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JOURNAL OF

PREVENTIVE

MEDICINE

                 ISSN: 1582-5388

 

 

 

 

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The resources utilization pattern in a general university hospital

Odetta Duma, Laura Munteanu

Abstract. University hospitals provide the highest level of medical care available for less frequent and very complicated conditions and instances of last referral care. The largest share of national health expenditure gets for hospitals, regardless of the health status and income level of a population. Within the hospital sector, the university hospitals after a negotiation of their budget with insurance houses generally get a big part of the available financial resources. In addition, a significant part of the other essential health sector resources like human, physical or technological are usually concentrated in these hospitals. The goal of the present study was to assess the supply of specialized services in a university hospital based on utilization pattern of existing resources. The concept of allocative efficiency has been used. Analysis was based on indicators, which are relevant for hospital activity: average hospital stay, bed turnover rate, occupancy rate, hospital mortality.

Key words: university hospital, utilization pattern, average hospital stay, bed turnover rate, occupancy rate, hospital mortality rate FULL TEXT.PDF

 

Epidemiological studies highlighting the relationship between environmental pollution with nitrogenous compounds and the health of children

Marieta Vasilov, Gabriela Mancaş, Gabriela Albu, Carmen Hura, Maria Brădăţan††††††††

Abstract. The authors present a synthesis of nine epidemiological studies performed in the interval 1988-2000 in areas with a long term-exposure to nitrogenous compounds, pollutants of environment (drinking water and food products). 1488 children (0-3 years) from five districts in eastern Romania were investigated for chronic effects. The selection of study areas has been made based on the incidence rate of infant methemoglobinemia in those districts. The chronic health effects were emphasized by some bioindicators of exposure and effect. The causal relationship has been proved especially by a higher frequency of cases with pathological methemoglobin levels in the exposed children (61.9%) in comparison with those unexposed ones (23.7%). The results were used as criteria for ranking the areas at risk in the East of Romania and also for risk communication..

Key words: environmental pollution, nitrogenous compounds, epidemiological studies, territories at risk, risk communication†† FULL TEXT.PDF

 

Inequalities in hypertensive patients from two catchment areas

Elena Lungu, Iliana Palamaru, Lidia Rusu

Abstract. The main objective of this survey was to evaluate if there are gender differences among patients diagnosed with primary hypertension. Two catchment areas in Iaşi city have been selected on socioeconomic status of inhabitants (higher status in A area; lower one in B area) and the hypertension cases randomly selected. The main outcome variable was the difference in the proportion of men and women with ischaemic heart disease (38.67% of men and 59.8% of woman in A area and 8.0% of men and 40.0% of woman in B area). Most of patients in both areas, which have been diagnosed by a specialist medical doctor with ischaemic heart disease, were women. The analysis of the behaviour related to smoking, showed a higher proportion of ischaemic heart disease among non-smokers, especially women (c2=6.55; p=0.08 in A area and (c2=6.62; p=0.08 in B area). A significant difference between men and women under the age of 50 was evident (c2=8.74; p=0.03). Women were also more likely having higher values of total cholesterol than men despite adjustment for age, obesity and smoking status (OR=0.56 men vs women).

Key words: inequalities, socioeconomic inequalities, primary hypertension, ischaemic heat disease†† FULL TEXT.PDF

 

Contributions to the dermatoglyphic diagnosis of epilepsy

Ana Ţarcă, C. Barabolski

Abstract. Palmary dermatoglyphics, of a group of 102 epilepsy-stricken children and teenagers (51 boys and 51 girls), with ages between 2 and 17 years, have been analyzed. Some significant distortions, inducing deep clinical implications, which differentiate the patients from the apparently normal population, have been found. Some of the palmary dermatoglyphic anomalies, occurring in high ratios with both boys and - especially - girls, predominantly on the left palms of the subjects (equally boys and girls), have also been observed at other European groups of epileptics. The papillary ridgesí disposition as a dense and very dense network at the Thenar/I level, and the finalization of line Tís direction in palmís field 11 and 12 - instead of 13 -, as we found, contribute to enriching the indicators of epilepsyís dermatoglyphic diagnosis - at least for the patients met in Moldavia, for which reference data had been provided.

Key words: epilepsy, dermatoglyphic diagnosis, children, teenagers†† FULL TEXT.PDF

 

Mechanism of action and biochemical effects of nitric oxide (NO)

Luminiţa Jerca, Oltiţa Jerca, Gabriela Mancaş, Irina Constantinescu, R.Lupuşoru

Abstract. Nitric oxide (NO) synthesized in endothelial cells, from the terminal guanidino nitrogen atom of L-ARG, by means of NO-synthase (NOS), activates guanylyl-cyclase in smooth muscle cells and plateletes, increasing the levels of the intracellular messenger cyclic guanylyl phosphate (GMPc). This phenomens produces smooth muscle relaxation and platelet aggregation inhibition, presumably by reduction of the intracellular free Ca2+ concentration. The endothelial vasodilator prostacyclin causes the same effects through adenylyl-cyclase activation, which increases intracellular level of AMPc. The biological activity of NO may be modified by oxygen-derived reactive species, such as anion superoxide (O2), hydrogen peroxide (H2O2) and hydroxyl radical (OH), contributing to regulate the vascular tone. NO may posses both cytoprotective and cytotoxic properties, depending on the amount and the isoform of NOS. NO may regulate hepatic metabolism directly by causing alterations in hepatocellular metabolism and function, or indirectly as a result of its vasodilator properties.

