Pub Date : 2023-12-01DOI: 10.52418/moldovan-med-j.66-2.23.07
O. Macagonova, Adrian Cociug, Tatiana Taralunga, V. Ciobanu, T. Braniste, V. Nacu
Background: The present work describes the possibility of manufacturing biomaterials from the extracellular matrix for the treatment of the skin wounds. Biomedical collagen-based materials are clinically effective. Collagen is the most abundant and major component of the skin. Porcine collagen is almost similar to the human collagen, it is not immunogenic when used for the therapeutic purposes. Biomaterials can be obtained from the decellularized dermis, being a matrix rich in the collagen and glycoproteins. Material and methods: 3 parallel groups of biomaterials were established and the average value was calculated. To ensure the effectiveness of the decellularization process, the decellularized porcine dermis was compared with the intact sample using qualitative and quantitative criteria. Results: Histologically, the decellularized tissues revealed the presence of fewer cells. As a result, were removed approximately 80.5% of the genetic material from porcine dermal structures, demonstrated by the spectrophotometric quantification of deoxyribonucleic acid. In vitro graft degradation study in 0.01 M phosphate buffer pH 7.4 combined with collagenase, demonstrated a significant (p < 0.05) loss of collagen sponge mass by 100% over one hour in the group II compared to the decellularized dermis in group I which decreased in the weight by 91.3% during 35 hours. Conclusions: Acellular biomaterials are immunologically inert, have hydrophilic and biodegradable properties, thus they can play a key role in the wound care, exerting the transfer of the bioactive molecules and drugs directly into the wound.
{"title":"The effectiveness of the tissue engineering in the obtaining of the biological materials from the extracellular matrix","authors":"O. Macagonova, Adrian Cociug, Tatiana Taralunga, V. Ciobanu, T. Braniste, V. Nacu","doi":"10.52418/moldovan-med-j.66-2.23.07","DOIUrl":"https://doi.org/10.52418/moldovan-med-j.66-2.23.07","url":null,"abstract":"Background: The present work describes the possibility of manufacturing biomaterials from the extracellular matrix for the treatment of the skin wounds. Biomedical collagen-based materials are clinically effective. Collagen is the most abundant and major component of the skin. Porcine collagen is almost similar to the human collagen, it is not immunogenic when used for the therapeutic purposes. Biomaterials can be obtained from the decellularized dermis, being a matrix rich in the collagen and glycoproteins. Material and methods: 3 parallel groups of biomaterials were established and the average value was calculated. To ensure the effectiveness of the decellularization process, the decellularized porcine dermis was compared with the intact sample using qualitative and quantitative criteria. Results: Histologically, the decellularized tissues revealed the presence of fewer cells. As a result, were removed approximately 80.5% of the genetic material from porcine dermal structures, demonstrated by the spectrophotometric quantification of deoxyribonucleic acid. In vitro graft degradation study in 0.01 M phosphate buffer pH 7.4 combined with collagenase, demonstrated a significant (p < 0.05) loss of collagen sponge mass by 100% over one hour in the group II compared to the decellularized dermis in group I which decreased in the weight by 91.3% during 35 hours. Conclusions: Acellular biomaterials are immunologically inert, have hydrophilic and biodegradable properties, thus they can play a key role in the wound care, exerting the transfer of the bioactive molecules and drugs directly into the wound.","PeriodicalId":32733,"journal":{"name":"The Moldovan Medical Journal","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139188084","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}
Pub Date : 2023-12-01DOI: 10.52418/moldovan-med-j.66-2.23.05
Vitalie V. Moscalu
Background: Re-evaluation of reconstructive possibilities in the correction of degenerative mitral valve disease is of great clinical necessity nowadays. Material and methods: Analyzing the nature of the pathologies that determined the development mechanism of valve insufficiency, 136 cases of anterior cusp prolapse and 152 cases of posterior cusp prolapse were determined. Results: Cord rupture was established in 79 (58.9%) patients, cusp defects (”Cleft”) were appreciated in positions A1, A2, A3 – 15 cases (5.9%) and in P1, P2, P3 – in 92 (86.6%) cases. The surgical techniques performed were separated into: (1) resection – for the anterior and posterior cusps – 45 cases and accompanied by the slide – in 30 cases; (2) with Gore-Tex neo-chordal implantation – 115 cases, with cord transfer – 30; (3) Cusp enlargement with autologous pericardium – 5 cases, Alfieri procedure – 8. Implantation of a support ring required 130 (97.0%) patients. The correction of the associated valve disease required 125 patients (De Vega – 89.1%, ring – 8). Coronary bypass was required – 16 patients. There were no postoperative fatal cases. Conclusions: Based on the data obtained, reconstructive repair surgery can be can recommend for valves of degenerative, post-traumatic, ischemic, post-endocardial etiology as effective and sustainable techniques over time, being a superior alternative to replacement with prosthetic valves.
