Jurnal Medical Brasovean

2

Authors: Filiz Adana, Hülya Arslantaş, Leman Kutlu Aslan

This study was planned to investigate the effect of nursing education on submissive behaviours. This research was carried out at a university with the students (n=39) of Higher School of Health, between 2009 and 2013 years. During 2009-2010 Academic Education Year, the Submissive Behaviours Scale (SBS) scores of the 1st grade were evaluated and they were revaluated while students attending to 4th grade. Of the students, the 1st grade mean SBS scores were found as 35.18± 8.16 and the 4th grade mean SBS scores as 40.49 ± 9.95 (p=0.000). It was detected that nursing education has increased the students’ submissive behaviour scores.

4

Authors: Lavinia Tiurean, Dana Popa, Liliana Rogozea

implications on the health of the individual, as well as repercussions for the health system, through the associated public costs, but mostly through the varied pathology that it leads to as a risk factor. Content: In developed countries smoking remains a notable economical impediment despite the legislative measures imposed, such as the interdiction of smoking in public spaces. Developing countries on the other hand have had little to deal with in this respect until recent years, yet current trends indicate that in the next 15 – 20 years in the absence of appropriate measures smoking may become a more serious and harder to deal with health risk factor. Conclusion: Over the years, many clinical studies associated multiple morbidities to smoking, an association which determined researchers in this domain to draw attention to the fact that recently smoking has become a real problem of public health.

4

Authors: Petre VH Boțianu, Anca Bacârea, Vladimir Bacârea

This paper presents a literature review concerning the actual arguments for using the negativepressure therapy in clinical practice; this method has recently emerged as a possibility to accelerate the healing process, being used more and more frequently for difficult wounds. The use of this therapy is based mainly on experimental data and observational studies, associated with the simplicity of its use and the absence of significant complications. In many clinical situations there are no randomized clinical trials to support its routine use. The exact indications are difficult to establish using an evidence-based approach due to the great heterogeneity of both the patients and wounds, further prospective randomized studies being necessary.

4

Authors: Ioan Scârneciu, Alexandru Constantina, Dan Grigorescu, Laurian Maxim

Pyonephrosis is one of the most severe pathologies caused by high urinary tract obstruction, which untreated may progress to serious complications that culminate with septic shock and death. The most common cause of pyonephrosis is represented by kidney stones. Currently eco-guided percutaneous nephrostomy provides a means to drain the pus from kidney cavity and determining residual kidney function. In this study have been included 65 cases which were observed for a period of 5 years. Lumbar pain was present in 84%, fever and chills are found in 46% of patients and irritative symptoms in 75% of cases. Cytobacteriological urine analysis shows E. coli urinary tract infections in 55%, Enterococcus in 9% of cases, Klebsiella in 3% of cases, Pseudomonas and Proteus in 1.5% cases each and 30% of patients had sterile urine cultures. In all cases the diagnosis was confirmed by imagistic means. The predominant etiologic factor was incriminated by urinary stones in 53 cases, followed by genital neoplasia with secondary ureteral obstruction in 6 cases. Treatment consisted of primary nephrectomy in 48% of cases, in 38% of cases nephrectomy is performed at 3 weeks after eco-guided percutaneous nephrostomy and drainage of pus, primary eco-guided percutaneous nephrostomy was applied in 4 cases with a positive result, the resumption of kidney function. In 3 cases, patients did not survive until surgery (severe urosepsis and secondary septic shock). In conclusion nephrectomy is the surgical treatment of choice. The best treatment is to diagnose and treat urinary stones, which is the main etiologic factor.

