List of Registered Papers

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Paper First author Other authors Status Details
Study of the electrophoretic behaviour of cephalosporins by capillary zone electrophoresis  Adina Sasebesi Validated View

Study of the electrophoretic behaviour of cephalosporins by capillary zone electrophoresis

First author: Adina Sasebesi

Coordinator(s): Hancu G

Keywords: cephalosporins capillary zone electrophoresis separation electrophoretic mobility

Background:

Nowadays cephalosporins are one of the most important and probably the most frequently used antibiotics in the world, both in terms of the number of compounds currently on the market as well as of their use for the treatment of infectious diseases. Although in therapeutics cephalosporins are not usually administered together, in our studies complex mixtures cephalosporins were analyzed in the same run to prove the suitability of the method for determination of all studied compounds.

Objective:

Our aim was to develop a rapid, simple and efficient method for the simultaneous separation of cephalosporins from different generation , to study the electrophoretic behaviour of certain cephalosporins, and also the optimization of the analytical conditions in order to obtain good separation resolution and short analysis time.

Material and Method:

In this study we analyzed ten cephalosporins derivatives: cefalexin, cefadroxil, cefaclor, cefazolin- first generation; cefuroxime, cefoxitin- second generation; cefoperazone, cefotaxime, ceftazidime, ceftriaxone-third generation. As separation method we used capillary zone electrophoresis, method based on the differences between the own electrophoretic mobilities of the analytes.

Results:

We performed a systematic screening of different background electrolytes at different pH values in order to determinate the optimum electrophoretic conditions. We obtained the best separation at a pH- 7, using a 25 mM disodium hydrogenophosphate - 25 mM sodium dihydrogenophosphate mixed buffer, + 25kV voltaje at a temperature of 25 ºC. Using the optimized electrophoretic conditions we achieved the baseline separation of seven cephalosporins in less then 10 minutes. The analytical method parameters of the optimized method have been checked for: repeatability, linearity, limit of detection.

Conclusions:

Using the described optimized electrophoretic procedures, capillary electrophoresis can be used for the identification and determination of cephalosporins in formulated pharmaceutical products and for separations from complex mixtures.

The association between serum CRP, total cholesterol, triglycerides and coronary artery disease  Beata Virginas Timea Gal Validated View

The association between serum CRP, total cholesterol, triglycerides and coronary artery disease

First author: Beata Virginas

Coordinator(s): Fodor G , Virginas Annamaria

Keywords: trigycerides total cholesterol CRP coronary artery disease

Background:

Although the coronary artery disease is one of the most common heart problem in the world, the risk factors are not totally clarified yet and some studies show contradictory results.

Objective:

Our aim was to investigate the interrelation of coronary heart disease (CHD) and CRP-, total cholesterol- and triglycerides level from the blood.

Material and Method:

Fasting triglycerides and total cholesterol as well as serum C-reactive protein (CRP) were collected on 41 men and women aged 22 to 83 years in the Internal Medicine Hospital III and IV, Targu-Mures from October 2013 to January 2014. 20 individuals were with CHD and 21 patients randomly selected for the non-CHD control group. Blood samples for CRP were collected a few days after admission.  All data were statistically analyzed on PC.

Results:

We did not find statistically significant difference between the two groups, concerning the aforementioned laboratory parameters (P value was 0.3372 for CRP; 0.1727 for cholesterol and 0.8010 for triglycerides).

Conclusions:

Our examination did not demonstrate correlation between coronary artery disease and serum CRP, total cholesterol and triglyceride values.

The numbers of tested individuals were few, undetected heart disease between elderly patients  or lipid-lowering therapies may have influenced the results.

Perinatal infection and pregnancy outcome of Roma and Romanian women  Beata Virginas Validated View

Perinatal infection and pregnancy outcome of Roma and Romanian women

First author: Beata Virginas

Coordinator(s): Virginas Annamaria , Szabo B

Keywords: Perinatal infection bacterial colonization Roma

Background: The Roma are the second largest ethnic minority in Romania, the most socially and economically disadvantaged minority. There is a lack of studies on perinatal infection in roma women.
Objective: The study aimed at determining the prevalence of perinatal infection and comparing pregnancy outcome in roma and romanian pregnant women
Material and Method: In this prospective study total of 252 pregnant women were enrolled from August 1, 2012 to October 2013 at a tertiary care hospital in Targu-mures, Romania. Women were screened for bacterial carriage on admission for premature rupture of membranes and delivery. Insemination sample were collected from maternal cervix.  Risk factors for colonization were collected by a questionnaire, coupled with data from an existing database.
Results: The average age of roma patient was 22 + 5, respectively 28 + 6 of the control group. There were more teenage pregnancies in the Roma group, Romanian women delivered more frequently after age 35. There was a significant difference in socioeconomic status of the two groups. Roma women had less hypertension, gestational diabetes and obesity, more induced abortion, preterm deliveries and grand multiparity. The prevalence of negative test result in the roma and the control group were 75 % and 81 %, respectively
Conclusions: However the majority of roma women had a low socioeconomic status with deficient pregnancy follow up, significant differences between the groups in the rates of the perinatal infection were not observed. Further clinical trials are needed to confirm these findings

ELECTRICAL PROPERTIES OF BIOLOGICAL TISSUES  Anca Enache Camil Fotescu Validated View

ELECTRICAL PROPERTIES OF BIOLOGICAL TISSUES

First author: Anca Enache

Coordinator(s): Florescu Monica

Keywords: electrical impedance biological tissue noninvasive investigation

Background: Electrical impedance (EI) is related to electrical properties in response to an alternating electrical field and it is used for characterizing a materials. For biological materials EI is a function associated with biological structure, cell size and water content. 
Objective:  The purpose of this work is to evaluate the changes of EI in biological tissues for a variation of electric field frequency.
Material and Method: Tesla BM-508 impedance meter was used in connection with two electrodes. The electrodes were fabricated from printed circuit boards with active area of one square centimeter. As biological samples turkey hepatic and renal tissues were used, which have been placed between the two electrodes and were used in same day. The electrical impedance values of each tissue were recorded by applying alternating voltages with constant amplitude and variable frequencies with values between 0.5 and 500 kHz. 
Results: Differences in electrical impedance values were noticed suggesting different electrical properties of liver and kidney tissues. Impedance values also vary function of frequency: for values below 100 kHz the changes are bigger and quickly, while for the frequencies above 100 kHz these are low and take a longer time to occur. These differences are determined by the water content of the material, but electrical properties often vary with changes in structure, composition. This might reflect normal biological variability but another potential source of variability is the change in tissue properties after death or simply reflect experimental artifacts.
Conclusions:

EI measurements were applied in animal experiments. The results obtained  indicate that electric impedance may be a potentially useful tool for the noninvasive investigation of tissue structure and properties or for monitoring physiological change. 
Future studies involving human samples will be undertaken to determine if similar trends as those reported can be revealed.

Post-operative complications in meningiomas involving major dural venous sinuses  Ionut Caravan Maria Iulia Crisan, Cristian Oancea, Andreia Libenciuc Validated View

Post-operative complications in meningiomas involving major dural venous sinuses

First author: Ionut Caravan

Coordinator(s): Florian I S

Keywords: meningioma dural sinus invasion complications

Background: Meningiomas are usually benign tumors. However, those with growth near the major dural venous sinuses, provide management problems due to possible invasion.  
Objective: The aim of our study was to analyze the correlation between meningiomas involving the major dural sinuses (MDS) and post-operative complications.  
Material and Method:

A single-center single-surgeon retrospective study was conducted on 257 patients with intracranial meningiomas, who underwent surgical treatment between January 2008 and December 2013 in the Neurosurgical Department of Cluj County Emergency Hospital. The mean age of the patients was 60 (ranging from 15 to 85), 62% of them being women. Aspects regarding World Health Organization (WHO) grade of tumors, MDS involving and post-surgical treatment complications were analyzed using EpiInfo software. The following were considered as major post-operative complications: hydrocephalus, hemorrhage, cerebral edema, venous infarction, seizures and motor deficit.

Results:

Of 257 patients, 21,79% were reported with MDS invasion and the most frequent dural venous sinuses invaded were superior sagittal sinus (57%) and cavernous sinus (30%). Major post-operative complications occurred in 22,95% of patients. The most common post-operative complications were hemorrhage (35%) and cerebral edema (21%). Meningiomas with higher WHO grade were more prone to invade the venous sinuses than those with lower grade (p=0.03). Patients with MDS invasion had a higher risk of post-operative complications [p=0.01; OR=2.3(CI95% 1.2-4.4)].

Conclusions:

The study emphasizes an increased rate of post-operative complications among patients with MDS invasion by meningiomas compared with those who had not invaded dural sinuses. 

Prognostic factors in Systemic Lupus Erythematosus  Nicoleta Roman Anicuta Ionela Morar, Marcela Leontina Farcas Validated View

Prognostic factors in Systemic Lupus Erythematosus

First author: Nicoleta Roman

Coordinator(s): Copotoiu Monica

Keywords: SLE prognosis LN treatment

Background:

Systemic Lupus Erythematosus (SLE) is an autoimmune, chronic disease that has a various clinical manifestation, evolutions and outcomes. Prognosis in SLE was significant improved in recent years, but the damage specific organs remains an important cause of morbidity in these patients.

Objective:

The aim of the study is to analyse the evolution and the prognostic factors of the patients diagnosed with SLE.

Material and Method:

This is a retrospective and prospective study performed on 74 patients hospitalized in the Rheumatology Department of Tg Mures County Clinical Emergency Hospital between 01.01.2009-30.12.2013. GraphPadPrism 5.0 (the Spearman correlation and the Anova Test) was used to assess the statistical dates.

Results:

In the study group 71 (94,95%) were women and 3 (4,05%) man. The mean age of our SLE patients was 36,04±11,84 years old. 14 (18,91%) developed infections, there was no statistically significant difference between infection occures and treatment with cyclophosphamide (CYC) (p=0,35). A positive, statistical correlation between the CYC and systemic vasculitis was noticed (p=0,001 r=0,38). Lupus nephropathy (LN) was seen in 10 (13,51%) of the patients. A 50 (67,65%) of patients were treated with corticosteroids, 10(13,51%) developes psychiatric disturbances, 4 (2%) femoral head avascular necrosis, 1 (2%) Cushingʼs syndrome, 1(2%) osteoporosis.

Conclusions:

Therapy with corticosteroids was associated with many side effects which may influence prognosis in SLE and LN is one of the most severe manifestations of SLE important for prognosis.

Weight gain during pregnancy and pathological associations  Maria Edwards Ardelean Validated View

Weight gain during pregnancy and pathological associations

First author: Maria Edwards Ardelean

Coordinator(s): Marginean C

Keywords: Pregnancy Obesity Weight Gain Pathological Associations

Background: This study shows that obese women can be at high risk of several complications during pregnancy and delivery, which is also true for newborns.
Objective: To study the effects of excessive weight gain during pregnancy on both the mother and the newborn and to study how much weight before pregnancy can affect the outcome of the birth.
Material and Method: My study group consists of 322 pregnant women (called Group A), who were admitted to the Targu Mures Obstetrics Clinic between 1st January 2012 & 1st January 2013. Group A has been further divided into: Group B (women weighing >=70kg at the beginning of pregnancy), Group C (women weighing <70kg at the beginning of pregnancy) and Group D (women who added >=15kg during pregnancy).
Results:

Women in Group B added more weight during pregnancy than women in Group C. Babies born to women in Group B weighed more than those born to women in Group C. Women in Group C had a higher risk of premature birth. Women in Groups B & D had a higher need to receive Oxytocin injections compared with those in Group C. Women in Groups B & D also had a higher risk of developing gestational diabetes, high blood pressure, preeclampsia and varicose veins compared with those in Group C.

Conclusions: Women from Groups B & D have a higher risk of developing pathological associations and of needing C-sections compared with women from Group C.

RHEUMATOID ARTHRITIS PATIENTS OUTCOME IN INTENSIVE CARE UNITS  Anicuta Ionela Morar Nicoleta Roman, Iulia Grancea Validated View

RHEUMATOID ARTHRITIS PATIENTS OUTCOME IN INTENSIVE CARE UNITS

First author: Anicuta Ionela Morar

Coordinator(s): Copotoiu Monica

Keywords: rheumatoid arthritis critical outcome

Background: Patients with systemic rheumatic diseases may be admitted to Intensive Care Unit because of worsening of or development of a new manifestation of the rheumatic disease,infection or adverse effects drugs.
Objective:

To evaluate the outcome of the patients diagnosed with rheumatoid arthritis admitted in the Intensive Care Unit. 

Material and Method:

An observational study on the patients admitted in the Intensive Care Unit for a critical condition due to the natural evolution of their previous condition - rheumatoid arthritis. We included all the critically ill patients admitted during the last decade, retrospectively for the first six years considered and prospectively for the remaining four years, that is between January the 1st 2003 and the last day of 2012. We used Graph Prism Pad5 to analyze the data. 

Results:

Of the 521 patients treated for rheumatic arthritis, only 23 evolved to a critically ill status . We dropped out 4 surviving patients due to unreliable data management. The reasons for admission were: acute respiratory failure , multiple system organ failure and acute kidney failure. Five in 19 patients had a diagnosis of severe sepsis, two patients had necrotizing vasculitis and one patient had myeloma. The following scores were calculated at admission: Acute Physiology and Chronic Health EvaluationII=15.41+-7.38; Sequential Organ Failure Assessment=6.529+-3.243; Simplified Acute Physiology Score =2 41.29+-13.52. The scores were correlated with demise, the cause of death and treatment. The only statistically significant correlation appeared to be Simplified Acute Physiology Score with sepsis (p = 0.047; r = 0.302).There was no significant difference between length of stay for survivors or dead; Acute Physiology and Chronic Health EvaluationII correlated with demise; Simplified Acute Physiology Score  correlated with sepsis  and demise. 

Conclusions:

While Acute Physiology and Chronic Health EvaluationII  correlates with demise in rheumatic arthritis envolved to a critical condition, Simplified Acute Physiology Score correlates  with sepsis as an aggravating factor.

The evolution of non-motor symptoms in patients with Parkinson’s disease treated with Duodopa intestinal gel  Natalia Pritcan Validated View

The evolution of non-motor symptoms in patients with Parkinson’s disease treated with Duodopa intestinal gel

First author: Natalia Pritcan

Coordinator(s): Szasz J A

Keywords: Parkinson’s disease, non-motor symptoms, Levodopa/Carbidopa intestinal gel (Duodopa).

Background:

Neurodegenerative diseases including Parkinson’s disease represent a major target area for outcome improvement. Levodopa/Carbidopa intestinal gel (Duodopa) is used to treat advanced Parkinson’s disease. 

 
Objective:

The purpose of our study is to observe the benefits of the use of enteral L-dopa infusion on non-motor symptoms for a period of six months at patients with advanced Parkinson’s disease.


Material and Method:

We performed a retrospective study of 18 patients with advanced Parkinson’s disease, hospitalized in Neurology Clinic of Targu Mures County Hospital which were selected for treatment with Duodopa.Each patient was quizzed according to “Non-Motor Symptom Assessment Scale for Parkinson’s Disease” during an interview.The used scale comprises 9 domains:(Cardiovascular, Sleep, Mood, Perceptual problems, Attention/Memory, Gastrointestinal tract, Urinary, Sexual function and Miscellaneous).Each symptom included in this scale was scored respecting the severity and the frequency.

Results:

By comparing  the dates obtained at baseline with those resulted after six months of treatement with Duodopa we have the following results: the symptoms included in the cardiovascular domain are the only with an unfavorable progres (overall score has increased by 62.5 percent) and the most significant improvement was of sexual function symptoms (overall score has decreased by 33.1 percent) and of sleep/fatigue (a decrease of 19 percent of the score).

 


Conclusions:

By providing a continuous flow of medication directly to the intestines, where it is absorbed, Duodopa can help maintain a constant level of levodopa in the blood and by that it decreases the number of times a patient alternates between stiffness and uncontrolled movements (on/off). Duodopa has also benefits on non-motor symptoms mainly on sexual function and sleep/fatigue.


Molecular basis of obesity  Florin Tripon George Crauciuc, Maria Oana Marginean Validated View

Molecular basis of obesity

First author: Florin Tripon

Coordinator(s): Marginean Oana , Banescu Claudia

Keywords: Obesity FTOgene BMIz

Background: Obesity is a major health problem.Previous studies have confirmed that mutations in the fat mass and obesity associated (FTO) gene is associated with body mass index (BMI) ,levels of leptin and ghrelin hormones. Objective:

The aim of our research was to evaluate, in a case-controlled study, if the polymorphisms of RS9939609 and RS17817449 FTO genes are associated with obesity.

Material and Method: We obtained the approval of the Ethic Committee of The University of Medicine and Pharmacy Tg.Mureș.Our study included a control group with 89 children whit age,gender and social status similar to those in the patients group,consisting of 90 young obesity patiens.We obtained from the analysis results(1stPediatrics Clinic Tg.Mures) the values of Leptin and BMIz-score(standard deviation).Genetic DNA was extracted from peripheral leukocytes after that was submitted to restriction fragment length polymorphism-chain polymerase reaction(RFLP-PCR).Amplified products were digested with ScaI respectively AlwNI fast digest enzymes.The results were seen by electrophoresis and a source of UV light. Results: The mean value of BMIz was +2.243 and the mean leptin level was 15.974 ng/ml.In the control group the RS9939609 genotype was found in the following variants: wild type at 33, Heterozygous at 42 and Homozygous mutant on 14. The RS17817449 in the same group was found as Heterozygous at 54 and Homozygous mutant at 35.In the patients group the RS9939609 genotype was found in the following variants: wild type at 28, Heterozygous at 29 and Homozygous mutant on 33. The RS17817449 in same group was found as wild type at 3, Heterozygous at 60 and Homozygous mutant at 27. Conclusions: In statistical terms there is a correlation between RS9939609 gene mutation and obesity. BMIz and leptin levels are directly proportional with the number of mutant allele, an maximum risk have the patients homozygous mutant. No association was found between RS17817449 gene mutation and obesity.

Management of diabetes and its complications – comparative study  Ingrid Feier Validated View

Management of diabetes and its complications – comparative study

First author: Ingrid Feier

Coordinator(s): Szabó Mónika

Keywords: Diabetes-related disease, Prevention, Comparison

Background:


The prevalence of diabetes mellitus in the European population is 6-8%, so it is considered a widespread disease. Prevention and management strategies are well defined and very similar in the European Union. However the implementation of these strategies is different in different countries.

Objective:


The aim of this study is to investigate the differences and its consequences in diabetes management, in a Romanian and German Day care Center.

Material and Method:

In our cross-sectional study we have carried out a comparison of different parameters such as glycated hemoglobin, body mass index, waist circumference, diabetic polyneuropathy, retinopathy, nephropathy on a group of 100 persons from Târgu Mures, Romania with another one also consisting  of 100 persons from Mülheim, Germany. All of the patients had type 2 diabetes.

Results:


The main difference between the two populations is that 93 % of the German persons participated in individual or group training sessions or even both, while none of the Romanian persons visited such a lesson. The mean HbA1c was not statistically different (6,92 %, measured 1 time/year on average  in the Romanian vs. 7,18 % in the German population, determined 3,63 times/year). BMI was 29,8 kg/m2 (German) vs. 30,17 kg/m2(Romanian),  mean waist circumference was 108 cm (Romanian) vs. 106,84 cm (German), the differences are not statistically significant. However microvascular complications of diabetes were more frequent in the Romanian population compared to the German population (p<0.05):  polyneuropathy 73% vs. 54%, retinopathy 28% vs. 7%, nephropathy 22% vs. 8%.

Conclusions:

There are no significant differences between the two groups concerning HbA1c, BMI and waist circumference, but it was a higher prevalence of microvascular complications in the Romanian group, which could be the consequence of the inadequate training and monitoring of HbA1c.

Some principles of local and systemic care of patients with electrocution  Diana-Larisa Suciu Anemona-Madalina Stana Validated View

Some principles of local and systemic care of patients with electrocution

First author: Diana-Larisa Suciu

Coordinator(s): Botan A

Keywords: electrocution, extensive soft, tissues necrosis,electric marks, skin grafts.

Background:

 Electrocutions are the most complex and destructive thermal injuries with high mortality and extensive loss of soft tissues.

 These injuries are produced, when electric current cross through the human body and have to be differentiated from other electrical injuries such as: electric flame or electric arch.

  Skin lesions (entrance and exit points) are known as electrical marks.

Objective:   This paper will deal only with electrocutions,when electric current penetrates a distinct anatomic area crossing through the human body and escaping by an opposite site, producing  characteristic   lesions.

Material and Method:

  This topic presents the case of a 34 year old man that climbed on an electrical pole connected to the industrial electric network (20000 V) ,in order to steal the electric wires.  When he touched the electric wire with his left hand he received a powerful electric discharge that penetrated the radial border of his second finger exiting by several exit points: the elbow joint, the anterior thigh and the right thorax,determining full-thickness burns and extensive necrosis of fascia and underlying muscles. Early escharotomies and extensive excision where mandatory to prevent severe sepsis and acute renal failure due to rabdomyolysis.

Results:

   A very good granulation bed has been obtained at the end of several weeks of local treatment and intensive care IN THE BURN ICU, these very good granular bad has eventually been grafted with meshed autologous  S.T.S.G. harvested from the right thigh. 

Conclusions:

   All electric injuries have to be admitted and cared as soon as possible in a Burn Centre,very large dissections and extensive excisions are the only way to explore the  damage determined by the electric current, thus avoiding early and late complications such as sepsis, acute renal failure, amputation and devastating scars.

EVALUATION ON KNOWLEDGE AND ATTITUDE IN A GROUP OF PEOPLE FROM MURES COUNTY TOWARDS FOOD ADDITIVE INTAKE  Victoria Ancuta Rus Andreea Gaurean, Laura Fisus, Florina Daniela Ruta Validated View

EVALUATION ON KNOWLEDGE AND ATTITUDE IN A GROUP OF PEOPLE FROM MURES COUNTY TOWARDS FOOD ADDITIVE INTAKE

First author: Victoria Ancuta Rus

Coordinator(s): Tarcea Monica

Keywords: nutrition, additives, health

Background: To evaluate the knowledge and attitudes in a group of people in Targu Mures on additives in food consumption and the risk thats confronts population health.
Objective:
Material and Method: Transversal descriptive epidemiological study was conducted on a representative sample of 90 people aged between 18 and 45 from Targu Mures during November 2012-April 2013, achieved by applying a questionnaire consisting of 29 questions concerning knowledge and attitudes towards additives and estimated food consumption of additives in food.
Results: In our group 71% know what food additives means, and the remaining 29% do not give importance to these additives, 67% are aware that additives can be harmful to the health, 77% considers artificial additives more harmful than natural ones, 71% considers these substances are necessary for the food safety, 80% consider that it distributes more food of inferior quality containing increasingly higher additived for 43% the official controls on food quality are sufficiently rigorous, 55 % recognize and undersand the significance of Es; are considered harmful the following: 3% antioxidants, 38% sweeteners, 36% acidifiers and 63% colorants.
Conclusions: In the group there is a significant percentage showing unhealthy food behavior and an increased intake of food additives, although thei knowledge of the presence and risk of food additives are well developed.

The psiho-social impact of the product label over the medical student  Laura Fisus Victoria Ancuta Rus Validated View

The psiho-social impact of the product label over the medical student

First author: Laura Fisus

Coordinator(s): Pașca Maria Dorina

Keywords: health medicine label product

Background: The medical student becomes more and more aware that his dietary decisions influence his life,health and development in the medical domain.The disease has more than one father,but only one mother:nutrition.
Objective:

The conducted study aims to find out the importance and the impact of the food label over the medical student. 

Material and Method: The psychological investigation-questionnaires(300 subjects-180 Ist year and 120 final year General Medicine) 
Results: Read the labels:Ist year 77.77%,final year-83.33%,are interested in the label Ist year-79.44%,final year-75%.Allotted time and attitude:before paying Ist year-66.11%, final year-66.66%,after exiting the shop,Ist year-20.83%,final year-16.66%,not reading label at all Ist year-17.23%,final year-12.51%.Where does he read it:in the shop- Ist year-76.11%,final year-66.66%,before eating it 1st year-12.50%, final year-12.50%,in a hurry,Ist year-11.04%,final year-20.84%.How do you read it:in a rush-Ist year-36.11 %,final year-50 %,carefully-Ist year-37.77 %,final year-33.33%,selectively-Ist year-26.11%,final year-26.11%.How do they read it:only what interests him-Ist year-50%,final year-25%,reads all-Ist year-39.44%,final year-58.33%,doesn’t read it-Ist year-10.56%,final year-20.84%.Layout:unclear-Ist year-80%,final year-75%,uninteresting-Istyear-10,55%,final year-16.66%,dull-Ist year-9,44% final year-8.33%.Changes:clearer labels–Ist year-80%,final year-75%,uninterested-Ist year-12,22%,final year-33.33%,more colorful–Ist year-5,71%,final year-8,33%.Reads the labels for-products without additives,synthetic dyes-Ist year-67,22%,final year-54.16%,no calories-Ist year-20%,final year-25%,out of boredom-Ist year-12,77%,final year-20.83%.Don’t like the label–Ist year-66,66%,final year-41.66%,not interested–Ist year-22,22%,final year-37.5%,read full label–Ist year-16,66%,final year-20.83%.
Conclusions: Judging by the conducted study,an important number of medical students pay attention to the product labels but still,there are some who do not pay attention to the label.Therefor further education on the importance of the product label is needed.

History of doping in athletism  Robert-Alexandru Vlad Gabriel-Cosmin Popescu Validated View

History of doping in athletism

First author: Robert-Alexandru Vlad

Coordinator(s): Hancu G

Keywords: athletism doping performance enhancing drugs history

Background: Doping is defined as the presence in the human body of substances which are prohibited according to the list published by the International Olympic Committee and/or the international organization of the member organization in question. The use of doping is prohibited within the sport of athletics; athletes who are found to have used such banned substances, either through a positive drugs test or public admission, receive a competition ban for a length of time, which reflects the severity of the infraction.
Objective:

The aim of this study is making a brief comparative presentation of substances and methods used for doping at the beginnings of professional sport to the modern ones that are used nowadays.

Material and Method: Since antiquity the athletes used substances, which could give them additional powers, but in those days “doping” wasn’t known. It became a big problem in modern sports in the XIX-th century; until 1960 when the first anti-doping committee was establish, substances like: amphetamine, ephedrine, diuretics, high growth hormone, were used. Despite the fact that antidoping rules became increasingly stricter, and more substances were prohibited, there are still athletes, which are “cheating”.
Results: There are lots of substances blamed for enhancing the capacity of concentration or the muscular mass, as: anabolic agents, peptidic hormones, growth factors, corticotrophins, beta 2 agonists, hormones and metabolic modulators, diuretics; but also we can mention forbidden methods like: blood transfusions, blood components manipulating.
Conclusions:

As the time is passing new methods of cheating by doping appear, substances that are untraceable (clean substances). Genetic doping could be a new tool used by today athletes. Sadly we can conclude that nowadays taking in consideration human nature and the social and economic implications of professional sports end of doping in athletics is unrealistic.

STATE OF THE ART CARDIAC SURGERY: MINIMALLY INVASIVE CABG (MINI CABG)  Marcus Jee Poh Hock Kaisser Gallaby, Vera Catarina Barnabe, Ong Wee Liam, Mihaela Budrescu Validated View

STATE OF THE ART CARDIAC SURGERY: MINIMALLY INVASIVE CABG (MINI CABG)

First author: Marcus Jee Poh Hock

Coordinator(s): Tinica G , Siveetharan S

Keywords: Mini CABG Coronary artery bypass grafting Cardiac Surgery Open Heart Surgery

Background:

The prevalence of coronary heart diseases(CHD)is drastically increasing. However,with today's increasing medical cost,and recovery time of the patient,enumerating infection and mortality rate, a standard CABG seems inaccessible these days.

Objective: Our objective is to search for a single surgical technique: advanced yet simple enough in-order to tackle all the above stated issues that can be applied to all medical institutes and preexisting  protocols. Material and Method:

In August2012 the authors traveled to India to research and collect data from the developer of this technique himself. This technique is a modified CABG, reducing its incision length to only 6cm compared to it predecessor of 14 cm, and refusing usage of heart-lung machine.There is no more need for a sternotomy(unless complications) thus reducing the pain scale and the length of hospital stay. The technique, starts as a 6cm incision at the 4th intercoastal space or at the midline, insertion and usage of Marquet Stabilizer, then the repair of the artery is done. All within 1-2 hours.

Results:

The "Mini CABG" technique that we are researching targets all the aberrations of a conventional CABG. Additionally producing better results not only on a medical scale but also on a socio-economic level including reduced cost(10x less), recovery time(3weeks only), pain score(3/10), admittance period(3-5 days), surgical duration(1-2 hours maximum), infection rates(0.22%), nil usage of heart-lung device, incision length(6CM ONLY), nil or partial sternotomy, massive decrease of blood transfusion needed.AS Such, with lower risk of infection and a smaller scar, less recovery time and pain, decreased bleeding risk, mortality rate decreased, and finally a much lower cost gives an unprecedented result of an improved quality of life to our patients.

Conclusions:

Based on the data and results of our findings,The"Mini CABG",proves superior to the conventional CABG in every aspect possible.We highly recommend that the standard protocol along with its indications should be altered in the coming future based on all its advantages.

3D echocardiographic assessment of the correlation between regional contractility and regression of left ventricular remodeling following revascularization of occluded coronary arteries  Ioan Sorin Pop Bogdan Daniel Jerdea, Paul Ruzsa, Daniel Balan Validated View

3D echocardiographic assessment of the correlation between regional contractility and regression of left ventricular remodeling following revascularization of occluded coronary arteries

First author: Ioan Sorin Pop

Coordinator(s): Benedek Theodora , Benedek I

Keywords: remodeling revascularization myocardial infarction left ventricle

Background: Regional contractility plays an important role in determination of the pattern of ventricular remodeling following an acute myocardial infarction.
Objective: We aimed to study the correlation between regional contractility and regression of left ventricular remodeling following revascularization of occluded coronary arteries using a 3D complex echocardiographic analysis.
Material and Method: We enrolled 38 cases with chronic total occlusion on left anterior descending artery that was revascularized. A reduction of the left ventricular diastolic diameter with more than 15% at 3 months after revascularization was considered to represent reversed remodeling (RR). Group 1 included 22 patients with RR positive, while group 2 included 16 pts without RR. Regional index of contraction amplitude was determined using 3D echocardiography, defined as the ratio between the sum of contraction amplitude in myocardial area irrigated by the occluded artery and the number of those myocardial segments.
Results: Baseline EF was lower in group 1 while ventricular volumes and RICA were significantly higher in group 1 as compared with group 2 (2,70 vs 2,05, p=0,01). We recorded a statistically significant correlation between RICA and the regression of remodeling (p=0,02). ROC analysis indicated a superior good predictive value of RICA for ventricular remodeling regression (area under the curve of 0.72, p=0.003). We identified a RICA cut-off point of 2.6, presenting a sensitivity of 77%, and a specificity of 69% for regression of ventricular remodeling regression.
Conclusions: Regional contractility could play a significant role in predicting the recovery following revascularization of chronically occluded artery, as indicated by regression of ventricular remodeling in patients with less severe impairment of regional contractility.

Clinical and functional outcomes of anterior cruciate ligament reconstruction and rehabilitation  ancuta diana badiu Adelina Macec Validated View

Clinical and functional outcomes of anterior cruciate ligament reconstruction and rehabilitation

First author: ancuta diana badiu

Coordinator(s): Russu O

Keywords: anterior cruciate ligament Tegner Lysholm Knee Scoring Scale ACL reconstruction and rehabilitation

Background: Anterior cruciate ligament tear is one of the most frequently knee trauma.Tegner Lysholm Knee Scoring Scale is one of the most used scale in the evaluation of anterior cruciate ligament deficient knee.Some have even claimed it to represent the "gold standard" method. Objective: The aim of this study is to demonstrate the efficiency and importance of anterior cruciate ligament reconstruction and rehabilitation of the patients with ACL tears in order to improve daily/sports activities. Material and Method: We realized a short retrospective study involving 47 patients, 18 females and 29 males, aged between 13 and 59 (mean age 27,4) with anterior cruciate ligament tear treated at the Orthopaedics and Traumatolgy Clinic in Targu Mures, during 2012-2013. All the patients were assessed using Tegner Lysholm Knee Scoring Scale that takes up symptoms during daily activities. Results: We determinated the Tegner Lysholm Knee Scoring Scale before surgery and in 10 cases (21,3%) we obtained values between 65-83 (wich means a fair outcome) and in 37 cases (78,7%) we obtained a score <65 (wich means a poor outcome).In the age group 20-25 years we observed mostly cases with a poor outcome (12 cases) and with a fair outcome mostly cases were <20 years (4 cases).After anterior cruciate ligament reconstruction we obtained in 7 cases (14,9%) values between 65-83 (a fair outcome), in 27 cases (57,4%) a score between 84-94 (good outcome) and in 13 cases (17,7%) values between 94-100 (excellent poutcome).In the age group >36 years we observed mostly cases with a fair outcome (4 cases), a good outcome were observed between 20-25 years (11 cases) and <20 years we had mostly cases with an excellent outcome (5 cases). Conclusions: Using Tegner Lysholm Knee Scoring Scale we have managed to demonstrate an improvement of life condition of the patients after ACL reconstruction and rehabilitation.

Genetic polymorphisms of XPD Arg156Arg and XPD Lys751Lys DNA repair genes in patients whit Acute Myeloid Leukemia  George Crauciuc Florin Tripon Validated View

Genetic polymorphisms of XPD Arg156Arg and XPD Lys751Lys DNA repair genes in patients whit Acute Myeloid Leukemia

First author: George Crauciuc

Coordinator(s): Banescu Claudia

Keywords: DNA repair pathways XPD AML

Background: Acute myeloid leukemia (AML) is characterized by an increase in the number of myeloid cells in the marrow and an arrest in their maturation, frequently resulting in hematopoietic insufficiency,with or without leukocytosis.Genetic defects are thought to be important factors in determining the desease and the response to chemotherapy and outcome. Xeroderma pigmentosum group D(XPD) are mainly involved in base excision repair(BER) and nucleotide excision repair(NER) of DNA repair pathways. Objective: The aim of the study was to estabilish some genetic relationship between AML and XPDArg156Arg and XPDLys751Lys genes polymorphisms. Material and Method: Our study included a number of 98 patients and a control group whit 157 healty persons.Genetic DNA was extracted from peripheral blood than was submitted to chain polymerase reaction(PCR).The PCR products was digested whit 2U of TfiI for XPD156 respectively PstI for XPD751 fast-digest enzymes.The results were seen by electrophoresis in 2% agarosis gel and a source of UV light. Results: The average age of both groups is 48.55 years, 59.50% being men and the remaining women.In the control group the results for XPD156 genotype were: 42% homozygote normal, 37.5% heterozygous and the other 20.5% homozygote mutant. In the patients group for the same gene 30.7% was homozygote normal, 52% heterozygous and 17.3% homozygote mutant.In the control group the results for XPD751 genotype were: 43.3% homozygous normal,43.9% heterozygous and the remaining homozygous mutant. In the patients group for the same gene 33.6% was homozygous normal, 53% heterozygous and 13.4% homozigous mutant. Conclusions: In statistical terms there is a correlation between XPDArg156Arg heterozygous genotype,one of the DNA repair pathway and AML(p=0.0321;OR 1.902;CI:1.074-3.368), not the same we can say about XPDLys751Lys gene mutation and susceptibility to AML.To our knowledge this is the first study from Romania who investigated both genes at the same time.

SOME METHODS OF THE SURGICAL AND CONSERVATIVE TREATMENT OF KELOID SCARS  Adriana Boțan Validated View

SOME METHODS OF THE SURGICAL AND CONSERVATIVE TREATMENT OF KELOID SCARS

First author: Adriana Boțan

Coordinator(s): Botan A , Cozma D V

Keywords: keloid scars post-burn deformities surgical treatment conservative treatment

Background: Plastic surgery has evolved as a medical specialty at the beginning of the twentieth century, especially during and after the First World War, out of the necessity for treating burns and post-burn deformities. Objective:

The aim of this clinical presentation is to emphasize some particularities in the surgical and conservative treatment of deforming scars.

Material and Method: In this scientific paper there are presented three cases of post-burn scars with various locations and a case of a postoperative keloid scar. The first three cases were treated using surgical techniques: large excision, local flaps, Z-plasty, full-thickness skin grafts and so on. The last case has been treated in a conservative manner: local infiltration of triamcinolone with xylocaine. Results: Surgical treatment is preferred for those cases where the postoperative result is considered to be superior to the initial aspect. Surgical techniques are applied only to old, neglected scars (hypertrophic scars are submitted only for conservative treatment). The regions where conservative treatment is mandatory are known as “noli me tangere” (the retroauricular, presternal and deltoid regions), invasive surgical techniques must be avoided at all costs. Conclusions: Scar management (especially for post-burn deformities) is an arduous process requiring long term follow-up and a perfect collaboration between patient and physician. Even after the reconstructive intervention, monitoring and conservative treatment of the surgical result is mandatory. Preventing scar development through various techniques (frequent light and deep massage, special topical gels, wearing of pressure garments) is the cornerstone of all therapeutic procedures involved in scar management.

Nursing postoperative complications in gastric cancer surgery  Krisztina-Georgina Pentek Validated View

Nursing postoperative complications in gastric cancer surgery

First author: Krisztina-Georgina Pentek

Coordinator(s): Molnar C

Keywords: gastric cancer index Charlson nursing

Background: Neoplasm pathology remain a major health problem. Gastric cancer in particular requires special attention in preoperative and especially postoperative nursing. Objective:
Identification of pre-operative risk factors in patients with gastric cancer and their correlation with postoperative patient evolution.

Material and Method:

 We studied, retrospective observational, a group of patients with gastric cancer (n = 195) during 01.01.2010- 31.12.2012 following age, gender, origin, diagnosis, laboratory examinations, mortality, Charlson comorbidity index, operation, postoperative evolution, postoperative index Clavien-Dindo.

Results: Of all the patients where postoperative complications were observed, we could establish a direct link between Charlson comorbidity index and postoperative complications (Clavien-Dindo index) with other factors (age, sex, laboratory exams) that influence the patient evolution. Conclusions:
Anticipation of postoperative complications in patients with gastric cancer confers a strategic advantage in management / nursing of these patients.

Calcium score as a predictor of coronary artery disease severity in patients with acute coronary syndromes  Charikleia Tsolakidou Validated View

Calcium score as a predictor of coronary artery disease severity in patients with acute coronary syndromes

First author: Charikleia Tsolakidou

Coordinator(s): Benedek Theodora

Keywords: Calcium score coronary syndromes coronary artery disease

Background:

Calcium score is used as a prognostic tool

Objective:

We aimed to assess the role of the calcium score as an indicator of severity of coronary artery disease in  subset of patients with acute coronary syndromes (ACS). 

Material and Method:

We enroled 30 patient with acute coronary syndromes –  who underwent Cardio Computed Tomographic Angiography (CCTA), for assesment of coronary artery circulation and calculation of calcium score. Patients were divided into three groups, according to their calcium score levels: group 1 – 7 patients with calcium score below 100, group 2 – 12 patients with calcium score between 100 and 400, and group 3 – 11 patients with calcium score above 400 

Results:

Mean calcium score was 25.08 +/-21.94 in gr.1, 203.97 +/- 76.68 in gr.2 and 808.8 +/- 369.48 in gr.3 (p<0.0001). Mean age was 60 years in gr.1, 65 years in gr.2 and 64 years in gr.3.  Ejection fraction was significantly lower in gr.3 as compared with the first two groups (54,33% in gr.1, 53% in gr.2 and 48,09% in gr.3, p=0.03). Location of the culprit artery in the left anterior descendent artery was encountered more frequently in group 3 (72,7% vs 66,7% vs 66,7%). Also, 3 vessel disease was more frequent in gr.3 (16,7% in gr.1 vs 3,3% in gr.2 vs 27,3% in gr.3) while one single artery disease was more frequent in group 1 – 83,3% in gr.1 vs 58,3% in gr.2 vs 9,1% in gr.3 (p=0.02). 

Conclusions:

Calcium score is significantly associated with the severity of coronary artery diseaase and can be used as a useful prediction tool to evaluate the prognostic significance of coronary lesions in a non-invasive way. 

Interferences between depression and life quality on patients suffering of type 2 diabetes  Madalina Crisan Madalina Salagean, Ioana Barsan Validated View

Interferences between depression and life quality on patients suffering of type 2 diabetes

First author: Madalina Crisan

Coordinator(s): Buicu Gabriela , Taran Livia

Keywords: depression life quality diabetes type 2

Background: Patients with diabetes have an icreased risk of developing along life, one or more depressive phases.Studies made upon patients with depression have showed a big rate of comorbidity with type 1 or 2 diabetes. Objective: Investigating the relation between depression and the quality of life of patiens suffering of diabetes type 2, being under treatment with oral antidepressants. Material and Method: A prospective study made on a number of 256 patiens with diabetes type 2 , treated in Mediab Center from Targu Mures in colaboration with specialized ambulatory of  Psyhiatric Clinic No.1, during September 2011-2013.

Batch No.1 :128 patients have recived daily dozes of  Duloxetina (60mg/day).
Batch No.2:128 patients have recived daily dozes of SSRI (Sertralina 50mg,Escitalopram 10 mg).
Short form of the quality of life evaluation questionaire was given,main request being asking them to describe the quality of life from their past month.The questionaire was completed in the begining of the antidepressive therapy and 1 year of therpy.
Results: High results were obtained for all questionnaires ,the average score was around 31.6 regarding the group which was supposed to take Duloxetina and 30.5 regarding the group which was to take SSRI.After one year,during which patients have continued the treatment with antidiabetics and antidepressant (Duloxetina and SSRI),the impact of diabetics and quality of life was reevaluated , obtaining a reduction of over 70% of all item in the questionnaire, scores being 8.4 in Duloxetina group and 13.4 in SSRI group. Conclusions: Comorbid depression of diabetes is associated with the reduction of life quality of patiens.Treatment with Duloxetina is superior to the one with SSRI when it comes in improving the life quality of patients suffering of depression associated with type 2 diabetes.

Radiographic evaluation of endodontic morphology in permanent teeth  Alexandra Stoica Pavel Dulau, Arnold Felix Bobb Validated View

Radiographic evaluation of endodontic morphology in permanent teeth

First author: Alexandra Stoica

Coordinator(s): Monea Monica

Keywords: endodontic configuration teeth anatomy root canal treatment

Background:

 A detailed description of the root canal anatomy which is considered normal, regarding the number of roots and root canals of one specific tooth, is a basic condition for a successful endodontic treatment. During the years, many efforts have been made in order to systematize and clarify the root canal configurations of permanent teeth, but even today we face difficult endodontic situations.

Objective:
The purpose of our paper is to present some rare anatomic aspects that were encountered during the endodontic treatment of permanent teeth, which we consider that are important to be taken into consideration. 

Material and Method:
We conducted a retrospective radiographic investigation based on all endodontic treatments provided by dental undergraduate and postgraduate students at the Faculty of Dental Medicine in Tg.Mures, between October 2011- February 2014. All anatomical variations related to unusual radicular form, number of roots and root canals were recorded and for each group of teeth the frequency of such alterations was calculated.

Results:
The results showed that the upper front teeth presented with curved roots in 17% of cases, for lower front teeth we found double canals in 32%, upper premolars had 3 roots in 6% of the cases and the first upper molar had 4 canals in 39% of the cases. 

Conclusions:
In conclusion, we must integrate these results into every day dental practice and in our work a major step forward was accomplished by the introduction of the endodontic microscope and cone beam computed tomography. 

Dentinogenetic capacity of dental pulp: a histological study  Alexandra Stoica Marius Ursu, Anamaria Roxana Szabo Validated View

Dentinogenetic capacity of dental pulp: a histological study

First author: Alexandra Stoica

Coordinator(s): Moldovan C , Monica Monea

Keywords: MTA Calcium hydroxide capping procedures dentine bridge.

Background:

 Early carious lesions induce odontoblast stimulation in tertiary dentine formation even before the lesion reach the dentine. The most used material for indirect pulp capping procedures was calcium hydroxide, which in the last decade was replaced frequently with Mineral trioxide aggregate. 

Objective:
The purpose of our study was to assess the histological characteristics of tertiary dentine induced by these materials in permanent molar teeth . 

Material and Method:
We used  23 molars scheduled for extraction for orthodontic reasons in patients of 18-24 years of age who gave a written agreement to participate in this study. In a time interval of 4-8 weeks prior to extraction, occlusal cavities were prepared and obturated with MTA or calcium hydroxide and glass ionomer cement. 

Results:
In teeth obturated with MTA as an indirect pulp capping material we noticed early development of dentine bridge, with a tubular structure, similar to secondary dentine. In the case of calcium hydroxide, the amount of new dentine formation was delayed, atubular dentine and stones were noticed.

Conclusions:  MTA proved to be superior to calcium hydroxide in inducing dentine bridge formation, which appered early after treatment. In time the differences in the amount of tertiary dentine between these materials are reduced, but there is a tendency of difuse mineralization induced by calcium hydroxide. 

Tissue reactions induced by dental pulp capping materials: a histological study  Ovidiu Cristea Romeo Brezeanu, Alexandra Stoica, Rania Timeea Seserman Validated View

Tissue reactions induced by dental pulp capping materials: a histological study

First author: Ovidiu Cristea

Coordinator(s): Monea Monica , Moldovan C

Keywords: MTA calcium hydroxide biocompatibility pulp capping

Background: Biocompatibility is a condition that must characterize all materials used in conservative dentistry, which means no risk of side effects on contact with host tissues. In the case of pulp capping materials, this is expressed by many variables such as carcinogenesis, cytotoxicity, biocompatibility and antimicrobial effect
Objective: The aim of this article is to evaluate the biocompatibility of materials used in pulp capping procedures, by measuring the degree of inflammation induced by these products after subcutaneous implantation in rats
Material and Method: We used 12 animals divided in 3 study groups and 1 control group; implants with Mineral trioxide Aggregate, Life cement and Calxyd were placed in subcutaneous tissue and histological evaluation was carried out after 7, 14 and 21 days.
Results: We obtained comparable results between MTA and Life cement, which demonstrates that these materials have similar degrees of biocompatibility
Conclusions: Based on this experimental study, MTA and calcium hydroxide containing cements express similar biocompatibilities, but this is not enough in order to eliminate the letter from every day dental practice. Further clinical studies are necessary in order to evaluate the potential of MTA to induce dentin bridge formation on exposed dental pulp

IMPACT OF SHORT BLS TRAININGS AMONG UNIVERSITY STUDENTS  Paul Mihai Boarescu Ioana Chirilă Invalidated View

IMPACT OF SHORT BLS TRAININGS AMONG UNIVERSITY STUDENTS

First author: Paul Mihai Boarescu

Coordinator(s): Bocșan C I

Keywords: basic life support cardiopulmonary resuscitation university students

Background: Survival from out-of-hospital cardiac arrest is dependent on the rapid onset of bystander cardiopulmonary resuscitation (CPR) and the early arrival of advanced rescuers and equipment. Bystander practice of basic life support (BLS) is therefore essential for patients’ survival and is an important part of effective emergency services for a patient that need resuscitation. However, bystanders, can only play their role within the chain of survival if they are adequately trained and if continuous repetitions of relevant training information are offered and used.
Objective: To survey the knowledge and attitude towards BLS of the university students from Cluj-Napoca and to determine the impact of short BLS practical trainings.
Material and Method: A questionnaire survey was administered to 165 university students during a campaign for first aid. The questionnaire consisted of three sections - section 1 with demographic data, section 2 completed before the BLS training and section 3 completed after a short BLS training. During the BLS training each student had his own instructor who explained the BLS protocol and they had the chance to perform CPR on a model.
Results: All 165 participants answered the questionnaire. The mean age of the sample population was 21.97±/2.68 years old and 110 (66.7%) participants were females. 81.21% of students mentioned that they have never taken the first aid education. Before BLS training 93.7% of the responders did not recognize the correct steps of BLS and 92.1% said that is necessary to check the pulse of the patient. After training 41.8% of the students mentioned the correct order of the steps in BLS, with a significant improvement of their knowledge regarding BLS (p=0.000).  All of them recognized the utility of the training.
Conclusions:  A short BLS practical training offer a basic knowledge of the life support in case of emergency situations.

PREGABALIN EFFECT ON THE INFLAMMATORY INDUCED PAIN   Ioana Chirilă Paul Mihai Boarescu Validated View

PREGABALIN EFFECT ON THE INFLAMMATORY INDUCED PAIN

First author: Ioana Chirilă

Coordinator(s): Bocșan Corina Ioana

Keywords: Pregabalin pain inflammation rats

Background:

Pregabalin is an antiepileptic drug from the new generation. It has analgesic, anxiolytic, and anticonvulsant effects due to a particular mechanism of action. 

Objective:

To investigate the analgesic effect of pregabalin in acute administration on inflammatory induced pain in rats.

Material and Method:

40 male Wistar Bratislava rats were included in the study. The animals were randomized in 4 homogenous groups of 10 rats: a control group treated with saline solution (0.5 ml/100 g), 1 group treated with diclofenac (15mg/kg) and 2 groups treated with pregabalin (PGB) (30 mg/kg, 15 mg/kg). Acute inflammation was performed by injecting 0.1 ml of kaolin into the posterior left paw. Inflammatory edema was followed up by measuring paw volume using a Ugo Basile plethysmometer. Pain threshold was measured at both paws and noted on response latency hyperalgesia produced by mechanical compression. The data were analyzed with statistic significance at p <0.05. 

Results:

Measurement of paw volume after PGB administration did not reveal significant changes of edema. Groups treated with PGB reveals elevated pain threshold in the first hours after administration. In PGB group treated with 30 mg/kg there is an inverse correlation between inflammatory edema and pain threshold at 2 hours (r = -0.698, p = 0.02).  Pain threshold values are increased significantly compared to control group at 1 hour (5,66±1,75 vs 4,47±1,67)  and 2 hours (6,33±1,67 vs 4,76±1,48) for group 3 (p=0,04), and at 1 hour in group 4 (7,66±2,48 vs 4,47±1,67p=0,03). 


Conclusions:

PGB did not significantly modify the volume of inflammatory edema in rats. Both doses of PGB show significant anti-hyperalgesic effect within 4 hours after administration on inflammatory induced pain. Anti-hyperalgesic effect is dose-dependent. 

IMPROVING THE QUALITY OF LIFE IN GERIATRIC PATIENTS WITH KINETOTHERAPY  Ion Daniel Mihaila Daniela Mihaila, Tudor Voda Validated View

IMPROVING THE QUALITY OF LIFE IN GERIATRIC PATIENTS WITH KINETOTHERAPY

First author: Ion Daniel Mihaila

Coordinator(s): Copotoiu Monica

Keywords: Kinetotherapy quality of life fall

Background: The concept of quality of life is very broad and dynamic. According to the World Health Organization it is the perception of the individuals’ position in life, expectations, standards and concerns.
Objective: The aim of the study is to analyse the beneficials of kinetotherapy in improving  the risk of falling of the geriatric patients, and such their quality of life.
Material and Method: This is a prospective study performed on 10 geriatric patients between 1st of November 2013 till 1st of March 2014. The Tinetti and the Berg scales were used in order to assess the gait. All the patients followed a physical rehabilitation programme and were reevaluated after one week, a month, and three month. Graph Pad Prism 5.0 was used to assess the statistical date.
Results: The mean age of the subjects involved in the study was 70.10 +/- 8.55 years old. Six were females and 4 males. Half of them were diagnosed with hypertension and one with atrial fibrillation. Three patients were obese and one suffered of osteoarthritis. At the initial evaluation four out of ten patients presented with medium risk for fall, three with high risk of falling and three with low risk of fallling according with the Tinetti scale. The Berg scale noticed 2 persons in need of an assissted device for walking,and 3 persons dependent of another one. The mean value of Berg scale at the beginning of the study was 37.40 +/- 19.11, unchainged after 3 months of physical exercise. The Tinetti scale’s mean values at the beginning were 18.70+/-8.17 and at the 3 months of 20.78+/- 5.16.; but one patient died during the study.
Conclusions: Despite the new rehabilitation programme imposed, none of the subjects involved in the study improved their outcome in terms of risk of falling and regaining independence.

INFECTIONS IN PRETERM BIRTH  Marcela Leontina Farcas Anca Geanina Clapon, Nicoleta Roman Validated View

INFECTIONS IN PRETERM BIRTH

First author: Marcela Leontina Farcas

Coordinator(s): Grama O

Keywords: risk factors infections preterm birth

Background:

The definition of preterm birth, accepted all around the world is pregnancy ending before 37 weeks or 259 days of gestation. Intrauterine infection has been recognized as a frequent and important mechanism in preterm birth.


Objective: The purpose of this study is to determine the frequency of preterm births associated with infections in urban versus rural environment and the age at which is the most frequently seen premature birth.
Material and Method: We performed an observational retrospective study on women admitted for preterm birth, under 37 weeks, during January - August 2013 in Obstetrics and Gynecology Clinic no.2 from Targu Mures.
Results: There were 102 preterm birth in this period, 37 (36,27%) from urban environment and 65 (63,73%) from rural environment. In  21 cases microbiological tests were not performed; in the 81 cases with microbiological tests, 51 were positives and 30 negatives. 74,19% of preterm birth in rural areas have been associated with infection compared with only 25,81% of preterm birth in urban areas.
Conclusions: Infections in preterm birth are most frequently in rural areas, perhaps because of socio-economic conditions, as well as the lack of health education.

EPIDEMIOLOGICAL AND CLINICAL FEATURES OF LIVER CIRRHOSIS  Xenia Dolghii Validated View

EPIDEMIOLOGICAL AND CLINICAL FEATURES OF LIVER CIRRHOSIS

First author: Xenia Dolghii

Coordinator(s): Macarie Melania

Keywords: Cirrhosis HCV Alcohol abuse

Background:

Cirrhosis is known as a highly alarming disease, moreover it is a frequently met pathology among the patients of Gastroenterology departments. Alcohol abuse and viral infection are the worldwide most common causes.

Objective: The aim of this study is to establish the main epidemiological and clinical aspects of this disease in our geographical area.
Material and Method: A retrospective study was performed which included all the  patients with liver cirrhosis admitted in Gastroenterology department of Tîrgu Mureș Emergency County Hospital between 01.01.2013-31.12.2013. The patients were divided in two groups: newly diagnosed, and the ones with a known diagnosis. The readmissions were excluded. Additionally, according to age the patients were stratified into 2 groups: under the age of 50 years old and over 50 years old.
Results: During the studied period 302 cirrhotic patients were admitted in the Gastroenterology division of Tîrgu Mureș Emergency County Hospital. In the study were included 239 patients with a median age of 58.13 years old. There has been noticed a male prevalence of cirrhotic patients (149 male vs 90 female) with a M/F ratio of 1.65/1. A higher predominance was noticed in the under 50 years old group with an underlined ratio of M/F of 2.5/1. Regarding the etiology, the most frequent is the toxic one, which was identified in 62.34% (n=149) of cases, followed by the viral etiology (HCV) detected in 27.19% (n=65) of cases. The distribution of both etiologies was concluded to be consistent even after the sample division in two subcategories; still with a predominance of toxic etiology in the under 50 years old group, 77.55% (n=38) vs 58.94% (n=112) of patients over 50 years old.
Conclusions: All these findings confirm that cirrhosis is a frequently encountered disease. Oftentimes it is diagnosed even among the young population being caused by alcohol abuse, succeeded by viral etiology.

CLINICAL FEATURES AND ULTRASOUND PARAMETERS IN PULMONARY ARTERIAL HYPERTENSION IN PEDIATRIC CARDIOLOGY  Hanga-Katalin Gáspár Validated View

CLINICAL FEATURES AND ULTRASOUND PARAMETERS IN PULMONARY ARTERIAL HYPERTENSION IN PEDIATRIC CARDIOLOGY

First author: Hanga-Katalin Gáspár

Coordinator(s): Toganel Rodica , Suteu Carmen

Keywords: Pulmonary Arterial Hypertension Pediatric Cardiology Echocardiography 6 Minute Walk Test

Background: Although the past decade has witnessed extensive progress in the field of pulmonary arterial hypertension(PAH), need remains for better understanding and management of this disease.
Objective: Evaluation and 1-year follow-up of clinical manifestations and ultrasound parameters of children suffering from PAH, receiving Bosentan, Sildenafil or combination therapy.
Material and Method: A total of 41 children were included, 21 from Târgu Mureș Emergency Institute for Cardiovascular Diseases and Transplantation and 20 from the National Institute of Cardiology Gottsegen György, Budapest. Patients were enrolled between January 2008- March 2013, aged between 4 months and 15 years (mean age 5.16), and divided into 4 groups based on the causative disease: idiopathic PAH, post-operative PAH, Eisenmenger’s syndrome and bronchopulmonary dysplasia(BPD). Symptoms, functional class, results of the six-minute walk test and heart ultrasound parameters have been evaluated at enrollment and one year after.
Results: In the Eisenmenger group, saturation improved with a mean value of 3.23%(3.8%), whereas distance walked increased with 30.6m(9.1%). Although saturation decreased averagely by 0.75%(0.8%) in the idiopathic group, and the drop in oxygen saturation at the end of the test was pronounced, distance walked increased significantly, with a mean value of 89.33m(28.7%). Right atrial area increased in all groups, most in BPD by 1.79cm2(39.9%), and least in the post-operative group by 0.75cm2(5.36%). TAPSE decreased in the idiopathic group with a mean value of 2.02mm(10.9%), and increased in the remaining three, most in the BPD group with 3.25mm(20.2%).
Conclusions: Bosentan and Sildenafil are efficient in improving life quality, functional status and exercise capacity in PAH, but do not significantly improve cardiac status, only stall the progression of the disease.Differences in disease progression can be noted, Eisenmenger patients react better to treatment than those suffering from idiopathic PAH. Further research is to be made to develop specific aetiologic therapies to combat this devastating disease.

HUNTER SYNDROME - DIAGNOSIS AND TREATMENT  Lorena-Elena Melit Maria Oana Marginean Validated View

HUNTER SYNDROME - DIAGNOSIS AND TREATMENT

First author: Lorena-Elena Melit

Coordinator(s): Duicu Carmen

Keywords: Hunter mucopolysaccharidose treatment Elaprase

Background: Mucopolysaccharidoses (MPSs) are a group of rare genetic disorders within the larger family of lysosomal diseases. MPSs disorders are caused by a deficiency in the activity of a specific lysosomal enzyme required for the degradation of glycosaminoglycans (GAGs). MPS type II, also called Hunter syndrome consists in a deficiency of an enzyme, iduronate-2-sulphatase. 
Objective: To present the details about one of our patients diagnosed with Hunter syndrome and a literature review.  Material and Method: Though several cases with metabolic disorders were diagnosed in our clinic during the years, only one patient remained under treatment and the follow-up details of this case are presented. Results:

A 2.7 year-old boy who was admitted to the Paediatrics Clinic with symptoms of a respiratory tract infection and a history of frequent ear infections and respiratory tract infections. His clinical examination showed the following abnormalities: high stature, moderately overweight, facial dismorphism (coarse facial features, prominent forehead,   a depressed nasal bridge), small stubby fingers with flexion of distal interphalangeal joints, joint stiffness, protruding abdomen with umbilical hernia, hepatomegaly and splenomegaly, and also mild mental retardation.
The clinical aspect was suggestive for MPS type I, II or VII. Dosage of enzymes with role in mucopolysaccharide lysosomal metabolism revealed low levels of iduronate-2-sulphatase, changes that bent for MPS type II. Enzymatic diagnosis was confirmed by molecular DNA analysis that showed a homozygote mutation of iduronate-2-sulphatase gene in intron 3 (c.419-2A> G). Enzyme replacement therapy with recombinant human iduronate-2-sulfatase (Elaprase®) was started.
The evolution of the case after almost two years of treatment with Elaprase is sensitively favorable, without the lost of neurological acquisitions.

Conclusions: Despite the modern methods of diagnosis and treatment, most of the patients with metabolic disorders dye in their childhood period.

