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1.
Medicine (Baltimore) ; 98(41): e17574, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593144

RESUMO

RATIONALE: Approximately 5000 species of wild mushroom are reported worldwide, of which 100 are documented as poisonous and <10 are fatal. The clinical picture of patients with wild mushroom intoxication depends mostly on the type of ingested mushroom, ranging from mild gastrointestinal symptoms to organ failure and death. PATIENT CONCERNS: We report 2 children, sister and brother admitted in our clinic for gastrointestinal symptoms: abdominal pain, nausea, vomiting, and diarrhea after wild mushroom ingestion. DIAGNOSIS: The laboratory tests revealed hepatic cytolysis syndrome, hyperbilirubinemia, impaired coagulation status, hypoalbuminemia, hypoglycemia, and electrolytic unbalances in both cases. Abdominal ultrasound showed hepatomegaly and ascites. INTERVENTION: After admission, both cases received penicillin by vein, activated charcoal, liver protectors, glucose, and electrolytes perfusions. Nevertheless, their status worsened and required the transfer to the pediatric intensive care unit for appropriate supportive measure. Therefore, therapeutic plasma exchange was initiated along with N-acetyl cysteine and hemostatic drugs. OUTCOMES: Despite all these therapeutic interventions, both cases developed hepatorenal syndrome and died after a couple of days from ingestion. LESSONS: Mushroom poisoning remains a public health problem in developing countries. Preventable strategies and education regarding the consumption of wild type mushrooms are essential for decreasing the morbidity and mortality rates in these areas.


Assuntos
Síndrome Hepatorrenal/etiologia , Intoxicação Alimentar por Cogumelos/complicações , Intoxicação Alimentar por Cogumelos/diagnóstico , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Agaricales/classificação , Ascite/diagnóstico por imagem , Criança , Pré-Escolar , Diarreia/diagnóstico , Diarreia/etiologia , Ingestão de Alimentos , Evolução Fatal , Feminino , Hepatomegalia/diagnóstico por imagem , Humanos , Masculino , Intoxicação Alimentar por Cogumelos/patologia , Intoxicação Alimentar por Cogumelos/terapia , Troca Plasmática/métodos , Romênia/epidemiologia , Ultrassonografia , Vômito/diagnóstico , Vômito/etiologia
2.
Chirurgia (Bucur) ; 114(4): 487-493, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31511135

RESUMO

Introduction: Crohn disease (CD) has seen a steady increase in incidence over the years in Romania. Laparoscopy had a slow evolution as a feasible therapeutic option for patients with CD. Material and Method: The study is retrospective. The period on which the data was gathered spread over 8 years (01.01.2011-01.01.2019). Data was retrieved from three Clinical Hospitals in Bucharest, Romania Results: the preoperative diagnosis of an intestinal fistula (p = 0,02), sepsis (p = 0.01 ) or increased age should be regarded as a limitation for a laparoscopic approach in CD complications. Also in emergency settings an open approach should be the mainstay treatment (approach p = 0.000001). Conclusion: Laparoscopy is a feasible surgical option in the treatment of surgical complication in CD. In order to increase the safety of the intervention, correct selection of patients is important.


Assuntos
Doença de Crohn/epidemiologia , Doença de Crohn/cirurgia , Fatores Etários , Doença de Crohn/complicações , Humanos , Fístula Intestinal/epidemiologia , Fístula Intestinal/cirurgia , Laparoscopia/estatística & dados numéricos , Laparotomia/estatística & dados numéricos , Seleção de Pacientes , Estudos Retrospectivos , Romênia/epidemiologia , Sepse/epidemiologia , Sepse/etiologia , Sepse/cirurgia , Resultado do Tratamento
3.
Environ Monit Assess ; 191(9): 591, 2019 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-31446497

RESUMO

Our study assessed the exposure to formaldehyde of Romanian school children in relation to the classroom indoor environment characteristics and respiratory and allergic symptoms reported in a questionnaire survey, using the data collected in the SINPHONIE (Schools Indoor Pollution and Health: Observatory Network in Europe) project. Measurements of formaldehyde and microclimate parameters were conducted in three classrooms per school, in five schools, together with one outdoor measurement at each school. Questionnaires were used to collect information on classroom characteristics and health effects among children. The indoor formaldehyde levels for a school week varied between 15.5 and 66.2 µg/m3, with a median value of 34.8 µg/m3. The adjusted odds ratios for allergy-like, asthma-like, and flu-like symptoms were 3.23 (95% CI 1.31-8.00), 2.69 (95% CI 1.04-6.97), and 2.39 (95% CI 1.04-5.50), respectively, when exposed to higher formaldehyde levels (≥ 35 µg/m3) during a school week, compared to lower formaldehyde level exposure (< 35 µg/m3). Higher levels of indoor formaldehyde were significantly associated with health symptoms in children. The high indoor formaldehyde levels were related to the use of water-resistant paint for ceiling coverings, moisture damage signs, and lower classroom natural ventilation rates.


