Patient-Perceived Quality Assessment in Orthopedics and Traumatology Departments during COVID-19 Pandemic.

The COVID-19 pandemic has led to significant disruptions in various healthcare systems. In Romania, the elective procedures in the orthopedic and traumatology specialty were one of the most affected. The study aims to investigate the influence of the COVID-19 pandemic on patient perceptions of quality in these departments. Standardized assessment tools were used, which consist of satisfaction questionnaires addressed to patients in order to assess the quality of health services in orthopedics and traumatology departments. Thus, a retrospective study was conducted using satisfaction questionnaires addressed to patients admitted to the orthopedics and traumatology departments of the County Clinical Emergency Hospital Bihor between January 2019 and December 2022. Eight reports, based on 746 questionnaires conducted during the studied period, were evaluated. To gauge patient satisfaction, Likert scales featuring five response options were used. A total of 627 questionnaires were valid, the exclusion criteria being incomplete questionnaires (the patients did not respond on all questions, n = 119). Four domains were analyzed: demographic data, hotel conditions, quality of medical care, and overall satisfaction. Demographic data highlight that patients exhibited an equitable distribution across residences, with 50.2% hailing from urban locales, while 53.5% (n = 333) were female. Regarding the overall impression, in 2020, there was a decline in the top rating of 5 compared to 2019, dropping to just 45.10% from 53.45%. Scores of 4 increased to 41.83%, while scores of 3 stayed under 8.5%. Scores of 2 and 1 were negligible. In 2021 and 2022, we can observe a sustained increase in the number of patients who awarded 5 points for overall impression and a decrease in the number of patients who awarded 4 points compared to previous years. The maximum difference between 2020 and 2021 and the period before and after this period was 27.24% (p-value < 0.001). The results indicate that while overall impressions of the hospital remained positive throughout the studied period, there were notable fluctuations in satisfaction levels during the pandemic. Patient satisfaction with attending physicians dipped in 2020 from 86.70% to 77.78% but recovered by 2022. The same trend can be observed with nurses and caregivers, as well as hotel services, during this period. These findings underscore the importance of addressing patient concerns and improving the quality of care delivery, particularly during times of crisis.

Preterm birth and stillbirth during COVID-19 pandemic in Bihor County/Romania.

Background: International studies have reported conflicting data about the effects of COVID-19 pandemic policy measures on maternal and neonatal health. A major impact was reported on stillbirth and prematurity. The published literature suggests that the economic setting influenced the effects of imposed mitigation measures with a more severe effect in low-income countries. Objectives: Our objective is to compare pregnancy outcomes at the only tertiary Maternity Hospital in Bihor County-Romania before and during the COVID-19 pandemic. This study aims to observe and document differences in perinatal outcomes across these periods, without inferring direct causation related to the pandemic or its associated restrictions. Materials and methods: We used data from the registries of Public Health Services Bihor to conduct a retrospective cohort analysis of preterm births and stillbirths during the COVID-19 pandemic in Bihor County, Romania. Pregnancy outcomes were compared between the pandemic period (March 2020-February 2022) to the corresponding historical pre-COVID-19 period (March 2018-February 2020). Maternal socio-demographic variables and neonatal characteristics of these periods were also examined. Results: The COVID-19 pandemic period was associated with an increase in the stillbirth rate (RR: 1.53, 95% CI, 1.05-2.23). Preterm birth was significantly impacted during this period and showed changes when analyzing gestational age (RR: 0.88, 95% CI, 0.79-0.96) or birth weight (RR: 0.91, 95% CI, 0.82-1.00). The main cause of stillbirth was intrauterine asphyxia due to placental causes (67.6%) or cord pathology (12.6%), the most frequently encountered maternal pathology was cardiovascular (28.3%) or infectious (21.7%). Our study revealed no significant changes in terms of maternal and neonatal characteristics during the two-year pandemic period. Conclusions: Lockdown restrictions in Bihor County, Romania were associated with an increase in stillbirths, whilst preterm birth rate decreased. This raises concerns about whether pandemic policy measures may have led to a failure in identifying and offering proper care for pregnant women who were more likely to experience an antepartum loss. Further studies across the globe are needed in order to integrate comparable data that will help develop adequate protocols and policies for protecting maternal and child health during the next pandemic that will follow.

The influence of the merger process between two tertiary hospitals in Romania on job satisfaction among staff.

