Medicine

Stress hyperglycemia and hyperlactatemia are commonly referred to as markers of stress severity and poor outcome in children with severe acute illness or febrile seizures. Our prospective study aimed to explore the risk factors for stress hyperglycemia and the predictive value of stress hyperglycemia for febrile seizure recurrence. We evaluated as risk factors for blood glucose level, serum lactate, acid–base status, and the clinical parameters relevant to the severity of the infectious context or to febrile seizure event: fever degree, fever duration, seizure type and aspect, seizure duration, and recurrence. Among 166 febrile seizures events in 128 children, the prevalence of stress hyperglycemia (blood glucose >140 mg/dl) was 16.9%. The comparison of the stress versus non-stress hyperglycemia groups revealed lower pH (median (interquartile range): 7.46 (7.37, 7.53) vs. 7.48 (7.42, 7.53), p = 0.049), higher lactate levels (30.50 mg/dl (15, 36) vs. 19.50 mg/dl (15, 27), p = 0.00...

Stress hyperglycemia is commonly identified in children with severe illness and previously normal glucose homeostasis. In the pediatric population febrile seizures are reported among stress-related conditions associated with stress hyperglycemia. The objective of this prospective study was to evaluate the possible association between blood glucose level and febrile seizure severity defined by fever degree, seizure type, seizure duration and hospitalization length. Among 167 febrile seizures the prevalence of stress hyperglycemia (blood glucose concentration over 150mg/dl) was 13.22%. There was a highly significant statistical association between seizure duration (exceeding 15 minutes) and increased blood glucose concentration (p= 0.001). Prolonged febrile seizures combined with high fever were significant risk factors for stress hyperglycemia. Further analysis on acute fluctuation of glycemia, persistence of hyperglycemia should be taken in consideration as possible prebdictive fact...

Background: Urinary tract infections (UTIs) are considered common facilitating factors along with other infections in triggering febrile seizures (FS). The main purpose of our study was to identify specific patterns of UTIs, using a combination of inflammatory biomarkers, in order to differentiate UTIs from other bacterial diseases triggering FS. Method: This study included a number of 197 distinct FS events from patients hospitalized in the Pediatric Clinical Hospital Sibiu, among which 10.2% were diagnosed with UTIs. Results: In one-third of the patients with UTI, the symptoms were limited to fever and FS. Using Two-Step cluster analysis, a distinct inflammatory pattern has emerged: higher platelet distribution of the population (PDW), platelet large cell ratio (P-LCR), mean platelet volume (MPV), C-Reactive Protein (CRP), and neutrophil to lymphocyte ratio (NLR). This pattern was associated mainly with bacterial lower respiratory infections. UTIs were highly unlikely in the patie...

The brain activity that is measured by electroencephalography (EEG) can be modified through operant conditioning, specifically using neurofeedback (NF). NF has been applied to several disorders claiming that a change in the erratic brain activity would be accompanied by a reduction of the symptoms. However, the expected results are not always achieved. Some authors have suggested that the lack of an adequate response may be due to an incorrect application of the operant conditioning principles. A key factor in operant conditioning is the use of reinforcers and their value in modifying behavior, something that is not always sufficiently taken into account. This work aims to clarify the relevance of the motivational value versus the purely informational value of the reinforcer. In this study, 113 subjects were randomly assigned two different reinforcer conditions: a selected reinforcer—the subjects subjectively selected the reinforcers—or an imposed reinforcer—the reinforcers were ass...

This study aims to present a possible approach to identify the most common combinations of possible risk factors for the outcomes following neonatal seizures. First, we extract important predictor variables from the published studies featuring aspects regarding neurological outcomes in the context of neonatal seizure. Then, we used association rules to build prediction models to determine associations of risk factors which are frequently identified in real-data / evidence based researches. A total of 15 studies and 14 variables were included to identify frequent patterns and generating association rules processe. We searched for accurate and valuable interrelationships between various risk factors. The FP-Growth algorithm generated different itemsets with the largest including four parameters: electroencephalography (EEG), seizures semiology (SO), aetiology (ET), birthweight (BW), with support 0.200. The insights regarding our results may help in creating evidence-based prevention p...

Background: Inflammatory markers association with many diseases is the subject of many articles and reviews. This study presents a comprehensive bibliometric review and visualization analysis of inflammatory biomarkers (IB) in the context of febrile seizure (FS) patients. Methods: The study focused on IB in FS using (1) bibliometric analysis specific indicators and maps in order to analyze and present the network of authors, journals, universities, and countries, and (2) automated literature screening and unsupervised clustering approach for filtering and topic cluster identification. Results: We conducted a literature mining search on FS research, specifically IB in the context of FS, using the automated tools VOSviewer and Bibliometrix. Indices of the inflammatory response (in the context of febrile seizures) identified by the literature mining are (pro/anti-inflammatory) cytokines, such as interleukin IL-1β, IL-6, IL-8, I-10, IL-22, tumor necrosis factor (TNF-α), neutrophil-to-ly...

