Jurnal Medical Brasovean

1

Authors: Liliana Rogozea

Editorialul pe care vi-l propun de aceasta dată este închinat paradoxurilor pe care le trăim adesea în viața de zi cu zi și care nu încetează să ne uimească și să ne determine să reflectăm asupra existenței noastre. Intoleranța și suprasuficiența sunt, fără îndoială, condiția esențială a regresului și dizarmoniei din viață. Și ce poate fi mai paradoxal decât să auzi o persoană care spune, de exemplu, că îl admiră pe Ioan Rațiu, dar care își permite să îi desconsidere pe cei care poate au altă opinie politică decât el, chiar dacă e vorba despre proprii lui părinți sau niște străini pe care i-a întâlnit pentru prima dată, în condițiile în care Ion Rațiu se considera obligat să promoveze diversitatea și toleranță, spunând: „Voi lupta până la ultima mea picătură de sânge ca să ai dreptul să NU fii de acord cu mine”. Convinși fiind că intoleranța naște intoleranță, iar nefericirea e doar o stare de fapt care îi determină pe unii oameni să fie negeneroși cu ei și cu cei din jur, să fie incapabili de a le oferi celor din jur dreptul de a avea o opinie, credem că educația în spiritul toleranței, a respectului reciproc și mai ales a dreptului la propria opinie trebuie să fie o preocupare majoră încă de pe băncile școlii. Indiferent că este vorba de un pacient sau de un aparținător, de un student sau de un necunoscut, dreptul la propria opinie trebuie să fie nu numai un drept sacru, ci și o modalitate de a asigura dezvoltarea armonioasă a societății.

4

Authors: Laura Larisa Dracea,Ioana Alexandra Cristeiu

Cystic fibrosis (CF) is a chronic multisystemic autosomal recessive genetic disease, with pancreatic insufficiency in 90% of patients. Specific gastrointestinal (GI) symptoms of CF can sometimes mimic clinical expression of other GI illnesses. CF and celiac disease (CD) share features of malabsorbtion syndrome, steatorrhea and failure to thrive. It is difficult to diagnose CD in CF patients and vice versa. Other chronic gastrointestinal problems may hide the features of CF. A case series report is presented, where GI symptoms associated to CF, made diagnosis difficult: two children with delayed CF diagnosis because lactase insufficiency; one CF patient who’s celiac disease was discovered following a GI infection with poor resolution. Having a chronic gastrointestinal illness does not exclude another one: persistent digestive malfunction after correct diagnosis and treatment of one GI disease is often a challenge for the clinician in order to make the diagnosis of the associated disease

5

Authors: Nadinne Roman, Silviu Caloian, Roxana Miclăuş, Liliana Rogozea

Physiotherapy or physical therapy has a history of about 900 years in Romania. The first written evidence refers to the existence of the Herculane Baths and the implementation of some physiotherapy procedures since the year 106, but this medical branch developed especially at the end of the 19th century, beginning with the 20th century, with the expansion of this specialty on the territory of Europe. Medical gymnastics developed as a result of physical training in military schools, and was later re-considered as a method of prevention and treatment for various illnesses. Balneotherapy has spread along with mineral water research, and electrotherapy was the last branch of physiotherapy that has appeared in our country.

6

Authors: Eleonora-Antoaneta Dinu, Ramona Delia Ionescu, Adriana Ersze Codruţa Nemet

Nosocomial infections are an important problem of healthcare activities, known during the time. The aim of these review is to convince the health care workers about the evidence base of hands colonization with multi drug resistant strains of bacteria and about still low compliance to hand hygiene measures (especially alcohol hand rub), regardless the programs in the hospitals. The knowledge, beliefs and behaviours of the personal are influencing factors for adherence to hand hygiene. The patient safety culture in the hospitals, a leadership, education, are the strategies for hand hygiene improvement.

6

Authors: Petronela-Cristina Chiriac, Letiţia-Doina Duceac, Vladimir Poroch, Magdalena Diaconu, Liviu Stafie, Valentin Cârlig, Monica Marilena Ţânţu

Infections with Klebsiella spp. producing beta-lactams are a challenge for the management of antibiotics in hospitals and a problem for community health. The study was conducted on 24 patients admitted to St. Mary's Children’s Emergency Clinical Hospital in Iasi. Most cases were reported in infants of 0-12 months (75.00%) in the second trimester, with a predominance of cases in boys. The most frequent were the hypopharyngeal aspirations (29.16%) and the urocultures (16.67%). Strains of K. pneumoniae ESBL were associated with E. coli, Acinetobacter spp. and Enterococcus spp. 18 of these (75.00%) were also resistant to cephalosporin. The issue of ESBL producing K. pneumoniae strains should be considered in order to be able to make the most appropriate recommendations for the use of antibiotics for the purpose of early and accurate application of control measures for multi-drug resistant micro-organisms.

