Jurnal Medical Brasovean

1

Authors: Liliana Rogozea

Dincolo de medicină, studenții mediciniști se remarcă tot mai mult și în alte domenii, iar medicii își dovedesc ulterior și alte abilități decât de a îngriji pacienți. Medici scriitori, medici muzicieni, medici politicieni, medici comentatori politici și de ce nu, medici bloggeri – iată direcții interesante ale activității acestora și care își au adesea originea în perioada studenției. Vă propun astăzi o scurtă incursiune în timpul liber al unui student la medicină, plecând de la faptul că, a rămas încă încetățenită ideea că medicina îți acaparează în totalitate toate momentele pe care le ai în afara celor petrecute la patul pacientului. Medicii cu înclinație spre literatură și recunoscuți pentru talentul lor nu sunt puțini, atât în România, cât și în străinătate; putem aminti doar câțiva din cei mai cunoscuți: Vasile Voiculescu, Augustin Buzura, C.D. Zeletin sau Friedrich Schiler, Mikhail Bulgacov, A.P. Cehov și William Somerset Maugham. Unii au reușit să își continue activitatea ca medici, pentru alții însă pasiunea pentru scris s-a dovedit mult mai puternică, dar și pentru unii și pentru alții influența medicinii a rămas hotărâtoare de-a lungul anilor. Și toate astea pentru că, așa cum spunea Petroniu în Satyricon: „Medicul nu e nimic altceva decât o mângâiere sufletească”.

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Authors: Petre Vlah-Horea Boțianu, Anca Bacârea, Radu Chirteș, Paul Ionescu, Gabriela Boțianu

We report a rare case of aneurysmal dilatation developed at the level of a Brescia-Cimino arteriovenous fistula performed for dialysis. In the particular clinical situation of our patient (significant clinical complaints and a functional renal transplantation) we performed an excision of the fistula with reconstruction of the radial artery by an autologous venous graft interposition, with good postoperative outcome. Although this solution was more technically demanding, it has allowed both a complete excision of the fistula and aneurysmal dilatation and the preservation of the hand blood supply.

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Authors: Liliana Rogozea

In 1946, under the auspices of the British mission in Romania, medical professionals receive an important gift: a publication made at Romanian Society of Statistics Publishing House. The book: Penicillin - Compendium of English medical publications with annual additions, structured in the following chapter: The discovery of penicillin Preparation of penicillin, Preliminary studies, laboratory methods and the chemical properties of penicillin, Pharmacology and experimental therapeutics, Clinical uses of penicillin, Penicillin surgical applications, Medical applications and Penicillin applications in different diseases. Volume has emerged as "the result of numerous requests of information on various aspects of penicillin by many of my Romanian Colleagues" as mentioned in the Introduction I G.B. Shirlaw, major British medical doctor at Mission Romania, and is proof of the good relations between the two nations

5

Authors: Popa Daniela

As medical knowledge grows exponentially, it is important that medicine graduates be prepared to continuously engage in new forms of learning in the future. This article provide evidences from recent research studies for designing teaching framework to facilitate active learning for medicine students. Active learning is a key element in knowledge retention, deep learning and academic performance. Current research shows that new approaches to teaching healthcare are: self-regulated learning, computer assisted learning, simulation and problem solving.

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Authors: Oana Dimienescu, Alina Jegan Bichis, Marius Alexandru Moga, Cristian Arvatescu, Nicusor Bigiu, Laura Dracea

Intrauterine growth restriction of the fetus (RCIU) is so far one of the most complex issue of obstetrics, representing a common complication of pregnancy where the fetus can be defined as the failure to reach the genetically programmed size. Genetic polymorphisms, maternal, placental and fetal are responsible for encoding proteins and hormones, being shown to influence the fetal growth. Among the best known genetic causes of intrauterine growth retardation are found placental, maternal and fetal genes. This paper presents a review of genetic changes found in intrauterine growth retardation, especially those related to placental genes , with predilection IGF, placental growth factor and other genetic mutations.

