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Considerations Regarding the Professional Practicing Choice of the Students from the Medical Faculties in Romania 关于罗马尼亚医学院学生专业执业选择的思考
Pub Date : 2021-03-01 DOI: 10.2478/amtsb-2021-0001
Simona Pârvu Beu
Abstract Analysing students’ options regarding the specialty and the country in which they want to practice, provides useful information in judicious planning of human resources in the health system, the factors that motivate the choice, being both personal, difficult to change, but also economic or social that can be influenced by legislation, so that the number of deficient specialties decreases, and the disparity of the ensuring the medical services in urban to rural areas is reduced. This paper is a qualitative study, with voluntary response, applied to students of public and private medical schools in Romania, that investigates the intention to the professional practicing choice after graduation and the reasons of their decisions. The results show the orientation towards the urban environment in a percentage of 100% or for migration - between 2.2% and 50%. Regarding the chosen specialties, the results show that the most frequently chosen specialties were as follows: cardiology, surgery, internal medicine, specialties considered deficient in 2020.(1)
摘要分析学生对专业和他们想实习的国家的选择,为明智地规划卫生系统的人力资源、激励选择的因素提供了有用的信息,这些因素既有个人的、难以改变的,也有可能受到立法影响的经济或社会的,从而减少了短缺专科的数量,缩小了城乡医疗服务保障的差距。本文是一项针对罗马尼亚公立和私立医学院学生的定性研究,采用自愿回答的方式,调查他们毕业后选择专业执业的意愿及其决定的原因。结果显示,对城市环境的取向为100%,或对移民的取向为2.2%至50%。关于选择的专业,结果显示,最常选择的专业如下:心脏病学、外科、内科,以及2020年被认为有缺陷的专业。(1)
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引用次数: 0
The Damage of Ocular Surface Due to Uncontrolled Intraocular Pressure in Neovascular Glaucoma 新生血管性青光眼眼压失控对眼表的损害
Pub Date : 2021-03-01 DOI: 10.2478/amtsb-2021-0008
A. Panga, D. Stănilă, A. Stănilă, A. Jurca
Abstract Neovascular Glaucoma (NVG) is a severe form of glaucoma characterized by neovascularization and the proliferation of fibrovascular tissue in the anterior chamber angle. Patients with NVG generally present with elevated intraocular pressure (IOP) and may experience severe pain. Ocular surface is affected by high IOP and can lead from moderated to marked conjunctival congestion that is frequently associated with edematous cornea. The aim of the study is to show how the high IOP can affect the ocular surface of the NVG patients and how we can treat and prevent the suffering. Materials and methods: We took in the study a number of 38 eyes from 35 patients with NVG in stage 3 with angle closure glaucoma, that presented high IOP and impaired ocular surface. Results and discussions: The ocular surface was damaged in patients that presented IOP between a minimum of 38 mmHg and maximum of 89 mmHg. The symptoms that patients presented were: conjunctival congestion in particular perikeratic, epithelial and stromal corneal edema, epithelial bubble, corneal ulcerations. Treatment followed rapid drop in IOP and the restoration and protection of ocular surface. The management of neovascular eye with high IOP was medical, laser and surgical. The restoration of ocular surface was made with lubricating hyperosmotic ophthalmic solutions, regenerative and protective agents. In all cases after the treatment was performed the ocular surface was restored. Conclusions: NVG is a very difficult pathology and is very hard to manage. The uncontrolled IOP in NVG patients affect the ocular surface and leads to complications. Long-term maintenance of normal intraocular pressure is important in NVG management but also in protecting the ocular surface.
摘要新血管性青光眼(NVG)是一种严重的青光眼,其特征是前房角的新生血管和纤维血管组织增生。NVG患者通常表现为眼压升高,并可能出现严重疼痛。眼表面受到高眼压的影响,可导致结膜充血,这种充血通常与角膜水肿有关。本研究的目的是展示高眼压如何影响NVG患者的眼表,以及我们如何治疗和预防这种痛苦。材料和方法:我们从35名NVG 3期闭角型青光眼患者中选取了38只眼睛进行研究,这些患者表现为高眼压和眼表受损。结果和讨论:眼压在最低38毫米汞柱至最高89毫米汞柱之间的患者眼表受损。患者出现的症状是:结膜充血,尤其是角周充血、上皮和基质角膜水肿、上皮泡、角膜溃疡。治疗后IOP迅速下降,并恢复和保护眼表。高眼压新生血管眼的治疗包括医学、激光和外科手术。采用润滑性高渗眼用溶液、再生剂和保护剂进行眼表修复。在所有病例中,在进行治疗后,眼表面都得到了恢复。结论:NVG是一种非常困难的病理学,很难处理。NVG患者的眼压失控会影响眼表并导致并发症。长期维持正常眼压在NVG管理中很重要,但在保护眼表方面也很重要。
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引用次数: 0
Behavioural Etiological Factors that Contribute to the Occurrence of Severe Early Childhood Caries 导致幼儿严重龋病发生的行为病因学因素
Pub Date : 2021-03-01 DOI: 10.2478/amtsb-2021-0019
D. Eşian, C. Bică, Anamaria Bud, O. Stoica, E. Bud
Abstract Severe early childhood caries (S-ECC) is one of the most common pathologies affecting primary dentition. The complex etiology is the result of the interaction of microbial factors and also of dietary factors. For this study a group of 40 children diagnosed with S-ECC was compared with a control group of 35 children without caries. The study data was obtained through clinical examination of both children and mothers, and on the basis of a questionnaire completed by the mothers of the subjects. The odontal status of the mothers was evaluated by determining the DMFT index. The results of the study showed that the mothers of the subjects with S-ECC had a significantly higher DMF-T caries index than the ones in the control group and that there is a close link between the birth of the child, newborn feeding method, mother’s habits, cariogenic diet and the occurrence of severe early childhood caries.
