Reflective practice – an objective of the career counselling and orientation process

The correlation of theory with practice in the educational process, materialized in various forms, one of which being the professional practice, brings with it a series of benefits for the students: from verifying and validating the knowledge to covering all the learning styles of students. It is also an important milestone in guiding student careers by facilitating reflexive approaches, with a significant contribution to the crystallization of the professional route. Having the study case as a central research method, this paper highlights the mentioned benefits of the professional practice. The sample consist of 100 respondents (students in the 3rd year of study), data processing being done in SPSS 20

Water-Oil Partition Profiling of Ionized Drug Molecules Using Cyclic Voltammetry and a 96-Well Microfilter Plate System

Purpose. A new experimental set-up for studying partitioning of ionizable drugs at the interface between two immiscible electrolyte solutions (ITIES) by amperometry is presented. The method is quite general, as it can be applied to any charged drug molecule. Methods. The procedure is based on 96-well microfilter plates with microporous filters to support 96 organic liquid membranes. The new methodology is first validated using a series of tetra-alkylammonium ions and subsequently used to construct the ion partition diagrams of 3,5-N,N-tetramethylaniline and 2,4-dinitrophenol. The lipophilicity of these drugs was examined by potentiometry and cyclic voltammetry in the NPOE/water system. Results. Cyclic voltammetry resulted in potential-pH profiles of the studied drugs. When the aqueous phase pK a is already known, the logP NPOEof lipophilic drugs could be determined using a very little amount of solvents and drugs. The values of the partition coefficients for the neutral forms agree well with those obtained by potentiometry. Conclusions. The procedure based on commercially available 96-well microfilter plates is shown to be useful for determining logP of ionized drugs in a rapid and efficient wa

Two-phase partition profiling of drugs and ionisable compounds

Lipophilicity of compounds with therapeutic interest represents one of the most important physicochemical parameters in predicting and interpreting transport processes across biological barriers. This property is commonly measured as a drug | membrane partitioning by its distribution in a biphasic system, such as a water | oil system. The lipophilicity is a key parameter used in a variety of fields that may predict absorption and other transport properties of drugs in the human body. For a long time, the understanding of the lipophilicity of ionisable and ionic drugs was limited by the lack of reliable experimental methods to estimate the partition coefficients. Recently the introduction of cyclic voltammetry has filled this gap, opening new perspectives for its use in drug design transfer through a mimic of a biological membrane. The aim of this thesis was to develop new systems for the study of pH-lipophilicity profiles of neutral and ionisable compounds and to illustrate the various contributions of those in order to extend the applications for drug studies. The existing electrochemical methodology has revealed a number of limitations, which calls for further development of existing procedures. In particular, it has proved difficulty to investigate the partitioning of highly hydrophobic and hydrophilic compounds. Consequently, new systems with various phase ratios have been developed in order to extend the electrochemical measurements to medicinal chemistry. In the present work, two systems named "drop system" using a small aqueous phase and "liquid membrane system" using a small organic phase have been developed to study charge transfer reactions. The drop system is based on the simple deposition of an aqueous drop containing a redox couple onto the surface of a platinum electrode and immersed into an organic electrolyte solution. The electrode | water | oil interfaces are in "series". The voltammetric response depends on the coupling of the redox reactions on the solid electrode with the charge transfer reactions at the interface between two immiscible electrolyte solutions (ITIES), being either ion transfer (IT) or electron transfer (ET). This new drop system ensures a rapid equilibrium between the phases and has been used to study the lipophilic molecules. The liquid membrane system consists in a small organic phase either supported by a hydrophobic membrane or hold between two cellulose membranes placed between two aqueous phases, leading also to two interfaces in "series". The flowing of current across the liquid membrane is associated with two ion transfer reactions across the two polarised liquid | liquid interfaces in "series". This new methodology is described as a useful tool to study the transfer of highly hydrophilic ions, such as amino acids. Furthermore, a fundamental work on the miniaturization of liquid | liquid partition chromatography in a microchannel has been completed in order to offer a better understanding of the drug transport mechanisms. In the present work, a stationary liquid phase was immobilized in a microchannel using a porous polyvinylidene difluoride (PVDF) membrane. The final goal is to develop a high-throughput method for logP measurements in microchips based on partition chromatography. A computer simulation was performed using a finite element method. The model is validated by comparison of the simulated data with both analytical and experimental data. Finally, transfer reactions across an adsorbed phospholipid monolayer (constituent of biological membrane) at the water | DCE interface were studied by quasi-elastic light scattering (QELS). This technique consists in measuring the interfacial tension at different potential step. The transfer of hydrophilic cations, like amino acids was found to be facilitated by the formation of a complex between the cation or proton with the phospholipid, followed by desorption of the phospholipid monolayer from the interface. The method allows to understand the drug interaction with biological membranes within the transport process across them and to access to the different association constants in the organic phase. The work presented in this thesis demonstrates how the analytical electrochemistry at liquid | liquid interfaces can be extended to evaluate the fundamental thermodynamic parameters of various ionic compounds. The systems used herein are examples of new ways to study the lipophilicity of drugs with applications in drug screening pharmaceutical research and development

