Auxological correlation between the maternal obesity, excessive weight gain during pregnancy, macrosomia, feeding practices and infant obesity

UMF “Iuliu Haţieganu” Cluj, UMF “Gr. T. Popa” Iaşi, UMF “Carol Davila” Bucureşti, Fac. Medicină Oradea, UMF Târgu Mureș, SJU SibiuThe infant and adult obesity is becoming a real public health concern in Romania too. The mother's obesity and excessive weight gain during pregnancy are proven risk factors for the obesity of the child in the future. The protective role of breastfeeding against obesity is already demonstrated. The most important issue is whether the choice of a milk formula with the right protein composition could also protect or not the newborn from becoming future obese infants and children.Obezitatea copilului şi adultului are rate îngrijorătoare şi în Romania. Obezitatea mamei şi creşterea excesivă în greutate a gravidei constituie factori de risc pentru macrosomie şi pentru obezitatea ulterioară a copilului. Rolul protector al laptelui de mamă în prevenţia obezităţii infantile este deja demonstrat. Se pune întrebarea dacă alegerea unei formule de lapte cu conţinut adecvat de proteine protejează sau nu nou-născuţii care au deja greutate mare la naştere, pentru dezvoltarea obezităţii în perioada de sugar si copil mic

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Former les étudiants et les enseignants à la pédagogie

Contexte : En Roumanie, le développement d’une formation pédagogique dans l’enseignement médical est devenu une nécessité pour les facultés de médecine. L'expérience de la Faculté de Médecine de l'Université de Médecine et de Pharmacie "Iuliu Hatieganu" de Cluj-Napoca en porte foi. Méthode : S'inspirant des modèles existants dans l'espace francophone, la Faculté a mis en place des programmes de formation pédagogique destinés aux étudiants et aux enseignants. Résultats : La popularité du cours initial destiné aux étudiants a augmenté d'année en année jusqu'à conduire à offrir un ensemble de trois cours optionnels dans le curriculum. À côté de cela, deux cent soixante-quinze enseignants ont bénéficié d'une formation mise en place à leur intention dans la Faculté. Le succès des formations à la fois auprès des étudiants et des enseignants a conduit à créer un département de psychologie et pédagogie médicale. Conclusion : Les résultats et la qualité des activités d'une institution d'enseignement doivent être également évalués à travers la solidité et la qualité du processus pédagogique

Cutaneous Sarcoid-Like Granulomas in a Child Known with Nijmegen Breakage Syndrome

Background: Nijmegen Breakage Syndrome(NBS) is a rare autosomal recessive disorder with specific clinical features, characteristic chromosomal breakage and combined imunodeficiency. Patients with this condition also associate growth retardation with microcephaly, predisposition to malignancy and specific skin manifestations. Case Presentation: Here we report a 3-year old girl known with NBS associated with cutaneous sarcoid-like lesions. She presented with one year history of squamous lesions on the face and upper and lower limbs. The lesions were biopsied and histopatological examination revealed nonnecrotizing epitheloid granulomas and raised the suspicion of a sarcoid-like entity. Conclusion: The interest of this case will serve to better understand clinical manifestations in a rare genetic entity. Close follow-up is advised as cutaneous granulomas may be the first manifestation of systemic granulomas

Repetition Rate Effects in Picosecond Laser Microprocessing of Aluminum and Steel in Water

Picosecond laser drilling was studied in the case of industrial steel and aluminum, which are difficult to microprocess by conventional methods. The dependence of hole morphology and dimensions on the pulse repetition rate and number of pulses in water and air were ascertained. For both materials, the diameter of the hole is larger in water than in air. In water, the diameter is larger at higher repetition rates than at lower ones, and increases with the number of pulses. In air, the hole diameter is not affected by the repetition rate, and remains constant from 100 to 100,000 pulses. Overall, material removal is more efficient in water than in air. The shape of the hole is generally more irregular in water, becoming more so as the number of pulses is increased. This is probably due to debris being trapped in the hole, since water flowing over the target surface cannot efficiently remove it. In aluminum, the depth of the hole is smaller at higher repetition rates. By scanning the beam over the aluminum target in water, the laser penetrates a 400-μm thick workpiece, generating a line with comparable widths at the entrance and exit surfaces

Ectodermal Dysplasia Showing the Clinical Overlap between Hay Wells Syndrome and Bowen Armstrong Syndrome

Background: Several clinical entities combine ectodermal dysplasia (ED) and cleft lip and/or palate (CL/P). These disorders have been recognized with a narrow phenotypic spectrum and very similar clinical features. Case Presentation: We report a case with a clinical diagnosis of Hay Wells syndrome (ankyloblepharon, ED and CL/P), who is a descendent of a mother with Bowen Armstrong syndrome (ED, CL/P, mental retardation). Conclusion: Due to the clinical similarities, we suggest that Hay Wells syndrome and Bowen Armstrong syndrome may be the same clinical entity with variable manifestations. This case highlights the difficulties in trying to classify the ED syndromes on clinical features

Efficiency of Oxygen Therapy by Simple Face Mask and Nasal Cannula for Acute Respiratory Failure in Infants and Young Children

Premises: Acute respiratory failure caused by respiratory diseases, which is a frequent pathology in infants and young children, requires oxygen therapy, which can be administered by different devices. Objectives: To evaluate the efficiency of two devices for oxygen administration by determining a clinical appraisal score for acute respiratory failure in infants and young children by oxygen therapy using simple face masks and nasal cannulas. Material and methods: 74 children, aged between one month and 3 years were included in our study. Oxygen therapy was administered by face mask to 38 patients, and by nasal cannula to 36 patients. A clinical appraisal score of respiratory failure was calculated both before and after oxygen therapy. Oxygen saturation was measured by pulse oximetry (SpO2) and arterial or capillary blood gas (SaO2) before, and 30 minutes and 60 minutes after the initiation of oxygen therapy. Results: We found an improvement in the clinical score regardless of the method of administration; this improvement was more obvious at 60 minutes than at the 30 min evaluation (p<0.001). The differences were statistically significant (p<0.0001) for all the measurements (baseline vs. 30 minutes, baseline vs. 60 minutes, 30 minutes vs. 60 minutes). An increase in both SaO2 and SpO2 values was found (p<0.001). Conclusions: The clinical score for acute respiratory failure and the SaO2 and SpO2 values significantly improved after oxygen therapy