The eating behaviors and nutritional status of school teachers

Introduction. There have been studies that have demonstrated the positive association between the incidence of diseases and irrational nutrition, which is characterized by serious violations of the diet, deficiency of vitamins, minerals, mainly calcium, magnesium, diets that do not meet regulatory requirements for content of the main food groups. The aim of this study was to investigate the association between eating behavior with nutritional status and body composition of high schools’ teachers. Material and methods. In order to achieve the proposed goal, a descriptive cross-sectional study was performed. Data collection was carried out in 2 stages. The first stage was the application of a structured questionnaire that was applied online. This questionnaire contains a total of 159 questions, of which 96 – determined the demographic grade and general clinical status,37 referred to the teachers' diet, 24 were organized in the form of a psychological questionnaire in which the respondents’ answers were appreciated on a scale with degrees from 0 to 5. The second stage was bioelectrical impedance analysis (BIA) of a sample using the TANITA BC730. The study sample consisted of 519 teachers, heads of departments and directors from a single school board, from the Republic of Moldova. Complex sample analyses were conducted using SPSS version 22.0 (IBM Corporation, Chicago, IL). Results. Women represented 97% of respondents from the primary schools and 89% – from the secondary schools. Average age was 46.6±3.77 years old. The work experience was 20.4±11.3 years. The majority of them were working in public schools (primary school – 4.6%; gymnasium – 52.2%, secondary schools – 43.2%) and 12.3% – in private schools. Most teachers were married (83.4%) and had in their custody on average 2 children (54.7%). Evaluating the body composition, the following data were obtained: teachers had an average height of 164.6±6.20cm; body mass – 67.9±14.2 kg; the share of body fat-28.4±8.87%; the muscle mass – 45.6±8.5kg; the bone mass – 2.4±0.42 kg; the BMI – 24.9±4.28; body water percentage – 52.3±5.89%; the metabolic age – 40±12.6 years; the daily energy requirement – 2370.2±455.11 kcal. More than 25.8±6.25% eat 2 times a day and more than 28.9±4.89% don't keep track. Around 46.0±9.57% claimed that they do not eat healthy and 37.6±12.09% said that they do not eat according to their age. Using Segmental body composition monitor model, we obtained that in 36.4±11.23% teachers have a subnormal constitutional and normal aesthetic type, 27.3±7.25% developed an overweight constitutional type and 9.1±0.25% – obese. More than 90.9±15.92% of teachers were at risk of developing osteoporosis. Conclusions. The health-saving behavior of teachers in relation to food was not formed. Teachers' awareness of the requirements of a healthy diet is insufficient, superficial, as a result, but also due to lack of time and, as the respondents admit, "laziness", with a sufficiently high motivation of teachers to improve their nutrition. Identified nutritional disorders affect the health and nutritional status of teachers

Teachers’ diet as a risk factor of the occupational environment in primary and general secondary educational institutions in the Republic of Moldova

Rezumat Obiective. Studiul a avut drept scop evaluarea igienică a regimului alimentar a cadrelor didactice ca factor de risc al mediului ocupațional. Material și metode. A fost realizat un studiu descriptiv transversal cu includerea a 519 cadre didactice, care activează în instituțiile de învățământ preuniversitar din Republica Moldova. Rezultate. Femeile au alcătuit 97% din respondenți. S-a constatat, că doar 8% din respondenți respectau regimul alimentar, iar circa 19% se alimentau luând masa doar o singură dată pe zi. Conform rezultatelor anchetării de mese diversificate au avut parte mai puțin de 46%. Regimul alimentar incorect a cauzat apariția unor patologii a aparatului digestiv la 34% de cadre didactice și a problemelor de sănătate a sistemului circulator – la 30% de respondenți. Concluzie. Rezultatele studiului demonstrează importanța regimului alimentar ca factor de risc, inclusiv ocupațional, pentru cadrele didactice.Summary Objectives. The aim of the study was the hygienic evaluation of the teachers’ diet as a risk factor of the occupational environment. Material and methods. A cross-sectional descriptive study was carried out with the inclusion of 519 teaching staff, who work in pre-university educational institutions in the Republic of Moldova. Results. Women made up 97% of respondents. It was found that only 8% of the respondents respected the diet, and about 19% ate only once a day. According to the results of the survey, less than 46% had diversified meals. The incorrect diet caused the appearance of pathologies of the digestive system in 34% of teachers and health problems of the circulatory system – in 30% of respondents. Conclusion. The results of the study demonstrate the importance of diet as a risk factor, including occupational, for teachers

Оценка факторов среды и поведенческих факторов, влияющих на состояние здоровья юных футболистов

