The Family as Recipient and Provider of Home Care: A Primary Care Perspective

Advances in modern medicine, effective medication and high-technology interventions contribute to the growth of chronic comorbidities among older people, and many children with chronic diseases that reach adulthood require long-term care at home, provided by formal and informal caregivers and coordinated by primary healthcare professionals. Home caring, performed under different conditions from those of hospital care, requires the involvement of the family that is recipient and provider of home care. This chapter discusses the contribution of family caregivers to personalized home care of dependent children and elderly recipients, coordinated by primary health professionals. Children and youth with special healthcare needs and children abused and neglected require special involvement of family caregivers. The use of digital healthcare for recipients with medical complexity is a modern way to connect home care patients to specialized care, reducing the costs of the hospital care system. However, the burden in home care should be recognized by the general practitioner. Specific interventions are addressed to the unsupportive families and real hidden patients to help maintain their health and functionality. Future family doctors’ interprofessional communication skills and resourcefulness should meet the societal changes, and the burden of home care in the modern family is approached from the perspective of academic medicine

Causes and Consequences of Genome Expansion in Fungi

Fungi display a large diversity in genome size and complexity, variation that is often considered to be adaptive. But because nonadaptive processes can also have important consequences on the features of genomes, we investigated the relationship of genetic drift and genome size in the phylum Ascomycota using multiple indicators of genetic drift. We detected a complex relationship between genetic drift and genome size in fungi: genetic drift is associated with genome expansion on broad evolutionary timescales, as hypothesized for other eukaryotes; but within subphyla over smaller timescales, the opposite trend is observed. Moreover, fungi and bacteria display similar patterns of genome degradation that are associated with initial effects of genetic drift. We conclude that changes in genome size within Ascomycota have occurred using two different routes: large-scale genome expansions are catalyzed by increasing drift as predicted by the mutation-hazard model of genome evolution and small-scale modifications in genome size are independent of drift

Electronic Cigarette Use and Its Relationship with Smoking and Alcohol and Illicit Drug Consumption among Romanian University Students

Background and objectives: This study assesses electronic cigarette (e-cigarette) use and its relationship with smoking and alcohol and illicit drug consumption among Romanian university students. Materials and methods: A cross sectional study using anonymous questionnaire was performed in 2017 among 400 university students from Cluj-Napoca, Romania. Results: 95.5% of the participants had heard about e-cigarettes and 43.7% of these had tried e-cigarettes during their lifetime, while 8.9% declared using cigarettes in the previous month (one out of five students who had tried them during their lifetime). Half of the students had smoked during their lifetime and one third had smoked in the previous month. Eighty-five percent of participants had experimented alcohol intoxication during their lifetime and 45% had done so in the previous month, while illicit drug use during their lifetime and the previous month was 34% and 9.5%, respectively. The results of the linear regression analyses show a positive correlation between e-cigarette use, smoking, experimentation with alcohol intoxication, and the use of illicit drugs. Conclusions: Future studies as well as educational activities should address the complex relationship between e-cigarette and other substance use among Romanian youth

The Impact of the COVID-19 Pandemic on Research and Volunteering Activities among Medical Students: A Cross-Sectional Study among Romanian and International Students from One Medical Faculty from Romania

Introduction: This study focuses on the influence of the COVID-19 pandemic on medical students in their last year of study at the Faculty of Medicine of the University of Medicine and Pharmacy in Cluj-Napoca, Romania. It analyzes the impact of social distance limits on the conduct of research activities required for the development of the graduation thesis, as well as assesses sixth-year students’ attitudes and behaviors toward volunteer activities during the COVID-19 pandemic. Methods: A cross-sectional survey was conducted in June–July 2021 among sixth-year students. It used an anonymous online questionnaire and was sent to all students from the Faculty of Medicine studying in the Romanian, English, or French sections (n = 606). The response rate was 38.28%, resulting in a final sample of 232 students from both Romanian and international sections. Results: The findings demonstrate that two-thirds of the students in the survey agreed that the COVID-19 pandemic had a substantial impact on their research. Some of the students had to choose another subject for their graduation thesis, while about a quarter of the students gave up collecting personal data, 25% of respondents stated that it was difficult to contact research participants, one-third of them linked the difficulty of doing activities at the hospital to the present outbreak, and almost 30% of the students had difficulty communicating with the coordinator. The disturbance of the research activity seems to be higher among international students in comparison with the Romanian students, while there are limited gender differences. One out of five medical students has been involved in volunteer activities during the pandemic. Most have opted to volunteer at hospitals (especially international students) and contribute to health education activities (especially women). Conclusions: This is the first study from Romania and one of the few from Europe that presents data regarding the influence of the COVID-19 pandemic on research and volunteering activities among medical students

Noninvasive Assessment of Hepatitis C Virus Infected Patients Using Vibration-Controlled Transient Elastography

Chronic infection with hepatitis C virus (HCV) is one of the leading causes of cirrhosis and hepatocellular carcinoma (HCC). Surveillance of these patients is an essential strategy in the prevention chain, including in the pre/post-antiviral treatment states. Ultrasound elastography techniques are emerging as key methods in the assessment of liver diseases, with a number of advantages such as their rapid, noninvasive, and cost-effective characters. The present paper critically reviews the performance of vibration-controlled transient elastography (VCTE) in the assessment of HCV patients. VCTE measures liver stiffness (LS) and the ultrasonic attenuation through the embedded controlled attenuation parameter (CAP), providing the clinician with a tool for assessing fibrosis, cirrhosis, and steatosis in a noninvasive manner. Moreover, standardized LS values enable proper staging of the underlying fibrosis, leading to an accurate identification of a subset of HCV patients that present a high risk for complications. In addition, VCTE is a valuable technique in evaluating liver fibrosis prior to HCV therapy. However, its applicability in monitoring fibrosis regression after HCV eradication is currently limited and further studies should focus on extending the boundaries of VCTE in this context. From a different perspective, VCTE may be effective in identifying clinically significant portal hypertension (CSPH). An emerging prospect of clinical significance that warrants further study is the identification of esophageal varices. Our opinion is that the advantages of VCTE currently outweigh those of other surveillance methods

