ISSN: 1582-5388





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Quality of life in patients with orthopedic trauma

VB Remizov, Elena Lungu

The actual objective of modern medicine concerning a better quality of life in patients in different stages of disorders, is possible to be achieved through knowledge about multiple aspects of etiopathogeny and pathology. Quality of life (QOL) is an important issue for the large number of patients who may need to adapt to severe and chronic disability due to joint stiffness. The loss of mobility in the joints makes patient more dependent on others which affects their quality of life. Any loss of ability to live independently in the community has a considerable detrimental effect on their quality of life. It follows that reduction in the incidence of fractures will not only save lives but will prevent a significant reduction in their quality of life (1).  Quality of life has emerged as a concept that refers to many subjective experiences, including well-being and daily functions. Quality of life measures are instruments that describe how patients who experience chronic conditions perceive the impact of disease. Besides the symptoms as pain, disturbances of sleep, limitation of mobility, there are measured emotional distress and severe restrictions in a multitude day - to - day (2). Ü FULL TEXT.PDF


Health Patterns and Determinants


Life expectancy in România

Anca Vitcu, Luminiţa Vitcu, Elena Lungu, Adriana Galan

Abstract. Aim. The present descriptive survey was aimed to find the appropriate patterns for life expectancy at birth by gender and area in România during 1997-2006 and to identify the counties with low life expectancies and low changes rates. Method. Descriptive statistics and specific methods recommended by WHO have been employed in order to calculate the gain in life expectancy and the changes in rates by gender and area. These methods have been accompanied by cluster analysis based on deterministic allocation aiming at identifying relatively homogenous groups of counties. Results. According to the analysis performed in this paper, a notable similarity in life expectancy trends in România and other EU countries could be observed. Also, an important fact was that against this ascending trend in life expectancy, the national average was still very low compared to the EU average. The pattern in life expectancy in România was different by gender, area, and development regions. The cluster analysis showed that there is o great number of counties for which the life expectancy falls below the first quartile. Conclusions. The patterns in life expectancy in România are different by gender, area and development regions. It is important to explore the association between life expectancy and life quality indices before confirming the hypothesis that the gain in life expectancy at different ages in România is also a gain in life quality.

Key words: life expectancy, gain in life expectancy, cluster analysis Ü FULL TEXT.PDF


Life expectancy impact on gdp per capita in România

Anca Vitcu, Elena Lungu, Luminiţa Vitcu

Abstract. Aim. The present survey was aimed at finding a statistical relationship between life expectancy at birth and Gross Domestic Products (GDP) per capita among a number of European countries and at national level, among Romanian counties. In the context of these models, the study tried to find the efficiency of policy plans which stimulate this connection. Material and method. The methods employed to find this connection between the two variables included multivariate statistical analysis. The efficiency was studied based on a common used method: ratios. Results. Regarding the analysis involving the European countries, there can be concluded that, the relationship between life expectancy at birth and GDP per capita can be defined by a linear regression model. Thus, higher levels of GDP per capita have been associated with high life expectancy at birth. Regarding efficiency of policy plans there can be noticed that the countries which explored in the best way the human capital in terms of life expectancy at birth vs GDP per capita, are countries with strong institutions.  On the other hand, the analysis employed at Romanian national level, provides a model which envisages that there are other factors that boost or cripple its economic growth. In terms of policy plans there can be remarked that the Romanian counties which explored less the relationship between life expectancy at birth and GDP per capita, are counties which confronted with factors of a malfunction market. Conclusions. The analysis undertaken in this study proves that at European level there is a strong positive correlation between life expectancy at birth and economic development, and countries that can successfully manage this relationship possess a distinct advantage in front of economic and social challenges. For România the model developed is strongly influenced by complementary factors. 

