http://repository.usmf.md:80/xmlui/handle/20.500.12710/30374 2026-04-12T08:48:23Z 2026-04-12T08:48:23Z Zorina, Zinovia Babuci, Angela Calancea, Sergiu Bendelic, Anastasia Botnari, Tatiana Botnaru, Doina Ostahi, Nadia http://repository.usmf.md:80/xmlui/handle/20.500.12710/30517 2025-05-16T10:23:32Z 2025-01-01T00:00:00Z

Anatomical variants of the deep brachial artery Zorina, Zinovia; Babuci, Angela; Calancea, Sergiu; Bendelic, Anastasia; Botnari, Tatiana; Botnaru, Doina; Ostahi, Nadia Introduction. Lately, due to the gradual increase of interventional radiological procedures and vascular reconstructive surgeries on the upper limb, knowledge about anatomical variants of the upper limb blood vessels has become more important. Our goal was to establish the anatomical variants of the deep brachial artery (DBA) in order to streamline the interventional procedures and surgical techniques carried on the upper limb. Materials and methods. The variability of the DBA, that is the main collateral branch of the brachial artery (BA), was studied on 70 formolized adult upper limbs. The cadaveric material belonged to the Department of Anatomy and Clinical Anatomy of Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova. Through anatomical dissection, the origin of the DBA, its course and relationship to the radial nerve (RN) were studied. Results. Anatomical variants of the DBA were identified in 14.3% of cases (95% CI [7.0-23.4]): in 8.6% (95% CI [2.6-15.8]) it presented number variants, and in 5.7% (95% CI [1.3-11.8]) – it was a component of common arterial trunks (CAT). In cases of double DBA, the second artery in 5.71% of cases, derived from the BA, having a various arrangement towards radial nerve (RN) when entering the humeromuscular canal (posterior to the RN – 2.9%; anterior to the RN – 1.43%; lateral to the RN – 1.43%); in the remaining 2.9% (95% CI [0.0-7.8]) – the second DBA had its origin in 1.43% (95% CI [0.0-4.8]) from the posterior circumflex humeral artery (PCHA) and superior collateral ulnar artery (SCUA). CAT with 3 branches were determined in 4.3% (95% CI [0.0-9.8]): 1) SCUA, subscapular artery (SA) and DBA (1.43%); 2) DBA and two muscular branches – 1.43%; 3) DBA, SCUA and a muscular branch were present in 1.43% of cases. CAT branching into two arteries: the DBA and SCUA were determined in 1.43%. Conclusions. The atypical origin of the DBA should be taken into consideration by surgeons when harvesting the muscle flaps from the lateral region of the arm. Knowledge about the common arterial trunks variation, particularly when the DBA appears as their component is necessary to increase the efficiency in coronary bypass and in diagnostics and treatment of the brachial region surgical interventions.

2025-01-01T00:00:00Z Zorina, Zinovia Babuci, Angela Crăciun, Ana Bendelic, Anastasia http://repository.usmf.md:80/xmlui/handle/20.500.12710/30516 2025-05-16T10:22:59Z 2025-01-01T00:00:00Z

Peculiarities of the perineum in morphoclinical aspect Zorina, Zinovia; Babuci, Angela; Crăciun, Ana; Bendelic, Anastasia Introduction. Women's health is one of the strategic priorities of contemporary gynecology and at the same time it is one of the primary factors determining the demographic situation in the Republic of Moldova. Genital prolapse (GP) encompasses a wide spectrum of disorders, from a barely modified anatomy of the vagina and clinically asymptomatic cases, to a complete vaginal eversion associated with severe urinary, defecation and sexual disorders. The morphological aspect of the pelvic diaphragm (PD) and perineal muscles (PM) requires a deep and extensive study, as they represent the main support for the pelvic organs and can provide us with understanding of the causes and mechanisms of genital prolapse occurrence. The aim of the study was to identify the morphoclinical peculiarities of the PD and PM in women with genital prolapse. Materials and methods. The study was carried on 103 patients diagnosed with GP, hospitalized in the Surgery Department of the Medical Center Galaxia, Chisinau, Republic of Moldova, during the period of 2021-2024. The age of the patients ranged from 20-71 years, with a mean age of 52.5±2.3 years. The 1st degree GP (1st group) was recorded in 35 patients (they received conservative treatment). The 2nd and 3rd degree GP (2nd group) was established in 68 patients (treated by surgery). Results. Incidence by age: 24.7% of patients were of reproductive age; 38.1% – were in premenopause and 37.2% – in postmenopause. Clinical picture: 30.8% of patients had urinary disorders (urinary incontinence, frequent or difficult urination); 58.3% complained of a foreign body sensation and pain in the lower abdominal region; 10.9% – difficult defecation. Number of symptoms: 1st group: 68.6% had a single symptom and in 31.4% two symptoms were registered; 2nd group: 14.7% of patients had a single symptom; 70.5% – 2 symptoms; 10.3% – 3 symptoms and 4.41% – 4 symptoms. Obstetric anamnesis: 7.2% patients of the 1st group and 26% patients of the 2nd group had perineal ruptures in labour. The ultrasound parameters of the perineum were low in all patients: perineal thickness – 9.4- 9.8 mm; perineal height – 10.2-11.7 mm; height of the perineal body (perineum tendinous center) – 8.9-12 mm; thickness of the bulbospongiosus muscle – 8.2-11 mm; thickness of the levator ani muscle – 9.12-10.42 mm. Conclusions. Genital prolapse occurs due to a disruption of the perineal muscles’ integrity. The main methods of early diagnostics of the structural and functional changes of the perineum are the transvaginal and transrectal ultrasound examination.

