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PLGA-The Smart Biocompatible Polimer: Kinetic Degradation Studies and Active Principle Release. PLGA--智能生物相容性聚合物:动力学降解研究和活性成分释放。
Pub Date : 2023-07-01 Epub Date: 2023-09-30 DOI: 10.12865/CHSJ.49.03.15
Maria-Viorica Ciocîlteu, Rău Gabriela, Manuel Ovidiu Amzoiu, Denisa Constantina Amzoiu, Cătălina Gabriela Pisoschi, Beatrice Anne-Marie Poenariu

The aim of our research was the development of prolonged delivery systems for therapeutic agents with various properties (prevention and treatment of bone diseases, anti-neoplastic, anti-inflammatory, antioxidant) that would ensure sustained therapeutic levels of the active principle, above the minimum inhibitory concentration, without reaching toxic levels over a long period of time as alternatives to conventional routes of administration. PLGA (poly lactic-co-glycolic acid), a biodegradable and biocompatible synthetic polymer, FDA approved, with a 65:35 lactic acid (LA): glycolic acid (GA) copolymer ratio, was chosen as delivery system. Our studies have shown that in PBS it undergoes two simultaneous degradation processes, hydrolysis and autohydrolysis, degrading completely in about 40 days. The release of the active principle is determined by the diffusion from inside the polymer matrix to the outside, which occurs simultaneously with the erosion of the polymer, during 35 days.

我们的研究目标是为具有各种特性(预防和治疗骨病、抗肿瘤、抗炎、抗氧化)的治疗药物开发长效给药系统,以确保活性成分的持续治疗水平高于最低抑制浓度,并且在很长一段时间内不会达到毒性水平,从而替代传统的给药途径。我们选择了聚乳酸-乙醇酸(PLGA)作为给药系统,PLGA 是一种可生物降解、生物相容性好的合成聚合物,经美国食品及药物管理局批准,其乳酸(LA)与乙醇酸(GA)的共聚物比例为 65:35。我们的研究表明,它在 PBS 中会同时经历水解和自动水解两个降解过程,在大约 40 天内完全降解。活性成分的释放取决于聚合物基质内部向外部的扩散,这种扩散与聚合物的侵蚀同时发生,历时 35 天。
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引用次数: 0
Acute Toxicity by Salvia Officinalis: A Rare Cause of Intestinal Sub-Occlusion. 丹参的急性毒性:一种罕见的肠道下闭塞病因。
Pub Date : 2023-07-01 Epub Date: 2023-09-30 DOI: 10.12865/CHSJ.49.03.17
Alessandro Rapino, Giovanna Ceccuzzi, Benedetta Perna, Roberto DE Giorgio, Matteo Guarino

Salvia officinalis is a perennial plant commonly used in culinary and medical preparations. Its large intake is usually related to psychiatric disorders (such as pica) and might induce different symptoms (e.g. vomiting, nausea, diarrhoea, salivation, arterial hypertension, tachycardia, vertigo, flushes, cyanosis and convulsions) likely ascribable to pro-cholinergic effects of various constituents. The identification of this toxicity is challenging because of its rarity and possible underlying psychiatric comorbidities. Herein we describe the case of a schizophrenic 56-year-old male admitted to the Emergency Department for abdominal pain and diarrhea resulted in a rare case of acute toxicity by Salvia officinalis.

丹参是一种多年生植物,常用于烹饪和医疗制剂。大量摄入丹参通常与精神疾病(如胃食欲减退)有关,并可能诱发不同症状(如呕吐、恶心、腹泻、流涎、动脉高压、心动过速、眩晕、潮红、发绀和抽搐),这可能与各种成分的促胆碱能效应有关。由于其罕见性和可能的潜在精神并发症,识别这种毒性具有挑战性。在此,我们描述了一例因腹痛和腹泻而被急诊科收治的 56 岁男性精神分裂症患者的病例,该病例是丹参急性中毒的罕见病例。
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引用次数: 0
Hydrocephalus Resolution with Third Ventriculostomy with Floor Stenting: Technical Note and Literature Review. 第三脑室造口术加底部支架治疗脑积水:技术说明和文献综述。
Pub Date : 2023-07-01 Epub Date: 2023-09-30 DOI: 10.12865/CHSJ.49.03.19
José Ricardo Vanzin, Artur Eduardo Martio, Moema Nene Santos, Nerio Dutra Azambuja, Octávio Ruschel Karam, Luciano Bambini Manzato

