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Medico-legal aspect of dental practice. 牙科执业的医疗法律方面。
Pub Date : 2018-07-01 Epub Date: 2018-07-31 DOI: 10.15386/cjmed-764
Upendra Singh Bhadauria, Pralhad L Dasar, N Sandesh, Prashant Mishra, Shaijal Godha

Law influences every aspect of human activity, and dentistry in this regard is no exception. Ethical standards of the dental profession are seeing a steady decline, altruistic concepts being overridden by a market driven system. A deficient knowledge regarding the medico-legal aspects halts the effective implementation and delivery of efficient services. The review thus provides an overview of ethical standards, consents and their types, negligence,, determination of negligence, liabilities of dental practitioners and solicitors in dental practices, which comprehensively form an integral part of the medico-legal aspect of dental practice.

法律影响着人类活动的方方面面,牙科在这方面也不例外。牙科行业的道德标准正在稳步下降,利他主义的概念被市场驱动的体系所推翻。医疗法律方面的知识不足阻碍了有效实施和提供高效服务。因此,该审查概述了牙科执业中的道德标准、同意书及其类型、疏忽、疏忽的确定、牙科医生和律师的责任,这些都是牙科执业医疗法律方面不可分割的一部分。
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引用次数: 0
Gheorghe Bȃrlea MD, PhD, pupil and collaborator of Professor Bilaşcu. georghe b<e:1>医学博士,博士生,bila<e:1>教授的学生和合作者。
Pub Date : 2018-07-01 Epub Date: 2018-07-31 DOI: 10.15386/cjmed-1068
Alexandru Rotaru, Cristian Barsu, Horatiu Rotaru

Being the first collaborator and assistant of Professor Gheorghe Bilaşcu, the founder of Cluj and National School of Dentistry, Dr. Gheorghe Bârlea kept very close to his master in developing the Dental Medicine in Cluj and in Romania, from 1908 to 1936. From the beginning of his career, he was involved in the establishment of the new Dental Clinic in the University of Superior Dacia as well as in the compilation of the teaching curriculum at the level of the avant-garde universities at that time. He was deeply involved in the recognition of Dentistry as discipline and medical practice and in the official achievement of the law and practice of this profession in Romania. Dr. Bârlea devoted his life and wotk to the cultural and social life of the Romanians, his efforts contributing to the Great Union of Romania. Passing away at an early age, Dr. Bârlea left Romanian dental profession without an important support.

作为克鲁日和国家牙科学院的创始人georghe bila教授的第一个合作者和助手,georghe b rlea博士在1908年至1936年期间在克鲁日和罗马尼亚发展牙科医学,与他的主人保持着非常密切的关系。从他的职业生涯开始,他就参与了苏必利尔达西亚大学新牙科诊所的建立,以及当时前卫大学水平的教学课程的编写。他深入参与了承认牙科是一门学科和医疗实践,并在罗马尼亚正式实现了这一专业的法律和实践。布赖亚博士毕生致力于罗马尼亚人的文化和社会生活,他的努力为罗马尼亚大联盟作出了贡献。布雷亚医生英年早逝,离开了罗马尼亚牙科行业,没有一个重要的支持。
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引用次数: 0
Cutaneous dental sinus of submental region: an eight years follow-up. 颏下区皮肤牙窦:8年随访。
Pub Date : 2018-07-01 Epub Date: 2018-07-31 DOI: 10.15386/cjmed-812
Pallav Mahesh Patni, Pradeep Jain, Hemalatha Hiremath, Swadhin Raghuwanshi, Prashansa Vijaywargia, Mona Jain Patni

A 22-year-old female patient had a history of a 7-month recurrent pus discharge from her chin. She had been previously treated by physicians, dermatologist, and surgeons. The sinus kept re-occurring and she was referred to dental hospital for opinion. The patient had cutaneous opening of size 5 mm × 6 mm with purulent discharge in submental region. Patient had undergone three surgical excisions and multiple antibiotic regimens. Patient had a history of trauma due to fall six years back. A 30 number standard gutta-percha was used to trace the sinus tract and dental origin was confirmed radiographically. The tract led to in-between the root canal apices of both mandibular incisors. Treatment included non-surgical endodontic treatment with both mandibular central incisors and antibiotic coverage following bacterial culture of discharge. The pus culture showed Streptococcus anginosus which was found to be sensitive to penicillin. Patient was kept on 1-week course of oral amoxicillin-clavulanate along with root canal therapy. The cutaneous sinus healed following root canal treatment and antibiotic coverage. On an 8-year follow-up skin of sub-mental region appeared normal and peri-apical healing with both mandibular central incisors was evident radiographically. Cutaneous lesions on face may be of dental origin. A cross referral between dentists, physicians, surgeons, and dermatologists should be considered in such cases.

