The Role of Psychosocial Programs Carried out in the Penitentiary Environment

Through this article I would like to draw attention to the usefulness and necessity of goingthrough the psychosocial assistance programs, through the multiple advantages offered both to thedetainees and to the society. This article aims to highlight the limits of these programs that can improvethe lives of detainees and free societ

The Role of Psychosocial Programs Carried out in the Penitentiary Environment

Through this article I would like to draw attention to the usefulness and necessity of goingthrough the psychosocial assistance programs, through the multiple advantages offered both to thedetainees and to the society. This article aims to highlight the limits of these programs that can improvethe lives of detainees and free societ

Particularities of Personality and Socio-Affective Behavior in Children with Mental Disabilities

The personality structure of the mentally deficient child presents fundamental differencesfrom that of the normal child. In the present article “Particularities of personality and socio-affectivebehavior in the mentally handicapped” the emphasis is placed on the personality model, personalitydisorders, as well as the affective processes in the mentally handicapped child. Unlike the intellectuallynormal child, the mentally deficient child does not present those gradual and successive passages, thatplasticity and mobility from one process to another. In addition to the quantitative differences, there arequalitative differences between children with mental deficiency and normal children, with a negativeimpact on the process of adaptation and integration in the community

The Role of Psychologist in the Penitentiary Environment to Provide the Recovery Conditions and Social Integration of the Prisoners

Freedom is a right that today’s man is born with or acquires at birth, a right that some ofour fellow citizens end up losing, at least temporarily, because of their behaviour or committed acts.Loss of freedom involves a constraint on the enjoyment of certain citizenship rights, and thisconstraint has a strong impact on the individual in detention, so the role of the psychologist is veryimportant in the detention environment. The psychologist’s objective is to provide the detainee withpsychological comfort to get him to accommodate, to accept his new condition and more than that togo through a process of awareness of his deeds that will later help him to revise his behaviour, tochange his vision of life, all for the purpose of his social reintegration

The advantages of minimally invasive plate osteosynthesis (MIPO) by anterior approach in distal humeral shaft fractures

Introduction: Complex distal humeral shaft fractures management is debatable due to the fact that ORIF with plates is associated with a higher morbidity while intramedullary nails do not present reliable results. Purpose: to emphasize the advantages of MIPO by anterior approach in distal humeral shaft fractures. Material and methods: We have operated 19 distal humeral shaft fractures (3 type 12-A, 11 type 12-B and 5 type 12-C / AO classification) using the MIPO technique imagined by Livani and Belangero, in order to avoid the problems related to the neural vascular structures of the arm and especially to the radial nerve. 5 patients were registered with traumatic radial nerve palsy. The proximal approach of 3-5 cm was realized between the biceps (medially) and deltoid muscle (laterally). The distal approach of 3-5 cm was performed by subperiosteal dissection of the lateral supracondylar ridge of the humerus, with retraction of brachioradialis and long carpal extensor muscle, as well as the radial nerve, even though unseen. A classic or a DCP plate of 4.5 mm with 10-14 holes was molded and twisted medially to adapt to the anterior face of the humeral lateral column and diaphysis, thus avoiding occlusion of the coronoid or of the olecranon fossae. The plate was inserted from distal to proximal and fixed onto the shaft with at least 2 proximal and 2 distal screws (after reestablishing the humeral axis, length and rotation). In a single case we have performed MIPO after surgical exploration of the nerve. The patient started a rehabilitation program immediately or after a short immobilization. 6 fractures in 6 patients (with arm wrestling mechanism in 3 cases) were operated by indirect reduction and biological plating, avoiding the related problems. According to AO classification, there was 1 fracture-type 12A, 2-type 12B and 3- type 12C. Results: 18 fractures healed within a mean time of 9 weeks after surgery, while we have recorded a non-union in an obese female patient. There were no vascular or nerve complications, except 3 transient paresthesia for the radial nerve. All primary neurological lesions recovered within 6-8 weeks. Elbow functional results were considered excellent according to SECEC score. Conclusions: The authors are promoting the advantages of this technique regarding safety and feasibility as well as plate stability which allows a fast rehabilitation. Even if it is a demanding technique, MIPO seems to be the best option for distal third humeral fractures and a viable solution for distal fractures with radial nerve palsy