Assuntos
Poluição do Ar em Ambientes Fechados/análise , Asma/epidemiologia , Formaldeído/análise , Hipersensibilidade/epidemiologia , Exposição por Inalação/análise , Instituições Acadêmicas , Asma/induzido quimicamente , Criança , Feminino , Humanos , Masculino , Fatores de Risco , Romênia/epidemiologia , Inquéritos e Questionários
4.
Parasitol Res ; 118(9): 2695-2703, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31309289

RESUMO

The purpose of our study was to evaluate the prevalence of Toxoplasma gondii infection in autochthonous Carpathian buffaloes from northwestern Romania by serology, PCR techniques, and mouse bioassay. Agreement between MAT and ELISA, correlation between indirect and direct detection methods, and risk factors were evaluated. The apparent overall seroprevalence of T. gondii was 8.1% by MAT and 6.6% by ELISA. The agreement between ELISA and MAT was fair. The apparent seroprevalence was significantly higher in adult buffaloes (12.5%) compared to calves (0.0%) and juveniles (1.9%) by MAT. Most of the positive adult buffaloes detected by MAT had antibodies at a low sera dilution and the highest dilution was 1:768 in a juvenile female (30 months). No viable T. gondii was detected by mouse bioassay, as no T. gondii cyst or DNA was found in the brain of mice and they did not seroconvert. However, T. gondii DNA was detected in two buffaloes: in a 30-month-old male buffalo by qPCR on the diaphragm digest and in a 252-month-old female buffalo by RE nPCR on the mesenteric lymph node. Both animals were negative in MAT and ELISA. The total prevalence of T. gondii by direct detection methods was 2.7%. There was no correlation between indirect and direct detection methods. Since no viable T. gondii was detected in buffaloes, the risk of human infection from buffalo meat is minimal. Buffaloes' biological response to a T. gondii infection appears to be very similar to the response of cattle.


Assuntos
Búfalos/parasitologia , Doenças dos Bovinos/parasitologia , Toxoplasma/isolamento & purificação , Toxoplasmose Animal/parasitologia , Animais , Anticorpos Antiprotozoários/sangue , Bovinos , Doenças dos Bovinos/sangue , Doenças dos Bovinos/epidemiologia , Feminino , Masculino , Carne/análise , Carne/parasitologia , Camundongos , Prevalência , Saúde Pública , Romênia/epidemiologia , Estudos Soroepidemiológicos , Toxoplasma/classificação , Toxoplasma/genética , Toxoplasmose Animal/sangue , Toxoplasmose Animal/epidemiologia
5.
Parasit Vectors ; 12(1): 370, 2019 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-31349861

RESUMO

BACKGROUND: Thelazia callipaeda (Spirurida, Thelaziidae) is a vector-borne zoonotic eye worm with a broad host spectrum. In Europe, it is an emerging threat, having greatly expanded its geographical distribution during the past two decades. In Romania, T. callipaeda has been previously reported in domestic and wild canids and felids. The aim of the present study was to assess the occurrence of T. callipaeda in mustelids in the country. METHODS: Between March 2015 and April 2019, 77 road-killed mustelids (3 pine martens, Martes martes; 6 European polecats, Mustela putorius; 13 beech martens, Martes foina; and 55 European badgers, Meles meles) were examined by necropsy. If present, all ocular nematodes were collected and stored in absolute ethanol, for subsequent morphological and molecular identification. RESULTS: Two animals were found to be infected with T. callipaeda: one European badger and one beech marten. The molecular analysis revealed a 100% nucleotide similarity to T. callipaeda haplotype h1 for all the sequenced specimens. CONCLUSIONS: To our knowledge, the present study demonstrates for the first time the occurrence of T. callipaeda in mustelids from Romania, records the easternmost locality of the parasite in Europe, and represents the first report of T. callipaeda in the European badger, Meles meles, extending the known host range for this parasite in Europe.


Assuntos
Olho/parasitologia , Especificidade de Hospedeiro , Mustelidae/parasitologia , Infecções por Spirurida/veterinária , Thelazioidea/isolamento & purificação , Animais , Feminino , Haplótipos , Masculino , Romênia/epidemiologia , Análise de Sequência de DNA , Infecções por Spirurida/epidemiologia , Thelazioidea/genética , Thelazioidea/fisiologia
6.
Orv Hetil ; 160(25): 980-986, 2019 Jun.
Artigo em Húngaro | MEDLINE | ID: mdl-31203642

RESUMO

Introduction and aim: With the rising consumer's health awareness, especially towards patients with celiac disease, gluten has become a food ingredient to be avoided by many people expecting various positive health effects. The strict adherence of diet requires serious abandonments and lifestyle changes that affect directly their quality of life. The aim of the present study was to recognise the quality of life of Hungarian and Romanian consumers following a gluten-free diet as well as to explore the negative effects on them. Method: An online questionnaire survey was conducted upon 1155 Hungarian and Romanian respondents. Results: For gluten-free consumers, self-control was relatively easy to overcome, but their lifestyle was negatively affected by social events and dining out. In addition, diet adherence was a burden from both lifestyle and financial point of view. For Hungarian consumers, external factors such as price, choice, taste and availability of products had become a major obstacle, while Romanian ones were more likely to be affected by internal factors (product information, diet knowledge, lifestyle, self-control). Mandatory labelling of substances and products causing allergies and intolerances has achieved its purpose, as it has made it easier for consumers on diet to choose food and increased their confidence. Conclusions: The study points out that dieters' quality of life can be enhanced not only by general actions (improving the preparedness of out-of-home meal services and rationalising the price of products), but also through country-specific community intervention. Orv Hetil. 2019; 160(25): 980-986.


