THE RELATIONSHIP BETWEEN BACTERIAL BIOFILMS AND INFLAMMATORY TISSUE CHANGES IN PATIENTS WITH CHRONIC RHINOSINUSITIS

Objectives. The involvement of bacterial biofilms in the pathophysiology of chronic rhinosinusitis (CRS) is intensively debated, despite the acknowledgement of their negative impact on postoperative evolution of the disease. This study aimed to evaluate the relationship between bacterial biofilms and inflammatory infiltrate of sinus mucosa, and the influence of comorbidities on biofilm development. Materials and methods. The study comprised 50 CRS patients, treated by endoscopic surgery. For biofilm identification and inflammatory infiltrate evaluation, sinus mucosa samples were taken during surgical intervention and studied by haematoxylin-eosin and toluidine blue staining. Results. Biofilms were present in 34 patients (68%). Among them, 22 patients displayed an abundant inflammatory infiltrate of the sinus mucosa, this association being statistically significant (p < 0.001). Biofilm development was also significantly associated with the following comorbidities: bronchial asthma (p = 0.006) and atopic background (p < 0.001). Conclusions. Bacterial biofilms were significantly associated with an abundant inflammatory infiltrate of the sinus mucosa, demonstrating an intensive local inflammatory response. Among the comorbidities frequently associated with CRS, bronchial asthma and atopic background proved a significant increase in the odds of biofilm development

Medical Informatics and Statistics in an Undergraduate Nursing Curriculum: Survey of Students’ Perception

Aim: A survey was conducted in undergraduate medical students enrolled in 3 or 4-year degree programs in Nursing, Midwifery, Radiology and Medical Imaging (technician), Physiotherapy and Kinetotherapy (technician) and Clinical laboratory (technician) in order to identify their perception of the medical informatics and statistics curriculum. Material and Method: A qualitative study was carried out in 1st year undergraduate students at the “Iuliu Haţieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania during the 2008-2009 academic year. A questionnaire containing 10 categories of items for assessing lectures and 19 for assessing practical activities was developed as an online tool with a database connection using Google Docs. Results: Students’ attendance to lectures proved not to be statistically related with their final mark. The mean final mark obtained by students (6.02±1.57) proved to be statistically lower compared to the expected mean (6.58±1.23; t = -2.76, DF = 54, p = 0.0078). The teacher, the problems solved during lectures, the lecture summaries as well as the course web page proved to statistically influence the learning process. The results revealed that all students were satisfied with the materials used within lectures and practical activities as well as with the objectiveness of the final evaluation. Most students classified the difficulty of the practical activities as reasonable (p < 0.05) and their pace as just about right (p< 0.05). The overall quality of the practical activities was classified as easy by 13% of respondents, pretty easy by 30%, reasonable by 29%, and difficult by 25%. Conclusions: Overall, undergraduate students were satisfied with the materials used within lectures and practical activities as well as with the teacher’s attitude and support in the learning process

Social Media as Source of Medical Information for Healthcare Students

Introduction: The scope of the research was a more detailed understanding of the influence of social media and the importance of student’s usage of social media context in relation to medical information. The research aimed to increase the understanding of social media and the impact on medical information use, informing policy and practice while highlighting gaps in the literature and areas for further research. Methods: The search of PubMed database was performed in October 2015, using terms to identify peer-reviewed research in which social media technologies were an important feature for health occupations, premedical, pharmacy, nursing or medical students. A systematic approach was used to retrieve papers and extract relevant data. Results: There were initially identified 435 studies involving social media, healthcare information and medical students subject headings (MeSH) terminology. After filtering for free full text articles, and exclusion of not students or social media specific ones, 33 articles were reviewed. The majority of the studies were interventional studies that either assessed the outcomes of online discussion groups or teaching methods through social media. The majority of studies focused on the use of social media as a teaching tool, how students use it and the implications upon their education. The largest number of original papers was published in 2013. Facebook, Podcasts, Multiplayer virtual worlds, Blogs, and Twitter were identified as being used by medical students. Conclusion: Social media is used as a tool of information for students mainly as the means for engaging and communicating with students

Evaluation of the Efficiency of Economic and Medical Activities in Romanian Hospitals

Medical work in public hospitals in Romania has a double subordination: strictly speaking the Health Care Directives is coordinated by the Ministry of Health and in terms of economics the activity is funded by the National Health Insurance through its county subsidiaries. This separation of the two fields, medical and economical, has generated problems in many cases of hospital activity in our country.Economic and financial parameters of 39 hospitals were extracted from their economic balance sheets for 2009-2010 and were entered into a multi-criteria analysis to generate an overall score. Then this was checked for possible relationships with the hospitals’ competence (established by the Ministry of Health with the help of a national program).The aim of this study was to assess the relationship between hospital medical competency and economical parameters in the Romanian Health Care System. The lack of correlation of the economic and financial parameters with the health parameters observed by our study reflects the current problems in the Romanian health system, where the impossibility of generating practical management solutions is the consequence of multiple subordination of hospital units, separate assessment of competence and administrative skills

