Central Nervous System: normal morphological aspects and in its acute demielinisation in multiple sclerosis

Catedra de AnatomieThis article represents an integrated study of the normal morpho-physiologycal structure of the Central Nervous System(CNS), but also in case of multiple sclerosis attack. Its various types, the global distribution, and the most likely accepted ethyologycal theory on multiple sclerosis occurrence are also included. Articolul dat reprezintă un studiu integrativ asupra structurii sistemului nervos central în stare normală din punct de vedere morfo-fiziologic, precum şi în cazul atacului de scleroză multiplă (SM). Sunt incluse totodată tipurile, distribuţia globală, precum şi cea mai probabilă teorie etiologică a sclerozei multiple

Early neurological manifestations, in patients with internal carotid artery stenosis

Coordonator ştiinţific: D.hab., prof. univ., Gavriliuc Mihail Catedra NeurologieThis article represents an observational and analytic clinical study, which reflects the most common and early neurological manifestations in patients with internal carotid artery stenosis, but also in patients who had an ischemic stroke , but haven’t been diagnosed with a stenosis of internal carotid artery. The analysis of risk factors, the study of “Watershed” phenomen, and paraclynic examinations’ results, in those which concern the consequences of an ischemic stroke, are also included. Manifestările neurologice precoce, la pacienţii cu stenoză de arteră carotidă internă Articolul dat reprezintă un studiu clinic analitic de tip observaţional, care reflectă cele mai frecvente şi precoce manifestări neurologice atît la pacienţii cu stenoză de arteră carotidă internă, cît şi la pacienţii care au suportat un accident vascular cerebral de tip ischemic, dar nu au avut stenoză de arteră carotidă internă. Sunt incluse se asemenea analiza factorilor de risc modificabili, fenomenul “Watershed” şi analiza datelor examenului paraclinic, în ceea ce priveşte consecinţele accidentului vascular cerebral ischemic

Bioethycal aspects of xenotransplantation

Catedra de Filosofie şi Bioetică USMF "Nicolae Testemiţanu"Bioethycal aspects of xenotransplantation This article represents an integrated study that reflects the common attributes of xenotransplantation as an alternative way of exchanging the damaged human tissues and organs. Its various types, the impact upon human rights and human psychology, its ethical sides and limits are also included. Articolul dat reprezintă un studiu integrativ ce reflectă atributele xenotransplantologiei drept cale alternativă de a înlocui organele şi/sau ţesuturile umane lezate. Sunt incluse de asemenea tipurile, limitele, aspectele etice, precum şi impactul asupra psihologiei şi drepturilor omului a xenotransplantologiei

Watershed ischemic stroke - clinical and imaging peculiarities

State Medicine and Pharmacy University „Nicolae Testemitanu”, Chișinău, Republic of MoldovaIntroduction: Watershed Stroke (WS) is a subtype of ischemic stroke, produced at the borderzones of main brain arteries’ vascularisation, and has proved to have specific features. Purpose and objectives: Specific clinical aspects’ analisis of WS as a classic ischemic stroke subtype. Determination of specific imaging pattern in patients with WS. Early neurological manifestations’ study in patients with WS. WS risk factors analysis. Study of classic brain CT use in WS diagnosis. Materials and Methods: 60 patients with ischemic stroke (IS), with male-female ratio= 1:0,86, divided in 2 groups: main group-30 patients wuth WS, and control group-30 patients with classic IS. Comparative imaging, clinical, and paraclinical features, together with statistic analysis were provided. Results: Inclusion criteria were the presence of 1 or 2 IS in past with a maximum of 3 years from the onset, the age ranking from 18 to 81, and CT-confirmed IS. Exclusion criteria were concomitant decompensated vascular pathologies, hemorrhagic stroke, and a period of more than 3 years from the first stroke. More frequently IS occurred in the middle cerebral artery territory, and more often it was primary, and bilateral or combined (involving 2 border zones at a time). The neurological deficit was found to be directly proportional with the proximity of the affected cerebral artery. Differences between neurological manifestations were found. In patients with WS they were characterizing generalized brain ischemic suffering (headache- 25,8%, dizziness- 27,3%, vision diminuation-6,6%, phosphenes-19,5%, tinnitus20,8%). A higher rate of internal carotid artery (ICA) stenosis was found in patients from the main group (46,6% versus 40%), with an evident prevalence for patients with moderate stenosis (41,66% for 51-70% of ICA stenosis versus other degrees of stenosis). The types and morphology of atherosclerotic plaque (AP) also showed differences between those 2 groups: a higher frequency of „hard” (ateromatous) plaques was identified in patients with WS in comparison with those from control group (46,66% versus 43,33%), together with higher rate of calcificates and emboligen potential were found in WS patients. Cerebral lacunarism was found much more frequently in patients with WS, especially in those with ICA stenosis. Conclusions: Neurological score in patients with WS is directly proportional with the proximity of the cerebral artery that was affected; Primary WS episodes have smaller neurological deficit score; ICA stenosis is a WS risk factor; AP has specific morphology in patients that underwent WS; Cerebral lacunarism development is directly dependent on the stenosis degree, being more frequently associated with WS; Neurological manifestations in patient with WS are specific for cerebral hypoperfusion state; Brain CT allows cortical WS diagnosis, but has some limitations in subcortical WS identification; The relationship between cerebral metabolism’s modifications adapted to brain hypoperfusion, are still a domain of further research

