Category Archives: AMM 2013, Volume 59, Number 1

Evaluation of Diagnosing Tuberculosis in Primary Care Medicine in Mureș County, Between 2006 and 2008

DOI: 10.2478/amma-2013-0003

Aim: Evaluation of the contribution of general practitioners to the early diagnosis of tuberculosis in the studied period. Analysis of cases not diagnosed as active TB, from those suspected by the general practitioner and the real cases with respiratory lesions.
Material and methods: We conducted an observational epidemiologic study aiming at evaluating the diagnosis of pulmonary TB at the level of primary care medicine.
Results: The difference between conformed TB patients that have been referred with the suspicion of TB and those without suspicion is significant (p <0.0001), and the risk of disease estimated by OR was 21.54. More than half of the patients (139), had positive microscopic examination and culturing, representing 62.61%. In 10.36% microscopic examination was positive and culturing was negative (13 patients). Negative microscopic examination and positive culturing were detected in 5.86% of the patients. The majority of suspected/confirmed new patients were living in urban environments. The urban/rural ratio was 1.27. The reasons why the general practitioner suspected tuberculosis, in the order of frequency, were the following: cough/dry cough, sweating/nocturnal sweating, fever/persisting fever. Among the TB types, we noted the large percentage of patients with infiltrating, nodular tuberculosis confined to the volume of one pulmonary segment (30.78%), and 19.87% of the cases were multicavity tuberculosis; also, we noted the presence of caseous tuberculosis with moderate volumes of infiltrates, confined to a pulmonary lobe (18.27%).
Conclusion: Early diagnosis of tuberculosis in the primary healthcare network is a continuous challenge for the general practitioner.

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Finite Element Analysis of the Achilles Tendon While Running

DOI: 10.2478/amma-2013-0002

Introduction: The Achilles tendon is the most frequent recipient of traumatic injuries. The aim of this study is to identify and describe the varying load at ankle level and especially at the Achilles tendon’s insertion on the calcaneus.
Methods: We conducted a finite element analysis of the Achilles tendon while running, with the aim of revealing maximal loads and strains during a step in a running sequence. A 3D model of the Achilles tendon was built, based on MRI slides of a healthy, injury-free subject, who was asked to run over a force plate in 50 iterations. We used the recorded data to establish maximum loads and strains.
Results: We noticed a quick rise of the intra-tendinous load, from almost negligible while airborne and on first ground contact, to roughly 40 MPa in the pre-airborne phase, with possible implications in both treatment and post-injury recovery of Achilles tendon lesions.
Conclusions: Our results suggest that while early weight bearing and early exercise routines are a modern approach, care must be given in increasing the loads on the recovering region.

 

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A Comparison of Oral Health Status in Active-, Occasional- and Non-Smoker Patients Versus Students

DOI: 10.2478/amma-2013-0001

Objective: The aim of this case-control study was to assess the smoker and non-smoker patients’ oral health status versus students.
Methods: The study was based on a clinical examination of 210 young adults (118 women, 92 men) aged between 22–32 years. 105 of these were students in the 5th and 6th grade of the Faculty of Dentistry in Tîrgu Mureș and the control group was represented by patients. Patients and students were classified into three groups: non-smokers, occasional- and active smokers. The clinical examination evaluated the dental caries, fillings, extractions, crowns, root remnants and dental plaque. DMF-S index scores were calculated, and with its help the index of treatment need, dental care index and intensity of caries were determined.
Results: The dental treatment need index, DMF-S index and intensity of caries showed increased values in patients. Root remnants (p <0.0001), decay (p = 0.0473) and dental plaque (p = 0.0363) were much higher in the group of active smoker students as in the non-smoker students. Among active smoker patients the incidence of dental calculus (p = 0.0005), of root remnants (p = 0.0022) and of fillings (p = 0.0441) showed a higher value than in the non-smokers.
Conclusions: This study showed that compared with non-student patients, in dental students, a better oral hygiene was coupled with healthier teeth and periodontal. Poor oral hygiene together with smoking seems to worsen the oral health status.

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Congenital Malformations of the Renourinary System — Risk Factors for the Development of Urinary Tract Infections, a Screening That is Required to Be Performed

Urinary tract infection (UTI) is the most commonly diagnosed bacterial infection in infants and children, with a significant consequence on the quality of life and health [1]. Congenital urinary tract abnormalities are the most common cause of UTI in children. The most frequent kidney abnormalities encountered during childhood are: obstructions of urinary tract (urethral valves, ureteropelvic and ureterovesical junctions’ obstructions), and dysfunctional voiding (vesicoureteral reflux) [2]. Primary vesicoureteral reflux (VUR) has an incidence of 20–60% among children with urinary tract infection. An early diagnosis of VUR is very important, as its missing recognition or a delayed diagnosis can lead to reflux nephropathy (RN) referring to renal scarring, as a cause of chronic renal failure in 5–40% of children aged below 16 years [3]. An antenatal screening with an accurate diagnosis followed by an immediately postnatal abdominal ultrasound made that these malformations to be diagnosed early [4] and decrease the number of urinary tract infections and their recurrences. Thus, since the neonatal period we can decide which child will be further monitored, which will receive medical treatment and which will require surgery [4].[More]

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