Considerations of Health Tourism in Braila

The author aims at highlighting the conditions that lead to exploitation of the region Lake Sarat spa. Located in the eastern part of Romania, in Baragan North, the resort is located at a distance of only 5.5 km from the city of Braila. Surrounded by a park of 40 ha (30 ha and 10 ha forest green area), which provides a framework both the monumentality very picturesque, and by old, Salt Lake Resort is a true oasis of greenery with beneficial effects on the human body. Building fund has grown over the past 30 years, achieving adequate facilities for tourism and spa treatment. As shown current zoning functions, the resort is only about 50% recovered in terms of space, ie to the northeast. Otherwise, there are areas that do not fulfill the role of recreational green spaces

Esophageal foreign body impaction as a presentation of underlying eosinophilic esophagitis

Introduction. Eosinophilic esophagitis (EoE) is a rare pathology characterized by chronic inflammation with mucosal eosinophilic infiltrate of the esophagus. The clinical symptoms vary according to the age group, from recurrent abdominal and thoracic pain, vomiting, dysphagia, food impaction and gastroesophageal reflux symptoms refractory to treatment with proton pump inhibitors. In the recent years, different studies suggest that EoE is now the leading cause of food impaction in the adult population. Case presentation. A 30-year-old female, without a pathological personal history, was admitted with symptoms of esophageal food impaction. Upper endoscopy revealed esophageal rings and the bolus impacted in the lower esophagus. Biopsy samples were obtained from several different locations, including areas away from the site of food impaction. Histopathologic examination revealed esophageal mucosal eosinophilic infiltrate >15 eosinophils per high-power field. Proton pump inhibitor (PPI) therapy, twice-daily dosing for 8 weeks was administered, as the first line treatment. Conclusions. Consensus guidelines for the diagnosis of EoE require symptoms of esophageal dysfunction, 15 or more eosinophils per high-power field on microscopic examination of esophageal biopsy after 8 weeks on a high-dose proton pump inhibitor (PPI), and the absence of alternative causes of eosinophilia

General Considerations Regarding the Industrial Activity of Arcelormittal Galati on The Environment

Although everyone acknowledges the fact that industrial activities are bad for people’s health and more so for the natural environment they are considered a necessary evil. You cannot expect to remain in the run of this competitive economic environment without industry. It is industry that makes the world go round even though if things keep going the same way we’ll soon not have a world to talk about. However, these days there seems to be a global campaign of raising awareness about the damage we cause to nature, but unfortunately likeeverything else this also happened to move extremely slowly towards Romania. In Romania, national environmental groups seem to have made little impact inreducing pollution

General Considerations Regarding the Reserves and Consumption of Energetic Resources

The knowledge of the processes of economic and social development ensues without adoubt the study and understanding of the market mechanisms, of the market in general, in all thefunctions it has been known to play throughout the history in the life of peoples, but especially in thatof mechanism which manages the adjustment and auto-adjustment of the economic processes.Generally speaking, the market is perceived as a meeting place, more or less abstract, where the offerof the sellers and the customers’ demand meet. The first being the manifestation form of theproduction in the conditions of the exchange economy, the second expressing the solvent humanneeds accompanied by the people’s capacity to buy the offered merchandise, if convenient

Gastrointestinal bleeding in patients admitted to the intensive care unit

Introduction. Gastrointestinal bleeding is a life-threatening condition, with a mortality depending on the cause and severity. The objective of this study was to retrospectively evaluate the epidemiological, clinical and evolutionary aspects of a series of patients diagnosed with gastrointestinal bleeding, admitted to the Intensive Care Unit of the Clinical Emergency Hospital of Bucharest, Romania. Material and methods. A retrospective, descriptive study was carried out, of patients diagnosed with upper and lower gastrointestinal bleeding, admitted to the Intensive Care Unit of the Clinical Emergency Hospital of Bucharest, Romania, between January 1st, 2013 – December 30th, 2018. The clinical variables were collected in a database designed exclusively for the study. Results. We observed that most of the cases were bleedings situated above the Treitz’s angle; the most frequent causes were peptic ulcer disease, followed by variceal hemorrhage and erosive gastroduodenitis. The three most frequent causes of upper gastrointestinal bleeding in our series were peptic ulcer disease, variceal hemorrhage and erosive gastroduodenitis. The global mortality due to gastrointestinal bleeding was 9.8%, with all cases occurring in the group of patients with upper gastrointestinal bleeding. Conclusions. It should be noted that in the group of patients who died, all had hemorrhagic shock at the time of admission, a fact that occurred only in 23% of the cases who survived. This highlights the prognostic value of the hemorrhagic shock on admission

Quality of life and special issues in women with inflammatory bowel diseases

Introduction. The impact of inflammatory bowel diseases (IBD) on the quality of life (QoL) of patients is significant and it has important social and professional consequences. Materials and methods. We aimed to describe the patients’ perspective regarding the impact of IBD on their overall QoL and to evaluate the differences between men and women. An observational cross-sectional study, that included 180 patients with IBD in clinical remission, was conducted. All the patients completed a number of 3 questionnaires in order to evaluate the general aspects of their QoL. A separate questionnaire was created regarding gender-specific issues in women with IBD encounter. Also, particular features such as the incidence of anemia and osteoporosis among IBD patients were documented. The data obtained were analyzed and compared between the two gender-classified groups. Results. According to the Short Inflammatory Bowel Disease Questionnaire (SIBDQ), patients had a general perception of a good QoL, but the impact was higher in women. Fatigue and tiredness were severely perceived almost to the same degree regardless of their gender, whereas anxiety and unemployment were more present in men. No significant differences in women with IBD during the active disease and during disease remission were found. Conclusions. The overall quality of life of IBD patients is affected in many aspects, leading to the deterioration of their social and professional lives, for both men and women, but some aspects remain gender-specific and require a personalized standard of care

