Clujul medical (1957)最新文献

Background: In recent years, fibre-reinforced composite posts have been proposed for the restoration of root filled teeth as an alternative to pre-fabricated posts or metal dowels.

Aims and objectives: The aim of the study was to analyze the effect of endodontic irrigants used for removal of calcium hydroxide on the push-out bond strength of fiber posts to root canal dentin.

Methods: Forty human permanent single-rooted mandibular premolars with relatively straight roots were taken and access cavities were prepared and biomechanical preparation done using Rotar Y protaper file till size F2. The samples were divided into Experimental group and Control group. In Experimental groups Intracanal dressing of calcium hydroxide was removed by 2.5% NaOCl and 17% EDTA (Group1), MTAD (Group II) and Qmix (Group III). Control group did not receive Intracanal calcium hydroxide dressing. Canals were obturated using size F2 protaper gutta-percha points and AH plus sealer. After storage for 24 hours, post space was prepared. Forty Tenax fiber post (Coltene) were cemented with Rely X U200 resin. The roots were then transversally sectioned into 3 slices of 1mm thickness corresponding to cervical, middle and apical third. The slices obtained were subjected to micro-push-out bond strength test using a universal testing machine. The data obtained was subjected to statistical analysis using One-Way ANOVA test. P value of .05 was considered as statistically significant level.

Results: The mean push-out bond strength values for controls, NaOCl/EDTA, MTAD and QMIX group at cervical third were 10.17, 15.84, 20.39 and 20.98 whereas at apical third 4.78, 8.85, 11.66 and 12.10.

Conclusion: Qmix showed higher push-out bond strength values followed by MTAD and NaOCl/EDTA. All the groups showed lowest push-out bond strength values in the apical third followed by middle and the maximum in the cervical region.

Gastrointestinal (GI) amyloidosis is rare and has varying clinical and endoscopic presentations. In this case series, we present three patients with primary systemic amyloid-light chain (AL) amyloidosis with GI involvement and complications of GI bleeding. We also provide a brief review of the literature, including clinical presentation, endoscopic findings, pathology, and management of GI amyloidosis. The endoscopic findings of GI amyloidosis can vary, including friable mucosa with erosions, ulcers, and submucosal hematomas or mucosal thickening with polypoid protrusions. The endoscopic findings may correlate with the pathologic deposition of amyloid fibrils. Treatment of GI amyloidosis is generally focused on management of the underlying condition and supportive care. Gastroenterologists should be familiar with the endoscopic findings as they may be the first suggestion of disease and allow for definitive diagnosis.

Background and aim: Developmental dysplasia of the hip (DDH) is a potentially disabling disease. There are many diagnostic approaches, Graf method ultrasonography being the most popular imaging method. Although considered as a healthy condition, the existence of hips at the 60 degree limit or the asymmetries higher than 4 degrees between left and right side may be a source of unfavorable evolution and consequently of late diagnosed dysplasia cases.

Methods: The retrospective study was conducted in the Radiology Department of the Emergency Clinical County Hospital Cluj-Napoca, by retrospective analysis of the database containing 3013 records of the subjects presented for DDH assessment between January 2008 and December 2014. The study focuses on investigating two possible sources of missed cases by clinical-ultrasound management of DDH: borderline and asymmetric hips. Two conditions were studied in patients considered healthy according to Graf method: borderline hips (those with α angle value of 60° and 61°) and asymmetric hips (left to right difference between the α angle values exceeds 4°). Three study groups were formed: healthy subjects, asymmetric/borderline subjects and patients with immature or mild dysplasia. The incidence of risk factors, clinical suspicion and the success of therapy were evaluated.

Results: There were no significant differences between the three groups regarding the role of the risk factors in DDH pathogenesis. Data reveal a high suspicion rate after the clinical examination, in groups II and III, compared to the healthy population. This means that from this point of view, Group II might be considered having at least a dysplastic prognosis. An increased correlation in the therapeutic results was observed between Group II patients and those from mild delayed maturation subgroups from Group III (IIa-, IIa+).

Conclusions: Asymmetric and borderline hips should be approached similarly to immature hips, clinical suspicion and the therapeutic outcome being similar.

Background and aims: It is very well know nowadays that despite all the good and qualitative information available, the patients who are supposed to be treated with radioiodine for differentiated thyroid cancer suffer from a lot of concerns prior the treatment. The aim of our study is to investigate the level of anxiety and lessening of the concerns pre and post RIT (radioiodine therapy) using a dedicated, special designed questionnaire.