Rate and causes for conversion from laparoscopic to open colecistectomy   Marta-Elena Rotaru Andreea Romaniuc, Alexandra Ancuta Bunoiu, Alexandra-Bianca Grama, Razvan Mares Validated View

Rate and causes for conversion from laparoscopic to open colecistectomy

First author: Marta-Elena Rotaru

Coordinator(s): Popa D

Keywords: laparoscopic cholecistectomy conversion complications

Background:

Nowadays laparoscopic colecistectomy is the gold standard procedure for treating gallblader diseases.In this study ,we determinated ,over a period of 5 years, the main reasons for conversion from laparoscopic to open colecistectomy and also the frequency of these cases.

Objective: The purpose of this study is to point  out a decline in the number of procedures requiring conversion from laparoscopic to open colecistectomy, but also to account for the particular cases in which such a procedure was mandatory in ensuring the optimal results.
Material and Method: This is a retrospective study undertaken  between 1st january 2008 and 31 st december 2012 at the first surgical Clinic of Mures county Emergency Hospital.The study involved 3.030 patients which underwent laparoscopic colecistectomy,from this number we found 30 cases which required conversion  and we further analysed them for possible causes.
Results: The data we colected revealed the number of  cases requiring conversion compared to the total number of laparoscopic colecistectomies as follow:  7 out of 516 cases in 2008,5 out of 650 cases in 2009, 10 out of 648 cases in 2010, 6 out of 563 cases in 2011, and  3 out of 659 cases in  2012. The main factors demanding conversion were:  rupture of  the inflamed gallblader ( cholecystitis) ,pericholecistitis, cholecystitis with empyema.
Conclusions: Our study has found that the number of conversions has decreased and out of  all occurrences of this procedure,the greater part were caused by the rupture of the inflamed gallbladder ( cholecystitis). 

Acute bacterial meningitis in infants and children  Lorena Emilia Rad Validated View

Acute bacterial meningitis in infants and children

First author: Lorena Emilia Rad

Coordinator(s): Grama Alina

Keywords: Bacterial meningitis infants and children Streptococcus pneumoniae Neisseria meningitidis

Background: Bacterial meningitis is an inflammation of the meninges, in particular the arachnoid and the pia mater, associated with the invasion of bacteria into the subarachnoid space. The inflammmatory process also affects the brain parenchyma(meningoencephalitis), the ventricles and spreads along the spinal cord. Acute complications include cerebral edema, increased intracranial pressure, ventriculitis, brain abcess, cerebral infarction, hydrocephalus. Objective: Our purpose for this study was to establish the most common meningeal pathogens and also the onset of bacterial meningitis. Material and Method: We performed a retrospective study and our research materials consisted of the medical records of the patients admitted in the Paediatrics Clinic of Targu-Mures between 2008 - 2012. Results: In the 5 year period (2008-2012) a number of 19 cases were diagnosed, 52.63% being boys and the remaining girls. In 2008 there were 0  cases, in 2009 were diagnosed 3 patients(15.78%),in 2010 - 5 patients(26.31%), in 2011 - 7 cases(36.84%) and in 2012 we found 4 cases(21.05%). There were 4 deaths(21.05%), with an equality between boys and girls, two of them had acute meningoencephalities and two had tuberculous meningitis(10,52% from all cases, 50% from deaths).

The pathogens involved were: Haemophillus Influenzae type B (10.52%), Streptococcus pneumoniae(10.52%),, E. Coli(10.52%),Mycobacteriam tuberculosis(10.52%), Neisseria meningitidis(5.26%) and 52.63% with unknown pathogens (10 cases, 7 with meningoencephalities - 36.84%). 52.63% were under 3 months, 21.05% between 3-24 months and 26.31% over 2 years old.
Conclusions: The factors of organism, age group and year significantly affected incidence, but the sex did not.Although it does not affect a large number of infants and children, it kills or permanently damages at least one fifth of those affected.

The Adherence to Treatment Regarding the Patients with Rheumatoid Arthritis  Ana-Maria Toma(Gabor) Estera Gabor Validated View

The Adherence to Treatment Regarding the Patients with Rheumatoid Arthritis

First author: Ana-Maria Toma(Gabor)

Coordinator(s): Copotoiu Monica

Keywords: adherence rheumatoid artritis medical problem

Background:

Non-adherence to medication regarding chronic diseases represents a major public health problem, which is difficult to manage. Adherence is also lower than it is expected in rheumatoid arthritis. This fact aggravates the evolution to invalidity of the disease and this is not only a medical problem, but also a social problem.

Objective:

The purpose of this study was to evaluate the adherence to treatment in patients with rheumatoid arthritis and to look for possible factors associated with non-adherence in order to prevent this phenomenon.

Material and Method:

A correlational, descriptive study of 50 patients hospitalized in the Rheumatology Clinic of Emergency County Hospital of Targu Mures between 1st July and 1st October 2013 was performed. There has been applied a questionnaire based on questions referring to the behavior of the patients to their treatment and it has been followed the possible factors that may influence the adherence to medication. GraphPad program and Microsoft Excel program were used for the statistical interpretation of the data.

Results: The adherence of the studied group was 66%. There were statistically significant differences between the patients under 60 years old and the patients over 60 years old (p=0,01; RR=1,7). Very significant differences were found between the group of the patients affected by the disease less than 10 years (inclusive) and the group diagnosed for more than 10 years  old (p=0,05; RR=1,8).
Conclusions:

The adherence to treatment is a problem for patients with rheumatoid arthritis. The age of the patients and the number of the years from diagnosis may influence the adherence to treatment.

New directions for the development of H1-antihistamines class  Roxana Goga Validated View

New directions for the development of H1-antihistamines class

First author: Roxana Goga

Coordinator(s): Rusu Aura , Hancu G

Keywords: H1-antihistamines mechanism of action astemizole cyanoguanidine derivates

Background:

At the beginning of the 1940’s the H1-antihistaminergic drugs were introduced via the first compound, phenbenzamine. After this molecule, the scientists started to develop other new compounds that were integrated in the first generation of H1-antihistaminergic compounds (e.g. clemastine, clorpheniramine, cyclizine and promethazine). Due to their well known side effects such as sedation or fatalities after overdose, the second generation had been developed with the aim of improving the quality of life based on their safety profile.  

Objective:

New directions for the development of H1-antihistamines class are the result of a sustained concern for these drugs. After several studies, the scientists highlighted the benefits of the second generation in other diseases.  

Material and Method:

Besides recent studies which shown with accuracy their molecular mechanism as inverse agonists, the studies revealed some interesting uses for several molecules (e.g. astemizole, hydroxyzine, cyclizine a.s.o.). These new discoveries give the opportunity of introducing them in the clinical use with the purpose of curing other diseases, for example astemizole in bruxism. Also the cyanoguanidine derivates of loratadine proved their efficacy in the tumor and inflammatory processes. 

Results:

Although they were categorized like antihistamines, the significant differences in pharmacokinetics, pharmacodynamics and their adverse effects led to a new approach for these molecules in order to be used for the treatment of other diseases.  

Conclusions:

The future directions for the H1-antihistaminic drugs put them under high priority update because there is an assiduous necessity to improve the clinical use in therapy and to develop new strategies of using these molecules. 

  

Preliminary clinical results after Medial Patellofemoral Ligament Reconstruction  Paul Ruzsa Mihaela-Alexandra Gal, Bogdan Daniel Jerdea, Ioan Sorin Pop Validated View

Preliminary clinical results after Medial Patellofemoral Ligament Reconstruction

First author: Paul Ruzsa

Coordinator(s): Russu O

Keywords: MPFL reconstruction patellofemoral instability Tegner Lyshom Scale patellar dislocation

Background: Medial patellofemoral ligament (MPFL) reconstruction is a surgical procedure indicated to patients with severe lateral patellofemoral instability. The first to describe this procedure was Dr. Ellera Gomes in 1992, and since then there have been various approaches to this technique. The most important structure that stabilizes the patella and helps prevent patellar subluxation or dislocation is MPFL. Injury or destruction of this ligament is one of the main causes of acute and recurrent patellofemoral instability.


Objective: The objective of this study was to evaluate the short-term clinical results of patients after MPFL reconstruction.

Material and Method: The study included the first 10 cases of MPFL reconstruction performed in the Orthopaedic and Traumatology Clinic, in Târgu Mureş, during 2012 - 2014. There were 6 female and 4 male patients aged between 16 - 38 years old who had recurrent patellar dislocations and underwent MPFL reconstruction with double bundle technique which replicates the native shape of the MPFL using a gracilis autograft. The clinical evolution of the patients was evaluated by using the Tegner Lysholm Knee Scoring Scale preoperative and postoperative. 

Results: All 10 cases had between 2 - 7 patellar dislocations before undergoing surgery. There were no postoperative patellar complications or redislocations and the patients regained full mobility after 6 weeks. The mean value of Tegner Lysholm score improved to 90.8 (range 82 - 95) from a preoperative mean value of 63.5 (range 55 - 72).

Conclusions: Regarding the different methods of treating lateral patellofemoral instability MPFL reconstruction is one of the most promising procedures performed nowadays. Our results show a significantly improved knee function and physical activity in patients treated with this procedure, but in order to clearly state the long-term benefits of this reconstruction technique a large scale case study, based on more cases, is required.

The correlation between clinical and histopathological diagnosis in adults with chronic tonsillitis  Adelina Huza Validated View

The correlation between clinical and histopathological diagnosis in adults with chronic tonsillitis

First author: Adelina Huza

Coordinator(s): Neagos Adriana

Keywords: clinical histopathological tonsil adults

Background:

The tonsil diseases are among the most common problems related to health in the general population.Difficulties in identifying clinical and laboratory changes involved in the tonsils physiopathology  created confusion in precise conclusions about treatment.

Objective: Describe the correlation in frequency of occurrence between age groups, gender and living environment in patients with chronic hypertrophic tonsillitis and evaluate whether histopathological diagnosis correlates with the clinical diagnosis.
Material and Method: This study was conducted within 3 years, from 2011 to 2013 on a cohort of 89 adults with hypertrophic and atrophic chronic tonsillitis prospectively enrolled, representing a simple randomized sample. They were divided in 3 age groups:18-30 years, 30-50 years and > 50 years; 2 living environments: urban and rural; by gender: male and female.The followed parameters: histopathological, clinical diagnosis, age, living environment and gender.
Results:

There are 84 patients with chronic hypertrophic tonsillitis and 5 with atrophic.The average age for hypertrophic is 31,24 years with a majority of male patients(n=43; 51,19%).There was no statistically significant difference in terms of chronic hypertrophic tonsillitis regarding gender(p=0,9525, t=0,06727), living environment (p=0,7949, t=0,2963) and age groups(p=0.8775). The correlation of clinical and histopathological diagnosis shows a significant difference between them, only 52,81%(n=47) of them match(p=0,1745, t=2,068).

Conclusions: There is no significant difference of occurrence related to age, gender and living environment.In most cases the treatment is instituted before the histopathological result is available, so in order to establish the best conduct it is highly important that the clinical diagnosis and the histopathological one to coincide.This studies shows that almost half(47,19%, n=42) of the patients have different histopathological and clinical diagnosis, conducting, perhaps, to errors in the medical practice.

Oxazolidinones: present and future   Karola Tolvai Validated View

Oxazolidinones: present and future

First author: Karola Tolvai

Coordinator(s): Rusu Aura

Keywords: oxazolidinones linezolid hybrids

Background:

Because of increasing bacterial resistance to classic antibiotics the synthesis of new molecules with antibiotic effect is a necessity and a permanent challenge. Discovered in the late '80s, the oxazolidinone class is one of the relatively new classes of synthetic antibiotics that is effective on Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus, penicillin-resistant streptococcus and vancomycin-resistant enterococcus. The first approved representative was linezolid.

Objective:

The aim of the study is to highlight the spectacular evolution of oxazolidinones class by presenting synthesis methods, the mechanism of action, biological effects and the new and promising molecules.

Material and Method:

At least thirty pharmaceutical companies tried to develop new improved molecules, starting with the linezolid structure. Some compounds did not exceed the phase 1 of the clinical trials, including eperezolid, ranbezolid. The reasons were inappropriate pKa properties, low solubility, poor safety profile or no significant difference from linezolid. Though there are more compounds under investigation. 

Results: Sutezolid appears to be superior to linezolid like a tuberculostatic agent. Also tedizolid phosphate is superior to linezolid by potency, spectrum and the safety profile. Promising derivatives are radezolid and posizolid. A very interesting class are the hybrids of oxazolidinone: catazolid (promising in the treatment of Clostridium difficile infections), MCB 3837 (does not produce bacterial resistance), a mefloquine’s hybrid (anti-tubercular activity), a hybrid biarylooxazolidinone (superior translation and bacterial inhibition), and nitroimidazolyl-oxazolidinone hybrids (potency at non-cytotoxic concentration). Other biological effects and possible uses are under investigation for some derivatives: anticoagulant activity, antidepressant, CNS depressant, phospholipase inhibitory, centrally acting muscle relaxants, antithyroid agent, antiblastic activity in chemotherapy, cycloserine analogues and even agriculture fungicide. 
Conclusions:

The class of oxazolidinones is characterized by the particular mechanism of action and the chemical structure of the compounds. Oxazolidinones comprise, alongside of linezolide, a series of compounds in different stages of development that are very promising as effective antibiotics but also for other biological effects.

The awareness of young athletes regarding their nutritional needs  Stefan Adrian Martin Validated View

The awareness of young athletes regarding their nutritional needs

First author: Stefan Adrian Martin

Coordinator(s): Tarcea Monica

Keywords: Sports nutrition athletes foods protein carbohydrate fat

Background: Diet provides the essential foundations for long-term success. The daily food intake has to maintain health and avoid the occurrence of injuries, assist in developing the best shape and, last but not least, it has to support the body in all the stages of training to bring the athlete to the start line of the competition.
Objective: To evaluate the knowledge of young athletes in the field of sports nutrition.
Material and Method: A transversal qualitative study was conducted to evaluate the nutritional knowledge of pupils from an institution such as the “Szász Adalbert” Sports High School in Tîrgu Mureş in 2013. A total of 100 students, members of various sports teams, were questioned, 76% males, 24% females, with a mean age of 17.84.
Results: A small precentage 17% of the young athletes planned their menu for the following day; 59% knew the correct answer to protein content foods; only 6% of the respondents answered correctly to questions related to foods containing carbohydrates; only 12% possessed knowledge about foods containing lipids. 
Conclusions: The pupils’ knowledge in nutrition is reduced to a worrying level for the proper development of the body because athletes need a sufficient amount of energy to do sports and for the proper development of the body. One major goal and a solution would be a solid education in nutrition which could be done in schools.

Anthropometric and Bioelectrical impedance measurements of paediatrics oncologic patients  Andrei Rendes Iordan Alexandru Mihalcea Validated View

Anthropometric and Bioelectrical impedance measurements of paediatrics oncologic patients

First author: Andrei Rendes

Coordinator(s): Mărginean Oana , Chinceşan Mihaela

Keywords: Bioelectrical impedance Anthropometry Children Malignancy,Body composition

Background: Poor nutritional status among paediatrics oncologic patients is a serios medical nowadays problem.Evaluation of body composition gives useful information abaut nutritional status of the patient,helping the doctor to manage and stop the nutritional deterioration applaying necessary hygienic-dietary measures.
Objective: The purpose of the study is to determine the nutritional status of the paediatrics patients with cancer using anthropometric measurements and bioelectrical impedance.
Material and Method: We performed a prospectiv study on 45 children hospitalized in the Paediatrics Clinic I Targu-Mures,between October 2013 and March 2014.The children wer divided into two groups:group  I,15 patients whit malignant diseases and group II,30 patients whit various pathologyes.We performed body composition using bioelectrical impedance:bio-impedance (BIA),fat%,fat mass (kg),fat-free mas (FFM),muscle mass,total body water (TBW),TBW%,and the following antropometric measurements:weight,height,body mass index (BMI),middle upper arm circumference (MUAC),tricipital skin fold (TSF).Data obtained from the two groups were statistically evaluated.
Results: The children with malignant diseases have height,weight,body mass index lower than control group,but whitout statistical significance (p>0.05),according to FFM (kg),TBW (kg),muscle mass (kg),BIA without major differences between the two groups.We found statistically significant differences according in MUAC:p=0.05; TSF:p=0.05; Fat%:p=0.02; Fat mass (kg):p=0.05; TBW%:p=0.03.
Conclusions: The study reveals that children with malignant diseases have a poor nutritional status comparing with the children suffering from other diseases.

Pulmonary affections associated with cardiovascular affections in the casuistry of the Forensic Medicine Institute of Targu Mures in the 2008-2010 period  Camelia Vig Nicolae - Alexandru Golovei - Petris Validated View

Pulmonary affections associated with cardiovascular affections in the casuistry of the Forensic Medicine Institute of Targu Mures in the 2008-2010 period

First author: Camelia Vig

Coordinator(s): Csiki G

Keywords: pulmonary edema pulmonary stasis pulmonary system cardiovascular system

Background:

The connection between the pulmonary system and cardiovascular system is well appreciated. Pulmonary vascular abnormalities and cardiac affections are frecvently present at patients with respiratory affections like chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, sarcoidosis, affections of the neuro-muscular system or thoracic wall, hypoventilation syndrome in obesity. The presence of pulmonary heart disease suggests a bad prognosis and increased risk of death. Systemic manifestations of pulmonary affections are important because they often increase the risk of cardiac death.

Objective: Studying the correlation between the pulmonary and cardiovascular affections
Material and Method:

We effectuated a statistical study of pleuro-pulmonar affections associated with cardiovascular affections in the causitry of the Forensic Medicine Institute of Târgu Mureş in the 2008-2010 period.

Results: The most frecvent pulmonary affections in this period were the pulmonary edema (35 cases in 2008, 120 cases in 2009 and 79 cases in 2010) and pulmonary stasis (17 cases in 2008, 67 cases in 2009 and 51 cases in 2010). The most frecvent cardiovascular affections associated to pulmonary edema were the coronarosclerosis (68,57% in 2008, 68,33% in 2009, 74,68% in 2010) and miocardosclerosis (51,42% in 2008, 50,83% in 2009, 59,49% in 2010). The most frecvent cardiovascular affections associated to pulmonary stasis were coronarosclerosis (64,70% in 2008, 67,16% in 2009 and 78,43% in 2010), miocardosclerosis (58,82% in 2008, 58,82% in 2010) and cardiomegaly in 2009 (56,71%).
Conclusions: In the examined period, the most frecvent pulmonary affections were pulmonary edema and pulmonary stasis. The most frecvent cardiovascular affections associated to these pulmonary affections were coronarosclerosis, miocardosclerosis and cardiomegaly in the case of pulmonary stasis.

The spectrum of neuroendocrine lung tumors, clinicopathological features and morphology  Adina Roman Sebastian Andone Validated View

The spectrum of neuroendocrine lung tumors, clinicopathological features and morphology

First author: Adina Roman

Coordinator(s): Mezei T

Keywords: neuroendocrine immunohistochemistry lung tumors

Background: Lung tumors with neuroendocrine differentiation include a wide spectrum of clinicopathological entities. These have some common morphologic, ultrastructural, immunohistochemical and molecular characteristics, but show significant differences in epidemiological, clinical, histological, survival and molecular characteristics. 


Objective: To review and study neuroendocrine lung tumors incidence and pathological features of cases registered at the Pathology Department at our institution.

Material and Method: We studied 52 neuroendocrine lung tumors diagnosed at the Pathology Department of Targu Mures County Clinical Emerngency Hospital over a ten year period, between 2003-2013. We studied parameters concerning various clinicopathological features.

Results: The selected 52 neuroendocrine tumors represent 10,8% of total lung tumors diagnosed at the same period. These were divided into two groups: low grade (28,8% of cases) and high-grade (71,2%) tumors. Former includes typical carcinoids and atypical carcinoids, the latter includes small cell lung carcinoma and large cell neuroendocrine carcinoma. Average age in the first group is 50 years and in the second one 58 years, this difference being significant (p=0.02). Immunohistochemical profiles show the following: the first group was positive for Chromogranin A (100%), Synaptophysin (26,6%) and CD56(20%) whereas the second group showed less Chromogranin A (43,7%), Synaptophysin and CD56 (18,7%) expression.

Conclusions: The incidence of neuroendocrine tumors in our institution is slightly lower compared to other similar studies and represent a significant proportion of diagnosed cases. We found that patients with low-grade tumors have a lower average age. Additionally there are some differences regarding the immunohistochemical expression of various neuroendocrine markers, most notably Chromogranin A. Despite the fact that there are studies regarding lung tumors in selected Romanian population, to our best knowledge so far there are no recently published data concerning tumors with neuroendocrine differentiation particularly.

Assessment of outcomes and differences between in- and out-of-hospital cardiac arrest patients  Bill Qalander Ali Mir-Kohler Nadia Al Namat, Xenia Lo Giudice Validated View

Assessment of outcomes and differences between in- and out-of-hospital cardiac arrest patients

First author: Bill Qalander Ali Mir-Kohler

Coordinator(s): Nedelea P , Cimpoesu Diana

Keywords: In-Hospital Cardiac Arrest Out-of-hospital cardiac arrest Cardiac Arrest

Background: The incidence rate of cardiac arrest in Romania has increased over the years due to cardiovascular disease and trauma. The documented outcome of patients after an out-of-hospital cardiac arrest (OHCA) or an in-hospital one (IHCA) yet remains poor. Resuscitation is often over shadowed by the failure of neurologic recovery of the affected patients. Objective: To understand better the differences in management and outcomes between OHCA and IHCA. Material and Method: We present a retrospective study. This was done at the Emergency Department of the University County Hospital St. Spiridon in Iasi, Romania between January 1st and December 30th of 2013. Results: There were 109 recorded patents with cardiac arrest (CA) - (59 OHCA, 50 IHCA), aged 29 to 88 years old with an overall survival rate of 7,3% (8 patients, 4 in the OHCA and 4 in the IHCA group). The aetiology of CA was mainly cardiac (36,7%). The initial rhythm of CA was a shockable one in 29 cases (26,6%) versus non-shockable in 80 cases (73,4%). Initial return of spontaneous circulation (ROSC) was achieved in 36 patients (33,02%) of the whole study group. The outcome of discharged patients was directly influenced by the duration of chest compressions (p<0.01); 2 patients from the group with IHCA were discharged with a cerebral performance category (CPC) 3, while 3 patients with a CPC 2 (2 from IHCA group and 1 from OHCA); only 2 patients were discharged with a CPC 1, both from the OHCA group. Conclusions: The success of resuscitation, both in OHCA and IHCA, is low. Similarities were found in other European reports, having multiple causes. Furthermore, the outcome of discharged patients was directly influenced by the duration of chest compressions during CPR.

Domestic Violence  Nadia Al Namat Bill Qalander Ali Mir-Kohler, Xenia Lo Giudice Validated View

Domestic Violence

First author: Nadia Al Namat

Coordinator(s): Dumea Mihaela , Cimpoesu Diana

Keywords: Domestic Violence Physical Trauma Psychological Trauma

Background: Domestic Violence is a pattern of behaviour which involves the abuse by one partner against another in an intimate relationship. The chronic exposure to domestic violence can cause not only immediate physical injury, but also mental shifts that occur as the mind attempts to process trauma or protect the body. Objective: To understand the nature and differences in domestic violence. Material and Method: We present a retrospective study. This was done at the Emergency Department of the University County Hospital St. Spiridon in Iasi, Romania between January and December 2013. The study included adult patients diagnosed with lesions caused by domestic violence. All patients in the study recognised the abuse, by family or first/second degree relatives, verbally. Results: There were 1105 patients, of which 105 (9,5%) were harmed physically and/or psychologically by one or more members of the family. We report an average age of 46,64 years, 82 women (78,1%) and 23 men (21,9%). Patients brought into the Emergency Department were mainly from the countryside, by ambulance accompanied either by physician or nurse - 56 (53,3%) or paramedics - 21 (20,0%). The mechanisms of lesions were presented either by punches - 60 (57,1%), blunt objects - 22 (21%) or mixed mechanisms - 23 (21,9%). The lesions were known to be caused mainly by a single aggressor - 98 (93,3%), husband - 53,4% - statistically significant correlation (p<0.01) identified the preponderance of female aggressed by a single aggressor (husband), and cases of males by several aggressors represented by second degree relatives. In all cases the association with sexual abuse was 1%. Conclusions: During that period domestic violence was frequently identified in cases of females from an urban environment, aggressed by close relatives. Sexual abuse was not recognised. This study requires confirmation at national level, in areas having different socio-economic and demographic features.

Laparoscopic Splenectomy   Xenia Lo Giudice Validated View

Laparoscopic Splenectomy

First author: Xenia Lo Giudice

Coordinator(s): Vittorio Lombardo

Keywords: Laparoscopic Splenectomy Laparoscopic vs conventional methods Splenomegaly

Background: Multiple techniques for splenectomy are now employed and include open, laparoscopic and hand-assisted laparoscopic splenectomy (HALS). Concerns regarding a purely laparoscopic splenectomy for massive splenomegaly (>20cm) arise from potentially longer operative times, higher conversion rates and increased blood loss. The laparoscopic technique offers the potential advantages of shorter hospital stay and less postoperative pain. Objective: To demonstrate the advantages and differences between Laparoscopic Splenectomy versus conventional methods. Material and Method: We report a case of laparoscopic splenectomy for a massive splenomegaly secondary to hematologic disease. Results: Operative time was 90 minutes, estimated blood loss was minimal, if any. Length of stay in hospital was 4 days. The patient had no postoperative complications. Conclusions: Laparoscopic splenectomy seems a safe and effective technique for the management of spleens larger than 20cm. The technique results in shorter hospital stays, and it seems a good alternative to open splenectomy when treating patients with massive splenomegaly. It should be performed by experiences surgeons with advanced laparoscopic skills.

PRELIMINARY STUDIES REGARDING THE EFFECT OF COLLAGENOUS GELS WITH MARINE ALGAE EXTRACTS IN THE TREATMENT OF INTRA-ORAL HERPES SIMPLEX  Edwin Sever Bechir Farah Curt-Mola Validated View

PRELIMINARY STUDIES REGARDING THE EFFECT OF COLLAGENOUS GELS WITH MARINE ALGAE EXTRACTS IN THE TREATMENT OF INTRA-ORAL HERPES SIMPLEX

First author: Edwin Sever Bechir

Coordinator(s): Monea Monica , Pacurar Mariana

Keywords: marine fish and algae herpes simplex treatment

Background: The treatment of intra-oral herpes simplex can also be performed by alternative methods. Objective: The aim of our research was represented by the determination of the healing properties of six products obtained from the use of collagenous gel extracts from marine fish skin, combined with tree marine algae, in the treatment of intra-oral herpes simplex. Material and Method: The extracts from the marine algae were incorporated in type I non denatured collagen matrices.

The trial was conducted on 42 patients (17 women and 25 men, aged between 11 and 46), affected by intra-oral herpes simplex. We determined the required number of applications and the time needed for healing, for every gel, respectively the remission period of the intra-oral herpes simplex lesions.
The application of the gels was performed two times daily, for 3 days, on the affected area.
The objective assessment consisted of: recording the decreasing level of the dimension and erythema of the herpes lesion and the remission period of the disease. For the subjective assessments, the patients were asked to state the presence/absence of pain while tasting, speaking and eating/chewing.
The evolution of the clinical symptomatology, after the first application of the gel, was evaluated daily, for 7 days, in order to ascertain the healing process, both objectively (the healing state of the herpes lesions and the remission period of the disease), and subjectively (the receding degree and time for the pain).
All the patients were kept under observation for one year and a half.
Results: The obtained results showed that the most efficient gel in the healing action was the collagenous gel containing 10% Ceramium Rubum. Conclusions: The resources offered by the Black Sea bio-system can be used, with good results, to reduce the healing time in patients suffering from herpes simplex.

Assay of calcium and magnesium from cheese products by complexometry and ICP method  Nicoleta Pascari Rodica Somesan Validated View

Assay of calcium and magnesium from cheese products by complexometry and ICP method

First author: Nicoleta Pascari

Coordinator(s): Gaz Florea S A , Ognean L

Keywords: Complexometry ICP Calcium and magnesium Cheese

Background: Milk is basic food since the first days of our lives, and together with its derivatives becomes the main source of calcium and magnesium ions that ensure a harmonious development of the body. The question is "what" and "how much" of these products should be eat to maintain a balance. Although nowadays the price and taste are first things that come in mind of regular customers, we need to know how to read and understand the information on the label to obtain maximum nutritional benefits.
Objective: Our aim was to determine and quantify calcium and magnesium in diary products to ensure enough supply of these ions based on the daily recommended doses.
Material and Method: Analysis of calcium and magnesium were done on a Perkin Elmer ICP as well as using complexometry analysis (titriplex III with colour indicators). Samples were prepared using and adopted literature method.
Results: While complexometry gave information for total quantity of magnesium and calcium, ICP was able to provide more detailed data. Surprisingly water collected from salted cheese („telemea”) was extremly rich in both calcium and magnesium with more than 1 g/ml Ca2+. Also other kind of cheese were analyzed as well as water used in the manufacturing process. All data gave a good reproducibility with RSD values less than 5.0.
Conclusions: The main component of milk is water, first link in the chain of manufacturing, therefore use of a natural source rich in minerals is "the ace" of every producer. Knowing the recommended daily dose for minerals it is possible to ensure necessary ion quantity without resorting to supplements Developed method was able to assay calcium and magnesium from different cheese products with a good reproducibility. A correlation of obtained values with recommended daily dose was made.

FAVORING FACTORS OF DEFICIENCY DISEASES IN CHILDREN  Andreea-Iulia Csiszer Niculina-Oana Diaconu, Alexandra Martin Validated View

FAVORING FACTORS OF DEFICIENCY DISEASES IN CHILDREN

First author: Andreea-Iulia Csiszer

Coordinator(s): Borka-Balas Reka

Keywords: anemia rickets children deficiency

Background:

The most common deficiency diseases in children are anemia, rickets and malnutrition. Although prevention methods are used for these diseases, serious cases requiring hospitalization and long-term treatment are identified.

Objective: To evaluate the favoring factors in deficiency diseases in children.
Material and Method:

We performed a retrospective study over a period of four years, in children hospitalized in the Pediatric Clinic No. 1, diagnosed with anemia and rickets between 2009 and 2012. We used Chi-square test to analyze the data.

Results:

The study population consists of 79 children: 69 were diagnosed with anemia and 10 with rickets. We considered anemia and rickets favoring factors: prematurity, short or absent breast feeding, early cow milk introduction, incorrect diversification, inadequate living conditions and inappropriate rickets prophylaxis. Of the 69 patients with anemia 55,1%  had inadequate living conditions, 39,2%  were incorrectly diversified and 29,0% were premature; we had only 10 patients with rickets, 30,0% were prematures, 40,0% did not receive prophylaxis of rickets with vitamin D, 20,0% were incorrectly diversified and 50,0%  had inadequate living conditions.

Conclusions:

Deficiency diseases are relatively common in children although we have methods of prophylaxis during pregnancy and in infants. The relative low number of our cases is because these were the hospitalized ones as moderate and severe cases, the mild forms were treated by the general practitioners. To decrease incidence of these diseases training of mothers regarding prevention and nutrition is necessary and also the monitoring of children with risk factors for deficiency diseases by the general practitioners.

Major events and evolution in Cystic fibrosis patients  Alexandra Martin Andreea-Iulia Csiszer, Niculina-Oana Diaconu, Simina-Elena Rusu Validated View

Major events and evolution in Cystic fibrosis patients

First author: Alexandra Martin

Coordinator(s): Balas Reka Borka

Keywords: Child Cystic Fibrosis Respiratory Infections Malabsorption Syndrome

Background:  Cystic fibrosis (CF) is the most common autosomal recessive disease among caucasians. The genetic defect is due to mutations in a gene on the long arm of chromosome 7, the gene that is responsible for encoding and regulating clor transmembrane conductance regulator (CFTR). Deficiency in the CFTR leads to clinical manifestations. Respiratory tract secretions are dehydrated and the extremely viscous mucus causes airway obstruction and secondarily infection, besides this, the mutation lead to chronic fat malabsorption and malnutrition.
Objective: Highlight the evolution of patients diagnosed with CF.
Material and Method: We performed a retrospective study in 2003 - 2013 on 22 cases diagnosed with CF in Pediatric Clinic 1. The data were analyzed with chi-square test.
Results: Sweat test was performed in 68.18% cases, in the other ones the diagnosis was based on clinical signs and symptoms, which revealed that 59% of patients had respiratory forms and 18.1% digestive form, while 22.7% of patients had combined form. The main respiratory signs and symptoms were productive cough: 72.7%, dyspnea: 59.1%, malaise: 50%, recurrent wheezing: 31.8%; while the digestive ones were: dystrophy: 45.5%, diarrhea: 40.9%, fatty stools: 36.4%, hepatomegaly: 63.6%. Family history shows that 18.2% had newborns or infant brothers deceased without a determined cause, and 9.1% had a family history of CF. In long-term evolution, 59.1% of patients have repeated pneumonia, the average hospital stay was 11 days. The patients average age on diagnosis of CF was 1 year.
Conclusions: The quality of life in patients with CF has improved significantly due to early diagnosis and treatment, however, frequent and prolonged hospitalizations, the cost of chronic treatment, complications and lack of etiologic therapy, causes still low life expectancy of these patients.

The incidence and clinical manifestations in pediatric gastritis   Niculina-Oana Diaconu Alexandra Martin, Andreea-Iulia Csiszer, Simina-Elena Rusu, Adriana Craciun Validated View

The incidence and clinical manifestations in pediatric gastritis

First author: Niculina-Oana Diaconu

Coordinator(s): Borka- Balas Reka

Keywords: : child gastritis symtoms

Background:  Gastritis is an inflammatory process, acute or chronic, localized diffuse or focal in the gastric mucosa of the stomach. The positive diagnosis of the gastritis is given on Sydney’s system criteria: endoscopic and histological.  From etiologic point of view there are two forms of gastritis: the primary one (caused by bile reflux or Helicobacter pylori infection) and secondary one (caused by burns, infections, drugs, head trauma, caustic and corrosive substances, system diseases etc). 
Objective: The aim of study was to determinate the incidence, to evaluate the symptoms, the diagnostic methods and the gravity of risk factors in pediatric gastritis. 
Material and Method: We performed a retrospective study on 209 patients of 2-17 years of age, admitted to the Pediatric Clinic I Targu-Mures, between 2009 and 2012. The obtained data were statistically processed considering variables like: age, gender, risk factors and their correlations with the symptoms, the outcome of endoscopy and the histological changes that confirms the gastritis.
Results: Gastritis occurs more often in females (61,7 %) from the rural area and in patients aged between 10-14 years of age (40,2 %). The most common symptoms were: abdominal pain (89,4 %), nausea (39 %), vomiting (38 %) and loss of appetite ( 29 %). We found Helicobacter pylori infection in about 23% of cases, the highest percentage was registered in the group aged between 10 and 14. 
Conclusions:

Clinical manifestations were correlated with the age group: younger children had unspecific symptomatology, the older had in most of the cases typical clinical picture. We remarked a seasonal evolution of the disease in children to, with two morbidity peaks: spring time and autumn.

Duodenal Levodopa infusion in advanced Parkinson’s disease  Diana Baciu Validated View

Duodenal Levodopa infusion in advanced Parkinson’s disease

First author: Diana Baciu

Coordinator(s): Szász J A

Keywords: Parkinson Duodopa motot fluctuations reduction of motor symptoms

Background:

The advanced stage of Parkinson’s disease is characterized  by motor fluctuations which are often difficult to control with traditional, peroral levodopa medication. They occur in most cases due to the progressive decreased  efficiency of the oral treatment.

Objective:

Levodopa/Carbidopa formulated as a gel suspension (Duodopa) permits continuous delivery into the small intestine using a portable pump.

The aim of our study was to follow-up the patients who received this treatment and to monitor the changes in motor fluctuations before and after the treatment.

Material and Method:

A total of 31 Parkinson’s disease patients were assessed for Duodopa pump therapy between 2011-2013.  Only 19 patients presented  different types of motor fluctuations except for diskynesias. These patients were monitored before and after the treatment.

Results:

The mean age of the investigated patients was 65.The reason for the infusion was related  in most cases  to “wearing-off’ and “freezing” fluctuations.

Objectively, all 19 patients experienced a significant reduction in the fluctuations, while achieving a better gait function.

Conclusions:

We conclude that  continuous duodenal infusion with Duodopa is a good and safe alternative for patients with advanced Parkinson’s disease, especially because of the symptom – relieving and stabilizing effect.

Comorbidities in patients with irritable bowel syndrome.  Natalia Pritcan Alina Burianov, Gheata Irina Paraschiva Validated View

Comorbidities in patients with irritable bowel syndrome.

First author: Natalia Pritcan

Coordinator(s): Macarie Melania

Keywords: IBS, comorbidities, psychiatric disorders.

Background:

Irritable bowel syndrome (IBS) is a symptom-based diagnosis characterized by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits, where extraintestinal symptoms occur frequently.

 


Objective:

The aim of this study was to analyze comorbidities, which appear with greater frequency in patients diagnosed with IBS. We took in consideration the following areas: psychiatric disorders, other gastrointestinal disorders, metabolic disorders and cardiovascular disorders.


Material and Method:

We performed a retrospective study of 2459 patients hospitalized in Gastroenterology Clinic of Targu Mures County Clinical Emergency Hospital between 01.01.2012 -31.12.2013.


Results:

During the studied period there were diagnosed 73 (2.9 %) patients with IBS. The average age of patients was 53.4 years, predomining at females (ratio of F/M  2.2/1) .It was noticed a semnificative association with other gastrointestinal disorders ( gastritis 64.3 %, hiatal hernia 35.6 %, hepatic steatosis 26 %, disorders of biliary pathway 20.5%, reflux esophagitis 16.4 %, hepatitis 4 % ) and psychiatric disorders ( anxiety 38.3 %, depression 38.3 % , schizophrenia 5.4% ). Other problems encountered were:cardivascular disorders 36.9 %, metabolic disorders 27.3 %, osteoarticular disorders 26 % .


Conclusions:

Including the fact that IBS is a disorder without an anatomical support the patients presenting this syndrom were hospitalized for their associated pathology.Most often IBS occurs at young women with psychological symptoms, such as anxiety and depression.


Study regarding psychoeducation of bipolar affective disorder patients  Ioana Lepădatu Validated View

Study regarding psychoeducation of bipolar affective disorder patients

First author: Ioana Lepădatu

Coordinator(s): Nireștean A , Lukacs Emese

Keywords: Psychoeducation Bipolar Affective Disorder General Practitioner

Background: Bipolar disorder is a severe and persistent mental illness.It is a highly recurrent disorder with a lifetime prevalence of around two percent.Approximately 10 percent of patients will end their life by suicide.Bipolar disorder is associated with interpersonal stress, job difficulties, high unemployment, low work productivity, difficulty maintaining, long-term relationships and reduced overall social, physical and emotional well-being. Objective: The study`s objective was to determine the efficiency of the psychoeducation of the patients with bipolar disorder as a control method in life. Material and Method: This is a retrospective study on a group of 35 general practitioners from Tîrgu-Mureș and 20 patients hospitalized in the Clinic of Psychiatry Tîrgu-Mureș, with clear diagnosis of bipolar affective disorder. Results: We discovered that psychoeducation of bipolar disorder patients is important for general practitioners and for this kind of patients.General practitioners are prepare for educated patients with bipolar affective disorder. Conclusions: The implication of psychoeducation is necessary because promoted significant changes in patients lives.Patients with bipolar affective disorder started to led a normal life thanks to education promoted by general pratitioners.

The surgical approach to Ebstein's Disease at IBCVT Târgu-Mureş   Denisa Pop Dominic Pascal Keller, Andrei-Marian Feier Validated View

The surgical approach to Ebstein's Disease at IBCVT Târgu-Mureş

First author: Denisa Pop

Coordinator(s): Horațiu Suciu H , Stroe V

Keywords: Ebstein cardiac malformation children surgical treatment

Background:

Ebstein's disease is an extremely rare congenital heart malformation which accounts for less than 1% of all congenital heart anomalies. It consists in the downward displacement of the septal and/or posterior leaflet of the tricuspid valve. This affects the atrial and ventricular anatomy and as result the part of the ventricle situated between the abnormal insertion of the valve and the normally positioned annulus becomes atrialized. The hemodynamic consequence is a tricuspid insufficiency. The anatomical spectrum is extremely wide making the symptoms and age of presentation to be different for each patient.

Objective:

The objective of this study is to support the surgical management of Ebstein’s disease in children at Institutul de Boli Cardiovasculare şi Transplant Târgu-Mureş.

Material and Method:

This study is a retrospective chart review based on 8 patients who underwent surgical treatment between 2005- 2013. Parameters including gender, age, weight, paraclinical investigations and associated pathologies were evaluated.

Results:

In this study were included 8 patients (1 male and 7 female) with the mean age of 5.58 years and the mean weight of 20.47 kg. All cases had a similar clinical presentation. Of the 8 patients, 1 (12.5%) died and 7 (87.5%) survived.


Conclusions:

Due to the anatomic variation of Ebstein’s disease there is no standard treatment for this malformation. The surgical treatment must be individualized and therefore it is extremely important to have an early diagnostic and detailed analysis of the anatomy and function of the heart.

Assessment of the noise pollution impact over the Romanian population from the urban areas  Denisia-Suzana Todor (Maftior) Adriana-Marta Bȋgiu, Ion Mihai Georgescu, Victoria Ancuta Rus Validated View

Assessment of the noise pollution impact over the Romanian population from the urban areas

First author: Denisia-Suzana Todor (Maftior)

Coordinator(s): Tarcea Monica

Keywords: noise pollution risk factors cardiovascular diseases hear

Background: Noise is a harmful factor present in human’s environment. It is a public health issue all over the world caused by mechanization, urbanization and growth of the urban population.
Objective: The purpose of this paper is to assess the impact of noise pollution on the health of the Romanian urban population.
Material and Method:  A qualitative study was done in Romania as part of the program for monitoring the urban noise, in 2010. The study was done through questionnaires, at a national level in 9 important cities, on a sample of people of different ages, living in flats and individual houses.
Results: The frequency of people disturbed by traffic noise, in areas with heavy traffic, is almost 3 times higher than the one in residential areas with little traffic. The analysis of the recorded symptoms in relation to the age of the persons that have been interviewed shows that children often have problems in learning process after noise exposure like: low performance, fatigue, attention deficit disorders as well as problems with relaxing and resting. Adults manifest a different profile with the following indicators: fatigue, irascibility, insomnia, stress, headaches. Pregnant women are more sensitive to noise than other vulnerable categories. Other health issues caused by noise pollution can be: cardiovascular diseases are most frequent in people over 60 of age (24%), psychological diseases are more likely to appear to adults who are over 60 (17.6%) than to those who are under 60. This study also showed a high frequency of hearing problems (12.35%) in adults who are over 60, this is also due to the senior age.
Conclusions: The quality of the environmental factors influences the population health status. Monitoring the risk factors and assessing the impact of noise on the population’s health represents an essential component of the prophylactic medical activities.

CONTRIBUTION OF RADIO-IMAGING EXAMINATION IN THE DIAGNOSTIC OF ACUTE CEREBRAL STROKE  Maria Ortopan Andrea Edina Oana Validated View

CONTRIBUTION OF RADIO-IMAGING EXAMINATION IN THE DIAGNOSTIC OF ACUTE CEREBRAL STROKE

First author: Maria Ortopan

Coordinator(s): Buruian M

Keywords: acute cerebral stroke CT age topography

Background:

Acute stroke represents an important category in cerebral pathology because of the frequency and serious consequences that result.One of the main imaging method for diagnosing acute cerebral stroke  remains computer tomography (CT) because it’s more accessible and faster.

Objective: The purpose of this study is to determine the distribution of acute stroke according to brain disorders,gender,age and topography.
Material and Method:

The retrospective study  included 8940 patients examined with CT scan in the Radiology and Medical Imaging Department of Târgu-Mureș Country Clinical Emergency Hospital  between  January,2013 and December,2012.Studied parameters:types of neurological disease,gender,age and topography.

Results:

The study revealed that 51,4% of all cases identified were ischemic strokes,26,2%  hemorrhagic strokes and 22,5% brain tumors.The distribution of patients according to gender shows that acute stroke is more common in men(53,6%) than women(46,93%).The male/female ratio is 1,13/1.Regarding the age distribution,the most affected age group is 40 to 70 years (58%).Concerning the topography,acute stroke is more common in the left cerebral hemisphere(53,06%) than  right cerebral hemisphere(46,93%).

Conclusions:

CT remains the most accessible imaging investigation to diagnose acute cerebral  stroke.This study shows that there are more cases of ischemic strokes than hemorrhagic strokes or brain tumors.This reveals also that acute stroke is more common in men and in the middle-aged.According to the lesion topography,left cerebral hemisphere prevails regarding acute stroke.

THE CT-SCAN EXAMINATION IN BRAIN TUMORS  Maria Ortopan Iulia Andrea Nagy, Adela Tabacitu (Toma) Validated View

THE CT-SCAN EXAMINATION IN BRAIN TUMORS

First author: Maria Ortopan

Coordinator(s): Buruian M

Keywords: brain tumors CT gender topography

Background:

Brain tumors are intracranial expansive and proliferating processes,developed from local anatomical structures or they are the results of secondary determinations.The exploration using native or contrast computer tomography (CT)  is one of the basic imaging methods that provides  information about the location, extension and tissue characteristics of intracranial masses.

Objective:

The aim of this study is to evaluate the brain tumors  distribution by gender,age,topography in patients investigated with CT.

Material and Method:

This is a retrospective study on a group of 2080 patients investigated with computer tomography in the Radiology and Medical Imaging Department of Targu-Mures Country Clinical Emergency Hospital between 2003-2012.

Results: The results showed that 52,1%  were women and 47,9% men.Concerning the age,the most affected age group for both genders was the 40 to 70 years, being present in a proportion of 63%.Topographically,the most affected cerebral hemisphere from the perspective of brain tumors is the left hemisphere at a rate of 53,1%.
Conclusions: Brain tumors remain an important category in cerebral pathology through the consequences so that their diagnosis using CT is proving one of the best imaging methods of investigation.The study revealed that this pathology affects mainly women, people in middle age and it meets with a higher frequency in the left cerebral hemisphere.

Lung adenocarcinomas. Clinicopathological study with respect to the upcoming new classification and EGFR-KRAS mutation analysis implications  Sebastian Andone Adina Roman Validated View

Lung adenocarcinomas. Clinicopathological study with respect to the upcoming new classification and EGFR-KRAS mutation analysis implications

First author: Sebastian Andone

Coordinator(s): Mezei T

Keywords: adenocarcinoma EGFR-KRAS mutation lung tumors

Background:

Adenocarcinoma, according to most studies, has become the most common histological type of lung cancer, surpassing squamous cell carcinoma. Histological type is an important prognostic factor, nevertheless genetic studies, such as EGFR and KRAS mutation analysis have proven to have significant impact on survival, treatment resistance or outcome.

Objective: To review and study adenocarcinoma lung tumors incidence and clincopathological features of cases registered at the Pathology Department.

Material and Method: Our retrospective study included 140 adenocarcinoma lung tumors diagnosed at the Pathology Department of Targu Mures County Clinical Emergency Hospital over a ten year period, between 2003-2013. We studied parameters concerning various clincopathological features.

Results:
The selected 140 lung adenocarcinomas represent 29.20% of total lung tumors diagnosed in the same period. Data shows increased incidence in men (71,40%) and an average of 60 years, with no significant differences between genders. We divided the cases into two groups: low-grade (58,4%) and high-grade (41,6%) tumors. Maximal size of tumor in the first group is 39 mm whereas in the second group is 51 mm, the difference being significant (p=0.01).  We also studied parameters that may suggest, according to some studies, possible EGFR or KRAS mutations. We obtained data for a five year period (2003-2007) about presence of necrosis (70% of cases), atypical glandular differentiation (35%)  or mucin growth patterns (10%).

Conclusions: The incidence of adenocarcinoma in our country is slightly lower compared to other regions, but is steadily increasing compared to squamous cell carcinoma. There are some well established histological types however a new classification scheme is expected to emerge in 2015. Since EGFR and KRAS mutation analysis is an important step in the optimal treatment of these patients,  it would be desirable that these tests be introduced into everyday practice.

The Benefits of the Respiratory Physiotherapy Program of the Intensive Care Unit's Mechanical Ventilated Patients  Oana-Laura Chis Validated View

The Benefits of the Respiratory Physiotherapy Program of the Intensive Care Unit's Mechanical Ventilated Patients

First author: Oana-Laura Chis

Coordinator(s): Copotoiu Monica , Copotoiu Ruxandra

Keywords: ICU respiratory physiotherapy

Background:

Respiratory physiotherapy program in the ICU is destinated to improve the vital prognosis of critically ill patients, who require early mobilization, for recovery and prevention of numerous diseases caused by prolonged bed rest.

Objective:

The objective was to evaluate the benefits of a respiratory rehabilitation programme, performed by a physiotherapist on the mechanically ventilated patients. The end points were: the maintaining of the ph to normal values, the lowering of the pCO2, the increasing of the pO2, the increasing of the SaO2.

Material and Method:

In the ICU of the Emergency County Hospital of Tirgu Mures, a prospective, interventional study was performed started from March till July 2013. A respiratory physiotherapy was initiated, twice a day, to a randomised group of mechanical ventilated patients. Twenty-eight patients were included in our study, divided in two groups (the treated and the control group). The variables used to monitor the effects of the respiratory physiotherapy were those depicted by the blood gase analysis. Data were analysed with GraphPad Prism 6.0.

Results:

On the first day we noted high values of the ph and pCO2 at 4 patients from the respiratory rehabilitation group. After the manoeuvres the value of paCO2 decreased from a mean value of 48.86 +/- 17.18 to 45.03 +/- 17.47 (p 0.0273). The pO2, after an initial decrease (p 0.0195) on the first day, we observed a constant rise. The SaO2 in the rehab group we noticed a normalisation of the mean value from 71.84% to 91.60%. On the fifth day the SaO2 values were similar with the ones from the first day (69.80% +/- 49.80%). An acid value of the ph (7.319+/- 0.184) was associated with the decreased SaO2.

Conclusions:

The additive respiratory management, supplied by a physiotherapist in respiratory rehabilitation, is beneficial for the outcome of the mechanical ventilated ICU patients.

SCREENING FOR CONGENITAL HYPOTHYROIDISM AND PHENYLKETONURIA IN MURES COUNTY -RESULTS AND FOLLOW-UP  Roxana-Cristina Campean Razvan Mares, Oana-Petronela Dîrțu Validated View

SCREENING FOR CONGENITAL HYPOTHYROIDISM AND PHENYLKETONURIA IN MURES COUNTY -RESULTS AND FOLLOW-UP

First author: Roxana-Cristina Campean

Coordinator(s): Pascanu Ionela Maria , Pitea Ana-Maria

Keywords: Screening Congenital Hypothyroidism Phenylketonuria

Background: A national screening program for congenital hypothyroidism (CHT) and Phenylketonuria (PKU) was started in 2009. PKU is a metabolic disease caused by an enzimatic deficiency,  leading to severe psycho-neurological retardation. Untreated CHT causes severe delayment in motor and neurological development.
Objective: 1. Evaluation of the results of the screening program for CHT and PKU in Mures county. 2. Follow-up of confirmed cases.
Material and Method: The study included all children born in the 8 maternities in Mures County  for which the screening for CHT and PKU was performed. The levels of thyroid stimulating hormone (TSH) and phenylalanine (Phe) were  tested by fluorometric assay. Newborns with levels of TSH greater than 10  µUI/L, respectively Phe greater than 3 mg/dl were retested.
Results: Elevated levels of TSH  or  Phe were found in 28, respectively 8 cases, out of 24151 tested. After retesting, CHT was confirmed in 6 cases and PKU in  6 cases. All children with confirmed CHT or PKU are  followed-up at the  Endocrinology Clinic (CHT) or Pediatrics Clinic I(PKU) in Targu Mures. Three children with confirmed PKU are evaluated periodically and receive special dietetic products.
Conclusions: CHT and PKU are rare diseases with severe consequences.  By discovering them at birth through neonatal screening they can be therapeutically controlled.

Toxicologically important byproducts of nitrate formed in fermented cheese  Damaris-Felicia Santa Validated View

Toxicologically important byproducts of nitrate formed in fermented cheese

First author: Damaris-Felicia Santa

Coordinator(s): Croitoru M D , Ibolya Fülöp

Keywords: cheese nitrate nitrite nitrosamines

Background: Many toxicological problems were associated with the presence of nitrate and nitrite in water and food. Especially sensitive to the toxic effects of these anions are children and pregnant women. Known sources of nitrate are water and vegetables, while milk and cheese products are usually considered nitrate free.
Objective:

Our purpose was to evaluate the possibility to generate toxic byproducts of nitrate when nitrate rich vegetables are mixed with cheese.


Material and Method: Different samples of cow and sheep curd were fortified with increasing amounts of nitrate anion (50, 100, 250, 500, 750 mg/kg NO3-). The amount of nitrite generated during the maturation of curd was assed by an HPLC-VIS method. Griess reaction was used for the derivatization of nitrite.
Results: Formation of the toxic nitrite in high amounts was recorded in all samples. Maximum amount of nitrite was recorded in a cow curd sample (27.7 mg/kg). During the end of the maturation process concentration of nitrite significantly decreased.
Conclusions: The results show that mixing high nitrate content vegetables with curd, high amount of toxic nitrite could be formed during the maturation process. Disappearance of nitrite once is formed could not be considered a "detoxification" process since there is a risk of formation of far more toxic compounds, as nitrosamines. Further studies are needed for clarification of these processes.

The assesment of errors in child nutrition  Florentina Negoita Alina Grama Validated View

The assesment of errors in child nutrition

First author: Florentina Negoita

Coordinator(s): Grama Alina

Keywords: Children Nutrition Errors Diversification

Background:

Unfortunatelly, errors that parents make in child solid foods may have serious immediate repercussions on the body and especially on its development, but the repercussions can also be delayed, resulting suffering as: obesity, diabetes, rickets, malnutrition, etc.

Objective:

The purpose of this paper is to highlight the nutritional mistakes that parents make in child solid foods and to assess their repercussions on the children’s body.

Material and Method:

 The study was performed between June 2013- February 2014 and included 100 children, aged between 6 months and 9 years, hospitalized in the Pediatric I Clinic of the  Emergency County Hospital, Targu -Mures . We prepared a prospective study, using a questionnaire consisting of multiple questions targeting general information about child nutrition, how to achieve diversification, the organization of the family, etc. 

Results: Of all questioned parents, we noticed a 45% smoking parents, and this is correlated with the fact that 48.4 % of children in the study were presented to the doctor for respiratory diseases. The average age of breast milk consumption is 6 months (47.6 % cases ), a percentage of 50.5% cases were fed with powdered milk and cow milk diet was used in 65 % of children ( which was introduced at the earliest in the diet at age 2 months). Solid foods was performed in 32.1 % of cases early and late in 21.4% cases, only a percentage of 25.2 % at 6 months parents initiating diversification . During diversification, they made ​​numerous errors, such as the introduction of improper food combinations at inadequate age, thus breaking the basic rules of proper diversification.
Conclusions:

Mismanagement of diversification and the introduction of inappropriate food items  at small age  can cause a number of diseases  since a young age,  stature - targeting evolution rate.

Characteristics of Primary Dentition Occlusion in Preschool Children: An Epidemiological study  Codruța Cosma Alexandru Petru Ciucu, Carmen Silvia Gabor, Cristina Bica Validated View

Characteristics of Primary Dentition Occlusion in Preschool Children: An Epidemiological study

First author: Codruța Cosma

Coordinator(s): -

Keywords: primary dentition occlusion flush terminal

Background:

Analysis of the occlusion in primary dentition consists in the arrangement of deciduous teeth and the occlusal relations of the anterior and posterior segments of both arches.
Considering these observations, the characteristics of the permanent dentition occlusion can be predicted very well.
Objective:
The objective of this study was to assess the occlusal characteristics of primary dentition and difference in various parameters, at children between 3 and 6 years of age.

Material and Method:
A total of 172 children between 3 and 6 years of age with complete primary dentition, from several Mureș county preschools were examined. The study group was assessed for several occlusal parameters:  primary molar and canine relations, degree of overjet and overbite, anterior and posterior crossbite, sissors bite, presence or absence of physiologic spaces and crowding.

Results:
Sagittal, vertical and transversal occlusal planes emphasise the following:
Percentage distribution of terminal molar relationship showed flush terminal in mesial step on 36% of subjects, while 58% presented ideal flush terminal relations in sagittal plane.
The degree of overbite was analysed, 70% of children showing normal 1/3 dental coverage or edge-to-edge incisal relation, compared to openbite found in only 11% of the cases. 
Overjet higher than 4mm has been observed in 15% of the children examined.
The incidence of anterior crossbite has been identified especially on the Lateral Incisor at a rate of 13% , indicating that 24 out of 172 children had this disorder.
Although we have identified a flush terminal in distal step of only  5% proportion, occlusal parameters suggesting functional mandibular retrognathism are at a rate of 15% for overjet  and 22% for Class II canine relation.

Conclusions:
The significant increase in distal canine relations and overjet above 4mm, leads to Class II/1 Angle abnormalities, as age increases. Presence of physiologic and primate spacing allow the normal dental replacement.

Meningitis in HIV seropositive patients in Tg. Mures  Raluca Petroi Oana Pocol Validated View

Meningitis in HIV seropositive patients in Tg. Mures

First author: Raluca Petroi

Coordinator(s): Garbovan Cristina

Keywords: meningitis HIV meningitis patients with HIV

Background: Meningitis is a disease caused by the inflammation of the protectiv membranes covering the
brain and spinal cord known as the meninges. Different forms of meningitis are associated with HIV infections .
Objective: The study's objective is to assess the epidemiology, clinical status and evolution of patients with meningitis and HIV.
Material and Method: This is a retrospective study on patients with meningitis and HIV infection, between 2012-2013 in Tg. Mures.
Results: The study group included 14 patients with meningites and HIV infections( 13 maels and 1 femal). We had 9 patients in 2012 and 5 patients in 2013. Based on etiology we had 57% with meningitis with TB.
Conclusions: Individuals who are HIV seropositiv are at an  increased risk for the development of certain types of meningitis the HIV seronegativ patients.

QUALITY OF LIFE AFTER ACL RECONSTRUCTION USING THE IKDC QUESTIONNAIRE  Lorand Vitalis Georgiana Miler, Viviana Alexandra Modi Validated View

QUALITY OF LIFE AFTER ACL RECONSTRUCTION USING THE IKDC QUESTIONNAIRE

First author: Lorand Vitalis

Coordinator(s): Russu O

Keywords: Anterior cruciate ligament ACL reconstruction IKDC knee scor

Background:

Arthroscopic procedures can be performed either to evaluate or to treat many orthopedic conditions, including torn floating cartilage, torn surface cartilage, ACL reconstruction and trimming damaged cartilage.

Objective:

The aim of the study was to assess the quality of life after anterior cruciate ligament reconstruction (ACL) with hamstring autografts, using the IKDC knee score questionnaire.

Material and Method:

We restrospectively studied a number of 66 patients who were  admitted to the Clinic of Orthopedics and Traumatology of Targu Mures; the patients underwent ACL reconstruction with hamstring autografts, between January 2012 and January 2014. All interventions were performed with a femur-first technique and close braided loop fixation on the femoral side with biocomposite screw fixation on the tibial side. In order to make the clinical assessment, we used the IKDC knee rating system, from the 10th to the 52nd week postoperatively (by phone interview). Questionnaire item included symptoms, functional limitations in sports and daily activities and also included the patients’ perception of the knee condition, sports and occupational activity levels.

Results:

The IKDC knee rating system score after ACL reconstruction was included in the interval between 79,5-97,7 with an average score of 89,9 which is actually considered to be appropriate. The mean age of the patients was 38, with a range between 34-53 years, including 53 male and 13 female patients. All patients had both a normal active life as well as a normal physical activity.

Conclusions:

The main goal of rehabilitation after ACL reconstruction surgery is to minimize postoperative complications and to protect the graft while allowing a quick return to normal daily activities. We considered that the IKDC knee rating system score after ACL reconstruction, with a value of 89,9 was a good outcome.

