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The results after amputation compared to a salvaged lower limb are currently debated. For below the knee the outcomes vary and there is no consensus. We therefore consider important to present long-term outcomes of pediatric amputations. Our case has had half a decade of active living after a juvenile amputation. The now elderly patient is evaluated using gait analysis and functional outcome scores and compared to similar level amputees adjusted for age and gender from a group of 18 lower limb amputees that performed gait analysis as part of a larger study to determine gait modifications in below the knee amputees. The measurements were taken using a Zebris spatial detection instrument. The reason for amputation was severe trauma (crush injury) at the age of 5. The female patient had a transtibial amputation of the left leg that subsequently underwent repeated prosthetic fittings.The Gillette gait index revealed abnormal gait for the entire group of 18 participants, including the juvenile amputee. For this case the score was 42.1 compared to a mean of the group of 39.7. This can be interpreted as a poorer function compared to the mean of the study group. The Prosthesis Evaluation Questionnaire: for Appearance, Frustration, Perceived Response, Social Burden, Well Being, Satisfaction, Self efficacy and Importance the juvenile amputee produced higher values compared to the group average. These were considered significant since they were more that 15% better. For Ambulation, Residual Limb Health, Sounds, Utility, Pain, Transfer and Prosthetic care the values were below this cut-off value and thus were deemed comparable. Qualitative increased asymmetry can be found for adduction-abduction and inward-outward rotation of the hip and inward-outward rotation of the ankle. We conclude that juvenile below the knee amputations can be successful procedures for severe trauma. They produce favorable outcomes up to 50 years. The psychological results are dependent on time from index surgery and personality and are not necessarily correlated to function and gait symmetry, but more to acceptance of the disease. [ABSTRACT FROM AUTHOR]

The budget is a tool multiannual financial forecasting both at micro and macro level. In this sense, regional and local government budget is a financial instrument that connects resources to use local funds in order to ensure the prosperity of the community concerned. Construction and especially budget execution highlights the effectiveness of local and regional government. Using a system of indicators correlated reveals income, expenditure and budgetary outturn.

Interstitial lung diseases (ILD) are a group of extremely heterogeneous conditions (over 200), with low prevalence, but in most cases with severe impact on the quality of life and survival of the patients. The ILD group comprises: idiopathic pulmonary fibrosis, sarcoidosis, hypersensitivity pneumonitis, colagen diseases, vasculitis, eosinophilic pneumonia etc. The prevalence of these diseases is unknown in Romania; the accurate diagnosis needs access to special investigations and expertise with this group of diseases. The authors propose the initiation of a National Registry for Interstitial Lung Diseases and Sarcoidosis (REGIS), based on the lessons learned from other national ILD) registries, which should allow building-up an extended clinical expertise in ILD, evaluating epidemiological data, creating an educational platform for young physicians, better understanding of the outcome and prognosis of these diseases, shaping Romanian Guidelines for the diagnosis and management of ILD, using the data base for clinical research. The registry is started as a pilot in two Romanian centres: "Marius Nasta" Institute of Pneumology in Bucharest and Pneumology Clinic, "Victor Babey" Infectious Diseases Hospital Timişoara. After refining the inclusion criteria for the data base, editing guidelines for ILD diagnosis and launching the registry website, other Romanian centres with interest in ILD will also be able to feed information.