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Sudden infant death syndrome (SIDS) is defined as the sudden death of an infant under one year of age, which apparently occurring during sleep, remains unexplained after a complete necropsy and review of the history and of the circumstances of death. The author review the new researches about the risk factors, the standard investigations of death, the classification and the recommendations for the prevention of SIDS. The major risk factors are the prone sleeping, the exposure of infants to environmental hyperthermia and to cigarette smoke. The investigation of death comprises the clinical history, the circumstances of death, the necropsy and the radiological, metabolic or genetical, bacteriological, virological and toxicological analyses. [ABSTRACT FROM AUTHOR]

Hepatitis B virus (HBV) is currently infecting over 350 million persons worldwide, being a major problem of public health; there are a lot of medical and non-medical risk factors for this type of infection. Objective: the aim of this study was to identify risk factors for HBV infections in young adults living in Craiova and nearby and to compare this factors based on infective status, gender, education and employment status. Methods: 93 young asymptomatic adults living in Craiova and nearby has been tested between april 2003-april 2004 for the detection of antiHBc Ig and anti HBs antibodies, using ELISA method; according to the results of this testing we have sepparate them in two group: exposed individuals and infected persons, in the past or in the present; subjects has been asked to complete a questionnaire regarding risk factors for HBV infections. Results: the first three risk factors from the medical domain has been: dental interventions (28%), injections (19%) and surgery (12%) and from the non-medical domain: intrafamilial sharing of personal hygiene objects (14%), sexual risk behaviour (12%) and intrafamilial contact with chronic HBV infected individuals (8%). Sexual risk behaviour is frequently discovered between infected subjects (p = 0.02), males (p = 0.018) and non-medical students (p = 0.045) Conclusions: as risk factors, from the medical domain we have noted dental interventions, injections and surgery as well as intrafamilial sharing of personal hygiene objects, sexual risk behaviour and intrafamilial contact with chronic HBV infected individuals from the non-medical domain; sexual risk behaviour is associated with infective status, males or being a non-medical student. [ABSTRACT FROM AUTHOR]

Congenital heart defects (CHD) are an important cause of infant mortality, which is why epidemiological studies can help monitoring the health of newborn babies, which are both a paediatric cardiology and a public health priority. Epidemiological evaluation of risk factors and of their influence on the development of CHD must be conducted before birth by means of prenatal prevention programmes, especially in the first trimester of pregnancy, and also by means of screening programmes. Epidemiological studies concerning the effects of risk factors are very important because the life expectancy of children suffering from CHD has increased and also because of the huge impact that this disease has on the lives of the children and of their families. [ABSTRACT FROM AUTHOR]

Congenital heart defects (CHD) are an important cause of infant mortality, which is why epidemiological studies can help monitoring the health of newborn babies, which is both a paediatric cardiology and a public health priority. Epidemiological evaluation of risk factors and of their influence on the development of CHD must be conducted before birth by means of prenatal prevention programmes, especially in the first trimester of pregnancy, and also by means of screening programmes. Epidemiological studies concerning the effects of risk factors are very important because the life expectancy of children suffering from CHD has increased and also because of the huge impact that this disease has on the lives of the children and of their families. [ABSTRACT FROM AUTHOR]

Introduction and aim. Chronic alcoholism determines complex metabolic disorders that involve different organs. In our country there are few epidemiologic data on the pathology related to the alcohol consumption. We aimed to look for the consequences of chronic alcoholism in an urban community from Transylvania. Methods. We carried out an epidemiologic study of medical disorders attributed to chronic alcohol consumption. We investigated a group of 928 patients (381 females, 547 males), aged 25-66 years, from a community of 3000 people, who declared consuming more than 20 g alcoohol per day and completed the CAGE questionnaire. Data were analyzed by descriptive statistical methods. Results. We observed a higher prevalence of digestive and metabolic diseases, and the prevalence was higher in males over 45 years than in females. Liver cirrhosis and liver steatosis were encountered in 2.69% males and 1.33% women, and 8.82% males and 6.13% women respectively. Peripheral neuropathy was 0.99% in males and 0.55% in females. Overall the prevalence levels were lower than expected. Conclusions. Complications caused by chronic ethanol consumptions have higher prevalence after 4 years and are more common in males than in females. [ABSTRACT FROM AUTHOR]