4

Authors: Filiz Adana, Hülya Arslantaş, Filiz Abacıgil, Süleyman Ümit Şenocak, Gülten Baydar,

In this study; it is aimed to determine the differences of the facilities in the schools giving nursing education in Turkey, at the level of bachelor’s degree. The study has been done between January 2010-May 2010 in the Colleges and Faculties giving nursing education in Turkey at the level of bachelor’s degree, according to the leaflet (in 2010) of “Student Selection and Placement Centre (OSYM)”. The research’s population constitutes 69 Colleges, 11 Faculties giving nursing education at the level of bachelor’s degree in Turkey in 2010. The research’s sample is also the research’s population. The research’s data was obtained from web pages of the universities, from some students studying nursing in the universities, and from some Student Affairs offices of the universities. In the end of our study some differences are determined related to education in the universities giving nursing education in bachelor’s degree in Turkey

4

Authors: Geanina Ioana Cătănescu, Laurențiu Nedelcu

Patient 64 years old, known with: chronic obstructive pulmonary disease, chronic respiratory insufficiency, many exacerbations in the last year that required hospitalization and also with other comorbidities (diabetes, hypertension, chronic renal disease, chronic viral hepatitis with C virus), was presented to the emergency room with systemic and pulmonary congestion. The evolution was with an episode of monomorphic ventricular tachycardia, due to hypokalaemia, hypoxia and acidosis (occurring in the context of severe obstructive pulmonary disease) requiring electrical cardioversion. Prognosis in this patient with chronic obstructive pulmonary disease depends on the frequency of exacerbations and infections, but also by the associated comorbidities.

5

Authors: Ştefania Diaconu, Cristian Falup-Pecurariu, Radu Mircea, Cătălin Dragoş Jianu

Fatigue is a common symptom of neurological diseases. It has been reported with a prevalence that varies between 38 and 77% after stroke. There are many factors associated with post-stroke fatigue, including demographic, physical, mental and organic factors. The mechanisms proposed to explain poststroke fatigue are not fully understood but include decreased corticospinal excitability, interruptions of neural networks within reticular activating system, lesions of brainstem and basal ganglia and cytokine abnormalities. The most commonly used scale to asses post-stroke fatigue is Fatigue Severity Scale (FSS). Therapeutic options include medical treatment, cognitive therapy and gradual training of physical activity. Fatigue represents a disabling symptom for patients with stroke, being frequently associated with depression, anxiety and cognitive impairment. It has long-time consequences on rehabilitation, daily living and morbidity and it requires further investigations in order to improve patients’ quality of life.

5

Authors: Deaconeasa Alina, Moșoiu Daniela

Romania has in Europe the highest cancer mortality rate. The present study through a qualitative research using a semistructurat interview with 17 patients is aiming to highlight palliative care needs of women with cervix cancer. The thematic analysis shows the reluctance of patients to use the word cancer. Identified needs are multiple: physical (lymphedema, bleeding, infection, pain, and anorexia), communication (diagnosis, empathic listening), psycho-emotional (insomnia, depression), relational (loneliness), existential (finding meaning, finding faith) and support the idea of including palliative care in the main stream health care system.

5

Authors: Voda Daniela, Spirea Dana, Oțelea Carmen

Invasive aspergillosis is a major cause of morbidity and mortality in immunocompromised children. We present a case of nine year old boy admitted in Children Hospital Brasov with acute lymphoblastic leukaemia with B cells, which developed one month after beginning chemotherapy, severe neutropenia and cough, haemoptysis, dyspnoea, chest pain, back pain and pyuria. Imagistic evaluation revealed pulmonary abscess, kidney abscess, spondylodiscitis L1-L2 with paravertebral abscess. Serologic test showed high titters of aspergillus antibody. The case was interpreted as pulmonary invasive aspergillosis with renal and vertebral dissemination. This boy was treated a period of seven month with complex antifungal therapy (intravenous and oral) in association with multiple scheme of antibiotherapy. The evolution was difficult, but favourable, with stopped chemotherapy and remission systemic fungal infection. Chemotherapy was reintroduced after 5 months with complete remission of the underlying disease.