Introduction: The management of refractory obstructive hydrocephalus is a paramount neurosurgical challenge. The endoscopic third ventriculostomy (ETV) has been accepted as the procedure of choice for obstructive hydrocephalus, depending on the presence of certain risk factors, such as intracranial infections, young age, previous shunt failure and distorted anatomy of the ventricular floor, that predispose occlusion or obstruction of the CSF outflow through the stoma.

Case report: A 20-year-old man with obstructive hydrocephalus due to primary aqueductal stenosis performed several neurosurgical procedures, including two previous ETV, without long term resolution. We performed another ETV, with stent placement at the stoma to prevent occlusion. After 25 months of asymptomatic follow-up, the patient presented with an enlarged fourth ventricle, and a new neuroendoscopic procedure showed a patent stoma and a well-placed stent.

Discussion: Stent placement on the third ventricular floor was already reported 19 times in the literature. Its success rate is about 94,7%, and complications happened in 2 cases, with functional impaired in only one of them.

Conclusion: Third ventriculostomy with floor stenting proved to be an effective procedure in our case of complex hydrocephalus. It is a viable option in cases where there is a greater chance of stoma occlusion.

导言:治疗难治性梗阻性脑积水是神经外科面临的一项重大挑战。内镜下第三脑室造口术(ETV)已被公认为治疗梗阻性脑积水的首选手术,这取决于是否存在某些风险因素,如颅内感染、年轻、既往分流失败和脑室底部解剖结构扭曲,这些因素容易导致通过造口流出的 CSF 堵塞或阻塞:病例报告:一名 20 岁男子因原发性导水管狭窄而患有梗阻性脑积水,曾进行过多次神经外科手术,包括之前的两次 ETV,但均未获长期缓解。我们又进行了一次 ETV,并在造口处放置了支架以防止闭塞。无症状随访25个月后,患者出现第四脑室扩大,新的神经内镜手术显示造口通畅,支架放置良好:讨论:在第三脑室底部放置支架在文献中已有19次报道。其成功率约为 94.7%,2 例出现并发症,其中只有 1 例功能受损:结论:在我们的复杂性脑积水病例中,第三脑室底支架植入术被证明是一种有效的手术。对于造口闭塞几率较大的病例,这是一种可行的选择。
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引用次数: 0
Genomic Profiling - A Need for Clinical Decision? -Case Reports. 基因组剖析--临床决策的需要?-案例报告。
Pub Date : 2023-07-01 Epub Date: 2023-09-30 DOI: 10.12865/CHSJ.49.03.22
Ana-Maria Ciurea, Michael Schenker, Cristina Mihaela Ciofiac, Liliana Streba, Ramona Schenker, Costin Teodor Streba

Cancer is still an important health issue worldwide due to increased incidence and mortality. Personalized medicine is the future of cancer treatment. Development in technology improved technical skills in DNA/RNA sequencing. NGS technology in solid-tumor samples can describe DNA or RNA analysis by including the entire genome to detect clinical relevant mutations. Genetic results may be considered having a dynamic impact because of heterogenous molecular alterations depending of time and treatment influence. We conducted a retrospective study of all NGS tests made in the last five years for the patients from 'Sf. Nectarie' Oncology Center, Craiova, Romania. We selected three relevant clinical cases where NGS analysis was performed and the results changed the perspective of the clinical decision. Our aim is to evaluate the importance of NGS results in clinical approach. Although medicine known an important development during the last decades, only a few patients can benefit of advanced personalized treatments. It is still hard to identify the alterations or gene mutations because of genetic tests are not easily available and only a small proportion of patients carries genetic alterations.