Aim: The purpose of this study is to evaluate the influence of the merger process of two tertiary hospitals located in the northwest of Romania on the professional satisfaction among medical and non-medical staff and to develop a standardized satisfaction questionnaire for romanian hospitals. Methods: 1750 questionnaires distributed within County Clinical Emergency Hospital Bihor (CCEHBh) ten months and one year and four months after the merger process were analyzed. Results: The percentage of staff who declare themselves satisfied with their work one year and four months after the merger is 80.14%. It has a downward trend compared to the result measured 10 months after the merger (86.14%) (χ2 test, p < 0.01). The aspects that were rated with the lowest percentage as satisfactory were the possibility of promotion (41.89%) and job security (53.38%). A statistically significant decrease was also recorded in the assessment of career prospects (from 81.49% to 74.73%, χ2 test, p < 0.0001). Conclusions: Even if there was a decrease in job satisfaction between the two evaluated periods, we can state that the general level at the last measurement is a good one (4.07 out of a maximum of 5). There was no significant difference in job satisfaction 1 year and 4 months after the merger for staff in the merged unit (4.06) compared to staff in the absorbing unit (4.09). The questionnaire applied in 2023 is one that has proven validity and reliability, being a good starting point for creating a standardized questionnaire that could be implemented in the vast majority of hospitals in Romania. The application of the questionnaire at an interval of 3-6 months would highlight the result of the implemented measures and the trend of employee satisfaction within CCEHBh.

Knowledge, Attitudes, Intentions and Vaccine Hesitancy among Postpartum Mothers in a Region from the Northwest of Romania.

This study aims to identify the presence of vaccine hesitancy and the factors that could have determined it in a group of mothers in the postpartum period, with an evaluation of both the level of knowledge and information, as well as the attitudes, perceptions, intentions and sources of information about vaccination. The study was based on a survey-Vaccine Hesitancy Identification Survey-applied in two maternity wards from Bihor County and structured into six subscales (34 items). Based on the answers to the key questions ("Which of the following statements best describes your plans for vaccinating your child?"-item 1 of subscale 4; "Overall, how hesitant do you consider yourself to be about vaccinating your child?"-item 4 of subscale 4), we identified two groups: the group of mothers without hesitant behavior (non-hesitant), called the group pro vaccine (GPV), and the group of mothers with hesitant behavior, called the group non vaccine (GNV). Vaccine hesitancy was identified in our study in 47.28% of the participants (191 of the 404 mothers included). Most of them come from an urban environment (57.59%), have university and post-secondary education (58.64%) and are prim parous (58.64%). The behavior of participants from GNV is influenced by a low level of knowledge and information regarding vaccination and by concerns related to adverse reactions, new vaccines and the number of vaccines administered. Also, this group is characterized by an increased perception of the risks related to vaccination, while the perception of the risks associated with the disease is low. For all subscales, important differences were registered between the two groups in favor of GPV, a group characterized by positive attitudes and perceptions and a better level of knowledge compared to GNV. This study aims to represent a starting point for the organization and running of information campaigns regarding vaccination at the level of Bihor County, especially in areas with low vaccination coverage, where this behavior is identified.

Variety of Serotonin Levels in Pediatric Gastrointestinal Disorders.

(1) Serotonin primarily regulates our emotions. A complex process, which includes dysfunctions in gastrointestinal motility and deregulation of the gene responsible for serotonin reuptake (SERT), is implicated in the pathophysiology of irritable bowel syndrome (IBS). This also encompasses changes in intestinal microbiota, the response to stress, the intricate interplay between the brain and the digestive tract, heightened sensitivity to visceral stimuli, and low-grade inflammation. This paper aims to investigate the effectiveness of probiotic therapy in managing gastrointestinal and neuropsychiatric symptoms related to serotonin levels, with a focus on individuals with serotonin deficiency and those with normal serotonin levels experiencing gastrointestinal disorders. (2) The study involved 135 pediatric patients aged 5-18 years with gastrointestinal disturbances, including constipation, diarrhea, and other symptoms, such as nausea, flatulence, feeling full, or gastrointestinal pain. (3) Serotonin testing was performed, and administering probiotics appeared to be effective in addressing serotonin deficiency and other gastrointestinal disorders. (4) Serotonin's pivotal role in regulating neurotransmitter secretion and its impact on neuropsychiatric health, coupled with gender differences and age-related declines, underscore the complexity of their influence on gastrointestinal and neuropsychiatric conditions.

