Photogrammetric modelling for urban medieval site mapping. A case study from Curtea de Argeş, Romania

Detailed mapping of urban historical sites superposed on natural landforms within built-up areas is a real challenge. Digital photogrammetric techniques meet the requirements for mapping archaeological sites within dense built-up areas. The objectives are to reveal the landform value in medieval site development and to analyse its impact on the landforms. The aim of the present study is to highlight the contribution of geomatics technologies for the evaluation and preservation of historical sites using UAV (Unmanned Aerial Vehicle) imagery and field photos for 3D modelling. Curtea de Argeş medieval site, established on Argeş River terraces and attested since the 13th century, represents the town core for which the specific methodology was applied

Infectious endocarditis in intravenous drug users with left heart disease

Departamentul Medicină Internă, USMF Nicolae TestemiţanuInfectious endocarditis (EI) is one of infectious endocardial pathologies, having a wide range of clinical forms with acute or subacute onset and severe complications. The incidence of EI is 3-10 episodes per 100 000 people / year. In 85-90% affect the left heart and only 5-10% the right heart, characteristic for intravenous drug users (UDIV), on intact valves. Hemoculture and ultrasound are indispensable elements in diagnosis and treatment. Mortality in EI is maintained at a high level of up to 26% and is dependent on the virulence of the pathogen, the evolution and complications of the disease

Afectarea cardiovasculară în hipotiroidismul subclinic

Hipotiroidismul subclinic (HTS) este o afecțiune răspândită cu efecte cardiovasculare (CV) adverse. Acesta este definit ca niveluri serice normale ale tiroxinei libere (fT4) și creșterea nivelului seric al hormonului stimulator tiroidian (TSH>4 mU/l) [35, 37] (fig. 1). Prevalența HTS la adulți a fost raportată între 7% și 10% [15] și ea crește o dată cu vârsta, fiind mai mare la femei [4]. HTS este o patologie mascată prin faptul că aceasta este în general asimptomatică, însă asociată cu efecte nocive asupra sistemului CV [35]. Printre acestea se numără rigiditatea arterială și disfuncția cardiacă diastolică [20], disfuncția endotelială [28], creșterea grosimii intima-medie la nivelul arterei carotide [22], boala arterelor coronare și decese legate cu boli coronariene [32]. Mecanismele ce leagă HTS cu bolile CV includ dislipidemia și stresul oxidativ [22, 39]

Pericardita exudativă – manifestare cardiovasculară în lupus Eritematos sistemic primar depistat. Caz clinic

Una dintre cele mai frecvente patologii ale țesutului conjunctiv, cu o mare variabilitate clinică și biologică este lupus eritematos sistemic (LES). Acesta prezintă o etiologie complexă cu afectare multiorganică datorită cascadei autoimune declanșate. Pericardita reprezintă cea mai frecventă manifestare cardiovasculară în LES. Diversitatea afectării organelor și sitemelor, determină o abordare complexă în stabilirea diagnosticului și inițierea tratamentului. Noi prezentăm cazul clinic al pacientei cu lupus eritematos sistemic primar depistat, care a necesitat o analiză multilaterală în vederea stabilirii conduitei terapeutice adecvate

