Category Archives: AMM 2015, Volume 61, Number 3
Resin-Based Composite and LCU-related Factors Affecting the Degree of Cure. A Literature Review: Part 1. Resin-Based Composites
Resin-Based Composite (RBC) is widely used in Dentistry to restore anterior and posterior teeth. There have been many advances in RBCs development to improve their clinical success rate and overcome the many disadvantages of the first materials. These materials are cured by visible light, and light curing units have also undergone considerable development. Recently, bulk-fill composite materials were introduced to be placed in the cavity in bulk, claiming replacement of the traditional layering technique. In this paper an overview of RBCs, their composition and properties will be presented. [More]
A One Time Opportunity for Generosity
Nine eleven celebrated a decade of safe measures taken in order to prevent further useless human losses. Since then, violence against human beings is supposed to be prevented and opposed by security measures. The number of human beings deceased as a result of that terrorism act was appreciated at 2982 (1).
Compared to this devastating attack against humanity, the fact that a number of 6467 patients died in the USA in 2012 while waiting for an available organ passed almost unobserved by the media (2). Still, a number of 22187 organ transplantations were performed from 8143 deceased donors. Summing up the lost human lives in the battle to survive by human organ transplantation, we can easily see that despite the organ shortage, the gift of life allowed 7571 otherwise lost patients to continue to live. To an accountable, it would be a positive balance. When looking at the figures of the waiting list, that is over 120 000 souls, the disparity between need and supply of transplantable organs is impressive (2).
So, are there ways or opportunities to increase organ donation? And doing so, are we at risk of disregarding moral or ethical values? Could we actually harm the donors and/or their families? [More]
The Prevalence of Chronic Liver Disease: Implications for Renal Impairment
Introduction. Renal disease plays an important role in the prognosis and evolution of chronic liver disease, in particular in its advanced stages. The aim of our study is to analyze the prevalence of chronic liver disease (hepatitis and cirrhosis of different etiologies) and to assess possible correlations between these and impaired renal function. Material and methods. We conducted a retrospective observational study based on data collected from observation charts of patients admitted to the 2nd Medical Clinic, Emergency County Hospital Tirgu-Mures between January 1st 2012-December 31 2013. In this study we included, based on informed consent, 401 patients with documented liver pathology, with preserved or modified renal function. Results. Age distribution shows that 41.1% of cases occured between 51 and 60 years of age. Sex distribution shows that 65.3% of cases were male. Toxic cirrhosis was found in 40.8% of males and viral C cirrhosis in 15.1% of women. Toxic cirrhosis associated the following complications: ascites (35.7%), encephalopathy (75%), PAH (68.6%), esophageal varices and upper GI bleed (35.7%). Analyzing the risk factors of renal failure we found that increased mean values of creatinine are associated with viral B cirrhosis (p = 0.02), portal vein diameter (OR 1.37), portal hypertension (OR 1.24), male gender (OR 1.84) and the age group 61-70 yo (OR 1.04). Conclusions. The current study demonstrated that renal function in chronic liver disease correlates with viral etiology of liver disease, its advanced stage, presence of portal hypertension, older age and male gender.
First Study of the Prosthesis Indication Deafnesses in Mureș County
Objective: The aim of this study was to asses the frequency of the deafness pathology in the Ear, Nose and Throat Clinic of the Emergency County Hospital in Tîrgu Mureș and two other private institutions that have an ear linked profile, with a special interest on those with indication for prosthesis. This is a pilot study, being conceived as a part of a larger one used to measure the number of possible cochlear implant recipients nationwide.
Methods: We gathered data from the interval 2011-2013, including in the study all the patients for which an audiometry testing was performed in this time interval. This was followed by a process of selection/exclusion applied to the original group in order to obtain significant statistical data.
Results: The most important part of the study was to quantify the different types of hypoaccusia and the relative number of candidates for various prosthesis available these days.
Conclusions: This study quantifies the rising need for hearing prosthesis and triggers a signal.
Predictive Factors in the Onset of Epilepsy in Children with Cerebral Palsy
Objectives: the aim of the study was to identify predictive risk factors of the development of epilepsy in patients with cerebral palsy (CP).
Materials and methods: We performed a bidirectional study in wich 177 patients diagnosed with CP with and without epilepsy have been selected for characteristics and risk factor comparison. We analyzed the history related to pregnancy and birth, gestational age, birth weight, fetal distress, the presence of neonatal convulsion, age of onset for the epilepsy, associated types of seizures, the response to anticonvulsant therapy and brain changes identified by Computer tomography and Magnetic resonance imaging examination.
