Search

With the help of dental implants, an oral rehabilitation can be performed not only very complex, but also very complete of various types of edentulous spaces. After insertion of the dental implants, they can be subsequently prosthetically restored through a wide range of implant-supported prosthetic restorations. In this material, we tried to highlight some particular aspects from the point of view of the laboratory stages of dental technique, which intervene in the technological flow of making implant-supported prosthetic restorations from ceramic masses on Zirconia structure.

Post and core devices are elements that contribute to the complete restoration of the coronary abutment, over which the final prosthetic restoration will be created. Their role is to retain the coronary portion of the restoration and to protect the remaining coronary structures. The retention function is dictated by the major indication of the method, massive coronary destruction that does not provide conditions for coronary aggregation of the restoration. Thus, this material is approaching two unique methods of making post and core devices totally metallic and/or hybrid (metal + totally ceramic component), using both classical technology, modern technologies, but also combinations of them.

Sedentary behavior, both professional, occupational, leisure and recreational, is one of the major risk factors for cardio-metabolic health and premature mortality. But, this type of sedentary behavior can be found in many of the existing professional activities in 2021, among them being the professional activities with a medical profile in the field of dentistry: specific activities in the dentist’s office (and here we discuss about dentists and dental nurses) and activities specific in the dental laboratory (in this case, we are talking about dental technicians).

When talking about dental assistance we actually refer to the prevention, detection and treatment of diseases of the oral and maxillo-facial region which, in most cases, have as a starting point or interest the dento-maxillary system. In this material, we tried to present a comparative study on the typology and complexity of different stages of dental treatments that can be performed in urban areas, compared to various stages of dental treatments that are performed and / or could be made in rural dental offices from in Romania.

The Specialization Institute in Dentistry (Dental Clinic), both the one that operated in Colțea Hospital and especially the one that operated in Colentina Hospital, both in Bucharest, the capital of Romania, were the first such higher education units in dentistry from Romania, they are in fact the vanguard of the future faculties of dentistry established in our country according to the Soviet model, in 1948. Thus, in this material we tried to highlight some of the most important moments in the existence of those reference units of dental education, period 1928-1948.

Nowadays, at work, many people spend more than half of their entire day working in a sitting position. Maintaining this position for a long period of time is a risk factor for health. The results of various studies have shown associations between maintaining a prolonged sitting position with morbidity due to chronic diseases, such as cardiovascular disease, diabetes, metabolic syndrome, obesity, etc. And, as we have already mentioned in the first part of this study, dental technicians are part of this category of staff, who carry out most of their specific activity, in a sitting position.

In general, the treatment of dentin hyperesthesia can be performed either at home or in the dentist’s office. The therapeutic approach aims at the use of products, which decrease the excitability of pulp nociceptors or reduce the permeability of the dentin canals. The purpose of this study is to compare the efficiency in the treatment of dentin hyperesthesia of a product containing potassium nitrate, compared to another product using Recaldent™ Technology. The results of this study indicated a significant decrease in pain sensitivity both after application of the product using Recaldent™ Technology and after the product containing potassium nitrate, the results being slightly in favour of the first product.

Introduction. In general, implant-prosthetic restorations, whether they are fixed or mobile, and regardless of their location (maxillary or mandibular), imply slightly different design and conceiving criteria, compared to the conventional prosthetic restorations already known. Purpose. In this material we tried to present some general and particular aspects regarding the design and manufacture of fixed implant-prosthetic restorations. Material and method. The study took place between September and December 2019 with the help of 31 dentists from Bucharest. Results and discussions. Following the application of the questionnaire, we were able to outline some aspects, frequently encountered in practice, by dentists who perform implant-prosthetic restorations related to occlusal balancing and the forces that appear at the level of implant restorations. Conclusions. The correct analysis and evaluation of the occlusal contacts and forces, leads to an increase in the life expectancy of prosthetic work as well as of their support (dental or implant).

The restoration of a proximal wall depends on several factors, the conformation system playing one of the most important parts of the working protocol. The vertical, transversal and sagittal adaptation of the matrix band implies the use of one or two wedges and of a sectional matrix device (usually with a ring shape) with tines. The size, configuration and the material the tines are made of determine most of the quality of the adaption and stabilization of the matrix band. Even if these standardized tines have various designs and variable flexibility, a truly efficient tine should have a customized configuration which can be obtained after taking the impression of the initial proximal wall. The clinical situations that allow the customization of the standard tines imply proximal caries that have not interrupted the proximal wall or that have interrupted it less than one third of the transversal distance.

