Sumar Lucrari Marisiensis

BASIC MEDICAL SCIENCES
STATISTICAL DATE ON HYGIENIC AND DIETETIC FACTORS THAT MODIFY THE

EVOLUTION OF PHYSIOLOGICAL AGEING ON THE UPPER RESPIRATORY TRACT
MUCOUSES.
Goanta Cristina-Maria1, Mihalcea R G1, Zagrean L1, Buga Alina Alexandra1
1
UMF Carol Davila Bucureti
Background: Current studies show that about 1/3 of the adult population smokes world wide. Some studies from
western Europe show that 37% of children live in houses that adults smoke in. Passive smokers have a 25-30%
higher risk to develop cardiovascular diseases and a 20-35% higer rick to develop lung cancer. Most studies
investigate effects smoking has on the lungs ignoring harmful effects it has on the oropharyngeal and laryngeal
mucosa, although the nose and the larynx are most exposed. Also many people that develop an ENT pathology
work in polluted areas and a chronic alcohol users. Objective: This study tries to associate the usual hygienic and
dietetic factors (smoking, alcohol consumption, work pollution, food type ) and the ENT pathology. Material and
methods: We evaluate a number of 130 aging patients with different ENT pathology with a questionnaire that
contained a series of questions about their lifestyle and statistical analyzed the data."Thiswork received financial
support through the project entitled "CERO " Career profile: Romanian Researcher", grant
numberPOSDRU/159/1.5/S/135760, cofinanced by the European Social Fund for Sectoral Operational Programme
Human Resources Development 2007-2013". Results: The study revealed important correlations between
statistical data and ENT pathology.92% of the patients were/are smokers, 87% work/used to work in polluted
environment (will be detailed in the full paper) and 88% were/are alcoho users. Conclusions: Hygienic and
dietetic factors are very important in the development of ENT pathology. Also, this pathology appears at a younger
age in patients that don't have a healthy lifestyle.
Keywords: smoking, alcohol, pollution, diet
HISTOPATHOLOGICAL DIAGNOSIS OF BLADDER UROTHELIAL CARCINOMA ON

TRANSURETHRAL RESECTION SPECIMENS
Catalin C1, Vacariu V1, Muresan D1, Badaluta C D1, Borda Angela1, Loghin Andrada1
1
UMF Trgu Mure
Background: Bladder cancer comprises a large spectrum of tumors. Some behave in a relatively benign fashion
and others are highly aggressive and lead rapidly to metastatic disease and death. Most bladder cancer are
urothelial carcinomas (UCs), other types include squamous cell carcinoma and adenocarcinoma. Objective: The
aim of our study was to evaluate the UCs diagnosed on the transurethral resection (TUR-V) specimens in our
Pathology Department over a 5 year period. Material and methods: We included in our study all the patients with
a TUR-V performed in the Urology Department and examined in the Pathology Department of Tirgu Mures
Emergency County Hospital between January 2010 and December 2014. For each patient we recorded the
following data: age, gender, histopathological diagnosis and in cases of UC, the histological variant. Results: From
the total number of 1454 cases analyzed, a diagnosis of UC was established in X cases, including only papillary
UC (25%), papillary and infiltrative UC (17.8%) and only infiltrative UC (17%). We observed a male predominance
(81 %), with only 18 % female patients. The average age of the subjects was 67 years old, ranging from 18 to 90.
Regarding the pathological stage, the majority of tumors with both exophytic and infiltrative component were in at
least pT1 or pT2 stage. Most of infiltrative UC without exophytic component were in pT2 stage. Other rare bladder
tumors represented 3.1 % of cases (adenocarcinoma, neuro-endocrine carcinoma etc), while benign lesions, the
most common cystitis, were found in 21.6 % cases. Conclusions: Histopahological diagnosis on TUR-V
specimens can establish a correct and complete diagnosis of UC (including the histologic variant and the
pathological stage), in order to allow subsequent therapeutic options.
Keywords: TUR-V, BLADDER, UROTHELIAL, CARCINOMA
CLINICOPATHOLOGIC ANALYSIS OF DEATH CAUSED BY PULMONARY EMBOLISM. A

RETROSPECTIVE AUTOPSY STUDY
POP MARIA CRISTINA1, Simon Melania Renata1, Stana Anemona Madalina1, Jung I1, Gurzu Simona1
1
UMF Trgu Mure
Background: Pulmonary embolism is one of the causes of sudden cardiac death which is very difficult to be
diagnosed due to nonspecific symptoms. Objective: In this retrospective study, we analyzed the incidence and
particular features of the pulmonary embolism in an autopsy material, consistent or inconsistent with the clinical
diagnosis. Material and methods: From 2009 to 2013 the autopsy data were collected from the archival section of
Department of Pathology of Emergency County Hospital of Tirgu-Mures, Romania. Results: From the 1130
autopsies performed in a period of 5 years, a total of 71 patients died as result of pulmonary embolism. They were
hospitalized in several units including Intensive Care Unit (n=16), Internal medicine departments (n=5), Cardiology
clinics (n=2), Nephrology (n=2), Orthopedics (n=2), and Pediatrics (n=1); in the remaining 43 cases, the patients
were admitted at SMURD and died below 24 hours after admission. Out of 71 patients, 30 males (42.25%), and 41
females (57.75%) aged between 1 month and 90 years old were included. Most of the patients 45 years were
males (M:F=9:5) while women mainly died as result of pulmonary embolism >45 years old (21 males and 36
females). Deep leg vein thrombosis was identified as the starting point in 19.72% of the cases (n=14). Regarding
the concordance between clinical and post-mortem diagnosis, 20 cases were concordant (28.16%) and 32 cases
have not been clinically diagnosed (45.07%). In the remaining 19 cases (26.76%) the clinical diagnosis was
partially consistent, since pulmonary embolism occurred as a complication of the primary disease. Conclusions:
The estrogen protection in women of childbearing age could explain the low prevalence of pulmonary embolism in
young females that do not use contraceptive pills. Pulmonary embolism remains one of the main causes of death
in hospitals with a significant rate of undiagnosed cases.
Keywords: pulmonary embolism, autopsy, diagnosis
PARENTS ATTITUDE AND KNOWLEDGE REGARDING ANTIBIOTIC USE ON THEIR

CHILDREN
Techere Alexandra1, Oprea V A1, Tatarici Andreea1, Tudor Bianca1, Toma Felicia1
1
UMF Trgu Mure
Background: Although multiple studies concerning antibiotic prescription habits of medical practitioners have
been conducted recently, parents beliefs and behaviors about the antibiotics used by their children still represent a
subject that hasn been explored enough in the field of medical studies. Since the first contact of the sick children
is with their parents, it is this attitude which the future medical healthcare and the healing of their children really
depend on. Objective: The aim of this study is to evaluate the level of knowledge, beliefs and habits of parents,
concerning the antibiotics which their children use. Material and methods: We have conducted a descriptive
cross-sectional study in two kindergartens from Trgu-Mure. Thus, questionnaires were distributed to parents,
having obtained their written agreement. Results: From 130 distributed questionnaires, response rate was 70%
and the final group included 90 subjects. 88,76% of them are from urban areas and 60,67% have more than one
child. On the other hand, 29,22% mentioned that the antibiotics must be administrated in viral infections, 43,83%
have stopped the antibiotic treatment because of their sides effects, 59,55% consider that doctors do not give
complete information about sides effects and only 9% started an antibiotic treatment without medical prescription.
Conclusions: The parents answers suggest their concern about antibiotics overuse.
Keywords: antibiotics, children, parents behavior
RADICAL CYSTECTOMY: SAMPLING TECHNIQUE AND ASSESSMENT OF PROGNOSTIC

FACTORS
Vacariu V1, Halaiu V B1, COSMA C1, Borda Angela1, Loghin Andrada1
1
UMF Trgu Mure
Background: Bladder cancer is the most common malignancy involving the urinary system, urothelial carcinoma
(UC) being the predominant histologic type. The diagnosis is established by transurethral resection (TUR-V) and
for infiltrative pT2 UC radical cystectomy is the recommended treatment. Objective: The aim of our study was to
present the sampling technique and the assessment of prognostic factors of radical cystectomy specimens
examined in our Pathology Department and to compare these findings with the TUR-V data in patients where
these data were available. Material and methods: We analyzed all the radical cystectomies performed in the
Urology Department and examined in the Pathology Department of Mures Emergency County Hospital between
January 2011 and December 2014. The following data were recorded: histopathological diagnosis, pathological
stage, presence of CIS and lymph node metastasis if present. The available TUR-V specimens were reanalyzed.
Results: From 34 radical cystectomy specimens examined, the majority (19 cases) were conventional UC, (9
infiltrative and 10 papillary tumors), 4 cases were micropapillary variant of UC and 2 cases had squamous
differentiation. The remaining cases were rare variants of UC (UC with giant cells, plasmacytoid variant of UC,
undifferentiated UC with giant cells). Regarding the pathological stage, we found one pTa, 2 pT1, 12 pT2, 11 pT3
and 8 pT4 tumors. Carcinoma in situ (CIS) was present associated with the infiltrative tumors in 16 cases. 12
cases presented lymph nodes metastasis. In 17 cases with available TUR-V, we found infiltrative pT2 UC or an
aggressive variant of UC. Conclusions: A correct examination of radical cystectomy specimen allows the
assessment of prognostic factors (histopathologic type, pathologic stage, presence of lymph node metastases),
which are important in the decision of further adjuvant therapy.
Keywords: Radical Cystectomy, TUR-V, Urothelial Carcinoma, Micropapillary variant of urothelial carcinoma
EVALUATION AND STANDARDIZATION OF A DNA EXTRACTION AND PURIFICATION

PROTOCOL FROM FORMALIN-FIXED, PARAFFIN-EMBEDDED TISSUE
Vacariu V1, Nechifor Boil Adela1, Borda Angela1
1
UMF Trgu Mure
Background: Nowadays, formalin-fixed, paraffin-embedded tissue (FFPET) does not only represent the classical
frame for tissue preservation and microscopical analysis, but also a reliable source for DNA sample assessment.
However, extracting an adequate DNA sample from FFPET remains a problematic issue. Objective: The aim of
our research was to set up a reliable DNA extraction protocol from FFPET in our laboratory and then to apply it to
a series of papillary thyroid microcarcinoma (PTMS) cases. Material and methods: Four cases, including three
papillary thyroid carcinomas and one block of normal thyroid tissue, were selected from the Department of
Pathology, Tirgu-Mure Emergency County Hospital archive to set up the DNA extraction protocol that was further
applied to 25 PTMCs. The DNA extraction protocol was based on a precipitation method (Master Pure DNA
purification kit, Epicentre), in accordance to the manufacturer instructions. A spectophotometer was used to
determine the concentration and purity (A260/A280 ratio) of the isolated DNA. Results: We successfully isolated
good quantity DNA from all our 25 PTMC cases (mean concentration: 147.477.8 ng/l; mean A260/A280 ratio:
1.630.1). The storage period of the tumor block did not influenced the DNA quantity (136.373.2, 127.655.5,
142.76, 204.5123.3 ng/l for tumor blocks stored for 1, 2, 3 and 4 years, respectively), nor did the size of the
tumor (123.449 ng/l in tumors sized 5 mm, compared to 149.271.4 ng/l in tumors sized 10 mm). Conclusions:
We validated an efficient, reproducible DNA extraction protocol from FFPET in our laboratory. Our technique
provided a good range of DNA concentrations and purity, offering new perspectives for further molecular analysis.
Acknowledgements: This paper was published under the frame of European Social Found, Human Resources
Development Operational Programme 2007-2013, project no. POSDRU/159/1.5/S/136893.
Keywords: Formalin-Fixed, Paraffin-Embedded Tissue, DNA extraction and purification protocol, Papillary thyroid
microcarcinoma
TYPE 1 DIABETIC RATS REPLICATE THE MOST COMMON BIOCHEMICAL AND

HEMATOLOGICAL FEATURES OF HUMAN DIABETES
Vntu Adriana1, Gherescu Doina1, Fic P1, Mrginean Alina 1, Dobreanu D1, Scridon Alina1
1
UMF Trgu Mure
Background: Studies on animal models are crucial for clarifying the pathogenesis and progression of diabetes
mellitus (DM), a complex metabolic disease associated with significant long-term complications. Objective: Our
study aimed to assess the most relevant biological changes occurring in rats with streptozotocin (STZ)-induced
type 1 DM over the long-term. Material and methods: Six-week-old male Wistar rats were randomly assigned to
control (n=14) or DM (n=17) groups. DM was induced using STZ (60 mg/kg, i.p.). All animals were monitored daily
up to 38 weeks of age. At the end of the study, non-fasting plasma glucose, total cholesterol, triglycerides, and
creatinine levels were measured. Complete blood count was also performed in all studied rats. Results: Diabetic
rats presented higher non-fasting glucose (509.1627.44 mg/dl in diabetics vs. 117.293.25 mg/dl in controls), total
cholesterol (137.1111.01 mg/dl in diabetics vs. 87.853.39 mg/dl in controls), and triglycerides (426.1968.62
mg/dl in diabetics vs. 68.597.43 mg/dl in controls) than controls (all p<0.001). Leukocyte count and hematocrit
were also significantly higher in diabetics compared to controls (p=0.02 and p<0.01, respectively). There was no
significant difference in plasma creatinine between the two groups (p=0.13), but creatinine clearance was
significantly lower in diabetics (1.750.11 ml/min) than in controls (2.750.10 ml/min; p<0.001). Among diabetics,
there was a significant negative correlation between glycemic levels and creatinine clearance (Spearman r= -0.68,
p<0.01), as well as between leukocyte count and uric acid values (Spearman r= -0.64, p=0.02). Conclusions:
Type 1 DM Wistar rats displayed significant hyperglycemia, hypercholesterolemia, hypertriglyceridemia, decreased
creatinine clearance, and leukocytosis over the long-term. These results support the usefulness of the STZdiabetic rat as a model that reliably replicates some of the most relevant DM-related complications, including
dyslipidemia, systemic inflammation, and kidney dysfunction.
Keywords: experimental model, type 1 diabetes mellitus, dyslipidemia, kidney dysfunction
INCIDENCE OF THYROID TUMORS IN MURE COUNTY OVER A 25 YEAR PERIOD A

RETROSPECTIVE STUDY
Vntu Adriana1, Pop Mdlina Sorina1, Halaiu V B1, Cota Ancua1, Borda Angela1
1
UMF Trgu Mure
Background: Thyroid cancer, the most common type of the endocrine neoplasms, has seen a significant surge in
incidence in recent years. Monitoring of the long-term evolution of this pathology aids to appreciate the success of
the screening processes. Objective: Our study aimed to assess the incidence of benign and malignant thyroid
tumors during the last 25 years in Mure County and to report the prevalence of different histologic types by age
and gender. Material and methods: This was a retrospective observational study that included data from 4889
surgical thyroid specimens registered in the Pathology Department of Emergency County Hospital Mure, between
1990-2014. Results: Out of the total number of cases, only 29.66% (n=1450) were benign or malignant tumors
and were further included in our analysis. The mean age of the patients was 48.610.37 years and the women to
men ratio was 6.25. Malignant tumors had a higher incidence than the benign ones (62.69% vs. 31.10%). Among
malignancies, differentiated thyroid carcinoma, including especially papillary carcinoma, was the most frequent
(86.58%, n=787). Undifferentiated (4.18%, n=38), poorly differentiated (3.53%, n=32) and medullary thyroid
carcinomas (2.86%, n=26) as well as other tumors (metastasis 0.90%, n=13; primary malignant lymphomas
0.76%, n=11; mesenchymal tumors 0.14%, n=2) were rare. All histologic types were more prevalent in patients
over 45 years old, regardless of gender. The increasing trend in the incidence of thyroid tumors was correlated
with a rising incidence of thyroid surgical specimens (Spearman r=0.70, p=0.0001 for benign and Spearman
r=0.90, p<0.0001 for malignant). Conclusions: Our study showed a rising incidence of thyroid cancer in Mure
County over the last 25 years, which is consistent with trends in other developed countries. This rise could be
attributed to a more rigorous histopathological examination and the use of new diagnostic methods, although these
are not sufficient to fully explain this phenomenon.
Keywords: thyroid cancer,, histologic types,, incidence
THE INVOLVEMENT OF AN EMOTIONAL CONFLICT IN THE DEVELOPMENT OF CANCER

Barmou Amani Diana1, Georgescu I M1, Serkedi Brigitta1, Al Hussein H1, Asmaa Barmou1, Pasca Maria Dorina1
1
UMF Trgu Mure
Background: Nowadays modern medicine chooses to separate the body from the emotional part, so we decided
to make a research to show a correlation between emotions and cancer. Objective: Our objective was to find a
link between an emotional shock and the development of cancer Material and methods: As a method of
psychological investigation we used a questionnaire which encrypted the way an emotional conflict has
implications on a patient diagnosed with cancer. Also, we identified the level of stress using Holmes and Rahe
stress scale .Every question from the questionnaire answered with "YES" had a certain number of points which
were summed at the end. The lot was formed from 51 oncologycal patients,with different types of cancer,and 51
healthy people, both males and females, with the ages between 18-80 years old. Results: In 84.32%(43) of the
oncologycal cases we could prove an emotional conflict. From those with recognized emotional conflicts,
46.51%(20) have spouse related issues(divorce ,death, abuse, illness,cheating ), 27.51%(12) have child related
issues ( death, disappointment, illness), 13.95%(6) have issues regarding first degree relatives ( mother, father,
brother, sister), 11.62%(5) have another type of issues (job related, money related, life related, anger, lack of
affection ). Also, based on our investigation tools, we determined their stress level, before and during cancer,thus
88.23% have their stress level above 300 . In the lot formed from healthy people 68.62% have an emotional
conflict but only 9.80% have their stress level above 300. Conclusions: This study is designed to prove the major
connection between an emotional conflict and the development of the disease. Also, we determined the high level
of stress in our patients lifes, everything above 300 represents a major disease risk.
Keywords: emotion, shock, cancer, stress
EVALUATING THE SEXUAL BEHAVIOR OF THE PATIENTS DIAGNOSED WITH CERVICAL

DYSPLASIA AND CERVICAL CARCINOMA
Nagy N1, Voidzan D S1
1
UMF Trgu Mure
Background: The Human Papilloma Virus (HPV) is a DNA virus capable of infecting people. There is cause "
effect relationship between the HPV infection and the development of the cervical cancer, the viral infection being
the necessary cause of the cancer, but not a sufficient cause. It is estimated that 80% of the women will acquire
HPV infection during lifetime and 50% - 75% of these will be an oncogene type. Objective: Evaluating the sexual
behaviour of the patients to identify the ways of transmission of the HPV at this population, and their knowledge
about the sexually transmitted diseases and HPV. Material and methods: The study was performed by applying a
questionnaire to the patients diagnosed with cervical dysplasia and cervical carcinoma from the Obstetrics and
Gynecology Clinic no.1 from Trgu Mure. Results: In the study 79 patients were included. Mean age: 43.01+/13,287 (minimum: 23 y.o., maximum 76 y.o.). 33.3% graduated from high school, and 29.3% from university.
50.6% live in marriage. 54.6% had their first sexual intercourse between 17 " 19 years old and 57.0% were
unprotected at their first sexual act. 81% of the patients experienced only vaginal penetration, 16.5% had multiple
types combined (vaginal, anal, oral). 54.4% had from 2 to 4 sexual partners during lifetime, 5.1% had more than 10
partners. In 48.1% of the cases the average duration of a sexual intercourse was between 10 " 20 minutes. 67.1%
heard about the HPV infection, but only 7.6% states that received treatment for it. Conclusions: More than 2 of 3
patients have high school or higher education level, and heard about the HPV infection, still their lifestyle has many
elements that represent a risk for the HPV infection and the development of cervical carcinoma. This paper was
published under the frame of European Social Found, Human Resources Development Operational Programme
2007-2013, project no. POSDRU/159/1.5/S/136893
Keywords: HPV, Cervical Cancer, Cervical Dysplasia, Sexual behaviour
RADICAL PROSTATECTOMY SAMPLING TECHNIQUE AND POST-OPERATORY

HISTOPROGNOSTIC FACTORS
Halaiu V B1, Vacariu V1, Vntu Adriana1, Loghin Andrada1, Borda Angela1
1
UMF Trgu Mure
Background: Radical prostatectomy (RP) is the first-line treatment for patients younger than 70 years diagnosed
with prostate adenocarcinoma (ADKP), with a life expectancy of over 10 years. Objective: The aim of our study is
to present the sampling technique of the RP specimen and to evaluate the post-operatory histoprognostic factors.
Material and methods: We analyzed 25 radical prostatectomies surgical specimens from the Urology Department
and examined in the Pathology Department of Emergency County Hospital Mure between January 2012 and
December 2014. After fixation in neutral formalin and painting the surface with ink, the specimens were sectioned
according to a precise protocol: the margins of the resection were sampled separately and the remaining prostate
was serially sectioned and embedded in paraffin. The histoprognostic factors evaluated were Gleason score,
anatomic stage, status of surgical margins and tumor volume. Results: The mean age of patients was 61.86.11
years. The most frequent Gleason score was 3+4=7 in 11 cases, followed by 4+3=5 in 7 cases, 4+4=8 in 4 cases
and 4+5=9 in 3 cases. Pathological staging pTNM showed a predominance of pT2c tumors in 12 cases, followed
by the pT3a stage in 8 cases, pT3b in 3 cases, pT2a and pT4 in one case each. 21 of the cases were N0, 3 were
Nx and only one case was N1. Regarding the status of surgical margins, 13 were negative, 11 were positive and
one could not be determined. It was possible to measure the tumoral volume of 21 prostatic surgical specimens;
the average tumor volume was 2.471.66 cm3. Conclusions: The study of the prostatectomy specimen allows the
evaluation of histoprognostic factors useful in assessing the risk of tumor recurrence and the necessity of adjuvant
therapy.
Keywords: radical prostatectomy,, adenocarcinoma,, histoprognostic factors.
GROWTH RATE OF STAPHYLOCOCCUS AUREUS: IS IT INCREASED IN PRESENCE OF

HUMAN HORMONES?
Feier A1, Jiga Maria Andrada1, Toma Felicia1, Man A1, Mare Anca1
1
UMF Trgu Mure
Background: It is known that some hormones exert a stimulating effect on the metabolic rate of cells in the human
body. There is little information regarding the activity of human hormones on prokaryotic cells. Objective: To
evaluate the effect of growth hormone (GH) and thyroid hormone (levothyroxine - T4) on the growth rate of
Staphylococcus aureus. Material and methods: For this study a clinical strain of S. aureus was used, identified at
genus and species level by conventional methods. Inoculum was created in sterile saline solution and adjusted at
0.5 McFarland turbidity. From this, 10 l were transferred in 3990 l of liquid broth nutrient. Three samples were
used: a control sample, a sample with addition of GH (0.05mg) and a sample with addition of T4 (20 g). From
these samples, serial dilutions were performed in sterile saline solution, from which 50 l were inoculated by
dissemination on solid medium on Petri dishes. The samples were incubated at 37C and the inoculation was
repeated hourly for five straight hours. For each sample, after 24 hours, the bacterial growth rate was examined by
evaluating the number of colony forming units/ml at 2 and 5 hours of incubation. The growth percentage difference
between the samples was calculated and growth curves were graphically represented. Results: The growth rate of
S. aureus did not varied significantly at 2 hours in the presence of GH or T4. After 5 hours of incubation, both
hormones induced a growth acceleration. The number of CFU was 25 times higher for GH and 7 times higher for
T4 compared to the moment 0. Conclusions: T4 and especially GH positively affect the growth rate of the S.
aureus strain used in this study.
Keywords: S. aureus, hormones, bacterial growth
LONG-TERM FOLLOW-UP OF TYPE 1 DIABETIC WISTAR RATS

Gherescu Doina1, Vntu Adriana1, Fic P1, PERIAN M1, Dobreanu D1, Scridon Alina1
1
UMF Trgu Mure
Background: Experimental models of type 1 diabetes mellitus (DM) are essential for elucidating the pathogenesis
of this complex metabolic disease. Despite the extensive volume of studies on diabetic rats, the evolution of this
condition over the long-term remains deficiently described. Objective: Our study aimed to provide an exhaustive
description of rats with streptozotocin (STZ)-induced type 1 DM over the long-term. Material and methods: Thirtyone 6-week-old Wistar rats were distributed to control (n=14) or DM (n=17) groups. DM was induced by injection
with STZ (60 mg/kg, i.p.) at the age of 11 weeks. If STZ failed to induce DM, the rats were reinjected with the same
STZ dose. Bodyweight, food and water intake were monitored weekly up to the age of 38. Systolic blood pressure
and heart rate were measured noninvasively in all rats. Results: The first STZ injection induced DM in 10
(58.82%) rats. A second similar dose of STZ induced DM in 5 (71.43%) of the remaining 7 rats, summing an
overall success rate of 88.24%. Only 4 deaths occurred throughout the study, all among the diabetics (23.5%).
Diabetics presented progressive, but less significant bodyweight increase than controls. Food and water intake
were significantly higher in the DM group (both p<0.001). At 38 weeks of age, there was no significant difference in
systolic blood pressures between controls and diabetics (p=0.15), but diabetics were significantly more bradycardic
(controls: 388.576.21 bpm versus diabetics: 286.4311.15 bpm, p<0.001). There was no significant difference in
any of the studied parameters between the rats that received one versus two STZ injections. Conclusions: This
study provides one of the longest follow-ups of rats with experimentally-induced type 1 DM. It is also the first to
demonstrate that STZ can be safely reinjected to animals with initial unsuccessful administration, without any
changes in their outcomes.
Keywords: experimental model,, long-term follow-up,, streptozotocin,, type 1 diabetes mellitus
MEDICAL RESEARCH: AN INTEREST, A DESIRE OR A TREND ? A CROSS-SECTIONAL

STUDY AT THE UNIVERSITY OF MEDICINE AND PHARMACY TRGU MURE, ROMNIA
Andreea Gheorghiu1, Nemes Georgiana1, Moldovan Alexandra Ramona1, Tripon F1, Maria Dorina Pasca1
1
UMF Trgu Mure
Background: We live in an era of research and our actions prove this.At our university the number of publications
increased significantly. But what is the reason behind this? Objective: Main objectives: to highlight the students'
(S) and the university staff's (US) involvement in medical research, the collaboration between them, methods for
research development and the identification of the main obstacles encountered in their work Material and
methods: Two types of questionnaires were created in a psychological manner containing between 10 to 12 items
approved by the Scientific Research Board of our university. One type was filled in by 600 S from general medicine
ranging from second to sixth year of study and the other type by 120 US members of 20 departments. Results:
Data analysis has proven that the main reason for research regarding US with 41.06% is desire,followed by
interest which has shown that 28.48% do it for academic acknowledgements, 24.5% for aggrandizement and
1.32% for financial purpose.Only 4.64% do research because it is a trend.Interest is the main reason for S to be
involved in research:69.2% for professional development, 13.57% for scholarships/prizes and 7.88% are motivated
by US. 5.32% specify that is a desire and just 4.03% of S think it is a trend. Conclusions: There is a good and
beneficial collaboration from both parts. The main obstacles encountered by US are the lack of reagents and
medical equipment. S have to face the refusal of the chosen department due to high request of researchpositionin
contrast to the few available positions. US need more grants from the university and they also require project
founding for S. According S, they need specific guidance and more workshops.Finally, in our university the main
reason regarding medical research is interest in the S case and desire in the US members case.
Keywords: Research, Students, University's staff
INCIDENCE OF PROSTATE CARCINOMA ON THE TRANSURETHRAL RESECTION OF

PROSTATE SPECIMENS
Muresan D1, Stroia Alexandra1, Catalin C1, Borda Angela1, Loghin Andrada1
1
UMF Trgu Mure
Background: The Transurethral Resection (TUR-P) is an endoscopic surgery procedure of the transitional zone of
the prostate in order to relieve moderate to severe urinary symptoms. It is well known that the main pathology of
the transition zone of the prostate is benign prostatic hyperplasia (BPH), but seldom prostate carcinoma (PCa)
may be also found on TUR-P specimens. Objective: The aim of our study was to evaluate the incidence of
prostate carcinoma (PCa) on the TUR-P specimens in our Pathology Department over a 5 year period. Material
and methods: We analyzed all the TUR-P performed in the Urology Department and examined the Pathology
Department of the Tirgu Mures Emergency County Hospital between between January 2010 and December 2014.
We recorded the histopathological diagnosis and in PCa cases the Gleason score. Results: A total number of
1095 cases were found over a 5 year period. The average age of the subjects was 70 years, ranging from 42 to
93. The histopathologic diagnosis showed that the most common diagnosis was, as expected, BPH (73.97%),
followed by PCa (184 cases -16.8%) and other diseases, such as basal cell hyperplasia, prostatitis and adenosis
(9.23%).The majority of PCa (106 cases) were high grade tumors, with a Gleason score 8, 66 cases were well
differentiated tumors with a Gleason score 7, and 17 cases were PCa after hormonal or radiotherapy.
Conclusions: Even if the transition zone of the prostate is mainly interested by BPH, PCa can also be found on
the TUR-P specimens. These tumors have the origin in the transitional zone and in these cases they are well
differentiated tumors, or can infiltrate it from the peripheral zone, and these are often big tumors, with high Gleason
score.
Keywords: TUR-P, Prostate, Prostate Adenocarcinoma
INFECTIOUS RISK ASSESSMENT IN MANEUVERS PERFORMED BY MANICURIST AND

PEDICURIST
Tatarici Andreea1, Techere Alexandra1, Ruta Florina Daniela1, Tudor Bianca1, Tudor Bianca1
1
UMF Trgu Mure
Background: There is a general consensus that infections are transmitted through parenteral ways. The danger of
transmission of viral, bacterial and fungal infections represent an important element which we should think about
when we want a manicure and pedicure treatment. Objective: The purpose of this investigation was to determine
the degree of risk for the accidental exposure to infectious agents and to verify the application of the bio-safety
standards in the routine activity of the manicurists and/or the pedicurist located in Trgu Mure. Material and
methods: I performed a descriptive, cross-sectional study which included 50 manicurists and/or pedicurists
which worked in beauty salons. I gave out a fill-out form to a number of 60 persons. The response rate was 83%.
I obtained the informed consent of each person which participated at the study.
Results: The information
regarding the professional bio-safety standards have been adequate, 62% are using hand gloves while making the
professional treatments, 62% are washing their hands before and after they remove their gloves, 100% perform
the sterilization of the working equipment after each treatment. Conclusions: The study has revealed the standard
of knowledge of the beauty-salons staff, the medical education being obligatory/mandatory in the training courses
of these employees, both for their owns safety and to prevent the spread of infections among customers.
Keywords: infections, manicure, pedicure
IN VITRO ANTIFUNGAL ACTIVITY OF VORICONAZOLE AND FLUCONAZOLE AGAINST

CANDIDA SPP. ISOLATED FROM ORAL FLUID
Tatarici Andreea1, Runcan R S1, Toma Felicia1, Mare Anca1
1
UMF Trgu Mure
Background: The incidence of fungal infections is increasing all over the world. Antifungal treatments are often
10
used even as prophylactic treatment, to prevent the development of fungal infections. This may lead to the
selection of resistant strains. Objective: Evaluation of fluconazole and voriconazole susceptibility of Candida spp.
isolated from the oral fluid of adults with dermatological pathology. Material and methods: A prospective study
was conducted between November " December 2014. Fifty samples of oral fluid were collected from adult persons,
admitted to the Dermatology Clinic Tg. Mures. The samples were transported to the Department of Microbiology of
the University of Medicine and Pharmacy Tg. Mures, where they were inoculated on Sabouraud agar. The isolated
Candida spp. were identified to the level of genus and species by conventional methods of diagnosis (germ tube
test, chromogenic culture media). For each isolate, the susceptibility to voriconazole and fluconazole was
assessed by disk diffusion method, following the CLSI standards. Results: Oral fluid colonization with Candida
spp. was reported in 86% of the 50 patients included in the study. From the total number of isolates, 70.88% from
the strains were successfully identified to species level, the rest being considered as non-albicans. Candida
albicans was the most frequently identified species (52.72%). The other identified species were found in smaller
percentages (Candida glabrata 10.9%, Candida tropicalis 5.45%, Candida krusei 1.81%). No strains were found
resistant to voriconazole. 96.36% of the strains were susceptible to voriconazole and 3.63% were intermediatesusceptible. One non-albicans strain (1.81%) was resistant to fluconazole, while all the other isolates were
susceptible (94.54%) or intermediate-susceptible (3.63%) to fluconazole. Conclusions: Candida albicans was the
most frequently isolated Candida species from oral fluid of the patients that were included in this study. The
resistance to azoles that are commonly used for the treatment of Candidiasis was recorded in a very small
percentage.
Keywords: fluconazole, voriconazole, susceptibility, Candida spp.
TOBACCO AND ALCOHOL: THE GENETIC FACTORS REGULATING ADDICTION

Chatzigianni Olympia Evangelia1, Heller M1, Mejia D1, Ghiciuc Cristina Mihaela1
1
UMF Gr. T. Popa Iai
Background: Recently, reports of teenagers and young adults presenting with Tobacco and/or Alcohol addiction
have increased. Unfortunately, tobacco is the leading cause of preventable death worldwide and alcohol follows
Third, so it is safe to say that prevention of these should be given priority. Today, the genetic field has made it
possible for us to tackle this problem beforehand via an approach that could establish a familial pre-disposition
determining increased risk factors for addiction. Objective: Our aim is to raise awareness since addiction
vulnerability is a very complex trait, at the same time to develop an inexpensive, simple-to-use screening test for
mutations of DRD2/GABRB1 (alcohol) and CHRNA5 (tobacco) genes which would discover increased risk factors
in the general population, hence stopping addiction in its footsteps. Material and methods: An experiment was
conducted on mice with one group having a gene mutation of Gabrb1. In accordance to that, multiple studies were
conducted on twins of different settings to achieve genetic accordance. Then, A question-based survey, obtained
from the general population, was concluded to illustrate our meta-analytic findings. Results: The results obtained
were particularly conclusive, the mice having a gene mutation of Gabrb1 overwhelmingly preferred drinking alcohol
over water. Additionally, in the twin studies, it was observed, that if one twin presented with alcohol or tobacco
addiction, the other twin would be at a higher risk to become addicted as well. Conclusions: Although
Environmental factors do heavily affect addiction properties, due to these studies, we have determined that genetic
mutations are a regulative factor. Conclusively, we wish to increase awareness and in addition to that propose
more in-depth research to eventually design a screening test to limit the probabilitiy of becoming addicted.
Keywords: -, -, -
RECREATIONAL DRUG USE AMONGST MEDICAL PROFESSIONALS.

Aslam Joiya S1, Jee Poh Hock M1, Siveetharan S1
1
UMF Gr. T. Popa Iai
Background: With the emergence of a rising recreational drug culture, we take a look at one of the most
strenuous and stressful professions, and how it interacts with Drugs. Are doctors, as advocates for healthy living,
contradicting their own advice to drug use? Cigarettes, Caffeine, Alcohol and more, we take a look at them all.
Objective: This paper aims to investigate what the public and the medical professions perception and opinion over
drug use is: where do we draw the lines, if there are any lines to be drawn; how prevalent is it in the surveyed
11
countries, and why so; to understand why drug use is prevalent, and how it may have an Impact on professional
integrity and cognitive abilities. I want to examine all sides of the debate and look at external and environmental
factors that affect drug use among medical professionals. Material and methods: A Comparative survey from 3
countries around Europe (Ireland, UK, Romania). The results will be analyzed taking into account the main ethical
values and principles applied in medical care, and whether the drug use amongst health professionals may be in
conflict with these values. I will reference, where applicable, all medical journals and relevant articles to further
bolster my study. Finally I would like to finish off by adding clips from interviews made specifically for the study.
Results: Results to be determined with an ongoing survey. Conclusions: The use of recreational drugs amongst
health professionals is an individual as well as a socio-public matter which needs to be adequately addressed for
its ongoing effects.
Keywords: Drugs, Tobacco, Alcohol, Marijuana
THE EMBRYOLOGICAL DEVELOPMENT OF THE DUCTUS ARTERIOSUS AND THE

NEONATAL PDA (PATENT DUCTUS ARTERIOSUS)
Crian Andrada Ioana1, Borz B1, Enciulescu C1, Gliga Carmen1
1
UMF Trgu Mure
Background: The Patent Ductus Arteriosus (PDA) is one of the most frequent pathologies encountered in infants,
related to the great vessels. Due to increased pressure differences between the left pulmonary artery and the
descending aorta and due to high blood flow throughout the ductus, its closure is prevented. When associated with
malformation pathology it can be kept open therapeutically. Objective: The aim of this study is to assess the
frequency of Patent Ductus Arteriosus distributed by the neonatal parameters registered at birth. Material and
methods: In this retrospective observational study we have analyzed premature born patients (under 37 weeks
and 6 days of amenorrhea) registered in 2012 at the Clinic of Neonatology Tirgu Mures. Their weeks of gestation,
weight, gender and Apgar score in the 1st and 5th minute were registered. In addition we have analyzed their short
term evolution regarding their prophylactic/therapeutic treatment or the surgical ligature. Results: In 2012, 45
cases of PDA were recorded, representing a frequency of 16% among premature deliveries. The gestational age
average is 29 weeks. Regarding the Apgar scores, a mean of 6 in 1 and 8 in 5 were recorded. Out of 45 cases,
23 (55%) were male and 22 (45%) were female subjects. 9 patients presenting Patent Ductus Arteriosus have
deceased at an average of 27 days after birth. 17 underwent prophylactic treatment: in 15 cases (88%) it was
effective. 5 patients underwent therapeutic treatment: in 4 cases (80%) it was effective. 1 surgical ligature was
recorded, the patient survived. Conclusions: Patent Ductusa Arteriosus is associated with underdevelopment of
the fetus, prematurity being the most important risk factor. Low Apgar scores recorded at birth are correlated with
inadequate adaptation to pulmonary ex-utero circulation and PDA. Patent Ductus Arteriosus is not distributed by
gender. Prophylactic and therapeutic drug treatments are efficient.
Keywords: embryology, patent ductus arteriosus, congenital cardiac malformation, fetal circulation
THE INFLUENCE OF THE MAIN SOURCES OF INFORMATION ON THE DECISION OF

VACCINATING/NON VACCINATING CHILDREN BETWEEN THE AGES OF 10-14 AGAINST
HPV INFECTION
Grigore Adelina Sofia1, Adriana Andries1, Craciun Raluca Adela1, Voidzan S1
1
UMF Trgu Mure
Background: Romania holds the first place in Europe in terms of mortality due to cervical cancer. The national
vaccination campaigns were unsuccessful, many parents refusing the vaccination. Objective: The importance of
the information sources regarding the decision of vaccination/non vaccination of children between the ages of 1014. Material and methods: We applied a cross-sectional study using questionnaires which were given to parents
of children from 3 random schools from Trgu Mure. Results: 918 parents were questioned. Based on their
current level of awareness, 1 out of 3 parents would vaccinate their child against HPV. The main reasons for nonvaccination were: fear of the side effects, the vaccine is a new one and it not sufficiently studied, or that they are
not informed about this vaccine. The main information sources were the family doctor (42.8% and 39.1%) and the
internet (42.3% and 42.9%) followed by the media . The parents who received information from the family doctor
were the ones who, on a scale from 1(very low) to 5(excellent) graded their knowledge of HPV
12
infection/vaccination 4 or 5, proving that the information given by the doctors are the most relevant. The quality of
the information given by the media was doubtful, it does not increase the level or quality of knowledge and it can
influence the decision of vaccination. Conclusions: Educational campaigns would have a higher success if they
were to be performed by the family/school doctor. The physician would have to give explanations regarding the
prevention methods, vaccinations, screening, risk and benefits. Acknowledgement: This paper was published
under the frame of European Social Found, Human Resources Development Operational Program 2007-2013,
project no. POSDRU/159/1.5/S/136893
Keywords: HPV infection, vaccination, decision to vaccinate, information sources
AN APPROACH TO SUDDEN CARDIAC DEATHS IN MEDICOLEGAL AUTOPSIES

Demeny Andrea1, Munteanu L1, Hdreanu V1
1
UMF Trgu Mure
Background: Sudden cardiac death(SCD) is defined as being a natural death, of a cardiac nature, with an
unexpected loss of consciousness, related or not, to the existing heart condition. It is a major health issue in the
developed countries, being the main cause of death. That is why the causes of SCD must be intensively studied, to
prevent unexpected deaths. Objective: This study is focused on discovering the main causes of premature death
and the predisposed population. Material and methods: Out of the total of 739 necropsies carried out at the
Medicine Institute in Targu Mures in 2012, it was determined that 234 were sudden deaths, which were
included in our study. We have documented the nature and the main causes of death, as well as the associated
cardio-coronary pathology, based on macroscopic descriptions and histopathology reports. Results: Based on
gender, 171(73%) were males and 63(27%) were females. The majority of the deaths, 72(31%) occurred during
the 6th decade of life. Out of these, 16 were females and 56 were males. There was a noticeable difference for the
deaths over 70 as well: 18% were men, and twice as many were women, 36%. Marital status also seems to have
made a difference: only 79(33%) were married. Out of the 234 necropsies, 35(15%) were of a violent cause. The
most frequent causes of death were: acute cardio-respiratory failure (ACRF) 89(38%), acute cardio-circulatory
failure 43(18%), cardiac arrest 39(16%), other 63(28%). The cardiac modifications observed macroscopically were:
atherosclerosis 196(84%), miocardiosclerosis 154(66%), anemia 87(37%) and other. Histopathologically, in 45
cases, there was evidence of an older myocardial infarction, and in 17(7%), of an acute myocardial infarction.
Conclusions: A much higher rate of sudden death was noticed in single/divorced men in their 50s, with the main
cause of death being ACRF, due to major cardiac arrhythmias.
Keywords: sudden death, atherosclerosis, necropsies
GENES INVOLVED IN AXONAL REGENERATION IN OLD POST-STROKE RATS

Zavaleanu Alexandra Daniela1, Gresita A1, Buga Ana Maria1, Popa Wagner A1
1
UMF Craiova
Background: It is well known that the body deteriorates while aging and recovery after an injury becomes more
and more difficult.This is why we decided to study if recovery after a brain injury is possibile and which are are
responsable genes. Objective: Our study wants to identify all the celular and molecular mechanisms that fail in
regenerating injured axons and neurons after a brain lesion, but also those genes which have a huge importance
when it comes to these processes. Material and methods: Thirty young male Sprague-Dawley rats were used for
this study and they were divided into 3-day and 14-day post stroke survival groups. On the other hand there were
also nineteen postnatal Sprague-Dawley rats. In addition, nineteen young male Sprague-Dawley rats were used as
a control group (naive). Cerebral infarction was induced by transcranial interruption of blood flow by transiently
lifting the middle cerebral artery with a tungsten hook. Subsequent to survival times of 3 or 14 days, rats were
deeply anesthetized and the blood removed by perfusion with neutral buffered saline. Brains were cut into 2mm
slices and the periinfarcted area was microdissected under a microscope. Results: A relative high number of
genes that are expressed in developmental period was up-regulated after stroke in adult brain. We founded Kif4
gene expression highly up-regulated after lesion in adult brain. The kinesin superfamiliy (KIF) genes encode a
class of microtubule-based motor proteins that are specialized in intracellular transport of membranous organelles.
During cellular division, KIF4 is essential for the organization of central spindles. Conclusions: We have found
developmental Kif 4 gene an important player in recovery process after stroke in adult brain after stroke. This Kif4
13
transcription factor can be an important therapeutically target to increase the axonal regeneration and to improve
the recovery after stroke in aged people.
Keywords: kif4, axonal regeneration, post-stroke rats, neurogenesis
NASAL CARRIAGE OF STAPHYLOCOCCUS AUREUS AMONG CHILDREN FROM

PRIMARY SCHOOL
Vulea Diana Monica1, Ciortianu Laura-Elena1, Mare Anca1, Toma Felicia1, Movileanu Ionela2, Man A1
1
UMF Trgu Mure

