Empty Nose Syndrome - entity and knowledges

Department of Otorhinolaryngology, Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, Republic of Moldova, The 8th International Medical Congress for Students and Young Doctors, September 24-26, 2020Introduction. Empty Nose Syndrome (ENS) is a complication of nasal surgery, an iatrogenic disease, where the nasal turbinates (especially the inferior turbinates) was damaged as a result of turbinate surgery which destroys the normalAim of the study. The knowledge and information about this syndrome is necessary to pay special attention during nose surgery and awareness of the diagnosis of ENS for its prevention. Materials and methods.. ENS symptomatology was evaluated using SNOT 20 or 22 (Sino- Nasal Outcome Test). Then SNOT-25 was used to evaluate symptomatology of ENS. New ENS6Q (Empty Nose Syndrome 6 Question-naire) was also used for evaluation. ENSIA proposed a modified fifty-five SNOT test (55) to evaluate ENS symptoms. This proposed SNOT-55 is based on SNOT-25 by adding thirty new articles. Results. Empty nose syndrome affects a small number of the population. The incidence is not known, as there is no specific research in this area. The absence of incidence studies is directly related to the lack of awareness of ENS among health professionals. This resulted in the absence of diagnostic criteria and the omission of an ENS diagnosis in the patient records. ENS appears as a result of turbine surgery and may occur within a few months. Every turbinate procedure can cause ENS if it performed too aggressively. Some turbine interventions increase the probability by ENS, for example partial or total resection of the lower nasal turbines or cauterization of the mucosal surface. At the moment, ENS can be diagnosed in the clinical setting and the diagnosis is able to be further supported by diagnostic tools available outside the clinical setting. The conservative management of the ENS is based on irrigation and hydration of the nose to maintain the remaining mucosa and should be performed to extend as best as possible the life of the patient. Permanent nose care is burdensome and time consuming. Conclusions. The quality of life is significantly reduced in patients with ENS. ENS has an impact on employment, physical health, social and financial aspects of the patient's life. While nasal reconstruction operations and treatments with regenerative drugs can lead to symptom improvement, it is important to remember that turbine tissue cannot be replaced or recovered and there is no cure for ENS. nasal physiology

Some aspects of otogenic meningitis

State Medical and Pharmaceutical University “Nicolae Testemitanu”, Chisinau, Republic of MoldovaIntroduction: Otogenic meningitis is the commonest intracranial complication of suppurative otitis media and continue to be an important cause of morbidity and mortality despite the availability of effective treatment. It is an inflammatory process of pia mater, arachnoid and cerebrospinal fluid in the subarachnoid space due to middle ear pathology that is very dangerous to patients lives caused by symptoms and association with other intracranial otogenic complications. Otogenic meningitis are not frequently encountered in practice but should be known by specialists (internists, ENT, infectionists, pediatrics, emergency medicine physicians, etc.) because these neuroinfections constitute major medical emergency and requires prompt medical intervention. Materials and Methods: In this study was analysed relevant articles on the topic, using PubMed, Hinari data base and other internet and literary sources. The study was conducted on a group of 165 pacients with intracranian otogenic complication of ENT clinic for the period of 10 years (2001-2010). Data were processed using computer programs Microsoft Word, Excel, Stats Direct Statistical Software Version 1,9,5. Results: Patient age was betweenl8-70 years and average of 41,23(±1,98). 55,75% (92) of them were males and 44,25% (73) were women. Isolated otogenic meningitis was determined in 38 (23% ± 3.28) patients and 112 (68% ± 3.63) patients - otogenic meningitis associated with intracranial otogenic complications. Symptoms of complications was headache (100%), fever (97%), photophobia (26%), irritability (78%), drowsiness (16%), vomiting (16%), neurological signs (100%). Conclusion: We determined the following aspects: 1. Otogenic meningitis is one of the most current problem in otolaryngology 2. Otogenic meningitis incidence is an index reflecting the otorhinolaryngology medical assistance and health culture of the population 3. Isolated otogenic meningitis is rarely encountered, more frequently are meeting associated withintracranial otogenic complications

