Jurnal Medical Brasovean

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.

4

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.

5

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.

6

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.

6

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.

7

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.

2

Authors: Liliana Rogozea

Ideea de a vorbi despre compromis nu e nici nouă nici inedită. Alexis Carel spunea că: „Civilizația este înainte de toate o disciplină; disciplina fiziologică, morală, socială și științifică.” Cu toate acestea medicina secolului actual, asemenea celei din perioadele anterioare este o îngemănare între respectarea strictă a regulilor etice ale profesiei, așa cum s-au format ele de-a lungul timpului, plecând de la celebrul non-nocere și compromisurile zilnice pe care, personalul medical le face în fiecare zi.

3

Authors: Emanuela Păltinişanu, Daniela Vodă, Oana Falup-Pecurariu

Hereditary spherocytosis is the most frequent type of chronic haemolytic anaemia, usually inherited in an autosomal dominant pattern. We present in this paper a case report of a child diagnosed with hereditary spherocytosis in the neonatal period. The diagnosis was made in the context of suggestive family history and typical presentation. The clinical course was outlined by numerous haemolytic crises which required repeated blood transfusions.

4

Authors: Dinu I. Dumitrașcu, Lucia I. Timis

Despite very advanced research and technology development in the medical field, malpractice and iatrogenic complications are still frequent in the health system. A main cause for medical errors is the human error. A simple and efficient tool in reducing medical complications is the briefing. The briefing is a succinct session of instructions for the medical staff on how to accomplish a given procedure or task. The aim of this paper is to make a review of the most efficient medical briefings described in the literature.

4

Authors: Monica Marilena Ţânţu, Carmen Domnariu

Communication is an integral part of the dynamism of social processes as well as their explanatory tool. Its main features are understanding, knowledge, socialization, influence and persuasion. Communication in nursing is different because of the context, involved behavioural typologies and the characteristics of the care process. It is carried out according to the general principles of communication adjusted to the specific of care activity. Effective communication leads to increased compliance of the patient to treatment, improved dependence and improved satisfaction from the patient. Benefits are for nurses, too, namely strengthening the image of professional nursing, permanent and progressive development of communicative competence.

4

Authors: Codarcea M. Dorin

ENT emergency medical activity is very complex in Brașov County , as is seen from a study made over a six month in 2013. The study revealed that ENT patology needs a complex and constantly approach, mainly because of the tourists are where we are working in.

4

Authors: Liliana Rogozea

Gheorghe Cârțan is one of the most fascinating personalities of Transylvania; more than having descended from Roman emperor Trajan's column as living proof of Dacian and Roman permanence and continuity, he is the one who has succeeded in enlightening the minds and souls of 19th century Transylvanians by the books he carried in his knapsacks from the other side of the mountains. The paper aims at arguing the importance of the books chosen by Badea Cârțan [Brother Cârțan] for the health education of Transylvanian Romanians, books that could be presented and signalled to researchers from other regions of Romania by various means, including online platforms.

4

Authors: Simona E Cioinac, T. Lavalle

Background: The number of patients with oncological diseases in hemodialysis is sharply increasing. These patients require hemodialysis and a personalized care that improves the tolerability, management of complications, pain, anxiety and fear of the patient and family. The literature presents approaches in different oncological diseases but there is still a dialysis treatment that allows greater tolerability. In this article, we describe the alternation of two different treatments and highlight the necessity of a personalized care process. Case presentation: Patient diagnosed with ovarian cancer, after countless series of complications, in the terminal phase requires service and haemodialysis customized. Prescribed treatment was: three treatments on-line hemodiafiltration of the duration 3:30 hours using monitors for intermittent haemodialysis. The fourth treatment catheter veno-venous hemodiafiltration of the duration 4 hours using monitors for continuous haemodialysis. Conclusion: The case presented shows the need to identify a personalized care pathway for the management of cancer patients on haemodialysis and their families. The alternation of the two treatments has allowed greater tolerance and fewer complications.