Universitatea de Stat de Medicină și Farmacie Nicolae Testemiţanu, Şcoala de Management în Sănătate Publică, Centrul Național de Medicină Sportivă Atletmed, Conferinţa știinţifico-practică cu participare internaţională ”Medicina sportivă: provocări și perspective” Chişinău, 12-13 noiembrie 2015Each type of sport is characterized by physical and psychoemotional high intensity overload, specifi c training, and different environmental factors action: climatic, mechanical, chemical, food, etc. The study was done on a group of 62 young football players. It was developed a questionnaire for the study of environmental and behavioral factors, health status and symptoms of overtraining. The outcomes show that 87,9% of athletes are satisfi ed with the training conditions, 48% of athletes reported about the presence of unfavorable environmental factors (air pollution, noise, etc.). Athletes eat 3 times a day, the meal is diversifi ed, composed of at least 2 courses, the highest share being at dinner, consuming meat and fresh fi sh. Most junior athletes (77%) have part of a full post effort recovery and lack of concentration is one of the most frequently mentioned complaints. Каждый вид спорта характеризуется физической и психомоциональной перегрузкой высокой интенсивности, специальной подготовкой, а также различными действиями факторов окружающей среды: климатических, механических, химических, питания и др.В исследовании приняли участие 62 молодых футболиста. Была разработана анкета для изучения экологических и поведенческих факторов, состояния здоровья и симптомов перетренированности. Результаты показывают, что 87,9% спортсменов удовлетворены условиями тренировки, 48% спортсменов сообщили о наличии неблагоприятных факторов внешней среды (загрязнение воздуха, шум и т.д.). Спортсмены питаются 3 раза в день, еда разнообразная, состоит по меньшей мере из 2-х видов, наибольшая доля приходясь на ужин, потребляют мясо и свежую рыбу. Для большинства юных спортсменов (77%) характерно полное восстановление, а отсутствие концентрации является одним из наиболее часто упоминаемых симптомов

Epidermolysis bullosa – a clinical study

Generalităţi. Au fost analizate fi șele de observaţie clinică (41 de cazuri) ale pacienţilor cu epidermolize buloase (EB), trataţi în perioada 2000-2014, în cadrul Spitalului Dermatologie și Maladii Comunicabile. Rezultate obţinute. Vârsta pacienţilor a oscilat între 2 luni și 52 de ani (m/f –28/13; rural/urban – 25/16). Spectrul nosologic depistat, s-a prezentat în felul următor: epidermoliza buloasă simplă (EBS) Koebner – 11 cazuri; EBS Weber–Cockayne – 9 cazuri; EBS asociată cu tulburări de pigmentare – 1 caz; epidermoliza buloasă joncţională (EBJ) Herlitz – 1 caz; epidermoliza buloasă distrofi că dominantă (EBDD) Cockayne-Touraine – 12 cazuri; EBDD Passini – 3 cazuri; epidermoliza buloasă distrofi că recesivă (EBDR) Hallopeau–Siemens – 4 cazuri. Așadar, EBS s-a constatat în 51,2% cazuri, EBJ – în 2,4% și EBD – în 46,34% cazuri. Manifestările buloase de epidermoliză au fost asociate cu o afectare unghială în 48,8% cazuri. Hiperhidroza, keratodermia palmo-plantară, alopecia și leziunile ichtioziforme s-au evidenţiat în 12,2% cazuri. La circa o jumătate dintre pacienţi au fost constatate o serie de maladii concomitente (anemii, pneumonii, hepatite, pancreatite, pielonefrite). Anomaliile dentare și afectarea mucoaselor s-au raportat la o treime dintre pacienţi, fi ecare al zecelea pacient având și retard mental. La circa 20% cazuri, au fost observate complicaţii cu agenţi microbieni (piodermii), iar la bolnavii cu EBDR Hallopeau–Siemens – cheloizi, acrosclerodactilie, contracturi, mutilaţii, stenoze esofagiene. Un caz de deces s-a constatat la pacientul cu EBJ Herlitz, la 2 luni de la naștere. O evoluţie favorabilă s-a observat la pacienţii cu forme epidermolitice și distrofi ce dominante (63,4%). Pe durata tratamentului de rutină, s-a constatat apariţia bulelor noi la toţi bolnavii. Epitelizarea eroziunilor s-a observat pe parcursul a 5-14 zile. După includerea în tratamentul topic a pansamentelor „Mepilex Lite”, „Mepitel”, durata epitelizării erupţiei s-a redus de 2 ori (3-7 zile). Concluzii. Profi lul epidermolizei buloase constată predominarea sexului masculin, precum și a formelor clinice de EB dominante; asocierea cu afectările unghiale și a mucoaselor, cu distrofi i dentare, anemii, complicaţii microbiene, în cazuri grave – acrosclerodactilie, mutilaţii, stenoză esofagiană. Încluderea în tratamentul topic a pansamentelor „Mepilex Lite”, „Mepitel” reduce durata epitelizării eroziunilor.Overview. The study included case histories of 41 patients with epidermolysis bullosa, who were treated in Hospital of Dermatology and Communicable Diseases during 2000-2014. Results. Patients’ age has oscillated from 2 till 52 years old (M/F-28/13; Rural/Urban – 25/16). Nosological spectrum ranged as follows: simple epidermolysis bullosa (EBS) Koebner–11 cases; EBS Weber-Cockayne – 9 cases; EBS associated with pigmented lesions – 1; jonctional epidermolysis bullosa – (EBJ) Herlitz – 1; dystrophic dominant form of EB (EBDD) Cockayne-Touraine – 12; EBDD Passini – 3; recessive form of EBD (EBDR) Hallopeau – Siemens – 4. Th us, EBS has been established in 51.2% of cases, EBJ – 2.4% of cases and EBD – in 46.34% of cases. Nail involvement was observed in 48.8 cases of EB. Hyperhidrosis, palmoplantar keratoderma, alopecia and ichthyosiform lesions were marked in 12.2% of cases. About half of patients has manifested a plenty number of associated diseases (anemia, pneumonia, hepatitis, pancreatitis, pyelonephritis). Dental anomalies and mucous membranes involvement were reported in 1/3 of patients, one in every 10 patients presented a mental retardation. In 20% of cases pyococcal complications (pyodermas) was described, in addition patients with EBDR Hallopeau-Siemens have developed keloid scars, acrosclerodactylitis, muscular contractions, mutilations, esophageal stenosis. A 2 month old infant with EBJ-H has died. More benign evolution was marked in patients with dominant forms of EBD (63.4%). All patients have presented a new bulla during obvious therapy. Epithelization of erosions occurred within 5-14 days. Topical treatment with “Mepilex Lite”, “Mepitel” reduced twice the time of lesion epithelization (3-7days). Conclusions. Epidermolysis bullosa profi le certifi es prevalence of this disease among males, as well as, increased number of dominant forms, association with nail and mucous membrane involvement, dental anomalies, anemia, microbial infections, in severe cases – acroscelro-dactylitis, mutilations, esophageal stenosis. “Mepilex Lite” and “Mepitel” dressings have reduced the time of lesion epithelization

