Introduction

Identification, study and testing of new remedies for treatment approaches of diseases, resulting from imbalance between oxidants and antioxidants in favor of oxidants, with potentially destructive potential and pathogenesis in liver disorders is of particular interest due to the increase in incidence and severity of these pathologies.

Material and methods

The action of novel local copper coordination compounds, thiosemicarbazide derivatives - CMD-4, CMJ-33 and CMT-67, was evaluated in experiments on white rats after subcutaneous administration in two different doses (0.1 and 1.0 µM / kg) 3 times a week for 30 days. The main indices of oxidative stress were evaluated: the level of malonic dialdehyde (MDA), nitric oxide derivatives (NO), S-nitrosothiols, advanced glycation end products (AGEs), advanced oxidation protein products (AOPP) and ischemia-modified proteins (IMP), and antioxidant system: - superoxidismutase (SOD) and catalase activity (CAT), the level of histidine (His) and total antioxidant activity (TAA) in liver tissue of white rats.

Results

The administration of CC resulted in the reduction of oxidative stress indices - MDA, AGEs and S-nitrosothiols, which denotes the antioxidant effect of the studied compounds. The level of NO and AOPP derivatives does not change substantially. When administering CMD-4 (1 µM / kg), SOD activity and catalase function decreased markedly. Changes in the content of His and TAA have been shown to be inconclusive, maintaining within the limits of the values recorded in the control group.

Conclusions

The elucidation of the modifications of the free radicals processes in liver tissues, which are the basis of the CC action, broadens the theoretical knowledge about the biological properties of a number of chemical compounds; as well provide new possibilities to explore perspective objects in order to obtain new efficient drug preparations.

Introduction

Alcohol intoxication is often the cause of traumatic brain injury. The purpose of the work was to study the features of lipid metabolism in erythrocytes and mitochondria of the cerebral cortex cell membranes of rats in traumatic brain injury on the background of chronic alcohol intoxication.

Materials and methods

The studies were carried out on 140 male rats of the Wistar line weighing 170-250 g. Chronic alcohol intoxication was caused by using 15% ethanol as the only source of fluid for 20 days. Reproduction of traumatic brain injury was carried out by a shock model. Statistical analysis of data was conducted by using „Primer Biostatistics 6.0”. The criteria of parametric statistics were used. The level of p <0.05 was statistically significant.

Results

Chronic alcohol intoxication in rats and inducing of traumatic brain injury separately causes a significant change of total phospholipids and cholesterol content, and their molar ratio in the membranes of erythrocytes and mitochondria of the cerebral cortex. Particularly pronounced were the changes in studied objects with combined pathology, meaning, traumatic brain injury on the background of chronic alcohol intoxication.

Discoordination of lipid metabolism was unidirectional, manifested in a significant reduction in the content of total phospholipids, and increased total cholesterol, which led to a violation of the molar ratio of total cholesterol/phospholipids in the direction of increasing the coefficient, which is normally about 1.0.

In subsequent monitoring periods, there was a gradual restoration of individual fractions of phospholipids, but on the 30th day of the study, it did not reach the control values. That means that discoordination of the metabolism of individual phospholipid fractions was so pronounced, that even on 30th day of arbitrary reproduction did not reach the initial values, which again emphasizes the severity of the morphofunctional state of red blood cells membranes’ disturbance.

Conclusions

The revealed features of lipid metabolism in the membranes of erythrocytes and mitochondria of the cerebral cortex in traumatic brain injury on the background of chronic alcohol intoxication are an important component for understanding the ongoing pathophysiological processes and searching for new effective drugs with targeted action.

Introduction

Overactive bladder (OAB) is a common and chronic complex of symptoms that increases in prevalence with advancing age and has a known adverse effect on the quality of life. OAB is a highly prevalent condition affecting 16.6% people from Europe. Women are more commonly affected, and there is an increased incidence with age. Studies in the United States suggest a prevalence of up to 43% in women. The use of urodynamics in the diagnosis of OAB remains controversial. Although it is a gold standard diagnostic test for detrusor overactivity, it is an invasive procedure and therefore should be limited to those with refractory OAB.

Material and methods

A prospective and randomized study was performed in 60 patients with OAB symptoms who followed behavioral therapy without any effect. The study cohort was divided in two groups. 30 patients (group A) with the mean age of 40 years were treated without a prior urodynamic study, and 30 patients (group B) with a mean age of 41.5 years with overactive detrusor, underwent a urodynamic testing prior to pharmacotherapy based on EAU guidelines that recognize the benefit from addition of Mirabegron 50 mg/day to Solifenacin 5 mg/day, and on the AUA guidelines that recommends combination therapy in patients with OAB. The study was performed during 2019-2022, at the Department of Urology and Surgical Nephrology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova. 

