Clujul medical (1957)最新文献

The orocutaneous fistulous tract of odontogenic origin is often a diagnostic challenge, due to its rare manifestation and absence of dental signs and symptoms. The odontogenic cutaneous fistula is often misdiagnosed as a superficial skin lesion of non-odontogenic origin delaying the treatment. The diagnosis and treatment must be precise and swift to improve the clinical outcome and minimize the complications. This article presents a rare case of odontogenic keratocyst involving a linguoverted impacted third molar presenting as orocutaneous fistula. The patient was initially treated with empirical antibiotic therapy with no resolution of the cutaneous fistula and thickening of the skin around the sinus opening resulting in cosmetic deformity. Once the fistula was attributed to the underlying odontogenic cyst, treatment was done by cyst enucleation along with the extraction of tooth and fistula excision. The purpose of the paper is to emphasize the importance of early and accurate diagnosis and prompt management of the orocutaneous fistula due to the odontogenic origin.

Background: Thrombin is a key factor of hemostasis, mediating the conversion of fibrinogen into fibrin. Along with prothrombin, of which thrombin is the active derivative, it has been found locally expressed in the central nervous system. This article aims to describe the role of thrombin in the normal functioning of the central nervous system and stroke.

Methods: In this mini-review, the specialized databases Medscape, PubMed, and Web of Science, from the years 2003-2018, were used to find relevant documents by using MeSH terms: "thrombin" and "stroke".

Results: Prothrombin and thrombin influence neural development, protection and regeneration, thrombin being a relatively strong regulating factor of brain function. However, high levels of thrombin are detrimental to neuronal health, and cause atherosclerotic plaque development and instability - a leading cause of cerebral infarction. In stroke, thrombin promotes direct cellular toxicity, vascular disruption, oxidative stress and inflammatory response. There is a direct correlation between thrombin activity in the affected brain hemisphere and the infarction volume. Direct acting thrombin inhibitors, like dabigatran, significantly decrease the risk of ischemic stroke.

Conclusion: Further studies on the correlation between thrombin levels, generation and activity and the risk and recurrence of ischemic cerebral stroke should give new insight on this association, resulting in an optimized practical therapeutic approach.

Introduction: The development of thyroid carcinoma is a complex process, in which both genetic and environmental factors play an important role. The rising incidence of thyroid neoplasm determines researchers to investigate factors implicated in this phenomenon. This article aims to elucidate the effects of the Chernobyl nuclear disaster on the Romanian population, studying the existing literature on radiation induced thyroid carcinoma. We analyzed the main studies published on this matter.

Methods: We used the PubMed and Google Scholar databases to search for articles upon the effects of the Chernobyl nuclear disaster on the incidence of thyroid carcinoma in the Romanian population. After a careful review of the existing literature, we selected the relevant and accessible studies, the first observation being that data on thyroid related effects of the Chernobyl nuclear disaster are scarce.

Results: From the selected studies, results show that there is a possible link between the Chernobyl fallout and the incidence of thyroid carcinoma. Multiple factors have been studied that play an important role in the increasing number of thyroid carcinoma cases, such as: better diagnostic techniques, incidentalomas, microcarcinomas and radiation exposure. In consequence it is difficult to measure the influence that the Chernobyl nuclear fallout has on thyroid carcinoma incidence.

Conclusion: Especially in pediatric patients, there seems to be a convincing evidence of radiation related thyroid carcinoma, while in adult patients the rising incidence due exclusively to nuclear fallout is not that clear. Further studies must be done on this matter to clearly see the influence radiation has on the incidence of thyroid cancer.

Background and aims: Although dental implants are widely and successfully used, failure rates because of bacterial colonization are still high. Adequate fabrication and sterilization techniques as well as proper management of infectious complications represent a constant field of interest and research. In this study, we focused our attention on implants with controlled porosity produced by Selective Laser Melting (SLM). The difficulty to sterilize porous implantable devices is well known and finding an adequate sterilization protocol represents a challenge worldwide. Before testing the biological and mechanical properties of porous implants, a preliminary study in order to determine a correct sterilization protocol must be conducted.Our aim was to establish a valid sterilization protocol for porous titanium alloy dental implants, as such protocols are not officially available yet.

