List of Papers

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The prognostic value of intratumoral microvessel density in gastrointestinal stromal tumors Kövecsi A View abstract

The prognostic value of intratumoral microvessel density in gastrointestinal stromal tumors

First author: Kövecsi A

Coauthors: Jung I , Gurzu Simona

Keywords: Gastrointestinal pathology Gastrointestinal pathology GIST, angiogenesis, CD31, CD105, VEGF-A

Background: In many cases of gastrointestinal stromal tumors (GISTs), the assessment of prognosis remains a challenge. Recently, the prognostic role of angiogenic markers, especially CD31, VEGF-A and CD105 was hypothesized. In this study, we proposed to present data regarding the possible prognostic value of the intratumoral microvessel density (IMVD) with immunohistochemical methods in patients with GISTs. Material and Method: Tissue microarray blocks (TMA) were performed from 80 GISTs diagnosed at the Department of Pathology of Tirgu-Mures (Romania) between 2003 and 2015. The IMVD was quantified with CD31, CD105. VEGF-A cytoplasmic expression of the tumor cells was also evaluated together with the Ki67 proliferation index. Results: VEGF-A expression was observed in 32.5% of cases (n=26). VEGF-A expression were directly correlated with the mitotic rate (p=0.0001), recurrence risk (p=0.001), intratumoral necrosis (p= 0.001) and presence of distant metastases (p=0.03). The IMVD quantified with CD31 showed a statistically significant correlation with tumor localization (p=0.01). Thus, GISTs from the small intestine showed higher IMVD value and higher Ki67 score (p=0.01). In the case of CD105-labeled IMVD, a statistically significant direct correlation was observed with the tumor size (p=0.02). Thus, independently of localization, cases larger than 5 cm were associated with a higher IMVD-CD105 and with an increased mitotic rate (p=0.001). Correlations between high IMVD-CD105 and increased risk of recurrence (p=0.00003) was also observed. The patients overall survival was significantly correlated with the IMVD quantified with CD31, but was not correlated in the case of CD105 and VEGF-A. Conclusions: Markers of tumor angiogenesis in GISTs, especially CD31, may be useful in assessing the prognosis, in addition to classical prognostic factors.

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Sciatic nerve regeneration in Wistar Albino rats evaluated by in vivo conductivity and in vitro 1H NMR relaxometry Anamaria Victoria Bumbu View abstract

Sciatic nerve regeneration in Wistar Albino rats evaluated by in vivo conductivity and in vitro 1H NMR relaxometry

First author: Anamaria Victoria Bumbu

Coauthors: Radu Fechete , Marcel Perian , Bogdan Septimiu Bumbu , Klara Brinzaniuc

Keywords: Plastic and reconstructive surgery Anatomy Rat’s sciatic nerve regeneration, electric conduct

Background: The aim of this study is to develop new in vivo and in vitro methods, based on electric conductivity and 1H NMR relaxometry to evaluate and quantify the nerve regeneration after injury. Material and Method: For this study, 32 Wistar Albino rats were divided into 2 groups. The left sciatic nerve was interrupted using a sharp blade. In the first group direct suture reconstruction was performed, and for the second group a silicone nerve graft was used. The rats were sacrificed at 4, 6, 8 and 10 weeks after nerve reconstruction. From each group a number of two rats were selected for in vivo electric conductivity and in vitro    1H NMR relaxometry measurements. Results: The threshold of the stimulating voltage, response time and conduction velocity were measured. The results were correlated with the time elapsed after injury and reconstruction methods. In the injured nerve we observed a significant increase in the threshold of stimulus and a decrease of conduction velocity. During regeneration process the response velocity increases slightly from week 4 to week 8 for the direct sutured nerve. The T2 distributions measured for all groups presents four peaks associated with 1H located in different pools: bounded on to the collagen fibrils from axons, epineurium, perineurium as free water and inside blood vessels. Conclusions: Significant differences were observed between direct suture and nerve graft reconstructions. The in vivo electric conductivity showed that the response velocity in the case of direct suture reconstruction at 10 weeks after lesion the nerve healed.

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The impact of Clostridium difficile infection on child’s ulcerative colitis – a case report Meliț Lorena Elena View abstract

The impact of Clostridium difficile infection on child’s ulcerative colitis – a case report

