Pensioners Versus Employees in Romania: A Regional Study

Romania may become overwhelmed by its ageing population in the future. One of the worrying issues is the falling support rate, which shows the relationship between the working population who is paying taxes and the nonworking population, aged 65 years or over (the pensioners). This paper has a regional focus, this ratio and some of the factors influencing it (fertility rate, immigration or life expectancy) being studied in different regions of Romania between 1996 to 2017. Forecasts by 2060 highlight that pensioners-employees ratio will increase over time if no legislative reforms are designed to increase the social security budget (and implicitly the pension system). The findings indicate that an increase in fertility rate and immigration will contribute to better support of pensioners. Since many people migrate to developed countries, Romania is not attracting immigrants to improve its labor force. Hence, a measure to redress the demographic decline and support the pensioners could be the increase in the rate of fertility, which could be sustained by the initiation and implementation of pronatalist policies, the increase in the economic status of the family. Among the results, it is also highlighted that an increase in life expectancy will deter the support because the ageing population will grow. As a result, it is necessary to explore and to implement measures to balance the country's social security budget having as target the old-age population

Rolul factorilor de risc în evoluția pneumoniilor nosocomiale.

Incidența în creștere, mortalitatea dramatică și costurile semnifi cative ale pneumoniilor nosocomiale (PN) impun necesitatea de a identifi ca factorii care infl uenţează prognosticul la pacienţii cu PN. Astfel, în prezenta lucrare au fost evidențiați și descriși unii factori de risc (vârsta înaintată, hipotensiunea arterială, coma, insufi ciența multiplă de organe, ventilația mecanică, infi ltrate pulmonare bilaterale la examenul radiologic, scorul clinic de infecție pulmonară ≥ 6 puncte, administrarea corticosteroizilor, H2-blocanților și antiacidelor) importanți în evoluția PN

Predictorii evoluţiei nefaste în pneumoniile nosocomiale

Background. Hospital-acquired pneumonia (HAP) is one of the most important nosocomial infection due to it’s high mortality, which ranges from 30-70% in different hospitals. A lot of studies are aimed to highlight the risk factors for mortality among HAP patients. Objective of the study. To identify the mortality predictors in hospital-acquired pneumonia. Material and Methods. A total of 110 patients with HAP were included in our study: 70 (63,6%) were survivors (S) and 40 (36,4%) non-survivors (NS). Differences of the clinical, radiological and laboratory characteristics between S and NS groups were analyzed by a regresional logistic model, using the MedCalc11.5.0.0 package. Results. There are several significant independent predictive factors for mortality in HAP: age ≥65 years (OR 10,9; p- 0,0019), confusion (OR 5,9; p-0,0049), the lenght of mechanical ventilation ≥48 hours (OR 15,4; p- 0,0003), high levels of creatinine (OR 7,6; p-0,0126), clinical pulmonary infection score ≥6 points (OR 7,4; p-0,0053) and bilateral pneumonic infiltration diagnosed by chest X-ray (OR 5,6; p-0,0114). The discriminatory power of the logistic model for predicting mortality was high - AUC 0,93 (95% CI: 0,86– 0,97). Conclusion. Our study highlighted several clinical, laboratory and imaging prognostic factors for HAP. Revealing the mortality risk factors in hospital-acquired pneumonia is important for the development of preventive measures to decrease mortality among HAP patients. Introducere. Pneumonia nosocomială (PN) este cea mai importantă dintre infecţiile nosocomiale, poate fi explicat şi prin indicele letalităţii înalte, care variază între 30-70%. Evidenţierea factorilor ce contribuie la evoluţia nefavorabilă a bolii se regaseşte în majoritatea studiilor dedicate PN. Scopul lucrării. Evidenţierea factorilor prognostici ai evoluţiei nefaste în pneumoniile nosocomiale. Material și Metode. Studiul a inclus 110 subiecţi cu PN, dintre care 70 (63, 6%) au supravieţuit (S) şi 40 (36, 4%) au decedat (D). Multiple variabile clinico-paraclinice, care au variat semnificativ în grupurile S şi D au fost incluse într-un model regresional logistic, utilizând softul MedCalc11.5.0.0. Rezultate. Ca variabile cu impact prognostic pentru survenirea decesului la bolnavii cu PN au fost evidenţiate: vârsta pacientului ≥65 ani (OR 10,9; p-0,0019), confuzie şi/sau obnubilare (OR 5,9; p-0,0049), ventilaţia mecanică invazivă cu o durată ≥48 ore (OR 15,4; p-0,0003), valorile crescute ale creatininei (OR 7,6; p-0,0126), scorul clinic de infecţie pulmonară ≥6 puncte (OR 7,4; p-0,0053) şi afectarea pulmonară bilaterală confirmată prin radiografia toracelui (OR 5,6; p-0,0114). AUC a modelului logistic a constituit 0, 93 (95% CI: 0,86–0,97), ce indică eficienţa înaltă de discriminare a cazurilor cu sfârşit letal. Concluzii. Studiul a evidenţiat un şir de factori prognostici pentru evoluţia PN - clinici, de laborator, imagistici. Cunoaşterea predictorilor evoluţiei nefaste în pneumoniile nosocomiale este importantă pentru elaborarea măsurilor preventive ale letalității la pacienţii cu PN

