Moldovan Medical Journal

3-6

Authors: Svetlana Lozovanu, Ion Moldovanu, Victor Vovc, Andrei Ganenco, Andrei Blajevschi, Tudor Besleaga

Background: The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has included major and radical changes in the personality disorder (PD) diagnosis method, from categorical to dimensional one. It includes Alternative Model for Personality Disorders (AMPD). This model explains that personality disorders are characterized by impairment in personality functioning and presence of pathological personality traits. The current study consists in the validation and cultural adaptation of the Russian version of the Personality Inventory for DSM-5 (PID-5), respecting the stages of intercultural adaptation specific to the medical, sociological and psychological fields. Material and methods: The PID-5 questionnaire translated into Russian was used by 30 Russian-speaking subjects living in the Republic of Moldova that use English in the specialized activity. After a 30 minute break, all of these subjects were asked to fill out the original questionnaire in English. Results: After comparing the answers to the 220 items, we obtained the following results: 26 persons, representing 86.7% of the total number of participants, responded identically to all 220 items, one person (3.3%) admitted only one difference in test responses, 3 persons (10.0%) admitted a different response in 3-4 items. Conclusions: The result of the presented work is the Russian-language version of the PID-5 questionnaire, which proposes a methodical evaluation of the Russian speaking people with a mental health problem, the residents of the Republic of Moldova.

11-15

Authors: Tatiana Lozan

Background: The aim of this study was to estimate overall prevalence of primary headaches and prevalence of migraine (MG) and tension-type headache (TTH) among adolescents in the Republic of Moldova. Metetial and methods: In total there were 3389 adolescents whose age ranged from 10 to 19 years, recruited from urban and rural areas of the country. This school-based study was conducted during the academic year 2015-2016. The information was collected with the use of self-administered questionnaire based on the criteria of International Classification of Headache Disorders: ICHD-2 (2004) and ICHD-3 (2013). Primary headaches were classified, according to the type of headache and after the frequency of headache attacks within the month. Results: The overall prevalence of primary headaches in Moldovan adolescents is 38.75% (girls – 49.7%, boys – 27.8%), and it is higher in urban area (48.23%) than in rural (30.05%). The prevalence of MG is 19.7%. The prevalence of MG is higher in girls (27.5%) than in boys (12.1%). The prevalence of migraine is higher in urban adolescents (27.1%) compared to rural ones (13.0%). The prevalence of TTH is 7.9%. The prevalence of TTH is almost equal in both sexes (8.0% in girls and 7.7% in boys). The prevalence of TTH in urban adolescents is 10.2% and it is more than 1.7 times higher compared to the recorded level in rural areas – 5.8%. Conclusions: The present study is the first Moldovan survey on epidemiology of headaches in adolescents. It is very important to continue developing different aspects of epidemiology of adolescents’ headaches in the Republic of Moldova.

20-25

Authors: Iuliana Feghiu, Sergiu Cobiletchi, Sergiu Sandru

Background: Administration of propofol and fentanyl for induction of general anesthesia is often associated with cardiovascular instability. This effect can be caused by changes in the cardiac autonomic tonus induced by the drugs. In the literature there is no consensus regarding the effect of propofol and fentanyl on sympathetic or parasympathetic balance of the heart. Material and methods: There was performed a randomized prospective study which was approved by the Ethic Committee. Written informed consent was signed by all patients. The study group involved 47 patients scheduled for surgical intervention, anesthetic risk ASA I-II. The analysis of heart rate variability and the changes in cardiac autonomic tonus was performed with Holter ECG at rest, after premedication with fentanyl solution and after induction of general anesthesia with propofol and fentanyl. Results: After administration of fentanyl in doses of 1.0 mkg/kg for premedication there were not significant changes of heart rate variability and autonomic heart tonus. Administration of propofol 2.5 mg/kg combined with fentanyl 1.0 mkg/kg for induction of general anesthesia leads to significant changes in heart rate variability. There was a considerable reduction of heart rate variability. The LFun (marker of sympathetic heart tonus) has enhanced by 6.8% compared with previous stage (67.1 (95% CI 63.1-71.1) vs 72.0 (95% CI 67.9-76.1) (p=0.004). The HFun (marker of parasympathetic cardiac tonus) has reduced by 19.8% (32.9 (95% CI 28.9-36.8) vs 26.4 (95% CI 20.4-34.3) (p=0.007). After administration of propofol and fentanyl for induction of general anesthesia the LFun/HFun ratio has enhanced by 30.8% (2.7 (95%CI 2.1-3.4) vs 3.9 (95%CI9 2.9-4.8) (p=0.003), signaling an enhanced sympathetic heart tonus. Conclusions: Administration of fentanyl solution in doses 1.0 mkg/kg for premedication is not associated with significant changes of autonomic tonus of the heart. Administration of propofol 2.5 mg/kg in combination with fentanyl 1.0 mkg/kg for induction of general anesthesia leads to significant enhanced sympathetic cardiac tonus.

