Opinions on Medical Education, Options and Career Choices of 4th Year Medical Students

AbstractThe University of Medicine and Pharmacy of Tîrgu Mureş is the only medical university in Romania that offers Hungarian-language education. We aimed to find out the opinions of 4th year Romanian and Hungarian-language students regarding education in our University, their learning habits, options, and future career choices. We found significant differences between the two student groups both in terms of learning habits and career choices. One of our most important finding was that the majority of Hungarian students considered that university education does not properly prepare them for the practice of medicine – a fact that should be given further consideration

Częściowe usunięcie przytarczyc versus całkowite usunięcie przytarczyc z autoprzeszczepem we wtórnej nadczynności przytarczyc — jednoośrodkowe, prospektywne badanie w grupie 43 pacjentów

  Introduction: The need for parathyroidectomy remains high in the group of patients on long-term dialysis with medically refractory secondary hyperparathyroidism (sHPT). We aim to compare the results after subtotal parathyroidectomies (sPtx) and total parathyroidectomies with autotransplant (tPtx + AT) performed for sHPT at a single referral centre. Material and methods: This prospective study comparatively analysed sPtx and tPtx + AT performed in our department between February 2010 and December 2014. We followed-up both surgical techniques, with respect to the main clinical symptoms, laboratory data, mortality, and recurrent disease. Results: Forty-three patients on whom we performed 26 sPtx and 19 tPtx + AT were entered in the study. There were no statistically significant differences between groups as far as demographic and preoperative clinical data are concerned. We did not encounter postoperative mortality in either of the groups. The follow-up period was significantly longer for the sPtx group (p = 0.04). The immediate postoperative serum calcium levels were significantly lower in the tPtx + AT group (p = 0.009). Definitive hypoparathyroidism was encountered in two patients in the sPtx group (8.3%) and in one from the tPtx + AT group (5.26%). Four patients from the sPtx group (16.6%) and three from the tPtx + AT group (15.78%) died during the follow-up due to causes unrelated to parathyroidectomy. Overall we had two recurrences in the sPtx group and none in the tPtx + AT group (p = 0.57). Conclusions: In our opinion both techniques have comparable results concerning the clinical and laboratory outcomes and rates of postoperative hypoparathyroidism, at least in short- and medium-term follow-up. (Endokrynol Pol 2016; 67 (2): 202–209)    Wstęp: Potrzeba wykonywania zabiegu usunięcia przytarczyc pozostaje na wysokim poziomie wśród grupy pacjentów poddawanych długoterminowej dializie cierpiących na wtórną nadczynność przytarczyc (sHPT) oporną na leczenie. W niniejszym badaniu, autorzy porównują wyniki po częściowym usunięciu przytarczyc (sPtx) oraz całkowitym ich usunięciu z autoprzeszczepem (tPtx + AT) wykonanym dla sHPT w jednym ośrodku referencyjnym. Materiał i metody: Niniejsze prospektywne badanie dokonuje analizy porównawczej sPtx oraz tPtx + AT, wykonanych w miejscu pracy autorów w okresie od lutego 2010 do grudnia 2014 roku. Autorzy porównali obie techniki operacyjne w związku z głównymi objawami klinicznymi, badaniami laboratoryjnymi, śmiertelnością oraz nawrotowością choroby. Wyniki: W badaniu wzięło udział 43 pacjentów: 26 poddano sPtx, a 19 tPtx + AT. Pomiędzy grupami nie było znaczących różnic statystycznych, jeśli chodzi o dane demograficzne i przedoperacyjne dane kliniczne. Nie stwierdzono śmiertelności pooperacyjnej w żadnej z grup. Okres obserwacji trwał zdecydowanie dłużej w grupie sPtx (p = 0,04). Stężenie wapnia w osoczu mierzone zaraz po operacji było znacznie niższe w grupie tPtx + AT (p = 0,009). Całkowita niedoczynność przytarczyc zidentyfikowano u dwóch pacjentów w grupie sPtx (8,3%) oraz jednego z drugiej grupy (5,26%). Czterech pacjentów z grupy sPtx (16,6%) i trzech z grupy tPtx + AT (15,78%) zmarło podczas okresu obserwacji z powodów niezwiązanych z usunięciem przytarczyc. Ogółem zidentyfikowano dwa nawroty choroby w grupie sPtx i żadnego z drugiej grupie (p = 0,57). Wnioski: W opinii autorów, obie techniki dają porównywalne wyniki, biorąc pod uwagę wyniki laboratoryjne oraz kliniczne, a także wskaźniki pooperacyjnej niedoczynności przytarczyc, przynajmniej w krótko- i średnioterminowym okresie obserwacji. (Endokrynol Pol 2016; 67 (2): 202–209)