Assuntos
Doença Celíaca/dietoterapia , Dieta Livre de Glúten/psicologia , Qualidade de Vida , Adulto , Doença Celíaca/diagnóstico , Doença Celíaca/epidemiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Hungria/epidemiologia , Masculino , Romênia/epidemiologia , Inquéritos e Questionários
7.
J Zoo Wildl Med ; 50(1): 270-273, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31120690

RESUMO

The prevalence and intensity of infection with digestive, liver, and pulmonary parasites in wild boars in Romania was determined by examination of 280 cadavers from 26 hunting grounds during the period 2012-2016. Eleven genera of parasites were recovered: nine within the digestive system (Eimeria, Ascaris, Globocephalus, Gongylonema, Hyostrongylus, Oesophagostomum, Physocephalus, Trichuris, and Macracanthorinchus); and two (Dicrocoelium, Metastrongylus ) located in the hepatic and pulmonary systems. The overall prevalence of infection was 80.7% (n = 280). Polyparasitism was found in 82.8% of positive cases. The mean intensity of parasitism was highest for pulmonary parasites (Metastrongylus salmi, 25.95). Regarding gastrointestinal parasites, the highest mean intensity occurred in the case of Oesophagastomum dentatum infections (22.14), whilst the lowest was that of Macracanthorhynchus hirudinaceus (1.66). Wild boars are an important source of infection for domestic pigs in Romania and neighboring countries where extensive breeding systems occur.


Assuntos
Enteropatias Parasitárias/veterinária , Pneumopatias Parasitárias/veterinária , Doenças dos Suínos/epidemiologia , Animais , Animais Selvagens , Fezes/parasitologia , Feminino , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Pneumopatias Parasitárias/epidemiologia , Pneumopatias Parasitárias/parasitologia , Masculino , Prevalência , Romênia/epidemiologia , Sus scrofa , Suínos , Doenças dos Suínos/parasitologia
8.
Parasit Vectors ; 12(1): 224, 2019 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-31088513

RESUMO

BACKGROUND: Angiostrongylus vasorum is a metastrongyloid nematode localized in the right heart and the pulmonary arteries of domestic dogs. The number of reports in Europe has recently increased, presumably as a consequence of a growing awareness among clinicians, animal owners and researchers, but also due to a growing incidence and territorial spread. So far, no studies have been conducted to assess the prevalence and distribution of A. vasorum in domestic dogs in Romania, and the awareness among veterinarians is limited or absent. The aim of the present study was to evaluate the countrywide seroprevalence of circulating antigens of A. vasorum and specific antibodies against A. vasorum in domestic dogs from Romania. METHODS: Between November 2016 and July 2017, blood was sampled from a total of 1545 domestic dogs from 23 counties of Romania. Details about their gender, age, breed, housing, use and origin were collected. All serum samples were tested for the presence of A. vasorum circulating antigens (AG) using monoclonal and polyclonal antibodies in a sandwich ELISA. Additionally, a sandwich ELISA using A. vasorum adult somatic antigen purified by monoclonal antibodies was used for specific antibody (AB) detection. RESULTS: A total of 33 dogs (2.14%, 95% CI: 1.82-3.56%) were seropositive for A. vasorum antigen or antibodies against the parasite. Three dogs were positive for antigen only (0.19%, 95% CI: 0.07-0.57%) and 30 dogs (1.94%, 95% CI: 1.36-2.76%) were positive for antibodies only. No dog was positive for both tests. The overall prevalence (AB or AG) and the AB prevalence were significantly higher in pure breed dogs compared to mixed breeds and mongrel dogs (P < 0.05) and in shepherd dogs compared to other groups (P < 0.05). There was no significant difference between males and females, between urban and rural dogs, between dogs with unrestricted access and with restricted access to the environment, and between dogs living outdoors and indoors. CONCLUSIONS: Our data suggest that the disease is present in Romania in dogs, as it was previously demonstrated in foxes. However, so far, no clinical case has been reported in the country and this may be related to a low awareness among vets.


