ISSN: 1582-5388





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Improvement of Health Status Monitoring and Evaluation Capacity in the Framework of Health Care System Reform – Phare Project

Daniela Manuc, Elena Lungu

The European Union within the Community Public Health Program 2003-2008 set down the objectives of establishing and operating a sustainable health monitoring system.

The system aims at producing comparable information on health and health-related behavior of the population, on disease and health systems. The system will continue the work of the previous community health programs and should be complementary to the activities of the Community Statistical Program and to work underway in Community agencies and in international organizations such as World Health Organization (WHO) and Organization for Economic Co-operation and Development (OECD).  Ü FULL TEXT.PDF


Health Patterns and Determinants


The Prevalence of  mrsa Among the Lying-in Women and Their New–Born Infants in Two Maternities From Iaşi

Luminiţa Smaranda Iancu, Medea Berea, M Onofriescu, Raluca Filimon, Ramona Gabriela Ursu, Andreea Mihaela Marian, G Berea, Simona Berea

Abstract. Methicillin-resistant (MRSA) is a risk factor of nosocomial infection (NI) with compromised hosts, including neonates. Objective. The objective of our study was to compare the prevalence of MRSA infections in the new–born(s) and in the laying – in woman, in two maternities from Iasi city. Materials and methods. There have been studied 161 new–born(s) and 381 lying-in woman in the A maternity; 1049 new–born(s) and 768 lying – in woman were studied in B maternity. S. aureus, was identified by classical methods, inclusive latex-agglutination test, and was isolated from: pharynx exsudates, vaginal discharges and lochia rubra. Sensitivity testing to methicillin was made with 5µg disks, using NCCLS standard. Results. Methicillin-sensitive  Staphylococcus aureus (MSSA) were identified in 23% (15 / 53) and 77% were identified like MRSA from the all of isolates (53), in A maternity; in B maternity, MSSA and MRSA represented 53.6% and 46.4% (19 / 41) respectively, from 41 isolates tested. Conclusions. The new–born(s) represent a risk group for severe infections with MRSA; specific measures like nasal ointment with mupirocin and antiseptic solutions for the skin lesions must be performed concerning control strategies and the prevention of MRSA transmission in neonate unit.

Key words: MRSA, new–born(s), laying–in woman, nosocomial infections, mupirocin  Ü FULL TEXT.PDF


Effects of the Sex Hormones and Their Modulators on DNA Damage in Skin Cells Measured in the Comet Assay

Rajendran C Gopalan, Louisa D Nelson, Julie M Thornton, Diana Anderson

Abstract. Aims. Hormones can react through receptors and/or possibly through the production of oxygen radicals. The Comet assay examined DNA damage produced by the androgens, testosterone (TES) and dihydrotestosterone (DHT), and the oestrogens, diethylstilbestrol (DES) and β-oestradiol in NCTC2544 cells (keratinocyte cell line) and primary keratinocytes. Materials and methods. The TES and DHT responses were evaluated with and without the androgen modulator, cyproterone acetate (CPA), and DES and β-oestradiol with and without the oestrogen modulator, tamoxifen (TAM). Oxygen radical-type effects in keratinocytes were evaluated with hydrogen peroxide (H202) by itself and in combination with catalase (CAT), CPA and TAM. Results and discussion. TES, DHT and DES produced positive responses, and the extent of the DNA damage produced was reduced by the appropriate modulator. The DNA damage induced by H202 was reduced by CAT, CPA, and TAM. Conclusions. These observations suggest by analogy, that oxygen radicals are involved in DNA damage produced by the hormones.

Key words: androgens, oestrogens, cyproterone acetate, tamoxifen, hydrogen peroxide, skin cells, oxygen radical damage  Ü FULL TEXT.PDF


p53 Expression in Haematological Malignancies: Response to Alkylating Agent in the Comet Assay

Afruj A Ruf, Ann C Cuthbert, Behzad Foroutan, Diana Anderson

Abstract. Aims. The P53 gene is a tumour suppressor, often inactivated by deletion and/or point mutation in malignancies. The incidence of p53 mutation in haematological malignancies varies with malignancy type and cell lineage affected. It is associated with disease progression, poor prognosis and resistance to chemotherapy. The wild-type p53 protein has a short half-life and cannot be detected by immunocytochemistry, whereas the mutated form has an extended half-life and can be. Materials and methods. Using lymphocyte cytospin preparations from patients with a range of haematological malignancies, p53 mutation was assessed with immunocytochemistry. Results. 83 patients showed intracellular p53 in 16 cases, including 4/18 (22%) Non-Hodgkin’s lymphoma (NHL), 3/15 (20%) chronic lymphocytic leukaemia (CLL), 2/13 (15%) myeloma, 2/19 (11%) chronic myeloid leukaemia (CML), 1/3 (33%) hairy cell leukaemia (HCL), 4/15 (27%) myelodysplatic syndromes (MDS) including two transformed acute myeloid leukaemia (AML).  Using the Comet assay, lymphocytes from the p53 positive NHL, CLL, CML and AML cases showed reduced damage to the alkylating agent, ethyl methanesulfonate (EMS), when compared to p53 negative cases. Conclusions. This suggested that mutant p53 positive cases are resistant to damage by cytotoxic agents.