22岁女性患者有7个月复发性下颚脓液排出史。她以前接受过内科医生、皮肤科医生和外科医生的治疗。鼻窦不断复发,她被转到牙科医院寻求意见。患者有5mm × 6mm大小的皮肤开口,并在颏下区有脓性分泌物。患者接受了三次手术切除和多种抗生素治疗。病人六年前因跌倒而有外伤史。使用30号标准杜仲胶追踪鼻窦道,放射学证实牙源。该通道通向两下颌门牙根管尖的中间。治疗包括下颌骨中切牙的非手术根管治疗和出院细菌培养后的抗生素覆盖。脓液培养为对青霉素敏感的血管链球菌。患者口服阿莫西林-克拉维酸酯治疗1周,同时进行根管治疗。经根管治疗及抗生素治疗后,皮肤窦愈合。在8年的随访中,颏下区皮肤表现正常,双侧下颌中切牙根尖周围愈合明显。面部皮肤病变可能是由牙齿引起的。在这种情况下,应考虑牙医、内科医生、外科医生和皮肤科医生之间的交叉转诊。
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引用次数: 2
Fecal transplantation: digestive and extradigestive clinical applications. 粪便移植:消化和外源性的临床应用。
Pub Date : 2018-07-01 Epub Date: 2018-07-31 DOI: 10.15386/cjmed-946
Mihaela Filip, Valentina Tzaneva, Dan L Dumitrascu

Background and aim: Fecal transplantation or fecal material transplantation (FMT) became a hot topic in gastroenterology in recent years. Therefore it is important to disseminate the up-to-date information on FMT. The aim of the paper is to review the knowledge on FMT and its clinical applications.

Methods: An extensive review of the literature was carried out. Titles from Pubmed were searched and analyzed. A narrative review has been written with emphasis on indications of FMT in different conditions.

Results: The guidelines recommend FMT in relapsing infection with Clostridium difficile. Several attempts to use FMT in other conditions have been analyzed. Attempts were recorded in other bowel disorders like IBD, IBS, chronic constipation and even colorectal cancer. The attempt to change the microbiota by FMT in diabetes and obesity represent challenges for the future.

Conclusions: Fecal transplantation represents an important therapeutic method, intensively investigated these years. Beside the indication for persistent and recurrent Clostridium difficile infection, several attempts were undertaken in other intestinal diseases and in metabolic conditions. The efficiency of these applications has to be demonstrated.

背景与目的:粪便移植或粪便材料移植(FMT)是近年来胃肠病学研究的热点。因此,传播关于FMT的最新信息非常重要。本文就FMT的相关知识及其临床应用作一综述。方法:广泛查阅相关文献。检索并分析了Pubmed上的标题。一篇叙述性的综述强调了FMT在不同情况下的适应症。结果:指南推荐FMT治疗难辨梭菌复发感染。分析了几种在其他条件下使用FMT的尝试。其他肠道疾病,如肠易激综合症、肠易激综合症、慢性便秘甚至结直肠癌,都有尝试的记录。通过FMT改变糖尿病和肥胖症患者的微生物群的尝试代表了未来的挑战。结论:粪便移植是一种重要的治疗方法,近年来被广泛研究。除了持续和复发性艰难梭菌感染的适应症外,还对其他肠道疾病和代谢疾病进行了几次尝试。必须证明这些应用程序的效率。
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引用次数: 30
Prevalence of traumatic dental injuries and their relation with predisposing factors among 8-15 years old school children of Indore city, India. 印度印多尔市8-15岁学龄儿童外伤性牙损伤患病率及其与诱发因素的关系
Pub Date : 2018-07-01 Epub Date: 2018-07-31 DOI: 10.15386/cjmed-898
Preene Juneja, Sadanand Kulkarni, Sapna Raje

Background: Dental injuries result in functional, esthetic and psychological disturbances accompanied by great concern from the child, the parent and the dentist. Oral injuries are fourth most common area of bodily injuries among 7-30 year-old individuals.