7

Authors: Simona Vetu; Mariana Constantinovici; Adriana Sarah Nica

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of upper limb, affecting motor, sensory and vegetative fibers of the median nerve in the carpal tunnel. This article attempts to highlight the limits and effectiveness of occupational therapy in this pathology. Physiotherapy and occupational therapy both play essential roles in hand therapy including rehabilitation in carpal tunnel syndrome. Their role in rehabilitation program is to identify and evaluate the patient’s impairment and disability according to ICF and to improve the patient’s ability to perform independently daily activities. Also, the disability induced by median nerve injury in CTS has a major impact on patient’s functioning and quality of life. Rehabilitation program for CTS may be limited by pain, recurrence of symptoms, adhesions, anxiety, etc. This paper’s aim is to present the role and the place of occupational therapy for CTS, emphasizing clinical and functional evaluation and some specific rehabilitation procedures.

7

Authors: Mihaela Elena Idomir

The purpose of this retrospective study was to dynamically analyze the spectrum of infections produced by Serratia spp. and resistance to antibiotic of the isolated strains. The study group included 259 Serratia strains isolated from various pathological products collected from patients hospitalized in the Clinical County Emergency Hospital of Brasov during a 3 year period (2014-2016). The results showed that these germs were more commonly involved in urinary infections (48.65%), infected varicose ulcers (16.22%), wound infections (16.22%) and low respiratory infections (10.81%). The resistance of Serratia strains to ß-lactams was high, with the exception of imipenem (1.65%). For aminoglycosides, the resistance was higher for gentamicin (66.36%). For kinolones, the resistance was high in nalidixic acid (91.67%) and norfloxacin (62.5%). The share of ESBL strains was high during the study period (49.81%). The study reveals the involvement of Serratia in infections in hospitalized patients and the importance of monitoring multirezistente strains.

7

Authors: Mircea Varga, Brigitta Serkedi, Tamara Melania Bălănescu

Glaucoma is a progressive optic neuropathy with characteristic changes in the optic nerve with progressive loss of visual capacity. Increased intraocular pressure is the main glaucoma risk factor. The goal of treatment is to maintain vision, lowering intraocular pressure with topical treatment, which affects the ocular surface. Aim of the study: Evaluation of dry eye syndrome and the role of preservatives in ocular surface damage. Material and method: A retrospective study on a group of 113 patients with topical treatment. Results and conclusions: Main symptom was the eye burn (37.16%). Eye surface damage was present in 56.64% cases. The main favouring factors are: the duration of treatment, the type of drugs. The symptoms weren’t present in 11.86% patients treated with prostaglandin analogues without preservatives. In 89.38% patients treated with artificial tears, the symptoms improved, demonstrating the role of artificial tears in antiglaucoma treatment

7

Authors: Popa Daniela

Empathy is an important skill that professionals in the medical field should demonstrate. This study aims to investigate the correlations between students’ self-perceived level of stress, well-being and empathy. A cross-sectional design was used, with data collection in a single sequence, from a non-randomized sample of 223 undergraduate students, distributed into 4 groups (the first year, the second, the third and the fourth year of studies), with no intended intervention. There were administered online 5 questionnaires. Current research shows that students who show a high level of stress are less likely to report a favorable attitude towards expressing empathy. Also, the higher they perceive the quality of life, the more empathetic they consider themselves in their relations with patients. The study emphasizes some significant ways to enhance aspects of professionalism.

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Authors: Anca-Stefania Mesaros, Meda Romana Simu, Cristina Borzan, Bastien Taddei

Dental wear is clinically defined as the progressive and irreversible loss of hard dental tissue caused by various mechanisms that do not involve plaque bacteria. The evolutions of lifestyles and diet, as well as the appearance of other pathologies have favored the development of new losses of dental tissues, associated with dental wear which includes abrasion, erosion and attrition. The objective of this work was to determine the therapeutic management of dental wear and especially erosion by an extensive review of literature. The successful treatment of dental wear requires early diagnosis, profound patient sensitization and an individualized protocol. These three points are essential in order to prevent the progression of the lesions and to limit at best their severity. Finally, school dental prevention programs should include the concept of dental erosion so that children learn the dangers quickly and adopt good eating and oral hygiene habits at an early age.

