crown and bridge two-component material in a Unidose® require more experience as setting time is shorter. Conclusions: The main benefits of the occlusal matrix technique are the technical ease of use due to its simplicity and its high accuracy in reconstructing occlusal morphology. Although the shortest time needed for occlusal matrix preparation was for the dual-cure resin cement, the best occlusal matrix was obtained with the temporary acrylic resin.

validated
The effect of Carisolv gel on periodontally compromised human root surfaces: an in vitro study Oros Cristina Diana View abstract

The effect of Carisolv gel on periodontally compromised human root surfaces: an in vitro study

First author: Oros Cristina Diana

Coordinator(s): Monea Adriana

Keywords: periodontal disease scaling and root planning CarisolvTM scanning electron microscopy

Background: - Objective: The aim of this in vitro study was to evaluate by scanning electon microscopy (SEM) the morphological aspects of root surfaces after application of Carisolv TM gel in association with scaling and root planing (SRP). Material and Method: 15 freshly extracted periodontally compromised human teeth were randomly assigned in 3 groups: 1) SRP alone; 2) passive topical application of Carisolv TM gel + SRP, 3) active topical application of Carisolv TM gel + SRP. The roots were instrumented until a smooth glass-like surface was achieved. All specimens were further analyzed by SEM. Results: Root surfaces of teeth treated by SRP alone showed more irregularities than root surfaces of teeth treated with CarisolvTM gel and SRP (p<0.05). Root surfaces of teeth treated by passive application of CarisolvTM gel and SRP were more irregular than those of teeth treated with active application of CarisolvTM and SRP (p<0.05). Conclusions: The treatment with CarisolvTM gel caused significant changes on root morphology of periodontally compromised teeth only when the chemical agent was actively applied. CarisolvTM gel failed to completely remove smear-layer, independently of the application technique.

validated
Cytological evaluation of oral candidal carriage in diabetics Csosz Cristina View abstract

Cytological evaluation of oral candidal carriage in diabetics

First author: Csosz Cristina

Coauthors: Stoica Alexandra

Coordinator(s): Moldovan C , Monea Adriana

Keywords: oral candidiasis diabetes mellitus cytology

Background: It has generally been assumed that oral candidiasis occurs with increased frequency in subjects with diabetes mellitus. Objective: The purpose of this study was to define the prevalence of oral candidal carriage in people with type 2 diabetes mellitus versus controls and to identify factors predisposing to colonisation in the diabetic patient. Material and Method: Material and methods 40 subjects with type 2 diabetes mellitus and 35 healthy controls were included in the study. From each individual mucosal scrapings were obtained from the dorsum of the tongue and buccal mucosa. The scrapings were smeared over a glass microscope slide and stained with periodic-acid-Schiff reagent. All slides were examined microscopically for the presence of Candida. Results: A significant difference in Candida species colonization was found between patients with diabetes mellitus and controls (p<0.05). There was a significant positive correlation between glycaemic control and candidal colonization in type 2 diabetics. In the diabetic group, no relationship was found between candidal carriage and age, gender or smoking habit. Conclusions: Diabetes mellitus is a predisposing factor for candidal colonization, and this predisposition is dependent of glucose control.

validated
postoperative care of patients with colostomy Pozdirca P C View abstract

postoperative care of patients with colostomy

First author: Pozdirca P C

Coordinator(s): Molnar C

Keywords: colostomy hygiene complication

Background: A colostomy is created as a meas to treat various disorders of the large intestine, including cancer, obstruction, inflammatory bowel disease, the postoperative care is very important for the patient and future healing and hygiene care. Objective: The purpose of this study is to evaluate the most used procedures and complications for different types of colostomy Material and Method: We conducted a study on all colostomised patients during  2009 - 2011, studying the case of 60 patients with colostomys in the Surgical Clinic I from the County Hospital of Targu-Mures. The studied parameters are: age, sex, clinical diagnosis, complications and operation type. Results: Out of a total number of examined patients 58% were male and 42% female patients, whit the age between 35 - 45 years old 25%, and over 60 years old 75%. Most comonly diagnosis were rectal cancer whit intestinal obstruction 45%, colon and sigmoid tumor 20%, rectal tumor 15%, colon cancer 15% and other diagnosis 5%. The most used procedure were exploratory laparatomy and Hartmann I for the Maydl and sigmoid colostomy 45% of the patients. Only one patient whit neo rectal cancer that recurrenced, four patients whit femural and terminal colostomy had complications because of the lack hygiene. An enterostomal therapist teaches the patients how to care for the colostomy because it is vital for patient and the family not to occur a complication Conclusions: Hartmann I and exploratory laparatomy are the most used procedures and there are less complications for patients with Maydl and sigmoid colostomy if personal hygiene is respected.

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