First author: Meliț Lorena Elena

Coauthors: Mărginean Maria Oana , Mărginean Cristina Oana

Keywords: Clostridium difficile children ulcerative colitis

Background: Clostridium difficile infection is a severe condition that affects mainly people with predisposing factors like elderly or immunocompromised hosts, individuals diagnosed with inflammatory bowel diseases, treatment with proton pump inhibitors, etc. Ulcerative colitis is a chronic inflammatory condition of the bowel and it belongs to the family of inflammatory bowel diseases. Material and Method: We report the case of a 16-year-old male adolescent diagnosed with ulcerative colitis who developed a severe infection with Clostridium difficile in order to underline the implications this infection regarding the patient’s management and evolution.  Results: We present the case of a 16-year-old male adolescent admitted in our clinic with rectal bleeding for approximately 1 week. His personal history revealed a similar episode one month before the admission with spontaneous remission. The clinical exam showed diffuse abdominal tenderness. The laboratory parameters were within normal ranges, and the colonoscopy pointed out multiple hemorrhagic lesions and edema of the rectum, sigmoid and descending colon, suggesting the diagnosis of ulcerative colitis, confirmed by the histopathological exam. We initiated steroids and adjuvant therapy, but the patient’s lack of compliance led to his discharge at request. After approximately 5 days he presented with fever, abdominal pain and an increased number of diarrheic stools, up to 11/day with fresh blood. The laboratory parameters showed leukocytosis, anemia, and increased inflammatory biomarkers. The stools exam revealed Clostridium difficile infection. Despite the eradication of Clostridium difficile infection, the patient’s evolution was stationary, needing multiple blood transfusions and human albumin substitution, and he continued to present up to 10 stools/day. We administered Azathioprine, but he developed side-effects. Thus, we initiated biological therapy (Infliximab) and the evolution improved slowly. Conclusions: Clostridium difficile infection can burden the evolution of ulcerative colitis. The early diagnosis and management of this infection are mandatory in children with ulcerative colitis.  

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In patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention, the occurrence of no-reflow is related to the magnitude of myocardial damage Serban RC View abstract

In patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention, the occurrence of no-reflow is related to the magnitude of myocardial damage

First author: Serban RC

Coauthors: Hadadi L , Sus Ioana , Lakatos Eva Katalin , Demjen Z , Scridon Alina

Keywords: ST-segment elevation myocardial infarction primary percutaneous coronary intervention no-reflow

Background: The no-reflow phenomenon complicates up to one third of primary percutaneous coronary interventions (PCI) performed in patients with ST-segment elevation myocardial infarction (STEMI), affecting the short- and long-term prognosis of these patients. Predicting no-reflow in this high-risk population could guide the interventionist in choosing the most adequate approach. Material and Method: A total of 428 patients treated by primary PCI for STEMI were included in the analysis. Parameters related to the magnitude of STEMI-related myocardial damage (i.e., hemodynamic [blood pressure, heart rate, Killip class, and left ventricular ejection fraction on admission], ECG [sum of ST-segment elevation], and biochemical [troponin I and creatine kinase-myocardial band levels] parameters) were assessed and compared between patients with and without no-reflow. Results: No-reflow occurred in 100 of the 428 patients. Heart rate (p<0.01), Killip class (p=0.02), troponin I (p=0.02), and creatine kinase-myocardial band (p=0.04) on admission were all significantly higher, whereas left ventricular ejection fraction was significantly lower (p<0.01) in patients with no-reflow. In multiple regression analysis, heart rate (p<0.01), left ventricular ejection fraction (p=0.03), and troponin I levels (p<0.01) remained independent predictors of no-reflow. Conclusions: The magnitude of myocardial damage, reflected by the higher heart rate and troponin I levels and the lower left ventricular ejection fraction on admission, appears to significantly affect the propensity to no-reflow in STEMI patients treated by primary PCI. These simple and widely available parameters could help identifying the patients that are most likely to develop no-reflow and who would benefit from more intensive prophylactic strategies.This work was supported by the University of Medicine and Pharmacy of Tîrgu Mureș Research Grant number 17800/1/22.12.2015.

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RESULTS OF TRANSSPHENOIDAL SURGERY FOR NON FUNCTIONING PITUITARY ADENOMAS IN THE 9TH DECADE Chinezu R View abstract

RESULTS OF TRANSSPHENOIDAL SURGERY FOR NON FUNCTIONING PITUITARY ADENOMAS IN THE 9TH DECADE

First author: Chinezu R

Coauthors: Balasa A , Borda Angela , Raverot G , Trouillas Jacqueline , Jouanneau E

Keywords: endoscopy transsphenoidal surgery pituitary tumors elderly

Background: Population ageing is common and the number of persons aged over 80, steadily increasing. Autopsies reveal that about 13% of very elderly patients could harbor a pituitary tumor. Surgical management of these tumors is controversial as exponential increase of post-surgical mortality in this extreme age group has been described. Our study aimed to determine the prevalence of pituitary tumors and safety of endoscopic transsphenoidal pituitary surgery in patients aged over 80. Material and Method: A retrospective study was performed on two series of elderly and very elderly patients operated between 2007 and 2015 for non-functioning pituitary adenomas. To properly delimit age groups a 5-year gap was imposed. Tumoral characteristics (height, invasion, histopathological grading), comorbidities, preoperative and postoperative visual, endocrinological status and surgery results were compared between the two groups. Results: Fifteen very elderly patients (>80) were compared to 49 elderly patients (65-75).A male predominance was seen in both series. No statistical difference was found between tumoral characteristics, comorbidities, preoperatory endocrinological or visual status. Postoperative, we found a statistically significant improvement, visual status in the very elderly group (p=0.0012). No deaths were recorded and no difference was noted in postoperative complications or length of hospital stay between the two groups. Conclusions: Age over 80 is not by itself a predictor of worse clinical outcome in the case of endoscopically treated pituitary tumors. Accent should be placed on visual pathway decompression, reduced surgery time.  