1

Authors: Liliana Rogozea

În urmă cu câțiva ani scriam câteva rânduri despre e-comunicare, abordând doar aspectele pe care aceasta le implica din punct de vedere al informațiilor pe care le primim prin intermediul internetului. Transmiterea informației științifice se face astăzi mult mai rapid și în cantitate mult mai mare, datorită internetului, iar folosirea mijloacelor virtuale de comunicare are atât efecte pozitive (a dispărut perioada de latență între realizarea unei documentări și posibilitatea de a fi pusă la dispoziția comunității medicale, a crescut volumul de informație care poate fi accesat într-o perioadă de timp) cât și efecte negative legate mai ales de neexsitența unui sistem de valori care să controleze informația disponibilă. Cu toate acestea astăzi vă propun un alt subiect: vecinul de pe net: dacă în trecut auzeam adesea pacienți care se sfătuiau cu aparținători, astăzi vecinul de pe scara blocului s-a mutat pe internet, adesea pe un blog pe care fiecare își poate da cu părerea, indiferent de pregătirea și competențele pe care le are. Tot mai mulți oameni se dovedesc a fi dispuși să urmeze tratamente sugerate de alți oameni pe forumuri, fiind convinși că e vorba de folosirea experienței proprii, mult mai valoroasă decât studiile personalului medical.

4

Authors: Elena Mihaela Constantinescu, Cristian - Adrian Constantinescu

The overall annual incidence of acute HCV infection is difficult to estimate, especially when most of the patients are asymptomatic. Hepatitis C is estimated to infect 71 million people worldwide, with approximately 55-85% of them evolving into a chronic infection with a 15-30% risk of developing cirrhosis within two decades. Specific prophylaxis against hepatitis C would lead to a better management of the financial resources currently used to treat the infection. The delay in developing a vaccine, despite the efforts of researchers around the world, is due to both the unique viral structure and the difficulty of enrolling people at risk in vaccination trials but also to the lack of a specific marker that offers protection.

5

Authors: Daniela Nuță, Michaela Nanu , Florentina Moldovanu, Delia Corina Elena, Geanina Mirela Toma, Angelica Chirică, Eugen Bărbulescu, Nicolae Nuță, Alexandra Cucu, Andra Neamțu

Sustainable prevention of iodine deficiency and achievement of optimal iodine nutrition in Romania is done for a long time. Thus, this pilot study proposes to evaluate the iodine nutrition state of 241 school children aged 6-7 years from one school located in each sector of Bucharest in 2015, after more than 10 years of compulsory universal salt iodization. The results of the study showed that the number of children with iodine deficiency decreased, while those with normal urine iodine increased, compared to the study performed before the compulsory universal salt iodization and median urinary iodine concentration was 203.2 that falls within the recommended values of World Health Organization. In conclusion, the iodine deficiency was not totally eradicated in Romania, but the situation has improved considerably over the previous 10 years

6

Authors: Diana Panait, Lavinia Dima, Gheorghe Coman, Liliana Rogozea, Mihaela Badea

Ascorbic acid is known in the medical field for its many uses in different pathologies. Knowledge about vitamin C is used since ancient time in order to prevent or cure some diseases. We consider important for the medical students to understand and to use vitamin C, showing thus their knowledge on this compound. The aim of this study is to identify the level of information of students from Faculty of Medicine Brasov possess in order to fill in the gaps in their knowledge. Results of this study show satisfactory level of information on the role, side effects and sources of vitamin C, according to the year of study of the students questioned, making thus necessary in further investigation to reassure that the implementation of this information is being realized.

7

Authors: Marius Irimie

Despite the advances that have occurred in the diagnosis and treatment of sexually transmitted diseases (STDs), they remain a public health problem worldwide. Of all etiologic agents of treatable STDs, Neisseria gonorrhoeae has the highest versatility to acquire antimicrobial resistance and high antigenically variability by circumventing the host defense. Currently, it is estimated a high prevalence of N. gonorrhoeae strains with resistance to most antimicrobial agents previously and currently available (sulfonamides, penicillins, cephalosporins, tetracyclines, macrolides and fluoroquinolones) which causes a great concern. This review analyzes the history and evolution of gonorrhea treatment regimens and acquired resistance to these therapies over time, and gonococcal antimicrobial resistance phenotypes to previously and currently recommended therapy.

8

Authors: Cristian Arvătescu, Oana Dimienescu, Carmen Martinescu, Silvia Moga , Nicusor Bigiu

Introduction: Endometriosis is a benign condition that affects a large number of women at fertile age. The most frequent localization of this ectopic tissue is the peritoneum. Clinically, it has a progressive evolution and is usually characterized by chronic pelvic pain, dysmenorrhea, dyspareunia and infertility. Objectives: This paper aims to point out the prevalence and the general profile of the woman afflicted by endometriosis and also to evaluate the methods of diagnosis and therapeutic. Material and methods: The study was conducted during the period January 2009-december 2015, on 317 patients admitted to the Clinical Hospital of Obstetrics and Gynaecology “Dr.I.A. Sbarcea” Brasov. Results: The most common found localization for endometriosis was in the peritoneum in 56.15% of cases and ovary in 43.85%. The pathology has a higher prevalence at women at fertile age (>25 years). Chronic pelvic pain was the main symptom for presenting to the hospital, followed by dysmenorrhea. The cases were treated mainly by laparoscopy; this intervention being considered the gold standard for this pathology. Conclusions: Endometriosis has a profound impact on quality of life, and developing a therapy that also improves fertility remains a challenge for clinicians and basic scientists.

