A mini-review regarding the carcinogenesis and morphology of serous tumors of the ovary, fallopian tube and peritoneum

Similar to the already well-recognized adenoma-carcinoma sequence in colorectal cancer pathogenesis, it has been believed for many decades that the progression of ovarian epithelial tumors occurs from benign serous cystadenomas to borderline tumors, to well-differentiated carcinomas, and ultimately, to poorly differentiated carcinomas. However, it is currently accepted that low-grade serous carcinoma (LGSC) and high-grade serous carcinoma (HGSC) are fundamentally different tumor types and, consequently, different diseases. In fact, whereas the benign-borderline-malignant sequence seems to apply quite well to low-grade serous carcinoma, the sequence of genetic alterations in high-grade serous carcinoma is substantially different. In this mini-review, we included the current consensus regarding the morphological and etiopathogenic results regarding serous tumors of the ovary, fallopian tube and peritoneum. It also briefly describes the history of benign, borderline and malignant serous tumors, discussing multiple types of dichotomies in serous carcinomas of the female genital tract and summarizing the current molecular classification

Studierea și evaluarea impactului social calculat în baza indicatorului DALY produs de infecția cu virusul hepatitei virale B

Centrul Național de Sănătate Publică, Centrul de sănătate publică mun. Chișinău, IMSP Spitalul Raional Fălești, Conferința Științifică „Centrul Medical «Galaxia» la 20 de ani”Articolul prezintă date privind nivelul povarei hepatitei virale B în Republica Moldova pentru anii 2005-2016. Studiul a fost realizat pe baza datelor de la 87 de pacienți cu hepatită virală B, formă fulminantă și ciroză hepatică. Cazurile selectate au inclus 14 pacienți din nordul țării, 19 din regiunea centrală, 8 din sud și 46 din Chișinău. Pentru a cuantifica povara și consecințele sociale ale hepatitei virale B, s-au determinat indicatorii YLL, YLD și DALY. Rezultatele principale arată că, pentru bărbați, DALY a fost de 1116,2 DALY din cauza HVB, iar pentru femei - 1003,0 DALY. Pe persoană, femeile au pierdut mai mulți ani de viață datorită HVB, respectiv 27,1 DALY, comparativ cu bărbații care au pierdut 22,3 DALY.The article presents data on the level of the burden of viral hepatitis B in the Republic of Moldova during 2005-2016. The study was conducted on the basis of data from 87 patients with viral hepatitis B, fulminant form and cirrhosis of viral hepatitis B. Selected cases included 14 patients from the Northern area, 19 from Center area, 8 from South and 46 from Chisinau. To quantify the burden and social impact of viral hepatitis B, the YLL, YLD and DALY indicators were determined. The main results show that total men lost 1116.2 DALY due to HVB, and women - 1003.0 DALY. Per person, women lost more years of life due to HVB, namely 27.1 DALY, compared to men who lost 22.3 DALY

Rezultate preliminare privind depistarea infecţiilor hemotransmisibile la utilizatorii de droguri injectabile

Articolul de faţă este dedicat evaluării nivelului de infectare cu HVB, HVC, HTLV 1/2, HSV 1/2, EBV şi CMV în rândul narcomanilor ce practică consumul de droguri intravenoase. S-a utilizat metoda descriptivă de studiu pe perioadă 2015-2016. Prin metoda ELISA au fost diagnosticaţi serurile a 141 de utilizatori de droguri la markerii HVB, HVC, HTLV 1/2, HSV 1/2, EBV şi CMV. Toţi aceşti markeri au fost identificaţi în mod individual şi în asociere. S-a constatat, că 56,0% sunt pozitivi pentru markerii hepatitei virale, 13,5% pentru anti-HTLV 1/2, 91,7% au avut un rezultat pozitiv pentru anti-HSV 1 IgG şi 19,1% pentru anti-HSV 2 IgG, EBV a fost găsit în 92,6%, anti-CMV în 100,0%. Aşadar, rezultatele obţinute arată concordanţa situaţiei din Republica Moldova cu alte ţări şi sugerează necesitatea continuării acestui studiu, în scopul de a dezvolta metode eficiente de monitorizare a acestei infecţii

High-grade versus low-grade serous carcinoma of the ovary – current differential diagnosis and perspectives