Key words: life expectancy at birth, GDP per capita, simple regression model, cluster analysis   Ü FULL TEXT.PDF


Community staphylococcal meningitis

Doina Fedulov, Doina Mihalache, Setalia Ostapov

Abstract. Aim. This epidemiological retrospective study was aiming to establish the incidence of primitive or secondary staphylococcal meningitis, in community, clinical peculiarities of evolution by the pathogenic mechanism and the associated co-morbidities, population accessibility to health services, the aspects of diagnosis and therapy, the susceptibility of staphylococcal infection to the antibiotics and the efficiency of the therapy. Materials and methods. The data on the staphylococcal meningitis have been obtained in the Clinical Hospital of Infectious Diseases from Iaşi. In this study there were included all cases from this region (North-East România). There have been investigated 87 hospitalized cases of staphylococcal meningitis between 1977 and 2007. Results. The incidence by sexes was 3.5/105 for men and 1.9/105 for women. A higher incidence by residence area was registered in rural area (3.8/105). The most frequent registered co-morbidities were registered within otorhynolaringology (ORL) pathology (14 cases): oto-mastoiditis 4 cases (4.5%), sinusitis 4 cases (4.5%), otitis 2 cases (2.3%), rhinopharingitis 3 cases (3.4%), amigdalitis 1 case (1.1%). Also, there were registered 6 cases (6.8%) of pulmonary tuberculosis and 5 cases of type II diabetes (5.7%). A proportion of 31% from the examined patients had a primitive meningitis and 69% of them secondary meningitis. The study of cerebrospinal fluid (CSF) helped us to determine the diagnosis of meningitis, as well as the etiology of the meningeal infection. Conclusions. In the period of 1977-2007 there has been registered a tendency of decreasing of the number of cases with staphylococcal meningitis from 13 patients to one patient per year. The prevalence in males was two times higher than the female one. The frequency of children with staphylococcal meningitis was 35.6% of cases.

Key words: staphylococcal meningitis, co-morbidities, cerebro-spinal fluid, antibiotic resistance, therapeutic strategies Ü FULL TEXT.PDF


Bacteriological study of staphylococcal strains isolated from patients with primary and secondary community-acquired meningitis

Doina Fedulov, Doina Mihalache, Tatiana Turcu, Cătălina Logigan, Georgeta Siniţchi, RV Lupuşoru

Abstract. Staphylococcus spp. susceptibility to antibacterial chemotherapeutics is changing and the incidence of resistant strains is growing. The aim of this study was to identify the characteristics and the susceptibility of the staphylococcal strains determining community-acquired meningitis in order to be able to choose the correct treatment. Materials and methods. There have been tested 220 strains isolated from at least two blood cultures in patients with primary and secondary meningitis, from cerebrospinal fluid (CSF) (the first, the second and the third intrathecal puncture) and from other pathological products. The strains have been isolated from 87 patients at Clinical Hospital of Infectious Disease Iaşi from January 1st, 1977 through March 1st, 2007. Classical methods of isolation and identification have been used (bacterioscopy, cultures from pathological products). Blood cultures were performed on heart-brain broth and thioglycolate medium and evaluated for 14 days. CSF cultures were performed on enriched solid and liquid broth and evaluated for 3-5 days. The other pathological products were cultured on selective media with sodium chlorinate salt. Identification was based on morphology Gram positive cocci and metabolic characteristics and coagulase test. Susceptibility of the isolated strains was tested using standard disc diffusion method on Müeller-Hinton agar. Minimum inhibitory concentrations (MIC) of some antibacterial chemotherapeutics (fluoroquinolones, ceftriaxone, vancomycin) were also determined using method of dilution antimicrobial susceptibility test on Müeller-Hinton broth. The Staphylococcus aureus ATCC 25923 strain was used as control. Results and discussion. The analyzed period was split into three smaller periods: 1977-1987, 1988-1998 and 1999-2007. During the first period, 45 staphylococcal strains have been identified (35 strains of S. aureus and 10 coagulase negative staphylococci). These strains were highly sensitive to classic antistaphylococcal therapy. However, S. aureus was found more sensitive to some antibacterial drugs compared to coagulase negative staphylococci. During 1988-1998, 19 staphylococcal strains have been isolated (13 strains of S. aureus and 6 coagulase negative staphylococci). Susceptibility to oxacillin, rifampin, lincomycin decreased under 73% and to trimethoprim-sulfamethoxazole – under 40%. During the last period, the 23 strains isolated (17 strains of S. aureus and 6 coagulase negative staphylococci) have been tested with 16 antibacterial drugs (including ciprofloxacin, imipenem, amoxicillin-clavulanic acid and vancomycin). Susceptibility to classic antistaphylococcal drugs decreased dramatically: oxacillin – 65.2%, gentamycin – 78%, lincomycin – 47.8%, erythromycin – 30.4%. Susceptibility to ceftriaxone, ofloxacin and sulbactam-ampicillin varies between 87-83%. The susceptibility to vancomycin and ciprofloxacin was 100%. Conclusions. During the analyzed period, staphylococcal resistance to classic antibacterial chemotherapeutics increased from 5% to 50% and, soon after that, resistance to systemic quinolones have been discovered.