Methods: A cross-sectional study of 54 differentiated thyroid cancer patients was conducted. Patients who met the inclusion criteria were invited to complete the radioprotection questionnaire pre and post RIT. The questionnaire comprises two sections (pre and post radioiodine treatment) with specific questions regarding aspects of radioprotection measures and the impact on the overall well-being. For uniform distribution of variables we used Pearson correlation and for monotonic relationship between variables, Spearman correlation.

Results: The pre-treatment questionnaire reported a strong confidence of the patients in the medical team, good and accurate information regarding the treatment, >50 % suffering from anxiety and concerns before the radioiodine treatment. The post treatment questionnaire revealed no fear of isolation, a lot of useful information and most of the patients would undergo another treatment, if necessary and also recommend it to others.

Conclusion: The milestone in having a good and compliant patient remains a very good communication between the medical team and the patient. We are able to influence and change things and have fewer patients with fear from radioactivity and treatment concerns if we dedicate enough time to give them the adequate information in the best way so it will be correctly received.

Background and aims: The nutritional disorders are modifiable predisposing factors of the current leading causes of morbidity and premature mortality, such as cardiovascular diseases, diabetes and cancers. An early recognition of appropriate interventions could decrease the burden of medical costs and increase the healthy life expectancy. The aims of our study were the description of nutritional status, its associated factors, and the detection of eating disorders among Romanian medical students of the "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca.

Methods: A cross-sectional study was conducted during the 2015-2016 academic year, including medical students from all study years, by an online questionnaire. The statistics, both descriptive and inferential, were calculated using EpiInfo.

Results: A total of 222 students from the University Romanian section were included, with a sex-ratio (men:women) of 0.22. The average body mass index of the medical students included was 21.3±3.3 kg/m2, for females it was 20.7±3 kg/m2 and for males 23.9±3.1 kg/m2. For the nutritional disorders such as overweight, the prevalence among males (30%) had a net predominance (p<0.001) over females (4.4%), while for underweight, it was prevalent only for female students (20.3%). Overweight was associated with low academic performance (odds ratio (OR)=7.2; 95% confidence interval (95% CI): 1-53.94), smoking (OR=2.4; 95% CI: 1-5.76) and binge drinking (OR=3; 95% CI: 1.26-7.25). Eating disorders were reported by 25.7% of the students and were significantly more prevalent in students in the second academic study cycle (47.4%; 95% CI: 34.7-60.3%) and in students with jobs (7%; 95% CI: 2.3-16.1%).

Conclusions: In this survey, two different distribution models of nutritional disorders for both genders were identified, with the predominance of overweight among men. Eating disorders were more prevalent among students in the second study cycle and those with jobs at the same time.

Hypertension is a major issue of public health because of its increasing prevalence and multiple complications caused by failing to achieve an efficient blood pressure control. Considering hypertension as a hemodynamic disorder allows to prescribe a tailored therapy guided by individual hemodynamic parameters, therefore leading to an increased rate of control. We present the case of a 59 years old diabetic, dyslipidemic and obese male who, although treated with 5 classes of antihypertensive drugs had uncontrolled hypertension that caused left ventricular failure. Using the HOTMAN system of hemodynamic monitoring using thoracic electrical bioimpedance allowed a quick identification of the cause and guided the therapy, achieving blood pressure control after 5 days of treatment. Treating hypertension by identifying the underlying hemodynamic imbalance allows prescribing a tailored therapy and shortens the initiation and stabilization phases of treatment.

The growing interest reflected in the studies on dental erosion is justified by the severe health problems it entails, i.e. esthetic, phonetic, masticatory disturbances and pulp complications. Most studies investigate the prevalence of dental erosion in adults and children, the severity of lesions and etiopathogenetic factors.

Background and aim: Dental erosions (DE) are one of the extraesophageal complications of gastroesophageal reflux disease (GERD). An increasing amount of papers shed light on this topic. We carried out a systematic review on the association between GERD and DE.

Methods: We studied the association between DE and GERD in adults and children. The search for published studies was performed in PubMed using search terms "dental erosion" and "gastro-esophageal reflux disease". References published since 2007 were included and a systematic review was carried out. Articles not assessing DE in GERD patients were excluded, and also case presentations and articles in languages of limited circulation. The prevalence of DE in patients with GERD, extrinsic and intrinsic etiological factors of DE and the severity of dental erosion lesions were analyzed.

Results: A total of 273 articles were found, 10 studies being retained for analysis. Correlations between DE and GERD, namely the prevalence and severity of dental erosion in GERD patients, were investigated. DE prevalence was between 10.6% - 42%, median 25.5%. Mean values of DE prevalence were 48.81% in GERD patients, compared to 20.48% in non-GERD controls. Comparative values of DE frequency in adults with GERD was 38.96%, compared to 98.1% in children with GERD.

