How to Improve Student Education in Cardiology? 13 Essential Answers Through Medical Simulation

DergiPark: 379021tmsjAims: Is there a difference, from a clinical point of view, between a first year resident and a 4th year one, in the branch of Cardiology? If so, do we need to diminish it? And more importantly, do we have the tools? In this study it is aimed to evaluate medical simulation and its applicability in cardiology as an education method contributing to make students and residents more experienced and sufficient. Methods: The descriptive, cross-sectional study based on a survey which was applied to the groups of students in Carol Davila’ University of Medicine and Pharmacy (146) and residents (33 out of which 18 in the first two years and 15 in the last 3 years) was conducted between November 2014 and January 2015. Responses regarding evaluation of medical simulation as an education method were analyzed by using descriptive statistics including frequencies and percentages.Results: The results showed that with the usage of medical simulation as an education method 128 (87.6 %) students would have felt more confident and learnt faster, while 113 (77.5%) students would have found studying more appealing. Furthermore 10 (68%) of residents in the 3rd, 4th, 5th year would have felt more experienced, if they actually encountered rare simulated pathologies; thus 16 (91%) of the residents in the 1st, 2nd year thought the risks would have decreased for patients.Conclusion: Medical Simulation remains a necessity as an education method to improve practical skills of both students and residents in branch of cardiolog

Analgezia postoperatorie precoce

Universitatea de Stat de Medicină şi Farmacie ”Nicolae Testemiţanu“, Catedra de obstetrică şi ginecologie nr. 1,Catedra de obstetcica şi ginecologie nr. 2, Clinica Familia, Catedra de antesteziologie şi reanimatologie nr. 2, Spital Clinic Municipal nr. 1, Al VI-lea Congres Național de Obstetrică și Ginecologie cu participare internațională, 13-15 septembrie 2018, Chișinău, Republica MoldovaIntroducere: Analgezia postoperatorie precoce permite o analgezie mai efi cientă şi o mobilizare mai rapidă pentru lăuzele bine motivate. Menţinerea analgeziei se face cu opioide antiinflamatoare nonsteroide şi paracetamol. Scopul lucrării: Studierea eficienţei în iniţierea unei analgezii precoce cât şi menţinerea analgeziei postoperatorii şi reducerea perioadei de imobilizare a lăuzei. Material şi metode. Au fost studiate 90 paciente postpartum ce au născut prin operaţie cezariană din Clinica Familia unde s-a administrat intraoperator preparate antiinflamatoare într-o doză unică. Rezultate. Utilizare antiinflamatoarelor a permis reducerea consumului de opioizi în perioada postoperatorie, mobilizarea mai rapidă şi mai eficientă după şase ore de la intervenţie. O atenţie sporită trebuie acordată în cazurile de hemoragii, afectarea renală în preeclamsiile severe. Determinantele materne cum ar fi: durerea postoperatorie, discomfort postoperator, restabilirea îngreunată şi tardivă sunt înlăturate prin utilizarea regulată a preparatelor antiinflamatorii nonsteroide. Concluzii: Naşterea prin cezariană nu este un obstacol pentru lăuză care vrea să îngrijească de copilul său la şase ore după operaţie. Utilizarea antiinflamatorilor permite reducerea considerabilă a preparatelor opioide şi a disconfortului de la utilizarea acestora

Vitamin D supplementation – still a subject of debate

Vitamin D is a standard vitamin supplementation for children in many countries, used mainly for preventing rickets. Many studies were published about the efficiency of vitamin D administration in children and adults for other pathologies besides rickets. Very often the results were contradictory, but nevertheless, more and more articles are published on this matter. There is no consensus for the effective vitamin D dosage nor for the vitamin D normal serum values. Both vitamin D deficiency and vitamin intoxication are dangerous for children. Recently some studies are showing controversial data that advise being more careful in prescribing vitamin D as a routine

Polymorphism of the Prolactin (PRL) Gene and Its Effect on Milk Production Traits in Romanian Cattle Breeds

In the present study, we investigated one polymorphism of the PRL gene (rs211032652 SNP) and assessed its influence on milk production and chemical composition in two Romanian cattle breeds. A total of 119 cattle from two breeds reared in Western Romania (64 Romanian Spotted and 55 Romanian Brown) were included in the research herd. A PCR-RFLP genotyping assay was used for the identification of the rs211032652 SNP variants. Shapiro’s test and Levene’s test were used to verify ANOVA assumptions and ANOVA and Tukey’s test were employed to test the associations between PRL genotypes and five milk traits. Among the studied breeds, our results showed that PRL genotypes were significantly associated (p < 0.05) with fat and protein percentage in the milk of Romanian Brown cattle. The AA genotype was associated with a higher fat percentage in milk (4.76 ± 0.28) compared to the GG genotype (4.04 ± 0.22, p = 0.048), as well as a higher protein percentage (3.96 ± 0.32% vs. 3.43 ± 0.15%, p = 0.027) in Romanian Brown cattle. Moreover, the PRL locus favored a significantly higher fat (p = 0.021) and protein (p = 0.028) percentage in the milk of Romanian Brown cattle compared to the Romanian Spotted breed, with a difference of 0.263% and 0.170%, respectively

Archaeometrical Characterization of Romanian Late Bronze Age Ceramic Fragments

Knowledge of the past can provide information to protect the future and the potential of the technological development in the analytical sciences can be successfully applied for the study and conservation of cultural objects. In this context, in the present paper we propose an analytical methodology to characterize seven samples of ancient ceramic objects (dating to the Late Bronze Age). The samples were analyzed using optical microscopy, and all the samples presented a strong inhomogeneity on the surface, as suggested by the different colors of the ceramics. X-ray fluorescence (XRF) results reveal a relatively heterogenous composition of the samples, as well as strong differences between the different surfaces of each sample. By comparative analysis of the diffractograms recorded for both sides of the same samples were observed some differences, especially in terms of relative concentration of the component minerals, and, in lesser content, in terms of new phases present in the samples. Corroborated results obtained by XRF and X-ray diffraction (XRD) offered information regarding mineralogical composition of the samples: for some of them illite/muscovite and plagioclase phases are present in higher quantities or a lower quartz content. The presence of these components was confirmed by Fourier-transform infrared spectroscopy (FTIR) analysis. The thermal analysis completes the analytical investigation of the ceramic samples. The thermal behavior of the sample conducted to some explanation regarding the observed differences, due to the raw materials (that the major clay mineral in the samples is represented by illite) or to environmental factors during their burial in the soil

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Accumulation by dispossession and public-private biomedical pluralism in Romanian health care

Neoliberal reforms in health care are an accumulation by dispossession. In examining this in Romania, we show that neoliberal reforms led to an uneven landscape of public and private care. We document how patients variously situated in Romanian society respond to this situation, and demonstrate the instability of their strategies—restraining from formal care, lifting-off from public care and hooking-up to private care. Public– private biomedical pluralism proves to be detrimental to vulnerable and better-off patients alike