{"title":"Repair surgical techniques in degenerative cardiac valve disease","authors":"Vitalie V. Moscalu","doi":"10.52418/moldovan-med-j.66-2.23.05","DOIUrl":"https://doi.org/10.52418/moldovan-med-j.66-2.23.05","url":null,"abstract":"Background: Re-evaluation of reconstructive possibilities in the correction of degenerative mitral valve disease is of great clinical necessity nowadays. Material and methods: Analyzing the nature of the pathologies that determined the development mechanism of valve insufficiency, 136 cases of anterior cusp prolapse and 152 cases of posterior cusp prolapse were determined. Results: Cord rupture was established in 79 (58.9%) patients, cusp defects (”Cleft”) were appreciated in positions A1, A2, A3 – 15 cases (5.9%) and in P1, P2, P3 – in 92 (86.6%) cases. The surgical techniques performed were separated into: (1) resection – for the anterior and posterior cusps – 45 cases and accompanied by the slide – in 30 cases; (2) with Gore-Tex neo-chordal implantation – 115 cases, with cord transfer – 30; (3) Cusp enlargement with autologous pericardium – 5 cases, Alfieri procedure – 8. Implantation of a support ring required 130 (97.0%) patients. The correction of the associated valve disease required 125 patients (De Vega – 89.1%, ring – 8). Coronary bypass was required – 16 patients. There were no postoperative fatal cases. Conclusions: Based on the data obtained, reconstructive repair surgery can be can recommend for valves of degenerative, post-traumatic, ischemic, post-endocardial etiology as effective and sustainable techniques over time, being a superior alternative to replacement with prosthetic valves.","PeriodicalId":32733,"journal":{"name":"The Moldovan Medical Journal","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139189755","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}
Pub Date : 2023-12-01DOI: 10.52418/moldovan-med-j.66-2.23.01
I. Casian, Ana Casian
Background: Thymoquinone (TQ) and thymohydroquinone (THQ) are natural substances with antibacterial, antimycotic, antiviral, anticancer, antioxidant activity. Previously, was developed the method for obtaining Wild bergamot essential oil with high TQ content. The objective of this study was to create methods for obtaining individual substances TQ and THQ from Wild bergamot herb. Material and methods: Aerial parts of Wild bergamot have been collected from the plantation of the Scientific Practical Centre of Nicolae Testemitanu State University of Medicine and Pharmacy. The hydrodistillation method has been used for essential oil isolation and fractionation, and purification of individual substances. The analytical part of study has been performed by the HPLC method. Results: THQ was obtained in crystalline form by reducing TQ directly in the essential oil with ascorbic acid, sulphurous acid, or natural components of the Wild bergamot essential oil. Subsequent oxidation of THQ with hydrogen peroxide or nitrous acid gave TQ. Additionally, the yield of TQ was increased by optimising the parameters of plant material fermentation and using two-stage hydrodistillation with intermediate oxidation of the THQ formed at the first stage. Conclusions: Several technological procedures were created to obtain THQ from the Wild bergamot essential oil with a yield from 68-74% to 93-97% and TQ from THQ with a yield of 87-92%. The procedure of plant material processing has been optimised also to obtain essential oil with 48-56% TQ and not more than 12% residual phenols.