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Screening for the intestinal carriage of carbapenemase-producing Gram-negative rods in hospitalized patients Pintea-Simon Ionela-Anca View abstract

Screening for the intestinal carriage of carbapenemase-producing Gram-negative rods in hospitalized patients

First author: Pintea-Simon Ionela-Anca

Coauthors: Cighir Teodora , Vornicu Antonela Mihaela , Toma Felicia , Man A

Keywords: Carbapenemase Gram negative bacilli Bacterial resistance Screening

Background: Infections caused by multiresistant germs reflect into an increased number of cases with severe evolution, high morbidity and mortality rates due to therapeutic failures, but also lead to increased costs for medical care. Infections due to carbapenemase-producing bacteria are increasingly involved in nosocomial infections and limit antibiotic therapy. Efficient screening methods are required to evaluate and control the epidemiology of this phenotype. Material and Method: Between January-June 2017, 1784 specimens of rectal swabs from high risk wards (ICU, Surgery) were screened for carbapenem-resistant Gram-negative rods (CRGN) on Brilliance CRE Agar. Suspected strains have been identified by routine methods and tested for susceptibility to imipenem and meropenem. The resistance phenotypes to carbapenems were confirmed by Rosco Diagnostica specific tests for Enterobacteriaceae (CPE) and non-fermentative Gram negative bacilli (CPNF). Data was processed statistically. Results: Of the total of 1784 rectal swabs collected, carbapenemase-producing strains were detected in 145 samples (8.13%) isolated from 85 patients. Of these, 45 strains (31%) were CPE and 100 (69%) were CPNF. Klebsiella pneumoniae (33 strains, 73.3%) predominated among the CPE, while Acinetobacter baumannii (61 strains, 61%) among the CPNF. All isolates originated from the ICU sections (general, urology, neonatology). Twenty patients presented repeated recurrences over time within their prolonged hospitalization. Time distribution showed the predominance of CPE and CPNF at the beginning of the screening (93 isolates from January to March), with a decreasing trend between April and June (52 isolates). OXA/OXA48 phenotype was the most prevalent within the CPE (65 strains; 65%), while MBL among CPNF (32 strains; 71.1%). Conclusions: Intestinal carriage of CRGN is prevalent in ICU patients. The most common carbapenemase producing strains were Acinetobacter baumanii, Pseudomonas aeruginosa and Klebsiella pneumoniae. A decreasing trend in the number of carbapenemase producing isolates was found, possibly due to a better implementation of germ control.

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Preliminary study on the antibacterial activity of lyophilised Vipera ammodytes ammodytes snake venom. Boda FA View abstract

Preliminary study on the antibacterial activity of lyophilised Vipera ammodytes ammodytes snake venom.

First author: Boda FA

Coauthors: Man A , Mare Anca , Berta Lavinia , Curticapean A , Dogaru Maria Titica

Keywords: vipera ammodytes long-nosed viper antibacterial MIC MBC

Background: Snake venom is a complex mixture of proteinaceous components, which exert numerous biochemical and pathophysiological effects, including neurotoxicity, myotoxicity, cytotoxicity and cardiotoxicity. Several venoms and venom components have also exhibited antibacterial activity, suggesting that some proteins might be used as potent antibacterial agents. Material and Method: The minimum inhibitory concentration (MIC) of Vipera ammodytes ammodytes (long-nosed viper) venom was determined against six bacterial strains using the serial two-folds dilution method (from 4.0 mg/ml to 1.9 μg/ml). The six bacterial strains used comprised of three Gram-positive (Staphylococcus aureus, Methicillin-resistant Staphylococcus aureus (MRSA), Enterococcus faecalis), and three Gram-negative (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa) bacteria. The minimum bactericidal concentration (MBC) was determined for concentrations above the observed MIC values by spot-inoculating the inhibited bacteria on Mueller-Hinton medium. Results: The V. ammodytes venom presented an inhibitory and bactericidal effect on S. aureus (MIC/MBC > 125 μg/ml), MRSA (MIC/MBC >125 μg/ml) and K. pneumoniae (MIC/MBC > 250 μg/ml). A partial inhibition was observed on P. aeruginosa strains at 4.0 mg/ml, but a bactericidal effect was lacking at this concentration. The venom showed no activity on E. coli and E. faecalis within the concentration range used for the experiment. Conclusions: The results of our study indicate that V. ammodytes ammodytes venom has a marked antibacterial activity against different Gram-positive and Gram-negative bacteria. The observed effect is possibly related to the venom's content in antibacterial proteins, particularly phospholipase A2 and L-amino-acid oxidases. Further separation of venom components may lead to the isolation of several antibacterial agents. Acknowledgements: This work was supported by the Studium Prospero Foundation and the Hungarian Academy of Sciences (Contract No. 139/26.01.2017).