由于癌症发病率和死亡率的上升,癌症仍然是全球重要的健康问题。个性化医疗是癌症治疗的未来。技术的发展提高了 DNA/RNA 测序的技术能力。实体瘤样本中的 NGS 技术可以描述 DNA 或 RNA 分析,包括整个基因组,以检测与临床相关的突变。由于分子改变的异质性取决于时间和治疗的影响,因此基因结果可被视为具有动态影响。我们对过去五年中 "Sf.Nectarie "肿瘤中心(罗马尼亚克拉约瓦)的患者进行的所有 NGS 检测。我们选择了三个相关的临床病例,在这些病例中进行了 NGS 分析,结果改变了临床决策的观点。我们的目的是评估 NGS 结果在临床方法中的重要性。尽管医学在过去几十年中取得了重大发展,但只有少数患者能从先进的个性化治疗中获益。由于基因检测不容易获得,而且只有一小部分患者携带基因改变,因此仍然很难确定基因改变或基因突变。
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引用次数: 0
Zinc-Boron Complex-Based Dietary Supplements for Longevity and Healthy Life. 基于锌硼复合物的膳食补充剂,促进长寿和健康生活。
Pub Date : 2023-07-01 Epub Date: 2023-09-30 DOI: 10.12865/CHSJ.49.03.10
Andrei Biţă, Ion Romulus Scorei, Tudor Adrian Bălşeanu, Gabriela Rău, Maria Viorica Ciocîlteu, George Dan Mogoşanu

The nutritional role of zinc (Zn) and boron (B) in the plant-animal-human food chain is highly topical worldwide research. Our data indicated that Zn-B complex (ZBC)-based dietary supplements can be used as stable non-toxic formulations, with high intestinal absorption rate, inducing alpha2-macroglobulin (A2M) expression for longevity and healthy life. ZBC is metabolized by hydrolysis, mainly at the absorption site (intestinal level), and most of it is excreted in the urine. Within seven hours from the administration in mice, almost the entire amount of orally absorbed ZBC is eliminated in a metabolized form. The highest amount of A2M protein in mouse liver was determined by immunoabsorbance assay in the chronic experiment (1000mg/kg of ZBC), followed by the subchronic experiment (at the same dose of ZBC), and by the acute experiment (5000mg/kg of ZBC).

锌(Zn)和硼(B)在植物-动物-人类食物链中的营养作用是全球研究的热点。我们的数据表明,以锌-硼复合物(ZBC)为基础的膳食补充剂可用作稳定无毒的制剂,具有较高的肠道吸收率,可诱导α2-巨球蛋白(A2M)的表达,从而促进健康长寿。ZBC 主要在吸收部位(肠道水平)水解代谢,大部分随尿液排出体外。小鼠在服药后 7 小时内,口服吸收的 ZBC 几乎全部以代谢形式排出体外。通过免疫吸附测定,小鼠肝脏中的 A2M 蛋白含量最高的是慢性实验(每千克 ZBC 含量为 1000 毫克),其次是亚慢性实验(ZBC 剂量相同)和急性实验(每千克 ZBC 含量为 5000 毫克)。
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引用次数: 0
Retrospective Study of a Patient with Multiple de Novo Skin Tumor Formations. 对一名多发性皮肤肿瘤患者的回顾性研究
Pub Date : 2023-07-01 Epub Date: 2023-09-30 DOI: 10.12865/CHSJ.49.03.18
Radu-Florin Fruntealată, Tudor Adrian Balseanu, Oliviu Nica, Alina Andreea Negrila, Ilaria Lorena Petrovici, Elena Alexandra Marinescu, George-Alin Stoica, Maria Stoica, Ana-Maria Ciurea, Marius-Eugen Ciurea

In Romania, the incidence of malignant melanocytic tumors is continuously increasing. According to the World Health Organization, the incidence of melanocytic and non-melanocytic skin neoplasms has increased considerably and globally, in the last decade. We present the case of a 49-year-old patient who, over the course of 7 years, came in the Plastic Surgery Clinic of the Emergency County Hospital of Craiova for the excision of a number of 25 skin tumor formations, located on the face, cervical region, trunk and upper limbs. Treatment included complete microsurgical excision and supervision. In the end, the patient's treatment compliance decreased significantly.

