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Effective communication between pharmacists and patients is essential for therapeutic success. The pharmacist's perspective may differ from that of the patient in terms of effective communication. Our study aimed to assess the communication efficiency in the pharmacist-patient relationship from the pharmacists' perspective. We hypothesize that the community pharmacist's perspective can lead to relevant aspects of patient-centred communication and their profession. A cross-sectional study was conducted through an online questionnaire addressed to pharmacists. A number of 506 questionnaires were collected, evaluated, analyzed and interpreted. The questionnaire focused on the following main issues: degree of job satisfaction, essential skills of a pharmacist working in a community pharmacy, different aspects of pharmacist-patient communication, shared decision-making, patient monitoring plan and other elements related to a patient under treatment (healthy lifestyle, receptivity to counselling, loyalty and appreciation of pharmaceutical services). The pharmacist's efficiency in communication with the patient and professional education were also targeted in the study. There are no significant differences between job satisfaction in women compared to men. However, the job satisfaction increases with the average age. Caregiver, communicator and life-long learner were identified as essential skills of a pharmacist. Pharmacists participating in the study generally perceive themselves as good communicators with the patient. Nevertheless, many particular aspects of communication with patients can be greatly improved. The lack of training in the spirit of the "patient-centred communication" concept has been identified. Still, more than a third of the respondents are missing the need for professional training. A periodic evaluation of the efficiency of pharmacist-patient communication in the community pharmacy is necessary. The degree of subjectivity of the pharmacist from this perspective and self-sufficiency would be significantly diminished if the pharmacists had access to the results of the periodic evaluations.
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This cross-sectional study conducted in Romania examines the increasing role of online pharmacies in providing Food for Special Medical Purposes (FSMP) to cancer patients. Key findings indicate patient satisfaction with ease of access, significant challenges related to costs, and the critical role of healthcare professionals in guiding FSMP selection. INTRODUCTION: As cancer treatments advance, the demand for supportive nutritional care becomes increasingly critical, with FSMPs playing a vital role in patient recovery and quality of life. METHODS: Employing a cross-sectional study design, we surveyed cancer patients from Romania to assess their experiences purchasing FSMPs through traditional and online pharmacies. We analyzed the factors influencing their choices, the perceived benefits and challenges of online access, and the role of healthcare professional guidance in their decision-making process. RESULTS: The study reveals that while patients appreciate the ease of access and the broad spectrum of available FSMPs online, they grapple with the financial burden and the need for reliable information to make informed decisions. Through a cross-sectional analysis, we found that the expertise and recommendations of healthcare professionals remain integral to the FSMP selection process, suggesting that digital solutions should enhance, not replace, traditional healthcare interactions. Moreover, our findings highlight a crucial gap in the taste and variety of FSMPs, suggesting that patient adherence could be improved through product innovation. The study found a significant association between the type of medical unit where patients followed their treatment (state-owned clinic) and whether they received recommendations from a specialist oncologist for using FSMPs. Nutritionists' recommendations were also significantly associated with a higher likelihood of purchasing FSMPs online. DISCUSSIONS: The study reveals that despite the benefits of digital access, a crucial need exists for regulatory measures and professional oversight to ensure the safe and informed use of FSMPs. The trust placed in healthcare professionals' recommendations continues to be instrumental in navigating the digital marketplace. CONCLUSION: This work paves the way for future strategies to integrate online solutions with established healthcare practices to optimize cancer care in the digital age.
