Practica Medicala最新文献

{"title":"Metabolic disorders and preventive measures against stones in the urinary tract","authors":"P. Nuraj, Agron Beqiri","doi":"10.37897/rjmp.2023.1.3","DOIUrl":"https://doi.org/10.37897/rjmp.2023.1.3","url":null,"abstract":"Introduction. Urolithiasis is not a simple disease, but it is a group of metabolic and endocrine disorders in the organism, coupled with changes in the urinary tract. Objectives. Research on the etiopathogenesis of urolithiasis; to analyze parathyroid hormones, to determine citrates in urine; their influence on the occurrence of urolithiasis. Research and the role of infection in the occurrence of urolithiasis, clinical symptoms, diagnostic methods, prevention methods and as well as preventive measures. Materials and methods. The research was conducted on our patients at the Urology Clinic, University Clinical Center of Kosovo, in Pristina. The work was prospective; in our research, we included 102 patients. Results. Our research has increased Parathormone in 5, 88% of cases. We had hypocitraturia in 57, 84% of cases. Hypocyturia then affects the creation of conditions for the crystallization and aggregation of stoneforming substances. Urolithiasis includes both sexes, primarily men 66, 7%, and women 33.3%. With X2- test we obtained a significant difference with statistical significance in the number of cases by gender (X2 = 11.3, P = 0.001). The most attacked age group was 40-49 years old. Symptoms are dominated by colic, nephralgia, dysuria, and hematuria. In this research, we have 22.5% of positive results of urine cultures. Conclusion. Therefore, there is still no explanation about the pathogenesis of urolithiasis, and with the knowledge of the etiopathogenesis of urolithiasis, symptoms, clinic, metabolic disorders and pathomorphology of urolithiasis, prophylactic measures can be taken, and urolith recurrence can be prevented.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43732169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Theoretical and practical aspects regarding the role of the working model in the workflow of porcelain fused to metal fixed restorations - Preliminary study","authors":"Sergiu Drafta, Radu Costea, Mihai Burlibasa, Viorel Perieanu, Ileana Ionescu, Irina Adriana Beuran, Simion Gheorghe Dumitru, Madalina Perieanu, Liliana Burlibasa, Florentina Caministeanu, Cristina Maria Serbanescu, Camelia Ionescu","doi":"10.37897/rjmp.2023.1.7","DOIUrl":"https://doi.org/10.37897/rjmp.2023.1.7","url":null,"abstract":"In dental practice, the fidelity of a model is given by the quality and type of material used, the technique by which it is made, and last but not least by the experience and skill of the dental technician. But, the emergence of CAD-CAM technology has led to a major change in the stages of making the working model, through the development of the virtual model. Thus, the purpose of this material is to perform a comparative study between several techniques for obtaining sectional working models, with or without pins, compared to the virtual model obtained by CAD-CAM technique.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":"171 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135951062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcopenia and ovarian cancer","authors":"I. Bălescu, N. Bacalbaşa, I. Brezean, C. Stoica, C. Tomescu, Cristina Martac, Andrei Voichitoiu, B. Gaspar","doi":"10.37897/rjmp.2022.4.7","DOIUrl":"https://doi.org/10.37897/rjmp.2022.4.7","url":null,"abstract":"Defined as the loss of the muscular mass, sarcopenia is a common finding in neoplastic patients, multiple mechanisms such as nutritional deficiency, proinflammatory tumoral related status or physical inactivity being cited. However, the loss of the muscular mass in such cases is associated with significant impact in regard to the type of treatment in such cases; in consequence, as expected the disease-free survival and overall survival might be influenced. The aim of the current paper is to discuss about the most important mechanisms leading to sarcopenia in ovarian cancer patients as well as the impact on the long-term outcomes.