Tissue Engineering and Regenerative Medicine laboratory (TERMLab), Univesity of Medicine and Pharmacy, Tirgu Mures
Background: Nasal colonization by Staphylococcus aureus, including MRSA (Methicillin-resistant Staphylococcus

aureus) is an important risk factor for infectious diseases, especially those of the skin and soft tissue. Objective:
To evaluate the nasal carriage of Staphylococcus aureus among children attending primary schools, for
epideomiological purpose. Material and methods: A prospective study was conducted between Septembers "
October 2014. The subjects included in this study were selected from two primary schools situated in two different
cities. The parent approval was requested, and they were also asked to fill in a questionnaire. The data filled in
these questionnaires were afterwards statistically processed. Nasal swabs were collected from 132 children and
placed in transport medium. After enrichment, S. aureus strains were identified at genus and species level by
conventional methods, in the Department of Microbiology from University of Medicine and Pharmacy Tg. Mure.
Results: In our study the mean age was 7.9 months and the sex ratio was slightly favorable to girls (56.81% girls,
43.18% boys). S. aureus colonization rate was almost similar in the two primary schools included in this study
(24.41% in the first unit and 22.85% in the second). There were no statistically significant differences in the
colonization rates between the two units (p = 0.5537). MRSA colonization rate was also close in the two schools
(1.61% in the first unit, 1.42% in the second). Almost half of the children (43.18%) received antibiotic treatments in
the last 6 months preceding the survey. Conclusions: Colonization rates with S. aureus and with MRSA strains
were similar in the 2 schools included in the study. In the last 6 months preceding the study, consumption of
antibiotics was reported from almost half of the subjects included in the study.
Keywords: Staphylococcus aureus, MRSA, nasal colonization
KNOWLEDGE ASSESSMENT AMONG STUDENTS FROM THE UNIVERSITY OF MEDICINE

AND PHARMACY TARGU MURES, REGARDING HUMAN PAPILLOMA VIRUS AND ANTIHPV VACCINATION.
Curticpian Ioana Maria1, Hum M1, Marcu Iuliana-Bianca1, Voidzan D S1
1
UMF Trgu Mure
Background: The main cause of cervical cancer is infection with the double-strainded-DNA Human Papilloma
Virus (HPV), with a development of 500.000 new cases each year worldwide. The virus is also incriminated in
development of oral and pharinx cancer especially in young people. HPV infection is usually silent, so that there
are no clear symptoms or clinical signs. Objective: Evaluating the attitude and knowledge of medical students
regarding sexually transmited diseases, HPV infection and their sexual behaviour. Material and methods: A
transversal study was conducted by applying a questionnaire to the first and sixth year students from UMF Targu
Mures. The questionnaire contained information about sexual history and behaviour, medical history, Human
Papilloma Virus and anti-HPV Vaccine. Results: We have questioned 522 students. 40% of 1st and 62.1% of 6th
year students discussed with their partners about the risk of STDs; 82,1% of 1st and 99.1% of 6th heard about
HPV; The level of knowledge regarding HPV: 22,4% of 1st year-very low, 47,8% of 6th-high. The main information
sources about HPV: 1st year 34.2% doctors, 6th year 77.3% university courses. Transmission methods of HPV:
heterosexual intercourse 67.9%(1st year), 94.8%(6th year); blood transfusion 57.9%(1st year), 43.5%(6th year).
HPV vaccination level of knowledge: 1st year 34,1% very low, 6th year 26.7% high. HPV vaccination information
about benefits received from family doctors/specialists 14,1%(1st year), 41% (6th year) The age of the first HPV
vaccination should be: 1st year 31,1% do not know, 6th year 64,2% at 12-14 years old. Conclusions: The results
show that the level of knowledge among students regarding HPV is relatively low in the first year and moderate in
the last. This paper was published under the frame of European Social Found, Human Resources Development
Operational Programme 2007-2013, project no. POSDRU/159/1.5/S/136893
14
Keywords: HPV, Cervical Cancer, Student, Sexual behavior
NEUROENDOCRINE NEOPLASMS: CLINICOPATHOLOGIC ANALYSIS OF 132 CASES

Popescu S D1, anta Virginia Alexandra1, Gurzu Simona1, Jung I1
1
UMF Trgu Mure
Background: Neoplasms with neuroendocrine differentiation (NEN) mainly arise in the lungs and gastrointestinal
tract but are also found in other organs. They include the grade 1 and grade 2 neuroendocrine tumors (NET) and
large and small cell neuroendocrine carcinomas (NEC). Objective: To perform a retrospective analysis of NENs.
Material and methods: The data was collected from the Department of Pathology of Emergency County Hospital
of Tirgu-Mures, Romania, for the 136 cases of NENs diagnosed during 2009-2014. The immunohistochemically
markers chromogranin, synaptophysin, neuron specific enolase (NSE) and CD56 were used to establish the
diagnosis whereas mitotic rate, tumor size and Ki67 index were indicators for NET vs. NEC.The following
parameters were taken into account: tumor location, patient age and gender and microscopically grade of
differentiation. Results: : From the 136 cases, 26 were metastases and were excluded from the study. From the
remaining 106 NENs, 54.72% were diagnosed in males (n=58) and 45.28% (n=48) in females. The median age of
patients was 58.5916.14 years, ranging from 9 to 92 years. The median number of NENs diagnosed yearly was
17.664.45 cases/year, with a proportional increasing number, from 11 cases diagnosed in 2009 to 24 cases in
2014. Primary location was lung (40.57%, n=43), folowed by pancreas (16.04%, n=17), stomach (15.09%, n=16),
appendix (8.49%, n=9), small intestine (9.44%, n=10), colorectal segments (3.77%, n=4), breast (3.77%, n=4), skin
(1.89%, n=2), and nasal septum in one patient (0.94%). Out of 106 NENs, 51 were NETs and 55 were NECs. The
NECs were diagnosed in more elderly patients compared with NETs (median age 63.1113.11 vs. 54.5217.99
years, p<0.0001) and more frequent in males (M:F ratio=1.5:1 vs. 1:1.04). From the 55 NECs, 34 were lung
carcinomas (61.82%). Conclusions: The incidence of NENs increased in the last 6 years and the NECs
especially involve the lungs of elderly males.
Keywords: neuroendocrine tumor, neuroendocrine carcinoma, gastrointestinal tract, lung
THE UTILITY OF IMMUNOCYTOCHEMISTRY IN THE DIAGNOSIS AND INTERPRETATION

OF CYTOLOGICAL SMEARS OBTAINED BY BRONCHOSCOPIC BRUSHING
Dascl Oana-Adina1, Mezei T1
1
UMF Trgu Mure
Background: Immunohistochemistry is used to visualize certain proteins in tissue sections by using specific
antibodies that recognize and specifically bind to them. In recent years the method has been also applied to
cytological smears, the method being coined immunocytochemistry. Objective: The aim of our study was to
assess the diagnostic value of immunocytochemistry in the evaluation of cytological smears obtained through
bronchoscopic brushing from patients with lung tumor suspicion. Material and methods: We prospectively
analyzed bronhoscopic smears from 10 patients (mean age 51.8 years, 9 males and 1 female) with clinical
suspicion of lung cancer. Smears were obtained using a cytology brush during routine bronchoscopy. For each
patient 2 smears were made: one with immediate alcohol fixation and one was dried at room temperature for 15-20
minutes. The alcohol fixed slides were stained using Papanicolau method, while the other was used for
immunocytochemical studies. Standard protocol was used, with markers for pancytokeratin, p63 and TTF1,
visualized with DAB. Results: Two out of the cases showed intense background staining, six presented
suboptimal staining, internal controls were poorly visualized. Four cases presented optimal staining as seen by the
visualization of internal positive control cell, such as respiratory epithelium and basal cell. Conclusions: Our
results indicate that both Papanicolau-stained smears and immunocytochemical visualization are significantly
influenced by the process of slide fixation and preparation. Bronchoscopic brushing offered sufficient cytological
material, however a delay in fixation decreases significantly the proper adherence of antibodies, the quality of the
slides and their post-stain analysis. Immunocytochemistry could therefore provide a presumptive diagnosis in a
shorter amount of time compared to immunohistochemistry, without implying additional expenses due to
processing the biopsy.
Keywords: immunocytochemistry,, cytology,, lung tumors,, bronchoscopy, brushing
15
ISCHAEMIC PRECONDITIONING AS A PRESERVATION FACTOR OF MUSCULAR

FUNCTION FOLLOWING ISCHAEMIA AND REPERFUSION IN ANIMAL SUBJECTS
Culbece Elena-Andreea1, Cotoi O S1, Grigorescu Bianca-Liana1
1
UMF Trgu Mure
Background: Ischaemia-reperfusion injury is an important clinical problem in many different organ systems.
Various studies argues that the exposure of tissue to brief periods of ischaemia-reperfusion, known as ischaemic
preconditioning is more protective in the ischaemic injury comparing with the ischemia-reperfusion insult.
Objective: To assess the conservation of muscle contractile function in rats suffering with diabetes, ischaemic
preconditioned. Material and methods: The study comprise of sixteen Wistar male rats subjects, divided in two
categories: Lot 1- witness and Lot 2- with induced diabetes mellitus (intraperitoneal Streptozotocin 60 mg/kg),
which have been ischaemic preconditioned ( three cycles of 10 minutes each, followed by 24 hourly reperfusion).
Posterior limb acute ischaemia has been induced to all subjects, followed by early reperfusion. In order to establish
the functional assessment, skeletal striated muscle, biochemical and biopsy samples have been collected. The
maximal force of isometric contraction has been established (muscle stretching) and muscle tetany has been
instigated using 300 Hz and 15-20 V electrical impulses, the length of stimulation sequence being 1 and 2
milliseconds. Results: Ischaemic lesions were more obvious for Lot 1 (mean value Creatine-Kinase: CK= 470.13
UI/L compared with CK= 230.88 UI/L in Lot 2, p=0.0001 and mean value of myoglobin = 390.25 ng/ml compared
with myoglobin 47.99 ng-ml in Lot 2, p=0.025). The histologic examination highlights the ischaemic and reperfusion
lesions of striated muscles, also extended coagulation necrosis, without significant disparities between Lot 1 and
Lot 2. The muscular contractility assessment (Maximum Isometric contraction force-MICF and during tetanisationTF) demonstrate that the two lots have relative equal values (MICF1=0.11Nm/g, MICF2=0.12Nm/g, p=0.96,
respective TF1=0.12Nm/g, TF2=0.11Nm/g, p=0.42). The quantification of muscle fatigue resulted from lowering the
contractility force doesn`t prove significant changes for the two lots (mean values of 0.44Nm/msec, respective
0.68Nm/msec, p=0.93). Conclusions: Ischaemic preconditioning is a contributory factor in the preservation of
contractile muscle function.
Keywords: preconditioning, contractility, ischaemia.
A PSYCHO-SOCIAL PERSPECTIVE ON ORGAN DONATION AMONG MEDICAL

PERSONNEL
Movileanu Ionela1, Harpa M1, Bancos Roxana Isadora2, Ciortianu Laura-Elena2, Vulea Diana Monica2, Pasca Maria Dorina
2
1
UMF Trgu Mure
Background: Organ transplant often represents the only medical treatment for a number of end stage pathologies.
At this moment there is considerable shortage of viable organs for transplant. These organs can be acquired either
from patients in cerebral death, or from living, consenting patients. Objective: The present study wishes to bring
to light the impact of organ donation among the professional field which makes it possible technically as well as its
implication from an educational stand, representing a psycho-social topic. Material and methods: As a
psychological method of investigation, questionnaires were used, consisting of 8 items. The target group was
represented by Medicine students, nurses and doctors. 60 students, 26 nurses and 16 doctors were interviewed.
Results: This study shows that organ donation is perceived, among medical students, as a life saving procedure
(60%), a helping method (18.3%), a way of expressing compassion(10%) while 5% of the students consider the
refuse of organ donation a waste. Age and the sex of the donor is considered irrelevant, and the loss of cerebral
activity is considered the optimal moment of donation. 100% of the nurses consider organ donation to be life
saving and would be willing to become a donor in the event of cerebral death, 50% emphasize the importance of
age, while the sex of the donor is considered irrelevant. The doctors highlight the life saving aspect of organ
donation as well as it being the only medical alternative for certain diseases. 75% answered that the donor sex is
not essential, and they would become organ donors in case of cerebral death. Conclusions: The result analysis
concludes that from a psycho-social point of view, organ donation is embraced among the medical staff, being
already a part of the medical-psycho-social education of the general population.
16
Keywords: doctor, organ, education, donation
A COMPARISON BETWEEN STUDENTS AND TEACHERS PHYSICAL ACTIVITY STATUS

Stanciu N1, Vian Cezara-Ilinca1, Stroia Alexandra1, Sabau Alexandra1, Pop M1
1
UMF Trgu Mure
Background: Physical activity is measured in international studies with the International Physical Activity
Questionnaire. In 2014 we concluded that Trgu Mures medical students in early years present a good physical
activity state, with an active life and appropriate nutrition but questions were asked about the status of our
teachers. Objective: Compare the physical status of medical students and the teachers from preclinical years.
Material and methods: Cross-sectional study with a convenience sample of 65 voluntary teachers and 85
students. last 7 days telephone format IPAQ was administered. Demographical data was recorded and the
subjects blood pressure and pulse were measured with an analogic Mac-Check sphygmomanometer. Statistical
analysis was performed using Microsoft Excel and MedCalc12.5 using a 0.05 level of significance. Results: While
the teachers age was almost double the students (41.27 vs 21.1 years) the male-female sample proportion was
similar (FM=1.82 in teachers and 2.03 in students). There is a statistically significant difference between the BMI in
both groups but they fall within normal limits. Unfortunately 40% of the teachers are overweight or in a higher risk
group compared with 8.24 for students. In a standard week the students physical activity is twice the teachers
Those differences are higher in females where the report is 2.88. If 60% of the students have a high physical
activity level, only 12% of the teachers fall in the same category, most of them (58%) having a medium activity
level. Although a negative non-significant correlation was found between the level of physical activity and BMI at
students (r=-0.21,p=0.053), it disappears at our teachers (r=0.01,p=0.88). Conclusions: There is a lack of
physical activity among the teachers in medical faculty. The students present in nascent form the problems that will
affect them 20 years from now. Health education should be a life-long process and physical activity should play an
important part.
Keywords: Physical Activity, IPAQ, Teachers
THE RECOVERY OF PATIENTS AFTER AMPUTATION AND PROSTHETIC LEG

Dragota Andreea1, Eniko Papp1
1
UMF Trgu Mure
Background: Amputation represents the intentional surgical removal of an entire limb, or part of a
limb.Disarticulation is explained from an excision at the point of a particular joint,while traumatic amputation means
complete loss of the limb due to trauma that may cause interruption of normal bodily function. Objective: The
target of physical therapy begin in the first 24 hours.Withdrawal of edema,preparation of the stub for
prosthesis,and adaption to the new conditions of static and dynamic.After the first initial process of rehab has
began,the physical development of the attaching limbs starts as well as resumption of the orthostatism position
and balance re-education.When the patient has become concious of the new adapations physically, mentally, and
emotionally, they will begin the process of walking. Initially using parallel bars,frame,canes,crutches will assist this
process.The overall goal of the rehab is to ultimately help the patient resume a healthy,normal lifestyle as prior
from their operation Material and methods: Prosthesis is a medical device that replaces a member or a part of the
member in case of an amputation. There are three important steps aseesed. First is the immediate prosthesis , in
the first 24 hours which allows walking and immediate physical therapy. Second step is the re-education prosthesis
after the stub was modeled . Two elastic stockings will help accelerate the withdrawal of edema and muscle
maturation. It takes from 3 to 6 weeks and the prosthesis must be corrected at each change of residual limb
volume. After 3 or 4 months patient receives final prosthesis. Results: From this entire process we have the
surgeon ,the physical therapist,the psychologist that will help the patient adjust back to society Conclusions:
Rehab from amputation is a long and hard process that can cause depression,physical and emotional pain,or even
phantom limb syndrome
Keywords: amputation, prosthetic leg, physical therapy, orthostatism
17
THE STUDY OF THE ANTINOCICEPTIVE EFFECT OF SOME ATYPICAL NEUROLEPTICS

IN THE HOT PLATE TEST
Marcu Iuliana-Bianca1, Curticpian Ioana Maria1, Mateescu Corina-Ioana1, Somodi Laura Ionela1, dan z1, Cucuiet SorinaNicoleta1
1
UMF Trgu Mure
Background: Atypical neuroleptics could be used in future as analgesics or as adjuvant in analgesia. Objective:
The aim of present study was to investigate the existence of an antinociceptive effect of some atypical neuroleptic
as Quetiapine and Aripiprazole in the acute model of pain , hot plate test in mice. Material and methods: We used
90 male white mice, animals were divided into groups of 10.To detect the placebo effect we use a control group
injected subcutaneous with saline phys. 0,1 ml/kgc. The antinociceptive effect of intraperitoneal administration of
Quetiapine (10,20,40,80 mg/kgc) and Aripiprazole (1,2,5,10 mg/kgc) were measured after 30 and 60 minutes on
Hote Plate Ugo Basile. Results: Quetiapine produced its antinociceptive effect statistically significant in three dose
(20,40,80 mg/kgc) at 30 min respectively at 60 min in all four dose. Aripiprazole produced its antinociceptive effect
statistically significant at 60 min only in a dose of 10 mg/kgc. Conclusions: Only quetiapine has antinociceptive
effect, in dose dependent manner.
Keywords: atypical neuroleptic, antinociceptive effect, hot plate test, mice
THE IMPACT OF THE INTERNET ON PHYSICIAN-PATIENT RELATIONSHIP

Ilie Ana Maria1, Rednik Anca Maria1, Popa Andra-Diana1, Branea Oana-Elena1, Pasca Maria Dorina1
1
UMF Trgu Mure
Background: The development of the information and especially the internet increased the importance of
questions related to information gathering. Because of the internet availability almost everywhere, patients could
search anything about issues like health, treatments or diagnosis. This is a fact that creates skepticism and lack of
confidence in medical profession. Objective: The aim of this study is to pinpoint the influence of online information
on medical act and also its impact on the doctor-patient relationship. Material and methods: We realized a study
using as main psychological method of investigation a questionnaire consisting of 9 items, conversation and
observation. The questionnaires were filled in by randomly selected people between 25 and 65 years old. Results:
This paper presents the results of a study applied to a number of 70 subjects to asses their perception about the
online medical information. The lot was formed by both males (30%) and females (70%), 65% come from urban
environment and 35% from the rural one. It important to know that 65% of them have higher education. The
results showed that 80% of the subjects use internet for obtaining medical resources. Only 37% of them consider it
useful in relation with their physician because it easier to understand medical terms while the rest of them are
more influenced in the wrong way by the online data. Thus it weakens the patient physician-relationship by lack of
trust. Worrying is the fact that almost 30% of subjects take medication without asking a doctor, using only the
online data. Conclusions: After processing the data we observed that the internet documentation on medical
matters creates confusions and it could weaken the physician-patient relationship even worse, people taking
medication by themselves. There are many factors that could mislead the patients such as the unauthorized sites
or data misinterpreting.
Keywords: internet, information, physician-patient, relationship
HISTOPATHOLOGIC FEATURES OF THE UPPER URINARY TRACT UROTHELIAL

CARCINOMA
Gingean Diana1, Borda Angela1, Loghin Andrada1
1
UMF Trgu Mure
Background: Neoplasms of the ureter and pelvis represent 20-25% of upper tract tumors in adults, with urothelial
carcinoma (UC) accounting for 90% of them. Male gender in the sixth-seventh decade of life is more affected by
this pathology. Since multifocality and high rate of recurrence are significant problems for patients with upper tract
18
UC, nephroureterectomy is the treatment of choice. Objective: The aim of this retrospective study was to have a
closer look at the histopathologic features of urothelial carcinomas of the renal pelvis and ureters. Material and
methods: We analyzed all the nephrectomy specimens performed in the Urology Department and examined in the
Pathology Department of Emergency County Hospital Mure between January 2009 and December 2013 and we
selected the UC of the renal pelvis and ureters. For each patient we analyzed his age, gender, tumor starting point,
histologic type, grade and pathologic stage. Results: From the total of 321 nephrectomy specimens, we included
in our study 28 patients with UC of the renal pelvis and ureters. 22 patients were men (79%) and the most cases of
carcinomas occurred between the age interval of 60-69 (35.7%) and 70-79 (35.7%) years old. 15 tumors were
located on the left side and 13 on the right side. As a general overview, 19 of the analyzed tumors (70.37%) had
high pathological stage (pT2-pT4) and the majority of the cases (12) representing 44.4% were in stage pT3.
Regarding the exophitic component, four patients had grade 2 tumors (G2) and 14 grade 3 (G3), meaning that
64.2% of the urothelial carcinomas were of high grade. Conclusions: Urothelial carcinomas of the upper urinary
tract have a high histologic grade and an advanced pathologic stage, so consequently, a poor prognosis.
Keywords: urothelial carcinoma,, upper urinary tract,, high stage and grade
TESTICULAR GERM CELLS TUMORS DIAGNOSTIC CRITERIA AND USEFULNESS OF

IMMUNOHISTOCHEMISTRY.
Badaluta C D1, Teul Carmen Ionela1, Catalin C1, Borda Angela1, Loghin Andrada1
1
UMF Trgu Mure
Background: Germ cell tumors (GCTs) are the most frequent testicular tumors (95%). They are classified as
seminomas, non-seminomatous GCTs and spermatocytic seminomas based on microscopical features. Mixt germ
cells tumors, composed of more than one type of germ cell tumor component, including one or more nonseminomatous element are classified as non-seminomatous GCTs, even if seminoma is the chief component.
Objective: Our study proposes a review of the testicular GCTs diagnosed in our Pathology Department,
presenting the diagnostic criteria, the immunohistochemistry methods used and the presence of preinvasive
lesions (IGCNU). Material and methods: We analysed 47 cases of testicular GCTs examined in the Pathology
Department of Mures Emergency County Hospital over a 5 years period (2010-2014). The histological type was
established according to precise diagnostic criteria, and in cases were necessary, immunohistochemistry was
performed; the pathological stage was set along with TNM 2009 recommendations. Results: We found 21 pure
seminomas (44,6%) and 26 non-seminomatous GCTs (55,31%). In this last category 10 cases were pure GCTs (5
embryonal carcinomas and 5 teratomas). The rest of 16 cases (29,8%) were mixt GCTs, composed of more than
one type of germ cell tumor contingent. The most aggresive type, EC was present non only in pure form but also
as a component in 10 cases of mixt GCTs. Immunohistochemistry was used in 10 cases of 14 mixt GCTs for
confirming the microscopical findings. Regarding the pathologic stage, 30 cases (64%) were pT1 tumors, 13 (28%)
pT2, 3 (6%) pT3 and only 1 (2%) pT4. IGCNU was identified in the peritumoral parenchyma in 26 cases (55%).
Conclusions: A correct and complete diagnosis, with the identification of all tumor components, is essential for
patients with testicular tumors, knowing that presence of same histologic types is considered an unfavorable
prognostic factor.
Keywords: Germ cell tumor, immunohistochemistry, seminomas, non-seminoma
SMOKER OR NON-SMOKER? SHOULD IT BE WRITTEN IN THE MEDICAL CURRICULUM

OF FUTURE PHYSICIANS?
Branea Oana-Elena1, Rednik Anca Maria1, Rusu S1, Branea I A1, Ilie Ana Maria1, Kikeli P I1, Preg Z1
1
UMF Trgu Mure
Background: Medical students must know how harmful smoking is, but in many countries this is a common
practice. Many informational campaigns were done, but is this strategy enough? The question arises as to why this
is so, and what can be done about it. Objective: The main objective was to implement the first Smoke Free
Medical University project in Romania, starting with the University of Medicine and Pharmacy Tirgu-Mures.This
study assesed tobacco use prevalence among third year students of the Faculty of General Medicine in 2014.
Also, it intended to appreciate students' knowledge and attitudes towards smoking. Material and methods: Using
a core questionnaire (72 items), based on Global Health Professions Students Survey, 362 students answered
19
during regular lecture, voluntarily and anonymously. Data was collected in order to realize a cross-sectional
designed study. IBM-SPSS program was used for descriptive statistical evaluation. Results: One third of students
are current smokers, but only 12.2% would take into consideration cessation. 74% tried smoking, of which more
than half before the age of 19 (62.5%) and 51.9% used other tobacco products. 81.2% affirmed there is an official
legal regulation banning smoking in university buildings and hospitals and the majority reported the law does not
apply. A large proportion (90.9%) expressed that it would be necessary to train health professionals on smoking
cessation techniques. Furthermore, they routinely recommend them. Most students (67.7%) would be interested in
attending special lectures and they felt that a smoke free university project would be beneficial in lowering smoking
practice. Conclusions: On the basis of these findings, it seems that smoking was widely prevalent among
students. Further approaches to educating health professional students are an important subject to be discussed.
Cosequently, educational media programs should be taken into consideration and tabacology communication
sessions would be useful by presenting disadvantages and the recklessness of smoking.
Keywords: smoking, university, student, questionnaire
TITLE COMPARATIVE STUDY FOR ECONOMIC SUSTAINABLITY IN 26 ROMANIAN

HOSPITALS
Negrea M1, Grancea Iulia2, Dogar C M3, Brnzaniuc Klara3
1
SCJUM
3
UMF Trgu Mure
2
Background: In Romania there isn`t a usual practice to evaluate medical activity from economic point of view and
there isn`t any contrywide evaluation for the hospitals economic activity. Economic evaluation is one of the most
important activities performed by the management team of the hospital because of it depend all of the strategic
planning of the future activity. The entire process is called Hospital Controlling and it`s the system of measurement
and control of all incomes and expenses in any economic activity, related to hospitals. Objective: To see if the
hospitals that we assesed are economic sustainable. Material and methods: We applied the controlling system
26 romanian hospitals, from all categories and countrywide distribution 9 Emergency county hospitals, 6 city
hospitals (municipale), 3 city hospitals(orasenesti), 4 single specialization, 2 pediatrics hospitals and 2 emergency
clinic hospitals(B). In total there were 10 clinic hospitals evaluated. Results: On global economic assesment of all
hospitals are economic sustainable after allocating all expenses for evaluation, treatment, accomodation of the
patients, with a mean 10.9% positive and 17 of the 26 with results below average. After applying the overhead
(administrative) expenses, 8.8%, more than half of the hospitals have a negative result, and the average is 2.1%
positive. Conclusions: In 2013 economic activity of the hospitals was unsustainable only relying on the income
from the CNAS and National programmes are too few to compensate the loss.
Keywords: Economic, Sustainablity, Romanian, Hospitals
ECONOMIC PERFORMANCE OF THE ACUTE CARE ON 16 MEDICAL SPECIALITIES IN

ROMANIAN HOSPITALS
Negrea M1, Grancea Iulia2, Dogar C M3, Brnzaniuc Klara3
1
SCJUM
3
UMF Trgu Mure
2
Background: Although it`s well known that the Romanian health system is underfinanced there isn`t yet a study
on how much or is made in by the medical specialties. It`s important for the strategic planning of the
hospitals because if they know the economic impact of the specialties the management team can decide how to
create the structure of the hospital and how to make the contracting strategy with the CNAS. Objective: To find
the economic performance for each of the specialties including all expenses, beside salaries and medication, Paraclinic investigations and accommodation expenses. Material and methods: In this study i have included 16
specialties 15 acute care specialties which admit and discharge patients and emergency medicine which is for
triage and transit, from 26 hospitals and it was mandatory that medical specialty included in study to be present in
at least 14 hospitals. All hospitals were evaluated by hospital controlling method. Results: 9 of the 16 specialties
20
evaluated had negative economic result, most of them were surgical specialties, and the results were similar in all
26 hospitals. Conclusions: The negative economic performance of the medical specialties cannot be influenced
by the management only minimizing the or maximizing the and it is a result of the financing system
which doesn`t have relative values correlated with the real need of the specialties.
Keywords: Economic, Performance, Acute care, Management
CLINICAL - MEDICAL
CLINICAL - MEDICAL
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CLINICAL - MEDICAL
THE EFFECT OF 10 DAYS OF LIFESTYLE INTERVENTIONS ON CARDIOVASCULAR

DISEASE RISK FACTORS AND THEIR EFFECTIVENESS IN DIFFERENT AGE GROUPS
Maricic M1, Golea Cristina1
1
UMF Trgu Mure
Background: Studies have clearly shown the benefits of eating a vegetarian, whole food diet on cardiovascular
health and multiple other organ systems. The effects are seen to not only halt the progress of disease but even
reverse certain chronic diseases found in the westernized countries. Objective: To analyze the effectiveness of 10
days of lifestyle interventions in subjects suffering from metabolic syndrome and establish the efficacy in each age
group. Material and methods: 534 patients aged 30 to 88 years of age with BMI values above 30 were admitted
to the Lifestyle Center of Herghelia, Romania for 10 days of lifestyle interventions between the year 2012 and
2014. Fasting total Cholesterol, HDL, LDL, Triglycerides and blood glucose were measured at the second and last
day of the stay at the lifestyle center. All subjects were eating a whole food plant based diet without any animal
products served by the health care provider. Results: Regardless of age all cardiovascular risk factors had a
significant positive change after 10 days, Total Cholesterol (200,5 vs 158,31 mg/dl), HDL (37,48 vs 39,79 mg/dl),
LDL (135,02 vs 108,27 mg/dl), triglycerides (170,44 vs 132,63 mg/dl) and blood glucose (111,29 vs 98,87 mg/dl)
all fasting values and with statistically significant alterations (p<0.0001). Conclusions: The use of a plant based
diet together with moderate exercise of 30 min brisk walking daily or most of the days of the week has been
investigated and gives clear evidence of efficacy, efficiency and availability for the general population regardless of
age and comorbidities in combating cardiovascular risk factors.
Keywords: Plant based Diet, Cardiovascular risk factors, Moderate exercise
THE TNF G308A GENE POLYMORPHISM IN CHILDREN WITH NEPHROTIC SYNDROME

Tripon F1, Crauciuc A1, Moldovan V1, Carmen Duicu1, Claudia Banescu1
1
UMF Trgu Mure
Background: Nephrotic syndrome (NS) is a disease with increased frequency in children. Certain genetic
mutations are involved in the NS pathway, prognostic and response to therapy. One of this can be the Tumor
Necrosis Factor (TNF ) G308A gene.Polymorphism at position 308 of the TNF- promoter, representing G to A
base transitions, has been linked to increased TNF transcription. Elevation of TNF- has been found in the plasma
and urine of some young NS patients. Objective: The aim of the study was to see if exist some correlation
between NS and the polymorphism of this gene. Material and methods: Our study included a number of 58 young
NS patients and a control group whit 120 healthy children. The TNF gene polymorphism were determined by
ARMS technique utilizing specific primers. Results: The mean age was 5.5 years, 54% being girls and the
remaining boys. In the control group the TNF genotype were: 54.2% GG-wild type and 45.8% AG- heterozygous.
In the patients group we found the following variants: 63.80% GG- wild type , 32.75% were heterozygous and
3.45% AA-homozygous mutants. Only the congenital NS patients were homozigot mutants. Conclusions: No
important association was found between NS and TNF G308A gene polymorphism. This single nucleotid
polymorphism may represent a risk factor to develop congenital NS but future studies whit a large number of
patients are needed. From our knowledge this is the first study which investigate the TNF G308A gene
polymorphism in NS patients from Romania.
Keywords: nephrotic, TNF, mutation
THE TYPES OF PROCEDURES UNDERTAKEN IN SURGERY DUE TO THE

COMPLICATIONS OF IRRITABLE BOWEL DISEASE
Treifi Maryam1, Muresan M1
1
UMF Trgu Mure
Background: Crohn disease and Ulcerative Colitis belong to the same disease class of inflammatory bowel
diseases (IBD). IBD causes chronic inflammation in the gastrointestinal (GI) tract. Chronic inflammation impairs the
ability of the affected organs to function properly, leading to symptoms such as abdominal cramping, alteration of
CLINICAL - MEDICAL
23
bowel habits, rectal bleeding and fatigue. Objective: The aim of the study was to analyse how many cases of IBD
complications ended up in surgery and what type of procedure was undertaken. It has been performed a
retrospective study of 25 patients between the years from 2009 to 2015 hospitalised at the surgery department of
the county hospital in Trgu Mure. The following factors were taken into consideration: age, sex, histopathology
and the type of procedure carried out. Material and methods: The retrospective study was conducted on records
of patients hospitalised and operated on at the County Hospital of Trgu Mure between the years 2009-2015 to
date. Results: During the studied period, there were diagnosed 25 patients, of those 21 were with ulcerative colitis
complications and 4 patients were with complications due to Crohn disease. The most affected age group was
between the ages of 51-60, with a female predominant ratio of 1:0.19. It was noted that there was a significant
number of enterectomies (50%) in comparison to other types of procedures related to ulcerative colitis. In Crohn
disease, the most common procedure undertaken was a right hemicolectomy (43%). Other procedures performed
included internal sphincterectomies, subtotal colectomy and rectal amputations. Conclusions: IBS is considered
to be a benign disease, however the patients were hospitalised to undertake surgery due to the severity of
complications the disease can forgo as IBS has the potential to become aggravatingly worse, more than people
would like to acknowledge.
Keywords: Crohn's Disease, Ulcerative Colitis, Complications, Surgery
EMERGENCE OF VANCOMYCIN-RESISTANT ENTEROCOCCI IN TARGU-MURES

Altendeitering Fiona Freya1, Szekely Edit1, Bilca Doina1
1
UMF Trgu Mure
Background: Vancomycin-resistant enterococci (VRE) harbouring plasmidic vanA/B genes are important
nosocomial pathogens causing hospital outbreaks. Although they have been increasingly occurring in Westernand Central-European countries for the last decade, such strains have not been reported from Romania before
2012. In our hospital the first VRE strains were identified in 2013. Objective: In this study we characterize VRE
strains isolated in Mures County Emergency Clinical Hospital since their emergence to date. Material and
methods: Enterococcus strains were isolated from different clinical specimens according to standard laboratory
protocols and identified to species level with Vitek2 Compact system. Antibiotic susceptibility testing was
performed on AST card. In case of vancomycin and/or teicoplanin resistance MIC was determined using Etest
(BioMrieux). The presence of vanA/B genes was detected by PCR. Results: Six Enterococcus faecium strains
resistant to glycopeptides were identified during the study period. Of these, 5 were resistant to both glycopeptides,
with the MIC of vancomycin over 256 ug/ml and the MIC of teicoplanin varying from 32 to over 256 ug/ml. All these
5 strains carried the vanA gene. The sixth strain was resistant only against vancomycin (MIC>256 ug/ml) and
harboured the vanB gene. There was no epidemiological link between the patients the strains were isolated from.
Conclusions: VRE strains were involved only in sporadic infections so far, nevertheless their emergence should
be carefully monitored given the increased potential of these strains to cause hospital outbreaks. In a setting where
other multidrug resistant organisms are already endemic, the emergence and spread of VRE would further
challenge therapeutic possibilities.
Keywords: VRE, Nosocomial-pathogen, vanA, vanB
CORRELATION BETWEEN IMAGISTIC AND PATHOLOGIC FINDINGS IN CEREBRAL

MENINGIOMA
Frincu Laura Maria1, Dobra Alexandra Mihaela1, Macesanu Adelina1, Buruian M1
1
UMF Trgu Mure
Background: Meningiomas are the most common intracranial primary neoplasm in adults. Over recent years,
interest in this clinically group of extra-axial tumors increased, bringing new questions and challenges in the fields
of radiology, histopathology and neurosurgery. Objective: The aim of the study is to analyze the correlations
between specific preoperative imaging features and the pathological grade in patients with meningiomas in order
to provide an appropriate treatment planning. Material and methods: We retrospectively studied a number of 289
patients with cerebral meningioma admitted to the Neurosugery Departement, Emergency Clinical County Hospital
of Targu-Mures between 2009-2013. Only 231 recieved CT scans and MRI studies and the most important
imaging findings were analysed and compared with the postoperative histology. Imaging findings observed
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CLINICAL - MEDICAL
included: edema, capsular enhacement, heterogeneous tumor enhancement, indinstinct tumor borders,
hyperostosis of the adjacent skull and extracranial tumor extension. Histopathological grades were assigned as
benign, atypical and malignant meningiomas according to the World Health Organization(WHO) classification.
Results: Of a total of 289 patients, we found that women were more prevalent compared to men and the mean
age was 60 years( range 24-83 years). Regarding the histopathological diagnosis, the vast majority age were
WHO grade I tumors ( 80.9%), followed by Grade II tumors (7.6%) and Grade III tumors (11.4%). Indistinct borders
and heterogeneous tumor enhancement were identified predictive factors for advanced histopathological grade.
Conclusions: Imaging evaluation can provide useful information on meningiomas, helpful in preoperative
diagnosis and therapeutic strategy. Imaging features may lead to noninvasive differentiation between benign and
atypical or malignant tumors.
Keywords: meningioma, imaging, histopathologic
THE IMPACT OF OBESITY AMONG PATIENTS WITH NON-VALVULAR ATRIAL

FIBRILLATION
Macesanu Adelina1, Frincu Laura Maria1, Tatar Maria Cristina1
1
UMF Trgu Mure
Background: Obesity is a profound public health concern with increasing prevalence, which has become the
epidemic of the new millenium. Obesity and its related risk factors, such as hypertension, vascular disease,
obstructive sleep apnea and pericardial fat have an important contribution toward AF risk. Objective: The aim of
the present study is to observe the linkage between AF and obesity and the possible consequences. Material and
methods: We retrospectively studied 355 patients with non-valvular atrial fibrillation (we excluded the cases with
post-rheumatic mitral stenosis, severe mitral regurgitation, significant aortic valve disease and the patients with
mechanical and bio prosthetic heart valves), hospitalized in 3rd Internal Medical Department, Emergency County
Hospital of Tg.Mures between January 2013- December 2014. Results: Of 355 patients with non-valvular atrial
fibrillation, 166 presented obesity (46,8%), the female sex being more prevalent (55,4%), compared to men
(44,6%), p=0,05. Regarding the type of AF,patients with obesity had paroxysmal AF (34,3%), persistent (12%) and
were more likely to develop permanent AF (53,6%).We noticed the same prevalence in patients without obesity
(paroxysmal-33,3%, persistent-7,4%, permanent-59,3%). A significant correlation was found between patients with
obesity and diabetes mellitus (p=0,01for women, p=0,001for men), as it was expected . No association was
foundbetween obesity and stroke in either of the sexes groups (p=0,63 in women,p=0,66 in men), although
obesity is a risk factor for this pathology. Conclusions: Obesity and AF frequently coexist, especially in women,
which may increase cardiovascular events, but does not affect the outcome of cerebro-vascularevents (stroke).
There are no difference regarding clinical types of AF between patients with obesity and normoponderal patients. It
represents one of the very few modifible risk factors, knowing that lifestyle choices that lead to weight loss favor
sinus rhythm.
Keywords: atrial fibrillation, permanent, obesity
DISTONIC DYSKINETIC ENCEPHALOPATHY DISORDER.ETIOLOGICAL & PROGNOSTIC

ASPECTS AND COMORBIDITIES
El-Najjar Vera1, Racos Elisabeta1
1
UMF Trgu Mure
Background: Infantile Distonic Dyskinetic Encephalopaties is a rare and severe affection manifesting mainly in the
inability to properly organize and execute voluntary movements, coordinate automatic movements and keep
posture,all of whitch causing a major motor disability. The first signs are observed in the first 3 months of the
infant's life, progressing until the age of 2 years. This major motor disability will affect the infants psychically in a
direct way, some of them developing sleep disorders, panic attacks, hetero-aggressiveness and atipic autism.
Objective: Early detection of both major motor disabilities and their impact on the child's psychic. Material and
methods: This is a retrospective study on a number of 25 patients hospitalized in the clinic of N.P.P. in 2014,
investigated neurologically, psychically and paraclinically (EEG, CT, MRI). Results: All the patients suffered
severe motor deficiency, 48% severe mental deficiency, 28% autism, 8% sleep disorders, 4% heteroaggressiviness. Conclusions: The motor disability is a disorder that will automatically entail and affect the
CLINICAL - MEDICAL
25
patient's psychical conditon.The treatment is complex: medicatonal treatment , CFM, and also special educational
techniques are required. Early diagnosis and treatment can lead to favorable prognostics.
Keywords: Diston-dyskinetic encephalopathy, etiology, comorbidities, prognostic
THERAPEUTIC ASPECTS OF ESOPHAGEAL VARICES IN LIVER CIRRHOSIS

Cecilia Maria Ujica1, Dan MD PhD G1
1
UMF Trgu Mure
Background: Variceal bleeding is a frequent and very serious complication of liver cirrhosis and a major cause of
mortality. Endoscopic treatment of esophageal varices using band ligation remains the standard followed by
sclerotherapy and pharmacological therapy Objective: To analize therapeutic options of esophageal varices
depending on the staging, complications and other features Material and methods: This is a retrospective study
on a number of 227 patients admitted in the 1st Gastroenterology Clinic,Targu-Mures, Emergency County Hospital,
between 01.01.2014 " 31.12.2014 and endoscopicaly diagnosed with esophageal varices due to liver cirrhosis.
They were stratified on the degree of esophageal varices, gender, age and associated complications, such as
acute or past varriceal bleeding Results: Sex ratio was 71,36% men and 28,63% women; 32% show grade 1
varices, 9% grade 1 and 2, 26% grade 2, 6% grade 2 and 3, 23% grade 3, 4 7% grade 3 and 4, 1% grade 4; 43%
show gastric fornix varices; 22% show red spots on varrices. Varriceal acute bleeding was noticed at 20%. Acute
variceal bleeding was treated with band ligation in 93% and sclerotherapy was used in 7%. Prophylactic band
ligation was performed at 5%, and follow-up band ligation on 4,5% Conclusions: Endoscopic band ligation is the
metod of choice in acute variceal bleeding and prophylaxis of bleeding and rebleeding. Medication remains an
adjuvant mean in all patients.Medication remains an adjuvant mean in all patients.
Keywords: variceal bleeding, cirrhosis, endoscopy, therapy
SCHIZOPHRENIA: THE ROLE OF PREMORBID DISORDER IN DEBUT AND EVOLUTION

OF SCHIZOPHRENIA WITH AN EARLY DEBUT
PETER IONELA1, SZABO RACO ELISABETA1
1
UMF Trgu Mure
Background: SDP is one of the most devastating and complex psychic disorder characterized by psychotic
states, delusions, speech disorders in children between 13-18 years old. Objective: The purpose of this thesis is
to establish a prototype concerning the first stages of SDP and its evolution. Material and methods: The present
thesis is a retrospective study including 16 patients with ages between 11.8-17.8 years old, whom were admitted in
Pediatric Neuropsychiatry Clinic from Trgu Mure in 2013-2014. The diagnosis was based on DSM-V and ICD10.
Results: Most of the patients were between 15-16 years old(31.25%), 62.5% girls, 81.25% live in rural area.
Almost half the patients had family history with psychiatric disorders and 81.25% had significant personal
history.18.75% had only positive symptoms, 6.25% only negative and 75% both symptoms. The illness had an
acute beginning in 68.75%. The evolution was favorable with remission of symptoms in 81.25%. Conclusions:
The family histories and the personal histories had a significant role. The beginning was acute in 68.75%. 75% had
both positive and negative symptoms. The evolution was favorable under treatment an psychological counseling.
The disharmonic premorbid personality was an unfavorable prognostic factor.
Keywords: Schizophrenia, premorbid personality, evolution
COMORBIDITIES ASSOCIATED WITH THE HIV INFECTION

Ducra Alina Maria1, Sincu Mihaela Cornelia1, Banias Laura1, Chiriac Carmen1
1
UMF Trgu Mure
Background: In the last 20 years managing HIV seropositive patients underwent remarkable changes, increasing
both life expectancy and quality of life. However, an HIV seropositive patient is still exposed to numerous health
problems, some of which are a consequence of chronic infection with HIV, others are caused by antiretroviral
therapy (ART). Objective: The study aims to identify the incidence and spectrum of opportunistic infections
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CLINICAL - MEDICAL
(correlated with the degree of immunosuppression) and non-acquired immune deficiency syndrome (non-AIDS)
comorbidities for which HIV seropositive patients required hospitalization in the chosen period. Material and
methods: The study is a retrospective, analytical study of the diagnoses of HIV-positive patients admitted to the
Infectious Diseases Clinic I, Targu Mures, in the period 1 January 2013-31 December 2013 (59,84% male and
40,16% female) with a median age around 26 years and a treatment uptake of 40.98%. Results: 122 patients
required hospitalization (47.84% of them repeatedly, for various pathologies). 35.25% of them presented
coinfection HIV-hepatitis B, 1.64% HIV- hepatitis C, 5.66% HIV-hepatitis A.29.51% of patients were hospitalized
for opportunistic infections : toxoplasmosis 4, pulmonary tuberculosis 22, digestive tuberculosis 7, progressive
multifocal leukoencephalopathy 2, pneumonia with Pneumocystis Carinii 1, digestive tract candidiasis 4. The T
CD4 average was 208.Non-AIDS comorbidities occurred in 70.49% of patients. The most frequent were
respiratory infections (35.56%): 46.25% bacterial pneumonia, 22.5% viral respiratory infections, 11.25% bronchitis,
10% bronchopneumonia. 23.56% of admissions were for digestive pathology: 32.65% gastritis, 22.45% diarrheal
diseases, 8.16% abdominal pain, 6.12% cirrhosis, 4.08% gallstones, 4.08% heartburn. The third most encountered
were pathologies of the central and peripheral nervous system: 40.91% cephalgic syndrome, 36.36% epilepsy,
13.63% lomboscitica. Conclusions: Thanks to advanced ART, HIV-positive patients do not have the same
vulnerability to opportunistic infections and their pathology spectrum is largely shared with the uninfected patients.
Keywords: HIV,, comorbidities,, non-AIDS,, opportunistic
THE TREATMENT OF MULTIPLE MYELOMA USING BORTEZOMIB (VELCADE)

