Clujul medical (1957)最新文献

Background: Adverse reaction to medication is common and may have a variety of clinical manifestations in the oral cavity. The present review paper aimed to describe adverse drug reactions (ADRs) which might be encountered by dental practitioners in every discipline.

Methods: In this narrative review article, the specialized databases such as PubMed, PubMed Central, MEDLINE, EBSCO, Science Direct, Scopus, and reference books from the years 2000-2016 were used to find relevant documents by using MeSH terms: Adverse Drug Reaction, Drug induced, Medication Related, Mouth, Oral Manifestation, Tooth, Hard Tissue, Soft Tissue.

Results: The data were categorized in 4 groups as follows: saliva and salivary glands involvement, soft tissue (mucosal) involvement, hard tissue involvement, and non specific conditions (taste disorders, halitosis, neuropathies, movement disturbances, and infection). Most articles were about the adverse effect of drugs on the function of salivary glands, which often cause a decrease in saliva secretion. Other reactions were less common; meanwhile, the side effect of bisphosphonate was increasing in the alveolar bone, because of its unlimited prescription.

Conclusion: Oral health care providers should be familiar with such events, as they will be confronted with them in their practice.

Mandibular premolar can present a complex pulp anatomy. Apart from the usual single root and single canal a many other variations may be seen. Hence not only a thorough knowledge of the root canal anatomy but also it's variations are indispensable pre requisites for the success of any endodontic treatment. Good magnification and CBCT scans will definitely be beneficial for successful endodontic treatment. The present case provides evidence that mandibular premolars may have more than one canal.

Background and aims: The cerebellum ("little brain"), the largest part of hind brain, lies in the posterior cranial fossa, beneath the occipital lobe and dorsal to the brainstem. It develops over a long period: it is one of the first structures in the brain to begin to differentiate, but one of the last to mature. The use of ultrasonography has significantly improved the evaluation of fetal growth and development and has permitted prenatal diagnosis of a variety of congenital malformations.The aim of our study was to evaluate the cerebellar growth and development using 2 different measuring techniques: microMRI and ultrasound technique. The cerebellum measurements were related to gestational age.

Methods: We used 14 human fetuses corresponding to 15-28 gestational weeks, immersed in a 9% formalin solution. Magnetic Resonance Imaging (MRI) was performed by employing a Bruker BioSpec 70/16USR scanner (Bruker BioSpin MRI GmbH, Ettlingen, Germany), operated at 7.04 Tesla for cerebellar volume measurement. Ultrasonographic measurements of the cerebellum diameter were performed on 14 pregnant women, 15 - 28 gestational weeks. Ultrasound scan used 5-10 MHZ for transvaginal approach. Taking into consideration the values of the cerebellum dimensions and considering the general shape of the cerebellum as a transverse ellipsoid, the volume of the cerebellum was calculated by a mathematical formula for ellipsoid volume.

Results: The study correlates the measurements from the microMRI study with the ultrasounds data and the results are superposable. Both established the exponential volume growth after the 22-23 GW. We used the ellipsoid volume formula for the cerebellar volume using the half of the three diameters of the cerebellum determined by ultrasound measurements:Cerebellar Volume = Ellipsoid volume = 3/4 π r1 r2 r3.

Conclusion: There is a linear correlation between the microMRI measurements and ultrasound determinations. Based on all collected data we could apply an easy formula to calculate the volume of cerebellum, a useful criterion in the evaluation of the cerebellar development and the appreciation of the gestational age.

Introduction: Recurrent Aphthous Stomatitis (RAS) is a common oral mucosal disorder which is characterized by recurrent ulcerations mainly confined to non-keratinized oral mucosa. Though the exact etiology is imprecise, stress and anxiety were found to be linked with the onset of RAS. The present study was directed to know the prevalence of RAS among female dental students in King Khalid University, to find out the association between RAS and psychological stress and the effectiveness of Hospital Anxiety and Depression scale (HADS) in finding out the psychological profile of RAS patients.

Method: 122 female dental students of age group 17 to 25 years were selected for the study. Subjects with relevant medical problems and deleterious habits were excluded. A questionnaire comprising general stress related questions and HAD scale were used to assess stress. Those who were giving history of ulcer were diagnosed as RAS based on the clinical features. The questionnaire results were used for statistical analysis and processed.