Aim: a) To assess the prevalence of traumatic dental injuries (TDI) and their relation with predisposing factors among 8-15 years old school children in Indore city, India.b) To collect baseline data as there have been no reported studies of TDI in central India to this date.

Methods: A cross sectional study was carried out among 4000 children of 60 schools in Indore using multistage random sampling method. Examination of permanent incisor teeth was done in accordance with the modified Elli's and Davey Classification using a standard mouth mirror and probe. Subjects who had clinical evidence of trauma were interviewed for details of the injury event by using structured questionnaire. Chi square test was used to analyze the distribution of all the measurement in this study at the statistical significance of 0.05.

Results: Among the 4000 children of 60 schools examined, 10.2% experienced TDI. 68.38% boys experienced TDI, which was approximately twice as higher in females being 31.62%. The most commonly affected teeth were maxillary central incisors. A higher number of children with incisal overjet greater than 3 mm had TDI than those with less than 3 mm, although this difference was not statistically significant. Lip closure incompetence was found to be more common in subjects having a TDI. Fall was the most common cause for TDI and place of occurrence was home. Most common type of fracture was class I and most of them were untreated.

Conclusion: The high level of dental trauma and low percentage of children with trauma seeking treatment stresses the need for increased awareness in Indore population.

背景:牙损伤导致功能、审美和心理障碍,并引起儿童、家长和牙医的高度关注。口腔损伤是7-30岁人群中第四大最常见的身体伤害。目的:a)评估印度印多市8-15岁学龄儿童创伤性牙损伤(TDI)的患病率及其与诱发因素的关系。b)收集基线数据,因为到目前为止印度中部还没有关于TDI的研究报告。方法:采用多阶段随机抽样方法,对印多尔市60所学校4000名儿童进行横断面调查。根据改良的Elli's和Davey分类,使用标准的口腔镜和探针对恒切牙进行检查。采用结构化问卷对有创伤临床证据的受试者进行访谈,了解损伤事件的细节。采用卡方检验分析本研究各项测量的分布,差异有统计学意义为0.05。结果:在60所学校的4000名儿童中,10.2%的儿童经历过TDI。68.38%的男孩经历过TDI,大约是女性的两倍,为31.62%。最常见的是上颌中门牙。切牙覆盖面积大于3mm的患儿TDI发生率高于小于3mm的患儿,但差异无统计学意义。唇部闭合不全在TDI患者中更为常见。跌倒是TDI最常见的原因,发生地点为家中。最常见的骨折类型为I级,大多数未经治疗。结论:高水平的牙外伤和低比例的儿童外伤寻求治疗强调需要提高认识在印多尔人口。
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引用次数: 38
Psycho-social impact of orthodontic treatment in Romanian teenagers and young adults. 罗马尼亚青少年正畸治疗的心理社会影响。
Pub Date : 2018-07-01 Epub Date: 2018-07-31 DOI: 10.15386/cjmed-915
Ana Mihailescu, Anca Labunet, Alexandrina Muntean, Andreea Kui, Radu Septimiu Campian
Background and aims This survey evaluated the psycho-social impact of oral health on the quality of life in Romanian teenage and young adult orthodontic patients. Methods Of the 300 standard questionnaires distributed in four dental offices, 125 questionnaires were returned. Each questionnaire contained 110 items, focusing on aspects like patients’ satisfaction, self-confidence, school/work performances and aesthetic concern, in relation to oral health. The patients were 16–25 years of age and all were undergoing or had undergone orthodontic treatment in the previous two years. Data analysis was performed using the Statistical Package for the Social Science software (SPSS), version 19.0. Results 57.90% of the orthodontic patients participating in this study were happy about their dental status, 56.52% declared themselves not shy because of their oral health issues, 52.33% considered themselves as attractive to other people, and 57.29% replied (awarding a score between 8 and 10) that they were confident when smiling. Regarding self-confidence and