Bulletin of Medical Sciences最新文献

{"title":"New trend in transfusion medicine – Patient blood management","authors":"Pál Sándor, Réger Barbara, Miseta Attila, Faust Zsuzsanna","doi":"10.2478/orvtudert-2021-0002","DOIUrl":"https://doi.org/10.2478/orvtudert-2021-0002","url":null,"abstract":"Abstract Transfusion is often part of hospital care, the indication being in constant change as an effect of latest multicentric studies’ result. Although transfusion-related complications decreased significantly, the intervention still involves risks, that are worth assuming if only the anemia of patient cannot be managed with other, safer methods. Management of patients declining transfusion or of those unsuitable for transfusion has brought instructive results in assessment of hemoglobin concentration conditioning the necessity of the intervention. Further development of these findings led to development of Patient Blood Management concept, aiming the optimization of blood product usage while improving morbidity and mortality of patient care. Patient Blood Management applies guides helping to avoid transfusions that are not definitely necessary for patients. Using restrictive transfusion principles, preoperative anemia management, tight hemostasis monitoring and treatment, is not only safer but also cost-effective. The objective of our paper is the brief report of some Patient Blood Management guidelines, and to promote and facilitate the application of the new approach.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"32 1","pages":"7 - 14"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83388653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diversity of root canal morphology of maxillary first molars","authors":"Juhász Kincső-Réka, K. Mónika, P. Mihai, Pop Silvia, Kerekes-Máthé Bernadette","doi":"10.2478/orvtudert-2021-0009","DOIUrl":"https://doi.org/10.2478/orvtudert-2021-0009","url":null,"abstract":"Abstract Introduction: The morphological characteristics of root canals may show divergent results for different populations. The precise knowledge of the tooth anatomy has a great importance from the point-of-view of the endodontic treatment. The aim of the present study is to map the root canal morphology and anatomical variations of the maxillary first molars on a local population, as well as the study of the possible communications between the canals. Material and method: CBCT images were evaluated during the study using the Ez3D Plus – 3D Imaging Dental Software. Teeth sections were examined in three directions: axial, saggittal and coronal. In case of maxillary first molars with four root canals the presence of an isthmus was evaluated between the two mesiobuccal root canals, on transversal sections. Results: In 23.72% of the cases three root canals were found, while in 76.27% of the cases four root canals were found. No statistically significant differences were found between genders. Among the mesiobuccal root canals the communication was found mostly in the middle third and this was extended to the apical third. Conclusions: Since the communication between the two mesiobuccal root canals is present in most of the cases, the clinicians have to be aware of this in order to achieve a successful therapy. In the majority of the cases the four root canal morphological variation is more freqvent than the three canal variation, but with aging this freqvency is reduced.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"40 1","pages":"63 - 69"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89079900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping of Echinacea-based food supplements on the Romania market and qualitative evaluation of the most commonly used products","authors":"Ferencz Elek, Demeter Eszter, Király Rebeka, Vancea Szende, Urkon Melinda, Laczkó-Zöld Eszter","doi":"10.2478/orvtudert-2020-0008","DOIUrl":"https://doi.org/10.2478/orvtudert-2020-0008","url":null,"abstract":"Abstract The aim of the study was to explore dietary supplements containing Echinacea on the Romanian market and their qualitative characterization. The products available on the market were aggregated in 2018, through an electronic search based on the register of the Romanian Medicine Agency (Agenția Națională a Medicamentului şi a Dispozitivelor Medicale din România – ANMDMR) and the list of dietary supplements registered by the Ministry of Agriculture and Rural Development (Institutul Național de Cercetare-Dezvoltare pentru Bioresurse Alimentare – IBA București, Serviciul național pentru plante medicinale, aromatice și produse ale stupului). There are no Echinacea containing medicines registered in Romania. However, there are 58 dietary supplements in the register, 52% of which are mono-components, 29% contain other herbs, plant extract or vitamins, while 19% are registered as tea. The label of 80% of monocomponent products and 76% of multicomponent supplements contains insufficient information: the plant name, its used part and processing methods (grist, extract, quantity) are not clearly identified. Among the listed dietary supplements, the 12 most commonly used formulations in pharmaceutical practice were subjected to phytochemical chromatographic evaluation: TLC and/or HPLC analysis were used. Three of seven monocomponent products showed proper chromatographic fingerprint, by TLC analysis. One monocomponent sample did not have an adequate chromatographic