Primary non-Hodgkin’s lymphoma of the common bile duct presenting as obstructive jaundice: a case report

Introduction. Primary non-Hodgkin’s lymphoma of the extrahepatic bile duct presenting as obstructive jaundice is an extremely rare disease. Case presentation. We report a case of obstructive jaundice caused by primary non-Hodgkin’s lymphoma of the common bile duct (CBD), in a 67-year-old male patient. Our patient showed clinical evidence of obstructive jaundice, and tomography revealed a dilated common bile duct with the suspicion of intra ductal lithiasis. Endoscopic retrograde cholangiopancreatography (ERCP) was performed, with efficient drainage and clinical resolution of the obstructive jaundice. One month later, the patient presented the same clinical signs of obstructive jaundice, only this time the ERCP revealed common bile duct distal stenosis. The next step was to perform an echoendoscopy (EUS), that visualized a homogeneous mass at the common bile duct distal level and cholangiocarcinoma was suspected. Fine needle aspiration (FNA) of the lesion obtained tissue fragments for histological examination. The diagnosis was diffuse B-cell type non-Hodgkin’s lymphoma in the marginal area, and the patient was evaluated in the Oncology Department for chemotherapy. Conclusions. It is very important to differentiate primary non-Hodgkin’s lymphoma of the bile ducts from other causes of obstructive jaundice, as the treatment approach and prognosis are fundamentally different. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the definitive diagnosis technique, avoiding surgical interventions and the classic exploratory laparotomy

Effects of the Lipid Profile, Type 2 Diabetes and Medication on the Metabolic Syndrome—Associated Gut Microbiome

Publication history: Accepted - 4 July 2022; Published online - 6 July 2022Metabolic syndrome (MetSyn) is a major health problem affecting approximately 25% of the worldwide population. Since the gut microbiota is highly connected to the host metabolism, several recent studies have emerged to characterize the role of the microbiome in MetSyn development and progression. To this end, our study aimed to identify the microbiome patterns which distinguish MetSyn from type 2 diabetes mellitus (T2DM). We performed 16S rRNA amplicon sequencing on a cohort of 70 individuals among which 40 were MetSyn patients. The microbiome of MetSyn patients was characterised by reduced diversity, loss of butyrate producers (Subdoligranulum, Butyricicoccus, Faecalibacterium prausnitzii) and enrichment in the relative abundance of fungal populations. We also show a link between the gut microbiome and lipid metabolism in MetSyn. Specifically, low-density lipoproteins (LDL) and high-density lipoproteins (HDL) display a positive effect on gut microbial diversity. When interrogating the signature of gut microbiota in a subgroup of patients harbouring both MetSyn and T2DM conditions, we observed a significant increase in taxa such as Bacteroides, Clostridiales, and Erysipelotrichaceae. This preliminary study shows for the first time that T2DM brings unique signatures of gut microbiota in MetSyn patients. We also highlight the impact of metformin treatment on the gut microbiota. Metformin administration was linked to changes in Prevotellaceae, Rickenellaceae, and Clostridiales. Further research focusing on the microbiome-metabolome patterns is needed to clarify the exact association of various gut microbial communities with the progression of T2DM and the occurrence of various complications in MetSyn patientsThis research was funded by UEFISCDI, project ID PN-III-P1-1.1-36PD-2019-0499, Grant number 224/2021 and C1.2.PFE-CDI.2021-587

Considerations of Health Tourism in Braila

The author aims at highlighting the conditions that lead to exploitation of the region Lake Sarat spa. Located in the eastern part of Romania, in Baragan North, the resort is located at a distance of only 5.5 km from the city of Braila. Surrounded by a park of 40 ha (30 ha and 10 ha forest green area), which provides a framework both the monumentality very picturesque, and by old, Salt Lake Resort is a true oasis of greenery with beneficial effects on the human body. Building fund has grown over the past 30 years, achieving adequate facilities for tourism and spa treatment. As shown current zoning functions, the resort is only about 50% recovered in terms of space, ie to the northeast. Otherwise, there are areas that do not fulfill the role of recreational green spaces

INCREASING COMPLIANCE THROUGH EFFICIENT PUBLIC CAMPAIGNS

This paper starts from the assumption that the degree of compliance of the taxpayer increases in direct proportion to the effectiveness of public campaigns carried out by the tax device. Information campaigns with a view to increase voluntary compliance can be carried out in various ways. They can emphasize either the potential benefits that taxpayers would receive if the compliance were full, or the potential losses when the degree of compliance is reduced. In theory, these campaigns are effective when intersecting with the promotion or warning of taxpayers about certain fiscal aspects. Following the presentation of campaigns carried out in other states, we propose the initiation of a campaign in Romania as well. Corporate taxpayers will choose out of several campaigns and in the end we will present the results of the research based on the methods of the questionnaire and of the interview