The aim of this study was to compare two computerized digital esthetic design methods (DSD and Visagismile) in order to properly choose the appropriate form of the maxillary frontal teeth for complete bimaxillary edentulous patients and to validate the use of these applications in complete edentulism. An online questionnaire was submitted to a group of 100 persons (dental doctors, dental medicine students and persons activating in other fields); the respective persons were requested to choose the form of maxillary frontal teeth for a group of four complete bimaxillary edentulous patients, whose esthetic design had been performed by using the two computerized progams. Following the respondents’ analysis of the esthetic previews elaborated for the four patients 60% of the total answers were in favour of DSD while the remaining 40% were in favour of Visagismile; these percentages are identical with the ones obtained on the basis of the answers given by dental doctors and dental medicine students. In case of the respondents activating in other fields the percentages were 66% in favour of DSD and 34% in favour of Visagismile. Based on the results of the study the two computerized methods were validated also for cases of complete edentulism but further studies to confirm this validation are still required. These two methods improve the dental doctor/patient communication and certainly provide a higher predictability of the esthetic results of prosthetic restorations not only for dentate patients but also in cases of complete edentulism.
Retroperitoneal tumors grow quietly and are generally large in size, more than half of them being larger than 20 cm at the time of diagnosis. They usually present several therapeutic challenges because of their rarity, relative late presentation and anatomical location, often in close relationship with several important structures in the retroperitoneal space. Due to intimate relationships with vital organs in retroperitoneum, extensive surgery with en bloc resection of the involved organ is often required, most frequently the kidneys, followed by colon, pancreas and spleen. Malignant tumors have a poor prognosis, the most significant factors regarding survival rates being delayed diagnosis, high histological grade, inoperability due to invasion into vital organs, and a positive surgical border.
Renal disease in pregnancy is a rare pathology, but it raises several problems in terms of normal pregnancy evolution. Among pregnant women with renal injury, the rate of complications such as spontaneous abortion, preeclampsia, hypertension, intrauterine growth restriction, premature birth, fetal and neonatal mortality are much higher. For a good understanding of the pathology and a correct management of pregnant women with renal disease, it is necessary to know the normal pregnancy changes and the differentiation of chronic kidney disease from the acute injuries occurring during pregnancy. It is useful to ensure counseling prior to conception and to perform all prophylactic measures in order to prevent pregnancy complications and subsequent decline in renal function in all cases of pregnant women with chronic renal insufficiency. Treatment of acute renal failure in pregnancy involves therapy of the underlying condition that caused renal injury, prevention of irreversible kidney injury and pre-vention of maternal and fetal secondary complications. Monitoring carefully this cate-gory of pregnant women, although additional risks strike, often results in favorabl pregnancy evolution.
Metformin was a revelation in the treatment of patients with type 2 diabetes, being widely used, with remarkable outcomes. Lately, research has greatly expanded the indications of metformin treatment, which can be used not only in diabetes but also in many other conditions. Although still debatable, several studies have shown the beneficial effects of metformin treatment in patients with psoriasis. This article is a review of the latest data of scientific literature about the effects of metformin administration in patients with diabetes and psoriasis, but also in nondiabetic patients with psoriasis
Introduction: Currently, parathyroidectomy represents the elective surgical treatment and the only one curative that relieves the patient of metabolic complications and improves the quality of life of the patient. Intraoperative confirmation of PTH is required to reflect the fact that the correct parathyroid gland has been extracted. Material and method: The study is retrospective. The period on which the data was gathered over a period of 2 years. The values of the PTH assay were obtained from blood drawn from the ipsilateral cephalic vein of the hyperproductive parathyroid gland: 1. at the moment of anesthesia induction; 2. at identification; 3. at 10 minutes after the extraction; 4. at 20 minutes after extraction. Results: We identified a number of 25 patients operated for primary hyperparathyroidism. Preoperative values of PTH were 380pg/mL with a maximum value of 821 pg/mL. PTH values decreased by 55% at 5 min, 68% at 10 minutes and 74% at 15 minutes. A marked reduction in PTH values occurred after the first 5 minutes while the interval between 10-15minutes associated a variation of only 8-10% decrease. Conclusion: Intraoperative PTH assay is a useful technique to predict the success of the intervention. The technique is standard although some issues have been raised and are still under discussion.
