Suffering – a state of vulnerability of the imprisoned patient

The penitentiary environment institutionalizes several vulnerable categories, even if this general vulnerability refers to all persons deprived of liberty. Sick detainees are also part of the groups with increased vulnerability.Various treatises on penitentiary ethics and medicine have been written in this regard. An unsolved problem is the suffering of the incarcerated patient, this being the main factor that underlines the vulnerability.The suffering of the sick detainee needs to be analyzed from the perspective of social bioethics and avoided/improved through bioethical-spiritual counselling mechanisms

Spiritual counseling of detainees in palliative care: bioethical study

Catedra de Filosofie și bioetică, Universitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”, Chișinău, Republica MoldovaRezumat Introducere. Întru susţinerea evoluţiei practico-ştiinţifică a medicinii în mediul penitenciar şi depăşirea perturbaţiilor etice existente în perioada îngrijirii paliative se va desfăşura prin abordarea interconexiunilor medicină - morală - instituţii penitenciare medicale - societate. În calitate de suport de referinţă, având actualitatea şi importanţa problemei, scopul trasat pentru valorificarea ştiinţifică este de a configura problemele teoretice şi practice ale bioeticii sociale cu aplicabilitate eficientă a consilierii spirituale a deţinuţilor bolnavi terminali. Material şi metode. Cercetarea ştiinţifică s-a realizat prin reperele teoretico-metodologice de bază: abordarea sistemico-structuralistă, metoda bioetică, analiza sinergetică, corelarea concepţiilor vital-morale în activitatea de îngrijire paliativă a deţinuţilor în fază terminală. S-a evidenţiat oportunitatea unor comparaţii a situaţiilor din ţară cu alte instituţii penitenciare similare din Europa. Rezultate. Condiţiile autohtone de detenţie a bolnavilor terminali sunt precare. Dacă tabloul stării de sănătate a pacienţilor din îngrijirea paliativă a societăţii moderne este sub normă, cu atât mai mult în mediul penitenciar. Conştientizarea importanţei problemei abordate, indiferent de mediu social, va contribui la fundamentarea unei paradigme ştiinţifice polidisciplinare, dedicate consilierii spirituale a pacienţilor bolnavi terminali, tratată prin prisma reperelor bioetice. Realizarea unui studiu pentru evidenţierea aspectelor bioetice necesare pregătirii viitorilor specialişti în medicină, cu activitate de îngrijire paliativă a deţinuţilor în fază terminală. Concluzii. Aplicabilitatea serviciilor de asistenţă spirituală în mediul penitenciar, cu precădere a deţinuţilor bolnavi terminali, va elabora modalităţi eficace de optimizare al climatului medical-spiritual specific traiului privat de libertate, cu repercusiuni pozitive a modului de viaţă paliativ. Subiectul serveşte eminamente şi întregirii siluetei bioeticii sociale prin abordarea principiilor şi imperativelor ei. Eticolarizarea procesului medical-spiritual a deţinuţilor bolnavi terminali va coagula tendinţele pluridisciplinare în stabilirea unei relaţii corecte şi eficiente între deţinut şi medic, deţinut şi societate, deţinut şi familie.Abstract Introduction. In order to support the practical and scientific evolution of medicine in the penitentiary environment and to overcome the existing ethical perturbations, the palliative care period will be carried out by approaching the interconnections medicine - moral - medical penitentiary institutions - society. As reference support, given the timeliness and importance of the issue, the purpose for scientific valorization is to set up the theoretical and practical problems of social bioethics with effective applicability of the spiritual counseling of terminally ill detainees. Material and methods. The scientific research was carried out by the basic theoretical and methodological landmarks: the systemic-structural approach, the bioethical approach, the synergistic analysis, the correlation of the vitalmoral concepts in the palliative care of the detainees in the terminal phase. It highlights the opportunity to compare the situation in the country with other similar penitentiary institutions in Europe. Results. Our nowadays conditions of detention of terminally ill patients are precarious. If, in general, the palliative care in modern society is under normality, in the penitentiary environment the situation is worse. Awareness of the importance of the problem addressed, regardless of the social environment, will contribute to the foundation of a multidisciplinary scientific paradigm dedicated to the spiritual counseling of terminally ill patients, treated in terms of bioethics. A first step would be to carry out a study highlighting the bioethical aspects necessary for the training of future medical specialists who are taking palliative care of prisoners in the terminal phase. Conclusions. The applicability of the spiritual assistance services in the penitentiary environment, especially on the terminally ill detainees, will elaborate effective ways to optimize the medical-spiritual climate specific to prisoners, with positive repercussions of the palliative lifestyle. The case serves as well as integrating the silhouette of social bioethics by addressing its principles and imperatives. The etiology of the medicalspiritual process of the terminally ill detainees will coagulate the multidisciplinary tendencies in establishing a fair and efficient relationship between the detainee and the physician, the detainee and society, the detainee and the family

Realizing the bioethical potential in establishing an efficient strategy for improving spirituality among detainees with attempted suicide