Several methods and materials are used in modern restorative dentistry for anterior dental lesions treatment. The desired aesthetic outcome can be obtained only with the correct treatment method correlated to case particularities. Sometimes, subjective and unrealistic approaches lead immediately or in time to undesirable dental restorations. The aim of the present paper is to evaluate the statistic distribution of aesthetic anterior dysfunctions detected on 425 patients from both genders that had restorative treatment during a period of 10 years. For each patient, there has been conducted an initial clinical examination and a photographic documentation was made. Also, each patient was asked to submit a questionnaire regarding his dental history. The results of the study represented the foundation for the discussions regarding the causes that led to aesthetic dysfunctions. The conclusions indicated that all errors that conducted to an initial failure of treatment are only connected with the medical decisions made by the dentist.

At this moment, geriatric dentistry represents a very well-defined discipline, which deals with the dental treatments in the elderly patients, more precisely the patients over 60 years old. Unfortunately, in Romania, geriatric dentistry is currently very superficiality treated, this being rather an optional study discipline in the curricula of Dental Medicine Faculties. Therefore, in this material we have tried to explain through solid arguments the importance of geriatric dentistry in the basic training of dentists, dental and dental prophylaxis nurses, as well as dental technicians.

The summer internship was and is a mandatory learning stage for all students of medical specialties in Romania, including students of dental medicine and dental technology programs. Thus, we have made a very interesting study, strictly related to the summer internship for the students from the first year of this specialty, which operates in one of the universities with medical profile in Bucharest.

Introduction: Esthetic dentistry aims to create a harmonious smile that is well integrated with the facial architecture of the patient. A good understanding of the patient’s esthetic perception is important when designing a smile. Materials and methods: 106 subjects, 51 patients 54 dental students took part in the study. Each subject was asked to evaluate 10 pictures showing frontal aspect of real cases. They were asked to rate the aesthetics of the clinical cases on a scale from 1 to 5. An open question was associated with each picture, where the subjects were asked to describe what they like and what they do not like about the picture. Results and discussions: The overall mean esthetic rating of dental students was 2,68, while the laypersons’ rating was 2,98. Crowded teeth are more often criticized by patients, while dental students consider that slight crowding give a more natural appearance and individualize the teeth. The presence of diastema is observed by dental students even when it is discrete. The discrepancy between maxillary and mandibular dental midline is more easily observed by dental students. Discolored teeth lead to low aesthetic scores for both groups of subjects. Dental students gave lower esthetic scores to restorations with uniform colour, while laypersons appreciate white restorations. The limited height of papillae is considered unattractive by dental students, while laypersons hardly notice this aspect. Conclusions: This study showed several differences in the aesthetic perception of dental students and laypersons. Students were generally more critical and gave lower scores than laypersons. They also observed and criticized more aspects regarding the smile.

A good outcome of an occlusal appliance requires a well-adapted device, both in terms of occlusal relations and internal fit, which helps achieve patient comfort and compliance. Digital technology had led to the manufacturing of night guards that display a better accuracy and properties of the resin, ease of fabrication in terms of time and materials and the possibility of duplication. This technical report describes the clinical and laboratory steps that need to be followed to produce an occlusal appliance in a fully digital protocol. Intraoral scans were acquired, as well as digital occlusal records. A virtual 3D dental device was designed using a CAD software, which was later manufactured via 3D printing technology. The occlusal appliance displayed a good internal fit and enhanced properties of the resin. Minimal occlusal adjustments were required to secure functional guidance during protrusive and lateral movements of the mandible.

This article is based on conversations from the project “Big Data in Psychological Assessment” (BDPA) funded by the European Union, which was initiated because of the advances in data science and artificial intelligence that offer tremendous opportunities for personnel assessment practice in handling and interpreting this kind of data. We argue that psychologists and computer scientists can benefit from interdisciplinary collaboration. This article aims to inform psychologists who are interested in working with computer scientists about the potentials of interdisciplinary collaboration, as well as the challenges such as differing terminologies, foci of interest, data quality standards, approaches to data analyses, and diverging publication practices. Finally, we provide recommendations preparing psychologists who want to engage in collaborations with computer scientists. We argue that psychologists should proactively approach computer scientists, learn computer scientific fundamentals, appreciate that research interests are likely to converge, and prepare novice psychologists for a data-oriented scientific future.