Astmul bronşic considerată una din din cele mai comune boli cronice ale copilului reprezintă cauză importantă de morbiditate si mortalitate cu prevalenţă în creştere conform estimărilor recente. La acest aspect contribuie subevaluarea diagnosticului la vârstă mică. Studiul îşi propune evaluarea anamnestică şi prin explorări clinico-paraclinice a incidenţei factorilor de risc sugestivi pentru suspiciunea de diagnostic de astm bronşic la copil la vârsta de 6-18 ani precum şi corelaţiile acestora cu gradul de severitate a bolii. Studiul a utililizat chestionare ce au inclus informaţii relevante pentru factorii de risc cunoscuţi ante şi postnatal precum şi cei asociaţi etapelor de viaţă preadolescent şi adolescent. Principalii factori de risc pentru astmul bronşic identificaţi în studiu (în ordinea frecvenţei) au fost: prezenţa atopiei personale, istoric de wheezing recurent, sexul masculin, mediul urban, expunerea la aeroalergeni de interior (praf, păr de animale, mucegai),sensibilizarea alergică la aeroalergeni (în special la acarieni), alimentaţia artificială, prezenţa atopiei familiale, fumatul pasiv. Polisensibilizarea alergică şi expunerea la fumul de ţigară se asociază cu forme mai severe de astm. Comorbidităţi alergice au fost prezente în majoritatea cazurilor cea mai frecventă fiind rinita alergică (78%) [ABSTRACT FROM AUTHOR]

In this study we have analyzed the psychopathology of the suicidal act by capturing the role of suicidal risk factors.We developed a complex observational epidemiological descriptive study of the extent to which aims to specify the suicidal rate within the studied and reference and analytically chosen population by capturing the role of suicidal risk factors.We sought possible factors that were correlated with suicide (demographic criteria): area of origin, age, schooling, professional status, and clinical data. Compared with the figures provided by the literature of speciality, the number of suicidants reported to the studied population was small. It seems that the male gender, young age, unmarried status, rural areas act as risk factors for committing suicide, according to the speciality literature [ABSTRACT FROM AUTHOR]

Risk factors represent a research priority regarding the cause of autism spectrum disorders (ASD). We pursued the characterization of a series of environmental factors suspected as being risk factors, involved in the etiopathogenesis of ASD. We conducted a clinical trial, case control, analytical, observational, and retrospective. We included in the study 54 children diagnosed with ASD and 54 healthy children. For inventorying the risk factors, we used a set of questions about the pre/ peri and postnatal periods. We performed statistical analysis for assessing the existing link between the disease and the risk factor.We observed a statistically significant relationship between ASD group and the exposure to pollutants during pregnancy, infections in the newborn period and parent's ages. In addition to case control type small studies, a cohort type approach is required in order to distinguish different genetic and environmental factors involved in the pathogenesis of ASD. [ABSTRACT FROM AUTHOR]

In this study we have analyzed the psychopathology of the suicidal act by capturing the role of suicidal risk factors. We developed an complex observational epidemiological study descriptive of the extent to which aims suicidal rate within the studied and reference chosen population and analytically by capturing the role of suicidal risk factors. We sought possible factors that were correlated with suicide (demographic criteria): area of origin, age, schooling, professional status, and clinical data. Compared with the figures provided by the literature of speciality, the number of suicidants reported to the studied population was small. It seems that male gender, young age, unmarried status, rural areas act as risk factors for committing suicide, caccording to the speciality literature [ABSTRACT FROM AUTHOR]

