Неинвазивная диагностика заболеваний печени

Department of Pediatrics, Nicolae Testemitanu State Medical and Pharmaceutical University, Congresul III al Medicilor de Familie din Republica Moldova, 17–18 mai, 2012, Chişinău, Republica Moldova, Conferinţa Naţională „Maladii bronhoobstructive la copii”, consacrată profesorului universitar, doctor habilitat Victor Gheţeul, 27 aprilie, Chişinău, Republica MoldovaNoninvasive tests quickly and reliably differentiate patients with advanced fibrosis and those without fibrosis; they can be used as a rapid method of screening patients with infections and with hepatitisviruses B, C, D. Elastography is a method based on ultrasound, a non-invasive concept in assessing the nature of the tissue, which provides information about the elasticity of tissue examined and the degree of fibrosis. Noninvasive tests are an attractive alternative to liver puncture biopsy for staging and monitoring of chronic liver disease. Elastography examination for children is a priority because it is a noninvasive method with high information (data) and can be applied in medical practice in screening, diagnosis and monitoring of patients.Неинвазивные тесты позволяют оперативно и достоверно дифференцировать пациентов с F1-F4 стадиями фиброза печени и могут быть использованы в качестве как скрининга, так и мониторинга за пациентами с вирусными инфекциями B, C, D. Эластография является методом, основанным на ультразвуковой неинвазивной концепции в оценке морфологической структуры ткани, и предоставляет информацию об ее эластичности и степени фиброза. Неинвазивные тесты предстают привлекательной альтернативой пункционной биопсии печени для стадиализации и мониторинга хронических заболеваний печени. Метод эластографии печени у детей является приоритетным, поскольку является неинвазивным с высокой степенью информативности и достоверности и может применяться в медицинской практике в качестве скрининга, диагностики и мониторинга пациентов с патологией печени

Diagnostic possibilities of PID in the Republic of Moldova

Departament of Pediatrics, State Medical and Pharmaceutical University “Nicolae Testimiteanu”, Republic of MoldovaAwareness activities: PID are rather rare disorders but they are more common than it was estimated. The rate of recognition and diagnosis of PID is directly dependent on awareness of medical staff (JMF manuscript 2011). According to V.Modell (2011), founder of the JMF, the awareness of medical staff and patients concerning PID remains low all over the world and the majority of patients with recurrent infections are not diagnosed or underdiagnosed. In fact, PID prevalence levels exceed the official data. The handbook entitled “Primary Immunodeficiencies in children” was elaborated for family practitioners, pediatricians and medical residents, and published in 2012. It covers the following topics: general information about children immune system, 10 warning signs for children with PID, clinical presentation, immunological and genetic features of the most common PID syndromes, diagnostic algorithms, and tables with reference values of immunological tests. New diagnostic possibilities of PID in Moldova (2012). Determination of lymphocyte subpopulations using cytoflowmetric analysis, assessment of the IgG subclasses, IgD, evaluation of the C1-estherase activity, phagocytic burst-test using dihydrorhodamine, phagocyitosis killing activity (E.coli) using cytoflowmetric analysis. Algorithm diagnostic of PID in Moldova: Clinical screening – 10 warning signs of PID JMF(clinical features characteristic for well-defined syndromes of PID are also taken into consideration). At risk of PID patients primary are evaluated:: family history, clinical course of disease (especially infectious syndrome characteristic for different forms of PID), documented presence of other features of PID (autoimmunity, malignancy), documented presence of other conditions which can because of infectious susceptibility (structural abnormalities, cystic fi brosis, etc). Children with major risk of IDP are selected and laboratory screening: WBC manual count is made, total IgA, IgG, IgM, Ig E. Patients with major risk of PID are examined using different diagnostic protocols depending on clinical presentation. Different immunological tests are carried out according to the Practice Parameter for the diagnosis and management of PID (Bonilla F. et al., 2005). ESID criteria for PID are used to establish the possible, probable and definitive diagnosis of PID if appropriate. Current situation: 6 children are diagnosed with PID in Moldova currently: • 5 patients with IgA selective deficiency (6-8 years old) • 1 patient with Di George syndrome (4 years old) Currently more than 150 genetic defects determining severe disorders of the immune system have been described. According to the European Society for Primary Immunodefi ciencies database most of the reported immune deficiencies occur with a frequency of not less than 1:100000. The improvement of the diagnosis PID will help to achieve in 2013-2014 the Project “Complex diagnostic approach for patients with rare forms of primary immunodeficiency” which will be achieved with Belarus Republic. Objective of the Project: To elaborate effective diagnostic approach based on the analysis of retrospective and prospective clinical, immunological and genetic data of patients with rare primary immunodeficiency syndromes in the territory of the Republic of Moldova and the Republic of Belarus. It is aimed to perform an in-depth analysis of the disease history, clinical data and immunological disorders in patients with rare (1:100000 to 1:1000000) primary Immunodeficiencies in Moldova and the Republic of Belarus. At least 50 patients with 20 primary immunodefi ciency syndromes of rare incidence will be included. On the basis of the received data in Moldova and the Republic of Belarus a similar algorithm and check-list for clinical and immunological assessment will be developed for children with rare primary immunodefi ciencies. Therefore, a complex diagnostic approach must be elaborated for rare primary immunodefi ciency syndromes, which will include clinical, immunological and genetic features, and will contribute to the same effective as for common immunodefi - ciency syndromes early diagnosis and appropriate treatment. Activities which will help to improve PID diagnosis in Moldova: Implementation of lectures on childhood PID topics in the curricula of postgraduate training for family doctors and pediatricians. PhD research on PID problems. Organization of the J Project meeting in Moldova in the nearest future