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INTRODUCTION: The aim of this retrospective, observational, descriptive study was to identify predictors of response to neoadjuvant therapy in breast cancer patients and to validate them using three anatomopathological scores, such as residual cancer burden (RCB) score, Chevallier system, and tumor-infiltrating lymphocytes (TIL) score. MATERIALS AND METHODS: We conducted a study on 88 female patients aged 37 to 78 years with confirmed breast cancer who were indicated for neoadjuvant chemotherapy. We analyzed different individual variables (such as age, menarche, and menopause), clinical/imaging characteristics of the breast tumor and axillary nodes, immunohistochemical biomarkers (such as ER/PR/HER2 and Ki67), and histopathological features (such as subtype and grading) in relation to three anatomopathological scores calculated based on the surgical resection specimen. RESULTS: The percentage of patients who could have benefited from conservative surgery increased from 6% at the time of diagnosis to 20% post-primary systemic therapy (PST). Age under 49 (p = 0.01), premenopausal status (p < 0.01), no special type (NST) (p = 0.04), high Ki67 (p < 0.01), triple-negative breast cancer (TNBC) (p = 0.02) are positive predictive factors of neoadjuvant therapy, while lobular/mixt carcinoma-type (p = 0.04), luminal A (p = 0.01), positive lymph node (p < 0.01), and low differentiation grade (p = 0.01) are negative predictive factors for the response to PST. CONCLUSION: There is a strong correlation between the RCB score and the Chevallier system for quantifying the response to PST, with most predictive factors being confirmed through appropriate statistical analysis for both. TIL score values correlated with only some of the predictors, most likely due to the importance of calculating this score on both biopsy specimens at diagnosis and resection specimens after chemotherapy.
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This study investigated the efficacy of an Adapted Kata Training Program (AKTP) in enhancing balance for a 10-year-old child with Autism Spectrum Disorder (ASD), employing a mixed-model approach for data collection. Over 12 weeks, the AKTP demonstrated significant improvements in the child's balance abilities, with an 11% increase in static balance, 8% in proprioceptive, 12% in horizontal, and 14% in vertical balance performance. These improvements persisted in a follow-up assessment after four weeks. Observations by the child's mother corroborated the above findings. Consequently, this research suggests the AKTP as a valuable non-pharmacological intervention to improve balance in children with ASD. However, further studies are necessary to validate these results and explore the impact on additional developmental domains, such as cognitive and motor skills.
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Foam rolling is widely used in fitness, sports, rehabilitation, and injury prevention. However, there are limited data available on the effect of foam rolling techniques on the upper limbs. The aim of this investigation is to assess the effects of foam rolling the latissimus dorsi area during the rest period between two consecutive lat pull-down exercise (LPDE) sets. Seventeen resistance training experienced volunteer male subjects (25.8 ± 3.4 years; 180.3 ± 9.0 cm; 79.7 ± 9.9 kg) participated in this research. Each subject performed 2 training sessions of LPDE in a random order, separated by one week. Each session consisted of 2 sets of maximum repetitions using 85% of their one-repetition maximum (1RM), with a 7 min rest period between sets. The rest period condition between sets was different in the 2 sessions: passive rest (Pr) or foam rolling the latissimus dorsi muscle bilaterally for 3 sets of 45 s (FRr). The following variables were assessed for each LPDE set: number of repetitions (REPS), average excursion per repetition in millimeters (EXC), average power of the set in watts (AP) and rating of perceived exertion (RPE). Pr did not show any significant change between the first and the second LPDE set for REPS, EXC, and AP. However, there was a significant increase for RPE (8.4 ± 0.5 vs. 8.9 ± 0.5 a.u., p = 0.003) between the two sets. FRr resulted in an increase for REPS (7.1 ± 1.5 vs. 8.2 ± 1.3, p < 0.001) and AP (304.6 ± 61.5 W vs. 318.8 ± 60.8 W, p = 0.034) between the first and the second LPDE sets, but no changes were observed for EXC and RPE. The use of foam rolling techniques on the latissimus dorsi area during the complete rest period between sets in LPDE at 85% 1RM appears to improve the number of repetitions and the movement power without affecting the RPE during the second set.
