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The study proposes a dynamic spatio-temporal profile of the distribution of tuberculosis incidence and air pollution in Romania, where this infectious disease induces more than 8,000 new cases annually. The descriptive analysis for the years 2012-2021 assumes an identification of the structuring patterns of mycobacterium tuberculosis risk in the Romanian population, according to gender and age, exploiting spatial modeling techniques of time series data. Through spatial autocorrelation, the degree of similarity between the analyzed territorial systems was highlighted and the relationships that are built between the analysis units in spatial proximity were investigated. By modeling the geographical distribution of tuberculosis, the spatial correlation with particulate matter (PM2.5) pollution was revealed. The identification of clusters of infected persons is an indispensable step in the construction of efficient tuberculosis management systems. The results highlight the link between the distribution of tuberculosis, air pollution and socio-economic development, which requires a detailed analysis of the epidemiological data obtained in the national tuberculosis surveillance and control program from the perspective of geographical distribution.
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The objective of this study was to identify spatial disparities in the distribution of cancer hotspots within Romania. Additionally, the research aimed to track prevailing trends in cancer prevalence and mortality according to a cancer type. The study covered the timeframe between 2008 and 2017, examining all 3,181 territorial administrative units. The analysis of spatial distribution relied on two key parameters. The first parameter, persistence, measured the duration for which cancer prevalence exceeded the 75th percentile threshold. Cancer prevalence refers to the total number of individuals in a population who have been diagnosed with cancer at a specific time point, including both newly diagnosed cases (occurrence) and existing cases. The second parameter, the time continuity of persistence, calculated the consecutive months during which cancer prevalence consistently surpassed the 75th percentile threshold. Notably, persistence of elevated values was also evident in lowland regions, devoid of any discernible direct connection to environmental conditions. In conclusion, this work bears substantial relevance to regional health policies, by aiding in the formulation of prevention strategies, while also fostering a deeper comprehension of the socioeconomic and environmental factors contributing to cancer.
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OBJECTIVE: To assess the fit between of the Romanian version of the Oral Health Impact Profile (OHIP-49) and Locker's conceptual model of oral health. BASIC RESEARCH DESIGN: Cross-sectional interview study. CLINICAL SETTING: Convenience sample of hospitalized internal medicine patients, in Cluj-Napoca, Romania. PARTICIPANTS: 340 participants (40% male), divided in two samples, sample N1 = 165 to analyse the theoretical model, and a cross-validation sample, N2 = 175. MAIN OUTCOME MEASURES: Path-analysis was used to assess the fit between the conceptual model proposed by Locker, and the data. RESULTS: Initial results showed an unsatisfactory fit to the data: χ² = 43.8 (df = 5, p = 0.001), χ² was found to be significant; GFI = 0.932, CFI = 0.948, TLI = 0.782, these indices presented values lower than 0.95, while SRMR = 0.053 and RMSEA = 0.22 (90% CI 0.16 - 0.28) were situated above the accepted threshold. Evaluation of the residual matrix and the modification indices lead to the respecification of the first model, obtaining an better fit of the second model: χ² = 17.63 (df = 9, p = 0.04), while GFI = 0.972, CFI = 0.988, TLI = 0.973, were above the threshold and SRMR = 0.036 and RMSEA = 0.07 (90% CI 0.02 - 0.12). CONCLUSIONS: The current study indicates that OHIP-49 represents an acceptable operationalization of the Oral Health related Quality of Life, as it was conceptualized by Locker's theoretical model.