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42303597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital diaphragmatic hernia with pneumothorax, a challenge for the neonatologist on call","authors":"Ioana-Luciana Constantin, Diana-Sanziana Arnautu, Delia Stratone, E. Rotaru, A. Tuta, A. Avasilcai, Vlad Dima, Livica Frăţiman, Irina Franciuc","doi":"10.37897/rjmp.2022.4.4","DOIUrl":"https://doi.org/10.37897/rjmp.2022.4.4","url":null,"abstract":"Objectives. Congenital diaphragmatic hernia (CDH) represents a developmental defect of the diaphragm, which allows the protrusion of the abdominal viscera into the thoracic cavity. In view of the fact that herniation occurs during a critical period of lung development, the pathological effect is pulmonary hypoplasia in different degrees, usually more severe on the ipsilateral side of the hernia, and also may be present contralateral if the mediastinum is bulged, compressing the lung. Material and Methods. We present the case of a patient hospitalized in the Neonatology Department of “St. Andrew” County Emergency Clinical Hospital of Constanta, diagnosed with left CDH at birth. Outcomes. Full-term male newborn, gestational age (GA) 39 weeks, birth weight (BW) 3300g, Apgar Score 6. The 35-year-old mother, Gravida-VI, Para-III, has a pregnancy with inadequate prenatal care, with no structural abnormalities of the fetus detected by the 3rd-semester ultrasound. At birth, the newborn needed neonatal resuscitation, initially with positive pressure ventilation (on mask and bag) and after that, intubated and mechanical ventilated. Chest X-Ray showed a left diaphragmatic hernia, and the pediatric surgery team was called for further therapeutic management. Approximately 48 hours postoperatively, the chest X-Ray identified right upper lobe pneumothorax, with complete remission in 24 hours, under mechanical ventilation. Conclusions. CDH represents a condition with a challenging diagnosis and management. In the best cases, newborns have a very good clinical outcome with neonatal care and surgical treatment after birth. The management of infants with congenital diaphragmatic hernia requires the services of an interprofessional team. After the diagnosis in the antenatal period, parents should be allowed to discuss with a team, including maternal-fetal medicine, pediatric surgery, neonatology, and social work as appropriate. Genetic evaluation and counseling are recommended to identify risks in future pregnancies. Following the repair in the postnatal period, a standardized and interdisciplinary follow-up to provide surveillance, screening, and clinical care is recommended to improve outcomes.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49180781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral oxygenation during the period of transition to extrauterine life after natural versus cesarean birth","authors":"L. Nastase, C. Condrat, Mihaela Gabriela Stefan, Lavinia Gusa, D. Crețoiu, Vlad Dima, N. Suciu, S. Stoicescu","doi":"10.37897/rjmp.2022.4.3","DOIUrl":"https://doi.org/10.37897/rjmp.2022.4.3","url":null,"abstract":"Objective. We aim to evaluate the implications of cesarean delivery compared to natural birth by analyzing newborns’ systemic and cerebral oxygenation levels during the first 10 minutes of life. Design. This paper presents a 4-year prospective cohort study. Setting. Polizu Maternity, \"Alessandrescu-Rusescu\" National Institute for Mother and Child's Protection, Bucharest, Romania. Patients. Randomly selected pregnant women and their fetuses. Interventions. During the 10 min following umbilical cord clamping, regional cerebral oxygen saturation (rcSO2) was measured using the INVOS 5100 device and peripheral oxygen saturation (SpO2) was determined using the Masimo SET pulse oximeter in neonates from cesarean and natural deliveries. Main outcome measures. The cerebral fractional tissue oxygen extraction (cFTOE) in the first 10 minutes of life was calculated based on these values. Results. Newborns delivered vaginally showed higher rcSO2 levels at 1 minute of life than those born via C-section (40.5 ± 16.5% vs 33.7 ± 14.8%, AUC = 0.625; IC 95%: 0.506 - 0.743; p = 0.043). Neonatal cFTOE at 1 minute of life was significantly higher in caesarean-delivered newborns versus naturally born neonates (0.40 ± 0.25 vs 0.50 ± 0.19, p = 0.03; AUC = 0.638; IC 95%: 0.517-0.758; p = 0.023). Conclusions. Prelabor cesarean delivery seemingly plays a significant role in the process of fetal and neonatal cerebral oxygenation immediately postnatally, which is highlighted by lower rcSO2 and higher cFTOE values. Cerebral oxygen saturation monitoring in the delivery room allows the optimization of oxygen therapy in order to prevent the consequences of hypoxia or hyperoxia.