Head and neck cancers, primarily squamous cell carcinomas (HNSCC), represent a significant health burden, being localized predominantly on the mucosal surfaces of the head and neck region. Approximately 3% of all cancer cases reported worldwide are attributed to head and neck cancer.
Neurogenic heterotopic ossification (HO) is the abnormal formation of bone in non-skeletal tissues, typically near major joints, following traumatic or nontraumatic spinal cord or brain injuries. This condition significantly affects the patients’ quality of life, often leading to joint ankylosis and severe limitations of mobility.
The success of proper oral hygiene depends on optimizing plaque control. Compared to tooth brushing alone, interdental brushes are more effective in reducing plaque and gingivitis. The aim of this pilot study was to find a storage and/or disinfection method to reduce the number of bacteria left on interdental brushes after use, thereby reducing the transfer of bacteria from one interdental space to another. We conducted a microbiological comparison of four different storage and/or disinfection methods for interdental brushes. The results suggest that mouthwash may be a useful and accessible method for patients to disinfect and reduce the bacterial load on interdental brushes. Larger, more thorough studies with a larger sample size are necessary to further validate this.
Abdominal aortic aneurysm (AAA) is a serious condition where the aorta becomes abnormally dilated, which can lead to serious health risks. Inflammation plays a crucial role in AAA. The neutrophil-to-lymphocyte ratio (NLR) is a known prognostic marker for various medical conditions, including AAA. This review aims to assess the role of NLR in predicting adverse outcomes in patients with AAA. A systematic review of articles from PubMed covering the years 2013 to 2023 was conducted using the PRISMA guidelines. Out of 1,701 articles identified, 24 full-text publications were screened, and only 8 were included. The studies used receiver operating characteristic analysis to determine the best NLR cut-offs, which ranged from 4 to 9.7. The studies provide evidence that links NLR to mortality and rupture in patients with AAA. The utility of NLR utility extends beyond AAA, demonstrating significance in conditions like acute limb ischemia, chronic kidney disease, and coronary artery disease. This review underscores the potential of NLR as a valuable prognostic tool in AAA, offering insights for risk stratification and patient management.
This study focuses on two of the most prevalent congenital heart defects: bicuspid aortic valve (BAV) and coarctation of the aorta (CoA). In severe forms, CoA is an emergency that can become life-threatening. Both diseases are linked to aortic vasculopathy, which represents a significant contributor to morbidity and mortality in young patients with congenital heart disease. The aim of this study was to investigate whether there are differences between patients with CoA and BAV, and patients with CoA and without BAV in terms of outcome and echocardiographic parameters, and to evaluate the efficacy of different echocardiographic parameters in predicting CoA.
Hypertensive disorders of pregnancy impact approximately 10% of pregnancies worldwide. During pregnancy, there are changes in the expression of coagulation and fibrinolytic proteins that promote clot formation. While a normal pregnancy is associated with increased coagulation, women with preeclampsia experience even greater coagulation. Aim of the study: To assess the potential of blood coagulation parameters and platelet indices as predictors for preeclampsia.
Arteriovenous fistula (AVF) is the preferred method of vascular access for patients with end-stage kidney disease. However, excessive inflammation and inadequate remodeling of the venous component may cause intimal hyperplasia and AVF stenosis. This could lead to vascular access failure and an increased risk of mortality. Serum albumin, neutrophil-to-lymphocyte ratio (NLR), C-reactive protein, mean platelet volume, platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index, interleukin-6, red cell distribution width, and fibrinogen have been identified as the most promising biomarkers in predicting AVF maturation and long-term patency. According to the 14 studies examined in this state-of-the-art review, with a total of 2,695 patients, NLR and PLR have shown the most promising prognostic role in terms of AVF outcome. Our findings indicate that systemic inflammatory indicators may be important in the development of dialysis-associated AVF dysfunction and warrant further evaluation of NLR and PLR as potential biomarkers for patient management and follow-up of AVF dysfunction.
