Analysis regarding the impact of 'fake news' on the quality of life of the population in a region affected by earthquake activity. The case of Romania-Northern Oltenia.

Purpose: The study aims to examine the impact of the wave of seismic activity in the northern region of Oltenia (Gorj County, Romania) in February 2023 and the belief in 'fake news' (circulated regarding causality, manifestations, and future developments of the seismic activity) on the quality of life of the affected population. It was considered opportune to conduct this study, given the novelty of such a situation, as the mentioned geographical area is not known to have a high seismic risk. Methods: The study was built based on the questionnaire to which 975 respondents, present/residing in Gorj County during the earthquakes and at least 14 days after, and with a minimum age of 18 years, responded. The data was collected between February 27, 2023, and March 31, 2023, at a reasonable time interval from the recording of the first seismic event in the region, assuming that the respondents' opinions regarding the negative impact of seismic events on societal life are well crystallized. The aim was to obtain information and analyze it in order to establish the respondents' perception regarding the negative effects of seismic activity and the elements of "fake news" promoted in this context on the quality of life of individuals in the region. Results: Our study indicates that individuals who are not concerned, due to their disbelief in "fake news" information, about the possibility of new strong earthquakes in the mentioned area feel the best physically, having an average satisfaction level of 82.80 (with a standard deviation of 19.70) on the WHOQOL-BREF scale. On the other hand, those who believed in the fake news experienced the lowest levels of psychological well-being, with an average satisfaction of 60.80 (and a standard deviation of 21.98). The WHOQOL-BREF is an instrument that assesses the quality of life across four distinct domains, and this study emphasizes the importance of accurate and trustworthy information for people's well-being. Conclusion: The results of the study highlight that the quality of life indicators of people in the geographic area affected by the wave of seismic movements are negatively impacted due to the release of "fake news" in the public domain regarding the cause of seismic movements in Gorj county (and the previous earthquakes in Turkey) and their future manifestations and developments (the possibility of high magnitude seismic movements), as well as the lack of information provided by the public authorities on the issue at hand (causes, effects, future manifestations, management measures).

Molecular prognostic factors in colorectal cancer: 5-year follow-up.

Colorectal cancer (CRC) is a frequently diagnosed and lethal disease. The risk of developing CRC is determined by environmental and genetic factors. Surgical treatment is the main curative modality for patients with CRC up to stage III. In recent years, a special place has been given to biological agents used as targeted therapy following the genetic analysis of the tumor: Bevacizumab (Avastin), Cetuximab (Erbitux), Ziv-aflibercept (Zaltrap). We present a study based on 46 colorectal tumor resection specimens from patients operated for CRC in the Surgery Departments of the Emergency County Clinical Hospital of Craiova, Romania. Histopathological examination and immunohistochemistry staining of tissue sections were performed to determine the degree of aggressiveness. Using the Kaplan-Meier test, we calculated the correlation coefficient between survival time and immunohistochemical prognostic factors. The patients were followed for 60 months postoperatively.

Has COVID-19 Modified the Weight of Known Systemic Inflammation Indexes and the New Ones (MCVL and IIC) in the Assessment as Predictive Factors of Complications and Mortality in Acute Pancreatitis?

We aimed at evaluating the prognostic capacity of the inflammatory indices derived from routine complete blood cell counts in two groups of patients with acute pancreatitis from two different time periods, before and during the COVID-19 pandemic, when a high incidence of complications with surgical risk and mortality was found. Two new markers were introduced: the mean corpuscular volume to lymphocyte ratio (MCVL) and the cumulative inflammatory index (IIC), which were calculated at a baseline in the two groups of patients. Of the already established markers, none of them managed to effectively predict the complications with surgical risk and mortality, with a decrease of less than 50% in specificity in the peri-COVID group. The MCVL had the best prediction of complications with surgical risk in both the pre-COVID and peri-COVID groups, validated it as an independent factor by multivariate analysis. The IIC had the best prediction of mortality in both periods and was proven to be an independent factor by multivariate analysis. As the IIC predicted death best, we tested the occurrence of death and found that patients with PA who had an IIC > 12.12 presented a risk of death 4.08 times higher in the pre-COVID group and 3.33 times higher in the peri-COVID group. The new MCVL and IIC independent markers had a superior sensitivity and specificity in predicting surgical risk complications and, respectively, mortality in the group of patients with acute pancreatitis during the COVID-19 pandemic, which makes them widely applicable in populations with modified immune and inflammatory status. Conclusions: In patients with acute pancreatitis, MCVL has a significant predictive value regarding complications with surgical risk (abscess, necrosis, and pseudocyst), and the IIC has a significant predictive value for mortality.