Impactul COVID-19 asupra pacienților cu patologie neurologică preexistentă

Introduction. Patients with neurological disorders are more vulnerable to possible complications of COVID-19. Objective of the study. Analysis of COVID-19 impact on patients with pre-existing neurological disease from the cohort of the ENERGY registry in the Republic of Moldova. Materials and methods. 64 patients with pre-existing neurological disease were selected from the cohort of 169 patients in the ENERGY registry: stroke (32p), dementia (5p), Parkinson’s disease (2p), multiple sclerosis (2p), neuropathy (3p), neuromuscular pathology (2p) and other (21p). Results. The study group consisted of 54.7% men and 45.3% women, mean age was 64.53 ± 14.5 years, 12.5% smokers, 18.8% vaccinated. They had somatic comorbidities: hypertension - 79.7%, DM - 28.1%, cancer - 18.8% and renal pathology - 17.2%. Suffered complications 68.8% of patients of which: pneumonia (64.1%), dyspnea (45.3%), coagulation disorders (7.8%), cardiovascular complications (6.3%), and required mechanical ventilation (18.8%). Mortality rate - 40.6%. The neurological manifestations were stroke (53.1%), headache (48.4%), vertigo (34.4%), dysexecutive syndrome (26.6%), coma (18.8%), ataxia (18.7%), and vegetative signs (14.1%), hyperactive (12.9%) and hypoactive delirium (12.5%), myalgia (11%), and status epilepticus (7.9%). The modified Rankin scale was 1.81p before infection, 3.53p at discharge and 3.21p over 6 months. Conclusions. Patients with pre-existing neurological pathology experienced severe complications during COVID 19 infection, mainly pneumonia, suffered strokes, headaches, and coma with an increased mortality rate (40.6%).Introducere. Pacienții care suferă de afecțiuni neurologice sunt mai vulnerabili la complicațiile posibile ale infecției COVID-19. Scopul lucrării: analiza impactul infecției COVID-19 asupra pacienților cu patologie neurologică preexistentă din cohorta Republicii Moldova în registrul ENERGY. Materiale și metode. Din cohorta de 169 de pacienți din registru ENERGY au fost selectate 64 de pacienți cu patologia neurologica preexistentă: AVC (32p), dementa (5p), boala Parkinson, precum (2p), scleroza multipla (2p), neuropatie (3p), patologia neuromusculară (2p) și altele (21p). Rezultate: Lotul de studiu compus din 54.7% bărbați și 45.3% femei, vârsta medie 64.53±14.5 ani, 12.5 % fumători, 18.8% vaccinați. Au prezentat comorbidități somatice: HTA- 79.7%, DZ – 28.1%, cancer – 18.8% și patologie renală- 17.2%. Au suferit complicații 68.8%, dintre care: pneumonie (64.1%), dispnee (45.3%), tulburări de coagulare (7.8%), complicații cardiovasculare (6.3%) și au necesitat ventilație mecanica (18.8%). Rata de mortalitate - 40.6%. Manifestările neurologice au fost: AVC (53.1%), cefalee (48.4%), vertij (34.4%), sindrom disexecutiv (26.6%), coma (18.8%), ataxie (18.7%), semne vegetative (14.1%), delir hiperactiv (12.9%) și hipoactiv (12.5%), mialgii (11%), status epileptic (7.9%). Scala Rankin modificată înainte de infectare a fost 1.81p, la externare – 3.53p și peste 6 luni – 3.21p. Concluzii. Pacienții cu patologie neurologică preexistentă au prezentat complicații severe în timpul infectării cu COVID 19, preponderent pneumonie, au suferit accidente vasculare cerebrale, cefalee și comă cu rata de mortalitate crescută (40.6%)

