EXPERIMENTAL INDUCTION OF TYPE 2 DIABETES MELLITUS AND THE EFFICIENCY OF BARIATRIC SURGERY IN ITS REVERSAL IN RATS.

BACKGROUND: Following recent years, there is an increased body of literature on the connections that might exist between type 2 diabetes mellitus and the efficiency of bariatric surgery in its reversal compared to other medical approaches such as dieting. AIM: To induce experimentally type 2 diabetes mellitus in rats in order to observe the effects of bariatric surgery in the recovery as well as the reestablishment of normal insulin levels in order to extend the findings in house animals. MATERIALS AND METHODS: This study was conducted in three stages: the first consisted in inducing type 2 diabetes mellitus (T2DM) in 40 young Wistar male rats, by initially feeding them human food high in vegetal fats, oleaginous seeds, simple and complex carbohydrates, sugars, lipids, fats, proteins and fructose for a period of 8 weeks followed by a single low dose of streptozotocin (STZ), administered through intraperitoneal injection. The second stage of the study started when the rats became obese and therefore qualified for the bariatric procedure and the third stage consisted of post-operation supervision and care. The surgical procedure, performed on 10 obese rats, consisted in reducing the size of the stomach by partial gastrectomy of a 1.5 - 2.0 cm wide and 6.5 - 7.5 cm long area on the large curvature. RESULTS: Showed rapid improvements in body weight and blood sugar control after 9 days. CONCLUSION: After putting the rats on a diet high in carbohydrates, sugars, lipids and fats and administering them STZ, the induction of type 2 diabetes was successful and the partial gastrectomy led to a better blood sugar control. The bariatric procedure provides a faster therapeutic response than conventional diets.

REDUCE CHILD MORTALITY AS A MILLENNIUM DEVELOPMENI GOAL IN ROMANIA.

AIM: To assess the efforts made in Romania towards achieving the Goal 4 from MDGs--Reduce Child Mortality. MATERIALS AND METHODS: A descriptive study about the deaths among Romanian children under five, between 2002 and 2015, from the perspective of the MDGs. To help track progress toward this commitment, following specific targets and indicators were developed: Target 1-Halve the mortality rate in children aged 1-4 years between 2002-2015; Target 2--Reduce infant mortality by 40% between 2002 and 2015; Target 3--Eliminate measles by 2007. The comparison allows establish the status (achieved or not) for each target. RESULTS: From 2002, the under-five mortality rate recorded a continuous descendent trend till now (20.8 to 10.3 under five deaths per 1000 inhabitants in 2013). The infant mortality rates declined from 17.3 to 8.5 deaths per 1,000 live births (2002-2013). Eliminating measles by 2007--was achieved one year later, because of the measles epidemic in 2005 and 2006. High vaccination rates have been maintained, with the proportion of children 1 year old vaccinated against measles reaching and being maintained at between 94-98%. CONCLUSIONS: Substantial progress has been made in Romania, in achieving the Millennium Development Goal no. 4. All the three targets were achieved. However, infant mortality still remains above the average of European Union (4 infant deaths per 1,000 live-births).

The Contribution of Alexithymia to Burnout in Forensic Physicians.

The Aim: The aim of the study was to identify the relationship between the level of burnout subdomains and alexithymia among forensic physicians working in forensic institutions in Romania. Material and Methods: A number of 37 forensic physicians were included in the survey. Burnout and alexithymia were measured by using the Maslach Burnout Inventory and Toronto Alexithymia Scale. The obtained data were processed using the SPSS 17.00 statistical software. Results: The subjects obtained an average of 43.27±3.71, which corresponds to a low level of alexithymia. For burnout scores, we have obtained M=14.97±13.13 for emotional exhaustion, M=7.91±6.87 for depersonalization and M=33.18±10.59 for personal accomplishment (low-level for emotional exhaustion and medium-level burnout for the other two factors). Among the socio-demographic variables, only the age correlated positively with the burnout factor personal accomplishment. Positive correlations were identified between burnout factors and TAS-20. Comparative analysis results are important for the presence of insomnia, depression, teaching activity and looking for professional support after critical events. Conclusions: Scores for forensic physicians are low-level for emotional exhaustion and medium-level for two subdomains and low-level for alexithymia. Factors revealed by the comparative analysis are important to adjust professional activity and to find strategies to cope with stressful professional events.

