Periodontitis, a prevalent oral condition, is facing difficulties in therapeutic approaches, some... more Periodontitis, a prevalent oral condition, is facing difficulties in therapeutic approaches, sometimes leading to failure. This literature review was conducted to investigate the diversity of other therapeutic approaches and their potential contributions to the successful management of the disease. This research scrutinized the alterations in microbial diversity and imbalances in crucial microbial species, which contribute significantly to the pathogenesis of periodontitis. Within the limitations of this study, we highlight the importance of understanding the treatment plan's role in periodontitis disease, opening the way for further research and innovative treatment plans to mitigate the impact of periodontitis on oral health. This will aid both healthcare professionals and patients in preventing and effectively treating periodontitis, ultimately improving oral health outcomes and overall systemic health and well-being.
Life-threatening injuries represent those types of lesions that certainly lead to the victim’s de... more Life-threatening injuries represent those types of lesions that certainly lead to the victim’s death if no qualified medical care is applied in due time. We hold important the aspect of imminent danger, and that the lesion, in its natural way of evolution, will determine the person’s death, his life being saved only by a qualified medical intervention. The juridical correspondent is represented in article 194: bodily harm - The new criminal code and the new criminal procedure code. The authors review and comment on the main particular aspects of life-threatening traumas, based on topography, anatomical aspects and forensic interpretation, in order to offer arguments to be incorporated from a medico-legal point of view, reported to the criteria of life-threatening conditions. We shall illustrate the subject by 6 case reports.
Introduction: The compressed air weapon is a type of arm to which the projectile is propelled due... more Introduction: The compressed air weapon is a type of arm to which the projectile is propelled due to the compression of air in a sealed chamber. These types of weapons belong to the category of non-lethal weapons and ammunition subject to authorization. However, accidental fatal cases, suicides or even deaths with intention attributed to these types of weapons are described in the literature. Case presentation: We are discussing the case of a 5-year-old boy who, at a picnic with several families, is shot and killed with a compressed air rifle, left unattended. The medical crew arrived at the scene could not save the boy's life. Necroptic examination revealed a gunshot wound through the heart, with the projectile stuck in the lateral-internal wall of the right ventricle. The projectile identified was a metal type projectile (lead), with a length of 8.5 mm and a diameter of 4.5 mm. Conclusions: Compressed air weapons, although considered non-lethal, have proven over time their extremely dangerous potential through the fatal injuries produced. Raising public awareness, limiting use and enforcing strict legislation could prevent tragic events.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Sudden cardiac death (SCD) is the leading cause of mortality globally (violent or non-violent), w... more Sudden cardiac death (SCD) is the leading cause of mortality globally (violent or non-violent), with few to no feasible remedies. The etiopathogenesis of SCD involves a complex and multilayered substrate in which dynamic factors interact with a preexistent cardiovascular pathology, which is often undiagnosed and untreated, leading to the rapid development of cardiac rhythm disorders and cardiac arrest. Cardiovascular disease is a rare but emerging factor in maternal mortality that can be justified by an upward trend in the mean age of pregnant individuals. Spontaneous coronary artery dissection (SCAD) is defined as a non-traumatic and non-iatrogenic separation of the coronary arterial wall by intramural hemorrhage with or without an intimal tear. The resulting intramural hematoma compresses the coronary arteries, reducing blood flow and causing myocardial ischemia. SCAD continues to be misdiagnosed, underdiagnosed, and managed as an atherosclerotic acute coronary syndrome, which may...
Background: Sudden cardiac death (SCD) is a significant global public health issue and the leadin... more Background: Sudden cardiac death (SCD) is a significant global public health issue and the leading cause of death worldwide. Its etiopathogenesis is complex and multilayered, involving dynamic factors interacting with a preexistent cardiovascular pathology, frequently unknown, and resulting in cardiac rhythm disorders and cardiac arrest; Methods: This study conducted a retrospective descriptive analysis over a one-year period, identifying 321 autopsy cases of sudden deaths from the Institute of Legal Medicine in Mures County, Romania, in 2019. From the 321 sudden death cases, 189 autopsy reports were selected for analysis based on inclusion and exclusion; Results: The autopsies had a mean age of 61.16 years and included 140 males and 49 females. No significant differences were found between the silent myocardial infarction (SMI) and no-SMI groups regarding demographic data. The SMI group exhibited higher thickness of LV (left ventricle), IV (interventricular septum), EAT LCx (epicar...