Key Words: haematological malignancies, p53 mutant protein, lymphocyte cytospin preparations, immuncytoochemistry, comet assay, ethyl methanesulphonateÜ FULL TEXT.PDF


International Perspectives on Correlation of Socio-Behavioral Risk Factors With Dental Caries

Daniela Manuc, Simona Bulgaru, Luminita Smaranda Iancu

Abstract. Diseases have as determinants the complex chain of environmental and behavioral events which are shaped by broader socioeconomic ones. Most studies of socio-behavioral risk factors of dental health have been carried out in industrialized countries, but such reports from low- and middle-income countries have been published in recent years. World Health Organization (WHO), international collaborative studies and other international studies related to social factors in dental caries using the same methodology, provide empirical evidence of social inequality in oral health across countries and across oral health care systems. The paper highlights the challenges to dental public health practice, particularly the importance of risk assessment in estimating the potential for prevention. In future public health programs, systematic risk factor assessment may be therefore used as an instrument in the planning and surveillance of oral health promotion and oral disease intervention programs.

Key words: dental health, public health, programs, health needs, health determinants  Ü FULL TEXT.PDF


Dermatoglyphics in Diabetes Mellitus of Type 2 (T2DM) or Non-Insulindependent

Ana Ţarcă

Abstract. Aim. The study is aimed to analyze the pathology of palmary dermatoglyphics of a group of population from Moldova (North-East part of Romania). Materials and methods. The study was performed on a group of 190 patients (60 men and 130 women), affected by diabetes mellitus type 2 (T2DM), aged between 40 and 82. The installation of the disease has occurred between the age of 35 and 80 years of age. Results. The results reached in the analysis of the 380 dermatoglyphic files have been compared with those recorded (by the author) for T1DM - affected patients, and for a reference sample from the same geographical region with the former ones. The observation to be made is that, regardless of the age of the malady’s onset or of the afferent complications generated by T2DM in time, the patients evidenced a palmary dermatoglyphic picture with a deep pathological charge, suggestively illustrated by 10 important distortions or anomalies carrying profound medical significance. Associated in various combinations, between 3 and 6, in the palmar print of each affected person, such anomalies recorded values sensibly different from those of the reference sample, being quite close to the behavior of T1DM - affected patients, in whom - actually - the clinical manifestations of the malady are (generally) similar. If, by its 10 individual palmary distortions T2DM is highly resembling T1DM, once they might be utilized as ,,markers” for a precocious diagnosis of the persons in whom the risk of T2DM is quite high, two important deviations at the level of the whole palmary picture permit the differentiation of the two forms of diabetes for  further possible populational studies have been evidenced. They refer to the sensible diminution of the pattern frequency in the interdigital space IV, which led to a different positioning of this compartment in the classical distribution formula, namely: III > Hp > IV > Th/I > II instead of: IV > III > Hp > Th/I > II. Conclusions. Distorsions might be markers in the individual diagnosis. Dermatoglyphic test represent one of the procedure for tracing diabetes in population.

Key words: palmary dermatoglyphics, distortions or anomalies, pathology, type 2 diabetes mellitus (T2DM)  Ü FULL TEXT.PDF


Transport and Health

Alexandra Cucu, Doina Lupulescu

Abstract. Transport is an essential factor for economic development. Unfortunately actual trends, indicating an unsustainable way of development, are leading to large detrimental health and environmental impacts. Consequently, the results of analyses of evidences for the type, magnitude and costs of transport-related health and environmental effects, international, integrated action on transport, environment and health were developed. They provide a valuable framework for the development of national and local action to address the transport related health effects, which falls under the responsibility and mission of the national public health authorities

Key words: environmental health, public health authorities, transport Ü FULL TEXT.PDF


The Role of Plantar Traumatisms in the Appearance of Plantar Ulcers

Júlia-Edit Fekete, L Gy Fekete

Abstract. Aim. The aim of the present study was to summarize the conclusions of the literature regarding the role of plantar traumatisms in the appearance of plantar ulcers. Materials and methods. The data base Medline was used for the identifying the literature in the field. We selected the studies the demonstrated a correlation between traumatisms and plantar ulcers and papers published as full text and abstracts too. We decided that a numbers of 3 studies satisfied our criteria that have formed our methanalysis. Results. In the selected studies, the plantar ulcer caused by diabetes is a well documented and described clinic notion. These studies evaluate the importance of different risk factors of the plantar ulcers. All by the studies mention the plantar traumatism, measured by a higher plantar pressure, as a risk factor for the appearance of the ulcers, as well as of the late complications as: leg amputation or other ulcers. Conclusions. There are studies that show the association between plantar ulcers. The studies taken into account by our methanalyzis underline plantar traumatism as a risk factor for the appearance of plantar ulcers.

