Extensive spinal epidural abscess complicated with hydrocephalus

Spinal epidural abscess is a rare but severe infection requiring prompt recognition in order to have a favorable outcome and appropriate treatment, mainly surgical. We present one of the largest extensions of such abscess in literature, involving the whole spine. No surgical treatment was tempted due to the involvement of 19 levels but antibiotics. The evolution of the lesion was complicated with hydrocephalus, by mechanism of cervical block of CSF flow, and needed first external derivation and later ventriculo-peritoneal drainage

CORRELATIONS BETWEEN CARIOUS DISEASE AND INFLAMMATORY SYNDROME IN RHEUMATOID ARTHRITIS

We aimed to analyse parameters defining carious disease in patients with rheumatoid arthritis (RA) and to evaluate potential correlations with inflammatory systemic parameters related to RA. Materials and method. We performed a complex clinical oral exam (DMFT, PI, RFR, RFS, CT) and inflammatory tests (ESR, C-reactive protein) and ASLO in seven patients known with RA. The results were statistically analyzed by SPSS 16 programs and Spearman`s correlation. The results showed a positive correlation between ASLO and DMFT, PI, CT, ESR and DMFT, PI, CT, C-reactive protein and variable: CT, PI; negative correlations were reported between ASLO and RFR, RFS, while C-reactive protein also associated with DMFT, RFR, RFS. Conclusions RA can influence the patient's cariogenic risk

Continuing education The place of ultrasonography in detecting fetal heart malformations

Abstract Most newborns with cardiac malformations are born without obvious risk factors, so the prenatal diagnosis depends on screening protocols. Fetal cardiac ultrasound should be a part of every ultrasound examination, especially when other malformations are discovered. Contrary to neural tube defects or trisomy 21, detecting fetal heart malformations implies therapeutically termination of pregnancy in only half of the cases. Echocardiographic exam (2D, 3D, Doppler) allows the diagnosis of 90% of cardiac defects, given performing machinery and an experimented examiner. Keywords: echocardiography, congenital heart malformations, standard sections, prenatal screening Rezumat Majoritatea nou-născuţilor cu malformaţii cardiace se nasc din mame fără factori de risc evidenţi, aşadar depistarea acestora înainte de naştere este dependentă de protocoalele de screening. Ecocardiografi a fetală ar trebui inclusă în fi ecare examinare ecografi că, mai ales în condiţiile depistării altor malformaţii. Spre deosebire de defectele de tub neural sau trisomia 21, depistarea unei malformaţii cardiace fetale nu implică decât în jumatate din cazuri întreruperea terapeutică a sarcinii. Examinarea ecocardiografi că (2D, 3D, Doppler) permite depistarea unui procent de 90% dintre malformaţiile cardiace, în condiţiile unei aparaturi performante şi a unui ecografi st experimentat. Cuvinte cheie: ecocardigrafi e, malformaţii cardiace congenitale, secţiuni standard, screening prenata

Computer Application for the Evaluation of the Dento-Somato-Facial Aesthetic Balance

DSF (Dento-Stomato-Facial) Aesthetic Software is an application that focuses on aesthetic evaluation based on the following inter-related directions: body aesthetics, dental-facial aesthetics, dento-gingival aesthetics, dental-dental aesthetic and dental aesthetics. The application employs different images processing technics and the modern .net development platform. The application contributes to a better identification and use of the dento-facial and somatic aesthetic evaluation criteria. The software can display all the determined measurements or only those which diverge from the normal ones. The final reports can be presented either superimposed on the patient picture showing the deviated segments or on a standard image from the software library which can be also access at any time though the help function. Although the application can reveal the deviated values from the normal ones, thus pointing towards a diagnostic, the final interpretation however belongs to the dentist. The practitioner will establish the final diagnostic by correlating the data obtained from the computer application with that from clinical and paraclinical evaluation which is necessary for a complete and complex approach of the case

Cervical Cancer Mortality in Romania: Trends, Regional and Rural–Urban Inequalities, and Policy Implications

Background and Objectives: Despite being largely preventable, cervical cancer mortality still remains an important public health problem globally, in Europe, and in Romania. The European Union member states are urged to implement systematic, population-based screenings for cervical cancer, but the programs developed by the countries remain very heterogeneous. This study aimed to investigate the differences in cervix cancer mortality between Romania and EU and within Romania over the last two decades and to reveal the major sources of inequalities and the policy implications. Materials and Methods: We analyzed the number of deaths and the mortality rates by cervical cancer, standardized using the direct method, over two decades (2001–2016 for the EU, and 2001–2019 for the national and sub-national analyses). Trends, mortality reduction over the years, and mortality differences at the beginning and end of the time interval have been calculated for the EU and Romania, at national and sub-national levels (rural–urban and regions). Results: Our results revealed differences in cervical cancer mortality between Romania and EU and within Romania (among regions and rural–urban areas). These differences used to be very high in the past and are still persisting. Conclusions: The country should revisit its national cervical cancer screening program, which has been implemented for many years, but with a very limited participation rate. Due to the similar problems existing in Central-Eastern Europe, targeted support from the EU for the members from this geographical area could contribute to the minimization of differences in cervical cancer mortality among the EU members

