Acta Marisiensis - Seria Medica

Abstract Background and objective : Providing brief advice to stop smoking (BASS) can significantly increase motivation to quit, long-term smoking cessation rates, and substantially impact public health. The study aimed to evaluate knowledge, attitudes, and willingness of community pharmacy staff in Mures County, Romania, to provide BASS to smokers. Methods : The observational, cross-sectional study included a sample of 96 professionals working in community pharmacies in Mures County, Romania. Data were collected using an online questionnaire. Descriptive statistics were calculated. Results : Generally, more than 90% of the respondents acknowledged that smoking is addictive, represents a health hazard, and increases the risk of lung and laryngeal cancer, chronic obstructive pulmonary disease, heart attack, and stroke. Up to 70% of the respondents recognized the most common scientifically proven quit medications, such as nicotine replacement therapy, bupropion, and varenicline. Most pharmacists agreed that they should regularly ask the patients about their smoking status and encourage smokers to quit. They also declared they should receive continual education regarding quit services, medications, and techniques. BASS was credited with very high efficacy by 17.1%, high efficacy by 26.8%, and moderate efficacy by 46.3% of the respondents. The most common perceived barriers to providing BASS in community pharmacies were lack of demand from smokers (78.0%), lack of time (73.2%), and lack of educational materials (39.0%). About 70% of the pharmacists received no formal training regarding quit services, but more than 75% were interested in earning such a qualification. About 65% of the respondents estimated they could dedicate 10-15 minutes of their daily working time to provide BASS to interested customers. Conclusions : Overall, the study found an acceptable level of knowledge and willingness of the participants in offering BASS, suggesting that a program to provide BASS in Mures County community pharmacies may be feasible and useful.

Ingrid Nădășan

Loránd Ferencz

Geanina Moldovan

Zoltán Ábrám

Valentin Nădășan

Acta Marisiensis. Seria Medica

Knowledge, attitudes, and willingness of community pharmacy staff in Mures County, Romania, to provide the brief advice to stop smoking: A cross-sectional study

罗马尼亚穆雷斯县社区药房工作人员提供简短戒烟建议的知识、态度和意愿：一项横断面研究

Abstract Ewing sarcoma with renal localization is one of the rarest members of the Ewing sarcoma family with less than 200 cases reported in the Medline database. Considering the fact that the majority of data published on the Ewing sarcoma with neuroectodermal differentiation is obtained through a few case reports and case series, it becomes understandable why we currently have no universally accepted treatment regimens. Case summary : A 33-year-old patient presented to the Emergency Department with right lumbar pain following a mild trauma and an episode of macroscopic hematuria. Physical examination confirmed hematuria and flank pain and a palpable flank mass was identified. MRI showed a cystic lesion of the upper pole of the right kidney of 127/110/123 mm. After prior agreement of the multidisciplinary team, a 3D laparoscopic right radical nephrectomy was done. The histopathological diagnosis revealed an Ewing sarcoma with extensive neuroectodermal differentiation staged as pT3N1M0L1V2R0. Despite swift implementation of the chemotherapy protocol, the progression of the disease was quickly noted. Currently, one year after diagnosis, the disease is still progressing despite the chemotherapy treatment, the patient being a third line chemotherapy candidate. As renal localization of Ewing sarcoma with extensive neuroectodermal differentiation is extremely rare, multimodal treatment strategies must be established by a multidisciplinary team. Despite its aggressive biological behavior, a proper therapeutic management might increase patient life expectancy.

Alexandra Daniela Sava

Tiberiu Bogdan Szekely

Cornelia Togănel

Adela Vacar

Catalina Bungardean

Simona Gurzu

Renal Ewing sarcoma with extensive neuroectodermal differentiation: Case report and literature review

广泛神经外胚层分化的肾尤文肉瘤：病例报告与文献综述

Abstract Objective : The aim of this study was to assess glial fibrillary acidic protein (GFAP) as a marker of short-term neurodevelopmental delay in pediatric patients with congenital defects (CHD) after cardiovascular surgical intervention. Methods : Included patients were screened by Denver Developmental Screening Test II scale a few days before and then at 4 to 6 months after the surgical intervention. Blood samples were collected preoperatory and at 24 hours after surgery; GFAP levels were assessed by enzyme-linked immunosorbent assay using commercial kit form BioVendor. Results : Forty children were enrolled and dichotomized into two groups based on peripheric oxygen saturation: cyanotic (&lt;95%) and non-cyanotic (&gt;=95%) group. 63% from our population had an abnormal neurodevelopmental outcome. Significant differences between groups were found in language domain scores preoperatory (p=0.03) and in fine motor domain postoperatory (p=0.03). In the postoperatory period, GFAP had significantly higher values (p=0.0248) in the cyanotic CHD group. Association between GFAP and NIRS were analyzed and significant differences were found in both groups with a good predicting model in the non-cyanotic CHD group (aria under curve of 0.7 for receiver operative characteristic). Higher GFAP levels from the postoperatory period correlated with neurodevelopmental impairment (mean value of: 0.66 ± 0.02ng/ml in those with good neurodevelopmental score, 0.69 ± 0.02ng/ml in those with low neurodevelopmental score, p=0.01). Conclusions : GFAP could be a reliable neuromarker in identifying early acute brain injury documented by NIRS monitorization during perioperatory period and it also could identify short term neurodevelopmental impairment documented by lower neurodevelopmental scores.

