Introduction: Matrix metalloproteinases (MMPs) are key enzymes involved in degradation of extracellular colagen matrix during periodontal disease progression. The aim of our work was to study the levels of MMP-1, MMP-2, MMP-7, MMP-9 and MMP-10 in saliva of patients with chronic periodontitis. Materials and methods: The study included 22 patients with chronic periodontal disease and 15 controls. We collect unstimulated whole saliva from all volunteers included in the study. Salivary levels of mentioned MMPs were analyzed using magnetic bead-based multiplex assays and Luminex technology. Results: MMP-1, MMP-7, MMP-9 and MMP-10 present statistically increased salivary levels at patients with periodontal disease versus the control group (p<0.05). Salivary level of MMP-2 at patients with chronic periodontitis was increased but statistically insignificant compared with healthy subjects (p=0.1). Conclusions. The increased level of these enzymes in patients diagnosed with periodontal disease reflects their implication in periodontal tissue degradation. Saliva is an excellent fluid useful in monitoring the severity of this oral disease that affects about half of the adult population around the world.
Pregnancy-specific dermatoses are a heterogeneous group of inflammatory dermatoses associated exclusively with pregnancy. Although these dermatoses are rare, it raises problems in medical practice because of their appearance, being difficult to diagnose, treat and the possibility of the fetus being affected. Pemphigoid Gestationis (PG) is a rare, autoimmune, strongly pruritic, vesiculobullous dermatosis with a strong impact on the patient. Polymorphic Eruption of Pregnancy (PEP) is a benign, self-limited inflammatory skin disorder that usually affects first pregnancy in the third trimester or immediately in the postpartum period. Other dermatoses associated with pregnancy include: Intrahepatic Cholestasis of Pregnancy (ICP), Atopic Eruption of Pregnancy (AEP) and Pruritic Folliculitis of Pregnancy (PFP). We will extensively present PG and PEP, to draw attention to the importance of correct diagnosis and the implications of treatment during pregnancy.
Tissue coverage of lower limb defects after tibial fractures remain one of the hardest areas for a surgeon to deal with. The definitive management of Gustillo type IIIB fractures depends on a series of factors, which have a high impact in the multidisciplinary management of this severe trauma. Although free flaps have been used succesfully in the last two decades, there remains some cases where easier plasties using the contralateral limb tissue reserved could be indicated. We describe our experience with a cross-leg flap in a severe-smoking patient for the reconstruction of a difficult leg defect.
Introduction: Despite the progress that has been made regarding the diagnosis, a worrying percentage of patients are still admitted in an emergency, with complicated colorectal tumors, which often require interventions without a curative visa. The study aims to analyze the factors involved in choosing the type of surgical treatment. Patients and methods: We included in the study a group of 431 patients admitted and operated in an emergency for complicated colorectal cancer in the Surgery II Clinic of the Clinical Emergency County Hospital “Sf. Ap. Andrei” from Galați, between 2008-2017. We retrospectively analyzed the patients’ data and we made statistical correlations between the type of emergency surgery and epidemiological, clinical, paraclinical, and intraoperative factors. Results: Colostomy was mainly practiced in older patients (p<0.01), from rural areas (p<0.01), with associated cardiac diseases (p<0.01), with hydro electrolytic disorders (p<0.03), rectal tumors (p<0.01), peritoneal carcinomatosis (p<0.02), frozen pelvis (p<0.01). Hartmann's operations were associated with patients with: leukocytosis (p<0.01), intestinal perforation (p<0.01), sigmoid tumors (p<0.01). Internal derivations were associated with patients with: liver metastases (p<0.01), splenic angle tumors (p<0.01), tumors invading other organs (p<0.01), and stage IV of the disease (p<0.01). Resections with anastomosis were associated with transverse colon tumors (p<0.01), well-differentiated tumors (p<0.01). Conclusions: The type of emergency surgery performed correlated well with the age of patients, the area, the comorbidities, the history of the disease, cachexia, anemia, oligoanuria, hydroelectrolyte disorders, tumor complication, and location of the tumor, hepatic metastases, and tumors’ invasion in other organs, tumor grading and stage of the disease.
In an attempt to standardize the X-ray analysis and to create relevant correlations between it and the functional results, we present a pilot model of an artificial neural network based on a Bayesian belief network (BNN) designed for the automatic analysis of anteroposterior X-ray of the knee following total knee arthroplasty and more precisely the analysis of the tibial component. A prospective analysis was conducted in which 30 patients were analyzed and two groups resulted: the first was made up of 12 cases considered “normal” by the examiners (optimal positioning and cementation) and the second one, which was considered “pathological” (incorrect positioning or cementation) and included 16 cases. Based on 22 points established on the tibial component several geometric sizes (calculated parameters) were computed. Several parameters were compared and the results were up to 75% accuracy, 81.25% sensitivity, and 66.7% specificity. BBNs can be a solution for X-ray evaluation of total knee arthroplasty and can improve the understanding of its evolution. It needs confirmation in time, its accuracy rising with the number of patients introduced in the analysis algorithm.
