Timisoara Medical Journal

(ISSN: 1583-526X) Open Access Journal
Rss Feed:

Editorial
Timisoara Med 2020, 2020(1), 11; doi: 10.35995/tmj20200111
Received: 5 Nov 2020 / Revised: 5 Nov 2020 / Accepted: 5 Nov 2020 / Published: 25 Nov 2020
Review
Timisoara Med 2020, 2020(1), 1; doi: 10.35995/tmj20200101
Received: 14 Sep 2020 / Revised: 28 Sep 2020 / Accepted: 28 Sep 2020 / Published: 19 Oct 2020
The prevention of heart failure (HF) development in patients with diabetes mellitus (DM) represents one of the greatest challenges to date. Several studies have shown that targeting a very strict HbA1c does not reduce cardiovascular risk in type 2 diabetes (T2D) patients, concluding
[...] Read more.
The prevention of heart failure (HF) development in patients with diabetes mellitus (DM) represents one of the greatest challenges to date. Several studies have shown that targeting a very strict HbA1c does not reduce cardiovascular risk in type 2 diabetes (T2D) patients, concluding that there are additional factors that contribute to the risk of HF, as well as mechanisms possibly related to the therapeutic agents used to lower glycemic values. All these findings led to the reconsideration of T2D management. SGLT2 inhibitors (SGLT2i), a new generation of antihyperglycemic drugs, have gained the attention of cardiologists, since they proved cardioprotective effects by reducing three-point major adverse cardiovascular events (MACE) and heart failure hospitalizations in T2D patients. The mechanisms underlying the cardiovascular protection of SGLT2 inhibitors in T2D are complex and multifactorial, but not fully understood. This review discusses the onset and prognosis of heart failure in T2D patients treated with SGLT2 inhibitors. Full article
Timisoara Med 2020, 2020(1), 7; doi: 10.35995/tmj20200107
Received: 15 Sep 2020 / Revised: 21 Oct 2020 / Accepted: 21 Oct 2020 / Published: 26 Oct 2020
Restorative dentistry is based on a continuous development of materials that make the best possible connection with dental tissues. Thus, dental adhesives have been researched with increasing interest. A successful adhesive system depends very much on its chemistry, as well as on the
[...] Read more.
Restorative dentistry is based on a continuous development of materials that make the best possible connection with dental tissues. Thus, dental adhesives have been researched with increasing interest. A successful adhesive system depends very much on its chemistry, as well as on the clinical procedures that must be appropriate for that type of dental adhesive. This review presents a retrospective of dental adhesives focusing on research into new types of adhesive systems that involves the use of nanoparticles. Dental adhesive systems are used in most clinical procedures related to restorative dentistry and can be classified into “etch-and-rinse” adhesives and “self-etch” adhesives. Recently, both types of adhesive systems have been modified, being loaded with different types of nanoparticles to try to improve them in terms of the thickness of the adhesive layer, but also to induce other special qualities. Therefore, in order to avoid compromising the restorative procedures by losing the restorations or by affecting the dental pulp due to cytotoxicity, several factors must be considered in choosing the adhesive system. Full article
Timisoara Med 2020, 2020(1), 8; doi: 10.35995/tmj20200108
Received: 21 Sep 2020 / Revised: 20 Oct 2020 / Accepted: 20 Oct 2020 / Published: 26 Oct 2020
The renin–angiotensin–aldosterone system (RAAS) has been recognized as a key player in the complex scenario of cardiovascular regulation. Aside from its role in the cardiovascular diseases, RAAS dysregulation has emerged as a central pathomechanism in the severe acute respiratory syndrome coronavirus 1 (SARS-CoV1)
[...] Read more.
The renin–angiotensin–aldosterone system (RAAS) has been recognized as a key player in the complex scenario of cardiovascular regulation. Aside from its role in the cardiovascular diseases, RAAS dysregulation has emerged as a central pathomechanism in the severe acute respiratory syndrome coronavirus 1 (SARS-CoV1) epidemic, dating back to 2002–2004, and the current COVID-19 pandemic with SARS-CoV2, with the latter involving the interaction with angiotensin-converting enzyme 2 (ACE2). ACE2 is the enzyme responsible for Ang 1-7 production that partly counteracts the RAAS effects and promotes nitric oxide synthase activation; moreover, it has also been reported to act as a receptor for both SARS viruses. In the setting of the ongoing COVID-19 pandemic, the SARS–ACE2 interaction is highly debated with respect to both viral infectivity and usage/discontinuation of RAAS medication—ACE inhibitors (ACEi) and angiotensin-receptor blockers (ARBs)—in diagnosed or suspected SARS-CoV2 patients. Since ACE inhibitors and ARBs are largely prescribed in cardiovascular pathology, a better understanding of the interaction between SARS-CoV2 and RAAS is urgently needed. In this review, we will briefly discuss the SARS-CoV2 and ACE2 interaction and why the discontinuation of RAAS medication is unsafe for either diagnosed or suspected SARS-CoV2 patients. Full article
Timisoara Med 2021, 2020(2), 2; doi: 10.35995/tmj20200202
Received: 2 Dec 2020 / Revised: 24 Dec 2020 / Accepted: 11 Jan 2021 / Published: 20 Jan 2021
(1) Background: Oral mucosal infections are a commonly encountered clinical pathology in patients who consult dentists, mainly for dental diseases. Currently, the involvement of oral and dental infections in cardiovascular and neurological diseases, among others, is widely discussed in the literature. In the
[...] Read more.