Abstract Introduction Osteoporosis is characterized by a reduction in bone mineral density. Among the factors that can contribute to the onset of osteoporosis we can enumerate alcohol consumption, smoking, glucocorticoid therapy, or the presence of diabetes mellitus. The incidence of osteoporosis increases with age. Materials and Methods A total of 183 women over the age of 50, with a mean age of 67.9 ± 7.74 years, were studied to visualize spinal column alterations. From this cohort, 103 patients underwent bone mineral density testing using dual-energy X-ray absorptiometry (DXA) and dorsolumbar radiography, while 80 patients did not undergo DXA testing. Assessment of the degree of vertebral involvement was performed using the Genant semiquantitative method. Results The highest percentage of vertebral fractures was observed in patients aged >70 years (100%). Within the studied cohort, 28% of patients displayed multiple vertebral fractures associated with age (p = 0.01). The most common site for vertebral involvement was the dorsolumbar region (D11–L2) across all age groups (p = 0.35). No statistically significant correlation (p = 0.22) was identified between DXA values and the presence of vertebral fractures, despite a trend of increased incidence of fractures as the T-score decreased. Conclusion Within the cohort, vertebral fractures were identified both in women with normal values of bone mineral density and in those with osteoporosis. Furthermore, the severity of these vertebral fractures did not correlate with bone mineral density values, highlighting the necessity of using both osteodensitometry and spinal radio-graphs for diagnosis.
Abstract Introduction Halitophobia is also known as false halitosis or psychosomatic halitosis. This pseudo-pathology originates from the somatization of the compulsive idea that the patient has bad breath in the absence of oral pathology. Case Presentation A patient addressed dental surgery complaining of a self-diagnosed halitosis. The dental consultation did not find any dental problem that could cause bad breath. She was referred to a general practitioner for further investigations to rule out a general condition. The investigations revealed a perfectly healthy person, without any chronic ailment that could cause bad breath. The patient refused to consult a psychologist or psychiatrist, considering that she does not have a mental health problem. Conclusions Patients with a suspicion of psychogenic halitosis require psychiatric counseling, and dentists have to be prepared with an efficient strategy for the correct management of these patients.
Abstract Introduction The sural nerve is a sensitive nerve whose function is to provide sensory supply for the posterolateral aspect of the distal third of the leg and the lateral side of the dorsum of the foot. This nerve is formed in the upper third of the calf from the terminal branches of the tibial and common peroneal nerves and the communicating branch of the sural nerve. Objectives The aim of our study is to showcase two anatomical variants of the sural nerve. Materials and methods Two formalin-preserved cadavers, one male and one female, embalmed using formalin 4% were dissected with the intent of being used as teaching materials for the students attending anatomy classes at the “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, Romania. Results In both cases, less common anatomical variations of the formation of sural nerve were discovered. On the male cadaver, we identified the sural nerve as a continuation of the medial sural cutaneous nerve. The lateral sural cutaneous nerve and the communicating branch of the sural nerve were both absent. On the female cadaver, we identified both the medial sural cutaneous nerve and the lateral sural cutaneous nerve. The sural nerve was, however, a continuation of only the lateral sural cutaneous nerve, with the medial sural cutaneous nerve as an independent branch. Conclusions We described two anatomical variants of the sural nerve, which are less common than those documented in the literature.
