A SCREENING OF THE HYDROGEN SULFIDE LEVELS IN PLOIESTI CITY, ROMANIA

Oil refineries and petrochemical facilities contribute to the pollution of the environment either air, water, or soil releasing hazardous and toxic air pollutants into the atmosphere. These include nitrogen oxides (NOx), carbon monoxide (CO), hydrogen sulfide (H2S), sulfur dioxide (SO2), and particulate matter (PM), affecting both environment and human health. In the range of air pollutants, hydrogen sulfide is less monitored and reported despite its importance in determining adverse effects. Background H2S concentrations in air were found to range commonly from 0.11 ppb to 0.33 ppb. The concentrations in urban areas can reach 1 ppb (~1.4 g m-3) up to more than 90 ppb (~125 g m-3) near sources of H2S emissions. In Romania, the standard for the air in protected areas for the hydrogen sulfide pollutant provides an admissible concentration, over a maximum interval of 30 minutes, of 15 µg/m³. Everything that exceeds this value is considered harmful to human health. The statistics for the H2S time series recorded in Ploiești City by the mobile laboratory of the Environmental Protection Agency Prahova between 2019 and 2021 with a sampling rate of 30 minutes showed that the mean ranged between 1.51 and 3.74 µg/m³, while the maximum reached 59.36 µg/m³ in the east of Ploiești in 2019. Overall, the highest variance occurred in the East and North parts due to the presence of the concentration peaks. Hydrogen sulfide must be considered on the public health agenda, both from the occupational perspective and for the ambient concentrations near significant H2S sources and in background urban areas. The monitoring infrastructure needs to be improved to allow continuous surveillance to ensure reliable databases that support research regarding the health effects of H2S across the concentrations occurring in the urban environment

Anticoagulant therapy in elderly patients

The pathology of recent years is dominated by lung thromboembolism, the more worrying factor as the algorithms for prophylaxis and treatment of diseases with high embolic risk are properly applied in medical practice and perform only of 75% antithrombotic protection. The aim is to present the benefits and risks of anticoagulant treatment in elderly patients with cardiovascular disease. Anticoagulant treatment is at least as important as for the other age groups because elderly patients have combinations of cardiovascular diseases and comorbidity which have anticoagulant treatment indications. We performed a retrospective study on 781 patients over 65 years, admitted between January 1, 2009 and March 31, 2010 in Medical Clinic IV, Department of Geriatrics. Statistical study followed their distribution by age, average residence, gender, cardiovascular diseases, anti-coagulant treatment indication and methods of implementation. From 781 patients, 758 cases (97%) were hospitalized for cardiovascular disease of these, 545 (72%) received anticoagulant therapy, 152 (20%) received also antiplatelet and 61 (8%) did not receive any of these forms. Adverse effects of anticoagulation therapy were recorded at 1.5% of patients. All these patients were under chronic anticoagulation therapy with antivitamin К and required permanent or temporary interruption. Anticoagulant therapy in the elderly is under-utilized due to fear of unwanted side effects taking into consideration the problems of monitoring chronic treatment with К antivitamin at home

General Romanian Interest Representation in Brussels: an Initial Assessment of Romania s Lobbyng Potential in the View of Eu Membership (English Version)

The paradigm shifts induced by the consecutive enlargements on the Eu polity reshape the questions regarding the influence of various interestson the sophisticated patterns of EU governance. Strongly motivated by the new focus of interest group research, this study aims to provide a tentative assessment of the potential of a future member state, Romania, to influence the European policy process. Thus a theoretically-based overview of the EU lobbyng arena is firstly performed, in order to isolate the relevant criteria by which to assess the lobbyng efficiency of interest groups in such a competitive environment. After a brief excursus on the particular Central and Eastern European repertoires for interest reprezentation, the analysis further proceeds to discussing the aforementioned criteria on the core study case material represented by the Romanian organizations activating in Brussels. No.pg. 132Lobbyng Potential, EU, Brussels, Romania

Fat Embolism Syndrome Mimicking a COVID-19 Infection

Fat embolism syndrome (FES) is a multiple organ disorder that can appear after pelvic and long bone fractures. The most common clinical finding is hypoxia, accompanied by diffuse petechiae, alveolar infiltrates, altered mental status, fever, polypnea, and tachycardia. We present a mild FES case on a 32-year-old man with no medical history admitted for an orthopedic procedure, following both tibia and fibulae fractures. Thirty hours postoperatively, he developed respiratory failure with altered mental status and needed admission in the intensive care unit. The chest radiography and later chest tomography raised the suspicion of a COVID-19 disease, even if our first suspicion was FES. After being carefully investigated in a dedicated COVID-19 ward and three negative RT-PCR SARS-CoV-2 tests, he returned to continue supportive treatment in the orthopedic intensive care ward. His evolution was favorable with discharge at ten days, without sequelae. In the context of the SARS CoV-2 pandemic, differential diagnosis has become an increasingly challenging process. Added to the variety of preexisting respiratory diseases and disorders, the COVID-19 infection, with its symptomatology so similar to multiple other pulmonary diseases, must not cloud our clinical judgement

