Moldovan Medical Journal

3-9

Authors: Lesnic Evelina

Background: Tuberculosis represents a social-related disease and for identifying the priority interventions for reducing its impact must be identified the main disparity features of patients. Material and methods: Global Competitiveness Report and Report of the National Centre for Health Management were used. The clinical study was retrospective, randomized, selective, and included 263 new pulmonary TB cases registered in three different Moldovan regions: Chisinau (center), Balti (north) and Cahul (south). Results: Attributable risk identified that in Chisinau compared to Balti predominated patients in economical vulnerable state, without health insurance, GeneXpert MTB/ Rifampicin sensible and those who successfuly finished the treatment. In Balti compared to Chisinau predominated chronic alcohol abusers, co-morbid patients, severe pulmonary tuberculosis, direct addressing to the hospital, patients infected with GeneXpert MTB/Rifampicin resistant strains of Mycobacteria. The major differences between Chisinau and Cahul groups, with predominance in Chisinau were homeless, co-morbid patients and those who successfully finished the treatment course. In Cahul predominated patients with rural residence, direct addressed to the regional hospital and severe forms of tuberculosis. Comparing the Balti and Cahul groups was established the predominance in Cahul of patients with rural residence, in economically vulnerable state and patient’s detection by general practitioner. In Balti predominated co-morbid patients, alcohol abusers, patients with severe forms of tuberculosis. Conclusions: Reduction of health care inequality will be achieved through social assistance of vulnerable groups and improvement of the general public life.

17-22

Authors: Lacusta Victor, Fala Valeriu, Romaniuc Dumitru, Bordeniuc Gheorghe, Fala Paula

Background: Caffeine is one of the most widely-used psychoactive substances, having multiple stimulating effects. Caffeine is being considered as eliciting a dose-dependent effect on sleep bruxism. Material and methods: There were investigated 100 patients with primary sleep bruxism. Patients were clinically examined, there were given several questionnaires, and they underwent a series of investigations: sleep bruxism recording; surface electromyography, occlusal reflex determination, jc.SSR (jaw clenching sympathetic skin response) recording and masseter muscle ultrasonography. Results: In patients with primary sleep bruxism, there were observed various coffee intake patterns/24 h: “abstinent” group – 32%; “1-3 cups” group – 38.1%; “4-6 cups” group – 19%; “>6 cups” group – 11%. People who consume >6 cups/24 h, have increased the number of nocturnal clenches. Pathological occlusal reflex indices were observed in the “1-3 cups” group (76.3%), “4-6 cups” group (89.5%), “>6 cups” (100% cases), “abstinent” group (50%). Disorders associated with the temporomandibular joint and the bruxism-associated pain reach pathological values in individuals who consume 4-6 or more cups of coffee. Excessive caffeine consumption leads to the increase of the amplitude of the sympathetic autonomous potential (jc.SSR, A2, mV) without significant changes in the central autonomous regulation time (jc.SSR, T, s). Conclusions: There were observed various coffee intake patterns in patients with primary sleep bruxism. Excessive coffee consumption is associated with the stress level. The masseter muscle thickness and dental wear show no statistically significant elevation trends, under the influence of various caffeine doses.

30-33

Authors: Oshurko Anatolii, Oliinyk Ihor, Tsyhykalo Oleksandr

Background: The research aims at identifying new methodological approaches to the study of morphological patterns of prenatal development of the human upper jaw. Material and methods: A working model has been developed and a device has been proposed, reasonable to be used for fixation of the examined object in a vertical position during computed tomography of maxillofacial and craniocerebral regions. For proper operation of the device there was introduced a method of vertical fixation of the examined objects during computed tomography of maxillofacial and craniocerebral regions. Results: In the basis of the useful model lies the task to develop a method of vertical fixation of objects under study during the computed tomography of maxillofacial and craniocerebral regions by holding the examined object of up to 540 mm in size; the object is fixed to the planetable using the right and left retainers that are fixed in vertical openings; the height is regulated with the help of the rack, connecting the planetable with the tripod; swivel mounting is led to the facial part of the examined object and the chin is fixed on the table; then the vertical and horizontal position of the chin is regulated by means of sliding vertical and horizontal mounting; the fixed examined object is then moved to the CT scanner with the help of mobile tripod supports. Conclusions: The proposed method is effective for vertical fixation of examined objects during the computed tomography of maxillofacial and craniocerebral regions in the desired position, that contributes to getting qualitative indicators of the examination and can be used during the spot-film radiography in direct and lateral projections in stable and desired position of the head and at the correct distance without imposing additional densities (shades) to provide accurate diagnostic results.