Comparative Analysis of Patient Satisfaction Surveys-A Crucial Role in Raising the Standard of Healthcare Services.

(1) Background: The study aimed to assess the patients' perception of the quality of the medical staff's care, the hotel's services, and the hospital's overall impression as well as to determine the best rating scale through a comparative analysis of patient satisfaction questionnaires. (2) Methods: A retrospective study was performed based on satisfaction questionnaires addressed to the patients hospitalized in the Orthopedics and Traumatology departments of the County Clinical Emergency Hospital Oradea between 2015 and 2019. Three different types of questionnaires were used during the study period, with the number of questions varying between 30 (variant A) and 37 (variant C). The evaluation was done using the Likert scales with three, four, or five answer variables. (3) Results: The items that we found to be present in all three categories of surveys and for which at least two different questionnaire variants used the Likert scales with various answer variables were chosen. In terms of the treatment given by the medical staff, hotel services, and the overall perception of the hospital, the patients perceive a higher level of quality. (4) Conclusions: The level of patient overall satisfaction or general impression about the hospital is strongly dependent on the quality of medical care provided by the doctors and the specific hotel conditions of the hospital. The quality assessment using the Likert rating scale with five binary variables is more accurate.

Organ Donation Awareness among Family Members of ICU Patients.

Background and Objectives: With one of the lowest donation rates in the European Union, Romania faces challenges in organ donation from brain death donors, within an opt-in system. This study aims to measure the attitudes and knowledge of ICU patient's relatives toward organ donation. Materials and Methods: A descriptive cross-sectional study was conducted in the intensive care unit of the Emergency Clinical County Hospital of Oradea, Romania. A 24-item self-administered questionnaire (N = 251) was used to collect data on knowledge about organ and tissue donation and transplantation, as well as the willingness to donate. Results: A high degree of awareness and willingness for organ donation and transplantation was recorded. The main positive predictor of willingness to donate was the perception of helping others by donating their organs after brain death (ß = 0.537, OR = 1.711, p < 0.05), and the main negative predictor was the idea that the whole body should be buried intact (ß = -0.979, OR = 0.376, p < 0.01). Conclusions: A basic understanding of organ donation and transplantation and favorable attitudes toward organ donation were registered. Families' interviews for organ donation consent may be affected due to extreme emotional distress.

Effect of Probiotic Therapy on Neuropsychiatric Manifestations in Children with Multiple Neurotransmitter Disorders: A Study.

Probiotics, also known as psychobiotics, have been linked to cognitive functions, memory, learning, and behavior, in addition to their positive effects on the digestive tract. The purpose of this study is to examine the psychoemotional effects and cognitive functioning in children with gastrointestinal disorders who undergo psychobiotherapy. A total of 135 participants, aged 5-18 years, were divided into three groups based on the pediatrician's diagnosis: Group I (Control) consisted of 37 patients (27.4%), Group II included 65 patients (48.1%) with psychoanxiety disorders, and Group III comprised 33 individuals (24.4%) with psychiatric disorders. The study monitored neurotransmitter levels such as serotonin, GABA, glutamate, cortisol, and DHEA, as well as neuropsychiatric symptoms including headaches, fatigue, mood swings, hyperactivity, aggressiveness, sleep disorders, and lack of concentration in patients who had gastrointestinal issues such as constipation, diarrhea, and other gastrointestinal problems. The results indicate that psychobiotics have a significant impact on reducing hyperactivity and aggression, and improving concentration. While further extensive studies are needed, these findings offer promising insights into the complexity of a child's neuropsychic behavior and the potential for balancing certain behaviors through psychobiotics.

Evaluation of the Knowledge and Attitude of Adolescents Regarding the HPV Infection, HPV Vaccination and Cervical Cancer in a Region from the Northwest of Romania.