在罗马尼亚,恶性黑色素细胞肿瘤的发病率持续上升。根据世界卫生组织的数据,在过去十年中,全球黑色素细胞和非黑色素细胞皮肤肿瘤的发病率大幅上升。我们介绍的病例是一名 49 岁的患者,在 7 年时间里,他来到克拉约瓦县急诊医院整形外科诊所,要求切除面部、颈部、躯干和上肢的 25 处皮肤肿瘤。治疗包括完整的显微外科切除和监护。最终,患者的治疗依从性明显降低。
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引用次数: 0
Considerations on Patients' Quality of Life Following Hand and Forearm Trauma in the Oltenia Region. 奥尔特尼亚地区手部和前臂创伤后患者生活质量的思考。
Pub Date : 2023-04-01 Epub Date: 2023-06-30 DOI: 10.12865/CHSJ.49.02.273
Alexandra Florinda Ghițan, Victor Gheorman, Ion Udriștoiu, Marius Eugen Ciurea

Hand and forearm trauma is a significant public health concern that has notable physical, psychological, and socioeconomic implications. Understanding the variations in occurrence and characteristics of injuries across different regions is crucial for effective implementation of preventive measures, management strategies, and resource allocation. The study involved 86 cases, with a range of ages from 18 to 70 years old. The participant group consisted of 11 females and 75 males. A series of clinical parameters were analyzed, including gender, age, environment, and cause of trauma. The study requested that participants provide information regarding if they reintegrated into their professional lives and complete the WHOQOL-BREF assessment, which is a tool used to evaluate quality of life. The current investigation has determined that the primary etiologies for hand and forearm injuries are crush and sharp cuts. The results of the investigation indicate a noteworthy association among Age and Cause, Gender and Age, Age and Professional reintegration, as well as between WHOQOL-BREF scores and different parameters. The procurement of epidemiological data plays a crucial role in broadening our comprehension of acute hand and forearm injuries in the Oltenia region.

手和前臂创伤是一个重要的公共卫生问题,具有显著的生理、心理和社会经济影响。了解不同地区伤害发生率和特征的差异对于有效实施预防措施、管理策略和资源分配至关重要。这项研究涉及86例病例,年龄从18岁到70岁不等。参与者组由11名女性和75名男性组成。分析了一系列临床参数,包括性别、年龄、环境和创伤原因。该研究要求参与者提供有关他们是否重新融入职业生活的信息,并完成WHOQOL-BREF评估,这是一种用于评估生活质量的工具。目前的调查已经确定,手部和前臂受伤的主要原因是挤压和尖锐割伤。调查结果表明,年龄与原因、性别与年龄、年龄与职业重新融合以及WHOQOL-BREF评分与不同参数之间存在显著关联。流行病学数据的获取在扩大我们对奥尔特尼亚地区急性手部和前臂损伤的理解方面发挥着至关重要的作用。
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引用次数: 0
Investigating the Neuroprotective and Neuroregenerative Effect of Trazodone Regarding Behavioral Recovery in a BL6C57 Mice Stroke Model. 在BL6C57小鼠卒中模型中研究曲唑酮对行为恢复的神经保护和神经再生作用。
Pub Date : 2023-04-01 Epub Date: 2023-06-30 DOI: 10.12865/CHSJ.49.02.210
Ianis Kevyn Stefan Boboc, Alina Catalina Chirea, Victor Gheorman, Andrei Gresita, Tudor-Adrian Balseanu, Bogdan Catalin, Daniela Calina

Stroke is a major cause of death and disability worldwide. Between 1990 and 2010, its global burden increased notably with reference to the absolute number of incident events, number of deaths, and disability-adjusted life-years lost. Trazodone is a triazolopyridine derivative that was approved for more than 40 years as monotherapy or in combination with other antidepressant drugs for the treatment of major depressive disorder in adult patients. The aim was investigated if trazodone can improve behavioural outcome after stroke in a mice model of middle cerebral artery occlusion (MCAo) due to the potential neuroprotective and neurodegenerative effects by using three behavioural tests: adhesive tape test, beam test and hole board test. Trazodone administration show modest improvements regarding the motor-sensorial function after stroke especially in the acute post-stroke phase in aged and young animals. The antidepressant effect of the drug was observed in the post-stroke period in aged animals and to a lesser extent in young animals. Future research is needed to evaluate the effects of trazodone at the cellular level to be sure that it has no benefit in stroke patients who do not suffer from depression.

