<abstract><title style='display:none'>Abstract</title><bold>Introduction:</bold> Our article underlines the importance of a good professional anamnesis, knowing all the chemical components with which the patient had been exposed to during her active life as a teacher.<bold>Case presentation:</bold> A 64-year-old female patient, teacher for 27 years, who had been retired for six years, presented cough with white phlegm and shortness of breath occurring during physical exertion, diffuse thoracic pain, and fatigue. Several lung functional tests were performed, which established the diagnosis of irreversible minor mixed ventilatory dysfunction. In order to establish the etiology of the patient’s symptoms, multiple clinical, laboratory, imaging, and functional investigations were performed including a chest radiograph, pulmonary functional testing, bronchial reversibility testing, a thoracic CT scan, fibrobronchoscopy, alveolar-capillary diffusion capacity measurement, otorhinolaryngology examination, thyroid ultrasound, as well as a cardiological consult. Finally, a positive diagnosis was established: bronchial hyperreactivity syndrome, chalk dust-induced diffuse pulmonary fibrosis.<bold>Conclusion:</bold> An essential part of clinical practice is a proper anamnesis, including detailed information on the professional history and exposure, as well as the composition of the dust/particles with which the patient had been in contact with.</abstract>

Chalk-induced Lung Fibrosis — Case Report

<abstract><title style='display:none'>Abstract</title>Myocardial infarction with non-obstructive coronary arteries (MINOCA) has been defined as clinical presentation of an acute coronary syndrome with laboratory evidence of myocardial necrosis, but with coronary stenosis of less than 50% on coronary angiography. On the other side, myocarditis is an inflammatory response triggered by viral, bacterial, fungal, lymphocytic, eosinophilic, or autoimmune myocardial injury, which may be associated with elevated myocardial necrosis serum biomarkers. We present the case of a young male patient with acute chest pain, ST-segment elevation, and high-sensitivity troponin levels of 22,162 ng/L.</abstract>

A Case of Acute Myocardial Injury – MINOCA or Myocarditis?

<abstract><title style='display:none'>Abstract</title><bold>Introduction:</bold> Gallbladder hydrops is an increase in the volume of the gallbladder without any inflammatory sign, bacterial infection or the presence of any abnormalities of the biliary ducts or of the gallbladder.<bold>Case presentation:</bold> A 52-year-old man presented at the Department of Internal Medicine complaining of moderate intensity pain in the right upper quadrant, low fever, fatigue, general weakness, symptoms stemming from an excessive intake of food (a meal abundant in animal proteins, fats, and alcohol) which appeared following a 6-week period of food restriction. On examination, the patient presented a globular abdomen, sensitive to deep palpation in the right upper quadrant, the liver and spleen being impalpable. Blood tests performed on admission showed liver-specific pathological changes. Abdominal ultrasound revealed hepatomegaly with homogeneous echostructure, slightly increased echogenicity with rear attenuation, with no focal images, intrahepatic biliary duct dilatation, or dilated suprahepatic veins. The gallbladder looked dropsical, with slender walls, with images of hyperechoic infundibular calculi with a posterior shadow cone, the largest having 14 mm. The portal vein and bile duct were normal in appearance.<bold>Conclusions:</bold> Gallbladder hydrops is a disorder commonly seen in children. Its occurrence in adults is uncommon, moreover since it occurs simultaneously with an episode of acute toxic hepatitis. Surgery for this patient was possible only after normalization of liver function tests, on admission there being no subjective complaints of marked intensity that required immediate surgery.</abstract>

Department of Physiology, University of Medicine and Pharmacy, Tîrgu Mureș,

Department of Epidemiology, University of Medicine and Pharmacy, Tîrgu Mureș,

Department of Anatomy, University of Medicine and Pharmacy, Tîrgu Mureș,

Gallbladder Hydrops Associated with an Episode of Acute Liver Toxicity in the Adult: May It Be Considered a Surgical Emergency or Not?

