Morphological and clinical features of regenerative process of bone tissue in fracture

Catedra de Histologie USMF “N. Testemiţanu”The main goal of this study was to histologically evaluate the regeneration of bone tissue in case of fractures. According to the type of mechanical stabilization applied, the bone consolidation undergoes whether endochondral, or intramembranous ossification. Each mechanism includes several stages, histologically and physiologically different. They ensure the arrival of osteoprogenitor cells at the site of the fracture and their activation, realized by inductive factors. Tissue engineering, that is implantation of biological or artificial material which creates a proper environment for bone regeneration, presents a new and promising field in fracture surgery. Scopul principal al lucrării a fost studiul histologic al regenerării ţesutului osos în fracturi. În dependenţă de tipul de imobilizare aplicat, consolidarea osoasă se realizează după modelul direct sau indirect. Fiecare mecanism de vindecare include mai multe etape, diferite din punct de vedere histologic şi fiziologic. Acestea asigură deplasarea celulelor osteoprogenitoare spre situsul fracturii şi activarea acestora prin factorii inductivi. O ramură nouă în chirurgia fracturilor o constituie ingineria tisulară, care constă în aplicarea implanturilor, naturale sau artificiale, care creează mediul favorabil regenerării ţesutului osos. Ţesutul osos este considerat un complex morfofuncţional cu rol mecanic şi biologic deosebit. Ţesutul se află într-o continuă reînnoire prin metabolismul său, sub acţiunea solicitărilor fiziologice şi patologice la care se expune. Osul este un organ aflat în permanentă transformare interioară, care îi asigură o importantă proprietate de adaptare – capacitatea de vindecare în caz de fracturi

Тяжелое течение язвенного колита, ассоциированного с хроническим вирусным гепатитом С

Association of ulcerative colitis and chronic viral hepatitis C raises difficult therapeutic problem. Treatment with corticosteroids, immunosuppressants and biotherapy can lead to rapid progression of chronic viral hepatitis. On the other hand, antiviral therapy with interferon is contraindicated in severe ulcerative colitis. Risk factors and difficult aspects of the management of this association are considered in the article on the example of a clinical case.Сочетание язвенного колита и хронического вирусного гепатита С ставит сложные терапевтические задачи. Лечение кортикостероидами, иммунодепрессантами и биопрепаратами может привести к быстрому прогрессированию хронического вирусного гепатита. С другой стороны, противовирусная терапия с интерфероном противопоказана при тяжелом течении язвенного колита. В статье на примере клинического случая рассматриваются факторы риска и сложные аспекты ведения таких пациентов

Maladiile cardiovasculare – Cauza principală a decesului

Bolile cardiovasculare în Republica Moldova, precum şi în majoritatea ţărilor Europene, ocupă un loc de frunte în structura cauzelor morbidităţii populaţiei, inclusiv a populaţiei apte de muncă. Nivelul mortalităţii, cauzat de maladiile cardiovasculare, conform studiilor efectuate, în cea mai mare măsură depinde de stilul de viaţă şi de calitatea serviciilor medicale

Temperature responsive 4D liquid crystal microactuators fabricated by direct laser writing by two-photon polymerization

Over the past decade, progress in direct laser writing by two-photon polymerization (DLW-TPP) of stimuli-responsive materials has made considerable inroads into the realization of microactuators. With the focus on performing complex tasks such as walking, grasping, or delivering drugs, these actuators require a controlled preprogrammed actuation. Liquid crystalline microactuators enable such programmed movement when the mesogenic alignment can be successfully controlled. To date, this has necessitated low crosslink density networks, which are not readily conducive to the fabrication of 3D geometries. Herein, a liquid crystalline photoresist is reported, which results in a highly crosslinked network, that permits fabrication of 4D microactuators having a highly crosslinked network in which the molecular alignment is determined by the alignment layers in the cell construct. In addition to controllable deformation of the microactuators, they also display a characteristic and unique polarization color that can be used for both identification and reporting in real time, enabling their integration into sensing and anti-anticounterfeiting microdevices

Язвенный колит: клинические и параклинические аспекты

Departamentul Medicină Internă, USMF N. Testemiţanu, USMF N. Testemiţanu, Spitalul Clinic Republican, Conferinţa Naţională de Gastroenterologie și Hepatologie cu participare internaţională 20 iunie 2014 Chişinău, Republica MoldovaUlcerative colitis (UC) represents a major problem in modern gastroenterology. The paper had the following goals: to study the signs and symptoms and the main complications, to appreciate the social impact of the disease, to evaluate the level of accuracy of the paraclinical tests in determining the UC phenotype (extension, activity). This is a retrospective study, which focused on the clinical aspects of UC in 105 patients hospitalized during 2011-2013 in the Gastroenterology Department of the Republican Clinical Hospital. UC affects equally both men and women, but has a high prevalence in young people, has a long course and imposes long-term disabilities. Any case of UC must be phenotyped, i.e. appreciating the extension, activity and longitudinal pattern. C-reactive protein (CRP) proves to be more informative marker concerning disease activity. Colonoscopy has a higher level in determining the level of macroscopical lesions, especially in extended forms of UC.Язвенный колит (ЯК) является важной проблемой современной гастроэнтерологии. Данное исследование имело следующие цели: изучить знаки, симптомы и главные осложнения, проанализировать социальные последствия заболевания, измерить уровень точности параклинических исследований путем определения фенотипа ЯК (протяженность, активность). Данное ретроспективное исследование, было нацелено на изучение клинических аспектов ЯК у 105 пациентов, находящихся в стационаре в период с 2011 по 2013 год в Отделении гастроэнтерологии Республиканской Клинической Больницы. ЯК поражает в равной степени мужской и женский пол, чаще встречается у лиц молодого возраста, имеет продолжительное течение, которое обуславливает длительную потерю трудоспособности. Во всех случаях необходимо фенотипировать ЯК (определение протяженности, активности и эволюции заболевания). С-реактивный белок является более информативным маркером активности заболевания чем СОЭ. Наиболее точным методом определения распространения макроскопических поражений является фиброколоноскопия, особенно при протяженных формах ЯК