中风是全世界死亡和致残的主要原因。1990年至2010年间,就事故事件的绝对数量、死亡人数和残疾调整后的生命损失年数而言,其全球负担显著增加。曲唑酮是一种三唑并吡啶衍生物,40多年来一直被批准作为单一疗法或与其他抗抑郁药物联合治疗成年患者的严重抑郁障碍。通过使用三种行为测试:胶带测试、光束测试和孔板测试,研究曲唑酮是否可以改善大脑中动脉闭塞(MCAo)小鼠模型中风后的行为结果,因为它具有潜在的神经保护和神经退行性作用。曲唑酮给药在中风后运动感觉功能方面显示出适度的改善,尤其是在老年和年轻动物的急性中风后阶段。该药物的抗抑郁作用在老年动物的中风后阶段观察到,在年轻动物中观察到的程度较小。未来的研究需要在细胞水平上评估曲唑酮的作用,以确保它对没有抑郁症的中风患者没有益处。
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引用次数: 0
Clinical Evaluation of Periodontal Status and IL-6 Gingival Fluid Level in Patients with Sjogren's Syndrome. 干燥综合征患者牙周状况和IL-6龈液水平的临床评价。
Pub Date : 2023-04-01 Epub Date: 2023-06-30 DOI: 10.12865/CHSJ.49.02.163
Dorin Nicolae Gheorghe, Dora Maria Popescu, Stefan Cristian Dinescu, Mihail Virgil Boldeanu, Petra Surlin, Florentin Vreju, Paulina Lucia Ciurea

The objective of the cross-sectional study was to assess periodontal and implant health condition among individuals diagnosed with Sjogren's Syndrome (SS), taking into account the clinical circumstances associated with this patient population. The clinical parameters employed to evaluate the periodontal status of both natural teeth and implants included: periodontal probing depth (PPD) measured at six sites per tooth/implant, clinical attachment level (CAL), bleeding on probing index (BOP), plaque index (PLQ). Gingival crevicular fluid samples were collected for interleukin-16 level evaluation. After clinical and immunological assessment of the study and control groups, the data was centralized, compiled and submitted for statistical analysis. In all four types of assessed periodontal parameters, there were statistically significant differences between the SS patients with no dental implants and the other test (SSi) and control groups (Cni and Ci). Nevertheless, in SS patients with dental implants, plaque levels were similar to that of controls. In addition, other periodontal parameters (PPD, BOP and CAL) were similar in SS patients with dental implants and controls, with no statistically significant difference. The highest GCF IL-6 levels were found in SS patients with no dental implants, the differences to the other study and control groups being statistically significant. In patients with SS and dental implants, there were no statistically significant differences to the other groups. Individuals diagnosed with Sjogren's Syndrome (SS) exhibit a less favorable periodontal condition compared to controls without SS. Notably, SS patients who undergo dental implant procedures demonstrate an improvement in their periodontal status. This highlights the importance of proactive and ongoing dental and periodontal surveillance for SS patients, aiming to decrease the risk of developing periodontal diseases.

横断面研究的目的是评估被诊断为干燥综合征(SS)的个体的牙周和种植体健康状况,同时考虑与该患者群体相关的临床情况。用于评估天然牙齿和种植体牙周状况的临床参数包括:在每个牙齿/种植体的六个部位测量的牙周探测深度(PPD)、临床附着水平(CAL)、探测出血指数(BOP)、斑块指数(PLQ)。收集牙缝液样本进行白细胞介素-16水平评估。在对研究组和对照组进行临床和免疫学评估后,对数据进行集中、汇编并提交统计分析。在所有四种类型的评估牙周参数中,没有种植牙的SS患者与其他测试组(SSi)和对照组(Cni和Ci)之间存在统计学显著差异。然而,在种植牙的SS患者中,斑块水平与对照组相似。此外,种植牙的SS患者和对照组的其他牙周参数(PPD、BOP和CAL)相似,无统计学显著差异。在没有种植牙的SS患者中发现了最高的GCF-IL-6水平,与其他研究组和对照组的差异具有统计学意义。在SS和种植牙的患者中,与其他组相比没有统计学上的显著差异。与没有干燥综合征的对照组相比,被诊断为干燥综合征(SS)的个体表现出较差的牙周状况。值得注意的是,接受牙种植手术的SS患者的牙周状况有所改善。这突出了对SS患者进行积极和持续的牙齿和牙周监测的重要性,旨在降低患牙周病的风险。
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引用次数: 0
The Prevalent Cases of Endometrial Carcinoma in Different Life Periods of Women-Clinical and Histopathological Diagnosis. 不同生命周期妇女子宫内膜癌的临床和组织病理诊断。
Pub Date : 2023-04-01 Epub Date: 2023-06-30 DOI: 10.12865/CHSJ.49.02.151
Hajrullah Latifi, Astrit M Gashi, Drilon Latifi