{"title":"Obtaining thymoquinone and thymohydroquinone from Wild bergamot (Monarda fistulosa L.)","authors":"I. Casian, Ana Casian","doi":"10.52418/moldovan-med-j.66-2.23.01","DOIUrl":"https://doi.org/10.52418/moldovan-med-j.66-2.23.01","url":null,"abstract":"Background: Thymoquinone (TQ) and thymohydroquinone (THQ) are natural substances with antibacterial, antimycotic, antiviral, anticancer, antioxidant activity. Previously, was developed the method for obtaining Wild bergamot essential oil with high TQ content. The objective of this study was to create methods for obtaining individual substances TQ and THQ from Wild bergamot herb. Material and methods: Aerial parts of Wild bergamot have been collected from the plantation of the Scientific Practical Centre of Nicolae Testemitanu State University of Medicine and Pharmacy. The hydrodistillation method has been used for essential oil isolation and fractionation, and purification of individual substances. The analytical part of study has been performed by the HPLC method. Results: THQ was obtained in crystalline form by reducing TQ directly in the essential oil with ascorbic acid, sulphurous acid, or natural components of the Wild bergamot essential oil. Subsequent oxidation of THQ with hydrogen peroxide or nitrous acid gave TQ. Additionally, the yield of TQ was increased by optimising the parameters of plant material fermentation and using two-stage hydrodistillation with intermediate oxidation of the THQ formed at the first stage. Conclusions: Several technological procedures were created to obtain THQ from the Wild bergamot essential oil with a yield from 68-74% to 93-97% and TQ from THQ with a yield of 87-92%. The procedure of plant material processing has been optimised also to obtain essential oil with 48-56% TQ and not more than 12% residual phenols.","PeriodicalId":32733,"journal":{"name":"The Moldovan Medical Journal","volume":"64 3-4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139190650","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}
Pub Date : 2023-12-01DOI: 10.52418/moldovan-med-j.66-2.23.06
Natalia Sumarga, Adrian Belii
Background: In this study the organization of long-term anticoagulant treatment has been evaluated to estimate whether clinical practice is in accordance with current recommendations for optimal use and effective control of oral anticoagulant (OAC) treatment. Material and methods: Mixed (quantitative and qualitative), transversal, descriptive, selective study. Samples: quantitative study – 394 adult patients, eligible for anticoagulant treatment; qualitative study – 39 family doctors. Results: The rate of use of OAC treatment is 68%. The period from the diagnosis of the disease to the initiation of OAC treatment lasted one month or more in 59.1% of patients. 60.6% of patients do not have sufficient knowledge regarding the treatment of OAC. The high price is the most important barrier to direct oral anticoagulant administration (91.1%). Patients’ satisfaction with OAC treatment control is low, mainly for vitamin K antagonists (59.8%). 75.5% of respondents claim that OAC treatment control and management is poor. 40.3% do not perform safe therapeutic International Normalized Ratio control, and 54.7% are not in the optimal therapeutic range. Conclusions: The main barriers to adherence to OAC treatment: the burden of regular monitoring of blood parameters, perceived concern about complications, limited access to laboratory tests and specialist doctors, insufficient information about anticoagulation, and deficiencies in communication with medical staff. There is limited conviction, and uncertainty persists in the initiation and monitoring of OAC treatment by family doctors.
{"title":"Directions for optimizing the organization of long-term anticoagulant treatment","authors":"Natalia Sumarga, Adrian Belii","doi":"10.52418/moldovan-med-j.66-2.23.06","DOIUrl":"https://doi.org/10.52418/moldovan-med-j.66-2.23.06","url":null,"abstract":"Background: In this study the organization of long-term anticoagulant treatment has been evaluated to estimate whether clinical practice is in accordance with current recommendations for optimal use and effective control of oral anticoagulant (OAC) treatment. Material and methods: Mixed (quantitative and qualitative), transversal, descriptive, selective study. Samples: quantitative study – 394 adult patients, eligible for anticoagulant treatment; qualitative study – 39 family doctors. Results: The rate of use of OAC treatment is 68%. The period from the diagnosis of the disease to the initiation of OAC treatment lasted one month or more in 59.1% of patients. 60.6% of patients do not have sufficient knowledge regarding the treatment of OAC. The high price is the most important barrier to direct oral anticoagulant administration (91.1%). Patients’ satisfaction with OAC treatment control is low, mainly for vitamin K antagonists (59.8%). 75.5% of respondents claim that OAC treatment control and management is poor. 40.3% do not perform safe therapeutic International Normalized Ratio control, and 54.7% are not in the optimal therapeutic range. Conclusions: The main barriers to adherence to OAC treatment: the burden of regular monitoring of blood parameters, perceived concern about complications, limited access to laboratory tests and specialist doctors, insufficient information about anticoagulation, and deficiencies in communication with medical staff. There is limited conviction, and uncertainty persists in the initiation and monitoring of OAC treatment by family doctors.","PeriodicalId":32733,"journal":{"name":"The Moldovan Medical Journal","volume":"44 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139192502","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}
