The effect of α-erhythropoietin administration in dialysed patients

Am efectuat un studiu deschis cu durată de o lună cu administrarea α-eritropoietinei (Repretine®) la 57 de pacienţi dializaţi. Am determinat efectul pozitiv al preparatului administrat în doze 4,000 – 8,000 IU, care sunt inferioare celor recomandate. De asemenea, am demonstrat că astfel de defi niţie simplă a statusului infl amator ca VSH > 30 mm/oră poate fi descriminativă pentru selectarea pacienţilor cu efectul maxim la administrarea dozelor reduse de medicament. Am demonstrat şi efi cienţa economică a eritropoietinei versus hemotransfuzii repetate la pacienţii dializaţi

European health care concept and health care strategies classification

Centrul Dializă şi Transplant Renal, IMSP Spitalul Clinic Republican, Al V-lea Congres de Urologie, Dializă şi Transplant Renal din Republica Moldova cu participare internaţională (1-13 iunie 2011)Summary. Logical link „health care strategy – strategy objective – health indicator” and EUPHID health model, accepted by the European Union, offered the possibility of elaboration of health care strategies classification. Therefore, health strategies can be divided in sanogenic strategies (oriented to the increase of health resources and amelioration of positive health and well being) and those based on the pathogenetic approach (reduction of risk factors as well as diagnosis and treatment of different diseases)

Clinical modifications of the cardiovascular system in patients with chronic pyelonephritis complicated with different stages of the chronic kidney disease

Centrul Dializă şi Transplant Renal IMSP Spitalul Clinic Republican, Al V-lea Congres de Urologie, Dializă şi Transplant Renal din Republica Moldova cu participare internaţională (1-13 iunie 2011)Summary. Comparative study of the arterial hypertension and chronic kidney disease has demonstrated the independent impact of the latter on pathological modifications in cardiovascular system, presented through the characteristic clinical picture. There was confirmed the role of renin-angiotensin-aldosterone system in the development of arterial hypertension, congestive heart failure, peripheral edema, as well as diastolic dysfunction (together with increased PTH levels). The severity of cardiovascular system affection correlates with chronic kidney disease stage

Efectul lărgirii uniunii europene asupra unor indicatori de sănătate

S-a efectuat un studiu comparativ al modifi cărilor pe care le-au suportat 20 de indicatori ai sănătăţii în 13 ţări-candidate în anul aderării la structurile comunitare, în comparaţie cu perioada de 5 ani după aderare. Analiza statistică efectuată a evidenţiat faptul că aderarea statelor-candidate la Comunitatea Europeană/ Uniunea Europeană a fost asociată cu o ameliorare statistic semnifi cativă a majorităţii indicatorilor studiaţi. Dinamica pozitivă a fost, în special, importantă în cazul maladiilor transmisibile, condiţionate de mediu şi stilul de viaţă, al mortalităţii cauzate de bolile cardiovasculare. De asemenea, au fost obţinutesuccese importante în managementul suferinţelor copiilor cu vârsta până la 5 ani

Chest X-ray utility in chronic dialysis patients

Euromed Diagnostic, Department of Radiology and Imaging, Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, the Republic of Moldova, The IVth Congress of Radiology and Medical Imaging of the Republic of Moldova with international participation, Chisinau, May 31 – June 2, 2018Background: Respiratory system pathologies are one of the most frequent causes of hospital admission for patients to chronic dialysis. Chest X-ray is an accessible and cost-effective way to diagnose such comorbidities and guide their management. The study aim was to assess the efficiency of follow-up chest X-rays performed twice per year for evaluation of chronic dialysis in outpatients. Material and methods: The study included 350 outpatients who underwent dialysis in Chisinau Dialysis unit of “BB-Dializa” S.R.L. during 2016. Basing on the National Clinical Protocol each patient except those on holiday dialysis underwent a chest X-ray in 3 projections twice per year. Additional chest X-rays could be performed if clinically indicated. Results: Simple chest X-ray in 3 projections has demonstrated to be an efficient instrument in diagnosis of both acute and chronic pulmonary, mediastinal and cardiac pathology. During the study period, 2 cases of BAAR+ tuberculosis were diagnosed and successfully treated. A total of 12 cases of pneumonia, 26 cases of chronic bronchitis, 1 case of primary lung cancer and 1 case of pulmonary metastases were also diagnosed at the routine follow-up chest X-rays. A total of 9 patients required hospital admission, while the rest underwent ambulatory treatment. Further investigations of the patient with lung metastases revealed a pancreatic malignancy. Conclusions: Proposed imaging management approach to the chronic dialysis outpatients has demonstrated its viability and efficiency in this cohort of 350 outpatients

