Assessment of All-Ceramic Dental Restorations Behavior by Development of Simulation-Based Experimental Methods

New dental materials are often introduced into the market and especially in the current practice, without a basic understanding of their clinical performance because long‐term controlled clinical trials are required, which are both time consuming and expensive. Ceramic materials are known for their relatively high fracture resistance and improved aesthetics, but brittleness remains a concern. The stressed areas of the materials are key factors for the failure analysis, and numerical simulations may play an important role in the understanding of the behavior of all‐ceramic restorations. Simulation‐based medicine and the development of complex computer models of biological structures are becoming ubiquitous for advancing biomedical engineering and clinical research. The studies have to be focused on the analysis of all‐ceramic restorations failures, investigating several parameters involved in the tooth structure–restoration complex, in order to improve clinical performances. The experiments have to be conducted and interpreted reported to the brittle behavior of ceramic systems. Varied simulation methods are promising to assess the biomechanical behavior of all‐ceramic systems, and first principal stress criterion is an alternative for ceramic materials investigations. The development of well‐designed experiments could be useful to help to predict the clinical behavior of these new all‐ceramic restorative techniques and materials

Assessment and recovery of patients with chronic periodontitis through an individualized approach

Department of Odontology, Periodontology and Oral Pathology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 8th International Medical Congress for Students and Young Doctors, September 24-26, 2020Introduction. Periodontitis is a chronic multifactorial inflammatory disease associated with dysbiotic plaque biofilms and characterized by progressive destruction of the tooth‐supporting structures. It is a major public health problem due to its high prevalence, as well as because it may lead to tooth loss and disability, attesting that, periodontitis accounts for the most teeth extractions being performed, thus leading to a substantial proportion of edentulism, and masticatory dysfunction. By negatively affecting chewing function and aesthetics, it becomes a source of social inequality, which damage the quality of life. The primary features of the disease imply visual inflammation, the loss of periodontal tissue support, manifested through clinical attachment loss (CAL) and radiographically assessed alveolar bone loss, furcations, presence of periodontal pocketing, gingival bleeding, and possible tooth mobility. Thus, detecting and assisting early reversible stages, in order to provide an conservative treatment, should be prioritized to rescuing compromised teeth in advanced stages of periodontitis, which as a fact, results in significant dental care costs, has a negative impact on general health, and doesn’t necessarily ensue a successful result. Aim of the study. The analysis of the possible efficient methods to be used in assessing the clinical manifestations of chronic periodontitis and recovery of patients with chronic periodontitis, through individual treatment adaptation, towards a maximized positive outcome. Materials and methods.. A clinical study has been performed on a group of 9 patients, 5 of them female and 4 male, aged between 24 and 56 years old, which, following a thorough examination according to the clinical criteria assigned to chronic periodontitis, 4 were diagnosed with a slight chronic periodontitis, 3 were diagnosed with the moderate type and other 2 with severe chronic periodontitis. Thus, after determining the extension of the inflammation, the clinical attachment loss, probing depths, presence of bleeding on probing, assessing the radiographic bone loss, each patient followed a professional hygienic treatment, under medicinal remedies, comprising of individual procedures, namely supra and subgingival scaling, root plaining, gingival curettage and, guided bone and tissue regeneration through a periodontal flap approach procedure in the severe forms of periodontitis. Results. Following the research and clinical praxis, patients were observed for a period of 6 months. In four patients, those diagnosed with a slight periodontitis, after receiving treatment and educational information upon oral hygiene at an early stage, the inflammation has stopped from progression and partially reversed. In patients with moderate type, it has notifiable subsided, oral health and gingival aspect improved, while gingival bleeding is occasionally present. Two patients with severe periodontitis, showed a positive outcome, with significant decrease in tooth mobility, substantial tissue support as the general oral health improved and inflammation stopped progressing. Conclusions. Individual treatments applied at the moment of each patients distinct condition, diagnosed properly according to the set clinical criteria, both in early and advanced stages, had positive results, without complications, the outcome being more positive when assessed at an early stage, eliminating major masticatory dysfunctions, additional costs implied, and quality life damage

