Institutional Repository in Medical Sciences of Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
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The impact of genetic polymorphism on the development of Hashimoto's thyroiditis
Get PDFIntroducere. Tiroidita Hashimoto (TH) este una dintre cele mai frecvente boli autoimune ale sistemului endocrin şi se caracterizează prin distrugerea celulelor tiroidiene de către anticorpii proprii Până în prezent, a fost identificată o relaţie între TH şi polimorfismele implicate în răspunsul imun. Scop. Acest studiu îşi propune să evidenţieze rolul polimorfismelor genetice în disreglarea căilor imune moleculare, contribuind la dezvoltarea şi evoluţia tiroiditei Hashimoto. Material şi metode. Studiul se bazează pe analiza a 16 surse bibliografice selectate din bazele de date PubMed, Oxford Academic, Medline şi Scopus, publicate în perioada 2014 - 2024. Revizuirea literaturii ştiinţifice a fost realizată conform următoarelor cuvinte-cheie: tiroidita Hashimoto, mecanisme moleculare ale tiroiditei autoimune, polimorfisme genetice. Rezultate. Tiroidita Hashimoto (HT) este însoţită de activarea celulelor T helper (Th1/Th17), activitate redusă a celulelor T reglatoare (Treg) şi producerea de anticorpi împotriva peroxidazei tiroidiene (TPOAb) şi tireoglobulinei (TgAb). Aceste procese imune sunt modulate de polimorfisme în genele antigenului limfocitar T citotoxic-4 (CTLA-4) şi antigenului leucocitar uman clasa II (HLA-II), care reglează toleranţa imună. Polimorfismele CTLA-4 şi HLA-II modifică reglarea celulelor Th1/Th17 şi Treg, favorizând răspunsul autoimun în TH. Polimorfismul CTLA-4 (+49A/ G) contribuie cel mai mult la dezvoltarea TH, urmat de HLA-DB103. Concluzii. Polimorfismele genelor CTLA-4 şi HLA-II sunt cei mai frecvenţi triggeri moleculari, implicaţi în căile imune, care dereglează toleranţa imuno-logică şi iniţiază patogeneza răspunsului autoimun. Aceste Polimorfismele alterează reglarea moleculară Th1/Th17 şi Treg, favorizând răspunsul autoimun în TH.Introduction. Hashimoto’s thyroiditis (HT) is one of the most common autoimmune disorders of the endocrine system and is characterized by the destruction of thyroid cells by its own antibodies. To date, a relationship has been identified between HT and genetic polymorphisms which were involved in the immune response. Objective. This study aims to highlight the role of genetic polymorphisms in the dysregulation of molecular immune pathways, contributing to the development and progression of Hashimoto’s thyroiditis. Material and methods. This study is based on the analysis of 16 scholarly sources from the PubMed, Oxford Academic, Medline, and Scopus databases, published between 2014 and 2024. The research of scientific literature was done according to the following key words Hashimoto’s thyroiditis, molecular mechanisms of autoimmune thyroiditis, genetic polymorphisms. Results. Hashimoto’s thyroiditis (HT) is accompanied by activation of T helper cells (Th1/ Th17), reduced activity of T regulatory cells (Treg), and production of antibodies against thyroid peroxidase (TPOAb) and thyroglobulin (TgAb). These immune processes are modulated by polymorphisms in the cytotoxic T-lymphocyte antigen-4 (CTLA-4) and human leukocyte antigen class II genes (HLA-II), which regulate immune tolerance. CTLA-4 and HLA-II polymorphisms alter the regulation of Th1/ Th17 and Treg cells, favoring the autoimmune response in HT. The CTLA-4 (+49A/G) polymorphism contributes most to HT development, followed by HLA-DB103. Conclusion. Polymorphisms of the CTLA-4 and HLA-II genes are the most frequent molecular triggers, involved in immune pathways, which deregulate immunological tolerance and initiate the autoimmune response. These polymorphisms alter the regulation of Th1/Th17 and Treg, favoring the autoimmune response in TH