Purpose: In Romania, after reaching the age of 18, teenage girls can make an informed decision about vaccination. The aim of the study was to evaluate both knowledge and attitudes related to HPV infection, HPV vaccination, cervical cancer, as well as intentions, reservations, reasons that could influence the decision related to vaccination. Patients and Methods: We applied an anonymized questionnaire to 690 teenage girls in the 18-19 age group, recruited from 15 high schools in Bihor County. Based on the answers to the question corresponding to item 14 of subscale 3, 2 groups were identified: the group with a hesitant behavior called the non-vaccine group (GNV) and the group with a positive behavior called the pro-vaccine group (GPV). The statistical analysis was processed by using IBM-SPSS 22. Results: The analysis revealed significant differences between the groups in terms of the level of knowledge and attitudes related to vaccination, the adolescent girls in the GPV being more aware of the role and importance of HPV vaccination and more open to the idea of vaccination. For the GNV, the behavior can be explained by the fact that even if they have heard about the HPV infection being transmitted through unprotected sex and they think that vaccination in general is necessary to prevent certain diseases, they do not know if HPV vaccination would be effective in protecting them in the future. Adolescents from GPV declare they would accept HPV vaccination if it would be offered to them or they are already vaccinated. Conclusion: Alongside interventions targeting parents and health-care professionals, it is necessary to improve the level of knowledge of adolescents about HPV infection, HPV vaccination and cervical cancer, by organizing information campaigns in schools, campaigns in which professionals in the field should be involved, but also by implementing education programs addressed to them.

The Epidemiology of Dental Pathologies in Elderly Patients Admitted to a Tertiary Level Hospital in Oradea, NW Romania: A 5-Year Retrospective Study.

Oral diseases can affect the quality of life of all individuals, including elderly people. In elderly people, the associated general diseases can increase the risk of dental pathologies or can impact their treatment. The main aim of this study was to identify elderly patients with dental pathology out of the total number of patients admitted to the Department of Oral and Maxillofacial Surgery at a tertiary-level hospital in North-Western Romania. Another aim was to describe the characteristics of the patients included in this study, as well as to analyze data from patients with dental pathologies. In this retrospective study, the medical records of patients admitted to the Department of Oral and Maxillofacial Surgery at the Bihor County Emergency Hospital between 2016 and 2020 were analyzed, with a focus on patients aged 65 years or more. After applying the exclusion criteria, 721 patients were kept in the study, of which 316 (43.8%) had at least one dental pathology. Most elderly patients with dental pathologies were admitted in 2018 (n = 89). The most common associated systemic diseases were arterial hypertension (n = 268) and ischemic heart disease (n = 233), while the most common dental pathologies were pulpitis (n = 185), chronic apical periodontitis (n = 61) and abscesses (n = 35). Most patients were either healed or had an improved condition at the time of discharge. The great number of dental pathologies, as well as the diversity in dental pathologies, underline the necessity for better preventive programs aimed not only at children, adolescents or young people but at the elderly population as well.

Maternal Serum Amyloid A as a Marker of Preterm Birth/PROM: A Systematic Review and Meta-Analysis.

Background and Objectives: Preterm birth, one of the leading causes of neonatal mortality, occurs in between 5 and 18% of births. Premature birth can be induced by a variety of triggers, including infection or inflammation. Serum amyloid A, a family of apolipoproteins, increases significantly and rapidly at the onset of inflammation. This study aims to systematically review the results of studies in the literature that have examined the correlation between SAA and PTB/PROM. Materials and Methods: To examine the correlation between serum amyloid A levels in women who gave birth prematurely, a systematic analysis was performed according to PRISMA guidelines. Studies were retrieved by searching the electronic databases PubMed and Google Scholar. The primary outcome measure was the standardized mean difference in serum amyloid A level comparing the preterm birth or premature rupture of membranes groups and the term birth group. Results: Based on the inclusion criteria, a total of 5 manuscripts adequately addressed the desired outcome and were thus included in the analysis. All included studies showed a statistically significant difference in serum SAA levels between the preterm birth or preterm rupture of membranes groups and the term birth group. The pooled effect, according to the random effects model, is SMD = 2.70. However, the effect is not significant (p = 0.097). In addition, the analysis reveals an increased heterogeneity with an I2 = 96%. Further, the analysis of the influence on heterogeneity found a study that has a significant influence on heterogeneity. However, even after outline exclusion, heterogeneity remained high I2 = 90.7%. Conclusions: There is an association between increased levels of SAA and preterm birth/PROM, but studies have shown great heterogeneity.

Pattern of Antibiotic Use among Hospitalized Patients at a Level One Multidisciplinary Care Hospital.