Pharmacoeconomic analysis of antibiotic therapy in the curative institution

Introduction. The rational use of drugs is one of the most important objectives of the health system because the financial resources for the purchase of preparations are constantly increasing at national and institutional level.This activity becomes very actual in the conditions in which the administration of the curative institution is forced to find methods of financial resources’ rational use to ensure an efficient and harmless pharmacotherapy.The use of antimicrobial preparations in the curative institution, according to the number and volume of financial resources, is an indispensable component of the analysis of the pharmaceutical market and of the control programs after infections and prophylaxis of the development of resistance of microorganisms.. Aim of study. Optimal antimicrobial therapy will facilitate a reduction in the cost of treatment for the patient as well as the degree of antibiotic resistance Methods and materials. In order to achieve this goal, the analysis of the acquisition of antibacterial preparations in PMI MCH Gheorghe Paladi- public medical institution+municipal clinical hospital, up to till pandemic, was performed, using the ABC / VEN analysis. The results of ABC / VEN can allow the assessment of the effectiveness of the implementation of national or institutional drug insurance programs in terms of clinical pharmacology and rational pharmacotherapy. Results. 1,235,000 lei were spent on purchasing synthetic antibiotics and chemotherapeutics. Following the ABC analysis, it was concluded that: In class A were included 6 preparations for which 78.3% were allocated, for class B another 8 medicines for which 15% were invested, for class C another 23 preparations - 6.7% of the financial resources. Conclusion. Analysis of the current evolution of infectious diseases, including the SARS CoV-2 pandemic and alarming global resistance demonstrates the need for developing effective infection control strategies. Based on the results of the study, we can conclude that the financial resources, released for the purchase of antibacterial preparations, were correctly distributed according to the requirements of the clinic

Involvement of bioethical principles in medication of tuberculosis

Bioethics plays an important role in addressing and establishing the TB treatment tactic, based on respecting moral values and fundamental principles, which refers to the quality of life, health, freedom, dignity and integrity of the suffering patient.The most important elements in the effective prevention and control of tuberculosis are the interventions adapted to facilitate the early diagnosis, the completion of the treatment and to support the clinical approach of the cases, and the involvement of the bioethical issues in this context would enhance the quality of life

BENEFITS AND RISKS OF INDUCED THERAPEUTIC HYPOTHERMIA FOR BRAIN INJURY PATIENT

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Hipotermia este definită ca, temperatură centrală sub 35°C, în cazul omului. Hipotermia terapeutică este o metodă nonfarmacologică, ce are drept scop diminuarea consumului cerebral al oxigenului, folosind în acest sens scăderea temperaturii corporale. Metabolismul cerebral descrește proporțional cu scăderea temperaturii astfel că, pentru fiecare 1°C de temperatură corporală scăzută, rata metabolică cerebrală a oxigenului se reduce cu 7%. Asigurarea protecției cerebrale în condiții de agresiune neuronală este definitorie în managementul pacientului critic. Scopul lucrării. Sinteză critică de literatură disponibilă, pentru formularea recomandărilor de conduită în utilizarea hipotermiei induse terapeutic la pacientul cu leziune cerebrală. Material și metode. Studiu de tip revistă narativă de literatură. Căutare bibliografică în baza de date PubMed, National Center of Biotechnology Information, Medline, Google Scholar, aplicând cuvintele cheie: „induced hypothermia”, „neuroprotection by therapeutic hypothermia”, „critical patient”, „brain injury”. Au fost procesate publicațiile în limba engleză datate din ianuarie 2016 până la ora actuală. Bibliografia finală a inclus 50 de referințe. Rezultate. Au fost detectate principii de conduită a hipotermiei induse terapeutic, la pacientul cu leziune cerebrală. Au fost detectate variabilele legate de sincronizare cu privire la debutul metodei de răcire, rata, profunzimea și durata răcirii și reîncălzirea, cu impact asupra mortalității și morbidității. Concluzie. Elaborarea unui ghid cu recomandări practice clare, cu referire la hipotermia indusă terapeutic la pacientul cu leziune cerebrală, este o necesitate majoră și actuală. Ca următoare etapă, sunt necesare studii de evaluare a impactului implementării măsurilor de hipotermie indusă terapeutic, asupra evoluției pacientului cu leziune cerebrală.Background. For humans, hypothermia is defined as core temperature below 35°C. Therapeutic hypothermia is a non-pharmacological method, which aims to reduce cerebral oxygen consumption and as a result to body temperature decreasing. Cerebral metabolism decreases proportionally with the body temperature, respectively for every 1°C reduced, the cerebral metabolic rate of oxygen is decreasing by 7%. Ensuring cerebral protection in conditions of neuronal aggression is crucial, in the critical patient management. Objective of the study. Critical review of the available literature concerning therapeutically induced hypothermia for brain injury patients management. Material and methods. It was performed a search in PubMed, NCBI (National Center of Biotechnology Information), Medline, Google, applying keywords: „induced hypothermia”, „neuroprotection by hypothermia”, „critical patient”, „brain injury”. There were analyzed articles in English language beginning with January 2016 up to present. The final bibliography included 50 references. Results. Were detected principles of therapeutically induced hypothermia for brain injury patients. Determination of variables related to the timing of onset of the cooling method, the rate, depth and duration of cooling and rewarming, with impact on mortality and morbidity. Conclusion. The development of a guideline with clear practical recommendations, for therapeutically induced hypothermia in brain injury, is a major and current necessity. As a next step, studies are needed to evaluate the impact of the therapeutically induced hypothermia measures implementation in brain injury patient