Bad news in medicine: an involvement of the bioethical and communicative dimension
Get PDFCommunicating difficult news about a newly discovered illness,
particularly in the absence of a survival perspective and in light of the
apparent decline in quality of life, has always posed challenges, even in
modern medicine.Delivering bad news often triggers intense emotional
responses, including shock, disbelief, and fear. Ineffective communication can undermine patient trust and hinder adherence to treatment
Self-esteem and the brain
Get PDFSelf-esteem, a critical psychological construct, reflects an individual’s subjective evaluation of the irworth and is intricately linked to
social and emotional processes. This paper explores the neural mechanisms under lying self-esteem, drawing on sociometer theory and neuroscientific findings. Key brain regions, including the prefrontal cortex
and cerebellum, are implicated in modulating self-esteem through social
cognition and emotional regulation. The discussion integrates theoretical
perspectives and empirical evidence to provide a comprehensive understanding of how self-esteem functions as a monitor of social acceptance
and influences psychological well-being
Molecular pathogenesis of I-cell disease: analysis of lysosomal enzyme trafficking defects
Get PDFIntroducere. Mucolipidoza II (boala celulelor I/inclusion-cell) este o tulburare genetică rară cauzată de mutaţii în gena GNPTAB care perturbă activitatea N-acetilgluco-zamin-1-fosfotransferazei. Acest defect împiedică marcarea corectă a enzimelor lizozomale, ducând la livrarea lor în plasmă în loc de lizozomi. Scop. Pentru a investiga mecanismele moleculare ale patogenezei bolii I-cell, inclusiv analiza mutaţiilor genei GNPTAB, perturbarea formării M6P şi acumularea substratelor nedegradate în celulele ţintă. Material şi metode. În cadrul acestui studiu, au fost analizate 25 articole ştiinţifice din bazele de date PubMed şi GeneCards din ultimii 10 ani, precum şi Clasificarea Internaţională a Bolilor (ICD-10/11). De asemenea, au fost revizuite studii recente şi descoperiri experimentale privind rolul patogenezei şi manifestărilor clinice ale acestei boli. Rezultate. Studiul a demonstrat că patogeneza bolii celulelor I se bazează pe deficitul de GlcNAc-1-fosfotransferază, care afectează atât formarea markerului manoză-6-fosfat pe en-zimele lizozomale, cât şi sortarea acestora din Aparatul Golgi către lizozomi. Fără ligandul M6P, enzimele nu se pot uni de receptorii M6P din Golgi şi sunt secretate extracelular. Ca urmare, lizozomii sunt lipsiţi de enzime hidrolitice, iar substraturi nedigerate se acumulează intracelular, formând incluziuni caracteristice în fibroblaste - „celule I” (inclusion-cell). Astfel, hipersecreţia de enzime extracelulare coexista cu acumularea intracelulară a substraturilor. Concluzii. Aceste descoperiri demonstrează că mutaţiile care perturbă activitatea GlcNAc-fosfotransferazei reprezintă un mecanism patogenic în boala celulelor I. Aceste defecte genetice afectează traficul enzimelor lizozomale mediate de M6P, declanşând o varietate de patologii celulare.Introduction. Mucolipidosis II (I-cell/Inclusion cell diseases) is a rare genetic disorder caused by mutations in GNPTAB gene that disrupt N-acetylglucosamine-1-phosphotrans-ferase. This mutation prevents proper labeling of lysosomal enzymes, leading to their secretion into plasma rather than delivery to lysosomes. Objective. To investigate the molecular mechanisms of