Analysis of cognitive status during rehabilitation after hip arthroplasty associated with pre-existing knee arthroplasty on the same leg: Case Presentation

Introduction: Hip arthroplasty conducted through either cemented or cementless prostheses must alleviate pain and restore joint mobility and muscle strength. The main goal is to restore mobility, stability and to maintain ADL (Activities of Daily Living) within normal parameters. Current surgical techniques allow for state-of-the-art surgeries to be performed. Yet, the postop-erative course is strongly influenced by both pre-and postoperative psychological factors, as well as by associated diseases. Materials and Methods: We present the case of a 79-year-old female patient from Iasi, a retired yet still physically active gym teacher who was admitted an emergency to the Orthopedics Clin-ic of the ”Sf. Spiridon” Emergency Hospital with a displaced left femoral neck fracture resulting from same-level fall. The patient had for 6 years a Scorpio-Stryker cemented knee prosthesis on the same leg. Through surgical intervention, a cementless bipolar Lépine prosthesis was inserted into the left hip. Then, the patient presented to the Department of Physical Medicine and Reha-bilitation of the Iasi Clinical Railroad Hospital to receive an adequate post-operative rehabili-tation program. Results: The psychosocial factors have been analyzed with the help of various recent and spe-cialized psychological scales. The obtained results confirm the fact that these factors significantly influence the rehabilitation of prosthesis-wearing patients. Conclusion: Our study emphasizes the psychological impact on standing and walking rehabili-tation in a patient with two prostheses on the same motor axi

Low back pain- Algorithm of diagnosis and management

Introduction: Low back pain is a frequent condition, associated as a symptom with a multitude of organic or non-organic pathologies, resulting in the appearance of disability generating negative economic and soc-professional consequences. Being a relatively common symptom among patients, we created this paper with the aim to high-light the importance of the clinical examination along with the correct direction of the patient to a profile depart-ment, the review of differential diagnoses, as well as the establishment of a particular recovery plan adapted to each case. Materials and Methods: We analyzed a series of recent articles using the PubMed and the Cochrane Library data-bases ,using the keywords words “low back pain” and “rehabilitation”, to obtain data on the clinical and paraclinical examination, positive and differential diagnosis of chronic low back pain, as well as on rehabilitation management. Results: Low back pain may appear due to vertebral conditions (inflammatory, infectious, traumatic, neoplastic, degenerative, metabolic), or due to extravertebral causes. Along with the anamnesis, clinical examination and im-agistic investigations, we establish the positive diag-nosis and create an individualised rehabilitation plan. The reha-bilitation protocol is divided into stages , the final goal is to minimize the ischemia-pain-contracture chain. Conclusion: The pathology of the lumbosacral spine can be characterized by the word "diversi-ty", being one of the causes of early disability of the population in the field of work. Our work highlights the importance of the clinical and paraclinical examination in outlining the differen-tial diagnosis of chronic lumbar pain, as well as the role of the multidisciplinary team in com-plex individualized rehabilitation treatment

NEW INSIGHTS INTO THE PATHOPHYSIOLOGY OF GEOGRAPHIC TONGUE

Geographic Tongue (GT), also known as benign migratory glossitis, is a benign inflammatory condition characterised by irregular, smooth, red patches on the tongue surface, often with a white or light-coloured border. Despite being a common oral condition, its pathophysiology remains poorly understood. This review aims to shed light on the latest insights into the pathophysiology of GT, exploring its etiological factors, immunological aspects, and potential genetic predispositions. We discuss the role of environmental factors, such as stress and dietary habits, and delve into the immunopathological mechanisms that may contribute to the manifestation of GT. The review also examines the possible genetic and epigenetic factors involved in GT and their interaction with environmental triggers. Recent advancements in molecular biology and genetics offer new perspectives in understanding the complex nature of GT, paving the way for improved diagnostic and therapeutic approaches. This review concludes with a discussion on the potential future directions in GT research, focusing on the need for larger epidemiological studies and the exploration of novel therapeutic targets

THE IMPACT OF GUT MICROBIOTA ON RECURRENT APHTHOUS STOMATITIS

Recurrent Aphthous Stomatitis (RAS) is a prevalent oral mucosal disorder characterized by recurring painful ulcers. The pathogenesis of RAS remains incompletely understood, but emerging evidence suggests a significant link between gut microbiota and the development of RAS. This review aims to explore the existing literature on the interplay between gut microbiota and RAS, focusing on how intestinal dysbiosis may influence the onset and severity of RAS. We discuss the role of gut microbiota in immune modulation, the breakdown of oral tolerance, and the possible pathways through which gut bacteria can affect oral health. Additionally, we examine the impact of diet, antibiotics, and probiotics on the gut microbiota and, subsequently, on RAS. The review concludes with potential therapeutic strategies targeting gut microbiota to manage and prevent RAS, paving the way for novel interventions in this field

DERMATOSCOPIC INSIGHTS INTO THE MOST COMMON POTENTIALLY MALIGNANT ORAL LESIONS

The early detection and accurate diagnosis of potentially malignant oral lesions, such as actinic cheilitis, leukoplakia, and oral lichen planus, are crucial for improving patient outcomes. Dermatoscopy, a non-invasive diagnostic technique, offers enhanced visualisation of these lesions, enabling precise assessment of morphological features critical for early recognition and differential diagnosis. This article aims to present dermatoscopic findings from cases of these common conditions, highlighting their importance in refining clinical management. Dermatoscopy not only improves diagnostic accuracy by revealing detailed lesion characteristics but also assists in evaluating malignancy risk, monitoring progression, and guiding the decision-making process for biopsy and treatment. While biopsy remains definitive for diagnosis, dermatoscopy serves as a valuable preliminary tool. Future research should focus on establishing standardised dermatoscopic criteria for oral lesions and integrating dermatoscopy into regular oral health evaluations to advance patient care