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This study aimed to investigate Romanian physicians' awareness, recommendation practices, and opinions regarding the use of Foods for Special Medical Purposes (FSMPs) products. A total of ten physicians were interviewed using a structured questionnaire, and their responses were analysed using thematic content analysis. The study found that physicians were aware of FSMPs and recommended them to their patients based on nutritional deficits, weight loss, or deglutition impairments. In addition, disease stage, treatment scheme, taste, affordability, and availability were identified as factors influencing the recommendation and use of FSMPs. While physicians generally did not consult clinical trials, clinical experience was deemed essential for recommending FSMPs to patients. Patients' feedback regarding the usage and sourcing of FSMPs was generally positive, with some expressing concerns about the availability of different flavours and the costs of purchasing the products. This study concluded that physicians play a vital role in recommending FSMPs to patients and ensuring they have the necessary nutritional support during treatment. However, it may be imperative to consider the provision of additional patient education materials and fostering collaborative efforts with nutritionists in order to optimise the prospects of positive outcomes in oncology treatment, while simultaneously alleviating the financial burdens faced by patients.
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Alimentos , Médicos , Humanos , Inquéritos e Questionários , Aromatizantes , Pesquisa QualitativaRESUMO
Caffeine supplementation has become increasingly popular among athletes. The benefits of caffeine include delaying the negative effects of fatigue, maintaining a high level of physical and mental performance, and improving certain abilities necessary for sport success. Given the complex nature of basketball, caffeine could be a legal, ergogenic stimulant substance, which will positively affect overall basketball performance. The purpose of this systematic review was to summarize evidence for the effect of acute caffeine ingestion on variables related to the basketball performance. Web of Science, PubMed, Scopus and ProQuest, MEDLINE, and ERIC databases were searched up to February 2021. Studies that measured the acute effect of caffeine on basketball performance were included and analyzed. Eight studies published between 2000 and 2021 were included in the analysis. Pre-exercise caffeine intake increased vertical jump height, running time at 10 and 20 m without the ball, overall basketball performance (number of body impacts, number of free throws, rebounds, and assists) during simulated games, and reduced the time required to perform a basketball-specific agility test. Equivocal results between caffeine and placebo groups were found for aerobic capacity, free throw and three-point accuracy, and dribbling speed. Pre-exercise caffeine ingestion did not affect RPE, but insomnia and urinary excretion were increased. The pre-exercise ingestion of 3 and 6 mg/kg caffeine was found to be effective in increasing several physical performance variables in basketball players during sport-specific testing and simulated matches. However, considering the intermittent nature and complexity of basketball, and individual differences between players, future studies are needed.
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Desempenho Atlético , Basquetebol , Substâncias para Melhoria do Desempenho , Corrida , Cafeína/farmacologia , Humanos , Substâncias para Melhoria do Desempenho/farmacologiaRESUMO
The study aimed to explore the sensitivity and specificity of a new methodological approach related to the musical rhythm for discriminating a competitive Cuban dancer's (CDCs) level. Thirty CDCs (Age 23.87 ± 1.76 years, body mass 60.33 ± 9.45 kg, stature 1.68 ± 0.07 m) were divided into three groups: beginner (BEG, n = 10), intermediate (INT, n = 10), and advanced (ADV, n = 10) according to their training experience/level. Each dancer was assessed while dancing at three different musical rhythms: fast (118 BPM), medium (96 BPM), and slow (82 BPM). The assessed variables were average heart rate (HRM), peak (HRP), and dancing time (DCT). The ADV group succeeded at all three musical combinations (317, 302, 309 s for 82, 96, 118 BPM). The INT group correctly performed only the first two combinations (304, 304 s for 82, 96 BPM), while a significant time difference was shown at the fast musical rhythm (198 ± 6.64 s) compared to the medium (p < 0.001) and slow rhythms (p < 0.001) respectively. As the speed of the musical rhythms increased, the BEG group was not able to follow the rhythm: their results were 300 ± 1.25 s for the slow musical rhythm, 94.90 ± 12.80 s for the medium musical rhythm and 34.10 ± 5.17 s for the fast musical rhythm (p < 0.001). The HRM and HRP grew along with the increase in musical rhythm for all groups (p < 0.001). The ROC analysis showed a high sensitivity and specificity in discriminating the groups for each rhythm's condition. The BEG and INT groups showed an AUC = 0.864 (95% CI = 0.864-0.954); INT and ADV showed an AUC = 0.864 (95% CI = 0.864-0.952); BEG and ADV showed an AUC = 0.998 (95% CI = 0.993-1.000). The results of this study provided evidence to support the construct and ecological validity of the time of the musical rhythms related to competitive CDCs. Furthermore, the differences in the performances according to various musical rhythms, fast (118 BPM), medium (96 BPM), and slow (82 BPM), succeeded in discriminating a dancer's level. Coaches and strength and conditioning professionals should include the Cuban Dance Field Test (CDFT) in their test battery when dealing with talent detection, selection, and development.