Clinical and therapeutic aspects of granuloma annulare in children

Generalităţi. Granulomul inelar este o dermatoză cronică, inflamatorie, benignă, afectând în 2/3 din cazuri, copii și adolescenţi, cu predilecţie sexul feminin (raportul feminin/masculin fi ind de 2/1). În 85% cazuri, are un caracter localizat și o evoluţie sub 2 ani. Maladia a fost descrisă primar de Colcott-Fox în 1895. Obiective. Evaluarea particularităţilor clinico-evolutive şi de tratament ale granulomului inelar la copii. Material şi metode. Studiul clinic retrospectiv a cuprins 27 de copii (fete/băieţi – 19/8; rural/urban – 15/12) cu granulom inelar, trataţi în spitalul Dermatologie și Maladii Comunicabile, pe parcursul anilor 2008-2016. S-au luat în consideraţie datele clinico-evolutive, paraclinice şi cele de tratament. Rezultate. Vârsta medie a pacienţilor a constituit 5,2 ani. Conform vârstei, bolnavii au fost repartizaţi în felul următor: până la 1 an – 1 caz; 1-4 ani – 15 cazuri; 5-8 ani – 4 cazuri; 9-12 ani – 3 cazuri; 13-15 ani – 4 cazuri. Durata maladiei a oscilat între 2 săptămâni şi 4 ani. Maladiile concomitente intercurente semnalate: infecţii respiratorii acute – 4 cazuri; dermatită alergică postmedicamentoasă, tonzilită cronică în acutizare – câte 2 cazuri; enterobioză intestinală, varicelă, boala Lyme – câte 1 caz. Dintre alţi factori declanşatori posibili ai dermatozei au fost suspectaţi: traume – 2 cazuri; medicamente (antibiotice, antiinfl amatoare nesteroidiene, antiseptice) – 5 cazuri; proba intradermală cu tuberculină – 1 caz. La 2 fraţi, s-au constatat cazuri familiale de granulom inelar. Forma localizată de granulom inelar s-a evidenţiat la 17 pacienti, iar cea diseminată – la 10 (2-6 plăci) pacienţi. Localizarea leziunilor cutanate a fost asimetrică şi diversă: membre inferioare – 18 (faţa dorsală – 10, gambe – 5, genunchi – 2, coapse – 1), membre superioare – 6 (dosul mâinilor – 3, antebraţe – 2, coate – 1), trunchi – 3 cazuri. Examenul obiectiv a evidenţiat papule sau noduli mici, de culoare roz-liliachie, ferme, lipsite de semne subiective, grupate în inele, cu evoluţie centrifugă, placardele fi ind de dimensiuni de la 2-5 cm până la 8-10 cm în diametru. Din investigaţiile paraclinice remarcăm: anemie – 2 cazuri, leucocitoză – 6 cazuri, VSH crescut – 9 cazuri, enterobioză intestinală – 1 caz. Pacienţii au fost consultaţi de medici specialişti (ftiziopulmonolog, reumatolog, endocrinolog) pentru a exclude şi alte patologii. Examenul histopalogic al leziunilor a evidenţiat (8 cazuri) prezenţa unui infi ltrat granulos dermic slab (prevalent histiocitar); un epiderm nemodifi cat; plaje mai mult sau mai puţin întinse de colagen în suferinţă, cu fragmentarea, omogenizarea şi degenerescenţa fi brinoidă a benzilor acestuia. Tratamentul s-a efectuat în cure şi a inclus: vitamina A, vasodilatatoare (acid nicotinic, pentoxifi lină etc.), pansamente oclusive cu dermatocorticoizi (Advantan, Elocom, Dermovate), masaje cu azot lichid (10 sedinţe), ultrasunet asociat cu unguente vasodilatatoare (6-8 şedinţe). Durata medie a tratamentului a constituit 12-15 zile. Majoritatea bolnavilor au benificiat de 1-2 cure consecutive de tratament, la un interval de 1-2 luni. Vindecarea clinică s-a constatat la 25 de pacienţi, inclusiv 8 pacienţi au administrat o cură de tratament, 2 cure – 10 pacienţi, 3-4 cure – 5 pacienţi şi 5-6 cure – 4 pacienţi. Concluzii. Cea mai frecventă formă de granulom inelar se dovedeşte a fi cea constatată în 2/3 din cazuri la sexul feminin şi, în jumătate din cazuri, la copiii mici (1-4 ani), cu localizări pe membrele inferioare. Asocierea granulomului inelar cu boli interne (diabet zaharat, boli autoimune, maligne, limfo-proliferative etc.) nu s-a constatat, excepţie fi ind un caz de boală Lyme. De menţionat, efi cacitatea tratamentului combinat (topic, crioterapie, general) în