Results

The success rate (61%) in the group A of patients was lower than in group B (81%). The proportion of patients who had urge urinary incontinence (UUI) (OAB wet) rather than frequency-urgency (OAB dry) in this series was high (50%), and this may have been a significant factor in our success rate. According to the results of the questionnaire, the clinical manifestations have improved after treatment, however in 50% of cases of urinary frequency and in 20% of urinary urgency remained unchanged. The symptomatology and urodynamic did not display different behavior between the groups. The mean post-treatment score for group A was 11.7 ± 3.27 and for group B was 15.32 ± 2.14. Ten subjects (8 receiving pharmacotherapy from group A and 2 from group B) presented with adverse events. The most frequent reported adverse events were dry mouth (15%), dyspepsia (6%), and headache (9%). Other than dry mouth, no adverse event occurred in >10% of subjects. 

Conclusions

Urodynamics can influence the treatment decisions in determining treatment pathways in women presenting with OAB. Women treated based on UDS diagnoses appear to have greater reductions in symptoms than those who do not.

Introduction

The Institute of Emergency Medicine from Chisinau has joined the Registry of Stroke Care Quality (RES-Q) in 2017.

Material and methods

We have analyzed the stroke patients’ data introduced in RES-Q between 2017­2022. Baseline characteristics, stroke-related factors, processes of care, and discharge destination were examined.

Results

Data were available for 489 stroke patients. The proportion of patients with ischemic strokes receiving thrombolysis therapy has substantially increased from 2.78% in 2017 to 20% in 2022, and the median door-to-needle time decreased from 85 minutes (2017) to 48 minutes (2021). Thrombectomy began to be performed in 2018 at the Institute of Emergency Medicine, the rate of stroke patients receiving thrombectomy increased from 3.23% in 2019 to 10% in 2022, median door-to-groin time decreased from 228.5 minutes in 2019 to 102 minutes in 2021. More than 80% of patients received secondary prevention therapies that were level-1 evidence-based processes of care: antihypertensive agents (89.47% – 98.44%), antiplatelet drugs (81.63% – 100%), anticoagulants for patients with atrial fibrillation (25% in 2018 vs 100% in 2021), but cholesterol-lowering medication was prescribed to approximately a half of the participants (44.23% – 60.0%). There were more deaths in the pandemic years (36.67% in 2021 vs 18.99% in 2017).

Conclusion

Most hospitalized stroke patients admitted to the Institute of Emergency Medicine received evidence-based care. The COVID-19 pandemic has left its mark on the number of stroke hospitalizations, but the quality of in-hospital stroke care was not dramatically affected. 

Introduction

Ischemic heart disease is one of the most widespread cardiovascular diseases. In Republic of Moldova the total number of patients with ischemic heart disease is 30-40 thousand per 1 million population and is observed more of working age with important social value.

Results

During the treatment, the increase of the nitric oxide level was registered even from the discharge stage, and in the second group being approximately at the same level as the initial stage. At the 3-month, nitric oxide level reached the normal level. There is an improvement of the endothelial dysfunction by the significant increase of the nitric oxide under the treatment at 6 months (in group I – 87.26±4.3 µM/L (p = 0.01), in group II – 95.33±10.85 µM/L).

Conclusions

The inclusion of meldonium in the complex treatment of patients with stable angina increases the clinical efficacy of basic pharmacotherapy when prescribing meldonium, mainly due to increased antianginal actions.

Introduction

The inferior third molar is the most encountered impacted permanent tooth. Pericoronitis of the lower third molar is a term used to describe the inflammation around the crown of a tooth, usually of an incompletely erupted mandibular third molar. Mandibular molar impactions are usually mesioangular, distoangular, vertical, and horizontal. The position and type of the impaction may affect the development of pericoronitis. This study was conducted to assess the positions of the lower wisdom tooth as a risk factor for pericoronitis.

Material and methods

The present study was conducted in the department of Oral and Maxillofacial Surgery and Oral Implantology „Arsenie Guțan”. A number of 120 patients were included in the study (66 women and 54 men) aged between 17-46 years old (mean 27 ± SD 6). All candidates were subjected to CBCT (cone beam computed tomography) scan and orthopantomography evaluation for a third molar position such as vertical, mesioangular, distoangular, and horizontal type. Data were stored in an Excel spreadsheet and then analyzed statistically using SPSS (Statistical Package for the Social Sciences).

Results

Based on the results of our study the greatest number of cases of pericoronitis was observed in the vertical position (92 cases) by Winter, followed by mesioangular position (24 cases) and distoangular position (4 cases). In the study we did not identify any patient with a horizontal position. By the classification of Pell and Gregory, most cases belonged to class I (73 cases). Third molars classified in position A (92 cases) had greater chance of pericoronitis when compared to those in B (24 cases) or C position (4 cases).