Clinical SYNATX Score for Risk Stratification after Acute Myocardial Infarction   Cristina Somkereki Laszlo Hadadi Validated View

Clinical SYNATX Score for Risk Stratification after Acute Myocardial Infarction

First author: Cristina Somkereki

Coordinator(s): Dobreanu D

Keywords: STEMI primary PCI SYNTAX Score clinical SYNTAX Score

Background: Primary percutaneous coronary intervention(pPCI) is the recommended treatment of acute myocardial infarction with ST-segment elevation (STEMI).Clinical SYNTAX Score (CSS)-a combined risk model integrating angiographic (SYNATX score-SXS) and three clinical variables -is a validated tool for post-PCI risk prediction in stable coronary artery disease patients .However ,CSS has never been studied prospectively in the context of STEMI.
Objective: to test and compare the predictive power of SXS and CSS for in-hospital mortality in a population of STEMI patients treated with pPCI.
Material and Method: a prospective clinical study was performed including all STEMI cases admitted during a one year period.SXS was calculated on the basis of emergency coronary angiography .The SXS values were combined with patients' age, left ventricular ejection fraction and creatinine clearance to obtain CSS.The overall in-hospital mortality was evaluated according to low,medium and high SXS and CSS tertiles .
Results: 134 patients were enrolled with a total in-hospital mortality of 9.7%.Fatality was significantly increased in the high SXS and CSS tertiles ( OR=3.63, p=0.02 and OR=14.67,p<0.0001,respectively).By adding just three simple clinical variables to the angiographic score ,3 of the 5 deceased patients with low/medium risk according to the SXS were reclassified in the group of patients with high risk according to CSS.
Conclusions: compared to SXS , CSS has a superior predictive power for in-hospital mortality in case of pPCI-treated STEMI .

Prevalence of other autoimmune diseases in pacients with thyroid autoimmune disease  Georgiana Mihaela Halip(Asofronie) Bogdan Halip Validated View

Prevalence of other autoimmune diseases in pacients with thyroid autoimmune disease

First author: Georgiana Mihaela Halip(Asofronie)

Coordinator(s): Pop-Radu Corina Cristina

Keywords: thyroid autoimmune coexisting diseases

Background: It is already known that on a genetic base, autoimmune diseases tend to coexist in the same pacients. Objective: The purpose of this study was to assess the prevalence of other autoimmune diseases in pacients with thyroid autoimmune disease. Material and Method: Retrospective study(based on observation sheets) between January 2011 and December 2013 on a group of 407 pacients of which 349 women and 58 mens, all admitted in the Endocrinology Clinic of Tg. Mures University Hospital. Results: The estimated prevalence was 7,86%. The most frequent associated disease was Addison's disease(1,71%), followed by DM type I and psoriasis (0,98%). The other ones found as associated had a prevalence less than 0,5% (miastenia gravis, rheumatoid artrithis, vitiligo, Sjögren syndrome, polimyositis, scleroderma, autoimmune hypofysitis, autoimmune trombocitopenia, antifosfolipidic syndrome, sustemic lupus eritematosus and celiac disease.) The highest prevalence was found in males(10,3%) compared to female (7,4%). The most frequent diseases in males were Addison's disease(5,17%) and DM type I(3,44%), followed by 1 case of psoriasis(1,72%). The most frequent autoimmune disease found in women was Addison's disease(1,14%), too, followed by rheumatoid atrithis ,miastenia gravis, vitiligo, psoriasis (0,57%). Conclusions: Assessing the fact that in general population the prevalence of autoimmune diseases is smaller and includes the thyroid autoimmune diseases who are on a high prevalence, we can conclude that in pacients with a thyroid autoimmune disease, other autoimmune diseases are more frequent associated..

Associated autoimmune diseases appear more frequently in males who were affected by a thyroid autoimmune disease.

Brain Dead Organ Donors in Romania. Scientific Aspect vs General View   Iulia Grancea Dana-Ioana Dumitru, Anicuta Ionela Morar Validated View

Brain Dead Organ Donors in Romania. Scientific Aspect vs General View

First author: Iulia Grancea

Coordinator(s): Copotoiu Sanda-Maria

Keywords: brain dead organ donor transplant in Romania donation agreement

Background:

There is worldwide a major deficit of organ donors, that triggers permanent measures as: to improve the system by increasing the number of donors,laws change,protocols and media campaigns.

Objective:

The aim was to follow and to analyze the organ donation system from the last eight years in Romania, and quantify a possible increase in the number of donors after legislative changes and after the PROTV’s campaign "There is Life after Death."

Material and Method:

I ran a retrospective-observational study.I have analyzed the donors’ and potential donors’ medical records from the Tg-Mures ICU Emergency County Hospital and from similar units(Cluj,Timisoara,Bucuresti,Iasi,Craiova).I also studied the information provided by PROTV through the 110 author news and their rating.Data were statistically analyzed with GraphPad: student-t test,Fisher,chi2.

Results:

The comparison between the increase of donors from 2012 to 2013 and the average increase(2006-2012)to 2013:p=0.9813(relative values).

Comparison of the absolute number of donors in 2013and average number(2006-2012) :p=0.0116,and 2013 with 2012:p=0.037.

The comparison between  increasing the percentage of donors out of all the potential donors in 2012-2013 compared to the average growth (2006-2012)-2013:p=0.4950.

Statistical correlation study:the number of donors and prospective donors from 2012 and 2013:p=0.7725,RR=1.21,CI:0.57-2.59.

The average of donors and potential donors of the years 2006-2012 compared to 2013:p=0.54,RR=1.39,CI:0.58-3.

Correlation test for percentage values regarding increasing the number of donors and potential donors from 2012to2013 and the average increase in the years 2006-2012 to 2013:p=0.0351,RR=0.87,IC<1.

Conclusions:

Increasing the number of donors was achieved by augmenting the number of brain dead patients identified as potential donors.It was an increase in the total base, added to an increase in the number of patients in brain death who fulfilled the donor criteria.There was no improvement of the evolution of patient’s status from “potential donor” to “donor”.This failed to increase the rate of donation agreements and also the brain dead patients’ management has not improved to allow viable organ harvesting.

 

The Atrioventricular Block in pediatric cardiology  Oana Bentz Validated View

The Atrioventricular Block in pediatric cardiology

First author: Oana Bentz

Coordinator(s): Gozar Liliana

Keywords: AVB pacemaker ECG malformation

Background:

The atrioventricular block is an impairment of the conduction which can be diagnosed in pediatric age groups. There are two distinct clinical entities of this pathology, namely congenital AVB and AVB that occurs post-surgery for congenital heart defect.

Objective: The goal is to analyze retrospective and prospective major disorders of driving from etiological point of view, therapeutic, evolutionarily.
Material and Method:

In this study we analyzed the individual papers of children hospitalized between 2008-2013 in the Cardiology Clinic II. We noted the full age, diagnosis, investigations and laboratory tests: ECG Holter EKG 24 hours monitoring, ultrasound, stress test.

Results:

The study included 91 children between the ages of 2 and 18 years of age. 17 patients were with congenital AVB and 74 with AVB which appeared after the cardiac surgery. Heart malformations operated according to this pathology were followed by: ventricular septal defect, transposition of the great arterias, atrial septal defect, mitral insufficiency, aortic insufficiency. Analyzing the associated pathology we found that the children of atrioventricular delay of ventricular fibrillation is frequently observed after complex operations for congenital heart defects (VSD = 45.28%, TGA = 26.42%, ASD = 18.87% mitral insufficiency = 5.66%, aortic insufficiency = 3.77%). In the study, most patients require implantation of pacemaker: in the group with congenital AVB 11 cases (65%), while in the AVB post-surgery 43 cases (58%).

Conclusions:

Congenital AVB is a major rhythm disorder that requires cardiology dispensary. Over 50% of patients require pacemaker implantation. AVB is one of the complications of surgical treatment of CHD. Some of these patients have evolved with the recovery of atrioventricular conduction.

The implicantion of respiratory disturbance index (RDI)and the number of oxygen desaturation in the evaluation of pacients with Obstructive Sleep Apnea Hypopnea Syndrome  Madalina Cristina Curtui Validated View

The implicantion of respiratory disturbance index (RDI)and the number of oxygen desaturation in the evaluation of pacients with Obstructive Sleep Apnea Hypopnea Syndrome

First author: Madalina Cristina Curtui

Coordinator(s): Neagos Adriana

Keywords: respiratory disturbance index apnea-hypopnea index obstructive sleep apnea hypopnea syndrome

Background: Obstructive Sleep Apnea Hypopnea Syndrome is characterized by reccurent episodes of partial or complete upper airway collapse during sleep. Clinical consequences are daytime sleepiness, fatigue, impaired concentration, memory disorders, irritability, diminished libido and erectile dysfunction. Pacients with OSAHS also have other comorbidities like obesity, hight blood presure, face abnormalities and chronic ethanolism. Objective: The aim of this study was to analyze the implication of RDI and the number of desaturation in the evaluation of pacients with OSAHS and to demonstrate if there is some correlation between these indices and the apnea hypopnea index. Material and Method: We performed a descriptive, collectiive, correlational study using the correlational Spearman test, on 151 pacients of the Galenus Clinic from Targu Mures, between the years 2006-2013. Results: The 151 pacinets were clasified in 4 groups according to the apnea hypopnea index.The snoring group with AHI<=10, the light apnea group with 10< AHI<=30, the moderate apnea group 30<AHI<=50 and the severe apnea group with AHI >50. The correlation between RDI and the number of desaturation wes significant for the snoring and severe apnea groups and nonsignificant for the other two.For each group we found a significant correlation between the AHI and RDI. Conclusions: The cardiorespiratory polysomnography is an important tool for the diagnosis and evaluation of pacients with OSAHS. Is important to treat these pacients' comorbidities and to improve their quality of sleep because the clinical consequences are affecting their lives.

Histopathological evaluation of lymphatic nodules in cancer of the uterine cervix.  Bogdan Daniel Jerdea Paul Ruzsa, Ioan Sorin Pop, Marinela-Radiana Faur, Mihaela Bianca Ilie Validated View

Histopathological evaluation of lymphatic nodules in cancer of the uterine cervix.

First author: Bogdan Daniel Jerdea

Coordinator(s): Chira Liliana , Stolnicu Simona

Keywords: lymphonodular cervical carcinoma metastasis adenocarcinoma

Background:

On worldwide scale, the cervical carcinoma is ranked second ,after breast cancer, in female cancer pathology .Recently conducted studies show that adjuvant therapy significantly improves overall survival for high-risk, early-stage patients who undergo surgical treatment for cervical carcinoma. Regarding the more sensitive problem of the cervical adenocarcinomas, studies tried to classify them by their pattern of invasion in order to recommend lymphadenectomy. 

Objective:

The aims of our study were to asses and evaluate the histopathological aspect and management of the lymphatic nodules and the presence of malign tissue in patients suffering from cervical carcinomas, given the microscopic type, clinical staging and preoperative treatment.

Material and Method:

  Our retrospective study was conducted on a sample of 160 cases and included patients suffering from cervical carcinoma who have undergone surgical treatment . We analyzed and compared the data of the  histopathological reports  from the years 2012-2013 of the Laboratory of Pathology , SPCLUJ Tirgu Mures. 

 

Results:

From 160 cases, 124 suffered hysterectomy with lymphadenectomy of whom 37.10% received preoperative treatment and 27.41% had lymphonodular metastasis. Of the total of 53 cases which had been preoperative treated, we discovered that 60. 37% of them showed residues of malign tissue but from the 46 patients that have undergone treatment and had lymphadenectomy only 15.21% presented lymphonodular metastasis.

Cervical adenocarcinomas and other epithelial tumors were diagnosed in 18.75% of total cases, all being in the 1st and 2nd clinical stage except for one mucinous adenocarcinoma found in the 4th clinical stage and from these, 4  of them, had lymphonodular metastasis. The rest were squamous cell carcinomas.

Conclusions: At every clinical stage of the squamous cell carcinoma, lymphonodules with metastases were predominant in cases that didn’t receive preoperative treatment. As for the adenocarcinomas and other epithelial tumors, lymphonodular metastasis were identified in both preoperative treated patients and non-treated patients.

CLINICAL AND ENDOSCOPIC CORRELATION OF INFLAMMATORY BOWEL DISEASE   Andra Oltean Ioan-Adrian Stoica Validated View

CLINICAL AND ENDOSCOPIC CORRELATION OF INFLAMMATORY BOWEL DISEASE

First author: Andra Oltean

Coordinator(s): Băţagă Simona

Keywords: Crohn Colitis inflammatory bowel endoscopy

Background:

Inflammatory bowel diseases (IBD) are idiopathic, chronic diseases of gastrointestinal tract of unknown etiology. The two major types of inflammatory bowel disease are Ulcerative Colitis (UC) and Crohn disease (CD). 

Objective:

The purpose of the paper is to follow the evolution of patients with inflammatory bowel diseases, to improve symptoms and to monitor possible gastrointestinal complications.

Material and Method:

The retrospective study was conducted on patients investigated by endoscopy laboratory of Emergency County Hospital of Târgu Mureş for a period of two years: January 1st 2012 until December 31 2013. 

Results:

From a total of 2761 patients, only 4.16% are known with inflammatory bowel disease. Among these, 16.52% are known with Crohn disease and 83.48% with Ulcerative Colitis. Gender distribution of IBD revealed a female distribution of CD: 68,42 % and a male distribution of  UC: 58,34%. In terms of distribution we can notice that prevails urban areas: 60,68 %. Out of the total, half presented local complications such as fissures and fistulas, 78% presents general complications, out of which 10% were cutaneous .

Conclusions: Time-trend analyses showed statistically significant increases in the incidence of IBD over time, especially at young age. Years ago, the incidence of UC was several times higher than that of CD. Crohn's disease incidence in our days is approaching UC with an evolution aggravated by multiple complications.

Renal involvement in Henoch-Schönlein purpura  Anca Lupu Estera Gabor, Alina Bagdasar Validated View

Renal involvement in Henoch-Schönlein purpura

First author: Anca Lupu

Coordinator(s): Duicu Carmen

Keywords: child Henoch Schönlein pupura renal involvement

Background: Henoch-Schönlein purpura (HSP) is the most common vasculitis in children, with a self-limiting evolution in over 90% of the cases and mainly affects skin, gastrointestinal tract, joints, and kidneys. The long term prognosis of HSP is moustly determined by the extent of renal involvement.
Objective: To evaluate renal involvement and factors affecting the prognosis in patients with HSP.
Material and Method: From 2008 to 2013, characteristics and clinical manifestations were reviewed from medical record of the Pediatrics Department of the Emergency County Hospital of Tîrgu-Mures, Romania. The collected information included age, gender, clinical manifestations, relevant auxiliary examination results, renal echography and treatment.
Results: There were 43 hospitalized children with Henoch-Schönlein purpura  from January 1, 2008 to December 31, 2013 consisting of 18 male (41,9%) and 25 female (58,1%). Mean age was 7.46 years (2-17 years). Approximately 65% of cases were presented during winter and spring. Upper respiratory tract infection was the most frequent event that preceded HSP (51,1%). In most patients (86,04%) purpura was the first symptom, twenty eight pacients (65,11%) had arthritis or arthralgia and thirteen pacients (30,23%) had gastrointestinal manifestations. Renal involvement was determined in 48,83% of cases. Proteinuria was in all of the cases mild (<3 g/24 h), haematuria was microscopic in 66% and macroscopic in 34% of cases. All pacients with Henoch Schönlein nefritis needed more than two hospitalization as a result of hematuria and proteinuria relapse.
Conclusions: Abnormal urinalysis (microscopic hematuria or proteinuria) are predictive factors of renal involvement in HSP.

The role of prenatal corticotherapy in the better outcome of the respiratory distress syndrome, including complications  Iulia Andrea Nagy Maria Ortopan, Andrea Edina Oana Validated View

The role of prenatal corticotherapy in the better outcome of the respiratory distress syndrome, including complications

First author: Iulia Andrea Nagy

Coordinator(s): Simon Márta

Keywords: premature corticosteroids respiratory distress syndrome

Background: Respiratory distress syndrome (RDS) is a common complication of prematurity and a life-threatening condition. Corticosteroids administered to women at risk of preterm delivery help enhancing fetal lung maturation.
Objective: The aim of this study is to determine the benefits of antenatal costricosteroids in decreasing the severity of RDS, intrahospital mortality and complications among preterm infants.
Material and Method: Our retrospective observational study enrolled 219 premature babies of 24-36 weeks, with RDS, treated in Mures Country Neonatal Intensive Care Unit between 2012-2013; population divided into two groups: group 1-  babies whose mothers received corticosteroids and group 2- babies with no prophylactic corticotherapy.
Results: Antenatal corticotherapy was administered to 48.9% of patients.The incidence of moderate/severe RDS was 47.1% in the group 1, compared to 52.9% in group 2. Moreover,  75% ( 12 cases) of all neonatal deaths due to RDS, were from group 2 (p=0.04).
Prenatal corticotherapy decreased the need for subsequent mechanical ventilation in neonates born between 28 -31 weeks of gestation: 42.9% vs. 57.1% (p=0.03) and reduced the incidence of intraventricular hemorrhage in neonates with a BW < 1500 g : 36.4% vs. 63.6% (p=0.03). No other outcomes were statistically significant.
Conclusions: We confirm the effectiveness of prenatal corticotherapy in leading to better outcomes in preterm infants.

Preoperative templating in cemented total hip replacement  Adelina Macec Costel Coroiu, Serban Pop, ancuta diana badiu, Diana Pop Validated View

Preoperative templating in cemented total hip replacement

First author: Adelina Macec

Coordinator(s): Russu O , Zazgyva Ancuta

Keywords: preoperative templating cemented total hip replacement radiologic magnification

Background: Using templates for preoperative planning of total hip replacement is an important step in preparing for the surgical intervention- not only does it provide an estimate of the size of implants, but it also anticipates the position , insertion depth and possible pitfalls in obtaining a biomechanically adequate hip endoprosthesis.
Objective: The aim of this study was to compare the preoperatively planned size of cemented total hip implants with the postoperatively obtained measures in a series of consecutive patients.
Material and Method: The study included 30 consecutive patients treated in the Clinic of Orthopaedics and Traumatology of Targu Mures that underwent cemented total hip replacement (ZCA All-Poly acetabular cup, Metabloc TM stem , Zimmer) during June 2013 and April 2014. We recorded preoperative estimates of radiologic magnification, acetabular and femoral component size and limb lengthening.Postoperatively we measured the same variables and compared them to the anticipated values.
Results: Our study group included 21 female and 9 patients with a mean age of 68 years (range 62-77 years). Principal diagnosis was primary hip arthritis in 83,33 % of cases ,with 5 cases of secondary coxarthrosis: 3 with protrusioacetabuli and 2 with developmental hip dysplasia.The preoperative estimates of radiologic magnification and the actual magnification were different in 63,33 % of cases. Acetabular cup size estimates were correct in 63,33 % of cases, while femoral stem size was correctly anticipated in 76,66 % of cases. Postoperative limb lengthening was in accordance with the estimated preoperative value in 21 cases.
Conclusions: There is a need for a better standardized radiologic examination of patients in order to correct the discrepancies between preoperative planning and the actual surgical intervention. The important differences in estimated and actual magnification of the radiologic image can interfere with the measurements of acetabular and femoral components and possibly influence adequate component positioning.

Assessing eating habits and obesity in a rural middle school and the importance of “Health Education” classes  Adriana-Marta Bȋgiu Denisia-Suzana Todor (Maftior) Validated View

Assessing eating habits and obesity in a rural middle school and the importance of “Health Education” classes

First author: Adriana-Marta Bȋgiu

Coordinator(s): Ceanǎ Daniela-Edith

Keywords: nutrition child obesity rural

Background: "A sound mind in a healthy body " - Every child has the right to receive information about healthy eating and well-being.
Objective: Evaluating eating habits and behaviors of a group of students from the rural  area  located  in  Braşov  county,  to  emphasize  the  importance  of  the  “Health Education” classes, and also evaluating dietary intake, lifestyle and knowledge they have on the topics up to this moment.
Material and Method: This was a prospective epidemiologic study, using surveys on eating habits and lifestyle. The surveys were filled by students from the Lunca  Cȋlnicului  Elementary  School,  Braşov.  155  students,  aged between  10  and 15 years,  previously  informed about  the objectives of  the investigation,  were questioned. Data  collection  took  place  between  01.11.2013  and  19.12.2013.  The  methodology included questions related  to  demographic  (age,  gender)  and anthropometric  (weight, height)  data  and  questions  about  eating  habits  and  life  style.  They  were  measured according to standard procedures and were followed by Body Mass Index calculations.
Results: The results of this particular study were not in agreement with present-day studies, which stress an alarming increase of obesity in schools. Out of the total number of the participating students, 63 percent have a normal weight, 35 percent are underweight and only 3 percent are overweight. The majority of the questioned students have the habit of  -food, soft drinks and sweets in excess as well as leading an unhealthy lifestyle.
Conclusions: All  the gathered information underline the students’ defective food  intake and unhealthy lifestyle, which makes “Health Education” classes imperative for this institution.

The importance of XRCC1 Arg399Gln DNA repair gene in the determining of lymphoma response to chemotherapy, radiotherapy and outcome  Cristina Georgiana Radu Anda Stefan, Florin Tripon, George Crauciuc Validated View

The importance of XRCC1 Arg399Gln DNA repair gene in the determining of lymphoma response to chemotherapy, radiotherapy and outcome

First author: Cristina Georgiana Radu

Coordinator(s): Demian Smaranda , Banescu Claudia

Keywords: XRCC1 Arg399Gln gene polymorphism lymphoma

Background:
Lymphoma is a type of blood cancer that occurs when B or T lymphocytes divide faster than normal cells or live longer than they are supposed to.DNA repair genes, such as XRCC1 gene have an important role in protecting individuals from cancer-causing agents. Polymorphisms in DNA repair genes have been identified and individuals with reductions in the capacity to repair DNA damage are observed in the population, but the impact of specific genetic variants on repair phenotype and cancer risk has not yet been clarified.


Objective:
The aim of the study was to investigate in a case-control study if XRCC1 Arg399Gln gene plays a role in susceptibility to malignant lymphoma, response to chemotherapy, radiotherapy and outcome.

Material and Method:
Our study included a number of 94 cases and a control group with 113 controls. We obtained from patient medical charts (Hematology Department of Tirgu Mures County Hospital) the values of interested data.Genetic DNA was extracted from peripheral blood, than was submitted to PCR- RFLP technique.

Results:
Analyzing our data we found the mean age was 57.45 years, of which 40.42% were males and 59.57% females. The chemotherapy was applied at 82.22% of patients, chemotherapy and radiotherapy at 11.11% and 6.66% have not received any treatment. The total remission was observed in 13.51% of patients, partial remission at 36.48% and 50% were resistant to treatment. All of this was reported at the genotype of XRCC1 gene.

Conclusions:
In statistical terms exist a correlation between heterozygous genotype(Arg/Gln) and the susceptibility to lymphoma in male patients (p=0. 03; OR: 0.38; CI:0,161-0,923). The homozygous mutant genotype is associated with the lack of total remission. To our knowledge this is the first study from Romania who investigated this gene mutation reported to clinical events.

Prevalence of overweight and obesity in school-aged children  Iulia Armean Elena - Ionela Tanase, Ioana Andrei, Vlad Frandes Validated View

Prevalence of overweight and obesity in school-aged children

First author: Iulia Armean

Coordinator(s): Ionela Pascanu , Raluca Pop

Keywords: overweight children standards

Background: The prevalence of childhood overweight and obesity has increased worldwide in recent decades. Obesity in childhood is associated with a wide range of serious health complications and an increased risk of premature illness and death later in life. 
Objective: Our purpose was to estimate the incidence of overweight in school-aged children using different growth standards. 
Material and Method: A cross-sectional study was conducted on a random sample of 1168 children between 6-14 years, from 8 rural and urban school institutions from Tg. Mures County from November 2013 to January 2014. Variables: age, gender, environment, standard deviations for weight, BMI and waist using WHO and Swiss standards. For measuring their heights we used a stadiometer, for their weights an electronic scale metrological checked and a mechanic taliometer for their waist. To calculate standard deviations we used GrowthAnalyzer and Anthroplus software and for statistical analysis M.O. Excel and GraphPadInStat v. 3.06 with statistical significance threshold α=0.05. The study was approved by the Ethics Committee from UMF Targu Mures and each legal representative signed an informed consent to participate. 
Results: 49.91% of subjects were girls, and 50.17% boys. The incidence of weight disturbances was different depending on the standards used: for girls 5.73% overweight and 2.95% low weight and for boys 6.92% overweight and 2.24% low weight when using Swiss standards, respectively 7.65% overweighted girls and 2.6% with low weight and 10.55% overweight and 2.76% low weighted boys with WHO standards. There is a statistical significant difference for both weight and BMI between the two standards (p=0.0001). 
Conclusions: This study proved that there is a real difference between various anthropometric standards used for weight evaluation, hence, in order to obtain accurate data for our population we need to develop and implement our own standards.

Urban vs. Rural– does the environment count in child development?  Elena - Ionela Tanase Iulia Armean, Andrada Otvos-Moldovan, Ioana Andrei Validated View

Urban vs. Rural– does the environment count in child development?

First author: Elena - Ionela Tanase

Coordinator(s): Ionela Pascanu , Raluca Pop

Keywords: Rural Urban environmental difference children

Background: The environment has been considered an important factor influencing children's nutrition and growth. Children in urban areas are considered to be more advantaged than those from rural areas thanks to higher standards of health, protection, education and sanitation. 
Objective: Our purpose was to assess the differences among children from urban and rural areas with focus on auxologic parameters.
Material and Method:

A cross-sectional study was conducted on a random sample of 1168 children 6-14 years of age, from 4 rural and 4 urban areas in Mures County from November 2013 to January 2014.  Variables analyzed: age, sex, environment, Tanner stage, age at menarche and SD scores (calculated with GrowthAnalyzer) for weight, BMI, waist, height, arm span, head circumference using the recommended Swiss standards.
Our research was approved by the local Ethics Committee and each legal representant signed an informed consent. Statistical analysis used M.O. Excel and GraphPad InStat v.3.06 with a level of significance of α=0.05.
Results: 51.88% of children came from urban areas and 50.25% were boys. Children from urban areas are shorter in mean compared with those from rural areas (p<0.001), even after adjusting for age and sex. The environment does not significantly influence children’s weight (p=0.55) or breastfeeding period (RR 1.02, IC 95% 0.88-1.2, p=0.76). There’s no significant difference between the mean age of onset of puberty, even after controlling for age (10.03 years in rural vs 10.22 years in urban girls, p=0.41 and 10.35 years rural vs 10.42 years in urban boys, p=0.52). The urban environment presents a higher risk of short stature (RR 2.6, CI 95% 2.01-3.36, p<0.001), but not for overweight.
Conclusions:
This study shows that for our region the environment has significant influence on height, but not weight and the previous described differences between rural and urban areas need to be reconsidered. 

Histological and immunohistochemical findings in peripheral T cell lymphoma  Dumitriţa Buzdugan Validated View

Histological and immunohistochemical findings in peripheral T cell lymphoma

First author: Dumitriţa Buzdugan

Coordinator(s): Cotoi O , Turcu M

Keywords: peripheral T cell lymphoma anaplastic CD30

Background: Peripheral T cell lymphoma is a rare variant of neoplasms but very aggressive and with poor outcome. The current WHO classification (dating 2008) for lymphomas still has categories such as unclassified or unspecified, demonstrating that this field is yet to be discovered.
Objective: The purpose of the study was to establish clinical and histological determinations for a number of 29 patients diagnosed in the Tîrgu Mureş County Hospital during a period of six years:2008-2013.
Material and Method: We used demographic information as: age, gender and clinical determinations as: sites of the primarily tumor, also histological and immunohistochemistry findings.
Results: Throughout years, the number of peripheral T cell lymphoma had been decreasing from 12 cases (41.4%) in 2008 to 3 cases (10.3%) in 2013. A higher frequency of peripheral T cell lymphoma is observed among men:18 patients (62.1%) as well as in subjects around their fifth decade of life. In genetic testing, there had been used markers like CD3 and CD45 RO both positives in 12 cases (41.4%), only CD3 in 14 cases (48.3%) and only CD45 RO in 2 cases (6.9%). For the 3 cases of anaplastic lymphoma, ALK protein was positive, but only in 66.6% CD30 was strongly positive.
Conclusions: Peripheral T cell lymphoma represents a rare variant of T cell lymphomas. Our study data are in correlation with those from specialized literature, most affected being the male gender and persons in fifth decade of life. The highest incidence was in 2008, 12 new cases from the total of 29 included in our study.

Assessment of microvascular damage in systemic sclerosis using nailfold capillaroscopy  Mihai Cumurciuc Silvia Ioana Morar Validated View

Assessment of microvascular damage in systemic sclerosis using nailfold capillaroscopy

First author: Mihai Cumurciuc

Coordinator(s): Parvu Mirela

Keywords: SSc microvascular damage Nailfold video capillaroscopy (NVC) Antibodies (Anti Scl-70,anti-centromer, anti Ro-52

Background:

Scleroderma (SSc) is a connective tissue disease characterized by fibrosis and degenerative lesions of the skin and internal organs.

Excessive fibrosis is preceded by complex vascular structural and functional abnormalities and perivascular inflammation

Early in the disease, the peripheral  microangiopathy may be well recognized and studied by nailfold capillaroscopy or better with the videocapillaroscopy, a non-invasive and safe technique , which is well reported to have both diagnostic and prognostic .

Objective:

The aim of the study is to follow the nailfold video capillaroscopy effectiveness  in the diagnosis of patients with systemic sclerosis.

Material and Method:

This study was performed on 10 patients admited  in the University Clinic  of Rheumatology Tg. Mures. 

Nailfold video capillaroscopy (NVC) was used to analyse microvascular abnormalities in patients with systemic sclerosis diagnosed according to ACR criteria.

Changes nailfold capillaries were evaluated by Videocap 3.0 magnification contact lenses 200X;

Capillaroscopic examinations were performed at fingers II-V on both hands in all patients. Microvascular damages were classified according to the Cutolo recomandations: -,,Early”  -,,Active”  - ,,Late” NVC pattern

 Was made  Anti Scl-70,  Anti-centromer, Anti Ro-52  antibodies, performed by ELISA methode.

Results:

 In the study group 9 patients (90%) were women and 1patient (10 %) was men. The mean age of our SSc patients is 46,5 years old. Presence of antibodies: Anti Scl-70 (7patients) Anti-centromer (2patients)Anti  Ro-52(1patient);

7 patients presented  „active to late ”NVC pattern, 2 patients  „late” NVC pattern, and 1 patient „early” NVC pattern


Conclusions:

Nailfold video  capillaroscopy represents the best and safest method for detecting and analysing microvascular abnormalities and  allows to monitoring this patients with  greater accuracy.

Treatment of bone and soft tissue suppurations with wide resection and continuous lavage  Renáta Czegő Radu-Dumitru Antoniu Validated View

Treatment of bone and soft tissue suppurations with wide resection and continuous lavage

First author: Renáta Czegő

Coordinator(s): Botan A

Keywords: osteo-articular suppurations continuous lavage wide resection

Background: Osteo-articular and soft tissue suppurations usually have multiple causes and they represent a disabling pathology with a big material and energetic consumption and a high medical cost. Therefore an early, and if it’s possible a definite solution for this category of pathology is the most important objective of the treatment. In this work we present three cases of chronic osteitis treated by the protocol of Plastic Surgery department of the Mures County Hospital.
Objective:

To emphasize the technique of continuous lavage in the focus of the suppuration as postoperative treatment of chronic bone infections.

Material and Method:

We selected 3 cases in which the evolution was the most suggestive for demonstrating the efficiency of our treatment technique. In all cases extensive excision and continuous lavage placed in the remaining cavity(5 weeks, first 2 weeks ciprofloxacin 1g/24 h, 3 weeks concentrated clorhexidine gluconat) was performed.

Results:

All the three cases had a favorable outcome, the suppurating and necrotic process was eradicated. We have to highlight that the lavage was made gravitationally in all cases, to permit the antiseptic and respectively the antibiotic fluids time to action inside the remaining cavity.The follow up of all cases was for a long period( 3-4 years) during this time no relaps has been noticed.

Conclusions:

The large excision of bone and soft tissue involved in the suppurative process is an essentially and necessary procedure in the therapy of chronic infections. The treatment with continuous lavage with antibiotics and antiseptics can give really good results in the definitive healing/care of the chronic bone and soft tissue suppurations if it is correctly applied.

Assessment of risk factors for anastomotic leak occurrence after resection of colorectal neoplasm  Teodora Irina Adam Roxana Patricia Furda, Alexandru Achim, Dragos Aconstantinesei, Vlad Bura Validated View

Assessment of risk factors for anastomotic leak occurrence after resection of colorectal neoplasm

First author: Teodora Irina Adam

Coordinator(s): Iancu C , Mocan L

Keywords: colorectal cancer colorectal resection anastomotic leak

Background:

Radical tumor resection following colorectal cancer remains the only curative procedure. The outcome of the intervention is influenced by serious postoperative complications such as anastomotic leak (AL). Therefore, identification and control of certain risk factors for AL could be of decisive importance in improving the outcome of these patients.

Objective:

Our aim is to identify risk factors in resection of colorectal neoplasm and assess their correlation with AL.

Material and Method:

We conducted a retrospective study by selecting 310 patients with colorectal cancer, 121 female and 289 male, treated between 01.01.2013 - 31.03.2014 at The 3rd Surgery Clinic from the “Prof. Dr. Octavian Fodor” Regional Gastroenterology and Hepatology Institute in Cluj-Napoca. All of the subjects underwent curative surgical intervention (resection and anastomosis) for colorectal neoplasm. Medical records and the standard form designed for this study were used for data collection.

Results:

Anemia and hypoproteinaemia represent significant risk factors for AL. No significant correlation was found between postoperative complications and tumor size. Also, intraoperative events did not influence the postoperative evolution. In contrast, delayed postoperative oral nutrition and patient mobilization increased the risk of AL. In this study there were 15 cases of postoperative deaths.

Conclusions:

AL consecutive neoplastic colorectal resections is determined by hypoproteinaemia, anemia, delayed postoperative oral nutrition and mobilization. The anastomosis technique (mechanical/ manual) did not prove to be a risk factor for AL.           

Laparoscopical Hysterectomy, Conversion Risks and intra and post-surgical complications  Dimitris Marin Argyriou Ralisa Spirchez, Iulia Rijnoveanu, Roxana Ioana Mihalcut Validated View

Laparoscopical Hysterectomy, Conversion Risks and intra and post-surgical complications

First author: Dimitris Marin Argyriou

Coordinator(s): Nicolau C R , Nedelcu Monica

Keywords: laparoscopic Hysterectomy Surgery

Background: The actual study represents an efficiency of the laparoscopic hysterectomy upon the classical technique(laparotomy)  Objective: The idea is that the laparoscopic hysterectomy could be more efficient than the classical technique. Material and Method:

 A retrospective study was effectuated upon 74 women Patients which starts in 2006 until 2014. Were finalised 56 of the cases with laparoscopic technique while 18 of them were converted on laparatomy due to the intraoperatory complications or the difficulties that appeared : the difficult anatomical conditions(adhesions), a voluminous uterus, nodules with intraligamentar development and technical difficulties concerning the laparoscopic equipment.

Results:

The procedure was endoscopic to 56 (75,7%) patients from which 40 (54%) were HyLT and 16 (21,6) were LAVH and the patients are aged 31-83 years old.

The LAVH cases were done, having a pathology such as genital prolaps and it has been required a complementary vaginal plasty. The HyLT were done removing the uterus through transvaginal way.

 In 90% of cases the vagina was sutured laparoscopic (Simple knot or Surjet). It didn't exist any early postoperatory complications while the hospitalisation was 3-5 days after the surgery

Conclusions:

 The laparoscopic hysterectomy represents a feasible technique and it should be applied on every patient in departments that are equipped with laparoscopic instruments, but before applying this technique we need a good evaluation on each situation: Mobile uterus, voluminous uterus, a less adipose abdominal wall and without previous incisions. LAVH is recommended also when genital prolaps occurs, but the gynecologist surgeon should be aware of the possible difficulties that may appear during the surgery and he should inform the patient about a possible conversion into laparatomy.  

Study of HER2, EGFR, p53 and PTEN during the development of human gastrointestinal tract  Ráduly Gergő Validated View

Study of HER2, EGFR, p53 and PTEN during the development of human gastrointestinal tract

First author: Ráduly Gergő

Coordinator(s): Pap Zsuzsanna

Keywords: HER2 EGFR PTEN fetal

Background:

The development of the gastrointestinal tract starts in the embryonic period and it has 3 phases. In the first phase, until week fourteen, the unique histological structure of each segment is estabilished. Between week fourteen and thirty, the second phase, the lymphoid elements appear in the wall of the gastrointestinal tract.The period between week thirty and fourty which is the third phase, is characterized by growth and maturisation of the gastrointestinal tract. HER2, EGFR, p53 and PTEN, being a part of a complex intracellular signaling pathway, have important role in embryiogenesis and development of certain organ systems, including the gastrointestinal tract. 

Objective:

Our goal is to study the expression of these markers in the digestive tract of 9-24 weeks old fetuses.

Material and Method: We studied tissue samples of fetal esophagus, stomach, small and large intestine collected from 18 post mortem fetuses of 9-24 weeks with Ultravision immunohistochemical techniques using p53, HER2, EGFR, PTEN primary antibodies. 
Results:

HER2 expression appears in the early fetal period whilst EGFR expression appears in the later fetal period. They reach their maximum at week 21, then their expression decreases until it dissappears. PTEN expression also appears in the early fetal period and in the later fetal period it becomes constant and uniform, after week 21 it is restricted to some parts of the epithelium.

Conclusions:

Although the expression of HER2, EGFR and PTEN appears in the intestinal epithelium in the early fetal period the expression of HER2 and EGFR dissappears but expression of PTEN is enhanced in the later fetal period.

Alcoholism-the psycho-social status in relation to alcohol ingestion in victims of suicide by hanging  Marinela-Radiana Faur Nicolae Stanciu, Bogdan Daniel Jerdea, Oana-Petronela Dîrțu Validated View

Alcoholism-the psycho-social status in relation to alcohol ingestion in victims of suicide by hanging

First author: Marinela-Radiana Faur

Coordinator(s): Hadarean V

Keywords: Alcohol Hanging Depression Suicide

Background:

Suicide by hanging is one of the major causes of violent death, being carried out through self-asphyxiation by strangulation. Hanging associated with alcohol ingestion is one of the most common methods of suicide worldwide and has become a public health issue. 

Objective:

To establish an epidemiological profile and evaluate blood alcohol concentrations in victims of suicide by hanging in the Mures county.

Material and Method:

Cross-sectional study includes 93 victims of suicide by hanging autopsied in IML Mures in 2012. Data  collected from the department’s archive, follows up similar attributes: gender, age, area of origin, social status, location and date of death, forensic pathological diagnosis, blood alcohol concentration at the time of autopsy, medical history. Statistical analysis was performed using both MS Excel and GraphPad InStat 3.06.

Results:

The suicide incidence was higher(3.4 times) in victims from the rural environment. Blood alcohol was present in more than half of victims(50.53%), providing no statistically significant association with sex or environment. A significantly association was shown between age below 25 and the presence of blood alcohol at time of autopsy(p=0.0257). The mean age of those who had not ingested alcohol(48.75 years) did not significantly differ from those with levels of alcohol up to 2.9 g/100ml. The mean blood alcohol value was significantly higher in males than females(1.611-1.057, p=0.04). A history of psychiatric disorders was found in 39.8% of victims, depression representing 78.37% and schizophrenia 13.51%. Married victims with psychiatric disorders (13-Depression, 1-Schizophrenia, 2-Epilepsia, 1-Dementia) present a higher number of cases than not married ones(8-Depression, 3-Schizophrenia, 1-Epilepsia). Post mortem examination revealed hanging mark(93), stasis(76), cardiovascular diseases(66) and cerebral edema(65).

Conclusions:

Study reveals an evaluation of epidemiologic profile registering higher values for alcohol ingestion in male victims and inhabitants from rural environment. Also depression was shown to be the main psychiatrical disorder.

Antibacterial activity of antiseptics and disinfectants  Ioana Banea Validated View

Antibacterial activity of antiseptics and disinfectants

First author: Ioana Banea

Coordinator(s): Toma Felicia , Man A

Keywords: antibacterial antiseptics disinfectants

Background:

 Within hospitals, a proper decontamination of surfaces and hands of the staff is mandatory, considering the need of nosocomial infections prevention.

Objective:

The comparison of antibacterial activity of various antiseptics and disinfectants that are commonly used in hospitals.

Material and Method: We analysed the activity of four type of antiseptics and four disinfectants on seven different bacterial species, using the standard CLSI microdilution method. In microtiter plates, binary dilutions were made of each decontaminant to a final volume of 100 μl. The bacterial suspensions were prepared at a concentration 0.5 McFarland, from which 10 μl were inoculated in 9990 μl Muller-Hinton broth. From the resulting inoculum, 100 μl were inoculated into each of the plate wells. The plates were incubated at 35°C for 24 hours. For each bacterial species and for each decontaminant, the last dilution were no growth was found was noted.
Results:

 Of the disinfectants, two showed very good antibacterial activity, keeping their efficiency even in dilutions of 1/4096. E. coli and Pseudomonas showed the highest resistance to these, the minimum inhibitory concentration being identified to a dilution of 1/256. Among the antiseptics, the most effective was the iodine based solution, which retained its efficiency on Clostridium in dilution 1/256; the sanitary alcohol presented the lowest activity, which in dilution of 1/32 has lost its bacteriostatic activity against staphylococci.

Conclusions:

The disinfectants have strong antibacterial activity, but there are some bacterial species which resist better than other, especially if these substances are diluted too much. For the decontamination of skin, other antiseptics than alcohol are recommended.

Short stature in school-aged children  Andrada Otvos-Moldovan Iulia Armean, Elena - Ionela Tanase, Vlad Frandes Validated View

Short stature in school-aged children

First author: Andrada Otvos-Moldovan

Coordinator(s): Pascanu Ionela , Pop Raluca

Keywords: short stature height measurement children

Background: The evaluation of height in children and the indication of further investigations are hyghly dependent on the growth charts used. The recommended standard for our country is the Swiss one, developed in 1989. Objective: The purpose of this study is to evaluate the different standards used for height measurement of children in Romania. Material and Method: Type of study- cross-sectional. The target population was children 6-14 years of age. Sample- randomized, represented by 1168 children from 8 schools in Mures County evaluated from November 2013 to January 2014. Variables analysed: age, sex, height, environment, height standard deviations using WHO and Swiss standards. Method: height was calculated as the average of at least 2 measurements whit the same stadiometer. We used GrowthAnalyzer and AnthroPlus to calculate standard deviations. Short stature was defined as height at least 2 SD below the standards used. The statistical analysis used M.O. Excel and GraphPadInStat3.06., with a level of statistical significance α=0,05. The study was approved by the Ethics Committee UMF Targu Mures and each legal representative signed an informed consent to participate. Results: Sex ratio favoured the boys (50.13% vs 49.86) and the more than a half of subjects came from urban areas (51.95%). Short stature incidence was different  depending  on the standards used (8.3% Swiss and 3.9% with WHO standards), with an agreement between Swiss and WHO standards of 43.75% for girls and 45.83% for boys. When comparing the SD obtained with each standards, there is a statistical significant difference, regardless of sex or age (p<0.001). Conclusions: There is an important difference in the incidence of short stature depending on the standards used. The low rate of agreement between the standards might show a source of error when defining short stature according to a certain standard and underlines the need for national references.

Correlation between post-PTCA resolution of ST segment and mortality in STEMI patients  Diana Elena Opincariu Carmen Oana Moldovan, Daniel Balan Validated View

Correlation between post-PTCA resolution of ST segment and mortality in STEMI patients

First author: Diana Elena Opincariu

Coordinator(s): Benedek I , Benedek Theodora

Keywords: STEMI revascularization ISSTE mortality

Background:

In transmural AMI, the myocardial necrosis causes changes in the electrical phenomena of the heart, which is visible through the ECG: elevated ST segment. The extent of the necrosis can be decreased through revascularization (thrombolysis or PTCA), which will cause a resolution in the ST segment elevation amplitude.
Objective: The present study aims to identify a correlation between mortality in STEMI patients and ST segment resolution following revascularization (PTCA).
Material and Method:
In total, 298 patients with STEMI who underwent pPCI were included in the study. We calculated the integrated score of ST segment elevation (ISSTE) by summing the amplitude of the ST segment elevations in all the leads and compared the pre and post-PTCA scores. An efficient revascularization was defined as a decrease in the ISSTE score by >=50%.
The study population was divided into 2 groups: group 1= patients that presented >=50% decrease in the ISSTE; group 2= patients that had a decrease in the ISSTE of <50%.
The analysis of the data was performed by using MS Excel, GraphPad InStat and Fisher’s exact statistical test.
Results:
Out of the total 298 patients, 259 (86.91%) presented a >=50% ISSTE decrease (group 1), whereas 39 (13.08%) patients had a <50% ISSTE decrease (group 2).
Patients in group 1 showed a lower mortality rate (6.56% - 17 cases) than patients in group 2 (25.64% - 10 cases), p=0.0008, the difference being highly statistically significant.
There were no statistically significant differences between the 2 groups regarding age (p=0.6371), sex (p=0.7202) or the infarct related artery (p=0.8784).

Conclusions: The study demonstrates the correlation between ST segment amplitude decrease, post-PTCA, and mortality in STEMI patients. An over 50% decrease in the ISSTE score, following revascularization, is associated with a decrease in mortality in STEMI patients.

Incremental value of MSCT for prediction of PCI complexity in left main stenosis  Daniel Balan Diana Elena Opincariu, Carmen Oana Moldovan, Ioan Sorin Pop Validated View

Incremental value of MSCT for prediction of PCI complexity in left main stenosis

First author: Daniel Balan

Coordinator(s): Benedek I , Benedek Theodora

Keywords: left main syntax score coronary computed tomographic angiography

Background:

Coronary angiography has become nowadays the
gold standard technique for diagnosis of coronary artery
stenoses, including those located in the left main (LM)
coronary artery.
A positive coronary angiography showing severe
narrowing of the LM indicates an urgent need for revascularization,
which could improve the tolerance to ischaemic
events in other coronary territories and reduce
the progression of the associated ventricular dysfunction.
Objective:
The aim of our study was to asses the
incremental value of Coronary Computed Tomography
Angiography (CCTA) added to classical coronary angiography,
for complex characterization of coronary lesions
and prediction of procedural complexity in patients
with significant Left Main (LM) stenoses.
Material and Method:
Thirty-six patients with LM
disease were enrolled in the study, and each subject underwent
CCTA followed by coronary angiography and
percutaneous revascularization.
Results:
Logistic regression analysis indicated a
good correlation between the angiographic-calculated
and the CCTA-derived Syntax scores for the whole
group (r=0.87, p<0.0001) and for the high risk subgroup
(r=0.86, p<0.0001), but not for the low and intermediate
risk (r=0.38, p=0.21 and r=0.62, p=0.07 respectively). In
cases which required complex PCI procedures, both angiographic
and CCTA Syntax score were significantly
higher than in those who did not require complex revascularization
procedures (24.5 +/- 11.5 vs 32.2 +/- 14.6,
p=0.09 for Angio Syntax, 35.3 +/- 11.5 vs 25.2 +/- 11.3,
p=0.01 for CCTA). In the same time, Ca scoring was
significantly higher and plaque volumes were significantly
larger in cases requiring complex revascularization
procedures (299.5 +/- 359.6 vs 917.3 +/- 495.4,
p=0.04 for calcium score, 79.7 +/- 28.5 vs 108.7 +/- 25.3
mm3, p=0.002 for plaque volumes).
Multivariate analysis identified the following CCTA
parameters as significant predictors of increased risk for
complex intervention in LM lesions: plaque volume , Ca scoring  and CCTA
Syntax score .
Conclusions:
CCTA derived parameters provide incremental
information to classical Coronary Angiography
for preoperative assessment of lesion severity in complex
left main stenosis. CCTA derived Syntax score significantly
correlates with the classical Coronary Angiography
Syntax score and identifies the subgroup of
patients who will be more exposed to procedural complications
during the revascularization interventions.

Factors involved in pubertal development and growth  Ioana Andrei Iulia Armean, Vlad Frandes, Andrada Otvos-Moldovan Validated View

Factors involved in pubertal development and growth

First author: Ioana Andrei

Coordinator(s): Ionela Pascanu , Raluca Pop

Keywords: perinatal factors puberty height weight

Objective: This study aims to assess the influence of perinatal factors on the debut of puberty and on height and weight in children. The research is motivated by the current debate about the importance of the prenatal environment as a determinant of later disease risk.
Material and Method:

A cross-sectional study was conducted in 1168 school-aged children, 6-14 years of age, from November 2013 to January 2014, in 8 schools from Mures County. Age, gender, environment, gestational age, weight at birth, breastfeeding duration, standard deviations on weight and height using GrowthAnalyzer, Tanner stage, and menarche age were assessed.
The study was approved by the local ethics committee and all legal representatives have signed an informed consent form.

Results:
For both boys and girls, the mean age of puberty onset did not differ according to birth-weight (girls: AGA 9.55± 1.5 years vs SGA 10.21±1.45 years, p=0.122; boys: AGA 10.29±1.6 years vs SGA 10.69±1.56years, p= 0.32), breastfeeding period( girls: breastfed 10.02±1.5 years vs formula fed 10.06±1.3years p=0.97; boys: breastfed 10.54±1.48 years vs formula fed 9.92±1.52 years, p=0.068) and gestational age (girls: premature 10.87±1.49 years vs at term 10.08±1.47years, p=0.13; boys: premature10.33±1.75 years vs at term 10.34±1.56years, p=0.94).
Both boys and girls, aged 6–9, born SGA are smaller, in terms of weight (for girls, 25.2 kg vs 27.8 kg, p=0.03; for boys, 22.65 kg vs 28.53 kg, p<0.0001) and height (for girls, 124.26 vs 127.59cm, p=0.028; for boys, 121.174 vs 128.590cm, p<0.0001). 
Compared with formula fed, breastfed boys, aged 6–9, are thinner (26.83 kg vs 28.98 kg, p=0.026).
Also, premature girls are thinner (mean weight: 22.629 kg vs 27.958 kg, p=0.0006) and shorter (mean height: 122.43 cm vs 127.56cm, p=0.0034).

Conclusions: Although gestational age, birth weight and breastfeeding do not influence the onset of puberty, they influence weight and height later in life.

High-sensitivity C-Reactive Protein and left ventricular remodeling in patients with type II diabetes mellitus and acute myocardial infarction  Carmen Oana Moldovan Diana Elena Opincariu, Daniel Balan Validated View

High-sensitivity C-Reactive Protein and left ventricular remodeling in patients with type II diabetes mellitus and acute myocardial infarction

First author: Carmen Oana Moldovan

Coordinator(s): Benedek Theodora , Benedek I

Keywords: acute myocardial infarction diabetes mellitus hs-CRP ventricular remodeling

Background: The degree of ventricular remodeling following  an acute myocardial infarction  might be influenced by the concentration of inflammation markers in patients with type 2 diabetes mellitus.
Objective:

We aimed at assessing the correlation between the amplitude of the left ventricular (LV) remodeling, epicardial fat thickness (EFT) and persistence of elevated circulating levels of an inflammation marker -highly sensitive CRP (hs-CRP)- at 7 +/- 2 days after an AMI in patients with type 2 DM. 

Material and Method:

The study included 45 patients with type II DM: group 1 – 22 low-to-intermediate risk, (hsCRP <3 mg/l), group 2 – 23 high-risk, (hsCRP >3 mg/l). The LV function and remodeling were assessed at baseline and at 6 months after the infarction.

Results:

The hs-CRP values were 1.71 +/- 0.78 mg/l in group 1, which was classified as low-to-intermediate risk, and 12.3 +/-11.1 mg/l in group 2, which was classified as high risk (p=0.0001). The clinical baseline characteristics of the study population showed no significant differences between the low-to-intermediate risk and the high-risk group in respect to age (p=0.8), gender (p=0.3), the presence of hypertension (p=0.7), dislipidemia (p=1) obesity (p=0.9), smoking status (p=0.2) and fasting glucose level (p=0.1)The echocardiographic and angiographic assessments at baseline revealed no statistically significant differences between the groups in regards to the ejection fraction (p=0.07), the LVED volume (p=0.14) and the location of the infarction. Ejection fraction (EF) at 6 months was significantly lower in gr.2 (46.27 +/- 4.7%, vs. 40.85 +/- 5.16%, p=0.0006). The Remodeling index was more pronounced in group 2 (12.49 +/-6.76% vs. 17.86 +/- 5.6%, p=0.005) and significantly correlated with circulating levels of hs-CRP (r=0.39, p<0.001). Multivariate analysis identified the hs-CRP values (OR: 4.09, p=0.03) as significant independent predictor for LV remodeling. 

Conclusions:

Persistence of a marked inflammation at 7 days post-infarction is associated with a more severe remodeling and impairment of ventricular function in patients with type 2 DM and AMI. 

Does Orthodontic Treatment Affect Patients’ Quality of Life?  Andra Laura Codoiu Codruța Cosma Validated View

Does Orthodontic Treatment Affect Patients’ Quality of Life?

First author: Andra Laura Codoiu

Coordinator(s): Soaita Claudia

Keywords: Orthodontic treatment Psychological changes self-esteem

Background: Facial and dental attractiveness represents an important element of quality of life for patients seeking orthodontic treatment. Many people find that a beautiful smile adds to self-esteem, social acceptance and leads toward self-confidence.
 Even though adults are no longer growing, they can also enjoy improvements that come from orthodontic treatment

Objective: The aim of this study was to assess the social and psychological changes that orthodontic treatment involves.
Material and Method: The survey included  80 students from the University Of Medicine And Pharmacy both males and females. They were questioned regarding  ‘Dental Self-confidence’, ‘ Psychosocial impact’, `Pain endurance` caused by dental treatment and `Satisfaction after orthodontic treatment`. Subjects were also required to share some amusing moments while wearing dental braces, and what improvements they would bring to it.
Results: The results of the study show that 58% of the questioned subjects decided to wear braces after medical advice and 55% of them were determined by their need to improve their dental aesthetics.
Also 74% of the subjects affirm that the pre-treatment didn`t affected their spirits as much as the pain endured throughout the first part of the treatment.
80% of the subjects stated that dinning was difficult, but, surprisingly, rigorous hygiene was easy to maintain for 74% of them.


Conclusions: Compared to the general population medical students seek orthodontic treatment without being referred by general practitioners, their knowledge allowing them to a better evaluation of their dental status. Despite the difficulties involved in wearing a fixed dental appliance, patients still focus on the final result, which increases their self-esteem, social acceptance and self-confidence.

Effect of magnification on locating the Canals in Maxillary Molars.  Bogdan Dumitrachi Bogdan Lucian Bucur, Alexandra Stoica Validated View

Effect of magnification on locating the Canals in Maxillary Molars.

First author: Bogdan Dumitrachi

Coordinator(s): Torcatoru Anca

Keywords: surgical operative microscope acces cavity dental loupes teeth canals

Background:

It is well known that one of the causes of the failure of endodontic therapy is the inability to localize and treat all the canals of the endodontic system. All categories of teeth may have extra roots and/or canals, but the likelihood of finding aberrant canal configurations is higher in premolars and molars.

Objective:

The purpose of this study is to determine if magnification could enhance the operator’s ability to locate more than three canals in maxillary molars.

Material and Method:

In this study 18 extracted first and second permanent maxillary molars were used. After creating the access cavity a sharp endodontic explorer was used to identify the canals. In order to increase the canal entrance detection, the pulp floor was stained using methylene blue. Each tooth was examined by single blinded operators with different experience, without magnification and using dental loupes at 4x magnification and surgical operative microscope (SOM) at 29.5x magnification.

Results:

The study results showed that after creating the access cavity, using no magnification, methylene blue and dental loupes, the undergraduate students found 4 canals in 2 teeth (11.11%).With the use of the surgical operative microscope, the results increased to 4 teeth (22.22%). Following the same steps the endodontic specialist discovered 4 canals in 22.22% without magnification. Using loupes and operative microscope 4 canals could be detected in 44.44% and 5 canals in 5.56% by the same specialist.

Conclusions:

The results of this study suggested that the use of magnification loupes and operative microscope (SOM) increases the ability of the operators to locate more than three canals in the first and second permanent maxillary molars. The operators experience has a great influence on locating canals in teeth with complex anatomy.

Community aquired pneumonia in school-aged children  Anca Raluca Suciu Ioana-Violeta Oltean, Madalina Salagean Validated View

Community aquired pneumonia in school-aged children

First author: Anca Raluca Suciu

Coordinator(s): Bodescu Virginia

Keywords: pneumonia children community clinical findings

Background: Community aquired pneumonia in children can be described as the presence of clinical signs and symptoms of pneumonia occuring in a previously healthy child.The child has not been hospitalized in the last 14 days before the onset of disease. Regarding the aetiology 80%-85% of infections are viral, 10% are bacterial while the rest of them have others causes.
Objective: The aim of the study is to determinate the frequency, sex and age distribution, causes, clinical and laboratory findings of community aquired pneumonia in school children and the effectivenes of the treatment.
Material and Method: From 265 children with pneumonia, addmited in to the Targu Mures Pediatric Clinical Hospital, during three years, only 58 of them met the criteria of inclusion in the study:age, a definitive diagnosis of pneumonia, no history of cronic diseas, immunosuppressants and immunodeficiency, the onset of the diseas while the patiens was in community(not in hospital). The study is retrospective and the data were optained from the observation charts.
Results: Most patients were between 6 and 10 years and most than half were female. Regarding clinical findings , caugh was the main sign (93%), followed by fever (86%), while short of breathing could be found in only 15% of cases. Less then half had neutrophilia and CRP, while ESR was elevated in 90% of cases.Only 20% had a radiological picture suggesting the diagnosis. About 90% of patient recived antibiotica, the most used being Cefuroxim, and the evolution was good in all cases.
Conclusions: Community aquired pneumonia raise special problems due to the high frequency, school absenteeism, difficulties of diagnosis and the cost of treatment.

Overview of the vaccinating protocols and difficulties in general medicine  Dorottya Miklósi Renáta Czegő, Annamária Pakucs Validated View

Overview of the vaccinating protocols and difficulties in general medicine

First author: Dorottya Miklósi

Coordinator(s): Constantin Martha Maria

Keywords: vaccine protocol pediatrics

Background:

Vaccines- nowadays represent a very controversial topic. Although they were invented to stimulate the immune system, the number of parents who have declined the vaccination of their child has increased. 

Objective:

Our aim was to investigate the vaccination protocols and the punctuality of their effectuation. We also researched the common reasons that are making parents skeptical. 

Material and Method:

In a prospective study we investigated the patient material of  the “Dr. Constantin Martha Maria” private practice from September 2013 to March 2014. We processed the data of 45 children. We analyzed the effectuation and the punctuality of the obligatory vaccinations due between the first 2-12 months. If there were cases where the parents declined the vaccination, we inquired the motives of their refusal. 

Results:

After processing the data we obtained the following results: 73,68% of the children received the mandatory vaccine after the first two months of life, 83,33% after the forth, 77,27% after the sixth month. In the twelfth month 44,44% were administered Pentaxim and 33,33% ROR/Priorix.

In 36,84% of the cases in the first, 38,88% the second, 50%  the third, 22.22%  the forth and 11,11% fifth vaccine there was a delay in the administration.

During our research time 5 parents refused the vaccination. In 3 of the cases they feared the risk of complications from vaccines more than the complications from infections. In one of the two remaining families they were skeptical about the effectiveness of the vaccines. In the last case the parents refused to vaccinate the infants because they suspected toxic ingredients in them. 

Conclusions:

Due to much media attention parents have become suspicious of the vaccination protocols. Despite the strong opinions, anti-campaigns, vaccines remain on of the greatest tools in the public health arsenal. They offer the promise of protection against a variety of infectious diseases and they should be administered at the designated time.  

Factors influencing child development  Vlad Frandes Ioana Andrei, Andrada Otvos-Moldovan, Elena - Ionela Tanase Validated View

Factors influencing child development

First author: Vlad Frandes

Coordinator(s): Pascanu Ionela , Pop Raluca

Keywords: child development breastfeeding birth weight onset of puberty

Background: Breastfeeding duration, gestational age, birth weight are all important factor that influence a child’s development. According to the latest evaluation, our country has one of the lowest percentage of exclusive breastfeeding in Europe. Objective: The evaluation of various factors considered having an influence on normal development


Material and Method:
Type of study: cross-sectional; randomized sample of 1168 children from 8 schools in Mures county, 6-14 years of age.
The study was approved by the Ethics Comitee UMF Tg-Mures; a signed consent from the legal representant was obtained for every subject.
Variables analyzed: age, sex, environment, age of the menarche, Tanner stage, gestational age, breastfeeding period,birth weight, medical history (vaccination, cardiac, renal, malabsorbtion, rickets).
Method: questionnaire for medical and perinatal history; clinical evaluation for pubertal status.
M.O. Excel was used for statistical analysis.