Psychopathology of defective conditions in schizophrenia

Catedra Psihiatrie, Narcologie şi Psihologie Medicală USMF „ Nicolae Testemiţanu” IMSP Spitalul Clinic Psihiatrie Centrul Medical „Fluid”The concept of residual state in schizophrenia doesn’t have a well-established definition according to up-to-date principles. The clinical description limits its attention to the recognition of the classic triad of symptoms revealed by Kraepelin in 1913 as: intellectual decay, aboulia and prostration, pseudo-psychopathic disturbances. In the development of residual states three factors were observed: clinical-dynamic, exogenous and endogenous factors. As syndromes 16 types of residual states were distinguished. The development of the residual states comprises three continuous stages: the primary stage, the stage of determination of “negative” symptoms, the stage of constant residual disturbances. In conclusion, we should remark that this concept needs a continuous investigation, because the present bibliography doesn’t assess the definitive adequate clinical-dynamic for these conditions present in schizophrenia. Noţiunea de stare reziduală în schizofrenie, în conceptele actuale nu are o definiţie bine structurată. Descrierea clinică se reduce la constatarea triadei clasice de simptome elaborată de Kraepelin în 1913: Scădere intelectuală, abulie şi anergie, tulburări pseudopsihopatice. În evoluarea stărilor reziduale se pot constata 3 factori: clinico-dinamici, endogeni şi exogeni. Sub aspect sindromologic se deosebesc 16 tipuri de stări reziduale (Leonhard, 1957). Evoluţia stărilor reziduale reprezintă 3 etape consecutive: Etapa iniţială, etapa stabilirii simptomelor „negative” , etapa tulburărilor reziduale constante. În concluzii, sursele bibliografice nu oferă suficiente criterii definitorii şi clinico-evolutive asupra acestor stări evolutive din schizofrenie, fapt pentru care necesită investigaţii în continuare

Влияние эмболических осложнений при инфекционном эндокардите

Department of Internal Medicine, Discipline of Cardiology, Medical Clinic No 3, Congresul III al Medicilor de Familie din Republica Moldova, 17–18 mai, 2012, Chişinău, Republica Moldova, Conferinţa Naţională „Maladii bronhoobstructive la copii”, consacrată profesorului universitar, doctor habilitat Victor Gheţeul, 27 aprilie, Chişinău, Republica MoldovaInfective Endocarditis (IE) is a severe disease with an in-hospital mortality rate of up to 20%, mostly due to embolic complications which increase the risk of death about 3 times. The incidence of cerebral embolism is 17-20% of all patients with IE, being probably underestimated because of its silent clinical evolution. Our survey data have revealed the presence of the embolic complications in 17% of all cases of IE, of which cerebral embolism prevailed 6.4%, followed by lung embolism in 4.3% of cases. The embolic syndrome developed more frequently in patients with valvular vegetations in 72.2%, being influenced by vegetation mobility, aortic location and by the pathogenic agent – Stph. Aureus. In IE, the embolic complications are widely undiagnosed and require imaging investigations (CT, MRI, Doppler investigation) for early diagnosis, initiation of appropriate treatment and improved prognosis in these patients.Инфекционный эндокардит (ИЭ) – это тяжёлое заболевание, с госпитальной летальностью до 20%, в основном из-за эмболических осложнений (ЭО), которые увеличивают риск смерти в 3 раза. Частота эмболий в мозговых артериях достигает 17-20% из всех пациентов с ИЭ. У обследованных нами больных эмболические осложнения развились в 17% случаях и преобладали церебральные эмболии в 6,4% случаях и легочные эмболии в 4,3% случаях. ЭО более часто, в 72,2% случаях, развились у пациентов с вегетациями на клапанах сердца, особое влияние имело мобильность вегетаций, аортальная локализация и возбудитель – золотистый стафилококк. Эмболические осложнения часто несвоевременно диагносцируются, из-за «скрытой» клиники, поэтому необходима ранняя диагностика (КТ, МРТ, Допплер сосудов) для уточнения диагноза, назначение своевременного лечения, критерии, которые повлияют положительно на прогноз пациентов с ИЭ