5

Authors: Mihaela Elena Idomir

The aim of this retrospective study was to analyse the involvement in pathology and antibiotic resistance of the Pseudomonas strains isolated from hospitalized patients. The spectrum of infections has been wide, Pseudomonas spp. being more often involved in wound infections (27.1%), infected varicose ulcers (23.2%), respiratory (18.2%) and urinary infections (17.8%). There were reported varying levels of resistance to the tested antibiotics except colistin. The results of the study show the importance of the antibiogram and of monitoring the resistance phenotypes in hospitals.

5

Authors: Andrada Nicolau

Dental diseases such as dental caries, periodontitis, trauma and dental abnormalities have spread with either explosive or remission stages throughout human history. In recent decades it has achieved a great dental caries prevalence. Studies in recent years have developed the idea that a phenomenon as complex as tooth decay, is dependent on the action of multiple factors, whose action must take place simultaneously in order to determine the pathological process .. Prevention of dental caries is an acute need because the high level of dental caries prevalence raises problems organizational, social and especially economical. The aim of this study was to determine the prevalence of caries in patients review to identify the main risk groups and the degree of application of methods to prevent dental caries. The study was conducted on a total of 148 patients aged 10-40 years, of which 89 female and 59 male who presented at the dental office during 1.10.2014-1.05.2015. These patients were determined the degree of oral hygiene and local or general dental fluoridation, dentists frequency of verification and determination of the appreciation of the illness by tooth decay (DMFT). Results of the study show the link between patients and dental health habits.

6

Authors: Meda-Romana Simu, Andreea Coman, Liliana Rogozea, Cristina Borzan

Workplace conditions are directly reflected on the health of dentists, influencing the quality of medical services and thus indirectly influencing the health of the general population. In the general context of occupational risk we proposed a review for assessment, identification and analysis of biological and chemical risk factors that professionals and patients are exposed to in the dental office, for an effective management of dental healthcare system in Romania, as part of health system.

6

Authors: Vodă Daniela, Mihaescu Satinger Miriam Shirley

onducted in Children Hospital Brasov, over a period of 12 month, and the principal aims were to determine the prevalence of urinary tract infections related age, sex, predisposing risk factors and treatment with antibiotics. We detect 188 cases with urinary tract infections with predominance of cystitis in adolescents. The most frequent encountered bacteria was Escherichia Coli and the most frequent treatment administrated in hospital were third cephalosporines. In our study, among congenital malformations, the most frequent were hydronephrosis and vesicoureteral reflux.

6

Authors: Magdalena Diaconu, Florentina Cristina Pleşa, Cătălin Constantin Lulciuc, Mugur

Polytrauma means multiple injuries of various anatomical regions out of which at least one or a single combination has vital risk. As a complex process, polytrauma requires primary, secondary and tertiary evaluation of critically ill patient, both systemically and targeted. The most accurate definition of major trauma is found in terms of injury severity score. Multiple trauma patients belong to the category of those who, during secondary and tertiary management, benefit substantially from the support of intensive care services, where opportunities for specific monitoring and supportive therapy are provided. Study objectives: to define the demographic profile of the patient with multiple injuries, to identify multiple injury prevalence in emergency section casuistry, to establish the types of trauma and their weight. The study was conducted over a period of 12 months, inretrospect, on a lot of 384 trauma patients. Trauma patient's demographic profile shows that it is a male, aged mainly between 31-40 years, followed by those aged between 51-60 years. In emergency section casuistry multiple injuries occupies 8% of pathology and the weights on types of trauma are comparable with the data in the literature.

9

Authors: Dan Ovidiu Grigorescu, Radu Vaidahazan, Maria-Cristina Mateescu, Silviu Mihai,

Silver and silver-based compounds have been used during the millenary history of humanity in order to treat wounds, infections, ulcers and other skin lesions due to their antibacterial, antiviral and antifungal properties. Though lately researchers have focused mainly on the discovery of new silver-organic compounds, through which the effects of silver could be put into evidence, in this review we demonstrated that the use of other forms of silver remains effective. Thus, the metallic form of silver and the inorganic compounds such as silver nitrate has proven to be a simple and inexpensive method and to have a remarkable therapeutic efficiency in different surgical specialties: General Surgery, ENT, Gynecology, Urology, Plastic Surgery, etc. This paper can be considered to be a monograph including the most important principles of the silver based treatment, its biological mechanisms of action at the molecular level (also in microorganisms) and its adverse reactions generated in the human body.