Key words: nitric oxide (NO), oxygen-derived reactive species, peroxynitrite (ONOOĮ), cytoprotective or/and cytotoxic propertiesFULL TEXT.PDF

 

Occupational medicine

 

Influence of ventilation and aerosol size on the annual effective dose received by reference workers in uranium mines

V.C. Tomulescu, Raluca Gheorghe, Olga Iacob

Abstract. A high level of radon daughters concentration has a tremendous impact on the effective dose received by the workers. This paper presents the annual effective doses received by different Reference Workers performing different type of activity in uranium mines. The effect of mitigation is presented as a comparison of the annual dose levels for equilibrium and for non-equilibrium conditions between radon and its short-lived decay daughters.

Key words: radon daughters, Reference Worker, annual effective doseFULL TEXT.PDF

Sputum cytology in occupational exposure to heavy metals Ė a preliminary study

Irina Anca Popescu, Doina Popa, Doina Hăv‚rneanu, T. Ghindaru, Irina Alexandrescu

Abstract. Our study aimed the early detection of respiratory injuries afflicted with occupational exposure to chromium, cadmium, nickel and their compounds, with a known high carcinogenic risk. 23 platers (average of exposure 15.57Ī5.05 years) and matched controls have been investigated by clinical examination (including otolaryngology exam) completed by sputum cytology and an individual questionnaire.

Heavy metals concentration, as well as the microclimate factors, were measured in working area and revealed the values near to the admitted limits. Sputum investigations found the type I cytology in 37.8% of workers vs. 82.6% of controls, type II cytology in 43.5% vs.17.4%, respectively. Two workers had sputum cytology of III type, with nucleolar alterations and suspected tumor cells. At 60.8% of people in exposed group were identified ferruginous bodies, in all types of sputum cytology, comparatively with only one case in control group. 74% of platers had chronic upper respiratory diseases vs. 26.1% of controls; 56.5% had pulmonary emphysema vs. 0% in control group. Plating industry is responsible for chronic respiratory diseases, with possible malignancy risk, even the concentrations of heavy metals in the air are in admitted limits.

Precancerous injuries can be seen by sputum cytology a simple, noninvasive, and not expansive method, requiring a carefully monitoring of workers. The presence, in a high proportion, of ferruginous bodies, unspecific to heavy metals exposure, entails revaluation of the exposure in working place.

Key words: sputum cytology, plating industry, heavy metals, ferruginous bodies FULL TEXT.PDF

 

Epidemiology: communicable disease

 

Emerging Shiga cytotoxin-producing Escherichia coli I. Enterohaemorrhagic E.coli O157: H7

Sofia Constantiniu

Abstract. One of several Shiga toxin-producing serotypes of Escherichia coli is O157 serotype. E.coli O157 was first identified as a human pathogen in 1982 and then has involved from a clinical novelty to a worldwide public health concern. This organism known to cause human illnesses develops from mild non-bloody diarrhoea to haemorrhagic colitis, haemolytic uremic syndrome and death. The bacterium evolved through acquisition of genes for Shiga toxin and many other virulence factors. The cattle and many other animal species represent the reservoir for human infection with E.coli O157. This serotype is transmitted by food, water and directly from one person to another. There are different laboratory methods for isolation and identification of E.coli O157. Surveillance, rapid reporting of cases and ready epidemiologic investigations are essential elements of timely public health response.

Key words: E.coli O157, virulence factor, clinical feature, epidemiology, laboratory diagnosis†† FULL TEXT.PDF

Experimental research

 

Reactivators of cholinesterase activity in methylparathion exposed rats

Irina Popovici, Didona Ungureanu, Cătălina Elena Lupuşoru

Abstract. The cholinesterase activity and the biochemical antioxidant parameters in the blood of rats exposed to an organophosphate pesticide, methylparathion, in dose of 1/20 from LD50, and subsequently treated with quaternary ammonium iodides from Mannich bases oximeshave been determined. Our research on the reactivator effects of both original synthesized substances named Q1 and Q2, compared with toxogonin, showed their reactivator capacity according with cholinesterase activity and the biochemical effects caused by the membrane oxidative stress.

Key words: cholinesterase, methylparathion, toxogonin, Mannich bases oxime, oxidative stress, superoxide dismutase, catalase, glutathione peroxidaseFULL TEXT.PDF

 

 

 

 

 

 

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