Lacramioara-Eliza Chiperi

Adina Huţanu

Glial fibrillary acidic protein as a serum neuromarker of brain injury in pediatric patients with congenital heart defects undergoing cardiac surgery

胶质纤维酸性蛋白作为先天性心脏病患儿心脏手术后脑损伤的血清神经标志物

Abstract Morphologic changes in organs vary from nonspecific to specific ones, depending on causes of sudden death, e.i whether it is an acute, subacute or chronic event. The aim of this pilot study was to observe the appearance and occurrence of morphological characteristics on organs that were exposed to long-term effects of hyperthermia. A sample of 7 rats was exposed to a water temperature of 41 °C, which is defined in the literature as “heat stroke temperature”, both sexes, weighing 250 to 300 g were used. Tissue samples, obtained by dissection of rats, were fixed in 10% buffered neutral formalin, at room temperature, then incorporated into paraffin blocks, cut at 4-5 microns, mounted and stained with standard hematoxylin-eosin (HE) method. In order to prove/exclude lipid and glycogen accumulation in hepatocytes we did additional histochemical staining, using Sudan black and Periodic Acid Shiff (PAS) method, respectively. We obtained samples from kidney, liver, pancreas, spleen, lung and brain. Analyzing tissue samples of different organs obtained from seven Wistar rats, we gained insight into morphological changes caused by induced hyperthermia. All sampled organs showed congestion and some degree of oedema. The most prominent changes were observed in liver and lung samples. Tissue samples of the lung of all seven rats showed signs of acute bronchitis and bronchiolitis, together with signs of initial bronchopneumonia. We also noticed signs of focal acute emphysema as well as focal accumulations of foamy macrophages. Our study suggests that changes in the vascular bed occur soon after hyperthermia and while some organs are more tolerant to heat stroke than others, most organs show similar changes consisting of capillary dilation, congestion and interstitial extravasation, observed after 30 minutes at a temperature of 40.5 °C, with the most significant changes observed in liver and lung samples.

Emina Dervišević

Nina Čamdžić

Suada Kuskunović-Vlahovljak

Muamer Dervišević

Multiorgan morphological changes caused by hyperthermia: Case study on experimental model

高温引起的多器官形态学变化：实验模型案例研究

Abstract Introduction : Hospital administration will have to constantly work around predicting demand of the critical care beds and evaluating the options of expanding the existing capacity. These expansions will be constantly requested by clinicians in private hospitals in India. It becomes imperative to infuse capital into such expansions predicting the utilisation pattern of the new beds. This study concentrates on factors considered for estimating the infrastructure enhancement in step down beds in progression of patient care. Methodology : Retrospective measurement of past bed occupancy rates of existing critical care beds, number of patients denied admissions through emergency department due to lack of intensive care beds was counted during previous 1 year. Cost estimates of building, equipment, manpower was collected. The prices that can be charged per rack basis was estimated, for revenue calculation. Return on investment tool using annual revenues divided by annual investment was used to measure the outputs. Results : For setting up a 34 bed HDU (High Dependency Unit), 4760 square feet of space was utilised, with USD 594,555 as investment, at a revenue of USD 527,425, which is 75% return in first year, provided occupancy is at 100%. At occupancy of 60%, which was seen within 6 months of commissioning new HDU, the breakeven can be achieved at 450 days. At 100% occupancy breakeven can be achieved in 290 days. Conclusion : Demand estimation and Utilisation analysis is valuable tools for administration to make decisions on major capital investments.

