Jurnal Medical Brasovean

2

Authors: Liliana Rogozea

Ideea de a vorbi despre compromis nu e nici nouă nici inedită. Alexis Carel spunea că: „Civilizația este înainte de toate o disciplină; disciplina fiziologică, morală, socială și științifică.” Cu toate acestea medicina secolului actual, asemenea celei din perioadele anterioare este o îngemănare între respectarea strictă a regulilor etice ale profesiei, așa cum s-au format ele de-a lungul timpului, plecând de la celebrul non-nocere și compromisurile zilnice pe care, personalul medical le face în fiecare zi.

3

Authors: Emanuela Păltinişanu, Daniela Vodă, Oana Falup-Pecurariu

Hereditary spherocytosis is the most frequent type of chronic haemolytic anaemia, usually inherited in an autosomal dominant pattern. We present in this paper a case report of a child diagnosed with hereditary spherocytosis in the neonatal period. The diagnosis was made in the context of suggestive family history and typical presentation. The clinical course was outlined by numerous haemolytic crises which required repeated blood transfusions.

4

Authors: Dinu I. Dumitrașcu, Lucia I. Timis

Despite very advanced research and technology development in the medical field, malpractice and iatrogenic complications are still frequent in the health system. A main cause for medical errors is the human error. A simple and efficient tool in reducing medical complications is the briefing. The briefing is a succinct session of instructions for the medical staff on how to accomplish a given procedure or task. The aim of this paper is to make a review of the most efficient medical briefings described in the literature.

4

Authors: Monica Marilena Ţânţu, Carmen Domnariu

Communication is an integral part of the dynamism of social processes as well as their explanatory tool. Its main features are understanding, knowledge, socialization, influence and persuasion. Communication in nursing is different because of the context, involved behavioural typologies and the characteristics of the care process. It is carried out according to the general principles of communication adjusted to the specific of care activity. Effective communication leads to increased compliance of the patient to treatment, improved dependence and improved satisfaction from the patient. Benefits are for nurses, too, namely strengthening the image of professional nursing, permanent and progressive development of communicative competence.

4

Authors: Codarcea M. Dorin

ENT emergency medical activity is very complex in Brașov County , as is seen from a study made over a six month in 2013. The study revealed that ENT patology needs a complex and constantly approach, mainly because of the tourists are where we are working in.

4

Authors: Liliana Rogozea

Gheorghe Cârțan is one of the most fascinating personalities of Transylvania; more than having descended from Roman emperor Trajan's column as living proof of Dacian and Roman permanence and continuity, he is the one who has succeeded in enlightening the minds and souls of 19th century Transylvanians by the books he carried in his knapsacks from the other side of the mountains. The paper aims at arguing the importance of the books chosen by Badea Cârțan [Brother Cârțan] for the health education of Transylvanian Romanians, books that could be presented and signalled to researchers from other regions of Romania by various means, including online platforms.

4

Authors: Simona E Cioinac, T. Lavalle

Background: The number of patients with oncological diseases in hemodialysis is sharply increasing. These patients require hemodialysis and a personalized care that improves the tolerability, management of complications, pain, anxiety and fear of the patient and family. The literature presents approaches in different oncological diseases but there is still a dialysis treatment that allows greater tolerability. In this article, we describe the alternation of two different treatments and highlight the necessity of a personalized care process. Case presentation: Patient diagnosed with ovarian cancer, after countless series of complications, in the terminal phase requires service and haemodialysis customized. Prescribed treatment was: three treatments on-line hemodiafiltration of the duration 3:30 hours using monitors for intermittent haemodialysis. The fourth treatment catheter veno-venous hemodiafiltration of the duration 4 hours using monitors for continuous haemodialysis. Conclusion: The case presented shows the need to identify a personalized care pathway for the management of cancer patients on haemodialysis and their families. The alternation of the two treatments has allowed greater tolerance and fewer complications.