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Thymoma is the most common tumor of the anterior mediastinum originating from epithelial thymic c... more Thymoma is the most common tumor of the anterior mediastinum originating from epithelial thymic cells. The tumors are often asymptomatic or with non specific symptoms. We present herein three cases admitted in our surgical for mediastinal tumor. The imagery exams revealed thymomas with lateral and paracardiac evolvement. Intraoperatively, we found tumors in closed contact with the pericardium, developed posterior to the phrenic nerve. In all cases, we performed complete excision of the tumors using a posterolateral thoracotomy. Frozen section was inconclusive in all cases; the final pathological exam diagnosed stage I thymoma. The postoperative course was uneventful for all three patients. The long term follow-up (14 years) revealed no recurrence.
Background: In sudden cardiac deaths (SCD), visceral adipose tissue has begun to manifest interes... more Background: In sudden cardiac deaths (SCD), visceral adipose tissue has begun to manifest interest as a standalone cardiovascular risk factor. Studies have shown that epicardial adipose tissue can be seen as a viable marker of coronary atherosclerosis. This study aimed to evaluate, from a forensic perspective, the correlation between body mass index (BMI), heart weight, coronary and valvular atherosclerosis, left ventricular morphology, and the thickness of the epicardial adipose tissue (EAT) in sudden cardiac deaths, establishing an increased thickness of EAT as a novel risk factor. Methods: This is a retrospective case–control descriptive study that included 80 deaths that were autopsied, 40 sudden cardiac deaths, and 40 control cases who hanged themselves and had unknown pathologies prior to their death. In all the autopsies performed, the thickness of the epicardial adipose tissue was measured in two regions of the left coronary artery, and the left ventricular morphology, macro...
Cuvinte cheie: hernie hiatală, 8 fire, boala de reflux gastro-esofagian, volvulus gastric Rezumat... more Cuvinte cheie: hernie hiatală, 8 fire, boala de reflux gastro-esofagian, volvulus gastric Rezumat: Managementul chirurgical al herniilor hiatale și a refluxului gastroesofagian necesită o corecție fără tensiune, cu un control adecvat al bolii de reflux. Autorii își prezintă propria tehnică operatorie patentată de profesorul Boțianu, ce folosește ca și cale de abord toracofrenotomia stângă. Prin această tehnică simplă și rapidă, fără a folosi material protetic, evitând astfel respingerea grefei, întreg ansamblul este fixat sub cupola diafragmatică. Abstract: Surgical management of hiatal hernias and complex gastroesophageal reflux disease (GERD) requires a tension free repair with reliable reflux control. The authors would like to emphasize their own technique patented by Professor Boțianu, performed through a left thoracophrenotomy Through this simple and quick technique and without using a synthetic mesh thus avoiding rejection, the whole ensemble is fixed under the diaphragm., Tel...
Rezumat: Severitatea endemiei tuberculoase din țara noastră rezultă din complexitatea unor cazuri... more Rezumat: Severitatea endemiei tuberculoase din țara noastră rezultă din complexitatea unor cazuri chirurgicale care ajung deseori în servicii de chirurgie, necesitând un management medico-chirurgical complex. Prezentăm cazul unui pacient în vârstă de 56 de ani, cunoscut în antecedente cu pleurezie dreaptă de etiologie tuberculoasă, cu o cavitate reziduală cu pereți calcari suprainfectată după o toracoplastie limitată și insuficientă C4-C7 efectuată în altă clinică de chirurgie toracică. Pentru desființarea acestei cavități s-a ales o soluție complexă, constând într-o toracopleuroplastie iterativă Boțianu pe 6 coaste într-un singur timp operator, cu sistem de irigație -aspirație în circuit închis, asociată cu plombaj muscular cu mare dorsal și dințat anterior pe pedicolul vascular comun și lambouri intercostale. Evoluția postoperatorie a fost favorabilă, cu obliterarea completă și definitivă a cavității și externare la 34 zile.
