Basic Concepts of Motivology (Fascicle I)

In the present study, we aimed to introduce into Romanian linguistic circulation a number of Motivology terms, a new linguistic discipline, and its dictionary not only includes the basic concept of Motivology, but also the terms from general linguistics and from other fields of linguistics – semasiology, onomasiology, derivation, linguopoetics, lexicography, etc., which are closely related to the theory of word motivation and stable polylexical units. The examples are brought, in particular, from the Romanian linguistic material, in order to demonstrate in such a way the necessity of researching language facts under their motivational aspect. At the same time, the terms proposed for the familiarization of all those interested in the given problem come to elucidate the research aspects of Motivology, which aims to study language phenomena from a different angle than the one carried out so far

Epidermolysis bullosa – a clinical study

Generalităţi. Au fost analizate fi șele de observaţie clinică (41 de cazuri) ale pacienţilor cu epidermolize buloase (EB), trataţi în perioada 2000-2014, în cadrul Spitalului Dermatologie și Maladii Comunicabile. Rezultate obţinute. Vârsta pacienţilor a oscilat între 2 luni și 52 de ani (m/f –28/13; rural/urban – 25/16). Spectrul nosologic depistat, s-a prezentat în felul următor: epidermoliza buloasă simplă (EBS) Koebner – 11 cazuri; EBS Weber–Cockayne – 9 cazuri; EBS asociată cu tulburări de pigmentare – 1 caz; epidermoliza buloasă joncţională (EBJ) Herlitz – 1 caz; epidermoliza buloasă distrofi că dominantă (EBDD) Cockayne-Touraine – 12 cazuri; EBDD Passini – 3 cazuri; epidermoliza buloasă distrofi că recesivă (EBDR) Hallopeau–Siemens – 4 cazuri. Așadar, EBS s-a constatat în 51,2% cazuri, EBJ – în 2,4% și EBD – în 46,34% cazuri. Manifestările buloase de epidermoliză au fost asociate cu o afectare unghială în 48,8% cazuri. Hiperhidroza, keratodermia palmo-plantară, alopecia și leziunile ichtioziforme s-au evidenţiat în 12,2% cazuri. La circa o jumătate dintre pacienţi au fost constatate o serie de maladii concomitente (anemii, pneumonii, hepatite, pancreatite, pielonefrite). Anomaliile dentare și afectarea mucoaselor s-au raportat la o treime dintre pacienţi, fi ecare al zecelea pacient având și retard mental. La circa 20% cazuri, au fost observate complicaţii cu agenţi microbieni (piodermii), iar la bolnavii cu EBDR Hallopeau–Siemens – cheloizi, acrosclerodactilie, contracturi, mutilaţii, stenoze esofagiene. Un caz de deces s-a constatat la pacientul cu EBJ Herlitz, la 2 luni de la naștere. O evoluţie favorabilă s-a observat la pacienţii cu forme epidermolitice și distrofi ce dominante (63,4%). Pe durata tratamentului de rutină, s-a constatat apariţia bulelor noi la toţi bolnavii. Epitelizarea eroziunilor s-a observat pe parcursul a 5-14 zile. După includerea în tratamentul topic a pansamentelor „Mepilex Lite”, „Mepitel”, durata epitelizării erupţiei s-a redus de 2 ori (3-7 zile). Concluzii. Profi lul epidermolizei buloase constată predominarea sexului masculin, precum și a formelor clinice de EB dominante; asocierea cu afectările unghiale și a mucoaselor, cu distrofi i dentare, anemii, complicaţii microbiene, în cazuri grave – acrosclerodactilie, mutilaţii, stenoză esofagiană. Încluderea în tratamentul topic a pansamentelor „Mepilex Lite”, „Mepitel” reduce durata epitelizării eroziunilor.Overview. The study included case histories of 41 patients with epidermolysis bullosa, who were treated in Hospital of Dermatology and Communicable Diseases during 2000-2014. Results. Patients’ age has oscillated from 2 till 52 years old (M/F-28/13; Rural/Urban – 25/16). Nosological spectrum ranged as follows: simple epidermolysis bullosa (EBS) Koebner–11 cases; EBS Weber-Cockayne – 9 cases; EBS associated with pigmented lesions – 1; jonctional epidermolysis bullosa – (EBJ) Herlitz – 1; dystrophic dominant form of EB (EBDD) Cockayne-Touraine – 12; EBDD Passini – 3; recessive form of EBD (EBDR) Hallopeau – Siemens – 4. Th us, EBS has been established in 51.2% of cases, EBJ – 2.4% of cases and EBD – in 46.34% of cases. Nail involvement was observed in 48.8 cases of EB. Hyperhidrosis, palmoplantar keratoderma, alopecia and ichthyosiform lesions were marked in 12.2% of cases. About half of patients has manifested a plenty number of associated diseases (anemia, pneumonia, hepatitis, pancreatitis, pyelonephritis). Dental anomalies and mucous membranes involvement were reported in 1/3 of patients, one in every 10 patients presented a mental retardation. In 20% of cases pyococcal complications (pyodermas) was described, in addition patients with EBDR Hallopeau-Siemens have developed keloid scars, acrosclerodactylitis, muscular contractions, mutilations, esophageal stenosis. A 2 month old infant with EBJ-H has died. More benign evolution was marked in patients with dominant forms of EBD (63.4%). All patients have presented a new bulla during obvious therapy. Epithelization of erosions occurred within 5-14 days. Topical treatment with “Mepilex Lite”, “Mepitel” reduced twice the time of lesion epithelization (3-7days). Conclusions. Epidermolysis bullosa profi le certifi es prevalence of this disease among males, as well as, increased number of dominant forms, association with nail and mucous membrane involvement, dental anomalies, anemia, microbial infections, in severe cases – acroscelro-dactylitis, mutilations, esophageal stenosis. “Mepilex Lite” and “Mepitel” dressings have reduced the time of lesion epithelization

