State of antioxidant system glutathione – glutathione S-transferase in deep fluoridation of tooth enamel in children with high risk of dental caries

Department of Pediatric Oro-Maxilo-Facial Surgery, Pedodontics and Orthodontics, Department of Biochemistry and Clinical Biochemistry, Nicolae Testemitsanu State University of Medicine and Pharmacy Chisinau, the Republic of MoldovaBackground: The high prevalence of dental caries in children determines the relevance of the search of ways to prevent this disease. The goal was a comparative study of the impact of fluor-prevention on the activity of glutathione S-transferase (GST) and content of glutathione of saliva, which play a protective antioxidant and antitoxic role, in children with high risk for dental caries. Material and methods: The study observed 100 children from 7 to 12 years old, 50 children had severe pathology of central nervous system (CNS). Within three years, all children underwent the preventive measures for dental caries, including oral hygiene, complex of vitamins, minerals and antioxidants. Additionally for 60 children was conducted deep fluoridation (DF), a combination of laser therapy with DF, and DF with photodynamic therapy (PDT). Results: The activity of GST, the contents of glutathione and total protein in the saliva were determined by spectrophotometric methods. DF of tooth enamel in healthy children reduced the activity of GST in the saliva in the process of observation, in children with disorders of the nervous system activity of the enzyme increased. Combination of DF with laser therapy decreased the activity of GST in the saliva of children with pathology of CNS, and DF with PDT – it increased. Conclusions: Completing of fluor-preventive complex for caries was effective for both healthy children and children with pathology of CNS

Доказательная медицина – способ изменения в деятельности практической медицины

School of Public Health, Nicolae Testemitanu State Medical and Pharmaceutical University, Congresul III al Medicilor de Familie din Republica Moldova, 17–18 mai, 2012, Chişinău, Republica Moldova, Conferinţa Naţională „Maladii bronhoobstructive la copii”, consacrată profesorului universitar, doctor habilitat Victor Gheţeul, 27 aprilie, Chişinău, Republica MoldovaUsing the principles of medical practice evidence-based medicine seeks to improve the diagnosis and treatment of patients, and also teaches doctors how to work with the scientific literature to find the most accurate arguments. This article describes the six steps of evidence-based medicine, the types of articles based on their clinical and scientific significance (POEM, DOE, POE). In clinical practice Evidence-based medicine to improve health care and improve the quality of patient care leads to the use of standards, which has several advantages for both the physician and patients.Использование практическим врачом принципов Доказательной Медицины способствует улучшению качества диагностики и лечения пациентов, а также учит врача, как правильно работать с научной литературой для поиска наиболее точных доводов. В данной статье описаны шесть шагов Доказательной Медицины, виды статей в зависимости от их клинической и научной значимости (POEM, DOE, POE). В медицинской практике Доказательная Медицина для улучшения медицинской помощи и повышения качества обслуживания пациентов ведет к использованию стандартов, что имеет ряд преимуществ как для врача, так и для пациентов

Effect of photodynamic therapy on glutathione S-transferase activity in oral liquid of children with high risk of caries

Department of Pediatric Oro-Maxilo-Facial Surgery, Pedodontics and Orthodontics, Department of Biochemistry and Clinical Biochemistry, Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, the Republic of MoldovaBackground: Pediatric dentistry is looking for new methods to influence the cariogenic microorganisms of dental biofilm without the use of antiseptics and antibiotics, which often have negative side effects. Photodynamic therapy (PDT) is a promising and effective method to influence on the cariogenic microorganisms without using antiseptics and antibiotics. Material and methods: Forty five children aged 7 to 12 years with high risk of dental caries and pathology of central nervous system were observed during three years of the complex preventive measures, including multivitamins, minerals, antioxidants and PDT of dental biofilm. The activity of glutathione S-transferase (GST), content of reduced glutathione (GSH), thiocyanate (SCN) and total protein in the oral liquid (OL) were determined by spectrophotometry (Diasys Diagnostics, DE). The results were statistically processed using the program Excel Microsoft: Microstat 2007. Results: In three years the protein content in OL of the children was below the initial content in all groups that may be the confirmation of PDT bacteriostatic effect. In all periods of the study significant changes in the content of GSH, thiocyanate and activity of GST in OL in the children were not observed. Conclusions: Our results are indicating that complex preventive measures including the non-invasive method of PDT were effective, without any negative side effects and had bacteriostatic action. These complex preventive measures may be recommended for children with high risk of caries and pathology of CNS