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TOBACCO CONSUMPTION AMONG PUPILS FROM 9th CLASS IN CHISINAU Topada Aculina View abstract

TOBACCO CONSUMPTION AMONG PUPILS FROM 9th CLASS IN CHISINAU

First author: Topada Aculina

Coauthors: Zoltan A , Nădășan V

Keywords: smoking pupils schools

Background: Adolescents represent a vulnerable population with risk for tobacco use. Our general aim was to analyze the particularities of tobacco consumption among pupils from 9th class in Chișinău, Republic of Moldova. Material and Method: The study included 12 schools from Chisinau, the sample included 368 pupils (177 girls and 191 boys) from 9th classes. The survey instrument was an anonymous online questionnaire applied earlier in the ASPIRE project that included a set of items regarding tobacco consumption among pupils. Results: Aproximately half (50.1%) of the pupils have tried to smoke a whole cigarette. The proportion of pupils who tried to smoke was higher among 14-15 year-olds (41.3%) than those aged 12-13 (25.5%) and 10-11 years old (13.1%). Pupils who have tried conventional cigarettes, have tried also electronic cigarettes (85.8%), hooka (34.5%) and cigars (29.9%). 10.3% of pupils smoked cigarettes occasionally 1-5 days a month. Among those who smoked during the past 30 days, 29.1% smoked less than one cigarette a day and 22.6% smoked 2-5 cigarettes a day. Conclusions: Tobacco consumption among 9th grade pupils was mostly casual, not regular. Adolescents represent a very important category of smokers towards whom tobacco control experts must concentrate their efforts, by strong educational policies to prevent smoking initiation and to promote early smoking cessation, before becoming severely addicted to nicotine.

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Measuring the retinal nerve fiber layer (RNFL) thickness as a method of early diagnosis in Alzheimer’s disease Ilinoiu Geanina Andreea View abstract

Measuring the retinal nerve fiber layer (RNFL) thickness as a method of early diagnosis in Alzheimer’s disease

First author: Ilinoiu Geanina Andreea

Coauthors: Covaciu Cristina , Mihai Adriana

Keywords: Alzheimer’s disease early diagnosis biomarkers retinal nerve fiber layer optical coherence tomography

Background: This study aims to identify the thickness of the retinal nerve fiber layer (RNFL) as a potential biomarker for early detection in Alzheimer’s disease (AD). Material and Method: Twenty four AD patients and 34 first degree relatives of AD patients (AD-REL) and a control lot from the general population have been included. All the participants had an optical coherence tomography (OCT) for both eyes and RNFL and macular thickness were analysed in all lots.  Results: The mean RNFL thickness was thinner in AD patients as compared to AD-REL for both eyes, but statistically significant for the right eye only (right eye AD = 94.8±10.5 mm, AD-REL=99.87±8.5 mm, p=0.04; left eye AD=96.5±8.9 mm, AD-REL=100±10.1 mm, p=0.17). The most significant difference was observed in the superior quadrant of the right eye (p<0.001). Comparing the RNFL of the two groups with the general population, it was observed that actually RNFL thickness in general population was thinner than AD and AD-REL groups, the most significant difference being in the superior quadrant of the right eye (mean difference between AD and general population = 25.2 mm, p<0.001; mean difference between AD-REL and general population = 52.4 mm, p<0.001 ). There were no statistical differences between the 3 groups when analysing the macular thickness.  Conclusions: The RNFL is thickest in relatives of patients with AD. This might support the hypothesis that there is an underlying pre-symptomatic inflammatory mechanism of the retinal nerve layer in individuals at risk of developing AD. However, further monitoring of these individuals is needed to fully support these findings.

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DIMENSIONAL PERSONALITY PROFILE AND ITS RELATIONSHIP WITH COMMUNICATION SKILLS Suciu Nicoleta View abstract