Pub Date : 2023-12-01DOI: 10.52418/moldovan-med-j.66-2.23.09
N. Diaconu, I. Civirjic, G. Sorici, A. Grosu, T. Cuzor, Sabina Racila-Iatco
Background: Few studies have evaluated the thrombolytic treatment in patients with intermediate-high risk pulmonary embolism, making this study more valuable. Material and methods: It was a prospective, non-randomized, open-label, single-center study. Eligible patients at the age of 18 or older with an acute pulmonary embolism (PE) confirmed by CT pulmonary angiography with onset until 14 day and signs of right ventricular (RV) overload on echocardiography took part in the study. Pulmonary Arterial CT Obstruction Index Rate (PACTOIR) was used to define the localization and the expansion zone of thromboembolism. This study included 18 patients with intermediate risk and acute submassive pulmonary thromboembolism. In thrombolysis (TT) group (n=9) were used 50 mg of tissue-plasminogen activator (t-PA) administered in infusion as 0.4 mg/h for 2 hours. In the standard anticoagulation group, unfractioned heparin (UFH) was administered as a bolus of 70 units/kg or a maximum of 5000 units, followed by continuous infusion at an initial rate of 16 units/kg or a maximum of 1000 units/h. Results: The mean age for TT group was 69 vs 63 for the UFH group. PACTOIR was 100% in 3 patients in the half-dose rt-PA group and in 2 patients in the UFH group. RV/LV diameter ratio decreased from baseline to 48 h post-procedure (1.55 vs. 1.13; mean difference, -0.42; p < 0.0001). Mean pulmonary artery systolic pressure was 55 mm Hg in both groups (p < 0.05), with 53 [43–60] in TT group vs. 41.5 [37–45] mmHg in UFH group, P<0.05. Also, RV/ LV ratio and systolic PAP decreased significantly in both groups. Severe bleeding with a need in red blood cell transfusion was seen in 0.11% (1 patient) in the TT group vs 0 in UFH group. The hospitalization length of stay was significantly shorter in the TT group (3.8±1.8, p < 0.05). The rate of secondary endpoints was significantly higher in the UFH group with a high rate of pulmonary hypertension (0 vs. 19%, p=0.003). Conclusions: Half-dose thrombolytic therapy in patients diagnosed with submassive pulmonary embolism significantly reduced death and hemodynamic decompensation in the first 7 days compared to anticoagulant therapy only. With all that being said, it can be concluded that patients with high-intermediate risk PE could benefit from reduced-dose TT.
{"title":"Optional therapeutic management of intermediate-risk pulmonary embolism patients","authors":"N. Diaconu, I. Civirjic, G. Sorici, A. Grosu, T. Cuzor, Sabina Racila-Iatco","doi":"10.52418/moldovan-med-j.66-2.23.09","DOIUrl":"https://doi.org/10.52418/moldovan-med-j.66-2.23.09","url":null,"abstract":"Background: Few studies have evaluated the thrombolytic treatment in patients with intermediate-high risk pulmonary embolism, making this study more valuable. Material and methods: It was a prospective, non-randomized, open-label, single-center study. Eligible patients at the age of 18 or older with an acute pulmonary embolism (PE) confirmed by CT pulmonary angiography with onset until 14 day and signs of right ventricular (RV) overload on echocardiography took part in the study. Pulmonary Arterial CT Obstruction Index Rate (PACTOIR) was used to define the localization and the expansion zone of thromboembolism. This study included 18 patients with intermediate risk and acute submassive pulmonary thromboembolism. In thrombolysis (TT) group (n=9) were used 50 mg of tissue-plasminogen activator (t-PA) administered in infusion as 0.4 mg/h for 2 hours. In the standard anticoagulation group, unfractioned heparin (UFH) was administered as a bolus of 70 units/kg or a maximum of 5000 units, followed by continuous infusion at an initial rate of 16 units/kg or a maximum of 1000 units/h. Results: The mean age for TT group was 69 vs 63 for the UFH group. PACTOIR was 100% in 3 patients in the half-dose rt-PA group and in 2 patients in the UFH group. RV/LV diameter ratio decreased from baseline to 48 h post-procedure (1.55 vs. 1.13; mean difference, -0.42; p < 0.0001). Mean pulmonary artery systolic pressure was 55 mm Hg in both groups (p < 0.05), with 53 [43–60] in TT group vs. 41.5 [37–45] mmHg in UFH group, P<0.05. Also, RV/ LV ratio and systolic PAP decreased significantly in both groups. Severe bleeding with a need in red blood cell transfusion was seen in 0.11% (1 patient) in the TT group vs 0 in UFH group. The hospitalization length of stay was significantly shorter in the TT group (3.8±1.8, p < 0.05). The rate of secondary endpoints was significantly higher in the UFH group with a high rate of pulmonary hypertension (0 vs. 19%, p=0.003). Conclusions: Half-dose thrombolytic therapy in patients diagnosed with submassive pulmonary embolism significantly reduced death and hemodynamic decompensation in the first 7 days compared to anticoagulant therapy only. With all that being said, it can be concluded that patients with high-intermediate risk PE could benefit from reduced-dose TT.","PeriodicalId":32733,"journal":{"name":"The Moldovan Medical Journal","volume":"37 39","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139194764","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}