Key words: Staphylococcus aureus, coagulase negative staphylococci, susceptibility, resistance Ü FULL TEXT.PDF


Clinical study of 57 cases of nosocomial meningitis

Cătălina Logigan, Doina Mihalache, Tatiana Turcu

Abstract. Aim. The aim of the present survey was to establish the incidence of the predisposing and risk factors, the clinical features, etiology and evolution of 57 cases of nosocomial meningitis, treated according to their antibiotic resistance patterns. Nosocomial meningitis occurs after neurosurgical interventions for cranio-cerebral trauma or tumors, after invasive explorations of the central nervous system, or after implanting foreign body materials for cerebro-spinal fluid (CSF) drainage. The incidence of nosocomial meningitis varies between 0.34% and 3.1%. Material and methods. The data referring to nosocomial meningitis were gathered from the archive of the Clinical Hospital of Infectious Diseases Iaşi, a referral hospital for Moldova region. (North-East România) We studied 57 cases of nosocomial meningitis (1997-2007). These cases belonged to 56 patients (one of which had two nosocomial meningitis on a ventriculo-peritoneal shunt). Results. The predisposing factors were neurosurgical interventions (55.36%), ventriculo-peritoneal shunts (32.14%), rahianesthesia and surgical interventions on the ear and nose areas (10.72%), and mielography (1.18%). The risk factors were: emergency surgery (16.07%), a Glasgow score lower than 10 (12.5%), external drainage of CSF for more than 7days (8.92%) and the presence of post-operative fistulae (7.14%). The registered symptoms were: stiff the neck (80.70%), fever (75.44%), headache (56.14%), encephalitic syndrome (31.58%). The etiological agents were followings: Staphylococcus spp 52.63% (S. aureus 56.67%, coagulase negative staphylococci for 43.33%), Enterococcus spp 8.77%, Streptococcus pyogenes and Pseudomonas spp. 7.01% each, Haemophilus influenzae 1.75%, Escherichia coli, Klebsiella pneumoniae and mixed etiology 3.51%. The resistance was: 20 strains of Meticillin resistant staphylococci, 12 of which were Meticillin resistant Staphylococcus aureus (MRSA); the Acinetobacter and Pseudomonas strains - sensitivity to Colimycin, Tobramycin and Meropenem; one strain of Enterococcus was Vancomycin resistant. Twenty cases of meningitis caused by Meticillin resistant staphylococci were treated with Vancomycin and Rifampin or Ciprofloxacin. Six patients had an unfavorable evolution. The therapeutic strategies for Acinetobacter spp, were: Meropenem and Colimycin in 5 cases and Meropenem with Chloramphenicol in 2 cases. Four patients died. The E. coli and K. pneumoniae meningitis received Meropenem or Ciprofloxacin and Colimistin. The evolution was unfavorable in 2 cases (50%). Two Enterococcus spp meningitis received Vancomycin and Meropenem and were cured; 3 cases treated with Pefloxacin and Ceftazydim died (one strain was Vancomycin-resistant). Two patients with Streptococcus pyogenes meningitis died within 24 hours of admission. Overall, 25 patients died, with a mortality rate of 44.64%. Conclusion. Nosocomial meningitis is a severe infection, with diverse etiology, which rises therapeutic problems due to antibiotic resistance and a high mortality rate.