1

Authors: Liliana Rogozea

Ideea de a vorbi despre compromis nu e nici nouă nici inedită. Alexis Carel spunea că: „Civilizația este înainte de toate o disciplină; disciplina fiziologică, morală, socială și științifică.” Cu toate acestea medicina secolului actual, asemenea celei din perioadele anterioare este o îngemănare între respectarea strictă a regulilor etice ale profesiei, așa cum s-au format ele de-a lungul timpului, plecând de la celebrul non-nocere și compromisurile zilnice pe care, personalul medical le face în fiecare zi. Dezvoltarea unui sistem de calitate, accesibil oricărui individ este un obiectiv profund moral și etic. Cu toate acestea medicii sunt adesea nevoiți să accepte compromisul de a decide care program de sănătate este prioritar și care sunt fondurile alocate pentru aceasta; iar atunci când decizia nu le aparține, ci aparține altor persoane (economiști, juriști sau simplu: politicieni) acceptarea compromisului, deși pare mai ușoară este la fel de complicată. Compromisul intervine și atunci când trebuie luate decizii legate de acceptarea realizării trialurilor clinice, convinși fiind că progresul medical este legat în permanență de menținerea unei balanțe optime între dezvoltarea unei noi cercetări medicale și asumarea criteriilor morale care mențin cercetarea în limitele moralității. Și totuși, compromisul nu e decât o etapă tranzitorie, pentru că „Etica nu este o fantezie mistică - nici o convenţie socială - nici un lux de care ne putem lipsi, subiectiv... Etica este o necesitate obiectivă a supravieţuirii omului - nu prin providenţa supranaturală, nici a vecinilor dvs., nici a toanelor dvs. – ci prin "graţia" realităţii şi natura vieţii.” (Ayn Rand în Virtutea dăruirii de sine)

3

Authors: Filiz Adana, Hülya Arslantaş, Filiz Abacıgil, Müge Çabuk, Şerife Çetinkaya, Özgür Demir

The aim of this study was to evaluate students’ knowledge and attitudes about ageing and sexuality. This cross-sectional study was conducted on 396 nursing and midwifery students in Adnan Menderes University Aydin Health School between 23 May 2011- 3 June 2011. Ageing sexuality knowledge and attitudes scale in elderly (ASKAS) was used in order to evaluate students’ knowledge and attitudes. It was found that there wasn’t a significant correlation between the students’ acceptance of sexual intercourse and their knowledge about sexuality in elder people (t=1.63; p=0.11). On the other hand, students who thought that older people could have sexual intercourse, were found to be more tolerant attitudes towards elderly sexuality(t=3.90; p=0.000). It was observed that the more the students had knowledge about elder sexuality, the more they had tolerant attitudes; however there was a negative correlation between age and knowledge/attitudes (r=0.625, p=0.000; r= -0.365, p= 0.003; r=-0.262, p= 0.09). No significant relation was found between ASKAS and other variables.

3

Authors: Agnieszka Ryczek

Human nature, but to a large extent determined by the bio-human can be to some extent shaped and changed. People are different from animals that are able to understand and analyze their own lives, and therefore they may try to make them morally better, that is laudable in terms of ethics.

4

Authors: Iosif Șamotă, Radu Dan Necula, Florin Lucian Petrică Sabou

Heterotopic ossification is defined as the presence of mature lamellar bone in soft tissues such as muscles, tendons, skin or organs, where bone normally doesn't exist. It can appear more frequent as a complication following central nervous system disorders like acute brain injuries, brain tumors or spinal cord injuries, or following burns, hip and elbow surgery. For heterotopic bone formation some local and general specific conditions are necessary. The three main conditions are: presence of a morphogenetic induction agent, mesenchymal progenitor stem cells and a permissive local and general environment.

