General Objectives and Methods in HIV/AIDS Surveillance

Preventing transmission of virus is still the single intervention known as effective in limiting the spread of HIV infection. So, the epidemiological surveillance of HIV/AIDS is an important tool used by public health specialists in controlling epidemics. Epidemiological surveillance is a continuous process of collecting, analysing, interpreting and disseminating data in order to plan, implement and assess public health interventions. The objectives of HIV/AIDS surveillance should be specific, measurable, transformed into actions, realistic, planned to be done in due time. The main methods used by HIV/AIDS surveillance in collecting the data are biological surveillance, behavioural surveillance, other sources of information. The main indicators recommended for any HIV/AIDS programme components include the fields of politics, condoms availability and quality, social stigmatus & discrimination, knowledge, vertical transmission, sex negotiation and attitude, sexual behaviour, especially in youngsters, injection with drugs, safe blood and derivatives, STI treatment and prevention, care and social support, social & health impact. Data collected by public health surveillance systems guide the responses to the events, measure and monitor the burden of the disease, assess public health politics, etc.. Integrated approach in epidemiological surveillance takes into account, generally, the integration of all activities that have to do with epidemiological surveillance into a single service with multiple functions using the same structures, procedures and personnel. Second generation HIV/AIDS surveillance is a WHO concept developped on modular systems. The metodology in risk behaviour surveillance studies includes: justifying, behavioural risk, methods for collecting data, behavioural data value, steps in organizing behavioural surveillance studies

General Objectives and Methods in HIV/AIDS Surveillance

Preventing transmission of virus is still the single intervention known as effective in limiting the spread of HIV infection. So, the epidemiological surveillance of HIV/AIDS is an important tool used by public health specialists in controlling epidemics. Epidemiological surveillance is a continuous process of collecting, analysing, interpreting and disseminating data in order to plan, implement and assess public health interventions. The objectives of HIV/AIDS surveillance should be specific, measurable, transformed into actions, realistic, planned to be done in due time. The main methods used by HIV/AIDS surveillance in collecting the data are biological surveillance, behavioural surveillance, other sources of information. The main indicators recommended for any HIV/AIDS programme components include the fields of politics, condoms availability and quality, social stigmatus & discrimination, knowledge, vertical transmission, sex negotiation and attitude, sexual behaviour, especially in youngsters, injection with drugs, safe blood and derivatives, STI treatment and prevention, care and social support, social & health impact. Data collected by public health surveillance systems guide the responses to the events, measure and monitor the burden of the disease, assess public health politics, etc.. Integrated approach in epidemiological surveillance takes into account, generally, the integration of all activities that have to do with epidemiological surveillance into a single service with multiple functions using the same structures, procedures and personnel. Second generation HIV/AIDS surveillance is a WHO concept developped on modular systems. The metodology in risk behaviour surveillance studies includes: justifying, behavioural risk, methods for collecting data, behavioural data value, steps in organizing behavioural surveillance studies

CONTRIBUTIONS TO THE ANTHROPOLOGY OF FLUIDO-COAGULANT BALANCE

Blood fluidity is controlled by complex physiological systems. Normally, the fine balance between coagulation and fibrinolysis prevents both bleeding and thrombosis. The accelerated urbanization we are living last decades modifies the basic environment, confining the human being to biochemical and metabolic remodeling. The alteration of this balance in favour of coagulation leads to thrombosis, the major challenge of the 21st century medicine. There are interesting changes not only in human’s anthropological evolution, but also from birth to death. The HORUS study performed by american and egyptian researchers investigated the prevalence of atherosclerosis in antique and modern Egyptians. Despite the belief that atherosclerosis is a modern disease, it seems to be evidences of atherosclerosis in Egyptian mummies. Despite multiple differences, between 30 and 60 years, the prevalence of atherosclerosis was quite similar in antique and modern Egyptians, respectively

THE SYNERGISTIC CONTROL OF CHOLESTEROL FRACTIONS – INNOVATIVE CONCEPTS IN OUR PATIENTS

Lipid-lowering drugs reached a peak since large scale development of statins, which control well LDL-Cand HDL-C levels.Beyond this “state-of-the-pharma”, recentresearch show that three are more efficient solutions. The dual clinical cases display distinct dyscolesterolaemic particularities which ask for innovative therapeutic solutions.The first clinical case is a 24 y. o. biomedical student, with severe coronary family history (a brother suddenly dead at the age of 28 y. o., father dead at 44 y. o. after the second MI), perfect preventive lifestyle, LDL-C 232 mg/dL, HDL-C 36 mg/dLandhs-CRP 3,6 mg/L. It was initiated a treatment with a redutable statin, in progressive dosages till the maximum one in the guidelines, LDL-C lowering to 202 mg/dL. Beyond statins, we can lower LDL-C more using PUFA and PCSK9 inhibitors.The second clinical case was a71 y. o. diabetic controlled by oral antidiabetics, with controlled hypertensionby ACE-inhibitors, LDL-C 65 mg/dL under statin. The subject presents with substernal pressure and emesis; an HDL-C value of 22 mg/mL and two tight stenoseson ACD segm. 1, and ADA segm. 2 are remarkable. Case interpretation: qualitative dimension – lowering HDL-C antioxidant capacity in acute coronary syndromes; quantitative dimension – low HDL-C remains a cardiovascular risk prediction in statin treated subjects. Beyond statins, we can increase more HDL-C using dalcetrapib, a CETP inhibitor. The drug classes proposed for these two patients are important pharmacologic tools in synergistic control of cholesterol fractions

