Tag Archives: management

Management of denture stomatitis: An overview

Nader Navabi1, Parham Shakibaei2, Alireza Ranjbar Hassani2

1. Oral Medicine Department, Kerman Dental School, Kerman University of Medical Sciences, Kerman, Iran
2. Student Research Committee, Dental School, Kerman University of Medical Sciences, Kerman, Iran

DOI: 10.2478/amma-2023-0007

Denture stomatitis is a common inflammation of the palatal mucosa beneath removable dentures. The objective of this article was to examine the systematic reviews and clinical trials pertaining to the treatment of denture stomatitis. For this research, electronic databases (PubMed, Embase, Scopus, and ISI Web of Science) were searched from January 2000 to June 2021 using specified MESH keywords. Irrelevant articles were eliminated in three steps based on their titles, abstracts, and body texts. In the final analysis, 47 papers were selected, which included 12 systematic reviews and 35 clinical trials. Herbal compounds and denture disinfection were the interventions most commonly indicated. We concluded that, possibly due to the complex nature of this lesion’s etiology, there is no present definitive therapy guideline for this prevalent lesion.

Keywords: , ,
Full text: PDF

Multi-trauma Patients Management: a Cross-sectional Study

Gomotîrceanu F, Bățagă T

Clinical Emergency County Hospital, Tîrgu Mureș, Romania

 

Introduction: The aim of this study was to evaluate the multi-trauma critical patient management in the Clinical Emergency County Hospital of Tîrgu Mureş, Romania.
Material and method: We conducted a cross-sectional study, data collection was achieved by extracting records from hospital patients database. We collected the data from January 2007 until June 2011. The initial search revealed a number of 784 patients diagnosed with multi-trauma. From this sample we included in the study only a number of 312 patients diagnosed with critical multi-trauma from whom 194 underwent emergency surgery. We evaluated clinical consults distribution, the frequency of mechanisms of injury, therapeutical and diagnostic procedures, clinical transfers, lesions associations, traumatic lesions that required emergency surgery, injured organs and thoracic injuries that required emergency surgery.
Results: From the total number of patients, 214 (68.58%) were men and 98 (31.42%) were women. The incidence of multi-trauma regarding age, showed a peak in the 1st and 2nd decade. Regarding the mechanism of injury, the main cause is represented by car accidents, followed by assault and fall. It was observed that the most frequent clinical consults were the surgical ones, followed by orthopaedic and neurosurgical consults. In the Surgical Department, in the studied period of time, there was admitted a number of 272 patients diagnosed with critical multi-trauma.
Conclusions: In recent years, the incidence of critical multi-trauma patients increased especially in the first and second life decades. Critical multi-trauma patients with emergency surgery presented a low vital prognosis, with a mortality of 4.77%. Survival of this category of patients could increase due to the establishment of a complete chain of care (patient management): accidents site, transport, emergency service, hospital operating room, intensive care postoperative therapy.

Keywords: , , ,
Full text: PDF

Management Algorithm for Surgical Patients Infected with Human Immunodeficiency Virus

Zaharia Kézdi Erzsébet Iringó1, Boţianu A2, Ioniţă Alexandrina1, Georgescu Anca1, Incze Andrea1, Şincu Nina1

1 Clinic of Infectious Diseases I, Tîrgu Mureș, Romania
2 Surgery Clinic II, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Objective: The purpose of this study was to establish the risk factors which influence the postoperative evolution of surgical patients infected with human immunodeficiency virus (HIV), and to conceive a management algorithm based upon these factors.
Methods: We have performed a bidirectional transversal study on a group of 73 HIV-positive patients who had undergone 104 surgical procedures during 2006–2010 in the university medical center of Tîrgu Mureş. We studied risk factors such as the number of CD4 T-cells (LTCD4) < 100/µl, anemia, thrombocytopenia, hypoproteinemia, leukopenia, wasting syndrome, ASA (American Society of Anesthesiologists) score, Altemeier class and NNISS (National Nosocomial Infections Survey Systems) score. We defined any registered postoperative complication, as well as all deaths within the first 30 days from surgery as poor outcome. We used GraphPad statistical program, Fisher test for the statistical analysis of data, we interpreted p <0.05 as statistically significant, for a CI of 95%.
Results: We have registered a total of 15 complications, 5 deaths. Risk factors associated with poor postoperative outcome were LTCD4 <100/µl (p=0.03) wasting syndrome (p=0.0001), ASA score > 1 (p=0.01), Altemeier class > II (p=0.0001), NNISS score 1 (p=0.0001).
Conclusions: HIV-infected patients with emergency surgical pathology will benefit of surgical treatment when the anesthetic risk does not overpass the surgical risk, while patients who require elective interventions will be operated after the correction of risk factors.