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42995807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venous thromboembolism in burn patients – low incidence or underdiagnosis?","authors":"M. Tiglis, I. Peride, T. Neagu, A. Niculae, I. Lascar","doi":"10.37897/rjmp.2022.4.5","DOIUrl":"https://doi.org/10.37897/rjmp.2022.4.5","url":null,"abstract":"Venous thromboembolism (VTE), essentially deep venous thrombosis and pulmonary embolism, urinary tract infection, and renal failure are the main unplanned hospital events with negative long-term impact on burn patients’ rehabilitation. Due to the hypercoagulable state induced by severe critical burns, either in the acute or recovery phase and the intimal vascular damage, the risk of VTE is increased, with an incidence varying from 0.4% to almost 60%. Other risk factors for VTE in burn patients are prolonged immobilization, long and multiple surgical interventions, central venous catheterization, wound infection and sepsis, extensive burns, and red blood cell transfusion. To avoid underdiagnosing VTE, in face of increased incidence of asymptomatic venous thromboembolism, high risk-patients should be routinely screened using Doppler ultrasound. Patients’ weight and burn size, as well as the high incidence of heparin resistance in the first weeks after injury, should be considered when establishing the optimal dose for venous thromboembolism prophylaxis, targeting an anti-Xa level of 0.2-0.5 IU/mL.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49537050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facing the outcome of prematurity – opinions from the general practitioner","authors":"Otilia Novac, Maura-Adelina Hincu, A. Avasilcai, Vlad Dima, G. Zonda, L. Păduraru","doi":"10.37897/rjmp.2022.4.2","DOIUrl":"https://doi.org/10.37897/rjmp.2022.4.2","url":null,"abstract":"Preterm birth is a leading cause of neonatal mortality and morbidity, affecting more than 15 million babies worldwide each year. Preterm infants also have higher rates of motor, functional, and cognitive deficits. Modern imaging has contributed significantly to a better understanding of the etiology of various forms of brain injury in neonates. The follow-up of premature newborns is essential to prevent and diminish neurological sequelae in time. A multi-disciplinary team is needed to adequately monitor this category of children, in which the family doctor has a significant role. The variety of adverse events that preterm infants can be exposed to before, during, and after birth poses significant obstacles to developing therapeutic interventions to prevent brain damage, including developmental vulnerability to injury during a particular gestational age. In addition, several procedures required for neonatal critical care, reduce mortality but increase the risk of brain injury. This review is aimed to update the reader about the complications of preterm birth, current therapeutic uses, imaging techniques, as well as present and future research on preterm birth.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47287577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors involved in burn wound healing – short review","authors":"T. Neagu, M. Tiglis, I. Peride, I. Lascar","doi":"10.37897/rjmp.2022.4.6","DOIUrl":"https://doi.org/10.37897/rjmp.2022.4.6","url":null,"abstract":"Burns represent one of the worldwide leading causes of injury. Burn wounds are associated with increased mortality and morbidity, especially the impaired quality of life due to hypertrophic scarring, scar pain and itching, paresthesia, and contractures. To properly influence the burn wound healing, it is important to establish a correct classification of the acute injury and to understand the main phase of burn wound healing process. There are various local and systemic factors that can be influenced to obtain proper healing. The most important factors include local necrosis and infection, increased local pressure and edema, anemia, hypoxia, hypotension, the presence of important chronic disease and medication, immunosuppression, nutritional status, age, and body constitution. After adequate fluid resuscitation and patient stabilization, the main step is represented by the detachment of the devitalized tissues and rapid coverage of the lesion. There are various methods to be used, like autologous or allogenic skin grafting, the use of skin substitutes, or tissue bioengineering. Knowing all these aspects, allows clinicians to properly define a therapeutic management for patients presenting severe burns.