Aspects of physician-patient communication in the program of smoking cessation.

The doctor-smoker patient communication is essential for smokers to realize the harmful effects of tobacco on health and the benefits of smoking cessation. Nicotine found in cigarettes is a powerful drug and a direct dependency generator, which makes smoking cessation difficult, the withdrawal syndrome being hard to overcome for many smokers. The doctor-smoker patient communication is a complex process of data, information and knowledge transmission, subjected to some semiotic rules. In the Counseling Center for Smoking Cessation (CCSC) from the Rehabilitation Clinical Hospital of Iasi the medical and psychological counseling and the pharmacologic therapy for smoking cessation is ensured by the qualified personnel. CCSC was founded in 2005, when the hospital was included in European Program: "European Network Smoke-Free Hospital", and experienced an important development in 2007 with the initiation "Stop Smoking" National Program of Ministry of Health. The doctor-smoker patient communication in the CCSC was conducted during the smoker's recruitment, therapeutic and post therapeutic period, a special place being occupied by the doctor-medical staff communication, including smoker medical students. The number of people who became nonsmokers after being counseled at our center was the evidence of the effectiveness of this communication. The obtained results determined us to join the global fight against smoking and to propose the introduction of the smoking cessation program in the curriculum of the medical education institutions.

PSYCHOTIC DISORDERS GENERATED BY AUTOIMMUNE ENCEPHALITIS (CLINICAL CASE).

Encephalitis is a brain inflammation, which could involve also the meninges. The etiology of encephalitis could be: viral, bacterial, fungal or autoimmune. Anti-NMDAR encephalitis is an immune disorder, easy to diagnose and is a treatable condition. Most patients with anti-NMDAR encephalitis develop a multistage illness that progresses from psychosis, memory deficits, seizures, to catatonic state and breathing instability. We present a case report of a 20-year old woman, who presented: amnesia, visual hallucination, illusions, seizures after that occurred following autoimmune encephalitis. The exact incidence of anti-NMDAR encephalitis is unknown, but it seems to be more frequent than any other known paraneoplastic encephalitis. The present case is important considering that autoimmune encephalitis is a rare frequency disorder in Romania, with patients presenting resounding psychiatric and neurological manifestations.

INFORMED CONSENT IN PSYCHIATRIC MEDICAL CARE: A PROSPECTIVE QUANTITATIVE STUDY.

UNLABELLED: Respecting fundamental ethics principles entails the process of obtaining an informed consent, which is a necessary requirement for offering good psychiatric medical care and conducting research studies on human subjects, who are regarded as the vulnerable population. Presently, in Romania, the informed consent regarding medical interventions is covered by the law of the patient's rights, Law 46/2003, chapter 3. The aim of this study is to evaluate the medical staff's perception of the need of the informed consent in the practice of psychiatric medical care. MATERIAL AND METHODS: This is a quantitative, inquiry based study, with prospective evaluation, based on the responses of 217 medical staff members involved in treating patients with psychiatric disorders. The study unfolded between July 2012 and July 2013, and the questionnaires were answered by medical staff members (psychiatrists, general practitioners, other clinical specialists, psychologists) from Iasi, Botosani, Vaslui, Suceava counties. RESULTS: The age group distribution of the medical staff involved in the medical care shows statistically significant differences between the groups questioned (χ2 = 227.14; df = 5; p = 0.001). Concerning the answers recorded at question no. 2, regarding informing the psychiatric patient, and comparing the studied groups of medical staff, a majority of affirmative answers was noted. CONCLUSIONS: The medical staff members involved in the patient's treatment recognizes the necessity of a full informed consent when discussing about psychiatric medical care. In psychiatry, the variation of competence raises multiple ethics discussions.

