Moldovan Medical Journal

5-10

Authors: Felicia Lupascu-Volentir, Gabriela Soric, Ana Popescu, Anatolie Negara, Elena Cosciug, Irina Stoicova

Background: Problems of nutritional status are widespread, of which malnutrition occurs more frequently in vulnerable groups of the population, especially in the low-income elderly, including the institutionalized elderly. Material and methods: The study was performed on a group of 50 participants over the age of 65, from the nursing home; the nutritional status was assessed according to the Mini-Nutritional Assessment (MNA) score, the frailty syndrome (FS) was established based on Fried criteria and severity of FS – based on the Clinical Frailty Scale. The obtained data were statistically processed by using the “Statistica 6.0” software program. The difference was considered statistically significant with p <0.05. Results: The MNA score showed a positive correlation with reduced physical activity: r= 0.4*, between reduced physical activity and reduced walking speed: r= 0.66*, reduced physical activity and fatigue (lack of energy): r= 0.94* (p≤0.05). The cluster analysis revealed that against the background of the same food intake, body weight, mobility, neurological status can easily change, the phenomenon underlying the separation of the elderly in different clusters (1 and 2), while moderately low food intake in the last 3 months led to significantly reduced mobility, impaired neurological status (severe dementia or depression). Conclusions: This study reported that the elderly in the nursing home have an increased risk of malnutrition, being associated with nutritional pattern, such as: involuntary weight loss, the presence of neuropsychiatric disorders, decline in food consumption, affecting the quality of life.

16-24

Authors: Lilia Grati

Background: This article analyzes the professional stress at healthcare professionals (HCP), related to their job. Health care providers can serve as role models in promoting healthy lifestyles; however, HCP commitment to help individuals to quit smoking may be influenced by their own smoking behavior. Material and methods: In order to determine the level of perceptual stress, the Perceived Stress Questionnaire (PSQ) was applied, PSQ developed by Levenstein et al. In order to determine the level of addiction to smoking, the Fagerstorm nicotine addiction test was applied. The research was attended by 210 subjects from 5 medical institutions: doctors, nurses, and resident doctors. Confidentiality is maintained. Results: The doctors accumulated 32% on the scale of severe dependence, 8% moderate dependence and only 9% mild dependence, after calculating the score and interpreting the data. The resident doctors have accumulated the maximum score on the scale of mild dependence, 7% moderate dependence and only 3% severe dependence, which speaks of the fact that they are the youngest category of medical workers at the beginning of their careers and still do not have good defense mechanisms. The nurses, who represent 9% of the entire group of subjects, accumulated 0% on the scale of severe dependence, 8% moderate dependence and 1% mild dependence. Conclusions: Comparative data on smoking dependence levels in doctors of 32% according to the perceived stress level 71% confirm this. Stressed health workers are more likely to smoke, have different social problems and are males. The results of research have shown that the prevalence of smokers among health care professionals is high (51%), implying the ineffectiveness of the current government anti-tobacco strategy. Introducing new pillar – Harm Reduction in National Antismoking Action Plan, along with prevention, cessation and protection from second-hand smoking, can improve current smoking situation in general. It would be helpful to implement training programs about Tobacco Harm Reduction for healthcare workers to improve their ability in smoking cessation counselling techniques to provide active support to their patients.

28-31

Authors: Maria Moldovanu, Cornelia Calcii

Background: Arterial ischemic stroke is a rare disease found in the pediatric population, with an incidence of 2-13 out of 100000 children per year. Children develop seizures more often in the initial phase of stroke compared to adults. Material and methods: There have been included children examined by brain MRI hospitalized in the department of neurology (early aged children), Hospital of Mother and Child Health Care, with a diagnose of ischemic stroke, with an acute focal neurological syndrome installed. The children not having an imagistic confirmation of arterial ischemic stroke were excluded. Results: The study lot was composed of 78 children, who corresponded to all the inclusion criteria for this study (Tab.1). The children were examined by 1.5T and 3T MRI with multiplanar assessment of brain structures. In cases with acute / subacute stroke specific diffusion sequences (DWI and ADC) were applied to determine the type of stroke, approximate installation period. Ischemic brain lesions on MRI are presented by areas of cytotoxic edema in acute/ subacute cases, in chronic / late cases by the appearance of changes such as lacunar defects, areas of encephalomalacia. Conclusions: The vast majority of children with brain lesions on MRI have convulsions with early onset and have developed recurrent seizures after the acute phase of stroke.