6

Authors: Elena Bobescu, Horatiu Rus, Eduard Belu, Alexandru Covaciu, Monica Marilena Tânțu

Aims: Evaluation of prognosis in patients with non ST elevation acute coronary syndromes (NSTE– ACS) and diabetes mellitus (DM) or metabolic syndrome (MS) in correlation with inflammatory and oxidative stress. Methods: 172 patients (pts) with NSTE-ACS were included in a prospective study for a period of 3 years and divided in three groups in relation with DM or MS association. Results: In NSTE-ACS patients with DM or MS it was observed a significant increased incidence of: lower than 40% ejection fraction (p<0.05); readmission for heart failure III-IV NYHA class and unstable angina (p<0.05); acute myocardial infarction and cardiac death (p<0.05) at 3 years of follow up in comparison with NSTE-ACS non MS non DM group. It was no significant differences between NSTE-ACS with diabetes mellitus and with metabolic syndrome groups at 3 years. In NSTE-ACS patients, presence of diabetes mellitus or metabolic syndrome were associated with significant higher incidence of inflammatory (p<0.05, p<0.01) and oxidative stress (p<0.05) at 6 months. Conclusions: In non ST elevation acute coronary syndromes patients, the presence of diabetes mellitus or metabolic syndrome was associated with significant higher incidence of low ejection fraction, readmission for heart failure III-IV NYHA class and unstable angina, acute myocardial infarction and cardiac death at 3 years of follow up and with significantly increased inflammatory and oxidative stress at 6 months.

6

Authors: Dan Ovidiu Grigorescu, Radu Vaidahazan, Claudiu Corâiu, Bogdan Bâldea, Silviu Mihai

Although hand trauma produced by firecrackers explosion has a small incidence, their increased frequency in a very short period of time represents a challenge for the plastic surgeon and a redoubtable public health problem. We analysed the pattern of injury, the available reconstruction methods, and the resources needed for the social reintegration. This retrospective study analysed 29 cases of hand trauma caused by firecrackers/fireworks explosion in the New Year period of the last 2 years. The data analysis shown that it was involved: a) mainly the dominant upper limb; b) the thumb (in all the cases); c) the three digital pinch elements; d) a concomitant the soft tissues damage. As surgical procedures, it was performed in every case the suture after debridement and at least one procedure of reconstruction with skin grafts and local plasties. Distal pedicled flap were used rarely for digital and soft tissues reconstruction. The study emphasized the continuous and progressive growth, in the last years, of this type of trauma incidence, worsening of situation in terms of lesions and the negative economic impact on the public health system.

8

Authors: Andreea Codruţa Coman, Doina Adina Todea, Meda Romana Simu, Livia Vincze,

Focusing the attention to the education for health, with the topic on obstructive sleep apnoea syndrome (OSAS) we can improve the humans health. The aim of this study was to evaluate the OSAS patients characteristics. We conducted an observational, descriptive, retrospective study in Sleep Laboratory of University of Medicine and Pharmacy "Iuliu Hatieganu", during 2010. From all 148 subjects, 79.05% were males; 89.19% - were between 30-69 years age. Mean neck circumference was 45.97± 5.31 cm and mean abdominal circumference was 116.36±17.26 cm. More than half of the subjects (55.14%) had severe OSAS with apnoea hypopnea index >30 events/sleep hour. There is a significant statistical correlation between AHI and neck circumference, abdominal circumference, medium oxygen saturation, minimum oxygen saturation, (p=0.000), Epworth Sleep Scale (p=0.001). The need of knowledge about OSAS and the importance of Sleep Laboratories are topics which need to be improved in order to have great education for health.

9

Authors: Filiz Abacıgil, Burak Capacı, Erdal Beşer, Bugrahan Gurcan, Mucahit Avcil, Anıl

Although hospital work environment is one of the most hazardous place to work, there are relatively little studies focused on heath personnel’s’ perceptions about workplace safety. This study investigated perceptions of health personnel about work safety at a university hospital and its relationship with occupational injuries. Questionnaire included demographics, exposure to an occupational injury, occupational safety scale for health personnel and universal precautions compliance scale. The lowest scores for the hospital safety were given for the dimensions measuring “occupational diseases and complaints” and “management support and approaches”. Gender, unsafe behaviours, and long working hours affected exposure to an occupational injury. Healthcare workers who experienced an occupational injury stated lower safety scores for the dimension “management support and approaches”. Hospital administrations should give much more attention to safety regulations in order to improve safety and health in hospitals. This study confirms the importance of management support (by arranging working hours, giving priority to training activities on safety practices and identifying problematic dimensions for safety) to come over occupational injuries.