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Dança , Música , Aptidão , Sensibilidade e EspecificidadeRESUMO
In terms of breastfeeding (BF) practices in Romania, there is a lack of up-to-date data. The aim of the present study was to assess current BF practices, and to investigate the factors associated with exclusive BF (EBF) under 6 months of age in northwestern Romania. A structured questionnaire was used to collect data among 1399 mothers of children aged 0-23 months, recruited between March and June 2019, from the community. BF practices were evaluated based on the World Health Organization indicators for assessing infant and young child feeding practices, whereas determinants of EBF were explored using logistic regression models. Almost all mothers (95.7%) breastfed their child at least once. The EBF rate was 46.7%, the continued BF rate at one year of age was 54.2%, and the continued BF rate at 2 years of age was 30.3%. The place of delivery and parental leave duration were strong determinants of EBF. The improving rates observed in this study for all the BF practices assessed suggest the continuation of efforts to develop effective national policies and programs for promoting, protecting, and supporting BF in Romania. Particular emphasis should be given to the creation in maternity hospitals of an environment that is supportive towards breastfeeding.
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Aleitamento Materno/psicologia , Aleitamento Materno/estatística & dados numéricos , Mães/psicologia , Mães/estatística & dados numéricos , Adulto , Aleitamento Materno/métodos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Maternidades , Humanos , Lactente , Recém-Nascido , Masculino , Romênia , Inquéritos e QuestionáriosRESUMO
An increasing number of patients require renal replacement therapy through dialysis and renal transplantation. Chronic kidney disease (CKD) affects a large percentage of the world's population and has evolved into a major public health concern. Diabetes mellitus, high blood pressure and a family history of kidney failure are all major risk factors for CKD. Patients in advanced stages of CKD have varying degrees of cardiovascular damage. Comorbidities of these patients, include, on the one hand, hypertension, hyperlipidemia, hyperglycemia, hyperuricemia and, on the other hand, the presence of mineral-bone disorders associated with CKD and chronic inflammation, which contribute to cardiovascular involvement. Acute complications occur quite frequently during dialysis. Among these, the most important are cardiovascular complications, which influence the morbidity and mortality rates of this group of patients. Chronic hemodialysis patients manifest acute cardiovascular complications such as intradialytic hypotension, intradialytic hypertension, arrhythmias, acute coronary syndromes and sudden death. Thus, proper management is extremely important.
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Anastomotic leaks (ALs) remain the most severe complication in digestive surgery, as well as the most consumptive in terms of human and financial resources. There is an abundance of international research which has focused on identifying and correcting risk factors, and on individualized surgical management as well. The most frequent risk factors are male sex, obesity, diabetes, advanced malignant disease, ASA score, perioperative blood loss or perioperative transfusion, long operation time, emergency operation and altered nutritional status. The aim of the present study was to measure the preoperative serum calcium level and to find a possible correlation between calcium levels and the risk of AL occurrence. A retrospective analysis of medical records for 122 patients who underwent surgical gut resection with anastomosis for different pathologies was carried out. Preoperative serum calcium level and the occurrence of AL was noted. The results revealed that the average value of total blood calcium was 8.78 mg/dl, without a significant difference in sex groups. Hypocalcemia was identified in 44 patients (36.1%). AL was identified in 8 patients (6.6%), with a statistically insignificant difference between male and female patients. The average value of blood calcium in the AL patient group was 8.07 mg/dl, while in patients without AL the average value was 8.83 mg/dl. Hypocalcemia, defined as a serum calcium level below 8.5 mg/dl, was observed in 7 of the 8 patients presenting with AL (87.5%) and 37 patients who did not present with AL (32.5%), a significant difference with which to consider and include hypocalcemia in the group of risk factors for AL (P=0.001). In conclusion, preoperative low serum calcium level can represent a risk factor for AL in digestive surgery.