Keywords: , , ,
Full text: PDF

Complex Multitrauma Patient: Head, Thorax, Abdomen and Limbs

Gomotîrceanu F1, Ghiga Dana2, Petrişor M3, Haifa B3, Băţagă T1

1 County Emergency Clinical Hospital, Tîrgu Mureş, Romania
2 Department of Research Methodology, University of Medicine and Pharmacy, Tîrgu Mureş, Romania
3 Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy, Tîrgu Mureş, Romania

Introduction: Multiple trauma represents the main cause of death in 40–50 years old patients. It requires a rigorous management of the critical patient to ensure a correct order in the performed maneuvers and a maximum efficiency.
Case report: We report a case of a 27 year-old patient with multiple trauma, victim of a train accident. The patient arrives with the presumptive diagnosis of multiple trauma due to train accident, open acute craniocerebral trauma, suspicion of acute subdural hematoma. After the evaluation in the emergency service, the patient was transferred to the Tîrgu Mureş Surgery Clinic, where an emergency intervention was performed. Any of the lesions presented (abdomen, thorax, extremities and head lesions) were able to produce the patient’s death by themselves.
Conclusions: The survival chances of multiple trauma patients increase due to a rigorous management and the application of a standardized evaluation protocol.

Keywords: , ,
Full text: PDF

Therapeutic Option in Patients over 60 Years with Esophageal and Esocardial Cancer

Roșca C, Molnar C, Popa D, Serac G, Gherghinescu M, Voidazan S, Copotoiu C

Surgery Clinic I, County Emergency Clinical Hospital, Tîrgu Mureș, Romania

DOI: DOI: 10.2478/amma-2014-0005

Background: Treatment of esophageal and esocardial cancer in patients over 60 years involves a particular management. Considering the comorbidities specific to this category of patients, recent data from the literature indicate an increased incidence of mortality and morbidity following therapy.
Material and method: We retrospectively studied a group of 55 patients admitted to the Surgical Clinic I of the County Emergency Clinical Hospital Tîrgu Mureș, in the January 1st, 2007 – December 31st, 2011 period, diagnosed with esophageal and esocardial cancer. Patients were divided into two groups: group I under the age of 60 years, and group II over this age. Inclusion criteria were age, diagnosis (tumor location), and we followed a series of parameters: demographics, type of surgery, the biological profile of patients, immediate postoperative morbidity and mortality.
Results: No statistically significant differences were observed in terms of demographics: gender (p = 0.78), area of origin (p = 0.69). The number of hospitalization days (p = 0.20) was influenced by the type of surgery, as well as pre- and postoperative comorbidities. Immediate postoperative mortality was 16.56%, the differences between the two groups was not statistically significant (p = 0.58). Parameters with statistical significance were found to be: age (p <0.0001), tumor location, type of surgery (p = 0.0031) and radical versus palliative surgery (p = 0.03).
Conclusions: Therapeutic attitude in patients over 60 years should be correlated with specific particularities to this category. Selection of patients for surgery and type of surgery is dictated by the patient’s condition and quantified by anesthesia and surgery team.

Keywords: , , ,
Full text: PDF

European Colorectal Cancer Management: Implemented as it is or Adapted to our National Specificity?

Dobre A, Hintea A, Azamfirei L

University of Medicine and Pharmacy, Tîrgu Mures, Romania

DOI: 10.1515/amma-2015-0025

Objective: We attempt to evaluate how the European treatment guides are implemented in a clinic hospital in Targu Mures and if those rules could be adopted as they are or must be adapted to our national specificity.
Methods: For a number of 441 patients included in the study, the electronic prospectively maintained archive of 3rd Surgery was interrogated for: age, preoperative colonoscopy, postoperative colonoscopies, chemo-radiotherapy enrollment, stage of the disease, type of surgery. Local and regional relapses were assessed and their incidence was related to type of surgery. Survival analysis was done in a simplified manner and differentiated for age below and above 75 years.
Results: Patient’s age distribution revealed a deviation to the right compared with a normal distribution with a median off 64.76±11.47. Colonoscopy was done in only 65 cases, exclusive preoperatively. Chemoradiotherapy was administered in 168 cases, only 12 of them initiated preoperatively. The type of surgery performed was found positively correlate with the stage of the disease. The survival probability for the patients in this study showed a 50% survival rate at 1 year and only 2% at 5 years.
Conclusions: Passive screening age in CRC should be decreased to 55 years. Stage 3 and 4 of disease for CRC are over 70% of cases, like 20 years ago. Survival rate in CRC is far lower than other studies. Integrated CRC management and European practical guides are still “in wishing”
stage.

Keywords: , ,
Full text: PDF