fingerprint. The labelling of multicomponent products was not appropriate. The TLC test suggests that based on the resulting fingerprint they contain E. purpureae herba. However, due to the presence of other components, the TLC does not allow a clear conclusion regarding the exact composition of the products. The developed HPLC method enables quantification of the concentration of caffeic acid, chicoric acid, echinacoside, chlorogenic and caftaric acids mixture in dietary supplements. None of the tested products contained echinacoside, which is a specific component of E. angustifolia and E. pallida root. In our method, the quantification of caftaric acid is approximate, because it partially overlaps the chlorogenic acid, which is a common component of plant samples, but negligible in Echinacea sp. The tested dietary supplements have a caffeic acid content of 20-140 µg/g, a chicoric acid content of 0.19-2.64 mg/g; the mixture of chlorogenic and caftartic acid is about 0.23-2.07 mg/g.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"32 1","pages":"111 - 123"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74621071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving the Management of Pediatric Upper Urinary Tract Infections at Odorheiu Secuiesc Hospital","authors":"Koncsag-Szász Előd, Szőcs-Gazdi Uzonka, Magyari Izabella, Jancsó Réka, Szalai Mária, M. Ildikó, Máthé Edina, Bodoni-Imre Tímea","doi":"10.2478/orvtudert-2020-0015","DOIUrl":"https://doi.org/10.2478/orvtudert-2020-0015","url":null,"abstract":"Abstract The primary goal of our retrospective analysis was to check the correctness of the diagnosis, and to identify the potential diagnostic errors among patients coded with N10 diagnosis in 2009, 2014 and 2019 in the pediatric ward of Odorheiu Secuiesc Hospital; we also assessed protocol-adherence in treatment and prophylaxis, and changes in antibiotic resistance of the isolated E. coli strains. During this 10 year-period significant improvements have been achieved in the treatment of upper urinary tract infections: in 2009 the diagnosis could be disputed in 31 out of 61 cases, while in 2019 this ratio is only 2 out of 31 cases; the number of cases pretreated with antibiotics decreased to a third, contaminated urine samples are rare to occur, the unmotivated antibiotics prophylaxis is essentially nonexistent, and there are no major documentation deficiencies either. In our study we present the antibiotic susceptibility of 50 E. coli strains isolated from the study group, which suggests some favorable changes.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"1 1","pages":"71 - 76"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79835342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of pharmaceutical competences among the Romanian population, based on an online survey","authors":"Fogarasi Erzsébet, Fülöp Ibolya, Szilveszter Szilvia, V. Erzsébet, Croitoru Mircea Dumitru","doi":"10.2478/orvtudert-2020-0009","DOIUrl":"https://doi.org/10.2478/orvtudert-2020-0009","url":null,"abstract":"Abstract From the year 1990s the pharmaceutical competenceshttps://www.thesaurus.com/browse/assignment based on drug supply has been completed with the patient consultation and communication. This fact has greatly expanded the work of the pharmacists. As a result of this, the concept of pharmaceutical care has been introduced and normalized in several countries. But, in spite of all efforts there are still major differences in health care policies and practices among European countries. The aim of this study was to check the estimation of the pharmacists’ duties by patients and the attitude towards online medicine acquisition. Materials and methods: we used a four - part questionnaire created in Google Forms. The content of the questionnaire consisted of: a.) checking of the demographic data, b.) assessment of patients’ attitudes towards pharmacies, c.) assessment of pharmacist competences, d.) examining the viability of an online drug supply. Results and discussion: 524 persons completed the questionnaire (88.7% women, 11.3% men). 66.8% were from the city and 33.2% from the village, respectively. Patients’ adherence to pharmacies in most cases depended on the location of the pharmacy (65.1%) and the kindness (36.5%) and competence (36.5%) of the pharmacist. Checked with three parallel questions, it turned out that the number of questions occurring in the patients’ mind at home always exceeded the proportion of the answered questions in the pharmacy. 68.1% of the respondents consulted a pharmacist in the absence of a physician. Many (54.4%) of that surveyed searched healthcare information on Google search, but few of them ordered medicinal products via Internet. Based on the results of our survey, 18.3% of the respondents searched healthcare information on healthcare professionals’ online platform. Their trust was much greater in such platforms than in information found on Google search. Conclusion: A slight loyalty to a certain pharmacy can make it difficult to follow the drug therapy. This adherence to a pharmacy can be increased by the kindness and skills of the pharmacist. Although patients search healthcare information on online interfaces this information do not convince them to order medicinal products via Internet. The high degree of trust in pharmacist or physician managed homepages highlight the importance of these interfaces.