(1) Background: Oral mucosal infections are a commonly encountered clinical pathology in patients who consult dentists, mainly for dental diseases. Currently, the involvement of oral and dental infections in cardiovascular and neurological diseases, among others, is widely discussed in the literature. In the present research, we elaborated a comprehensive report on rare oral mucosal infections, including oral syphilis and head and neck tuberculosis. (2) Methods: The research was performed by the authors using three databases (PubMed, Wiley, and ScienceDirect). Scientific articles published from January 2000 to January 2020 were selected and reviewed to assess the epidemiology, symptoms, and diagnosis of oral syphilis and head and neck tuberculosis. (3) Results: Oral syphilis was mainly noticed as ulcers and secondary types of disease. Tuberculosis of the head and neck was most frequently encountered as cervical lymphadenopathy. (4) Conclusions: Rare oral infections diagnosis may be challenging due to their evolving polymorphic clinical appearance and their ability to mimic various diseases in the oral cavity and head and neck area. Full article
Timisoara Med 2021, 2020(2), 8; doi: 10.35995/tmj20200208
Received: 10 Dec 2020 / Revised: 26 Jan 2021 / Accepted: 4 Feb 2021 / Published: 16 Feb 2021
Chronic kidney disease (CKD) affects around 13% of the adult population, has become a considerable concern worldwide, and is characterized by inadequate renal clearance, resulting in the accumulation of various potential toxic compounds. Metabolomics, one of the many important parts of “omics” science,
[...] Read more.
Chronic kidney disease (CKD) affects around 13% of the adult population, has become a considerable concern worldwide, and is characterized by inadequate renal clearance, resulting in the accumulation of various potential toxic compounds. Metabolomics, one of the many important parts of “omics” science, refers to the systematic study of metabolites in a living system and their changes because of pathophysiological and genetic modifications. The use of metabolomics in the nephrology field of research has offered a better understanding of the pathomechanisms of CKD. The most recent technologies used for the evaluation of plasma and urinary metabolites are nuclear magnetic resonance (NMR) and mass spectroscopy (MS). A major research direction of modern medicine is to develop new therapies and new biomarkers for the early diagnosis of patients with CKD. Experimental studies of renal metabolism unequivocally demonstrated that kidney function has a huge impact on several circulating metabolites. Moreover, metabolites themselves appear to have an essential role in CKD pathogenesis/complications, being recognized as potential biomarkers with prognostic, diagnostic, and therapeutic value for the disease. The present paper provides a bird’s eye view on metabolomics and a summary of the most recent studies of metabolomics carried out in patients with CKD. Full article
Timisoara Med 2021, 2020(2), 7; doi: 10.35995/tmj20200207
Received: 11 Dec 2020 / Revised: 2 Feb 2021 / Accepted: 4 Feb 2021 / Published: 18 Feb 2021
Pentacyclic triterpenes represent an important class of intensively studied substances in the past two decades due to their wide spectrum of pharmacological effects. Even though this class is being thoroughly researched for the development of new drugs, to date, no representative has qualified
[...] Read more.
Pentacyclic triterpenes represent an important class of intensively studied substances in the past two decades due to their wide spectrum of pharmacological effects. Even though this class is being thoroughly researched for the development of new drugs, to date, no representative has qualified to become a suitable candidate for various therapies. Although a large part of past and ongoing studies focuses on triterpene chemical derivatization or formulation to increase its bioavailability, other researchers are focused on obtaining semisynthetic derivatives not necessarily with increased hydrophilicity but with a superior biological effect compared to their parent compound. The current review aims to report the biological assessment of several ring-modified pentacyclic triterpene derivative series. Full article
Timisoara Med 2021, 2021(1), 3; doi: 10.35995/tmj20210103
Received: 4 May 2021 / Revised: 14 Jun 2021 / Accepted: 14 Jun 2021 / Published: 25 Jun 2021
Renal elastography is a real-time ultrasound-based imaging method that can potentially be used in order to assess diffuse diseases of native kidneys. In order to find a place in the clinical practice for renal elastography, what is influencing the obtained results should be
[...] Read more.
Renal elastography is a real-time ultrasound-based imaging method that can potentially be used in order to assess diffuse diseases of native kidneys. In order to find a place in the clinical practice for renal elastography, what is influencing the obtained results should be known. The kidney shear wave speed is influenced by different factors such as age, gender, measurement depth or urinary pressure. The relationship with renal function and also with renal fibrosis is different across different studies, with not all studies showing an increase in renal stiffness in more advanced renal diseases. However, the changes in renal blood flow seem to influence renal elastography, and a decrease in renal blood flow could be the cause of the decrease in the shear wave speed and could have a bigger influence on elastography compared to renal fibrosis. This paper provides a summary about the factors that seem to influence renal elastography and also regarding the limitations of this method according to the published studies thus far. Full article
Timisoara Med 2021, 2021(1), 2; doi: 10.35995/tmj20210102
Received: 14 May 2021 / Revised: 29 May 2021 / Accepted: 29 May 2021 / Published: 25 Jun 2021
This review discusses the current research data on using microRNAs as biomarkers for the diagnostics and screening of Parkinson’s Disease (PD). We provide a comprehensive, critical analysis of the overwhelmingly diverse data on circulant microRNAs associated with PD. We also highlight the possible
[...] Read more.