Assuntos
Angiostrongylus/isolamento & purificação , Anticorpos Anti-Helmínticos/sangue , Antígenos de Helmintos/sangue , Doenças do Cão/epidemiologia , Infecções por Strongylida/veterinária , Animais , Doenças do Cão/parasitologia , Cães , Ensaio de Imunoadsorção Enzimática , Feminino , Masculino , Animais de Estimação/parasitologia , Prevalência , Romênia/epidemiologia , Estudos Soroepidemiológicos , Infecções por Strongylida/epidemiologia
9.
Parasitol Res ; 118(5): 1667-1671, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30877438

RESUMO

Neospora caninum is a heteroxenous parasitic Apicomplexan protozoan, able to infect a variety of domestic and wild animals, mainly associated with reproductive disorders and abortions in susceptible species. Considering the importance of Romania in the European buffalo industry and the severe economic losses caused by N. caninum infection in livestock, the aim of the present study was to assess the occurrence of neosporosis in buffaloes raised in household and farming systems in northwestern Romania. Overall, 197 serum samples were tested for the presence of N. caninum-specific antibodies by ELISA. Additionally, from 74 slaughtered buffaloes, diaphragm digest, heart, and lymph node samples were tested for the presence of N. caninum DNA. The overall seroprevalence was 68.5%. The seroprevalence was significantly higher in adult animals compared to calves and young ones and in the household system compared to farm. By nPCR, six samples were found to be positive for N. caninum DNA, of which three were serologically negative. The present study reveals a high prevalence of N. caninum-specific antibodies in buffaloes in northwestern Romania and to our best knowledge, it is the first one performed in Romania.


Assuntos
Anticorpos Antiprotozoários/sangue , Búfalos/parasitologia , Coccidiose/epidemiologia , Coccidiose/veterinária , Neospora/isolamento & purificação , Animais , Coccidiose/parasitologia , Testes Diagnósticos de Rotina , Ensaio de Imunoadsorção Enzimática/veterinária , Feminino , Masculino , Neospora/imunologia , Gravidez , Prevalência , Romênia/epidemiologia , Estudos Soroepidemiológicos
10.
Parasitol Res ; 118(5): 1371-1384, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30911912

RESUMO

Sand flies were collected in a location from Romania in order to estimate their abundance and seasonal variation in correlation with environmental and anthropic factors. From May to October 2017, eight premises with different animal species were sampled for sand flies in a household from Fundatura village, Vaslui County, in North-Eastern Romania. Animal-related data, shelter-related data, and climatic parameters were recorded. All (n = 150) collected sand flies were Phlebotomus perfiliewi. A mono-modal type of abundance trend has been recorded (a single peak at the beginning of August). The first day of capture was in mid-July. The total number of females during the peak season was significantly higher than the total number of males. The highest percentage of males was recorded at the beginning and at the end of the sand fly activity. Only the traps placed in the poultry enclosure built from clay and wood were positive. A strong positive correlation was recorded between the total number of collected sand flies and the minimum and the maximum temperature. The analysis of the climatic data shows that the first presence of sand flies was registered only after the average minimum temperature for the previous 7 days was above 15 °C.


Assuntos
Animais Domésticos/parasitologia , Insetos Vetores/parasitologia , Leishmaniose Visceral/epidemiologia , Phlebotomus/parasitologia , Aves Domésticas/parasitologia , Estações do Ano , Animais , Clima , Meio Ambiente , Feminino , Leishmania infantum/crescimento & desenvolvimento , Leishmania infantum/isolamento & purificação , Masculino , Phlebotomus/crescimento & desenvolvimento , Dinâmica Populacional , Romênia/epidemiologia , Temperatura Ambiente
11.
J Pediatr Endocrinol Metab ; 32(1): 33-39, 2019 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-30864372

RESUMO

Background Previous genome-wide association studies (GWAS) identified IGF1, IRS1, GCKR, PPARG, GCK1 and KCTD1 as candidate genes for insulin resistance and type 2 diabetes (T2D). We investigated the associations of these previously reported common variants in these genes with insulin resistance in overweight children from Romania and Moldova. Methods Six single nucleotide polymorphisms (SNPs), IGF1 (rs35767), IRS1 (rs2943634), GCKR (rs780094), PPARG (rs1801282), GCK1 (rs1799884) and KCTD15 (rs29941), were genotyped in 100 overweight children along with clinical and metabolic parameters. Homeostatic model assessment of insulin resistance (HOMA-IR) above 3.4 (defining insulin resistance) was used as the outcome. Results Children differed in insulin resistance status despite having similar body mass index (BMI) standard deviation scores (SDS) (World Health Organization, [WHO] reference). The identified predictors for altered insulin metabolism were higher cholesterol levels, higher diastolic blood pressure and higher waist-to-hip-ratio (as a marker for increased abdominal fat). None of the SNPs showed significant association with increase in the risk for insulin resistance in children (p range=0.478-0.724; odds ratio [OR] range=1.924-4.842); however, the risk allele in GCKR (rs780094, p=0.06, OR=6.871) demonstrated near statistical significance. Conclusions The interrogated risk alleles did not show any significant association with insulin resistance in children in our cohort; however, the GCKR (rs780094) might be a viable candidate in larger cohorts. The lack of replication of the proposed association may point to differences in linkage disequilibrium or effect modifiers across studies.