Phospho-calcic metabolism modficiations in predialytic chronic kidney failure

Centrul Dializă şi Transplant Renal IMSP Spitalul Clinic Republican, Al V-lea Congres de Urologie, Dializă şi Transplant Renal din Republica Moldova cu participare internaţională (1-13 iunie 2011)Summary. Calcium and phosphorus metabolism disturbances are characteristic for predialytic kidney failure and are determined by both hormonal levels’ changes, renal secretion and absorption affection. The central role in pathologic effects development is played by parathormone, which is responsible for the great majority of extraosseous pathological effects, including atherosclerosis potentiation, specific arterial media sclerosis (Monkenberg) and myocardial fibrosis development. These pathological processes contribute to the higher cardiovascular complication rate development in patients with chronic kidney failure

The role of chronic viral infections in patients with chronic kidney disease

Centrul Dializă şi Transplant Renal IMSP Spitalul Clinic Republican, Al V-lea Congres de Urologie, Dializă şi Transplant Renal din Republica Moldova cu participare internaţională (1-13 iunie 2011)Summary. Chronic viral infections (herpesviridae, hepatitis B and C) can be responsible for previously inexplicable increase in lethality of the patients with advanced chronic kidney disease, especially treated by dialysis or kidney transplant. This hypothesis is supported both by literature review and presented empirical data

Renin-angiotensin-aldosterone system modifications in patients with chronic kidney failure

Centrul Dializă şi Transplant Renal IMSP Spitalul Clinic Republican, Al V-lea Congres de Urologie, Dializă şi Transplant Renal din Republica Moldova cu participare internaţională (1-13 iunie 2011)Summary. The role of the renin-angiotensin-aldosterone system activation is difficult to underestimate in initial stages of development and progression of the chronic kidney disease. Medical blockade of this system can slow down, stop or even inverse pathological modifications in kidneys. In the same time advanced chronic kidney disease especially in the stage of terminal renal insufficiency is associated with reninangiotensin-aldosterone system „disorganisation”, that siginificantly hampers such medical interventions in respective patient population

Association of clinical manifestations of haemodynamic disorders with cardiovascular risk factors in patients with chronic pyelonephritis in various stages of chronic kidney disease

Centrul Dializă şi Transplant Renal IMSP Spitalul Clinic Republican, Al V-lea Congres de Urologie, Dializă şi Transplant Renal din Republica Moldova cu participare internaţională (1-13 iunie 2011)Summary. Clinical manifestations of the haemodynamic modifications have showed a statistically authentic correlation both with conventional (renin-angiotensine-aldosteron system activation, phosphorus-calcium metabolism modifications, age, arterial hypertension) and unconventional (anemia, proteinuria, dimensional and functional kidney indices) cardiovascular risk factors in patients with different stages of the chronic kidney disease. In the same time clinical features of the cardiovascular system affection have correlated with echocardiographic modifications such as valvular affection, left ventricle hypertrophy associated with diastolic dysfunction, heart cavities dilation and the increase in the right ventricle systolic pressure

Cyclosporine generics in immunosupression of the kidney transplant patients

Centrul Dializă şi Transplant Renal IMSP Spitalul Clinic Republican, Catedra Urologie şi Nefrologie Chirurgicală USMF “N. Testemiţanu”, Al V-lea Congres de Urologie, Dializă şi Transplant Renal din Republica Moldova cu participare internaţională (1-13 iunie 2011)Summary. Practical implementation of Cyclosporine A generics implies combined application of 2 general international health care strategies: scientifically substantiation and diversification. Administration of the high-cost medications’ generics provides the possibility of significant treatment costs’ reduction through the drug selection diversification on both individual and the whole health care system’s levels. Scientifical substantiation, which is the basis of modern medicine, allows determining the conditions when generics administration is associated with maximum benefits and minimal side effects to any given patient. Scientifical substantiation is practically performed through comparative analysis of each possibility advantages and disadvantages in the light of the „problem oriented approach”, supported by special bioequivalence studies