5

Authors: Mihaela Elena Idomir

The aim of this retrospective study was to analyse the involvement in pathology and antibiotic resistance of the Pseudomonas strains isolated from hospitalized patients. The spectrum of infections has been wide, Pseudomonas spp. being more often involved in wound infections (27.1%), infected varicose ulcers (23.2%), respiratory (18.2%) and urinary infections (17.8%). There were reported varying levels of resistance to the tested antibiotics except colistin. The results of the study show the importance of the antibiogram and of monitoring the resistance phenotypes in hospitals.

5

Authors: Andrada Nicolau

Dental diseases such as dental caries, periodontitis, trauma and dental abnormalities have spread with either explosive or remission stages throughout human history. In recent decades it has achieved a great dental caries prevalence. Studies in recent years have developed the idea that a phenomenon as complex as tooth decay, is dependent on the action of multiple factors, whose action must take place simultaneously in order to determine the pathological process .. Prevention of dental caries is an acute need because the high level of dental caries prevalence raises problems organizational, social and especially economical. The aim of this study was to determine the prevalence of caries in patients review to identify the main risk groups and the degree of application of methods to prevent dental caries. The study was conducted on a total of 148 patients aged 10-40 years, of which 89 female and 59 male who presented at the dental office during 1.10.2014-1.05.2015. These patients were determined the degree of oral hygiene and local or general dental fluoridation, dentists frequency of verification and determination of the appreciation of the illness by tooth decay (DMFT). Results of the study show the link between patients and dental health habits.

6

Authors: Meda-Romana Simu, Andreea Coman, Liliana Rogozea, Cristina Borzan

Workplace conditions are directly reflected on the health of dentists, influencing the quality of medical services and thus indirectly influencing the health of the general population. In the general context of occupational risk we proposed a review for assessment, identification and analysis of biological and chemical risk factors that professionals and patients are exposed to in the dental office, for an effective management of dental healthcare system in Romania, as part of health system.

6

Authors: Vodă Daniela, Mihaescu Satinger Miriam Shirley

onducted in Children Hospital Brasov, over a period of 12 month, and the principal aims were to determine the prevalence of urinary tract infections related age, sex, predisposing risk factors and treatment with antibiotics. We detect 188 cases with urinary tract infections with predominance of cystitis in adolescents. The most frequent encountered bacteria was Escherichia Coli and the most frequent treatment administrated in hospital were third cephalosporines. In our study, among congenital malformations, the most frequent were hydronephrosis and vesicoureteral reflux.

6

Authors: Magdalena Diaconu, Florentina Cristina Pleşa, Cătălin Constantin Lulciuc, Mugur

Polytrauma means multiple injuries of various anatomical regions out of which at least one or a single combination has vital risk. As a complex process, polytrauma requires primary, secondary and tertiary evaluation of critically ill patient, both systemically and targeted. The most accurate definition of major trauma is found in terms of injury severity score. Multiple trauma patients belong to the category of those who, during secondary and tertiary management, benefit substantially from the support of intensive care services, where opportunities for specific monitoring and supportive therapy are provided. Study objectives: to define the demographic profile of the patient with multiple injuries, to identify multiple injury prevalence in emergency section casuistry, to establish the types of trauma and their weight. The study was conducted over a period of 12 months, inretrospect, on a lot of 384 trauma patients. Trauma patient's demographic profile shows that it is a male, aged mainly between 31-40 years, followed by those aged between 51-60 years. In emergency section casuistry multiple injuries occupies 8% of pathology and the weights on types of trauma are comparable with the data in the literature.

9

Authors: Dan Ovidiu Grigorescu, Radu Vaidahazan, Maria-Cristina Mateescu, Silviu Mihai,

Silver and silver-based compounds have been used during the millenary history of humanity in order to treat wounds, infections, ulcers and other skin lesions due to their antibacterial, antiviral and antifungal properties. Though lately researchers have focused mainly on the discovery of new silver-organic compounds, through which the effects of silver could be put into evidence, in this review we demonstrated that the use of other forms of silver remains effective. Thus, the metallic form of silver and the inorganic compounds such as silver nitrate has proven to be a simple and inexpensive method and to have a remarkable therapeutic efficiency in different surgical specialties: General Surgery, ENT, Gynecology, Urology, Plastic Surgery, etc. This paper can be considered to be a monograph including the most important principles of the silver based treatment, its biological mechanisms of action at the molecular level (also in microorganisms) and its adverse reactions generated in the human body.