BACKGROUND: Antimicrobial resistance is one of the world's most serious health issues. Antibiotic resistance, excessive drug expense, and an increased risk of adverse reactions are all common outcomes of incorrect antibiotic prescribing. The goal of this study was to evaluate the prevalence of antibiotic prescriptions for inpatients to find areas for improvement. METHODS: A retrospective study at Emergency Clinical County Hospital of Oradea, Romania was performed for five years between 2017 and 2021. Data was collected using medical records of the patients and reports from the pharmacy. Antibiotic consumption was expressed as DDD/100 BD according to the World Health Organization (WHO) by antibiotics, classes, and AWaRe classification. RESULTS: The prevalence of antibiotic prescription was 53.8% during five years evaluated with a significant increase in 2021. A total of 13,677.42 DDD/100 BD antibiotics were prescribed, especially for surgical and medical prophylaxes. The most prescribed antibiotics were ceftriaxone, followed by metronidazole, and cefuroxime but there were some differences between years and wards. The most frequent antibiotic classes prescribed were cephalosporins (43.73%). The use of Watch Group antibiotics was high in all wards (59.69%). CONCLUSIONS: The prevalence of antibiotic use was high with cephalosporins being the most prescribed antibiotics. As a result, interventions are required.

The Motivation of Medical Staff and the Work Interestedness in the Context of the COVID-19 Pandemic, in a Tertiary Hospital in Romania.

The purpose of this study was to evaluate the impact of the COVID-19 pandemic on the motivation and work interestedness of employees in a tertiary hospital located in the northwest of Romania. In the study, 2230 employee satisfaction questionnaires distributed during 2019-2021 in the Oradea Emergency County Clinical Hospital (CCEHO) were analyzed. The percentage of those who declare themselves motivated at the hospital level remains relatively constant, at around 75%. There were differences between staff categories. The percentage of those who evaluate work interestedness with the qualifier "high" decreased from 45.45% for the year 2019 to 41.78% for the year 2021. The degree of motivation and work interestedness showed a significant increase for TESA staff during the pandemic period compared to the year 2019. A non-significant statistical increase in the percentage of motivated staff was observed among physicians, auxiliary staff and the radiology department staff. The motivation of nurses and laboratory staff decreased, but statistically insignificantly. The COVID-19 pandemic brought statistically significant changes at the level of motivation of the hospital staff only for the administrative staff, and the work interestedness for physicians and nurses decreased statistically significantly, especially in the second year of the pandemic. Older staff with an average level of education are more likely to be unmotivated, as shown by the regression model.

Study to Identify and Evaluate Predictor Factors for Primary Open-Angle Glaucoma in Tertiary Prophylactic Actions.

The aim of this study is to develop a predictive model with several explanatory variables that can guide ophthalmologists to make a more objective assessment of the evolution of open-angle glaucoma (OAG) during tertiary prevention. Objectives: The evaluation of risk factors and different predictors of symptom progression between patients with POAG and non-glaucoma patients (NG), as well as between primary open-angle glaucoma with high intraocular pressure (POAG) and primary open-angle glaucoma with normal intraocular pressure (NTG), in tertiary prophylactic activities. Methods: This research is an analytical epidemiological study of a prospective cohort. For the study, we took into account personal medical history, physical ophthalmological examination, intraocular pressure (IOP) values, and visual field (VF) parameters, examined with the Opto AP-300 Automated Perimeter using the "fast threshold" strategy. The results of gonioscopy were inconsistently recorded; they were not considered in the study due to missing values, the processing of which would have seriously distorted the statistical analysis. Ophthalmological examination was completed with a dichotomous questionnaire entitled "Symptom Inventory", made according to the accusations of patients resulting from a "focus group" study. The study was carried out in the ophthalmology office within the Integrated Outpatient Clinic of the Emergency Clinical Hospital of Oradea, Bihor County (IOCECHO) between January−December 2021. The threshold of statistical significance was defined for p value < 0.05. The obtained results were statistically processed with specialized software SPSS 22. Results: The study included 110 people, of which 71 (64.54%) had POAG (IOP > 21 mmHg) and 39 people (35.46%) had NTG (IOP < 21 mmHg), the two groups being statistically significantly different (χ2 = 9.309, df = 1, p = 0.002). For the POAG group, glaucomatous loss was early, AD < −6 dB, according to the staging of glaucomatous disease, HODAPP classification. In addition, the groups of POAG and NTG patients was compared with a group of 110 NG patients, these three groups being statistically significantly different (χ2 = 34.482, df = 2, p = 0.000). Analysis of confounding factors (age, sex, residence, marital status) shows a statistically significant relationship only for age (F = 2.381, df = 40, p = 0.000). Sex ratio for the study groups = 5.11 for OAG and =5.87 for NG. After treatment (prostaglandin analogues and neuroprotective drugs) IOP decreased statistically significantly for both POAG and NTG. Conclusions: this study identified possible predictors of OAG, at the 5% level (risk factors and symptoms as independent variables) using a dichotomous questionnaire tool with a complementary role in tertiary prophylactic activities. The implementation of the focus group interview results as a socio-human research technique will be supportive to clinicians.