Pub Date : 2023-12-01DOI: 10.52418/moldovan-med-j.66-2.23.15
Lilia Rotaru, O. Grosu, Stanislav Groppa
Background: Parkinson’s disease (PD) affects more than 1% of the population aged over 65 years and manifests with both motor symptoms – bradykinesia, rest tremor, rigidity, and non-motor symptoms. Cognitive impairment and dementia are recognized non-motor symptoms that can significantly affect the quality of life of both the patient and caregivers and are a risk factor for institutionalization in nursing homes and a risk factor for early mortality. Cognitive impairment is frequent in Parkinson’s disease (PD) that can develop even before the diagnosis of Parkinson’s disease based on its motor features. Conclusions: There are several clinical, molecular, and imaging factors that constitute risk factors for the development of Parkinson’s disease dementia, in which basal cholinergic and prefrontal dopaminergic systems are involved. Histological changes are Lewy-body, Alzheimer, but also vascular pathology. Clinically can be distinguished subjective cognitive decline, mild cognitive impairment and, subsequently, Parkinson’s disease dementia. There are no remedies with a proven effect to prevent the occurrence of cognitive decline in PD. The only approved drug for already developed D-PD is the cholinesterase inhibitor – donepezil. Non-pharmacological interventions are thought to be beneficial. A multidisciplinary approach to cognitive impairment is recommended, with specific pharmaceutical treatment of the cognitive disorder and comorbidities, and appropriate rehabilitation.
{"title":"Current level of knowledge about Parkinson’s disease cognitive impairment: review","authors":"Lilia Rotaru, O. Grosu, Stanislav Groppa","doi":"10.52418/moldovan-med-j.66-2.23.15","DOIUrl":"https://doi.org/10.52418/moldovan-med-j.66-2.23.15","url":null,"abstract":"Background: Parkinson’s disease (PD) affects more than 1% of the population aged over 65 years and manifests with both motor symptoms – bradykinesia, rest tremor, rigidity, and non-motor symptoms. Cognitive impairment and dementia are recognized non-motor symptoms that can significantly affect the quality of life of both the patient and caregivers and are a risk factor for institutionalization in nursing homes and a risk factor for early mortality. Cognitive impairment is frequent in Parkinson’s disease (PD) that can develop even before the diagnosis of Parkinson’s disease based on its motor features. Conclusions: There are several clinical, molecular, and imaging factors that constitute risk factors for the development of Parkinson’s disease dementia, in which basal cholinergic and prefrontal dopaminergic systems are involved. Histological changes are Lewy-body, Alzheimer, but also vascular pathology. Clinically can be distinguished subjective cognitive decline, mild cognitive impairment and, subsequently, Parkinson’s disease dementia. There are no remedies with a proven effect to prevent the occurrence of cognitive decline in PD. The only approved drug for already developed D-PD is the cholinesterase inhibitor – donepezil. Non-pharmacological interventions are thought to be beneficial. A multidisciplinary approach to cognitive impairment is recommended, with specific pharmaceutical treatment of the cognitive disorder and comorbidities, and appropriate rehabilitation.","PeriodicalId":32733,"journal":{"name":"The Moldovan Medical Journal","volume":"31 28","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139194817","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}
Pub Date : 2023-12-01DOI: 10.52418/moldovan-med-j.66-2.23.03
Veronica Cotelea, N. Corolcova, Luminita Mihalcean, M. Burac, Liliana Profire, Iurie Dondiuc
Background: Preterm birth remains a leading obstetrical complication because of the incomplete understanding of its multifaceted etiology. It is known that immune alterations toward a proinflammatory profile are observed in women with preterm birth, but therapeutic interventions are still lacking because of scarcity of evidence in the integration of maternal and placental interrelated compartments. Objective: To investigate value of Lactoferrin (LF) and Interleukine-6 (IL-6) in the preterm labor. Material and methods: The study comprised 65 women with spontaneous preterm labor and 65 women with term labor. Maternal plasma concentrations of Lactoferrin and Interleukine-6 were detected by standard test system Aeskulisa Lactoferrin and Best-Vector A-8768 for Interleukine-6 Ref 3307 which (GmbH & Co, Germany) gave an analytical sensitive of 1.0 U/ml for Lactoferrin and 0.131 pg/ml for Interleukine-6. Results: Plasma levels of Lactoferrin in women with preterm labor were lower (μmedian = 0.90 U/ml) (p<0.001) than in the control subjects (μmedian = 40.68 U/ml). Plasma levels of Interleukine-6 in the plasma in women with preterm were predictably higher (μmedian = 51.90 pg/ml) than that in the control subjects with term delivery (μmedian = 21.51 pg/ml) (p<0.001). Conclusions: The study findings suggest that plasma levels of Lactoferrin and Interleukine-6 in women with preterm labor may be considered as a promising early biomarker for preterm labor.
