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1.
Medicina (Kaunas) ; 57(2)2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33572732

RESUMO

Background and Objectives: During the coronavirus disease 2019 (COVID-19) pandemic, patients with chronic diseases suffering exacerbations have required acute medical care. The purpose of our study was to determine useful criteria for the differentiation of patients with acute clinical syndromes and suspicion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Materials and Methods: This was an observational retrospective study, conducted in an internal medicine clinic from April to May 2020. We collected clinical, biological, and computed tomography (CT) data on patients with exacerbations of chronic diseases and clinical suspicion of SARS-CoV-2 infection. Patients with an already-positive real-time reverse-transcription polymerase chain reaction (RT-PCR) test for SARS-CoV-2 on presentation at the emergency department were excluded from our study. Results: Of 253 suspected cases, 20 were laboratory-confirmed as having SARS-CoV-2 infection by RT-PCR, whereas COVID-19 diagnosis was ruled out in the remaining 233. Venous thromboembolism (VTE) correlated significantly with COVID-19 diagnosis in suspected patients, while laboratory markers were not significantly different between the two groups. Of the suspected patients, significantly higher percentages of dry cough, fever, myalgias, sore throat, loss of smell and appetite, and ground-glass opacities (GGOs) on CT were found in SARS-CoV-2-positive individuals. Conclusions: The study demonstrated that, until receiving the result of an RT-PCR test for SARS-CoV-2 (usually 12-24 h), association with VTE as a comorbidity, fever, dry cough, and myalgia as clinical features, and GGO on CT are the main markers for the identification of COVID-19 patients among those suspected with acute clinical syndromes. Our results also provide evidence for doctors not to rely solely on biological markers in the case of suspected SARS-CoV-2 infection in patients with exacerbations of chronic diseases. These data are useful for faster decision-making with regard to suspected COVID-19 patients before receiving RT-PCR test results, thus avoiding keeping patients in crowded emergency departments.


Assuntos
/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , /métodos , Tosse/fisiopatologia , Diagnóstico Diferencial , Feminino , Febre/fisiopatologia , Humanos , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pandemias , Faringite/fisiopatologia , Estudos Retrospectivos , Romênia/epidemiologia , Síndrome , Tomografia Computadorizada por Raios X , Adulto Jovem
2.
Artigo em Inglês | MEDLINE | ID: mdl-33546326

RESUMO

The first months of 2020 were marked by the rapid spread of the acute respiratory disease, which swiftly reached the proportions of a pandemic. The city and county of Suceava, Romania, faced an unprecedented crisis in March and April 2020, triggered not only by the highest number of infections nationwide but also by the highest number of infected health professionals (47.1% of the infected medical staff nationwide, in April 2020). Why did Suceava reach the peak number of COVID-19 cases in Romania? What were the vulnerability factors that led to the outbreak, the closure of the city of Suceava and neighboring localities, and the impossibility of managing the crisis with local resources? What is the relationship between the population's lack of confidence in the authorities' ability to solve the crisis, and their attitude towards the imposed measures? The present article aims to provide answers to the above questions by examining the attitudes of the public towards the causes that have led to the outbreak of an epidemiological crisis, systemic health problems, and the capacity of decision makers to intervene both at local and national level. The research is based on an online survey, conducted between April and May 2020, resulting in a sample of 1231 people from Suceava County. The results highlight that the development of the largest COVID-19 outbreak in Romania is, without a doubt, the result of a combination of factors, related to the medical field, decision makers, and the particularities of the population's behavior.


Assuntos
/psicologia , Surtos de Doenças , Opinião Pública , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Romênia/epidemiologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-33525330

RESUMO

The COVID-19 pandemic stressed the importance of understanding the sources of vulnerabilities that can lead to a financial crisis and highlighted the predominant impact on health systems. Firstly, the paper aims to conduct a retrospective analysis of the Romanian health care system, over the period of time 1985-2019, based on our own computed sustainability index for public health. Secondly, using the Gregory-Hansen cointegration method, we provide new evidence on the causal relationship between health expenditure and GDP for Romania over the period of time 1985-2017. Based on the retrospective analysis of the long-run co-movement between health spending and GDP, the study allows one to prospectively examine not only the effects of the COVID-19 pandemic on health care spending, but also to reveal the government's fiscal position and vulnerabilities. Our results highlight the intergenerational costs related to the policy incoherence roadmap and regulatory fragmentation, stressing the importance of economic system resilience through fiscal diligence and the consolidation of the institutional context.