Pain level after ACL reconstruction: A comparative study between free quadriceps tendon and hamstring tendons autografts

Objective: The objective of this study was to compare the pain levels and analgesic consumption after single bundle ACL reconstruction with free quadriceps tendon autograft versus hamstring tendon autograft. Patients and methods: A total of 48 patients scheduled for anatomic single-bundle ACL reconstruction were randomized into two groups: the free quadriceps tendon autograft group (24 patients) and the hamstring tendons autograft group (24 patients). A basic multimodal analgesic postoperative program was used for all patients and rescue analgesia was provided with tramadol, at pain scores over 30 on the Visual Analog Scale. The time to the first rescue analgesic, the number of doses of tramadol and pain scores were recorded. The results within the same group were compared with the Wilcoxon signed test. Results: Supplementary analgesic drug administration proved significantly higher in the group of subjects with hamstring grafts, with a median (interquartile range) of 1 (1.3) dose, compared to the group of subjects treated with a quadriceps graft, median = 0.5 (0.1.25) (p = 0.009). A significantly higher number of subjects with a quadriceps graft did not require any supplementary analgesic drug (50%) as compared with subjects with hamstring graft (13%; Z-statistics = 3.01, p = 0.002). The percentage of subjects who required a supplementary analgesic drug was 38% higher in the HT group compared with the FQT group. Conclusion: The use of the free quadriceps tendon autograft for ACL reconstruction leads to less pain and analgesic consumption in the immediate postoperative period compared with the use of hamstrings autograft. Level of Evidence: Level I Therapeutic study Keywords: ACL reconstruction, Pain, Hamstring tendons, Free quadriceps tendo

A Three-Year Analysis of Toxic Benzene Levels and Associated Impact in Ploieşti City, Romania

This study examines the levels of benzene and the potential health impact during three years of continuous monitoring (2019–2021), including the COVID-lockdown period from 2020 in a city that is an important Romanian center for petroleum refining and associated product manufacturing. The dataset contains benzene, toluene, NOx, PM10 concentrations, and meteorological factors monitored by six automatic stations from the national network of which four are in the city and two outside. Special attention was given to the benzene dynamics to establish patterns related to the health impact and leukemia. An assessment of the exposure was performed using EPA’s ExpoFIRST v. 2.0 for computing the inhalation Average Daily Dose (ADD) and Lifetime Average Daily Dose (LADD). The health impact was estimated based on several indicators such as lifetime cancer risk (LCR), Hazard Quotient (HQ), Disability-Adjusted Life Years (DALY), and Environmental burden of disease (EBD). Overall, the annual average of all stations was almost similar between years i.e., 3.46 in 2019, 3.41 in 2020, and 3.63 µg/m3 in 2021, respectively. The average of all stations during the lockdown period was 2.67 µg/m3, which was lower than the multiannual average of the 2019–2021 period, i.e., 3.5 µg/m3. Significant correlations were present between benzene and other pollutants such as NOx (r = 0.57), PM10 fraction (r = 0.70), and toluene (r = 0.69), and benzene and temperature (r = −0.46), humidity (r = 0.28), and wind speed (r = −0.34). Regarding the ADD, in all scenarios, the most affected age categories are small children, despite a lower outdoor exposure time. From birth to −4, 5.6 × 10−4, and 4.04 × 104 mg/kg-day, and 3.95 × 10−4, 10.6 × 10−4, and 6.76 × 10−4 mg/kg-day for the LADD, respectively. The Integrated Lifetime Cancer Risk (ILTCR) values were 14.1 × 10−5 in winter, 9.04 × 10−5 in spring, 8.74 × 10−5 in summer, and 10.6 × 10−4 in autumn. The ILTCR annual averages were 1.08 × 10−4 (2019), 1.07 × 10−4 (2020), 1.04 × 10−4 (2021), and 1.06 × 10−4 for the entire period. The resulting ILTCR values point out very risky conditions, with the annual averages reaching the definite cancer risk category. The corresponding burden based on the DALY’s loss due to leukemia in Ploieşti was estimated at 0.291 (2 μg/m3 benzene), 0.509 (3.5 μg/m3 benzene), 0.582 (4 μg/m3 benzene), and 0.873 DALYs per 100,000 inhabitants (6 μg/m3 benzene), respectively. The current study provides useful insights for a better understanding of the exposure levels to benzene and associated health impact in Ploieşti despite the limitations determined by the data hiatus and incomplete or missing information regarding the health impact