Current Health Sciences Journal
vol. 43 no. 4, 2017
1. Update on Endoscopy-Based Imaging Techniques in the Diagnosis of Esophageal Cancer
MANUELA IOANA VASILE(1), C.S. MIREA(2), I.D. VILCEA(2), C.V. OBLEAGA(3), RALUCA CAMPEANU(4), M. POPESCU(5), I. ROGOVEANU(6), S. CAZACU(6), S.S. MOGOANTA(2), E. MORARU(2)
View online - Abstract - Download PDF Update on Endoscopy-Based Imaging Techniques in the Diagnosis of Esophageal Cancer PDF
The early diagnosis of esophageal cancer is necessary for improving the surviving of patients with this disease. To ensure an accurate staging, there are necessary imaging tests to establish the local and regional extension, as well as excluding the metastases. Computed tomography (CT), endoscopic ultrasonography (EUS), and positron emission computed tomography (PET-CT) constitute standard methods for esophageal cancer staging. These techniques are complementary; using only one of these tests is not suitable for correct staging. The role of EUS has improved the doctors’ ability to evaluate and select the patients to undergo surgery, radiotherapy, or chemotherapy.
2. Isolation of Collagen from Marine Resources from the Black Sea
MELAT CHERIM(1), RODICA SIRBU(2), IONELA BELU(3)
View online - Abstract - Download PDF Isolation of Collagen from Marine Resources from the Black Sea PDF
Purpose: Evaluation of possibilities of obtaining type I fibrillar collagen from fish skin using the Black Sea marine resources and suitable cross-linking agent for this one to stay stable at body or room temperature. Materials and methods: Collagen has been extracted from the skin of the Grey mullet and Sturgeon by the acidic method with Acetic acid 0.5M. Cross-linking has been performed by using Tanic acid at 4-6oC. The rheological behaviour was determined by using a Haake VT 550 rheo-viscometer. Results: The collagen was isolated from the skin of Gray mullet and Sturgeon. (Acipenser gueldenstaedtii). Hydrogels have a pseudoplastic behavior. Tanic acid was used for cross-linking like a better alternative, eliminating the toxicity of glutaraldehyde. Conclusion. The yield of collagen extraction was higher for the Gray mullet skin, than Sturgeon. Pseudo-plastic behavior allows them to be successfully applied in the treatment of wounds. The isolated type I collagen may serve as an attractive alternative to mammalian collagen for biomedical and pharmaceutical applications.
3. Formulation and Characterization of Ciprofloxacin loaded PLGA Microspheres for Applications in Orthopedic Infections
ANDREEA-GABRIELA MOCANU(1), IONELA BELU(2), O. CROITORU(3), MARIA VIORICA CIOCILTEU(3), C.V. MANDA(3), J. NEAMTU(3)
View online - Abstract - Download PDF Formulation and Characterization of Ciprofloxacin loaded PLGA Microspheres for Applications in Orthopedic Infections PDF
Purpose-Osteomyelitis is a bone infection that appears as a complication after a fracture or orthopedic surgery. Ciprofloxacin is a broad spectrum antibiotic that can be used in local drug delivery systems for the treatment of bone related infections due to its bactericidal activity against both Gram-negative and Gram-positive bacteria. The purpose of the present study was to include ciprofloxacin in poly (lactic-co-glycolic acid) (PLGA) microspheres. Material and methods-Microspheres were prepared by both water/oil/water (w/o/w) solvent evaporation method and solid/oil/water (s/o/w) dispersion solvent evaporation method. The obtained microspheres were characterized by Fourier Transform Infrared Spectroscopy. High performance liquid chromatography method was deployed to determine the encapsulation ratio. Results-The solvent evaporation method chosen for this experiment resulted in microspheres with good entrapment efficiency. Furthermore the microspheres obtained by the s/o/w method displayed better entrapment efficiency. Conclusion-The particles obtained through the s/o/w technique should be further investigated in order to develop a local drug delivery system.