8

Authors: Roxana Miclăuş, Adriana Sarah Nica, Nadinne Roman, Silviu Caloian, Cristina Mateescu, Liliana Rogozea

The paper attempts an historical and scientific medical review of the most important aspects that have led to the evolution of Sovata resort from the salty salt status to the recognition today in the top of the most important therapy and spa resorts of Romania, as follow: from salt deposit exploited ever since the Roman era, until 1562, when documentary evidence of salt extraction by the Szeklers is documented, through the moment of Sovata's attestation as a place of worship in a letter from Mikhail Korniş in 1597 as an invitation to a balneal leisure to Báthory István from Poland, then the organization and settlements of the baths (the first half of the nineteenth century), then Certification of spa resort Sovata de Sus (today's resort) in 1901 and obtaining permission for the therapeutic use of salt water of lakes and springs in 1902. The development of infrastructure, communications and accommodation conditions takes place in parallel with the recognition of the therapeutic value of the area and particularly the Lake Ursu (the Lake of the Bears), derived from the geological particularities of the area and the therapeutic power of the lake waters, respectively the description of the Helios thermal phenomenon in Lake Ursu. The paper also points to the thriving development until the recession of 1914, the First World War, the reconstruction efforts and the maximum development in the interwar period, parallel with the beginning of medical education in the Sovata spa resorts. Also, the paper present the down of specialization in balneology for doctors inside the resort, led by Professor dr. Marius Sturza, and then continued at the Balneology and Physiotherapy Clinic set up in the Medical University of Cluj in 1939 and the contribution of Professor Iuliu Moldovan from Cluj to the knowledge development, research and scientific recognition of the bathing properties of the Sovata baths. The resort had development stagnation during World War II and then after the Nationalization of 1948, which brought to the state patrimony all the spa facilities, the therapeutic factors of water and the benefits of their exploitation, the lands and villas belonging to the private owners and the joint stock company existing at Sovata. The privatization after 1990 changed the strict therapeutic concept of balneotherapy and the conditions of approach and access to balneal treatment and after 2000 added the commercial aspect of tourism to the concept of balneotherapy or Spa

12

Authors: Kamile ÖNER, Hülya ARSLANTAŞ

In this period adolescents may have to deal with many problems. One of these problems is the feeling of loneliness and over time can create bigger problems for the adolescent. This study is cross-sectional study to determine loneliness, and associated factors in high school students. This study employed a cross-sectional design and was implemented with 657 students attending high school. Sample size in the research was calculated as 657 persons by using 99% power and 95% significance interval and multi-sampling method was used in sample selection. A Personal Information Form and UCLA Loneliness Scale were used in this study. Descriptive statistics, unrelated samples t test, one way analysis of variance, levene homogeneity of variance test and Kruskall Wallis test were used to evaluate data. When characteristics of the adolescents were investigated; 46.0% were female, 30.6% were in 9th grade, 40.9% were 17 years old and the adolescents in the study reported moderate level of loneliness. Female students (=52.33 ± 5.82) had a higher loneliness level when compared to male students (=49.74 ± 7.45). Mean loneliness scores were higher in female students (t=5.001, p=0.000), in students studying in Science High School (=15.559,p=0.004); those whose mothers worked (t=2.370,p=0.018); those whose Internet use led to anger/depression (t=2.429, p=0.015); in adolescents who have thought of self-harm in the last year (t=3.043,p=0.002). In the study, the loneliness level of adolescents were not affected by the following factors: living with parents or in dormitories (t(649)=0.378; p>0.05), family structure (t(641)=1.702; p>0.05), the area they live (F(2.654)=2.342; p>0.05), income level (F(2.654)=1.978; p>0.05), availability of sufficient pocket money/allowance (t(665)=0.033; p>0.05), number of siblings (F(2.633)=0.468; p>0.05), relationships with siblings (t(623)=1.209; p>0.05), the father's education (F(3.648)=1.596; p>0.05) and the mother's education (X2(3)=0.965; p>0.05). The study found that students had a moderate level of loneliness, and the factors including being female, having a working mother, internet use resulting in anger/depression and thoughts of self-harm in the last year led to a higher loneliness score.