cure repetate consecutive.Overview. The granuloma annulare is a benign inflammatory chronic dermatitis that in two thirds of cases affecting children and adolescents, prevailing in females (ratio female / male, being 2/1), having in 85% of cases a located character and evolving less than 2 years. The disease was described primarily by Colcott-Fox in 1895. Objectives. Evaluation of the particularities of clinical course and treatment of the granuloma annulare in children. Materials and methods. Retrospective clinical study included 27 children (girls / boys-19/8; rural / urban-15/12) with granuloma annulare, hospitalized in the Dermatology and Communicable Diseases Hospital, during the years 2008-2016. Evolving clinical data, laboratory tests and treatment have been taken into account. Results. The average age was 5,2 years. Patients were divided by age as follows: up to 1 year – 1 case; 1-4 years – 15 cases; 5-8 years – 4 cases; 9-12 years – 3 cases; 13 to 15 years – 4 cases. 15 were from rural areas, 12 children from the urban areas. Disease duration varied from 2 weeks to 4 years.  Intercurrent accompanying diseases were reported: acute respiratory infections – 4 cases; allergic dermatitis adverse drug reactions, chronic tonsillitis in acute worsening – 2 cases of each; intestinal enterobius, chickenpox, Lyme disease – 1 case of each. Among other possible triggers of dermatitis were suspected: trauma in 2 cases; medicines (antibiotics, NSAIDs, antiseptics) – 5 cases; intradermal test with tuberculin- 1 case. At two brothers were observed familial cases of granuloma annulare. Localized form of the annulare granuloma was revealed in 17 patients, and the disseminated form – 10 (2-6 plates) patients. Asymmetric localization of skin lesions was diverse, namely, lower limbs – 18 (dorsal side – 10; legs – 5; knee – 2; hip – 1); upper limbs – 6 (dorsal of the hands – 3; forearms – 2; elbows – 1). Local examination reveals papules or small nodules, by lilac pink colour, firm, without any subjective signs, divided into rings with a centrifugal evolution, the size of the plaques was from 2.5 cm to 10.8 cm in diameter. From clinical investigations we note: anemia – 2 cases, leukocytosis – 6 cases; increased ESR – 9 cases; intestinal enterobius – 1 case. The patients were consulted by specialist physicians (pulmonologist, rheumatologist, endocrinologist) to exclude other pathologies. Histopathology revealed lesions (8 cases): the presence of a weak dermal infi ltrate granular (histiocytic prevalence); epidermis unchanged; areas with  more or less extensive damaging of collagen, fragmentation, homogenization and fi brinoid degeneration of its bands. The treatment was carried out in the course, including: Vitamin A, vasodilators (nicotinic acid, pentoxifylline, etc.), occlusive dressing with topical corticosteroid (Advantan, Elocom, Dermovate), massages with liquid nitrogen (10 sessions), ultrasound associated with vasodilator unguents (6-8 sessions). Average duration of treatment was 12-15 days. Most patients received 1-2 consecutive treatment cycles with intervals of 1-2 months. The clinical healing has been found in 25 patients, including: a course of treatment 8 patients received, 2 cycles – 10 patients, 3-4 cures – 5 patients, 5-6 cures – 4 patients. Conclusions. The most frequent form of granuloma annulare proves to be a locazed form, found in two thirds of cases in female patients, and in half of cases in young children (1-4 years) localized on the lower limbs. The association of granuloma annulare with internal diseases (diabetes mellitus, autoimmune diseases, malignant, lympho-proliferative, etc.) was not found, the exception being a case of Lyme disease. It is mentioned, the effectiveness of combination therapy (topical, cryotherapy, general) in consecutive repeated courses