严重幼儿龋病(Severe early childhood龋齿,S-ECC)是影响初级牙列最常见的疾病之一。复杂的病因是微生物因素和饮食因素相互作用的结果。在这项研究中,40名被诊断为S-ECC的儿童与35名没有龋齿的对照组儿童进行了比较。研究数据是通过对儿童和母亲的临床检查获得的,并以受试者母亲填写的问卷为基础。通过测定DMFT指数来评价母亲的牙齿状况。研究结果显示,S-ECC受试者的母亲DMF-T龋指数明显高于对照组,儿童的出生、新生儿喂养方式、母亲的生活习惯、致龋饮食与儿童早期严重龋的发生有着密切的联系。
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引用次数: 0
Predictive Biological Markers for Anastomotic Leakage after Curative Surgery for Colorectal Cancer 癌症大肠癌术后吻合口瘘的预测生物学标志物
Pub Date : 2021-03-01 DOI: 10.2478/amtsb-2021-0014
Erika Bimbo-Szuhai, A. Maghiar, A. Huniadi, M. Șandor, M. Botea, Codruța Macovei, Corina Beiușan, Claudia Teodora Judea Pusta
Abstract anastomotic leakage is one of the most important postoperative complications for colorectal cancer patients undergoing curative surgery. Early recognition of patients in risk would be essential for preventing the high mortality rates associated with these complications. C reactive protein (PCR), tumour necrosis factor (TNF-alpha), cortisol levels and granulocyte/lymphocyte ratio (G/L) were compared in this period in patients who developed leakage vs patients without this complication. Material and methods: 52 colorectal cancer patients who underwent elective surgery in a private clinical hospital were evaluated preoperatively and postoperatively for the patients. Results: 14 patients (26,9%) developed clinically significant anastomotic leakage. The best cut-off value for preoperative G/L ratio of 5,8 had sensitivity of 71,43% and specificity of 73,68%. Conclusions: Preoperative G/L ratio can be used as a largely available tool for identifying the colorectal cancer patients at high risk for anastomotic leakage.
摘要吻合口瘘是癌症大肠癌术后最重要的并发症之一。早期识别有风险的患者对于预防与这些并发症相关的高死亡率至关重要。C反应蛋白(PCR)、肿瘤坏死因子(TNF-α)、皮质醇水平和粒细胞/淋巴细胞比率(G/L)在这一时期对发生渗漏的患者和没有这种并发症的患者进行了比较。材料与方法:对52例在私立临床医院接受择期手术的癌症患者进行术前和术后评估。结果:14例(26,9%)患者出现临床显著吻合口瘘。术前G/L比值为5,8的最佳截止值的敏感性为71,43%,特异性为73,68%。结论:术前G/L比值可作为识别癌症吻合口瘘高危患者的一种广泛可用的工具。
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引用次数: 0
Intramuscular Abdominal Wall Endometriosis, an Unusual Finding for General Surgeon 肌内腹壁子宫内膜异位症,普通外科医生的不寻常发现
Pub Date : 2021-03-01 DOI: 10.2478/amtsb-2021-0012
A. Mihețiu, D. Bratu, O. Popescu
Abstract Defined as the ectopic development of uterine tissue outside the uterine cavity, endometriosis is an increasingly common condition that can lead to various complications from chronic pain syndrome, infertility, obstruction due extrinsic compression to malignancy of endometriosis foci. Extrapelvic positioning of endometriosis is rare, diagnosis can be difficult both clinically and imaging, and treatment does not always ensure the absence of recurrences.
