Iodine deficiency in childhood can influence the mental and somatic growth and development of children by decreasing the thyroid hormone production. Iodine deficiency can be quantified by testing ioduria concentration. Our study has analyzed ioduria concentration of children detected with stature delay, coming from two distinct regions of Sibiu County, namely Gura Rîului, a known endemic area, and Şeica Mare, a lowland region. Approximately 60% of these children with iodine deficiency were detected in both regions, but a much lower average of ioduria was identified in the endemic area, where 23% of children presented severe iodine deficiency. The results are related to those published in other articles and call for their extension to larger group of children throughout the country, because iodine deficiency is still an issue of public health with multiple effects on the mental and somatic growth and development of children.
At this moment, geriatric dentistry represents a very well-defined discipline, which deals with the dental treatments in the elderly patients, more precisely the patients over 60 years old. Unfortunately, in Romania, geriatric dentistry is currently very superficiality treated, this being rather an optional study discipline in the curricula of Dental Medicine Faculties. Therefore, in this material we have tried to explain through solid arguments the importance of geriatric dentistry in the basic training of dentists, dental and dental prophylaxis nurses, as well as dental technicians.
Stress hyperglycemia is commonly identified in children with severe illness and previously normal glucose homeostasis. In the pediatric population febrile seizures are reported among stress-related conditions associated with stress hyperglycemia. The objective of this prospective study was to evaluate the possible association between blood glucose level and febrile seizure severity defined by fever degree, seizure type, seizure duration and hospitalization length. Among 167 febrile seizures the prevalence of stress hyperglycemia (blood glucose concentration over 150mg/dl) was 13.22%. There was a highly significant statistical association between seizure duration (exceeding 15 minutes) and increased blood glucose concentration (p= 0.001). Prolonged febrile seizures combined with high fever were significant risk factors for stress hyperglycemia. Further analysis on acute fluctuation of glycemia, persistence of hyperglycemia should be taken in consideration as possible prebdictive factor for stress hyperglycemia, by comparison to the peak blood glucose concentration .
In acute pancreatitis some prognostic scores have been suggested, based on clinical, laboratory and radiological criteria. The most popular are: Ranson score, APACHE II score and CT severity index (CTSI). The trend is to find a prognostic marker that is easy to use, cheap, and reproductible. Recently, the increase of the intra-abdominal pressure (IAP) has drawn attention. Material and Methods: From January 2012 to April 2014, a group of 64 patients, admitted to the Clinical Department of Anaesthesia and Intensive Care and the Surgical Departments of the SCJU Sibiu, with the diagnosis of acute pancreatitis, were included in this observational prospective study. The cut-off values, the specificity and sensitivity of the prognostic scores were calculated using the receiver operating characteristics (ROC) analysis curves. Results: At a cut-off value of 12 mm Hg IAP max has a sensitivity of 0,75, similar to Ranson score at 48 h (0.72 at a cut-off value 3) and CTSI (0,73 at a cut-off value 4). Better results are just for APACHE II score at 24 h (0,88 at a cut-off value 8). IAP max has a specificity of 0,88, simillary to CTSI (0,83) and APACHE II score (0,82). Conclusions: In our study maximum IAP could be correlated with prognostic markers for severe evolution in acute pancreatitis.
Cardiorenal syndrome (CRS) is a serious condition in which cardiac dysfunction leads to renal impairment and viceversa, with a high risk of mortality. This paper is a review of the most recent studies that investigated the role of Levosimendan on kidney function in case of patients with CRS. Compared with standard therapy (diuretics, other inotropes), Levosimendan has renoprotective effects associated with a lower mortality rate, it leads to an important improvement in NYHA class, a decrease in markers of congestion (BNP) and shortage of hospitalization stay. A study from 2018, in which Levosimendan was compared with Dobutamine, indicated that although both agents increase renal perfusion, only Levosimendan can improve GFR. In conclusion, Levosimendan – through its protective profile for both heart and kidneys, provides higher survival expectancy and seems to be the ideal alternative to the standard therapy in the management of hemodynamic CRS at present.