I-cell disease pathogenesis, including analysis of GNPTAB gene mutations, impaired M6P formation and accumulation of undegraded substrates in target cells. Material and methods. This study analyzed 25 scientific articles from PubMed and GeneCards databases over the past 10 years, alongside the International Classification of Diseases (ICD-10/11). Additionally, recent studies and experimental findings affecting the role of pathogenesis and clinical manifestations of this disease were reviewed. Results. The study showed that the pathogenesis of I-cell disease is based on a deficiency of GlcNAc-1-phosphotrans-ferase, which impairs not only the formation of the mannose-6-phosphate marker on lysosomal enzymes but also their sorting from the Golgi to lysosomes. Without M6P tags, enzymes cannot bind to Golgi M6P receptors and are secreted extracellularly. Consequently, lysosomes are deprived of hydrolytic enzymes, while undigested substrates accumulate intracellularly, forming characteristic fibroblast inclusions - “inclusion-cell”. Thus, hypersecretion of extracellular enzymes coexists with intracellular storage of substrates. Conclusion. These findings demonstrate that mutations that disrupt GlcNAc phosphotransferase activity constitute a pathogenic mechanism in I-cell disease. These genetic defects disrupt M6P-mediated lysosomal enzyme trafficking, triggering a variety of different cellular pathologies
The Tirone David procedure in acute type of aortic dissection – when, how, and why? The experience of Professor Dr. George I.M. Georgescu Institute of Cardiovascular Diseases
Get PDFIntroduction. Acute type A aortic dissection represents a life-threatening cardiovascular emergency with catastrophic
natural history and extremely high mortality in the absence of prompt surgical intervention. Over the last decades, surgical
management has evolved from supracoronary replacement and composite root replacement (Bentall procedure) towards
valve-sparing strategies, among which the Tirone David reimplantation procedure has gained increasing acceptance.
Material and methods. We performed a single-center, retrospective observational study at the Professor Dr. George I.M.
Georgescu Institute of Cardiovascular Diseases, Iasi, Romania, reviewing all patients undergoing surgery for acute type
A aortic dissection over a 25-year period (January 2000 – January 2025). According to intraoperative anatomy and hemodynamic
status, patients were treated with one of the following strategies: supracoronary ascending aortic replacement
(with or without valve replacement), composite root replacement (Bentall), or valve-sparing aortic root replacement
(Tirone David).
Results. A total of 256 patients were operated for acute type A aortic dissection. Mean age was 55.8 years, with male predominance
(69%). Hypertension was the most frequent risk factor (75%), and severe aortic regurgitation was present in
48% of cases. Valve-sparing root replacement was performed in 73% of patients (84% in the last 4 years), of which 16%
were Tirone David procedures. Operative mortality was 13.7%, with a favorable downward trend over time. The most
common complications were acute renal failure (21.5%, with hemodialysis in 16.8%), atrial fibrillation (18%), infectious
complications (14-17%), neurological events (9.9%), and re-exploration for bleeding (11.3%). Median ICU stay was 9.8
days, and median hospital stay 17 days.
Conclusions. In carefully selected patients with repairable cusps and reconstructable aortic root, the Tirone David procedure
is our operation of choice, providing preservation of physiological hemodynamics and avoidance of lifelong anticoagulation.