The Impact of Changes regarding Working Circumstances during COVID-19 Pandemic upon Patients Evaluated for Thyroid Dysfunction.

We evaluated patients who presented with thyroid dysfunction correlated symptoms that started when the Government took important measures to reduce the spread of COVID-19. These measures have influenced the safety of many people's jobs. Data were collected from 378 patients that were clinically evaluated at the Endocrinology Department, between September 2020 and January 2021. Their health status modifications were statistically analyzed in correlation with their life and work changes. These changes were induced by measures associated with the COVID-19 pandemic. The lifestyle changes correlated with the COVID-19 pandemic have been present in both categories of patients: euthyroid and dysthyroid patients; 87.50% of euthyroid patients physically felt the pandemic-induced changes in their lives. It resulted in changes in lifestyle and job insecurity has a statistically significant influence (p < 0.01) on their state of health. The presence of life/work changes in men is strongly reflected in their state of health (p = 0.0004). Work instability that occurred as a side effect of the COVID-19 pandemic induced symptoms that made many people believe they have an endocrinology disorder.

Pattern of Antibiotic Use in the Perinatal Period in a Public University Hospital in Romania.

Background and Objectives: Antibiotics are the most frequently prescribed drugs in hospitals and their prescription is increased during pregnancy and labor. There are limited data about this issue, and the safe use of antibiotics in pregnancy and antibiotic resistance remains a concern. The aim of the study is to evaluate the use of antibiotics among pregnant women attending hospital for five years. Materials and Methods: Antibiotic consumption and treatment information of patients were retrospectively collected from a hospital software program and expressed as defined daily dose (DDD) according to the World Health Organization (WHO) methodology for inpatients between 2017 and 2021. We evaluated antibiotic prescription by name, classes, and Food and Drug Administration (FDA) categories. Results: Antibiotic consumption shows a decreasing trend between 2017 and 2019, but an increasing one between 2020 and 2021. Ceftriaxone was the most prescribed antibiotic in each year, followed by cefixime, amoxicillin, metronidazole, cefuroxime, ampicillin, and ciprofloxacin. We noticed that first- and fourth-generation cephalosporins were not prescribed to these patients. A very small percentage of women in this study received antibiotics such as aminoglycosides; fluoroquinolones were generally contraindicated in the perinatal period. A large percentage of prescriptions were antibiotics classified as category B by the FDA. The most common infections that occurred in the perinatal period were those of the kidney and urinary tract in a higher number than in other studies. Conclusions: Our study shows that many classes of antibiotics used in perinatal women belong to category B antibiotics, the most prescribed being cephalosporins. Because of insufficient safety evidence and the potential for teratogenic effects on the fetus, restricted use among the category C and D antibiotic classes was seen and anticipated. Improving maternal health requires the involvement of healthcare experts in risk assessment and evaluation of existing data for appropriate antibiotic selection, dose, duration of medication, and monitoring.

Detection of Intraocular Hypertension during Opportunity Screening (Check-Up Medical Inspections).