Risk factors represent a research priority regarding the cause of autism spectrum disorders (ASD). We pursued the characterization of a series of environmental factors suspected as being risk factors, involved in the etiopathogenesis of ASD. We conducted a clinical trial, case control, analytical, observational, retrospectiv. We included in the study 54 children diagnosed with ASD and 54 healthy children. For inventorying the risk factors, we used a set of questions about the pre/ peri and postnatal periods. We performed statistical analysis for assessing the existing link between the disease and the risk factor. We observed a statistically significant relationship between ASD group and the exposure to pollutants during pregnancy, infections in the newborn period and parent's ages. In addition to case control type small studies, a cohort type approach is required in order to distinguish different genetic and environmental factors involved in the pathogenesis of ASD [ABSTRACT FROM AUTHOR]

At this moment, there are several models for the evaluation of the cardiovascular risk in the general population. These models include the classical cardiovascular risk factors: dislipidemy, high arterial essential blood pressure, diabetes, smoking, etc. Such models are not perfect, that is why, in the last years, a large number of biochemical parameters have been evaluated in several studies. The data existing today allows us to centralise these biological markers for atherosclerosis in five groups according to the pathogenetic mechanism: inflammation markers, lipoproteic markers, haemostasis markers, oxidation markers and other markers, all of these biological markers for atherosclerosis being presented in this paper. [ABSTRACT FROM AUTHOR]

Introduction: Stroke is a rare pathology in pediatrics, which due to the progress in imagistic techniques is more and more frequently diagnosed. It can be either ischemic or hemorrhagic, the ischemic one being more frequent in child, with multiple causes and different risk factors. The early diagnosis is essential for the proper treatment. The aim is to present a rare pathology in infant that requires a prompt, multidisciplinary approach for the diagnosis and emergency treatment. Material and method: We present the case of a 7-month-old male infant admitted in our clinic due to a sudden right hemiparesis and central facial one. Results: The 7-month-old patient, without family or personal pathological history, presented the onset of the disease approximately 27 hours before the admission with clonic manifestations of the right superior limb and oral commissure, followed by the development of a right hemiparesis and a central facial one. The imagistic investigations pointed out a cortical ischemic injury, affecting 2 thirds of the left cerebral hemisphere, with the lack of opacification in the left medium cerebral artery, establishing the diagnosis of ischemic stroke. We identified the following risk factors: arteriovenous malformation (hypoplasia of the left internal carotid artery), anti-phospholipidic syndrome, thrombophilia and dyslipidemia. Under neurologic supportive therapy, anticoagulant, vasodilator, depletive and anticonvulsant treatment, the patient's evolution was favorable, starting the physical recovery after 3 weeks from the onset. Conclusions: The diagnosis of stroke must be considered at any age, and the identification of the risk factors is essential for these patients' management that require multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Neonatal hypoxic-ischemic encephalopathy is the leading cause of disability and infant mortality through its consequences on the central nervous system. It is defined by neurological damage occurred in the newborn due to hypoxia and cerebral ischemia secondary to fetal acute or chronic distress. Most cases of neonatal encephalopathy have their antecedents in the prenatal period. It is unknown if neonatal encephalopathy is the result of a single insult (hypoxia-ischemia), multiple insults (infection and hypoxia-ischemia), or combinations of acute or chronic conditions. Approximately 70 percent of neonatal encephalopathy are associated with events dated before the onset of labor. Among the antepartum factors there are maternal, placental and fetal factors. The strongest risk factor is represented by intrauterine growth restriction. [ABSTRACT FROM AUTHOR]