ADDITIONAL DEMOGRAPHIC AND CLINICAL EVIDENCES ON THE RELEVANCE OF THE SYSTEMIC THERAPY IN ALCOHOL DEPENDENCE.

The modern treatment for alcohol dependence is still problematic, in many cases with the costs exceeding benefits. In these conditions a new management approach was developed lately, known as the systemic therapy. In this way, the crystallization and practical transposition of this new treatment approach is represented by the Clubs of Alcoholics in Treatment. These clubs are in fact a form of psycho-social intervention consisting of multi-family communities in order to maintain long-term abstinence from alcohol and to change their lifestyle and behavior. Thus, in the present paper we were interested in understanding the demographics of this systemic theory and how these aspects are influencing the final results of the therapy, as well as studying/confirming how relevant is this systemic approach on the management of alcohol dependence. Our results presented in this report bring additional evidences for the superiority of the systemic, multi-family approach of alcohol-related problems, as complemented to the standard medicinal therapy. Moreover, the data collected from patients in this study might suggest that patients with a higher educational level and therefore better capacity of understanding the information, with family support, and also with a better occupational insertion, have accepted to follow The Clubs of Alcoholics in Treatment program, with a subsequently better evolution.

Disparities in the access to primary healthcare in rural areas from the county of Iasi - Romania.

AIM: To identify the factors that may conduct to various forms of social exclusion of the population from the primary healthcare and to analyze health disparities as population-specific differences in the access to primary healthcare in rural compared to urban residence areas from Iasi, the second biggest county, situated in the North--East region of Romania. MATERIALS AND METHODS: This research is a type of inquiry-based opinion survey of the access to primary healthcare in rural compared to urban areas of the county of Iasi. Data were collected by face-to-face interviews. There were taken into account the socioeconomic status (education level in the adult population, employment status, family income, household size) and two temporal variables (the interval of time spent to arrive at the primary healthcare office as a marker for the geographical access and the waiting time for a consultation). The study group consisted of two samples, from rural and urban area, each of 150 patients, all ages, randomly selected, who were waiting at the family doctor's practice. RESULTS: The study has identified disparities related to a poor economic status assessed through the employed status ("not working" 15% in urban and of 20% in rural).The income calculated per member of family and divided in terciles has recorded significant differences for "high" (36.7% urban and 14.7% rural) and "low", respectively (14.6% urban and 56.6% rural). High household size with more than five members represented 22.6% of the total subjects in rural and 15.3% in urban areas. The assessment of the education level in the adult population (> 18 years) revealed that in the rural areas more than a half (56%) of the sample is placed in the category primary and secondary incomplete, whereas the value for secondary complete and postsecondary was 37.3%. The proportion of respondents in the urban areas who have post-secondary education is five times higher than those in rural areas (15.4% vs. 2.7%). The reduced geographical access assessed as the interval of time spent to arrive at the primary healthcare office revealed, on average, 25 minutes in urban versus 75 minutes in rural areas. CONCLUSIONS: The research outcomes highlight the fact that the population living in rural communities from the county of Iasi, are disadvantaged in accessing the primary health services, with negative consequences on the health status.

Epidemiological assessments on incidence of acute gastroenteritis in 0-14 aged children, in the Iasi County, Romania, between 2009-2012.

UNLABELLED: The study aim was to assess the epidemiological potential of acute gastroenteritis (AGE) in children between 2009 and 2012. MATERIAL AND METHODS: We studied two groups; first, a lot of 7237 cases (group A) recorded in the Iasi County through passive surveillance system, reported monthly by the network of primary health care, the assisted outpatients, respectively, those reported by hospitals. The second group (group B) was composed of 4191 hospitalized cases reported also in the passive surveillance system m by telephone, weekly, during only June/end of May to October/beginning of November. Structural peculiarities of the two groups are due to different reporting methodology, so that they were analyzed separately. RESULTS: AGE cases come from urban or rural areas in relatively stable proportions and slightly increased in rural areas compared to urban. The distribution by sex of cases from the group B is maintained at the same shape from one year to another, with a slight predominance in males. The best represented age group in every studied was 0-3 (54.3% of all cases), followed by children between 5 and 10 years with 17.5%). Laboratory investigations have enabled the etiologic diagnosis for hospitalized cases, which ranged from 15.3 to 17.5%, with the exception of 2009 when the diagnosis was noted for almost half of the discharged patients (47.5%). CONCLUSIONS: AGE remains a public health problem in the Iasi County and Romania also, by affecting all age groups, but especially children under 3, an insufficient knowledge of the etiology, and economic losses insufficiently evaluated.

