Transforming the Management of Articular Fractures in the Foot: A Critical Examination of Current Methods and Future Directions: A Review.

This study provides a comprehensive examination of the current methodologies and potential strategies for the treatment of articular fractures of the foot. In the field of orthopedic healthcare, these fractures present a significant challenge due to their complex nature and the fact that they affect the routines of patients. The motivation behind this study is based on two main concepts. The first one is represented by the use of emerging medical technologies and personalized medicine to bring a significant transformation in the management of foot fractures and give a better quality of treatment that is accepted by the patient. However, because there are inequities in the availability of the necessary medical care and equipment, as well as uneven incorporation in clinical settings, new technologies cannot be used to treat these types of fractures. Regarding the second concept behind this study, it is indicated that although current treatment methods are essential, they have a number of shortcomings when it comes to properly addressing these types of injuries. An approach is needed that takes into account the biomechanical points of view and the particularities of each patient. This approach could be applied in all hospital settings. Through this study, we want to highlight the progress made in recent years in surgical techniques such as 3D printing, minimally invasive surgery (MIS), and biological products. However, in the application of this new discovery, new obstacles have been discovered that prevent the efficient treatment of these types of injuries. This study examines the effectiveness and limitations of current treatments, as well as how differences in healthcare, such as available equipment, training of medical staff, and technological advances, affect patient outcomes in everyday life. This research wishes to emphasize that continuous innovation, interdisciplinary collaboration, and the use of an optimal approach that is appropriate for each patient, are essential. This study aims to provide new insights and useful recommendations for future research and clinical practice. The main role of this research is to improve the quality of life of patients and increase the standards of care in this complex field, which is in permanent evolution.

Dynamics of the association between visual and auditory functional changes in glaucoma. Preliminary results.

Glaucoma is a multifactorial degenerative optic neuropathy characterized by the irreversible loss of retinal ganglion cells. Vascular, genetic, anatomical and immune factors are present in etiopathogenic mechanisms. Being the second cause of blindness worldwide after cataract, and with an irreversible character, glaucoma has turned into a disease with a significant impact on public health. Patients with primary open-angle glaucoma (POAG) may have central neurodegenerative changes, such as sensorineural hearing loss and static changes. Aim: The aim of this study was to estimate the connections between visual and auditory functional changes in glaucoma. The subjects were grouped as follows: patients with glaucoma compared with patients without glaucoma, while trying to identify the functional defect of the optic nerve (visual field) and a hearing testing (audiogram). Materials and methods: The prospective, cross-sectional study included 32 eyes of 16 subjects with POAG in a group of study and 24 eyes of 12 healthy subjects in the other group, with a mean age of both groups between 61,64 ± 6,53 years old. Both groups were examined from ophthalmological, audiological and radioimaging perspectives with Pure-tone audiometry (PTA) and magnetic resonance imaging (MRI) for brain. All patients had ophthalmologic assessments according to a standardized protocol. Moreover, auditory functional parameters (audiometry) were recorded. Results: Female cases, over 65 years old, with residency in a city, predominated in the group of study. Compared to the control group, patients in the group of study had average levels of the PTA and modified visual field (VF) parameters. Multivariate analysis demonstrated that the correlation of PTA was indirect, reduced in intensity, both with MD (r = -0.108; p = 0.585), Cal HOV (r = -0.268; p = 0.168) and the slope profile of the right eye. Multivariate analysis demonstrated that there was a correlation of the right PTA, which was indirect, reduced in intensity, both with MD (r = -0.108; p = 0.585), Cal HOV (r = -0.268; p = 0.168) and the slope profile of the right eye. The left ear PTA correlation was indirect, moderate in intensity, statistically significant with both MD (r = -0.584; p = 0.001) and slope profile (r = -0.377; p = 0.048) and reduced as intensity with Cal HOV (r = -0.147; p = 0.456) of the left eye. Conclusions: Patients with POAG showed changes in audiometry in connection with ophthalmological parameters, a fact suggesting that the auditory system might have been affected in POAG. This study highlighted the interdisciplinarity of the medical field with the aim of ensuring the quality of life of glaucoma patients. A good collaboration between the ophthalmologist and the otolaryngologist was very important for our patients. Abbreviations: RE = Right eye, LE = Left Eye, POAG = Primitive Open Angle Glaucoma, PTA = Pure-tone audiometry, VF = visual field, MRI = magnetic resonance imaging, IOP = Intraocular pressure, BVAC = best visual acuity corrected, MD = mean defect, CNS = central nervous system, SAP = standard automated perimetry, CCT = central corneal thickness, ONH = Optic nerve head, CDR = Cup/ Disc ratio, RNFL = Retinal fiber layers.

Glaucoma - a neurodegenerative disease with cerebral neuroconnectivity elements.