29-32

Authors: Oleg Popadyuk, Roman Kutsyk, Maryana Voloshyn

Background: Experimental and clinical studies show that wound healing cannot be evaluated as optimally effective today. For the treatment of wounds today, various methods and means are used. Wound dressing was developed from both natural and synthetic materials. However, polymeric biodegradable materials, saturated with various active drugs, which are effective, easy to use, have insignificant disadvantages and need further study. The aim was to study the effectiveness of the use of biodegradable polymeric film “biodén nano” in the treatment of suppurable postoperative wounds of the skin in the experiment. Material and methods: The research was carried out on 45 guinea-pigs of the species “Murchaky” in the clinical and biological base (Vivarium) of the Ivano-Frankivsk National Medical University, in accordance with the requirements for the maintenance and handling of laboratory animals. The pelvic wounds were simulated after staphylococcus aureus 2.0*108 KU/ml infection. Results: The change in the wound area of the group IV and group V decreased slightly up to the third day, and after 7 days the area of the wound surface was reduced by 7% and 13.6% respectively. During the observation period, 14 days, the wound area in relation to the initial area was 35.5% in group IV and 43% in group V. Conclusions: The biodegradable polymeric film “biodep nano” demonstrated high antimicrobial and wound healing properties in an experimentally simulated peptic cutaneous wound of the skin.

38-43

Authors: Maria Iacubitchii, Eugeniu Bendelic, Suleiman Alsaleim

Background: Being analogous to a blood surrogate, the aqueous humor has an important role in the regulation of the homeostasis of the ocular tissues. It has many functions: provides nutrition, removes excretory products, transports neurotransmitters, stabilizes the ocular structures, influences the intraocular pressure, and participates in the immune response against invading pathogens and inflammation. Aqueous humor’s unique composition (electrolytes, proteins, biologically active substances, and organic solutes) is required to maintain adequate functionality of the ocular system. Its secretion is a complex biochemical reaction that gives specific properties and makes the difference from other human fluids. Different factors (traumatic, physical, chemical, pharmacological) and eye pathologies influence its composition, modifying its physiological properties, and cause pathological conditions in the anterior segment. In the last decade, it was made massive progress in the characterization of the composition of aqueous humor in different pathologies (glaucoma, myopia, keratoconus, age-related macular degeneration, branch retinal vein occlusion, etc.). It determined the biomarkers for eye’s pathologies and identified the progression of the disease. Conclusions: The detailed knowledge of biochemical and physiological properties of aqueous humor is necessary in understanding the pathophysiology of eye’s diseases. The significant variations in the differentially abundant changes in human aqueous humor may be relevant for future diseases treatment in order to get favorable outcomes in patients. Specific markers for pathologies represent nowadays an important field of research. These markers are necessary for early diagnosis and selecting the proper treatment for each individual case by stopping the clinical disease progression.

51-55

Authors: Gheorghe Guzun, Radu Turchin

Background: The complete diagnosis of pathomorphological disorders in case of diseases of the spine determines the choice of effective treatment, pathogenetically argued in various diseases which, according to modern classifications, do not have a direct link with it. Continuous improvement of diagnostic and treatment methods in some pathologies, both surgical and therapeutical requires a more detailed study of clinical anatomy and spinal biomechanics. Thus, perhaps even revising concepts are well-rooted in the consciousness of scientists and modern practitioners. As we will try to analyze the anatomical-clinical component of the appearance and recovery of antero-lateral abdominal wall hernias, we will limit ourselves to some analysis and discussion of one of the predisposing factors, namely the lack of resistance or insufficient resistance of the abdominal muscles. This is closely related to the condition of the constituent elements of the abdominal wall, and in particular depends on the innervation and vascularization of the musculoaponeurotic layers, which determine the strength and muscle tone. Conclusions: One of the causes of inguinal hernias is the decrease in the tone of the abdominal muscles. It depends on several factors: the elasticity of the muscular tissue, state of neuro-muscular transmission, the state of peripheral nerve fibers and motor neurons in the spinal cord, superior motion control centers. Thus, the causes of muscle tone decrease can be both muscular in origin and generated by pathology of the nervous system at different levels. Because the causes are multiple, the treatment is different at certain stages of hernia development. In this way, our treatment – qualitative nutrition, vitamins, special exercises, spinal region work, paravertebral muscles massage fit perfectly into hernia etiology and pathogenesis. This treatment is physiologically accessible and can be performed and supervised by physicians with non-surgical specialties in stationary or outpatient settings, after prior consultation with the surgeon.