RENEB Inter-Laboratory Comparison 2021: Inter-Assay Comparison of Eight Dosimetry Assays.

Tools for radiation exposure reconstruction are required to support the medical management of radiation victims in radiological or nuclear incidents. Different biological and physical dosimetry assays can be used for various exposure scenarios to estimate the dose of ionizing radiation a person has absorbed. Regular validation of the techniques through inter-laboratory comparisons (ILC) is essential to guarantee high quality results. In the current RENEB inter-laboratory comparison, the performance quality of established cytogenetic assays [dicentric chromosome assay (DCA), cytokinesis-block micronucleus assay (CBMN), stable chromosomal translocation assay (FISH) and premature chromosome condensation assay (PCC)] was tested in comparison to molecular biological assays [gamma-H2AX foci (gH2AX), gene expression (GE)] and physical dosimetry-based assays [electron paramagnetic resonance (EPR), optically or thermally stimulated luminescence (LUM)]. Three blinded coded samples (e.g., blood, enamel or mobiles) were exposed to 0, 1.2 or 3.5 Gy X-ray reference doses (240 kVp, 1 Gy/min). These doses roughly correspond to clinically relevant groups of unexposed to low exposed (0-1 Gy), moderately exposed (1-2 Gy, no severe acute health effects expected) and highly exposed individuals (>2 Gy, requiring early intensive medical care). In the frame of the current RENEB inter-laboratory comparison, samples were sent to 86 specialized teams in 46 organizations from 27 nations for dose estimation and identification of three clinically relevant groups. The time for sending early crude reports and more precise reports was documented for each laboratory and assay where possible. The quality of dose estimates was analyzed with three different levels of granularity, 1. by calculating the frequency of correctly reported clinically relevant dose categories, 2. by determining the number of dose estimates within the uncertainty intervals recommended for triage dosimetry (±0.5 Gy or ±1.0 Gy for doses <2.5 Gy or >2.5 Gy), and 3. by calculating the absolute difference (AD) of estimated doses relative to the reference doses. In total, 554 dose estimates were submitted within the 6-week period given before the exercise was closed. For samples processed with the highest priority, earliest dose estimates/categories were reported within 5-10 h of receipt for GE, gH2AX, LUM, EPR, 2-3 days for DCA, CBMN and within 6-7 days for the FISH assay. For the unirradiated control sample, the categorization in the correct clinically relevant group (0-1 Gy) as well as the allocation to the triage uncertainty interval was, with the exception of a few outliers, successfully performed for all assays. For the 3.5 Gy sample the percentage of correct classifications to the clinically relevant group (≥2 Gy) was between 89-100% for all assays, with the exception of gH2AX. For the 1.2 Gy sample, an exact allocation to the clinically relevant group was more difficult and 0-50% or 0-48% of the estimates were wrongly classified into the lowest or highest dose categories, respectively. For the irradiated samples, the correct allocation to the triage uncertainty intervals varied considerably between assays for the 1.2 Gy (29-76%) and 3.5 Gy (17-100%) samples. While a systematic shift towards higher doses was observed for the cytogenetic-based assays, extreme outliers exceeding the reference doses 2-6 fold were observed for EPR, FISH and GE assays. These outliers were related to a particular material examined (tooth enamel for EPR assay, reported as kerma in enamel, but when converted into the proper quantity, i.e. to kerma in air, expected dose estimates could be recalculated in most cases), the level of experience of the teams (FISH) and methodological uncertainties (GE). This was the first RENEB ILC where everything, from blood sampling to irradiation and shipment of the samples, was organized and realized at the same institution, for several biological and physical retrospective dosimetry assays. Almost all assays appeared comparably applicable for the identification of unexposed and highly exposed individuals and the allocation of medical relevant groups, with the latter requiring medical support for the acute radiation scenario simulated in this exercise. However, extreme outliers or a systematic shift of dose estimates have been observed for some assays. Possible reasons will be discussed in the assay specific papers of this special issue. In summary, this ILC clearly demonstrates the need to conduct regular exercises to identify research needs, but also to identify technical problems and to optimize the design of future ILCs.

[Perspectives of patients with Duchenne muscular dystrophy: A focal group to improve healthcare quality]. / Perspectivas de pacientes con distrofia muscular de Duchenne: grupo focal para mejorar la calidad asistencial.