THE ETIOLOGY AND THERAPEUTIC MANAGEMENT OF PNEUMOTHORAX AND PNEUMOMEDIASTINUM IN CHILDREN

Introduction. Pneumothorax, pyopneumothorax and pneumomediastinum are rare but severe entities in pediatric respiratory pathology. They are often associated with severe pulmonary infections with multidrugresistant germs and are a major cause of morbidity in children, most of the time being medical emergencies. Material and method. The objective of the study was to analyze retrospectively for a period of 4 years the etiology, the treatment and the clinical and laboratory data of a group of 48 children admitted and treated in SCUC Grigore Alexandrescu Hospital, Bucharest with diagnosis of pneumothorax, pyopneumotorax or pneumomediastinum. Patients with traumatic pneumothorax were excluded. Results. The main etiology was pneumonia followed by primary spontaneous pneumothorax, congenital malformations (especially digestive tract), and asthma. The pneumonia frequency was 42.48%, and Streptococcus pneumoniae was the most frequent etiologic agent The group also included 2 cases of pleuropulmonary tuberculosis and one case with hydatid cyst, Marfan syndrome, cystic fibrosis, foreign body aspiration, lymphoma and pneumonia with Pneumocystis jirovecii. Dyspnea and chest pain dominated the clinical picture. The therapeutic conduct was dictated by the etiology. It included simple oxygen therapy in small pneumothoraces, pleural drainage in the massive ones and pleural drainage and broad spectrum antibiotic therapy in the case of pyopneumothorax. It was considered necessary to establish pleural drainage in 64.29% of children, 52% of those with pneumothorax, and all patients with pyopneumothorax. The duration of pleural drainage ranged from one day to 35 days for the pneumothorax, with a median of 6 days, respectively between one day and 32 days, with a median of 19 days for the pyopneumothorax. The average patient hospitalization was 16 days. Conclusions. Pneumothorax is rare in daily clinical practice, but can be a major pediatric emergency. Treatment aims to ensure full lung expansion and prevent relapses. Management is different depending on etiology and severity. Oxygen therapy is very important, and it increases the rate of reabsorption four times. Prognosis is often good for patients without sequelae, in primary spontaneous pneumothorax, recurrences are frequent

Reflective practice – an objective of the career counselling and orientation process

The correlation of theory with practice in the educational process, materialized in various forms, one of which being the professional practice, brings with it a series of benefits for the students: from verifying and validating the knowledge to covering all the learning styles of students. It is also an important milestone in guiding student careers by facilitating reflexive approaches, with a significant contribution to the crystallization of the professional route. Having the study case as a central research method, this paper highlights the mentioned benefits of the professional practice. The sample consist of 100 respondents (students in the 3rd year of study), data processing being done in SPSS 20

Concept Development of a New Lumbar Intervertebral Disk Implant

Worldwide spinal cord injury incidence is rising, due to spikes in traffic incidences, violence and an increase in ageing population, prone to injuries. To satisfy an expanding market, a wide variety of spinal implantable devices are available. The current study develops a new concept for a lumbar intervertebral disk implant which addresses the disadvantages of current commercialised devices. The proposed intervertebral disk implant concept limits the anatomical movements of the trunk, replicating the functions of a natural intervertebral disk. Three concept variations were designed and evaluated using FEA simulations for three main operating hypotheses: Compression of vertebrae in normal up-right position; Lifting weights at a correct and at an incorrect angle; Shock in the lumbar region. Von Misses stress, URES: Resultant Displacement and ESTRN: Equivalent Strain studies were used to evaluate the capability of the intervertebral disk implant concept to withstand the design load. Concept 3 failed URES and ESTRN simulations for the hypotheses which involved lifting weights and delivering a shock in the lumbar region. Simulation revealed optimum results for Concept 1, which was selected for further research