Assuntos
Biomarcadores/análise , Resistência à Insulina/genética , Obesidade/genética , Obesidade Pediátrica/genética , Polimorfismo de Nucleotídeo Único , Proteínas Adaptadoras de Transdução de Sinal/genética , Adolescente , Índice de Massa Corporal , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Proteínas Substratos do Receptor de Insulina/genética , Fator de Crescimento Insulin-Like I/genética , Masculino , Moldávia/epidemiologia , Obesidade/epidemiologia , PPAR gama/genética , Obesidade Pediátrica/epidemiologia , Prognóstico , Proteínas Serina-Treonina Quinases/genética , Proteínas Repressoras/genética , Romênia/epidemiologia
12.
Medicine (Baltimore) ; 98(10): e14684, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30855458

RESUMO

Closure of the atrial septal defect (ASD) and patent ductus arteriosus (PDA) are among the most frequent cardiac interventional procedures. This was a prospective study, which started together with the implementation of a national program of pediatric interventional cardiology in Romania. We used Cocoon devices in 83 consecutive cases from 92 implantations for ASD and PDA. 27 cases were ASD closure and 56 cases PDA closure. Regarding the ASD closure, the median age was 8.5 years (range 3-25 years) and median weight 25 kg (range 11.5-63 kg). The mean follow-up was 17.4 ±â€Š6.7 months (range 3-26 months). The mean ASD diameter by transesophageal echocardiography was 15.2 ±â€Š4.1 mm (range 8-26 mm). The mean device diameter used was 17.3 ±â€Š5.6 mm (range 8-32 mm). Regarding the PDA closure, the median age was 36 months (range 4-192 months) and median weight 14 kg (range 5-58 kg). The mean follow-up was 15 ±â€Š8 months (range 3-28 months). The mean PDA minimum diameter was 2.5 ±â€Š0.8 mm. The success implantation rate for both groups was 97.6% (2 cases of withdrawn for ASD and PDA), while the complication rate was 2.3% (including 2 ASD device embolization). In the first 24 hours, the closure rates were 96.3% for ASD, 98.2% for PDA, and 100% at 1-month follow-up for both procedures. On short and intermediate follow-up (3-28 months), no device-related complications were noted.The Cocoon devices are safe for transcatheter closure of both ASD and PDA, and the initial experience with their use in our emerging center is encouraging.


Assuntos
Cateterismo Cardíaco , Permeabilidade do Canal Arterial , Comunicação Interatrial , Complicações Pós-Operatórias , Dispositivo para Oclusão Septal , Adolescente , Cateterismo Cardíaco/efeitos adversos , Cateterismo Cardíaco/métodos , Criança , Pré-Escolar , Permeabilidade do Canal Arterial/diagnóstico , Permeabilidade do Canal Arterial/epidemiologia , Permeabilidade do Canal Arterial/cirurgia , Ecocardiografia Transesofagiana/métodos , Feminino , Seguimentos , Comunicação Interatrial/diagnóstico por imagem , Comunicação Interatrial/epidemiologia , Comunicação Interatrial/cirurgia , Humanos , Masculino , Avaliação de Processos e Resultados (Cuidados de Saúde) , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Desenho de Prótese , Romênia/epidemiologia , Dispositivo para Oclusão Septal/efeitos adversos , Dispositivo para Oclusão Septal/estatística & dados numéricos , Adulto Jovem
13.
Diabetes Metab Syndr ; 13(1): 596-602, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30641772

RESUMO

The aims were to assess the prevalence and characteristics of dyslipidemia phenotypes in a Romanian population-based sample from the PREDATORR study. METHODS: PREDATORR was an epidemiological study with a cross-sectional, cluster random sampling design. Participants were classified into four dyslipidemia phenotypes based on the NCEP ATP III criteria: isolated hypertrigliceridemia, isolated hypoHDL-C, isolated hyperLDL-C and mixed dyslipidemia (≥2 standard lipid abnormalities). Overall, 2656 were included in the analysis by dyslipidemia phenotypes. RESULTS: An estimated 67.1% of Romanian adults have at least one lipid abnormality: 27.5% (95%CI26.0-28.9%) have elevated TG, 29.4% (95%CI27.9-30.8%) have low HDL-C and 47.8% (95%CI46.3-49.2%) have elevated LDL-C (26.2% had LDL-C levels ≥2.58 mmol/l associated with CHD or CHD risk equivalent). Also, 30% Romanian adults have mixed dyslipidemia with 7.6% (95%CI6.1-9.0%) having all three lipid abnormalities. THE AGE: and sex-adjusted prevalence of isolated dyslipidemia phenotypes in Romanian adult population was 23.7% (95%CI22.2-25.1%) for hyperLDL-Cholesterolemia, 9.3% (95%CI7.8-10.7%) for hypoHDL-Cholesterolemia and 4.1% (95%CI2.6-5.5%) for hypertriglyceridemia. Among participants with triglycerides ≥2.25 mmol/l, 15.2% (95%CI13.7-16.6%) of Romanian adults have non-HDL-C levels ≥3.36 mmol/l. CONCLUSIONS: The PREDATORR survey indicated a high prevalence of dyslipidemia phenotypes in the Romanian population aged 20-79 years, providing data on its association with several cardiometabolic risk factors.