Results:
Sex ratio:boys 50.25% and girls 49.74%; environment ratio: urban 51.88% rural 48.11%; age repartition: 41.52% 6-9 years of age, 58.73% 10-14 years of age. 
For 27.05% of children we have no data regarding the breastfeeding period; 45.65% of the rest of the sample were breastfed at least 6 months and 17.37% were not breastfed at all. 
8.35% of the children were born with low birth weight. The mean age for puberty stage II was 10.35±1.6 years for boys and 10.26±1.58 years for girls.
Cardiological history was present in 3.32%, renal disease in 1.28%, rickets in 2.76%, and malabsorbtion in 0.7% of subjects.

Conclusions:
1. There is an improvement in the percentage of children breastfed according to WHO recommendations.
2. The incidence of low birth weight is about the same as the last evaluation available from the WHO. 
3. The age of onset of puberty has not lowered in our country, compared to the global tendency.


URINARY TRACT INFECTION: DIAGNOSIS AND MANAGEMENT OF THE INITIAL UTI IN INFANTS 0 TO 12 MONTHS  Andrea Edina Oana Maria Ortopan, Iulia Andrea Nagy Validated View

URINARY TRACT INFECTION: DIAGNOSIS AND MANAGEMENT OF THE INITIAL UTI IN INFANTS 0 TO 12 MONTHS

First author: Andrea Edina Oana

Coordinator(s): Duicu Carmen

Keywords: urinary tract infection renal malformations infants urine culture

Background: The urinary tract infection(UTI) is caused by the emergence of certain bacteria in the bladder and sometimes in the kidneys,most commonly involved bacteria is E.Coli. UTI most often is associated with certain,renal malformations,including hydronephrosis,renal duplicity,
vezicoureteral reflux(VUR).
Objective: The purpose of this study is to determine the risk factors that lead to the emergence of UTI in infants 0 to 12 months depending on age,gender,urine culture,renal malformations.
Material and Method: We performed a retrospective observational-analytic study(2009-2013) on 261 infants aged 0 to 12 months,boys and girls. All the patients were diagnosed with UTI at Pediatric Clinic II Targu Mures. We watched the value of creatinine to track if they had or not nitrate retention. Studied parameters: gender,age,creatinine,urine culture.
Results: The results have shown that  in the first year of life most commonly affected by UTI are the boys(57,5%) compared to girls(42,5%). Of the 261 cases studied,161 infants had the value of creatinine more than 0,3mg/dl,what indicates that they presented nitrate retention. We done the urine culture to all pacients and this showed us at a rate of 70% that the most involved in the emergence of UTI in infants between 0 to 12 months is E.Coli. Regarding renal anomalies,results showed this: hydronephrosis(17,9%), pyelectasis(8%), renal duplicity(5,4%), VUR(4,5%).
Conclusions: In the firs year of life,UTI affects most often the boys and the bacteria that is involved most commonly is E.Coli. It is important to diagnose in early stages a kidney abnormality,because a renal malformation can mantain a UTI and this way we can try to prevent renal demage through the administration of a chimioprophilaxie.

Aspects regarding supraventricular tachycardia in the pediatric patient  Octavian-Laurentiu Sendrea Validated View

Aspects regarding supraventricular tachycardia in the pediatric patient

First author: Octavian-Laurentiu Sendrea

Coordinator(s): Gozar L

Keywords: Pediatric patient, Supraventricular tachycardia, Tachycardia induced cardiomyopathy

Background: The most frequent tachyarrhythmias in children are supraventricular tachycardias (SVT). The majority of them are with normal structural hearts and despite being more frequent there`s a high incidence of tachycardia resolution especially in the younger children and the life-threatening events are less likely to occur.

Objective: To evaluate the incidence of each type of arrhythmia, evolution by age groups, the presence of tachycardia induced cardiomyopathy and the treatment required.

Material and Method: We performed a retrospective study in the Pediatric Cardiology Department of Tirgu Mures between January 1 st 2005 and December 31 st 2013 that analyses the patient`s medical papers, ECG strips, treatment protocols and the patient`s evolution.

Results: From the total of 67 pediatric patients with SVT the repartition was as follows: 48 (72%) were diagnosed with paroxysmal supraventricular tachycardia (PSVT) and 19 (28%) were diagnosed with permanent tachycardias in the form of atrial ectopic tachycardia AET (18 cases, 27%) and permanent jonctional reciprocating tachycardia PJRT (1 case, 1%). Tachycardia induced cardiomyopathy was present in 8 patients (12% from the general group and 42% from the permanent tachycardias group). The long-term therapy used in the PSVT cases was: Beta-blocker (41 cases, 86%), Amiodarone (4 cases, 8%), Sotalol, Propafenone and Verapamil each with 1 case (2%); in the AET cases was: Beta-blocker (6 cases, 33%), Amiodarone (8 cases, 44%), Sotalol (3 cases, 17%) and Propafenone (1 case, 6%) and the only case with PJRT was treated with a Beta-blocker. The long-term evolution divided the patients as follows: cured (18 cases,27%,statistically correlated with the onset in the younger age p<0.0001), under chronic treatment (22 cases,33%) and those who needed radiofrequency ablation (27 cases,40%).

Conclusions: The PSVT was the most frequently observed tachyarrhythmia. From the permanent tachycardias cases there were several who developed cardiomyopathy. A significant group of pediatric patients had a complete resolution of the tachycardia.

XRCC1Arg194Trp gene polymorphism and risk of lymphoma in a Romanian population  Anda Stefan Cristina Georgiana Radu, George Crauciuc Validated View

XRCC1Arg194Trp gene polymorphism and risk of lymphoma in a Romanian population

First author: Anda Stefan

Coordinator(s): Macarie I , Banescu Claudia

Keywords: XRCC1Arg194Trp gene polymorphism lymphoma

Background: Lymphoma is a type of cancer that begins in immune system cells called lymphocytes. Like other cancers, lymphoma occurs when lymphocytes are in a state of uncontrolled cell growth and multiplication. Some genetic syndromes characterized by defects in DNA repair (for example XRCC1Arg194Trp or XRCC1Arg399Gln) may be associated with elevated risk of lymphomas.

Objective: The aim of this case-control study was to evaluate if the XRCC1Arg194Trp polymorphism contributes to the development of lymphomas.

Material and Method: We have realized a retrospective, analytical and observational study on a total number of 94 patients hospitalized in the Hematology Department of the Tirgu-Mures County Hospital, during March 2002 and November 2013, and a control group of 113 patients. We have extracted and analyzed data from the patients charts such as: age, gender, LDH or Ann-Arbor staing. XRCC1Arg194Trp genotypes were determined by using a PCR-RFLP method.

Results: Our study revealed that the average age of the patients diagnosed with lymphomas is 57.45 years. From the total of 94 patients, 40.42% were males and 59.57% were females. Between the two groups of heterozygotes we have obtain a value of p=<0.0001, OR=7.346 with 95% CI 2.664-20.259. In the patients group, the results were: 71.27% normal homozygotes, 24.46% heterozygotes and 4.25% variant homozygotes. In the control group we have obtained: 94.69% normal homozygotes, 4.42% heterozygotes and 0.88 variant homozygotes.

Conclusions: This study showed the existence of a correlation between XRCC1Arg194Trp polymorphism and a high risk for developing malignant lymphomas.

THE MODELING OF NEURULATION-EMBRYOLOGICAL TEACHING METHODS  Csilla Hegedus Claudia Costan Validated View

THE MODELING OF NEURULATION-EMBRYOLOGICAL TEACHING METHODS

First author: Csilla Hegedus

Coordinator(s): Gogolak Hrubecz Edit

Keywords: neurulation neurohistogenesis telendiencephalic derivates

Background: The casts pieces, exposed in the Museum of Anatomy and Embryology from of the University of Medicine and Pharmacy Tg. Mureş represents the epigenetic stages of the embryo-fetogenic development of the central nervous system and the decisive moments of neurohistogenesis. 
Objective: The use of gypsum 13 cast pieces is organically completing the visual, auditiv and proprioceptive learning methods. 
Material and Method: The demonstrative pictures with the nomina embryologica, associated the these casts have the same role. The majority of the exhibits were elaborated according the classical anatomical atlases, transforming the plane images, which were magnified, with the help of skilfull molding technicians, up to 200-1000 times of the original size. 
Results:

The neurulation that follows of the blastocistgenesis and the gastrulating has been reproduced in tridermic state. The casts are the reciprocal materialization of the neural tube. The formation of the neural plate is lead by the cordomezoblast. The forming and closing of the sulcus neuralis, the presence of the former anterior and posterior neuroporus, under the inductive action of the dorsal chord are represented on 5 casts, 8 casts are representing metamerisation of the neural folds. Their division into 5 cerebral vesicles, the appearance of the rombencephalic-pontin curve, is followed by the duplication of the telencephalic vesicle. The rombencephalic swellings united on median plane marks the beginning of the development of the cerebellum.The appearance of the telen-diencephalic derivates, the optic vesicles, the olfactive bulbs are significant. 

Conclusions: Increasing the number of the casts assures a larger acces of the demonstrative material. The classical method of gypsum casts has been partially replaced by high resolution microscopes guided by softwares capable of transforming plane pictures to 3D images. 

Anatomical variation of the Sciatic nerve division  Ioana-Vasilica Gherman Ráduly Gergő, Attila Szőllősi, Flavia-Cristina Roman Validated View

Anatomical variation of the Sciatic nerve division

First author: Ioana-Vasilica Gherman

Coordinator(s): Coţovanu A , Pávai Z

Keywords: Sciatic Nerve Common Fibular Nerve Tibial Nerve anatomic variation

Background: The Sciatic nerve classically emerges from the lesser pelvis through the greater sciatic foramen, inferior to Piriformis muscle, and separates into Tibial nerve and Common Fibular nerve at the superior angle of the popliteal fossa. Rarely, the Sciatic nerve may divide within the pelvis. In such case, there are different ways the Tibial nerve and Common Fibular nerve emerge from the pelvis. Objective: This paper describes an antomical variation of Sciatic nerve division into its two major branches, Tibial nerve and Common Fibular nerve, whitin the pelvic cavity, and the particular exit of these two branches through the greater sciatic foramen. Material and Method: The subject of our paper is a formalin-fixed cadaver from the Anatomy Department of the University of Medicine and Pharmacy of Târgu Mureş. During dissection of the gluteal regions we have found a bilateral variation of the Sciatic nerve division and a rare relation between Tibial nerve, Common Fibular nerve and Piriformis muscle. Results: The Sciatic nerve divides in the pelvic cavity into Common Fibular nerve and Tibial nerve. The Common Fibular nerve exits the pelvis through suprapirifom foramen, completly separated from the Tibial nerve, which finds his way out of the pelvic cavity through infrapiriform foramen. Conclusions: In conclusion, this paper presents the abnormalities of the Sciatic nerve division and the relation between Tibial nerve, Common Fibular nerve and Piriformis muscle on a formalin-fixed cadaver. In addition to the anatomical aspects, there are some practical consequences we should consider: these variations may facilitate nerve compression by surrounding anatomic structures resulting in non-discogenic sciatic; surgeons should be aware of the potential complications that may appear during interventions on posterior hip; injuries associated with deep intramuscular injections in the gluteal region; possible failure of anesthesia during sciatic nerve block.

Risk factors for incisional hernias of the abdominal wall  Claudiu Linul Validated View

Risk factors for incisional hernias of the abdominal wall

First author: Claudiu Linul

Coordinator(s): Popa D , Gherghinescu M

Keywords: incisional hernia, risk factors, treatment modality

Background: Postoperative abdominal incisional hernias are tardily complications of the different types of laparatomy.There are many factors that favor them.Several of them are endogenous(obesity, smoking,hypoproteinemia) and others are exogenous(work condition,postoperative wound infection,abdominal incision type,drug treatments).The analysis of these factors enabled an understandig of the mechanism of production and the choice of optimal treatment modality.
Objective: The purpose of this study is to evaluate the relationship between different risk factors and the occurrence  of postoperative incisional hernias.The study also analyses the chosen treatment modality trying to asses the postoperative results.
Material and Method: This is a descriptive retrospective study performed on a lot of 337 patients admitted and treated in the first Surgical Clinic of Mures County Emergency Hospital betwwen 1.01.2009 and 31.12.2012.
Results: The study involved patients who developed either primary or as a recurrence an incisional hernia whence 85 cases in 2009,81 cases in 2010,72 cases in 2011 and 99 cases in 2012.The results showed that:66,5% were woman and 33,5% men(p=0,001).Concerning the age,the most affected age group was the 50 to 60 years,being present in a proportion of 32,9%.The most frequent location for incisional hernias was encountered below and over the navel at a rate of 41,8%.In terms of risk factors:diabetes present in 37 cases(11%),chronic pulmonary diseases in 9 cases(2,7%)including-asthma in 4 cases(1,2%),smoking in 13 cases(3,9%),consumptive syndrome in 31 cases(9,2%).
Conclusions: Postoperative incisional hernias still remain an important class of diseases in the abdominal wall pathology being responsible for a high number of late readmission.Incisional hernias are more common in woman,6th decade of life and obese patients with or without association of septic time intra and postoperatively.

The importance of tracking heterozygote carriers in glycogen storage disease type II (Pompe disease)  Lavinia Raluca Sarafoleanu Andreea Monica Rujan, Daniela Costina Segarceanu, Roxana Viorela Blendea Validated View

The importance of tracking heterozygote carriers in glycogen storage disease type II (Pompe disease)

First author: Lavinia Raluca Sarafoleanu

Coordinator(s): Dobrescu Amelia

Keywords: acid maltase heterozygous genotypic state glycogen storage disease type II genetic counselling

Background: Pompe disease is an autosomal recessive disorder,caused by a deficiency of alpha glucosidase(acid maltase) which leads to the accumulation of glycogen in lysosomes.Three major clinical forms of this pathology are recognised,charachterised by skeletal muscle and respiratory impairment(adult and juvenile forms),often associated with cardiomyophaty(infantile form).
Objective: The aim of this paper is to reveal a study of a non-inbred family in which there is a relapse of the adult form of the disease over two successive generations.
Material and Method: The first generation reveals M.I index,affected by the adult form of the disease,diagnosis being established by identification of acid maltase deficiency in leukocytes.Enzyme deficiency identified in leukocytes(and/or fibroblasts) is sufficient to diagnose this pathology,molecular analysis not being a common practice.By molecular genetics analysis,mutations c.2104>C and c-32-13T>G have been identified at patient M.I. In the second generation,the daughter of the index case,H.I aged 25 is diagnosed with Pompe disease as a result of accidental discoveries of high CPK levels,molecular analysis identifying the same heterozygous compound genotypic state as her mother`s.Furthermore it was determined that H.I `s father is a heterozygous for mutation c-32-13T>G.
Results: Analysing all the data leads to the fact that the 25 year old patient inherited the mutation c.2104C>T from her mother and c-32-13T>G,a commonly found mutation in the late onset of the disease from her father.
Conclusions: The results raise the question of the existence of a higher percentage than the current known carriers of mutations commonly associated with Pompe disease.Therefore,a genetic counselling practice,a screening by enzyme dosage and later molecular analysis to family members in which this pathology is present are neccesary,even if the disease is rare and the transmission is autosomal recessive.

The correlation between MRI and arthroscopy in knee injuries  Georgiana Miler Lorand Vitalis Validated View

The correlation between MRI and arthroscopy in knee injuries

First author: Georgiana Miler

Coordinator(s): Russu O

Keywords: MRI arthroscopy knee injures trauma

Background:

Injuries of the knee joint  occur most often due to trauma at this level, the most commonly affected being the anterior cruciate ligament , as well as both the internal and external meniscus. The anterior cruciate ligament and the two menisci are prone to injuries when the knee rotates during a sustained effort. The severity of this type of injuries depends on its location, on the degree of stretching, as well as on physical shape and muscle strength.

Objective: The purpose of this study is to highlight the correlation between MRI and arthroscopic in knee injuries. Material and Method:

 

Data were collected from  60 patients who suffered knee injuries during 1.10.2013-1.05.2013, and received medical care at the clinic of Orthopedics and Traumatology 2 Targu Mures.

Results:

43 patients suffered ligament damage to the anterior cruciate, damage is noticeable both on MRI and arthrosocpic in proportion of 79%.

2 patients had lesions of the posterior cruciate ligament and both stood out on MRI and at arthrosocopy
44 patients presented  external meniscus lesions, stood out both on MRI and arthroscopy in 93%

28 patients had lesions of the internal meniscus, which revealed both on MRI and arthroscopy in proportion of 57% and 7 patients had presented Baker cyst which has been described by  both MRI and arthroscopy in proportion of 14%.

Conclusions:

MRI and arthroscopy  were compared by using the Kappa coefficient method. The value of the coefficient showed a high agreement between the two techniques. 

Gambling. When does it become a problem?  Eliza-Dumitrita Sirbu Flavia-Cristina Roman, Raluca Adnana Zaharia, Laura Banias Validated View

Gambling. When does it become a problem?

First author: Eliza-Dumitrita Sirbu

Coordinator(s): Gabos Grecu Marieta

Keywords: gambling control addiction money

Background: Nowadays, the modern society offers a large set of possibilities to entertain oneself, such as the sports of chances, involving gaming and betting, the so called "gambling". But when is the thin line between the "recreational" gambling and the pathological one, being crossed?
Objective: The pathological gambling belongs to the group of the Impulse Control Disorders and it is an addiction defined by a persistent and urging desire to engage into activities of risk and faith. It is often associated with other Impulse Control Disorders, substance abuse or dependence. The aim of this paper is to outline the maladaptive patterns of gambling behaviour.
Material and Method:  Questionnaires and conversations with the target group have been used as a method of psychological investigation.
Results: The great variety of gambling choices provides a high number of gamblers. Either it is about casino games or non-casino gambling games, betting or staking systems("betting strategy"), all these actions require three elements to be present: consideration, chance and prize. The maladaptive behaviour of these people seems to be the result of a diminished sensitivity toward gratifications of any kind. In this manner, there appears the need to involve larger amounts of money in order to get the same feeling of excitement, leading to unsuccessful attempts to stop gambling.
Conclusions: Every gambler is unique, so the recovery has to be particular, involving counseling and medication therapy. The observation of the target group over the years should be taken into consideration, in order to reach a better understanding of this public issue.

Sphenoid ridge meningiomas.Clinicopathological study,surgical management and review  Iuliana Cirstea Roxana-Cristina Campean Validated View

Sphenoid ridge meningiomas.Clinicopathological study,surgical management and review

First author: Iuliana Cirstea

Coordinator(s): Balasa A

Keywords: sphenoid ridge meningioma, skull base meningiomas Simpson grade

Background:

Sphenoidal ridge meningioma, also known as sphenoidal wing meningioma are the most common of the skull base meningiomas. In the literature is shown that these tumors have been classified as one of the most difficult to treat because important neurovascular structures (optic nerve,carotid artery and cavernous sinus) are usually involved.

Objective:

To analyze the clinicopathological aspects, review the imaging techniques, and the surgical management of  these tumors.

Material and Method:

We retrospectively analyzed 21 patients who were admitted to the Neurosurgery Department of Targu Mures County Emergency Clinical Hospital between 2001 - 2012. All the patients underwent surgical treatment.Studied parameters were: age,gender,clinical presentation,imaging features as shown on CT scan and MRI,surgical procedures performed,postoperatively results,histopathological diagnosis.

Results:

The mean values were: age: 55,57(±11,32), tumor dimensions:4,31(±1,27); 76,19% of the patients were females and 23,81% males; 52,3% of the tumors were located on the inner third ,38% on the external third and only 9,5% on the middle third of the sphenoidal ridge. In 28% of the cases neurovascular structures were involved .57,1% of the patients presented seizures, 52,3% visual deterioration and 38% headache.Total microscopic tumor resection ,Simpson grade I or II,were achieved in 76,2% of cases. Postoperatively, one patient died,28% presented postoperative complications and 66,6% experienced resolution of their symptoms .The histopathological features are varied and  tumor recurrences had been found in 4 cases (19%) for whom reoperation was performed.

Conclusions:

The average onset age is 50 yearsWomen are more likely to develop sphenoid ridge meningioma compared to men.The main onset symptoms are seizures and visual disturbances.The diagnosis is based on imaging studies,especially post contrast study of either CT scan or MRI,wich is highly sensitive in detecting these tumors.Adequate resection is difficult, given the neurovascular structures involvement.

The Marking Ability of Three Conventional Occlusal Indicators on Ceramic Surfaces  Madalina Zegrean Validated View

The Marking Ability of Three Conventional Occlusal Indicators on Ceramic Surfaces

First author: Madalina Zegrean

Coordinator(s): Soaita Claudia

Keywords: conventional occlusal indicators marking ability ceramic surfaces

Background: Occlusal indicators are used for the occlusal contacts registrations. There are several types of conventional occlusal indicators made of different materials with various colors, thicknesses and marking abilities. Bausch uses wax and a bonding agent for his articulating films in order to increase their quality and to make them capable of marking especially on occlusal surfaces which are hard to test.
Objective: In this study we compared three occlusal indicators in order to observe the marking ability on ceramic teeth.
Material and Method: Five patients with metalo-ceramic crowns were included in the study. Sixteen teeth with ceramic occlusal surfaces were examined and 46 pairs of occlusal contacts were compared. The occlusal indicators used were Bausch Articulating Foil (8µ), Henry Schein Articulating Paper (80µ) and Bausch Articulating Paper (200µ). The occlusal surfaces were photographed in similar conditions for all indicators. Using specific computer software the area of each occlusal contact was determined and statistical tests were used to compare the results.
Results: There were 40 contacts registered with the 8µ Foil, 42 contacts with the 80µ Paper and 39 contacts with the 200µ Paper. In several cases one contact registered with the 200µ and 80µ Paper was marked by two or three areas registered with the 8µ Foil. The comparison of the 46 pairs of occlusal contacts shows that the difference between 8µ Foil and 80µ Paper was not significant, but a significant difference between 200µ Paper and the other ones (p<0,0001) was found. 
Conclusions: The 200µ paper marks larger areas than the 8 and 80µ indicators. The registrations on the occlusal surfaces are similar with the 8µ foil and the 80µ paper. The significant difference of the three occlusal indicators is given by the thickness and not by the marking ability of the indicators. All three indicators are able of marking ceramic surfaces, after drying the teeth.

Accuracy of CHADS2, CHA2DS2-VASC, and HAS-BLED scores in evaluation of stroke and bleeding risk  Alexandra Murar Andreia Gherasâm Validated View

Accuracy of CHADS2, CHA2DS2-VASC, and HAS-BLED scores in evaluation of stroke and bleeding risk

First author: Alexandra Murar

Coordinator(s): Dorgo Monica , Carașca E

Keywords: stroke risk anticoagulation major bleeding

Background: Nowadays, several diseases such as atrial fibrillation encountered in clinical practice requires several types of scores to stratify stroke and bleeding risk. Bleeding risk and stroke risk are closely related. Objective: The aim of this study was to established whether HAS-BLED score is a better predicting score compared with other clinical scores for the category of patients that benefit from oral anticoagulation when balacing ischaemic stroke against intracranial bleeding and to compare CHADS2 and CHA2DS2-VASc risk categories. Material and Method: We performed a retrospective studies that involved 146 patients of which 131 (89,72%) were on anticoagulating oral treatment, from the medicine and cardiology departments in our hospital, with a follow up period of 6 months. For each patient we calculated the CHADS2, CHA2DS2-VASc and HAS-BLED scores. We also divided the stroke risk categories calculated through CHADS2 and CHA2DS-VASc scores in low, medium and high. A HAS-BLED score>3, a CHA2DS-VASc>= 2, and CHADS2>2 were considered high. Results: We found a statistical correlation between the CHA2DS2-VASc>=2 and the hemorrhagic events (p=0,0004, t test) and between the HAS-BLED score>3 and the bleeding events, with a a superior correlation of HAS-BLED score. We did not find a statistic difference between the CHADS2>2 score and the bleeding rate (p=0,065), on the other hand the CHADS2 score in anticoagulated group statistically correlated with the ischaemic events. There was a shift of risk degree from the CHADS2 stroke risk score compared to CHA2DS2-VASc. Conclusions: Patients with atrial fibrillation and a high HAS-BLED score develop a higher clinical benefit from oral anticoagulation when balacing ischaemic stroke against intracranial bleeding. HAS-BLED score was superior to CHA2DS2-VASc in predicting bleeding events. 

COMPARISON OF THE EVOLUTION OF HEALTHCARE SYSTEMS IN THE CASE OF SOME EU COUNTRIES AND ROMANIA DURING THE ECONOMIC AND FINANCIAL CRISIS  Claudiu Neagu Validated View

COMPARISON OF THE EVOLUTION OF HEALTHCARE SYSTEMS IN THE CASE OF SOME EU COUNTRIES AND ROMANIA DURING THE ECONOMIC AND FINANCIAL CRISIS

First author: Claudiu Neagu

Coordinator(s): Buicu F

Keywords: healthcare systems indicators funding

Background: Public health indicators displayed the true efficiency and state of healthcare systems.
Objective: Comparison of the healthcare system in Romania and other 12 EU Member States.
Material and Method: We used the comparison of various indicators for the system financing, performance indicators and indicators of the workforce for Romania and 12 EU Member States, using international databases or reports of  Romanian indicators to various international institutions.
Results: During the studied period Romania was the last place at financing, with an increase of the co-payments percentage in 2004 ( 2nd  place) but with a return to the initial value (6th place). Performance indicators are maintained in plateau with elevated values for the number of  acute care admissions, acute care hospital beds and average length of stay for acute care (bed-days). It can be observed a maintaining in plateau of the number of physicians and nurses throughout the period ( the last respectively penultimate place) and the number of graduated physicians and graduated nurses ( 2nd  place) followed by a decrease in 2008 (4th place).
Conclusions: Although the financing of healthcare services increased, it can be observed a continuing attempt to reduce  the expenses for the medical and pharmaceutical services at EU level. It is necessary a reduction of the acute care hospital beds and a policy to maintain the healthcare professionals in Romania for a better coverage of the population with health services.

Teenagers’ Junk Food Intake and Their Awareness Level Concerning Its Negative Effects on Health  Estera Gabor Ana-Maria Toma(Gabor), Alina Bagdasar, Raluca Soana, Nicolae Stanciu Validated View

Teenagers’ Junk Food Intake and Their Awareness Level Concerning Its Negative Effects on Health

First author: Estera Gabor

Coordinator(s): Tarcea Monica

Keywords: junk food teenagers diet issue

Background: Nowadays junk food is highly accessible to teenagers, given the growing number of fast-food restaurants in the proximity of educational establishments and the wide range of packed snacks and soft drinks affordable in every store. The young people’s preference for an unhealthy diet is common knowledge at the level of the entire society.
Objective: The purpose of this paper is to analyse the young generation’s consumption of junk food, the degree of acknowledgement of its negative effects and the teachers and parents’ involvement in their education regarding this issue.
Material and Method: We performed a descriptive study on 378 students from: „Europe Elementary School”, „Unirea” National College and „ Transilvania” Economical High School Targu Mures, “Auto” Technical College Drobeta Turnu Severin and „Traian Lalescu” Teoretical High School of Orşova.  As measure of assessment a questionnaire has been applied.GraphPad and Microsoft Excel programmes were used for the statistical interpretation of the data. 
Results: The participants were 51% girls and 49%boys. 55% of the participants consume junk food rarely, 21% 1-2 times a week, 11% 3-4 times/week, 3% every day, 10 % don’t consume at all. The majority of participants (79%) consume junk food because of its good taste. 79% of the participants showed interest in improving their diet. 81% of the participants said that their teachers mentioned the healthy eating habits during classes.
Conclusions: The intake of junk food among teenagers it is an important problem in nowadays society, but our study revealed the students’ interest in making improvements in their diet.

Sexual dysfunction,disease or taboo  Marta Toderic Ana Maria Toderic, Diana Orsan, Rolando Burdea Validated View

Sexual dysfunction,disease or taboo

First author: Marta Toderic

Coordinator(s): Sipos R

Keywords: sexual disorder men

Background: Sexual dysfunctions in men affect not only the sexual life of the person involved but also the couple's harmony. The most frequent cause for such a disorder is either socio-economical or psychogenic.  Objective: This study wants to evaluate the nature of sexual dysfunctions in men. Material and Method: We followed, according to their medical records, 958 patients that were evaluated at ON clinic  Tg Mures between 1st december 2005 and 1st december 2008. The nature of the observations is retrospectiveand statistical. We focused on individual patological antecedents but also on smoking, alcohol and coffee use. Results: Regarding the ageof the patients that acused sexual dysfunctions, there aren't any large varietions in the range age 18-60, the number of men over 60 that acused this sort of disorder is significantly lwer compared to the others groups. Psychogenic sexual dysfunctions were confirmed only in 5.74% of the patients and out of those who had organic based dysfunction , 1 out of 5 had hyperglicemia/diabetes 2 out of 5 had dyslipidemia. Conclusions: According to our study, sexual dysfunctionsare mainly of organic causes and are often found overshaodowing high risk factors for stroke, HBP, IC. Sexual dysfunction is a disease not a taboo topic and the knowleadge of this reality may increace both the qualityof the life and it's lifespan.

Osteochondritis Dissecans Tali a Review and Case Presentation  Thomas Seregelyi Validated View

Osteochondritis Dissecans Tali a Review and Case Presentation

First author: Thomas Seregelyi

Coordinator(s): Solyom Arpad , Ivanescu A

Keywords: Osteochondritis Dissecans Ankle Talus Mosaicplasty

Background: Osteochondritis Dissecans Tali (OCD) is an osseous lesion of the talus due to avascular necrosis with secondary involvement of the overlying cartilage. In the early stages both, a potential of restoration with complete healing and progression with separation of an osteochondral fragment with gradual fragmentation of the articular surface, are possible.
Objective: The purpose of this study is to gain an overview of the clinical picture and possible treatment options of OCD, with special focus on ipsilateral mosaicplasty type autologous osteochondral graft of the talar dome.
Material and Method: Literature searches and review concentrated on published scientific papers discussing the disease and possible treatment options individually or in comparison, both reviews and primary studies. Special focus was put on a case of stage III OCD and the surgical treatment with an ipsilateral mosaicplasty type autologous osteochondral graft of the talar dome.
Results: On basis of the literature men seem to be more prone to develop OCD. It is most common in the second decade of life and up to 40-50% of cases in yound adults the disease is reported to resolve spontaneously. Mechanical and traumatic factors are etiologically dominant, with some sources mentioning a probable genetic predisposition. Clinical symptoms are unilateral and unspecific. MRI is the diagnostic and staging tool of choice, separating non-surgical (stage I, sometimes stage II) from possible surgical lesions (stage III and IV). With the aim to avoid arthrosis of the joint, several treatment options are discussed, but no consens could be found.
Conclusions: Ipsilateral mosaicplasty type autologous osteochondral graft of the talar dome seems to be a viable treatment option of unresolved osteochondritis.

Anal condyloma accuminata treated with plasma argon coagulation   Andreea Morar Alexandra Neag Validated View

Anal condyloma accuminata treated with plasma argon coagulation

First author: Andreea Morar

Coordinator(s): Catinean A

Keywords: condyloma accuminata plasma argon coagulation HPV alternative treatment

Background: A 27 year old man that presented with repeated rectal bleeding , itching and soreness after defecation. An anoscopy was performed and during this procedure a biopsy was taken. The histological examination showed markers for HPV infection (koilocytes) and he was diagnosed with condyloma accuminata. He was diagnosed with condyloma accuminata. Following this diagnosis we decided to try a treatment with argon plasma coagulator.This is a non-contact method of endoscopically delivered high-frequency thermal coagulation allowing well-controlled superficial tissue destruction. Objective: The purpose of this work is to present a new approach in treating anal condyloma accuminata with argon plasma coagulation. Material and Method:
A 27 year old man that presented with repeated rectal bleeding , itching and soreness after defecation. An anoscopy was performed and during this procedure a biopsy was taken. The histological examination showed markers for HPV infection (koilocytes) and he was diagnosed with condyloma accuminata. He was diagnosed with condyloma accuminata. Following this diagnosis we decided to try a treatment with argon plasma coagulator.This is a non-contact method of endoscopically delivered high-frequency thermal coagulation allowing well-controlled superficial tissue destruction. Results: After two argon plasma coagulator treatments the condylomas accuminata were resolved , with no complications during the interventions and the follow-up. Conclusions: The results obtained indicate that plasma argon coagulation seems a safe and effective treatment for anal condylomas. Using this method anogenital warts can be removed in layers in a controlled manner. Furthermore we can notice the excellent quality of cicatrization and the complete lack of incidents during or after the treatment.

Pediatric Heart Transplantation  Flavia-Cristina Roman Eliza-Dumitrita Sirbu, Diana Carmen Sima, Ioana-Vasilica Gherman, Florin-Adrian Tofan Validated View

Pediatric Heart Transplantation

First author: Flavia-Cristina Roman

Coordinator(s): Suciu H , Stroe V

Keywords: pediatric heart transplant end-stage disease

Background: A heart transplant is a surgical procedure performed on patients with end-stage heart failure or severe coronary artery disease.

Pediatric heart transplantation is now accepted therapy.
Objective: This paper presents the particularities of the recipient, the variety, difficulties and the specifics of the approaches when heart transplantation is to consider. Material and Method: The paper outlines more aspects, like: medical conditions of the pediatric patients, most commonly end-stages of heart diseases; the poor availability of donors compatible with the pediatric recipient - the heart comes from a recently deceased or brain dead pediatric donor, also called 'a beating heart cadaver'; the surgical approach, that is particular to each case separately, considering both the pathology and anatomical particularities of the recipient and the heart of the donor. Results: The data collected in our clinic, "Emergency Institute for Heart Disease and Transplantation, Tîrgu-Mureș", points out some particular cases of heart conditions in which heart transplantation is the only solution. There are 4 cases of heart diseases in children ranging 3.5 to 17 years old having undergone cardiac transplantation. The long-term results are patients socially reintegrated with lower dose maintenance immunosuppression.
The surgical approach is adjusted according to each particular case.
Conclusions:
We want to support pediatric heart transplantation in Romania, based on the promising results obtained so far.
Heart transplantation is not considered to be a cure for heart disease,but a life-saving treatment intended to improve the quality of life for recipients.
It is very important to understand that the heart transplant is the transition from a fatal condition to a chronic disease. 


PARTICULARITIES OF RISPERIDONE IN ATYPICAL ANTIPSYCHOTICS CLASS  Adina Radu Validated View

PARTICULARITIES OF RISPERIDONE IN ATYPICAL ANTIPSYCHOTICS CLASS

First author: Adina Radu

Coordinator(s): CAMIL E. VARI , MARIA T. DOGARU

Keywords: atypical antipsychotics Risperidone bone tissue

Background: Risperidone is an atypical neuroleptic ( it does not induce iatrogenic Parkinsonism, but was found to produce hyperprolactinemia and metabolic syndrome ). Recent animal studies have shown that the drug induces changes in bone tissue, when chronically administered in high doses. Weight gain combined with bone changes, both induced by the treatment with atypical antipsychotics, can result in decreased stability and impaired bone skeletal integrity. Objective: The aim of this study was to assess the effects of risperidone on bone structure, and also various other effects such as metabolic syndrome and hyperprolactinemia. Material and Method: The experiment was performed on several groups of rats, by administering risperidone orraly in doses of 1 mg/ kg bw / day and 2 mg/ kg bw / day for 8 weeks. Bones were evaluated using both radiological and histological methods, and compared with a control group. Results: Risperidone administration for a period of 8 weeks produced discrete changes in bones. Conclusions: Studying the mechanisms which produce metabolic and bone changes is very important, as these alterations can affect patients quality of life. This research was performed according to the EU standards and regulations regarding the ethics of laboratory animals studies.

Acne treatments: a review of the present for identifying the future research perspectives  Elena Adriana Simion Validated View

Acne treatments: a review of the present for identifying the future research perspectives

First author: Elena Adriana Simion

Coordinator(s): Todoran Nicoleta

Keywords: acne treatment adapalene future

Background: Acne vulgaris is a chronic disease of the pilosebaceous follicle that most usually occurs during puberty. It causes polymorph cutaneous lesions such as comedones, papules, cysts, pustules and abscesses. Although it is not a life-threatening condition, it has a major impact on the quality of life of teenagers and adults alike.  Objective: The objective of this paper is to gather data on the currently available treatment  forms and also to explore new treatment options in order to establish future research directions. Material and Method: The means of research used were online medical articles and studies regarding the treatment of acne in controlled groups, as well as post trial maitenance studies. Results: While topical retinoids have been in use for 30 years, it is considered that they should be used as first-line therapy. One such example is an antibiotic-free, combination gel with adapalene 0.1% and benzoyl peroxide 2.5%. Topical antibiotics such as erythromycin, doxycycline or clindamycin are still being used, but the development of bacterial resistance and cross resistance is an important issue to be adressed. The new disposition in the treatment of acne is targeting the environment in which Propionibacterium acnes thrives, either by limiting within the pilosebaceous follicles it's "nutrients", or by having bacterial members in the skin microbiome whose development is competitive,rein in the overgrowth of P. acnes. Also, a recent study states the benefits of a peptide named LZ1(a Tryptophan-Lysine-rich peptide) with 15 aminoacid residues that contains powerful antimicrobial activity against bacteria pathogens of acne vulgaris. However beneficial topical treatments may be, we must not forget the importance of dietary habits in the development of acne(the Western diet or the role of dairy products). Conclusions: The present documentation is the starting point for identifying the future perspectives in developing more targeted acne treatments.

Olanzapine - adverse events associated with long-term treatment  Ionela Sabau Validated View

Olanzapine - adverse events associated with long-term treatment

First author: Ionela Sabau

Coordinator(s): Vari C E , Dogaru Maria Titica

Keywords: olanzapine toxic effects hypercoagulability

Background:

Over the recent years, olanzapine has become one of the most commonly prescribed atypical antipsychotic drugs due to its superior efficacy in treating the negative and cognitive symptoms of schizophrenia and its lower propensity to cause hyperprolactinemia and extra-pyramidal side-effcts. However, there are major concerns about the long-term treatment metabolic disturbances that can lead to iatrogenic metabolic syndrome, but there is limited experimental data available on its dose-dependent toxicity.

Objective: The aim of our study was to examine the side effects induced by olanzapine in doses ranging from high to toxic and to get a better understanding of the mechanisms underlying these effects. Material and Method:

Experiments were carried out on rats. Olanzapine was administered via oral route in doses of 2, 4 and 6 mg / kg bw / day for 8 weeks. Toxicity signs were evaluated.

Results: Olanzapine causes dose-dependent toxic effects, hypercoagulability, tachypnea, wheezing. Conclusions: The side effects associated with olanzapine long-term treatment have not been systematically explored yet. Studies carried out in rodents may offer valuable insight into the mechanisms that underlie these serious side effects.

Replantation of digits and hand: injury patterns and mechanism analysis  Adelina Macec Validated View

Replantation of digits and hand: injury patterns and mechanism analysis

First author: Adelina Macec

Coordinator(s): Dorobanțu D

Keywords: traumatic hand amputations mechanisms of amputation replantation complications

Background: Traumatic amputation of the hand is a mutilating injury with a great psychological impact on the patients. Replantation is an important tehnique in the management of hand trauma.
Objective: The aim of the study is to analyze the injury patterns , to evaluate the frequency of complication occured after replantation and to study the functional results of 55 completely amputations in 120 patients, aged 3 to 75.
Material and Method: A retrospective study based on the observation sheets and surgical procedure  was conducted on patients with traumatic hand amputation at different levels of the hand ,treated at the Department of Plastic Surgery and Reconstructive Microsurgery of the Clinical Emergency County Hospital from Targu Mures during January 2008 and December 2013.
Results: From those 120 patients, 88 were men and 32 women.Was observed a prevalence of amputation in the age group 41-60 years,especially males. Out of the total number of amputation, 55 were complete amputations and 65 were partial amputations.21 amputation were transmetacarpal, 26 were at the first metacarpophalangeal joint, 23 at the radiocarpal joint  and 50 through digits II-V. The most common mechanisms of amputation were: guillotine in 78 cases, avulsion in 31 cases and crush in 11 cases.There was no major immediate and late complications in 83 cases , necroses occured in 21 cases and in 10 cases appeared vascular complication and there was 6 cases with infections.We observed that hand parts which are amputated by guillotine forces have better reattachment and a lower risk for complications.
Conclusions: Viability of the replanted part is guaranted by the successful vessel anastomosis and by the quality of nerves, tendons and bone repair.Results improved with more careful selection of patients and more experience in the technique.The main factor influencing functional result is the type and the mechanisms of amputation.

PATIENT SATISFACTION AND SOCIAL IMPLICATIONS AFTER MONOPOLAR RADIOFREQUENCY TREATMENT WITH ENERGY FLOW CONTROL FOR FAT REDUCTION IN COSMETIC DERMATOLOGY  Andreea-Luciana Chiotoroiu Claudiu Neagu Validated View

PATIENT SATISFACTION AND SOCIAL IMPLICATIONS AFTER MONOPOLAR RADIOFREQUENCY TREATMENT WITH ENERGY FLOW CONTROL FOR FAT REDUCTION IN COSMETIC DERMATOLOGY

First author: Andreea-Luciana Chiotoroiu

Coordinator(s): Morariu S H

Keywords: monopolar radiofrequency satisfaction social impact

Background: Unhealthy eating and sedentariness induced in the last years a growth of obesity among the worldwide population, including Romania.  Thus, fat reduction became a necessary element in beauty and health.
Objective: The purpose of this article is to study the patient satisfaction and social implications after a monopolar radiofrequency treatment with Energy Flow Control  for fat reduction in comparison to other methods.
Material and Method: A satisfaction survey conducted in the Dermatology Clinic of Targu Mures in 2013, using 20 questions on 18 patients that underwent  a radiofrequency treatment with Energy Flow Control for fat reduction.
Results: All patients fully answered the questions of the survey, and almost 94,44% of them initially felt dissatisfied with their weight and appearance.  All patients have used other techniques of loosing weight and almost 66,66% of them would rather use this technique instead of other especially for the minimum effort (in almost 58,33% of the cases). An average of 88,88% of the patients felt satisfied of the results, and almost 61,11% of them felt more pleased about their aspect after this procedure. Almost 55,55% of the subjects  observed an ease in creating and maintaining personal relationships and an average of 44,44% felt more appreciated in work and society. The majority of the patients also felt a higher level of confidence and wellbeing. Although almost 55,55% of the patients admitted that they did not follow the exact indications of their doctor, an average of 72,22% would recommend this technique to other people.
Conclusions: The majority of the patients felt a high grade of satisfaction after the monopolar radiofrequency treatment with Energy Flow Control and acknowledge a positive impact of the results in their social and personal life.

Thrombotic complications in patients with Polycythemia Vera  Ioana-Violeta Oltean Ioana Barsan, Madalina Crisan Validated View

Thrombotic complications in patients with Polycythemia Vera

First author: Ioana-Violeta Oltean

Coordinator(s): Candea Marcela

Keywords: polycythemia vera thrombosis dyslipidemia

Background: Polycythemia Vera (PV) is a myeloproliferative disorder with predominantly erythroid hyperplasia, but also leukocytosis and thrombocytosis, in which thrombosis is the most common complication.
Objective: The aim of this study is to analyse the clinical characteristics, laboratory data and the association of thrombotic complications of PV with various patient characteristics.
Material and Method: A retrospective study was performed on 60 patients admitted in Hematology Clinic in Targu-Mures between 2000-2013 with the diagnosis of PV. The various characteristics of patients who had developed thrombosis were statistically compared with those of patients without thrombosis.
Results: From 60 patients with PV 80% were males and 20% were females, with an average age of 57 years. The averages at diagnosis were18,2 g/dl for hemoglobin, 55,7% for hematocrit, 13,7x109/l for white blood cell count and 468,2x109/l for platelets count.
47 thrombotic complications were recorded in 32 patients: 31,9% of these episodes occurred before diagnosis and 68,08% occurred at presentation and during follow-up. The most commonly affected vascular beds were cardiac, cerebrovascular and deep vein thrombosis.
71,6% of patients with PV had one or more cardiovascular risk factors. Hypertension and dyslipidemia were most prevalent (51,6%), followed by smoking (18,3%) and diabetes (13,3%).
Statistically in PV patients with thrombosis compared to those without thrombosis wasn't a significant difference in the mean hemoglobin, hematocrit, white cell count and platelet count. There was a nonsignificant association between hypertension and thrombosis (OR = 1,372; p = 0,743), while between dyslipidemia and thrombotic events was a significant association (OR = 4,655; p = 0,0142).
Conclusions: Thrombotic complications in Polycythemia Vera are common and more frequent at patients with raised platelets count (>450x109/l), raised white blood cell count (>15x109/l) and dyslipidemia.

Classic Approach Of Parastomal Hernias  Adela Sztan Adelina Mărtinică Validated View

Classic Approach Of Parastomal Hernias

First author: Adela Sztan

Coordinator(s): Molnar C , Gherghinescu M

Keywords: parastomal hernia treatment

Background:

 Parastomal hernias are a local, late complication that takes place after a stoma procedure: colostomy, enterostomy, gastrostomy.

 

Objective:

 The aim of this study is to follow the surgical treatment and postoperative course of patients with parastomal hernias.

 

Material and Method:  We performed a retrospective study on a group of 100 patience suffering from postoperative hernias, hospitalized and treated at Surgery Clinic I of the Targu-Mures County Clinical Emergency Hospital, between 1st January 2013 and 31st December 2013. The criteria used have been demographics, comorbidities and the type of stoma that caused the hernia.


Results:

 Of the studied group, parastomal hernias made up 6% of the cases. Gender proportions showed a prevalence in men (2:1). Obesity is a frequent comorbidity in postoperative parastomal hernias with the BMI's average of 31,23. In 3 of the cases, the hernia appeared after a terminal colostomy, while in 3 other cases it appeared after a lateral Maydl loop colostomy. The reconstruction of the abdominal wall was done using monoplane technique in 3 cases, by the use of a polypropylene mesh in 2 cases and in another case repositioning the colostomy was preferred.

 

Conclusions:

 Parastomal hernia is a late postoperative complication that requires specific surgical treatment, the local septic element implies the choice for an adequate surgical procedure.

An Analytical approach to an alternative treatment of Idiopatic Thrombocytopenic Purpura : Glucocorticoids Versus IVIG  Ong Wee Liam Marcus Jee Poh Hock, Kaisser Gallaby, Vera Catarina Barnabe, Mihaela Budrescu Validated View

An Analytical approach to an alternative treatment of Idiopatic Thrombocytopenic Purpura : Glucocorticoids Versus IVIG

First author: Ong Wee Liam

Coordinator(s): Miron Ingrith , Ghiciuc Cristina Mihaela

Keywords: Idiopatic Thrombocytopenic Purpura Glucorticosteroids Intravenous Immunoglobulin

Background:

Idiopathic Thrombocytopenic Pupura (ITP) is defined an autoimmune disease characterized by a decrease in platelet count (thrombocytopenia), causing a distinctive purpuric rash and increasing the risk to hemorrhage. Today, ITP patients are treated via glucocorticoids (GCS) as a first line treatment according to treatment protocols. However, an alternate route of treatment namely, intravenous immune globulin (IVIG) has been shown to produce better results.

Objective:
Our Objective is to compare the effectiveness of corticosteroids (GCS) and intravenous immune globulin (IVIG).

Material and Method:
A retrospective analysis was done on the data of 53 patients (31 female and 22 Male) who underwent corticosteroids and IVIG in the year 2012 and 2013 in Sf. Maria Hospital Iasi. Our analysis focused on the elements of: Platelet count progression, Hemorrhage symptoms, side effects of both corticoids and IVIG, prognosis and remission states.

Results:
A Total of 53 cases reviewed, all the patients reached platelet count of >200.000/mm3. However GCS treatment takes average from 6-61 days and IVIG takes about 7-9 days. And the relapse rate for GCS is 35% while IVIG treated patients had 10%. The side effects of GCS compared to IVIG are vast. This include: Cushing Syndrome, Electrolyte distrubance, and secondary infections. Meanwhile, the side effects of IVIG are insignificant such as : Nausea , Headaches and mild allergies. 

Conclusions:
Based on the results that we have obtained, treatment with IVIG proves superior in every aspect, especially in the prognosis and side effects caused by its counterpart. We would like to suggest a change in the standard treatment protocol to replace glucorticoids with IVIG as a first line treatment.

THE CORRELATION BETWEEN PREOPERATIVE AND POSTOPERATIVE DIAGNOSIS OF PELVIC ENDOMETRIOSIS  Mihail Petrut Validated View

THE CORRELATION BETWEEN PREOPERATIVE AND POSTOPERATIVE DIAGNOSIS OF PELVIC ENDOMETRIOSIS

First author: Mihail Petrut

Coordinator(s): Puscasiu L

Keywords: endometriosis correlation preoperative diagnosis postoperative diagnosis

Background:

Endometriosis is defined as the presence of endometrial glands and stroma outside the endometrial cavity and the uterine musculature. The pelvis is the most common site of endometriosis, but endometriotic implants may occur nearly anywhere in the body.

Objective:

Evaluating the diagnostic correlation between the preoperative and postoperative diagnosis in pelvic endometriosis.

Material and Method:

We performed a retrospective study that aimed to identify all cases of pelvic endometriosis operated in the Obstetrics and Gynecology Clinic I between 01.01.2012 and 31.12.2013; we evaluated the concordance between the preoperative diagnosis and the postoperative diagnosis.

Results:

A total of 163 patients were included in the study, of which in only 103 cases (63%) we found a concordance between the preoperative and postoperative diagnoses.

Conclusions:

A correct preoperative diagnosis of pelvic endometriosis is often difficult because of the lack of symptoms or pathognomonic signs, thus confusion with other pelvic pathology is very common.

The impact of nutrition in the treatment and the prevention of gastritis  Roxana-Maria Hadmaș Ioana luciana zecheru Validated View

The impact of nutrition in the treatment and the prevention of gastritis

First author: Roxana-Maria Hadmaș

Coordinator(s): Simona Bățagă

Keywords: gastritis lifestyle diet

Background: Gastritis are acute or chronic inflammation of the stomach mucosa, the disease affecting a rate of approximately 50% of the total population.
Objective:

The aim of this research is to show the importance of rational food, both in the prevention, and also in the treatment of chronic gastritis.

Material and Method: This is a retrospective observational analytical study carried out under direct and indirect questionnaires. The study shall be carried out on a sample of 200 persons, 100 diagnosed with gastritis, 100 healthy, men and women.
Results:

Out of the 100 cases of patients diagnosed with gastritis , 91% intend to change their way of life to treat the disease ,but only 53% of the 100 healthy individuals were intend to change their way of life to prevent problems.

Regarding to the distribution by gender , a percentage of 95% from the female were more open to change their lifestyle, they have kept a restrictive diet and have obtained good results. . In this restrictive diet  is forbidden the consumption of carbonated drinks, acidic foods, fried foods, animal fats and sweets. At the opposite pole 30% of men refused to keep a diet and only 25% of those who accepted a scheme have accepted a strictly one. The results were: at the men who had refused the regime, gastritis got worse and it was necessary medicinal therapy.

Conclusions: The study shows that a balanced lifestyle helps dealing with the treatment and the healing, and it is also efficient in the prevention of the disease.

Atypical Wegener`s Granulomatosis inducing breast nodules with microcalcification  Mihaela Budrescu Marcus Jee Poh Hock, Ong Wee Liam, Vera Catarina Barnabe, Florin-Adrian Tofan Validated View

Atypical Wegener`s Granulomatosis inducing breast nodules with microcalcification

First author: Mihaela Budrescu

Coordinator(s): Georgescu R , Colcer Ioana

Keywords: Wegener granulomatosis breast microcalcifications

Background: Wegener`s Granulomatosis is a non-neoplastic idiopatic form of necrotizing granulomatous vasculitis that effects small to medium sized vessels, whereby it can cause multiple systemic failure especially to the renal and the respiratory systems and this can lead to fatality.
Objective: Breast involvement is unusual and very rare and it`s frequently mistaken for breast carcinoma. We want to prove that masses localized in the right breast of our patient, is caused by Wegener`s Granulomatosis.
Material and Method: We sent the patient for diagnostical tests namely mamography, surgical exam/conclusion, ANCA for definitive Wegener’s and biopsy for histopathological examination. urine analysis and pulmonary biopsy.
Results:

Based on the tests, ANCA for definitive Wegener’s came out positive. Also the result of the biopsy shows that there are typical Wegener’s lesion, Biopsy from the lung also indicates that there are granulomatose lesions suggesting for Wegener’s Granulomatosis. 
Mammography showed a few nodules with micro-calcifications. Twenty-five reports of breast involvement in this rare disease were found in the literature, however none described microcalcifications.
The patient had microhematuria which is suggestive of renal involvement. 
Conclusions:
As a conclusion, even though breast involvement in a case of Wegener’s Granulomatosis is very rare (0.3% in literature), based on our case, we would like to call out to all medical personnel to consider the possibility of a Wegener’s should they encounter a case of breast carcinoma with a patient suffering from Wegener’s Granulomatosis. 

The Anterolateral Ligament: a New Perspective in Knee Anatomy  Radu Branea Andrei-Marian Feier, Al Hussein Hussam, Mircea Tabacar Validated View

The Anterolateral Ligament: a New Perspective in Knee Anatomy

First author: Radu Branea

Coordinator(s): Ivanescu A , Hanca Ancuța

Keywords: ALL description Anterolateral ligament knee anatomy

Background:

The existence of the Antero-lateral ligament has been documented for over 100 years, but its importance was neglected. Paul Segond first described the anterolateral ligament in 1879 as a fibrous tissue between the lateral femoral condyle and tibia. However, recent studies have shown that the Antero-lateral ligament has a major importance both clinically and surgically, providing knee stability.

Objective:

Provide an anatomical description of the anterolateral ligament of the knee (ALL) and describe its clinical correlations.

Material and Method:

A dissection of the anterolateral region of the

knee was performed in eight paired cadaveric knees, 2 males and 2 females, considering our possibilities in the Anatomy Department. The ligamentous structure was clearly observable in all dissected knees. The origin was found on the lateral femoral epicondyle, and there were two points of insertion: one in between Gerdy’s tubercle and the fibular head, and the other one with a small fibrous extension on the lateral meniscus. Its tract was found in a close relation to the lateral collateral ligament(LCL).
Results: The ALL was identified in all 8 knees, completely independent from the iliotibial band and the LCL. The origin was found 2 mm anterior and 3 mm inferior to the LCL. The measurements were: 38 mm in length, 7 mm in width and 3 mm in thickness. 
Conclusions: The ALL is an independent structure in the anterolateral region of the knee. It is considered to have a major role both anatomically and clinically, providing stability to the knee and medial tibial rotation(pivot-shift). Its importance may be of great surgical utility in relation to ACL injuries, but further studies are needed.

CHRONIC URTICARIA ASSOCIATED WITH HYPERURICEMIA- A CASE REPORT  Oana-Cristiana Burdun Nicoleta Sala, Andrea Rab Validated View

CHRONIC URTICARIA ASSOCIATED WITH HYPERURICEMIA- A CASE REPORT

First author: Oana-Cristiana Burdun

Coordinator(s): Ureche Corina , Bancu Ligia

Keywords: urticaria hyperuricemia angioedema

Background: Urticaria appears as raised, well-circumscribed areas of erythema and edema involving the dermis and epidermis that are very pruritic.  The etiologic agent is more likely to be identified in acute urticaria (40-60%) than in chronic urticaria (10-20%). Chronic urticaria may be caused by many factors.
Objective: We want  to find out if there is a causative relation between hyperuricemia and chronic urticaria.
Material and Method:

We describe  a 56-years old-man , with a history of acute pancreatitis (June 2013). He presented to our department for multiple episodes of generalized urticarial lesions which started 3 month before the presentation. Despite the treatment with oral corticosteroids,  first and second-generation antihistamines he presented 3 days before the hospitalization facial angioedema. His lab values showed:  VSH 1h=5mm/h(NV=3-9mm/h), fibrinogen=327mg%(NV=150-400), CIC=8.72ug Equiv/ml(neg<16), ANA=neg, serum Ig E=35 UI(NV<100), TSH=N,  Ac anti-HCV=neg, Ag HBs=neg, VDRL=neg, Ig G antitoxoplasma gondii=pos. During hospitalization he has been treated with Rovamycine without any signs of amelioration. Abdominal CT scan didn’t describe modifications.  Moreover he also presented a gout flare (swelling, redness, heat and pain of metatarsophalangeal joints) with uric acid=9.9mg%(NV<5.7) . After 8 days of treatment with Allopurinol 3x100mg the uric acid value decreased to 6.4mg% while the urticarial lesions disappeared. He is treated at home with Allopurinol and  second-generation antihistamines with significant signs of amelioration in present.

Results: Although we have not found studies underlying the relation between hyperuricemia and urticaria, we tend to think that urticarial lesions appeared as a consequence of increased serum uric acid levels.    
Conclusions:

The correlation between urticaria and hyperuricemia should be studied in large trials.

Method for screening organic xenoestrogens in biological samples from pregnant women  Ioana luciana zecheru Adriana Modroiu, Roxana-Maria Hadmaș Validated View

Method for screening organic xenoestrogens in biological samples from pregnant women

First author: Ioana luciana zecheru

Coordinator(s): Croitoru M D , Fülöp Ibolya

Keywords: xenostrogens pregnancy intrauterine exposure foodstuff

Background:

Many widely used xenoestrogens have been recently identified. These compounds are used in a large variety of food stuffs, personal care products and consumer goods. Negative health effects on fertility and pregnancy outcomes were correlated with the presence of such compounds in maternal circulation.Corelation between intrauterine exposure and the side effects of this exposure is followed.

Objective: The purpose of this paper is to obtain an HPLC method suitable for determination of the following xenoestrogens from pregant womens'urine and placental blood (buthylated hydroxytoluene, phenoxyacetic acid, bisphenol A, 2,4-dichlor phenol, 2-nonoethyl hexyl phthalate, triclosan, benzophenone, mono buthyl phthalate, mono benzyl phthalate, 2,5-dichlor phenol, methyl p-hydroxybenzoate, propyl p-hydroxybenzoate) in order to dose the quantity of those compounds in their system.
Material and Method:

An HPLC-UV method was developed using reagents and solvents compatible for an MS detection. Gradient elution was used; mobile phase consisted of water brought to pH 2.5 with acetic acid and acetonitril.
Quizzes regarding daily intake of xenostrogens were delivered to the subjects.

Results:

All xenoestrogens were successfully separated at the baseline. Large amounts of phthalates were found on consumer goods that come daily in contact with children or pregnant women. 

Conclusions:

The new HPLC method that was developed is suitable for separation of the most frequently used xenoestrogens or their metabolites. The level of these substances should be monitored in foodstuffs and consumer goods and avoidance of such products should be recommended by health care personnel to pregnant women and children.

Rare mammary gland diseases: a continuous challenge for the clinician  Paula Maria Gliga Alexandra Diana Mihuti Validated View

Rare mammary gland diseases: a continuous challenge for the clinician

First author: Paula Maria Gliga

Coordinator(s): Marian D

Keywords: tumor breast surgery imaging

Background: The mammary gland can be a site of rare conditions, that may simulate a broad spectrum of primary breast malingancies.  Objective: We intend to highlight the peculiarities of these extremely rare conditions, to correlate clinical simptoms with imaging, microscopic and serological examinations in order to avoid an extensive, useless surgery.  Material and Method: The current study was conducted on a group of 17 patients undergoing surgery in surgical clinics from Tirgu Mures during a 10 year period (2004-2013).  Results: Of the 17 tumors, 9 were lymphomas, 3 were tuberculous in nature, 2 melanomas, 1 hydatid cyst, 1 toxoplasmosis and 1 APUD tumor. The mean age of presentation was 51. The majority of tumors were located in the breast (11). 6 mastectomies, 10 sectorectomies and 1 fine needle aspiration cytology were performed.  Conclusions: In most cases (12), confusion with breast neoplasm was due to presence at the breast level of an irregular mass, with different degrees of attachment to the skin and surrounding tissues, as well as existance of an almost constant axillary adenopathy. We suggest a closer correlation of clinical imaging, fine needle aspiration, cytology and serological tests, for a better preoperative diagnosis. Thus we could avoid broad unnecesary surgical excision instead of a sistemic treatment of the underlying disease. 