school/work performances, 58% of the participants declared they avoided speaking in public because of the aspect of their teeth and 47.42% considered that their school/work performances during the fix appliance therapy stayed the same as before appliance. Nevertheless, the self-perceived facial aspect improved during orthodontic treatment (64.74% of replies had scores between 8 and 10 during the treatment versus 24.67% before the treatment). Several correlations were found between aspects such as psycho-social and functional variables, physical self-evaluation, and oral health issues. Conclusion Patients’ satisfaction was improved during and after appliance therapy, for more than half of the participants. Self-confidence was low in relation to school/work performances; almost half of the patients reported stagnation in their school/work performances during the fix appliance therapy. However, more than 64% of the patients participating in this study were quite satisfied about their facial aspect during and after the orthodontic treatment. Thus, the common concerns of the patients anxious about their aspect during appliance therapy are not supported by the findings of this study.
背景和目的:本调查评估罗马尼亚青少年和青年正畸患者口腔健康对生活质量的心理和社会影响。方法:在4个牙科诊所发放标准问卷300份,回收问卷125份。每份问卷包含110个项目,重点关注患者对口腔健康的满意度、自信心、学业/工作表现和审美关注等方面。患者年龄16-25岁,均在前两年接受或曾接受过正畸治疗。数据分析使用社会科学统计软件包(SPSS) 19.0版进行。结果:参与本研究的正畸患者中,57.90%的人对自己的牙齿状况感到满意,56.52%的人表示自己不会因为口腔健康问题而害羞,52.33%的人认为自己对他人有吸引力,57.29%的人回答(得分在8到10分之间)他们在微笑时很自信。在自信心及学业/工作表现方面,58%受访者表示因牙齿状况而避免在公众场合发言,47.42%认为矫治矫治期间的学业/工作表现与矫治矫治前相同。然而,在正畸治疗期间,自我感知的面部方面有所改善(64.74%的受访者在治疗期间得分在8到10分之间,而治疗前的得分为24.67%)。在心理社会和功能变量、身体自我评价和口腔健康问题等方面发现了一些相关性。结论:半数以上的患者在矫治期间及矫治后满意度均有提高。在学校/工作表现方面,自信心较低;几乎一半的患者报告在固定矫治器治疗期间学业/工作表现停滞不前。然而,参与本研究的患者中,超过64%的人对正畸治疗期间和治疗后的面部面貌非常满意。因此,本研究的结果并不支持患者在矫治过程中对自身状况的担忧。
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引用次数: 2
Improving communication within the interdisciplinary team monitoring young women with onco-gynecological pathology in Romania. 改善罗马尼亚患有妇科肿瘤病理的年轻妇女跨学科监测小组内部的沟通。
Pub Date : 2018-07-01 Epub Date: 2018-07-31 DOI: 10.15386/cjmed-948
Ioan Lancrajan, Ioan Lisencu, Laurentiu Ignat, Rares Trisca, Madalina Coman, Floarea Mocean

Background: The quality of medical care, as well as the application of effective treatments in the management of patients with gynecologic neoplasm, is of great importance. Finding new and efficient ways of communication between the doctors involved in the multidisciplinary team for the management of the disease, from the diagnosis to the reintegration into society, would help improve the quality of comprehensive patient care.

Objective: The objective of the study was to assess the collaboration of family physicians with specialists treating patients suffering from gynecologic cancer, in order to improve the relationship between them via electronic communication.

Study design: We conducted a descriptive, transversal study on 353 family physicians and 37 specialist doctors from Romania, between January and June 2015. For statistical data analysis, R for Data Analysis and Graphics version 3.2.1 was used.

Results: Most of the family physicians and specialist doctors believed that they provided the best care that they could, but consider that a multidisciplinary approach using online communication methods, in which doctors collaborate among each other, is needed.

Conclusions: Finding a simple, efficient and modern means of communication is essential in order to increase the efficiency of medical care overall.