Assuntos
Doenças Cardiovasculares/epidemiologia , Dislipidemias/epidemiologia , Rim/fisiologia , Doenças Metabólicas/epidemiologia , Vigilância da População , Adulto , Idoso , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Análise por Conglomerados , Estudos Transversais , Dislipidemias/sangue , Dislipidemias/diagnóstico , Feminino , Seguimentos , Humanos , Masculino , Doenças Metabólicas/sangue , Doenças Metabólicas/diagnóstico , Pessoa de Meia-Idade , Vigilância da População/métodos , Prevalência , Fatores de Risco , Romênia/epidemiologia
14.
Medicine (Baltimore) ; 98(2): e14081, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30633215

RESUMO

Developmental dysplasia of the hip (DDH) is one of the most common congenital abnormalities of the musculoskeletal apparatus in newborns. The aim of this study was to analyze the contribution of ultrasonography in the detection of DDH in newborns and infants, identifying the regional incidence of this pathology in the central area of Romania, emphasizing the risk factors that underlie DDH etiopathogenicity.This article represents a retrospective study of 847 newborns and infants examined in the Imagistic Department of a medical center from the central area of Romania, between January 1 and December 31, 2016. The ultrasound examinations were performed for the bilateral coxofemoral joints, using the method and technique described by Graf. For subjects born in the same medical center, data regarding mother's age, birth weights, and type of delivery (natural vs. caesarian section) were statistically analyzed.In our study group, the frequency of ultrasound diagnosis obtained from the examinations of right and left hips showed that the most frequent stage was type IA, and the rarest stage was III. The IA stage of right coxofemoral joints (87.3%) was higher than in the left coxofemoral joints (87.2%). The incidence of hip dysplasia (type III) diagnosed with ultrasound examinations in subjects from the central area of Romania was 0.2% (0.1% in both hips and 0.1% for the left coxofemoral joint).The musculoskeletal ultrasound examination is effective in early detection of hip dysplasia. The implementation of national and regional programs that promote indications, risk factors, and the screening age for DDH in both rural and urban areas could be a step forward in the early diagnosis of hip dysplasia for newborns and infants. The low incidence of DDH from our study group is not able to identify the role of advanced age of the mother, high birth weight of the newborn, or caesarean section as risk factors involved in the etiology of hip dysplasia. The implementation of national and regional programs that promote the musculoskeletal ultrasound as a screening imagistic investigation for DDH, in both rural and urban areas, could be a step forward in the early diagnosis of hip dysplasia for newborns and infants.


Assuntos
Luxação Congênita de Quadril/diagnóstico por imagem , Diagnóstico Precoce , Feminino , Luxação Congênita de Quadril/epidemiologia , Luxação Congênita de Quadril/etiologia , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Fatores de Risco , Romênia/epidemiologia , Ultrassonografia
15.
Microb Drug Resist ; 25(5): 639-643, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30614756

RESUMO

In the last few decades, methicillin-resistant Staphylococcus aureus (MRSA) strains have become a serious health care problem. However, in the European Union/European Economic Area countries the prevalence of the invasive MRSA isolates has decreased in recent years; in Romania, the considerably high prevalence of these strains is still unchanged. In this study, 396 staphylococcal strains were screened using molecular biology techniques for the presence of the nucA, mecA, and mecI genes and for the detection of the possible mutations accumulated in the mecI gene. More than half of the collected Staphylococcus strains (59.34%) were determined as S. aureus, and 63 strains were considered as MRSA. Small number of MRSA strains (n = 6; 54.54% of invasive S. aureus) originated from hemoculture. The mecI gene was present in 22 MRSA strains and in 4 methicillin-resistant coagulase-negative staphylococci strains. The majority of the mecI-positive MRSA strains contained the C to T substitution at position 202; furthermore, one previously undescribed mutation (C to G transversion at nucleotide position 285) was detected in one MRSA strain.


Assuntos
Proteínas de Bactérias/genética , Resistência a Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/genética , Mutação , Proteínas Repressoras/genética , Antibacterianos/uso terapêutico , Técnicas de Tipagem Bacteriana , Hemocultura , Proteínas de Ligação a DNA/genética , Desoxirribonucleases/genética , Expressão Gênica , Humanos , Meticilina/uso terapêutico , Staphylococcus aureus Resistente à Meticilina/classificação , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Proteínas de Ligação às Penicilinas/genética , Prevalência , Romênia/epidemiologia , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia
16.
Niger J Clin Pract ; 21(12): 1570-1575, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30560819

RESUMO

Introduction: Midfacial fractures are extremely important oral and maxillofacial problems because they take varied forms and are frequently accompanied by major long-term esthetic or functional complications. Their etiology and epidemiology vary significantly in the literature, and the main causes are varied by population. The aim of this study is to identify the main traumatic etiology of midfacial fractures, along with the main categories of affected patients in our geographical area, in order to establish the need for measures that can prevent fractures in the future. Materials and Methods: We conducted a retrospective study over a 10-year period in 379 patients. Data were extracted from the patients' charts, and the following variables were taken into consideration: sex, age, environment of origin, education level, and traumatic etiology. Results: Midfacial fractures most frequently affected the 20-29 years age group (31.93%), male sex (n = 333, 87.86%, M:F = 7.23:1), patients from urban areas (n = 206, 54.35%), and patients without education (46.70%). The most frequent etiology was interpersonal violence (44.85%), followed by fall trauma (16.62%) and road traffic accidents (15.30%). Statistical correlations evidenced that urban environment favors midfacial fractures caused by interpersonal violence and road traffic accidents or sports injuries, while in rural areas, domestic accidents and animal attacks are predominant (P = 0.000). Conclusions: The overwhelming incidence of interpersonal violence in our population is currently a major public health problem. Implementing laws and initiating national programs for the prevention of interpersonal violence would lead to a considerable reduction of midfacial fractures in the Western Romanian population.