HYPOLIPEMIANT MEDICATION AND BONE REMODELING  Diana Orsan Roxana Anamaria Dodu, Ana Maria Toderic, Marta Toderic Validated View

HYPOLIPEMIANT MEDICATION AND BONE REMODELING

First author: Diana Orsan

Coordinator(s): Sipos R , Pavai Z

Keywords: Statins Fibrates Osteoporosis Bone structure

Background: The role of the hypolipemiant medication in bone remodeling is a subject that has sparked controversy. Though some authors has demonstrated their action in the sense of stimulating osteogenesis, others have demonstrated a stimulation of bone resorption. Bone remodeling balance is given by the balance between osteoblastic and osteoclastic activity and by the mode of action of statins and fibrates on them.
Objective: Purpose of the paper is to demonstrate the histologic mode of action of statins and fibrates on bone remodeling and callus process.
Material and Method: For our experimental study we used Wistar rats and all sufferd a mediodiaphysary fracture. We analyzed 6 subgroups of 12 rats each: 1- ovarectomized control, 2- ovarectomized treated with statins, 3 ovarectomized treated with fibrates, 4- nonovarectomized control, 5-nonovarectomized treated with statins and 6- nonovarectomized treated with fibrates. Results: On bone structure, at week 6 and 8 statins reduced the bone trabeculas size on nonovariectomized rats, but increased them in osteoporotic rats, while fibrates showed no difference in comparison with the control groups. The fracture healing process was enhanced when simvastatin was administred, regardless if the bone was osteoporotic or not. At the same time, no obvious positive effect of fenofibrate on fracture healing process was observed, the outcome of the fracture being similar in fenofibrate treated rats and control group, both without osteoporosis.
Conclusions: Hypolipemiant treatment influences the fracture repair process and we sustain the treatment with simvastatine in the cases of an association between osteoporosis and dyslipidemia

ETIOPATHOGENIC ASPECTS AND THERAPEUTIC FEATURES ON ATRIAL FIBRILLATION PATIENTS  Aurelia Pop Nicolae - Alexandru Golovei - Petris Validated View

ETIOPATHOGENIC ASPECTS AND THERAPEUTIC FEATURES ON ATRIAL FIBRILLATION PATIENTS

First author: Aurelia Pop

Coordinator(s): Sirbu Ileana Voichita

Keywords: ATRIAL FIBRILLATION ETIPATHOGENY ANTICOAGULANT LEFT ATRIAL DIMENSIONS

Background: Atrial fibrillation, according to European Society of Cardiology is the most common diagnosed cardiac arrhythmia. A physician must take into consideration not only thromboembolic risk, but also the risk of bleeding, comorbidities and patient’s compliance.
Objective: The purpose of this study was to highlight the etiology, the correlation between the pathology and the structural changes of the left atrium and the assessment of therapeutic conduct.
Material and Method:  In this retrospective study we have included patients treated in Cardiology I Clinic, Mures County Emergency Clinical Hospital, between January 2012 and May 2012,with diagnosis of atrial fibrillation.
Results:

We found 210 patients diagnosed with AF,of which 54.3% males and most of all patients (36.7%)were between 65-74 years old.The highest percentage ,41%, have permanent AF and regarding the etiology,non-valvular AF has the greatest preponderance(66.7%).Also, the left atrium diameter and area modify their values mainly in permanent AF and they are influenced by the existence of a valvulopathy or dilated cardiomyopathy. From all patients with AF, 140 patients have non-valvular AF and we have calculated the CHA2DS2-VASc score:4.2% have a low thromboembolic risk(score=0), 16.9% have an intermediary risk (score=1) and the rest of the patients have a high risk(score2).Concerning the therapeutic conduct 86.7% of 210 patients receive a standard treatment according to the European guidelines.

Conclusions:

. In our study, non-valvular AF is the most frequent. Left atrium dimensions are influenced by the existence of a valvulopathy or a cardiomyopathy.There is a statistical significant correlation between left atrial dimensions and permanent AF. A part of high risk patients have not received anticoagulant, although the bleeding risk was not high because of the reduced patient compliance and associated pathologies.

Metabolic effects of Venlafaxine  Alina Haidau Validated View

Metabolic effects of Venlafaxine

First author: Alina Haidau

Coordinator(s): Kolcsar Melinda , Dogaru Maria Titica

Keywords: Venlafaxine antidepressants metabolic effects body weight

Background:

Metabolic effects of Venlafaxine

Objective:

Antidepressant therapy is often associated with metabolic changes consecutive differential effects on appetite (anorexia in the first place, followed by increased calorie intake). Venlafaxine is an antidepressant whose mechanism of action is controversial and only partially elucidated, so are its unpredictable side effects after prolonged administration.

Material and Method:

Venlafaxine was administered to two groups of rats orally in a dose of 10 mg / kg body weight  and 40 mg / kg body weight for six weeks, and the third group served as control. We monitored parameters of lipid metabolism and  body weight compared with control grup.

Results:

At the end of the administration period, we observed statistically significant increase in the weight of experimental animals compared to control grup.

Conclusions:

The result can be associated with the induction of carbohydrate and lipid metabolism disorders correlated with excess of weight.

Clinical features and treatment in anxiety disorders  Simina-Elena Rusu Alexandra Martin, Niculina-Oana Diaconu, Claudiu Ghiragosian Validated View

Clinical features and treatment in anxiety disorders

First author: Simina-Elena Rusu

Coordinator(s): Nirestean A , Taran Livia

Keywords: Anxiety disorders clinical features treatment in anxiety disorders

Background:

Anxiety disorders are prevalent mental disorders characterized buy a “fear without object” and excessive worry and apprehension accompanied by psychic and somatic symptoms of stress. Somatic signs are usually associated wich indicates an overactivity of there autonomic nervous system.

Objective:

The aim of the study was to evaluate the incidence of the anxiety disorders in different populational groups and also to find out wich group is more likely to develop this mental disorder.

Material and Method:

We used preliminary retrospective study on group of 68 patients admitted to 2 Psychiatry department of Targu Mures County Clinical Emergency Hospital between 1 January 2013 – 31 December 2013.The following parameters were analyzed: the patients background; gender; professional training level; social network support; adaptive skills during the critical stress  ages; patients special features and the symptomatology . we also reviewed the modern therapeutics approach for this disorder.

Results:

 75% of the patients are females; 76,4% live in a urban environment; 58,8 % had medium level of training social network support; 60,29% had proven difficult adaptive skills during the critical stress; specials features were found in all patients; none of the patients underwent behavioral therapy and 70% of the patients were treat with SSRI and benzidiazepines 

Conclusions:

Anxiety disorders is more frequent in the female subjects. Persons who live in a urban environment are more likely to develop anxiety disorders. The most efficiency therapeutic  method is the bitherapy, that associated benzodiazepines and SSRI and no patient did behavioral therapy.

Correlation between dental age and chronological age  Dmitrii Todirica Andrei Majeri Validated View

Correlation between dental age and chronological age

First author: Dmitrii Todirica

Coordinator(s): Bud E

Keywords: Dental age Chronological age Radiographic evaluation Correlation

Background: In planning the orthodontic treatment for children (7-16 years old), it is very important to assess the dental maturity (dental age), which can lead to a simple and uncomplicated treatment (for example: the orthodontic treatment in a child that has a dental maturity which is delayed can be started later, which will lead to a shorter treatment time).

Dental age assessment (DAA) is used in situations where age is unknown (ex: forensic medicine). DAA is achieved using analysis techniques that integrates the known ages of the teeth at different tooth developmental stages.
Objective: Determination of dental age from panoramic radiographs (OPG) using the Demirjan method.
Evaluating the nature of correlation between Chronological and Dental age.
Material and Method: The study was undertaken on 120 radiographs,both boys and girls within the age group 6-16. Data was collected and analyzed using the Demirjan method, by 2 examineers. The used method analyzed the development stages of the 7 mandubular left teeth.
Results: A correlation has been found between dental age and chronological age.In girls, an advanced dental maturation was seen in all age stages, with an average of 42 days. Significant differences were seen in the 5.5-7 age group, and 11-14 age group, where growth spurt occurred. In boys, the chronological age was ahead of the dental age with an average of 87 days. Big gaps among dental age, which were higher, and chronological age, were observed in the age group 13-16. Boys in the age group 12-14 years, had a delayed dental age. The lowest difference between chronological age and dental age was observed in the 6-9 years age group. Conclusions: Estimating the dental age using the Demirjan standards will lead to a fairly approximate age assessment of the chronological age in healthy children.

Changes in lipid metabolism induced by Mirtazapine  Adela Sos Validated View

Changes in lipid metabolism induced by Mirtazapine

First author: Adela Sos

Coordinator(s): Kolcsar Melinda , Dogaru Maria Titica

Keywords: mirtazapine antidepressants lipid metabolism triglyceride

Background:

Mirtazapine is different from other antidepressants, because it acts on the feed-back mechanisms of catecholamine release in the CNS.

Objective:

It seems that long-term therapy, may enhance the appearance of modifications in the lipid metabolism. This study pursues lipid metabolism parameters compared to a control grup.


Material and Method:

Mirtazapine was administered to two groups of rats orally in a dose of 10mg/kg body weight and 40 mg / kg body weight for six weeks, and the third group served as control.During this period of six weeks, lipid metabolism parameters were compared to the control group.

Results:

After this established period, blood samples were analysed for the determination of triglycerides and cholesterol. The results showed a statistically significant increase in the level of triglycerides as against the control group.

Conclusions:

The results of this experiment indicates the problem of inducing dyslipidemia in prolonged treatments with Mirtazapine.

The importance of dipstick test in the screening for urinary tract infections  Madalina Salagean Anca Raluca Suciu, Ioana-Violeta Oltean Validated View

The importance of dipstick test in the screening for urinary tract infections

First author: Madalina Salagean

Coordinator(s): Caldararu Carmen , Dogaru G A

Keywords: nitrite test, leucocyte-esterase test, urinary tract infection, screening

Background:
Screening tests are used commonly  to make a presumtive diagnosis for urinary tract infections (UTI). They use analysis of urine nitrites (NIT) for indicating bacteriuria and leukocyte esterase (LE) for detecting pyuria. But there are known factors that can lead to a false negative test.
Objective:
To estimate the sensitivity, specificity, positive and negative predictive values of urine dipstick as a screening test for UTI.
Material and Method:
We performed a retrospective analysis of patients admitted in the Nephrology Department of Targu Mures County Clinic Hospital between 2010 and 2013. Only patients with urine dipstick test, urinary sediment and urinalysis in observation sheets were included in the study.
Sensitivity, specificity and predictive values were analysed for nitrite test, leukocytes and both, using urine culture as the gold standard method for diagnosting UTI.
Results:
The study was conducted on 556 patients ( 333 women and 223 men), of which 151 had criteria for UTI ( monomicrobial urine culture with 100.000 colony forming units per ml).
The sensitivity of nitrite test was 29% with a 98% specificity. Associated with a positive predictive value (PPV) of 96% and a negative predictive value (NPV) at 58%.
The sensitivity for LE test and the combined LE plus NIT test were 75% and 97%.
Positive NIT plus LE had NPV at 99% with a poor PPV 30%.
Conclusions:
NIT test had 2% chance for a false positive and 71% for a false negative, meaning a positive NIT test implies a likely UTI but a negative test is unreliable.
Testing for both LE and NIT gives better overall performance than either test alone because of it's highest sensitivity.
Also a negative combined test seems to be useful to exclude the presence of infection.
Confirmation is still needed, so urine culture and multiple screening tests, not just dipstick, are recommended.

Tobacco use among medical and nursing students  Emőke- Anita Bokor Validated View

Tobacco use among medical and nursing students

First author: Emőke- Anita Bokor

Coordinator(s): Germán- Salló Márta

Keywords: tobacco use health-profession students cessation

Background: Smoking is a serious threat to global health, killing nearly 6 million people each year. Although tobacco use has declined in developed countries, smoking rates has increased in developing countries. Health care professionals occupy an important role in supporting smoking cessation among their patients, hereby improving health. 
Objective:

Since many of physician’s personal habits and attitudes are formed during their education, and because it is proven that their smoking status is influencing their ability in counseling smokers, the aim of this study was to determine the prevalence of and attitudes toward smoking among medical students.

Material and Method:

In March 2014 a self-administered survey was conducted among first year students at the University of Medicine and Pharmacy of Târgu-Mureș using an adapted version of Global Health Professional Students Survey (GHPSS) questionnaire and evaluating the prevalence of smoking, knowledge and attitudes, training received in cessation counseling. The World Health Organization (WHO) developed GHPSS in 2004 to collect data on tobacco use and cessation counseling among health-profession students.  

Results:

159 first year students completed the questionnaire (69 medical students, 90 nursing students). The overall smoking rate was 20.75% (25.56% nursing students, 14.50% medical students). 19.49% had already quit smoking. 4.4% started smoking after starting their studies. 5.03% related that they had smoked inside of the main building of the university. More than two- third of students supported tobacco control measures. 72.78% thinks that health-professionals should be role models for the society. Only 17.83% reported receiving training in tobacco cessation counseling and 80.25% thinks that should be important receiving a training like this. 

Conclusions:

Smoking prevalence among medical and nursing first year students is high. The majority of students is supporting tobacco control policies. There is a serious need in providing tobacco prevention and cessation training among students.

Clinical and imagistic aspects of cerebral venous thrombosis  Ioana Barsan Madalina Crisan, Anca Raluca Suciu, Rodiana Gusu Validated View

Clinical and imagistic aspects of cerebral venous thrombosis

First author: Ioana Barsan

Coordinator(s): Macavei I

Keywords: thrombosis seizures headache

Background: Cerebral Venous Thrombosis (CVT) has a diverse etiology, sometimes very hard to establish, representing a major neurological emergency.
Objective: Following the clinical manifestations and imagistic investigations of CVT.
Material and Method: This is a retrospective study which included 25 cases with CVT admitted in the Neurology Clinic of Mureş Clinical County during 2012-2103, noticing the age, sex , early clinical manifestations, demographics and affected venous areas. For establishing the diagnosis, the patients have been investigated using paraclinical and imagistic methods.
Results: From this study, CVT represents 1.31% of the total 1895 patients with stroke. The majority of patients (76%) were women. 60% were from rural areas. The age range with the highest incident rate is 30-59 years old. The most frequent early symptom was headache (41.66%), followed by seizures (22.22%), intracranial hypertension (16.66%), cranial nerve syndrome (13.66%) and other manifestations (5.55%). Most often the lesions were located in the Superior Transverse Sinus (39.28%), Sigmoid and Superior Sagital Sinus (both with 25%), Cavernous Sinus (7.14%) and Deep Venous System (3.58%). In this study the most frequent risk factor were hypercoaguable disorders, followed by infections, inflammatory diseases and puerperium. The imagistic investigations were MRI (38%), angio-CT (24%), angio-RMN (20%) and CT (18%).
Conclusions: The most common form of debut in CVT is the atypical form. Recognizing this pathology is essential for prompt treatment in particular clinical circumstances.

THE POTENTIAL PROKINETIC FUNCTION OF D,L-HOMOCYSTEINE THIOLACTONE BY BLOCKING POTASSIUM CHANNELS OF ISOLATED RAT DUODENUM  Jovana Stević Validated View

THE POTENTIAL PROKINETIC FUNCTION OF D,L-HOMOCYSTEINE THIOLACTONE BY BLOCKING POTASSIUM CHANNELS OF ISOLATED RAT DUODENUM

First author: Jovana Stević

Coordinator(s): ass. dr. Marija Stojanović

Keywords: Homocysteine potassium channel Prokinetic role rat

Background:

The sulfur-containig amino acid homocysteine acts as a blocker of the potassium
channels and  enhanced the tone, frequency and amplitude of spontaneous  contractions  in  the gastrointestinal smooth muscles which could provide prokinetic function.
Objective:
To examine the potential prokinetic function of D,L-homocysteine thiolactone by blocking 
potassium channels of isolated rat duodenum.
Material and Method:
Experiments were perfomed on isolated duodenum male albino Wistar rat (n=3). The
mechanical activity of duodenal segments was measured using isometric transducers connected to the Sensor Medics Dynograph Recorder R511A printer. After a one-hour adaptation, spontaneous activity of duodenal segment was registered for 30 min. Then frequency, amplitude and tone of duodenal segments in the presence of potassium channel blocker-tetraethylammonium chloride (TEA) and D, L-homocysteine thiolactone were examined. 
Results:
Application of D,L-homocysteine (1 mM) significantly  enhanced (p<0.05)  amplitude,
frequency  and  tone  of  spontaneous  contractions  of  isolated  segments.  TEA  (10  mM)  also significantly  increased  amplitude,  frequency  and  tone  of  spontaneous contractions. After incubation for 30 min, TEA was added to D,L-homocysteine. Results show that there was no significant change (p>0.05) in tone, amplitude and frequency regarding to the group with TEA.
Conclusions:
D,L-homocysteine thiolactone enhanced amplitude, frequency and tone of duodenum
motility. In the presence of TEA there was no significant change in value of these parameters. So, we have found that D,L-homocysteine thiolactone is really capable of blocking potassium channels in the gastrointestinal smooth muscles which suggest that D, L-homocysteine thiolactone might provide prokinetic effects in different gastrointestinal disorders.

Clinical and histopathological correlations in rhinosinusitis  Cristina Maria Blebea Norbert Scoupi Validated View

Clinical and histopathological correlations in rhinosinusitis

First author: Cristina Maria Blebea

Coordinator(s): Muhlfay G , Lostun G

Keywords: rhinosinusitis fess correlation histopathological

Background: Rhinosinusitis is a common and well-recognized clinical syndrome that affects a significant percentage of the patients from a Otorhinolaringology Department.Functional endoscopic sinus surgery(FESS) is now a well established strategy for the treatment of chronic rhinosinusitis(CRS) unresponsive to medical treatment. Objective: The objective of this study was to assess the correlation between histological and clinical diagnosis in rhinosinusitis, by evaluating the results of histopathological examination of postoperative material from FESS. Material and Method: This study is a retrospective analysis based on patients who underwent FESS over a 5 years period. The analysis covered 674 results of routine postoperative histopathological examination material from Targu-Mures County Hospital's Department of Otorhinolaringology who underwent surgical procedures between the years 2009-2013. The histopathological examination was conducted in Hematoxylin and Eosin and PAS staining in Targu-Mures County Hospital's Morphopathology Department. Results: The study comprised 673 patients, aged 5-87(mean age 47), of which 280 were women and 393 were men. Of the 673 patients, 535(79,9%) were identified with chronic inflammation and/or nasal poliposis. Inflammatory polyps within the nose and paranasal sinuses were confirmed by histopathological examination in 56(8,3%) patients. Hypertrophic changes were diagnosed in 45(6,6%) patients. Fungal rhinosinusitis was present in 18(2,6%) patients including 2 with fungus ball. Inverted papilloma was recognized in 12(1.7%) patients of whom 3 were women and 9 were men. There were 4 cases of pyogenic granuloma, 1 case of Wegener granulomatosis,squamous-cell carcinoma,nasal hemangiopericytoma,nasal angiofibroma,myospherulosis and 1 case of respiratory epithelial adenomatoid hamartoma. Conclusions: The preoperative clinical diagnosis can be inaccurate in patients with CRS. Histopathological examination of postoperative material in patients who underwent surgical treatment, offers valuable information for post-operative care, it also does not imply any risk to the patient and could always add value to the future clinical approach. The histopathological examination's importance is underlined by the number of clinical misdiagnosed tumoral afflictions in this current study.

Surgical Approach in Large Incisional Hernias  Adelina Mărtinică Adela Sztan Validated View

Surgical Approach in Large Incisional Hernias

First author: Adelina Mărtinică

Coordinator(s): Molnar C , Gherghinescu M

Keywords: large incisional hernia

Background:

Incisional hernias are one of the common complications that might occur after a laparotomy. Although significant progress has been made, correcting incisional hernias continues to be problematic, with a recurrence rate increasing. In the case of large incisional hernias, surgical treatment can often prove to be difficult. The use of a mesh in order to reinforce the abdominal wall can be necessary for a lasting result. 
Objective:
The aim of this study is to follow the types of surgical procedures and the postoperative course of patients with large incisional hernias.
Material and Method:
We performed a retrospective study on a number of 100 patients diagnosed with insicional hernias, admitted at the Surgery Clinic I of the Targu-Mures County Clinical Emergency Hospital between 1st January 2013 and 31st December 2013. We analyzed the incidence in correlation with sex, BMI, the type of the surgical treatment, the diameter of the hernia and of the parietal flaw. 
Results:

In 15% of the cases the incisional hernias were large, the size of the hernia being an average of 24 cm. Gender comparison showed a prevalence of 3/2 male/female ratio. Obesity is a frequent co-morbidity in large incisional hernias with the BMI's average of 30.27. In 66% of the cases the most frequent surgical treatment was the reinforcement of the abdominal wall with a polypropylene mesh placed on lay. The Oscar Ramirez procedure was used in 26% of the cases. 

Conclusions:

The main aim of the surgical treatment for large incisional hernias was to reestablish abdominal wall integrity. This could be achieved by using a mesh. The type and positioning of prosthetic devices is crucial and demands an adequate selection of patients. 

SOFT TISSUE TUMORS: CLINICOPATHOLOGIC ANALYSIS OF 1297 CASES  Mircea Golea Validated View

SOFT TISSUE TUMORS: CLINICOPATHOLOGIC ANALYSIS OF 1297 CASES

First author: Mircea Golea

Coordinator(s): Gurzu Simona , Jung I

Keywords: soft tissue tumors liposarcoma hemangioma histogenesis

Background: Soft tissue tumors are relatively rare and constitute a highly heterogeneous histopathologic group of neoplasm, difficult to be diagnosed.  In case of malignant tumors, the main prognostic parameter remains their histological features.
Objective: To perform a preliminary study about the clinicopathological aspects of soft tissue tumors. 
Material and Method: The data was retrieved from the archives of the Department of Pathology of the Emergency County Hospital of Targu-Mures, Romania. All consecutive cases diagnosed as soft tissue tumors between 2009 and 2014 were taken into account.
Results: A total of 1758 soft tissue tumors were diagnosed over tis period. From these, 461 cases were pseudotumors, being excluded from the study. Out of the remaining 1297 cases, 12.79% were malignant tumors diagnosed in similar percentage in both females and males (M:F=1:1.01). The median age of patients was 44.83+20.22 years, ranging between 1 and 89 years. Most of the benign tumors were lipomas (40.67%) and hemangiomas (30.24%). RRegarding the origin of the malignant tumors, tumors of the connective tissue were predominant (29.41%), followed by adipose tissue (22.94%), muscle differentiation (17.06%), the vascular, cartilaginous and primary bone tumors being more rare (9.41%, 8.23% and 4.12%, respectively). However, 8.83% of the malignant tumors were diagnosed as "undifferentiated sarcomas".
Conclusions: Despite the utility of immunostains currently ussed in the daily diagnosis, soft tissue tumors remain a challenging tumor group whose histogenesis is still undetermined.

Attitudes and knowledge of physicians regarding vaccination and their intentions to vaccinate the populations  Maria Magdalena Aloje Iulia Laura Gavrilă Validated View

Attitudes and knowledge of physicians regarding vaccination and their intentions to vaccinate the populations

First author: Maria Magdalena Aloje

Coordinator(s): Voidazan S

Keywords: vaccination infectious diseases side effects prevent

Background:  Vaccination depends on infectious   diseases’s   epidemiology. There’s no vaccine that has 100% efficiency and does not have side effects. 
Objective:

The aim of the study was to compare and analyze the relationship between doctors knowledge , beliefs and attitudes about vaccination and their intentions to vaccinate the populations.

Material and Method: We used a prospective study and analyzed 79 persons applying a questionnaire which contained 27 questions  for 3 months from January, February and March 2014. This questionnaire was applied only on pediatrics doctors and family physicians. They were classified according to: gender, age, years  of practice, level of knowledge, reasons for not undergo vaccination.The data were descriptively analyzed.
Results:

Out of the 79 subjects  46,8% were family physicians and 53,2% were pediatrics doctors. 45,6% of them had the age between 45-54 years, 54,4% of them made scientific research ;  59,5% were primary doctors, 13,9% were specialist doctors and 26,6% were resident physicians;  17,7 of physicians think that more then 10 children/week  were scheduled for vaccination, 48,1%  between 1-5 children/week and 34,2% between 6-10 children/week. 91,1% of subjects agreed with the National Program of Immunization and 79,7% recommend optional vaccines. 

Conclusions: Most of the physicians agreed with the fact that vaccination is necessary to prevent the infectious diseases and they also recommend optional vaccines.

ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN  Iulia Laura Gavrilă Alina Grama, Maria Magdalena Aloje, Diana-Ionela Lapusneanu Validated View

ASPECTS REGARDING THE ETIOLOGY AND CLINICAL MATTERS OF THE FEBRILE SEIZURES IN CHILDREN

First author: Iulia Laura Gavrilă

Coordinator(s): Grama Alina

Keywords: seizure fever children

Background: Febrile seizures are the most common seizure disorder in childhood. They are a benign epileptic manifestation of infancy occurring between 6 months and 5 years of age and affecting an estimated 2-5 % of children with no neurological history.  
Objective:

Evaluation of febrile seizures on children hospitalized in Pediatrics 1 Clinic of Targu Mures County. 

Material and Method:

We performed a retrospective study at Pediatrics 1 Clinic of Targu Mures County on 195 patients hospitalized in the period 2009 – 2012.

Results:

Febrile seizures frequency was higher in 2012, with a male preponderance (M / F 1.41/1) in the rural environment. The age group 6 months to 5 years was most affected (91.3%). Associated diseases  were: superior (80%) and inferior (24.1%) airway  infections, urinary infections (8.2%), acute enterocolitis (2.6%), eruptive diseases (9.7%), vaccination reaction (3.6%), bacterial infection (97.4 % ). Tonic-clonic seizures were frequent (56.4 %) and recurrent seizures were presented in 25.6% cases. Duration of the seizures was under 15 min  in 87.7%.  Maximum age of onset below 1 year happened in 25.1% of cases. Family history of epilepsy appeared in 6.7%.

Conclusions:

As in the literature, this study demonstrates that  short and single, simple febrile seizures, with  tonic-clonic manifestations appeared most frequently, especially for male children between 6 months and 5 years old. Recurring febrile seizures are associated with age at first seizure under 1 year. 

Is olanzapine safe in pregnancy?   Oana-Dorina Cioban Diana Dobrin Validated View

Is olanzapine safe in pregnancy?

First author: Oana-Dorina Cioban

Coordinator(s): Osz Bianca Eugenia , Dogaru Maria Titica

Keywords: Olanzapine dead fetuses resorptions

Background: Atypical antipsychotics are used for the treatment of schizophrenia, bipolar disorder or autism. They are also the most commonly used antipsychotics in pregnancy, because they have fewer side effects than classic antipsychotics.
Objective:

The aim of our study was to seen how olanzapine is affecting fetal development in Wistar rats.


Material and Method:

The study was made using two groups of pregnant rats. Group I, or control group (n=20) those receiving saline solution and Group II (n=20) treated with 6 mg/kg body weight olanzapine. At the end of the gestation animals were anesthetized, cesarean dissection wad done and the uterine content was examined. The number of live fetuses, death fetuses, implantation sites and resorptions were noted.


Results: In rats treated with olanzapine death fetuses and early or late resorbed embryos were identified along with healthy fetuses.
Conclusions: Olanzapine affects the gestation in different developmental stages.

Developing an optimal RP-HPLC and gel electrophoresis methods for separation and identification of Naja haje snake venom enzymes  Diana Ciurca Anca-Teodora Berdan Validated View

Developing an optimal RP-HPLC and gel electrophoresis methods for separation and identification of Naja haje snake venom enzymes

First author: Diana Ciurca

Coordinator(s): Florea S A G , Cormos B

Keywords: Snake venom, RP-HPLC, Gel electrophoresis, Enzymes.

Background: Snake venom proteomes are complex mixtures of biologically active substances. The most important compounds are the enzymes, which have already demonstrated their therapeutical potential. The venom of Naja haje, an Elapidae member, has been analyzed from this point of view. Understanding the fully biochemical role of its enzymes has determined the scientists to find new separation and identification methods.
Objective: Our goal was to develop a proper RP-HPLC with UV detection and gel electrophoresis method for separation and identification of Naja haje snake venom enzymes, known for its neurotoxic venom.  For achieving a good resolution, analytical conditions were optimized.
Material and Method: Analysis of venom was performed on an “Ultimate 1100” Dionex HPLC system equipped with a quaternary pump, a C18 RP-HPLC column and UV detection at different wavelength values using two mobile phases, A and B, containing different concentrations of acetonitrile and trifluoroacetic acid aqueous solution at different pH values. An elution gradient at a flow of 0,600 mL/min was used. The samples were prepared by diluting pure venom with mobile phase A. The RP-HPLC method was followed by an electrophoretic separation, for a better insight of the venom chemical composition.
Results: An optimal RP-HPLC method has been developed by changing different parameters such as the pH value of mobile phase A, elution gradient and using different UV wavelengths. The best resolution were obtained at a pH value of 7,4, in gradient elution varying from 5% to 45% in mobile phase B at a wavelength of 210 nm.
Conclusions: Proteomic analysis of the venoms of Naja species supports the hypothesis that snake venom proteomes contain a large number of enzymes. A comprehensive catalog of venom composition may serve as a starting point for studying structure-function correlations of individual toxins for the development of new research tools and drugs of potential clinical use.

Evaluation of physical activity amongst medical students according to IPAQ in Targu Mures  Nicolae Stanciu Marinela-Radiana Faur, Evelyne-Christine Chiriac, Estera Gabor, Mihaela-Alexandra Gal Validated View

Evaluation of physical activity amongst medical students according to IPAQ in Targu Mures

First author: Nicolae Stanciu

Coordinator(s): Pop M

Keywords: Physical Activity Schellong II IPAQ BMI

Background: International Physical Activity Questionnaire (IPAQ) was developed to measure physical activity. The short form IPAQ has been tested extensively and is now used in many international studies.
Objective:

Seek for an association between MET score computed using IPAQ and BMI. Seeking a correlation between MET score and heart rate/blood pressure recovery time after submaximal stress test.

Material and Method:
Cross-sectional study includes a convenience sample of 85 voluntary students (spring 2014). “Short last 7 days telephone format” IPAQ was administered. Demographical data was recorded and the subjects underwent a cardiovascular stress test (Schellong II). Blood pressure and heart rate were determined until reaching pre-test values using a Sanitas SBC25 monitor. Statistical analysis was performed using Microsoft Excel and GraphPad InStat 3.06.
Results:
Our study included a larger female sample (M:F =0.49) with an average age of 20.98 years (Standard deviation=1.32 years). Physical activity MET-minutes/week ranged between 9012 and 66 with a high physical activity level in 60.82%, while low and medium activity level represents 19.59%. While BMI ranged from 17.17 to 28.08 comparing it across MET quartiles we found the highest median on the first quartile (22.53) but without statistically significant differences (p=0.057). However an association was found between MET lower than 1000 and BMI over 25.Most of the students recovered normal BP and HR in 2 minutes (84.71% fully-recovered in 4 minutes). We found a weak negative correlation (r=-0.18), statistically non-significant (p=0.09) between MET values and recovery time. 
Conclusions:
Medical students in early years present a good physical activity state, with an active life and appropriate nutrition. As expected higher BMI was found in patients with lower MET-minutes/week, overweight subjects presenting an association with MET-minutes under 1000. BP and HR recovery correlation with MET need more data to gain a better perspective.

Correlation study between generalized anxiety and internet addiction disorder among students from UMF Targu Mures  Alina Georgiana Moisa Alexandra Cristina Miclea Validated View

Correlation study between generalized anxiety and internet addiction disorder among students from UMF Targu Mures

First author: Alina Georgiana Moisa

Coordinator(s): Buicu Gabriela , Ardelean M

Keywords: Generalized anxiety Internet addiction HARS UMF students

Background: The spectrum of anxiety disorder is among the most prevalent psychiatric disorders and according to the fifth edition of DSM,it includes‘’features of excessive fear and anxiety and related behavioral disturbances’’.The latest studies show that internet addiction has been labeled with mental disorders like anxiety, depression, stress and obsessive compulsive disorder.
Objective: The purpose of this study is to seek out the relation between the levels of anxiety and the levels of internet usage among students from UMF Targu Mures.
Material and Method:

Demographic data was gathered from a survey lot of 34 students which have been using the internet  for more then 3 years.Hamilton Anxiety Rating Scale(HARS) and Internet Addiction Test (IAT-survey provided by Dr. Kimberly Young) were applied.Statistical analysis was performed in Excel and GraphPad.

Results: From  34 participants,21 women and 13 men, with the average age of  24; 61% are celibate, 30% are in a relationship and 9% are married .Regarding the religious orientation 82% are ortodox ,12% adventists,3% muslims and 3% atheists.HARS showed that 71% of them have mild anxiety and 29% have moderate anxiety .IAT identified that 18% of the students are rare internet users, 50% are average  users, meening that online surfing is a little bit too much at times and 32% are experiencing occasional problems because of the internet. Correlation analysis between HARS and IAT assessed a strong correlation coefficient (r=0,74),with a p value < 0,0001 ,statistically considered extremly significant.
Conclusions: Results indicate that the students from UMF Targu Mures are facing mild or moderated anxiety disorder in the context of average and high internet addiction .This outcome is in line with the results of other recent studies that were made in the internet addiction field.

Flow citometry or molecular biology for HLA-B27 detection in seronegative spondylarthropaties?  Iulia Armean Validated View

Flow citometry or molecular biology for HLA-B27 detection in seronegative spondylarthropaties?

First author: Iulia Armean

Coordinator(s): Dobreanu Minodora

Keywords: ankylosing spondilitis HLA-B27 cross-reacticity flow cytometry

Background: Ankylosing spondilitis is a chronic inflammatory disease affecting the axial skeleton, the entheses and occasionally, the periferal joints. While the role of HLA-B27 in pathogenesis is still incompletely elucidated, it has become increasingly clear that the presence of this molecule can be associated, with the entire group of seronegative spondylarthropaties. This molecule can be detected by two techniques: phenotypic (by flow cytometry) and molecular biology tests.
Objective: Flow cytometry technique is relatively fast and cheap but recent studies showed that it has an important limitation: interference of specific monoclonal anti HLA B27 antibody with other related phenotypes. This study is meant to emphasize the interference problem in patients diagnosed in Emergency Hospital of Tg. Mures during May 2010- March 2014.
Material and Method: A retrospective study was conducted on a random group of 98 persons 14-80 years of age, from Rheumatology Department. We relied on data from patient medical forms, including the clinical symptoms, diagnosis and laboratory results. We performed flow cytometry tests with a BD FACS Calibur analyser, using BD HLA-B27 kit which is a qualitative two-color direct immunofluorescence method for the rapid detection of HLA-B27 antigen expression on circulant T lymphocytes. For the samples with uncertain results, HLA-SSP and HLA-SSO typing techniques were used to clarify genotype.
Results: Our study includes 41 females and 57 males. The flow cytometry showed us 27 positives and 58 negatives results. For 13 subjects flow cytometry revealed a dim expression of HLA B27. Genotypes HLA B07 and HLA B39 has been frequent identified by molecular biology techniques, which were mandatory to clarify the incert situation. 
Conclusions: We conclude that flow cytometry is a useful test in screening for the presence of the HLA-B27 molecule, and cross-reactivities have to be determined by molecular techniques.

Variations from the normal structure of the urothelium in the bladder  Victor Vacariu Vasile Bogdan Halatiu Validated View

Variations from the normal structure of the urothelium in the bladder

First author: Victor Vacariu

Coordinator(s): Borda Angela , Loghin Andrada

Keywords: Urothelium Squamous metaplasia Nephrogenic adenoma Von Brunn's nests

Background: Urothelium is the epithelium that lines the bladder mucosa. This epithelium may present variations from the normal structure (metaplastic or reactive proliferation changes), which can be clinically confused with bladder neoplasms.
Objective: The aim of the study is to describe these variations and to emphasize the importance of recognizing them, in order to be differentiated from benign or even malignant bladder tumors.
Material and Method: 335 Trans-Urethral Resection (TUR) of the bladder performed in the Urology Department and examined in the Pathology Department of Emergency County Hospital Mures between January 2013 and December 2013 were reviewed. The following features were looked for: Von Brunn's nests, considered as solid urothelial nests budding beneath the urothelium, squamous metaplasia representing the replacement of the urothelium by a stratified squamous epithelium, cystitis cystica (CC) in which von Brunn nests become cystically dilated and acquire a luminal space, cystitis glandularis (CG) a glandular metaplasia of the urothelium and nephrogenic adenoma (NA) a distinct metaplastic lesion characterized by a proliferation of gland-like structures lined by hobnail cells.
Results: 11 cases of CG were identified, 8 were typical CG, 1 was of intestinal type, and 2 were associated with chronic and encrusted cystitis. We found 5 cases of CC, 2 of them associated with chronic and encrusted cystitis, while in one case CC and CG were associated. Also a case of NA was identified. Von Brunn's nests and squamous metaplasia were frequently found on TUR fragments, but they are not mentioned in the diagnosis since they are considered normal structures, although they are different from typical appearance of the urothelium.
Conclusions: This study shows the importance of recognizing the variations from the normal structure of the urothelium and of considering them in the differential diagnosis of bladder neoplasms. Their correct diagnosis can avoid inappropriate treatments.

Analysis of Nissen and Dor procedures and their usage on patients who underwent laparoscopic surgery for hiatal hernia in the Surgery Clinic no.2, Mures County Hospital  Radu-Dumitru Antoniu Mircea Tabacar, Renáta Czegő Validated View

Analysis of Nissen and Dor procedures and their usage on patients who underwent laparoscopic surgery for hiatal hernia in the Surgery Clinic no.2, Mures County Hospital

First author: Radu-Dumitru Antoniu

Coordinator(s): Muresan M G

Keywords: hiatal hernia fundoplication mures

Background: A hiatal hernia is the protrusion of the upper part of the stomach into the thorax. When hiatal hernias are symptomatic, acid reflux usually produces the symptoms. If the hernia itself is causing chest discomfort or other symptoms, surgery may be necessary. The main surgery performed is called fundoplication. Nissen, Dor and other procedures with somewhat different indications are the surgical techniques used. Objective: To asses the surgical techniques used for the treatment of hiatal hernias and their incidence in the Surgery Clinic no.2, Mures County Hospital during the last five years. Material and Method: A retrospective descriptive study was initiated. Eighty five patients diagnosed with hiatal hernias were included in our study. They were classified according to gender, age and to surgical techniques. All of them were examined and treated in the Surgery Clinic no.2, Mures County Hospital between January 2009 and February 2014.  Results: There is a visible tendency for the laparoscopic approach to this kind of pathological condition during the years. Out of 85 patients diagnosed with hiatal hernia during the last five years 8.2% were treated using Dor procedure and in 91.8% Nissen technique was applied. Conclusions:

Minimally invasive surgery is becoming more and more common in the treatment of hiatal hernias in the Surgery Clinic no.2, Mures County Hospital during the years, Nissen fundoplication being the typical technique.

Clinical features and co-morbidities in dementia due to Alzheimer’s disease  Reka Gyero Amani Diana Barmou, Ion Mihai Georgescu, Zoltan Kovacs, Júlia Magyar Validated View

Clinical features and co-morbidities in dementia due to Alzheimer’s disease

First author: Reka Gyero

Coordinator(s): Gabos Grecu I

Keywords: Dementia Alzheimer's disease Co-morbidities Clinical features

Background:

Alzheimer’s disease is the most common form of dementia, a neurological disease characterized by loss of mental ability severe enough to interfere with normal activities of daily living. Alzheimer’s disease usually occurs in old age, and is marked by a decline in cognitive functions such as remembering, reasoning and planning.

Objective:

The aim of this study is to evaluate the most common co-morbidities that occur in dementias due to Alzheimer’s disease, and also to point out the most customary clinical aspects of the disease in discussion.

Material and Method: I have conducted a retrospective study on 228 patients hospitalized in year 2013 to the Psychiatric Institute of Targu Mures. I have evaluated  the patients based on their medical backgrounds, focusing mainly on the coexisting general medical conditions and the most frequent clinical manifestations. 
Results: Out of 228 patients 146 (64,03%) were female and 82 (35,96%) were male with an average age of 82 years.  The most commonly encountered pathologies were arterial hyperstension (46,05%), chronic ischemic cardiomyopathy (38,59%), stroke in the silvian territory (30%), diabetes type II (10,96%), permanent atrial fibrillation (7,89)  and atherosclerosis (15,78%).  Clinical features most frequently found were agnosia, apraxia, aphasia, temporo-spatial disorientation and decline of self management,  anxiousness, irritability, acalculia,  memory impairment and decline of thought processing and mixed insomnia.  Less common clinical features were depressive mood disorder, delirious paranoid ideas, auditory and visual hallucinations. 
Conclusions: Dementias due to Alzheimer’s disease are pathologies which affect women and men in a 1,8:1 ratio with an average age of 82 years. The most frequent underlying general medical conditions are arterial hypertension and chronic ischemic cardiomyopathy. Clinical manifestations such as decline of self-care, agnosia, apraxia or aphasia are sever enough to interfere with the patient’s daily living.

ACUTE POSTPROCEDURAL EVOLUTION OF ALCOHOL SEPTAL ABLATION IN OBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY  Ruxandra Darie Validated View

ACUTE POSTPROCEDURAL EVOLUTION OF ALCOHOL SEPTAL ABLATION IN OBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY

First author: Ruxandra Darie

Coordinator(s): Dobreanu D , Mitre Adriana

Keywords: OHCM alcohol septal ablation interventional therapy

Background: Hypertrophic cardiomyopathy is a primary cardiac disorder caused by various mutations in the genes that encode the sarcomere proteins. Catheter based treatment has become the  therapy of choice in the European space, due to great improvement in symptoms, highly decreased gradient and, of course, its minimally invasive character.


Objective: The purpose of this study was to evaluate the risks and outcome of the interventional therapy, by analyzing the decreasing level of LVOT gradient and SAM persistence at the moment of echocardiographic reevaluation. Furthermore, we evaluated the prevalence, severity and management of ASA complications.

Material and Method: We focused our retrospective observational study on 18 patients sample with septal ablation performed between 2009-2014, at the Emergency Clinical County Hospital of Targu Mures.

Results: The processed data revealed that 33,3%(6) of the patients did not experience any complications after the ablation procedure. There was no early mortality associated to the ASA, although we had experienced 3 cases(16,6%) of spontaneous ventricular fibrillation in the immediate periprocedural period, which were successfully converted to sinus rhythm. Among the other complications, RBBB had the highest frequency: 38,8%(8), followed by transient 3rd degree AVB in 27,7%(5) of the cases. Also, 16,6% experienced paroxysmal AF, 2 patients developed a 1st degree AVB and 1 developed a permanent 3rd degree AVB. 2 patients requiered pacemaker implantation after ASA.
As far as the postprocedural echocardiographic criteria are concerned, 27,7%(5) of the patients had no pathological gradient In the LVOT, 16,6%(3) had a 30 mmHg residual gradient, 16,6%: 25 mmHg, 2 patients: 20 mmHg, 16,6%: 15 mmHg, 1 patient: 10 mmHg and 1 patient: 60 mmHg. After ASA, SAM was absent in 72,3%(13) of the cases, and still present in 27,7%.

Conclusions: Results of the study show that alcohol septal ablation can be done with high success and, even though complications are not rare, they are manageable.

Histopathologic prognostic factors in renal cell carcinoma  Oana Bianca Hintea Ioan Serban Fanfaret Validated View

Histopathologic prognostic factors in renal cell carcinoma

First author: Oana Bianca Hintea

Coordinator(s): Borda Angela , Loghin Andrada

Keywords: renal carcinoma prognosis factors histopathology

Background: Renal carcinomas are a group of tumors histologically and prognostically heterogeneous. According to the most recent recommendations, histopathological type, in addition to tumor stage and grade are the strongest prognostic markers in renal carcinomas. Presence of sarcomatoid differentiation must also be taken into consideration.
Objective: To present the prognostic factors in renal carcinomas and the way they are assessed on surgical specimens.
Material and Method: In our retrospective study we included 266 cases, all evaluated in the Pathology Laboratory of Mures County Hospital, between January 2009 and December 2013. All the samples were processed following a standard protocol: fixation in neutral formalin, paraffin embedding, sectioning and staining with hematoxylin-eosin. The parameters assessed for each patient were: age, gender, histopathological type ( according to WHO classification), pathological stage (according to TNM classification), Fuhrman grade, and presence of sarcomatoid differentiation must also be taken into consideration.
Results: Of 266 cases 87.21% were clear cell renal cell carcinomas, 6.39% papillary renal cell carcinomas (35.29% type 1 and 64.70% type 2), 6.01% chromophobe renal cell carcinomas and 0.37% Bellini collecting duct carcinomas. Most of the tumors were diagnosed in pT1b pathological stage, with a Fuhrman grade 2. The tumor size varied between 12 and 130 mm. In 9.02% cases we noticed sarcomatoid differentiation.
Conclusions: Correct tumor classification, grading, staging and systematic examination of radical nephrectomy specimens are essentials for patient management. Tumor type, tumor stage and Fuhrman grade are independent histopathological factors which should be included in pathology reports.

OSM RULZ  Larisa Dogar, Paul Mihai Boarescu Validated View

OSM RULZ

First author:

Coordinator(s): Molnar C , Sipos R

Keywords: OSM CLuj Paula Eddy

Background: ala bala portocala ala bala portocala ala bala portocalaala bala portocalaala bala portocala Objective: ala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocala
Material and Method: ala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocala
Results: ala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocala
Conclusions: ala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocalaala bala portocala

The effects of corticosteroid therapy on the pathology of the scapulohumeral joint  Mircea Tabacar Radu-Dumitru Antoniu, Radu Branea, Larisa Marina Zahan Validated View

The effects of corticosteroid therapy on the pathology of the scapulohumeral joint

First author: Mircea Tabacar

Coordinator(s): Ivanescu A

Keywords: shoulder rotator cuff corticosteroids

Background: The shoulder is one of the most complex joints of the human body, with the largest range of motion. Therefore, shoulder lesions are frequent and shoulder pain is a common source of distress. Subacromial steroid injections are often used in patients with shoulder pain as a short-term palliative treatment. However, the deleterious long-term effects of steroid injections have been documented. Objective: The aim of this study is to determine the most frequent shoulder pathology in patients who had received subacromial steroid injections. Material and Method: We conducted a prevalence study between January 2013 and December 2013 at the Orthopaedics and Traumatology Clinic I in Tirgu Mures, involving 65 patients, 31 females and 34 males, aged between 21 and 86 (mean age 51.96). We analyzed patients who complained of chronic shoulder pain and had received one or more subacromial steroid injections. Their conditions were diagnosed using clinical examinations and para-clinical examinations (X-ray, ultrasonography, MRI ). Results: The data we collected from the 65 patients indicated that the most frequent impairment of the shoulder was the supraspinatus tendon tear (45%), followed by the chronic shoulder instability (29%) and shoulder impingement syndrome (26%). 24 patients (36.92%) underwent surgery, out of which 16 (67%) were classic open surgeries and 8 (33%) were arthroscopic surgeries.  Conclusions: The most frequent lesion which followed a subacromial steroid injection was the supraspinatus tendon tear.

Parathormone(PTH) and electrolytes in end stage renal disease (ESRD) and hemodialysis (HD) patients.Focus on magnesium  Iuliana Cirstea Roxana-Cristina Campean, Stela Niculiseanu Validated View

Parathormone(PTH) and electrolytes in end stage renal disease (ESRD) and hemodialysis (HD) patients.Focus on magnesium

First author: Iuliana Cirstea

Coordinator(s): Gliga Mirela

Keywords: ESRD Magnesium( Mg+2 ) parathormone (PTH)

Background:

In ESRD patients disturbances in the metabolism of electrolytes are well known,also development of secondary hyperparathyroidism  in these patients is almost inevitable.It is known that serum calcium(Ca+2) as well as serum phosphate (P) levels have key roles on PTH regulation and synthesis. In literature it is shown that serum magnesium (Mg+2) may also have an important role in regulating the  PTH secretion.

Objective:

To evaluate the relationship between PTH levels and serum Mg+2,Ca+2 and P levels and to correlate them with the disease's  progression.

Material and Method:

We performed a retrospecive , comparative study on 75 patients admitted to the Nephrology Department of Mures County Emergency Clinical Hospital between January 2013 and March 2014.We studied the following parameters: age, serum Mg+2, Ca+2 , P levels and estimated glomerular filtration rate (eGFR).Patients were divided in two groups:  A - the ESRD group and B- the HD group. Data were analyzed using t-test and Pearson correlation coefficient.

Results:

Mean values and standard deviation (SD)  for  group A were: age: 57,4(±13,04), Mg+2:2,16mg/dl(±0,53), Ca+2: 9,56mg/dl(±1,2),P: 4,72mEq/ml(±1,3),PTH: 64,91pg/ml(±9,32), eGFR: 26,58 ml/min/1,73 m2(±15,5). Group B: age 51,5(±13,66), Mg+2:2,57mg/dl(±0,48),Ca+2: 8,68mg/dl(0,88), P:3,79mEq(±0,97),PTH: 343,62 pg/ml(±36,93),eGFR: 5,66ml/min/1,73 m2(±1,66).There was a significant statistical difference between Mg+2 levels (p<0,005) and P levels( p<0.001) in  group A compared to group B .A reverse correlation was found between Mg+2 and PTH levels (r= -0,46),in group A and also between Ca+2 and PTH levels (r=-0,43) for group  A and  B (r=-0,31).We found a significant correlation between Mg+2 levels and  eGFR in both groups.

Conclusions:

Increased levels of serum Mg+2 were noticed especially in HD patients.Patients with higher serum Mg+2 levels tend to have lower PTH levels; therefore, controlling this two parameters is of major importance in both ESRD and HD patients.

The quality of life of diabetic patients  Ralisa Spirchez Dimitris Marin Argyriou, Armina Mihanos (Grama) Validated View

The quality of life of diabetic patients

First author: Ralisa Spirchez

Coordinator(s): Pasca Maria Dorina

Keywords: Diabetes mellitus Quality of life Patients

Background: This paper captures how diabetes affects the quality of life of patients. Objective: The study establishes a relationship between the patient’s level of intervention on diabetes and implications of the disease in patients lives.
Material and Method: Conversation , observation and questionnaire comprising ten questions referring to patient’s quality of life on physically, mentally and socially plan.
Results:

The results are based on a sample of 50 people , rural and urban , male and female , ages 25 to 75 years, who were handed the questionnaire:

- Females are affected at a rate of 58%, while the proportion of males is 42%;

- The quality of life of diabetic patients is affected more intense in rural areas (66%) than urban areas (34%);

-  The quality of life is most affected to the population group aged over 75 years old (26%) , followed by ages 50-70 years old (10%), then the group aged 25-35 years old and 40 -45 years old (4%) , the last place occupied being the population group aged 35-40 years old and 45-50 years old (2%).

The remaining information shows a relationship based on intervention and acceptance.

Conclusions: Diabetes mellitus has implication in the quality of life of the diabetic patients, but closely related to their level of education , the environment in which they live, their age and level of acceptance and understanding of the disease. 

Dietary habits of medical students  Aurelia Alexandra Tarca Alina-Georgiana Corduneanu, Ioan Serban Fanfaret, Dora-Ildiko Suba Validated View

Dietary habits of medical students

First author: Aurelia Alexandra Tarca

Coordinator(s): Pop Raluca , Sipos R

Keywords: 24hr recall macronutrient empty calories physical activity

Background: Dietary assessment is an important part of general assessment, but it is time consuming and subjective. Medical students are supposed to have healthy eating habits. Objective: Comparison of dietary habits of students from UMF Tg. Mures. Material and Method: Type of study - cross-sectional; target population - medical students; sample - 91 students divided in two groups from the first (46 subjects) and fourth year (43 subjects) of General Medicine at UMF Tg. Mures. Method - 24hr recall questionnaire. Variables analyzed: age, sex, environment, study year, body mass index, waist, percentage of fat, protein, carbohydrate, fiber, empty calories, recommended caloric intake, number of meals, physical activity frequency.  Results: 71.4% of students consume at least 3 meals/day. 75.8% consume more empty calories than the recommended quantity. When comparing the macronutrient composition there was no statistically significant difference between the 2 groups, but only 6/91 have a balanced diet according to the dietary recommendations. 56.04% of students consume more calories than their calculated requirement. Students from the first year are more likely to engage in physical activity (RR 1.54, 95% CI - 1.03-2.3, p=0.03). The incidence of weight disturbances was 30.4% in the first year group and 24.4% in the fourth year group. Conclusions:

Medical students tend to consume high amounts of empty calories, have an imbalanced diet and do not exercise. The 24hr recall is a useful tool for evaluating personal diet and allows tailored recommendations. More emphasis should be put on nutritional education among medical students.

A closer approach to Alexander Monro family and its influence in modern anatomy  Marta Ostopovici Ruxandra Darie Validated View

A closer approach to Alexander Monro family and its influence in modern anatomy

First author: Marta Ostopovici

Coordinator(s): Enciulescu C

Keywords: Monro anatomy foramen bursa

Background: The study of anatomy blossomed between 18th and 19th centuries. A major role in the history of anatomy is played by Alexander Monro family, a family of three Scottish anatomists who held the chair of anatomy at the University of Edinburgh for 126 years, from 1720 to 1846. The founder of this dynasty of medicine was John Monro, a military surgeon who moved to Edinburgh around the year 1700 and influenced the development of a medical school in that town.


Objective: The purpose of this study is to prove the value of a strong legacy, left behind by an unusual family, that involves three generations of anatomists at Edinburgh University.

Material and Method: Our descriptive study is based on gathering information from online journals and historical articles, which provided us a collection of factual knowledge about Monroes' medical career, discoveries and publications.


Results: From our research we found out that Alexander Monro family, formed by primus, secundus and  tertius, published around 89 scientific papers and books and described Monro's ependymal cyst, interventricular foramen, point of incision in ascites, olecranian intratendinous bursa and hypotalamic sulcus. Alexander Monro secundus also described Monro-Richter line, an important landmark in diagnosis of appendicitis. Probably one of the most important theory of Monro dynasty is the Monro's doctrine.

Conclusions: It is well known that the Monro dynasty stands as one of the most notable families in the history of medicine. Their studies involved many medical fields, such as nervous, gastrointestinal, lymphatic and reproductive systems. Without any doubt, the Monro family brought a priceless treasure to history of medicine.

Epicardial fat thickness as a new risk assessment tool in post acute myocardial infarction patients  Roxana Ioana Hodas Suzana-Vasilica Sincaru Validated View

Epicardial fat thickness as a new risk assessment tool in post acute myocardial infarction patients

First author: Roxana Ioana Hodas

Coordinator(s): Benedek I , Benedek Teodora

Keywords: inflammatory markers coronary syndromes

Background:

Epicardial fat represents a new inflammatory marker which has been proved to be associated with the severity of coronary artery disease

Objective:

We aimed at assessing the correlation between the amplitude of the left ventricular (LV) remodeling at 6 months post acute myocardial infarction (AMI) and several markers expressing an increased inflammatory status, such as epicardial fat thickness (EFT) and persistence of elevated circulating levels of highly sensitive C-Reactive Protein (hs-CRP).

Material and Method:

The study included 92 patients with revascularized AMI:  group 1 (n=49) - hsCRP <3.0 mg/l, and group 2 (n= 43) -hs-CRP >3.0 mg/l; left ventricular end-diastolic (LVED) and end-systolic (LVES) volumes were determined at baseline and at 6 months, together with EFT, ejection fraction (EF) and remodeling index (RI). 

Results:

The mean EF at 6 months was 46.2+/-3.7% in group 1, and 40.8+/-4.2% in group 2, p=0.0006. Six-month EF significantly correlated with hs-CRP circulating levels at baseline (r=-0.57, p<0.0001) and with the EFT (r=-0.61, p<0.0001). Patients in gr.2 demonstrated a significantly larger EFT (8.7+/-1.8 mm vs 6.3+/-1.7 mm, p=0.0006) and a significantly more pronounced adverse remodeling (RI 17.8+/-5.6 vs 12.4+/-6.7, p=0.005). Linear regression demonstrated a good correlation between hsCRP level and EFT (r=0.6251, p<0.0001).  Multivariate analysis revealed that hs-CRP values >3.0 mg/dl (Odds ratio [OR] 2.8, p=0.02), an EFT > 7.0 mm (OR: 6.3, p=0.001) and the anterior location of the infarction (OR: 2.6, p=0.03) were independent predictors for deleterious left ventricular remodeling after an AMI. 

Conclusions:

A larger amount of epicardial adipose tissue and the persistence of a marked inflammation at seven days post-infarction are associated with a more severe impairment of ventricular function in patients with AMI. 

Experimental studies using enzyme biosensors for electrochemical detection of toxic compounds  Ligia Chelmea Niculina Dragomir Validated View

Experimental studies using enzyme biosensors for electrochemical detection of toxic compounds

First author: Ligia Chelmea

Coordinator(s): Badea Mihaela , Floroian Laura

Keywords: electrochemical enzyme biosensors chlorpyrifos ethyl oxon methyl paraoxon heavy metals

Background:

Toxic compounds (pesticides, mycotoxins, heavy metals) are incriminated in many toxicological mechanisms, through their effects on biosystems. It is implied the necessity of a new specific method, rapid and cheap, for detection of different samples: water, food, biological fluids.

Objective:

This study has proposed optimisation of enzyme electrochemical biosensors as viable alternative for applications in toxicology, environment analyses or studies about food quality.

Material and Method:

We studied and optimized electrochemical biosensors which use commercial and mutant acetylcholinesterases for possible detection of organophosphorus pesticides (chlorpyrifos ethyl oxon, methyl paraoxon) and heavy metals (cadmium, lead).

Results:

There were characterized kinetic parameters for two types of electrochemical biosensors, obtained by immobilisation of acetylcolinesterase on the working electrode. There were electrochemical analysed the inhibitory action of different compounds studied by obtaining the corresponding calibration curves and inhibition degrees.

Conclusions:

Studies have identified different inhibitory activities of the compounds studied, which can be exploited for analytical analysis of real samples. Using enzyme biosensors in screening or assay provides rapid and sensitive analytical methods for quantification in toxicology.


Acknowledge

The research leading to these results has received partial funding from the European Community's Seventh Framework Programme (FP7/2007-2013) under grant agreement n° 245199. It has been carried out within the PlantLIBRA project (website: www.plantlibra.eu). This report does not necessarily reflect the Commission views or its future policy on this area.

 

Family's role in healthy lifestyle choices.  Simona Loredana Tolus Validated View

Family's role in healthy lifestyle choices.

First author: Simona Loredana Tolus

Coordinator(s): Farr Ana-Maria

Keywords: lifestyle youth nutrition education

Background: Taking into consideration the impact of the lifestyle on current and future individual and societal wellbeing and development, it is important to understand the behavioral patterns and related specific determinants for the lifestyle of the Romanian young generations.
Objective: To assess the lifestyle quality of young people based on a survey investigating some behavioral aspects such as eating habits, physical activity, rest, etc. It also looks at the influence that the family and the entourage play in developing a healthy lifestyle.
Material and Method: The survey was conducted between December 2013 and April 2014, through an on-line questionnaire. It included 41 questions regarding: socio-demographic data, anthropometric measurements and habits regarding nutrition, family (and personal) medical and behavioral history. The study group comprises 168 young people, aged between 15 and 35 years, four from each county of Romania, with symmetric gender distribution; the average age is 22.4 and the median 22. This presentation is confined to nutritional aspects.
Results: 75% of surveyed people presented normal body weight, 12.5% are overweight and 12.5% are underweight. 110 (65.4%) of the respondents are omnivores, 42 (25%) are vegetarians, and 6 (3.5%) are vegans. 60.7% have breakfast daily, 16.6% 2-3 times a day, 15.4% seldom and 7.14% almost never. 78.5% from the total eat fast-food occasionally, 4.1% often and 17.2% never.  123 (73.2%) received education regarding healthy lifestyle habits within their families. Out of these 84.5% have assimilated them. 54.7% were taught to read food labels from which 68.4% avoid food additives. 69.6% of participants consider it would have been easier if they had been taught some healthy habits in childhood.
Conclusions: The family environment plays an important role in shaping the lifestyle of children. On the understanding and application of this principle depends the health of future generations. 

