Rolul consumului de fructe şi legume în menţinerea PH-ului oral normal

Salivar pH, an important indicator of a person's health, is measured in the morning, immediately after awakening, because throughout the day it may vary depending on the foods consumed. Average values should be 6.7 (with wide variations between 5, 6 -8).Fruits and green vegetables have an alkaline effect once they get into the stomach. For the present study, we have comprised a group of 31 patients with general illness (HTA-associated diabetes), which we compared with a control group of 25 patiens, aged 50-85 years, to whom we measured the pH salivary. In the study group, low pH values were recorded due to the general diseases associated with the medication used, to restrict the consumption of fruits and vegetables, compared to the control group where the recorded pH has higher value

MONITORIZATION OF THERAPEUTICAL ACT PERFORMANCE IN THE DIGITALIZED ERA - DETERMINATION OF PATIENT’S SATISFACTION -

Improvement of a patient’s health condition assumes the application, in the most convenient moment of time, of complete therapeutical actions based on a doubtless diagnosis. Such services are appreciated by the patient in most varied ways, and compared with the health services administered or provided by similar medical structures. Any manifested discontent may have immediate or latent repecussions upon the dignity, professional image and, equally, upon the economic efficiency of the medical structure involved. The system of performance indices refers directly and pragmatically to a quasi-objective quantification of the quality of the therapeutical acts administered, within some time interval, by the medical structure in charge with this. Analysis of qualiy criteria attainment involves a relatively complex graph of activities, among which mandatory are: identification and elimination of the causes of insatisfaction, establishment of corrective measures and directions when problems do appear, interrogation of patients as to their expressed discontents (as well as comparatively with their expectations), total involvement of all members of the medical team in solving patients’ needs. Critical analysis and periodical elaboration of new performance standards capable of assuring a high level of health services’ quality and, implicitly, of the satisfaction level expected by patients

CLINICAL EVALUATION OF CERAMIC PROSTHETIC RESTORATIONS ON A ZIRCONIUM STRUCTURE AFTER 4 YEARS

The mechanical properties of zirconium are optimum, comparatively with the other ceramic materials. Initial and fracture resistance, as well as its resistance to flexion, the white, opaque colour, permitting several shades, the special biological properties, largely recommend largescale utilization of zirconium in prosthetic restorations. Zirconium crowns and bridges were realized in 129 patients (81 women and 48 boys), with ages between 15 and 57 years, along 4 years. The working method applied in the laboratory made use of the CAD-CAM system, followed by scanning on a Dental Wings scanner and a CAM burring system from Wieland 917, 18. In a few cases, repeated evaluations demonstrated accidents and complications, such as skeletal fractures, ceramic chipping, decementation, etc

MARFAN SYNDROME – A CONTINUOUS MULTIDISCIPLINARY CHALLENGE

The paper discusses the clinical case of a 26 year-old pacient, diagnosed, as early as the age of 10 years, with a valvular pathology (at that time, objective reasons preventing the development ofadditional investigations on its etiology and recommended treatment). In January 2012, the patient suffers two tachyarhythmic episodes, during a longer trip, while driving his car and, next February, a routine stomatological exam evidences an ogival palatine arch and malar hypoplasia, so that a cardiological consultation follows. Clinical examination revealed a longiline status, arachnodactylia, pectus excavatum and telesystolic mitral murmur. Echocardiographic examination evidences prolapse of anterior mitral valve and mild secondary anterior mitral regurgitation, dilatation of the ascending aorta and mild aortic regurgitation. The suspicion of Marfan syndrome, based on the Ghent criteria, revised in 2010, was confirmed. Treatment with betablocking drugs (Bisoprolol) was recommended. Patient’s evolution was favourable

PRESENT AND FUTURE PERSPECTIVES IN INTERNATIONAL MEDICAL ASSISTANCE

Paneuropean development of patients’ rights represent a relatively recent concern, the legislative norms of which aim at granting to patients real-time access to all sorts of medical services. To this end, the European Union implemented a unitary normative professional and juridical background: Directive 2011/24/U.E. on the rights of patients to international treatments. Consequently, the patients are free to choose themselves the suppliers of medical services which do not include hospitalization, without a previous authorisation (country, doctor and medical institution) while, in the case of long-term treatments, a principial authorisation will be necessary. In both cases, the carrier of the therapeutic service receives the payment for his actions at the level of those established at national level, the difference being usually payed by the patient

THE PHYSICIAN – PATIENT RELATION IN THE ACTUAL ECONOMICOSYSTEMIC CONTEXT (CRISIS OF THE SANITARY SYSTEM)