Conclusions

As a result of a detailed analysis, vertical position of the lower third molar is more associated with the appearance of pericoronitis. Considering Pell and Gregory classification, position A is more associated with the occurrence of pericoronitis compared to the position B or C. The prophylactic removal of the lower third semi-erupted vertical molar, or which is situated in position A, is indicated to prevent pericoronitis.

Introduction

Peripheral biomarkers have numerous uses in the treatment, prognosis, and pharmacovigilance of epilepsy. Unfortunately, no peripheral biomarker has demonstrated proven efficacy, although several options are being investigated. In this article, we want to analyze the main areas in which peripheral biomarkers can present their usefulness, including participation in the processes of inflammation, dysfunction of the blood-brain barrier, changes in metabolism, hormones, and growth factors. 

Material and methods

Publications on diagnostic biomarkers of epilepsy were reviewed. References were identified by PubMed, MEDLINE and Scopus search until June 2022, with various combinations of the terms – „epilepsy”, „seizures”, „epileptogenesis”, „biomarkers”, „neuroimaging”, „inflammation”, „status epilepticus”, „prognosis”. A qualitative and analytical study was performed focused on primary studies published in 2020-2022. More than 85 sources were identified and 33 were selected for analysis from the PubMed, MEDLINE, and Scopus online databases. 12 articles, 5 clinical trials, 2 meta-analyses, 7 reviews, and 7 systematic reviews were identified.

Results

Screening articles from online databases according to the search criteria, we found 258 titles on molecular and cellular biomarkers in epilepsy highlighted. The final bibliography included 33 sources that summarized that biomarkers of epileptogenesis are expensive and difficult to research, but the identification of biomarkers specific to the entire epileptogenic process, in close proximity to neuronal damage, have demonstrated the possibility of predicting the risk of seizures, epilepsy and resistance to treatment.

Conclusions

Epilepsy remains a continuous area of research; a special role is occupied by specific biomarkers of great clinical importance, being necessary for the prognosis of the disease, the risk of neurological sequelae, refractory to anti-epileptic drugs. Thus, their identification could have a significant impact on the clinical course of the disease.

Introduction

Vitamin D plays an important role in maintaining musculoskeletal health. As the glomerular filtration rate decreases, vitamin D deficiency also occurs. The aim of this paper is to highlight the level of vitamin D depending on the stage of chronic kidney disease.

Materials and methods

A structured search was performed in the PubMed, Scopus and HINARI databases, where the relevant articles have been taken into account, published in the last 20 years. The search terms used (in English) were: „vitamin D deficiency”, „pathogenesis of vitamin D”, ”the impact of vitamin D in chronic kidney disease”, „chronic kidney disease”.

Results

Several studies have shown that the change in vitamin D levels is dependent to the decrease of glomerular filtration rate. The lowest serum vitamin D concentration was observed in stage 5 of chronic kidney disease. Vitamin D deficiency occurs due to a decrease in the number of nephrons and a decrease in the number of proximal tubular cells that absorb vitamin D (25 (OH) D) to be subsequently hydroxylated to its active form by 1α-hydroxylase.

Conclusions

Patients with vitamin D-deficient due to chronic kidney disease have an increased risk of decreased bone mineral density and multiple fractures.

Introduction

The incidence and prevalence of gout have increased worldwide in recent decades. Scientists at the Rochester Epidemiology Project (MN, USA) have seen a two-fold increase in the incidence of primary gout (patients without diuretic exposure) over a 20-year period, which ended in 1996. The increase of incidence may be related due to the difficulty and often unsatisfactory treatment options. The aim of the study was to systematize the recommendations on dietary treatment, and medication for patients with gout.

Materials and methods

An analytical, qualitative, and secondary study was performed in the form of a synthesis article. 115 sources were identified and analyzed; from this list, 44 sources were selected according to the impact score during the publication period and according to the level of recommendations.

Results

44 articles were included. Most studies were small, retrospective analyses performed in single centers, with concerns for bias. Eleven studies (including five randomized controlled trials) reported improved patient outcomes following pharmacological interventions with known efficacy in gout, including allopurinol, prednisolone, NSAIDs and anakinra. Eight studies reported improved outcomes associated with non-pharmacological interventions: inpatient rheumatology consultation and a hospital gout management protocol. No studies to date have prospectively evaluated strategies designed to prevent re-admissions of patients hospitalized for gout flares.

Conclusions

Urate crystals is completely soluble when we can lower the serum level of uric acid to normal values, but this often requires long-term treatment. The early onset of rehabilitation of affected joints helps to reduce the articular inflammatory process, the pain syndrome and it delays the progression of the underlying pathology while improving the quality of life in patients with gout. Further research is needed to enable healthcare providers to individualize and optimize gout treatment strategies, ensuring that patients with gout receive effective, safe, and high-quality care.