Stanca M1, Abaza Maria1, Costache Roxana1, Candea Marcela1
1
UMF Trgu Mure
Background: Multiple myeloma or plasma cell myeloma is a cancer arising from plasma cells. Plasma cells form a
part of our immune system. In myeloma, these cells become abnormal, multiply uncontrollably and release only
one type of antibody " known as paraprotein " which has no useful function. The collections of the abnormal
plasma cells accumulate in the bone marrow and interfere with the production of normal blood cells. Bortezomib, a
proteasome inhibitor, fights these pathologic modifications. Objective: The aim of this study is to prove the
efficiency of Bortezomib, a proteasome inhibitor. Material and methods: We conducted a retrospective study on a
group of 63 patients with myeloma admitted in the Medical Clinic I " Hematologic Disease of Trgu-Mure in 2014.
We have analyzed the prevalence of complete respondence, partial respondence and non-respondence in the
treatment with Bortezomib (Velcade"). Results: The group was divided according to the type of paraprotein
secreted by the myeloma (IgG 82%, IgA 16%, IgE 2%), the stage of the myeloma (stage 3 - 89%) and the
symptoms (70% symptom B). The division by drugs regimen showed that 37 patients from our group have been
treated with Velcade" from which 19 have achieved complete response to the treatment, 14 patients presented
partial response and 4 patients were non-respondent to the treatment with Velcade". The rest of the patients have
been treated with other cytostatics, therefore: 11 patients corresponding to VAD from which 3 achieved full
response, 6 presented partial response and 2 were non-respondent. 15 patients corresponding to the treatment
with VMCP from which 6 achieved complete response, 8 presented partial response and 1 was a non-responder.
Conclusions: When compared with other treatments with cytostatics, Bortezomib (Velcade") produces a response
in previously non-respondent patients that results in an increased survival rate.
Keywords: Bortezomib (VELCADE), multiple myeloma, treatment, proteasome inhibitor
TREATMENT OF A THORACOABDOMINAL AORTIC ANEURYSM BY MFM CASE REPORT

Hanea Madalina1, Costache V1
1
Facultatea de Medicin Victor Papilian Sibiu
Background: The aortic aneurysm is a pathological dilatation of the aortic wall due to multiple degenerative
disease that weaken the aortic wall. The risk of aneurysm rupture depends on its enlargement and rate of growth.
The MFM represents a new generation of stents which will laminate the blood flow in the aneurysmal sac and
toward the branches and collaterals, decreasing shear stress in the aneurysm. Objective: The MFM (Multilayer
Flow Modulator ) represents a new auto-expandable generation of three-dimensional stents using cobalt alloy. It is
formed by several inter-connected layers giving a porosity which will laminate the blood flow in the aneurysmal sac
and toward the branches and collaterals. It decreases shear stress in the aneurysm that allowed physiological
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27
thrombus to form. The MFM gets endothelialized permitting the reduction process to start. Material and methods:
A 68 years old patient was diagnosticated with double thoraco-abdominal aortic aneurysm and in the 9th of
February 2015 he presented at Polisano European Hospital for treatment. He has multiple comorbidities: essential
high blood pressure, second type diabetes, systemic atherosclerosis and hypercholesterolemia.One day after the
admission, a right femoral approach was tempt, without success due to extended iliac calcifications which blocked
the MFM delivery system. In the 16th of February, a left femoral access is made and under the angiographic
visualization, 2 MFM stents are placed on the aneurysms, first in the abdominal aorta and the second in the
thoracic aorta. Results: The post-operation evolution is favorable, the CT scan reveals the distal thoracic aorta
and the abdominal aorta patent, with regular laminate blood flow toward the branches and collaterals.
Conclusions: We present here a case report of a thoraco-abdominal aneurysm succesfully treated by MFM in the
Polisano European Hospital. This university hospital has the largest series in the country in the endovascular
treatment of abdominal and thoraco-abdominal aneurysms.
Keywords: stent, aneurysm, thoraco-abdominal
ASSESSMENT OF THROMBOEMBOLIC RISK FACTORS IN ATRIAL FIBRILLATION. IS

TRANSESOPHAGEAL ECHOCARDIOGRAPHY NECESSARY?
Costea S V1, Mares R G1, Sirbu Ileana Voichita1
1
UMF Trgu Mure
Background: Atrial fibrillation is one of the most common cardiac diseases,affecting 1% of the global population.
ESC guidelines recommend emergent cardioversion in atrial fibrillation debuted<48h.If the period is over 48h, a
transesophageal echocardiography(TEE) should be performed to exclude a thrombus.Also, the patient must be
treated efficiently 3 weeks with oral anticoagulants.After this period,Esc guidelines admit cardioversion without
TEE to exclude thrombi. Objective: The aim of this study is to assess if electrical cardioversion non-preceded by
TEE is really safe for all patients. Material and methods: We conducted a retrospective study,gathering data from
96 patients with non-valvular atrial fibrillation.The data was collected from the patient's medical files of the
Cardiology Clinic No1 Targu Mures.We recorded:age,sex,duration of atrial fibrillation, dimensions of left
atrium,spontaneous contrast/thrombi in LA/LAA,blood velocities and diabetes. Results: After analysis,21.62% of
the patients treated with oral anticoagulants had thrombi in LAA.At the second admission,97.30% of the patients
had INR 2-3.We discovered significant association between LAA thrombosis and age,patients over 65 years
having 3.34 higher risk(p=0.005)for LAA thrombosis.Also we found CHADS-VASc<2 as a protective factor for LAA
thrombosis(OR=0.1880,p=0.037).Moreover,atrial fibrillation debuted over 3 months is significantly associates with
LAA thrombosis(p=0.012).We didn't found significant associations between sex,atrial dimensions,diabetes and
LAA thrombosis at patients treated with oral anticoagulants. Conclusions: After analysing this study we come out
with the question:is electrical cardioversion non-preceded by TEE really safe for all patients?We also wonder if the
patients are correctly followed-up and anticoagulated.The vast majority of patients had INR 2-3,but we cannot be
confident that INR was 2-3 over the entire period of 3 weeks.In conclusion,due to our possibilities to monitor the
patients,we believe that TEE may be performed especially for those with higher embolic risk,even if they were
treated with anticoagulants 3 weeks.
Keywords: atrial fibrillation, left atrial appendage thrombosis, transesophageal echocardiography
ROUTINE DUPLEX SCAN IN SEVERE CHRONIC VENOUS INSUFFICIENCY MAXIMIZES

THE POST-OPERATIVE HEALING RATE OF VENOUS ULCERS.
Borz B1, Boan M1, Vultur Mara Andreea1, Crian Andrada Ioana1, Becica M1, Balogh Z1
1
UMF Trgu Mure
Background: The surgical treatment of severe chronic venous insufficiency (C4-C6) is aiming the alleviation of the
venous hypertension, by stopping the venous reflux in the superficial veins and perforating veins, due to failure of
the valves. The anatomical and physiopathological details are provided by the Doppler instrument (duplex scan).
Objective: The purpose of the study is to demonstrate that the use of duplex scan in severe cases of chronic
venous insufficiency is correlated with best post-operative results in terms of healing of the ulcer. Material and
methods: We reviewed the charts of 30 patients with severe venous insufficiency operated in the 2nd Surgical
department. The patients received duplex scan performed by well-trained angiologist. We made sure that the deep
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venous system is permeable. We marked the reflux areas where the incompetent valves were situated. There is
always a valve reflux of the perforating veins in the proximity of the ulcer. The surgical procedure consisted in the
resection of the saphenofemoral junction, the stripping of the greater saphenous vein, ablation of the varicose
veins and ligation of the marked incompetent perforating veins. Results: The healing process of the ulcer began
from the first postoperative day with obvious reduction of the size of the ulcer after 5 days and a complete healing
after 4 weeks. Conclusions: The use of the duplex scan in all patients with severe chronic venous insufficiency
enable us to deal precisely with the reflux source represented by the jonctional valve failure or/and incompetent
perforating veins, thus allowing the complete healing of the ulcers.
Keywords: Duplex scan, Incompetent veins, Venous ulcer
THE SURVEY OF PATIENTS PERCEPTION AND UNDERSTANDING OF ORAL

ANTICOAGULATION THERAPY
Flp Z Z1, Drgus Emke1, Elekes Andrea Henrietta1, Gyalai Z1
1
UMF Trgu Mure
Background: Various pathologies require the initiation of anticoagulation therapy. Vitamin K is the most commonly
used antagonists for this purpose in Romania. The therapy is safe and effective if the INR (International
Normalized Ratio) is between therapeutic values, however this requires periodic follow up and good long term
doctor-patient relationship. Objective: Our purpose was to evaluate patients knowledge and understanding of oral
anticoagulation therapy and how this treatment affects their quality of life. Material and methods: We conducted
an informative survey at the 4th Department of Cardiology, Emergency County Hospital in Tirgu Mures, during
October 2014 and February 2015. We surveyed 117 patients, who met the inclusion criteria. Furthermore, we
investigated the influence of this therapy on their lifestyle, side-effects, as well as patients attitude towards the
therapy and their awareness. Results: 62% of the respondents knew the definition of anticoagulant and 38% could
also define the term INR. Since the initiation of the anticoagulant therapy, 23% of the patients experienced sideeffects and severe haemorrhage occurred in 3 cases. 72% of the patients had doubts about changing the
administration of a new type of anticoagulant and 53% declared that they would not pay more money for this.
Conclusions: Two-third of the surveyed patients was well informed about anticoagulant therapy and its
importance, however less than 30% could define the term INR. Half of the patients are concerned about the effect
of oral anticoagulation therapy on their lifestyle.
Keywords: anticoagulant, therapy, INR, treatment
THE EVOLUTION OF THE FIRST PSYCHOTIC EPISODE OUTLINED BY THE

IDENTIFICATION OF THE PRODROMAL SYMPTOMS.
Nemes Georgiana1, Kovacs Alexandra 1, Taran Livia1, Buicu Gabriela1
1
UMF Trgu Mure
Background: During the first psychotic episode,it hard to precisely tell in which direction it will evolve,however
the question always arise if it is whether or not the beginning of schizophrenia.The premorbid functional stage of
the patient and also the prodromal phase,which refers to the first signs and symptoms of the disorder preceding a
psychotic episode can lead us towards a diagnostic and can outline sometimes the individual risk of the patient.
Objective: The aim of our study was to conclude if a prodrome can have certain implications towards
schizophrenia. Material and methods: This is a retrospective study which includes the evaluation of 2 lots of
patients who are in the first 5 years since the onset of the disorder.The first lot included 20 patients who were
diagnosed with schizophrenia and acute psychotic episode,as the DSM IV TR and PANSS tests concluded.The
second lot included 20 patients who were diagnosed with major depressive episode and major depressive affective
disorder, as the HAMD and BDI test concluded.The interview with the patient and the family focused on identifying
the prodrome type and risk factors,as well as personality traits,psycho traumas,resilience etc, which could suggest
a certain type of future evolution. Results: Prodromal symptoms such as irritability,low tolerance to
frustrations,suspiciousness,disinhibited behavior,aggressiveness,impulsivity and bizarre beliefs matched the
psychotic onset.Depressive or irritated mood,anxiety,social isolation and insomnia were not specific to any
schizophrenia onset. Conclusions: Patients who report unspecific symptoms in the period preceding the
onset,present a risk of developing not only a depressive disorder but a psychotic disorder as well.Detecting the
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29
prodrome facilitates an early intervention in the treatment of the disorder.A delayed treatment is associated with a
lower chance of remission and a less favorable long term prognosis.
Keywords: prodrome, first psychotic episode, schizophrenia
THE DIAGNOSTIC APPROACH FOR CERVICAL INCOMPETENCE

azberga z2, Iolanda Elena BLIDARU, MD PhD2, Jee Poh Hock M2
2
UMF Gr. T. Popa Iai
Background: The diagnosis of cervical incompetence(CI) is notoriously difficult. Clinical assessment alone is
unreliable, but there have been no tests which accurately confirm the diagnosis. Digital vaginal examination(DVE)
of the cervix in pregnancy has also proved to be of little value, because the earliest changes arise in the upper
cervix and cannot be detected digitally. Transvaginal ultrasonography(TVUS) does allow detailed examination of
the entire cervix and provides an objective diagnosis. Objective: The purpose of this study is to explore the
hypothesis that TVUS improves the accuracy of the diagnosis of Cervical Incompetence. Material and methods:
In Voda Obstetrics & Gynecology Hospital, IASI after evaluating the history of the patients whom present
risks of CI (miscarriages ,cervical/uterine anomalies and exposure to diethylstilbestrol) will undergo the following
methods; DVE,TVUS and bacteriological examination to diagnose CI. Our Research presents cases of Cervical
incompetence to evaluate the advantages and disadvantages of each method regarding its safety, efficiency,
accuracy. Results: By using DVE the diameter of dilated external-os can be assessed and whether the prolapsed
membrane is evident. The consistency of the cervix changes(softening and firmness) is an important sign that is
suggestive of impending miscarriage that can only be assessed digitally. The use of TVUS provides measurement
of the shortened cervical length(<25mm), cervical effacement and diameter of internal-os which may improve the
prediction of risk of preterm delivery .TVUS also shows the image of funneling of the cervix with changes in the
shape of T, Y, V, or U. A Vaginal swap was used to obtain bacteriological culture in order to assess the normal
flora and the non-evident of bacterial vaginosis and beta-hemolytic streptococcus - as these may lead to
chorioamnionitis which is contraindicated for cerclage. Conclusions: The accuracy of diagnosing cervical
incompetence could behighly improved viautilizing all 3 method stated above (DVE, TVUS and bacteriological
examination).
Keywords: Transvaginal Ultrasonography, Digital Vaginal Examination, Cervical Incompetent, Diagnosis
CSF BIOMARKERS AND ALZHEIMER'S DISEASE EARLY DETECTION - A COMPARATIVE

STUDY
Reda A1, Cernat I2
1

SUUB
Background: Alzheimer's disease (AD), is a progressive neurodegenerative disorder, mainly characterized by the
formation of senile plaques of -amyloid peptides and tau tangles, leading to neurodegeneration, causing cognitive
impairments and memory loss. In the near future, AD is going to be considered as a major public health issue with
patients reaching 76 million in 2030. Till this moment, the main trigger of the pathogenesis of AD is still unknown.
Accordingly, biomarkers are considered to be promising diagnostic tools that can help approach the pathological
side of AD in an ordered manner to achieve early diagnosis. Objective: assessing the efficiency of Cerebrospinal
fluid (CSF) biomarkers (Total tau, P-tau and -amyloid 1-42) to predict the development of AD Material and
methods: A comparison was done, between two studies published on the same cohort of patients, being
monitored for a range of 4.1-11.8 years, to test the efficiency of Cerebrospinal fluid (CSF) biomarkers (Total tau, Ptau and beta-amyloid 1-42) to predict the development of AD. The cohort consisted on 137 patients with mild
cognitive impairment (MCI), along with other 39 healthy subjects. On the course of the study, 57 patients with MCI
developed AD while 21 others developed different kinds of dementia. Results: The result of the first study "after 46 years of monitoring" stated that all tested types of CSF biomarkers were strongly related to the development of
AD in MCI patients. Yet, on the long-term, the second study, published around 6 years later, shows that betaamyloid 1-42 levels are efficient as early biomarkers (5-10 years) before AD development, while Total tau and Ptau are later markers. Conclusions: Such findings reach to the conclusion that further research to explore the
early biomarkers of Alzheimer disease should be conducted, in order to target AD in the early MCI state, where
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the cognitive and behavioral deterioration is still manageable.

Keywords: alzheimer's, csf biomarkers, amyloid, tau
TIME TO TREATMENT AND PROGNOSIS OUTCOME IN PATIENTS PRESENTING WITH

ACUTE ST ELEVATION MYOCARDIAL INFARCTION (STEMI)
Ismaiel A1, Deaconu A1
1
Background: Myocardial infarction(MI) is caused by myocardial cell death due to prolonged ischemia. It is a major
cause of death worldwide, a significant public health problem in industrialized countries and an increasingly
significant problem in developing countries. Objective: The aim of this study was to assess and compare the
prognosis, complications, systolic and diastolic functions of patients presenting with acute STEMI within 1-3 hours,
4-6 hours and >6 hours. Material and methods: A retrospective study was performed on 98 patients out of which
48 patients (49%) reached to the hospital within 1-3 hours (group1) from the onset of their symptoms, 26 patients
(26.5%) within 4-6 hours (group2) and 24 patients (24.5%) in > 6 hours (group3). Results: In this study, 76.5% of
the patients were males while 23.5% were females. The mean age was 58 with a minimum age of 29 and
maximum of 79. Percutaneous Coronary Intervention was performed in 79.2% of group3, 70.8% of group1 and
57.7% of group2. Fibrinolytics were initiated in 42.3% of group2, 29.2% of group1 and 20.8% of group3. Post MI
management complications were found in 20.8% of group3, 7.7% of group2 and 6.3% of group1. Systolic
dysfunction was present in 83.3% of group3, 80.7% of group2 and 79.1% of group1. Diastolic dysfunction was
found in 62.5% in group2, 56.3% in group1 and 52.2% ingroup3. Mortality rates were 7.7% ingroup2 and 4.2% in
group3. Conclusions: Patients that presented in >6 hours from onset of symptoms showed higher rates of
systolic dysfunction and post MI management complications. Patients that presented within 4-6 hours had a higher
mortality rate and diastolic dysfunction. On the other hand, patients that presented within 1-3 hours had more
preserved systolic function, less complications and no mortalities. This study shows that prognosis and better
outcome are linearly associated with time-to-treatment.
Keywords: Myocardial Infarction, STEMI, Prognosis, Time Treatment
IMPROVEMENT OF LIFE QUALITY AND NON MOTOR SYMPTOMS RELIEF IN PATIENTS

WITH ADVANCED PARKINSON'S DISEASE.
Pritcan Natalia1, Oltean Andra1, Szasz J A1, Constantin Viorelia1
1
UMF Trgu Mure
Background: Parkinson Disease is a chronic, progressive neurologic disease that is characterised by four cardinal motor
manifestations: tremor at rest, rigidity, bradykinesia, and postural instability. However, non-motor symptoms, such as cognitive,
neuropsychiatric, sleep, autonomic and sensory disturbances are gaining increasing attention.Objective: The present study
aims to evaluate the progress of non-motor symptoms on patients with advanced Parkinson disease, treated with
Levodopa/Carbidopa intestinal gel (Duodopa), over a period of two years. The evolution of the pacients life quality
was also monitored and studied. Material and methods: We performed a retrospective study of 17 patients with
advanced Parkinson disease, hospitalized in Neurology Clinic of Targu Mures County Hospital, which were
selected for treatment with Duodopa.The revised questionnaire
Non-Motor Symptom assessment scale for
Parkinson Disease , along with a questionnaire on quality of life, was applied for each patient.
Results: By
comparing the numbers obtained at baseline with those resulted after six, twelve, eighteen and twenty-four
months of treatement with Duodopa, we have the following results : the symptoms included in the cardiovascular
domain are the only ones with an unfavorable progres ( p=0.05), the gastrointestinal tract domain during the two
years of study revealed statistically significant improvement (p=0.046). The remaining fields (sleep/fatigue,
mood/cognition, perceptual problems/hallucinations, attention/memory, urinary, sexual function) and the life quality
improvement questionnaire revealed no significant modifications. Conclusions: There are many non-motor
symptoms in Parkinson Disease, a variety of them appear even before the classical motor symptoms. By
providing a continuous flow of medication directly to the intestines, where it is absorbed, Duodopa can help
maintain a constant level of levodopa in the blood and by that, it decreases the number of times a patient
alternates between stiffness and uncontrolled movements (on/off) having benefits also on several non-motor
symptoms
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Keywords: Parkinson's Disease, Non-motor symptoms, Duodopa
HELLP SYNDROME: DIAGNOSIS AND MANAGEMENT

Heller M2, lrhiati a2, azberga z2, Iolanda Elena BLIDARU, MD PhD2
2
UMF Gr. T. Popa Iai
Background: HELLP, a syndrome characterized by hemolysis, elevated liver enzyme levels and a low platelet
count, is an obstetric complication that is frequently misdiagnosed at its initial presentation. Many investigators
consider the syndrome to be a variant of preeclampsia, but it may be a separate entity. The etiopathogenesis of
HELLP syndrome remains unclear, which poses a challenge for tending physicians in diagnosing and initiating
proper therapeutic strategies to prevent fatal outcome. Objective: To evaluate the feasibility and reliability of the
current guideline to diagnose and therapeutic protocol for HELLP syndrome. Material and methods: To evaluate
the difficulty in prepartum diagnosis and therapeutic challenge in the management of postpartum complication.We,
from Voda Obstetrics & Gynecology Hospital,IASI are presenting a few cases of HELLP syndrome after
diagnosing with the current recommended guidelines; blood tests, radiological ,pathological and
gynaecological/surgical procedures were performed. Results: The first patient had been afflicted by a fulminant
HELLP syndrome causing delivery after 32 weeks of pregnancy. Consecutively, she suffered a sub-total liver
infarction followed by a severe coagulopathy and septic peritonitis. The second patient was diagnosed with HELLP
syndrome at 36 weeks of pregnancy. The initially mild syndrome exacerbated after delivery leading to hemorrhagic
shock and acute renal failure. In the third case, a woman with asymptomatic hepatitis B delivered in the 36th week
of pregnancy. Post partum, her pre-existing condition worsened fulminantly resulting in sub-acute liver dystrophy
and massive coagulopathy. Conclusions: Since HELLP syndrome patients present with unique clinical patterns
,the mainstay of therapy is supportive management, as we should tailor the emergency management according to
each patient to reduce the maternal and fetal complications.
Keywords: HELLP Syndrome, Glucorticosteroids, Thrombocytopenia, Obstetric
METABOLIC PROFILE AND OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN

Cojocaru Valentina1, Bercea Mara-Maria1, Pacanu Ionela Maria1
1
UMF Trgu Mure
Background: Osteoporosis is characterized by reduced bone mass and disruption of bone architecture, resulting
in increased risk of fragility fractures. Recent studies have focused their interest in researching the association
between bone mineral density (BMD) and atherogenic lipid profile. However, the results are controversial.
Objective: The aim of this study is to analyze if serum levels of total cholesterol, HDL-cholesterol, LDL-cholesterol,
triglycerides, magnesium, uric acid, iron, phosphate are associated with an increased risk for osteoporosis.
Material and methods: A retrospective case-control study was conducted, including 296 postmenopausal women
registered at Endocrinological Department of Targu Mures, 196 having documented osteoporosis and 100 with
normal BMD. Subjects with a body mass index (BMI) between 18.5 and 35 kg/m were selected, in order to avoid
the influence of extreme BMI on BMD. Results: A serum level of cholesterol > 200mg/dl was associated with an
increased risk for osteoporosis ( OR=4.91, p< 0.0001). For HDL-cholesterol we obtained that a serum level
>45mg/dl is associated with osteoporosis (OR=2.83, p<0.05). LDL-cholesterol >150 mg/dl has been a risk factor
for low BMD (OR=3.03, p<0.05). Serum levels of triglycerides >130mg/dl and magnesium >2mg/dl are protective
factors for osteoporosis (OR=0.76, p<0.05; respectively OR=0.24, p<0.05). No association was found between
serum uric acid, phosphate, iron serum levels and risk for osteoporosis. Conclusions: A high serum level of total
cholesterol, HDL-cholesterol and LDL-cholesterol are risk factors for osteoporosis. Protective factors are high
levels of triglycerides and magnesium. Iron, uric acid and phosphate serum levels do not influence BMD.
Keywords: Osteoporosis, risk factors, serum lipids
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CLINICAL AND PATHOLOGICAL FEATURES OF GASTRIC CARCINOMA

Pais Alexandra1, Vlad Diana Mihaela1, Macarie Melania1
1
UMF Trgu Mure
Background: Gastric carcinoma is a severe pathology and it is a disease commonly seen in our casuistry.There
are many histologic subtypes of gastric cancer and the prognosis of this severe disease is correlated with the
histopathological type. Objective: The aim of this paper is to establish the most important clinical and endoscopic
aspects of gastric cancer but also to correlate these with the histopathological type,with an emphasis on the gastric
carcinoma with signet ring cell,the histological form with a severe prognosis. Material and methods: We made a
retrospective study on a series of consecutive patients who underwent upper gastrointestinal endoscopy in
Gastroenterology and Endoscopy Unit of Targu-Mures County Clinical Emergency Hospital between 01st of
January 2011-31 of December 2014.In all cases with abnormal aspects at endoscopy multiple biopsies were made
and a pathologic diagnosis was available.The study included only the cases that were confirmed by the
Histopathology Department. Results: In the studied period there were diagnosed 172 patients with gastric
neoplasia,with a mean age of 66.47 years.The most frequently histopathological form was gastric
adenocarcinoma.The signet ring cell gastric carcinoma was diagnosed in 54 patients.We also observed a
predominance of the male gender (119 males and 53 women, respectively) with a ratio M/F of 2.24/1, ratio which
in case of signet ring cell gastric carcinoma was 1.45/1.The mean age of the patients with signet ring cell gastric
carcinoma was 60.57 years.The most frequent localization was the antrum in 44.18%(76) reported to all
neoplasms,but in case of signet ring cell gastric carcinoma the most common encountered localization was at the
body of the stomach in 48.27%(28) cases. Conclusions: The gastric cancer still represents a frequent
pathology.Major risk factors are the age and the masculine gender.The signet ring cell gastric carcinoma tends to
appear at younger ages and it is more frequent located on the stomach's body.
Keywords: gastric carcinoma, signet ring cell carcinoma, endoscopy
CLINICAL AND EPIDEMIOLOGICAL ASPECTS OF PATIENTS WITH NONALCOHOLIC

FATTY LIVER DISEASE
Vlad Diana Mihaela1, Pais Alexandra1, Macarie Melania1
1
UMF Trgu Mure
Background: Nonalcoholic fatty liver disease is one of the most common cause of chronic liver disease.It is
associated with the elements of the metabolic syndrome:obesity,type 2 diabetes mellitus and insulin
resistance,arterial hypertension,dyslipidemia and its prevalence is increasing rapidly throughout the world.
Objective: The aim of the study is to assess the main clinical and epidemiological aspects of this disease in our
geographical area. Material and methods: Our retrospective study included pacients hospitalized in the
Gastroenterology Clinic of the Emergency Clinical County Hospital in Targu Mures from 1st January 2014 to 31
December 2014.We included pacients with fatty liver disease diagnosed by ultrasound,both newly diagnosed and
with known diagnosis.The parameters assessed for each pacient were:liver enzymes,ultrasound result and the
presence of diabetes,obesity,dyslipidemia,hypertension.We excluded pacients with fatty liver disease secondary to
alcohol consumption or other ethiologies. Results: 259 pacients with fatty liver disease were hospitalized in the
Clinic of Gastroenterology in 2014.We observed a slight predominance of the male gender(133 males and 126
women) with a M/F ratio of 1.05/1.Considering the main risk factors,the most frequent association was with arterial
hypertension 50.19%(130) of them followed by dyslipidemia 39.76%(103).Diabetes was present in 15.05%(39) of
cases and obesity in only 12.35%(32).High levels of hepatic enzymes were found in 60 pacients.(23.16%)
Conclusions: Nonalcoholic fatty liver disease is a pathology frequently found in pacients with hypertension and
dyslipidemia.Clinicians should look for metabolic risk factors in pacients with this illness.
Keywords: fatty liver disease, dyslipidemia, arterial hypertension
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ANTIBIOTIC RESISTANCE EVOLUTION AMONG E. COLI STRAINS CAUSING URINARY

TRACT INFECTIONS
Szabolcs S1, Barabs Hajdu Enik1
1
UMF Trgu Mure
Background: Escherichia coli (E. coli) is a Gram-negative, facultative anaerobic, bacterium that is commonly
found in the intestine. Most strains are harmless, but some can cause gastrointestinal or urinary tract infections.
Objective: The aim of this study was to numerically evaluate the resistance of E. coli isolates to certain antibiotics
and to search for trends and/or tendencies regarding resistance evolution. Material and methods: We chose a
sample of 510 E. coli antibiotic sensitivity test (AST) results for urine cultures performedbetween 1st May 2012 and
1st March 2015 in the Laboratory of the Targu Mures County Hospital. The chosen antibiotics were: Ampicillin
(AMP), Amoxicillin (AMC), Cephotaxime (CTX), Cephtadizime (CAZ), Cephuroxim (CXM), Gentamycine (GM),
Nalidixic Acid (NA), Trimethoprim/Sulfametoxazone (STX), Tetracycline (TE), Levofloxacin (LEV), Norfloxacin
(NOR), Nitrofurantoin (F). In some months due to lack of material, some antibiotics were not tested. Results: The
tested pathogen showed at least one case of resistance for every single antibiotic, the highestbeing 57.78% to
AMP and the lowest being 0.56% to CAZ. The fastest yearly increase appeared in LEV (80.01% between 2012
and 2013). Resistance to the following substances increased every year: AMP (p=0.0157), LEV (p=0.046), GN
(p=0.18), whereas sensitivity seemed to increase in the case of AMC (p=0.0350). Antibiotic resistance values
reach their peak during the warmer months, the most frequent being September with 9 peaks (28.12%), while the
colder months showed to have the least amount of peaks: December and February 0%. E coli presents no regular
peaks during a year. Conclusions: The lack of regular antibiotic resistance testing inhibits the precise evaluation
of resistanceevolution. Furthermore it also limits treatment options in case of more resistant strands. Antibiotic
resistance seems to be increasing on a yearly basis. The most resistant strains seem to appear during the warmer
months of the year with no regular cycle.
Keywords: E Coli, Antibiotic, Resistance, Evolution
PDQ-4 - DECAS - COMPARATIVE STUDY REGARDING THE CONNECTIONS BETWEEN

THE PERSONALITY DIMENSIONS AND THE MALADAPTIVE TRAITS
Adriana Andries1, Grigore Adelina Sofia1, Craciun Raluca Adela1, Nirestean A1, Szasz I Z1
1
UMF Trgu Mure
Background: According to the Big Five Theory, the personality is structured in five personality traits. These traits
are expressed differently in every personality disorder category. Objective: The aim of this study is to show the
connections between the five personality traits ( openness, conscientiousness, extraversion, agreeability, and
emotional stability) and the presence of maladaptive personality traits. Material and methods: The study was
conducted on a seventy-four medical student group using a composed questionnaire. The questionnaire contained
two personality tests, PDQ-4 (The Personality Diagnostic Questionnaire-4) and DECAS ( personality inventory test
based on the Big Five Theory). Results: The five personality traits levels are correlated with the presence of
maladaptive personality traits. We found negative correlations between the presence of maladaptive personality
traits in all of the three clusters, and the agreeability and emotional stability traits. Also, we found negative
correlations between the extraversion trait and the A and C cluster maladaptive characters, unlike the B cluster,
which was positively correlated with this trait. Conclusions: According to our study results, we can conclude that
the high number of maladaptive traits is associated with low scores of agreeability and emotional stability. We can
apply the same conclusion regarding the A and B clusters characters and the extraversion trait, and reverse it on
the B cluster, where the high number of maladaptive traits is associated with low scores of extraversion.
Keywords: Big Five Theory, personality disorders, DECAS, PDQ-4
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CLINICAL - MEDICAL
NON PHARMACOLOGICAL MANAGEMENT EFFICIENCY ON PROCEDURAL PAIN DURING

IM INJECTIONS
PASC ANDRADA LARISA 1, BUTA OLIMPIA AURORA1, BARBA ANDREEA1, SUCIU LAURA MIHAELA1, CUCEREA
MANUELA1
1
UMF Trgu Mure
Background: In the first day of life, almost all healthy term neonates are subject to two or three painful
percutaneous procedure including intramuscular injection. Newborn infants can perceive pain,process pain
sensation and respond to pain through facial expressions, behavioral responses and physiological signals.Using
pharmacological agents like analgesics for short term painful interventions are questionable because these agents
have poor efficiency and adverse side effects. Non pharmacological methods are convenient, inexpensive and well
tolerated by the infants and are the best choices addressing short term procedural painful interventions like
intramuscular injection. Objective: The purpose of our study was to compare the efficiency of three non
pharmacological pain relief strategies: breastfeeding (BF), routine care measure and skin-to-skin contact (SSC) on
newborns receiving their first IM injection for hepatitis B vaccine. Material and methods: 90 infants were recruited
by convenience sampling from the neonatal nursery at a medical center in Tirgu Mures and included in one of
three groups. The IM injection procedures were controlled to be administered within one minute in all newborns in
all three groups. Outcomes variables included newborn infant pain, physiological responses and cry duration.
Results: The study participants were 15 male and 15 female healthy term newborn infants in each of the three
groups(n=30), for a total sample of 90. Infants in the BF and SSC group had significantly lower pain score compare
to standard care group. The pain score in newborn infants were significantly related to their state before painful
procedure and baseline pain score. Conclusions: Non pharmacological methods tested in our study are
efficacious tools and should be incorporated into caregiving newborns undergo very short painful interventions.
Keywords: pain, newborn, non pharmacological methods
OBSTETRICAL AND PERINATAL FACTORS AFFECTING NEONATAL PAIN RESPONSE TO

ROUTINE PROCEDURAL INTERVENTIONS
BUTA OLIMPIA AURORA1, PASC ANDRADA LARISA 1, BARBA ANDREEA1, SUCIU LAURA MIHAELA1, SIMON
MARTA1
1
UMF Trgu Mure
Background: It is now widely accepted that neonates perceive and respond to pain and that acute and repetitive
pain experience have long term effects resulting in increased sensitivity to pain and reduce pain thresholds.
Objective: The study aimed to explore the associations of obstetrical and perinatal factors with pain response of
term newborn infants receiving non pharmacological interventions for painful routine care procedures Material and
methods: Pain response to procedural painful routine care at 72 hours of life was analyzed according to the
obstetrical and perinatal factors. Newborn infants were included into two groups according to mode of delivery:
spontaneous vaginal delivery (SVD) and cesarean section (CS). For each child, one outcome parameters were
assessed: Premature Infant Pain Profile (PIPP) score. At the age of 72 hours, the expression of the neonate pain
was assessed 30 seconds before and during heel lance, and after that at three different times in the recovery
phase, documented by video recording and then also analyzed by 2 independent researchers Results: Difference
in pain response according to obstetrical and perinatal characteristics and baseline characteristics were statistically
analyzed. Some baseline characteristics of the mothers and child differed among the groups according to the
mode of delivery. The only variable highly associated with the behavioral parameters was Apgar score less than 7
at 1 and 5 minutes. Conclusions: Our finding rise important methodological issues that need to be considered as
future studies are designed to examine the impact of obstetrical and perinatal factors on pain response in
neonates.
Keywords: neonatal pain, procedural interventions, PIPP
CLINICAL - MEDICAL
35
CENTRAL DIABETES INSIPIDUS, CLINICAL AND LABORATORY CHARACTERISTICS

Onijan Adela Tatiana1, Pacanu Ionela1
1
UMF Trgu Mure
Background: Central diabetes insipidus (CDI) is a rare condition characterized by insufficient synthesis or
secretion of antidiuretic hormone (ADH) due to disturbances in the hypothalamic neurohypophyseal tract.
Objective: The objective of the study is to analyze the clinical and laboratory findings in patients diagnosed with
central diabetes insipidus. The characteristics of the entire study sample are first interpreted separately, and then
in comparison to primary polydipsia (PP). Material and methods: The retrospective study was conducted between
January 2004 and December 2014 in the Endocrinology Clinic, Tg.-Mures. We included 91 patients who were
divided into two groups: a group of 62 patients representing patient with CDI, and another group of 29 patients who
are diagnosed with PP. Results: The group included 29 women, representing 46.8%, and 33 men, representing
53.2% of all the patients diagnosed with CDI. The average age of identification of this condition is 31 years. CDI
occurs after surgery in a proportion of 33.9%, tumoral etiology represents 25.8%, and in 27.4% of the cases was
considered idiopathic form. In the patients diagnosed with PP, the idiopathic etiology occurred in 65.5% of the
cases.The patients suffering from CDI were submitted to the water restriction test with monitoring of urine
output.During the water restriction period the average urine output was 6347 ml, and after administration of
Desmopressin it revealed a significant decrease up to 2074 ml. In those with PP the average urine output was
3716.The urinary average density in the patients suffering from CDI was 1002, and after Desmopressin
administration it improved to 1017.In the patients suffering from PP, the urinary average density was 1018.
Conclusions: Although symptoms may be identical, the correct identification of the etiology and the appropriate
treatment of both disorders can improve the quality of the patients life.
Keywords: central diabetes insipidus, diuresis, Desmopressin
THE INFLUENCE OF PERIODICAL MEDICAL EXAMINATIONS OVER READMISSION

RATES, IN PATIENTS WITH ACUTE DECOMPENSATED HEART FAILURE
Stoica A1, Pager Brigitta1, Carasca E1
1
UMF Trgu Mure
Background: The cardiovascular diseases, which include heart failure, represent the most prevalent pathology on
the globe. Acute decompensation of heart failure is due to a series of factors, including the lack of patient
compliance and his absence from periodical medical examinations Objective: Our study goal is to analyze in
which way, the visit to the treating physician, in 7 and 30 days from discharge, influence de evolution of heart
failure and the readmission rates Material and methods: The study was conducted on 53 patients, from 4th
Medical Clinic, in Targu Mures, that were hospitalized for acute decompensated heart failure. They were monitored
over 6 months after their discharge. Results: From a total of 53 patients, only 3 came to the 7th-day examination.
In the first month, 21 patients were presented, of which 17 in emergency. After the 1st month and until the 6th
month, 33 patients were presented, of which 21 in emergency. 3 patients died during the study. All the patients
who came to the 7th-day examination, had at least one presentation in emergency, while 14 patients, who had not
been to any medical examination after their discharge, had not came in emergency either. Conclusions: The lack
of patient compliance to periodical medical examinations can explain, largely, negative evolution of many patients
with heart failure; it also can explain the avoidance of hygienic-dietary and therapeutic guidance.
Keywords: heart failure, compliance, readmission
CLINICAL AND EPIDEMIOLOGICAL ASPECTS OF LIVER CIRRHOSIS AMONG THE YOUNG

AND MIDDLE-AGED PATIENTS
Dolghii Xenia1, Bordianu Alexandra1, Vulea Diana Monica1, Macarie Melania1
1
UMF Trgu Mure
Background: In the past several decades liver cirrhosis has become a major problem, furthermore it is regularly
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CLINICAL - MEDICAL
diagnosed among the young population.The number of young patients suffering from cirrhosis caused by alcohol
abuse is progressively increasing. Objective: The aim of this study is to define the main clinical and
epidemiological features of liver cirrhosis among the young population. Material and methods: A retrospective
study was performed which included the patients diagnosed with liver cirrhosis admitted in Gastroenterology
department of Trgu Mure Emergency County Hospital between 01.01.2013-31.12.2014. According to age
category, the patients were stratified into two groups:under and over 50 years old. Also the patients were
separated by sex categories and living areas.All the readmissions were excluded. Results: During the studied
period 627 patients suffering from cirrhosis were admitted in Gastroenterology department of Trgu Mure
Emergency County Hospital.There were included in the study 398 patients being separated by age category into
two groups: over 50 years old(309)and under 50 years old(88)with an underlined ratio of >50/<50 of 3,5/1. There
has been noticed a male prevalence in the age category of cirrhotic patients under 50 years old with a ratio of M/F
of 3/1.Concerning the geographical distribution of cirrhotic patients under 50 years old there was noticed a
prevalence in the rural living area(50 rural vs 38 urban) with a ratio of R/U of 1,3/1. Etiologically among the cirrhotic
patients under 50 years old there was identified the toxic etiology in 82,9%(n=73)of cases, followed by HCV in
13,6%(n=12)of cases,HBV in10,2%(n=9) of cases. There were detected 2,2%( n=2)cases of autoimmune cirrhosis
and 2,2%(n=2)cases of cirrhosis due to Wilson disease either.Also there were identified 10 patients with an
associated etiology of cirrhosis:viral and toxic. Conclusions: All these findings totally confirm that cirrhosis
represents an alarming issue of actual society,especially regarding its etiology and an early age it is diagnosed.
Keywords: Cirrhosis, Alcohol Abuse, Young Age
PERINATAL RISK FACTORS FOR CHRONIC LUNG DISEASE IN INFANTS BORN BEFORE
32 WEEKS OF GESTATIONAL AGE
Gmbuan Ana-Maria1, Cucerea Manuela1
1
UMF Trgu Mure
Background: Chronic lung disease (CLD) is one of the most severe late complication of prematurity, associated
with oxygen therapy and mechanical ventilation. Objective: To identify risk factors for CLD. Material and
methods: prospective study conducted at the Clinic of Neonatology I Targu-Mures. Data were collected over from
01.07.2014 to 31.12.2014. All the surviving infants born before 32 weeks of gestational age were included.
Regarding the statistical analysis p-value < 0.05 ( 95% CI ) was considered significant. Results: 47 preterm
neonates with mean gestational age (GA) 29.11 2,70 weeks and mean birthweight (BW) of 1109.36 257.40g
were enrolled in the study. 8 of them were diagnosed with CLD (20.78%). The incidence of CLD was 54.54% in
infants with BW 1000g and 0% in the group with BW between 1001-1500g. Infants with CLD had significantly
lower GA (p=0.002), BW (p=0.000), Apgar score at 1 (p=0.010) and 5 minutes (p=0.044). The duration of CPAP
support (p=0.009), mechanical ventilation (p=0.000) and oxygen therapy (p=0.000) were significantly higher.
Significant correlations (r<0.3) were found between the occurrence of CLD and the need for surfactant
administration (p = 0.024), apnea of prematurity (p = 0.006), intraventricular hemorrhage (p = 0.027), ulcerative
necrotic enterocolitis (p = 0.033) and retinopathy of prematurity (p = 0.000). Conclusions: low BW and GA, birth
asphyxia, severe respiratory distress, oxygen therapy, ventilatory support, and perinatal infections were recognized
as risk factors for CLD in infants with low gestational age and low birth weight.
Keywords: chronic lung disease,, prematurity,, risk factors
PREVALENCE OF THE COMPLICATIONS IN THE HEPATIC CIRRHOSIS

Rusu M1, Golea Andreea Manuela1, Craciun Nicoleta1
1
UMF Trgu Mure
Background: The hepatic cirrhosis is a well known condition of our present days . This pathology has a major role
, both national and global, because of the high incidence, but especially through the major complications which the
patients experience . Objective: The purpose of our study was to monitor the evolution of our patients with hepatic
cirrhosis, to identify the prevalence of the complications and to evaluate the correlations between the type of
cirrhosis and the complications it associates. Material and methods: We have elaborated an observational and
retrospective study performed on 205 patients. They were hospitalized in the Medical Clinic II in Targu-Mures,
between 1 january 2012 - 31 december 2013. GraphPad and Microsoft Excel programmes were used for the
CLINICAL - MEDICAL
37
statistical interpretation. Results: In the study group there were 69 women and 136 men. In our study the hepatic
cirrhosis occurred in patients between 21 and 90 years of age. The analysis showed that 110 were from the rural
area and 95 from the urban area. Regarding the etiology the most frequent one is the toxic cirrhosis which was
identified in 143 cases followed by the viral etiology (CHV) detected in 46 cases. 5 cases were primary biliary
cirrhosis and 1 secondary. The most common complications were 98 cases of ascites, 124 esophageal varices ,
162 portal hypertension, 32 hepatic encephalopathy and 25 upper gastrointestinal bleeding. We have found
statistically significant correlations between toxic cirrhosis and the complications. Conclusions: It has been proven
that the main etiology of the hepatic cirrhosis is the toxic one. Our study showed that the toxic cirrhosis correlates
with all the mentioned complications.
Keywords: toxic cirrhosis, ascites, esophageal varice
DIABETIC DYSLIPIDEMIA A MAJOR RISK FACTOR IN CARDIOVASCULAR DISEASES