4. Utilizing Multiparameter Scores and Procalcitonin as Prognosis Markers for the Degree of Severity of Acute Pancreatitis
ELENA IRINA CALUIANU (TURMACU)(1), D.O. ALEXANDRU(2), M. GEORGESCU(3), D. MERCUT(4), E.T. TRASCA(4), MARIA IANCAU(5)
View online - Abstract - Download PDF Utilizing Multiparameter Scores and Procalcitonin as Prognosis Markers for the Degree of Severity of Acute Pancreatitis PDF
Aim: Corroborating the Ranson, Marshall, computer tomography severity index (EPIC score) multiparameter tests with the biological marker procalcitonin in order to establish the degree of severity of acute pancreatitis for therapeutic management and rate of complications. Material and method: 20 patients were surveyed, diagnosed with acute pancreatitis in the surgery clinic of the Military Emergency Hospital Dr. Ștefan Odobleja, between 2016-2017, with the aim of determining the clinical, etiological and severity diagnosis by corroborating the multiparameter scores with the plasma level of procalcitonin. Results: Following the use of multiparameter scores to identify the degree of severity of acute pancreatitis, we established that the best prediction is achieved by the Ranson score and the computer tomography severity index (EPIC score), with an accuracy of 90%. As for the values of the correlation coefficient, this was highly significant when correlating Ranson score and procalcitonin (r = 0.918). Other correlations were also highly significant, with values of r = 0.797 when correlating EPIC score and procalcitonin, and r = 0.736 when correlating Marshall score with procalcitonin. Conclusion: Our study achieved an early identification of the severe form of acute pancreatitis, by using the multiparameter tests and the biologic marker procalcitonin, allowing for the appropriate therapy to be implemented and thus decreasing the complication rate of this pathological entity. Levels of serum procalcitonin exceeded the normal limit of 2 ng/ml for 37.5% of the intermediate - severe form patients, and for 100% of the severe form patients. The levels of procalcitonin were highly correlated with the Ranson score, with a slightly lower correlation for the Marshall and EPIC scores.
5. Positive and Negative Predictive Factors for Treatment Response in Patients with Chronic Viral C Hepatitis
ADINA MARIA KAMAL(1), P. MITRUT(1), ALEXANDRA DANA CIOBANU(1), C.K. KAMAL(2), OANA SORINA TICA(3), A.A. TICA(4)
View online - Abstract - Download PDF Positive and Negative Predictive Factors for Treatment Response in Patients with Chronic Viral C Hepatitis PDF
More than 200 million people worldwide are infected with hepatitis C virus. In the United States, suggested estimates are that more than 5 million people live with HCV. The purpose of this paper is to identify, within the Southwestern Romanian population, host factors associated with the response to Pegylated Interferon and Ribavirin treatment for Hepatitis C virus infection. We investigated several factors and their correlation to sustained virological response. The study included 267 patients diagnosed with chronic Hepatitis C between 2013 and 2016, treated with Pegylated Interferon and Ribavirin in the 2nd Medical Department of the Emergency County Hospital Craiova. From the 267 patients included in this study, 149 (55,81%) achieved sustained virological response during the 48 weeks of treatment. Several factors were taken in consideration regarding the treatment response. Positive predictive factors for achieving sustained virological response were: the female gender (35,96%), Low Viral Load at the beginning of treatment, Early Virological Response 75 (28,09%), Rapid Virologic Response133 (49,81%), and stage of fibrosis, with Stage F1 having the highest rate of Sustained Virological Response during double therapy 81 (30,34%). Although at the present time a number of more effective antiviral products have been approved for the treatment of viral hepatitis C, in our country the standard of treatment remains with PegInterferon and Ribavirin therapy. Multiple clinical and paraclinical tools can identify patients with a high chance of responding to treatment, or those who, during treatment, do not meet the criteria for prolonging therapy.
