Human Papilloma Virus (HPV) Infection and HPV Vaccination: Assessing the Level of Knowledge among Students of the University of Medicine and Pharmacy of Tirgu Mures, Romania

Introduction: Human Papilloma Virus (HPV) infection, a cause in the development of cervical cancer, remains a topic of great interest. About 80% of sexually active women are at risk of acquiring an HPV infection at some point in life, the peak incidence of infection having been identified in young women. The aim of the study was to assess medical students’ knowledge and attitudes about sexually transmitted diseases, HPV infection, HPV vaccinations, and the students’ sexual behaviour. Material and method: A transversal study was conducted by applying a questionnaire to students on the first and 6th year of school at the Faculty of Medicine of Tirgu Mures University, Romania. Results: The study resulted in 522 questionnaires fully completed. The percentages of students who have heard about HPV were 82.1% from the first year and 99.1% from the 6th year of medicine school, but the level of knowledge was different: 62% of senior students had a good or very good level of knowledge, whereas 55.1% of first year students, had little knowledge on the topic. About 75% of 6th year students would have their child vaccinated against HPV, compared with only 52.4% of first year students (p &lt;0.001). Conclusions: The level of knowledge about HPV infection among students in their first year of medicine school is rather low, significantly lower compared to year 6th year students, which suggests acquiring some basic information in this area since the first year of college or even high school.</p

Colonization, Infection and Risk Factors for Death in an Infectious Disease ICU in Romania

Knowing the bacterial strains in the intensive care unit (ICU) is important for reducing the rate of bacterial transmission and the risk of healthcare-associated infections (HAIs), allowing for targeted interventions to reduce the risk of death by HAIs. We performed a retrospective case-control study in a single center that included 320 bacteriologically screened patients from the ICU of the Infectious Diseases Hospital in Constanta between September 2017 and March 2020. Sixty-five secondary bacterial infections were identified as the cause of hospital admission and 60 bacterial colonizations. There were 20 cases and 300 controls for the mortality rate and risk factors for death. Multivariate analysis identified that hospitalization of patients for HIV infection (OR 11.82, 95% CI: 1.69-83.62, P ≤0.05) and Clostridioides difficile infection (OR 7.38, 95% CI: 1.39 -39.22, P ≤ 0.05) were independent risk factors associated with death. We observed that the number of colonizations or secondary infections in the ICU was similar, and the mortality rate in the ICU was influenced by HIV infection or Clostridioides difficile infection

EXPUNEREA OCUPAȚIONALĂ LA NANOPARTICULE - PROBLEMĂ DE SĂNĂTATE PUBLICĂ NEGLIJATĂ ÎN ROMÂNIA

Persons exposed to "natural" or "engineered" nanoparticles – either in production processes or during the transport of these materials, and especially when using nanoparticles/nanomaterials – are susceptible to their toxic action by inhalation, ingestion or skin contact. The study aimed to analyse the legislation and concerns of international nanoscience agencies as compared to the provisions of the relevant legislation in Romania, in order to describe the current status quo of health policies in the field of occupational exposures to nanoparticles. European institutions are turning to modern and varied solutions to raise awareness of the risk that nanoparticle represent for public health, and to stimulate scientific research in the field; they also encourage Member States to pursue a similar policy. Romanian legislation has not yet taken on the European Union's recommendations regarding health protection for occupational exposure to nanoparticles.   Keywords: nanoparticles, nanomaterials, occupational exposure, public healthPersoanele expuse la nanoparticule &rdquo;naturale&rdquo; sau &rdquo;fabricate&rdquo;&nbsp; fie &icirc;n cadrul unor procese de producţie, fie pe parcursul transportului acestor materiale, dar mai ales &icirc;n timpul utilizării nanoparticulelor/nanomaterialelor sunt susceptibili la acţiunea toxică a acestora, prin inhalare, ingestie sau contact cu pielea. Studiul și-a propus să analizeze legislația și preocupările agențiilor internaționale &icirc;n domeniul nanoparticulelor, &icirc;n comparație cu prevederile legislației &icirc;n domeniu din Rom&acirc;nia pentru a descrie status quo-ul actual &icirc;n ceea ce privesc politicile de sănătate &icirc;n domeniul expunerilor ocupaționale la nanoparticule. Instituțiile europene apelează la soluții moderne și variate pentru creșterea gradului de conștientizare a riscului nanoparticulelor asupra sănătății publice, stimulează cercetarea științifică &icirc;n domeniu și &icirc;ncurajează statele membre să ducă o politică similară. Legislația din Rom&acirc;nia nu a preluat &icirc;ncă recomandările Uniunii Europene &icirc;n domeniul protejării sănătății ca urmare a expunerii ocupaționale la nanoparticule. Cuvinte cheie: Nanoparticule, nanomateriale, expunere occupațională, sănătate publică