Clinical epidemiological study on the incidence of Escherichia coli infections in the cancer patients admitted to Surgery Department II of the Iasi Regional Oncology Institute in 2013.

UNLABELLED: The aim of study was to identify pathogens involved in hospital-acquired or community-acquired infections in patients suffering from various types of cancers. MATERIAL AND METHODS: A clinical epidemiological study included a group of 355 cancer patients admitted and operated at the Surgery Department II of the Iasi Regional Oncology Institute in 2013 was performed using data from hospital statistical service and the surgery and laboratory records, then processed by epidemi ological and statistical methods. RESULTS: In cancer patients the pathogen most commonly involved in infections was E. coli, followed by Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, and Enterococcus faecalis, Enterobacter cloacae and Acinetobacter. Analysis of bacterial resistance to antibiotics of the pathogen most commonly involved revealed that of the 29 E. coli strains 22 were tested for resistance/sensitivity to ampicillin; of these, 19 strains showed resistance, and only 3 were sensitive; 14 E. coli strains of were resistant to cephalosporins and 8 sensitive; all strains tested were sensitive to carbapenems, imipenem or meropenem and polypeptides (colistin); the 10 tested strains showed resistance to monobactams (aztreonam). CONCLUSIONS: E. coli was incriminated in most urinary tract infections, the other pathogens being identified sporadically. Surgical wound infections were caused mostly by E. coli and Staphylococcus aureus, followed by Pseudomonas aeruginosa. In our study we encountered increased resistance of E. coli to penicillins, cephalosporins, monobactams (aztreonam), fluoro-quinolones and tetracyclines.

Clinical-epidemiological trends of herpes zoster: a 5-year study.

UNLABELLED: Herpes zoster (shingles) is a neurocutaneous viral disease, in recent years its incidence increasing throughout the world. AIM: To study the incidence of herpes zoster among Iasi county patients requiring hospital admission and to analyze the clinical and epidemiological features and socioeconomic status of the study group. MATERIAL AND METHODS: Retrospective study of 158 patients admitted to the largest clinical dermatology department in North-eastern Romania, the Clinical Dermatology Department of the Iasi "Sf. Spiridon" University Emergency Hospital. The study was conducted over a period of five years and included the analysis of epidemiological data, socioeconomic status, clinical forms of disease, associated diseases, pathology reports for skin biopsy fragments, administered treatment, and disease course. RESULTS: This study confirms that shingles is not a sex-specific disease, the female/male ratio being 1.22: 1. Most patients belonged to the age group 70-80 years, accounting for about 35% of all patients, followed by the age group 60-70 years (24.6% of cases). A slight increase in the number of cases was recorded in autumn and summer in patients living in rural areas. 1.3% of the cases were diagnosed both with the disseminated form of disease, and complications (eczematization, bacterial superinfection, skin necrosis). 7.6% of patients presented additional skin disorders (pityriasis versicolor, impetigo, psoriasis vulgaris, mucocutaneous candidiasis), which raised the suspicion of an immune deficiency predisposing to shingles. The absence or late initiation of specific antiviral therapy correlated with prolonged hospital stay up to 4-6 days. We found an association between the erythematous form of shingles and young age, while the hemorrhagic or necrotic forms were present in the elderly and/or ill patients. The course was favorable and the length of illness was significantly shortened when the treatment adequate to the clinical form was administered. Associated comorbidities (essential hypertension 38.6%, dyslipidemia 24.6%, diabetes, mellitus 9.49%, chronic venous disease, other skin diseases) represent a factor complicating the development of herpes zoster by the cumulative stress the body is exposed to. CONCLUSIONS: The main statistically significant epidemiological data in the study group are: older age (over 60 years), associated diseases (which by the marked imbalances induced in the body increase the risk of varicella zoster virus reactivation) intense psychological stress. The following parameters did not change the risk of developing shingles: area of origin, sex, the season at disease onset, number of hospital days, and administered treatment. Early diagnosis and treatment of this disease is important for maintaining a good quality of life, to avoid complications, to limit the extent of the disease and its transmission to others.