INTRODUCTION: Duchenne muscular dystrophy is a complex disease that requires a multidisciplinary and coordinated approach. Given that therapeutic efforts are centred on improving the quality of life of the patient, the aim of this study is to find out the views of young people and adolescents with Duchenne muscular dystrophy, their families, and health professionals as regards the healthcare provided by the hospital in order to improve their quality of life. METHODS: A qualitative study was conducted using 3 focal groups consisting of patients, families, and healthcare professionals. A thematic guide was prepared, and the information from the interviews was gathered using a sound recorder. In order to analyse the information, the transcriptions were coded and the significant data of each interview were extracted and grouped into various topics. RESULTS/CONCLUSIONS: The main worries of the 3 groups were along the same line. On the one hand, the importance of a coordinated multidisciplinary team in the same unit that provides the integral care. On the other hand, sport as a common interest in these adolescents, and the consideration of a positive relationship between leisure and quality of life, finding that their participation in physiotherapy groups of great use. To achieve this objective, it is necessary to improve the coordination between the hospital and the different groups. The parents also demanded better cover in the social and psychological care offered by the hospital. Lastly, the importance of humanising the care was mentioned (privacy, adapting of structures, transmission of information, sexuality…).

Selenocysteine insertion sequence binding protein 2 (Sbp2) in the sex-specific regulation of selenoprotein gene expression in mouse pancreatic islets.

Selenoproteins are a group of selenocysteine-containing proteins with major roles in cellular antioxidant defense and thyroid hormone metabolism. Selenoprotein expression is determined by hierarchical mechanisms that result in tissue-specific levels. Current data inadequately explain the abundance of various selenoproteins under normal and pathological conditions, including in pancreatic ß-cells. Selenocysteine insertion sequence binding protein 2 (SBP2) is a critical protein in selenoprotein translation that also plays an essential role in stabilizing selenoprotein transcripts by antagonizing nonsense-mediated decay (NMD). Importantly, dysfunctional SBP2 is associated with endocrine disorders in humans. Here we describe the impact of induced Sbp2 deficiency in pancreatic ß-cells on selenoprotein transcript profiles in the pancreatic islets of C57BL/6J mice. Sex differences were noted in control mice, in which female islets showed 5 selenoproteins decreased and one increased versus male islets. Induced Sbp2 deficiency in pancreatic ß-cells altered expression of only 3 selenoprotein transcripts in male islets, whereas 14 transcripts were reduced in female islets. In all cases, decreased transcription was observed in genes known to be regulated by NMD. The differential impact of Sbp2 deletion on selenoprotein transcription between sexes suggests sex-specific hierarchical mechanisms of selenoprotein expression that may influence islet biology and consequentially metabolic disease risk.

A novel mutation in the TG gene (G2322S) causing congenital hypothyroidism in a Sudanese family: a case report.

BACKGROUND: Congenital hypothyroidism (CH) has an incidence of approximately 1:3000, but only 15% have mutations in the thyroid hormone synthesis pathways. Genetic analysis allows for the precise diagnosis. CASE PRESENTATION: A 3-week old girl presented with a large goiter, serum TSH > 100 mIU/L (reference range: 0.7-5.9 mIU/L); free T4 < 3.2 pmol/L (reference range: 8.7-16 pmol/L); thyroglobulin (TG) 101 µg/L. Thyroid Tc-99 m scan showed increased radiotracer uptake. One brother had CH and both affected siblings have been clinically and biochemically euthyroid on levothyroxine replacement. Another sibling had normal thyroid function. Both Sudanese parents reported non-consanguinity. Peripheral blood DNA from the proposita was subjected to whole exome sequencing (WES). WES identified a novel homozygous missense mutation of the TG gene: c.7021G > A, p.Gly2322Ser, which was subsequently confirmed by Sanger sequencing and present in one allele of both parents. DNA samples from 354 alleles in four Sudanese ethnic groups (Nilotes, Darfurians, Nuba, and Halfawien) failed to demonstrate the presence of the mutant allele. Haplotyping showed a 1.71 centiMorgans stretch of homozygosity in the TG locus suggesting that this mutation occurred identical by descent and the possibility of common ancestry of the parents. The mutation is located in the cholinesterase-like (ChEL) domain of TG. CONCLUSIONS: A novel rare missense mutation in the TG gene was identified. The ChEL domain is critical for protein folding and patients with CH due to misfolded TG may present without low serum TG despite the TG gene mutations.