Concept Development of a New Lumbar Intervertebral Disk Implant

Worldwide spinal cord injury incidence is rising, due to spikes in traffic incidences, violence and an increase in ageing population, prone to injuries. To satisfy an expanding market, a wide variety of spinal implantable devices are available. The current study develops a new concept for a lumbar intervertebral disk implant which addresses the disadvantages of current commercialised devices. The proposed intervertebral disk implant concept limits the anatomical movements of the trunk, replicating the functions of a natural intervertebral disk. Three concept variations were designed and evaluated using FEA simulations for three main operating hypotheses: Compression of vertebrae in normal up-right position; Lifting weights at a correct and at an incorrect angle; Shock in the lumbar region. Von Misses stress, URES: Resultant Displacement and ESTRN: Equivalent Strain studies were used to evaluate the capability of the intervertebral disk implant concept to withstand the design load. Concept 3 failed URES and ESTRN simulations for the hypotheses which involved lifting weights and delivering a shock in the lumbar region. Simulation revealed optimum results for Concept 1, which was selected for further research

Use of Lung Ultrasound in Reducing Radiation Exposure in Neonates with Respiratory Distress: A Quality Management Project

Background and Objectives: Our quality management project aims to decrease by 20% the number of neonates with respiratory distress undergoing chest radiographs as part of their diagnosis and monitoring. Materials and Methods: This quality management project was developed at Life Memorial Hospital, Bucharest, between 2021 and 2023. Overall, 125 patients were included in the study. The project consisted of a training phase, then an implementation phase, and the final results were measured one year after the end of the implementation phase. The imaging protocol consisted of the performance of lung ultrasounds in all the patients on CPAP (continuous positive airway pressure) or mechanical ventilation (first ultrasound at about 90 min after delivery) and the performance of chest radiographs after endotracheal intubation in any case of deterioration of the status of the patient or if such a decision was taken by the clinician. The baseline characteristics of the population were noted and compared between years 2021, 2022, and 2023. The primary outcome measures were represented by the number of X-rays performed in ventilated patients per year (including the patients on CPAP, SIMV (synchronized intermittent mandatory ventilation), IPPV (intermittent positive pressure ventilation), HFOV (high-frequency oscillatory ventilation), the number of X-rays performed per patient on CPAP/year, the number of chest X-rays performed per mechanically ventilated patient/year and the mean radiation dose/patient/year. There was no randomization of the patients for the intervention. The results were compared between the year before the project was introduced and the 2 years across which the project was implemented. Results: The frequency of cases in which no chest X-ray was performed was significantly higher in 2023 compared to 2022 (58.1% vs. 35.8%; p = 0.03) or 2021 (58.1% vs. 34.5%; p = 0.05) (a decrease of 22.3% in 2023 compared with 2022 and of 23.6% in 2023 compared with 2021). The frequency of cases with one chest X-ray was significantly lower in 2023 compared to 2022 (16.3% vs. 35.8%; p = 0.032) or 2021 (16.3% vs. 44.8%; p = 0.008). The mean radiation dose decreased from 5.89 Gy × cm2 in 2021 to 3.76 Gy × cm2 in 2023 (36% reduction). However, there was an increase in the number of ventilated patients with more than one X-ray (11 in 2023 versus 6 in 2021). We also noted a slight annual increase in the mean number of X-rays per patient receiving CPAP followed by mechanical ventilation (from 1.80 in 2021 to 2.33 in 2022 and then 2.50 in 2023), and there was a similar trend in the patients that received only mechanical ventilation without a statistically significant difference in these cases. Conclusions: The quality management project accomplished its goal by obtaining a statistically significant increase in the number of ventilated patients in which chest radiographs were not performed and also resulted in a more than 30% decrease in the radiation dose per ventilated patient. This task was accomplished mainly by increasing the number of patients on CPAP and the use only of lung ultrasound in the patients on CPAP and simple cases