Objective: The aim of this study was to assess the choices made by clinicians in selecting archwires during the initial, intermediate and final stages of orthodontic treatment with fixed appliances. Methods: We carried out a questionnaire-based study at the Orthodontics and Pedodontics Clinic Târgu Mureș, between March 2012 and September 2012. The questionnaires consisted of two parts: the first included questions related to the dimension, alloy used in fabrication, section (round or rectangular) and manufacturer of the archwires used by the orthodontists in their orthodontic practice, the second part was concerned with their personal opinion about the physical properties and disadvantages of the archwires. Results: From a total number of 90 distributed questionnaires, 62 were returned. The majority of clinicians are using stainless steel (SS) and nickel-titanium alloy (NiTi) wires in their fixed orthodontic treatments, very few are using beta-titanium (Beta Ti), copper nickel-titanium (Co- NiTi) and esthetic archwires. The preferred dimension seem to be 0.022 inches in the appliance system. Regarding the wire dimensions, 0.014, 0.016 inch wires are mostly used from the round section group and 0.016 × 0.022 inch, 0.017 × 0.025 inch from the rectangular ones. Conclusions: There is a general lack of agreement between the clinicians surveyed regarding the properties of an ideal archwire and the disadvantages of the used wires. The most frequently used alloys seemed to be the SS and NiTi
In this paper a novel approach on knowledge integration in presented in the context of the knowledge-based society/economy (KBS/E). What this paper brings new is the transdisciplinary integrative approach of the knowledge through the “conceptual knowledge space” as a potentiality, and the “practical transdisciplinary knowledge space”, as actuality, with the transition between them through the included middle. Are introduced some of the most important practical educational environmental transdisciplinary conceptual and applied spaces, as innovative groundbreaking clusters that foster the origination, transfer and implementation of knowledge in the process of achieving sustainable development of the continuously integrative society. The University is considered the most appropriate space for this transdisciplinary approach of knowledge achievement, being a natural habitat of the synergistic integration of education, research and industry, and with its adaptability and adequateness in the knowledge economy space. University should become an open space in a reconfiguration in a integration of a highrequired degree with breadth profile competence in the integrated fields of different disciplines, with the need to have a depth profile of the knowledge in research on particular cognitive field. A new redefined mission of university by collaborating with industry should be linked to a redefinition of the role of the research in universities in the knowledge based society/economy.
Objectives: Gout is the most common inflammatory arthritis of the 21 century, but is still frequently misdiagnosed. This review aims to provide guidance for gout management in clinical practice, which includes the diagnosis, treatment of acute episodes, but also long-term therapy to reduce serum urate, as well as lifestyle changes and prevention of recurrent episodes.
Design: Systematic review without meta-analysis.
Methods: We have systematically searched Google Scholar, PubMed, and all relevant worldwide guidelines to identify and select clinical guidelines for gout. We have included eligible gout articles according to predefined inclusion and exclusion criteria after selecting titles, abstracts and full texts. The characteristics of the recommendations reported in the guidelines included were extracted and analyzed.
Results: We selected 27 eligible papers and tried to facilitate the identification of recommendations for the treatment of gout in the acute phase, but also in the chronic phase. The recommendations were detailed and explained during this extensive review.
Conclusions: Despite the availability of effective serum urate reduction therapies, overall gout management is poor. Achieving therapeutic goals is often low both at the initiation of therapy and in long-term treatment. Optimal strategies for managing gout are necessary in both acute and chronic gout flames in patients who are prone to the development of this pathology.
Background and Aim: Non-alcoholic fatty liver disease (NAFLD) is considered to be the most common of all liver disorders, and its prevalence is almost certainly increasing. Because of the presence of NAFLD in metabolic syndrome and of latter’s role in the appearance of colorectal polyps, many studies have tried to find a link between the liver disease and colorectal polyps. The aim of the study was to determine whether NAFLD is a risk factor for colorectal polyps.
