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Introduction. Dento-maxillary anomalies are characterized by changes in the size, shape, position and inclination of the morphological elements that make up the stomatognathic system. Recent studies demonstrate the fact that not only traumatic occlusion (OT) is the etiological factor of TMJ dysfunction. But muscular factors, vicious habits and dento-maxillary anomalies are also involved. Created by the Marti Helkimo in 1972 to investigate the prevalence and severity of signs and symptoms of temporomandibular dysfunction. Material and method. The study was carried out on a group of 78 patients from the personal case with various dentomaxillary anomalies and TMJ suffering. We statistically processed the data obtained from the clinical examination, in order to compare the situation of patients with temporomandibular dysfunction compared to that of patients without joint disorders at the time of the initial examination. Results. Most patients with class II/2 anomalies: 42.86% presented an anamnestic index of I, and a percentage of 20.69% had a Helkimo anamnestic index of II. So with this type of anomaly, the patients indicated obvious signs of ATM dysfunction. The Helkimo anamnestic index had the highest scores in the II/2 anomaly in the female sex, followed by class II/1 anomalies in the male gender. This index correlates better with the clinical one in the female for all types of anomalies. Conclusion. The most important examination in the case of TMJ pathology is represented by the thorough clinical examination. There is a directly proportional relationship between the degree of severity of the malocclusion and the Helkimo index points.

Background and Objectives: Lower extremity amputations (LEAs) represent a significant health problem. The aim of our study was to analyse the type and trends of diabetes-related LEAs in patients hospitalized in one surgical centre in Bucharest between 2018 and 2021. The second aim was to assess the impact of the COVID-19 pandemic on the trends of LEAs. Materials and Methods: We performed a retrospective analysis of all lower limb amputations performed between 01 January 2018 and 31 December 2021 in the Department of Surgery, Dr. I. Cantacuzino Clinical Hospital, Bucharest, Romania. We evaluated demographic parameters, type of LEA, the level, the laterality and trends of the amputations, the main aetiologies leading to amputation, and the length of hospitalization. Results: During the study period, 1711 patients underwent an LEA. The mean age was 64.53 ± 9.93 years, 71.6% (n = 1481) being over 60. Men outnumbered women by a ratio of 3.62:1. The most frequent interventions were ray amputations in 41.2% (n = 705) of patients; then, there were amputations of the toe (20.4%, n = 349), transtibial amputations (18.9%, n = 323), transfemoral amputations (10.6%, n = 181), and midfoot amputations (9%, n = 154). Wet gangrene was the most frequent aetiology (40.9%, n = 699). The total number of LEAs decreased constantly throughout the analysed period, such that 616 LEAs were performed in 2018 and 323 LEAs in 2021 (p < 0.001). There was a statistically significant increase in the rate of major LEAs in the pandemic vs. pre-pandemic period (37% vs. 24.4%, p < 0.001). Conclusions: In our study, the total number of LEAs decreased throughout the analysed period, but there was an increase in the rate of major LEAs in the pandemic vs. pre-pandemic period. Being over 65 years of age, leucocytosis, sepsis at presentation, and diabetic polyneuropathy were important risk factors for the necessity of LEA in complicated diabetes-related foot disease. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) is a microvascular complication that frequently affects numerous patients diagnosed with diabetes. For the diagnosis of CKD, the guidelines recommend the identification of the urinary albumin/creatinine ratio and the determination of serum creatinine, based on which the estimated rate of glomerular filtration (eGFR) is calculated. Serum creatinine is routinely measured in clinical practice and reported as creatinine-based estimated glomerular filtration rate (eGFRcr). It has enormous importance in numerous clinical decisions, including the detection and management of CKD, the interpretation of symptoms potentially related to this pathology and the determination of drug dosage. The equations based on cystatin C involve smaller differences between race groups compared to GFR estimates based solely on creatinine. The cystatin C-based estimated glomerular filtration rate (eGFRcys) or its combination with creatinine (eGFRcr-cys) are suggested as confirmatory tests in cases where creatinine is known to be less precise or where a more valid GFR estimate is necessary for medical decisions. Serum creatinine is influenced by numerous factors: age, gender, race, muscle mass, high-protein diet, including protein supplements, and the use of medications that decrease tubular creatinine excretion (H2 blockers, trimethoprim, fenofibrate, ritonavir, and other HIV drugs). The low levels of creatinine stemming from a vegetarian diet, limb amputation, and conditions associated with sarcopenia such as cirrhosis, malnutrition, and malignancies may lead to inaccurately lower eGFRcr values. Therefore, determining the GFR based on serum creatinine is not very precise. This review aims to identify a new perspective in monitoring renal function, considering the disadvantages of determining the GFR based exclusively on serum creatinine. [ABSTRACT FROM AUTHOR]

