Archive issue

Current Health Sciences Journal

vol. 44 no. 2, 2018

1. Recent Developments in Tele-Ultrasonography

Elena Codruta Constantinescu, Carmen Nicolau, Adrian Saftoiu

A long-standing trend that will continue to grow in healthcare is providing high quality services for all the patient, no matter the distance and no matter the place. One approach currently being used to increase population access to healthcare services is telemedicine. This narrative review presents one branch of e-health, in particular the use of teleultrasonography (TUS) in clinical practice, the challenges and barriers encountered. Current advances in ultrasound technology, including the growth of portable and small ultrasound devices have increased the range of applications of TUS, from traumatic patients in emergency medicine, maternal ultrasound and even for monitoring and screening for chronic illnesses. Even though some barriers are still looking for a solution, like standardized training and protocols, errors in data acquisition, the lack of trained professionals to operate in remote areas, TUS has the potential to redesign future health care systems.

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2. Hepatitis C Infection in Hemodialysis Patients

Daniel Cosmin Caragea, Alexandru Radu Mihailovici, Costin Teodor Streba, Michael Schenker, Bogdan Ungureanu, Iulia Nicoleta Caragea, Romeo Popa, Cosmin Obleaga, Cristin Constantin Vere

Three centuries after the identification of hepatitis C virus (HCV), specialized literature has outlined the epidemiology, viral kinetics and clinical manifestations of this infection. A major cause of morbidity-mortality in patients with renal transplantation and in hemodialysis patients is HCV infection. In high seroprevalence countries, internal accounts are not uniform. The European trend is to decrease the incidence and prevalence of HCV in hemodialysis patients. In Europe, the prevalence of HCV infection among hemodialysis patients tends to be higher than that of the general population, but it is variable by region. Some studies indicate a decrease in incidence in parallel with prevalence in dialysis centers over the last 10 years, while others maintain a high incidence. In some countries, as is the case with Romania, both prevalence and incidence remain high, with the major route of transmission being nosocomial, probably due to limited resources for a rapidly growing dialyzed p

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3. In Vitro Cytotoxicity of Zinc Fructoborate, a Novel Zinc-Boron Active Natural Complex

Carmen Nicoleta Oancea, Anisoara Cimpean, Raluca Ion, Johny Neamtu, Andrei Bita, Ion Romulus Scorei, Andreea Silvia Neamtu, Otilia-Constantina Rogoveanu, Sorin Ioan Zaharie, Gerd Birkenmeier

In recent years, the role of zinc in biological systems has been a subject of intense research. Zinc is required for multiple metabolic processes as a structural, regulatory, or catalytic ion. The objective of this study, was to assess the toxicity profile of a newly synthesized zinc-boron molecule on cultured cells. Zinc fructoborate, at different levels of concentration, was tested for its impact on the Vero kidney cell line (ATCC® CCL-81™) using the MTT assay. The compound exhibited a low cytotoxic effect on the cell line. Thus, our study demonstrates that the zinc fructoborate could become a promising dietary supplement molecule.

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4. Blood Coagulation Fallowing an Acute Ischemic Stroke

Mirela Diana Sfredel, Emilia Burada, Bogdan Catalin, Venera Dinescu, Georgica Tartea, Maria Iancau, Eugen Osiac

Objective. Hemostasis is a complex physiological process that stops bleeding at the site of a vascular injury. Although the majority of vascular accidents are ischemic, the role of hypercoagulable state and stroke needs further investigation. Materials and Methods. Fresh whole blood was taken from 61 acute ischemic stroke patients and compared to 18 healthy subjects and investigated with optical coherence tomography imaging after initiating coagulation. We used an OCT1300SS system (Thorlabs) and did 3D scans. We then processed the images with ImageJ. For each image mean, integrated density, skewness and kurtosis of gray values were analyzed. Results. Mean gray value and integrated intensity of sampled data showed an intrinsic difference detected with OCT. This difference was further confirmed by the data distribution analysis. Conclusions. Results suggest, that normal blood coagulation, is not a random reaction while in the case of stroke patients, the relatively symmetrical distributi

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5. Quality of Life-a Goal for Schizophrenia’s Therapy