The Bentall operation remains indicated for irreparable valves, severely fragile tissue, or critical hemodynamic
instability, where procedural simplicity and predictability are paramount. Our institutional experience demonstrates that
the Tirone David procedure is feasible and safe in the acute setting, with encouraging early outcomes and a trend toward
improved survival
THE RELATIONSHIP BETWEEN WORKAHOLISM AND ACADEMIC STRESS: A THEORETICAL AND APPLIED APPROACH IN THE UNIVERSITY CONTEXT
Get PDFUniversitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”, Chișinău, Republica MoldovaIntroducere. Workaholismul, tot mai prezent în profesii precum cea academică sau medicală, are efecte negative asupra echilibrului psihic şi social. Studiul explorează factorii psihosociali ai fenomenului şi relaţia sa cu stresul academic în context universitar. Analiza sprijină prevenţia şi susţinerea sănătăţii mintale. Scop. Demersul teoretico-apli-cativ urmăreşte explorarea relaţiei dintre workaholism, stresul academic, starea de bine subiectivă şi mecanismele de coping în contextul universitar. Material şi metode. Pentru a explora relaţia dintre workaholism şi stresul academic, am utilizat patru instrumente validate, menite să ofere o evaluare complexă a dimensiunilor implicate: DUWAS (măsurarea workaholismului), chestionarul OMS-5 (evaluarea stării de bine), scala SEMCA (mecanisme cognitive de coping) şi scala PASS (percepţia stresului academic). Rezultate. Ţinând cont de scopul şi metodologia studiului, anticipăm obţinerea unor rezultate care vor evidenţia complexitatea interacţiunilor dintre workaholism, stresul academic, starea de bine subiectivă şi mecanismele cognitive de coping utilizate de studenţi. Se presupune că studenţii cu tendinţe workaholice accentuate vor manifesta un nivel crescut de stres perceput în context academic, ceea ce sugerează o relaţie pozitivă semnificativă între implicarea compulsivă în activitatea academică şi intensitatea stresului resimţit. Scorurile ridicate pot reflecta un dezechilibru între efort şi satisfacţie, cu impact asupra echilibrului psihoemoţional. Concluzii. Rezultatele anticipate arată că workaholismul nu este doar o formă de angajament, ci şi un potenţial risc pentru echilibrul psihoemoţional al studenţilor. Nivelurile ridicate se asociază cu starea de bine scăzută şi strategii de coping disfuncţionale, afectând performanţa şi sănătatea mintală.Introduction. Workaholism, increasingly present in academic and medical professions, negatively affects psychosocial balance. This study explores the phenomenon’s psychosocial factors and its relationship with academic stress in the university context. The analysis supports prevention and the promotion of mental health. Objective. The theoretical and applied approach aims to explore the relationship between workaholism, academic stress, subjective well-being, and coping mechanisms in the university context. Material and methods. To explore the relationship between workaholism and academic stress, we used four validated instruments designed to provide a comprehensive assessment of the relevant psycological dimensions: DUWAS (measuring workaholism), the WHO-5 Well-Being Index, SEMCA (cognitive coping mechanisms), and PASS (perceived academic stress). Results. Considering the aim and methodology of the study, we anticipate results that will highlight the complex interactions between workaholism, academic stress, subjective well-being, and the cognitive coping mechanisms used by students. Students with strong workaholic tendencies are expected to report higher academic stress, indicating a clear link between compulsive study and stress levels. Elevated scores may reflect an imbalance between effort and emotional satisfaction, with consequences for psychological well-being. The findings may confirm that excessive academic involvement increases students’ psychological vulnerability. Conclusion. The anticipated results suggest that workaholism is not merely a form of commitment, but also a potential risk to students’ psychological well-being. High levels are associated with lower well-being and dysfunctional coping strategies, negatively impacting performance and mental health
Internal osteosynthesis in unstable pelvic ring and acetabular injuries