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"52 1","pages":"124 - 131"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80738546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Deep Brain Stimulation on High Frequency Oscillations in a Chronic Epilepsy Model","authors":"Mihály István, Bod Réka-Barbara, O. Károly, Berki Ádám-József, Szilágyi Tibor","doi":"10.2478/orvtudert-2020-0014","DOIUrl":"https://doi.org/10.2478/orvtudert-2020-0014","url":null,"abstract":"Abstract Temporal lobe epilepsy (TLE) is a severe neurological disease which is often pharmacoresistant. Deep brain stimulation (DBS) is a novel method for treating epilepsy; however, its mechanism of action is not fully understood. We aimed to study the effect of amygdala DBS in the pilocarpine model of TLE. Status epilepticus was induced by pilocarpine in male Wistar rats, and spontaneous seizures occurred after a latency period. A stimulating electrode was inserted into the left basolateral amygdala and two recording electrodes into the left and right hippocampus. A stimulus package consisted of 0.1 ms-long biphasic pulses applied regularly at 4 Hz for 50 seconds. This package was repeated four times a day, with 5-minute pauses, for 10 days. We also used an age-matched healthy control group of stimulated animals and another one of sham-operated rats. From the hippocampal local field potentials high frequency oscillations (HFOs) were analyzed as these are promising epilepsy biomarkers. HFOs are short oscillatory events between 80-600 Hz which were detected offline using an open-source application of MATLAB, the RIPPLELAB system. We found that the HFO rate was significantly higher in pilocarpine-treated rats compared to the control groups (0.41 ± 0.14 HFO/min vs. 0.006 ± 0.003 in the stimulated control group and no HFO in the sham-operated group). In the pilocarpine group an instantaneous decrease in HFO rate was observed while the stimulation was on (0.44 ± 0.15 HFO/min vs 0.07 ± 0.03 HFO/min, p=0.017). The effect was short-lived because the frequency of HFOs did not change significantly in the time windows between stimulus packages or during the ten-day stimulation period. The difference of HFO rates between epileptic and control groups could be used in the electrographic assessment of epilepsy. The decreased frequency of HFOs during stimulation may be useful to study the efficacy of DBS.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"57 1","pages":"63 - 70"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82444119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of enantiomeric purity of esomeprazole by capillary electrophoresis","authors":"P. Attila, Hancu Gabriel, Kelemen Hajnal, G. Árpád","doi":"10.2478/orvtudert-2020-0016","DOIUrl":"https://doi.org/10.2478/orvtudert-2020-0016","url":null,"abstract":"Abstract Proton pump inhibitors are the most effective agents used in gastric hyper-acidity-related disorders. Omeprazole is a benzimidazole-derivative compound with an asymmetric sulphur in its structure, which generates its chiral character. Esomeprazole (S-omeprazole) was the first proton pump inhibitor introduced as an enantiomerically pure compound in therapy, after the successful chiral switch of the racemic omeprazole. This work is aimed at performing a complementary study to an already published chiral separation method of omeprazole. As preliminary analysis, the electrophoretic behavior of omeprazole enantiomers and the possible mechanism of the chiral resolution was studied using different background electrolytes containing different β-cyclodextrin derivatives, as chiral selectors. The robustness of the chiral separation method was tested by applying a Plackett-Burman design. The method was validated according to current ICH guidelines and proved to be reliable, linear, precise and accurate for the determination of 0.2% R-omeprazole as chiral impurity in esomeprazole samples. The validated method was successfully used for the analysis of esomeprazole-containing gastro-resistant tablets. According to our results, valuable information on the mechanism of chiral separation of omeprazole was gained and the application area of the previously developed method was successfully enlarged. The presented rapid and cost-effective capillary electrophoresis method proved to be suitable for the determination of enantiomeric purity of esomeprazole from pharmaceutical preparations and could represent an alternative for the available compendial methods.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"21 1","pages":"93 - 101"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82616324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-surgical therapy of diabetic foot infections based on recent guidelines and published data","authors":"Urbán Edit, G. Márió","doi":"10.2478/orvtudert-2020-0006","DOIUrl":"https://doi.org/10.2478/orvtudert-2020-0006","url":null,"abstract":"Abstract Chronic, non-communicable diseases are affecting the lives of more and more people worldwide; due to obesity and inadequate eating habits, the proportion of diabetics is on an increasing trend globally. The development of a number of macro- and microangiopathic pathologies associated with the onset of diabetes affects the life expectancy of patients. Diabetic foot infection (DFI) is one of the most serious long-term complications of diabetes and may be considered an intersection of infectious