Opinions of Romanian Dental Students Toward Tobacco Use Interventions in the Dental Setting.

The aim of the present study was to assess smoking habits as well as attitudes toward smoking cessation counseling among Romanian dental students in order to build an evidence base for further undergraduate curriculum development. A 38-item self-administered questionnaire was delivered to first to sixth dental students enrolled at the University "Lucian Blaga" Sibiu. The questionnaire covered sociodemographics, smoking habits, knowledge concerning health effects, attitudes, and confidence toward smoking cessation counseling. Smoking was reported by 37 % of participants and was more prevalent among clinical (48.98 %) than preclinical (29.58 %) and basic science students (35.93 %). Students' knowledge that tobacco affects general and oral/dental health and knowledge of dental students regarding the smoking and alcohol behavior taken during medical history varied according to academic year and smoking status, but not according to gender. Only 51.1 % of all students agreed or strongly agreed that they were adequately trained to provide tobacco cessation education. 58.6 %, respectively 52.9 %, strongly agreed that is part of their role as a dentist to assist their patients to stop smoking and to prevent patients from starting to use tobacco products, while only 35.8 % believed that smoking cessation counseling provided by a dentist can be effective in helping patients stop smoking. The main determinants of student's attitudes toward smoking cessation counseling were academic year, clinical experience in the dental settings, and knowledge of smoking adverse effects. Dental school should offer adequate training in tobacco dependence and available continuing education in tobacco intervention in aim to encourage oral health care practitioners to have up-to-date information in aim to play their role effectively in the overall smoking cessation and prevention activities.

The efficiency of subconjunctival bevacizumab in refractory glaucoma - case report.

Anti-vascular endothelial growth factor (anti-VEGF) therapy used as adjunctive to glaucoma filtration surgery may help filtering bleb survival because vascular endothelial growth factor has an important role in the angiogenesis of new vessels and in the fibrogenesis, which lead to scar formation and bleb failure. Bevacizumab is a non-selective monoclonal antibody against all isoforms of VEGF-A. We present the case of an inflammatory glaucoma of a 67-year-old female, with uncontrolled intraocular pressure on maximal tolerable medical treatment, who underwent trabeculectomy and received 1.25 mg/0.05 ml of bevacizumab (Avastin) subconjunctivally at the end of the surgery and an additional injection one month later. Right eye intraocular pressure (IOP) was 26 mm Hg at preoperative visit and after surgery, it decreased and remained normal at each postoperative examination with no additional IOP-lowering medication. A localized avascular bleb with moderate elevation was observed six months postoperatively.

Correlations Between Intratumoral Microvessel Density and Histopathological Type or Neoadjuvant Radiotherapy for Rectal Carcinoma.

PURPOSE: This study aims to evaluate intratumoral microvessel density in rectal carcinoma cases with different histopathological type (adenocarcinoma and mucinous carcinoma) and different preoperatory neoadjuvant radiotherapy status (irradiated / non-irradiated) ,thus analyzing any possible statistical correlation between these parameters. MATERIAL AND METHODS: Our prospective study consists in standard immunohistochemistry procedures using CD34, CD31 and CD105 antibodies, which were performed on 25 samples of rectal carcinoma, in order to determine intratumoral microvessel density. RESULTS: The 25 case study group was divided either by histopathological type or by prior radiotherapeutical treatment as follows: 9 cases of mucinous carcinoma versus 16 cases of adenocarcinoma and 13 cases of rectal cancer that have not received neoadjuvant radiotherapy versus 12 cases of rectal cancer with preoperatory radiotherapy. CONCLUSIONS: The number of intratumoral microvessels is higher in non-irradiated rectal tumors and in adenocarcinomas, this remark being statistical significant (with only one exception - CD34 staining in non-irradiated versus irradiated tumors) for all types of vessels (new-grown and mature). This result is due to the benefic effect of neoadjuvant radiotherapy on decreasing angiogenic activity, thus having an important prognostic value for rectal cancer.

Autophagy and Neovascularization in Colorectal Cancer.