Using ArcGIS software in the pre-hospital emergency medical system.

AIM: To measure the accessibility to healtcare services in order to reveal their quality and to improve the overall coverage, continuity and other features. MATERIAL AND METHODS: We used the software ESRI Arc GIS 9.3, the Network Analyst function and data provided by Ambulance Service of Iasi (A.S.I.) with emergencies statistics for the first four months of 2012, processed by Microsoft Office Excel 2010. As examples, we chose "St. Maria" Children's Emergency Hospital and "St. Spiridon" Emergency Hospital. RESULTS: ArcGIS Network Analyst finds the best route to get from one location to another or a route that includes multiple locations. Each route is characterized by three stops. The starting point is always the office of Ambulance Service of Iasi (A.S.I.), a second stop at the case address and the third to the hospital unit chosen according to the patient's diagnosis and age. Spatial distribution of emergency cases for the first four months of 2012 in these two examples is one unequable, with higher concentrations in districts located in two areas of the city. CONCLUSIONS: The presented examples highlight the poor coverage of healthcare services for the population of Iasi, Romania, especially the South-West area and its vulnerability in situations of emergency. Implementing such a broad project would lead to more complex analyses that would improve the situation of pre-hospital emergency medical services, with final goal to deserve the population, improve the quality of healthcare and develop the interdisciplinary relationships.

Clinical-epidemiological study on advanced non-small cell lung cancer.

AIM: To assess the clinical and epidemiological features of all three main histological types of non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: The study included 34 patients with NSCLC admitted to specialized units of the Iasi Regional Cancer Institute (IRCI) in the interval May 2012 - May 2014. Data were collected electronically based on a clinical-epidemiological survey form. The obtained data were then processed and interpreted by statistical-mathematical methods using the correlation index (significant at p < or = 0.05 and highly significant at p < 0.005), chi-square and Y tests. Data were analyzed using SPSS 13.0 (SPSS Inc. Chicago, Illinois, USA). RESULTS: Most NSCLC patients were aged 56-71 years, the Pearson correlation index between age and diagnosis being p = 0.01. Sex difference was highly significant (p = < 0.001) and so was the relationship between heavy smoking and age groups. Most cases were histogenetically classified as adenocarcinomas (22%). Four patients (21%) were in stage IIIA NSCLC, 4 (21%) IIIB, 9 (47.3%) IV, and 15 (79%) unspecified stage. All patients received primary chemotherapy. Single or associated complications included anemia and other hematologic disorders (26-74.6%), respiratory failure, hemoptysis, cachexia, atelectasis, etc. Surgery was performed in 5 (14.7%) stage IIIA NSCLC patients. CONCLUSIONS: NSCLC showed a highly significant predominance in the age groups 56-71 years, and the most common histologic type was adenocarcinoma. All patients received primary chemotherapy, and patients with stage IIIA underwent surgery. Anemia and other hematologic disorders were the most common complications.

Epidemiological evaluation regarding the role of cystic fibrosis as a risk factor for child malnutrition.