IMPACT OF COVID-19 ON PATIENTS WITH PRE-EXISTING NEUROLOGICAL DISEASES

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Pacienții care suferă de afecțiuni neurologice sunt mai vulnerabili la complicațiile posibile ale infecției COVID-19. Scopul lucrării: analiza impactul infecției COVID-19 asupra pacienților cu patologie neurologică preexistentă din cohorta Republicii Moldova în registrul ENERGY. Materiale și metode. Din cohorta de 169 de pacienți din registru ENERGY au fost selectate 64 de pacienți cu patologia neurologica preexistentă: AVC (32p), dementa (5p), boala Parkinson, precum (2p), scleroza multipla (2p), neuropatie (3p), patologia neuromusculară (2p) și altele (21p). Rezultate: Lotul de studiu compus din 54.7% bărbați și 45.3% femei, vârsta medie 64.53±14.5 ani, 12.5 % fumători, 18.8% vaccinați. Au prezentat comorbidități somatice: HTA- 79.7%, DZ – 28.1%, cancer – 18.8% și patologie renală- 17.2%. Au suferit complicații 68.8%, dintre care: pneumonie (64.1%), dispnee (45.3%), tulburări de coagulare (7.8%), complicații cardiovasculare (6.3%) și au necesitat ventilație mecanica (18.8%). Rata de mortalitate - 40.6%. Manifestările neurologice au fost: AVC (53.1%), cefalee (48.4%), vertij (34.4%), sindrom disexecutiv (26.6%), coma (18.8%), ataxie (18.7%), semne vegetative (14.1%), delir hiperactiv (12.9%) și hipoactiv (12.5%), mialgii (11%), status epileptic (7.9%). Scala Rankin modificată înainte de infectare a fost 1.81p, la externare – 3.53p și peste 6 luni – 3.21p. Concluzii. Pacienții cu patologie neurologică preexistentă au prezentat complicații severe în timpul infectării cu COVID 19, preponderent pneumonie, au suferit accidente vasculare cerebrale, cefalee și comă cu rata de mortalitate crescută (40.6%).Introduction. Patients with neurological disorders are more vulnerable to possible complications of COVID-19. Objective of the study. Analysis of COVID-19 impact on patients with pre-existing neurological disease from the cohort of the ENERGY registry in the Republic of Moldova. Materials and methods. 64 patients with pre-existing neurological disease were selected from the cohort of 169 patients in the ENERGY registry: stroke (32p), dementia (5p), Parkinson’s disease (2p), multiple sclerosis (2p), neuropathy (3p), neuromuscular pathology (2p) and other (21p). Results. The study group consisted of 54.7% men and 45.3% women, mean age was 64.53 ± 14.5 years, 12.5% smokers, 18.8% vaccinated. They had somatic comorbidities: hypertension - 79.7%, DM - 28.1%, cancer - 18.8% and renal pathology - 17.2%. Suffered complications 68.8% of patients of which: pneumonia (64.1%), dyspnea (45.3%), coagulation disorders (7.8%), cardiovascular complications (6.3%), and required mechanical ventilation (18.8%). Mortality rate - 40.6%. The neurological manifestations were stroke (53.1%), headache (48.4%), vertigo (34.4%), dysexecutive syndrome (26.6%), coma (18.8%), ataxia (18.7%), and vegetative signs (14.1%), hyperactive (12.9%) and hypoactive delirium (12.5%), myalgia (11%), and status epilepticus (7.9%). The modified Rankin scale was 1.81p before infection, 3.53p at discharge and 3.21p over 6 months. Conclusions. Patients with pre-existing neurological pathology experienced severe complications during COVID 19 infection, mainly pneumonia, suffered strokes, headaches, and coma with an increased mortality rate (40.6%)

Complicațiile neurologice la pacienții cu infecția COVID-19: rezultatele ENERGY în Republica Moldova