1

Authors: Liliana Rogozea

Ideea de a vorbi despre compromis nu e nici nouă nici inedită. Alexis Carel spunea că: „Civilizația este înainte de toate o disciplină; disciplina fiziologică, morală, socială și științifică.” Cu toate acestea medicina secolului actual, asemenea celei din perioadele anterioare este o îngemănare între respectarea strictă a regulilor etice ale profesiei, așa cum s-au format ele de-a lungul timpului, plecând de la celebrul non-nocere și compromisurile zilnice pe care, personalul medical le face în fiecare zi. Dezvoltarea unui sistem de calitate, accesibil oricărui individ este un obiectiv profund moral și etic. Cu toate acestea medicii sunt adesea nevoiți să accepte compromisul de a decide care program de sănătate este prioritar și care sunt fondurile alocate pentru aceasta; iar atunci când decizia nu le aparține, ci aparține altor persoane (economiști, juriști sau simplu: politicieni) acceptarea compromisului, deși pare mai ușoară este la fel de complicată. Compromisul intervine și atunci când trebuie luate decizii legate de acceptarea realizării trialurilor clinice, convinși fiind că progresul medical este legat în permanență de menținerea unei balanțe optime între dezvoltarea unei noi cercetări medicale și asumarea criteriilor morale care mențin cercetarea în limitele moralității. Și totuși, compromisul nu e decât o etapă tranzitorie, pentru că „Etica nu este o fantezie mistică - nici o convenţie socială - nici un lux de care ne putem lipsi, subiectiv... Etica este o necesitate obiectivă a supravieţuirii omului - nu prin providenţa supranaturală, nici a vecinilor dvs., nici a toanelor dvs. – ci prin "graţia" realităţii şi natura vieţii.” (Ayn Rand în Virtutea dăruirii de sine)

3

Authors: Filiz Adana, Hülya Arslantaş, Filiz Abacıgil, Müge Çabuk, Şerife Çetinkaya, Özgür Demir

The aim of this study was to evaluate students’ knowledge and attitudes about ageing and sexuality. This cross-sectional study was conducted on 396 nursing and midwifery students in Adnan Menderes University Aydin Health School between 23 May 2011- 3 June 2011. Ageing sexuality knowledge and attitudes scale in elderly (ASKAS) was used in order to evaluate students’ knowledge and attitudes. It was found that there wasn’t a significant correlation between the students’ acceptance of sexual intercourse and their knowledge about sexuality in elder people (t=1.63; p=0.11). On the other hand, students who thought that older people could have sexual intercourse, were found to be more tolerant attitudes towards elderly sexuality(t=3.90; p=0.000). It was observed that the more the students had knowledge about elder sexuality, the more they had tolerant attitudes; however there was a negative correlation between age and knowledge/attitudes (r=0.625, p=0.000; r= -0.365, p= 0.003; r=-0.262, p= 0.09). No significant relation was found between ASKAS and other variables.

3

Authors: Agnieszka Ryczek

Human nature, but to a large extent determined by the bio-human can be to some extent shaped and changed. People are different from animals that are able to understand and analyze their own lives, and therefore they may try to make them morally better, that is laudable in terms of ethics.

4

Authors: Iosif Șamotă, Radu Dan Necula, Florin Lucian Petrică Sabou

Heterotopic ossification is defined as the presence of mature lamellar bone in soft tissues such as muscles, tendons, skin or organs, where bone normally doesn't exist. It can appear more frequent as a complication following central nervous system disorders like acute brain injuries, brain tumors or spinal cord injuries, or following burns, hip and elbow surgery. For heterotopic bone formation some local and general specific conditions are necessary. The three main conditions are: presence of a morphogenetic induction agent, mesenchymal progenitor stem cells and a permissive local and general environment.