Lichen planus is an autoimmune, itching disorder that involves T lymphocytes, which may interest the skin, mucous membranes and exoskeletons. The presence of lichen manifestations both at the skin, mucous membranes and at the level of the skin attachments (hair and nails) is rarely mentioned in the literature. Although lichen planus may have a self-limiting evolution, early treatment is important in shortening the evolution of the disease and in controlling the symptoms. The therapeutic effects of retinoids (immunomodulatory, anti-inflammatory, anti-proliferative effects) make them an appropriate choice in the treatment of lichen with (cutaneous-mucosal, nail and planopilaris lesions. We will present the cases of 2 patients with muco-cutaneous, nails and scalp disorder due to lichen planus, and the time of presentation to the doctor made the difference between the complete remission of the disease and the evolution towards severe, extended, definitive alopecia in the scalp and genital lichen sclerosus.
Lung ultrasonography is an excellent alternative to chest radiography, with better sensitivity, specificity, positive and negative predictive values and, finally, with better accuracy. The lung ultrasonography is proven to be useful in trying to reduce the request of chest radiography. In the opinion of most specialists, lung ultrasonography is recommended to be a valuable tool for the diagnosis of community-acquired pneumonia in children. Considering the fact that clinical examination remains essential because it suspects the diagnosis, the evolution does not require radiologic follow-up, also the pathologic findings at the clinical examination may change over the course of a day, the possibility of the clinician to maintain the objectivity is essential. For this goal to be possible, it would be ideal that the clinician himself performs the ultrasonography (in real-time).
Guided bone regeneration using titanium-reinforced expanded teflon non-absorbable membranes (e-PTFE) has proven, through rigorous studies on many occasions, that it is a safe and predictable method to achieve bone growth at mandible and maxilla level, both vertically and horizontally. However, the technique itself is one that requires special operative skills and is not without postoperative complications. The purpose of this paper is to review most of these postoperative complications, their management and the key operative elements that help preventing them. Complications are presented both from the perspective of the meta-analysis performed from the present literature and from the point of view of the author’s personal experience, personal casuistry being presented. This paper will discuss all this starting with the complications without negative impact on the bone regeneration such as, late exposure of the membrane and ending with the most serious ones, such as the suppuration of the augmented anatomical regions. All of these can be avoided or minimized by using a correct operating technique. In addition, once installed, we can minimize the negative effects on bone regeneration by a proper management applied at the right time.
The main objective was to identify pregnancy risk factors arising from the behaviour and lifestyle of Mureş county women during pregnancy. The postpartum women monitored in this study were from Mureş county and were interviewed by applying a questionnaire during the period they were in the hospital for postnatal care immediately after birth. The questions aimed at identifying prenatal risk factors and the unhealthy behaviour of women before and during pregnancy, referring to the socio-economic and cultural status (low family income or unemployment, less than high school studies, rural background and marital status), obesity during pregnancy, alcohol consumption, coffee consumption, no physical activity. We identified, among the three major ethnicities in Mureş county (Romanian, Hungarian, Roma), the behaviour and lifestyle components with risk in pregnancy and after comparing profiles of these groups we identified the Roma ethnicity as being at the highest perinatal risk.
Electroconvulsive therapy (ECT) has been a controversial topic, both in the general population and in the medical community since its initial implementation in 1938. Despite clinical applications and proven efficacy in psychiatric and neurological pathologies, such as schizophrenia, catatonia, psychotic disorders, depressive episodes, Parkinson’s disease and psychiatric pathological conditions that occurr during pregnancy or childbed, reluctance to apply ECT persists due to the low degree of information and professional training. The purpose of this article is to emphasize the importance of informing the medical team of the specific training in the provision of adequate nursing within the electroconvulsive therapy. These premises make an essential contribution to the smooth running of the therapeutic process. Taking into account the close interpersonal contact that the medical nurses have with the patient through the profession specifics, it is the appropriate framework to inform the patient and the family regarding the need to establish electroconvulsive therapy, the risks, but especially its benefits. In conclusion, there is a need to establish training courses for nurses so as to ensure the functioning of the therapeutic team as a unit.