Cristina Mihaela Ghiciuc

Salivary biomarkers of obstructive sleep apnea syndrome in children

The present pilot study was performed to evaluate the HPA axis and ANS activity by measuring salivary cortisol and α‐amylase diurnal trajectory and production, respectively, in mild or moderate‐to‐severe (MS) OSA‐affected, but otherwise healthy, children. Moreover, a correlative analysis was performed between the salivary biomarker concentrations and the PSG variables characterizing the OSA severity.

Cotton-Made Cellulose Support for Anti-Allergic Pajamas

The cotton used to produce an interlock knitted fabric is alkaline boiled, bleached and after drying, it is grafted with monochlorotriazinyl-beta-cyclodextrin (MCT-β-CD) as a support of an inclusion compound (IC) with natural anti-allergic active principles, in order to improve the curative properties and the comfort. Are used: extract of Viola tricolor Herb (VtH), solution of propolis (P) and of menthol (M), as well as the pharmacologic products: advantan (AD), hydrocortisone (HYD) and pimechrolimus (PI). The dimensions of the active compound molecules were established with software. The textile material grafted with MCT-β-CD and with active principles absorbed in the cyclodextrin cavity is investigated by EDX. The anti-microbial activity of VtH, P and M was tested. Tactile determinations of softness were performed with human appraisers. By assembling the anti-allergic knitted fabric with untreated fabric, therapeutic pajamas were obtained. The manner to process and manufacture the pajamas for patients with contact and atopic (DA) dermatitis (DC) is presented.

Serum testosterone and depressive symptoms in severe OSA patients

Obstructive sleep apnoea (OSA), also characterised by hypoxia‐related sleep‐ fragmentation, has been studied in relation to depression and serum testosterone deficit. In middle‐aged men, it has been reported the association between depressive mood and low serum testosterone level; however, no data are available about this association in OSA patients. Therefore, the aim of this study was to investigate in adult obese males, affected by severe OSA, the relationship between serum testosterone concentration and depressive symptoms, in order to identify among all measured parameters (serum testosterone morning concentration, polysomnography parameters, body mass index, Epworth Sleepiness Scale) those predictors for OSA‐related depression. Forty patients diagnosed with severe OSA and forty subjects for the control‐matched group were enroled in the study. The results indicated that the serum testosterone in OSA group was significantly lower than in controls. In addition, the OSA group presented a level of depression although moderate, yet significantly higher than controls. Furthermore, a statistically significant inverse correlation has been found between serum testosterone level and depressive symptoms. Among all variables, serum testosterone level was shown to be the only independent variable significantly predictor for depression in OSA patients.

Restoring the Salivary Cortisol Awakening Response Through Nasal Continuous Positive Airway Pressure Therapy in Obstructive Sleep Apnea

Partial and largely conflicting data are currently available on the interplay between obstructive sleep apnea (OSA) and hypothalamus-pituitary-adrenal axis (HPA) activity in adult obese men. This study was performed to evaluate the daily trajectories of salivary cortisol, specifically with respect to the salivary cortisol awakening response (CAR), a common method used to assess HPA axis activity. The main findings of this study were that adult male obese subjects who were newly diagnosed with severe OSA showed the following: (1) a flattening of the CAR; (2) levels of cortisol at awakening that were lower than those of the controls; and (3) maintenance of the physiological circadian activity of the HPA axis, with the highest hormone concentrations produced in the morning and the lowest in the evening. This study was also designed to investigate the effects of 3 and 6 mos of treatment with continuous airways positive pressure (CPAP). CPAP use resulted in a significant recovery of the sleep patterns disrupted by OSA; moreover, mild neuropsychological signs of depression and anxiety in severe OSA patients were concomitantly progressively improved by CPAP treatment. Furthermore, this study reports that 3 and 6 mos of CPAP therapy restored the presence of CAR and was able to significantly reduce the difference in the morning cortisol levels between the OSA and control groups. In conclusion, we report here that compared with obese nonapneic matched controls, OSA patients present a dysregulation of HPA axis activity, as shown by the flattening of the diurnal pattern of cortisol production in response to repeated challenge due to hypoxia and sleep fragmentation. This dysregulation was especially detectable in the first hour after awakening and restored after 3 and 6 mos of treatment with CPAP.