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47464076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic therapy of inflammatory breast cancer with type 2 diabetes mellitus – Prevention of high risk of radiation-induced progression of tumor tissue cancer","authors":"Oleksii Volodymyrovich Movchan, I. Y. Bagmut, I. Smolanka, M. Sheremet, Lidia Anatolyivna Sukhanova, Oleksandr Vasyliovych Bagmut, I. Kolisnyk, Olexksii Oleksandrovich Halmiz, O. Havrish, A. Lyashenko, I. Dosenko, A. Loboda, O. M. Ivankova, V. V. Maksymyuk, Volodymir Volodymyrovich Tarabanchuk","doi":"10.37897/rjmp.2022.4.8","DOIUrl":"https://doi.org/10.37897/rjmp.2022.4.8","url":null,"abstract":"Introduction. Cancer mortality in diabetic patients has been reported to increase moderately compared to non-diabetic patients. The aim of the study aimed to assess the findings and identify radiotherapy's role in the comprehensive care of diabetic IBC patients with various hyperglycemia correction strategies. Methods. Patients with diabetes have shown a higher risk of radiation-induced cancer progression for tumor tissue, especially for inflammatory form. For 7 patients, to continue systematic chemotherapy with a scheme change (consecutive anthracyclines-taxanes, 2-week interval) and insulin with individual scheme for hyperglycemia correction on the basis of glycemic control – 1st group, the other (7 patients) – 2nd group, was given radiotherapy to the breast gland and lymphatic drainage ways. 45–50 Grey was prescribed for 25-28 fractions (per 1.8-2.0 Grey), 46–50 Grey in 23-25 fractions were used for zones of regional metastasis and for hyperglycemia correction metformin 2000 mg/day PO divided q8-12hr with meal on the basis of glycemic control. Results. Assessed were the number of patients who qualified for surgery and overall survival for 24 months. 2nd group showed a superior response following resistance to prior systemic treatment. Thus, 5 (71.41%) of the 7 patients exhibited a consistent response – complete or partial regression. There were only 2 individuals (28.61%) who responded to treatment among the patients who maintained chemotherapy. Conclusions. Breast cancer of the aggressive IBC variety requires multidisciplinary treatment from breast surgery, medical, and radiation oncology. Patients with diabetes appear to experience more side effects from radiation therapy than patients without the disease. Hyperglycemia, higher total RT doses, and radiosensitizers are a few techniques that can improve the impact of RT on local-regional management. Local-regional control rates for IBC are increasing with an individual patient strategy. Metformin also improves insulin resistance and has anticancer benefits.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43833600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oligohydramnios: A review of etiology and management options","authors":"M. Plotogea, C. Mehedințu, V. Varlas, R. Mateescu, A. Edu, L. Crăciun, Vlad Dima, C. Berceanu, A. Petca, Bogdan-Gabriel Spinu","doi":"10.37897/rjmp.2022.4.1","DOIUrl":"https://doi.org/10.37897/rjmp.2022.4.1","url":null,"abstract":"Oligohydramnios is both a consequence of fetal malformations and of uteroplacental insufficiency. Its existence is associated with a high rate of both antepartum and intrapartum complications. It is vital that its occurrence is detected as early as possible so that we can manage it correctly. The main causes of its occurrence are identified and described in this review. The management of oligohydramnios is most often expectant, the timing of delivery also being determined by Doppler examination and changes in parameters measuring fetal growth and development.","PeriodicalId":55841,"journal":{"name":"Practica Medicala","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47461391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}