Material and Methods: We examined 560 patients diagnosed with NAFLD who underwent colonoscopy at Mures County Hospital, between January 2011 and June 2014. Fatty liver disease was assessed by abdominal ultrasound, with NAFLD defined as fatty liver disease in the absence of alcohol use of > 40 g/week or other secondary causes. We divided the 560 patients into two groups, according to the presence or absence of polyps. Data were collected from patient’s history, physical exam, laboratory tests and abdominal ultrasound.
Results: The prevalence of colorectal polyps was 16.6% (93) in the NAFLD patients. 51 (54.8%) of them were female, and the Chi2 test identified a statistically significant association between the female gender and the appearance of polyps (p=0.028; OR=1.652; CI= 1.052-2.596). No statistical association was found between the smoking status and the development of colorectal polyps (p=0.245) and only 18 of 93 patients were smokers. Of 93 patients with polyps, 68 (73.1%) have associated diabetes mellitus, but without statistical correlation (p=0.214). According to family history of colorectal polyps none of the patients have data about a possible polyposis pathology.
Conclusions: Our study demonstrates a relationship between some characteristics of NAFLD and the development of colorectal polyps. Further studies are required to confirm whether NAFLD is a risk factor for the appearance of polyps.
Background and aim: Hepatocellular carcinoma (HCC) is one of the most important health problem, with an increasing incidence worldwide. The aim of the present study was to determine the factors that predict HCC occurrence in a group of patients with liver cirrhosis developed on various etiologies.
Material and Methods: A total of 282 consecutive patients with liver cirrhosis seen between January 1, 2013 and July 31, 2014 were enrolled in a prospective study. Data from patient’s history, physical exams, laboratory tests and abdominal ultrasound were collected.
Results: 282 patients were included in the study with a median age of 59.6 and a male/female ratio of 1.38/1; 12.41% (35) were diagnosed with HCC. Alcohol consumption was documented in 19 cases (54.28%), without statistical association (p=0.621), and 7 (20%) were smokers (p=0.403). According to etiological factors of liver cirrhosis: 7 (20%) had background B virus infection, 15 (42.85%) HCV infection and 11 (31.42%) cases incriminated other causes of cirrhosis (alcohol). Chi2 test identified a statistically significant association between the occurrence of HCC and viral etiology of cirrhosis (p = 0.001, r = 18,830). No statistical association was found between Child Pugh scoring of cirrhosis and HCC (p=0.774) and a statistically significant association but inversely proportional was identified between neoplasia and obesity (p=0.008, r= -0.157).
Conclusion: In conclusion the viral etiology of liver cirrhosis is found to be an important risk factor for HCC, and liver cancer was inversely associated with nutritional status.
The craniofacial skeleton in the growing child is responsive to changing functional demands and environmental factors. Orthopedic modification of facial bones through the application of constant forces over long periods of time has been a mainstay of orthodontic and dentofacial orthopedic therapy.
Aim of the study
The aim of this study was to evaluate changes in pharyngeal structures after rapid palatal expansion (RPE) and compare them with those after using a removable mandibular advancement device (MAD).
Material and methods
In order to accomplish function we modified the pattern of neuromuscular activity throught mandible forward position.
This finding shows that maxillary deficiency and mandibular retrognathism have been reportedly linked to OSA as both etiologic factors and sequelae of prolonged mouth breathing during the period of growth, these illustrate the potential interaction between alteration in respiratory function and craniofacial morphology.
Craniofacial anatomic defects, including inferior displacement of the hyoid bone, larger gonial angle, smaller anterior cranial base, altered anterior and posterior facial heights, and mandibular deficiency, have been suggested as predisposing factors for upper airway obstruction during sleep. Cephalometry has been used extensively in the fields of orthodontics and anthropology to record craniofacial form. Recently, it has been also suggested that cephalometry could be an adjunctive procedure for assessing craniofacial patterns associated with OSAS.
Estimating efficacy of rapid maxillary expansion and mandibular advanced in the treatment of paediatric SDB. This might provide alternatives to primary treatments and/or enhance interdisciplinary treatment planning for the children suffering from OSA. The relationships between maxillofacial malocclusions and upper airway volumes were investigated. Literature studies on the association of upper airway narrowing with dento-skeletal malocclusions have been confirmed by us for the group of patients studied.