Introducere. Naşterea prematură este o cauză importantă de morbiditate şi mortalitate perinatală. De aceea, obiectivul acestui studiu este de a evidenţia corelaţia dintre lungimea colului uterin (măsurat transvaginal) - precum şi aspectul acestuia - şi biomarkerul fibronectină în predicţia naşterii premature. Materiale şi metodă. În lotul nostru am inclus 62 de paciente, cu vârsta gestaţională de 22 de săptămâni. Criteriul iniţial de selecţie pentru screening a fost lungimea colului uterin, limita de cut-off fiind lungimea colului uterin de 25 mm, conform literaturii de specialitate. Parametrii studiaţi pe parcursul studiului au fost: lungimea colului uterin în dinamică; prezenţa/absenţa modificărilor ecografice la nivelul orificiului uterin (funneling); prezenţa/absenţa sludge-ului; prezenţa/ absenţa ariei glandelor cervicale; dozarea fibonectinei fetale din secreţia cervico-vaginală prin utilizarea kitului de determinare calitativa a FF. Gravidele au fost reevaluate apoi din două în două săptămâni. Rezultate. Pacientele incluse în studiu au avut vârste cuprinse între 20 şi 39 de ani. Categoria de vârstă cu rata cea mai mare de naşteri premature a fost cea de peste 35 de ani, cu un procent de 35%. Dintre pacientele cu LC<25 mm, 38 au născut prematur, iar 12 au născut la termen. Comparativ cu LC<25 mm, evaluarea concomitentă a lungimii colului şi a valorii FF≥50 ng/ml, pentru predicţia naşterii premature înainte de 37 de săptămâni, a crescut de la 19,5% la 58,3%. De asemenea, opt paciente la care s-a asociat prezenţa sludge-ului şi/sau a funnelingului la LC<25 mm au născut înainte de 35 de săptămâni. Concluzii. Deşi fiecare test are propriile sale măsuri de performanţă şi utilizări adecvate, testele clinice sunt concepute pentru a fi la fel de precise, exacte, specifice şi sensibile, atât cât este posibil. Aceste concepte de bază sunt pietrele de temelie ale fiabilităţii rezultatelor testelor, oferind astfel încredere furnizorilor de îngrijire a sănătăţii în utilizarea lor clinică. [ABSTRACT FROM AUTHOR]

Efectul nașterii asupra funcţiei planșeului pelvian constituie o problemă incomplet elucidată, în ciuda multiplelor studii efectuate. Afectarea planșeului pelvian (pelvic floor disorders; PFD) este reprezentată de incontinenţa urinară (UI), prolapsul pelvian simptomatic (sPOP), incontinenţa fecală (IF) și disfuncţiile sexuale. Din cauza intervalului lung de timp care trece de la naștere, a complexităţii și variabilităţii nașterii, precum și a multiplilor factori asociaţi, o legătură cauzală evidentă nu este totdeauna certă. Cu toate acestea, traumatismul obstetrical determinat de trecerea capului fetal prin planșeul pelvian, precum și existenţa prolapsului pelvian și a incontinenţei urinare, ca patologii frecvente, nu pot fi contestate. Studiile efectute până în prezent s-au bazat pe chestionare clinice, pe examinări clinice, ecografice și RMN funcţional, aducând informaţii importante. Studiile au fost eterogene în privinţa conceptului și modului de efectuare, dar, ca factori de risc comuni pentru PFD, au identificat factorii congenitali, prima naștere pe cale vaginală, greutatea peste 4500 g a fătului și înălţimea sub 1,60 m a gravidei, eforturi prelungite de împingere în expulzie, precum și obezitatea pacientei. În ceea ce privește nașterea instrumentală, există diferenţe între studii, unele identificând-o ca factor agravant, altele negăsind o legătură cauzală. S-a conturat și conceptul de PFD ca boală cronică, cu evoluţie progresivă în timp. Cunoașterea acestor legături cauzale între diversele tipuri de naștere, diversele etape ale nașterii și PFD este necesară pentru a putea consilia corect, știinţific și individualizat pacientele în alegerea unei căi de naștere, dar și pentru a putea începe imediat după naștere măsurile de profilaxie secundară. Într-un domeniu atât de sensibil la influenţe emoţionale și sociale, existenţa unor dovezi știinţifice certe ar constitui un aport semnificativ la sănătatea femeilor, privită pe parcursul întregii vieţi, precum și pentru politicile de sănătate publică. [ABSTRACT FROM AUTHOR]