Assuntos
/economia , Gastos em Saúde , Pandemias/economia , Saúde Pública/economia , Humanos , Estudos Retrospectivos , Romênia/epidemiologia
4.
Medicine (Baltimore) ; 100(1): e24062, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33429770

RESUMO

ABSTRACT: Colorectal cancer is a heterogeneous disease with multiple epigenetic alterations and different molecular features. The molecular classification is based on 2 major distinct pathways: microsatellite stable pathway and the microsatellite instability pathway. Molecular profiling of colorectal cancer provides important information regarding treatment and prognosis. Aim of the study was to assess the frequency of microsatellite instability in colon cancer and the clinicopathological characteristics of the tumors with high level of microsatellite instability (MSI-H) in our region. The secondary outcome was to assess the frequency of v-raf murine sarcoma viral oncogene homolog B1 (BRAF) mutations in colon cancer.The study included 129 patients with colon cancer fit for surgery. Demographic data, clinical and pathological data, immunohistochemistry staining pattern (4 mismatch repair proteins were investigated), and BRAF gene mutations were assessed. According to microsatellite instability status by polymerase chain reaction, patients were divided into 3 groups: microsatellite stable (MSS) = 108 patients, high level of microsatellite instability (MSI-H) = 15 patients and low level of microsatellite instability (MSI-L) = 6 patients. Different clinicopathological comparisons between MSS and MSI-H patients, and between MSS and MSI-L patients were performed.Microsatellite instability was found in 16.3% patients: 11.6% had MSI-H and 4.7% had MSI-L. Significantly more patients in the MSI-H group than in the MSS group were female (P = .01) and had a family history of colon cancer (P < .001). MSI-H and MSI-L groups were associated with the ascending colon location of the tumors, were mostly type G3, T2, and stage I whereas MSS tumors were mostly G2, pT3, and stage III. Overall, BRAF mutations were identified in 18/129 patients (13.9%). BRAF mutant tumors were predominantly associated with MSI-H and MSI-L tumors. Immunohistochemistry had a sensitivity of 76% and a specificity of 89% in detecting MSI tumors and an accuracy of 87.6%.The frequency of microsatellite instability in our study was 16.3%. MSI-H is a distinct molecular phenotype of colon cancer with particular features: female gender, family history of colorectal cancer, a predilection for the ascending colon, poorly differentiated, predominantly T2, and stage I. The frequency of BRAF mutations was 13.9% and mutations were more often present in the MSI tumors.


Assuntos
Neoplasias do Colo/genética , Técnicas de Diagnóstico Molecular/métodos , Idoso , Neoplasias do Colo/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Técnicas de Diagnóstico Molecular/estatística & dados numéricos , Mutação/genética , Proteínas Proto-Oncogênicas B-raf/análise , Proteínas Proto-Oncogênicas B-raf/genética , Romênia/epidemiologia , Estatísticas não Paramétricas
5.
Ren Fail ; 43(1): 49-57, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33307933

RESUMO

BACKGROUND: There is limited information about the clinical characteristics, treatment and outcome of maintenance hemodialysis patients with COVID-19. Moreover, regional differences are also conceivable since the extend and severity of outbreaks varied among countries. METHODS: In this retrospective, observational, single-center study, we analyzed the clinical course and outcomes of 37 maintenance hemodialysis patients (median age 64 years, 51% men) hospitalized with COVID-19 from 24 March to 22 May 2020 as confirmed by real-time PCR. RESULTS: The most common symptoms at admission were fatigue (51%), fever (43%), dyspnea (38%) and cough (35%). There were 59% mild/moderate patients and 41% severe/critical patients. Patients in the severe/critical group had a significantly higher atherosclerotic burden since diabetic kidney disease and vascular nephropathies were the most common primary kidney diseases and eighty percent of them had coronary heart disease. Also, Charlson comorbidity score was higher in this group. At admission chest X-ray, 46% had ground-glass abnormalities. Overall, 60% patients received hydroxychloroquine, 22% lopinavir-ritonavir, 11% tocilizumab, 24% systemic glucocorticoids, and 54% received prophylactic anticoagulation. Seven (19%) patients died during hospitalization and 30 were discharged. The main causes of death were cardiovascular (5 patients) and respiratory distress syndrome (2 patients). In Cox regression analysis, lower oxygen saturation, anemia and hypoalbuminemia at admission were associated with increased mortality. CONCLUSIONS: In conclusion, we observed a high mortality rate among maintenance hemodialysis patients hospitalized for COVID-19. Anemia, lower serum albumin and lower basal oxygen saturation at admission were factors associated with poor prognosis.