6. P53 Immunoexpression in Laryngeal Squamous Cell Carcinoma
LILIANA CERCELARU(1), A.E. STEPAN(1), C. MARGARITESCU(1), A. OSMAN(2), IONELIA-CARMEN POPA(1), CRISTIANA EUGENIA SIMIONESCU(1), OTILIA MARGARITESCU(3)
View online - Abstract - Download PDF P53 Immunoexpression in Laryngeal Squamous Cell Carcinoma PDF
p53 is a marker described in the premalignant lesions with a high risk of malignant transformation for laryngeal cancer. It is a tumor suppressor gene that during the cancer gains also oncogenic activity. We aimed to study the p53 immunoexpression in 38 cases of laryngeal squamous cell carcinomas and the relation with the clinicopathological aspects. We obtained variable p53 expression regarding the differentiation degree and tumor stage. The higher p53 immunotaining values were observed in high grade and advanced stages lesions. P53 may be useful in identifying aggresive laryngeal squamous carcinomas, a useful aspect for better stratification of patients for therapy.
7. Odontal-Periodontal Changes in Patients with Type 1 Diabetes
DORA POPESCU(1), D. GHEORGHE(1), ILEANA PUIU(2), ANA-MARIA RCA(3)
View online - Abstract - Download PDF Odontal-Periodontal Changes in Patients with Type 1 Diabetes PDF
Diabetes mellitus is a complex disease characterized by insufficient insulin secretion and / or an inefficiency of target tissues to its metabolic action. Periodontal disease was recognized as the sixth leading complication of a diabetes. Gingival sulcus bleeding is considered as an important clinical parameter in the diagnosis of periodontal disease. This research is based on comparison of the clinical and paraclinical data between groups of patients with type 1 diabetes and periodontal disease on the one hand and groups of patients with periodontal disease without diabetic disease on the other hand. We can conclude that there is sufficient data to confirm the existence of a bidirectional relationship between metabolic changes in type 1 diabetes and periodontal (odontal-periodontal) disorder of patients, especially in adolescents and young adults. Both diseases can influence each other more or less, so for diabetics there is a predilection to develop periodontal disease as diabetes is a risk factor for severe parodontopathies.
8. Biological Evaluation of Two 1,4-Naphthoquinone Derivatives Against a Breast Human Adenocarcinoma Cell Line
FLAVIA MARIA CRETU(1), B.P. STANOIU(2), CATALINA PISOSCHI(1), ANCA PREDESCU(3), GABRIELA RAU(4)
View online - Abstract - Download PDF Biological Evaluation of Two 1,4-Naphthoquinone Derivatives Against a Breast Human Adenocarcinoma Cell Line PDF
Two novel 1,4-naphthoquinone derivatives containing salicylic acid and procaine moieties were synthesized and evaluated for their anticancer activity in vitro. The antiproliferative effect was assayed against MDA-MB-231 cells, a human breast adenocarcinoma cell line, using CellTiter-Glo® Luminescent Cell Viability Assay. Both compounds tested proved a growth inhibition effect on this cell line in a dose-dependent manner. Our results showed that the compound with procaine effectively reduces breast cancer MDA-MB-231 cells viability and proliferation at higher concentration while that with salicylic acid had an inhibitory effect at lower concentrations and might be tested as an anticancer agent.
9. EGFR Immunoexpression in Laryngeal Squamous Cell Carcinoma
LILIANA CERCELARU(1), A. E. STEPAN(1), C. MARGARITESCU(1), A. OSMAN(2), IONELIA-CARMEN POPA(1), CRISTIANA SIMIONESCU(1), OTILIA MARGARITESCU(3)
View online - Abstract - Download PDF EGFR Immunoexpression in Laryngeal Squamous Cell Carcinoma PDF
Epidermal growth factor receptor (EGFR) is a tyrosine kinase molecule associated to the initial stages of neoplastic transformation. High expression of EGFR is connected to aggressive tumor behavior and high risk of metastasis and treatment failure. The aim of our study was to analyze the immunohistochemical expression of EGFR in 38 cases of laryngeal squamous cell carcinomas depending on clinicopathological parameters related to prognosis. The EGFR immunoreactions have statistical significant higher values in high grade carcinomas. Although the EGFR values were superior in advanced stages lesions, the aspect was not significant EGFR may be useful in identifying the aggressive laryngeal squamous carcinomas.