The Roma population is Europe's largest ethnic minority, yet data on the prevalence of non-communicable diseases remain scarce in medical literature. This study aimed to compare the clinical and metabolic particularities of a Roma population with diabetes with a group of non-Roma. We conducted an observational, transversal study and evaluated 808 adult patients with diabetes mellitus, from a tertiary diabetes care hospital. The prevalence of metabolic syndrome was high among both groups, 94.3% in the Roma patients and 89.1% in the non-Roma. A slightly higher mean value of the triglyceride–glucose (TyG) index was observed among the Roma group (10.07 ± 0.71 versus 9.71 ± 0.82). Among the non-Roma, variables that were significantly associated with the TyG index were glycated hemoglobin (HbA1c), total cholesterol (TC), high density lipoprotein–cholesterol (HDL-c), and low-density lipoprotein-cholesterol (LDL-c), while among the Roma, HbA1c and HDL-c were correlated with this index. There were no differences concerning myocardial infarction; however, the number of patients with a history of stroke was 2.1 times higher in the Roma group compared to the non-Roma group. The prevalence of cardiovascular risk factors, cardiovascular disease, and microvascular complications among the study's Roma population are quite significant, underscoring the importance of ethnic disparities in approaching healthcare management strategies. [ABSTRACT FROM AUTHOR]

Background and Objectives: Cardiac autonomic neuropathy (CAN) is a severe complication of diabetes mellitus (DM) strongly linked to a nearly five-fold higher risk of cardiovascular mortality. Patients with Type 2 Diabetes Mellitus (T2DM) are a significant cohort in which these assessments have particular relevance to the increased cardiovascular risk inherent in the condition. Materials and Methods: This study aimed to explore the subtle correlation between the Ewing test, Sudoscan-cardiovascular autonomic neuropathy score, and cardiovascular risk calculated using SCORE 2 Diabetes in individuals with T2DM. The methodology involved detailed assessments including Sudoscan tests to evaluate sudomotor function and various cardiovascular reflex tests (CART). The cohort consisted of 211 patients diagnosed with T2DM with overweight or obesity without established ASCVD, aged between 40 to 69 years. Results: The prevalence of CAN in our group was 67.2%. In the study group, according SCORE2-Diabetes, four patients (1.9%) were classified with moderate cardiovascular risk, thirty-five (16.6%) with high risk, and one hundred seventy-two (81.5%) with very high cardiovascular risk. Conclusions: On multiple linear regression, the SCORE2-Diabetes algorithm remained significantly associated with Sudoscan CAN-score and Sudoscan Nephro-score and Ewing test score. Testing for the diagnosis of CAN in very high-risk patients should be performed because approximately 70% of them associate CAN. Increased cardiovascular risk is associated with sudomotor damage and that Sudoscan is an effective and non-invasive measure of identifying such risk. [ABSTRACT FROM AUTHOR]

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An increase in prevalence of gestational diabetes mellitus (GDM) was observed using new diagnostic criteria. We evaluated the prevalence of GDM in a population of pregnant women (109 women with gestational age of 24-28 weeks) and risk factors for GDM, such as maternal obesity and weight gain. The evaluation of each patient included an oral glucose tolerance test (OGTT) using the new diagnostic criteria of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) for GDM, 2D ultrasounds and the registration of risk factors. The prevalence of GDM in the age group ≥30 years was 11.9%, which is comparable to the results of other studies. The relative risk (RR) for GDM was 1.738 (95% CI 0.630-4.795) in women over 30 years and 3.782 (95% CI 1.127-12.686) in women over 35. Weight gain in the group with GDM was significantly higher than in the group that included pregnant women without GDM (p

Abstract The persistence of an epidemic of obesity and type 2 diabetes suggests that new nutritional strategies are needed if the epidemic is to be overcome. A promising nutritional approach suggested by this thematic review is metabolic effect of low glycaemic-index diet. The currently available scientific literature shows that low glycaemic-index diets acutely induce a number of favorable effects, such as a rapid weight loss, decrease of fasting glucose and insulin levels, reduction of circulating triglyceride levels and improvement of blood pressure. The long-term effect of the combination of these changes is at present not known. Based on associations between these metabolic parameters and risk of cardiovascular disease, further controlled studies on low-GI diet and metabolic disease are needed.