Get PDFUniversitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”, Chișinău, Republica MoldovaIntroducere. Trauma pelvină este una dintre cele mai dificile probleme în chirurgia traumatismelor, iar frecvenţa sa este de 3-7% din numărul total de leziuni musculo-schelet-ice. Fracturile oaselor pelvine se datorează, de obicei, unui traumatism cu energie cinetică mare: accidente rutiere, ca-tatraumatisme. Scop. Scopul lucrării a fost de a prezenta şi introduce în practica clinică a diferitor metode de stabilizare internă pelvină şi evaluarea rezultatelor tratamentului chirurgical. Material şi metode. În studiu au fost incluşi 120 pacienţi, trataţi în perioada anilor 2018-2025, în cadrul Institutului de Medicină Urgentă, Chişinău, Republica Moldova, şi supravegheaţi în dinamică care au fost trataţi chirurgical prin diferite metode de osteosinteză internă: plăci înşurubate, şuruburi percutanate, sacroplastie, fixare spino-pelvină. Rezultate. Au fost utilizate în dependenţă de tipul fracturilor diferite metode de fixare internă atât singulare cît şi combinate. S-a introdus în practica clinică tratamentul chirurgical etapizat, cât şi unimomentan. S-a solidificat echipa chirurgicală. După efectuarea osteosinte-zei interne la toţi pacienţii s-a format bloc osos satisfăcător, care a fost evaluat radiologic, în dinamică. Pe perioada de supraveghere la 4 pacienţi au fost înregistrate complicaţii mecanice iar la 6 complicaţii septice care au fost rezolvate. 10 pacienţi cu fracturi acetabulare osteosintetizate au fost protezaţi. Toţi pacienţii sau întors la activitatea cotidiană. Concluzii. Metodele de fixare internă au permis o stabilizare fermă a leziunilor, evidenţiind o rată scăzută a morbidităţii, comparativ cu metodele de osteosinteză externă a fracturilor de bazin. Aceasta a permis efectuarea intraoper-atorie a reducerilor osoase şi a permis formarea unui bloc osos satisfăcător.Introduction. Pelvic trauma is one of the most difficult problems in trauma surgery, and its frequency is 3-7% of the total number of musculoskeletal injuries. Pelvic bone fractures are usually due to high kinetic energy trauma: road accidents, falling from height. Objective. The purpose of the paper was to present and introduce into clinical practice different methods of internal pelvic stabilization and the evaluation of the surgical treatment results. Material and methods. The study included 120 patients, treated between 2018-2025, at the Institute of Emergency Medicine, Chisinau, Republic of Moldova, and monitored in dynamics who was surgically treated using various methods of ORIF: plates, percutaneous screws, sacroplasty, spino-pelvic fixation. Results. Depending on the type of fractures, different methods of internal fixation, both single and staged, were used. Staged and single-moment surgical treatment was introduced into clinical practice. The surgical team was solidified. After performing ORIF in all patients, a satisfactory fusion was formed, which was evaluated radiologically in dynamics. During the surveillance period, mechanical complications were recorded in 4 patients and septic complications were resolved in 6. 10 patients with fixed acetabular fractures had hip replacement 9 month after trauma. All patients returned to daily activity. Conclusion. Internal fixation methods allowed firm stabilization of the lesions, showing a low morbidity rate, compared to external osteosynthesis methods of pelvic fractures. This allowed intraoperative bone reductions and allowed the formation of a satisfactory bone block
Public health risk of radon exposure and climate change: is there a link?
Get PDFIntroduction. Climate change is emerging as a critical determinant of indoor radon
dynamics and related health risks. Radon (²²²Rn), a radioactive gas and the second leading
cause of lung cancer worldwide, infiltrates buildings from uranium-bearing soils. Indoor
concentrations are shaped by meteorological conditions and building features—both
increasingly influenced by climate change and energy-efficiency policies. This article
synthesizes international evidence with regional data to outline three principal pathways
through which climate change intensifies radon exposure: (1) permafrost thaw in highlatitude
regions, (2) increased airtightness of buildings due to energy-saving measures, and
(3) shifting weather patterns that favor radon indoor accumulation. A 100 Bq/m³ rise in
radon is associated with a 16% increase in lung cancer risk, and an estimated 35–40% of
radon-related lung cancers could be prevented if exposure were reduced below the WHOrecommended
threshold of 100 Bq/m³.
Purpose of the research is to study and synthesize international experiences in
developing and utilizing methods to assess the impact of meteorological parameters on
indoor radon concentrations under regional climate change conditions.
Material and methods. A literature review was conducted using 60 peer-reviewed
sources from Web of Science, PubMed, and ResearchGate. In addition, the study introduces
a regional methodology adapted to Moldova’s climate and building conditions, aimed at
assessing how changing environmental factors affect indoor radon exposure and public
health.
Results. Permafrost degradation is releasing radon previously trapped in frozen soils, with
concentrations exceeding 200 Bq/m³, persisting for years in homes with basements. In
temperate regions such as the Republic of Moldova, poorly ventilated, energy-efficient
buildings retain radon indoors, with post-renovation increases of 22–120% observed.
