A rare anatomic variation: Triple mental foramina.

Multiple mental foramina (MF) are rarely found in the human mandible. We report on the case, as documented using cone beam computed tomography (CBCT), of the triple MF that were identified on the right hemimandible of a 28-year-old female patient. The distal foramen was located on the mandible between the apices of the second premolar root and the first molar mesiovestibular root, being reached by a thin canal that left the mandibular canal. A pair of mesial foramina were identified between the apices of the premolar teeth. Thus, the three foramina corresponded to a surface area of 23.49mm2 of the mandible. On the opposite side, a single mental foramen had a surface area of just 13.25mm2. On each side, retromolar canals that opened into the retromolar fossae were also found. The anatomic possibility of multiple MF increases the surface area at risk during surgical procedures, increases the risk of neurovascular damage and obscures the common tooth-related location of the mental foramen. Practitioners should, therefore, consider a personalised and imaging-documented approach so as to avoid treatment failure.

Bilateral giant and unilateral duplicated sphenoidal tubercle.

The sphenoidal tubercle (SphT), also known as pyramidal tubercle or infratemporal spine projects from the anterior end of the infratemporal crest of the greater sphenoidal wing. As it masquerades the lateral entrance in the pterygopalatine fossa it could obstruct surgical corridors or the access for anaesthetic punctures. The SphT is, however, an overlooked structure in the anatomical literature. During a routine cone beam computed tomography study in an adult male patient we found bilateral giant SphTs transforming the infratemporal surfaces of the greater wing into veritable pterygoid foveae. Moreover, on one side the SphT appeared bifid, with a main giant partition, of 9.17 mm vertical length, and a secondary laminar one. The opposite SphT had 14.80 mm. In our knowledge, such giant and bifid SphTs were not reported previously and are major obstacles if surgical access towards the pterygopalatine fossa and the skull base is intended.

Factors that Impact Caregivers of Patients with Schizophrenia.

Schizophrenia, a term first introduced by Eugen Bleurer in 1911, is a controversial topic, a symbol of profound behavioral and personality disorders. Although schizophrenia mainly affects the patients, directly, it indirectly affects their caregivers. Because caregivers of subjects with schizophrenia experience significant burden in taking care of the patient, usually over a long period of time, we decided to analyze some of the factors that can impact the perceived level of stress. Our study group consisted of caregivers 124 patients with schizophrenia, interviewed between January 2018 and July 2019. We analyzed demographic, clinical and other medical variables of patients and caregivers. We also evaluated caregivers' burden, using the adapted Zarit interview. The average Zarit score in our study was 42.36±8.64, which shows moderate to high burden. Several factors that influence the perceived burden of the caregiver have been identified, such as patient gender, age of onset, patient and caregiver marital status, patient level of education and social functioning, caregiver age, somatic comorbidities and therapeutic compliance of the patient.

Mental Disorders in Chronic Liver Diseases with Viral Etiology.

The study of chronic viral hepatitis represents a real challenge for modern medicine. If we also analyze this illness from the point of the mental changes involved, the complexity of the study increases. To the etiological, symptomatological polymorphism, alongside the paraclinical and conduct diagnosis, there may be easily added the multitude of mental disorders. The authors have tried, through this paper, to draw the attention upon the importance of studying certain mental disorders connected to a somatic disease, each and every representing a distinct entity, but which together may reach a remarkable complexity.

[Epidemiologic research to assess some socioeconomic aspects of health care in patients with infections caused by group A beta hemolytic streptococcus and their complications]. / Cercetari epidemiologice pentru evaluarea unor aspecte socio-economice ale asistentei bolnavilor cu infectii cauzate de streptococul betahemolitic grup A si ale complicatiilor acestora.

Authors present some epidemiological aspects of medical and socioeconomic implications caused by group A beta hemolytic streptococcus (ABHS) infections and by their complications, assessed on 10948 inpatients with angina, 323 with scarlet fever, and 644 with erysipelas, hospitalized in the City of Galati, between 2000-2003. All these three major diseases determined by ABHS needed 79125 days of hospitalization, with an average period of 6.4 days for angina, 76 for scarlet fever, and 10.4 for erysipelas. The costs of the mere hospitalization of these inpatients (11915) amounted to 14,479,543,800 lei. This fact highlights how costly the infections caused by AHBS are.

[Epidemiologic aspects of group A betahemolytic streptococcus infections in Galati County between 1990 and 2000]. / Aspecte epidemiologice ale infectiilor cauzate de streptococul betahemolitic grup A, în judetul Galati, în perioada 1990-2000.

The infections caused by group A betahemolytic streptococcus represent a major problem of community health, worldwide and in Romania, too. Between 1990-2000, in the Galati County, scarlet fever registered values of morbidity with a yearly variability between 8.2 and 54.1 cases/100,000 inhabitants. Angina, although underrated, reached values of 30-80%ooo, followed by erysipelas with an incidence of 80-100%ooo. The socio-economical impact was partially highlighted by assessing the dynamics of hospitalizations which registered values from 363.86 to 527.14%ooo inhabitants. To the previous, the costs of bacteriological investigations were added. For example, 60-80% of cases of angina were positive.

[Epidemiology of poststreptococcal, non-suppurative, late complications, in a Moldavian area (Romania) during the last decade]. / Epidemiologia complicatiilor tardive nesupurative poststreptococice, într-un teritoriu din Moldova (România) în ultimul deceniu.

The ubiquity of the acute infections caused by the group A beta-haemolytic streptococcus (ABHS) requires the continuation of the screening strategies of the risk to develop nonsuppurative late complications. The aim of this study was to assess the poststreptococcal pathologic evolution in an area where, during the last 10 years, there were recorded high values of the morbidity due to acute infections determined by ABHS. Using methods of retrospective data collecting, in Galati district, during 1990-2003, they monitored the dynamics of the case incidence and general and hospitalized morbidity, according to various age and home environment categories, for acute rheumatic fever (RF), carditis (CR), and acute poststreptococcal glomerulonephritis (APSG). The results emphasized the need to re-launch some targeted prevention programs, in order to lower the still high morbidity, due to these complications and, implicitly, to limit the deriving invalidity or social economical loss.