Clinical and Epidemiological Factors Predicting the Severity of Psoriasis

Introduction: Psoriasis, a systemic disease with a chronic course, is associated with a high degree of comorbidities and decreased quality of life

Ghidurile pentru practica epidemiologică în spital - o necesitate în strategia de supraveghere a infecţiilor nosocomiale

Universitatea de Medicina şi Farmacie Gr. T. Popa, Iaşi, România, Disciplina de Asistenţa Primară a Stării de Sănătate şi Epidemiologie, Unitatea de Epidemiologie, Clinică Iaşi, Disciplina de Boli InfecţioaseIntroducere. Evoluţia infecţiilor nosocomiale (IN) are un caracter dinamic, fiind dependentă de numeroși factori. Monitorizarea terapiei cu antibiotice în cadrul acţiunilor de supraveghere a infecţiilor nosocomiale cu includerea rezultatelor în Ghidul pentru practică epidemiologică de spital are ca scop ameliorarea semnificativă a evoluţiei acestei patologii iatrogene. Scopul studiului a urmărit limitarea infecţiilor nosocomiale prin standardizarea recomandărilor de antibioterapie. Obiectivele studiului au constat în supravegherea sistematică a incidenţei IN apărute în perioada 2002-2011, concomitent cu înregistrarea evoluţiei rezistenţei la antibiotice a tulpinilor microbiene izolate de la pacienţii spitalizaţi în sectiile de Chirurgie toracică, Terapie intensivă și Pneumologie ale Spitalului Clinic de Pneumoftiziologie Iași. Material și metode. Studiul longitudinal, care a inclus pacienţii spitalizaţi, a urmărit identificarea incidenţei IN, conform definiţiei de caz, și a cauzelor de producere a acestora prin înregistrarea factorilor de risc cu ocazia anchetei epidemiologice. Din datele laboratorului de microbiologie privind tulpinile cu semnificaţie clinică izolate din produselele patologice (spută, lichid pleural, aspirat bronșic, secreţie din plaga postoperatorie etc.) a fost analizată sensiblitatea acestora la antibiotice. Rezultate. În perioada studiată au fost identificate cazurile de IN în serviciile de Terapie intensivă și Chirurgie toracică. Numărul total al acestora a fost 180, cu variaţii de la 48 în anul 2002 la 6 în 2011 și o incidenţă specifică de 1,52 IN pleurale/ 100 de pacienţi internaţi. După forma clinică au predominat IN de plagă operatorie profundă (pleurale) și, respectiv, superficială. Etiologia IN a fost dominată de tulpinile multiplurezistente de Pseudomonas aeruginosa și Staphylococcus aureus, iar cele respiratorii, fără caracteristici de nosocomialitate, Streptococcus pneumoniae și Haemophilus influenzae. Strategia generală în IN este de antibioterapie de dezescaladare și utilizarea asocierii unui antibiotic de ultimă generaţie (precum linezolid/vancomicină) cu un aminoglicozid de ultimă generaţie sau o fluorochinolonă în infecţiile cu stafilococ, iar în cele cu Pseudomonas – a carbapenemelor, urmate de asocierea de peniciline cu inhibitori de betalactamaze, cu sau fără aminoglicozid. Concluzii. Beneficiile colaborării dintre clinician, infecţionist, epidemiolog și microbiolog sunt cuantificate prin scăderea riscului și incidenţei IN, iar informaţiile privind profilul de sensibilitate a tulpinilor microbiene izolate oferă posibilitatea antibioterapiei adecvate. Elaborarea unui ghid naţional, cu recomandări generale, la care fiecare spital, să asocieze rezultatele analizei anuale a particularităţilor profilului de rezistenţă a tulpinilor circulante în unitatea medicală proprie, reprezintă o necesitate în contextul actual în care patologia infecţioasă indusă de riscul infecţiilor nosocomiale generează suferinţă și invaliditate pentru pacienţi, dar și pierderi economice importante pentru sistemul de sănătate

Исследование полиморфизмов экзона 11 в гене BRCA1 у пациентов с диагнозом рака яичников в раннем возрасте

Investigation of exon 11 BRCA1 gene polymorphisms in patients diagnosed with ovarian cancer at early age.Mutațiile germinale la nivelul genelor BRCA1 şi BRCA 2 conferă un risc crescut de a dezvolta cancer ovarian, iar unele polimorfismele la nivelul acestor gene pot constitui alele de susceptibilitate cu penetranță scăzută. În această lucrare ne-am propus o evaluare a frecvenței unor polimorfisme genice la nivelul exonului 11 a genei BRCA1, într-un lot de 50 de paciente diagnosticate cu cancer ovarian la vârstă timpurie. Frecvența polimorfismul rs19642 în lotul studiat este foarte apropiată de cea identificată la populația Europei, dar diferită de frecvența raportată la populația din Africa sau Asia. În urma secvențierii complete a exonului 11 au fost identificate 7 polimorfisme mononucleotidice comune (SNP) ale genei BRCA1: rs1799949, rs16940, rs799917, rs16941, rs16942 rs4986850 şi rs1799950 care au fost asociate unui număr de 4 haplotipuri. Cele mai frecvente haplotipuri (H1 și H2) cumulează peste 80% dintre alelele acestui lot de paciente şi păstrează proporțiile descrise în literatura de specialitate.Исследование полиморфизмов экзона 11 в гене BRCA1 у пациентов с диагнозом рака яичников в раннем возраст