This review discusses the current research data on using microRNAs as biomarkers for the diagnostics and screening of Parkinson’s Disease (PD). We provide a comprehensive, critical analysis of the overwhelmingly diverse data on circulant microRNAs associated with PD. We also highlight the possible underlying molecular pathogenesis-related circulant microRNAs in the context of the natural history of PD. Full article
Timisoara Med 2021, 2021(1), 5; doi: 10.35995/tmj20210105
Received: 25 Apr 2021 / Revised: 4 Jul 2021 / Accepted: 8 Jul 2021 / Published: 5 Aug 2021
(1) Purpose: The employment of platelet-rich fibrin (PRF) in the extracted teeth socket has been shown to aid tissue healing. It also minimizes detrimental consequences. The rationale of this systematic review is to observe the possible association between PRF employment and postoperative consequences
[...] Read more.
(1) Purpose: The employment of platelet-rich fibrin (PRF) in the extracted teeth socket has been shown to aid tissue healing. It also minimizes detrimental consequences. The rationale of this systematic review is to observe the possible association between PRF employment and postoperative consequences following mandibular third molar surgery. (2) Materials and Methods: The following databases were explored electronically (till 28 February 2021): PubMed, Cochrane library, Embase, International Clinical Trials Registry Platform (ICTRP), and ClinicalTrials.gov. A manual explore was accomplished on various journals regarding the subject of oral and maxillofacial surgery. The online explore applied the keywords “platelet-rich fibrin or PRF,” and “mandibular third molar.” To review the efficiency of PRF, the accompanying post-operative consequences were collected: pain, swelling, trismus, inter-incisal distance, analgesic consumption, soft tissue healing, bone healing, socket complications, and periodontal parameters. (3) Results: Just 9 full-text studies out of 26 were comprised of review for qualitative analysis. All of the studies were randomized clinical trials (RCTs), with eight split-mouth designs and one parallel design study. Significant outcomes were usually observed for pain, postoperative swelling, mouth opening, periodontal pocket depth, soft tissue healing, and the incidence of alveolar osteitis or dry sockets, but not constantly. The qualitative scrutiny disclosed that the PRF had no considerable outcome in bone healing. (4) Conclusions: Local administration of PRF is a practical way of alleviating pain, trismus, oedema, and enhancing soft tissue healing following mandibular third molar extraction. PRF tends to have no function in bone healing following extraction. More controlled clinical trials and RCTs are necessitating exploring the end results of PRF following mandibular third molar extraction. Full article
Research
Timisoara Med 2020, 2020(1), 2; doi: 10.35995/tmj20200102
Received: 14 Sep 2020 / Revised: 12 Oct 2020 / Accepted: 12 Oct 2020 / Published: 20 Oct 2020
(1) Background: To determine the association between patient-reported outcome measures and return to work after knee arthroscopy. (2) Material and Methods: Retrospective analysis of data on patients scheduled for knee arthroscopy in 2019 for which symptom severity was available using International Knee Documentation
[...] Read more.
(1) Background: To determine the association between patient-reported outcome measures and return to work after knee arthroscopy. (2) Material and Methods: Retrospective analysis of data on patients scheduled for knee arthroscopy in 2019 for which symptom severity was available using International Knee Documentation Committee subjective knee evaluation form (IKDC), Knee Disability And Osteoarthritis Outcome Score For Joint Replacement (KOOS JR), Tegner Lysholm scale and Euroqol EQ5D5L. Paid sick leave was retrieved from electronic patient records. (3) Results: 61 patients (mean age 46.44 ± 7.61 years, 28 (45.9%) males) met the inclusion criteria. All patients ultimately returned to work. Forty-six (75.41%) received a mean of 28.5 (range 7–68) days of paid medical leave after surgery. Of those, three patients were already on medical leave. There were no differences in demographics and clinical scores between patients who received paid sick leave and those who did not. No significant correlation was found between days of absence and clinical scores. (4) Conclusions: There was no association between absence from work and commonly used clinical scores in patients undergoing knee arthroscopy. Full article
Timisoara Med 2020, 2020(1), 3; doi: 10.35995/tmj20200103
Received: 15 Sep 2020 / Revised: 25 Sep 2020 / Accepted: 14 Oct 2020 / Published: 21 Oct 2020
(1) Background: In the current clinical practice of the COVID-19 infection, the focus should not be placed on the positive RT-PCR results, but rather on the epidemiological, clinical, and imaging aspects specific to the disease. (2) Case Report: We present the case of
[...] Read more.
(1) Background: In the current clinical practice of the COVID-19 infection, the focus should not be placed on the positive RT-PCR results, but rather on the epidemiological, clinical, and imaging aspects specific to the disease. (2) Case Report: We present the case of a 34-year-old female, who had contacts with both her parents, both of whom were confirmed to have SARS-CoV-2 infection by RT-PCR testing. She presented for about one week symptoms suggestive of COVID-19 infection, determining her to repeatedly go to the emergency room, where she had three negative SARS-CoV-2 RT-PCR tests. The blood tests revealed leukopenia with lymphocytopenia, with increased lactate dehydrogenase (LDH) and C-reactive protein (CRP). Moreover, the chest X-ray showed modifications specific for COVID-19, and the diagnosis of COVID-19 was set. Drug treatment with hydroxychloroquine, azithromycin, cephalosporins, systemic corticosteroids, anticoagulants, bronchodilators, and interleukin-6 inhibitors was initiated, together with oxygen therapy. (3) Discussion: SARS-CoV-2 RT-PCR testing may give false negative results due to inadequate biological sampling, or to the accuracy of the test methods. A significant contribution to the diagnosis is made by the specific computed tomography (CT) criteria of COVID-19. (4) Conclusions: A priority for COVID-19 diagnosis accuracy is epidemiological investigation, together with clinical criteria and CT imaging, even in the presence of a negative RT-PCR test. Full article
Timisoara Med 2020, 2020(1), 4; doi: 10.35995/tmj20200104
Received: 18 Sep 2020 / Revised: 14 Oct 2020 / Accepted: 14 Oct 2020 / Published: 21 Oct 2020
In this paper, the acetylcholinesterase inhibitor drug tacrine was investigated by two complementary instrumental techniques, namely infrared spectroscopy and thermal analysis, as pure drug and in solid binary mixtures with nine excipients frequently used in the pharmaceutical industry, namely starch, sodium carboxymethyl cellulose,
[...] Read more.