Department of Neurology no. 1, Nicolae Testemitanu SUMPhBackground. ENERGY registry developed by the European Academy of Neurology study neurological manifestations in patients with COVID-19 infection. Diomid Gherman Institute of Neurology and Neurosurgery join these efforts in December 2020. Objective of the study. The aim of the study was to present the Moldovan cohort of patients with COVID 19 infection and neurological manifestation registered in the ENERGY. Material and Methods. The registry record demographic data, comorbidities, complications, new neurological finds in confirmed COVID-19 patients during the consultation or hospital stay, and status at discharge appreciated with Rankin score. The patients were evaluated at 6 and 12 months by phone. Results. Moldovan cohort of patients with COVID 19 and neurologic manifestation by May 2021 consist of 168 patients (50,6% men and 49,4% women). New neurological findings in patients with COVID-19 infection were: Stroke (62,5%); Headache (48,2%); Cognitive impairment (35,7%); Vertigo(32,2%); Disexecutive sindrom (27,3%); Stupor/coma (22,1%); Hipoactive delirium/ acute encefalopathy (17,9%); Myalgia (11,3%); Hiperactive delirium (9,5%); Dysautonomia (9,5%); Ataxia (9,4%); Spinal cord disorder (7,2%); Peripheral neuropathy(5,4%); Sleep disturbances (4,8%). Mortality rate in the cohort was 22.61%. Conclusion. The most frequently neurological manifestation was stroke, cognitive impairment and headache. They have many comorbidities, history of neurological disease, complication during hospital stay and high mortality rate.Introducere. Registrul ENERGY dezvoltat de Academia Europeană de Neurologie studiază manifestările neurologice la pacienții cu infecție COVID-19. Institutul de Neurologie și Neurochirurgie „Diomid Gherman” aderă la acest proiect din decembrie 2020. Scopul lucrării. Prezentarea unui lot de pacienți din Republica Moldova cu infecție COVID-19 și cu manifestări neurologice, înregistrați în Registrul ENERGY. Material și Metode. Registrul include date demografice, istoricul pacientului (deprinderi nocive, comorbidități), simptome și semne neurologice raportate la consultații și pe parcursul spitalizării, evoluția maladiei, inclusiv complicațiile sesizate și aprecierea stării la externare după scala Rankin. Pacienții au fost contactați și evaluați la 6 și 12 luni prin telefon. Rezultate. Lotul de pacienți cu COVID-19 și manifestări neurologice până în mai 2021 consta din 168 de pacienți (50,6% bărbați și 49,4% femei). Manifestările neurologice au fost: accidente cerebro-vasculare (62,5%); cefalee (48,2%); tulburări cognitive (35,7%); vertigo (32,2%); disexecutiv sindrom (27,3%); stupor/coma (22,1%); delir hipoactiv/encefalopatie acută (17,9%); mialgie (11,3%); delir hiperactiv (9,5%); disautonomia (9,5%); ataxie (9,4%); mielopatie (7,2%); polineuropatie (5,4%); tuburări de somn (4,8%). Rata de mortalitate reprezintă 22,61%. Concluzii. Cele mai frecvente manifestări neurologice sunt accidentele cerebro-vasculare, cefalee și tulburări cognitive. Acești pacienți au multe comorbidități, istoric pe patologii neurologice, dezvoltă complicații pe parcursul spitalizării și prezintă o rată înaltă de mortalitate

Mortalitatea la pacienții cu COVID-19 și afectare neurologică. Rezultatele registrului ENERGY în Republica Moldova

Background. The European Academy of Neurology registry (ENERGY) is an international instrument that studies neurological complications in patients with COVID 19. From December 2020, the Institute of Neurology and Neurosurgery adheres to this register. Objective of the study. Analysis of deceased patients with COVID 19 infection and neurological manifestations in the Republic of Moldova, registered in the ENERGY. Methods and materials. The registry includes general variables, demographics data (source of infection, place of visit, and duration of infection), comorbidities, neurological manifestations, and COVID-19 complications reported during hospitalization, diagnostic tests, disease progression. Results. The study included 58 deaths, 21 men (36.2%) and 37 women (63.8%), mean age - 70.6 ± 12.1 years; most examined at the hospital (98.3%); source of infection - unknown (84.5%). Reinfected with COVID-19 - 2 people, 8 patients were vaccinated. The neurological manifestations were: Stroke (62.1%), headache (41.4%), cognitive impairment (44.8%), vertigo (24.1%), myalgia (6.9%), hypersomnolence (12.1%), coma (3.4%), sleep disturbances (1.7%), disexecutive syndrome (35.5%). Complications were present in 87.9% of patients: dyspnea (63.8%), pneumonia (84.5%), cardiovascular (17.2%), ventilation (43.1%). 53 patients (91.4%) had multiple comorbidities. 79.3% patients were admitted to intensive care. Conclusions. Mortality rate is very high (34.3%) due to the presence of many comorbidities, risk factors, old age, the association of severe neurological manifestations with the development of complications during hospitalization. Women were the most prone.Introducere. Registrul Academiei Europene de Neurologie (ENERGY) reprezintă un instrument internațional care studiază complicațiile neurologice la pacienții cu infecția COVID-19. Din decembrie 2020 Institutul de Neurologie și Neurochirurgie aderă la acest registru. Scopul lucrării. Analiza pacienților decedați cu infecție COVID-19 și cu manifestări neurologice din Republica Moldova, care au fost înregistrați în registrul ENERGY. Material și metode. Registrul include variabile generale, date demografice (sursa de contagiune, locul vizitei, durata infecției), comorbidități, manifestări neurologice și complicațiile COVID-19 raportate pe parcursul spitalizării, testele diagnostice, evoluția maladiei. Rezultate. Studiu a inclus 58 decese, 21 bărbați (36.2%) și 37 femei (63.8%) cu vârsta medie 70.6 ± 12.1 ani; majoritatea examinați la spital (98.3%); sursa de infectare – necunoscută (84.5%). S-au reinfectat cu COVID-19 – 2 persoane, s-au vaccinat - 8 pacienți. Manifestările neurologice au fost: AVC (62.1%),cefalee (41.4%),tulburări cognitive (44.8%), vertigo (24.1%), mialgie (6.9%), hipersomnolența (12.1%), coma (3.4%), tulburări de somn (1.7%), disexecutiv sindrom (35.5 %). Complicațiile au fost prezente la 87.9% pacienți: dispnee (63.8%), pneumonie (84.5%), cardiovasculare (17.2%), ventilație (43.1%). 53 pacienți (91.4%) au avut comorbidități multiple. Au fost admiși în terapie intensivă 79.3% pacienți. Concluzii. Rata de mortalitate este foarte înaltă (34.3%) din cauza prezenței multor comorbidități, factori de risc, a vârstei înaintate, asocierea manifestărilor neurologice severe cu dezvoltarea complicațiilor pe parcursul spitalizării. Femeile au fost cele mai predispuse