The persistence of the spiritual-moral climate issue within the penitentiary institutions remains a taboo element for contemporary society.Spiritual counselling in penitentiary institutions aims to extend and improve the quality of life for all detainees. Realizing the bioethical potential in the spiritual counselling of detainees with attempted suicide will solve one of the biggest social problems in the penitentiary environment

Bioethical and practical aspects of spiritual counseling of sick detainees

The topicality of the approached problem is not only the improvement of the quality of life of the detainee but also the breaking of the usual stereotypes of our society related to the prison environment. A complex and current analysis of the medical scientific field is the spiritual counseling of sick detainees, addressing the bioethical and methodological aspects for their psychosomatic rehabilitation. In all precarious situations where the human individual is involved as a victim, it requires a special approach to the habitat environment, and the prison one, a particular approach related not only to the harmfulness of the system, but also to the institutional legal-criminal norms. Solving multiple problems requires the involvement and organization of teams of specialists, focused on the entire spectrum of recovery of the vulnerable humanness

Numerical Analysis of Flow in Kaplan Turbine Runner Blades Anticavitation Lip with Modified Hydro-dynamic Profile

In order to increase the lifetime of runner blades of Kaplan turbines damaged by cavitation erosion, an anticavitation lip is attached to the periphery of the runner blades on the suction side. The anticavitation lip overtakes the cavitation pitting which appears between the runner blades and the runner chamber. A blade with the original anticavitation lip was modeled using CAE. The numerical simulations showed the tip vortex position and the source of the cavitation erosion. Using these data, a modified profile of the anticavitation lip was designed

Pseudarthrosis of the scafoid treated using osteo-cellular grafting. Clinical case

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Osul scafoid este afectat în proporție de 6070% cazuri din toate fracturile oaselor carpiene [Reigstad, 2015]. Complicațiile fracturilor de scafoid sunt osteonecroza, instabilitatea carpiană, pseudartroza și artroza deformantă a articulației pumnului. Incidența pseudartrozei de scafoid este de 5-15% din cazuri [Haismen, 2007]. Pseudartroza de scafoid este diagnosticată dacă fractura nu se consolidează în termen de 6 luni. Scopul lucrării. Prezentarea unui caz clinic de tratament chirurgical a pseudartrozei de scafoid cu utilizarea grefei osteo-celulare (GOC). Materiale și Metode. Datele anamnestice, clinice și paraclinice au fost prelevate din fișa medicală. Pacientul a fost investigat prin radiografia articulației pumnului și examinări de laborator. Rezultate. Un bărbat de 21 de ani, cu durere pronunțată și limitarea mișcărilor în articulația pumnului stâng, a fost internat în Secția Chirurgia Mâinii, Spitalul clinic de traumatologie și ortopedie. Din anamneză pacientul a suferit un traumatism prin cădere cu sprijin în mâna stângă aproximativ 1 an în urmă. A primit tratament ortopedic, fără succes. Prezintă indicații către tratament chirurgical al pseudartrozei de scafoid. După prelevarea și îmbogățirea prin inginerie tisulară a celulelor stem mezenchimale autologe, care au fost combinate cu alogrefă demineralizată, s-a obținut GOC. Conform planului preoperator s-a efectuat osteosinteza cu utilizarea de GOC. Examinările imagistice și clinice la distanță au arătat un rezultat satisfăcător. Concluzii. Utilizarea grefei osteo-celulare în pseudartroză de scafoid este o metodă sigură cu rezultate promițătoare, studiul clinic în această direcție continuă.Background. The scaphoid bone is affected around 6070% of all carpal bone fractures [Reigstad, 2015]. Complications of scaphoid fractures are osteonecrosis, carpal instability, pseudarthrosis, and deforming arthrosis of the wrist joint. The incidence of scaphoid pseudarthrosis is 5-15% of cases [Haismen, 2007]. Scaphoid pseudarthrosis is diagnosed if the fracture does not heal within 6 months. Objective of the study. Presentation of a clinical case of surgical treatment of scaphoid pseudarthrosis with the use of osteo-cellular graft (OCG). Material and methods. Anamnesis, clinical and paraclinical data were taken from the medical databases. The patient was investigated by radiography of the wrist joint and laboratory examinations. Results. A 21-year-old man, with pronounced pain and limitation of movements in the left wrist joint, was admitted to the Department of Hand Surgery, Clinical Hospital of Traumatology and Orthopedics. From the anamnesis, the patient suffered a fall trauma with support in the left hand about 1 year ago. He received orthopedic treatment, without success. There is an indication for surgical treatment of scaphoid pseudarthrosis. After harvesting and tissue-engineered enrichment of autologous mesenchymal stem cells, which were combined with demineralized allograft, OCG was obtained. After preoperative planning, osteosynthesis was performed using OCG. Remote imaging and clinical examinations showed a satisfactory outcome. Conclusion. The use of osteo-cellular graft in scaphoid pseudarthrosis is a safe method with promising results, the clinical study in this direction continues