Синдром хронической почечной недостаточности у детей

The authors present a clinical observation of a patient with chronic renal failure, as well as the literature data, regarding pathogenesis of this severe condition.Автор представляет клиническое наблюдение пациента с хронической почечной недостаточностью. Представлен обзор литературы и выдвинутых до сих пор патогенетических гипотез

CATALYTIC WAVE OF CHLORATE IONS IN THE PREZENCE OF THE MOLYBDENUM (VI) - 2,3-DIHYDROXYBENZALDEHYDE COMPLEX

The polarographic catalytic current in acid solutions of Mo(VI), 2,3-dihydroxybenzaldehyde (2,3-DHBA) and chlorate ions has been investigated. The scheme of reactions taking place in the solutions and on the electrode has been elaborated. The increase of the catalytic current is explained by the formation of the active intermediate complex [Mo(V)×2,3-DHBA (ClO3-)]. The rate constant of formation for the active intermediate complex K = 2.5 × 106 mol-1 × dm3 × s-1, the activation energy of reaction Ea=14.0 kcal×mol-1 and the activation entropy ∆Sa¹= -28.3 e.u. have also been determined

THE INFLUENCE OF THIOSEMICARBAZONE 2,3-DIHYDROXYBENZALDEHYDE ON CATALYTIC CURRENTS IN THE SYSTEM MOLYBDENUM (VI) – POTASSIUM CHLORATE IN ACID SULFATE SOLUTIONS

The polarographic catalytic current in acid solutions of Mo(VI), thiosemicarbazone 2,3-dihydroxybenzaldehyde (TSC 2,3-DHBA) and chlorate ions has been investigated. The scheme of reactions, taking place in the solutions and on the electrode, has been proposed. The increase of the catalytic current is explained by the formation of an active intermediate complex [Mo(V)×TSC 2,3-DHBA (ClO-3)]. The rate constant of this complex formation K = 2.56 × 106 mol-1×dm3×s-1, the activation energy Ea = 15.9 kcal×mol-1 and the reaction activation entropy ∆Sa¹ = -23.5 e.u. have been calculated

DESIGN AND SYNTHESIS OF COORDINATION COMPOUNDS WITH TETRADENTATE LIGANDS DERIVED FROM ALKYLATED THIOSEMICARBAZIDE

This work is devoted to the investigation of the template reactions of organic compounds derived from S-alkylisothiosemicarbazide and β-dicarbonylic compounds (acetyl(benzoyl)acetone, 2,6-diformylpyridine, 2,6-diformyl-4-methylphenol, 1-hydroxy-2-naphthaldehyde, sodium nitromalonic dialdehyde, 1,1,3,3-tetraetoxypropane, 3-ethoxyacroleine) in the presence of 3d-metal ions, determination of the structure and properties of the prepared complexes. There were elaborated original methods for synthesis of open-chain or macrocyclic coordination compounds of nickel(II), copper(II), oxovanadium(IV) and cobalt(II) with N4, N3O and N2O2 tetradentate ligands. Two types of hexaazamacrocyclic systems with trans- and cis- arrangement of thiosemicarbazide fragments have been obtained using template condensation of different precursors. The biostimulative properties (biomass accumulation and increasing of enzymatic activity) of complexes have been established. Some complexes of nickel(II) have been studied as coloring agents for plastics

Synthesis, physicochemical properties and crystal structure of isothiocianato [2-(diphenylphosphino)benzaldehyde selenosemicarbazonato(1(-))] nickel(II)

The syntheses of a new ligand 2-(diphenylphosphino)benzaldehyde selenosemicarbazone (HL) and the corresponding complex with Ni(II) of the formula [Ni(L)(NCS)] are reported. The complex was characterized by single crystal X-ray analysis. The compound complex is diamagnetic and has a markedly deformed square-planar structure with PNSe set of donor atoms of the ligand, the Schiff base monoanion, and the N atom of the coordinated NCS group. The phosphorus atom deviates even by 0.494(3) Angstrom from the mean plane defined by the other coordination atoms (NSeN) and the metal atom. (C) 2003 Published by Elsevier B.V