5

Authors: Laura Floroian, Mihaela Badea, Iosif Șamotă

Bioglass is a chemical compound that is part of a compositional family with the best bioactivity properties demonstrated by the connection with living tissue within few hours. This new class of biomaterials, based on a mixture of amorphous oxide (SiO2-Na2O-CaO-MgO K2O-P2O5), was patented in 1968 by Larry Hench by preparing well known Bioglass 45S5. Depending on the percentage of SiO2 mainly these biomaterials can be bioinert, bioactive and bioresorbable. Hench and Clark were the first researchers who have observed this material bioactivity in vitro and in vivo have demonstrated the potential osteointegrable. There have also been noted and antimicrobial and anti-inflammatory properties and the ability to easily control the crystallinity by applying appropriate heat treatments present in the vitreous phase bioglass. All these are arguments plus for this class of biomaterials to be a prime objective of the research in the field.

5

Authors: Cristian Falup-Pecurariu, Bogdan Cârlan, Ștefania Diaconu, Radu Mircea, Alina Voina, Sorin Paripaș, Oana Falup-Pecurariu, Roxana Alexandru, Cătălin Jianu

Traumatic brain injuries have an important impact on patients’ quality of life, with various short- and long-term consequences. Sleep disorders are frequently encountered in these patients and are associated with significant functional daytime disturbances and impaired rehabilitation potential. The aim of this prospective study is to determine the prevalence of insomnia following traumatic brain injury and also to review the clinical features, tools of assessment and main outcomes of this sleep disorder.

5

Authors: Magdalena Diaconu, Cristian Georgescu, Cristina Pleşa, Monica Ţânţu

Polyradiculoneuritis is a fairly rare disease, but with significant neurological impairment, which may even lead to death if not treated in time. However, early and constant treatment has claimed favourable results. Plasmapheresis is an effective etiopathogenetic treatment option for polyradiculoneuritis. Our case is a 50-year-old woman, diagnosed with acute polyradiculoneuritis, Fisher form, who has been conducted five plasmapheresis sessions. Initially, the patient had diplopia, right eyelid ptosis, right facial asymmetry, upper limb paresthesia, distally stressed, limited movements of abduction, abolished tendon reflexes in the lower limbs, ataxia, muscle hypotonia. It was established the diagnosis of acute polyradiculoneuritis based on the clinical picture, in conjunction with the results of NMR (nuclear magnetic resonance) and laboratory tests (blood parameters, cerebrospinal fluid). It was decided to apply plasmapheresis treatment as therapeutic modality, performing the 5 sessions every two days. After the third session, the clinical condition of the patient improved, the motor deficit was in remission, normal coordination. At the end of the five sessions of plasmapheresis, the evolution was favourable, halting progression of neurological deficits, improving the general condition and reducing the limb motor deficit, but maintaining VI and VII cranial nerve paresis. Using plasmapheresis resulted in improved patient dependency and improved quality of life in a shorter period of time as compared to therapy without plasmapheresis results, thus supporting its effectiveness in polyradiculoneuritis. This is precisely why we chose to present this case, although our experience in this regard is relatively recent, for about a year.

6

Authors: Laura Floroian, Mihaela Badea, Iosif Șamotă

Although recently accepted by the scientific community, the research into nanotechnologies and biotechnologies are currently the priority directions for several prestigious international research laboratories of physics, chemistry, medicine, molecular and cellular biology, study of materials and cybernetics. Field became interdisciplinary and is booming, and the goal is to develop new technologies and high-performance materials. An important category of materials for nanotechnology and biotechnology is the biomaterials. They are used to direct material, restore the functions of living systems supplement and have a major impact on biomedical applications, particularly in the medical and pharmaceutical industry.