Grigore M1, Banciu Andreea Maria1, Boitan Minerva1
1
Facultatea de Medicin Victor Papilian Sibiu
Background: Cardiovascular diseases (CVD) is the principal cause of morbidity and mortality in Diabetes Mellitus
patients. Dyslipidemia is an abnormality within the lipid profile, common especially in type II and it is a major risk
factor for CVD among hypertension, obesity and smoking. Objective: The aim of this study is to prove the major
risk of Dyslipidimia in CVD. Material and methods: A total of 100 patients (11 type I, 89 type II, 61 men, 39
women, age range: 38 - 69 years, mean age: 55.52 years, mean time since diagnosis 8 years [range 2 " 29]),
HbA1c 7.45 [range 4 - 14], Treatment: 61 % insulin-dependent, 39 % oral diabetes medication), from Emergency
Country Hospital of Sibiu were included in a retrospective study. Results: More than 50% of patients had elevated
triglycerides, LDL-Cholesterol, Cholesterol, and low HDL-Cholesterol levels. Dyslipidemia is more frequent in type
II (94 %), BMI influenced the lipid profile (21 % > 25 kg/m2, 68 % > 30 kg/m2 [3 % > 25 kg/m2, 3% > 25 kg/m2 had
type I]), over 60 % had dyslipidemia. CVD and comorbidities: Hypertension (72 %), Ischemic Cardiomyopathy (48
%), Cardiac Insufficiency (17 %), Gout (3 %), Pancreatitis (2 %), Hyperthyroidism (4 %), Hypothyroidism (6 %).
Conclusions: CVD is more frequent in men, the age between 50-60 years and in type II Diabetes. Dyslipidemia is
influenced by gender [Men had more elevated triglycerides, lower HDL-C level and less LDL-C level compared
with women who had higher LDL-C and not a decrease HDL-C as men], there is a correlation showed in one third
of patients: the increases of LDL-C level and the decrease of HDL-C and the risk of CVD is very high (more than
60% suffers of Hypertension, Cardiomyopathy or Cardiac Insufficiency), the reduce of HDL-C is more important
than a higher increase of LDL-C.
Keywords: Cardiovascular Disease, Dyslipidemia, HDL-Cholesterol, Obesity
ASSESSMENT OF CLINICAL RISK FACTORS FOR OSTEOPOROSIS IN PATIENTS WITH

CONSISTED FRACTURE
Simion G2, Stanca M2, Luparu Alina2, Pascanu Ionela2, Bataga T2
2
UMF Trgu Mure
Background: Osteoporosis is a very frequent age-related disease, characterized by low bone mass, which leads
to fragility fractures caused by minimal trauma. Even though, this pathology is still undiagnosed and, therefore,
untreated. This leads to the hospitalization of the patients directly into the orthopedic clinic with a consisted
fracture, knowing that the consequences of a fracture are: increase mortality, morbidity, institutionalization and
economic costs. Objective: The aim of this study is to reveal how many cases of fracture we could prevent by
discovering the patients with high-risk for osteoporotic fracture and treating them. Material and methods: Our
study included a number of 100 patients hospitalized with a consisted fracture. We evaluate the clinical risk factors
for an osteoporotic fracture in all these patient using Frax, a tool that has been developed for this purpose by
WHO. Results: In the study group age ranged between 40 and 90 years old, 57% of patients being women, and
the remaining men. 32.5% of men had medium risk of a major osteoporotic fracture in the next 10 years; 38.5% of
women had medium risk and 8.7% of them had high risk of developing a major osteoporotic fracture in the next 10
years. Patients with a medium risk should perform a complete biochemical evaluation and a DXA scan for bone
mineral density determination and those with a high risk for a fragility fracture it is highly recommended to start
specific antiosteoporotic treatment. Conclusions: We discovered a considerable percentage of patients with a
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CLINICAL - MEDICAL
medium or high risk of developing a major fracture in the next 10 years, which means that the consisted fracture
could have been an osteoporotic one.
Keywords: fragility fractures in the orthopedic service, undiagnosed osteoporosis, consisted fracture,
THE EVALUATION OF MALNUTRITION RISK USING PYMS SCORE AND CONNECTIONS

BETWEEN THE RISK FACTORS
Madarasz Halmaciu Alexandra1, Man Lidia1, Marginean Dr. Oana1
1
UMF Trgu Mure
Background: Malnutrition can be defined as a state of nutrition in which deficiency or an excess of energy,
proteins and other nutrients causes measurable adverse effects on tissue and body form and on clinical outcome,
a nutritional imbalance which affects the quality of life. Objective: The aim of this study is to estimate the
malnutrition risk using the PYMS score and also to realise a connection between the age of patients and the
pathology, the admission period and the value of the final score. Material and methods: This prospective study
was conducted between January and December 2014. We studied a number of 786 patients who were aditted to
the Pediatrics department, Emergency Clincal County Hospital of Targu Mures. We used the Peadiatric Yorkhill
Malnutrition Score (PYMS) which rate BMI, weight loss, dietary intake and predicted effect of the current condition
of nutritional status, with a score of 0-2 for each element. A score of 0 indicates a patient with low risk of
malnutrition, a score of 1 a moderate risk and a score of 2 or above indicates high risk. Results: From the total of
studied patients 36,51% presented a low risk of malnutrtion, 20,48% indicates a medium score and 43% exhibit a
high risk. The most frequent incriminated pathology is the gastrointestinal one with a percentage of 24,26%
followed closely by the respiratory pathology represented by 24,26% of the cases. Concerning the age of patients,
the age group between 1 and 3 year represents 54,14% and the group 4-7 year represent 19,23%.The period of
hospitaliation between 15 and 19 days is associated in 80,64% from the cases with a high risk of malnutrition.
Conclusions: Nutrition screening using the PYMS score offer us the opportunity to identify children at risk of
malnutrtion.
Keywords: PYMS score, malnutrtition, nutrition screening, children
THE ULCER OF GASTRIC STUMP: A CASE-CONTROL STUDY

Spac Roxana1, Nina Sincu 1, Stoica Andreea Bianca1, Stoica I1, Gavriela Adriana Radoiu1, Negovan Anca1, Pantea
Cristina Monica1
1
UMF Trgu Mure
Background: The discovery of Helicobacter pylori (H. pylori) infection reduced the need to perform gastrectomy in
peptic ulcer disease (PUD) patients, even among a population with high prevalence of H. pylori infection.
Objective: To study the effects of biliary reflux, H. pylori infection and use of gastrotoxic medication (NSAID,
antiplatelet therapy) in ulcer occurrence among patients with partial gastric resection performed for peptic ulcer
disease. Material and methods: A consecutive series of patients with gastric resection for PUD, who underwent
endoscopic examination between 2012-2014 for dyspeptic symptoms, were retrospectively analyzed. We analyzed
the correlation between biliary reflux, gastrotoxic medication consumption, H. pylori infection and the severity of the
lesions in 58 patients with gastric resection. We used Lanza classification in order to establish the severity of the
endoscopic lesions and we applied questionnaires in order to determine drug exposure and the presence of other
diseases. In all the patients enrolled we performed upper digestive endoscopy and four biopsies were taken and
analyzed. Results: We compare risk factors for ulcer occurrence in the studied group (n=10 patients with Lanza 4
score) and in the control group (patients with no endoscopic lesions n=26, Lanza 0 score). Ulcers of gastric stump
was statistically significant more frequent in patients with gastrotoxic medication in comparison with patients with
no drug exposure (p=0.048, 80% vs. 38.4%). The frequency of H. pylori infection, biliary reflux on endoscopy and
premalignant histological lesions (gastric atrophy and or intestinal metaplasia) were not correlated with ulcers in
our study. Conclusions: Gastrotoxic medication but not Helicobacter pylori infection was the most important risk
factor for ulcer in patients with partial gastrectomy.
Keywords: gastric resection, ulcer, NSAID, biliary reflux
CLINICAL - MEDICAL
39
CLINICAL ASSESSMENT OF MULTIPLE SCLEROSIS PATIENTS TREATED WITH

GLATIRAMER ACETATE
Romaniuc Andreea1, Molnr Kinga1, Marta Elena Rotaru1, Zeffer T1, Blaa Rodica1, Maier Smaranda1
1
UMF Trgu Mure
Background: Multiple sclerosis (MS) is a chronic multifocal inflammatory, demyelinating and immune-mediated
disease of the central nervous system that affects an estimated 2.5 million people worldwide and is one of the
most common causes of neurological disability in young adults. Glatiramer acetate (GA) is a peptide mixture of
four aminoacids currently used as a first line drug in the treatment of MS. Objective: To evaluate the clinical status
using the Expanded Disability Status Scale (EDSS), the relapse rate and the individual tolerability of patients
treated with GA. Material and methods: This is a retrospective study evaluating 56 patients from the 1st
Neurology Department in Trgu Mure who were treated with GA between 2004-2015. In these patients we noted
the following: sex, age, type of disease onset, clinical forms of MS, annualized relapse rates (ARR) before and
during the treatment and the initial and present EDSS scores. Results: The mean age at MS onset was 33.5 years
(SD=7.8). In the study were included 39 women and 17 men. The mean treatment duration was 4.3 years
(minimum=1 year, maximum=10 years). The initial EDSS was 2.2 (SD=1.2) and the current EDSS is 2.4 (SD=1.8).
46 patients have relapsing remitting MS (RRMS) and 10 secondary progressive MS (SPMS).4 patients converted
from RRMS to SPMS. 71% of the patients had a stationary or decreasing evolution of EDSS score. ARR has
decreased during the treatment in 86% (n=48) of the cases with a statistical significance in both RRMS and SPMS
groups (p=0.0001 and p=0.01).Out of 8 patients with an initial EDSS 4.0 only 3 had a deterioration of
neurological status. We observed that almost 90% (n=50) of the patients had no adverse reactions to the
treatment. Conclusions: GA reduces the ARR, delays the disease progression and is well tolerated in patients
with MS.
Keywords: multiple, sclerosis, glatiramer, acetate
THE PATTERN OF SYSTEMIC LUPUS ERYTHEMATOSUS MANIFESTATIONS IN

PATIENTS MONITORED IN THE UNIVERSITY CLINIC OF RHEUMATOLOGY OF TARGU
MURES
Brinzan-Antal Gabriella- Zsuzsanna1, Zolya Eniko-Kinga1, Copotoiu Monica1
1
UMF Trgu Mure
Background: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder with a broad spectrum
of clinical manifestations encompassing almost all organs and tissues. Assessing disease activity in SLE is crucial
to the physician as it forms the basis for treatment decisions. Objective: The main aim of our study was to
evaluate the outcome of patients diagnosed with systemic lupus erythematosus (SLE) using in daily practice the
SLEDAI score. Material and methods: A prospective study was performed in the University Clinic of
Rheumatology of Targu Mures starting from 1st January 2015. Patients diagnosed with lupus, were assessed, by
using Systemic Lupus Erythematosus Disaese Activity (SLEDAI) score. Demographic data such as gender, age,
the onset of the disease, treatment and clinical and paraclinical data were collected. The correlation between the
clinical manifestations and lab tests was obtained by using the GraphPad Prism 5.0 software. Results: Fifteen
patients were recorded. 14 were female and 1 male. The mean age was 49.63 +/- 13.52 years old. The mean (in
years) from the onset of the disease was 7.33+/-7.87. The final overall SLEDAI score was 20.53+/-10.48.
Analysing the data retrieved from the SLEDAI score we were able to find correlations between the organ brain
syndrome and serositis in lupus (pleurisy, pericarditis " p:0.005, r: 0.681) and also fever (p:0.001). Patients that
presented serositis also associated leukopenia and thrombocytopenia. No correlations were found with low
complement or anti DNAds antibodies. Conclusions: Leukopenia and thrombocytopenia are to be monitored in
lupus as markers of activity. We weren able to find the cause of association between the organ brain syndrome
and serositis in our patients. Further studies are to be performed.
Keywords: Lupus, SLEDAI, manifestations
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CLINICAL - MEDICAL
THE IMPACT OF COGNITIVE IMPAIRMENT ON DAILY LIVING ACTIVITIES,IN PATIENTS

WITH DEMENTIA
Craciun Raluca Adela1, Grigore Adelina Sofia1, Adriana Andries1, Buicu Gabriela1
1
UMF Trgu Mure
Background: Dementias are defined as a class of mental disorders,characterised by progressive impairment of

mental functions,especially memory loss,behavioral disturbances and personality changes.Although dementia
represents an illness which is more and more frequent, as it's incidence is increasing worldwide,the therapeutic
resources are still limited and have modest efficiency. Objective: The aim of this study was to establish a
correlation between the level of cognitive impairment and functional abilities of patients with Dementia from two
nursing homes: Residential Center for Elderly and Residential Center for Elderly Sarmasu.
Material and
methods: The demographics were collected from medical records of fifty institutionalized patients with dementia.
ADCS-ADL scale was applied on caregivers while MMSE scale was apllied on patients.The data was statistically
processed and analysed. Results: There were 50 patients included in the study.30% males and 70% females,with
mean age of 79.2 years.. Regarding the type of dementia,42% had Mixed Dementia(Alzheimer disease and
Vascular Dementia), 38% had Vascular Dementia, 18% of patients had Alzheimer disease and 2% had Mixed
Dementia (Parkinson disease Dementia and Vascular Dementia).14% of patients had just one comorbidity,20%
had two comorbidities and 66% had more than two comorbidities.Based on MMSE score, 24% of patients had Mild
Dementia (20-26 points),30% had Moderate Dementia(11-19 points) and 46% had Severe Dementia(<10 points).
In term of ADCS-ADL,96% had a Severe ADL Impairment,4% had Moderate ADL Impairment and there was no
patients with Minore ADL Impairment. Conclusions: The stage of cognitive impairment has an impact on daily
living activities. When combined with dementia, the comorbidities have an important role also, lowering the
performance of the patient, making them dependent on their caregivers.
Keywords: Cognitive decline,, daily living activities,, dementia
INVESTIGATION OF ULCER AND BLEEDING SIGNS IN PATIENTS WITH NON-STEROIDAL

ANTI-INFLAMMATORY DRUGS AND LOW-DOSE ASPIRIN CONSUMPTION: A CASECONTROL STUDY
Stoica Andreea Bianca1, Stoica I1, Spac Roxana1, Negovan Anca1
1
UMF Trgu Mure
Background: Non-steroidal anti-inflammatory drugs (NSAID) and low-dose aspirin (LDA) are well known to cause
gastrointestinal mucosal injury. The gastrointestinal side effects of NSAIDs and antiplatelet therapy are important
causes of patients addressability to the gastroenterologist in a population with a high prevalence of Helicobacter
pylori infection. Objective: To determine the prevalence and severity of endoscopic upper gastrointestinal lesions
in patients taking low-dose aspirin and non-aspirin non-steroidal anti-inflammatory drugs. Material and methods:
We perform a longitudinal descriptive study of upper gastrointestinal endoscopy and medical records (including
medication) in patients referred for endoscopy in III-rd Medical Clinic Targu-Mures during a period of three years
(2011-2013). Data were collected and analyzed from 1421 patients referred for endoscopy, 226 patients taking lowdose of aspirin, 111 patients taking NSAID and 750 control group (without gastrotoxic medication). Results: The
most frequent indication for endoscopy was epigastric pain in our series (65.7% in patient taking NSAID and 45.1%
in patients taking low-dose aspirin). Only patients with NSAID consumption presented statisticaly significant more
frequent signs of active bleeding comparative with controls (18% vs. 7.73%, p<0.05) in our study. The prevalence
of gastric and/or duodenal ulcers was significantly higher in patients taking NSAID (17.1%) comparative with those
taking low-dose aspirin (12.3.%) and in both of these, comparative with control group (9.46%). Conclusions:
Gastrointestinal toxicity was higher in patients taking NSAID comparative with patients taking low-dose aspirin
(bleeding and ulcers), but long-term therapy with aspirin is one of the most important causes of addressability for
endoscopic evaluation.
Keywords: NSAID, aspirin, ulcer, bleeding
CLINICAL - MEDICAL
41
FAVORABLE FACTORS OF IRON DEFICIENCY ANEMIA IN INFANTS AND YOUNG

CHILDREN
Grama Alexandra -Bianca1, Campean Roxana-Cristina1, Marginean Cristina Oana1
1
UMF Trgu Mure
Background: Iron deficiency anemia is the most common hematologic disease of infancy and childhood.It is
estimated that 30% of the global population suffer from iron deficiency anemia. Objective: In the present study we
aimed to evaluate the favoring factors of anemia in infants and young children. Material and methods: We
performed a prospective study on 42 children hospitalized in the Pediatrics Clinic 1 Targu Mures between
November 2014 and March 2015 using a questionnaire consisting of multiple questions targeting: factors favoring
the anemia as :presence of anemia during pregnancy, foods mistakes in infant (excessive consumption of cow
milk,incorrect diversification) blood loss,etc. The children were divided into two groups :group 1(case):16 patients
with iron deficiency anemia and group 2 (control):26 patients with various pathologies .Data obtained from the two
groups were statistically evaluated. Results: The results have shown that infant anemia is correlated positively
with maternal anemia during pregnancy [ p-0.04 , with OR 8.33 (IC 95% :1.833-82.8) ].This represents a greater
chance of developing iron deficiency anemia due to anemia during pregnancy. We also noticed that anemia is
more common in infants who consume large amonuts of cow milk (>500 ml ) [ p - 0.02 with OR 6.22 (IC 95% :1.232.2)]. Statistically we did not find significant correlation between incorrect diversification and anemia in infants (p0.94).Also the flour consumption does not significantly influence the appearance of iron deficiency anemia in
infants ( p-0.32). Conclusions: Based on this results ,we observed that a diet with a high content of milk and
anemia during pregnancy favors the development of iron deficiency anemia in infants.
Keywords: Pediatrics, anemia, iron deficiency
THE ROLE OF THE IL 6 190 C/T AND THE IL/6 174 C/G POLYMORPHISMS IN THE
DEVELOPMENT OF GASTRITIS IN CHILDREN
Mrginean Maria Oana1, Oprea C1, Fanfaret I S1, Mrginean C D1, Bnescu Claudia1, Pitea Ana Maria1
1
UMF Trgu Mure
Background: Polymorphisms in the promoter region of the proinflammatory cytokine, interleukin (IL)-6 have been
related to several chronic inflammatory diseases, including children gastritis. Objective: The aim of the study was
to establish the relation between the polymorphisms of the gene IL 6 190 C/T, IL 6 174 C/G and child gastritis, to
conclude whether this patients differ from children without digestive pathology regarding genotype polymorphisms
distribution. Material and methods: We conducted a study on 123 hospitalized children in terms of IL 6 190 C/T,
IL 6 174 C/G polymorphisms, symptoms (abdominal pain, nausea, vomiting, pirosis), which we correlated with
endoscopical modifications, histopatological changes and Helicobacter Pylori infection. The patients were divided
according to their histopatological changes into a control group (I), including 55 children without histopatological
changes and a study group (II), which included 68 children which had histopatological changes. Results: The
distribution of IL 6 190 C/T genotypes in the gastritis group included 35% CC, 44.85% CT and 20,15% TT, while
for the control group they were 48.55%; 38.90% and 12.55% respectively, withouth any significant statistically
corellation (p=0,16). The distribution of the IL 6 174 C/G genotype in the gastritys group was 7% CC, 78% CG i
15% GG, while in the study group was 22,5%, 33.4% and 44.1%. Therefore, the CG phenotype of the IL 6
polymorfism was more frequent in the study group (p<0.05), while the genotype GG was more frequent in the
control group (p < 0.05). The vomiting, loss of appetite and histopatological changes were positively correlated with
the polymorphisms of the genes CG and GG ( p < 0.05). Conclusions: Gastritis is more frequently found in
children which have the CG genotype of the IL 6 174 gene polymorphism, also correlated with vomiting, loss of
appetite and histopatological changes especially in genotype CG and GG.
Keywords: children, gastritis, IL 6 190 C/T gene polymorphisms, IL 6 174 C/G gene polymorphisms
42
CLINICAL - MEDICAL
THE ROLE OF RISK FACTORS IN CHILD RICKETS

Oprea C1, Mrginean Maria Oana1, Mares R G1, Campean Roxana-Cristina1, Marginean Cristina Oana1
1
UMF Trgu Mure
Background: Rickets is a disease whose prevalence can be drastically decreased with efficient prophylaxis and
avoiding various risk factors. Objective: The aim of this study was to assess whether the most frequent risk
factors known to be involved in the pathogenesis of rickets are positively correlated with different manifestations of
the disease in the patients included in this study. Material and methods: We conducted a prospective study on a
group of 66 hospitalized children using questionairres which were filled in by their mothers. The questionnaire
included questions related to the main predisposing factors involved in the development of rickets, including: sun
exposure, vitamin D prophylaxis, data regarding the alimentation, the development of the children and the patients
birth aspects. Each child was examined in order to determine whether he had or not manifestations of the disease.
Results: We divided the children into a control group of 34 children and a group of 32 children with manifestations
of the disease (19 with skeletal manifestations and 13 with subclinical manifestations). Out of the risk factors
studied, we discovered a positive correlation between the consumption of cereals (p = 0.03), low exposure to the
sun (< hour) (p = 0.048), the male sex (68.75%), anemia (RR=2,04, p<0,05) and the study group. Also we
observed a statistically significant greater number of children with late closure of the fontanela, later than 18
months (RR=2,4, p<0,05) in the rickets group and a positive correlation between neck sweating and skeletal
manifestations of the disease (RR= 3.67, p<0,05). We also discovered a greater, statistically significant incidence
(p<0,05) of the following unspecific symptoms in the study group: restlessness, poor appetite and agitation.
Conclusions: The main risk factors which were linked in our study with the patogenesis of the disease included
cereals consumption, low exposure to the sun, anemia and male sex.
Keywords: child, rickets, risk factors, clinical manifestations
ANTIBIOTIC RESISTANCE IN ENTEROPATHOGENS CAUSING ACUTE DIARRHEAL

DISEASE
Banias Laura1, Ducra Alina Maria1, Chiriac Carmen1
1
UMF Trgu Mure
Background: Globally, diarrheal disease has a high morbidity rate and is one of the most common infectious
causes of death in underdeveloped countries. Antimicrobial treatment meets serious problems determined by the
emergence and spread of antibiotic resistance. Objective: The purpose of this study is to assess the frequency
and the type of bacterial enteropathogens causing acute infectious diarrheal illness who present resistance to
antibiotics. Material and methods: The retrospective analytical study includes patients hospitalized in Infectious
Diseases Clinics I, II Tg. Mures, between september 2013 and august 2014 who presented acute infectious
diarrheal illness. Parameters taken in consideration (obtained from patient's medical records) are: gender, age,
area of origin, ethyology of diarrheic illness (determined by coprobacteriologic examination) and the results of drug
susceptibility testing performed through disk diffusion method to identify the sensitivity, resistance or intermediate
sensitivity of the pathogen agent to a certain number of antibiotics. The statistical analysis was executed with the
program Microsoft Office Excel. Results: During these 12 months, 76 patients were admited for bacterial
confirmed infections, various bacterial strains. The gender distribution was approximately equal (47.47% females
and 52.63% males). The most frequently isolated bacterial enteropathogen was Salmonella, various serotypes
(71.05%), which presents resistance to ampicillin in 38.89% of the cases and in smaller proportion to a number of
fluoroquinolones and cephalosporines tested. Shigella strains were found resistant to ampicillin(18.18%),
ciprofloxacin(9.09%) and trimethoprim/sulfamethoxazole (18.18%). Pathogenic strains of E. coli present resistance
to most of the penicillins and cephalosporins tested (ampicillin 81.82%, ticarcillin 63.64%, cefuroxime 72.73%).
Conclusions: A large proportion of the enteropathogens that cause diarrheal disease present resistance to betalactam antibiotics. Antibiograms help epidemiological surveillance of bacterial resistance.
Keywords: Salmonella, Shigella, antibiotic resistance, diarrheal disease
CLINICAL - MEDICAL
43
THE (IM)PERFECT BODY I LIVE IN

Sirbu Eliza Dumitrita1, Roman Flavia-Cristina1, Brodt A M1, Grecu Gabos Marieta1
1
UMF Trgu Mure
Background: These days, modern society sets high standards regarding the concept of ideal beauty. In a world
where there is no room for mistakes in one's appearance, a tendency of perfectionism, therefore body
dissatisfaction is inevitable. Objective: Comparing one's aspect to those of public figures perceived as attractive is
the most common thing nowadays. In front of all these "get skinny" messages provided by media and "loose
weight" programmes and smartphone's apps, how are teenagers holding up? The aim of this study is to outline the
impact of publicity in the self esteem of adolescents and to asses their risk on taking the dark path of anorexia.
Material and methods: Questionnaires and conversations with the target group (teenage students, girls and boys
going to different highschools in Targu Mures.) have been used as a method of psychological investigation.
Results: The weight stigma, the popularity of looking thin, the fame and success of fashionable people influence
the emotional health of an individual. Free access to pro-anorexia groups, apps that help you get the perfect body
in no time etc, definitely provide a high number of future anorexic patients among highschool students. More than
half of the inteviewed subjects (63.2%) declare not liking their body in the mirror, while 40% admit having tried one
way or an other to loose weight with more or less success. Conclusions: The influence of the media in one's life
choices is impressive. In order to cope with the social demands, to avoid rejection anorexic patients get into a
devastating "addiction to be skinny". The anxiety, induced by the feeling of being trapped in an imperfect body(that
constantly needs to ascend to a better form, more representative), leads to a compulsive food restriction, which
ultimatly can be deadly.
Keywords: anorexia, death, rejection, smartphone apps
ANTI-RO/SSA 52 ANTIBODIES IN AUTOIMMUNE DISEASES

Mihai Gabriela1, Micu Isabela1, Budianu Mihaela1, Lrincz Andrea1, Copotoiu Monica1
1
UMF Trgu Mure
Background: Anti-Ro/SSA 52(aSSA52) are among the most frequently detected autoantibodies against
extractable nuclear antigens(ENA).However, controversial data exist regarding the aSSA52 antibodies diagnostic
utility in autoimmune diseases(AD). Objective: Our purpose is to study the clinical significance and immunological
manifestations in patients displaying aSSA52. Material and methods: This is a single center,prospective and
retrospective study in an adult population (patients >18 years old) of men and women diagnosed with AD
fromMure County Emergency Clinical Hospital,Rheumatology Division.From 44 patients with immunoblotting
panel for ENA analysis 81.81%(n=36) have inclusion criteria. Results: Among the 36 selected sera, 27.8%(n=10)
have aSSA52 positive reactivity.Gender distribution in the positive group show high female prevalency(100%) and
a mean age (SD) of 45.92(11.78)years. All 10 patients displayaSSA52 antibody association with at least one other
antibody detected by ENA panel.A significant association(p=0.019) in proportion of 90%(n=9)is with SSa(Ro).Other
immunological findings show a significant association(p=0.034) with Rheumatoid Factor in 40% (n=4).The most
common associated autoimmune disease with aSSA52 antibody is Systemic lupus erythematosus
(SLE)60%(n=6), Undifferentiated connective tissue disease 20% (n=2) followed by 10% Myositis (n=1) and
Sjogren Syndrome 10%(n=1).However none of the AD is significantly associated with aSSA52(p>0.05). Clinical
manifestations:In 40%(n=4)of our cases,patients present suggestive modifications for interstitial lung disease on X
ray imaging, but without any clinical significance(p=0.077).Thus in our Myositis case,there was an association
between aSSA52, Jo-1 antibody and interstitial lung modifications. In the positive cohort Raynaud phenomen is
present in 20% (n=2) without any clinical relevance(p=0.518).In proportion of 40%(n=4) our patients complain of
Sicca symptoms but again with no clinical significance regarding the possible association between aSSA52 and
Sicca. Conclusions: aSSA52 antibodies detection did not show any disease specificity.In order to establish the
possible diagnostic value in clinical or biological features of various autoimmune diseases further studies should be
made.
Keywords: anti-Ro/SSA 52(aSSA52), autoimmune diseases(AD), diagnostic utility
44
CLINICAL - MEDICAL
THE EVOLUTION OF INCIDENCE IN PATIENTS WITH ATOPIC DERMATITIS TREATED IN

THE DERMATOLOGY CLINIC TRGU MURE
Florea Mihaela Adela1, Pager Brigitta1, Susan Cristina Iulia1, Cotoi O1, Morariu S1
1
UMF Trgu Mure
Background: Atopic dermatitis (AD) is one of the clinical manifestations of the atopic syndrome wich is
characterized by skin inflamation, chronic recurency, intense itching and the existence of personal and family
history of atopy. The diagnosis is relatively difficult to asses in the absence of a specific biomarker. Objective:
Comparing the hospitalized and nonhospitalized pacients with AD from 2012 with a similar study from 1997
Material and methods: A statistical analysis was performed on 153 patients diagnosed with typical and atypical
forms of AD, admited or consulted ambulatory in 2012. The clinical diagnose was confirmed by the presence of at
least 3 major and 3 minor criteria accourding to Hanifin and Rajka classification. To determin the incidence
evolution of AD, these data were compared with similar data from a study performed 16 years ago (1997). Results:
In 2012, the number of hospitalized patients was 25 (16.33% ) and of those treated ambulatory was 128 (83.66%),
while in 1997, the number of hospitalized pacients was 29 (70.73%) and the outpatients was 12 (29.27%). In 2012,
47.05% were typical forms of AD and 52.95% atypical, while in 1997, 36% were typical forms and 64% atypical.
Accourding to age, there are 2 spikes in the incidence of AD in 2012: 25.5% for 0-2 years and 51% for those over
18 years, while in1997, 9.75% for 0-2 years and 65.8% over 18 years. Accourding to gender, in 2012 50.3% were
M, 49.7 F and in 1997, 56.1% M and 43.9% F. In 2012 73.55 % came from urban areas , while in 1997 70%.
Conclusions: Accourding to our study we assed an increase in the absolute number of consulted patient in
ambulatory. There is also an increase in the incidence of AD in the age group 0-2 years, with approximately 15%
compared to the previous study.
Keywords: atopic, dermatitis, dermatology, incidence
THE BENEFIT OF USING NON INVASIVE VENTILATION (CPAP) FOR CARBON MONOXIDE
POISONING TREATMENT.
Oana Mates1, Boeriu C1, Turucz Emilia1
1
UMF Trgu Mure
Background: Carbon monoxide acts pathogenically by displacing oxygen from the haemoglobin molecule, shifting
the oxyhaemoglobin dissociation curve to the left, and possibly by combining with the other iron-containing
pigments of the body. Tissue hypoxia results, the central nervous system and heart suffering the principal
damage.Severe exposures to CO result in loss of consciousness, or death. Patients commonly have
neuropsychological sequelae after carbon monoxide poisoning. Objective: In case of CO poisoning treatment with
hyperbaric oxygen is recommended because it reduces carboxyhaemoglobin dissociation half-life from more than
four hours at room air or 45 minutes on 100% oxygen to 23 minutes at 2.5 atmospheres absolute. In Romania we
have only private HBO chamber that are not availble for emergency situation, The only treatment option for
cases with CO poisoning is the administration of 100% high flow oxigen trough non-rebriefing facial mask. There
are data that suggests that CPAP enhance the elimination of CO by providing 100% via a tight-fitting mask and
might be superior to loosely applied 100% nonrebreather facial masks Material and methods: We conducted a
retrospective descriptive study set in the Emergency Depatment of Mures County Emergency Clinical Hospital. We
reviewed all cases presented in the emergency department with carbon monoxide poisoning during 11.201402.2015. Then we compared the half life CO level in patient treated with high flow oxigen delivered through nonrebriether face mask or using CPAP at 10 Hgmm Results: In our preliminary results we include 14 cases, 5 were
treated with CPAP and 9 cases were treated with high flow oxigen delivered through non-rebriether face mask.
The preliminary results show a more rapid CO elimination using CPAP versus oxygen delivery through nonrebreather oxygen mask Conclusions: This result based on a small group of cases is not statistically significant by
the moment (p= 0.12), but it shows a beneficial trend for the use of CPAP.
Keywords: Carbon monoxide poisoning, CPAP, carboxyhemoglobin
CLINICAL - MEDICAL
45
GENETIC POLYMORPHISMS OF GLUTATHIONE S-TRANSFERASE AND SPONTANEOUS

MICROALBUMINURIA IN PATIENTS WITH TYPE 2 DIABETES MELLITUS
Hum M1, Crauciuc A1, Curticpian Ioana Maria1, Tripon F1, Stoian Dr. Adina1, Bnescu Dr. Claudia1
1
UMF Trgu Mure
Background: Type 2 Diabetes Mellitus (DM 2) is a metabolic disorder that affects a semnificative number of
adults. Genetics and enviromental factors have a major role in the appearance of the disease. Glutathione-Stransferases (GSTs) are a family of detoxificating enzymes that protect the cells against oxidative stress and may
represent a future target for diabetic drug treatment. Objective: Our aim in the present study was to investigate
whether the genetic polymorphisms of glutathione S-transferase GSTM1 and GSTT1 is associated with the
appearance of spontaneous microalbuminuria in DM 2. Other objectives would be finding corelations between
certain variables(body mass index - BMI,chosen drug treatment,polyneuropathy,blood pressure etc)and
microalbuminuria. Material and methods: A prospective observational study was conducted on 40 unrelated
patients with DM 2 and 98 healty controls.Spontaneous microalbuminuria from morning urine was determined in
patients with DM 2. The following variables were recorded from these patients:GST M1 and GST T1 genotype,
age, sex, diabetes lenght, BMI, blood pressure, the presence of peripheral neuropathy, microalbuminuria and the
diabetes treatment used. Results: No significant correlation has been found between microalbuminuria and GST
T1 active genotypes(p>0,05) or GST M1 active genotypes(p>0,05).A significant correlation was found between
GSTM1 active genotypes and the systolic blood pressure (p=0.024) as well as between microalbuminuria and
age(p=0,04),microalbuminuria and BMI(p=0,04). A significant positive correlation has also been detected between
GSTM1 active genotypes and the presence of DM 2(p=0.0001). Conclusions: Our data shows that
microalbuminuria can be influenced by age and BMI and that the genetic polymorphism of GST M1 may influence
the occurrence of DM 2 but not of microalbuminuria.GST M1 active genotypes may influence indirectly the
occurence of microalbuminuria through the effect on systolic blood pressure. "This paper was published through a
project funded by internal research grants of the University of Medicine and Pharmacy Targu Mures, Romania,
contract no.10/23.12.2014"
Keywords: GST T1, GST M1, microalbuminuria, DM 2
FREQUENCY OF ACCIDENTS THROUGH OCCUPATIONAL EXPOSURE IN HEPATITIS B

VIRUS INFECTION IN TARGU-MURES EMERGENCY CLINICAL COUNTY HOSPITAL
Mihailescu Madalina1, Iakab Melinda Ibolya1, Daniela Singeorzan1, Bacrea Anca1
1
UMF Trgu Mure
Background: Hepatitis B infection caused by the hepatitis B virus is a major public health problem worldwide and
is transmitted directly through blood or other body fluids. Blood and serous fluids contain the highest concentration
of the HBV and one of the primary ways of hepatitis B viral transmission is by blood through percutaneous
exposure. Objective: This study aims to assess the frequency of accidents through occupational exposure in
hepatitis B virus infection among health care providers. Material and methods: This was a prospective study
carried out on 281 health care providers between 20 and 54 years, which have been in contact by accident with
several patients or their body fluids, included between January 2010 and December 2012. We made this study at
the Department of SSCIN of Emergency Clinical County Hospital of Targu-Mures, Romania. Results: After
processing the data, we obtained the following results: women predominated and the sample structure consisted of
66.54% female and 33.46% male. The average age was 31.5 years and the most exposed group of age was 20-30
years with 56.58%. There was also a higher risk of accidents among medical residents (35.95%) and nurses
(33.45%). Approximate 34.52% of accidents were produced on surgical wards and 29.54% on Emergency &
Intensive Care Unit. Conclusions: From our research we noticed that there is a higher risk of young health care
providers being exposed to accidents through occupational exposure, but only few of them get the infection with
hepatitis B because the majority agrees with the vaccine and respects the treatment.
Keywords: hepatitis b virus, hepatitis B infection, occupational exposure
46
CLINICAL - MEDICAL
THE VALVULOPATHIES IN ACUTE MYOCARDIAL INFARCTION WITHOUT ELEVATION OF

ST SEGMENT
Daniela Singeorzan1, Mihailescu Madalina1, Sahlean D1, Macarie C1
1
UMF Trgu Mure
Background: Valvular heart disease is characterized by damage to or a defect in one of the four heart valves: the
mitral, aortic, tricuspid and pulmonary.Heart valve disease occurs when one or more of the heart valves do not
work correctly because of valvularstenosis or valvular insufficiency.This condition causes the heart to pump harder
to circulate the right amount of blood though the body. Objective: The aim of the study was to assessthe link
between occurrence of valvulopathies and the risk factors. Material and methods: A retrospective review of the
cardiology data was performed in all consecutive cases of acute myocardial infarction without elevation of ST
segment diagnosed between 2013 and 2014 at the Department of Cardiology of Emergency County Hospital of
Targu-Mures, Romania. Results: We analyzed the results statistically and we noticed that out of 106 cases,
70.75% were men and 29.25% were women. The average age of patients was 65 years with a range between 37
and 91 years. 27 subjects had valvulopathy associated with dyslipidemia, 30 patients had diabetes, 78 of them had
hypertension,theejection fraction was preserved at 85 patients while 14 of them were smokers. Conclusions: We
can conclude that during non ST elevated myocardial infarction, several valvulopathies are frequently present, with
the dominance of mitral insufficiency, probably ischaemic and aortic stenosis, mostly degenerative, in association
with the advanced age of the patients.
Keywords: the valvulopathies, acute myocardial infarction, risk factors
THE CORRELATION BETWEEN DEPRESSION AND MAJOR NEUROCOGNITIVE

DISORDERS
Suba Dra Ildik1, Suvanjeiev R G1, Nadasdy T1, Abecassis A1, Gabos Grecu I1
1
UMF Trgu Mure
Background: Depression is a major cause of morbidity worldwide, the number of people who would suffer from
this, once or repeatedly, during their lifetime is between 15-20%. This disorder is characterized by pervasive and
persistent low mood accompanied by low self-esteem and loss of interest and pleasure in normally enjoyable
activities, loss of motivation, concentration and memory problems, insomnia. Major neurocognitive disorders (NCD)
are the other major cause of morbidity and also is ranked 7th most common cause of death after cardiovascular
and tumorous diseases. The patients gradually decrease in the ability to think and remember, gradually occurs
language and orientation problems. The most common form of major NCD is Alzheimer disease (AD) (60-70%).
Objective: To find correlation between depression and neurocognitive disorders in literature. Material and
methods: Review of literature. Results: Pseudodementia Depressiva is a type of disorder in which symptoms
consistent with dementia, occurs in patients who formerly had undiscovered/untreated depression. In these cases
the treatment of depression reverses the symptoms of dementia.
is one of the most common
neurocognitive symptom of AD (Lee and Lyketson 2003); the prevalence of Major Depressive Disorder (MDD) is
between 20-30% in AD (Lyketson et. al. 2002) (Prof.Dr. Gabos Grecu Iosif - i bolile psihosomatice
University Press, Trgu Mure, 2009). Although it is not clear that MDD is causing NCD, it influences in several
ways the risk of NCD. The conclusion of a study, published in the journal Neurology(2010) by Dr. Jane
Saczynski, is: is associated with an increased risk of dementia and AD in older men and women
Conclusions: Based on the review of literature, depression seems to be a risk factor for major NCD. Our plans
are to investigate this, in a follow up research based on the patients who came to the 1st Clinic of Psychiatry Tirgu
Mures.
Keywords: depression, major neurocognitive disorders, Alzheimer's disease (AD)
CLINICAL - MEDICAL
47
SCREENING OF GASTROESOPHAGEAL REFLUX IN CHILDREN

Stanciu Liana1, Oprea C1, Mrginean Maria Oana1, Marginean Cristina Oana1
1
UMF Trgu Mure
Background: Gastroesophageal reflux is one of the most common and frequent pathologies encountered in
pediatrics and pediatric gastroenterology centers.Gastroesophageal reflux occurs several times a day for
infants,children,adolescents and adults when it is asymptomatic or it produces few symptoms.If it causes
symptoms or complications that are associated with significant morbidity,gastroesophageal reflux may represent a
pathology called gastroesophageal reflux disease. Objective: The aim of this study is to determine whether the
proposed questionnaire is able to establish the gastroesophageal reflux in children. Material and methods: For
this study we evaluated a number of 50 pediatric patients using a questionnaire that contained a series of
questions based on age, gender and presence of significant symptoms of children aged 0 to 8 years old, also
children over 8 years old according to two questionnaires adapted to each age group (vomiting, weight loss,
irritability, nocturne coughing, hiccups, etc). Results: Out of the criteria studied for the diagnosis of the disease, we
discovered that the symptoms which are significantly correlated with the gastroesophageal reflux disease are the
following : nocturne coughing (p=0,02, RR=2,03), epigastric pain (p=0,04, RR=2,04), retrosternal burn (p<0,01,
RR=2,44) and painful swallowing (p<0,01, RR=2,4). Moreover, we concluded from our database that the
gastroesophageal reflux disease is approximately twice more frequent in children older than 8 years in comparison
with children which are younger than 8 years (RR=2,24, p<0,01). Conclusions: Gastroesophageal reflux disease
is a condition which has become more frequent in children over the few years and is associated in this study with
these symptoms: nocturne coughing, epigastric pain, retrosternal burn and painful swallowing. So the used
questionnaires are a very useful tool for the diagnosis of gastroesophageal reflux.
Keywords: gastroesophageal, reflux, disease
OSTEOPOROSIS: THE DEGREE OF AWARENESS REGARDING THE RISKS OF

CONTRACTING IT IN PEOPLE AGED OVER 40
Bnzari Elena1, Feier A1, Ostopovici Marta-Lucia1, Adrian I1, Larisa Zahan1
1
UMF Trgu Mure
Background: Osteoporosis is a bone disease that is characterized by a decrease in bone mass and density and
currently possesses one of the most serious health challenges. The main factors that lead to this condition are:
age, nutrition, physical activity, endocrine changes, lifestyle, general health condition and taken medication.
Objective: To assess the degree of awareness regarding the risks of contracting osteoporosis along with the
effects that lifestyle and dairy product consumption can have on this condition on subjects aged above 40.
Material and methods: The survey was performed in February 2015 and involved 68 subjects, 30 male, 38
female, aged over 40 at the Orthopedics and Traumatology Clinic in Tirgu Mures. 55.88% (n=38) of respondents
were from urban geographic area. Patients were questioned using the questionnaire designed by P. Glibowski.
The questions assessed socio-demographics, milk and dairy product consumption, physical activity and knowledge
about osteoporosis and also issues such as its prevention, incidence and morbidity. Results: Osteoporosis was
diagnosed in 30.88% (n=21) subjects out of whom 45.16% (n=14) were women. 7.35% (n=5) never consumed any
dairy products. In the previous year, 29.41% (n=20) of the subjects reported having fractures out of whom
25%(n=5) had osteoporosis. Physical activity of any kind was undertaken by 92.64 (n=63) individuals. 72.05%
(n=49) of subjects were aware that consuming dairy products is beneficial to bone health and this awareness was
higher among those diagnosed with osteoporosis. Physical activity of any kind was also recognized as being
important in preventing this condition. Conclusions: Subjects reported average to good awareness of the risks in
developing osteoporosis. The knowledge concerning osteoporosis in individuals aged above 40 is still insufficient.
Further studies are needed in order to assess the awareness of contracting osteoporosis in the general healthy
population.
Keywords: osteoporosis, risks, awareness
48
CLINICAL - MEDICAL
THE INFLUENCE OF THE GROWTH HORMONE TREATMENT OVER THE VELOCITY OF

CHILDREN WITH GROWTH FAILURE
Abaza Maria1, Pacanu Ionela1, Huu Simona Loredana1
1
UMF Trgu Mure
Background: Since Somatropinum, human growth hormone (rhGH), became available, children with growth
failure caused by growth hormone deficiency, Turner syndrome, Prader"Willi syndrome, chronic renal insufficiency
and those born SGA (small for gestational age) can benefit from this treatment. Objective: The aim of this study is
to find out if there is any relationship between IGF-1 increment and growth velocity, weight and BMI in short
children treated with Somatropinum. Material and methods: In a retrospective study we investigated data from
patients treated with rhGH between 2009 and 2015, aged between 3 and 16 years in Mure County Hospital,
Department of Endocrinology. We had two groups, one of 45 patients treated for one year and one of 29 patients,
treated for two years. We noted for every patient the height, growth velocity, IGF-1, BMI and weight. Statistical
analysis was performed using GraphPad Prism 6. Results: Patients with GH deficiency had the biggest growth
velocity in the first year of treatment. In our study group the response to Somatropinum decreased in the second
year: the first group had a mean velocity of 8.88 cm/year, while the second group had a 7.41 cm/year mean
velocity. We also had a statistically significant correlation between IGF-1 increment and height, weight and BMI
increase (p<0,005) in both groups. Conclusions: The effects of rhGH treatment at short children are clearly
beneficial, having spectacular results in the first year of treatment. All the growth parameters increase, and there is
a relationship between their raise.
Keywords: growth velocity, rhGH treatment, short children
TWO POLES OF IATROPHOBIA-FRANCE AND EGYPT

Chirales Cristina-Ioana1, Fanfaret I S1, Pasca Maria Dorina1
1
UMF Trgu Mure
Background: Iatrophobia, the fear of doctor/going to a doctor, is largely spread in a multicultural diversity
world.This paper aims visualization/analysis of iatrophobia among patients from two different countries-an
occidental one, France and an Arabic one, Egypt Objective: The study was made on 40 patients from ginecology
and nephrology's wards Assiut County Hospital, Egypt and 40 patients from diabetology and pneumology's wards
Angers County Hospital, France in order to illustrate the level of this phobia with its causes and manifestations
from a different socio-cultural view. Material and methods: It has been used the questionnaire and conversation
with the patient as a method of psychological investigation. Results: Following analysis, it has been revelead the
existence of iatrophobia at a rate of 70% in Egypt and 52% in France. In addition to that, Egyptian women face this
fear more than men because they had a bad experience in childhood concerning the medical field-39%. Most of
the patients are afraid of going to the doctor because it may be necessary a surgical exploration-41% in Egypt or
after their first consultation-35% in France.This phobia is highly manifested through sweaty hands and forehead-22
% in Egypt and increasing cardiac and respiratory frequency 27% in France and leads all the wayto the worsening
of the situation in which the patient is-65 % in Egypt and 42% in France.It may be handled, in most of the cases
with anxiolytic and antidepressive medication-40% in France and medicinal plants-30% in Egypt. Conclusions:
Iatrophobia is an important fear which adopts a different dimension correlated with its socio-cultural environnement
and it reduces proportionally with a higher level of medical education and style of living.
Keywords: iatrophobia, manifestations, France, Egypt
CLINICAL - SURGICAL
CLINICAL - SURGICAL
49
50
CLINICAL - SURGICAL
WHY TO CHOOSE LAPAROSCOPIC APPENDECTOMY ?