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Oral Health , Quality of Life , Cross-Sectional Studies , Female , Humans , Male , Models, Theoretical , Romania , Surveys and QuestionnairesABSTRACT
BACKGROUND AND OBJECTIVES: Rat experimentation is the first line of research by which a medical hypothesis is usually tested. Platelet Rich Fibrin (PRF) is a relatively new bio-material that has shown promise to enhance healing in the field of bone research and tissue engineering. In order to perform PRF based experiments on rats, a proper protocol of obtaining PRF from rats needs to be established. MATERIALS AND METHODS: 35 Wistar rats were used to obtain PRF by using cardiac puncture blood draw and quick subsequent centrifugation. The PRF samples wereanalyzed and compared to standard literature PRF composition. RESULTS: PRF samples analysis showed persistent results pertaining to known PRF composition. CONCLUSIONS: Our experiment has shown that our protocol of obtaining PRF is capable of providing high quality PRF from rats.
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Platelets play a crucial role in wound healing as they are reservoirs of growth factors and cytokines which play a fundamental role in homeostasis and tissue remodeling. Recently, fields such as dermatology and plastic and reconstructive surgery have become interested in the tissue regenerative properties of these compounds, especially since it promotes wound healing, improves scar outcomes and has rejuvenating effects on the skin and other tissues. We evaluated the effects of Platelet Rich Fibrin (PRF) in full thickness skin graft healing. Our study included 40 male Wistar rats. Skin grafts were assessed macroscopically using planimetry. The full thickness skin grafts in the test group, displayed a lower necrosis rate compared to the control group. Our study displays the potential benefits of using Platelet Rich compounds to facilitate wound healing and integration of full thickness skin grafts.
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Oncological excision surgery in the oral and maxillofacial area amputates important structures or open cavities (sinus, nose, mouth) which are usually "closed". The disappearance of an eye, tongue, soft palate or cheek, raises serious issues regarding the resumption of partial or total functions of that region, in terms of social reintegration of the patient. In the cephalic extremity, the reconstruction material is limited, so specialists resort to resources located away from the defect to achieve closure. The temporal flap isn't used very often, although this procedure has the advantages of a shorter time for surgery and for healing.
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A 31-year-old patient presented in the Emergency Department with a tibial fracture following a car accident that crushed the lower third of his thigh and the proximal and median part of his calf. Tibial fracture fixation with an intramedullary rod, was complicated by a Morel-Lavallée lesion. Sequential debridement procedures were performed with partially successful granulation tissue proliferation under NPWT (Negative-Pressure Wound Therapy). To further promote the already delaying granulation, plastic surgeons opted for PRP/PRF (Platelet Rich Plasma/Platelet Rich Fibrin) which allowed appropriate skin grafting. In our opinion, PRP/PRF should be considered as a viable adjuvant therapy to promote granulation.
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A 59-year-old patient presented in the ER with wound dehiscence and skin necrosis on the right ankle, with osteosynthesis implant visible, after open reduction and fixation with plate and screws, performed abroad, 16 days prior to the presentation, for a bimalleolar fracture. The patient was admitted to the plastic surgery department, where surgical debridement of the necrotic tissue was initially performed. Postoperatively, the patient was treated with Negative-pressure wound therapy (VAC dressing) and Platelet rich plasma (PRP) therapy. Upon obtaining granulation tissue without signs of infection, a sural fasciocutaneous flap was performed to cover the skin defect. Proper graft integration and healing was observed.
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We report the case of a 46-year-old male patient who, after disease-free intervals of five, four and one and a half years following resection of an 'atypical' parathyroid adenoma in 1982, relapsed with clinical and laboratory recurrence of primary hyperparathyroidism (PHP). Noninvasive, traditional and modern imaging methods localized small distinct metastatic foci in both lungs without evidence of primary thyroid, neck or mediastinal tumor. Three successive bilateral lung nodule excisions resulted in a long PHP remission, while a three month treatment with normal saline infusions, diuretics, calcitonine and pamidronate infusions, following the last recurrence, resulted in moderate improvement of hypercalcemia and hypercalciuria with no effect on both PTH secretion or on the size of new metastatic lung foci. Recurrent mPCa with or without secretion of biologically active PTH is optimally treatable with successive surgical resections of the metastases and intermittent medical treatment to achieve PTH secreting tumor mass reduction and a beneficial metabolic effect.