Sonia Daga

Janipalli Lakshmi Prasad

Naveen P. Kumar

Evaluating demand of High Dependency Unit beds in a hospital with insights on return on capital investment

评估医院高依赖病房床位需求及资本投资回报分析

Abstract Introduction Outcome and predictors of early- and late-onset septic shock are still controversial. The aim of the study was to compare the relevant predictors of 28-day mortality in early- and late-onset septic shock and other non-septic critical illnesses. Material and Methods We conducted a prospective, observational, pilot study. A group of 46 patients with early septic shock and 42 nonseptic critically ill patients from the emergency department and 56 patients with late septic shock from the hospital were enrolled. On admission to the ICU, the most important potential predictors of 28-day mortality were assessed. Results In terms of predicting 28-day mortality, a higher mNUTRIC score was the only common predictor for all three groups. Multi-drug resistant (MDR) bacterial aetiology was a common predictor in both forms of septic shock. Older age, female gender, increased neutrophilto-lymphocyte ratio (NLR) and increased need for vasoactive agents were common predictors in late septic shock and non-septic critically ill patients. Increased red blood cell distribution width coefficient of variation (RDW-CV) was predictor in early septic shock and non-septic critically ill patients. Central venous-arterial carbon dioxide difference (Pcv-aCO2) was predictor in patients with early septic shock. Inflammatory index and MDR carrier status were predictors in non-septic critically ill patients. Conclusions A higher mNUTRIC score is a predictor of 28-day mortality in early and late septic shock and in critically ill non-septic patients. MDR aetiology was predictive of 28-day all-cause mortality in both types of septic shock, and Pcv-aCO2 was predictive in patients with early septic shock.

Ioana Denisa Botoș

Carmen Pantiș

Marcel Ovidiu Negrău

Constantin Bodolea

Mihai Octavian Botea

Elisabeta Ioana Hirișcău

Cosmin Ion Puia

Predictors of mortality in patients with early versus late onset of septic shock. A prospective, observational and comparative pilot study

早期与晚期脓毒性休克患者死亡率的预测因素：一项前瞻性、观察性和比较性初步研究

Abstract Reactive oxygen species causes harm to cell membranes and biomolecules, wherefore chronic diseases develop. Antioxidants scavenge such free radicals combating oxidative stress. This research aimed to determine the antioxidant potential of the aqueous stem bark, root and leaf extracts of Rhaphiolepis bibas against standards. DPPH radical scavenging activity was high from th stem bark extract at 72.33% with root extract at 65.85% and leaf extract at 55.91%, while ascorbic acid scavenged 89.53% of DPPH radicals. The leaf extract had the highest H 2 O 2 scavenging activity of 91.92% with stem bark at 91.17% and the root extracts at 89.12%. The aqueous root extract of R. bibas had a significantly higher FRAP capacity in comparison to the leaf extracts and the stem bark. The abilities to chelate iron by the leaf extract were statistically higher compared to the root and stem bark extracts. Stem bark extracts had the highest phenol content of about 149.44 followed by the root extract at 141.14 and the least amount of phenol was found in the aqueous leaf extract having 73.012 Gallic acid equivalent/g. The root extracts had the highest total flavonoid 377.66-milligram quercetin equivalent/gram dry weight followed by stem bark extract at 255.72 and the least amount was found in aqueous leaf extract having 164.52 mgQE/g of sample dry weight. The existence of secondary metabolites linked to antioxidant action was shown by the qualitative phytochemical screening.

Ibrahim Waweru Kariuki

Mathew Ngugi

John Maingi

Qualitative phytochemical screening and in vitro antioxidant activities of aqueous extracts of Rhaphiolepis bibas (Lour.) Galasso &amp; Banfi

定性植物化学筛选及Rhaphiolepis bibas (Lour.) Galasso &amp; Banfi水提取物的体外抗氧化活性

Abstract Introduction The aim of this research was to examine the existence of broncho-obstruction of the airways in patients suffering from chronic obstructive pulmonary disease, as well as changes in resistance values in this part of the bronchial tree after inhalation of salbutamol. Methods This study was designed as a prospective, interventional clinical trial that included a sample of 147 patients suffering from COPD. Patients were stratified into four groups of thirty patients each based on the severity of airflow limitation (based on the post-bronchodilator FEV1 value), according to the GOLD grade. The test was conducted at the University Clinical Center Sarajevo, Clinic for Lung Diseases and Tuberculosis “Podhrastovi” Results The results of our research showed that the average values of FEV1 compared to the predicted values of this parameter in subjects in the GOLD 4 group before the administration of salbutamol were statistically significantly lower than the average values of FEV1 in other subjects of the GOLD group. After the administration of salbutamol, a statistically significant increase in the value of FEV1 was registered in all tested groups. When the response to salbutamol was compared among the GOLD groups, it was assessed that the difference in the percentage increase in predicted FEV1 values after the administration of salbutamol among the tested groups was not statistically significant. Conclusion Bronchodilation with salbutamol and additional ipratropium had a significant effect on both mentioned parameters, especially in the COPD group, which speak in favor of the presence of increased peripheral resistance in all groups of patients. A statistically significant bronchodilator response was obtained in GOLD 1 and GOLD 2 groups, i.e. in groups of patients with milder forms of the disease.