Samuel M1, Kardos Anita1, Muresan M1, Petrisor M1
1
UMF Trgu Mure
Background: Kurt Semm,a Germangynaecologist, was the first to radically change McBurney procedure when
he performed thefirst laparoscopic appendectomy on May 30, 1980.Semm technique used a laparoscope to
visualize the appendix. The technique was efficient, effective and minimally invasive. Larson elegantly iterated
several reasons why a laparoscopic approach seems preferable to open appendectomy: superior visualization,
identification of lesions in structures other than the appendix, reduced tissue trauma, the potential for more rapid
return to normal activity, good exposure in obese patients, and decreased wound surface area to serve as a focus
for infection. Objective: The aim of this study is to find out whether laparoscopic or classical appendectomy is
more reliable for thepatient. Material and methods: This is a retrospective studywhichwas conducted in
Chirurgie 2 clinic from Spitalul Clinic Judeean de Urgenta Tg. Mures. Data was collected from the medical
history.We included all the patients with appendicitis from January 2014 to January 2015,a total of 72.Data
included sex,days of hospitalization,operative time(minutes),method. Results: From the data collected we found
out that from the total of 72 patients,a number of 31 were females and 41 males.Comparing the operator time we
found out that with the classical method the mean time was 65 minutes and with the laparoscopic method only 46
minutes (conducted with unpaired t test)p=0.002.Comparing thedays of hospitalization, the Mann-Whitney
statistical test revealed the fact that for the classical method the mean was 4.5 days and for the laparoscopic one
just 2.8 days with a p=0,003. Conclusions: This study shows that both the operator time and time of
hospitalization arefewer with laparoscopic appendectomy,which is great for the patient and more profitable for the
hospital.
Keywords: appendectomy, laparoscopic, classic
EORTC SCORES OF RECURRENCE AND PROGRESSION IN A ROMANIAN COHORT

tefan Anda Simina1, Boja R M1, Golea O I1, Schwartz L1, Chiujdea S1, Vartolomei M D1, Martha Orsolya1
1
UMF Trgu Mure
Background: The European Organization for Research and Treatment of Cancer (EORTC) developed a scoring
system and risk tables in order to predict the recurrence and progression in case of (NMIBC) non-muscle-invasive
bladder cancers. The EORTC study was done in various countries, but it was never performed on a Romanian
population. Objective: The aim of this study was to correlate the EORTC score with the recurrence and the
progression in Romanian cohort with NMIBC. Material and methods: We have realized a retrospective study on a
total number of 306 patients admitted in the Urology Clinic of Trgu-Mure with NMIBC, during 1st of January 2006
and 31st of December 2008, with an average follow-up period of 42 months. The inclusion criteria were: bladder
tumor at the first manifestation, treated by TUR-B (transurethral resection), T grade < 2; the exclusion criteria being
the lack of follow-up (15 patients). Results: Our study revealed that from the total of 291 patients diagnosed with
NMIBC, 80.41 % were males and 19.59 % were females. According to the depth of tumor invasion (T stage), we
observed that 74.91 % were Ta tumors. Most of the patients (46,73%) had a recurrence score between 1-4, from
whom 24.26 % had recurrence. 135 patients had a progression score in the range 2-6 and 36 patients with a score
varying from 14 to 23. The progression incidence was 17/291 patients durring follow-up. We noticed an increase in
young patients <50 yr. with NMIBC from 8 per year to 11 in 2008. Conclusions: EORTC scores are an usefull tool
in predicting the recurrence and progresion in NMIBC even for Romanian patients. Acknowledgement. This paper
is supported by the Sectoral Operational Programme Human Resources Development (SOP HRD), financed from
the European Social Fund and by the Romanian Government under the contract number
POSDRU/159/1.5/S/133377.
Keywords: recurrence, progression, EORTC, bladder cancer
CLINICAL - SURGICAL
51
THE SURGICAL APPROACH TO COMPLETE ATRIOVENTRICULAR CANAL DEFECTS

DISEASE AT IUBCVT TRGU-MURE
Gavrilovici L2, Antoniu R2, Samuel M2, Beleaua M A2, Suciu H2, Stroe V2
2
UMF Trgu Mure
Background: The atrioventricular canal defects, refers to the atrioventricular septal defects or endocardial cushion
defects and includes a wide spectrum of anatomic abnormalities. These kind of anatomic abnormalities are also
known as complete atrioventricular canal. The atrioventricular canal defects acount 4% of all congenital cardiac
malformations and over half of the cardiac defects seen at children with trisomy 21 (Down syndrome). Objective:
The purpose of this study is to support the surgical management of complete atrioventricular canal defects in
children at
de Boli Cardiovasculare i Transplant Trgu-Mure as the only center in the country
Material and methods: This study is a retrospective chart review based on 57 patients which underwent surgical
treatment between 2010 - 2015. Parameters like, gender, age, weight, paraclinical investigations and associated
pathologies were evaluated. Results: In this study were included 57 patients with the mean of age 2,5 years and
the mean of weight 10.08 kilos. Therefore after the surgical interventions we had 57 cases grouped in the next
categories: type A " the complete atrioventricular canal (34 cases); type B " the incomplete form
(11 cases); and the last but not the least
type C " the intermediate form (12 cases). The surgical
correction in this cases consists of totally correction, closing SAV, SVD, patching ostium primum and ostium
secundum and doing the valvulopasty on the mitral valve and the tricuspid valve. Conclusions: Taking into
consideration the anatomic variations of the atrioventricular canal defects, is found that is no standard treatment for
this congenital cardiac malformations and the surgical treatment is extremely important to be adapted on the case
scenario. Therefore is very important to have an early diagnostic and detailed analysis of the anatomy and function
of the heart for the properly surgical treatment.
Keywords: complete atrioventricular canal defects, surgical treatment, results
THE USE OF THE SAPHENOUS VEIN GRAFT FOR THE BYPASS OF THE LEFT ANTERIOR
DESCENDING CORONARY ARTERY
Ambrus Mrta1, Al Hussein H1, Moraru L1, Suciu H1
1
UMF Trgu Mure
Background: According to the latest American Heart Association guidelines for coronary artery bypass grafting
(CABG), the use of the left internal thoracic artery (LITA) to bypass the left anterior descending (LAD) coronary
artery has I. Class recommendation and Level of Evidence B. Nevertheless, in some cases the patients'
perioperative data render it unsuitable and the use of the saphenous vein graft (SVG) should be considered.
Objective: The purpose of this study is to assess those cases and circumstances in which the saphenous vein
graft is preferred to the left internal thoracic artery for the bypass of the left anterior descending coronary artery
and to evaluate the efficiency of these interventions. Material and methods: We retrospectively evaluated 200
patients' surgical case, who had undergone CABG for LAD coronary artery disease in 2014 at the Institute of
Cardiovascular Disease and Transplantation, Trgu-Mure. The patients were divided into two subgroups
according to the graft choice: LITA group and SVG group. Results: The preoperative data shows that the patients
on whom CABG was performed using a SVG had a significantly higher risk (p<0.0001) of 30 days mortality
(calculated with EuroSCORE II) compared to the LITA group. The mean age in the SVG group (65 years) was
significantly higher (p<0.0001) than in the other group (58 years). The patients in the SVG group had a mean
ejection fraction of 49%, significantly lower (p=0.0081), than the LITA group's 52%. Patients with left main coronary
artery subocclusion received preponderantly SVG (68.75%). Conclusions: The use of SVG was preferred to the
arterial conduit when patients had advanced age, impaired left ventricular systolic function, high risk for
postoperative mortality, several comorbidities including left subclavian artery stenosis and left main coronary artery
subocclusion. The mortality ratio varied with the comorbid conditions, but the overall mortality ratio for isolated
CABG was lower than expected or as expected.
Keywords: Coronary Artery Bypass Grafting (CABG), Left Anterior Descending Coronary Artery, Saphenous Vein
Graft (SVG), Left Internal Thoracic Artery (LITA)
52
CLINICAL - SURGICAL
THE OUTCOME IN NON-SURGICAL TREATMENT OF INFANT HEMANGIOMAS

Parlici Alexandra Elena1, Niculiseanu Stela1, Lapusneanu Diana Ionela1, Moise Cristina-Manuela1, Uleru Alexandra Ioana1
, Gozar H1
1
UMF Trgu Mure
Background: Hemangiomas are benign tumors that consist of new-formed and dilated blood vessels. It is not a
life-threatening condition, but it can impact the normal development and growth of the child. Systemic Betablockers and local Bleomicin help reducing the tumor size. Objective: The aim of this study is to determine the
benefits of asociating beta-blockers with bleomicin in the treatment, local complication prevention and prognosis of
infantile hemangiomas. Material and methods: In the Pediatric Surgery and Orthopedy Clinic of the Emergency
County Hospital of Tirgu Mures, a retrospective observational study was performed, including 216 patients who
where admitted and diagnosed with Hemangiomas, from January 2008 until August 2014; population divided into
several groups, according with the type of therapy that was performed: group 1: children who received only local
Bleomicin; group 2: children who received systemic Propranolol; group 3: children who received other type of
therapy(surgical excision). Results: group 1 consisted of 47,2%; group 2 consisted of 7,87%; group 3 consisted of
44,9%. All of these groups where compared and statistically analyzed. We compared the initial dimension of
tumors with the final dimension, after the treatment was performed. We obtained the following data: Mean value
decreased from initial size tumor of 15,03 cm to 4,75 cm, after Propranolol (p=0,05), also in case of Bleomicin, the
mean value of initial size tumor decreased from 14,22cm to 5, 9cm (p=0,03). Conclusions: We confirm the
effectiveness of both systemic Propranolol and local Bleomicin treatment in the better outcomes of infant
hemangiomas non-surgical treatment.
Keywords: hemangioma, propranolol, bleomicin
A HOLISTIC APPROACH TO THE DIABETIC FOOT

Boan M1, Borz B1, Boan A2
1
UMF Trgu Mure

Chinese Free University of Shanghai & Hong Kong
Background: Chronic ulcers of the lower limb are a terrible burden from a medical, social and economical
standpoint. The total cost of local and systemic care for such lesions sums up to billions of dollars per year
worldwide. While not forming the majority of cases, chronic ulcers in diabetic patients represent a great challenge
in the matter of treatment and limb salvage procedures. Objective: To underline the importance of early local
treatment and systemic management of chronic wounds in diabetic patients. Material and methods: Over the
span of one year the Plastic Surgery Department has treated 31 patients with chronic ulcers of the lower limb, out
of which 10 had diabetic ulcers. All patients underwent two main treatment strategies: invasive surgical treatment
and conservative treatment, though quite often both methods were implemented together.a. Invasive procedures
(sharp debridement) are always required by the presence of large necrotic wounds and extensive soft tissue
infections. The aim is transforming the chronic infected wound into an acute surgical wound, thus breaking the
vicious circle of chronic lesions.b. Conservative treatment consists of different methods of passive
debridement.While conservative treatment can be implemented on its own, aggressive procedures are always
followed by conservative methods in order to obtain either spontaneous healing or a good granulation bed for
future grafting. Results: The consistent use of the above mentioned therapeutic principles has led, over the years,
to the dramatic decrease of limb amputations, which had been "standard procedures" prior to the introduction of
these methods. Conclusions: Early treatment of every lesion of the lower limb in a diabetic patient is the main
step in preventing the transformation in chronic wounds.
Keywords: chronic ulcers of the lower limb, conservative treatment, surgical treatment, diabetes
CLINICAL - SURGICAL
53
THE SURGICAL APPROACH TO TYPE I CHIARY MALFORMATIONS

Talpalaru Alina1, Balasa A1
1
UMF Trgu Mure
Background: Named after the pathologist who first described them, Chiari malformations consist of a wide array
of malpositions of different parts of the cerebellum which may or may not associate other neurosurgical conditions
such as hydrocephalus and syringomyelia. It is this diversity that poses great difficulty in precisely defining them
both from an anatomical point of view and regarding their symptoms. Generically, Type I Chiari malformations are
expressed by the following key concepts: a heterogeneous entity with the common feature of impaired
cerebrospinal fluid circulation through the foramen magnum, cerebellar tonsillar herniation on MRI and associated
syringomyelia. Objective: The aim of this study is to provide a general overview of the most common surgical
approach to Type I Chiari malformations, which is the median suboccipital approach followed by cervical
laminectomy to the level of tonsillar herniation. Material and methods: For this study, the cases of 15 patients(4
male, 11 female), between the ages 21 and 68 years were analyzed.Out of these patients only 2 presented
associated neurosurgical pathology: 1 with myelomeningocele and 1 with an expansive tumor near the foramen
magnum. All patients received surgical treatment between 2009 and 2014 in the Neurosurgery Department of
Mures County Emergency Hospital. Results: In the presence of symptomatic manifestations and imagistical
confirmation of Type I Chiari malformations, surgery is the elective treatment providing good postoperative results
even when faced with complications specific to this pathology. 14 out of the 15 patients were treated using the
median suboccipital approach, the 15th requiring a far lateral approach. Conclusions: The suboccipital approach
remains the gold standard in terms of surgical technique for Type I Chiary malformations, but great care should be
taken in patient selection in regard to the onset of symptoms.
Keywords: surgical, approach, Chiari, malformation
CHOOSING THE TYPE OF SURGERY IN PATIENTS WITH ESOPHAGEAL CANCER UNDER

AND OVER 60 YEARS
Halaiu V B1, Stoica Iulia Alexandra1, Roca C1, Molnar C1
1
UMF Trgu Mure
Background: Esophageal cancer is one of the most common cancers of the digestive tract and its treatment is
most often surgical. Objective: The aim of this study was to evaluate therapeutic management and assess
comorbidities and early postoperative complications in patients diagnosed with esophageal cancer. Material and
methods: We conducted a retrospective study that included 103 patients admitted in the Surgical Clinic I of the
Emergency County Hospital Mure between January 2009 and December 2013 with the diagnosis of esophageal
cancer. Patients were divided into two groups according to age: group 1 (n=50) aged < 60 years and group 2
(n=53) aged >=60 years. Results: The mean age of patients was 53.127.0 years for group 1 and 68.666.22
years for group 2. There was no significant difference in terms of surgical therapy (radical surgery vs. palliative
surgery) between the two groups (p=0.93). Furthermore, no statistically significant difference was found between
the two groups in terms of hospitalization days (p=0.94), nor regarding number of days spent in intensive care
(p=0.66), or number of hospital deaths (O.R.=0.3795; p=0.11). Evaluating comorbidities using the Charlson score
we found a significant difference between group 1 and group 2 (2.861.9; 5.222.91; p<0.0001). Early
postoperative complications were evaluated by Clavien Dindo classification, the difference between the two groups
being insignificant (p=0.29). Conclusions: Our study supports the notion that age alone should not be a criterion
in the selection of therapeutic conduit (radical surgery or palliative surgery).The indication of surgery should be in
accord with the patient condition, the final decision depending on a consensus between the patient and the
surgical team.
Keywords: esophageal cancer,, therapeutic management,, postoperative complications.
54
CLINICAL - SURGICAL
ARE PATIENTS RETURNING TO PRE-INJURY ACTIVITIES AFTER ANTERIOR CRUCIATE

LIGAMENT RECONSTRUCTION?
Feier A1, Popa Andra-Diana1, Ostopovici Marta-Lucia1, Bnzari Elena1, Russu O1
1
UMF Trgu Mure
Background: Tear of the anterior cruciate ligament (ACL) is a common injury and the treatment is mostly surgical.
The ability to return to daily activities varies between patients. Most patients do not return to their pre-injury level of
sports participation after ACL reconstruction surgery. Objective: This cross-sectional study aims to review and
explore the ability of individuals who undergo ACL reconstruction to return to pre-injury sports and daily life
activities. Material and methods: A retrospective study was conducted analyzing cases from Orthopedics and
Traumatology Clinic of Trgu-Mure County Hospital covering the period between January 2014 and December
2014. The study involved 61 patients with a mean age of 30 (range 15-47). All patients included in the study
underwent arthroscopic ACL reconstruction. The patients were questioned using an in house made questionnaire
that included questions regarding the psychological readiness to return to sport and recreational activity, reasons
for not returning and self-reported knee function, knee-related quality of life and level of satisfaction with knee
function and surgery. The most important outcome evaluated was return to the pre-injury sport or recreational
activity. Results: Out of 61 subjects, 7 were excluded for not being able to complete and answer the
questionnaire. The mean period after ACL reconstruction surgery was 10.1 months ( 1.9 months). 81.48% (n=44)
of participants were playing sports before the injury and 35.18% (n=19) were playing competitive sports. At followup, 55.55% (n=30) of patients returned to pre-injury sports and recreational activities. 92.59% (n=50) of the
patients followed a type of physical therapy after the reconstruction. The reasons for not returning to sports and
recreational activities included: fear of re-injury, pain and insecurity feeling. Conclusions: Only half of the subjects
managed to return to pre-injury sports and recreational activities after approximately one year from ACL
reconstruction.
Keywords: ACL reconstruction, quality of life, return to sport
FACIAL RECONSTRUCTION WITH PEDICLED FASCIOCUTANEOUS RADIAL FOREARM

FLAP AFTER RESECTION OF GIANT HEMANGIOMA IN THE FRONTO-PARIETOTEMPORAL AND PERIORBITAL REGION
Bubau Marina1, Macec Adelina2, Pavel M1, Toma M1, Dorobantu D1
1
UMF Trgu Mure

Spitalul Clinic Judetean de Urgenta Mures
Background: Hemangiomas are the most common benign vascular tumors, appeared as a result of structural
abnormalities during development of blood vessels. Approximately 80% are cutaneous, located in the oro-maxillofacial area, but can develop in other tissues. A large majority spontaneously involute by the age of seven, however,
some can grow interfering with vital functions such as breathing and seeing. Surgical treatment is compulsory for
large hemangiomas, when complications occur(hemorrhage, ulceration) or when other therapies(corticosteroids,
interferon) are ineffective.Patient D.A., female, aged 35, known for giant hemangioma(15/7cm) in the right frontoparieto-temporal and periorbital region, which relapsed despite numerous interventions performed since the age of
eight in different medical centers in Romania. Objective: On July 15, 2014 the patient underwent surgery, having
the hemangioma excised. The main tissular defect was covered with a left fronto-parietal rotation skin-flap and with
a right temporal rotation skin-flap. The secondary defect was repaired with a split-thickness-skin-graft(STSG)
harvested from the right thigh. Postoperative evolution was favourable, being scheduled for facial reconstruction in
the next six months. Material and methods: On February 2, 2015 the patient undergoes surgery for the
reconstruction of the inferior eyelid and the right fronto-temporal region with pedicled fasciocutaneous radial
forearm flap(the Italian method). The secondary defect is covered with STSG. Results: Using a free flap for the
facial reconstruction was not an option as the facial vascularization had been affected by vascular proliferative
processes, increasing the risk that the flap would not survive. Consequently, this standard was replaced with
a classical tehnique used mainly in the nasal reconstruction. The method was adaptated to the case, thus
succeeding the rehabilitation of the abovementioned segments. Conclusions: Dealing with a giant recurrent
hemangioma, which caused an extensive tissular defect after excision and without the posibility of using modern
CLINICAL - SURGICAL
55
reconstructive methods, we managed to use a classical tehnique with favourable outcome.

Keywords: giant hemangioma, facial reconstruction, forearm flap, Italian tehnique
PHYLLODES TUMORS - HOW TO BE DONE ?

Matei Bianca1, Tbcar M1, Butiurca V1, Antoniu R1, Molnar C1, Russu C1
1
UMF Trgu Mure
Background: Phyllodes tumor is a very rare breast tumor. It accounts for only 1% of breast tumors. The incidence
is 1:100 000 cases ( 58% bening forms, 12% unspecified histological and 30% malignant , 20% with metastasis ).
The treatment of Phyllodes tumors is always surgical. Compared to adenocarcinoma , Phyllodes tumors tend to
affect a younger population , with a different management based on histological findings. The challenge lays in
choosing the proper treatment algorithm according to the predicted evolution of the disease. Objective: We
present the case of a 59 years old patient with a malignant Phyllodes tumor , unusual aggressive variety , affecting
in evolution both breasts and developing also an endothoracic ( pleuro-pulmonary ) extension. Material and
methods: The first surgery consisted of a simple left mastectomy. After only one month we had to do a left radical
mastectomy ( Halsted procedure ) and right radical mastectomy (Madden operation) due to the local recurrence
and bilateral extension. The parietal defect was covered with a slipped abdominal flap. Results: Postoperative
evolution was affected by complications. A cutaneous-subcutneous abdominal flap necrosis and an exo and
endothoracic recurrence occured, which reclaimed re-excision. Ulteriorly , the patient developed signs of acute
respiratory failure and deceased from pulmonary complications in the tenth postoperative day, from the last
surgical intervention. Conclusions: Choosing the proper management in Phyllodes tumors is crucial because of
their tendency to recur and metastasize. Unusual aggressive nature of the breast Phyllodes tumors remains a
challenge for both ( patient and surgeon ) and radical procedure remains probably the best choice.
Keywords: breast, Phyllodes, tumor, mastectomy
CLINICAL-PATHOLOGICAL CORRELATIONS IN PHYLLODES TUMORS OF THE BREAST

Matei Bianca1, MONCEA DENISA1, BARSAN IULIA1, Tbcar M1, STOLNICU SIMONA1, MOLNAR C1
1
UMF Trgu Mure
Background: Phyllodes tumor is a rare fibroepithelial breast neoplasm.The management can be difficult since
some clinical,radiological and pathological features may overlap. Objective: To study the clinical,pathological and
prognostic parameters in Phyllodes tumors diagnosed and treated between 2003-2014 in Targu-Mures and to
determine which parameters may influence prognosis. Material and methods: Accesing the database of the
pathology,surgery and oncology departments we identified 25 cases of phyllodes breast tumors (2003-2014).The
following parameters have been evaluated in each case:age,tumor diameter,tumor margins,surgical margins of the
specimen,histological type,numer of mitosis,nuclei pleomorphism,presence of necrosis,surgical and oncological
treatment. Results: Out of 25 cases,17 were benign,3were borderline and 5 were malignant(high grade).The
median age was 52,56.The tumor size ranged between 25-140mm in benign,34-110mm in borderline and 30130mm in malignant tumors.All benign tumors had well-delimitated margins while malignant and borderline tumors
had ill-defined margins.Most benign tumors had rare mitosis (1/10HPF),the borderline upt to 15 mitoses/10HPF
and the malignant tumors exceeded 20 mitoses(up to 100 mitoses/10HPF).Benign and borderline tumors lack
necrosis and stromal overgrowth,which was present in all malignant tumors.Nulcei pleomorphism was low in
benign tumors and moderate in borderline tumors while in malignant tumors was high.Mastectomy without axillary
dissection was the surgical treatment.In 20% of the cases ,the tumor was not excised within safety limits.75% of
the patients with malignant tumors died of the disease (one was lost from follow-up) while in benign/borderline
tumors only 1 patient developed local recurrence. Conclusions: Phyllodes tumor is relatively uncommon (0,45%
out of all breast lesions),with a large size of presentation ranging(25-130mm) and a history of rapid growth.There
are no specific clinical or radiological features that distinguish between benign/borderline/malignant PT ( they may
overlap) so the pathological examination remains the gold standard in management of such lesions.
Keywords: breast, Phyllodes, tumor, pathology
56
CLINICAL - SURGICAL
DRAMATIC WORK-RELATED ELECTROCUTION IN A YOUNG PATIENT-CASE REPORT

Boan Adriana 1, Boan A2
1
UMF Trgu Mure

Chinese Free University of Shanghai & Hong Kong
Background: Electrocutions, especially those on medium voltage (around 20 KW) are among the most severe
accidents due to early complex consequences and late permanent invalidities. Objective: To present the dramatic
aspect of medium voltage electrocutions. Material and methods: This is the story of a 22 year old boy who
suffered a severe electrocution falling on a 20 KW power line, accidentally dropped on the balcony platform in the
building where he was working. He sustained an circuit with extensive destructions of the soft tissues
of both upper limbs, nose, abdominal wall and left thigh. He was admitted in the Plastic Surgery Department,
where extensive sharp debridement, fasciotomies and early tangential excisions have been performed. He
underwent numerous excisions of the necrotic tissues in the following period, according to the well known limbsalvage procedures. Despite the intensive systemic and local care he lost the two main nerves (medial and ulnar)
of the right upper limb, the left forearm becoming necrotic and gangrened, a large area of his right abdominal wall
and the most part of the nasal pyramid. Results: This patient underwent a lot of complex surgical procedures:
goretex reconstruction of the right axillary artery, covered by a latissimus dorsi myocutaneous flap, extensive skin
grafting, amputation of the left forearm and total rhinoplasty using a paramedian forehead flap. Conclusions: This
is one of the most dramatic cases of electrocution, the extensive lesions suffered by this patient have been
compensated only by his youth and robustness. The amputated left forearm has been supplied with a cinematic
prosthesis and will undergo tendon transfer to his paralytic right upper limb.
Keywords: work-related electrocution, medium voltage electrocution, sharp debridement, limb-salvage
procedures
A THERAPEUTIC OPTION FOR LOW RECTAL CANCER - THE MODIFIED SCHIESEL

TECHNIQUE
Tbcar M1, Matei Bianca1, Antoniu R1, Butiurca V1, Molnar C1, Russu C1
1
UMF Trgu Mure
Background: Intersphincteric resection to preserve anal sphincter function for low rectal cancer extending into the
anal canal was reported by Schiessel et al. in 1994. The introduction of LigaSure-type devices to the oncologic
surgery of the low rectal tumors is an additional step in the quest for sphincter preservation. Objective: The aim of
this paper is to present the surgical technique which may change the therapeutic attitude towards the low rectal
neoplasias. Material and methods: The key points of the modified Schiesel technique which uses LigaSure
(LigaSure Impact and LigaSure Small-Jaws) are presented, underlining the advantages which allow us to
thoroughly respect the principles of oncologic surgery, considering the well-established indications and
contraindication of this type of procedure. Results: The decrease of the operative time, the improved access to
anatomic spaces and the efficiency of the intra- and postoperative hemostasis, are the main advantages
of this technique. Conclusions: The intersphincteric rectal resection for the low rectal cancer may be the most
efficient surgical alternative from the oncologic and functional points of view, changing the perspective for both the
patient and the operative surgeon.
Keywords: low rectal cancer, Intersphincteric resection, LigaSure
THE ACCURACY OF THE ALVARADO SCORE IN DIAGNOSING ACUTE APPENDICITIS IN

PEDIATRIC POPULATION
Toth T1, Ligia Natea1, Codreanu Ana Maria1, Ene Andreea1, Orsolya Pop1, Gozar H1, Pric R1
1
UMF Trgu Mure
Background: Appendicitis is a common cause of abdominal pain that requires an emergent operation. The
Alvarado score was developed in order to sustain the clinical diagnosis. Objective: The main objective of this
CLINICAL - SURGICAL
57
study is to determine whether the Alvarado score increases the accuracy of diagnosing appendicitis in pediatric
population. Material and methods: Our retrospective study comprised 133 patients aged between 2 and 18 who
had been presented with suspected appendicitis at the County Emergency Clinical Hospital of Trgu Mure
between 1st of April 2012 and 30th of July 2014. The Alvarado score was calculated from variables such as: pain in
the right lower quadrant, anorexia, nausea or vomiting, tenderness in the right lower quadrant, rebound pain,
pyrexia, leucocytosis, and neutrophilic leukocytosis left shift. Patients were divided into three groups according to
the Alvarado Score: AS<4, AS 5-7, AS 8-10. The values of sensitivity, specificity and the area under the ROC
curve were also determined. Results: The overall mean age of the 78 male and 55 female patients was 10,78
years. The most frequent symptoms were: pain in the right lower quadrant in 117 (87,96%) of the patients, 114
(85,71%) of the patients complained of tenderness in the right lower quadrant. 65 (48,87%) of the patients had an
Alvarado score<7 and 68 (51,12%)>7. According to the statistical analyses the cut off value was 7, where the
specificity is 93,3% and sensitivity 56,8%. The analysis of ROC curves demonstrated an area under the curve of
81,1%. Conclusions: The Alvarado score can be of assistance in setting the diagnosis of acute appendicitis, but
it cannot be used as an exclusive standard. The final decision remains on the opinion of the Surgeon.
Keywords: Alvarado score, appendicitis, pediatric population
THE NEXT BIG THING: DAVINCI CORONARY BYPASS SURGERY

Muratib Fizah1, Jay Pravinchandra T1, Aburahma K1, Singh Sra J1, Jee Poh Hock M1
1
UMF Gr. T. Popa Iai
Background: Today there is an increasing frequency of patients suffering from CAD and while lifestyle changes
and treatment cannpt relieve the symptoms, usually a CABG is indicated.Previously the authors/co-orfinatoes
studied the mini-CABG technique and proved it superior to conventional CABG. However with the state-of-the-art
CABG DaVinci untilises the concept of robotic syrgery which allows more percise movements inside the thoracic
cavity. Objective: To introduce a new technique in the field of coronary bypass graphing. Material and
methods: Our aim is to study and compare the DaVinci CBS to the latest advancement in CABG surgical
technique and conclude that(if) the DaVinci CBS would prove superior and beneficial for performing a complex
surgery. Results: 112 patients were included, but only 45 underwent robotic surgery via MIDCAB, and 46 TECAB
and 12 were converted to open-heart surgery there was 2 deaths upn follow up after a year and 50% of the
patients recorded with anastomic stenosis and blockages. Conclusions: Overall permeability was 98%, thereby
concluding that the DaVinci surgical technique wielded promising results and potential. Therefore, we would like to
suggest a change to the standard protocol to incluse the DaVinci technique as an intervention method.
Keywords: CABG, CAB, DaVinci, Cardiothoracic surgery
RECTAL CANCER: WAIT AND WATCH

Chatzigianni Olympia Evangelia2, Gabriel D M P2, Porumb V2
2
UMF Gr. T. Popa Iai
Background: Worldwide research has shown that the status quo for treatment of Lower Localized Advanced
Rectal Cancer (LLARC) is to perform neoadjuvant therapy plus surgical approach (abdominoperineal resection
[APR] and total mesorectal excision [TME]) resulting in the need of a colorectal stoma. During the past few years,
research and clinical experience in neoadjuvant therapy for LLARC has shown favorable results in the shrinkage of
the tumor size and cell apoptosis, however more research is needed. Objective: To evaluate the feasibility and
safety of the Wait and Watch method with strict selection criteria (cCR). Material and methods: We, from
Regional de Oncologie Iasi (IRO) are presenting the first cases of LLARC after chemoradiotherapy that
utilize the and Watch method, an intensive follow-up protocol. According to our hospital guidelines, once
diagnosed with rectal cancer, the patient will undergo chemo-radiotherapy (45G and Xeloda) for 8 weeks,
replacing the usual neoadjuvant therapy (4-6 weeks). After an 8 week standby period, re-evaluation by
colonoscopy, MRI and biopsy is carried out. In the circumstance of a clinical Complete Response (cCR), the
and Watch method is continued .Pre- and post-therapeutic variations of macroscopic (endoscopy) and
microscopic characteristics are then compared to evaluate the success of chemo-radiotherapy. These variations
are used to demonstrate the results. Results: Based on the observation study , It shows that if the patient achieve
cCR can have the benefit to avoid surgery and preserved anal sphincter which dramatically improve quality of life.
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CLINICAL - SURGICAL
The study also shows that 8 days of the standby in the protocol isn't sufficient due to most of the patient achieve
cCR between 10-18days.Even if the patient can't achieve cCR, Surgical approach still is a valid option.
Conclusions: Wait and watch method is a Safe, Simple and Effective strategy in managing patients with Lower
Advanced Rectal Cancer who achieve Clinical Complete Respond.
Keywords: Wait and Watch, Colorectal Cancer, Chemoradiotherapy, Clinical Complete respond
SYSTEMATIC REVIEW OVER TRANSTIBIAL VERSUS ANTEROMEDIAL TUNNEL IN

ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION
Grigora T1, Robul A1, Octav Marius R1, Ciprian Ovidiu R1
1
UMF Trgu Mure
Background:
Increasing
evidence
has
shown
that
anatomic
single-bundleanterior
cruciate
ligamentreconstruction (ACLR) better restores normal knee kinematics and functionality than nonanatomic ACLR.
Objective: The purpose of this study was to systematicallyreviewthe risks, benefits, advantages and
disadvantages of the artroscopictranstibial (TT)technique and anteromedial (AM) portal technique for creating the
ACL femoral tunnel. Material and methods: A PubMed search of English - language studies published between
January 2010, and February 2015, was performed using the following keywords: cruciate ligament or

and
were studies reporting risks, benefits, advant
disadvantages of the two ACL femoral techniques. Results: The PubMed search produced 89 articles. After
application of our inclusion and exclusion criteria and additional search of article references, 8 articles were
included and systematically reviewed. Two clinical studies showed better Lysholm score and IKDC score with the
AM technique as compared with the TT technique. One clinical study showed comparable KT-1000 measurements
for both AM andTTfemoral drilling techniques, whereas one study was unable to show any difference. Three postoperative 3D CT studies showed that the AM technique positions theACLtunnel closer to the nativeACLfootprint
in both femur and tibia. Conclusions: ACL reconstruction using a single-bundleTT can achieve good or excellent
results, but anatomicACL reconstruction is essential to the restoration of normal knee kinematics and achieving
successful results aftersurgery.
Keywords: transtibial technique, anteromedial technique, ACL reconstruction, single-bundle
COMPARATIVE STUDY ON THE BRACHIAL PLEXUS BLOCK PERFORMED EITHER BY

NEUROSTIMULATION OR BY ULTRASOUND GUIDANCE - VASCULAR INCIDENCE RATE
GINDILA EMANUELA-DAMARIS1, Lazar Alexandra1, Szederjesi J1
1
UMF Trgu Mure
Background: "This paper was published under the frame of European Social Found, Human Resources
Development Operational Programme 2007-2013, project no. POSDRU/159/1.5/S/136893"The regional brachial
plexus block is a convenient anesthetic solution in the upper limb surgery, having some advantages over general
anesthesia. Amoung these we mention the minimal degree of invasiveness, the use of a small number of
medications,no airway instrumentation and the maintenace of homeostasis of the main organs and systems.
Objective: The study offers preliminary data and compares the two methods of brachial plexus block
performance.The compared data reffer to the incidence of the vascular incidents. These may be encountered
during brachial plexus performance. Material and methods: : Prospective randomized study, which includes 100
adult patients with indication for hand surgery. The patients were divided into two groups of 50 . In one group,
anesthesia was performed by neurostimulation (NS), and in the other group ultrasonography was used (US). The
anthropometric data and the number of vascular incidents during anesthesia - arterial punctures, intravenous
punctures, intravascular injection - were recorded. Results: : The overall rate of the vascular incidents during
anesthesia was 11%. (n=11). Between the two groups, the vascular incidents rate was 2 in the US group and 9 in
the NS group, with a statistically significant difference - p = 0, 025. No intravascular injections were recorded in the
two groups. Conclusions: The statistically significant difference of the rate of vascular incidents in the two groups
reveals the fact that the brachial plexus block, performed by ultrasound guidance, due to the visualization of
vascular structures, significantly reduces the vascular incidence rate during anesthesia.
CLINICAL - SURGICAL
59
Keywords: anesthesia, brachial plexus, ultrasound, neurostimulation
DOES SKIN SUTURING TECHNIQUE AND SUTURE MATERIAL INFLUENCE THE

OUTCOME IN WOUND HEALING ? A PRELIMINARY PROSPECTIVE STUDY ON 52
LAPAROTOMY CASES
Ioncioaia B1, Sntean Ioana Maria1, Bud I T1, Muresan M1
1
UMF Trgu Mure
Background: Appropriate wound healing is imperative in surgical patients. Without it the success of a surgical
procedure could be in some ways doubted. This matter has been studied for decays from the microscope straight
to the clincal setting. Objective: There are quite few written evidence on how various skin closure techniques and
the material used are influencing this process in the abdominal wound. The purpose of this paper was to some
extent to clarify this matter. Material and methods: We have conducted a prospective study, with 52 patients that
required laparotomy for various surgical pathologies regarding the abdominal cavity and abdominal wall. The
patients were divided in two groups concerning the type of sutures (interrupted versus continuous) and material
(absorbable versus nonabsorbable) used. 39 patients have been sutured in an interrupted manner, 21 of them with
absorbable thread while the rest of 18 with nonabsorbable; The second group of 13 patients have been stitched
using continuous suture, 8 with absorbable while 5 of them with nonabsorbable thread.The wound was inspected
in the 5th postoperative day for dehiscence. Results: The group sutured with continuous stitches had presented
no wound dehiscence in the 5th postoperative day, whereas 2 from the 39 patients sutured with interrupted
stitches, developed wound dehiscence in the 5th postoperative day.Both patients were stitched using interrupted
sutures, one being a absorbable material while the other nonabsorbable. Conclusions: Abdominal wound
dehiscence is not significantly influenced by the use of specific sutures nor their material, thus wound healing is
rarely impaired by these factors if correct surgical management is achieved.
Keywords: wound dehiscence, wound healing, suture type, suture material
THE ROLE OF SENTINEL LYMPH NODE IN GASTRIC CANCER LYMPHADENECTOMY

Bara T1, Csilla-Katalin Bartha1, Kovcs Z1, Bara T1
1
UMF Trgu Mure
Background: The status of lymph nodes is the main prognostic factor, important in the evolution of gastric cancer
and inevitable to a suitable postoperatory therapy of the patients. For the accurate detection lymph nodes invasion
stage we can use only the extended lymphadenectomy and histopathological examination. Identification of sentinel
nodes takes a more accurate detection of the status of lymph nodes. Objective: Accurate determination of the
lymph nodes invasion stage. Material and methods: A retrospective study was performed at the 2ndGeneral
Surgery Clinic of Targu-Mures in the period of 1st January 2014- 1st March 2015 for the detection of sentinel node
in the gastric cancer. There were established criteria of including in the study. Results: : Identifying of sentinel
nodes took place at 27 cases. In 70, 37% of the cases total gastrectomy had been performed. D2
lymphadenectomy had been performed in 55, 55%. The most frequent localization of the tumor was at the gastric
antrum (40,74%). In 48, 2% were identified 2 sentinel nodes. At tumors placed at the antrum in the majority of
cases the methylene blue appeared at lymph nodes belonging to 3rd and 6th group. Tumors placed in antrum had
shown lymph nodular metastases in 11 groups of lymphatic nodes, the majority of cases belonging to 3rd and 6th
groups. The most frequent histopathological diagnosis was adenocarcinoma, in one case there was identified
metastases while in three cases
gastric Conclusions:
cancer
Identification of sentinel lymph nodes
makes it possible the dissection of lymph nodes, the identification of lymphoid metastases, having a prognostic
value in the evolution of gastric cancer. These paper was published under the frame of European Social Found,
Human Resources Development Operational Programme 2007-2013, project no. POSDRU/159/1.5/S/136893.
Keywords: gastric cancer, sentinel lymph node, lymph node metastases
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CLINICAL - SURGICAL
CARDIOCIRCULATORY ASSIST DEVICES NOWADAYS

Roman Flavia-Cristina1, Sirbu Eliza Dumitrita1, Suciu H1, Stroe V1
1
UMF Trgu Mure
Background: Cardiocirculatory assist devices are a hot, fascinating topic in cardiac surgery today. Most of these
devices are also known as an effective bridge-to-transplantation strategy for patients with heart failure, especially
caused by dilated cardiomyopathy. Objective: This paper emphasizes the importance of using device therapies as
a means of reducing mortality and morbidity in patients with chronic, severe heart pathology. Material and
methods: A brief classification of cardiocirculatory assist devices and their current basic indications, along with our
clinic "The Emergency Institute of Cardiovasculary Disease and Transplant" new experience. This experience is
about the use of a new LVAD( Left Ventricular Assist Device) for the first time in Romania in January 2015.
Results: This paper is a comprehensive view on the huge range of different cardiocirculatory assist devices and
an inside view of the development of new surgical and device assisted therapies in Romania. Conclusions: The
management of heart failure has significantly improved by means of invasive treatments and device assisted
therapies. Nowadays, LVADs are approved of as a bridge-to-transplantion, as well as an alternative to
transplantation.
Keywords: heart surgery, heart failure, bridge-to-transplantation device, mechanical heart support
RISK FACTORS AND OBSTETRICAL CONSEQUENSES OF PREMATURE RUPTURE OF

MEMBRANES
Zolya Eniko-Kinga1, Brinzan-Antal Gabriella- Zsuzsanna1, Kiss S L1
1
UMF Trgu Mure
Background: The definition of premature rupture of membranes, accepted all around the world is the break of the
amniotic sac before 37 weeks. Premature rupture of membranes(PROM) is one of the most common complications
of both preterm pregnancies. Objective: The purpose of this study is to determine the most frequent risk factors
and obstetrical consequences of premature rupture of membranes. Material and methods: In this retrospective
study were included 101 pregnant women under 37 weeks, which has the Zeiwang test positive during JanuaryDecember 2012 from Obstetrics and Gynecology no.1 from Targu Mures, Romania. We analized the observation
papers to collect the information reffering to risk factors and obstetrical consequences before and after the break of
the amniotic sac. Results: The average age of the patients was 30+/-5, but there were also some teenage
pregnancies too(11.88%).There were 77 patients with normal socioeconomical factors(76.23%) and 24 patients
with low socioeconomical factors(23.76%). The average gestational age was between 26 and 34 weeks(65.34%).
In 13 cases we found genital tract infections with different microorgasms like Streptococcus Agalactiae and
Candida Albicans. 15%(14.85%) of the patients had complications during birth. The most frequent complications
were umbilical cord prolapsing(6.93%) and circular cord around the baby neck(7.92%).
Conclusions: Premature
rupture of membranes is an important risk factor for prematurity. There are a number of risk factors, which have
been associated with premature rupture of membranes, including cigarette smoking, antepartum bleeding, multiple
gestation and polyhidramnios.
Keywords: Premature rupture of membranes, risk factors, obstetrical consequences
THE ACCURACY OF TRU-CUT BIOPSY IN DIAGNOSIS OF BREAST LESIONS

Mocian I1, Georgescu R1, Colcer Ioana1
1
UMF Trgu Mure
Background: Tru-Cut biopsy (TCB) of suspicious breast lesions is a reliable alternative to surgical biopsy for a
histopathological diagnosis. TCB is less invasive and less expensive than surgical biopsy, can be performed
quickly and provides a diagnosis with a comparable high degree. Objective: The aim of this study is to evaluate
the diagnostic accuracy of TCB. Material and methods: This was a retrospective analysis of 163 breast lesions in
155 consecutive female patients who underwent TCB, in Surgery Department of Clinical County Hospital Mures,
CLINICAL - SURGICAL
61
between 2012 and 2014. TCB diagnoses were compared with surgical diagnoses in the 94 lesions(90 patients)
subsequently surgically excised. Rest of 69 lesions(65 patients) were excluded from our study. Sensitivity and
specificity for TCB were evaluated. Results: From a total of 94 TCB included in our study, histopathology showed
78.72% (n=74) malignant lesions and 21.27% (n=20) benign lesions. Malignant lesions was found on surgical
excision in 2 TCB-benign lesions. Rest of all cases showed good correlations between TCB and surgical excision.
Sensitivity of TCB was 97.37% and specificity was 100%. Conclusions: TCB is an accurate diagnostic alternative
to surgical biopsy in patients with breast lesions.
Keywords: Breast lesions,, Tru-Cut biopsy,, Accuracy
PATENT DUCTUS ARTERIOSUS-CLINICAL AND THERAPEUTIC APPROACH