Role of ambulatory electrocardiographic monitoring in management of supraventricular extrasystoles in children

Departamentul Pediatrie, USMF “N.Testemiţanu”Management of children with supraventricular extrasystoles (SE) can be challenging without clear specifications of guidelines on diagnosis and medical treatment. Ambulatory electrocardiographic monitoring (Holter ECG) is one of the methods widely used in the SE onset management in children. Our study performed analysis of 31 children with supraventricular extrasystoles who undergone ambulatory monitoring for 24 hours. Performing ECG Holter allowed primary diagnosis of supraventricular extrasystoles in 31 children as compared to 15 diagnosed by classic ECG. Managementul copiilor cu extrasistolii supraventriculare poate fi o provocare în lipsa specificărilor clare ale ghidurilor în privinţa diagnosticului şi necesităţii aplicării tratamentului medicamentos. Monitorizarea electrocardiografică ambulatorie (ECG Holter) este una din metodele pe larg utilizate în managementul aritmiilor la copii. Studiul nostru a supus analizei 31 de copii cu extrasistolii supraventriculare, care au fost supuşi monitorizării ambulatorii timp de 24 ore. Conform înregistrării Holter s-a stabilit primar diagnosticul de extrasistolii supraventriculare la 31 de copii versus ECG standard normală la 15 din aceşti pacienţi

The dynamics of the pyrophosphatase in primary and secondary osteoporosis and under the influence of bioremedies of algal origin

Laboratorul Biochimie al Laboratorului Central Ştiinţific al USMF „Nicolae Testemiţanu”The dynamics study of the inorganic pyrophosphatase activity at 1.5, 3 and 6 months after primary and secondary osteoporosis (OP) induction was performed, that denoted a phasic character of its changes. Biological preparations of algal origin with high content of organic Zn showed pronounced osteoregenerative properties by effective stimulation of inorganic pyrophosphatase activity, the highest eficiency being characteristic for biopreparation BP-Zn1. The research performed confirms a prospect of the studied preparations use as effective osteogenic remedies for the correction of metabolic disturbances caused by OP. Studiul în dinamică, la 1,5; 3 şi la 6 luni de la iniţierea procesului patologic denotă caracterul fazic al modificărilor activităţii pirofosfatazei anorganice, în OP primară şi în cea secundară. Biopreparatele de origine algală, cu un conţinut sporit de Zn organic, manifestă proprietăţi osteoregeneratoare pronunţate prin faptul că stimulează eficient activitatea pirofosfatazei anorganice osoase, prioritar fiind biopreparatul BP-Zn1. Cercetările efectuate confirmă perspectiva utilizării remediilor studiate în calitate de mijloace eficiente de corecţie în dereglările metabolice provocate de osteoporoză

The endovascular treatment of acute ischemic stroke - a perspective for Republic of Moldova

Department of Neurosurgery, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 6th International Medical Congress for Students and Young Doctors, May 12-14, 2016Introduction: The endovascular approach as an elective method of treatment for acute ischemic stroke, gained rapidly its popularity, practical application and legal consent after major international trials. Purpose and objectives: this study represents a review of international clinical trials outcomes containing the up to date and comprehensive recommendations regarding the acute ischemic stroke endovascular treatment. Methods and materials: Cases of 5 international trials were reviewed in order to accomplish a view, contending the best approach for the patients that fitted: therapeutic window (from 6h to 12h); proximal arterial thrombosis confirmed by angiographic CT; a National Institutes of Health Stroke Scale (NIHSS) evaluation (from 8 up to 29), age 18-80 and the most important reference – used technique: mechanical maneuvers (thrombectomy, thrombaspiration, mechanical rupture, entrapment or the temporary endovascular bypass) versus both thrombolysis (thrombolytic agents with adjunctive therapy) and mechanical actions. Results: Best outcome were registered for the patients that have been treated both with thrombolysis and using the mechanical approach as well: high scores for Barthel index and great rating for an early reperfusion, CT confirmed. Conclusion: Involving the data of an increased rate for the acute ischemic stroke, raising by years, in the Republic of Moldova, as well as the abominable long term effect on the patient’s life quality, an endovascular intervention is requested.Considering the speed of development of endovascular neurosurgery, rational premises could be made equally in our republic with the foundation of endovascular specialists, exploiting the full capacity of CT and availability of the essential drugs. Consequently, the education of the population is needed to determine the early symptoms of an ongoing stroke, so on they could fit the therapeutic window for the endovascular engagement, starting with basic thrombolysis, in order to diminish the potential irreversible impact on the patient’s health

The dynamic of glycoprotein metabolism indices in primary and secondary osteoporosis and under the influence of bioremedies of algal origin