Mihail Cristian Pirlog, Dragos Ovidiu Alexandru, Ruxandra Elena Popescu, Liliana Balcu, Livia Mihaela Strunoiu, Lavinia Corina Duica, Mircea Mihai Dutescu

Quality of Life (QOL) assessment represents a good instrument to monitor the evolution of schizophrenia and the treatment’s outcomes. The present study has evaluated the relationship between the level of the QOL and different socio-demographical and clinical factors. Lower QOL for schizophrenic persons was influenced by the severity of symptoms and cognitive deficits, while same low level of QOL could be considered an indicator for suicidal behavior. The correct therapeutically management of individuals with schizophrenia could lead to better outcomes in terms of life satisfaction of patients and response to the treatment’s strategies.

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6. EGFR Immunoexpression in Malignant Serous and Mucinous Ovarian Tumors

Andreea-Elena Cirstea, Alex Emilian Stepan, Roxana Eugenia Zavoi, Cristiana Eugenia Simionescu

The epithelial growth factor receptor (EGFR) is involved in various stages of cancer growth such as tumor initiation, angiogenesis and metastasis, being an attractive target for oncogenic therapy. The present study aims to evaluate the EGFR expression in 54 cases of serous and mucinous ovarian borderline tumors and carcinomas. EGFR expression was present in more than half of the investigated tumors, more frequently in carcinomas than in borderline tumors, especially in the serous type. The highest values of the final staining score (FSS) were observed only in serous carcinomas in the advanced stages of the disease. As a result of frequent expression of EGFR in ovarian tumors, it is necessary to monitor EGFR inhibitors for ovarian cancer therapy, but probably after establishing more rigorous selection and stratification criteria for patients.

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7. The Association between Nod2 R702w Polymorphism and Susceptibility to Colorectal Cancer in Romanian Patients

Florin Burada, Cecil Sorin Mirea, Mihai Gabriel Cucu, Ionica Dan Vilcea, Alina Cimpoeru, Mihai Ioana

It is well recognized that the inflammatory bowel disease (IBD) is associated with an increased risk of colorectal cancer (CRC). More susceptibility IBD genes have been reported, NOD2 being one of the most extensively investigated. The aim of this study was to evaluate a possible correlation between NOD2 rs2066844 C>T (also known as Arg702Trp or R702W) variant and CRC risk in a Romanian population. A total of 373 Romanian subjects (108 patients diagnosed with sporadic CRC and 265 controls) were enrolled in this hospital-based case-control study. The NOD2 R702W variants were detected by Real-time PCR using a predesigned TaqMan Genotyping Assay. The association between the genetic risk variant and CRC was expressed as odds ratios (OR) with 95% confidence intervals (CI). We did not find any statistically significant difference when we compared CC genotype with CT genotype (OR 1.1, 95% CI: 0.46-2.61; p=0.83) between CRC patients and controls. No TT homozygous genotype was detected. Also, w

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8. Colorectal Cancer Biomarkers -A New Trend in Early Diagnosis

Sebastian Constantin Toma, Bogdan Silviu Ungureanu, Stefan Patrascu, Valeriu Surlin, Ion Georgescu

Colorectal cancer (CRC) is one of the most widespread malignancy, posing as a great challenge due to its high incidence and mortality in both genders. Yet, it also stands as one of the most preventable diseases because of its known malignant transformation mostly from tubular adenomas or serrated polyps, therefore offering a strong incentive to the screening programs that are being developed for this disease. Current diagnosis of CRC has surely evolved along with the evolutionary step in gastrointestinal technology of flexible endoscopy. These innovations have promoted colonoscopy as a primary choice for screening programs of colonic lesions, proving to be of great benefit for patient’s well-being. In this review, we present the current status of CRC screening methods from the non-invasive options to the long developed colonoscopic and imaging techniques. We search through PubMed and Medline databases and chose relevant articles on CRC with focus on blood based biomarkers and stool

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9. Histopathological Prognostic Factors for Colic Adenocarcinoma

Anne-Marie Al Khatib, Alex Emilian Stepan, Claudiu Margaritescu, Bianca Catalina Andreiana, Mirela-Marinela Florescu, Cristiana Eugenia Simionescu, Raluca Niculina Ciurea