PURPOSE: This study aims to determinate the microvessel density at the base of the tumor, as well in tumor's mass, in order to determinate the number of neovascularization vessels (marked with CD105) in comparison with presence or absence of autophagy puncta. MATERIAL/METHODS: Standard immunohistochemistry was performed on 38 samples of colorectal adenocarcinoma, in order to determinate the presence of autophagy and neovascularization blood vessels with the help of LC3, CD34, CD31 and CD105 antibodies. RESULTS: The autophagy process was observed in the cancerous cells and was noted as present in both regions of interest from the tumor. The mean number of blood vessels market with CD105 is higher in tumor mass then at its base, p value of the Student t test being highly significant (p<0.0001). CONCLUSIONS: The presence of autophagy puncta was notice in every case, both in the mass of the tumor and at its base. Microvascular density of new-grown blood vessels is higher in the mass of the tumor compared with the base of the tumor.

Assessing oral cancer knowledge in Romanian undergraduate dental students.

The aim of this study is to investigate the level of Romanian dental students' knowledge regarding the oral cancer risk and non-risk factors as well as oral cancer signs, symptoms, and diagnostic signs. A total of 192 first- to sixth-year undergraduate dental students (mean age 22.20 ± 2.94 years) who consented to participate in the study filled in a questionnaire enquiring about their knowledge of oral cancer. A score of the oral cancer knowledge was calculated for each participant based on their correct answers. Regarding the knowledge of oral cancer risk factors, the vast majority of the students correctly recognized tobacco (96.8 %), having a prior oral cancer lesion (85.1 %), the consumption of alcohol (77.7 %), and older age (64.2 %). Respectively, 87.7 and 54.3 % knew the tongue and the floor of mouth to be the most common oral cancer sites. Of the students, 71.3 % agreed that oral cancer examinations for those 20 years of age and older should be provided during regular periodic health examinations, 92.9 % considered that patients with suspicious oral lesions should be referred to specialists, and 84.6 % agreed that oral cancer examinations should be a routine part of a comprehensive oral examination. A significant association was found between the year of study in the dental school, age, and knowledge of the oral cancer knowledge scores. Although students' knowledge increased with academic year, there is a clear need to enhance the dental curricula in oral cancer clinical training in oral cancer prevention and examination for dental students.

The role of Spectral Domain Optical Coherence Tomography in monitoring uncontrolled hypertensive type 2 diabetic patients.

RATIONALE: The pathogenesis of diabetic retinopathy is multifactorial, and a range of hyperglycemia-linked pathways has been implicated in the initiation and progression of this condition. All the cells in the retina are affected by the diabetic milieu, and in view of such disease and tissue complexity, it is unlikely that any single process is solely responsible for the retinal pathophysiology. Dyslipidemia is considered a trigger to rapid worsening of the condition and its treatment is becoming a part of normal diabetes treatment. Nevertheless, as establishing causal mechanisms and related conditions remain an important research goal, also the means to follow up the impact on the retina and other ocular tissues are as important. OBJECTIVE: this retrospective study shows the progression of diabetic macular edema (DME) in patients with dyslipidemia related to poor glycemic and blood control in subjects with existing DME by measuring the total macular volume (TMV) and thickness through the spectral domain optical coherence tomography (SD- OCT). METHODS AND RESULTS: 30 uncontrolled cases of type 2 diabetes that were measured monthly by SD- OCT through a period of 3 months with correlation to the degree of dyslipidemia and hyperglycemia, were analyzed. CONCLUSION: The role of OCT in monitoring the progression of DME in patients with uncontrolled type 2 diabetes is essential and the collaboration between the ophthalmologist and endocrinologist is essential to monitor the course of disease in uncontrolled patients.

Instability of self-esteem, self-confidence, self-liking, self-control, self-competence and perfectionism: associations with oral health status and oral health-related behaviours.