10. Echocardiographic Parameters in Acute Pulmonary Edema
C. MILITARU(1), RUXANDRA DELIU(2), I. DONOIU(3), D.O. ALEXANDRU(4), C.C. MILITARU(3)
View online - Abstract - Download PDF Echocardiographic Parameters in Acute Pulmonary Edema PDF
Purpose: The present study proposes the comprehensive ultrasound evaluation of a consecutive batch of .patients with acute cardiogenic pulmonary edema. Method: The registry included all patients with acute pulmonary edema from 2 emergency hospitals between February and May 2016. During the first 3 days of admission, a transthoracic ultrasound was performed which included the parameters of systolic and diastolic function of the left ventricle, right ventricular systolic function, heart cavity dimensions, estimated pulmonary pressure, and the presence and severity of valvular disease. Results: A total of 70 patients were enrolled in the registry. The mean ejection fraction of the left ventricle was 39.5±11.4% and the average indexed end-diastolic volume was 77.7±29.5ml/m2, above the upper limit of normal. All patients in whom diastolic function could be evaluated had a degree of diastolic dysfunction. Functional parameters of the right ventricle were normalized as average, and the mean pulmonary artery pressure was increased: 40.9±16.7mmHg. The most common valvular heart disease were mitral and tricuspid insufficiency, with moderate or severe impairment in 82.8%, respectively 65.7% of the patients
11. Association of Some Components of the Metabolic Syndrome with the Subtype of Mild Cognitive Impairment
CATALINA COTEANU(1), ALICE GUSTI(2), M.F. COTEANU(3), SIMONA GUSTI(4)
View online - Abstract - Download PDF Association of Some Components of the Metabolic Syndrome with the Subtype of Mild Cognitive Impairment PDF
In the last 30 years there has been a long way in what concerns the ability to test and diagnose cognitive disorders. On the other hand, it is more and more obvious the necessity to discover new parameters, which can clearly witness the passage from the physiological state of aging to a cognitive impairment in various stages (ranging from mild cognitive impairment to severe dementia). Bringing together all the clinical, paraclinical and neuropsychological data trying to discover the missing link between metabolic disorders, chronic inflammatory changes, progression of atherosclerosis, and the appearance of cognitive disorders, remains an extremely attractive and challenging field of research. By this study, we observed that there is a slight supremacy of the amnestic-MCI in patients with metabolic syndrome, without being able to extract statistically significant data. The interesting data obtained in this study emphasized the connection between the triglycerides/HDL-cholesterol ratio and the presence of the amnestic-MCI subtypes in patients with metabolic syndrome. The data obtained led to the conclusion that an increase in diastolic blood pressure in older people is a prediction factor for cognitive decline.
12. The Role of Early Diagnosis of Hepatorenal Cystic (HRC) Syndrome in Children-Clinical Trial
DIANA STEFANIA MATEESCU(1), C.E. NICULESCU(2), C.C. VERE(3), M.S. SERBANESCU(4), I. ROGOVEANU(3)
View online - Abstract - Download PDF The Role of Early Diagnosis of Hepatorenal Cystic (HRC) Syndrome in Children-Clinical Trial PDF
The hepatorenal cystic (HRC) syndrome is a heterogeneous group of severe monogenic conditions that may be detected before birth. Effective programme evaluation of children with HRC syndrome is a systematic way to identify the renal and urinary tract malformations which represent the most common cause of end-stage renal disease (ESRD). We conducted a study involving 50 patients, who were between 3 months and 16 years of age, with multiple admissions in the Nephrology Department of “Maria Sklodowska Curie” Children Emergency Hospital from Bucharest, during 6 years (April 14th 2010-October 24th 2016), to evaluate the HRC syndrome. The admission symptomatology was mainly represented by the nephrology evaluation which was essential in the management of children’s polycystic kidney disease. For example, a premature infant (gestational age=32 weeks) with positive heredo-collateral history (mother and grandmother were diagnosed with polycystic kidney disease), was tested positive for cystic renal disease after the fetal morphology was performed. It was also done a genetic determination for the presence of PKD1 and PKD2 mutations which are specific to autosomal dominant polycystic kidney disease-ADPKD. However, the genetic test was negative and a postnatal nephrological evaluation was performed using renal ultrasound. The image revealed autosomal recessive polycystic kidney disease-ARPKD. This study emphasizes the importance of an early diagnosis (prenatal, neontal, postnatal) correlated with the admission symptoms and also with the genetic diagnosis (mutations of PKD1 and PKD2).