The majority of colorectal carcinomas are adenocarcinomas derived from the colic mucosae cell, more frequently moderately differentiated. The purpose of this study was to determine de incidence of CRC and the relationship between histopathological risk factors in patients with colic adenocarcinomas. The study included 144 cases of CRC diagnosed within the Pathology Laboratory of the Clinical County Hospital of Craiova in the year 2017.The biological material consisted in samples from colectomies and hemicolectomies provided from patients admitted within the surgical clinics of the same hospital, then fixed with 10% buffered formalin and afterwards processed using the classic histopathological technique of paraffin inclusion and staining with hematoxylin and eosin. We observed certain histopathological parameters such as: pattern, grading, stage, vascular invasion and neural invasion. The mean age of diagnostic was 68,6±11,2, and it was predominantly male patients (64.6%). Most cases p

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10. Social Functioning in Schizophrenia Clinical Correlations

Mircea Mihai Dutescu, Ruxandra Elena Popescu, Liliana Balcu, Lavinia Corina Duica, Livia Mihaela Strunoiu, Dragos Ovidiu Alexandru, Mihail Cristian Pirlog

Schizophrenia remains one of the major psychiatric disorder with huge social and economic costs for the individual and community. The role of psycho-social factors is important both on the etiopathogenesis of the illness and its evolution, lack of social functioning and associated stress have impact on everyday life of people with this diagnosis. Our study of 100 subjects with schizophrenia has showed significant correlations between clinical and social items: bigger number of admissions, longest duration of the evolution, cognitive deficits, smoking, suicidal behavior, age, marital status, smoking, and level of perceived stress. The social functioning was influenced by these factors, and the therapeutically management during the hospitalization does not showed an improvement of the social function.

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11. Algorithm for Calculating the Protein Intake in Enteral and Parenteral Nutrition in Premature Infants

Eugen Cristi Stoicanescu, Florica Popescu, Andrei Zavate

Introduction. Calculating the exact nutritional balance especially for the premature infant has always been a challenge for the daily practice of the clinician. Purpose: we intend to establish a simplified formula and mathematical algorithms to calculate the necessary amino acids and proteins for the nutrition of the premature newborn, covering most of the international recommendations and also to give to the neonatal intensive care physician the opportunity of their rapid customization for each case. Methods: following an extensive literature revision we have established the protein intake recommendations, indications and contraindications for enteral and parenteral nutrition in premature infants, by age of gestation, birth weight and postnatal age. Then, these recommendations were translated into simplified mathematical equations and we have proceeded to develop logical algorithms to enable the rapid choice of the best equation that fits each individual case with all its peculiaritie

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12. Immunoexpression of Transforming Growth Factor Beta 3 (TGFβ3) and Its Receptor Type III (TGFβRIII) in Basal Cell Carcinomas

Diana Florescu, Alex Emilian Stepan, Claudiu Margaritescu, Cristiana Eugenia Simionescu, Desdemona Stepan

Basal cell carcinomas (BCCs) are malignant tumors with particular biological prognosis and behavior, and the biomolecular investigation of these lesions can provide important therapeutic targets for epithelial neoplasia. In this study we analyzed the immunoexpression of transforming growth factor beta 3 (TGFβ3) and its receptor type III (TGFβRIII) for 53 cases of BCC in relation to the main histopathological prognostic parameters. The results indicated statistically significant differences of TGFβ3 and TGFβRIII expression related to histological type and lesion stage, the both proteins being higher expressed in adenoid and morpheaform advanced stage tumors. In this study, TGFβ3 and TGFβRIII immunoexpression analysis indicated their utility for identifying aggressive BCCs with potential for tumor progression.

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13. Epidemiology of Traumatic Brain Injury in Oltenia Region: a Retrospective Study

Andreea Lavinia Zorila, Marian Valentin Zorila, Razvan Stefan Tolescu, Roxana Eugenia Zavoi, Daniela Cernea