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Authors: Maria-Elena Cocuz

Measles, acute viral infectious disease, highly contagious, affects especially children of all ages but can be seen at any age. Measles morbidity is low if vaccination coverage rate is increased more than 95%. Prevention is achieved through measles vaccination, with two doses of vaccine. This is a retrospective study, performed on 550 patients hospitalized with measles in the Clinical Infectious Diseases Hospital of Brasov during 1 Jan. 2012-1 Nov. 2016. The objective was to analyse some epidemiological and clinical aspects. In 2012, 436 patients were hospitalized, then the number of patients has decreased to 0 in 2014 and 2015; in 2016 there were again reported cases of measles – 48. Most cases were in children – 94.18%; in infants frequency was high – 31% cases. Most patients had complications, of which the most common were pneumonia – 88.36% cases. The evolution was favourable in all cases. Education of the population in favor of measles vaccination is imperative for effective prevention of the disease.

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Authors: Kamile Öner, Hülya Arslantaş

This study is conducted as a cross sectional research in order to investigate the depression, internet addiction and loneliness relationship in adolescents of high school students. It is targeted to reach 690 students. In the study, Personal Information Form, Beck Depression Scale, Internet Addiction Scale and UCLA Loneliness Scale are used. In the evaluation of the data, descriptive statistics (frequency and percentage values, minimum, maximum, average and standard deviation), and Pearson correlation coefficients are used. When the characteristics of adolescents of high school students participated the survey are examined, it is found that 46.0% of the adolescents are women, 30.6% of them study in 9th grade, 30.9% of them are 17 years old, and 74.3% of them have internet connections in their homes. It is determined that the level of internet addiction in the adolescents with depression tendency (=19.40±18.61) is significantly higher than the adolescents without depression tendency (=9.81±11.77) and the level of loneliness in the adolescents with depression tendency (=52.61±6.57) is significantly higher than the adolescents without depression tendency (=50.75±6.74). It is determined that there is no significant relation between the levels of loneliness and internet addiction in the adolescents (r=0.011; p>0.05). Besides, it is determined that there is a positive and high level relation between the depression level and internet addiction of the adolescents (r=0.384; p<0.05) and there is a positive and low level relation between the loneliness level and internet addiction of the adolescents (r=0.090; p<0.05)

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Authors: Teodora Mathe, Liliana Rogozea

Professional activities very demanding in terms of emotional and interpersonal networking, specific to the profession as a physician, nurse, psychologist, social worker may have negative consequences described in the literature as the burnout syndrome: a three dimensional construct composed of emotional exhaustion, depersonalization and low personal achievements. Aim: analysis of the characteristics of people with low and medium burn-out syndrome in departments where staff come into contact with patients aged below 18 years. Method: The study was conducted on a group of 129 medical employees from health care, whom had applied Maslach Burnout Inventory (MBI); The analysis covered three domains: emotional exhaustion, depersonalization, low level of personal achievements. Results and Conclusions: People with medium and low level of burnout do not recognize the need for professional help in a significant proportion: regarding the depersonalization (54.26% and 16.28%) and regarding the personal achievements (19.38% and 12.38%)

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Authors: Veronica Cristea, Codruța Nemet, Ana-Maria Tibrea, Liliana Rogozea

Background: The variables of temperatures (sudden temperature drop) and humidity (high values) express a high risk of upper respiratory tract infections. Material and methods: Starting from this we gathered the necessary data to see the meteorological modifications correlated to the appearance of the upper respiratory tract infections (URTI) in Brasov County we performed a retrospective study in Brasov, analysing a period of 3 years, between 2011 and 2013. Conclusions and discussions: Low temperatures together with a high value of humidity revealed an increase in the Upper Respiratory Tract Infection. Low temperatures also showed a decrease in the body defence mechanism against the infections which resulted in a higher rate of reported cases. Brasov County has a unique meteorological characteristic with lower temperatures and high humidity compared to other parts of Romania. The results showed an increase in the upper respiratory tract infections at medium temperatures from the years included in the study.