<abstract>
<title style='display:none'>Abstract</title>
Coronary artery disease (CAD) represents one of the leading causes of morbidity and mortality across Europe. Most of the patients do not experience any warning sign before the coronary event develops, therefore screening this group of patients is essential to prevent major cardiac events. Coronary computed tomography angiography (CCTA) offers a noninvasive approach of the coronary arteries, providing information not only on the presence and severity of the coronary stenosis, but is also able to characterize the structure of the coronary wall. CCTA allows complex evaluation of the extension of CAD, and by assessing the structure of the atherosclerotic plaque, it can identify its degree of vulnerability. The napkin-ring sign (NRS) represents a ring-like attenuation of the non-calcified portion of the coronary lesion and has a high specificity (96–100%) for the identification of thin cap fibroatheroma (TCFA) or culprit lesion in acute coronary syndromes (ACS). It is also an independent predictor for ACS events and the strongest predictor for future ACS. Modern CCTA can provide submillimeter isotropic spatial resolution. Thus, CT attenuation-based tissue interpretation enables the assessment of total coronary plaque burden and individual plaque components, with a similar accuracy as intravascular ultrasoud-based investigations. This review aims to present the important role of CCTA as a potent screening tool for patients with CAD, and the current evidences in the detection and quantification of vulnerable plaques.
</abstract>

The Napkin-Ring Sign – the Story Behind Invasive Coronary Angiography

<abstract><title style='display:none'>Abstract</title><bold>Introduction:</bold> In the last 15 years, the most important revolution in dentistry has been the introduction and then the widespread adoption of the dental operating microscope. The <bold>aim</bold> of this study was to evaluate the usage of the dental operating microscope among young specialized and general practitioner dentists in Tîrgu Mureș.<bold>Material and Methods:</bold> A 9-point questionnaire about dental microscope usage was distributed among endodontists, practitioners of other specialties, and general practitioners with less than 10 years of experience.<bold>Results:</bold> According to our results, the dental operating microscope is used mainly during root canal therapy by endodontists. Practitioners of other specialties (prosthetists, alveolar dental surgeons, and orthodontists) use the microscope in a small percentage during coronal restoration, prosthetics, or periodontal surgery. Most general practitioners are not interested in using magnification in their practice.<bold>Conclusions:</bold> Endodontists use the dental operating microscope when they face complicated cases and have access to it. Working under magnification is awakening the interest of doctors of other specialties also. Private practices should invest in acquiring a microscope, and young general practitioners should be motivated in using it during dental treatments.</abstract>

The Usage of the Dental Operating Microscope among Young Dentists in Tîrgu Mureș: A Questionnaire Survey

<abstract><title style='display:none'>Abstract</title> Background: Previous studies regarding various types of malocclusions have found correlations between the angle of the base of the skull and prognathism. Aim of the study: This cephalometric study sought to investigate the function of the cranium base angle in different types of malocclusion on a group of Romanian subjects. Materials and methods: Forty-four cephalometric radiographs were selected from patients referred to orthodontic treatment. The cephalometric records were digitized, and with the CorelDRAW Graphics Suite X5 software 22 landmarks have been marked on each radiograph. A number of linear and angular variables were calculated. Results: The angle of the base of the skull was found to be higher in Class II Division 1 subjects compared to the Class I group. The cranial base lengths, N-S and S-Ba, were significantly larger in both categories of Class II malocclusion than in Class I patients, but measurements were comparable in Class I and Class III. The SNA angle showed no considerable variation between Class I subjects and the other groups. SNA-SNP was significantly increased above Class I values in Class II Division1 and Class II Division 2 groups. No significant dissimilarities were observed for these lengths between Class I and Class III patients. Conclusions: The angle of the cranium base (S-N-Ba, S-N-Ar) does not have a major role in the progression of malocclusion. In Angle Class II malocclusion the SNA angle is increased, and SNB is increased in malocclusion Class III. The anterior skull base length is increased in Class II anomalies. The length of the maxillary bone base is increased in Class II malocclusions type; in Class III type of malocclusion the length of the mandible bone is increased.</abstract>