Parathyroidectomy in the treatment of secondary hyperparathyroidism. Clinical and laboratory outcomes/ Paratiroidectomia în tratamentul hiperparatiroidismului secundar. Aspecte clinice şi de laborator

Introducere. Hiperparatiroidismul secundar este frecvent întâlnit la pacienţii dializaţi. Paratiroidectomia rămâne o soluţie terapeutică în cazul hiperparatiroidismului secundar refractar şi a celui terţiar. Scopul acestui studiu este de a urmări impactul paratiroidectomiei, indiferent de tehnica chirurgicală utilizată, asupra simptomatologiei şi principalelor constante biologice. Material şi metodă. Am studiat 29 de pacienţi la care s-a efectuat paratiroidectomie pentru hiperparatiroidism secundar şi terţiar, la Clinica Chirurgie II, Spitalul Clinic Judeţean de Urgenţă Mureş, în perioada februarie 2010- mai 2013. Paramentrii urmăriţi au fost clinici şi de laborator (parathormonul, calciul total, fosforul şi fosfataza alcalină serică, hemoglobina şi hematocritul) determinaţi preoperator, imediat postoperator şi pe termen scurt şi mediu de urmărire. Rezultate. Simptomele clinice s-au ameliorat la majoritatea pacienţilor incluşi. Valorile parathormonului seric s-au redus semnificativ, rămânând scăzute pe întreaga perioadă de urmărire; valorile medii ale calcemiei, fosfatemiei, fosfatazei alcaline s-au redus semnificativ statistic în perioada de urmărire după paratiroidectomie. Hemoglobina şi hematocritul au prezentat creşteri semnificativ statistice atât pe termen scurt cât şi mediu de urmărire. Am întâlnit două cazuri de hiperparatiroidism persistent după prima intervenţie (6,89%); 8 pacienţi au prezentat hipocalcemii în prima lună postoperator (sindrom “hungry bones”). Nu am întâlnit mortalitate în seria studiată. Concluzii. Paratiroidectomia, indiferent de tehnica chirurgicală utilizată, rămâne o soluţie fezabilă în tratamentul hiperparatiroidismului secundat şi terţia

Pre- and Postoperative Evaluation of Patients with End-Stage Heart Failure Undergoing Cardiac Transplant – a Descriptive Study

Background: Heart transplantation is still the treatment of choice in patients with end-stage heart failure, refractory to medical treatment, in NYHA class III and IV, with dilated cardiomyopathy of various etiologies, including post-myocardial infarction

Immunosuppressive Medication and Non-Rejection-Related Complications Following Heart Transplantation

Background: Although the clinical evolution of a patient with heart failure is initially improved by transplantation, a number of potential complications may occur in the post-transplant period, which may be directly related to the effects of chronic immunosuppression. The purpose of this study was to analyze the occurrence and frequency of post-transplant complications related to immunosuppressive treatment in the Institute of Cardiovascular Diseases and Transplantation of Târgu Mureș, Romania

Cardiac autonomic neuropathy in type 1 and type 2 diabetes patients

Abstract Background Cardiac autonomic neuropathy (CAN) in diabetes is among the strongest risk markers for future global and cardiovascular mortality. The aim of this study was to analyse CAN prevalence and to compare the associations between CAN, the glycaemic control, cardiovascular risk factors, peripheral neuropathy, retinopathy and macroangiopathy in patients with type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Methods One hundred ninety-five diabetic patients were included in this study. All patients were evaluated for detection of CAN (with standardised cardiovascular reflex tests), diabetes-related microvascular complications (polyneuropathy, retinopathy), common carotid artery intima-media thickness (IMT) and ankle-brachial index (ABI). Results The prevalence of CAN was 39.1% in T2DM and 61.8% in T1DM patients. Multivariate logistic regression analysis demonstrated that in T2DM, the odds [OR (95% confidence intervals)] of CAN increased with diabetes duration [1.67(1.42–1.92)], HbA1c [1.74(1.34–2.27)], cholesterol [1.01(1.00–1.01)], triglycerides [1.01(0.99–1.00)], smoking [2.35(1.23–4.49)], systolic blood pressure [1.01(1.00–1.03)], BMI [1.16(1.08–1.24)], glomerular filtration rate [0.91(0.88–0.93)], peripheral neuropathy [25.94(11.04–44.25)], retinopathy [13.13(3.03–84.73)] and IMT [10.12 (7.21–15.32)]. In T1DM, the odds of CAN increased with diabetes duration [1.62(1.13–2.31)], HbA1c [4.49(1.27–15.9)], age of patients [1.14(1.03–1.27)], glomerular filtration rate [0.94(0.89–0.99)], peripheral neuropathy [31.6(4.5–45.8)] and IMT [5.5(2.3–8.3)]. Conclusion This study indicated that CAN is a more frequent complication in T1DM. Apart from glycaemic control, the existence of CAN is associated with potentially modifiable cardiovascular risk only in T2DM patients. The presence of other micro- and macrovascular complications increases the probability of having CAN in both types of DM (but more pronounced in T2DM)