SCREENING FOR IODINE DEFICIENCY – MORE THAN A MEDICAL APPROACH

Working as a team began more and more important in many fields, including medicine. After an era of fragmentation, when the need of deepen the knowledge led to supra-specialization, we witness now the reassembly of these distinct parts, in order to obtain a comprehensive view. This is true not only for research, but also for the clinical practice. We present the building of a team who started with a screening and continued with other evaluations in a city from the eastern part of Romania. The goal of the study was to evaluate the iodine status in a former iodine deficient area. Two parameters were necessary, evaluation of thyroid volume and urinary iodine in a representative group of children. The initial pure endocrinological team increased by adopting new members: medical (nurses, epidemiologist, biochemist) and non-medical (schoolteachers). The results induced new studies and the team had growth and proved the utility of interdisciplinarity

Romanian Questionnaire to Assess the Prevalence of Occupational Hand Eczema among Healthcare Providers

Abstract Occupational skin diseases have an unknown prevalence in Romania, although they are considered the most frequent occupational diseases reported in Western European countries. Self-reported hand eczema among healthcare providers by questionnaire aims to estimate the prevalence of work-related hand eczema and associated risk factors in hospitals and outpatient units in Romania. The aim of this study is to discuss and to validate a questionnaire for surveying work-related skin diseases and exposure among healthcare providers

Epidemiology Of Priority Infectious Diseases In The Interdisciplinary Education System Of Dental Medicine

The objectives of medical education aim at ensuring that the information is conveyed accurately to the future generations of doctors, in an updated system, based on interdisciplinarity. The academic structures where the medical education takes place have earned the liberty to assert themselves, becoming an important partner of the health system which offers services whose pertinence is widely acknowledged and having the confirmation of the impact of its actions by complying with all its rights and obligations. The important character of the institutional reform in the field of medical education is to assume the continuity of its actions and to assess whether they lead to the benefits sought after. The curricular changes should observe the current exigencies that govern the medical education within the faculties of medicine, including: transparency, competitiveness and efficiency. The interdisciplinary approach of the epidemiology of infectious diseases is carried out during the didactic process from the faculties of medicine following several directions, outlining: the microbiological characteristics of the pathogen agents involved in the aetiology of the disease; the clinical particularities in the case of studied entities; the structure of the epidemiologic process as well as the concrete measures of general, special and specific prevention that need to be enforced to limit the consequences of the disease on the individual, and especially on the collectivity as a whole. The infectious pathology is of actuality in the integrative educational system of Dental Medicine and the tendency of emergence and re-emergence of infectious diseases creates the premises for a correct and complete formation of the future doctors with regard to the epidemiologic dimension of the phenomena

Cognitive-Behavioral Coping, Illness Perception, and Family Adaptability in Oncological Patients with a Family History of Cancer

Aim. The study investigated the differences between patients with and without a family history of cancer regarding coping strategies, illness perception, and family adaptability to the disease. Material and Methods. A total of 124 patients diagnosed with cancer were included in the research (55 of them with a family history of cancer). The Cognitive Emotion Regulation Questionnaire, the Strategic Approach to Coping Scale, the Family Adaptability and Cohesion Scale, and the Illness Perception Questionnaire were applied. The data were processed using the SPSS 21 software. Results. Patients with previous records of cancer in the family get significantly higher scores for the illness coherence factor. Family satisfaction is significantly higher for patients with a genetic risk, compared to the one reported by patients who suffer from the disease but have no genetic risk. Cognitive-behavioral coping strategies and family cohesion are factors that correlate with an adaptive perception of the illness in the case of patients with a family history of cancer. Conclusion. Results are important for the construction of strategies used for patients with a family history of cancer

HBV genotypes circulation in pregnant women in Romania: a pilot study

Background: The risk of mother to child transmission of hepatitis B virus (HBV) is recognized worldwide, a reason for which the World Health Organization aims to reduce this public health issue of major concern in the next ten years. The aim of our study was to detect circulating HBV genotypes in a selected population of pregnant women, as scientific evidence to recommend personalized antiviral therapy and to obtain updated epidemiological information

SNP GENOTYPING BY TAQMAN ALLELE DISCRIMINATION TECHNIQUE

Breast cancer is the most frequent neoplasm in women worldwide and the principal cause of deaths by cancer, the majority being by metastatic disease. About half of breast tumors are hormone dependent, and in post- menopause women the preferred first line treatment uses third generation aromatase inhibitors. Aromatase is encoded by CYP19 gene on 15q21.1, and there is strong evidence that mutations in this gene affect its expression, with direct consequences on cancer phenotype and response to treatment. Several single nucleotide polymorphisms have been studied on CYP19A1 transcription variant, notably rs727479, rs10046, rs4646 and rs700518. We implemented a Taqman- based allele discrimination assay for the rapid investigation of the 4 SNPs in CYP19A1. We genotyped 22 metastatic breast cancer patients by the technique described

MYELOPROLIFERATIVE NEOPLASMS WITH CONCURRENT BCR-ABL FUSION GENE AND JAK2V617F MUTATION

This study investigates the occurrence of BCR-ABL fusion gene and JAK2V617F mutation in myeloproliferative neoplasms (MPN) patients at diagnosis, in order to evaluate the clinical features, and compare them to the literature data. The study was conducted between January 2012 and February 2014 and included 190 cases of MPN from Regional Institute of Oncology Iasi. Molecular evaluation of BCR-ABL transcript and JAK2V617F mutation by RT-PCR, were assessed for diagnosis and monitorization. Only 2 patients showed simultaneous occurrence of both the JAK2V617F mutation and the BCR/ABL translocation. Pacient 1 presented a complex clinical picture with clinical signs of CML and essential thrombocythemia, while the second patient had a clinical picture suggestive of polycythemia vera. The screening for the JAK2V617F mutation and BCR-ABL should be considered at MPN diagnosis. Following these patients up might provide new data regarding the long term evolution of such cases