Менеджмент профилактики цирроза печени взрослого населения

School of Management in Public Health, Nicolae Testemitanu State Medical and Pharmaceutical University, Congresul III al Medicilor de Familie din Republica Moldova, 17–18 mai, 2012, Chişinău, Republica Moldova, Conferinţa Naţională „Maladii bronhoobstructive la copii”, consacrată profesorului universitar, doctor habilitat Victor Gheţeul, 27 aprilie, Chişinău, Republica MoldovaLiver cirrhosis is the important for the Republic of Moldova, because they are among the leading causes of morbidity, disability and mortality of the adult population. To identify the role of the incidence of liver cirrhosis in the determined of health status was analysis the association/correlation in the incidence, morbidity, disability and mortality. This study included adult population with liver cirrhosis, and the results showed a strong link between “incidence/morbidity,” and a weak correlation was established between the “morbidity/mortality. “Knowing this allows organizing preventive measures, secondary and tertiary prevention. Also, describe the determinants and health activities related to primary prevention.Цирроз печени является важной проблемой для Республики Молдова, поскольку он является одной из ведущих причин заболеваемости, болезненности, инвалидности и смертности взрослого населения. В целях выявления роли заболеваемости циррозом печени в оценке состояния здоровья населения, был проведен анализ ассоциации/корреляции в соотношении заболеваемости, болезненности, инвалидности и смертности. В это исследование было включено взрослое население, страдающее циррозом печени, и результаты показали прочную связь между «заболеваемостью/болезненностью». Слабая корреляция была установлена между «заболеваемостью/смертностью». Знание этого позволяет организовать превентивные меры вторичной и третичной профилактики. Также, описаны детерминанты здоровья и медикосанитарные мероприятия, относящиеся к первичной профилактике

Some epidemiological aspects of diabetes at international and national levels

Department of Biochemistry and Clinical Biochemistry, Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, the Republic of MoldovaBackground: Diabetes has become the epidemic that can’t be neglected anymore. In 2010, the estimated world adult population that had diabetes was 285 million, while in 2013 this number has increased to 382 million. In the case of a growing trend, in 2035 it is estimated that approximately 592 million people will carry this disease. It is thought that in 90% of all the cases there is type 2 diabetes. With an increase of the incidence, the disease prevalence, mortality, serious complications, inability to work with major health care expenses and a loss in quality of life of the patient, the type 2 diabetes has become a problem of a great importance for an individual, medicine and society. This study represents a systematic analysis of the literature by estimating in the epidemiological impact of the diabetes, presenting some aspects correlated with the incidence, prevalence of the disease and the mortality, enumerating the risky factors considered to be capable of influencing the dynamic of these indicators. Conclusions: In conclusion, our review highlights a significant epidemic of diabetes at national and international levels with a rapid increase in prevalence over the last two decades. It is evident that several modifiable and non-modifiable risk factors play an important role in the pathogenesis of diabetes. Hence there is a need for urgent preventive and curative strategies to be implemented

Duplex ultrasonography in evaluation of complications of portal hypertension in liver cirrhosis