Biomimetic Sensitive Elements for 2,4,6-Trinitrotoluene Tested on Multi-Layered Sensors

In spite of technological progress, most of the current techniques for 2,4,6-trinitrotoluene (TNT) detection are time consuming due to laborious sensor preparation. Thereby, the aim of this work was to enlarge the knowledge for preparing sensitive elements for TNT with the aid of molecular imprinting; a known technique used to deliver biomimetic materials. The study first depicts the auto-assembly mechanism of (TNT) with functional diamino-silanes (i.e., N-(2-aminoethyl)-3-aminopropyl methyl dimethoxysilane), via “double” Meisenheimer complexes. This mechanism is being described herein for the first time and applied further to obtain molecularly imprinted polymer (MIP) films for TNT recognition. For testing the potential application of films as chemical sensor elements, typical rebinding assays of TNT in a liquid state and the rebinding of TNT in a vapor state, using multilayered sensor chips composed of quartz-chromium (Cr)-gold (Au)-titanium oxide (TiO2), were employed. Batch rebinding experiments have shown that thinner films were more efficient on retaining TNT molecules in the first five min, with a specificity of about 1.90. The quartz-Cr-Au-TiO2-MIP capacitive sensors, tested in vapor state, registered short response times (less than 25 s), low sensitivity to humidity and high specificity for TNT

Clinically Relevant Prenatal Ultrasound Diagnosis of Umbilical Cord Pathology

Umbilical cord abnormalities are not rare, and are often associated with structural or chromosomal abnormalities, fetal intrauterine growth restriction, and poor pregnancy outcomes; the latter can be a result of prematurity, placentation deficiency or, implicitly, an increased index of cesarean delivery due to the presence of fetal distress, higher admission to neonatal intensive care, and increased prenatal mortality rates. Even if the incidence of velamentous insertion, vasa praevia and umbilical knots is low, these pathologies increase the fetal morbidity and mortality prenatally and intrapartum. There is a vast heterogeneity among societies’ guidelines regarding the umbilical cord examination. We consider the mandatory introduction of placental cord insertion examination in the first and second trimester to practice guidelines for fetal ultrasound scans. Moreover, during the mid-trimester scan, we recommend a transvaginal ultrasound and color Doppler assessment of the internal cervical os for low-lying placentas, marginal or velamentous cord insertion, and the evaluation of umbilical cord entanglement between the insertion sites whenever it is incidentally found. Based on the pathological description and the neonatal outcome reported for each entity, we conclude our descriptive review by establishing a new, clinically relevant classification of these umbilical cord anomalies

The Strategy against Iatrogenic Prematurity Due to True Umbilical Knot: From Prenatal Diagnosis Challenges to the Favorable Fetal Outcome

True umbilical knot (TUK), although not a commonly encountered pathology, hasan important psychological burden on the mother and obstetrician. It has an extremely low prenatal ultrasound diagnosis rate, despite its adverse perinatal outcomes when unknown. We conducted a retrospective observational analytical study on a 7-year period (2015–2021), including all pregnancies overseen by a single fetal-maternal medicine specialist for monitoring and delivery. We analyzed the prenatal detection rate and correlations between prenatal diagnosis of TUK and pregnancy outcome in terms of associated maternal and fetal factors, time and mode of delivery, fetal weight at birth, maternal level of stress, and iatrogenic prematurity. We compared our results with an electronic search of the literature to study the relationship between TUK and prematurity. We prenatally diagnosed 16 TUKs, and there were two false positives and two undiagnosed knots. All of those women had birth at term. The main finding of the review was a small number of studies that included enough cases for analysis. The prematurity rate due to TUK is 14.2%, significantly increased compared to the general population. An umbilical artery flow velocimetry notch in twin pregnancies complicated by TUK was an important ultrasonographic finding. We consider intrauterine fetal death exceptional, and the main adverse neonatal outcome is due to iatrogenic prematurity caused by maternal anxiety of knowing the prenatal diagnosis and mode of delivery. The elective method for diagnosis should be the second-trimester ultrasound scan using three-dimensional (3D) reconstruction and cesarean delivery for a good neonatal outcome. Pregnant women should be counseled to understand the implications of iatrogenic prematurity, especially respiratory distress syndrome, to ensure these infants are delivered at term