Are systemic changes an attribute of difficult asthma?

Disciplina pneumologie și alergologie,Departamentul de medicină internă, Universitatea de Stat de Medicină și Farmacie „Nicolae Testemiţanu”, Chișinău, Republica Moldova, Catedra de dermatovenerologie,Universitatea de Stat de Medicină și Farmacie „Nicolae Testemiţanu”, Chișinău, Republica Moldova, Catedra de oftalmologie, Universitatea de Stat de Medicină și Farmacie „Nicolae Testemiţanu”, Chișinău, Republica Moldova, Institutul de ftiziopneumologie „Chiril Draganiuc”, Chișinău, Republica Moldov

Kerion Celsi caused by Microsporum canis – clinical cases

Generalităţi. Au fost analizate 21 de fişe de observaţie clinică a bolnavilor, trataţi în anii 2000-2015, în spitalul Dermatologie şi Maladii Comunicabile pentru Tinea capitis infiltrativ-purulentă, provocată de Microsporum canis. Rezultate. Total bolnavi – 21, dintre care fetiţe – 7, băieţi – 14. Repartizarea conform vârstei a fost următoarea: până la 1 an – 1, 1-3 ani – 6, 4-7 ani – 11 şi 8-9 ani – 3 pacienţi, vârsta medie constituind 4 ani. Majoritatea pacienţilor erau din mediul rural (80%). La 15 pacienţi, durata maladiei a variat între 2-4 săptămâni, iar la 6 pacienţi – între 1 şi 3 luni. Majoritatea pacienţilor (17) au fost depistaţi în perioada vară-toamnă. Tratamentul ambulator, anterior spitalizărilor în clinica noastră, a inclus: corticosteroizi topici – 13 cazuri, antibiotice – 15 cazuri. Au fost înregistrate următoarele maladii concomitente: anemie nutriţională – 9 , enterobioză intestinală – 7 cazuri. Tabloul clinic, la internare, prezenta formaţiuni pseudotumorale multiple de tip Kerion Celsi (14 cazuri), cu aspect acut inflamator, purulent, zemuire pronunţată, cu dimensiuni între 2-3 şi 10-15 cm în diametru, cu margini regulate şi bine delimitate, dureroase la palpare. Erupţii solitare cu acelaşi aspect s-au observat la 7 pacienţi. Fluorescenţa verde-pal a fost identificată la 7 pacienţi, utilizând lampa Wood. Adenopatia regională (retroauriculară, cervical-posterioră, submandibulară) a fost semnalată la 16 pacienţi. Diagnosticul clinic a fost completat cu cel paraclinic prin prezenţa artrosporilor de tip Microsporum şi filamentelor miceliene scurte în materialul recoltat. La toţi pacienţii a fost identificată cultura Microsporum canis. Pacienţii au fost supuşi tratamentului corespunzător: Grizeofulvină (20 mg/kg corp/zi), keratoplastice (ung. Ichtiol 10%, ung. Levomycol), coloranţi anilinici (liquori Castellani, sol. Albastru de metilen 2%), tinctură de Iod 2-5%. Alopecia cicatricială reziduală s-a constatat la 6 copii. Concluzii. Cazurile clinice aduse în discuţie confirmă prezenţa micozelor de tip Kerion Celsi, provocate de Microsporum canis, la copiii cu un fundal morbid predispozant. Depistarea tardivă şi tratamentele neadecvate ale pacienţilor sunt soldate frecvent cu sechele sub formă de alopecie cicatricială. Menţionăm, totodată, raritatea formelor descrise.Overview. Were analyzed 21 clinical observation