1

Authors: Liliana Rogozea

Vorbim adesea de situații în care schimbarea în medicină e asigurată de descoperirea cauzei unei îmbolnăviri sau a unui tratament pentru o boală care impresionează prin faptul că e invalidantă sau că produce un număr mare de decese. Cu toate acestea istoria medicinei ne arată că există și alte lucruri care ar trebui să ne impresioneze: modul în care oamenii reacționează în fața bolilor care afectează un număr mare de persoane de-a lungul timpului. În contextul în care apar noi și noi provocări în domeniul epidemiilor, provocări care se alătură celor existente, nu putem să nu ne întrebăm cât de mult ne folosesc sau ne încurcă paradigmele din domeniul sănătății publice și ce ar trebui să facem pentru a avea un echilibru între acestea și obținerea de noi rezultate în combaterea unor afecțiuni și crearea unor obiceiuri

3

Authors: Ciprian Adrian Dinu, Dan Botezatu, Gabriela Balan, Dragos Cristian Voicu, Iuliu Fulga

Arrhythmia refers to any disorder of the heart rate or frequency. It may be transient or continuous, present at birth or acquired, or caused by toxins or medication. The main risk of any arrhythmia consists in the decrease of the ejection fraction or the degeneration of arrhythmia into ventricular fibrillation. An investigation of the cardiovascular parameters (starting with ECG and ending with an electrophysiological study) contributes to an accurate diagnosis and to the medicinal or surgical treatment of arrhythmia.

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Authors: Silviu Caloian, Roxana Miclaus, Nadinne Roman

Microsoft Xbox Kinect is a soft device applied into a video game: a sensor attached to a video camera detects body movement and helps to control video games through gestures, movements and voice commands. It is useful in medical and therapeutic practice developing a virtual reality custom and based on a video game, allowing the user to perform physical and cognitive rehabilitation therapies, using virtual rehabilitation exercises. Used in several Rehabilitation centres around the world, Microsoft Xbox Kinect is exploited in Romania as MIRA – “Medical Interactive Recovery Assistant”, platform for medical rehabilitation addressed to disabled children and their physiotherapists and rehabilitation physicians. The system might be also used in high-tech medical rehabilitation using virtual rehabilitation and research, with modern equipment, but and not extravagant costs.

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Authors: Bianca Ioana Chesaru, Ciprian Adrian Dinu, Michaela Dobre, Monica Elia Georgescu

Iron deficiency is an illness of the entire body, where anaemia occurs in an advanced stage. In the iron deficiency anaemia, the decrease of haemoglobin is accompanied by a decrease of serum iron, while the total iron binding capacity increases, the result being transferrin saturation lower than 10%. These paraclinical tests underlay the composition of a study group comprising children diagnosed with iron deficiency anaemia at St. John’s Emergency Clinical Hospital for Children in Galați during August 1st, 2013 - July 1st, 2014. The results of the study revealed illness occurrences by age divisions and genders and by the number of cases reported in comparison with the reported national data. The occurrence frequency of infantile iron deficiency anaemia, as well as the risks supposed by the iron deficiency installed require further efforts to raise the population’s awareness as to the importance of healthy eating, starting with early childhood.

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Authors: Laura Floroian, Dan Floroian, Mihaela Badea

Over the years have been introduced and used many deposition techniques to obtain coatings of the biomaterial implants in order to increase their functionality. The latest methods, by which coatings of high quality with a variety of special properties were obtained, are pulsed laser deposition and matrix assisted pulsed laser evaporation, which are based on the fact that a pulsed laser is able to vaporize congruent and instantly any material. First their advantage is that materials with complex composition can be transferred on the substrate without stoichiometry change. In this way is possible to obtain also multistructures and the size of the layers can be controlled with very high precision (less than angstrom).

6

Authors: Dan Grigorescu, Sabina Biris, Radu Vaidahazan, Claudiu Coraiu, Floredana Sav, Ciprian Cimpeanu

The primary cancellation of the posttraumatic or iatrogenic soft tissue defects at the fingers of the hand (2-5) could be performed according to long term established protocols by using a primary suture or a plasty (free skin or flaps). When the defect is characterized by a deepness lack of soft tissues, the flaps are the only option to restore the structure and the function of the damaged finger. A lot of flaps were created to ensure the coverage of the defects located at the fingers, but most of them were effective to cancel the defects with smaller or equal dimensions with those of a single phalanx. The great majority of these flaps don’t have a real potential to solve the problems raised by larger defects two times larger than that, being the structural equivalent of the double-phalangian defects. The aim of this article is to emphasize the main types of flaps that could be used to ensure the coverage of the soft tissue defects in the fingers and their limits in solving the cancellation of bigger defects that overstep the single phalanx dimensions.