In this paper, the acetylcholinesterase inhibitor drug tacrine was investigated by two complementary instrumental techniques, namely infrared spectroscopy and thermal analysis, as pure drug and in solid binary mixtures with nine excipients frequently used in the pharmaceutical industry, namely starch, sodium carboxymethyl cellulose, polyvinylpyrrolidone K30, fumed silica (Aerosil), talc, anhydrous lactose, magnesium stearate, mannitol and calcium lactate pentahydrate. The corroboration of obtained data by the two complementary methods confirmed the incompatibility of this drug with anhydrous lactose, mannitol, magnesium stearate and calcium lactate under both ambient conditions and thermal stress, and thermally induced interactions between tacrine and silica. In the development of new generic solid formulations, four of the investigated excipients (i.e., starch, sodium carboxymethyl cellulose, polyvinylpyrrolidone K30 and talc) can be used, since they are compatible with tacrine under ambient conditions as well as under thermal stress. Full article
Timisoara Med 2020, 2020(1), 6; doi: 10.35995/tmj20200106
Received: 24 Sep 2020 / Revised: 16 Oct 2020 / Accepted: 19 Oct 2020 / Published: 26 Oct 2020
Although it recorded a breakthrough for the treatment of metastatic melanoma in the last decade, this disease remains a challenge in terms of finding an efficient treatment, reducing secondary resistance to treatment, and understanding the complexity of the molecular mechanisms involved in its
[...] Read more.
Although it recorded a breakthrough for the treatment of metastatic melanoma in the last decade, this disease remains a challenge in terms of finding an efficient treatment, reducing secondary resistance to treatment, and understanding the complexity of the molecular mechanisms involved in its development, progression and metastasis. This study aims to verify the multitarget effect of a natural compound, betulinic acid (BA), a pentacyclic triterpene, as antimelanoma agent by applying two experimental models: a human melanoma cell line—A375 and the chick chorioallantoic membrane model. The methods applied in this study were: MTT cell viability assay for cytotoxicity assessment and the chorioallantoic membrane assay (CAM) for antiangiogenic evaluation. The results indicated a significant decrease of A375 cells viability after a 72 h BA treatment even at the lowest concentration tested—1 µM (61.95% viable cells), with a calculated IC50 of 9.437 µM. In addition, BA inhibited not only the in ovo A375-induced tumor growth but also the angiogenesis on the primary site at 72 h post application. These data highlight the potential antimelanoma effect of BA by targeting the tumor cells via multiples pathways as inducing cell death and suppressing the angiogenic process, a must have for tumor development. Full article
Timisoara Med 2020, 2020(1), 10; doi: 10.35995/tmj20200110
Received: 27 Sep 2020 / Revised: 25 Oct 2020 / Accepted: 25 Oct 2020 / Published: 30 Oct 2020
(1) Background: Both open surgery and endovascular strategies are accepted methods for the treatment of critical limb ischemia (CLI) due to superficial femoral artery disease (SFA). There is currently only one randomized trial results (BASIL-1) that compared open vs. endo procedures for SFA
[...] Read more.
(1) Background: Both open surgery and endovascular strategies are accepted methods for the treatment of critical limb ischemia (CLI) due to superficial femoral artery disease (SFA). There is currently only one randomized trial results (BASIL-1) that compared open vs. endo procedures for SFA treatment. In this study, we wanted to compare two treatment strategies for superficial femoral artery vascular disease. (2) Material and methods: A study was conducted on 235 patients (part of a national project—“Development of the public infrastructure research and development and creation of new infrastructure”) in which the open vs. endovascular strategy was compared in patients with critical limb ischemia and SFA disease. (3) Results: Primary outcomes are the time elapsed until major events related to the index leg or death. Secondary outcomes are amputation-free survival rate, reintervention on the index leg, major cardiovascular events and postoperative complications. (4) Conclusion: After 6 months, we had an overall mortality rate of 7.23% and an amputation-free survival of 89.36%. Full article
Timisoara Med 2021, 2020(2), 3; doi: 10.35995/tmj20200203
Received: 10 Dec 2020 / Revised: 19 Jan 2021 / Accepted: 19 Jan 2021 / Published: 25 Jan 2021
(1) Background: Complete atrioventricular block is a well-known complication of alcohol ablation as a septal reduction therapy, implemented in selected patients with hypertrophic obstructive cardiomyopathy (HOCM). It usually occurs during or immediately after the intervention. Rare cases of late complete atrioventricular block (CAVB)
[...] Read more.