Assuntos
/mortalidade , Falência Renal Crônica/terapia , Diálise Renal , Idoso , /terapia , Causas de Morte , Comorbidade , Feminino , Mortalidade Hospitalar , Humanos , Falência Renal Crônica/sangue , Falência Renal Crônica/etiologia , Falência Renal Crônica/mortalidade , Masculino , Pessoa de Meia-Idade , Oxigênio/sangue , Admissão do Paciente , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Romênia/epidemiologia , Albumina Sérica Humana/análise , Índice de Gravidade de Doença
6.
Chirurgia (Bucur) ; 115(6): 747-755, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33378633

RESUMO

Introduction: Lymph node metastasis is regarded as an important prognostic factor for predicting disease recurrence and survival in patients with colorectal cancer. Several studies suggest that the lymph node ratio has a greater importance in survival than the number of metastatic lymph nodes. The scope of this study is to examine the 5-year survival of rectal cancer patients, examining several prognostic factors with emphasis on lymph node status. Material and Methods: A retrospective study was conducted at single surgical clinic from Romania, using data from patients who have been treated for rectal cancer between January 2009 and December 2014. Patient present status and regarding the multimodal treatment was assessed through telephonic method, data was extracted from the electronic database of the clinic and histopathological reports. Results: A total number of 144 patients affected by rectal cancer were assessed. Statistical analysis of the variables showed that age (p=0.001), T stage(p=0.049), N stage (p=0.005), LNR (p=0.006), type of surgery (p 0.001), presence of vascular invasion (p 0.001), metastases (p 0.001), to be significant prognostic factors for survival. Conclusions: The 5-year survival of the patients we included in the study was 63,9%. Nodal status, expressed by lymph node ratio proved to be a significant prognostic factor of patient survival.


Assuntos
Recidiva Local de Neoplasia , Neoplasias Retais , Bases de Dados Factuais , Humanos , Excisão de Linfonodo , Linfonodos/patologia , Linfonodos/cirurgia , Estadiamento de Neoplasias , Prognóstico , Neoplasias Retais/mortalidade , Neoplasias Retais/patologia , Neoplasias Retais/cirurgia , Estudos Retrospectivos , Romênia/epidemiologia , Resultado do Tratamento
7.
Medicina (Kaunas) ; 56(12)2020 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-33317190

RESUMO

Background and Objectives: The population has been overwhelmed with false information related to the Coronavirus disease (COVID-19) crisis, spreading rapidly through social media and other channels. We aimed to investigate if frontline healthcare workers affected by infodemia show different psychological consequences than frontline clinicians who do not declare to be affected by false news related to the COVID-19 pandemic. Materials and Methods: One hundred twenty-six frontline healthcare workers from the Intensive Care Unit (ICU) and Emergency Departments in Romania completed a survey to assess stress, depression, anxiety, and sleep disorders, between March and April 2020. We split the sample of frontline healthcare workers into two groups based on the self-evaluated criteria: if they were or were not affected by infodemia in their activity. Results: Considering limitations such as the cross-sectional design, the lack of causality relationship, and the sample size, the results show that, the frontline medical workers who declared to be affected by false news were significantly more stressed, felt more anxiety, and suffered more from insomnia than healthcare workers who are not affected by false information related to pandemic time. Conclusions: The infodemia has significant psychological consequences such as stress, anxiety, and insomnia on already overwhelmed doctors and nurses in the outbreak of the COVID-19 crisis. These findings suggest that medical misinformation's psychological implications must be considered when different interventions regarding frontline healthcare workers during the COVID-19 pandemic are implemented.


Assuntos
Meios de Comunicação , Informação de Saúde ao Consumidor , Pessoal de Saúde/psicologia , Doenças Profissionais/epidemiologia , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , Comunicação , Estudos Transversais , Decepção , Depressão/epidemiologia , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/psicologia , Relações Profissional-Paciente , Romênia/epidemiologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/psicologia
8.
J Gastrointestin Liver Dis ; 29(4): 549-553, 2020 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-33331349