Identification and quantification of parabens in cosmetic products by RP-HPLC method  Carmen Maria Rusz Laura Elena Gliga Validated View

Identification and quantification of parabens in cosmetic products by RP-HPLC method

First author: Carmen Maria Rusz

Coordinator(s): Gaz Florea S A

Keywords: Parabens, RP-HPLC, Optimization, Parahydroxybenzoic esters.

Background: Nowadays, esters of parahydroxybenzoic acid, also known as parabens, are widely used as preservatives by cosmetic and pharmaceutical industries. These compounds used mainly for their bactericidal and fungicidal properties are known as being a potentially harmful substance. Research suggests a link between these substances and many health issues. One of the most common is breast cancer but they also can affect men's reproductive system and are linked to endocrine disruption, reproductive toxicity, immunotoxicity, neurotoxicity and skin irritation. We can avoid them and protect our health by using paraben-free products.
Objective: Our aim was to find out whether these parabens are present or not in the analyzed cosmetic products and quantify them. Analytical conditions were optimized in order to achieve a good resolution and a short analysis time.
Material and Method: Analysis of parabens was performed on an “Ultimate 1100” Dionex HPLC system equipped with a quaternary pump, a C18 RP-HPLC column (250 mm x 4.6 mm, 5 μm) and UV detection at different wavelength values using two mobile phases, A and B, containing different concentrations of methanol and phosphoric acid aqueous solution. An isocratic elution with a flow of 1,0 mL/min was used. Standard were prepared at a concentration of 0.1 mg/mL in mobile phase A, while samples were purified using a SPE procedure.
Results: An optimal RP-HPLC method has been developed by changing composition of the mobile phase. The best resolution were obtained using 25% mobile phase A and 75% mobile phase B, in less then 12 minutes, at a wavelength of 272 nm .
Conclusions: The developed method was applied for the determination of several parabens from different cosmetic products with a good reproducibility. A correlation of obtained values with accepted limit by European legislation was made.

Yeast oral colonization in oro-maxillo-facial pathology  Despina Luciana Temistocle Anca Mare Validated View

Yeast oral colonization in oro-maxillo-facial pathology

First author: Despina Luciana Temistocle

Coordinator(s): Cecilia Petrovan , Man A

Keywords: OMF pathology oral colonization Candida

Background: Candida and especially Candida albicans colonizes the oral mucosa and becomes invasive when the immune system weakens. Therefore, frequently oral and maxillofacial pathology can be associated with Candida.
Objective: The qualitative and quantitative assessment of yeast colonization of the oral cavity in patients with oro-maxillo-facial (OMF) conditions, and the establishment of an association between the different contributing factors and colonization.
Material and Method: The samples were collected by rinsing the mouth with sterile saline, from 70 patients hospitalized in OMF clinic; historical data were also collected. The samples were analysed at the Microbiology Laboratory of UMF Tg Mures; Sabouraud agar medium was used. For each isolate, the antifungigram for fluconazole and voriconazole was performed following the CLSI standards.
Results:

From 70 samples, 45.7% were positive for 11 different yeast species. Among the studied predisposing factors,  smoking was significantly associated with yeasts colonization (OR=2.34; 1.42-3.84 at 95% IC, p<0.05). Men presented higher colonization than women, although not significant (OR=1.863; 0.94-3.67 at 95% IC, p=0.075). Poor oral hygiene can also determine Candida colonization (from 18 people who never brush their teeth, 10 have Candida 55.6%).
Candida albicans was the predominant species (56.8%),fact confirmed by the literature. In 5 cases several yeast species were identified in the same sample. The testing of C. albicans and non-albicans to fluconazole showed an increased resistance (52.4%) in both cases, while the resistance to voriconazole was 50% and 12.5% respectively.
Conclusions: Colonization with yeasts of the oral cavity is present in about half of the patients with OMF conditions and this is probably not only due to classical predisposing factors, but also due to chronic oral pathology. There is a high diversity of yeast species, which showed a high resistance to the currently used azoles in oropharyngeal mycosis therapy.

Thyroid noduls in Graves' disease and Hashimoto's thyroiditis  Izabela-Diana Bogdan(Cocos) Validated View

Thyroid noduls in Graves' disease and Hashimoto's thyroiditis

First author: Izabela-Diana Bogdan(Cocos)

Coordinator(s): Szántó Zsuzsanna

Keywords: thyroid nodule cancer

Background:  Graves' disease is characterized classically by diffuse goiter , thyroid nodules and thyroid cancer rarely appear amid these disease . In contrast, in Hashimoto chronic autoimmune thyroiditis is commonly nodular goiter , and described the association of thyroid cancer often .
Objective:

 Evaluation of thyroid morphology in Graves and Hashimoto diseases ; to study the frequency of thyroid malignant processes amid Basedow disease .

Material and Method:  The retrospective study included 145 patients with Graves' disease and 100 with Hashimoto hospitalized in Clinic of Endocrinology Department of Targu -Mures , between January 2009 and December 2013. We watched hormonal dosages ( TSH , free T4 , free- T3) , antithyroid antibodies ( TRAb , anti - TPO) , the results of scans thyroid , of fine needle aspiration biopsy  , of histopathological examinations , and specific treatment followed .
Results:  34.4% of the cases of Basedow's disease had nodules : in 10.3 % as uninodular goiter, in 24.13 % as multinodular goiter .  64 % of them were with thyreostatic treatment ( with methimazole), 36 % have not yet received this therapy . 2.06 % of Graves disease amid nodules were malignant : 100 % papillary carcinoma thyroid .  40 % of patients with Hashimoto 's disease had thyroid nodules .
Conclusions:

 Thyroid nodules appeared rather frequent in the Graves disease , possibly because of methimazole therapy , but with a lower rate of malignancy . In nodular goiter Hashimoto appeared more frequently .

The clinical course of Secondary Progressive Multiple Sclerosis  Mădălina-Nicoleta Mirica Validated View

The clinical course of Secondary Progressive Multiple Sclerosis

First author: Mădălina-Nicoleta Mirica

Coordinator(s): Bălașa Rodica

Keywords: SPMS, EDSS, Heterogenity, Descriptive.

Background: Multiple sclerosis (MS) is the most common disease of the central nervous system that causes permanent disability in young adults. Whether it is accompanied by superimposed relapses or not, the secondary progressive form induces a gradual disability over a variable amount of time.

Objective: To evaluate the symptoms and to highlight the evolution of patients with diagnosed Secondary Progressive Multiple Sclerosis (SPMS) at the Neurology Clinic no 1 in Tîrgu Mureș.

Material and Method: We have retrospectively analyzed the discharge charts of patients diagnosed with SPMS, admitted from January 2011 until December 2013. We have used clinical and paraclinical parameters such as: age, gender, onset symptoms, admission symptoms, EDSS score, cerebral and spinal MRI exams; resulting data was analyzed using with descriptive statistical methods.

Results: From a total of 349 MS cases, 54 had the secondary progressive form (16%), out of which 59% were men and 41% women, the average onset age was 35 ±11,4 years (32, 96 for women and 39,05 for men), with an 11 years evolution for women and 7.9 years for men. The clinical onset was monosymptomatic for 69% of those admitted to hospital and plurisymptomatic for the remaining 31%. The prevalent symptomatology had to do with the motor deficit pyramidal syndrome both at onset and admission. The average EDSS score at admission was 6 (between 4 and 8.5).

Conclusions: Multiple sclerosis is a disease with profound heterogeneity in its clinical course and although it is more common in women and may appear at an earlier stage in life, it is more severe in men and with a faster evolution towards the secondary progressive form.

Evolution of the Prevalence of Cardiovascular Diseases and Risk Factors in Females  AbdulRahman Ismaiel Validated View

Evolution of the Prevalence of Cardiovascular Diseases and Risk Factors in Females

First author: AbdulRahman Ismaiel

Coordinator(s): Nagwa I

Keywords: Cardiovascular DIsease Females Risk Factors Prevalence

Background: Cardiovascular disease (CVD) remains the leading global cause of death. It's the no. 1 killer of women followed by cancer. Although there is an overall reduction in the death rates due to CVD over the previous decades, the decline rate is slower in females than males.
Objective: To evaluate and compare the evolution prevalence, and risk factors of CVD in women from 2012 till 2014 to recommend future management and prevention plans accordingly. 
Material and Method: A search for statistical reports about prevalence and risk factors of CVD in women was done. This study was based on statistical reports of The American Heart Association (AHA) for years 2012 and 2014. 
Results: The comparison between AHA statistical reports of 2012 and 2014 in women showed that the death rate of CVD declined by 4.6%. The most common type of CVD is coronary heart disease (CHD). It's prevalence declined by 12%. From these CHD, myocardial infarction (MI) and heart attack had no change in the prevalence rate. Angina also had the same prevalence rate. Stroke survivors declined by 13.6%. Heart failure (HF) declined by 7.69%. Risk  factors include hypertension, dyslipedemia, smoking, physical inactivity and diabetes. Death rates due to hypertension declined from 56.1% to 55.2%. Cholesterol rates over 200 mg/dL decreased from 46.3% to 43.9%. Smoking rates decreased from 17.5% to 16.7%. Inactivity rates increased from 16.4% to 17.7%. Diabetes rates increased by 1%. 
Conclusions: Reports revealed a decline in the death rates due to CVD in women mainly CHD, stroke and HF while MI and angina had the same prevalence rates. Risk factors like hypertension, smoking and dyslipedemia showed a decline in rates. On the contrary, physical inactivity and diabetes rates increased. Results reveal that essential need for modification of management and prevention plans for CVD in women to reduce the prevalence and death rates are required. 

SMOKING FREQUENCY AND LIFESTYLE IN A GROUP OF NEWBORN MOMS FROM MURES HOSPITALS   Ion Mihai Georgescu Florina Daniela Ruta, Septimiu Voidazan, Amani Diana Barmou Validated View

SMOKING FREQUENCY AND LIFESTYLE IN A GROUP OF NEWBORN MOMS FROM MURES HOSPITALS

First author: Ion Mihai Georgescu

Coordinator(s): Tarcea Monica

Keywords: pregnancy smoking risk factor

Background:

Smoking, as a major risk factor for the health of the pregnant women and her child, is an important matter of public health, influencing the development of the family and community as well.

Objective: To assess attitudes towards active and passive smoking during pregnancy in a group of newborn moms from Tg. Mures obstetrical hospitals wards.
Material and Method: We used in 2013 a crossectional study based on a questionnaire assessing lifestyle and smoking behavior during pregnancy, in a group of 240 women from Mures county, with a mean age of 27.9 years.
Results: In the study group 19% were pre-pregnancy smokers from wich 14.91% had smoked during pregnancy, and 8% were ex-smokers, also more than 20.4% are passive smokers during pregnancy. The risk factors associated with smoking in pregnancy were: 2.62% of them held a restrictive diet in the last months of pregnancy, 43% had consumed at least 3 cups of coffee per day, 2.62% had consumed alcohol weekly, 36.5% have reduced alot their physical activity, 20% had a low intake of dairy and 10.67% have gained 20 kilos during pregnancy.
Conclusions: The protection of the mother and her baby is a priority in healthcare because these population groups are most exposed to environmental risk factors and have an increased susceptibility to diseases. Some behavioral risk factors in pregnancy have to be followed closely by the General Practitioners, Midwife or the ObGyn Specialists in order to avoid complications and to maintain the health of the mother and fetus.

Dimensional profile of personality in alcohol use disorder  Adela Tabacitu (Toma) Alina Beresteanu Validated View

Dimensional profile of personality in alcohol use disorder

First author: Adela Tabacitu (Toma)

Coordinator(s): Nirestean A , Szasz I

Keywords: alcohol use disorder personality Big Five

Background:

The relationship between personality dimensions and alcohol use disorder has always been a fundamental, but insufficiently discussed problem in psychopathology.

Objective:

The purpose of this study is to find correlations between the dimensions of the Big Five model, measured by questionnaire Disposition - Extraversion - Conscientiousness - Agreeabilness - emotional Stability (DECAS) and alcohol use disorder.

Material and Method:

We evaluated  in terms of personality 50 patients admitted to the Psychiatric Clinics I and II, Targu Mures, diagnosed with alcohol use disorder, using the questionnaire DECAS. Data were pooled and processed by statistical methods.

Results:

We found a negative correlation between the dimension of Disposition, Conscientiousness, Agreeabilness and emotional Stability and alcohol use disorder. Despite the results published in the literature, we have not found a significant positive correlation between the dimension of Extraversion and the alcohol use disorder.

Conclusions:

Low Disposition, Conscientiousness, Agreeabilness and emotional Stability, as variants deviated considerably from the statistical norm of the dimensions of Big Five, are a risk factor for alcohol use disorder, and bring another argument to the concept of the premorbid personality in psychopathology. As a result emerges an approach with opening towards complex therapeutic strategies that includes all bio-psycho-socio-cultural concepts.

 

The incidence of dental trauma in adolescent athletes  Mihaela Laura Crisan Marcel Silaghi, Timea Orban, Khaled Abo Salok, Cristina Bica Validated View

The incidence of dental trauma in adolescent athletes

First author: Mihaela Laura Crisan

Coordinator(s): -

Keywords: Adolescent athletes Dental trauma Mouthguard

Background: Following past studies on the incidence of dental trauma in athletes, it was noticed that they do not have enough knowledge regarding the use of mouthguard during sports activities.
Objective: To investigate the incidence of dental trauma in adolescent athletes and their knowledge on the use of mouthguard while practicing sports.
Material and Method: We made 70 questionnaires each comprising 10 questions addressed to the young athletes in the 9th grade at the Sports High School "Szasz Adalbert" of Targu Mures. Data were collected by individual interview with each child. Based on these questionnaires we obtained information concerning their age, the sport they practice, their knowledge on the use of mouthguard and the dental trauma they suffered while practicing sports. We also wanted to know if the trauma they suffered was a dental or a soft tissue trauma, and if, after such trauma, they went to see the dentist.
Results: We found that 51% of the interviewed athletes suffered dental and soft tissue trauma during play and training, the sports they practice most being football and handball. Also, 44% of the atheletes have knowledge of mouthguard , but only a very small number of them (1.4%) use it during the practice of sports. Most of the adolescents who have suffered a dental trauma went to see the dentist after 1 day.
Conclusions: The study results showed that young athletes need more knowledge and education on the prevention of dental trauma to be offered by their coaches and by dentists. The importance of an appropiate facial protection in contact sports should be supported and encouraged both by sports coaches and parents.

The evolution of esophageal cancer between 2008-2013 in Mureș county  Pál Hunor Attila Szőcs, Gyopár Arabella Sikó-Barabási, Ede Duka, Pál Szilvia Validated View

The evolution of esophageal cancer between 2008-2013 in Mureș county

First author: Pál Hunor

Coordinator(s): Demian R F

Keywords: esophageal cancer poor prognostic commoner in men

Background:

The esophageal cancer is the sixth most common cause of cancer death worldwide. 95% of this kind of cancer are adenocarcinoma or SCC (squamous cell carcinoma). Even  if the histology and incidency of adenocarcinoma and SCC is different, many risk factor (smoking, nutrition habits), and the formation process of cancer cells are similar. The esophageal cancer is diagnosed in 90% of cases in anvanced stages. Despite the evolution of diagnostic and therapeutic methods the prognostic is poor, the five year survival is between 10-13%.

Objective:

Our aim was to follow the evolution of esophageal cancer in Mureș county between 2008-2013, following the incidence, distribution by sexes, place of provenance, by group of ages, the six month, one and two year survival.


Material and Method:

We performed a retrospective study on 66 pacients (55 male, 11 female), threated in the Oncology Clinics of Targu Mureș with esophageal cancer, from 2008 to 2013.


Results: The incidence of esophageal cancer is low, between 0.3113-0.8751% of all cancer cases. The highest man/woman ratio was in 2009, 10, and the lowest in 2013, 2. Rural/urban ratio was the highest in 2009, 10, the lowest in 2010, 1,5. The age group with the highest incidence was between 51 and 60, followed by the patients with ages between 61-70. The six month survival was the highest in 2010, 80%, the lowest in 2008, 40%, the one year survival is between 50%, in 2010 and 18,19% in 2009, the two year survival is low, between 26,7%, in 2008 and, 9,09% in 2009. The most frequently used cytostatic drugs in 2012-2013 were carboplatin and cisplatin.
Conclusions: The incidence of esophageal cancer is low, between 0.3113-0.8751%. Is more common in men (83%), and in rural areas (62%). The incidence peaks in the sixth decade.  The two year survival is low, between 26,7% and 9,09%.

The study of Arg399Gln polymorphism of the X-ray repair cross-complementing group 1 (XRCC1) gene in chronic myeloproliferative disorders  Alina Beresteanu Adela Tabacitu (Toma) Validated View

The study of Arg399Gln polymorphism of the X-ray repair cross-complementing group 1 (XRCC1) gene in chronic myeloproliferative disorders

First author: Alina Beresteanu

Coordinator(s): Banescu Claudia

Keywords: Arg399Gln polymorphism gene myeloproliferative disorders

Background: The DNA repair gene XRCC1 is located on chromosome 19q13, and its gene product is implicated in single-strand break repair and base excision repair mechanisms. Single nucleotide polymorphisms (SNPs) in the XRCC1 gene (exon 10, Arg399 Gln, dbSNP no.rs25487) leads to the supposition that variant alleles may diminish repair kinetics, influencing susceptibility to adverse health effects, including cancer.


Objective: The aim of this study is to evaluate the association between XRCC1 Arg399Gln gene polymorphism and myeloproliferative neoplasms risk.

Material and Method: We performed a case-control study. In the case group were included 58 patients with myeloproliferative disorders(polycythemia vera, essential thrombocythemia, primary myelofibrosis) diagnosed in Hematology Clinic 1 Tirgu Mures, and 113 healthy persons. We used PCR-RFLP assay for genotyping.

Results: Data were analyzed using GraphPad (Fisher’s Exact test). Significant association was detected between variant Arg399Gln genotype and incidence of myeloproliferative disorder (P=0.0345; OR= 2.070; 95% CI: 1.088 to 3.937).

Conclusions:

XRCC1 mutation correlate with a genetic transition to malignancy and is implicated in pathogenesis of chronic myeloproliferative disorders.

Sphincter Saving Techniques in Low Anorectal Cancer  Karoly Deak Cosmina Marian Validated View

Sphincter Saving Techniques in Low Anorectal Cancer

First author: Karoly Deak

Coordinator(s): Molnar C , Russu C P

Keywords: sphincter saving procedure low anorectal cancer oncological

Background:

Regarding the surgical treatment of low anorectal cancer one theme of debate was if sphincter saving procedures are the appropriate choice in terms of oncological radicality, the rate of local complications and functional results achieved.

Objective:

Our aim was to compare sphincter saving procedures with other surgical techniques used for the treatment of low anorectal cancer.

Material and Method:

We made a retrospective study on 320 patients (N=320) treated in the Surgery I Clinic of the Targu Mures Emergency Clinical County Hospital, from 2004 to 2013, for low anorectal cancer. We have studied the postoperative results and complications after sphincter saving procedures made for low anorectal cancer (very low Dixon anterior rectal resection; low rectal resection with peranal anastomosis) and compared them with those after other surgical procedures involving a colostomy (Milles’s abdomino-perineal rectal amputation; Hartmann’s procedure).

Results: Over a 10 years period we reviewed a number of 320 cases of patients treated for low anorectal cancer. To 35% of them a sphincter saving procedure was used (a very low Dixon resection in 22.18% and low rectal resection with peranal anastomosis in 12.82% of cases) and to 58.44% a surgical procedures involving a colostomy was performed (in 51.26% the Milles rectal amputation and for 7.18% the Hartmann’s procedure). A number of 21 (6.56%) cases were inoperable. After sphincter saving techniques a rate of 19.64% of immediate postoperative complications was found.
Conclusions: Surgical techniques of sphincter preservation represent viable alternatives to operations that make the patient a permanent bearer of a colostomy, if thorough oncological principles are respected and a rigorous selection of cases is made. The technological progress of medical devices, in recent years also come to facilitate these conservative techniques, for the benefit of the patients.

REFLEXOTHERAPY: A MASSAGE WHICH CAN FUNCTION AS A TREATMENT  Iulia Niculoiu Raisa Petrovici Validated View

REFLEXOTHERAPY: A MASSAGE WHICH CAN FUNCTION AS A TREATMENT

First author: Iulia Niculoiu

Coordinator(s): Nicoleta Todoran

Keywords: reflexotherapy, foot therapy, predefined pressure points

Background:

The increasing popularity of alternative treatments demands a serious debate about scientific documentation, efficacy and safety. Different methods of treatment, referred to as alternative treatments, are used by millions of patients every day. Reflexology is one of these treatments.

Objective:

This article is intended to illustrate reflexotherapy as an example of complementary or alternative therapy.

Material and Method:

Documentary study.

Results: Our documentation revealed that reflexology is based on the idea that human body is a holistic system, and if you disturb the balance in any of the parts, it is immediately displayed on the rest. It has been shown that applying pressure on specific areas of the body during a massage helps to improve the function of organs or helps to reduce pain. This kind of therapy can be applied to all ages, it has no toxicity like many of the allopathic drugs, the recovery is fast and the patients do not have to take pills at a certain hour or day. 
Conclusions:

We are living in a world which is constantly progressing and our resistance to drugs is lower so we have to take several pills for one disease. We try to reduce the stress, to be more relaxed but for these we have no pills. So why not try a massage which is functioning as a treatment too?

Development of silver complexes with fluoroquinolones  Gabriel-Cosmin Popescu Robert-Alexandru Vlad Validated View

Development of silver complexes with fluoroquinolones

First author: Gabriel-Cosmin Popescu

Coordinator(s): Rusu Aura

Keywords: fluoroquinolones silver silver complexes complexation

Background:

Fluoroquinolones (FQs) are a class of synthetic antibiotics, with a structure based on the model of nalidixic acid. The fluorine atom at position 6 and the piperazine substituent at position 7 enhanced the spectrum of activity and improved pharmacokinetics parameters. The 4-oxo and 3-carboxyl groups confer FQs excellent chelatation properties with metallic ions. The silver ions and silver-based compounds are known to be toxic to microorganisms through a strong biocide effect. Some silver complexes of FQs have been already obtained and studied for increased antibacterial and antifungal activity.

Objective:

The aim of this paper is to summarize the existing data regarding the silver complexes of FQs in terms of synthesis method, physico-chemical properties, biological effects, and new directions for development.

Material and Method:

Although the synthesis methods of the silver complexes of FQs are relative simple, the real challenge is to determine precisely the chemical structure of the obtained complexes and their phisico-chemical properties. Finally their biological activities and potential as safe active substances arethe next level in the research work.

Results:

Nowadays, there are several study directions regarding the complexation of FQs with silver. The characterization of this type of complexes is still a challenge for many scientists. Their antimicrobial and antifungal activities are promising; therefore trials are being conducted regarding bioavailability and further formulation of new pharmaceutical products. Silver complexes of FQs ought to be examined in term of potential drug resistance; as there are chances that those bacteria that are insensitive to pure FQs might be sensitive to silver complexes of FQs. 

Conclusions: It has been noticed that the bacteria have developed resistance towards a numerous number of active substances; therefore the need for new active antibiotics is greater than ever. Viewing the current situation, silver complexes of FQs may prove to be useful in the future

Study regarding the lifestyle and eating habits as cardiovascular risk factors for coronary patients from the Cardiology Clinic II Adults.  Luminita Boros (Huza) Validated View

Study regarding the lifestyle and eating habits as cardiovascular risk factors for coronary patients from the Cardiology Clinic II Adults.

First author: Luminita Boros (Huza)

Coordinator(s): Farcas Dan

Keywords: lifestyle risk factors coronary disease diet

Background: The identification of the main risk factors related to the coronary patients’ diet can be the starting point for the conception of an educational plan regarding nutrition for these patients.
Objective: The given study makes an evaluation of the lifestyle and eating habits, in connection with other personal data, as risk factors in the occurrence and development of coronary disease, on patients hospitalized in the Cardiology Clinic II Adults, IUBCVT Targu-Mures.
Material and Method: We have investigated a group of patients hospitalized during October, 2013 - March, 2014, diagnosed with Coronary Cardiopathy, by answering a questionnaire asking for personal information, lifestyle and diet, anthropometric data, laboratory analysis. 
Results: The study group comprises 40 patients, ages between 43 and 82, out of which: 14 are women and 26 men. 87,5% have a medium level of education; 95% have low/average income. Regarding lifestyle: 62,5% are smokers or former smokers, 77,5% are sedentary or with little physical activity, 77,5% have average/high level of stress. The diet analysis reflects a high consumption of: refined cereals (52,5%), fatty meat and sausage (57,5%), other animal fats (95%), refined vegetable oils (65%), low intake of: vegetable (55%) and fruit (45%), legume (47,5%), oleaginous (62,5%), fish (60%). In conformity with the anthropometric data, 82,5% have the BMI>25, being overweight or obese, 92,5% have the abdominal circumference over the normal limit. All patients are dyslipidaemic under treatment, 70% have high blood pressure, 27,5% have type II diabetes or altered tolerance to carbohydrates. 
Conclusions: The outcome suggests the fact that low income and low level of formal education, as well as smoking, increase the risk of coronary disease occurrence, together with a high-calorie diet, rich in animal fats, little intake of fruits and vegetables, by facilitating the development of dyslipidemia and obesity. 

Evaluation of craniocerebral traumatisms treated at the Mures County Emergency Hospital between 2008-2012  Ede Duka Pál Hunor, Attila Szőcs, Eva Joo, Izabella Paula Peter Validated View

Evaluation of craniocerebral traumatisms treated at the Mures County Emergency Hospital between 2008-2012

First author: Ede Duka

Coordinator(s): Madaras A

Keywords: Craniocerebral trauma evaluation hematoma politrauma

Background: „Injuries to the brain are among the most likely to result in death and permanent disability.”(IBIA)
Caracteristics: trauma to the head, alteration in consciousness,need for emergency care, secondary injuries and posttraumatic disorders.

Objective: Etiological evaluation.
Distribution of TBI occurrence by gender, age groups, enviroment.
Vascular involvement.
Predisposing factors.
Mortality ratio and complications.
To create a baseline statistical evaluation for further studies.
Material and Method: Retrospective study on 1496 patients (1201 male, 295 female) hospitalized with the diagnosis of CCT at the Department of Neurosurgery of Mures County Emergency Hospital btw. 01.01.2008-31.12.2012.
GraphPad,MedCalc,Excel
Results: Predominance of male patients: 80,28%.
Age, 50-70 age groups, CDC database scale shows higher occurrence rate at the working class between the ages 27-59 years 40,97%.
Urban areas 57,7%; population density and workplace diversity offer a larger etiology.
Four major groups: falls 61,7%, accidents 15,57%, traffic accidents 16,78% and agression 5,95%. In the case of falls 41,17% of the cases occur from the same level.
In 61,95% of the cases we found hematomas and hemorrhages. Most common: SDH 29,41%,SAH 12,09%,IV & IC hem. 11,64% EDH 8,82%.
Predisposing factors: Age, Epilepsy 9,16%, Chronic alcoholism 16,71%.
Mortality : 13,03%.
38% of the cases were high risk scenarios, who underwent surgery: GCS<8, severe head trauma, CT scans showing severe abnormalities. 53,76% of them survived (RR=1.3677; P<0.0001); Polytrauma and Chronic alcoholism were among the
strongest factors in the decease ratio of high risk patients.
Conclusions: TBI afflicts in higher percentage men.
Age category of 50-70 years of age, and mostly in the working class
Predominance of Falls and Accident
High percentage of vascular involvement – any trauma strong enough to cause a fracture will most likely cause hemorrhage.
Patients with CCT have a moderately high level of mortality.
With the help of CT,  surgical intervention can increase the rate of survival.
Alcohol abuse and epilepsy along with age are the main predisposing factors.
Postoperative death is mainly caused by: Politrauma: heart,lungs; Chronic alcoholism.

Cost efficiency in HIV/AIDS treatment  Júlia Magyar Reka Gyero Validated View

Cost efficiency in HIV/AIDS treatment

First author: Júlia Magyar

Coordinator(s): Kézdi–Zaharia E. Iringó

Keywords: HIV TB co-infection Cost Treatment

Background: HIV is a lentivirus that causes the  AIDS, a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive. The treatment of these disease is a huge problem worldwide. The cost is very high, and it grows bigger as the disease evolves.TB is a major cause of death among people living with HIV/AIDS, whose impaired immune system make them particulary vulnerable to the devastating effect of TB. 
Objective: The purpose of this study is to find out if there are differences in the cost of the treatment of patients with HIV/AIDS and HIV seropositive patients co-infected with TB.
Material and Method: A retrospective study was performed which included all the  HIV seropositive patients admitted in Infectious Disease Hospital nr.1  between 01.01.2013-31.12.2013. The patients were divided in two groups:HIV seropositiv patients with TB co-infection an without TB co-infection.
Results:  During the studied period 24 HIV seropositive patients with TB co-infection were admitted. 5 of this patients were readmitted more then 4 times (a total of  45 admissions). 196 patient without  TB co-infection were admitted. We chosed randomly 24 patients from this group. TB co-infected patients spent in hospital a total of 467 days, in average 19 days and the cost of the treatment was 250709 ron, in average 1044,23ron. Patients without TB co-infection were in hospital a total of 273 days, 11 in average, and the treatment cost was 150774, in average 6282,25 ron.
Conclusions:

The treatment of  HIV/AIDS patients without TB co-infection is 35% cheaper and they spent 42% less days in the hospital. We can reduce the cost of the treatment by preventing TB infection. 

The contribution of ligasure devices in colorectal surgery  Andrada Blaj (Sîngeorzan) Alina Parfene (Arghira) Validated View

The contribution of ligasure devices in colorectal surgery

First author: Andrada Blaj (Sîngeorzan)

Coordinator(s): Molnar C , Russu C

Keywords: colorectal cancer LigaSure „no ligatures” resections

Background:

The colorectal cancer represents a worldwide health issue, with an increasing tendency in incidence. In the complex treatment of the colorectal cancer, the surgical resection represents the main step, without which, the hope for a cure is not possible. The progress of the medical devices industry comes to support both the surgeons but mainly the patients by adding to the surgical arsenal of the sealing-cutting devices LigaSure type.

Objective:

This study’s objective was to highlight the advantages of LigaSure devices usage in colorectal surgery.

Material and Method: We made a retrospective, randomized study, which included a number of 440 patients treated for colorectal cancer, between 2010 and 2013, in Surgery I Clinic of the Targu Mures Emergency Clinical County Hospital. The positive effects of using LigaSure devices in the ablative surgery of the colorectal cancer, to realize the tumor resection and an extended lymphadenectomy, were followed.
Results: Out of the total number of patients, 12,06% were treated for right colon cancer, for 17,28% the localization was in the transvers colon, 2,95% to the left colon, in 63,4% of the cases, the tumor was localized in rectum, and in 4,31% into the anal channel.  The LigaSure usage benefits, represented by: the shortening of the surgical time, reduced intraoperative blood losses, reduced post operatory complications, through the ’’no ligatures’’ resection, and using of more ’’airy’’ surgical kits, were analyzed.
Conclusions:

The efficiency of LigaSure devices usage in the surgical treatment of the colorectal cancer makes possible a resection and an extended lymphadenectomy without ligatures, in safe conditions and in shorter surgical time.

The relationship between kindergartners’ and the nutrition act in the educational environment  Andreea Daiana Muresan Validated View

The relationship between kindergartners’ and the nutrition act in the educational environment

First author: Andreea Daiana Muresan

Coordinator(s): Pașca Maria Dorina

Keywords: kindergartners’ educational environment nutrition

Background:

The kindergartners’ diet has to be varied and plentiful, no matter where the nutritional act takes place, at home or at the kindergarten. At this age children are very active and therefore need a diet that is rich not only in nutrients but in energy as well.

Objective:

Investigating kindergartners’ nutrition in the educational environment. Evaluating kindergartener’s nutrition in the educational environment from the parents’ point of view.

Material and Method:

The study population was comprised of 50 parents of children between the ages of 3 and 6, that are attending kindergarten with an extended schedule.

Data was collected by means of conversation and questionnaire filling. The questionnaire focuses on details of the daily menu plan, the children’s nutritional behavior and the quality and quantity of the vitamins and macronutrients in the children’s diet.

Results:

According to the parents’ answers, almost all of them (84%) are content with their children being offered a meal by the kindergarten and also by the quality of the food provided there. Most of them (66%) do not wish to change this situation, because they have observed positive changes in the nutritional behavior of their children during the time spent in kindergarten they feed themselves, they enjoy eating together with other people and are more orderly in their eating habits.

It has been observed that some parents (48%) are knowledgeable about the quality and quantity of vitamins and macronutrients in food while others. 48% are not. The parents were not involved on establishing the daily menu served by the kindergarten, and have been informed about it only on their request. Some parents (18%) want to introduce some changes in their children’s diets, consisting of increasing their intake of fiber from fruits and vegetables.

Conclusions: There is a lack of nutritionist in the preschool educational environment that needs to be addressed.

Study of physiotherapy recovery methods in operated patients with total injuries of the Achilles tendon  Alecsandra Cristina Matei Alexandra Lavinia Turc Validated View

Study of physiotherapy recovery methods in operated patients with total injuries of the Achilles tendon

First author: Alecsandra Cristina Matei

Coordinator(s): Neagu N

Keywords: tendon kinetic achilles mobility

Background: Achilles tendon represents the strongest tendinous structure of the human body. Even though, it can be bend to direct or indirect traumas, their effect being the rupture at different levels.
Objective: The aim of this study is to demonstrate the balneophysiotherapy recovery methods in patients with total rupture of the Achilles tendon, which suffered a reconstruction surgery of the structure.
Material and Method: For realizing this paper, I have included into study a number of 16 patients taken on record in Department of Orthopaedic and Trauma Surgery and in Department of Plastic and Reconstructive Surgery from the Mures County Emergency Clinical Hospital, during January 2010 – February 2014. The 16 patient were separated in two groups, Group A and Group B, by the levels of Achilles tendon criteria. Group A was formed from 8 patients with the tendon injury at the musculotendinous junction, and Group B from another 8 patients, with the tendon injury at the calcaneal insertion. All the patients suffered surgical interventions for tenorrhaphy of the Achilles tendon, with postoperative immobilization in flexion position for the first 6 weeks, and a 90° talocrural joint immobilization in the next period of time. After the gypsum removal, the patients received a balneophysiotherapy and kinetotherapy treatment for the mobility and muscle strength recovery at the injury level.
Results: After the balneary and kinetics treatment, we observed extremely positive results in 12 out of 16 patients, 7 patient from Group A and 5 patients from Group B, their mobility being recovered 90-100%. In 4 patients, 1 from Group A and 3 from Group B, we noticed difficulties in joint movement and muscle strength exercises.
Conclusions: In Achilles tendon injuries at different levels, the reconstructive surgery of the structure is important, but balneophysiokinetotherapy is the most responsible for the restoration of function and mobility of the segment.

Anomalous Pulmonary Venous Return  Andrei-Marian Feier Marta Ostopovici, Denisa Pop, Miriam Ciobanu- Huma, Pavel Bujorean Validated View

Anomalous Pulmonary Venous Return

First author: Andrei-Marian Feier

Coordinator(s): Suciu H , Stroe V

Keywords: APVR congenital cardiac anomaly pulmonary veins drainage in right atrium

Background:  Total anomalous pulmonary venous return(TAPVR) is a rare congenital cardiac malformation in which pulmonary venis drain into the right atrium. The anomaly forms are classified in four groups, depending upon the abnormal connections to the systemic veins : supracardiac, infracardiac, cardiac and mixed. Partial anomalous pulmonary venous return(PAPVR) is a condition in which not all the pulmonary veins drain into the left atrium. The incidence of APVR is 1-2% of cardiac congenital anomalies and there is no sex difference in frequency observed in our study. Newborns with TAPVR are usually cyanotic with cariac insufficiency and also atrial septal defect is associated.


Objective:   The purpose of this study is to evaluate the surgical and post-operative management of total and partial anomalous pulmonary venous return at Institutul de Urgenta pentru Boli Cardio-Vasculare si Transplant Tirgu-Mures.

Material and Method:   This retrospective study describes our experience with APVR based on 24 patients, 16 male and 8 female,aged between 2 days and 18 years, who underwent surgical treatment between 2011-2014. 9 patients were presenting supracardiac TAPVR, 2 infracardiac and 5 cases of cardiac type. 8 patients presented PAPVR.

Results:   The surgical management for the TAPVR patients consisted in all cases in the ligation of the vertical (innominate) vein and connection of the common pulmonary veins collector to the posterior aspect of the left atrium. In PAPVR the anomalous pulmonary vein is redirected and connected to the left atrium. The atrial septal defect was present in all TAPVR cases and in 7 cases (87,5%) of PAPVR. The ASD was corrected using heterologous pericardial patch.

Conclusions:   In the past several years there has been a significantly increase in the surgical treatment of APVR, showing great results with low mortality rate. Further clinical studies are needed to evaulate the post-operative status in patients that underwent surgical APVR repair.

Gallbladder disorders in colorectal cancer  Costel Coroiu Ioachim Iustinian Simion, Adelina Macec, Alina-Olimpia Goidescu, Razvan Ion Validated View

Gallbladder disorders in colorectal cancer

First author: Costel Coroiu

Coordinator(s): Molnar C

Keywords: colorectal cancer cholecystectomy cholelithiasis correlation

Background: Colorectal cancer is a disease that affects increasingly more people and is the second cause of death after lung cancer for male and the third cause of death for female, after breast cancer and cervical cancer. Besides inherited conditions, age, radiation or food habits, there are associated factors such as cholecystectomy or cholelithiasis which can increase the risk of developing colorectal cancer. Objective: The purpose of our study is to observe and demonstrate if patients with cholelithiasis or cholecystectomy in their past have an increased risk to develop colorectal cancer. Material and Method: We performed a retrospective study of 942 patients with colorectal cancer, hospitalized in Surgery Clinic I of Targu Mures County Hospital between 2003 and 2013, aged between 24 and 89. Results: In this group 6.05% developed cecum cancer, 5.84% ascending colon cancer, 14.76% transverse colon cancer (including the right and the left colic flexure), 3.93% descending colon cancer, 18.68 sigmoid cancer, 17.30% recto-sigmoid cancer and 33.44% rectum cancer. From this group a percentage of patients had gallbladder disorders: a part of them had cholecystectomy and a part had gallstones at the moment of the diagnosis. Conclusions: In our group there is a meaning percentage of patients with gallstones and cholecystectomy which can emphasize that colorectal cancer is more frequently to patients that had been suffering of different forms of gallbladder disorders. 

A Neoteric approach to the classical management of multiple tubal ectopic pregnancy  Vera Catarina Barnabe Marcus Jee Poh Hock, Ong Wee Liam, Daniel Mejia, Kaisser Gallaby Validated View

A Neoteric approach to the classical management of multiple tubal ectopic pregnancy

First author: Vera Catarina Barnabe

Coordinator(s): Blidaru Iolanda , David Cristina

Keywords: multiple ectopic pregnacies MTX fertility salpingectomy/salpingostomy

Background: Unlike the past, Today we have the ability to detect and diagnose an ectopic pregnancy using early multi modal methods. However the classical management negates the patient of any other normal pregnancy. The classical Treatment for tubal ectopic pregnancy are salpingectomy or salpingostomy, either performed laparoscopically or by open surgery. Objective: Our research analyses a new and unusual approach of the management in Romania of multiple tubal ectopic pregnancies applied by the physicians of Cuza Voda Hospital Iasi. This new approach gives a chance to hopeful young patients especially, to have a successful future pregnancy prior to surgical treatment for the ectopic pregnancy.
Material and Method: Our approach utilizes a scoring system also known as the Fernandez index to grade the severity of the ectopic case followed by a medical treatment of methotraxate transvaginally injected at the site of implantation assisted with ultrasonography or by intramuscular route. 
Results: We analysed 143 data from our patients in Cuza Voda Hospital, and found a better success rate in managing multiple ectopic pregnancies, comparing to the classical salpingectomy and salpingotomy. complete elimination of the ectopic pregnancy and a decline of serum hCG to undetectable levels. 
Conclusions: After interpreting the data from our results, we conclude that management with MTX holds a better success rate thus allowing the patients to salvage their Fallopian tube allowing future pregnancies, ectopic it maybe, but it provides a better quality of life for the patient knowing that they still have a chance to have a normal pregnancy.

The food pyramid of medical students  Alina-Georgiana Corduneanu Aurelia Alexandra Tarca, Ioan Serban Fanfaret, Roxana-Mihaela Corduneanu, Dora-Ildiko Suba Validated View

The food pyramid of medical students

First author: Alina-Georgiana Corduneanu

Coordinator(s): Pop Raluca , Sipos R

Keywords: food frequency questionnaire food pyramid physical activity

Background: Diet evaluation should be a part of general medical assesment and tailored recommendandations should be provided. Objective: The evaluation of the food pyramid of medical students. Material and Method:

Type of study –cross-sectional; target population – medical students;sample-76 students divided in two groups from the first(45 subjects) and fourth year (31 students) of General Medicine at UMF Tg.Mures. Method – self administered food frequency questionnaire developed based on the NHANES III and adapted to local dietary habits. Variables analyzed: age, sex, environment, study year, body mass index, waist, number of meals, physical activity frequency, and food pyramid.

Results:

54.83% of fourth year students and 46.67% of first year students do not engage in regular physical activity. None of the subjects have a normal food pyramid. When comparing the food pyramid of the 2 groups, we found that first year students consume higher number of portions from all food groups, significant for fruits and vegetables (7.18 vs. 5.18 portions/day, p=0.006) on average, and have a higher chance of normal fruits and vegetables portions consumption (RR=0.49, 95% CI – 0.28-0.86, p=0.01). 59.21% of all subjects consume the recommended number of portions of fruits and vegetables and only 18.42% do not exceed the recommendations for concentrated sweets and fat.

Conclusions:

Medical students tend to consume higher amouts than the recommended number of portions of all food groups and do not engage in regular physical activity. A nutritional evaluation should be performed at the start of each school year with individualised diet recommendations.

VARIANTS OF ANTIBIOTHERAPY USED IN PRACTICAL DENTISTRY  Veronica Grozescu Adriana Chifor, Adrian Muica, Diana Pop Validated View

VARIANTS OF ANTIBIOTHERAPY USED IN PRACTICAL DENTISTRY

First author: Veronica Grozescu

Coordinator(s): Tudor Bianca , Molnar-Varlam Cristina

Keywords: antibiotics resistance antibiogram prescription

Background: Antibiotics have played an important role in the treatment of bacterial infections of dental diseases but they also have negative influences due to inappropriate prescription or overdoses. This may cause resistance to the human body, as several bacteria have developed resistance to a large scale of antibiotics. The issue is not using antibiotics, as they showed up to be a great help in treating different types of diseases, but their usage. 
Objective: The purpose of this study was to assess the current use of antibiotics in dentistry.
Material and Method: 100 dental practitioners from Targu-Mures were asked to complete a self-made questionnaire regarded to antibiotic prescription and proper usage of antibiotics. Only 70 completed the questionnaire, others refused. 
Results: Due to this survey we have found out that the most prescribed antibiotic was based on a preparation of amoxicillin and clavulanic acid, as practitioner’s first choice. Their second choice was based on a derivate of lincomycin. Monthly prescriptions were reported as: only 14% write over 15-20 antibiotic prescriptions per month, 29% reported an average between 5-15 prescriptions and other 55% say they have an average of 1-5 antibiotic prescriptions per month. The antibiogram used before prescribing was considered by 44,6% of the practitioners unnecessary and 55,4% reported as important. Out of the 55,4% only 12% collect samples from periodontal infections. Others do not collect samples as they say they do not have the needed equipment for this process. 
Conclusions: It has been noticed that more than 50% of dental practitioners are aware of the usage of antibiotics but prescribe them without having a secure result of the antibiogram that may cause resistance of the bacteria in the human body. There has been also a discrepancy towards the usage of antibiotics in different diseases. Many practitioners prescribe antibiotics for minor causes which may not need it.

The impact of anorexia on the self-esteem of teenage high school girls  Andreea Madalina Todea Validated View

The impact of anorexia on the self-esteem of teenage high school girls

First author: Andreea Madalina Todea

Coordinator(s): Pasca Maria Dorina

Keywords: anorexia self-esteem teenegers nutritional disorders

Background: Nutritional disorders are afflictions characterized by changes in the nutritional behavior that have serious physical and psychological consequences. Anorexia is one such a disease that causes havoc among teenagers.
Objective:

Investigating the impact of anorexia on the self-esteem of teenage high school girls and assessing the risk of developing the condition.

Material and Method:

The study population consisted of 80 adolescent girls with ages between 15-18 years, going to the most prominent high schools in Tirgu Mures. Data was collected using a questionnaire, the Rosenberg scale and the conversation method. The questions in the questionnaire were meant to evaluate the risk of developing anorexia, while the Rosenberg scale measured the girls’ view of their self-image, self-esteem and confidence.

Results:

Among the 80 girls included in the study, 50 (62.5%) have a high risk of developing anorexia, while the other 30 (37.5%) show a low risk of developing the condition. Most (60%) of the subjects possess a very low self-esteem.

It has been observed that teenagers follow very strict diets, poor in nutrients, that are often combined with physical exercise, occasional purging by self-induced vomiting and/or laxative or diuretic abuse, with the purpose to lose weight.

Conclusions: The study shows that the teenagers that suffer from anorexia have precarious self-esteem and display a number of nutritional deficiencies.

Postoperative anastomotic fistulas in colorectal cancer  Alina Parfene (Arghira) Andrada Blaj (Sîngeorzan) Validated View

Postoperative anastomotic fistulas in colorectal cancer

First author: Alina Parfene (Arghira)

Coordinator(s): Molnar C , Russu C

Keywords: colorectal cancer anastomotic fistulas biologic status

Background: Colorectal cancer represents an important medical and social issue due to its high incidence and associated mortality. The most important step in treating this disease is the surgical treatment accompanied by additional oncologic treatment. Cause of the poor biologic status of these patients, the colorectal surgery for cancer can be associated with high rate of postoperative complications.
Objective:

The aim of this study is to identify associated factors that can be related with the apparition of the postoperative anastomotic fistula after colorectal cancer treatment.

Material and Method: We made a randomized, retrospective study on a number of  1005 patients that have underwent a resection, for colorectal cancer,followed by an anastomosis, between the years 2003 and 2013, in the Surgery I Clinic of the Targu Mures Emergency Clinical Country Hospital. The rate of postoperative anastomotic fistulas has been studied in relation with the biological status of the patients and the localization of the tumor.
Results: From the total of 1005 patients, in 5,67% the tumor was located in the cecum,5,47% in ascending colon,13,83% in transvers colon,3,68%  in the descending colon,17,52% in the sigmoid colon,16,22% was located at the rectosigmoid junction,31,34% was rectal cancer and 6,27% anal cancer. The postoperative anastomotic fistulas had a higher rate after the rectal resection and even higher after emergency procedures.
Conclusions: The colorectal surgery for cancer, due to the poor biological status of those patients, often having a locally advanced tumor, is associated with a high percentage of anastomotic fistulas, mainly in cases operated under emergency condition. A preoperative preparation, if possible, could be attempted in order to decrease the number of postoperative complications.

"OFF-LABEL" MEDICATION USE IN ENDOCRINOLOGY AND PEDIATRICS II CLINICS FROM TIRGU MURES  Brigitta Pager Alexandru Stoica, Dora-Ildiko Suba Validated View

"OFF-LABEL" MEDICATION USE IN ENDOCRINOLOGY AND PEDIATRICS II CLINICS FROM TIRGU MURES

First author: Brigitta Pager

Coordinator(s): Vari C

Keywords: “off-label medication” “efficacy” “safety”

Background: "Off-label" medication represents using drugs based on clinical experience with recommendations not included in the MA (Market Authorization) and without the support of phase III trials.
Objective: Prescribing "off-label" medication could be very efficient sometimes, but imposes conscious risk taking by the prescriber..
Material and Method:

We analyzed clinical records from the Endocrinology and Pediatrics II Clinics from Tirgu Mures over the years 2011-2013. The "off-label" uses of Metformin in polycystic ovary syndrome (PCOS) and of fluoroquinolones on pediatric patients were searched.  and unlicensed medication in pediatric use.

Results: The risk-benefit balance was analyzed in terms of efficacy versus safety to the above mentioned medications for use without the MA. 23,25% (30 of 129 cases) of PCOS patients were treated with Metformin in mono-therapy or associated with antiandrogenic drugs. Fluoroquinolones were used in pediatric patients only in imperative situations (0,79%, 56 from 7074 searched cases), in infections with bacteria resistant to other antibiotics.
Conclusions: The risk-benefit balance was analyzed in terms of efficacy versus safety to the above mentioned medications for use without the MA. 23,25% (30 of 129 cases) of PCOS patients were treated with Metformin in mono-therapy or associated with antiandrogenic drugs. Fluoroquinolones were used in pediatric patients only in imperative situations (0,79%, 56 from 7074 searched cases), in infections with bacteria resistant to other antibiotics.

Experimental studies for electrochemical and enzymatic detection of biological active sulfur compounds  Niculina Dragomir Ligia Chelmea Validated View

Experimental studies for electrochemical and enzymatic detection of biological active sulfur compounds

First author: Niculina Dragomir

Coordinator(s): Badea Mihaela , Moga M

Keywords: cysteine thiourea electrochemical methods enzymatic techniques

Background: Sulfur presence in the molecules of the organic-compounds imprints them different properties, depending on the function where this is found. Those properties can be used in biochemical analysis and detection of sulfur-compounds in laboratories.
Objective: This work has proposed to prove the infliction of the electrochemical methods and spectral analysis in enzymatic catalysis (in the presence of the peroxidase) for the analysis of the different behaviours of some sulfur-compounds.
Material and Method: It has been studied and optimized electrochemical analysis methods for cysteine and thiourea using screen-printed electrodes. It has been analyzed the enzymatic kinetics of the system peroxidase - oxygenated water - 3, 3’-diaminobenzidine in the presence of different concentrations of the sulfur compounds.
Results: The results have shown different possibilities of detection for the studied compounds and this fact offers an advantage for their detection in real testing. Following these enzymatic kinetics studies it has been observed the activating behaviour of the peroxidase in the presence of cysteine, and the inhibitor behaviour in the presence of the thiourea.
Conclusions: The realized studies allow the determination of the studied compounds from standard watery testing and indicate the fact that they can be successfully applied in subsequent analysis of real testing. These studies bring supplementary dates of differential action mechanisms of sulfur compounds in enzymatic peroxidase systems.

Association study of ATG16L1 gene polymorphism with osteopenia and osteoporosis  Radu Anghel Popp Marius Florin Farcas Validated View

Association study of ATG16L1 gene polymorphism with osteopenia and osteoporosis

First author: Radu Anghel Popp

Coordinator(s): Pop I V

Keywords: osteoporosis osteopenia polymorphism fracture

Background: Osteoporosis and osteopenia represent a public health problem which will continue to rise as population ages. Autophagy is one of the possible mechanisms which might influence bone mineral density and total bone mass. Autophagy is a process which plays a critical role in the cell's defense against various stress stimuli and failure of this mechanism in osteocytes might explain their increased death rate with age, eventually leading to osteopenia and osteoporosis.
Objective:

The purpose of this study was to investigate the role of a polymorphism in the autophagy related ATG16L1 gene with regard to osteoporosis and osteopenia in population groups from Romania.

Material and Method:

By means of molecular genetics techniques, respectively PCR-RFLP (Polymerase Chain Reaction - Restriction Fragment Length Polymorphism) we analyzed the genotype and allelic distribution of a polymorphism, rs2241880 in the ATG16L1 autophagy related gene, in three population groups. Each group consisted of 55 individuals and by means of bone densitometry they were classified as following: a control group with healthy individuals, a group composed of osteoporotic individuals and a group composed of osteopenic individuals. Statistical analysis was performed for two separate models, dominant and recessive, using Fisher's exact test.

Results:

We obtained an allelic frequency for the risk wild type allele of the ATG16L1 rs2241880 polymorphism of: 45.5% in the control group, 56.4% in the osteopenic group and 52.7% in the osteoporotic group. We obtained no statistically significant differences between the study group when comparing the genotypes distribution in either analysis model.

Conclusions:

Our work represents the first case-control study between allelic variants of the ATG16L1 gene and osteoporosis and osteopenia. We found no statistically significant difference between the study groups, hence the rs2241880 polymorphism is not a genetic risk factor for low mineral density in our population.

Clinical studies on molar incisor hypomineralisation  Timea Orban Mihaela Laura Crisan Validated View

Clinical studies on molar incisor hypomineralisation

First author: Timea Orban

Coordinator(s): Bica Cristina

Keywords: MH MIH HSI

Background: Hypomineralisation is a qualitative defect of 1-4 first permanent molars with or without the affection of permanent incisors. MH is the molar hypomineralisation, in this case there are no affected incisors. MIH is the molar incisor hypomineralisation, in this case there are at least one affected first permanent molar and one affected permanent incisor. Objective: The aim is to examine 261 children with or without hypomineralisation in order to develop the hypomineralisation severity index (HSI). An other objective is to clarify aetiological factors.  Material and Method: There were examinated with visual criteries 261 children between 9-11 years, 63 of them showed signs of hypomineralisation ( prevalence of 24,1%). There were 9 children with MH and 12 with MIH. The parents completed a questionnaire describing their perinatal and medical histories. 

An index of hypomineralisation severity was computed, based on the extension of the affection on dental surfaces.
Results: Some medical conditions affect the mineralisation of the first permanent molars and permanent incisors ( antibiotic use, fevers, ear infections, tonsillitis, asthma, infections and illnesses during pregnancy, birth prematurity, birth complications etc.). One or more conditions were collated with hypomineralisation at 57 children of 63, this means 90,47%. 
In MH in 77,77% there were only one affected first permanent molars, and in MIH in 75% there were affected all four first permanent molars. 
Conclusions: The first conclusion is that hypomineralisation severity index of MH is allways lower than hypomineralisation severity index of MIH, this means MIH is a more severe form of hypomineralisation than MH. An other conclusion is that some medical conditions can affect the mineralisation of the enamel. 

Evolutive particularities of cardiovascular disorders in children with Marfan syndrome  Adriana Craciun Aurica Creta, Iulia Laura Gavrilă, Armina Mihanos (Grama) Validated View

Evolutive particularities of cardiovascular disorders in children with Marfan syndrome

First author: Adriana Craciun

Coordinator(s): Fagarasan Amalia

Keywords: Marfan syndrome follow-up mitral regurgitation aortic disease

Background:   Many clinicians view the Marfan syndrome in term of classical  cardiovascular, ocular and musculoskeletal abnormalities. Aortic root disease, leading to aneurysmal dilatation, aortic regurgitation and dissection, is the main cause of morbidity and mortality in MFS. Mitral valve prolapse is frequently identified in patients with MFS. However only one point in the systemic score is assigned for MVP. Objective: The aim of this study is to show a follow-up image of the cardiovascular disorder in children with Marfan syndrome. Material and Method: We conducted a retrospective study at the Pediatric Cardiology Clinic from Targu-Mures in the period 2003-2013. We had a total of 15 patients with MFS (all of them presenting MVP and mitral regurgitation ) and a control group comprising 15 patients with chronic MR and MVP without any other pathologies associated. Studied parameters were: age, sex, area, family history, the clinical and echocardiographic status at the moment of diagnosis, periodic controls,  the occurence of arrythmias, the efficiency of the treatment, the need of surgical interventions. Results: MFS was found to be more common in females (73.34%) from the rural area (60%). 53.33% of the children showed a family history of MFS.  At the moment of diagnosis 73.33% of the patients had an aortic root dilatation  and  40% had medium MR. 80% of the patients with medium MR  at initial diagnosis suffered mitral valve replacement surgery whereas only 12.5% of patients who had initial minor MR suffered a surgical treatment. In what concerns the  control group: 60% had initial medium MR and only 55% suffered surgery treatment in time. Conclusions: Life expectancy in Marfan syndrome is quite reduced but the early diagnosis and the improvement of the treatment, especially the surgical one, improves the prognostic.

Aortic revascularization: diagnostic and therapeutic aspects   Ioan Serban Fanfaret Madalina Anciuc, Mihai Toma, Alexandru Braniste, Aurelia Alexandra Tarca Validated View

Aortic revascularization: diagnostic and therapeutic aspects

First author: Ioan Serban Fanfaret

Coordinator(s): Russu Eliza

Keywords: claudication ischemia smoking

Background: The vascular surgeon needs to correctly evaluate the revascularization candidates, in order to choose the right procedure, in both infrainguinal and aortic obstructive arterial disease. Objective: To assess all patients admitted for either intermittent claudication or critical ischemia of the lower limbs to Surgery Clinic No. 1 from Mures County Hospital, as symptoms for aortic obstructive disease, between January 2009 and December 2013. Material and Method: We included 177 cases in our study, evaluating them for: gender, age, blood pressure, blood glucose level, body mass index smoking habit, claudication index, type of surgical procedure performed, early graft patency. Results: 90.3% of the patients included were men and 9.7% were women with the average age of 60 years with values ranging from 36 to 80 years. Patients presented an average value of the body mass index (BMI) of 26.3 corresponding to the overweight pre-obese category after the WHO classification. The average value of the systolic blood pressure was 140 mmHg and the average value of the diastolic blood pressure was 87 mmHg. Blood glucose levels ranged from 77 mg/dl to 495 mg/dl with the average value being 132.7 mg/dl, 68% of the patients being diagnosed with diabetes mellitus whille 32% of the patients weren't diagnosed with diabetes mellitus. Regarding smoking habit 91% of the patients were smokers while only 9% of them were non-smokers. Based on Leriche-Fontaine classification, 8.7% of the patients were included in the stage 2, 32.6% in stage 3, 34.1% in stage 4 and 24.6% in stage 5.  Conclusions: The majorty of the patients were men, with elevated BMI, both with high blood pressure and blood glucose levels, smokers with an advanced index of claudication. Most of the patients seek medical help when they are already in an advanced stage of critical ischaemia.

Quality of life in patients with implantable cardioverter defibrillators  Camelia Tănăsuc Diana Claudia Costas, Ioana Sus, Roxana Rudzik Validated View

Quality of life in patients with implantable cardioverter defibrillators

First author: Camelia Tănăsuc

Coordinator(s): Dobreanu D

Keywords: quality of life ICD SF-12v2 Health Survey

Background:

Implantable cardiac defibrillators (ICDs) ensure proper and quick treatment of malignant ventricular arrhythmias, both in primary and in the secondary prevention. ICDs therapies reduce mortality and improve outcomesbut the impact on quality of life (QOL) is not well known.

Objective:

The aim of this study was to assess QOL in relationship to clinical parameters in patients with implanted ICD for ventricular arrhythmia.

 
Material and Method:

 16 patients (14 men and 2 women) with implanted ICD for primary and secondary prevention of malignant ventricular arrhythmia were enrolled. The Medical Outcome Trust Short Form (SF-12v2) Health Survey was completed for all patients and the physical status score (PSS) and mental status score (MSS) were correlated with a series of clinical dates and ICD therapy.

  
Results:

For all study subjects, the mean±SD baseline PSS scorewas 41±9.69 with a median equal to 40.5 andthe mean MSSscore was 50±12.78 with a median of 48.There were 8 patients with PSS score ≤40.5, classified as‘low’ PSS group. They were older (51±8.35 vs 46±21.69) and more likely to have severe heart failure and myocardial infarction compared with patients with higherscores. The MSS was also lower (45±14.83vs54±10.10) in low PSS group.

For the8 patients with MSS score ≤48 classified aslow MSS group,they were also older (53±13.72 vs 44±17.96) and more likely to have severe heart failure and myocardial infarction. The PSS was lower (39±8.91vs 60±5.99, p=0.00006) in low MSS group.Interestingly, the type and number of ICD therapies do not appear to influence any PSS or MSS. :Except PSS between Low and high MSS group, the differences are not statistically significant

 
Conclusions:

The link between clinical characteristics and QOL in patients with ICD are still incompletely defined. Following more patients over extended periods may indicate that the clinical features correlate significantly with QOL change.