1

Authors: Liliana Rogozea

Deși măsurile stricte de prevenție și de respectare a igienei mediului, locuinței și a celei individuale sunt singurele măsuri eficiente la ora actuală, în lipsa unui vaccin sau a unei terapii țintite, totuși campaniile de educație pentru sănătate au fost nu numai reduse ca număr, dar și aproape lipsite de reflexie în presa nemedicală. Astfel, atât personalul medical cât și misionarii sau mass-media care s-au ocupat de afecțiune au încercat să prezinte cu lux de amănunte evoluția numărului de cazuri, modul de răspândire a acestora, dar nu există informații despre numărul de campanii de sănătate duse în această perioadă sub egida OMS sau a altor organizații non-guvernamentale. Această reflexie amară m-a făcut să mă reîntorc în timp, la campania din 1938 din România, care a inclus un număr foarte mare de prelegeri de educație pentru sănătate, sau la preocuparea constantă din Gazeta de Transilvania din secolul al XIX-lea și începutul secolului XX, în care medici celebri din Brașov susțineau educația populației prin articole scrise cu regularitate.

3

Authors: Nicoleta Taus, Main Farraj

Glutathionperoxidase is an enzyme that catalyses the reduction of hydroperoxides, including hydrogen peroxide, glutathione reduction. Glutathione peroxidase has the function to protect cells from oxidative stress-induced changes. Toxicological studies have demonstrated the production of reactive oxygen species by titanium dioxide nanoparticles. In the present study, it was shown experimentally change in the enzyme glutathione peroxidase in guinea pigs that was implanted titanium screw.

4

Authors: Evelina Enășcuț, Dan Minea

Cerebrovascular disease is a leading cause of death worldwide. Stroke, ischemic or haemorrhagic, is accompanied by changes in all body systems. Among these, in literature is described the neurogenic heart disease. This represents all cardiovascular consequences arising in the context of acute brain pathologies. It includes: variations in blood pressure, left ventricular dysfunction, arrhythmias and sudden cardiac death.

4

Authors: Laura Larisa Dracea

Bacterial resistance is a serious health problem all over the world and a major topic to be discussed, therefor should be a focus for all those who are engaged in the battle against infections. Over the last few decades, there are strong signals coming from medical research and international organizations, that there are observed new, dangerous and antibiotic resistant bacteria. Profiles of bacterial species that are particularly concerning and factors that are contributing to emergence of resistance are discussed in this review. Strategies in fighting against this phenomenon and prescription optimisation based on knowledge about resistance acquiring mechanisms and therapeutic approaches in specific fields have to be developed and implemented in current practice.

4

Authors: Andrea Neculau, Nicolau Andrada, Florin Leașu, Liliana Rogozea

Prominent Romanian medicine figure, Jacob Felix is part of people who were not only perfectly integrated in their country of adoption, but have also greatly contributed to its prosperity. Equally concerned of hygiene and health organization problems, he bequeathed us a treatise on history of hygiene in 3 volumes that can be used today as a model of organizing information in the field. Unfortunately not all of his lectures have been retained, but studied documents shows that Felix was a very active person in medical and socio-political life, representing a model in this direction.

4

Authors: Dan L. Dumitrașcu

This is an essay dedicated to the issues linked to medical elite. The author defines the meaning of elite and describes the medical elite. The focus is put on the aspects that impose the elite: achievements in clinical practice, or in medical education or in biomedical research. Of course, the true elite is challenged by the false elite, pushed by charlatanerie. However, true members of the medical elite are able to resist to the passing of the time.

5

Authors: Călin Cobelschi, Adrian Maier, Iulian Toader, Alen Alfred Redalf Gheorghiu, Mircea Hogea, Alina Mihaela Pascu, Adrian Bărăcan

Diabetes is a common disease in the contemporary world. Diabetic foot is one of the major complications of diabetes because of it’s major individual, economic and social impact. Infection of diabetic foot lesions increases the complexity of treatment and worsens the prognostic. Surgical treatment and antibiotic therapy represent milestones in the approach of diabetic foot infections. This paper describes a bacteriological survey of a lot of patients hospitalised in a surgery department for infected lesions of diabetic foot.

6

Authors: Diana Ungureanu, Dan Minea, Iosif Șamotă, Marius Moga

Cranial ultrasound examinations are performing on preterm newborns to provide information about neonatal brain injury for the prediction of long term neurological outcomes. Because of recent developments in the technology and process of performing cranial ultrasound examinations, and in the classification and understanding of the predictive value of abnormal findings, it is timely and important to consider the value for cranial ultrasound screening in neonatal intensive care units (NICUs).