It is currently recognized that an injudicious strategy about caries in the last decades has been not only focusing of research mostly in children, but also the narrow focusing on fluoride, because despite sufficient availability of fluoride in water and oral healthcare products, caries levels escalate steadily as people get older and caries remain a main public health issue to be settled. In the last two decades the scientific community intensified efforts of exploring other products for caries prevention, herbal products being one of these approaches. Preliminary evidence indicated that clinical trials for caries prevention with herbal products are heterogeneous in design, quality and products evaluated, we therefore performed a scoping review intended to explore the main characteristics of such clinical trials. From an initial collection of 1986 unique papers from different literature databases, 56 articles satisfied the inclusion and exclusion criteria. The species investigated, dosage forms, study designs, duration of intervention, controls, endpoints, quality of reporting, and risk of bias are discussed. Of the trials reviewed here, 85.71% reported positive results but given the methodological flaws and biases affecting them, it is difficult to conclude on the efficacy of those products based on the studies published thus far.

Objective. The purpose of the study is to identify the musculoskeletal problems in dental professionals and the causes leading to them to rank. The most frequent ones were ranked in order to elaborate operational and global projects and differentiated treatment and prophylaxis units focused on that certain problem. Material and method. The 133 subjects (dental students and specialist) answered a 14 items questionnaire. Results. The results of the questionnaire were centralized and statistically analyzed using descriptive statistics. Discussions. The results showed that most of the subjects (69.92%) had growth problems. 90.23% of them did not consulted a kinetoterapist but they were aware of the necessity of seeking specialty treatment in the future. Conclusions. The present study conducted to preliminary conclusions that will be the start point of further extended studies, emphasizing the necessity of Kinetotherapy classes in Dental School.

Objective. The purpose of the study is to evaluate the knowledge and universal application of decontamination methods of impressions in dental practices. Material and method. The study involved 131 persons (dentists and dental students at Faculty of Dental Medicine). All the participants completed a questionnaire regarding the knowledge of transmission risk and rates of infections agents through dental impressions and the importance of different methods of decontamination. Results. Most of the subjects (93.89%) are aware of classical safe standard to achieve infection control in dental office. The youngest ones are well instructed in dental school. Most of the participants concluded that ere is a risk of transmission of infectious agents through different devices (impressions, prosthetic components) are sent out of the practice. Still only 35.11% of the respondents use a decontamination process of impressions. Among these (46 subjects), only 25 of them follow a well-conducted decontamination protocol. Many of the subjects consider that the infections risk of dental devices is minor and the decontamination procedure only makes the technological process more difficult. Conclusions. Dental practitioners consider that there is a minor risk of person-to-person transmission of infectious through dental devices. Doctors and technicians as well do not use a multi-step process of decontamination, because it makes the workflow more difficult.

Romania and Ukraine share the Black Sea coastline, the Danube Delta and associated habitats, which harbor the endemic, aquatic Pontocaspian biota. Currently, this biota is diminishing both in numbers of species and their abundance because of human activities, and its future persistence strongly depends on the adequacy of conservation measures. Romania and Ukraine have a common responsibility to address the conservation of Pontocaspian biodiversity. The two countries, however have different socio-political and legal conservation frameworks, which may result in differences in the social network structure of stakeholder institutions with different implications for Pontocaspian biodiversity conservation. Here, we study the social network structure of stakeholder organizations involved in conservation of Pontocaspian biodiversity in Romania and the implications of network structure for conservation outcomes. Then we compare the findings from Romania to an earlier similar study from Ukraine. We apply a mix of qualitative and quantitative social network analysis methods to combine the content and context of the interactions with relational measures. We show that Pontocaspian biodiversity plays a minor and mostly incidental role in the inter-organizational interactions in Romania. Furthermore, there is room for improvement in the network structure through e.g. more involvement of governmental and nongovernmental organizations and increased motivation of central stakeholders to initiate conservation actions. Social variables, such as lack of funding, hierarchical, non-inclusive system of conservation governance and continuous institutional reforms in the public sector are consequential for the network relations and structure. Social network of stakeholders in Ukraine is more connected and central stakeholders utilize their favorable positions. However, neither in Ukraine is the Pontocaspian biodiversity a driver of organizational interactions. Consequently, both networks translate into sub-optimal conservation actions and the roads to optimal conservation are different. We end with sketching out conservation implications and recommendations for improved national and cross-border conservation efforts.