Danciu Elena1, Suciu H1, Matei M1
1
UMF Trgu Mure
Background: At this moment,PDA represent one of the most frequent Congenital Heart Disease.The concept of
PDA defines the postpartum persistence of the embryological communication between distal area of Aortic Isthmus
and left Pulmonary Artery.Despite the fact that PDA is a simple anatomic structure,functional complications that
can occure may represent a real danger for patient life.Furthermore,there are some particular cases of
PDA,complicated by other CHD, when is mandatory to maintain this patency. Objective: Our purpose is to
evaluate by a descriptive survey the PDA records of Institute of Transplantation and Cardiovascular Diseases Tg.Mures and to state some conclusions related to clinical and therapeutic approach of this pathology. Material
and methods: We conducted an descriptive and analytical study at the Department of Pediatrics of Institute of
Transplantation and Cardiovascular Diseases- Tg.Mures,in which were evaluated a total of 343 medical records
from January 5th 2011 to December 23th 2014.Cases of PDA associated with different CHD and demographic
data including age,sex,weight and length were collected.The datas were analyzed by SPSS software and ChiSquare test was used to compare variables between groups. Results: The study reveals that the mean age of the
patients at surgical intervention time was 6 months(in the range of 1 day to 15 years,with median of 7 months).The
percentage of females was 54,8% and males 45,2%.The Chi-Square test showed that there was a significant
difference in frequency between males and females for:PAD+Fallot Tetralogy(p<0,001),PAD+Aortic
Coarctation(p<0,007),PAD+Transposition of Great Vessels(p<0,001),Isolated PAD(p<0,000).The frequency of
Isolated PAD is 21%,Ductal-dependent circulation was found in 17,5% of cases and the most frequent CHD
associated with PAD are ASD(30,9%),VSD(26,5%),TGV(16,6%) and AoCo(16%). Conclusions: The association
between PAD+FT,PAD+Aortic Coarctation and PAD+TGV have a higher frequency in males than in females.Also
the most frequent CHD associated with PAD is ASD,VSD,TGV and AoCo.
Keywords: PDA, Epidemiological aspect, frequency
TESTING OF VALVULAR XENOGRAFTS SEEDED WITH STEM CELLS ON ANIMAL MODEL

Movileanu Ionela1, Harpa M1, Deac R1, Suciu H1, Olah P1, Simionescu D1
1
Background: Regenerative medicine is a new medical field that gains more and more territory in research these
days. Present therapy for valvular pathology is the surgical approach or in some cases using percutaneous
implantation. Current replacement options are represented by mechanical valves or biological ones, represented
by porcine or bovine xenografts or human homografts. Mechanical valves require life-long anticoagulation and
biological valves fail because of degeneration and calcification. Their applicability depends on various parameters
of the patient such as age, comorbidities or an eventual pregnancy. Objective: The object of this study is to
design a living heart valve using regenerative medicine that could overcome the shortcomings of the existent
options, creating a valve that could keep up with the growth of the organism and its changes. Material and
methods: In order to obtain a tissue engineered heart valve, the source of the organ regeneration, represented by
stem cells, were seeded on a biological scaffold, specifically a non-immunogenic acellular matrix. Using a 29 days
protocol, biological scaffolds were obtained by decellularizing porcine heart valves. Seeding them with autologous
adipose derived stem cells new functional heart valves were obtained. To prove their effectiveness these were
sutured inside tubular conduits made of acellular pericardium and implanted in pulmonary position in sheep.
Results: Conduits were successfully implanted through a lateral thoracotomy in the 3rd intercostal space, creating
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CLINICAL - SURGICAL
an extra-anatomical shunt between the right ventricle outflow tract and pulmonary artery. Early results appear
promising with good valvular function and physiological hemodynamic parameters. The follow up is represented by
a 5 months period in which they will be monitored using transthoracic echography, physical observation and
examination. Conclusions: Preliminary results look encouraging, but only longer follow ups and microscopic and
macroscopic analysis will prove their effectiveness.Acknowledgments:This work was supported by a grant from
the Romanian National Authority for Scientific Research, CNCS"UEFISCDI, project number PN-II-ID-PCCE-2011-20036.
Keywords: regenerative, heart, valve, medicine
MANAGEMENT OF ACUTE SCROTUM SYNDROME IN CHILDREN: EFFICIENCY AND

OUTCOME
Fangli D1, Elec Emese1, Tamas I1, Derzsi Z1, Gozar H1
1
UMF Trgu Mure
Background: Acute scrotum syndrome in children is the acute inflammation of the scrotum which is caused by
various pathologies. The need of intervention is often a problem for the physician and often the intervention can
reveal a torsion which could lead to necrosis of testis. Objective: The examination of the effectiveness of
treatment scheme in acute scrotum syndrome. Material and methods: The study is retrospective, which examines
the data of hospitalized patients diagnosed with acute scrotum syndrome at the Pediatric Surgery and Orthopedic
Clinic in Trgu Mure, in the interval of 1. January 2008 " 31. December 2014. We also examined the diagnosis at
hospital admission, persistence of symptoms, applied treatment, period of hospitalization, outcome, discharge
diagnosis, treatment cost and histology results. There were 235 male patients, between the age of 18 years and
first day of life. Results: The post operatory diagnosis of the 235 patients was distributed as follows: 51
orchiepididymitis, 76 Morgagni hydatid torsion, 56 testicular torsion, 21 testicular torsion with irreversible necrosis,
15 haematoma, 4 testicular cancer modification, 12 other pathologies. The average time of hospitalization was 54
hours and the cost was 1420 lei. In the 77 testicular torsion cases the quick intervention saved a total of 72.7% of
the affected testicle. Conclusions: Immediate intervention is suggested, reducing hospitalization cost and time
along with increased and positive recovery prognosis.
Keywords: acute scrotum syndrome, immediate intervention, cost efficiency
HANDSEWN VS. STAPLED ANASTOMOSES AFTER LOW ANTERIOR RESECTION OF

RECTAL TUMORS
Antoniu R1, Matei Bianca1, TABACAR M1, Coro M1, Sorin S1
1
UMF Trgu Mure
Background: There is a lack of studies comparing handsewn and stapled suturing in the surgeries of rectal
tumours. Objective: The goal was to evaluate the safety and effectiveness of stapled over manually sutured
colorectal anastomosis surgery after low anterior resection of rectal tumours. Material and methods: Data were
retrospectively collected from 144 patients who underwent elective colorectal anastomosis surgery from January
2004 to December 2014. Patients were divided into two groups according to the method of digestive tract
reconstruction: 74 patients received stapled suturing (group I) and 70 patients who received handsewn suturing
(group II). All the operations were evaluated regarding tumour localisation and complications. Results: The mean
distance between the tumour and the anal verge was 9.7 cm in group I and 10.84 cm in group II. Postoperative
complications (6.94%) were more likely to occur following stapled anastomoses (8.1%) rather than handsewn
anastomoses (5.7%). Conclusions: Application of the stapler in treating rectal tumours showed it's advantages in
terms of better accessibility in low localisation of the tumour. Postoperative complications were more common with
stapled anastomoses. Although, both techniques are effective, there is a need of larger studies on this subject.
Keywords: colorectal, anastomosis, stapler, surgery
CLINICAL - SURGICAL
63
CLINICAL OUTCOMES AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION:

DOES AGE MAKE A MAJOR DIFFERENCE?
Popa Andra-Diana1, Feier A1, Caldarus C1, Ilie Ana Maria1, Hozoi Elena Madalina1, Russu O1
1
UMF Trgu Mure
Background: The anterior cruciate ligament (ACL) is one of the most commonly injured knee ligaments. In
general, the incidence of ACL injury is higher in people who participate in high-risk sports, such as basketball,
football, skiing and soccer. The goal of the ACL reconstruction surgery is to prevent instability and restore the
function of the torn ligament, creating a stable knee and allowing the patient to return to sports and daily activities.
Objective: The purpose of this study is to evaluate if age is a significant factor in a proper recovery of the knee
function after ACL reconstruction. Material and methods: A short term retrospective study was conducted
between 2014 and 2015 at the Orthopaedics and Traumatology Clinic in Tirgu Mures, involving 54 patients, aged
between 15 and 47(mean age 30 years). The patients were subdivided into two groups according to the age: over
30 years old and under this age - 25 patients and 29 respectively. All the patients underwent ACL reconstruction.
The mean period after reconstruction was 10.1 months ( 4.2 months). The data regarding ACL surgeries was
collected from the hospital register. The patients were questioned by using the Tegner Lysholm Knee Scoring
scale. The scale describes 8 important knee abilities: limp, support, pain, instability, locking, sweelling, stairclimbing and squatting. The scale range from 0 to 100, a higher value means a better health status. Results: The
gathered data from the first group, aged under 30 years show a mean score of 89.66 (range 67-100) while from the
second group, aged over 30 years, a score of 89.09 (range 41-100) was obtained. There was no statistically
significant difference between the groups (p = 0.20). Conclusions: Patients over 30 years old who underwent ACL
reconstruction tend to have a similar recovery to patients under 30 years old who underwent the same surgery.
Keywords: ACL reconstruction, age in ACL, recovery after ACL
SURGICAL MANAGEMENT IN PATIENTS WITH COMPLICATED ACUTE DIVERTICULITIS

Caglar Sena Ebru1, TANASE I1
1
Background: Diverticulitis is an inflammation of pouches called diverticula created by herniation of mucosa into
the colon wall. Complicated diverticulitis is present in approximately 10-25% with complications such as peritonitis,
obstruction, and abscess. Objective: The aim of this study was to identify the best surgical approach according to
globally known classifications with minimum risk of complications and postoperative hospital stay. Material and
methods: A retrospective study was performed on 85 patients hospitalized between January2012- June2014 with
complicated acute diverticulitis. The patients were selected from a general population with no gender or age
discrimination. The gathered data consisted in demographics, diagnosis upon admission, investigations, means of
treatment and patient
status at discharge.
Results: The gender distribution was relatively
equal(females:males=51,76:48,24). The main complications upon admission were abscess(35,2%) and
peritonitis(20%). Performed investigations were most accurate using CT-scan(60%) followed by
Ultrasonogram(80%) and abdominal X-ray(69,4%). Only 16,4% performed colonoscopy with 14,2% large-bowel
perforation. Both genders were equally represented in classification of Hinchey. Conservative treatment was
initiated in most patients except 7,05% requiring surgical intervention. Descendening&sigmoid colon were affected
mostly. In cases with limited disease, anastomosis-per-primam was preferred, while Hartmann procedure was
preserved for large peritoneal abscesses and peritonitis. The laparoscopic approach was used with mild-moderate
disease. Hospital stay was longer for surgically treated patients(difference of 7 days). Complications were
encounteredin 7,05%most commonly dueto deep venous thrombosis and wound infections with no mortality
cases present. Conclusions: Hinchey and Hansen classifications offered a good guideline for treatment
approach. Colonoscopy was associated with perforation risk. Resection and anastomosis-per-primam was
prefered for limited disease while the Hartmann procedure was more suitable for peritoneal abscesses or
peritonitis. Minimally invasive treatment can be applied in cases of Hinchey class I-II, either as sole therapy or
followed by bowel resection. Laparoscopic non-resective procedures reduced the morbidity rate but didn't reduce
hospital stay.
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CLINICAL - SURGICAL
Keywords: diverticulitis, acute, complicated, surgical management
THE NEONATAL CARDIAC SURGICAL EMERGENCIES AT IUBCVT TRGU-MURE

Keller D P2, Szabo T2, Stroe V2, Suciu H2
2
UMF Trgu Mure
Background: The congenital heart defects are present in the neonatal period. This study is based on the critical
congenital heart diseases that are dependent on a patent ductus arteriosus (PDA) or require intervention within the
first month. The early repair of these congenital defects can prevent major morbidity and mortality and minimize
the need of future surgeries. Neonatal arrhythmias are also included as they can present as emergencies.
Objective: The objective of this study is to create an overview on the experience of Institutul de Boli
Cardiovasculare i Transplant Trgu-Mure in the surgical management of the neonatal emergencies. We are
looking to demonstrate also the improvement in our clinic ability to cover a larger number of patients each year in
order to fit the high demands. Material and methods: This study is a retrospective chart review based on 136
patients who underwent surgical treatment between 2010-2014. The inclusion criteria are age, diagnostics and
associated pathologies and the most important- the urgency of surgery.Data were analyzed using Microsoft Excel.
Results: In the study were included 136 patients (82 male and 54 female) with the mean age of 17.80 days
ranging from 10 hours to 1 month. The intra-operative mortality rate was 2.20% (3 patients) and was due to cardiac
failure. Analyzing the activity of our clinic, the single-center in Romania for the treatment of neo-natal emergencies,
we observed an increase of 18.51% in the number of patients in 2014 compared with 2010. Conclusions: The
high survival rate of 97.80% highlights the importance of an experienced team and of an adequate surgical
approach in dealing with neonatal emergencies. In these cases, the surgical treatment must be rushed and
therefore it is extremely important to have an early diagnostic, underlying once more the need for interdisciplinary
teams.
Keywords: emergency, neonate, cardiac, surgery
A RARE CASE OF CONGENITAL LOBAR EMPHYSEMA

Kuo Chu Hsuan, Patricia4, Tarca Dr Elena4
4
UMF Gr. T. Popa Iai
Background: Congenital lobar emphysema (CLE) is a lung abnormality that results in progressive overinflation of
one or more lobes of a neonate lung; most common occurrence in the left upper or the right middle lobe. It is a
potentially reversible though possibly life-threatening cause of respiratory distress in neonates with a prevalence
rate of 1 in 20,000 to 1 in 30,000. There are many presumed mechanisms for progressive overdistension of a lobe
including obstruction, cartilage deficiency, dysplasia, and immaturity. Objective: We present a neonate admitted
to Saint Mary Children Hospital, Iasi, with a respiratory distress syndrome since seven days of life.
Material and
methods: Investigation revealed the overexpansion of the left upper lobe with mediastinal herniation, shifting of
the mediastinum to the opposite side and collapse of the ipsilateral lower lobe. Both his vascular anatomy and the
bronchial wall were normal. Results: A complete lobectomy of the left lung was performed under general
anaesthesia with one lung ventilation. Conclusions: He dramatically improved after surgery. The SaO2
normalized within 12 hours of Surgery (lobectomy) and the postoperative period was uneventful. The early
diagnosis and the importance of surgical intervention is noteworthy. The importance of follow up was stressed.
Keywords: Lobectomy, Congenital Lobar Emphysema, Lung abnormality
THE INFLUENCE OF SURGICAL TREATMENT ON THE EVOLUTION OF

VESICOURETERIC REFLUX IN CHILDREN
Ligia Natea1, Toth T1, Codreanu Ana Maria1, Stanescu Alexandra1, Gales Angela Tabita1, Horea G1, Radu- Alexandru P1
1
UMF Trgu Mure
Background: Vesicoureteric reflux is a common pediatric urologic disorder which results in retrograde urine
passing. The main cause of the permanent parenchimal renal damage is the urinary tract infection. Therapeutic
CLINICAL - SURGICAL
65
approach of these children has been directed at preventing infection by antibiotic prophylaxis and/or surgical
correction of reflux Objective: Find the influence of the surgical treatment on the evolution of the vesicoureteric
reflux in children. Material and methods: We retrospectively identified 202 patients diagnosed with vesicoureteric
reflux between 1st January 2003 and 31th December 2013 from medical records which belong to the Department
of Pediatric Surgery and Orthopedics and the Department of Pediatrics II, Emergency County Hospital TrguMure. We included in the study patients with primary vesicoureteric reflux and also subjects with reflux associated
with anatomical abnormalities. As surgical treatment we had open surgery, where cross-trigonal Cohen
ureteroneocystostomy was commonly used and minimally invasive surgery as endoscopic treatment of
vesicoureteral reflux Results: From the total of 202 children, 60.9% were female. The age distribution was: 34.7%
under 12 months and 12.9% between 12 and 24 months. The main cause for a visit to a doctor was in 92.6% of
the cases, the urinary tract infection. The percentage of patients treated with chemoprophylaxis was 96%. From
the total group, 22.3% needed surgical treatment, where in 73.33% cases it used open surgery. Succes rate after
the first surgery was 86.36% for cross-trigonal Cohen ureteroneocystostomy and 50% for endoscopic treatment
Conclusions: Antibiotics prophilaxy did not reduce significantly the number of urinary tract infections but reduced
the risk of developing new or progressive renal damage.The most affected group is under 12 months but they have
a better evolution with chemoprophylaxis. In patients with a great degree of reflux the best solution is surgical
treatment
Keywords: vesicoureteric reflux, Ureteroneocystostomy, urinary tract infection, chemoprophylaxis
THE EFFICIENCY OF SCOLIOSIS SCREENING PROGRAM FOR CHILDREN FROM

MURES COUNTY, A FOUR YEARS RETROSPECTIVE STUDY
Niculiseanu Stela1, Parlici Alexandra Elena1, Gozar H1, Derzsi Z1
1
UMF Trgu Mure
Background: Idiopathic scoliosis is a progressive disease of vertebral spine with unknown etiology. It is often
associated with female gender and begins in childhood, having a high evolving potential and therefore early
detection and treatment are very important. Objective: The main objective of this study is to demonstrate the
efficiency of early screening of scoliosis in children. Material and methods: This retrospective study was
performed on a lot of 22.851 patients from the schools in Mures County, all the children were between IVth - VIIIth
classes including, in the period 2011 - 2014. The screening was accomplished by specialist physicians of Pediatric
Surgery and Orthopedics, according to a well-defined standard protocol. Results: From a total of 22.851 examined
patients, 957 were suspected to have scoliosis. Among them, 880 presented for diagnostic confirmation and
beginning of specialized treatment at the county specialty service from The Polyclinic of Pediatric Surgery and
Orthopedic (County Clinical Hospital, Targu Mures). From 814 patients that came, the diagnosis was confirmed
with spine X-rays in 672 cases and only 145 were yet under treatment. Therefore the screening detected 716 new
cases. It was determined that the female gender was prevalent 64,55% (568) with a higher incidence in the urban
environment 61,36% (540). Conclusions: The scoliosis screening program in schools is medically and financially
efficient, and we recommend continuing this screening for all students in this age group at national level.
Keywords: scoliosis,, screening,, efficiency
RECURRENCE OF CUTANEOUS SQUAMOUS CELL CARCINOMA AFTER SURGERY.

Caldarus C1, Pavel M1, Popa Andra-Diana1, Dorobantu D1, Cotoi O S1
1
UMF Trgu Mure
Background: Non-melanoma skin cancers (NMSCs) are the most common type of skin tumor including basal cell
cancer and squamous cell cancer. They represent about one-third of all malignancies diagnosed worldwide each
year. Cutaneous squamous cell carcinoma (cSCC) is the second most common form of NMSCs and the risk of
cSCC invasiveness is measured regarding the tumor size, anatomical location, and histological subtype.The
recommended treatment is usually surgical. Objective: The purpose of this study is to evaluate if there is a
correlation between gender and frequency of the cSCC relapses after surgery at a certain part of the body.
Material and methods: A retrospective study was conducted, analyzing data between 2004-2014 at the Plastic
Surgery Department 1, in Tirgu Mures. All patients underwent cutaneous squamous cell carcinoma surgery. The
data regarding cSCC surgeries were collected from the hospital register and pathology results.The patients were
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subdivided according the gender, age (<70 years and >70 years) and anatomical location of the cSCC (head,
neck, trunk, upper limb, lower limb, unspecified region) Results: The study involved 160 patients, aged between
40 and 93 years,88 male and 72 female. 65% (n=104) of cases were head cSCC (50% male and 50% female).
The resection safety margins had a mean of 135.78 mm2.From 32 recurrences 68.75% (n=22) were located in the
head region, 72.72% (n=16) in women and 27.27% (n=6) in men.There was a statistically significant difference
between the genders (p=0.015) Conclusions: There is a correlation between the gender and the cSCC
recurrence, the head region being the most frequent location for relapses. Of the two non-melanomic skin cancer
types, squamous cell carcinoma is the one that recurs more often and give metastases, so patients should be
monitored constantly
Keywords: Cutaneous squamous cell carcinoma, relapses, anatomical location
CORRELATIONS BETWEEN THE CLINIC AND HISTOPATOLOGIC DIAGNOSIS OF

CHRONIC RHINITIS WITH POLYPS
MOROZAN TATIANA1, Gingean Diana1, Neagos Adriana1, Simona Mocanu1
1
UMF Trgu Mure
Background: Chronic rhinitis with polyps is a major health care issue that affects the quality of life of
approximately 0.5-4% of the general population and even if patients are offered an expensive clinical management
the incidence and prevalence are growing. The etiology is multifactorial and this disease is described as a
persistent symptomatic inflammation of the nasal cavity. Those affected by it, have an abnormal remodeling of the
epithelium ( goblet cell hyperplasia, basal cell hyperplasia, or metaplasia). Objective: The aim of this study was to
determine if there is a correlation between the clinical diagnosis and the histopathologic diagnosis of chronic
rhinitis with polyps. Material and methods: We included 117 patients from the ORL Department of Tg-Mures
County Hospital, from January to December 2013, with inflammatory affections of the rhino sinus. The clinical
diagnosis was based upon the presence of nasal symptoms such as nasal blockage/obstruction/congestion or
nasal discharge (anterior/posterior nasal drip) facial pain/pressure reduction or loss of smell for more 12 weeks.
Nasal endoscopy was performed and in 66 of the participants we confirmed the presence of polyps and sent
biopsy specimens to the Pathology Department for diagnosis. Results: From the 66 samples, 52 (78.8%) were
confirmed chronic rhinitis with polyps, the remaining 14 (21.2%) had different diagnosis (chronic hypertrophic
rhinitis, allergic rhinitis). The majority of the patients were men with the average age of 47. Conclusions: We
observed a statistical significance regarding the correlation between the clinical and histopathologic diagnosis.
Even though the patients had visible polyps at both the clinical and endoscopic examinations, the histopatologic
exam is needed for confirmation and to exclude a malignancy.
Keywords: nasal polyps, chronic rhinitis, nasal obstruction
COMBINED APPROACH OF THE ANTERIOR SKULL BASE IN SINONASAL TUMOURS:

CASE STUDY
Jay Pravinchandra T2, Aburahma K2, Aden M B2, Palade D2
2
UMF Gr. T. Popa Iai
Background: Cancers arising in the sinonasal cavity and the base of skull are extremely rare. It has been
estimated that the incidence of sinonasal cancers is approximately 1/500,000 to 1/1,000,000 people. Objective:
The aim of this presentation is to highlight the importance of the approach method. Although use of
the endoscope during sinus surgery is now the norm for the vast majority of otolaryngologists, external sinus
surgery techniques still have a place in the management of sinonasal tumours. Material and methods: Combined
approach is a procedure, which refers to the combination of external sinus surgery and the use of endoscopic
techniques. The result concerning a combined approach of the anterior skull base for the treatment of these
particular sinonasal tumours were reviewed. The limitations and advantages were compared and a combined
surgical technique was favoured. The operative techniques are reported. Results: A 50-year-old male was
admitted to our clinic with complaints of nasal obstruction, fullness sensation and a headache located to the frontal
region. Additional investigations concluded a diagnosis of an inverted papilloma with frontal sinus invasion. A
combined approach of using external sinus surgery as an adjunct to endoscopic techniques in these special
circumstances such as rare tumours proved to be highly effective. The benefit of direct visualization afforded by
CLINICAL - SURGICAL
67
external approaches combined with endoscopy that can assess if there is a tumor left in place in skull base
malignancies proved to be extremely valuable in this patient management. Thus, a combined approach is far
superior to a single approach alone. Conclusions: The combined approach of endoscopic resection performed
with an external approach, when properly planned and in expert hands, has an accepted role in Surgical
Otorhinolaryngology. The combined approach remains an important option in the management of complex
diseases.
Keywords: Combined approach, endoscopy, Sinonasal tumours
LIFE QUALITY AFTER TOTAL HIP REPLACEMENT: A SHORT-TERM COMPARISON

BETWEEN CEMENTED AND UNCEMENTED PROSTHESIS
Rednik Anca Maria1, Branea Oana-Elena1, Ioanovici A C1, Ilie Ana Maria1, Russu O1
1
UMF Trgu Mure
Background: The hip is an essential joint, allowing the execution of complex moves. One of the best ways to
assess its integrity is using the Oxford score, a patient self-administered questionnaire consisting of 12 multiple
choice questions on daily living, function and pain, also important in evaluating the evolution after a total hip
arthroplasty, cemented or not. Objective: The aim of the study is to assess and compare the quality of life in
patients after hip replacement with a cemented prosthesis or an uncemented one at 1 year post-intervention.
Material and methods: A short-term retrospective study was conducted. A number of 40 patients were included,
17 males and 23 females, aged 40 to 80 (mean age 63.3), who underwent total hip replacement at the Orthopedics
and Traumatology Clinic of Targu Mures between January 2014 and April 2014. They were divided into 2 groups:
20 with cemented prosthesis and 20 with an uncemented one. The patients were questioned by telephone using
the Oxford hip score. Results: The results showed a mean score of 34.85 in the patients with cemented prosthesis
and 41.75 in the ones with an uncemented one, with the following distribution in the cemented prosthesis group:
35% scored between 20-29, 30% between 30-39 and 35% between 40-48. In the uncemented prosthesis group,
5% scored between 20-29, 20% between 30-39 and 75% between 40-48. The females in the first group scored
34.69 and the males 35.55, whereas in the second group, the females scored a mean of 45.82 and the males
38.81. Conclusions: The results show a significant improvement in everyday life, a better hip function and less
residual pain after an uncemented total hip arthroplasty than after a cemented one. However, for a better
understanding of the phenomena, further studies are necessary.
Keywords: arthroplasty, oxford score, hip replacement
THYROID SURGERY - BETWEEN IGNORANCE AND MALPRACTICE

Mihuti Alexandra1, Dorin M1, Pop Anisoara1
1
UMF Trgu Mure
Background: Thyroid surgery is still erroneously considered a difficult surgery. Recently some terminology
clarifications have appeared as well as a shift in the surgical approach of the thyroid gland, both in terms of benign
and malignant pathology or redo surgery. Accidental removal of parathyroids is a complication at the limit of
malpractice and inadequately mastered surgical technique by the surgeon. Objective: The current paper tries to
outline the extremely confusing yet topical boundaries between malpractice, inevitable complications and technical
deficiency in thyroid surgery. Material and methods: We conducted a retrospective study over a period of 10
years (2005-2014) in which we analysed all the thyroid interventions in the surgical clinics from Targu Mures: 3065.
Results: A number of 2750 women (89,7%) versus 315 men (10,3%) were operated. The average age was 50
years (49,66), ages ranging between 1 and 98 years. Of the total cases, 2074 (67,67%) were benign, 679
(22,15%) were malignant, while 286 patients (9,33%) required redo surgery for both benign and malignant
conditions. A total of 26 patients (0,85%) had their thyroid gland of normal appearance removed on the first
surgery. Of all patients with benign conditions, 377 (18,1%) had between 1 and 3 parathyroids removed. In the
cases of malignancies, 70 patients (10,3%) had between 1 and 2 parathyroids removed. In patients who had their
perfectly normal thyroid gland removed, without pathological changes, on the first surgery, we found that a number
of 6 patients (23,07%) had between 1 and 2 parathyroids removed. Conclusions: 1. To be a surgeon involves
great responsability, primarily for the patient. "Primum non nocere" is still of utmost importance. 2.Collaboration
with the endocrinologist and pathologist can temper the excessive surgical determination, especially in the case of
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young surgeons. 3. Blaming the doctor for malpractice will increase his/her interest for an exceptional training.
Keywords: thyroid surgery, malpractice, deficient surgical technique
ACCURACY OF LOE TEST IN ACL TEAR DIAGNOSIS COMPARING TO LACHMAN TEST

Abaza Maria1, Stanca M1, Russu O1
1
UMF Trgu Mure
Background: The Anterior Cruciate Ligament is a very important stabilizer of the knee joint, its tear being one of
the most common knee injuries, happening especially in young and physically active population. Objective: The
aim of this study is to establish the accuracy of LOE (loss of extension) test in ACL tear diagnosis, comparing to
Lachman test, considered the most sensitive and specific clinical test in this pathology. Material and methods: In
a prospective study from November to April 2014 21 patients suspected with ACL tear were evaluated with both
Lachman and LOE tests. The LOE test was performed using the goniometer for the extension angle and also
measuring the heel - table distance for the both legs during knee extension. A contingency table was used to find
out the sensibility and the specificity of LOE test. A Fisher test was applied to detect the association. Statistical
analysis was performed using GraphPad Prism 6. Results: Mean age of patients was 28 years, 7 patients were
female and 14 were male. The sensitivity of LOE test was 0, 66, its specificity was 0, 33, the positive predictive
interval was 0,857 and the negative predictive interval was 0, 142. Lachman test was negative in 3 cases of 21,
and LOE test in 7 cases. The statistical analysis did not show a significant association between the two tests.
Conclusions: This preliminary study shows that LOE test could be useful in ACL tear clinical diagnosis, being
positive in 2/3 of the cases, but it doesn have a big specificity and also it cannot be compared to Lachman test,
which is considered the `gold standard`. Even so, extending the study on a bigger group of patients will clarify the
real reliability of this new test.
Keywords: ACL tear, LOE, clinical test
CLINICAL ASPECTS AND MANAGMENT OF PEDIATRIC BURNS: A RETROSPECTIVE

STUDY
Ene Andreea1, Furdui B1, Zacharias Cora1, Toth T1, Gozar H1, Prisca R1
1
UMF Trgu Mure
Background: Burn injuries are a distinctive category of traumas, in wich incriminated agent, such as physical,
chemical, electrical, ionizing, produces distructive lesions to the skin and sometimes even to the tissues below.
This particular injuries can be classified by their gravity, etiology, deepness and extension. Objective: The aim of
this study was to evaluate the clinical aspects and the management of the pediatric burns. Material and methods:
We studied a number of 730 patients presented in the Department of Pediatric Surgery of the Emergency County
Hospital Mures between 1st of the January 2007 and 1st of March 2015, diagnosed with burn injuries, hospitalized
and ambulatory treated. Results: From 730 patients, 27,26% needed hospitalization. Most cases were registered
in 2010 (22,32%). Most lesions were found in the toddlers group(44,79%). Analyzing our data, we found a higher
proportion of 55,20% in the male population. We treated 71,37% patients came from rural areas. The most
common lesion mechanism was scald, with 52,32% of total cases. From topographic point of view, most of the
burns were located to the upper limb, 49,86%. A percent of 91,50% presented 2nd degree burns, only 2,19% being
appreciate with 4th degree. We treated 78,35% burns <10% body surface ( BS), 12,9% patients with burns <20%
BS, 5,6% <30% BS and 3,15% up to 30% BS. The average of hospitalization was 13,47 days. The hospitalized
wounds were treated as follows: 98 needed excisional debridement, 78 received nonexcisional debridement and
23 patients required skin grafts. Conclusions: Burns remain an important cause of injury in children besides
efforts to improve the treatment of these patients. Despite the fact that most require a long period of hospitalization
and aggresive surgical management, immediate complications and mortality rate is very low
Keywords: burn injuries, debridement, wound, pediatric
CLINICAL - SURGICAL
69
SURGICAL MANAGEMENT OF ACUTE AORTIC DISSECTION

Furdui B1, Ene Andreea1, Suciu H1, Stroe V1
1
UMF Trgu Mure
Background: Cardiovascular diseases represents the major cause of mortality world wide . Since the first part of
20th first century aortic dissection was exclusively a post mortem diagnosis. With the advent of cardiopulmonary
by-pass and the new emaging techniques have forever changed the natural history of this aortic wall disease,
alowing better pacient management and erlier diagnosis. Objective: The purpose of this study is to display the
surgical aspects of this emergency condition and the experience of aortic dissection at the Emergency
Cardiovascular Disease and Transplant Institute of Trgu-Mure. Material and methods: This retrospective study
reviewed 69 pacients with aortic dissection who were operated at the IBCvT from Trgu-Mure on a period of 5
years, betwen 2010 and February 2015. From these 69 pacients 24(34,78%) had DeBakey type II dissection,
29(42.02%) DeBakey type I ( ascending aorta and aortic arch) and 16(23,18%) DeBakey type I ( ascending and
abdominal aorta). There were 2 iatrogenic , 3 chronic dissections and 5 pacients presenting carotide artery
dissection. Many pacients presented associated complications related with this disease: Cardiac tamponade
27,53% , aortic failure 26,08% and mallperfusion syndrome 5.79% Results: Analysing our data we found a higher
proportion in the male population: 66,66% male and 33.33 female. the male population had also a higher index of
associated pathologies, such as : severe aortic failure 43,47male and the female group had only 13,04% and with
aortic rupture 32,60 male and 17,39% female . 9 pacients(18,36%) had Bentall operation and 40 pacients
(81,64%) had the aorta replecement procedure. 7 pacients died during surgery and 2 pacients before.
Conclusions: As a conclusion the only eficient treatment af the aortic dissection is the surcical procedure. This
aortic wall disease still represents a life threatning emergency in wich every minute counts and for that reason it is
also known as the minute batle.
Keywords: aortic dissection, Bentall operation, aortic wall disease
PANCREATIC-GASTRIC ANASTOMOSIS WITH AND WITHOUT SUTURES

Tudor A1, Dogar C M1, Tudor Bianca1, Molnar C1
1
UMF Trgu Mure
Background: The study was conducted with the approval of the Ethics Committee of the University of Medicine
and Pharmacy of Trgu Mures. Objective: To identify a feasible technique that is fast and that has the lowest rate
of pancreatic fistula. Material and methods: We practiced two types of surgical procedures. Thus, after splitting
the cervix of the pancreas and suture closing of the proximal pancreatic stump, the distal pancreatic stump was
anastomosed to the posterior gastric wall. In the first group of five piglets we used for the anastomosis two purse
strings that ware passed through the mucosa and seromuscular of the posterior gastric wall. For the second
groups' anastomosis we used transfixing threads through the pancreatic parenchyma and the posterior gastric
wall. Postoperative we drew blood for amylase level determination. Ten days after the surgery the animals ware
humanly euthanized. Results: Macroscopicaly we identified a blocked anastomosis fistula with an perianastomotic
abscess of about 1 centimeter in diameter at one piglet and acute pancreatitis like changes in two piglets, all three
of them belonging to the second group. Microscopically, no pancreatic and gastric fistulas were observed in the
first group, patchy necrosis of the mucosa and submucosal gastric was found and the pancreatic necrosis of
pancreatic stump was only superficial. In the second group, fistulas were found in two cases, both presenting with
high amylase levels, one highlighted macro- other microscopically, bordered by large areas of coagulation necrosis
and hyperplasia of the pancreatic ducts. The time necessary for the anastomosis procedure was significantly
reduced in the first group. Conclusions: The double purse pancreatic-gastric anastomosis is a feasible, safe and
fast procedure. Acknowledgment: This paper is supported by the Sectoral Operational Programme Human
Resources Development (SOP HRD), financed from the European Social Fund and by the Romanian Government
under the contract number POSDRU/159/1.5/S/133377/
Keywords: Pancreatic Fistula, Anastomosis, double purse, Acute pancreatitis
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NUTRITION AND DIETETICS
71
ASSESSING THE BEHAVIORAL AND DIETARY HABITS OF PATIENTS WITH GASTRIC

PATHOLOGY
Rus Victoria1, Man Pop Roxana Delia1, Edis A1, Tudor Bianca1, Ruta Florina Daniela1, Bataga Simona1
1
UMF Trgu Mure
Background: Stomach diseases occur after unhealthy diet, stress or negligence of old diseases. Claiming a lack
of time, modern man does not eat healthy (consumes in a hurry fast-food) and has a sedentary lifestyle (due to
many hours spent in the office or on the computer). To be physically and mentally healthy human body needs
quality food, exercise, rest, a good stress management and social support. Objective: This study aims to assess
the behavioral and dietary habits of patients with gastric pathology. Material and methods: For this study we
used a food frequency questionnaire containing 26 questions about personal data, eating behavior, types of foods
and beverages containing additives, sugars and fats consumed in the menu, consumption frequency and
knowledge or attitude towards healthy eating. Results: From patients who completed evaluation questionnaires,
women predominated and the sample structure consisted of 30.1% male and 69.9% female. The average age was
47.2 years. There is a significant percentage who have unhealthy eating behavior or consume only a main meal
daily or eat irregularly (30.2%). From the 60 investigated patients, 33 (54.59%) consume meat every day, 16
(25.94%) did not consume acid diary products, and a number of 36 patients (60.54%) did not consume can
products at all. Approximate 27.7% subjects ate patistry products everyday and almost 67.9% patients answered
that they are are going to sleep after they ate dinner, and some of them consumed alcohol before meals.
Conclusions: From the assessment of patient data surveyed we noticed that there is a lack of nutritional
education regarding the effects and role of physical education and sports in combating obesity and other chronic
diseases, post-prandial relaxing activities and the formation of healthy eating behavior.
Keywords: diet, gastric pathology, lifestyle
HEALTHY FOOD AND PHYSICAL ACTIVITY- IS IT A DELIGHT OR A PUNISHMENT FOR

SCHOOL-AGED CHILDREN?
Hintea Mdlina Monica1, Emke Kiss1, Grama Alina1
1
UMF Trgu Mure
Background: An adequate, healthy diet and physical activity are essential during the childhood because eating
habits remain the same in adulthood, too. In our days, children tend to consume more calories and fewer nutrients,
therefore the prevalence of obesity is increasing. Objective: The aim of this study is to evaluate the lifestyle and
food preferences of school-aged children. Material and methods: This is a cross-sectional study conducted on a
sample of 196 pupils from a school in Sighisoara city. Children aged between 7 and 15 years were measured
(height and weight) and were questioned about their intake of certain foods, number of meals, physical activity,
oral hygiene. Results: A percentage of 12.76% children are obese and 9.18% are overweight. Eating breakfast is
a rare habit for 41.84% of children and 27.55% never consume breakfast. There is a daily consumption of meat
products (60.20%) and sweets (46.30%). Sometimes, children prefer to eat in front of the TV or PC (63.78%). Only
15.31% brush their teeth after every meal. A percentage of 36.22% children don practice any kind of physical
activity after school. We found a significant consume of carbonated soft drinks among obese and overweight
children, compared to underweight children (32.56% vs.18.18%; p=0.03). Girls who don have physical activity are
significantly more than boys who are in the same category ( 45.19% vs. 26.09%; p=0.0003). Boys are more likely
to be overweight and obese than girls (31.52% vs. 13.46%; p=0.002). Conclusions: This study shows that
children have some bad eating habits and they aren`t interested in practicing any kind of physical activity.
Educational programs about a healthy lifestyle and evaluation of nutritional status are important strategies to
decrease the prevalence of obesity.
Keywords: eating habits, physical activity, children
72
NUTRITION AND LIFESTYLE DURING LACTATION

Emke Kiss1, Hintea Mdlina Monica1, Grama Alina1
1
UMF Trgu Mure
Background: The nursing mother`s nutrition and lifestyle is just as important as thepregnant woman`s
nourishment. However, there is insufficient information about the nutritional needs in this period, in fact mothers
tend to consume increased calorie diets instead of nutrient"dense food. Objective: This study aims to assess
the behavioral and dietary habits of nursing mothers. Material and methods: A cross"sectional study was
conducted to evaluate the nutritional knowledge of nursing mothers with different ages from Mure county. A total
of 431 were questioned through an on-line questionnaire about their personal data, lifestyle and eating habits.
Results: A percentage of 88.4 of the mothers consider that eating breakfast is important. Just 53.5 % of them
consume fruits during a day, and 62.1 % vegetables. A percentage of 52.3 of surveyed mothers is convinced that
white bread is healthier than whole grain bread, 44.7 % think the opposite. There is a daily consumption of
processed meat ( 54.2 % ) and only 13.3 % consume fish regularly. A percentage of 50.2 of surveyed mothers said
that they usually eat fast- food. A percentage of 20.8 of the mothers smoke and they do not do any kind of physical
activity, while 82.1 % do some physical activity and are non-smokers. Mothers who do not smoke usually do not
consume alcohol, while there are some who smoke but do not drink (83.8%, 16.2%, p = 0.001). Conclusions: This
study shows that nursing mothers do not have the necessary information about what they are supposed to eat
during lactation. The unhealthy eating habits and lifestyle can threaten their and the baby`s life. The only solution
to this problem are the educational programs about breastfeeding and the nursing mother`s needs.
Keywords: eating habits, life style, lactation, physical activity
ASSESSMENT ON LIFESTYLE, DIET AND EATING HABITS IN A GROUP OF PREGNANT

WOMEN FROM TARGU MURES COUNTY
Istrate Andra 1, Eremia A1, Timpu L1, Mogan Andreea1, Rus Victoria1, Ana Farr1
1
UMF Trgu Mure
Background: Pregnant women lifestyle is very important regarding pregnancy evolution, in order to prevent
complications, and to deliver a healthy baby. A quality and quantity balanced diet is indispensable in maintaining
the health of the mother and to ensure normal growth and development of the fetus. Objective: Pregnant women
lifestyle and diet assesment. Material and methods: The study was a descriptive epidemiological on a
representative sample of 100 pregnant women aged between 21 and 40 years old, from Tg. Mures, and was
conducted between October 2014 and March 2015. In the study group was applied a questionnaire consisting of
40 questions related to: demographic data, data on anthropometric measurements during pregnancy, tobacco use
before and during pregnancy and frequency of food consumption per week. Results: In the investigated group the
average age was 30.5 years, predominantly the urban area. 52% of respondents were at first pregnancy and 39%
at second pregnancy. Regarding caffeine intake, consumption frequency was "once a day" observed in 51% of
subjects, while 43% had no caffeine intake. A share of 16% and 15% admitted alcohol intake and smoking during
pregnancy. Most pregnant (86%) had a traditional diet pattern and a proportion of 28% consumed between 4-5
meals/day and 68% had declared a change in meals frequency. Regarding pregnant BMI before pregnancy, the
data collected revealed that a proportion of 69% of pregnant women had normal BMI, 20% were overweight, and
6% had I degree obesity. Conclusions: In the sample studied we observed the existence of a representative
number of pregnant women which do not give great importance to healthy lifestyle, being less interested in healthy
eating. Every pregnant should be counseled to eat properly during pregnancy and and how to avoid and correct
inappropriate eating behavior with examples of appropriate solutions.
Keywords: lifestyle, diet, pregnant
73
STUDENTS CAUGHT BETWEEN THE PRODUCT LABEL AND A HEALTHY DIET

Laura Fisus1, Pasca Dorina Maria1
1
UMF Trgu Mure
Background: Product labels play an important role nowadays. These represent the key of correct nutritional
information among the population. A proper understanding of the product label can provide valuable information on
what calorie number, ingredients and unhealthy product components are concerned. Objective: Drawing student
attention towards product labels to insure a healthy lifestyle. Material and methods: The study is was based on a
psychological investigation that had as main components explanation and the questionnaire distributed among a
representative lot of 400 Medical students (1st " final year of study) and Petru Maior " Engineer students (1st " final
year of study). Results: Based on the distributed questionnaires we found out the following: referring to the
essential elements of the product label, knew the correct answer 38% from PMU and 45% from UMF; the product
label role was known by 60% from PMU and 88% from UMF; on what the barcode is concerned , 58% from PMU
and 67% from UMF gave the right answer; on what the caffeine from beverages is concerned 28% from PMU and
68% from UMF answered correctly; the symbol from ecological products was known by 19% from PMU and 44%
from UMF; the product label layout for dietetic products, was known by 18% from PMU and 39% from UMF,
elements that do not appear on the product label were familiar to 33% from PMU and 45% from UMF; elements
that are compulsory on product labels were known by 45% from PMU and 63% from UMF and the significance of
light when it comes to beverages was known by 47% and 52% from UMF. Conclusions: Despite the great
importance of the product label, the students, one of the most significant category of buyers, still have
understanding issues when it comes to its elements.
Keywords: student, product label, nutrition, healthy diet
THE RELATIONSHIP BETWEEN EXERCISE PARAMETERS, BODY WEIGHT, AND

