"Background: A germline mutation of the MisMatch Repairgene that causes a malfunctioning DNA system is the defining feature of the hereditary illness known as Lynch syndrome. This review will discuss the endocrine aspects of LS and highlight current advancements in the area. Methods: We searched the available literature of the last 10 years for terms such as endocrine tumors and LS. Our goal is to provide a summary of the most recent information available on the endocrine perspective in Lynch syndrome. Results: The hormonal chemoprevention methods cited are the use of combined oral contraceptives, the use of progestogen-releasing intrauterine devices, and the use of progesterone-only drugs. In addition, after surgical exclusion of the uterus and ovaries, a method frequently adopted for LS patients, it is necessary to start hormonal menopausal therapy, taking into account certain age-specific features. In addition, numerous LS-associated endocrine tumor types have been described. Conclusions: Many hormonal variants are available that are useful in the chemoprevention involved in the treatment of LS. Menopausal hormone therapy is imperative for LS patients who need it. Clinicians need to be aware of the possible association of certain types of aggressive endocrine cancers associated with LS."
"Virtual reality (VR), initially a form of entertainment has begun to find its way in healthcare practice. One of its main areas of interest is the treatment of psychiatric disorders. When using VR, the basic ethical principles underlying the physician-patient relationship should be respected, but they should be customized by the presence of an additional layer of complexity generated by the interposition of the virtual world. The physician-patient relationship is often multidirectional, often including a larger team of healthcare professionals, family members or acquaintances, working conjointly to optimize the medical care. Each time other participants are involved within this relationship, the complexity of the ethical issues tends to increase. For example, if the patient has decreased insight, it is possible that other persons must make some medical decisions – resulting a prioritization of beneficence compared to autonomy. Also, we must take into account the fact that many psychiatric symptoms can be seen as a form of "virtual reality" by the patient. The healthcare provider must take additional safety measures to minimize the harms made by VR techniques in psychiatric patients, by using methods that are individually tailored. The main aim of this paper is to debate the ethical aspects surrounding the applicability of virtual reality in treating psychiatric patients, with an emphasis on the elements that were mentioned earlier. "
The aim of this study was to compare two computerized digital esthetic design methods (DSD and Visagismile) in order to properly choose the appropriate form of the maxillary frontal teeth for complete bimaxillary edentulous patients and to validate the use of these applications in complete edentulism. An online questionnaire was submitted to a group of 100 persons (dental doctors, dental medicine students and persons activating in other fields); the respective persons were requested to choose the form of maxillary frontal teeth for a group of four complete bimaxillary edentulous patients, whose esthetic design had been performed by using the two computerized progams. Following the respondents' analysis of the esthetic previews elaborated for the four patients 60% of the total answers were in favour of DSD while the remaining 40% were in favour of Visagismile; these percentages are identical with the ones obtained on the basis of the answers given by dental doctors and dental medicine students. In case of the respondents activating in other fields the percentages were 66% in favour of DSD and 34% in favour of Visagismile. Based on the results of the study the two computerized methods were validated also for cases of complete edentulism but further studies to confirm this validation are still required. These two methods improve the dental doctor/patient communication and certainly provide a higher predictability of the esthetic results of prosthetic restorations not only for dentate patients but also in cases of complete edentulism.
Aim. To identify the main facial features associated to facial attractiveness in women nowadays. Method. A descriptive study was conducted on a sample of 20 female public figures, very famous and successful women, most frequently actresses, singers or models, considered very beautiful nowadays. Their selection followed the analysis of several recent tops that aimed identifying most beautiful women, in which raters were lay persons. Data was collected by analyzing photos from frontal and lateral view, during rest position and smiling. Results. The persons analyzed registered diverse facial traits. Most obvious trends, encountered in more than 75% of them, included: Caucasian race; straight and long hair; average nasal tip protrusion; maxillary dental midline concordant to facial midline; a thicker lower lip compared to the upper lip; exposure of only maxillary incisors during smile; decreased or absent buccal corridor; maxillary central incisors of oval/rectangular shape; absence of maxillary teeth crowding. Other frequently encountered features were: American nationality; brown hair; eyes with medium size, almond shape, wide set, of green color; nose with an average width; face with a decreased lower third and a slightly convex profile; a thick lower lip and an average upper lip; exposure during smiling till the first molar, with a normal smile line. Conclusions. The public beautiful women nowadays register features that are generally associated to an increased facial attractiveness. Knowledge of trends in facial beauty is useful in dental practice, in order to understand better patient's need in terms of esthetic expectations.