Department of Orthodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy, Str. Gheorghe Marinescu nr. 38 540139, Tîrgu Mureș,

Department of Pedodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy, Str. Gheorghe Marinescu nr. 38 540139, Tîrgu Mureș,

Original Research. Correlation Between Cranial Base Morphology And Various Types Of Skeletal Anomalies

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>Introduction</title>
Drug-induced gingivitis is caused by the administration of certain drugs such as hydantoin, calcium blockers, beta-blockers, cyclosporine, and oral contraceptives. The aim of this study was to evaluate the modifications linked to drug-induced gingivitis such as changes in color, volume, and consistency, and the clinical signs of periodontal disease.
</sec>
<sec><title style='display:none'>Materials and methods</title>
The study was based on a questionnaire made up of 14 questions, formulated using colloquial language to increase addressability.
</sec>
<sec><title style='display:none'>Results</title>
The most frequently used drugs were beta-blockers (37%), calcium channel blockers (33%), followed by anticonvulsants (18%), oral contraceptives (8%) and cyclosporine (4%). Color changes occurred in 81% of anticonvulsant treatments and 57% of oral contraceptives. Increases in the gingival volume were higher with anticonvulsants (73%) followed by cyclosporine (67%). Gingival consistency was higher with anticonvulsant treatments (90%), followed by calcium channel blockers (60%). Gingival changes and gingival bleeding during brushing were higher with anticonvulsant treatments, followed by beta-blocker medication. Spontaneous gingival bleeding had a higher prevalence in anticonvulsant treatments, followed by cyclosporine.
</sec>
<sec><title style='display:none'>Conclusions</title>
The patients most affected by gingival enlargement were those under hydantoin treatment, followed by cyclosporine. Calcium channel blockers and beta-blockers had similar effects on gingival pathology. The intensity of the pathological changes that occurred secondary to the administration of these drugs was influenced by the dose, the duration of the treatment, and the association of several drugs. Early detection and management of gingival enlargement is important in order to allow patients to continue with their therapy, and also to increase their quality of life.
</sec>
</abstract>

Drug-Induced Changes in the Gingival Tissue

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>Introduction</title>
During the COVID-19 pandemic, vitamin D was used along with vitamin C and zinc as a preventive and curative therapy against SARS-CoV-2 infection. Vitamin D toxicity, even if it is rare, occurs when serum concentrations exceed 150 ng/mL and is usually manifested by hypercalcemia phenomena.
</sec>
<sec><title style='display:none'>Case report</title>
We hereby report a case of two twin sisters who self-medicated with vitamin D in a dose of 4 × 4,000 IU/day for almost 10 months as a method of ‘protection’ against COVID-19, influenced by mass media advertising. The patients presented to the emergency department with hypervitaminosis D-related symptoms such as hypertension, headache, nausea, vomiting, and diffuse abdominal pain. Laboratory investigations revealed high levels of vitamin D and calcium.
</sec>
<sec><title style='display:none'>Conclusions</title>
Vitamin D toxicity can lead to difficulties in positive and differential diagnosis because of the multiple complications of hypercalcemia.
</sec>
</abstract>

Vitamin D Toxicity Due to Self-Medication During the COVID-19 Pandemic – a Case Report