PAMAM6 dendrimers and DNA: pH dependent "beads-on-a-string" behavior revealed by small angle X-ray scattering

DNA interactions with polycations are not only important for our understanding of chromatin compaction but also for characterizing DNA-binding proteins involved in transcription, replication and repair. DNA is known to form several types of liquid-crystalline phases depending, among other factors, on polycation structure and charge density. Theoretical studies and simulations have predicted the wrapping of DNA around spherical positively charged polycations. As a potential mimic of the histone octamer or other DNA wrapping proteins, poly(amido amine) generation 6 (PAMAM6) dendrimers have been chosen for our study. The self-assembly of DNA induced by PAMAM6 has been investigated using small angle X-ray scattering (SAXS) in order to reveal the assemblies' structure dependence on the pH of the environment and on dendrimers concentration. We demonstrate that at pH 8.5 dense phases are formed and characterized by a 2D-columnar hexagonal lattice which is transformed into a 3D hexagonal lattice with increasing dendrimer concentration (charge ratio N/P). Moreover, a systematic analysis of the scattering data collected from diluted samples at pH 8.5 and 5.5 have led us to propose a wrapping scenario of DNA around PAMAM6 at pH 5.5.Comment: 12 pages, 7 figure

L’architecture de l’information dans le discours scientifique

As the title suggests, we would like to study a peculiarity of the mathematical scientific discourse, namely the informational organization. Our theoretical framework is discourse analysis, more precisely, discourse analysis of the Geneva School under the direction of prof. Eddy Roulet. We used the same theoretical framework to characterize the mathematical discourse in French (see Toma 2009, Toma 2017). This general issue brings us to at least two particular goals: on the one hand, we must fram the specificity of the texture of the mathematical discourse (in the framework of the semantic and syntactic modules) and, on the other hand, we must grasp the flow of information in mathematical discourse (in the context of informational and topical organization)

Determinarea carotenoidelor în extractele speciilor genului calendula și tagetes

Background. Carotenoids have played a significant role in reducing the risk of chronic disease. The most studied in this regard is β-carotene, present in medicinal plants specific including Calendula and Tagetes genus. Objective of the study. Comparative analysis of β-carotene content in liquid and dry extracts obtained fromflowers of species Tagetes and Calendula, cultivated in the colection of the Scientific Center for the Cultivation of Medicinal Plants of Nicolae Testemitanu SUMPh. Material and Methods. Liquid extracts obtained by repeated maceration, dry extracts, by rotary evaporation, were subjected to phytochemical evaluation by thin layer chromatography (TLC) and UVVIS spectrophotometry, equivalent to β-carotene. Results. Beta-carotene was identified by TLC in hexane- ethyl acetate (50:50, v/v), retention times were established. Caratenoid content (mg %) varied as follows: in T. patula (75.34), T. erecta (21.97), C. officinalis variety Natali (13.09), C. officinalis variety Diana (12.39), C. officinalis local population (10.99). The carotenoids varied in dry extracts too, determined in highest amount in T. patula flowers (137.87 mg%). Conclusion. This study demonstrated the opportunity for further research of Tagetes varieties that could serve as sources of carotenoids for antioxidant phyto-pharmaceuticals. Introducere. Carotenoidele posedă un rol semnificativ în reducerea riscului de boli cronice. Cel mai studiat în acest sens este β-carotenul, prezent în speciile plantelor genului Calendula și Tagetes. Scopul lucrării. Analiza comparativă a conținutului de β-caroten în extracte lichide și uscate obținute din florile speciilor Tagetes și Calendula, colectate din colecția Centrului Științific pentru Cultivarea Plantelor Medicinale a USMF „Nicolae Testemițanu”. Material și Metode. Extractele lichide obținute prin macerare repetată și extractele uscate prin evaporare rotativă au fost supuse evaluării chimice prin cromatografie în strat subțire (CSS) și spectrofotometrie UV-VIS, în recalcul la β-caroten. Rezultate. Prin CSS, a fost identificat β-carotenul în mediu de hexan și etil acetat (50:50, v/v) și s-au stabilit factorii de retenție. Conținutul total de caratenoide (mg%) a variat după cum urmează: în T. patula (75.34), T. erecta (21.97), C. officinalis soiul Natali (13.09), C. officinalis soiul Diana (12.39 ), C. officinalis populație locală (10.99). Conținutul de carotenoidele a variat și în extracte uscate, determinate în cantitate maximă în florile de T. patula (137.87 mg%). Concluzii. Acest studiu a demonstrat oportunitatea de cercetare în continuare a soiurilor de Tagetes, care pot servi ca sursă de carotenoide pentru fitopreparate cu efecte antioxidante

