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Small rodent species (Mammalia: rodentia) – carriers of Leptospirosis
Get PDFThe study was conducted under the USM subprogram 010701 and contract no. 01-23p-096/03-05-
2024, funded by the National Environmental FundIntroduction. In the Republic of Moldova, small rodents are represented by 8 species from
the family Cricetidae and 8 from the family Muridae, of which 2 species (Cricetus cricetus
and Micromys minutus) are rare and legally protected. Eleven species are widespread across
various ecosystems, where they achieve high population densities and possess a high
adaptive potential to anthropogenic and climatic changes. Thus, the small rodents represent
an important link in the circulation of many pathogens such as Leptospirosis that is
recognized as an emerging global public health problem, being addressed in an
interdisciplinary context related to biomedicine, ecology, veterinary medicine, public health,
in social and economic aspects.
Purpose of the study. This study aimed to characterize the ecological features of small
rodents with significant epidemiological importance and their role in the formation and
maintenance of leptospirosis foci.
Material and methods. The study was conducted from 2020 to 2024 across different
seasons in various ecosystems of the republic. Small rodents were captured using live and
snap traps, following standard methodologies. Each trapping session lasted five days. Traps
were set in lines or randomly, with 50 to 100 traps placed at 5-meter intervals and baited
with pieces of bread crust soaked in unrefined sunflower oil.
Results. During the study period, 8 small mammal species were identified: Mus musculus,
M. spicilegus, Apodemus sylvaticus, A. flavicollis, A. uralensis, A. agrarius, Clethrionomys
glareolus, and Microtus spp. Species of the Apodemus genus were dominant, comprising
over 70% of all collected individuals. High rates of Leptospira spp. infection were detected
specifically in A. agrarius, A. sylvaticus, and A. flavicollis. No human leptospirosis cases
were registered in 2020–2021. However, from 2022 to 2024, 25 cases were reported in the
Republic of Moldova. In 2022, 3 cases were diagnosed in Briceni, Drochia, and Slobozia
districts. In 2023, 6 cases were recorded: 4 in Glodeni district, one in Ocnița district, and
one in Chișinău. In 2024, 16 cases were reported: 5 in Drochia, 3 in Glodeni, 2 in Chișinău,
and one each in Fălești, Florești, Ocnița, Orhei, Râșcani, and Telenești districts. Four death
cases occurred in Ocnița, Fălești, and Drochia, the cause being delay in seeking medical
assistance.
Conclusions. Species of the Apodemus genus are dominant across various terrestrial
habitats. They hold the highest proportion in small rodent communities, are widely
distributed throughout all studied ecosystems, and exhibit high adaptive potential. The
species A. flavicollis, A. agrarius, and A. sylvaticus are of particular epidemiological
importance due to their high levels of Leptospira spp. carriage and their specific ecological
traits. Human leptospirosis cases were reported primarily in the northern and central
regions of the republic
Assessment of the action of pesticides on the viability of the fetus
Get PDFIntroducere. Substanţele utilizate pentru a suprima şi a eradica organismele considerate dăunătoare sunt denumite „pesticide”. Grupurile vulnerabile (femeile însărcinate, ce alăptează, copiii) sunt deosebit de susceptibile la efectele nocive ale pesticidelor. O provocare este expunerea timpurie la pesticide. Scop. Estimarea riscului expunerii la pesticide cu efect de perturbatori endocrini ce pot afecta viabilitatea şi dezvoltarea la animalele de laborator şi elaborarea măsurilor de prevenţie. Material şi metode. Studiile şi investigaţiile ştiinţifice au fost realizate în cadrul Agenţiei Naţionale pentru Sănătate Publică. Cercetările s-au înfăptuit pe animale de laborator (şobolani linia Wistar) aflate în condiţii de vivariu, acomodate la cerinţele de întreţinere timp de 21 zile, distribuite în lotul martor şi 2 loturi experimentale. Rezultate. Expunerea la pesticide în etapa fetală, în primul an de viaţă poate fi deosebit de periculoasă. În grupele experimentale au fost incluse femele şobolani cu masa corporală medie 200g. Numărul de fetuşi născuţi vii a variat între 4-12. Viabilitatea fetuşilor a fost afectată. În 1 grup fetuşii au început să moară la ziua a 7 şi 14, în al 2 lot-după 7 zile de viaţă. Astfel, în urma studiului au fost evidenţiate efecte negative ale pesticidelor asupra organismului fetuşilor luând în