The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

Dumitru Ferechide

Dumitru Ferechide

Statistical Study Regarding the Presence of Gram Bacteria in Patients with Cardiovascular Disease and Periodontal Disease

Pathogenic bacteria, originating in the inflamed periodontium, can make their way into the body through the vascular system, either by entering the bloodstream or lymph directly or as internalized particles of immune cells.
This research aims to investigate the existence of a potential connection between two pathologies – periodontitis and ischemic heart disease – by utilizing a DNA-DNA hybridization technique to highlight the presence of seven periodontal pathogens: A. actinomycetemcomitans, P. gingivalis, P. endodontalis, P. intermedia, T. forsythia, C. rectus and F. Nucleatum. The study was conducted over a period of 3 years on a sample consisting of 119 patients with cardiovascular disease and periodontal disease, divided into 3 groups by pathologies, as follows: the first group consisted of 31 patients with ischemic cardiomyopathy, the second group consisted of 43 patients with periodontal disease and ischemic cardiomyopathy, and the third group consisted of 45 patients with periodontal disease. The results show the possibility of a correlation between the composition of the bacterial flora in the group of patients with cardiac disease and those with associated pathologies.

In conclusion, we may state that periodontitis may be seen as a risk factor in heart disease, which may certify the possibility of an etiological connection between the two pathologies.

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Benefits of Upper Limb Functional Electrical Stimulation in Children with Spastic Cerebral Palsy

Aim: The aim of this study was to assess the effectiveness of Functional Electrical Stimulation in upper limb rehabilitation in children with cerebral palsy. Methods: 90 children with spastic cerebral palsy, age between 6 and 9 years, were randomized into two groups. 45 children, represented the control group, performed conventional physical and occupational therapy and robot-assisted therapy. In addition to the control group, the experimental group received functional electrical stimulation interventions with postural control on the affected upper limb. Results: The experimental group's motor performance after treatment (improved coordination by 8.2%, wrist flexion by 9.75°, three-fingered grasp strength by 1.04°, and functional limitation lowered by 5.93) was considerably better than the control group's which coordination increased by 5.5%, wrist flexion by 8.72°, three-fingered grasp strength by 0.7 and functional limitation decreased by 2.33. Conclusions: Functional electrical stimulation intervention was found to be an effective manner to improve motor performance, in terms of coordination, range of motion, and three-fingered grasp strength, visibly reducing functional limitation and improving performance in activities of daily living.

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Influence of the Upper Limb Motor Deficit on the Functional Independence in Patients with Cerebral Palsy

Cerebral palsies (CPs) disturb the voluntary movement control at extremities’ level, entailing various disability degrees. In over 80% of the CP cases there is an upper limb disorder, mainly manifested by the decrease in hand control and the presence of contractures1, which, in time, lead to the adoption of abnormal postures which affect the abilities of the CP patients’ hands. The aim of this study was to identify the way the motor deficit at upper limb level – reflected by coordination disturbances and by the condition of the three-fingered (tripod) grasp – influences the CP patient’s functional independence. The study demonstrated the existence of significant correlations betweenFunctional Independence Measure (FIM) score2, coordination and three-fingered grasp. It was proven that the unilateral coordination dysfunctions have a strong negative influence on the coordination of the opposite side and lead to a decrease of the functional independence level. Therefore, the rehabilitation treatment is recommended to be based on a bilateral training, both in order to improve coordination and to obtain a functional level of the threefingered grasp power and of the physiological amplitude at wrist flexion level.

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The Challenges of Melanoma during COVID-19 Pandemic

Diagnosis, tratament and follow-up of patients with melanoma during COVID-19 pandemic is quite challenging. These patients are often immunocompromised, but, on the other hand, management of this malignant skin cancer should not be delayed. It is necessary to diagnose and stage the melanoma as soon as possible, in an attempt to provide a better prognosis. There are few data regarding the treatament of melanoma during COVID-19 pandemia. However, the general recommandations suggest testing all cancer patients prior administration of the therapy. The European Society for Medical Oncology (ESMO) provided guidelines regarding therapy of this skin cancer during COVID-19 pandemic. Every patient is different, and it is always important to evaluate the risks and benefits.

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Identification of Osteoarthritis with Multiple Joint Involvement in Elderly Institutionalized Patients Concomitant with...

Related to the rehabilitation of patients with osteoarthritis, kinesiotherapy addresses the methods, procedures and methodology that will be used depending on the anatomic, functional and clinical stage of the disease and its location after setting treatment goals. Furthermore, priorities of the rehabilitation program are established considering both medical issues and also paramedical and social aspects [1].
The kinesiotherapeutic opera tional strategy in rehabilitating patients with osteoarthritis is planned according to the characteristic comorbidities of elderly patients [2]. Clinical trials highlight that cardiovascular mortality is reduced when sedentary individuals become moderately active [3,4].

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The Rehabilitation of Elderly Institutionalized Patients with Osteoarthritis (Multiple Joint Involvement) Using...

Osteoarthritis, as a major cause of disability and due to the high prevalence among chronic diseases, represents one of the most important public health problems worldwide [1]. The limitation of physical function and the restriction of independence produce negative effects on the mental status of patients suffering from osteoarthritis, namely the emergence of depression and decreased self-confidence [2,3].
Developing a kinesiotherapeutic strategy based on the clinical, anatomical and functional stage of the disease and other comorbidities, as well as exploiting psychological and psychopedagogical resources will improve the physical performance and increase the independence of these patients [4,5].

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Surgical Attitude Towards the Hepatic Hydatid Pericystic Cavity

There are a variety of anatomoclinical forms of hepatic echinococcosis. This has led to finding and applying a number of surgical procedures which have the same aim, namely the reduction or elimination of the pericystic cavity. Besides, solving the residual pericystic cavity after the elimination of the parasite represents the main problem of the surgical treatment. The postoperative complications of the hydatid cyst are caused by the failure to adapt the surgical procedures to the morphological characteristics of the pericystic cavity.
In the Romanian medical literature, the surgeries performed for the hepatic hydatid cyst are divided into the so-called conservative surgeries, which abandon the pericystic cavity or resect a part of the pericyst, and the so-called radical surgeries, which completely remove the pericystic cavity by sacrificing a smaller or greater area of the parenchyma of the liver.

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Nonsurgical Treatment of Hepatic Hydatid Cyst

Hopes for a medical treatment of the hydatid cyst are old. However, the noninvasive treatments (vaccinotherapy, immunotherapy, chemotherapy) used so far did not lead to a cure. The latest drugs introduced as treatment are albendazole and mebendazole with a parasiticidal effect and praziquantel with a parasitostatic effect. Chemotherapy indications, established by WHO in 1996, are the adjuvant treatment administered preoperatively and postoperatively in the plurivisceral hydatid disease
when surgical treatment is contraindicated. The contraindications for chemotherapy are given by the occurrence of cysts complications or by the death of the parasite (1). The results of chemotherapy as a single treatment are 10-13% cure, 40-60% partial remission, 10-30% failure (1,2). Albendazole is a benzimidazole anthelmintic derivative for roundworms, flatworms and the larval forms of E. Granulosus. It acts at the level of the parasites’ cells, respectively of the proligerous membrane of E. Granulosus by inhibiting the poly-merization of ?-tubulin from which the intracyto-plasmic tubules are formed and through which glucose is absorbed. Blocking glucose absorption causes parasite’s death through a process of vesicula-tion and fibrosis of the proligerous membrane which becomes infertile. Albendazole dosage is 10-15/mg/kgc/day, in two daily doses, over a 30-day course of treatment, which is to be repeated after a two-week pause.

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