Surgical management of hiatal hernias and complex gastroesophageal reflux disease (GERD) requires... more Surgical management of hiatal hernias and complex gastroesophageal reflux disease (GERD) requires a tension free repair with reliable reflux control. The authors would like to emphasize their own technique patented by Professor Boțianu, performed through a left thoracophrenotomy Through this simple and quick technique and without using a synthetic mesh thus avoiding rejection, the whole ensemble is fixed under the diaphragm. Cuvinte cheie: hernie hiatală, 8 fire, boala de reflux gastro-esofagian, volvulus gastric Rezumat: Managementul chirurgical al herniilor hiatale și a refluxului gastroesofagian necesită o corecție f ă r ă tensiune cu un control adecvat al bolii de reflux. Autorii i și prezint ă propria tehnică operatorie patentată de profesorul Boțianu, ce folose ște ca și cale de abord toracofrenotomia stângă. Prin această tehnică simplă și rapidă, fără a folosi material protetic, evitând astfel respingerea grefei, intreg ansamblul este fixat sub cupola diafragmatică.
The severity of tuberculosis as an endemic malady in our country is a consequence of the complexi... more The severity of tuberculosis as an endemic malady in our country is a consequence of the complexity of surgical cases which often reach service as serious surgical emergencies, requiring a complex surgical management. We are reporting the case of a 56-year old patient, whose right pleural tuberculosis etiology is known, having a residual cavity with limestone walls which got infected after a limited and insufficient C4-C7 thoracoplasty performed in another thoracic surgery clinic. A complex solution was chosen in order to eliminate this cavity, consisting of an iterative thoracopleuroplasty. Boţianu, on six ribs in a single-operator real-time, with a closed-circuit suction-irrigation system, associated with the transposition of latissimus dorsi muscle and serratus anterior on a common vascular pedicle and intercostal flap. The postsurgery course was favourable, the cavity being eliminated permanently and completely within 34 days. Rezumat: Severitatea endemiei tuberculoase din țara ...
Objective: The main objective of this study is to evaluate the medico-legal aspects of fatal road... more Objective: The main objective of this study is to evaluate the medico-legal aspects of fatal road traffic accidents. Methods: This is a retrospective study consisting of 80 forensic autopsies performed at the Institute of Legal Medicine – Tîrgu Mureș, Romania during a two years period, between January 1st, 2016 to December 31st, 2017. The information obtained was based on the medical records and the evaluation of autopsy reports. Results: Male victims involved in road traffic accidents were nearly three times more numerous than women (72.5% vs. 27.5%). Divided into 3 age groups (under 35 years old, 36-59 years old and over 60 years old) we noticed a relatively uniform distribution of the victims, with a slight dominance of the 36-59 age group and the over 60 years of age group. The highest number of victims was among the pedestrians (36.25%), followed in decreasing order by the drivers (33.75%), passengers (17.5%), cyclists (7.5%) and motorcyclists (5%). Positive alcohol testing was...
Life-threatening injuries represent those types of lesions that certainly lead to the victim’s de... more Life-threatening injuries represent those types of lesions that certainly lead to the victim’s death if no qualified medical care is applied in due time. We hold important the aspect of imminent danger, and that the lesion, in its natural way of evolution, will determine the person’s death, his life being saved only by a qualified medical intervention. The juridical correspondent is represented in article 194: bodily harm - The new criminal code and the new criminal procedure code. The authors review and comment on the main particular aspects of life-threatening traumas, based on topography, anatomical aspects and forensic interpretation, in order to offer arguments to be incorporated from a medico-legal point of view, reported to the criteria of life-threatening conditions. We shall illustrate the subject by 6 case reports.