Laboratorul Biochimie USMF „Nicolae Testemiţanu”The changes of the content of hexoses and N-acetylneuraminic acid were studied in primary and secondary experimental osteporosis and under the influence of biological preparations of algal origin. The concentration of hexoses decreased at 3 months in primary and secondary osteoporosis. In 1,5, 3 and 6 months after osteoporosis induction the experimental studies revealed osteoregenerative action of the preparations manifested by the increase of hexoses content. S-a studiat modificările conţinutului de hexoze sumare şi acid N-acetilneuraminic în osteoporoza experimentală primară şi secundară în dinamică la 1,5, 3 şi 6 luni şi sub influenţa biopreparatelor de origine algală. Conţinutul de hexoze sumare s-a redus veridic în perioada de 3 luni în osteoporoza primară şi cea secundară. În urma investigaţiilor efectuate s-a depistat efectul osteoregenerativ al preparatelor cercetate, ceea ce se manifestă prin creşterea conţinutului de hexoze sumare

Rat spleen lysosomal enzymes activities changes in aseptic inflammation and under the influence of sulphated polysaccharides

Laboratorul Biochimie al Laboratorului Central Ştiinţific al USMF „Nicolae Testemiţanu”The aim of the study was to evaluate the influence of sulphated polysaccharides from the cyanobacteria Spirulina platensis (PSS) biomass upon the activity of lysosomal enzymes in aseptic inflammation. PSS had positive influence on different magnitude in aseptic inflammation, which was demonstrated by the increase of the activities of acidic phosphatase, N-acetyl--glucosidase, -glucosidase, arilsulfatase C and the dicrease of cathepsin D activity. PSS can be considered a pathogenic remedy for the correction of the metabolic disturbances in the spleen induced by aseptic inflammation. Studiul efectuat a fost axat pe cercetarea influenţei polizaharidelor sulfatate extrase din biomasa cianobacteriei Spirulina platensis (PSS) la administrarea enterală asupra activităţii enzimelor lizozomale în splină în inflamaţia aseptică. Rezultatele studiului denotă efecte pozitive de magnitudine diferită ale administrării PSS în inflamaţia aseptică, ce se manifestă prin creşterea activităţii fosfatazei acide, N-acetil--glucozidazei, -glucozidazei, arilsulfatazei C şi reducerea activităţii catepsinei D. PSS pot fi considerate remediu patogenic de corecţie a dereglărilor metabolice în splină provocate de inflamaţia aseptică

Influence of some new biologically active compounds on the main indicators of carbohydrate metabolism in experimental hepatopathy

Laboratorul ştiinţific Biochimie, USMF „Nicolae Testemiţanu”The experimental toxic hepatopathy (HP) was modeled by long term administration of CCl4. It was established that CCl4 caused pronounced disorders of carbohydrate metabolism manifested by the increased level of the metabolites – lactate, pyruvate and malate, and changes in tissue enzyme activity – the increased activity of lactate dehydrogenase (LDH) and the reduction of the functionality of the main dehydrogenases of the Krebs cycle – NADP-dependent malate dehydrogenase (NADP-MDH), NADP-dependent isocitrate dehydrogenase (ICDHNADP) and succinate dehydrogenase (SDH). The administration of local biologically active compounds (BAC) – CMD-8, CMJ-23 and CMJ-33, of Spirulina Platensis sulphatated polysaccharides (SSP) and of the remedy BioR Fe-Se in the toxic HP exerted important influences both on the evolution of metabolites content changes and on the activity of the investigated enzymes. The tested BAC succeeded to reduce the intensity of the toxic effects of CCl4 on hepatocytes by inducing a tendency of normalization and even by restoring to normal levels of the carbohydrate metabolites content, as well as of the functionality of studied cellular enzymes. Pe animale de laborator s-a modelat hepatopatia (HP) toxică prin administrarea de durată a CCl4. S-a stabilit că CCl4 a provocat tulburări pronunţate ale metabolismulu glucidic care s-au manifestat prin creşterea nivelului de metaboliţi – lactat, piruvat şi malat şi modificări ale activităţii enzimelor tisulare – creşterea activităţii lactatdehidrogenazei (LDH) şi reducerea funcţionalităţii principalelor dehidrogenaze ale ciclului Krebs – malatdehidrogenazei NADPdependente (MDH-NADPd), izocitrat dehidrogenazei NADP-dependente (ICDH-NADPd) şi succinatdehidrogenazei (SDH). Administrarea compuşilor biologic activi (CBA) autohtoni – CMD-8, CMJ-23 şi CMJ-33, polizaharidelor sulfatate din spirulină şi a remediului BioR Fe-Se în HP toxică a exercitat influenţe importante atât asupra modificărilor conţinutului de metaboliţi, cât şi a dinamicului de activitate a enzimelor investigate. CBA luaţi în studiu au reuşit să reducă intensitatea efectelor toxice ale CCl4 asupra hepatocitelor prin tendinţa de normalizare şi chiar readucerea la valori normale a nivelului de metaboliţi glucidici, precum şi a funcţionalităţii enzimelor celulare studiate