Department of Radiology and Imaging, School of Public Health, Nicolae Testemitsanu State University of Medicine and Pharmacy, Chisinau, the Republic of MoldovaBackground: Portal hypertension is a serious complication in liver cirrhosis and it is responsible for most of the deaths at patients with the respective disease. Determination of the pressure gradient by the catheterisation of hepatic veins is a laborious method and often associated with complications. There are necessary accessible methods to evaluate portal hypertension with an acceptable degree of confidence. This study aims to determine Doppler hemodynamic indicators with important predictable goal in case of complications of the portal hypertension associated with liver cirrhosis. Material and methods: The study group included 111 patients diagnosed clinicaly, biologicaly and imagining with liver cirrhosis. The cytolytic, cholestatic, hepatoprive syndromes and the gravity of hypersplenism were evaluated. Esophageal varices were identified by upper endoscopy. The hepatic morphology, including the personalisation of the vascular tree, was evaluated by conventional and duplex ultrasonography. Results: The increase of the vascular resistance at the level of lienal artery (r = 0.454), and the Splenoportal Index had an important correlation with the severity of the Splenomegalic Syndrome (r = 0.516). The prediction of the esophageal varices with high risk for haemorrhage was set at the value of 7-10 cm/sec of the time-weighted average velocity measured in the hepatic portal vein (RP 3.13). Ascites and portal thrombosis were more frequent at an index of the portal hypertension of (IHTP) >2.1 (RP 3.5). Conclusions: Evaluation of the hemodynamic indicators by duplex ultrasonography allowed to highlight the predictive parameters in case of complications of the portal hypertension associated with liver cirrhosis

Факторы, которые влияют на здоровье мигрантов

School of Management in Public Health, Nicolae Testemitanu State Medical and Pharmaceutical University, Congresul III al Medicilor de Familie din Republica Moldova, 17–18 mai, 2012, Chişinău, Republica Moldova, Conferinţa Naţională „Maladii bronhoobstructive la copii”, consacrată profesorului universitar, doctor habilitat Victor Gheţeul, 27 aprilie, Chişinău, Republica MoldovaMigrant’s health has been and remains one of the most important issues on the political agenda of the Republic of Moldova. The impact of migration on migrant’s health is still very poorly studied. Given study is only one approach to some aspects of the migrant’s health.Здоровье мигрантов было и остается одним из наиболее важных вопросов в политической повестке дня Республики Молдова. Влияние миграции на здоровье мигрантов по-прежнему весьма слабо изученo. Предложенное исследование является только одним из подходов к некоторым аспектам здоровья мигрантов

Некоторые эпидемиологические аспекты острых вирусных гепатитов В, С и D в муниципии Кишинэу

School of Public Health in Management, State University of Medicine and Pharmacy "Nicolae Testemitanu"This article presents the results of the retrospective study on the epidemiology of parenteral viral hepatitis B, C and D in Chisinau municipium, in the period of 1992-2011 years. The dynamic of the epidemic process of the acute parenteral viral hepatitis in the mentioned period has a continuous reduction trend. The incidence rate of viral hepatitis B decreased from 88.9 cases to 100.000 pop. in 1992 to 3.2 0 / 0000 in 2011, viral hepatitis C – from 80 / 0000 to 2.40 / 0000 and viral hepatitis D – from 20 / 0000 to 0.10 / 0000, respectively. The detailed analysis has been done on 511 cases of acute viral hepatitis recorded in the period of 2006-2011 years. The most affected age group was the 18-29 years old (1280 / 0000). The highest intensity of the epidemic process of the parenteral viral hepatitis was determined in the suburban area (towns and rural places), where the incidence rate constitutes 780 / 0000. The immunization program of the newborns and risk groups has to continue and the nonspecific activities (blood safety, injection safety, qualitative health services) has to be ensured, also the information of the population regarding the epidemiological situation and prophylactic measures has to be provided.В статье представлены результаты ретроспективного эпидемиологического анализа заболеваемости острыми вирусными гепатитами в Кишинёве в период 1992-2011 гг. В ходе исследования был проведен детальный анализ 511 случаев заболевания острыми вирусными гепатитами, выявленных в период 2006 – 2011 гг. В результате анализа было выявлено, что динамика заболеваемости острыми парентеральными вирусными гепатитами у населения муниципия в указанный период имеет непрерывную тенденцию к снижению. Таким образом, уровень заболеваемости вирусным гепатитом В снизился от 88,9 случаев на 100 тыс. населения, зарегистрированных в 1992 году, до 3,2 случая на 100 тыс. населения к 2011 году, заболеваемость вирусным гепатитом С в 1992 году составила 8,00 / 0000, а к 2011 её уровень снизился до 2,40 / 0000. Та же тенденция коснулась и вирусного гепатита D, уровень заболеваемости которого, в том же периоде, изменился от 2,00 / 0000 до 0,10 / 0000, соответственно. Наивысшие показатели заболеваемости острыми вирусными гепатитами были выявлены в возрастной группе 18-29 лет (1280 /0000) среди сельских жителей и населения пригородов муниципия (780 / 0000). В указанной эпидемиологической обстановке существует необходимость в продолжение проведения программ по иммунизации новорожденных детей и лиц с высокой степенью риска инфицирования, мероприятий неспецифического характера по обеспечении безопасности медицинских манипуляций, в том числе при гемотрансфузиях, а также оказания квалифицированной медицинской помощи и информирование населения относительно эпидемиологической ситуации