Introduction. Serous carcinoma is responsible for 47% of all ovarian cancers, and from these cases, only 5% are represented by low-grade serous carcinoma, the rest of them accounting for high-grade serous carcinoma. Objective. The aim of this study is an observational approach of the differences and similarities of the two types of serous carcinoma of the ovary, that must be seen as different forms of cancer and rendered with care. Methods. We performed a retrospective study using three cases of ovarian high-grade serous carcinoma and three cases of ovarian low-grade serous carcinoma, diagnosed at the University Emergency Hospital Bucharest. We analyzed patients’ age, clinical symptoms, macroscopic and microscopic features together with immunohistochemistry tests. Results. Mean age for HG carcinoma was 71.3 years old and for LG carcinoma 47.6 years old. Average tumor diameter was with 5.67 cm higher for LG carcinoma. The most encountered stage for HG tumors was pT2a and for LG tumors was pT1a. Mean value for Ki67 was with 36.33% higher for HG carcinoma. AR expressed diffuse positivity in two cases of LG and only focal positivity in two cases of HG. CD44 expressed focal positivity in all cases of LG and had different patterns in HG. Conclusions. We found considerable differences between patients’ mean age, macroscopic and microscopic features, together with immunohistochemistry expression for Ki67, AR, CD44

Epidemiologia infecției cu noul tip de coronavirus (COVID-19) în perioada inițială a pandemiei în Republica Moldova

National Agency for Public Health, Chisinau, Republic of MoldovaIntroduction. In the Republic of Moldova, the first case of COVID-19 was confirmed on March 7, followed by a significantly increasing incidence across the country. It is important to describe the clinical and epidemiological aspects that were adjusted to the national context in order to develop and implement optimal public health care measures. Material and methods. A cross-sectional descriptive study was conducted from March 7 to April 6, 2020, using the surveillance system data of the Republic of Moldova on COVID19 case incidence. All cases of COVID-19 were confirmed by Real-Time PCR. Results. During the reference period, 965 cases of COVID-19 were registered, whereas the urban incidence rate was 1.4 times higher than the rural one. The mean age of infected population was 45.2 years, whereas the most affected age group was 50-59 years, found in 232 cases. Healthcare workers made up 26.6±1.4% out of 965 diseased patients. They included nurses – 34.2±3.0%, auxiliary medical staff – 29.6±2.8%, doctors – 27.2±2.8%, first-aid assistants – 7.4±1.6%, pharmacists – 1.2±0.7%, paramedics – 0.4±0.4%. The health status of people diagnosed with COVID-19 was severe in 8.0±0.9% of cases; moderate severity – in 34.7±1.5% and satisfactorily severe – in 57.3±1.6% of cases. Conclusions. The identified clinical and epidemiological aspects allowed readjusting the public health policies in order to prevent the spread of COVID-19 infection among the elderly and medical workers.Introducere. Primul caz de infectare cu noul tip de coronavirus COVID-19 în Republica Moldova a fost confirmat la data de 7 martie 2020, ulterior a fost înregistrată o creștere semnificativă a îmbolnăvirilor. Aspectele clinico-epidemiologice ajustate contextului național sunt necesare a fi descrise pentru elaborarea și implementarea acțiunilor optime de sănătate publică. Material și metode. Am realizat un studiu descriptiv transversal în perioada 7.03.2020 – 6.04.2020, folosind datele din sistemul de supraveghere a Republicii Moldova cu privire la cazurile de infecție COVID-19, care au fost confirmate prin tehnici de biologie moleculară (Real-Time PCR). Rezultate. În perioada de referință au fost înregistrate 965 cazuri de COVID-19, mediul urban fiind afectat de 1,4 ori mai mult decât cel rural. Vârsta medie a celor infectați a fost de 45,2 ani, iar cel mai afectat grup de vârstă a fost cel de 50-59 ani – 232 cazuri. Dintre cele 965 persoane infectate, lucrătorii medicali reprezintă 26,6±1,4%: asistenți medicali – 34,2±3,0%; personal medical auxiliar – 29,6±2,8%; medici – 27,2±2,8%; felceri – 7,4±1,6%; farmaciști – 1,2±0,7%; paramedici – 0,4±0,4%. Starea de sănătate a persoanelor diagnosticate cu COVID-19 a fost gravă în 8,0±0,9%, de gravitate medie în 34,7±1,5% și satisfăcătoare în 57,3±1,6%. Concluzii. Aspectele clinico-epidemiologice identificate permit reajustarea politicelor de sănătate publică referitor la prevenirea răspândirii infecției COVID-19 printre persoanele în vârstă și lucrătorii medicali

Hepatita virală B la lucrătorii medicali din Republica Moldova

În studiul realizat s-a demonstrat, că seroprevalenţa markerului AgHBs la lucrătorii medicali în Republica Moldova constituie 11,8%, iar la anti-HBcor (sum) – 19,5%. Nivelul protector de anti-HBs (≥10 UI/ml) s-a demonstrat la 58,6% din numărul total de lucrători medicali investigaţi, cea mai mică valoare s-a înregistrat la vârsta de 61 ani şi mai mult (16,7±15,2%). Aceste date justifică faptul, că personalul medical necesită o doză booster de vaccin contra hepatitei virale B la 10 ani după vaccinarea primară. Totodată, seroprevalenţa markerilor anti-HBs concomitent cu anti-HBcor s-a demonstrat în 31,3±5,0% cazuri.