 

Fluoxetine Transfer into Breast Milk in Sheep  Alexandra Grosan Anda Cucean Validated View

Fluoxetine Transfer into Breast Milk in Sheep

First author: Alexandra Grosan

Coordinator(s): Vari C E , Osz Bianca Eugenia

Keywords: fluoxetine concentration breastfead

Background:

Postpartum depression usually occurs in the first four weeks after birth and is affecting 1 of 500 women. Confusion, mood changes or paranoia are the most common symptoms that can make the mother to kill herself or her child; so the treatment is imperative. The antidepressants can cross the blood-milk barrier and the child is exposed to the medication. When the treatment is initiated the doctor should take into account the potential adverse effects in the breastfed children.

Objective: The aim of the study was to determine how fluoxetine is excreted into sheep milk.
Material and Method:

The study was made using six sheep treated daily with 20 mg fluoxetine for two weeks, until the drug reached the steady-state concentration. Plasma and milk samples were collected daily for 20 days to see how the drug is excreted into milk. On day 14 blood samples were also collected from lambs. The drug concentrations in the samples were then measured by HPLC/MS method.

Results: Both fluoxetine and its active metabolite, norfluoxetine were identified in significant concentration in plasma and sheep milk. In lambs plasma there were found only small amounts of fluoxetine
Conclusions: Fluoxetine is excreted into milk and can be ingested by the children therefore it is recommended that breastfeeding to be done before the next dose, when drug concentration in maternal blood is the lowest

Physical chemical properties of ascorbate and its bioavailability  Attila Szőcs Ede Duka, Pál Hunor, Eva Joo Validated View

Physical chemical properties of ascorbate and its bioavailability

First author: Attila Szőcs

Coordinator(s): Vancea Szende

Keywords: calcium ascorbate, partition coefficient, plasma concentration,

Background:

Although ascorbic acid may be considered as “probably the most – studied substance in the history “, very few publications are available about the biodisponibility of salts and derivatives of ascorbic acid from different products that are administered orally. Related to oral administration of vitamin C, calcium ascorbate has a strong interest in the medical practice, but there is no data in the medical literature about the bioavailability of this salt.


Objective:

The purpose of this study is to describe the physical-chemical properties of calcium ascorbate in order to predict the absorption, respectively correlating the absorption with the ascorbic acid concentration in plasma, following administration of a dietary supplement containing 90 mg calcium ascorbate and bioflavonoids.


Material and Method:

We have measured the pH value of this preparation.We have determined the partition of calcium ascorbate between a solution and octanol, at 2 different pH values, the concentration of ascorbate being measured with an UV spectrophotometric method, initially and after extraction. The dissociation constant has been determined using 5 buffer solutions with different pH values, the concentration of ionized/nonionized forms being measured with an UV spectrophotometric method. The ascorbic acid plasma concentration has been determined by a high performance liquid chromatographic method.

Results:

The measured pH value supports that calcium-ascorbate is less acidic than ascorbic acid. The partition coefficient value higher than ascorbic acid’s value indicates a better absorption in the body, which can be correlated with the measured concentrations.


Conclusions:

Calcium ascorbate supplemented with bioflavonoids can be an effective alternative to oral administration of vitamin-C.


Clamp adaptation for special clinical cases that require dental dam isolation  Nicolae Cristian Eugen Cazacu Validated View

Clamp adaptation for special clinical cases that require dental dam isolation

First author: Nicolae Cristian Eugen Cazacu

Coordinator(s): Cazacu C

Keywords: Dental Dam clamp adaptation Dr Cazacu HuFriedy, Hygenic, SDI

Background:

Dental Dam is the safest and most efficient isolation technique in endodontics and restorative dentistry.

It is also used in esthetics, orthodontics, prosthetics, pedodontics and periodontology (for teeth immobilization). 

Objective:

The aim of this study is to list which elements of the clamp should be modified in order to assure a tighter constriction on the anchor tooth. 

Material and Method:

26 patients were examined, diagnosed and treated from various diagnoses like: simple decay, gangrene, chronic apical periodontitis, endodontic retreatments.

The clamps used in this study are produced by HuFriedy, Hygenic and SDI.

In those clinical cases where the anchor tooth did not provide enough stability to the standard clamp – as provided by the producer – we have done some adjustments to some of the elements of the clamp: the arch, the wings, the plateau, the active area, the contact points.

Results:

In 6 cases were necesarry different adaptations in order to assure a secure constriction of the clamp on the anchor tooth. 

Conclusions:

The classic clamps cannot provide enough grip in all the clinical cases due to the huge variety and position and implantation of the anchor teeth. Therefore in such situations, the clamps should be adapted in order to provide enough stability and assure the safe isolation during the treatment.

The modified clamps – with fine adjustments - will be useful in other similar cases, so they must be kept. 

THE PHENOMENON OF UNEXPECTED BIRTH AND ANALYSIS OF ITS CAUSES, CONDITIONS, COMPLICATIONS AND RESOLUTIONS IN CLINICAL HOSPITAL NR 1, CHIŞINĂU, REPUBLIC OF MOLDOVA  Victor Juncu Patricia Marinciuc, Andra Madalina Marinciuc Validated View

THE PHENOMENON OF UNEXPECTED BIRTH AND ANALYSIS OF ITS CAUSES, CONDITIONS, COMPLICATIONS AND RESOLUTIONS IN CLINICAL HOSPITAL NR 1, CHIŞINĂU, REPUBLIC OF MOLDOVA

First author: Victor Juncu

Coordinator(s): Burnusus C

Keywords: Unexpected birth Maternal mortality Fetal mortality

Background:

The unexpected delivery at home is a rare case but represents a particular situation, emotionally charged and often anxiety. First two previously in good health concerned, on the other hand, the prehospital care not are exceptionally familiar with this situation. Medicine of Reproductive Health is unanimously recognized by the international community  as a public health problem by first intention. Worldwide daily record is 536 000 of maternal deaths, or about one maternal death every minute, 30 cases of severe maternal morbidity correspond to each maternal death. Also, 3 million neonatal deaths, 3 million stillborn and yearly, 10 million women that as a result of birth will survive, but with complications, some with definitive repercussions on their social life and family. 

Objective:

The analysis of the sudden birth phenomenon outside hospitals in department of obstetrics Nr 123 in SCM 1.

Material and Method: There had been analysed patient cards through years 2011-2013 and 2 lots selected. the case lot and the control, also the analysis of statistics of both lots.
Results:

In the study, we examined cases of unexpected births in Clinical Municipal Hospital Nr.1, during the period 2011-2013 (in  2011 were 8300 births, of which 22 unexpected births (0,27 %); in 2012 – 8400 births, of wich 35 unexpected births (0,42 %) and in  2013 -  8450 births, 36 unexpected births (0,43 %)) analyzing  the causes, major complications, ongoing process and subsequent health of mother and child.

Conclusions:

The sudden birth is a phenomenon that occurs more frequently in women with multigestational or secundary pregnancy, before 35 years, or from social vulnerable classes. The rise of incidence of the phenomenon should alert the doctors.

A study of the accuracy of fine needle aspiration cytology in thyroid pathology  Alexandra Contra Validated View

A study of the accuracy of fine needle aspiration cytology in thyroid pathology

First author: Alexandra Contra

Coordinator(s): Georgescu R

Keywords: FNA cytology Bethesda thyroid nodule

Background: FNA cytology of the thyroid gland is considered to be an essential test in the diagnosis of the thyroid diffuse lesions or nodules. This is because of the great accuracy it has in confirming benign lesions and avoiding unnecessary surgery which can lead to thyroid hormone dependence in patients with benign lesions. Other complications may be hypoparathyroidism and lesions of the laryngeal nerve.
Objective: The aim of this study is to evaluate the accuracy of fine needle aspiration cytology (FNAC) in the diagnosis of thyroid nodules which should be referred for surgery.
Material and Method: This is a retrospective study conducted on 319 clinically diagnosed cases of thyroid nodules which were referred to our clinic and underwent FNAcytology for diagnosis. The categorizing system for the results was according to the Bethesda classification: insufficient for diagnosis, benign, atypical follicular lesion of undetermined significance, suspicious for malignancy, malignant sampling. The gold standard of this study was the final histological diagnosis or ecography  follow-up after at least 6months in case of non-malignant nodule.
Results: The median age was 53 years and the occurrence in female was 90,6% while in male only 9,4%. 53 cases (17,5%) were diagnosed as insufficient for diagnosis, 199 cases (65,7%) as benign, 46 cases(15,2%) as atypical follicular lesion of undetermined significance, 4 cases (1,3%) as suspicious for malignancy and 1 case(0,3%)as malignant sampling. Cytology diagnoses were compared with their corresponding histological ones. FNAC achieved a sensitivity of 76,47%, a specificity of 83,1%, a positive predictive value of 35,1%, a negative predictive value of 96,7%, a false positive rate of 16,9%, a false negative rate of 23% with a total accuracy of 82,3%. Conclusions: FNA cytology has a good accuracy in the initial diagnosis of patients with thyroid nodules or diffuse lesions, reducing unnecessary surgery.

Postoperative complications in colorectal cancer  Istvánfi Noémi Marta Costel Coroiu, Ioachim Iustinian Simion Validated View

Postoperative complications in colorectal cancer

First author: Istvánfi Noémi Marta

Coordinator(s): Molnar C , Russu C

Keywords: colorectal cancer postoperative complications biologic status

Background: Colorectal cancer is known as the second cause of death by cancer in Europe.Surgical treatment represents the most important part in the medical management of this disease accompanied by the oncologic treatment.Being an important cause of morbidity and mortality, postoperative complications can be associated to biologic factors that are known to increase its rate. Objective: The purpose of this paper is to study the postoperative complications that appear after surgical interventions for colorectal cancer and to identify associated factors. Material and Method: Our retrospective study includes a number of 1005 patients that were operated for colorectal cancer between the years 2003 and 2013 in the Surgery Clinic I of the Targu Mures County Hospital.We have studied the rate of postoperative complications in the relation with the localization of the cancer in the colon,the type of operation made and the biological status of the patients. Results: From the total of 1005 patients, in 5.67% the tumor was located in the cecum, 5.47% in ascending colon, 13.83% in transvers colon( including left and right flexure), 3.68% in descending colon, 17.52% in the sigmoid colon, 16.22% in the recto-sigmoid junction, 31.34% rectal cancer and 6.27% anal cancer. The postoperative complications were mostly represented by fistulas, wound infections and evisceration. Conclusions: The poor biological status encountered in cancerous disease is influencing the rate of postoperative complications. Locally advanced and complicated tumors, often operated in emergency condition, are associated with a higher percentage of fistulas and wound infections. An adequate preoperative preparation, to improve the patient's biological status, can decrease the number of postoperative complications.

MOLECULAR MODELING AND RAMAN SPECTROSCOPY IN THE CHARACTERIZATION OF ENANTIOSPECIFIC INTERACTION BETWEEN PROPRANOLOL AND CYCLODEXTRINES*  Raul Nicoara Validated View

MOLECULAR MODELING AND RAMAN SPECTROSCOPY IN THE CHARACTERIZATION OF ENANTIOSPECIFIC INTERACTION BETWEEN PROPRANOLOL AND CYCLODEXTRINES*

First author: Raul Nicoara

Coordinator(s): Bodoki Ede , Stiufiuc R

Keywords: propranolol, SERS, beta-cyclodextrin, chiral selector,chiral purity

Background: Surface Enhanced Raman-Scattering (SERS) has the main advantage of being able to provide specific unimolecular information. The characterization of different molecules has been made, but no methods were created for the assessment of enantiomeric purity of substances using SERS.
Objective: The study of interaction between target drug molecules (propranolol) and noble metal colloids using molecular modeling and Surface Enhanced Raman-Scattering (SERS).
Material and Method: For the spectroscopic assays a DeltaNu Raman spectrometer (excitation laser 735 nm) and silver or gold colloids were used. In order to create a chiral environment and develop the premises for chiral analysis using chemometric treatment of SERS spectra, the influence of different native and semi-synthetic cyclodextrines was also investigated. Molecular modeling (density functional theory) was used for the prediction of spectral behavior of the target molecule and also for the confirmation of the nature of guest-host type interaction between the beta-blocker and the chiral selector.
Results: Major spectral differences between R and S isomers are observed in the presence of beta-cyclodextrin. The R isomer presents a characteristic spectrum denoting an enantiospecific interaction of the physisorbed beta-blocker molecule and beta-cyclodextrin, whilst the spectrum of S isomer shows no specific change. The influence of different factors (pH, ionic force, target:selector molar ratio, etc.) and also the kinetics of the interaction has been studied in detail.
Conclusions: Adding beta-cyclodextrin to the silver metal colloid and understanding the undelaying interaction mechanism enables the simple assessment of the enantiomeric purity of propranolol from different pharmaceutical formulations in the absence of any tedious sample pre-treatment and expensive chiral separation techniques.

The assessment of the quality of linden teas from Romanian pharmacies  Adrian-Gabriel Morosan Validated View

The assessment of the quality of linden teas from Romanian pharmacies

First author: Adrian-Gabriel Morosan

Coordinator(s): Cioanca Oana , Hancianu Monica

Keywords: linden antioxidant phenolic content

Background: Tiliae flos represents a medicinal plant used in therapy, both in traditional and modern medicine for its sedative, antispasmodic, immunomodulatory and slight carminative properties. Nowadays, extensive studies on Tiliae sp. are mainly conducted by Mexican researchers, while in Romania several years ago a group conducted by Prof. MirceaTamas (UMF Cluj) analyzed some of the Romanian endemic species.
Objective:

The aim of our study was to assess the pharmaceutical quality of the linden tea samples found in pharmaceutical network (according to Pharmacopoeial provisions), in order to prove an existent correlation between the chemical composition of the plant material and the biological properties.
Material and Method:
Samples were bought from pharmaceutical network in Iasi and they were codified with numbers from 1 to 5, two as bulk and three as sachets packages. The samples were analyzed starting with macroscopic and microscopic features. For the chemical analysis we obtained hydro-alcoholic (ethanol 60%) extracts 5g/100mL. The phytochemical study included qualitative (TLC) and quantitative methods (spectrophotometry), whereas the biological properties was assessed by DPPH technique.
Results: We noted that there are differences between the samples from macroscopic point of view. TLC revealed that there is a similar compound spectra for all samples, with rutin and hyperoside as common substances in all five extracts. Samples 1 and 2 (bulk-50g) contain the highest quantities of polyphenols, whereas samples 5 has the lowest value. The best antioxidant potential was noted for sample 2 in direct correlation to its chemical composition. Moreover, sample 4 (sachets) from the same producer had the second best activity.
Conclusions:
Some of the samples can't be identified macroscopically (Pharmacopoeia monograph) due to intensive grounding. The provenience of linden is of extreme importance; both samples (2-bulk, 4-sachets) from the same producer had the best antioxidant potential. For all samples we could correlate the biological activity with the phenolic content.

Increased mean platelet volume as a prediction factor for cardiovascular events in non-diabetic overweight patients  Nicolae - Alexandru Golovei - Petris Validated View

Increased mean platelet volume as a prediction factor for cardiovascular events in non-diabetic overweight patients

First author: Nicolae - Alexandru Golovei - Petris

Coordinator(s): Tilea I , Bocicor Andreea-Elena

Keywords: MPV prediction factor

Background: Leading cause of death in today’s world is from cardiovascular risk factors and cardiovascular diseases. It is considered that MPV, which correlates with platelet reactivity, is also an independent risk factor in the atherosclerotic disease.
Objective: The aim of this study is to investigate the relation between overweight patients and mean platelet volume (MPV).
Material and Method: This is a retrospective chart review study of 100 hospitalized patients in the Cardiovascular Recovery Clinic between 01.01.2013 and 01.12.2013. All diabetic patients have been excluded from this study.
Results: patients present a mean age of 61 and a standard deviation of 13.01 years; 60% of the patients are males; 40% live in a urban environment; 70% of patients are smokers; there are no statistically significant correlations between MPV and patients between 40 and 49 of age (p>0.05); there are statistically significant correlations between MPV and patients between age 50-59 (p<0.05); there are statistically significant correlations between MPV and patients between age 60-69 (p<0.05); there are statistically significant correlations between MPV and patients between age 70-79 (p<0.05);
Conclusions: The platelet count and MPV was detected to be increased in overweight patients.
MPV is an important, simple, always available as well as a cost effective tool that can be useful in predicting cardiovascular events.

Diabetic Nephropathy- The most common cause of Chronic Kidney Disease (CKD) ?  Zoltan Kovacs Reka Gyero Validated View

Diabetic Nephropathy- The most common cause of Chronic Kidney Disease (CKD) ?

First author: Zoltan Kovacs

Coordinator(s): Mathe L

Keywords: Nephropathy Diabetes Hiperglycemia

Background:

Hyperglycemia in the long term causes hemodynamical changes in the microcirculation of the kidneys, membrana basalis thickening, increase in the volum of the extracelular matrix, mesangial expansion, fibrosis. These form the Kimmelstiel-Wilson syndrome. It is characterised by diffuse or nodular glomerulosclerosis afferent and efferent hyaline aterosclerosis, leading  progressively towards renal failure.
Objective:

Verifying if the most common cause of Chronic Kidney disease (CKD) in patients with diabetes is Diabetic Nephropathy, respectively what other factors can be taken into account as triggers of renal damage, and Chronic Kidney Disease (CKD).
Material and Method:

Retrospective study involving 100 patients suffering from both Diabetes Mellitus and Chronic Kidney disease. Patients are from the Mures and Covasna counties in Romania. Patienst who are in stage 1 of CKD are excluded from this study because at this stage diagnosis is difficult;  patient is asymptomatic, proteinuria and a rise in creatinin may indicate it however. In order to remove inaccuracies we chose to ignore those cases and focus on patients in  more advanced stages.
Results:

Our study has shown that Diabetic Nephropathy is the most significant trigger of Chronic Kidney Disease (CKD) in patients with diabetes. Other triggers such as infection(pyelonephritis), and obstructive nephropathy have proven to be a lot less frecvent.

Conclusions:
In patients suffering from Diabetes mellitus the most common cause of Chronic Kidney Disease (CKD) is Diabetic Nephropathy- also known as Kimmelstiel-Wilson syndrome.

The Relation of Interleukin 6 Gene-190 T/C Polymorphisms with Anthropometric and Biochemical Characteristics in a group of Obese Children  Maria Oana Marginean Florin Tripon Validated View

The Relation of Interleukin 6 Gene-190 T/C Polymorphisms with Anthropometric and Biochemical Characteristics in a group of Obese Children

First author: Maria Oana Marginean

Coordinator(s): Banescu Claudia , Pitea Ana-maria

Keywords: anthropometry child IL-6 gene-190 T/C polymorphism obesity

Background:
Child obesity represents a problem of certain actuality in the field of pediatrics, due to its increased incidence and its associated complications, that appear to be in relationship with the low-grade inflammation known to be present in the context of excessive adiposity. Interleukin-6 is an inflammatory cytokine, extensively studied as possible marker of obesity complications; the IL-6 gene 190 T/C polymorphism influences the producing and plasma-level of this cytokine. Objective:
The aim is to establish the relations between anthropometric and biochemical parameters of a group of obese children and these gene polymorphism. Material and Method:
A prospective study which assessed 182 children hospitalized in the First Pediatric Clinic, divided into two groups: 86 obese patients (Body Mass Index, BMI over 2SD) and 96 controls, children with normal nutritional status. We assessed anthropometric parameters (BMI; Middle Upper-arm Circumference, MUAC; Tricipital Skin-fold Thickness,TST), biochemical tests were performed (lipid profile, proteins, albumins) and both groups underwent IL-6 190 T/C polymorphism analysis. Results:
The CT genotype was observed to appear more frequently in the obese group (75%) than in the control group (statistically significant difference, p=0.0001). In the whole cohort, 89.3 % of the cases had the C allele. The polymorphism of the gene IL-6 190 T/C was correlated with anthropometric and paraclinical parameters: MUAC and TST had statistically significanttly higher values in the obese group for the IL-6 190 CC, CT and TT haplotypes (p=0.0001). Conclusions:
The polymorphism of the gene IL-6 190 T/C may modulate genes to determine the nutritional status; it provides a good characterization of the profile of an obese child. The IL-6 190 C alleles appeared more frequently in obese children; anthropometric parameters (BMI, MUAC, TST) and serum albumins levels correlate with C allele carriers of IL-6 190 gene in obese children.

STUDY ON THE IMPROVEMENT OF THE GLYCEMIC CONTROL BY SITAGLIPTIN TREATMENT IN A RODENT MODEL OF DIABETES*  Flavia Gutue Validated View

STUDY ON THE IMPROVEMENT OF THE GLYCEMIC CONTROL BY SITAGLIPTIN TREATMENT IN A RODENT MODEL OF DIABETES*

First author: Flavia Gutue

Coordinator(s): Berbecaru Anca

Keywords: diabetes, sitagliptin, postprandial hyperglycemia

Background:
Objective: The aim of this study was to evaluate the sitagliptin therapy effect on glycemic control and total cholesterol level in normal and streptozotocin-induced diabetic rats. We also investigated the tolerability of multiple oral doses of sitagliptin in diabetic rats by monitoring the side effects.
Material and Method: Sitagliptin was administered orally once a day at normal and diabetic rats. Glucose and cholesterol levels were measured from tail bleeds with a glucometer/cholesterolmeter. Postprandial plasma glucose was measured at specified time points after meals. 
Results: Oral administration of a single dose of sitagliptin at normal rats determines glucose postprandial mean levels significantly lower comparative with the corresponding mean values of untreated control animals. At diabetic rats after a single dose of sitagliptin postprandial glucose average values have increased, but close to the reference, measured before treatment administration. After three weeks of daily treatment with single oral dose of sitagliptin, in diabetic rats were noted elevated average values of blood glucose and total cholesterol during the research. 
Conclusions:

These observations confirm that sitagliptin improves postprandial hyperglycemia levels, but failed to bring to normal blood glucose levels of diabetic rats. Mean level of total cholesterol remained elevated during treatment of diabetic rats, confirming that metabolic changes cannot be restored only by sitagliptin. 
Sitagliptin is a useful oral drug for type 2 diabetes, especially for postprandial glycemia control. It must be emphasized that in patients with type 2 diabetes to improve glycemic control, dipeptidyl peptidase-4 inhibitors (sitagliptin) should be administered in combination with other oral antidiabetic agents such as biguanide or sulfonylurea, especially when diet and exercises plus mentioned oral antidiabetic, at the maximum tolerated dose, do not provide adequate glycemic control.

Post-operative quality of life in ACL injuries: a short-term monthly comparison  Andrei-Marian Feier Radu Branea, Marta Ostopovici, Oana Coman, Mihai Alexandru Kovacs Validated View

Post-operative quality of life in ACL injuries: a short-term monthly comparison

First author: Andrei-Marian Feier

Coordinator(s): Russu O

Keywords: Tegner Lysholm scale monthly comparison ACL rehabilitation

Background: The anterior cruciate ligament (ACL) has an important role in maintaining knee stability, mostly by resisting the anterior translation of the tibia. Rupture of the ACL is a common injury and the treatment is mostly surgical.


Objective: The aim of this study is to determine and compare the quality of life on a monthly basis on different groups of patients who underwent ACL surgical reconstruction.

Material and Method: This is a short-term retrospective study that analyses data between October 2013 and March 2014 at the Orthopedics and Traumatology Clinic in Tirgu-Mures. The study involves 36 patients, 27 male, 9 female, aged between 16 and 44 (with a mean age of 29.2). All patients involved in the study underwent arthroscopically reconstruction of the ACL using the hamstring autograft technique. The patients were questioned using the Tegner Lysholm scoring scale, which describes 8 commonly affected everyday life abilities. In order to be able to compare the monthly quality of life conditions, the patients were divided into six groups according to the monthly period when the surgical intervention took place. The score ranges from 0 to 100, a higher value means a better life condition.

Results: The results of the questioning show a monthly Tegner Lysholm score of: 50(range 43-64) in the first month, 69 (64-73) in the second month, 76 (68-82) in the third month, 87 (76-100) in the fourth month and fifth month,and 90 (81-94) in the sixth month.

Conclusions: The study shows a significant increase in the patients quality of life from one month to another, patients being able to retain almost full function of the knee in approximately six months from the surgery. However, more detailed studies are required in order to fully understand the rehabilitation process.

CLINICAL ASSESSMENT OF PATIENTS WITH NEUROCOGNITIVE DISORDERS(NCD), TREATED AT THE 1ST CLNIC OF PSYCHIATRY TARGU MURES BETWEEN IANUARY 1ST 2012 AND IANUARY 1ST 2013  Dora-Ildiko Suba Brigitta Pager, Alina-Georgiana Corduneanu, Aurelia Alexandra Tarca, Róbert Gábor Suvanjeiev Validated View

CLINICAL ASSESSMENT OF PATIENTS WITH NEUROCOGNITIVE DISORDERS(NCD), TREATED AT THE 1ST CLNIC OF PSYCHIATRY TARGU MURES BETWEEN IANUARY 1ST 2012 AND IANUARY 1ST 2013

First author: Dora-Ildiko Suba

Coordinator(s): Gabos-Grecu I

Keywords: "neurocognitive disorders" "antidemential therapy" "distribution of comorbidities"

Background:

In the 21st century the problem of neurocognitive disorders (NCD) is growing. The NCDs influence the cognitive functions, temporo-spatial orientation, decrease the standards of living of the patient ant their family. It makes difficult to integrate into the community, and probably has an influence on mood, sleep, and cardiovascular system. These factors gradually contribute to a possible depression, lethargic state, frustration, guilt, melancholia and suicidal thoughts .

Objective:

To Assess the administered antidemential treatment and the prevalence of comorbidities.

Material and Method:

Patients with dementia at 1st Clinic of Psychiatry,TarguMures, between day hospitalizations from January 01.2012 to January 01.2013. 375 patients were examined. The analyzed parameters: the type of dementia, gender incidence, distribution of comorbidities and the used antidemential therapy.

Results:

 68% (254 patients) had major or mild NCD due to Alzheimer’s disease, 19% (71) had Vascular NCD, 13% (50) had NCD due to multiple etologies. Gender distribution: 59,5% (223) female and 40,5% (152) male. Comorbidities: 39% (145 patients) know with hypertension, 31% (115 patients) know with chronic ischemic cardiopathy, 37% (138) had acute psychotic disorder and 13% (48) respectively 11% (41)of the patients had major depression and organic mood disorders. The administered antidemential-treatment: in 39% (145 cases) galantaminum, in 30% (114) rivastigminum, in 24% (89) memantinum, in 23% (87) donepezil hydrochloride; in 21% of the cases combinations were used as: memantinum and galantaminum in 9% (35 cases), memantinum and donepezil hydrochloride in 5% (20) and memantinum plus rivastigminum in 5% (18).


Conclusions:

Alzheimer’s disease is the most frequent NCD, is more common between female then male patients, the treatment was corresponding to the guidelines: the antidemential treatment was chosen corresponding to the severity of the NCD, the dose was raised gradually, and combinations were used. 

Our results are in concordance with international guidelines and literature.

ASSOCIATION BETWEEN THROID STIMULATING HORMONE LEVELS AND ATRIAL FIBRILLATION IN A GROUP OF PATIENTS WITH HYPERTHYROIDISM  Andreea Ionita Miu Ioana Alina, Alice Simionescu, Marian Botoncea Validated View

ASSOCIATION BETWEEN THROID STIMULATING HORMONE LEVELS AND ATRIAL FIBRILLATION IN A GROUP OF PATIENTS WITH HYPERTHYROIDISM

First author: Andreea Ionita

Coordinator(s): Capraru Oana

Keywords: hyperthyroidism atrial fibrillation TSH

Background: One of the most common arrhythmias seen in hyperthyroid patients is atrial fibrillation, most frequently discovered before the changes in the thyroid hormones. Data in literature showed that the incidence of atrial fibrillation increases in the case of a suppressed thyroid stimulating hormone (TSH) level.
Objective: The aim of our study was to determine if there is a correlation between the TSH levels and the incidence of atrial fibrillation in a group of patients with hyperthyroidism and also how atrial fibrillation progressed during antithyroid pharmacotherapy.
Material and Method: We made a retrospective analysis of the patients hospitalized in the Endocrinology Department, between 2009-2012, for thyroid diseases. From 1450 patients we chose 72 patients with hyperthyroidism. During each hospitalization we checked the TSH level, heart rate and the specific medication for their condition. We also looked for the prevalence of atrial fibrillation in these patients and how it progressed during treatment for hyperthyroidism. 
Results:

From the initial 72 patients observed, 75% were women and 25% were men. The etiology of hyperthyroidism was: 48.8% Basedow-Graves disease, 31.9% toxic polinodular goiter, 13.8% amiodarone induced hyperthyroidism and 5.5% toxic adenoma. 
During at least a one year follow-up, 72.5% of patients had a statistically significantly increase of the TSH level after antithyroid pharmacotherapy, and the atrial fibrillation converted spontaneously to sinus rhythm. The rest of the patients continued to have atrial fibrillation, despite the normalization of thyroid function.
Conclusions: The incidence of atrial fibrillation increases along with a suppresed TSH level and during antithyroid pharmacotherapy most of the patients convert spontaneously to sinus rhythm.   

vitamin D3 - the study of human knowledge and awareness of the importance of vitamin D3  Maria-Andrada Bejan Validated View

vitamin D3 - the study of human knowledge and awareness of the importance of vitamin D3

First author: Maria-Andrada Bejan

Coordinator(s): Curticapean A

Keywords: vitamin D3, sunshine vitamin, calcitriol

Background: Vitamin D is a group of fat-soluble secosteroids. In humans, vitamin D is unique both because it functions as a prohormone and because the body can synthesize it (as vitamin D3) when sun exposure is adequate (hence its nickname, the "sunshine vitamin").Vitamin D fits within the definition of vitamin as it is "an organic compound required as a vital nutrient in tiny amounts by an organism.   Additionally, like other compounds called vitamins, in the developed world vitamin D is added to staple foods, such as milk, to avoid disease due to deficiency. Vitamin D is converted to calcidiol in the liver. Part of the calcidiol is converted by the kidneys to calcitriol, the biologically-active form of vitamin D. This circulates as a hormone in the blood, regulating the concentration of calcium and phosphate in the bloodstream and promoting the healthy growth and remodeling of bone. Calcidiol is also converted to calcitriol outside of the kidneys for other purposes, such as the proliferation, differentiation and apoptosis of cells; calcitriol also affects neuromuscular function and inflammation.
Objective: The goal of this study is to analyze human knowledge and significant impact on the vitamin in the body, and its use.
Material and Method: We conducted a study based on a questionnaire with 20 questions on 114 subjects aged 0-89 years.
Results: The data obtained were processed statistically, but not compared with other studies.
Conclusions: Survey results revealed the human knowledge regarding vitamin D3, and the importance of transmission of as much information about it.

The influence of the vegetarian diet on the erythrocyte superoxide dismutase activity. A study in the Romanian population  Maria Magdalena Boanca Ileana Cristea, R. C. Prelicz Validated View

The influence of the vegetarian diet on the erythrocyte superoxide dismutase activity. A study in the Romanian population

First author: Maria Magdalena Boanca

Coordinator(s): Craciun Elena Cristina

Keywords: B12 vitamin, superoxide dismutase, vegetarian diet

Background: Currently, an increasingly number of Romanian people chose the vegetarian diet because epidemiological studies all over the world have shown that vegetable-rich diets are associated with higher life expectancy. The harmful effects of vegetarianism that result from the deprivation of some essential micronutrients have been addressed repeatedly.
Objective:

The aim of the present study was to examine the impact of a vegetarian diet not supplemented with vitamin B12, on the antioxidant status, through the evaluation of oxidative stress biomarkers and vitamin B12 status, in healthy volunteers: ovo-lacto vegetarians and non-vegetarians from Romania.

Material and Method:
The vegetarian subjects were divided according to the duration of adherence to a vegetarian diet in three groups: 2-10 years (A), 11-20 years (B) and 21-27 years (C).
We investigated the activity of the erythrocyte superoxide dismutase (SOD) on a Cobas Mira Plus (Roche) using Ransod kit. The serum vitamin B12 assay was performed using electrochemiluminiscence immunoassay on Roche Elecsys 2010 analyzer..
Results: Mean serum vitamin B12 was highest in omnivores than in ovo-lacto vegetarians subjects (p<0.05). We did not observed a statistically significant association between the duration of adherence to the vegetarian diet, in the investigated groups, and serum vitamin B12 level. We have observed significantly higher values of SOD activity in the vegetarians from group A in comparison with the control group. In the other two groups (B and C) the activity of SOD was significantly decreased (p<0.05).
Conclusions: Ovo-lacto vegetarians have lower concentrations of serum B12 vitamin in comparison with omnivores. The variation of the SOD activity dependent on the duration of adherence to a vegetarian diet suggests an adaptive response of the organism to the increase of the oxidative stress due to the decline of vitamin B12 level.

Male breast cancer  Alexandra Diana Mihuti Paula Maria Gliga Validated View

Male breast cancer

First author: Alexandra Diana Mihuti

Coordinator(s): Marian D

Keywords: male breast cancer practical aspects

Background: The male breast cancer is a rare disease, representing 0.2-1.5% of male neoplasms and 1-5.7% of breast neoplasm, according to literature.Despite the fact that the pathology is similar to that of the female breast cancer, the unfavorable evolution at men is due to the diagnosis in late stages of the malady.
Objective: In this paper we aimed to emphasize the particularities of this type of neoplasm at man, the factors which delay the early diagnosis of the illness and also the clinical signs that should catch our attention on the disease.
Material and Method: This is a retrospective and multicentric study analyzing the frequency and particularities of this lesion within a 10 years interval (2004-2013), in the Surgical Clinics from Targu Mures. In this 10 years we found a number of 35 male patients operated of breast cancer.
Results: The mean age of presentation was 63.8 years (rage 20 to 87 years) with a prevalence of urban areas: 74.28% of the patients.The majority of the tumor were localized in the left breast (19 patients- 54.28%).The fixation of the tumor in skin and muscles was diagnosed in 28 cases -80%. 2 patients (5.71%) had distant metastasis. The predominant histological type (82.8%) was the infiltrating ductal carcinoma, 41.37% of these carcinomas being in the second phase of histological malignity.One of the carcinoma associates with Paget's illness of the areola.Other types of neoplasms were highlighted: angiosarcoma, round cells sarcoma, leiomyosarcoma, Burkitt limfoma, fibrosarcoma breast metastasis, malign melanoma.The elective surgical treatment was Pattey radical mastectomy (85.71%).The instant post operatory mortality was 0.
Conclusions: The ignorance of the patient and not checking the breast during the routine controls, make the men to come in more advanced stages than women.Asymmetry, eccentricity, firmness, fixation or ulceration of the breast should raise suspicion.For early diagnosis of the illness,is necessary to develop screening programs.

OPTIMISATION OF THE HPLC ENANTIOSEPARATION WITH CHIRAL SELECTOR AND POLAR ORGANIC MOBILE PHASES   Elena Farcas Katina Sylvestre Dosso Validated View

OPTIMISATION OF THE HPLC ENANTIOSEPARATION WITH CHIRAL SELECTOR AND POLAR ORGANIC MOBILE PHASES

First author: Elena Farcas

Coordinator(s): Curticapean A

Keywords: HPLC, Enantiomers, Chiral compounds

Background:   Objective: Nowadays, the pharmaceutical industry needs fast and cheap methods in order to obtain pure enantiomers, so that the molecules can be well characterized or in order to find a way to extend the characterization of the practical applications of a certain subtance.
Material and Method:

An optimisation for acidic, neutral and bifunctional compounds was performed after a rapid screening method development for basic molecules. 
The stationary phase was cellulose tris(3-chloro-4-methylphenylcarbamate) and the main mobile phase was acetonitrile.
The temperature was setteled at 25?C and the flow-rate was 1.0 ml/min.
In this rapid screening were used basic additives (buthylamine, triethylamine and diethylamine) and acidic additives (acetic acid, trifluoroacetic acid and formic acid). The nature and the concentration of these additives were found to be significant on the enantiomers retention, selectivity and resolution.
The best results were obtained with acetic acid and diethylamine.
The optimisation was performed by varying the concentration of the basic additive, diethylamine(0.01-0.1%) and the concentration of the acidic additive, acetic acid (0.1-0.3 %) .
Results: After the optimisation process the method offered a complete resolution of 58% of the studied compounds, but when the screening results are combined, 79% of the non basic compounds were enantioresolved.
Conclusions: The rapid screening revealed the strong impact of the addition of a small quantity of both acidic and basic additives on enantioresolution, enantioselectivity and retention of these chiral compounds.

What is not a poison? All things are poisons and nothing is without toxicity?. Oganometallic compounds as possible anticancer drugs.  Ioana Paler Validated View

What is not a poison? All things are poisons and nothing is without toxicity?. Oganometallic compounds as possible anticancer drugs.

First author: Ioana Paler

Coordinator(s): Avrigeanu Veronica , Gaz Florea S A

Keywords: antitumoral, organometallic, ferrocifen

Background:

Metal-containing macromolecules in the human body are extensive including various metals such as iron (transferrin, hemoglobin), molybdenum (xanthine oxidase), vanadium (hemovanadin), zinc (carbonic anhydrase) or copper (hepatocuprein). Therefore, an increasing interest in the introduction of different metal ions within biological macromolecules such as proteins and nucleic acids is manifested in a continuing area of research. Whereas many organometallic compounds are toxic and unstable in air and water, some of them, especially the ferrocenyl derivatives have a low degree of toxicity with therapeutic value.
           

Objective:  Many organometallic compounds play a key role in cancer treatment in nowadays? society. For example, cisplatin is a common drug used in chemotherapy. Although platinum based drugs (such as cisplatin and carboplatin) are successful, they also have unfavorable side effects and are unable to treat some types of cancer. For this reason, ruthenium and iron compounds are now being studied extensively for their anticancer abilities, ferrocifen being currently one of the best candidates as treatment with antitumoral effects. Therefore the application of different organic metal-containing derivatives as antitumoral drugs is being described. 
Material and Method: The use of organometallic medicinals is widespread including meralein (mercury, antiseptic), silver sulfadizine (prophylactic treatment for severe burns), arsphenamine (arsenic, antimalarial).
Results:
Conclusions:
In conclusion, the use and evaluation of these compounds as potential anticancer agents offer opportunities which cannot be achieved by ordinary small molecules. New and modern compounds with possible antitumoral effects could be obtained by the stereoselective synthesis or modification of multifunctional natural products such as sugars.

The effectiveness of different toothpastes in dentine hypersesitivity treatment  Luchian Petra Validated View

The effectiveness of different toothpastes in dentine hypersesitivity treatment

First author: Luchian Petra

Coordinator(s): Monea Adriana

Keywords: dentine hypersensitivity toothpaste visual analog scale

Background: Dentine hipersensitivity is a common global oral health problem affecting many individuals.He is generally reported by the pacient as a sharp pain caused by one of several different stimuly and which cannot be explained by any other form of dental diseas.Many treatment regimens have been recomanded over the years and in particular, attention has been focused on toothpastes containing various substances that obliterete the dentinal tubules.
Objective: The study aimed to evaluate and compare the clinical efficiency of Calcium Sodium Phospholicate (Novamin), arginine and calcium-carbonate (Pro--Argine technology), sodium fluoride and classic paste without fluoride used as placebo in treating dentinal hypersensitivity.
Material and Method: 40 patients with dentine hypersensitivity based on symptoms and differential diagnosis were included in the study and divided in 4 groups.They received different toothpaste as treatment for dentine hypersensitivity as follows: gropuA (n=10) toothpaste with Novamin, group B (n=10) Pro-Argine technology, group C (n=10) flouride toothpaste and group D( n=10) classic toothpaste without fluoride.The reduction of dentinal hypersensitivity was evaluated using a Visual Analog Scale at first, second, third and fourth week of treatment.
Results: Reduction of dentinal hypersensitivity was observed in all groups, even in group D ( classic toothpaste without fluoride), the placebo effect being quite strong in some subjects.
Conclusions: The study shows untill now that all toothpastes gave good results and satisfactory for patients.Is the placebo effect an important determinant of results? The study is still in progress.

Arterial Trauma  Cora Zacharias Validated View

Arterial Trauma

First author: Cora Zacharias

Coordinator(s): Suciu H , Stroe V

Keywords: arterial injuries fasciotomy limb salvage multidisciplinary team

Background:

Acute injuries of vessels constitute an important therapeutic problem, representing a serious threat to life. Vascular injuries in large numbers are usually seen only during military conflicts. However, with the increasing number of vehicular accidents, violent crimes and the common use of arterial cannulation, such injuries are being seen more frequently in civilian practice as well. The incidence of vascular trauma varies among countries and also between urban and rural areas and accounts for approximately 10% of all deaths. 

Objective: This clinical study describes the experience of arterial trauma at the Emergency Cardiovacular Disease and Transplant Institute of Tg.Mures.
Material and Method:

The retrospective study was made between  2010 and 2014, including 123  pacients: 91 (74%) pacients with iatrogenic injury and 32 (26%) pacients with penetrating and blunt trauma. There were 25 (20%) penetrating injuries caused by industrial, domestic, agresion and autoagresion trauma and 7 (5,7%) blunt injury that caused politrauma.The mean age for traumatic injuries such as domestic, industrial, road trafic accidents and penetrating injury was on young patients between 17 and 45 years. 

Results:

Early extremity fasciotomies were performed for compartment syndrome after acute ischemia and revascularization in 8 patients (6,5%) with arterial trauma. Two patients needed multiple skin grafting procedures or myocutaneous flaps to close the wound. Two amputations were required for limb ischemia. Both patients were involved in routier accidents (blunt trauma).There were two deaths caused by penetrating injuries.

Conclusions:

A multidisciplinary approach to the management of the arterial trauma patient will help create circumstances in which optimal care can be provided. Early fasciotomy has been cited as a major factor contributing to limb salvage and preservation of function, especially in politraumatic injuries with multiple fractures and dislocations. Primary amputation must be taken into consideration if the duration of ischemia is  >6 hours, as a life saving procedure. 

Dental Dam use by the students in clinical years in Dentistry in Romania  Nicolae Cristian Eugen Cazacu Mioara Maria Vlad Validated View

Dental Dam use by the students in clinical years in Dentistry in Romania

First author: Nicolae Cristian Eugen Cazacu

Coordinator(s): Cazacu C

Keywords: Dental dam use by students difficulty in placing dental dam Dr Cazacu

Background: The safest and most efficient isolation technique in endodontics and restorative dentistry is the dental rubber dam. It is also used in esthetics, orthodontics, prosthetics, pedodontics and periodontology.
Objective:

This study evaluates the attitude of students in clinical years concerning the use of the rubber dam.

Material and Method:

A structured questionnaire was developed in order to measure students perceptions of the use of the rubber dam and circulated to the current fifth and final year clinical students in dentistry in Romania.

Results:

A secure and comfortable isolation was identified as the main advantage of using a rubber dam, while the difficulty to place is considered as the main disadvantage. More than a half of students appreciated they had received adequate training in rubber dam use for adults.

The most commonly cited difficulty in placing a rubber dam was tight contacts.

Most students are confident regarding which system and which clamps to use.

The majority of students prefer to use the rubber dam on adults than children for the same procedure.

 

Conclusions:

Students in clinical years prefer to use the rubber dam in endodontics.

More exercise on patients will improve students’ confidence and certainly will reduce the time spent to place the dental dam. 

Use of microfiltration technique to improve diagnostic accuracy of pleural effusion cytology  Izabella Paula Peter Fórika Gertrúd, Elek-Tamás Kálmán Validated View

Use of microfiltration technique to improve diagnostic accuracy of pleural effusion cytology

First author: Izabella Paula Peter

Coordinator(s): Mezei T

Keywords: Microfiltration pleural effusion lung cancer cytology

Background:

The cytological examination of the pleural effusion has a major role in the management of patients with suspicion of or confirmed lung cancer.  Smears created from pleural effusions are sensitive to smear preparation and technique.  

Objective:

The purpose of our study was to present a new method for enhacing pleural effusions diagnostic accuracy by improving cellular yield using microfiltration.

Material and Method:

Pleural effusion from  10 patients with confirmed or suspected lung cancer were used. We subjected them to microfiltration, created smears by touching the microfilter to the slides. The smears were stained with Hemacolor (air-dried smears) and Cytocolor (alcohol-fixed smears). Microphotos (4x objective) were taken of the smears. We evaluated and counted cellularity  and noted the presence or absence of cellular aggregates.

Results:

We found that microfiltration of pleural effusion produces better cellularity, in average 400 cells/field. This, compared to other methods was significantly higher. Cellular conglomerates were present in nearly all cases, also a better preservation of cellular morphology was observed. Additionally we found that smears stained with Cytocolor showed visibly better quality as compared to Hemacolor stained slides. 

Conclusions:

 Microfiltration of pleural effusions is a new method of improving smear cellularity. Its routine use is expected to enhance the diagnostic value of effusion cytology in the management of lung cancer patients. This method also concentrates cells in smaller area, therefore requires a shorter smear analysis time compared with other techniques. The presence of cell aggregates further underlines its potential in increasing pleural effusion cytology specificity and sensitivity.

Association between Diabetes Mellitus and Metabolic Syndrome  Ioan Serban Fanfaret Madalina Anciuc, Maria Oana Marginean, Alina-Georgiana Corduneanu, Corina-Ioana Mateescu Validated View

Association between Diabetes Mellitus and Metabolic Syndrome

First author: Ioan Serban Fanfaret

Coordinator(s): Fazakas Zita

Keywords: diabetes carbohydrates metabolism

Background: There are common factors involved in the development of Diabetes Mellitus and Metabolic Syndrome which will lead to later cardiovascular complications. Objective: The aim of the study is to evaluate the link between Diabetes Mellitus and Metabolic Syndrome. Material and Method: We included 106 patients being in the evidence of three General Pactitioners Cabinets from Tg. Mures. Information was provided from the medical records of all patients diagnosed with both Diabetes type 1 and 2, evaluating them for: gender, age, medical conditions, complications, medical tratament and laboratory analysis. Results: Patients were divided in two groups: group A included 70 patients following treatment with oral antidiabetic medication and group B included 36 patients following insulin treatment. In group A the average age was 64 years. The average blood glucose level at diagnosis was 181.5 mg% and after 4 years of treatment: 120.3 mg%, p<0.0001 considered extremely significant. Glycated hemoglobin average value at diagnosis was 6.7% and after 4 years 5.2%. LDL average at diagnosis was 187.7mg%, HDL average was 41.1 mg%, TG average was 348.9 mg% and blood pressure was 180/100 mmHg. In group B the average age was 45 years. The average of the blood glucose level at diagnosis was: 311 mg% and after 4 years of treatment 113.3 mg%, p<0.0001 considered extremely significant. Glycated hemoglobin average value at diagnosis was: 7.9% and after 4 years 5.1%. LDL average at diagnosis was: 157.3 mg%, HDL average was: 38.2 mg%, TG average was: 325.1 mg% and blood pressure was 160/90 mmHg.  Conclusions: Diabetes Mellitus has a negative influence over the lipid metabolism, carbohydrates and cardiovascular system, thus treating patients diagnosed with Diabetes is a task that requires a team of physicians from different specializations.

Biological effects of Electromagnetic waves emitted by mobile telephones and wireless internet routers on germination and growth of Broccoli,(Brassica Oleracea)  Alexandru Ceamburu Simion Geambasu, Felicia Stratulat, Razvan Ion Validated View

Biological effects of Electromagnetic waves emitted by mobile telephones and wireless internet routers on germination and growth of Broccoli,(Brassica Oleracea)

First author: Alexandru Ceamburu

Coordinator(s): Alecu A

Keywords: Electromagnetic exposure Mobile telephones Wifi routers Brassica Oleracea

Background: We all know that electromagnetic radiation is found everywhere and numerous studies have shown how dangerous it can be.A topical issue that everyone is interested in,is how harmful  this radiation is,when mobile telephones are on standby and especially during conversation.
Objective: The objective of this study was to observe how the radiation emitted by mobile telephones and wifi routers is affecting cellular division of plants and thus making a comparison with the daily effects of atmospheric electromagnetic radiation.
Material and Method: This study was carried out since March 25 to April 1, 2014 at the “Lotus Life”Integrative Medicine Center.We cultivated  four groups of seeds  of Broccoli.Each group was placed on a culture media consisting of a dry piece of cotton wool,a plastic plate and a piece of polystyrene.Between each group was maintained  a distance of 2 meters and all groups were placed in a well lit room at an average temperature of 20 degrees and average humidity of 50%.
Results: First group exposed at wirelles with frequency of 2,4 GHz:from 50 seeds developed 46 plants(92 %) with an average length of 1,5 cm.The second group exposed 24 hours/day on telephones on stand-by with frequency of 1,9GHz:from 56 seeds grew 35 plants(64%)with an average lengh of 0.8cm.The third group exposed 24hours/day on mobile telephone which 12 hours/day in conversation:from 56 seeds grew 26 plants (46 %)with an average length of 0.7cm.Control group:from 57 seeds developed 37 plants (64%)with an average length of 1 cm.
Conclusions: The obtained results relieved that the development of the four groups was unequally, depending on the frequency of the electromagnetic waves on wich the groups were exposed.The top group was the one that has been exposed to wirelles waves and the weakest group based on the criteria of germination and growth rate was the third group.

Correlation of self-reported halitosis, organoleptic and instrumental halitosis measurements in a sample of Romanian students  Robert Văsii Bencze Albert, Andreea Andrei Validated View

Correlation of self-reported halitosis, organoleptic and instrumental halitosis measurements in a sample of Romanian students

First author: Robert Văsii

Coordinator(s): Monea Adriana

Keywords: halitosis organoleptic measurement instrumental measurement

Background: Halitosis represents a common dental condition, although sufferers are not always aware of it.
Objective: The aim of this study was to evaluate the presence of halitosis in a sample of Romanian students and to examine the correlation between self-reported halitosis and instrumental halitosis measurements in these subjects.
Material and Method: 52 students (mean age: 20 years) were included in the study. A self-reported questionnaire was used to detect self-reported halitosis and other variables possibly linked to it (medical and dental history, oral hygiene and others). Organoleptic halitosis measurement was carried out by an odor judge, and compared with instrumental halitosis measurement by sulfide monitoring using KISS ME METER halitometer. The results were statistically analyzed using correlation tests.
Results: The results show that the values recorded by halitometer correlated best with organoleptic assessment and least with self-reported results.
Conclusions: Due to the diverse influencing factors, proof of halitosis should always be obtained with two different methods. The combination of KISS ME METER and organoleptic approaches enables simple, reliable and fast detection.

Correlations between high sensitivity C-reactive protein, severity of coronary artery disease and evolution of ventricular function in post acute myocardial infarction patients   Suzana-Vasilica Sincaru Roxana Ioana Hodas Validated View

Correlations between high sensitivity C-reactive protein, severity of coronary artery disease and evolution of ventricular function in post acute myocardial infarction patients

First author: Suzana-Vasilica Sincaru

Coordinator(s): Benedek I , Benedek Teodora

Keywords: CRP acute myocardial infarction

Background:

Inflammation plays an important role in the evolution of coronary artery disease. Highly sensitive C reactive protein represent a new inflammatory marker which has been proved to be associated with the severity of coronary artery disease.

Objective:

We studied the correlation between hs-CRP circulating levels in the postinfarction phase, the severity of coronary artery stenoses and the evolution of left ventricular function. 

Material and Method:

We studied 83 with acute myocardial infarction (AMI) and primary PCI divided into 2 groups based on hsCRP levels, after setting the cutoff point for hsCRP value at 2 mg/dl: group 1 – 35 patients with low-risk, and group 2 – 48 patients with high-risk. 

Results: Involvement of a multivascular disease was recorded in 48.5% of patients in group 1 and in 72.9% of patients in group 2 (p=0.037), with a mean number of coronary arteries with significant stenoses of 1.69 in group 1 vs 1.97 in group 2 (p=0.019). Location of the culprit lesion in the left anterior descending artery was identified in 47.9% of cases in group 1 and in 20% of cases in group 2 (p=0.01). Left anterior descending artery stenosis was identified in 42.8% of patients from group 1 and in 83.3% of patients in group 2 (p=0.0002). Elevated levels of hsCRP values significantly correlated with the values of ejection fraction (r=-0.52, p<0.0001) 
Conclusions: Increased levels of hsCRP indicate an overexpressed inflammatory status which is correlated with a more severe coronary artery disease and a worse ventricular function in the postinfarction phase. 

A comparative study of safety of drinking tea in Romania and Republic of Moldova  Lilia Burlacu Validated View

A comparative study of safety of drinking tea in Romania and Republic of Moldova

First author: Lilia Burlacu

Coordinator(s): Tohati A , Fazakas Zita

Keywords: fluoride food safety tea pH

Background: Tea is one of the most popular drinks. It is obtained by infusing the dried leaves of Camellia sinensis or other plants or dried fruits. The consumption of this beverage is encouraged due to its many health benefits. A disadvantage to be considered, however, is the high fluoride concentration.
Objective:

The purpose of study is to assess the safety of drinking tea in Romania and Republic of Moldova by correlating individual consumption habits with the quality of commercialized products.

Material and Method:

We have developed an online questionnaire regarding individual preferences and brewing habits of tea in the Moldovan and Romanian population. 321 people aged 15 to 60 years (originally from Romania and Republic of Moldova) completed the questionnaire. According to the performed ranking, we selected 71 varieties of teas (16 of them are common in both countries) and analyzed them at the Biochemistry Department of UMPh Tirgu Mures. We used a fluoride ion selective electrode Orion 720 A and Hanna pH meter.

Results: Nearly 9 out of 10 Moldovans drink tea daily, most of them consuming 2 cups a day. In Romania only 4 out of 10 people drink tea daily, and the majority only a cup a day. The mean fluoride concentration in teas commercialized in Moldova (n=45, [F]=1 ppm) is lower than in Romania (n=42, [F]=1.5 ppm).
Conclusions: Republic of Moldova records a higher tea consumption than Romania. Although we found a lower fluoride level in teas marketed in Moldova, its toxic effect is amplified by the large concentration of fluoride in the country's drinking waters. In Romania the risk of fluorosis is increased by a consumption of more than 2 cups of tea per day and the risk is higher in children.

Gingival Retractions: Reality and Expectations  Adriana Chifor Veronica Grozescu, Dan Dragos Sita, Dorina Petronela Tocariuc Validated View

Gingival Retractions: Reality and Expectations

First author: Adriana Chifor

Coordinator(s): Molnar-Varlam Cristina

Keywords: gingival retraction impression setting latex

Background: It is known that dental practitioners generally use gingival retraction methods for successful prosthetic treatment. Problems that occur in the process of impression are the marginal details. 
Objective: The purpose of this study is to evaluate the possible interactions and inhibitory potential between gingival retraction solutions and different elastomers used for the impression process. Another objective is to see if these materials affect the setting of impression materials. We also studied the effect of latex gloves and cords contaminated with latex on the impression materials setting. The impression details were studied after gingival retraction on plastic lid models. 
Material and Method: This study involved using four impression materials:  a polyether, two condensation silicones (hydrophilic and hydrophobic) and an addition-silicone. It was also used a conventional gingival retraction solution with aluminum chlorine, ferric sulfate, aluminum sulfate and zinc chloride. The effects of the retraction material, retraction cords and latex gloves were tested in-vitro on each impression material. The impression material was mixed and packed into a plastic lid where retraction solution was added. It was also evaluated the interaction between impression materials and latex. There was a contact between retractions cords and latex gloves with elastomers. Polymerization inhibition was firstly analyzed by the examination of impression materials and then by the molded surface. 
Results: The polyether was inhibited only by aluminum sulfate and ferric sulfate solutions.  The hydrophilic condensation silicone had its polymerization inhibited   by sulfur compounds. Sulfuric solutions inhibit the polymerization of the addition- silicone. Because of latex contamination on cords, the polymerization of addition- silicone and polyether was inhibited.
Conclusions: Gingival retraction solutions are one of the predisposing factors that may inhibit the setting of impression materials and affect the details of mold reproduction. Dentists could not be capable of detecting inhibitory effects of gingival retractions materials or cords because the phenomenon tends to occur at levels that are beyond visual detection. 

Anatomo-clinical aspects of the ACL reconstruction using the ,,semiT" technique  Loredana Ungureanu Larisa Marina Zahan Validated View

Anatomo-clinical aspects of the ACL reconstruction using the ,,semiT" technique

First author: Loredana Ungureanu

Coordinator(s): Ivanescu A

Keywords: ACL reconstruction medial portal semiT technique pivot shift

Background: The ACL is the main structure that stabilizes the knee. The injuries of this ligament are the most common lesions found in knee trauma. Over the years various reconstruction techniques were used, the most recent studies show that drilling the femoral tunnel through a medial portal has many advantages,  Objective: To show that the ACL reconstruction using the semiT technique with the femoral tunnel drilled through the medial portal has a lot of advantages regarding the outcomes than drilling the femoral tunnel transtibial. Material and Method: We performed an observational retrospective study on 120 patients admitted and diagnosed with ACL tears in the Orthopedic and Traumatology Clinic I on a period of 4 years ( 2010 - 2013 ). All these patients underwent ACL reconstruction using the semiT technique. 

42 patients ( group 1 ) had the femoral tunnel drilled through the medial portal and 78 patients ( group 2 ) had the femoral tunnel drilled transtibial.
Results: The follow-up at 3 and 6 months showed that the pivot shift phenomenon was absent in all patients from group 1 comparing to the patients included in group 2, in which only 5% of them had no pivot shift phenomenon. Conclusions: The malposition of the graft affects the joint stability and the final outcomes. The pivot shift phenomenon ( anterior translation and internal rotation of the tibia ) is the main cause for the unsatisfactory outcomes. This phenomenon appears as a result of the graft verticalization. By drilling the femoral tunnel through the medial portal this malposition of the graft an be avoided.

Pathogenic microorganisms ethiology in cervico vaginal smears  Stefania Roboschi Maria Chifan Validated View

Pathogenic microorganisms ethiology in cervico vaginal smears

First author: Stefania Roboschi

Coordinator(s): Tudor Bianca

Keywords: candida infection cytology microorganisms

Background:

Cervicovaginal infection is one of the most common problems in clinical medicine. Although the cytologic evaluation reveals a wide range of tissue modifications caused by multiple factors ( microorganism infections), usually, the cause of these changes is HPV infection. In most cases these changes in the tissue structure are reversible, still they can lead to cancer development.

Objective:

Our aim was to determine the prevalence of pathogenic microorganisms infections in cervicovaginal smears and the tissular modifications that occur during and after the infection.

Material and Method:

It was a retrospective study including 239 cytodiagnosis reports ( Bethesda 2001) between March 2011 and March 2014. All the data was analysed using Microsoft Xcell 2007 and EpiInfo 7.

Results:

Our analysis showed that 36.4% were from urban area and 36.4% rural, the mean age being 42 years. The data analysis also revealed that there were 45.18% cases of Candida infection, 17.57% Cocobacillus infections and 2% Trichomonas infections.

Conclusions:

The most prevalent pathogens were Candida and Cocobacillus regardless of age, hormonal status and social environment.

SUPRAMOLECULAR DRUG CARRIERS  Iulia Maria Niculoiu Validated View

SUPRAMOLECULAR DRUG CARRIERS

First author: Iulia Maria Niculoiu

Coordinator(s): Avrigeanu Veronica , Gaz Florea S A

Keywords: supramolecular chemistry, drug delivery, bioavailability, host-guest

Background:

Nowadays innovation in many therapeutic areas such as cancer, inflammatory or infective diseases arise in synthesis of new potent drugs. However, many of them failed in initial phases of development due to limited solubility, stability and high toxicity. Therefore new doors for therapeutic delivery and targeting of drugs have been opened by using new drug-delivery systems and new modes of action.

Objective: A number of macromolecular delivery systems are under investigation in which the drug molecule is encapsulated inside a macrocyclic host molecule, forming discrete host-guest complexes. Several carrier types are highlighted focusing especially on new supramolecular delivering systems.
Material and Method:

Documentary study. Results: . Conclusions:

In conclusion the supramolecular carriers exhibit great potential as efficient drug delivery improving the targeting properties by decreasing the dosage amount to be administrated, minimizing the side effect and lowering the toxicity.