Scleroderma in children: clinical, evolutive and treatment particularities

Material si metode. Studiul retrospectiv a fost efectuat pe un lot de 31 de pacienţi (vârste 1-18 ani; fetiţe/băieţi – 24/10) cu sclerodermie circumscrisă (morfee), observaţi în secţia copii a Spitalului Dermatologie și Maladii Comunicabile, în perioada 2011-2015. S-au luat în consideraţie datele clinico-evolutive, paraclinice și cele de tratament. Rezultate. S-au observat următoarele forme clinice: morfeea în plăci – 25 de cazuri; atrofodermia Passini-Pierini – 4 cazuri; morfeea liniară (în bandă) și lichen scleroatrofi c Zumbush – câte 1 caz. Durata maladiei a oscilat în limitele de la 1-2 luni la 2 ani. Maladiile concomitente raportate: boala Lyme – 2 cazuri; sacroileită bilaterală, amigdalită cronică, alopecie areată, vitiligo diseminat, cheloizi multipli, nev pigmentar diseminat, pitiriazis versicolor – câte 1 caz. Leziuni cutanate multiple (2-6) la bolnavii cu morfee în plăci au fost semnalate în 24 de cazuri, dimensiunile fi ind, în 21 de cazuri, până la 5-12 cm. Localizarea erupţiilor: regiunile laterale ale toracelui și abdomen – 12 cazuri; extremităţi – 10 cazuri (membre inferioare – 7; membre superioare – 3); extremitate cefalică – 3 cazuri. Toate stadiile evolutive de morfee în plăci erau prezente în 7 cazuri și anume: în centru – o arie atrofi că, la mijloc – o zonă scleroasă și periferic – o bordură eritematoasă. Procesul cutanat s-a limitat la stadiul de induraţie în 11 cazuri, cel eritemato-edematos – 5 cazuri și de atrofi e – 2 cazuri. Forma liniară de morfee s-a localizat unilateral, la nivelul toracelui anterior, cu extindere pe membrul inferior drept. Lichenul scleroatrofi c Zumbush (sclerodermia în picături) s-a manifestat prin macule multiple, de 3-5 mm, rotund-ovalare, bine delimitate, alb-sidefi i, ușor deprimate, pe alocuri grupate, având localizări pe coapsă și gamba stângă. Leziunile cutanate, la bolnavii cu atrofodermie Passini-Pierini, au fost diseminate pe torace, abdomen, membre superioare/inferioare, prezentând plăci hipercromice, bine delimitate, 5-12 cm în diametru, cu o netă depresiune a tegumentului și lipsa semnelor infl amatorii, respectiv de scleroză. S-a efectuat un tratament general, topic, fi zioterapeutic în cure (3-8), în dependenţă de stadiul evolutiv (antibiotice, vasodilatatoare, ung. heparină, ung. tacrolimus, ultrasunete cu vasodilatatoare, enzime proteolitice, parafi noterapie etc.). Rezultatele tratamentului, la 15 bolnavi cu morfee în plăci, au fost bune după 2-4 cure și la 10 bolnavi – după 5-8 cure consecutive de tratament. Rezultate mult mai modeste au fost obţinute la pacienţii cu morfee liniară, observându-se o stabilizare a procesului abia după 3-5 cure de tratament. Bolnavii cu atrofodermie Passini-Pierini și lichen scleroatrofic Zumbush, practic, nu au răspuns la tratament. Concluzie. Studiul efectuat relevă o frecvenţă majoră a morfeei circumscrise în plăci multiple la copii, fi ind de 2 ori mai des întâlnită la sexul feminin și având un răspuns bun la tratament combinat în cure repetate consecutive. De mentionat, o asociere a morfeei circumscrise cu boala Lyme și diverse maladii autoimune.Material and methods. Th is retrospective study was made on 31 patients (aged 1-18; girls/boys – 24/10) with circumscribed scleroderma treated in the children’s department of the Hospital of Dermatology and Communicable Diseases during 2011-2015. Clinical, evolutive, paraclinical and treatment data were taken into consideration. Results. Th e following clinical types of scleroderma were observed: scleroderma in plaques – 25 cases, Passini-Pierini atrophic scleroderma – 4 cases; linear scleroderma – 1 case; Zumbush lichen sclerosus et atrophicus – 1 case. The duration of the disease ranged between 1-2 months to 2 years. The following concomitant diseases were reported: Lyme disease – 2 cases; bilateral sacroiliitis, chronic tonsillitis, alopecia areata, disseminated vitiligo, multiple keloids, disseminated pigmented nevus, pityriasis versicolor – 1 case each. Multiple cutaneous lesions (2-6) in patients with scleroderma in plaques were found in 24 cases, out of them, 21 cases had dimensions ranging from 5 to 12 cm. Localization of cutaneous lesions was: lateral regions of thorax and abdomen – 12 cases; extremities – 10 cases (lower extremity – 7 cases, upper extremity – 3 cases); cephalic extremity – 3 cases. All evolutive stages of scleroderma in plaques were found in 7 cases, in particular: atrophic region in the center, a mid-zone of sclerous derma, a peripheric erythematous zone. The cutaneous process was limited at the induration stage in 11 cases, at the edematous-erythematous stage in 5 cases, and atrophic stage in 2 cases. Linear scleroderma was localized unilaterally at the anterior part of the thorax with extension on the right lower extremity. Zumbush lichen sclerosus et atrophicus was represented by multiple macules, 3-5 mm in dimension, round-oval shape, well delimited, write-greyish in colour, slightly depressed, sometimes grouped were localized on the left thigh and calf. Cutaneous lesions in patients with Passini-Pierini atrophic scleroderma were disseminated on the thorax, abdomen, upper and lower extremities and represented well delimitated hyperchromic plaques, 5-12 cm in diameter, with skin depression and lack of infl ammatory and sclerotic signs. General, topic, physiotherapeutic treatment was applied in courses (3-8) depending on the evolutive stage (antibiotics, vasodilators, heparin unguents, tacrolimus, ultrasound with vasodilators, proteolytic enzymes, paraffin therapy etc.). Treatments’ results in 15 patients with scleroderma in plaques were good after 2-4 courses and in 10 patients after 5-8 consecutive courses. Modest results were obtained in one patient with linear scleroderma with stabilization of the results after 3-5 courses. Patients with Passini-Pierini and Zumbush scleroderma did not respond to the treatment. Conclusions. The study shows an increased frequency of circumcised scleroderma in plaques in children, and is twice more frequent in girls and has good response aft er treatment applied in consecutive courses. It also should be mentioned that circumcised scleroderma was associated with Lyme disease and several autoimmune diseases

