Correlation between periodontal status and Parkinson's disease; a literature review

This systematic review aims to explore the relationship between chronic inflammation of periodontal disease and neurodegenerative disorders (especially Parkinson's disease), focusing primarily on pathophysiological, clinical and immunological aspects. An exhaustive search on this topic was performed in several databases (including PubMed, Scopus and Web of Science) selecting articles published between 2006 and 2023. After reviewing the titles, abstracts and protocols of each study, 13 articles were extracted for detailed assessment. The main indicators in the study included clinical signs of gingival inflammation, bleeding on probing (BoP), bone loss (BL), periodontal probing depth (PPD), and clinical attachment loss (CAL). Additionally, levels of inflammatory markers such as epidermal growth factor (EGF), interleukin-8 (IL-8), interleukin-17 (IL-17), interferon γ-induced protein 10 (IP-10), and monocyte chemoattractant protein-1 (MCP-1) were monitored. The investigation also explored the presence of one of the main periodontal pathogens (Porphyromonas gingivalis) in the microbiota of Parkinson's disease patients. In conclusion, the data presented further support the intricated relationship between periodontal health and neurodegenerative processes, including aspects related to changes in clinical periodontal indices, immunological indices, as well as oral hygiene and patient medication

Non-operative management of the sigmoid volvulus – case presentation

Sigmoid volvulus happens when the sigmoid wraps around itself and its mesentery. Sigmoid volvulus accounts for 2% to 50% of all colonic obstructions. This pathology generally affects adults, and it is more common in males. The etiology is multifactorial and controversial; the main symptoms are diffuse abdominal pain, distention and constipation, while the pregnant signs are abdominal distention and tenderness. Laboratory findings are not pathognomonic: abdominal X-ray radiographs show a dilated sigmoid colon and multiple intestinal air-fluid levels, abdominal CT and MRI demonstrate a whirled sigmoid mesentery. Flexible endoscopy reveals a spiral sphincter-like twist of the mucosa. The diagnosis of sigmoid volvulus is established by clinical, radiological, endoscopic, and sometimes operative findings. Although flexible endoscopic detorsion is advocated as the primary treatment choice, emergency surgery is required for patients who present with peritonitis, bowel gangrene, or perforation, or for patients whose non-operative treatment is unsuccessful. Although emergency surgery includes various non-definitive or definitive procedures, resection with primary anastomosis is the most commonly recommended procedure. After a successful non-operative detorsion, elective sigmoid resection and anastomosis is recommended. The overall mortality is 10% to 50%, while the overall morbidity is 6% to 24%

Cholelitiasis in an adult patient with mild hereditary spherocytosis – a case report

Hereditary spherocytosis (HS) is an inherited abnormality of the red blood cell, caused by defects in structural membrane proteins. The condition is dominantly inherited in 75% of people. The severity of the disorder is related to the type and amount of membrane disruption, which is genetically determined. A patient who suffers from this disorder is commonly found in a surgical ward when the disease becomes unmanageable by a hematologist. Surgeons encounter complications such as: jaundice, splenomegaly, gallstone sand severe anemia. We present the case of a 66-year-old woman with a history of hereditary spherocytosis who presented at the emergency room for pain in the right upper quadrant, jaundice and anemia and was diagnosed with gallbladder stones and common bile duct obstruction

Knowledge, Attitudes, and Practices of Dental Students from Romania Regarding Self-Perceived Risk and Prevention of Infectious Diseases

University education is a leading source of information for dental practitioners. Particular emphasis should be given to determining the extent to which students acquire positive knowledge, attitudes, and practices (KAP) and positive metacompetences beyond the scope of each studied dental discipline. We performed a cross-sectional questionnaire-based study among dentistry students from Romania to assess self-perceived risk of infectious diseases and their KAP on topics related to infectious disease prevention. The surveyed students presented good knowledge regarding personal protective equipment (PPE), and their PPE practices significantly correlated with the perceived usefulness of PPE. Only 45.1% correctly recognized all vaccine-preventable diseases (VPDs), but knowledge regarding VPDs significantly improved with increasing year of study (τb = 0.298, p = 0.001), confirming a positive education effect. Awareness regarding the need for screening for bloodborne viruses is poor; the majority of students had never performed a test for hepatitis C virus infection (HCV) (59.4%) or for human immunodeficiency virus (HIV) infection (60.4%). Furthermore, most respondents incorrectly considered themselves at high or very high risk of acquiring BBV, and perceived risk was inversely correlated with willingness to treat patients with hepatitis B virus (HBV) infection (τb = −0.214, p = 0.018), HCV infection (τb = −0.234, p = 0.013), or HIV infection (τb = −0.242, p = 0.006). This led to 3.0% of respondents stating that they would hypothetically deny dental treatment to a patient with HBV infection, 5.0% for HCV infection, and 10.9% for HIV infection, the proportion being significantly higher for HIV (z = −2.2, p = 0.026). In conclusion, better knowledge is needed among dental students regarding their own vaccination history, screening for bloodborne viruses, accurate estimates for their risk of acquiring bloodborne viruses during routine dental practice, and the existence of post-exposure measures following occupational exposure. Improving student knowledge and awareness could translate into a higher willingness to treat patients with chronic viral infections and into a safer and more inclusive dental practice. We propose an adaptation to the university curriculum to cover these key areas for targeted focus to empower future dental practitioners and to facilitate the improvement of across-discipline metacompetences for infection prevention and control

