STUDY ON THE USE OF M-HEALTH APPLICATIONS IN ROMANIAN MEDICAL PRACTICE

Objective. The aim of this study is to identify m-Health services in Romania and evaluate their effectiveness in line with international experience. Material and method. The study provides for the analysis of telemedicine services and applications focusing on the specific mobile health of international and national literature and practice through the Internet. We accessed and analyzed m-Health applications and programs, articles or reports, starting from the objectives, procedures, services belonging to, the cost, the impact, the behavior of the beneficiaries. Results. Relevant m-Health WHO reports, studies on applications used in Europe, recent reviews on the systematic analysis of the impact of m-Health applications, examples of applications in Romania have been identified. The main areas where these applications / services are present on the Romanian medical services market have been identified, specifying the objectives, the beneficiaries of services, their impact and their behavior Discussions. The applications of mobile medicine (m-Health) are becoming more frequent, more diversified, using various sensors and addressing chronic diseases such as: diabetes, asthma, chronic lung disease, epilepsy, coronary pathology, follow-up and management of susceptible patients as well as concerning communicable diseases and tracing of vectors of certain communicable diseases and endemic areas. Applications are also used for emergency and disaster management. The cost of accessing and receiving health services is decreasing, with higher accessibility, including in remote areas and with deficient medical services (for Romania as the Danube Delta, mountain areas etc.). Conclusions. Although m-Health services have begun to spread also in Romania, we still can not assess their effectiveness because the impact is still quite limited. Positive results are reported especially in the management of chronic conditions such as diabetes (especially juvenile diabetes) and epilepsy, significant decrease in the time of presentation of the patient with myocardial infarction to a hospital capable of initiating angiographic intervention per primum, better management of the urgency, and pre-hospital assistance. It also increases the addressability of patients in rural and remote areas to quality medical services

Psychological characteristics of elderly patients with oral diseases

The proportion of older people continues to grow worldwide. This, along with an increase in the prevalence of oral diseases, will significantly challenge health and social policy planners. Oral health is often neglected in the elderly and oral diseases associated with aging are complex, adversely affecting the quality of life. Identifying the psychopathology or the type of deviation from normality in the elderly, involves the assessment of psychological health and the operation with the psychological health major symptomatology. One of the dentist’s difficulties may be the recognition of a particular disorder in the case of an individual who is accusing a suffering state. The communication between the doctor and the elderly patient, which is the key in geriatric practice, is not optional, because it helps to achieve an efficient medical act in an appropriate, relevant and satisfactory manner for the care of the elderly patient. Discussion with the patient should be appropriate to the level of understanding of the individual elderly person. The patient’s cooperation is essential for any type of dental treatment. The biopsychosocial concept is fundamental to find an optimal treatment for oral diseases. The oral health influences the mental health of patients, changing their self-esteem, mood and satisfaction, even influencing their social life and quality of life. This is an important factor that has a direct influence on the general health and quality of life of older people, fundamental factors for “healthy aging”

Field theory conjecture for loop-erased random walks

We give evidence that the functional renormalization group (FRG), developed to study disordered systems, may provide a field theoretic description for the loop-erased random walk (LERW), allowing to compute its fractal dimension in a systematic expansion in epsilon=4-d. Up to two loop, the FRG agrees with rigorous bounds, correctly reproduces the leading logarithmic corrections at the upper critical dimension d=4, and compares well with numerical studies. We obtain the universal subleading logarithmic correction in d=4, which can be used as a further test of the conjecture.Comment: 5 page

Antropological Elements in the Implant-Prosthetic Rehabilitation

The dental anthropology can bring various contributions in the assessment of the pathology of the stomatognathic system as this field encompasses the genetic and clinical researches focused on the developmental defects of crowns, post-eruptive changes (dental wear, culturally-related dental changes) as well as patterns of teeth loss. The implant-prosthetic rehabilitation is highly recomended for these patients as having the highest rate of success in the therapy of the stomatognathic system disorders. The anthropological elements related to the optimisation of the implant-prosthetic rehabilitation of the stomatognathic system are related to the anatomical and morphological featires of prosthetic field, the favourable and non-favourable areas of the prosthetic field, the type and the orientation of the traction and pressure masticatory forces as well as the lamina dura preservation when edentation is associated to periodontal disease

THE RELATIONSHIPS BETWEEN MASTICATION AND BRAIN FUNCTIONS: A REVIEW

The active mastication has not only role in food intake and digestion, but also in the maintaining and promotion of the cognitive functions. It was demonstrated the increase of the blood supply in neuronal areas during mastication due to the stimulation of dental baroreceptors, alveolar baroreceptors and masticatory muscles during. Chewing was associated with greater alertness, more positive mood, faster reaction times, improved focus as well as with the improvement of the learning ability. On the other part, epidemiologic studies found that elderly individuals with high number of absent teeth are more likely to develop cognitive dysfunction, and neurodegenerative diseases like Alzheimer and dementia