Rapid Quantitative Analysis of Ethanol and Prediction of Methanol Content in Traditional Fruit Brandies from Romania, using FTIR Spectroscopy and Chemometrics

Fourier Transform Infrared (FTIR) spectroscopy in combination with chemometrics were applied for the quality control of 26 fruit brandies made by traditional technology in Romania. Firstly, for the identification and quantitative evaluation of methanol and ethanol in such samples, 4 mixtures of methanol and ethanol standard solutions and a spiked sample were fingerprinted in the 1200 - 950 cm-1 FTIR spectral range, identifying specific wavelength of 1020 and 1112 for methanol, 1047 and 1087 for ethanol. Then, the FTIR spectra of all brandy samples in the range 3500 - 750 cm-1 was registered and the methanol and ethanol concentrations were determined according to the previous calibration. By PCA (Principal component analysis) of FTIR areas (1170 -1000 cm-1), the variability and discrimination between samples was possible, discriminating between the biological and geographical origin of brandy samples. Based on peak areas and intensities, it was predicted the concentration of methanol in all samples, using Partial least squares regression (PLS). The correlation between FTIR and the reference method (GC-FID) was well correlated and significant (p&lt;0.05). It was demostrated that FTIR technique offer a good prediction and statistical correlation with GC-FID technique for methanol quantification. </p

Attitudes and Practices Regarding Research among Romanian Medical Undergraduate Students

Objectives: This study focuses on the assessment of attitudes and practices regarding research among undergraduate medical students from Cluj-Napoca, Romania. Material and Methods: A cross-sectional study was performed thorough anonymous questionnaires (May&ndash;June 2018) among 510 third- and fifth-year students of Iuliu Hatieganu University of Medicine and Pharmacy from Cluj-Napoca, Romania. Results: More than 60% of the third- and fifth-year students declared that they were interested and willing to perform research during medical studies, while more than two-thirds were interested in doing so after graduation. In total, 6% of third-year students and 31% of fifth-year students declared that they had prepared a scientific presentation for a medical congress at least once. Around 9% of the third-year students contributed to the writing of a scientific article and participated in research projects. Among fifth-year students, one-quarter were involved in writing scientific papers, and 21% participated in research projects. Conclusions: To the best of our knowledge, this study assesses, for the first time in Romania, the perspectives and behaviors of medical undergraduate students with regard to involvement in research activities. The results show that Romanian medical students value opportunities for conducting research, which encourages institutional initiatives that support their involvement in curricular and extracurricular research activities

Rapid Quantitative Analysis of Ethanol and Prediction of Methanol Content in Traditional Fruit Brandies from Romania, using FTIR Spectroscopy and Chemometrics

Fourier Transform Infrared (FTIR) spectroscopy in combination with chemometrics were applied for the quality control of 26 fruit brandies made by traditional technology in Romania. Firstly, for the identification and quantitative evaluation of methanol and ethanol in such samples, 4 mixtures of methanol and ethanol standard solutions and a spiked sample were fingerprinted in the 1200 - 950 cm-1 FTIR spectral range, identifying specific wavelength of 1020 and 1112 for methanol, 1047 and 1087 for ethanol. Then, the FTIR spectra of all brandy samples in the range 3500 - 750 cm-1 was registered and the methanol and ethanol concentrations were determined according to the previous calibration. By PCA (Principal component analysis) of FTIR areas (1170 -1000 cm-1), the variability and discrimination between samples was possible, discriminating between the biological and geographical origin of brandy samples. Based on peak areas and intensities, it was predicted the concentration of methanol in all samples, using Partial least squares regression (PLS). The correlation between FTIR and the reference method (GC-FID) was well correlated and significant (p&lt;0.05). It was demostrated that FTIR technique offer a good prediction and statistical correlation with GC-FID technique for methanol quantification. </p

Performance of Ultrasound Techniques and the Potential of Artificial Intelligence in the Evaluation of Hepatocellular Carcinoma and Non-Alcoholic Fatty Liver Disease

Global statistics show an increasing percentage of patients that develop non-alcoholic fatty liver disease (NAFLD) and NAFLD-related hepatocellular carcinoma (HCC), even in the absence of cirrhosis. In the present review, we analyzed the diagnostic performance of ultrasonography (US) in the non-invasive evaluation of NAFLD and NAFLD-related HCC, as well as possibilities of optimizing US diagnosis with the help of artificial intelligence (AI) assistance. To date, US is the first-line examination recommended in the screening of patients with clinical suspicion of NAFLD, as it is readily available and leads to a better disease-specific surveillance. However, the conventional US presents limitations that significantly hamper its applicability in quantifying NAFLD and accurately characterizing a given focal liver lesion (FLL). Ultrasound contrast agents (UCAs) are an essential add-on to the conventional B-mode US and to the Doppler US that further empower this method, allowing the evaluation of the enhancement properties and the vascular architecture of FLLs, in comparison to the background parenchyma. The current paper also explores the new universe of AI and the various implications of deep learning algorithms in the evaluation of NAFLD and NAFLD-related HCC through US methods, concluding that it could potentially be a game changer for patient care