Acute ischemic cholecystitis in Takayasu’s syndrome – a rare finding

Introduction. Takayasu’s arteritis or pulseless disease is a systemic inflammatory disease of an unknown etiology, affecting medium and large arteries and their branches, leading to stenosis, occlusions, or aneurysmal degeneration. It is more frequent in young Asian women. Case presentation. We present a rare case of Takayasu’s disease in a young woman, who initially developed an acute ischemic cholecystitis. Ischemia is one of the mechanisms involved in the pathogenesis of acute acalculous cholecystitis. As this mechanism is most often involved in elderly people, such an uncommon finding at young age should be a reason to suspect a vasculitis with small vessel occlusion. Conclusions. Acute cholecystitis in this patient was the first onset sign of Takayasu’s arteritis. An acute acalculous cholecystitis at young age could be of ischemic origin and should also be considered as a possible epiphenomenon of a generalized vasculitis disease

SPIEGEL HERNIA – CASE PRESENTATION

he Spieghelian hernia or ventro-lateral hernia is produced through the effect of rupture of the abdominal wall fibers, near the semi lunar line. The hernia sac is usually accompanied by extra peritoneal fatty tissue and is intra parietal, it passes through the aponeurosis of the transverse muscle and internal oblique muscle, and it grows under the aponeurosis of the external oblique muscle. The Spiegel hernia is rare and is difficult to diagnose clinically. In this article we present the case of a 43-year-old patient who presented at the emergency department for a pseudo-tumor mass in the left flank and was diagnosed with Spiegel hernia

INCIDENTAL FINDING OF A SIGMOID INTUSSUSCEPTION ASSOCIATED WITH RECTAL PROLAPSE – A CASE REPORT

Colonic intussusception in adults is extremely rare, accounting for about 5% of all cases of intussusception. The telescoping of a proximal segment in the lumen of the adjacent segment has a classic classical triad in the symptomatology of children: abdominal pain, bloody diarrhea and palpable abdominal mass. In the adult patient, the symptoms are almost absent, and rarely they consist of constipation, bloody stool, or a malignant pathology that accompanies intussusception, weight loss, and anemia. We present the case of a 86-year-old patient who underwent a surgical procedure for repairing a rectal prolapse; intraoperatively, we discovered a sigmoid intussusception for which we performed a segmentary sigmoidectomy, repairing the rectal prolapse by rectosacropexy with alloplastic mesh

Rare small bowel obstruction due to phytobezoar – Case presentation

Phytobezoar is a rare cause of small bowel obstruction. This pathology represents 0.4%-4% of all mechanical bowel obstructions. Symptoms are similar to other small bowel obstructions. The most common localisation of the obstruction is represented by the terminal ileum. Phytobezoars are to be considered in patients who have had gastric surgery, a high fiber intake or psychiatric disorders. Also, multiple sclerosis has shown to affect bowel motility, which is important to our case. Surgery is always indicated. A low fiber diet and prokinetics are indicated for the prevention of this pathology. We present the case of a 43-year-old female who was admitted to the ICU following a car accident. The patient presented bowel obstruction symptoms (nausea and vomiting, bloating, not passing gas and severe abdominal pain) the 5th day after admission and was transferred to the operating room for exploratory laparotomy. Intraoperatively, we discovered a phytobezoar which was confirmed by the histopathological exam

Solitary cecum diverticulitis – A surprising diagnosis

Cecum diverticulosis is a benign, rare and generally asymptomatic disease that can manifest with acute diverticulitis or bleeding, thus complicating the differential diagnosis of the right iliac fossa pathology. The optimal management of this disease does not have a well-established treatment plan, as it may vary in some centers from conservative treatment, consisting of only antibiotics, to segmental colectomy or even right hemicolectomy. We present the case of a 45-year-old patient, prior diagnosed with chronic pain in the right iliac fossa after appendectomy, who was diagnosed with a single cecum diverticulum