RESUMO

BACKGROUND AND AIMS: Inflammatory bowel diseases (IBD) patients management has been challenging during the ongoing coronavirus disease 2019 (COVID-19) pandemic, due to lockdowns, limitation of access to medical facilities and new recommendations regarding patient management. The implications of the COVID-19 pandemic on IBD patients' management were assessed in our Tertiary Gastroenterology Center in Bucharest, Romania. METHODS: Medical records of IBD patients admitted between 15th of March and 15th of August 2020 were retrospectively reviewed and compared to a control cohort of consecutive IBD patients admitted to our unit during the corresponding period of 2019. RESULTS: There was a highly significant shift towards one-day hospitalization during the referral period in 2020 for IBD cases (91% in 2020 vs 82.2% in 2019, p=0.0001). There was no statistically significant difference between the distribution of patient's gender, IBD phenotype or newly diagnosed IBD cases. A significantly lower proportion of admitted patients received 5-aminosalicylic acid (29% vs 41.2%, p=0.0001), whereas a substantially higher number of patients were prescribed biological therapy in 2020 in comparison to the corresponding 2019-time frame (79.5% vs 57.9%, p<0.0001). The distribution of the biological agent used was significantly different in 2019 in comparison to the 2020 period mainly due to the increase in vedolizumab prescription in 2020 (p<0.0001). During the study period in 2020, seven IBD patients (1.7%) were diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-Cov2) infection, all of them with mild symptoms without impact on the IBD course. CONCLUSIONS: The COVID-19 pandemic led to reorganizing medical care, limiting the hospital admissions in favor of severe IBD cases, favoring telemedicine for mild disease and optimization of treatment for moderate to severe IBD with an increased use of biologicals aimed to maximize the risk/benefit ratio. Incidence of SARS-Cov2 infection during the first wave of COVID-19 infection in our study group was 1.7% and did not adversely impact the IBD disease course.


Assuntos
Anti-Inflamatórios/uso terapêutico , Produtos Biológicos/uso terapêutico , Prestação Integrada de Cuidados de Saúde/tendências , Hospitalização/tendências , Doenças Inflamatórias Intestinais/tratamento farmacológico , Telemedicina/tendências , Anti-Inflamatórios/efeitos adversos , Produtos Biológicos/efeitos adversos , Humanos , Incidência , Doenças Inflamatórias Intestinais/diagnóstico , Doenças Inflamatórias Intestinais/epidemiologia , Segurança do Paciente , Estudos Retrospectivos , Romênia/epidemiologia , Centros de Atenção Terciária , Fatores de Tempo , Resultado do Tratamento
9.
Medicina (Kaunas) ; 56(12)2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33352889

RESUMO

Coinfection with both SARS-CoV-2 and influenza viruses seems to be a real and severe problem. However, coinfection is far from a simple matter, and cannot be considered having more unfavorable outcomes as a direct consequence. In reality, the aftermath is powerfully nuanced by the presence of risk factors and specific molecular mechanisms. Our objective was to raise awareness around the unpredictable association between COVID-19 pandemics and the upcoming flu season, and make arguments about the need to develop new routine testing protocols for both viruses, at least during the period with an expected high incidence. Our reasoning is built around the various impacts that the whole range of risk groups, common immunological mechanisms, and complex interactions, such as influenza vaccination, will have on patients' prognosis. We show that the more flawed clinical course is due to managing only one of the infections (and, subsequently, neglecting the other condition).


Assuntos
/epidemiologia , Vacinas contra Influenza/administração & dosagem , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Coinfecção/epidemiologia , Suscetibilidade a Doenças , Humanos , Pandemias , Prognóstico , Fatores de Risco , Romênia/epidemiologia , Estações do Ano
10.
Biomed Res Int ; 2020: 5607236, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33354566

RESUMO

During the outbreak of an epidemic, it is of immense interest to monitor the effects of containment measures and forecast of outbreak including epidemic peak. To confront the epidemic, a simple SIR model is used to simulate the number of affected patients of coronavirus disease in Romania and Pakistan. The model captures the growth in case onsets, and the estimated results are almost compatible with the actual reported cases. Through the calibration of parameters, forecast for the appearance of new cases in Romania and Pakistan is reported till the end of this year by analysing the current situation. The constant level of number of patients and time to reach this level is also reported through the simulations. The drastic condition is also discussed which may occur if all the preventive restraints are removed.


