Timisoara Medical Journal

Iron deficiency anemia (IDA) and vitamin D deficiency are among the most prevalent micronutrient deficiencies worldwide, particularly affecting pregnant women. The physiological demands for both iron and vitamin D increase significantly during pregnancy to support maternal health, fetal development, and placental function. Failure to meet these demands leads to adverse outcomes, including preterm birth, low birth weight, preeclampsia, and maternal infections. Hepcidin, a liver-derived peptide hormone, is central to systemic iron regulation. It modulates dietary iron absorption and mobilization from body stores through its interaction with ferroportin. In healthy pregnancy, hepcidin levels are physiologically suppressed to enhance iron bioavailability. However, inflammation or vitamin D deficiency may elevate hepcidin levels, exacerbating IDA and complicating its management. Vitamin D, primarily recognized for its role in calcium metabolism, is also a key regulator of hepcidin expression. Through receptor-mediated pathways, vitamin D suppresses hepcidin synthesis, improving iron absorption and mobilization. The coexistence of IDA and vitamin D deficiency during pregnancy creates a complex clinical scenario, compounded by overlapping risk factors like poor diet, limited sun exposure, and chronic inflammation. Emerging evidence highlights hepcidin as a dynamic biomarker capable of differentiating IDA from anemia of inflammation. This review explores the intricate relationship between vitamin D deficiency and IDA, with a focus on hepcidin as both a regulator and biomarker. We discuss physiological and pathological mechanisms, diagnostic applications of hepcidin, and therapeutic opportunities, including the synergistic role of vitamin D and iron supplementation. By addressing the dual burden of vitamin D deficiency and IDA, this review provides a comprehensive framework for improving maternal and neonatal outcomes through targeted interventions and biomarker-guided therapies. Future research should focus on refining diagnostic tools and exploring innovative therapies to optimize anemia management in pregnancy. Full article

Abstract: Chronic hyperglycemia in the context of type 2 diabetes predisposes patients to developing diabetic chronic kidney disease. The following clinical case covers a 55-year old patient with a longstanding history of type 2 diabetes and essential hypertension admitted for typical symptoms of uncontrolled diabetes to the Diabetes Department of "Pius Brinzeu" Emergency Hospital. Clinical evaluation and laboratory results pointed to the diagnosis of nephrotic syndrome, however, did not present at first a clear cause for such high levels of proteinuria. This report follows the meticulous logic needed in order to establish the cause of nephrotic syndrome, all the way to a justifiable renal biopsy. Once diabetic nephropathy was established, adding treatment with an SGLT2i was considered a valid treatment option due to its antiproteinuric effects. Full article

This case report details the clinical use of layered lithium disilicate crowns, employing a customized technique that combines a modified chamfer on the vestibular surface with Vertical-Prep on the lingual surface. This concept was applied on six mandibular anterior teeth (4. 1, 4. 2, 4. 3, 3. 1, 3. 2, 3. 3) trying to achieve mechanical advantage of the vertical preparations alongside the aesthetic accomplishment of the modified chamfer technique. The lithium disilicate material used was characterized by high strength and biologic characteristics of the material made it possible to achieve highly satisfactory esthetic result with the color near to the patient’s original teeth. In terms of function, the restorations provided good stability and comfort to the patients and none of the patients complained any discomfort in the six-year follow up period. Both the crowns were proved to have long term sturdiness with out any fractures or wearing and thus this treatment modality can be held as successful outcome. This case also supports the concept of having a well-developed mode of preparation in tandem with using high quality ceramics in the creation of durable, esthetical dental restorations. Full article

This case report describes the use of a minimally invasive approach to the anterior dentition using feldspathic ceramic veneers with two axes of insertion. It was developed to restore as much of the hard structures of teeth as possible while at the same time giving the best esthetic outcome. Unlike other types of veneers that require extensive changes to the tooth shape due to single-axis placement, the technique presented allows for two axes of insertion. This approach enables minimal preparation and preserves most of the tooth structure. The veneers were applied on both maxillary and mandibular anterior teeth and additional six years follow up did not show any sign of fractures, debonding or marginal degradation hence proving the long-term success of this concept. The case highlights the significance of rigorous bonding sequence and the particularity of the fabrication process to achieve long-term outcome stability of the restorations. This work further confirms the applicability of double veneer technique as a reliable option for patients who desire change in their teeth appearance but without undergoing surgical procedures, but more research needs to be done with respect to its versatility in dentistry. Full article