NUTRITIONAL HABITS OF JUNIOR HANDBALL PLAYERS
Martin A1, Martin Alexandra1, Tarcea Monica1
1
UMF Trgu Mure
Background: It is known that young athletes have different nutritional needs than adults. When training, between
the period of accumulation and the period of growth, a balance must be established in order to obtain the
corresponding physical parameters. Normal body development in relationship with the effort will be obtained by
imposing a proper food intake plan. The primary objective is to satisfy the qualitative and quantitatively needs of
the athlete. Objective: To assess the relationship with proper food ingestion and physical activities. Material and
methods: A transversal epidemiological qualitative study was conducted to assess the physical parameters of
pupils from C.S. Olimpic sports club in Trgu Mure in 2015. A total of 57 players, members of the handball team,
aged 10-16 were questioned, and the results were analyzed using chi-square test. Results: Significant differences
were found between exercise parameters and exercise duration (p=0.0001), intensity (p=0.018), body mass index
(p=0.028) and age of the athletes (p=0.0001). A significant difference was also found between the weight of
athletes and the intensity of exercise (p=0.0001). All data were interpreted/ analyzed in relation to food
consumption. Conclusions: We have identified a relationship between food consumption and exercise
parameters. In the case of young athletes the daily food intake must achieve energy balance to impose body mass
balance. Ensuring the normal function of the body development is the main objective. Moreover, it plays a
significant role in achieving a high level of training within a minimum of 240 minutes per week at high effort
parameters.
Keywords: nutrition,, young athletes,, physical parameters
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COMPOSITION AND STRUCTURE OF THE MENU FOR TOP LEVEL YOUNG ATHLETES
INVOLVED IN TEAM SPORTS
Martin A1, Martin Alexandra1, Tarcea Monica1
1
UMF Trgu Mure
Background: Food ingestion planning is an important component of the activity in sports performance. The
primary objective of this action is to provide the energy needs. Appropriate choice of food allows the athlete to fully
recover shortly after training sessions regardless of the period between sports activities. Objective: To assess
the presence of a relationship between food ingestion, body weight of the athletes, and the specific sporting
activity. Material and methods: A transversal epidemiological qualitative study was performed to assess the food
ingestion of athletes from the C.S. Olimpic sports club Trgu Mure in 2015. A total of 57 players, members of the
handball team aged 10-16 were questioned and the surveys were analyzed using chi-square test. Results:
Significant differences were recorded between age and nutritional behavior (p=0.025); body mass index and
nutritional behavior (p=0.033); days of the week with activity and the adapted intensity (p=0.0001); snacks
consumed and level of the effort on that particularly day (p=0.022); distribution of food consumption into the three
main meals and the age of athletes (p=0.001). Conclusions: A connection was identified between the meals
consumed daily, the percentage of their distribution and the effort used. Moreover, BMI was correlated with the
nutritional behavior and nutritional knowledge. All these aspects influence the effort through resistance, duration,
and intensity. If such factors are not at high levels during exercise (depending on objectives) competitive sporting
practice will be affected negatively.
Keywords: young athletes,, meals,, macronutriens,, effort
FAST FOOD CONSUMPTION IN THE EATING HABITS OF TEENAGERS

Georgeta Livia Stefan 1, DICUI MARCELA AURA1, Vasilache Simida1, Grama Alina1
1
UMF Trgu Mure
Background: Nutrition plays a decisive role in the health of teenagers reflected in the growth and harmonious
development in relation to their age. More and more research in the field have shown that a healthy diet ensures a
proper physical development, increase the capacity of attention, memory, concentration it also improves immunity
eliminating the risk of diesase while an unhealthy diet jeopardizes not only the life of the individual but also the
genetic found that will affect development of future generation. Objective: During this reasearch, my goals were
of identifying and evoluating eating habits during teenage, finding the link betwen family affection and eating habits
and showing the fact that large deviation from normal weight can cause the occurrence of certain disease.
Material and methods: The methods used to assess nutritional status were the questionaire and anthropometrical
parameters evoluation (height, weight and percentage of body fat). The study was conducted on a sample of 200
students of 9-th to 12-th grades with ages between 14 and 20 years from Tg Mures and was conducted in
November-December 2014. The student learned information on BMI and fat percentage. Results: After
processing the data provided by the questionnaire and anthropometric parameters evoluation, we found that 65%
of the total of 200 students consume fast food once a week and 80% of them said that their friends eat fast food
products. Conclusions: The study highlights the frequency of fast food consumption in teenagers' eating habits
and the frequency of diseases like diabets, obesity, cardiovascular disease, their family history of hypertension.
Keywords: Fast food, nutrition, teenagers, BMI
EDUCATIONAL ASPECT CONCERNING EATING FRUITS AT THE YOUNG STUDENTS

Vlad Ramona Elena1, Pasca Maria Dorina1
1
UMF Trgu Mure
Background: Health education at the primary level classes represent one of the main ways of promoting correct
knowledge regarding different ways of health, and, at the same time, of forming attitudes and skills necessary for a
healthy and responsible behavior. Objective: Forming elementary knowledge about correct eating habits and a
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healthy diet and making the young students aware concerning fruit consumption. Material and methods: The
methods used for the psychological investigation were: the questionnaire, the experiment, the conversation and
the demonstration. The investigation was conducted on 200 fourth-grade students, aged between 9 and 11 years
old, and proved the actual connection between the education for a healthy alimentation and the growth in fruit
consumption among students. This programme has been developed for six months (October 2014-March 2015)
using several educational strategies such as: Power Point materials, games, discussions between children and
parents at four classes belonging to a Secondary School nr. 113 in Bucharest. Results: As a result of the data
supplied by applying the questionnaire, before and after the experimental period, I have noticed that the
educational intervention concerning the fruit consumption led to a significant growth of the latter. Comparing the
results of the experimental group, it was noticed a growth in the number of students who eat at least a fruit a day
from 79% up to 100%, and of those who eat 3 fruit a day, from 21% to 63%. Moreover, there has been a significant
growth of those who prefer raw fruits to those who prefer cooked fruits, from 42% to 81%. Conclusions: It has
been emphasized the efficiency of the educational activities in point of acquiring the necessary knowledge and
forming the health eating habits at an early school age. Students have understood the benefits of the fresh fruit
consumption for an optimal health and for a strong and resistant body.
Keywords: fruit, pupils, health, alimentation
THE IMPORTANCE OF DIAGNOSIS AND DIET THERAPY IN CELIAC DISEASE

Miklos Andreea Doriana 1, Badea Ioana1, Farr Ana-Maria1
1
UMF Trgu Mure
Background: Celiac disease is a condition that affects a large percentage of the population,and is unfortunately
growing. In Romania celiac disease falls among the category of underdiagnosed diseases. A healthy and gluten
free diet is the most important thing,and the only treatment for a patient with celiac disease, and these patients are
not trained enough on this diet. Objective: We wanted to see if the disease is correctly diagnosed and to put the
emphasis on the importance of the diet. Material and methods: For this study we researched the records of
Pathological Anatomy Department from Emergency County Hospital Trgu Mure between 2010-2014 to find out
the incidence of the disease and the number of correctly diagnosed cases based on the histopathological
diagnosis. Results: Out of a total of 135 patients found in records about 23% of them had the suspicion of having
celiac disease before biopsy, but the histopathological diagnosis shows that there are not any pathological
changes in the duodenal mucosa, about 25% had the diagnosis confirmed. 58% of the patiens was women, 42%
are men and 3% children. 16 % of the patients with celiac diasease confirmed is represented by females, and only
8% of them are males. There was only 1 case of celiac disease in children. Conclusions: The study shows that
there is need to pay more attention for this disease to be diagnosed in a greater extent and the patients should be
more informed about their new diet and their new lifestyle they have to follow.
Keywords: celiac disease, diagnosis, diet
INCIDENCE OF SATURATED AND UNSATURATED FATS IN THE DIET OF A GROUP OF

CARDIAC PATIENTS.
Sarmasan Anisoara Alina1, Nemes L1, Oltean Oana1, Farcas D M1
1
UMF Trgu Mure
Background: Humans have evolved consuming an equal ratio of n-6/n-3 polyunsaturated fatty acids . However, in
the last 100 years, the consumption of n-6 PUFA has increased due to changing lifestyle habits and food
production methods. Particulary, the consumption of meat and products rich in arachidonic acid and cereal grains
or vegetable oils rich in n-6 PUFA. Consequently, in modern diets the dietary ratio of n-6/n-3 PUFA and saturated
fatty acid vs PUFA has dramatically increased to 15:1 This of balance ratio has been associated with an increase
of the pathogenesis of many diseases including cardiovascular. Objective: This study aims to assess the
behavioral and dietary habits of patients with cardiovascular diseases especially their intake ratio of n-6/n-3 and
saturated fatty acid PUFA ratio. Material and methods: For this study we used a food frequency questionnaire on
a group of cardiac patients, the questionnaire contained 2 food tables one containing foods high in saturated fatty
acids considered as cardiovascular risk factors the other considered as protective containing foods high in PUFA.
Data collected from medical history included: sex, age, bp, somatometric parameters (height, weight, BMI) Lipid
76
profile values (cholesterol, HDL, LDL, triglycerides) also were observed. Results: 53% off patients were male
47% female, with a mean age of 64 years, only 16.67% of our patients were of normal weight 40.00% being
severely obese ,13.33% very severely obese. 80% confirmed that they prepare their meals fried in saturated fats
regularly. 81% of our patients used some kind of saturated animal fat on a daily basis compared to 14% who used
n-3 polyunsaturated fatty acids. Conclusions: Most outstanding conclusion of our study was the realization that
patients lack all knowledge regarding the different type of fats. Also our study confirmed the absence of PUFA and
n-3 fatty acids in the diet of cardiovascular patient.
Keywords: Dietary fat, essential fatty acid, Omega-3 fatty acids, saturated fatty acid
NURSES AND MIDWIVES
NURSES AND MIDWIVES
77
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NURSES AND MIDWIVES
MANAGEMENT OF A CHILD WITH JAUNDICE

Leuca Anca Liana1, Lazar Martina1, Gall Zsuzsuanna1
1
UMF Trgu Mure
Background: Jaundice is caused by an increase in serum bilirubin concentration and makes the skin appear
yellow. It is the most common condition that requires medical attention. Jaundice may be present at birth or may
appear at any time during childhood, depending on etiology. Objective: The aim of this study is to determine the
circumstances in which jaundice appears in children of different ages, depending on epidemiological, clinical and
paraclinical data. Material and methods: We performed a retrospective study on a group of 36 patients, boys and
girls, hospitalized at Pediatric Clinic II of Mures between 2011 and 2014. All the patients were diagnosed
with several types of jaundice such as: physiological jaundice (8.3%), extended neonatal jaundice (69%) and
jaundice syndrome (due to hepatic injury). Results: The results have shown that jaundice affects most commonly
boys (72.2%) compared to girls (27.8%). Of the 36 studied cases, 11 were premature and the rest of 25 were fullterm. The paraclinical data indicates that 90.9% of our patients have an increased level of indirect bilirubin. Also,
the ultrasound exam showed that only 19.4% present modification of any type. Conclusions: Jaundice is a
disease that appears more often in newborns and the most affected by this anomaly are boys. It is important to
diagnose this disease because unconjugated bilirubin is neurothoxic and can cause death in newborns and lifelong
neurologic sequelae in infants who survive.
Keywords: jaundice, child, unconjugated bilirubin
MANAGEMENT OF A CHILD WITH RICKETS

Lazar Martina1, Leuca Anca Liana1, Gall Zsuzsanna1
1
UMF Trgu Mure
Background: Rickets is a disease of growing bone that is unique to children and adolescents. It is caused by a
failure of osteoid to calcify in a growing person. Vitamin D deficiency rickets occurs when the metabolites of vitamin
D are deficient. Objective: The purpose of this study is to evaluate the patient with rickets depending on
epidemiological, clinical data and paraclinical. Material and methods: This is a retrospective study over a period
of two years, on a group of 105 children of different ages diagnosed with rickets and hospitalized in 2nd Pediatric
Department in Targu-Mures, between January 2013 and December 2014. Results: After processing the data, we
obtained the following results: from the total of 105 patients 62.86% were boys and 37.14% were girls. Referring to
the environment, 64.8% were originated from rural and 35.2% from urban area. The clinical and paraclinical data
showed that almost all of our patients with rickets had at least one associated disease, like: anemia, distrophia and
hypotrophia. Also we observed that only half of our patients have an increased alkaline phosphatase.
Conclusions: Rickets is a very common disease, although exists an accessible and affordable prevention mode. It
affects more often boys than girls, with a higher frequency in the rural environment. The rickets can be associated
with other diseases, some of them with severe prognosis.
Keywords: rickets, vitamin D, anemia, hypotrophia
PSYCHOPATY CHECK LIST REVISED AND EARLY IDENTIFICATION ANTISOCIAL

PERSONALITY TRAITS
LADARIU IONELA PETRONELA1, Nirestean A1, Horvath A1
1
UMF Trgu Mure
Background: Antisocial personality disorder is characterized by persistent disregard and violation of the rights of
others that begins from age 15 and continues into adolescence. In childhood these persons usually have
oppositional defiant disorder which develops into conduct disorder in adolescence. Objective: The objective of our
research is to demonstrate the usefulness of psychometric instruments Psychopathy Check -List Revised in early
identification of antisocial traits. Material and methods: The application of psychometric instruments in a statistical
population (N = 42) consisted of records from patients hospitalizes in the Infantile Neuropsychiatry Clinic
diagnosed with conduct disorder or attention deficit disorder and hyperactivity, aged between 15 and 18 years.
Results:
NURSES AND MIDWIVES
79
Lowest score when applying psychometric instrument was 7 points and highest at 34 points. 12 of the participants
were male, 30 female. 24 of the participants were from urban areas and 18 from rural areas. All patients come
from dysfunctional families, 6 with a history of suicide attempts and 4 being registered with medical-legal issues.
Conclusions: Psychopaty Check -List Revised is useful and easy to apply for identify antisocial traits. Conduct
disorder respectively attention deficit disorder and hyperactivity represent risk factors for installation of antisocial
personality disorder after age 18.
Keywords: Psychopaty Check-list Revised, Antisocial personality, Attention deficit disorder, Conduct disorder
RESTRAINING MEASURES IN THE PSYCHIATRIC HOSPITAL AND CORRELATIONS WITH

DIAGNOSIS AND TREATMENT
Sarmasan Alexandra Paula1, Simon Melania Renata1, Mihai Adriana1, Szasz I Z1
1
UMF Trgu Mure
Background: Violence is a negative deviation of the healthy behavior; having a multifactorial etiology, numerous
risk factors and psycopathological manifestations, the required treatment measures are both necesary and
controversial: the restraining measures. This type of treatment is used under the legal therms by the authorized
medical stuff, methodology and confidentiality being respected. Objective: The purpose of this study was to
evaluate the correlations between cases of psychopathological violence, diagnosis, treatment and the incidence of
restrained patients from the department of acute psychosis. Material and methods: We realised a retrospective
study based on data collected between 2014-2015 from the patient`s medical paper and restaining register. The
study included 50 patients from the department of acute psychosis of Psychiatry Clinic II of Targu-Mures, that
underwent a psychiatric intervention betweeen 2014-1015. We used demographic data and clinical data on
diagnosis and received treatment. Results: Our study included 50 restrained patients out of 50 hospitalised
consisting of 30 male(60%) with ages between 22-85 years and 20 female(40%) with ages between 19-75 years;
We found 14 registered diagnosis of the restrained patients and the most frequent was schizophrenia with a
prevalence of 22%, followed by dementia and alcohol use disorder with a prevalence of 16%, major depressive
episodes:prevalence of 12%; brief psychotic disorder: prevalence of 10% and organic personality disorder with a
prevalence of 8%. Out of 20 often used drugs, we found 10 elected of which: Clonazepamum 71,4% followed by
Alprazolamum, Valproic acid and Midazolamum with a 50% prevalence. Conclusions: Out of 50 restrained
patients, most are men (60%) diagnosed with schizophrenia (22%) and the elected drugs are Clonazepamum
(71,4%), Alprazolamum, Valproic acid and Midazolamum( 50%).
Keywords: restraining measures,, violence,, acute psychosis
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DENTISTRY
DENTISTRY
DENTISTRY
81
IN VITRO EVALUATION OF MARGINAL FIT OF DIFFERENT CROWNS FABRICATED WITH

DIGITAL AND CONVENTIONAL METHODS
Rat G D1, strnad gabriela2, oait claudia1
1
UMF Trgu Mure

petru maior
Background: The marginal fit of different restorations is a very important criterion for their long-term success.To
obtain better adaptation and better results dentists nowadays started to use more frequent digital dental crown
fabrication . Objective: The aim of this in vitro study was to compare the marginal adaptation of different crowns
fabricated with digital and conventional method. Material and methods: For this study were analyzed four
different crowns, one made with the conventional method, and the other three crowns were fabricated with CadCam system , one made from zirconium, another one made from milled Co-Cr and the last one made from milled
wax with lost-wax method .An extracted molar was prepared to receive these different crowns. An impression was
made with double phase technique using honigum that is a hydrophilic poly vinylsiloxane and the impression was
send to laboratory. A system was created allowing marginal gap measures in the same points for each subject.
Therefore were obtained twenty measures for each crown by direct visualization using a microscope. Results: For
zirconium were obtained an average marginal gap of 54,830,03 microns, for milled Co-Cr an average of
63,4229,85microns, for milled wax with lost-wax method 76,7732,74microns and for the crown made with
conventional method an average of 136,6790,35 microns. Conclusions: This study showed that cad cam
tehnology for crown manufacturing have achieved superior adaptation over conventional methods, therefore a
better fit and longevity for prosthetic restorations.
Keywords: CAD-CAM, marginal fit, crown
UTILIZATION OF DIGITAL PHOTOGRAPHY IN DENTAL OFFICES IN TRGU MURE

Dicu A1, oait Claudia1
1
UMF Trgu Mure
Background: Digital photography has today, penetrated into all segments of dentistry, providing new facts and
perceptions in prosthodontics, orthodontics, periodontics or surgery. Objective: The aim of this paperwork was to
investigate the frequency, ease and success of use of digital photography in the dental offices in Tirgu Mures. It
also informs the students and the inexperienced practitioner and gives some insight into the overall importance of
the digital dental photography that makes everyday practice more comprehensive, better quality and easier.
Material and methods: A questionnaire was randomly distributed to 30 dentists in Tirgu Mures. It was comprised
of six questions regarding the dentist specialty, experience in dentistry and the importance of digital photography
in one office, the frequency and the cases that one uses dental photography.
Results: Among the practitioners
questioned, 86,6% consider that the digital photography is important and 73,3% of dentists are using photography
for evaluate the treatment and as judicial-medical. In opposite only 36,6% of the questioned dentists are using it for
communication between dentists-patients-dental technicians. Regarding the utilization of digital photography
46,6% are using photography in rare clinical situations and 30% are using digital photography in one of ten
patients. Conclusions: The research and questionnaire undertake showed that digital photography is not largely
used among the practitioners in Trgu Mure. The reason most clinicians use the photography is to be covered by
a forensic document. The highest percent were in rare pathology patients and the specialty of dentistry that largely
uses dental photography is orthodontics. Today dental photography is an important step in the practice of
dentistry. Clinicians must now integrate existing photographic principles with today contemporary
camera systems and computer software technology, this method of practice leading to predictable outcomes for
their patients.
Keywords: digital photography, dentistry, dental offices, Trgu Mure
82
DENTISTRY
THE ROLE OF COMPUTER SOFTWARE IN THE DENTAL OFFICE

Stoica A1, Vartolomei A1, Asmaa Barmou1, Monea Monica1
1
UMF Trgu Mure
Background: It is well known that computer based information methods have played an essential role in the
evolution of human society. Similar to other scientific fields, the development and benefits of informatics software
has had an important impact in dental health care systems as well. Objective: The aim of our study was to
determine the degree of application of computer based methods on daily basic activities of a private dental office,
with emphasis on the most used work compartments. Material and methods: An original questionnaire was
developed and send to 200 dentist with private dental practice from Mures county. The answers were collected in a
time period of 7-14 days and only those who answered all the questions were used for the final evaluation. For
statistical analysis we determined the relative standard deviation for the studied parameters by using GraphPad
Statistics Guide. Results: From 133 valid answers, 48,12% find the use of computer software too expensive,
37,83% use electronic patients records, 44.36% admit that the use of electronic devices improves the quality of
dental medical treatment and 90% noticed a positive impact of these instruments upon patients. Conclusions:
The majority of medics who answered consider that the development of informatics science has changed the
concepts of modern dental health care by introducing new technologies in patients records and treatment options.
Dental software has an important role in improving the quality of medical act and elimination of time consuming
procedures.
Keywords: dental software, office technology, teledentistry, electronic patients records
DO CHILDREN STILL FEAR THE DENTIST NOWADAYS?

Pzitor Andreea1, Bic Cristina1, Bic Cristina1
1
UMF Trgu Mure
Background: It is well known that in children fear is generally present in a more obvious way than in adults. This
state of anxiety occurs in children even when they think of the dentist. Objective: The purpose of this study is to
evaluate what children feel when they just think of meeting the dentist, even if it is a routine control or the treatment
of a dental problem. The level of fear is also evaluated for several dentistry procedures. Material and methods: A
questionnaire was compiled in an original manner. The questions were made up in a special way so that children
could understand them. Six targeted questions were formulated, the multiple choice answers were illustrated by
suggestive emoticons. Using the emoticons and the colour printed questionnaire helped the little ones to choose
the most suitable answers to the addressed questions. Results: Out of the total 332 young respondents, 201 were
aged between 11-14 years. Children who live in urban areas were chosen in the same percentage as children from
the rural areas, gender distribution was 52 % girls and 48% boys. The majority of the children included in the study
declared that they are relaxed when they are in the dental chair (37%), while 33% of them stated they are anxious,
10% that they are tensed, the rest of the percentage declared that they are terrified and because of this they feel
sick, or they just simply ask the interruption of the treatment and they live the surgery. Conclusions: Nowadays
children do not fear the dentist as much as we expected, most of them describing a state of relaxation or slight
anxiety when they are in the waiting room and also during dental treatments.
Keywords: children, anxiety, emoticons, dentist
STUDY REGARDING THE EVALUATION OF DENTAL INDEXES AND LEVEL OF DENTAL

INFORMATION AT PREGNANT WOMEN IN MURES AREA
Ghirca Diana Madalina1, Vultur Daniela-Raluca1, Tma G1, Tohati A1
1
UMF Trgu Mure
Background: Pregnant women represent a distinctive category of patients which need special attention. Dental
problems can aggravate during the pregnancy because of the women disregard of dental hygiene but also
because their lack of information. Objective: The aim of this study is to evaluate the oral health of pregnant
DENTISTRY
83
women, both before and during the pregnancy. It was also evaluated the level of knowledge of pregnant women
and their interest for oral hygiene. Material and methods: We evaluated 83 women in the third trimester, from
rural and urban environment in Mures area. We applied a questionnaire to evaluate: the frequency at the dentist,
dental problems before and during the pregnancy, the information level of the patients. We performed dental
examinations to determine dental plaque and calculus indexes, frequency of decays and extractions. Results:
During the pregnancy, 33,33% women from urban environment and 25,80% women from rural environment went
to the dentist. During this pregnancy, 37,5% women from urban environment and 35,48% from rural environment
declared that they suffer from dental problems. 83,33% women from urban environment and 74,19% from rural
environment think that dental problems can affect their own health and the baby health but from these, a big
percent(30% and 43,47%) don know exactly how. 77,77% of women from urban environment have OHI-S index
satisfying and 60% from rural environment have OHI-S index unsatisfying. The percent of teeth with decays was
20,36% for urban environment and 24,28% for rural environment. Conclusions: Our study showed that there
aren considerable differences between urban and rural environment regarding dental hygiene during pregnancy.
Pregnant women associate dental problems only with severe pain and the lack of knowledge in considerable.
Keywords: pregnant women, information, dental index
THE HYDRO-ALGINATE IMPRESSION: WHY?

Szolon T1, Bor Andreea1, Molnar-Varlam Cristina1, Molnar-Varlam Cristina1
1
UMF Trgu Mure
Background: Choosing the properly impression material and a right method for a specific clinical situation, which
can reproduce in an accurate way the details and dimensions of the prosthetic field, have the most important roles
to accomplish fixed dentures. However, decisive in our choise should be the comparative studies which include the
chemical and mechanical behavior of the impression material. Objective: One of the most appreciated techniques
is the hydro-alginate impression but in our country dentists tend to let it behind. Our aim is to prove that dentists
should consider it,evaluate its properties and use it in specific cases. Material and methods: We simulated in the
laboratory a clinical situation which helped us evaluate the differences between the hydro-alginiate impression,
condensation-cured silicones impression, addition-cured silicones and alginates. We evaluated the accuracy, the
time that is needed to take the impression, the marginal adaptation, the stability, the risks and problems that may
occur and the right moment to cast the models. In order to evaluate the biomechanical behavior measurements
were made using a digital micrometer, each model being measured 3 times. Results: The accuracy of the
conventional impression can be influenced by many factors. The linear measurements confirmed that the most
accurate reproduction can be obtained by immediately casting the model. The smallest delay can cause significant
detail distortion. The global monophasic hydro-alginate impression can be realised in a maximum of 10 minutes,
compared with biphasic silicones that need 30 minutes to be done. Conclusions: The dentist has to choose the
proper material and correlate it with different clinical situations and techniques used. The right choise can be made
only if we know in detail the properties of the impression materials which determine their performances. Dentists
tend to be interested, when choosing an impression material, by their physical state in the final phase, irreversible.
Keywords: hydro-alginates, silicones, alginate, accuracy
INFORMATIVE STUDY REGARDING THE USE OF BIOLOGICAL METHODS FOR

PRESERVING PULP VITALITY
Tma G1, Nicolau A C1, Ghirca Diana Madalina1, Ttaru A1, Monea Adriana Maria1
1
UMF Trgu Mure
Background: The major objective of dental therapy is the preservation of pulp vitality as long as possible.
Objective: Evaluation of the applicability of biological methods for conservative treatment of vital pulp among
dentists and students; investigation of the conditions in which the methods are applied, as well as the therapeutic
success rate. Material and methods: 92 dentists from Mures County and 224 students from different universities
in Romania completed a questionnaire. Usage conditions and success rate of direct and indirect pulp capping were
the topics of the questionnaire. Results: The mentioned questionnaire revealed that all the dentists used the
indirect pulp capping and the pulp excision was not necessary in 13.04% of cases. As for the students, 80,21%
used indirect pulp capping with a higher success rate than the dentists Direct pulp capping was used by 84,78%
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DENTISTRY
of dentists with 4,46% rate of success, and by 38.39% of students, pulp excision being necessary in 53.66%.
Conclusions: Indirect pulp capping technique is used by both, dentists and students, having good clinical results
on both sides. Direct pulp capping technique is more often used by dentists, but with a higher success rate when
students apply it.
Keywords: direct-pulp-capping, indirect-pulp-capping, dentists, students
POLYMERIZATION SHRINKAGE OF LIGHT-INITIATED TOOTH COLORED DENTAL

FILLING MATERIALS
Tiplica S1, Molnar-Varlam Cristina2, Bor Andreea1, Bors Andreea1
1
UMF Trgu Mure

S.C. Hygieia S.A.
Background: The use of composite based resins in dentistry have risen markedly in recent years as a response to
an increased demand for esthetic restorations. Their drawbacks however, can include poor marginal adaptation or
postoperative sensitivity. This is particularly associated with the polymerization shrinkage accompanying the
placement of these materials. Objective: This in vitro study was carried out to determine the volumetric changes of
currently used resin based composites in view of different curing profiles Material and methods: Three aesthetic
direct restoratives were analysed: two composites Nanofill (Schulzer), Zmack (Zermack) and a compomer Dyract
Extra (Dentsply). Following manufacturers instructions for the manipulation/mixing of the materials, unset pastes
were placed in stainless mold, shaped as a prism. The prepared specimens were polymerized with two types of
curing lamp: halogen (Optilux 501, Kerr) and LED (Demetron, Kerr ) for 10, 20 and 30 seconds. A precision digital
micrometer was used (Digital Caliper, MESSZEUGE GMBH) to measure dimensions of the mold and cured
specimens. A mathematical volumetric method was used to assess the volumetric shrinkage of the tested
materials Results: The polymerization of all the tested materials was accompanied by shrinkage. Significantly
increasing dimensional changes were measured for the two composites highly dependent with the curing time and
light type, as well as notable contraction for compomers in line with polymerization time. Conclusions:
Polymerization shrinkage may be affected by the type of light source and the time of curing. Clinicians have to be
aware about this negative aspect of light activated resin composites. Only a thorough understanding of the
mechanisms that cause contraction and the techniques that may reduce its effect, will allow dentists to gain a
better use of these materials.
Keywords: polymerization shrinkage, composites, compomers, light-curing
DENTAL AGE ASSESSMENT USING CAMERIERES METHOD ON A GROUP OF

CHILDREN FROM TARGU MURES
Tirintica Andra Roxana1, Esian Daniela1
1
UMF Trgu Mure
Background: Precise estimation of age in children is important in forensic medicine, human anthropology,
pediatric endocrinology and orthodontic treatment. Dental age and bone age are important parameters in
assessing the overall development of children. Radiographic dental age estimation is currently a simple and
objective method from infancy to adolescence. Objective: To assess a group of children from Targu-Mures by
means of modified Cameriere European Formula and to correlate the efficacy of chronological and dental age.
Material and methods: The studied group has 51 children, ranging from 4 to 13 years. From our group 41.18 %
are girls and 58.82 % boys. Dental age was assessed by using Cameriere method based on 7 left mandibular
teeth. We measured the distance between the inner sides of the two open apices and the length of the teeth .
Results: A correlation has been found between dental age and chronological age (p<0.0001 , IC=95%) . The
average chronological age of our group was 8.17 and by Cameriere method the average dental age was 7.79 .
Conclusions: This study indicates that, Cameriere formula was reliable for age estimation in our group. The age
of the children in the study group can be estimated with a good degree of accuracy using this radiographic method.
Keywords: Cameriere, Dental Age, Age Estimation
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85
BACTERIAL ADHERENCE TO SUTURE MATERIALS USUALLY USED IN ORAL SURGERY:

AN IN VITRO STUDY
Suciu V I1, Mare Anca1, Man A1, Toma Felicia1, Ormenian Alina1, Grigora R1
1
UMF Trgu Mure
Background: Surgical sutures are applied to hold the tissues together allowing the process of healing to take
place without any complications. The type of suture material may influence how it is colonized by different bacteria
and contribute to post surgical wound infections. Objective: The goal of the study was to determine the bacterial
adherence to different types of suture materials: non-absorbable and absorbable, monofilament and multifilament.
Material and methods: For this study we used four different bacterial strains: (Staphylococcus aureus methicillinresistant - MRSA, Enterococcus faecalis, Escherichia coli and Pseudomonas aeruginosa) and four different types
of suture materials: one nonabsorbable (silk) and three resorbable (polydioxanone, polyglycolic acid and
polyglycolic acid impregnated with chlorhexidine diacetate). All sutures materials were size 4-0. 0.5 Mcfarland
inoculum were prepared from each bacterial strains. 1 cm segments from each type of suture material were
immersed in 1 ml of bacterial inoculum for 5, 60 and 120 seconds. The segments were then washed three times in
sterile saline solution to remove unadherent bacteria. Afterwards the suture materials were vortexed in 1 ml of
sterile saline solution from which 50 l were disseminated onto agar plates for colonies count. Each test was
repeated three times. Results: The bacterial adherence of each bacterial strain was influenced, statistically
significant (p<0.001), by the type of suture material that was used. The strain of bacteria and time influenced the
bacterial adherence (p<0.001), with the exception of Enterococcus faecalis, where time wasn a factor (p>0.05).
Conclusions: The in vitro study demonstrated that type of suture material can have an impact in bacterial
adherence, which may lead to surgical wound infection and postoperative complications.
Keywords: bacteria, suture, adherence, oral surgery
ASSESSMENT OF GYMNASIUM PUPIL'S KNOWLEDGE REGARDING ORAL HYGIENE AND

PREVENTION BASIC RULES: COMPARISON BETWEEN URBAN AND RURAL
ENVIRONMENT
Popa Bianca-Irina1, Olaru N1, Popa Marius Florin1, Tohati A1
1
UMF Trgu Mure
Background: Cavities are permanently damaged areas in the hard surface of the teeth that developdue to a
combination of factors. Cavities are one of the world's most common health problems especially among children,
teenagers and older adults. Objective: The aim of this study is to asses the knowledge of gymnasium pupils
regarding their oral hygiene and daily habits and to inform them about the basic rules of prevention in order to have
a proper oral health. Material and methods: We evaluated 2400 children aged between 10 and 15 from different
environments, rural and urban, from four counties in Romania ( Braov, Brila, Bacu and Mure). First, we
applied an anonymous questionnaire to asses their knowledge, then we sustained an interactive presentation
about the basic rules of oral hygiene. After 3 months we came back to the same children and applied a similar
questionnaire, to evaluate the improvement of their knowledge. Results: We analyzed the results statistically and
the first stage of our study revealed that 61,15% of the children brush their teeth 2 times/day or more often and in
the second stage we observed an increase of 7,16%. The most significant difference between the two stages was
found in Braov, in rural environment ( 17,17%). We also observed an increase of 23,93% from stage one to stage
two, among the children who started brushing their teeth for 3-4 minutes. At the beginning, 52,57% of the
evaluated pupils knew what dental cavity means, and after our presentation the percentage raised to 71,19%. An
astonishing 89,54% of their feedback revealed that our project was very useful. Conclusions: Our study not only
assessed children knowledge about oral hygiene, but also changed their daily habits. Also, pupils are willing to
participate at this kind of activities, that are more needed in the rural environment!
Keywords: oral, hygiene, knowledge, prevention
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SURGICAL CROWN LENGTHENING A SURVEY ON SPECIALIZED DENTISTS

EXPERIENCE
Rudzik Alexandra1, Ormenian Alina1, Grigora R1
1
UMF Trgu Mure
Background: Surgical crown lengthening (SCL) is a step in treating functional and esthetic impairment of the
tooth by using different procedures such as gingivectomy, apically positioned flap and alveolectomy, depending of
the integrity of the tooth. Even if it implies surgical skills, this procedure can be performed by most dental
practitioners. Objective: The aim of this study was to assess different specialized dentists experience on surgical
crown lengthening. Material and methods: This study is an online questionnaire survey of randomly selected
dentists from Romania, regarding their experience on SCL. Descriptive analysis of data was done using Microsoft
Excel 2010 and subgroup analysis was performed using Chi-square test in GraphPad Prism 6, with a significance
level of 95%. Results: : 61 questionnaires were submitted in February and March 2015. The majority of the
responders were specialized dental practitioners (30, 49.1%), followed by dental surgeons (15, 24.5%). 49 (80.3%)
dentists said they performed surgical crown lengthening, without a statistically significant difference regarding the
location of the practice, rural or urban (p=0.3). Among the different dental specialties represented in our study,
dental surgeons were more likely to perform SCL when compared both to general dental practitioners (100% vs.
76.6%, p=0.04) and all other specialties together (100% vs. 78.2%, p=0.01), without any difference between other
dental specialties and general dental practitioners. The preferred surgical procedure was gingivectomy (26, 53%),
usually on teeth with cavity lesion (11, 42.3%), followed by alveolectomy and gingivectomy (17, 34.6%) mainly
used in case of residual root (10, 58.8%). Conclusions: In our study, the SCL was mainly performed by dental
surgeons, probably due to their specific training. In disagreement with other studies, the most commonly used
technique was gingivectomy. As expected, the tooth integrity influenced the choice of a specific technique.
Keywords: Surgical Crown Lengthening, Gingivectomy, Dental Surgeons
THE EFFECTIVENESS OF TOOTHPASTE IN INCREASING THE SALIVARY PH

Bostan Cristina1, Serfz N E1, Sabau Alexandra1, Pop Sanda1, Monea Adriana Maria1
1
UMF Trgu Mure
Background: Salivary pH plays the key role in the defense mechanism of oral cavity, including protection of teeth
from demineralization. Objective: The aim of this study was to compare the buffering capacity of different
toothpastes, by determining salivary pH. Material and methods: One hundred subjects aged 20 to 25 were
included in the study (fifty smokers and fifty non-smokers). Five different toothpastes were used, each one for ten
smokers and ten non-smokers. From each subject 1.5ml of un-stimulated saliva were collected before and after
brushing. Salivary pH was measured immediately after collecting, using both a digital pH-meter and pH test paper.
Results: The accurate results of the pH-meter showed that each toothpaste increased salivary pH with 3-20%,
each measurement being in-between 7.1-8. The pH strip also proved a difference between before and after tooth
brushing, but not as accurate as the pH-meter. The difference between pH levels in smokers and non-smokers
was not statistic significant. Conclusions: : This study shows that each toothpaste helps saliva alkalization,
reducing any risk of imbalance between demineralization and remineralisation of dental hard tissues. One subject
that remains to be explored is how long the buffering capacity lasts for each toothpaste used in the present study.
Anyway, brushing is the way in which the teeth are provided a better cavity protection.
Keywords: salivary pH, toothpaste, pH-meter, pH strip
SMOKING: WHO ARE WE AND WHO SHOULD WE BE?

Branea Oana-Elena3, Pop Sanda3, Kikeli I3, Preg Z3
3
UMF Trgu Mure
Background: The University of Medicine and Pharmacy Targu-Mures is the first Smoke Free Medical University in
Romania. The project assesed the prevalence of smoking among students. Objective: The study aimed to
DENTISTRY
87
determine the prevalence of smoking and behavior of dental students regarding smoking. Material and methods:
Students play an important role in implementation of the project Free Medical University in Targu Mures.
Based on Global Health Professions Student Survey, a study was conducted on March 2014 using a
questionnaire with 72 questions that was completed anonymously by students from the I-VI years (a total of 581
students). Descriptive statistics were computed using the IBM-SPSS program. Results: Dental students hold
the highest percentage (38,7%) of smokers in the University of Medicine and Pharmacy Targu-Mures. The study
showed that the prevalence of smokers (61,3%) is twice higher than people who do not smoke (38,7%). Also,
81,6% have experienced smoking, out of which more than half started before the age of 17 (61,6%). 91.7% of
students would like to be trained in specialized courses on smoking cessation techniques, but only 17,3% want to
relinquish this practice. Conclusions: Despite the fact that tobacco use represents a significant risk factor for oral
cancer and periodontal disease, and it has been estimated that 80% of oral cancers are attributable to tobacco
use, dental students do not realize the danger to which they are exposed.
Keywords: smoking, dental-students, risk
88
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PHARMACY
89
TURNING CODEINE CONTAINING OTC ANALGESICS INTO RECREATIONAL PRODUCTS

Climan Monica - Simina1, Croitoru M1, Flp Ibolya1
1
UMF Trgu Mure
Background: Codeine is a natural occurring alkaloid found in opium and in some parts of the world is used for
recreational purpose. Codeine can be used in treating low to moderate intensity pain and is sold in over the
counter products (OTC) in combinations with several non steroidal anti-inflammatory drugs (NSAID), as
acetaminophen, aspirin and ibuprofen. Combination of low dose codeine (8-15 mg) with NSAID prevents the use of
the product for recreational purpose, because reaching the recreatinal dose of codeine brings significant NSAID
induced toxicity. However, internet offers methods for extracting codeine from OTC medicines. Objective: The
purpose of this work is to verify if codeine containing OTC medication sold in Romania can be used for codeine
extraction. Material and methods: An internet available method for codeine extraction was used for extracting
codeine from seven most commonly used analgesics products in Romania. An reverse phase HPLC method with
UV detection was used for quantification of codeine and NSAID amounts extracted from the products. Results:
Large variations in codeine recovery (20-90%) were observed among the tested products. Highest amounts of
NSAID found in the extract were: 900 mg for acetaminophen, 300 for aspirin and 80 for ibuprofen. Conclusions:
The codeine containing OTC products sold in Romania can be used recreationally using an easily available
extraction method. Large differences in the recovery of codeine is a high risk of overdose. Technological methods
that prevent the separation of codeine from the NSAIDs should be employed for obtaining analgesics OTCs with
codeine; proper labeling should also be used for such products in order to prevent intoxications with NSAIDs.
Keywords: codeine, recreational use, codeine containing analgesics
ARGUMENTS IN SUSTAINING THE NECESSITY OF A GUIDE FOR COMMUNITY

PHARMACISTS IN COUNSELING PATIENTS ABOUT COMMON SKIN DISORDERS
Simion Adriana1, Butucea Anca1, Todoran Nicoleta1
1
UMF Trgu Mure
Background: Pharmacists have a very important role in today's community: Patient counseling and providing
appropriate, relevant and understandable information are essential in their practice. Patients consult their
community pharmacist more than any other healthcare professional and skin disorders are among the most
frequent problems a pharmacist is consulted about. Objective: This documentation aims to gather the basic
information about the clinical aspects of the most common skin disorders in order to elaborate a strategy that can
guide the community pharmacist in approaching the practical situation in which they have to make the following
decision: to treat, using over-the-counter(OTC) medication or to send the patient for a dermatological consult.
Material and methods: A bibliographic study completed with the personal notes on the practical situations
encountered during the professional practice performed as a student in the community pharmacy. Results: Given
that the pharmacist is often times the first and last professional consulted, it is crucial that he provides up-to-date
information regarding the OTC treatment for the most common skin disorders, including dry skin, acne, psoriasis,
fungal infections and dermatitis( atopic, seborrheic or contact).Taking a dermatological history is a key component
in diagnosing a skin condition. From using the more common acronyms( WWHAM or SIT DOWN SIR) to using
clinical reasoning to get to a diagnosis, the pharmacist uses the information gathered to find the best solution for
the patient, whether it is recommending a treatment or referring him to a physician. Conclusions: The present
documentation represents the starting point of a guideline formulated to help community pharmacists better
themselves and elevate their diagnostic skills in regard to the common skin disorders. A questioner with answers
structured dichotomically could really help the pharmacist better asses and diagnose skin conditions which in fact
would mean providing optimal care for the patient.
Keywords: skin disorders, skin asses and diagnosis, community pharmacy, OTC medications
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CAN OXIDATIVE STRESS BE CONSIDERED AN ILLNESS?

Faliboga Luana1, Orosan Mihaela-Veronica1, Croitoru M1, Erzsbet Fogarasi1
1
UMF Trgu Mure
Background: Overproduction of free radicals together with a decrease in the antioxidant defense of the human
body is called oxidative stress. The main free radicals that are produced in the human body are superoxide anion,
hydroxyl free radical, nitric oxide, nitrogen dioxide and other carbon and oxygen centered free radicals. Other non
radical substances that are able to produce free radicals during their decomposition are of highly
importance(hydrogen peroxide, peroxynitrite). Objective: The aim of this study is to understand the importance of
the free radicals in some pathological processes and to show that even many studies had confirmed their
participation in many diseases, the oxidative stress is not considered yet an illness and drug are not developed for
this purpose, the only available `treatment` being some food supplements with unproved efficiency. Material and
methods: Therapeutic strategies are starting to be used to limit the amounts of free radicals during heart surgeries
such as administration of natural spin traps to remote ischemic preconditioning or during an acute brain ischemic
process. Results: Antioxidants such as small doses of alcohol and other antioxidants from the red wine have also
been proved efficient in reducing the risk of atherosclerosis, due to their antioxidant abilities. Conclusions:
Oxidative stress has been associated in the scientific literature with many pathological processes vascular damage
in diabetes, oxidation of LDL and atherosclerosis, neurodegenerative disorders, reperfusion injuries during heart
surgery and ischemia and others. However, oxidative stress is not recognized as an illness despite of all the
studies that have shown its importance along the years.
Keywords: oxidative stress, free radicals, illness
STUDY REGARDING THE RECREATIONAL USE OF BENZODIAZEPINES

Butucea Anca1, Simion Adriana1, Vlad R1, Hancu G1
1
UMF Trgu Mure
Background: Drug addiction is a chronic, relapsing disease characterized by compulsive drug seeking and use
despite harmful consequences as well as neurochemical and molecular changes in the brain. It is widely known
that long term treatments with benzodiazepines will most likely induce a state of tolerance and addiction. This
adverse reaction was noticed and studied in clinical trails let by the drug's manufacturers, as well as observed on
patients during treatment. But what if this adverse reaction was not sought out only to be avoided but on the
contrary, explored for its recreational purposes ? Objective: The main objective of this scientific paper is to draw
attention towards the recreational use of benzodiazepines, the combinations in which are utilized and the effects
they are desired for, as well as upon the long term effects of benzodiazepine addiction. Material and methods:
The resources used for the research were books, manuscripts and articles concerning the misuse of
benzodiazepines and the effects sought by the users for recreational purposes. Results: The National Institute on
Drug Abuse (NIDA) has labeled Flunitrazepam (Rohypnol) among other substances as a "club drug". The trend of
overdosing with benzodiazepines alone or in combination with other drugs such as Methadone, Ketamine or
ethanol is reportedly helpful for enhancing an altered state of consciousness. But consuming drugs in excessive
quantities in order to produce euphoria is a serious problem and may lead to fatal poisonings. Conclusions: The
present research is a preamble of a wider paper, which will contain besides the class of benzodiazepines a
summary of the main classes of drugs released on the current pharmaceutical market that are the target of abuse.
Keywords: benzodiazepines, abuse, recreational use, drug addiction
THE PHARMACOTOXICOLOGICAL PROFILE OF MODERN NEUROLEPTICS DETERMINED

THROUGH PRECLINICAL EXPERIMENTS
Braila Andreea Iasmina1, Dogaru Maria1, Vari C1
1
UMF Trgu Mure
Background: Considering that modern neuroleptics and classic neuroleptics have different mechanisms of action,
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91
their adverse reactions profiles should be different. Objective: Because of the controversy concerning the side
effects/adverse reactions of atypical neuroleptics in the literature, this study objective was to analyse the side
effects/adverse reactions of risperidone and olanzapine after being administred in high doses toadultWistar white
rats. Material and methods: Three groups of animals, with ten animals each, were treated with 4 mg/kg body
weight risperidone, 6 mg/kg body weight olanzapine for nine weeks. The third group served as control group. The
animals were studied daily to observe any pathological changes that may have occurred during the experiment. At
the end of the nine weeks time frame the animals were sacrificed and samples were taken for histopathological
examination. Results: In both treated groups visible pathological changes were identified and the group treated
with olanzapine also presented pulmonary toxicity. Conclusions: Olanzapine has pulmonary toxicity at large
doses.
Keywords: atypical neuroleptics, chronic toxicity, rats
AMISULPRIDE AN ATYPICAL ANTIPSYCHOTIC?