Assuntos
/epidemiologia , Pandemias , /prevenção & controle , Simulação por Computador , Previsões , Humanos , Conceitos Matemáticos , Modelos Biológicos , Paquistão/epidemiologia , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Romênia/epidemiologia , Fatores de Tempo
11.
Artigo em Inglês | MEDLINE | ID: mdl-33105688

RESUMO

This study aimed to assess dental care needs in Cluj region during the State of Emergency, declared due to the COVID-19 pandemic, compared to the same period of the year 2019. A descriptive retrospective analysis was conducted, which retrieved patients seeking emergency dental services at the Emergency Department of County General Hospital and "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania, the only dental service available in April 2020. Recorded data cover the month of April 2020 and is compared with the same period of 2019. During April 2020, 724 patients received dental care, whereas only 160 patients were treated in April 2019 in the same facility. The number of patients with acute apical periodontitis, abscess, and acute pulpitis was significantly higher in 2020. The percentage of patients receiving sedative filling for the treatment of acute pulpitis in 2020 was significantly higher than in 2019, while the proportion of patients receiving pulpectomy was higher in 2019. The percentage of patients receiving endodontic drainage for the treatment of acute periapical periodontitis in 2020 was higher. This study demonstrates that the COVID-19 pandemic impacted the use of medical care services and could further impact the oral health and quality of life of patients.


Assuntos
Infecções por Coronavirus/epidemiologia , Odontologia/estatística & dados numéricos , Serviço Hospitalar de Emergência , Pneumonia Viral/epidemiologia , Betacoronavirus , Estudos Transversais , Humanos , Pandemias , Estudos Retrospectivos , Romênia/epidemiologia
12.
Chirurgia (Bucur) ; 115(2): 129-137, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33119486

RESUMO

As the COVID-19 pandemic extends, its negative consequences on the effectiveness of therapeutic programs - previously assumed by the medical community and imperatively suspended for a difficult-to-predict period of time - are becoming increasingly worrying. In this context, as the evidence-based recommendations are not possible, most of the national and international scientific societies tried to develop balanced recommendations (1-4). The Romanian Society of Coloproctology (SRCP) and the Romanian Association for Endoscopic Surgery (ARCE) have created a working group that, taking into account recent publications, the statements of international academic societies, the national legislative context and the unique experience of countries severely affected by this pandemic (China, Italy, Spain, USA, etc.) proposes for Romania, the following recommendations for medical practice in colorectal surgery during the COVID-19 pandemic. These recommendations are subjected to continuous review, depending on the global and national situation of the pandemic, the particular needs of each hospital, the recommendations of the competent authorities and the evolution of the literature that publishes the conclusions of ongoing clinical trials.


Assuntos
Cirurgia Colorretal/normas , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Betacoronavirus , Humanos , Pandemias , Romênia/epidemiologia , Resultado do Tratamento
13.
Medicina (Kaunas) ; 56(11)2020 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-33121072

RESUMO

Background and objectives: The current pandemic of SARS-CoV-2 has not only changed, but also affected the lives of tens of millions of people around the world in these last nine to ten months. Although the situation is stable to some extent within the developed countries, approximately one million have already died as a consequence of the unique symptomatology that these people displayed. Thus, the need to develop an effective strategy for monitoring, restricting, but especially for predicting the evolution of COVID-19 is urgent, especially in middle-class countries such as Romania. Material and Methods: Therefore, autoregressive integrated moving average (ARIMA) models have been created, aiming to predict the epidemiological course of COVID-19 in Romania by using two statistical software (STATGRAPHICS Centurion (v.18.1.13) and IBM SPSS (v.20.0.0)). To increase the accuracy, we collected data between the established interval (1 March, 31 August) from the official website of the Romanian Government and the World Health Organization. Results: Several ARIMA models were generated from which ARIMA (1,2,1), ARIMA (3,2,2), ARIMA (3,1,3), ARIMA (3,2,2), ARIMA (3,1,3), ARIMA (2,2,2) and ARIMA (1,2,1) were considered the best models. For this, we took into account the lowest value of mean absolute percentage error (MAPE) for March, April, May, June, July, and August (MAPEMarch = 9.3225, MAPEApril = 0.975287, MAPEMay = 0.227675, MAPEJune = 0.161412, MAPEJuly = 0.243285, MAPEAugust = 0.163873, MAPEMarch - August = 2.29175 for STATGRAPHICS Centurion (v.18.1.13) and MAPEMarch = 57.505, MAPEApril = 1.152, MAPEMay = 0.259, MAPEJune = 0.185, MAPEJuly = 0.307, MAPEAugust = 0.194, and MAPEMarch - August = 6.013 for IBM SPSS (v.20.0.0) respectively. Conclusions: This study demonstrates that ARIMA is a useful statistical model for making predictions and provides an idea of the epidemiological status of the country of interest.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Modelos Estatísticos , Pneumonia Viral/epidemiologia , Infecções por Coronavirus/mortalidade , Previsões , Humanos , Incidência , Pandemias , Pneumonia Viral/mortalidade , Prevalência , Reprodutibilidade dos Testes , Romênia/epidemiologia
14.
Medicine (Baltimore) ; 99(33): e21284, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32871986