{"title":"Are Lactoferrin and Interleukine-6 preterm birth participants?","authors":"Veronica Cotelea, N. Corolcova, Luminita Mihalcean, M. Burac, Liliana Profire, Iurie Dondiuc","doi":"10.52418/moldovan-med-j.66-2.23.03","DOIUrl":"https://doi.org/10.52418/moldovan-med-j.66-2.23.03","url":null,"abstract":"Background: Preterm birth remains a leading obstetrical complication because of the incomplete understanding of its multifaceted etiology. It is known that immune alterations toward a proinflammatory profile are observed in women with preterm birth, but therapeutic interventions are still lacking because of scarcity of evidence in the integration of maternal and placental interrelated compartments. Objective: To investigate value of Lactoferrin (LF) and Interleukine-6 (IL-6) in the preterm labor. Material and methods: The study comprised 65 women with spontaneous preterm labor and 65 women with term labor. Maternal plasma concentrations of Lactoferrin and Interleukine-6 were detected by standard test system Aeskulisa Lactoferrin and Best-Vector A-8768 for Interleukine-6 Ref 3307 which (GmbH & Co, Germany) gave an analytical sensitive of 1.0 U/ml for Lactoferrin and 0.131 pg/ml for Interleukine-6. Results: Plasma levels of Lactoferrin in women with preterm labor were lower (μmedian = 0.90 U/ml) (p<0.001) than in the control subjects (μmedian = 40.68 U/ml). Plasma levels of Interleukine-6 in the plasma in women with preterm were predictably higher (μmedian = 51.90 pg/ml) than that in the control subjects with term delivery (μmedian = 21.51 pg/ml) (p<0.001). Conclusions: The study findings suggest that plasma levels of Lactoferrin and Interleukine-6 in women with preterm labor may be considered as a promising early biomarker for preterm labor.","PeriodicalId":32733,"journal":{"name":"The Moldovan Medical Journal","volume":"33 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139195137","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}
Pub Date : 2023-12-01DOI: 10.52418/moldovan-med-j.66-2.23.10
Catalina Gutu, O. Grosu, Lilia Rotaru, S. Odobescu, Ion Moldovanu
Background: Autosomal Dominant Cerebral Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is caused by mutations in NOTCH3 gene, classic symptoms include migraine with aura, ischemic strokes, apathy, depression and dementia. Headache is usually the first symptom, characterized by recurrent attacks of migraine with typical, hemiplegic or prolonged aura with unusual frequency. Material and methods: All the data were picked from the patient’s medical recordings. The patient had undergone a complete clinical exam, a contrast enhanced MRI-scan and a genetic test. Then a literature review was done based on the peculiarities of the case. Results: A 43-year-old woman presented with pulsatile, alternating, severe headache, accompanied by phono, and photophobia, nausea and vomiting, with an onset at 35 years and a frequency of 12/30, triggered by menstruation and stress, preceded by a day by a visual aura lasting 5-6 minutes. Family history revealed cases of stroke and migraine. Neurologic examination was normal, but a contrast enhanced MRI showed diffuse polymorph confluent subcortical white matter lesions, involving external capsule and anterior poles of the temporal lobes. NOTCH3 gene sequencing revealed the presence of a heterozygote missense c.421C>T mutation, localized in the 4thexone. After establishing the diagnosis, the patient was prescribed a symptomatic treatment. Conclusions: Headache in CADASIL patients has well-defined diagnostic criteria in the International Classification of Headache Disorders, is being considered a secondary headache which may resemble or not migraine with aura. The patient presented a migraine-with-aura-like headache but with some peculiarities.
