AORTIC ARCH CALCIFICATION IN HYPERTENSIVE PATIENTS WITH CHRONIC KIDNEY DISEASE

Introduction. Vascular calcification is an independent risk factor related to cardiovascular mortality in CKD patients. Advanced aortic arch calcification assessed by semi-quantitative estimation on posteroanterior chest X-ray is a strong independent predictor of cardiovascular events in CKD and non-CKD patients, beyond traditional risk factors. An association between aortic arch calcification and hypertension has been previously reported however, the presence of CKD has not recorded in most studies. The aim of our study was to identify risk factors related to aortic arch calcification in hypertensive CKD patients. Material and method. A retrospective observational study on 63 hypertensive patients with CKD stages G2 to G4, that had a posteroanterior chest X ray available was conducted. The study population was divided into 2 groups according to presence or absence of aortic arch calcification on chest X-rays. Chest X-ray identified 43 patients with aortic arch calcification. Laboratory data were recorded for every individual simultaneously with the following comorbidities: coronary artery disease, carotid stenosis, hypertensive cardiopathy, lower extremity arterial disease. Outcomes. Groups were homogenous regarding gender distribution, creatinine levels and diabetes mellitus prevalence. We found no a statistically significant difference regarding comorbidities between the two groups. Lactate dehydrogenase and alkaline phosphatase had a statistically significant association with aortic arch calcification (p = 0.043, p = 0.006 respectively). Conclusions. Increased alkaline phosphatase remains an important risk factor for aortic arch calcification even in patients with less advanced CKD. Lactate dehydrogenase is yet to be validated as a marker for aortic arch calcification in CKD patient, however, our study reports a statistically significant association between lactate dehydrogenase and aortic arch calcification in patients with CKD

CHESTIONARUL ”NOSQ-2002” AR PUTEA FI O METODĂ DIAGNOSTICĂ UTILĂ ÎN SUPRAVEGHEREA STĂRII DE SĂNĂTATE A PERSONALULUI MEDICAL DIN SECTORUL MEDICINEI DENTARE – UN STUDIU ROMÂNESC

Occupational skin diseases are under-reported in many countries, especially in the Eastern Europe, including Romania. Improper healthcare legislation and regulations in the field of health and safety at work might be a few causes of developing occupational skin diseases, but also the lack of standardised diagnostic criteria and evaluation tools are common in these countries. Dental staff is exposed to a wide range of occupational hazards, many of them being haptens, which could cause occupational skin diseases. The most common occupational skin diseases in contact dermatitis. Without a reliable diagnostic tool in place, usually the dental staff (as many other professions) overlook and underestimate the presence of occupational skin diseases, which can lead to unproper prevention, chronic skin lesions, disability and loose of efficiency and productivity. Periodic medical examination is mandatory in many countries all over the globe, comprising in a minimum set of investigations, including clinical examination, questionnaires, blood tests and additional procedures, tailored on the occupation, workplace, industrial sector and potential exposure. It is important to standardise the employees’ periodical medical evaluation using reliable tools oriented to the skin pathology. The Nordic Occupational Skin Questionnaire (NOSQ) might represent one of these tools which might be useful for a comprehensive evaluation of the potential occupational skin diseases. NOSQ  was created by a group of experts from the Nordic countries and it is meant to assess the presence and clinical features of occupational skin diseases in the workplace.   Key words: dental healthcare, occupational diseases, skin, questionnaireBolile profesionale ale tegumentului au o raportare relativ scăzută în multe țări, în special în Europa de Est, implicit în România. Legislația și reglementările necorespunzătoare în domeniul sănătății și al securității la locul de muncă pot fi câteva din cauzele aparției bolilor profesionale ale pielii, dar deasemenea lipsa criteriilor standard de diagnostic și ale metodelor de evaluare sunt frecvente în aceste țări [1]. Personalul medical care lucrează în cabinetele stomatologice este expus la o gamă largă de riscuri profesionale, multe dintre ele fiind antigene ce pot produce dermatoze profesionale. Cea mai frecventă dermatoză profesională este dermatita de contact. Fără metode de diagnostic, personalul din stomatologie (ca și alte multe profesii), subestimează prezența bolilor dermatozelor profesionale, ceea ce duce la o prevenție ineficientă, dizabilități și pierderea eficienței și productivității muncii. Examinarea medicală periodică este obligatorie în multe țări de pe glob, cuprinzând un set minim de investigații, inclusiv examen clinic obiectiv, chestionare, analize de sânge și investigații suplimentare în funcție de locul de muncă, sectorul industrial și potențiala expunere. Este important ca evaluarea medicală periodică să fie standardizată, utilizandu-se metode de evaluare și diagnostic orientate către patologiile tegumentului. Chestionarul ”Nordic Occupational Skin Questionnaire” (NOSQ) poate reprezenta una dintre aceste metode care poate fi utilă într-o evaluare completă a potențialelor boli profesionale ale pielii. NOSQ a fost creat de către un grup de experți din țările nordice și este menit să evalueze prezența și caracteristicile clinice ale bolilor profesionale ale pielii la locul de muncă.   Cuvinte cheie: servicii stomatologice, boli profesionale, piele, chestiona

Exploring the Dynamic Role of Bacterial Etiology in Complicated Urinary Tract Infections

Background and Objectives. Numerous studies have been conducted to explore the epidemiological characteristics of urinary tract infections (UTI) and sepsis. However, there is still a lack of relevant bacteriological features and prognostic information regarding urosepsis based on bacteriological etiology. The current study aims to evaluate the bacterial etiology of complicated UTI (cUTI) and bacterial resistance to antibiotics and whether they present an intrinsic risk of developing urosepsis. Materials and Methods. A retrospective study was performed that included 102 patients who were diagnosed with cUTI and admitted to the urology department of the “Sfântul Apostol Andrei” County Emergency Clinical Hospital (GCH) from September 2019 to May 2022. Results. A considerable number of patients, n = 41 (40.2%), were diagnosed with multi drug-resistant (MDR) infection. Escherichia coli (E. coli) was identified as the prevailing pathogen, accounting for 51 patients. Klebsiella manifested itself as the subsequent causative agent in 27 instances. The presence of Enterococcus spp. infection was documented in 13 patients, whereas Pseudomonas emerged as the etiological perpetrator in the clinical context of 8 patients. The current study found a substantial prevalence of resistance to first-line antibiotics. The overall resistance rate was 74.5% for penicillin, 58.82% for trimethoprim–sulfamethoxazole and 49% for fluoroquinolones; cephalosporin resistance displayed an inverse correlation with antibiotic generation with fourth-generation cephalosporins exhibiting a resistance rate of 24.5%, and first-generation cephalosporins demonstrating a resistance rate of 35.29%. Conclusions. Age, comorbidities and indwelling urinary catheters are risk factors for developing MDR infections. While the intrinsic characteristics of the causative bacterial agent in cUTI may not be a risk factor for developing urosepsis, they can contribute to increased mortality risk. For empiric antibiotic treatment in patients with cUTI who are at a high risk of developing urosepsis and experiencing a potentially unfavorable clinical course, broad-spectrum antibiotic therapy is recommended. This may include antibiotics, such as amikacin, tigecycline, carbapenems and piperacillin–tazobactam