13. Histopathological Study of Oral Pseudoepitheliomatous Hyperplasia
ROXANA MARIA PASCU(1), STEFANIA CRAITOIU(2), ALMA MARIA FLORESCU(1), LUMINITA DAGUCI(1), ILEANA CRISTIANA PETCU(1), EMILIA GEORGIANA PASCU(3), MONICA MIHAELA CRAITOIU(1)
View online - Abstract - Download PDF Histopathological Study of Oral Pseudoepitheliomatous Hyperplasia PDF
Pseudoepitheliomatous hyperplasia, also called Heck’s disease, is an epithelial, inconstant and conjunctive proliferation that develops as a response to a great variety of stimuli. It is a lesion associated to different diseases, being found in the following etiopathogenic conditions: infectious pathogenic conditions, tumoral pathogenic conditions, inflammatory pathogenic conditions. We studied oral pseudoepitheliomatous hyperplasia for which we performed a histopathological study, on a group of 47 cases of oral pseudoepitheliomatous hyperplasias, where we investigated the following: oral epithelium changes, changes in the underlying lamina propria and associated etiopathogenic conditions. The main changes of the oral epithelium were: elongation of the epithelial apexes (17.02%), acanthosis (100%), dyskeratosis (14.89%), and in the underlying lamina propria: fibrosis (29.78%), inflammatory infiltrate (70.21%) and vascular proliferation (10.64%). The most frequent associated etiopathogenic conditions were the infectious ones (55.31%), followed by the tumoral ones (29.79%), on the last place being the inflammatory conditions (14.89%).
14. Clinical, Histological and Immunohistochemical Evaluation of Larynx Cancer
M.S. CIOLOFAN(1), A.N. VLAESCU(2), CARMEN-AURELIA MOGOANTA(1), ELENA IONITA(3), MIHAELA-ROXANA MITROI(1), F. ANGHELINA(1)
View online - Abstract - Download PDF Clinical, Histological and Immunohistochemical Evaluation of Larynx Cancer PDF
Laryngeal cancer represents the malignant degeneration, of epithelial nature or from the connective tissue, which starts in the constitutive elements of the larynx. Cancer localization in the larynx represents between 1% and 3% of all malignant tumors and approximately 50% of ear, nose and throat (ENT) tumors. Squamous cell carcinoma is the most common form (around 95%) of laryngeal cancer, with high incidence in human males from southern and central Europe, Romania occupying one of the top places. Material and Methods. Our study consisted of 490 patients diagnosed with laryngeal cancer from 2010 to 2016. They have been clinically, histologically, immunohistochemically, genetically, therapeutically and prognostically analyzed. Suspended microlaringoscopy has been the standard, allowing tumor extension evaluation and biopsy. All specimens were microscopically analyzed in standard or special histology stainings. For unclear histology specimens, immunohistochemical stainings were performed. Results and discussions. Histological types have been represented as follows: 31 carcinomas in situ, 17 microinvasive carcinoma, 205 poorly differentiated carcinomas, 138 moderately differentiated carcinomas, 63 well differentiated carcinomas, 8 papillary carcinomas, 1 leiomyosarcoma, 1 chondrosarcoma, 6 basaloid squamous cell carcinomas, 4 verrucous carcinoma, 1 malignant melanoma. Conclusions. The study brings to light the importance of integrated clinical, morphological and genetic evaluation of laryngeal cancer, regarding tumoral invasion grading and establishing an adequate surgical and oncologic treatment. The importance of immunohistochemistry in laryngeal cancer concerns prognosis factors which correlate with the evolution and histopathological degree of the lesion. The analysis of tumor invasion can lead to the development of therapeutic conduct and the establishment of prognostic markers.