The aim of the study is the early detection of OHT (Ocular hypertension) in patients, in the activity of secondary prophylaxis (opportunity screening-medical check-up), to prevent blindness caused by POAG (Primary Open Angle Glaucoma). In Romania, medical examination of personnel with responsibilities in Transport Safety (TS) is legally regulated, being mandatory as a result of the internal transposition of European legislation in the field. The addressability of the patients for examination was determined by personal choice, depending on the accessibility of the medical service on the profile market (availability and price). The design of the study is epidemiological, observational, descriptive and retrospective. The standardized medical protocol included: personal medical history (anamnesis), physical ophthalmological examination, Intraocular pressure (IOP) measurement and Visual Field (VF) performance, with Automated Perimeter "Optopol PTS 910" through "Fast Threshold" strategy. The specialized medical research was completed with a dichotomous questionnaire entitled "Symptom Inventory", made according to the recommendations of patients resulting from "Focus group" research. The study was carried out within the "Check-up" type medical controls upon request, only for personnel with positions in Transport Safety (TS), during January−December 2021 at S.C. ARTIMED S.R.L. Oradea, Bihor County. Health analysis was performed for 820 people, of whom 71 people (8.65%) tested positive for IOP > 21 mmHg, (suspected OHT) compared to 749 (91.35%) with normal values (Normal intraocular pressure-NIOP); the two lots being statistically significantly different (x2 = 560.590, df = 1, p = 0.000). The study involved 754 men (92.0%) and 66 women (8.0%), the sex ratio is 11.42 (Exp (B) = 0.782, Sig = 0.558, 95% CI = 0.343−1783; sex is not a significant predictor at the 5% level). The prevalence of OHT was 8.66% for the whole group, 8.48% for men and 10.60% for women. In the screening action for the whole group of patients the following was determined: IOP reference = 20.85 mmHg, Sensitivity (Se) = 91.5% and 1-Specificity (Sp) = 0.073, (Sp = 92.7%). The predictive value of the screening test was: Positive Predictive Value (PPV) = 90.1% and Negative Predictive Value (NPV) = 91.7%; Area under the ROC Curve (Receiver Operating Characteristic) = 0.986, Sig. = 0.000, CI95% = 0.979−0.993. A binary logistical model of a questionnaire was developed to determine the screening parameters which significantly predicted OHT: IOP (OR = 4.154, 95% CI: 3.155−5.469), Age < 40 years (OR = 0.408, 95% CI: 0.239−0.698) and Pattern Defect (PD) (OR = 1.475% CI: 1.130−1.925). The results of this study assess health status through regular medical examinations, and highlight their importance and usefulness in secondary prevention activity. The particularity of this "check-up" type for personnel with attributions in transport safety is based on two essential aspects: the legal obligation to perform it and the fact it is financed by the beneficiary (the employer). In patients suspected of OHT after antiglaucoma treatment, IOP statistically significantly decreased.

Oral Health among Elderly, Impact on Life Quality, Access of Elderly Patients to Oral Health Services and Methods to Improve Oral Health: A Narrative Review.

Dental health is often neglected among the elderly because of the numerous comorbidities in this population, such as cardiovascular diseases. However, dental health influences general health and quality of life by impacting both the general health and the psychological state of the individual. The present review highlights the main dental comorbidities in the elderly population, their impact on the quality of life, the barriers towards access to dental care in the elderly and methods to improve their dental health. Information related to dental care and its importance must be provided both to older individuals and their caregivers in order to detect dental pathology and treat it adequately. Ensuring dental health involves the whole society of elders, caregivers, dental care providers, the public sector, health policymakers, and the private sector.

Aspects of Tertiary Prevention in Patients with Primary Open Angle Glaucoma.