DIMENSIONAL PERSONALITY PROFILE AND ITS RELATIONSHIP WITH COMMUNICATION SKILLS

First author: Suciu Nicoleta

Coauthors: Marginean Oana , Kutasi Reka , Popa Cosmin

Keywords: personality dimensions DECAS communication skills

Background: This study aims to identify the correlations between medical students’ dimensional personality profile and the communication skills associated with it. A factorial combination of personality dimensional factors can indicate a person's communication skills. Material and Method: Our sample, N=134, consists of first, second and third year medical students, from the University of Medicine and Pharmacy, Tirgu-Mures, with a mean average age of 22.27. The sample was assessed with the DECAS Personal Inventory, an efficient instrument that measures five dimensions of personality: Openness, Conscientiousness, Extraversion, Agreeableness, and Emotional Stability, in rapport with The Big Five theory. The DECAS tests were collected and statistical data was interpreted with GraphPrism7 and Person correlation was used for all personality dimensions. Results: Our results indicate the following - Openness was M=8.29, SD=3.40; Extraversion M=10.81, SD=4.11; Conscientiousness M=10.81, SD=3.40; Agreeableness M=10.04, SD=3.30; and Emotional Stability M=7.97, SD=4.14.  Thus, there is a positive statistically significant correlation between Openness and Extraversion (P<.001, CI 0.14 to 0.45) and a positive statistically significant correlation between Agreeableness and Emotional Stability (P<.001, CI 0.18 to 0.48). The positive correlation between dimensional factors revealed a personality profile characterized by intellectual interest, mild social abilities, moderate interpersonal connection, but poor emotional stability regarding the relationship with another person.The positive correlation between dimensional factors indicates a personality profile characterized by intellectual interest, mild social abilities, moderate interpersonal connection, but poor emotional stability regarding the relationship with another person. Conclusions: It is important to develop a special academic program for these students in order to improve their communication skills such as assertive communication, empathy and congruence with have the role to improve the emotional stability of medical students in relation with patients/another person.   

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Chiral discrimination of venlafaxine enantiomers by capillary electrophoresis using cyclodextrins as chiral selectors Budău Monica View abstract

Chiral discrimination of venlafaxine enantiomers by capillary electrophoresis using cyclodextrins as chiral selectors

First author: Budău Monica

Coauthors: Hancu G , Rusu Aura , Uilăcan Alexandra , Muntean Daniela Lucia

Keywords: venlafaxine antidepressant capillary electrophoresis enantioseparation cyclodextrins

Background: Venlafaxine (VEN) is a modern antidepressant of the serotonin-norepinephrine reuptake inhibitor (SNRI) class. It is a chiral substance, used in therapy as a racemic mixture, though differences between the pharmacological actions of the enantiomers of both VEN and its metabolites are documented. Material and Method: Capillary electrophoresis (CE) represents an interesting option in the enantioseparation of pharmaceutical substances with advantages related to the rapid method development, low consumption of analytes, reagents and chiral selectors and high versatility in using different chiral selectors. Cyclodextrins (CDs) are the most frequently used chiral selectors in capillary electrophoresis because of their large availability, low UV absorbance and capacity to include in their cavity a large number of organic substances. Results: A complex screening using different native and derivatized, neutral and ionized CDs was carried out to find the optimal chiral selector for the determination. Chiral resolution was observed when using the anionic sulfobutyl ether β-CD (SBE-β-CD), but the best results were obtained by using a dual CD system containing a neutral and a ionized CD (SBE-β-CD + HP-β-CD). The analytical conditions were optimized using “one factor at time” technique. The optimized conditions were the following: 25 mM borax, pH 9.30, 5 mM SBE-β-CD + 10 mM HP-β-CD chiral selectors, + 20 kV voltage, 20 oC temperature, 50 mbar/1 sec injection parameters, 230 nm UV detection. The analytical performances of the method were verified and the method was applied for the determination of VEN from pharmaceutical preparations. Conclusions: Capillary electrophoresis proved to be a useful and attractive option for the preliminary stereoselective analysis of VEN.

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Cardiac transplantation - the method of choice in cardiac pathology Dumitru Costel View abstract

Cardiac transplantation - the method of choice in cardiac pathology

First author: Dumitru Costel

Coauthors: Anca Sin

Keywords: Cardiac Transplantation Immunohistology Biopsy

Background: Cardiac transplantation in humans was first performed in the world in 1967. In the 1980s it became a form of accepted treatment for end-stage heart diseases. Cardiac transplantation is considered as a viable therapeutic alternative in those patients whose survival is estimated to be below 50% at 1 year under medical treatment. The therapeutic target of cardiac transplantation is not only prolonging the life of the patient, but also improving the quality of life so that it is similar to that of healthy people. According to the literature, the mean survival time of patients receiving this procedure is 8.3 ± 1 year, during which patients are compulsorily enrolled in immunosuppressive therapy programs. The general guidelines for cardiac transplantation indication are established in their current form since 1995. The achievement of the cardiac transponder pursues two objectives of primary importance. The first objective is the long-term survival of the patient with irreversible cardiac disorders; secondly, improvement in post-transplant quality is sought. The immune response of the transplanted patient to allograft involves two mechanisms: one cellular and one humoral, manifested by overactive, acute and chronic rejection reactions. Endomiocardial biopsy remains the gold standard in the diagnosis of the rejection reaction after a cardiac transplant. Recently, techniques based on molecular gene expression in peripheral blood have been developed, being used as non-invasive methods to detect acute rejection reactions. Material and Method: -- Results: -- Conclusions: Heart transplantation remains the procedure of choice in end-stage heart diseases, especially in those with an estimated 1-year survival below 50% despite optimum medical therapy. The main issue associated with heart transplantation is represented by the immune response, leading to acute or chronic transplant rejection, which can be diagnosed with the help of endomiocardial biopsy.

