Obstructive sleep apnea syndrome (OSAS) is the most common breathing-related sleep disorder. It is characterized by recurrent episodes of partial or complete airway obstruction during sleep, resulting in a reduction in or the total cessation of airflow, despite ongoing respiratory efforts, leading to oxygen desaturation and arousal. The purpose of this literature review is to evaluate the most common characteristics of this pathology, as well as to investigate the most effective treatment options, providing an update on the management of OSA patients.
Chronic otitis with cholesteatoma is a potentially dangerous disease that can lead to the development of intracranial abscesses. Although cerebellar abscess is half as common as cerebral abscess, it is known for its particularly difficult diagnosis, which requires the visualization of the pathological process continuity from the mastoid to the posterior fossa. In this article, we present an extremely rare case from the literature of cholesteatomatous otomastoiditis complicated with meningitis and cerebellar abscess, along with the description of technical surgical details for the plugging of the bony defect between the mastoid and posterior fossa with muscle and surgical glue. The particularity of this case lies in the late presentation to the doctor of an immunocompetent patient, through a dramatic symptomatology of life-threatening complications. We emphasize the importance of responsibly treating any episode of middle ear infection and considering the existence of underlying pathologies. In such cases, we recommend additional neuroimaging explorations, which can prevent potentially lethal complications. The treatment of such intracranial complications must be carried out promptly and requires collaboration between a neurosurgeon and an ENT surgeon.
Background and Objectives: Dental anxiety can hinder both treatment delivery and dental education. Few studies have examined this issue among Romanian dental students. This study assessed the prevalence, intensity, and main procedural triggers of dental anxiety, with a focus on experiences related to local anesthesia. Methods: A cross-sectional survey was conducted (January–May 2024) among 122 fourth-year students using the validated Romanian version of the Modified Dental Anxiety Scale (MDAS) and additional items on demographics, prior anesthesia and perceived complications. Data analysis included descriptive statistics, chi-square tests, and t-tests. Results: Overall, 21.3% of respondents scored in the low anxiety range, 75.4% in the moderate range, and 3.3% in the severe range (MDAS ≥ 19). No significant gender differences were identified (p > 0.05). Injections with local anesthetic were rated as the most distressing procedure, followed by drilling, whereas scaling was reported as least stressful. The majority (86.9%) had undergone previous local anesthesia, with very few adverse events recalled. Conclusions: Romanian dental students reported moderate dental anxiety overall, with local anesthesia injections as the main trigger. The lack of gender differences points to a potential buffering effect of clinical exposure. Incorporating structured anxiety management into dental curricula may enhance both student well-being and patient care.
The parathyroid and thymus glands are key components of the endocrine and immune systems, respectively, with intriguing developmental, anatomical, and functional interrelationships. This study starts from the hypothesis that, given their shared embryological origin, it is plausible that the thymus and parathyroid glands interact functionally and may share pathological pathways. The present study explores the developmental pathways, spatial proximity, and potential cross-talk between these glands. Recent studies suggest that parathyroid hormone (PTH) may influence thymic function, including T-cell maturation and immune regulation, while thymic signaling molecules could impact calcium homeostasis and parathyroid activity. Understanding the functional and etiopathogenical relations between these endocrine glands offers new insights into endocrine–immunological crosstalk, and therapeutic approaches targeting disorders such as hypoparathyroidism, thymomas, myasthenia gravis and thymic hypoplasia. Perspectives and conclusion: Future research is essential to discover the molecular mechanisms underpinning this dynamic interrelation and its broader implications for health and disease. Because there is still very little data on this interaction, in-depth studies are necessary on large groups of patients. This research proposes a cross-study of the receptors for the main substances secreted by the two categories of endocrine glands. At the same time, it is essential to carry out an in-depth study on the cervico-pericardial ligaments through the lens of this glandular interaction. These ligaments could contain the main blood and nerve communication pathway between the parathyroids and the glands.
Background and Objectives: Anxiety in dental settings can hinder both treatment delivery and educational experiences. For students in training, fear of specific procedures, particularly local anesthesia, may persist despite progressive clinical exposure. Evidence on this issue among Romanian dental students is scarce. This study aimed to assess the prevalence, intensity, and main procedural triggers of dental anxiety among Romanian dental students, with a specific focus on experiences related to local anesthesia. Methods: A cross-sectional study was conducted between January and May 2024 on 122 fourth-year students (79 females, 43 males) enrolled at the Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iași, Romania. Participants completed the validated Romanian version of the Modified Dental Anxiety Scale (MDAS) and answered additional items on demographic factors, prior exposure to local anesthesia, perceived complications, and procedures most likely to trigger anxiety. Data analysis included descriptive statistics, chi-square tests, and t-tests. Results: Overall, 21.3% of respondents scored in the low anxiety range, 75.4% in the moderate range, and 3.3% in the severe range (MDAS ≥19). No significant gender differences were identified (p > 0.05). Injections with local anesthetic were rated as the most distressing procedure (mean 2.29 ± 1.02), followed by drilling, whereas scaling was reported as least stressful. The majority (86.9%) had undergone previous local anesthesia, with very few adverse events recalled. Conclusions: The findings show that Romanian dental students experience mostly moderate levels of anxiety, with local anesthesia injections remaining the dominant trigger. The lack of gender differences points to a potential buffering effect of clinical exposure. These results support the inclusion of structured anxiety management within dental education and provide context-specific data for comparison with international cohorts.
Self-inflicted penetrating injuries in patients with mental disorders are a rare phenomenon. The authors report the case of a prisoner who recurrently presented to the emergency department over a period of four years for self-insertion of six metal foreign bodies into the skull. Computed tomography each time revealed the presence of a metal foreign body (screw, nail, metal rod, and wire) passing through the frontal bone into the frontal lobe. In each situation, the foreign body was safely extracted with a favorable outcome. Despite the use of the latest imaging modalities, metal artifacts can limit the assessment of vascular involvement, and special attention must be given to preoperative planning. Surgical extraction of the foreign body can be safely performed when appropriate preoperative planning is carried out to consider all possible complications.