sheets of patients treated in the years 2000-2015 in Hospital of Dermatology and Communicable Diseases for infiltrative-purulent Tinea capitis caused by Microsporum canis. Results. Total number of patients – 21, of which girls – 7, boys – 14. Age distribution was as follows: up to 1 year old – 1, 1-3 y.o. – 6, 4-7 y.o. – 11 and 8-9 y.o. – 3 patients, average age being 4 years. Most patients came from rural areas (80%). The duration of disease in 15 patients was observed 2-4 weeks, in 6 patients – 1 to 3 months. Most patients (17) were found summer-autumn. The treatment before hospitalization included: topical corticosteroids – 13 cases, antibiotics – 15 cases. Among concomitant diseases were recorded: nutritional anemia – 9, intestinal enterobioza – 7 cases. The clinical features on admission included multiple pseudotumoral formations Kerion Celsi with a purulent acute-inflamatory aspect, pronounced press, having sizes 2-3 up to 10-15 cm in diameter with regular edges, well defined, painful on palpation. Unique eruptions with the same clinical features were observed in 7 patients. The pale-green fluorescence with Wood lamp was identified in 7 patients. Regional limph nodes (retroauricular, posterior cervical, submandibular) were detected in 16 patients. The clinical diagnosis was completed with the paraclinical one: the presense of arthrospores type Microsporum and short mycelial filaments in the collected material. In all patients was identified Microsporum canis culture. The treatment included: Grizefulvine (20mg/kg/day), keratoplastiks (ung. Ichtiol 10%, ung. Levomycol), aniline dyes (Liq. Castellani, Sol. Methilene blue 2%), iodine tincture 2-5%. The residual scar alopecia was observed in 6 children. Conclusions. Clinical cases brought to discussion confirm the presence of forms of Kerion Celsi type caused by Microsporum canis in children with predisposing morbid background. Late detection and improper treatment of patients commonly are resulting sequelae in the form of scar alopecia. Must be mentioned the rarity of described cases

Disability Rights as a Necessary Framework for Crisis Standards of Care and the Future of Health Care

In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment to both distributive and recognitive justice. The disability rights movement\u27s demand “Nothing about us, without us” requires substantive inclusion of disabled people in decision-making related to their interests, including in crisis planning before, during, and after a pandemic like Covid-19

Disability Rights as a Necessary Framework for Crisis Standards of Care and the Future of Health Care

In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment to both distributive and recognitive justice. The disability rights movement's demand “Nothing about us, without us” requires substantive inclusion of disabled people in decision-making related to their interests, including in crisis planning before, during, and after a pandemic like Covid-19