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Obesity is a worldwide pandemic health issue. Obesity is associated with the pathogenesis of type 2 diabetes, hypertension, dyslipidemia, cardiovascular diseases, cancer, and kidney diseases. This systemic disease can affect the kidneys by two mechanisms: Indirectly through diabetes mellitus (DM) and hypertension and directly through adipokines secreted by adipose tissue. Obesity is a risk factor for chronic kidney disease (CKD), which is associated with an increased risk of morbidity and mortality among the adult population. Increased visceral adipose tissue leads to renal glomerular hyperfiltration and hyperperfusion, which may lead to glomerular hypertrophy, proteinuria, and CKD development. Adipokines are hormones produced by fat tissue. They are involved in energy homeostasis, sugar and fat metabolism, reproduction, immunity, and thermogenesis control. Hormones and cytokines secreted by adipose tissue contribute to the development and progression of CKD. Decreased serum or urinary adiponectin levels are specific in diabetic and non-diabetic CKD patients, while leptin presents increased levels, and both are associated with the development of glomerulopathy. Excessive adipose tissue is associated with inflammation, oxidative stress (OS), insulin resistance and activation of the renin angiotensin-aldosterone system (RAAS). Therefore, adipose tissue dysfunction plays an important role in the development of CKD.
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As life expectancy increases, a rise in the number of chronically ill patients is observed due to the aging population. Among the various diseases, chronic kidney disease is at present one of the main causes of morbidity and, due to its typical complications, it is also one of the most important causes of mortality in the general population. For these reasons, the understanding of the kidney aging process, its consequences and its adequate management are essential. The judicious use of certain types of drugs, the prevention of episodes of renal injury either by toxic mechanisms or by dehydration are important aspects and are part of the apropriate approach for elderly patients. The most effective treatment of various types of conditions with a negative impact on renal function and for which an increased incidence is known as we age should also be considered. Thus, in the case of elderly patients, in order to protect the kidneys, an integrative approach is recommended, one that includes both elements of prevention and the appropriate treatment of existing diseases.
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Renal cell carcinoma (RCC) accounts for over 90% of all renal malignancies, and mainly affects the male population. Obesity and smoking are involved in the pathogenesis of several systemic cancers including RCC. The phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) signalling pathway regulates cell growth, differentiation, migration, survival, angiogenesis, and metabolism. Growth factors, hormones, cytokine and many extracellular cues activate PI3K/AKT/mTOR. Dysregulation of this molecular pathway is frequently reported in human cancers including RCC and is associated with aggressive development and poor survival rate. mTOR is the master regulator of cell metabolism and growth, and is activated in many pathological processes such as tumour formation, insulin resistance and angiogenesis. mTOR inhibitors are used at present as drug therapy for RCC to inhibit cell proliferation, growth, survival, and the cell cycle. Temsirolimus and everolimus are two mTOR inhibitors that are currently used for the treatment of RCC. Drugs targeting the PI3K/AKT/mTOR signalling pathway may be one of the best therapeutic options for RCC.