Parental factors associated with intrauterine growth restriction

Introduction. Linear growth failure is caused by multiple factors including parental factors. Objective. The aim of this study was to evaluate parental risk factors for intrauterine growth restriction (IUGR) on a population of Romanian newborn infants in a tertiary level maternity facility for a period of 2.5 years. Methods. A retrospective matched case-control study was conducted in the Emergency County Hospital of Cluj-Napoca, a university hospital in North-Western Romania. The sample was selected from 4,790 infants admitted to the Neonatal Ward at 1st Gynecology Clinic between January 2012 and June 2014. Results. The age of mothers was significantly lower in the IUGR group compared to controls (p=0.041). A significantly higher percentage of mothers had hypertension in the IUGR group compared to those in the control group (p<0.05). No other significant differences were identified with regard to the investigated characteristics of mothers between IUGR infants compared to controls (p>0.13). The age of fathers of infants with IUGR proved significantly lower compared to controls (p=0.0278). The analysis of infants’ comorbidities revealed no significant difference between groups for respiratory distress, hyperbilirubinemia, hypocalcaemia, and heart failure (p>0.27). Intracranial hemorrhage, necrotizing enterocolitis and hypoglycemia were significantly higher in the IUGR group compared to controls. The logistic regression identified hypertension as a significant risk factor for IUGR (OR=2.4, 95% CI [1.3-4.5]). Conclusion. Although the age of the mothers and fathers proved significantly lower in the IUGR group compared to controls, only hypertension in the mothers proved significant risk factors for IUGR

Scientific Journal Articles Output from Medical Doctoral Theses. A Comparative Study

The scope of the present study was to contrast publication rates and particularities of original scientific articles related to medical PhD theses defended between 2009 and 2013 from one developing country (Romania) and two developed countries (France and the United Kingdom) within the European Union. A sample from each of the three countries was evaluated and then compared based on the journal type (national/international), time span between two consecutive articles from the same thesis, number of articles, journal impact factor and journal rank. The results of our quantitative analysis suggest that the majority of Romanian articles were published in Romanian journals, while French and the United Kingdom articles were published in greater proportions in journals outside the borders of their own country. The time span between two consecutive articles from the same thesis was similar for the three groups. Even though articles from Romanian theses were significantly more numerous than in those from France or the United Kingdom, they were published in less cited journals, according to their impact factor. Furthermore, most of the Romanian articles were published in the bottom half of the journals’ ranking, while the majority of articles from France or the United Kingdom were published in the top half of the ranking

Design and Implementation of Data Collection Instruments for Neonatology Research

im: The aim of our research was to design and implement data collection instruments to be use in context of an observational prospective clinical study with follow-up conducted on new born with intrauterine growth restriction. Methods: The structure of the data collection forms (paper based and electronic based) was first identified and for each variable the best type to accomplish the research aim was established. The code for categorical variables has also been decided as well as the units of measurements for quantitative variables. In respect of good practice, a set of confounding factors (as gender, date of birth, etc.) have also been identified and integrated in data collection instruments. Data-entry validation rules were implemented for each variable to reduce data input errors when the electronic data collection instrument was created. Results: Two data collection instruments have been developed and successfully implemented: a paper-based form and an electronic data collection instrument. The developed forms included demographics, neonatal complications (as hypoglycemia, hypocalcemia, etc.), biochemical data at birth and follow-up, immunological data, as well as basal and follow-up echocardiographic data. Data-entry validation criteria have been implemented in electronic data collection instrument to assure validity and precision when paper-based data are translated in electronic form. Furthermore, to assure subject’s confidentiality a careful attention was given to HIPPA identifiers when electronic data collection instrument was developed. Conclusion: Data collection instruments were successfully developed and implemented as an a priori step in a clinical research for assisting data collection and management in a case of an observational prospective study with follow-up visits

Molecular Phylogenetic Analyses Indicate a Wide and Ancient Radiation of African Hepatitis Delta Virus, Suggesting a Deltavirus Genus of at Least Seven Major Clades

Hepatitis D virus (HDV) is a satellite of hepatitis B virus (HBV) for transmission and propagation and infects nearly 20 million people worldwide. The HDV genome is a compact circular single-stranded RNA genome with extensive intramolecular complementarity. Despite its different epidemiological and pathological patterns, the variability and geographical distribution of HDV are limited to three genotypes and two subtypes that have been characterized to date. Phylogenetic reconstructions based on the delta antigen gene and full-length genome sequence data show an extensive and probably ancient radiation of African lineages, suggesting that the genetic variability of HDV is much more complex than was previously thought, with evidence of additional clades. These results relate the geographic distribution of HDV more closely to the genetic variability of its helper HBV