Новые возможности в лечении обострений хронической обструктивной болезни легких

Catedra Farmacologie şi farmacie clinică, USMF “Nicolae Testemiţanu”, Spitalul Clinic al Ministerului Sănătăţii, Chişinău, Conferinţa Ştiinţifico-Practică „Medicina modernă, actualităţi şi perspective”, consacrată aniversării de 40 de ani ai Spitalului Clinic al Ministerului Sănătăţii, 27-28 mai, 2010, Chişinău, Republica MoldovaThe study included 90 patients with confirmed clinical diagnosis of exacerbation of chronic obstructive pulmonary disease (COPD) Grade II. The patients were randomized in 3 groups: group I (n = 25) was administered fenspiride in combination with tiotropium bromide, group II (n = 32) - beclomethasone dipropionate, group III (n = 33) - tiotropium bromide. The treatment of COPD exacerbations with Fenspiride significantly increased the efficiency of the basic treatment, which manifested by periods of regression, decreased respiratory symptoms due to the pronounced anti-inflammatory effect. It helped develop the antitussive and mucolytic effects more rapidly, decrease the intensity of dyspnoea and decrease the markers of systemic inflammation, which allowed installation of a stable positive effect for 12 months in 80.0 % of cases, while basic treatment - only 48.5% of cases.В исследовании включены 90 пациентов с подтвержденным клиническим диагнозом обострения хронической обструктивной болезни легких (ХОБЛ) II степени. Пациенты были разделены на 3 группы: I группа (n = 25) принимали фенспирид в сочетании с тиотропия бромидом, группа II (n = 32) - беклометазон дипропионат, III группа (n = 33) - тиотропия бромид. Включение фенспирида в лечении обострений ХОБЛ значительно повышает эффективность базисной терапии, что проявляется уменьшением времени регрессии респираторных симптомов заболевания в связи с его выраженным противовоспалительным эффектом, что способствует развитию противокашлевого и муколитического эффектов, что уменьшает интенсивность одышки, снижает уровень маркеров системного воспаления и позволяет устанавливать стабильный положительный эффект в течение 12 месяцев в 80,0% случаев, в то время как только базовое лечение - в 48,5% случаев

Eficienţa simvastatinei în tratamentul bronhopneumopatiei cornice obstructive, asociate cu cardiopatie ischemică