15. Prenatal, Obstetric and Perinatal Aspects in Pregnancy Associated with Pregestational Diabetes
A.V. TETILEANU(1), C. BERCEANU(2), S. PAITICI(3), LOREDANA ELENA CIUREA(4), SABINA BERCEANU(2)
View online - Abstract - Download PDF Prenatal, Obstetric and Perinatal Aspects in Pregnancy Associated with Pregestational Diabetes PDF
We report the case of a 37-year old primigesta, primipara (IGIP) patient with a singleton, naturally obtained pregnancy, diagnosed with type I diabetes mellitus from the age of three, carrier of an insulin pump for 11 years. The patient was diagnosed in adolescence with with a tumor of the ischio-rectal fossa with multiple attempts of excision which failed due to the particular situation of the tumor. Ultrasound examination diagnosed in the first trimester of pregnancy a voluminous right ovarian cystic tumor. The patient presented pregnancy-induced hypertension starting with 28 gestational weeks. Maternal-fetal and obstetric management assumed sequential ultrasound examination, ovarian tumor and maternal blood pressure drug control, and also the surgical management of the ischio-rectal tumor. Cesarean section was performed at 38 gestational weeks, outcoming with a live fetus, normal weight, good neonatal progression and favorable postoperative progression of the mother. In this case report, we emphasize the fact that in pregestational diabetes mellitus and pregnancy-induced hypertension, constant glycemic control, performed by the insulin pump, prior and during gestation, and the maternal blood pressure control are essential for maternal-fetal outcome.
16. Case Presentation of Soft Tissue Defect after Bimalleolar Fracture Osteosynthesis
A. GRECU(1), O. NICA(2), DANIELA MARINESCU(3), DANIELA VINTILA(4), M. CIUREA(5)
View online - Abstract - Download PDF Case Presentation of Soft Tissue Defect after Bimalleolar Fracture Osteosynthesis PDF
A 59-year-old patient presented in the ER with wound dehiscence and skin necrosis on the right ankle, with osteosynthesis implant visible, after open reduction and fixation with plate and screws, performed abroad, 16 days prior to the presentation, for a bimalleolar fracture. The patient was admitted to the plastic surgery department, where surgical debridement of the necrotic tissue was initially performed. Postoperatively, the patient was treated with Negative-pressure wound therapy (VAC dressing) and Platelet rich plasma (PRP) therapy. Upon obtaining granulation tissue without signs of infection, a sural fasciocutaneous flap was performed to cover the skin defect. Proper graft integration and healing was observed.
17. Adaptive and Pathological Reshuffling in the Venous Wall in Special Hemodynamic Conditions-Acquired Arteriovenous Fistula
DANIELA MARINESCU(1), GEORGIANA GRAURE(2), M. BICA(1), ELENA CATALINA BICA(3), D. RADULESCU(1)
View online - Abstract - Download PDF Adaptive and Pathological Reshuffling in the Venous Wall in Special Hemodynamic Conditions-Acquired Arteriovenous Fistula PDF
Hemodialysis and peritoneal dialysis are the two possible choices in chronic renal disease in the uremic stage. Native arteriovenous fistula is susceptible to complications, some posing vital risk and requiring prompt treatment. We present the case of a patient undergoing hemodialysis on native AVF. An aneurism developed progressively on the arterialized cephalic vein. The AVF was abolished by closing the arteriotomy with a venous patch and excising the aneurismal venous segment. The pathology exam of the surgical specimen showed unequal vessel wall thickness due to hyperplasia of the media and subintimal space, with calcifications within the hyperplastic media.
18. The Correlation between the Complexity of the Reconstruction in the Labial Region and the Extent of the Postoperative Defect - Report of 3 Cases
A.I. SALAN(1), V. PADUREANU(2), A. CAMEN(3), ALEXANDRA CIUCA(1), E.M. CIUCA(3)
View online - Abstract - Download PDF The Correlation between the Complexity of the Reconstruction in the Labial Region and the Extent of the Postoperative Defect - Report of 3 Cases PDF
Lips are structures that play an essential role in aesthetics, nutrition and speech. Their complex anatomy-with three different layers composed of skin, mucosa, and muscles-makes surgical management of this area a therapeutic challenge. We report here 3 cases of surgical reconstruction of the upper lip after the excision of tumors of varying sizes. The resulted defect from tumor extirpation is always closely linked to the time elapsed from the appearance of the tumor to the presentation in the ambulatory of Oral and Maxillofacial Surgery.
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