(1) Background: Complete atrioventricular block is a well-known complication of alcohol ablation as a septal reduction therapy, implemented in selected patients with hypertrophic obstructive cardiomyopathy (HOCM). It usually occurs during or immediately after the intervention. Rare cases of late complete atrioventricular block (CAVB) have been reported, but data are still scarce in the literature regarding this issue. (2) Case report: We report the case of a 70-year-old male patient, with mild aortic stenosis, but with a significantly degenerated valve and perivalvular tissue, and a nonspecific intraventricular conduction delay, which developed intensely symptomatic CAVB, four months after alcohol septal ablation (ASA) for HOCM, along with left ventricular pressure gradient recurrence. Both problems were resolved by implantation of a dual chamber pacemaker, with pacing optimization to a short atrioventricular interval, along with a maximal tolerated betablocker therapy. With the description of the patient’s treatment and evolution in comparison with other reports and studies, this case report highlights the fact that a close clinical, electrical and echocardiographic surveillance is warranted for this kind of patients, as late CAVB may be a life-threatening complication. Previous electrical conduction problems and degenerated aortic valve and perivalvular tissue may be predisposed for this type of complication, independent of betablocker therapy. This treatment has several other beneficial effects and thus it should not be interrupted after the procedure. Full article
Timisoara Med 2021, 2020(2), 4; doi: 10.35995/tmj20200204
Received: 15 Dec 2020 / Revised: 18 Jan 2021 / Accepted: 22 Jan 2021 / Published: 26 Jan 2021
(1) Background: Oronasal communication is described in the scientific literature as a common complication that occurs after a cleft palate surgery. In some cases, it can also be a consequence of oral surgery procedures; the main problem of this type of rare accident
[...] Read more.
(1) Background: Oronasal communication is described in the scientific literature as a common complication that occurs after a cleft palate surgery. In some cases, it can also be a consequence of oral surgery procedures; the main problem of this type of rare accident is related to the correct healing process and treatment option. (2) Case report: A patient with oronasal communication caused by an unsuccessful attempt of a superior canine odontectomy presented at the Emergency Department of the Oral and Maxillofacial Surgery Hospital, Timișoara. The case management is described from the first consult to one-year follow-up. We consider that this pathology was optimally treated surgically, and the results are more than satisfactory, taking into consideration the high rates of recurrence. (3) Conclusion: This case report can be a useful to a general dentist who is trying to decide whether to perform the canine odontectomy or refer to a specialist surgeon due to the accidents and complications of this procedure. Full article
Timisoara Med 2021, 2020(2), 5; doi: 10.35995/tmj20200205
Received: 22 Dec 2020 / Revised: 27 Dec 2020 / Accepted: 2 Feb 2021 / Published: 8 Feb 2021
(1) Background: Meniscal lesions are one of the most prevalent pathologies in orthopedics; meniscal root tears have been recognized as a specific subset with poor mid- to long-term results after standard treatment options (observation, physical therapy, arthroscopic partial meniscectomy) and frequent progression to
[...] Read more.
(1) Background: Meniscal lesions are one of the most prevalent pathologies in orthopedics; meniscal root tears have been recognized as a specific subset with poor mid- to long-term results after standard treatment options (observation, physical therapy, arthroscopic partial meniscectomy) and frequent progression to osteoarthritis. Meniscal root repair has emerged as a new technique with promising results. We present a case report and review the current literature regarding the diagnosis, indications to repair, current techniques, alternatives and expected outcomes. (2) Case report: A 49-year-old woman, with a body mass index of 30 and no significant comorbidities or history of trauma, involved in moderate to heavy physical activity, presented with left knee pain at the internal meniscal line, which worsened over the last 4 months, despite an intra-articular steroid shot. Based on the magnetic resonance imaging (MRI), she was diagnosed with a type 2 medial meniscus posterior root tear and moderate internal compartment chondropathy (Outerbridge 2). She underwent side-to-side repair of the meniscal lesion and reattachment of the root through a bone tunnel over a button. Postoperatively, she was non-weight-bearing (NWB) for 6 weeks and with the knee immobilized at 30° of flexion. At 6 months’ follow-up, the patient was fully ambulant without crutches, with active knee flexion between 0° and 130°. (3) Conclusion: Meniscal root repair is reasonably accessible. It may provide additional benefits over current treatment options when used judiciously and with an adequate surgical technique. Full article
Timisoara Med 2021, 2020(2), 9; doi: 10.35995/tmj20200209
Received: 8 Feb 2021 / Revised: 15 Feb 2021 / Accepted: 18 Feb 2021 / Published: 22 Feb 2021
(1) Background: Infection with Echinococcus granulosus is the cause of hydatid cysts located frequently in the liver and lungs, but also in the kidneys, bones, spleen, brain and muscles. Cystic echinococcosis is sometimes complicated to treat, requiring radical surgery and prolonged medication. The
[...] Read more.