Meteorological parameters, including air temperature, humidity, and wind speed, exert
strong influence on indoor radon concentrations. Winter levels are typically 2–5 times
higher than in summer, driven by reduced ventilation and pressure gradients. The proposed
methodology integrates radon monitoring using high-sensitivity electret ion chambers,
meteorological observations (temperature, wind, humidity), building characteristics, and
regional climate projections. Statistical approaches, including multi-factor analysis and
cross-correlation, will be applied to assess how meteorological variability affects radon
exposure and associated lung cancer risks.
Conclusions. Radon exposure must be recognized as an emerging public health concern
in the context of climate change. The increased use of airtight buildings and shifts in climate
parameters are likely to elevate radon levels indoors. Systematic radon testing, optimized
ventilation design, and predictive exposure modeling are vital for developing prevention and
adaptation strategies. The Republic of Moldova and similar regions must integrate these
considerations into climate and public health policy frameworks
PREDICTORS OF UNFAVORABLE FUNCTIONAL OUTCOME AFTER INTRAVENOUS THROMBOLYSIS IN ISCHEMIC STROKE
Get PDFUniversitatea de Stat de Medicină și Farmacie „Nicolae Testemițanu”, Chișinău, Republica MoldovaIntroducere. Tromboliza intravenoasă (TIV) este unul din tratamentele cheie în accidentul vascular cerebral ischemic acut, dar rezultatele pe termen lung sunt variabile. Identificarea factorilor predictivi pentru un rezultat funcţional nefavorabil este esenţială pentru optimizarea managementului pacienţilor. Scop. Identificarea factorilor clinici şi biochimici care ar putea prezice evoluţia funcţională nefavorabilă la 3 luni după TIV în cadrul accidentului vascular cerebral ischemic acut. Material şi metode. Studiu retrospectiv observaţional pe un lot de 79 de pacienţi interveniţi prin IVT în perioada ianuarie-decembrie 2024 în cadrul INN. A fost aplicată regresia logistică univariate, iar predictorii semnificativi au fost incluşi in regresia logistică multiplă. Analiza statistică a fost efectuată utilizând programului R (versiunea 4.4.2). Rezultate. 44 pacienţi (56%) au prezentat scor mRS (scala Rankin modificată) la 3 luni nefavorabil (>2). Genul, fibrilaţia atrială, timpul de la debut până la intervenţie au fost excluşi în urma analizei univariate (p>0.05). Valorile maxime ale leucocitelor şi VSH înregistrate pe parcursul internării, semnificative în analiza univariată, au pierdut relevanţa în modelul de regresie multiplă (p>0.05). NIHSS (odds ratio [OR], 1.42; interval de încredere [IC] 95%, 1.18-1.61; p 8 puncte, vârsta > 65 ani şi tensiunea arterială sistolică > 177 mmHg la internare s-au asociat cu risc crescut de rezultat funcţional nefavorabil (mRS > 2) la 3 luni la pacienţii trataţi prin tromboliză intravenoasă sistemică (sensibilitate înaltă, dar specificitate scăzută).Introduction. Intravenous thrombolysis (IVT) is a key treatment for acute ischemic stroke, but long-term functional outcomes remain variable. Identifying independent predictors of an unfavorable functional outcome (modified Rankin Scale score >2) is crucial for risk stratification and optimizing patient management. Objective. To identify clinical and biochemical independent predictors of unfavorable 3-month functional outcomes (mRS>2) following intravenous thrombolysis in acute ischemic stroke patients. Material and methods. A retrospective observational study on a group of 79 patients undergoing IVT between January and December 2024 at the INN was performed. Univariate logistic regression was applied and significant predictors were included in multiple logistic regression. Statistical analysis was performed using the R program (version 4.4.2). Results. 44 patients (56%) had an unfavorable 3-month mRS score (>2). Gender, atrial fibrillation, time from onset to intervention were excluded after univariate analysis (p>0.05). Maximum leukocyte counts and ESR (erythrocyte sedimentation rate) recorded during hospitalization, significant in univariate analysis, lost relevance in the multiple regression model (p>0.05). NIHSS (odds ratio [OR], 1.42; 95% confidence interval [CI], 1.18-1.61; p 8 points, age > 65 years, and systolic blood pressure > 177 mmHg at admission were associated with an increased risk of unfavorable functional outcome (mRS > 2) at 3 months in patients undergoing systemic intravenous thrombolysis (high sensitivity, low specificity)