5

Authors: Laura Floroian, Mihaela Badea, Iosif Șamotă

Bioglass is a chemical compound that is part of a compositional family with the best bioactivity properties demonstrated by the connection with living tissue within few hours. This new class of biomaterials, based on a mixture of amorphous oxide (SiO2-Na2O-CaO-MgO K2O-P2O5), was patented in 1968 by Larry Hench by preparing well known Bioglass 45S5. Depending on the percentage of SiO2 mainly these biomaterials can be bioinert, bioactive and bioresorbable. Hench and Clark were the first researchers who have observed this material bioactivity in vitro and in vivo have demonstrated the potential osteointegrable. There have also been noted and antimicrobial and anti-inflammatory properties and the ability to easily control the crystallinity by applying appropriate heat treatments present in the vitreous phase bioglass. All these are arguments plus for this class of biomaterials to be a prime objective of the research in the field.

5

Authors: Cristian Falup-Pecurariu, Bogdan Cârlan, Ștefania Diaconu, Radu Mircea, Alina Voina, Sorin Paripaș, Oana Falup-Pecurariu, Roxana Alexandru, Cătălin Jianu

Traumatic brain injuries have an important impact on patients’ quality of life, with various short- and long-term consequences. Sleep disorders are frequently encountered in these patients and are associated with significant functional daytime disturbances and impaired rehabilitation potential. The aim of this prospective study is to determine the prevalence of insomnia following traumatic brain injury and also to review the clinical features, tools of assessment and main outcomes of this sleep disorder.

5

Authors: Magdalena Diaconu, Cristian Georgescu, Cristina Pleşa, Monica Ţânţu

Polyradiculoneuritis is a fairly rare disease, but with significant neurological impairment, which may even lead to death if not treated in time. However, early and constant treatment has claimed favourable results. Plasmapheresis is an effective etiopathogenetic treatment option for polyradiculoneuritis. Our case is a 50-year-old woman, diagnosed with acute polyradiculoneuritis, Fisher form, who has been conducted five plasmapheresis sessions. Initially, the patient had diplopia, right eyelid ptosis, right facial asymmetry, upper limb paresthesia, distally stressed, limited movements of abduction, abolished tendon reflexes in the lower limbs, ataxia, muscle hypotonia. It was established the diagnosis of acute polyradiculoneuritis based on the clinical picture, in conjunction with the results of NMR (nuclear magnetic resonance) and laboratory tests (blood parameters, cerebrospinal fluid). It was decided to apply plasmapheresis treatment as therapeutic modality, performing the 5 sessions every two days. After the third session, the clinical condition of the patient improved, the motor deficit was in remission, normal coordination. At the end of the five sessions of plasmapheresis, the evolution was favourable, halting progression of neurological deficits, improving the general condition and reducing the limb motor deficit, but maintaining VI and VII cranial nerve paresis. Using plasmapheresis resulted in improved patient dependency and improved quality of life in a shorter period of time as compared to therapy without plasmapheresis results, thus supporting its effectiveness in polyradiculoneuritis. This is precisely why we chose to present this case, although our experience in this regard is relatively recent, for about a year.

6

Authors: Laura Floroian, Mihaela Badea, Iosif Șamotă

Although recently accepted by the scientific community, the research into nanotechnologies and biotechnologies are currently the priority directions for several prestigious international research laboratories of physics, chemistry, medicine, molecular and cellular biology, study of materials and cybernetics. Field became interdisciplinary and is booming, and the goal is to develop new technologies and high-performance materials. An important category of materials for nanotechnology and biotechnology is the biomaterials. They are used to direct material, restore the functions of living systems supplement and have a major impact on biomedical applications, particularly in the medical and pharmaceutical industry.