Determinarea cantitativă a acizilor hidroxicinamici in Cynarae folium

Background. Cynara scolymus L. is an herbaceous, perennial plant with a rich content of phenolic compounds accumulated in the basal and stem leaves of the plant. The plant product Cynarae folia (CF) is known and used to combat a wide range of gastrointestinal, cardiovascular and metabolic disorders. Objective of the study. Identification and dosing of hydroxycinnamic acids (HA) in the CF plant product harvested from the collection of the Scientific-Practical Center in the Field of Medicinal Plants (SPCFMP). Material and Methods. The plant product CF, pharmacopoeically processed, served as material; extractant - ethyl alcohol; standard substances - caffeic and chlorogenic acid (Sigma-Aldrich), thin layer chromatography plate (Merk Milipore), spectrophotometer (Meterthech UV / VIS SP-8001); the statistical analysis was performed with the Excel 2019 program. Results. The use of the solvent system ethyl acetate-acetic acid-water (5:1:1), demonstrated the presence of HA with the determination of Rfs of caffeic acids 0.93 and chlorogenic 0.48. The spectrophotometric dosage at 540 nm wavelength, in the recalculation of HA to caffeic acid echivalent, in the extractive solutions of CF (1:10) obtained on the water bath with refrigerant, with ethyl alcohol of 20% and purified water, reflected the average value of 0.92 ± 0.014%; dosing of HA at 340 nm, in the recalculation to chlorogenic acid, of the extractive solutions of CF obtained with ethyl alcohol of 30%, showed the value of 1.71 ± 0.28%. Conclusion. The study showed that the CF plant product harvested from the SPCFMP collection of Nicolae Testemitanu SUMPh is presented as a product rich in hydroxycinnamic acids and requires in-depth study to capitalize on the plant product of local origin.Introducere. Specia Cynara scolymus L. este o plantă ierbacee, perenă, cu conținut bogat de compuși fenolici acumulați în frunzele bazele și tulpinale ale plantei. Produsul vegetal Cynarae folia (CF) este cunoscut și utilizat în combaterea unui spectru larg de afecțiuni cardiovasculare, metabolice și ale tractului gastrointestinal. Scopul lucrării. Identificarea și dozarea acizilor hidroxicinamici (AH) în produsul vegetal CF recoltat din colecția Centrului Științifico-Practic din Domeniul Plantelor Medicinale (CȘPDPM). Material și Metode. Ca material a servit produsul vegetal CF, procesat farmacopeic; extragent – alcool etilic; substanțe standard – acid cafeic și acid clorogenic (Sigma-Aldrich), placă pentru cromatografie în strat subțire (MerkMilipore), spectofotometrul (Meterthech UV/VIS SP-8001); analiza statistică a fost realizată cu programul Excel 2019. Rezultate. Folosirea sistemului de solvenți acetat de etil–acid acetic–apă (5:1:1), a demonstrat prezența AH cu determinarea Rf-lor acizilor cafeic 0,93 și clorogenic 0,48. Dozarea spectrofotometrică la lungimea de undă 540 nm, în recalcul la acid cafeic, a AH în soluțiile extractive de CF (1:10) obținute la baia de apă cu refrigerent, cu alcool etilic de 20% și apă purificată, a reflectat valoarea medie de 0,92 ± 0,014%; dozarea AH la 340 nm, în recalcul la acid clorogenic, a soluțiilor extractive de CF obținute cu alcool etilic de 30%, a prezentat valoarea de 1,71 ± 0,28%. Concluzii. Studiul efectuat a demonstrat că produsul vegetal CF recoltat din colecția CȘPDPM a USMF „Nicolae Testemițanu” se prezintă ca un produs bogat în acizi hidroxicinamici și necesită studiu aprofundat pentru valorificarea produsului vegetal de origine autohtonă.Studiu realizat cu suportul proiectului 20.80009.800724 ”Studiul biologic și fitochimic al plantelor medicinale cu acțiune antioxidantă, antimicrobiană și hepatoprotectoare” din cadrul Programului de Stat (2020-2023), conducător de proiect: CIOBANU Nicolae, dr. șt. farm., conf. univ., autoritatea contractantă: Agenția Națională pentru Cercetare și Dezvoltar