Diabetes mellitus is a serious condition, causing multiple health problems due to the disease itself, but also to the complications that these patients are predisposed to. Being a current health problem, many patients tend to disregard the doctor's recommendations concerning the necessary measures to maintain adequate and continuous control of the glycaemia levels. This, in turn, may cause complications, which include neuropathy, microangiopathy and a predisposition to infections due to weak local defence mechanisms. In otorhinolaryngology, the infectious pathology is one of the most often causes for presentation to the physician. Ranging from common otitis, acute pharyngitis or laryngitis and sinusitis, these different entities will cause significant discomfort for the patient, prompting the need for medical care. In patients with diabetes, the natural course of the disease is altered, with more severe symptoms, a more extended period of recovery and the predisposition for aggravated cases with the tendency to complications. Such complications may be life-threatening if we take into account the complications associated with acute sinusitis for example, which include orbital or cerebral abscesses. Our paper aims to present the authors experience on the complete approach of patients with infectious pathology concerning the sinuses associating diabetes mellitus. Always, we must keep in mind that patients with diabetes represent a particular class of patients that require a personalized approach. They are predisposed to a vicious circle, in which the infection causes diabetes imbalance, which in turn decreases the defense mechanism and predisposes to complications. The correct management must always include a proper control of diabetes, a complete evaluation that will determine if complications are already present and aggressive management of the infection, with regular check-ups to determine the evolution of the patient.
Introduction: Matrix metalloproteinases (MMPs) are key enzymes involved in degradation of extracellular colagen matrix during periodontal disease progression. The aim of our work was to study the levels of MMP-1, MMP-2, MMP-7, MMP-9 and MMP-10 in saliva of patients with chronic periodontitis. Materials and methods: The study included 22 patients with chronic periodontal disease and 15 controls. We collect unstimulated whole saliva from all volunteers included in the study. Salivary levels of mentioned MMPs were analyzed using magnetic bead-based multiplex assays and Luminex technology. Results: MMP-1, MMP-7, MMP-9 and MMP-10 present statistically increased salivary levels at patients with periodontal disease versus the control group (p<0.05). Salivary level of MMP-2 at patients with chronic periodontitis was increased but statistically insignificant compared with healthy subjects (p=0.1). Conclusions. The increased level of these enzymes in patients diagnosed with periodontal disease reflects their implication in periodontal tissue degradation. Saliva is an excellent fluid useful in monitoring the severity of this oral disease that affects about half of the adult population around the world.
Pregnancy-specific dermatoses are a heterogeneous group of inflammatory dermatoses associated exclusively with pregnancy. Although these dermatoses are rare, it raises problems in medical practice because of their appearance, being difficult to diagnose, treat and the possibility of the fetus being affected. Pemphigoid Gestationis (PG) is a rare, autoimmune, strongly pruritic, vesiculobullous dermatosis with a strong impact on the patient. Polymorphic Eruption of Pregnancy (PEP) is a benign, self-limited inflammatory skin disorder that usually affects first pregnancy in the third trimester or immediately in the postpartum period. Other dermatoses associated with pregnancy include: Intrahepatic Cholestasis of Pregnancy (ICP), Atopic Eruption of Pregnancy (AEP) and Pruritic Folliculitis of Pregnancy (PFP). We will extensively present PG and PEP, to draw attention to the importance of correct diagnosis and the implications of treatment during pregnancy.
Renal disease in pregnancy is a rare pathology, but it raises several problems in terms of normal pregnancy evolution. Among pregnant women with renal injury, the rate of complications such as spontaneous abortion, preeclampsia, hypertension, intrauterine growth restriction, premature birth, fetal and neonatal mortality are much higher. For a good understanding of the pathology and a correct management of pregnant women with renal disease, it is necessary to know the normal pregnancy changes and the differentiation of chronic kidney disease from the acute injuries occurring during pregnancy. It is useful to ensure counseling prior to conception and to perform all prophylactic measures in order to prevent pregnancy complications and subsequent decline in renal function in all cases of pregnant women with chronic renal insufficiency. Treatment of acute renal failure in pregnancy involves therapy of the underlying condition that caused renal injury, prevention of irreversible kidney injury and pre-vention of maternal and fetal secondary complications. Monitoring carefully this cate-gory of pregnant women, although additional risks strike, often results in favorabl pregnancy evolution.
Breast cancer remains a significant health concern, with predictions indicating a rise in global incidence. While the primary focus is on oncological radicality, the aesthetic and psychological impacts of surgical interventions, such as radical mastectomy, cannot be ignored. This study, conducted over 8 years, aimed to identify factors that can prevent unnecessary lymphadenectomy. The research analyzed various parameters, including age, BMI, tumor size, and immunohistochemistry, to determine their correlation with axillary lymph node invasion. The results highlighted the importance of tumor size and estrogen receptor status in predicting axillary lymph node metastasis. The study underscores the value of sentinel lymph node biopsy in early breast cancer treatment, emphasizing its benefits over complete axillary lymph node dissection.