Conferinţa naţională în medicina internă din Republica Moldova cu participare internaţională, 19-20 mai 2011, Chişinău, Republica MoldovaSummary. The aim of the study was to appreciate the influence of simvastatin on the clinical and laboratory indices in patients with chronic obstructive pulmonary disease and associated ischemic cardiopatia. We noted that simvastatin determines a more rapid resolution of the clinical symptoms by influencing the inflammatory indices and a more significant positive dynamics of the lipid components in the serum in comparison with the standard therapy.Scopul lucrării: studierea influenţei simvastatinei asupra dinamicii indicilor clinici şi de laborator în bronhopneumopatia cronică obstructivă, asociată cu cardiopatie ischemică. Material şi metode. În studiu au fost incluşi 35 de bolnavi de bronhopneumopatie cronică obstructivă (BPCO), gradul II, în exacerbare, asociată cu cardiopatie ischemică (CPI) (angină pectorală de efort CF II). Au fost studiate proteina-C-reactivă, fibrinogenul şi spectrul lipidic. Lotul-martor (15 bolnavi) a primit tratament antiinflamator standard; lotul de bază (20 de bolnavi) – simvastatină câte 20 mg/zi adiţional la tratamentul standard. Rezultate. Simptomele clinice s-au redus veridic statistic mai repede la pacienţii care au folosit simvastatină, în comparaţie cu bolnavii din lotul-martor: dispneea – cu 3,2±0,1 zile, tusea – cu 3,3±0,2 zile, tahipnoea – cu 4,6±0,5 zile, tahicardia – cu 5,8±0,4 zile (p<0,05). În lotul de bază a avut loc normalizarea mai rapidă a indicilor de laborator, în comparaţie cu lotul-martor: leucocitele – cu 5,2±0,3 zile, VSH – cu 4,9±0,2 zile, proteina-C-reactivă – cu 4,2±0,1 zile, fibrinogenul – cu 4,5±0,1 zile (p<0,05); în lotul de bază nivelul total al colesterolului a scăzut cu 23,3% (de la 7,3±0,7 până la 5,6±0,5 mmol/l), trigliceridele – cu 19% (de la 2,1±0,4 până la 1,7±0,3 mmol/l), LDL – cu 30% (de la 4,4±0,8 până la 3,1±0,7 mmol/l), pe când în lotul-martor – cu 12%, 5% şi 18%, respectiv. Nivelul HDL s-a majorat cu 8% (de la 0,84±0,03 până la 0,91±0,04 mmol/l) sub influenţa simvastatinei şi doar cu 2% în lotul-martor. La pacienţii din lotul de bază s-a înregistrat majorarea VEMS cu 12%, fapt care indică îmbunătăţirea pasajului bronşic şi care a permis micşorarea dozei de bronholitice la 40% din pacienţii din lotul dat. Concluzii. Includerea simvastatinei potenţează efectul tratamentului standard şi determină diminuarea mai rapidă a simptomelor clinice ale BPCO asociată cu CPI, prin acţiune asupra indicilor inflamaţiei sistemice, şi o dinamică pozitivă mai evidentă a spectrului lipidic

COLD ATMOSPHERIC PLASMA TREATMENT MODULATES THE EXPRESSION OF cdk1, tnfα AND tp53 GENES IN HUMAN OSTEOSARCOMA CELLS

Osteosarcoma (OS), a malignancy primarily affecting children and adolescents, is the most frequently encountered malignant, non-hematologic, bone tumor. Despite the gradual improvement of survival rates, the management of this disease remains problematic due to challenges such metastasis development, its heterogeneous characteristics, and resistance to cytostatic drugs. Cold atmospheric plasma (CAP), a partially ionized gas operating at near room temperature, which is comprised of free carriers, excited or neutral molecules, and active radicals capable of initiating diverse physical phenomena and chemical reactions represent a new and innovative potential solution in cancer therapy. The aim of this study was to evaluate the capacity of CAP produced by our custom-build plasma source to induce cytotoxic effects to HOS cells and to analyze post-treatment modulations of cdk1, tnfα and tp53 genes expression. Direct and indirect CAP treatments effectiveness on HOS cells were evaluated by MTT assay and the regulation of interest genes expression were carried out by RT-qPCR analysis. Cell viability analysis revealed a strong cytotoxic effect of direct CAP treatment on HOS cells, while the indirect treatment resulted in a slight decrease of cells viability. Direct CAP treatment modulates the expression of all analyzed genes, both at 2- and 24-hours post-treatment. In conclusion, direct CAP treatment produced by our custom-build plasma source have cytotoxic effects on HOS cells in a dose-dependent manner up to 24 hours post-treatment. Furthermore, direct CAP treatment induces cell cycle arrest of HOS cells, and the CAP-induced cell death is independent of tp53 gene