CAT, GPX1, MnSOD, GSTM1, GSTT1

Oxidative damage at the DNA level may be promoted by high levels of reactive oxygen species (ROS), leading to genomic instability and increased neoplastic risk. Superoxide dismutase (SOD), glutathione peroxidase (GPX), and catalase (CAT) enzymes are implicated in the prevention of DNA damage by ROS. The aim of the study was to investigate the relationships between CAT C262T, GPX1 Pro198Leu, MnSOD Ala16Val, GSTM1, GSTT1, and GSTP1 Ile105Val polymorphisms and the risk of CML. No association was observed between CML and variant genotypes of GPX1, MnSOD, GSTM1, and GSTT1 polymorphisms in any of the investigated cases. Our study suggests that the homozygous variant genotype of the GSTP1 Ile105Val gene polymorphisms may be associated with the risk of developing CML (OR=2.5; 95% CI=1.08–5.7; P value = 0.02), while the heterozygous genotype of the CAT C262T polymorphism seems to have a protective effect against CML (OR=0.59, 95% CI=0.39–0.89, P value = 0.01). In most cases, no association was found between laboratory parameters and prognostic factors and the variant genotype of investigated gene polymorphisms. We concluded that CAT, GPX, MnSOD, GSTM1, and GSTT1 gene polymorphisms are not associated with the risk of CML. Variant genotype of the GSTP1 Ile105Val gene polymorphisms may contribute to the risk of developing CML

Humanistic Medicine, a Forgotten Concept? The Correct Approach in Palliative Care of Chronic Patients

Palliative care in Romania is a relatively new emerging field. Challenges of this specialty, its uniqueness and the several problems posed by a particular category of patients, the chronically ill patients, make this medical specialty a particularly complex one in certain situations, requiring a multidisciplinary team well-prepared in terms of theory and practice. Unlike in the case of most medical specialties, particular emphasis is laid on the “human” side of medical care, this specialty introducing the concept of “total pain”

Gallbladder Hydrops Associated with an Episode of Acute Liver Toxicity in the Adult: May It Be Considered a Surgical Emergency or Not?

Introduction: Gallbladder hydrops is an increase in the volume of the gallbladder without any inflammatory sign, bacterial infection or the presence of any abnormalities of the biliary ducts or of the gallbladder

PERCEPTIA RISCULUI DE CONTACTARE A UNOR BOLI CU TRANSMITERE SEXUALA: EXPERIENTE LA UN GRUP DE ADOLESCENTI DIN TIRGU MURES, ROMANIA