36-39

Authors: Mikhail Postnikov, Svetlana Chigarina, Ksenia Gaylis, Svetlana Plamadeala, Elizaveta Postnikova, Cristina Postaru

Background: The study of the patient’s quality of life is an important condition for assessing the effectiveness of the treatment and the clinical condition of patients after treatment, in addition to objective diagnostic methods. The purpose of the study was to investigate the dynamics of changes in the quality of life of dental patients suffering from caries of the contact areas of the lateral group of teeth, after treatment in accordance with the established plan for the use of various matrix systems, in the study groups. Material and methods: The study involved 147 patients: 48 patients of the 1st experimental group; 54 patients of the 2nd experimental group; 45 patients of the 3rd experimental group. Results: In the course of the study, it turned out that such a criterion as the quality of life is an informative dynamic indicator, the value of which depends on the method of treatment used. Conclusions: In the course of the study, the effectiveness of the use of a separation-retaining device for the restoration of the lateral group of teeth during the treatment of caries in the contact areas of the teeth was assessed as a factor influencing the quality of life of patients.

44-49

Authors: Elena Costru-Tasnic, Mihail Gavriliuc, Elena Manole

Background: Ischemic stroke is one of the leading causes of mortality and disability worldwide. Numerous studies were performed to assess the risk of clinical deterioration of acute ischemic stroke patients, including the risk of haemorrhagic transformation. The complexity of cerebral ischemia pathology raised the possibility of a multitude of candidate-molecules to be studied as stroke biomarkers. The blood brain barrier integrity biomarkers have shown promising results both in fundamental and clinical studies. Matrix metalloproteinases have been extensively analysed and gave encouraging results for predicting unfavourable neurological outcome, including the risk for haemorrhagic transformation. Matrix metalloproteinase-9 plays a crucial role in the disruption of the blood-brain barrier following focal cerebral ischemic stroke. Elevated matrix metalloproteinase-2 levels are responsible for the degradation of tight junction proteins, basal lamina and neuronal injury after ischemia, and may contribute to infarction and hemorrhagic volume. The review provides an overview of matrix metalloproteinases’ role in the prognosis of acute ischemic stroke patients, regarding the stroke outcome and the risk of haemorrhagic transformation. Conclusions: Matrix metalloproteinases, especially gelatinases, are extensively studied for their predictive value in ischemic stroke evolution. Matrix metalloproteinase-2 and matrix metalloproteinase-9 correlate with stroke severity and haemorrhagic transformation in acute ischemic stroke, but large validation studies are needed for practical translation. Future studies should focus on developing a biomarker panel for predicting outcomes in stroke patients.

54-61

Authors: Eugene Calenici

Background: Review is based on the biggest observational population study of all the risk factors of COVID-19 infection. The study was carried out in Royal College of General Practitioners, Oxford, and covering over 4 million of people. Were studied and analyzed risk factors as: age, sex and ethnicity, socioeconomic level, living space dimensions, rural-urban population, body mass index, smoker status, pregnancy, hypertension, chronic kidney disease, ischemic heart disease, chronic respiratory diseases including asthma, and chronic obstructive pulmonary disease, and type 1 and 2 diabetes. Patient variable with malignancy and immunocompromised status was separated due to the small number of patients in each group. Conclusions: By September 2020 more than 28.000 articles had been published related to COVID-19 in less than 9 months, 211 new papers every day. Most of them had small population of the studies. In the investigated sample, it was found that increasing age, male sex, economic deprivation, urban location and black ethnicity were associated with higher chances of testing positive for SARS-CoV-2. Active smoking decreased the chance of a positive test. The review covers the most important subjects influencing the development of severe infection outcomes.

68-77

Authors: Valentin Friptu, Diana Mitriuc, Olga Popusoi

Background: Multiple studies have found a relatively increased risk of placenta-mediated pregnancy complications in women with congenital thrombophilia, especially early recurrent pregnancy loss, fetal loss, early-onset preeclampsia, intrauterine growth restriction, and premature abruption of normally positioned placenta. However, the extent of the association and the absolute risk are very modest, but they significantly increase in pregnant women with severe obstetric complications. Conclusions: There is convincing evidence that deficiency of natural anticoagulants (antithrombin, protein C, protein S) is a risk factor for late fetal loss. Factor V Leiden G1691A gene mutation and prothrombin G20210A gene mutation are associated with a double risk for early and unexplained recurrent pregnancy loss and for non-recurrent late fetal loss. The association of congenital thrombophilia with preeclampsia is much more uncertain, being probably limited factor V Leiden G1691A gene mutation and more severe cases of preeclampsia. Fewer data are available on intrauterine growth restriction (IUGR) and premature abruption of the normally positioned placenta. There is insufficient evidence to suggest an association of other forms of congenital thrombophilia with adverse pregnancy outcomes. In addition, genetic and epidemiological research suggests that placenta-mediated pregnancy complications are of polygenic multifactorial etiology, with a risk determined by the interaction of multiple genetic variants and other risk factors.