The purpose of the study is to assess the health of patients in the activity of tertiary prevention dedicated to preventing blindness caused by POAG (primary glaucoma with open angle and high tension) and NTG (primary glaucoma with open-angle and statistically normal tension-particular form of glaucoma with open angle) and preservation of the remaining visual function. The design of the study is epidemiological, observational, descriptive and retrospective, and uses only the data recorded in the existing records in the archives of the Ophthalmology office within the Integrated Outpatient Clinic of the Emergency Clinical Hospital of Oradea (IOCECHO) during the years 1999-2019 (anamnestic data; objective examination and paraclinical examination: intraocular pressure-IOP and visual field-VF). The methods of the study included the standardized protocol: anamnesis, physical ophthalmological examination, IOP determination, and computerized perimetry with the "Fast Threshold" strategy performed with the "Opto AP-300" perimeter. The obtained results were statistically processed with a specialized software (S.P.S.S.-I.B.M. Statistics version 22). The study examined the available data of 522 patients of which 140 were men (26.8%) and 382 were women (73.2%). The gender ratio was 0.37. In the period 1999-2019, 150,844 people with ophthalmic pathology were consulted in the Ophthalmology office of IOCECHO out of which 522 patients (0.35%) were diagnosed with primitive open-angle glaucoma, 184 people (35.2%) presented high IOP (POAG), and 338 people (64.8%) had statistically normal IOP (NTG). The annual proportion of cases diagnosed with glaucoma in the total number of patients examined was between 0.1% (2005; 2008; 2010) and 2.4% in 2012, when 101 people were detected. In the studied records, no cases of uni- and/or bilateral blindness were mentioned. The mean age of glaucoma patients at the first consultation was 60.81 ± 12.14 years with high frequencies in the 55-69 age groups and at the last consultation it was 66.10 ± 12.47 years with high frequencies in the age groups between 60-74 years. Monitoring and treatment of glaucoma patients was beneficial; IOP decreased statistically significantly: in patients with POAG by 46.16%, from 30.50 ± 7.98 mmHg to 16.42 ± 3.01 mmHg (p = 0.000) and in those with NTG by 17.44%, at 16.39 ± 3.66 mmHg at 13.53 ± 1.92 mmHG (p = 0.000). The duration of treatment and monitoring was on average 5.1 ± 3.4 years, for 184 patients (35.2%) with POAG and 5.1 ± 3.8 years for 338 patients (64.8%) with NTG. Tertiary prevention of glaucoma, by providing specialized care, ensures effective control of IOP and implicitly of the long-term evolution of the disease. IOP is the only modifiable risk factor in patients with POAG and NTG and its decrease prevents the progression of the disease and emphasizes the importance of early diagnosis and treatment. The management of the glaucoma patient consisted of: complete ophthalmological examination (subjective and objective), paraclinical examination with IOP, and VF measurement (valuable ophthalmological diagnostic tool) for disease detection and effective assessment of disease progression in order to improve the process of therapeutic decision making.

Differences between Active and Semi-Active Students Regarding the Parameters of Body Composition Using Bioimpedance and Magnetic Bioresonance Technologies.

The aim of the study was to identify differences in obesity-related parameters between active sports students and semi-active or sedentary students, differentiated by sex, in order to optimize health. The study sample included 286 students, of which the male experimental sample consisted of 86 active sports students, age X ± SD 21.25 ± 0.32 years; height X ± SD 181.08 ± 3.52 cm; control group consisting of 89 semi-active students aged X ± SD 21.07 ± 0.1.13 years; height X ± SD 182.11 ± 1.32. The female experimental sample includes 57 active sports students, age X ± SD 21.02 ± 0.92 years; height X ± SD 167.48 ± 1.34 cm; the control group includes 54 semi-active students aged X ± SD 21.57 ± 0.1.98 years; height X ± SD 168.42 ± 1.76. The study used a thalliometer, Tanita Health Ware software and Quantum Resonance Magnetic Analyzer equipment to investigate height (cm), Body Mass Index (BMI), muscle mass (kg, %), as well as the obesity analysis report, and componential analysis of body and nourishment. The differences registered between the samples of active and semi-active sports subjects were predominantly statistically significant for p < 0.05. The differences registered between the samples of active and semi-active sports subjects were predominantly statistically significant for p < 0.05. The most important parameters regarding obesity and body composition that registered significant differences between the two male groups were in favor of the group of active athletes: triglyceride content of abnormal coefficient 0.844 (CI95% 0.590-1.099), abnormal lipid metabolism coefficient 0.798 (CI95% 1.091-0.504), obesity degree of body (ODB %) 10.290 (CI95% 6.610-13.970), BMI 2.326 (CI95% 1.527-3.126), body fat (kg) 2.042 (CI95% 0.918-3.166), muscle volume (kg) 2.565 (CI95% 1.100-4.031), Lean body weight (kg) 2.841 (CI95% 5.265-0.418). In the case of female samples, the group of active sportswomen registered the biggest differences compared to the group of students who were significantly active in the parameters: abnormal lipid metabolism coefficient 1.063 (CI95% 1.380-0.746), triglyceride content of abnormal coefficient 0.807 (CI95% 0.437-1.178), obesity degree of body (ODB%) 8.082 (CI95% 2.983-13.181), BMI 2.285 (CI95% 1.247-3.324), body fat (kg) 2.586 (CI95% 0.905-4.267), muscle volume (kg) 2.570 (CI95% 0.154-4.985), lean body weight (kg) 4.118 (CI95% 1.160-7.077). The results of the study directly facilitate the understanding of the complexity of the impact of obesity on multiple parameters of body composition and health.