The traditional treatment of dental caries gives great importance to achieving certain types of cavities in all patients, regardless of the risk of carious disease. This requires a major sacrifice of the healthy tissues, regardless of whether these injuries are hollow or not. Unlike the classic concept, the modern concept of treatment is based as a priority on the maximum conservation of the hard tooth structure integrity and influencing factors that can cause early wound healing or passivation or the surcease of the other wounds. [ABSTRACT FROM AUTHOR]

The traditional treatment of dental caries gives great importance to achieving certain types of cavities in all patients, regardless of the risk of carious disease. This requires a major sacrifice of the healthy tissues, regardless of whether these injuries are hollow or not. Unlike the classic concept, the modern concept of treatment is based as a priority on the maximum conservation of the hard tooth structure integrity and influencing factors that can cause early wound healing or passivation or the surcease of the other wounds. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a major problem for individ, medicine and societies. Despite the progression made for the prevention and the treatment of diabetic chronic complications, amputations of lower-extremity is still a major health problem, with psychosocial implications and high costs. Diabetic foot is the mirror of diabetic chronic complications and c1uster in a different proportions micro- and macroangiopathy, sensory, motor and autonomie neuropathy, osteo-arthropathy and skin disorders. Amputations in diabetie patients represent 50% of nontraumatic amputations. The number of major amputations decreased but minor amputations are still frequent. 85% of amputations are preceded of foot ulcers and 15% of diabetic patients develop ulcer during their lifetime. Screening to identify the patients at risk, followed by specific education, good metabolic control and proper footwear play an important role in' the prevention of foot ulcer and amputation. For patients with foot ulcer and/or amputation, therapeutic footwear promotes heeling and walking (associated with other medical and surgical measures). It seems that.among the serious and costly chronic complications of diabetes mellitus, such as cardiacdisease, renal failure, and blindness, the complications of the foot are best represented: 40-70%, of non-traumatic amputations of lower limbs are due to diabetes. Anually, 2% of diabetic patients will develop foot ulceration, while 15% will develop ulceration during their entire life. Amputation rate varies largely among countries and geographical regions. 15-19% of patients were reported to have undergone amputation with the diagnosis of diabetes mellitus at the time of the surgical intervention. Discussions regarding the complications of the diabetic foot are focussed on two major issues: foot ulceration and lower limb amputation. Combined, these two entities represent the cause of substantial medical effort, contributing at the same time to significant morbidity and mortality in diabetes mellitus. The link between diabetic ulceration and amputation of the lower limbs is unsolluble, taking into account the fact that ulcerations precede 85% of the amputations. Other risk factors for amputations include a very old diabetes mellitus, licemic imballance, peripheric neuropathy, peripheral.vascular disease, history of ulceration, anterior amputation, retinopathy", and nefropathy. [ABSTRACT FROM AUTHOR]

End of millennium marks an upward trend in medicine both technically and conceptually. Medical work is changing for all team members: physicians, nurses, and not least patients. Spectrum of chronic diseases, and thus diabetes, is marked by complexity management that training has a crucial role in the implementation and achievement of goals proved effective in preventing complications. The impact of personal, familial and social damage in patients with diabetes lower limb is known equally the benefits of education in preventing complications of the most unwanted - amputation - were demonstrated. To achieve these objectives, not easy, and barriers are ways that each of us must overcome. [ABSTRACT FROM AUTHOR]