Periodontitis, a prevalent oral condition, is facing difficulties in therapeutic approaches, some... more Periodontitis, a prevalent oral condition, is facing difficulties in therapeutic approaches, sometimes leading to failure. This literature review was conducted to investigate the diversity of other therapeutic approaches and their potential contributions to the successful management of the disease. This research scrutinized the alterations in microbial diversity and imbalances in crucial microbial species, which contribute significantly to the pathogenesis of periodontitis. Within the limitations of this study, we highlight the importance of understanding the treatment plan's role in periodontitis disease, opening the way for further research and innovative treatment plans to mitigate the impact of periodontitis on oral health. This will aid both healthcare professionals and patients in preventing and effectively treating periodontitis, ultimately improving oral health outcomes and overall systemic health and well-being.
Life-threatening injuries represent those types of lesions that certainly lead to the victim’s de... more Life-threatening injuries represent those types of lesions that certainly lead to the victim’s death if no qualified medical care is applied in due time. We hold important the aspect of imminent danger, and that the lesion, in its natural way of evolution, will determine the person’s death, his life being saved only by a qualified medical intervention. The juridical correspondent is represented in article 194: bodily harm - The new criminal code and the new criminal procedure code. The authors review and comment on the main particular aspects of life-threatening traumas, based on topography, anatomical aspects and forensic interpretation, in order to offer arguments to be incorporated from a medico-legal point of view, reported to the criteria of life-threatening conditions. We shall illustrate the subject by 6 case reports.
Introduction: The compressed air weapon is a type of arm to which the projectile is propelled due... more Introduction: The compressed air weapon is a type of arm to which the projectile is propelled due to the compression of air in a sealed chamber. These types of weapons belong to the category of non-lethal weapons and ammunition subject to authorization. However, accidental fatal cases, suicides or even deaths with intention attributed to these types of weapons are described in the literature. Case presentation: We are discussing the case of a 5-year-old boy who, at a picnic with several families, is shot and killed with a compressed air rifle, left unattended. The medical crew arrived at the scene could not save the boy's life. Necroptic examination revealed a gunshot wound through the heart, with the projectile stuck in the lateral-internal wall of the right ventricle. The projectile identified was a metal type projectile (lead), with a length of 8.5 mm and a diameter of 4.5 mm. Conclusions: Compressed air weapons, although considered non-lethal, have proven over time their extremely dangerous potential through the fatal injuries produced. Raising public awareness, limiting use and enforcing strict legislation could prevent tragic events.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Sudden cardiac death (SCD) is the leading cause of mortality globally (violent or non-violent), w... more Sudden cardiac death (SCD) is the leading cause of mortality globally (violent or non-violent), with few to no feasible remedies. The etiopathogenesis of SCD involves a complex and multilayered substrate in which dynamic factors interact with a preexistent cardiovascular pathology, which is often undiagnosed and untreated, leading to the rapid development of cardiac rhythm disorders and cardiac arrest. Cardiovascular disease is a rare but emerging factor in maternal mortality that can be justified by an upward trend in the mean age of pregnant individuals. Spontaneous coronary artery dissection (SCAD) is defined as a non-traumatic and non-iatrogenic separation of the coronary arterial wall by intramural hemorrhage with or without an intimal tear. The resulting intramural hematoma compresses the coronary arteries, reducing blood flow and causing myocardial ischemia. SCAD continues to be misdiagnosed, underdiagnosed, and managed as an atherosclerotic acute coronary syndrome, which may...
Background: Sudden cardiac death (SCD) is a significant global public health issue and the leadin... more Background: Sudden cardiac death (SCD) is a significant global public health issue and the leading cause of death worldwide. Its etiopathogenesis is complex and multilayered, involving dynamic factors interacting with a preexistent cardiovascular pathology, frequently unknown, and resulting in cardiac rhythm disorders and cardiac arrest; Methods: This study conducted a retrospective descriptive analysis over a one-year period, identifying 321 autopsy cases of sudden deaths from the Institute of Legal Medicine in Mures County, Romania, in 2019. From the 321 sudden death cases, 189 autopsy reports were selected for analysis based on inclusion and exclusion; Results: The autopsies had a mean age of 61.16 years and included 140 males and 49 females. No significant differences were found between the silent myocardial infarction (SMI) and no-SMI groups regarding demographic data. The SMI group exhibited higher thickness of LV (left ventricle), IV (interventricular septum), EAT LCx (epicar...
