Air pollution is a serious problem in Romania, with the country ranking 13th among the most polluted countries in Europe in the 2021 World Air Quality Report. Despite the recognized impact of pollutants on health, there has been a lack of large-scale studies conducted in Romania. This study investigated the impact of air pollutants on patients with chronic respiratory, cardiovascular, cerebrovascular, or metabolic diseases in Bucharest and its metropolitan area from 20 August 2018 to 1 June 2022. The daily limit values for particulate matter PM10 and PM2.5 were exceeded every month, especially during the cold season, with a decrease during the COVID-19 pandemic restrictions. A significant statistical correlation was found between the monthly average values of PM2.5 and PM10 and hospitalizations for respiratory and cardiovascular diseases. A 10 µg/m3 increase in monthly average values resulted in a 40–60% increase in admissions for each type of pathology, translating to more than 2000 admissions for each pathology for the study period. This study highlights the urgent need for national and local measures to ensure a cleaner environment and enhance public health in Romania according to international regulations.
Background/Objectives: This paper brings to light the results of extensive research on the dimension of dental care in Romania in terms of priorities and policies defined at the governmental level for a 25-year period (1999–2023). This research aims to present both individual and ecosystem perspectives on the influence of the way oral health strategies are shaped in Romania. Methods: The data collected are analyzed through the prism of the “iron triangle of healthcare”, focusing on the evolution of dental care from the perspective of the interrelationship of three important components: cost, quality, and access to healthcare services. Results: The paper provides insight and clarity into the context in which the doctor–patient relationship is constructed and developed, as well as a vision of how oral health policies should be designed to meet the individual needs of the patient, which will have an impact on the health and quality of life of the whole community. Conclusions: This study emphasizes the need to reconfigure oral health policies in Romania. Despite some input achievements like a considerable number of dentists, the systemic challenges that developed over these 25 years (such as insufficient funding, the reduced reimbursed procedures, and the limited dentists contracting with NHIH) have significantly contributed to a stagnation or decline of the oral health outcomes at the societal level.
Background/Objectives: Standard dental practice is being reshaped by digital technologies, and artificial intelligence (AI) is emerging as one of the most challenging recent innovations. Methods: The present study assessed the interest of Romanian dentists in the integration of AI into their current practice through an anonymous questionnaire distributed to 200 respondents. The questionnaire addressed the integration of AI in dentistry by analyzing the following areas of intervention: stages of patient care, perceived impact on the doctor–patient relationship, data security, implementation costs, and the legislative framework. Results: The results showed that 53.6% of dentists reported low difficulties, 37.3% reported moderate difficulties, and 9.1% reported high difficulties with using digital tools. Dentists’ reported willingness to adopt AI-based solutions was as follows: 58.6% were very willing, 30% were moderately willing, and only 11.4% were not very willing. Currently, 80.5% already use digital techniques in their daily practice. The participants emphasized the need to maintain a strong doctor–patient relationship while recognizing the benefits of increased efficiency. They were aware of the risk of diminishing human connection and trust. Also, data security and the financial stress associated with implementing and maintaining new systems were seen as major obstacles. Conclusions: The dentists surveyed showed an increased interest in modern digital technologies, provided that there is a clear legal framework, a strong data protection system, and the preservation of the doctor–patient relationship based on trust and confidentiality that defines the medical profession.
Dental endo-osseous implants have become a widely used treatment for replacing missing teeth. Dental implants are placed into a surgically created osteotomy in alveolar bone, the healing of the soft tissue lesion and the osseointegration of the implant being key elements to long-term success. Autophagy is considered the major intracellular degradation system, playing important roles in various cellular processes involved in dental implant integration. The aim of this review is an exploration of autophagy roles in the main cell types involved in the healing and remodeling of soft tissue lesions and implant osseointegration, post-implant surgery. We have focused on the autophagy pathway in macrophages, endothelial cells; osteoclasts, osteoblasts; fibroblasts, myofibroblasts and keratinocytes. In macrophages, autophagy modulates innate and adaptive immune responses playing a key role in osteo-immunity. Autophagy induction in endothelial cells promotes apoptosis resistance, cell survival, and protection against oxidative stress damage. The autophagic machinery is also involved in transporting stromal vesicles containing mineralization-related factors to the extracellular matrix and regulating osteoblasts’ functions. Alveolar bone remodeling is achieved by immune cells differentiation into osteoclasts; autophagy plays an important and active role in this process. Autophagy downregulation in fibroblasts induces apoptosis, leading to better wound healing by improving excessive deposition of extracellular matrix and inhibiting fibrosis progression. Autophagy seems to be a dual actor on the scene of dental implant surgery, imposing further research in order to completely reveal its positive features which may be essential for clinical efficacy.
Periimplantitis represents an inflammatory disease of the soft and hard tissues surrounding the osseointegrated dental implant, triggering progressive damage to the alveolar bone. Cumulative data have revealed that periimplantitis plays a crucial part in implant failure. Due to the strategic roles of autophagy and its upstream coordinator, the AKT/mTOR pathway, in inflammatory responses, the crosstalk between them in the context of periimplantitis should become a key research target, as it opens up an area of interesting data with clinical significance. Therefore, in this article, we aimed to briefly review the existing data concerning the complex roles played by ROS in the interplay between the AKT/mTOR signaling pathway and autophagy in periimplantitis, in each of the main cell types involved in periimplantitis pathogenesis and evolution. Knowing how to modulate specifically the autophagic machinery in each of the cellular types involved in the healing and osseointegration steps post implant surgery can help the clinician to make the most appropriate post-surgery decisions. These decisions might be crucial in order to prevent the occurrence of periimplantitis and ensure the proper conditions for effective osseointegration, depending on patients’ clinical particularities.
Air pollution, climate change and global warming show direct linkage. Introduction - Background: Research in the field has proposed and demonstrated their link to increased allergenicity in plants, leading to increased allergic diseases. Allergen patterns are changing in response to climate change. Across Europe, up to 12% of the population suffers from allergic diseases (bronchial asthma and allergic rhinitis) caused by the pollen grains. The medical costs of these types of allergies are enormous and are increasing with the spread of common ragweed - Ambrosia artemisiifolia* in Europe. In practice, more and more patients are turning to allergists. Methods: Based on these data, the research aims to identify safety measures and specific legislation to control and eradicate common ragweed in the countries most affected by the spread of this plant in Europe, increase in population exposure in countries affected by the presence of common ragweed and the socio-economic impact of allergic rhinitis and bronchial asthma at European level.[1][2] Our database search did not reveal any other research that has addressed this topic to date. Results: This research identifies specific legislation to the countries most affected by the spread of this plant pollen grains at European level, changes in allergen patterns and monitoring/safety eradication measures decided by local authorities, and data on the spread of common ragweed over the last two decades, costs per treatment, increased allergic rhinitis and bronchial asthma morbidity in the most affected areas. Conclusions: At European level, there are no universally valid models for eradicating this weed. Various methods can be used to limit the spread of common ragweed and its pollen production (e.g. mowing once or twice a year of overgrown land, ploughing, chemical control, public information, etc.). Local and regional cooperation should be considered essential to promote phytosanitary & safety measures and exchange of information on methods to identify and manage the spread of common ragweed. Unified legislation at European level would help all affected countries; reduce morbidity from respiratory allergic diseases and the costs of treating these diseases.