Archive issue


Current Health Sciences Journal

vol. 43 no. 2, 2017

1. Iodine Deficiency, Still a Global Problem?

BIANCA GEORGIANA BIBAN , CORINA LICHIARDOPOL

Iodine Deficiency Disorders are a major public health problem worldwide affecting all groups of people of which children and lactating women are the most vulnerable categories. At a global scale, aproximately 2 billion people suffer of iodine deficiency (ID) of which aproximately 50 million present with clinical manifestations. Assesing iodine levels through different methods has proven to have a key role when discussing treatment options. Screening programs, and early ID diagnostic is important for pregnant women’s follow-up, especially in known countries with iodine dificiency. Universal salt iodization programs have been proposed over the world, but unfortunately have covered about 71% of the world’s population. The aim of this article is to adress the current standings of iodine status and influence on general population with a general focus on newborns and pregnant women and to review the worldwide perspective on available prevention methods.

View online - Abstract - Download PDF

2. ?-arrestin 1 Overexpression Increases Temozolomide Resistance in Human Malignant Glioma Cells

S.A. ARTENE, C. FOLCUTI, ANICA DRICU

Many studies highlighted ?-arrestins (?-arr) as essential proteins behind the regulation of major cell signaling pathways in different types of cancer. An impaired ?-arrestin 1 (?-arr 1) activation/phosphorylation was suggested to be associated with a high malignant phenotype of glioma. Elevated levels of ?-arrestin 2 (?-arr 2) mRNA were also found in advanced stages of breast cancer compared to early stages. In addition, ?2-arrestin was also linked to a suppressive effect on tumor growth in other types of cancers such as prostate or non-small cell lung cancer. In this study, we analyzed the effect of ?-arr 1 overexpression on the cytotoxic effect of Temozolomide (TMZ) in two malignant glioma (MG) cell lines: U-343MGa and Cl2:6. For this purpose, the cells were transected with ?-arr 1 and then treated with different concentrations of TMZ for 24, 48 and 72 hours. At the end of the treatment, the cell viability was analyzed by Prestoblue viability assay. Our results showed that TMZ treatment induced cytotoxicity in MG cells while ?-arr 1 transfection significantly reduced the TMZ cytotoxic effect in both U-343MGa and Cl2:6 MG cell lines. These results suggest that ?-arr 1 overexpression may be a cause of TMZ resistance in MG.

View online - Abstract - Download PDF

3. Estimation of Oxidative Stress Involvement by Superoxide Dismutase Variation in Cardiac Arrhythmias

MARIA CRISTINA BEZNA, DOINA CARSTEA, MARINELA BEZNA, CATALINA PISOSCHI, O. ISTRATOAIE, D.O. ALEXANDRU, C. EFREM, R.P. MELINTE

Cardiac arrhythmias, commonly diagnosed in young people, involve multiple etiopathogenic factors, including oxidative stress. Purpose: Evaluation of superoxide dismutase (SOD) variations as an antioxidant enzyme (with a physiological role in the dismutation of highly reactive oxygen free radicals into oxygen and water) in young patients with cardiac arrhythmias. Material and method: The study was conducted on a group of 40 young patients with a mean age of 34 years old, of both sexes, with non-lesional cardiac dysrhythmias, compared to a control group of 40 healthy subjects, determining for both groups the SOD serum level. Diagnosis of cardiac rhythm disorder was supported by electrocardiogram, imaging and laboratory investigations. Results: SOD recorded a 61% decrease of mean values in patients compared to controls. The decreasing variation was found in all arrhythmia types, as follows: atrial fibrillation (51,54%), sinus bradycardia (54,86%), atrial flutter (55,71%), extrasystolic ventricular arrhythmia (64,20%), extrasystolic atrial arrhythmia (65,27%), combined arrhythmias (65,93%), supraventricular paroxysmal tachycardia (71,32%) and sinus tachycardia (74,24%). SOD deficiency demonstrates the involvement of oxidative stress in cardiac arrhythmic pathogenesis, excess oxygen radicals interfering with multiple mechanisms related to the onset of arrhythmogenesis. The SOD decrease was more important in females (60,57%) than in males (67,06%) and in those with nutrition poor in antioxidants. Conclusions: SOD estimation represents a biomarker whose decrease and deficiency implies occurrence of oxidative stress and implicitly highlights its role in cardiac arrhythmic pathology in young people, with the possibility of monitoring and correction by pharmacological or non-pharmacological therapeutic means.