Key words: nosocomial meningitis, cerebro-spinal fluid, therapy Ü FULL TEXT.PDF


New dermatoglyphic investigations on infantile autism

Ana Ţarcă

Abstract. Aim. The present study resumes and completes – from a dermatoglyphic perspective – the researches on the autist syndrome on an extended sample group formed of 207 affected people (104 boys and 103 girls) – comparatively with the batch of 137 subjects (67 boys and 70 girls), analyzed in 2003 – with ages between 2.5 and 18 years. Material and method. A total number of 414 finger and palmar prints have been taken over in the Mental Health Center of Iaşi, all subjects coming from Moldova (North-East part of Romania). Results. Worth mentioning are the important modifications in the frequency of some palmar distortions, bearing deep pathological significance, more exactly either an increased (AR, Co and the transverse palmar sulcus) or a decreased (reduced a-b and dense network of the ridges from Thenar/I) occurrence of theirs. Also, in the 2008 series, the weight of many of the distortions evidenced is higher, for all the three possible positions of disposition in their carriers, and especially for the bilateral one, which suggests doubling of the pathological charge at the palm level in the actual series of autistst. As to the sexual dimorphism and bilateral differences in the distributions of palmar anomalies, however, the two series of autists show an unitary behaviour, the AR, LU, T11+T12, reduced a-b, Cx and transverse palmar sulcus distortions being more frequent in boys, while tt’t’’, the dense network from Th/I, Co and t0 – in girls; also, LU, t0, T11+T12, Cx, Co and transverse palmar sulcus are more frequently occurring on the left hand, whereas AR, tt’t’’, the dense network from Th/I and the reduced a-b – on the right one. More than that, in both groups of autists (of 2008 and, respectively, 2003), the percent values recorded for all palmar distortions under analysis are considerably different from that of the reference, which is another proof that the either genetic or teratologic causal factors involved in the development of infantile autism have been active in the first 3-5 months of intrauterine life, when the epidermal papillary ridges are also finalized. Conclusions. The results obtained are contributing to a better knowledge of the indices of dermatoglyphic diagnosis of the autist syndrome. They may be also employed as reference data for a precocious tracing of this severe malady, at least in the region of Moldova  (North-East România) from which the affected people come.

Key words: palmar dermatoglyphics, pathology, distortions or anomalies, infantile autism  Ü FULL TEXT.PDF



Estimation of boron concentration in some drinking water samples of rural areas

Diana Diaconu, V Nastase, Mara-Mihaela Nănău, O Nechifor, Elena Nechifor

Abstract. Aim. Significant risks for human health may results from exposure to non pathogenic toxic contaminants that are often globally ubiquitous in waters from which drinking water is derived. In Moldova’s rural areas (România) the wells are important water sources for the population. Material and methods. We have investigated the level of boron (B) in relation with other chemical parameters of water quality in 60 samples from 8 districts from Moldova (North-East România) in the period of 2005-2006 (nitrate, chloride, calcium, magnesium, total hardness, sodium, potassium, bicarbonate). Results. We have found out that the level of boron are below Romanian’s sanitary norm, but there were noticed that well waters are polluted with nitrate. Conclusions. The presence of boron in drinking water sources in this territory is of natural origin. Thus, there is not a problem of aquifer pollution with boron.