Introducere. Prolapsul genital este o afecțiune în care uterul, rectul, vezica urinară, uretra, intestinul subțire sau vaginul prolabează sau se deplasează din pozițiile lor normale. Prolapsul de vezică urinară este denumit cistocel. Rectocelul reprezintă proeminarea peretelui anterior al rectului în vagin, cauzată de relaxarea mijloacelor de fixare și susținere ale vaginului. Material și metodă. Ne-am propus să analizam factorii de risc pentru prolapsul genital analizând un lot de 207 paciente diagnosticate cu această afecțiune în cadrul Clinicii de Obstetrică-Ginecologie a Spitalului Universitar de Urgență București în perioada 1 ianuarie 2010 - 31 decembrie 2012. Rezultate. 92 de paciente au fost diagnosticate cu rectocel. 115 paciente au fost diagnosticate cu cistocel. Dintre acestea, la 52 de paciente a fost evidențiat cistocel și rectocel. Media de vârstă a pacientelor a fost de 68,5 ani. 97 de paciente (46,85%) erau obeze cu IMC >30, 115 (55,5%) au avut cel puțin o naștere pe cale vaginală, iar 25 dintre ele au afirmat aplicare de forceps. 125 (60,38%) erau fumătoare și prezentau tuse cronică, 85 de paciente (41,66%) prezentau tulburări trofice caracteristice menopauzei, iar 52 de paciente (25,12%) au afirmat constipație cronică. Din totalul pacientelor internate cu prolaps genital, 180 au fost operate, iar restul de 27 de paciente au primit recomandarea de a li se aplica un pesar vaginal și a respecta un regim igieno-dietetic. Concluzii. Cei mai frecvenți factori de risc întâlniți în cazul cistocelului și/sau rectocelului sunt multiparitatea, menopauza și tusea cronică. De asemenea, în cazul studiului nostru, cea mai frecventă patologie a fost prolapsul peretelui vaginal anterior. [ABSTRACT FROM AUTHOR]

Introducere. Fistula faringo-cutanată (FFC) este cea mai frecventă complicaţie la pacienţii cu laringectomie totală şi creşte morbiditatea şi costurile de tratament, prelungeşte perioada de îngrijiri postoperatorii şi de internare şi amână posibilitatea instituirii tratamentului adjuvant. Scop. Ne propunem să evaluăm rata incidenţei şi să evidenţiem factorii cei mai importanţi care au determinat apariţia FFC la pacienţii noştri. Material şi metodă. In acest scop am realizat un studiu retrospectiv pe o perioadă de 5 ani, pe un lot de 116 pacienţi cu laringectomie totală. Din aceştia, 13 pacienţi (11%) au prezentat FFC. Rezultate şi discuţii. între factorii citaţi în literatură ce favorizează dezvoltarea FFC, amintim: consumul de alcool şi fumatul preoperator, radio- şi chimioterapia, malnutriţia, extensia locală, bolile asociate, marginile plăgii, traheotomia, vârsta, extensia la faringe, valorile hemoglobinei şi ale albuminei (anemia) preoperator. Analizând aceşti factori la pacienţii noştri cu FFC am putut incrimina anemia preoperatorie, stadiul avansat al tumorii cu extensie spre faringe, bolile asociate (diabet, boală obstructivă pulmonară cronică, hepatopatie), vomă în a doua zi postoperator, radio-chimioterapia. Tratamentul FFC a constat în punerea în repaus a faringelui şi esofagului (prin gastrostomă) şi antibioterapie (conform antibiogramei). închiderea fistulei s-a realizat în medie în a 28-a zi postoperatoriu. Concluzii. Anemia preoperatorie, stadiul avansat al tumorii cu extensie spre faringe, bolile asociate (diabet, boală obstructivă pulmonară cronică, hepatopatie), vomă în a doua zi postoperatoriu, radio-chimioterapia reprezintă factori de risc ce predispun la apariţia FFC. Tratamentul zilnic local şi sistemic a permis închiderea spontană a defectului în decursul unei perioade medii de aproximativ o lună. [ABSTRACT FROM AUTHOR]