Study on the Vaccination of the Population of Romania against Monkeypox in Terms of Medical Security.

Although it has been shown in numerous studies that immunization of the population by vaccination is the most effective way to protect against smallpox or other polioviruses, the anti-vaccination public rhetoric recorded during the COVID-19 pandemic is likely to influence the populations acceptance of vaccination against newly emerging viruses. This fact influenced our decision to study the vaccination of the Romanian population against the virus that causes monkeypox, aiming to identify the degree of compliance regarding the decision related to vaccination acceptance/non-acceptance/hesitation, based on the survey of a representative sample of respondents. The study is based on an online questionnaire completed between 1 July and 31 July 2022 by 820 individuals, aged 18 years or above, with a permanent residency in Romania. The study was undertaken in order to observe the attitudes of the respondents regarding the acceptance, refusal, or hesitation of vaccination against monkeypox. The sociological data resulting from the application of the questionnaire on 820 people highlighted that 97.16% were vaccinated with the vaccines of the national mandatory scheme and 53.32% were vaccinated with the optional vaccines (rotavirus vaccine, anti-hepatitis A, meningococcal vaccine, etc.). Although 47.13% of respondents considered monkeypox to be a real problem facing humanity today, only 26.37% of those surveyed expressed their fear of becoming infected, and 29.30% were willing to immunize themselves against the virus by vaccination. Only 19.59% of respondents believed that the monkeypox disease will generate a new global pandemic, while 31.86% considered pandemics to be a human security issue, and 30.28% expressed their desire to accept a reduction in some rights and freedoms, in the short term, for the adoption of institutional measures to combat a possible pandemic caused by monkeypox. The study clearly highlights the fact that monkeypox is perceived as a threat to the health of the population, with relatively low acceptance of conspiracy theories regarding its origins/manifestation/consequences among respondents (between 21.7% and 28.9%). The vaccination of the population against monkeypox is strongly influenced by the validity of the results obtained over time, in the vaccination campaigns against the smallpox virus (vaccine found in the mandatory vaccination scheme in Romania until 1979). We believe that the negative public rhetoric regarding the COVID-19 vaccination is likely to negatively influence monkeypox vaccination. Although specialized studies and practical results showed that the immunization of the population through vaccination represents an important vector in the prevention/management of pandemic-type issues, we believe that a national pro-vaccination campaign, based on scientific evidence, can lead the population to accept vaccination when the epidemiological context requires it. We also believe that a culture of health security needs to be developed among citizens to raise awareness of the role of vaccines as an important vector in the field of population health.

Analysis of the impact of the armed conflict in Ukraine on the population of Romania.

Purpose: The study aims to highlight the behavior of people in a state in the vicinity of a military conflict zone. Specifically, it highlights the psychological behavior of Romanian citizens after the invasion of Ukraine by the Russian Federation. It was considered appropriate to carry out this study, given the novelty of such a situation, since, after the end of the Second World War, Europe has no longer faced major problems of insecurity caused by armed conflicts of this magnitude. Methods: The study was based on the questionnaire applied to a number of 1,193 people with permanent residence in Romania and a minimum age of 18 years. The data were collected in the beginning phase of the invasion of Ukraine by the troops of the Russian Federation, i.e. between March 1-17, 2022. The aim was to obtain information that would allow the observation of re-spondents' opinions on the conflict in Ukraine and its potential escalation, and on the other hand, to allow the assessment of quality of life, using the WHQOL-BREEF measurement instrument. Results: Based on the results of the study, the highest average satisfaction among the four domains of WHOQOL-BREF is represented by the "Psychological" domain, of the category of people with the lowest fear about a potential future war between Romania and the Russian Federation (83.62 ± 17.48). On the contrary, the lowest average is represented by the "Environment" domain, for the category of persons who do not feel protected by the fact that Romania is a NATO member state (61.77 ± 20.96). Conclusions: The results of the study show that the indices of the quality of life of the people in Romania, as a state in the proximity of a military conflict with the potential to escalate, are negatively influenced by the fears of people who believe that the war in Ukraine will escalate into a regional or global conflict, or that the Russian Federation is going to use its nuclear arsenal against Ukraine or another NATO member state.