Result: 14% of the total students were having RAS. 70% could correlate the onset of ulcer with certain specific factors; stress being the major causative agent (91%). In HAD scale, 88% of students were having anxiety and 65% had depression; all patients with depression had anxiety.

Conclusion: The prevalence of RAS in female dental students in KKU was around 14%. There is a strong relationship between psychological stress and RAS, as in most of the other studies. HAD scale alone can be used for detecting the psychological factor in RAS.

Background and aim: The non-alcoholic fatty liver disease (NAFLD) and its sub-entity, the non-alcoholic steatohepatitis (NASH) represent a field of a tremendous progress in recent years. Clinicians need to remain updated with new data on pathogenesis and therapy. The present mini review aims to present some new scientific reports on the diagnosis of NAFLD and NASH for clinical practitioners.

Methods: A systematic literature search of the main international databases was performed. We looked for seminal and innovative papers published in main international languages. A narrative review of the topic was consequently written.

Results: This review describes new data on the diagnosis of NAFLD including NASH. Liver punction biopsy remains the gold standard. However many patients and clinicians prefer to use noninvasive methods. We present the serological tests and the imaging methods used to diagnose inflammation and fibrosis occurring in NAFLD and NASH.

Conclusions: NAFLD-NASH are multifaceted entities that have to be diagnosed and treated by skilled and informed practitioners.

Background and aim: Therapeutic decision in dentistry is a complex cognitive process for the practitioners because it involves taking into consideration several factors, including patients' preferences. The hypothesis of this study was that apicoectomy might be indicated more often than necessary and in order to confirm or invalidate it a survey was designed. We also aimed to explore whether the preferences were associated or not with dentist-related or practice-related characteristics.

Methods: The survey included questions about treatment options in case of four scenarios, each one concerning an anterior and a posterior tooth with apical periodontitis, with or without previous endodontic treatment and also general questions, such as medical specialties, age and years of experience. The distribution of the questionnaires was done by email and direct distribution in the dental offices, in Cluj County, Romania.

Results: After descriptive statistical analysis was performed, preferences rates were subjected to Chi-square test (including McNemar test for significance). Statistically significant differences were considered when p≤0.05.

Conclusions: The results indicate that dentists prefer nonsurgical endodontic treatment in case of a tooth with apical periodontitis. Apicoectomy was the second option treatment preferred by general dentists, oral and maxillo-facial surgeons, prosthodontists and endodontists.

Background and aims: Community-acquired pneumonia (CAP) is a both common and serious childhood infection. Antibiotic treatment guidelines help to reduce inadequate antibiotics prescriptions.

Methods: We conducted a retrospective study at the Clinical Emergency Hospital for Children, 3rd Pediatric Clinic, Cluj-Napoca and Dr. Gavril Curteanu Clinical City Hospital, in Oradea. All patients discharged with a diagnosis of CAP between December 1, 2014 and February 28, 2015, were included in the study.

Results: There were 146 cases discharged with pneumonia in Cluj-Napoca center (mean age 4 years; range: 1 month - 16 years), and 212 cases in Oradea center (mean age 0.9 years; range: 2 weeks - 8 years). All cases were analyzed. The analysis made in Clinical Emergency Hospital for Children, 3rd Pediatric Clinic, Cluj-Napoca, showed that the antibiotics used in children hospitalized with community-acquired CAP are cefuroxime (43%), ceftriaxone (23%), macrolides (16%), ampicillin in association with an aminoglycoside (6%) and other antibiotics. The same antibiotics were used in Dr. Gavril Curteanu Clinical City Hospital of Oradea, where ampicillin in association with aminoglycoside was utilized in younger children (mean age 1.3 years), while ceftriaxone in older children (5.7 years) and children with high inflammation markers (ESR, CRP). From 11 pleurisy cases, 9 received cefuroxime or ceftriaxone.

Conclusions: There was a wide variability in CAP antibiotic treatment across university hospitals, regarding antibiotic choice and dosing. Antibiotic selection was not always related to the clinical and laboratory characteristics of the patient. The national guideline was not followed, especially in children aged one to three months.