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Authors: Elena-Mihaela Bucur, Elena Nica, Katalin Csutak, Sanda Florian, Emanuela Cojocaru, Maria Mitrica, Oana Falup-Pecurariu

Pancreatitis is an inflammatory disease that affects all age groups, with lower incidence in children compared with adults. Despite it is low incidence at children pancreatitis caries a high emotional burden both to the parents and children. The aim of this study was to highlight the correlations between laboratory parameters, abdominal ultrasound and diagnosis of acute pancreatitis at children admitted at the Children Clinic Hospital Braşov. We have enrolled a number of 11 patients that fulfilled the criteria of pancreatitis. At these children we have performed all the lab exams, and we have identified the existence of correlation between symptoms, elevated serum amylase levels and abnormal abdominal ultrasonography. Imaging examinations plays an important role in the diagnosis of acute pancreatitis. The incidence of acute pancreatitis is increasing in children.

6

Authors: Mihaela Elena Idomir, Carmen Daniela Neculoiu

The aim of this retrospective study was to analyse the involvement in pathology and antibiotic resistance of the Acinetobacter strains isolated from hospitalized patients. The spectrum of infections has been wide, Acinetobacter spp. being more often involved in wound infections (36.2%), low respiratory infections (30.1%) and infected varicose ulcers (12.8%). In the studied period there were detected high levels of resistance to most tested antibiotics, the most effective being tobramycin (90.28%), minocycline (71.66%) and sulbactam - ampicillin (49.91 %).

7

Authors: Simona Grigorescu, Dan Grigorescu, Liliana Rogozea

Currently, the burnout syndrome is considered to be one of the most significant problems caused by stress at work. In the multidimensional theory, it is viewed as a consequence of specific work, generates negative consequences both at individual level (personal and professional) and at the institutional and social one. Burnout is a problem that must be prevented, being more difficult to remove it. In this regard, it should be identified the initial professional, environmental and organizational stressing factors, and in the same time it should sought complex strategies for prevention and subsequently, applying appropriate intervention programs to increase the effectiveness of the strategies in order to reach an appropriate adaptation of the burnout syndrome subjects.

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Authors: Hülya Arslantas, Filiz Adana, Rüveyda Yüksel, Muazzez Şahbaz, Süleyman Ümit Şenocak, Duygu Yesilfidan

This research was planned to determine the views of the nursing students about the nursing informatics and the use of computers. The universe of the study was formed by 580 students who were studying in the Nursing Department of Adnan Menderes University Aydin School of Health in the 2013-2014 academic year. By using an interval of 95% confidence known universe interval sampling method, it was projected to reach 232 students. Data were collected with the “questionnaire” which was prepared according to the literature by researchers. The questionnaire consisted of 22 questions about the descriptive characteristics of the students, their computer usage status as some questions were taken from the questions used by Turhan and Kose in their studies, and the views of the students about nursing informatics. Data were analysed by using SPSS 15.0, and percentage tests, mean and chi-square test were used in the analysis of the data. The percentage of the first grade students finding the use of technology unnecessary in nursing practice was found to be higher compared to the students in other grades in a statistically significant way. The percentage of the fourth grade students finding the use of computers in the health care system as adequate was found to be higher compared to the students in other grades in a statistically significant way

11

Authors: Marius Irimie

In the last years numerous biological agents have been included in the therapeutic arsenal of dermatologists. Biological agents act by modifying the host immune response against disease including monoclonal antibodies and a series of proteins that changes the activity of some cytokines (interferon, interleukins), enzymes or growth factors. In dermatology, psoriasis is the main condition for which biological therapies are authorized. With the advancement of knowledge in the pathophysiology of skin disorders, biological therapies started being used off label in the treatment of other cutaneous inflammatory conditions. We make a review of off label indications of biological therapies in skin diseases other than psoriasis.