Abstract Background Migraine, a primary headache disorder, is a debilitating condition with reduced productivity, increased disability, and a very high economic burden. The present study aimed to individualize the treatment protocols for episodic and chronic migraine in order to reduce the duration, frequency, and severity of attacks, as well as the disability associated with migraine by comparing monotherapy and dual therapy. Materials and Methods We conducted a prospective observational study between February 2019 and July 2021. Patients were diagnosed with migraine based on simplified diagnostic criteria. Episodic migraine was present in 62% and chronic migraine in 38% of cases. Disability due to headache was assessed using the Migraine Disability Assessment Score (MIDAS) questionnaire. Prophylactic therapy was individualized, with 210 patients receiving monotherapy (propranolol, flunarizine, or valproic acid) and 190 patients receiving dual therapy (propranolol and flunarizine, or valproic acid and flunarizine). Disability at baseline was graded from I to IV, and improvement after treatment was graded as no recurrence of headache, grade I, grade II, and grade III. Results After 2–3 months of therapy, we observed significant improvement in the form of reduction in the frequency of attacks and reduction of disability. Patients with grade II disability who received dual therapy showed 100% improvement with no recurrence of headaches. Treatment with valproic acid resulted in no recurrence in 100% of patients with grade I and 85.7% of patients with grade II disability scores. Significant improvement was observed in all grades of disability with dual therapy. Conclusion Dual prophylactic therapy was more efficient than monotherapy in reducing the frequency, duration, and severity of symptoms in grade III and grade IV patients.
Abstract Introduction The COVID-19 pandemic that started in 2019 was a modern-world challenge for medical professionals. The SARS-Cov-2 virus targeted the respiratory and, later, the cardiovascular system. We aimed to identify the risk factors and particularities of acute myocardial infarction associated with SARS-Cov-2 infection. Material and Methods This cross-sectional study included 92 patients admitted to the Cardiology Department of Mureș County Emergency Hospital with myocardial infarction, divided into two groups: 46 patients with COVID-19 and 46 patients without COVID-19. Demographic data, risk factors, non-communicable diseases, and laboratory findings were studied and compared. Results The mean age of the patients was 65 years, and the majority were male. The identified risk factors were hypertension, body mass index >25 kg/m2, and dyslipidemia. The risk factors for poor prognosis were leukocyte count, higher neutrophil-lymphocyte ratio, higher monocyte-to-lymphocyte ratio, and higher high sensitivity troponin I levels. Left ventricular ejection fraction was significantly lower in patients with COVID-19. Conclusions COVID-19 is an aggravating factor of acute myocardial infarction. This research highlights the importance of prevention against the SARS-CoV-2 virus.
Abstract Introduction During the COVID-19 pandemic, vitamin D was used along with vitamin C and zinc as a preventive and curative therapy against SARS-CoV-2 infection. Vitamin D toxicity, even if it is rare, occurs when serum concentrations exceed 150 ng/mL and is usually manifested by hypercalcemia phenomena. Case report We hereby report a case of two twin sisters who self-medicated with vitamin D in a dose of 4 × 4,000 IU/day for almost 10 months as a method of ‘protection’ against COVID-19, influenced by mass media advertising. The patients presented to the emergency department with hypervitaminosis D-related symptoms such as hypertension, headache, nausea, vomiting, and diffuse abdominal pain. Laboratory investigations revealed high levels of vitamin D and calcium. Conclusions Vitamin D toxicity can lead to difficulties in positive and differential diagnosis because of the multiple complications of hypercalcemia.
Abstract Background Cervical cancer is the fourth most common female malignancy worldwide. In developing countries, it is the most common subtype of cancer and the third leading cause of cancer mortality among women. Artificial intelligence has the potential to be of real use in the prevention and prompt diagnosis of cervical cancer. The aim of our study was to develop a medical platform consisting of an automated observation sheet containing colposcopy data, a software that would use a machine learning module based on clinical and image data for diagnosis and treatment, and a telemedicine module to enable collaboration between gynecologists. Materials and methods Clinical and colposcopy image data from 136 patients were introduced into a machine learning module designed to generate an algorithm for proposing a preliminary diagnosis and treatment. The clinical and imaging data were corroborated to generate six options: ‘Follow-up’, ‘Pharmacotherapy’, ‘Biopsy’, ‘Curettage’, ‘DTC’, and ‘Conization’. Results Data generated by the machine learning module regarding treatment options were compared with the opinion of gynecologists and yielded an accuracy of 78% for ‘Follow-up’, 81% for ‘Pharmacotherapy’, 84% for ‘Biopsy’, 90% for ‘Curettage’, 96% for ‘DTC’, and 81% for ‘Conization’. Conclusions The developed software can be an important step towards the digitization of existing gynecology offices and the creation of intelligently automated gynecology offices related to prevention and treatment of cervical cancer. More data is needed to improve the accuracy of the developed software.
