Correlations between gastroesophageal reflux disease and obstructive sleep apnea

University “Dunarea de Jos”, Galati, Romania, The 6th International Medical Congress for Students and Young Doctors, May 12-14, 2016Introduction. Obstructive sleep apnea (OSA), also referred to as obstructive sleep apneahypopnea— is a sleep disorder that involves cessation or significant decrease in airflow in the presence of breathing effort and is characterized by recurrent episodes of upper airway collapse during sleep. The negative intrathoracic pressure presented in apnea leads to gastroesophageal reflux. Gastroesophageal reflux disease (GERD) occurs when the amount of gastric juice that refluxes into the esophagus exceeds the normal limit, causing symptoms with or without Associated esophageal mucosal injury. Objective. My objective is to make correlations between OSA and GERD in a group of Romanian and French patients with OSA and GERD symptoms. Materials, methods. I studied 100 patients, 44 women and 56 men. The diagnosis of OSA was established by overnight polysomnography. The severity of OSA was estimated by IAH (apneahypopnea index). To evaluate GERD symptoms I used GERD questionnaire. Others parameters that were observed were the age, sex, alcohol consumption (g/day), body mass index (BMI), day somnolence expressed by Epworth scale and the activity by Dijon scale. The statistics were made in Excel 2016 and SPSSv.20. The correlations were interpreted with the Pearson index (r).Results In the studied group were 44 women and 56 men. The average age was 52,32 years, average IAH for Romanian group was 32.56/h, average Epworth score for the whole group was 8.85 points, the average BMI = 29,4 kg/ m2 (34,03 for Romanians), the average GERDQ score was 9,3 points and the average Dijon score was 12.3 points. The correlation between GERDQ and IAH was significantly positive with r = 0.35. IAH was strongly correlated with BMI (r = 0.525).GERDQ has strong correlations with BMI for Romanians but not for French patients (r = 0.45 vs. r = -0.21). The most powerful positive correlation was between GERDQ and the alcohol consumption (r =0.428) especially for the Romanian patients. Epworth was correlated with BMI for the whole group (r = 0,3) and with the age (r = 0.34), especially for the French group. (r = 0.65) Also GERDQ and Epworth scale were negatively correlated with Dijon scale. DISCUSSIONS. Researchers in North Carolina conducted a study in 181 patients with sleep apnea and nighttime GERD symptoms in 2003 and the conclusion was that the treatment with nCPAP decreased the frequency of nocturnal GERD by 48%. Also there are studyes suggesting that the treatment with IPP for GERD decreases the number of apneas. Conclusions 1. Obesity is a main risk factor for OSA and GERD. 2. Men present more severe GERD and OSA than women for the Romanian group. 3. GERD is more severe at the Romanian patients who drink more alcohol. 4. GERD is more severe if the patients have more severe OSA

Assessment of data regarding patients resort to dental services

Rezumat Asistenţa stomatologică de ambulatoriu este cea mai reprezentativă în acordarea serviciilor medicale, constituind conform datelor adresabilităţii 20-25%, ocupînd astfel locul doi după numărul de adresări la medicii de profil terapeutic, în special medicii de familie. Maladiile stomatologice sunt cele mai răspîndite afecţiuni care necesită măsuri eficiente de profilaxie şi tratament, îndeosebi în combaterea cariei şi a afecţiunilor parodontului ca problemă medico-socială de importanţă la etapa actuală. În aceste condiţii structurile stomatologice de stat actualmente sunt instituţii de bază ce acordă asistenţă stomatologică specializată de ambulatoriu populaţiei.Summary Out-patient dental services are the most representative in rendering medical services and constitute, according to the figures indicating the patients’ presentation to the dentist, 20-25%, ranking the second after the number of those seeking general medical assistance, family doctors’ help in particular. The dental diseases are the most wide-spread disorders necessitating effective measures of prevention and treatment of, primarily, caries and parodontal pathoses, their combating being at present an important medico-social problem

Some aspects of dental etiology and erosion clinical picture

Rezumat. Au fost supuse analizei 160 de fişe de evidenţă a pacienţilor cu eroziune dentară. Particularităţile de alimentaţie, unii factori ai mediului ambiant şi voma, s‑au prezentat ca cei decesivi la apariţia eroziunilor adamantinale.Summary. One hundred sixty medical records of patients with dental erosion have been analyzed. The diet peculiarities, some environmental factors and vomiting have proved to be decisive in the development of enamel erosions

Quality of professional dental assistance rendered to population in the specialized institutions with different forms of activity