Shingles in children

Generalităţi. Studiul clinic retrospectiv a fost realizat pe un lot de 28 de pacienţi (băieţi – 16, fetiţe – 12) cu Zona Zoster, trataţi în anii 2000-2015, în Spitalul Dermatologie și Maladii Comunicabile. Diagnosticul a fost stabilit în baza aspectelor clinice. Rezultate obţinute. Vârsta medie a pacienţilor a constituit 9 ani. Majoritatea erau din mediul rural (71,4%). Durata maladiei la spitalizare a variat între 3 și 5 zile. Maladii concomitente intercurente semnalate: dermatită de contact iritativă – 4 pacienţi; helmintoze – 2 pacienţi; rinofaringită acută și piodermie acută – câte 2 pacienţi; anemie nutriţională de gradul I, acnee vulgară, pitiriazis alb al feţei, obezitate și epilepsie – câte 1 pacient. Din antecedentele personale: 8 pacienţi au făcut infecţii respiratorii acute, iar 1 pacient a suportat o intervenţie chirurgicală privind viciul cardiac. Tratamentul ambulator a inclus coloranţi anilinici (15 cazuri) și aciclovir cu analgezice (6 cazuri). Caracterul sezonier al maladiei nu s-a observat. Expresia clinică de varicelă a fost înregistrată în fragedă copilarie la toţi bolnavii. Fenomenele prodromale (febră, cefalee, fatigabilitate) s-au manifestat la 7 pacienţi. Comune pentru bolnavii incluși în studiu, au fost acuzele la senzaţii de arsură, dureri discrete și parestezii. Sindromul algic pronunţat s-a înregistrat la 2 pacienţi cu vârste de 8 și 14 ani. Leziunile eritemato-veziculoase (formă tipică) s-au constatat la 25 de pacienţi. Forma hemoragică s-a observat la 3 pacienţi. Afectarea dermatomală asimetrică a fost comună și a inclus: intercostală – 20 de cazuri, lombsciatică și cefalică – câte 3 cazuri, femurală și toraco-abdominală – câte 1 caz. S-a indicat tratament general și topic: Aciclovir, analgezice, vitamine, laser He-Ne (fl ux iradiant la distanţă). Vindecarea clinică completă s-a observat în 10-14 zile de la iniţierea tratamentului. Complicaţii și reacţii adverse la tratament nu au fost semnalate. Concluzii. Zona Zoster pediatrică este rară, implicând, de obicei, vârstele școlare, se instalează pe un fundal de reactivare a focarelor de infecţie cronică și imunosupresie, tabloul clinic fi ind tipic, evoluţia ușoară, sindromul algic discret, iar tratamentul cu Aciclovir – eficient.Overview. Retrospective clinical study was conducted on a sample of 28 patients (boys – 16, girls – 12) with shingles, treated between 2000 and 2015 at the Hospital of Dermatology and Communicable Diseases. The diagnosis was based on clinical aspects. Results. Mean age of patients was 9 years old. Most were from rural areas (71.4%). Th e period before hospitalization varied between 3 and 5 days. Accompanying diseases inter-reported: irritant contact dermatitis – 4 patients; helminthosis – 2 patients; acute nasopharyngitis and acute pyoderma – 2 patients; nutritional anemia fi rst degree, acne, pityriasis white face, obesity and epilepsy – 1 patient each one. From personal history: 8 patients were with acute respiratory infections, and 1 patient – surgical correction of the cardiac defect. Outpatient treatment included aniline dyes (15 cases) and acyclovir with analgesics (6 cases). Th e seasonal nature of the disease was not observed. Th e clinical expression of chickenpox in early childhood was recorded in all patients. Prodromal phenomena (fever, headache, fatigability) occurred in 7 patients. Common for all the patients included in the study were the complaints of burning pain, minor aches and numbness. Intense algesic syndrome was recorded in 2 patients aged 8 to 14 years. Erythemato-vesicular lesions (typical form) were found in 25 patients. Bleeding form was noticed in 3 patients. Asymetrical dermatomal damage was common and included: intercostal – 20 cases lombosciatic and cephalic – 3 cases each one, femoral and thoraco-abdominal – 1 case each one. It was recommended general and topical treatment: acyclovir, analgesics, vitamins, He-Ne laser (radiant flux away). Complete clinical recovery was observed in 10-14 days after initiation of the treatment. Complications and side eff ects of the treatment were not observed. Conclusions. Pediatric shingles is rare, usually involves school ages, is placed on a background of reactivation of chronic infectious diseases and immunosuppression, the clinical picture is typical, with mild evolution, discrete painful syndrome and a good response to the acyclovir treatment