{"title":"Cephalalgic syndrome in autosomal dominant cerebral arteriopathy with subcortical infarctions and leucoencephalopathy","authors":"Catalina Gutu, O. Grosu, Lilia Rotaru, S. Odobescu, Ion Moldovanu","doi":"10.52418/moldovan-med-j.66-2.23.10","DOIUrl":"https://doi.org/10.52418/moldovan-med-j.66-2.23.10","url":null,"abstract":"Background: Autosomal Dominant Cerebral Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is caused by mutations in NOTCH3 gene, classic symptoms include migraine with aura, ischemic strokes, apathy, depression and dementia. Headache is usually the first symptom, characterized by recurrent attacks of migraine with typical, hemiplegic or prolonged aura with unusual frequency. Material and methods: All the data were picked from the patient’s medical recordings. The patient had undergone a complete clinical exam, a contrast enhanced MRI-scan and a genetic test. Then a literature review was done based on the peculiarities of the case. Results: A 43-year-old woman presented with pulsatile, alternating, severe headache, accompanied by phono, and photophobia, nausea and vomiting, with an onset at 35 years and a frequency of 12/30, triggered by menstruation and stress, preceded by a day by a visual aura lasting 5-6 minutes. Family history revealed cases of stroke and migraine. Neurologic examination was normal, but a contrast enhanced MRI showed diffuse polymorph confluent subcortical white matter lesions, involving external capsule and anterior poles of the temporal lobes. NOTCH3 gene sequencing revealed the presence of a heterozygote missense c.421C>T mutation, localized in the 4thexone. After establishing the diagnosis, the patient was prescribed a symptomatic treatment. Conclusions: Headache in CADASIL patients has well-defined diagnostic criteria in the International Classification of Headache Disorders, is being considered a secondary headache which may resemble or not migraine with aura. The patient presented a migraine-with-aura-like headache but with some peculiarities.","PeriodicalId":32733,"journal":{"name":"The Moldovan Medical Journal","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139189561","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}
Background: The use of myocardial cytoprotectors (meldonium) in patients with exertional angina is a scientific-practical dilemma. Material and methods: An open randomized clinical trial was conducted involving 160 patients with chronic heart faliure (117 men and 43 women) aged 37 to 81 years. Of them, 142 patients had angina pectoris of stable effort from different functional classes, and 21 – unstable angina pectoris. Study groups were comparable according to the frequency of indication of background drugs and meldonium. Results: The number of patients with normal diastolic function in both groups, but with a net superiority to meldonium combination administration, has considerably increased: 41 patients (91.11%) in group II vs 33 (58.93%) in the group treated with basic treatment after 9 months of medication; 43 patients (95.56%) group II vs 36 (64.29%) in group I at 12 months of medication. During this period, no patients with pseudonormal type of diastolic dysfunction were registered, these passing into a ”more” favorable category – delayed relaxation. Conclusions: The data obtained confirmed the benefit of using cardiocitoprotection in inducing the reverse-remodelling of the myocardium of left ventricle regardless of the initial ventricular geometric pattern, but the administration of mildronate combination demonstrated a significantly superior efficiency to the basic treatment in hypertrophy of left ventricle regression, an event notable towards the end of the research period.
{"title":"Influence of the cytoprotective drug meldonium on diastolic dysfunction of the myocardium","authors":"Olga Chetruș, Ghenadii Calin, Oxana Sirbu, Diana Sasu, Svetlana Gavriliuc, Valeriu Istrati","doi":"10.52418/moldovan-med-j.66-2.23.04","DOIUrl":"https://doi.org/10.52418/moldovan-med-j.66-2.23.04","url":null,"abstract":"Background: The use of myocardial cytoprotectors (meldonium) in patients with exertional angina is a scientific-practical dilemma. Material and methods: An open randomized clinical trial was conducted involving 160 patients with chronic heart faliure (117 men and 43 women) aged 37 to 81 years. Of them, 142 patients had angina pectoris of stable effort from different functional classes, and 21 – unstable angina pectoris. Study groups were comparable according to the frequency of indication of background drugs and meldonium. Results: The number of patients with normal diastolic function in both groups, but with a net superiority to meldonium combination administration, has considerably increased: 41 patients (91.11%) in group II vs 33 (58.93%) in the group treated with basic treatment after 9 months of medication; 43 patients (95.56%) group II vs 36 (64.29%) in group I at 12 months of medication. During this period, no patients with pseudonormal type of diastolic dysfunction were registered, these passing into a ”more” favorable category – delayed relaxation. Conclusions: The data obtained confirmed the benefit of using cardiocitoprotection in inducing the reverse-remodelling of the myocardium of left ventricle regardless of the initial ventricular geometric pattern, but the administration of mildronate combination demonstrated a significantly superior efficiency to the basic treatment in hypertrophy of left ventricle regression, an event notable towards the end of the research period.","PeriodicalId":32733,"journal":{"name":"The Moldovan Medical Journal","volume":"74 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139189316","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}
