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

SMITH-LEMLI-OPITZ SYNDROME WITH SEVERE INVOLVEMENT OF THE ORAL CAVITY IN A TEENAGER

The Smith-Lemli-Opitz syndrome (SLOS) is a plurimalformative syndrome transmitted by autosomal recessive inheritance. SLOS is caused by the deficiency in the enzyme 7-dehydrocholesterol-delta-reductase (DHCR7) resulting in cholesterol metabolism disorders, more precisely the incapacity to transform dehydrocholesterol into cholesterol. The syndrome is marked by characteristic facial dysmorphism, multiple malformations and intellectual disability. We are reporting the case of a 15 year old patient diagnosed postnatally with bilateral hands and feet polydactyly, and clinodactyly in the 5th toe of the right foot which was surgically treated when the patient was 6 months old. The association with suggestive modifications of the oral cavity (dental impactions, palatoschisis, enlarged alveolar ridges and uvula bifida) that required complex orthodontic therapy and the genetic consult establish the diagnosis of Smith-Lemli-Opitz syndrome