Conclusions: DE is a condition associated with GERD. DE prevalence is higher in GERD patients. Intrinsic pathogenetic factors with direct action on the hard dental tissues are GERD, while extrinsic factors are represented by diet. Among the patients diagnosed with GERD, youth under the age of 18 had a higher frequency compared to adults.

Background and aims: Arteriovenous fistula (AVF) maturation failure rates remain high in patients with end-stage renal disease (ESRD). Although preoperative morphological and functional assessment of blood vessels by duplex ultrasonography (DUS) has been shown to improve AVF maturation, there is no consensus regarding the optimal vein (VD) and artery (AD) diameters to be universally used for AVF creation. To improve patient selection, set out to investigate if there is a correlation between preoperative VD/AD and clinical covariates, and postoperative AVF outcome.

Methods: This was a prospective cohort study conducted during January-August 2014. ESRD patients referred to "Niculae Stăncioiu" Heart Institute Cluj-Napoca, who had a VD ≥1.9 mm and AD ≥1.5 mm, as measured by DUS, and underwent AVF creation were enrolled. We assessed whether preoperative VD/AD and clinical covariates were associated with AVF maturation rate and primary patency at 2 years after AVF creation.

Results: Of 115 patients referred for AVF creation, 93 were included in the study. Mean (± standard deviation) VD was 3.3 ± 1.1 mm and VDs were distributed in quartile Q1 <2.55 mm, Q2: 2.56-3.10 mm, Q3: 3.11-3.70 mm and Q4: >3.71 mm. Mean AD was 3.3 ± 1.4 mm and ADs were distributed in Q1 <2.55 mm, Q2: 2.56-3.10 mm, Q3: 3.11-3.70 mm, and Q4, >3.71 mm. AVF maturation rate increased proportionally with VD from Q1 (62%) to Q2 (70%), Q3 (82%) to Q4 (96%) (p=0.03). Based on AD, a higher AVF maturation rate was observed in Q3 (86%), Q4 (83%) vs Q1 (71%) and Q2 (67%). Long-term primary patency of AVFs seemed not to be influenced by VD and AD. In older patients and those with peripheral arterial disease, AVF maturation failure tended to be higher.

Conclusions: Our findings suggest that a preoperative VD ≥1.9 mm and AD ≥1.5 mm have a successful maturation rate of AVF greater than 60% in ESRD patients. The maturation rate of surgical AVF increases proportionally with the size of VD used for AVF creation.

Background and aims: Cancer has emerged as the leading cause of death in human populations. The contribution of alcohol has been highly suspected. The purpose of this paper was to analyze the time trend of digestive cancers in Romania, in terms of mortality rates (1955-2012), and incidence rates (2008-2012), and the alcohol consumption data (1961-2010), aiming to find out if there is any association.

Methods: The data on six more common digestive cancers mortality rates (1955-2012) and incidence rates (2008-2012) were obtained from the historical and recent country statistics and publications of International Agency for Research on Cancer (IARC)/World Health Organisation (WHO), as age-standardized rate expressed per 100,000 population (ASRw). Data on alcohol consumption were obtained from the statistics and publications of WHO and United European Gastroenterology (UEG), as liters of pure alcohol/year.

Results: Between 1955-2012, the ASRw of mortality registered an increase of the cancers of the esophagus in M (from 2.03 to 3.90), and of colorectal cancer in both sexes (from 4.65 to 18.20 in M, and from 4.57 to 9.70 in F). Between 1980-2012, an increasing trend of mortality was registered, in both sexes, for the cancers of the pancreas (from 5.50 to 9.30 in M and from 2.92 to 5.10 in F) and liver (from 1.77 to 11.00, in M, and from 0.83 to 4.20 in F). In terms of incidence, between 2008-20012, an increasing trend of ASRw was registered for the cancers of the esophagus in M (from 3.90 to 4.30), gastric cancer in M (from 15.90 to 16.30), colorectal cancer in both sexes (from 27.60 to 34.50 in M and from 19.00 to 20.20 in F), pancreatic cancer in F (form 5.20 to 5.90), and liver cancer in M (from 8.10 to 9.20). Alcohol consumption per capita (liters pure alcohol/year) increased in the same period, from an average of 5 in 1961, to 12.8 in 2003-2005, and to 14.4 in 2008-2010.

Conclusions: Given the parallel increase of some digestive cancers and alcohol consumption registered in our area, alcohol could represent more than a coincidence.