THE OBJECTIVE of the study was focused on describing the perception of adolescents from an urban climate on their knowledge about sexually transmitted diseases, their sexual experiences, to identifying the level of knowledge regarding contraceptive methods and information sources.MATERIAL AND METHODS: We used a cross-sectional study, by applying an evaluation questionnaire about education and sexual behaviour to 200 students. The data were collected during the period of 01.10.2012-15.12.2012 in high schools from Tg Mures city.RESULTS: Boys were earlier to practice sex and had an earlier sexual debut compared to girls. At age of 17-18 years, we identified equal proportions between the sexes, with increasing numbers of girls who have had a sexual contact. Among questioned adolescents who had sexual contact 42.8 to 44.8% reported they had protected sex. Out of all the teenagers who have had sexual intercourse, 60% had received sexual education information. These were provided primarily by friends, and after by parents and physicians. Girls are more interested than boys to talk to their sexual partner about the risk of a possible pregnancy or methods of contraception.In conclusion, our result can provide useful information on the sexual behaviour of Romanian teenagers in urban areas, which can be beneficial for starting health programs in schools, with the aim to assist the young population to avoid unwanted pregnancy or sexually transmitted diseases. Keywords: sexually transmitted diseases, sexual behaviour, adolescent.OBIECTIVUL studiului s-a axat pe descrierea perceptiei adolescentilor din mediul urban cu privire la cunostintele legate de bolile cu transmitere sexuala, experientele lor sexuale, identificarea nivelului de cunoastere a metodelor de contraceptie si sursa de informare.MATERIAL SI METODA: Am apelat la un studiu de tip transversal, prin aplicarea unui chestionar de evaluare a educatiei si a comportamentului sexual la 200 de elevi. Culegerea datelor s-a facut in perioada 01.10.2012-15.12.2012, in licee ale orasului Tg Mures. REZULTATE: Baietii au fost mai precoce in ceea ce priveste practica sexuala, viata sexuala debutand mai devreme decat la fete. La varsta de 17-18 ani identificam procente egale pe sexe, cu cresterea numarului de fete care au avut un contact sexual. Printre adolescentii chestionati, si care au avut contacte sexuale, intre 42,8-44,8% au raportat ca au facut sex protejat. Din totalul de adolescenti care au avut contacte sexuale, peste 60% au primit informatii de educatie sexuala. Acestea au fost furnizate cu precadere de catre prieteni, apoi de catre parinti si medici. Fetele sunt mult mai interesate decat baietii sa discute cu partenerul sexual despre riscul unei posibile sarcini sau despre metodele de contraceptie. In concluzie, rezultatele noastre pot furniza informatii utile cu privire la comportamentul sexual al adolescentilor romani din mediul urban, fiind benefice pentru demararea unor programe de sanatate in scoli, cu scopul de a veni in ajutorul tinerilor pentru a evita o sarcina nedorita sau bolile cu transmitere sexuala.  Cuvinte cheie: boli cu transmitere sexuala, comportament sexual, adolescent

Serum hs-CRP, YKL-40 and brain-derived neurotrophic factor (BDNF) associated biomarkers in non-dipper hypertension profile?

Background: Twenty-four hours dynamic blood pressure (BP) behaviour displays dipper profile defined as nocturnal systolic BP (SBP) reduction>10% compared to daytime. Non-dipper profile, nocturnal absence of SBP fall, associates an increased cardiovascular risk. We investigated the concomitant association of inflammatory bio-markers - high-sensitivity- C-reactive protein (hs-CRP), Human Chitinase3-like1 (YKL-40) and autonomic nervous system (total brain-derived neurotrophic factor, BDNF) with respect to non-dipping blood pressure status

Cardiovascular Autonomic Neuropathy in Context of Other Complications of Type 2 Diabetes Mellitus

The aim of this study was to investigate the relationship between cardiac autonomic neuropathy (CAN) and other micro- and macrovascular complications and risk factors for type 2 diabetes. We included, in this study, 149 patients with type 2 diabetes. We evaluated their cardiovascular risk factors, demographic data, and any major micro- and macrovascular complications of their diabetes. Assessments of CAN were based upon Ewing’s battery. Results. CAN was present in 38.9% of patients. In the CAN group, the duration of diabetes, BMI, systolic blood pressure, lipid levels, and HBA1c were all significantly higher than those in the other group. A significant association was found between CAN and retinopathy, peripheral neuropathy, ABI, and IMT. Multivariate logistic regression demonstrated that, in type 2 diabetes, the odds of CAN (OR (95% confidence intervals)) increase with the age of the patients (1.68 (1,4129–2.0025)), the average diabetes duration (0.57 (0.47–0.67)), cholesterol (1.009 (1.00-1.01)), HbA1c levels (1.88 (1.31–2.72)), peripheral neuropathy (15.47 (5.16–46.38)), BMI (1.12 (1.05–1.21)), and smoking (2.21 (1.08–4.53)). Conclusions. This study shows that CAN in type 2 diabetes is significantly associated with other macro- and microvascular complications and that there are important modifiable risk factors for its development