The working conditions in which specialists of dental technology carry out their activity are factors conducive to a series of changes that affect the body. Thus, factors like prolonged static effort, length of work, work rhythm and ratio between dynamic and static effort lead to metabolic disorders and imbalances which may cause excess weight – one of the most frequent issues society today is struggling with, and which is harmful to the quality of life. This research was conducted on 30 subjects. Initial assessment of body mass index was made for students specializing as dental technologists within “Carol Davila” University of Medicine and Pharmacy of Bucharest and then, five years later after subjects started to work, they were assessed again, taking account of the physical activity performed and diet kept. The purpose of the study was to set out how effective physical exercise is in maintaining / improving the body mass index parameters and, therefore, the quality of life. Conclusions: This study points out to positive statistical association of regular and constant exercise with maintaining normal values of body mass index. Our proposition is to implement kinetoprophylaxis programs on dental laboratory technicians for preventing prolonged static effort’s outcomes, maximizing body functionality and improving the quality of life by stimulating subjects to adopt an active physical exercise regimen, as well as preventing overweight and obesity in these subjects.

One of the most drawbacks of CRRT is anticoagulation. Excessive anticoagulation determines bleeding complications; whole circuit clotting decreases dialysis effectiveness, increases blood loss and necessitates transfusions. The aim of the study was to evaluate efficacy and safety of Tinzaparin as anticoagulation for extracorporeal circuit in CRRT. The optimal necessary dose of tinzaparin was examined in 12 CRRT sessions, 7 CVVHDF (Qb = 134 ± 15.7 ml/min, Qd = 35 ± 7 ml/min, minimal UF = 500 ml/h, total time = 120.5 h) and 5 CVVH (Qb = 150 ± 13 ml/min, minimal UF = 500 ml/h, total time = 72.5 h) in 9 pts (M = 5, F = 4, mean age = 51.78 ± 8.9 y, BW = 60 ± 15.3 Kg) with acute renal failure and associated comorbidities. The initial dose of tinzaparin was 5 IU a Xa/Kgc in 2 pts with thrombocitopenia

Daily or intermittent hemodialysis in ARF is, in general, efficient, but the procedure has various complications due to associated comorbidities and unphysiological ways of renal substitution. The aim of the study was to establish the efficiency (hydro-electrolytic equilibrium, acido-basic equilibrium, fluid balance, evolution of renal function, patient survival) and complications (hypotension, hemorrhagic, vascular access, etc.) during CRRT. We performed CRRT in 24 pts with ARF on native kidney (n = 20) or renal transplant (n = 4). In 19 cases (M = 11, F = 8, mean age = 43.2 ± 15.7 y, BW = 49 ± 7.5 kg, mean BP = 107 ± 16.6 mmHg) we made CVVHF and in 11 cases (M = 6, F = 5, mean age = 39 ± 9.9 y, BW = 55.5 ± 5.6 kg, mean BP = 104 ± 18.8 mmHg) CVVHDF. 16pts (66.6%) have been associated severe, one or more comorbidities: MSOF in 2 pt, sepsis in 3pt, coma in 2 pts, anasarca in 6 pts (1pt hepatic cirrhosis, 1pt severe cardiac failure and 4pts nephrotic syndrome), CID in 1pt, acute pancreatitis in 3 pt, liver failure and hepato-renal syndrome in 1 pt. Mean period of CVVHF was 21.6 ± 11.3 h with a mean blood flow rate of 116.9 ± 16.4 ml/min and an ultrafiltration rate of 6.42 ± 4.6 ml/min. Creatininemia level decreased from 12.6 to 8.3 mg% and urea level decreased from 237 to 166 mg%. In CVVHDF mean period of procedure was 24.0 ± 8.5 h, mean blood flow 134 ± 15.2 ml/min and mean ultrafiltration rate 5.6 ± 2.1 ml/min. Decreased of creatininemia level was from 11.6 to 6.36 mg% and for urea level from 236 to 137 mg%. Vascular approach was by jugular vein in 15 pts, femoral vein in 6 pts, subclavia vein in 1 pt and native fistula in 2 pts. Anticoagulation was performed with UHF in 14 pts and LMWH in 9 pts. In 1 pt anticoagulation was performed by repeated washback with saline solution. Renal function was recovery completely in 8 pts (33.3%), partially in 4 pts (17.2%) and 10 pts (41.7%) goes to chronic HD. Survival rate was 100% in CVVHF and 82% in CVVVHDF (2 pts died). Complications of procedures appear in 5/24 pts (20.8%) and were represented by cardiac events (hypotension in 2 pts, arrhythmia in 1 pt), bleeding disorders (hemorrhages in 2 pts, clotting in dialyser or lines in 4 pts) and diselectrolithemias (hypophosphatemia in 2 pts). In 1 pt has been necessary to change the femoral catheter to subclavia site due to thrombosis. In conclusion, continuous renal replacement therapy is efficient and well tolerated with a low frequency of complications.