Methods: Twenty dental implants were fabricated from a titanium alloy by SLM. Ten of them were made using a 150W laser beam (porosity of 1% - group A) and the rest using a 75W laser beam (porosity of 23% - Group B), all of them with a non-defined internal structure. The implants were initially sterilized (5 from group A and 5 from group B, using dry heat - 180°C for 2 hours; the rest using steam sterilization - 121 °C for15 min) and then spent 18 hours in culture media with developing bacteria (Bacillus cereus (ATCC 11778), Staphylococcus aureus (ATCC 49444), Enterococcus faecalis (ATCC 29212), Listeria monocytogenes (ATCC 19114), three Gram negative bacteria: Escherichia coli (ATCC 25922), Salmonella typhimurium (ATCC 14028) and Pseudomonas aeruginosa (ATCC 27853). The first ten implants (5 from group A and 5 from group B) were then sterilized with dry heat and the others with steam. After sterilization, they were all placed in sterile culture media in order to observe if any bacterial growth were present.

Results: The culture media was observed 18 hours after the sterilized implants were placed inside. No bacterial growth was observed.

Conclusions: Our tests reached their aims of defining a protocol to sterilize porous implants. Future tests regarding biological and mechanical aspects of these implants may now follow.

Background and aim: Oral health status and oral health related quality of life (OHRQoL) of working adolescents has been very little reported in literature. Therefore, this study aimed to determine oral health status and OHRQoL in a group of adolescent workers.

Methods: This cross-sectional study was conducted in an apprentice training center in western Turkey between December 2016 and January 2017. The study group population was 585, and the sample size was 514 students between 14 and 18 years old. The Decayed, Missing, and Filled Teeth (DMFT) Index, the Turkish version of the Oral Health Impact Profile-14 (OHIP-14), and a form requesting the socio-demographic information of the students were used as data collection tools. Permissions were obtained from the relevant school, parents, students, and ethical committee. The data were analyzed using descriptive statistics, the Student's t-test, and the Pearson correlation coefficient.

Results: The results showed significant relationships between the tooth brushing frequency, dental visit frequency, dental trauma history, smoking, and the OHIP-14 subdomains (p < 0.05).

Conclusion: Poor oral health and a lack of good oral health attitudes may have negative impact on the oral health related quality of life (OHRQoL) of working adolescents. Dental health education programs in collaboration with schools and dental health services may be beneficial for promoting oral health and improving the OHRQoL of working adolescents.

Background and aims: Despite their usefulness, CT-guided procedures have a low profile in Romania. The current study has the purpose of describing a first experience in performing these procedures.

Methods: Tumors and fluid collections that were inaccessible for biopsy or drainage by ultrasound or endoscopic guidance were included. The procedures were performed using a 64-slice GE Optima CT660 CT scanner. The biopsies were carried out using the coaxial technique with an 18 G semiautomatic needle. The drainages were performed using 10 F pig-tail drains that were inserted using the Seldinger technique. Data regarding the size and location of the target lesion, puncture technique, success and complication rates were recorded.

Results: Between May 2017 and April 2018, 30 procedures were performed, of which 26 biopsies and 4 drainage insertions. Of the biopsies 3 were mediastinal, 8 pulmonary, 6 retroperitoneal, 4 pelvic, and 5 of the bone. The drainages were performed for pelvic lymphoceles. The average lesion size was 3.2 cm (0.7-9 cm), with a depth from the skin of 9.1 cm (0.6-15.2 cm). The average procedure duration was 58 minutes (31-93 minutes). A conclusive histopathological diagnosis was set after 92.3% of biopsies. Three procedures resulted in complications, two being minor (hemothorax, soft tissue hematoma) and one severe (tension pneumothorax requiring drainage).

Conclusions: CT guidance offers safe access to lesions that cannot be biopsied or drained under ultrasound or endoscopic guidance.

Background and aims: The purpose of the present study was to measure the prevalence of problem and pathological gambling in children and adolescents at a national level, given that previous studies at regional level had demonstrated high rates of prevalence.