World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions

BACKGROUND: To help adapt cardiovascular disease risk prediction approaches to low-income and middle-income countries, WHO has convened an effort to develop, evaluate, and illustrate revised risk models. Here, we report the derivation, validation, and illustration of the revised WHO cardiovascular disease risk prediction charts that have been adapted to the circumstances of 21 global regions. METHODS: In this model revision initiative, we derived 10-year risk prediction models for fatal and non-fatal cardiovascular disease (ie, myocardial infarction and stroke) using individual participant data from the Emerging Risk Factors Collaboration. Models included information on age, smoking status, systolic blood pressure, history of diabetes, and total cholesterol. For derivation, we included participants aged 40-80 years without a known baseline history of cardiovascular disease, who were followed up until the first myocardial infarction, fatal coronary heart disease, or stroke event. We recalibrated models using age-specific and sex-specific incidences and risk factor values available from 21 global regions. For external validation, we analysed individual participant data from studies distinct from those used in model derivation. We illustrated models by analysing data on a further 123 743 individuals from surveys in 79 countries collected with the WHO STEPwise Approach to Surveillance. FINDINGS: Our risk model derivation involved 376 177 individuals from 85 cohorts, and 19 333 incident cardiovascular events recorded during 10 years of follow-up. The derived risk prediction models discriminated well in external validation cohorts (19 cohorts, 1 096 061 individuals, 25 950 cardiovascular disease events), with Harrell's C indices ranging from 0·685 (95% CI 0·629-0·741) to 0·833 (0·783-0·882). For a given risk factor profile, we found substantial variation across global regions in the estimated 10-year predicted risk. For example, estimated cardiovascular disease risk for a 60-year-old male smoker without diabetes and with systolic blood pressure of 140 mm Hg and total cholesterol of 5 mmol/L ranged from 11% in Andean Latin America to 30% in central Asia. When applied to data from 79 countries (mostly low-income and middle-income countries), the proportion of individuals aged 40-64 years estimated to be at greater than 20% risk ranged from less than 1% in Uganda to more than 16% in Egypt. INTERPRETATION: We have derived, calibrated, and validated new WHO risk prediction models to estimate cardiovascular disease risk in 21 Global Burden of Disease regions. The widespread use of these models could enhance the accuracy, practicability, and sustainability of efforts to reduce the burden of cardiovascular disease worldwide. FUNDING: World Health Organization, British Heart Foundation (BHF), BHF Cambridge Centre for Research Excellence, UK Medical Research Council, and National Institute for Health Research

National trends in total cholesterol obscure heterogeneous changes in HDL and non-HDL cholesterol and total-to-HDL cholesterol ratio : a pooled analysis of 458 population-based studies in Asian and Western countries

Background: Although high-density lipoprotein (HDL) and non-HDL cholesterol have opposite associations with coronary heart disease, multi-country reports of lipid trends only use total cholesterol (TC). Our aim was to compare trends in total, HDL and nonHDL cholesterol and the total-to-HDL cholesterol ratio in Asian and Western countries. Methods: We pooled 458 population-based studies with 82.1 million participants in 23 Asian and Western countries. We estimated changes in mean total, HDL and non-HDL cholesterol and mean total-to-HDL cholesterol ratio by country, sex and age group. Results: Since similar to 1980, mean TC increased in Asian countries. In Japan and South Korea, the TC rise was due to rising HDL cholesterol, which increased by up to 0.17 mmol/L per decade in Japanese women; in China, it was due to rising non-HDL cholesterol. TC declined in Western countries, except in Polish men. The decline was largest in Finland and Norway, at similar to 0.4 mmol/L per decade. The decline in TC in most Western countries was the net effect of an increase in HDL cholesterol and a decline in non-HDL cholesterol, with the HDL cholesterol increase largest in New Zealand and Switzerland. Mean total-to-HDL cholesterol ratio declined in Japan, South Korea and most Western countries, by as much as similar to 0.7 per decade in Swiss men (equivalent to similar to 26% decline in coronary heart disease risk per decade). The ratio increased in China. Conclusions: HDL cholesterol has risen and the total-to-HDL cholesterol ratio has declined in many Western countries, Japan and South Korea, with only a weak correlation with changes in TC or non-HDL cholesterol.Peer reviewe

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe