Clinical and epidemiological aspects of gout, a dysmetabolic disabling disorder.

UNLABELLED: Gout is a disease caused by disturbances of uric acid metabolism and it manifests as rheumatic pain with various clinical and developmental issues, but without any major diagnosis problems; it might unfavorably interfere with other metabolisms, especially with carbohydrate and lipid metabolism that interact and erode each other. AIMS: To provide clinical and laboratory data and to follow the development of gout in patients treated in the clinic. MATERIAL AND METHODS: The study included 28 patients (25 male and 3 female patients) diagnosed with gout, admitted to the First Clinic of Rheumatology of the Clinical Rehabilitation Hospital Iasi during 2012-2013. RESULTS AND DISCUSSION: A new diagnostic method, dual energy computed tomography, was effective in some selected cases of gout, as it may reveal uric acid crystals with specific densities in the damaged joints and periarticular soft tissues. CONCLUSIONS: Gout is a disorder that occurs when the uric acid produced by the body is stored in the form of crystals in joints and/or soft tissues. In joints, uric acid crystals precipitate and cause inflammatory arthritis that leads to swelling, redness, heat, pain and joint functional impotence.

Osteoporosis in rheumatoid arthritis.

UNLABELLED: Osteoporosis (OP) is a disease of great medical and social importance and it is reported frequently and precociously in rheumatoid arthritis (RA) patients. MATERIAL AND METHODS: A retrospective study was conducted on a random sample of 180 patients admitted in the period 2011-2012 to the Rheumatology Clinic of the lasi Rehabilitation Hospital. The patients were diagnosed with RA and osteoporosis and some clinical and biological parameters were analyzed. Patients were divided into two groups for a comparative study: group I--seropositive = 115 cases (63.89%); group II-- seronegative = 65 cases (36.11%). RESULTS AND DISCUSSION: The 180 patients diagnosed with RA and osteoporoses were randomized into other two groups. The serum rheumatoid factor (RF) in RA and osteoporosis patients was determined by Latex and Waaler Rose reaction. The radiological examination showed that 23.47% of patients in group I and 9.23% of patients in group II have experienced at least one fracture. DXA (Dual X-Ray Absorptiometry) testing showed a value of <-3.5 in group I (13,04%) and in group II ( 9.23%), these results indicating a high risk of fracture, particularly in group I (seropositive). CONCLUSIONS: The results confirm that RA patients are at increased risk ofosteoporosis, and the additional risk of disability and serious socioeconomic implications negatively affect the prevention and development of the disease.

The third age--a current issue for the family physician.

Since our birth, we are programmed to experience predetermined stages of life whose passage is inevitable as the passage of time (childhood, youth, adulthood, old age). Although each of these stages of development differs in its specific tasks, the old age seems to be the most burdensome, resulting in significant changes: physical and intellectual decline, major changes in the importance of the professional, marital, parental and social role. One of the main indicators of the quality of life, the average life expectancy increased significantly in the last 3-4 decades and the mankind gained decades of active life in a relatively short period of time. Therefore, one of the goals of medicine has become the prolongation of life, the pursuit of old age, the wish to remain healthy, to be able of physical and intellectual performance and useful in the private and social life. The old age is conditioned by a complex combination of factors: the individual genetic predisposition, the lifestyle of society and the environment, all of which affect the opinions regarding health and subsequently the attitude towards health. The family physician has the social obligation to research and promote health, to fight diseases. The family physician achieves this by researching the aging field and by trying to find solutions to improve the quality of life in the elderly, which is a prerequisite of maintaining the integration of the elderly into family life and society, of preserving the biological and social independence of aged persons. The maintenance of an active private and social life is a method of fighting premature aging associated with infirmity and disease. This action cannot be successful without the active involvement of the elderly and without their acceptance in the society. Aging is a biological process that affects the entire body, following the period of development and it is considered the final stage of biomorphosis.

Clinical and epidemiological study on the prevalence of rheumatoid arthritis in some demographic structures.

UNLABELLED: The structure of the epidemiological process of rheumatoid arthritis (RA) is integrated in a broader framework of multiple interactions between intrinsic predisposing factors and the external environmental factors that may have a triggering or stimulating effect. The summative phenom enon is the result of the additive effect of risk factors, the individualized response of body structures and functions, depending on the genetic makeup explain the complexity of the epidemiologic study. AIM: To evaluate the epidemiological, clinical and biological features of a series of RA patients. MATERIAL AND METHODS: The study included 103 RA patients admitted to the Rheumatology Clinic of the Iasi Rehabilitation Hospital in the interval January, 2010 - December, 2012. RESULTS: The analysis of epidemiological data provided information on pre-existing infections caused by the living environment conditions, diet, etc., that may cause damage at cellular and molecular level. CONCLUSIONS: The present clinical and epidemiological study describes the biological mechanisms and phenomena dependent on physical and social environment. These mechanisms favor and stimulate the occurrence, expansion and development of the disease at population level.

Doctor-patient dialogue--basic aspect of medical consultation.

Family medicine is the specialty that provides ongoing primary medical care and improves the health status of the individual, of the family and of the community through preventive, educational, therapeutic and rehabilitation measures. The family doctor often makes the interdisciplinary synthesis, in a flexible manner, either alone or in most cases with interdisciplinary consultation. In the latter case, the family doctor initiates the team work and makes the final evaluation by using the longitudinal follow-up of the disease. The doctor-patient encounter represents the "confrontation" with the greatest moral weight, due to the complexity of the values involved, the status of the doctor in a society, and patient's involvement in decision making. The patient is a person who should be treated with respect, honesty, professionalism and loyalty, whatever the clinical status, severity of illness, mental competence or incompetence. A focus, on an international scale, is represented by the characteristics of a good doctor, family physician included, as the latter is the first link in the network of health services. Each model of consultation varies in a more or less subtle way in priorities assignment, and suggests slight differences regarding the role played by doctor and patient in their collaboration. The qualities of a good family physician include not only the strictly professional competences, that also apply to other medical specialties, but also duties, such as, clearly explaining to patients issues concerning their health, informing them about all the possible preventive measures of diseases, making a diagnosis, initiating and supervising a therapy. Medical responsibility lies at the crossroads between medical science and the conscience of the doctor.

[Dental treatment strategies for elderly patients]. / Strategia de tratament stomatologic la pacientul vârstnic.

UNLABELLED: The elderly are influenced from a various and complex combination of factors, such us individual genetic predispositions, lifestyle, society and environment, the sum of all the individual life experiences concerning the dental care, the caries, the periodontal and iatrogenic diseases. AIM: This paper evaluates the dental treatment in the elderly. MATERIAL AND METHODS: The study was performed on 112 patients, aged over 65, at the Clinical Department of Dental Semiology und Geriatric Dentistry, Iasi, Romania. RESULTS: The treatment interventions were dental hygiene procedures (in 97 patients), restaurations (in 29 patients), removable partial and total denture preocedures (in 50 patients), fixed prosthetic procedures (in 18 patients), rebasing of dentures (in 25 patients) and teeth extractions (in 26 patients). There were 36 endodontic emergencies and 15 periodontal emergencies and 8 emergencies that resulted from other causes. CONCLUSIONS: The periodical dental examinations and the proper daily oral hygiene routine are still important in the old age and they should not be neglected, because the prosthetical components request also treatment interventions.