Particularities of management in men’s stable angina

Departament of Internal Medicine, SMPhU N. Testemitanu, SMPI MCH Sfanta Treime, Hepato-Surgical Laboratory, SMPhU Nicolae TestemitanuIntroduction In the US the AP has a prevalence of 3.3%, for men – 3.4%, and for women – 3.2%. In the European countries, according to the data of European Society of Cardiology (ESC), the prevalence of AP raises increases with age for both sexes: from 4-7% for men aged between 45 and 64, and from 5-7% from the women of the same age, from 12-14% for the men aged between 65 and 84 and 10-12% for women of the same age [1, 2]. The most common AP complication is the acute myocardial infarction (AMI). In the United States the prevalence of the myocardial infarction among adults aged ≥20 is 2.8%, 4.0% for men and 1.8 for women. The scientists, who studied this field, have calculated that every 43 seconds an American citizen may develop AMI [1]. According to population studies of Olmsted County and Framingham, the patients with AP develop AMI in 3.-3.5 % per year, so in 30 patients with AP, the AMI progresses in one person [2, 5]. In the United States, IHD causes 146.5 deaths per 100000 of population among men and 80.1 per 100000 of population among women. IHD is responsible for 25.3% of deaths [4, 5]. In Europe, IHD is responsible for 1.8 million of deaths per year, which corresponds to 20% of men and 21% of women. In the Republic of Moldova the death rate because of IHD per 100.000 of population is 138 per men and 51 per women, simultaneously, Romania presents a death rate approximately 2 times smaller: 75 per 100.000 of population – men and 21 per 100.000 – women, and the highest death rate because of IHD is in Russia: 186 per 100.000 of population – men and 44 per 100.000 of population – at women [6]. Various observational studies have proved the existence of sex differences both in clinical and paraclinical presentation, and in therapeutic options which are not effective and safe in equal measures for men and women. At the same time, it has been proved that the men are involved to a lesser extent in the population studies pointing the cardiovascular diseases, so from 62 randomized studies in Europe only 33.5% of participants were women [3, 5]. It was found that men with AP who seek medical attention have a superficial approach, involving more frequently the noninvasive methods versus the invasive methods, and they have a lesser possibility than men of revascularization treatment. So, among the men with AP, 4.2% of them dispose of revascularization, meanwhile only in 2.4% of women with AP dispose of this option of treatment [2, 5]. Taking into consideration the growing of the incidence of AP in women, the determination of a late diagnosis because of clinical atypical manifestations and the reduced involvement of women with AP in population studies, we intend to study the AP peculiarities of women from the Republic of Moldova, which means an actual health and social problem. The aim of the study: to study the etiological, clinical and paraclinical peculiarities and the treatment of stable angina in men. Objectives of the study. To study the cardiac predisposing factors and comorbidities in men with stable angina. To analyze the peculiarities of clinical evolution of stable angina in men. To evaluate the paraclinical results in patients that was included in the study. To evaluate the treatment of stable angina in men. The study included 116 patients with AP, admitted to the Municipal Hospital Sfanta Treime and the Cardiological Institute during September 2015 – November 2016. Diagnostic of Stable Angina was determined by clinical criteria: anamnesis, clinical manifestations, objective data; instrumental examination: electrocardiography in all patients, effort test and coronary angiography in patients selected for revascularization by coronary artery bypass grafting, Holter monitor ECG, stress test medication in a group of patients for technical reasons; Laboratory tests: lipidogram, coagulation, blood glucose, blood counts in all patients, and markers of myocyte injury in some patients with UAP for financial reasons. Results and discussions According to the study goals and objectives, we analyzed in detail AP patients with predisposing factors to determine, comorbidities, clinical manifestations and complications, results paraclince specific treatment and preventive measures in these patients. Starting from the paper’s purpose patients were divided into 2 groups according to sex. In our study group were predominantly men, numbering 67, which constituted 57,8%, compared to women – 49 which corresponds to 42,2%. AP increased prevalence among men is explained by the fact that women have a protective role of ovarian hormones in premenopausal period. We aimed to evaluate patients in the study depending on age and sex, the data is illustrated in the following graphic. In patients aged up to 64 years, AP predominates in men than women: ≤44 years (2,8% vs 0%), 45-54 years (16,5% vs 9,2%); 55-64 years old (46,5% vs 29,4%) and after age 65, AP prevalence is higher in women compared to men: 65-74 years old (32% vs 22,8%); 75-84 years old (26,8% vs 11%); ≥85 years (2,6% vs 0,4%). This phenomenon can be explained by the combination of a new risk factor in women and certain post-menopausal and longer life expectancy of women than men [1, 4]. Analyzing the results, we note that the initial diagnosis of AP was established more frequently in men (62.6%) compared to women (51.6%). Acute Coronary Syndrome was suspected equally to men (22.4%) and women (23.72%). At the same time, women were hospitalized more frequently with other diagnoses (24.2%) vs men (12.2%). According to the pain location, we can observe that in men typical retrosternal pain and precordial pain is determined 82,4% vs 88,5% in biggest proportion compared to women‘s. At the same time, for women’s prevailed pain in the atypical locations in 5.2% and missing of the pain in 12.4%. This results is explaining by a big prevalence of atypical clinical picture of AP. Analyzing this obtained results, we can observe, that men’s pain radiates predominantly on a left shoulder – 67.2 % vs 48.4 %, during the time that extension of the pain in other regions is present more frequently for women’s. In the left shoulder and hand – 17.8% vs 9.8%, interscapulo – vertebral 17.8% vs 14.8%, throat – 8% vs 6.6%, mandible – 3.2% and other locations – 4.8% vs 1.6%. Studying the data obtained, we note that in most of the patients, the AP gives the administration of nitroglycerin, a rate less prevalent in men (59.1%) than in women (62.3%). Anginal pain at rest was determined that yield more often in men (21.5%) than in women (17.1%), and improving crisis management nitroglycerin angina both at rest and was in an amount almost equal to both sexes 19.4% vs 20.6%. Various observational studies have proved the existence of sex differences both in clinical and paraclinical presentation, and in therapeutic options which are not effective and safe in equal measures for men and women. At the same time, it has been proved that the men are involved to a lesser extent in the population studies pointing the cardiovascular diseases, so from 62 randomized studies in Europe only 33.5% of participants were women [Stramba-Badiale M., 2009]. It was found that men with AP who seek medical attention have a superficial approach, involving more frequently the noninvasive methods versus the invasive methods, and they have a lesser possibility than men of revascularization treatment. So, among the men with AP, 4.2% of them dispose of revascularization, meanwhile only in 2.4% of women with AP dispose of this option of treatment. In the study group gr II IC prevailed in almost equal proportion in both sexes, women (57.8%) vs men (59.1%), followed by IC gr. III (36.2%) vs. (35.6%). Gr. IV IC and IC gr. I was in the minority. We should notice that the anti-ischemic therapy, most commonly administered beta-AB, slightly more prevalent in men (73.2%) vs (68.6%), BCC, commonly administered to women (56.2%) vs ( 44.5%) and less nitrates: 14.9% for women vs 12.2% men. The cytoprotective benefited equally to men (41.3%) and women (39.2%). For prophylactic antiplatelet prevailed slightly more prevalent in men (71.2%) vs women (70.3%). Statins and anticoagulants were given less frequently in women. Conclusions Angina pectoris is higher in men than in women (57,8% vs 42,2%). The rate of pathology is changing with age, up to 64 years, angina is more frequent is meat in men (65,8%) vs 38,6 in women, and after the age of 65 years, women prevail (61,4% vs 34,2%). In patients with angina clinical picture was more often represented by the retrosternal pain in 52,7% and dependent in physical exertion in 68,5% of medium intensity, with a duration of 5-10 minutes at those with stable angina (15,9%) and 20 minutes from those with unstable angina (14,7%), that were ameliorated after nitroglycerin intaking. Men representing the angina pectoris have administrated the pharmacological treatment mostly with: notice that the anti-ischemic therapy, most commonly administered beta-AB, slightly more prevalent in men (73.2%) vs (68.6%), BCC, commonly administered to women (56.2%) vs (44.5%) and less nitrates: 14.9% for women vs 12.2% men