Seroprevalence of viral hepatitis B, C and E in TB patients from the Republic of Moldova

Introduction. For the first time, in the Republic of Moldova, there was established the seroprevalence of viral hepatitis B, C and E markers in patients with tuberculosis depending on gender, age and geographical areas. Material and methods. 200 blood samples were collected from patients with tuberculosis and tested by the immuno-fermentative method for presence of viral hepatitis B, C and E markers. Results. Following the investigations, it was established that the seroprevalence of the anti-HEV Ig marker in patients with tuberculosis is 12.0±2.3%. The seroprevalence of viral hepatitis B marker HBsAg in patients with tuberculosis was 13.5±2.4%, and that of viral hepatitis C anti-HCV – 9.0±2.0%. The study of investigations results for the presence of nominated markers depending on the geographical areas showed a significant statistically difference in the seroprevalence of the anti-HEV IgG marker in TB patients in the Central area of the country compared to the Southern area(p<0.05). Conclusions. Patients with tuberculosis have a higher risk of developing viral hepatitis B, C and E, mainly affecting people aged 40-49 and > 60 years, including males

Clinico‑morphological aspects and new immunohistochemistry characteristics of ovarian high‑grade serous carcinoma

Introduction. High‑grade serous carcinoma of the ovary is an aggressive form of cancer, with unknown precursor lesions and often delayed diagnosis because of non‑specific, mild symptoms. Objective. We performed a clinical‑pathological study of ovarian high‑grade serous carcinomas, in order to evaluate morphological and new immunohistochemistry characteristics of this malignancy. Methods. This is a retrospective study of 10 cases of ovarian high‑grade serous carcinoma. We evaluated patients’ age, symptoms at presentation, macroscopic aspects, bilateral involvement, microscopic features: papillary/solid areas, mitotic index, psammoma bodies, tumoral extension, lymph node metastasis, immunohistochemistry markers: CD44, ER, AR, Ki67 index. Results. Mean age was 56.9 years old. Tumors were bilateral in 50% of cases. Only 30% were limited to the ovary. Maximum tumor diameter was 16 cm. Solid component in a proportion of 50‑95% was more characteristic. Most tumors had a mitotic index of 30‑50 mitosis/10HPF (70% of cases). 20% of cases contained psammoma bodies. 2 cases out of 7 had lymph node metastasis. We noticed one case with pleural metastasis (M1). We observed AR80% was noticed in 30% of cases. CD44 was positive in 50% of cases and one case had diffuse positivity of CD44 in corpus luteum cells near the tumoral bed. Conclusions. The majority of patients with ovarian high‑grade serous carcinomas presented with extraovarian extension and were characterized by high mitotic index, rare presence of psammoma bodies, AR expression <10%, novel marker CD44 positive in 50% of cases and curious positivity in corpus luteum cells associated with the tumor

Assessment of anti SARS-COV-2 antibodies present in convalescent plasma donors aimed at being used in COVID-19 treatment

Agenția Națională pentru Sănătate Publică, Republica Moldova, Centrul Național de Transfuzie a Sângelui, Republica Moldova, Universitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”, Republica Moldova, SC Balkan Pharmaceuticals SRL, Chișinău, Republica MoldovaIntroduction. Currently, COVID-19 treatment includes several options, including the use of convalescent plasma. Therefore, the presence of anti-SARS-CoV-2 in blood donors after the clinical recovery of COVID-19, depending on their place of residence, age and the clinical manifestation of the disease is of scientific-practical interest. Material and methods. A total of 119 donors among patients were examined, namely, males aged 18-60 years, having a past history of COVID-19 disease, being confirmed by PCR and treated, showing a negative PCR-based test result, which was performed at least 14 days after clinical recovery. The presence/absence of anti-SARS-CoV-2 was assessed by enzyme-linked immunosorbent assay. Results. The obtained data showed that 87.4% of plasma donors responded to COVID-19 infection by anti-SARS-CoV-2 IgG expression, being predominantly found in the 26-35 age group. Most donors experienced mild and medium clinical forms. It is important to note that all severe clinical manifestations of the infection were followed by formation of anti-SARS-CoV-2 IgG. Urban living environment was predominantly found in convalescent donors (75.0%), which indicates that they are better informed by medical institutions. Conclusions. The study shows that male blood donors aged 18-60 years, subsequently cured and being positive to anti-SARS-CoV-2 IgG can serve as a source of fresh plasma used for the treatment of COVID-19 patientsIntroducere. Tratamentul COVID-19 include mai multe opțiuni, inclusiv utilizarea plasmei convalescente. Astfel, prezintă un interes științifico-practic existența anticorpilor anti SARS-CoV-2 la donatorii de sânge după recuperarea clinică de COVID-19, în funcție de mediul de trai, de vârstă și de forma de manifestare clinică a bolii. Material și metode. Au fost examinați 119 donatori din rândul pacienților, persoane de sex masculin, cu vârsta de 18-60 ani, cu istoric de boală COVID-19, caz confirmat prin PCR, vindecați, cu rezultat negativ pentru COVID-19, confirmat de testul PCR, la cel puțin 14 zile de la recuperarea clinică. Prezența/absența anti SARS-CoV-2 a fost apreciată prin analiza imunoenzimatică. Rezultate. Datele obținute relevă că 87,4% dintre donatorii de plasmă au răspuns la infecția COVID-19 prin expresia anti SARS-CoV-2 IgG, cu predominare în grupul de vârstă de 26-35 ani. Majoritatea donatorilor au făcut forma clinică ușoară și medie. Este important de menționat că toate formele clinice grave de manifestare a infecției au fost însoțite de producerea de anti SARS-CoV-2 IgG. Donatorii sunt preponderent din mediul urban (75%), fapt ce indică că aceștia sunt mai bine informați de instituțiile medicale. Concluzii. Donatorii de sânge de genul masculin, cu vârsta de 18-60 ani, au avut o imunogeneză activă în urma infectării cu SARS-CoV-2, manifestând un nivel înalt de pozitivitate la anticorpii infecției date