6

Authors: Nadinne Roman, Angela Repanovici, Liliana Rogozea

The concept of medical ethics occurred with the development of medical ac and medical science to help the main character of health system-the patient. The basic principles of bioethics focused on beneficence and on patient autonomy are complementary with medical rehabilitation specialization, converging to the same destination: patient independence. Over the last decade both disciplines have benefit from expansion and development, but most often not converged, being raised ethical and moral judgment related to behaviour and conduct of medical staff and reported in the scientific and academic therapists activity. This work wants to raise awareness of physical therapists and medical specialists in recovering, providing data on the evolution of these disciplines.

7

Authors: Andrada Nicolau

Epidemiological studies suggest that almost the entire world population has suffered or suffer from one or another form of periodontitis. The permanent tooth affected by caries in children has skyrocketed. The article is a brief overview of the issues related the epidemiology of dental caries and periodontitis, based on the literature in order to understand the phenomenon represented by some of the most common human diseases and their implications on the health of the population. Understanding the factors that influence the occurrence of periodontitis underpins the development of health education programs capable of improving the health of the population and to assure the development agenda at the institutional level to be involved not only dentists, but also general medical practitioner or teachers from the level of education, especially preschool and school.

9

Authors: Cătălina Croitoru,Overcenco Ala, Opopol Nicolae, Pantea Valeriu, Crudu Petru, Barbă Oleg

The phenomenon of climate change has driven appearance of a multiplicity of studies in medicine as an argumentation for elaboration of adaptation measures. It was investigated a number of death cases in cold season (November-March) of very cold winters 2005/2006 and 2009/2010 compared with the period of reference (2001-2010) in 4 regions of the Republic of Moldova. During these cold winters the significant increase both in the absolute number of deaths and in excess deaths has been registered, that is directly correlated with very low temperatures of corresponding periods. At the same time the number of excess deaths was about three times higher during 2009/2010 compared to 2005/2006 (0.001

1

Authors: Liliana Rogozea

Începutul este întotdeauna legat de visele pe care ni le facem în adolescență, de valorile morale pe care ne construim aceste vise, pentru că așa cum spunea Paulo Coelho în Alchimistul: „Toţi oamenii la adolescenţă ştiu care este legenda lor personală. În acest moment al vieţii, totul este limpede, totul este posibil şi oamenii nu se tem să viseze şi să dorească ce le-ar plăcea să facă. Cu toate acestea, pe măsură ce timpul trece, o forţă misterioasă încearcă încet, încet să dovedească faptul că legenda personală este imposibil de realizat. Sufletul lumii se hrăneşte cu fericirea oamenilor, sau cu nefericirea, cu invidia, cu gelozia. Împlinirea legendei personale este singura îndatorire a oamenilor.”

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Authors: Daniela Voda

In this prospective study I presented the efficiency / toxicity of iron chelation therapy for 8 children with β thalassemia major, hospitalized in Children Hospital Brasov between march 2011-march 2013. Evaluation of hemochromatosis based from level of serum ferritin (every 3 month), echocardiography (every 6 month), abdominal ultrasound (every 3 month), and complete growth assessment (every 6 month). I evaluated desferrioxamine toxicity by yearly ophthalmology and audiology examination and deferasirox toxicity by biochemistry every month (ALT, AST, and creatinine).

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Authors: Daniela Drăguș

One of the major issues pharmaceutical companies confront themselves with in the commercial practice is related to the replacement of innovative drugs with generic ones, a much cheaper alternative, and at the same time, a lot more accessible to the patients. Comparing generic and innovative drugs it must be pointed out that both of them have to respect certain standards (related to purity, efficacy) and have the same active substances; the difference consists in the quantity of inactive substances or the organoleptic differences between them. From an ethical point of view, the use of generic drugs increases the population’s accessibility to these drugs, but it raises various issues related to how much the patients are informed about this, how the efficacy of these drugs has been verified or their safe use.