Monitor of the epidemiological situation of HIV infection amoung people

Introduction: HIV/AIDS represents a very major and serious disease affecting more and more people early age. At the end of 2010 an estimated - 34 million [31.6 million - 35.2 million] people globally living with HIV, 2.7 million [2.4 million - 2.9 million] new HIV infections in 2010, 1.8 million [1.6 million - 1.9 million] people died of AIDS-related illnesses in 2010. According to CDC published, new incidence of HIV infections estimates in 2011 showed that the annual number of new HIV infections was stable overall from 2006 through 2009. According to UNAIDS and WHO estimates, 47% (6.6 million) of the estimated 14.2 million people eligible for treatment in low- and middle-income countries were accessing lifesaving antiretroviral therapy in 2010, an increase of 1.35 million since 2009. The 2011 UNAIDS World AIDS Day report also highlights that there are early signs that HIV treatment is having a significant impact on reducing the number of new HIV infections. In Moldova, during 1987-2007 there were detected 4201 HIV infected persons, including the territories from the right bank of the eastern territories of the republic, 2939-1192 people and 70 foreigners. Methods: This article reflects the information given population through computerization and flashmob organization to the World Day in order to combat HIV / AIDS - December 1. The following m ethods were used: observation, epidemiological, historical, economic and demographic. For further computerization and HIV / AIDS 27 students of “Nicolae Testemitanu” State Medical and Pharmaceutical University performed a flash mob in Chisinau center for the population. Results: Work done in informing people has increased the knowledge about this disease. Goals, objectives, strategies and activities for implementation in infections disease control, combating HIV/AIDS is provided in the National Health Policy of the Republic of Moldova, Law “On HIV/AIDS”. Conclusion: It’s necessary continuously to monitor the epidemiological situation of the HIV infections in developing preventive measures

Some aspects of knowledge and attitudes of medical students regarding sexual education and information

Within the last decade, the indicators of unsafe sexual behavior (incidence of Sexually Transmitted Infections STIs, unwanted pregnancy) have grown significantly, especially among the young people. Cumulatively there have been 4,131% new cases reported of 2007, including about 33% reported during 2006-2007 alone. A stable increase in the number of newly reported HIV cases can be seen over the last 8 years. Out of 731 newly reported HIV cases in 2007, about 63.2% have been transmitted sexually. Since 2005, the sexual route of transmission has been prevailing and there are steady trends of up-surging rates of sex route among the newly reported cases. Thus, women account for most of the newly reported HIV cases with sexual route of transmission (57.2% - 2006; 66.2% - 2007). The coverage of pregnant women with HIV testing during 2003-2007 is within the 96­ 99.4% rage (prevalence among pregnant women going up 0.1% -2005; 0.21% -2006; 0.23% -2007). This article reflects the analyses research case/test organized in November 2009 in the Orhei Medical School and SMPhU. The scientific sample was presented to 81 students: 41 of Medical School from IV year and 40 of SMPhU from II year. The young in the both groups had the same (18-20 years) age. Results One of the objectives assayed was - from where do young people receive information about Prevention of STIs - who is a trustworthy person for young - as we wished to receive information about this subjects. In the questionnaire were proposed questions with truthful & wrong answers. It is mentioned that medical students from Medical School in 13.2% cases were presented wrong answers, in compared than students from SMPhU in 33.9% cases. They were asked to indicate the necessity of providing reproductive health and sexual education (prevention STIs, contraception, conception). In the 87.9% cases respondents answered that the first discussion on this topic they had with friends/ colleges. The second position had a lyceum or gymnasium teacher 64.3%. And only, the third in order was family 45.2%.The young people were asked about consequences of STIs. In the majority cases they presented neurophysiology (76.7%) and socio-morally (98.8) watches. The physical and sterility (32.2%) was mentioned in the last order. Discussions The КАР in RM - survey carried out in 2008 among young people, ages 19-24, indicate worrisome lower condom use rates among young women, only 35.8% of young women reporting condom use at last contact compared to 67.1% of young men. Anecdotal evidence suggests that are differences between men and women in the ability to negotiate safer sexual behaviour. The same quality researches are necessary for improved informative / educative processes in the management of reproductive health medical services, of preventions STIs