Abstract Introduction Sweet syndrome, also called acute febrile neutrophilic dermatosis, is a rare disorder characterized by skin lesions accompanied by high fever and elevated inflammatory markers. Case Presentation In January 2023, a 73-year-old Caucasian male was diagnosed with acute myeloblastic leukemia and subsequently chemotherapy with azacitidine and venetoclax was initiated. One week after the second round of chemotherapy with azacitidine, the patient developed a fever of 39˚C. Physical examination revealed purple plaques on the skin of the head, neck, and arms associated with pain but not itching. Initially, the plaques appeared at the site of the subcutaneous azacitidine injection (left upper extremity) and then began to spread. The infectious diseases consultation established the diagnosis of multiple abscesses. Antibiotic therapy was initiated with meropenemum and linezolidum, and later colistin was associated, but the skin lesions and the patient’s condition worsened. A dermatology consultation was performed, which established the diagnosis of Sweet syndrome, and subsequently corticosteroid therapy was started. The skin lesions started to improve after 3 days. Conclusions Sweet syndrome is a rare condition that is difficult to diagnose because of the wide spectrum of differential diagnoses.
Abstract Background The study was aimed to evaluate whether a mechanical biaxial tester can be used in a uniaxial mode to evaluate the mechanical properties of tendons. Materials and methods The study was carried out on specimens of porcine superficial digital flexor tendon (n = 9). The mechanical properties (elastic modulus, and stress at 15% strain) were measured two times consecutively in the uniaxial mode with the BioTester® 5000 (CellScale) equipment. Results Values of 0.313 ± 0.096 MPa for the elastic (Young’s) modulus and of 0.702 ± 0.174 MPa for the stress (at 15% strain) were measured, indicating that the porcine superficial digital flexor tendon is not a strong tendon. Conclusions When suitable specimens cannot be obtained for a biaxial evaluation, tendons can be evaluated mechanically in the BioTester® 5000 employing the uniaxial mode.
Abstract Background 3D printing has changed the paradigm of personalized medicine. Similarly to fingerprints, there are no two identical hearts; consequently, in cardiology, diagnosis and treatment, either medical, interventional or surgical, must be individualized according to the specific problem of a particular patient. The aim of this proof-of-concept study was to analyze two measurement methods, the planimetric and the photogrammetric method, in the process of creating a 3D-printed model from cardiac computed tomography angiography images and to evaluate the accuracy of an aortic valve anatomical model. Material and methods Cardiac computed tomography images, obtained from 20 patients with severe aortic stenosis, underwent stereolithographic reconstruction using 3D Slicer to create digital 3D models of the aortic valves. Serial measurements of six key elements of the aortic valvular apparatus were measured on the 3D model and compared to the measurements taken on the 2D computed tomography images. Results The differences between the two measurement methods were sub-millimetric in case of the left ventricular outflow tract and the sinotubular junction, and 1.386 mm for the left sinus of Valsalva (p = 0.0412), 0.3476 mm for the right sinus of Valsalva (p = 0.1874), and 0.6905 mm for the non-coronary Valsalva sinuses (p = 0.1353). Sinus heights were also similar, with a difference of 0.0119 mm (p = 0.6521). Conclusion In this study, the results of digital photogrammetry were superimposable to those of computed tomography scan measurements. The accuracy of each 3D-printed model depends on geometric complexity, the level of training of the personnel, and on the resources of each 3D printing laboratory.