Catedra Terapie Stomatologică, FECMF USMF „Nicolae Testemiţanu” IMSP, Centrul stomatologic municipal, ChişinăuThe results of dentists’ opinion questioning had a particular role in improving the dental assistance for population. This is explained by the positive changes in the healthcare system directly connected with the increase in the technical-material basis of the medical institutions, with the introduction of different forms of organization and financing of medical services, the dental ones inclusively. All these are oriented towards improving the quality of medical assistance and offering the population guaranteed and accessible medical services. The work presents the results of dentists’ questioning in the institutions with different forms of rendering dental services to population. Un rol special în perfecţionarea asistenţei stomatologice a populaţiei l-au avut rezultatele sondajului opiniei medicilor stomatologi. Acest fapt e explicat de schimbările pozitive în sistemul de sănătate, legate în mod direct de progresul bazei tehnico-materiale a instituţiilor medicale, de introducerea diferitor forme de organizare şi de finanţarea serviciilor medicale, inclusiv a celor stomatologice. Această situaţie este orientată spre sporirea calităţii asistenţei medicale şi garantarea accesibilităţii populaţiei la diferite servicii medicale. În această lucrare sunt prezentate rezultatele sondajului medical a stomatologilor în instituţiile cu diferite forme de acordare a serviciilor stomatologice populaţiei

Some measures to urgently combat the clinical manifestations of allergies of the immediate type in therapeutic dentistry

Rezumat. Informația dată demonstrează eficența aplicării urgente a măsurelor de combatere a unor reacții alergice de tip imediat în stomatologia terapeutică. Actualitatea problemei. În activitatea clinică a medicului stomatolog, astfel ca și în alte ramuri a medicinei pot apărea situații de urgență, necesare să fie rapid diagnosticate, acordânduse pacientului ajutorul medical la timp și eficace. Profesorul universitar Stenli Malomed (2009, Los Angeles, SUA) a supus unei analize profunde frecvența stărilor de urgență apărute în activitatea somatologilor privați (4000 de medici) pe parcursul a zece ani de activitate clinică. Rezultatele au prezentat circa 30000 de situații extremale din care au fost apreciate: leșinul în 15407 cazuri; reacții alergice ușoare în 2583 cazuri, iar de tip anafilactic în 304 cazuri. Ciar și în succesele reanimatologiei mondiale performante, morbiditatea de la șocul anafilactic (Rabinovici S.A., 2005) a atins 60 la 100 din cazurile clinice a patologiei. Scopul lucrării. Estimarea eficienții clinice a măsurilor de urgență antialergică acordate în cazul reacțiilor de tip imediat apărute în activitatea stomatologilor terapeuți.Summary. The given information demonstrates the effectiveness of urgent application of measures to combat allergic reactions of immediate type in therapeutic dentistry. The actuality of the subject. In the clinical activity of the dentist, as in other branches of medicine, emergency situations may arise, necessary to be quickly diagnosed, providing the patient with timely and effective medical help. University professor Stenli Malomed (2009, Los Angeles, USA) subjected to a deep analysis the frequency of emergency states arising in the work of private dentistry (4000 doctors) during ten years of clinical activity. The results presented about 30000 extreme situations from which they were assessed: fainting in 15407 cases; mild allergic reactions in 2583 cases, and anaphylactic type in 304 cases. As well as in the successes of the world performing resuscitation, the morbidity from anaphylactic shock (Rabinovich S. A., 2005) reached 60 to 100 of the clinical cases of the pathology. Purpose of the work. Estimation of clinical effectiveness of emergency antiallergic measures granted in case of immediate type reactions occurring in the work of therapeutic dentists

CHRONIC GRANULOMATOUS DISEASE WITH NEONATAL ONSET

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Boala granulomatoasă cronică (BGC) este o patologie a sistemului imunitar cauzată de o disfuncție genetică a fagocitelor, care determină susceptibilitatea către infecții severe în primii ani de viață, însă debutul în perioada neonatală este foarte rar. Scopul lucrării. Prezentarea cazului clinic de BGC cu debut în perioada neonatală. Material și metode. Datele clinico-anamnestice au fost prelevate din cartela de ambulatoriu și fișele medicale. Pacientul a efectuat testarea imunologică complexă, precum și examenul molecular-genetic pentru confirmarea diagnosticului. Rezultate. Un băiat de 6 luni a fost direcționat la Centrul de Boli Rare al IMC cu acuze la infecții recidivante. Copilul a dezvoltat episoade infecțioase din perioada neonatală, manifestate prin piodermită, bronhopneumonie acută bilaterală, osteomielită și septicemia stafilococică. Până la vârsta de 6 luni a suportat septicemii repetate, cu afectarea pielii, oaselor și a ganglionilor limfatici. Istoricul familial al copilului a fost agravat prin prezența infecțiilor severe ale pielii la rudele copilului din partea mamei. Luând în considerație datele anamnestice, a fost realizată testarea sistemului imun în Laboratorul de Alergologie și Imunologie Clinică al USMF „Nicolae Testemițanu”. Testele imunologice au relevat testul NBT (nitroblue tetrazolium) negativ, iar examenul molecular-genetic realizat de compania Invite (SUA) a identificat o mutație în gena hemizigotă CYBB (c.1241>A(p. Asp396Glu), fapt care a confirmat diagnosticul de BGC X-lincată de tip recesiv. Ulterior a fost inițiată terapia profilactică și frecvența episoadelor infecțioase acute a scăzut semnificativ. Concluzii. Aprofundarea cunoștințelor medicilor despre manifestările eterogene ale BGC va contribui la diagnosticul mai precoce, la inițierea timpurie a terapiei și la scăderea ratei mortalității.Background. Chronic granulomatous disease (CGD) is a rare congenital defect of the immune system due to a genetic dysfunction of phagocytes that leads to recurrent life-threatening infections in the first years of life, but very rarely onset occurs in the neonatal period. Objective of the study. To present a clinical case of CGD with neonatal onset. Material and methods. Anamnesis, clinical and paraclinical data were taken from the outpatient care and medical records. The patient underwent complex immunological studies, as well as a molecular genetic study to confirm the diagnosis. Results. A 6-month-old boy was referred to the Center for Rare Diseases, the Institute of Mother and Child Healthcare with complaints of recurrent infections. In the neonatal period, the child developed infectious episodes, manifested by pyoderma, bilateral acute bronchopneumonia, osteomyelitis, and staphylococcal septicemia. Up to 6 months, he underwent repeated septicemia (3 episodes) with skin, bones, and lymph node involvement. The family history was positive for recurrent furunculosis in the child’s grandfather and uncle on the mother’s side. Taking into account the anamnestic data, a study of the immune system was carried out in the Laboratory of Allergology and Clinical Immunology of the SUMF “Nicolae Testemitanu”. Immunological studies revealed a negative NBT (nitroblue tetrazolium) test result and a molecular genetic study conducted by Invite (USA) revealed a mutation in the hemizygous CYBB gene (c.1241>A (p. Asp396Glu). The diagnosis of recessive X-linked CGD was established. The child was started on prophylactic therapy and the frequency of episodes of acute infections decreased significantly. Conclusions. Increasing the knowledge of doctors about the disease will contribute to earlier diagnosis, earlier initiation of therapy, and will decrease the mortality rate