Correlations comorbidities on quality of life in patients with COPD

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is characterized by limited airflow that is incompletely reversible, can progress and may be associated with an abnormal inflammatory response of lungs to irritants. COPD is a major cause of morbidity in the elderly, affecting about 15% of the population aged over 65 years. Material and Methods: In the questionnaires the following indices were studied: age, 6 minutes walk test (6MWD), index smoker - pack / year, Health - related quality of life (HRQL) instruments included: Saint George's Respiratory Questionnaire (SGRQ), Clinical COPD Questionnaire (CCQ), and comorbidities evaluated by Charlson and CDS index. The study was conducted on a group of 60 patients (30 men and 30 women) aged between 50-80 years and average of 64.45 (± 8.59). Results: Average data obtained from analyzing questionnaires were: 18.05 (±19.45) package /year - index smoker, 245.30 (±89.88) - 6MWD. Correlational analysis showed that there was no correlation between Charlson index 2.43 (±1.52) and 6-minute walk test p= -0.41, index smoker p= 0.04, Health - related quality of life instruments: CCQ 64.03 (±11.14), p= 0.25, SGRQ 2.86 (± 0.78), p= 0.31, as well as between CDS 4.33 (±2.52) and 6MWD p= -0.35, index smoker p= -0.01, CCQ 64.03 (±11.14), p= 0,29, SGRQ 2.86 (± 0.78), p= 0.38. Conclusion: Analyzing the impact of comorbidities on quality of life, we found a significant contribution to pathologies associated quality of life in elderly patients. The results tell us that COPD patients differentiate specific allegations of complaints characteristic of other diseases and can be used as specific tools for measuring quality of life of COPD

Caz clinic. Asfixie neonatală

IMSP Institutul Mamei şi Copilului, Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Departamentul Pediatri

Fat Embolism Syndrom. Review.

Сatedra Fiziologia omului şi Biofizică Catedra Anesteziologie şi Reanimatologie № 1 „Valeriu Ghereg”Fat embolism syndrome (SEL) and fat embolism (FE) are controversial diseases. Despite the progress in medicine, mortality for these patients remains high. In this regard, the problem needs to be investigated. In the article we reviewed the main aspects of the manifestetion, treatment, prevention, diagnosis and incidence of SEL. Sindromul emboliei lipidice (SEL) şi embolia lipidică (EL) sunt afecţiuni controversate. În pofida progresului medical letalitatea pentru aceasta categoria de pacienţi rămîne înaltă. În legătura cu aceasta SEL necisită studierea. În articolul am revizuit aspectele principale ale manifestării, tratamentului, profilaxiei, diagnosticul şi incidenţa SEL

Visualisation of xanthan conformation by atomic force microscopy

Direct visual evidence obtained by atomic force microscopy demonstrates that when xanthan is adsorbed from aqueous solution onto the heterogeneously charged substrate mica, its helical conformation is distorted. Following adsorption it requires annealing for several hours to restore its ordered helical state. Once the helix state reforms, the AFM images obtained showed clear resolution of the periodicity with a value of 4.7 nm consistent with the previously predicted models. In addition, the images also reveal evidence that the helix is formed by a double strand, a clarification of an ambiguity of the xanthan ultrastructure that has been outstanding for many years

Вентилятор-ассоциированная пневмония в отделениях реанимации новорожденных и интенсивной терапии

