Moldovan Medical Journal

3-9

Authors: Fulga Veaceslav, Ceausu Amalia Raluca, Cimpean Anca Maria, Saptefrati Lilian, Raica Marius

Background: Due to its anti-apoptotic and anti-proliferative contradictory functions, BCL2 role in breast carcinoma progression is not clearly understood. The purpose of this study was to highlight BCL2 expression during metastatic progression of invasive breast carcinoma of no special type (NST). Materials and methods: The specimens, primary tumors and corresponding lymph node metastases (LNM) from 84 patients were immunostained for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor (HER)-2, basal cytokeratin CK5, nuclear protein Ki67 and B-cell lymphoma (Bcl)-2 receptor. Results: BCL2 expression was higher at primary site than in axillary metastases. Its score correlates positively with hormone receptors’ level and negatively with HER2, CK5 and Ki67 at both sites. Switch of molecular profile was determined in 22.62% of cases. BCL2 expression was not influenced by subtypes switch. Changes of BCL2 expression were found in 25% of cases with stable molecular subtype. The Luminal A and Luminal B/Ki67 were encountered in the majority of BCL2 transitions, mainly from positive to negative state. Conclusions: Molecular subtypes and BCL2 expression are not stable during tumor progression and metastatic development. In the present study we established immunohistochemically that BCL2 is not influenced by subtypes’ transitions. BCL2 switches were encountered only in cases with a stable HER2, Luminal A or B phenotypes. We expect a further confirmation of our results by other research groups.

15-19

Authors: Visternicean Elena

Background: It is known that etiological structure of recurrent miscarriage has genetic, anatomical, infectious and immunological factors; however, the cause of recurrent miscarriage in 50-60% of cases is not completely clear. Homocysteine is a sulfur-containing intermediate product in the normal metabolism of methionine. Development mechanisms of vascular complications of hyperhomocysteinemia are currently being intensively studied. Hyperhomocysteinemia affects a number of mechanisms involved in thrombogenesis including coagulation cascade, vessel-thrombocytic section, oxidation-reduction reactions, endothelium, and vascular smooth muscle cells and is associated with an increased risk of adverse outcomes in pregnancy. Materials and methods: The study included 50 women who had experienced the loss of at least two consecutive pregnancies. The level of the total serum homocysteine was measured via the chemiluminescent method. Results: We found that plasma homocysteine concentration < 10 μmol/l was found in 16 patients (32,0%, 95% CI 19,07 – 44,93), 9 patients (18.0%, 95% CI 7,36 – 28,64) had a fasting plasma homocysteine between 10 μmol/l to 12 μmol/l and 25 patients (50.0%, 95%CI 36,15 – 63,85) had significantly high total serum homocysteine values. Among them, 23 patients (46.0%, 95%CI 32,19 – 59,81) had the concentration between 12 – 30 μmol/l and 2 patients (4,0%, 95%CI -1,43 – 9,43) had the concentration > 30μmol/l. The complex of B vitamin supplementation was recommended at least 2 to 3 months before conception. In the current study, 40 women (80.0%, 95% CI 68,92 – 91,08) have become pregnant, passed the critical periods for pregnancy loss and continued the folate intake during the pregnancy. Conclusions: The prevalence of hyperhomocysteinemia was more in unexplained primary early recurrent miscarriages. The complex of B vitamin supplementation was recommended at least 2 to 3 months before conception and 40 women (80.0%, 95% CI 68,92 – 91,08) became pregnant, passed the critical periods for pregnancy loss and continued the folate intake during the pregnancy.

22-25

Authors: Mamadova Farah, Azizova Gulnara, Dadashova Arzu

Background: The aim of this work is to study the markers of apoptosis (granzyme B) and oxidative stress (nitric oxide), as well as indicators of endothelial damage - cystatin C and lipid metabolism in patients with congestive heart failure, and to identify the relationship between these parameters. Material and methods: The study included 114 patients (men and women) with congestive heart failure (CHF), out of which 41 patients with CHF, 39 patients with CHF and diabetes mellitus type 2, and 34 patients with CHF with metabolic syndrome. Biochemical parameters were measured with the help of reagent sets produced by “Human” company (Germany), the contents of granzyme B and cystatin C – with the help of commercial sets produced by “USCN Life Science Inc” company (China), while nitric oxide concentration was determined using a commercial kit by “R&D System”. Results: Analysis of indicators of apoptosis factors and oxidative stress in studied patients revealed a substantial increase in patients with heart failure in the presence of diabetes mellitus type 2, compared to two other groups of patients. The concentration of cystatin 3 in patients with diabetes mellitus type 2 increased significantly with *р <0,05. Conclusions: The studied parameters allow us to suggest that complications in CHF are due to the intensity of oxidative stress, apoptosis and atherogenesis, and are interconnected with biochemical changes in lipid and carbohydrate metabolism.