Awareness about antibiotic resistance in a self-medication user group from Eastern Romania: a pilot study

Background Awareness about antibiotic resistance depends on the attitudes and information about antibiotic resistance of both patients and physicians. Persons who practice self-medication are at high risk of also self-medicating with antibiotics. The purpose of the present study was to evaluate the awareness about antibiotic resistance by investigating the practice in a group of self-medication users in a sample of adults in Romania and the variables associated with such practice. Material and Methods A cross-sectional self-filled questionnaire based study was conducted from December 2016 through January 2017 amongst 218 self-medication users (SMUG). The attitudes, the level of knowledge, the perceptions, about antibiotic use (ABU) and about antibiotic resistance (ABR) were compared to a reference group represented by medical residents group in their specialty training (MRG) considered to have a higher level of knowledge and awareness about ABU and ABR. Results The response rate was 87.2% in the SMUG group and 100% in the MRG group. The SMUG group reported self-medication practices for antibiotics with a high frequency at any time in life (72%), but with a very low frequency from the month previous to the date of the study (12%), comparative with the MRG group (75% and 7%, respectively). The multivariate logistic regression analysis showed that self-medication with antibiotics at any time in life in the SMUG group could be predicted by the answers to two questions regarding the practices and knowledge about ABU (Q13 and Q20). On the other hand, in the MRG group, a question about ABR perception (Q23), could be predictor for self-medication with antibiotics. Self-medication with antibiotics in the month previous to the date of the study in the SMUG group could be predicted with three questions: one about ABU practice (Q14), one about ABR perception (Q26) and one referring to ABR knowledge (Q28). On the other hand, in the MRG group, a question about ABR knowledge (Q32) could be predictor for self-medication with antibiotics. The reduced awareness about ABR in the SMUG group, is revealed by the reduced number of subjects (38%), who did not know that missing an antibiotic dose during a medical treatment contributes to ABR, comparative with the MRG group (84%). Indirectly, low ABR awareness in the SMUG group is revealed by the confusion about the appropriate use of antibiotics in bacterial or viral infections (that antibiotics are not used against viruses). Conclusions The findings from our study on the awareness about antibiotic resistance in the SMUG group might help the policy makers and regulatory authorities to develop educational programs directed to change the perceptions and attitudes about the appropriate use of antibiotics in order to diminish self-medication practices with antibiotics.

Imbalance in the diurnal salivary testosterone/cortisol ratio in men with severe obstructive sleep apnea: an observational study

INTRODUCTION The complex relationship between sleep disorders and hormones could lead to alterations in the production of cortisol and testosterone in obstructive sleep apnea (OSA) patients. OBJECTIVE The purpose of this study was to determine the diurnal trajectories of salivary free-testosterone, free-cortisol and their ratio (T/C). METHODS Ten subjects newly diagnosed with OSA, based on nocturnal polysomnography evaluation and excessive daytime sleepiness, and seven matched controls were consecutively recruited. Cortisol and testosterone were measured in salivary samples collected upon awakening, at noon and in the evening. The psychometric evaluation of anxiety/depression and referred sexual function disturbances was performed to evaluate the presence of neuropsychological comorbidities. RESULTS AND CONCLUSION The main finding was that OSA subjects displayed hypocortisolism upon awakening and a significant reduction in testosterone concentration in the evening in comparison with the control group, which has maintained the physiological testosterone and cortisol diurnal fluctuation, with higher hormone concentrations in the morning and lower concentrations in the evening. The use of data from multiple diurnal measurements rather than a single point allowed the detection of T/C ratio changes of opposite signs at the beginning and end of the day: the OSA subjects had a higher T/C ratio than the controls in the morning, while their T/C ratio was significantly lower than that of the controls in the evening. The imbalances in the anabolic-catabolic diurnal equilibrium suggest that OSA is associated with a dysregulation of the hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes, potentially an underlying cause of some of the neuropsychological comorbidities observed in OSA patients.

Distinct activation of the sympathetic adreno-medullar system and hypothalamus pituitary adrenal axis following the caloric vestibular test in healthy subjects