摘要子宫内膜异位症被定义为子宫腔外子宫组织的异位发育,它是一种越来越常见的疾病,可导致各种并发症,从慢性疼痛综合征、不孕、外源性压迫引起的梗阻到子宫内膜异位病灶的恶性。子宫内膜异位症的盆腔外定位是罕见的,临床和影像学诊断都很困难,治疗并不总是确保没有复发。
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引用次数: 0
Dril Procedure: Treatment for Vascular Access Induced Hand Ischemia. Case Report 钻孔程序:治疗血管通路引起的手部缺血。病例报告
Pub Date : 2021-03-01 DOI: 10.2478/amtsb-2021-0007
Claudiu Helgiu
Abstract Native vascular access (AVF arteriovenous fistula) for chronic hemodialysis (CH) performed proximally to the diabetic patient, between the brachial artery and the basilic vein or cephalic vein, determines the risk of distal (hand) ischemia. The correction of the ischemia can be done differently depending on its severity, starting from the vasodilator medication, reaching the cancellation of the vascular access with the accomplishment of the chronic hemodialysis on the central venous catheter. DRIL procedure (Distal Revascularization and Interval Ligation) corrects distal ischemia while maintaining functional vascular access, an important aspect in diabetic patients in whom vascular capital is deficient. We further describe a case of a diabetic patient with right L-T brachiocephalic arteriovenous fistula, with important ischemic phenomena in which the DRIL procedure resolved the ischemia, the patient using vascular access as usual, the second postoperative day.
摘要糖尿病患者在臂动脉和基底静脉或头静脉之间进行的慢性血液透析(CH)的固有血管通路(AVF动静脉瘘)决定了远端(手)缺血的风险。根据缺血的严重程度,可以采取不同的方法来纠正缺血,从血管舒张药物开始,到通过在中心静脉导管上进行慢性血液透析来取消血管通路。DRIL程序(远端血运重建和间隔结扎)纠正远端缺血,同时保持功能性血管通路,这是血管资本不足的糖尿病患者的一个重要方面。我们进一步描述了一例患有右L-T臂头动静脉瘘的糖尿病患者,该患者具有重要的缺血现象,其中DRIL程序解决了缺血,患者在术后第二天照常使用血管通路。
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引用次数: 0
Colonization of Candida After the Placement of a Tongue Piercing, a Case Report 舌穿孔后念珠菌定植一例报告
Pub Date : 2020-12-01 DOI: 10.2478/amtsb-2020-0076
Szende Ledan-Muntean, Bianca Tudor
Abstract The practice of piercing the body’s different areas is a commonly observed form of body modification. It implies puncturing the skin tissue resulted in an opening, in which specific jewellery or an intradermal implant could be inserted. The tongue piercing is a highly popular form of this practice, but can be followed by multiple acute and chronic complications, such as bacterial and fungal infections. Our case describes the clinical situation of a 25 year old immunocompetent woman, who sought medical help after observing tissue abnormalities, following a newly inserted tongue piercing. We identified a correctly and professionally placed tongue jewellery associated with all clinical hallmarks of oral Candidiasis. Our aim was to microbiologically identify and treat the present yeast colonies.
摘要刺穿身体不同部位的做法是一种常见的身体改造形式。这意味着刺穿皮肤组织会产生一个开口,可以在其中插入特定的珠宝或皮内植入物。舌头穿孔是这种做法的一种非常流行的形式,但随后可能会出现多种急性和慢性并发症,如细菌和真菌感染。我们的病例描述了一名25岁的免疫活性女性的临床情况,她在新插入舌头穿孔后观察到组织异常后寻求医疗帮助。我们发现了一种正确且专业放置的舌头首饰,与口腔念珠菌感染的所有临床特征相关。我们的目的是从微生物学上鉴定和处理目前的酵母菌落。
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引用次数: 1
Immediate Postextractional Implant Insertion in Posterior Maxilla. Therapeutic Attitude 后上颌即刻拔除种植体植入术。治疗的态度
Pub Date : 2020-12-01 DOI: 10.2478/amtsb-2020-0078
D. Dumitra, V. Nicolae
Abstract The immediate postextractional implant insertion is a specific way of surgical approach to implanto-prosthetic treatment. This article addresses the indications, advantages, and surgical techniques of immediate postextraction insertion, illustrated with a clinical case. Objectives: presentation of the indications, advantages and surgical procedure of immediate postextractional implant insertion. Materials and methods: The present study considered the presentation of a case in which we opted for the insertion of implants immediately postextractionally as a therapeutic attitude. Results and discussions: The advantages and disadvantages of this therapeutic technique were represented as follows. The advantage of this technique is given by the shortening of the time necessary to complete the treatment until the prosthetic phase, the disadvantage being represented by the insertion of the implant in positions sometimes less advantageous to the prosthesis. Also, the fact that we could not preserve the alveolar ridge, keeping the bone volume necessary to insert the implant in the best position of the prosthesis by complying with the biomechanical principles, made over time, a series of complications that occurred due to vicious insertion of the implant and non-compliance with those biomechanical principles. Conclusions: The analysis of the case as a whole, represents the main premise from which any dental treatment must be started, so that the functionality of the prosthetic and aesthetic reconstruction will have to be taken into account when we choose the best treatment option.