(1) Background: Infection with Echinococcus granulosus is the cause of hydatid cysts located frequently in the liver and lungs, but also in the kidneys, bones, spleen, brain and muscles. Cystic echinococcosis is sometimes complicated to treat, requiring radical surgery and prolonged medication. The hydatid cyst in the retroperitoneal space is frequently asymptomatic, unless it grows and produces symptoms caused by high intracystic pressure, secondary infection, wall breaking and allergy. (2) Case Report: We present the case of a 47-year old male patient, admitted for a giant bilobed retroperitoneal hydatid cyst. Following diagnosis, the patient was operated on using an anterior midline abdominal approach. The cyst was inactivated, the contents were evacuated and the cavity was drained and cleaned by opening the cyst in the middle area and at its lower pole, respectively. Subsequently, the cyst required re-installation of the drain. The evolution of the case was finally favorable but confirmed that the postoperative evolution of large hydatid cysts can be unexpected and even followed by complications. (3) Conclusions: For the presented case, the classic surgical method was the appropriate choice, considering the large size of the hydatid cyst. Bilobed cysts and those with calcified walls may cause problems with the spontaneous closing of the remaining cavity. For complicated cysts, the treatment is radical or conservative surgery, while for uncomplicated cysts, minimally invasive treatment is an appropriate choice. Full article
Timisoara Med 2021, 2021(2), 2; doi: 10.35995/tmj20210202
Received: 18 May 2021 / Revised: 10 Oct 2021 / Accepted: 10 Oct 2021 / Published: 26 Oct 2021
Gaucher Disease (GD) is a rare inherited lysosomal storage disease caused by biallelic mutations in the gene encoding the lysosomal enzyme acid β-glucocerebrosidase, with progressive accumulation of the sphingolipid glucosylceramide in the lysosomes of macrophages, mainly in the liver, spleen, bone, and bone
[...] Read more.
Gaucher Disease (GD) is a rare inherited lysosomal storage disease caused by biallelic mutations in the gene encoding the lysosomal enzyme acid β-glucocerebrosidase, with progressive accumulation of the sphingolipid glucosylceramide in the lysosomes of macrophages, mainly in the liver, spleen, bone, and bone marrow. It is characterized by anemia, thrombocytopenia, hepatosplenomegaly, sometimes severe bone involvement and, in certain forms, neurological involvement. We present the case of a 77-year-old male, diagnosed in 2006, at 63, with GD type1. At the onset, the patient presented fatigue, asthenia, upper abdominal discomfort, skin pallor and minor bone pain. During follow-up, CT was performed and displayed an enlarged spleen (25 cm) and a well-defined mass in the kidney cortex, but it could not establish whether it was malignant or not. Considering the patient refused surgery at that moment, a new CT exam was performed six months later, and the kidney tumor significantly increased in size. Nephrectomy and necessity splenectomy were performed, and recovery was uneventful. The histopathological examination revealed clear cell renal cell carcinoma, grade 2 Fuhrman. Enzyme substitution therapy with Imiglucerasum was initiated in 2012 with favorable evolution. Seven years later, during a routine ultrasound follow-up, a 4/3.8 cm hyperechoic mass was found in the eighth liver segment. The biological tests revealed a high value of alpha-fetoprotein (AFP-185.2 ng/mL). Considering the patient’s history, possible diagnoses of the newly found focal liver lesion were: gaucheroma, metastasis secondary to kidney cancer, or a primitive liver tumor. Core biopsy was performed, and it was suggestive of a poorly differentiated hepatocellular carcinoma G3. A non-anatomical resection of liver segments VII and VIII with partial resection of inferior vena cava was performed, followed by full post-operative recovery. A histopathological examination confirmed the initial diagnosis. Currently, one month postoperatively, the patient in good clinical condition, continues the enzyme replacement treatment and is undergoing oncological follow-up. We presented a complex case of GD, diagnosed at an advanced age, who responded well to substitution therapy in regard to hematologic and bone symptoms, but who unfortunately developed two types of cancer managed aggressively despite the advanced age. Full article
Timisoara Med 2020, 2020(1), 5; doi: 10.35995/tmj20200105
Received: 12 Aug 2020 / Revised: 10 Oct 2020 / Accepted: 12 Oct 2020 / Published: 3 Dec 2020
(1) Background: Primary hyperparathyroidism is a common disorder of the parathyroid glands and the third most frequent endocrinopathy, especially among elderly women. Secondary hyperparathyroidism is a common complication of chronic kidney disease, associated with high cardiovascular morbidity and mortality. In both primary and
[...] Read more.
(1) Background: Primary hyperparathyroidism is a common disorder of the parathyroid glands and the third most frequent endocrinopathy, especially among elderly women. Secondary hyperparathyroidism is a common complication of chronic kidney disease, associated with high cardiovascular morbidity and mortality. In both primary and secondary hyperparathyroidism, the need to correctly identify the parathyroid glands is mandatory for a better outcome. Elastography can be an effective tool in the diagnosis of parathyroid lesions, by differentiating possible parathyroid lesions from thyroid disease, cervical lymph nodes, and other anatomical structures. There are currently no guidelines or recommendations and no established values on the elasticity of parathyroid lesions. (2) Material and Methods: In our studies, we have evaluated, by Shear Wave elastography (SWE), both primary and secondary hyperparathyroidism, determining that parathyroid glands have a higher elasticity index than both thyroid tissue and muscle tissue. (3) Results: For primary hyperparathyroidism, we have determined, using 2D-SWE, the parathyroid adenoma tissue (mean elasticity index (EI) measured by SWE 4.74 ± 2.74 kPa) with the thyroid tissue (11.718 ± 4.206 kPa) and with the surrounding muscle tissue (16.362 ± 3.829 kPa). For secondary hyperparathyroidism, by SWE elastographic evaluation, we have found that the mean EI in the parathyroid gland was 7.83 kPa, a median value in the thyroid parenchyma of 13.76 kPa, and a mean muscle EI value at 15.78 kPa. (4) Conclusions: Elastography can be a useful tool in localizing parathyroid disease, whether primary or secondary, by correctly identifying the parathyroid tissue. We have determined that an EI below 7 kPa in SWE elastography correctly identifies parathyroid tissue in primary hyperparathyroidism, and that a cut-off value of 9.98 kPa can be used in 2D-SWE to accurately diagnose parathyroid disease in secondary hyperparathyroidism. Full article
Timisoara Med 2020, 2020(1), 9; doi: 10.35995/tmj20200109
Received: 28 Sep 2020 / Revised: 22 Oct 2020 / Accepted: 22 Oct 2020 / Published: 17 Nov 2020
(1) Background: Toxoplasma gondii and cytomegalovirus belong to a group of pathogens entities called TORCH agents. TORCH represents an acronym which derives from the name of a series of certain pathogenic agents (Toxoplasma gondii, Other agents, Rubella virus,
[...] Read more.