In România, the crisis of the sanitary system is a component of the generalized economic-social crisis manifested in the 90’s, concomitantly with the sudden demolition of the centralized production system. The opportunities of public health, determined in relation with the “health market”, on the basis of the demand-supply intercourse, have been either ignored by the political factors or managed asymmetrically to the basic principles of the new system, most frequently in the absence of minimal financing. In this way, the quality of the therapeutical action becomes uncertain, insufficient, quantitatively and qualitatively regressing, reflecting, in a structural way, the losses caused by the ever-increasing migration of the Romanian medical specialists. The present diagnosis of the health status in Romania reveals severe, inconsistent realities, that can be systemically controlled only by a modulated, appropriate and effective management, and by a suitably-sized financing of capital expenditure and staff

EFFICIENT MEASURES FOR BURNOUT PREVENTION IN PALLIATIVE CARE

The term burnout, meaning ”professional exhaustion”, was introduced by Herbert Freudenberger in 1974. On May 21, 2014 , the World Health Assembly, the decisional organ of the World Health Organization, voted the resolution for the integration and development of the capacity of palliative care services as a constituent part of the health systems. The resolution represents a major pace in the development of palliative care at world level, once the ministers responsible for the field took upon themselves - by means of information and training programs - the task of services’ development, mainly at community level, the support from the part of the next of kins, the elaboration of educational programs, of guides and clinical protocols for specialists, of instruments for the monitorization of the quality of services provided, an easier access of patients to medication, as well as partnerships with the civil society. Burnout is a state of emotional, mental and physical overfatigue caused by excessive and prolongued stress. It is installed mainly when the person affected with it feels care-worn and uncapable of fulfilling his/her usual duties. As the stress continues, he/she will come to lose the interest or motivation which made him/her assume a certain position in the organizational hierarchy. The burnout phenomenon includes three components: emotional exhaustion, depersonalization and lack of professional accomplishment. The main observations on the phenomenon indicate that, apparently, the burnout level in palliative care is not higher than in other services, such as intensive therapy or surgery. Nevertheless, mention should be made of a characteristic of the palliative care services which influences the burnout level, namely the emotional relation created between the patient and the medical team, as a result of the prolongued duration of the care service

Comparative Study Regarding The Gum-Periodontal Manifestations During Pregnancy And Non-Pregnancy

The pregnancy, by itself is not able to produce the taint of the limit paradont but the hormonal change together with the vitamin deficit which occures during this periode may affect the local reaction of tissues concerning the bacterial plack, the real cause of this problem. In case of pregnancy woman the bacterial flora inside protection against it decreases, so the oral hygiena and the alimentation hold the main role in the evolution of the gingivo – paradontal diseases. A comparative study involving 25 pregnancy woman and 25 unpregnant over shows that the appearance of gingivo –parodontal diseases is bigger in the first lot that the second one. We also concluded that, in case of pluri –even pregnant woman, the paradontal teritory is more affected because of the previous pregnancies

RESIZING OF THE CRANIOMANDIBULAR RELATION IN THE REHABILITATION OF DENTAL ABRASION

Dental abrasion appears as a complex phenomenon among the multitude of clinical manifestations occurring in patients who require a complex oral rehabilitation. The therapeutical solutions for such cases are quite elaborate, involving interdisciplinary contributions from the part of various specialists.Obviously, elucidation of the complex cases of dental abrasion is possible when their standardized classification and, equally, a well-established therapeutical conduct, considering the class of dental abrasion, are available.Considering the advance of the adhesive techniques, the conservative treatment of dental abrasion is more indicated than the conventional method.Consequently, a 3-stage protocol of coronary reconstruction is recommended in cases of erosion with undersizing of the lower segment. The immediate aesthetic results are satisfacatory for the patient, as well as the functional ones, not requiring longer accomodation times. The reconstructions are resistant, due to the progress recorded by the adhesive techniques and composite resins (nano-hybrids, nano-composites)

THE RELIABILITY CRITERION IN MICROBIOLOGICAL DIAGNOSIS

The control of quality assumes a set of procedures elaborated and applied by the staff of the Laboratory of medical analyses for the continuous evaluation of the activity and for granting the quality of the results obtained, namely a correct reflection of patients’ health condition. Management of quality should consider the general and specific standards of quality and competence established by SR EN ISO 15189:2013 for the Laboratories of medical analyses. The risk of error exists in any medical action, the microbiological diagnosis included. Organization of the internal control of quality is the responsibility of the chief of the Laboratory of medical analyses, while its legal representative has the obligation to assure the resources necessary in this respect. The internal control of quality is performed on a regular basis and whenever necessary. The results of the the internal control are analyzed by the specialist in charge with it, who decides the acceptance or rejection of the obtained results. The laboratory of medical analyses should periodically participate to programs of external evaluation of quality. The (internal and external) control of quality contributes to reducing the number of erroneous microbiological result