32-34

Authors: Kramar Hanna

Background: Screening studies have revealed in new 3-(2-R1-6-R2-4-oxyquinoline-3(4H)-yl)alkyl (alkaryl-, aryl) carboxylic acid derivative (PC-66 compound) expressive analgesic properties without any damaging effects on the stomach. Therefore, in-depth study of the pharmacological properties of PC-66 compound as a pain management agent is considered topical. Objective of the study – to evaluate a pain-killing effect of PC-66 compound compared to ketorolac and diclofenac sodium on various rat pain models. Material and methods: In experiments on 101 Wistar male rats (180-210 g) of somatic model (tail-flick) and neuropathic pain model (ligation of the sciatic nerve), and formalin test (5% formalin solution, 0.1 ml subplantarly) we investigated the antinociceptive activity of the PC-66 compound (1.0 mg/ kg) versus ketorolac (2.4 mg/kg) and diclofenac (4.0 mg/kg) administered intraperitoneally. Results: In the tail-flick model, PC-66 compound presented significant growth of PT at Hour 1 and Hour 2 by 40.6% and 50.6%, respectively. The analgesia effect of the test compound was superior to the one of diclofenac sodium, but inferior to ketorolac at Hour 1 and Hour 2, yet surpassed it by duration of action. In the formalin test model, analgesic effect of compound PC-66 was the most evident in the first (central) phase, and slightly changed the latent period and duration of the second phase of the test, while diclofenac mostly influenced Phase II (inflammatory) of the formalin test. In the model of neuropathic pain, compound PC-66 also demonstrated pronounced pain-killing effect: PT of subject rat limb grew on average by 46.7% in 2 hours following intraperitoneal administration. For this activity, PC-66 was slightly inferior to ketorolac, which caused PT growth by 51.9%. Conclusions: new 3-(2-R1-6-R2-4-oxyquinoline-3(4H)-yl) alkyl (alkaryl-, aryl) carboxylic acid derivative (PC-66 compound) presented distinct analgesic effect both in somatic and neuropathic pain models.

39-43

Authors: Bernaz Emilian P., Ciobanu Gheorghe Ch., Tentiuc Elizaveta V., Borovic Eduard I., Vovc Liviu A.

Background: Antibiotics have had a profound impact on humanity’s health, by improving our ability to prevent, cure and reduce the transmission of many infectious diseases. It is widely known, that the unnecessary or inappropriate use of antibiotics, occurs up to 50% of prescriptions only in the United States and Canada. Fortunately all negative impact on the human health can be roughly imagined. Material and methods: For this study we used the data of a six-year (2009-2014) period in the Emergency Medicine Institute and their main subdivisions which show the consumption dynamics of antibacterials use in natural indexes. Results: The total annual medium consumption of antimicrobials was registered as the following: ICD 1796.98 DDD/1000, SSOTD 566.12 DDD/1000 and EMI 584.05DDD/1000, with the parenteral to enteral forms share of respectively 94.67% to 5.33%, 85.62% to 14.38% and 83.52% to 16.48%. Five from nine main groups: beta-lactam antibacterials, penicilins, other beta-lactam, aminoglycoside, other antibacterials and quinolone antibacterials registered around 90% of all antibiotics consumption. Comparatively to Australian hospitals and hospitals other worldwide countries in EMI consumption per DDD/1000 was lower: by 3.39 and 2.22 times for tetracyclines, by 5.1 and 4.63 for beta-lactam and penicilins, as well as by 2.55 and 1.63 for macrolides and lincosamides. Conclusions: The obtained data about the dynamics of antibacterials consumption in EMI and their main departments, in comparison with hospitals from other worldwide countries, represents important arguments and reserves for improving quality treatment, planning, rational prescription and utilization of antibiotics in hospitals.