2025-01-01T00:00:00Z Zemleanschih, Ecaterina Istrati, Nina http://repository.usmf.md:80/xmlui/handle/20.500.12710/30515 2025-05-16T10:22:28Z 2025-01-01T00:00:00Z

Vestibular migraine. Pathogenesis, differential diagnosis, treatment method Zemleanschih, Ecaterina; Istrati, Nina Introduction. Vestibular migraine (VM) is probably the second most common cause of dizziness, affecting approximately 3% of population. In recent years, the appearance of new studies aiming to understanding the pathophysiology of VM. Methods and outcomes. This abstract presents a detailed analysis of recent articles and research on VM from the sources like PubMed, ScienceDirect and others published in last 5 years. Results. The clinical presentation of VM is diverse. Episodes of dizziness usually last between 5min and 72h, although shorter and longer episodes have been reported. Differential diagnoses include Meniere’s disease, benign paroxysmal positional vertigo, brainstem aura, transient ischemic attack, persistent perceptual postural vertigo, and episodic type 2 ataxia. Episodes can be accompanied by other symptoms of migraine, including migrainous headache, photophobia, phonophobia and visual aura. The pathophysiology of VM is incompletely understood. Both environmental and genetic factors are likely to be important and recent studies have suggested possible loci of interest at 5q35 and 22q12. One proposed mechanism is hypoperfusion of the inner ear during migrainous attacks secondary to vasospasm resulting in vertiginous symptoms. Alternatively, episodes may be due to sensitization and activation of the trigeminovascular system leading to release of the pro-inflammatory neuropeptides substance P and calcitonin gene-related peptide (CGRP), which has connections with brain areas associated with processing of nociceptive information as well as thalamic and vestibular-associated cortices. Studies using standard methods have shown that migraine treatments can also be effective for VM. For acute attacks, abortive treatment includes triptans and antiemetics to manage headache and vestibular symptoms. Preventive strategies involve pharmacological options like beta-blockers, tricyclic antidepressants, anticonvulsants, and calcium channel blockers with reduction of triggers, physical therapy and mitigation of comorbidities. Conclusions. VM is a complex disorder with evolving diagnostic and therapeutic approaches. Recent research has significantly improved our understanding of its pathogenesis and management. Further studies are needed to validate novel treatment strategies and refine diagnostic criteria.

2025-01-01T00:00:00Z Saidacari, Cătălina Șevcenco, Nina http://repository.usmf.md:80/xmlui/handle/20.500.12710/30514 2025-05-16T10:21:49Z 2025-01-01T00:00:00Z

The role of bacterial plaque in gingival pathogenesis Saidacari, Cătălina; Șevcenco, Nina Background. Currently, catarrhal gingivitis is one of the most common chronic conditions in humans. This condition is primarily caused by bacterial plaque, which promotes gingival inflammation. Bacterial plaque contains microorganisms and metabolic products that, through toxins and enzymes, cause immune and inflammatory changes in the gingival tissue at both the cellular and molecular levels. In the absence of proper oral hygiene, the virulence of microorganisms increases, triggering an inflammatory process manifested by changes in the color, texture, and volume of the gums, as well as bleeding during brushing. Materials and methods. Case Presentation. The patient L. T., 13 years old, underwent a clinical examination at the Integrated Specialized Consultative Department of the IMSP Mother and Child Center, accompanied by her parents. She reported pain and sensitivity during eating, bleeding, and discomfort while brushing her teeth. At the clinical examination, the following indices were determined: oral hygiene index OHI-S and papillary-marginal-alveolar (PMA - Parma 1960). Results. Using the Oral Hygiene Index by G. Green and I. Vermillion, an unsatisfactory level of oral hygiene was observed, with a value of 2.6. The evaluation of inflammation according to the PMA index indicated moderate gingival inflammation, ranging from 47%. The established diagnosis was generalized chronic catarrhal gingivitis, moderate form. The treatment plan aimed at symptom relief and the elimination of local causative factors through bacterial plaque control. Treatment steps: symptom relief, professional ultrasonic cleaning and brushing with "Orbis Prophy" paste, local antiseptic and anti-inflammatory treatment with "Oramet" gel applied to the gums for 7-10 days, twice a day, and "Celista" spray 3-4 times a day. Conclusions. The knowledge of dental plaque as an etiological factor in the development of gingivitis, as well as the adoption of control measures for it, is essential because the signs of gingivitis disappear quickly with the application and maintenance of preventive measures.

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