Effects of a Novel Proprioceptive Rehabilitation Device on Shoulder Joint Position Sense, Pain and Function

Background and Objectives: Shoulder disorders are associated with pain, restricted range of motion and muscular strength, moderate disability and diminished proprioception. This study aimed to compare the effectiveness of an innovative technology-supported and a classical therapist-based proprioceptive training program in addition to conventional physiotherapy, on joint position sense (JPS), pain and function, in individuals with different musculoskeletal shoulder disorders, such as rotator cuff tear, subacromial impingement syndrome and superior labrum anterior and posterior tear. The innovative element of the proprioceptive training programme consists of the use of the Kinesimeter, a device created for both training and assessing shoulder JPS. Materials and Methods: The shoulder JPS test and the DASH outcome questionnaire were applied to fifty-five individuals (28 females, 27 males, mean age 56.31 &plusmn; 6.75), divided into three groups: 17 in the conventional physiotherapy group (control group); 19 in the conventional physiotherapy + classical proprioceptive training program group (CPT group); and 19 in the conventional physiotherapy + innovative proprioceptive training program group (KPT group). Assessments were performed before and after a four-week rehabilitation program, with five physiotherapy sessions per week. Results: When baseline and post-intervention results were compared, the value of the shoulder JPS and DASH outcome questionnaire improved significantly for the KPT and CPT groups (all p &lt; 0.001). Both KPT and CPT groups showed statistically significant improvements in JPS, pain and function, compared to the control group which received no proprioceptive training (all p &lt; 0.05). However, the KPT group showed no significant benefits compared to the CPT group. Conclusions: Our findings indicate that using the Kinesimeter device as a novel, innovative proprioceptive training tool has similar effects as the classical proprioceptive training programs among individuals with different non-operated musculoskeletal shoulder disorders such as: rotator cuff tear, subacromial impingement syndrome, and superior labrum anterior and posterior tear

Could fibrinogen and hsCRP be useful for assessing personal risk in workers exposed to a mixture of ultrafine particles and organic solvents?

Purpose: Our study focuses on elucidating if two common inflammatory biomarkers, easily performed in any laboratory - high-sensitivity C-reactive protein (hsCRP), as well as fibrinogen - could be used to assess the personal health risk of workers exposed to a complex occupational exposure to ultrafine particles (UFP) and a mixture of organic solvents. Methods: To assess the inflammatory response on the body, laboratory determinations were performed by testing the serum levels of hsCRP and fibrinogen, in exposed and unexposed groups. Results: There are no statistically significant differences for hsCRPs (p-0.25), medians were similar in groups. The mean values of fibrinogen in the three groups were: in the workers group (1st group): 346.2 mg/dl, in the office staff group (2nd group): 328.7 mg/dl, and in the control group (3rd group): 284.8 mg/dl, with significant differences between 1st group vs 3rd group and between 2nd group vs 3rd group (p-0.002). UFP levels differ between the groups, as follows: 1st group were exposed to the highest levels, ranging from 48349 to 3404000 part/cm3; 2nd group, ranging from 17371 to 40595 part/cm3; and 3rd group, ranging from 213 to 16255 part/cm3. Conclusions: Our study demonstrates that fibrinogen is a useful inflammatory biomarker for exposure to a mixture of UFP and organic solvents. On the other hand, hsCRP is not a useful inflammatory biomarker in occupational exposure to UFP and organic solvents. Further studies are needed to demonstrate the extent to which fibrinogen is more or less influenced by organic solvents or UFP alone