Medžida Rustempašić

Parameters of dynamic spirometry before and after administration of salbutamol in COPD patients

慢性阻塞性肺疾病患者使用沙丁胺醇前后动态肺功能参数的变化

Abstract Objective Dry-route manufacturing technology development poses challenges to pharmaceutical technology research specialists, relying on active substance characteristics, excipient selection, and parameter optimization. Amongst various technological possibilities high shear mixing generally ensures dosage uniformity and tablet dissolution through influential shear forces, potentially enhancing dry powder blend processability. This study explores the processability of a placebo formulation within the quality by design framework to address some of the aforementioned challenges. Methods A 24 full-factorial experimental design was used to assess the manufacturability of a placebo formulation via high shear mixing. The effect of impeller and chopper speed, high shear mixing time, and homogenization/lubrication times on powder blend rheology and compression properties was investigated. Results The findings of the present study showed that product critical quality attributes like resistance to crushing or disintegration time are mainly dependent on the mixing efficiency translated by the impeller speed and high shear mixing time. Software augmented process development enabled the attainment of the design space, ensuring the fulfilment of desired product performance criteria. Furthermore, the study has also shown that the careful selection of excipients is crucial in the case of dry-route manufacturing technologies, as sodium lauryl sulphate can noticeably influence the processability of powder blends due to its lubricant properties. Conclusions Considering the advantages and challenges raised by high-shear mixing, software aided data analysis can further augment the formulation, scale-up and lifecycle management of products developed using this technological process.

Béla Kovács

Erzsébet Orsolya Tőkés

Éva Katalin Kelemen

Katalin Zöldi

Edit Suba

Boglárka Kovács-Deák

István Székely-Szentmiklósi

Francisc Boda

Tibor Casian

Exploring the impact of high shear mixing process parameters on the physical characteristics of excipient powder blend by design of experiments

通过实验设计探索高剪切混合工艺参数对辅料粉末混合物物理特性的影响

Abstract Objectives Polycystic Ovarian Syndrome (PCOS) is a complex condition affecting 4% to 26% of the world-wide population and is characterized by enlarged ovaries and cysts. These cysts are actually immature ovarian follicles that have failed to mature and release an egg, which is a process known as anovulation. This study aims to explore the potential of miRNA as therapeutic and diagnostic biomarkers for PCOS, focusing on the identification and expression analysis of novel candidates like miR-34a-3p and its target Rapamycin-insensitive companion of mTOR (RICTOR). The objective is to enhance our understanding of the molecular mechanisms associated with PCOS, particularly the roles of miRNAs in its pathogenesis. In future, we plan to test miR-34a-3p mimics/inhibitors and RICTOR downregulation to improve insulin sensitivity and ovarian function. We will also explore combined therapies and conduct trials to assess their efficacy and safety in PCOS patients, aiming to develop practical treatments for PCOS. Methods National Centre for Biotechnology Information (NCBI) database, TargetScan, and miRbase were explored to identify the novel miRNA candidates, resulting in the discovery of miR-34a-3p. Secondary structure was constructed using RNA Fold, and Ct and melt curve analysis assessed its statistical expression levels. Additionally, similar research was conducted to analyze the expression levels of RICTOR, a target of miR-34a-3p. Result The secondary structure showed miR-34a-3p has a minimum free energy of −47.20 kcal. Additionally shows dysregulation in both miR-34a-3p and RICTOR in individuals with PCOS. Furthermore, overexpression of RICTOR and decrease in miR-34a-3p levels suggest their possible role in the pathogenesis of PCOS. Conclusion In PCOS, miR-34a-3p is downregulated, and there’s an inverse relationship between miR-34a-3p and RICTOR levels. qRT-PCR results showed high RICTOR expression in PCOS patients. RICTOR plays a crucial role in the mTOR pathway, affecting insulin signaling, metabolism, and cellular growth, which are all implicated in PCOS.

Manya Saravanan

Ameya K P

Ashikha Shirin Usman P P

Durairaj Sekar

Identification and expression of microRNA-34a-3p and its target Rapamycin-insensitive companion of mTOR (RICTOR) in polycystic ovarian syndrome in South Indian population

南印度人群中多囊卵巢综合征微小RNA-34a-3p及其靶标雷帕霉素不敏感的mTOR伴侣(RICTOR)的鉴定与表达

出版信息	出版商: Sciendo，出版周期: ，期刊类型: journal，开源期刊: 否
基本数据	创刊年份: 2020，原创研究文献占比: ，自引率:， Gold OA占比:

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