considerare calea de expunere in utero, prin laptele matern. În cazul dat, efectul cumulativ al pesticidelor ce provine din alimentaţie este mai pronunţat. Concluzii. Pentru a proteja sănătatea şi a reduce impactul pesticidelor, este necesară o abordare integrată la capitolul evaluarea riscurilor, utilizarea şi monitorizarea pesticidelor. Este destul de important să se ia în considerare vulnerabilităţile specifice ale anumitor grupuri de populaţie.Introduction. Substances used to suppress and eradicate organisms considered harmful are called “pesticides”. Vulnerable groups (pregnant women, who breastfeeds, children) are particularly susceptible to the harmful effects of pesticides. One challenge is early exposure to pesticides, from the first weeks. Objective. Estimating the risk of exposure to endocrine disrupting pesticides, chemicals that can affect the viability and development of laboratory animals, and developing preventive measures. Material and methods. Scientific studies and investigations were carried out within the Laboratory of the National Agency for Public Health. The researches were carried out on laboratory animals (Wistar rats) in vivarium conditions, adapted to the maintenance requirements for 21 days, distributed in the control group and 2 experimental groups. Results. Exposure to pesticides in the fetal stage, in the first year of life, can be particularly dangerous. Female rats with an average body mass of 200 g were included in the experimental groups. The number of fetuses born alive ranged from 4-12. The viability of the fetuses in the experimental groups was affected. In group 1, fetuses began to die on days 7 and 14, in group 2-after 7 days of life. Thus, the study revealed negative effects of pesticides on the fetuses’ body, taking into account the route of exposure in utero, through breast milk. In this case, the cumulative effect of pesticides coming from food is more pronounced. Conclusion. To protect health and reduce the impact of pesticides, an integrated approach to risk assessment, pesticide use and monitoring is needed. It is quite important to consider the specific vulnerabilities of certain population groups in order to develop strategies. Taking precautions is vital
Use of systemic antibacterial agents during pregnancy
Get PDFIntroducere. Utilizarea preparatelor antibacteriene în sarcină reprezintă o problemă actuală în medicină, constituind majoritatea prescripţiilor pentru tratamentul infecţiilor la gravide. Selectarea antibacterienelor trebuie să se bazeze pe particularităţile farmacologice şi riscurile pentru mamă şi făt. Scopul lucrării a constat în stratificarea grupelor de antibacteriene în funcţie de riscurile potenţiale pentru mamă şi făt, cu formularea recomandărilor de utilizare în timpul sarcinii. Material şi metode. S-a realizat o sinteză narativă a articolelor în perioada 2018-2025 din bazele de date PubMed, Medscape, Google Scholar şi ScienceDi-rect referitor la aspectele de folosire a antibacterienelor în sarcină. Au fost selectate informaţii relevante privind indicaţiile, profilul de siguranţă, eficacitatea şi posibilele efecte asupra mamei şi fătului. Rezultate. S-a constatat că penicilinele, cefalosporinele, carbapenemii, monobactamii, asocierile beta-lactamine + inhibitori de beta-lactamaze, glicopeptidele, lincosamidele şi derivaţii de nitroimidazol sunt considerate sigure pentru utilizare în sarcină (grupa B), nefiind asociate cu efecte teratogene. Macrolidele, lipo-glicopeptidele (telavancina, dalbavancina), ansamicinele, polimixinele, fluorochinolonele şi oxazolidindinonele pot fi utilizate cu precauţie, în funcţie de severitatea infecţiei şi de starea clinică a gravidei (grupa C). Tetraciclinele, ami-noglicozidele şi sulfamidele combinate se consideră contraindicate în sarcină (grupa D). Concluzii. Administrarea preparatelor antibacteriene în sarcină necesită o argumentare minuţioasă şi o monitorizare riguroasă. Preparatele din grupa C pot fi utilizate cu precauţie prin evaluarea beneficiilor şi riscurilor. Antibacterienele contraindicate în sarcină pot fi utilizate după indicaţii speciale.Introduction. The use of antibacterial agents during pregnancy is a current problem in medicine, constituting the majority of prescriptions for the treatment of infections in pregnant women. The selection of antibacterial should be based on the pharmacological characteristics and risks for the mother and fetus. Objective. The purpose of the work was to stratify the groups of antibacterials according to the potential risks for the mother and fetus, with the formulation of