MORTALITY IN PATIENTS WITH COVID-19 AND NEUROLOGICAL IMPAIRMENT. RESULTS OF ENERGY STUDY IN THE REPUBLIC OF MOLDOVA

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Registrul Academiei Europene de Neurologie (ENERGY) reprezintă un instrument internațional care studiază complicațiile neurologice la pacienții cu infecția COVID-19. Din decembrie 2020 Institutul de Neurologie și Neurochirurgie aderă la acest registru. Scopul lucrării. Analiza pacienților decedați cu infecție COVID-19 și cu manifestări neurologice din Republica Moldova, care au fost înregistrați în registrul ENERGY. Material și metode. Registrul include variabile generale, date demografice (sursa de contagiune, locul vizitei, durata infecției), comorbidități, manifestări neurologice și complicațiile COVID-19 raportate pe parcursul spitalizării, testele diagnostice, evoluția maladiei. Rezultate. Studiu a inclus 58 decese, 21 bărbați (36.2%) și 37 femei (63.8%) cu vârsta medie 70.6 ± 12.1 ani; majoritatea examinați la spital (98.3%); sursa de infectare – necunoscută (84.5%). S-au reinfectat cu COVID-19 – 2 persoane, s-au vaccinat - 8 pacienți. Manifestările neurologice au fost: AVC (62.1%),cefalee (41.4%),tulburări cognitive (44.8%), vertigo (24.1%), mialgie (6.9%), hipersomnolența (12.1%), coma (3.4%), tulburări de somn (1.7%), disexecutiv sindrom (35.5 %). Complicațiile au fost prezente la 87.9% pacienți: dispnee (63.8%), pneumonie (84.5%), cardiovasculare (17.2%), ventilație (43.1%). 53 pacienți (91.4%) au avut comorbidități multiple. Au fost admiși în terapie intensivă 79.3% pacienți. Concluzii. Rata de mortalitate este foarte înaltă (34.3%) din cauza prezenței multor comorbidități, factori de risc, a vârstei înaintate, asocierea manifestărilor neurologice severe cu dezvoltarea complicațiilor pe parcursul spitalizării. Femeile au fost cele mai predispuse.Background. The European Academy of Neurology registry (ENERGY) is an international instrument that studies neurological complications in patients with COVID 19. From December 2020, the Institute of Neurology and Neurosurgery adheres to this register. Objective of the study. Analysis of deceased patients with COVID 19 infection and neurological manifestations in the Republic of Moldova, registered in the ENERGY. Methods and materials. The registry includes general variables, demographics data (source of infection, place of visit, and duration of infection), comorbidities, neurological manifestations, and COVID-19 complications reported during hospitalization, diagnostic tests, disease progression. Results. The study included 58 deaths, 21 men (36.2%) and 37 women (63.8%), mean age - 70.6 ± 12.1 years; most examined at the hospital (98.3%); source of infection - unknown (84.5%). Reinfected with COVID-19 - 2 people, 8 patients were vaccinated. The neurological manifestations were: Stroke (62.1%), headache (41.4%), cognitive impairment (44.8%), vertigo (24.1%), myalgia (6.9%), hypersomnolence (12.1%), coma (3.4%), sleep disturbances (1.7%), disexecutive syndrome (35.5%). Complications were present in 87.9% of patients: dyspnea (63.8%), pneumonia (84.5%), cardiovascular (17.2%), ventilation (43.1%). 53 patients (91.4%) had multiple comorbidities. 79.3% patients were admitted to intensive care. Conclusions. Mortality rate is very high (34.3%) due to the presence of many comorbidities, risk factors, old age, the association of severe neurological manifestations with the development of complications during hospitalization. Women were the most prone