INITIAL INTERNSHIP EVALUATION OF THE STUDENTS PHARMACEUTICAL PRACTICE FROM THE UNIVERSITY OF MEDICINE AND PHARMACY, CLUJ NAPOCA  Alina-Maria Daraban Validated View

INITIAL INTERNSHIP EVALUATION OF THE STUDENTS PHARMACEUTICAL PRACTICE FROM THE UNIVERSITY OF MEDICINE AND PHARMACY, CLUJ NAPOCA

First author: Alina-Maria Daraban

Coordinator(s): Mirel Simona

Keywords: pharmaceutical practice, practical guide, internship of students, professional development

Background: Finding a new way of approaching the practical training of students in the pharmacy is mandatory, one in accordance with the changes concerning the concept of modern pharmacy.
Objective: The purpose of the study was to evaluate the perception of the organization, the development and the evaluation of the initial stage in the internship of students, in order to to establish the adequate objectives for the current standards of the pharmacist profession.
Material and Method: An online survey was made using Google Docs-Create Form extension and was completed by students from the 2nd, 3rd and 4th year of study, from the Faculty of Pharmacy, University of Medicine and Pharmacy "Iuliu Hatieganu" in Cluj-Napoca.
Results: The study was conducted on 308 students. 89.90% of the respondents had actually participated in the internship and the main responsibilities of the students included: ordering and storage of pharmaceutical products(93.81%); reception of products(79.15%); working with the receipts(57.32%); providing drugs and health products(33.55%). Most of the students appreciate that they were very well integrated into the work in the pharmacy(31,92%),this being due largely pharmacist tutor, who, in general, expressed interest in mentoring activities. Most of the students believe that only 25% of the theoretical knowledge gained in college was useful during the internship and 89.57% considered useful to develop a practice guideline adapted to the year of study.
Conclusions: Feed-back from the students shows that they are aware of the usefulness of the internship, but believe the theme must be updated and a better correlation between work in pharmacy and theoretical knowledge gained in college has to be made. A first step is to develop a practical guide adapted to each year of study.The involvement of the tutor pharmacist is also essential to the success of this activity.

ANTITHROMBOTIC THERAPY IN PACIENTS WITH ACUTE CORONARY SINDROME (ACS) AND CONGENITAL PROTHROMBOTIC STATES  Florina-Maria Andrica Validated View

ANTITHROMBOTIC THERAPY IN PACIENTS WITH ACUTE CORONARY SINDROME (ACS) AND CONGENITAL PROTHROMBOTIC STATES

First author: Florina-Maria Andrica

Coordinator(s): Petrescu L

Keywords: Acute Coronary Sindrome, in-stent thrombosis, anticoagulants, congenital prothrombotic state

Background:  Nowadays, atherothrombotic pathophysiology caused by atherosclerosis, became the main public enemy, especially because of the consequences of the coronary and cerebral vascular occlusions. In most cases, hospitalized pacients present increasing factors for thrombotic events- congenital procoagulation disorders.
Objective:

  Drug interventions to prevent thrombosis and/or intimal hyperplasia leading to reocclusion/restenosis of treated arteries to these patients. The main issues to consider concerning such drug interventions are: - the most effective and safest antithrombotic therapy; - the duration and modality of the antithrombotic treatment; - the efficacy of dual therapy with antithrombotic drugs.

Material and Method:    During the last 2 years, in the Institute of Cardiovascular Medicine from Timisoara, 987 pacients with ACS were hospitalized, 518 of whom were diagnosed with STEMI, being managed with PCI and 469 pacients with NSTEMI. The most common Blood Craze Disorders were: protein C and S decrease: 9 pacients (37,5%), severe increase of PCR hs: 7 pacients (29%), von Willebrand factor increase: 3 pacients (12,5%), hyperhomocysteinemie: 2 pacients (8.3%).
Results:
     Some of these pacients used the association between Dual Antiplatelet Therapy (clopidogrel+acetylsalicylic acid )+inhibitor of GP IIb/IIIa(Eptifibatide) and anticoagulants s.c. in limited use: Enoxaparine (antifactor X), and others used, antifactor II-a for anticoagulation, for a minimum period of 30 days: Dabigatran associated to the antiplatelet terapy.
        Intrastent thrombosis rate was extremly high, 8 of the patients were diagnosed with Acute Thrombosis or Subacute Stent Thrombosis (33,3%), 4 of them died (16,6%) after reiterate thrombosis, Myocardial Infarction.
Conclusions: According to prothrombotic evolution, the pacients diagnosed with Acute Ischemic Syndrome, especially  myocardial, despite of a correct therapeutical attitude, we must suspect an genetical disorder caused by coagulability or prothrombogenity, that came to aggravate the atherotrombotic process initiated by the atherosclerosis risk factors.

DETERMINATION OF CALCIUM IN FRESH JUICES OF CITRUS GENUS SPECIES  Andrei Uncu Validated View

DETERMINATION OF CALCIUM IN FRESH JUICES OF CITRUS GENUS SPECIES

First author: Andrei Uncu

Coordinator(s): Iurie T , Calalb Tatiana

Keywords: calcium, atomic absorption spectrometry, complexonometric, permanganatometric citrus juices

Background: It is known that calcium is a mineral with difficulties in its absorption because it is affected in the body by the concomitant administration of vitamins like A, D, C and some minerals. In these situations it is recommended to consume calcium-fortified products: citrus juices. They contain citric acid ,which has an essential role in calcium absorption through the gut.
Objective: We have proposed benchmarking of calcium content in fresh juices obtained from fruits of some species of Citrus genus by applying atomic absorption methods (elemental calcium), permanganatometric and complexonometric methods (ionic calcium).
Material and Method: Orange, lemon, mandarin and grapefruit fresh juice, balance, juice extractor, atomic absorption spectrometer Thermo Scientific ICE 3000, centrifugal, vacuum filtration set, pH meter, laboratory glassware, chemical reagents prepared in accordance with requirements of RF X.
Results: The juice was filtered, centrifuged and the liquid phase was collected. For detection and quantitative determination of calcium by atomic absorption spectrometry samples were diluted, and in order to avoid partial flame ionization the lanthanum chloride solution was added. A calibration curve was established and the absorbance of elemental calcium was measured in acetylene-air flame. Elemental calcium was calculated: orange - 30 mg/100 ml, mandarin - 35 mg/100 ml, grapefruit - 84 mg/100 ml and lemons - 34 mg/100 ml. To determine the amount of soluble calcium ions, which are found in citrus form in its predominant form as citrate, the permanganatometric and complexonometric determinations were made. The results from both methods are similar, showing same trends and correlations.
Conclusions: Comparative evaluation of calcium ions and the amount of elemental calcium in analyzed citrus juices shows that the percentage of ions in soluble phase is more in lemon fruit. This is explained by much higher content of citric acid in lemon fruit compared with other species of Citrus genus fruits.

THE ELABORATION OF METHOD OF QUANTITATIVE DETERMINATION FOR THE COMBINED OINTMENT WITH IZOHYDROFURAL AND METHYLURACIL  Tatiana Iuresco Validated View

THE ELABORATION OF METHOD OF QUANTITATIVE DETERMINATION FOR THE COMBINED OINTMENT WITH IZOHYDROFURAL AND METHYLURACIL

First author: Tatiana Iuresco

Coordinator(s): Uncu Livia , Bobrov Elena

Keywords: combined ointment, izohydrofural, methyluracil, quantitative determination, UV-VIS spectrophotomet

Background: It was created a new pharmaceutical form - combined ointment with izohydrofural and methyluracil, which combines the antibacterial action of izohydrofural and the regenerating action of methyluracil. This ointment can be used in treating skin diseases, in surgery, obstetrics and gynecology, ophthalmology, proctology due to high efficiency and good way of application.
Objective: The new pharmaceutical form for external use - combined ointment with izohydrofural and methyluracil is researched. The aim of this study was to elaborate the method of quantitative determination of active substances from the combined ointment by physico-chemical methods UV-VIS spectrophotometry.
Material and Method: In research it was used: the combined ointment with izohydrofural and methyluracil, dimethylformamide, UV-VIS spectrophotometer Agilent-8453. For the quantitative determination, first of all active substances were extracted from the ointment with dimethylformamide.
Results: Absorption spectrophotometry in ultraviolet and visible (UV-VIS) is regarded as one of the classical methods of analysis of drugs, although its importance has not reduced over time. The interest of researchers for this method is explained that it is simple, fast and relatively cheap. It was examined the possibility of using this specific method for quantitative determination of the combined ointment with izohydrofural and methyluracil. It was analysed the extraction of active substances with dimethylformamide from the ointment. It was obtained the absorption spectrum in the wavelength of 190-300 nm, reference solution being dimethylformamide. Izohydrofural gives a maximum of absorption at wavelength of 373 nm and methyluracil at 267 nm. This research allows elaboration of quantitative determination of active substances by spectrophotometric method.
Conclusions: It was elaborated the quantitative determination of the combined ointment with izohydrofural and methyluracil by spectrophotometric method. In conclusion, the method is exactly and reproducible, errors are within acceptable limits of drug control requirements.

ETNOBOTANICALS - SINTETIC OBTAINED PLANTS. FARMACOTOXICOLOGICAL ANALYSIS, SOCIAL IMPLICATIONS  Vlad-Andrei Mititelu Robert Calin Validated View

ETNOBOTANICALS - SINTETIC OBTAINED PLANTS. FARMACOTOXICOLOGICAL ANALYSIS, SOCIAL IMPLICATIONS

First author: Vlad-Andrei Mititelu

Coordinator(s): Vari C E

Keywords: etnobotanicals, mephedrone, flephedrone, methylone, MDPV

Background: Over the time there were two generations of ethnobotanical products containing  substances like: mephedrone, flephedrone, methylone and MDPV, that became illegal. However, since 2011 a third generation was released having some structural derivatives of some already known compounds that were not included on the list, but with farmacophore groups that provide pharmacological tropism in the central nervous system and with potential psychotropic effects.
Objective: The goal of this study is to analyze the effects and risks that come along with the substances present within the composition of some ethnobotanical products like : Special Gold, Magic, Charge, Explosion, Maraciuca or Zen.
Material and Method: We conducted a survey among ethnobotanical product users and the most noteworthy substances were analyzed from a structural, physico-chemical, pharmacological, toxicological point of view, also adding populational data (obtained from the consumers).
Results: The data obtained was statistically compared with that found in the literature, with those provided by the National Antidrug Association from our country and those provided by UPU Mures.
Conclusions: The processing of questionnaires and the pharmacotoxicological analysis of the specified substances helped us to establish the prevalence and the incidence and to elaborate a hypothesis on the risk factors associated with consumption.

DEVELOPMENT OF A HPLC BENZITURON ASSAY FROM PURE SUBSTANCE AND 10% INJECTABLE SOLUTION  Veronica Zgureanu Validated View

DEVELOPMENT OF A HPLC BENZITURON ASSAY FROM PURE SUBSTANCE AND 10% INJECTABLE SOLUTION

First author: Veronica Zgureanu

Coordinator(s): Iurie T

Keywords: Benzituron, HPLC assay, validation

Background: Benzituron is a new substance with isothiouretic structures is able of decrease blood pressure on the base  of activation of Nitric oxide-synthetase.
Objective: The development of new sensitive and fast method for Benzituron assay from pure substance and from injectable pharmaceutical form is present.
Material and Method: An Agilent 1200 HPLC-DAD instrument and pure Benzituron in substance and its injactable solutions of 10%. The proposed HPLC methods  uses a inversed phase mechanism for the analyte separation, on Zorbax Eclipse XDB C18 column (150X 4mm, 0,5 ?m) with gradient elution of 1 mL/min flow rate at 30oC. The mobile phase consists of a mixture of tricloracetic acid  and  acetonitril = (80:20). The detection is set at 222 nm.
Results: The calibration curve is linear on the range 0-25 mg/mL with  a quantification limit of 0,05 mg/mL for Benzituron. Equation regresion is expressed by y= 604,9 x - 64,6 and correlation coefficient of Pearson is valued as r2=0,9998. HPLC methods for assay was validated according to ICH requirements, such as: the parameters of repeatability, reproducibility and fidelity.
Conclusions: In calculating all these parameters were used the results of assay of three experimental series of Benzituron  in pure substance and its  injectable Solution of  10% with 5 replicates for each series.

THE STUDY OF THE ANTIBIOTIC RESISTANCE THROUGH A PHARMACOLOGICAL APPROACH IN THE MONITORING OF THIS PHENOMENA  Mihail Anton Validated View

THE STUDY OF THE ANTIBIOTIC RESISTANCE THROUGH A PHARMACOLOGICAL APPROACH IN THE MONITORING OF THIS PHENOMENA

First author: Mihail Anton

Coordinator(s): Uncu Livia

Keywords: antibiotic resistance, respiratory infection, action spectrum

Background: Every year in the European Union alone, an estimated 25 000 patients die because of a serious resistant bacterial infection. Antibiotic resistance increases the costs of treatment because of longer hospital stays, more expensive antibiotic drug use and treatment, as well as indirect costs to families and society. In many countries in the European Region, antibiotics can be bought over the counter. Often data is not collected on antibiotic resistant infections, so although doctors are very well aware of the problem, its scale is not being charted.
Objective:

1. Appreciate the antibiotic resistance level for the pathogens most commonly involved in respiratory infections. 
2. Update the action spectra of antibiotics used to treat respiratory infections.
Material and Method:
The researches have been performed at the National Centre for Public Health, Epidemiology Centre for extremely dangerous diseases laboratory, Respiratory diseases department.
As the object of study, bacterial strains that are most often involved in respiratory infections in Moldova were selected. The bacterial resistance was studied to antibacterial agents most often used in the ethiotropic therapy of respiratory diseases.
Results: 665 antibiograms of microorganisms strains, detected at 83% of patients diagnosed with respiratory infections, were investigated. Action spectra of amoxicillin, cefuroxime, ceftriaxone, ciprofloxacin and the macrolide group of antibiotics (erythromycin, clarithromycin and azithromycin) were updates.
Conclusions: The highest rates of resistant pathogens involved in respiratory infections were found to macrolide antibiotics group (especially to erythromycin). The lowest rates of antibiotic resistance were found to cephalosporins (particularly ceftriaxone).

HIGH-THROUGHPUT NIR - CHEMOMETRIC METHODS FOR PREDICTING PHARMACOTECHNICAL PROPERTIES OF INDAPAMIDE SUSTAINED RELEASE TABLETS*  Cristina Sirbu Validated View

HIGH-THROUGHPUT NIR - CHEMOMETRIC METHODS FOR PREDICTING PHARMACOTECHNICAL PROPERTIES OF INDAPAMIDE SUSTAINED RELEASE TABLETS*

First author: Cristina Sirbu

Coordinator(s): Tomuta I , Achim Marcela

Keywords: NIR spectroscopy, chemometry, indapamide, sustained release tablets

Background: The concept of Process Analytical Technology (PAT) was recently introduced by FDA, EMA and ICH in drug manufacturing guidances. Near Infrared (NIR) spectroscopy is a key component of the PAT toolbox due to enabling rapid and direct analysis of pharmaceutical powder blends and intact solid forms.
Objective: The aim of this study is to develop and validate NIR-chemometric methods for the pharmacotechnical characterization of indapamide sustained release tablets. 
Material and Method: Calibration samples consisting of powder blends for tableting and indapamide sustained release tablets were prepared according to an experimental design with 3 variables and 5 levels (25 samples were prepared). The samples were measured using a NIR spectrometer (MPA, Bruker Optics, Germany) in transflectance mode for powder blends and in transmittance mode for tablets.  PLS regression method and different pre-treatment methods: straight line subtraction (SLS), vector normalization (SNV), min-max normalization (MMN), multiplicative scatter correction (MSC), first derivate (FD), FD+SLS, FD+SVN, FD+MSC were used in the developement of the calibration models.
Results:

Different calibration models were evaluated regarding the quantification of indapamide, lactose and HPMC in powder blends for tableting and tablets (80-120% API) and the pharmacotehnical properties of tablets (crushing strength, friability and kinetic release) using NIR-chemometric technique. Then, using the best calibration models (FD+MSC for powder blends for tableting and FD for tablets), the methods were fully validated according to the ICH guidance. The validation results showed good precision, trueness and accuracy, between +/-10 acceptance limits for the prediction of indapamide content and pharmacotehnical properties of tablets and between +/-5 acceptance limits for the prediction of lactose and HPMC content..

Conclusions: Such quick NIR-chemometric methods can be used for on-line, in line or at line monitoring of the manufacturing process of indapamide sustained release tablets and are helpful in achieving the goals of the PAT concept.

QUALITY ASSESSMENT OF SOME SOFT DRINKS  Sabina Puscasu Mihaela Constantin Validated View

QUALITY ASSESSMENT OF SOME SOFT DRINKS

First author: Sabina Puscasu

Coordinator(s): Cuciureanu Rodica

Keywords: soft drinks, legislation, acidity sugar content, flavors and colorings

Background:

Soft drinks are food products made of flavored concentrates, fruit and/or vegetable juice, fruit and/or herbs syrup, flavoring substances, drinkable water or mineral water, natural or synthetic sweeteners, with added vitamins, coloring, with/without added carbon dioxide.
These products can be qualitative assessed based on sensory, physicochemical and chemical parameters according to the legislation in force.
Objective: Our research has aimed the qualitative assessment of 17 types of soft drinks, according to the Soft Drinks Standard (STAS 2567-87).
Material and Method:
We analyzed 17 samples of soft drinks from different makers. We determined the sensory properties and chemical properties (total acidity, sugar content). We also identified the colorings (natural or synthetic) and the flavoring substances using paper chromatography.

Results:
As far as the sensory assessment (aspect, viscosity, smell, taste) is concerned, the products meet the quality requirements, according to their nature. The acidity (grams of citric acid per liter) for the analyzed soft drinks varies between 1.85 g citric acid/L and 8.00 g citric acid/L. The total sugar content is less than stated on the label, the difference varying between 0.27% and 2.07%, except for one sample which claimed to be sugar free and the experimental results were accordingly. The chromatographic identification of colorings and flavoring substances led to results in accordance with the information on the label.

Conclusions: Our analysis has proved that the 17 soft drinks meet the quality requirements of the legislation in force.

REVIEW REGARDING POLYMERS APPLICATION IN MODERN NANOTECHNOLOGY  Maria Ruxandra Soare Validated View

REVIEW REGARDING POLYMERS APPLICATION IN MODERN NANOTECHNOLOGY

First author: Maria Ruxandra Soare

Coordinator(s): Mircia Eleonora , Hancu G

Keywords: biodegradable polymers, nanotechnology, tissue engineering

Background: Polymer-based drug research aims to develop modern release systems of medicinal substances in order to obtain maximum efficiency and to reduce to minimum the undesirable side effects; systems that are capable of transporting micro- or macromolecular substances to desired location in the human body: organ, tissue, cell or intracellular formations. The use of polymers in order to achieve prolonged release systems is based on their capacity to generate systems that decompose chemically and are disposed by normal metabolic routes.
Objective:

Nanotechnology development led to an extension of applications of treatments with microspheres, microemulsions, nanospheres, nanocapsules based on polymers.
Many of these systems use carriers or molds are made of biodegradable polymers and used as controlled release forms administered orally and parenterally. The availability of a wide range of biodegradable polymers, both natural and synthetic influences significantly the therapy in many diseases.
Material and Method: There is a growing interest for this type of polymers, justified by their ability to achieve controlled release drug systems which are likely to disappear from the body, this process being of particular importance for systems intended for parenteral administration. Obtaining injectable polymers, biodegradable polymers incorporating microspheres, microparticles, nanoparticles, organ and tissue grafting, polymeric implantable formulation systems for the cancer treatment, the encapsulation of biologically active materials, replacing the cancerous breast with a biodegradable polymer matrix, healing of wounds by implanting a collagen matrix, cartilage and vascular tissue engineering, are just a few of their applications.
Results: Taking in consideration its characteristics, nanodevice polymers can be used as innovative tools for detection and monitoring disease diagnosis and for treatment.
Conclusions: The therapy of the future is currently oriented towards the development of nanodvices including biosensors and biodetectors for the quantitative determination of traces of biological substances or pathologic proteins that can be used as biomarkers of pathologic processes in the body.

DNA BARCODING TECHNIQUE - PROGRESSES AND APPLICATIONS  Viorela-Alexandra Racoiu Validated View

DNA BARCODING TECHNIQUE - PROGRESSES AND APPLICATIONS

First author: Viorela-Alexandra Racoiu

Coordinator(s): Crisan Gianina

Keywords: DNA barcoding, Aconitum, intergenic spacer

Background: A fundamental part of the recognition and the description of biodiversity is the species identification. Apart from traditional methods, alternative ones have been discovered such as DNA barcoding technique. This technique is based on a short fragment of genomic DNA.
Objective: The aim of the study is to present DNA barcoding technique with its advantages and its accuracy to identify the differences between a number of species of the genus Aconitum L.
Material and Method: The plant samples were collected from different locations in China between 2007 and 2009. They were identified by the professors from Chinese Academy of Sciences. Fresh leaves of the samples were dried in silica gel. Genomic DNA has been isolated from 10 mg of each leaf sample and using the DNA barcode psbA - trnH intergenic spacer.
Results: Among two of the most widely Aconitum species used in medical purposes in Chinese medicine A.carmichaeli and A.kusnezoffii inversions of the sequence were observed. The studied samples were gathered in ten groups by the sequence alignment and most of the presented Aconitum species could become differentiated by the psbA-trnH intergenic spacer.
Conclusions: DNA barcoding is a powerful tool which is inseparably associated with taxonomy and it will improve species discovery.  By combining the psbA-trnH intergenic spacer, other DNA barcode sequence and geographic information, psbA - trnH is a useful maker for the identification of Aconitum species.

TESTING THE Ni-SOD-LIKE ACTIVITY OF TWO BIMETALLIC COORDINATION COMPLEXES USING A UV/VIS TITRATION METHOD  Rita Mathe Validated View

TESTING THE Ni-SOD-LIKE ACTIVITY OF TWO BIMETALLIC COORDINATION COMPLEXES USING A UV/VIS TITRATION METHOD

First author: Rita Mathe

Coordinator(s): Curticapean A

Keywords: Ni-SOD, UV/Vis titration, superoxide, ROS

Background: The study of superoxide dismutases (SOD) has gained a significant increase because of the implication of the reactive oxygen species (ROS) in the human physiopathology. There are four types on SODs, classified by their prosthetic group: Cu,Zn-; Fe-; Mn-; and Ni-SOD. They catalyze the disproportionation of the superoxide anion to hydrogen peroxide and molecular oxygen. To study the mechanism of catalysis, purified enzymes, SOD-maquettes or SOD-mimetics can be employed.
Objective: This paper presents two potential Ni-SOD-mimetic coordination complexes and their interaction with the superoxide anion.
Material and Method:

Both complexes are bimetallic coordination compounds with one octa-coordinated Zn(II) or Ni(II) center and a square planar Ni(II) center which should play the role of active site.
The supposed interaction between each of the complexes with the superoxide anion was studied spectrophotometrically, using a UV/Vis titration method. The solvent used for the reaction was DMSO. The crown ether 18C6 was used to prepare the KO2 titrant solution. Two concentration levels for both complexes' solutions and the superoxide solution were used. Spectra were recorded between 270 and 1300 nm, each 5 minutes, after a fresh addition of superoxide solution.
Results: The changes in some absorption bands, during titration, demonstrate the reaction of both bimetallic complexes with the superoxide anion.
Conclusions:
Based only on these results, it cannot be yet stated for sure whether or how the square planar Ni(II) is involved.

Acknowledgements
The author would like to thank Prof. Dr. Winfried Plass and Dipl.-Chem. Markus Schimidt for all the support given during the ERASMUS-Placement time at Friedrich-Schiller University Jena.

CONTRIBUTIONS TO THE KNOWLEDGE OF THYMUS STOJANOVII DEGEN  Silvia Popovici Validated View

CONTRIBUTIONS TO THE KNOWLEDGE OF THYMUS STOJANOVII DEGEN

First author: Silvia Popovici

Coordinator(s): Arcus Mariana

Keywords: Thymus stojanovii, part of the botanical group Labiatae

Background:
Objective: This paper aims to study the morphology and anatomy of Thymus stojanovii and its compliance to the botanical group Labiatae, known for its high content in essential oils, flavones  and tannins, with multiple applications in human diseases.
Material and Method:

The vegetative organs (stem and leaves) of Thymus stojanovii have undergone the following stages:
- Establishing and preserving fresh material in 70% alcohol;
- cross cutting;
- washing sections with sodium hypochlorite;
- Washing sections with acetic water and distilled water;
- coloring the sections with iodine green and red rutheniu.
Results:
- The outline of the upper cross section is square shaped with attenuated ribs; the external wall of the epidermis is covered with a striate cuticle and secretory and tector hairs; the rib has colenchyma; the central cylinder has ring shaped leading tissues, the wooden ring closing a thick spinal;
- Cross-section through the lower stem is almost circular; the epidermis has cells with striated external walls; the colenchyma is present in the ribs; the central cylinder is large; the marrow contains cells with cellulose walls.
- Leaves have diacitic stomata;  in cross section, both epidermis contain large, rare tector and secretory hairs; the mesophyll has lacunose and palisadical tissue; the median beam is the most developed, covered by a thick sclerenchyma cord.
Conclusions: Taking all these into account, it was found that Thymus stojanovii has all the general  anatomical and morphological characteristics of the Labiatae botanical group.

RESEARCH CONCERNING DEVELOPMENT OF A BIORELEVANT DISSOLUTION TEST FOR ORAL FORMULATIONS CONTAINING NORFLOXACIN  Ioana Iancu Validated View

RESEARCH CONCERNING DEVELOPMENT OF A BIORELEVANT DISSOLUTION TEST FOR ORAL FORMULATIONS CONTAINING NORFLOXACIN

First author: Ioana Iancu

Coordinator(s): Anuta Valentina

Keywords: Norfloxacin, Biorelevant dissolution media, In Vivo - In Vitro Correlations (IVIVC)

Background: In recent years, the scope of in vitro dissolution testing has expanded considerably to include screening and predicting the in-vivo performance of drug formulations. Since the new objectives were of high complexity, the compendial dissolution tests proved to be frequently inadequate, due to an ignorance of physiological phenomena.
Objective: The aim of the study is the development of biorelevant dissolution tests for oral formulations containing a BCS Class IV drug, norfloxacin, and comparison with the compendial methods in terms of successful predicting the in-vivo performance and in-vitro-in-vivo correlations (IVIVC).
Material and Method:

Drug release experiments were performed with USP Apparatus 2 at 50 rpm. Experiments were run in triplicate. 
Compendial USP30 simulated gastric fluid (SGF), simulated intestinal fluid (SIF) and acetate buffer pH 4.0 (the dissolution medium stated under the Norfloxacin Tablets Monograph) were used to evaluate the release kinetics of norfloxacin.
Biorelevant dissolution media simulating fasted and fed state in both gastric and intestinal environment were prepared by using physiological surface active agents (bile salts and lecithin).
Results:
Comparison of dissolution profiles obtained in compendial and biorelevant media indicated that bile components play an important role in the solubilization of norfloxacin.
The in-vitro dissolution profiles were compared with the in-vivo pharmacokinetic data, by using the FDA Level A (Wagner-Nelson) correlation method. In contrast to results obtained with biorelevant media, compendial media failed to match the in vivo data as they do not reflect the essential conditions for the solubilization of norfloxacin.
Conclusions: In-vitro dissolution testing using biorelevant media was combined with in-silico physiologically based pharmacokinetic (PBPK) modeling for the generation of simulated plasma profiles and the development of IVIVCs. Following this approach, prediction of the plasma profile of orally administered norfloxacin and validation of the biological relevance for the dissolution tests was achieved.

CONTENT OF EPHEDRINE AND CAFFEINE OF SOME NATURAL HERBAL SUPPLEMENT RECOMMENDED FOR A WEIGHT LOSS PROGRAM  Madalina Zaharia Validated View

CONTENT OF EPHEDRINE AND CAFFEINE OF SOME NATURAL HERBAL SUPPLEMENT RECOMMENDED FOR A WEIGHT LOSS PROGRAM

First author: Madalina Zaharia

Coordinator(s): Croitoru M D

Keywords: ephedrine, caffeine, weigh loss, natural supplements

Background:

Nowadays, a slim body is a beauty standard for most people. Some people try to obtain a weight loss  by turning to so called "natural" sliming products. These products, most of the time, contain substances as caffeine and ephedrine which in some circumstances can be effective for reducing felling of hunger and increase mental and physical abilities. Unfortunate, overdosing with such products is possible especially since they are most of the time marketed as harmless products and some active substances are not even listed on the label. Because of this, many people tend to overdose the product.
Such overdose is a serious health threat because ephedrine and other adrenergic stimulants can cause hypertension and tachycardia that might be even lethal. Because such adverse effects in some countries ephedrine was withdrawn from the market but still appears as "natural herbal supplements".
Objective: Our goal was to measure using the HPLC technique the content of caffeine and ephedrine in natural supplements and teas recommended for weigh loss programs.
Material and Method: A simple reversed phase HPLC-UV method was employed for analysis of pills and teas recommended for a weight loss programs.
Results:
Results showed that the tested products are not a health danger from the caffeine point of view because most of them contained similar quantities to those consumed by an "usual" coffee drinker.
Ephedrine, however, was present in high amounts in some products. Use of such products can lead to an ephedrine intake that exceeds the dose of 24 mg/day, accepted by FDA . When ephedrine was present, it was unlisted in most of the cases making impossible for one to distinguish between risky products and harmless herbal supplements.
Conclusions: Based on our results can be seen that a tight control of herbal supplements is needed since they can be in certain conditions a health threat.

ANTIOXIDANT ACTIVITY AND CHEMICAL COMPOSITION OF THREE BASIL VARIETIES FROM BIOCULTURES GROWN IN ROMANIA  Veronica Gradinariu Olga Punga, Ioana Lavinia Stefan Validated View

ANTIOXIDANT ACTIVITY AND CHEMICAL COMPOSITION OF THREE BASIL VARIETIES FROM BIOCULTURES GROWN IN ROMANIA

First author: Veronica Gradinariu

Coordinator(s): Cioanca Oana , Hancianu Monica

Keywords: Basil, bioculture, antioxidant, GS-MS, HPLC

Background:

Ocimum sanctum is a well known aromatic plant from Lamiaceae family. Besides its culinary uses, it is considered to be sacred in different traditional Hindu practices. According to Ayurvedic medicine, Tulsi is used as treatment for colds, headaches, stomach cramps, inflammations, malaria, cardiac disorders and other poisoning disturbances.
On the other hand, Ocimum basilicum is cultivated worldwide and numerous mixtures of basil are used for supportive therapy of gastrointestinal malfunctions.
Objective:
The present study aimed to asses the chemical composition and antioxidant potential of the hydroalcoholic extract (50%) obtained from O. basilicum, O. basilicum var. rubrum and O. sanctum included in biocultures from Romania (Biological Research Center Stejarul Piatra Neamt).
For a fuller screening, the volatile oils were included in the research.
Material and Method: The volatile fractions isolated by steam distillation in Neo-Clevenger apparatus were analyzed using gas chromatography (GS-MS). The polyphenols were determined using Folin-Ciocalteu method. A high performance liquid chromatography (HPLC-MS) was used to identify the main compounds. In addition, the antioxidant capacity was investigated by two tests: scavenger of DPPH (2,2-diphenyl-1-picrylhydrazyl) radicals and pherozine chelating activity.
Results:
As expected, the GS-MS analysis showed that there were qualitative differences between the two types of isolated volatile oils: linalool, the main compound of basil volatile oil, lacks in Tulsi oil. The phenolic derivatives profile established by HPLC proved that O. sanctum sample was different both qualitatively and quantitatively from both samples of O. basilicum varieties: the flavonoides were represented in O. sanctum oil.
The antioxidant test results were correlated to the chemical composition with differences between the two species.
Conclusions: All in all, the results state once again that O. sanctum has a different chemical profile and, therefore, should not be substituted by  O. basilicum in food supplements.

THE RISKS OF PHYTOTHERAPY IN PREVENTION AND TREATMENT  Ana Moiseev Validated View

THE RISKS OF PHYTOTHERAPY IN PREVENTION AND TREATMENT

First author: Ana Moiseev

Coordinator(s): Calalb Tatiana

Keywords: phytotherapy, responsability of treatment, risks

Background: Phytotherapy is a widely applied form of medical treatment which relies on the use of plants in the treatment of many diseases. The used herb products can have great results, but can be very dangerous when they are not utilized properly.
Objective: The aim of this study was to evaluate the awareness of people towards the medicinal plants used and its correlation between the benefits and risks of phytotherapic treatment.
Material and Method: In order to achieve the goals of study, the following research methods have been used: observation, personal interviews, questionnaire (with 30 topics) and statistical processing of the results.
Results:

The evaluation of questionnaires has revealed the most informative indices of risks and failures when using medicinal plants: wrong way of preparation and use of the plant products, lack of diagnosis, ignoring medical consultation, treatment of one disease and ignoring the attendant maladies.
The results have shown that 91 % of respondents consider phytotherapy to be a useful treatment method, and 65% experienced at least once secondary effects after using medicinal plants. High level of errors are due to the particularities of administration, sickness and individual ones.
It is gratifying that even having experience in using medical plants, 74% of those interviewed still consider the consultation of a specialist to be absolutely necessary when taking the decision about phytotherapic treatment.
Conclusions: The study shows a need for a qualitative and accessible information of the population about the benefits and risks of phytotherapy.

CHEMOMETRIC DETERMINATION OF PROPRANOLOL?S ENANTIOMERIC EXCESS BY SURFACE ENHANCED RAMAN SPECTROSCOPY  Oana Alexandra Hosu Validated View

CHEMOMETRIC DETERMINATION OF PROPRANOLOL?S ENANTIOMERIC EXCESS BY SURFACE ENHANCED RAMAN SPECTROSCOPY

First author: Oana Alexandra Hosu

Coordinator(s): Ede Bodoki , Stifiuc R

Keywords: propranolol, chiral purity, SERS, multivariate data

Background:

Chromatographic and electrophoretic separations has proven their value in pharmaceutical industry, offering good selectivity, specificity and linear range, however they may also require lengthy method development, separation and analysis times.
The key to the present issue seems to be given by the chemometric interpretation of spectroscopic data (PCA and PLS regression analysis), where quantitative information regarding pharmaceuticals can be easily extracted without a prior sample pretreatment and/or separation.

Objective: The aim of this study is to develop a rapid and non-destructive method which determines the chiral purity of pharmaceutical preparations with propranolol.
Material and Method: The enantiomers of propranolol are physisorbed on the surface of coloidal silver nanoparticles and in the presence of a chiral selector (beta-ciclodextrine) their spectroscopic behaviour is significantly dissimilar. Their enantiospecific interaction has been characterized by Surface Enhanced Raman Spectroscopy (SERS - Advantage 785 Raman Benchtop Spectrometer, Intevac, USA) and the same spectroscopic technique combined with multivariate data analysis (Simca-p+ software package - Umetrics) has been employed for the assessment of its enantiomeric purity.
Results: Known molar fractions of propranolol?s enantiomers with a fixed concentration of beta-cyclodextrine and silver nanoparticles were analysed by SERS using a 785 nm excitation laser. The validation sets? spectra were used for the build up of the PLS model which eventualy served for the prediction of the enantiomeric excess of real pharmaceutical samples (tablets).
Conclusions:
The obtained results demonstrate once again the high analytical value of multivariate data analysis in general, and regression modeling in particular. 
Separation sciences may benefit the most of this data treatment toolbox, especially in applications where time is crucial, separation and sample pre-treatment is complicated and expensive.

Genetics answering reproductive questions  Oana Nechifor Validated View

Genetics answering reproductive questions

First author: Oana Nechifor

Coordinator(s): Banescu Claudia

Keywords: reproductive disorders cytogenetics infertility factors

Background:

Infertility can be defined as the failure to conceive following twelve months of unprotected intercourse. Although, in many cases, infertility results from unidentified factors (10%), a variety of reasons are implicated: problems with sperm (35%), problems with ovulation (in 20%), fallopian tubes illnesses (30%) and cervical mucus abnormalities (5%). The genetic causes of infertility are various and include chromosomal abnormalities, single gene disorders and phenotypes of multifactorial inheritance. Considered a reproductive disorder, spontaneous abortion represents noninduced embryonic or fetal death or passage of products of conception before 20 weeks of gestation.

Objective:

The aim of this study was mainly to illustrate the findings in cytogenetic investigations conducted on infertile men and women and also on females facing spontaneous abortion (SAB) in the reported cases. 

Material and Method:

This cross-sectional analysis, operated between 2010 and 2013, consisted in investigating 128 patients suffering from fertility ailments, out of whom 71 (55,47%) are males and 57 (44,53%) are females. 

Results:

The study showed that 12,5% of included patients were aged under 30, and 82,81% were older than 31. Genetics revealed that 99,21% have had a karyotype investigation and 8,6% of them have been investigated for genic disorders. Results showed that 54,38% of females, diagnosed with reproductive diseases, have had two or more spontaneous abortions. Comparatively, in case of males the study disclosed 29.57% pathologically modified semen analyses, which was less than the result obtained in mentioned studies (35%). 

Conclusions:

It has been proven that underlying causes of infertility and abortion are multiple and the treatment scheme must be kept up to date. Our conclusions addressed the problem of reproductive disorders (infertility and abortion). Genetic investigations should be often performed when suspecting diseases interfering with conception, by encouraging the inclusion of cytogenetic analyses into the follow-up.

  Assigned View

First author:

Keywords:

THE SYNTHESIS, CARACTERIZATION, BIOLOGICAL ACTIVITY AND COMPARATIVE STUDY OF SOME QUATERNARY AMMONIUM DERIVATIVES OF 2-ARYL THIAZOLE  Irina Ielciu Validated View

THE SYNTHESIS, CARACTERIZATION, BIOLOGICAL ACTIVITY AND COMPARATIVE STUDY OF SOME QUATERNARY AMMONIUM DERIVATIVES OF 2-ARYL THIAZOLE

First author: Irina Ielciu

Coordinator(s): Palage Mariana

Keywords: quaternary ammonium derivatives, the 2-aryl-thiazolic ring, contractile action

Background: Quaternary ammonium derivatives are widely spread in drug therapy and the research in this group present an increased interest for the development of new molecules. The thiazole ring is present in many consecrated drugs and it is of great interest in the drug synthesis domain. Our research is based on the synthesis of some new quaternary ammonium derivatives which have at the basis the 2-aryl-thiazolic system differently substituted in the 2 and 4 positions.
Objective: The objectives of the study are the synthesis, purifying, elucidating the structure, testing the pharmacological activity and evaluating the chemical structure-activity correlation of the 2-aryl-thiazole quaternary ammonium derivatives.
Material and Method:

The synthesis of these compounds was carried out by alkyling some nitrogen containing non-aromatic heterocicles with halogenated compounds which contain the 2-aryl-thiazolic system.
Some compounds containing a nucleophilic component represented by a non-aromatic heterocicle (piperazine, pyperidine, morpholine, N-methyl-pyperidine, N-methyl-morpholine, N-methyl-piperazine) were alkylated with 2-aryl-4-halometilen-thiazolic derivatives in order to obtain some quaternary compounds.
Compounds that have the benzenic nucleus in the 2 position of the thiazolic ring susbtituted in para with electron withdrawing groups  (e.g. -CF3) or electron donating groups (e.g. -CH3) have been synthesized with the purpose of testing the influence of the substituents upon the reaction’s yield and upon the biological activity. 
To elucidate the structure of the synthesized compounds elemental quantitative analysis, UV, IR, 1H-NMR and Mass Spectroscopy were performed.

Results: The quantitative analysis and spectral analysis allowed establishing the chemical structure of the compounds. As for the biological activity, the compounds presented a significant contractile action.
Conclusions: Depending on the obtained results for both the pharmacological activity and structure analysis, it will be possible to establish some structure-activity relations.

A 'special protocol ' for the local treatment of full-thickness burn.  Anemona-Madalina Stana Diana-Larisa Suciu Validated View

A 'special protocol ' for the local treatment of full-thickness burn.

First author: Anemona-Madalina Stana

Coordinator(s): Botan A

Keywords: burn eschar, sharp debridement, autolytic debridement, synthetic dressings, skin grafting.

Background:

This is a clinical presentation demonstrating the efficiency of the combination between the sequential tangential excision and the autolytic debridement on behalf of different synthetic dressings.

 

Objective:

Thermal burns are produced by open fire, electric flames, hot liquid or the contact with hot objects. Full-thickness burns are those lesions involving all skin structures. Skin layers transform into a leathery, dry eschar, so the only adequate treatment is the excision of the eschar as soon as possible and skin grafting of the remaining defect. 

Material and Method:

This paper presents only 2 cases with full-thickness burns selected from the period between 2011-2013; the other 15 cases with deep burns admitted in the above mentioned  period have been treated by the same protocol, so any statistic analysis is difficult.

         In the Burn Centre of Targu Mures (due to the ‘local conditions‘ in this medical unit) in the last 15 years has been used a ‘special protocol’ which is a mixture of early sharp debridement combined with autolytic debridement that  remove the burn eschar and  obtain an adequate granulation for skin grafting. 

Results:

This incomplete tangential excision of the burn eschar gave very good results. The thin layer of eschar remaining at the end of the sharp debridement prevents the accidental removal of healthy tissue avoiding the brisk bleeding requiring blood transfusion. Complete removal of the burn eschar and adequate wound bed preparation followed by early cover with STSG is the only way to prevent early and late complications of  full-thickness burns.

Conclusions:

The surgical procedure mentioned above is a cheap, safe and easy way to achieve the goals mentioned at the beginning of this  paper, thus avoiding all major early and late complications which could follow more aggressive surgery.

 

MORINDA CITRIFOLIA L.: THERAPEUTIC BENEFITS AND SIDE EFFECTS  Georgiana Orbeanu Validated View

MORINDA CITRIFOLIA L.: THERAPEUTIC BENEFITS AND SIDE EFFECTS

First author: Georgiana Orbeanu

Coordinator(s): Miron Anca , Trifan Adriana

Keywords: Morinda citrifolia L.

Background: Morinda citrifolia L. (Rubiaceae), known as Noni, is widely distributed in tropical Asia, India and the Pacific Islands. Preparations from its roots, stems, bark, leaves and fruits have been used in folk remedies by Polynesians for over 2000 years. Morinda citrifolia has been reported to have a broad range of therapeutic effects, including antibacterial, antitumoral, analgesic, anti-inflammatory, hypotensive and immune enhancing effects.
Objective:

Noni products are used as dietary supplements and distributed by several companies, also in the Romanian pharmacies; Noni juice, obtained from M. citrifolia fruit, has become a popular tonic in recent years since and it is reputed to prevent lifestyle-related diseases such as diabetes, hypertension and atherosclerosis. 
The effects of M. citrifolia have not been elucidated in detail. However, there is some evidence for biological activities in various assay systems. The anticancer activity of an alcohol-precipitate of Noni fruit juice was demonstrated on mice infected with Lewis lung carcinoma. Several studies were carried out on aqueous and hydroalcoholic extracts from fruits and roots of M. citrifolia in order to evaluate their antioxidant effects (free-radical-scavenging activity, inhibition of low-density lipoprotein oxidation, hydrogen peroxide scavenging effects). 
The use of herbal products for therapeutic purposes is common for women during gestation and lactation periods. Citotoxicity studies revealed that extracts of Morinda citrifolia affected prenatal development and labor process, but did not induce maternal toxicity in Wistar rats.
Material and Method:
Results: Many of Noni major constituents, which may contribute to its reputed and diversified health benefits, have been identified (anthraquinones, flavonoids, polysaccharides, lignans, triterpenoids).
Conclusions: The consumption of Noni supplements around the world is currently high and despite the marketing strategies around Noni, these supplements should be investigated for quality control purposes (especially regarding their standardisation) so that the pharmacist would be able to advise the pacient properly.

Surgical approach of aortic valve disease associated with coronary artery disease  Al Hussein Hussam Daniel Razvan Cernica, Stela Mariana Al Hussein, Ioan Teodor Bud, Delia-Maria Ceteras Validated View

Surgical approach of aortic valve disease associated with coronary artery disease

First author: Al Hussein Hussam

Coordinator(s): Moraru L , Suciu H

Keywords: aortic valve stenosis coronary artery disease aortic prosthesis coronary artery bypass grafting

Background: The combination between aortic  valve stenosis and coronary lesions represents a particular group of pathology whose severity is given by the association of the left ventricular hypertrophy and reduced blood flow toward the myocardium.
Objective: The aim of the study is to evaluate the surgery results at this category of patients with increased surgical risk. 
Material and Method:

We retrospectively reviewed  83 patients with aortic valve stenosis (AoVS)  and  coronary artery disease (CAD) who were operated at the Cardiovascular Surgery  Clinic from the IBCvT Tîrgu Mures on a period of 4 years,  2010-2013, in this study being included 3 other groups of patients with valvular lesions associated to the existing AoV : AoVS with aortic insufficiency(38), AoVS with mitral insufficiency(6), AoVS with mitral valve stenosis(4) who also presented associated coronary lesions. 
Were evaluated the pre-surgical data related to the aortic valve disease (left ventricle hypertrophy, ejection fraction of the left ventricle, the aortic ring size,  the number and the severity of the associated coronary lesions, pre-surgical acute coronary events), details of the surgery and the postoperative evolution. 
Results: From the 131 cases the male patients represented the largest number of cases (67,2%), whereas female patients were 32,8%, with the medium age of 66 years. Was performed aortic valve replacement with mechanical valve prosthesis in 79 cases and biological prosthesis in 48 cases. To them was also performed coronary artery  bypass grafting with autologous saphenous vein graft in 73 cases on the left anterior descending artery,  10 cases on the left circumflex artery, 53 cases on the right coronary artery,  and in 16 cases was used the left internal mammary artery. 
Conclusions: Although the association of these two groups of diseases represents a combination with severe prognosis for the patient, with appropriate surgical treatment were obtained good results and favourable evolution of the patients.

Comparison of colorectal surgery for cancer in two different countries: Italy and Romania  Dana-Ioana Dumitru Gianni Versari, Iulia Grancea Validated View

Comparison of colorectal surgery for cancer in two different countries: Italy and Romania

First author: Dana-Ioana Dumitru

Coordinator(s): Valeria Tonini , Georgescu R

Keywords: colorectal cancer laparoscopic surgery

Background: Colorectal cancer is the second leading cause of cancer death.The appropriate treatment for these patients is removal of all colonic and rectal affected area.
Objective: The aim of the study was to compare the results of colorectal surgery for cancer in two differents countries:Italy and Romania.
Material and Method: Were included in this retrospective study 600 consecutive patients who undergone colorectal surgery for cancer at the Department of General Surgery and Emergency of Bologna,St.Orsola  Hospital(group1) and the last 600 patients who had colorectal surgery for cancer at Targu Mures County Clinical Hospital(group2).
Results: Significant differences were found in the stage of the disease with a higher incidence of advanced disease in group2(T3-T4-65%-group1,80%-group,p<0,05).
In group1,a radical resection of tumor was performed in95% of cases and 75% in group2.This could be explained with the use of colonic cancer screening in Bologna.
In group1,70% of patients had an emergency operation,30% an elective operation,otherwise in group2 were30%versus70%.The higher incidence of emergency operation in group1could be explained with a different organisation plan of Hospital Unit.
A laparoscopic approach was performed in40% of patients in group1 and 7% in group2(p<0.01).Statistically different were also found in the comparison between mechanical and manual anastomosis(70%-group1,20%-group2).
There were no significant differences regarding mortality,morbidity post-operative 30-day and hospital stay:group1-3%,28%,9days; group2-5%,27%,13days.

Conclusions: This study demonstrated that the results of colorectal surgery for cancer are similar in the two countries if we only analyse the mortality and morbidity,but shows some significant differences in the management of colorectal tumors.There is a higher number of advanced disease and palliative operation in group2, probably due to a lack of screening program for colorectal cancer in Romania.Moreover in group 2 there is a more traditional approach with a lesser use of laparoscopy and mechanical devices.

Comparative study of three products obtained from grapes regarding tannins and anthocyanins content  Bianca-Mihaela Ivanof Validated View

Comparative study of three products obtained from grapes regarding tannins and anthocyanins content

First author: Bianca-Mihaela Ivanof

Coordinator(s): Bucur Laura , Popescu Antoanela

Keywords: Wine . .

Background:
Objective: The aim of the paper is to evaluate the quality of products obtained from grapes regarding their tannins and anthocyanins content, which gives their astringency and colour.
Material and Method: The material is represented by the three products obtained from black grapes: must, homemade wine and merchandised wine (Patrician Wine,Constanta 2009). In the paper were used officinal spectrofotometric methods from the European Pharmacopoeia 6th Edition.
Results:

Astringency and the colour of the products are correlated with the content of tanins respectively anthocyanins. Tannin content of the three products obtained from grapes showed that the must, which stays the least in contact with the marc of grapes has the lowest quantity of tannins: 9,94 mg % (m/V). Comparative analysis of the tannins content from the two wines showed that tannins are higher in the merchandised wine (78,67 mg%, m/V) than in the homemade wine (50 mg%, m/V). This difference can be explained by the improvement in the manufacturing methods by adding oenological tannins to increase astringency.
The lowest quantity of antocyanins is in must (9,94 mg%, m/V) and is correlated with a lighter colour of the product. In the wine sortiments the colour is darker in the merchandised wine, inspite of the low content of anthyocyanins, due to the oenological tannins added which determines a brown nuance.
Conclusions: Astringent taste of the products is correlated with the tannins content. The colour, as a quality parameter, is influenced not just by the anthocyanins content, but also by the oenological tannins added.

Homeopathy in past, present and future  Svetlana Gincu Validated View

Homeopathy in past, present and future

First author: Svetlana Gincu

Coordinator(s): Safta V

Keywords: Homeopathy, alopathy. alopathy .

Background: In reality homeopathic medicine is also highlighting the existence of the second type with the drug commonly used in international therapeutic namely allopathic medicine. The common name of "medicine" concept reflects a common origin, function and similar structure. This is why, as there are allopathic pharmacology, by analogy, there should be a science of homeopathic medicine, "homeopathic pharmacology".
Objective: The aim of the work lies in evaluation of the existing situation of homeopathy in Moldova based on interviewing patients, pharmacists and doctors, and evaluation of the homeopathic medication in touch on allopathic medication.
Material and Method: This study is a selective research-district. Raw data were collected through surveys, using structured questionnaires and official statistics published by the Ministry of Health of the Republic of Moldova and Drug Agency. To collect the necessary information three questionnaires havw been prepared using the opinion of patients, pharmacists and doctors.
Results:

After data collection, all questionnaires were analyzed and analytical tables were elaborated. Today, homeopathy is still in a period of reviewing precisions and attempts to be placed with principles based on evidences.
Conclusions: The analysis is underlining defining facts and accomplishments from the end of XVIIIth Century (The Past) to the beginning of the XXIst Century (The Present). Based on the  obtained dates, we will make an incursion in the future (Perspective of homeopathy).

ADVANCED GLYCATION END PRODUCTS AS MARKERS OF AGE-RELATED CARDIO-VASCULAR DISEASE  Anca-Mihaela Tudor Razvan Liviu Florea, Corina Serbu Validated View

ADVANCED GLYCATION END PRODUCTS AS MARKERS OF AGE-RELATED CARDIO-VASCULAR DISEASE

First author: Anca-Mihaela Tudor

Coordinator(s): Margina Denisa , Mitrea Niculina

Keywords: glycation, AGE, cardio-vascular, disease, biochemistry

Background: Glycation is the major cause of spontaneous damage to cellular and extracellular proteins in physiological systems. There are multiple types of glycation adducts identified "in vivo" in tissues and blood; they form as a result of a nonenzymatic reaction between reducing sugars and protein amino groups. The initial glycation reaction is followed by a cascade of chemical reactions resulting in the formation of intermediate products (Schiff base, Amadori and Maillard products) and finally to a variety of derivatives named Advanced Glycation End products (AGEs).
Objective: In the present study we aim at evaluating the AGE level in serum samples isolated from senescent patients, compared to controls.
Material and Method:

We selected 30 patients: 20 senescent ones (75-85 years old) and 10 control healthy subjects, ages 30 to 44 years, without any diagnosis of cardio-vascular pathology.
On serum samples we assessed the advanced glycation end products level, using a rapid, non-destructive fluorimetric method.
Results: The results show that the senescent group was characterized by a significantly higher AGE level; the results obtained for the selected parameter correlated with the age of the patients.
Conclusions:
Specifically, AGEs are considered to be formed slowly throughout life and their concentration in the blood and tissues is considered to represent the life-long accumulation of glycation adducts. So, the AGE level is associated with the ageing process.  
The AGE level is correlated with the age of the patients and could be used for the assessment of the risk of cardio-vascular disease. 
Understanding AGE formation and biochemistry as well as AGE-induced effects on extracellular and intracellular functions will serve in the process of finding effective therapies that block excessive accumulation of these species and their pathological outcomes.

The evolutive dental opinion: blank progress or academic maturity ?  Claudiu Vartolomei Diana Pop, Dorina Petronela Tocariuc, Molnar-Varlam Cristina , Adelina Macec Validated View

The evolutive dental opinion: blank progress or academic maturity ?

First author: Claudiu Vartolomei

Coordinator(s): Molnar-Varlam Cristina

Keywords: dental student questionnaire sylabbus curriculum

Background:

“Hallway” debates on a variety of aspects such as syllabus, curriculum, lecturers, university facilities and leisure time may determine a conflictual situation and a restriction to informational access and practical applications provided by the university as a dental career fulfillment among students. 

Objective:

The purpose of this study was to identify and present personal inconveniences and incompatibilities of the second, third, and fourth year dental student in the University of Medicine and Pharmacy from Targu Mureș with the professional environment.

Material and Method: The study was based on a questionnaire by inviting 261 students divided into years of study to expose their opinion and individual experience. They were required to answer 12 questions concerning their affinity with the dental student status and all the abovementioned elements which interfere with it. The data was statistically manually analysed.
Results: The most important results are as follows: 49,1% of the dental students believe that the dental practitioner career fits them perfectly. 42,6 % consider that that University facilities are adequate for a proper vocational development altough a percentage of 56,4 declare that the curricula is insufficient and at the same time permits them no leisure time (49.1 %).
Conclusions:

After evaluating the results of the survey, the following have been revealed: students appear to mainly disagree with both the curricula and the dense syllabus. The greatest discontentments of the dental students are related to the deficiency of practical classes in comparison to the theoretical offered information, the repetitive lack of working materials and the little opportunity to treat pacients. As the study intended to identify the vulnerable areas and possible suggestions regarding the improvement of student life, surprisingly, most of the students would not change many aspects in their actual experience.

The impact of the spiritual dimension in determining anxiety among medical students.  Cezar Mateiciuc ALEXANDRU VIRGIL Chiheri Validated View

The impact of the spiritual dimension in determining anxiety among medical students.

First author: Cezar Mateiciuc

Coordinator(s): Nireștean A , Cîmpan Dana

Keywords: anxiety spirituality correlation S.T.A.I. , D.S.E.S.

Background:

Lately there has been a tendency among the psychological scientists and psychiatrists of having a more reconciliant attitude towards the spiritual dimension of the human psychic, thus modern psychology is trying to integrate the religious system of a person in both the understanding of some pathological deviation of the mental condition and the therapeutic strategy for the mental disease.

Objective:

The aim of this study was to determine the level of correlation between the anxiety score and the spirituality score among medical students.

Material and Method:

For this study, the anxiety S.T.A.I.(State Trait Anxiety Inventory) questionnaire  and spirituality D.S.E.S.(Daily Spiritual Experience Scale) questionnaire have been used on 220 students from UMF Targu Mures. The data has been processed using Pearsnon´s correlation coefficient.

Results:

In 4 out of 22 lots of students there was a statistically significant correlation coefficient: the lot of 5th-6th year dental medical students(r=0,2715, p=0,0449), the lot of 5th-6th year medical students(r=-0,2923, p=0,0304), the lot of first-second and 5th-6th year medical students(r=-0,2147, p=0,0243) and the lot of all female participants(r=0,3493, p=0,0054).

Conclusions:

The lot formed by 5thand 6th year dental students and the lot of female students presented a weak positive correlation, suggesting that in these, spirituality may induce anxiety, while the lot of 5thand 6th medical students and the lot of all medical students showed weak regression, suggesting that in these cases, spirituality may have a protective effect on the level of anxiety. The divergence of the results may be caused by the very different approach on spirituality by the individual human being and also by the heterogeneity of religions and belief systems in the study lots. There might also be a mutual interrelation in the sense that an increased level of chronic anxiety will probably determine some individuals to search for for higher spiritual experience, thus affecting the outcome of the correlation study. 

Are students able to use self-medication correctly? An assessment regarding the prevalence of self-administrated drugs among UMF students  Oana-Elena Branea Validated View

Are students able to use self-medication correctly? An assessment regarding the prevalence of self-administrated drugs among UMF students

First author: Oana-Elena Branea

Coordinator(s): Vari C E , Dogaru Maria Titica

Keywords: self-medication UMF students associated risks

Background:

Self-medication can be defined as the use of drugs to treat self-diagnosed disorders, the intermittent or continued use of a prescribed drug for chronic or recurrent disease or symptoms. According to recent surveys on self-medication in Romania, 87% of the people self-managed their medication and 50% considered to have enough knowledge to self-administer drugs.

Objective:

The purpose of this study was to assess the prevalence and attitudes towards self-medication among students of the Faculty of General Medicine, UMF Targu-Mures. Also, the study intended to appreciate students' knowledge and the associated risk factors with self-administration of drugs.

Material and Method: Using a self administered questionnaire, approved by the Ethics Committee, data was collected in order to realize a cross-sectional designed study. The target population was represented by 720 students from the I-VI years, who answered it voluntarily and anonymously.
Results: Results found that over 90% of the students used drugs without prescription, 49% of them, monthly and 39% at least once a year. One out of three interviewed students use pharmacist’s advice in self-medicating. Moreover, by using self-medication, 19,5% of students tried to avoid long waits when a medical examination. VIst year students responded in a considerable number (62%) that their medical practice is appropriate to choose the right medicine. It is relevant that 43% of the Ist year students advise other people, while 91% of VIst year students do the same. Also, 59.83% of respondents do not believe or do not know whether self-medication is a risk factor or not.
Conclusions:

Self-medication was proved to be widely used among students. Further approaches to educating the general population is an important issue to be tackled. Therefore, field educational media programs should be taken into consideration. Regarding medical students, having Clinical Pharmacology Communication Sessions would be useful by presenting advantages and disadvantages of self-medication.

Onychophagy: bad habit or actual disease?  Dorina Petronela Tocariuc Anca Mare, Adriana Chifor, Molnar-Varlam Cristina Validated View

Onychophagy: bad habit or actual disease?

First author: Dorina Petronela Tocariuc

Coordinator(s): Tudor Bianca , Man A

Keywords: nail-biting habit enterobacteriaceae dental-wear

Background: Nail-biting is a common but unsolved problem in psychiatry, psychology, medicine and dentistry. It is often associated with somatic complications and decreased quality of life.
Objective: The purpose of the study was to evaluate the differences between people’s oral carriage of enterobacteriaceae with and without nail-biting habits (NBH). The correlation of onychophagy with dental wear on certain teeth surfaces and with the existing tics and conditions and the correlation with age at which this habit starts were also evaluated. 
Material and Method: A prospective study was conducted on 100 people (50 with NBH, 50 without NBH).  Saliva samples were collected by oral rinsing with 10 ml of sterile saline solution. The samples were centrifuged, 10 µl from the sediment was inoculated on MacConkey agar and on Sabouraud agar, each colony type being afterwards identified to the genus level by biochemical tests. Subjects completed the self-made questionnaire with 7 items and they were reviewed in terms of dental health. The questionnaire was evaluated statistically. 
Results: Oral carriage of enterobacteriaceae was identified in 24% of the subjects with chronic NBH, while only 18% of the subjects without these habits had it, this difference not being statistically significant (p=0,6242). Klebsiella spp. were the most frequent species identified at the subjects with chronic NBH (50%), followed by Escherichia coli (25%) and Enterobacter spp. (25%). In three cases, without chronic NBH, there was more than one species of enterobacteriaceae identified. Dental wear was discovered in a small number at the subjects with chronic NBH (18%).  Onychophagy was found as a manifestation under stress (82%), boredom (34% ) and also as a habit (48% ). 
Conclusions: In this study, chronic NBH was not found as a risk factor for oral carriage of enterobacteriaceae.  It may interfere with the overall body health, with dental wear and with exposure to some infectious diseases.