AIM: Our aim was to explore whether instability of self-esteem, self-confidence, self-liking, self-control, self-competence and perfectionism each has an independent contribution to the self-rated oral health and oral health-related behaviours. MATERIAL AND METHODS: A cross-sectional study design was used. Data were collected between November 2008 and May 2009. The sample consisted of 205 Romanian adults (mean age: 29.84 years; 65.2% women; 40% married) who were a random population drawn consecutively from the registry file of two private dental practices in the Iasi area. The questionnaire included information about demographic, psychological, self-reported oral health and oral health-related behaviour items. RESULTS: The comparison of participants who never flossed their teeth with those who flossed everyday showed statistically significant lower levels of self-confidence (P < 0.05), self-liking (P = 0.001), self-competence (P < 0.0001), self-control (P < 0.05) and Perfectionism Scores (P < 0.05). Significant higher levels of self-competence were scored in persons who used weekly mouthrinses comparing with never users (P = 0.012). Also patients who visited the dentist mainly when treatment is needed or when pain presented lower levels of self-competence and self-control comparing with those who visited the dentist mainly for check-up or for tooth cleaning and scaling (P < 0.05). Oral health behaviours (toothbrushing and mouthrinse frequencies) were predicted by multiple regression analyses using sociodemographic (age, gender), self-competence and perfectionism variables. CONCLUSIONS: Our study showed that instability of self-esteem, self-confidence, self-competence, self-liking, self-control and perfectionism was associated not only with self-rated dental health but also with oral health behaviours. Understanding the psychological factors associated with oral hygiene can further the development and improvement in therapeutic strategies to be used in oral health-improving programs, as well as of programs aimed at prevention and education.

Management of borderline ovarian tumors.

UNLABELLED: Borderline ovarian tumors are an intermediate stage between benign cystadenomas and adenocarcinomas. AIM: The paper evaluates the management of borderline ovarian tumors (BOTs) in the patients admitted and treated in our clinic in the interval January 2003 - June 2011. MATERIAL AND METHODS: The observation sheets and pathology results of 264 patients with malignant ovarian tumors were analyzed. RESULTS: Of the 264 malignant ovarian tumors 74 (28.03%) were low malignant potential. Patients with BOT were aged 18-72 years (mean 46 +/- 6.2 years) and those with invasive tumors 14-83 years (mean 53 +/- 9.8 years). 92.18% were in stage 1. Sixty tumors were graded G1. 53.52 % of the tumors were over 10 cm (maximum 30 cm) in size. The histological types were: serous - 35 cases, mucinous - 19 cases, mixed (serous and mucinous) - 8 cases, and endometrioid - 2 cases. Fifteen patients presented intraepithelial carcinoma and 11 noninvasive implants into the peritoneal cavity. Five women had recurrences. CONCLUSIONS: Ovarian borderline tumors with histological characteristics of carcinoma, but with good behavior are now with better defined histological features. The biggest challenge in the management of women with these tumors is to identify the subset that will behave in a malignant fashion and to develop effective treatment for them.

[Colorectal cancer--clinical course, epidemiologic and pathologic aspects]. / Cancerul colorectal--consideratii asupra tendintelor evolutive ale profilului epidemiologic si anatomoclinic.

UNLABELLED: In the past 3 years colorectal cancer became the second cause death (after the broncho-pulmonary cancer) exceeding gastric cancer by 4150 deaths in 2002 (19,05 per hundred thousand inhabitants) and 4860 deaths in 2006. MATERIAL AND METHODS: 644 of the 18,978 patients coloscopically investigated at the lasi Gastroenterology and Hepatology Institute in the interval 2000-2007 in which pathology results revealed colorectal cancer, and 279 patients operated at the First Clinic Surgery of the Iasi "Sf. Spiridon" Hospital during 2008-2010 were selected for this study. RESULTS: Colorectal carcinoma has a high incidence in the patients over 60 years. Sex distribution of the tumors showed that this disease most commonly affects males. The male/female ratio was 1.3. In less than 3% of the cases the disease occurred at ages under 40 years. The most frequent clinical manifestations were intestinal transit disorder (97%), pain syndrome on the left side of the abdomen (82.82%), and progressive severe constipation (67.89%). 24.07% of the colorectal cancer cases were located at the level of the proximal colon (cecum, ascending colon, hepatic flexure, transverse colon and splenic flexure), while 75.9% were located at the distal level. The most frequent macroscopic form was the vegetative one (89.91%).

The relationship between self-reported oral health, self-regulation, proactive coping, procrastination and proactive attitude.