RESUMO

RATIONALE: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, which quickly spread throughout the world, has been putting medical workers all over the world in difficulty because of the high number of cases combined with the lack of information about the disease. Although pediatric cases are rare, the group age under 12 months has been in general more susceptible to develop severe forms of the disease compared with the patients in the age interval of 1 to 18 years. PATIENT CONCERNS: Three newborns have been tested positive for SARS-CoV-2 infection. One of them presented bilateral decreased air entry, while the other 2 had no respiratory symptomatology. All 3 developed diaper erythema and oral candidiasis. DIAGNOSIS: For building up the report, newborns that were positive for coronavirus disease 2019 (COVID-19) infection were included in the case series. The chest X-ray of the symptomatic patient revealed a medium degree of hilar parenchymal infiltration and a slight infiltration of the visceral pleura. INTERVENTIONS: The patients were admitted in our isolated neonatology ward. All of them received antifungal treatment for the oral candidiasis and topic cream for diaper erythema. The symptomatic patient also received prophylactic antibiotherapy, human immunoglobulins, aminophylline, and parenteral nutrition. OUTCOMES: All 3 neonates were discharged after 2 consecutive negative tests for SARS-CoV-2. Patients 1 and 2 fully recovered, whereas the condition of patient 3 improved. LESSONS: Even if there are only a few reported cases of neonates infected with COVID-19 and most of them present mild manifestations, newborns need a more careful insight because of the nonspecific symptomatology.


Assuntos
Betacoronavirus , Candidíase Bucal/virologia , Infecções por Coronavirus/complicações , Eritema/virologia , Pneumonia Viral/complicações , Dermatopatias Virais/patologia , Adolescente , Candidíase Bucal/patologia , Criança , Pré-Escolar , Infecções por Coronavirus/virologia , Eritema/patologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pandemias , Pneumonia Viral/virologia , Romênia/epidemiologia , Dermatopatias Virais/virologia
15.
Chirurgia (Bucur) ; 115(4): 486-492, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32876022

RESUMO

Background: Burns are common reasons for emergency department presentations. While extensive or special burns require treatment in a specialized center, the majority are amenable to ambulatory treatment or hospitalization in a surgical ward. Romania has a national data collecting mechanism regarding all hospitalized patients, but there are no available statistics concerning non-hospitalized burn cases. This study aims to explore the amplitude of burn trauma by analyzing data from an Emergency Department at a major Romanian regional trauma center. Methods: This is a retrospective single-center 1-year study of all burn-related emergency department presentations at the trauma referral center for Romania's North-East region, in 2015. Included in the study were all cases of burns, indiscriminate of their etiology. Results: A total of 355 burn cases were analyzed. The average monthly number of cases was 29.58, with a maximum of 54 and a minimum of 18. There were 206 males and 149 females and 57.7% urban residents. Only 134 cases have been hospitalized during this period. Conclusions: Almost two-thirds of cases have not been hospitalized, thus missing from national statistics. Precise epidemiological data is paramount for a successful national burn management strategy. Creation of a national burn registry is suggested.


Assuntos
Queimaduras/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Assistência Ambulatorial/estatística & dados numéricos , Unidades de Queimados/estatística & dados numéricos , Queimaduras/terapia , Feminino , Humanos , Tempo de Internação , Masculino , Estudos Retrospectivos , Romênia/epidemiologia , Resultado do Tratamento
16.
Acta Vet Scand ; 62(1): 42, 2020 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-32746875

RESUMO

Canine vector-borne diseases are caused by pathogens transmitted by arthropods including ticks, mosquitoes and sand flies. Many canine vector-borne diseases are of zoonotic importance. This study aimed to assess the prevalence of vector-borne infections caused by Dirofilaria immitis, Ehrlichia canis, Borrelia burgdorferi sensu lato, Anaplasma spp. and Leishmania infantum in a dog kennel in Argeș County, Romania. Dog kennels are shelters for stray dogs with no officially registered owners that are gathered to be neutered and/or boarded for national/international adoptions by various public or private organizations. The international dog adoptions might represent a risk in the transmission of pathogens into new regions. In this context, a total number of 149 blood samples and 149 conjunctival swabs from asymptomatic kennel dogs were assessed using serology and quantitative real-time polymerase chain reaction. Antibodies against B. burgdorferi s.l. were detected in one dog (0.6%), anti-Anaplasma antibodies were found in five dogs (3.3%), while ten dogs (6.7%) tested positive for D. immitis antigen. Overall, 20.1% (30/149) of dogs were positive for L. infantum DNA. All samples were seronegative for anti-Leishmania antibodies. When adopting dogs from this region of Romania, owners should be aware of possible infection with especially L. infantum. The travel of infected dogs may introduce the infection to areas where leishmaniasis is not present.