Key words: boron, well water   Ü FULL TEXT.PDF


Peculiar issues concerning the occupational risk in an asbestos - cement factory

Doina Popa, Stela Simirad, Iulia Roman, R Branişteanu, Cristina Hâncu, Irina Alexandrescu

Abstract. Aim. The risks of carcinogenic and co-carcinogenic effects from asbestos continue owing to the persistence of the fibres from mining, milling, manufacturing and its use in building materials and other products. This paper wass aimed to achieve the risk assessment in occupational exposures to asbestos in an industrial unit producing asbestos-cement for a period of 30 years and also an evaluation of the possible correlation between exposure and cytogenetic alterations in peripheral blood, which might be a quantitative comparable and reliable method of risk assessment. Material and methods. The retrospective evaluation of the magnitude of occupational risk has been performed on the basis of the laboratory data established through the “membrane filter” method. The enhancement of cytogenetic alterations by using the peripheral lymphocyte cultures - Evans and O’Riordan, method - on a representative group of 30 subjects, with the mean age of 42.2±8.9 years and the work length in asbestos industry of 17.5±8.7 years was performed. The results were compared with those of a matched control group through the “t” Student test and the Spearman correlation factor for p<0.05. The obvious correlation between the incidence of cytogenetic alterations, the cumulated exposure and the work length, respectively have been calculated. Results. The exposure risk, quantified in fibres/ml (l>5mm, d>3mm, l/d ≥3/1), evaluated after 1981 presented the following values: in 1981-1985 32 f/ml and in 1998 0.003 f/ml. The employees who have taken contact with the asbestos powders presented significantly higher frequencies for the structural chromosomal aberrations, compared to the control group have registered values of 3.60 ± 1.39 (IC95% 3.05-4.17) and 1.85 ± 1.05 (IC95% 1.42-2.27). Conclusion. Asbestos is carcinogenic for humans. The latency period for tumor occurrence is about 20 years. Our results with regard high correlation of the cytogenetic aberrations and the cancer incidence in populations occupationally or environmentally exposed to potentially genotoxic factors are in concordance with the recent literature in the field.

Key words: asbestos, occupational exposure, chromosomal aberrations, cancer  Ü FULL TEXT.PDF


ENHIS indicators - environmental determinants - a country based report

Alexandra Cucu

Abstract. The Romanian environmental health status features, as reflected by the internationally available data, are reviewed in order to draw attention to future intervention priorities for the decision makers. ENHIS (Environment and Health Information System) indicators have been elaborated as responding to the important amount of the effects attributable to environmental factors a system of environmental health indicators, children specific, and the supporting tools for data collection and reporting was elaborated in line with the CEHAPE (The Children Health Action Plan for Europe), Budapest, 2004 and EU strategy. The ENHIS indicators, focused on children’s health, demonstrate the important contribution of environmental determinants on global burden of diseases.

Key words: environmental determinants, indicators, accessibility, policies, burden of diseases Ü FULL TEXT.PDF


Dental  Health


The mothers’ role in effecting and supervising the early childhood oro-dental hygiene

Marinela Păsăreanu, Dana Rotaru, Adriana Balan

Abstract. Aim. Tooth brushing twice daily is a recommended component of oral self-care soon after the eruption of primary dentition. This study was aiming to investigate oral hygiene and frequency of oral cleaning in children up to 6 year old, in relation to mother-related factors. Material and methods. The study was carried out on a number of 157 children aged between 2.6-5.5 y.o. from Iasi. Mothers answered to questions about their own oral self-care and their activity in their children’s oral hygiene. The child’s oral hygiene was assessed on the basis of visible dental plaque on the labial surface of the upper central incisors. Results. Twice daily oral cleaning was reported by 7% of all children. Once daily cleaning was reported by 2.6 - 3.5 year old children as 8.3%, by 3.6 and 4.5 aged children as 21.7% and by 4.6 to 5.5 year old children as 34.4%. 49.7% from mothers lacked the skill to clean their children’s teeth, according to their answers. Dental plaque was observed in 55%-76% of the children. Clean teeth were more likely in children of mothers who themselves had a higher tooth brushing frequency. Conclusions. More emphasis should be placed on mothers own tooth brushing and their skill to their children’s cleaning in order to improve oral hygiene in early childhood,.