View online - Abstract - Download PDF

4. Assessing the Degree of Severity of Acute Pancreatitis by Using Multiparameter Scores

ELENA IRINA CALUIANU, D.O. ALEXANDRU, D. MERCUT, M. GEORGESCU, E.T. TRASCA, MARIA IANCAU

Aim: To establish a clinical severity diagnosis and a therapeutical strategy in acute pancreatitis (A.P.) by using multiparameter bioclinical and morphological scores. Material and Method: 71 patients, diagnosed with A.P., between 2012-2016, admitted to the surgical clinics of the Military Emergency Hospital “Dr. Stefan Odobleja” and the Clinical County Emergency Hospital of Craiova, were investigated, following the severity diagnosis, both at admission and in evolution, with the aim of obtaining an optimal therapeutic approach. The Ranson, Imre, Marshall, Balthazar and EPIC scores were used. Results: By analyzing specially the values of the computer tomography severity index of the study group patients, 14.29% of patients were classified as light severity AP with favorable prognosis, 37.14% of patients moderate severity AP, and 48.57% severe AP. The examination of the CT, one of the most important diagnosis tests for AP, established that 34.29% of patients suffered from AP in Balthazar grade B and 22.85% Balthazar grade C, the severity forms we encountered most in our study. The correlation between HCT (hematocrit) value and Ranson score presents a Pearson correlation coefficient r of-0.339, which indicates the existence of a statistically significant inversely proportional relation. Conclusion: Corroboration of the bioclinical and imagistic data, summed as multiparameter scores, allowed us to classify AP into different severity forms: moderate severity AP (14.29%), moderate-severe AP (37.14%) and severe AP (48.57%), which will then facilitate choosing the right therapeutic approach.

View online - Abstract - Download PDF

5. Which is the Best Imaging Method in Pancreatic Adenocarcinoma Diagnosis and Staging

M.I. COSTACHE, CORNELIA ALEXANDRA COSTACHE, CRISTIANA IULIA DUMITRESCU, A.A. TICA, M. POPESCU, ELENA ANGELA BALUTA, ALINA CARMEN ANGHEL, A. SAFTOIU, DANIELA DUMITRESCU

Introduction. Imaging has a decisive role in the diagnosis and staging of pancreatic cancer, the most used imaging methods being computed tomography, magnetic resonance imaging and endoscopic ultrasonography. Material and method. They were studied retrospectively over a 3 years period, 140 patients with pancreatic cancer. Aim of the study: This study aims to determine the effectiveness of CT, MRI and EUS in diagnosis and staging of panceatic cancer. Results. CT showed a diagnostic accuracy of 83.3%, with sensitivity and specificity of 81.4% and 43% respectively. MRI showed superior diagnostic accuracy compared to CT (89,1%). However, EUS demonstrated the best diagnostic value in PC (accuracy of 92,7%). Concerning the locoregional staging, the 3 diagnostic methods showed similar result. There were no significant differences concerning the diagnosis of intra-abdominal metastases. Differences have appeared in the case of extra-abdominal. Thus, there were 4 cases of lung metastases which have been identified only on CT and MRI. Conclusion. EUS is the most effective technique used in the diagnosis of pancreatic cancer, the present study demonstrating an accuracy of 92.7%. Moreover, EUS offers the possibility to collect samples for cytological examination by EUS guided fine needle aspiration. However, there are some limitations of EUS in identifying extra-abdominal metastases. Thus, the assessment of tumor extension must be completing by performing CT or MRI.

View online - Abstract - Download PDF

6. Urinary tract infection with Klebsiella pneumoniae in Patients with Chronic Kidney Disease

OANA MARIANA CRISTEA, CARMEN SILVIA AVRAMESCU, MARIA BALASOIU, F.D. POPESCU, FLORICA POPESCU, M.O. AMZOIU

Study Motivation: After assessing electronic databases of medical scientific literature, we have observed that the interrelation between urinary tract infections (UTIs) and chronic kidney disease (CKD) is poorly studied, especially when UTIs are caused by Klebsiella pneumoniae (K. pneumoniae). Materials and methods: K. pneumoniae was isolated in 14 urine samples from patients with CKD addmited in the Nephrology Department of the County Emergency Clinical Hospital Craiova. The isolated strains were statistically analyzed in the correlation with the different clinical and functional parameters (age, gender, CKD stage, comorbidities, biochemical parameters-serum urea, creatinine, uric acid and blood electrolytes). The degree of K. pneumoniae susceptibility to antibiotics from different pharmacodynamic classes was assessed. Results: UTIs with K. pneumoniae in patients with CKD in the investigated period represented 0.51% from the total admissions in the clinic and 32.60% from cases of UTI. Eleven patients with this type of infection (78.56%) were in stage 4 and 5 CKD, and from them 4 also had diabetes mellitus type 2 (28.57%). We observed an increased level for serum creatinine (100%), blood urea (85.71%), and serum uric acid (45.45%). Two patients died after installation of cardiovascular changes in CKD, at advanced ages and in the presence of urinary infection. Multiple drug resistance occurred in 6 strains of K. pneumoniae correlated with the degree of kidney failure, advanced age, male gender, and diabetes mellitus. Conclusions: UTI with K. pneumoniae in patients with CKD is the second cause of urinary infection which raises problems of unfavorable evolution of CKD and also the recurrence of UTI with multiple drug resistance in CKD, which may lead to pharmacotherapeutical problems.