Esophageal achalasia is a primary smooth muscle motility disorder specified by aperistalsis of the tubular esophagus in combination with a poorly relaxing and occasionally hypertensive lower esophageal sphincter (LES). These changes occur secondary to the destruction of the neural network coordinating esophageal peristalsis and LES relaxation (plexus myentericus). There are limited data on segmental involvement of the esophagus in adults. We report on the case of a 54-year-old man who presented initially with complete aperistalsis limited to the distal esophagus. After a primary good response to BoTox-infiltration of the distal esophagus the patient relapsed two years later. The manometric recordings documented now a progression of the disease with a poorly relaxing hypertensive lower esophageal sphincter and complete aperistalsis of the tubular esophagus (type III achalasia according to the Chicago 3.0 classification system). This paper also reviews diagnostic findings (including high resolution manometry, CT scan, barium esophagram, upper endoscopy and upper endoscopic ultrasound data) in patients with achalasia and summarizes the therapeutic options (including pneumatic balloon dilatation, botulinum toxin injection, surgical or endoscopic myotomy).

Background and aims: Cancer is a leading cause of death in Ecuador with high social and economic impact. This study aims to determinate the influence of living at a high altitude on the risk of developing or dying from cancer among the Ecuadorian population.

Methods: This is an ecological and epidemiological analysis of cancer mortality and prevalence rates, based on national data from the Ecuadorian National Statistics and Census Institute, corresponding to the period between 2005 and 2014. This study includes the analysis of various types of cancer: gastric, colorectal, hepatic/bile duct, breast, uterine/cervix, and lymphatic/hematopoietic, using rates of mortality and prevalence. Additionally, the association between the risk of getting or dying from cancer and living at high altitude was investigated. This comparison was made between the population living in Highlands, over 2000 meters above sea level, and low-lying regions.

Results: Living at high altitude was associated with a higher prevalence of cancer and also with a high mortality rate due to cancer. Risk of getting cancer was related to living at a higher altitude, as well as an increased risk of death by cancer: gastric (OR:1.204; p<0.001), colorectal (OR:1.421; p<0.001), hepatic/bile duct (OR:1.184; p<0.001), breast (OR:1.067; p=0.030), or lymphatic/hematopoietic neoplasms (OR:1.135; p<0.001).

Conclusions: Through an epidemiologic analysis, the association between developing or dying from cancer and living at high altitude was obtained. However, further researche is needed to clarify these findings, something that could have a substantial impact on cancer prevention.

Introduction: The bisphosphonate-related osteonecrosis of the jaw was first referred to in 2003. Bisphosphonates action is focused on the osteoclasts. The drastic inhibition of the osteoclastic function is harmful for the jaws which are the only bones of the human skeleton in relative contact with the external environment. The adverse effects of the bisphosphonate-related therapy include the pathology for which they are prescribed, the atypical fractures in pathological bone.

Method: The aim of this research was to analyze the risk factors and the treatment methods in case of osteonecrosis of the jaws. To achieve these goals, the author analyzed the observation sheets of the patients admitted to the Oral and Maxillofacial Surgery Clinic during the period 2010-2015. The inclusion criteria were as follows: treatment with bisphosphonates, current or previous; the lesions of the mucous gingiva of the maxillaries followed by exposed necrotic bone, older than 8 weeks, with no tendency of healing; specific radiological image showing extended osteolysis with diffuse outline or radiopacity surrounded by radio-transparence, representing the necrotic bone sequestered; no metastasis in the necrotic maxillary bone; patient with no medical background of cervical-facial radiations. The patients who met these criteria were admitted in the study after signing the informed consent. Afterwards, the information found in the notes of the observational sheet (anamnesis, general examination and the imagistic investigation, treatment, postoperative recovery, prescription, postoperative recommendations) were gathered and submitted for statistic analysis.

Results: Of the 20 patients in total, 13 were women and 7 men, of ages ranging from 43 to 83. The most numerous cases were registered in the seventh age decade. All patients included in the study had lesions of the gingival maxillary mucosal areas with exposure of the subjacent necrotic bone. 60% of them were under intravenous treatment with zoledronic acid (Zometa®). A single patient was under oral treatment with bisphosphonates. 19 of these 20 patients developed osteonecrosis following a dental extraction while one case was due to the instability of the mandibular mobile prosthesis. 61% of the patients included in the study developed a necrotic process in the mandibular bone, 80% of the localizations were in the posterior area. As first intention, the choice of treatment was represented by local lavages with antiseptic solutions, general antibiotics and sequestrectomy. Of these patients, a third had relapsed and needed radical surgery treatment.

Conclusions: Prevention of the bisphosphonate-related osteonecrosis of the jaw represents the best method of treatment. The development of bone sequesters damages the volume of the maxillary bone as such, reducing the chances for prosthetic functional rehabilitation of the dento-maxillary s