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Thymoma is the most common tumor of the anterior mediastinum originating from epithelial thymic c... more Thymoma is the most common tumor of the anterior mediastinum originating from epithelial thymic cells. The tumors are often asymptomatic or with non specific symptoms. We present herein three cases admitted in our surgical for mediastinal tumor. The imagery exams revealed thymomas with lateral and paracardiac evolvement. Intraoperatively, we found tumors in closed contact with the pericardium, developed posterior to the phrenic nerve. In all cases, we performed complete excision of the tumors using a posterolateral thoracotomy. Frozen section was inconclusive in all cases; the final pathological exam diagnosed stage I thymoma. The postoperative course was uneventful for all three patients. The long term follow-up (14 years) revealed no recurrence.
Background: In sudden cardiac deaths (SCD), visceral adipose tissue has begun to manifest interes... more Background: In sudden cardiac deaths (SCD), visceral adipose tissue has begun to manifest interest as a standalone cardiovascular risk factor. Studies have shown that epicardial adipose tissue can be seen as a viable marker of coronary atherosclerosis. This study aimed to evaluate, from a forensic perspective, the correlation between body mass index (BMI), heart weight, coronary and valvular atherosclerosis, left ventricular morphology, and the thickness of the epicardial adipose tissue (EAT) in sudden cardiac deaths, establishing an increased thickness of EAT as a novel risk factor. Methods: This is a retrospective case–control descriptive study that included 80 deaths that were autopsied, 40 sudden cardiac deaths, and 40 control cases who hanged themselves and had unknown pathologies prior to their death. In all the autopsies performed, the thickness of the epicardial adipose tissue was measured in two regions of the left coronary artery, and the left ventricular morphology, macro...
Cuvinte cheie: hernie hiatală, 8 fire, boala de reflux gastro-esofagian, volvulus gastric Rezumat... more Cuvinte cheie: hernie hiatală, 8 fire, boala de reflux gastro-esofagian, volvulus gastric Rezumat: Managementul chirurgical al herniilor hiatale și a refluxului gastroesofagian necesită o corecție fără tensiune, cu un control adecvat al bolii de reflux. Autorii își prezintă propria tehnică operatorie patentată de profesorul Boțianu, ce folosește ca și cale de abord toracofrenotomia stângă. Prin această tehnică simplă și rapidă, fără a folosi material protetic, evitând astfel respingerea grefei, întreg ansamblul este fixat sub cupola diafragmatică. Abstract: Surgical management of hiatal hernias and complex gastroesophageal reflux disease (GERD) requires a tension free repair with reliable reflux control. The authors would like to emphasize their own technique patented by Professor Boțianu, performed through a left thoracophrenotomy Through this simple and quick technique and without using a synthetic mesh thus avoiding rejection, the whole ensemble is fixed under the diaphragm., Tel...
Rezumat: Severitatea endemiei tuberculoase din țara noastră rezultă din complexitatea unor cazuri... more Rezumat: Severitatea endemiei tuberculoase din țara noastră rezultă din complexitatea unor cazuri chirurgicale care ajung deseori în servicii de chirurgie, necesitând un management medico-chirurgical complex. Prezentăm cazul unui pacient în vârstă de 56 de ani, cunoscut în antecedente cu pleurezie dreaptă de etiologie tuberculoasă, cu o cavitate reziduală cu pereți calcari suprainfectată după o toracoplastie limitată și insuficientă C4-C7 efectuată în altă clinică de chirurgie toracică. Pentru desființarea acestei cavități s-a ales o soluție complexă, constând într-o toracopleuroplastie iterativă Boțianu pe 6 coaste într-un singur timp operator, cu sistem de irigație -aspirație în circuit închis, asociată cu plombaj muscular cu mare dorsal și dințat anterior pe pedicolul vascular comun și lambouri intercostale. Evoluția postoperatorie a fost favorabilă, cu obliterarea completă și definitivă a cavității și externare la 34 zile.