Abnormal uterine bleeding is a term used to describe any irregular bleeding from the uterus that is not part of a woman's normal menstrual cycle and can happen during different life periods. Abnormal uterine bleeding can have structural etiologies (polyp, adenomyosis, leiomyoma, malignancy) or nonstructural etiologies (coagulopathy, ovulatory dysfunction, and not-classified). The post- and pre-menopausal period requires a detailed investigation to establish the etiology of the bleeding because the chances that the woman has a malignancy are plentiful in this period. The treatment plan is determined based on the underlying cause of the bleeding. The main objective of this paper was to determine the prevalence of endometrial carcinoma in different periods, focusing on the postmenopausal period. This research was a cross-sectional study and included 79 cases of abnormal uterine bleeding in different periods of women's lives. Our study found that abnormal uterine bleeding occurs more frequently during the premenopausal period (59%) and that the causes of irregular bleeding during this period were mainly benign. Our study focused on the postmenopausal period, where we found that 32.9% of irregular uterine bleeding occurs during this period, and the leading causes were malignant pathologies (83.3%), mainly endometrial adenocarcinomas. The average age was 66.7 years. During the study, it was observed that 50% of women with abnormal uterine bleeding due to malignancy were classified as overweight, 25% were obese, and 25% had normal weight. It was confirmed that obesity is a co-factor of malignancy in the postmenopausal period, and the pathophysiological mechanism is well understood now. Our study also found a high number of co-morbidities among women with abnormal uterine bleeding due to malignancy. We came to the conclusion that any abnormal uterine bleeding should be initially investigated in a multidisciplinary manner, an accurate diagnosis should be determined, and then a treatment plan should be established. The treatment strategy should be determined depending on the cause of abnormal bleeding.

异常子宫出血是一个术语,用于描述子宫中的任何不规则出血,这些出血不是女性正常月经周期的一部分,可能发生在不同的生命周期。异常子宫出血可能有结构性病因(息肉、子宫腺肌病、平滑肌瘤、恶性肿瘤)或非结构性病因(凝血障碍、排卵功能障碍,未分类)。绝经后和绝经前需要进行详细的调查,以确定出血的病因,因为在这个时期,女性患恶性肿瘤的可能性很大。治疗方案是根据出血的根本原因确定的。本文的主要目的是确定子宫内膜癌在不同时期的患病率,重点是绝经后时期。这项研究是一项横断面研究,包括女性生命中不同时期的79例异常子宫出血。我们的研究发现,异常子宫出血在绝经前时期发生得更频繁(59%),而这一时期不规则出血的原因主要是良性的。我们的研究集中在绝经后时期,发现32.9%的不规则子宫出血发生在这一时期,主要原因是恶性病变(83.3%),主要是子宫内膜腺癌。平均年龄66.7岁。在研究过程中,观察到50%因恶性肿瘤导致异常子宫出血的女性被归类为超重,25%为肥胖,25%为正常体重。已证实肥胖是绝经后恶性肿瘤的共同因素,其病理生理机制目前已得到很好的了解。我们的研究还发现,恶性肿瘤导致异常子宫出血的女性中有大量合并症。我们得出的结论是,任何异常子宫出血都应该以多学科的方式进行初步调查,确定准确的诊断,然后制定治疗计划。应根据异常出血的原因确定治疗策略。
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引用次数: 0
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