Methods: After designing the sample (2006 children and adolescents aged 11-19 years) we used two validated instruments for measuring the prevalence of problem and pathological gambling in children and adolescents - South Oaks Gambling Screen -Revised for Adolescents (SOGS-RA) and 20 Questions of Gamblers Anonymous Revised for Adolescents (20 GA-RA).

Results: The following data have been found: gambling at risk is 7.1% and problem and pathological gambling is 4%, when results were analyzed by SOGS-RA; prevalence of problem gambling is 10.1% and pathological gambling is 2.6% when results were analyzed by 20 GA-RA.

Conclusions: High rates of prevalence are noticed in Romania, similar to other European countries. This rates are based on self-reported questionnaires, meaning that real rates may be higher than reported, being known that children and adolescents tend to give socially expected response. An important issue is that we found pathological gambling at the age of only 11 years. Our results compared to those of other studies from Romania are very similar to those from other European countries.

Introduction: Active pharmaceutical ingredients are present in various sections of the environment, because of both the human and veterinary use of medicinal products. Ways of minimizing the risk of environmental contamination should be observed during all pharmaceutical activities (research, manufacturing, prescribing, dispensing and disposal of medicinal products).

Methods: For the present study we searched specific literature on this subject, using the main international databases (Thomson Reuters - Web of Science, SCOPUS and Science Direct).

Results: This narrative review focuses on the main aspects concerning environmental contamination with medicinal products. Consequently, the present study is structured on four different topics: environmental research on medicinal products, minimizing environmental contamination, waste disposal management and towards a greener community pharmacy.

Conclusion: Waste management activities are important for reducing the presence of active pharmaceutical ingredients in the environment. Pharmacists should inform patients on proper pharmaceutical waste disposal and organize collection programs for unused and expired medicines, in order to develop a greener pharmacy for the future.

Background and aims: The parameters evaluated during 24-hour ambulatory blood pressure monitoring were reported to be predictors of cardiovascular events. We aimed to investigate mean blood pressure, blood pressure variability and pulse pressure during 24-hour ambulatory blood pressure monitoring in type 2 diabetes patients and to establish their relationship with the presence of atherosclerotic cardiovascular disease (CVD).

Methods: The observational study included type 2 diabetes patients randomly selected and distributed in 2 study groups depending on the presence of atherosclerotic cardiovascular disease: CVD(-), n=90, and CVD(+), n=87. Daytime, nighttime and 24-hour systolic and diastolic blood pressure were monitored and mean blood pressure, blood pressure variability and pulse pressure were calculated.

Results: The study groups were comparable as age, gender ratio, smoking status, body mass index and abdominal circumference. Diabetes and hypertension duration were significantly higher in the CVD(+) group. Mean systolic and diastolic blood pressure, blood variability, dipper prevalence did not differ between study groups. Pulse pressure was significantly higher in the CVD(+) group compared to CVD(-) group (daytime pulse pressure 56.2±13.1 vs. 50.6±11.3 mmHg, p=0.003; nighttime pulse pressure 56.5±14.2 vs. 50.7±12.4 mmHg, p=0.005; 24-hour pulse pressure 54.7±13.6 vs. 49.0±12.0 mmHg, p=0.003).

Conclusions: Ambulatory pulse pressure was significantly higher in patients with type 2 diabetes and atherosclerotic cardiovascular disease compared to those without cardiovascular disease, although mean systolic and diastolic blood pressure and blood pressure variability were similar.

Aim: The aim of this study was to compare the antimicrobial efficacy of cysteamine, calcium hydroxide[Ca(OH)2], triple antibiotic paste (TAP), chlorhexidine (CHX) and their combinations against Enterococcus faecalis (E. Faecalis).

Methods: The E. Faecalis eradication capacity of cysteamine, Calcium hydroxide (Ca[OH]2), TAP, CHX, and their combinations was tested on E. Faecalis by Kirby Brauer disc diffusion method.

Results: Cysteamine in combination with TAP was able to completely eradicate E. Faecalis within 24 hours. Ca(OH)2 was unable to show its effect on E. Faecalis in the given time.

Conclusion: Cysteamine increased the E. Faecalis eradicating capacity of TAP and also showed positive results when used in combination with Ca(OH)2, which if used alone was unable to show any action in 24 hours.