Assuntos
Anaplasmose/epidemiologia , Doenças do Cão/epidemiologia , Ehrlichiose/veterinária , Leishmaniose Visceral/veterinária , Doença de Lyme/veterinária , Anaplasma/isolamento & purificação , Anaplasmose/microbiologia , Animais , Anticorpos Antibacterianos/análise , Borrelia burgdorferi/isolamento & purificação , DNA de Protozoário/análise , Vetores de Doenças , Doenças do Cão/microbiologia , Doenças do Cão/parasitologia , Cães , Ehrlichia canis/isolamento & purificação , Ehrlichiose/epidemiologia , Ehrlichiose/microbiologia , Feminino , Leishmania infantum/isolamento & purificação , Leishmaniose Visceral/epidemiologia , Leishmaniose Visceral/parasitologia , Doença de Lyme/epidemiologia , Doença de Lyme/microbiologia , Masculino , Prevalência , Romênia/epidemiologia
17.
Artigo em Inglês | MEDLINE | ID: mdl-32751368

RESUMO

The present paper intends to address the impact of COVID-19 crisis upon the consumer buying behavior of fresh vegetables directly from local producers as observed 30 days later, after enforcing the state of emergency in Romania within a well-defined area, namely, the quarantined area of Suceava. The study relies on the interpretation of answers received from the quarantined area (N = 257) to a questionnaire applied online nationwide. The starting point of this paper is the analysis of the sociodemographic factors on the purchasing decision of fresh vegetables directly from local producers before declaring the state of emergency in Romania (16 March 2020). Further research has been conducted by interpreting the changes triggered by the COVID-19 crisis on the purchasing intention of such products before and after the end of the respective crisis. The aim of this scientific investigation relies on identifying the methods by which these behavioral changes can influence the digital transformation of short food supply chains.


Assuntos
Betacoronavirus/isolamento & purificação , Comportamento do Consumidor , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Quarentena , Verduras , Adulto , Infecções por Coronavirus/virologia , Feminino , Abastecimento de Alimentos , Humanos , Intenção , Masculino , Pandemias , Pneumonia Viral/virologia , Romênia/epidemiologia , Inquéritos e Questionários
18.
Medicine (Baltimore) ; 99(31): e21512, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756188

RESUMO

RATIONALE: Syncope is described as the loss of consciousness and postural muscle tone with a short duration and fast onset. Micturition syncope can be caused by abnormal vasovagal response or by the dysfunction of the blood pressure regulating mechanism, which occurs before, during, or immediately after urination. PATIENT CONCERNS: We present 4 cases of COVID-19 hospitalized in the Department of Infectious Diseases of the Academic Emergency Hospital Sibiu, Romania, cases that presented micturition syncope. DIAGNOSES: During hospitalization, patients confirmed with SARS-Cov-2 infection using real time reverse transcriptase-polymerase chain reaction (RT-PCR) assay, presented micturition syncope in different stages of the infection (at the beginning and in the second week of evolution). INTERVENTIONS: Other causes of syncope such as adrenal insufficiency secondary to corticosteroids treatment, cardiac rhythm disorders, neurological impairment, dehydration, vasoactive medication, malignancies, pulmonary hypertension and coughing were excluded. The treatment of SARS-CoV-2 infection was performed following the local and national guidelines. OUTCOMES: The clinical course of all 4 patients diagnosed with COVID-19 and micturition syncope was favorable. To our knowledge, micturition syncope in COVID-19 patients has yet not been reported by other authors. LESSONS: To our knowledge, micturition syncope associated with the evolution of COVID-19, has yet not been reported by other authors.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Síncope/virologia , Idoso , Infecções por Coronavirus/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia , Romênia/epidemiologia
19.
PLoS One ; 15(8): e0237510, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32810155