Introduction: Osteoarthritis is considered as the most common joint disease. Sulfur mustard (SM) is a toxic compound, which was applied as a chemical warfare agent by Iraq against Iran veterans during 1980-1988. Chemical veterans suffer from chronic implications caused by sulfur mustard that not only adversely affect their quality of life, but also restrict their working abilities and their participation in social activities. This study aims to consider the prevalence of osteoarthritis disorders among Iranian SM-exposed veterans. Methods: In this cross-sectional study, 248 Iranian SM exposed patients were evaluated from 2013 to 2014. Veterans filled a special questionnaire for COPCORD studies and then general and specific rheumatology examinations were applied under the supervision of internists and rheumatologists. The obtained data from 245 filled questionnaires were analyzed by SPSS software and the results were reported as a percentage or mean ±SD. Results: Bone and joint pain (72%), knee joint pain (52.5%), Joint stiffness (49.2%), and shoulder joint pain (45.8%) were the most common type of complications in these patients. Osteoarthritis in at least one joint was the most common type of osteoarthritis in veterans. 69.5% of veterans had osteoarthritis in at least one joint. Knee osteoarthritis was the second most common type of osteoarthritis, which has been found in 58.4% of all veterans. The prevalence of neck osteoarthritis in all veterans was 23.9%. Conclusion: The total prevalence of musculoskeletal disorders among Iranian veterans was significantly higher than the average of society.
Background: As an essential part of the treatment chain and also the link between physicians and patients, pharmacists play a major role in optimizing drug administration. Compliance with a therapeutic regimen is necessary for therapeutic success, while non-adherence can lead to disease progression and eventually treatment failure. This study aimed to evaluate the impact of pharmacist’s patient education on different parameters of patient compliance. Results: The results showed the patients receiving the intervention compared to the control group, were significantly more adherence to the correct drug use dose (p = 0.016), time of use (p = 0.018), treatment duration (p =0.001), and frequency (p = 0.049). Conclusions: This study indicates that detailed patient counseling at pharmacies can positively influence different parameters of patients’ adherence.
Today's recognition of health as a fundamental value of humanity and the spectacular digital evolution of the environment dominated by permanent and dynamic changes has brought healthcare marketing to the forefront. The trends continuously affecting medical services have generated the need for increased involvement of marketing, with all current developments in healthcare having an indispensable marketing dimension. The successful implementation of a health marketing strategy aimed at enhancing patient satisfaction and fostering a positive care recipient experience, coupled with the cost-effectiveness of the health services offered, has necessitated the development of an adaptive marketing function that harmonizes the set objectives, addresses capability gaps, accommodates cultural realities, and considers individual mentalities and situational circumstances. The direct interaction with patients has made it possible to understand the need for a new paradigm of healthcare services, the demand to comprehend patient satisfaction and positive experience, the call for creating innovative models to address the patient experience, and, above all, the requirement to communicate with the patient continuously and effectively throughout the continuum of healthcare. The challenge for the management of future health systems and organizations is encapsulated in the words of Professor Drucker, who stated that the best way to predict the future is to create it. An exploratory research on the state-of-the-art of the literature was conducted with key references to the most important aspects captured by specialists on positive patient experience and satisfaction, which contributes by highlighting the determining factors that have led to the paradigm shift in healthcare.
The impact of artificial intelligence (AI) on our lives can no longer be neglected, and thus, understanding this phenomenon and how humans interact with it is becoming more important than ever. The study emphasizes one of the psychological characteristics that helps us in accepting AI and using it to its fullest, namely the psychological resilience that each of us, and in particular emergency service workers, possesses in different proportions. The analysis of the relationship between the two dimensions (psychological resilience and AI) highlights, among other things, the importance of how organizations can use this interaction to achieve a framework for developing the psychological resources of their employees so that they are increasingly receptive to the use of AI in their work, pursuing the benefits it brings. The study is conducted on 89 emergency service workers and focuses on the positive and highly statistically significant relationship between psychological resilience and attitudes towards AI. The study also particularly emphasizes the relationship between tenacity and self-efficacy, self-confidence, ability to learn from life experiences, rapid recovery from negative events, social and family resources as dimensions of psychological resilience in relation to attitude towards IA of emergency workers.
Introduction: Tetanus is an old world disease where 2 centuries ago people had realized the link between wound leading to muscle spasm and fatality, Even today there are many cases of fatalities of tetanus being reported from different parts of the country even after viability of a tetanus toxoid and Immunoglobulin injections. This one of very few recent studies done in India on tetanus, as there is very little data available on tetanus so we are trying to share our experience on tetanus, so it will help the physicians to get a better understanding. Materials and Methods: This retrospective study has done collecting the patients' detail from 2017- 2019, detailed case sheet review was done and the patients' clinical presentation and the prognosis were noted in predesigned format. Inclusion criteria – all diagnosed cases of tetanus, exclusion criteria – patient already received treatment from the local hospital. The patient details were kept confidential during all times. Results: The total of 58 cases – 35 males and 23 females, The average duration of hospital stay was 15 days. The most common occupation were farmers (barefoot workers). The site of injury was the foot in 65% cases followed by injuries to the fingers or the hand in 30% and 5% cases due to injury while tooth picking with a pin, splinter removal using pins. Clinical symptoms – trismus “lockjaw” (41), difficulty in walking (2), limb pain/stiffness (17), back muscle pain/stiffness (12), dysphagia (7), 72% autonomic dysfunction. Opisthotonus position and risus sardonicus developed after 7-8 days of infection. 20% of cases were vaccinated still developed diseases. 18% mortality was noted most cases were unvaccinated cases. Conclusion: Tetanus is preventable diseases if TT vaccination and IMMUNOGLOBIN are administered on time. In all primary health care levels, the cold chain should be maintained for vaccines. The patients should be made sensitized about the consequence of the disease process.