recommendations for use during pregnancy. Material and methods. A narrative synthesis of articles from 2018-2025 from the PubMed, Medscape, Google Scholar and ScienceDirect databases was conducted regarding aspects of the use of antibacterials during pregnancy. Relevant information regarding indications, safety profile, efficacy and possible effects on the mother and fetus was selected. Results. It was found that penicillins, cephalosporins, car-bapenems, monobactams, beta-lactam + beta-lactamase inhibitor combinations, glycopeptides, lincosamides and nitroimidazole derivatives are considered safe for use during pregnancy (group B), not being associated with teratogenic effects. Macrolides, lipoglycopeptides (telavancin, dalba-vancin), ansamycins, polymyxins, fluoroquinolones and ox-azolidinedinones can be used with caution, depending on the severity of the infection and the clinical condition of the pregnant woman (group C). Tetracyclines, aminoglycosides and combined sulfonamides are considered contraindicated in pregnancy (group D). Conclusion. The administration of antibacterial drugs during pregnancy requires careful reasoning and rigorous monitoring. Group C drugs can be used with caution by evaluating the benefits and risks. Antibacterial drugs contraindicated in pregnancy can be used in extreme cases and with absolute indications
The current relevance of ethics and axiology in brain health examination
Get PDFIn today’s medical activity, the role of ethics is increasingly evident.
At the same time, medical ethics today is in a specific existential framework in which the relationships and situations created are, in most cases,
assessed in a predetermined way by certain normative acts. Trends appear
in which, to a certain extent, the meaning of ethics is distorted, formalizing its essence. In such conditions, the role of axiology as the basic theoretical support of ethics increases. Brain health highlights an extensive
space for applying ethical principles: from assessments of human habitat
conditions, which determine the level of brain health, to disorders of a
certain severity of the nervous system centered on the brain. The importance of the functions of medical ethics on a solid axiological support is
increasingly increasing, capitalizing on an appreciable potential in the
strategies applied to the contingent of people with brain disorders
THE ROLE OF MICROBIOTA-GUT-BRAIN AXIS IN ALZHEIMER'S DISEASE MECHANISMS AND THERAPIES
Get PDFUniversitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”, Chișinău, Republica MoldovaIntroducere. Boala Alzheimer (BA) e o afecţiune neuro-degenerativă progresivă cu etiologie multifactorială. Cercetările evidenţiază rolul axei microbiotă-intestin-creier (MGBA - microbiota-gut-brain axis) în neuroinflamaţie şi declin cognitiv, implicând perturbări ale microbiotei intestinale, răspunsuri imune, metaboliţi. Scop. Analiza rolului microbiotei intestinale în dezvoltarea şi progresia BA, explorarea mecanismelor presupuse ale axei microbiotă-in-testin-creier şi sintetizarea principalelor rezultate. Material şi metode. Un studiu sistematic a fost realizat utilizând un set de date de 50 de articole (2015-2025) din PubMed, ScienceDirect şi Google Scholar.Au fost incluse review-uri, studii originale şi rapoarte de caz, cu accent pe disbioză, neuroinflamaţie, metaboliţi microbieni acizi graşi cu lanţ scurt (SCFA), N-oxid de trimetilamină (TMAO) şi terapii propuse. Rezultate. Cele mai frecvent raportate mecanisme au fost disbioza intestinală, neuroinflamaţia, metaboliţii microbie-ni (SCFA, TMAO), stresul oxidativ. Amiloidele bacteriene pot acţiona ca prioni inducând reacţia încruţişată de denaturarea şi agregarea a amiloidului nativ. Produsele microbiotei pot activa microglia, intensificând răspunsul inflamator din sistemul nervos central, ceea ce duce la disfuncţii microgliale, neurotoxicitate şi afectarea clearance-ului amiloidic. Perspective terapeutice: probiotice, intervenţii dietetice şi restaurarea SCFA au fost cele mai comune. Transplantul fecal şi reglarea acidului biliar microbian sunt abordări emergente. Concluzii. MGBA reprezintă un factor important în dezvoltarea BA, prin căi imune, metabolice şi inflamatorii. Strategiile ce vizează microbiota intestinală prin dietă şi probiotice sunt promiţătoare, deşi validarea clinică este limitată. Sunt necesare cercetări suplimentare pentru strategii de tratament.Introduction. Alzheimer’s disease (AD) is a progressive neurodegenerative disorder with a multifactorial etiology. Research highlights the role of the microbiota-gut-brain axis (MGBA) in