OBJECTIVES: This cross-sectional study investigated the relationship between self-regulation, proactive coping, procrastination and proactive attitude, perceived oral health and self-reported oral-health behaviours. METHODS: The study sample consisted of 198 first year medical students. The questionnaire included information about socio-demographic factors, behavioural variables, self-reported oral health status, proactive coping (proactive coping subscale of the Proactive Coping Inventory), procrastination (Procrastination Scale) and proactive attitude (Proactive Attitude Scale). RESULTS: Significant differences were found on self-regulation, proactive coping, procrastination and proactive attitude scales between participants who rated their gingival condition as very good/excellent and those who evaluated it as being poor, very poor or normal (p < 0.05). Results revealed significant differences in procrastination level among individuals who never visit their dentist and those who visit their dentist for check-up or for tooth cleaning and scaling (p = 0.001) or when treatment is needed or when in pain (p < 0.05). In multiple linear regression analyses, proactive coping was associated with toothbrushing frequency and reason for dental visiting. CONCLUSIONS: The result suggested that procrastination and proactive coping are important determinants of perceived oral health and self-reported oral-health behaviours.

Inherited defects of thyroid hormone metabolism.

Intracellular metabolism of thyroid hormone and availability of the active hormone, triiodothyronine is regulated by three selenoprotein iodothyronine deiodinases (Ds). While acquired changes in D activities are common, inherited defects in humans have not been identified. Selenium (Se) is an essential trace element required for the biosynthesis of selenoproteins, and selenocysteine insertion sequence (SECIS) binding protein 2 (SBP2) represents a key trans-acting factor for the cotranslational insertion of selenocysteine into selenoproteins. In 2005 we reported the first mutations in the SBP2 gene in two families in which the probands presented with transient growth retardation associated with abnormal thyroid function tests, low triiodothyronine (T3), high thyroxine (T4) and reverse T3, and slightly elevated thyrotropin. Affected children were either homozygous or compound heterozygous for SBP2 gene mutations and the relatively mild phenotype was due to partial SBP2 deficiency, affecting the expression of a subset of selenoproteins. In vivo studies of these subjects have explored the effects of Se and thyroid hormone supplementation. In vitro experiments have provided new insights into the effect of SBP2 mutations. A broader and more complex phenotype was brought to light by the subsequent identification of three new cases from different families with SBP2 gene mutations. These mutations caused a severe SBP2 deficiency resulting in reduced synthesis of most of the 25 known human selenoproteins. Here we summarize the clinical presentation of SBP2 mutations, their effect on SBP2 function and downstream consequences for selenoprotein synthesis and function.

Stanniocalcin 1 induction by thyroid hormone depends on thyroid hormone receptor ß and phosphatidylinositol 3-kinase activation.

CONTEXT: Thyroid hormone (TH) mediated changes in gene expression were thought to be primarily initiated by the nuclear TH receptor (TR) binding to a thyroid hormone response element in the promoter of target genes. A recently described extranuclear mechanism of TH action consists of the association of TH-liganded TRß with phosphatidylinositol 3-kinase (PI3K) in the cytosol and subsequent activation of the PI3K pathway. OBJECTIVE: The aim of this study was to examine the effect of TH, TRß and PI3K on stanniocalcin 1 (STC1) expression in human cells. DESIGN: We treated human skin fibroblasts with triiodothyronine (T3) in the absence or presence of the PI3K inhibitor LY294002, a dominant negative PI3K subunit, Δp85α, and the protein synthesis inhibitor cycloheximide (CHX). The role of the TRß was studied in cells from patients with resistance to thyroid hormone (RTH). STC-1 mRNA expression was measured by real-time PCR. RESULTS: We found an induction of STC1 by T3 in normal cells, but less in cells from subjects with RTH (2.7 ± 0.2 vs. 1.6 ± 0.04, P < 0.01). The effect of T3 was completely abrogated by blocking PI3K with LY294002 (3.9 ± 0.5 vs. 0.85 ± 0.5; P < 0.05) and greatly reduced after transfection of a dominant negative PI3K subunit, demonstrating dependency on the PI3K pathway. CONCLUSION: These results establish STC1 as a TH target gene in humans. Furthermore, we show that STC1 induction by TH depends on both TRß and PI3K activation.

Seasonal characteristics of flood regimes across the Alpine-Carpathian range.