Copyright of Farmacia is the property of Societatea de Stiinte Farmaceutice Romania and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Aims: Obesity is one of the most common co-morbidities in the world and is on the rise. This article aims to analyze the nutritional approaches of these patients, analyzing as many food patterns as possible. Material and Method: We analyzed the literature available in the fields of PubMed and Scopus using the following filters: obesity management, dietary patterns in obesity management, diets for weight loss, and lifestyle intervention among obese patients. We have selected articles published exclusively in English, between 2014 and 2020. Results: A multitude of dietary patterns are published in order to help obese patients lose weight, but the difficulty of this process and cardiovascular risk can be influenced by severe diets, intense hyper lipidic. Conclusions: The implementation of a healthy diet, through food re-education, could lead to a weight loss similar to different food patterns, not only without increasing mortality but with increasing the health status of the patient. [ABSTRACT FROM AUTHOR]

Introduction: The optimal management of overweight and obese patients should combine medical nutritional therapy with caloric restriction, physical activity, and cognitive-behavioral therapy. Material and Methods: We conducted an observational study, which included patients who underwent nutritional intervention to lose weight, in the Nutrislim nutrition and diabetes clinic, in Bucharest, between 2016 and 2018. The patients were adults, mostly women, overweight or obese and sedentary. After analyzing the eating patterns, nutritional therapy was adjusted for every patient in accordance with his/her needs. Results: Most of the patients were overweight (n=10). The eating patterns showed a protein consumption of 14.95% in women and 14.17% in men. Carbohydrates accounted for 43.72% of female's nutrition and 40.23% of male's nutrition. An important intake was from lipids (38.95% for women and 43.49% for men), of which polyunsaturated fat reached the lowest proportion (7.71% in women, 3.37% in men). Conclusions: Implementation of a healthy diet, which can remain a lifestyle intervention after the nutritional program ends, is the most beneficial for the patient. The weight loss is sustained by conserving the muscular mass. [ABSTRACT FROM AUTHOR]

Introduction: Diabetic peripheral neuropathy is a frequent complication and disability of diabetes mellitus that requires complex management. The importance of an early diagnosis is emphasized by the high risk of subsequent foot ulceration or amputation and an increase in the mortality rate. The aim of the study was to evaluate the utility of quantitative sensory testing in monitoring peripheral diabetic neuropathy and its correlation with micro- and macrovascular complications of diabetes mellitus. Material and Methods: We included 136 patients admitted to N. C. Paulescu National Institute for Diabetes, Nutrition and Metabolic Diseases over six months, and analyzed their clinical and paraclinical data using Excel and PSPP software. Each patient had quantitative sensory testing performed. Results: The group consisted of 61.03% males and 38.97% females, with a mean age of 55.97±15.2 years. Of them, 22.79% presented type 1 diabetes mellitus, 30.88% had type 2 diabetes mellitus, and 46.32% had insulin-treated type 2 diabetes mellitus, with a mean glycated hemoglobin of 9.64%±2.49% and a mean duration of diabetes mellitus of 11.94 years. Diabetes complications were diabetic peripheral neuropathy (68.38%), diabetic retinopathy (27.94%), chronic kidney disease (25.74%), atherosclerotic disease (38.24%). Diabetic peripheral neuropathy diagnosis positively correlated with age (p=0.031), body mass index (p<0.0001), albumin to creatinine ratio (p=0.049), presence of chronic kidney disease (p=0.01) and diabetic retinopathy (p=0.001), and diabetes duration (p<0.001). Conclusions: Diabetic peripheral neuropathy accounts for considerable morbidity and mortality and reduced quality of life. Clinical recognition is required for allowing early symptomatic management in order to reduce the morbidity associated with this condition. Quantitative sensory testing is used for screening and diagnosing diabetic peripheral neuropathy. Given the significant association with other microvascular complications, such as chronic kidney disease and diabetic retinopathy, neuropathy's diagnosis should immediately lead to screening for other complications of diabetes and certain risk factors and consequent measures. [ABSTRACT FROM AUTHOR]

Copyright of Farmacia is the property of Societatea de Stiinte Farmaceutice Romania and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Internal Medicine / Medicină Internă is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Aims. Insulin resistance is documented in type 1 diabetes and it has been associated with chronic complications. Diabetic nephropathy is a major cause of morbidity and mortality. The purpose of this article is to quantify insulin resistance in type 1 diabetes subjects according to the presence or absence of advanced renal disease. A secondary objective was to study the possible association between insulin resistance and advanced renal disease. Material and Methods. This was a cross-sectional study that included 167 type 1 diabetes patients. Insulin resistance was determined using the eGDR (estimated glucose disposal rate) formula. The association between eGDR and diabetic nephropathy was assessed in uni and multivariate models using stepwise logistic regression analysis of variables. The contribution of individual predictors in the final regression model was examined using Wald statistic. Results. Significantly lower eGDR's values were observed in patients with nephropathy: 5 vs. 7.3 (p<0.001). In univariate analysis eGDR was significantly associated with diabetic nephropathy (p<0.001). eGDR variable was retained in the final model of stepwise logistic regression (p<0.001) and showed the strongest association with diabetic nephropathy (Wald = 30.4). Conclusions. In type 1 diabetes patients insulin resistance was the most important independent risk factor associated with advanced renal disease. [ABSTRACT FROM AUTHOR]