neuroinflammation and cognitive decline, involving disruptions of the gut microbiota, immune responses, and metabolites. Objective. Analysis of the role of the intestinal microbiota in the development and progression of AD, exploration of the putative mechanisms of the microbiota-gut-brain axis and synthesis of the main results. Material and methods. A systematic study was performed using a dataset of 50 articles (2015-2025) from PubMed, ScienceDirect and Google Scholar. The selection included reviews, original researches and case reports, focusing on dysbiosis, neuroinflammation, microbial metabolites short-chain fatty acid (SCFA), trimethylamine N-oxide (TMAO) and proposed therapies. Results. The most frequently reported mechanisms were intestinal dysbiosis, neuroinflammation, microbial metabolites (SCFA, TMAO), oxidative stress. Bacterial amyloids can act as prions inducing the cross-reaction of native amyloid denaturation and aggregation. Microbiota products can activate microglia, enhancing the inflammatory response in the central nervous system, leading to microglial dysfunction, neurotoxicity and impaired amyloid clearance. Therapeutic perspectives: probiotics, dietary interventions and SCFA restoration were the most common. Fecal transplantation and microbial bile acid regulation are emerging approaches. Conclusion. MGBA is an important factor in the development of AD, through immune, metabolic and inflammatory pathways. Strategies targeting the gut microbiota through diet and probiotics are promising, although clinical validation is limited. Further research is needed for treatment strategies
The role of ultradiafiltration in drug, alcohol, and surrogate poisoning
Get PDFIntroducere. Consumul de alcool, droguri este o problemă majoră de sănătate publică.63,2% din populaţia adultă a RM consumă alcool, ceia ce constituie 12,9 litri de alcool pur per persoană.13.5% din decese în rândul tinerilor cu vârste între 20 şi 39 de ani sunt atribuite consumului de alcool, droguri şi surogate Scop. Demonstrarea eficienţei metodei de ultradiafiltrare (CVVHDF) în stabilizarea şi recuperarea pacienţilor cu intoxicaţii severe cu alcool, droguri şi surogate, internaţi în secţia de terapie intensivă. Material şi metode. Analiza tacticii de tratament şi evoluţia unui pacient de 36 ani, internat în UTI cu intoxicaţia acută severă cu droguri, alcool şi surogate, complicată cu insuficienţa renală acută şi sindrom de strivire (mioglobina>500 ng/ml), starea de cunoştinţa dereglată la nivel de coma (GCS-6 p), supus terapiei de epurare extracorporală (CVVHDF). Rezultate. După 72 ore de Ultradiafiltrare continua la pacient s-a determinat o evoluţie favorabilă: statut neurologic (scor Glasgow crescut de la 6 la 14),reluarea diurezei după 48 h.Sindrom uremic cu evoluţie pozitivă (ureea-17.8 la 7.8 mmol/L, cre-atinina-234.5 la 66 mmol/L). Sindrom de rabdomioliză normalizat (CK-9641U/L la 150U/L, CK-MB-415U/L la500 ng/ ml la la 500 ng/ml), impaired consciousness of coma (GCS-6 p), subject to extracorporeal treatment (CVVHDF). Results. After 72 hours of continuous Ultradiafil-tration in the patient, a favorable development was determined: neurological status (score Glasgow increased from 6 to 14), resumption of diuresis after 48 hours. Positive uremic syndrome (urea-17.8 at 7.8 mmol/L, creatinine-234.5 at 66 mmol/L). Normalised rhabdomyolysis syndrome (CK-9641U/L to 150U/L, CK-MB-415U/L to 500 ng/ml to <50 ng/ml. Hydro-electrolyte balance: gradually normalized. Hemodynamically stabilized, no need for inovasotropic agents. The patient was disconnected from CVVHDF on day 3, transferred to the ward. Conclusion. Method of ultradiafiltration (CVVHDF) is essential in severe drug poisoning, complicated with coma, acidosis, kidney failure or crushing syndrome. This method helps to stabilize the critical patient, counteracts imbalances, eliminates toxins and reduces morbidity, favoring the prognosis
New biomarkers in the diagnosis and prognosis of neonatal infections in respiratory distress syndrome
Get PDFIntroduction. Bronchopulmonary dysplasia (BPD) and neonatal respiratory
distress syndrome (nRDS) are major complications in preterm infants, often
resulting in long-term health issues. Identifying reliable biomarkers for these
conditions is crucial for improving clinical outcomes. Infectious diseases are a
predominant cause of childhood death. Neonatal infection in particular remains
a common tragedy, with ∼7 million cases and ∼700,000 deaths per year,
currently accounting for 40% of mortality in those under 5 years of age (Hanieh
Talebi et.all.2025).