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>Background</title>
Migraine, a primary headache disorder, is a debilitating condition with reduced productivity, increased disability, and a very high economic burden. The present study aimed to individualize the treatment protocols for episodic and chronic migraine in order to reduce the duration, frequency, and severity of attacks, as well as the disability associated with migraine by comparing monotherapy and dual therapy.
</sec>
<sec><title style='display:none'>Materials and Methods</title>
We conducted a prospective observational study between February 2019 and July 2021. Patients were diagnosed with migraine based on simplified diagnostic criteria. Episodic migraine was present in 62% and chronic migraine in 38% of cases. Disability due to headache was assessed using the Migraine Disability Assessment Score (MIDAS) questionnaire. Prophylactic therapy was individualized, with 210 patients receiving monotherapy (propranolol, flunarizine, or valproic acid) and 190 patients receiving dual therapy (propranolol and flunarizine, or valproic acid and flunarizine). Disability at baseline was graded from I to IV, and improvement after treatment was graded as no recurrence of headache, grade I, grade II, and grade III.
</sec>
<sec><title style='display:none'>Results</title>
After 2–3 months of therapy, we observed significant improvement in the form of reduction in the frequency of attacks and reduction of disability. Patients with grade II disability who received dual therapy showed 100% improvement with no recurrence of headaches. Treatment with valproic acid resulted in no recurrence in 100% of patients with grade I and 85.7% of patients with grade II disability scores. Significant improvement was observed in all grades of disability with dual therapy.
</sec>
<sec><title style='display:none'>Conclusion</title>
Dual prophylactic therapy was more efficient than monotherapy in reducing the frequency, duration, and severity of symptoms in grade III and grade IV patients.
</sec>
</abstract>

Dual versus Monotherapy in the Prophylaxis of Acute and Chronic Migraine

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>Background</title>
3D printing has changed the paradigm of personalized medicine. Similarly to fingerprints, there are no two identical hearts; consequently, in cardiology, diagnosis and treatment, either medical, interventional or surgical, must be individualized according to the specific problem of a particular patient.
</sec>
<sec>
<title style='display:none'>The <bold>aim</bold></title> of this proof-of-concept study was to analyze two measurement methods, the planimetric and the photogrammetric method, in the process of creating a 3D-printed model from cardiac computed tomography angiography images and to evaluate the accuracy of an aortic valve anatomical model.
</sec>
<sec><title style='display:none'>Material and methods</title>
Cardiac computed tomography images, obtained from 20 patients with severe aortic stenosis, underwent stereolithographic reconstruction using 3D Slicer to create digital 3D models of the aortic valves. Serial measurements of six key elements of the aortic valvular apparatus were measured on the 3D model and compared to the measurements taken on the 2D computed tomography images.
</sec>
<sec><title style='display:none'>Results</title>
The differences between the two measurement methods were sub-millimetric in case of the left ventricular outflow tract and the sinotubular junction, and 1.386 mm for the left sinus of Valsalva (p = 0.0412), 0.3476 mm for the right sinus of Valsalva (p = 0.1874), and 0.6905 mm for the non-coronary Valsalva sinuses (p = 0.1353). Sinus heights were also similar, with a difference of 0.0119 mm (p = 0.6521).
</sec>
<sec><title style='display:none'>Conclusion</title>
In this study, the results of digital photogrammetry were superimposable to those of computed tomography scan measurements. The accuracy of each 3D-printed model depends on geometric complexity, the level of training of the personnel, and on the resources of each 3D printing laboratory.
</sec>
</abstract>

Accuracy of 3D-Printed Models of Aortic Valves – a Comparative Analysis Between Planimetric and Photogrammetric Measurements

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>Background</title>
The study was aimed to evaluate whether a mechanical biaxial tester can be used in a uniaxial mode to evaluate the mechanical properties of tendons.
</sec>
<sec><title style='display:none'>Materials and methods</title>
The study was carried out on specimens of porcine superficial digital flexor tendon (n = 9). The mechanical properties (elastic modulus, and stress at 15% strain) were measured two times consecutively in the uniaxial mode with the BioTester® 5000 (CellScale) equipment.
</sec>
<sec><title style='display:none'>Results</title>
Values of 0.313 ± 0.096 MPa for the elastic (Young’s) modulus and of 0.702 ± 0.174 MPa for the stress (at 15% strain) were measured, indicating that the porcine superficial digital flexor tendon is not a strong tendon.
</sec>
<sec><title style='display:none'>Conclusions</title>
When suitable specimens cannot be obtained for a biaxial evaluation, tendons can be evaluated mechanically in the BioTester® 5000 employing the uniaxial mode.
</sec>
</abstract>