摘要拔出后即刻植入是植入假体治疗的一种特殊手术方法。本文介绍了拔出后立即插入的适应症、优点和手术技术,并结合一个临床病例进行了说明。目的:介绍拔出后立即植入植入物的适应症、优点和手术程序。材料和方法:本研究考虑了一个病例,在该病例中,我们选择在拔出后立即插入植入物作为一种治疗态度。结果与讨论:该治疗技术的优点和缺点如下。这种技术的优点是缩短了完成治疗直到假体阶段所需的时间,缺点是将植入物插入有时对假体不太有利的位置。此外,随着时间的推移,我们无法通过遵守生物力学原理来保留牙槽嵴,保持将植入物插入假体最佳位置所需的骨体积,这是由于植入物的恶性插入和不遵守这些生物力学原理而发生的一系列并发症。结论:对整个病例的分析代表了任何牙科治疗必须开始的主要前提,因此在我们选择最佳治疗方案时,必须考虑到假体的功能和美学重建。
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引用次数: 0
The Influence of Risk Factors on the Choice of Therapeutic Method in Peripheral Arterial Disease 外周动脉疾病危险因素对治疗方法选择的影响
Pub Date : 2020-12-01 DOI: 10.2478/amtsb-2020-0066
Oana Stoia, I. Manițiu, Ioan Bitea, Gabriela Eminovici, M. Teodoru
Abstract Peripheral arterial disease (PAD) is characterized by obstruction in the lower limbs, mainly due to atherosclerosis. The prevalence of the pathology in people under 40 years of age is 6% and 15-20% in the population over 65 years old.(1,2) Approximately 50% of the affected persons are, at the time of examination, asymptomatic.(3) The most important risk factors associated with this condition are smoking, diabetes mellitus (DM), high cholesterol and high blood pressure (HBP). The current study shows that, regardless of the association of risk factors or pre-hospital treatment, these patients do not benefit from a certain type of treatment (drug or interventional), which corresponds to the existing data in the literature, which do not document the choice of type of treatment depending on the patient’s age or comorbidities.
摘要外周动脉疾病(PAD)以下肢阻塞为特征,主要由动脉粥样硬化引起。40岁以下人群的病理学患病率为6%,65岁以上人群的患病率为15-20%。(1,2)在检查时,大约50%的受影响者没有症状。(3) 与这种情况相关的最重要的危险因素是吸烟、糖尿病(DM)、高胆固醇和高血压(HBP)。目前的研究表明,无论风险因素或院前治疗的关联如何,这些患者都不会从某种类型的治疗(药物或介入治疗)中受益,这与文献中的现有数据相对应,文献中没有记录根据患者年龄或合并症选择的治疗类型。
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引用次数: 0
Haemorrhagic Cerebrovascular Accident (CVA) Etiology and Case Report 出血性脑血管意外(CVA)病因及病例报告
Pub Date : 2020-12-01 DOI: 10.2478/amtsb-2020-0061
M. Luchian, A. Saceleanu
Abstract A haemorrhagic cerebrovascular accident refers to a spontaneous bleeding in the cerebral parenchyma, located either supratentorial or infratentorial, that occurs in the absence of a surgical or traumatic cause. The incidence is estimated at 12-15 new cases per 100.000 inhabitants per year. Intracranial haemorrhage is the third most frequent cause of stroke, the vast majority being represented by primary/hypertensive (spontaneous) intracerebral haemorrhage, ruptured saccular aneurysm, a vascular malformation or haemorrhage associated with the use of anticoagulants or thrombolytic agents. A cerebral tomography computer examination is the examination of choice in diagnosis of haemorrhagic CVAs. The treatment can be either therapeutic or surgical, depending on the case, with the consideration that an immediate medical treatment is mandatory for the best odds of recovery.(1)
出血性脑血管意外是指在没有手术或创伤原因的情况下,发生在幕上或幕下的脑实质自发性出血。据估计,发病率为每年每10万居民12至15例新发病例。颅内出血是中风的第三大常见原因,绝大多数是原发性/高血压性(自发性)颅内出血、囊状动脉瘤破裂、血管畸形或与使用抗凝血剂或溶栓剂相关的出血。脑断层计算机检查是诊断出血性cva的首选检查。治疗可以是治疗,也可以是手术,视情况而定,考虑到必须立即进行药物治疗,以获得最大的康复机会。
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引用次数: 0
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Acta Medica Transilvanica
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