Key words: plantar, traumatism, ulcer, methanalyzis, risk factor  Ü FULL TEXT.PDF


Predispozing and Promoting Factors of  Mal Perforant Pedis

L Gy Fekete, Júlia-Edit Fekete

Abstract. Aim. The aim of our study was to determine the prevalence of predisposed and favorizing factors of mal perforant pedis (MPP). Materials and methods. The studied lot was represented by 40 inpatients diagnosed with plantar ulcers, in the Tg. Mures, Dermatologic Clinic in the period of 1996-2000. The predisposed factors considered were: sex, nutrition status, inpatient, reinpatient, life style, alcohol consumption, smoking. Working environment and repeated exposure to the same pollutant were considered as favorizing factors. Results and discussion. Mans were more frequent in the studied lot (82.5% vs 17.5%) and aged patients (73.5% retired vs 27.5% active). Nutrition status revealed 20% over weight and 50% under weight. Average length stay was about 23.3 days and for the inpatients with 6 years was about 3.45 days. 65% of them were smokers. Alcohol consumption > 100 ml/day was registered in 32.5% and 22.5% respectively. Regarding patients occupation, 27.5% used to have difficult physical work duty, 57.5% medium physical work and about 15% used to have intellectual duties. We mentioned local exposure to polivirilchlorid, particularly present in the composition of rubber boots, 35% of patients confirming the ware of these boots more than 5 years. The prolonged ortostatism (> 8 hours/day) along time (> 20 years) was present in 60% of patients. Repeated examinations of the plantar zone were found in approximately 45% of patients. Conclusions. The results of this study were in close concordance with those found in the literature in the field, related to predisposed and favorizing factors of plantar ulcers.

Key words: mal perforant pedis, predisposed factors, favorizing factors, neurologic, osteoarticular, vascular Ü FULL TEXT.PDF


Dental  Health


Streptococcus  mutans and Lactobacillus Levels in Oral Cleft Patients

Joanna Antoszewska, Teresa Matthews-Brzozowska, Beata Kawala

Abstract. Aim.  The aim of the present study was to search the manner in which cariogenic bacteria might coexist with know bacteria that produce volatile sulfur compounds and represent the cause of habitasis.  Materials and methods. 100 patients aged 11-21y with palatal clefts and malocclusions were divided into two groups: group A was treated with fixed orthodontic appliances, group B was treated with removable appliances. The untreated group C represented the control one.  Patients were examined for halitosis and an assessment for cariogenic bacteria from saliva samples was performed.  Significance established at p<0.05 was used to analyze the data by U-Mann-Whitney test and r-Spearman coefficient. Results. The patients presented lower levels of Streptococcus mutans than expected. Group B showed an inverse relationship between halitosis and the presence of cariogenic bacteria.  Groups A and C had higher levels of Streptococcus mutans that did not inhibit the development of microbes that produce volatile sulfur compounds. Conclusion. Our study showed that cleft palate patients have a diminished caries risk comparing to non cleft ones. Therefore, these patients have special oral hygiene needs and must focus on brushing either the tongue or an appliance.

Key words: cariogenic bacteria, halitosis, cleft palate, orthodontics  Ü FULL TEXT.PDF


Systemic Impact of MIH Syndrome on the Child and Adolescent

Marinela Păsăreanu, Adriana Bălan, A Maxim

Abstract.  Aim. The aim of our study  was to monitoring the prevalence of the First Permanent Molar and Incisor Hypomineralisation Syndrome (MIH) in schoolchildren from Iasi. Materials and methods. The surveyhas been carried out on a number of 681 children aging from 8 to 11: 401 girls (58.9%) and 280 boys (41.1%). The Enamel Defect Index (EDI) was used in order to classify data. Results and discussion. Our study showed a prevalence of enamel development in permanent incisors of 10.28% and in first permanent molars of 4.26%. The prevalence of MIH Syndrome was 14.54%, a quite high value, explained by the low fluoride concentration in the studied area. The enamel defects in permanent incisors had a RR of 2.41 (1.59 - 3.67 CI 95%). The prevalence of defect emergence in the first permanent molars is more probable if the affected incisors have a lower prevalence (r= - 0.50). Conclusions. Our study revealed a MIH Syndrome prevalence of 14.54%. The correlation between the permanent incisors and the first permanent molars was r = - 0.50 and on the mandible r = 0.22. The ratio of affected first permanent molars compared to the incisors was of 1/4.

Key-words: mineralization, prevalence, Molar Incisor Hypomineralisation Syndrome  Ü FULL TEXT.PDF


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