Biomechanical Uniaxial Analysis of Porcine Tendon in the CellScale BioTester® 5000

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>Introduction</title>
Sweet syndrome, also called acute febrile neutrophilic dermatosis, is a rare disorder characterized by skin lesions accompanied by high fever and elevated inflammatory markers.
</sec>
<sec><title style='display:none'>Case Presentation</title>
In January 2023, a 73-year-old Caucasian male was diagnosed with acute myeloblastic leukemia and subsequently chemotherapy with azacitidine and venetoclax was initiated. One week after the second round of chemotherapy with azacitidine, the patient developed a fever of 39˚C. Physical examination revealed purple plaques on the skin of the head, neck, and arms associated with pain but not itching. Initially, the plaques appeared at the site of the subcutaneous azacitidine injection (left upper extremity) and then began to spread. The infectious diseases consultation established the diagnosis of multiple abscesses. Antibiotic therapy was initiated with meropenemum and linezolidum, and later colistin was associated, but the skin lesions and the patient’s condition worsened. A dermatology consultation was performed, which established the diagnosis of Sweet syndrome, and subsequently corticosteroid therapy was started. The skin lesions started to improve after 3 days.
</sec>
<sec><title style='display:none'>Conclusions</title>
Sweet syndrome is a rare condition that is difficult to diagnose because of the wide spectrum of differential diagnoses.
</sec>
</abstract>

Sweet Syndrome in a Patient with Acute Leukemia on Azacitidine and Venetoclax Treatment

<abstract><title style='display:none'>Abstract</title>Science is becoming more challenging, not only for scientists, but also for editors and publishers. Faced with limited funding within an expanding economic crisis, competition between scientists is increasing. The struggle for professional survival is leading some to revert to dishonest tactics to get ahead of the pack and cheating or fraud may be involved. Confronted with these new realities, which have become more debatable within the public arena, mainly as a result of an increase in blogs and social media, editors and publishers are reinforcing current publishing platforms in a bid to reduce the risks and to fortify their journals against future submission- and fraud-related problems. Ultimately, this places greater scrutiny — and stress — on the authorship, leading to an increase in militarization. At some point — which certain hints already indicate — the criminalization of science will begin as publishers fail to curtail fraud.</abstract>

The Militarization of Science, and Subsequent Criminalization of Scientists

<abstract><title style='display:none'>Abstract</title>Wound healing is a complex restorative process of the altered cutaneous tissue, which is impaired by numerous local and systemic factors, leading to chronic non-healing lesions with few efficient therapeutic options. Stem cells possess the capacity to differentiate into various types of cell lines. Furthermore, stem cells are able to secrete cytokines and growth factors, modulating inflammation and ultimately leading to angiogenesis, fibrogenesis, and epithelization. Because of their paracrine activity, these cells are able to attract other cell types to the base of the wound, improving the formation of new skin layers. Mesenchymal stem cells derived from the adipose tissue, bone marrow, and placenta, offer numerous ways of implementation. The process of harvesting, growing, and administrating stem cells depends on the site and type of the cells, but recent trial results showed improvement of wound healing independent of the administration site. Bioengineered skin substitutes are validated for treatment of chronic wounds with direct application on the skin surface. These offer physical scaffolding for the migrating cells and promote secretion of growth factors, thus facilitating rapid wound healing. Obtaining further clinical data is essential, but stem cell therapy may become a first-line therapeutic choice for the treatment of non-healing chronic wounds.</abstract>