Железодефицитная анемия при воспалительных заболеваниях кишечника

USMF Nicolae Testemițanu, IMSP SR ACSR, Conferinţa consacrată aniversării celor 40 de ani de la fondarea SCM Sfânta Treime 17 iunie 2016 Chișinău, Republica MoldovaInflammatory bowel disease (IBD) represents a group of intestinal disorders that cause prolonged inflammation of the digestive tract, with genetic determinism, consequence of an inappropriate immune response to exogenous stimulation. They are characterized by recurrent episodes of inflammation of the gastrointestinal tract, interspersed with periods of remission. Inflammatory bowel diseases are currently treated with predominantly digestive symptoms, but in medical practice we meet and associated systemic manifestations of basic pathology. Extraintestinal manifestations are generally related to the activity of the bowel disease and may precede or be simultaneous to the bowel symptoms, the presence of these symptoms is commonly associated with a decline in the quality of patients with IBD life, which requires a quick diagnosis, accurately and treatment suitable. One of the most common manifestations of IBD is anemia, in case that is not diagnosed and treated has a significant impact on quality of life.Воспалительные заболевания кишечника (ВЗК) это группа полиэтиологических заболеваний, возникающих вследствие неадекватного иммунного ответа на экзогенные раздражители. Они характеризуются повторяющимися эпизодами воспаления желудочнокишечного тракта, чередующимися с периодами ремиссии. Воспалительные заболевания кишечника представлены патологиями с преимущественно симптомами co cтороны желудочно-кишечного тракта, но в медицинской практике встречаются и системные проявления, связанные с основным заболеванием. Внекишечная симптоматика, обусловленная течением заболевания может предшествовать или ассоциироваться с кишечными симптомами. В совокупности это отрицательно влияет на качество жизни пациентов с ВЗК и определяет постановку правильного предварительного диагноза и назначения адекватного лечения. Одной из самых распространенных проявлений ВКЗ является анемия, которая без своевременной диагностики и лечения оказывает значительное влияние на прогноз пациентов и влияет на качество жизни