RESUMO

Periodontitis is a highly prevalent condition leading to a continuous destruction of tooth-supporting tissues. It increases the risk for various systemic diseases and adverse pregnancy outcomes. Therefore, screening for periodontitis is important. Screening measures can range from self-reported symptoms to clinical full-mouth periodontal examination. The hypothesis of our study was that self-reported parameters and clinical definition perform equally well in identifying periodontitis patients. The aim of this study was to develop, validate its internal consistency, and evaluate a self-reported instrument against periodontal clinical evaluation for diagnosis of periodontitis in a group of postpartum women, as well as to describe their periodontal status and the risk factors associated with periodontal disease. A cross-sectional study on postpartum women was conducted in a tertiary university hospital, from April 2018 to March 2019. Sociodemographic and behavioral data, periodontal clinical parameters, and self-reported periodontal perception were collected. A 16-item questionnaire was developed to obtain information about perceived periodontal alterations and oral hygiene habits. The utility of the questionnaire was tested against a periodontal diagnosis based on a full-mouth periodontal examination. The questionnaire was applied in 215 postpartum women aged 29.16±5.54 years (mean age (y) ± standard deviation) having the following periodontal status: 16 individuals without periodontal disease (7.44%), 32 individuals with gingivitis (14.88%), 19 individuals with mild periodontitis (8.84%), 132 individuals with moderate periodontitis (61.39%), and 16 individuals with severe periodontitis (7.44%). A significant association was observed between oral hygiene score, smoking status, and periodontal conditions (p<0.05). A significant association between the self-reported items related to "gum swelling", "halitosis", "previous periodontal diagnosis" and "previous periodontal treatment" with clinical periodontitis have been identified (p<0.05). Using self-reported questionnaires for detection of periodontal disease was ineffective in our studied population, since self-reported parameters and clinical definition do not appear to perform equally in identifying periodontitis cases. Clinical periodontal examination remains the gold standard for screening. Periodontitis was frequent in our group and the severity was significantly associated with the oral hygiene score and smoking. These results underline the necessity for periodontal clinical examination during pregnancy.


Assuntos
Doenças Periodontais/epidemiologia , Doenças Periodontais/etiologia , Transtornos Puerperais/epidemiologia , Transtornos Puerperais/etiologia , Autorrelato , Adolescente , Adulto , Estudos Transversais , Europa Oriental/epidemiologia , Feminino , Gengivite/epidemiologia , Gengivite/etiologia , Halitose/epidemiologia , Halitose/etiologia , Humanos , Higiene Bucal/estatística & dados numéricos , Periodontite/epidemiologia , Periodontite/etiologia , Período Pós-Parto , Gravidez , Prevalência , Fatores de Risco , Romênia/epidemiologia , Autorrelato/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
20.
Sci Total Environ ; 745: 141170, 2020 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-32758733

RESUMO

The study examines the association between exposure to sub-micrometric Particulate Matter (PM1) and allergic response in a group of sensitive young children (age: 2-10 years) from Ploiesti city, Romania. The city is the only urban agglomeration in Europe surrounded by four oil refineries. A panel study was conducted by collecting medical information from children with respiratory illnesses and atopy (n = 135). Hot Spot Analysis revealed the areas of the city that are susceptible to high levels of PM1. We found a close interaction between exposure to PM1 outdoor concentrations and various physiological changes and clinical symptoms in children including triggering of allergic reactions, rhinitis, alteration of lung function, upper and lower respiratory tract symptoms, and bronchial asthma. During the 2-year study period, the incidence of hospitalizations was 40.7%. Strong correlations (p < 0.001) were observed between the PM1 exposure and hospitalizations, and exposure and Immunoglobulin E (IgE). PM1 exposure was also correlated with eosinophils (p < 0.05). Another positive correlation was observed between hospitalizations and IgE levels (p < 0.05). The mean results of tested indicators were as follows: wheezing (5.3, 95% CI (1.4-1.8); Coeff. of var. (CV) = 30%), IgE (382, 95% CI (349-445); CV = 102%), and EO% (5.3, 95% CI (3.3-4.2); CV = 69.5%). We can conclude that exposure to PM1 influenced the frequency of wheezing episodes, increased hospitalizations, and the levels of allergic blood indicators in children, especially in infants and pre-schoolers. CAPSULE: Exposure to sub-micrometric particles (PM1) influences the frequency of wheezing episodes, hospitalizations, and the levels of allergic blood indicators in children, especially in infants and pre-schoolers.


Assuntos
Hipersensibilidade , Material Particulado/efeitos adversos , Material Particulado/análise , Criança , Pré-Escolar , Cidades/epidemiologia , Europa (Continente) , Humanos , Lactente , Sons Respiratórios/etiologia , Romênia/epidemiologia
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