Stem Cell Therapy in Wound Healing

<abstract><title style='display:none'>Abstract</title><bold>Background:</bold> Chondral and osteochondral injuries of the knee joint are undervalued in subjects undergoing orthopedic surgery. Chondral lesions are difficult to diagnose as they do not present specific clinical signs. The objective of the study was to establish the prevalence of cartilage injuries in patients undergoing arthroscopy of the knee for knee pain or instability.<bold>Materials and methods:</bold> A retrospective study was conducted on 355 consecutive knee arthroscopies. Chondral lesions were found in 247 (69.6%) cases. Regarding their location, chondral lesions were more likely to be located on the medial femoral condyle (53.8%), while lesions on the lateral femoral condyle alone (0.8%) were the least frequent ones. Chondral injuries were frequently found with associated articular findings such as meniscal lesions (56.68%) and anterior cruciate ligament tears (2.84%) or both menisci and anterior cruciate ligament tear (15.38%). The ICRS grade II cartilage lesions were most frequently diagnosed (56.3%) while grade IV was the least frequent type (6.9%).<bold>Conclusions:</bold> Chondral damage is frequently diagnosed during knee arthroscopy, present in more than 50% of the arthroscopies performed for various indications, and an important part of cartilage injuries were linked with other intraarticular findings, such as anterior cruciate ligament tear and medial meniscus tear.</abstract>

Prevalence of Chondral Lesions in Knee Arthroscopy

<abstract><title style='display:none'>Abstract</title> Periodontal disease is a chronic inflammatory disease that results from the activity of altered oral microbiome, leading to altered immune reaction, destruction of tissues supporting the teeth, and oral bone loss. This disease is particularly associated with an expressed systemic inflammation, being considered nowadays an inflammatory disorder. At the same time, inflammation has been recognized to play a major role in the development of atherosclerotic lesions. Atheromatous plaque formation is triggered by alterations in the structure of the endothelium, which lead to the expression of adhesion molecules and recruitment of immune cells such as macrophages, in the arterial wall. While the association between periodontal disease, inflammation and cardiovascular diseases has been well established, the causality relation between these three entities has not been demonstrated so far. This review presents the most common advances in understanding the complex link between periodontal disease, inflammation and atherosclerosis, as a common pathway leading to increased cardiovascular risk.</abstract>

Review. The Link between Periodontal Disease, Inflammation and Atherosclerosis — an Interdisciplinary Approach

<abstract><title style='display:none'>Abstract</title><bold>Background:</bold> Totaling about 60% of all causes of death, chronic illnesses are the main cause of global mortality. Unhealthy behaviors, such as unbalanced eating or insufficient physical activity, can trigger metabolic changes, manifested by hypertension, high blood sugar, hyperlipidemia, obesity. These changes are grouped into the category of metabolic risk factors. Over time, these factors can cause cardiovascular diseases associated with a high mortality rate.<bold>Aim of the study:</bold> To evaluate the perception of healthy eating in a Romanian population.<bold>Material and methods:</bold> We applied a validated online questionnaire aimed to investigate people’s attitude towards diet and their motivation regarding food consumption in ten countries, based on an international project. For the present paper, we evaluated a Romanian sample of 821 adult respondents.<bold>Results:</bold> Most of the subjects (82.82%) were from an urban area, and 68.94% were women. Regarding the prevalence of chronic diseases, 3.53% of participants had cardiovascular disease, 6.69% had high cholesterol levels, 7.18% were obese, and 6.57% were suffering from high blood pressure. Significant correlations have been identified between calorie count, excessive sugar and salt consumption, gender variables, cardiovascular disease, obesity, and high blood pressure. Also, tradition is very important in relation to eating behaviors, being highly correlated with obesity. The general direction of answers was correct, even if half of the questionnaire items were formulated in a ‘negative’ way, and disagreement is needed for a consistent response with a correct perception of healthy diets. The overall perception of healthy eating was consistent with scientific information in the field.<bold>Conclusion:</bold> Women are generally better informed than men regarding healthy eating. Also, there is a possible conflict between traditional food-related cultural values and modern nutritional guidelines based on scientific information.</abstract>

Perception of Healthy Eating among Romanian Adults

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Journal of Interdisciplinary Medicine

 The Journal of Interdisciplinary Medicine aims to publish top quality papers related to any fields of medicine that present an interdisciplinary dimension.  The journal...

 The Journal of Interdisciplinary Medicine aims to publish top quality papers related to any fields of medicine that present an...

Journal of Interdisciplinary Medicine

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