Pub Date : 2023-12-01DOI: 10.52418/moldovan-med-j.66-2.23.13
Victor Ojog
Background: Portal vein is the most enigmatic vessel of our body because it regulates own contractile performances using a special pace-maker mechanism represented by cells of Cajal. The contribution of various metabolic mediators and natural vasotropic agents in the control of the portal blood circuit is much less studied compared to the arterial system in general and the hepatic system in particular. The studies designed on the structure, function, and reactivity of the portal vein in different preconditioning have brought some common but also distinct evidence of the arterial system. Nitric oxide production is higher partly due to reduced arginase expression, but muscular media is thinner. Periodic spontaneous contractions directed towards the liver gate are characteristic for portal vein (PV), and the longitudinal muscle fibers are considered to be responsible for this phenomenon. Spontaneous rhythmic oscillations of the cells of Cajal are triggered by increasing calcium ion concentration leading to their depolarization. PV constrictor effect of phenylephrine is dependent on the activity of receptors to ET-1. For PV is characterized the acetylcholine induced contraction either in vivo or in vitro, and this effect is thought to be dependent on ET-1. Conclusions: The establishment of main particularities of portal vein reactivity of action of different paracrine, endocrine, and hemodynamical stimuli represents an important tool for prediction of contractile disorders leading plausible to portal hypertension. Likewise, a well proven interplay between cholinergic and adrenergic stimulations and on the other hand between Ang II and ET-1 actions must be a support for pharmacological modulating of portal vein reactivity disorders.
背景：门静脉是人体最神秘的血管，因为它通过以卡亚尔细胞为代表的特殊起搏器机制来调节自身的收缩性能。与一般动脉系统，特别是肝脏系统相比，对各种代谢介质和天然血管促进剂在门静脉血路控制中的作用的研究要少得多。对门静脉在不同预处理条件下的结构、功能和反应性进行的研究带来了一些与动脉系统相同但又不同的证据。一氧化氮的产生较高，部分原因是精氨酸酶的表达减少，但肌肉介质变薄。指向肝门的周期性自发收缩是门静脉（PV）的特征，纵向肌纤维被认为是造成这一现象的原因。卡贾尔细胞的自发性节律振荡是由钙离子浓度增加导致其去极化引发的。苯肾上腺素的血管收缩效应取决于 ET-1 受体的活性。在体内或体外，乙酰胆碱诱导的皮层收缩具有特征性，这种效应被认为依赖于 ET-1。结论：确定门静脉对不同旁分泌、内分泌和血流动力学刺激作用的主要特殊性，是预测可能导致门静脉高压的收缩障碍的重要工具。同样，胆碱能和肾上腺素能刺激之间，以及 Ang II 和 ET-1 作用之间的相互作用已得到充分证实，这必须为门静脉反应性疾病的药物调节提供支持。
{"title":"Morphofunctional traits and reactivity of the portal vein","authors":"Victor Ojog","doi":"10.52418/moldovan-med-j.66-2.23.13","DOIUrl":"https://doi.org/10.52418/moldovan-med-j.66-2.23.13","url":null,"abstract":"Background: Portal vein is the most enigmatic vessel of our body because it regulates own contractile performances using a special pace-maker mechanism represented by cells of Cajal. The contribution of various metabolic mediators and natural vasotropic agents in the control of the portal blood circuit is much less studied compared to the arterial system in general and the hepatic system in particular. The studies designed on the structure, function, and reactivity of the portal vein in different preconditioning have brought some common but also distinct evidence of the arterial system. Nitric oxide production is higher partly due to reduced arginase expression, but muscular media is thinner. Periodic spontaneous contractions directed towards the liver gate are characteristic for portal vein (PV), and the longitudinal muscle fibers are considered to be responsible for this phenomenon. Spontaneous rhythmic oscillations of the cells of Cajal are triggered by increasing calcium ion concentration leading to their depolarization. PV constrictor effect of phenylephrine is dependent on the activity of receptors to ET-1. For PV is characterized the acetylcholine induced contraction either in vivo or in vitro, and this effect is thought to be dependent on ET-1. Conclusions: The establishment of main particularities of portal vein reactivity of action of different paracrine, endocrine, and hemodynamical stimuli represents an important tool for prediction of contractile disorders leading plausible to portal hypertension. Likewise, a well proven interplay between cholinergic and adrenergic stimulations and on the other hand between Ang II and ET-1 actions must be a support for pharmacological modulating of portal vein reactivity disorders.","PeriodicalId":32733,"journal":{"name":"The Moldovan Medical Journal","volume":"15 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139195162","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}
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