Clinical studies have revealed that the main objective of implants in the edentulous jaw is to provide support for fixed prostheses or to stabilize complete dentures. Various attachment systems were developed for universal use in partially and completely edentulous patients such as clasps, cone-shape telescope copings, magnets, bar systems, locators. The aim of this case report is to present the Locator attachment that does not use the splinting of implants. Four implants were placed in the foraminal region and the Locator attachment system was used to connect overdentures to mandibular dental implants. The results proved that the Locator attachment system offers the possibility to obtain a higher retention and an improved stability for overdentures in edentulous patients with a severely resorbed mandible and lack of vertical space between the arches.

Aim: To evaluate the prevalence of HBV, HCV, HDV and HEV infections in populations with different categories of risk and the seroprevalence of HBV and HCV infections in subjects asking for a medical examination.Method: We conducted a cross-sectional, epidemiological study in 2,851 subjects from the SubCarpathian and South-Eastern Romania (including 17 counties, 34% of the country area and 42% of the population). The subjects were divided into four groups: controls (n=2,540, i.e. consecutive subjects asking for a medical examination), subjects with very low risk (students; n=44), with low risk (doctors and nurses; n=93) and with high risk for viral hepatitis (hemodialysis patients; n=174). All subjects were screened for HBsAg, antiHCV and ALT level. In populations at risk, antiHBs, HBeAg, antiHBe, antiHBc (IgG), HBV-DNA, HCV-RNA, antiHDV(IgG) and antiHEV(IgG) were also assessed.Results: In controls, HBV seroprevalence was 5.59% and HCV seroprevalence 4.56%. The risk factors for HBV infection were: age, male gender and South-East region of Romania. The risk factors for HCV infection were: age, female gender, elevated ALT level and the South-East region of Romania. In the very low risk population HBV, HCV, HDV and HEV seroprevalence was: 2.27%, 0%, 0% and 12.5%, respectively. In low risk population the seroprevalence was 2.15%, 1.07%, 0% and 13.98%. In hemodialysis patients, HBV and HCV seroprevalence were 7.91%, respectively 39.26%. HCV-RNA was detectable in 20.69% cases.Conclusion: In the South and South-Eastern Romania the seroprevalence of viral hepatitis infections is intermediate, similar to other Romanian regions or the Balkans.

The present paper represents a quantitative study concerning benthic communities from the Some

Oral implants and attachment systems represent an easy solution for preventing vertical displacement of removable dentures. Retention force is the most important operational parameter for an attachment system. Starting from the design phase it's possible to test different designs and evaluate mechanical retention with relatively low costs using numerical simulation. In this study, a methodology was proposed for evaluation of retention force using numerical simulation. In order to validate the methodology, simulated results were compared with experimental reference data obtained in the same conditions. The magnitude of the retention force for the spherical blunt - metallic matrix attachment system produced by Straumann was determined using a specially designed experimental setup. Qualitative and quantitative analysis demonstrated that numerical model is stable and predicts correctly the retention force. Uncertainties led to acceptable deviations from experimental values.