37-41

Authors: Lesnic Evelina, Kulcitkaia Stela, Niguleanu Adriana

Background: Tuberculosis represents the major threat for the health protection in the military forces. The aim of this retrospective and descriptive study was the evaluation of risk factors, clinical presentation and treatment outcomes of tuberculosis in military recruits. Material and methods: 51 military recruits with tuberculosis diagnosed during 01.01.2010-31.12.2015 in Chisinau military quarters and managed in the Hospital of Pneumophtysiology were assessed. Results: Most of military recruits aged 18-22, were residents of the rural localities, graduated incomplete general school or lyceum and were economically vulnerable. One half of the group consisted of active smokers and every tenth patient abused alcohol. Every fourth patient had tuberculosis in childhood and every tenth had family contact with a tuberculosis-affected person. Disease’s insidious onset was established in one half of the group and the acute onset in every fourth patient. Every tenth patient was diagnosed with tuberculosis within the first 6 months after the enrollment. Only one half of the groups were symptomatic patients, who complained of cough, asthenia and loss of weight. Pulmonary infiltrative tuberculosis predominated among recruits. Extensive infiltrates and involvement of both lungs were identified in a lower proportion. The high rate of successful treatment outcome was endangered by the high rate of lost to follow-up patients, demonstrating poor evaluation and follow-up after the discharging from the hospital. Conclusions: The epidemiological studies among military recruits are limited. The high rate of young, economically vulnerable men with risk factors demonstrates their priority for active screening. Treatment outcomes must be improved by the implementation of the adequate follow-up after hospital discharging.

46-49

Authors: Raevschi Elena

Background: Cardiovascular disease is the leading cause of mortality at the global and national level. Ischeamic heart diseases, cerebrovascular diseases and hypertensive heart disease together identify a highest proportional mortality that defines them as major contribution cardiovascular diseases worldwide. Premature mortality analyzing compared to traditional moves target from classical focus on the occurrence of deaths to focus on the losses caused by these deaths. The purpose of the study is to assess the premature mortality evolution from major cardiovascular diseases among adults in the Republic of Moldova for the period of 2003-2015. Material and methods: the research is a descriptive population study over the time of 13 years. The premature mortality phenomenon was counted in the years of potential life lost (YPLL). Age-adjusted rates were calculated using the direct method of standardization applying WHO World Standard Population Distribution (%) based on world average population between 2000-2025. Results: Overall period from 2003 to 2015, premature mortality rate from ischeamic heart diseases (+10.7%) and hypertensive heart disease (+41%) have registered increasing trends versus premature mortality rate from cerebrovascular diseases with decreasing trend (-23.9%). All together determined the decreasing trend (-2.4%) of major cardiovascular diseases premature mortality rate. When analyzing percentage changes of premature mortality increasing trends by age, the study findings identified the higher percentage changes in younger groups for ischeamic heart diseases premature deaths than hypertensive heart disease. Conclusions: Despite the general decreasing trend of major cardiovascular diseases premature mortality rate, ischemic heart diseases compared to cerebrovascular and hypertensive heart disease identify the most pronounced trends of the deaths event rejuvenation in the Republic of Moldova for the period 2003-2015.

54-57

Authors: Raevschi Elena, Ababii Ion, Vataman Eleonora

Background: Implementation of ongoing behavioral risk factor surveillance system (BRFSS) can improve prevention and control of noncommunicable diseases (NCDs) in the Republic of Moldova. Delphi study regarding the development of ongoing behavioral risk factor surveillance system in the Republic of Moldova contributes to evidence-based credible model of implementation in order to support National Strategy on Noncommunicable Diseases Prevention and Control for the period 2012-2020. The article has highlighted the aspects of designing Delphi survey which should be considered for making sense of consensus. Material and methods: The study used Delphi techniques to achieve in an effective way experts’ consensus in terms of development of ongoing BRFSS in the Republic of Moldova. Results: The research found that Delphi panelists similarly trained and competent in the area of knowledge related to the target issue contributed to achievement of the consensus agreement for all items in discussion regardless the national or international affiliation. Conclusions: Well-designed Delphi panel are important for effective and reasonable survey management in terms of achieving feasible consensus agreement to support effective decision-making for further development.