Temporomandibular disorders (TMD) affect the temporomandibular joints, the masticatory muscles, and surrounding tissues. Among symptoms such as jumps, joint noises, reduced mouth opening (closed lock), difficulties in closing the mouth (subluxation or open lock), pain is the most common symptom encountered among patients diagnosed with temporomandibular disorders. As literature on this topic is abundant and sometimes controversial, the authors focus on reviewing the state of art of occlusal splints indications. Therefore, the most common occlusal splints, like Lucia jig, nociceptive trigeminal inhibition (NTI), directive splints, etc., are being described, based on their design and therapeutic indications. Cases of malocclusions associated or not with parafunctions are usually manageable using the splints mentioned in this article. In case of disc displacements, occlusal appliances can be used, but as the etiology is multifactorial, there are some limitations, depending on the complexity of each clinical situation.
Introduction: Tooth impaction is defined as the absence of a tooth on the arch, after its normal eruption age. The main reason canines are impacted is the lack of space required for the tooth to erupt.
Aim of study: The main objective of this study is to determine the types of malocclusions associated with canine impaction (Lindauer classification). A secondary objective is to establish the correlation between these parameters and identification of subjects with high risk of canine impaction based on pre-existing malocclusion.
Material and methods: This study was performed on a sample of 20 patients, 9 men and 11 women. The dental casts were subject to Angle classification and various measurements such as arch perimeter, Pont’s index, sum of the mesiodistal width of the incisor and arch length were performed. The Lindauer sectorial classification was determined based on the patients’ panoramic radiography.
Results: According to the data collected, the Class II /2 malocclusion is more frequent, and it is associated with the impacted canine (approximately 50%). According to the Lindauer classification higher frequency of the impacted canines was found in Sector IV.
Conclusion: The diagnosis for impacted canines is often associated with Class II /2 malocclusion, and according to the Sector classification, it is often localised in Sector IV.
Introduction. Cryptogenic organizing pneumonia (COP), first described in 1985 as BOOP bronchiolitis obliterans organizing pneumonia, is an acute inflammatory disease characterized histopathologically by intracellular granulomas formed by connective tissue and miofibroblasts (Masson bodies).
Case presentation. 62-year-old female patient, known with type 2 DZ, ICC, CIND (paroxysmal FiA) and HTAE, under treatment with Amiodarone, is hospitalized with acute respiratory symptomatology. Laboratory tests show bilateral basaltic crepitation risers, biological inflammatory syndrome, and radiologically multiple opacities with ½ inferior condensation appearance for which empiric antibiotic treatment was initiated. Evolution of the patient was unfavourable, despite antibiotic treatment. Therefore, it is decided to do a fibrobronchoscopic examination (bronchial aspiration for cytology and BK), thoracic CT followed by thoracoscopy and pulmonary biopsy.
The diagnosis of COP was based on the typical radiological appearance of bronchopneumonia but that is not responding to antibiotic treatment. The bronchoalveolar lavage revealed nonspecific inflammatory infiltration with lymphocytes and polymorphonuclear cells, the histopathological examination revealed the presence of Masson bodies, alveolar fibroblast polyps and bronchiolar polyps. As amiodarone is known to have pulmonary adverse effects, among which COP was very rarely quoted, treatment with amiodarone was discontinued and cortisone treatment with prednisone 70 mg/day was initiated, with rapid progressive improvement of symptomatology and slow improvement of imaging. In treatment month 3, after the decrease in prednisone to 30 mg/day, the general condition of the patient worsens in parallel with the biological and imaging parameters secondary to the reintroduction of the amiodarone treatment, an event treated as a recurrence of drug-induced obliterans pneumonia. The evolution of the patient was favourable, with the remission of clinical symptoms and radiological appearance, in the absence of relapses one and a half years after the end of the treatment.
Conclusions. This paper presents a complete case of cryptogenic organizing pneumonia in a patient undergoing amiodarone treatment, which has a complete response to cortisone treatment only after the trigger factor has been removed.