Caries prevention — schematic presentation

Rezumat. Avantajul prezentării schematice a unui material este exprimat prin faptul, că poate fi redat: concret, succinct, informativ, complet şi integral. De aceea noi ne-am propus prezentarea profilaxiei cariei — schematic cu unele propuneri proprii asupra problemei în cauză.Summary. The advantage of schematic presentation of a material is expressed by the fact that it can be played: specifically, briefly, informative, completely and fully. Therefore we have proposed schematic presentation of caries prevention, with some own proposals on the matter

Monteggia fracture-dislocations surgical treatment aspects

Catedra Traumatologie, Ortopedie şi Chirurgie de Campanie, USMF “N. Testemiţanu”, Spitalul Clinic Traumatologie şi Ortopedie, Chişinău, Conferinţa a XI-a Naţională a ortopezilor-tramatologi din Republica Moldova “Politraumatisme – concepţii contemporane de diagnostic şi tratament”, 21 mai 2009, Chișinău, Republica MoldovaEste prezentat tratamentul chirurgical a 12 bolnavi adulţi cu leziunea Monteggia. La toţi pacienţii s-a efectuat osteosinteza osului ulnar. Capul osului radial în 7 cazuri a fost redus chirurgical, iar în 5 – înlăturat (într-un caz s-a efectuat plastia defectului osos în aria fracturii cu grefă cilindrică fasonată din capul radial rezectat). Rezultatele finale sunt pozitive.The surgical treatment of 12 adult patients with Monteggia lesions is presented. All the patients had undergone the osteosynthesis of the ulnar bone. The head of the radial bone in 7 cases was reduced surgicaly, and in 5 cases was removed (in one case was performed the plasty of the bone defect with a cylindrical bone graft processed from the resected radial head into the area of the fracture). The final results are positive

Analysis of Fiscality and Economic Growth at EU Level

Purpose/objectives: What this article proposes is to make a presentation as clear and current as possible of the member states' taxation, direct and indirect taxation being the main categories to which we refer. The choice of the theme was motivated by our interest in discovering the effects of some decisions taken at the European level. It is desired to discover the way and the impact in which taxation influences economic growth in the European community. Design/methodology: Mix research technique has been used. While qualitative research entails in-depth literature readings and reports, quantitative analysis entails presenting data via graphs and tables. Findings: Taxation was and will remain a main component in the general economy that influences the good functioning of a system. Its effectiveness is conditioned by the legal regulations that each state designs individually, but not without the influence of the communities of which it is a part. For example, Romania was conditioned upon its entry into the European Union to modify its laws in order to be at the same level as the states in the Union. It is a laborious process that takes a long time and is constantly changing and improving. The process of designing and implementing these programs is tried to be carried out as easily as possible for each individual state, being individualized by economy, regional power, global impact, etc. The progress of each country entered in this sense is very important and is constantly monitored, and periodic reporting is very useful. Originality/value: The work is an original research work conducted by the researchers. The findings will add to the body of knowledge on the area of research funding in Romania. Possible practical implications: The completed project is addressed to those people who are interested in the fiscal side of an economy, especially understanding the process of economic growth, how difficult it is to reach a favorable situation at such a high level.. It can also represent a starting point for bachelor's, master's level studies, in order to broaden general knowledge, or even in-depth study for a final paper