Assuntos
Ossos Faciais/lesões , Traumatismos Faciais/etiologia , Fraturas Ósseas/etiologia , Fraturas Maxilares/etiologia , Fraturas Orbitárias/etiologia , Violência/estatística & dados numéricos , Acidentes por Quedas/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/etiologia , Criança , Traumatismos Oculares/epidemiologia , Traumatismos Oculares/etiologia , Traumatismos Faciais/epidemiologia , Feminino , Fraturas Ósseas/epidemiologia , Humanos , Incidência , Masculino , Fraturas Maxilares/epidemiologia , Pessoa de Meia-Idade , Fraturas Orbitárias/epidemiologia , Estudos Retrospectivos , Romênia/epidemiologia , Distribuição por Sexo
17.
Chirurgia (Bucur) ; 113(3): 374-384, 2018 May-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29981668

RESUMO

Introduction: National databases for pancreaticoduodenectomies (PD) have contributed to better postoperative outcomes after such complex surgical procedure because the multicentre collection of data allowed more reliable analyses with quality assessment and further improvement of technical issues and perioperative management. The current practice and outcomes after PD are poorly known in Romania because there was no national database for these patients. Thus, in 2016 a national-intent electronic registry for PD was proposed for all Romanian surgical centers. The study aims to present the preliminary results of this national-intent registry for PD after one-year enrollment. Patients Methods: The database was started on October 1st, 2016. Data were prospectively collected with an electronic online form including 102 items for each patient. The registry was opened to all the Departments of Surgery from Romania performing PD, with no restriction. Results: During the first year of enrollment were collected the data of 181 patients with PD performed by 24 surgeons from four surgical centers. The age of patients was 64 years (28 - 81 years), with slightly male predominance (61.3%). Computed tomography was the main preoperative imaging investigation (84.5%). All the PDs were performed by an open approach. The Whipple technique was used in 53% of patients, and a venous resection was required in 14.3% of cases. A posterior approach PD was considered in 16.6% of patients. The stomach was used to treat the distal remnant pancreas in 50.1% of patients. The operative time was 285 min (110 - 615 min), and the estimated blood loss was 400 ml (80 - 3000 ml). The overall morbidity rate was 55.8%, with severe (i.e., grade III-IV Dindo-Clavien) morbidity rate of 10%, and 3.9% in-hospital mortality rate. The overall pancreatic fistula, delayed gastric emptying and hemorrhage rates were 19.9%, 39.8% and 15.5%. Periampullary malignancies were the main indications for PD (78.9%), with pancreatic cancer on the top (48%). Conclusions: To build a prospective electronic online database for PD in Romania appears to be a feasible project and a useful tool to know the current practice and outcomes after PD in our country. However, improvements are still required to encourage a larger number of surgical centers to introduce the data of patients with PD.


Assuntos
Registros Eletrônicos de Saúde , Neoplasias Pancreáticas/cirurgia , Pancreaticoduodenectomia , Adulto , Idoso , Idoso de 80 Anos ou mais , Registros Eletrônicos de Saúde/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/epidemiologia , Pancreaticoduodenectomia/estatística & dados numéricos , Hemorragia Pós-Operatória , Estudos Prospectivos , Fatores de Risco , Romênia/epidemiologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
18.
Chirurgia (Bucur) ; 113(3): 399-404, 2018 May-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29981671

RESUMO

Background: POSSUM and P-POSSUM are risk scores recommended by ERAS Society for the preoperative evaluation of patients undergoing major surgery. Methods: This study includes 113 consecutive pancreaticoduodenectomy performed in a single centre between July 2013-December 2015. Patients data were prospectively collected using Excel 2009 and retrospectively analysed with R v3.2.4 software. Biological status score, surgical severity score and risk scores for complications and death were calculated using: http://www.riskprediction. org.uk/index-pp.php. Results: Morbidity rate was 61,95%: 19,47% general complications, 14,16% wound infections and 28,32% PD specific complications (11,5% POPF; 8,85% DGE and 6,19% PPH). Comparing the observed and estimated morbidity and mortality, we obtained statistical significant results (p=0,05 and p=0,03, respectivelly). When we considered only specific PD complications and subsequent mortality, there was no longer significant difference between observed and estimated values (p=0,8 and p=0,86).The under ROC curve aria was 0,61 for morbidity and 0,64 for specific PD morbidity, respectively 0,61 for mortality and 0,68 for specific PD complications related mortality. CONCLUSION: P-POSSUM represents a useful tool for appreciating the complication and death risk after PD, but better results could be obtain by considering also specific PD risk factors.