SUPRAFEE ŞI ELEMENTE OSOASE: 1.Scuama osului frontal prezintă: a.tuberozităile frontale sunt două proeminene situate la 3 cm deasupra marginilor supraorbitale. b.arcadele sprâncenoase sunt proeminene osoase situate deasupra marginilor supraorbitale. c.glabela este o proeminenă mediană, situată între arcadele sprâncenoase. d.marginile supraorbitale sunt concave inferior şi în 1/3 medială sunt rotunjite; participă la formarea additusului orbitar; ele pot prezenta două incizuri:-incizura supraorbitală situată la unirea 1/3 mediale cu 2/3 laterale a marginii supraorbitale; prin această incizură trece mănunchiul vasculo-nervos supraorbital.-incizura frontală este situată medial de incizura supraorbitală. e.găurile supraorbitală şi frontală se află uneori în locul incizurilor cu acelaşi nume; prin gaura frontală trece nervul supratrohlear. f.sutura metopică sau frontală este situată pe linia mediană deasupra incizurii nazale. g.procesul zigomatic al frontalului este situat în partea laterală a arcadelor sprâncenoase; de la nivelul lui porneşte linia temporală; procesul zigomatic se articulează cu procesul frontal al zigomaticului. 2.Feele anterioare ale corpurilor şi ale proceselor frontale ale oaselor maxilare (vezi osul maxilar) 3.Feele externe ale oaselor nazale prezintă originea muşchiului procerus şi a muşchiului nazal. 4.Feele externe ale oaselor zigomatice au o formă patrulateră şi convexă. În apropierea marginii orbitale se află gaura zigomatico-facială prin care trece nervul zigomatico-facial (ramură a nervului zigomatic). Inferior se află ariile de origine ale muşchilor zigomatici mare şi mic. Procesul frontal al osului zigomatic se articulează cu procesul zigomatic al frontalului la nivelul suturii fronto-zigomatice. 5.Additusul orbitar este delimitat de marginea infraorbitală a osului maxilar, de marginea orbitală a osului zigomatic, de marginea supraorbitală a osului frontal şi de crestele lacrimale anterioară şi posterioară care delimitează între ele fosa sacului lacrimal. 6.Apertura piriformă reprezintă deschiderea anterioară a cavităii nazale şi este limitată superior de oasele nazale şi infero-lateral de incizurile nazale ale oaselor maxilare. În partea inferioară se observă o proeminenă-spina nazală anterioară formată prin articularea extremităilor anterioare ale incizurilor nazale ale oaselor maxilare. Norma frontalis 1. scuama frontalului; 2. sutura metopică; 3. gaura frontală; 4. gaura supraorbitală; 5. canalul optic; 6. creasta lacrimală anterioară; 7. faa orbitală a aripii mari a sfenoidului; 8. faa orbitală a corpului osului maxilar; 9. gaura infraorbitală; 10. osul nazal; 11. apertura piriformă; 12. septul nazal; 13. corpul mandibulei; 14. gaura mentală; 15. faa anterioară a corpului maxilarului; 16. ramul mandibulei; 17. fosa canină; 18. sutura zigomatico-maxilară; 19. faa laterală a osului zigomatic; 20. fisura orbitală inferioară; 21. creasta lacrimală posterioară; 22. linia temporală a frontalului; 23. glabela; 24. fisura orbitală superioară; 25. tuberozitate frontală;

Charcot foot or Charcot neuropathy is a rare disease found in patients with diabetes mellitus and is characterized by bone damage to the foot leading to deformities, instability, functional impotence and even amputation. The mechanism is still under discussion, without a consensus regarding the pathophysiology of this condition. The treatment is a complex one, non-surgical and surgical, the non-surgical one addressing especially the acute phase of the disease, the surgical one being complex and ranging from osteotomy, debridement, arthrodesis, internal or external fixation or even amputation. A good management of diabetes, of its peripheral complications, an early recognition of the Charcot type foot, prevents the evolution towards this serious condition.

Breast cancer is the most common form of malignant tumour in females, its frequency being constantly increasing and being the second cause of mortality, after lung cancer, in women. The objective of the study is to evaluate the efficacy, performance and safety of modified radical mastectomy in clinical and technical terms in patients with breast cancer. Method and Results: A 5 year retrospective study was performed on the patients who underwent surgery for breast cancer. Of the 129 patients aged between 20 and 99 years, the maximum incidence is observed in the age group 60-69 years. The most used surgical procedures were: modified radical mastectomy (MRM) in 48 cases and sectorectomy in 32 cases. Madden type of MRM was performed in 95.83%, with no major intra or postoperative complications. Conclusions: Modified radical mastectomy is the first-choice surgery for patients diagnosed with breast cancer in more advanced stages of this disease, compared to conservative therapy which is i...