EDUCATION THROUGH INNOVATION IN THE FIELD OF METALLIC MATERIALS SCIENCE

The importance of the innovation process lies in its main functions, those of generating and leading to the conception and development of new processes and products, based on creativity. Hence the need of education for innovation. In this article we present, for a start, the main stages of an innovation process. Then, elements of innovation management, innovation strategies, innovation activities. We also present aspects regarding the financing of the innovation process and of the technology transfer. As results of the efficient application of these theoretical elements specific to an innovation process, we present the main elements of a patent (Invention Patent no. 107025/1993) of one of the authors. This patent, entitled "Burner" has gone through all stages, from conception to implementation in industry. This implementation took place in the former Special Steels Plant ok Targoviste (COST), in Electric Steel Mill no. 1 (OE1), with a good technological and economic efficienc

1st International Experts' Meeting on Agitation: Conclusions Regarding the Current and Ideal Management Paradigm of Agitation.

Agitation is a heterogeneous concept without a uniformly accepted definition, however, it is generally considered as a state of cognitive and motor hyperactivity characterized by excessive or inappropriate motor or verbal activity with marked emotional arousal. Not only the definition but also other aspects of agitated patients' care are still unsolved and need consensus and improvement. To help the discussion about agitation among experts and improve the identification, management, and treatment of agitation, the 1st International Experts' Meeting on Agitation was held in October 2016 in Madrid. It was attended by 20 experts from Europe and Latin America with broad experience in the clinical management of agitated patients. The present document summarizes the key conclusions of this meeting and highlights the need for an updated protocol of agitation management and treatment, the promotion of education and training among healthcare professionals to improve the care of these patients and the necessity to generate clinical data of agitated episodes

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Ulcerative colitis - clinical and paraclinical features

Department of Gastroenterology, State Medical and Pharmaceutical University “Nicolae Testemitanu", Republic of MoldovaIntroduction: Ulcerative colitis (UC) represents a major problem in modern gastroenterology, mostly due to the incomplete knowledge on its etiology and pathogenesis and a lack of a “Gold Standard” regarding diagnosis and treatment. Purpose and objectives: To study the signs and symptoms and the main complications, to appreciate the social impact of the disease, to evaluate the level of accuracy of the paraclinical tests in determining the UC phenotype (extension, activity). Materials and methods: This is a retrospective study, which focused on the clinical aspects of UC in 105 patients hospitalized between 2011 and 2013 in the Gastroenterology Department of the Republican Clinical Hospital. The precision of the inflammatory markers (erythrocyte sedimentation rate - ESR, C reactive protein - CRP) in appreciating the UC activity was studied on a cohort of 44 cases. The level of UC extension was determined in 49 cases, comparing two methods - colonoscopy and irrigography. Results: UC affects primarily people of childbearing age and labor force (76.2% - less than 40 y.o.), has a long course (average duration - 4,6 ± 3,9 years) and a high level of impairment (37.1% have a certain degree of disability, out of them 79.4% are less than 40 y.o.). The patients are presenting mostly with local symptoms (abdominal pain 85.7%, bloody diarrhea 80%, tenesmus 68.5%). These are associated with general symptoms (fatigue 100%, weight loss 21.5% , high/slight fever 16.2%). The only extraintestinal manifestation observed was the arthralgia (8.5% ). The most frequent complication in UC is anemia (27.6%), which significantly correlates with disease activity (r = 0,59, p < 0,01). CRP has a higher correlation with UC activity, compared with ESR (r = 0,78 versus r = 0,69, p < 0,01). Colonoscopy has a higher accuracy in determining the level of macroscopical lesions, especially in extended forms of UC (the error rate in irrigography - 33.3%). Conclusion: UC affects equally both men and women, but has a high predom inancy in young people, has a long course of the disease and imposes long-term disability. Any case of UC must be phenotyped, i.e. appreciating the extension, activity and longitudinal pattern. CRP proves to be more informative marker in regards to disease activity. In order to determine the macroscopic extent, it is recommended to use colonoscopy rather than irrigography

Importance of vascularization of the bone and significance of angiogenesis in the fracture

Catedra de Histologie, Citologie şi EmbriologieBone circulation plays an important role in bone physiology. Angiogenesis at the fracture site has been identified as one of the most significant parameters influencing the healing procedure. This is explained by the fact that osteoblasts and endothelial cells are intimately located within the skeleton, and their interaction is an integral component of bone repair. The features of local vascularity have also determined new approaches in the surgical treatment by shifting away from the mechanical toward the biological aspects of fracture fixation, thus preserving the blood supply to the bone fragments. Circulaţia sangvină a osului joacă un rol substanţial în fiziologia acestuia. Angiogeneza în focarul fracturii s-a dovedit a fi unul dintre cei mai importanţi parametri ce influenţează procesul de regenerare. Aceasta se explică prin faptul că osteoblastele şi celulele endoteliale sunt intim localizate în cadrul scheletului, şi interacţiunea lor asigură continuitatea proceselor reparative din os. Particularităţile vascularizării locale au determinat şi noi abordări în tratamentul chirurgical, prin trecerea de la aspectul mecanic la cel biologic al fixării fracturilor, astfel păstrându-se sursa vasculară a fragmentelor osoase