Cystic fibrosis (CF) is the most common monogenic autosomal recessive disorder with progressive chronic evolution which is potentially lethal. Poor growth is a characteristic of children suffering from cystic fibrosis. A poor nutritional status is an independent risk factor for inadequate survival in cystic fibrosis and is associated with disease complications. The appropriate nutritional management is an important part of the treatment so that the patient with cystic fibrosis can achieve normal growth and development and maintain the best possible health status. A balanced diet supplemented with snacks high in fat and calories is necessary to increase the caloric intake in children with cystic fibrosis. Children with cystic fibrosis have higher caloric needs than healthy children of the same age and sex. Malnutrition in CF is multifactorial. Cystic fibrosis is a complex multisystem disorder affecting mainly the gastrointestinal tract and respiratory system. In the past, malnutrition was an inevitable consequence of disease progression, leading to poor growth, impaired respiratory muscle function, decreased exercise tolerance and immunological impairment. A positive association between body weight and height and survival has been widely reported. The energy requirements of patients with CF vary widely and generally increase with age and disease severity. Cystic fibrosis remains a paediatric disorder which is often underdiagnosed but which, if therapeutically managed properly (by means of drug therapy as well as by appropriate physiotherapy techniques), can lead to improved quality of life and, thus, to a bigger life expectancy.

Clostridium difficile epidemic outbreak in an oncology unit.

AIMS: Contributions to the knowledge of some peculiarities of C. difficile involvement in human pathology, nosocomial infections (NI) included. MATERIAL AND METHODS: This clinico-epidemiological and laboratory study included 14 patients admitted to the Medical Clinic of the Iasi Regional Cancer Institute with the diagnosis of C. difficile NI based on detection of toxins A and B in stool samples. The data were assessed and interpreted using an algorithm which revealed the peculiarities of C. difficile NI outbreak occurrence and evolution. RESULTS: Of the 14 cases included in the study, 5 (35.8 %) had community-onset infections and 9 (64.3%) oncology unit-onset infections. The average hospital stay was 22 days. Immunocompromised condition and the use of antibiotics in the ciprofloxacin, colistin and cefotaxime group for 4 - 10 days were the main risk factors. CONCLUSIONS: This epidemic C. difficile NI outbreak which affected immunocompromised patients with high susceptibility to infection, common finding in oncology care was brought under control by active preventive measures associated with concomitant antimicrobial therapy effective in C. difficile infections.

Prognostic factors in resectable pancreatic cancer.

The pancreatic cancer is a disease with exponentially increased incidence, especially over the last decades, being the sixth or even fifth cause of death by cancer in most of the modern societies. Moreover, it is estimated that almost 95% of the patients with this disease are presenting to the doctor in the advanced and unresectable stages. Also, over the past few decades the development and advance of the surgical methods and techniques have improved only morbidity and hospital postoperative mortality, without significant impact on survival. In this way, in the present mini-review we want it to make a short description for some modern aspects regarding the factors implicated in pancreatic cancer survival.

Descriptive study on acute gastroenteritis in 3,883 patients admitted in "sf. Maria" children hospital from Iasi, Romania, between 2008 and 2013.

UNLABELLED: The aim of study was to assess some population characteristics in children of acute gastroenteritis (AGE) admitted in a regional pediatric hospital. MATERIAL AND METHODS: For the present transversal descriptive study we considered a group of subjects hospitalized for AGE in 2008-2013 (2013--only 6 months) in "Sf. Maria" Emergency Hospital for Children Iasi, Romania. Consultations in the Emergency Unit of this hospital did not take into consideration. RESULTS: Number of AGE cases admitted to "St. Maria" Emergency Hospital for Children Iasi between 2008 and 2013 has seen a steady decline. Male subjects are better represented (54.1%); largest age group 1-4 years, with 1,827 cases, immediately followed by group 0-1 year (1789 cases); together, the two-age groups account for 93.1% of admissions for AGE. Distribution of cases by seasons showed balanced values, with higher percentages in summer (29.7%) and spring (25.5%). The number of cases is relatively constant and lower in winter, affecting predominantly younger groups (0-5 years) compared to the summer when cases aged 5 to 14 years were admitted more frequent. Most cases presented at admission vomiting (41.2%) and fever (40.7%); the presence of bacterial flora was identified in 82.2% of stool specimens, and blood in 13.4% of cases. CONCLUSIONS: A higher number of education measures should be implemented in urban and rural areas in order todecrease the contamination with pathogenic agents involved in infectious acute gas- troenteritis in children.

Assessment of nutritional habits on a group of pupils from a countryside elementary school in Romania.