Introduction The vestibular acute stress induces reversible alert-like reactions that involve the sympathetic adrenal-medullar system and hypothalamic-pituitary-adrenal axis responses. The present study aimed to evaluate salivary α-amylase and salivary cortisol production in relation with cardiovascular reactivity induced by acute stress in healthy subjects. Material and methods Forty-eight young healthy male volunteers were examined under basal conditions and at various times after reaching the maximal nystagmic reaction following air caloric vestibular test. Heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were recorded at the same time as measurement of the salivary α-amylase and salivary cortisol. At the end of the caloric vestibular test session, perceived stress scale questionnaires were administered to measure the self-perceived stress impact induced by the task, and individual scores were compared with those measured on the enrollment day. Results Following caloric vestibular test-evoked vertigo, salivary α-amylase and cortisol showed distinct trends in their production after acute stress: Student’s t-test was used to compare the α-amylase vs cortisol slopes of the respective interpolated regression lines, and the difference was significant (t = -3.283; p<0.001); an increase in salivary cortisol production corresponded with a decrease in the salivary α-amylase concentration. In addition, salivary biomarker modifications were associated with consistent changes in the heart rate, systolic blood pressure and mean arterial pressure. Conclusions Using the air caloric vestibular test task as a stressor, the present study demonstrated a connection between the acute hormonal stress response to vestibular stimulation and cardiovascular output. However, further research is needed before we can define the potential importance of the consistent cardiovascular activity changes evoked by vestibular stimulation and the possible functional consequences for cardiovascular regulation and orthostatic tolerance in humans.

Antibacterial effects of metal oxides-containing nanomaterials in dentistry

The development of dental nanomaterials with antibacterial properties represents a new step against antibacterial resistance, but there are concerns regarding the efficacy of the antibacterial effects of nanoparticles when mixing them with other materials or when using them for surface coating materials. The objective of this review article is to summarize the experimental data regarding the antibacterial effects of metal oxide-containing nanomaterials used in dentistry. Titanium dioxide and zinc oxide are the most studied nanoparticles with antimicrobial properties in dentistry. Most of the dental materials (cements, resin composites, mouthwashes, dental implants) containing metal oxide nanoparticles exhibited in vitro antibacterial activities. One study found that zinc oxide nanoparticles incorporated into glass ionomer cement did not promote antibacterial activity against Streptococcus mutans. There are only few comparative data on the antibacterial behavior of different types of nanoparticles in dental materials. Metal oxide nanoparticles are a promising future direction for dental materials with antibacterial properties.

Inhibition of bcl-2 and cox-2 Protein Expression after Local Application of a New Carmustine-Loaded Clinoptilolite-Based Delivery System in a Chemically Induced Skin Cancer Model in Mice

Our research has focused on in vitro and in vivo evaluations of a new Carmustine (BCNU)-loaded clinoptilolite-based delivery system. Two clinoptilolite ionic forms—hydrogen form (HCLI) and sodium form (NaCLI)—were prepared, allowing a loading degree of about 5–6 mg BCNU/g of zeolite matrix due to the dual porous feature of clinoptilolite. Clinoptilolite-based delivery systems released 35.23% of the load in 12 h for the BCNU@HCLI system and only 10.82% for the BCNU@NaCLI system. The BCNU@HCLI system was chosen to develop gel and cream semisolid dosage forms. The cream (C_BCNU@HCLI) released 29.6% of the loaded BCNU after 12 h in the Nylon synthetic membrane test and 31.6% in the collagen membrane test, higher by comparison to the gel. The new cream was evaluated in vivo in a chemically induced model of skin cancer in mice. Quantitative immunohistochemistry analysis showed stronger inhibition of B-cell lymphoma-2 (bcl-2) and cyclooxygenase 2 (cox-2) protein expression, known markers for cancer survival and aggressiveness, after the treatment with C_BCNU@HCLI by comparison to all the control treatment types, including an off-label magistral formula commercially available Carmustine cream as reference, bringing evidence that a clinoptilolite-based delivery systems could be used as a cancer drug carriers and controlled release systems (skin-targeted topical delivery systems).

From autoimmune thyroid disease and CREST syndrome to incidental discovery of incipient gastric carcinoma: a case report

Autoimmune thyroid diseases (AITDs), including Graves’ Disease and Hashimoto’s Thyroiditis (chronic autoimmune thyroiditis), are the most common organ-specific autoimmune disorders, occurring mostly in middle-aged women. AITDs are often associated with other autoimmune diseases such as vitiligo or systemic sclerosis (scleroderma), but there have been only few reports of AITDs concurring with CREST syndrome (Calcinosis, Raynauds phenomenon, Esophageal dysmotility, Sclerodactyly and Telangiectasias), a limited form of scleroderma. Furthermore, these disorders have been associated with lymphoid malignancies, but only rarely with other cancers such as lung or breast. We report the case of a 59 year-old female patient who presented at the Endocrinology clinic for vertigo, dysphoria and fatigue. Clinical examination and serologic determinations revealed the diagnosis of an overlap syndrome between euthyroid autoimmune thyroiditis and CREST syndrome. Further investigations led to the detection of an incipient gastric adenocarcinoma which was promptly treated with total gastrectomy.