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Chiral separation of amlodipine enantiomers by capillary electrophoresis using experimental design method optimization and cyclodextrins as chiral selectors Cârcu-Dobrin Melania View abstract

Chiral separation of amlodipine enantiomers by capillary electrophoresis using experimental design method optimization and cyclodextrins as chiral selectors

First author: Cârcu-Dobrin Melania

Coauthors: Sabău Alexandra Georgiana , Hancu Gabriel , Gyéresi Árpád

Keywords: amlodipine capillary electrophoresis chiral separation cyclodextrine experimental design

Background: Amlodipine (AML) is a dihydropyridine-type inhibitor of the slow calcium channels, used in the treatment of hypertension and angina pectoris. AML is a chiral substance used in therapy as a racemate, but the two enantiomers, R(+)-AML and S(-)-AML do not have the same pharmacological activity, the calcium channel blocking activity residing in the S(-)-AML enantiomer. Our objective was the development of a simple method for the discrimination of the two enantiomers of AML by capillary electrophoresis (CE) using cyclodextrins (CDs) as chiral selectors. Material and Method: CE due to its rapid method development, short analysis time, large versatility in choosing and changing chiral selectors and low consumption of reagents, offers an useful alternative in the chiral separation of pharmaceuticals. The most frequently used chiral selector in CE are CDs, which are added directly in the buffer solution. Results: In the preliminary analysis, a complex screening of several native and derivatized CDs was carried out in order to establish the optimum chiral selector. As a result of this process carboximethyl-β-CD (CM-β-CD) was selected for the enantiomeric separation. A factorial analysis study using orthogonal experimental design in which several factors are varied at the same time was performed in order to optimize the separation. The optimized method (25 mM phosphate buffer, pH = 9.0, 15 mM CM-β-CD, 15 °C, + 25 kV, 30 mbar/1 second, detection at 230 nm) was successful for baseline separation of AML enantiomers within 5 minutes. Conclusions: The analytical performances of the optimized method were checked and the applicability of the developed method was verified by quantifying the AML enantiomers from pharmaceutical preparations. CE proved to be a suitable method for the enantioseparation of AML and can be used successfully in its preliminary chiral analysis.

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The depression prevalence rate in Romania Covaciu Cristina-Georgeta View abstract

The depression prevalence rate in Romania

First author: Covaciu Cristina-Georgeta

Coauthors: Bacârea V , Mihai Adriana

Keywords: Clinical Medicine Psychiatry depression prevalence rate socio-demographic factors

Background: The principal objective of this study was to evaluate the prevalence of depression among the Romanian population. Material and Method: 375 persons were the subjects of a study done for screening depression. The dates for this transversal, cross-sectional study were collected in a balanced way from every county. The study was done by landline telephone and we used the patient health questionnaire 2 (PHQ - 2) followed in the appropriate cases by patient health questionnaire 9 (PHQ - 9). We controlled socio-demographic factors such as: gender, age, residence, professional status. Results: The results showed a 12.53% prevalence of depression in Romania: 8.8% mild, 2.13% moderate and 1.6% moderate/severe. The prevalence of depression is the highest at an age of 70 years old or more - 23.7%. The gender distribution shows that between 19-29 years old, females are a lot more affected, but between 30-39 years old the situation is opposite, while for over 70 years old the results are similar. Yet, it is known (Breslau J et al, 2011) that the prevalence of depression may fluctuate according to socio-cultural factors. In another study (Mihai A et al, 2014), that linked depression to employment status, a higher prevalence of depression 18-23% was found. Conclusions: Evaluation of depression correlated with socio-demographic factors is very important for understanding the ways in which the health system should respond. The strenght of this study was that of reaching persons over 60 years old, both from urban and rural areas.

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Influence of formulation and test variables on the in vitro availability of oxicams from polymeric films Antonoaea Paula View abstract

Influence of formulation and test variables on the in vitro availability of oxicams from polymeric films

First author: Antonoaea Paula

Coauthors: Muntean Daniela Lucia , Ciurba Adriana , Vlad Robert Alexandru , Bîrsan Magdalena , Todoran Nicoleta

Keywords: Farmacie (Pharmacy) Farmacie (Pharmacy) oxicams, polymeric films, variables