PARTICULAR ASPECTS OF IMPACTED MAXILLARY CANINE IN CHILDREN – A NARRATIVE REVIEW

Canine impactions are frequently encountered in the pediatric population. Impacted canines may pose a functional and esthetic problem for patients and can affect the neighboring teeth (incisors and premolars). Early detection and management of such pathology may help the pediatric dentist and orthodontist to prevent many unwanted local and regional complications. Various surgical and orthodontic techniques may be used to recover impacted maxillary canines. The decision to surgically correct these impacted teeth is usually made by the orthodontist. The treatment of impacted teeth requires a multidisciplinary team comprising orthodontist, pediatric dentist, dento-alveolar surgeon, and sometimes a periodontist

ANGULAR CHEILITIS: A MULTIDISCIPLINARY APPROACH TO DIAGNOSIS AND MANAGEMENT

Angular Cheilitis (AC) represents a multifaceted oral pathology characterized by erythematous lesions at the labial commissures. Despite its prevalence, AC is often inadequately addressed due to its polymorphic etiology, which can encompass infectious agents, nutritional deficits, and systemic conditions. This article provides a systematic review of the pathophysiology, clinical presentation, and etiological factors of AC, including nutritional deficiencies, infectious agents, and systemic diseases. Emphasizing a multidisciplinary strategy, we discuss the collaborative roles of dental, medical, and dermatological expertise in the accurate diagnosis and effective management of AC. We outline diagnostic criteria, appropriate laboratory tests, and imaging techniques tailored to address the multifaceted nature of the condition. Management strategies encompass a range of options from topical treatments and medications to dietary modifications and preventative measures, with an emphasis on evidence-based practices. This review advocates for integrated care models to optimize treatment efficacy, patient compliance, and to mitigate the recurrence of AC. Our analysis aims to enhance the understanding of AC and to provide a framework for its management, contributing to better patient care and opening avenues for future research

THE IMPACT OF SYSTEMIC CORTICOSTEROID THERAPY ON ORAL HEALTH: COMPLICATIONS AND MANAGEMENT STRATEGIES

Corticosteroids, including glucocorticoids, mineralocorticoids, and androgenic hormones, are hormonal mediators produced by the adrenal glands and are widely used in the treatment of various conditions, including dental diseases. While systemic corticosteroid therapy offers significant therapeutic benefits, it is crucial to understand the potential adverse effects on oral health. This paper aims to highlight the impact of systemic corticosteroid therapy on oral health, focusing particularly on the associated complications and management strategies. The paper emphasizes specific complications that may occur in the oral cavity as a result of corticosteroid use, the most important being an increased susceptibility to oral infections such as candidiasis and impaired bone metabolism, with a significant reduction in the mineral density of the mandibular bone (BMD), as well as delayed wound healing, the occurrence of oral ulcers, and changes in the oral microbiome. Furthermore, the importance of rigorous oral care and regular dental monitoring for patients undergoing systemic corticosteroid therapy is underlined. The role of oral health specialists in the early detection and efficient management of oral complications, as well as patient education regarding proper oral hygiene practices and possible side effects, is of crucial importance. In conclusion, it is essential for healthcare providers to be vigilant regarding the potential oral health complications associated with systemic corticosteroid therapy, and early detection, prevention, and the implementation of appropriate management strategies are fundamental for optimizing oral health outcomes in patients undergoing corticosteroid treatment

EMERGING USE OF JANUS KINASE INHIBITORS FOR ORAL LICHEN PLANUS

Oral lichen planus (OLP) is a chronic inflammatory condition that poses significant therapeutic challenges. Emerging evidence suggests that topical Janus Kinase (JAK) inhibitors could represent a novel treatment paradigm for OLP. This review explores the pathophysiology of OLP, highlighting the role of the JAK-STAT pathway in its pathogenesis. We discuss the current landscape of topical JAK inhibitors, including their mechanism of action, efficacy, and safety profile. The review also examines recent clinical trials and observational studies that shed light on the potential of these agents in managing OLP. Finally, we provide a perspective on the future of JAK inhibitors in the context of OLP treatment, considering both their therapeutic potential and the need for further research

ORAL MANIFESTATIONS OF VIRAL INFECTIONS IN IMMUNOCOMPROMISED CANCER PATIENTS

Immunodeficiencies induced by chemotherapy make cancer patients vulnerable to to reactivation of latent viruses and to primary viral infections caused by exposure to environmental factors, such as air, water, microbial flora and debris. Patients with hematological cancers are more prone than patients with solid tumors to develop viral infections that affect the oral cavity due to high-dose chemotherapy regimens and prolonged immunosuppression. Viruses of the Herpetoviridae family (herpes simplex, varicella, cytomegalovirus, Epstein-Barr) and human papillomavirus cause mouth pain with difficulties in eating and oral ulcerations that can spread, leading to life-threatening systemic infection. Therapeutic approaches for the more severe and atypical oral manifestations seen in cancer immunosuppressed patients include inhibitors of virus replication, antivirals, surgical excision and analgesics, but the painful oral lesions are associated with longer healing times. The differential diagnosis of a oral ulcers in cancer patients is broad, but it should include various viral infections