Background: Recognized widely for its irreversible effects, periodontal disease stands as one of the most prevalent conditions, particularly emphasizing the potential for permanent damage caused by gingivitis, extending to encompass the entirety of the supportive complex, including the connective tissue and alveolar bone. Patients necessitating comprehensive periodontal and prosthetic treatments require an interdisciplinary approach, involving the coordination of pre-treatment procedures and appropriate prosthetic strategies. The adoption of advanced materials and techniques can prove beneficial in addressing complex dental issues. (2) Methods: Forty specimens were prepared using the prescribed procedure, with 20 acting as controls and the other 20 integrating AgNPs. The initial step involved crafting wax patterns of distinct shapes: dumbbell shapes for tensile testing and rectangular shapes for roughness assessments. These dimensions were aligned with ASTM D-638 and ISO 527-2 standards and adjusted to match the specifications of the analysis device for mechanical properties. (3) Results: In this case, the results indicate minimal differences in heat-curing acrylic resins compared to the control samples at a 5% concentration. However, notable disparities arise at concentrations of 10% and 20%. (4) Conclusions: Temporary prosthetic constructions are essential for preventing functional imbalances and complications. Incorporating AgNPs at a 5% concentration maintains mechanical properties while providing antibacterial effects for long-term interim prosthodontic restorations. Higher nanoparticle concentrations may reduce resin mechanical properties without affecting material surface condition Full article

(1) Background: This study delved into a current topic in dental medical practice to analyse the role and impact in communication of messages within health promotion campaigns. (2) Methods: This study analyses the patients' opinions about the role and importance of using an effective communication style in health promotion campaigns. The main aspects aims to analyse based on patients' opinions, the consistency of messages in health promotion campaigns, the repetitive nature of these messages, the adaptation of communication methods according to the target group's background and the importance of collaboration between state bodies and those organizing health promotion campaigns. (3) Results: The results of this study once again emphasize the close connection between the efficiency of health promotion campaigns, the way campaigns are coordinate and the messages for the target population. Most patients are aware about an effective communication in health promotion campaigns, believing that may influence the recipients' decision to adopt a healthy lifestyle concerning oral health. Regarding the effectiveness of health promotion campaigns for oral health, the study’s results reveal a significant lower positive impact among rural patients compared to urban ones. This indicates the need of change in how information is communicated to the population and to increase the level of health education. (4) Conclusions: In conclusion, the data obtained provides valuable and profound insights into how patients perceive the importance and role of communication in health promotion campaigns. The understanding of their perceptions and requirements forms the basis for developing and implementing efficient health communication and strategies, ultimately leading to improved community health and well-being. By personalizing and adapting the messages and communication methods, health promotion campaigns can become much more effective with a greater impact on health-related behaviours and attitudes. Full article

This study aimed to explore the relationship between inflammatory markers, apolipoprotein E (ApoE) levels, renal function, and mortality in patients with diabetic foot ulcers (DFUs). Conducted as a single-center prospective study at the Clinical County Emergency Hospital of Arad, Romania, the study included 90 patients diagnosed with infected DFUs. The main objective was to determine the risk factors for mortality over a three-year follow-up period, focusing on early versus late deaths. The results indicated a significant correlation between elevated levels of ApoE, pentraxin 3 (PTX3), procalcitonin (PCT), and impaired renal function with increased mortality. Patients with higher levels of these biomarkers, particularly those with impaired renal function, were more likely to experience early death, especially within the first 90 days after surgery. The findings underscore the critical role of these factors in predicting mortality and highlight the need for early intervention and aggressive management of these risk factors to improve outcomes in this vulnerable population. Despite advancements in medical and surgical care, the prognosis for patients with DFUs remains poor, particularly due to the recurrent nature of the ulcers and the presence of comorbidities like chronic kidney disease. Full article