Assuntos
Neoplasias do Ducto Colédoco/mortalidade , Fístula Pancreática/etiologia , Fístula Pancreática/mortalidade , Pancreaticoduodenectomia/efeitos adversos , Pancreaticoduodenectomia/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Ducto Colédoco/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fístula Pancreática/diagnóstico , Fístula Pancreática/cirurgia , Valor Preditivo dos Testes , Estudos Prospectivos , Curva ROC , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Romênia/epidemiologia , Resultado do Tratamento
19.
Chirurgia (Bucur) ; 113(3): 405-411, 2018 May-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29981672

RESUMO

Background: Pancreatic cancer (PC) is usually diagnosed in the 7th decade, but cases diagnosed in younger patients are associated with a greater disease burden, through the potential years of life lost. The aim of our study was to compare the differences in risk factors, clinical presentation and treatment options between patients diagnosed with pancreatic adenocarcinoma below 45 years of age (very early onset pancreatic adenocarcinoma - VEOPC), and those diagnosed over 45 years. Methods: A retrospective study has been conducted by registering in standardized Excel Worksheets all PC cases diagnosed in our tertiary referral center between 01.01.2015 and 31.12.2017. Only patients with a documented diagnosis of pancreatic adenocarcinoma (PDAC) were included in the statistical analysis that has been conducted using the NCSS v9 Statistical Software package. Categorical data have been compared using Chi2 test or Fisher Exact as appropriate, with a statistical significance p value 0.05. Results: There were 296 patients diagnosed with pancreatic solid tumors during the study period, 183 cases with documented histology: 80.87% PDAC, 17.5% neuroendocrine tumors, 2 cases of LMNH and 1 MANEC tumor. In our study group there were 24 patients (16.22%) with VEOPC. Family history of pancreatic neoplasia (33.3% vs 1.03%, p=0.0004) and alcohol consumption (42.86% vs 5.41%, p=0.01) were significantly more prevalent in young patients. Pain, as primary symptom, was reported at higher rates in patients with VEOPC (60% vs 22.94%, p=0.006). Tumors were more frequently located in the head of the pancreas in younger patients (56.52%) and in the body of the pancreas in older patients (52.07%, p=0.02). There was no significant difference in therapy or death rate during follow-up period between the two study groups, although patients diagnosed under 45 years were more frequently subjected to a radical resection (33.3% vs 22.69%). Conclusions: Our study has identified alcohol consumption and family history of pancreatic neoplasia as risk factors for VEOPC. Pain is the primary symptom at diagnosis in young patients with PDAC. In our cohort, therapeutic options do not differ significantly in PDAC patients with age of onset.


Assuntos
Adenocarcinoma/diagnóstico , Adenocarcinoma/tratamento farmacológico , Idade de Início , Antineoplásicos/uso terapêutico , Cuidados Paliativos , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/tratamento farmacológico , Adenocarcinoma/etiologia , Adenocarcinoma/mortalidade , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/efeitos adversos , Quimioterapia Adjuvante/métodos , Feminino , Seguimentos , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos/métodos , Neoplasias Pancreáticas/etiologia , Neoplasias Pancreáticas/mortalidade , Prevalência , Estudos Retrospectivos , Fatores de Risco , Romênia/epidemiologia , Distribuição por Sexo , Fumar/efeitos adversos , Taxa de Sobrevida , Resultado do Tratamento
20.
Chirurgia (Bucur) ; 113(3): 344-352, 2018 May-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29981665

RESUMO

Pancreatic cancer (i.e., pancreatic ductal adenocarcinoma, PDAC) is an important healthcare issue and a highly lethal disease. Thus, almost 80% of patients with PDAC will die within one year after diagnosis. Several factors including smoking, obesity, advanced age, diabetes mellitus and chronic pancreatitis have been associated with increased risk of PDAC. Hepatitis B virus (HBV) infection is also considered as a risk factor for PDAC development in some studies. However, the role of HBV infection in PDAC is poorly explored. The present paper reviews the current relevant literature exploring the impact of HBV infection in PDAC. Assessment of HBV infection impact in PDAC is challenging because its effects could be easily underestimated. Indeed, the role played by occult B infection (OBI) and intrinsic difficulties to detect HBV antigens or DNA in pancreatic tissue remains major limitations to further progress. To date a significant proportion of available literature suggests the potential oncogenic role of HBV in PDAC but experimental evidences remain scarce. Remarkably, it appears that HBV infection might influence some clinical and pathological features of patients with PDAC. Future researches to better define the role of HBV infection in developing PDAC are urgently needed.


Assuntos
Carcinoma/cirurgia , Carcinoma/virologia , Vírus da Hepatite B/patogenicidade , Hepatite B/complicações , Pancreatectomia , Neoplasias Pancreáticas/cirurgia , Neoplasias Pancreáticas/virologia , Carcinoma/mortalidade , Carcinoma/patologia , Progressão da Doença , Humanos , Pancreatectomia/mortalidade , Neoplasias Pancreáticas/mortalidade , Neoplasias Pancreáticas/patologia , Fatores de Risco , Romênia/epidemiologia , Resultado do Tratamento
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