UNLABELLED: Food is a major contributor to healthy children and youth. The study of this factor must be complex, considering the dietary habits of the population. MATERIAL AND METHODS: 65 pupils from rural area were surveyed weekly about eating chicken, fish, fruits, bread and cereal by-products. A special attention was given to daily consumption of fruits (to those who recognize this contribution). RESULTS AND DISCUSSION: chicken appears in menus mostly 2-3 times a week (40.0%) or 4-7 times (27.7%). Fish is particularly present in menus one time (47.6%) or 2-3 times (26.2%). Fruits are provided in 75.4% cases 4-7 times a week. The dominant consumption of bread is of 4-7 times (90.8%) and of cereal by-products is of 2-3 times (58.5%) or even of 4-7 times (27.7%) a week. Self body weight is considered to be appropriate by 63.1% teenagers and in 23.1% cases they considered their body weight is too high. CONCLUSIONS: The implementation of national dietary programs can change the nutritional habits of children if they are based on a real assessment, achieved only with the help of surveys conducted by questionnaire method.

Age at initiation of sexual life, protection at first intercourse and sources of information regarding sexual and reproductive health.

OBJECTIVES: this study is intended to determine: age at initiation of sexual life, protection at first intercourse and sources of information regarding sexual and reproductive health. The trends identified by this study can form the basis of public health programmes. MATERIAL AND METHODS: between 2011 and 2012, 564 subjects, 18-35 years old, from urban and rural environment, have responded to a questionnaire with 96 items on family-related topics. In the present study we focused on three items. The Pearson chi-square tests were employed using the statistical programs SPSS. RESULTS AND DISCUSSION: most of the subjects had engaged in their first intercourse at 17-18 years old (48.58%). The number of individuals who had started their sexual life earlier than at 17 years of age was higher in males and in young subjects (p < 0.001). The protection at first intercourse was very low (38.4%) and the condom was the main method (34%). The protection was significantly higher in urban environment and in case of people with average and high educational level (p < 0.001). As for the information on the subject of sexual behavior, the smallest contribution came from doctors and sanitary staff (12.6%), from the school (15.2%), from parents, relatives (17%). Friends and acquaintances contributed to the largest extent--45.7%, and the contribution of Internet was 41%. CONCLUSIONS: Diminishing the pregnancy rate in teenagers and the unwanted pregnancy rate, as well as the rate of sexually transmitted infections, requires a multidisciplinary approach in the prevention programmes. The school and parents are crucial factors within the education programmes.

Overweight and gastrointestinal symptoms among adults of working age in Iasi City, Romania.

UNLABELLED: The objectives were to determine the presence of gastrointestinal symptoms and overweight in a sample of working age adults, from Iasi city (North-East Romania) and relationship with eating habits. MATERIAL AND METHODS: For this survey a sample was randomly chosen from family doctors records and 158 adults participated (65 males and 93 females, aged 19-64 years). Eating habits and food-frequency questionnaires were conducted, and Body Mass Index (BMI), waist and Body Fat Percent (FAT) were measured. For recent symptoms we used Gastrointestinal Symptom Rating Scale (GSRS). RESULTS: 43.1% of male and 47.3% of female were overweight and 21.5% of male and 21.6% of female were obese. The total body fat exceeded its normal limits in 70.8% of men and in 32.3% of women. Waist was high (abdominal obesity) in 49.5% of women and in 26.2% of men. Present gastrointestinal symptoms were: reflux (23.4%), abdominal pain (8.9%), indigestion (32.9%), diarrhea (6.3%) and constipation (8.9%). Overweight or obese subjects accused reflux, indigestion (p < 0.01) and constipation (p < 0.05) more frequently than those with normal weight. Odd ratio value and 95% confidence interval for obese versus normal weighted subjects was 8.23 (2.15-37.58) for reflux and 11.65 (3.34-45.5) for indigestion. CONCLUSIONS: Our findings up-date epidemiological data and suggest the need to promote healthy eating habits in order to reduce the tendency of obesity and to improve digestive function in population.