Glaucoma is one of important causes of irreversible vision loss and remains a global health problem. The pathophysiology of glaucoma involves several etiopathogenic mechanisms that have generated the development of topical and surgical treatments with an effect in slowing the progression of the disease. In the last decade, it was concluded that glaucomatous optic neuropathy is a disease with neurodegenerative elements, the destructive neuronal lesions being located not only in the structure of the retina, but also at the central visual pathways. This review highlights the experimental and clinical data obtained so far, which underline the neurodegenerative character of the glaucomatous disease and the elements of neuroconnectivity developed during the evolution of the disease.

Post renal transplant type 2 diabetes mellitus in a case of familial juvenile nephrophthisis.

Familial juvenile nephronophtisis, an autosomal recessive tubulointerstitial chronic nephritis, is characterized by progressive renal disease and end stage renal failure, which require kidney transplantation. Post-transplant diabetes mellitus (PTDM) incidence after kidney transplantation varies from 4-25%. Obesity, positive oral glucose tolerance test, metabolic syndromes, and post-transplantation multi-drug, high dose, long-term immunosuppressive therapy are the risk factors incriminated.We present the case of a 15-year-old overweight boy who was diagnosed with familial juvenile nephronophtisis five years before, afterwards progressive renal disease and end stage renal failure. This young patient developed PTDM three years after renal transplantation. His underweight brother, with the same medical history, did not develop PTDM.Transplantation was mandatory for a child with familial juvenile nephronophtisis.The case illustrates the risk factors for PTDM.

Thermal behaviour of procaine and benzocaine Part II: compatibility study with some pharmaceutical excipients used in solid dosage forms.

BACKGROUND: The compatibility study of active substances with excipients finds an important role in the domain of pharmaceutical research, being known the fact that final formulation is the one administered to the patient. In order to evaluate the compatibility between active substance and excipients, different analytical techniques can be used, based on their accuracy, reproducibility and fastness. RESULTS: Compatibility study of two well-known active substances, procaine and benzocaine, with four commonly used excipients, was carried out employing thermal analysis (TG/DTG/HF) and Fourier Transform Infrared Spectroscopy (UATR-FT-IR). The selected excipients were microcrystalline cellulose, lactose monohydrate, magnesium stearate and talc. Equal proportion of active substance and excipients (w/w) was utilized in the interaction study. The absolute value of the difference between the melting point peak of active substances and the one corresponding for the active substances in the analysed mixture, as well the absolute value of the difference between the enthalpy of the pure active ingredient melting peak and that of its melting peak in the different analysed mixtures were chosen as indexes of the drug-excipient interaction degree. All the results obtained through thermal analysis were also sustained by FT-IR spectroscopy. CONCLUSIONS: The corroboration of data obtained by thermal analysis with the ones from FT-IR spectroscopy indicated that no interaction occurs between procaine and benzocaine, with microcrystalline cellulose and talc, as well for the benzocaine-lactose mixture. Interactions were confirmed between procaine and benzocaine respectively and magnesium stearate, and for procaine and lactose.

Hyperhomocysteinemia in renal diseases.

Homocysteine is a sulfurated amino acid used for the synthesis of methionine. The last decade's researches proved that hyperhomocysteinemia is an independent risk factor for atherosclerotic vascular disease. The vascular injury induced by several mechanisms of hyperhomocysteinemia is the hallmark of homocysteine's atherogenic properties. Hyperhomocysteinemia is present in 85% of the patients with chronic renal failure (cardiovascular diseases are the main cause of mortality) and persists after initiating dialysis or after renal transplantation. Although folic therapy or folinic acid therapy reduce homocysteine levels with 20-40% in hemodialysis patients, the effects on cardiovascular morbidity have yet to be proven in future studies.

The importance of residual renal function in chronic dialysed patients.

In the last decade, many researches have reached to the conclusion that preservation of residual renal function (RRF) is important after initiating dialysis, as well as in the predialysis period. RRF has been proven to contribue to the quality of life of dialysis patients. Longer preservation of RRF provides a better small and middle molecule removal, improved volemic status and arterial pressure control, diminished risk of vascular and valvular calcification due to better phosphate removal. Deterioration of RRF results in worsening of anemia, inflammation and malnutrition. It is now proven a direct relationship between RRF value and survival in dialysis patient. Several therapeutical intervention have been proven to ameliorate the decline of RRF in dialysis patients. Some of them are identical with those before initiating dialysis: ACE-inhibitors and/or angiotensin-receptor blockers, limiting the use of nephrotoxic drugs, avoiding contrast media procedures, adequate control of blood pressure. Others are specific for dialysis period: adequate dialysis dose, avoiding excessive ultrafiltration, preventing arterial hypotension during dialysis sessions, using biocompatible dialysis membranes, ultrapure water for dialysis, dietary interventions.