Background: Transdermal therapeutic systems (TTS) are pharmaceutical forms for prolonged release. Diffusion of the active substance through TTS is characterized by the drug mobilization among the polymeric chains of the matrix. The availability of the active ingredient in TTS is time and formulation dependent. The purpose of this study is an individual and comparative analysis of a release/permeation profile using mathematical and statistical methods. Material and Method: Films based on hydroxypropylmethylcellulose and oxicams (meloxicam/tenoxicam) were obtained by solvent evaporation technique. The availability of the active substance was evaluated by the Franz method under different experimental conditions. Comparative analyzes of the results were based on the influence of the pH of the receptor compartment, test membranes and formulation variables. Results: Using the analysis by pairwise procedure of the individual yield curves, the statistical parameters f1 and f2 were calculated. The values of f1 higher than 15 shows some differences between formulations, most likely due to formulation variables, but f2 values between 50-100 indicate that the yield profiles are somewhat similar. Simple regression linearization of the yield curves shows an increased percentage in concentration of the active substance released depending on the formulation and test variables. The AUC shows that the rate of release and the amount of oxicam yielded are influenced by the pH of the acceptor compartment and by the type of test membranes. Conclusions: The variability of the in vitro availability of oxicams from the polymeric films analyzed under the same experimental conditions demonstrates the influence of the composition of the formulations. A pH of 7.4 was favorable to the passage of a higher concentration of the active substance. The transfer through the test membranes was influenced by their structural particularities. The study was carried out through the internal grant 275/11.01.2017 of University of Medicine and Pharmacy of Tîrgu Mures, Romania.

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Omega 3 PUFAs Significantly Reduce Plasma Concentrations of TIMP-1 and MCP-1 in Cerebral Ischemic Rats Huțanu Adina View abstract

Omega 3 PUFAs Significantly Reduce Plasma Concentrations of TIMP-1 and MCP-1 in Cerebral Ischemic Rats

First author: Huțanu Adina

Coauthors: Horvath Emoke , Orădan Alex , Chiriac Liviu , Voidăzan Septimiu , Munteanu Daniela , Dobreanu Minodora

Keywords: Neurology MCP-1 TIMP-1 Omega 3 ischemic stroke

Background: The aim of the study was to assess the dynamic changes in cytokines profile in tMCAO (transient Middle Cerebral Artery Occlusion) ischemic rats in comparison with Omega 3 polyunsaturated fatty acids preconditioning. Material and Method: 40 Wistar male adult rats randomly divided into sham (n=10), ischemic (n=20) and Omega 3 groups (n=10), underwent tMCAO using a silicone thread technique. The surgical procedure was performed with the minimum invasive procedure. Blood was withdrawn at 6h and 24h after reperfusion, and ischemia was verified 24h after reperfusion by MRI acquisition. Neurological assessment was performed using a five-point scale behavioral test. Five cytokines (TNFalfa, IL6, TIMP-1, MCP-1 and VEGF) were analyzed simultaneously using the multiplex immunoassay based on xMAP technology. Results: Plasma concentration of TIMP-1 was higher in ischemic and Omega 3 group compared to sham, 6h after reperfusion; in the ischemic group, the concentration of TIMP-1 (44.33 ± 20.8 ng/ml) raised significantly at 24h comparing to Omega 3 group (15.67 ± 7.70 ng/ml), p<0.0001. Plasma MCP-1 concentration did not differ between sham (0.70± 0.46 ng/ml) and Omega 3 group (0.89 ±0.30 ng/ml), but in the ischemic group, MCP-1 plasma level was significantly higher (1.51 ±0.67 ng/ml), p=0.001. While in the ischemic group, concentrations were elevated at both points of measurement, in the Omega 3 group the level significantly decreased after 24h (p=0.0005). Conclusions: Omega 3 PUFAs decreased plasma MCP-1 level, a key cytokine involved in the inflammatory cell migration. Additionally, in Omega 3 preconditioning group, TIMP-1 expression was lower, probably due to a lower activation of matrix metalloproteinases.This work was supported by an internal research grant from the University of Medicine and Pharmacy Tîrgu-Mureș (Project nr. 17803/1/22.12.2015).

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CORRELATIONS BETWEEN PERSONALITY DISORDERS AND AXIS I DISORDERS Szasz Istvan Zsolt View abstract

CORRELATIONS BETWEEN PERSONALITY DISORDERS AND AXIS I DISORDERS

First author: Szasz Istvan Zsolt

Keywords: Personality disorders The Personality Diagnostic Questionnaire - Version DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Personality traits

Background: Personality disorders can be defined as unhealthy patterns of thinking and behaving which can be described by pathological personality traits. These traits lead to impairment in social functioning and increase the vulnerability for Axis 1 disorders. The present study investigated the prevalence of personality disorders and the relationship between personality disorders and Axis 1 disorders in a sample of university students. Material and Method: A sample of university students (N=294) completed The Personality Diagnostic Questionnaire - Version 4 and the DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure-Adult. Results: 14,28% of the students met diagnostic criteria for at least one personality disorder, with no significant gender difference. There was a moderate correlation between depression and borderline personality disorder(r=0.27, p<0.0001), anxiety and avoidant personality disorder(r=0.49, p<0.0001), psychosis and antisocial personality disorder(r=0.30, p<0.0001) and an increased vulnerability for substance use among students with Cluster B personality traits. Personality functioning is more impaired among persons with borderline personality traits. Conclusions: The results suggest that personality disorders increase the vulnerability for Axis 1 disorders which might have a great impact on the quality of life.

