Schimbările climatice și efectele asupra sănătății - disciplină opțională în formarea medicală

Introducere. Nevoia integrării cunoștințelor despre efectele schimbărilor climatice asupra sănătății în formarea medicală este în creștere. Abordarea impactului schimbărilor climatice asupra sănătății în cadrul activităților educaționale este o provocare oportună pentru universitățile/facultățile de medicină. Scopul proiectului CLIMATEMED este dezvoltarea unui curriculum, lărgirea cunoștințelor des-pre efectele asupra sănătății ale schimbărilor climatice, educație mai largă la această temă. Proiectul promovează creștereamotivației profesorilor și elaborarea de ghiduri metodologice, oferind în același timp formarea continuă a medicilor practicieni. Scopul. Pornind de la opiniile studenților și ale medicilor, se pregătesc materiale didactice cu scopul predării cunoștințelor privind schimbările climatice și efectele lor asupra sănătății. Material și metode. Materialele didactice elaborate sunt concepute într-un for-mat potrivit pentru predarea tradițională față în față, precum și în format electronic pentru e-learning. Pentru evaluarea nevoilor, rezumarea propunerilor, dezvoltarea strategiei necesare s-a aplicat metoda World Café. Participanții, care și-au exprimat opiniile, erau studenți mediciniști de la UMFST din Târgu Mureș, respectiv medici practicieni, dar în viitor se pot interoga și cadrele didactice de la Facultatea de Medicină. Rezultate. Pornind de la un studiu efectuat care concluzionează că doar 15% din școlile de medicină chestionate au cursuri care predau schimbările climatice și sănătatea, opiniile studenților târgumureșeni arată importanța sublinierii aspec-telor legate de schimbările climatice de către cadrele didactice, înțelegerii bolilor și prin prisma schimbărilor climatice. Persoanele interogate au relatat ce fel de subiecte ar trebui să fie incluse într-un curs nou privind impactul schimbărilor climatice asupra sănătății, în ce semestru/modul și în ce format ar fi potrivit să fie predat. Subiectele relatate cel mai des erau: căldură excesivă și boli legate de căldură, vreme extremă, boli transmise prin vectori, siguranță alimentară, poluarea aerului, sănătate mintală etc. Începând cu anul universitar 2022/2023, studenții de la medicină, anii I-IV, pot alege ca materie opțională Schimbările climatice și efectele asupra sănătății. Concluzii. Există o cerință din ce în ce mai mare din partea studenților mediciniști ca instituțiile de învățământ medical să includă în planul de învățământ cunoștințe legate de efectele schimbărilor climatice asupra sănătății. Cadrele didactice sunt de acord și sunt dispuși ca cunoștințele privind efectele schimbărilor climatice asupra sănătății să ocupe o parte mai importantă în pregătirea medicală. Educarea cunoștințelor în domeniul sănătății legate de efectele schimbărilor climatice ar trebui să facă parte din formarea profesioniștilor din domeniul sănătății. Proiectul CLIMATEMED a contribuit la pregătirea unor materiale educaționale și la introducerea unei discipline opționale în curriculumul de pregătire a studenților de la Facultatea de Medicină, UMFST din Târgu Mureș (medicină, respectiv asistenți medicali generaliști)

Knowledge, attitudes, and willingness of community pharmacy staff in Mures County, Romania, to provide the brief advice to stop smoking: A cross-sectional study

Background and objective: Providing brief advice to stop smoking (BASS) can significantly increase motivation to quit, long-term smoking cessation rates, and substantially impact public health. The study aimed to evaluate knowledge, attitudes, and willingness of community pharmacy staff in Mures County, Romania, to provide BASS to smokers

Consequences of Misdiagnosed and Mismanaged Hereditary Angioedema Laryngeal Attacks: An Overview of Cases from the Romanian Registry