Kerion Celsi caused by Microsporum canis – clinical cases

Generalităţi. Au fost analizate 21 de fişe de observaţie clinică a bolnavilor, trataţi în anii 2000-2015, în spitalul Dermatologie şi Maladii Comunicabile pentru Tinea capitis infiltrativ-purulentă, provocată de Microsporum canis. Rezultate. Total bolnavi – 21, dintre care fetiţe – 7, băieţi – 14. Repartizarea conform vârstei a fost următoarea: până la 1 an – 1, 1-3 ani – 6, 4-7 ani – 11 şi 8-9 ani – 3 pacienţi, vârsta medie constituind 4 ani. Majoritatea pacienţilor erau din mediul rural (80%). La 15 pacienţi, durata maladiei a variat între 2-4 săptămâni, iar la 6 pacienţi – între 1 şi 3 luni. Majoritatea pacienţilor (17) au fost depistaţi în perioada vară-toamnă. Tratamentul ambulator, anterior spitalizărilor în clinica noastră, a inclus: corticosteroizi topici – 13 cazuri, antibiotice – 15 cazuri. Au fost înregistrate următoarele maladii concomitente: anemie nutriţională – 9 , enterobioză intestinală – 7 cazuri. Tabloul clinic, la internare, prezenta formaţiuni pseudotumorale multiple de tip Kerion Celsi (14 cazuri), cu aspect acut inflamator, purulent, zemuire pronunţată, cu dimensiuni între 2-3 şi 10-15 cm în diametru, cu margini regulate şi bine delimitate, dureroase la palpare. Erupţii solitare cu acelaşi aspect s-au observat la 7 pacienţi. Fluorescenţa verde-pal a fost identificată la 7 pacienţi, utilizând lampa Wood. Adenopatia regională (retroauriculară, cervical-posterioră, submandibulară) a fost semnalată la 16 pacienţi. Diagnosticul clinic a fost completat cu cel paraclinic prin prezenţa artrosporilor de tip Microsporum şi filamentelor miceliene scurte în materialul recoltat. La toţi pacienţii a fost identificată cultura Microsporum canis. Pacienţii au fost supuşi tratamentului corespunzător: Grizeofulvină (20 mg/kg corp/zi), keratoplastice (ung. Ichtiol 10%, ung. Levomycol), coloranţi anilinici (liquori Castellani, sol. Albastru de metilen 2%), tinctură de Iod 2-5%. Alopecia cicatricială reziduală s-a constatat la 6 copii. Concluzii. Cazurile clinice aduse în discuţie confirmă prezenţa micozelor de tip Kerion Celsi, provocate de Microsporum canis, la copiii cu un fundal morbid predispozant. Depistarea tardivă şi tratamentele neadecvate ale pacienţilor sunt soldate frecvent cu sechele sub formă de alopecie cicatricială. Menţionăm, totodată, raritatea formelor descrise.Overview. Were analyzed 21 clinical observation sheets of patients treated in the years 2000-2015 in Hospital of Dermatology and Communicable Diseases for infiltrative-purulent Tinea capitis caused by Microsporum canis. Results. Total number of patients – 21, of which girls – 7, boys – 14. Age distribution was as follows: up to 1 year old – 1, 1-3 y.o. – 6, 4-7 y.o. – 11 and 8-9 y.o. – 3 patients, average age being 4 years. Most patients came from rural areas (80%). The duration of disease in 15 patients was observed 2-4 weeks, in 6 patients – 1 to 3 months. Most patients (17) were found summer-autumn. The treatment before hospitalization included: topical corticosteroids – 13 cases, antibiotics – 15 cases. Among concomitant diseases were recorded: nutritional anemia – 9, intestinal enterobioza – 7 cases. The clinical features on admission included multiple pseudotumoral formations Kerion Celsi with a purulent acute-inflamatory aspect, pronounced press, having sizes 2-3 up to 10-15 cm in diameter with regular edges, well defined, painful on palpation. Unique eruptions with the same clinical features were observed in 7 patients. The pale-green fluorescence with Wood lamp was identified in 7 patients. Regional limph nodes (retroauricular, posterior cervical, submandibular) were detected in 16 patients. The clinical diagnosis was completed with the paraclinical one: the presense of arthrospores type Microsporum and short mycelial filaments in the collected material. In all patients was identified Microsporum canis culture. The treatment included: Grizefulvine (20mg/kg/day), keratoplastiks (ung. Ichtiol 10%, ung. Levomycol), aniline dyes (Liq. Castellani, Sol. Methilene blue 2%), iodine tincture 2-5%. The residual scar alopecia was observed in 6 children. Conclusions. Clinical cases brought to discussion confirm the presence of forms of Kerion Celsi type caused by Microsporum canis in children with predisposing morbid background. Late detection and improper treatment of patients commonly are resulting sequelae in the form of scar alopecia. Must be mentioned the rarity of described cases