and non-infectious diseases; these infections can significantly reduce the quality of life of affected patients. The purpose of this review was to summarize the latest recommendations for conservative (non-surgical) therapy for DFIs and diabetic foot osteomyelitis (DFO).","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"21 1","pages":"53 - 62"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79632111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of the phytochemical and antimicrobial activity of Primula veris L. extracts","authors":"V. Erzsébet, Lieb Dorottya, Maráz Anna","doi":"10.2478/orvtudert-2020-0013","DOIUrl":"https://doi.org/10.2478/orvtudert-2020-0013","url":null,"abstract":"Abstract Methanol, ethanol (50%) and aqueous extracts were prepared from the roots, leaves and flowers of Primula veris collected and dried under natural conditions in meadows near Marosludas in April 2018. The polyphenol contents of the plant parts, as well as the antioxidant capacity were measured by ABTS spectrophotometric methods. For the microbiology section, aqueous and ethanolic extracts (100 mg/ml) were prepared from the roots, leaves and flowers of Primula veris followed by testing of their antimicrobial activity against human pathogenic yeasts (Candida albicans, Candida parapsilosis, Candida glabrata) and bacteria (Gram negatives:, Escherichia coli, Acinetobacter sp., Pseudomonas aeruginosa, Enterobacter cloacae; Gram-positive: Enterococcus faecalis, Listeria monocytogenes, Staphylococcus aureus) by agar well diffusion method. Ethanol proved to be the most effective solvent for all three drugs to determine the polyphenol content. The flower drug contains the highest amounts of polyphenols. With the ABTS method of antioxidant measurement, ethanolic extracts are more effective than aqueous extracts. Agar well diffusion studies showed that all extracts caused complete inhibition within the inhibition zone in the yeasts tested. The inhibitory effect of aqueous extracts was stronger than that of ethanolic extracts in the case of all three plant parts. The greatest inhibition was caused by extracts of the roots with ethanol. The three yeasts tested showed similarly high sensitivity to roots extracts, while the inhibitory effect was weaker for leaf extracts. Candida parapsilosis was resistant to leaf and flower extracts. Pseudomonas aeruginosa, Enterococcus faecalis and Staphylococcus aureus, like fungi, showed good sensitivity to extracts, while other bacteria showed little or no inhibitory effect.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"12 1","pages":"102 - 110"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78178131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of multidrug-resistant bacteria in tracheal secretions from critically ill patients in the intensive care unit","authors":"Berki Ádám-József, Benkő Csongor, Székely Edit, Szász Izabella Éva, Vas Krisztina Eszter","doi":"10.2478/orvtudert-2020-0017","DOIUrl":"https://doi.org/10.2478/orvtudert-2020-0017","url":null,"abstract":"Abstract Ventilator-associated pneumonia is a severe nosocomial infection that affects the disease course of critically ill patients. Awareness of potential pathogens is essential for prevention, early detection, and proper treatment, as well. In this retrospective cross-sectional study, we investigated the tracheal secretions collected from critically ill patients with the aim to detect the occurrence of multidrug-resistant bacteria. We examined the bacteriological culture results of the tracheal secretions of the patients hospitalized at the Intensive Care Unit of Tîrgu Mureș Emergency Clinical County Hospital between 1st November 2017 and 31st January 2018. Admission diagnoses and comorbidities were recorded, and white blood cell counts were monitored. We determined the quality of the lower respiratory samples by microscopic examination and the results of the microbiological tests, taking into account the germ count of pathogens and the antibiotic-resistance pheno-type. During the three months, 194 samples were received from 107 patients for bacteriological examination. After the first sample collection 34 (31.77%) tracheal secretions were positive for pathogens, while in the remaining samples normal upper respiratory bacterial flora was found. From the 34 positive samples, 22 were colonizing pathogens and 30 were isolated in a clinically significant amount. Predominantly Staphylococcus aureus (n=14; 26.9%), Klebsiella pneumoniae (n=9; 17.3%), Escherichia coli (n=8.1%) and other Gram-negative bacteria (n=21; 40.4%) were identified. Among these strains 38 (73.07%) were not multidrug-resistant. The rate of positivity of individual sampling showed a positive correlation with the average duration of hospital stay (p=0.0016; r=0.8740). A total of 26 patients developed early-onset or late-onset ventilator-associated pneumonia. Potential risk factors for infection with multidrug-resistant bacteria were found. We can conclude that recently admitted patients in the intensive care unit are rarely carriers of multidrug-resistant bacteria, but become colonized or infected with multidrug-resistant strains during long-term intensive care.","PeriodicalId":9334,"journal":{"name":"Bulletin of Medical Sciences","volume":"21 1","pages":"77 - 83"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83217293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}