Pricopie Andreea Iulia1, Lungu Ioana-Andreea1, Dogaru Maria Titica1, Vari C1
1
UMF Trgu Mure
Background: Amisulpride is an atypical antipsychotic used in the treatment of schizophrenia. It is a benzamide

derivative with antipsychotic and antidepressant properties, and acts by specifically blocking the D2dopamine
receptors. The results regarding amisulpride effects on body weight, dyslipidemia and the risk of producing
diabetes when used in long-term treatment are very controversial. Objective: The objective of this research is to
deepen studies regarding amisulpride effects of on body weight and the risk of producing diabetes.
Material and
methods: We used two groups of animals, each containing ten animals. For six weeks, one group was treated
with amisulpride 1 mg/kg and the other one served as control group and received placebo. During the experiment,
the animals were weighed weekly and their blood sugar levels were measured. Results: Compared with the other
modern antipsychotics, which act on 5HT2 receptors, the metabolic effects of amisulpride are much weaker.
Conclusions: Amisulpride is an atypical antipsychotic, with a different pharmacotoxicological profile among
modern antipsychotics.
Keywords: amisulpride, rat, blood sugar level, weight gain
OLANZAPINE-INDUCED LIVER TOXICITY

Huza Carmen1, Ciupu Madalina1, Dogaru Maria1, Vari C1
1
UMF Trgu Mure
Background: Olanzapine is one of the most frequently used modern antipsychotics. It acts as an antagonist of
5HT2 serotonin receptors and D2 dopaminergic receptors, with a higher affinity for 5HT2 receptors. Thus, it has a
different pharmacodynamic and pharmacotoxicological profile compared to classic neuroleptics. Objective: The
aim of this study was to evaluate liver toxicity following long term admininistration of olanzapine. Material and
methods: This study was conducted on two groups of 10 Wistar rats. The control group received the vehicle used
for suspending the active substance. The other group received a daily dose of 2 mg/kg body weight olanzapine
during 6 weeks. At the end of the experiment, the animals were sacrificed and livers were evaluated
macroscopically and histopathologically. Results: Following the macroscopic and histopathological analysis,
significant differences were found between the two groups, suggesting liver toxicity due to olanzapine.
Conclusions: Olanzapine has a hepatotoxic potential.
Keywords: olanzapine, rat, safety, hepatotoxicity
MYCOTOXINS. STUDY OF ACUTE AND CHRONIC TOXICITY ON HUMANS AND ANIMALS

Berdan Anca-Teodora1, Augustin C1
1
UMF Trgu Mure
Background: Mycotoxins are secondary metabolites of fungus and molds which contaminate the food and feed
from all over the world. They can threat the humans and animal health, being known as potent carcinogen,
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mutagen, teratogen and immunotoxic substances. The main classes of mycotoxins include aflatoxins, ochratoxins,
trichothecenes, zearalenones and fumonisines.Different types of mycotoxins produce various and even synergistic
effects. Objective: The main purpose is a comparative study between the effects of mycotoxins. It has already
been proven the strong carcinogenity of aflatoxin B1, the esophageal cancer caused by fumonisines, the
estrogenic properties of zearalenones and the nephrotoxicity of ochratoxins. Material and methods: Samples of
Aflatoxin B1, Ochratoxin A and Zearalenone are used in liquid cromatographic methods of separation and
quantification, by using reference mycotoxins purchased from Fermentec Inc., Israel, and a Dionex Ultimate 3000
modular liquid chromatographic system. The simultaneous separation and quantification of the three mycotoxins
follow a laborious extraction process that takes about 120' for each sample and then a gradient chromatografic
method for over 27'. Results: Comparative data presentation with what has already been reported is intended.
There is a variety of consequences induced by the use of contaminated food for humans or fodder for animals,
depending on species, individual reactivity and susceptibility. Conclusions: The worldwide contamination with
mycotoxins is a real, significant problem. Most of the molds are capable of producing more than one mycotoxin on
a food substrate, so the level of toxicity is increased. Mycotoxins are a real danger to human and animal health
because of everyday, chronic ingestion. Acute effects are rare and lead to mycotoxicosis, but the chronic effects
lead to multiple organ toxicity and even cancer.
Keywords: mycotoxins,, toxicity,, cancer,, food.
HYPERPROLACTINEMIA AND MODERN ANTIPSYCHOTICS ?

Miklos Amalia1, Dogaru Maria1, Vari C1
1
UMF Trgu Mure
Background: The correlation between the potential of antipsychotic drugs to stimulate the secretion of prolactine
and the effects on the test subject`s behaviour are obvious for many types of medical substances.Risperidone and
Olanzapine are considered to be the most active antipsychotics and are widely used nowadays in medical practice.
Objective: The present study was designed to assess the elevated prolactine levels in chronic,low-doses
administration of antipsychotics to laboratory animals. Material and methods: A total of 40 animals were randomly
divided,according to body weight and clinical condition ,into four experimental groups.Experimental groups were
treated for six weeks with Risperidone 0,75 mg/kg body weight,Olanzapine 1 mg/kg body weight or Amisulprid
1mg/kg body weight.The fourth group served as control ,and received only the vehicle used to suspend the active
substances. Results: The microscopically analysis revealed the specific effects of the studied antipsychotics , on
tissues , on which the studied substances show directly or indirectly , a pharmacological tropism.These effects
were conclusive in the animals treated with Risperidone and Amisulprid , compared with the control group.
Conclusions: The affinity for blocking the D2 receptor is probably greater for Risperidone than for other modern
antipsychotics.
Keywords: antipsyhotics, hyperprolactinemia, rats
PHOSPHODIESTERASE-5 INHIBITORS: OVERVIEW, PRESENT AND PERSPECTIVES

tefana Stcescu1, Hancu G1
1
UMF Trgu Mure
Background: Erectile dysfunction (ED) is a daily uncomfortable reality that affects millions of men worldwide,
based on complex pathophysiological mechanisms, both peripheral and central, that are not yet fully understood.
Currently, phosphodiesterase-5 inhibitors (PDE) are the first choice for the treatment of ED, due to good efficacy
and tolerability; mechanism of action involving inhibition of PDE present in the corpus cavernosus and prevention
of cGMP degradation thus enhancing the vasodilatator effect of nitric oxide and stimulating the blood flow at this
level. Objective: The aim of our study is to make a brief comparative presentation of the main chemical and
pharmacological aspects regarding the class of PDE inhibitors emphasizing on the three derivatives already
introduced in therapy (sildenafil, vardenafil, tadalafil). Also this review describes the latest advances in PDE
research, the potential of future therapeutic applications and the development of new potential drug candidates.
Material and methods: Using the latest studies in the field we point out the main characteristics of future
candidates for a new erectile dysfunction medication in comparison with the existing treatments. Results:
Comparing the pharmacology and pharmacokinetics of the studied PDE inhibitors we can conclude that these vary
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slightly, but with potentially important clinical differences in duration of activity; but all have almost similar clinical
efficacy and adverse effect profiles in patients with ED of various ethiologies. Conclusions: Although the
incidence of erectile dysfunction is increasing, few patients manage to overcome their psychological distress and
seek counseling from a medical specialist, most resorting to self-medication. Consequently there is a trend by
unscrupulous elements to take advantage of this aspects, using concealed, structurally modified analogues or
counterfeit medicines, problem which increased over the past years.
Keywords: erectile disfunction, Phosphodiesterase-5 inhibitors, sildenafil, tadalafil
CHIRAL SEPARATION OF FLUOXETINE BY CAPILLARY ELECTROPHORESIS USING

CYCLODEXTRINS AS CHIRAL SELECTORS
Carcu-Dobrin Melania1, Rusu S1, Hancu G1
1
UMF Trgu Mure
Background: Fluoxetine is a drug used in the treatment of depression, a major psychical disorder which,
nowadays, affects more and more people. Fluoxetine, an antidepressant of the selective serotonin reuptake
inhibitor (SSRI) class, is a chemical substance with an asymmetric carbon atom which confers optical activity. The
differences between the pharmacologic effects of the enantiomers and the seteroselective metabolism of fluoxetine
are well known. Objective: The aim of this study was to develop a chiral separation technique for the
enantioseparation of fluoxetine by capillary electrophoresis using cyclodextrins as chiral selectors. Material and
methods: As method of separation we chose capillary zone electrophoresis, because of its advantages related to
the: low consumption of substances, chiral selectors and solvents; rapid method of development, high resolution.
Several cyclodextrins (neutral and ionized, natural and derived) were tested in order to find the optimal chiral
selector. The influence of electrophoretic and analytical parameters on the chiral resolution was examined and
optimized. Results: The best results were obtained using a phosphate buffer solution at pH 5.0 and 10 mM
heptakis (2 3 6-tri-o-methyl)--cyclodextrin as chiral selector. The performance of the analytical method was
verified in terms of: reproductibility, linearity, robustness and accuracy. The applicability of the method was verified
by quantifying the fluoxetine enantiomers from pharmaceutical preparations (Prozac and from a generic drug).
Conclusions: Capillary zone electrophoresis proved to be a suitable method for the enantioseparation of
fluoxetine and can be used successfully in its preliminary chiral analysis.
Keywords: fluoxetine, capillary electrophoresis, enantiomers, cyclodextrins
CYCLODEXTRINS SCREENING FOR THE CHIRAL SEPARATION OF SIBUTRAMINE BY

CAPILLARY ELECTROPHORESIS
Hilochie Alexandra-Elena1, Hancu G1, Tero- Vescan Amelia1
1
UMF Trgu Mure
Background: Sibutramine is a serotonin, dopamine and noradrenalin reuptake inhibitor used as an anti-obesity
drug when weight loss is medically indicated. This drug shows dual actions by enhancing satiety to decrease food
intake and enhancing thermogenesis to increase energy expenditure. Sibutramine contains a chiral carbon and
consequently two enantiomers are available. Objective: For the development of sibutramine as a chiral drug and
for pharmacological and pharmacokinetic research, the enantioselective isolation and determination of sibutramine
are needed. Our aim was the development of a simple, rapid and efficient method for the chiral separation of
sibutramine enantiomers. Material and methods: For the enantioresolution of sibutramine we employed a
capillary zone electrophoretic method, taking in consideration its advantages related to the low consumption of
analyte, chiral selector and solvents, rapid method development, short analysis time and high separation
efficiency. A systematic cyclodextrin screening approach was used in order to find the optimum chiral selector. Our
aim was not only to obtain high chiral resolutions and short analysis times but also to study the effect of several
electrophoretic parameters on the separation. Results: The highest chiral was obtained when using a phosphate
buffer electrolyte at a pH of 4.5, + 20 kV applied voltage, 15 C system temperature, 50 mbar/1 second
hydrodinamic injection; and 10 mM randomly methylated cyclodextrin as chiral selector. The analytical
performance of the method was evaluated in terms of: repeatability, linearity, robustness and the limit of detection
and quantification were calculated. Conclusions: Sibutramine enantiomers were separated successfully by
capillary zone electrophoresis using substituted cyclodextrins as chiral selectors, with a very short migration time
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and acceptable resolution. The elaborated method can be used in preliminary chiral analysis.
Keywords: sibutramine, capillary electrophoresis, chiral separation, cyclodextrins
UV-VIS SPECTROMETRY DETERMINATION OF CAFFEINE FROM CHOCOLATE

Ciobanu Diana - Luminia1, Sarkany Anita1, Bojan Andrada Simina1, Gz Florea A1
1
UMF Trgu Mure
Background: Caffeine, an alkaloid found in coffee, tea and cocoa is the most widelypsychoactive drug consumed
in the world. It is a nervous system (CNS) stimulant with both positive and negative effects. It is called a "safe drug"
due to its very high toxic doses (over 10 grams per days for an adult), while normal use is, on average for an adult,
at around 500 milligrams daily. Some of the positive effects noticed after uses of caffeine are wakefulness, a better
coordination of the body, better focus, faster and clearer flow of the thoughts. Objective: The aim of the study was
to develop a proper method for extraction of caffeine, identification and quantification the level of caffeine from
different types of chocolate found on Romanian market by UV-VIS spectrometric method. Material and methods:
Caffeine was extracted using warm water from fat free chocolate powder. Analysis of caffeine was performed on a
Specord 2100 UV-VIS system using purified water as reference solvent in 10 mm quartz cuvette. The samples
were degreased by extraction with pentane. Results: Different types of chocolate have been analyzed. Samples
were degreased using pentane as solvent for extraction (10 mL of pentane for 3 times). A calibration curve lying
between 0.08 g/mL and 0.89 g/mLhas been made. The points are well fitted on the line with a correlation
coefficient R2=0.957. The maximum wavelength has been observed at 277 nm. Several samples have been
analyzed and the content of caffeine is between 16 mg (milk chocolate) and 35 mg (dark chocolate). Conclusions:
The content of caffeine in chocolate is far less than 400 mg (daily quantity considered safe for healthy adults).
Combining 2 cups of coffee, one coke and an energy drinks with a chocolate gave a greater quantity than the daily
allowed dosage.Acknowledgement: Multidisciplinary laboratory and experimental station of UMF TrguMure.
Keywords: caffeine,, chocolate,, UV-VIS spectrometry.
GENERICS VERSUS ORIGINALS PATIENT CHOICE, IS THE FINANCIAL COST AN

IMPEDIMENT
Popescu G1, Vlad R1, Lungu Ioana-Andreea1, Hancu G1
1
UMF Trgu Mure
Background: An original drug is a term used for a new drug that has been proven to have a positive effect on a
particular disease after extensive research and clinical studies; which is based on a patented molecule. Generic
drugs are copies of brand-name original drugs that have exactly the same dosage, intended use, effects, route of
administration, risks, safety, and strength as the original drug. The prescribing doctor, the pharmacist and the price
have an important role when a patient receives a drug and if we consider the OTCs we also have to take into
consideration the commercial aspects. Objective: Our objective is to find out what patients choose between a
generic and an originator, their confidence in the pharmacist and if they are influenced in any way by commercials
when buying drugs, all of this aspects also beinginfluenced by sex, age and the area of work in which they
operate. Material and methods: We used questionnaires, many of which were completed online. Results: The
majority of those surveyed declared that they know what a orginal respectively a generic means. The price of the
medicine is also an important factor in choosing a certain drug. Only a few patients said that public advertisment
makes them buy that product. Conclusions: With healthcare costs continuing to rise, generic drugs are looking
more attractive than ever. The prospect of getting the same drug at a lower cost is tempting to anyone with a large
drug bill " patient or insurer alike. Speaking as a community pharmacist, many patients rely on us for medication
information. Therefore, we need to stay current on our understanding of the important counseling topics with each
and every medication we dispense, and it is our duty to maintain our skills as patient educators so that we may
convey such information in an appropriate manner.
Keywords: original, Generic, survey, pharmacist role
PHARMACY
95
RISK FACTORS FOR HYPERKALEMIA IN A NEPHROLOGY DEPARTMENT

Solovastru A1, TARTA I1, Marian Claudia Niculina1, Dogaru G1, Carasca E1
1
UMF Trgu Mure
Background: Hyperkalemia is considered a life-threatening condition due to the risk of ventricular arrhythmias and
cardiac arrest. Objective: The aim of our study was to evaluate the prevalence and risk factors for hyperkalemia in
a group of hospitalised patients. Material and methods: We performed a cross-sectional study on 217
consecutive patients addmitted in a Nephrology Department between January and December 2014. Demographic,
clinical, laboratory parametersand medication on addmittance were collected in a database. We defined
hyperkalemia as potassium values above 4.8 mmol/l. Results: Fourty three patients had hyperkalemia (19,18%),
and 15,02% had potassium values above 5 mmol/l.Serum creatinine (p=0,0009), serum urea (p 0,0001) and uric
acid were significantly higher in patients with hyperkalemia. Beta blockers or spironolactone administration and
beta blockers associated with angiotensin converting enzyme inhibitors bitherapy were the main risk factors for
elevated potassium levels in our patients. Conclusions: Beta blockers alone or in combination with angiotensin
converting enzyme inhibitors, especially in patients with impaired renal function, are to be used with caution.
Keywords: Hyperkalemia, medication, arrhythmias, risk factors
COMPARATIVE STUDY OVER MEDICATION REGIMEN COMPLEXITY IN PATIENTS WITH

DIABETES AND HYPERTENSION
Marian Claudia Niculina1, TARTA I1, Solovastru A1, Dogaru G1, Caldararu Carmen1
1
UMF Trgu Mure
Background: Previous studies suggest that complex therapy regimens are the main cause to poor adherence to
long-term medications in chronic diseases. Objective: To compare medication regimen complexity index (MRCI),
the contribution of complexity components (medicine count, frequency) and to explore the relationship with the
comorbidity index in patients with hypertension and diabetes mellitus. Material and methods: Cross-sectional
study on a group of 80 patients admitted in the Nephrology Department of County Clinical Hospital of Targu-Mures.
Clinical, laboratory and demographical data were reviewed from the observation sheets. The complexity of the
medication regimen was assessed using the medication regimen complexity index (MRCI). Comorbidities were
assessed with Charlson comorbidity index. Results: 60 patients with arterial hypertension and 20 patients with
diabetes mellitus were included in the study. Age, serum creatinine, hemoglobin, uric acid and lipid parameters
showed no significant differences between groups. Charlson comorbidity index was higher in diabetes patients.
Total MRCI was greater for diabetic than for hypertensive patients (p=0,0012). Therapy complexity was not
statistically different when comparing the underlying conditions, but statistically significant associations were found
when assessing comorbidities. In female patients MRCI was greater for diabetes (p=0,01) than for hypertension. In
male patients MRCI showed no differences between these conditions (p=0,13). Conclusions: The complexity of
therapeutic regimen is higher in diabetes than in hypertension, therefore diabetic patients should be closely
monitored in order to improve compliance and adherence
Keywords: diabet, hypertension, medication
OPTIMIZING A PHARMACEUTICAL FORMULATION USING DESIGN OF EXPERIMENT

WITH SPECIALIZED SOFTWARE
Borsan Anca-Maria1, Bogdan Andrada Andreea2, Todoran Nicoleta1
1
UMF Trgu Mure

S.C. Hygieia S.A.
Background: Design of Experiment (DoE) represents a modern concept that involves various mathematical and
statistical methods in order to develop an optimized pharmaceutical formulation by predicting and modeling its
quality. In such approaches, the use of specially designed software is indispensable. Objective: This paper aims
to highlight the major steps taken for analysis using specialized software in order to optimize a pharmaceutical
96
PHARMACY
formulation by DoE. For this purpose, three sets of experimental results obtained in previous studies have been
used to exemplify the steps of such analysis. Material and methods: Experimental data: 9 dissolution profiles (10
hours) of 9 products in form of multiparticulate dosage forms (pellets) with 2 formulation variables (3 types of
dimensions and the amount of dissolution prolonged agent in 3 different proportions). Software: Minitab17 (trial
demo version). Bibliographic data: dissolution profile of a reference product. Results: The software analysis
follows these main steps: Selecting the experimental variables (X= independent variables, e.g. the formulation
factors; Y= dependent variables, e.g. the dissolution and kinetic of release parameters) and their levels of variation
in the designed experimental plan; Establish the matrix of the data in the designed space; Data fitting and
Validation of the factorial plan; Generating the plot (observed/predicted); Identifying areas of the best
similarity of experimental data compared with data of the reference product; Verifying the quality of optimized
formulation by experimental method. Conclusions: Design of experiment and analysis of few (minimal)
experimental data using specialized software represents a simple and relative rapid method for optimize a
pharmaceutical formulation. This method requires minimal knowledge of mathematical and statistics analysis.
Keywords: Design of Experiment (DoE), Optimization of Formulation, Pharmaceutical Technology
BLOOD PRESSURE MANAGEMENT IN HOSPITALIZED PATIENTS WITH CHRONIC

KIDNEY DISEASE: DO PHYSICIANS HAVE ANY CONTROL?
Ghazzawi Daria1, CARLAN OTILIA1, Annamaria Szanto1, TARTA D1, Caldararu Carmen2, Dogaru G1, Carasca E1
1
UMF Trgu Mure

SCJ MURES
Background: Hypertension is independently associated with mortality and disease progression in chronic kidney
disease (CKD). That is why the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice
Guideline forthe Management of Blood Pressure in Chronic Kidney Disease provide guidance for blood pressure
management in these patients. Objective: The aim of our study was to to verify if the guidelines for blood pressure
control in patients with chronic kidney disease are respected by the threating physicians. Material and methods:
A Cross-sectional study was performed on 595 patients addmitted in a nephrology department between 2011 and
2014. Observation sheets were restrospectively analysed for demographical data, sistolic and diastolic blood
pressure values, personal history of diabetes and hypertension, creatinine levels, 24 hours proteinuria and the use
of angiotensin converting enzyme inhibitors(ACEIs) or angiotensin receptor blockers(ARBs).Chronic kidney
disease was defined as estimated glomerular filtration rate(GFR) below 60 ml/min/1.73sqm and MDRD formula
was used to estimate GFR. Results: In our study group, 307 patients were diagnosed with CKD based on MDRD
estimated GFR, out of which 110 were diabetic patients. An optimal management of blood pressure(BP) values in
CKD patients with diabetes was found in 26.36% of cases, from which 51.72% were female patients. 52 patients
had low proteinuria levels (under 0.15g in 24 hours) and only 24 (46,15%) of them had BP levels below
140/90mmHg.On the other hand, 142 patients had elevated proteinuria over 0.15g/24 hours and the BP
management was optimal (BP levels unde 130/80 mmHg) in 12 (8,45%) patients. 71 patients with elevated
proteinuria were under therapy with ACEIs or ARBs. Only 147 patients were under threatment with ACEIs or
ARBs. Conclusions: Blood pressure control and physicians adherence to hypertension guidelines in patients with
CKD is insufficient. Furthermore, increased attention should be paid in patients that are at risk of adverse
outcomes due to proteinuria.
Keywords: CKD, Hypertension, Proteinuria
USING SCIENTIFIC SOFTWARE FOR MATHEMATICAL AND STATISTICAL ANALYSIS IN

DEVELOPING PHARMACEUTICAL OR COSMETIC FORMULATIONS
Asoltanei Claudia1, Hran Oana Raluca1, Todoran Nicoleta1, Ciurba Adriana1
1
UMF Trgu Mure
Background: Mathematical and statistical analysis of data is indispensable for all formulation stages, both in the
pharmaceutical and cosmetics developments. Specialized software market includes a wide variety of scientific
packages. The most important aspects that must be considered when choosing to use a certain package are: the
facilities for the management of statistics data, the statistical functions available for analysis and the simplicity of
user interface. Objective: This paper aims to present the interface and the available functions for mathematical
PHARMACY
97
and statistical analysis of three professional statistical software packages that can be used in common statistical
analysis or in predictive and modeling analysis of experimental data determined during the formulation developing
process of pharmaceuticals or cosmetics. Material and methods: Software packages: GraphPad Prism
(GraphPad Software, Inc., v.5 trial demo version); DDSolver (an Excel Ad In Program); Minitab (v.17, trial demo
version). Experimental data: bibliographic data. Results: In order to emphasize the practical usefulness of the
statistical software in formulation developing studies, there are presented 3 types of analysis: A group data
analyses by two way Anova method for determine the statistical significance of differences; A dissolution data
modeling by fitting the dissolution profile with mathematical equations as predicted functions of time; An
experimental data analysis to identify the interaction between the formulation factors that influence the release of
the active substance. Conclusions: In all formulations developing processes of pharmaceuticals or cosmetics, the
analysis of data through mathematical and statistical methods are essential and even critical to make experimental
decisions. Using specially designed software for this purpose has become a common practice in the
pharmaceutical industry. In this context, we believe that organizing workshops with such topics could be useful to
those students who are interested in this field.
Keywords: Statistical software, Mathematical and statistical analysis, Pharmaceutical and cosmetic technology,
Development of formulation
PHARMACO-TECHNOLOGICAL PROPERTIES OF LORATADINE FAST-DISINTEGRATING

TABLETS FORMULATED WITHOUT LOCTOSE
Pop Ioana-Viorica1, Ciurba Adriana1, Todoran Nicoleta1
1
UMF Trgu Mure
Background: A fast - disintegrating drug delivery system represents a solid dosage form that combines the
advantages of both liquid and solid formulations, thereby offering a solution for those patients who have difficulties
in swallowing conventional tablets. Loratadineis a second generation long acting H1 histamine selective peripheral
antagonist drug. Lactose, one of the most commonly used directly compressible adjuvant, is known as a binding
agent which yields tablets of high mechanical resistance. Objective: The objective of this study is formulation of a
product in form of loratadine -orally disintegrating tablets, containing other binders than those based on lactose,
with optimal physico-chemical and pharmaco-technological properties. The challenge consists in finding the proper
disintegrants combination and their optimal ratio which can ensures a fast dispersion and dissolution of the tablets.
Material and methods: We proposed 7 formulations of orally disintegrating tablets containing 10 milligrams of
loratadine, using croscarmellose sodium and pregelatinized starch in various concentrations as superdisintegrants
combined with microcrystalline cellulose, mannitol, maltodextrin as binder agents. The tablets obtained by direct
compression method were evaluated in terms of hardness, drug content, wetting time, disintegration time,
dispersion time and in vitro release rate of loratadine. Results: Each of all 7 studied formulations has shown a
proper disintegration time, as all determined values were in range of 16 0.10 to 120 0.10seconds. These values
are influenced either by the type and the amount of the used superdisintegrants. Maltodextrin used as diluent in
combination with mannitol and microcrystalline cellulose leads to a prolonged disintegration time. Conclusions:
Preparation of loratadine-orally fast-disintegration tablets formulated without lactose, by direct compression metho,
is simple and reproducible. The evaluation of our tablets leads to promising results in terms of ensuring the best
disintegrating characteristics for tablets and the optimal release profile of loratadine by using croscarmellose
sodium and pregelatinized starch as superdisintegrants.
Keywords: Loratadine,, fast-disintegrating tablets,, superdisintegrants,, in vitro release
DOPING IN HORSE RACING

Vlad R1, POPA CRISTINA1, Dogariu C A1, Popescu G1, Butucea Anca1, Hancu G1
1
UMF Trgu Mure
Background: Doping represents the use of prohibited substances, with the purpose of increasing the
performances of the contestants. Unfortunatelly in all sports doping is present and represents a cruel reality in
sports in which animals are involved, such as equestrian sports. From antiquity cases of using increasing
performance drugs were mentioned, nowadays the Federation Equestre Internationale (FEI) the world governing
body of equestrian sports has a Code of Conduct especially formulated to protect the welfare of the horse.
Objective:
98
PHARMACY
The aim of this study is to make a brief comparative presentation of the substances used to increase the
performances of race horses, and also to present how a banned substance can be detected in biological samples
and the rules that govern the participation of the animals in competition. Material and methods: The number of
doping tests increased after the 2000 as were also the number of horses found doped. The list of banned
substances increased and is increasing constantly, including substances such as: adrenaline, barbiturics, beta
blockers, NSAIDs, corticosteroids. Results: Human athletes can decide for themselves if they wish to take drugs,
horses do not, as a result, there is a moral and ethical dimension when medicating animals. The analyst can
keep up with the pharmacologist who are creating new drugs that are untraceable, and also genetic doping could
be a tool that is used nowadays. Conclusions: There will always be riders, trainers and veterinarians who will
attempt to get more out of an animal using exogenous aids. The fight to preserve the welfare of the horse and the
spirit of the sport continues as the Code of Conduct of FEIremains unequivocal: all times the welfare of the
horse must be paramount and must never be subordinated to competitive or commercial inuences.
Keywords: doping, horse, banned substances, performance
INDEX OF AUTHORS
INDEX OF AUTHORS
anta Virginia Alexandra 14

tefan Anda Simina 50
tefana Stcescu 92
oait Claudia 81
oait Claudia 81
A
Abaza Maria 26, 48, 68
Abecassis A 46
Aburahma K 57, 66
Aden M B 66
Adrian I 47
Adriana Andries 11, 33, 40
Al Hussein H 6, 51
Altendeitering Fiona Freya 23
Ambrus Mrta 51
Ana Farr 72
Andreea Gheorghiu 8
Annamaria Szanto 96
Antoniu R 51, 55, 56, 62
Aslam Joiya S 10
Asmaa Barmou 6, 82
Asoltanei Claudia 96
Augustin C 91
Azberga Z 29, 31
B
Blaa Rodica 39
Bnescu Claudia 41
Bnescu Dr. Claudia 45
Bnzari Elena 47, 54
BARBA ANDREEA 34
BARSAN IULIA 55
BUTA OLIMPIA AURORA 34
Bacrea Anca 45
Badaluta C D 2, 18
Badea Ioana 75
Balasa A 53
Balogh Z 27
Banciu Andreea Maria 37
Bancos Roxana Isadora 15
Banias Laura 25, 42
Bara T 59
Barabs Hajdu Enik 33
Barmou Amani Diana 6
Bataga Simona 71
Bataga T 37
Becica M 27
Beleaua M A 51
Bercea Mara-Maria 31
Berdan Anca-Teodora 91
Bic Cristina 82
Bilca Doina 23
Boan A 52, 56
Boan Adriana 56
Boan M 27, 52
Boeriu C 44
Bogdan Andrada Andreea 95
Boitan Minerva 37
Boja R M 50
Bojan Andrada Simina 94
Bor Andreea 83, 84
Borda Angela 2, 4, 5, 7, 9, 17, 18
Bordianu Alexandra 35
Bors Andreea 84
Borsan Anca-Maria 95
Borz B 11, 27, 52
Bostan Cristina 86
Brnzaniuc Klara 19
Braila Andreea Iasmina 90
Branea I A 18
Branea Oana-Elena 17, 18, 67, 86
Brinzan-Antal Gabriella- Zsuzsanna 39, 60
Brodt A M 43
Bubau Marina 54
Bud I T 59
Budianu Mihaela 43
Buga Alina Alexandra 2
Buga Ana Maria 12
Buicu Gabriela 28, 40
Buruian M 23
Butiurca V 55, 56
Butucea Anca 89, 90, 97
C
Climan Monica - Simina 89
CARLAN OTILIA 96
COSMA C 4
CUCEREA MANUELA 34
Caglar Sena Ebru 63
Caldararu Carmen 95, 96
Caldarus C 63, 65
Campean Roxana-Cristina 41, 42
Candea Marcela 26
Carasca E 35, 95, 96
Carcu-Dobrin Melania 93
Carmen Duicu 22
Catalin C 2, 9, 18
Cecilia Maria Ujica 25
Cernat I 29
Chatzigianni Olympia Evangelia 10, 57
Chirales Cristina-Ioana 48
Chiriac Carmen 25, 42
Chiujdea S 50
Ciobanu Diana - Luminia 94
Ciortianu Laura-Elena 13, 15
Ciprian Ovidiu R 58
Ciupu Madalina 91
Ciurba Adriana 96, 97
Claudia Banescu 22
Codreanu Ana Maria 56, 64
Cojocaru Valentina 31
Colcer Ioana 60
99
100 INDEX OF AUTHORS
INDEX OF AUTHORS
Constantin Viorelia 30
Copotoiu Monica 39, 43
Coro M 62
Costache Roxana 26
Costache V 26
Costea S V 27
Cota Ancua 5
Cotoi O 44
Cotoi O S 15, 65
Craciun Nicoleta 36
Craciun Raluca Adela 11, 33, 40
Crauciuc A 22, 45
Crian Andrada Ioana 11, 27
Croitoru M 89, 90
Csilla-Katalin Bartha 59
Cucerea Manuela 36
Cucuiet Sorina-Nicoleta 17
Culbece Elena-Andreea 15
Curticpian Ioana Maria 13, 17, 45
D
DICUI MARCELA AURA 74
Dan MD PhD G 25
Dan Z 17
Danciu Elena 61
Daniela Singeorzan 45, 46
Dascl Oana-Adina 14
Deac R 61
Deaconu A 30
Demeny Andrea 12
Derzsi Z 62, 65
Dicu A 81
Dobra Alexandra Mihaela 23
Dobreanu D 5, 8
Dogar C M 19, 69
Dogariu C A 97
Dogaru G 95, 96
Dogaru Maria 90, 91, 92
Dogaru Maria Titica 91
Dolghii Xenia 35
Dorin M 67
Dorobantu D 54, 65
Drgus Emke 28
Dragota Andreea 16
Ducra Alina Maria 25, 42
E
Edis A 71
El-Najjar Vera 24
Elec Emese 62
Elekes Andrea Henrietta 28
Emke Kiss 71, 72
Enciulescu C 11
Ene Andreea 56, 68, 69
Eniko Papp 16
Eremia A 72
Erzsbet Fogarasi 90
Esian Daniela 84
F
Flp Ibolya 89
Flp Z Z 28
Faliboga Luana 90
Fanfaret I S 41, 48
Fangli D 62
Farcas D M 75
Farr Ana-Maria 75
Feier A 7, 47, 54, 63
Fic P 5, 8
Florea Mihaela Adela 44
Frincu Laura Maria 23, 24
Furdui B 68, 69
G
Gmbuan Ana-Maria 36
Gz Florea A 94
GINDILA EMANUELA-DAMARIS 58
Gabos Grecu I 46
Gabriel D M P 57
Gales Angela Tabita 64
Gall Zsuzsanna 78
Gall Zsuzsuanna 78
Gavriela Adriana Radoiu 38
Gavrilovici L 51
Georgescu I M 6
Georgescu R 60
Georgeta Livia Stefan 74
Ghazzawi Daria 96
Gherescu Doina 5, 8
Ghiciuc Cristina Mihaela 10
Ghirca Diana Madalina 82, 83
Gingean Diana 17, 66
Gliga Carmen 11
Goanta Cristina-Maria 2
Golea Andreea Manuela 36
Golea Cristina 22
Golea O I 50
Gozar H 52, 56, 62, 65, 68
Grama Alina 74
Grama Alexandra -Bianca 41
Grama Alina 71, 72
Grancea Iulia 19
Grecu Gabos Marieta 43
Gresita A 12
Grigora R 85, 86
Grigora T 58
Grigore Adelina Sofia 11, 33, 40
Grigore M 37
Grigorescu Bianca-Liana 15
Gurzu Simona 3, 14
Gyalai Z 28
H
Hdreanu V 12
INDEX OF AUTHORS
INDEX OF AUTHORS
Hran Oana Raluca 96

Halaiu V B 4, 5, 7, 53
Hancu G 90, 92, 93, 94, 97
Hanea Madalina 26
Harpa M 15, 61
Heller M 10, 31
Hilochie Alexandra-Elena 93
Hintea Mdlina Monica 71, 72
Horea G 64
Horvath A 78
Hozoi Elena Madalina 63
Huu Simona Loredana 48
Hum M 13, 45
Huza Carmen 91
I
Iakab Melinda Ibolya 45
Ilie Ana Maria 17, 18, 63, 67
Ioanovici A C 67
Iolanda Elena BLIDARU, MD PhD 29, 31
Ioncioaia B 59
Ismaiel A 30
Istrate Andra 72
J
Jay Pravinchandra T 57, 66
Jee Poh Hock M 10, 29, 57
Jiga Maria Andrada 7
Jung I 3, 14
K
Kardos Anita 50
Keller D P 64
Kikeli I 86
Kikeli P I 18
Kiss S L 60
Kovcs Z 59
Kovacs Alexandra 28
Kuo Chu Hsuan, Patricia 64
L
Lrincz Andrea 43
LADARIU IONELA PETRONELA 78
Lapusneanu Diana Ionela 52
Larisa Zahan 47
Laura Fisus 73
Lazar Alexandra 58
Lazar Martina 78
Leuca Anca Liana 78
Ligia Natea 56, 64
Loghin Andrada 2, 4, 7, 9, 17, 18
Lrhiati A 31
Lungu Ioana-Andreea 91, 94
Luparu Alina 37
M
Mrginean Alina 5
Mrginean C D 41
Mrginean Maria Oana 41, 42, 47
MOLNAR C 55
MONCEA DENISA 55
MOROZAN TATIANA 66
Macarie C 46
Macarie Melania 32, 35
Macec Adelina 54
Macesanu Adelina 23, 24
Madarasz Halmaciu Alexandra 38
Maier Smaranda 39
Man A 7, 13, 85
Man Lidia 38
Man Pop Roxana Delia 71
Marcu Iuliana-Bianca 13, 17
Mare Anca 7, 9, 13, 85
Mares R G 27, 42
Marginean Cristina Oana 41, 42, 47
Marginean Dr. Oana 38
Maria Dorina Pasca 8
Marian Claudia Niculina 95
Maricic M 22
Marta Elena Rotaru 39
Martha Orsolya 50
Martin A 73, 74
Martin Alexandra 73, 74
Mateescu Corina-Ioana 17
Matei Bianca 55, 56, 62
Matei M 61
Mejia D 10
Mezei T 14
Micu Isabela 43
Mihai Adriana 79
Mihai Gabriela 43
Mihailescu Madalina 45, 46
Mihalcea R G 2
Mihuti Alexandra 67
Miklos Amalia 92
Miklos Andreea Doriana 75
Mocian I 60
Mogan Andreea 72
Moise Cristina-Manuela 52
Moldovan Alexandra Ramona 8
Moldovan V 22
Molnr Kinga 39
Molnar C 53, 55, 56, 69
Molnar-Varlam Cristina 83, 84
Monea Adriana Maria 83, 86
Monea Monica 82
Morariu S 44
Moraru L 51
Movileanu Ionela 13, 15, 61
Munteanu L 12
Muratib Fizah 57
Muresan D 2, 9
Muresan M 22, 50, 59
101
102 INDEX OF AUTHORS
INDEX OF AUTHORS
N
Nadasdy T 46
Nagy N 6
Neagos Adriana 66
Nechifor Boil Adela 4
Negovan Anca 38, 40
Negrea M 19
Nemes Georgiana 8, 28
Nemes L 75
Nicolau A C 83
Niculiseanu Stela 52, 65
Nina Sincu 38
Nirestean A 33, 78
O
Oana Mates 44
Octav Marius R 58
Olah P 61
Olaru N 85
Oltean Andra 30
Oltean Oana 75
Onijan Adela Tatiana 35
Oprea C 41, 42, 47
Oprea V A 3
Ormenian Alina 85, 86
Orosan Mihaela-Veronica 90
Orsolya Pop 56
Ostopovici Marta-Lucia 47, 54
Popa Marius Florin 85

Popa Wagner A 12
Popescu G 94, 97
Popescu S D 14
Porumb V 57
Preg Z 86
Preg Z 18
Pric R 56
Pricopie Andreea Iulia 91
Prisca R 68
Pritcan Natalia 30
R
Racos Elisabeta 24
Radu- Alexandru P 64
Rat G D 81
Reda A 29
Rednik Anca Maria 17, 18, 67
Roca C 53
Robul A 58
Roman Flavia-Cristina 43, 60
Romaniuc Andreea 39
Rudzik Alexandra 86
Runcan R S 9
Rus Victoria 71, 72
Russu C 55, 56
Russu O 54, 63, 67, 68
Rusu M 36
Rusu S 18, 93
Ruta Florina Daniela 9, 71
P
Pzitor Andreea 82
PASC ANDRADA LARISA 34
PERIAN M 8
PETER IONELA 25
POP MARIA CRISTINA 3
POPA CRISTINA 97
Pacanu Ionela Maria 31
Pacanu Ionela 35, 48
Pager Brigitta 35, 44
Pais Alexandra 32
Palade D 66
Pantea Cristina Monica 38
Parlici Alexandra Elena 52, 65
Pasca Dorina Maria 73
Pasca Maria Dorina 6, 15, 17, 48, 74
Pascanu Ionela 37
Pavel M 54, 65
Petrisor M 50
Pitea Ana Maria 41
Pop Anisoara 67
Pop Ioana-Viorica 97
Pop M 16
Pop Mdlina Sorina 5
Pop Sanda 86
Popa Andra-Diana 17, 54, 63, 65
Popa Bianca-Irina 85
S
Sntean Ioana Maria 59
SIMON MARTA 34
STOLNICU SIMONA 55
SUCIU LAURA MIHAELA 34
SZABO RACO ELISABETA 25
Sabau Alexandra 16, 86
Sahlean D 46
Samuel M 50, 51
Sarkany Anita 94
Sarmasan Alexandra Paula 79
Sarmasan Anisoara Alina 75
Schwartz L 50
Scridon Alina 5, 8
Serfz N E 86
Serkedi Brigitta 6
Simion Adriana 89, 90
Simion G 37
Simionescu D 61
Simon Melania Renata 3, 79
Simona Mocanu 66
Sincu Mihaela Cornelia 25
Singh Sra J 57
Sirbu Eliza Dumitrita 43, 60
Sirbu Ileana Voichita 27
Siveetharan S 10
INDEX OF AUTHORS
INDEX OF AUTHORS
Solovastru A 95
Somodi Laura Ionela 17
Sorin S 62
Spac Roxana 38, 40
Stana Anemona Madalina 3
Stanca M 26, 37, 68
Stanciu Liana 47
Stanciu N 16
Stanescu Alexandra 64
Stoian Dr. Adina 45
Stoica A 35, 82
Stoica Andreea Bianca 38, 40
Stoica I 38, 40
Stoica Iulia Alexandra 53
Strnad Gabriela 81
Stroe V 51, 60, 64, 69
Stroia Alexandra 9, 16
Suba Dra Ildik 46
Suciu H 51, 60, 61, 64, 69
Suciu V I 85
Susan Cristina Iulia 44
Suvanjeiev R G 46
Szabo T 64
Szabolcs S 33
Szasz I Z 33, 79
Szasz J A 30
Szederjesi J 58
Szekely Edit 23
Szolon T 83
T
Tbcar M 55, 56
Tma G 82, 83
Ttaru A 83
TABACAR M 62
TANASE I 63
TARTA D 96
TARTA I 95
Talpalaru Alina 53
Tamas I 62
Taran Livia 28
Tarca Dr Elena 64
Tarcea Monica 73, 74
Tatar Maria Cristina 24
Tatarici Andreea 3, 9
Teul Carmen Ionela 18
Techere Alexandra 3, 9
Tero- Vescan Amelia 93
Timpu L 72
Tiplica S 84
Tirintica Andra Roxana 84
Todoran Nicoleta 89, 95, 96, 97
Tohati A 82, 85
Toma Felicia 3, 7, 9, 13, 85
Toma M 54
Toth T 56, 64, 68
Treifi Maryam 22
Tripon F 8, 22, 45
Tudor A 69
Tudor Bianca 3, 9, 69, 71
Turucz Emilia 44
U
Uleru Alexandra Ioana 52
V
Vntu Adriana 5, 7, 8
Vacariu V 2, 4, 7
Vari C 90, 91, 92
Vartolomei A 82
Vartolomei M D 50
Vasilache Simida 74
Vian Cezara-Ilinca 16
Vlad Diana Mihaela 32
Vlad R 90, 94, 97
Vlad Ramona Elena 74
Voidzan D S 6, 13
Voidzan S 11
Vulea Diana Monica 13, 15, 35
Vultur Daniela-Raluca 82
Vultur Mara Andreea 27
Z
Zacharias Cora 68
Zagrean L 2
Zavaleanu Alexandra Daniela 12
Zeffer T 39
Zolya Eniko-Kinga 39, 60
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