Introduction: Venous thromboembolism (VTE), in its clinical spectrum, includes both deep venous thrombosis (DVT) and pulmonary embolism (PE). It is a disease with high incidence and morbidity in hospital and community settings. Venous thromboembolism has various risk factors and there are studies proving that the risk of increasing the incidence of the disease is proportional to the risk factors. Diagnosis, treatment and complications of lower limb deep vein thrombosis (DVT) depend on the anatomical location and extent of the process. The post-thrombotic syndrome (PTS) is the most common complication of deep vein thrombosis (DVT) and clinically it is characterized by chronic pain, edema, enlarged veins, skin induration and other signs of the affected limb, while, in severe cases, it can develop venous ulcers. The incidence of peripheral trophic disorders by age and the prevalence of risk factors for deep vein thrombosis of the lower limbs were examined in this regard. Materials and method: A retrospective study (January 2013 - December 2015) was conducted by collecting data from medical documents available in ""Floreasca"" Emergency Hospital Bucharest, Romania. The patients diagnosed with deep vein thrombosis, on the basis of Doppler ultrasound, were divided into two groups, according to age: group A (59 patients aged ≤50 years) and group B (130 patients aged> 50 years). A number of data from the medical anamnesis, along with clinical and paraclinical data were collected by us and we were interested in the incidence of peripheral trophic disorders caused by deep vein thrombosis of the lower limbs correlated with the risk factors. The study showed the incidence of deep venous thrombosis in a certain age and a certain environment of origin. The incidence of patients who have had a VTE history is half the patients with deep vein thrombosis who have had prophylactic anticoagulant therapy before hospitalization. The incidence of patients who have had prophylactic anticoagulant therapy before hospitalization is 61.1% of the patients with deep vein thrombosis and a VTE history. The incidence of trophic disorders caused by deep vein thrombosis of the lower limbs in patients who have had prophylactic anticoagulant therapy before hospitalization and in patients who also had a history of VTE is higher in those over 50 years old. The study showed the association of some risk factors for venous thrombosis with an age-related factor. Conclusions: Improving preventive strategies and an optimally efficient utilization of these strategies for patients at risk of venous thrombosis can lead to improved clinical outcomes in practice and also to the post-thrombotic syndrome prevention. Taking into consideration the risk factors by age group and a better understanding of epidemiology and the risk factors for the first or recurrent venous thrombosis can lead to optimal use of prophylactic strategies and improved quality of life. DVT affects all age groups and the incidence associated with PTS is high, therefore the prevalence of PTS in general population is considerable.
"Background: Cardiovascular disease can be triggered and accelerated by hypertension and the underlying changes in the structure and function of arteries. The purpose of this review is to explore some vascular changes that occur in hypertension as a consequence of the imbalance between cell proliferation and cell death, processes that play an important role in stabilizing the thickness of the arterial wall during vascular remodeling. Methods: The authors conducted research through PubMed and Google Scholar databases using the following search formula: (hypertensive*) AND ((vascular modifications)) OR (vascular changes)) AND (cell death). Results: From 40 articles, only 17 publications were included in this study, taking into account four processes that can be preceded or followed by inflammation and depend on the interaction between local growth factors, vasoactive substances, and hemodynamic stimuli: Cell proliferation and growth; Cell migration; Cell death; Degradation or reorganization of extracellular matrix. Conclusions: To summarize, maladaptive vascular changes in hypertension can represent a major argument for prompt and maximal therapeutic intervention in patients with high cardiovascular risk. Moreover, they can represent an important step in discovering new markers of cardiovascular risk and in the development of new targeted therapies for different pathways of cellular signaling through which the reversibility of abnormal vascular changes could be obtained. "
Colorectal cancer is the third most common cancer worldwide and represents a significant major public health issue. Therefore, the interest in detecting the multiple factors implied in the development of cancer has increased recently. One of the factors could be the Helicobacter pylori infection, but a direct causal connection is missing. This gram-negative bacterium infects approximately 4 billion individuals globally and various conditions such as gastroduodenal ulcers or gastric adenocarcinomas can be induced by it. Some of the reported carcinogenic effects of Helicobacter pylori bacterium are hypergastrinemia, chronic inflammation, dysbiosis, and toxin production. Each of these elements involved in the pathogenesis has various mechanisms of action. Dysbiosis can occur due to various treatments for the eradication of the Helicobacter pylori infection. This bacterium also has a proinflammatory effect at the gastric level which can predispose to the development of dysplasia or even neoplasia. The toxins produced by this bacterium, such as the vacuolating cytotoxin A, promote inflammation. In this review, we discuss the possible connections between the Helicobacter pylori infection, through its diverse pathogenic mechanisms, and colorectal neoplasm. Prospective studies are necessary to determine whether there certainly is a direct link between the two conditions.
The diagnosis in Carpian tunnel syndrom is based on clinical symptoms and electrodiagnostic studies. Electrodiagnostic studies help to stage both motor and sensory nerve damage.