Given the continuous growth of the bacterial resistance phenomenon, the appropriate choice of antibiotherapy represents an important step in the treatment and prophylaxis of infectious diseases. Depending on the symptomatology, the dose required for the effective treatment of an infection may vary. Inadequate dosing not only reduces the effectiveness of the antibiotic, but also promotes the emergence of resistant bacterial strains. Also, too high of a dose increases the toxic side effects of antibiotics. Therefore, a personalised antibiotherapy according to: the patient's clinical status, body mass, associated chronic diseases, etc. represents a promising approach in the treatment of infectious diseases. The purpose of this study is to present the most important current affairs regarding the emergence of new antibiotics, the maximum doses recommended by the latest version of the "European Committee on Antimicrobial Susceptibility Testing" (EUCAST - version 9/2019) and providing an indication on whether these antibiotics are used in Romania.
This article was written because of the necessity of clarifying the recent biomedical selection criterion for the medical exam of the students who are applying for higher military education. In order to screen for or monitor liver disorders or hemolytic anemia the bilirubin is measured. The increased values of the bilirubin can be caused by multiple factors and they are presented in the following chapters.
Background and Aim: Various studies have reported that 4-7 percent of adults with palpable thyroid nodules that 50-70 percent of it’s diagnosed with high-accuracy sonography. Although most thyroid nodules are non-cancerous and do not require treatment, a small percentage of them are associated with a potential risk of malignancy, which is an important early diagnosis by ultrasound or pathology. The present study aimed to compare the ultrasound with the pathologic results of fine-needle aspiration (FNA) of thyroid nodules for the rapid diagnosis of thyroid malignancies in patients referred to Baqiyatallah Hospital. Methods: The study population consisted of 100 (80 female, 20 male) patients with thyroid nodules in the age range of 19-82 years referred to the radiology ward of Baqiyatallah Hospital who were studied by the cross-sectional method. All patients were first scoring by ultrasound, then fine needle aspiration with thyroid nodule ultrasound was performed, and the specimens were referred to the pathology department for further evaluation. Results: The pathologic results from fine-needle aspiration showed that only 8 of the 100 patients studied had malignant nodules that, by ultrasound scoring, 7 patients had 4 scores and 1 patient had 3 scores. However, the other 92 patients with benign nodules 57.60% of patients had score 1, 30.43% of patients had score 2 and 11.97% of patients had score 3. Conclusion: According to the results of this study, it seems that ultrasound scoring is useful in the rapid diagnosis of thyroid nodules and prevent unnecessary thyroid nodule FNA.
Gastrointestinal infections are among the most common infectious diseases found all over the world, varying depending on the etiological agent. Symptoms usually include diarrhea, vomiting, and abdominal pain. Water and electrolyte imbalance is the main consequence of gastrointestinal infections. Most of them are cured or self-limited in few days, but at the same time, for a specific population such as immunocompromised, elderly patients or new-borns, these infections are potentially severe. In this context, it is very important to identify the etiological agents of acute diarrhea for the appropriate treatment and infection control measures. While routine laboratory diagnosis of parasitic diarrhea still depends largely on microscopic examination of fecal samples, immunological and molecular methods are becoming increasingly commercially available and, in well-resourced settings, will ultimately displace traditional methods. The present paper presents some of the most common and well-known pathologies of this type, being a brief presentation of the variety of gastrointestinal diseases, each with characteristic clinical manifestations and diagnosis.
Laparoscopic sleeve gastrectomy (LSG) is becoming popular between the bariatric procedures. There are few studies available in the literature about LSG impact on esophageal motility, with debatable results. Technically, it modifies the anatomy of the esophago-gastric junction; it can damage the phreno-esophageal ligament and decrease the lower esophageal sphincter pressure that will predispose to reflux. Gastroesophageal reflux disease (GERD) is already common in obese patients due to frequent hiatal hernia, high intraabdominal pressure, increased transient lower esophageal sphincter relaxations (TLESR), altered esophageal motility and poor esophageal clearance. LSG can worsen gastroesophageal reflux disease, but also the weight loss achieved after it and the decrease of acid production in the small gastric pouch will probably reduce the GERD symptoms. Dysphagia and odynophagia were reported after sleeve gastrectomy, but usually associated with anatomical narrowing of the gastric sleeve, caused by esophageal dismotility or secondary to diabetes mellitus, low tiamine level, the use of opioids and non-steroidal anti-inflammatory drugs, even hypothyroidism. In addition to upper GI tract endoscopy, high-resolution esophageal manometry (HRM) should be required for all patients planning to undergo a LSG, and in the follow-up period according to the contractility pattern.