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Hemodialysis is a method for the renal replacement therapy followed by series of acute and chronic complications. Dyselectrolytemia appears in patients undergoing dialysis through mechanisms related to the chronic kidney disease and/or to the dialysis therapy and for this group of patients it is associated with an increase of morbidity and mortality. The dialysate has a standard composition, which can be modified according to the patient's characteristics. During hemodialysis patients are exposed to 18,000-36.000 litres of water/year, and the water purity along with the biochemical composition of the dialysate are essential. The individualization of the dialysis prescription is recommended for each patient and it has an important role in preventing the occurrence of dyselectrolyemia. The individualization of the treatment prescription according to the blood constants of each patient is the prerogative of the nephrologist and the association of the electrolyte imbalances with the patients cardiovascular mortality explains the importance of paying special attention to them.
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Ambroise Paré was a renowned French barber-surgeon, considered by many to be "the father of surgery". Originating from a family of barber-surgeons, he unraveled the secrets surgery at an early age, and he masters it by participating in the many military actions of the French Army of those times. As recognition of his merits, the kings of France proclaimed him their chief barber-surgeon and even president of the Royal College of French Surgeons. He was a doctor endowed with many qualities and contributed to the development of many medical specialties. Ambroise Paré has brought many contributions and innovations to the development of medicine. Worldwide, his name is closely related to the use of surgical hemostasis. As a true Professor, he offered his entire medical experience through the publication of 25 manuscripts that address various medical specialties. Perseverant and perfectionist by nature, Ambroise Paré represents a true role model for generations of surgeons to come.
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Cirurgiões , França , História do Século XVI , Humanos , MasculinoRESUMO
INTRODUCTION: Neuroendocrine tumors are derived from cells that have the unique ability to synthesize, store and secrete a variety of metabolically active substances, peptides and amines, characteristic of the tissue of origin, which can cause distinct clinical syndromes. MATERIAL AND METHODS: We present the case of a 58-year-old patient diagnosed and surgically treated in January 1996 for stage III inferior rectal cancer, who was readmitted after 18 years presenting persistent diarrheic syndrome and asthenia. Investigations performed (abdominal CT) showed multiple liver metastases, initially suspected as being related to the rectal cancer. Biopsy of liver metastases and pathological and immunohistochemical analysis demonstrated the neuroendocrine origin (moderately differentiated neuroendocrine tumor). Seven months after the identification of liver metastases and after initiation of oncological therapy with Interferon and Somatostatin, the patient presented severe hypoglycemia (serum glucose 13-70 mg/dl) proved to be due to insulin-like factors (serum insulin level 64.9 ìU/ml) secreted by metastases. Due to the aggressive evolution of neuroendocrine tumor, with multiple episodes of severe hypoglycemia, resistant to treatment, the patient died approximately one month after the occurrence of hypoglycemic episodes. CONCLUSION: Despite comprehensive tests (abdominal CT scan, colonoscopy, bone scintigraphy and PET/CT), the primary site of the neuroendocrine tumors remained unknown.
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UNLABELLED: The analysis of the Management Unit of the National TB Programme (NTP) database, together with the reports of the TB county managers, allowed to the authors to identify some weaknesses of TB control in Romania in the recent years and to propose the appropriate measures. PROBLEMS: The marked decrease in the reduction of TB cases reported annually from 2,761 in 2005-2006, to 145 in 2007-2008 and the stagnation of mortality rate: 7.5 per ten thousand in 2007 and 7.6 per ten thousand in 2008. Deficiencies in data recording and reporting through informatic system of the NTP. Lack of financial resources for system maintenance and upgrade. Deficiencies in monitoring and control of mycobacterium resistance to antituberculous drugs phenomenon at national level. Sensitivity testing only for a small percentage of culture confirmed new TB cases (21%). Higher percentage of MDR in new TB cases compared to the results of national survey of mycobacterium drug resistance 2003-2004. Lack of personnel: 16 TB dispensaries without any pulmonologist, vacancies for 259 doctors, 436 nurses and 433 auxiliary personnel. Important deficiencies in the NTP network's infrastructure and logistics countrywide. Discontinuities in the supply with first and second line antituberculous drugs resulting in interruption of treatments. Lack of an officially endorsed protocol for the diagnosis, treatment and monitoring of cases with TB/HIV co-infection. Solutions: Revitalization of monitoring-supervision activities of the NTP running countrywide, provision with necessary financial resources to perform the scheduled visits in counties. Providing maintenance and upgrade of the informatic system for data collection. Implementation of the necessary measures in order to attract and maintain the personnel in the NTP network. Conduct the national survey of mycobacterium susceptibility to first and second line antituberculous drugs and drug susceptibility testing of the most culture confirmed TB cases. Restore the centralized procurement of TB drugs. Finalization and official endorsement of the protocol for TB/HIV co-infection initiated in 2004.