Results: epilepsy was found in 91 (51.4%) patients, most frequently in quadriplegic form (76.2% vs 23.8%), OR:3.04, 95% CI:1.42-6.52, p-0.005. In this group, the most common were partial seizures (34.4%), epileptic encephalopathy like Lennox Gastaut and West type (62.5%), and also neonatal seizures. Eighty percent of on-term infants with neonatal seizures later developed epilepsy. Factors like fetal distress, low birth weight, cytomegalovirus infection, history of pathological pregnancy were associated with an increased risk of developing epilepsy. Imaging change, especially cerebral atrophy had the highest frequency (37.5% vs 16%) in pacients with epilepsy. 28 (30.8%) patients had resistance epilepsy, 13 (46.4%) of them having quadriplegia. Early onset of epilepsy constitutes a sign of severity of epileptic forms (OR:3.09, 95% CI:1.187-8.061, p-0.01).
Conclusions: The data are consistent with those in literature but is necessary following this study to clarify and support the assumption on preddictive factors and prognosis of epilepsy in this population.
Experimental Evaluation of Dental Implant Biomechanics Given Certain Stages of the Fixing Substrate Deterioration by Video Image Correlation Method
Background: Dental implants are useful tools and represent a widely spread technique for oral rehabilitation. Their long standingness is highly influenced by the mechanical and geometrical properties of the surrounding osseous tissue in which they are placed. In some unsuccessful cases though, the dental implant is exposed to masticatory forces and other functional acts, and osseous tissue may resorb near its vicinity, leading to the dental implants loss. We investigated the strain distribution inside the fixating substrate, given certain stages of its deterioration near the dental implants.
Material and methods: For our investigations we used cilindro-conical screw-type dental which were submitted to vertical forces between 0-1000 N. The dental implants were fixed inside a plastic material used in photo-elastic measurements. To evaluate the strain distribution inside the fixing substrate, we used a non-contact, experimental investigation tool, the Video Image Correlation (VIC-3D) optical system. This system allows the implementation in the dental implants optimisation from stress-strain state point of view.
Results: The strain field distribution inside the fixating substrate was measured at three different levels of the dental implant, when it was loaded alone and in the case when there were loaded two dental implants simultaneously.
Conclusions: The most stresses are concentrated in the neck-area of the dental implant. If there are loaded two or more dental implants simultaneously, the distance between them influences strain distribution. The measurements were conducted in vitro and do not represent the in vivo conditions, but serve further important facts regarding biomechanical properties of dental implants.
Is NAFLD a Risk Factor for Colorectal Polyps? An Analysis of Single Romanian Centre
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.
Arylsulfatase A: An Important Metabolic Factor in Pathophysiology of Different Diseases
Arylsulfatase A (ARSA) is a lysosomal enzyme that plays an important role in catalysis of degradation of cerebrosidesulphate. The deficiency of this lysosomal enzyme causes an autosomal recessive disorder, called metachromatic leucodystrophy. However, a low ARSA activity can be observed in clinically healthy people, called ARSA pseudodeficiency. In our study we investigated the possible linkage between ARSA activity and sulfatide deficiency causing characteristic aspects of degenerative diseases, such as end stage kidney disease, type 2 Diabetes mellitus, Parkinson syndrome, prostate cancer and HIV (Human Immunodeficiency Virus) infection. We used a spectrophotometric method to determine the activity of ARSA. This method of enzyme dosage is based on a 4 hour long hydrolysis of the ARSA enzyme on 4-nitrocatechol sulfate (p-NCS) substrate. The unit of this measurement is nmol/ml/4h. Our findings show significant values in type 2 diabetes, Parkinson syndrome and chronic kidney disease. The importance of sulfatide in these diseases is well-known, thus presumably the variation of the ARSA’s activity might play an important role in the pathophysiology of these diseases, involving a vicious cycle between sulfatide degradation andthese diseases.
Clinical and Psychological Correlations between Job Loss and Depressive Experience
Introduction: Stressful life events have a negative effect on mental health. Job loss is an event with a psychotraumatic character. Identification of the main sources of stress faced by the individual is essential in the management of depression.
Objective: The aim of this study was to identify the main risk factors that play a role in the onset and maintenance of depression.
Material and methods: we made a prosepctive study including 68 outpatients aged over 18, recently diagnosed with Major Depressive Disorder (MDD), without psychotic features, with initiated antidepressant treatment, being in evidence of First Clinic of Psychiatry Tirgu-Mures, between 01.01.2013-31.12.2013. To assess the severity of depression and to measure the antidepressant treatment efficacy we used Hamilton Depression Scale (HAM-D17) at study onset, respectively at endpoint. The parameters followed were: HAM-D17 score, response to treatment, the mean number of hospitalizations in a year.
Results: The group included 82.35% women and 17.65% men, mostly from urban areas, aged between 35 and 68, with a HAM-D17 score between 24 and 27. The major stressful life events inventory shows that 20.58 % of the patients were unemployed. The observed effects were more extensive in men.
Conclusions: How stressful life events exert their influence on mood is complex. The onset of depression often seems to coincide with a stressful event, although sometimes the event is only the revelator of an episode ready to trigger. The findings indicate the need of prevention politics for relapse of the disease, which is a disadvantage regarding the re-employment.