Abstract Endometriosis is a chronic inflammatory gynecological disease affecting 190 million women or 10% of women of reproductive age worldwide. The disease is marked by the presence of endometrial-like tissue outside the uterus, being associated in many cases with chronic pain and infertility. The current recommendations of international professional societies underline the need for laparoscopy, eventually followed by histological verification, as the gold standard for diagnosis. However, many societies recommend the initiation of specific treatment before obtaining a definitive surgical diagnosis. Various national and international societies have released guidelines for endometriosis assessment based on biomarkers; however, none of these recommendations proved to be clinically useful or able to replace diagnostic laparoscopy. In recent years it was demonstrated that oxidative stress, defined as an imbalance between reactive oxygen species and antioxidants that is directly linked with an increased inflammatory response in the peritoneal cavity, may be involved in the pathophysiology of endometriosis. The identification of a genetic predisposition for endometriosis can identify the patients at risk and may help clinicians promptly initiate therapeutic management of their patients in order to ameliorate their prognosis.
Abstract Introduction Acrylic resins are the most frequently used materials for the bases of prostheses, and are also used in the re-optimization and the repair of prostheses. The aim of our study was to investigate whether direct contact with the resin causes decomposition of methyl methacrylate and formation of ketone bodies in the oral cavity. Material and methods The in vitro study included 12 samples of autopolymerized polymethyl methacrylate and 8 samples of thermopolymerized polymethyl methacrylate. Some of the resin samples were intentionally prepared incorrectly, with modified powder to liquid ratios or thermal regime, to be able to compare them with samples prepared according to the manufacturer’s instructions. Some of the samples were immersed in gastric juice or alcohol for 48 h at 37 °C in a thermostatic bath to simulate the environment and temperature of the oral cavity, while others were kept at room temperature. The Legal reaction was used to identify the presence of ketone bodies in the solutions. Results The samples that were prepared incorrectly and were kept at 37 °C were the most affected. The presence of ketone bodies was demonstrated by the formation of a precipitate on the bottom of the test tube and the color change of the solution. Samples that were kept at room temperature were less affected, both from a spectrophotometric and biochemical point of view. Conclusion The quality of polymethyl methacrylate can be improved by respecting the manufacturer’s instructions and work protocols, and by avoiding substances that are considered aggressive, such as gastric juice, alcohol, and local factors in the oral cavity.
Abstract Introduction Drug-induced gingivitis is caused by the administration of certain drugs such as hydantoin, calcium blockers, beta-blockers, cyclosporine, and oral contraceptives. The aim of this study was to evaluate the modifications linked to drug-induced gingivitis such as changes in color, volume, and consistency, and the clinical signs of periodontal disease. Materials and methods The study was based on a questionnaire made up of 14 questions, formulated using colloquial language to increase addressability. Results The most frequently used drugs were beta-blockers (37%), calcium channel blockers (33%), followed by anticonvulsants (18%), oral contraceptives (8%) and cyclosporine (4%). Color changes occurred in 81% of anticonvulsant treatments and 57% of oral contraceptives. Increases in the gingival volume were higher with anticonvulsants (73%) followed by cyclosporine (67%). Gingival consistency was higher with anticonvulsant treatments (90%), followed by calcium channel blockers (60%). Gingival changes and gingival bleeding during brushing were higher with anticonvulsant treatments, followed by beta-blocker medication. Spontaneous gingival bleeding had a higher prevalence in anticonvulsant treatments, followed by cyclosporine. Conclusions The patients most affected by gingival enlargement were those under hydantoin treatment, followed by cyclosporine. Calcium channel blockers and beta-blockers had similar effects on gingival pathology. The intensity of the pathological changes that occurred secondary to the administration of these drugs was influenced by the dose, the duration of the treatment, and the association of several drugs. Early detection and management of gingival enlargement is important in order to allow patients to continue with their therapy, and also to increase their quality of life.