Parental COVID-19 Vaccine Hesitancy for Children in Romania: National Survey.

PURPOSE: Once vaccination against COVID-19 was also possible for children over 12 years of age, parents/legal guardians had to give their consent for their vaccination. It is a crucial moment, given the large number of infected people in Romania and the fact that these children are a source of transmission of the virus in the community. The refusal or hesitation of the parents/legal guardians, regarding the agreement for the vaccination of the children, determined us to focus on this subject, wishing, based on the questioning of as many parents as possible, to extract the reasons underlying these decisions. METHODS: This study is designed to observe the attitudes of parents/legal guardians regarding the refusal, hesitation, or acceptance of vaccination of children. The persons targeted to answer the questionnaire had to meet three conditions: to be at least 21 years old, to have a stable residence in Romania, and to be parents/legal guardians of at least one child under 18 years of age. The questionnaire was applied online to a number of 581 parents/legal guardians, being structured to obtain socio-demographic data and other categories of data that allow us to analyze their views on vaccinating children. RESULTS: Sociological data resulting from the application of the questionnaire on 581 parents/legal guardians show that 183 (31.5%) adults and 140 (24.1%) children got infected with COVID-19. The total number of respondents shows that only 411 (70.7%) adults and 185 (31.8%) children are vaccinated. CONCLUSIONS: From the analysis of the data obtained through the questionnaire, following the application of the Kendall and Spearman statistical analysis tests, it is found that there is a strong link between participants' trust/distrust in "fake news" information and their decision to vaccinate their children.

Role of Helicobacter pylori in the triggering and evolution of hemorrhagic gastro-duodenal lesions.

The majority of studies concerning Helicobacter pylori (H. pylori) are oriented towards the implication of infection with H. pylori in processes that end in the formation of neoplasia, without assessing the impact of the bacterium in triggering acute gastroduodenal hemorrhagic episodes. The present study includes 166 patients with upper digestive hemorrhage, admitted to the ATI Clinic, the Gastroenterology Clinic or to the Surgery II Clinic of the County Emergency Clinical Hospital in Craiova, Romania between 2017 and 2019. All patients were monitored for evolution and received treatment according to current guidelines, and hemorrhagic lesions were biopsied. In the study group, 56.8% of the patients with upper gastrointestinal bleeding (UGIB) were positive for H. pylori and 43.2% were negative. In patients less than 50 years of age, non-steroidal anti-inflammatory drug (NSAID) use and H. pylori infection had a cumulative effect in causing bleeding lesions, but in patients older than 50 years of age, the use of NSAIDs was replaced by therapies with oral antiplatelet or anticoagulant agents. The need for hemostasis surgery was more common in patients who exhibited H. pylori-positive UGIB compared to H. pylori-negative (16 vs. 9.7%). In patients with H. pylori-positive hemorrhagic lesions, gastric resection was frequently required to obtain hemostasis. Persistence of H. pylori infection in patients with a history of gastric resection (4.1%) still predisposes to a hemorrhagic or neoplastic complication.

Neutrophil/Lymphocyte Ratio as Predictor of Anastomotic Leak after Gastric Cancer Surgery.

INTRODUCTION: Neutrophil/lymphocyte ratio (NLR) is known as a prognostic for the outcome of the patients with gastric cancer. As no definite risk marker for anastomotic leakage after gastric resection was identified, we investigated the possible role of NLR. METHODS: Peripheral blood count for neutrophils and lymphocytes was done at the patient's admission. We retrospectively evaluated 204 gastric cancer patients, who underwent gastric resection, comparing the values of NLR between the group of patients with anastomotic leakage and those without complications. RESULTS: Using the ROC curve, we found the cutoff value of NLR, which permitted the comparison of the group with low NLR, presenting increased NLR. The cutoff value for NLR was 3.54. Between the two groups, we could observe statistically significant differences in developing fistula (p < 0.01) and complications leading to death (p < 0.025). The odds ratio for patients with NLR greater than 3.54 to develop anastomotic leak was 17.62, compared to those with lower NLR. CONCLUSION: Peripheral blood NLR proved to be a predictor for anastomotic leakage.