Bradyarrhythmias − a cause of cardiac syncope

Departamentul Medicină Internă, USMF Nicolae Testemiţanu, IMSP SCM Sfânta Treime, Laboratorul hepato-chirurgical, USMF Nicolae TestemiţanuThe prevalence of bradyarrhythmias requiring permanent cardiostimulation, is unknown. The main pathophysiological consequences of bradyarrhythmias are related to the decrease in cardiac output. In the case of severe bradyarrhythmias due to the sudden decrease in low cerebral fl ow occurs syncope. Bradyarrhythmias are one of the most recognized causes of syncope. Establishing a relationship between symptom and bradycardia should be the goal of a medical assessment for cardiostimulation and cardiac resynchronization therapy

Тромбэмболии – внекишечные проявления воспалительных заболеваний кишечника

USMF Nicolae Testemițanu, IMSP SR ACSR, IMSP SCM Sfânta Treime, USMF Nicolae Testemiţanu, IMSP SCM Sfânta Treime, Conferinţa consacrată aniversării celor 40 de ani de la fondarea SCM Sfânta Treime 17 iunie 2016 Chișinău, Republica MoldovaInflammatory bowel disease: ulcerative colitis and Crohn’s disease, are chronic inflammatory conditions that are characterized by local and systemic inflammation, predominantly affecting the gastrointestinal tract, but that may determine numerous extra-intestinal manifestations, including venous thrombosis. Inflammatory bowel disease patients have an increased risk of venous thromboembolism (VTE), which represents a significant cause of morbidity and mortality. According to numerous studies the prevalence of TVE is considered between 1.2% and 6.1% or even up to 39%. The etiology is multifactorial, including genetic and acquired risk factors, which are present at the same time, multiplies the risk to the patient. The role of mechanical and pharmacological prophylaxis against VTE using anticoagulants is also crucial.Воспалительное заболевание кишечника (ВЗК) – язвенный колит и болезнь Крона – считаются преимущественно системными патологиями с преобладанием клиники со стороны пищеварительной системы, но так же могут ассоциироваться с внекишечными проявлениями, включая венозную тромбоэмболию (ВТЭ). У пациентов с ВЗК повышенный риск развития ВТЭ, которая является одной из основных причин заболеваемости и смертности. Согласно исследованиям распространенность ВТЭ от 1,2% до 6,1% или даже до 39%. ВЗК считаются полиэтиологическими заболеваниями, включая генетические и приобретенные факторы риска, которые, при их сочетании, многократно увеличивают риск для пациента. Важную роль в механической и фармакологической профилактике тромбоэмболических осложнений играет использование антикоагулянтов, что и является решающим моментом

Cardiopatia ischemică – aspecte noi de diagnostic şi tratament intervenţional. Caz clinic

Bolile aparatului circulator au fost cauza decesului a 657,4 persoane la 100000 locuitori, dintre care cardiopatia ischemică deține circa 60%. În RM în a. 2006 incidența CPI a fost estimată de 142,5 la 10000 locuitori și mortalitate în a. 2008 - 1175,0 persoane la 100000 locuitori. Coronaroangiografia și angioplastia percutană sunt metode moderne de tratament a bolii cardiace coronariene, caracterizate prin invazivitate scăzută și eficiență ridicată. Raportăm cazul clinic a unui bărbat de 50 de ani cu diagnosticul: Cardiopatie ischemică, căruia i s-a efectuat coronaroangiografia, iar ca metodă de tratament revascularizare prin PCI

Neurofibromatosis type I − cause of hypertension?

Departamentul Medicină Internă, USMF Nicolae Testemiţanu, IMSP SCM Sfânta TreimeNeurofibromatosis type 1 (NF1) is a multisystem genetic disorder that is characterized by cutaneous findings, most notably café-au-lait spots and axiliary freckling by skeletal dysplasia, and by the growth of both benign and malignant nervous system tumors, most notably benign neurofibromas. Cardiovascular manifestations of neurofi bromatosis are: hypertension, valvular stenosis, congenital heart defects, complete cardiac block, hipertrofic cardiomyopathy, myocardial infarction, coronary spasm