To evaluate the prevalence of HBV, HCV, HDV and HEV infections in populations with different categories of risk and the seroprevalence of HBV and HCV infections in subjects asking for a medical examination.We conducted a cross-sectional, epidemiological study in 2,851 subjects from the SubCarpathian and South-Eastern Romania (including 17 counties, 34% of the country area and 42% of the population). The subjects were divided into four groups: controls (n=2,540, i.e. consecutive subjects asking for a medical examination), subjects with very low risk (students; n=44), with low risk (doctors and nurses; n=93) and with high risk for viral hepatitis (hemodialysis patients; n=174). All subjects were screened for HBsAg, antiHCV and ALT level. In populations at risk, antiHBs, HBeAg, antiHBe, antiHBc (IgG), HBV-DNA, HCV-RNA, antiHDV(IgG) and antiHEV(IgG) were also assessed.In controls, HBV seroprevalence was 5.59% and HCV seroprevalence 4.56%. The risk factors for HBV infection were: age, male gender and South-East region of Romania. The risk factors for HCV infection were: age, female gender, elevated ALT level and the South-East region of Romania. In the very low risk population HBV, HCV, HDV and HEV seroprevalence was: 2.27%, 0%, 0% and 12.5%, respectively. In low risk population the seroprevalence was 2.15%, 1.07%, 0% and 13.98%. In hemodialysis patients, HBV and HCV seroprevalence were 7.91%, respectively 39.26%. HCV-RNA was detectable in 20.69% cases.In the South and South-Eastern Romania the seroprevalence of viral hepatitis infections is intermediate, similar to other Romanian regions or the Balkans.

Peritoneal dialysis (PD) is the first option for patients in end stage renal disease (ESRD). Several complications such as peritonitis, exit-site or tunnels infections are encountered during PD. Other complications such as pain, proteic malnutrition, hyperglycemia, hypertension, cardiac failure are described in patients on continuous ambulatory peritoneal dialysis (CAPD) or APD (automated peritoneal dialysis). Rare complications are incapsulated sclerosing peritonitis, hemoperitoneum or pneumoperitoneum. We present the case of a female patient, 66 years old, on cyclic continuous peritoneal dialysis (APD-CCPD) admitted for pneumoperitoneum developed during a dialysis change from a CCPD schedule, due to an error in the Tenckhoff catheter and peritoneal dialysis manipulation. The treatment consisted in extracting the air during manual peritoneal dialysis changes, with the patient in Trendelenburg position and pressing on the abdominal wall, without any other complications.

Renal transplantation could be associated with severe complications. Pneumothorax is a rare and severe complication among renal transplant recipients. The relationship between pneumothorax and post transplantation status, pulmonary infections or immunosuppressive treatment is controversial. We report the case of a young female with normal renal graft function who developed recurrent pneumothorax after three years of kidney graft.

The antiviral treatment of chronic C hepatitis has improved significantly over the past decade with the introduction of interferons (IFNs), and more recently, pegylated IFNs. Up to two-thirds of all patients treated with pegylated IFN combined with ribavirin can now achieve viral eradication if treated according to current guidelines. Despite this success rate, hematological, immunological, rheumatological and dermatological side effects have been reported in chronic hepatitis C patients treated with IFN-alpha. The subjects of this report are two young females with chronic hepatitis C, who developed rheumatoid syndrome and/or erythema nodosum during antiviral treatment with IFN-alpha or pegylated IFN combined with ribavirin.

Cardiovascular mortality and morbidity are high in chronic renal failure (CRF) patients. Previous studies on non-uraemic patients with heart failure (HF), hypertension or diabetes mellitus (DM) showed that QT and QTc prolongation and dispersion represent cardiovascular risk factors. The patients with long QT interval have more often ventricular premature beats and sudden death than those with normal QT interval. The aim of our study was to evaluate the frequency and predictive value of QT and QTc prolongation in CRF patients, included or not in a chronic dialysis programme. On 68 patients (M/F = 36/32, mean age = 47.6 years), with CRF we analyzed QT and QTc interval with a digital 12 lead electrocardiogram-CARDIAX. 8/68 patients (11.8%) had long QT interval (0.45"). After having calculated QT corrected (QTc) interval according to the heart rate, 28/68 patients (41.2%) had QT prolongation (0.45"). Multivariate statistical analysis of clinical factors, but also of biological, electrocardiographic, echocardiographic data and 24 hours of ECG and blood pressure monitoring showed that QT prolongation is statistically significant (p0.05) correlated with: number of years of renal failure (p = 0.0001), serum concentrations of potassium and calcium (p = 0.0001) and diastolic BP (p = 0.05). QT prolongation in CRF patients is not dependent on the level of uremia or the type of chronic renal substitution (hemodialysis or continuous ambulatory peritoneal dialysis). There were no statistically significant correlations between QT prolongation and serum concentrations of Mg, PO4, HCO3 and Hb. Long QT interval was not dependent either on the dipper/nondipper profile of mean BP values or ejection fraction of left ventricle. In our study long QT interval was not statistically significant correlated with arrhythmias or sudden death. Despite the high incidence of QT prolongation in CRF patients (41.2%), short-term consequences are not as severe as those in cardiac patients. This is possibly explained by the different pathogenic mechanisms of arrhythmia in CRF when electrolytic disorders are the main cause for the development of arrhythmia. During a mean follow-up of 3.8 months (3-5.5) there were no cases of sudden death on patients with QT prolongation, and arrhythmia incidence was not statistically significant higher than in subjects with normal QT interval.