Epidemiological peculiarities of trichomycosis in the Republic of Moldova

Generalităţi. S-a efectuat un studiu cu utilizarea metodei de analiză retrospectivă a datelor statistice prin morbiditatea pilomicozelor (microsporie, tricofiţie, favus) în perioada 1950-2015 şi a datelor Laboratorului micologic, acumulate în Dispensarul Dermatovenerologic Republican, astăzi Spitalul Dermatologie şi Maladii Comunicabile. Rezultate. Morbiditatea prin pilomicoze în RM, în anii 1950-2015, este caracterizată în felul următor: o dominare netă a tricofiţiei până în anul 1963, provocată în marea ei majoritate de fungi antropofili, cu un vârf al incidenţei în anii 1954 şi 1956; o scădere ulterioară evidentă a morbidităţii prin tricofiţie până în prezent şi modificarea spectrului micologic; prevalenţa microsporiei zooantropofile, începând cu anul 1964, cu o creştere progresivă a morbidităţii, maximele observându-se în anii 1974-1976, fără o scădere esenţială în ultimele decenii, comparativ cu anii 1980-1990; lipsa favusului din anul 1974. Media raportului microsporiei, tricofiţiei şi favusului în perioada susnumită a oscilat, respectiv: anii 1950-1959 – 1:34:1,9; anii 1960-1969 – 1:1,2:0,01; anii 1970-1979 – 5:1:0,0002; anii 1980- 1999 şi 2000-2015 – 9:1:0. Media incidenţei teritoriale în RM (nordul, sudul, centrul, Găgăuzia, Chişinău) a microsporiei/tricofiţiei în ultimii 5 ani (2011-2015) a constituit, respectiv: 15,04/1,64; 30,56/1,79; 36,72/3,94; 28,12/0,9; 31,8/0,9. De asemenea, în anii 2000-2015, se observă o prevalenţă absolută a fungilor zoofili, respectiv, Microsporum canis – 100% şi Trichophyton mentagrophytes var. gypseum – 98,3% cazuri. Concluzie. Astfel, microsporia zooantropofilă rămâne pilomicoza cea mai des înregistrată în RM (anul 2015) – 31 de cazuri la 100 000 populaţie, media incidenţei în centrul RM fiind cea mai înaltă (36,72 cazuri la 100 000 populaţie).Overview. A retrospective study was done analyzing statistical data on morbidity with trichomycosis (microsporosis, trichophytosis and favus) during 1950-2015 and data presented by mycological lab of Hospital of Dermatology and Communicable Diseases. Results. Morbidity due to trichomycosis in the Republic of Moldova during 1950-2015 is characterized as follows: negligible predominance of trichophytosis until 1963 caused, in majority of cases, by antropophylic fungi,the highest level was achieved in 1954 and 1956, respectively; then a significant decrease in cases number is observed until present days with changing of fungi causative agents; prevalence of zooantropophylicmicrosporia started to increase in 1964, the highest level was achieved in 1974-1976, and is still on top our days comparative with 80s-90s of XX century; cases of favus haven’t been registered since 1974. Microsporosis, trichopytosis and favus ratio has oscillated during the estimated period as follows: 50s-1:34:1.9, 60s – 1:1.2:0.01, 70s – 5:1:0.0002, 80-90s – and 2000-2015- 9:1:0. Territorial incidence media of microsporosis, trichophytosis and favus in the Republic of Moldova (North, South, Centre, Chisinau and Gagauzia ) in recent 5 years (2011-2015) amounted as follows: 15.04/1.64; 30.56/1.79; 36.72/3.94; 28.12/0.9; 31.8/0.9. Also, during 2000-2015 was observed an absolute prevalence of zooantrophylic fungi: Microsporum canis – 100% and Trichophyton mentagraphyte var. gypseum – 98.3% cases respectively. Conclusions. Thus, zooantropophylic microsporosis still represents the most frequent form of trichomycosis, in 2015 in the Republic of Moldova have been registered 31 cases per 100.000 population, average incidence in the central part of the country was the highest one (36.72 cases per 100.000 population)