(1) Background: Toxoplasma gondii and cytomegalovirus belong to a group of pathogens entities called TORCH agents. TORCH represents an acronym which derives from the name of a series of certain pathogenic agents (Toxoplasma gondii, Other agents, Rubella virus, Cytomegalovirus, Herpes virus). They could cross the placenta barrier and cause serious damage to the fetus if a primary infection occurs in a pregnant woman. Immunized women are relatively protected against a reinfection and the risk of a materno-fetal infection in these categories of pregnant women is considered low. (2) Aim of the study: To analyze changes in the percentage of pregnant women seronegative to Toxoplasma gondii and cytomegalovirus along a period of ten years, from 2008 to 2018. (3) Material and Methods: We studied the changes in percentage of seronegative Toxoplasma gondii and Cytomegalovirus pregnant women along two periods: 2008–2010 and 2015–2018. Only pregnant women with declared medium of provenience and unequivocal results were enrolled in the study. (4) Results: In urban areas, we found an increase in the percentage of pregnant women seronegative to Toxoplasma gondii (RR = 1.488, p < 0.0001), respectively to cytomegalovirus (RR = 1.985, p < 0.0001), from 2008–2010 to 2015–2018. A similar increasing trend was found also in rural areas: Toxoplasma gondii (RR = 1.136, p < 0.0322), respectively cytomegalovirus (RR = 1.088, p < 0.8265) but it did not reach a significant threshold for cytomegalovirus. (5) Conclusion: Our study showed that the percentage of women seronegative to Toxoplasma gondii and cytomegalovirus antibodies increases along a period of ten years, from 2008–2010 to 2015–2018, in both urban and rural areas. Probably, the main cause of this trend is represented by the improvement in hygienic condition and food quality control. These results present an argument for continuing the TORCH screening of pregnant women. Full article
Timisoara Med 2021, 2020(2), 1; doi: 10.35995/tmj20200201
Received: 2 Dec 2020 / Revised: 19 Dec 2020 / Accepted: 30 Dec 2020 / Published: 20 Jan 2021
(1) Background: Parents play an important role in children’s oral health by contributing to the development of proper oral hygiene and eating behaviors as well as offering the child access to dental services. The aim of this study was the evaluation of parents’
[...] Read more.
(1) Background: Parents play an important role in children’s oral health by contributing to the development of proper oral hygiene and eating behaviors as well as offering the child access to dental services. The aim of this study was the evaluation of parents’ involvement in their child’s visits to the dental office. (2) Methods: The cross-sectional study was conducted in 2020 in Romania on a sample of 105 parents using an online self-administered questionnaire. (3) Results: Only 9.52% of parents brought their children to the dental office for their first visit in their 1st year of life; 51.53% of children visit the dentist at least once a year but for only 42.86% of children, the reason of their last visit was a regular dental check-up. (4) Conclusions: parents underestimate the role of dental service utilization for their children; the first visit to the dental office for most children is at an older age than optimal, the frequency of dental visits is less than recommended, and they are treatment-oriented. Full article
Timisoara Med 2021, 2020(2), 6; doi: 10.35995/tmj20200206
Received: 17 Jan 2021 / Revised: 3 Feb 2021 / Accepted: 3 Feb 2021 / Published: 8 Feb 2021
(1) Introduction: Prostate cancer is the second leading cause of cancer-related death in men in developed countries. Due to the existing biomarkers’ limitations, there is a stringent need to develop novel, better non-invasive markers for prostate cancer diagnostic and monitoring. (2) Material and
[...] Read more.
(1) Introduction: Prostate cancer is the second leading cause of cancer-related death in men in developed countries. Due to the existing biomarkers’ limitations, there is a stringent need to develop novel, better non-invasive markers for prostate cancer diagnostic and monitoring. (2) Material and methods: We assessed, by real-time PCR, the expression level of 84 long non-coding RNA (lncRNA) in plasma and the exosomes isolated from prostate cancer patients’ plasma and urine. (3) Results: Only a few lncRNAs were detected in high abundance (Ct between 25 and 30 cycles) across all sample types, the vast majority showing relatively modest levels (Ct > 30 cycles). As expected, plasma and plasma exosomes contain far more lncRNA species than urine, irrespective of whether they originate from patients or controls. We identified two statistically significant dysregulated lncRNAs in prostate cancer samples vs. controls: RBM5-AS1, 2.89 times downregulated in plasma (p = 0.036), and SNHG16, 13.69 times upregulated (p = 0.029) in urine exosomes. (4) Conclusions: These preliminary data need further validation in additional independent, more extensive studies before they can be considered as biomarkers for prostate cancer. Full article
Timisoara Med 2021, 2020(2), 10; doi: 10.35995/tmj20200210
Received: 5 Feb 2021 / Revised: 26 Feb 2021 / Accepted: 4 Mar 2021 / Published: 8 Mar 2021
The article provides an extensive analysis of the data obtained in bioequivalence studies, which can be considered for further evaluation in the development of general and individual therapeutic regimens. Concrete data obtained in two bioequivalence studies compared amiodarone formulations and included plasma levels
[...] Read more.