背景:在妇科肿瘤患者的管理中,医疗服务质量和有效治疗方法的应用是非常重要的。从诊断到重新融入社会,在参与多学科团队的医生之间寻找新的和有效的沟通方式,将有助于提高对患者的全面护理质量。目的:本研究的目的是评估家庭医生与专科医生治疗妇科癌症患者的合作情况,以便通过电子通信改善他们之间的关系。研究设计:2015年1月至6月,我们对来自罗马尼亚的353名家庭医生和37名专科医生进行了一项描述性横向研究。统计数据分析使用R For data analysis and Graphics版本3.2.1。结果:大多数家庭医生和专科医生认为他们提供了他们所能提供的最好的护理,但认为需要采用多学科的方法,使用在线交流方法,医生之间相互协作。结论:寻找一种简单、高效、现代化的通讯手段是提高医疗服务整体效率的必要条件。
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引用次数: 0
Association between different blood groups, depression and oral health status of dental students. 不同血型、抑郁与牙科学生口腔健康状况的关系
Pub Date : 2018-07-01 Epub Date: 2018-07-31 DOI: 10.15386/cjmed-830
Kaluram Yadav, Jitender Solanki, C L Dileep, B R Adyanthaya, Prashant Mishra, Omprakash Yadav

Introduction: Knowledge of blood groups and their association with oral diseases and depression is very important, as it may help in early diagnosis and treatment strategies.

Method: A cross sectional descriptive study was conducted among dental students of a private dental college. The study was conducted in two phases, in the first phase the blood samples of each student were collected and sent for blood group examination in laboratory. Data for oral health status was collected by recording oral hygiene, dental caries and questions regarding oral hygiene habits and adverse oral habits. Depression level was recorded using a pre-validated, 21 item close ended questionnaire. Data thus collected was subjected to statistical analysis using chi-square and frequency distribution test using SPSS software.

Results: The total study subjects were 315, 95 males and 220 females. On applying chi-square test between blood group and Decayed, Missing and Filled Teeth (DMFT) score, a highly significant association (p=0.00) was observed. A non-significant association p=0.217 and p=0.668 was observed between gender and DMFT and Oral hygiene index-simplified and Blood group respectively. When comparing blood group and Depression score, a non-significant association (p=0.74) was observed.

Conclusion: DMFT score varies in different blood groups and this might suggest a positive association between blood groups and DMFT score, while depression, oral hygiene and gender might not be affected by the different blood groups.

了解血型及其与口腔疾病和抑郁症的关系是非常重要的,因为它可能有助于早期诊断和治疗策略。方法:对一所私立牙科学院的牙科学生进行横断面描述性研究。研究分两个阶段进行,第一阶段采集每个学生的血液样本,送到实验室进行血型检查。口腔健康状况数据通过记录口腔卫生、龋齿情况以及有关口腔卫生习惯和不良口腔习惯的问题来收集。使用预先验证的21项封闭式问卷记录抑郁水平。收集的数据使用SPSS软件进行卡方检验和频率分布检验的统计分析。结果:研究对象共315人,其中男性95人,女性220人。对血型与龋缺补牙(DMFT)评分进行卡方检验,发现有极显著相关性(p=0.00)。性别与DMFT、简化口腔卫生指数、血型的相关性分别为p=0.217、p=0.668,无统计学意义。在比较血型与抑郁评分时,无显著相关性(p=0.74)。结论:DMFT评分在不同血型之间存在差异,血型与DMFT评分之间可能存在正相关关系,而抑郁、口腔卫生和性别可能不受不同血型的影响。
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引用次数: 5
Incidental findings during follow-up scans in oncological patients. 肿瘤患者随访扫描时的偶然发现。
Pub Date : 2018-07-01 Epub Date: 2018-07-31 DOI: 10.15386/cjmed-931
Cosmin Caraiani, Anamaria Pop, Adriana Calin, Lidia Ciobanu, Claudia Militaru, Alexandra Berghe, Radu Badea

Background and aim: To assess the prevalence of incidental findings during follow-up scans of patients with oncologic pathology.

Methods: 499 follow-up scans from different patients with cancer pathology were retrospectively analyzed. Findings which were not suspected by the clinician or known from previous scans were considered as incidental lesions. We excluded lesions that were already suspected by the clinician or were already recorded in the patient's history before the initial computed tomography (CT) scan. The CT scans were performed on two different machines ("Siemens Somatom Sensation, 64 slices, Erlangen, Germany" and "Siemens Somatom Emotion, 16 slices, Erlangen, Germany").Most of the patients had a native scan followed by a thoraco-abdominal-pelvic image acquisition after the injection of intravenous contrast media.