EVALUAREA AMPLITUDINII SI A TENDINTEI DE EVOLUTIE A BOLILOR CU TRANSMITERE SEXUALA IN AREALUL MURESEAN

INTRODUCTION: Sexually transmissible diseases represent an important public health problem, even for the adolescents and young people, because of an increased morbidity, its complications, premature deaths and even its economic-social implications.The study suggests monitoring of sexually transmissible diseases (syphilis and infective gonococcus) by determining their morbidity in Mures and Harghita County, during the period 2005-2012, together with the associated risk factors and life style.MATERIAL AND METHOD: I carried out a descriptive epidemiological study by analyzing cases of sexual transmissible diseases (syphilis, gonorrhoea) reported by the Public Health Ministry for the period 2005-2012 in Mures and Harghita County. I followed the trend of infection and incidence of transmissible diseases in function of age, sex, provenance and seasonality.RESULT: The incidence of syphilis in Mures County varied between 20.1%ooo in 2005 and 10.2%ooo in 2012, but in Harghita County it varied between 36.4%ooo in 2005 and 13.4%ooo in 2012. For infective gonococcus, the incidence in Mures County varied between 1.2%ooo in 2005 and 1.0%ooo in 2012, while in Harghita County it varied between 9.5%ooo in 2005 and 6.8%ooo in 2012.CONCLUSION: I concluded that the evolution of cases of syphilis in the two counties is comparable. Infective gonococcus appears most often at male patients who live in cities. The cases of syphilis and gonorrhoea were more common at young patients (second to third decade) who are sexually active. Keywords: Syphilis, gonorrhoea, Mures, Harghita.INTRODUCERE: Bolile transmise pe cale sexuala reprezinta o problema importanta de sanatate publica, inclusiv in randul adolescentilor si tinerilor, din cauza morbiditatii ridicate, complicatiilor pe care le pot induce, deceselor premature, cat si din cauza implicatiilor economico-sociale.Studiul si-a propus monitorizarea unor boli cu transmitere sexuala (sifilis si infectiile gonococice), prin determinarea dinamicii morbiditatii acestora, in judetele Mures si Harghita, in perioada 2005-2012, in conexiune cu factorii de risc legati de stilul si modul de viata.MATERIAL SI METODA: Am efectuat un studiu epidemiologic descriptiv analizand cazurile de boli cu transmitere sexuala (sifilis, gonoree) raportate de catre Directiile de Sanatate Publica Mures si Harghita, in perioada 2005-2012. S-a urmarit trendul infectiei, incidenta bolilor transmisibile, fiind analizata in functie de: varsta, sex, mediul de provenienta si sezonalitate.REZULTATE: Incidenta prin sifilis in judetul Mures a variat intre 20,1%ooo in 2005 si 10,2%ooo in 2012, iar in judetul Harghita a variat intre 36,4%ooo in 2005 si 13,4%ooo in 2012. Pentru infectiile gonococice, incidenta in judetul Mures a variat intre 1,2%ooo in 2005 si 1,0%ooo in 2012, iar in judetul Harghita a variat intre 9,5%ooo in 2005 si 6,8%ooo in 2012.CONCLUZII. Am constatat o evolutie descendenta a cazurilor de sifilis in judetele comparate; infectiile gonococice apar, cu precadere, la persoanele de sex masculin cu mediul de provenienta urban; cazurile de sifilis si gonoree au fost apanajul persoanelor tinere (decada a doua si treia de varsta) si active sexual. Cuvinte cheie: sifilis, gonoree, Mures, Harghita