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Authors: Marius Moga, Cosmuță Adina, Nicușor Bîgiu, Petru Ifteni, Victoria Burtea, Alina Pascu

Multiple sclerosis (MS, SM) is a condition that interferes with the decision of having a child because of the complex associated-morbidity and treatment. This paper indentifies and highlights the importance of a reliable evaluation of the relationship MS – pregnancy. We can hereby conclude how the pregnancy influences the evolution of MS and also in which degree the MS influences the evolution of the puerperium. Therefore, to ensure a good management of this complex situation, this article proposes some indications to be taken into account whenever this morbid association occurs.

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Authors: Mimoza Velickovski, Bedri Veliu, Radmila Maksimovska-Simonovska, Gordana Ristovska

Article is a retrospective study based by a questionnaire survey for quantifying annoyance and the sleep disturbance level within the adult population. The conclusion of the study is that population in Kumanovo who live and work in trade-business-residential and residential areas were exposed to increased noise level and they reported annoyance and sleep disturbance.

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Authors: Ştefania Diaconu, Radu Mircea, Bogdan Cârlan, Oana Falup-Pecurariu, Monica Moarcăş, Cristian Falup-Pecurariu

Traumatic brain injury is a frequent medical condition that major affects the patient’s quality of life. Sleep disorders represent important consequences of traumatic brain injuries, both in the acute or chronic phase following the trauma. Posttraumatic sleep disturbances include hypersomnia, insomnia, narcolepsy, sleep apnoea and circadian sleep-wake disorders. The aim of this study is to review the clinical aspects and the epidemiology of these particular sleep disorders, the most important assessment tools (subjective methods like scales or objective measurements like polysomnography) and their management.

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Authors: Anamaria Raluca Badea, Laurențiu Nedelcu

Cardiac autonomic neuropathy (CAN) is one of the most common complications of diabetes mellitus. CAN is recognized as a strong independent predictor for cardiac events, it increases both mortality and morbidity risk in diabetic patients. The imbalance between sympathetic and parasympathetic nervous system due to an impaired autonomic function is leading to an increased arrhythmic risk. Heart rate variability (HRV) reflects the cardiac autonomic function and a reduced HRV in diabetic patients reflects a sympathetic dominance. In clinical practice HRV measurements are obtained with an analysis of RR fluctuations in continuous ECG monitoring. HRV indexes are analysed in time and frequency domains. Further researches are required to standardize HRV indexes by gender and age.

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Authors: Cristian-Adrian Constantinescu, Elena-Mihaela Constantinescu

The incidence of Helicobacter pylori infection is between 3-10% of the population per year in developing countries and 0.5% per year in developed countries. There are significant correlations between the prevalence of H. pylori infection, hygiene and living conditions of childhood. The natural reservoir of H. pylori infection is human, describes many possible routes of transmission: oral-oral, fecal-oral, gastro-oral, iatrogenic, aquatic and zoonotic Based on genetic differences, H. pylori have been classified in seven varieties, with different geographical distribution, prevalence specific ethnic groups. Suggested origin of H. pylori infection is in East Africa, from where it spread ago a hundred thousand years The first form of the disease, which manifests itself in all patients infected with H. pylori is active chronic gastritis. Later complications occur or developments such chronic gastritis to ulcer disease and gastric cancer.

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Authors: Gheorghe Banu

Trekking is not practised only by apparently healthy people, but also by an increased number of subjects with risk factors associated with subclinical or diagnosed cardiovascular diseases, with or without treatment. This study has focused on a sample of 56 subjects belonging to the age group 46-55 years, and is part of an ample research on a group of 164 trekkers, aged between 35 and 65 years. They were monitored by measuring the blood pressure, heart rate and electrocardiogram on a route between Bușteni (850 m), up the Cerbului Valley (2000 m) to Omu Peak (2500 m) and back. The conclusions were: for the untreated hypertensive, blood pressure jumps determine more frequently cardiovascular events with clinical expression of angina of effort and electrocardiographic changes of ischemic ST -T; treated hypertensive patients have moderate tolerance to climbing effort with ischemic ECG changes in dynamics; cardiovascular events of the type: angina, arrhythmias, myocardial sequelae were not complicated with fatal or non -fatal events.