Renovascular hypertension: mechanisms of development, clinical manifestation, management of treatment. Review of literature

This presentation is a review of international literature that elucidates the clinical manifestation, management of treatment, and mechanisms of renovascular hypertension. Another object of our work is to report some real clinical cases relating to this study and make a difference between international and Moldavian practice in the management of patients with renovascular hypertension. Hypertension in the presence of renal artery stenosis may not necessarily be renovascular hypertension. The two conditions may simply co-exist. Renovascular hypertension is usually symptomless, while hypertension that is difficult to control with antihypertensive therapy is probably the best indication as to whether further diagnostic evaluation is indicated. Some features of renovascular hypertension include: a worse prognosis than essential hypertension, less amenable to drug treatment, a greater risk of dose-dependent side effects, a higher risk of progression to accelerated hypertension and it may result in irreversible ischaemic failure of the affected kidney. Renal artery stenosis may be present in up to 30% of drug resistant hypertensive patients. Arteriosclerotic renovascular disease is an increasingly important cause of renal failure. Functional diagnostic tests for renovascular hypertension such as rapid sequence intravenous urography have now been superseded by the captopril challenge test and in particular scintigraphy following captopril provocation. Tests of prediction as to whether correction of a demonstrated renal artery stenosis will lead to an improvement in the blood pressure include renal vein renin estimations and scintigraphy. The key diagnostic procedure is renal angiography. The approaches to management primarily include appropriate antihypertensive therapy, while there is an increasing place for percutaneous transluminal angioplasty, with or without stenting of an occluding lesion. There is still a small place for corrective surgery. Renal ischaemia due to atherosclerotic renovascular disease is becoming an increasing problem in nephrology. Treatment should be directed at preserving or even restoring renal function

Pulmonary sclerosing hemangioma. Case report

Pulmonary sclerosing hemangioma (PSH) is a rare benign neoplasm of an epithelial origin and was reported by Liebow and Hubbell in 1956. The incidence accounted for approximately 1% of all pulmonary tumors, following hamartoma among the benign tumors. The finding of multiple bilateral lesions is rare and less reported in the literature. We report one such case seen recently at our hospital. A 55-year-old non-smoker woman without a unremarkable family and medical histories was admitted to our hospital in August 2008. She presented with mild dyspnea and asthenia. In February 2007 she was diagnosed with bilateral basal pneumonia (detected on chest radiography) and treated with third-generation cefphalosporin. In July 2008 she notified increasing dyspnea, cough, subfebrile temperature and weight loss (5 kg in 2 month). Radiological differential diagnosis was performed with all of the disseminated pulmonary lesions (inclusively with septical pneumonia and pulmonary metastasis). There were a very few findings in the physical examination of the patient: she was hipoponderal and there was a diminuation of vesicular murmur on bilateral pulmonary basis and wheezing above the left site. Laboratory examinations (except an unimportant anemia and high level of ESR 65) including respiratory function tests were within normal ranges. The bilateral purulent endobronchitis was detected on fibrobronchoscopy. In sputum cultures were positive for Citrobacter spp, E.faecium and Candida spp. On her 2nd day of admission the temperature level backs to normal (under the antibiotic treatment). Chest computed tomography (CT) images revealed a chronic inflammatory process with pulmonary bules. Left pulmonary biopsy was then performed. On general examination of the left lung there were presented sclerosis and multiple lesions in S8. Histological view was suspected for tumor lesion of an origin from endothelium of the lung vessels. The differential diagnosis was performed between an pulmonary hemangioepithelioma and pulmonary sclerosing hemangioma. By immunohistochemical analysis with CD34 the pulmonary hemangioepithelioma was excluded (this tumor has a very bad prognosis for patient). In December 2009 there were no dynamic changes on chest radiography or on chest CT: no new lesions or any growth of the old ones. Discussion Pulmonary sclerosing hemangioma in more than 80% of all cases occurs in female patients who are mostly in their 40s (range from 11 to 80 years). 80% of the patients are asymptomatic and the lesions are generally discovered incidentally by chest radiography. In symptomatic patients the cough, the dyspnea, the chest pain and hemoptysia are mainly observed. The diagnosis remains based on histological findings. A limited resection of the lesion or a lobectomy is the treatment of choice. The prognosis of patient is excellent (survival range from 5 to 30 years)