View online - Abstract - Download PDF

7. The Importance of the Correlation between the Ultrasonographic Evaluation of Endometrium and Histopathological Findings in Patients with Endometrial Hyperplasia and Carcinoma

V. STOENESCU, M.B. NOVAC, LORENA DIJMARESCU, MAGDA MANOLEA, LILIANA NOVAC, P. TOMESCU, MIHAELA NICULESCU

Purpose. The aim of this study was to estimate how ultrasonographic evaluation of endometrium and histopathological findings are correlated in a group of premenopausal and postmenopausal women. Material and Methods. I have studied 106 premenopausal and postmenopausal women who underwent endometrial biopsy based on results of transvaginal ultrasonography. Results. Mean age of patients was 52.29±8.14 years. Postmenopausal status <10 years was common in 20 patients (18.86%), postmenopausal status >10 years was common in 21 patients (19.81%), and premenopausal status in 65 patients (61.32%). Transvaginal sonography reported EH in 97 cases (91.50%) and EH was confirmed by pathology in 88 cases (83.01%). Conclusion. Endometrial thickness was correlated with histopathological diagnosis much better in postmenopausal women.

View online - Abstract - Download PDF

8. Diagnosis and Treatment Particularities in Osteoarticuar Tuberculosis

I. PROCOPIE, D.N. ANUSCA, V. ONTICA, R. MURESAN

Osteoarticular tuberculosis (OATB) is a secondary chronic infection with paubacillary bacillus Koch (BK) that has bone and joint interest. Today in Romania, tuberculosis is a primary public health problem, according to World Health Organization (WHO) in 2015 alone, there have been 10.4 million new cases of tuberculosis (TB) in the world, of which 15.195 in Romania. Pulmonary and extrapulmonary tuberculosis, especially the osteoarticular form, with multiple outbreaks should of had a minimal impact, but because of the multiple characteristics such as: epidemiological, geographic, associated diseases, diagnosis capacity, therapeutic options, gene pool and racial evolutiv traits, the disease spreading and management in both developed and underdeveloped countries, the TB infection has seen an increase in the number of cases (e.g. Africa and Asia). Today there is a fecundity upsurge of BK infection, especially pronounced in low income populations, country side people being the most affected. There are multiple breakthroughs in the understanding of Mycobacterium tuberculosis physiopathology. This fact offers us a modern and genetically guided approach in the diagnosis, evolutive patterns and treatment involving the OATB.

View online - Abstract - Download PDF

9. Laparoscopic Cholecystectomy with Freehand Laparoscopic Camera Controller

K. SAPALIDIS, N. MICHALOPOULOS, S. MANTALOVAS, I. KESISOGLOU

Introduction: Free hand laparoscopic camera controller (FHLCC) is a new innovative robotic device that has been recently implemented and adopted in laparoscopic surgery, providing the surgeon more comfort in carrying out his surgical skills without the difficulties related to the mutual understanding of the movements of the camera. Case presentation: We report the first case of laparoscopic cholecystectomy performed in our hospital with the aid of the free hand laparoscopic camera controller. Conclusion: Free hand laparoscopic camera controller provides the surgeon comfort in carrying out his surgical skills without the difficulties related to the mutual understanding of the movements of the camera. It combines the benefits of minimally invasive and robotic assisted surgery, increases efficiencies and improves patient recovery times.

View online - Abstract - Download PDF

10. Cardiac Arrhythmias in Patient with Isolated Persistent Left Superior Vena Cava

OANA-MARIA CORICI, M. GASPAR, ANIKO MORNOS, MARIA IANCAU

We report here the case of a 47-year-old male presented with atypical chest pain, fatigue and arrhythmias that was found to have persistent left superior vena cava. The clinical exam was normal. Twelve leads ECG showed sinus rhythm of 70 beats/min, QRS axis of 90 degree and right bundle branch block. Transthoracic echocardiography revealed left ventricular hypertrophy, a large coronary sinus and mild pulmonary hypertension. Saline contrast echocardiography was performed and micro-bubbles were visible first into the coronary sinus and then passed through the right atrium. Multislice computed tomography confirmed the presence of persistent left superior vein cava and the site of drainage into the right atrium via a large coronary sinus. Right superior vein cava was absent. In this case report, we emphasize the importance of full assessment in patient with persistent left superior vena cava.

View online - Abstract - Download PDF