Key words: oral hygiene, frequency of oral cleaning, mother, early childhood Ü FULL TEXT.PDF


The relevance of the emotional factor in paediatric dentistry

Carmen Savin, A Maxim

Abstract. Aim. The present survey consists in a psycho-sociological analyze aiming at determine the emotional factors that influence the child motivation and behaviour at dental office – before, during and after the treatment. Material and methods. The study was carried out on a number of 110 children aged between 6-11 years and on a number of 100 parents, from Iaşi city. The relevant emotional and attitudinal reactions were determined using a questionnaire by interview. Results. In the studied sample, most of the children had fear of dentist (61.8%). The chance of girls having fear towards dentist was 2.46 higher compared to boys (OR=2.46, p=0.025, 95%CI).The results of un-parametric correlation indicated the presence of a significant considerable correlation between the presence of fear in the parents and the presence of fear in their children (r=0.74, p<0.01, 95%CI). Conclusions. A correct evaluation of the emotional reactions of the child offers the possibility to pick up the most appropriate methods and techniques of communication and behavioural shaping with direct impact on the quality of dental management with long term psycho-somatic and psycho-social implications.

Key words: fear, child, behavioural management, questionnaire   Ü FULL TEXT.PDF


The role of the psychological factor in paediatric dental management

Carmen Savin, A Maxim

Abstract. Aim. The present study was aimed to emphasise the role of psychological factor in establishing of an effective and efficient relation and communication between child patient and paediatric dental practitioner as well as to perform a correct individualization of the behavioural and therapeutical management techniques. Material and methods. The present study is an integrative part of an interdisciplinary mixed pilot study carried out on a number of  88 subjects (54 girls and 34 boys) aged between 6-8 years old, from two Iaşi school communities, with the following structure: 64 subjects normal from psycho-mental viewpoint and 24 subjects with audio sensory disabilities. In reasoning of the proposed aim, we have performed a complex assortment of investigations: projective draw test (thematic projective test), Raven's progressive matrix test and questionnaire. Results. The thematic projective draw test illustrated for the normal subjects group: rounded draw outlines, light harmonious colours, an integrative systemic aspect. For the subjects with disabilities it showed: the lack of integrative aspect, affective liability, intrinsic variable personality demodulation, an austere reflection of the ambient environment, etc. It was found a significantly correlation between the IQ level and the conduct manifested by child (r=-0.857, p<0.01, 95%CI). Evaluation of the risk proportion (Chi-square test) revealed that in an unfavourable family environment, the risk for developing an abnormal conduct was 11.8 times higher (χ2= 49.5, p<0.01, 95%CI). Conclusions. The paediatric dental practitioner must approach the child patient (normal or with audio sensory disabilities) in the intricacy of its problems and determinatives, using a large range of clinical and para-clinical investigations contributing to the perfectively paediatric dental - behavioural and therapeutical, preventive, interceptive and curative management

Key words: child, disability, management, thematic draw, Raven progressive matrix test  Ü FULL TEXT.PDF



Criminality and the workplace. Links between the occupational status and various offences in the Romanian penal legislation

Laura Grădinariu

Abstract. Aim. The aim of this paper is to analyze what types of crimes can occur in workplaces, according to the Romanian criminal legislation, in order to raise the awareness regarding the possibility that workers may be victims or perpetrators (or both) for certain offences. Method. The study offers an overall perspective on the possible crimes in connection either with the workplace or with certain professions. It also evaluates the efficiency of the legislation in what concerns the prevention of the crimes described, in order to identify ways for improving the occupational-related criminal system. Results. There is a need for increased awareness-raising towards the danger of crimes committed in the workplace, as many people would tend not to report abusive behaviours (to which they are victims or witnesses) in order not to threaten their employment status. Conclusions. The recommendations for improving the implementation of the legislation in the field include the provision of basic legal education for workers, in order to make them able to recognize a crime and support and aid for people reporting a crime committed in the workplace.

Key words: workplace, crime, perpetrator, illegal causing of abortion, negligence, aggravating factor  Ü FULL TEXT.PDF


Book Review