Correlation between dental caries and quality of life in children

Introduction. Measuring quality of life at an individual level can provide important data on health status and the effects of healthcare services. The aim of this study was to assess the impact of caries and its treatment on quality of life (QoL) in school-aged children. Materials and methods. A cross-sectional prospective study was carried out within the Department of Pediatric Oral-Maxillo-Facial Surgery and Pedodontics Ion Lupan of the Nicolae Testemitanu SUMPh. The research group (L1) consisted of 70 children with dental caries. In the control group (L0) 70 children free of dental caries were included. For QoL assessment, the Child-Oral Impacts on Daily Performances (Child-OIDP) questionnaire was applied. The study was conducted in accordance with ethical requirements with the written consent of the children's parents. The Spearman ρ (rho) coefficient, calculated via nonparametric rank correlation test, was used to determine the correlation between tooth decay degree and its impact on children's QoL. The Child-OIDP self-administered questionnaire was used to collect data and data was analyzed using Epi-Info. Results. A total of 140 students responded, of whom 49.2% experienced at least one impact. The most affected performances were eating (22.3%), followed by smiling (18.5%) and emotional state (6.5%), and the least affected daily activities were playing (0.8%) and schoolwork (1.1%). The main causes were bleeding gums (39.3%), injury (26.8%) and sensitivity (33.7%), and adolescents reported an average of 1.5 pathologies as perceived causes of impact. Conclusion. A significant positive association of very high, high and moderate intensity was established between the indicators of dental caries and the impact of the oral health status on QoL. The high prevalence of dental caries' impact on children's QoL indicates their increased treatment needs and insufficient access to dental care. Estimating the impact of oral health status on daily performance is important for the creation of health policies that address the needs of the population

Quality assurance standards in healthcare

School of Management in Public Health, Nicolae Testemitsanu State University of Medicine and Pharmacy, Department of Radiology, Medpark International Hospital, Chisinau, the Republic of MoldovaBackground: The Association Agreement between the European Union (EU) and the Republic of Moldova (RM) creates a framework for closer cooperation in many areas, including health care. This requires adjustment of legislation and quality assurance standards in RM to the EU acts and international instruments. The article provides an overview of the concept of healthcare quality and related standardization processes for quality assurance and health care assessment. It comprises a literature review of the published work in this area with a special emphasis on the standards and normative legislature applied to healthcare as well as a brief description of the regulatory standardization structures and organizations at the local, regional and international level. Conclusions: Healthcare quality does not represent an absolute standard of excellence, but rather a much wider concept comprising optimal service delivery for all involved parties and a shared commitment for continuous improvement. After proclaiming its independence, RM has adopted a series of legislations aimed at adjusting the national standards to those implemented at the EU and international level, having become an affiliated member of the European Committee for Standardization (CEN) and a correspondent member of the International Organization for Standardization (ISO). These steps are in complete agreement with the European integration course taken by the Republic of Moldova. Continuing these efforts is the key to reaping the benefits of European integration