Objective: to summarize contemporary evidence on the use of circulating
immunological biomarkers in the diagnosis of secondary immunodeficiencies
and to identify promising biomarkers for use in personalized management in
neonates.
Material and methods: The study was analytical, based on a review of the
scientific literature from the PubMed and Google Scholar databases, published
between 2018 and 2023.
Rezults. Studies have highlighted potential biomarkers and mechanisms
involved in their pathogenesis. Endothelin-1 (ET-1) is a promising biomarker
for predicting BPD, as it is associated with bronchoconstriction and pulmonary
hypertension, with elevated levels indicating early risk in preterm infants with
nRDS. Interleukin-6 (IL-6) is another significant biomarker, with higher serum
levels correlating with BPD development, underscoring the role of
inflammation in lung injury. Oxidative stress is also critical, as preterm infants
have immature antioxidant defenses, leading to increased lung tissue damage.
Specifically, neonatal APCs typically produce less proinflammatory
(interleukin-1β [IL-1β], TNF-α) and T helper 1 (Th1) promoting cytokines (IL-
12p70, type 1 IFN), but equal or greater amounts of Th17 promoting cytokines
(IL-23, IL-6) compared with adult cells. Robust neonatal production of IL-6
induces a physiological hepatic acute phase response at birth, including
induction of mannose binding lectin (MBL), C-reactive protein (CRP), and
LPS-binding protein (LBP) that rise in the first week of life, possibly broadly
enhancing resistance to infection, and contributes to healing of tissues injured
during birth. Conclusion. Biomarkers diagnosis in lung lesions in newborn
children has a major diagnostic value for preventing infant mortality and
evolution newborn management
Vitamin D deficiency in children and its prevention strategies
Get PDFIntroducere. Deficienţa de vitamina D a fost recunoscută ca o afecţiune pediatrică frecventă la nivel mondial care afectează mineralizarea osoasă, răspunsul imun şi creşterea. A rămas adesea subdiagnosticată şi netratată, crescând riscul de rahitism, osteomalacie, infecţii şi dezvoltare motorie afectată la copii. Scop. Scopul studiului a fost de a evalua principalele cauze, consecinţele clinice şi strategiile de prevenire ale deficitului de vitamina D la copii printr-o revizuire a literaturii actuale. Material şi metode. A fost efectuată o revizuire sistematică pe baza propunerii WHO şi a Societăţii Endocrinologice. Datele incluse au acoperit diverse grupe de vârstă pediatrică şi factori de risc. Parametrii revi-zaţi au inclus recomandările privind doza zilnică, etilogia şi prevalenţa. Au fost aplicate metode de analiză descriptivă şi comparaţie Rezultate. Deficienţa de vitamina D la copii este frecventă şi poate apărea din cauza expunerii limitate la soare, pigmentaţiei închise a pielii, alăptării exclusive fără suplimentare, alimentaţiei sărace în vitamina D şi a unor boli cronice precum tulburările de absorbţie, afecţiunile hepatice sau renale. OMS recomandă 5-10 pg de vitamina D zilnic pentru sugari, iar Societatea Endocrină recomandă 30 pg/ zi pentru copii şi adolescenţi. Vitamina D3 (colecalciferol) este preferată faţă de D2, datorită absorbţiei mai bune. Suplimentarea profilactică recomandată este de 400 Ul/zi la sugari şi 600 Ul/zi la copiii de peste un an. Concluzii. Acest studiu a confirmat că deficitul de vitamina D la copii este o condiţie prevenibilă. Screeningul regulat, conştientizarea factorilor de risc, controlul regulat şi suplimentarea adecvată cu colecalciferol s-au dovedit a reduce complicaţiile clinice în majoritatea cazurilor.Introduction. Vitamin D deficiency was recognized as a common global pediatric condition affecting bone mineralization, immune response, and growth. It remained frequently underdiagnosed and undertreated, increasing the risk of rickets, osteomalacia, frequent infections, and impaired motor development in children. Objective. The purpose of the study was to assess the major causes, clinical consequences, and prevention strategies of vitamin D deficiency in children through current literature review. Material and methods. A systematic review