IMSP Institutul Mamei şi Copilului, Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Departamentul PediatrieVentilator-associated pneumonia (VAP) is defined as nosocomial pneumonia in mechanically ventilated patients. VAP is a major problem in neonatal care, as it is considered to be the main cause of infection-related death in the NICU. The goal of the study was to determine the characteristics and risk factors for VAP in critically newborns, as well as to determine the main bacterial agents involved in VAP, in order to initiate the specific treatment as soon as possible. Materials and methods: This study was performed on a group of 75 patients hospitalized in NICU at IMSP IMsC, during the 2015 year, without any respiratory surgical pathology, with age up to one month, who received mechanical ventilation (VAP) for more than 48 hours. These children were divided into 2 groups, clinically and paraclinical evaluated. Results: The study results demonstrate that mechanical ventilation causes an increased risk for VAP, as higher as the exposure to mechanical ventilation increase and decrease the gestational age and birth weight. The most involved bacteria in the pathological process seems to be gram–negative species which would allow us to improve approaching tactics. Considering that these children require more special and more frequent use of invasive care methods, which in itself represents a risk factor for VAP, and a high risk of death among newborns, this nosology deserves more attention in order to improve therapeutic management.Вентилятор-ассоциированная пневмония (ВАП) считается внутрибольничной пневмонией у больных находящихся на искусственной вентиляции легких. ВАП является одной из основных проблем в уходе за новорожденными в отделениях реанимации и интенсивной терапии новорожденных. Считается наиболее важной инфекционной причиной смерти у новорожденных. Цель исследования: Целью данного исследования было изучение факторов риска, клинических и лабораторных особенностей ВАП у новорожденных в критическом состоянии, а также выявление бактериальных агентов вызывающих ВАП, с целью начала специфического антибактериального лечения на ранней стадии. Материалы и методы: Данное исследование включало 75 пациентов, госпитализированных в ОРИТ PMSI IMşiC в течение 2015 года без лёгочной хирургической патологии, в возрасте до одного месяца, которые находились на искусственной вентиляции (ИВЛ)> 48 часов. Эти дети были разделены на 2 группы и были oбследованы клинически и лабораторнo. Результаты: Результаты исследования показали, что длительная ИВЛ повышaeт риск развития ВАП, особенно в группе детей с малым гестационным возрастом и малой массой тела при рождении. Изолирование бактериальных культур из крови и эндотрахеальной трубки выявили преобладание грамотрицательной флоры, что позволило нам улучшить тактику подхода и результаты лечения. Учитывая тот факт, что эти дети требуют особoй заботы и более частого использования инвазивных методов, что само по себе является фактором риска для ВАП и высоким риском смерти среди новорождённых, эта нозология заслуживает внимания в целях улучшения терапевтической тактики

Antibiotic therapy in the treatment of acute otitis media

Department of Otorhinolaryngology, District Hospital of Orhei, the Republic of Moldova, Department of Pharmacology, Dunarea de Jos University of Galati, RomaniaBackground: Acute otitis media is an infection of abrupt onset that usually presents with ear pain. Worldwide acute otitis media affects about 8-11% of people a year. In acute otitis media, antibiotics may speed recovery but may result in side effects. Antibiotics are often recommended in those with severe disease or under two years old. Material and methods: Our study included a retrospective analysis of 117 patients with acute otitis media, whose medical records were examined. The information was analyzed statistically. Results: The results demonstrated an increased involvement of older people and women. The use of antibiotics to treat acute otitis media is determined by Cefazolin in 49-50% cases, Ceftriaxone - 49%, Cefotaxime – 48%, Cefoperazone – 14%, Amoxicillini Clavulanic acid in 16% of cases. Antibiogram was released for 53 patients, and according to it: Cefazolin – 23%, Amoxicilini Clavulanic acid – 15% and the rest were treated with cephalosporin third generation. Conclusions: Depending on severity, the treatment requires the use of antibiotics with broad spectrum. Antibacterial therapy according to antibiogram is contemporary and has the advantage of assessing the appropriate antibiotic