The aim of this paper is to analyse the differences in the long-term regimes of extreme precipitation and floods across the Alpine-Carpathian range using seasonality indices and atmospheric circulation patterns to understand the main flood-producing processes. This is supported by cluster analyses to identify areas of similar flood processes, both in terms of precipitation forcing and catchment processes. The results allow to isolate regions of similar flood generation processes including southerly versus westerly circulation patterns, effects of soil moisture seasonality due to evaporation and effects of soil moisture seasonality due to snow melt. In many regions of the Alpine-Carpathian range, there is a distinct shift in flood generating processes with flood magnitude as evidenced by a shift from summer to autumn floods. It is argued that the synoptic approach proposed here is valuable in both flood analysis and flood estimation.

Investigating the relationship among self-reported oral health status, oral health-related behaviors, and self-consciousness in Romanian dental patients.

BACKGROUND: The purpose of this study was to investigate whether self-consciousness, self-reported oral health status, and oral health-related behaviors were associated in a Romanian population. METHODS: A cross-sectional study design was used. Data were collected between January and March 2008. The sample consisted of 180 Romanian adults (mean age: 35.8 years; 72.6% women; 57% married) who were a random population drawn consecutively from the registry file of a private dental practice in the Iasi area. The questionnaire included information about demographic, psychologic, self-reported oral health, and oral health-related behavior items. The self-consciousness (SC) scale with three subscales (public SC, private SC, and social anxiety) was applied. RESULTS: Significant differences were found on the public SC scale in relation to denture/removable false teeth and on the total SC scale in relation to periodontal problems. When oral health behaviors were analyzed, private SC was associated with oral health behaviors (flossing, use of mouthrinse, and dental visit frequency). There was no association between toothbrushing frequency and the self-consciousness subscales. CONCLUSION: The moderating effects of self-consciousness should be considered when evaluating risk-reduction interventions and tailoring intervention efforts to oral health promotion.

Neuroprotective and consequent neurorehabilitative clinical outcomes, in patients treated with the pleiotropic drug cerebrolysin.

BACKGROUND: Discovery of neurotrophic factors--emblematic: the nerve growth factor (NGF)--resulted in better approaching central nervous system (CNS) lesions. Recently, another crucial property has been unveiled: their rather unique pleiotropic effect. Cerebrolysin is a peptide mixture that penetrates the blood-brain barrier in significant amounts and mimics the effects of NGF. METHODS: Comparative analysis: Cerebrolysin treated (10 ml x 2/day, i.v. x 3 weeks) vs. non-treated, in patients (all received aside, a rather equivalent complementary, pharmacological and physical, therapy). Two lots of patients, admitted in our Physical & Rehabilitation (neural-muscular) Medical-PR(n-m)M-Clinic Division, during 2007-2009: 69 treated with Cerebrolysin (22 F, 47 M; Average: 59.333; Mean of age: 61.0 Years old; Standard deviation 16.583) and 70 controls (41 F, 29 M; A: 70.014; M.o.a.: 70.5 Y.o.; S.d.: 6.270) were studied. The total number of assessed items was 13: most contributive in relation with the score of Functional Independence Measure at discharge (d FIM), were: admission (a FIM), number of physical therapy days (PT), number of hospitalization days (H), age (A) and--relatively--days until the first knee functional extension (KE). Concomitantly, the main/key, focused on neuro-motor rehabilitative outcomes, functional/analytical parameters, have been assessed regarding the speed in achieving their functional recovery. RESULTS: Concerning d FIM, there have not been objectified significant differences between the two lots (p=0.2453) but regarding key, focused on neuro-motor rehabilitative outcomes, functional/analytical parameters: KE (p=0.0007) and days until the first time recovery of the ability to walk between parallel bars (WPB--p=0.0000)--highly significant differences in favor of Cerebrolysin lot resulted. CONCLUSION: Cerebrolysin administration, as neurorehabilitative outcomes, proved to hasten, statistically significant, especially the recovery of some critical, for standing and walking, parameters. Thus encouraged, we have now initiated a comprehensive national, 5 year retrospective, multi-centre--based on unitary data acquisition frame and mathematical apparatus--study, to evaluate the results of the treatment with Cerebrolysin in traumatic brain injuries (TBI).