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Mycobacterium tuberculosis/isolamento & purificação , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologia , Antituberculosos/uso terapêutico , Técnicas de Laboratório Clínico/economia , Diagnóstico Diferencial , Resistência Microbiana a Medicamentos , Infecções por HIV/complicações , Humanos , Incidência , Sistemas Computadorizados de Registros Médicos/economia , Testes de Sensibilidade Microbiana/economia , Testes de Sensibilidade Microbiana/métodos , Mycobacterium tuberculosis/efeitos dos fármacos , Vigilância da População , Fatores de Risco , Romênia/epidemiologia , Taxa de Sobrevida , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/economia , Tuberculose Pulmonar/mortalidadeRESUMO
UNLABELLED: Romania decided and initiated a DRS for anti-TB drugs at national level using the standardized methodology proposed by WHO and IUATLD. The DRS protocol was designed with technical assistance from WHO; the surveillance started in June 2003 and ended in June 2004. It was tested the susceptibility to the 4 first line anti-TB drugs: Isoniazide (H), Rifampicin (R), Streptomycin (S), Ethambutol (E). Drug susceptibility testing used: indirect absolute concentration method. There were included in the survey 1251 TB patients from the 60 clusters: 869 new cases and 382 previously treated. From the penitentiary system were included 85 TB patients, 47 new cases and 38 previously treated. RESULTS: [table: see text]. Estimations of the trend of anti-TB drug resistance in Romania for the next period was proposed.
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Antituberculosos/farmacologia , Farmacorresistência Bacteriana , Mycobacterium tuberculosis , Vigilância da População , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Tuberculose Pulmonar/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise por Conglomerados , Etambutol/farmacologia , Feminino , Humanos , Isoniazida/farmacologia , Masculino , Testes de Sensibilidade Microbiana/métodos , Pessoa de Meia-Idade , Mycobacterium tuberculosis/efeitos dos fármacos , Prisioneiros , Rifampina/farmacologia , Romênia/epidemiologia , Estreptomicina/farmacologia , Organização Mundial da Saúde , Adulto JovemRESUMO
The authors analyze the current status of anti-TB activity in Romania, in which several factors are involved: the pneumo-phthisiology network, the central unit (M. Nasta Institute of Pneumology), the Health Insurance, Health Ministry as well as international funding and technical assistance units (Global Fund, World Health Organisation). Current TB incidence data are reviewed, as well as the events in NPTC during 2005: training of the personnel involved in TB care (pneumologists and general practitioners, nurses, laboratory staff), improving TB care in risk groups (children, inmates, HIV positives, gypsies), improving the functionality of bK laboratory network, improving access of multidrug resistant TB patients to good quality services, improving the system for acquiring and distributing medication, developing a functional system for monitoring the NPTC, integrating TB in the national system for transmissible diseases survey, elaborating guidelines on different aspects of TB care. In 2005, WHO performed an evaluation mission in Romania, finally proposing solutions for current issues: the Government Decision of the NPTC actions, establishing the status of the county NPTC managers, using incentives for patients, improving drug management by application to international organisms, increasing the personnel numbers in national reference laboratories, improving the informational circuits between factors involved in NPTC.