Emergency department (ED) physicians frequently encounter patients presenting with angioedema. Most of these involve histamine-mediated angioedema; however, less common forms of angioedema (bradykinin-mediated) also occur. It is vital physicians correctly recognize and treat this; particularly since bradykinin-mediated angioedema does not respond to antihistamines, corticosteroids or epinephrine and hereditary angioedema (HAE) laryngeal attacks can be fatal. Here we present four case reports illustrating how failures in recognizing, managing, and treating laryngeal edema due to HAE led to asphyxiation and death of the patient. Recognition of the specific type of angioedema is critical for rapid and effective treatment of HAE attacks. Bradykinin-mediated angioedema should be efficiently differentiated from the most common histamine-mediated form. Improved awareness of HAE and the associated risk of life-threatening laryngeal edema among emergency physicians, patients, and relatives and clear ED treatment protocols are warranted. Moreover, appropriate treatments should be readily available to reduce fatalities associated with laryngeal edema

What Patients Find on the Internet When Looking for Information About Percutaneous Coronary Intervention: Multilanguage Cross-sectional Assessment

BackgroundThe internet provides general users with wide access to medical information. However, regulating and controlling the quality and reliability of the considerable volume of available data is challenging, thus generating concerns about the consequences of inaccurate health care–related documentation. Several tools have been proposed to increase the transparency and overall trustworthiness of medical information present on the web. ObjectiveWe aimed to analyze and compare the quality and reliability of information about percutaneous coronary intervention on English, German, Hungarian, Romanian, and Russian language websites. MethodsFollowing a rigorous protocol, 125 websites were selected, 25 for each language sub-sample. The websites were assessed concerning their general characteristics, compliance with a set of eEurope 2002 credibility criteria, and quality of the informational content (namely completeness and accuracy), based on a topic-specific benchmark. Completeness and accuracy were graded independently by 2 evaluators. Scores were reported on a scale from 0 to 10. The 5 language subsamples were compared regarding credibility, completeness, and accuracy. Correlations between credibility scores on the one hand, and completeness and accuracy scores, on the other hand, were tested within each language subsample. ResultsThe websites’ compliance with credibility criteria was average at best with scores between 3.0 and 6.0. In terms of completeness and accuracy, the website subsets qualified as poor or average, with scores ranging from 2.4 to 4.6 and 3.6 to 5.3, respectively. English language websites scored significantly higher in all 3 aspects, followed by German and Hungarian language websites. Only German language websites showed a significant correlation between credibility and information quality. ConclusionsThe quality of websites in English, German, Hungarian, Romanian, and Russian languages about percutaneous coronary intervention was rather inadequate and may raise concerns regarding their impact on informed decision-making. Using credibility criteria as indicators of information quality may not be warranted, as credibility scores were only exceptionally correlated with content quality. The study brings valuable descriptive data on the quality of web-based information regarding percutaneous coronary intervention in multiple languages and raises awareness about the need for responsible use of health-related web resources

Mutational spectrum and genotype-phenotype relationships in a cohort of Romanian hereditary angioedema patients caused by C1 inhibitor deficiency

Background: Hereditary angioedema due to C1 inhibitor deficiency (C1-INH-HAE) caused by SERPING1 mutations is a rare monogenic disorder characterized by a high frequency of de novo mutations, allelic heterogeneity and populational differences. Geno- and phenotype correlation data are limited. Addressing the pathogenic complexity, we proposed to analyze the clinical and genetic characteristics in a set of Romanian patients. Material and Methods: 49 patients from 22 unrelated families with C1-INH-HAE were investigated, by calculating clinical severity score (CSS), C1-INH and C4 level assessment by nephelometric assays, C1-INH function study by functional enzyme-linked immunosorbent assay, and mutation analysis by sequencing and MLPA. Clinical manifestations by missense vs other mutation mechanisms were compared. Results: The mean age at diagnosis and onset was 28.8±14.7 and 15.1±15.2 years, while the diagnostic delay 13.1±10.1 years. CSS ranged from 2 to 9, with a mean of 5.4±1.8. The frequency of missense and nonsense mutations, splice defects, frameshift mutations and large gene rearrangements was 61.22, 6.12, 22.4, 6.12 and 4.08%; in the regulatory sequence no mutation was described. In type II, only missense mutations were noted. Lower levels of C1-INH characterized index cases caused by mechanisms other than missense mutation, with more severe consequences on protein synthesis (p=0.017). 53% of the cases were identified by familial screening. Conclusion: A later onset of disease manifestations and a higher frequency of missense mutations characterize HAE in Romanian patients with SERPING1 mutation. Genetic analysis improves the management of affected families, and may inform about disease severity