was carried out based on guidelines from the World Health Organization and the Endocrine Society. Included data covered various pediatric age groups and risk factors. Reviewed parameters included daily dosage recommendations, etiology, and prevalence. Descriptive analysis and comparison methods were applied. Results. Key risk factors for vitamin D deficiency in children include limited sun exposure, darker skin pigmentation, exclusive breastfeeding without vitamin D supplementation, inadequate nutrition, and chronic illnesses. The WHO recommends 5-10 pg (200-400 IU) of vitamin D daily for infants, while the Endocrine Society suggests 30 pg (1,200 IU) daily for children and adolescents. Vitamin D3 (cholecalciferol) is preferred over D2 due to better absorption and longer-lasting effects. Preventive supplementation includes 400 IU/day for infants and 600 IU/day for children over one year, this is mainly observed in high-risk groups Conclusion. This study confirmed that vitamin D deficiency in children is a preventable condition. Regular screening, risk factor awareness, regular checkup and appropriate cholecalciferol supplementation have been demonstrated to reduce clinical complications in most of the cases
Surgical treatment of humeral shaft fractures
Get PDFIntroducere. Fracturile diafizei humerale reprezintă o provocare terapeutică, opţiunile de tratament variind de la metode conservatoare la intervenţii chirurgicale. Alegerea metodei chirurgicale optime este dictată de tipul fracturii, necesitând o strategie de fixare adaptată pentru a obţine un rezultat funcţional bun. Scop. Analiza retrospectivă a metodelor de osteosinteză în fracturile diafizei humerale, evaluând aplicarea principiilor de stabilitate (absolută vs. relativă) cu diferite implanturi (plăci, tije). Material şi metode. Studiu retrospectiv pe 42 pacienţi. În reducerile deschise, s-a urmărit stabilitatea absolută (fracturi tip A/B) sau relativă (tip C) cu plăci DCP, LCP sau PHILOS. Pentru fracturile de tip A2/A3 tratate prin reducere închisă, s-a optat pentru fixare cu tijă centromedulară blocată. Rezultate. Vârsta medie a pacienţilor a fost de 58,7 ani. Durata medie de spitalizare a variat în funcţie de procedură: 7,3 zile pentru pacienţii supuşi reducerii deschise şi fixării cu placă, comparativ cu 4 zile pentru pacienţii la care s-a aplicat tija centromedulară prin reducere închisă, indicând o recuperare intraspitalicească mai rapidă pentru tehnicile minim-invazive. Concluzii. Alegerea metodei de osteosint-eză trebuie adaptată tipului de fractură. Plăcile oferă versatilitate pentru obţinerea stabilităţii absolute sau relative, în timp ce tija centromedulară este o opţiune biologică eficientă pentru fracturile simple (A2, A3) tratate prin tehnici minim-invazive.Introduction. Humeral shaft fractures are a therapeutic challenge, with options ranging from conservative to surgical methods. The choice of the optimal surgical method is dictated by the fracture type, requiring an adapted fixation strategy to achieve a good functional outcome and ensure proper healing. Objective. A retrospective analysis of osteosynthesis methods for humeral shaft fractures, evaluating the application of stability principles (absolute vs. relative) with different implants (plates, nails). Material and methods. A retrospective study on 42 patients. In open reductions, the goal was absolute (type A/B fractures) or relative (type C) stability using DCP, LCP, or PHILOS plates. For type A2/A3 fractures treated by closed reduction, fixation with a locked intramedullary nail was chosen. Results. The average patient age was 58.7 years. The mean length of stay varied by procedure: 7.3 days for patients undergoing open reduction and plating, compared to 4 days for those who received an intramedullary nail via closed reduction, indicating a faster in-hospital recovery for minimally invasive techniques. Conclusion. The choice of osteosynthesis method must be adapted to the fracture type. Plates offer versatility for absolute or relative stability, while the intramedullary nail is an effective biological option for simple fractures (A2, A3) treated with minimally invasive techniques