Years of potential life lost and causes of death in the Republic of Moldova, 2014-2023
Get PDFIntroducere. Anii Potenţiali de Viaţă Pierduţi (APVP) sunt un indicator esenţial de sănătate publică, utilizat pentru a evalua impactul mortalităţii premature şi a stabili priorităţi de intervenţie. Studii recente arată o scădere generală a mortalităţii în Republica Moldova, dar analiza APVP rămâne limitată. Scop. Scopul acestui studiu transversal este analiza tendinţelor APVP şi a principalelor cauze ale deceselor premature în Moldova (2013-2024), cu accent pe diferenţele de sex, regiune şi mediu. Material şi metode. Am utilizat o bază de date depersonalizată a certificatelor medicale de deces pentru perioada 2014-2023, furnizată de Agenţia Naţională pentru Sănătate Publică. Au fost incluse în total 181947 de înregistrări de deces ale persoanelor cu vârsta între 15 şi 70 de ani. APVP a fost calculat atât ca valoare absolută, cât şi ca medie APVP per deces. Rezultate. Între 2014 şi 2023, numărul total de APVP a scăzut cu peste 30%. În 2023, APVP a fost de 125511 ani pentru bărbaţi şi 49469 ani pentru femei. Aproximativ 65% dintre decesele premature au avut loc în mediul rural, variind de la 18% în Chişinău la 34% în regiunea Centru. La bărbaţi, principalele cauze de APVP au fost bolile cardiovasculare (30%), cauzele externe (19%), neoplasmele (17%) şi bolile aparatului digestiv (15%). Cele mai mari valori medii ale APVP per deces au fost pentru cauzele externe (21 ani) şi bolile infecţioase (19,7 ani), în timp ce bolile cardiovasculare şi neoplasmele au fost asociate cu cele mai scăzute valori (9,5 ani). Concluzii. În perioada 2014-2023, mortalitatea prematură la adulţi a înregistrat un declin semnificativ, mai ales pentru cauze externe şi boli infecţioase la bărbaţi. Progresul a fost mai evident în Centru şi Sud, în timp ce îmbunătăţirile au fost mai puţin pronunţate în capitală şi Nord.Introduction. Years of Potential Life Lost (YPLL) is a key public health indicator used to quantify the impact of premature mortality and identify priority areas for intervention. Recent studies have shown overall improvements in mortality in Moldova; however, analysis focused specifically on YPLL remains limited. Objective. The aim of this cross-sectional study is to analyze YPLL trends and the main causes of premature deaths in Moldova (2013-2024), with a focus on differences by sex, region, and place of residence. Material and methods. We used a depersonalised dataset of medical death certificates covering the period from 2014 to 2023, provided by the National Agency for Public Health. A total of 181,947 individual death records of people aged between 15 and 70 years were included. YPLL was calculated both as absolute values and as mean YPLL per death. Results. Between 2014 and 2023, total YPLL decreased by over 30%. In 2023, YPLL amounted to 125,511 years for males and 49,469 years for females. Approximately 65% of premature deaths occurred in rural areas, with regional variation ranging from 18% in Chisinau to 34% in the Centre region. Among males, the leading causes of YPLL were cardiovascular diseases (30%), external causes (19%), neoplasms (17%), and digestive diseases (15%). The highest mean YPLL per death was observed for external causes (21 years) and infectious diseases (19.7 years), while cardiovascular diseases and neoplasms were associated with the lowest values (9.5 years). Conclusion. From 2014 to 2023, premature adult mortality declined significantly, particularly for external causes and infectious diseases among males. The most substantial progress was observed in the Centre and South regions, while improvements were less marked in the capital and North