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EVALUATION OF THE VERTICAL DIMENSION OF BASIS MANDIBULAE IN PATIENTS WITH DIFFERENT VERTICAL SKELETAL PATTERNS Kész ( Bartók) Blanka View abstract

EVALUATION OF THE VERTICAL DIMENSION OF BASIS MANDIBULAE IN PATIENTS WITH DIFFERENT VERTICAL SKELETAL PATTERNS

First author: Kész ( Bartók) Blanka

Coauthors: Mártha Krisztina , Kerekes- Máthé Bernadette , Székely Melinda

Keywords: basis mandibulae hipodivergent hiperdivergent normodivergent orthopantomography

Background: The vertical facial type of humans has a great impact on the morphology of mandible. These morphological  differences have an important clinical implication. The purpose of this study was to evaluate  the differences of the vertical dimensions of basis mandibulae according to vertical skeletal growth pattern using orthopantomograms (OPG). Material and Method: The study was conducted on 40 orthopantomograms of patients diagnosed with different vertical growth patterns based of cephalometric analysis. The sample included 13 normodivergent, 13 hiperdivergent and 14 hipodivergent subjects. The vertical dimension of basis mandibulae was measured on the left hemimandible on every OPG with the Image- Pro Insight software. Results: It was found that the vertical dimension of the basis mandibulae was significantly bigger in the hipodivergent facial type under the canalis mandibulae. Furthermore, in the hiperdivergent facial type the vertical dimension was significantly smaller above the canalis mandibulae under the apexes of first molar. Conclusions: According to our results the skeletal divergence has a significant impact on the vertical dimension of basis mandibulae.

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Prophylaxis Versus Infectious Complications in Malignant Lymphoma Patients after Autologous Hematopoietic Stem Cell Transplantation Pakucs Annamária View abstract

Prophylaxis Versus Infectious Complications in Malignant Lymphoma Patients after Autologous Hematopoietic Stem Cell Transplantation

First author: Pakucs Annamária

Coauthors: Lázár Erzsébet , Köpeczi Judit Beáta , Benedek I

Keywords: autologous hematopietic stem cell transplantation malignant lymphoma infectious complications prevention

Background: The autologous transplantation of stem-cells (ASCT) harvested from peripheral blood represents an elementary therapeutic method for recidivated or treatment resistant malignant lymphoma patients. Due to the high dose myeloablative conditioning regimen followed by aplasia the bacterial and fungal infections represent a high risk after the transplantation. Material and Method: A retrospective analysis was performed including a group of malignant lymphoma patients that underwent ASCT during 2017. The aim of the study was the examination of the occurring bacterial infections, with or without previous prophylactic tratment and determining their impact on hospitalization period. Results: The study had a total number of 14 enrolled patients. Because of the presence of central venous catheter, all of the patients benefited from prophylactic medication with 3rd generation cephalosporine. In case of neutropenic fever occurrence carbapenem administration has been intitiated. In 11 cases it was no evidence of bacterial infection and the median post ASCT hospitalization of this group was 14.3 days. In 2 cases bacteriological evidence of infection has been found, with a median post ASCT hospitalization of 18 days. One pathological agent was a pseudomonas aeruginosa revealed from pharyngeal secretion. The other colonized bacteria were a coagulase negative staphylococcus. In these cases targeted antibiotic therapy has been initiated according to the antibiogram. Conclusions: The antibiotic prophylaxis decreases the appearance of bacterial infections after ASCT and also decreases the hospitalization period conducting to a faster patient recovery and a cost efficient patient management.

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In vitro study of angiotensin converting enzyme (ACE) inhibitory activity of red wine and its correlation with polyphenol profile Fogarasi Erzsébet View abstract

In vitro study of angiotensin converting enzyme (ACE) inhibitory activity of red wine and its correlation with polyphenol profile

First author: Fogarasi Erzsébet

Coauthors: Croitoru MD , Fülöp Ibolya , Éles Orsolya , Muntean Daniela Lucia

Keywords: Pharmacy ACE inhibitory activity red wine micro plate reader polyphenols

Background: Many phytochemical research studies showed the ACE inhibitory activity of some polyphenols as: flavan-3-ols, procyanidins, etc. Although, ACE inhibitory activity of some polyphenols is a widely studied issue, the number of works which study red wine's antihypertensive capacity is low. Due to the high polyphenol content of red wines we intended to measure its ACE inhibitory activity. Material and Method: Twenty-eight red wines available on Romanian and also on the international market were used in this study. The ACE inhibitory activity was quantified using an artificial substrate with a tripeptide structure (N-[3-(2-furyl)acryloyl]-phenylalanyl-glycyl-glycine, FAPGG). Under the influence of ACE the tripeptide structures is dissociated on FAP (furylacryloylphenylalanine) and GG (glycyl-glycine). The hydrolysis is quantified by measurement of absorbance decrease during 20 minutes at 340 nm, using a FluoSTAR OPTIMA micro plate reader. The measurement was performed in triplicate and the result was calculated by MARS Data Analysis Software. Enalapril was used as a positive standard and the results were expressed as percent of ACE inhibition (Inh.%).