In the context of the COVID19 pandemic, during last year all public attention has been focused on Medicine. Epidemiology is no longer just one medical specialty among many others, but became the main paradigm and the unique background of medical science. The individual pacient has turned into the collective pacient. Medical policies are not centered on the pacient anymore, but on its social group. In this article I will try to show how the characteristics of medical practice changed since the pandemic began and which are the deontological implications of such changes. With a short introduction on the medical policies proposed by the WHO during the last decades, I wish to underline the recent history of medical practice and its obvious turning point occasioned by the pandemic. Once the new bioethical vantage points are set, I wonder to which extent posthumanist philosophy foresaw this new deontological paradigm. Having Rosi Braidotti`s "The Posthuman" as my starting point, I maintain that medical doctors no longer practice on a humanist background, but with a sort of commitment that goes beyond the individual. However, this is not an antihumansit pledge, because contemporary medical doctors still adhere to certain humanist principles. As it so often happens, we will be left with even more questions. If the pacient is no longer the individual, but the group of individuals, which is the nature of a symptom and how should we decipher its meaning? How would a new medical science look like if we are to build it not on a human but on a posthuman biology?

In the context of the COVID19 pandemic, during last year all public attention has been focused on Medicine. Epidemiology is no longer just one medical specialty among many others, but became the main paradigm and the unique background of medical science. The individual pacient has turned into the collective pacient. Medical policies are not centered on the pacient anymore, but on its social group. In this article I will try to show how the characteristics of medical practice changed since the pandemic began and which are the deontological implications of such changes. With a short introduction on the medical policies proposed by the WHO during the last decades, I wish to underline the recent history of medical practice and its obvious turning point occasioned by the pandemic. Once the new bioethical vantage points are set, I wonder to which extent posthumanist philosophy foresaw this new deontological paradigm. Having Rosi Braidotti`s “The Posthuman” as my starting point, I maintain...

Supraprotezarea este o metodă de tratament specifică edentaţiei totale sau subtotale caracterizată prin confecţionarea unei proteze totale cu sprijin pe ţesuturi moi şi dure (os, rădăcini sau dinţi restanţi), care pe faţa mucozală cuprinde o parte a dinţilor restanţi preparaţi prin diferite metode sau a implantelor. Dinţii restanţi respectiv implantele sunt utilizaţi fie izolaţi, fie solidarizaţi prin sisteme speciale conferind un plus de menţinere şi stabilitate faţă de proteza totală clasică. În cazul supraprotezării pe dinţi naturali se preferă păstrarea rădăcinilor şi cât mai puţin din coroanele dentare pentru ca braţul de rezinstenţă să fie mai mare decât braţul forţă. Alte denumiri: overlay denture, overdenture, superimposed prosthesis, proteza totală telescopată, proteza biologică etc. Overlay= proteză mobilizabilă care prezintă o extensie metalică sau polimerică peste suprafeţele incizale, ocluzale ale dinţilor restanţi. Overdenture= proteză care se sprijină pe ţesuturi moi şi dure (os, rădăcini sau dinţi restanţi). Proteza totală telescopată= sistem de cape primare, capele secundare fiind incluse în proteză. Proteza biologică= proteză acceptată biologic de ţesuturile înconjurătoare. Supraprotezarea desemnează o restaurare protetică mobilă cu sprijin pe unul sau mai mulţi dinţi restanţi sau implante, pe care îi (le) acoperă total, cu scopul de a îmbunătăţi sprijinul, stabilitatea şi retenţia protezei. Stabilizarea şi menţinerea suplimentară a unei proteze totale se poate face: 1. Direct: prin ancorarea acesteia cu ajutorul unor mecanisme speciale la dinţii ori rădăcinile păstrate sau recuperate. 2. Indirect: prin aceleaşi mecanisme conectate la diversele tipuri de implante. Overdenture stabilizată suplimentar direct Stabilizarea suplimentară se poate face:-La dinţii existenţi-La dinţii reconstituiţi-La rădăcinile obţinute prin scurtarea coroanei dentare-La rădăcinile recuperate chirurgical, endodontic şi parodontal. Dinţii şi rădăcinile au rolurile următoare:-Preaiu o ma re parte din presiunea ocluzală, asigurând un bun sprijin protezei totale, pe care o stabilizează şi în plan orizontal