The article provides an extensive analysis of the data obtained in bioequivalence studies, which can be considered for further evaluation in the development of general and individual therapeutic regimens. Concrete data obtained in two bioequivalence studies compared amiodarone formulations and included plasma levels of amiodarone and the active metabolite desethylamiodarone. The analysis included mean data and variability in plasma concentrations and pharmacokinetic parameters. In addition, a global and structural meta-analysis of the individual plasma level sets was performed. The half-life of amiodarone was not well defined and the total area below the plasma level curves was less appropriate for estimating bioequivalence. Full article
Timisoara Med 2021, 2021(1), 1; doi: 10.35995/tmj20210101
Received: 19 Apr 2021 / Revised: 27 Apr 2021 / Accepted: 8 May 2021 / Published: 12 May 2021
(1) Background: Parents need an increased level of awareness regarding the role of fluoride in maintaining optimal oral health of their children. This cross-sectional study aimed to assess the level of parents’ knowledge and behavior towards fluoride administration in children. (2) Methods: an
[...] Read more.
(1) Background: Parents need an increased level of awareness regarding the role of fluoride in maintaining optimal oral health of their children. This cross-sectional study aimed to assess the level of parents’ knowledge and behavior towards fluoride administration in children. (2) Methods: an online self-administered Google Forms questionnaire was used. (3) Results: 73.97% did not administer fluoride products to their children. From 16 parents who have given their child local fluoride products, 15.06% made it on the recommendation of the dentist. In total, 71.23% did not know exactly the importance of using fluoride for optimal oral health of the child. In total, 63.01% did not know the possible side effects of excess fluoride. (4) Conclusions: The dentist has an important role to educate the parents and also their children on the appropriate use of fluoride at home and in dental offices, explaining to them the benefits it brings for optimal oral health status and to motivate patients for adequate oral hygiene, proper diet and regular check-ups. Full article
Timisoara Med 2021, 2021(1), 4; doi: 10.35995/tmj20210104
Received: 19 May 2021 / Revised: 27 Jun 2021 / Accepted: 30 Jun 2021 / Published: 1 Jul 2021
(1) Aim: To analyze the publication output from Romania in the Web of Science (WoS) category of orthopedics. (2) Methods: We have used the WoS Core Collection Advanced Search between 2009 and 2018. (3) Results: Under the WoS Orthopedics category in SCI-Expanded, we
[...] Read more.
(1) Aim: To analyze the publication output from Romania in the Web of Science (WoS) category of orthopedics. (2) Methods: We have used the WoS Core Collection Advanced Search between 2009 and 2018. (3) Results: Under the WoS Orthopedics category in SCI-Expanded, we found 72 articles with Romania as the country of origin, representing 0.105% of the total Romanian research output. Using journal rankings, distribution by quartile was: 1–12 (16.7%), 2–33 (45.8%), 3–9 (12.5%) and 4–18 (25%). Average citations in total and per year by category were: 1–22.6 range 1–91 (2.56), 2–8.85 range 0–30 (1.64), 3–8.44 range 1–30 (1.25), and 4–4.11 range 0–16 (0.74). Thirteen articles published from 1986 to 2008 were excluded by limiting the timespan. When searching for all document types and all WoS core collection citation indexes, we found 107 items; the total citations increased from 714 to 806. (4) Conclusions: Orthopedic publications from Romania have increased in the last decade, but are still low compared to category averages; however, the bibliometric qualitative distribution and patterns mostly resemble that of comparators. Full article
Timisoara Med 2021, 2021(2), 3; doi: 10.35995/tmj20210203
Received: 30 May 2021 / Revised: 1 Jul 2021 / Accepted: 17 Oct 2021 / Published: 17 Nov 2021
(1) Background: Placenta accreta spectrum (PAS) is a pathologic invasion of the placental trophoblasts to the myometrium and beyond. This study evaluates the demographic features, risk indicators, feto–maternal outcome, and treatment options in PAS women at our center. (2) Methods: This is a
[...] Read more.
(1) Background: Placenta accreta spectrum (PAS) is a pathologic invasion of the placental trophoblasts to the myometrium and beyond. This study evaluates the demographic features, risk indicators, feto–maternal outcome, and treatment options in PAS women at our center. (2) Methods: This is a retrospective study carried out in 39 patients with placenta accreta spectrum in our tertiary health care center Sri Maharaja Gulab Singh (SMGS) Hospital, from July 2019 to September 2020. (3) Results: Most patients in our study were in the 30–35 years age group. The previous lower segment Caesarean section (LSCS) was the most critical risk factor for PAS in our research. Thirty-two of the women with PAS (82.05%) had undergone a hysterectomy, and eight patients did not undergo a hysterectomy. Twenty-eight patients needed Intensive Care Unit (ICU) care, 13 of them required ventilatory support, and three of them died due to hemorrhagic shock. In our study, preterm birth occurred in 26 patients (53.84%), while 21 (53.8%) required Neonatal Intensive Care Unit (NICU) admission, and six (15.4%) had early neonatal death and stillbirth. (4) Conclusion: PAS is a devastating event in women’s pregnancy. It leads to high maternal morbidity, mortality, and adverse neonatal outcome. The critical risk indicators for PAS are previous LSCS and placenta previa. Every case with these two concurrent conditions should be operated on in a planned way in the presence of senior obstetricians and of an anesthesiology team. Full article

Journal Browser