Traumatic brain injury (TBI) represents a common cause of presentation in the emergency room and is considered a major health problem all over the world. Our study objective was to provide a regional perspective from a county hospital regarding epidemiologic aspect of TBI in a single year and to compare it with existing studies. 592 patients fulfilled the inclusions criteria and their characteristics were noted. We observed that the highest rate of TBI was among older people with an age over >60 years with 40.88%, which represented 242 of cases. Middle age adults (40 to 60 years) represented 34.29% whereas young adults were 16.72%. The remaining cases of 8.11% suffered mostly of concussions (80%) and were encountered in the <20 years group. While comparing with the local population of the Dolj County we obtained an incidence of 89.6 per 100.000 people. When discussing gender, we observed that most of the patients were male with a ratio of 2,3:1. Over one year, 132 deaths were cause of

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14. Investigation of Achievement Orientation of Nursing and Midwifery Students

Nasibe Yagmur Filiz, Funda Erol, Handenur Basaran, Fatma Tanrikulu, Yurdanur Dikmen

Purpose: This study was conducted to determine the achievement orientation of nursing and midwifery students and to examine some factors that may affect their achievement orientation. Material/Methods: The descriptive sample of this research was created by 209 first-year students voluntarily attending and studying in the Department of Nursing and Midwifery at the Faculty of Health Sciences of a public university in Turkey. The data were collected with "Student Presentation Form" and "2x2 Achievement Orientation Scale". Mann Whitney-U test and Kruskal Wallis test were used with frequency, percentage, arithmetic mean and standard deviation in evaluating the data. Results: The students were found to have 3.39±0.54 in the learning-approach orientation sub-dimension, 3.27±0.75 in the learning-avoidance orientation sub-dimension, 2.73±0.76 in the performance-approach orientation sub-dimension and 2.74±0.74 points in the performance-avoidance orientation sub-dimension. A significant diffe

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15. A Diagnostic Challenge: Pancreatic Cancer or Autoimmune Pancreatitis?

Irina Mihaela Cazacu, Adriana Alexandra Luzuriaga Chavez, Adrian Saftoiu, Tonya G. Whitlow, Priya Bhosale, Manoop S. Bhutani

We report a rare case of seronegative autoimmune pancreatitis (AIP) that presented as a pancreatic focal lesion and was considered to be pancreatic cancer based on the clinical presentation and imaging findings. The endoscopic ultrasound-guided biopsies of the pancreatic mass revealed no malignant cells and the pancreatic swelling had become diffuse on repeat imaging. AIP was suspected and a trial of steroids was considered as a diagnostic and therapeutic method. The patient responded dramatically to corticosteroid treatment with resolution of symptoms and normal imagining and laboratory parameters. This case highlights the challenge in the diagnostic approach of a pancreatic mass.

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16. The Association Between Helicobacter Pylori Infection and Liver and Biliary Tract Disorders

Decebal Popescu, Dan Andronescu, Petru Aurel Babes

Helicobacter Pylori (HP) persistently colonizes the stomach in about 50% of the globe population and it is the main risk factor for peptic ulcer, as well as for gastric adenocarcinoma and MALT gastric lymphoma. The treatment for HP revolutionized the management of the peptic ulcer disease, providing permanent healing in many cases. Preventing colonization of HP would be the primary prevention of gastric malignancy and peptic ulceration. At the same time, the presence of HP provides protection for some diseases (gastroesophageal reflux disease and its complications, esophageal adenocarcinoma, asthma), the eradication of the microorganism having negative repercussions. HP has an increasingly recognized role in other extragastric pathologies. Thus, immune thrombocytopenic purpura has improved after treating HP infection. There are controversial association with ischemic heart disease and cerebrovascular disease. The current article highlights an important association between HP infection

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17. Severe Thrombocytopenia in Patient with Dermatomyositis

Andreea Daniela Tudorancea, Paulina Lucia Ciurea, Florentin Ananu Vreju, Elena Madalina Vintila, Stefan-Cristian Dinescu

Dermatomyositis (DM) is part of a heterogeneous group of systemic diseases called idiopathic inflammatory myopathies. As in other autoimmune connective tissue diseases (CTD), abnormalities of hematopoietic tissue and/or peripheral blood cells may develop and represent an important prognostic factor. Most common CTD associated with thrombocytopenia (TP) are systemic lupus erythematosus and antiphospholipid syndrome. DM-related TP is less frequent and may develop in the context of an underlying malignancy. Severe TP related to myositis is a very rare occurrence. We report a case of a male patient diagnosed with acute DM, debilitating muscle weakness and rapid development of severe TP.

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