THE ROLE OF BETABLOCKERS IN LOWERING THE RISK OF CHEMOTHERAPY-INDUCED HEART FAILURE IN BREAST CANCER

Anthracyclines and molecular targeted therapy, pharmacologic agents currently used in breast cancer, are potentially cardiotoxic, leading to cardiac dysfunction, and even to overt heart failure. This paper reviews the art of protecting the heart in breast cancer recipients of chemotherapy with betablockers. The main mechanism of anthracycline induced cardiotoxicity is the oxydative stress, occurring in mitochondrial arena. Recent trials supporting β-blockers cardioprotection in this particular population of patients are discussed. As a result of these studies, betablockers are, along with renin-angiotensin-aldosterone antagonists, statins, and dexrazoxane, the most cardioprotective drugs. The paper also covers some methods (biomarkers, imaging), integrating the sphere of prevention with those of monitoring and treatment. The trials outcomes are illustrated by curves, plots, histograms, tables, etc

Balanced scorecard, management tool in hospitals reform

The Balanced Score Card (BSC) is a very useful tool for the private companies around the world. The goal of this paper is to introduce this concept in the health literature, in order to innovate the hospital management. Thus, there is a theoretical basis for solving the many complex aspects of the hospital activities. Despite some tensions and compromises, the interplay between the four quarters of the BSC demonstrates the ability to solve many problems of a hospital. The next step will be to apply effectively this tool in hospital management. Keywords: balanced score card, hospital managementThe Balanced Score Card (BSC) is a very useful tool for the private companies around the world. The goal of this paper is to introduce this concept in the health literature, in order to innovate the hospital management. Thus, there is a theoretical basis for solving the many complex aspects of the hospital activities. Despite some tensions and compromises, the interplay between the four quarters of the BSC demonstrates the ability to solve many problems of a hospital. The next step will be to apply effectively this tool in hospital management. Keywords: balanced score card, hospital management Content available only in Romania

Legea reformei în domeniul sănătăţii - abordare analitică în corelaţie cu reglementările din domeniu

The 95/2006 Health Reform Law is the 'spinal cord' of the health system reform legislative cluster. This paper was inspired both by the letter and spirit of the law besides the practical issues experienced by the authors as local health decisionmakers. The main trend of this work is the interplay between law 95 and other eleven laws, including public employee’s issues. This article also highlights some european ideas implemented for the first time in our national legislation. Key words: health reform, legislation, national health programmes, public clerkContent available only in RomanianThe 95/2006 Health Reform Law is the 'spinal cord' of the health system reform legislative cluster. This paper was inspired both by the letter and spirit of the law besides the practical issues experienced by the authors as local health decisionmakers. The main trend of this work is the interplay between law 95 and other eleven laws, including public employee’s issues. This article also highlights some european ideas implemented for the first time in our national legislation. Key words: health reform, legislation, national health programmes, public cler

Un model de optimizare a activității în secții de tip USTACC din spitale de urgență

The MATUCC (Monitoring and Advanced Treatment Units of Critical Cardiac patients) concept launched in 2010 by the Romanian Ministry of Health aims an increase of quality standards in coronary care in Romania. The MATUCC of Emergency County Hospital Pitesti was founded in 2013 in the current building. Learning from the experience of some prestigious hospitals, we conceived a new model of MATUCC, more appropriate to the new standard of care for the critical coronary patient in an Emergency Hospital. The present paper displays the new model created in our hospital, harmonized with regulatory authorities exigencies published in 2012, model that may be uptaken and adjusted for other Romanian hospitals.  Keywords: MATUCC, new standard, emergency zonal hospitalConceptul USTACC (Unităţi de Supraveghere şi Tratament Avansat al pacienţilor Cardiaci Critici), lansat în anul 2010 de Ministerul Sănătăţii are ca obiectiv creşterea standardelor de calitate ale îngrijirii pacienţilor coronarieni din ţara noastră. USTACC din Spitalul Judeţean de Urgenţă Piteşti a fost înfiinţat în 2013 în clădirea actuală. Învăţând din experienţa unor prestigioase spitale, am conceput un nou model de USTACC care să răspundă mai bine noului standard de îngrijire a pacientului critic coronarian în Spitalul de Urgenţă. Lucrarea de faţă prezintă modelul nou creat în cadrul spitalului nostru, armonizat cu regulamentul USTACC emis de Ministerul Sănătăţii în anul 2012, model ce poate fi preluat şi adaptat la nivelul altor spitale din România.  Cuvinte cheie: USTACC, noul standard, spital zonal de urgenţ