Hepatitis C viral infection (HCV) results in liver damage leading to inflammation and fibrosis of the liver and increasing rates of hepatic decompensation and hepatocellular carcinoma (HCC). However, the host's immune response and viral determinants of liver disease progression are poorly understood. This review will address the determinants of liver injury in chronic HCV infection and the risk factors leading to rapid disease progression. We aim to better understand the factors that distinguish a relatively benign course of HCV from one with progression to cirrhosis. We will accomplish this task by discussion of three topics: (1) the role of cytokines in the adaptive immune response against the HCV infection; (2) the progression of fibrosis; and (3) the risk factors of co-morbidity with alcohol and human immunodeficiency virus (HIV) in HCV-infected individuals. Despite recent improvements in treating HCV infection using pegylated interferon alpha (PEGIFN-alpha) and ribavirin, about half of individuals infected with some genotypes, for example genotypes 1 and 4, will not respond to treatment or cannot be treated because of contraindications. This review will also aim to describe the importance of IFN-alpha-based therapies in HCV infection, ways of monitoring them, and associated complications.

We studied 24 patients with acute renal failure (ARF) or acutization of chronic renal failure (CRF) caused by a variety of different disorders. A rapid decline in renal excretory function, fluid, electrolyte, and divalent ion disturbances determined us to initiate continuous renal replacement: continuous venovenous hemofiltration (CVVHF) - 28 procedures in 15 patients and continuous venovenous hemodiafiltration (CVVHDF) - 11 procedures in 11 patients. The mean duration of CVVHF was 21.6+/-6.9 h, with a mean blood flow rate of 116.9+/-16.4 ml/min and an ultrafiltration rate of 6.4+/-4.6 ml/min. The serum creatinine level decreased from 12.6 to 8.3 mg% and the concentration of urea from 237 to 166 mg%. The mean duration of hemodiafiltration was 24+/-8.5 h, with a mean blood flow rate of 134+/-15.2 ml/min, a mean dialysate flow of 35+/-7 ml/min and a mean ultrafiltration rate of 5.6+/-2.1 ml/min. The serum creatinine level decreased from 11.6 to 6.36 mg% and the concentration of urea from 236 to 137 mg%. Survival rate was 79.2% (19/24 patients). The complete recover of renal function was achieved in 5 patients, partial recover in 5 patients and 9 patients were included in chronic dialysis. In 8/24 (30%) patients we encountered complications, such as hypotension in 2 cases, bleeding disorders in 5 cases or diselectrolithemias in 2 cases. As a consequence, continuous renal replacement therapy is efficient, having an acceptable rate of adverse effects in patients with ARF or acutization of CRF.

Liver impairment in renal transplant recipients is not a common complication and is associated, in most cases, with viral infections (HBV, HCV, HVD, HGV) or drug hepatotoxicity (Cyclosporin, Azathioprine, statins). Cytomegalovirus (CMV) infection is common, with 50 to 80% of the adult population being seropositive for CMV antibodies. In immunocompetent individuals, primary infection is usually asymptomatic or associated with minor illness. CMV remains latent after primary infection. In immunocompromised patients, as in renal transplant recipients or transplant recipients of other solid organ or bone marrow, the virus can cause serious disease. This could be the result of newly acquired infection or reactivation of the latent virus. One of the organs involved in CMV disease is the liver. The subjects of this report are renal transplant recipients with liver impairment due to CMV induced acute hepatitis.