Results: 28% of the patients had unsuspected incidental findings. The prevalence of incidental findings was similar: 56.6% of them were found in men and 43.4% in female patients. In 6 cases (1.2%) the presence of unsuspected pulmonary embolism was discovered. From these cases, 5 (83.3%) had metastatic disease at the moment of the follow-up CT scan and 1 (16.6%) had metastasis-free disease. In 17 patients out of 499 (3.4%) we incidentally made an important discovery which either changed the cancer therapy or required immediate treatment.

Conclusion: Incidental findings are not rare in oncological patients and the radiologist has to be aware of their presence in order not to overlook them and to correctly diagnose them.

背景和目的:评估肿瘤病理患者随访扫描中偶然发现的发生率。方法:回顾性分析499例不同肿瘤病理患者的随访扫描。未被临床医生怀疑或从以前的扫描中已知的发现被认为是偶然病变。我们排除了临床医生已经怀疑的病变或在初次计算机断层扫描(CT)之前已经在患者病史中记录的病变。CT扫描在两台不同的机器上进行(Siemens Somatom Sensation, 64片,Erlangen, Germany)和Siemens Somatom Emotion, 16片,Erlangen, Germany)。大多数患者在静脉注射造影剂后进行了原生扫描,然后进行了胸腹盆腔图像采集。结果:28%的患者有意外发现。意外发现的发生率相似:男性占56.6%,女性占43.4%。在6例(1.2%)中发现了未被怀疑的肺栓塞。在随访CT扫描时,5例(83.3%)为转移性疾病,1例(16.6%)为无转移性疾病。在499例患者中的17例(3.4%)中,我们偶然发现了一个重要的发现,要么改变了癌症治疗方法,要么需要立即治疗。结论:肿瘤患者的偶发现象并不罕见,放射科医师应注意偶发现象的存在,以免忽视偶发现象,正确诊断偶发现象。
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引用次数: 2
Are negative symptoms in schizophrenia a distinct therapeutic target? 精神分裂症的阴性症状是一个独特的治疗目标吗?
Pub Date : 2018-01-01 Epub Date: 2018-01-15 DOI: 10.15386/cjmed-864
Octavia Oana Capatina, Ioana Valentina Miclutia

Background and aims: The relationship between negative symptoms and cognition in schizophrenia is not clear, inconsistent findings have been reported by multiple authors and meta analyses. The aim of this study was to investigate the relationship between cognition and primary negative symptoms.

Methods: 67 outpatients diagnosed with schizophrenia were evaluated using PANSS and the NSA-16 scale. Correlation and regression analyses were used in the present study to investigate the relationship between the primary negative symptoms and cognition.

Results: No relationship was found between the PANSS Cognitive factor and Negative factor, but when investigating the relationship of the Cognitive PANSS factor with the negative symptoms evaluated with the NSA-16 scale, it was shown that there is a significant association between cognition and motor retardation.

Conclusions: Our study reveals the relative independence of cognitive factor from the global negative domain of the psychopathology, even though the association with motor retardation was clear. These findings also support the need of using appropriate assessment tools in order to gain a more refined understanding of the phenomenology of schizophrenia.

背景与目的:精神分裂症的阴性症状与认知之间的关系尚不清楚,多个作者和荟萃分析报道了不一致的结果。本研究的目的是探讨认知与原发性阴性症状之间的关系。方法:采用PANSS和NSA-16量表对67例精神分裂症门诊患者进行评估。本研究采用相关分析和回归分析探讨原发性阴性症状与认知的关系。结果:PANSS认知因子与负性因子无相关性,但在研究认知PANSS因子与用NSA-16量表评价的负性症状的关系时,发现认知与运动发育迟滞之间存在显著相关性。结论:我们的研究揭示了认知因素相对独立于精神病理的整体消极领域,尽管与运动迟缓的关联是明确的。这些发现也支持需要使用适当的评估工具,以获得对精神分裂症现象学更精确的理解。
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引用次数: 5
期刊
Clujul medical (1957)
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