INTERACTIONS BETWEEN MASTICATION AND STRESS

The main neuroendocrine response to stress is via activation of the hypothalamic-pituitary-adrenal (HPA) axis that contribute to the release of glucocorticoid hormone and ACTH. The activation of the HPA axis is a physiological reaction related to stress adaptation but repeated or prolonged HPA axis hyperactivity induces various physiological and psychological disorders. Mastication attenuates stress-induced disorders, cognitive and psychological impairment via suppression of stress-induced activation of the hypothalamic-pituitary-adrenal axis and autonomic nervous system. Chewing induces the increase of the histamine level in the hippocampus that contribute to the recovery of stress-attenuated N-methyl-D-aspartate receptors and the stimulation of the neural centers on long-term. The measuring of stress markers in saliva (alpha-amylasesympathetic nervous system marker, salivary cortisol – endocrine marker, immunoglobulin A-immune system marker) facilitates the assessment of the role of mastication in the stress level attenuation

THE ROLE OF THE CULTURAL ANTHROPOLOGICAL FACTORS IN THE PRESERVATION OF THE ORAL HEALTH: A REVIEW

To increase the effectiveness of the dental prevention and therapeutic politics, World Health Organisation has focused the projects regarding the dental health on health insurance systems, social environment, as well as on cultural factors. Cultural factors related to oral health include concepts regarding ethiological factors and dental treatment, race, geographic area, family habits and influence, gender factor, socioeconomic factors, nutritional factors, and cultural beliefs and taboos. Unfavourable anthropological factors are associated both with high prevalence of the edentation in Romania and difficulties to apply the most appropriate prosthetic solutions for the long term success. Romania has a close collaboration with WHO (project Oral Health Programme) to initiate programs, focused on various cultural and demographic factors, aiming to improve the oral health statu

MODERN THERAPEUTIC MANAGEMENT OF TEMPOROMANDIBULAR DISORDERS: A REVIEW

The effective temporomandibular disorders (TMD) therapeutic management can be performed only if the causal factors are accurately detected. A modern TMD management favourises approach from a biopsychosocial model where active and adaptive type treatments are fundamental. The management of psychological and behavioral factors must be considered and approached simultaneously with physical factors to accelerate the return to normal functioning of TMD patients with chronic pain. The new multimodal approach of TMD consider self-management as the most important part of TMD therapy, with primary focus on the change of the behavior of TMD patients (Greene). This approach include various components as follows: dental treatments (occlusal adjustments, stabilization splints), cognitive behavioral therapy, relaxation techniques, physical therapy (electrotherapy techniques, low-level laser therapy, neuromusculoskeletal techniques, acupuncture), anti-inflammatory medication. Conclusions.The modern management of TMD must focuses on the implementation of effective therapeutic algorithms based on accurate diagnostic and assessment of clinical and biological indices. TMD treatment implies multidisciplinary intervention of dentists, physicians, physiotherapists and psychologists

GENETIC FACTORS INVOLVED IN THE DEVELOPMENT OF CLEFT LIP AND/OR PALATE

The etiology of cleft lip (CL) and/or cleft palate (CP) has been studied in the past decade and it seems to be heterogeneous and multifactorial, with a combination of both genetic and environmental risk factors. Epidemiological surveys have shown that CL and/or CP (CL/P) are among the most frequently observed birth defects in children. The advances in the field of genetics during the past decades have led to great improvements in the early diagnosis, intervention, prophilaxy and also therapy of various genetic disorders, including those involving the abnormal development of cranio- facial structures. Fogh-Andersen (1942) provided the first population-based evidence that OC has a strong genetic component. Since then, various linkage studies have suggested numerous loci could have a causal role in CL/P. Inconsistent results could be caused by the small size of the studies or genetic heterogeneity association studies. There are many roles of the genes that are involved in oral cleft: some genes function as growth factors (eg, TGF-α, TGF-β3), transcription factors (MSX1, IRF6, TBX22), or factors that play a part in xenobiotic metabolism (CYP1A1, GSTM1, NAT2), nutrient metabolism (MTHFR, RARA) or immune response (PVRL1, IRF6). The most intensively investigated genes have been the TGF-α and MTHFR genes. Although a large number of candidate gene studies have been conducted in this field, and several genome-wide association studies (GWAS) have recently provided more clues, specific causal variants and biological mechanisms responsible for occurrence of nonsyndromic cleft lip with or without cleft palate (NSCL/P) remain unclea