Surgical management of hiatal hernias and complex gastroesophageal reflux disease (GERD) requires... more Surgical management of hiatal hernias and complex gastroesophageal reflux disease (GERD) requires a tension free repair with reliable reflux control. The authors would like to emphasize their own technique patented by Professor Boțianu, performed through a left thoracophrenotomy Through this simple and quick technique and without using a synthetic mesh thus avoiding rejection, the whole ensemble is fixed under the diaphragm. Cuvinte cheie: hernie hiatală, 8 fire, boala de reflux gastro-esofagian, volvulus gastric Rezumat: Managementul chirurgical al herniilor hiatale și a refluxului gastroesofagian necesită o corecție f ă r ă tensiune cu un control adecvat al bolii de reflux. Autorii i și prezint ă propria tehnică operatorie patentată de profesorul Boțianu, ce folose ște ca și cale de abord toracofrenotomia stângă. Prin această tehnică simplă și rapidă, fără a folosi material protetic, evitând astfel respingerea grefei, intreg ansamblul este fixat sub cupola diafragmatică.
The severity of tuberculosis as an endemic malady in our country is a consequence of the complexi... more The severity of tuberculosis as an endemic malady in our country is a consequence of the complexity of surgical cases which often reach service as serious surgical emergencies, requiring a complex surgical management. We are reporting the case of a 56-year old patient, whose right pleural tuberculosis etiology is known, having a residual cavity with limestone walls which got infected after a limited and insufficient C4-C7 thoracoplasty performed in another thoracic surgery clinic. A complex solution was chosen in order to eliminate this cavity, consisting of an iterative thoracopleuroplasty. Boţianu, on six ribs in a single-operator real-time, with a closed-circuit suction-irrigation system, associated with the transposition of latissimus dorsi muscle and serratus anterior on a common vascular pedicle and intercostal flap. The postsurgery course was favourable, the cavity being eliminated permanently and completely within 34 days. Rezumat: Severitatea endemiei tuberculoase din țara ...
Objective: The main objective of this study is to evaluate the medico-legal aspects of fatal road... more Objective: The main objective of this study is to evaluate the medico-legal aspects of fatal road traffic accidents. Methods: This is a retrospective study consisting of 80 forensic autopsies performed at the Institute of Legal Medicine – Tîrgu Mureș, Romania during a two years period, between January 1st, 2016 to December 31st, 2017. The information obtained was based on the medical records and the evaluation of autopsy reports. Results: Male victims involved in road traffic accidents were nearly three times more numerous than women (72.5% vs. 27.5%). Divided into 3 age groups (under 35 years old, 36-59 years old and over 60 years old) we noticed a relatively uniform distribution of the victims, with a slight dominance of the 36-59 age group and the over 60 years of age group. The highest number of victims was among the pedestrians (36.25%), followed in decreasing order by the drivers (33.75%), passengers (17.5%), cyclists (7.5%) and motorcyclists (5%). Positive alcohol testing was...
Life-threatening injuries represent those types of lesions that certainly lead to the victim’s de... more Life-threatening injuries represent those types of lesions that certainly lead to the victim’s death if no qualified medical care is applied in due time. We hold important the aspect of imminent danger, and that the lesion, in its natural way of evolution, will determine the person’s death, his life being saved only by a qualified medical intervention. The juridical correspondent is represented in article 194: bodily harm - The new criminal code and the new criminal procedure code. The authors review and comment on the main particular aspects of life-threatening traumas, based on topography, anatomical aspects and forensic interpretation, in order to offer arguments to be incorporated from a medico-legal point of view, reported to the criteria of life-threatening conditions. We shall illustrate the subject by 6 case reports.
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