Результаты внедрения Национальной программы по борьбе с вирусными гепатитами B, C и D в 2017 году

În prezentul articol sunt discutate particularităţile evoluţiei moderne a procesului epidemic prin hepatitele virale B, C şi D în Republica Moldova şi implementarea măsurilor de control şi de răspuns la aceste boli, cum ar fi Programul Naţional de combatere a hepatitelor virale B, C şi D pentru anii 2017-2021, care a fost aprobat, ulterior a fost propus pentru implementare în Republica Moldova începând cu 2017. Ca urmare a aplicării celor trei programe anterioare, morbiditatea prin hepatite virale parenterale a scăzut semnificativ. Dar, pentru a reduce în continuare incidenţa hepatitelor virale acute la nivelul indicatorilor înregistraţi în majoritatea ţărilor europene, precum şi pentru a îmbunătăţi situaţia epidemiologică şi starea de sănătate a populaţiei Republicii Moldova, este necesar să fie implementate consecvent toate obiectivele din prezentul program. De asemenea, informaţia privind epidemiologia hepatitelor virale oferită de personalul Laboratorului de infecţii hemotransmisibile din cadrul Agenţiei Naţionale pentru Sănătate Publică a fost utilizată pentru a susţine măsurile de diagnostic, tratament şi profilaxie a hepatitelor virale. În studiu au fost folosite metode epidemiologice, analitice şi statistice.This article discusses particularities of modern evolution of epidemic process of viral hepatitis B, C and D in the Republic of Moldova and the implementation of measures of control and response to these diseases, such as named before National Program which last year have been developed and implemented in the Republic of Moldova. As a result of the introduction of the previous three programs the morbidity of parenteral viral hepatitis has decreased significantly. But in order to further reduce the incidence of acute viral hepatitis to the indicators registered in most European countries, as well as to improve the epidemiological situation and the health status of the population of the Republic of Moldova it is necessary to implement consequently all the objectives of the present Program. Also scientific data on the epidemiology of viral hepatitis provided by the staff of laboratory of blood borne infections from the National Agency for Public Health have been used to argue prophylaxis measures against viral hepatitis. The epidemiological, analytical and statistical methods have been applied in the study.В статье обсуждаются особенности современной эволюции эпидемического процесса вирусных гепатитов В, С и D в Республике Молдова и внедрение мер по борьбе с этими заболеваниями и реагированию на них, отражённых в Национальной программе борьбы с вирусными гепатитами B, C и D на 2017-2021 годы, которая впоследствии была одобрена для реализации в Республике Молдова с 2017 года. После принятия трех предыдущих программ заболеваемость парентеральными вирусными гепатитами значительно снизилась. Однако необходимо снизить показатели заболеваемости острыми вирусными гепатитами до уровня зарегистрированных показателей в большинстве европейских стран, а также для улучшения эпидемиологической ситуации и состояния здоровья населения Республики Молдова необходимо последовательное внедрение всех задач представленной программы. Кроме того, информация об эпидемиологии вирусных гепатитов, представляемая сотрудниками лаборатории гемо трансмиссивных инфекций Национального агентства общественного здравоохранения была использована для улучшения диагностики, лечения и профилактики вирусных гепатитов. В исследовании использовались эпидемиологические, аналитические и статистические методы